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+{"segments": [{"id": 1, "seek": 4804, "start": 21.02, "end": 48.04, "text": "بسم الله الرحمن الرحيم في المحاضرة الثانية لمساعدة الأدوية و أدوية العين اليوم ان شاء الله سوف نتحدث على common drug preparations التراكيب الدوائية الشائعة التي يتناورها المريض في أي صورة من الصورة one solutions and suspensions", "tokens": [3555, 38251, 21984, 34892, 5016, 27842, 34892, 5016, 32640, 8978, 9673, 5016, 46958, 25720, 6024, 104, 7649, 10632, 32767, 3794, 995, 22488, 3660, 16247, 3215, 2407, 10632, 4032, 5551, 3215, 2407, 10632, 18863, 9957, 45595, 20498, 16472, 13412, 16606, 21984, 8608, 38688, 8717, 2655, 24401, 12984, 15844, 2689, 4110, 34122, 16712, 23557, 4117, 1829, 3555, 32748, 2407, 16373, 10632, 25124, 16373, 27884, 38392, 7251, 2655, 8315, 13063, 11296, 9673, 16572, 11242, 8978, 36632, 20328, 13063, 3660, 9154, 31767, 13063, 3660, 472, 6547, 293, 6535, 8302], "avg_logprob": -0.1274527609348297, "compression_ratio": 1.7370892018779343, "no_speech_prob": 5.960464477539063e-08, "words": 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الهدف أربع one to prevent decomposition تحلل و التلف of chemically sensitive drugs by gastric secretions الهدف التاني من هذه الأقراس", "tokens": [317, 1341, 20163, 7766, 37495, 22653, 14739, 2655, 9381, 2288, 16247, 2304, 3615, 16606, 6055, 3215, 37746, 8978, 16247, 2304, 3615, 16606, 2423, 3224, 3215, 5172, 5551, 25513, 3615, 472, 281, 4871, 48356, 6055, 5016, 1211, 1211, 4032, 16712, 46538, 295, 4771, 984, 9477, 7766, 538, 17898, 1341, 4054, 626, 2423, 3224, 3215, 5172, 16712, 7649, 1829, 9154, 29538, 16247, 4587, 23557, 3794], "avg_logprob": -0.3422851706854999, "compression_ratio": 1.4076086956521738, "no_speech_prob": 0.0, "words": [{"start": 819.4, "end": 819.94, "word": "entric", "probability": 0.232421875}, {"start": 819.94, "end": 820.48, "word": " coating", "probability": 0.392578125}, {"start": 820.48, "end": 821.06, "word": " drugs", "probability": 0.81884765625}, {"start": 821.06, "end": 822.1, "word": " يعني", "probability": 0.57489013671875}, {"start": 822.1, "end": 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"probability": 0.059722900390625}, {"start": 848.64, "end": 849.22, "word": " prevent", "probability": 0.84033203125}, {"start": 849.22, "end": 850.22, "word": " dilution", "probability": 0.951904296875}, {"start": 850.22, "end": 850.7, "word": " of", "probability": 0.962890625}, {"start": 850.7, "end": 850.86, "word": " the", "probability": 0.845703125}, {"start": 850.86, "end": 851.3, "word": " drug", "probability": 0.87060546875}, {"start": 851.3, "end": 852.52, "word": " before", "probability": 0.765625}, {"start": 852.52, "end": 853.0, "word": " it", "probability": 0.96630859375}, {"start": 853.0, "end": 853.44, "word": " reaches", "probability": 0.88916015625}, {"start": 853.44, "end": 853.64, "word": " the", "probability": 0.90673828125}, {"start": 853.64, "end": 854.12, "word": " intestine", "probability": 0.9404296875}, {"start": 854.12, "end": 856.12, "word": " يعني", "probability": 0.75732421875}, {"start": 856.12, "end": 856.36, "word": " لو", "probability": 0.84716796875}, {"start": 856.36, "end": 856.6, "word": " أن", "probability": 0.280517578125}, {"start": 856.6, "end": 857.14, "word": " هذه", "probability": 0.80126953125}, {"start": 857.14, "end": 859.04, "word": " الأقراس", "probability": 0.73681640625}, {"start": 859.04, "end": 860.48, "word": " ذابت", "probability": 0.9658203125}, {"start": 860.48, "end": 861.58, "word": " في", "probability": 0.96875}, {"start": 861.58, "end": 862.74, "word": " المعدة", "probability": 0.8121744791666666}, {"start": 862.74, "end": 864.78, "word": " فسوف", "probability": 0.892578125}, {"start": 864.78, "end": 865.34, "word": " تخفف", "probability": 0.9638671875}, {"start": 865.34, "end": 865.48, "word": " في", "probability": 0.34521484375}, {"start": 865.48, "end": 865.66, "word": " سلوك", "probability": 0.8399658203125}, {"start": 865.66, "end": 865.72, "word": " ال", "probability": 0.37109375}, {"start": 865.72, "end": 866.26, "word": " dilution", "probability": 0.87353515625}, {"start": 866.26, "end": 869.06, "word": " فتدخل", "probability": 0.98779296875}, {"start": 869.06, "end": 869.38, "word": " إلى", "probability": 0.85546875}, {"start": 869.38, "end": 869.82, "word": " الأمعاء", "probability": 0.8873291015625}, {"start": 869.82, "end": 870.98, "word": " مخففة", "probability": 0.988671875}, {"start": 870.98, "end": 872.04, "word": " فلا", "probability": 0.891845703125}, {"start": 872.04, "end": 872.42, "word": " تؤدي", "probability": 0.9664713541666666}, {"start": 872.42, "end": 872.58, "word": " إلى", "probability": 0.94677734375}, {"start": 872.58, "end": 873.0, "word": " الهدف", "probability": 0.98876953125}, {"start": 873.0, "end": 875.4, "word": " لكن", "probability": 0.89306640625}], "temperature": 1.0}, {"id": 30, "seek": 90136, "start": 876.92, "end": 901.36, "text": "إفرازات الأمعاء قليلة نسبيا فالتخفيف يكون قليل ويكون امتصاص للدواء المركز من خمالات الأمعاء الدقيقة فيذهب إلى الدم وهو في تركيز عالي فيودي إلى اللي هو تركيز علاجي عالي في الدم أو في البلازم", "tokens": [28814, 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"end": 879.82, "word": " نسبيا", "probability": 0.7841796875}, {"start": 879.82, "end": 881.62, "word": " فالتخفيف", "probability": 0.8465983072916666}, {"start": 881.62, "end": 881.84, "word": " يكون", "probability": 0.979736328125}, {"start": 881.84, "end": 882.86, "word": " قليل", "probability": 0.98681640625}, {"start": 882.86, "end": 883.44, "word": " ويكون", "probability": 0.8199869791666666}, {"start": 883.44, "end": 884.3, "word": " امتصاص", "probability": 0.9322265625}, {"start": 884.3, "end": 886.34, "word": " للدواء", "probability": 0.90625}, {"start": 886.34, "end": 887.28, "word": " المركز", "probability": 0.9869791666666666}, {"start": 887.28, "end": 888.2, "word": " من", "probability": 0.96826171875}, {"start": 888.2, "end": 888.54, "word": " خمالات", "probability": 0.607666015625}, {"start": 888.54, "end": 888.8, "word": " الأمعاء", "probability": 0.9793701171875}, {"start": 888.8, "end": 889.28, "word": " الدقيقة", "probability": 0.9108072916666666}, {"start": 889.28, "end": 890.3, "word": " فيذهب", "probability": 0.96484375}, {"start": 890.3, "end": 890.46, "word": " إلى", "probability": 0.7900390625}, {"start": 890.46, "end": 890.86, "word": " الدم", "probability": 0.982666015625}, {"start": 890.86, "end": 891.4, "word": " وهو", "probability": 0.7442626953125}, {"start": 891.4, "end": 891.56, "word": " في", "probability": 0.9619140625}, {"start": 891.56, "end": 892.28, "word": " تركيز", "probability": 0.986328125}, {"start": 892.28, "end": 893.56, "word": " عالي", "probability": 0.9435221354166666}, {"start": 893.56, "end": 894.9, "word": " فيودي", "probability": 0.70458984375}, {"start": 894.9, "end": 895.34, "word": " إلى", "probability": 0.7587890625}, {"start": 895.34, "end": 897.2, "word": " اللي", "probability": 0.6488037109375}, {"start": 897.2, "end": 898.18, "word": " هو", "probability": 0.97265625}, {"start": 898.18, "end": 899.04, "word": " تركيز", "probability": 0.977783203125}, {"start": 899.04, "end": 899.74, "word": " علاجي", "probability": 0.9361979166666666}, {"start": 899.74, "end": 900.22, "word": " عالي", "probability": 0.97607421875}, {"start": 900.22, "end": 900.36, "word": " في", "probability": 0.95703125}, {"start": 900.36, "end": 900.64, "word": " الدم", "probability": 0.9853515625}, {"start": 900.64, "end": 900.88, "word": " أو", "probability": 0.65283203125}, {"start": 900.88, "end": 900.96, "word": " في", "probability": 0.55419921875}, {"start": 900.96, "end": 901.36, "word": " البلازم", "probability": 0.7779541015625}], "temperature": 1.0}, {"id": 31, "seek": 93147, "start": 903.25, "end": 931.47, "text": "يبقى أنا قاعد في التاني اللي انا ليش انا مغلف الأقراس هذه حتى تصل إلى الدم بتركيز عالي three to prevent nausea and vomiting due to gastric irritation كثيرا بعض الناس ياخد ال diacorphin مثلا او ال aspirin مثلا او اي مادة لعلاج الروماتيزم او ألام المفاصل", "tokens": [1829, 3555, 4587, 7578, 41850, 12174, 995, 22488, 8978, 16712, 7649, 1829, 13672, 1829, 1975, 8315, 32239, 8592, 1975, 8315, 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904.03, "word": " التاني", "probability": 0.5472005208333334}, {"start": 904.03, "end": 904.17, "word": " اللي", "probability": 0.56182861328125}, {"start": 904.17, "end": 904.37, "word": " انا", "probability": 0.648193359375}, {"start": 904.37, "end": 904.67, "word": " ليش", "probability": 0.9365234375}, {"start": 904.67, "end": 904.83, "word": " انا", "probability": 0.68505859375}, {"start": 904.83, "end": 905.33, "word": " مغلف", "probability": 0.8611653645833334}, {"start": 905.33, "end": 906.55, "word": " الأقراس", "probability": 0.8206787109375}, {"start": 906.55, "end": 906.87, "word": " هذه", "probability": 0.87841796875}, {"start": 906.87, "end": 907.49, "word": " حتى", "probability": 0.822021484375}, {"start": 907.49, "end": 907.91, "word": " تصل", "probability": 0.99169921875}, {"start": 907.91, "end": 908.71, "word": " إلى", "probability": 0.78125}, {"start": 908.71, "end": 908.93, "word": " الدم", "probability": 0.89990234375}, {"start": 908.93, "end": 909.47, "word": " بتركيز", "probability": 0.9482421875}, {"start": 909.47, "end": 909.99, "word": " عالي", "probability": 0.9501953125}, {"start": 909.99, "end": 911.47, "word": " three", "probability": 0.3447265625}, {"start": 911.47, "end": 912.15, "word": " to", "probability": 0.7431640625}, {"start": 912.15, "end": 912.69, "word": " prevent", "probability": 0.8525390625}, {"start": 912.69, "end": 913.65, "word": " nausea", "probability": 0.9140625}, {"start": 913.65, "end": 913.91, "word": " and", "probability": 0.94482421875}, {"start": 913.91, "end": 914.41, "word": " vomiting", "probability": 0.9873046875}, {"start": 914.41, "end": 915.03, "word": " due", "probability": 0.93212890625}, {"start": 915.03, "end": 915.33, "word": " to", "probability": 0.96826171875}, {"start": 915.33, "end": 915.81, "word": " gastric", "probability": 0.929443359375}, {"start": 915.81, "end": 916.35, "word": " irritation", "probability": 0.96630859375}, {"start": 916.35, "end": 918.67, "word": " كثيرا", "probability": 0.9609375}, {"start": 918.67, "end": 919.83, "word": " بعض", "probability": 0.9443359375}, {"start": 919.83, "end": 920.25, "word": " الناس", "probability": 0.9860026041666666}, {"start": 920.25, "end": 921.45, "word": " ياخد", "probability": 0.931640625}, {"start": 921.45, "end": 921.65, "word": " ال", "probability": 0.91650390625}, {"start": 921.65, "end": 923.03, "word": " diacorphin", "probability": 0.341583251953125}, {"start": 923.03, "end": 923.41, "word": " مثلا", "probability": 0.95751953125}, {"start": 923.41, "end": 923.93, "word": " او", "probability": 0.7060546875}, {"start": 923.93, "end": 924.01, "word": " ال", "probability": 0.93798828125}, {"start": 924.01, "end": 924.59, "word": " aspirin", "probability": 0.666259765625}, {"start": 924.59, "end": 925.03, "word": " مثلا", "probability": 0.977783203125}, {"start": 925.03, "end": 926.45, "word": " او", "probability": 0.967041015625}, {"start": 926.45, "end": 926.69, "word": " اي", "probability": 0.910400390625}, {"start": 926.69, "end": 927.45, "word": " مادة", "probability": 0.9334309895833334}, {"start": 927.45, "end": 929.33, "word": " لعلاج", "probability": 0.72265625}, {"start": 929.33, "end": 930.01, "word": " الروماتيزم", "probability": 0.7689208984375}, {"start": 930.01, "end": 930.35, "word": " او", "probability": 0.935791015625}, {"start": 930.35, "end": 930.71, "word": " ألام", "probability": 0.393798828125}, {"start": 930.71, "end": 931.47, "word": " المفاصل", "probability": 0.976806640625}], "temperature": 1.0}, {"id": 32, "seek": 95824, "start": 932.58, "end": 958.24, "text": "يأخذ على مائدة فاضية مائدة empty stomach بعد يوم أو امين يجد انه بلق هو سيلونوزيا غثيان و لو استمر سيلو vomiting و severe pain ممكن يصير له gastric ulcer و دائما على طبية تقول", "tokens": [1829, 10721, 9778, 8848, 15844, 3714, 16373, 41891, 6156, 46958, 10632, 3714, 16373, 41891, 6707, 9665, 39182, 7251, 20498, 34051, 1975, 2304, 9957, 7251, 7435, 3215, 16472, 3224, 4724, 1211, 4587, 31439, 8608, 26895, 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"probability": 0.62548828125}, {"start": 938.98, "end": 939.14, "word": " يوم", "probability": 0.968994140625}, {"start": 939.14, "end": 939.28, "word": " أو", "probability": 0.802734375}, {"start": 939.28, "end": 939.56, "word": " امين", "probability": 0.5769856770833334}, {"start": 939.56, "end": 939.88, "word": " يجد", "probability": 0.89111328125}, {"start": 939.88, "end": 940.64, "word": " انه", "probability": 0.894287109375}, {"start": 940.64, "end": 941.84, "word": " بلق", "probability": 0.8121744791666666}, {"start": 941.84, "end": 942.08, "word": " هو", "probability": 0.958984375}, {"start": 942.08, "end": 942.94, "word": " سيلونوزيا", "probability": 0.8622233072916666}, {"start": 942.94, "end": 943.84, "word": " غثيان", "probability": 0.799560546875}, {"start": 943.84, "end": 944.44, "word": " و", "probability": 0.67724609375}, {"start": 944.44, "end": 944.56, "word": " لو", "probability": 0.88720703125}, {"start": 944.56, "end": 944.84, "word": " استمر", "probability": 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\ No newline at end of file
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/3fvbb6oXXV8.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/3fvbb6oXXV8.srt
new file mode 100644
index 0000000000000000000000000000000000000000..223eb4923d32e49e16ddc93fb37766e9cde5b930
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/3fvbb6oXXV8.srt
@@ -0,0 +1,1528 @@
+1
+00:00:20,740 --> 00:00:24,000
+بسم الله الرحمن الرحيم الحمد لله يا رب العالمين و
+
+2
+00:00:24,000 --> 00:00:26,200
+أصلي و أسلم على النبي الأمين و عليه و آله و أصحابه أجمعين و 
+
+3
+00:00:26,200 --> 00:00:30,600
+أتباعه السلام عليكم و رحمة الله و بركاته الآن احنا 
+
+4
+00:00:30,600 --> 00:00:36,640
+عملنا Cycloplegia و عملنا بعدها Retinoscopy الآن
+
+5
+00:00:36,640 --> 00:00:43,260
+ما عملنا description after اللي هو Retinoscopy we
+
+6
+00:00:43,260 --> 00:00:46,580
+need to make or write
+
+7
+00:00:51,600 --> 00:01:01,440
+بيقول لي أنه أنا عملت prescription  والخاصة بتحدث من
+
+8
+00:01:01,440 --> 00:01:05,820
+قيمة اللي هو الـ .. الـ .. الـ optical power
+
+9
+00:01:05,820 --> 00:01:15,980
+according to the age of patient according to type
+
+10
+00:01:15,980 --> 00:01:17,300
+of cycloplegia
+
+11
+00:01:21,130 --> 00:01:28,010
+and according to the disease هذا
+
+12
+00:01:28,010 --> 00:01:34,010
+مش مكتوب يعني بدخسهم على حسب تلت حاجة الـ age كل
+
+13
+00:01:34,010 --> 00:01:40,070
+مكان الـ age بتاعه صغير بدخسهم أقل correct صحيح
+
+14
+00:01:40,070 --> 00:01:45,550
+بدخسهم أقل لأن السنة مثلاً قوية كتير فأنا مثلاً بدأي 
+
+15
+00:01:45,550 --> 00:01:49,810
+maximum plus بدخسهم نص من .. اللي هو قيمة الـ
+
+16
+00:01:49,810 --> 00:01:53,250
+Accommodation  تخصم نص .. بدنا نخصم اثنين، بتخصم واحد 
+
+17
+00:01:53,250 --> 00:01:58,430
+لأن السنة مثلاً قوية كتير فانا في حاجة إلى high
+
+18
+00:01:58,430 --> 00:02:06,590
+plus عشان أخليها إيش؟ released .. واحد طيب
+
+19
+00:02:06,590 --> 00:02:11,810
+according to type of Accommodation طب و لو أتربين؟
+
+20
+00:02:11,810 --> 00:02:15,590
+بختلف عن Sacrobitol A
+
+21
+00:02:25,410 --> 00:02:30,650
+أو كتير طيب الـ activity of cerebral muscle يعني الـ
+
+22
+00:02:30,650 --> 00:02:34,550
+disease طب لما يكون فيه عنده market Esotropia
+
+23
+00:02:34,550 --> 00:02:39,350
+ممكن أخدم حاجة أحيانا
+
+24
+00:02:39,350 --> 00:02:43,630
+أنا في الـ market Esotropia ممكن أعطي full
+
+25
+00:02:43,630 --> 00:02:44,090
+atropine
+
+26
+00:02:52,510 --> 00:02:54,950
+فأنا أكتب مثل مثل مثل مثل مثل مثل مثل مثل مثل مثل
+
+27
+00:02:54,950 --> 00:03:04,170
+مثل مثل مثل مثل مثل مثل مثل مثل مثل مثل مثل
+
+28
+00:03:29,210 --> 00:03:34,890
+و هكذا يبقى الحالة البصرية أو المعاناة لو تفلق
+
+29
+00:03:34,890 --> 00:03:40,230
+بتحكم فيها والأكل بتوصل الـ muscle و Non-Cycloplegia
+
+30
+00:03:40,230 --> 00:03:43,270
+اللي استخدمته و الـH بتعمل طبعاً طيب الدكتور مش 
+
+31
+00:03:43,270 --> 00:03:46,730
+يصبح لما يكون أصغر بيقول دلوقتي ما بديش من أكتر؟
+
+32
+00:03:46,730 --> 00:03:52,870
+طيب يعني حقهم أكتر مش عارف؟ لا أه حقهم أكتر لا
+
+33
+00:03:52,870 --> 00:03:58,190
+يعني هو أنا قصدت الآن لما يكون 
+
+34
+00:04:13,870 --> 00:04:17,890
+ما هي هي يعني أنا هي هي اللي بقوله، يعني أنا بدي
+
+35
+00:04:17,890 --> 00:04:21,870
+أخصمه less في حتة ما كان عنده hyper activity of
+
+36
+00:04:21,870 --> 00:04:24,750
+the cerebral muscle، hyper activity of the
+
+37
+00:04:24,750 --> 00:04:26,710
+cerebral muscle بدي أخصمه less وممكن ما أخصمهوش
+
+38
+00:04:26,710 --> 00:04:32,250
+بالمرة، حتى لو كان Atropine، لأن الـ cerebral muscle
+
+39
+00:04:32,250 --> 00:04:36,690
+كل ما حطيتها plus over plus، كل ما صارت
+
+40
+00:04:36,690 --> 00:04:42,310
+suppression كل ما حطلها plus أكتر بيعمل suppression
+
+41
+00:04:42,310 --> 00:04:45,210
+and accommodation و بيعملها release أو relaxation
+
+42
+00:04:45,210 --> 00:04:49,870
+لأن هي اللي هي قصده لكن لو هي يعني خليني نمشي 
+
+43
+00:04:49,870 --> 00:04:56,350
+شوية لو أنه خسرنا له مثلاً أربعة خسرنا له واحد و
+
+44
+00:04:56,350 --> 00:05:00,250
+Sacro بين طوليه الطفل هذا الـ ISO هيدر هيدر الـ ISO
+
+45
+00:05:00,250 --> 00:05:04,390
+مش هيأثر كتير يعني أنا يعني كأني عملت له partial
+
+46
+00:05:04,390 --> 00:05:04,710
+correction
+
+47
+00:05:11,700 --> 00:05:17,000
+وما ذلك ويقول لي أن أنا بدي post-cycloplegic
+
+48
+00:05:17,000 --> 00:05:21,440
+visit يعني مش أنا أعطيته النضارة و مع السلامة و
+
+49
+00:05:21,440 --> 00:05:25,880
+خلاص مدى الحياة؟ لا لا لا من اسمع له شهر بدي يكون 
+
+50
+00:05:25,880 --> 00:05:30,640
+عندي ثاني بدي أقيم له بالـ cover test و أقيم له بالـ
+
+51
+00:05:30,640 --> 00:05:35,840
+vision حاجتين at
+
+52
+00:05:35,840 --> 00:05:38,260
+this phase of consultation it is particularly
+
+53
+00:05:38,260 --> 00:05:40,380
+important to assess the effect of the
+
+54
+00:05:45,210 --> 00:05:50,930
+يعني بتعمل له إيش اللي هو الـ cover test مشهور is
+
+55
+00:05:50,930 --> 00:05:57,250
+there any deviation with his prescription ما خلص
+
+56
+00:05:57,250 --> 00:06:01,410
+ما هي الـ cycle راحت يعني يعني ممكن تحذر عليه أثناء
+
+57
+00:06:01,410 --> 00:06:06,190
+الـ cycle عملنا له prescription و راح قاعد و سبعين
+
+58
+00:06:06,190 --> 00:06:11,210
+أو شهر وجاني ثاني الآن طبعاً اللي عيد رجعت لأن
+
+59
+00:06:11,210 --> 00:06:16,250
+normal activity و normal accommodation و لا شيء هو 
+
+60
+00:06:16,250 --> 00:06:19,950
+النضارة، الآن أنا بعمله assessment، إيش
+
+61
+00:06:19,950 --> 00:06:25,090
+assessment؟ تقييم جديد، بعمله تقييم جديد، إيش
+
+62
+00:06:25,090 --> 00:06:28,930
+prescription will be determined by the individual
+
+63
+00:06:28,930 --> 00:06:29,790
+circumstances
+
+64
+00:06:39,410 --> 00:06:45,030
+ولا كل الناس اللي بالـ Atropine أخصمولهم واحد ولا كل
+
+65
+00:06:45,030 --> 00:06:48,250
+الناس اللي بيساكموا الـ  Accommodation أخصمولهم نص ولا كل
+
+66
+00:06:48,250 --> 00:06:53,870
+الأعمار كده؟ لا لا أنا بقول أن كل واحد له ظروفه 
+
+67
+00:06:53,870 --> 00:07:01,090
+الخاصة وينبغي على الفاحص أن يكون حكيماً ويُتقِن
+
+68
+00:07:12,150 --> 00:07:17,490
+هنا هاي Esotropia إيه؟ فعملنا minimum plus which
+
+69
+00:07:17,490 --> 00:07:21,590
+would allow this Heterotropia .. Heterotrophia ..
+
+70
+00:07:21,590 --> 00:07:25,590
+phoria .. Heterotropia to become compensated فهنا
+
+71
+00:07:25,590 --> 00:07:30,350
+عملت minimum plus ففي الـ Esotropia لأ بدي أعمل
+
+72
+00:07:30,350 --> 00:07:30,750
+إيش؟
+
+73
+00:07:42,480 --> 00:07:47,400
+بالتالي إذا كنت أنا أريد
+
+74
+00:07:47,400 --> 00:07:54,140
+أن أفهم هذه القواعد فانا ممكن أشتغل أي شغل
+
+75
+00:08:06,540 --> 00:08:11,020
+at near is greater than that for distance it is
+
+76
+00:08:11,020 --> 00:08:16,240
+likely to impair distance visual acuity طيب أنتم
+
+77
+00:08:16,240 --> 00:08:20,800
+عارفين الـ .. الـ .. الـ Esotropia ممكن تيجي من 
+
+78
+00:08:20,800 --> 00:08:31,180
+Accommodation hyper activity أو Convergence axis و
+
+79
+00:08:31,180 --> 00:08:35,980
+بما أن الـ Convergence و الـ Accommodation عندهم
+
+80
+00:08:35,980 --> 00:08:43,440
+direct relation مترابطة تردي إذا زاد Accommodation المزيد 
+
+81
+00:08:43,440 --> 00:08:48,980
+من الـ super base والعكس صحيح فانا الآن بدي أنا 
+
+82
+00:08:48,980 --> 00:08:58,920
+أتّقن اللي هو فهم هذه القضية، الآن لو أنا أعطيت
+
+83
+00:08:58,920 --> 00:09:00,780
+full plus
+
+84
+00:09:05,210 --> 00:09:10,170
+الـ full plus correction هيعمل لي good near vision
+
+85
+00:09:10,170 --> 00:09:17,810
+لكن هيعمل لي impairment على الـ distance هو أما كنت 
+
+86
+00:09:17,810 --> 00:09:23,150
+في التلاتة و الأربع سنين لا يدرك هذه الهدركة الناس
+
+87
+00:09:23,150 --> 00:09:30,110
+اللي في رياض الأطفال و الناس اللي في التّربية 
+
+88
+00:09:32,850 --> 00:09:36,430
+بيجي .. يعني أمه ملبّسة نضارة بيقرا تبعهم لكن مثلاً
+
+89
+00:09:36,430 --> 00:09:39,390
+لو راح يلعب مع الولاد وشي بيكون impaired شوي أو
+
+90
+00:09:39,390 --> 00:09:44,410
+قاعد في الصف الدراسي بعيد ستة سبعة متر بيشوفش كويس
+
+91
+00:09:44,410 --> 00:09:47,390
+و بيقول ده إيه المشكلة أمه أنه ما شافش في الصف كويس
+
+92
+00:09:47,390 --> 00:09:53,250
+هو هذه حاجة من الإدراك أو من الفهم اللي أنه صار 
+
+93
+00:09:53,250 --> 00:09:57,850
+بيفهم عكس اللي هو الـ child اللي pre school ما يكونش
+
+94
+00:09:57,850 --> 00:10:03,880
+ودري كده فبيقول لي في الحالة يعني يعني أنا يا بعمل 
+
+95
+00:10:03,880 --> 00:10:10,000
+Bifocal يا بعمل Multifocal lenses حتى أني أعمل 
+
+96
+00:10:10,000 --> 00:10:14,800
+race للمشكلة هذه فيه لو نظر هكذا Straight بعيد
+
+97
+00:10:14,800 --> 00:10:21,700
+بيشوف من اللي هو الـ lens اللي فوق و لو نظر تحت أو
+
+98
+00:10:21,700 --> 00:10:27,500
+قريب شوف من هناك طبعاً الـ Bifocal تختلف عن الـ 
+
+99
+00:10:27,500 --> 00:10:35,490
+Multifocal لأنه فيها two types of lenses بس لكن الـ 
+
+100
+00:10:35,490 --> 00:10:41,450
+Multifocal أو الـ Progressive فيها يعني كل التدرج
+
+101
+00:10:41,450 --> 00:10:48,370
+فطبعاً أريح وإن كان أنا بعرف الأطفال في كسر نضارة
+
+102
+00:10:48,370 --> 00:10:51,930
+كل أسبوعين أو تلت أسابيع أو شهر فلو بدي أعطيه
+
+103
+00:10:51,930 --> 00:10:56,870
+Progressive بده ميزانية عند أهله ستمية شكل في كل
+
+104
+00:10:56,870 --> 00:11:02,490
+شهر يعني بطلعوا إيش؟ تمام تمام في المصاريف، صحيح؟
+
+105
+00:11:10,330 --> 00:11:29,010
+أو Riboflavin Riboflavin
+
+106
+00:11:29,010 --> 00:11:32,410
+Riboflavin Riboflavin Riboflavin Riboflavin Riboflavin Riboflavin Riboflavin Riboflavin
+
+107
+00:11:32,410 --> 00:11:34,510
+Riboflavin Riboflavin Riboflavin Riboflavin Riboflavin Riboflavin Riboflavin Riboflavin
+
+108
+00:11:34,510 --> 00:11:34,630
+Riboflavin Riboflavin Riboflavin Riboflavin Riboflavin Riboflavin
+
+109
+00:11:41,680 --> 00:11:50,160
+المهم في هذه الحالات هي الترخيص على أقل أو أكثر
+
+110
+00:11:50,160 --> 00:12:00,260
+أقل أقل أقل أقل أقل أقل أقل أقل أقل أقل أقل أقل 
+
+111
+00:12:00,260 --> 00:12:03,040
+أقل أقل أقل أقل 
+
+112
+00:12:07,460 --> 00:12:13,960
+plus one ممكن أعطيه minus one و لو إيجى minus
+
+113
+00:12:13,960 --> 00:12:18,680
+three نعطيه minus خمسة يعني كده اه يعني minus كامل
+
+114
+00:12:18,680 --> 00:12:25,560
+و هكذا طب ليش؟ لأنه معروف أن الـ minus بينزل و الـ
+
+115
+00:12:25,560 --> 00:12:30,740
+Stimulate Accommodation  و لما الـ Accommodation يصيله 
+
+116
+00:12:30,740 --> 00:12:35,060
+تحفيز الـ Convergence هيزيد ففي محاولة الـ
+
+117
+00:12:35,060 --> 00:12:39,390
+Convergence لأنه إكزوان أنا يعني اتغلق الـ Exo
+
+118
+00:12:39,390 --> 00:12:45,710
+deviation و أصبح فيه نوع من Concentration أو
+
+119
+00:12:45,710 --> 00:12:52,490
+Straight vision و يعني تيجي بالتجربة و لازم
+
+120
+00:12:52,490 --> 00:12:56,410
+تجربة أول مرة ما تظبطش ثاني مرة بتظبط شوي و بعدين
+
+121
+00:12:56,410 --> 00:13:01,250
+تظبط أكثر بيصير عندكوا سليقة في كمية اللي هو الـ
+
+122
+00:13:01,250 --> 00:13:06,860
+description للناس الـ Exo طبعاً هذا لن يكفي طبعاً لابد
+
+123
+00:13:06,860 --> 00:13:12,000
+من Orthoptic exercises و أحسن جهاز مما الـ 
+
+124
+00:13:12,000 --> 00:13:18,560
+Orthoptic exercises صينبتوا four صينبتوا four لكن 
+
+125
+00:13:18,560 --> 00:13:24,420
+في الـ home بقدر أنا أعمل Convergence exercise أقعد 
+
+126
+00:13:24,420 --> 00:13:28,020
+في أي target و أعلم الطفل أن هو يحركه Slowly لما 
+
+127
+00:13:28,020 --> 00:13:28,340
+يصل
+
+128
+00:13:32,380 --> 00:13:37,380
+400-500 في اليوم في محاولة احنا بنحاول نجنب 
+
+129
+00:13:37,380 --> 00:13:38,340
+الجراحة بقدر الممكن
+
+130
+00:13:41,420 --> 00:13:46,380
+إذا مضى وقت كافي، ست شهور مثلاً، على الـ description 
+
+131
+00:13:46,380 --> 00:13:50,780
+و الـ exercise و ما نفعش، بيكون بده إيش؟ بده Surgery
+
+132
+00:13:50,780 --> 00:13:54,640
+و الـ Surgery في الحالة دي، إيش هي الـ Surgery في 
+
+133
+00:13:54,640 --> 00:14:01,140
+الحالة دي؟ في الـ Exam؟ Lateral Recession و Medial
+
+134
+00:14:01,140 --> 00:14:09,400
+Recession، أحسن أحسن Insomnia and agitation a minus
+
+135
+00:14:09,400 --> 00:14:13,830
+over correction might allow the compensation of the
+
+136
+00:14:13,830 --> 00:14:16,130
+heterophoria or the attainment of binocular
+
+137
+00:14:16,130 --> 00:14:19,810
+fixation هذا اللي قلنا in every case consideration
+
+138
+00:14:19,810 --> 00:14:23,210
+must be given as to whether the patient will be
+
+139
+00:14:23,210 --> 00:14:27,330
+able to tolerate the proposed prescription when it
+
+140
+00:14:27,330 --> 00:14:30,350
+is compared to the present correction if any يعني
+
+141
+00:14:30,350 --> 00:14:34,010
+في كل حالة حالات نشوف هل المريض بيحتمل هذه الوصفة 
+
+142
+00:14:34,010 --> 00:14:38,890
+ولا لا دائماً يا بناتي في فرق بين المنح النظري ومنح
+
+143
+00:14:38,890 --> 00:14:45,510
+العملي عارف النضارة ممكن أكتب على ورق ما يشاء له، 
+
+144
+00:14:45,510 --> 00:14:52,070
+لكن اللي يكذب و يهدأ أو يصدقه، أتعامل، أثقال على
+
+145
+00:14:52,070 --> 00:14:59,270
+الأرض، و لما أنا كنت بتعامل مع بشر و مع نضارة، فمن
+
+146
+00:14:59,270 --> 00:15:03,390
+الصعب جداً أن أعطي واحد نضارة توجهه على الأرض، أو
+
+147
+00:15:03,390 --> 00:15:06,190
+نضارة تمنعه من سياقة سيارة، أو نضارة تمنعه من
+
+148
+00:15:06,190 --> 00:15:13,210
+الكتابة و القراءة هذه مهمة لذلك دائماً أنا لازم أشوف
+
+149
+00:15:13,210 --> 00:15:17,610
+اللي أنا عملته عملي على المريض أسأله هل هو يرى
+
+150
+00:15:17,610 --> 00:15:20,430
+القريب و يرى البعيد وكده وكده وكده وكده وكده وكش
+
+151
+00:15:20,430 --> 00:15:26,270
+اندوبيا شوي ولا اكزو ولا ايزو ولا حاجة لازم أتأكد أن
+
+152
+00:15:26,270 --> 00:15:31,210
+الوصفة بتاعتي وصفة صحيحة ولائقة بهذا المريض عشان 
+
+153
+00:15:31,210 --> 00:15:34,790
+هيك أنا لازم أطلب منه عليه في الـ Rebutin وكون 
+
+154
+00:15:34,790 --> 00:15:36,190
+عندي أنا وسيلة التطبيق
+
+155
+00:15:48,170 --> 00:15:50,570
+الآن في الـ Myopia احنا اتكلمنا في Reflection three 
+
+156
+00:15:50,570 --> 00:15:55,370
+طويلة عن هذا الموضوع وفي الـ Pharmacology كم 
+
+157
+00:15:55,370 --> 00:16:00,070
+اتكلمنا عنها يعني نقولها أن في Progressive Myopia
+
+158
+00:16:00,070 --> 00:16:05,810
+و هذه لو وصلت للمنتهى خطيرة لأنها هتعمل Color
+
+159
+00:16:05,810 --> 00:16:09,170
+Retinal Degeneration و Degeneration هي طالب
+
+160
+00:16:09,170 --> 00:16:10,810
+المكّولة و الـ central vagina
+
+161
+00:16:23,140 --> 00:16:30,700
+10%-25% بين Myopia Progressive Myopia بين أطفال
+
+162
+00:16:30,700 --> 00:16:36,220
+أقل من 10 سنوات وجدوا أن في أوروبا 10 إلى 25 منهم
+
+163
+00:16:36,220 --> 00:16:41,460
+Progressive بيزيد مثلاً كل سنة ديوبتر ديوبتر ديوبتر
+
+164
+00:16:41,460 --> 00:16:47,980
+في آسيا لهم 90 إلى 80 من بين الأطفال الـ Myopia
+
+165
+00:16:47,980 --> 00:16:50,120
+60 إلى 80 منهم
+
+166
+00:16:54,930 --> 00:17:01,870
+أما يعني فرض على الباحثين أنه وجدوا وسيلة طبعاً 
+
+167
+00:17:01,870 --> 00:17:07,970
+احنا اتعلمنا أنه حط لهم إيش Contact lenses أو اللي 
+
+168
+00:17:07,970 --> 00:17:11,650
+هو Multifocal أو Bifocal lenses واتعلمنا هذا في الـ 
+
+169
+00:17:11,650 --> 00:17:14,270
+Refraction لكن أحد الناس اللي دخلوا الخط الـ 
+
+170
+00:17:14,270 --> 00:17:19,240
+Pharmacology استخدموا الـ Atropine واستخدموها يعني الـ
+
+171
+00:17:19,240 --> 00:17:22,540
+Atropine و استخدموا الـ Atropine for a long time
+
+172
+00:17:22,540 --> 00:17:29,460
+أقل شي سنة أكثر شي ست سنوات وفعلاً وده نتائج جيدة 
+
+173
+00:17:29,460 --> 00:17:34,310
+في هذا الموضوع ووجدوا نتائج جيدة يعني بيقولوا له
+
+174
+00:17:34,310 --> 00:17:38,230
+daily administration of Atropine Sulfate one person
+
+175
+00:17:38,230 --> 00:17:42,370
+اه Children was reported to reduce the rate of
+
+176
+00:17:42,370 --> 00:17:46,690
+Myopic progression اه في الأطفال في بعض في التسابق 
+
+177
+00:17:46,690 --> 00:17:52,170
+سنة وتسابق هذا يعني أكيد أنه عملوا بحث زي هذا
+
+178
+00:17:52,170 --> 00:17:58,950
+ولمدة متفاوتة Atropine has been shown to retard
+
+179
+00:17:58,950 --> 00:18:07,910
+دراسة في أسلحة طول العين وكانت تشير إلى أن هذه كانت 
+
+180
+00:18:07,910 --> 00:18:10,150
+تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب
+
+181
+00:18:10,150 --> 00:18:11,610
+تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب
+
+182
+
+216
+00:21:05,770 --> 00:21:10,370
+العين وجدوه أنه جامع الـ prevention للأجزاء اللي
+
+217
+00:21:10,370 --> 00:21:15,050
+يمجزن القضايا associated with experimental myopic
+
+218
+00:21:15,050 --> 00:21:19,790
+myopia اللي هو chickens لسه يعني بيجربوه لسه على
+
+219
+00:21:19,790 --> 00:21:28,960
+دجاج واشي فين وصل الآن هنحاول نتبع نشوف يعني هي ..
+
+220
+00:21:28,960 --> 00:21:33,500
+يعني ممكن إذا كان .. يعني طلع ناجح إنه ما يعملش
+
+221
+00:21:33,500 --> 00:21:37,840
+عمال الأطرابين في Sacreblegia .. for Sacreblegia
+
+222
+00:21:37,840 --> 00:21:41,940
+ولا يعمل dilatation بالصورة هذه ويكون بدين وأنا
+
+223
+00:21:41,940 --> 00:21:48,980
+أظن إنه الـ future حافظ بالمفاجأة يعني مش مقول إنه 
+
+224
+00:21:48,980 --> 00:21:51,800
+مئات الملايين من الأطفال اللي عندهم progressive
+
+225
+00:21:51,800 --> 00:21:57,940
+myopia يعني overseas هو الواقعي في كل العالم أن
+
+226
+00:21:57,940 --> 00:22:02,780
+نضطر بدون يعني حل صحيح لأن المشكلة يعني كل واحد
+
+227
+00:22:02,780 --> 00:22:06,680
+يسأل نفسه لو أبوه شايف ابنه عمال عينيه بسبب الـ
+
+228
+00:22:06,680 --> 00:22:11,840
+damage بدأ وهو مثلا سنة تلاتة يصير معه one two
+
+229
+00:22:11,840 --> 00:22:18,000
+three لها تموصل twelve years لو كان مثلا minus ten
+
+230
+00:22:18,000 --> 00:22:25,650
+أو minus twelve أنا شايف أن هو نظره بيذهب، تروح
+
+231
+00:22:25,650 --> 00:22:31,110
+للعلماء اطبع له عيون بيقول لك مافيش الحل بيكون أنت
+
+232
+00:22:31,110 --> 00:22:35,810
+آسف جدًا على أن أنت مش قادر تنقذ نظر ابنك من
+
+233
+00:22:35,810 --> 00:22:40,610
+الضياء مشكلة كبيرة ولا صغيرة هذه pathological
+
+234
+00:22:40,610 --> 00:22:47,090
+pathological عامة يعني advanced effects of
+
+235
+00:22:47,090 --> 00:22:53,610
+cycloplegics ما 
+
+236
+00:22:53,610 --> 00:23:01,080
+هي المضار والأثار الجانبية للـ Cycloblegics بيقول لي
+
+237
+00:23:01,080 --> 00:23:05,740
+في عديد من الـ Cycloblegics أدركوها بدري حتى من
+
+238
+00:23:05,740 --> 00:23:10,940
+القرون الوسطى وبعض الأبحاث في 1904 حدثت على هذا
+
+239
+00:23:10,940 --> 00:23:18,520
+الموضوع الآن منها أن خاصة الأتروبيل يعني
+
+240
+00:23:18,520 --> 00:23:23,950
+الأتروبيل بيعمل high temperature بيعمل
+
+241
+00:23:23,950 --> 00:23:28,410
+hallucinations and attacks يعني حلوة أو ترنح،
+
+242
+00:23:28,410 --> 00:23:33,350
+طبعًا كل ما يكون فيه overdose بيعمل psychotic
+
+243
+00:23:33,350 --> 00:23:39,070
+reactions، آه psychotic يعني أشياء نفسية حس
+
+244
+00:23:39,070 --> 00:23:43,630
+هارويد يوسوس يعني في الأطفال أطفال ممكن يعمل
+
+245
+00:23:43,630 --> 00:23:47,830
+death في قليل من الحالات خاصة الأطفال صغير سن،
+
+246
+00:23:47,830 --> 00:23:53,370
+اللي هو الـ body weight low، body weight ممكن بيقول لي
+
+247
+00:23:53,370 --> 00:24:00,970
+بيعمل dry mouth و dry skin يعني بيمنع غضب العرق وغضب اللي وعارف أنّه تشتغل في واحد يعني كأنه أديب،
+
+248
+00:24:00,970 --> 00:24:08,010
+أديب يعني في الإنجليزي عمل عن أتروبين قصة عمل 
+
+249
+00:24:08,010 --> 00:24:14,570
+story جال الأتروبين في حال يكون يعني overdose
+
+250
+00:24:14,570 --> 00:24:18,970
+بيخلّي العيان blind as hat و dry as bone، dead as
+
+251
+00:24:20,010 --> 00:24:26,150
+beet أبيض روت، and mad as hatter يعني كده الشيء
+
+252
+00:24:26,150 --> 00:24:32,630
+يعني أقول لك الأتروبين ممكن يخلّي المريض أعمى
+
+253
+00:24:32,630 --> 00:24:41,750
+كالخفاش وجاف كالعظم وأحمر كالشمندرة هو مجنون كالهتر،
+
+254
+00:24:41,750 --> 00:24:52,170
+أحد الحيوانات اللي هو لا يستقل بنش يمين بعض تنزل
+
+255
+00:24:52,170 --> 00:24:55,910
+ع الشمال بعض تنزل فوق بعض تنزل تحت يعني هيك
+
+256
+00:24:55,910 --> 00:24:58,630
+مدحية طبعًا هي هذه من الكلام اللي احنا قلناه ليش
+
+257
+00:24:58,630 --> 00:25:03,450
+blind as bad؟ لأن في loss of accommodation، full
+
+258
+00:25:03,450 --> 00:25:10,310
+accommodation loss، واحدة، ليش dry as moon؟ ليش يا
+
+259
+00:25:10,310 --> 00:25:15,460
+عزيزي؟ لأن salary glance و sweetie glance و عزفين
+
+260
+00:25:15,460 --> 00:25:19,460
+و احنا عارفين أنّه الـ الـ كل بخر تتبقى بيه
+
+261
+00:25:19,460 --> 00:25:27,080
+برودة يعني احنا بنعلق بفرق الجو بتبخر علقنا،
+
+262
+00:25:27,080 --> 00:25:33,700
+بنحس بالبرودة يعني دي حكم من الله سبحانه وتعالى
+
+263
+00:25:33,700 --> 00:25:37,780
+فكان اللي وجودها دي العراقية بتاعتنا وقفت في فرقة
+
+264
+00:25:38,680 --> 00:25:43,020
+رمين هنحس أنّه إحنا جلدنا جاف ولسان كمان جاف لأن
+
+265
+00:25:43,020 --> 00:25:48,700
+مافيش لعاب فهتكون كلها جفاف في جفاف طب هتلاقي
+
+266
+00:25:54,820 --> 00:25:58,400
+إجابة؟ as beetroot عارفين الشمندر ده؟
+
+267
+00:26:03,500 --> 00:26:06,560
+الشمندر زي اللفت أحمر أحمر آه اللي زي اللفت
+
+268
+00:26:06,560 --> 00:26:09,180
+بيحطوه على اللفت حتى و عشان يسبوه أحمر
+
+269
+00:26:09,180 --> 00:26:13,020
+بيسبوه أحمر أبقوه آه مش عارف إيه الوي شمندر
+
+270
+00:26:13,020 --> 00:26:17,680
+شمندر شمندر آه بيحطوه بيحطوه على اللفت بيصير
+
+271
+00:26:17,680 --> 00:26:20,080
+أحمر أحمر خالص بدل الصبغة الصناعية بدل الصبغة
+
+272
+00:26:20,080 --> 00:26:29,160
+الصناعية طيب الأدوية اللي هو هيسخن هيسخن نتيجة
+
+273
+00:26:29,160 --> 00:26:36,450
+لأن وفيش فقد للحرارة قد تجي الأعراض هيسخن هتتمدد
+
+274
+00:26:36,450 --> 00:26:42,510
+الأوعية الدموية بتاعته هيحمر الحرارة هتمدد هيصير
+
+275
+00:26:42,510 --> 00:26:48,570
+أحمر زي الشمندر وبعدين مع سخونة ويسقط الـ
+
+276
+00:26:48,570 --> 00:26:53,590
+central nervous system هيصير نخم زي الهتر فهو
+
+277
+00:26:53,590 --> 00:26:56,670
+هذه يعني القولة هي بس بس بتفسر هذه الكلمة اللي
+
+278
+00:26:56,670 --> 00:27:01,370
+جاب له هي هذه بتفسر بس أنا شايفها بأسلوب أدبي
+
+279
+00:27:01,370 --> 00:27:11,800
+يعني الـ cycle of mentolate لشك أنّه less adverse أو
+
+280
+00:27:11,800 --> 00:27:15,140
+له الـ effects بتاعته less adverse than إيش؟ الـ
+
+281
+00:27:15,140 --> 00:27:21,420
+atropine فمثلا الـ central nervous system وجدوا أنّه
+
+282
+00:27:21,420 --> 00:27:24,760
+أثر الـ cycle of mentolate على الـ central nervous
+
+283
+00:27:24,760 --> 00:27:33,440
+system بالـ 1% كثير بالنصف percent أقل ممكن يعمل
+
+284
+00:27:33,440 --> 00:27:40,060
+بلوان Pearson's confusion للإنسان اضطراب difficulty
+
+285
+00:27:40,060 --> 00:27:45,880
+in speaking الكلام يعني في الطفل يعني مش واضح
+
+286
+00:27:45,880 --> 00:27:50,660
+hallucinations يتكلم كلام مش مفهوم والتكسيح ترنم
+
+287
+00:27:50,660 --> 00:27:54,700
+fortunately there have been no filter reports
+
+288
+00:27:54,700 --> 00:27:57,940
+following these effects ما صارش
+
+289
+00:28:02,860 --> 00:28:09,340
+أطفال أكثر من الـ نصف فمية بيقول لي أنّه في ناس
+
+290
+00:28:09,340 --> 00:28:13,780
+ركزوا الـ cyclopentolate إلى two percent اتنين فمية
+
+291
+00:28:13,780 --> 00:28:18,440
+خلوه two percent وهو two percent not available in
+
+292
+00:28:18,440 --> 00:28:21,900
+بريطانيا حتى مش عندنا احنا ولا في cyclopentolate في
+
+293
+00:28:21,900 --> 00:28:27,640
+المغرب لكن صنعوا أحد الشركات اتنين فمية and noted
+
+294
+00:28:27,640 --> 00:28:28,360
+hallucinations
+
+295
+00:28:34,020 --> 00:28:42,120
+بالإيش بـ 2% 9 تسعة سنين يعني أثر عليه فهو ده two
+
+296
+00:28:42,120 --> 00:28:45,360
+Pearson's sacroment layer elicited reactions in
+
+297
+00:28:45,360 --> 00:28:51,000
+four patients out of 40 years يبقى two percent
+
+298
+00:28:51,000 --> 00:28:55,240
+أكثر من واحد percent كمان ولو جبت three percent
+
+299
+00:28:55,240 --> 00:29:00,260
+أكثر أكثر one case has been reported in which
+
+300
+00:29:00,260 --> 00:29:04,460
+central nervous system effects of 0.2
+
+301
+00:29:04,460 --> 00:29:07,520
+cyclopentolate بقى الـ patient had a history of
+
+302
+00:29:07,520 --> 00:29:12,080
+chronic dementia لأ هذا هو مريض أساسًا يعني لأ نعزف
+
+303
+00:29:12,080 --> 00:29:19,480
+السبب للـ cyclopentolate هنا لو اختلفت نسبة الأتروبين
+
+304
+00:29:19,480 --> 00:29:26,620
+هدر نفس عدد أيام التقاطية؟ cyclopentolate قبل نفس
+
+305
+00:29:26,620 --> 00:29:27,000
+عدد
+
+306
+00:29:31,700 --> 00:29:34,220
+تركيزها أعلى من الواحد فمأن هي فرضية إذا كان هو في
+
+307
+00:29:34,220 --> 00:29:36,740
+بريطانيا مافيش اتنين فرمية فبراحنا احنا مافيش
+
+308
+00:29:36,740 --> 00:29:41,600
+اتنين فرمية لكن صحيح لو يوم يجي عندنا فعلًا الـ 2%
+
+309
+00:29:41,600 --> 00:29:44,360
+هتكون قوية كثير بس هيكون الـ side effect أكثرها
+
+310
+00:29:44,360 --> 00:29:49,120
+أكثر طبعًا هذا صح فبس احنا نصفه عليه خدنا أنّه كل
+
+311
+00:29:49,120 --> 00:29:53,100
+مدى التركيز كل ما الـ cycle of three ملاي يصير أخطر
+
+312
+00:29:53,100 --> 00:30:00,040
+من الـ adverse الـ cycle of three الثاني problem
+
+313
+00:30:03,720 --> 00:30:06,960
+طبعًا هالناس هيقولوا ليه ما دخل Cyclopentolate في
+
+314
+00:30:06,960 --> 00:30:11,520
+المعيدة ولا المعاق بيقولهم بيروح على الأنف بيمطس
+
+315
+00:30:11,520 --> 00:30:17,860
+من brain of the nose وبيروح الدم وبيعرض الدم
+
+316
+00:30:17,860 --> 00:30:21,300
+بيوزعه على الجسم كله following the use of
+
+317
+00:30:21,300 --> 00:30:25,240
+cyclopentolate in premature babies have been
+
+318
+00:30:25,240 --> 00:30:29,800
+reported it was found that cyclopentolate 0.5
+
+319
+00:30:29,800 --> 00:30:30,760
+decreased
+
+320
+00:30:37,000 --> 00:30:43,120
+يعني بالتجربة أنّه وجدوا secretion of HCL قدوكليرك
+
+321
+00:30:43,120 --> 00:30:46,860
+أسد in stomach أنّه بيقل
+
+322
+00:30:49,410 --> 00:30:54,910
+أنا قطرة بنسبة إنما الرابع في المية ما بيأثر from
+
+323
+00:30:54,910 --> 00:30:59,550
+the above it was appeared that 0.5% should be used
+
+324
+00:30:59,550 --> 00:31:04,990
+whenever possible and 1% should be used sparingly
+
+325
+00:31:04,990 --> 00:31:12,150
+يعني بيقول يعني بتاعك الـ 1% هيعمل إيه؟ أكثر وبتاعي
+
+326
+00:31:12,150 --> 00:31:15,350
+أنا في الأطفال وإي كان طبعًا الأطفال بدهم 1% العكس
+
+327
+00:31:15,350 --> 00:31:16,450
+هم الأكبر بدهم نصف percent
+
+328
+00:31:20,530 --> 00:31:24,830
+لكن أنا بتجنب فيه مية حاجة أن أتجنب أن أنا ممكن
+
+329
+00:31:24,830 --> 00:31:30,630
+أُسَكِّل فانكتار really يمكن أعش في القطرة بسرعة يعني
+
+330
+00:31:30,630 --> 00:31:35,270
+ما أخليش القطرة دي ما أحطش عديد قطرة نقطة واحدة أنا
+
+331
+00:31:35,270 --> 00:31:40,350
+متهملش طيب الـ homotropian
+
+332
+00:31:56,930 --> 00:32:01,410
+Less toxic than atropine has produced problems in
+
+333
+00:32:01,410 --> 00:32:04,690
+the past في الماضي في سنة واحد وستين مثلا reported
+
+334
+00:32:04,690 --> 00:32:08,450
+symptoms effects such as ataxia and hallucinations
+
+335
+00:32:08,450 --> 00:32:12,370
+in four children who had received six drops of
+
+336
+00:32:12,370 --> 00:32:16,310
+homatropin 2% وقلنا أن في homatropin في منه one،
+
+337
+00:32:16,490 --> 00:32:22,170
+two، three، four، five يعني منه خاص تركيزات فوجدوا
+
+338
+00:32:22,170 --> 00:32:29,750
+أن في أربع أطفال اخذوا الـ two percent قطرة عمل لهم
+
+339
+00:32:29,750 --> 00:32:35,250
+hallucinations اللي هو صاروا يتكلموا كلام مش معقول
+
+340
+00:32:35,250 --> 00:32:40,010
+شد أن he had received six drops of homotropin two
+
+341
+00:32:40,010 --> 00:32:45,470
+percent at ten minute intervals حصل فيهم الـ
+
+342
+00:32:45,470 --> 00:32:48,690
+hallucinations such a dose must be considered
+
+343
+00:32:48,690 --> 00:32:52,150
+excessive طبعًا دوسة كثيرة ست نقطة ليش عملوا ست
+
+344
+00:32:52,150 --> 00:32:52,250
+نقطة؟
+
+345
+00:32:55,500 --> 00:32:59,740
+excessive and it is not surprising the problems
+
+346
+00:32:59,740 --> 00:33:06,940
+arose يعني كل ما قل عدد النقط كل مكان أفضل يعني
+
+347
+00:33:06,940 --> 00:33:13,380
+كنا مثلًا نستعمله نقطة ومثلًا بعد أكثر شوية ربع
+
+348
+00:33:13,380 --> 00:33:18,920
+ساعة مثلًا نقطة هنا وهنا ونعمله اللي هو بعد مثلًا
+
+349
+00:33:18,920 --> 00:33:25,130
+ساعة اللي هو الـ إيش الـ Comparison with other
+
+350
+00:33:25,130 --> 00:33:27,790
+psychopathics هو الـ Tropic Amide is relatively
+
+351
+00:33:27,790 --> 00:33:33,550
+free from adverse reactions طبعًا الـ Tropic Amide
+
+352
+00:33:33,550 --> 00:33:40,430
+mainly من رياتك، mainly من رياتك، وقلنا احنا لا
+
+353
+00:33:40,430 --> 00:33:45,650
+نعتمد عليه كـ يعني strong psychopathic
+
+354
+00:33:58,870 --> 00:34:07,030
+في حالة واحدة اللي صلها loss of consciousness مع
+
+355
+00:34:07,030 --> 00:34:17,450
+شحوب ما حدش
+
+356
+00:34:17,450 --> 00:34:20,910
+ذكر غير هذا الحال في كل تاريخ Tropic in water
+
+357
+00:34:27,150 --> 00:34:32,530
+هو نفسه مريض من شيء ثاني يعني طيب الـ psychological
+
+358
+00:34:32,530 --> 00:34:38,110
+كمان ممكن تعمل allergic reactions أشياء حسية يعني
+
+359
+00:34:38,110 --> 00:34:41,650
+can carry too many compounds خاصة الأتروبين
+
+360
+00:34:41,650 --> 00:34:48,800
+الأتروبين هو المشهور most famous يعني في اللي هو
+
+361
+00:34:48,800 --> 00:34:52,620
+تسبيب الحساسية for producing reactions but
+
+362
+00:34:52,620 --> 00:34:57,320
+cyclopidylate has also been implicated أقل لكن
+
+363
+00:34:57,320 --> 00:35:01,520
+عاملًا it might appear that the use of cyclopidics
+
+364
+00:35:01,520 --> 00:35:06,320
+is potentially hazardous اللي هو فيه مخاطر if the
+
+365
+00:35:06,320 --> 00:35:11,720
+precautions إيش precautions احترام الأمنية
+
+366
+00:35:11,720 --> 00:35:13,060
+precautions
+
+367
+00:35:14,840 --> 00:35:21,080
+مذكرة في هذه القصة ملاحظة من المدرس فرصة تأثير
+
+368
+00:35:21,080 --> 00:35:27,180
+غير مباشرة تتخلص منها وستكون حالة غير عادية يعني
+
+369
+00:35:27,180 --> 00:35:32,840
+أنا ممكن أستعمل أي دراج في العين بس فيه قرارات
+
+370
+00:35:32,840 --> 00:35:39,660
+حسب التنبيهات والتحذيرات وممكن أمشي بكل دراج في
+
+371
+00:35:39,660 --> 00:35:46,190
+الجسم ممكن أني أنا يعني أحط إيش على مال تحذيرات
+
+372
+00:35:46,190 --> 00:35:50,270
+معينة وأنصح عليها المريض ممكن يعني مثلًا أنا
+
+373
+00:35:50,270 --> 00:35:57,750
+أتربين طبعًا أتربين هذا home use في البيت لأنّه عايز
+
+374
+00:35:57,750 --> 00:36:02,250
+three إلى four إلى five days بأطلب من الـ mother
+
+375
+00:36:02,250 --> 00:36:10,110
+أنّه put this bottle in the refrigerator في الثلاث أيام
+
+376
+00:36:16,550 --> 00:36:21,110
+بعدين apply only أو store only one drop in each
+
+377
+00:36:21,110 --> 00:36:28,750
+eye every twelve hours آه twice daily one drop
+
+378
+00:36:28,750 --> 00:36:35,110
+just one drop in the center بس التحذير
+
+379
+00:36:35,110 --> 00:36:46,010
+الثاني if any symptoms appear tell me عشان آخذ الـ
+
+380
+00:36:46,010 --> 00:36:53,970
+drug وأخبرني أيوة أخبرني فيه allergy فيه fever
+
+381
+00:36:53,970 --> 00:37:03,810
+فيه hallucinations فيه any rash آه أي أي حاجة
+
+382
+00:37:03,810 --> 00:37:09,450
+أخبرني آه وجيب الـ drug معك هكذا بقى الصح عشان
+
+383
+00:37:09,450 --> 00:37:14,650
+نشوف منهم ولمش منهم كويس؟ لكن لو أنا ما أعطيتش الـ
+
+384
+00:37:14,650 --> 00:37:20,750
+precautions بكون أنا blamed أنا وأنا ملابس يعني
+
+385
+00:37:20,750 --> 00:37:24,310
+دايمًا أنا أقرأ السلاح دو حد داين كيف السلاح دو حد
+
+386
+00:37:24,310 --> 00:37:30,990
+داين أستعمله حتى لو أتره ولا أتره خيري طيب آخر
+
+387
+00:37:30,990 --> 00:37:39,920
+slide أين؟ أقول أن هناك اتفاقات عضوية وعضوية بعد
+
+388
+00:37:39,920 --> 00:37:45,800
+وضع اتفاقات عضوية وعضوية في اتفاقات عضوية وعضوية
+
+389
+00:37:45,800 --> 00:37:47,320
+في اتفاقات عضوية في اتفاقات عضوية في اتفاقات عضوية
+
+390
+00:37:47,320 --> 00:37:49,800
+في اتفاقات عضوية في اتفاقات عضوية في اتفاقات عضوية
+
+391
+00:37:49,800 --> 00:37:53,980
+في اتفاقات عضوية في اتفاقات عضوية في اتفاقات عضوية
+
+392
+00:37:53,980 --> 00:38:00,020
+في اتفاقات عضوية في اتفاقات عضوية في اتفاقات عضوية
+
+393
+00:38:00,020 --> 00:38:02,640
+في اتف
+
+394
+00:38:08,810 --> 0
+
+431
+00:40:55,690 --> 00:40:59,110
+يقرأ وليه يطلع برا يعني. هذه الفترة لابد منها. هذا
+
+432
+00:40:59,110 --> 00:41:04,070
+قبل ما يخبروا القطر. يجب أن يكونوا متأكدين أن ركب 
+
+433
+00:41:04,070 --> 00:41:07,730
+دراجة
+
+434
+00:41:07,730 --> 00:41:10,690
+نارية أو ركب سيارة يجب أن يكون مفهوم.
+
+435
+00:41:15,700 --> 00:41:20,380
+مع سيارة بقوله استدعي من يقولك السيارة بدأت في
+
+436
+00:41:20,380 --> 00:41:28,000
+الليل عشان the dazzling evaluation of arterial
+
+437
+00:41:28,000 --> 00:41:32,060
+chamber depth عشان اتفادى ليش the angelic closure
+
+438
+00:41:32,060 --> 00:41:36,580
+of glaucoma attack ask whether the patient has 
+
+439
+00:41:36,580 --> 00:41:38,320
+previously undergone psychological
+
+440
+00:41:45,140 --> 00:41:50,280
+قالولك قال نعم قال هل any adverse effects حدثت قبل 
+
+441
+00:41:50,280 --> 00:41:53,540
+ذلك allergy أو fever أو أو أو أو طب لو صار
+
+442
+00:41:53,540 --> 00:41:58,060
+ما بعطيهش يعني؟ اه لو صار ما بعطيهش يعني لأنه خلاص
+
+443
+00:41:58,060 --> 00:42:04,380
+في previous history طب وإيش بعطيته؟ ممكن أغير؟
+
+444
+00:42:04,380 --> 00:42:11,200
+شيء بديل شيء بديل ولكن اللي أنا أعطيته قطرة مثلا
+
+445
+00:42:11,200 --> 00:42:14,500
+Atropine أو .. أو Saccharin فاللي هي أعطيها زي كتر
+
+446
+00:42:14,500 --> 00:42:19,800
+مني أو شتة مني عن هذه القطرة حتى لو حدث في غيابي
+
+447
+00:42:19,800 --> 00:42:26,320
+بلاء أحمد رقباه أنه يعني يعطوه the antidote لو رأى
+
+448
+00:42:26,320 --> 00:42:30,120
+المستشفى provide advice on what action the patient
+
+449
+00:42:30,120 --> 00:42:33,400
+should take in the event of adverse reaction لو 
+
+450
+00:42:33,400 --> 00:42:39,350
+حدث كده كده مثلا وكان مثلا ليل بعيد عنيف مثلا مريض
+
+451
+00:42:39,350 --> 00:42:43,490
+رافع أو خان يوم نفسه يكون معاه ورفع أن أنا حاطط له 
+
+452
+00:42:43,490 --> 00:42:47,070
+كده كده كده اتربيه مثلا حتى لو ذهب 
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/3fvbb6oXXV8_postprocess.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/3fvbb6oXXV8_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..0d4a5c5f6e635ae7283bfcf0e9af876a22d910d2
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/3fvbb6oXXV8_postprocess.srt
@@ -0,0 +1,1808 @@
+1
+00:00:20,740 --> 00:00:24,000
+بسم الله الرحمن الرحيم الحمد لله يا رب العالمين و
+
+2
+00:00:24,000 --> 00:00:26,200
+أصلي و أسلم على النبي الأمين و علاني و أصلي و
+
+3
+00:00:26,200 --> 00:00:30,600
+اتبعين السلام عليكم و رحمة الله و بركاته الآن احنا
+
+4
+00:00:30,600 --> 00:00:36,640
+عملنا Cyclopidemia و عملنا بعدها ريتنوسكوبي الآن
+
+5
+00:00:36,640 --> 00:00:43,260
+ماعملنا description after اللي هو ريتنوسكوبي we
+
+6
+00:00:43,260 --> 00:00:46,580
+need to make or write
+
+7
+00:00:51,600 --> 00:01:01,440
+بيقوللي انه انا عملت prescription و الخاصن حدث من
+
+8
+00:01:01,440 --> 00:01:05,820
+قيمة اللي هو ال .. ال .. ال optical power
+
+9
+00:01:05,820 --> 00:01:15,980
+according to the age of patient according to type
+
+10
+00:01:15,980 --> 00:01:17,300
+of cycloplegia
+
+11
+00:01:21,130 --> 00:01:28,010
+and according to the disease هذا
+
+12
+00:01:28,010 --> 00:01:34,010
+مش مكتوب يعني بدخسهم على حسب تلت حاجة ال age كل
+
+13
+00:01:34,010 --> 00:01:40,070
+مكان ال age بتاعه صغير بدخسهم أقل correct صحيح
+
+14
+00:01:40,070 --> 00:01:45,550
+بدخسهم أقل لإن السنة مثلا جوية كتير فأنا مثلا بدأي
+
+15
+00:01:45,550 --> 00:01:49,810
+maximum plus بدخسهم نصمن .. اللي هو قيمة ال
+
+16
+00:01:49,810 --> 00:01:53,250
+Sacroblasia تخصم نص .. بدنا نخصم اتنين، بتخصم واحد
+
+17
+00:01:53,250 --> 00:01:58,430
+لإن السنة مثلا قوية كتير فانا في حاجة إلى high
+
+18
+00:01:58,430 --> 00:02:06,590
+plus عشان أخليها إيش؟ released .. واحد طيب
+
+19
+00:02:06,590 --> 00:02:11,810
+according to type of Sacroblasia طب و لو أتربين؟
+
+20
+00:02:11,810 --> 00:02:15,590
+بختلف عن Sacrobitol A
+
+21
+00:02:25,410 --> 00:02:30,650
+أو كتير طيب ال activity of cerebral muscle يعني ال
+
+22
+00:02:30,650 --> 00:02:34,550
+disease طب لما يكون فيه عنده market ايزوتروفيا
+
+23
+00:02:34,550 --> 00:02:39,350
+ممكن اخدم حاجة احيانا
+
+24
+00:02:39,350 --> 00:02:43,630
+انا في ال market ايزوتروفيا ممكن اعطي full
+
+25
+00:02:43,630 --> 00:02:44,090
+atropine
+
+26
+00:02:52,510 --> 00:02:54,950
+فانا اكتب مثل مثل مثل مثل مثل مثل مثل مثل مثل مثل
+
+27
+00:02:54,950 --> 00:03:04,170
+مثل مثل مثل مثل مثل مثل مثل مثل مثل مثل مثل
+
+28
+00:03:29,210 --> 00:03:34,890
+و هكذا يبقى الحالة البصرية او المعانية لو تفلق
+
+29
+00:03:34,890 --> 00:03:40,230
+بتحكم فيها والأكل بتوصل ال muscle و non-cyclopedia
+
+30
+00:03:40,230 --> 00:03:43,270
+اللي استخدمته و الـH بتعمل طبعا طيب الدكتور مش
+
+31
+00:03:43,270 --> 00:03:46,730
+يبقاش لما يكون أصغر بيقول دلوقتي مابديش من أكتر؟
+
+32
+00:03:46,730 --> 00:03:52,870
+طيب يعني حقهم أكتر مش عارف؟ لأ أه حقهم أكتر لأ
+
+33
+00:03:52,870 --> 00:03:58,190
+يعني هو أنا قصدت الآن لما يكون
+
+34
+00:04:13,870 --> 00:04:17,890
+ما هي هي يعني انا هي هي اللي بقوله، يعني انا بدي
+
+35
+00:04:17,890 --> 00:04:21,870
+اخصمه less في حتة ما كان عنده hyper activity of
+
+36
+00:04:21,870 --> 00:04:24,750
+the cerebral muscle، hyper activity of the
+
+37
+00:04:24,750 --> 00:04:26,710
+cerebral muscle بدي اخصمه less وممكن ماخصمهوش
+
+38
+00:04:26,710 --> 00:04:32,250
+بالمرة، حتى لو كان أترومين، لأن الcerebral muscle
+
+39
+00:04:32,250 --> 00:04:36,690
+كل ما حطيتها plus over plus، كل ما صارت
+
+40
+00:04:36,690 --> 00:04:42,310
+suppressionكل ما حطلها plus أكتر بيعمل suppression
+
+41
+00:04:42,310 --> 00:04:45,210
+and accommodation و بيعملها release أو relaxation
+
+42
+00:04:45,210 --> 00:04:49,870
+لأن هي اللي هي قصدته لكن لو هي يعني خليني نمشي
+
+43
+00:04:49,870 --> 00:04:56,350
+شوية لو انه خسرنا له مثلا أربع خسرنا له واحد و
+
+44
+00:04:56,350 --> 00:05:00,250
+ساكره بين طوليه الطفل هذا ال ISO هيدر هيدر ال ISO
+
+45
+00:05:00,250 --> 00:05:04,390
+مش هيأثر كتير يعني أنا يعني كأني عملتله partial
+
+46
+00:05:04,390 --> 00:05:04,710
+correction
+
+47
+00:05:11,700 --> 00:05:17,000
+وما ذلك ويقول لي ان انا بدي post-psychopathic
+
+48
+00:05:17,000 --> 00:05:21,440
+visit يعني مش انا اعطيته النضارة و مع السلامة و
+
+49
+00:05:21,440 --> 00:05:25,880
+خلاص مدى الحياة لأ لأ لأ من اسمعين لشهر بدي يكون
+
+50
+00:05:25,880 --> 00:05:30,640
+عندي تاني بدي اقيمله بال cover test و اقيمله بال
+
+51
+00:05:30,640 --> 00:05:35,840
+vision حشتين at
+
+52
+00:05:35,840 --> 00:05:38,260
+this phase of consultation it is particularly
+
+53
+00:05:38,260 --> 00:05:40,380
+important to assess the effect of the
+
+54
+00:05:45,210 --> 00:05:50,930
+يعني بتعمله ايش اللي هو ال cover test مشهور is
+
+55
+00:05:50,930 --> 00:05:57,250
+there any deviation with his prescription ما خلص
+
+56
+00:05:57,250 --> 00:06:01,410
+ما هي ال cycle راحت يعني يعني ممكن تحذر عليه أثناء
+
+57
+00:06:01,410 --> 00:06:06,190
+ال cycle عملنا له prescription و راح جاعد و سبعين
+
+58
+00:06:06,190 --> 00:06:11,210
+أو شهر وجاني تانيالان طبعا اللي عيد رجعت لان
+
+59
+00:06:11,210 --> 00:06:16,250
+normal activity و normal accommodation و لاش هو
+
+60
+00:06:16,250 --> 00:06:19,950
+النضارة، الان انا بعمله assessment، ايش
+
+61
+00:06:19,950 --> 00:06:25,090
+assessment؟ تقييم جديد، بعمله تقييم جديد، ايش
+
+62
+00:06:25,090 --> 00:06:28,930
+prescription will be determined by the individual
+
+63
+00:06:28,930 --> 00:06:29,790
+circumstances
+
+64
+00:06:39,410 --> 00:06:45,030
+ولا كل الناس اللي بالأترابين اخصمولهم واحد ولا كل
+
+65
+00:06:45,030 --> 00:06:48,250
+الناس اللي بيساكموا الventilate اخصمولهم نص ولا كل
+
+66
+00:06:48,250 --> 00:06:53,870
+الأعمار كده لا لا انا بقول ان كل واحد له ظروفه
+
+67
+00:06:53,870 --> 00:07:01,090
+الخاصة وينبغي على الفاحس ان يكون حكيما ويطقن
+
+68
+00:07:12,150 --> 00:07:17,490
+هنا هاي ايزو فوريا ايه فعملنا minimum plus which
+
+69
+00:07:17,490 --> 00:07:21,590
+would allow this heterotrophia .. heterotrophia ..
+
+70
+00:07:21,590 --> 00:07:25,590
+فوريا .. heterotrophia to become compensated فهنا
+
+71
+00:07:25,590 --> 00:07:30,350
+اعملت minimum plus ففي ال ايزو تروفيا لأ بدى اعمل
+
+72
+00:07:30,350 --> 00:07:30,750
+ايش؟
+
+73
+00:07:42,480 --> 00:07:47,400
+بالتالي اذا كنت انا اريد
+
+74
+00:07:47,400 --> 00:07:54,140
+ان افهم هذه القواعد فانا ممكن اشتغل اي شغل
+
+75
+00:08:06,540 --> 00:08:11,020
+at near is greater than that for distance it is
+
+76
+00:08:11,020 --> 00:08:16,240
+likely to impair distance visual equity طيب انتوا
+
+77
+00:08:16,240 --> 00:08:20,800
+عارفين ال .. ال .. الisotropia ممكن تيدي من
+
+78
+00:08:20,800 --> 00:08:31,180
+accommodation hyper activity او convergence axis و
+
+79
+00:08:31,180 --> 00:08:35,980
+بما ان ال convergence و ال accommodationعندهم
+
+80
+00:08:35,980 --> 00:08:43,440
+direct relation متراسب تردي إذا زاد اكمالية المزيد
+
+81
+00:08:43,440 --> 00:08:48,980
+من ال super base والعكس صحيح فانا الان بدي انا
+
+82
+00:08:48,980 --> 00:08:58,920
+اتقن اللي هو فهم هذه القضية، الان لو انا اعطيت
+
+83
+00:08:58,920 --> 00:09:00,780
+full plus
+
+84
+00:09:05,210 --> 00:09:10,170
+الـ full plus correction هيعمللي good near vision
+
+85
+00:09:10,170 --> 00:09:17,810
+لكن هيعمللي impairment على ال distance هو اما كنت
+
+86
+00:09:17,810 --> 00:09:23,150
+في التلاتة والاربع سنين لا يدرك هذه الهدركة الناس
+
+87
+00:09:23,150 --> 00:09:30,110
+اللي في رياضي الأطفال والناس اللي في التدائيات
+
+88
+00:09:32,850 --> 00:09:36,430
+بيجي .. يعني أمه ملابسة نضارة بيقرا تبعهم لكن مثلا
+
+89
+00:09:36,430 --> 00:09:39,390
+لو راح يلعب مع الولاد وشي بيكون impaired شويه أو
+
+90
+00:09:39,390 --> 00:09:44,410
+قاعد في الصف الدراسي بعيد ستة سبعة متر بيشوفش كويس
+
+91
+00:09:44,410 --> 00:09:47,390
+و بيقول ده ايه المشكلة أمه أنه ماشوفش في الصف كويس
+
+92
+00:09:47,390 --> 00:09:53,250
+هو هذي حاجة من الإدراك أو من الفهم اللي انه صار
+
+93
+00:09:53,250 --> 00:09:57,850
+بيفهم عكس اللي هو ال child اللي pre school مايكونش
+
+94
+00:09:57,850 --> 00:10:03,880
+ودري كهدي فبقوللي في الحالة يعنييعني انا يا بعمل
+
+95
+00:10:03,880 --> 00:10:10,000
+bifocal يا بعمل multifocal lenses حتى اني اعمل
+
+96
+00:10:10,000 --> 00:10:14,800
+race للمشكلة هذه فيه لو نظر هكذا straight بعيد
+
+97
+00:10:14,800 --> 00:10:21,700
+بشوف من اللي هو ال lens اللي فوق و لو نظر تحت او
+
+98
+00:10:21,700 --> 00:10:27,500
+قريب شوف من هناك طبعا ال bifocal تختلف عن ال
+
+99
+00:10:27,500 --> 00:10:35,490
+multifocal لأنه فيها two types of lenses بسلكن ال
+
+100
+00:10:35,490 --> 00:10:41,450
+multifocal أو ال progressive فيها يعني كل التدرج
+
+101
+00:10:41,450 --> 00:10:48,370
+فطبعا أريح وإن كان أنا بعرف الأطفال في كاس نضارة
+
+102
+00:10:48,370 --> 00:10:51,930
+كل أسبوعين أو تلت أسابيع أو شهر فلو بدي أعطيه
+
+103
+00:10:51,930 --> 00:10:56,870
+progressive بده ميزانية عند أهله ستمية شكل في كل
+
+104
+00:10:56,870 --> 00:11:02,490
+شهر يعني بطلعوا ايش تمام تمام في المصاريف، صحيح؟
+
+105
+00:11:10,330 --> 00:11:29,010
+أو ريبان ريبان
+
+106
+00:11:29,010 --> 00:11:32,410
+ريبان ريبان ريبان ريبان ريبان ريبان ريبان ريبان
+
+107
+00:11:32,410 --> 00:11:34,510
+ريبان ريبان ريبان ريبان ريبان ريبان ريبان ريبان
+
+108
+00:11:34,510 --> 00:11:34,630
+ريبان ريبان ريبان ريبان ريبان ريبان
+
+109
+00:11:41,680 --> 00:11:50,160
+المهم في هذه الحالات هي الترخيص على أقل او اكتر
+
+110
+00:11:50,160 --> 00:12:00,260
+اقل اقل اقل اقل اقل اقل اقل اقل اقل اقل اقل اقل
+
+111
+00:12:00,260 --> 00:12:03,040
+اقل اقل اقل اقل
+
+112
+00:12:07,460 --> 00:12:13,960
+plus one ممكن اعطيه minus one و لو ايجا minus
+
+113
+00:12:13,960 --> 00:12:18,680
+three نعطيه minus خمسة يعني كده اه يعني minus كامل
+
+114
+00:12:18,680 --> 00:12:25,560
+و هكذا طب ليش؟ لأنه معروف انه ال minus لنزل و ال
+
+115
+00:12:25,560 --> 00:12:30,740
+stimulate اكموليشي اكموليشي و لما الاكموليشي يصيله
+
+116
+00:12:30,740 --> 00:12:35,060
+تحفيز ال convergence هيزيل ففي محاولة ال
+
+117
+00:12:35,060 --> 00:12:39,390
+convergence لأنه اكزوان انا يعني اتغلق ال exo
+
+118
+00:12:39,390 --> 00:12:45,710
+deviation و أصبح فيه نوع من concentration او
+
+119
+00:12:45,710 --> 00:12:52,490
+straight vision و يعني تبتيجي بالتجربة و لازم
+
+120
+00:12:52,490 --> 00:12:56,410
+تجربه اول مرة تظبطش تاني مرة بتظبط شويه و بعدين
+
+121
+00:12:56,410 --> 00:13:01,250
+تظبط اكتر بصير عندكوا سليقة في كمية اللي هو ال
+
+122
+00:13:01,250 --> 00:13:06,860
+description للناس ال exoطبعا هذا لن يكفي طبعا لابد
+
+123
+00:13:06,860 --> 00:13:12,000
+من orthoptic exercises و احسن جهاز مما ال
+
+124
+00:13:12,000 --> 00:13:18,560
+orthoptic exercises صينبتوا four صينبتوا four لكن
+
+125
+00:13:18,560 --> 00:13:24,420
+في ال home بقدر انا اعمل convergence exercise اقعد
+
+126
+00:13:24,420 --> 00:13:28,020
+في اي target و اعلم الطفل ان هو يحركه slowly لما
+
+127
+00:13:28,020 --> 00:13:28,340
+يصل
+
+128
+00:13:32,380 --> 00:13:37,380
+400-500 في اليوم في محاولة احنا بنحاول نجنب
+
+129
+00:13:37,380 --> 00:13:38,340
+الجراحة بقدر الممكن
+
+130
+00:13:41,420 --> 00:13:46,380
+إذا مضى وقت كافي، ست شهور مثلا، على ال description
+
+131
+00:13:46,380 --> 00:13:50,780
+و ال exercise و مانفهش، بيكون بده إيش؟ بده surgery
+
+132
+00:13:50,780 --> 00:13:54,640
+و ال surgery في الحالة دي، إيش هي ال surgery في
+
+133
+00:13:54,640 --> 00:14:01,140
+الحالة دي؟ في ال exam؟ لاترال ريسيشن و ميديال
+
+134
+00:14:01,140 --> 00:14:09,400
+ريسيشن، أحسن أحسن Insomnia and agitation a minus
+
+135
+00:14:09,400 --> 00:14:13,830
+over correctionmight allow the compensation of the
+
+136
+00:14:13,830 --> 00:14:16,130
+heterophoria or the attainment of binocular
+
+137
+00:14:16,130 --> 00:14:19,810
+fixation هذا اللي قلنا in every case consideration
+
+138
+00:14:19,810 --> 00:14:23,210
+must be given as to whether the patient will be
+
+139
+00:14:23,210 --> 00:14:27,330
+able to tolerate the proposed prescription when it
+
+140
+00:14:27,330 --> 00:14:30,350
+is compared to the present correction if any يعني
+
+141
+00:14:30,350 --> 00:14:34,010
+في كل حالة حالات نشوف هل المريض بيحتمل هذه الوصفة
+
+142
+00:14:34,010 --> 00:14:38,890
+ولا لا دائما يا بناتي في فرق بين المنح النظري ومنح
+
+143
+00:14:38,890 --> 00:14:45,510
+العمليعارف النظارة ممكن اكتب على ورق ما يشاء ليه،
+
+144
+00:14:45,510 --> 00:14:52,070
+لكن اللي يكذب و يهدأ او يصدقه، اتعامل، اثقال على
+
+145
+00:14:52,070 --> 00:14:59,270
+الأرض، و لما انا كنت بتعامل مع بشر و مع نظارة، فمن
+
+146
+00:14:59,270 --> 00:15:03,390
+الصعب جدا ان اعطي واحد نضارة توجهه على الأرض، او
+
+147
+00:15:03,390 --> 00:15:06,190
+نضارة تمنعه من سوق سيارة، او نضارة تمنعه من
+
+148
+00:15:06,190 --> 00:15:13,210
+الكتابة و الكرارةهذه مهمة لذلك دائما انا لازم اشوف
+
+149
+00:15:13,210 --> 00:15:17,610
+اللى انا عملته عملي على المريض واسأله هل هو يرى
+
+150
+00:15:17,610 --> 00:15:20,430
+القريب ويرى البعيد وكده وكده وكده وكده وكده وكش
+
+151
+00:15:20,430 --> 00:15:26,270
+اندربياشي ولا اكزو ولا ايزو ولا حاجة لازم اتأكد ان
+
+152
+00:15:26,270 --> 00:15:31,210
+الوصفة بتاعتى وصفة صحيحة ولائقة بهذا المريض عشان
+
+153
+00:15:31,210 --> 00:15:34,790
+هيك انا لازم اطلب منه اليه عليه في الrebutin وكون
+
+154
+00:15:34,790 --> 00:15:36,190
+عندى انا وسيلة التطبيق
+
+155
+00:15:48,170 --> 00:15:50,570
+الان في ال myopis احنا اتكلمنا في reflection three
+
+156
+00:15:50,570 --> 00:15:55,370
+طويلة عن هذا الموضوع وفي ال pharmacology كم
+
+157
+00:15:55,370 --> 00:16:00,070
+اتكلمنا عنها يعني نقولها انه في progressive myopia
+
+158
+00:16:00,070 --> 00:16:05,810
+و هذه لو وصلت للمنتهى خطيرة لانها هتعمل color
+
+159
+00:16:05,810 --> 00:16:09,170
+retinal degeneration و degeneration هي طالب
+
+160
+00:16:09,170 --> 00:16:10,810
+المكولة و ال central vagina
+
+161
+00:16:23,140 --> 00:16:30,700
+10%-25% بين مايوابس Progressive Myopia بين أطفال
+
+162
+00:16:30,700 --> 00:16:36,220
+أقل من 10 سنوات وجدوا أن في أوروبا 10 إلى 25 منهم
+
+163
+00:16:36,220 --> 00:16:41,460
+progressive بزيد مثلا كل سنة ديوبتر ديوبتر ديوبتر
+
+164
+00:16:41,460 --> 00:16:47,980
+في الأسوين لهم 90 إلى 80 من بين الأطفال ال مايوابس
+
+165
+00:16:47,980 --> 00:16:50,120
+60 إلى 80 منهم
+
+166
+00:16:54,930 --> 00:17:01,870
+أما يعني فرض على الباحثين أنه وجدوا وسيلة طبعا
+
+167
+00:17:01,870 --> 00:17:07,970
+احنا اتعلمنا انه حطلهم ايش contact lenses او اللي
+
+168
+00:17:07,970 --> 00:17:11,650
+هو multifocal او bifocal lenses واتعلمنا هذا في ال
+
+169
+00:17:11,650 --> 00:17:14,270
+refraction لكن احد الناس اللي دخلوا الخط ال
+
+170
+00:17:14,270 --> 00:17:19,240
+pharmacology استخدموا ال myopsو استخدموها يعني ال
+
+171
+00:17:19,240 --> 00:17:22,540
+atropine و استخدموا ال atropine for a long time
+
+172
+00:17:22,540 --> 00:17:29,460
+اقل شي سنة اكتر شي ست سنوات و فعلا وده نتائج جيدة
+
+173
+00:17:29,460 --> 00:17:34,310
+في هذا الموضوعووجدوا نتائج جيدة يعني بيقولوا ليه
+
+174
+00:17:34,310 --> 00:17:38,230
+daily administration of أطرابين سلفية one person
+
+175
+00:17:38,230 --> 00:17:42,370
+اه children was reported to reduce the rate of
+
+176
+00:17:42,370 --> 00:17:46,690
+myopic progression اه في الأطفال في بعض في التسابق
+
+177
+00:17:46,690 --> 00:17:52,170
+سنة وتسابق هذا يعني أكيد انه عملوا بحث زي هذا
+
+178
+00:17:52,170 --> 00:17:58,950
+ولمدة متفاوتة أطرابين has been shown to retard
+
+179
+00:17:58,950 --> 00:18:07,910
+دراسةفي أسلحة طول العين وكانت تشير إلى أن هذه كانت
+
+180
+00:18:07,910 --> 00:18:10,150
+تتجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب
+
+181
+00:18:10,150 --> 00:18:11,610
+تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب
+
+182
+00:18:11,610 --> 00:18:13,290
+تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب
+
+183
+00:18:13,290 --> 00:18:13,470
+تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب
+
+184
+00:18:13,470 --> 00:18:14,150
+تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب
+
+185
+00:18:14,150 --> 00:18:28,350
+تجارب تجارب تج
+
+186
+00:18:33,330 --> 00:18:41,230
+لو هذا الضوء العادى بتاعنا في الأوراق تعرضه لشخص
+
+187
+00:18:41,230 --> 00:18:42,930
+او طفولة او طفولة او طفولة او طفولة او طفولة او
+
+188
+00:18:42,930 --> 00:18:44,270
+طفولة او طفولة او طفولة او طفولة او طفولة او طفولة
+
+189
+00:18:44,270 --> 00:18:44,510
+طفولة او طفولة او طفولة او طفولة او طفولة او طفولة
+
+190
+00:18:44,510 --> 00:18:45,650
+او طفولة او طفولة او طفولة او طفولة او طفولة او
+
+191
+00:18:45,650 --> 00:18:50,710
+طفولة او طفولة او طفولة او طفولة
+
+192
+00:18:50,710 --> 00:18:54,890
+او طفولة او طفولة ا
+
+193
+00:19:02,270 --> 00:19:07,470
+هيكون lost فلما انا اعطيه ست شهور او سنة او سنتين
+
+194
+00:19:07,470 --> 00:19:12,110
+او تلات او اربع انا بكون فاقام في عزله عن الحياة
+
+195
+00:19:12,110 --> 00:19:19,850
+والانتفاع من نظره الحياة ده كمان المهمة انه وجدوا
+
+196
+00:19:19,850 --> 00:19:28,120
+ان اكتر من 80% من هؤلاء الأطفالللتقارة ال
+
+197
+00:19:28,120 --> 00:19:31,800
+preparation هيستهنف
+
+198
+00:19:31,800 --> 00:19:39,780
+تاني ال preparation هيستهنف يعني بس 12 الى 20%
+
+199
+00:19:39,780 --> 00:19:45,000
+منهم هو انه خلاص يعني هيفضل و هيتقدمش لكن فوق
+
+200
+00:19:45,000 --> 00:19:48,680
+تانية و فمية منهم راح يتقدم و يستهنف اللي هو ال
+
+201
+00:19:48,680 --> 00:19:54,220
+preparation لذلك يعني ان كانت هذه فكرة نظريا قيمة
+
+202
+00:19:58,920 --> 00:20:04,120
+أو إلى تخفيف ألمه أو تخفيف معاناته لاش فكرة جيدة
+
+203
+00:20:04,120 --> 00:20:10,800
+لكن اللي يكتب ذلك ويصدقه العمل اللي هو العمل اللي
+
+204
+00:20:10,800 --> 00:20:11,040
+هو العمل اللي هو العمل اللي هو العمل اللي هو العمل
+
+205
+00:20:11,040 --> 00:20:11,220
+اللي هو العمل اللي هو العمل اللي هو العمل اللي هو
+
+206
+00:20:11,220 --> 00:20:11,380
+العمل اللي هو العمل اللي هو العمل اللي هو العمل
+
+207
+00:20:11,380 --> 00:20:14,400
+اللي هو العمل اللي هو العمل اللي هو العمل اللي هو
+
+208
+00:20:14,400 --> 00:20:19,300
+العمل اللي هو العمل اللي هو العمل اللي هو العمل
+
+209
+00:20:19,300 --> 00:20:25,660
+اللي هو العمل اللي هو العمل اللي هو الع
+
+210
+00:20:29,750 --> 00:20:35,530
+و يبحثوا عن البديل فوجدوا البديل في الفيرنزبين
+
+211
+00:20:35,530 --> 00:20:40,850
+الفيرنزبين هذا هو أساسا كانوا استخدم في الالجسترو
+
+212
+00:20:40,850 --> 00:20:46,490
+انتستينال diseases قبل الطب الباطنية كانوا
+
+213
+00:20:46,490 --> 00:20:51,030
+بيستخدموه في ال ulcers في treatment of ulcers of
+
+214
+00:20:51,030 --> 00:20:58,210
+stomach and ulcers of diodenum هذا الآنلما عملوا
+
+215
+00:20:58,210 --> 00:21:05,770
+منه قطرة واستخدموه فى العين مركب قطرة واستخدموه فى
+
+216
+00:21:05,770 --> 00:21:10,370
+العين وجدوه انه جامع ال prevention للأجزاء اللى
+
+217
+00:21:10,370 --> 00:21:15,050
+يمجزن القضايا associated with experimental myopic
+
+218
+00:21:15,050 --> 00:21:19,790
+myopia اللى هو chickens لسه يعني بيجربوه لسه على
+
+219
+00:21:19,790 --> 00:21:28,960
+دجاج واشي فوين وصل الان هنحاول نتبع نشوفيعني هي ..
+
+220
+00:21:28,960 --> 00:21:33,500
+يعني ممكن إذا كان .. يعني طلع ناجح إنه مايعملش
+
+221
+00:21:33,500 --> 00:21:37,840
+عمال الأطرابين في Sacreblegia .. for Sacreblegia
+
+222
+00:21:37,840 --> 00:21:41,940
+ولا يعمل dilatation بالصورة هذه و يكون بدين و أنا
+
+223
+00:21:41,940 --> 00:21:48,980
+أظن إنه ال future حافظ بالمفاجأة يعني مش مقول إنه
+
+224
+00:21:48,980 --> 00:21:51,800
+مئات الملايين من الأطفال اللي عندهم progressive
+
+225
+00:21:51,800 --> 00:21:57,940
+myopia يعني overseasهو الواقعي في كل العالم ان
+
+226
+00:21:57,940 --> 00:22:02,780
+نفضر بدون يعني حل صحيح لإن المشكلة يعني كل واحد
+
+227
+00:22:02,780 --> 00:22:06,680
+يسأل نفسه لو أبوه شايف ابنه عمال عينيه بسبب ال
+
+228
+00:22:06,680 --> 00:22:11,840
+damage بدأ و هو مثلا سنة تلاتة يصير معاه one two
+
+229
+00:22:11,840 --> 00:22:18,000
+three لها تموصل twelve years لو كان مثلا minus ten
+
+230
+00:22:18,000 --> 00:22:25,650
+او minus twelve انا شايف ان هو نظره بيذهبتروح
+
+231
+00:22:25,650 --> 00:22:31,110
+للعلماء اطبع له عيون بيقولك مافيش الحل بكون انت
+
+232
+00:22:31,110 --> 00:22:35,810
+اسف جدا على انه انت مش قادر تنقذ نظر ابنك من
+
+233
+00:22:35,810 --> 00:22:40,610
+الضياء مشكلة كبيرة ولا صغيرة هذه pathological
+
+234
+00:22:40,610 --> 00:22:47,090
+pathological عامة يعني advanced effects of
+
+235
+00:22:47,090 --> 00:22:53,610
+cycloplegics ما
+
+236
+00:22:53,610 --> 00:23:01,080
+هي المضاروالأثار الجيانبية لل Cycloblegics بقول لي
+
+237
+00:23:01,080 --> 00:23:05,740
+في عديد من ال Cycloblegics أدركوها بدري حتى من
+
+238
+00:23:05,740 --> 00:23:10,940
+القرون الوسطى وبعض الأبحاث في 1904 حدثت على هذا
+
+239
+00:23:10,940 --> 00:23:18,520
+الموضوع الآن منها انه خاصة الأتروبيل يعني
+
+240
+00:23:18,520 --> 00:23:23,950
+الأتروبيل بيعمل high temperatureبيعمل
+
+241
+00:23:23,950 --> 00:23:28,410
+hallucinations and attacks يعني، حلوة أو ترنح،
+
+242
+00:23:28,410 --> 00:23:33,350
+طبعا كل ما يكون فيه overdose، بيعمل psychotic
+
+243
+00:23:33,350 --> 00:23:39,070
+reactions، اه psychotic يعني أشياء نفسية، حس
+
+244
+00:23:39,070 --> 00:23:43,630
+هارويد يوسوس يعني، في الأطفال، أطفال ممكن يعمل
+
+245
+00:23:43,630 --> 00:23:47,830
+death في قليل من الحالات، خاصة الأطفال، صغر، سن،
+
+246
+00:23:47,830 --> 00:23:53,370
+اللي هو ال body weight low، body weight ممكنبيقولي
+
+247
+00:23:53,370 --> 00:24:00,970
+بيعمل dry mouth و dry skin يعني بيمنع غضب العرق و
+
+248
+00:24:00,970 --> 00:24:08,010
+غضب اللي وعارف انها تشتغل في واحد يعني كانه أديب،
+
+249
+00:24:08,010 --> 00:24:14,570
+أديب يعني في الإنجليزي عمل عن أتروبين قصة عمل
+
+250
+00:24:14,570 --> 00:24:18,970
+story جال الأتروبين في حال يكون يعني overdose
+
+251
+00:24:20,010 --> 00:24:26,150
+بيخلّي العيان blind as hat و dry as bone، dead as
+
+252
+00:24:26,150 --> 00:24:32,630
+beet أبيض روت، and mad as hatter يعني كده الشيء
+
+253
+00:24:32,630 --> 00:24:41,750
+يعني أقولك الأتروبين ممكن يخلّي المريض أعمى
+
+254
+00:24:41,750 --> 00:24:52,170
+كالخفاش وجاف كالعظم وأحمر كالشمندرهو مجنون كالهتر،
+
+255
+00:24:52,170 --> 00:24:55,910
+احد الحيوانات اللي هو لا يستقل، بنش يمين، بعض تنزل
+
+256
+00:24:55,910 --> 00:24:58,630
+ع الشمال، بعض تنزل فوق، بعض تنزل تحت، يعني هيك
+
+257
+00:24:58,630 --> 00:25:03,450
+مدحية طبعا هي هذه من الكلام اللي احنا قلناه، ليش
+
+258
+00:25:03,450 --> 00:25:10,310
+blind as bad؟ لأنه في loss of accommodation، full
+
+259
+00:25:10,310 --> 00:25:15,460
+accommodation loss، واحدة، ليش dry as moon؟ليش يا
+
+260
+00:25:15,460 --> 00:25:19,460
+عزيزي؟ لأنه salary glance و sweetie glance و عزفين
+
+261
+00:25:19,460 --> 00:25:27,080
+و احنا عارفين انه ال .. ال .. كل بخر تتبقى بيه
+
+262
+00:25:27,080 --> 00:25:33,700
+برودة، يعني احنا بنعلق، بفرق الجو، بتبخر علقنا،
+
+263
+00:25:33,700 --> 00:25:37,780
+بنحس بالبرودة، يعني دي حكم من الله سبحانه وتعالى
+
+264
+00:25:38,680 --> 00:25:43,020
+فلكان اللي وجودها دي العراقية بتاعتنا وقفت في فرقة
+
+265
+00:25:43,020 --> 00:25:48,700
+رمين هنحس إنه إحنا جلدنا جاف و لسان كمان جاف لإن
+
+266
+00:25:48,700 --> 00:25:54,820
+مافيش لعاب فهتكون كلها جفاف في جفاف طب هتلاقي
+
+267
+00:25:54,820 --> 00:25:58,400
+إجابة؟ as beetroot عارفين الشمال ده؟
+
+268
+00:26:03,500 --> 00:26:06,560
+الشمندر .. زي اللفت أحمر أحمر .. أه اللي زي اللفت
+
+269
+00:26:06,560 --> 00:26:09,180
+بيحطوه على اللفت حتى و .. عشان يسبوه أحمر ..
+
+270
+00:26:09,180 --> 00:26:13,020
+بيسبوه أحمر أبقوه .. أه مش عارف ايه الوي شمندر ..
+
+271
+00:26:13,020 --> 00:26:17,680
+شمندر .. شمندر أه بيحطوه .. بيحطوه على اللفت بيصير
+
+272
+00:26:17,680 --> 00:26:20,080
+أحمر أحمر خالص بدل الصبغة الصناعية .. بدل الصبغة
+
+273
+00:26:20,080 --> 00:26:29,160
+الصناعية طيب الأدوة اللي هو هيسخن .. هيسخن نتيجة
+
+274
+00:26:29,160 --> 00:26:36,450
+لإن وفيش فقدللحرارة قد تجي الأعراض، هيسخن، هتتمدد
+
+275
+00:26:36,450 --> 00:26:42,510
+الأوضة الدموية بتاعته، هيحمر، الحرارة هتمدد، هيصير
+
+276
+00:26:42,510 --> 00:26:48,570
+أحمر زي الشماندة، و بعدين مع سخونة و يسقط ال
+
+277
+00:26:48,570 --> 00:26:53,590
+central nervous system، هيصير نخم، زي الهتر، فهو
+
+278
+00:26:53,590 --> 00:26:56,670
+هذه يعني القولة هي بس بس بتفسر هذه الكلامة اللي
+
+279
+00:26:56,670 --> 00:27:01,370
+جابله، هي هذه بتفسر، بس أنا شايفها بأسلوب أدبي
+
+280
+00:27:01,370 --> 00:27:11,800
+يعنيالcycle of mentolate لشك انه less adverse او
+
+281
+00:27:11,800 --> 00:27:15,140
+له ال effects بتاعةه less adverse than ايش؟ ال
+
+282
+00:27:15,140 --> 00:27:21,420
+atropine فمثلا ال central nervous system وجدوا انه
+
+283
+00:27:21,420 --> 00:27:24,760
+اثر ال cycle of mentolate على ال central nervous
+
+284
+00:27:24,760 --> 00:27:33,440
+system بال 1% كثير، بالنصف percent اقلممكن يعمل
+
+285
+00:27:33,440 --> 00:27:40,060
+بلوان Pearsonت confusion للإنسان اضطراب difficulty
+
+286
+00:27:40,060 --> 00:27:45,880
+in speaking الكلام يعني في الطفل يعني مش واضح
+
+287
+00:27:45,880 --> 00:27:50,660
+hallucinations يتكلم كلام مش مفهوم والتكسيح ترنم
+
+288
+00:27:50,660 --> 00:27:54,700
+fortunately there have been no filter reports
+
+289
+00:27:54,700 --> 00:27:57,940
+following these effects ماصارش
+
+290
+00:28:02,860 --> 00:28:09,340
+أطفال أكتر من ال نصف فمية بيقول لي إنه في ناس
+
+291
+00:28:09,340 --> 00:28:13,780
+ركزوا السيكولومتاليت إلى two percent اتنين فمية
+
+292
+00:28:13,780 --> 00:28:18,440
+خلوه two percent و هو two percent not available in
+
+293
+00:28:18,440 --> 00:28:21,900
+بريطانيا حتى مش عندنا احنا ولا في سيكولومتاليت في
+
+294
+00:28:21,900 --> 00:28:27,640
+المغرب لكن صنعوا احد الشركات اتنين فمية and noted
+
+295
+00:28:27,640 --> 00:28:28,360
+hallucinations
+
+296
+00:28:34,020 --> 00:28:42,120
+بالإيش ب 2% 9 تسعة سنين يعني اثر عليه فهو ده two
+
+297
+00:28:42,120 --> 00:28:45,360
+Pearson's sacroment layer elicited reactions in
+
+298
+00:28:45,360 --> 00:28:51,000
+four patients out of 40 years يبقى two percent
+
+299
+00:28:51,000 --> 00:28:55,240
+اكتر من واحد percent كمان ولو جبت three percent
+
+300
+00:28:55,240 --> 00:29:00,260
+اكتر اكتر one case has been reported in which
+
+301
+00:29:00,260 --> 00:29:04,460
+central nervous system effectsof 0.2
+
+302
+00:29:04,460 --> 00:29:07,520
+cyclopentolate بقى ال patient had a history of
+
+303
+00:29:07,520 --> 00:29:12,080
+chronic dementia لأ هذا هم مريض أساسا يعني لأ نعزف
+
+304
+00:29:12,080 --> 00:29:19,480
+السبب لل cyclopentolate هنا لو اختلفت نسبة التربين
+
+305
+00:29:19,480 --> 00:29:26,620
+هدر نفس عدد أيام التقاطية؟ cyclopentolate قبل نفس
+
+306
+00:29:26,620 --> 00:29:27,000
+عدد
+
+307
+00:29:31,700 --> 00:29:34,220
+تركيزها أعلى من الواحد فمان هي فرضية اذا كان هو في
+
+308
+00:29:34,220 --> 00:29:36,740
+بريطانيا مافيش اتنين فرمية فبراحنا احنا مافيش
+
+309
+00:29:36,740 --> 00:29:41,600
+اتنين فرمية لكن صحيح لو يوم ايجي عندنا فعلا ال 2%
+
+310
+00:29:41,600 --> 00:29:44,360
+هتكون قوية كتير بس هيكون ال side effect اكترها
+
+311
+00:29:44,360 --> 00:29:49,120
+اكتر طبعا هذا صح فبس احنا نصفه عليه خدنا انه كل
+
+312
+00:29:49,120 --> 00:29:53,100
+مدى التركيز كل ما ال cycle of three ملاي يصير اخطر
+
+313
+00:29:53,100 --> 00:30:00,040
+من ال adverse ال cycle of three التاني problem
+
+314
+00:30:03,720 --> 00:30:06,960
+طبعا هالناس هيقولوا ليه ما دخل Cyclopentolate في
+
+315
+00:30:06,960 --> 00:30:11,520
+المعيدة ولا المعاق بيقولهم بيروح على الأنف بيمطس
+
+316
+00:30:11,520 --> 00:30:17,860
+من brain of the nose و بيروح الدم و بيعرض الدم
+
+317
+00:30:17,860 --> 00:30:21,300
+بيوزعه على الدسم كله following the use of
+
+318
+00:30:21,300 --> 00:30:25,240
+cyclopentolate in premature babies have been
+
+319
+00:30:25,240 --> 00:30:29,800
+reported it was found that cyclopentolate 0.5
+
+320
+00:30:29,800 --> 00:30:30,760
+decreased
+
+321
+00:30:37,000 --> 00:30:43,120
+يعني بالتجربة انه وجدوا secretion of HCL قدوكليرك
+
+322
+00:30:43,120 --> 00:30:46,860
+أسد in stomach انه بيقل
+
+323
+00:30:49,410 --> 00:30:54,910
+أنا قطرة بنسبة إنما الرابع في المية ما بيأثر from
+
+324
+00:30:54,910 --> 00:30:59,550
+the above it was appeared that 0.5% should be used
+
+325
+00:30:59,550 --> 00:31:04,990
+whenever possible and 1% should be used sparingly
+
+326
+00:31:04,990 --> 00:31:12,150
+يعني بيقول يعني بتاعك ال 1% هيعمل إيه؟ أكتر وبتاعي
+
+327
+00:31:12,150 --> 00:31:15,350
+أنا في الأطفال وإي كان طبعا الأطفال بدهم 1% العكس
+
+328
+00:31:15,350 --> 00:31:16,450
+هم الأكبر بدهم نصف percent
+
+329
+00:31:20,530 --> 00:31:24,830
+لكن انا بتجنب فيه مية حاجة ان اتجنب ان انا ممكن
+
+330
+00:31:24,830 --> 00:31:30,630
+اسكل فانكتار really امكن اعش في القطرة بسرعة يعني
+
+331
+00:31:30,630 --> 00:31:35,270
+ماخليش القطرة دي ماحطش عديد قطرة نقطة واحدة انا
+
+332
+00:31:35,270 --> 00:31:40,350
+متهملش طيب ال homotropian
+
+333
+00:31:56,930 --> 00:32:01,410
+Less toxic than atropine has produced problems in
+
+334
+00:32:01,410 --> 00:32:04,690
+the past في الماضي في سنة واحد وستين مثلا reported
+
+335
+00:32:04,690 --> 00:32:08,450
+symptoms effects such as ataxia and hallucinations
+
+336
+00:32:08,450 --> 00:32:12,370
+in four children who had received six drops of
+
+337
+00:32:12,370 --> 00:32:16,310
+homatropin 2% وقلنا ان في homatropin في منه one,
+
+338
+00:32:16,490 --> 00:32:22,170
+two, three, four, five يعني منه خاص تركيزات فوجدوا
+
+339
+00:32:22,170 --> 00:32:29,750
+ان في أربع أطفالأخذوا الـ two percent قطرة عمل لهم
+
+340
+00:32:29,750 --> 00:32:35,250
+hallucinations اللي هو صاروا يتكلموا كلام مش معقول
+
+341
+00:32:35,250 --> 00:32:40,010
+شد ان he had received six drops of homotropin two
+
+342
+00:32:40,010 --> 00:32:45,470
+percent at ten minute intervals حصل فيهم ال
+
+343
+00:32:45,470 --> 00:32:48,690
+hallucinations such a dose must be considered
+
+344
+00:32:48,690 --> 00:32:52,150
+excessive طبعا دوسة كتيرة ست نقطة ليش تعملوا ست
+
+345
+00:32:52,150 --> 00:32:52,250
+نقطة؟
+
+346
+00:32:55,500 --> 00:32:59,740
+excessive and it is not surprising the problems
+
+347
+00:32:59,740 --> 00:33:06,940
+arose يعني كل ما قل عدد النقط كل مكان أفضل يعني
+
+348
+00:33:06,940 --> 00:33:13,380
+كنا مثلا نستعمله نقطة و مثلا بعد أكتر شوية ربع
+
+349
+00:33:13,380 --> 00:33:18,920
+ساعة مثلا نقطة هنا و هنا و نعمله اللي هو بعد مثلا
+
+350
+00:33:18,920 --> 00:33:25,130
+ساعة اللي هو ال إيشالـ Comparison with other
+
+351
+00:33:25,130 --> 00:33:27,790
+psychopathics هو الـ Tropic Amide is relatively
+
+352
+00:33:27,790 --> 00:33:33,550
+free from adverse reactions طبعا ال Tropic Amide
+
+353
+00:33:33,550 --> 00:33:40,430
+mainly من رياتك، mainly من رياتك، وقولنا احنا لا
+
+354
+00:33:40,430 --> 00:33:45,650
+نعتمد عليه كيعني strong psychopathic
+
+355
+00:33:58,870 --> 00:34:07,030
+في حالة واحدة اللي صلها loss of consciousness مع
+
+356
+00:34:07,030 --> 00:34:17,450
+شحوب ماحدش
+
+357
+00:34:17,450 --> 00:34:20,910
+ذكر غير هذا الحال في كل تاريخ Tropic in water
+
+358
+00:34:27,150 --> 00:34:32,530
+هو نفسه مريض من إشي تاني يعني طيب ال psychological
+
+359
+00:34:32,530 --> 00:34:38,110
+كمان ممكن تعمل allergic reactions أشياء حسية يعني
+
+360
+00:34:38,110 --> 00:34:41,650
+can carry too many compounds خاصة الأترابين
+
+361
+00:34:41,650 --> 00:34:48,800
+الأترابين هو المشهورmost famous يعني في اللي هو
+
+362
+00:34:48,800 --> 00:34:52,620
+تسبيب الحساسية for producing reactions but
+
+363
+00:34:52,620 --> 00:34:57,320
+cyclopidylate has also been implicated أقل لكن
+
+364
+00:34:57,320 --> 00:35:01,520
+عاملا it might appear that the use of cyclopidics
+
+365
+00:35:01,520 --> 00:35:06,320
+is potentially hazardous اللي هو فيه مخاطر if the
+
+366
+00:35:06,320 --> 00:35:11,720
+precautions ايش precautions احترام الأمنية
+
+367
+00:35:11,720 --> 00:35:13,060
+precautions
+
+368
+00:35:14,840 --> 00:35:21,080
+مذكرة في هذه القصة ملاحظة من المدرس، فرصة تأثير
+
+369
+00:35:21,080 --> 00:35:27,180
+غير مباشرة تتخلص منها و ستكون حالة غير عادية يعني
+
+370
+00:35:27,180 --> 00:35:32,840
+انا ممكن استعمل اي دراج في العين، بس فيه قرارات
+
+371
+00:35:32,840 --> 00:35:39,660
+حسب التنبيهات والتحذيرات وممكن امشي بل كل دراج في
+
+372
+00:35:39,660 --> 00:35:46,190
+الجسمممكن اني انا يعني احط ايش على مال تحذيرات
+
+373
+00:35:46,190 --> 00:35:50,270
+معينة وانصار عليها المريض ممكن يعني مثلا انا
+
+374
+00:35:50,270 --> 00:35:57,750
+اتربين طبعا اتربين هذا home use في البيت لانه عايز
+
+375
+00:35:57,750 --> 00:36:02,250
+three الى four الى five days باطلب من ال mother
+
+376
+00:36:02,250 --> 00:36:10,110
+انه put this bottle in the refrigerator في التلاتج
+
+377
+00:36:16,550 --> 00:36:21,110
+بعدين apply only او store only one drop in each
+
+378
+00:36:21,110 --> 00:36:28,750
+eye every twelve hours اه twice daily one drop
+
+379
+00:36:28,750 --> 00:36:35,110
+just one drop in the center بس التحذير
+
+380
+00:36:35,110 --> 00:36:46,010
+التاني if any symptoms appear tell meعشان اخد ال
+
+381
+00:36:46,010 --> 00:36:53,970
+drug و اخبرني ايوة اخبرني فيه allergy فيه fever
+
+382
+00:36:53,970 --> 00:37:03,810
+فيه hallucinations فيه any rash اه اي اي حاجة
+
+383
+00:37:03,810 --> 00:37:09,450
+اخبرني اه و جيب ال drug معاكي هكذا بقى الصح عشان
+
+384
+00:37:09,450 --> 00:37:14,650
+نشوف منهم و لمش منهم كويس؟لكن لو انا ماعطيتش ال
+
+385
+00:37:14,650 --> 00:37:20,750
+precautions بكون انا blamed انا و انا ملابس، يعني
+
+386
+00:37:20,750 --> 00:37:24,310
+دايما انا اقرأ السلاح دو حد داين، كيف السلاح دو حد
+
+387
+00:37:24,310 --> 00:37:30,990
+داين استعمله حتى لو اتراه، ولا اتراه خيري طيب، اخر
+
+388
+00:37:30,990 --> 00:37:39,920
+slide اين؟أقول ان هناك اتفاقات عضوية و عضوية بعد
+
+389
+00:37:39,920 --> 00:37:45,800
+وضع اتفاقات عضوية و عضوية في اتفاقات عضوية و عضوية
+
+390
+00:37:45,800 --> 00:37:47,320
+في اتفاقات عضوية في اتفاقات عضوية في اتفاقات عضوية
+
+391
+00:37:47,320 --> 00:37:49,800
+في اتفاقات عضوية في اتفاقات عضوية في اتفاقات عضوية
+
+392
+00:37:49,800 --> 00:37:53,980
+في اتفاقات عضوية في اتفاقات عضوية في اتفاقات عضوية
+
+393
+00:37:53,980 --> 00:38:00,020
+في اتفاقات عضوية في اتفاقات عضوية في اتفاقات عضوية
+
+394
+00:38:00,020 --> 00:38:02,640
+في اتف
+
+395
+00:38:08,810 --> 00:38:12,410
+ماذا حصل لها؟ ترمى جيماية. طب هي عندها حوال مثلا و
+
+396
+00:38:12,410 --> 00:38:14,150
+لا عندها حوال .. هي عندها السينما و مصر أساسا
+
+397
+00:38:14,150 --> 00:38:18,050
+active؟ لا. آه لكن اللي حصلت لها وجدت أنه فيه
+
+398
+00:38:18,050 --> 00:38:21,930
+psychotic reactions. جاءت تكلم حالها. أو بدت يعني
+
+399
+00:38:21,930 --> 00:38:25,470
+.. آه يعني منوحي نفسية. طبعا في السينما. طيب.
+
+400
+00:38:25,750 --> 00:38:28,810
+immediately after the second installation, the
+
+401
+00:38:28,810 --> 00:38:32,670
+patient reported neurological symptoms. في يعني
+
+402
+00:38:32,670 --> 00:38:37,140
+بعد النقطة التانية ال psychologicalit's a
+
+403
+00:38:37,140 --> 00:38:41,520
+drowsiness، نوع من نواصق، dizziness، ذوخة، nausea
+
+404
+00:38:41,520 --> 00:38:47,280
+and fatigue طيب، ten minutes later, similarly
+
+405
+00:38:47,280 --> 00:38:50,900
+central nervous system symptoms in the form of
+
+406
+00:38:50,900 --> 00:38:58,240
+restlessness، مش راحة، مش نوم، cheerfulness، كلام
+
+407
+00:38:58,240 --> 00:39:01,440
+فيه
+
+408
+00:39:01,440 --> 00:39:11,270
+يعني نكت، بنكت يعنيبعد عشرين دقائق صاروا يزعجوا و
+
+409
+00:39:11,270 --> 00:39:16,750
+يضحكوا بصوت عالي و يضحكوا بصوت عالي و يضحكوا بصوت
+
+410
+00:39:16,750 --> 00:39:17,830
+عالي و يضحكوا بصوت عالي و يضحكوا بصوت عالي و
+
+411
+00:39:17,830 --> 00:39:19,750
+يضحكوا بصوت عالي و يضحكوا بصوت عالي و يضحكوا بصوت
+
+412
+00:39:19,750 --> 00:39:22,470
+عالي و يضحكوا بصوت عالي و يضحكوا بصوت عالي و
+
+413
+00:39:22,470 --> 00:39:23,170
+يضحكوا بصوت عالي و يضحكوا بصوت عالي و يضحكوا بصوت
+
+414
+00:39:23,170 --> 00:39:23,530
+عالي و يضحكوا بصوت عالي و يضحكوا بصوت عالي و
+
+415
+00:39:23,530 --> 00:39:32,330
+يضحكوا بصوت عالي و يضحكوا بصوت عالي و
+
+416
+00:39:32,330 --> 00:39:38,080
+يضكيف انه ال central nervous system في ما يسمونه
+
+417
+00:39:38,080 --> 00:39:41,840
+stimulation و ما يسمونه depression، يعني أطوار،
+
+418
+00:39:41,840 --> 00:39:46,780
+أطوار على الجهاز العصبي الأخر الشيء ال precautions
+
+419
+00:39:46,780 --> 00:39:52,900
+of adverse effects of psychotherapy، يعني
+
+420
+00:39:52,900 --> 00:39:55,900
+التحذيرة، the following precautions should be
+
+421
+00:39:55,900 --> 00:39:57,760
+observed in the use of psychologics
+
+422
+00:40:07,640 --> 00:40:13,860
+أبو أو أمه أو تنين الاسباب لتفهيمها في التجارب
+
+423
+00:40:13,860 --> 00:40:18,740
+البيولوجية نحن نحط القطر عشان في عضلة ننخيها عشان
+
+424
+00:40:18,740 --> 00:40:22,540
+نبين لو عنده حوار لو عنده كده واحد اثنان الاطفال
+
+425
+00:40:22,540 --> 00:40:28,280
+او والديين يجب ان يكونوا متأكدين ان الفوتوفوبيا
+
+426
+00:40:28,280 --> 00:40:35,080
+ممكنة ويمكن ان يتم تحريرها باستخدام عضلات شمسية او
+
+427
+00:40:35,080 --> 00:40:35,520
+رأس كبير
+
+428
+00:40:43,110 --> 00:40:47,530
+يجب أيضًا أن يكونوا متأكدين أن الوضع قريب وممكن أن
+
+429
+00:40:47,530 --> 00:40:52,370
+تكون الوضع مبتدئ. الفترة هذه مثلًا سنجرب من طول
+
+430
+00:40:52,370 --> 00:40:55,690
+الليل، هيبقى مثلًا اتناشر ساعة بلاش يقرأ، بلاش
+
+431
+00:40:55,690 --> 00:40:59,110
+يقرأ وليه يطلع برا يعني. هذه الفترة لابد منها. هذا
+
+432
+00:40:59,110 --> 00:41:04,070
+قبل ما يخبروا القطر. يجب أن يكونوا متأكدين أن ركب
+
+433
+00:41:04,070 --> 00:41:07,730
+دراجة
+
+434
+00:41:07,730 --> 00:41:10,690
+نارية أو ركب سيارة يجب أن يكون مفهوم.
+
+435
+00:41:15,700 --> 00:41:20,380
+مع سيارة بقوله استدعي من يقولك السيارة بدأت في
+
+436
+00:41:20,380 --> 00:41:28,000
+الليل عشان ال dazzling evaluation of arterial
+
+437
+00:41:28,000 --> 00:41:32,060
+chamber depth عشان اتفادى ليش ال angelic closure
+
+438
+00:41:32,060 --> 00:41:36,580
+of glaucoma attack ask whether the patient has
+
+439
+00:41:36,580 --> 00:41:38,320
+previously undergone psychological
+
+440
+00:41:45,140 --> 00:41:50,280
+قالولك قال نعم قال هل any adverse effects حدثت قبل
+
+441
+00:41:50,280 --> 00:41:53,540
+ذلك allergy او fever او او او او طب لو صار
+
+442
+00:41:53,540 --> 00:41:58,060
+مابعطيهش يعنى؟ اه لو صار مابعطيهش يعنى لأنه خلاص
+
+443
+00:41:58,060 --> 00:42:04,380
+في previous history طب و ايش بعطيته؟ ممكن اغير؟
+
+444
+00:42:04,380 --> 00:42:11,200
+اشي بديل اشي بديلولكن اللي انا اعطيته قطرة مثلا
+
+445
+00:42:11,200 --> 00:42:14,500
+Atropine او .. او Saccharin فاللي هي اعطيه زي كتر
+
+446
+00:42:14,500 --> 00:42:19,800
+مني او شتة مني عن هذه القطرة حتى لو حدث في غيابي
+
+447
+00:42:19,800 --> 00:42:26,320
+بلاء أحمد رقباه انه يعني يعطوه ال antidote لو رأى
+
+448
+00:42:26,320 --> 00:42:30,120
+المستشفى provide advice on what action the patient
+
+449
+00:42:30,120 --> 00:42:33,400
+should take in the event of adverse reaction لو
+
+450
+00:42:33,400 --> 00:42:39,350
+حدث كده كده مثلا و كان مثلا ليل بعيد عنيفمثلا مريض
+
+451
+00:42:39,350 --> 00:42:43,490
+رافع او خان يوم نفسه يكون معاه ورفع ان انا حاطيتله
+
+452
+00:42:43,490 --> 00:42:47,070
+كده كده كده اتربيه مثلا حتى لو ذهب
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/3fvbb6oXXV8_raw.json b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/3fvbb6oXXV8_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..291d823c76cbbad3137b3c7c53a4f437126344f5
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/3fvbb6oXXV8_raw.json
@@ -0,0 +1 @@
+{"segments": [{"id": 1, "seek": 4658, "start": 20.74, "end": 46.58, "text": "بسم الله الرحمن الرحيم الحمد لله يا رب العالمين و أصلي و أسلم على النبي الأمين و علاني و أصلي و اتبعين السلام عليكم و رحمة الله و بركاته الآن احنا عملنا Cyclopidemia و عملنا بعدها ريتنوسكوبي الآن ماعملنا description after اللي هو ريتنوسكوبي we need to make or write", "tokens": [3555, 38251, 21984, 34892, 5016, 27842, 34892, 5016, 32640, 21542, 2304, 3215, 24976, 3224, 35186, 12602, 3555, 18863, 45340, 9957, 4032, 5551, 9381, 20292, 4032, 5551, 3794, 19528, 15844, 28239, 21292, 16247, 2304, 9957, 4032, 11203, 7649, 1829, 4032, 5551, 9381, 20292, 4032, 1975, 2655, 3555, 3615, 9957, 21136, 37440, 25894, 24793, 4032, 12602, 35571, 3660, 21984, 4032, 4724, 31747, 9307, 3224, 6024, 48506, 1975, 5016, 8315, 6225, 42213, 8315, 10295, 3474, 404, 327, 14058, 4032, 6225, 42213, 8315, 39182, 11296, 12602, 36081, 1863, 41779, 4117, 2407, 21292, 6024, 48506, 19446, 25957, 1211, 8315, 3855, 934, 13672, 1829, 31439, 12602, 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" ولا", "probability": 0.9453125}, {"start": 407.95, "end": 408.25, "word": " كل", "probability": 0.9501953125}, {"start": 408.25, "end": 409.03, "word": " الأعمار", "probability": 0.9344075520833334}, {"start": 409.03, "end": 409.61, "word": " كده", "probability": 0.8924153645833334}, {"start": 409.61, "end": 409.93, "word": " لا", "probability": 0.464599609375}, {"start": 409.93, "end": 410.29, "word": " لا", "probability": 0.595703125}, {"start": 410.29, "end": 411.85, "word": " انا", "probability": 0.891845703125}, {"start": 411.85, "end": 412.29, "word": " بقول", "probability": 0.98681640625}, {"start": 412.29, "end": 412.49, "word": " ان", "probability": 0.83447265625}, {"start": 412.49, "end": 412.89, "word": " كل", "probability": 0.869140625}, {"start": 412.89, "end": 413.29, "word": " واحد", "probability": 0.989013671875}, {"start": 413.29, "end": 413.49, "word": " له", "probability": 0.383056640625}, {"start": 413.49, "end": 413.87, "word": " ظروفه", "probability": 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{"start": 957.37, "end": 957.71, "word": " نقولها", "probability": 0.7838541666666666}, {"start": 957.71, "end": 958.21, "word": " انه", "probability": 0.800537109375}, {"start": 958.21, "end": 958.45, "word": " في", "probability": 0.93603515625}, {"start": 958.45, "end": 959.63, "word": " progressive", "probability": 0.8974609375}, {"start": 959.63, "end": 960.07, "word": " myopia", "probability": 0.955322265625}, {"start": 960.07, "end": 960.69, "word": " و", "probability": 0.5205078125}, {"start": 960.69, "end": 961.03, "word": " هذه", "probability": 0.333251953125}, {"start": 961.03, "end": 962.31, "word": " لو", "probability": 0.359130859375}, {"start": 962.31, "end": 962.69, "word": " وصلت", "probability": 0.9431966145833334}, {"start": 962.69, "end": 963.21, "word": " للمنتهى", "probability": 0.786474609375}, {"start": 963.21, "end": 963.79, "word": " خطيرة", "probability": 0.9166666666666666}, {"start": 963.79, "end": 964.63, "word": " لانها", "probability": 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30731, 4688, 9154, 16095], "avg_logprob": -0.3411989741179408, "compression_ratio": 1.707070707070707, "no_speech_prob": 1.7881393432617188e-07, "words": [{"start": 983.14, "end": 984.04, "word": "10", "probability": 0.0965576171875}, {"start": 984.04, "end": 984.74, "word": "%", "probability": 0.440673828125}, {"start": 984.74, "end": 985.18, "word": "-25", "probability": 0.6524658203125}, {"start": 985.18, "end": 985.92, "word": "%", "probability": 0.99365234375}, {"start": 985.92, "end": 986.4, "word": " بين", "probability": 0.377197265625}, {"start": 986.4, "end": 988.1, "word": " مايوابس", "probability": 0.517578125}, {"start": 988.1, "end": 989.64, "word": " Progressive", "probability": 0.4827677408854167}, {"start": 989.64, "end": 989.94, "word": " Myopia", "probability": 0.685302734375}, {"start": 989.94, "end": 990.16, "word": " بين", "probability": 0.90673828125}, {"start": 990.16, "end": 990.7, "word": " أطفال", "probability": 0.9639892578125}, {"start": 990.7, "end": 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0.74462890625}, {"start": 1004.82, "end": 1005.22, "word": " 80", "probability": 0.98046875}, {"start": 1005.22, "end": 1006.22, "word": " من", "probability": 0.8525390625}, {"start": 1006.22, "end": 1006.44, "word": " بين", "probability": 0.98876953125}, {"start": 1006.44, "end": 1007.08, "word": " الأطفال", "probability": 0.989013671875}, {"start": 1007.08, "end": 1007.32, "word": " ال", "probability": 0.82177734375}, {"start": 1007.32, "end": 1007.98, "word": " مايوابس", "probability": 0.78115234375}, {"start": 1007.98, "end": 1009.0, "word": " 60", "probability": 0.845703125}, {"start": 1009.0, "end": 1009.18, "word": " إلى", "probability": 0.9580078125}, {"start": 1009.18, "end": 1009.46, "word": " 80", "probability": 0.96337890625}, {"start": 1009.46, "end": 1010.12, "word": " منهم", "probability": 0.990234375}], "temperature": 1.0}, {"id": 34, "seek": 103608, "start": 1014.93, "end": 1036.09, "text": "أما يعني فرض على الباحثين أنه وجدوا وسيلة طبعا احنا اتعلمنا انه حطلهم ايش contact lenses او اللي هو multifocal او bifocal lenses واتعلمنا هذا في ال refraction لكن احد الناس اللي دخلوا الخط ال pharmacology استخدموا ال myops", "tokens": [10721, 15042, 37495, 22653, 6156, 43042, 15844, 29739, 39319, 12984, 9957, 14739, 3224, 49610, 3215, 14407, 46952, 26895, 3660, 23032, 3555, 3615, 995, 1975, 5016, 8315, 1975, 2655, 3615, 19528, 8315, 16472, 3224, 11331, 9566, 1211, 16095, 1975, 1829, 8592, 3385, 18059, 1975, 2407, 13672, 1829, 31439, 39824, 36483, 1975, 2407, 272, 351, 36483, 18059, 4032, 9307, 3615, 19528, 8315, 23758, 8978, 2423, 1895, 26766, 44381, 1975, 24401, 2423, 8315, 3794, 13672, 1829, 11778, 9778, 1211, 14407, 33962, 9566, 2423, 31818, 1793, 44713, 9778, 40448, 14407, 2423, 452, 3370], "avg_logprob": -0.2947916626930237, "compression_ratio": 1.5662100456621004, "no_speech_prob": 5.960464477539063e-08, "words": [{"start": 1014.93, "end": 1015.11, "word": "أما", "probability": 0.500640869140625}, {"start": 1015.11, "end": 1016.23, "word": " يعني", "probability": 0.891845703125}, {"start": 1016.23, "end": 1017.01, "word": " فرض", "probability": 0.93212890625}, {"start": 1017.01, "end": 1017.23, "word": " على", "probability": 0.8447265625}, {"start": 1017.23, "end": 1018.61, "word": " الباحثين", "probability": 0.977294921875}, {"start": 1018.61, "end": 1019.59, "word": " أنه", "probability": 0.5067138671875}, {"start": 1019.59, "end": 1019.89, "word": " وجدوا", "probability": 0.9186197916666666}, {"start": 1019.89, "end": 1020.51, "word": " وسيلة", "probability": 0.9713541666666666}, {"start": 1020.51, "end": 1021.87, "word": " طبعا", "probability": 0.785736083984375}, {"start": 1021.87, "end": 1022.13, "word": " احنا", "probability": 0.9474283854166666}, {"start": 1022.13, "end": 1022.69, "word": " اتعلمنا", "probability": 0.92255859375}, {"start": 1022.69, "end": 1023.05, "word": " انه", "probability": 0.746826171875}, {"start": 1023.05, "end": 1023.65, "word": " حطلهم", "probability": 0.62518310546875}, {"start": 1023.65, "end": 1023.95, "word": " ايش", "probability": 0.6957194010416666}, {"start": 1023.95, "end": 1025.35, "word": " contact", "probability": 0.32958984375}, {"start": 1025.35, "end": 1025.85, "word": " lenses", "probability": 0.81640625}, {"start": 1025.85, "end": 1027.55, "word": " او", "probability": 0.903076171875}, {"start": 1027.55, "end": 1027.97, "word": " اللي", "probability": 0.844970703125}, {"start": 1027.97, "end": 1028.29, "word": " هو", "probability": 0.97802734375}, {"start": 1028.29, "end": 1029.05, "word": " multifocal", "probability": 0.9365234375}, {"start": 1029.05, "end": 1029.23, "word": " او", "probability": 0.9404296875}, {"start": 1029.23, "end": 1029.73, "word": " bifocal", "probability": 0.8670247395833334}, {"start": 1029.73, "end": 1030.95, "word": " lenses", "probability": 0.5205078125}, {"start": 1030.95, "end": 1031.39, "word": " واتعلمنا", "probability": 0.87451171875}, {"start": 1031.39, "end": 1031.51, "word": " هذا", "probability": 0.61865234375}, {"start": 1031.51, "end": 1031.63, "word": " في", "probability": 0.73388671875}, {"start": 1031.63, "end": 1031.65, "word": " ال", "probability": 0.86083984375}, {"start": 1031.65, "end": 1032.03, "word": " refraction", "probability": 0.6527099609375}, {"start": 1032.03, "end": 1032.99, "word": " لكن", "probability": 0.837890625}, {"start": 1032.99, "end": 1033.21, "word": " احد", "probability": 0.45166015625}, {"start": 1033.21, "end": 1033.49, "word": " الناس", "probability": 0.9949544270833334}, {"start": 1033.49, "end": 1033.63, "word": " اللي", "probability": 0.804931640625}, {"start": 1033.63, "end": 1033.87, "word": " دخلوا", "probability": 0.7978515625}, {"start": 1033.87, "end": 1034.15, "word": " الخط", "probability": 0.72021484375}, {"start": 1034.15, "end": 1034.27, "word": " ال", "probability": 0.63427734375}, {"start": 1034.27, "end": 1034.91, "word": " pharmacology", "probability": 0.63623046875}, {"start": 1034.91, "end": 1035.59, "word": " استخدموا", "probability": 0.9737548828125}, {"start": 1035.59, "end": 1035.69, "word": " ال", "probability": 0.7919921875}, {"start": 1035.69, "end": 1036.09, "word": " myops", "probability": 0.49951171875}], "temperature": 1.0}, {"id": 35, "seek": 105044, "start": 1037.02, "end": 1050.44, "text": "و استخدموها يعني ال atropine و استخدموا ال atropine for a long time اقل شي سنة اكتر شي ست سنوات و فعلا وده نتائج جيدة في هذا الموضوع", "tokens": [2407, 44713, 9778, 40448, 2407, 11296, 37495, 22653, 2423, 412, 1513, 533, 4032, 44713, 9778, 40448, 14407, 2423, 412, 1513, 533, 337, 257, 938, 565, 1975, 4587, 1211, 44049, 8608, 1863, 3660, 1975, 4117, 2655, 2288, 44049, 8608, 2655, 8608, 1863, 2407, 9307, 4032, 6156, 3615, 15040, 4032, 3215, 3224, 8717, 2655, 16373, 7435, 10874, 25708, 3660, 8978, 23758, 9673, 2407, 11242, 45367], "avg_logprob": -0.19873047340661287, "compression_ratio": 1.4615384615384615, "no_speech_prob": 0.0, "words": [{"start": 1037.02, "end": 1037.22, "word": "و", "probability": 0.80615234375}, {"start": 1037.22, "end": 1038.04, "word": " استخدموها", "probability": 0.83447265625}, {"start": 1038.04, "end": 1039.0, "word": " يعني", "probability": 0.8291015625}, {"start": 1039.0, "end": 1039.24, "word": " ال", "probability": 0.50048828125}, {"start": 1039.24, "end": 1040.04, "word": " atropine", "probability": 0.7504069010416666}, {"start": 1040.04, "end": 1040.2, "word": " و", "probability": 0.552734375}, {"start": 1040.2, "end": 1040.6, "word": " استخدموا", "probability": 0.8505859375}, {"start": 1040.6, "end": 1040.64, "word": " ال", "probability": 0.935546875}, {"start": 1040.64, "end": 1041.12, "word": " atropine", "probability": 0.93505859375}, {"start": 1041.12, "end": 1041.92, "word": " for", "probability": 0.91455078125}, {"start": 1041.92, "end": 1042.02, "word": " a", "probability": 0.5732421875}, {"start": 1042.02, "end": 1042.18, "word": " long", "probability": 0.94873046875}, {"start": 1042.18, "end": 1042.54, "word": " time", "probability": 0.8876953125}, 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new file mode 100644
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0.88623046875}, {"start": 1685.68, "end": 1686.08, "word": " مكان", "probability": 0.99169921875}, {"start": 1686.08, "end": 1686.94, "word": " الحقنة", "probability": 0.987060546875}, {"start": 1686.94, "end": 1687.66, "word": " خمس", "probability": 0.92578125}, {"start": 1687.66, "end": 1688.04, "word": " دقائق", "probability": 0.92236328125}, {"start": 1688.04, "end": 1688.36, "word": " مثلا", "probability": 0.900146484375}, {"start": 1688.36, "end": 1689.22, "word": " حتى", "probability": 0.9052734375}, {"start": 1689.22, "end": 1690.24, "word": " يعني", "probability": 0.94091796875}, {"start": 1690.24, "end": 1690.98, "word": " يوقف", "probability": 0.9713541666666666}, {"start": 1690.98, "end": 1691.5, "word": " أي", "probability": 0.8076171875}, {"start": 1691.5, "end": 1692.0, "word": " سيل", "probability": 0.980224609375}, {"start": 1692.0, "end": 1692.46, "word": " للدم", "probability": 0.8994140625}], "temperature": 1.0}, {"id": 60, "seek": 172496, "start": 1698.14, "end": 1724.96, "text": "فهي ممكن في أي اسكليفة muscle في الجسم انه يكون في حقن ممكن الـtoed muscle مثلا ممكن اللي هو القفل يالب هنا الـhumerus ممكن في الفخل لكن ال common site هي gluteal region قفل الإنسان", "tokens": [5172, 3224, 1829, 3714, 43020, 8978, 36632, 24525, 4117, 20292, 5172, 3660, 8679, 8978, 25724, 38251, 16472, 3224, 7251, 30544, 8978, 11331, 4587, 1863, 3714, 43020, 2423, 39184, 1353, 292, 8679, 50113, 15040, 3714, 43020, 13672, 1829, 31439, 25062, 5172, 1211, 7251, 6027, 3555, 34105, 2423, 39184, 14645, 37287, 3714, 43020, 8978, 27188, 9778, 1211, 44381, 2423, 2689, 3621, 39896, 1563, 1169, 304, 4458, 12174, 5172, 1211, 33688, 1863, 3794, 7649], "avg_logprob": -0.3665364604029391, "compression_ratio": 1.6588235294117648, "no_speech_prob": 0.0, "words": [{"start": 1698.1399999999999, "end": 1699.34, "word": "فهي", "probability": 0.50164794921875}, {"start": 1699.34, "end": 1700.54, "word": " ممكن", "probability": 0.8134765625}, {"start": 1700.54, "end": 1700.8, "word": " في", 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عملوا", "probability": 0.8435872395833334}, {"start": 2143.52, "end": 2143.82, "word": " حاجة", "probability": 0.9886067708333334}, {"start": 2143.82, "end": 2144.3, "word": " اسمها", "probability": 0.9401041666666666}, {"start": 2144.3, "end": 2146.2, "word": " hypervolemia", "probability": 0.5878499348958334}, {"start": 2146.2, "end": 2147.88, "word": " للدم،", "probability": 0.7058919270833334}, {"start": 2147.88, "end": 2148.76, "word": " hypervolemia", "probability": 0.8684895833333334}, {"start": 2148.76, "end": 2149.32, "word": " الحاجة", "probability": 0.8336588541666666}, {"start": 2149.32, "end": 2150.44, "word": " ذات", "probability": 0.78466796875}], "temperature": 1.0}, {"id": 76, "seek": 217953, "start": 2151.07, "end": 2179.53, "text": "طيب .. جال .. جال .. يعني ال .. ال .. الدكتور جالهم اعطوه مثلا حقنا لكدا في الوريد ماحسبوش الجرعة بدل مثلا مايعطوا على جد الطفل مثلا نصف الجرعة او ربع الجرعة راحوا اعطوه جرعة كاملة لو ده أخدت ماقدرش نطلعها خلاص يعني اللي أخدها بال .. 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2597.65, "word": " بيسأل", "probability": 0.78505859375}, {"start": 2597.65, "end": 2598.21, "word": " عليهم", "probability": 0.845703125}, {"start": 2598.21, "end": 2599.61, "word": " انتراك", "probability": 0.618499755859375}, {"start": 2599.61, "end": 2600.47, "word": " فيكال", "probability": 0.7373046875}, {"start": 2600.47, "end": 2601.67, "word": " انجيكشن", "probability": 0.8492024739583334}, {"start": 2601.67, "end": 2601.67, "word": " انتراك", "probability": 0.716064453125}, {"start": 2601.67, "end": 2601.67, "word": " فيكال", "probability": 0.884765625}, {"start": 2601.67, "end": 2601.85, "word": " انجيكشن", "probability": 0.9927571614583334}, {"start": 2601.85, "end": 2601.85, "word": " انتراك", "probability": 0.82012939453125}, {"start": 2601.85, "end": 2601.85, "word": " فيكال", "probability": 0.9627278645833334}, {"start": 2601.85, "end": 2601.85, "word": " انجيكشن", "probability": 0.994384765625}, {"start": 2601.85, "end": 2602.51, "word": " انتراك", "probability": 0.83111572265625}, {"start": 2602.51, "end": 2602.51, "word": " فيكال", "probability": 0.95361328125}, {"start": 2602.51, "end": 2602.51, "word": " انجيكشن", "probability": 0.992431640625}, {"start": 2602.51, "end": 2604.77, "word": " انتراك", "probability": 0.8482666015625}, {"start": 2604.77, "end": 2605.25, "word": " فيكال", "probability": 0.9749348958333334}, {"start": 2605.25, "end": 2605.61, "word": " انجيكشن", "probability": 0.9905598958333334}, {"start": 2605.61, "end": 2605.61, "word": " انتراك", "probability": 0.890625}, {"start": 2605.61, "end": 2605.61, "word": " فيكال", "probability": 0.9881184895833334}, {"start": 2605.61, "end": 2605.67, "word": " انجيكشن", "probability": 0.9932454427083334}, {"start": 2605.67, "end": 2608.43, "word": " انتراك", "probability": 0.93212890625}, {"start": 2608.43, "end": 2608.43, "word": " فيكال", "probability": 0.9910481770833334}, {"start": 2608.43, "end": 2608.43, "word": " انجيكشن", "probability": 0.9943033854166666}, {"start": 2608.43, "end": 2608.81, "word": " انتراك", "probability": 0.9547119140625}, {"start": 2608.81, "end": 2608.91, "word": " فيكال", "probability": 0.9918619791666666}, {"start": 2608.91, "end": 2608.91, "word": " انجيكشن", "probability": 0.9949544270833334}, {"start": 2608.91, "end": 2609.01, "word": " انتراك", "probability": 0.9649658203125}, {"start": 2609.01, "end": 2609.17, "word": " فيكال", "probability": 0.9920247395833334}, {"start": 2609.17, "end": 2609.17, "word": " انجيكشن", "probability": 0.9945475260416666}, {"start": 2609.17, "end": 2609.21, "word": " انتراك", "probability": 0.96875}, {"start": 2609.21, "end": 2609.21, "word": " فيكال", "probability": 0.99072265625}, {"start": 2609.21, "end": 2609.21, "word": " انجيكشن", "probability": 0.9927571614583334}, {"start": 2609.21, "end": 2609.21, "word": " انتراك", "probability": 0.9705810546875}, {"start": 2609.21, "end": 2609.21, "word": " فيكال", "probability": 0.98876953125}, {"start": 2609.21, "end": 2609.21, "word": " انجيكشن", "probability": 0.9908040364583334}, {"start": 2609.21, "end": 2609.21, "word": " انتراك", "probability": 0.970703125}, {"start": 2609.21, "end": 2609.21, "word": " فيكال", "probability": 0.9869791666666666}, {"start": 2609.21, "end": 2609.21, "word": " انجيكشن", "probability": 0.9823404947916666}, {"start": 2609.21, "end": 2609.21, "word": " انتراك", "probability": 0.9716796875}, {"start": 2609.21, "end": 2609.21, "word": " فيكال", "probability": 0.98388671875}, {"start": 2609.21, "end": 2609.21, "word": " انجيكشن", "probability": 0.978515625}, {"start": 2609.21, "end": 2609.47, "word": " انتراك", "probability": 0.971923828125}, {"start": 2609.47, "end": 2610.17, "word": " فيكال", "probability": 0.9816080729166666}, {"start": 2610.17, "end": 2611.83, "word": " انجيكشن", "probability": 0.9651692708333334}, {"start": 2611.83, "end": 2613.31, "word": " انتراك", "probability": 0.972412109375}, {"start": 2613.31, "end": 2616.05, "word": " فيكال", "probability": 0.9781901041666666}, {"start": 2616.05, "end": 2616.65, "word": " انجيكش", "probability": 0.94677734375}], "temperature": 1.0}, {"id": 92, "seek": 262559, "start": 2623.35, "end": 2625.59, "text": "السلام عليكم ورحمة الله وبركاته", "tokens": [6027, 3794, 37440, 25894, 24793, 4032, 2288, 35571, 3660, 21984, 4032, 26890, 4117, 9307, 3224], "avg_logprob": -0.14392089564353228, "compression_ratio": 0.9666666666666667, "no_speech_prob": 1.7881393432617188e-07, "words": [{"start": 2623.35, "end": 2623.43, "word": "السلام", "probability": 0.780517578125}, {"start": 2623.43, "end": 2623.87, "word": " عليكم", "probability": 0.965576171875}, {"start": 2623.87, "end": 2624.55, "word": " ورحمة", "probability": 0.82415771484375}, {"start": 2624.55, "end": 2624.77, "word": " الله", "probability": 0.9814453125}, {"start": 2624.77, "end": 2625.59, "word": " وبركاته", "probability": 0.9822265625}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 2626.293, "duration_after_vad": 2313.0793749999925}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/56qoM90_Okc.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/56qoM90_Okc.srt
new file mode 100644
index 0000000000000000000000000000000000000000..0bae692727a2f5c462a0f34fce08d2af53ab1b50
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/56qoM90_Okc.srt
@@ -0,0 +1,1595 @@
+1
+00:00:20,920 --> 00:00:23,180
+بسم الله الرحمن الرحيم الحمد لله رب العالمين و
+
+2
+00:00:23,180 --> 00:00:25,420
+أصلي و أسلم على النبي الأمين محمد و على آله 
+
+3
+00:00:25,420 --> 00:00:29,200
+وأصحابه و التابعين السلام عليكم ورحمة الله وبركاته
+
+4
+00:00:29,200 --> 00:00:33,700
+في هذا اليوم سوف نبدأ فصلاً جديدًا حول استخدام
+
+5
+00:00:33,700 --> 00:00:39,260
+الصبغات في العين استخدام الصبغات في العين هي
+
+6
+00:00:39,260 --> 00:00:44,780
+diagnostic مش treatment يعني لما أعمل أنا staining
+
+7
+00:00:44,780 --> 00:00:49,740
+للقرنية to predict، diagnosing يعني أي قرنية
+
+8
+00:00:49,740 --> 00:00:54,380
+الابريجية هذا diagnostic لما أحقن الفلوريسين في
+
+9
+00:00:54,380 --> 00:00:58,580
+الوريد عشان أصور في ال phantasm camera الشبكية
+
+10
+00:00:58,580 --> 00:01:04,060
+عشان أكتشف أي defect في الشبكية هذا fluorescein
+
+11
+00:01:04,060 --> 00:01:08,640
+angiography هذا diagnostic عشان أحط الفلوريسين في
+
+12
+00:01:08,640 --> 00:01:12,200
+العين عشان أشوف ال potency للسليكون ال
+
+13
+00:01:18,450 --> 00:01:21,710
+لما أعمل ال fitting بتاع ال hard contact lenses في
+
+14
+00:01:21,710 --> 00:01:25,730
+العيين هذا diagnosis مش treatment يعني يبقى هي
+
+15
+00:01:25,730 --> 00:01:36,650
+diagnostic agents حقيقة ال usefulness of staining
+
+16
+00:01:36,650 --> 00:01:44,050
+في ال differential staining يعني أنه أنا لما أحط
+
+17
+00:01:44,050 --> 00:01:53,360
+الصبغة أقدر أعمل differential diagnosis هل أنه في
+
+18
+00:01:53,360 --> 00:01:57,460
+القرنية
+
+19
+00:01:57,460 --> 00:02:02,700
+ابريطين ولا لأ مثلاً هل في وشن أنجيوغرافي في
+
+20
+00:02:02,700 --> 00:02:07,700
+filling كامل ولا في defect هل obstruction أو nasal
+
+21
+00:02:07,700 --> 00:02:10,660
+lacrimal duct موجود؟ 
+
+22
+00:02:15,960 --> 00:02:22,020
+هذا اسمه differential diagnosis by the use أو
+
+23
+00:02:22,020 --> 00:02:27,620
+using of stains  أود أن أعرف أن في
+
+24
+00:02:27,620 --> 00:02:36,600
+الماضي كان هناك حوالي 34 نوعًا من الصبغات حوالي 34
+
+25
+00:02:36,600 --> 00:02:45,410
+في الماضي وأسماؤها جميلة كان مثلاً نسمع بالسفرانينو
+
+26
+00:02:45,410 --> 00:02:51,010
+و ال mandala red و ال brillant black و ال victorian
+
+27
+00:02:51,010 --> 00:02:56,370
+أسماؤها كلها اختفت الآن الأشياء التي available in
+
+28
+00:02:56,370 --> 00:03:00,790
+الاستخدام بشكل منتظم هم fluorescein and rose bengal
+
+29
+00:03:00,790 --> 00:03:06,110
+fluorescein فقط fluorescein and rose bengal
+
+30
+00:03:13,960 --> 00:03:17,820
+يعني إيش الذي أنا .. الصفات المثالية للصبغة التي 
+
+31
+00:03:17,820 --> 00:03:23,140
+لو أنا بدي أصنعها بدي يكون one يكون water soluble
+
+32
+00:03:23,140 --> 00:03:28,960
+يذوب في الماء وأي صبغة لا تذوب في الماء بيكون
+
+33
+00:03:28,960 --> 00:03:33,540
+toxic و
+
+34
+00:03:33,540 --> 00:03:39,940
+الصبغة التي تتحلل في intrusion مش هيكون تمام في الصفراء
+
+35
+00:03:39,940 --> 00:03:45,430
+يعني الذي هو lipid soluble مثلاً مش هيكون لأنه
+
+36
+00:03:45,430 --> 00:03:49,230
+الصبغة ضروري يكون water soluble عشان يتخلل الأنسجة
+
+37
+00:03:49,230 --> 00:03:56,010
+ما يكونش lipid soluble مثلاً واحد ثاني selectively
+
+38
+00:03:56,010 --> 00:04:00,510
+stain certain cells or structures in the eye يعني
+
+39
+00:04:00,510 --> 00:04:06,550
+أنا مش حاطتها عشان ألون كل العين بدي ألون نوعًا من ال
+
+40
+00:04:06,550 --> 00:04:15,440
+خلايا مثلاً epithelial cells مثلاً ويصبح يعني مكان
+
+41
+00:04:15,440 --> 00:04:19,540
+معين وأنواع معينة من الخلايا مش صابغة عامة يعني
+
+42
+00:04:19,540 --> 00:04:24,640
+مش زي صبغة الثياب حط الثياب في الصبغة بيطلع كله
+
+43
+00:04:24,640 --> 00:04:30,640
+مصبوغًا لا أنا بدي أحطها عشان تصبغ شيئًا و تبين defect
+
+44
+00:04:30,640 --> 00:04:37,720
+معين ما تصبغ كل المكان تلاتة  الصبغة skin
+
+45
+00:04:37,720 --> 00:04:39,700
+ما تصبغليش الجلد
+
+46
+00:04:53,440 --> 00:04:57,320
+ثالثًا، الصبغة يجب أن يكون من السهل إزالتها، يعني أنا ساعة
+
+47
+00:04:57,320 --> 00:05:03,260
+ما أحط الصبغة وبدي أشيلها بالماء، أشيلها بالماء،
+
+48
+00:05:03,260 --> 00:05:04,400
+أحط عليه مياه وبيطلع
+
+49
+00:05:28,680 --> 00:05:32,840
+مش حق تعمل حاجات
+
+50
+00:05:43,520 --> 00:05:49,780
+الصبغات يجب أن تكونوا غير مهيجة للوضع الطبيعي لما
+
+51
+00:05:49,780 --> 00:05:56,040
+يعملوا تهيج ولا
+
+52
+00:05:56,040 --> 00:06:03,880
+يعملوا نخس لأخير يجب أن تكونوا غير مهيجة خصوصًا
+
+53
+00:06:03,880 --> 00:06:10,620
+عندما يقوموا بالتغيير البيولوجي يعني ما يعملش مصابة
+
+54
+00:06:10,620 --> 00:06:12,080
+يعمل التهاب
+
+55
+00:06:19,380 --> 00:06:23,800
+طيب هذه تمام صفات لل ideal properties وهذا بتقول
+
+56
+00:06:23,800 --> 00:06:27,700
+أنه مش موجود هذا بتقول أنه مش موجود لهد أن يعمل
+
+57
+00:06:27,700 --> 00:06:35,780
+بعض الحاجة طيب فلوريسين اتكلم عنه أشهر واحد الآن
+
+58
+00:06:35,780 --> 00:06:40,520
+ال regular use for fluorescent دوليًا
+
+59
+00:06:50,200 --> 00:06:55,760
+fluorescein في high dilution لما أنا بخففه بيعمل
+
+60
+00:06:55,760 --> 00:07:03,340
+fluorescence نوعًا من التوهج نوعًا من التوهج used as a
+
+61
+00:07:03,340 --> 00:07:07,620
+topical stain كلمة topical يعني حطه سطحي آه موضعي
+
+62
+00:07:07,620 --> 00:07:12,980
+لا مش موضعي local موضعي يبدو  الحقنة الشيء الذي أحطه أنا
+
+63
+00:07:12,980 --> 00:07:16,540
+أحقنه زي البنج الموضعي هذا local لكن قطرة ال
+
+64
+00:07:27,220 --> 00:07:32,320
+يمكن استخدامه أيضًا كحقنة في fluorescein
+
+65
+00:07:32,320 --> 00:07:38,380
+angiography لما نتصور إحنا قاع العين نحطه
+
+66
+00:07:38,380 --> 00:07:42,660
+intravenous injection و بالكاميرا بتاعة العين أو
+
+67
+00:07:42,660 --> 00:07:47,440
+the fundus نأخذ الذي هو ال image الذي إحنا عايزينه
+
+68
+00:07:47,440 --> 00:07:52,640
+يبقى استخدامه topically أو injection بس في حالة
+
+69
+00:07:52,640 --> 00:07:57,050
+fluorescein angiographyThe normal corneal
+
+70
+00:07:57,050 --> 00:08:00,110
+epithelium is impermeable to the tear film and
+
+71
+00:08:00,110 --> 00:08:04,350
+substances dissolved in it يعني لما بيحطوا على
+
+72
+00:08:04,350 --> 00:08:10,090
+الطبقة السطحية السليمة وده القرنية ما أقدرش أنه يدخل
+
+73
+00:08:10,090 --> 00:08:15,110
+impermeable الذي هذا ال intact epithelium لكن لو
+
+74
+00:08:15,110 --> 00:08:17,470
+في خدش يدخل ويكون فيه  تفاعل 
+
+75
+00:08:24,760 --> 00:08:30,620
+الفلوريسين عالعيون هيك بعد دقائق ينزل لأنه لا يمتص
+
+76
+00:08:30,620 --> 00:08:35,060
+لأنه لا يمتص لأنه لا يمتص لأنه لا يمتص لأنه لا 
+
+77
+00:08:35,060 --> 00:08:35,680
+يمتص لأنه لا يمتص لأنه لا يمتص لأنه لا يمتص لأنه
+
+78
+00:08:35,680 --> 00:08:36,140
+لا يمتص لأنه لا يمتص لأنه لا يمتص لأنه لا يمتص
+
+79
+00:08:36,140 --> 00:08:38,660
+لأنه لا يمتص لأنه لا يمتص لأنه لا يمتص لأنه لا
+
+80
+00:08:38,660 --> 00:08:39,060
+يمتص لأنه لا يمتص لأنه لا يمتص لأنه لا يمتص لأنه
+
+81
+00:08:39,060 --> 00:08:40,980
+لا يمتص لأنه لا يمتص لأنه لا يمتص لأنه لا يمتص
+
+82
+00:08:40,980 --> 00:08:52,760
+لأنه لا يمتص لأنه لا يمتص لأنه 
+
+83
+00:08:52,760 --> 00:08:58,890
+لا الفلوريسين مستحلب بالماء ليس من جنس ال tear
+
+84
+00:08:58,890 --> 00:09:03,650
+film ولا من جنس ال corneal epithelium إذا كانت
+
+85
+00:09:03,650 --> 00:09:09,570
+هذه الطبقة  محطمة، محطمة يعني خدش،  سرطعة، فال tear
+
+86
+00:09:09,570 --> 00:09:12,030
+film يمكن أن يحصل على إتصال
+
+87
+00:09:18,490 --> 00:09:21,270
+هناك فرق في ال PH بين المادة،
+
+88
+00:09:21,690 --> 00:09:23,890
+السطح والطبقات العميقة وهذا
+
+89
+00:09:23,890 --> 00:09:28,270
+يسبب لون أخضر في منطقة هذا التكوين
+
+90
+00:09:28,270 --> 00:09:35,810
+يبقى أنا في حالة بيكون فيه corneal defect زي مثلاً
+
+91
+00:09:35,810 --> 00:09:44,950
+هنا corneal defect على طول هلاقي أن الفلوريسين 
+
+92
+00:09:44,950 --> 00:09:46,090
+دخل ال stream
+
+93
+00:09:52,600 --> 00:09:58,640
+أو مكان القرحة في الحالة هتظهر green color من
+
+94
+00:09:58,640 --> 00:10:03,180
+نتيجة اختلاف ال pH بين البشرة و الستروما في
+
+95
+00:10:03,180 --> 00:10:11,220
+اختلاف في ال PH طيب
+
+96
+00:10:11,220 --> 00:10:15,280
+العوامل التي تؤثر على الفلوريسين أو الفلوريسين هتكلم
+
+97
+00:10:15,280 --> 00:10:20,500
+باختصار ما هي العوامل التي تؤثر على أن الفلوريسين 
+
+98
+00:10:40,810 --> 00:10:47,790
+الـ PH بتاع 
+
+99
+00:10:47,790 --> 00:10:53,670
+محلول الفلوريسين كل ما كان عالي كل ما الفلوريسين يتوهج
+
+100
+00:10:53,670 --> 00:10:58,310
+أكثر وأفضل الصبغة بتاعة الخضراء اللون فال قلوية
+
+101
+00:10:58,310 --> 00:11:03,390
+يعني إيش القلوية بيكون strong alkaline قلوية
+
+102
+00:11:03,390 --> 00:11:10,050
+strong alkaline بيكون الفلوريسين بيعطي توهج أكثر
+
+103
+00:11:10,050 --> 00:11:13,870
+and thus the area of the pit is shown up المنطقة
+
+104
+00:11:13,870 --> 00:11:18,610
+الخدش بتاعة الابيثيليوم بنشوفها أكثر تكون واضحة أكثر
+
+105
+00:11:19,620 --> 00:11:25,720
+فأدعوا أأخذ من هذا أن لو ال pH واطي منخفض مثلاً ستة
+
+106
+00:11:25,720 --> 00:11:34,840
+بالكاد راح نشوف الفلوريسين لو ال PH منخفض تحت
+
+107
+00:11:34,840 --> 00:11:39,740
+السبعة بالكاد نشوف الفلوريسين وكل ما زاد ال PH
+
+108
+00:11:39,740 --> 00:11:43,940
+كل ما كان التوهج أكثر مثلاً زي هذه
+
+109
+00:11:54,740 --> 00:11:58,820
+الفلوريسين يبقى عامل ال PH والعامل الثاني defects
+
+110
+00:11:58,820 --> 00:12:04,640
+in the epithelium طبعًا كل ما كان ال defect أكبر كل
+
+111
+00:12:04,640 --> 00:12:09,000
+ما الفلوريسين دخل واخد طريقه ينتشر داخل  strong
+
+112
+00:12:09,000 --> 00:12:15,140
+وبالتالي يكون الوهج أكثر واللون أوضح لكن خدش
+
+113
+00:12:15,140 --> 00:12:22,220
+خفيفة زي ما بيقولوا يعني بسن القلم هتكون طبعًا توافق
+
+114
+00:12:22,220 --> 00:12:26,590
+خفيف لأن ما فيش انتشار للفلوريسين ف it fits in
+
+115
+00:12:26,590 --> 00:12:30,790
+epithelium عصر ثاني absorption of light energy
+
+116
+00:12:30,790 --> 00:12:35,410
+طبعًا أنتم عارفين ال light فيله طول موجي
+
+117
+00:12:35,410 --> 00:12:41,690
+wavelength فبقولي كل ما زاد ال wavelength الذي أنا 
+
+118
+00:12:41,690 --> 00:12:46,830
+بسلطه على العين كل ما أعطاني وهج أكثر يعني لما
+
+119
+00:12:46,830 --> 00:12:50,970
+أنا أقعدي مثلاً على ضوء شمعة  أسلط الفلوريسين في
+
+120
+00:12:50,970 --> 00:12:52,970
+العين هشوفه قليل
+
+121
+00:12:59,180 --> 00:13:03,640
+أحسن وهج للفلوريسين في العين في ال wave front
+
+122
+00:13:03,640 --> 00:13:12,240
+between 525 to 530 وهذا بيكون تقريبًا بالضوء
+
+123
+00:13:12,240 --> 00:13:16,640
+الأحمر تقريبًا بالضوء الأحمر، تعرفين الطول الموجي؟ 
+
+124
+00:13:16,640 --> 00:13:22,840
+أطول الطول الموجي هو الأحمر عمليًا إحنا بنستخدم معه ال
+
+125
+00:13:22,840 --> 00:13:24,420
+filter الأزرق ال Cobalt
+
+126
+00:13:28,670 --> 00:13:37,370
+ال Cobalt بتاع ال Violet هذا بينقل أضواء محددة
+
+127
+00:13:37,370 --> 00:13:42,150
+بينقل أضواء يعني ما يخليش ال .. ال .. ال .. ال light
+
+128
+00:13:42,150 --> 00:13:47,730
+الثاني قوي يعني أو .. أو .. أو يدخل كأنه فيه تخصص 
+
+129
+00:13:47,730 --> 00:13:55,990
+يعني كأنه فيه تخصص وفيه تناسب ما بين ال violet و
+
+130
+00:13:55,990 --> 00:14:00,230
+بين ال greenيعني قريبين من بعض يعني فعلاً أنا لما
+
+131
+00:14:00,230 --> 00:14:06,070
+بأخذ الأحمر لما بأخذ الأحمر علي الفلوريسين تاسيتلام 
+
+132
+00:14:06,070 --> 00:14:11,970
+بيكون قليل ال .. الوضوح يعني ما يوضحش بس بيكون قليل 
+
+133
+00:14:11,970 --> 00:14:18,070
+ساعة أما أنا أخد ال .. ال cobalt filter لأ بيكون
+
+134
+00:14:18,070 --> 00:14:25,210
+يعني متخصص فعلاً بيكون متخصص فعلاً طيب indications
+
+135
+00:14:25,210 --> 00:14:26,790
+follows ما هي
+
+136
+00:14:29,860 --> 00:14:32,340
+يعني الحالات التي تأتي لاستخدام فيها ال
+
+137
+00:14:32,340 --> 00:14:36,260
+fluorescein أو دوائل الصبغات الزرقاء detection of
+
+138
+00:14:36,260 --> 00:14:38,820
+defects in the cornea التي تأتي خدش وهذا دي
+
+139
+00:14:38,820 --> 00:14:43,060
+international ما هو أي طفل يحك عينه بيخاف أن يكون
+
+140
+00:14:51,430 --> 00:14:56,370
+حتى من ضوء النهار أقدر أنا أدرك أن فيه defect أشوف
+
+141
+00:14:56,370 --> 00:14:59,030
+من ضوء النهار أقدر أعرف أن فيه defect باللون
+
+142
+00:14:59,030 --> 00:15:06,050
+الأخضر contact lens fitting وها دي جاية شريحة عبقرية
+
+143
+00:15:06,050 --> 00:15:11,490
+نفس المعلومات فيه الذي هو المعلومات بتاع الذي هو
+
+144
+00:15:11,490 --> 00:15:15,850
+Goldman determination of nasal and lacrimal duct
+
+145
+00:15:15,850 --> 00:15:16,490
+patency
+
+146
+00:15:22,180 --> 00:15:27,620
+assessment of tear break up time وهذا جاي؟ آه الذي
+
+147
+00:15:27,620 --> 00:15:32,760
+هو مدى انتشار tear film هل هو عادي أو قصير؟ tear
+
+148
+00:15:32,760 --> 00:15:37,700
+flow assessment هل فعلاً يعني tear flow يعني مناسب
+
+149
+00:15:37,700 --> 00:15:42,140
+ولا غير مناسب نبدأ من الخطوة الأولى الذي هو corneal
+
+150
+00:15:42,140 --> 00:15:46,020
+defects والفلوريسين يجب أن يكون استخدامه رتينا 
+
+151
+00:15:46,020 --> 00:15:49,520
+لإزالة جسم غريب غير مستخدم لتحقيق أي ضرر
+
+152
+00:15:54,870 --> 00:15:59,070
+طبعًا لما بيجي foreign body في القرنية بيكون سريع
+
+153
+00:15:59,070 --> 00:16:05,010
+خاصة شغل الحدادين الحدادين
+
+154
+00:16:05,010 --> 00:16:10,130
+سيكون هو بيستخدم منشار الحديد بيكون السرعة بتاعته
+
+155
+00:16:10,130 --> 00:16:18,850
+مرتفعة جدًا فيبدأ الحديد الذي هو تحت المنشار يعني
+
+156
+00:16:18,850 --> 00:16:25,780
+يخرج منه نتوئات أو أجسام دقيقة من الحديدفإذا ضربت
+
+157
+00:16:25,780 --> 00:16:33,240
+في العين وهي ساخنة طبعًا راح تدخل يعني بسرعة حسب
+
+158
+00:16:33,240 --> 00:16:37,340
+حجمها وسرعتها ممكن تخترق إلى ال petrius أو إلى ال
+
+159
+00:16:37,340 --> 00:16:43,840
+retina أو تسدها بفتحة قنانية وتيجي في stroma ورا
+
+160
+00:16:43,840 --> 00:16:49,800
+المثير هو نصيب منها فهو
+
+161
+00:16:49,800 --> 00:16:53,860
+بيجي للطبيب بيشخص  مسألة أن في foreign body بده
+
+162
+00:16:53,860 --> 00:17:00,400
+هو يطلعه طبعًا نستخدم needle جوج صغير خالص الذي هو
+
+163
+00:17:00,400 --> 00:17:05,200
+needle of insulin بنطلعه تحت topical anesthesia
+
+164
+00:17:05,200 --> 00:17:11,680
+أحط قطرة مخدر زي ال xylocaine و بنطلع الجسم تمامًا
+
+165
+00:17:11,680 --> 00:17:16,260
+فأطلع الجسم الحديد وأقول له روح دفّن لا هذا قصة 
+
+166
+00:17:16,260 --> 00:17:22,270
+ثانية لسه قصة ثانية أولاً في bare area مش bare area
+
+167
+00:17:22,270 --> 00:17:29,030
+منطقة مكشوفة يعني لو قلنا هي الابيثيليوم ..
+
+168
+00:17:29,030 --> 00:17:33,810
+الابيثيليوم .. الابيثيليوم
+
+169
+00:17:33,810 --> 00:17:39,330
+بي .. أنا مش عارف اسمه الابيثيليوم بيغطي .. هاي
+
+170
+00:17:39,330 --> 00:17:46,250
+الابيثيليوم بيغطي القرنية دلوقت هاي الاسم الغريب
+
+171
+00:17:46,250 --> 00:17:55,640
+وقف هنا عمل إيه؟ و راح هنا شوية strong طبعًا
+
+172
+00:17:55,640 --> 00:18:00,620
+إحنا جينا وعملنا وأنا عملت extraction  كفيف قلّعناه
+
+173
+00:18:00,620 --> 00:18:04,180
+إيش الذي صار أن المنطقة هذه عملها هيك في التي بتيها
+
+174
+00:18:04,180 --> 00:18:09,840
+وهي strong هذه المنطقة بيها ال area حقي ما فيش فيها 
+
+175
+00:18:09,840 --> 00:18:19,860
+بتيها المنطقة مشهورة طبعًا في هنا nerve endings ما
+
+176
+00:18:19,860 --> 00:18:24,540
+هي nerve endings؟ هي أثر صار، مؤلمة جدًا، مؤلمة
+
+177
+00:18:24,540 --> 00:18:28,680
+جداً، تعرضها للضوء أو الماء أو شيء، ممكن تشوفها
+
+178
+00:18:28,680 --> 00:18:32,520
+تمامًا، لو الجرح عندنا، إحنا مشغولين من المنطقة، نفس
+
+179
+00:18:32,520 --> 00:18:39,900
+الشيء، الآن، بالحركة الفلوريسين، يبين أخضر
+
+180
+00:18:51,830 --> 00:19:02,430
+وبنبدأ patching أقل شهر 48 ساعة ويبقى
+
+1
+
+216
+00:21:48,590 --> 00:21:52,170
+معارض الـ contact lenses soft ليش الفيروسين 
+
+217
+00:21:54,970 --> 00:21:57,390
+الـ contact lens زي حالتك كراتو كونس مثلا أو الـ
+
+218
+00:21:57,390 --> 00:22:01,750
+high astigmatism بدي استخدم ايش لفلوريسيا يبقى one
+
+219
+00:22:01,750 --> 00:22:07,150
+fitting of rigid contact lens the thigh is in
+
+220
+00:22:07,150 --> 00:22:12,290
+studying the area where the lens is clearing or
+
+221
+00:22:12,290 --> 00:22:16,650
+touching the cornea in the case of contact lens
+
+222
+00:22:16,650 --> 00:22:22,790
+طبعا أنا عندي صورة هنا high hard contact lens في
+
+223
+00:22:22,790 --> 00:22:24,530
+ماطق خضراء وماطق زرقاء
+
+224
+00:22:36,240 --> 00:22:42,520
+في فراخ والأدرق يعني
+
+225
+00:22:42,520 --> 00:22:45,880
+مكان ما بتيجي الـ contact lens على صوتها القنانية
+
+226
+00:22:45,880 --> 00:22:51,340
+in contact على طول بيكون إبلاه وكده لأنه مافيش
+
+227
+00:22:51,340 --> 00:22:57,520
+مكان للي فروسين يدخل ومكان ما بتكون الـ lens
+
+228
+00:23:03,730 --> 00:23:08,830
+الفيروسين دخل مع كثير فيلم فبكون أخضر اللون طبعا
+
+229
+00:23:08,830 --> 00:23:13,570
+أنا لما بحط الـ lens وبقدر أحكم بالمنظر هذا هل الـ
+
+230
+00:23:13,570 --> 00:23:17,750
+fitting هذا صح ولا لأ؟ طبعا أصعب شيء أن يكون الـ
+
+231
+00:23:17,750 --> 00:23:21,230
+dependence جاي عليهش على الـ center الـ dependence
+
+232
+00:23:21,230 --> 00:23:24,850
+يكون على الـ center فيعمل مشاكل في الـ vision وفي
+
+233
+00:23:24,850 --> 00:23:28,690
+الـ oxygenation هذا في كل الـ lenses
+
+234
+00:23:48,830 --> 00:23:54,350
+السكليران contact lenses هتكون هي dependence
+
+235
+00:23:54,350 --> 00:24:00,260
+بتاعها على السكليرانو بعدين الكونيا شوية curvature
+
+236
+00:24:00,260 --> 00:24:05,800
+كاملة فأنا بقدر من الـ .. من الـ .. من الـ
+
+237
+00:24:05,800 --> 00:24:12,680
+fluorescent أن أعرف يعني مستوى المسافة ما بين اللي
+
+238
+00:24:12,680 --> 00:24:19,640
+هو الكونيا واللي هو كوتاكليز بيباني يعني مش لازم
+
+239
+00:24:19,640 --> 00:24:23,280
+scleral كوتاكليز تكون in contact with كونيا
+
+240
+00:24:27,940 --> 00:24:32,400
+تتعامل مع إغلاق هذه الملاحظات في التفاصيل المناسبة
+
+241
+00:24:32,400 --> 00:24:42,240
+فروسين
+
+242
+00:24:42,240 --> 00:24:45,740
+صوديوم لا يجب أن يكون استخدام للدراسة أو للتناسب
+
+243
+00:24:45,740 --> 00:24:52,320
+لأنها تبقى مباشرة تتبع تدخل إلى المادة يعني ممكن
+
+244
+00:24:52,320 --> 00:24:57,110
+أن الفروسين يدخل في نفس المادة ويكون irreversible
+
+245
+00:24:57,110 --> 00:25:01,830
+ما يقدرش يشيل طبعا هنا تلف الحالة يعني لأنه بأثر
+
+246
+00:25:01,830 --> 00:25:07,070
+على الـ vision يعني بعدين طبعا هنا هاي أكتر من حاجة
+
+247
+00:25:07,070 --> 00:25:13,670
+حتى هنا في defect معين في الموضوع هذا وهنا هاي الـ
+
+248
+00:25:13,670 --> 00:25:18,450
+fitting وهنا شوف ايش اللي هو الصورة وين الليل 
+249
+00:25:18,450 --> 00:25:18,750
+الأخضر
+
+250
+00:25:25,550 --> 00:25:29,610
+تستغرب ثاني للفلوريسين أبلينايشن تونومتر في
+
+251
+00:25:29,610 --> 00:25:35,210
+أبلينايشن 
+
+252
+00:25:35,210 --> 00:25:38,890
+تونومتر بيزي بيريتي الفلوريسين observed under
+
+253
+00:25:38,890 --> 00:25:44,390
+cobalt blue filter light again assumes practical
+
+254
+00:25:44,390 --> 00:25:51,890
+significance يعني احنا بدون فلوريسين صعب أنه احنا
+
+255
+00:25:51,890 --> 00:25:55,370
+نجري صدارة العين بهذا الجهاز وعلى فكرة
+
+256
+00:26:19,030 --> 00:26:21,590
+الجزء من المنطقة التي تم اكتشافها تم اكتشافها
+
+257
+00:26:21,590 --> 00:26:28,530
+باستخدام حلول الطي يعني احنا بنحط فلوريسين صحيح في
+
+258
+00:26:28,530 --> 00:26:35,610
+اللي هو الكون يبقى تيبت سك والكون هاي الكون هاي
+
+259
+00:26:35,610 --> 00:26:40,410
+الكون طبعا بيجي الكون القرنية القرن رأس الكون بيجي
+
+260
+00:26:40,410 --> 00:26:44,730
+القرنية في القرن القرنية عايش فيه فلوريسين وبنفضل
+
+261
+00:26:44,730 --> 00:26:46,730
+احنا نعمل adjustment
+
+262
+00:26:49,610 --> 00:26:55,170
+للجهاز لغاية ما نشوف اللي هو هذا الشكل وهذا في الـ
+
+263
+00:26:55,170 --> 00:27:01,350
+end point لو حدث هذا معناه أنه نقرأ على التدريج
+
+264
+00:27:01,350 --> 00:27:07,370
+كم ضغط العين طيب الـ concentration of Fluorescein
+
+265
+00:27:07,370 --> 00:27:11,290
+is very important بقول يعني التركيز في Fluorescein
+
+266
+00:27:11,290 --> 00:27:15,870
+مهم in this technique and it should not be too low
+
+267
+00:27:18,860 --> 00:27:21,800
+عشان يعطينا رؤية واضحة when the examiner
+
+268
+00:27:21,800 --> 00:27:26,520
+visibility of it is impaired or too high طبعا أحسن
+
+269
+00:27:26,520 --> 00:27:32,220
+شيء نحط اللي هو ايش fluorescein strips عارفين الـ
+
+270
+00:27:32,220 --> 00:27:36,820
+strips الـ fluorescein اه هذا ده التركيز الكويس مع
+
+271
+00:27:36,820 --> 00:27:42,340
+الدم هو جاف وبعدين مع الـ film بيكون الـ dilution
+
+272
+00:27:42,340 --> 00:27:48,690
+معقول لكن لو وضعنا solution من الأساس ممكن يكون
+
+273
+00:27:48,690 --> 00:27:53,870
+مخفف ويدخل العين يتخفف أكثر يتخفف أكثر الـ business
+
+274
+00:27:53,870 --> 00:27:58,430
+are often obtained when using Benoxin-A
+
+275
+00:27:58,430 --> 00:28:02,030
+-Hydrochloride هذا اللي هو the topical anesthetic
+
+276
+00:28:16,220 --> 00:28:20,500
+عشان فيه touch والمغاربة بيقولوا الناس الـ
+
+277
+00:28:20,500 --> 00:28:23,620
+autometrist في العالم بيستخدموا touchless
+
+278
+00:28:23,620 --> 00:28:32,380
+tonometry ايش يعني؟ بيقول لأ بدون ما تلمس القرانين،
+
+279
+00:28:32,380 --> 00:28:36,140
+والوحيد اللي بيعمل touchless tonometry ايش هو؟
+
+280
+00:28:36,140 --> 00:28:41,120
+air puff، بيعمل ايش؟ دربتين air وبيعمل digital
+
+281
+00:28:41,120 --> 00:28:48,210
+reading فهو عاقل صحيح بس مش دقيقة مش دقيقة يعني
+
+282
+00:28:48,210 --> 00:28:53,210
+ممكن العشرين مثلا يكتبها ثمانيتاشر يعني في يعني
+
+283
+00:28:53,210 --> 00:28:57,690
+تفويت شوية في القيمة هذا أضاف منه لكن هذا أيلكوا
+
+284
+00:28:57,690 --> 00:29:03,190
+أحسن لأنه مش عايزين أناستيزيا لأن القوية is very
+
+285
+00:29:03,190 --> 00:29:08,770
+sensitive organ يعني لو الهوى اجي عليها بحب حسه
+
+286
+00:29:08,770 --> 00:29:10,070
+كيف نعمل احنا
+
+287
+00:29:16,380 --> 00:29:20,000
+Goldman by employing sterile fluorescein paper
+
+288
+00:29:20,000 --> 00:29:22,760
+strips يبقى واضح اللي هو أشطة بتاعة الـ
+
+289
+00:29:22,760 --> 00:29:30,460
+fluorescein هي أفضل شيء because
+
+290
+00:29:30,460 --> 00:29:32,800
+goldman's type of national thermometer involves
+
+291
+00:29:32,800 --> 00:29:36,020
+contact with eye a typical aesthetic has to be
+
+292
+00:29:36,020 --> 00:29:39,660
+administered with fluorescein لازم اللي هو
+
+293
+00:29:49,560 --> 00:29:54,920
+طبعا هذه الصورة تشير
+
+294
+00:29:54,920 --> 00:30:00,340
+لـ lacrimal potency ايش lacrimal potency؟ نيزو
+
+295
+00:30:00,340 --> 00:30:07,200
+لقرم البطنسي أنه يعني هل هو normal ولا obstructed؟
+
+296
+00:30:07,200 --> 00:30:11,520
+اه هو يعني فيه obstruction طبعا الـ obstruction زي
+
+297
+00:30:11,520 --> 00:30:15,600
+ما قرتمتوا بيجي من الـ trauma أو بيجي من نيزر الـ
+
+298
+00:30:15,600 --> 00:30:15,940
+disease
+
+299
+00:30:20,760 --> 00:30:23,660
+طيب، to demonstrate the potency of the lacrimal
+
+300
+00:30:23,660 --> 00:30:26,660
+drainage system in patients complaining of
+
+301
+00:30:26,660 --> 00:30:32,580
+frequent untroublesome epiphora، what's epiphora؟
+
+302
+00:30:32,580 --> 00:30:36,800
+سيلان الدموع، جران الدموع أخد، هذا اسمه epiphora
+
+303
+00:30:51,640 --> 00:30:56,020
+لأنه عايز أنا مش أقيس على سطح القنانية لأ عايز
+
+304
+00:30:56,020 --> 00:31:05,140
+أجري لتحت الأنفة فلازم تكون سائق أو
+
+305
+00:31:05,140 --> 00:31:11,340
+أجيب
+
+306
+00:31:11,340 --> 00:31:14,520
+نفس الـ strip أحطه في محلول
+
+307
+00:31:17,440 --> 00:31:22,980
+طبعا الهدف منه أنه أعمل تسييل لفلوريسين، then a
+
+308
+00:31:22,980 --> 00:31:27,240
+new drop of saline solution are also installed in
+
+309
+00:31:27,240 --> 00:31:29,840
+the peripheral cell to decrease the volume of
+
+310
+00:31:29,840 --> 00:31:33,220
+liquid present and patients are asked to blow
+
+311
+00:31:33,220 --> 00:31:37,200
+their nose in a white tissue يعني أنا بعد خمس
+
+312
+00:31:37,200 --> 00:31:39,980
+دقائق بحطه كمان نفط الفلوريسين في العين اللي هو
+
+313
+00:31:39,980 --> 00:31:40,460
+فيه
+
+314
+00:31:46,280 --> 00:31:52,040
+فأجيب تيشو ورق أبيض نشاف كده بيقولوا يعني أعمل
+
+315
+00:31:52,040 --> 00:31:59,500
+broad للأنف يعني يحاول ينفد فإن نزل اللي هو اللي
+
+316
+00:31:59,500 --> 00:32:04,720
+من الأنف أي د ستشارد فيه fluorescein بيكون ايش؟
+
+317
+00:32:04,720 --> 00:32:09,840
+بيكون patent والمال ازناش احتمال يكون مغلق فأنا
+
+318
+00:32:09,840 --> 00:32:12,220
+مقدرش احتمال يكون مغلق إلا لما أشوف وضع الـ
+
+319
+00:32:12,220 --> 00:32:12,660
+puncture
+
+320
+00:32:19,660 --> 00:32:23,340
+بيصير stenosis أحيانا أو بيصير inversion أو
+
+321
+00:32:23,340 --> 00:32:27,300
+منversion أو حتى الـ .. الـ margin of eyelid كلها
+
+322
+00:32:27,300 --> 00:32:36,480
+بيصير لها تغيير في المكان تغيير في المكان طيب
+
+323
+00:32:36,480 --> 00:32:39,320
+your understanding of the tissue proves a potency
+
+324
+00:32:39,320 --> 00:32:41,760
+of lacrimal range of the particular eye
+
+325
+00:32:48,350 --> 00:32:55,390
+التفصيل مستمر في الـ eye. لا تشير إلى مصطلح البصيب
+
+326
+00:32:55,390 --> 00:32:57,450
+تتجه إلى البصيب تتجه إلى البصيب تتجه إلى البصيب
+
+327
+00:32:57,450 --> 00:32:59,650
+تتجه إلى البصيب تتجه إلى البصيب تتجه إلى البصيب
+
+328
+00:32:59,650 --> 00:33:01,510
+تتجه إلى البصيب تتجه إلى البصيب تتجه إلى البصيب
+
+329
+00:33:01,510 --> 00:33:04,270
+تتجه إلى البصيب تتجه إلى البصيب تتجه إلى البصيب
+
+330
+00:33:04,270 --> 00:33:08,270
+تتجه إلى البصيب تتجه إلى البصيب تتجه إلى البصيب
+
+331
+00:33:08,270 --> 00:33:09,610
+تتجه إلى البصيب تتجه إلى البصيب تتجه إلى البصيب
+
+332
+00:33:09,610 --> 00:33:17,110
+تتجه إلى البصيب تتجه إلى البصيب
+
+333
+00:33:17,640 --> 00:33:24,160
+هنا تشوف الاناتومي وهنا نازولاكت مالدكت في جزء
+
+334
+00:33:24,160 --> 00:33:32,800
+منه نازل وفي جزء منه بونى في البون اه شايفين كيف
+
+335
+00:33:32,800 --> 00:33:36,600
+الجزء اللي اللي هو فوق بيكون بونى وبعدين بينزل في
+
+336
+00:33:36,600 --> 00:33:42,930
+اللي هو الـ upper terminate of the laws وهنا تشوفي
+
+337
+00:33:42,930 --> 00:33:46,090
+كيف الـ .. نازي وجارتي وماله .. كيف الـ .. التسويق
+
+338
+00:33:46,090 --> 00:33:50,650
+اللي في الروسين فيه .. نازي هالبقى طبعا لو مش
+
+339
+00:33:50,650 --> 00:33:55,050
+بقتلت كان مثلا واقف هنا أو واقف هنا بيبان يعني طيب
+
+340
+00:33:55,050 --> 00:34:00,130
+assessment of tear film طبعا أنتم عارفين الـ tear
+
+341
+00:34:00,130 --> 00:34:06,870
+film يعني في بعض الحلال زي مثلا الـ .. الـ old age
+
+342
+00:34:16,670 --> 00:34:28,350
+ممكن أن يكون فيه defect في تيرفيلم إذا
+
+343
+00:34:28,350 --> 00:34:33,630
+رأيت تيرفيلم يمكن أن يكون استخدامه لتحسين وقت
+
+344
+00:34:33,630 --> 00:34:40,750
+الفيروسين الـ TBUT التي هي المقاومة بعد الانقلاق
+
+345
+00:34:40,750 --> 00:34:44,010
+لتظهر
+
+346
+00:34:44,010 --> 00:34:48,830
+في الـ precorneal A تيرفلم بعد انقلاق، يعني خلي
+
+347
+00:34:48,830 --> 00:34:55,370
+المريض يعمل انقلاق، غمضة يعني التيرفلم يصيب يوم
+
+348
+00:34:55,370 --> 00:34:59,370
+جديد، وإذا كان التير ملون بالفلورسين، فهو يصبح
+
+349
+00:34:59,370 --> 00:35:04,350
+فلوريسان، فلوريسان لير سيظهر بعد بعض الوقتيوجد
+
+350
+00:35:04,350 --> 00:35:07,310
+عليه مارش كريتر ده الانتر بلانك period convention
+
+351
+00:35:07,310 --> 00:35:15,690
+المهم أنه باختصار أنه احنا بنقدر بسلطنا نشوف الوقت
+
+352
+00:35:15,690 --> 00:35:20,750
+الزمن اللي مار مابين وضع الفلورسين ومابين ظهور الـ
+
+353
+00:35:20,750 --> 00:35:28,410
+defects في ايش في التير فيلم نقدر نشوف الـ defects
+
+354
+00:35:28,410 --> 00:35:31,170
+شايفين الـ defects كيف؟ بتتجمع؟
+
+355
+00:35:34,060 --> 00:35:39,720
+في الأول كانت كاملة وبنعد الوقت الزمني كم الوقت
+
+356
+00:35:39,720 --> 00:35:45,780
+الزمني يستغرق ظهور الـ defects اللي هو الـ tear film
+
+357
+00:35:45,780 --> 00:35:52,920
+فهنا بيقول ليه الـ break up time can be lengthened
+
+358
+00:35:52,920 --> 00:35:58,400
+by application of viscous drops يعني لو حطيت
+
+359
+00:35:58,400 --> 00:36:00,640
+drops viscous
+
+360
+00:36:07,480 --> 00:36:15,840
+ممكن أن الفليروسين يقبع أكثر في المكان، هذا معروف،
+
+361
+00:36:15,840 --> 00:36:20,080
+بس طبعا أنا مش عايز أحفظ فيسكس، عايز أكيس طبيعي،
+
+362
+00:36:20,080 --> 00:36:24,220
+هل الـ break up time normal ولا غير normal، قصير
+
+363
+00:36:24,220 --> 00:36:29,080
+ولا عادل؟ هو تقليد بشكل كبير في سندروم T-deficiency
+
+364
+00:36:29,080 --> 00:36:37,640
+مثل كيراتو كوندراتايفس سيكا أو سيكا يعني هلاجي أنا
+
+365
+00:36:37,640 --> 00:36:41,680
+الناس اللي عندهم الـ virus disease أو كيراتو
+
+366
+00:36:41,680 --> 00:36:45,820
+كوندراتايفس سيكا هلاجي أنه قصير الوقت على طول
+
+367
+00:36:45,820 --> 00:36:55,020
+بيظهر ايش الـ defect أسرع في 1980 considers انه
+
+368
+00:36:55,020 --> 00:36:56,040
+break up time of
+
+369
+00:36:59,770 --> 00:37:02,770
+فاطو جنومونيك أو dry eye فاطو جنومونيك علامة
+
+370
+00:37:02,770 --> 00:37:06,890
+تشخيصية أنه عنده dry eye لو أقل من عشر ثواني
+
+371
+00:37:06,890 --> 00:37:10,370
+وبدأت تبين الـ defect هنا ورانا ورانا على ساعة
+
+372
+00:37:10,370 --> 00:37:15,570
+القرانية بيكون ايش في عنده dry eye if the tear
+
+373
+00:37:15,570 --> 00:37:20,410
+film breaks up immediately الطائرات مفتوحة و
+
+374
+00:37:20,410 --> 00:37:25,410
+البريكز يظهر في نفس المكان ولكن هناك ربما بعض
+
+375
+00:37:25,410 --> 00:37:29,890
+البروكيز في هذه المناطق يعني ممكن أحيانا يكون
+
+376
+00:37:29,890 --> 00:37:35,490
+البريكز أفضل طبيعي لكن في .. في بعض اليوكوماز مثلا
+
+377
+00:37:35,490 --> 00:37:42,710
+في سطح القرن في بعض يعني disease معين
+
+378
+00:37:46,430 --> 00:37:50,610
+احنا يعني بنشخص أي وقت قبل ما نحط اللي هو 13 for
+
+379
+00:37:50,610 --> 00:37:55,990
+diagnosis or break-up time طبعا الـ dry eye مشكلة
+
+380
+00:37:55,990 --> 00:38:01,490
+جديدة بس هي تشخيص dry eye مشكلة كبيرة يعني معناه
+
+381
+00:38:01,490 --> 00:38:09,730
+أنه عايز compensate me tears forever وعايز
+
+382
+00:38:09,730 --> 00:38:14,090
+نموذج من الحياة forever بس كونه أنه كان a co
+
+383
+00:38:14,090 --> 00:38:19,470
+-optimist عادر على تشخيص dry eye هذا شرف ليه وبعد
+
+384
+00:38:19,470 --> 00:38:24,370
+هيك الـ treatment بيصير عليه كلام بيصير عليه كلام
+
+385
+00:38:24,370 --> 00:38:32,850
+طيب tears flow assessment نشوف تدفق مجرى اللي هو
+
+386
+00:38:32,850 --> 00:38:37,570
+الدم أو تدفق اللي هو الدم على صرف العين يعني أقصد
+
+387
+00:38:38,810 --> 00:38:41,330
+The half-life of dogs in the congenital cell is
+
+388
+00:38:41,330 --> 00:38:45,590
+very short الحقيقة أنه احنا قلنا فيه تجديد دائما
+
+389
+00:38:45,590 --> 00:38:50,930
+للدموع الـ outflow سريع it will depend on the
+
+390
+00:38:50,930 --> 00:38:53,790
+potency of the nasal lacrimal duct and the rate of
+
+391
+00:38:53,790 --> 00:38:58,650
+tear production بعتمد على تسرق الدموع في الـ nasal
+
+392
+00:38:58,650 --> 00:39:02,030
+lacrimal duct وعلى الـ rate of tear production
+
+393
+00:39:02,030 --> 00:39:05,170
+اللي هو إنتاج الدموع وتعرفين إنتاج الدموع بيصير
+
+394
+00:39:05,170 --> 00:39:12,100
+من عدة مصادر الجبلة بتجيبلي ايش؟wall frame، عندي
+
+395
+00:39:12,100 --> 00:39:18,280
+
+431
+00:42:57,980 --> 00:43:06,690
+حاطة العشري العينلو dropper لمس يد أي واحد أو لمس
+
+432
+00:43:06,690 --> 00:43:10,230
+رمش أي واحد أو لمس كوريا لأي واحد أو كتابة فيها
+
+433
+00:43:10,230 --> 00:43:16,490
+لأي واحد معناه البكتيريا دخلتها فلو
+
+434
+00:43:16,490 --> 00:43:19,050
+حطيناها بقى نكلا الناس التانية ممكن تعملوا كوريا
+
+435
+00:43:19,050 --> 00:43:23,010
+لأخر لذا contamination of fluorescein eye drops is a
+
+436
+00:43:23,010 --> 00:43:27,510
+very serious risk خطير، even greater than
+
+437
+00:43:27,510 --> 00:43:30,570
+they are encountered with the majority of other
+
+438
+00:43:30,570 --> 00:43:34,270
+eye drops أكثر من أي eye drop ثانية As these
+
+439
+00:43:34,270 --> 00:43:37,370
+individual's drops are liable to become infected
+
+440
+00:43:37,370 --> 00:43:42,510
+with bacteria and at the same time are frequently
+
+441
+00:43:42,510 --> 00:43:47,430
+used on damaged tissues that is prone to infection
+
+442
+00:43:47,430 --> 00:43:51,910
+يعني احنا بننقط للمرضى اللي عندهم قرحة الـ ulcer و
+
+443
+00:43:51,910 --> 00:43:56,930
+عندهم abrasion و عندهم infection فبتنتقل لـ drops
+
+444
+00:43:56,930 --> 00:44:04,190
+very great care must be taken in their use فقول
+
+445
+00:44:04,190 --> 00:44:08,910
+ليه؟ لازم أاخذ أقصر رياض الحرارة؟ لأن الـ PS
+
+446
+00:44:08,910 --> 00:44:13,430
+أرجينوزا اختصار الـ Pseudomonas أرجينوزا most
+
+447
+00:44:13,430 --> 00:44:18,970
+virulent bacteria for corneal invasion is an
+
+448
+00:44:18,970 --> 00:44:22,510
+especially dangerous pathological microorganisms
+
+449
+00:44:22,510 --> 00:44:26,230
+with which fluorescein eye-drops are inclined to
+
+450
+00:44:26,230 --> 00:44:31,890
+become invaded هذا شيء معروف عند العلماء في دعم
+
+451
+00:44:31,890 --> 00:44:36,870
+نيتريك استيت أو نيتريك في تركيز 2 على 1000
+
+452
+00:44:36,870 --> 00:44:40,550
+strength is the best bactericide for preservative
+
+453
+00:44:40,550 --> 00:44:45,020
+of these groups يعني الفلوريسيين انتوا عارفين
+
+454
+00:44:45,020 --> 00:44:49,680
+يعني هو منه سائل ومنه أقراص لو بنا .. يعني نحطله
+
+455
+00:44:49,680 --> 00:44:54,420
+preservative أفضل نحطله .. له إيش؟ أملاح الـ ..
+
+456
+00:44:54,420 --> 00:45:00,300
+أستيتي بتاعة الفينايل Mercury زبق أو نتري بقول إنه
+
+457
+00:45:00,300 --> 00:45:06,570
+هذا بكتريسيدل قوي للـ أرجينوزا هذه طبعا قربت لهوهو
+
+458
+00:45:06,570 --> 00:45:10,970
+مفيد ضد الـ Pseudomonas إذا كانت الوضع ممكن أن
+
+459
+00:45:10,970 --> 00:45:16,570
+تأخذ وقت طويل ولكن أقوى طريقة عملياتهم هي مجموعة
+
+460
+00:45:16,570 --> 00:45:20,770
+واحدة استرالية واحدة أو مجموعة استرالية بسيطة
+
+461
+00:45:20,770 --> 00:45:22,630
+بسيطة بسيطة بسيطة بسيطة بسيطة بسيطة بسيطة بسيطة
+
+462
+00:45:22,630 --> 00:45:25,850
+بسيطة بسيطة بسيطة بسيطة بسيطة بسيطة بسيطة بسيطة
+
+463
+00:45:36,210 --> 00:45:42,630
+أو إن ولابد أعمل جاف dry fluorescent strip جاف
+
+464
+00:45:42,630 --> 00:45:48,410
+لبكتيريا اللي لاتعيش في وسط الجاف both of which are
+
+465
+00:45:48,410 --> 00:45:51,590
+readily available and to be highly recommended
+
+466
+00:45:51,590 --> 00:45:55,030
+موجودين طبعا الـ strips احنا عندنا في البلد موجود
+
+467
+00:45:55,030 --> 00:45:59,170
+صح بس الـ monodrops drop بس مش موجود المرة الجاية
+
+468
+00:45:59,170 --> 00:46:01,770
+سوف أتكلم عن الـ rose bengal شكرا لكم على حسب
+
+469
+00:46:01,770 --> 00:46:02,270
+الإسلام 
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/56qoM90_Okc_raw.json b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/56qoM90_Okc_raw.json
new file mode 100644
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+{"segments": [{"id": 1, "seek": 5032, "start": 20.92, "end": 50.32, "text": "بسم الله الرحمن الرحيم الحمد لله رب العالمين و أصلي و أسلم على النبي الأمين محمد و على أهاليه وأصحابه و التابعين السلام عليكم ورحمة الله وبركاته في هذا اليوم سوف نبدأ فاصلا جديدا حول استخدام الصبغاء في العين استخدام الصبغاء في العين هي diagnostic مش treatment يعني لما اعمل انا staining الكورنيا to predict، diagnosing يعني أي كورنيا الابريجية", "tokens": [3555, 38251, 21984, 34892, 5016, 27842, 34892, 5016, 32640, 21542, 2304, 3215, 24976, 3224, 12602, 3555, 18863, 45340, 9957, 4032, 5551, 9381, 20292, 4032, 5551, 3794, 19528, 15844, 28239, 21292, 16247, 2304, 9957, 3714, 35571, 3215, 4032, 15844, 5551, 3224, 6027, 1829, 3224, 36725, 9381, 5016, 16758, 3224, 4032, 16712, 16758, 3615, 9957, 21136, 37440, 25894, 24793, 4032, 2288, 35571, 3660, 21984, 4032, 26890, 4117, 9307, 3224, 8978, 23758, 45595, 20498, 8608, 38688, 8717, 44510, 10721, 6156, 33546, 15040, 10874, 16254, 28259, 11331, 12610, 44713, 9778, 3215, 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18611, "start": 165.05, "end": 186.11, "text": "و ال mandala red و ال brillant black و ال victorian اسمها كله اختفى الان الاشياء اللي available in news regularly هم fluorescein and rosmangala fluorescein only fluorescein and rosmangala", "tokens": [2407, 2423, 7411, 5159, 2182, 4032, 2423, 8695, 394, 2211, 4032, 2423, 4403, 37832, 24525, 2304, 11296, 28242, 3224, 1975, 46456, 5172, 7578, 2423, 7649, 2423, 33599, 1829, 16606, 13672, 1829, 2435, 294, 2583, 11672, 8032, 2304, 5029, 2706, 384, 259, 293, 18953, 76, 656, 5159, 5029, 2706, 384, 259, 787, 5029, 2706, 384, 259, 293, 18953, 76, 656, 5159], "avg_logprob": -0.4147028727609603, "compression_ratio": 1.4966887417218544, "no_speech_prob": 0.0, "words": [{"start": 165.05, "end": 165.41, "word": "و", "probability": 0.95703125}, {"start": 165.41, "end": 165.73, "word": " ال", "probability": 0.2005615234375}, {"start": 165.73, "end": 166.65, "word": " mandala", "probability": 0.57025146484375}, {"start": 166.65, "end": 167.07, "word": " 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زي مثلا هنا corneal defect على طول هلاقي انه ال florescein دخل ال stream", "tokens": [51, 511, 68, 307, 257, 21677, 2649, 1296, 264, 12961, 11, 264, 3753, 293, 264, 2452, 644, 2451, 293, 341, 7700, 257, 3092, 2017, 294, 264, 1859, 295, 341, 11723, 7251, 3555, 4587, 7578, 1975, 8315, 8978, 11331, 6027, 3660, 4724, 1829, 30544, 8978, 3224, 1181, 716, 304, 16445, 30767, 1829, 50113, 15040, 34105, 1181, 716, 304, 16445, 15844, 23032, 12610, 8032, 15040, 38436, 16472, 3224, 2423, 932, 2706, 384, 259, 11778, 9778, 1211, 2423, 4309], "avg_logprob": -0.3766233812678944, "compression_ratio": 1.4714285714285715, "no_speech_prob": 0.0, "words": [{"start": 558.49, "end": 558.99, "word": "There", "probability": 0.5081685384114584}, {"start": 558.99, "end": 559.19, "word": " is", "probability": 0.861328125}, {"start": 559.19, "end": 559.43, "word": " a", "probability": 0.92822265625}, {"start": 559.43, "end": 559.69, "word": " pH", "probability": 0.7431640625}, {"start": 559.69, "end": 560.23, 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27188, 32887, 3794, 9957], "avg_logprob": -0.533482130084719, "compression_ratio": 0.8679245283018868, "no_speech_prob": 0.0, "words": [{"start": 640.8100000000001, "end": 642.21, "word": "الـ", "probability": 0.213104248046875}, {"start": 642.21, "end": 643.61, "word": " PH", "probability": 0.259765625}, {"start": 643.61, "end": 647.79, "word": " بتاع", "probability": 0.612060546875}, {"start": 647.79, "end": 648.77, "word": " محلول", "probability": 0.9444580078125}, {"start": 648.77, "end": 649.45, "word": " الفروسين", "probability": 0.8450927734375}], "temperature": 1.0}, {"id": 22, "seek": 67861, "start": 650.23, "end": 678.61, "text": "كل ما كان عالي كل ما الفلوريسين توهج أكتر و أفضل الصبغة بتاعة الخضراء اللون فال تمانية يعني ايش التمانية بيكون strong alkaline تمانية strong alkaline بيكون الفلوريسين بيعطي توهج أكتر and thus the area of the pit is shown up المنطقة الخش بتاع الامثليم بنشوفها أكتر تكون واضحة أكتر", "tokens": [28820, 19446, 25961, 6225, 6027, 1829, 28242, 19446, 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0.96044921875}, {"start": 697.24, "end": 697.54, "word": " fluorescent", "probability": 0.85693359375}, {"start": 697.54, "end": 698.4, "word": " وكل", "probability": 0.724365234375}, {"start": 698.4, "end": 698.64, "word": " ما", "probability": 0.9306640625}, {"start": 698.64, "end": 699.04, "word": " زاد", "probability": 0.9775390625}, {"start": 699.04, "end": 699.22, "word": " ال", "probability": 0.97705078125}, {"start": 699.22, "end": 699.74, "word": " pH", "probability": 0.97119140625}, {"start": 699.74, "end": 700.72, "word": " كل", "probability": 0.8935546875}, {"start": 700.72, "end": 701.62, "word": " ما", "probability": 0.92578125}, {"start": 701.62, "end": 701.78, "word": " كان", "probability": 0.94677734375}, {"start": 701.78, "end": 702.3, "word": " وهج", "probability": 0.8263346354166666}, {"start": 702.3, "end": 703.52, "word": " مثلا", "probability": 0.96337890625}, {"start": 703.52, "end": 703.68, "word": " زي", "probability": 0.843017578125}, {"start": 703.68, "end": 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"end": 1402.71, "word": " فيعمل", "probability": 0.623291015625}, {"start": 1402.71, "end": 1403.31, "word": " مشاكل", "probability": 0.7889811197916666}, {"start": 1403.31, "end": 1403.61, "word": " في", "probability": 0.95458984375}, {"start": 1403.61, "end": 1403.69, "word": " ال", "probability": 0.94287109375}, {"start": 1403.69, "end": 1403.95, "word": " vision", "probability": 0.9453125}, {"start": 1403.95, "end": 1404.59, "word": " و", "probability": 0.9697265625}, {"start": 1404.59, "end": 1404.85, "word": " في", "probability": 0.56298828125}, {"start": 1404.85, "end": 1405.21, "word": " ال", "probability": 0.94287109375}, {"start": 1405.21, "end": 1405.89, "word": " oxygenation", "probability": 0.902099609375}, {"start": 1405.89, "end": 1407.97, "word": " هذا", "probability": 0.83447265625}, {"start": 1407.97, "end": 1408.11, "word": " في", "probability": 0.513671875}, {"start": 1408.11, "end": 1408.29, "word": " كل", "probability": 0.974609375}, {"start": 1408.29, "end": 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{"start": 1448.26, "end": 1449.38, "word": " مستوى", "probability": 0.97021484375}, {"start": 1449.38, "end": 1451.32, "word": " المسافة", "probability": 0.98876953125}, {"start": 1451.32, "end": 1451.88, "word": " ما", "probability": 0.93408203125}, {"start": 1451.88, "end": 1452.2, "word": " بين", "probability": 0.986328125}, {"start": 1452.2, "end": 1452.68, "word": " اللي", "probability": 0.94482421875}, {"start": 1452.68, "end": 1452.92, "word": " هو", "probability": 0.9775390625}, {"start": 1452.92, "end": 1453.56, "word": " الكونيا", "probability": 0.9353841145833334}, {"start": 1453.56, "end": 1454.34, "word": " و", "probability": 0.806640625}, {"start": 1454.34, "end": 1454.92, "word": " اللي", "probability": 0.98291015625}, {"start": 1454.92, "end": 1455.26, "word": " هو", "probability": 0.98876953125}, {"start": 1455.26, "end": 1456.34, "word": " كوتاكليز", "probability": 0.7041219075520834}, {"start": 1456.34, "end": 1457.64, "word": " بيباني", "probability": 0.90263671875}, {"start": 1457.64, "end": 1457.94, "word": " يعني", "probability": 0.4649658203125}, {"start": 1457.94, "end": 1459.26, "word": " مش", "probability": 0.93798828125}, {"start": 1459.26, "end": 1459.64, "word": " لازم", "probability": 0.9892578125}, {"start": 1459.64, "end": 1460.46, "word": " scleral", "probability": 0.7027180989583334}, {"start": 1460.46, "end": 1461.46, "word": " كوتاكليز", "probability": 0.8785807291666666}, {"start": 1461.46, "end": 1461.72, "word": " تكون", "probability": 0.92578125}, {"start": 1461.72, "end": 1461.88, "word": " in", "probability": 0.94580078125}, {"start": 1461.88, "end": 1462.3, "word": " contact", "probability": 0.95361328125}, {"start": 1462.3, "end": 1462.62, "word": " with", "probability": 0.93994140625}, {"start": 1462.62, "end": 1463.28, "word": " كونيا", "probability": 0.8148600260416666}], "temperature": 1.0}, {"id": 49, "seek": 149492, "start": 1467.94, "end": 1494.92, "text": "تتعامل مع إغلاق هذه الملاحظات في التفاصيل المناسبة فروسين صوديوم لا يجب أن يكون استخدام للدراسة أو للتناسب لأنها تبقى مباشرة تتبع تدخل إلى المادة يعني ممكن أن الفروسين يدخل في نفس المادة", "tokens": [2655, 2655, 3615, 10943, 1211, 20449, 11933, 17082, 15040, 4587, 29538, 9673, 15040, 5016, 19913, 9307, 8978, 16712, 5172, 33546, 26895, 9673, 8315, 35457, 3660, 6156, 32887, 3794, 9957, 20328, 2407, 16254, 20498, 20193, 7251, 7435, 3555, 14739, 7251, 30544, 44713, 9778, 3215, 10943, 24976, 3215, 23557, 3794, 3660, 34051, 24976, 2655, 8315, 35457, 5296, 33456, 11296, 6055, 3555, 4587, 7578, 3714, 3555, 33599, 25720, 6055, 2655, 3555, 3615, 6055, 3215, 9778, 1211, 30731, 9673, 18513, 3660, 37495, 22653, 3714, 43020, 14739, 27188, 32887, 3794, 9957, 7251, 3215, 9778, 1211, 8978, 8717, 36178, 9673, 18513, 3660], "avg_logprob": -0.5963273195876289, "compression_ratio": 1.780104712041885, "no_speech_prob": 5.960464477539063e-08, "words": [{"start": 1467.94, "end": 1468.26, "word": "تتعامل", "probability": 0.6139404296875}, {"start": 1468.26, "end": 1468.74, "word": " مع", "probability": 0.81591796875}, {"start": 1468.74, "end": 1469.42, "word": " إغلاق", "probability": 0.5476837158203125}, {"start": 1469.42, "end": 1470.22, "word": " هذه", "probability": 0.75634765625}, {"start": 1470.22, "end": 1471.0, "word": " الملاحظات", "probability": 0.7762451171875}, {"start": 1471.0, "end": 1471.8, "word": " في", "probability": 0.56494140625}, {"start": 1471.8, "end": 1472.3, "word": " التفاصيل", "probability": 0.6925048828125}, {"start": 1472.3, "end": 1472.4, "word": " المناسبة", "probability": 0.882080078125}, {"start": 1472.4, "end": 1482.24, "word": " فروسين", "probability": 0.53179931640625}, {"start": 1482.24, "end": 1482.74, "word": " صوديوم", "probability": 0.700927734375}, {"start": 1482.74, "end": 1482.94, "word": " لا", "probability": 0.361083984375}, {"start": 1482.94, "end": 1483.08, "word": " يجب", "probability": 0.9169921875}, {"start": 1483.08, "end": 1483.18, "word": " أن", "probability": 0.66845703125}, {"start": 1483.18, "end": 1483.48, "word": " يكون", "probability": 0.766357421875}, {"start": 1483.48, "end": 1483.74, "word": " استخدام", "probability": 0.8486328125}, {"start": 1483.74, "end": 1484.34, "word": " للدراسة", "probability": 0.6612060546875}, {"start": 1484.34, "end": 1485.48, "word": " أو", "probability": 0.75048828125}, {"start": 1485.48, "end": 1485.74, "word": " للتناسب", "probability": 0.226470947265625}, {"start": 1485.74, "end": 1487.84, "word": " لأنها", "probability": 0.5547688802083334}, {"start": 1487.84, "end": 1488.28, "word": " تبقى", "probability": 0.6443328857421875}, {"start": 1488.28, "end": 1488.58, "word": " مباشرة", "probability": 0.3971405029296875}, {"start": 1488.58, "end": 1489.2, "word": " تتبع", "probability": 0.63421630859375}, {"start": 1489.2, "end": 1489.82, "word": " تدخل", "probability": 0.50244140625}, {"start": 1489.82, "end": 1490.48, "word": " إلى", "probability": 0.1497802734375}, {"start": 1490.48, "end": 1490.98, "word": " المادة", 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"probability": 0.869140625}, {"start": 1669.83, "end": 1670.21, "word": " يدخل", "probability": 0.9010009765625}, {"start": 1670.21, "end": 1670.63, "word": " العين", "probability": 0.938720703125}, {"start": 1670.63, "end": 1671.45, "word": " يتخفف", "probability": 0.9388671875}, {"start": 1671.45, "end": 1671.81, "word": " اكتر", "probability": 0.892578125}, {"start": 1671.81, "end": 1672.73, "word": " تخفف", "probability": 0.804473876953125}, {"start": 1672.73, "end": 1673.05, "word": " اكتر", "probability": 0.989013671875}, {"start": 1673.05, "end": 1673.61, "word": " ال", "probability": 0.3154296875}, {"start": 1673.61, "end": 1673.87, "word": " business", "probability": 0.1124267578125}, {"start": 1673.87, "end": 1674.29, "word": " are", "probability": 0.5380859375}, {"start": 1674.29, "end": 1674.63, "word": " often", "probability": 0.62109375}, {"start": 1674.63, "end": 1675.07, "word": " obtained", "probability": 0.5068359375}, {"start": 1675.07, "end": 1675.59, "word": " when", "probability": 0.489990234375}, {"start": 1675.59, "end": 1676.11, "word": " using", "probability": 0.95751953125}, {"start": 1676.11, "end": 1678.11, "word": " Benoxin", "probability": 0.4219156901041667}, {"start": 1678.11, "end": 1678.43, "word": "-A", "probability": 0.5252685546875}, {"start": 1678.43, "end": 1679.53, "word": "-Hydrochloride", "probability": 0.8097795758928571}, {"start": 1679.53, "end": 1679.99, "word": " هذا", "probability": 0.8798828125}, {"start": 1679.99, "end": 1680.35, "word": " اللي", "probability": 0.94580078125}, {"start": 1680.35, "end": 1680.65, "word": " هو", "probability": 0.98974609375}, {"start": 1680.65, "end": 1680.87, "word": " the", "probability": 0.134765625}, {"start": 1680.87, "end": 1681.35, "word": " topical", "probability": 0.854248046875}, {"start": 1681.35, "end": 1682.03, "word": " anesthetic", "probability": 0.75}], "temperature": 1.0}, {"id": 57, "seek": 172182, "start": 1696.22, "end": 1721.82, "text": "عشان فيه touch و المغاربة بيقولوا الناس ال autometrist في العالم بيستخدموا touchless tonometry اش يعني؟ بيقول لأ بدون ما تلمس القرانين، و الوحيد اللي بيعمل touchless tonometry ايش هو؟ air puff، بيعمل ايش؟ دربتين air و بيعمل digital reading", "tokens": [3615, 8592, 7649, 8978, 3224, 2557, 4032, 9673, 17082, 9640, 49401, 4724, 1829, 39648, 14407, 2423, 8315, 3794, 2423, 1476, 649, 12940, 8978, 18863, 45340, 4724, 1829, 14851, 9778, 40448, 14407, 2557, 1832, 2952, 34730, 1975, 8592, 37495, 22653, 22807, 4724, 1829, 39648, 5296, 10721, 47525, 11536, 19446, 6055, 19528, 3794, 25062, 2288, 7649, 9957, 12399, 4032, 2423, 2407, 5016, 25708, 13672, 1829, 4724, 1829, 25957, 1211, 2557, 1832, 2952, 34730, 1975, 1829, 8592, 31439, 22807, 1988, 19613, 12399, 4724, 1829, 25957, 1211, 1975, 1829, 8592, 22807, 11778, 25513, 2655, 9957, 1988, 4032, 4724, 1829, 25957, 1211, 4562, 3760], "avg_logprob": -0.2356250064074993, "compression_ratio": 1.672811059907834, "no_speech_prob": 0.0, "words": [{"start": 1696.22, "end": 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"word": " شكرا", "probability": 0.8782552083333334}, {"start": 2760.79, "end": 2761.15, "word": " لكم", "probability": 0.693603515625}, {"start": 2761.15, "end": 2761.59, "word": " على", "probability": 0.88525390625}, {"start": 2761.59, "end": 2761.77, "word": " حسب", "probability": 0.538818359375}, {"start": 2761.77, "end": 2762.27, "word": " الاسلام", "probability": 0.5208333333333334}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 2766.26275, "duration_after_vad": 2407.1031249999924}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/56qoM90_Okc_raw.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/56qoM90_Okc_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..98b8251d284d25403a9fb666f2b73fc4ab96ec01
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/56qoM90_Okc_raw.srt
@@ -0,0 +1,1876 @@
+1
+00:00:20,920 --> 00:00:23,180
+بسم الله الرحمن الرحيم الحمد لله رب العالمين و
+
+2
+00:00:23,180 --> 00:00:25,420
+أصلي و أسلم على النبي الأمين محمد و على أهاليه
+
+3
+00:00:25,420 --> 00:00:29,200
+وأصحابه و التابعين السلام عليكم ورحمة الله وبركاته
+
+4
+00:00:29,200 --> 00:00:33,700
+في هذا اليوم سوف نبدأ فاصلا جديدا حول استخدام
+
+5
+00:00:33,700 --> 00:00:39,260
+الصبغاء في العين استخدام الصبغاء في العين هي
+
+6
+00:00:39,260 --> 00:00:44,780
+diagnostic مش treatment يعني لما اعمل انا staining
+
+7
+00:00:44,780 --> 00:00:49,740
+الكورنيا to predict، diagnosing يعني أي كورنيا
+
+8
+00:00:49,740 --> 00:00:54,380
+الابريجيةهذا diagnostic لما احقن الفلوريسين في
+
+9
+00:00:54,380 --> 00:00:58,580
+الوريد عشان اصور في ال phantasm camera ال retina
+
+10
+00:00:58,580 --> 00:01:04,060
+عشان اكتشف اي defect في ال retina هذا fluorescein
+
+11
+00:01:04,060 --> 00:01:08,640
+angiography هذا diagnostic عشان احط الفلوريسين في
+
+12
+00:01:08,640 --> 00:01:12,200
+العين عشان اشوف ال potency سلكيان ال
+
+13
+00:01:18,450 --> 00:01:21,710
+لما عمل ال fitting بتاع ال hard contact lenses في
+
+14
+00:01:21,710 --> 00:01:25,730
+العيين هذا diagnosis مش treatment يعني يبقى هي
+
+15
+00:01:25,730 --> 00:01:36,650
+diagnostic agents حقيقة ال usefulness of staining
+
+16
+00:01:36,650 --> 00:01:44,050
+في ال differential staining يعني انه انا لما احط
+
+17
+00:01:44,050 --> 00:01:53,360
+ال stainبقدر اعمل differential diagnosis هل انه في
+
+18
+00:01:53,360 --> 00:01:57,460
+الكون
+
+19
+00:01:57,460 --> 00:02:02,700
+ابريطين ولا لأ مثلا هل في وشن أنجيوغرافي في
+
+20
+00:02:02,700 --> 00:02:07,700
+filling كامل ولا في defect هل obstruction او nasal
+
+21
+00:02:07,700 --> 00:02:10,660
+lacrimal duct موجود؟
+
+22
+00:02:15,960 --> 00:02:22,020
+هذا اسمه differential diagnosis by the use او
+
+23
+00:02:22,020 --> 00:02:27,620
+using of which states I like to know that in the
+
+24
+00:02:27,620 --> 00:02:36,600
+past there were about 34 types of states حوالي 34
+
+25
+00:02:36,600 --> 00:02:45,410
+في الماضي واسمها جميلة كان مثلا نسمع بالسفرانينو
+
+26
+00:02:45,410 --> 00:02:51,010
+ال mandala red و ال brillant black و ال victorian
+
+27
+00:02:51,010 --> 00:02:56,370
+اسمها كله اختفى الان الاشياء اللي available in
+
+28
+00:02:56,370 --> 00:03:00,790
+news regularly هم fluorescein and rosmangala
+
+29
+00:03:00,790 --> 00:03:06,110
+fluorescein only fluorescein and rosmangala
+
+30
+00:03:13,960 --> 00:03:17,820
+يعني إيش اللي أنا .. الصفات المثالية للستين اللي
+
+31
+00:03:17,820 --> 00:03:23,140
+لو أنا بدي أصنعه بدي يكون one يكون water soluble
+
+32
+00:03:23,140 --> 00:03:28,960
+يدوء في الماء و أي stain لا يدوء في الماء بيكون
+
+33
+00:03:28,960 --> 00:03:33,540
+toxic و
+
+34
+00:03:33,540 --> 00:03:39,940
+ال stain بتاعه في intrusion مش هيكون تمام في الصفر
+
+35
+00:03:39,940 --> 00:03:45,430
+يعني اللي هو lipid soluble مثلالأ مش هيكون لأنه
+
+36
+00:03:45,430 --> 00:03:49,230
+stain ضروري يكون water soluble عشان يتخلل الأنسين
+
+37
+00:03:49,230 --> 00:03:56,010
+مايكونش level soluble مثلا واحد تاني selectively
+
+38
+00:03:56,010 --> 00:04:00,510
+stain certain cells or structures in the eye يعني
+
+39
+00:04:00,510 --> 00:04:06,550
+أنا مش حاطة عشان ألون كل العين بدي ألون نوع من ال
+
+40
+00:04:06,550 --> 00:04:15,440
+cells مثلا epithelial cells مثلا ويصبحيعني مكان
+
+41
+00:04:15,440 --> 00:04:19,540
+معين و أنواع معينة من الخلايا مش صابغة عامة يعني
+
+42
+00:04:19,540 --> 00:04:24,640
+مش زي صابغة الثياب حط الثياب في الصابغة بيطلع كله
+
+43
+00:04:24,640 --> 00:04:30,640
+مصبوخ لأ انا بدي احطه عشان يصبغ شيء و يبين defect
+
+44
+00:04:30,640 --> 00:04:37,720
+معين مايصبغ كل المكان تلاتة شضمة stain skin
+
+45
+00:04:37,720 --> 00:04:39,700
+ماصبغليش skin
+
+46
+00:04:53,440 --> 00:04:57,320
+ثالثًا، الوضع يجب أن يكون مستحيلًا، يعني أنا ساعة
+
+47
+00:04:57,320 --> 00:05:03,260
+ما أحط الستيل و بدي أشيله بالوطن، أشيله بالوطن،
+
+48
+00:05:03,260 --> 00:05:04,400
+أحط عليه ميارة و بيطلع
+
+49
+00:05:28,680 --> 00:05:32,840
+مش حق يعمل حاجات
+
+50
+00:05:43,520 --> 00:05:49,780
+السمن يجب أن يكونوا غير مغلقين للوضع الطبيعي لما
+
+51
+00:05:49,780 --> 00:05:56,040
+يعملوا حرجان ولا
+
+52
+00:05:56,040 --> 00:06:03,880
+يعملوا نخس لأخير يجب أن يكونوا غير مغلقين خصوصا
+
+53
+00:06:03,880 --> 00:06:10,620
+عندما يقوموا بالتغيير البيولوجي يعني مايعملش مصابة
+
+54
+00:06:10,620 --> 00:06:12,080
+يعمل انفلامش
+
+55
+00:06:19,380 --> 00:06:23,800
+طيب هذه تمام صفات لل ideal properties وهذا بتقول
+
+56
+00:06:23,800 --> 00:06:27,700
+انه مش موجود هذا بتقول انه مش موجود لهد ان يعمل
+
+57
+00:06:27,700 --> 00:06:35,780
+بعض الحاجة طيب فلوريسين اتكلم عنه اشهر واحد الان
+
+58
+00:06:35,780 --> 00:06:40,520
+ال regular use for fluorescent internationally
+
+59
+00:06:50,200 --> 00:06:55,760
+florescence in high dilution لما انا بخاففه بيعمل
+
+60
+00:06:55,760 --> 00:07:03,340
+florescence نوع من التوهج نوع من التوهج used as a
+
+61
+00:07:03,340 --> 00:07:07,620
+topical stain كلمة topical يعني حطه سطحي اه موضع
+
+62
+00:07:07,620 --> 00:07:12,980
+لا مش موضع local موضع يبدو حجنة الشي اللي بحطه انا
+
+63
+00:07:12,980 --> 00:07:16,540
+بحجنة زي البنج الموضعي هذا local لكن قطرة ال
+
+64
+00:07:27,220 --> 00:07:32,320
+It can be also used as injection in fluorescein
+
+65
+00:07:32,320 --> 00:07:38,380
+angiography لما نتصور احنا قائلة الشبكية نحطه
+
+66
+00:07:38,380 --> 00:07:42,660
+intravenous injection و بالcamera of the eye او
+
+67
+00:07:42,660 --> 00:07:47,440
+the fundus ناخد اللي هو ال image اللي احنا عايزينه
+
+68
+00:07:47,440 --> 00:07:52,640
+يبقى استخدامه topically او injection بس في حالة
+
+69
+00:07:52,640 --> 00:07:57,050
+fluorescein angiographyThe normal conial
+
+70
+00:07:57,050 --> 00:08:00,110
+epithelium is imperiable to the tear film and
+
+71
+00:08:00,110 --> 00:08:04,350
+substances dissolved in it يعني لما بيحطوا على
+
+72
+00:08:04,350 --> 00:08:10,090
+intact epithelium و ده conia مابقدرش ان هو يدخل
+
+73
+00:08:10,090 --> 00:08:15,110
+imperiable اللي هدا ال intact epithelium لكن لو
+
+74
+00:08:15,110 --> 00:08:17,470
+كتش يدخل ليكون فيه دفكة
+
+75
+00:08:24,760 --> 00:08:30,620
+فلوريسين عالين هيك بعد دقائق منزل لأنه لا يمتص
+
+76
+00:08:30,620 --> 00:08:35,060
+لأنه لا يمتص لأنه لا يمتص لأنه لا يمتص لأنه لا
+
+77
+00:08:35,060 --> 00:08:35,680
+يمتص لأنه لا يمتص لأنه لا يمتص لأنه لا يمتص لأنه
+
+78
+00:08:35,680 --> 00:08:36,140
+لا يمتص لأنه لا يمتص لأنه لا يمتص لأنه لا يمتص
+
+79
+00:08:36,140 --> 00:08:38,660
+لأنه لا يمتص لأنه لا يمتص لأنه لا يمتص لأنه لا
+
+80
+00:08:38,660 --> 00:08:39,060
+يمتص لأنه لا يمتص لأنه لا يمتص لأنه لا يمتص لأنه
+
+81
+00:08:39,060 --> 00:08:40,980
+لا يمتص لأنه لا يمتص لأنه لا يمتص لأنه لا يمتص
+
+82
+00:08:40,980 --> 00:08:52,760
+لأنه لا يمتص لأنه لا يمتص لأنه
+
+83
+00:08:52,760 --> 00:08:58,890
+لا يالفلوريسين مستعمر بالماء ليس من جنس الـ tear
+
+84
+00:08:58,890 --> 00:09:03,650
+film ولا من جنس الـ corneal epithelium إذا كانت
+
+85
+00:09:03,650 --> 00:09:09,570
+هذه الحاجة محطمة، محطمة يعني خدش، سرقطع، فالـ tear
+
+86
+00:09:09,570 --> 00:09:12,030
+film يمكن أن يحصل على إتصال
+
+87
+00:09:18,490 --> 00:09:21,270
+There is a pH difference between the substance,
+
+88
+00:09:21,690 --> 00:09:23,890
+the surface and the deep partitions and this
+
+89
+00:09:23,890 --> 00:09:28,270
+causes a green color in the area of this formation
+
+90
+00:09:28,270 --> 00:09:35,810
+يبقى انا في حالة بيكون فيه corneal defect زي مثلا
+
+91
+00:09:35,810 --> 00:09:44,950
+هنا corneal defect على طول هلاقي انه ال florescein
+
+92
+00:09:44,950 --> 00:09:46,090
+دخل ال stream
+
+93
+00:09:52,600 --> 00:09:58,640
+أو مكان الالسة في الحالة هتظهر green color من
+
+94
+00:09:58,640 --> 00:10:03,180
+نتيجة اختلاف ال pH بين الابيثريام و الستروما في
+
+95
+00:10:03,180 --> 00:10:11,220
+اختلاف في ال pH طيب
+
+96
+00:10:11,220 --> 00:10:15,280
+factors affect the fluorescence او الفلورسين هتكلم
+
+97
+00:10:15,280 --> 00:10:20,500
+باختصار ما هي العوامل التي تؤثر على ان الفلورسين
+
+98
+00:10:40,810 --> 00:10:47,790
+الـ PH بتاع
+
+99
+00:10:47,790 --> 00:10:53,670
+محلول الفروسينكل ما كان عالي كل ما الفلوريسين توهج
+
+100
+00:10:53,670 --> 00:10:58,310
+أكتر و أفضل الصبغة بتاعة الخضراء اللون فال تمانية
+
+101
+00:10:58,310 --> 00:11:03,390
+يعني ايش التمانية بيكون strong alkaline تمانية
+
+102
+00:11:03,390 --> 00:11:10,050
+strong alkaline بيكون الفلوريسين بيعطي توهج أكتر
+
+103
+00:11:10,050 --> 00:11:13,870
+and thus the area of the pit is shown up المنطقة
+
+104
+00:11:13,870 --> 00:11:18,610
+الخش بتاع الامثليم بنشوفها أكتر تكون واضحة أكتر
+
+105
+00:11:19,620 --> 00:11:25,720
+فادعا اخد من هذا ان لو ال pH واضي منخفض مثلا ستة
+
+106
+00:11:25,720 --> 00:11:34,840
+بالكاد راح نشوف ال fluorescent لو ال pH منخفض تحت
+
+107
+00:11:34,840 --> 00:11:39,740
+السبعة بالكاد نشوف ال fluorescent وكل ما زاد ال pH
+
+108
+00:11:39,740 --> 00:11:43,940
+كل ما كان وهج مثلا زي هذه
+
+109
+00:11:54,740 --> 00:11:58,820
+الفلوريسين يبقى عامل ال PH والعامل التاني defects
+
+110
+00:11:58,820 --> 00:12:04,640
+in the epithelium طبعا كل ما كان ال defect أكبر كل
+
+111
+00:12:04,640 --> 00:12:09,000
+ما الفلوريسين دخل واخد طريقه ينتشر داخل strong
+
+112
+00:12:09,000 --> 00:12:15,140
+وبالتالي يكون الورد أكتر و اللون أوضح لكن كشتة
+
+113
+00:12:15,140 --> 00:12:22,220
+خفيفة زي ما بقولوا يعني بسن القلم هتكون طبعا توافق
+
+114
+00:12:22,220 --> 00:12:26,590
+خفيفلأن مافيش انتشار للفلوسينة ف it fit in
+
+115
+00:12:26,590 --> 00:12:30,790
+epithelium عصر تاني absorption of light energy
+
+116
+00:12:30,790 --> 00:12:35,410
+طبعا انتوا عارفين ال light فيله طول موجي
+
+117
+00:12:35,410 --> 00:12:41,690
+wavelength فبقولي كل ما زاد ال wavelength اللي انا
+
+118
+00:12:41,690 --> 00:12:46,830
+بصلقه على العين كل ما اعطاني واحد اكتر يعني لما
+
+119
+00:12:46,830 --> 00:12:50,970
+انا اقعدي مثلا على ضوء شمعة اكسب الفلوسينة في
+
+120
+00:12:50,970 --> 00:12:52,970
+العين هشوفه قلوة
+
+121
+00:12:59,180 --> 00:13:03,640
+أحسن وهج للفروسين في العين في ال wave front
+
+122
+00:13:03,640 --> 00:13:12,240
+between 525 to 530 و هذا بيكون تقريبا بالضوء
+
+123
+00:13:12,240 --> 00:13:16,640
+الأحمر تقريبا بالضوء الأحمر، تعرفين الطول نوجي؟
+
+124
+00:13:16,640 --> 00:13:22,840
+أطول الطول نوجي هو الأحمر عمش احنا بستخدم معاه ال
+
+125
+00:13:22,840 --> 00:13:24,420
+filter الأزرق ال COVID
+
+126
+00:13:28,670 --> 00:13:37,370
+الـ Cobalt بتاع الـ Violet هذا بينقل أضواء عملية
+
+127
+00:13:37,370 --> 00:13:42,150
+تنكت أضواء يعني مخليش ال .. ال .. ال .. ال light
+
+128
+00:13:42,150 --> 00:13:47,730
+التاني قوي يعني أو .. أو .. أو يدخل كأنه فيه تخصص
+
+129
+00:13:47,730 --> 00:13:55,990
+يعني كأنه فيه تخصص وفيه تناسب ما بين ال violet و
+
+130
+00:13:55,990 --> 00:14:00,230
+بين ال greenيعني جاربين من بعض يعني فعلا انا لما
+
+131
+00:14:00,230 --> 00:14:06,070
+باخد الأحمر لما باخد الأحمر علي الهيروسين تاسيتلام
+
+132
+00:14:06,070 --> 00:14:11,970
+بيكون جليل ال .. الوضوح يعني ميوضح بس بيكون جليل
+
+133
+00:14:11,970 --> 00:14:18,070
+ساعة اما انا اخد ال .. ال cobalt filter لأ بيكون
+
+134
+00:14:18,070 --> 00:14:25,210
+يعني متخصص فعلا بيكون متخصص فعلا طيب indications
+
+135
+00:14:25,210 --> 00:14:26,790
+follows ما هي
+
+136
+00:14:29,860 --> 00:14:32,340
+يعني الحالات اللي بتيجي استخدام فيها ال
+
+137
+00:14:32,340 --> 00:14:36,260
+fluorescein او دوائل الاسماء الورن detection of
+
+138
+00:14:36,260 --> 00:14:38,820
+defects in the colon اللي بتيجي افتحه وهذا دي
+
+139
+00:14:38,820 --> 00:14:43,060
+international ما هو اي طفل بيحك اينه بخاف ان يكون
+
+140
+00:14:51,430 --> 00:14:56,370
+حتى من ضوء النهار بقدر انا ادرك انه فيه defect شوف
+
+141
+00:14:56,370 --> 00:14:59,030
+من ضوء النهار بقدر اعرف انه فيه defect باللون
+
+142
+00:14:59,030 --> 00:15:06,050
+الأخضر contact lens fitting وها دي جاية شريحة عبقر
+
+143
+00:15:06,050 --> 00:15:11,490
+نفس التلوميتا فيه اللي هو التلوميتا بتاع اللي هو
+
+144
+00:15:11,490 --> 00:15:15,850
+Goldman determination of nasal and lacrimal duct
+
+145
+00:15:15,850 --> 00:15:16,490
+patency
+
+146
+00:15:22,180 --> 00:15:27,620
+assessment of tear break up time وهذا جاي؟ اه اللي
+
+147
+00:15:27,620 --> 00:15:32,760
+هو مدى انتشار tear film هل هو عادي او قصير؟ tear
+
+148
+00:15:32,760 --> 00:15:37,700
+flow assessment هل فعلا يعني tear flow يعني مناسب
+
+149
+00:15:37,700 --> 00:15:42,140
+ولا غير مناسب نبدأ من الخطوة الأولى اللي هو corner
+
+150
+00:15:42,140 --> 00:15:46,020
+defects والفلورسين يجب أن يكون استخدام رتينيا
+
+151
+00:15:46,020 --> 00:15:49,520
+لإزالة جسم غير مستخدم لتحقيق أي ضرر
+
+152
+00:15:54,870 --> 00:15:59,070
+طبعا لما بيجي foreign body فيه القرنية بيكون سريع
+
+153
+00:15:59,070 --> 00:16:05,010
+خاصة شغول الحددين الحددين
+
+154
+00:16:05,010 --> 00:16:10,130
+سيكون هو بيستخدم منشار الحديد بيكون السرعة بتاعته
+
+155
+00:16:10,130 --> 00:16:18,850
+مرتفعة جدا فيبدأ الحديد اللي هو تحت المنشار يعني
+
+156
+00:16:18,850 --> 00:16:25,780
+يخرج منه نتوئات او اجسام دقيقة من الحديدفإذا ضربت
+
+157
+00:16:25,780 --> 00:16:33,240
+في العين و هي ساخنة طبعا راح تدخل يعني بسرعة حسب
+
+158
+00:16:33,240 --> 00:16:37,340
+حجمها و سرعتها ممكن تخترب إلى ال petrius او إلى ال
+
+159
+00:16:37,340 --> 00:16:43,840
+retina او يسدها برثة قنانية و تيجي فى stroma ورا
+
+160
+00:16:43,840 --> 00:16:49,800
+المثير هو نصيب منها فهو
+
+161
+00:16:49,800 --> 00:16:53,860
+بيجي للطبيببيشخص مسلتلان انه في foreign body بده
+
+162
+00:16:53,860 --> 00:17:00,400
+هو يطلعه طبعا بستخدم needle جوج صغير خالص اللي هو
+
+163
+00:17:00,400 --> 00:17:05,200
+needle of insulin بنطلعه تحت topical anesthesia
+
+164
+00:17:05,200 --> 00:17:11,680
+بحط قطرة mint زي الوكالين و بنطلع الجسم تماما
+
+165
+00:17:11,680 --> 00:17:16,260
+فأطلع الجسم الحديد و أقول له اروح دفك لأ هذا قصة
+
+166
+00:17:16,260 --> 00:17:22,270
+تانية لسه قصة تانية اولا في bare areaمش bare area
+
+167
+00:17:22,270 --> 00:17:29,030
+منطقة مكشوفة يعني لو قلنا هي الابفيليام ..
+
+168
+00:17:29,030 --> 00:17:33,810
+الابفيليام .. الابفيليام
+
+169
+00:17:33,810 --> 00:17:39,330
+بي .. انا مش عارف اسمه الابفيليام بيغطي .. هاي
+
+170
+00:17:39,330 --> 00:17:46,250
+الابفيليام بيغطي القرانية دلوقت هاي الاسم الغريب
+
+171
+00:17:46,250 --> 00:17:55,640
+وقف هنا عمل ايه؟ و رست هناشوية strong طبعا
+
+172
+00:17:55,640 --> 00:18:00,620
+احنا جينا وعملنا و انا عملت extraction كفيف قلعناه
+
+173
+00:18:00,620 --> 00:18:04,180
+اش اللي صار ان المنطقة هذه عملها هيك في اللي بتيها
+
+174
+00:18:04,180 --> 00:18:09,840
+وهي strong هذه المنطقة بيها ال area حقي مافيش فيها
+
+175
+00:18:09,840 --> 00:18:19,860
+بيتيها المنطقة مشهورة طبعا في هنا lay up endingsما
+
+176
+00:18:19,860 --> 00:18:24,540
+هي nerve endings؟ هي أثر صار، مؤلمة جدا، مؤلمة
+
+177
+00:18:24,540 --> 00:18:28,680
+جدا، تعرضها للضوء أو الماء أو شيء، ممكن تشوفها
+
+178
+00:18:28,680 --> 00:18:32,520
+تماما، لو الجن عندنا، احنا مشغول من المنطقة، نفس
+
+179
+00:18:32,520 --> 00:18:39,900
+الشيء، الآن، بالحركة الورسين، يبين أخضر
+
+180
+00:18:51,830 --> 00:19:02,430
+وبيدوا patching أقل شهر أربعين ساعة ويبقى
+
+181
+00:19:02,430 --> 00:19:04,470
+24 ساعة ويبقى 24 ساعة ويبقى 24 ساعة ويبقى 24 ساعة
+
+182
+00:19:04,470 --> 00:19:11,230
+ويبقى 24 ساعة ويبقى 24 ساعة ويبقى 24 ساعة ويبقى 24
+
+183
+00:19:11,230 --> 00:19:12,570
+ساعة ويبقى 24 ساعة ويبقى 24 ساعة ويبقى 24 ساعة
+
+184
+00:19:12,570 --> 00:19:12,790
+ويبقى 24 ساعة ويبقى 24 ساعة ويبقى 24 ساعة ويبقى 24
+
+185
+00:19:12,790 --> 00:19:13,890
+ساعة ويبقى 24 ساعة ويبقى 24 ساعة ويبقى 24 ساعة
+
+186
+00:19:13,890 --> 00:19:15,130
+ويبقى 24 ساعة ويبقى 24 ساعة ويبقى 24 ساعة ويبقى 24
+
+187
+00:19:15,130 --> 00:19:15,710
+ساعة ويبقى 24 س
+
+188
+00:19:26,460 --> 00:19:30,580
+يقول يبقى أنا بقصبه بعد ما طلع الجسم غريب بقصبه
+
+189
+00:19:30,580 --> 00:19:34,100
+بالإيش بالفلوسينة if a small foreign body has
+
+190
+00:19:34,100 --> 00:19:37,820
+penetrated the eye a corresponding grain rival it
+
+191
+00:19:37,820 --> 00:19:43,480
+will be seen issuing from the interior wall فتفرضي
+
+192
+00:19:43,480 --> 00:19:48,620
+أن هذا الفلوسينة دخل ورا القرنية مثلًا راعي الائرز
+
+193
+00:19:48,620 --> 00:19:52,820
+أو الcellar body على الأقل أنه هيعطيني الفلوسينة
+
+194
+00:19:52,820 --> 00:19:54,620
+أن هنا دخل من هنا
+
+195
+00:19:57,800 --> 00:20:03,340
+في يعني منطقة صغيرة خضراء فالوضع الفاروسيين will
+
+196
+00:20:03,340 --> 00:20:07,360
+also demonstrate قوام الألثار that might be better
+
+197
+00:20:07,360 --> 00:20:10,980
+to use rose bengal which is more selective بعدين
+
+198
+00:20:10,980 --> 00:20:14,360
+بنتكلم مع rose bengal امثلة الاروجينز ايش
+
+199
+00:20:14,360 --> 00:20:20,240
+الاروجينز؟ اه ايه يعني انت قلتلتش؟ due to tracheas
+
+200
+00:20:20,240 --> 00:20:27,300
+اتعرفوا tracheas؟ ايش tracheas؟ انترجن of the
+
+201
+00:20:27,300 --> 00:20:27,760
+eyelash
+
+202
+00:20:35,010 --> 00:20:40,890
+Rubbing glasses. فبقول يعني في الحالة هذه صعب ان
+
+203
+00:20:40,890 --> 00:20:44,590
+احط انا فيروسين of little help in diagnosis of
+
+204
+00:20:44,590 --> 00:20:49,210
+keratoconnectivist zika يعني في ال .. في ال spring
+
+205
+00:20:49,210 --> 00:20:51,810
+katara صعب احط فيروسين ان انا بتيجي بقى
+
+206
+00:20:51,810 --> 00:20:55,050
+superficial other forms of connectivitis
+
+207
+00:20:59,400 --> 00:21:04,920
+لأنه مافيش إزالة كاملة لإبثاليوم Superficial
+
+208
+00:21:04,920 --> 00:21:12,220
+Erosions يعني بس خدوش خفيفة و سطحية لإبثاليوم
+
+209
+00:21:12,220 --> 00:21:16,420
+طبعا الصورة هذه محتاجة فيها واضح فيها طبعا هنا
+
+210
+00:21:16,420 --> 00:21:23,220
+استخدمنا ال cobalt وهنا اللي هو ال red light ال
+
+211
+00:21:23,220 --> 00:21:27,560
+cobalt طبعا أوضح نبدأ
+
+212
+00:21:27,560 --> 00:21:32,590
+بال contact lens fittingcontact lenses اللى
+
+213
+00:21:32,590 --> 00:21:39,230
+بتستخدم لازم تكون rigid لكن لو وضعنا soft contact
+
+214
+00:21:39,230 --> 00:21:42,810
+lenses مع الفيروسين عصير ال coloration حدهم سبب
+
+215
+00:21:42,810 --> 00:21:48,590
+يبقى هو بيصبح ال soft contact lenses عشان هيك انا
+
+216
+00:21:48,590 --> 00:21:52,170
+معارض ال contact lenses soft ليش الفيروسين
+
+217
+00:21:54,970 --> 00:21:57,390
+الـ contact lens زي حالتك كراتو كونس مثلا او الـ
+
+218
+00:21:57,390 --> 00:22:01,750
+high astigmatism بدي استخدم ايش لفلوريسيا يبقى one
+
+219
+00:22:01,750 --> 00:22:07,150
+fitting of rigid contact lens the thigh is in
+
+220
+00:22:07,150 --> 00:22:12,290
+studying the area where the lens is clearing or
+
+221
+00:22:12,290 --> 00:22:16,650
+touching the cunea in the case of contact lens
+
+222
+00:22:16,650 --> 00:22:22,790
+طبعا انا عندي صورة هنا high hard contact lens في
+
+223
+00:22:22,790 --> 00:22:24,530
+ماطق خضراء وماطق زرقاء
+
+224
+00:22:36,240 --> 00:22:42,520
+في فراخ و الأدرق يعني
+
+225
+00:22:42,520 --> 00:22:45,880
+مكان ما بتيجي ال contact lens على صوتها القنانية
+
+226
+00:22:45,880 --> 00:22:51,340
+in contact على طول بيكون إبلاه و كده لأنه مافيش
+
+227
+00:22:51,340 --> 00:22:57,520
+مكان للي فروسين يدخل و مكان ما بتكون ال lens
+
+228
+00:23:03,730 --> 00:23:08,830
+الفيروسين دخل مع كثير فيلم فبكون أخضر اللون طبعا
+
+229
+00:23:08,830 --> 00:23:13,570
+انا لما بحط ال lens و بقدر احكم بالمنظر هذا هل ال
+
+230
+00:23:13,570 --> 00:23:17,750
+fitting هذا صح ولا لأ طبعا اصعب شئ ان يكون ال
+
+231
+00:23:17,750 --> 00:23:21,230
+dependence جاي عليهش على ال center ال dependence
+
+232
+00:23:21,230 --> 00:23:24,850
+يكون على ال center فيعمل مشاكل في ال vision و في
+
+233
+00:23:24,850 --> 00:23:28,690
+ال oxygenation هذا في كل ال lenses
+
+234
+00:23:48,830 --> 00:23:54,350
+السكليران contact lenses هتكون هي dependence
+
+235
+00:23:54,350 --> 00:24:00,260
+بتاعها على السكليرانو بعدين الكونيا شوية curvature
+
+236
+00:24:00,260 --> 00:24:05,800
+كاملة فانا بقدر من ال .. من ال .. من ال
+
+237
+00:24:05,800 --> 00:24:12,680
+fluorescent ان اعرف يعني مستوى المسافة ما بين اللي
+
+238
+00:24:12,680 --> 00:24:19,640
+هو الكونيا و اللي هو كوتاكليز بيباني يعني مش لازم
+
+239
+00:24:19,640 --> 00:24:23,280
+scleral كوتاكليز تكون in contact with كونيا
+
+240
+00:24:27,940 --> 00:24:32,400
+تتعامل مع إغلاق هذه الملاحظات في التفاصيل المناسبة
+
+241
+00:24:32,400 --> 00:24:42,240
+فروسين
+
+242
+00:24:42,240 --> 00:24:45,740
+صوديوم لا يجب أن يكون استخدام للدراسة أو للتناسب
+
+243
+00:24:45,740 --> 00:24:52,320
+لأنها تبقى مباشرة تتبع تدخل إلى المادة يعني ممكن
+
+244
+00:24:52,320 --> 00:24:57,110
+أن الفروسين يدخل في نفس المادةو يكون irreversible
+
+245
+00:24:57,110 --> 00:25:01,830
+ما يقدرش يشيل طبعا هنا تلف الحالة يعني لأنه بأثر
+
+246
+00:25:01,830 --> 00:25:07,070
+على ال vision يعني بعدين طبعا هنا هاي أكتر من حاجة
+
+247
+00:25:07,070 --> 00:25:13,670
+حتى هنا في defect معين في الموضوع هذا وهنا هاي ال
+
+248
+00:25:13,670 --> 00:25:18,450
+fitting وهنا شوف إيش اللي هو الصورة وين الليل
+
+249
+00:25:18,450 --> 00:25:18,750
+الأخضر
+
+250
+00:25:25,550 --> 00:25:29,610
+تستغرب تاني للفلوريسين أبلينايشن تونومتر في
+
+251
+00:25:29,610 --> 00:25:35,210
+أبلينايشن
+
+252
+00:25:35,210 --> 00:25:38,890
+تونومتر بيزي بيريتي الفلوريسين observed under
+
+253
+00:25:38,890 --> 00:25:44,390
+cobalt blue filter light again assumes practical
+
+254
+00:25:44,390 --> 00:25:51,890
+significance يعني احنا بدون فلوريسين صعب انه احنا
+
+255
+00:25:51,890 --> 00:25:55,370
+نجري صدارة العين بهذا الجهازو على فكرة
+
+256
+00:26:19,030 --> 00:26:21,590
+الجزء من المنطقة التي تم اكتشافها تم اكتشافها
+
+257
+00:26:21,590 --> 00:26:28,530
+باستخدام حلول الطي يعني احنا بنحط فلوريسين صحيح في
+
+258
+00:26:28,530 --> 00:26:35,610
+اللي هو الكون يبقى تيبت سك والكون هاي الكون هاي
+
+259
+00:26:35,610 --> 00:26:40,410
+الكون طبعا بيجي الكون القرنية القرن رأس الكون بيجي
+
+260
+00:26:40,410 --> 00:26:44,730
+القرنية في القرن القرنية عايش فيه فلوريسين وبنفضل
+
+261
+00:26:44,730 --> 00:26:46,730
+احنا نعمل adjustment
+
+262
+00:26:49,610 --> 00:26:55,170
+للجهاز لغاية ما نشوف اللي هو هذا الشكل وهذا في ال
+
+263
+00:26:55,170 --> 00:27:01,350
+end point لو حدث هذا معناه انه نقرأ على التدريج
+
+264
+00:27:01,350 --> 00:27:07,370
+كام ضغط العين طيب ال concentration of Fluorescein
+
+265
+00:27:07,370 --> 00:27:11,290
+is very important بقول يعني التركيز في Fluorescein
+
+266
+00:27:11,290 --> 00:27:15,870
+مهم in this technique and it should not be too low
+
+267
+00:27:18,860 --> 00:27:21,800
+عشان يعطينا رؤية واضحة when the examiner
+
+268
+00:27:21,800 --> 00:27:26,520
+visibility of it is impaired or too high طبعا احسن
+
+269
+00:27:26,520 --> 00:27:32,220
+شئ نحط اللي هو ايش fluorescein strips عارفين ال
+
+270
+00:27:32,220 --> 00:27:36,820
+strips ال fluorescein اه هذا ده التركيز الكويس مع
+
+271
+00:27:36,820 --> 00:27:42,340
+الدم هو جاف و بعدين مع ال film بيكون ال dilution
+
+272
+00:27:42,340 --> 00:27:48,690
+معقوللكن لو وضعنا solution من الأساس ممكن يكون
+
+273
+00:27:48,690 --> 00:27:53,870
+مخفف و يدخل العين يتخفف اكتر تخفف اكتر ال business
+
+274
+00:27:53,870 --> 00:27:58,430
+are often obtained when using Benoxin-A
+
+275
+00:27:58,430 --> 00:28:02,030
+-Hydrochloride هذا اللي هو the topical anesthetic
+
+276
+00:28:16,220 --> 00:28:20,500
+عشان فيه touch و المغاربة بيقولوا الناس ال
+
+277
+00:28:20,500 --> 00:28:23,620
+autometrist في العالم بيستخدموا touchless
+
+278
+00:28:23,620 --> 00:28:32,380
+tonometry اش يعني؟ بيقول لأ بدون ما تلمس القرانين،
+
+279
+00:28:32,380 --> 00:28:36,140
+و الوحيد اللي بيعمل touchless tonometry ايش هو؟
+
+280
+00:28:36,140 --> 00:28:41,120
+air puff، بيعمل ايش؟ دربتين air و بيعمل digital
+
+281
+00:28:41,120 --> 00:28:48,210
+readingفهو عاقل صحيح بس مش دقيقة مش دقيقة يعني
+
+282
+00:28:48,210 --> 00:28:53,210
+ممكن العشرين مثلا يكتبها تمانتاش يعني في يعني
+
+283
+00:28:53,210 --> 00:28:57,690
+تفويت شويه في القيمة هذا اضاف منه لكن هذا ايلكوا
+
+284
+00:28:57,690 --> 00:29:03,190
+احسن لانه مش عايزين اناستيزيا لان القوية is very
+
+285
+00:29:03,190 --> 00:29:08,770
+sensitive organ يعني لو الهوى اجي عليها بحب حسه
+
+286
+00:29:08,770 --> 00:29:10,070
+كيف نعمل احنا
+
+287
+00:29:16,380 --> 00:29:20,000
+Goldman by employing sterile fluorescein paper
+
+288
+00:29:20,000 --> 00:29:22,760
+strips يبقى واضح اللي هو أشيطة بتاعة ال
+
+289
+00:29:22,760 --> 00:29:30,460
+fluorescein هي الأفضل شيء because
+
+290
+00:29:30,460 --> 00:29:32,800
+goldman's type of national thermometer involves
+
+291
+00:29:32,800 --> 00:29:36,020
+contact with eye a typical aesthetic has to be
+
+292
+00:29:36,020 --> 00:29:39,660
+administered with fluorescein لازم اللي هو
+
+293
+00:29:49,560 --> 00:29:54,920
+طبعا هذه الصورة تشير
+
+294
+00:29:54,920 --> 00:30:00,340
+لـ lacrimal potency ايش lacrimal potency؟ نيزو
+
+295
+00:30:00,340 --> 00:30:07,200
+لقرم البطنسي انه يعني هل هو normal ولا obstructed؟
+
+296
+00:30:07,200 --> 00:30:11,520
+اه هو يعني فيه obstruction طبعا ال obstruction زي
+
+297
+00:30:11,520 --> 00:30:15,600
+ما قرتمتوا بيجي من ال trauma او بيجي من نيزر ال
+
+298
+00:30:15,600 --> 00:30:15,940
+disease
+
+299
+00:30:20,760 --> 00:30:23,660
+طيب، to demonstrate the potency of the lacrimal
+
+300
+00:30:23,660 --> 00:30:26,660
+drainage system in patients complaining of
+
+301
+00:30:26,660 --> 00:30:32,580
+frequent untroublesome epiphora، what's epiphora؟
+
+302
+00:30:32,580 --> 00:30:36,800
+سيالان الدموع، جران الدموع أخد، هذا اسمه epiphora
+
+303
+00:30:51,640 --> 00:30:56,020
+لأنه عايز انا مش اقيس على سطح القنانية لأ عايز
+
+304
+00:30:56,020 --> 00:31:05,140
+اجري لتحت الأنفة فلازم تكون سائق او
+
+305
+00:31:05,140 --> 00:31:11,340
+اجيب
+
+306
+00:31:11,340 --> 00:31:14,520
+نفس ال strip احطه في محلول
+
+307
+00:31:17,440 --> 00:31:22,980
+طبعا الأدفة منه أنه أعمل تسييل لفلوريسين، then a
+
+308
+00:31:22,980 --> 00:31:27,240
+new drop of saline solution are also installed in
+
+309
+00:31:27,240 --> 00:31:29,840
+the peripheral cell to decrease the volume of
+
+310
+00:31:29,840 --> 00:31:33,220
+liquid present and patients are asked to blow
+
+311
+00:31:33,220 --> 00:31:37,200
+their nose in a white tissue يعني أنا بعد خمس
+
+312
+00:31:37,200 --> 00:31:39,980
+دقائق بحطه كمان نفط الفلوريسين في العين اللي هو
+
+313
+00:31:39,980 --> 00:31:40,460
+فيه
+
+314
+00:31:46,280 --> 00:31:52,040
+فجيب تيشو ورق أبيض نشاف كده بيقولوا يعني اعمل
+
+315
+00:31:52,040 --> 00:31:59,500
+broad للأنف يعني يحاول ينفد فإن نزل اللي هو اللي
+
+316
+00:31:59,500 --> 00:32:04,720
+من الألف أي دستشارد فيه fluorescein بيكون ايش؟
+
+317
+00:32:04,720 --> 00:32:09,840
+بيكون patent والمال ازناش احتمال يكون مغلق فانا
+
+318
+00:32:09,840 --> 00:32:12,220
+مقدرش احتمال يكون مغلق الا لما اشوف وضع ال
+
+319
+00:32:12,220 --> 00:32:12,660
+puncture
+
+320
+00:32:19,660 --> 00:32:23,340
+بصير stenosis أحيانا أو بصير inversion أو
+
+321
+00:32:23,340 --> 00:32:27,300
+منversion أو حتى ال .. ال margin of eyelid كلها
+
+322
+00:32:27,300 --> 00:32:36,480
+بصير لها تغيير في المكان تغيير في المكان طيب
+
+323
+00:32:36,480 --> 00:32:39,320
+your understanding of the tissue proves a potency
+
+324
+00:32:39,320 --> 00:32:41,760
+of lacrimal range of the particular eye
+
+325
+00:32:48,350 --> 00:32:55,390
+التفصيل مستمر في الـ eye. لا تشير إلى مصطلح البصيب
+
+326
+00:32:55,390 --> 00:32:57,450
+تتجه إلى البصيب تتجه إلى البصيب تتجه إلى البصيب
+
+327
+00:32:57,450 --> 00:32:59,650
+تتجه إلى البصيب تتجه إلى البصيب تتجه إلى البصيب
+
+328
+00:32:59,650 --> 00:33:01,510
+تتجه إلى البصيب تتجه إلى البصيب تتجه إلى البصيب
+
+329
+00:33:01,510 --> 00:33:04,270
+تتجه إلى البصيب تتجه إلى البصيب تتجه إلى البصيب
+
+330
+00:33:04,270 --> 00:33:08,270
+تتجه إلى البصيب تتجه إلى البصيب تتجه إلى البصيب
+
+331
+00:33:08,270 --> 00:33:09,610
+تتجه إلى البصيب تتجه إلى البصيب تتجه إلى البصيب
+
+332
+00:33:09,610 --> 00:33:17,110
+تتجه إلى البصيب تتجه إلى البصيب
+
+333
+00:33:17,640 --> 00:33:24,160
+هنا تشوف الاناتومي و هنا نازولاكت مالدكت فى جزء
+
+334
+00:33:24,160 --> 00:33:32,800
+منه نازل و فى جزء منه بونى فى البون اه شايفين كيف
+
+335
+00:33:32,800 --> 00:33:36,600
+الجزء اللى اللى هو فوق بيكون بونى و بعدين بينزل فى
+
+336
+00:33:36,600 --> 00:33:42,930
+اللى هوالـ upper terminate of the laws و هنا تشوفي
+
+337
+00:33:42,930 --> 00:33:46,090
+كيف ال .. نازي و جارتي و ماله .. كيف ال .. التسويق
+
+338
+00:33:46,090 --> 00:33:50,650
+اللي في الروسين فيه .. نازي هالبقى طبعا لو مش
+
+339
+00:33:50,650 --> 00:33:55,050
+بقتلت كان مثلا واقف هنا او واقف هنا بيبان يعنى طيب
+
+340
+00:33:55,050 --> 00:34:00,130
+assessment of tear film طبعا انتوا عارفين ال tear
+
+341
+00:34:00,130 --> 00:34:06,870
+film يعني في بعض الحلال زي مثلا ال .. ال old age
+
+342
+00:34:16,670 --> 00:34:28,350
+ممكن ان يكون فيه defect في تيرفيلم اذا
+
+343
+00:34:28,350 --> 00:34:33,630
+رأيت تيرفيلم يمكن ان يكون استخدامه لتحسين وقت
+
+344
+00:34:33,630 --> 00:34:40,750
+الفيروسينالـ TBUT التي هي المقاومة بعد الانقلاق
+
+345
+00:34:40,750 --> 00:34:44,010
+لتظهر
+
+346
+00:34:44,010 --> 00:34:48,830
+في الـ precorneal A تيرفلم بعد انقلاق، يعني خلّي
+
+347
+00:34:48,830 --> 00:34:55,370
+المريض يعمل انقلاق، غمضة يعني التيرفلم يصيب يوم
+
+348
+00:34:55,370 --> 00:34:59,370
+جديد، وإذا كان التير ملون بالفلورسين، فهو يصبح
+
+349
+00:34:59,370 --> 00:35:04,350
+فلوريسان، فلوريسان لير سيظهر بعد بعض الوقتيوجد
+
+350
+00:35:04,350 --> 00:35:07,310
+عليه مارش كريتر ده الانتر بلانك period convention
+
+351
+00:35:07,310 --> 00:35:15,690
+المهم انه باختصار انه احنا بنقدر بسلطنا نشوف الوقت
+
+352
+00:35:15,690 --> 00:35:20,750
+الزمن اللي مار مابين وضع الفلورسين ومابين ظهور ال
+
+353
+00:35:20,750 --> 00:35:28,410
+defects في ايش في التير فيلم نقدر نشوف ال defects
+
+354
+00:35:28,410 --> 00:35:31,170
+شايفين ال defects كيف؟ بتتجمع؟
+
+355
+00:35:34,060 --> 00:35:39,720
+في الأول كانت كاملة و بنعد الوقت الزمنى كم الوقت
+
+356
+00:35:39,720 --> 00:35:45,780
+الزمنى يستغرق ظهور ال defects اللى هو ال tear film
+
+357
+00:35:45,780 --> 00:35:52,920
+فهنا بيقول ليه ال break up time can be lengthened
+
+358
+00:35:52,920 --> 00:35:58,400
+by application of viscous drops يعني لو احطيت
+
+359
+00:35:58,400 --> 00:36:00,640
+drops viscous
+
+360
+00:36:07,480 --> 00:36:15,840
+ممكن ان الفليروسين يقبع اكتر في المكان، هذا معروف،
+
+361
+00:36:15,840 --> 00:36:20,080
+بس طبعا انا مش عايز احفظ فيسكس، عايز اكيس طبيعي،
+
+362
+00:36:20,080 --> 00:36:24,220
+هل ال break up time normal ولا غير normal، قصير
+
+363
+00:36:24,220 --> 00:36:29,080
+ولا عادل؟هو تقليد بشكل كبير في سندروم T-deficiency
+
+364
+00:36:29,080 --> 00:36:37,640
+مثل كيراتو كوندراتايفس سيكا او سيكا يعني هلاجي انا
+
+365
+00:36:37,640 --> 00:36:41,680
+الناس اللي عندهم ال virus disease او كيراتو
+
+366
+00:36:41,680 --> 00:36:45,820
+كوندراتايفس سيكا هلاجي انه قصير الوقت على طول
+
+367
+00:36:45,820 --> 00:36:55,020
+بيظهر ايش ال defect فاستر في 1980 considers انه
+
+368
+00:36:55,020 --> 00:36:56,040
+break up time of
+
+369
+00:36:59,770 --> 00:37:02,770
+فاطو جنومونيك او dry eye فاطو جنومونيك علامة
+
+370
+00:37:02,770 --> 00:37:06,890
+تشخصيه انه عنده dry eye لو أقل من عشر ثانواني
+
+371
+00:37:06,890 --> 00:37:10,370
+وبدأت تبين ال defect هنا ورانا ورانا على ساعة
+
+372
+00:37:10,370 --> 00:37:15,570
+القرانية بيكون ايش في عنده dry eye if the tear
+
+373
+00:37:15,570 --> 00:37:20,410
+film breaks up immediatelyالطائرات مفتوحة و
+
+374
+00:37:20,410 --> 00:37:25,410
+البريكز يظهر في نفس المكان ولكن هناك ربما بعض
+
+375
+00:37:25,410 --> 00:37:29,890
+البروكيز في هذه المناطق يعني ممكن أحيانا يكون
+
+376
+00:37:29,890 --> 00:37:35,490
+البريكز أفضل طبيعي لكن في .. في بعض اليوكوماز مثلا
+
+377
+00:37:35,490 --> 00:37:42,710
+في سطح القرن في بعض يعني disease معين
+
+378
+00:37:46,430 --> 00:37:50,610
+أحنا يعني بنشخص أي وقت قبل ما نحط اللي هو 13 for
+
+379
+00:37:50,610 --> 00:37:55,990
+diagnosis or break-up time طبعا ال dry eye مشكلة
+
+380
+00:37:55,990 --> 00:38:01,490
+جديدة بس هي تشخيص dry eye مشكلة كبيرة يعني معناه
+
+381
+00:38:01,490 --> 00:38:09,730
+أنه عايز compensate me tears forever وعايز
+
+382
+00:38:09,730 --> 00:38:14,090
+نموذج من الحياة forever بس كونه أنه كان a co
+
+383
+00:38:14,090 --> 00:38:19,470
+-optimistعادر على تشخيص dry eye هذا شرف ليه وبعد
+
+384
+00:38:19,470 --> 00:38:24,370
+هيك ال treatment بيصير عليه كلام بيصير عليه كلام
+
+385
+00:38:24,370 --> 00:38:32,850
+طيب tears flow assessment نشوف تدفق مجرى اللي هو
+
+386
+00:38:32,850 --> 00:38:37,570
+الدم أو تدفق اللي هو الدم على صرف العين يعني أقصد
+
+387
+00:38:38,810 --> 00:38:41,330
+The half-life of dogs in the congenital cell is
+
+388
+00:38:41,330 --> 00:38:45,590
+very short الحقيقة أنه احنا قلنا فيه تجديد دايما
+
+389
+00:38:45,590 --> 00:38:50,930
+للدموع ال outflow سريع it will depend on the
+
+390
+00:38:50,930 --> 00:38:53,790
+potency of the nasal lacrimal duct and the rate of
+
+391
+00:38:53,790 --> 00:38:58,650
+tear production بعتمد على تسرق الدموع في ال nasal
+
+392
+00:38:58,650 --> 00:39:02,030
+lacrimal duct و على ال rate of tear production
+
+393
+00:39:02,030 --> 00:39:05,170
+اللي هو إنتاج الدموع و تعرفين إنتاج الدموع بيصير
+
+394
+00:39:05,170 --> 00:39:12,100
+من عدة مصادر الجبلة بتجيبلي إيش؟wall frame، عندى
+
+395
+00:39:12,100 --> 00:39:18,280
+cows، accessory،
+
+396
+00:39:18,280 --> 00:39:25,520
+aqueous اللى هو secretion و المبون ده glance ال
+
+397
+00:39:25,520 --> 00:39:32,500
+oil مبون glance ال oil فانا يعني انا كان شغل مصنع
+
+398
+00:39:32,500 --> 00:39:36,260
+يعني في العين الدموع بتطلع من مصنع مش من مصدر واحد
+
+399
+00:39:36,260 --> 00:39:43,310
+من تلات مصادر او تلات مصادروبالتالي لو اي مصدر من
+
+400
+00:39:43,310 --> 00:39:50,570
+هذه المصادر المنتجة في المصنع انه يتوقف رح يصير ال
+
+401
+00:39:50,570 --> 00:39:55,570
+production فيه مشكلة مثلا لو جوبال سيز تختفي زي ما
+
+402
+00:39:55,570 --> 00:40:01,790
+حصلت في حالات إتراكومة رح يصير مافيش museum زي
+
+403
+00:40:01,790 --> 00:40:08,840
+الموبانا الجلانز تتوقف fish oilالكراوس وولفرينج
+
+404
+00:40:08,840 --> 00:40:17,980
+اتوقف فيشي اكيواس يبقى انا try laminar ثلاثة طبقات
+
+405
+00:40:17,980 --> 00:40:25,460
+اللي هو التلفان يبقى انا بقيس بالفلوريسين هل انه
+
+406
+00:40:25,460 --> 00:40:30,020
+الإنتاج كافي ولا مش كافي في مشكلة ولا مش كافية
+
+407
+00:40:30,020 --> 00:40:36,280
+دلوقتي اتوش الفلوريسين اختفى من المجففةas a major
+
+408
+00:40:36,280 --> 00:40:42,060
+of tear flow ماذا يختفي لفلوريسين على سطحه وهو لو
+
+409
+00:40:42,060 --> 00:40:48,200
+اختفى بسرعة إذا الإنتاج قوي كثير لو اختفى عادي
+
+410
+00:40:48,200 --> 00:40:54,160
+يانو يكون عادي طب لو اختفى ببفء شديد لذا الإنتاج
+
+411
+00:40:54,160 --> 00:41:02,700
+قليل يعني فش ما يسهليعني انا كأني انا حطيت على
+
+412
+00:41:02,700 --> 00:41:10,060
+البلاط شيء من الصبغة وبعدين يعني بدأت انا ادخل ماء
+
+413
+00:41:10,060 --> 00:41:15,960
+ادخل ماء بعد فترة الماء سوف يجد الصبغة ياخدها لكن
+
+414
+00:41:15,960 --> 00:41:21,440
+في حالة ان الماء المتدفق قليل جدا فان الصبغة سوف
+
+415
+00:41:21,440 --> 00:41:27,720
+تموت طيب بيردنسون
+
+416
+00:41:27,720 --> 00:41:33,960
+في التسعة وسبعيناستخدموا الفلوريسين لإيقاف مقارنة
+
+417
+00:41:33,960 --> 00:41:39,060
+بين مقارنة الدراجات والتلفة وجدوا ان مقارنة
+
+418
+00:41:39,060 --> 00:41:44,620
+الفلوريسين في الفيلم التاريخ تتقل بسرعة في
+
+419
+00:41:44,620 --> 00:41:49,700
+المريضين الصغيرين لماذا الفلوريسين يختفي في
+
+420
+00:41:49,700 --> 00:41:55,580
+المريضين الصغيرين أسرع؟ لأن الproduction عامand
+
+421
+00:41:55,580 --> 00:42:00,000
+thus viscous solutions were cleared at a slower
+
+422
+00:42:00,000 --> 00:42:04,900
+rate than aqueous ones وفي كبار السن و في نفس ال
+
+423
+00:42:04,900 --> 00:42:09,040
+end of disease يكون زي ما أقول لك يعني الفلورسين
+
+424
+00:42:09,040 --> 00:42:18,560
+اختفاه بده وقت لأن ال tear flow ضعيف في حاجة اسمها
+
+425
+00:42:18,560 --> 00:42:20,480
+stains contamination
+
+426
+00:42:29,840 --> 00:42:38,240
+عن الcontamination وهي جو مناسب للبكتيريا لإنمه
+
+427
+00:42:38,240 --> 00:42:44,500
+خاصة pseudomonas erzionosa اللي بتعمل bacterial
+
+428
+00:42:44,500 --> 00:42:49,180
+coronal acid ليش؟
+
+429
+00:42:49,180 --> 00:42:55,100
+لأنه في الوسط بتلويز نفس البوتل تحط لعيان بعدين
+
+430
+00:42:55,100 --> 00:42:57,980
+عيان ثاني بعد عيان ثالث عيان رابع في آخر يوم تكون
+
+431
+00:42:57,980 --> 00:43:06,690
+حاطة العشري العيانلو droper لمس ايد اي واحد او لمس
+
+432
+00:43:06,690 --> 00:43:10,230
+رمش اي واحد او لمس كورية لأي واحد او كتابة فيها
+
+433
+00:43:10,230 --> 00:43:16,490
+لأي واحد معناه البكتيريا دخلها فلو
+
+434
+00:43:16,490 --> 00:43:19,050
+حطيناها بقى نكلا الناس التانية ممكن تعملوا كورية
+
+435
+00:43:19,050 --> 00:43:23,010
+لأخر لذا contamination of leucine I drops is a
+
+436
+00:43:23,010 --> 00:43:27,510
+vertically serious riskخطير، even greater than
+
+437
+00:43:27,510 --> 00:43:30,570
+they are encountered with the majority of other
+
+438
+00:43:30,570 --> 00:43:34,270
+eye drops أكثر من أي eye drop تانية As these
+
+439
+00:43:34,270 --> 00:43:37,370
+individual's drops are liable to become infected
+
+440
+00:43:37,370 --> 00:43:42,510
+with bacteria and at the same time are frequently
+
+441
+00:43:42,510 --> 00:43:47,430
+used on damaged tissues that is prone to infection
+
+442
+00:43:47,430 --> 00:43:51,910
+يعني احنا بننقط للمرضى اللي عندهم كونة ال ulcer و
+
+443
+00:43:51,910 --> 00:43:56,930
+عندهم abrasion و عندهم infectionفبتنتقل ل drops
+
+444
+00:43:56,930 --> 00:44:04,190
+very great care must be taken in their use فقول
+
+445
+00:44:04,190 --> 00:44:08,910
+ليه؟ لازم أاخد أقصر رياض الحرارة؟ لأن ال PS
+
+446
+00:44:08,910 --> 00:44:13,430
+أرجينوزا اختصار ال pseudomonas أرجينوزا most
+
+447
+00:44:13,430 --> 00:44:18,970
+virulentBacteria for corneal invasion is an
+
+448
+00:44:18,970 --> 00:44:22,510
+especially dangerous pathological microorganisms
+
+449
+00:44:22,510 --> 00:44:26,230
+with which fluorescein I-drops are inclined to
+
+450
+00:44:26,230 --> 00:44:31,890
+become invaded هذا شيء معروف عند العلماء في دعم
+
+451
+00:44:31,890 --> 00:44:36,870
+نيتريك استيت أو نيتريك في تركيز 2 على 1000
+
+452
+00:44:36,870 --> 00:44:40,550
+strength is the best bactericide for preservative
+
+453
+00:44:40,550 --> 00:44:45,020
+A of these groupsيعني الفلوريسيين انتوا عارفين
+
+454
+00:44:45,020 --> 00:44:49,680
+يعني هو منه سائل ومنه أسربس لو بنا .. يعني نحطله
+
+455
+00:44:49,680 --> 00:44:54,420
+presentative أفضل نحطله .. له إيش؟ أملاح ال ..
+
+456
+00:44:54,420 --> 00:45:00,300
+أستيتي بتاعة الفينايل Mercury زبق أو نتري بقول إنه
+
+457
+00:45:00,300 --> 00:45:06,570
+هذا بكتريسيدل قوي للإيرجينوزل هذه طبعا قربت لهوهو
+
+458
+00:45:06,570 --> 00:45:10,970
+مفيد ضد الـ Pseudomonas إذا كانت الوضع ممكن أن
+
+459
+00:45:10,970 --> 00:45:16,570
+تأخذ وقت طويل ولكن أقوى طريقة عملياتهم هي مجموعة
+
+460
+00:45:16,570 --> 00:45:20,770
+واحدة استرالية واحدة او مجموعة استرالية بسيطة
+
+461
+00:45:20,770 --> 00:45:22,630
+بسيطة بسيطة بسيطة بسيطة بسيطة بسيطة بسيطة بسيطة
+
+462
+00:45:22,630 --> 00:45:25,850
+بسيطة بسيطة بسيطة بسيطة بسيطة بسيطة بسيطة بسيطة
+
+463
+00:45:36,210 --> 00:45:42,630
+أو إن و لابد أعمل جاف dry fluorescent strip جاف
+
+464
+00:45:42,630 --> 00:45:48,410
+لبكتير اللي لاتعيش في وسط الجاف both of which are
+
+465
+00:45:48,410 --> 00:45:51,590
+readily available and to be highly recommended
+
+466
+00:45:51,590 --> 00:45:55,030
+موجودين طبعا ال strips احنا عندنا في البلد موجود
+
+467
+00:45:55,030 --> 00:45:59,170
+صح بس ال monodrops drop بس مش موجود المرة الجاية
+
+468
+00:45:59,170 --> 00:46:01,770
+سوف اتكلم عن ال rose bengal شكرا لكم على حسب
+
+469
+00:46:01,770 --> 00:46:02,270
+الاسلام
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/6nZKRnLf7lA.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/6nZKRnLf7lA.srt
new file mode 100644
index 0000000000000000000000000000000000000000..2b0255de9ec578c841b7ec46e3d2cc88286521e5
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/6nZKRnLf7lA.srt
@@ -0,0 +1,1648 @@
+1
+00:00:26,010 --> 00:00:33,550
+السلام عليكم ورحمة الله وبركاته اليوم سنكمل اللي 
+
+2
+00:00:33,550 --> 00:00:38,530
+هو solutions of contact lenses هتكلم اليوم شوية 
+
+3
+00:00:38,530 --> 00:00:44,210
+على enzymatic cleaners وهذه أحدث صيحة في عالم 
+
+4
+00:00:44,210 --> 00:00:49,650
+تنظيف العدسات اللاصقة بيقول in form of tablets 
+
+5
+00:00:53,040 --> 00:00:56,160
+containing N-enzyme are dissolved in either saline 
+
+6
+00:00:56,160 --> 00:00:59,400
+or distilled water to remove the denatured protein 
+
+7
+00:00:59,400 --> 00:01:02,120
+deposited from the surfaces of the contact lens
+
+8
+00:01:02,120 --> 00:01:07,040
+يبقى احنا نجيب القرص بتاع الانزيم ونحطه اما فيه 
+
+9
+00:01:07,040 --> 00:01:12,440
+saline او فيه distilled water ماء مقطر تلقائيا 
+
+10
+00:01:12,440 --> 00:01:18,540
+المحلول هنا بدوره هو الـ N مهمته هذا أنه يشيل الـ
+
+11
+00:01:18,540 --> 00:01:25,980
+protein المترسب على سطح الـ contact lens يعني ثبت أن
+
+12
+00:01:25,980 --> 00:01:31,000
+النزيم هاضم يعني حتى في القناة الهضمية هو هاضم و
+
+13
+00:01:31,000 --> 00:01:34,900
+they are originally introduced for use about once 
+
+14
+00:01:34,900 --> 00:01:38,620
+a week with hydrogel lenses يعني هم كانوا يحطوهم 
+
+15
+00:01:38,620 --> 00:01:42,440
+على hydrogel lenses once weekly يعني في الأسبوع 
+
+16
+00:01:42,440 --> 00:01:47,380
+يعني في الشهر أربع مرات،  بقى في البداية كان قصده بيستخدم 
+
+17
+00:01:47,380 --> 00:01:51,120
+الـ rigid contact lenses يعني كان في الـ hydrogel الـ
+
+18
+00:01:51,120 --> 00:01:56,640
+contact lenses لكن ممكن استخدام الـ rigid contact
+
+19
+00:01:56,640 --> 00:02:03,300
+lenses في العادي استعمال الـ contact lens بيعمل 
+
+20
+00:02:03,300 --> 00:02:09,660
+فيلم أو بروتين على سطح الـ contact lens وهذا
+
+21
+00:02:09,660 --> 00:02:15,570
+البروتين جاء أساسًا من tear film أساسًا من tear film
+
+22
+00:02:15,570 --> 00:02:24,530
+اللي هو بيشكل زي الـ circulation يعني في تجديد أو
+
+23
+00:02:24,530 --> 00:02:28,170
+refreshing للإيش اللي هو tear film وبالتالي في
+
+24
+00:02:28,170 --> 00:02:32,530
+protein في الـ contact lens فبترسب على سطح العدسة 
+
+25
+00:02:32,530 --> 00:02:37,310
+اللي لمسكها تمامًا لو حطينا صخرة في مجرى ماء بعد شوية 
+
+26
+00:02:37,310 --> 00:02:39,670
+بتصير خضراء وتصير عليها طحالب وزي كده 
+
+27
+00:02:43,870 --> 00:02:48,550
+ممكن أن يكون فيه fat deposits و protein deposits 
+
+28
+00:02:48,550 --> 00:02:53,810
+أو another test أصعب شيء في الإزالة إيش اللي هو الـ
+
+29
+00:02:53,810 --> 00:02:58,170
+protein الشيء الصعب أنه احنا نزيله اللي هو الـ 
+
+30
+00:02:58,170 --> 00:03:05,270
+protein في  أكمين في grab uric طيب حيبدأ في الـ 
+
+31
+00:03:05,270 --> 00:03:12,730
+papain هو إنزيم one of the enzymatic أو enzymes
+
+32
+00:03:12,730 --> 00:03:18,950
+used in protein removing tablets is a thermostable
+
+33
+00:03:18,950 --> 00:03:24,850
+يعني لو تعرض للحرارة بتتكسّرش يعني مستقر في الحرارة 
+
+34
+00:03:24,850 --> 00:03:29,670
+thermostable are endobotidase يعني وزي البروتينات 
+
+35
+00:03:29,670 --> 00:03:35,130
+found in the papaya throat الآن في غزة سمعت أنا 
+
+36
+00:03:35,130 --> 00:03:36,150
+كده باسمه بابا 
+
+37
+00:03:41,450 --> 00:03:47,310
+هذا أخذوا منه البابين 
+
+38
+00:03:47,310 --> 00:03:53,570
+بابين بابين 
+
+39
+00:03:53,570 --> 00:03:57,570
+بابين بابين بابين بابين بابين بابين بابين بابين
+
+40
+00:03:57,570 --> 00:03:57,650
+بابين بابين بابين بابين بابين بابين بابين بابين
+
+41
+00:03:57,650 --> 00:03:58,030
+بابين بابين بابين بابين بابين بابين بابين بابين
+
+42
+00:03:58,030 --> 00:04:01,410
+بابين بابين بابين بابين بابين بابين بابين بابين
+
+43
+00:04:01,410 --> 00:04:08,130
+بابين بابين بابين 
+
+44
+00:04:17,460 --> 00:04:22,360
+السبتيلزم هو إنزيم من بكتيريا باسيلاس 
+
+45
+00:04:22,360 --> 00:04:28,300
+الأكليكينوفورمس، لأ هنا السبتيلزم إنزيم بس لا يُخلّص 
+
+46
+00:04:28,300 --> 00:04:32,260
+من البضائع، يُخلّص من إيش؟ بكتيريا اسمها باسيلاس
+
+47
+00:04:32,260 --> 00:04:36,540
+الأكليكينوفورمس Equilibrium of the efficiency of
+
+48
+00:04:36,540 --> 00:04:41,280
+papain and subtilisin يعني قارنوا بين اثنين وجدوا 
+
+49
+00:04:41,280 --> 00:04:47,220
+أنه طبعًا الـ papain أقوى في إزالة البروتينات الـ 
+
+50
+00:04:47,220 --> 00:04:52,940
+heavy protein deposits بينما الـ subtilisin في الـ
+
+51
+00:04:52,940 --> 00:04:56,820
+light protein deposits يبقى لو العدسة اللاصقة 
+
+52
+00:04:56,820 --> 00:05:04,260
+عليها طبقة بروتينية سميكة آه هو الـ papain بينما لو
+
+53
+00:05:04,260 --> 00:05:08,540
+طبقة رفيعة 
+
+54
+00:05:08,540 --> 00:05:15,200
+وخفيفة بالفترة إيه اللي هو Subtilisin  الفترة 
+
+55
+00:05:15,200 --> 00:05:18,340
+however when chemical disinfection and enzymatic
+
+56
+00:05:18,340 --> 00:05:22,380
+cleaning was compared with oxidative disinfection 
+
+57
+00:05:22,380 --> 00:05:25,480
+alone, the lenses treated by the former method 
+
+58
+00:05:25,480 --> 00:05:27,000
+were significantly cleaner
+
+59
+00:05:29,480 --> 00:05:33,240
+by later يعني قارنوا بين عدسة لاصقة بنحط لها 
+
+60
+00:05:33,240 --> 00:05:38,420
+hydrogen peroxide ماء أكسجين باستمرار وبين عدسة
+
+61
+00:05:38,420 --> 00:05:44,420
+بنحط لها الـ papain إنزيم من ضمن الجو اللي بنحط 
+
+62
+00:05:44,420 --> 00:05:51,440
+لها الـ papain ملاحظة أن الـ papain once weekly
+
+63
+00:05:51,440 --> 00:05:57,940
+فلما الـ hydrogen الـ hydrogen peroxide daily كل يوم
+
+64
+00:05:59,860 --> 00:06:06,360
+فمش مقبول يحطوا كل يوم إنزيم مكلف، فهم الآن وجدوا
+
+65
+00:06:06,360 --> 00:06:09,420
+أفضل طريقة الجمع بين الحسنين كيف الجمع بين 
+
+66
+00:06:09,420 --> 00:06:15,060
+الحسنين أن كل يوم يحطوا hydrogen peroxide محلول 
+
+67
+00:06:15,060 --> 00:06:22,120
+في الكأس وفي آخر الأسبوع يوم الجمعة مثلًا يحطوا إيش 
+
+68
+00:06:22,120 --> 00:06:26,040
+بابين هيك يقول لك أن هيك أفضل 
+
+69
+00:06:28,710 --> 00:06:32,170
+with either type of cleaner were contaminated more 
+
+70
+00:06:32,170 --> 00:06:35,930
+than those treated with both بس كان احنا جمعنا 
+
+71
+00:06:35,930 --> 00:06:40,190
+بين اللي هو البروتين كإنزيم والهيدروجين 
+
+72
+00:06:40,190 --> 00:06:46,690
+الهيدروجين بيروكسايد كـ disinfectant هذا كل يوم وهذا مرة 
+
+73
+00:06:46,690 --> 00:06:51,350
+في الأسبوع وجدوا أن النظافة والطهارة والتطهير
+
+74
+00:06:51,350 --> 00:06:55,090
+أفضل بالطريقتين من واحد واضح بالنسبالي؟ 
+
+75
+00:07:00,490 --> 00:07:04,350
+وقبل فترة من السنوات طلعوا محلول اسمه Comfort 
+
+76
+00:07:04,350 --> 00:07:09,950
+drops وكلمة Comfort تشي براها Comfort يعني راحة و
+
+77
+00:07:09,950 --> 00:07:14,570
+comfort يعني مريض these drops which are also 
+
+78
+00:07:14,570 --> 00:07:18,470
+referred to as re-wetting solution أو 
+
+79
+00:07:18,470 --> 00:07:24,070
+conditioning أو cushioning drops يعني نوع من 
+
+80
+00:07:24,070 --> 00:07:29,130
+الترطيب ونوع من الراحة cushioning زي الوسادة 
+
+81
+00:07:34,720 --> 00:07:40,640
+وطريقة يعني Can be installed into the eyes of
+
+82
+00:07:40,640 --> 00:07:44,220
+contact lens wearers at any time during wear to
+
+83
+00:07:44,220 --> 00:07:47,800
+enhance comfort يعني أنا وأنا شايفين، والواحد لفّ الـ
+
+84
+00:07:47,800 --> 00:07:52,200
+contact lens بيحطها كل شوية تعمل comfort عشان هي
+
+85
+00:07:52,200 --> 00:07:55,960
+تسمّيها comfort The eye can tolerate adverse
+
+86
+00:07:55,960 --> 00:08:00,140
+atmospheric conditions and while it can also 
+
+87
+00:08:00,140 --> 00:08:02,460
+tolerate the wearing of contact lenses 
+
+88
+00:08:05,370 --> 00:08:11,310
+in coping with both يعني بقول اللي بدك تعرفه أن 
+
+89
+00:08:11,310 --> 00:08:16,230
+عامل الطبيعة احنا ما نتعرضلوش للضوء ومن الغبار ومن
+
+90
+00:08:16,230 --> 00:08:20,910
+الإجهاد هذا عامل إجهاد يعني طيب وضع الـ
+
+91
+00:08:20,910 --> 00:08:23,490
+contact lens عامل إجهاد يا أخي 
+
+92
+00:08:32,420 --> 00:08:35,200
+هي بنعملها بشكل يعني هي بتبقى نعمل foreign body في 
+
+93
+00:08:35,200 --> 00:08:39,020
+العين مهما زينّاها أو مهما .. مهما خليناها smooth
+
+94
+00:08:39,020 --> 00:08:45,040
+بيفضل أنّه في إجهاد عليها في الـ contact lens فبيقول لي 
+
+95
+00:08:45,040 --> 00:08:52,320
+أن كانت العوامل الجوية صعبة والعدسة مثلًا hard قاسية 
+
+96
+00:08:52,320 --> 00:08:57,820
+فممكن العين ما تتحمل الـ .. الـ .. إيش الجهدين مع 
+
+97
+00:08:57,820 --> 00:09:03,010
+بعض يعني جهد واحد لحاله يكفي كيف يكون الجو مغبر
+
+98
+00:09:03,010 --> 00:09:08,130
+وقراءة كثيرة وفيه ضوء كثير وساطة وشيء يعني ممكن
+
+99
+00:09:08,130 --> 00:09:11,150
+العين ما تتحمل فبيقول الـ factors that reduce
+
+100
+00:09:11,150 --> 00:09:15,590
+contact lens tolerance ما هي العوامل التي تؤثر على 
+
+101
+00:09:15,590 --> 00:09:21,850
+عدم تحمل العدسة اللاصقة فيها عوامل أول عامل أنّه in
+
+102
+00:09:21,850 --> 00:09:28,230
+particular يعني عن خصوص الـ dry smoky environment
+
+103
+00:09:28,230 --> 00:09:30,970
+يكون الجو جاف 
+
+104
+00:09:34,370 --> 00:09:38,510
+سواء من التدخين أو أبخرة أو حاجة هذا الجو غير 
+
+105
+00:09:38,510 --> 00:09:41,930
+مناسب للناس اللي عندها حساسية قد تجعل التغيير في 
+
+106
+00:09:41,930 --> 00:09:47,850
+الـ lens تعمل اضطراب في الظّلفة ما بين الـ contact
+
+107
+00:09:47,850 --> 00:09:52,850
+lens ومن tear film which turns an acceptable
+
+108
+00:09:52,850 --> 00:09:58,090
+situation into an intolerant terrible one يقلّ
+
+109
+00:09:58,090 --> 00:10:01,390
+التحمل بالعين للعدسة اللاصقة تلاقي الواحد بالكره
+
+110
+00:10:06,280 --> 00:10:11,880
+وبرد كذلك تالي certain drugs such as
+
+111
+00:10:11,880 --> 00:10:15,960
+antihistamines which have an anti-muscarinic
+
+112
+00:10:15,960 --> 00:10:18,380
+effect can induce contact lens intolerance 
+
+113
+00:10:18,380 --> 00:10:21,920
+الـ antihistamines ناخدها أيام الحساسية والوجه
+
+114
+00:10:21,920 --> 00:10:27,080
+فاكرين كم سنة بتديكن جي كس مثلاً أو بيهيسمانال
+
+115
+00:10:27,080 --> 00:10:33,670
+هستامينال في حاجات زي هذه ناخدها للاحتقانات حتى في 
+
+116
+00:10:33,670 --> 00:10:37,470
+ناس بتناقش بروزولين وكلام في أنفه، فهذه كلها 
+
+117
+00:10:37,470 --> 00:10:45,410
+أنتيهستامين فبيقول لو احنا بناخد قطرة أنتيهستامين أو
+
+118
+00:10:45,410 --> 00:10:50,670
+أقراص أنتيهستامين ممكن تؤثر على تحمل العنصر لأنها 
+
+119
+00:10:50,670 --> 00:10:55,450
+بتجفف في الإفراز تمامًا بتجفف في إفراز الغدد 
+
+120
+00:11:02,240 --> 00:11:06,560
+اللي .. اللي هو الـ cells والـ glands اللي في العين 
+
+121
+00:11:06,560 --> 00:11:12,180
+خاصة الـ meibomian glands والـ accessory lacrimal 
+
+122
+00:11:12,180 --> 00:11:16,280
+glands meibomian and accessory يعني الواحد بياخد
+
+123
+00:11:16,280 --> 00:11:21,300
+الحقنة بتاعة الرشح أو إيش أو الحساسية أو الشراب أو
+
+124
+00:11:21,300 --> 00:11:25,640
+الأقراص أو حتى في العين قطرة لأ يعني اللي بيلبس
+
+125
+00:11:25,640 --> 00:11:29,080
+contact lens مش لازم .. لازم يحط قطرة حساسية قطرات
+
+126
+00:11:29,080 --> 00:11:32,120
+الحساسية بتاعة العين عارفينها؟الوقت فيّا تلاقي في 
+
+127
+00:11:32,120 --> 00:11:35,460
+الربيع الآن عينه بتشق شوية وعينه حمراء وشغله وحاسس فيها 
+
+128
+00:11:35,460 --> 00:11:38,900
+رمل بوشي فيروح يقول للدكتور يقول له معايا حساسية
+
+129
+00:11:38,900 --> 00:11:43,300
+يعني أو هي يقول له آه معاك حساسية خذ مثلًا قطرة زي
+
+130
+00:11:43,300 --> 00:11:50,140
+مثلًا كوليستين أنتيهستامين برايفيل مثلًا أو يقول له مثلًا 
+
+131
+00:11:50,140 --> 00:11:54,040
+يقول له كرايزين أكتر أسامي يعني وهو بيلبس 
+
+132
+00:11:54,040 --> 00:11:56,300
+contact lens بيقول للدكتور أنه بيلبس contact lens
+
+133
+00:11:56,300 --> 00:12:02,040
+تلاقي حاسس أنّه كتير فيلم بيصير disturbed ورقيق وإشي 
+
+134
+00:12:02,040 --> 00:12:05,140
+العدسة اللي هتسكب .. مش هي البيئة بتاعتها، 
+
+135
+00:12:05,140 --> 00:12:08,180
+العدسة اللي هتسكب هي الترطيب فلما يكون في قطرات الـ
+
+136
+00:12:08,180 --> 00:12:12,560
+comfort كل شوية كل ساعة كل ساعتين بخسر الطلبة، 
+
+137
+00:12:12,560 --> 00:12:19,780
+بيكون .. بيخفف فـ three وهذا بهمكم hormonal 
+
+138
+00:12:19,780 --> 00:12:25,080
+changes in women التغيرات الهرمونية في النساء can 
+
+139
+00:12:25,080 --> 00:12:29,000
+also modify the quantity or quality of tears 
+
+140
+00:12:31,140 --> 00:12:34,000
+إستروجين وبروجستيرون تعرفين فيه إستروجين 
+
+141
+00:12:34,000 --> 00:12:38,580
+وبروجستيرون وهو يعني الهرمونين الأنثويين اللي هم 
+
+142
+00:12:38,580 --> 00:12:44,120
+بتتغير لذلك يعني حتى لو في واحدة بتدرس أو ست يعني 
+
+143
+00:12:44,120 --> 00:12:48,960
+تعمل لازك مثلًا في فترة الرضاعة أو الحمل ما نخليهاش 
+
+144
+00:12:48,960 --> 00:12:53,600
+تعمل ممكن أنّه دراج نعم ممكن أنّه دراج أو تغير 
+
+145
+00:12:53,600 --> 00:13:00,000
+نفسها إيوا أقول حتى في الـ elasticity أو  قُرنية سوري 
+
+146
+00:13:00,000 --> 00:13:03,640
+في الـ electricity of the cornea بيكون فيه تغيير 
+
+147
+00:13:03,640 --> 00:13:07,760
+لذلك إذا بدنا نعمل احنا أي procedure في الـ cornea
+
+148
+00:13:07,760 --> 00:13:12,340
+بدنا نعمله في أوقات ما فيش فيها hormonal changes in 
+
+149
+00:13:12,340 --> 00:13:20,860
+females فالآن نرجع ثاني بالنسبة للـ lens wearing 
+
+150
+00:13:20,860 --> 00:13:27,280
+females هتلاقي في أحوال تغير هرموني أنّه لا تقلع 
+
+151
+00:13:27,280 --> 00:13:32,390
+العدسة اللاصقة لأنّه بيعمل لها من الـ dryness أو الاضطراب
+
+152
+00:13:32,390 --> 00:13:37,450
+حتى في إفراز الـ aqueous tears وحتى اللي هو الـ 
+
+153
+00:13:37,450 --> 00:13:45,210
+meibomian glands طيب يبقى الـ comfort احنا ما قلناش إنزيمية
+
+154
+00:13:45,210 --> 00:13:50,570
+وغير إنزيمية يعني هي wetting إيه جانب كل ساعة 
+
+155
+00:13:50,570 --> 00:13:55,050
+ساعتين اللي عادي سلاسقة بيحط نقطة هنا ونقطة هنا 
+
+156
+00:13:55,050 --> 00:14:00,890
+بغرض أنّه يجعل العدسة اللاصقة smooth و conditioning ويترد 
+
+157
+00:14:00,890 --> 00:14:05,650
+أي دمع ثاني يعني اعمل مساعد ما نقولش أنّه اعمل 
+
+158
+00:14:05,650 --> 00:14:09,930
+منظف زي الـ hydrogen peroxide مثلًا ما نقولش طب 
+
+159
+00:14:09,930 --> 00:14:13,930
+alternative methods of hydrogel contact lens
+
+160
+00:14:13,930 --> 00:14:18,450
+disinfection الحقيقة أنا بتكلم على استخدام الإشعاع
+
+161
+00:14:18,450 --> 00:14:26,690
+خاصة الـ ultraviolet والـ ultrasound في يعني تعقيم
+
+162
+00:14:26,690 --> 00:14:30,640
+العدسة اللاصقة، طب من الواضح أن استخدام الـ ultra
+
+163
+00:14:30,640 --> 00:14:37,420
+violet أو الـ ultrasound هذا بتاع اللي هو الشركات و
+
+164
+00:14:37,420 --> 00:14:43,480
+مصانع مش يعني user زينا مش user وبالتالي يعني احنا 
+
+165
+00:14:43,480 --> 00:14:47,660
+بنقدر نقول أن هذا للعينات اللي أحدث الـ fresh
+
+166
+00:14:47,660 --> 00:14:52,560
+الحديثة أو الجديدة، العينات اللي أحدث الجديدة ما
+
+167
+00:14:52,560 --> 00:14:56,130
+بحط لها hydrogen peroxide ولا بحط لها enzymes لأ
+
+168
+00:14:56,130 --> 00:15:01,010
+بالجملة المصانع بمليون وبمليونين عدسة 
+
+169
+00:15:01,010 --> 00:15:04,830
+بنخليهم على الـ ultra bio طبعًا الـ ultra bio تستحيل
+
+170
+00:15:04,830 --> 00:15:10,590
+تحتها أيش أيش مايكروب أو بكتيريا أو فانجس حتى أو
+
+171
+00:15:10,590 --> 00:15:17,370
+فيروس لذلك الآن المصانع ركزوا على إيش أنا بقول لك 
+
+172
+00:15:17,370 --> 00:15:23,410
+أنا بعمل عينات جديدة رخيصة short duration إيه short
+
+173
+00:15:23,410 --> 00:15:26,770
+duration فترة قصيرة يعني فترة قصيرة نلبسها أسبوع 
+
+174
+00:15:26,770 --> 00:15:29,730
+أسبوع يعني وبعده نرجع ما يصير عليها protein وما 
+
+175
+00:15:29,730 --> 00:15:33,010
+protein ونحط عليها أنتيهستامين ولا لأ لأ أرميها و
+
+176
+00:15:33,010 --> 00:15:38,150
+نيجيها ليش تكون مثلًا مثلًا بمئة دولار لأ تكون
+
+177
+00:15:38,150 --> 00:15:42,010
+بعشرة دولار في التفكير التسويقي بتاعك بقول لك أنا
+
+178
+00:15:42,010 --> 00:15:46,150
+بنتج بالعشرة دولار وببيع أكتر فده عندما أحط عليه
+
+1
+
+216
+00:19:05,930 --> 00:19:10,370
+specification to be ordered يعني أنا صحيح بحط
+
+217
+00:19:10,370 --> 00:19:13,970
+الأولى على السهلة بشوفش فيها كويس التانية أحسن التالتة
+
+218
+00:19:13,970 --> 00:19:17,910
+أحسن بس هنجرب تلاتة عدسات هذه التلاتة عدسات صاروا
+
+219
+00:19:17,910 --> 00:19:23,090
+contaminated منهم كده هل هو لعيبتهم كده لـ
+
+220
+00:19:23,090 --> 00:19:26,270
+disposable؟
+
+221
+00:19:26,270 --> 00:19:29,950
+لأ، لإني حافظ عليهم، فإني أعملهم كده الـ use of
+
+222
+00:19:29,950 --> 00:19:33,490
+trial lenses assumes particular importance when
+
+223
+00:19:33,490 --> 00:19:36,590
+complex designs such as bifocals are to be
+
+224
+00:19:36,590 --> 00:19:41,250
+supplied و أكثر أهمية لما تكون ال contact lenses هالي
+
+225
+00:19:41,250 --> 00:19:43,730
+bifocal أو trifocal
+
+226
+00:19:48,640 --> 00:19:53,080
+multifunction مش معقول أنها مكلفة إني ألقيها فبدها
+
+227
+00:19:53,080 --> 00:20:00,540
+كيل بدها تفيل وبدها نحطها في hydrogen peroxide هيك
+
+228
+00:20:00,540 --> 00:20:03,360
+هم بيكملوا لنا موضوع solutions of contact lenses والآن
+
+229
+00:20:03,360 --> 00:20:07,300
+هنبدأ في therapeutic drugs and their uses الأدوية
+
+230
+00:20:07,300 --> 00:20:12,760
+اللي تستخدم في علاج العين في علاج العين بقول لي
+
+231
+00:20:12,760 --> 00:20:17,540
+باختصار كلمة Anti-infective يعني مضاد
+
+232
+00:20:24,090 --> 00:20:29,090
+effective against a variety of infections يعني طيب
+
+233
+00:20:29,090 --> 00:20:32,970
+واسع من الكائنات اللي بتعمل infection مثلا
+
+234
+00:20:32,970 --> 00:20:37,670
+viruses, rickettsia, bacteria, fungi and so on
+
+235
+00:20:37,670 --> 00:20:40,930
+rickettsia هي كائنات ما بين الفيروسات و ما بين
+
+236
+00:20:40,930 --> 00:20:45,710
+البكتيريا زي اللي بتعمل ال syphilis rickettsia
+
+237
+00:20:45,710 --> 00:20:50,370
+يبقى هو بيقول يعني أنا أطلب مني إني 
+
+238
+00:20:59,600 --> 00:21:05,440
+و لا البروتوزيوه أكارثوموبه ولا الفانجاي و حتى لا
+
+239
+00:21:05,440 --> 00:21:09,920
+الركسيا لو خشت الآن لو أنا ما عنديش هذه المنظومة من
+
+240
+00:21:09,920 --> 00:21:13,760
+المضادات
+
+241
+00:21:13,760 --> 00:21:18,740
+بتاعة ال infection عيون البشر إيش بيصير فيها؟
+
+242
+00:21:18,740 --> 00:21:24,460
+مصيبة مصيبة the mechanism of action of these agents
+
+243
+00:21:24,460 --> 00:21:29,490
+varies greatly كيف تعمل؟ إحنا بنتحدث أو بنتحدث كيف
+
+244
+00:21:29,490 --> 00:21:34,810
+تعمل المضادات الحيوية البكتيريا مثلا فمنها من يمزق
+
+245
+00:21:34,810 --> 00:21:40,670
+ال cell wall ومنها من يتحد بـ ribosomes بناءها من
+
+246
+00:21:40,670 --> 00:21:45,810
+تكوين .. ليش؟
+
+247
+00:21:45,810 --> 00:21:49,330
+طاقة .. ribosomes ليش؟ بتخليها low levels of
+
+248
+00:21:49,330 --> 00:21:53,750
+energy اه طيب ومنها من يهاجم in Euclides
+
+249
+00:22:03,610 --> 00:22:08,050
+وهكذا طيب طيب the mechanism of action of these
+
+250
+00:22:08,050 --> 00:22:11,690
+agents varies greatly and to some extent will
+
+251
+00:22:11,690 --> 00:22:14,310
+depend on the organism on which the particular
+
+252
+00:22:14,310 --> 00:22:18,390
+agent acts كمان بعتمد على non-microbe هلي يستجيب
+
+253
+00:22:18,390 --> 00:22:22,180
+ولا لا يستجيب In the majority of cases however some
+
+254
+00:22:22,180 --> 00:22:27,300
+competitive inhibition of a biochemical process is
+
+255
+00:22:27,300 --> 00:22:31,180
+involved as a result of the concentration level
+
+256
+00:22:31,180 --> 00:22:38,500
+يبقى أحيانا في دواء يستخدم ب level قليل لكن بيكون
+
+257
+00:22:38,500 --> 00:22:41,800
+effective وفي العكس دواء يستخدم ب concentration
+
+258
+00:22:41,800 --> 00:22:46,060
+عالي و بيكون تأثيره ضعيف حسب المعيك وال ميبك اللي
+
+259
+00:22:46,060 --> 00:22:46,660
+أخذناه قبلها
+
+260
+00:23:02,250 --> 00:23:05,950
+Drugs for the treatment of infections قولنا في شيء
+
+261
+00:23:05,950 --> 00:23:10,550
+اسمه MIC Minimum
+
+262
+00:23:10,550 --> 00:23:15,630
+Inhibitory Concentration are often published for
+
+263
+00:23:15,630 --> 00:23:19,710
+the common anti-infective drugs بقول لي these
+
+264
+00:23:19,710 --> 00:23:26,590
+values يعني كل drug إله Mike، these values will
+
+265
+00:23:26,590 --> 00:23:31,510
+vary according to the infecting organism يعني
+
+266
+00:23:31,510 --> 00:23:35,330
+Staphylococcus aureus مثلا تختلف عن Staphylococcus
+
+267
+00:23:35,330 --> 00:23:41,210
+epidermidis يعني هذا ميكروب متعايش Flora و هذا
+
+268
+00:23:41,210 --> 00:23:48,570
+ميكروب شرس فانا بدي ميك يوطي البكتيريا الشرسة حتى
+
+269
+00:23:48,570 --> 00:23:54,910
+يعني لا تفعل مضاعفة اه بيقول لي the might for a
+
+270
+00:23:54,910 --> 00:23:57,570
+strain of Methicillin-resistant Staphylococcus
+
+271
+00:23:57,570 --> 00:24:02,490
+aureus is considerably higher than that of normal
+
+272
+00:24:02,490 --> 00:24:04,730
+Staphylococcus aureus يعني بيقول لي حتى
+
+273
+00:24:04,730 --> 00:24:07,950
+Staphylococcus aureus في منها يحطم أنواع البنسلين
+
+274
+00:24:07,950 --> 00:24:09,890
+ويحلله
+
+275
+00:24:11,380 --> 00:24:14,680
+فأبدي أنا علاج يكون ال mic بتاعه يتناسى في هذه
+
+276
+00:24:14,680 --> 00:24:21,680
+الشراسة وهذه المقاومة باختلاف اللي هو الاستفحاء
+
+277
+00:24:21,680 --> 00:24:27,160
+الكاسية العادية اللي ما بتعمل تكسير لإيش لاتفاتكس
+
+278
+00:24:27,160 --> 00:24:31,740
+when it comes to treating ophthalmic infections
+
+279
+00:24:38,520 --> 00:24:42,060
+There are many more factors to take into
+
+280
+00:24:42,060 --> 00:24:46,020
+consideration يبقى أنا في الأول بأتكلم عن الالتهابات
+
+281
+00:24:46,020 --> 00:24:51,080
+الرئتين، التهابات الحلق، التهابات الأمعاء،
+
+282
+00:24:51,080 --> 00:24:55,100
+التهابات المجال المولية، لكن يقول لنا إحنا العين
+
+283
+00:24:55,100 --> 00:25:02,260
+تختلف، العين إقليم شبه مستقل، إذا أقول كون فيدرالي،
+
+284
+00:25:02,260 --> 00:25:05,920
+كون فيدرالي، مش فيدرالي بقى يعني، العين دخولها
+
+285
+00:25:05,920 --> 00:25:11,160
+وخروجها مش سهل، فيه بريئة فلما أتكلم أنا الآن بدي
+
+286
+00:25:11,160 --> 00:25:17,700
+أنا أوجد أشياء تؤثر في العلم أو العلاج يؤثر فيها
+
+287
+00:25:17,700 --> 00:25:22,900
+في العلم اختلف عن باقي الجسم فمثلا when the locus
+
+288
+00:25:22,900 --> 00:25:26,620
+or site of infection will determine not only the
+
+289
+00:25:26,620 --> 00:25:30,120
+route of the administration but also the prognosis
+
+290
+00:25:30,120 --> 00:25:35,240
+infections of the anterior eye يعني في ال eye
+
+291
+00:25:35,240 --> 00:25:39,620
+segment قصدهم يعني حاجات في القرنية و في ال AC و
+
+292
+00:25:39,620 --> 00:25:43,400
+حتى في ال iris تختلف عن أشياء في ال retina back
+
+293
+00:25:43,400 --> 00:25:47,580
+further back يعني صحيح أنا مهما بدي أعالج شيء في
+
+294
+00:25:47,580 --> 00:25:51,660
+القرن اه زي بدي أعالج شيء في ال retina أو الفترياس
+
+295
+00:25:51,660 --> 00:25:55,060
+طبعا مختلف ال retina و الفترياس بيبقوا injection
+
+296
+00:25:55,060 --> 00:26:00,700
+رترو بربر اه رترو بربر بيجيبوه مش القطر أو القرن
+
+297
+00:26:00,700 --> 00:26:04,860
+من هذا فهناك مثلا consideration مش مولود في جسمها،
+
+298
+00:26:04,860 --> 00:26:07,240
+أهم اسم منها أخذها الأقراس أو الحجونة والدم
+
+299
+00:26:07,240 --> 00:26:11,480
+بيشيل، بيوزع، بيوزع، لكن الدم ما بتبدأ توزع على
+
+300
+00:26:11,480 --> 00:26:15,740
+العين، الدم بتوزع مثلا على اللي هو الرئتين وعلى
+
+301
+00:26:15,740 --> 00:26:18,220
+اللي هو القلب وعلى الحاجات هذه
+
+302
+00:26:25,940 --> 00:26:33,240
+والله واحد مع severe acute endocyclitis ممكن أعطيه
+
+303
+00:26:33,240 --> 00:26:38,100
+cortison كل ساعة أو واحد طالع من intraocular
+
+304
+00:26:38,100 --> 00:26:43,080
+operation طالع من ultra intraocular operation كل
+
+305
+00:26:43,080 --> 00:26:48,160
+ساعة و ساعتين بدي أعطيه قطرات جوية لكن واحد مع
+
+306
+00:26:48,160 --> 00:26:55,250
+شوية infection في الملتحمة جد جات يعني كل ست ساعات
+
+307
+00:26:55,250 --> 00:26:59,870
+قطرة أفلوس كل ست ساعات فالاهتمام حسب ال label of
+
+308
+00:26:59,870 --> 00:27:05,350
+inflammation هل ال inflammation شديد ولا مش شديد
+
+309
+00:27:05,350 --> 00:27:09,390
+الأهم الثالث في العين tear flow و similarly
+
+310
+00:27:09,390 --> 00:27:13,350
+affect the absorption of anti-infective agents
+
+311
+00:27:13,350 --> 00:27:16,770
+يعني الشباب عندهم tear flow normal و قوي
+
+312
+00:27:26,170 --> 00:27:32,150
+هنا ال .. يعني في تفاعل وفي دوران لل .. ال .. ال
+
+313
+00:27:32,150 --> 00:27:36,010
+.. إيش؟ الدوائية وفي استقبال إلها و absorption لكن
+
+314
+00:27:36,010 --> 00:27:39,950
+واحد مع dry eye يعني وده صح واحد مع dry eye واحد
+
+315
+00:27:39,950 --> 00:27:49,290
+وده صح طيب هتكلم على البكتيريا لأنه ال .. يعني
+
+316
+00:27:49,290 --> 00:27:53,450
+more than ninety percent of eye infections is إيش؟
+
+317
+00:27:56,230 --> 00:27:59,770
+فأتكلم دائما عن البكتيريا لكن مش مع ذلك الفيروسات
+
+318
+00:27:59,770 --> 00:28:02,130
+إيه اللي يعني أننا خاصة ال herpes simplex
+
+319
+00:28:02,130 --> 00:28:06,370
+كيلوتايتس برضه بنختار فيهم فالبكتيريا بقول as with
+
+320
+00:28:06,370 --> 00:28:10,930
+most of pharma drugs the antibacterials used on
+
+321
+00:28:10,930 --> 00:28:14,410
+the eye were originally blocked for systemic use
+
+322
+00:28:14,410 --> 00:28:21,990
+يعني إحنا ما استوردناش للعين من القمر مضادة حيوية لأ
+
+323
+00:28:21,990 --> 00:28:26,280
+بقول المضادة الحيوية اللي بنعطيها systemic يعني
+
+324
+00:28:26,280 --> 00:28:33,320
+العلاج الجهاز التنفسي أو الجهاز الهضمي أو الجهاز
+
+325
+00:28:33,320 --> 00:28:39,000
+البولي التناسلي هي نفس المضادة الحيوية اللي
+
+326
+00:28:39,000 --> 00:28:47,040
+بنعطيها للعين بس بصورة drops to the point نشتاق
+
+327
+00:28:47,040 --> 00:28:54,310
+منها يعني اشتقاق however in the main It is the ones
+
+328
+00:28:54,310 --> 00:28:58,830
+that have no or very restricted systemic use that
+
+329
+00:28:58,830 --> 00:29:01,770
+are most popular for treatment of the eye بس في
+
+330
+00:29:01,770 --> 00:29:08,310
+حاجة يعني هي حكمة يعني خلونا .. حكمة بقول يعني أن
+
+331
+00:29:08,310 --> 00:29:15,470
+في بعض الأدوية قليلا تستخدم systemic زي مثلا
+
+332
+00:29:15,470 --> 00:29:20,490
+chloramphenicol قليلا تستخدم systemic لأنه بيعمل
+
+333
+00:29:20,490 --> 00:29:22,270
+مشاكل على الدم
+
+334
+00:29:26,090 --> 00:29:33,890
+المناعة فبيخافوا منه أن يُعطوه إلا حالات نادرة بقول
+
+335
+00:29:33,890 --> 00:29:40,490
+هذا للعين جوهري وذهبي ليش؟ لأن الأدوية العادية
+
+336
+00:29:40,490 --> 00:29:43,230
+المضادة الحيوية العادية اللي بنمانعها كل يوم
+
+337
+00:29:43,230 --> 00:29:50,610
+البكتيريا إيش بتعملها؟ resistance يعني سرها
+
+338
+00:30:00,880 --> 00:30:05,700
+استخدام ال antibiotic بكثرة كل ما ال resistance
+
+339
+00:30:05,700 --> 00:30:12,800
+زادت لأن الشفرة أو التركيب الكيميائي يعني أقصد
+
+340
+00:30:12,800 --> 00:30:17,840
+المضاد الحيوي يتكشف الفكسيري طول نفسي أيوة لكن
+
+341
+00:30:17,840 --> 00:30:21,420
+antibiotic ولا في السنة بيستخدم مرة أو مرتين أو
+
+342
+00:30:21,420 --> 00:30:28,380
+تلاتة في مجتمع ما هذا للعين ذهبي لأن هو مش هيروح على
+
+343
+00:30:28,380 --> 00:30:32,080
+الدم و يعمل المشاكل بتاعة ال .. النقطة الواحدة
+
+344
+00:30:32,080 --> 00:30:37,440
+بتعملش .. بتعملش يخلق إضاءة و المناعة، شايفين كيف؟
+
+345
+00:30:37,440 --> 00:30:40,560
+زي ما جال الشعرش جال .. بذلك قدرت الأيام وما بينا
+
+346
+00:30:40,560 --> 00:30:46,940
+أهليها مصايب قوم عند قوم فوائده، أنت مش حافظين،
+
+347
+00:30:46,940 --> 00:30:52,780
+أنت فاهم الشعرش صح؟ اه، ما بينا أهليها فوائده قوم،
+
+348
+00:30:52,780 --> 00:30:57,440
+مصايب قوم عند قوم فوائده زي واحد بيقول لك يعني يركب
+
+349
+00:30:57,440 --> 00:31:00,920
+على جمل وجمل اللي هو قال بيموت، شايف نفسي قال
+
+350
+00:31:00,920 --> 00:31:05,220
+لحقوني بسكينة، لحقوه بالسكينة، ذبحوه وقالوا و
+
+351
+00:31:05,220 --> 00:31:09,160
+الله غير انفرقوا عليه، فهم قاعدين وهم مش عارفين
+
+352
+00:31:09,160 --> 00:31:13,200
+أنه يحجوهم بجمل و يتبحوه، فهو زي مصيبة، راح جمله
+
+353
+00:31:13,200 --> 00:31:17,760
+وركوبه بتاعته، لكن هم استفادوا وأكلوا لحم تلات
+
+354
+00:31:17,760 --> 00:31:24,500
+أربع أيام أو خمس أيام طيب، يبقى الـ Antibiotics
+
+355
+00:31:24,500 --> 00:31:32,020
+الأقل تداولًا للـ Systemic Use هي الأفضل للعين،
+
+356
+00:31:32,020 --> 00:31:38,340
+كويس؟ Although some antibacterials are marketed as
+
+357
+00:31:38,340 --> 00:31:41,040
+simple ophthalmic preparations containing just one
+
+358
+00:31:41,040 --> 00:31:43,820
+active ingredient, many preparations contain
+
+359
+00:31:43,820 --> 00:31:49,530
+either Antibacterials or Steroids and Antibiotics
+
+360
+00:31:49,530 --> 00:31:53,510
+يعني الآن تفننوا حتى بدل أن يحطوا نقطة مضادة حيوية
+
+361
+00:31:53,510 --> 00:31:59,650
+يحطوا اثنين استيرويد بقى؟ اه لأ وفي Antibiotics في
+
+362
+00:31:59,650 --> 00:32:03,490
+Antibiotics اثنين أو ثلاثة يعني مثلا قطرة ال
+
+363
+00:32:03,490 --> 00:32:06,010
+Maxitrol اللي في السوق مليانة في السوق اسمها
+
+364
+00:32:06,010 --> 00:32:09,230
+Maxitrol فيها Two Antibiotics
+
+365
+00:32:14,720 --> 00:32:18,320
+لأ في قطرات فيها three antibiotics يعني مولا في
+
+366
+00:32:18,320 --> 00:32:21,680
+اتحاد اتحاد اتحاد نقطة حط فيها يعني أكثر من
+
+367
+00:32:21,680 --> 00:32:25,240
+antibiotic خاصة في حالات الخطيرة خاصة في الحالات
+
+368
+00:32:25,240 --> 00:32:31,240
+الخطيرة وهذا يعني إيش زيادة في الفائدة للمريض
+
+369
+00:32:33,970 --> 00:32:37,170
+قسموا المجموعات اللي تستخدم في علاج العين ك
+
+370
+00:32:37,170 --> 00:32:40,930
+Antibiotics Beta Lactams مجموعة البنسلين بتاعك
+
+371
+00:32:40,930 --> 00:32:45,130
+العصلية فهي البنسلين اللي قبل مئة سنة تقريبا
+
+372
+00:32:45,130 --> 00:32:50,310
+اسمها Beta Lactams وهنا Tetracyclines التتراسيكلينات
+
+373
+00:32:50,310 --> 00:32:58,690
+وهنا Macrolides المجموعات اللي هي التتراسيكلين وال
+
+374
+00:32:58,690 --> 00:33:02,680
+generations بتاعتهم التتراسيكلين Chloramphenicols
+
+375
+00:33:02,680 --> 00:33:08,780
+مجموعة Fluoroquinolones مجموعة الـ Oflox والزيمر
+
+376
+00:33:08,780 --> 00:33:13,060
+والحيات هذه حديثة طبعا حديثة أحدث شيء Amino
+
+377
+00:33:13,060 --> 00:33:17,900
+glycosides مجموعة الجين التمايسين والأبجين
+
+378
+00:33:17,900 --> 00:33:22,200
+والحيات هذه ثم سالفة مجموعة السالفة الآن obsolete
+
+379
+00:33:22,200 --> 00:33:24,680
+مستخدمات يعني كان زمان مهم
+
+380
+00:33:32,190 --> 00:33:36,250
+لو اتكلمنا على ال beta-lactam باختصار beta-lactams
+
+381
+00:33:36,250 --> 00:33:41,370
+هذه البنسلين مجموعة البنسلين الأصلي ال beta
+
+382
+00:33:41,370 --> 00:33:46,450
+-lactams فيه ring يعني هي اللي عليها السهم عشان
+
+383
+00:33:46,450 --> 00:33:51,670
+هيك ال ring هذه beta ring lactam ring فسموها بناء
+
+384
+00:33:51,670 --> 00:33:51,990
+على
+
+385
+00:33:56,310 --> 00:34:00,310
+بياخد أو بيحتوي على Beta-Lactam سموه في المجموعة
+
+386
+00:34:00,310 --> 00:34:04,870
+هذه وهي الـ Penicillin ومشتقاته طبعا الـ Procaine
+
+387
+00:34:04,870 --> 00:34:11,030
+Penicillin الأصلي اللي حتى الآن injectable اشتق منه
+
+388
+00:34:11,030 --> 00:34:17,690
+عدة مشتقات حتى إنها كده قول يعني بالعشرة Penicillin
+
+389
+00:34:17,690 --> 00:34:21,770
+كده Penicillin كده مضادلة كده Penicillin يعني في
+
+390
+00:34:21,770 --> 00:34:27,500
+التركيب الكيميائي بتاع Penicillin أضفوله ذرات وجزئيات
+
+391
+00:34:27,500 --> 00:34:34,180
+فأصبح في منه أشياء كثيرة فمثلا ما منكم إلا
+
+392
+00:34:34,180 --> 00:34:40,980
+مثلا مارور مع ال .. ال أمو بذكير مثلا أمو بذكير
+
+393
+00:34:40,980 --> 00:34:46,960
+هنا في السوية يعني هو .. يعني كمان كلمة بقى على ال
+
+394
+00:34:46,960 --> 00:34:51,380
+.. لمون وربع أشهر شكل العلماء أمو بذكير هذا إحدى
+
+395
+00:34:51,380 --> 00:35:00,260
+المشتقات فتال البنسلين بعدين طوروا منه لفظة سلن
+
+396
+00:35:00,260 --> 00:35:06,
+
+431
+00:38:01,090 --> 00:38:05,330
+طيب بيقول اللي ال tetracycline مش بس بيشتغل على 
+
+432
+00:38:05,330 --> 00:38:08,910
+البكتيريا بل بيشتغل على ال spiral cases وعلى
+
+433
+00:38:08,910 --> 00:38:13,010
+الكلياميديا اللي بتعمل ال trachoma وعلى بعض ال
+
+434
+00:38:13,010 --> 00:38:16,530
+organisms يعني كمان وصلة type 1 أكثر من البكتيريا
+
+435
+00:38:16,530 --> 00:38:22,310
+أشياء أخرى resistance بيقولوا البكتيريا ال gram
+
+436
+00:38:22,310 --> 00:38:25,530
+negative اللي اسمها سودوموناس سودوموناس خطيرة جدا
+
+437
+00:38:25,530 --> 00:38:27,270
+هي بتعمل colon ulcer
+
+438
+00:38:30,930 --> 00:38:36,570
+الهيلو بيقدرش عليها و البروتياس برضه بتعمل كورن
+
+439
+00:38:36,570 --> 00:38:42,450
+الألثل برضه ما بيقدرش عليها لكن باقي البكتيريا
+
+440
+00:38:42,450 --> 00:38:46,550
+العادية بتاعة ال conjuctivitis وإشي هي كويسة 
+
+441
+00:38:46,550 --> 00:38:53,110
+side effects سيستانيك بيعمل ال stomach upset طعم 
+
+442
+00:38:53,110 --> 00:38:56,430
+متعب وين في المدى هذا سيستانيك لو أخدنا كبسولة
+
+443
+00:38:56,430 --> 00:39:03,000
+نوزيا و vomiting و Diarrhea لو أخدنا كبسولات و
+
+444
+00:39:03,000 --> 00:39:09,240
+كمان لو أخدنا كبسولات ممكن يعمل على أسنان الأطفال
+
+445
+00:39:09,240 --> 00:39:18,120
+تلون برتقالي أو أصفر يترسب في هضم الأطفال و هضم
+
+446
+00:39:18,120 --> 00:39:24,840
+الحوامل they permanently color teeth yellow and
+
+447
+00:39:24,840 --> 00:39:31,390
+slow bone growth يعني يبطئ من نمو العظام في
+
+448
+00:39:31,390 --> 00:39:35,970
+الأطفال بسبب قدرات كالسيوم المغنيسيوم يتحد 
+
+449
+00:39:35,970 --> 00:39:40,750
+بالكالسيوم والمغنيسيوم ويمنعهم من أن يكونوا مدبّزين 
+
+450
+00:39:40,750 --> 00:39:44,990
+في العظام في بناء العظام عشان هيك Contra-indicated
+
+451
+00:39:44,990 --> 00:39:50,990
+في الأطفال وفي الحوامل عشان يخش في أعضاء الجنين
+
+452
+00:39:50,990 --> 00:39:55,490
+البرج ال fix from topical application نجي للعين
+
+453
+00:39:55,490 --> 00:40:02,630
+للعين بيقول إن القطر في العين قرر مافيش حدات في العين
+
+454
+00:40:02,630 --> 00:40:08,290
+يعني نافع عليه due to the slow dose of the drug
+
+455
+00:40:08,290 --> 00:40:11,730
+يعني احنا إن قطر بيقول لك واحد في المية تتراساكلين 
+
+456
+00:40:11,730 --> 00:40:19,770
+قطرة ولا هتعمل جد كبسولة في خلال أربع أو خمس أشهر 
+
+457
+00:40:19,770 --> 00:40:25,610
+يعني إن قطر التتراساكلين في العين مدة أربع أشهر 
+
+458
+00:40:27,450 --> 00:40:32,170
+الجرعة تساوي كبسولة هذا فيما يتعلق بالـ Systemic
+
+459
+00:40:32,170 --> 00:40:38,770
+فيعني مافيش من الخوف لكن الحقيقة إن ال penetration
+
+460
+00:40:38,770 --> 00:40:42,670
+across the intact cornea is poor and these
+
+461
+00:40:42,670 --> 00:40:46,190
+compounds are best used for surface infections as
+
+462
+00:40:46,190 --> 00:40:51,510
+ointment يعني في مرهم الترميسين والجرديسايكلين 
+
+463
+00:40:51,510 --> 00:40:55,930
+والغوزيسين كل هذه كانت بس كعلاج طيب لـ infection 
+
+464
+00:40:56,860 --> 00:41:02,140
+و الـ Blepharitis و Lid Infection والكلام ده لكن
+
+465
+00:41:02,140 --> 00:41:06,660
+مش ليه علاج ال Intraocular Infection ولا حتى
+
+466
+00:41:06,660 --> 00:41:11,980
+Keratitis كويس؟ إن موجود Gordacycline و Teramycin
+
+467
+00:41:11,980 --> 00:41:13,320
+مش هو Teramycin المرمى
+
+468
+00:41:44,540 --> 00:41:52,300
+الحديث الولادة الذين نزلوا مفتهابات في الملتحق
+
+469
+00:41:52,300 --> 00:41:58,480
+الولادة
+
+470
+00:41:58,480 --> 00:42:06,680
+أول ما الطفل يولد في الساعة الأولى تجي الممرضة تغسل
+
+471
+00:42:06,680 --> 00:42:13,180
+عينيه بصابون تشطفهم وتضع لهم مرهم ترميسين في
+
+472
+00:42:13,180 --> 00:42:18,580
+الصباح وفي المساء هذا prophylaxis لو ولد لهم
+
+473
+00:42:18,580 --> 00:42:25,920
+عنده تلور في مجاري الولادة أكثر أكثر هذا يمنع إن
+
+474
+00:42:25,920 --> 00:42:31,980
+تطور ال infection تطور ال infection في ال 83
+
+475
+00:42:35,270 --> 00:42:43,630
+و روش و نيو تور ايضا اقترح انترامسبرينسيلين و
+
+476
+00:42:43,630 --> 00:42:49,030
+تتراساكليين 1% كمشروع بروفيلاكتك يعني قال اه اعطي 
+
+477
+00:42:49,030 --> 00:42:53,910
+الأم حقنة في
+
+478
+00:42:53,910 --> 00:42:58,390
+العضل فيها بنسلين وتتراساكليين عشان لو ولد
+
+479
+00:42:58,390 --> 00:43:04,240
+المولود بالذهاب إن ما يفلش فيه إذا كانت الـ Infection 
+
+480
+00:43:04,240 --> 00:43:11,040
+كلياميديا زي الـ تراكوما فالتتراساكليت تريتمنت يعني
+
+481
+00:43:11,040 --> 00:43:13,500
+مرهم هو أن يتم تجربته على آخر 
+
+482
+00:43:13,500 --> 00:43:32,060
+الانتيبايوتك 
+
+483
+00:43:36,430 --> 00:43:39,850
+هو أكثر من أي انتيبايوتك آخر 
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/6nZKRnLf7lA_postprocess.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/6nZKRnLf7lA_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..0d24857980634abcc42e45bd97d3b0e766899084
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/6nZKRnLf7lA_postprocess.srt
@@ -0,0 +1,1932 @@
+1
+00:00:26,010 --> 00:00:33,550
+السلام عليكم ورحمة الله وبركاته اليوم سنكمل اللي
+
+2
+00:00:33,550 --> 00:00:38,530
+هو solutions of contact lenses هتكلم اليوم شوية
+
+3
+00:00:38,530 --> 00:00:44,210
+على enzymatic cleaners وهذه أحدث صحيحة في عالم
+
+4
+00:00:44,210 --> 00:00:49,650
+تنظيف العدسات اللسانية بيقول in form of tablets
+
+5
+00:00:53,040 --> 00:00:56,160
+containing N-enzyme are dissolved in either saline
+
+6
+00:00:56,160 --> 00:00:59,400
+or distilled water to remove the natured protein
+
+7
+00:00:59,400 --> 00:01:02,120
+deposited from the surfaces of the contaminant
+
+8
+00:01:02,120 --> 00:01:07,040
+يبقى احنا نجيب القرص بتاع الانزين ونحطه اما فيه
+
+9
+00:01:07,040 --> 00:01:12,440
+saline او فيه distilled water ماء مقطر تلقاعب
+
+10
+00:01:12,440 --> 00:01:18,540
+المحلول هنا بدور هو ال N هو مهمته هذا انه يشيل ال
+
+11
+00:01:18,540 --> 00:01:25,980
+proteinالمترسد على سطح ال contact lens يعني ثبت ان
+
+12
+00:01:25,980 --> 00:01:31,000
+النزيم هاضم يعني حتى في القناة الهضمية هو هاضم و
+
+13
+00:01:31,000 --> 00:01:34,900
+they are originally introduced for use about once
+
+14
+00:01:34,900 --> 00:01:38,620
+a week with hydrogel lenses يعني هم كانوا يحطوهم
+
+15
+00:01:38,620 --> 00:01:42,440
+على hydrogel lenses once weekly يعني في الأسبوع
+
+16
+00:01:42,440 --> 00:01:47,380
+يعني في الشهر أربع مرةبقى إفلسري كان قصه بيستخدم
+
+17
+00:01:47,380 --> 00:01:51,120
+الـ rigid contact lenses يعني كان في الهيدروجي ال
+
+18
+00:01:51,120 --> 00:01:56,640
+contact lenses لكن ممكن استخدام ال rigid contact
+
+19
+00:01:56,640 --> 00:02:03,300
+lenses في العادى استعمال ال contact lens بيعمل
+
+20
+00:02:03,300 --> 00:02:09,660
+فيلم أو بروتين على سطح ال contact lens وهذا
+
+21
+00:02:09,660 --> 00:02:15,570
+البروتين جاء أساسا من تفيلموجهة أساسا من تير فيلم
+
+22
+00:02:15,570 --> 00:02:24,530
+اللي هو بيشكل زي ال circulation يعني في تجديد أو
+
+23
+00:02:24,530 --> 00:02:28,170
+refreshing للإيش اللي هو تير فيلم وبالتالي في
+
+24
+00:02:28,170 --> 00:02:32,530
+protein في ال contact lens فبترسب على سطح العدسة
+
+25
+00:02:32,530 --> 00:02:37,310
+اللي لمسكها تماما لو حطينا صخرة في مجرماء بعد شوية
+
+26
+00:02:37,310 --> 00:02:39,670
+بتصير خضرة وصير عليها تحارب وزي كده
+
+27
+00:02:43,870 --> 00:02:48,550
+ممكن ان يكون فيه fat deposits و protein deposits
+
+28
+00:02:48,550 --> 00:02:53,810
+او another test اصعب شيء في الإزالة ايش اللي هو ال
+
+29
+00:02:53,810 --> 00:02:58,170
+protein الشيء الصعب انه احنا نزيله اللي هو ال
+
+30
+00:02:58,170 --> 00:03:05,270
+protein في أكمين في grab uric طيب حيبدأ في ال
+
+31
+00:03:05,270 --> 00:03:12,730
+papainهو انزين one of the enzymatic أو enzymes
+
+32
+00:03:12,730 --> 00:03:18,950
+used in protein removing tablets is a thermostable
+
+33
+00:03:18,950 --> 00:03:24,850
+يعني لو تعرض الحرارة بتكساش يعني مستقر في الحرارة
+
+34
+00:03:24,850 --> 00:03:29,670
+thermostable are endobotidase يعني وزي البروتينات
+
+35
+00:03:29,670 --> 00:03:35,130
+found in the tau tau throat الآن في غزة سمع أنا
+
+36
+00:03:35,130 --> 00:03:36,150
+كده باسمه بابا
+
+37
+00:03:41,450 --> 00:03:47,310
+هذا أخذوا منه بربيع
+
+38
+00:03:47,310 --> 00:03:53,570
+بربيع بربيع
+
+39
+00:03:53,570 --> 00:03:57,570
+بربيع بربيع بربيع بربيع بربيع بربيع بربيع بربيع
+
+40
+00:03:57,570 --> 00:03:57,650
+بربيع بربيع بربيع بربيع بربيع بربيع بربيع بربيع
+
+41
+00:03:57,650 --> 00:03:58,030
+بربيع بربيع بربيع بربيع بربيع بربيع بربيع بربيع
+
+42
+00:03:58,030 --> 00:04:01,410
+بربيع بربيع بربيع بربيع بربيع بربيع بربيع بربيع
+
+43
+00:04:01,410 --> 00:04:08,130
+بربيع بربيع بربيع
+
+44
+00:04:17,460 --> 00:04:22,360
+السبتيلزم هو نبات من بكتيريا باسيلاس
+
+45
+00:04:22,360 --> 00:04:28,300
+الأكليكينوفورمس، لأ هنا السبتيلزم إنزيم بس لا يُخل
+
+46
+00:04:28,300 --> 00:04:32,260
+من البضائع، يُخل من أيش؟ بكتيريا اسمها باسيلاس
+
+47
+00:04:32,260 --> 00:04:36,540
+الأكليكينوفورمسEquilibrium of the efficiency of
+
+48
+00:04:36,540 --> 00:04:41,280
+papain and subtilism يعني قارنوا بين اتنين وجدوا
+
+49
+00:04:41,280 --> 00:04:47,220
+انه طبعا ال papain اقوى في ازالة لبروتينات ال
+
+50
+00:04:47,220 --> 00:04:52,940
+heavy protein deposits بينما ال subtilism في ال
+
+51
+00:04:52,940 --> 00:04:56,820
+light protein deposits يبقى لو العدسة اللازقة
+
+52
+00:04:56,820 --> 00:05:04,260
+عليها طبقة بروتينية سميكة اه هو ال papainبينما لو
+
+53
+00:05:04,260 --> 00:05:08,540
+طبقة رفيعة
+
+54
+00:05:08,540 --> 00:05:15,200
+وخفيفة بالفترة إيه اللي هو Subtilism الفترة
+
+55
+00:05:15,200 --> 00:05:18,340
+however when chemical disinfection and enzymatic
+
+56
+00:05:18,340 --> 00:05:22,380
+cleaning was compared with oxidative disinfection
+
+57
+00:05:22,380 --> 00:05:25,480
+alone, the lenses treated by the former method
+
+58
+00:05:25,480 --> 00:05:27,000
+were significantly cleaner
+
+59
+00:05:29,480 --> 00:05:33,240
+by later يعني قارنه بين عدسة لاسكا بنحط لها
+
+60
+00:05:33,240 --> 00:05:38,420
+hydrogen peroxide ماء أكسجين باستمرار وبين عدسة
+
+61
+00:05:38,420 --> 00:05:44,420
+بنحط لها ال papain انزين من أنضاف لجو اللي بنحط
+
+62
+00:05:44,420 --> 00:05:51,440
+لها ال papain ما ملاحظة ان ال papain once weekly
+
+63
+00:05:51,440 --> 00:05:57,940
+فلما ال hydrogen ال hydrogen peroxide daily كل يوم
+
+64
+00:05:59,860 --> 00:06:06,360
+فمش مقلول يحطوا كل يوم انزيب مكلف فهم الأن وجدوا
+
+65
+00:06:06,360 --> 00:06:09,420
+أفضل طريقة الجمع بين الحسناجين كيف الجمعة بين
+
+66
+00:06:09,420 --> 00:06:15,060
+الحسناجين انه كل يوم يحطوا hydrogen peroxide محلول
+
+67
+00:06:15,060 --> 00:06:22,120
+في الكاس وفي آخر السبوع يوم الجمعة مثلا يحطوا اش
+
+68
+00:06:22,120 --> 00:06:26,040
+بابيد هيك يقولك ان هيك أفضل
+
+69
+00:06:28,710 --> 00:06:32,170
+with either type of cleaner were contaminated more
+
+70
+00:06:32,170 --> 00:06:35,930
+than those treated with both بس كان احنا جامعنا
+
+71
+00:06:35,930 --> 00:06:40,190
+بين اللي هو البرتين كإنزين والهيدروجين
+
+72
+00:06:40,190 --> 00:06:46,690
+الهيليبروإكسايد كdisinfectant هذا كل يوم و هذا مرة
+
+73
+00:06:46,690 --> 00:06:51,350
+في الأسبوع وجدوا انه النظافة و الطهارة و التطهير
+
+74
+00:06:51,350 --> 00:06:55,090
+أفضل بالتانين من واحد واضح بالنسبالي؟
+
+75
+00:07:00,490 --> 00:07:04,350
+و قبل فترة حد السنوات طلعوا محلول اسمه comfort
+
+76
+00:07:04,350 --> 00:07:09,950
+drops و كلمة comfort تشي براها comfort يعني راحة و
+
+77
+00:07:09,950 --> 00:07:14,570
+comfort يعني مريض these drops which are also
+
+78
+00:07:14,570 --> 00:07:18,470
+referred to as re-wetting condition او
+
+79
+00:07:18,470 --> 00:07:24,070
+conditioning او cushioning drops يعني نوع من
+
+80
+00:07:24,070 --> 00:07:29,130
+الترتيب و نوع من الراحة cushioning زي الوسادة
+
+81
+00:07:34,720 --> 00:07:40,640
+وطريقة يعني Can be installed into the eyes of
+
+82
+00:07:40,640 --> 00:07:44,220
+contact lens wearers at any time during wear to
+
+83
+00:07:44,220 --> 00:07:47,800
+enhance comfort يعني أنا وانا شوفوا، والواحد لف ال
+
+84
+00:07:47,800 --> 00:07:52,200
+contact lens، بيحطها كل شوية تعمل comfort، عشان هي
+
+85
+00:07:52,200 --> 00:07:55,960
+تسميها comfort The eye can tolerate adverse
+
+86
+00:07:55,960 --> 00:08:00,140
+atmospheric conditions and while it can also
+
+87
+00:08:00,140 --> 00:08:02,460
+tolerate the wearing of contact lenses
+
+88
+00:08:05,370 --> 00:08:11,310
+in coping with both يعني بقول اللي بدك تعرف انه
+
+89
+00:08:11,310 --> 00:08:16,230
+عامل الطبيعة احنا ماتعطلقوا من الضوء و من الغبار و
+
+90
+00:08:16,230 --> 00:08:20,910
+من الإجهاد هذا عامل إجهاد يعني طيب وضع ال
+
+91
+00:08:20,910 --> 00:08:23,490
+contactless عامل إجهاد يا أخي
+
+92
+00:08:32,420 --> 00:08:35,200
+هي بنعمل الشكل يعني هي بقى نعمل foreign body في
+
+93
+00:08:35,200 --> 00:08:39,020
+العين مهما زيّنها أو مهما .. مهما خلّينها smooth
+
+94
+00:08:39,020 --> 00:08:45,040
+بيفضل أنه في إجهاد عليه في الcontact lens فبقولّي
+
+95
+00:08:45,040 --> 00:08:52,320
+إن كانت العوامل الجوية صعبة و العدسة مثلا hard رجل
+
+96
+00:08:52,320 --> 00:08:57,820
+فممكن العين ما تتحمل ال .. ال .. إيش الجهدين مع
+
+97
+00:08:57,820 --> 00:09:03,010
+بعض يعني جهد واحد لحاله يكفيفكيف يكون الجو مغفر
+
+98
+00:09:03,010 --> 00:09:08,130
+وقراءة كثيرة وفيه ضوء كثير وساطة وشيء يعني ممكن
+
+99
+00:09:08,130 --> 00:09:11,150
+العين ما تتحمل فبقول ال factors that reduce
+
+100
+00:09:11,150 --> 00:09:15,590
+contact lens tolerance ما هي الأوامل التي تؤثر على
+
+101
+00:09:15,590 --> 00:09:21,850
+عدم تحمل العدسة الأخرى فيها عوامل أول عامل انها in
+
+102
+00:09:21,850 --> 00:09:28,230
+particular يعني عن خصوص ال dry smoky environment
+
+103
+00:09:28,230 --> 00:09:30,970
+يكون الجو جاف
+
+104
+00:09:34,370 --> 00:09:38,510
+سواء من التنخين أو أبخرة أو حاجة هذا الجو غير
+
+105
+00:09:38,510 --> 00:09:41,930
+مناسب للناس اللي عندها سلسلة قد تجعل التغيير في
+
+106
+00:09:41,930 --> 00:09:47,850
+الـ Lens تعمل اضطراب في الظلافة ما بين ال contact
+
+107
+00:09:47,850 --> 00:09:52,850
+lens و من التير film which turns an acceptable
+
+108
+00:09:52,850 --> 00:09:58,090
+situation into an intolerant terrible one يقل
+
+109
+00:09:58,090 --> 00:10:01,390
+التحمل بالعين للعدسة اللاصفة تلاقي الواحد بالكره
+
+110
+00:10:06,280 --> 00:10:11,880
+وبرد كذلك تالي certain drugs such as
+
+111
+00:10:11,880 --> 00:10:15,960
+antihistamines which have an anti-masculinic
+
+112
+00:10:15,960 --> 00:10:18,380
+effect can induce contact lenses لنا ال
+
+113
+00:10:18,380 --> 00:10:21,920
+antihistamines ناخدها أيام الحساسية والواجهة
+
+114
+00:10:21,920 --> 00:10:27,080
+فاكرين كم سنة تديكن جيكس مثلا او بالهيسمانال
+
+115
+00:10:27,080 --> 00:10:33,670
+هستانيل في حاجات زي هذه ناخدها الاحتقاناتحتى فينا
+
+116
+00:10:33,670 --> 00:10:37,470
+ناس مناقش بروزولين وكلام في أنفه، فهذه كلها
+
+117
+00:10:37,470 --> 00:10:45,410
+أنتيستامين فبقول لو احنا بناخد قطرة أنتيستامين أو
+
+118
+00:10:45,410 --> 00:10:50,670
+أقلاص أنتيستامين ممكن تأثر على تحمل العنصر لأنها
+
+119
+00:10:50,670 --> 00:10:55,450
+بتجفف في الإفراز تماما بتجفف في إفراز الغدل
+
+120
+00:11:02,240 --> 00:11:06,560
+اللي .. اللي هو ال cells و ال glance اللي في العين
+
+121
+00:11:06,560 --> 00:11:12,180
+خاصة ال wall frank و ال cross accessory لكريمال
+
+122
+00:11:12,180 --> 00:11:16,280
+glance wall frank and cross يعني الواحد بياخد
+
+123
+00:11:16,280 --> 00:11:21,300
+الحقنة بتاعة الرشح أوشي أو الحسية أو الشراب أو
+
+124
+00:11:21,300 --> 00:11:25,640
+الأقاص أو حتى في العين قاطرة لأ يعني اللي بلبس
+
+125
+00:11:25,640 --> 00:11:29,080
+contact lens مش لازم .. لازم يحط قاطرة حسية قاطرات
+
+126
+00:11:29,080 --> 00:11:32,120
+الحسية بتاعة العين عارفينها؟الوقت فينا تلاقي في
+
+127
+00:11:32,120 --> 00:11:35,460
+الربيع الآن يشق شويه وعينه حمره وشغله وحاس فيها
+
+128
+00:11:35,460 --> 00:11:38,900
+رمل بوشي فيروح يقولوا للدكتور يقولوا معايا حاسية
+
+129
+00:11:38,900 --> 00:11:43,300
+يعني او هي يقولوا اه معاك حاسية خد مثلا قطرة زي
+
+130
+00:11:43,300 --> 00:11:50,140
+مثلا كوليهيست انتستيل برايفيل مثلا او يقولوا مثلا
+
+131
+00:11:50,140 --> 00:11:54,040
+يقولوا كرايزين اكتير اسامي يعني و هو بلبس
+
+132
+00:11:54,040 --> 00:11:56,300
+contactless بجلس للدكتور انه بلبس contactless
+
+133
+00:11:56,300 --> 00:12:02,040
+تلاقي حاسس انه كتير فيلم بصير disturbedو رقيق و
+
+134
+00:12:02,040 --> 00:12:05,140
+إشي العدسة اللي هتسكب .. مش هي البيئة بتاعتها،
+
+135
+00:12:05,140 --> 00:12:08,180
+العدسة اللي هتسكب هي ترتيب فلما يكون في قطع ال
+
+136
+00:12:08,180 --> 00:12:12,560
+comfort كل شوية، كل ساعة، كل ساعتين، خسر الطلبة،
+
+137
+00:12:12,560 --> 00:12:19,780
+بيكون .. بيخفف ف three و هذا بهمكوا hormonal
+
+138
+00:12:19,780 --> 00:12:25,080
+changes in women التدوير الهرموني في النساء can
+
+139
+00:12:25,080 --> 00:12:29,000
+also modify the quantity or quality of tears
+
+140
+00:12:31,140 --> 00:12:34,000
+استروجين وبروجيسترول تعرفين فيه اندرسان استروجين
+
+141
+00:12:34,000 --> 00:12:38,580
+وبروجيسترول وهو يعني الهرمونين الانسويين اللي هم
+
+142
+00:12:38,580 --> 00:12:44,120
+بتعاقبوا لذلك يعني حتى لو وقع بده طالبة او ست يعني
+
+143
+00:12:44,120 --> 00:12:48,960
+تعمل لازك مثلا في فترة الرضاعة او الحمض مانخلاش
+
+144
+00:12:48,960 --> 00:12:53,600
+تعمل ممكن انها دراج نعم ممكن انها دراج او تغيظ
+
+145
+00:12:53,600 --> 00:13:00,000
+نفسك ايوة اقول حتى في ال elasticity او دقونةسوري
+
+146
+00:13:00,000 --> 00:13:03,640
+في ال electricity of the cornea بيكون فيه تغيير
+
+147
+00:13:03,640 --> 00:13:07,760
+لذلك اذا بدنا نعمل احنا اي procedure في ال cornea
+
+148
+00:13:07,760 --> 00:13:12,340
+بدنا نعمله في اوقات مافيش فيها hormonal changes in
+
+149
+00:13:12,340 --> 00:13:20,860
+females فالان نرجع تاني بالنسبة لل lens wearing
+
+150
+00:13:20,860 --> 00:13:27,280
+females هتلاقي في احوال تغير هرموني انه لا تتقلع
+
+151
+00:13:27,280 --> 00:13:32,390
+سلسلة كافيةلأنه بيعملوها من ال dryness او الطراب
+
+152
+00:13:32,390 --> 00:13:37,450
+حتى في افراز الاكيوستيرز و حتى اللي هو ال
+
+153
+00:13:37,450 --> 00:13:45,210
+limousine طيب يبقى ال comfort احنا مقولهاش انزيمية
+
+154
+00:13:45,210 --> 00:13:50,570
+و غير انزيمية يعني هي wetting ايه جانب كل ساعة
+
+155
+00:13:50,570 --> 00:13:55,050
+ساعتين اللي عادى سلاسقة بيحط نقطة هنا و نقطة هنا
+
+156
+00:13:55,050 --> 00:14:00,890
+بغرض انه يجعل عدسة اللاسقة smoothو conditioning و
+
+157
+00:14:00,890 --> 00:14:05,650
+يترد أي دست تاني يعني اعمل مساعد ماجولاش انه اعمل
+
+158
+00:14:05,650 --> 00:14:09,930
+منظف زي الهيدروجين بالإكسايد مثلا ماجولاش طب
+
+159
+00:14:09,930 --> 00:14:13,930
+alternative methods of hydrogel contact lens
+
+160
+00:14:13,930 --> 00:14:18,450
+disinfection الحقيقة انا بتكلم على استخدام الإشعاع
+
+161
+00:14:18,450 --> 00:14:26,690
+خاصة ال ultraviolet و ال ultrasound في يعني تعقيم
+
+162
+00:14:26,690 --> 00:14:30,640
+العدسة اللاصقةطب من الواضح ان استخدام ال ultra
+
+163
+00:14:30,640 --> 00:14:37,420
+violet او ال ultra sound هذا بتاع اللي هو شركات و
+
+164
+00:14:37,420 --> 00:14:43,480
+مصانع مش يعني user زينا مش user وبالتالي يعني احنا
+
+165
+00:14:43,480 --> 00:14:47,660
+بنقدر نقول ان هذا للعليسات اللي اثقى ال fresh
+
+166
+00:14:47,660 --> 00:14:52,560
+الحديثة او الجديدة العليسات اللي اثقى الجديدة ما
+
+167
+00:14:52,560 --> 00:14:56,130
+بحطولها hydrogen peroxide ولا بحطولها enzymesلأ
+
+168
+00:14:56,130 --> 00:15:01,010
+بالجملة المصانع بالميت ألف و بالميتين ألف عنسة
+
+169
+00:15:01,010 --> 00:15:04,830
+بنخلهم على ال ultra bio طبعا ال ultra bio تستحيل
+
+170
+00:15:04,830 --> 00:15:10,590
+تحتها أيش أيش مايكروب او بكتيريا او فانجس حتى او
+
+171
+00:15:10,590 --> 00:15:17,370
+فيروس لذلك الان المصانع ركزوا على ايش انا بقولك
+
+172
+00:15:17,370 --> 00:15:23,410
+انا بعمل عنسات جديدة رخيصةshort duration ايه short
+
+173
+00:15:23,410 --> 00:15:26,770
+duration فترة قصيرة يعني فترة قصيرة نلبسها اسبوع
+
+174
+00:15:26,770 --> 00:15:29,730
+اسبوع يعني وفده نبسها مايصير عليها protein و ما
+
+175
+00:15:29,730 --> 00:15:33,010
+protein و نحط عليها تحتين ولا لأ لأ ارميها و
+
+176
+00:15:33,010 --> 00:15:38,150
+نيبغيها ليش تكون مثلا مثلا بمائة دولار لأ تكون
+
+177
+00:15:38,150 --> 00:15:42,010
+بعشرة دولار في التفكير الإتصالي بتاعك بقولك أنا
+
+178
+00:15:42,010 --> 00:15:46,150
+بنتج بالعشرة دولار و ببيع أكتر فده عندما أحط عنده
+
+179
+00:15:46,150 --> 00:15:47,650
+مية دولار تبتعد سنتين تلاتة
+
+180
+00:15:53,980 --> 00:15:58,160
+بعضهم كانوا يكونوا فقط مفاجئين بشكل مباشر عندما
+
+181
+00:15:58,160 --> 00:16:01,580
+يكونوا محاولين محاولة ميكرو بيوجيكال عندما يكون
+
+182
+00:16:01,580 --> 00:16:06,960
+هناك بكتيريا نقل البكتيريا نرى المفاعل فمثلا في
+
+183
+00:16:06,960 --> 00:16:12,100
+سنة تسعة و تمانين صار بحث و وددوا انه ميتين و
+
+184
+00:16:12,100 --> 00:16:17,940
+تلاتة وسبعين وسبع من عشرة نانو متر ultravioletwith
+
+185
+00:16:17,940 --> 00:16:23,340
+an intensity of one thousand one hundred one per
+
+186
+00:16:23,340 --> 00:16:26,060
+cubic centimeter achieved satisfactory
+
+187
+00:16:26,060 --> 00:16:30,260
+disinfection with short exposure times يعني دقايق
+
+188
+00:16:30,260 --> 00:16:35,480
+معدودة تقريبا كل الميكروبات ماتت في هذا الطول
+
+189
+00:16:35,480 --> 00:16:40,300
+الموجي قادة ال ultra viral فمثلا شافوا اللي أكل في
+
+190
+00:16:40,300 --> 00:16:45,580
+موبا اللي هو قدام العدوى القرنية قعدت بورفاجة
+
+191
+00:16:48,300 --> 00:16:53,060
+في أقل من ثلاث دقائق في التلاتة وتسعين هاريس عامل
+
+192
+00:16:53,060 --> 00:16:56,600
+بحث برضه بقى concluded that ultraviolet radiation
+
+193
+00:16:56,600 --> 00:16:59,800
+of this wavelength is an effective and rapid
+
+194
+00:16:59,800 --> 00:17:04,240
+method of disinfecting contact lenses بس قلت هي ده
+
+195
+00:17:04,240 --> 00:17:08,780
+مش في البيت عندها، هي ده شغل إيش؟ شركات ومصانع؟
+
+196
+00:17:08,780 --> 00:17:16,310
+طبعا هذين care أو heavily care of طيالةفبقى try on
+
+197
+00:17:16,310 --> 00:17:23,390
+lenses اللي هي استخدمها احنا لإيش للتجريب نبتدأ
+
+198
+00:17:23,390 --> 00:17:28,830
+خاصة في ال heart في ال heart او ال rigid يعني بدنا
+
+199
+00:17:28,830 --> 00:17:32,450
+نشوف راحة المريض من ناحية ال fitness و من ناحية ال
+
+200
+00:17:32,450 --> 00:17:36,310
+.. اللي هو ال optical power و من ناحية ال shape و
+
+201
+00:17:36,310 --> 00:17:39,830
+من ناحية الراحة عدة حاجات فاحنا بدنا نشوف
+
+202
+00:17:49,570 --> 00:17:53,010
+في الولايات المتحدة، 96% من المستخدمين للمصباح
+
+203
+00:17:53,010 --> 00:17:53,930
+الجديد للمصباح الجديد للمصباح الجديد للمصباح
+
+204
+00:17:53,930 --> 00:17:56,770
+الجديد للمصباح الجديد للمصباح الجديد للمصباح
+
+205
+00:17:56,770 --> 00:18:07,330
+الجديد للمصباح الجديد للمصباح الجديد للمصباح
+
+206
+00:18:07,330 --> 00:18:09,310
+الجديد للمصباح الجديد للمصباح الجديد للمصباح
+
+207
+00:18:09,310 --> 00:18:09,410
+الجديد للمصباح الجديد للمصباح الجديد للمصباح
+
+208
+00:18:09,410 --> 00:18:09,830
+الجديد للمصباح الجديد للمصباح الجديد للمصباح
+
+209
+00:18:09,830 --> 00:18:10,970
+الجديد للمصباح الجديد للمصباح الجديد للمصباح
+
+210
+00:18:10,970 --> 00:18:12,270
+الجديد للمصباح الجديد للمصباح الجديد للمصباح
+
+211
+00:18:12,270 --> 00:18:13,330
+الجديد للمصباح الج
+
+212
+00:18:44,370 --> 00:18:50,430
+في حالات ال rigid lenses غالية rigid lenses
+
+213
+00:18:55,470 --> 00:18:58,650
+It is usually considered to be necessary to
+
+214
+00:18:58,650 --> 00:19:02,510
+evaluate the fit of several lenses from a non
+
+215
+00:19:02,510 --> 00:19:05,930
+-disposable fitting set to decide the
+
+216
+00:19:05,930 --> 00:19:10,370
+specification to be ordered يعني أنا صحيح بحط
+
+217
+00:19:10,370 --> 00:19:13,970
+الأولى علسة بشوفش فيها كويس التانية أحسن التالتة
+
+218
+00:19:13,970 --> 00:19:17,910
+أحسن بس هنجرب تلاتة عدسات هذه التلاتة عدسات صاروا
+
+219
+00:19:17,910 --> 00:19:23,090
+contaminated منهم كدههل هو لعيبتهم كده لـ
+
+220
+00:19:23,090 --> 00:19:26,270
+disposable؟
+
+221
+00:19:26,270 --> 00:19:29,950
+لأ، لإني حافظ عليهم، فاني أعملهم كده الـ use of
+
+222
+00:19:29,950 --> 00:19:33,490
+trial lenses assumes particular importance when
+
+223
+00:19:33,490 --> 00:19:36,590
+complex designs such as bifocals are to be
+
+224
+00:19:36,590 --> 00:19:41,250
+supplied و أكتر أهمية لما تكون ال contact هالي
+
+225
+00:19:41,250 --> 00:19:43,730
+bifocal أو trifocal
+
+226
+00:19:48,640 --> 00:19:53,080
+multifunction مش معقول انها مكلفة اني ألقيها فبدها
+
+227
+00:19:53,080 --> 00:20:00,540
+كيل بدها تفيل وبدها نحطها في hydrogen peroxide هيك
+
+228
+00:20:00,540 --> 00:20:03,360
+هم بيكملنا موضوع solutions of contact lenses والآن
+
+229
+00:20:03,360 --> 00:20:07,300
+هنبدأ في therapeutic drugs and their uses الأدوة
+
+230
+00:20:07,300 --> 00:20:12,760
+اللي تستخدم في علاج العين في علاج العين بقوللي
+
+231
+00:20:12,760 --> 00:20:17,540
+باختصار كلمة Anti-infective يعني مضاد
+
+232
+00:20:24,090 --> 00:20:29,090
+effective against a variety of infections يعني طيب
+
+233
+00:20:29,090 --> 00:20:32,970
+واسع من الكائنات اللي بتعمل infection مثلا
+
+234
+00:20:32,970 --> 00:20:37,670
+viruses, rickettsia, bacteria, fungi and so on
+
+235
+00:20:37,670 --> 00:20:40,930
+rickettsia هي كائنات ما بين الفروسات و ما بين
+
+236
+00:20:40,930 --> 00:20:45,710
+البكتيريا زي اللي بتعمل ال syphilis rickettsia
+
+237
+00:20:45,710 --> 00:20:50,370
+يبقى هو بيقول يعني انا اطلب مني اني
+
+238
+00:20:59,600 --> 00:21:05,440
+و لا البروتوزيوه أكارثوموبه ولا الفانجاي و حتى لا
+
+239
+00:21:05,440 --> 00:21:09,920
+الركسيا لو خشت الآن لو أنا ماعنديش هذه المنظومة من
+
+240
+00:21:09,920 --> 00:21:13,760
+المضادات
+
+241
+00:21:13,760 --> 00:21:18,740
+بتاعة ال infection عيون البشر ايش بيصير فيها؟
+
+242
+00:21:18,740 --> 00:21:24,460
+مصيبة مصيبة الميكانيزم of action of these agents
+
+243
+00:21:24,460 --> 00:21:29,490
+varies greatlyكيف تعمل؟ احنا بتحدثنا أو بتحدث كيف
+
+244
+00:21:29,490 --> 00:21:34,810
+تعمل المضادات الحيوية البكتيريا مثلا فمنها من يمزق
+
+245
+00:21:34,810 --> 00:21:40,670
+ال cell wall ومنها من يتحد بـ ribosomes بناءها من
+
+246
+00:21:40,670 --> 00:21:45,810
+تكوين .. ليش؟
+
+247
+00:21:45,810 --> 00:21:49,330
+طاقة .. ribosomes ليش؟ بتخليها low levels of
+
+248
+00:21:49,330 --> 00:21:53,750
+energy اه طيب ومنها من يهاجم in Euclides
+
+249
+00:22:03,610 --> 00:22:08,050
+وهكذا طيب طيب the mechanism of action of these
+
+250
+00:22:08,050 --> 00:22:11,690
+agents varies greatly and to some extent will
+
+251
+00:22:11,690 --> 00:22:14,310
+depend on the organism on which the particular
+
+252
+00:22:14,310 --> 00:22:18,390
+agent acts كمان بعتمد على non-microbe هلي استجيب
+
+253
+00:22:18,390 --> 00:22:22,180
+ولا لايستجيبIn the majority of cases however some
+
+254
+00:22:22,180 --> 00:22:27,300
+competitive inhibition of a biochemical process is
+
+255
+00:22:27,300 --> 00:22:31,180
+involved as a result of the concentration level
+
+256
+00:22:31,180 --> 00:22:38,500
+يبقى أحيانا في دواء يستخدم ب level قليل لكن بيكون
+
+257
+00:22:38,500 --> 00:22:41,800
+effective وفي العكس دواء يستخدم ب concentration
+
+258
+00:22:41,800 --> 00:22:46,060
+عالي و بيكون تأثيره ضعيف حسب المعيك وال ميبك اللي
+
+259
+00:22:46,060 --> 00:22:46,660
+أخدناه قبلها
+
+260
+00:23:02,250 --> 00:23:05,950
+Drugs for the treatment of infections قولنا في شيء
+
+261
+00:23:05,950 --> 00:23:10,550
+اسمه MIC Minimum
+
+262
+00:23:10,550 --> 00:23:15,630
+Inhibitory Concentration are often published for
+
+263
+00:23:15,630 --> 00:23:19,710
+the common anti-infective drugsبقول لي these
+
+264
+00:23:19,710 --> 00:23:26,590
+values يعني كل drug إله Mike، these values will
+
+265
+00:23:26,590 --> 00:23:31,510
+vary according to the infecting organism يعني
+
+266
+00:23:31,510 --> 00:23:35,330
+Staphylococcus aureus مثلا تختلف عن Staphylococcus
+
+267
+00:23:35,330 --> 00:23:41,210
+epidermidis يعني هذا ميكروب متعايش Flora و هذا
+
+268
+00:23:41,210 --> 00:23:48,570
+ميكروب شرسفانا بدي ميك يوطي البكتيريا الشرسة حتى
+
+269
+00:23:48,570 --> 00:23:54,910
+يعني لا تفعل مضاعفة اه بيقولي the might for a
+
+270
+00:23:54,910 --> 00:23:57,570
+strain of Methicillin-resistant Staphylococcus
+
+271
+00:23:57,570 --> 00:24:02,490
+aureus is considerably higher than that of normal
+
+272
+00:24:02,490 --> 00:24:04,730
+Staphylococcus aureus يعني بيقولي حتى
+
+273
+00:24:04,730 --> 00:24:07,950
+Staphylococcus aureus في منها يحطم أنواع البنسالي
+
+274
+00:24:07,950 --> 00:24:09,890
+ويحلله
+
+275
+00:24:11,380 --> 00:24:14,680
+فابدى انا علاج يكون ال mic بتاعه يتناسى في هذه
+
+276
+00:24:14,680 --> 00:24:21,680
+الشراسة وهذه المقاومة باختلاف اللى هو الاستفحاة
+
+277
+00:24:21,680 --> 00:24:27,160
+الكاسية العادية اللى ما بتعمل تكسير لإيش لاتفاتكس
+
+278
+00:24:27,160 --> 00:24:31,740
+when it comes to treating ophthalmic infections
+
+279
+00:24:38,520 --> 00:24:42,060
+There are many more factors to take into
+
+280
+00:24:42,060 --> 00:24:46,020
+consideration يبقى أنا في الأول بأتكلم عن التهيبات
+
+281
+00:24:46,020 --> 00:24:51,080
+الرئتين، التهيبات الحلق، التهيبات الأمعاء،
+
+282
+00:24:51,080 --> 00:24:55,100
+التهيبات المجال المولية، لكن يقولنا احنا العين
+
+283
+00:24:55,100 --> 00:25:02,260
+تختلف، العين إقليم شبه مستقل، اذا أقول كون فدرالي،
+
+284
+00:25:02,260 --> 00:25:05,920
+كون فدرالي، مش فدرالي بقى يعني، العين دخولها
+
+285
+00:25:05,920 --> 00:25:11,160
+وخروجها مش سهل، فيه بريئةفلما اتكلم انا الآن بدي
+
+286
+00:25:11,160 --> 00:25:17,700
+انا اوجد اشياء تؤثر في العلم او العلاج يؤثر فيها
+
+287
+00:25:17,700 --> 00:25:22,900
+في العلم اختلف عن باق الجسم فمثلا when the locus
+
+288
+00:25:22,900 --> 00:25:26,620
+or site of infection will determine not only the
+
+289
+00:25:26,620 --> 00:25:30,120
+route of the administration but also the prognosis
+
+290
+00:25:30,120 --> 00:25:35,240
+infections of the anterior eyeيعني في ال eye
+
+291
+00:25:35,240 --> 00:25:39,620
+segment قصدهم يعني حاجات في القرنية و في ال AC و
+
+292
+00:25:39,620 --> 00:25:43,400
+حتى في ال iris تختلف عن أشياء في ال retina back
+
+293
+00:25:43,400 --> 00:25:47,580
+further back يعني صحيح أنا مهل بدي عالج شيء في
+
+294
+00:25:47,580 --> 00:25:51,660
+القرن اه زي بدي عالج شيء في ال retina او الفترياس
+
+295
+00:25:51,660 --> 00:25:55,060
+طبعا مختلف ال retina و الفترياس بيبقوا injection
+
+296
+00:25:55,060 --> 00:26:00,700
+رترو بربر اه رترو بربر بيجيبوه مش القطر او القرن
+
+297
+00:26:00,700 --> 00:26:04,860
+من هذافهي مثلا consideration مش مولود في جسمها،
+
+298
+00:26:04,860 --> 00:26:07,240
+أهم الاسم منها أخدها الأقراس أو الحجونة والدم
+
+299
+00:26:07,240 --> 00:26:11,480
+بيشيل، بيوزع، بيوزع، لكن الدم مابتداش يوزع على
+
+300
+00:26:11,480 --> 00:26:15,740
+العين، الدم يوزع مثلا على اللي هو الرئتين وعلى
+
+301
+00:26:15,740 --> 00:26:18,220
+اللي هو القلب وعلى الحاجات هذه
+
+302
+00:26:25,940 --> 00:26:33,240
+والله واحد مع severe acute endocyclitis ممكن اعطيه
+
+303
+00:26:33,240 --> 00:26:38,100
+cortison كل ساعة او واحد طالع من intraocular
+
+304
+00:26:38,100 --> 00:26:43,080
+operation طالع من ultra intraocular operation كل
+
+305
+00:26:43,080 --> 00:26:48,160
+ساعة و ساعتين بدي اعطيه قطرات جوية لكن واحد مع
+
+306
+00:26:48,160 --> 00:26:55,250
+شوية infection في الملتحمة جد جات يعنيكل ست ساعات
+
+307
+00:26:55,250 --> 00:26:59,870
+قطرة أفلوس كل ست ساعات فالاهتمام حسب ال label of
+
+308
+00:26:59,870 --> 00:27:05,350
+inflammation هل ال inflammation شديد ولا مش شديد
+
+309
+00:27:05,350 --> 00:27:09,390
+الاهام التالت في العين تيري فلو و ال similarly
+
+310
+00:27:09,390 --> 00:27:13,350
+affect the absorption of anti-infective agents
+
+311
+00:27:13,350 --> 00:27:16,770
+يعني الشباب عندهم تيري فلو normal و قوي
+
+312
+00:27:26,170 --> 00:27:32,150
+هنا ال .. يعني في تفاعل و في دوابان لل .. ال .. ال
+
+313
+00:27:32,150 --> 00:27:36,010
+.. إيش؟ الأجوية و في استقبال إلها و absorption لكن
+
+314
+00:27:36,010 --> 00:27:39,950
+واحد مع dry eye يعني و ده صح واحد مع dry eye واحد
+
+315
+00:27:39,950 --> 00:27:49,290
+و ده صح طيب هتكلم ع ال bacteria لأنه ال .. يعني
+
+316
+00:27:49,290 --> 00:27:53,450
+more than ninety percent of eye infections is إيش؟
+
+317
+00:27:56,230 --> 00:27:59,770
+فبتكلم دايما عن البكتيريا لكن مش مع ذلك الفيروسات
+
+318
+00:27:59,770 --> 00:28:02,130
+إيه اللي يعني أننا خاصة ال herpes simplex
+
+319
+00:28:02,130 --> 00:28:06,370
+كيلوتايتس برضه بنختار فيهم فالبكتيريا بقول as with
+
+320
+00:28:06,370 --> 00:28:10,930
+most of pharma drugs the antibacterials used on
+
+321
+00:28:10,930 --> 00:28:14,410
+the eye were originally blocked for systemic use
+
+322
+00:28:14,410 --> 00:28:21,990
+يعني احنا مستوردناش للعين من القمر مضادة حيوية لأ
+
+323
+00:28:21,990 --> 00:28:26,280
+بقول المضادة الحيوية اللي بنعطيها systemicيعني
+
+324
+00:28:26,280 --> 00:28:33,320
+العلاج الجهاز التنفسي او الجهاز الهضمي او الجهاز
+
+325
+00:28:33,320 --> 00:28:39,000
+البولي التناسلي هي نفس المنطقة الحيوية اللي
+
+326
+00:28:39,000 --> 00:28:47,040
+بنعطيها للعين بس بصورة drops to the point نشتاق
+
+327
+00:28:47,040 --> 00:28:54,310
+منها يعني اشتقاق however in the mainIt is the ones
+
+328
+00:28:54,310 --> 00:28:58,830
+that have no or very restricted systemic use that
+
+329
+00:28:58,830 --> 00:29:01,770
+are most popular for treatment of the eye بس في
+
+330
+00:29:01,770 --> 00:29:08,310
+حاجة يعني هي حكمة يعني خلونا .. حكمة بقول يعني ان
+
+331
+00:29:08,310 --> 00:29:15,470
+في بعض الأدوية قليلا تستخدم systemic زي مثلا
+
+332
+00:29:15,470 --> 00:29:20,490
+chlorine phenicol قليلا تستخدم systemic لأنه بيعمل
+
+333
+00:29:20,490 --> 00:29:22,270
+مشاكل على الدم
+
+334
+00:29:26,090 --> 00:29:33,890
+المناع فبيخافوا منه ان يُعطوه إلا كهلات نادرة بقول
+
+335
+00:29:33,890 --> 00:29:40,490
+هذا للعين جوهري ودهبي ليش؟ لأن الأدوية العادية
+
+336
+00:29:40,490 --> 00:29:43,230
+المضادة الحيوية العادية اللي بنمانعها كل يوم
+
+337
+00:29:43,230 --> 00:29:50,610
+البكتيريا إيش بتعملها؟ resistance يعني سرها
+
+338
+00:30:00,880 --> 00:30:05,700
+استخدام ال antibiotic بكترة كل ما ال resistance
+
+339
+00:30:05,700 --> 00:30:12,800
+زادت لأن الشفرة أو التركيب الكيميائي يعني اقصد
+
+340
+00:30:12,800 --> 00:30:17,840
+المضارض الحيوي يتكشف الفكسيري طول نفسي ايوة لكن
+
+341
+00:30:17,840 --> 00:30:21,420
+antibiotic ولا في السنة بيستخدم مرة او مرتين او
+
+342
+00:30:21,420 --> 00:30:28,380
+تلاتة في مجتمع ما هذا لعين ذهبيلأن هو مش هيروح على
+
+343
+00:30:28,380 --> 00:30:32,080
+الدم و يعمل المشاكل بتاعة ال .. النقطة الواحدة
+
+344
+00:30:32,080 --> 00:30:37,440
+بتعملش .. بتعملش يخلق إضاءة و المناعة، شايفين كيف؟
+
+345
+00:30:37,440 --> 00:30:40,560
+زي ما جال الشعرش جال .. بذلك قدرت الأيام و ما بينا
+
+346
+00:30:40,560 --> 00:30:46,940
+أهليها مصايب قوم عند قوم فوائده، انت مش حافظين،
+
+347
+00:30:46,940 --> 00:30:52,780
+انت فاهم الشعرش صح؟ اه، ما بينا أهليها فوائده قوم،
+
+348
+00:30:52,780 --> 00:30:57,440
+مصايب قوم عند قوم فوائدهزي واحد بيقولك يعني يراكب
+
+349
+00:30:57,440 --> 00:31:00,920
+على جمل وجمل اللي هو قال بيموت، شايف نفسي قال
+
+350
+00:31:00,920 --> 00:31:05,220
+لحقوني بسكينة، لحقوه بالسكينة، ذبحوه و قالوا و
+
+351
+00:31:05,220 --> 00:31:09,160
+الله غير انفرقوا عليه، فهم قاعدين و هم مش عارفين
+
+352
+00:31:09,160 --> 00:31:13,200
+انه يحجوهم بجمل و يتبحوه، فهو زي موصيبة، راح جمله
+
+353
+00:31:13,200 --> 00:31:17,760
+و ركوبه بتاعته، لكن هم استفدوا و أكلوا لحم تلت
+
+354
+00:31:17,760 --> 00:31:24,500
+اربع ايام او خمس ايامطيب، يبقى الـ Antibiotics
+
+355
+00:31:24,500 --> 00:31:32,020
+الأقل تداولًا للـ Systemic Use هي الأفضل للعين،
+
+356
+00:31:32,020 --> 00:31:38,340
+كويس؟ Although some antibacterials are marketed as
+
+357
+00:31:38,340 --> 00:31:41,040
+simple ophthalmic preparations containing just one
+
+358
+00:31:41,040 --> 00:31:43,820
+active ingredient, many preparations contain
+
+359
+00:31:43,820 --> 00:31:49,530
+eitherAntibacterias or Asteroids and Antibiotics
+
+360
+00:31:49,530 --> 00:31:53,510
+يعني الأن تفننوا حتى بدل أن يحطوا نقطة مضادة حيوية
+
+361
+00:31:53,510 --> 00:31:59,650
+يحطوا اتنين استيرويد بقى؟ أه لأ وفي Antibiotics في
+
+362
+00:31:59,650 --> 00:32:03,490
+Antibiotics اتنين أو تلأ يعني مثلا قطرة ال
+
+363
+00:32:03,490 --> 00:32:06,010
+Maxitrol اللي في السوق مليانة في السوق اسمها
+
+364
+00:32:06,010 --> 00:32:09,230
+Maxitrol فيها Two Antibiotics
+
+365
+00:32:14,720 --> 00:32:18,320
+لأ في قطرات فيها three antibiotics يعني مولا في
+
+366
+00:32:18,320 --> 00:32:21,680
+اتحاد اتحاد اتحاد نقطة حط فيها يعني اكتر من
+
+367
+00:32:21,680 --> 00:32:25,240
+antibiotic خاصة في حالات الخطيرة خاصة في الحالات
+
+368
+00:32:25,240 --> 00:32:31,240
+الخطيرة وهذا يعني ايش زيادة في الفايدة للمريض
+
+369
+00:32:33,970 --> 00:32:37,170
+قسموا المجموعات اللي تستخدم في علاج العين ك
+
+370
+00:32:37,170 --> 00:32:40,930
+Antibiotics Beta Leptams مجموعة البنسينية بتاعك
+
+371
+00:32:40,930 --> 00:32:45,130
+العصلية فهي البنسينين اللي قبل مئة سنة تقريبا
+
+372
+00:32:45,130 --> 00:32:50,310
+اسمها Beta Leptams وهنا تترى Cyclins الترميسينات
+
+373
+00:32:50,310 --> 00:32:58,690
+وهنا Macrolides المجموعات اللي هي الترميسين و ال
+
+374
+00:32:58,690 --> 00:33:02,680
+generations بتاعتهم الترميسينChloramphenicols
+
+375
+00:33:02,680 --> 00:33:08,780
+مجموعة Fluoroquinolones مجموعة الـ Oflox والزيمر
+
+376
+00:33:08,780 --> 00:33:13,060
+والحيات هذه حديثة طبعا حديثة أحدث شيء Amino
+
+377
+00:33:13,060 --> 00:33:17,900
+glycosides مجموعة الجين التمايسيين والأبجين
+
+378
+00:33:17,900 --> 00:33:22,200
+والحيات هذه ثم سالفة مجموعة السالفة الآن obsolete
+
+379
+00:33:22,200 --> 00:33:24,680
+مستخدمات يعني كان زمان مهم
+
+380
+00:33:32,190 --> 00:33:36,250
+لو اتكلمنا على ال beta-lactam باختصار beta-lactams
+
+381
+00:33:36,250 --> 00:33:41,370
+هذه البنسيرينة مجموعة البنسيرين الأصلي ال beta
+
+382
+00:33:41,370 --> 00:33:46,450
+-lactams فيه ring يعني هي اللي عليها السهم عشان
+
+383
+00:33:46,450 --> 00:33:51,670
+هيك ال ring هذه beta ring lactam ring فسموها بناء
+
+384
+00:33:51,670 --> 00:33:51,990
+على
+
+385
+00:33:56,310 --> 00:34:00,310
+بياخد أو بيحتوي على Beta-Lactam سموه في المجموعة
+
+386
+00:34:00,310 --> 00:34:04,870
+هذه وهي الـ Benzaline ومشتقاته طبعا الـ Brocaine
+
+387
+00:34:04,870 --> 00:34:11,030
+Benzaline الأصلي اللي حتى الآن injectable اشتق منه
+
+388
+00:34:11,030 --> 00:34:17,690
+عدة مشتقان حتى إنها كده قول يعني بالعشرة Benzaline
+
+389
+00:34:17,690 --> 00:34:21,770
+كده Benzaline كده مضادلة كده Benzaline يعني في
+
+390
+00:34:21,770 --> 00:34:27,500
+التركيب الكيميائي بتاع Benzalineأضفوله ذرّار و
+
+391
+00:34:27,500 --> 00:34:34,180
+جذئاب فأصبح في منه أشياء كثيرة فمثلا ما منكم إلا
+
+392
+00:34:34,180 --> 00:34:40,980
+مثلا مارور مع ال .. ال أمو بذكير مثلا أمو بذكير
+
+393
+00:34:40,980 --> 00:34:46,960
+هنا في السوية يعني هو .. يعني كمان كلمة بقى ع ال
+
+394
+00:34:46,960 --> 00:34:51,380
+.. لمون وربع أشهر شكل العلماء أمو بذكير هذا إحدى
+
+395
+00:34:51,380 --> 00:35:00,260
+المشتقات فتال البنسة ديبعدين طوروا منه لفظة سلن
+
+396
+00:35:00,260 --> 00:35:06,540
+أمبي سلن أموز سلن وان أموز كتر أمبي سلن بفر سلن
+
+397
+00:35:06,540 --> 00:35:10,920
+طور وان أمبي كتر لكن أنا بهم مثل آخر إيش استخدامه
+
+398
+00:35:10,920 --> 00:35:15,060
+في العين؟ يعني هذا systemic؟ أه، كويس، لكن إيش
+
+399
+00:35:15,060 --> 00:35:21,940
+استخدامه في العين؟ في العين بيقول ليه؟ فالسلن pass
+
+400
+00:35:21,940 --> 00:35:23,500
+across the ocular
+
+401
+00:35:27,460 --> 00:35:36,980
+مورلي للأسف، إيش في ال barriers؟ كوريا،
+
+402
+00:35:36,980 --> 00:35:38,060
+و سكليرا
+
+403
+00:35:47,650 --> 00:35:52,690
+بلاد ايش؟ بتاعتنا ال barrier و بلاد ايش؟ براير ال
+
+404
+00:35:52,690 --> 00:35:57,790
+barrier لأ مش براير لأشتغلنا في ال brain في القرار
+
+405
+00:35:57,790 --> 00:36:01,490
+و في ال iris وشيء كل هذه barriers طيب فبقولي يا
+
+406
+00:36:01,490 --> 00:36:05,490
+روح عبر هذه ال barriers very poor and products
+
+407
+00:36:05,490 --> 00:36:08,750
+containing them are rarely used in the treatment
+
+408
+00:36:08,750 --> 00:36:12,170
+of ocular infections يعني أنا الحمد لله إيلي في
+
+409
+00:36:12,170 --> 00:36:18,950
+الفيل بالقليل من عشرين سنةلم نستخدم قطرة بنسرين أو
+
+410
+00:36:18,950 --> 00:36:23,830
+مشطقاته ولا مرحب بنسرين أو مشطقاته عشان هذا السبب
+
+411
+00:36:23,830 --> 00:36:28,430
+يبقى بنسرين بيبقى لهم systemic use لكن ال local
+
+412
+00:36:28,430 --> 00:36:34,350
+use في العين في عندهم مشكلة مش مفيدة كتير راحوا
+
+413
+00:36:34,350 --> 00:36:38,450
+طبعا بعد هيك تترا cyclines تترا cyclines هذه
+
+414
+00:36:38,450 --> 00:36:45,240
+family كبيرة في منها عديد من أعضاءفمثلًا broad
+
+415
+00:36:45,240 --> 00:36:51,220
+spectrum وسط ال .. اه chlor .. اه chlor
+
+416
+00:36:51,220 --> 00:36:56,340
+tetracyclines و دي ميه؟ دي مثال chlor tetracycline
+
+417
+00:36:56,340 --> 00:37:01,900
+و oxytetracycline و tetracycline بعد و doxycycline
+
+418
+00:37:01,900 --> 00:37:07,000
+و انجلاندر مش انت خدت دوكدا سيلين؟ دوكدا سيلين هو
+
+419
+00:37:07,000 --> 00:37:11,770
+هذامجموعات التراميسين بس طوروا على المجموعة
+
+420
+00:37:11,770 --> 00:37:16,350
+الأساسية للتترا سايكلين و حطوله تفضسيلين سنة وتاخر
+
+421
+00:37:16,350 --> 00:37:20,570
+once daily which has a broader spectrum and more
+
+422
+00:37:20,570 --> 00:37:26,510
+specific لهو indications طيب
+
+423
+00:37:26,510 --> 00:37:29,670
+تترا سايكلين are effective against gram positive
+
+424
+00:37:29,670 --> 00:37:33,270
+and gram negative بكتيريا يشتغل على gram positive
+
+425
+00:37:33,270 --> 00:37:36,390
+و gram negative وهذا احنا بيقولنا broad spectrum
+
+426
+00:37:37,470 --> 00:37:42,710
+لما مضاد حيوي بيشتغل بس على ال gram positive أو بس
+
+427
+00:37:42,710 --> 00:37:45,410
+على ال gram negative بيقول عنه narrow spectrum
+
+428
+00:37:45,410 --> 00:37:51,150
+antibiotic لكن لما بيكون بيشتغل على gram positive
+
+429
+00:37:51,150 --> 00:37:56,030
+and gram negative بيكون بيشتغل على مئات أنواع من
+
+430
+00:37:56,030 --> 00:37:57,110
+البكتيريا بيقول عنه
+
+431
+00:38:01,090 --> 00:38:05,330
+طيب بيقول اللي ال tetracycline مش بس بيشتغل على
+
+432
+00:38:05,330 --> 00:38:08,910
+البكتيريا بل بيشتغل على ال spiral case وعلى
+
+433
+00:38:08,910 --> 00:38:13,010
+الكلياميديا اللي بتعمل ال trachoma وعلى أخر ال
+
+434
+00:38:13,010 --> 00:38:16,530
+organisms يعني كمان وصلة type 1 أكتر من البكتيريا
+
+435
+00:38:16,530 --> 00:38:22,310
+أشياء أخرى resistance بيقولوا البكتيريا ال ground
+
+436
+00:38:22,310 --> 00:38:25,530
+negative اللي اسمها Sodomorus Sodomorus خطيرة جدا
+
+437
+00:38:25,530 --> 00:38:27,270
+هي بتعمل colon ulcer
+
+438
+00:38:30,930 --> 00:38:36,570
+الهيلو بيقدرش عليها و البروتياس برضه بتعمل كورن
+
+439
+00:38:36,570 --> 00:38:42,450
+الألثل برضه مابيقدرش عليها لكن باقي البكتيريا
+
+440
+00:38:42,450 --> 00:38:46,550
+العادية بتاعة ال congenitivites و إشي هي كويسة
+
+441
+00:38:46,550 --> 00:38:53,110
+side effects سيستانيك بيعمل ال stomach upset طعم
+
+442
+00:38:53,110 --> 00:38:56,430
+متعب وين في المدى هذا سيستانيك لو أخدنا كرسولة
+
+443
+00:38:56,430 --> 00:39:03,000
+نوزيا و vomiting on دياريةفلو أخدنا كابسولات و
+
+444
+00:39:03,000 --> 00:39:09,240
+كمان لو أخدنا كابسولات ممكن يعمل على أسنان الأطفال
+
+445
+00:39:09,240 --> 00:39:18,120
+تلون برتقالي أو أصفر يترسب في هضام الأطفال و هضام
+
+446
+00:39:18,120 --> 00:39:24,840
+الحوامل they permanently color teeth yellow and
+
+447
+00:39:24,840 --> 00:39:31,390
+show bone growthالعينا يبطئ من نمو الأعضاء في
+
+448
+00:39:31,390 --> 00:39:35,970
+الأطفال بسبب قدرات كالسيوم المغنيزيوم يتحد
+
+449
+00:39:35,970 --> 00:39:40,750
+بالكالسيوم المغنيزيوم ويمنعهم من أن يكونوا مدبزشين
+
+450
+00:39:40,750 --> 00:39:44,990
+في البون في بناء البون عشان هيك Contra-indicated
+
+451
+00:39:44,990 --> 00:39:50,990
+في الأطفال وفي الحوابل عشان يخش في أعضاء الجنيد
+
+452
+00:39:50,990 --> 00:39:55,490
+البرج ال fix from topical application نجي للعين
+
+453
+00:39:55,490 --> 00:40:02,630
+لعينبقول ان القطر في العين قرر مافيش حدات في العين
+
+454
+00:40:02,630 --> 00:40:08,290
+يعني نايبها عليه due to the slow dose of the drug
+
+455
+00:40:08,290 --> 00:40:11,730
+يعني احنا انا قطر بقولك واحد في المية تترا ساكلين
+
+456
+00:40:11,730 --> 00:40:19,770
+قطرة ولا هتعمل جد كابسولة في خلال اربع اش أشهر
+
+457
+00:40:19,770 --> 00:40:25,610
+يعني انا قطر التترا ساكلين في العين مدت اربع أشهر
+
+458
+00:40:27,450 --> 00:40:32,170
+الجوعة تساوي كرسولة هذا فيما يتعلق بالـ Systemic
+
+459
+00:40:32,170 --> 00:40:38,770
+فيعني مافيش من الخوف لكن الحقيقة ان ال penetration
+
+460
+00:40:38,770 --> 00:40:42,670
+across the intact cornea is poor and these
+
+461
+00:40:42,670 --> 00:40:46,190
+compounds are best used for surface infections as
+
+462
+00:40:46,190 --> 00:40:51,510
+ointment يعني في مرحم الترميسيين والجردرسيكليين
+
+463
+00:40:51,510 --> 00:40:55,930
+والغوزيسيين كل هذه كانت بس كندرة طيبة ال infection
+
+464
+00:40:56,860 --> 00:41:02,140
+والـ Blepharitis و Lid Infection و الكلام ده لكن
+
+465
+00:41:02,140 --> 00:41:06,660
+مش ليه علاج ال Intraocular Infection ولا حتى
+
+466
+00:41:06,660 --> 00:41:11,980
+Keratitis كويس؟ انه موجود Gordacycline و Teramycin
+
+467
+00:41:11,980 --> 00:41:13,320
+مش هو Teramycin المرمى
+
+468
+00:41:44,540 --> 00:41:52,300
+الحديث الولانا الذين نزلوا مفتهابات في الملتحق
+
+469
+00:41:52,300 --> 00:41:58,480
+الوولانا
+
+470
+00:41:58,480 --> 00:42:06,680
+اول مالطف يولد في الساعة الأولى تجي الناستغسل
+
+471
+00:42:06,680 --> 00:42:13,180
+عينيه بصرايه تشفهم و تضع لهم مرهم ترميسين في
+
+472
+00:42:13,180 --> 00:42:18,580
+الصباح و في المساء هذا profile axis لو ولد لهم
+
+473
+00:42:18,580 --> 00:42:25,920
+عندها تلور في مجاري الولادة اكتر اكتر هذا يمنع انه
+
+474
+00:42:25,920 --> 00:42:31,980
+تطور ال infection تطور ال infection في ال 83
+
+475
+00:42:35,270 --> 00:42:43,630
+و روش و نيور تور ايضا اقتنع انترامسبربنسيلين و
+
+476
+00:42:43,630 --> 00:42:49,030
+تتراساكليين 1% كمشروع بروفيلافتك يعني قال اه اعطي
+
+477
+00:42:49,030 --> 00:42:53,910
+الأم حقنا في
+
+478
+00:42:53,910 --> 00:42:58,390
+العضل فيها بنسلين و تتراساكليين عشان لو ولد
+
+479
+00:42:58,390 --> 00:43:04,240
+المولود بالذهاب انه مايفلش فيهإذا كانت الانفكارية
+
+480
+00:43:04,240 --> 00:43:11,040
+كلياميديا زي التراكومة، فالتراثيكليت تريتمنت يعني
+
+481
+00:43:11,040 --> 00:43:13,500
+مرهم هو أن يتم تجاربه على أخرى
+
+482
+00:43:13,500 --> 00:43:32,060
+الانتيبويتكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكي
+
+483
+00:43:36,430 --> 00:43:39,850
+هو اكثر من اي انتيباتيك اخر
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/6nZKRnLf7lA_raw.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/6nZKRnLf7lA_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..da56122d53ee3e598740ded347f85d5103245885
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/6nZKRnLf7lA_raw.srt
@@ -0,0 +1,1940 @@
+1
+00:00:26,010 --> 00:00:33,550
+السلام عليكم ورحمة الله وبركاته اليوم سنكمل اللي
+
+2
+00:00:33,550 --> 00:00:38,530
+هو solutions of contact lenses هتكلم اليوم شوية
+
+3
+00:00:38,530 --> 00:00:44,210
+على enzymatic cleaners وهذه أحدث صحيحة في عالم
+
+4
+00:00:44,210 --> 00:00:49,650
+تنظيف العدسات اللسانية بيقول in form of tablets
+
+5
+00:00:53,040 --> 00:00:56,160
+containing N-enzyme are dissolved in either saline
+
+6
+00:00:56,160 --> 00:00:59,400
+or distilled water to remove the natured protein
+
+7
+00:00:59,400 --> 00:01:02,120
+deposited from the surfaces of the contaminant
+
+8
+00:01:02,120 --> 00:01:07,040
+يبقى احنا نجيب القرص بتاع الانزين ونحطه اما فيه
+
+9
+00:01:07,040 --> 00:01:12,440
+saline او فيه distilled water ماء مقطر تلقاعب
+
+10
+00:01:12,440 --> 00:01:18,540
+المحلول هنا بدور هو ال N هو مهمته هذا انه يشيل ال
+
+11
+00:01:18,540 --> 00:01:25,980
+proteinالمترسد على سطح ال contact lens يعني ثبت ان
+
+12
+00:01:25,980 --> 00:01:31,000
+النزيم هاضم يعني حتى في القناة الهضمية هو هاضم و
+
+13
+00:01:31,000 --> 00:01:34,900
+they are originally introduced for use about once
+
+14
+00:01:34,900 --> 00:01:38,620
+a week with hydrogel lenses يعني هم كانوا يحطوهم
+
+15
+00:01:38,620 --> 00:01:42,440
+على hydrogel lenses once weekly يعني في الأسبوع
+
+16
+00:01:42,440 --> 00:01:47,380
+يعني في الشهر أربع مرةبقى إفلسري كان قصه بيستخدم
+
+17
+00:01:47,380 --> 00:01:51,120
+الـ rigid contact lenses يعني كان في الهيدروجي ال
+
+18
+00:01:51,120 --> 00:01:56,640
+contact lenses لكن ممكن استخدام ال rigid contact
+
+19
+00:01:56,640 --> 00:02:03,300
+lenses في العادى استعمال ال contact lens بيعمل
+
+20
+00:02:03,300 --> 00:02:09,660
+فيلم أو بروتين على سطح ال contact lens وهذا
+
+21
+00:02:09,660 --> 00:02:15,570
+البروتين جاء أساسا من تفيلموجهة أساسا من تير فيلم
+
+22
+00:02:15,570 --> 00:02:24,530
+اللي هو بيشكل زي ال circulation يعني في تجديد أو
+
+23
+00:02:24,530 --> 00:02:28,170
+refreshing للإيش اللي هو تير فيلم وبالتالي في
+
+24
+00:02:28,170 --> 00:02:32,530
+protein في ال contact lens فبترسب على سطح العدسة
+
+25
+00:02:32,530 --> 00:02:37,310
+اللي لمسكها تماما لو حطينا صخرة في مجرماء بعد شوية
+
+26
+00:02:37,310 --> 00:02:39,670
+بتصير خضرة وصير عليها تحارب وزي كده
+
+27
+00:02:43,870 --> 00:02:48,550
+ممكن ان يكون فيه fat deposits و protein deposits
+
+28
+00:02:48,550 --> 00:02:53,810
+او another test اصعب شيء في الإزالة ايش اللي هو ال
+
+29
+00:02:53,810 --> 00:02:58,170
+protein الشيء الصعب انه احنا نزيله اللي هو ال
+
+30
+00:02:58,170 --> 00:03:05,270
+protein في أكمين في grab uric طيب حيبدأ في ال
+
+31
+00:03:05,270 --> 00:03:12,730
+papainهو انزين one of the enzymatic أو enzymes
+
+32
+00:03:12,730 --> 00:03:18,950
+used in protein removing tablets is a thermostable
+
+33
+00:03:18,950 --> 00:03:24,850
+يعني لو تعرض الحرارة بتكساش يعني مستقر في الحرارة
+
+34
+00:03:24,850 --> 00:03:29,670
+thermostable are endobotidase يعني وزي البروتينات
+
+35
+00:03:29,670 --> 00:03:35,130
+found in the tau tau throat الآن في غزة سمع أنا
+
+36
+00:03:35,130 --> 00:03:36,150
+كده باسمه بابا
+
+37
+00:03:41,450 --> 00:03:47,310
+هذا أخذوا منه بربيع
+
+38
+00:03:47,310 --> 00:03:53,570
+بربيع بربيع
+
+39
+00:03:53,570 --> 00:03:57,570
+بربيع بربيع بربيع بربيع بربيع بربيع بربيع بربيع
+
+40
+00:03:57,570 --> 00:03:57,570
+بربيع بربيع بربيع بربيع بربيع بربيع بربيع بربيع
+
+41
+00:03:57,570 --> 00:03:57,570
+بربيع بربيع بربيع بربيع بربيع بربيع بربيع بربيع
+
+42
+00:03:57,570 --> 00:03:57,650
+بربيع بربيع بربيع بربيع بربيع بربيع بربيع بربيع
+
+43
+00:03:57,650 --> 00:03:58,030
+بربيع بربيع بربيع بربيع بربيع بربيع بربيع بربيع
+
+44
+00:03:58,030 --> 00:04:01,410
+بربيع بربيع بربيع بربيع بربيع بربيع بربيع بربيع
+
+45
+00:04:01,410 --> 00:04:08,130
+بربيع بربيع بربيع
+
+46
+00:04:17,460 --> 00:04:22,360
+السبتيلزم هو نبات من بكتيريا باسيلاس
+
+47
+00:04:22,360 --> 00:04:28,300
+الأكليكينوفورمس، لأ هنا السبتيلزم إنزيم بس لا يُخل
+
+48
+00:04:28,300 --> 00:04:32,260
+من البضائع، يُخل من أيش؟ بكتيريا اسمها باسيلاس
+
+49
+00:04:32,260 --> 00:04:36,540
+الأكليكينوفورمسEquilibrium of the efficiency of
+
+50
+00:04:36,540 --> 00:04:41,280
+papain and subtilism يعني قارنوا بين اتنين وجدوا
+
+51
+00:04:41,280 --> 00:04:47,220
+انه طبعا ال papain اقوى في ازالة لبروتينات ال
+
+52
+00:04:47,220 --> 00:04:52,940
+heavy protein deposits بينما ال subtilism في ال
+
+53
+00:04:52,940 --> 00:04:56,820
+light protein deposits يبقى لو العدسة اللازقة
+
+54
+00:04:56,820 --> 00:05:04,260
+عليها طبقة بروتينية سميكة اه هو ال papainبينما لو
+
+55
+00:05:04,260 --> 00:05:08,540
+طبقة رفيعة
+
+56
+00:05:08,540 --> 00:05:15,200
+وخفيفة بالفترة إيه اللي هو Subtilism الفترة
+
+57
+00:05:15,200 --> 00:05:18,340
+however when chemical disinfection and enzymatic
+
+58
+00:05:18,340 --> 00:05:22,380
+cleaning was compared with oxidative disinfection
+
+59
+00:05:22,380 --> 00:05:25,480
+alone, the lenses treated by the former method
+
+60
+00:05:25,480 --> 00:05:27,000
+were significantly cleaner
+
+61
+00:05:29,480 --> 00:05:33,240
+by later يعني قارنه بين عدسة لاسكا بنحط لها
+
+62
+00:05:33,240 --> 00:05:38,420
+hydrogen peroxide ماء أكسجين باستمرار وبين عدسة
+
+63
+00:05:38,420 --> 00:05:44,420
+بنحط لها ال papain انزين من أنضاف لجو اللي بنحط
+
+64
+00:05:44,420 --> 00:05:51,440
+لها ال papain ما ملاحظة ان ال papain once weekly
+
+65
+00:05:51,440 --> 00:05:57,940
+فلما ال hydrogen ال hydrogen peroxide daily كل يوم
+
+66
+00:05:59,860 --> 00:06:06,360
+فمش مقلول يحطوا كل يوم انزيب مكلف فهم الأن وجدوا
+
+67
+00:06:06,360 --> 00:06:09,420
+أفضل طريقة الجمع بين الحسناجين كيف الجمعة بين
+
+68
+00:06:09,420 --> 00:06:15,060
+الحسناجين انه كل يوم يحطوا hydrogen peroxide محلول
+
+69
+00:06:15,060 --> 00:06:22,120
+في الكاس وفي آخر السبوع يوم الجمعة مثلا يحطوا اش
+
+70
+00:06:22,120 --> 00:06:26,040
+بابيد هيك يقولك ان هيك أفضل
+
+71
+00:06:28,710 --> 00:06:32,170
+with either type of cleaner were contaminated more
+
+72
+00:06:32,170 --> 00:06:35,930
+than those treated with both بس كان احنا جامعنا
+
+73
+00:06:35,930 --> 00:06:40,190
+بين اللي هو البرتين كإنزين والهيدروجين
+
+74
+00:06:40,190 --> 00:06:46,690
+الهيليبروإكسايد كdisinfectant هذا كل يوم و هذا مرة
+
+75
+00:06:46,690 --> 00:06:51,350
+في الأسبوع وجدوا انه النظافة و الطهارة و التطهير
+
+76
+00:06:51,350 --> 00:06:55,090
+أفضل بالتانين من واحد واضح بالنسبالي؟
+
+77
+00:07:00,490 --> 00:07:04,350
+و قبل فترة حد السنوات طلعوا محلول اسمه comfort
+
+78
+00:07:04,350 --> 00:07:09,950
+drops و كلمة comfort تشي براها comfort يعني راحة و
+
+79
+00:07:09,950 --> 00:07:14,570
+comfort يعني مريض these drops which are also
+
+80
+00:07:14,570 --> 00:07:18,470
+referred to as re-wetting condition او
+
+81
+00:07:18,470 --> 00:07:24,070
+conditioning او cushioning drops يعني نوع من
+
+82
+00:07:24,070 --> 00:07:29,130
+الترتيب و نوع من الراحة cushioning زي الوسادة
+
+83
+00:07:34,720 --> 00:07:40,640
+وطريقة يعني Can be installed into the eyes of
+
+84
+00:07:40,640 --> 00:07:44,220
+contact lens wearers at any time during wear to
+
+85
+00:07:44,220 --> 00:07:47,800
+enhance comfort يعني أنا وانا شوفوا، والواحد لف ال
+
+86
+00:07:47,800 --> 00:07:52,200
+contact lens، بيحطها كل شوية تعمل comfort، عشان هي
+
+87
+00:07:52,200 --> 00:07:55,960
+تسميها comfort The eye can tolerate adverse
+
+88
+00:07:55,960 --> 00:08:00,140
+atmospheric conditions and while it can also
+
+89
+00:08:00,140 --> 00:08:02,460
+tolerate the wearing of contact lenses
+
+90
+00:08:05,370 --> 00:08:11,310
+in coping with both يعني بقول اللي بدك تعرف انه
+
+91
+00:08:11,310 --> 00:08:16,230
+عامل الطبيعة احنا ماتعطلقوا من الضوء و من الغبار و
+
+92
+00:08:16,230 --> 00:08:20,910
+من الإجهاد هذا عامل إجهاد يعني طيب وضع ال
+
+93
+00:08:20,910 --> 00:08:23,490
+contactless عامل إجهاد يا أخي
+
+94
+00:08:32,420 --> 00:08:35,200
+هي بنعمل الشكل يعني هي بقى نعمل foreign body في
+
+95
+00:08:35,200 --> 00:08:39,020
+العين مهما زيّنها أو مهما .. مهما خلّينها smooth
+
+96
+00:08:39,020 --> 00:08:45,040
+بيفضل أنه في إجهاد عليه في الcontact lens فبقولّي
+
+97
+00:08:45,040 --> 00:08:52,320
+إن كانت العوامل الجوية صعبة و العدسة مثلا hard رجل
+
+98
+00:08:52,320 --> 00:08:57,820
+فممكن العين ما تتحمل ال .. ال .. إيش الجهدين مع
+
+99
+00:08:57,820 --> 00:09:03,010
+بعض يعني جهد واحد لحاله يكفيفكيف يكون الجو مغفر
+
+100
+00:09:03,010 --> 00:09:08,130
+وقراءة كثيرة وفيه ضوء كثير وساطة وشيء يعني ممكن
+
+101
+00:09:08,130 --> 00:09:11,150
+العين ما تتحمل فبقول ال factors that reduce
+
+102
+00:09:11,150 --> 00:09:15,590
+contact lens tolerance ما هي الأوامل التي تؤثر على
+
+103
+00:09:15,590 --> 00:09:21,850
+عدم تحمل العدسة الأخرى فيها عوامل أول عامل انها in
+
+104
+00:09:21,850 --> 00:09:28,230
+particular يعني عن خصوص ال dry smoky environment
+
+105
+00:09:28,230 --> 00:09:30,970
+يكون الجو جاف
+
+106
+00:09:34,370 --> 00:09:38,510
+سواء من التنخين أو أبخرة أو حاجة هذا الجو غير
+
+107
+00:09:38,510 --> 00:09:41,930
+مناسب للناس اللي عندها سلسلة قد تجعل التغيير في
+
+108
+00:09:41,930 --> 00:09:47,850
+الـ Lens تعمل اضطراب في الظلافة ما بين ال contact
+
+109
+00:09:47,850 --> 00:09:52,850
+lens و من التير film which turns an acceptable
+
+110
+00:09:52,850 --> 00:09:58,090
+situation into an intolerant terrible one يقل
+
+111
+00:09:58,090 --> 00:10:01,390
+التحمل بالعين للعدسة اللاصفة تلاقي الواحد بالكره
+
+112
+00:10:06,280 --> 00:10:11,880
+وبرد كذلك تالي certain drugs such as
+
+113
+00:10:11,880 --> 00:10:15,960
+antihistamines which have an anti-masculinic
+
+114
+00:10:15,960 --> 00:10:18,380
+effect can induce contact lenses لنا ال
+
+115
+00:10:18,380 --> 00:10:21,920
+antihistamines ناخدها أيام الحساسية والواجهة
+
+116
+00:10:21,920 --> 00:10:27,080
+فاكرين كم سنة تديكن جيكس مثلا او بالهيسمانال
+
+117
+00:10:27,080 --> 00:10:33,670
+هستانيل في حاجات زي هذه ناخدها الاحتقاناتحتى فينا
+
+118
+00:10:33,670 --> 00:10:37,470
+ناس مناقش بروزولين وكلام في أنفه، فهذه كلها
+
+119
+00:10:37,470 --> 00:10:45,410
+أنتيستامين فبقول لو احنا بناخد قطرة أنتيستامين أو
+
+120
+00:10:45,410 --> 00:10:50,670
+أقلاص أنتيستامين ممكن تأثر على تحمل العنصر لأنها
+
+121
+00:10:50,670 --> 00:10:55,450
+بتجفف في الإفراز تماما بتجفف في إفراز الغدل
+
+122
+00:11:02,240 --> 00:11:06,560
+اللي .. اللي هو ال cells و ال glance اللي في العين
+
+123
+00:11:06,560 --> 00:11:12,180
+خاصة ال wall frank و ال cross accessory لكريمال
+
+124
+00:11:12,180 --> 00:11:16,280
+glance wall frank and cross يعني الواحد بياخد
+
+125
+00:11:16,280 --> 00:11:21,300
+الحقنة بتاعة الرشح أوشي أو الحسية أو الشراب أو
+
+126
+00:11:21,300 --> 00:11:25,640
+الأقاص أو حتى في العين قاطرة لأ يعني اللي بلبس
+
+127
+00:11:25,640 --> 00:11:29,080
+contact lens مش لازم .. لازم يحط قاطرة حسية قاطرات
+
+128
+00:11:29,080 --> 00:11:32,120
+الحسية بتاعة العين عارفينها؟الوقت فينا تلاقي في
+
+129
+00:11:32,120 --> 00:11:35,460
+الربيع الآن يشق شويه وعينه حمره وشغله وحاس فيها
+
+130
+00:11:35,460 --> 00:11:38,900
+رمل بوشي فيروح يقولوا للدكتور يقولوا معايا حاسية
+
+131
+00:11:38,900 --> 00:11:43,300
+يعني او هي يقولوا اه معاك حاسية خد مثلا قطرة زي
+
+132
+00:11:43,300 --> 00:11:50,140
+مثلا كوليهيست انتستيل برايفيل مثلا او يقولوا مثلا
+
+133
+00:11:50,140 --> 00:11:54,040
+يقولوا كرايزين اكتير اسامي يعني و هو بلبس
+
+134
+00:11:54,040 --> 00:11:56,300
+contactless بجلس للدكتور انه بلبس contactless
+
+135
+00:11:56,300 --> 00:12:02,040
+تلاقي حاسس انه كتير فيلم بصير disturbedو رقيق و
+
+136
+00:12:02,040 --> 00:12:05,140
+إشي العدسة اللي هتسكب .. مش هي البيئة بتاعتها،
+
+137
+00:12:05,140 --> 00:12:08,180
+العدسة اللي هتسكب هي ترتيب فلما يكون في قطع ال
+
+138
+00:12:08,180 --> 00:12:12,560
+comfort كل شوية، كل ساعة، كل ساعتين، خسر الطلبة،
+
+139
+00:12:12,560 --> 00:12:19,780
+بيكون .. بيخفف ف three و هذا بهمكوا hormonal
+
+140
+00:12:19,780 --> 00:12:25,080
+changes in women التدوير الهرموني في النساء can
+
+141
+00:12:25,080 --> 00:12:29,000
+also modify the quantity or quality of tears
+
+142
+00:12:31,140 --> 00:12:34,000
+استروجين وبروجيسترول تعرفين فيه اندرسان استروجين
+
+143
+00:12:34,000 --> 00:12:38,580
+وبروجيسترول وهو يعني الهرمونين الانسويين اللي هم
+
+144
+00:12:38,580 --> 00:12:44,120
+بتعاقبوا لذلك يعني حتى لو وقع بده طالبة او ست يعني
+
+145
+00:12:44,120 --> 00:12:48,960
+تعمل لازك مثلا في فترة الرضاعة او الحمض مانخلاش
+
+146
+00:12:48,960 --> 00:12:53,600
+تعمل ممكن انها دراج نعم ممكن انها دراج او تغيظ
+
+147
+00:12:53,600 --> 00:13:00,000
+نفسك ايوة اقول حتى في ال elasticity او دقونةسوري
+
+148
+00:13:00,000 --> 00:13:03,640
+في ال electricity of the cornea بيكون فيه تغيير
+
+149
+00:13:03,640 --> 00:13:07,760
+لذلك اذا بدنا نعمل احنا اي procedure في ال cornea
+
+150
+00:13:07,760 --> 00:13:12,340
+بدنا نعمله في اوقات مافيش فيها hormonal changes in
+
+151
+00:13:12,340 --> 00:13:20,860
+females فالان نرجع تاني بالنسبة لل lens wearing
+
+152
+00:13:20,860 --> 00:13:27,280
+females هتلاقي في احوال تغير هرموني انه لا تتقلع
+
+153
+00:13:27,280 --> 00:13:32,390
+سلسلة كافيةلأنه بيعملوها من ال dryness او الطراب
+
+154
+00:13:32,390 --> 00:13:37,450
+حتى في افراز الاكيوستيرز و حتى اللي هو ال
+
+155
+00:13:37,450 --> 00:13:45,210
+limousine طيب يبقى ال comfort احنا مقولهاش انزيمية
+
+156
+00:13:45,210 --> 00:13:50,570
+و غير انزيمية يعني هي wetting ايه جانب كل ساعة
+
+157
+00:13:50,570 --> 00:13:55,050
+ساعتين اللي عادى سلاسقة بيحط نقطة هنا و نقطة هنا
+
+158
+00:13:55,050 --> 00:14:00,890
+بغرض انه يجعل عدسة اللاسقة smoothو conditioning و
+
+159
+00:14:00,890 --> 00:14:05,650
+يترد أي دست تاني يعني اعمل مساعد ماجولاش انه اعمل
+
+160
+00:14:05,650 --> 00:14:09,930
+منظف زي الهيدروجين بالإكسايد مثلا ماجولاش طب
+
+161
+00:14:09,930 --> 00:14:13,930
+alternative methods of hydrogel contact lens
+
+162
+00:14:13,930 --> 00:14:18,450
+disinfection الحقيقة انا بتكلم على استخدام الإشعاع
+
+163
+00:14:18,450 --> 00:14:26,690
+خاصة ال ultraviolet و ال ultrasound في يعني تعقيم
+
+164
+00:14:26,690 --> 00:14:30,640
+العدسة اللاصقةطب من الواضح ان استخدام ال ultra
+
+165
+00:14:30,640 --> 00:14:37,420
+violet او ال ultra sound هذا بتاع اللي هو شركات و
+
+166
+00:14:37,420 --> 00:14:43,480
+مصانع مش يعني user زينا مش user وبالتالي يعني احنا
+
+167
+00:14:43,480 --> 00:14:47,660
+بنقدر نقول ان هذا للعليسات اللي اثقى ال fresh
+
+168
+00:14:47,660 --> 00:14:52,560
+الحديثة او الجديدة العليسات اللي اثقى الجديدة ما
+
+169
+00:14:52,560 --> 00:14:56,130
+بحطولها hydrogen peroxide ولا بحطولها enzymesلأ
+
+170
+00:14:56,130 --> 00:15:01,010
+بالجملة المصانع بالميت ألف و بالميتين ألف عنسة
+
+171
+00:15:01,010 --> 00:15:04,830
+بنخلهم على ال ultra bio طبعا ال ultra bio تستحيل
+
+172
+00:15:04,830 --> 00:15:10,590
+تحتها أيش أيش مايكروب او بكتيريا او فانجس حتى او
+
+173
+00:15:10,590 --> 00:15:17,370
+فيروس لذلك الان المصانع ركزوا على ايش انا بقولك
+
+174
+00:15:17,370 --> 00:15:23,410
+انا بعمل عنسات جديدة رخيصةshort duration ايه short
+
+175
+00:15:23,410 --> 00:15:26,770
+duration فترة قصيرة يعني فترة قصيرة نلبسها اسبوع
+
+176
+00:15:26,770 --> 00:15:29,730
+اسبوع يعني وفده نبسها مايصير عليها protein و ما
+
+177
+00:15:29,730 --> 00:15:33,010
+protein و نحط عليها تحتين ولا لأ لأ ارميها و
+
+178
+00:15:33,010 --> 00:15:38,150
+نيبغيها ليش تكون مثلا مثلا بمائة دولار لأ تكون
+
+179
+00:15:38,150 --> 00:15:42,010
+بعشرة دولار في التفكير الإتصالي بتاعك بقولك أنا
+
+180
+00:15:42,010 --> 00:15:46,150
+بنتج بالعشرة دولار و ببيع أكتر فده عندما أحط عنده
+
+181
+00:15:46,150 --> 00:15:47,650
+مية دولار تبتعد سنتين تلاتة
+
+182
+00:15:53,980 --> 00:15:58,160
+بعضهم كانوا يكونوا فقط مفاجئين بشكل مباشر عندما
+
+183
+00:15:58,160 --> 00:16:01,580
+يكونوا محاولين محاولة ميكرو بيوجيكال عندما يكون
+
+184
+00:16:01,580 --> 00:16:06,960
+هناك بكتيريا نقل البكتيريا نرى المفاعل فمثلا في
+
+185
+00:16:06,960 --> 00:16:12,100
+سنة تسعة و تمانين صار بحث و وددوا انه ميتين و
+
+186
+00:16:12,100 --> 00:16:17,940
+تلاتة وسبعين وسبع من عشرة نانو متر ultravioletwith
+
+187
+00:16:17,940 --> 00:16:23,340
+an intensity of one thousand one hundred one per
+
+188
+00:16:23,340 --> 00:16:26,060
+cubic centimeter achieved satisfactory
+
+189
+00:16:26,060 --> 00:16:30,260
+disinfection with short exposure times يعني دقايق
+
+190
+00:16:30,260 --> 00:16:35,480
+معدودة تقريبا كل الميكروبات ماتت في هذا الطول
+
+191
+00:16:35,480 --> 00:16:40,300
+الموجي قادة ال ultra viral فمثلا شافوا اللي أكل في
+
+192
+00:16:40,300 --> 00:16:45,580
+موبا اللي هو قدام العدوى القرنية قعدت بورفاجة
+
+193
+00:16:48,300 --> 00:16:53,060
+في أقل من ثلاث دقائق في التلاتة وتسعين هاريس عامل
+
+194
+00:16:53,060 --> 00:16:56,600
+بحث برضه بقى concluded that ultraviolet radiation
+
+195
+00:16:56,600 --> 00:16:59,800
+of this wavelength is an effective and rapid
+
+196
+00:16:59,800 --> 00:17:04,240
+method of disinfecting contact lenses بس قلت هي ده
+
+197
+00:17:04,240 --> 00:17:08,780
+مش في البيت عندها، هي ده شغل إيش؟ شركات ومصانع؟
+
+198
+00:17:08,780 --> 00:17:16,310
+طبعا هذين care أو heavily care of طيالةفبقى try on
+
+199
+00:17:16,310 --> 00:17:23,390
+lenses اللي هي استخدمها احنا لإيش للتجريب نبتدأ
+
+200
+00:17:23,390 --> 00:17:28,830
+خاصة في ال heart في ال heart او ال rigid يعني بدنا
+
+201
+00:17:28,830 --> 00:17:32,450
+نشوف راحة المريض من ناحية ال fitness و من ناحية ال
+
+202
+00:17:32,450 --> 00:17:36,310
+.. اللي هو ال optical power و من ناحية ال shape و
+
+203
+00:17:36,310 --> 00:17:39,830
+من ناحية الراحة عدة حاجات فاحنا بدنا نشوف
+
+204
+00:17:49,570 --> 00:17:53,010
+في الولايات المتحدة، 96% من المستخدمين للمصباح
+
+205
+00:17:53,010 --> 00:17:53,930
+الجديد للمصباح الجديد للمصباح الجديد للمصباح
+
+206
+00:17:53,930 --> 00:17:56,770
+الجديد للمصباح الجديد للمصباح الجديد للمصباح
+
+207
+00:17:56,770 --> 00:18:07,330
+الجديد للمصباح الجديد للمصباح الجديد للمصباح
+
+208
+00:18:07,330 --> 00:18:09,310
+الجديد للمصباح الجديد للمصباح الجديد للمصباح
+
+209
+00:18:09,310 --> 00:18:09,410
+الجديد للمصباح الجديد للمصباح الجديد للمصباح
+
+210
+00:18:09,410 --> 00:18:09,830
+الجديد للمصباح الجديد للمصباح الجديد للمصباح
+
+211
+00:18:09,830 --> 00:18:10,970
+الجديد للمصباح الجديد للمصباح الجديد للمصباح
+
+212
+00:18:10,970 --> 00:18:12,270
+الجديد للمصباح الجديد للمصباح الجديد للمصباح
+
+213
+00:18:12,270 --> 00:18:13,330
+الجديد للمصباح الج
+
+214
+00:18:44,370 --> 00:18:50,430
+في حالات ال rigid lenses غالية rigid lenses
+
+215
+00:18:55,470 --> 00:18:58,650
+It is usually considered to be necessary to
+
+216
+00:18:58,650 --> 00:19:02,510
+evaluate the fit of several lenses from a non
+
+217
+00:19:02,510 --> 00:19:05,930
+-disposable fitting set to decide the
+
+218
+00:19:05,930 --> 00:19:10,370
+specification to be ordered يعني أنا صحيح بحط
+
+219
+00:19:10,370 --> 00:19:13,970
+الأولى علسة بشوفش فيها كويس التانية أحسن التالتة
+
+220
+00:19:13,970 --> 00:19:17,910
+أحسن بس هنجرب تلاتة عدسات هذه التلاتة عدسات صاروا
+
+221
+00:19:17,910 --> 00:19:23,090
+contaminated منهم كدههل هو لعيبتهم كده لـ
+
+222
+00:19:23,090 --> 00:19:26,270
+disposable؟
+
+223
+00:19:26,270 --> 00:19:29,950
+لأ، لإني حافظ عليهم، فاني أعملهم كده الـ use of
+
+224
+00:19:29,950 --> 00:19:33,490
+trial lenses assumes particular importance when
+
+225
+00:19:33,490 --> 00:19:36,590
+complex designs such as bifocals are to be
+
+226
+00:19:36,590 --> 00:19:41,250
+supplied و أكتر أهمية لما تكون ال contact هالي
+
+227
+00:19:41,250 --> 00:19:43,730
+bifocal أو trifocal
+
+228
+00:19:48,640 --> 00:19:53,080
+multifunction مش معقول انها مكلفة اني ألقيها فبدها
+
+229
+00:19:53,080 --> 00:20:00,540
+كيل بدها تفيل وبدها نحطها في hydrogen peroxide هيك
+
+230
+00:20:00,540 --> 00:20:03,360
+هم بيكملنا موضوع solutions of contact lenses والآن
+
+231
+00:20:03,360 --> 00:20:07,300
+هنبدأ في therapeutic drugs and their uses الأدوة
+
+232
+00:20:07,300 --> 00:20:12,760
+اللي تستخدم في علاج العين في علاج العين بقوللي
+
+233
+00:20:12,760 --> 00:20:17,540
+باختصار كلمة Anti-infective يعني مضاد
+
+234
+00:20:24,090 --> 00:20:29,090
+effective against a variety of infections يعني طيب
+
+235
+00:20:29,090 --> 00:20:32,970
+واسع من الكائنات اللي بتعمل infection مثلا
+
+236
+00:20:32,970 --> 00:20:37,670
+viruses, rickettsia, bacteria, fungi and so on
+
+237
+00:20:37,670 --> 00:20:40,930
+rickettsia هي كائنات ما بين الفروسات و ما بين
+
+238
+00:20:40,930 --> 00:20:45,710
+البكتيريا زي اللي بتعمل ال syphilis rickettsia
+
+239
+00:20:45,710 --> 00:20:50,370
+يبقى هو بيقول يعني انا اطلب مني اني
+
+240
+00:20:59,600 --> 00:21:05,440
+و لا البروتوزيوه أكارثوموبه ولا الفانجاي و حتى لا
+
+241
+00:21:05,440 --> 00:21:09,920
+الركسيا لو خشت الآن لو أنا ماعنديش هذه المنظومة من
+
+242
+00:21:09,920 --> 00:21:13,760
+المضادات
+
+243
+00:21:13,760 --> 00:21:18,740
+بتاعة ال infection عيون البشر ايش بيصير فيها؟
+
+244
+00:21:18,740 --> 00:21:24,460
+مصيبة مصيبة الميكانيزم of action of these agents
+
+245
+00:21:24,460 --> 00:21:29,490
+varies greatlyكيف تعمل؟ احنا بتحدثنا أو بتحدث كيف
+
+246
+00:21:29,490 --> 00:21:34,810
+تعمل المضادات الحيوية البكتيريا مثلا فمنها من يمزق
+
+247
+00:21:34,810 --> 00:21:40,670
+ال cell wall ومنها من يتحد بـ ribosomes بناءها من
+
+248
+00:21:40,670 --> 00:21:45,810
+تكوين .. ليش؟
+
+249
+00:21:45,810 --> 00:21:49,330
+طاقة .. ribosomes ليش؟ بتخليها low levels of
+
+250
+00:21:49,330 --> 00:21:53,750
+energy اه طيب ومنها من يهاجم in Euclides
+
+251
+00:22:03,610 --> 00:22:08,050
+وهكذا طيب طيب the mechanism of action of these
+
+252
+00:22:08,050 --> 00:22:11,690
+agents varies greatly and to some extent will
+
+253
+00:22:11,690 --> 00:22:14,310
+depend on the organism on which the particular
+
+254
+00:22:14,310 --> 00:22:18,390
+agent acts كمان بعتمد على non-microbe هلي استجيب
+
+255
+00:22:18,390 --> 00:22:22,180
+ولا لايستجيبIn the majority of cases however some
+
+256
+00:22:22,180 --> 00:22:27,300
+competitive inhibition of a biochemical process is
+
+257
+00:22:27,300 --> 00:22:31,180
+involved as a result of the concentration level
+
+258
+00:22:31,180 --> 00:22:38,500
+يبقى أحيانا في دواء يستخدم ب level قليل لكن بيكون
+
+259
+00:22:38,500 --> 00:22:41,800
+effective وفي العكس دواء يستخدم ب concentration
+
+260
+00:22:41,800 --> 00:22:46,060
+عالي و بيكون تأثيره ضعيف حسب المعيك وال ميبك اللي
+
+261
+00:22:46,060 --> 00:22:46,660
+أخدناه قبلها
+
+262
+00:23:02,250 --> 00:23:05,950
+Drugs for the treatment of infections قولنا في شيء
+
+263
+00:23:05,950 --> 00:23:10,550
+اسمه MIC Minimum
+
+264
+00:23:10,550 --> 00:23:15,630
+Inhibitory Concentration are often published for
+
+265
+00:23:15,630 --> 00:23:19,710
+the common anti-infective drugsبقول لي these
+
+266
+00:23:19,710 --> 00:23:26,590
+values يعني كل drug إله Mike، these values will
+
+267
+00:23:26,590 --> 00:23:31,510
+vary according to the infecting organism يعني
+
+268
+00:23:31,510 --> 00:23:35,330
+Staphylococcus aureus مثلا تختلف عن Staphylococcus
+
+269
+00:23:35,330 --> 00:23:41,210
+epidermidis يعني هذا ميكروب متعايش Flora و هذا
+
+270
+00:23:41,210 --> 00:23:48,570
+ميكروب شرسفانا بدي ميك يوطي البكتيريا الشرسة حتى
+
+271
+00:23:48,570 --> 00:23:54,910
+يعني لا تفعل مضاعفة اه بيقولي the might for a
+
+272
+00:23:54,910 --> 00:23:57,570
+strain of Methicillin-resistant Staphylococcus
+
+273
+00:23:57,570 --> 00:24:02,490
+aureus is considerably higher than that of normal
+
+274
+00:24:02,490 --> 00:24:04,730
+Staphylococcus aureus يعني بيقولي حتى
+
+275
+00:24:04,730 --> 00:24:07,950
+Staphylococcus aureus في منها يحطم أنواع البنسالي
+
+276
+00:24:07,950 --> 00:24:09,890
+ويحلله
+
+277
+00:24:11,380 --> 00:24:14,680
+فابدى انا علاج يكون ال mic بتاعه يتناسى في هذه
+
+278
+00:24:14,680 --> 00:24:21,680
+الشراسة وهذه المقاومة باختلاف اللى هو الاستفحاة
+
+279
+00:24:21,680 --> 00:24:27,160
+الكاسية العادية اللى ما بتعمل تكسير لإيش لاتفاتكس
+
+280
+00:24:27,160 --> 00:24:31,740
+when it comes to treating ophthalmic infections
+
+281
+00:24:38,520 --> 00:24:42,060
+There are many more factors to take into
+
+282
+00:24:42,060 --> 00:24:46,020
+consideration يبقى أنا في الأول بأتكلم عن التهيبات
+
+283
+00:24:46,020 --> 00:24:51,080
+الرئتين، التهيبات الحلق، التهيبات الأمعاء،
+
+284
+00:24:51,080 --> 00:24:55,100
+التهيبات المجال المولية، لكن يقولنا احنا العين
+
+285
+00:24:55,100 --> 00:25:02,260
+تختلف، العين إقليم شبه مستقل، اذا أقول كون فدرالي،
+
+286
+00:25:02,260 --> 00:25:05,920
+كون فدرالي، مش فدرالي بقى يعني، العين دخولها
+
+287
+00:25:05,920 --> 00:25:11,160
+وخروجها مش سهل، فيه بريئةفلما اتكلم انا الآن بدي
+
+288
+00:25:11,160 --> 00:25:17,700
+انا اوجد اشياء تؤثر في العلم او العلاج يؤثر فيها
+
+289
+00:25:17,700 --> 00:25:22,900
+في العلم اختلف عن باق الجسم فمثلا when the locus
+
+290
+00:25:22,900 --> 00:25:26,620
+or site of infection will determine not only the
+
+291
+00:25:26,620 --> 00:25:30,120
+route of the administration but also the prognosis
+
+292
+00:25:30,120 --> 00:25:35,240
+infections of the anterior eyeيعني في ال eye
+
+293
+00:25:35,240 --> 00:25:39,620
+segment قصدهم يعني حاجات في القرنية و في ال AC و
+
+294
+00:25:39,620 --> 00:25:43,400
+حتى في ال iris تختلف عن أشياء في ال retina back
+
+295
+00:25:43,400 --> 00:25:47,580
+further back يعني صحيح أنا مهل بدي عالج شيء في
+
+296
+00:25:47,580 --> 00:25:51,660
+القرن اه زي بدي عالج شيء في ال retina او الفترياس
+
+297
+00:25:51,660 --> 00:25:55,060
+طبعا مختلف ال retina و الفترياس بيبقوا injection
+
+298
+00:25:55,060 --> 00:26:00,700
+رترو بربر اه رترو بربر بيجيبوه مش القطر او القرن
+
+299
+00:26:00,700 --> 00:26:04,860
+من هذافهي مثلا consideration مش مولود في جسمها،
+
+300
+00:26:04,860 --> 00:26:07,240
+أهم الاسم منها أخدها الأقراس أو الحجونة والدم
+
+301
+00:26:07,240 --> 00:26:11,480
+بيشيل، بيوزع، بيوزع، لكن الدم مابتداش يوزع على
+
+302
+00:26:11,480 --> 00:26:15,740
+العين، الدم يوزع مثلا على اللي هو الرئتين وعلى
+
+303
+00:26:15,740 --> 00:26:18,220
+اللي هو القلب وعلى الحاجات هذه
+
+304
+00:26:25,940 --> 00:26:33,240
+والله واحد مع severe acute endocyclitis ممكن اعطيه
+
+305
+00:26:33,240 --> 00:26:38,100
+cortison كل ساعة او واحد طالع من intraocular
+
+306
+00:26:38,100 --> 00:26:43,080
+operation طالع من ultra intraocular operation كل
+
+307
+00:26:43,080 --> 00:26:48,160
+ساعة و ساعتين بدي اعطيه قطرات جوية لكن واحد مع
+
+308
+00:26:48,160 --> 00:26:55,250
+شوية infection في الملتحمة جد جات يعنيكل ست ساعات
+
+309
+00:26:55,250 --> 00:26:59,870
+قطرة أفلوس كل ست ساعات فالاهتمام حسب ال label of
+
+310
+00:26:59,870 --> 00:27:05,350
+inflammation هل ال inflammation شديد ولا مش شديد
+
+311
+00:27:05,350 --> 00:27:09,390
+الاهام التالت في العين تيري فلو و ال similarly
+
+312
+00:27:09,390 --> 00:27:13,350
+affect the absorption of anti-infective agents
+
+313
+00:27:13,350 --> 00:27:16,770
+يعني الشباب عندهم تيري فلو normal و قوي
+
+314
+00:27:26,170 --> 00:27:32,150
+هنا ال .. يعني في تفاعل و في دوابان لل .. ال .. ال
+
+315
+00:27:32,150 --> 00:27:36,010
+.. إيش؟ الأجوية و في استقبال إلها و absorption لكن
+
+316
+00:27:36,010 --> 00:27:39,950
+واحد مع dry eye يعني و ده صح واحد مع dry eye واحد
+
+317
+00:27:39,950 --> 00:27:49,290
+و ده صح طيب هتكلم ع ال bacteria لأنه ال .. يعني
+
+318
+00:27:49,290 --> 00:27:53,450
+more than ninety percent of eye infections is إيش؟
+
+319
+00:27:56,230 --> 00:27:59,770
+فبتكلم دايما عن البكتيريا لكن مش مع ذلك الفيروسات
+
+320
+00:27:59,770 --> 00:28:02,130
+إيه اللي يعني أننا خاصة ال herpes simplex
+
+321
+00:28:02,130 --> 00:28:06,370
+كيلوتايتس برضه بنختار فيهم فالبكتيريا بقول as with
+
+322
+00:28:06,370 --> 00:28:10,930
+most of pharma drugs the antibacterials used on
+
+323
+00:28:10,930 --> 00:28:14,410
+the eye were originally blocked for systemic use
+
+324
+00:28:14,410 --> 00:28:21,990
+يعني احنا مستوردناش للعين من القمر مضادة حيوية لأ
+
+325
+00:28:21,990 --> 00:28:26,280
+بقول المضادة الحيوية اللي بنعطيها systemicيعني
+
+326
+00:28:26,280 --> 00:28:33,320
+العلاج الجهاز التنفسي او الجهاز الهضمي او الجهاز
+
+327
+00:28:33,320 --> 00:28:39,000
+البولي التناسلي هي نفس المنطقة الحيوية اللي
+
+328
+00:28:39,000 --> 00:28:47,040
+بنعطيها للعين بس بصورة drops to the point نشتاق
+
+329
+00:28:47,040 --> 00:28:54,310
+منها يعني اشتقاق however in the mainIt is the ones
+
+330
+00:28:54,310 --> 00:28:58,830
+that have no or very restricted systemic use that
+
+331
+00:28:58,830 --> 00:29:01,770
+are most popular for treatment of the eye بس في
+
+332
+00:29:01,770 --> 00:29:08,310
+حاجة يعني هي حكمة يعني خلونا .. حكمة بقول يعني ان
+
+333
+00:29:08,310 --> 00:29:15,470
+في بعض الأدوية قليلا تستخدم systemic زي مثلا
+
+334
+00:29:15,470 --> 00:29:20,490
+chlorine phenicol قليلا تستخدم systemic لأنه بيعمل
+
+335
+00:29:20,490 --> 00:29:22,270
+مشاكل على الدم
+
+336
+00:29:26,090 --> 00:29:33,890
+المناع فبيخافوا منه ان يُعطوه إلا كهلات نادرة بقول
+
+337
+00:29:33,890 --> 00:29:40,490
+هذا للعين جوهري ودهبي ليش؟ لأن الأدوية العادية
+
+338
+00:29:40,490 --> 00:29:43,230
+المضادة الحيوية العادية اللي بنمانعها كل يوم
+
+339
+00:29:43,230 --> 00:29:50,610
+البكتيريا إيش بتعملها؟ resistance يعني سرها
+
+340
+00:30:00,880 --> 00:30:05,700
+استخدام ال antibiotic بكترة كل ما ال resistance
+
+341
+00:30:05,700 --> 00:30:12,800
+زادت لأن الشفرة أو التركيب الكيميائي يعني اقصد
+
+342
+00:30:12,800 --> 00:30:17,840
+المضارض الحيوي يتكشف الفكسيري طول نفسي ايوة لكن
+
+343
+00:30:17,840 --> 00:30:21,420
+antibiotic ولا في السنة بيستخدم مرة او مرتين او
+
+344
+00:30:21,420 --> 00:30:28,380
+تلاتة في مجتمع ما هذا لعين ذهبيلأن هو مش هيروح على
+
+345
+00:30:28,380 --> 00:30:32,080
+الدم و يعمل المشاكل بتاعة ال .. النقطة الواحدة
+
+346
+00:30:32,080 --> 00:30:37,440
+بتعملش .. بتعملش يخلق إضاءة و المناعة، شايفين كيف؟
+
+347
+00:30:37,440 --> 00:30:40,560
+زي ما جال الشعرش جال .. بذلك قدرت الأيام و ما بينا
+
+348
+00:30:40,560 --> 00:30:46,940
+أهليها مصايب قوم عند قوم فوائده، انت مش حافظين،
+
+349
+00:30:46,940 --> 00:30:52,780
+انت فاهم الشعرش صح؟ اه، ما بينا أهليها فوائده قوم،
+
+350
+00:30:52,780 --> 00:30:57,440
+مصايب قوم عند قوم فوائدهزي واحد بيقولك يعني يراكب
+
+351
+00:30:57,440 --> 00:31:00,920
+على جمل وجمل اللي هو قال بيموت، شايف نفسي قال
+
+352
+00:31:00,920 --> 00:31:05,220
+لحقوني بسكينة، لحقوه بالسكينة، ذبحوه و قالوا و
+
+353
+00:31:05,220 --> 00:31:09,160
+الله غير انفرقوا عليه، فهم قاعدين و هم مش عارفين
+
+354
+00:31:09,160 --> 00:31:13,200
+انه يحجوهم بجمل و يتبحوه، فهو زي موصيبة، راح جمله
+
+355
+00:31:13,200 --> 00:31:17,760
+و ركوبه بتاعته، لكن هم استفدوا و أكلوا لحم تلت
+
+356
+00:31:17,760 --> 00:31:24,500
+اربع ايام او خمس ايامطيب، يبقى الـ Antibiotics
+
+357
+00:31:24,500 --> 00:31:32,020
+الأقل تداولًا للـ Systemic Use هي الأفضل للعين،
+
+358
+00:31:32,020 --> 00:31:38,340
+كويس؟ Although some antibacterials are marketed as
+
+359
+00:31:38,340 --> 00:31:41,040
+simple ophthalmic preparations containing just one
+
+360
+00:31:41,040 --> 00:31:43,820
+active ingredient, many preparations contain
+
+361
+00:31:43,820 --> 00:31:49,530
+eitherAntibacterias or Asteroids and Antibiotics
+
+362
+00:31:49,530 --> 00:31:53,510
+يعني الأن تفننوا حتى بدل أن يحطوا نقطة مضادة حيوية
+
+363
+00:31:53,510 --> 00:31:59,650
+يحطوا اتنين استيرويد بقى؟ أه لأ وفي Antibiotics في
+
+364
+00:31:59,650 --> 00:32:03,490
+Antibiotics اتنين أو تلأ يعني مثلا قطرة ال
+
+365
+00:32:03,490 --> 00:32:06,010
+Maxitrol اللي في السوق مليانة في السوق اسمها
+
+366
+00:32:06,010 --> 00:32:09,230
+Maxitrol فيها Two Antibiotics
+
+367
+00:32:14,720 --> 00:32:18,320
+لأ في قطرات فيها three antibiotics يعني مولا في
+
+368
+00:32:18,320 --> 00:32:21,680
+اتحاد اتحاد اتحاد نقطة حط فيها يعني اكتر من
+
+369
+00:32:21,680 --> 00:32:25,240
+antibiotic خاصة في حالات الخطيرة خاصة في الحالات
+
+370
+00:32:25,240 --> 00:32:31,240
+الخطيرة وهذا يعني ايش زيادة في الفايدة للمريض
+
+371
+00:32:33,970 --> 00:32:37,170
+قسموا المجموعات اللي تستخدم في علاج العين ك
+
+372
+00:32:37,170 --> 00:32:40,930
+Antibiotics Beta Leptams مجموعة البنسينية بتاعك
+
+373
+00:32:40,930 --> 00:32:45,130
+العصلية فهي البنسينين اللي قبل مئة سنة تقريبا
+
+374
+00:32:45,130 --> 00:32:50,310
+اسمها Beta Leptams وهنا تترى Cyclins الترميسينات
+
+375
+00:32:50,310 --> 00:32:58,690
+وهنا Macrolides المجموعات اللي هي الترميسين و ال
+
+376
+00:32:58,690 --> 00:33:02,680
+generations بتاعتهم الترميسينChloramphenicols
+
+377
+00:33:02,680 --> 00:33:08,780
+مجموعة Fluoroquinolones مجموعة الـ Oflox والزيمر
+
+378
+00:33:08,780 --> 00:33:13,060
+والحيات هذه حديثة طبعا حديثة أحدث شيء Amino
+
+379
+00:33:13,060 --> 00:33:17,900
+glycosides مجموعة الجين التمايسيين والأبجين
+
+380
+00:33:17,900 --> 00:33:22,200
+والحيات هذه ثم سالفة مجموعة السالفة الآن obsolete
+
+381
+00:33:22,200 --> 00:33:24,680
+مستخدمات يعني كان زمان مهم
+
+382
+00:33:32,190 --> 00:33:36,250
+لو اتكلمنا على ال beta-lactam باختصار beta-lactams
+
+383
+00:33:36,250 --> 00:33:41,370
+هذه البنسيرينة مجموعة البنسيرين الأصلي ال beta
+
+384
+00:33:41,370 --> 00:33:46,450
+-lactams فيه ring يعني هي اللي عليها السهم عشان
+
+385
+00:33:46,450 --> 00:33:51,670
+هيك ال ring هذه beta ring lactam ring فسموها بناء
+
+386
+00:33:51,670 --> 00:33:51,990
+على
+
+387
+00:33:56,310 --> 00:34:00,310
+بياخد أو بيحتوي على Beta-Lactam سموه في المجموعة
+
+388
+00:34:00,310 --> 00:34:04,870
+هذه وهي الـ Benzaline ومشتقاته طبعا الـ Brocaine
+
+389
+00:34:04,870 --> 00:34:11,030
+Benzaline الأصلي اللي حتى الآن injectable اشتق منه
+
+390
+00:34:11,030 --> 00:34:17,690
+عدة مشتقان حتى إنها كده قول يعني بالعشرة Benzaline
+
+391
+00:34:17,690 --> 00:34:21,770
+كده Benzaline كده مضادلة كده Benzaline يعني في
+
+392
+00:34:21,770 --> 00:34:27,500
+التركيب الكيميائي بتاع Benzalineأضفوله ذرّار و
+
+393
+00:34:27,500 --> 00:34:34,180
+جذئاب فأصبح في منه أشياء كثيرة فمثلا ما منكم إلا
+
+394
+00:34:34,180 --> 00:34:40,980
+مثلا مارور مع ال .. ال أمو بذكير مثلا أمو بذكير
+
+395
+00:34:40,980 --> 00:34:46,960
+هنا في السوية يعني هو .. يعني كمان كلمة بقى ع ال
+
+396
+00:34:46,960 --> 00:34:51,380
+.. لمون وربع أشهر شكل العلماء أمو بذكير هذا إحدى
+
+397
+00:34:51,380 --> 00:35:00,260
+المشتقات فتال البنسة ديبعدين طوروا منه لفظة سلن
+
+398
+00:35:00,260 --> 00:35:06,540
+أمبي سلن أموز سلن وان أموز كتر أمبي سلن بفر سلن
+
+399
+00:35:06,540 --> 00:35:10,920
+طور وان أمبي كتر لكن أنا بهم مثل آخر إيش استخدامه
+
+400
+00:35:10,920 --> 00:35:15,060
+في العين؟ يعني هذا systemic؟ أه، كويس، لكن إيش
+
+401
+00:35:15,060 --> 00:35:21,940
+استخدامه في العين؟ في العين بيقول ليه؟ فالسلن pass
+
+402
+00:35:21,940 --> 00:35:23,500
+across the ocular
+
+403
+00:35:27,460 --> 00:35:36,980
+مورلي للأسف، إيش في ال barriers؟ كوريا،
+
+404
+00:35:36,980 --> 00:35:38,060
+و سكليرا
+
+405
+00:35:47,650 --> 00:35:52,690
+بلاد ايش؟ بتاعتنا ال barrier و بلاد ايش؟ براير ال
+
+406
+00:35:52,690 --> 00:35:57,790
+barrier لأ مش براير لأشتغلنا في ال brain في القرار
+
+407
+00:35:57,790 --> 00:36:01,490
+و في ال iris وشيء كل هذه barriers طيب فبقولي يا
+
+408
+00:36:01,490 --> 00:36:05,490
+روح عبر هذه ال barriers very poor and products
+
+409
+00:36:05,490 --> 00:36:08,750
+containing them are rarely used in the treatment
+
+410
+00:36:08,750 --> 00:36:12,170
+of ocular infections يعني أنا الحمد لله إيلي في
+
+411
+00:36:12,170 --> 00:36:18,950
+الفيل بالقليل من عشرين سنةلم نستخدم قطرة بنسرين أو
+
+412
+00:36:18,950 --> 00:36:23,830
+مشطقاته ولا مرحب بنسرين أو مشطقاته عشان هذا السبب
+
+413
+00:36:23,830 --> 00:36:28,430
+يبقى بنسرين بيبقى لهم systemic use لكن ال local
+
+414
+00:36:28,430 --> 00:36:34,350
+use في العين في عندهم مشكلة مش مفيدة كتير راحوا
+
+415
+00:36:34,350 --> 00:36:38,450
+طبعا بعد هيك تترا cyclines تترا cyclines هذه
+
+416
+00:36:38,450 --> 00:36:45,240
+family كبيرة في منها عديد من أعضاءفمثلًا broad
+
+417
+00:36:45,240 --> 00:36:51,220
+spectrum وسط ال .. اه chlor .. اه chlor
+
+418
+00:36:51,220 --> 00:36:56,340
+tetracyclines و دي ميه؟ دي مثال chlor tetracycline
+
+419
+00:36:56,340 --> 00:37:01,900
+و oxytetracycline و tetracycline بعد و doxycycline
+
+420
+00:37:01,900 --> 00:37:07,000
+و انجلاندر مش انت خدت دوكدا سيلين؟ دوكدا سيلين هو
+
+421
+00:37:07,000 --> 00:37:11,770
+هذامجموعات التراميسين بس طوروا على المجموعة
+
+422
+00:37:11,770 --> 00:37:16,350
+الأساسية للتترا سايكلين و حطوله تفضسيلين سنة وتاخر
+
+423
+00:37:16,350 --> 00:37:20,570
+once daily which has a broader spectrum and more
+
+424
+00:37:20,570 --> 00:37:26,510
+specific لهو indications طيب
+
+425
+00:37:26,510 --> 00:37:29,670
+تترا سايكلين are effective against gram positive
+
+426
+00:37:29,670 --> 00:37:33,270
+and gram negative بكتيريا يشتغل على gram positive
+
+427
+00:37:33,270 --> 00:37:36,390
+و gram negative وهذا احنا بيقولنا broad spectrum
+
+428
+00:37:37,470 --> 00:37:42,710
+لما مضاد حيوي بيشتغل بس على ال gram positive أو بس
+
+429
+00:37:42,710 --> 00:37:45,410
+على ال gram negative بيقول عنه narrow spectrum
+
+430
+00:37:45,410 --> 00:37:51,150
+antibiotic لكن لما بيكون بيشتغل على gram positive
+
+431
+00:37:51,150 --> 00:37:56,030
+and gram negative بيكون بيشتغل على مئات أنواع من
+
+432
+00:37:56,030 --> 00:37:57,110
+البكتيريا بيقول عنه
+
+433
+00:38:01,090 --> 00:38:05,330
+طيب بيقول اللي ال tetracycline مش بس بيشتغل على
+
+434
+00:38:05,330 --> 00:38:08,910
+البكتيريا بل بيشتغل على ال spiral case وعلى
+
+435
+00:38:08,910 --> 00:38:13,010
+الكلياميديا اللي بتعمل ال trachoma وعلى أخر ال
+
+436
+00:38:13,010 --> 00:38:16,530
+organisms يعني كمان وصلة type 1 أكتر من البكتيريا
+
+437
+00:38:16,530 --> 00:38:22,310
+أشياء أخرى resistance بيقولوا البكتيريا ال ground
+
+438
+00:38:22,310 --> 00:38:25,530
+negative اللي اسمها Sodomorus Sodomorus خطيرة جدا
+
+439
+00:38:25,530 --> 00:38:27,270
+هي بتعمل colon ulcer
+
+440
+00:38:30,930 --> 00:38:36,570
+الهيلو بيقدرش عليها و البروتياس برضه بتعمل كورن
+
+441
+00:38:36,570 --> 00:38:42,450
+الألثل برضه مابيقدرش عليها لكن باقي البكتيريا
+
+442
+00:38:42,450 --> 00:38:46,550
+العادية بتاعة ال congenitivites و إشي هي كويسة
+
+443
+00:38:46,550 --> 00:38:53,110
+side effects سيستانيك بيعمل ال stomach upset طعم
+
+444
+00:38:53,110 --> 00:38:56,430
+متعب وين في المدى هذا سيستانيك لو أخدنا كرسولة
+
+445
+00:38:56,430 --> 00:39:03,000
+نوزيا و vomiting on دياريةفلو أخدنا كابسولات و
+
+446
+00:39:03,000 --> 00:39:09,240
+كمان لو أخدنا كابسولات ممكن يعمل على أسنان الأطفال
+
+447
+00:39:09,240 --> 00:39:18,120
+تلون برتقالي أو أصفر يترسب في هضام الأطفال و هضام
+
+448
+00:39:18,120 --> 00:39:24,840
+الحوامل they permanently color teeth yellow and
+
+449
+00:39:24,840 --> 00:39:31,390
+show bone growthالعينا يبطئ من نمو الأعضاء في
+
+450
+00:39:31,390 --> 00:39:35,970
+الأطفال بسبب قدرات كالسيوم المغنيزيوم يتحد
+
+451
+00:39:35,970 --> 00:39:40,750
+بالكالسيوم المغنيزيوم ويمنعهم من أن يكونوا مدبزشين
+
+452
+00:39:40,750 --> 00:39:44,990
+في البون في بناء البون عشان هيك Contra-indicated
+
+453
+00:39:44,990 --> 00:39:50,990
+في الأطفال وفي الحوابل عشان يخش في أعضاء الجنيد
+
+454
+00:39:50,990 --> 00:39:55,490
+البرج ال fix from topical application نجي للعين
+
+455
+00:39:55,490 --> 00:40:02,630
+لعينبقول ان القطر في العين قرر مافيش حدات في العين
+
+456
+00:40:02,630 --> 00:40:08,290
+يعني نايبها عليه due to the slow dose of the drug
+
+457
+00:40:08,290 --> 00:40:11,730
+يعني احنا انا قطر بقولك واحد في المية تترا ساكلين
+
+458
+00:40:11,730 --> 00:40:19,770
+قطرة ولا هتعمل جد كابسولة في خلال اربع اش أشهر
+
+459
+00:40:19,770 --> 00:40:25,610
+يعني انا قطر التترا ساكلين في العين مدت اربع أشهر
+
+460
+00:40:27,450 --> 00:40:32,170
+الجوعة تساوي كرسولة هذا فيما يتعلق بالـ Systemic
+
+461
+00:40:32,170 --> 00:40:38,770
+فيعني مافيش من الخوف لكن الحقيقة ان ال penetration
+
+462
+00:40:38,770 --> 00:40:42,670
+across the intact cornea is poor and these
+
+463
+00:40:42,670 --> 00:40:46,190
+compounds are best used for surface infections as
+
+464
+00:40:46,190 --> 00:40:51,510
+ointment يعني في مرحم الترميسيين والجردرسيكليين
+
+465
+00:40:51,510 --> 00:40:55,930
+والغوزيسيين كل هذه كانت بس كندرة طيبة ال infection
+
+466
+00:40:56,860 --> 00:41:02,140
+والـ Blepharitis و Lid Infection و الكلام ده لكن
+
+467
+00:41:02,140 --> 00:41:06,660
+مش ليه علاج ال Intraocular Infection ولا حتى
+
+468
+00:41:06,660 --> 00:41:11,980
+Keratitis كويس؟ انه موجود Gordacycline و Teramycin
+
+469
+00:41:11,980 --> 00:41:13,320
+مش هو Teramycin المرمى
+
+470
+00:41:44,540 --> 00:41:52,300
+الحديث الولانا الذين نزلوا مفتهابات في الملتحق
+
+471
+00:41:52,300 --> 00:41:58,480
+الوولانا
+
+472
+00:41:58,480 --> 00:42:06,680
+اول مالطف يولد في الساعة الأولى تجي الناستغسل
+
+473
+00:42:06,680 --> 00:42:13,180
+عينيه بصرايه تشفهم و تضع لهم مرهم ترميسين في
+
+474
+00:42:13,180 --> 00:42:18,580
+الصباح و في المساء هذا profile axis لو ولد لهم
+
+475
+00:42:18,580 --> 00:42:25,920
+عندها تلور في مجاري الولادة اكتر اكتر هذا يمنع انه
+
+476
+00:42:25,920 --> 00:42:31,980
+تطور ال infection تطور ال infection في ال 83
+
+477
+00:42:35,270 --> 00:42:43,630
+و روش و نيور تور ايضا اقتنع انترامسبربنسيلين و
+
+478
+00:42:43,630 --> 00:42:49,030
+تتراساكليين 1% كمشروع بروفيلافتك يعني قال اه اعطي
+
+479
+00:42:49,030 --> 00:42:53,910
+الأم حقنا في
+
+480
+00:42:53,910 --> 00:42:58,390
+العضل فيها بنسلين و تتراساكليين عشان لو ولد
+
+481
+00:42:58,390 --> 00:43:04,240
+المولود بالذهاب انه مايفلش فيهإذا كانت الانفكارية
+
+482
+00:43:04,240 --> 00:43:11,040
+كلياميديا زي التراكومة، فالتراثيكليت تريتمنت يعني
+
+483
+00:43:11,040 --> 00:43:13,500
+مرهم هو أن يتم تجاربه على أخرى
+
+484
+00:43:13,500 --> 00:43:32,060
+الانتيبويتكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكيكي
+
+485
+00:43:36,430 --> 00:43:39,850
+هو اكثر من اي انتيباتيك اخر
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/C1m98JTIFy4_raw.json b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/C1m98JTIFy4_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..f2c8e25204142331847f589af796637f0da63621
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/C1m98JTIFy4_raw.json
@@ -0,0 +1 @@
+{"segments": [{"id": 1, "seek": 4294, "start": 20.82, "end": 42.94, "text": "أعوذ بالله من الشيطان الرجيم بسم الله الرحمن الرحيم الحمد لله رب العالمين وأصلي وأسلم على النبي الأمين محمد وعلى آله وأصحابه والتابعين السلام عليكم ورحمة الله وبركاته في هذا اليوم سنكمل ما كنا قد بدأنا Recyclopedia Examination الفحص فحص العين", "tokens": [10721, 3615, 2407, 8848, 20666, 43761, 9154, 25124, 1829, 9566, 7649, 34892, 7435, 32640, 4724, 38251, 21984, 34892, 5016, 27842, 34892, 5016, 32640, 21542, 2304, 3215, 24976, 3224, 12602, 3555, 18863, 45340, 9957, 36725, 9381, 20292, 36725, 3794, 19528, 15844, 28239, 21292, 16247, 2304, 9957, 3714, 35571, 3215, 4032, 3615, 23942, 19753, 43761, 36725, 9381, 5016, 16758, 3224, 16070, 2655, 16758, 3615, 9957, 21136, 37440, 25894, 24793, 4032, 2288, 35571, 3660, 21984, 4032, 26890, 4117, 9307, 3224, 8978, 23758, 45595, 20498, 8608, 1863, 24793, 1211, 19446, 9122, 8315, 12174, 3215, 47525, 10721, 8315, 1300, 34080, 47795, 24755, 2486, 27188, 5016, 9381, 6156, 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طيب الكورانية ليش؟ شوفوا يعني الكربتش هكذا كورنية يعني في بعض التأثير عليه", "tokens": [4117, 10943, 13546, 995, 20449, 9122, 2288, 9307, 41779, 4117, 37746, 6055, 3555, 9957, 16472, 9122, 13063, 22653, 995, 2423, 1347, 8608, 9566, 5016, 11296, 33251, 13063, 7649, 10632, 6505, 294, 9848, 1131, 6490, 293, 24436, 294, 452, 40216, 23032, 1829, 3555, 33251, 13063, 7649, 10632, 32239, 8592, 22807, 13412, 38688, 14407, 37495, 22653, 33251, 25513, 2655, 8592, 8032, 4117, 15730, 9122, 13063, 1863, 10632, 37495, 22653, 8978, 45030, 11242, 16712, 10721, 12984, 13546, 47356], "avg_logprob": -0.3688322380185127, "compression_ratio": 1.5614973262032086, "no_speech_prob": 0.0, "words": [{"start": 831.36, "end": 831.96, "word": "كاميرا", "probability": 0.76373291015625}, {"start": 831.96, "end": 832.34, "word": " مع", "probability": 0.88916015625}, {"start": 832.34, "end": 833.08, "word": " كراتوسكوب", "probability": 0.7568766276041666}, {"start": 833.08, "end": 833.94, "word": " تبين", 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units عارفين ما هي single use units؟ الأنابيب هي كده انبوب بلاستيك ولها هنا تبع القطرة هنا مثلا two milliliter", "tokens": [11622, 1829, 29910, 995, 4032, 43242, 8315, 2167, 764, 6815, 6225, 9640, 5172, 9957, 19446, 39896, 2167, 764, 6815, 22807, 16247, 8315, 21292, 3555, 39896, 9122, 3215, 3224, 16472, 3555, 37746, 4724, 15040, 14851, 1829, 4117, 35525, 11296, 34105, 6055, 3555, 3615, 25062, 9566, 25720, 34105, 50113, 15040, 732, 1728, 388, 1681], "avg_logprob": -0.38237029426502733, "compression_ratio": 1.3783783783783783, "no_speech_prob": 0.0, "words": [{"start": 1130.34, "end": 1130.98, "word": "زي", "probability": 0.49658203125}, {"start": 1130.98, "end": 1131.56, "word": " ذا", "probability": 0.4918212890625}, {"start": 1131.56, "end": 1132.38, "word": " و", "probability": 0.450927734375}, {"start": 1132.38, "end": 1133.36, "word": " عندنا", "probability": 0.828369140625}, {"start": 1133.36, "end": 1134.68, "word": " single", "probability": 0.90087890625}, {"start": 1134.68, 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اللي هو أصلي تسعة شعر of the cellular muscle is totally abolished by complete atropine psychoplegia بيجبّل على السبتر خالص but not by the full effects of other psychoplegics لكن psychopentolate مثلا أو ماتروبيا لأ مش مية في مية", "tokens": [40228, 22653, 7251, 39648, 36145, 31439, 6225, 8592, 2288, 2423, 8027, 20193, 7251, 2655, 10721, 49115, 11331, 49975, 20666, 1878, 16384, 404, 6363, 654, 4032, 322, 264, 661, 1011, 2423, 8027, 13672, 1829, 31439, 5551, 9381, 20292, 6055, 3794, 27884, 13412, 3615, 2288, 295, 264, 29267, 8679, 307, 3879, 23183, 4729, 538, 3566, 412, 1513, 533, 4681, 404, 6363, 654, 4724, 1829, 7435, 3555, 11703, 1211, 15844, 21136, 3555, 2655, 2288, 16490, 6027, 9381, 457, 406, 538, 264, 1577, 5065, 295, 661, 4681, 404, 6363, 1167, 44381, 4681, 404, 317, 48278, 50113, 15040, 34051, 3714, 9307, 32887, 21292, 995, 5296, 10721, 37893, 3714, 10632, 8978, 3714, 10632], "avg_logprob": -0.4019097089767456, "compression_ratio": 1.5355805243445693, "no_speech_prob": 0.0, 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الدولار،", "probability": 0.8992919921875}, {"start": 3005.32, "end": 3005.46, "word": " ال", "probability": 0.65380859375}, {"start": 3005.46, "end": 3005.7, "word": " Euro", "probability": 0.1837158203125}, {"start": 3005.7, "end": 3006.16, "word": " يساوي", "probability": 0.986572265625}, {"start": 3006.16, "end": 3006.48, "word": " كذا،", "probability": 0.9671223958333334}, {"start": 3006.48, "end": 3007.16, "word": " السترنيني", "probability": 0.659423828125}, {"start": 3007.16, "end": 3007.44, "word": " يساوي", "probability": 0.9857177734375}, {"start": 3007.44, "end": 3007.84, "word": " كذا", "probability": 0.9775390625}, {"start": 3007.84, "end": 3008.48, "word": " من", "probability": 0.98046875}, {"start": 3008.48, "end": 3008.68, "word": " اللي", "probability": 0.8408203125}, {"start": 3008.68, "end": 3008.92, "word": " هو", "probability": 0.9931640625}, {"start": 3008.92, "end": 3010.06, "word": " الدولار،", "probability": 0.8382568359375}, {"start": 3010.06, "end": 3010.76, "word": " والشياكل", "probability": 0.5969482421875}, {"start": 3010.76, "end": 3010.88, "word": " و", "probability": 0.5732421875}, {"start": 3010.88, "end": 3011.14, "word": " الكلام", "probability": 0.9176432291666666}, {"start": 3011.14, "end": 3011.84, "word": " ده،", "probability": 0.7530924479166666}, {"start": 3011.84, "end": 3013.1, "word": " فصار", "probability": 0.8929036458333334}, {"start": 3013.1, "end": 3013.36, "word": " هو", "probability": 0.99072265625}, {"start": 3013.36, "end": 3014.86, "word": " الأساس،", "probability": 0.887451171875}, {"start": 3014.86, "end": 3015.18, "word": " مع", "probability": 0.91162109375}, {"start": 3015.18, "end": 3015.48, "word": " أنه", "probability": 0.7303466796875}, {"start": 3015.48, "end": 3015.6, "word": " لا", "probability": 0.72216796875}, {"start": 3015.6, "end": 3016.08, "word": " يستخدم", "probability": 0.8775634765625}, {"start": 3016.08, "end": 3016.38, "word": " لكل", "probability": 0.96484375}, {"start": 3016.38, "end": 3017.32, "word": " الناس،", "probability": 0.9014892578125}, {"start": 3017.32, "end": 3017.6, "word": " نظرا", "probability": 0.8792317708333334}, {"start": 3017.6, "end": 3017.72, "word": " من", "probability": 0.319580078125}, {"start": 3017.72, "end": 3018.64, "word": " خطره،", "probability": 0.98076171875}, {"start": 3018.64, "end": 3019.04, "word": " لكن", "probability": 0.97314453125}, {"start": 3019.04, "end": 3019.56, "word": " يفضل", "probability": 0.91650390625}, {"start": 3019.56, "end": 3019.78, "word": " هو", "probability": 0.939453125}, {"start": 3019.78, "end": 3021.46, "word": " الأقوى،", "probability": 0.9529296875}, {"start": 3021.46, "end": 3022.38, "word": " وهو", "probability": 0.7529296875}, {"start": 3022.38, "end": 3023.02, "word": " رئيس", "probability": 0.990478515625}, {"start": 3023.02, "end": 3023.54, "word": " هذه", "probability": 0.95703125}, {"start": 3023.54, "end": 3024.68, "word": " المجموعة", "probability": 0.9630859375}, {"start": 3024.68, "end": 3025.02, "word": " من", "probability": 0.9267578125}, {"start": 3025.02, "end": 3025.26, "word": " price", "probability": 0.10357666015625}], "temperature": 1.0}, {"id": 103, "seek": 302935, "start": 3027.49, "end": 3029.35, "text": "ان شاء الله في المحاضرة القادمة", "tokens": [7649, 13412, 16606, 21984, 8978, 9673, 5016, 46958, 25720, 25062, 18513, 46007], "avg_logprob": -0.22370793727728036, "compression_ratio": 1.0555555555555556, "no_speech_prob": 0.0, "words": [{"start": 3027.49, "end": 3028.05, "word": "ان", "probability": 0.250732421875}, {"start": 3028.05, "end": 3028.23, "word": " شاء", "probability": 0.954833984375}, {"start": 3028.23, "end": 3028.43, "word": " الله", "probability": 0.96875}, {"start": 3028.43, "end": 3028.71, "word": " في", "probability": 0.94677734375}, {"start": 3028.71, "end": 3029.03, "word": " المحاضرة", "probability": 0.780517578125}, {"start": 3029.03, "end": 3029.35, "word": " القادمة", "probability": 0.9586588541666666}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 3029.995, "duration_after_vad": 2665.2668749999884}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/DLjdO_qFie8.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/DLjdO_qFie8.srt
new file mode 100644
index 0000000000000000000000000000000000000000..0af7352c8ad6ac5f78df27bd2acb8702c8d0efb2
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/DLjdO_qFie8.srt
@@ -0,0 +1,1534 @@
+1
+00:00:20,770 --> 00:00:23,090
+أعوذ بالله من الشيطان الرجيم بسم الله الرحمن
+
+2
+00:00:23,090 --> 00:00:27,710
+الرحيم الحمد لله رب العالمين وأصلي وأسلم على النبي 
+
+3
+00:00:27,710 --> 00:00:31,890
+الكريم محمد وعلى آله وأصحابه والتابعين  السلام
+
+4
+00:00:31,890 --> 00:00:38,870
+عليكم ورحمة الله وبركاته اليوم سنبدأ بقصة جديدة عن 
+
+5
+00:00:38,870 --> 00:00:46,650
+المدرياتيكس المدرياتيكس المدرياتيكس هم الشيطانين اللي
+
+6
+00:00:46,650 --> 00:00:48,850
+يستطيع أن يقوم بتعريف الأطفال
+
+7
+00:00:53,830 --> 00:01:00,270
+Good Examination of the posterior segment of the
+
+8
+00:01:00,270 --> 00:01:07,950
+eye. Optic discs, optic vessels, macula and 
+
+9
+00:01:07,950 --> 00:01:12,810
+retinal background.Mydriatics
+
+10
+00:01:12,810 --> 00:01:15,770
+dilate the pupil to facilitate a more thorough
+
+11
+00:01:25,170 --> 00:01:34,490
+وهي عامة تستخدمها على المرضى الكبار السن كما لو
+
+12
+00:01:34,490 --> 00:01:37,270
+كانوا المرضى الكبار السن عاماً أصغر وعاماً أصغر
+
+13
+00:01:37,270 --> 00:01:41,210
+وعاماً أصغر وعاماً أصغر وعاماً أصغر وعاماً أصغر
+
+14
+00:01:41,210 --> 00:01:42,890
+وعاماً أصغر وعاماً أصغر وعاماً أصغر وعاماً أصغر
+
+15
+00:01:42,890 --> 00:01:43,070
+وعاماً أصغر وعاماً أصغر وعاماً أصغر وعاماً أصغر
+
+16
+00:01:43,070 --> 00:01:43,110
+وعاماً أصغر وعاماً أصغر وعاماً أصغر وعاماً أصغر
+
+17
+00:01:43,110 --> 00:01:47,770
+وعاماً
+
+18
+00:01:47,770 --> 00:01:57,660
+أصغر وعاماً أصغر وعاماً  أبس فترة بيوبيلي قوية
+
+19
+00:01:57,660 --> 00:02:04,560
+بيكون ال pupil size small واحدة كمان بيكونوا 
+
+20
+00:02:04,560 --> 00:02:09,420
+liable to cataract opacities in the lens and liable
+
+21
+00:02:09,420 --> 00:02:16,960
+to diseases in choroid and retina و ال diabetic
+
+22
+00:02:16,960 --> 00:02:22,980
+retinopathy اللي بيبقى مرضى السكري يعني كثير من
+
+23
+00:02:22,980 --> 00:02:27,990
+المرضى يطلبوا اللي هو accurate examination of the
+
+24
+00:02:27,990 --> 00:02:33,730
+fundus و لاجب انه يكون فيه dilatation لل pupil لان 
+
+25
+00:02:33,730 --> 00:02:38,410
+اسمها pupil ما بيكفي لفحص ال periphery of the
+
+26
+00:02:38,410 --> 00:02:42,870
+fundus هكذا ديوز of pediatrics كان essential in 
+
+27
+00:02:42,870 --> 00:02:46,590
+any age group كمان ممكن في اي age group يتطلب
+
+28
+00:02:46,590 --> 00:02:52,820
+especiallyوالدماغولة أو المنطقات الخارجية للرتينا
+
+29
+00:02:52,820 --> 00:03:01,120
+تحتاج إلى ملاحظة حذرة.الآن بدأنا نعرف إيش فيه
+
+30
+00:03:01,120 --> 00:03:07,400
+أدوات أو دراجس تستخدم في هذا المنحو مارتن دويل في 
+
+31
+00:03:07,400 --> 00:03:15,840
+نينتين سيستي سيبن قرر إصلاح مدرياتيك لا يستخدم عنه
+
+32
+00:03:15,840 --> 00:03:24,220
+للاستخدام من دماغولة يبقى الماكولا؟ اه اللهم يجعله
+
+33
+00:03:24,220 --> 00:03:41,300
+كذا ايوة
+
+34
+00:03:41,300 --> 00:03:45,080
+يا عزيزي يا
+
+35
+00:03:45,080 --> 00:03:48,280
+سامي جاهز؟
+
+36
+00:03:53,100 --> 00:03:56,960
+مش عارف الاساس دي هو ال remote؟ الاساس بريمون
+
+37
+00:03:56,960 --> 00:04:01,340
+بريمون؟
+
+38
+00:04:01,340 --> 00:04:04,340
+بريمون؟ بريمون؟ بريمون؟ بريمون؟ بريمون؟
+
+39
+00:04:04,340 --> 00:04:04,380
+بريمون؟ بريمون؟ بريمون؟ بريمون؟ بريمون؟
+
+40
+00:04:04,380 --> 00:04:04,480
+بريمون؟ بريمون؟ بريمون؟ بريمون؟ بريمون؟
+
+41
+00:04:04,480 --> 00:04:08,880
+بريمون؟ بريمون؟ بريمون؟ بريمون؟ بريمون؟
+
+42
+00:04:08,880 --> 00:04:12,380
+بريمون؟ بريمون؟ بريمون
+
+43
+00:04:29,230 --> 00:04:37,430
+ولو لا يستغنى عن توثيق البابو في الexamination ماذا
+
+44
+00:04:37,430 --> 00:04:41,530
+ماكولا، كان البروفيسور المشرف عليها، ده هو اللي
+
+45
+00:04:41,530 --> 00:04:46,410
+بيقول الكلمة، بيقولي don't comment on ماكولا وده
+
+46
+00:04:46,410 --> 00:04:53,010
+وده لاتش، ماكولا عايز ده لاتش، سيدروف وانا سيدروف
+
+47
+00:04:53,010 --> 00:04:58,690
+مشهورExamine patients attitudes to pupil 
+
+48
+00:04:58,690 --> 00:05:02,050
+dilatation during optometric examination and found
+
+49
+00:05:02,050 --> 00:05:06,770
+that the majority were in favor بفضله لما تقولوا 
+
+50
+00:05:06,770 --> 00:05:10,970
+يعني بدون توصية مش هتكون الفحص مية لمية لو انا 
+
+51
+00:05:10,970 --> 00:05:14,970
+عملتك توصية هيك بقولك favor يعني هم بفضله بما ال
+
+52
+00:05:14,970 --> 00:05:18,730
+preference although a large proportion suffered
+
+53
+00:05:18,730 --> 00:05:24,030
+adverse effects such as glare and blurred vision رغم 
+
+54
+00:05:24,030 --> 00:05:24,670
+الفوتوفوبيا
+
+55
+00:05:36,320 --> 00:05:45,720
+ما هي الصفات المثلى لأي قطرة توسع البؤبؤ؟ one quick 
+
+56
+00:05:45,720 --> 00:05:53,000
+onset يبدأ بسرعة adequate duration إن النقطة اللي 
+
+57
+00:05:53,000 --> 00:06:01,180
+بحطها تفضل تعمل حتى أنتهي من الفحصيعني انا بتصور
+
+58
+00:06:01,180 --> 00:06:06,980
+ايش وش المثالي، حط نقطة بس هتروبك in mind تفضل نص
+
+59
+00:06:06,980 --> 00:06:13,320
+ساعة، ماتجسرش فيه، محتاجش كمان نقطة زي تانية عشان
+
+60
+00:06:13,320 --> 00:06:17,040
+أجوّيها يعني، three fast recovery after the 
+
+61
+00:06:17,040 --> 00:06:20,360
+examination بعد ما اعمل examination ينتهي على طول
+
+62
+00:06:20,360 --> 00:06:23,960
+الأثر، ماتطلعش في الشارع، مايسوق سيارة أو يبدأ 
+
+63
+00:06:23,960 --> 00:06:24,640
+يمشي في الشمس
+
+64
+00:06:28,650 --> 00:06:32,070
+انا بقولك شئ مثالي عارف ايش الشئ المثالي اللي فيش
+
+65
+00:06:32,070 --> 00:06:37,650
+منه يعني زي البشر هل في بشر في كل شئ مية في المية 
+
+66
+00:06:37,650 --> 00:06:42,270
+يعني انا افترض انه بدأ drug مية في المية طبعا مش
+
+67
+00:06:42,270 --> 00:06:47,050
+سماش مولود اه بقول fast recovery after examination
+
+68
+00:06:47,050 --> 00:06:50,450
+يعني انا ساعة ما اعمل examination دل فاندس
+
+69
+00:06:57,590 --> 00:07:03,130
+light reflex abolished لأنه وانا ببحث مايكونش ال
+
+70
+00:07:03,130 --> 00:07:06,750
+light reflex يشتغل بأي درجة لأنه اذا اشتغل سيعكس
+
+71
+00:07:06,750 --> 00:07:09,450
+على ال examination لان ال examination بده light
+
+72
+00:07:09,450 --> 00:07:15,350
+فساعات يحط ال light يصغر البقبق بيكون مشكلة وانا
+
+73
+00:07:15,350 --> 00:07:19,950
+أظن ان tropicamide يعني نوعا ما بحد كبير بلغ ال
+
+74
+00:07:19,950 --> 00:07:28,250
+light reflex بينما ال final frame لأ بلغيشلا
+
+75
+00:07:28,250 --> 00:07:33,050
+سيكروبليزيا يعني يعمل بس على ال people اللي ماعملش
+
+76
+00:07:33,050 --> 00:07:39,230
+على ciliary muscle وهذا ممكن فش لو تنبغوا و تنبغوا
+
+77
+00:07:39,230 --> 00:07:44,830
+بنفس العصب فعلا sympathetic ك people يعني قادر هو
+
+78
+00:07:44,830 --> 00:07:52,210
+ب quick reversal in an emergency يعني للافرض انه
+
+79
+00:07:52,210 --> 00:07:52,970
+بدأت
+
+80
+00:07:59,870 --> 00:08:05,350
+الآن يعني اكون قادر على انه يرجع بسرعة مايستممش في
+
+81
+00:08:05,350 --> 00:08:13,810
+ال .. في التقدم نحو ال attack و لا يعني reverse
+
+82
+00:08:13,810 --> 00:08:20,070
+يعني ايش reverse عكسي لا عكسي يعني عمال هو بيوسع
+
+83
+00:08:20,070 --> 00:08:25,550
+بيوسع بيوسع انا قصة الضغط او شوفت بداية قلم انا 
+
+84
+00:08:25,550 --> 00:08:30,170
+مانيش يكمل توسيعه بدي يرجع تانيلأن لو كان التفسير
+
+85
+00:08:30,170 --> 00:08:35,310
+هو ماذا سأفعل؟ Glucoma attack وهذا طبعا لا يوجد
+
+86
+00:08:35,310 --> 00:08:41,410
+منه طيب, no rise in intraocular pressure ماعملش
+
+87
+00:08:41,410 --> 00:08:45,370
+ارتفاع في ضغط العين, no other pharmacological 
+
+88
+00:08:45,370 --> 00:08:49,410
+effect ماعملش حساسية، ماعملش stinging، ماعملش
+
+89
+00:08:49,410 --> 00:08:54,430
+burning طيب, no cytotoxic reactions، ماعملش
+
+90
+00:08:54,430 --> 00:08:55,290
+care attacks مثلا
+
+91
+00:08:59,760 --> 00:09:06,400
+للـ corneal epithelium مثلا و لا روحلي على الدم و
+
+92
+00:09:06,400 --> 00:09:09,500
+يعملي مثلا bradycardia او تافيكارديا او يعملي على
+
+93
+00:09:09,500 --> 00:09:13,280
+القلب no
+
+94
+00:09:13,280 --> 00:09:17,660
+adverse subjective complaints such as stinging و
+
+95
+00:09:17,660 --> 00:09:21,720
+لا يشكل المريض من burning و stinging و حاجة طبعا 
+
+96
+00:09:21,720 --> 00:09:24,540
+الأشياء هذه بحق بعضها
+
+97
+00:09:42,320 --> 00:09:46,800
+indications او دوائي الاستعمال متى انا استعمل
+
+98
+00:09:46,800 --> 00:09:53,100
+المدرياتيكس only one recent answer of floating 
+
+99
+00:09:53,100 --> 00:09:54,260
+patriots opacity
+
+100
+00:10:05,760 --> 00:10:12,880
+دكتور مشهور في دباب زي الدباب جسم أسود يتحرك احنا
+
+101
+00:10:12,880 --> 00:10:20,280
+هذه بيسميها في طب العيون mask of volitance انتم 
+
+102
+00:10:20,280 --> 00:10:25,140
+زيكوا مشوفهاش إلا انطلع في شيء في رأسه اللي بطلع
+
+103
+00:10:25,140 --> 00:10:30,260
+شيء في رأسه ممكن يشوفها لأن هذي فيها نوع من ال
+
+104
+00:10:30,260 --> 00:10:36,150
+liquefaction of the vitreous ويكون فيه بعض
+
+105
+00:10:36,150 --> 00:10:40,990
+aggregations of cells انت بتدرس aggregations يعني 
+
+106
+00:10:40,990 --> 00:10:48,490
+تجمع من الخلايا فلما هذا التجمع يمر بال visual 
+
+107
+00:10:48,490 --> 00:10:53,590
+axis بشوف و الهايوهايه اسمك الهايوهايه مياه
+
+108
+00:10:53,590 --> 00:10:56,690
+بيشوفوها لما مياه بيشوفوها لأنه عنده core retinal 
+
+109
+00:10:56,690 --> 00:11:00,910
+degeneration و عنده في ال .. في ال .. في opacity
+
+110
+00:11:00,910 --> 00:11:02,130
+بسيطة في ال
+
+111
+00:11:07,490 --> 00:11:14,110
+اخد بزيادة عيب فال طبعا اول ما يقول انه هو شايف اي
+
+112
+00:11:14,110 --> 00:11:20,690
+floaters زي هذه بيكون يعني واجب ان انا اعمل 
+
+113
+00:11:20,690 --> 00:11:26,590
+fundus examination خاصة ان شاك من اي flashing عارفين ايش
+
+114
+00:11:26,590 --> 00:11:33,570
+ال flashing؟ ومضات ضوئية سريعة ومفاجئة وهذه غالبا
+
+115
+00:11:37,310 --> 00:11:41,870
+مش ال retinal detachment بقعد ما هي choroidal
+
+116
+00:11:41,870 --> 00:11:45,670
+detachment يعني تعرفين ال retina و ال choroid مسخين 
+
+117
+00:11:45,670 --> 00:11:53,750
+لبعض مع السن و شوية liquefaction لل vitreous يصير
+
+118
+00:11:53,750 --> 00:12:00,150
+liquefied مش vitreous القعدة بتاعته تنسلخ شوية شوية 
+
+119
+00:12:00,150 --> 00:12:04,800
+عن إيش؟ عن ال retina فيبدأ يعملوا أمضاء تانيةعمل 
+
+120
+00:12:04,800 --> 00:12:09,980
+attachment تاني وضع صعب يعني ان كان .. بدأ بيعمل
+
+121
+00:12:09,980 --> 00:12:15,040
+عمى طيب relatively sudden decrease in visual 
+
+122
+00:12:15,040 --> 00:12:22,500
+activity يعني طفل مثلا كان بيشوف ستة ع ستة شوية 
+
+123
+00:12:22,500 --> 00:12:27,460
+صارت ستة ع تسعة ستة ع اتناشر بدأ يتراجع reflection
+
+124
+00:12:27,460 --> 00:12:28,540
+مش مبين للحقيقة
+
+125
+00:12:37,570 --> 00:12:42,850
+و يبقى دلوقتي يعني كل شيء لا يصح بال lenses ال
+
+126
+00:12:42,850 --> 00:12:48,850
+glasses بيكون في organic diseases هنا بيدي دور
+
+127
+00:12:48,850 --> 00:12:55,250
+الطبيب و بيدي دور ال team work team work يعني
+
+128
+00:12:55,250 --> 00:12:59,670
+حضرتك هو الطبيب طبعا في المستشفى بيقولك please for 
+
+129
+00:12:59,670 --> 00:13:04,940
+reflection تبلك تبل reflectionو تقولوا يعني بس
+
+130
+00:13:04,940 --> 00:13:07,720
+تقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا
+
+131
+00:13:07,720 --> 00:13:08,120
+بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا
+
+132
+00:13:08,120 --> 00:13:13,900
+بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا
+
+133
+00:13:13,900 --> 00:13:15,800
+بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا
+
+134
+00:13:15,800 --> 00:13:16,200
+بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا
+
+135
+00:13:16,200 --> 00:13:16,600
+بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا
+
+136
+00:13:16,600 --> 00:13:26,700
+بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا
+
+137
+00:13:27,320 --> 00:13:30,960
+هل هو cataract؟ هل هو جلوكوما؟ هل هو floaters في
+
+138
+00:13:30,960 --> 00:13:36,440
+الفتيريس؟ نظيف في الشبكية؟ هل هو macular degeneration قديمة؟ 
+
+139
+00:13:36,440 --> 00:13:41,100
+فيه سبب هذا اللي هتشوفه إلا بالفحص بعد التوسيع
+
+140
+00:13:41,100 --> 00:13:45,400
+three unexplained loss of visual activity المعنى
+
+141
+00:13:45,400 --> 00:13:50,260
+هو visual field analysis فطالعا constricted وأنتوا
+
+142
+00:13:50,260 --> 00:13:52,060
+أظنوا أخدتوا أي شيء مثل هذا؟
+
+143
+00:14:00,270 --> 00:14:04,930
+إنما totally أو partially مثلا temporal له تفسير
+
+144
+00:14:04,930 --> 00:14:09,470
+نزل له تفسير و هكذا فبكون بدنا نعمل good
+
+145
+00:14:09,470 --> 00:14:12,210
+examination for the retina and of the disc
+
+146
+00:14:30,340 --> 00:14:36,000
+مافيش فيه ارتفاع يبقى فيه something عامله pain
+
+147
+00:14:36,000 --> 00:14:41,540
+ربما يحتاج إلى توسعة ربما يحتاج الى توسعة يمكن 
+
+148
+00:14:41,540 --> 00:14:49,240
+انه عنده tumor عنده حاجة عنده exudation عنده يعني
+
+149
+00:14:49,240 --> 00:14:56,440
+spell ciliary body ciliary muscle five redness of
+
+150
+00:14:56,440 --> 00:15:00,180
+the eye حمر في العين دهوهو ليه attributed to 
+
+151
+00:15:00,180 --> 00:15:03,160
+infection ولا allergy ولا raise in hypertension
+
+152
+00:15:03,160 --> 00:15:08,720
+يعني عنده حمار في عينه و العلاج مادعمش فيه ولا 
+
+153
+00:15:08,720 --> 00:15:13,680
+العلاج اللي هو الحمرار في العين ليس مثلا بحساسية 
+
+154
+00:15:13,680 --> 00:15:19,520
+ولا infection عدوى في العين مثلا زي ال bacteria 
+
+155
+00:15:19,520 --> 00:15:23,500
+مثلا ولا اتفاقضة في العين والحمار هذا لم يستجب
+
+156
+00:15:23,500 --> 00:15:26,320
+العلاج الحساسية ولا العلاج ال antibiotic في العين
+
+157
+00:15:40,560 --> 00:15:44,000
+ضربة للعين to exclude the presence of ocular
+
+158
+00:15:44,000 --> 00:15:49,820
+damage يعني أحيانًا الضربة للعين تعمل detachment
+
+159
+00:15:49,820 --> 00:15:56,300
+الشبكية تعمل bleeding في الفتيريس تعمل tear-tear
+
+160
+00:15:56,300 --> 00:16:02,860
+يعني تمزق الكوريا تعمل recession تمزق للangle of EC
+
+161
+00:16:02,860 --> 00:16:09,920
+أحيانًا تعمل dislocation لللنس الحياة بتعمل
+
+162
+00:16:09,920 --> 00:16:19,660
+bleeding in the AC في هذا المثل محتاج إلى توسعة
+
+163
+00:16:19,660 --> 00:16:27,060
+ليه ماش توسعة البقبة رفاهية لأ ليست رفاهية لما توسعة
+
+164
+00:16:27,060 --> 00:16:32,080
+البقبة إله indications دواعي إذا حل أي دوام هذه
+
+165
+00:16:32,080 --> 00:16:37,200
+الدواعي واجب أن أعطي المريض وقتا كافيا في التوسيع
+
+166
+00:16:37,200 --> 00:16:44,040
+وفي الفحص أنا إنسان له قيمة عند الله وعند الناس
+
+167
+00:16:44,040 --> 00:16:50,280
+مايقولوا يلا يمشي وبيهم شهادة او انا يعني افتعل
+
+168
+00:16:50,280 --> 00:16:54,040
+عارف عارف مش عارف احيله من اللي يعرف
+
+169
+00:16:58,400 --> 00:17:02,120
+كمال في الدراسات الـ Difficulty in observing the 
+
+170
+00:17:02,120 --> 00:17:06,040
+fundus due to reduced transparency of the media
+
+171
+00:17:06,040 --> 00:17:11,240
+اه انت عارفين ال .. ال .. ال .. ال media or the 
+
+172
+00:17:11,240 --> 00:17:18,920
+eye are transparent تدعى من كوريا أكيوساهيومر لينس 
+
+173
+00:17:18,920 --> 00:17:24,500
+فتيرياس هذه اسمها ocular media أو سوائل العين
+
+174
+00:17:24,500 --> 00:17:25,800
+transparent
+
+175
+00:17:31,990 --> 00:17:41,330
+أو نتيجة لمرض بيصير some of these media not 
+
+176
+00:17:41,330 --> 00:17:47,030
+transparent يعني 
+
+177
+00:17:47,030 --> 00:17:58,130
+مثلا في حالة الكيراتيتس في حالة corneal ulcer في
+
+178
+00:17:58,130 --> 00:17:59,510
+حالة corneal edema
+
+179
+00:18:05,980 --> 00:18:17,560
+في حالة bleeding in AC في حالة cataract progressive 
+
+180
+00:18:17,560 --> 00:18:26,560
+cataract في حالة vitreous bleeding
+
+181
+00:18:29,480 --> 00:18:36,240
+بختارش ان اشوف كويس فلو فاهمة ان التوسيع للبقبة
+
+182
+00:18:36,240 --> 00
+
+216
+00:22:41,610 --> 00:22:44,810
+smile كيف طلع الكون الـ lenticule اسمه lenticule
+
+217
+00:22:44,810 --> 00:22:52,430
+extraction كل هذا يحتاج أن القبة أقل شيء يكون six 
+
+218
+00:22:52,430 --> 00:22:59,420
+millimeterوهذا يُفحص بجهاز اسمه Aperometer فهذا
+
+219
+00:22:59,420 --> 00:23:05,100
+أيضا يحتاج إلى توسيع كمان
+
+220
+00:23:05,100 --> 00:23:10,500
+Diagnostic Uses يعني Diagnostic Uses لأغراض اللي
+
+221
+00:23:10,500 --> 00:23:17,460
+هو التشخيص أغراض التشخيص يعني تشخيص tumor في
+
+222
+00:23:17,460 --> 00:23:21,780
+الشبكية tumor في الكورويد كلام زي هذا برضه
+
+223
+00:23:26,990 --> 00:23:32,170
+في أشياء علاجية و نحن شرحنا في ال cycle of
+
+224
+00:23:32,170 --> 00:23:36,930
+miotic عشان يمنع الـ posterior synechia و حتى جولنا
+
+225
+00:23:36,930 --> 00:23:41,290
+في ناس جايين بيعملوا alternation between mydriasis و
+
+226
+00:23:41,290 --> 00:23:46,230
+myosis و mydriasis myosis و mydriasis لأن حتى في
+
+227
+00:23:46,230 --> 00:23:50,590
+الـ mydriasis لو فضل على هيئة يومين ثلاثة ممكن يصير 
+
+228
+00:23:50,590 --> 00:23:56,500
+بدل التصاق فحق مثلا الـ pilocarpine يفكها برضه في
+
+229
+00:23:56,500 --> 00:24:02,200
+حالة الـ iritis لازم أحط أما pilocarpine لو توفر
+
+230
+00:24:02,200 --> 00:24:06,840
+أحسن و أما magnetic الـ pilocarpine فوق أنه بيوسع
+
+231
+00:24:06,840 --> 00:24:13,560
+نوعا ما أنه بيعمل راحة لل ciliary muscle بيعمل راحة
+
+232
+00:24:13,560 --> 00:24:18,100
+لل ciliary muscle لأنه بيكون في التهاب بتاع 
+
+233
+00:24:18,100 --> 00:24:21,180
+الـ iritis في شيء من الـ spasm في الـ ciliary muscle
+
+234
+00:24:21,180 --> 00:24:26,360
+ال tropicamide لحاله ضعيف، ال cycloplegics يستخدمون
+
+235
+00:24:26,360 --> 00:24:33,860
+كتابة مصاحبة وفي بعض الأحيان يستخدمونها كمُجارات
+
+236
+00:24:33,860 --> 00:24:37,720
+للـ cycloplegia بمجارات مجانية cycloplegia بمجارات مجانية
+
+237
+00:24:37,720 --> 00:24:38,020
+cycloplegia بمجارات مجانية cycloplegia بمجارات مجانية
+
+238
+00:24:38,020 --> 00:24:40,320
+cycloplegia بمجارات مجانية cycloplegia بمجارات مجانية
+
+239
+00:24:40,320 --> 00:24:42,740
+cycloplegia بمجارات مجانية cycloplegia بمجارات مجانية
+
+240
+00:24:42,740 --> 00:24:48,620
+cycloplegia بمجارات مجانية cycloplegia بمجارات
+
+241
+00:24:48,620 --> 00:24:53,900
+مجانية cycloplegia بمجارات مجان
+
+242
+00:24:55,680 --> 00:24:59,100
+بسبب اهتمام بسيط بالقبّة لحالها بـ Sphincter Pupillae
+
+243
+00:24:59,100 --> 00:25:09,220
+Muscle الآن سأنقل إلى الـ Indications الـ 12 Indications طيب،
+
+244
+00:25:09,220 --> 00:25:14,980
+هل فيه side effects؟ هل فيه آثار جانبية للميدرياتيكس؟
+
+245
+00:25:14,980 --> 00:25:21,700
+مهما قلنا يعني ممكن تقليلها وممكن التغلب عليها إلى
+
+246
+00:25:21,700 --> 00:25:27,160
+تناولها بطريقة علمية واضحة، وكان مرحبًا بأن
+
+247
+00:25:27,160 --> 00:25:33,000
+الـ mydriatics أتت من نظر مخطط وإزالة
+
+248
+00:25:33,000 --> 00:25:36,940
+الحماية لـ glare، فوتوفوبيا، وهذا ما فيش فرق لزمان،
+
+249
+00:25:36,940 --> 00:25:45,440
+طالما فتحنا الباب، دخلت شمس كثيرة، عملت فوتوفوبيا،
+
+250
+00:25:45,440 --> 00:25:52,560
+التي كانت مفاجئة في بعض المجالات من حياتهم اليومية في
+
+251
+00:25:52,560 --> 00:25:57,060
+حياته اليومية لو وسّع بقوة، notably driving a motor
+
+252
+00:25:57,060 --> 00:26:02,100
+vehicle خاصة في قيادة السيارات والدراجات النارية
+
+253
+00:26:02,100 --> 00:26:07,120
+وما شابهها. These authors considered that patients
+
+254
+00:26:07,120 --> 00:26:12,320
+should be informed قبل ما نحط له قطرة، أن نبلغهم
+
+255
+00:26:12,320 --> 00:26:16,160
+about the visual disturbances that can be
+
+256
+00:26:16,160 --> 00:26:19,080
+associated with mydriatics. مش هنقولش ضحكوا
+
+257
+00:26:19,080 --> 00:26:19,440
+عليها
+
+258
+00:26:23,900 --> 00:26:29,120
+بيجيبوا form معين مقبول وبيطلب من المريض أو يريه
+
+259
+00:26:29,120 --> 00:26:33,300
+المريض أن كان طفل أو قاصر أن هو يبقى عليه عشان في
+
+260
+00:26:33,300 --> 00:26:39,540
+شيء اسمه مسئولية قانونية legal responsibility فهو
+
+261
+00:26:39,540 --> 00:26:43,960
+عشان الجراح يحمي حاله والمبنج يحمي حاله بيخليه
+
+262
+00:26:43,960 --> 00:26:50,240
+يعمل توقيع على أن الجراح أو المبنج لا يتحملان أي
+
+263
+00:26:50,240 --> 00:26:54,810
+مسئولية قانونية عن النتائج، يعني إيه فضلالي أنا وسعت
+
+264
+00:26:54,810 --> 00:27:00,390
+من قبة ماشي بسيارة بعدها مباشرة وأعمل حدث تصادم
+
+265
+00:27:00,390 --> 00:27:06,310
+وأدّعي الشرطة، قال ما هم حطولي في عيني قطرات، من
+
+266
+00:27:06,310 --> 00:27:10,510
+اللي حط لك؟ فلانة أو فلان أو فلان
+
+267
+00:27:21,110 --> 00:27:24,410
+يعني هدوء الدكاترة اللي كانوا يعني مسئوليني عني في
+
+268
+00:27:24,410 --> 00:27:30,310
+تعليمي نصحني كمان نصيحة بيقول لي اه دكتور محمد قبل
+
+269
+00:27:30,310 --> 00:27:40,510
+أن ترسل المريض الموسع حدقة عينه إلى البيت install one
+
+270
+00:27:40,510 --> 00:27:48,010
+drop of pilocarpine in each eye to be relaxed in
+
+271
+00:27:48,010 --> 00:27:48,490
+your sleep
+
+272
+00:27:56,240 --> 00:28:00,900
+وما أصيب إليك calling حط له
+
+273
+00:28:00,900 --> 00:28:05,760
+في كل عين قطرة pilocarpine عشان ترجع الأمور للباب
+
+274
+00:28:05,760 --> 00:28:09,980
+اللي فتحته، ساكرة ثاني، وهذه نصيحة أنا مُرتَزِف فيها،
+
+275
+00:28:09,980 --> 00:28:13,900
+وبقول الله يزيد الخير، من علمني الله يزيد الخير
+
+276
+00:28:27,830 --> 00:28:38,990
+يبقى الـ information يبقى الـ information
+
+277
+00:28:38,990 --> 00:28:41,450
+يبقى الـ information يبقى الـ information يبقى الـ
+
+278
+00:28:41,450 --> 00:28:41,530
+information يبقى الـ information يبقى الـ
+
+279
+00:28:41,530 --> 00:28:41,590
+information يبقى الـ information يبقى الـ
+
+280
+00:28:41,590 --> 00:28:41,610
+information يبقى الـ information يبقى الـ
+
+281
+00:28:41,610 --> 00:28:41,650
+information يبقى الـ information يبقى الـ
+
+282
+00:28:41,650 --> 00:28:41,770
+information يبقى الـ information يبقى الـ
+
+283
+00:28:41,770 --> 00:28:42,010
+information يبقى الـ information يبقى الـ
+
+284
+00:28:42,010 --> 00:28:44,030
+information يبقى الـ information يبقى الـ
+
+285
+00:28:44,030 --> 00:28:45,010
+information يبقى الـ information يبقى الـ
+
+286
+00:28:45,010 --> 00:28:48,630
+information يبقى الـ information يبقى الـ
+
+287
+00:28:48,630 --> 00:28:52,730
+information يبقى الـ information يبقى الـ
+
+288
+00:28:52,730 --> 00:28:56,860
+information يبقى of near vision لقراءة near vision
+
+289
+00:28:56,860 --> 00:29:04,600
+هانسأل المريض مدة ست ساعات مدة ست ساعات، لو قلنا له هيك
+
+290
+00:29:04,600 --> 00:29:07,920
+هو يقول اه ما الدكتور قال له؟ هو يعني نفسيا يحتاج
+
+291
+00:29:07,920 --> 00:29:10,980
+الراحة ست ساعات، قال له مش راحة الحلوة ليه؟ لكن
+
+292
+00:29:10,980 --> 00:29:14,880
+المشكلة أني أنا ما أقول له شغلة و يروح يفتح الكمبيوتر
+
+293
+00:29:14,880 --> 00:29:24,180
+وبده يقرأ، مش على متصل، يشغل إضاءة، عينه داخله فيها ضوء،
+
+294
+00:29:24,180 --> 00:29:27,920
+جالدي دي عالِمين، جال عمالي، ممكن كثير يطلب الشرطة
+
+295
+00:29:27,920 --> 00:29:35,260
+عشان تقبض عليه، كل شيء بيصير، الدنيا هذه عجيبة طب
+
+296
+00:29:35,260 --> 00:29:39,040
+benefits of wearing sunglasses and or broad
+
+297
+00:29:39,040 --> 00:29:43,600
+brimmed hat to alleviate photophobia يعني أنا كمان
+
+298
+00:29:43,600 --> 00:29:47,360
+أكلمه في الموضوع أني بقوله بعد ما تطلع من هنا من
+
+299
+00:29:47,360 --> 00:29:53,220
+العيادة أو من المستشفى الأفضل تلبس نظارات شمسية أو
+
+300
+00:29:53,220 --> 00:30:01,700
+تضع قبعة لها بقول له غفرف أو حاجة يعني أمامها و
+
+301
+00:30:01,700 --> 00:30:07,760
+برود حتى يمنع الإضاءة باتجاهك الحاجة
+
+302
+00:30:07,760 --> 00:30:15,160
+الثانية desirability of avoiding riding يعني أن أنا 
+
+303
+00:30:15,160 --> 00:30:22,860
+عارف عن رغبتي أن أنا أسوق سيارة أو غير سيارة أو
+
+304
+00:30:22,860 --> 00:30:25,740
+motorcycle حتى دراجة أو driving a car immediately
+
+305
+00:30:25,740 --> 00:30:33,340
+after ده ميدرياز، يبقى نفسه أن نحن سنوسع لرجل
+
+306
+00:30:33,340 --> 00:30:38,560
+أو امرأة معه سيارة، أنه نحن أفضل قبل أن أبقى على
+
+307
+00:30:38,560 --> 00:30:45,440
+مقاطعة أن يتصل بمن يقود له السيارة، وإلا يجد يعني
+
+308
+00:30:45,440 --> 00:30:50,140
+فالواجب postpone اليوم التالي جيب واحد يسوق سيارة
+
+309
+00:30:50,140 --> 00:30:55,940
+وأخر خاصة بالليل خاصة بالليل، فبالليل أضواء
+
+310
+00:30:55,940 --> 00:31:02,340
+السيارات مرتفعة، فممكن تعمل dazzling وممكن يعمل
+
+311
+00:31:02,340 --> 00:31:08,100
+car accidents، يبقى هذه أولًا الـ information أما من
+
+312
+00:31:08,100 --> 00:31:12,640
+الـ information لأنه photophobia و cycloplegia
+
+313
+00:31:12,640 --> 00:31:18,440
+احتمال mydriasis Contra
+
+314
+00:31:18,440 --> 00:31:23,720
+indications طبعًا هي هذه منها الـ adverse يعني الـ
+
+315
+00:31:23,720 --> 00:31:26,140
+side effects، الـ photophobia و loss of
+
+316
+00:31:26,140 --> 00:31:30,600
+accommodation و dazzling و كل هذا هو الـ side
+
+317
+00:31:30,600 --> 00:31:33,400
+effects، كويس هيك؟
+
+318
+00:31:36,670 --> 00:31:41,350
+ممنوع علي أن أنا أستعمل هذه القطرات في أي عين من 
+
+319
+00:31:41,350 --> 00:31:55,630
+العيون في أي مريض من المرضى يتأكد
+
+320
+00:31:55,630 --> 00:32:03,430
+أن ما فيش معاناة الاستعمال يتأكد
+
+321
+00:32:03,430 --> 00:32:10,300
+وهذه مسئولية مسئوليته أن هو يسأل أو يفحص قبل إيش
+
+322
+00:32:10,300 --> 00:32:17,300
+قبل أن يضع one patients using pilocarpine for the
+
+323
+00:32:17,300 --> 00:32:22,000
+treatment of glaucoma طبعًا هذه مدة قديمة قبل عشرين
+
+324
+00:32:22,000 --> 00:32:29,940
+سنة وأكثر كالـ pilocarpine هو سيد أو الخط الأول في
+
+325
+00:32:29,940 --> 00:32:37,020
+علاج لـ open angle glaucoma بضيق الـ fornix شد الـ iris
+
+326
+00:32:37,020 --> 00:32:41,480
+centrally فبيفتح الـ angle اللي عند الـ root تقفز الـ
+
+327
+00:32:41,480 --> 00:32:45,080
+iris طبعًا
+
+328
+00:32:45,080 --> 00:32:47,500
+لا يعني أن هذا التغلب الـ biochemical بينهم بيفتح
+
+329
+00:32:47,500 --> 00:32:53,640
+السدادة، لكن من يوم ما طلع الـ timolol والـ timolol الـ
+
+330
+00:32:53,640 --> 00:32:57,340
+beta blockers اسمهم تغلب على الـ beta blockers
+
+331
+00:32:57,340 --> 00:33:05,970
+ما بيعملش الـ myosis، لأن الـ myosis بيتبعوا artificial
+
+332
+00:33:05,970 --> 00:33:12,910
+myopia و increase of accommodation لأن فيه شوية
+
+333
+00:33:12,910 --> 00:33:18,810
+shared space وبعدين فيه الـ visual field بيصير
+
+334
+00:33:18,810 --> 00:33:26,390
+narrow الـ visual field بيصير narrow لكن ربما في
+
+335
+00:33:26,390 --> 00:33:27,350
+بعض الدول حتى الأقل
+
+336
+00:33:33,460 --> 00:33:40,340
+فكيف أن أنا يعني واحد عنده pinhole pupil أن أحط له
+
+337
+00:33:40,340 --> 00:33:48,800
+موسع مش هيشتغل يعني المقبض موصد مسكّن مش سهل أهالي
+
+338
+00:33:48,800 --> 00:33:55,300
+يفتحوا له لأن سبق الـ pilocarpine سبق اللي هو الـ mydriatics
+
+339
+00:33:55,300 --> 00:34:00,840
+نين narrow angle للمقلة يعني هو عنده أساسًا الـ
+
+340
+00:34:00,840 --> 00:34:07,340
+angle narrow وعشان هي كهو على حِتفة من ناحية the
+
+341
+00:34:07,340 --> 00:34:13,600
+shutting of this angle يعني ممكن في لحظة تبقى 
+
+342
+00:34:13,600 --> 00:34:20,300
+closure ونخش فيها attack خطيرة طب أنا كيف أعرف أنّه
+
+343
+00:34:20,300 --> 00:34:29,180
+في narrow angle؟ شكرا لك، بالـ reflection العادي
+
+344
+00:34:29,180 --> 00:34:33,200
+عمل لي hypermetropia فوق الـ 5 مثلاً أو فوق الـ 6
+
+345
+00:34:34,700 --> 00:34:39,100
+طبعًا يستثنى الأطفال الصغار تحت 6 سنين لأن العين
+
+346
+00:34:39,100 --> 00:34:46,040
+flexible لكن واحد كبر وعنده narrow angle و
+
+347
+00:34:46,040 --> 00:34:53,760
+النضارة بتاعته واضح أنها very thick فلما حطيتها على
+
+348
+00:34:53,760 --> 00:34:57,380
+الجهاز
+
+349
+00:34:57,380 --> 00:35:02,680
+طلعت لي plus 6 مثلاً narrow angle
+
+350
+00:35:05,400 --> 00:35:10,040
+الهستوري تاخد أي علاج سبق أن عينك حمرت كده كده لو
+
+351
+00:35:10,040 --> 00:35:12,800
+اندليت أنا من الهستوري أنه صابوا أي بلوكوما قبل
+
+352
+00:35:12,800 --> 00:35:17,160
+هيك، قد تاك حاجة كويس
+
+353
+00:35:17,160 --> 00:35:22,780
+الـ anterior chamber shallow until الـ chamber وهذا بتبين
+
+354
+00:35:22,780 --> 00:35:29,520
+بالـ light العادي أو بالـ slit lamp optical section بيبان
+
+355
+00:35:29,520 --> 00:35:32,800
+المسافة ما بين القرنية
+
+356
+00:35:48,410 --> 00:35:54,230
+بركة ماء لو فيها مثلاً 30 سم بمشي فيها
+
+357
+00:35:54,230 --> 00:35:59,830
+بِرجليّ، بيقول عنها ضحلة، لكن لو فيها متريال لا عميق
+
+358
+00:35:59,830 --> 00:36:05,230
+بغرق فيه، فالـ AC لما تكون القرنية والـ iris
+
+359
+00:36:05,230 --> 00:36:11,070
+قريبين من بعض ليست هذه يعني 2 millimeter بيقول
+
+360
+00:36:11,070 --> 00:36:16,690
+عنها shallow AC ضحلة قريبين عن بعض هيك يعني، لكن
+
+361
+00:36:16,690 --> 00:36:20,730
+لما تكون بعيد عن بعض بيقول deep زي مثلاً من الناس اللي
+
+362
+00:36:20,730 --> 00:36:27,530
+عندهم الـ lens مش lens اللي ذبولة أكيد بيكون 
+
+363
+00:36:27,530 --> 00:36:38,430
+فيه deep AC AC لذيذ يا عزيزي، جدا جميل، طيب، أبضم 
+
+364
+00:36:38,430 --> 00:36:41,170
+shallow anterior chamber يعني مش shallow بس 
+
+365
+00:36:46,560 --> 00:36:52,560
+يبقى سواء فيه narrow angle أو shallow chamber هما
+
+366
+00:36:52,560 --> 00:36:59,580
+threatening signs for attack of acute اللي هو 
+
+367
+00:36:59,580 --> 00:37:04,920
+الـ glaucoma dislocation of the crystalline lens هو 
+
+368
+00:37:04,920 --> 00:37:10,340
+an intraocular lens إيش يعني dislocation of the
+
+369
+00:37:10,340 --> 00:37:13,900
+crystalline lens؟
+
+370
+00:37:16,090 --> 00:37:22,670
+طبعًا أنا يعني بدي أوسّع وفي مشكلة في الـ news فيهم
+
+371
+00:37:22,670 --> 00:37:29,570
+تير قطر أو حتى اتركوا الـ اسمها mydriatics لكن صارتها
+
+372
+00:37:29,570 --> 00:37:39,450
+dislocation dislocation، وأجع الفرح في يعني
+
+373
+00:37:39,450 --> 00:37:44,670
+هو في الناس اللي في الناس الصادر في الـ  excimer laser في
+
+374
+00:37:44,670 --> 00:37:49,470
+الـ excimer laser يعني في Intraocular lens عامل كتاركت و
+
+375
+00:37:49,470 --> 00:37:53,630
+artificial lens موجود poly مثال مثل الـ acrylic lens
+
+376
+00:37:53,630 --> 00:38:01,410
+جال هل حقيقة أنه في رابط بين الـ ciliary muscle وبعد
+
+377
+00:38:01,410 --> 00:38:08,150
+الـ lens هل هذه الـ lens بتعمل accommodation لأ إذا
+
+378
+00:38:08,150 --> 00:38:11,730
+كانت بتعرف تجاوبني تجاوبني بتعرف تجاوبني قولي later
+
+379
+00:38:11,730 --> 00:38:18,120
+on وبديبرك تجاوبني لأن في بعض الناس شغلته يعني إيش
+
+380
+00:38:18,120 --> 00:38:26,080
+أن يمسك الخيط، يعني يا بناتي هذه شبكة هنا الـ
+
+381
+00:38:26,080 --> 00:38:34,000
+muscle وهنا الـ lens، هذه الـ muscle هيك وهنا الـ 
+
+382
+00:38:34,000 --> 00:38:38,800
+zonule في الـ equator و pre equator و post equator
+
+383
+00:38:38,800 --> 00:38:44,220
+وده الـ lens، هذه الـ lens وهذه الـ muscle، الآن الـ
+
+384
+00:38:44,220 --> 00:38:52,160
+zonules هدول هم اللي بيوصلوا القوة من الـ muscle
+
+385
+00:38:52,160 --> 00:38:56,480
+إلى الـ lens الآن
+
+386
+00:38:56,480 --> 00:39:01,540
+الـ zonules صح موجودين في عملية الـ extracapsular
+
+387
+00:39:01,540 --> 00:39:06,040
+extracapsular cataract extraction أنا الحقيقة 
+
+388
+00:39:06,040 --> 00:39:08,020
+ما شيلتش الـ zonules
+
+389
+00:39:11,780 --> 00:39:18,300
+أنّ خليت شيء اسمه capsular bag بس
+
+390
+00:39:18,300 --> 00:39:23,920
+أنا فتحت من أمام وعملت removal للنزع، طرحت برة اللي
+
+391
+00:39:23,920 --> 00:39:29,660
+هي في الـ crystalline lens، فالـ zonules اللي هنا بيضلوا في المكان
+
+392
+00:39:29,660 --> 00:39:35,440
+وأنا روح جبت هذه الـ optic وهذه الـ haptic
+
+393
+00:39:41,520 --> 00:39:47,380
+الآن لما الـ muscle اللي هي هنا بتنكمش
+
+431
+00:43:06,690 --> 00:43:08,010
+راح تهيأ المزاقة
+
+432
+00:43:25,190 --> 00:43:31,230
+يعملها في الـ AC الامبلانتيشن المشكلة في الـ AC
+
+433
+00:43:31,230 --> 00:43:36,610
+لينزيز انه لها علاقة بالـ أنجل و لها علاقة بالـ
+
+434
+00:43:36,610 --> 00:43:43,130
+ايريز ممكن تعمل friction مع الـ ايريز و تطلع نوع من
+
+435
+00:43:43,130 --> 00:43:50,910
+الميلانين و من هذا يسكر الـ أنجل أو حتى يعمل نوع من
+
+436
+00:43:50,910 --> 00:43:52,530
+الـ irritation و العيبيتس
+
+437
+00:43:57,710 --> 00:44:02,370
+والـ Hypopion والكلام هذا ففي الحالة هذه أنا بتوقف
+
+438
+00:44:02,370 --> 00:44:05,410
+عن التوسيع خاصة في الـ Optometry خاصة في الـ
+
+439
+00:44:05,410 --> 00:44:08,570
+Optometry المشاكل الحالية دي بدها Cortisone وبدها 
+
+440
+00:44:08,570 --> 00:44:14,390
+جانب متابعة عبر اللي هو إيش الطبيب
+
+441
+00:44:22,860 --> 00:44:26,060
+by mechanical blockage of the angle of the iris
+
+442
+00:44:26,060 --> 00:44:30,360
+بقى a state of semi dilatation of the pupil might
+
+443
+00:44:30,360 --> 00:44:33,980
+initiate this rise by producing pupillary block
+
+444
+00:44:42,820 --> 00:44:46,620
+أمام الـ iris هذا لذيذ الشيء كمان. This can occur
+
+445
+00:44:46,620 --> 00:44:49,800
+in semi dilated eyes because of the shallow
+
+446
+00:44:49,800 --> 00:44:54,100
+anterior chamber and anterior place lens. يعني الـ
+
+447
+00:44:54,100 --> 00:44:59,900
+lens هذه هي عملت narrowing و sharrowing للاسي و
+
+448
+00:44:59,900 --> 00:45:05,810
+narrowing للانجلالأيريز تكون أكثر مقارنة بمقارنة
+
+449
+00:45:05,810 --> 00:45:16,690
+الكابسول باللينز بمقارنة مقارنة بمقارنة الكابسول
+
+450
+00:45:16,690 --> 00:45:19,630
+باللينز بمقارنة مقارنة مقارنة مقارنة مقارنة مقارنة
+
+451
+00:45:19,630 --> 00:45:19,950
+مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة
+
+452
+00:45:19,950 --> 00:45:31,170
+مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارن
+
+453
+00:45:31,880 --> 00:45:36,220
+أيه سيدي؟ وفيه narrow angle ففي الحالة هذه تسميها
+
+454
+00:45:36,220 --> 00:45:38,100
+Contra Indication للتوسيع 
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/DLjdO_qFie8_postprocess.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/DLjdO_qFie8_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..0eb2ae000c85a99d34684e004c47bcea1516ee8b
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/DLjdO_qFie8_postprocess.srt
@@ -0,0 +1,1816 @@
+1
+00:00:20,770 --> 00:00:23,090
+أولي بالله من الشيطان الرجيم بسم الله الرحمن
+
+2
+00:00:23,090 --> 00:00:27,710
+الرحيم الحمد لله رب العالمين وأصلي وأسلم على النبي
+
+3
+00:00:27,710 --> 00:00:31,890
+الكريم محمد وعلى آله وأصحابه والتابعين السلام
+
+4
+00:00:31,890 --> 00:00:38,870
+عليكم ورحمة الله وبركاته اليوم سنبدأ بقصة جديدة عن
+
+5
+00:00:38,870 --> 00:00:46,650
+مدرياتيكس مدرياتيكس مدرياتيكس هم الشيطانين اللي
+
+6
+00:00:46,650 --> 00:00:48,850
+يستطيع أن يقوم بتعريف الأطفال
+
+7
+00:00:53,830 --> 00:01:00,270
+Good Examination of the posterior segment of the
+
+8
+00:01:00,270 --> 00:01:07,950
+eye. Optic discs, optic vessels, macula and
+
+9
+00:01:07,950 --> 00:01:12,810
+retinal background.Magnetics
+
+10
+00:01:12,810 --> 00:01:15,770
+dilate the pupil to facilitate a more thorough
+
+11
+00:01:25,170 --> 00:01:34,490
+وهي عامة تستخدمها على الوطنين الكبار السنين كما لو
+
+12
+00:01:34,490 --> 00:01:37,270
+كانوا الوطنين الكبار السنين عاماً أصغر وعاماً أصغر
+
+13
+00:01:37,270 --> 00:01:41,210
+وعاماً أصغر وعاماً أصغر وعاماً أصغر وعاماً أصغر
+
+14
+00:01:41,210 --> 00:01:42,890
+وعاماً أصغر وعاماً أصغر وعاماً أصغر وعاماً أصغر
+
+15
+00:01:42,890 --> 00:01:43,070
+وعاماً أصغر وعاماً أصغر وعاماً أصغر وعاماً أصغر
+
+16
+00:01:43,070 --> 00:01:43,110
+وعاماً أصغر وعاماً أصغر وعاماً أصغر وعاماً أصغر
+
+17
+00:01:43,110 --> 00:01:47,770
+وعاماً
+
+18
+00:01:47,770 --> 00:01:57,660
+أصغر وعاماً أصغر وعاماً أبس فترة بيوبيلي قوية
+
+19
+00:01:57,660 --> 00:02:04,560
+بيكون ال pupil size small واحدة كمان بيكونوا
+
+20
+00:02:04,560 --> 00:02:09,420
+liable to cataract oposites in the lens and liable
+
+21
+00:02:09,420 --> 00:02:16,960
+to diseases in choroid and retina و ال diabetic
+
+22
+00:02:16,960 --> 00:02:22,980
+retinopathy اللي بيبقى مرضى السكري يعني كثير من
+
+23
+00:02:22,980 --> 00:02:27,990
+المياه تطلباللي هو accurate examination of the
+
+24
+00:02:27,990 --> 00:02:33,730
+fundus و لاجب انه يكون فيه dilatation لل pupil لان
+
+25
+00:02:33,730 --> 00:02:38,410
+اسمها pupil ما بيكفي لفحص ال periphery of the
+
+26
+00:02:38,410 --> 00:02:42,870
+fundus هكذا ديوز of pediatrics كان essential in
+
+27
+00:02:42,870 --> 00:02:46,590
+any age group كمان ممكن في اي age group يتطلب
+
+28
+00:02:46,590 --> 00:02:52,820
+especiallyوالدماغولة أو المنطقات الخارجية للرتينا
+
+29
+00:02:52,820 --> 00:03:01,120
+تحتاج إلى ملاحظة حذرة.الان بدأنا نعرف إيش فيه
+
+30
+00:03:01,120 --> 00:03:07,400
+أدوات أو دراجس تستخدم في هذا المنحو مارتين دويل في
+
+31
+00:03:07,400 --> 00:03:15,840
+نينتين سيستي سيبن قرر إصلاح مدرياتيك لا يستخدم عنه
+
+32
+00:03:15,840 --> 00:03:24,220
+للاستخدام من دماغولةيبقى الماكولا؟ اه اللهم يجعله
+
+33
+00:03:24,220 --> 00:03:41,300
+كذا ايوة
+
+34
+00:03:41,300 --> 00:03:45,080
+يا عزيزي يا
+
+35
+00:03:45,080 --> 00:03:48,280
+سامي جاهز؟
+
+36
+00:03:53,100 --> 00:03:56,960
+مش عارف الاساس دي هو ال remote؟ الاساس بريمونت
+
+37
+00:03:56,960 --> 00:04:01,340
+بريمونت؟
+
+38
+00:04:01,340 --> 00:04:04,340
+بريمونت؟ بريمونت؟ بريمونت؟ بريمونت؟ بريمونت؟
+
+39
+00:04:04,340 --> 00:04:04,380
+بريمونت؟ بريمونت؟ بريمونت؟ بريمونت؟ بريمونت؟
+
+40
+00:04:04,380 --> 00:04:04,480
+بريمونت؟ بريمونت؟ بريمونت؟ بريمونت؟ بريمونت؟
+
+41
+00:04:04,480 --> 00:04:08,880
+بريمونت؟ بريمونت؟ بريمونت؟ بريمونت؟ بريمونت؟
+
+42
+00:04:08,880 --> 00:04:12,380
+بريمونت؟ بريمونت؟ بريمون
+
+43
+00:04:29,230 --> 00:04:37,430
+ولو لا يستغنى عن توثيق البابو في الexamination مذا
+
+44
+00:04:37,430 --> 00:04:41,530
+ماكولا، كان البروفيسور المشرف عليها، ده هو اللي
+
+45
+00:04:41,530 --> 00:04:46,410
+بيقول الكلمة، بيقولي don't comment on ماكولا وده
+
+46
+00:04:46,410 --> 00:04:53,010
+وده لاتش، ماكولا عايز ده لاتش، سيدروف وانا سيدروف
+
+47
+00:04:53,010 --> 00:04:58,690
+مشهورExamine patients attitudes to pupil
+
+48
+00:04:58,690 --> 00:05:02,050
+dilatation during optometric examination and found
+
+49
+00:05:02,050 --> 00:05:06,770
+that the majority were in favor بفضله لما تقولوا
+
+50
+00:05:06,770 --> 00:05:10,970
+يعني بدون توصية مش هتكون الفحص مية لمية لو انا
+
+51
+00:05:10,970 --> 00:05:14,970
+عملتك توصية هيك بقولك favor يعني هم بفضله بما ال
+
+52
+00:05:14,970 --> 00:05:18,730
+preference although a large proportion suffered
+
+53
+00:05:18,730 --> 00:05:24,030
+adverse effects such as glare and blind opium رغم
+
+54
+00:05:24,030 --> 00:05:24,670
+الفطوفوبيا
+
+55
+00:05:36,320 --> 00:05:45,720
+ما هي الصفات المثلة لأي قطرة توسع البور؟ one quick
+
+56
+00:05:45,720 --> 00:05:53,000
+onset يبدأ بسرعة adequate duration إن النقطة اللي
+
+57
+00:05:53,000 --> 00:06:01,180
+بحطها تفضل تعمل حتى أنتهي من الفحصيعني انا بتصور
+
+58
+00:06:01,180 --> 00:06:06,980
+ايش وش المثالي، حط نقطة بس هتروبك in mind تفضل نص
+
+59
+00:06:06,980 --> 00:06:13,320
+ساعة، ماتجسرش فيه، محتاجش كمان نقطة زي تانية عشان
+
+60
+00:06:13,320 --> 00:06:17,040
+اجويها يعني، three fast recovery after the
+
+61
+00:06:17,040 --> 00:06:20,360
+examination بعد ما اعمل examination ينتهي على طول
+
+62
+00:06:20,360 --> 00:06:23,960
+الأثر، ماتطلعش في الشارع، مايسوق سيارة أو يبدأ
+
+63
+00:06:23,960 --> 00:06:24,640
+يمشي في الشمس
+
+64
+00:06:28,650 --> 00:06:32,070
+انا بقولك شئ مثالي عارف ايش الشئ المثالي اللي فيش
+
+65
+00:06:32,070 --> 00:06:37,650
+منه يعني زي البشر هل في بشر في كل شئ مية في المية
+
+66
+00:06:37,650 --> 00:06:42,270
+يعني انا افترض انه بدأ drug مية في المية طبعا مش
+
+67
+00:06:42,270 --> 00:06:47,050
+سماش مولود اه بقول fast recovery after examination
+
+68
+00:06:47,050 --> 00:06:50,450
+يعني انا ساعة ما اعمل examination دل فاندس
+
+69
+00:06:57,590 --> 00:07:03,130
+light reflex abolished لأنه وانا ببحث مايكونش ال
+
+70
+00:07:03,130 --> 00:07:06,750
+light reflex يشتغل بأي درجة لأنه اذا اشتغل سيعكس
+
+71
+00:07:06,750 --> 00:07:09,450
+على ال examination لان ال examination بده light
+
+72
+00:07:09,450 --> 00:07:15,350
+فساعات يحط ال light يصغر البقبق بيكون مشكلة وانا
+
+73
+00:07:15,350 --> 00:07:19,950
+اظن ان tropic mind يعني نوعا ما بحد كبير بلغ ال
+
+74
+00:07:19,950 --> 00:07:28,250
+light reflex بينما ال finale frame لأ بلغيشلا
+
+75
+00:07:28,250 --> 00:07:33,050
+سيكروبليزيا يعني يعمل بس على ال people اللي ماعملش
+
+76
+00:07:33,050 --> 00:07:39,230
+على celery muscle وهذا ممكن فش لو تنبغوا و تنبغوا
+
+77
+00:07:39,230 --> 00:07:44,830
+بنفس العصب فعلا sympathetic ك people يعني قادر هو
+
+78
+00:07:44,830 --> 00:07:52,210
+ب quick reversal in an emergency يعني للافرض انه
+
+79
+00:07:52,210 --> 00:07:52,970
+بدأت
+
+80
+00:07:59,870 --> 00:08:05,350
+الان يعني اكون قادر على انه يرجع بسرعة مايستممش في
+
+81
+00:08:05,350 --> 00:08:13,810
+ال .. في التقدم نحو ال attack و لا يعني reverse
+
+82
+00:08:13,810 --> 00:08:20,070
+يعني ايش reverse عكسي لا عكسي يعني عمال هو بيوسع
+
+83
+00:08:20,070 --> 00:08:25,550
+بيوسع بيوسع انا قصة الضغط او شوفت بداية قلم انا
+
+84
+00:08:25,550 --> 00:08:30,170
+مانيش يكمل توسيعه بدي يرجع تانيلأن لو كان التفسير
+
+85
+00:08:30,170 --> 00:08:35,310
+هو ماذا سأفعل؟ Glucoma attack وهذا طبعا لا يوجد
+
+86
+00:08:35,310 --> 00:08:41,410
+منه طيب, no rise in intraocular pressure ماعملش
+
+87
+00:08:41,410 --> 00:08:45,370
+ارتفاع في ضبط العين, no other pharmacological
+
+88
+00:08:45,370 --> 00:08:49,410
+effect ماعملش حساسية، ماعملش stinging، ماعملش
+
+89
+00:08:49,410 --> 00:08:54,430
+burning طيب, no more cartoxic reactions، ماعملش
+
+90
+00:08:54,430 --> 00:08:55,290
+care attacks مثلا
+
+91
+00:08:59,760 --> 00:09:06,400
+للـ corneal epithelium مثلا و لا روحلي على الدم و
+
+92
+00:09:06,400 --> 00:09:09,500
+يعملي مثلا bradycardia او تافيكارديا او يعملي على
+
+93
+00:09:09,500 --> 00:09:13,280
+القلب no
+
+94
+00:09:13,280 --> 00:09:17,660
+adverse subjective complaints such as stinging و
+
+95
+00:09:17,660 --> 00:09:21,720
+لا يشكل المريض من burning و stinging و حاجة طبعا
+
+96
+00:09:21,720 --> 00:09:24,540
+الأشياء هذه بحق بعضها
+
+97
+00:09:42,320 --> 00:09:46,800
+indications او دوائي الاستماع متى انا استعمل
+
+98
+00:09:46,800 --> 00:09:53,100
+المدرياتيكس only one recent answer of floating
+
+99
+00:09:53,100 --> 00:09:54,260
+patriots opacity
+
+100
+00:10:05,760 --> 00:10:12,880
+دكتور مشهور في دباب زي الدباب جسم أسود يتحرك احنا
+
+101
+00:10:12,880 --> 00:10:20,280
+هذه بيسميها في طب العيون mask of volitance انتوا
+
+102
+00:10:20,280 --> 00:10:25,140
+زيكوا مشوفهاش إلا انطلع في شيء في رأسه اللي بطلع
+
+103
+00:10:25,140 --> 00:10:30,260
+شيء في رأسه ممكن يشوفها لأن هذي فيها نوع من ال
+
+104
+00:10:30,260 --> 00:10:36,150
+liquefaction of the vitiasو يكون فيه بعض
+
+105
+00:10:36,150 --> 00:10:40,990
+aggregations of cells انت بتدرس aggregations يعني
+
+106
+00:10:40,990 --> 00:10:48,490
+تجمع من الخلايا فلما هذا التجمع يمر بال visual
+
+107
+00:10:48,490 --> 00:10:53,590
+axis بشوف و الهايوهايه اسمك الهايوهايه مياه
+
+108
+00:10:53,590 --> 00:10:56,690
+بيشوفوها لما مياه بيشوفوها لأنه عنده core retinal
+
+109
+00:10:56,690 --> 00:11:00,910
+degeneration و عنده في ال .. في ال .. في opacity
+
+110
+00:11:00,910 --> 00:11:02,130
+بسيطة في ال
+
+111
+00:11:07,490 --> 00:11:14,110
+اخد بزيادة عيب فال طبعا اول ما يقول انه هو شايف اي
+
+112
+00:11:14,110 --> 00:11:20,690
+floaters زي هذه بيكون يعني واجب ان انا اعمل
+
+113
+00:11:20,690 --> 00:11:26,590
+modalitation خاصة ان شاك من اي flashing عارفين ايش
+
+114
+00:11:26,590 --> 00:11:33,570
+ال flashing؟ ومضارب ضوئية سريعة ومفاجئة وهذه غالبا
+
+115
+00:11:37,310 --> 00:11:41,870
+مش ال retinal detachment بقعد ما هي koroidal
+
+116
+00:11:41,870 --> 00:11:45,670
+detachment يعني تعرفين ال retina و ال koroid مسخين
+
+117
+00:11:45,670 --> 00:11:53,750
+لبعض مع السن و شوية liquefaction لل vitreous يصير
+
+118
+00:11:53,750 --> 00:12:00,150
+liquefied مش visit القعدة بتاعته تنسلخ شوية شوية
+
+119
+00:12:00,150 --> 00:12:04,800
+عن إيش؟ عن ال retina فيبدأ يعملوا أمضاء تانيةعمل
+
+120
+00:12:04,800 --> 00:12:09,980
+attachment تاني وضع صعب يعني ان كان .. بدأ بيعمل
+
+121
+00:12:09,980 --> 00:12:15,040
+عمى طيب relatively sudden decrease in visual
+
+122
+00:12:15,040 --> 00:12:22,500
+activity يعني طفل مثلا كان بيشوف ستة ع ستة شوية
+
+123
+00:12:22,500 --> 00:12:27,460
+صارت ستة ع تسعة ستة ع اتناشر بدأ يتراجع reflection
+
+124
+00:12:27,460 --> 00:12:28,540
+مش مبين للحقيقة
+
+125
+00:12:37,570 --> 00:12:42,850
+و يبقى دلوقتي يعني كل شيء لا يصح بال lenses ال
+
+126
+00:12:42,850 --> 00:12:48,850
+glasses بيكون في organic diseases هنا بيدي دور
+
+127
+00:12:48,850 --> 00:12:55,250
+الطبيب و بيدي دور ال team work team work يعني
+
+128
+00:12:55,250 --> 00:12:59,670
+حضرتك هو الطبيب طبعا في المستشفى بيقولك please for
+
+129
+00:12:59,670 --> 00:13:04,940
+reflection تبلك تبل reflectionو تقولوا يعني بس
+
+130
+00:13:04,940 --> 00:13:07,720
+تقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا
+
+131
+00:13:07,720 --> 00:13:08,120
+بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا
+
+132
+00:13:08,120 --> 00:13:13,900
+بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا
+
+133
+00:13:13,900 --> 00:13:15,800
+بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا
+
+134
+00:13:15,800 --> 00:13:16,200
+بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا
+
+135
+00:13:16,200 --> 00:13:16,600
+بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا
+
+136
+00:13:16,600 --> 00:13:26,700
+بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا
+
+137
+00:13:27,320 --> 00:13:30,960
+هل هو كترك؟ هل هو جلوكومة؟ هل هو floaters في
+
+138
+00:13:30,960 --> 00:13:36,440
+الفتريس؟ نظيف في الشبكية؟ هل هو ماركولار قديمة؟
+
+139
+00:13:36,440 --> 00:13:41,100
+فيه سبب هذا اللي هتشوفه إلا بالفحص بعد التوسيع
+
+140
+00:13:41,100 --> 00:13:45,400
+three unexplained loss of visual activity المعنى
+
+141
+00:13:45,400 --> 00:13:50,260
+هو visual في ال analysis فطالعا constricted وأنتوا
+
+142
+00:13:50,260 --> 00:13:52,060
+أظنوا أخدتوا أي شيء مثل هذا؟
+
+143
+00:14:00,270 --> 00:14:04,930
+إنما totally أو partially مثلا temporal له تفسير
+
+144
+00:14:04,930 --> 00:14:09,470
+نزل له تفسير و هكذا فبكون بدنا نعمل good
+
+145
+00:14:09,470 --> 00:14:12,210
+examination for the retina and of the disc
+
+146
+00:14:30,340 --> 00:14:36,000
+مافيش فيه ارتفاع يبقى فيه something عامله pain
+
+147
+00:14:36,000 --> 00:14:41,540
+ربما يحتاج الى توسيله ربما يحتاج الى توسيله يمكن
+
+148
+00:14:41,540 --> 00:14:49,240
+انه عنده tumor عنده حاجة عنده exudation عنده يعني
+
+149
+00:14:49,240 --> 00:14:56,440
+spell celery body celery muscle five redness of
+
+150
+00:14:56,440 --> 00:15:00,180
+the eye حمر في العين دهوهو ليه attributed to
+
+151
+00:15:00,180 --> 00:15:03,160
+infection ولا allergy ولا raise in hypertension
+
+152
+00:15:03,160 --> 00:15:08,720
+يعني عنده حمار في عينه و العلاج مادعمش فيه ولا
+
+153
+00:15:08,720 --> 00:15:13,680
+العلاج اللي هو الحمرار في العين ليس مثلا بحاسسية
+
+154
+00:15:13,680 --> 00:15:19,520
+ولا infection عدوة في العين مثلا زي ال bacteria
+
+155
+00:15:19,520 --> 00:15:23,500
+مثلا ولا اتفاقضة في العين والحمار هذا لم يستجب
+
+156
+00:15:23,500 --> 00:15:26,320
+العلاج الحاسسية ولا العلاج ال antibiotic في العين
+
+157
+00:15:40,560 --> 00:15:44,000
+ضربة للعين to exclude the presence of ocular
+
+158
+00:15:44,000 --> 00:15:49,820
+damage يعني أحيانًا الضربة للعين تعمل detachment
+
+159
+00:15:49,820 --> 00:15:56,300
+الشبكية تعمل bleeding في الفتريس تعمل tear-tear
+
+160
+00:15:56,300 --> 00:16:02,860
+يعني تمزق الكراي تعمل recession تمزق للangle of EC
+
+161
+00:16:02,860 --> 00:16:09,920
+أحيانًا تعمل dislocation لللنسالحياة بتعمل
+
+162
+00:16:09,920 --> 00:16:19,660
+bleeding in the AC في هذا المثل محتاج إلى توسية
+
+163
+00:16:19,660 --> 00:16:27,060
+ليه ماش توسية البقبة رفاية لأ ليست رفاية لما توسية
+
+164
+00:16:27,060 --> 00:16:32,080
+البقبة إله indications دواعيفإذا حل أي دوام هذه
+
+165
+00:16:32,080 --> 00:16:37,200
+الدواعي واجب أن أعطي المريض وقتا كافيا في التوسيق
+
+166
+00:16:37,200 --> 00:16:44,040
+وفي الفحص أنا إنسان له قيمة عند الله وعند الناس
+
+167
+00:16:44,040 --> 00:16:50,280
+مايقولوا يلا يمشي وبيهم شهادة او انا يعني افتعل
+
+168
+00:16:50,280 --> 00:16:54,040
+عارف عارف مش عارف احيله من اللي يعرف
+
+169
+00:16:58,400 --> 00:17:02,120
+كمال في الدراسات الـ Difficulty in observing the
+
+170
+00:17:02,120 --> 00:17:06,040
+front bus due to reduced transparency of the media
+
+171
+00:17:06,040 --> 00:17:11,240
+اه انت عارفين ال .. ال .. ال .. ال media or the
+
+172
+00:17:11,240 --> 00:17:18,920
+eye are transparent تدعى من كوريا أكيوساهيومر لينس
+
+173
+00:17:18,920 --> 00:17:24,500
+فيترياس هذه اسمها ocular media أو ساعة العين
+
+174
+00:17:24,500 --> 00:17:25,800
+transparent
+
+175
+00:17:31,990 --> 00:17:41,330
+أو نتيجة لمرض بيصير some of these media not
+
+176
+00:17:41,330 --> 00:17:47,030
+transparent يعني
+
+177
+00:17:47,030 --> 00:17:58,130
+مثلا في حالة الكيروتيتس في حالة كورنال ألسان في
+
+178
+00:17:58,130 --> 00:17:59,510
+حالة الكورنال إديمة
+
+179
+00:18:05,980 --> 00:18:17,560
+في حالة bleeding NAC في حالة cataract progressive
+
+180
+00:18:17,560 --> 00:18:26,560
+cataract في حالة vitreous bleeding
+
+181
+00:18:29,480 --> 00:18:36,240
+بختارش ان اشوف كويس فلو فاهمة ان التوسيق للبقبه
+
+182
+00:18:36,240 --> 00:18:43,860
+ساعدني على ان اعمل bypass لال opacity وقد لا يعمل
+
+183
+00:18:43,860 --> 00:18:47,880
+يعني المرحلة اللي معناها هي حين نكون massive
+
+184
+00:18:47,880 --> 00:18:51,920
+patriation في نفس ال diabetics massive ايش
+
+185
+00:18:51,920 --> 00:18:58,460
+massive؟ تحمل كل ال patriots في شمبا مليون ادم
+
+186
+00:19:01,810 --> 00:19:06,930
+فانا بوصي و بحاول من قران اشوف ماذا بعد اشواء هذا
+
+187
+00:19:06,930 --> 00:19:13,110
+بحاول مارضج احمر مارضج مثلا طب لو كان في complete
+
+188
+00:19:13,110 --> 00:19:18,510
+cataract انا
+
+189
+00:19:18,510 --> 00:19:23,670
+بتكلم عن التوسيع بتكلم عن ريتناسكوبي او
+
+190
+00:19:23,670 --> 00:19:25,430
+اوفراموسكوبي direct او oran direct
+
+191
+00:19:31,010 --> 00:19:34,910
+هو يعمل بالديرتوف تانيسكوب او بالديرتوف تانيسكوب
+
+192
+00:19:34,910 --> 00:19:43,450
+وفي وسيلة تالتة اللي هي وكس لينس ناينتي داوكتر
+
+193
+00:19:43,450 --> 00:19:51,350
+ودستيتلان وكس بسيكتوها عارفين؟ هو
+
+194
+00:19:51,350 --> 00:19:55,350
+بتالي انه لو في complete cataract مش هينفع حتى في
+
+195
+00:19:55,350 --> 00:20:00,690
+كل التوسيق وانا هانفع بحاجة إلى ليش الاترسال
+
+196
+00:20:03,220 --> 00:20:08,600
+و في غير كمان في CT طيب
+
+197
+00:20:08,600 --> 00:20:15,660
+diabetic patients anyway has a general role القادة
+
+198
+00:20:15,660 --> 00:20:23,680
+بقولي ان المريض السكري اللي لا يفتكي المفروض once
+
+199
+00:20:23,680 --> 00:20:25,980
+yearly
+
+200
+00:21:01,540 --> 00:21:04,400
+بالنسبة للدراسات الاجتماعية الاجتماعية الاجتماعية
+
+201
+00:21:04,400 --> 00:21:07,860
+الاجتماعية الاجتماعية الاجتماعية الاجتماعية
+
+202
+00:21:07,860 --> 00:21:08,000
+الاجتماعية الاجتماعية الاجتماعية الاجتماعية
+
+203
+00:21:08,000 --> 00:21:08,040
+الاجتماعية الاجتماعية الاجتماعية الاجتماعية
+
+204
+00:21:08,040 --> 00:21:08,140
+الاجتماعية
+
+205
+00:21:12,000 --> 00:21:16,360
+full palatation of the body وضف اليهم في الدياميتس
+
+206
+00:21:16,360 --> 00:21:31,360
+any session او PRP ايش PRP photo refractive photo
+
+207
+00:21:31,360 --> 00:21:38,080
+coagulation laser pan retinal pan retinal photo
+
+208
+00:21:38,080 --> 00:21:38,920
+coagulation
+
+209
+00:21:50,480 --> 00:21:56,580
+طيب فعبث photography تصوير الكاميرا على الرغم من
+
+210
+00:21:56,580 --> 00:22:01,860
+أنه الأن recently طلعت كاميرات ممكن تشتغل without
+
+211
+00:22:01,860 --> 00:22:07,000
+مدرياتيز لأن الكاميرات اللي هو ال universal
+
+212
+00:22:07,000 --> 00:22:12,280
+الموجودة بين إيدينا تحتاج إلى توسيع الحركة
+
+213
+00:22:23,690 --> 00:22:29,890
+surgery with a wavefront based procedure كل الناس
+
+214
+00:22:29,890 --> 00:22:35,110
+اللي نعملهم لازك وما بعد اللازك نطلع جديد شرحناهم
+
+215
+00:22:35,110 --> 00:22:41,610
+ال .. لو smile حضرتوا ال .. يوم العلم؟ شوفتوا
+
+216
+00:22:41,610 --> 00:22:44,810
+smile كيف طلع الكون الـ lenticule اسمه lenticule
+
+217
+00:22:44,810 --> 00:22:52,430
+extraction كل هذا بحتاج أن البقبه أقل شيء يكون six
+
+218
+00:22:52,430 --> 00:22:59,420
+millimeterوهذا يُفحص بجهاز اسمه Aperometer فهذا
+
+219
+00:22:59,420 --> 00:23:05,100
+أيضا يحتاج إلى توسيع كمان
+
+220
+00:23:05,100 --> 00:23:10,500
+Diagnostic Uses يعني Diagnostic Uses لأغراض اللي
+
+221
+00:23:10,500 --> 00:23:17,460
+هو التشخيص أغراض التشخيص يعني تشخيص tumor في
+
+222
+00:23:17,460 --> 00:23:21,780
+الشبكية tumor في الكورويد كلام زي هذا برضه
+
+223
+00:23:26,990 --> 00:23:32,170
+في أشياء علاجية و احنا شرحنا في ال cycle of
+
+224
+00:23:32,170 --> 00:23:36,930
+mentolate عشان يمنع البوستيرو سينيتيا و حتى جولنا
+
+225
+00:23:36,930 --> 00:23:41,290
+في ناس جايين بيعمل alternation between meiosis و
+
+226
+00:23:41,290 --> 00:23:46,230
+بيوزنز و مدريازز ميوزنز و مدريازز لأن حتى في
+
+227
+00:23:46,230 --> 00:23:50,590
+المدريازز لو فضل على هيئة يومين تلاتة ممكن يصير
+
+228
+00:23:50,590 --> 00:23:56,500
+بدل اتصاق فحق مثلا ال bio carbine يفكها برضهففي
+
+229
+00:23:56,500 --> 00:24:02,200
+حالة اليوبيايتس لازم احط اما psychological لو توفر
+
+230
+00:24:02,200 --> 00:24:06,840
+احسن واما magnetic ال psychological فوق انه بيوسع
+
+231
+00:24:06,840 --> 00:24:13,560
+نوعا ما انه بيعمل راحة لل celery muscle بيعمل راحة
+
+232
+00:24:13,560 --> 00:24:18,100
+لل celery muscle لانه بيكون في الاتهاب بتاع
+
+233
+00:24:18,100 --> 00:24:21,180
+اليوبيايتس في شيء من ال spasm في الcellar muscle
+
+234
+00:24:21,180 --> 00:24:26,360
+ال tropic emite لحاله ضعيفالسيكروفيجيكز يستخدمون
+
+235
+00:24:26,360 --> 00:24:33,860
+كتابة مصاحب وفي بعض الأحيان يستخدمونها كمجارات
+
+236
+00:24:33,860 --> 00:24:37,720
+كوليسيا بمجارات مجانية كوليسيا بمجارات مجانية
+
+237
+00:24:37,720 --> 00:24:38,020
+كوليسيا بمجارات مجانية كوليسيا بمجارات مجانية
+
+238
+00:24:38,020 --> 00:24:40,320
+كوليسيا بمجارات مجانية كوليسيا بمجارات مجانية
+
+239
+00:24:40,320 --> 00:24:42,740
+كوليسيا بمجارات مجانية كوليسيا بمجارات مجانية
+
+240
+00:24:42,740 --> 00:24:48,620
+كوليسيا بمجارات مجانية كوليسيا بمجارات
+
+241
+00:24:48,620 --> 00:24:53,900
+مجانية كوليسيا بمجارات مجان
+
+242
+00:24:55,680 --> 00:24:59,100
+بسبب اهتمام باسي بالبقب لحاله بـSphincter Propelli
+
+243
+00:24:59,100 --> 00:25:09,220
+Muscle الان هانقل Indications 12 Indications طيب،
+
+244
+00:25:09,220 --> 00:25:14,980
+هل فيه side effects؟ هل فيه أثار جانبية للمضاتكس؟
+
+245
+00:25:14,980 --> 00:25:21,700
+مهما قلنا يعني ممكن تقليلها وممكن التغلب عليها إلى
+
+246
+00:25:21,700 --> 00:25:27,160
+تناولها بطريقة علمية واضحةوكان مرحبًا بأن
+
+247
+00:25:27,160 --> 00:25:33,000
+المدريازيات أتت من نظر مخطط وإزالة
+
+248
+00:25:33,000 --> 00:25:36,940
+الحماية لـ Glare فوتوفوبيا وهذا مافيش فرق لزمان،
+
+249
+00:25:36,940 --> 00:25:45,440
+طالما فتحنا الباب، دخل شمس كتيرة، عملت فوتوفوبيا،
+
+250
+00:25:45,440 --> 00:25:52,560
+اللي كانت مفاجئة ببعض المجالات من حياتهم اليوميةفي
+
+251
+00:25:52,560 --> 00:25:57,060
+حياته اليومية لو وسع بقوة، notably driving a motor
+
+252
+00:25:57,060 --> 00:26:02,100
+vehicle خاصة في قيادة السيارات والدرجات النارية
+
+253
+00:26:02,100 --> 00:26:07,120
+وما شابها. These authors considered that patients
+
+254
+00:26:07,120 --> 00:26:12,320
+should be informed قبل ما نحطه لنقطرة انه نبلغهم
+
+255
+00:26:12,320 --> 00:26:16,160
+about the visual disturbances that can be
+
+256
+00:26:16,160 --> 00:26:19,080
+associated with mid-reactors. مش هنقولش ضحكوا
+
+257
+00:26:19,080 --> 00:26:19,440
+عليها
+
+258
+00:26:23,900 --> 00:26:29,120
+بيجيبوا form معين مقبول و بيطلب من المريض او وريه
+
+259
+00:26:29,120 --> 00:26:33,300
+المريض ان كان طفل او قاصر ان هو يبقى عليه عشان في
+
+260
+00:26:33,300 --> 00:26:39,540
+اشي اسمه مسئولية قانونية legal responsibility فهو
+
+261
+00:26:39,540 --> 00:26:43,960
+عشان الجراح يحمي حاله و المبنج يحمي حاله بيخليه
+
+262
+00:26:43,960 --> 00:26:50,240
+يعمل توقيع على ان الجراح او المبنج لايتحملان اي
+
+263
+00:26:50,240 --> 00:26:54,810
+مسئولية قانونية عن النتائجيعني إيه فضلالي أنا وسعت
+
+264
+00:26:54,810 --> 00:27:00,390
+من بقبع ماشي بسيارة بعدها مباشرة و أعمل حدث تصادم
+
+265
+00:27:00,390 --> 00:27:06,310
+و أدوع الشرطة قال ما هم حطولي في عيني قطرات، من
+
+266
+00:27:06,310 --> 00:27:10,510
+اللي حطلك؟ فلانة أو فلان أو فلان
+
+267
+00:27:21,110 --> 00:27:24,410
+يعني اهد الدكاترة اللي كانوا يعني مسئوليني عني في
+
+268
+00:27:24,410 --> 00:27:30,310
+تعليمي نصحني كمان نصيحة بيقوللي اه دكتور محمد قبل
+
+269
+00:27:30,310 --> 00:27:40,510
+ان ترسل المريض الموسع حدقتاه الى البيت install one
+
+270
+00:27:40,510 --> 00:27:48,010
+drop of pyrocarbine in each eye to be relaxed in
+
+271
+00:27:48,010 --> 00:27:48,490
+your sleep
+
+272
+00:27:56,240 --> 00:28:00,900
+وماصيش إليك calling حطله
+
+273
+00:28:00,900 --> 00:28:05,760
+في كل عين نفت بلو كربين عشان ترجع الأمور للباب
+
+274
+00:28:05,760 --> 00:28:09,980
+اللي فتحته، ساكره تاني، وهذه نصيحة أنا مرتزف فيها،
+
+275
+00:28:09,980 --> 00:28:13,900
+وبقول الله يزيد الخير، من علمني الله يزيد الخير
+
+276
+00:28:27,830 --> 00:28:38,990
+يبقى ال information يبقى ال information
+
+277
+00:28:38,990 --> 00:28:41,450
+يبقى ال information يبقى ال information يبقى ال
+
+278
+00:28:41,450 --> 00:28:41,530
+information يبقى ال information يبقى ال
+
+279
+00:28:41,530 --> 00:28:41,590
+information يبقى ال information يبقى ال
+
+280
+00:28:41,590 --> 00:28:41,610
+information يبقى ال information يبقى ال
+
+281
+00:28:41,610 --> 00:28:41,650
+information يبقى ال information يبقى ال
+
+282
+00:28:41,650 --> 00:28:41,770
+information يبقى ال information يبقى ال
+
+283
+00:28:41,770 --> 00:28:42,010
+information يبقى ال information يبقى ال
+
+284
+00:28:42,010 --> 00:28:44,030
+information يبقى ال information يبقى ال
+
+285
+00:28:44,030 --> 00:28:45,010
+information يبقى ال information يبقى ال
+
+286
+00:28:45,010 --> 00:28:48,630
+information يبقى ال information يبقى ال
+
+287
+00:28:48,630 --> 00:28:52,730
+information يبقى ال information يبقى ال
+
+288
+00:28:52,730 --> 00:28:56,860
+information يبof near vision لقراية near vision
+
+289
+00:28:56,860 --> 00:29:04,600
+هان الساعة مدت ست ساعات مدت ست ساعات لو قوله هيك
+
+290
+00:29:04,600 --> 00:29:07,920
+هو يقول اه ما الدكتور قال ليه؟ هو يعني نفسيا بحاجة
+
+291
+00:29:07,920 --> 00:29:10,980
+الحلوة ست ساعات قاله مش حاجة الحلوة ليه؟ لكن
+
+292
+00:29:10,980 --> 00:29:14,880
+المشكلة اني انا ماقولهش شغلة وروح يفتح الكمبيوتر
+
+293
+00:29:14,880 --> 00:29:24,180
+وبده يقرأ مش على متصصشغل إضاءة، عينيه داخلتهم ضوء،
+
+294
+00:29:24,180 --> 00:29:27,920
+جالدي دي عالمين، جال عمالي، ممكن كتير يطلب الشرطة
+
+295
+00:29:27,920 --> 00:29:35,260
+عشان تقبل عليه، كل شيء بيصير، الدنيا هذه عجيبة طب
+
+296
+00:29:35,260 --> 00:29:39,040
+benefits of wearing sunglasses and or broad
+
+297
+00:29:39,040 --> 00:29:43,600
+brimmed hatto alleviate photophobia يعني انا كمان
+
+298
+00:29:43,600 --> 00:29:47,360
+اكلمه في الموضوع اني بقوله بعد ما تطلع من هنا من
+
+299
+00:29:47,360 --> 00:29:53,220
+العياذة او من المستشفى الأفضل تلبس نظارات شمسية او
+
+300
+00:29:53,220 --> 00:30:01,700
+تضع فاقية لها بقوله غفرف او حاجة يعني امامها و
+
+301
+00:30:01,700 --> 00:30:07,760
+برود حتى يمنع الإضاءة اتجاهك الحاجة
+
+302
+00:30:07,760 --> 00:30:15,160
+التانيةdesirability of avoiding riding يعني ان انا
+
+303
+00:30:15,160 --> 00:30:22,860
+عارف عن رغبتي ان انا اسوق سيارة او غير سيارة او
+
+304
+00:30:22,860 --> 00:30:25,740
+motor cycle حتى بسكلت او driving a car immediately
+
+305
+00:30:25,740 --> 00:30:33,340
+after ده مدرياتكية يبقى نفسها ان احنا هنوسع لرجل
+
+306
+00:30:33,340 --> 00:30:38,560
+او ست معاه سيارةإنه احنا أفضل قبل أن أبقى على
+
+307
+00:30:38,560 --> 00:30:45,440
+مقاطرة أن يتصل بمن يقود له السيارة فإلا يجد يعني
+
+308
+00:30:45,440 --> 00:30:50,140
+فالواجب postpone اليوم التالي جيب واحد يسوي سيارة
+
+309
+00:30:50,140 --> 00:30:55,940
+و اخر خاصة بالليل خاصة بالليل فبالليل أضواء
+
+310
+00:30:55,940 --> 00:31:02,340
+السيارات مرتفعة فممكن يعملوا dazzling و ممكن يعمل
+
+311
+00:31:02,340 --> 00:31:08,100
+car accidentsيبقى هاي أولا ال information اما من
+
+312
+00:31:08,100 --> 00:31:12,640
+ال information لأنه photophobia وcyclopedia
+
+313
+00:31:12,640 --> 00:31:18,440
+احتمالك ميريسيا Contra
+
+314
+00:31:18,440 --> 00:31:23,720
+indications طبعا هي هذه منها ال adverse يعني ال
+
+315
+00:31:23,720 --> 00:31:26,140
+side effects ال photophobia و loss of
+
+316
+00:31:26,140 --> 00:31:30,600
+accommodation و dazzling و كل هذا هو ال side
+
+317
+00:31:30,600 --> 00:31:33,400
+effects كويس هيك؟
+
+318
+00:31:36,670 --> 00:31:41,350
+ممنوع عليا ان انا استعمل هذه القطرات في اي عين من
+
+319
+00:31:41,350 --> 00:31:55,630
+العيون في اي مريض من المرضى يتأكد
+
+320
+00:31:55,630 --> 00:32:03,430
+ان مافيش معاناة الاستعمال يتأكد
+
+321
+00:32:03,430 --> 00:32:10,300
+وهذه مسئوليةمسؤوليته ان هو يسأل او يفحص قبل ايش
+
+322
+00:32:10,300 --> 00:32:17,300
+قبل أن يضع one patients using pyrocarbine for the
+
+323
+00:32:17,300 --> 00:32:22,000
+treatment of glaucoma طبعا هذه مدة قديمة قبل عشرين
+
+324
+00:32:22,000 --> 00:32:29,940
+سنة و اكتر كالpyrocarbine هو سيد او الخط الأول في
+
+325
+00:32:29,940 --> 00:32:37,020
+علاج ل open angle glaucoma بضيق الفوربشد ال iris
+
+326
+00:32:37,020 --> 00:32:41,480
+centrally فبيفتح ال angle اللي عند ال road تقفض ال
+
+327
+00:32:41,480 --> 00:32:45,080
+iris طبعا
+
+328
+00:32:45,080 --> 00:32:47,500
+لا يعني انه هذا التغلب ال biochemical بينهم بيفتح
+
+329
+00:32:47,500 --> 00:32:53,640
+سدريا لكن من يوم ما طلع ال تمولور والتمولين ال
+
+330
+00:32:53,640 --> 00:32:57,340
+beta blockers اسمهم تغلب عني ال beta blockers
+
+331
+00:32:57,340 --> 00:33:05,970
+مابيعملش ال meiosisلأن الميوز بيتبعوا artificial
+
+332
+00:33:05,970 --> 00:33:12,910
+myopia و increase of accommodation لأنه فيه شوية
+
+333
+00:33:12,910 --> 00:33:18,810
+share space و بعدين فيه ال visual field بيصير
+
+334
+00:33:18,810 --> 00:33:26,390
+narrow ال visual field بيصير narrow لكن ربما في
+
+335
+00:33:26,390 --> 00:33:27,350
+بعض الدول حتى الأقل
+
+336
+00:33:33,460 --> 00:33:40,340
+فكيف ان انا يعني واحد عنده pin hold pupil ان احطله
+
+337
+00:33:40,340 --> 00:33:48,800
+موسع مش هيشتغل يعني المقبض موصد مسكّن مش سهل اهالي
+
+338
+00:33:48,800 --> 00:33:55,300
+تفتحه لان سبق ال bio carbon سبق اللي هو المدرياتيك
+
+339
+00:33:55,300 --> 00:34:00,840
+نين narrow angle للمقمة يعني هو عنده أساسا ال
+
+340
+00:34:00,840 --> 00:34:07,340
+angle narrowوعشان هي كهو على حتفة من ناحية the
+
+341
+00:34:07,340 --> 00:34:13,600
+shutting of this angle يعني ممكن في لحظة تبقى
+
+342
+00:34:13,600 --> 00:34:20,300
+closure ونخش فيها attack خطيرة طب انا كيف اعرف انه
+
+343
+00:34:20,300 --> 00:34:29,180
+في narrow angle؟ شكرا لك بال reflection العادي
+
+344
+00:34:29,180 --> 00:34:33,200
+عملني hypermetroid فوق الخمسة مثلا او فوق الستة
+
+345
+00:34:34,700 --> 00:34:39,100
+طبعا يستفنى الأطفال الصغار تحت six سنين لأنه العين
+
+346
+00:34:39,100 --> 00:34:46,040
+flexible لكن واحد قضل و عنده narrow angle و
+
+347
+00:34:46,040 --> 00:34:53,760
+النضارة بتاعته واضح انه very thick فلما حطيتها على
+
+348
+00:34:53,760 --> 00:34:57,380
+الجهاز
+
+349
+00:34:57,380 --> 00:35:02,680
+طلعتلي plus six مثلا narrow angle
+
+350
+00:35:05,400 --> 00:35:10,040
+الهستوري تاخد أي علاج سبق أن عينك حمرت كده كده لو
+
+351
+00:35:10,040 --> 00:35:12,800
+اندليت أنا من الهستوري أنه صابوا أي بلوكومة قبل
+
+352
+00:35:12,800 --> 00:35:17,160
+هيك قد تاك حاجة كويس
+
+353
+00:35:17,160 --> 00:35:22,780
+ال نور مادي شلوق until ال chamber وهذا بتبين
+
+354
+00:35:22,780 --> 00:35:29,520
+بالlight العادي أو بالسلام optical section بيبان
+
+355
+00:35:29,520 --> 00:35:32,800
+المسافة ما بين الكورية
+
+356
+00:35:48,410 --> 00:35:54,230
+بركة مياه لو فيها مثلا تلاتين سانتي بمشي فيها
+
+357
+00:35:54,230 --> 00:35:59,830
+برجليا بيقول عنها ضحلة لك لو فيها متريال لأ عميق
+
+358
+00:35:59,830 --> 00:36:05,230
+بغرق فيه ف ال AC لما تكون الكورنيا وال آيروس
+
+359
+00:36:05,230 --> 00:36:11,070
+قريبين من بعض ليست ده يعني two millimeter بيقول
+
+360
+00:36:11,070 --> 00:36:16,690
+عنها shallow AC ضحلة قريبين عن بعض هيك يعني لكن
+
+361
+00:36:16,690 --> 00:36:20,730
+لما تكون بالعن بعضبقول deep زى مثلا من الناس اللى
+
+362
+00:36:20,730 --> 00:36:27,530
+عندهم الفاكهة مش الفاكهة اللذب مشهولة أكيد بيكون
+
+363
+00:36:27,530 --> 00:36:38,430
+فيه deep اسي اسي لذيذ يا عزيزي جدا جميل طيب أبضم
+
+364
+00:36:38,430 --> 00:36:41,170
+شلو until chamber يعني مش شلو بس
+
+365
+00:36:46,560 --> 00:36:52,560
+يبقى سواء فيه narrow angle أو shallow chamber هما
+
+366
+00:36:52,560 --> 00:36:59,580
+threatening signs for attack of acute اللي هو
+
+367
+00:36:59,580 --> 00:37:04,920
+العيبروكومة dislocation of the crystalline lens هو
+
+368
+00:37:04,920 --> 00:37:10,340
+an intraocular lens إيش يعني dislocation of the
+
+369
+00:37:10,340 --> 00:37:13,900
+crystalline lens؟
+
+370
+00:37:16,090 --> 00:37:22,670
+طبعا انا يعني بدي اوسع و في مشكلة في the news فيهم
+
+371
+00:37:22,670 --> 00:37:29,570
+تير قطر او حتى اتركوا الاسمازرواها لكن صارها
+
+372
+00:37:29,570 --> 00:37:39,450
+dislocation dislocation واجع فرح فيعني
+
+373
+00:37:39,450 --> 00:37:44,670
+هو في الناس اللي في الناس الصادر في kicksسيلوس في
+
+374
+00:37:44,670 --> 00:37:49,470
+الكيكس يعني في انتراكور لينز عامل كتراكت و
+
+375
+00:37:49,470 --> 00:37:53,630
+Artificial lens موجود poly مثال مث أكريليت لينز
+
+376
+00:37:53,630 --> 00:38:01,410
+جالر هل حقيقة أنه في رابط بين السيلري مواصل وبعد
+
+377
+00:38:01,410 --> 00:38:08,150
+اللينز هل هذه اللينز بتعمل accommodation لأ اذا
+
+378
+00:38:08,150 --> 00:38:11,730
+كانت بتعرف تجاوبى تجاوبى بتعرف تجاوبى قولي later
+
+379
+00:38:11,730 --> 00:38:18,120
+on و بديبرك تجاوبىلأن في بعض الناس شغلته يعني إيش
+
+380
+00:38:18,120 --> 00:38:26,080
+أن يمسك الأخطر يعني يا بناتي هذه شبكة هنا ال
+
+381
+00:38:26,080 --> 00:38:34,000
+muscle و هنا ال lens هاي ال muscle هيك و هنا ال
+
+382
+00:38:34,000 --> 00:38:38,800
+zinnius في ال equator و pre equator و post equator
+
+383
+00:38:38,800 --> 00:38:44,220
+و ده ال lens هاي ال lens و هاي ال muscleالآن الـ
+
+384
+00:38:44,220 --> 00:38:52,160
+zanules هدولة هم اللي بيوصلوا القوة من ال muscle
+
+385
+00:38:52,160 --> 00:38:56,480
+إلى الناس الآن
+
+386
+00:38:56,480 --> 00:39:01,540
+ال zanules صح موجودين في عملية ال extra capsula
+
+387
+00:39:01,540 --> 00:39:06,040
+extra capsula كtract extraction أنا الحقيقة
+
+388
+00:39:06,040 --> 00:39:08,020
+ماشيلتش ال zanules
+
+389
+00:39:11,780 --> 00:39:18,300
+انه خليت شي اسمه capsular bag بس
+
+390
+00:39:18,300 --> 00:39:23,920
+انا فتحت من امام وعملت removal للنزب مطر برا اللى
+
+391
+00:39:23,920 --> 00:39:29,660
+هى فى الكترين فالزنيوز اللى هنا فيضنوا فى المكان
+
+392
+00:39:29,660 --> 00:39:35,440
+وانا روح جب هى ال optic و هى ال haptic
+
+393
+00:39:41,520 --> 00:39:47,380
+الان لما ال muscle اللى هى هنا بتنكمش و بتجى هنا
+
+394
+00:39:47,380 --> 00:39:55,680
+اه و بتلف الضنيول ال
+
+395
+00:39:55,680 --> 00:40:00,500
+.. ال matter بتاع ال artificial lens البولي ميثايل
+
+396
+00:40:00,500 --> 00:40:09,140
+مثل اكريلية هى inert واحدة و بعدين solid مافيش
+
+397
+00:40:09,140 --> 00:40:12,690
+فيها accommodationin change in power or shape
+
+398
+00:40:12,690 --> 00:40:20,290
+وبالتالي سواء الناس عاملة contraction او عاملة
+
+399
+00:40:20,290 --> 00:40:27,810
+relaxation ما بيأثر مافي difference بتعمل
+
+400
+00:40:27,810 --> 00:40:34,850
+contraction او relaxation لأن الدنيا لا توصل ال
+
+401
+00:40:34,850 --> 00:40:39,170
+power للناس الناس هذا مش طبيعي الناس artificial
+
+402
+00:40:43,170 --> 00:40:47,990
+عشانك احنا هذا الـ sonofabric المسكين لاجب انه
+
+403
+00:40:47,990 --> 00:40:54,210
+نعطيه magnifier يجرى فيه plus three مثلا يجرى فيه
+
+404
+00:40:54,210 --> 00:41:00,070
+لأنه فيه complete loss و بقى combination فبالتالي
+
+405
+00:41:00,070 --> 00:41:06,410
+هذا يعني انا بدى وسّاله طبعا انا مانديش اوسع
+
+406
+00:41:06,410 --> 00:41:09,970
+الcellular muscle بدى واسع sphincter pupillary
+
+407
+00:41:09,970 --> 00:41:10,330
+muscle
+
+408
+00:41:13,000 --> 00:41:18,620
+بقدر امكان انا يعني ممكن انه استفيد وفش اي اثر على
+
+409
+00:41:18,620 --> 00:41:25,060
+السيري مصر فش اي اثر على السيري مصر يبقى ال ال ال
+
+410
+00:41:25,060 --> 00:41:26,340
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+411
+00:41:26,340 --> 00:41:27,540
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+412
+00:41:27,540 --> 00:41:29,460
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+413
+00:41:29,460 --> 00:41:30,840
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+414
+00:41:30,840 --> 00:41:30,900
+ال ال ال
+
+415
+00:41:39,200 --> 00:41:45,420
+فهنا في إتراك للفيديو Refraction مش صح يعني حطيت
+
+416
+00:41:45,420 --> 00:41:49,860
+الاتراك واللنز عشان تعملليه Refraction ساعتنا
+
+417
+00:41:49,860 --> 00:41:55,240
+بيصير ال dislocation تطلع من مكانها بيصير في إتراك
+
+418
+00:41:55,240 --> 00:42:04,900
+يعني مثلا هذا اللنز مثلا هاي ال AC وهي اللنز هنا
+
+419
+00:42:06,690 --> 00:42:13,010
+فلو أنا حاطط مثلا لين صناعية، هي هنا، مكانها، وهذه
+
+420
+00:42:13,010 --> 00:42:20,190
+مثلا طلعتلي صارت هنا، قعدتلي هنا أو قعدتلي هنا أو
+
+421
+00:42:20,190 --> 00:42:23,910
+هنا،
+
+422
+00:42:23,910 --> 00:42:28,800
+صار وضع كلهمشكلة يعني الناس هيعملها desinflation و
+
+423
+00:42:28,800 --> 00:42:33,200
+كلام زهيرة و reflection لخبط بتاع عينه لأ فهذا في
+
+424
+00:42:33,200 --> 00:42:36,380
+الأول يعني الحالة دي حالة جراحية انهم يعملوا
+
+425
+00:42:36,380 --> 00:42:39,780
+extraction للناس هذه في الأول و ذبطوا الموضوع
+
+426
+00:42:39,780 --> 00:42:44,540
+الجراحي في العين قبل أن انا أدور على ال dilatation
+
+427
+00:42:44,540 --> 00:42:47,740
+واضح؟
+
+428
+00:42:47,740 --> 00:42:52,700
+Interocular lens of the anterior chamber or iris
+
+429
+00:42:52,700 --> 00:42:58,970
+supported typeاحيانا في موانع تمنع من زراع العلسة
+
+430
+00:42:58,970 --> 00:43:06,690
+هنا مثلا هو بيشتغل بسكين بيشتغل في المنطقة هذه و
+
+431
+00:43:06,690 --> 00:43:08,010
+راح تهيأ المزاقة
+
+432
+00:43:25,190 --> 00:43:31,230
+يعملها في ال AC الامبلانتيشن المشكلة في ال AC
+
+433
+00:43:31,230 --> 00:43:36,610
+لينزيز انه لها علاقة بال أنجل و لها علاقة بال
+
+434
+00:43:36,610 --> 00:43:43,130
+ايريز ممكن تعمل friction مع ال ايريز و تطلع نوع من
+
+435
+00:43:43,130 --> 00:43:50,910
+الميلانين و من هذا يسكر ال أنجل او حتى يعمل نوع من
+
+436
+00:43:50,910 --> 00:43:52,530
+ال irritation و العيبيتس
+
+437
+00:43:57,710 --> 00:44:02,370
+والـ Hypopion والكلام هذا ففي الحالة هذه انا بتوقف
+
+438
+00:44:02,370 --> 00:44:05,410
+عن التوسيع خاصة في الـ Optometry خاصة في ال
+
+439
+00:44:05,410 --> 00:44:08,570
+Optometry المشاكل الحالية دي بدها Cortisone وبدها
+
+440
+00:44:08,570 --> 00:44:14,390
+جانب متابعة عبر اللي هو إيش الطبيب
+
+441
+00:44:22,860 --> 00:44:26,060
+by mechanical blockage of the angle of the iris
+
+442
+00:44:26,060 --> 00:44:30,360
+بقى a state of semi dilatation of the pupil might
+
+443
+00:44:30,360 --> 00:44:33,980
+initiate this rise by producing pupillary block
+
+444
+00:44:42,820 --> 00:44:46,620
+أمام الـ iris هذا لذيذ الشيء كمان. This can occur
+
+445
+00:44:46,620 --> 00:44:49,800
+in semi dilated eyes because of the shallow
+
+446
+00:44:49,800 --> 00:44:54,100
+anterior chamber and anterior place lens.يعني ال
+
+447
+00:44:54,100 --> 00:44:59,900
+lens هذه هي عملت narrowing و sharrowing للاسي و
+
+448
+00:44:59,900 --> 00:45:05,810
+narrowing للانجلالأيريز تكون أكثر مقارنة بمقارنة
+
+449
+00:45:05,810 --> 00:45:16,690
+الكابسول باللينز بمقارنة مقارنة بمقارنة الكابسول
+
+450
+00:45:16,690 --> 00:45:19,630
+باللينز بمقارنة مقارنة مقارنة مقارنة مقارنة مقارنة
+
+451
+00:45:19,630 --> 00:45:19,950
+مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة
+
+452
+00:45:19,950 --> 00:45:31,170
+مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارن
+
+453
+00:45:31,880 --> 00:45:36,220
+أيه سيدي؟ وفيه narrow angle ففي الحالة هذه تسميها
+
+454
+00:45:36,220 --> 00:45:38,100
+Contra Indication للتوسيع
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/DLjdO_qFie8_raw.json b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/DLjdO_qFie8_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..cb66af29d769aa5f26f38aff7c6f7c5b088e22bd
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/DLjdO_qFie8_raw.json
@@ -0,0 +1 @@
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بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا", "tokens": [2407, 6055, 39648, 14407, 37495, 22653, 4724, 3794, 6055, 4587, 20498, 14407, 39894, 4587, 20498, 14407, 39894, 4587, 20498, 14407, 39894, 4587, 20498, 14407, 39894, 4587, 20498, 14407, 39894, 4587, 20498, 14407, 39894, 4587, 20498, 14407, 39894, 4587, 20498, 14407, 39894, 4587, 20498, 14407, 39894, 4587, 20498, 14407, 39894, 4587, 20498, 14407, 39894, 4587, 20498, 14407, 39894, 4587, 20498, 14407, 39894, 4587, 20498, 14407, 39894, 4587, 20498, 14407, 39894, 4587, 20498, 14407, 39894, 4587, 20498, 14407, 39894, 4587, 20498, 14407, 39894, 4587, 20498, 14407, 39894, 4587, 20498, 14407, 39894, 4587, 20498, 14407, 39894, 4587, 20498, 14407, 39894, 4587, 20498, 14407, 39894, 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شابها. 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pupil ان احطله موسع مش هيشتغل يعني المقبض موصد مسكّن مش سهل اهالي تفتحه لان سبق ال bio carbon سبق اللي هو المدرياتيك نين narrow angle للمقمة يعني هو عنده أساسا ال angle narrow", "tokens": [5172, 4117, 33911, 16472, 1975, 8315, 37495, 22653, 36764, 24401, 43242, 3224, 5447, 1797, 44533, 16472, 1975, 5016, 9566, 43761, 3714, 41779, 3615, 37893, 8032, 1829, 8592, 2655, 17082, 1211, 37495, 22653, 9673, 4587, 3555, 11242, 3714, 2407, 9381, 3215, 47524, 4117, 11703, 1863, 37893, 8608, 3224, 1211, 1975, 3224, 6027, 1829, 6055, 5172, 2655, 5016, 3224, 5296, 7649, 8608, 3555, 4587, 2423, 12198, 5954, 8608, 3555, 4587, 13672, 1829, 31439, 9673, 3215, 16572, 9307, 1829, 4117, 8717, 9957, 9432, 5802, 5296, 19528, 4587, 46007, 37495, 22653, 31439, 43242, 3224, 5551, 3794, 32277, 995, 2423, 5802, 9432], "avg_logprob": -0.34215560129710604, "compression_ratio": 1.6407766990291262, "no_speech_prob": 0.0, "words": [{"start": 2013.46, "end": 2013.94, "word": "فكيف", "probability": 0.90380859375}, {"start": 2013.94, "end": 2014.12, "word": " ان", "probability": 0.33056640625}, {"start": 2014.12, "end": 2014.54, "word": " انا", "probability": 0.873291015625}, {"start": 2014.54, "end": 2014.94, "word": " يعني", "probability": 0.74658203125}, {"start": 2014.94, "end": 2015.4, "word": " واحد", "probability": 0.960693359375}, {"start": 2015.4, "end": 2016.24, "word": " عنده", "probability": 0.98974609375}, {"start": 2016.24, "end": 2016.66, "word": " pin", "probability": 0.483642578125}, {"start": 2016.66, "end": 2017.34, "word": " hold", "probability": 0.220703125}, {"start": 2017.34, "end": 2019.0, "word": " pupil", "probability": 0.96630859375}, {"start": 2019.0, "end": 2019.82, "word": " ان", "probability": 0.67822265625}, {"start": 2019.82, "end": 2020.34, "word": " احطله", "probability": 0.9393310546875}, {"start": 2020.34, "end": 2021.02, "word": " موسع", "probability": 0.7294921875}, {"start": 2021.02, "end": 2021.64, "word": " مش", "probability": 0.93017578125}, {"start": 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مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارن", "tokens": [6027, 10721, 13546, 1829, 11622, 6055, 30544, 5551, 4117, 49115, 3714, 4587, 9640, 1863, 3660, 4724, 2304, 4587, 9640, 1863, 3660, 33251, 16758, 3794, 12610, 20666, 1211, 9957, 11622, 4724, 2304, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 4724, 2304, 4587, 9640, 1863, 3660, 33251, 16758, 3794, 12610, 20666, 1211, 9957, 11622, 4724, 2304, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863, 3660, 3714, 4587, 9640, 1863], "avg_logprob": -0.21458332697550456, "compression_ratio": 7.1647058823529415, "no_speech_prob": 0.0, "words": [{"start": 2701.97, "end": 2702.83, "word": "الأيريز", "probability": 0.540087890625}, {"start": 2702.83, "end": 2704.09, "word": " تكون", "probability": 0.507568359375}, {"start": 2704.09, "end": 2704.49, "word": " أكثر", "probability": 0.5821940104166666}, {"start": 2704.49, "end": 2705.53, "word": " مقارنة", "probability": 0.6060302734375}, {"start": 2705.53, "end": 2705.81, "word": " بمقارنة", "probability": 0.505615234375}, {"start": 2705.81, "end": 2706.93, "word": " الكابسول", "probability": 0.5440673828125}, {"start": 2706.93, "end": 2707.09, "word": " باللينز", "probability": 0.4263916015625}, {"start": 2707.09, "end": 2707.81, "word": " بمقارنة", "probability": 0.6176350911458334}, {"start": 2707.81, "end": 2708.51, "word": " مقارنة", "probability": 0.6790771484375}, {"start": 2708.51, "end": 2710.15, "word": " بمقارنة", "probability": 0.815673828125}, {"start": 2710.15, "end": 2716.69, "word": " الكابسول", "probability": 0.662353515625}, {"start": 2716.69, "end": 2719.63, "word": " باللينز", "probability": 0.806884765625}, {"start": 2719.63, "end": 2719.63, "word": " بمقارنة", "probability": 0.8804931640625}, {"start": 2719.63, "end": 2719.63, "word": " مقارنة", "probability": 0.84755859375}, {"start": 2719.63, "end": 2719.63, "word": " مقارنة", "probability": 0.80048828125}, {"start": 2719.63, "end": 2719.63, "word": " مقارنة", "probability": 0.79228515625}, {"start": 2719.63, "end": 2719.63, "word": " مقارنة", "probability": 0.8015625}, {"start": 2719.63, "end": 2719.63, "word": " مقارنة", "probability": 0.81630859375}, {"start": 2719.63, "end": 2719.63, "word": " مقارنة", "probability": 0.8431640625}, {"start": 2719.63, "end": 2719.81, "word": " مقارنة", "probability": 0.884375}, {"start": 2719.81, "end": 2719.81, "word": " مقارنة", "probability": 0.92578125}, {"start": 2719.81, "end": 2719.85, "word": " مقارنة", "probability": 0.95244140625}, {"start": 2719.85, "end": 2719.85, "word": " مقارنة", "probability": 0.966015625}, {"start": 2719.85, "end": 2719.85, "word": " مقارنة", "probability": 0.974609375}, {"start": 2719.85, "end": 2719.95, "word": " مقارنة", "probability": 0.97958984375}, {"start": 2719.95, "end": 2719.95, "word": " مقارنة", "probability": 0.9830078125}, {"start": 2719.95, "end": 2719.95, "word": " مقارنة", "probability": 0.9857421875}, {"start": 2719.95, "end": 2719.95, "word": " مقارنة", "probability": 0.987109375}, {"start": 2719.95, "end": 2719.95, "word": " مقارنة", "probability": 0.98828125}, {"start": 2719.95, "end": 2719.95, "word": " مقارنة", "probability": 0.9888671875}, {"start": 2719.95, "end": 2719.95, "word": " مقارنة", "probability": 0.9892578125}, {"start": 2719.95, "end": 2719.95, "word": " مقارنة", "probability": 0.98955078125}, {"start": 2719.95, "end": 2719.95, "word": " مقارنة", "probability": 0.99013671875}, {"start": 2719.95, "end": 2719.95, "word": " مقارنة", "probability": 0.990625}, {"start": 2719.95, "end": 2719.95, "word": " مقارنة", "probability": 0.99072265625}, {"start": 2719.95, "end": 2719.95, "word": " مقارنة", "probability": 0.9908203125}, {"start": 2719.95, "end": 2719.95, "word": " مقارنة", "probability": 0.99091796875}, {"start": 2719.95, "end": 2719.95, "word": " مقارنة", "probability": 0.99091796875}, {"start": 2719.95, "end": 2719.95, "word": " مقارنة", "probability": 0.9912109375}, {"start": 2719.95, "end": 2719.95, "word": " مقارنة", "probability": 0.99150390625}, {"start": 2719.95, "end": 2719.95, "word": " مقارنة", "probability": 0.99189453125}, {"start": 2719.95, "end": 2719.95, "word": " مقارنة", "probability": 0.99208984375}, {"start": 2719.95, "end": 2719.95, "word": " مقارنة", "probability": 0.99228515625}, {"start": 2719.95, "end": 2720.03, "word": " مقارنة", "probability": 0.99228515625}, {"start": 2720.03, "end": 2722.67, "word": " مقارنة", "probability": 0.9923828125}, {"start": 2722.67, "end": 2731.17, "word": " مقارن", "probability": 0.9912109375}], "temperature": 1.0}, {"id": 92, "seek": 273810, "start": 2731.88, "end": 2738.1, "text": "أيه سيدي؟ وفيه narrow angle ففي الحالة هذه تسميها Contra Indication للتوسيع", "tokens": [10721, 1829, 3224, 8608, 1829, 16254, 22807, 4032, 41185, 3224, 9432, 5802, 6156, 41185, 21542, 6027, 3660, 29538, 6055, 38251, 1829, 11296, 4839, 424, 2333, 8758, 24976, 2655, 41779, 40228], "avg_logprob": -0.599798406324079, "compression_ratio": 1.0769230769230769, "no_speech_prob": 1.7881393432617188e-07, "words": [{"start": 2731.88, "end": 2732.32, "word": "أيه", "probability": 0.4427998860677083}, {"start": 2732.32, "end": 2732.54, "word": " سيدي؟", "probability": 0.69171142578125}, {"start": 2732.54, "end": 2732.84, "word": " وفيه", "probability": 0.411376953125}, {"start": 2732.84, "end": 2733.12, "word": " narrow", "probability": 0.5595703125}, {"start": 2733.12, "end": 2733.62, "word": " angle", "probability": 0.7978515625}, {"start": 2733.62, "end": 2734.42, "word": " ففي", "probability": 0.6634521484375}, {"start": 2734.42, "end": 2734.84, "word": " الحالة", "probability": 0.9637044270833334}, {"start": 2734.84, "end": 2735.18, "word": " هذه", "probability": 0.6083984375}, {"start": 2735.18, "end": 2736.22, "word": " تسميها", "probability": 0.4300994873046875}, {"start": 2736.22, "end": 2736.7, "word": " Contra", "probability": 0.5838623046875}, {"start": 2736.7, "end": 2737.28, "word": " Indication", "probability": 0.6463623046875}, {"start": 2737.28, "end": 2738.1, "word": " للتوسيع", "probability": 0.968017578125}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 2746.8045, "duration_after_vad": 2384.2074999999904}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/DLjdO_qFie8_raw.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/DLjdO_qFie8_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..31cafe533537cde33112a7903260edb2f80d20c6
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/DLjdO_qFie8_raw.srt
@@ -0,0 +1,1900 @@
+1
+00:00:20,770 --> 00:00:23,090
+أولي بالله من الشيطان الرجيم بسم الله الرحمن
+
+2
+00:00:23,090 --> 00:00:27,710
+الرحيم الحمد لله رب العالمين وأصلي وأسلم على النبي
+
+3
+00:00:27,710 --> 00:00:31,890
+الكريم محمد وعلى آله وأصحابه والتابعين السلام
+
+4
+00:00:31,890 --> 00:00:38,870
+عليكم ورحمة الله وبركاته اليوم سنبدأ بقصة جديدة عن
+
+5
+00:00:38,870 --> 00:00:46,650
+مدرياتيكس مدرياتيكس مدرياتيكس هم الشيطانين اللي
+
+6
+00:00:46,650 --> 00:00:48,850
+يستطيع أن يقوم بتعريف الأطفال
+
+7
+00:00:53,830 --> 00:01:00,270
+Good Examination of the posterior segment of the
+
+8
+00:01:00,270 --> 00:01:07,950
+eye. Optic discs, optic vessels, macula and
+
+9
+00:01:07,950 --> 00:01:12,810
+retinal background.Magnetics
+
+10
+00:01:12,810 --> 00:01:15,770
+dilate the pupil to facilitate a more thorough
+
+11
+00:01:25,170 --> 00:01:34,490
+وهي عامة تستخدمها على الوطنين الكبار السنين كما لو
+
+12
+00:01:34,490 --> 00:01:37,270
+كانوا الوطنين الكبار السنين عاماً أصغر وعاماً أصغر
+
+13
+00:01:37,270 --> 00:01:41,210
+وعاماً أصغر وعاماً أصغر وعاماً أصغر وعاماً أصغر
+
+14
+00:01:41,210 --> 00:01:42,890
+وعاماً أصغر وعاماً أصغر وعاماً أصغر وعاماً أصغر
+
+15
+00:01:42,890 --> 00:01:43,070
+وعاماً أصغر وعاماً أصغر وعاماً أصغر وعاماً أصغر
+
+16
+00:01:43,070 --> 00:01:43,110
+وعاماً أصغر وعاماً أصغر وعاماً أصغر وعاماً أصغر
+
+17
+00:01:43,110 --> 00:01:47,770
+وعاماً
+
+18
+00:01:47,770 --> 00:01:57,660
+أصغر وعاماً أصغر وعاماً أبس فترة بيوبيلي قوية
+
+19
+00:01:57,660 --> 00:02:04,560
+بيكون ال pupil size small واحدة كمان بيكونوا
+
+20
+00:02:04,560 --> 00:02:09,420
+liable to cataract oposites in the lens and liable
+
+21
+00:02:09,420 --> 00:02:16,960
+to diseases in choroid and retina و ال diabetic
+
+22
+00:02:16,960 --> 00:02:22,980
+retinopathy اللي بيبقى مرضى السكري يعني كثير من
+
+23
+00:02:22,980 --> 00:02:27,990
+المياه تطلباللي هو accurate examination of the
+
+24
+00:02:27,990 --> 00:02:33,730
+fundus و لاجب انه يكون فيه dilatation لل pupil لان
+
+25
+00:02:33,730 --> 00:02:38,410
+اسمها pupil ما بيكفي لفحص ال periphery of the
+
+26
+00:02:38,410 --> 00:02:42,870
+fundus هكذا ديوز of pediatrics كان essential in
+
+27
+00:02:42,870 --> 00:02:46,590
+any age group كمان ممكن في اي age group يتطلب
+
+28
+00:02:46,590 --> 00:02:52,820
+especiallyوالدماغولة أو المنطقات الخارجية للرتينا
+
+29
+00:02:52,820 --> 00:03:01,120
+تحتاج إلى ملاحظة حذرة.الان بدأنا نعرف إيش فيه
+
+30
+00:03:01,120 --> 00:03:07,400
+أدوات أو دراجس تستخدم في هذا المنحو مارتين دويل في
+
+31
+00:03:07,400 --> 00:03:15,840
+نينتين سيستي سيبن قرر إصلاح مدرياتيك لا يستخدم عنه
+
+32
+00:03:15,840 --> 00:03:24,220
+للاستخدام من دماغولةيبقى الماكولا؟ اه اللهم يجعله
+
+33
+00:03:24,220 --> 00:03:41,300
+كذا ايوة
+
+34
+00:03:41,300 --> 00:03:45,080
+يا عزيزي يا
+
+35
+00:03:45,080 --> 00:03:48,280
+سامي جاهز؟
+
+36
+00:03:53,100 --> 00:03:56,960
+مش عارف الاساس دي هو ال remote؟ الاساس بريمونت
+
+37
+00:03:56,960 --> 00:04:01,340
+بريمونت؟
+
+38
+00:04:01,340 --> 00:04:04,340
+بريمونت؟ بريمونت؟ بريمونت؟ بريمونت؟ بريمونت؟
+
+39
+00:04:04,340 --> 00:04:04,340
+بريمونت؟ بريمونت؟ بريمونت؟ بريمونت؟ بريمونت؟
+
+40
+00:04:04,340 --> 00:04:04,340
+بريمونت؟ بريمونت؟ بريمونت؟ بريمونت؟ بريمونت؟
+
+41
+00:04:04,340 --> 00:04:04,380
+بريمونت؟ بريمونت؟ بريمونت؟ بريمونت؟ بريمونت؟
+
+42
+00:04:04,380 --> 00:04:04,480
+بريمونت؟ بريمونت؟ بريمونت؟ بريمونت؟ بريمونت؟
+
+43
+00:04:04,480 --> 00:04:08,880
+بريمونت؟ بريمونت؟ بريمونت؟ بريمونت؟ بريمونت؟
+
+44
+00:04:08,880 --> 00:04:12,380
+بريمونت؟ بريمونت؟ بريمون
+
+45
+00:04:29,230 --> 00:04:37,430
+ولو لا يستغنى عن توثيق البابو في الexamination مذا
+
+46
+00:04:37,430 --> 00:04:41,530
+ماكولا، كان البروفيسور المشرف عليها، ده هو اللي
+
+47
+00:04:41,530 --> 00:04:46,410
+بيقول الكلمة، بيقولي don't comment on ماكولا وده
+
+48
+00:04:46,410 --> 00:04:53,010
+وده لاتش، ماكولا عايز ده لاتش، سيدروف وانا سيدروف
+
+49
+00:04:53,010 --> 00:04:58,690
+مشهورExamine patients attitudes to pupil
+
+50
+00:04:58,690 --> 00:05:02,050
+dilatation during optometric examination and found
+
+51
+00:05:02,050 --> 00:05:06,770
+that the majority were in favor بفضله لما تقولوا
+
+52
+00:05:06,770 --> 00:05:10,970
+يعني بدون توصية مش هتكون الفحص مية لمية لو انا
+
+53
+00:05:10,970 --> 00:05:14,970
+عملتك توصية هيك بقولك favor يعني هم بفضله بما ال
+
+54
+00:05:14,970 --> 00:05:18,730
+preference although a large proportion suffered
+
+55
+00:05:18,730 --> 00:05:24,030
+adverse effects such as glare and blind opium رغم
+
+56
+00:05:24,030 --> 00:05:24,670
+الفطوفوبيا
+
+57
+00:05:36,320 --> 00:05:45,720
+ما هي الصفات المثلة لأي قطرة توسع البور؟ one quick
+
+58
+00:05:45,720 --> 00:05:53,000
+onset يبدأ بسرعة adequate duration إن النقطة اللي
+
+59
+00:05:53,000 --> 00:06:01,180
+بحطها تفضل تعمل حتى أنتهي من الفحصيعني انا بتصور
+
+60
+00:06:01,180 --> 00:06:06,980
+ايش وش المثالي، حط نقطة بس هتروبك in mind تفضل نص
+
+61
+00:06:06,980 --> 00:06:13,320
+ساعة، ماتجسرش فيه، محتاجش كمان نقطة زي تانية عشان
+
+62
+00:06:13,320 --> 00:06:17,040
+اجويها يعني، three fast recovery after the
+
+63
+00:06:17,040 --> 00:06:20,360
+examination بعد ما اعمل examination ينتهي على طول
+
+64
+00:06:20,360 --> 00:06:23,960
+الأثر، ماتطلعش في الشارع، مايسوق سيارة أو يبدأ
+
+65
+00:06:23,960 --> 00:06:24,640
+يمشي في الشمس
+
+66
+00:06:28,650 --> 00:06:32,070
+انا بقولك شئ مثالي عارف ايش الشئ المثالي اللي فيش
+
+67
+00:06:32,070 --> 00:06:37,650
+منه يعني زي البشر هل في بشر في كل شئ مية في المية
+
+68
+00:06:37,650 --> 00:06:42,270
+يعني انا افترض انه بدأ drug مية في المية طبعا مش
+
+69
+00:06:42,270 --> 00:06:47,050
+سماش مولود اه بقول fast recovery after examination
+
+70
+00:06:47,050 --> 00:06:50,450
+يعني انا ساعة ما اعمل examination دل فاندس
+
+71
+00:06:57,590 --> 00:07:03,130
+light reflex abolished لأنه وانا ببحث مايكونش ال
+
+72
+00:07:03,130 --> 00:07:06,750
+light reflex يشتغل بأي درجة لأنه اذا اشتغل سيعكس
+
+73
+00:07:06,750 --> 00:07:09,450
+على ال examination لان ال examination بده light
+
+74
+00:07:09,450 --> 00:07:15,350
+فساعات يحط ال light يصغر البقبق بيكون مشكلة وانا
+
+75
+00:07:15,350 --> 00:07:19,950
+اظن ان tropic mind يعني نوعا ما بحد كبير بلغ ال
+
+76
+00:07:19,950 --> 00:07:28,250
+light reflex بينما ال finale frame لأ بلغيشلا
+
+77
+00:07:28,250 --> 00:07:33,050
+سيكروبليزيا يعني يعمل بس على ال people اللي ماعملش
+
+78
+00:07:33,050 --> 00:07:39,230
+على celery muscle وهذا ممكن فش لو تنبغوا و تنبغوا
+
+79
+00:07:39,230 --> 00:07:44,830
+بنفس العصب فعلا sympathetic ك people يعني قادر هو
+
+80
+00:07:44,830 --> 00:07:52,210
+ب quick reversal in an emergency يعني للافرض انه
+
+81
+00:07:52,210 --> 00:07:52,970
+بدأت
+
+82
+00:07:59,870 --> 00:08:05,350
+الان يعني اكون قادر على انه يرجع بسرعة مايستممش في
+
+83
+00:08:05,350 --> 00:08:13,810
+ال .. في التقدم نحو ال attack و لا يعني reverse
+
+84
+00:08:13,810 --> 00:08:20,070
+يعني ايش reverse عكسي لا عكسي يعني عمال هو بيوسع
+
+85
+00:08:20,070 --> 00:08:25,550
+بيوسع بيوسع انا قصة الضغط او شوفت بداية قلم انا
+
+86
+00:08:25,550 --> 00:08:30,170
+مانيش يكمل توسيعه بدي يرجع تانيلأن لو كان التفسير
+
+87
+00:08:30,170 --> 00:08:35,310
+هو ماذا سأفعل؟ Glucoma attack وهذا طبعا لا يوجد
+
+88
+00:08:35,310 --> 00:08:41,410
+منه طيب, no rise in intraocular pressure ماعملش
+
+89
+00:08:41,410 --> 00:08:45,370
+ارتفاع في ضبط العين, no other pharmacological
+
+90
+00:08:45,370 --> 00:08:49,410
+effect ماعملش حساسية، ماعملش stinging، ماعملش
+
+91
+00:08:49,410 --> 00:08:54,430
+burning طيب, no more cartoxic reactions، ماعملش
+
+92
+00:08:54,430 --> 00:08:55,290
+care attacks مثلا
+
+93
+00:08:59,760 --> 00:09:06,400
+للـ corneal epithelium مثلا و لا روحلي على الدم و
+
+94
+00:09:06,400 --> 00:09:09,500
+يعملي مثلا bradycardia او تافيكارديا او يعملي على
+
+95
+00:09:09,500 --> 00:09:13,280
+القلب no
+
+96
+00:09:13,280 --> 00:09:17,660
+adverse subjective complaints such as stinging و
+
+97
+00:09:17,660 --> 00:09:21,720
+لا يشكل المريض من burning و stinging و حاجة طبعا
+
+98
+00:09:21,720 --> 00:09:24,540
+الأشياء هذه بحق بعضها
+
+99
+00:09:42,320 --> 00:09:46,800
+indications او دوائي الاستماع متى انا استعمل
+
+100
+00:09:46,800 --> 00:09:53,100
+المدرياتيكس only one recent answer of floating
+
+101
+00:09:53,100 --> 00:09:54,260
+patriots opacity
+
+102
+00:10:05,760 --> 00:10:12,880
+دكتور مشهور في دباب زي الدباب جسم أسود يتحرك احنا
+
+103
+00:10:12,880 --> 00:10:20,280
+هذه بيسميها في طب العيون mask of volitance انتوا
+
+104
+00:10:20,280 --> 00:10:25,140
+زيكوا مشوفهاش إلا انطلع في شيء في رأسه اللي بطلع
+
+105
+00:10:25,140 --> 00:10:30,260
+شيء في رأسه ممكن يشوفها لأن هذي فيها نوع من ال
+
+106
+00:10:30,260 --> 00:10:36,150
+liquefaction of the vitiasو يكون فيه بعض
+
+107
+00:10:36,150 --> 00:10:40,990
+aggregations of cells انت بتدرس aggregations يعني
+
+108
+00:10:40,990 --> 00:10:48,490
+تجمع من الخلايا فلما هذا التجمع يمر بال visual
+
+109
+00:10:48,490 --> 00:10:53,590
+axis بشوف و الهايوهايه اسمك الهايوهايه مياه
+
+110
+00:10:53,590 --> 00:10:56,690
+بيشوفوها لما مياه بيشوفوها لأنه عنده core retinal
+
+111
+00:10:56,690 --> 00:11:00,910
+degeneration و عنده في ال .. في ال .. في opacity
+
+112
+00:11:00,910 --> 00:11:02,130
+بسيطة في ال
+
+113
+00:11:07,490 --> 00:11:14,110
+اخد بزيادة عيب فال طبعا اول ما يقول انه هو شايف اي
+
+114
+00:11:14,110 --> 00:11:20,690
+floaters زي هذه بيكون يعني واجب ان انا اعمل
+
+115
+00:11:20,690 --> 00:11:26,590
+modalitation خاصة ان شاك من اي flashing عارفين ايش
+
+116
+00:11:26,590 --> 00:11:33,570
+ال flashing؟ ومضارب ضوئية سريعة ومفاجئة وهذه غالبا
+
+117
+00:11:37,310 --> 00:11:41,870
+مش ال retinal detachment بقعد ما هي koroidal
+
+118
+00:11:41,870 --> 00:11:45,670
+detachment يعني تعرفين ال retina و ال koroid مسخين
+
+119
+00:11:45,670 --> 00:11:53,750
+لبعض مع السن و شوية liquefaction لل vitreous يصير
+
+120
+00:11:53,750 --> 00:12:00,150
+liquefied مش visit القعدة بتاعته تنسلخ شوية شوية
+
+121
+00:12:00,150 --> 00:12:04,800
+عن إيش؟ عن ال retina فيبدأ يعملوا أمضاء تانيةعمل
+
+122
+00:12:04,800 --> 00:12:09,980
+attachment تاني وضع صعب يعني ان كان .. بدأ بيعمل
+
+123
+00:12:09,980 --> 00:12:15,040
+عمى طيب relatively sudden decrease in visual
+
+124
+00:12:15,040 --> 00:12:22,500
+activity يعني طفل مثلا كان بيشوف ستة ع ستة شوية
+
+125
+00:12:22,500 --> 00:12:27,460
+صارت ستة ع تسعة ستة ع اتناشر بدأ يتراجع reflection
+
+126
+00:12:27,460 --> 00:12:28,540
+مش مبين للحقيقة
+
+127
+00:12:37,570 --> 00:12:42,850
+و يبقى دلوقتي يعني كل شيء لا يصح بال lenses ال
+
+128
+00:12:42,850 --> 00:12:48,850
+glasses بيكون في organic diseases هنا بيدي دور
+
+129
+00:12:48,850 --> 00:12:55,250
+الطبيب و بيدي دور ال team work team work يعني
+
+130
+00:12:55,250 --> 00:12:59,670
+حضرتك هو الطبيب طبعا في المستشفى بيقولك please for
+
+131
+00:12:59,670 --> 00:13:04,940
+reflection تبلك تبل reflectionو تقولوا يعني بس
+
+132
+00:13:04,940 --> 00:13:07,720
+تقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا
+
+133
+00:13:07,720 --> 00:13:08,120
+بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا
+
+134
+00:13:08,120 --> 00:13:13,900
+بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا
+
+135
+00:13:13,900 --> 00:13:15,800
+بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا
+
+136
+00:13:15,800 --> 00:13:16,200
+بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا
+
+137
+00:13:16,200 --> 00:13:16,200
+بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا
+
+138
+00:13:16,200 --> 00:13:16,200
+بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا
+
+139
+00:13:16,200 --> 00:13:16,600
+بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا
+
+140
+00:13:16,600 --> 00:13:26,700
+بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا بتقوموا
+
+141
+00:13:27,320 --> 00:13:30,960
+هل هو كترك؟ هل هو جلوكومة؟ هل هو floaters في
+
+142
+00:13:30,960 --> 00:13:36,440
+الفتريس؟ نظيف في الشبكية؟ هل هو ماركولار قديمة؟
+
+143
+00:13:36,440 --> 00:13:41,100
+فيه سبب هذا اللي هتشوفه إلا بالفحص بعد التوسيع
+
+144
+00:13:41,100 --> 00:13:45,400
+three unexplained loss of visual activity المعنى
+
+145
+00:13:45,400 --> 00:13:50,260
+هو visual في ال analysis فطالعا constricted وأنتوا
+
+146
+00:13:50,260 --> 00:13:52,060
+أظنوا أخدتوا أي شيء مثل هذا؟
+
+147
+00:14:00,270 --> 00:14:04,930
+إنما totally أو partially مثلا temporal له تفسير
+
+148
+00:14:04,930 --> 00:14:09,470
+نزل له تفسير و هكذا فبكون بدنا نعمل good
+
+149
+00:14:09,470 --> 00:14:12,210
+examination for the retina and of the disc
+
+150
+00:14:30,340 --> 00:14:36,000
+مافيش فيه ارتفاع يبقى فيه something عامله pain
+
+151
+00:14:36,000 --> 00:14:41,540
+ربما يحتاج الى توسيله ربما يحتاج الى توسيله يمكن
+
+152
+00:14:41,540 --> 00:14:49,240
+انه عنده tumor عنده حاجة عنده exudation عنده يعني
+
+153
+00:14:49,240 --> 00:14:56,440
+spell celery body celery muscle five redness of
+
+154
+00:14:56,440 --> 00:15:00,180
+the eye حمر في العين دهوهو ليه attributed to
+
+155
+00:15:00,180 --> 00:15:03,160
+infection ولا allergy ولا raise in hypertension
+
+156
+00:15:03,160 --> 00:15:08,720
+يعني عنده حمار في عينه و العلاج مادعمش فيه ولا
+
+157
+00:15:08,720 --> 00:15:13,680
+العلاج اللي هو الحمرار في العين ليس مثلا بحاسسية
+
+158
+00:15:13,680 --> 00:15:19,520
+ولا infection عدوة في العين مثلا زي ال bacteria
+
+159
+00:15:19,520 --> 00:15:23,500
+مثلا ولا اتفاقضة في العين والحمار هذا لم يستجب
+
+160
+00:15:23,500 --> 00:15:26,320
+العلاج الحاسسية ولا العلاج ال antibiotic في العين
+
+161
+00:15:40,560 --> 00:15:44,000
+ضربة للعين to exclude the presence of ocular
+
+162
+00:15:44,000 --> 00:15:49,820
+damage يعني أحيانًا الضربة للعين تعمل detachment
+
+163
+00:15:49,820 --> 00:15:56,300
+الشبكية تعمل bleeding في الفتريس تعمل tear-tear
+
+164
+00:15:56,300 --> 00:16:02,860
+يعني تمزق الكراي تعمل recession تمزق للangle of EC
+
+165
+00:16:02,860 --> 00:16:09,920
+أحيانًا تعمل dislocation لللنسالحياة بتعمل
+
+166
+00:16:09,920 --> 00:16:19,660
+bleeding in the AC في هذا المثل محتاج إلى توسية
+
+167
+00:16:19,660 --> 00:16:27,060
+ليه ماش توسية البقبة رفاية لأ ليست رفاية لما توسية
+
+168
+00:16:27,060 --> 00:16:32,080
+البقبة إله indications دواعيفإذا حل أي دوام هذه
+
+169
+00:16:32,080 --> 00:16:37,200
+الدواعي واجب أن أعطي المريض وقتا كافيا في التوسيق
+
+170
+00:16:37,200 --> 00:16:44,040
+وفي الفحص أنا إنسان له قيمة عند الله وعند الناس
+
+171
+00:16:44,040 --> 00:16:50,280
+مايقولوا يلا يمشي وبيهم شهادة او انا يعني افتعل
+
+172
+00:16:50,280 --> 00:16:54,040
+عارف عارف مش عارف احيله من اللي يعرف
+
+173
+00:16:58,400 --> 00:17:02,120
+كمال في الدراسات الـ Difficulty in observing the
+
+174
+00:17:02,120 --> 00:17:06,040
+front bus due to reduced transparency of the media
+
+175
+00:17:06,040 --> 00:17:11,240
+اه انت عارفين ال .. ال .. ال .. ال media or the
+
+176
+00:17:11,240 --> 00:17:18,920
+eye are transparent تدعى من كوريا أكيوساهيومر لينس
+
+177
+00:17:18,920 --> 00:17:24,500
+فيترياس هذه اسمها ocular media أو ساعة العين
+
+178
+00:17:24,500 --> 00:17:25,800
+transparent
+
+179
+00:17:31,990 --> 00:17:41,330
+أو نتيجة لمرض بيصير some of these media not
+
+180
+00:17:41,330 --> 00:17:47,030
+transparent يعني
+
+181
+00:17:47,030 --> 00:17:58,130
+مثلا في حالة الكيروتيتس في حالة كورنال ألسان في
+
+182
+00:17:58,130 --> 00:17:59,510
+حالة الكورنال إديمة
+
+183
+00:18:05,980 --> 00:18:17,560
+في حالة bleeding NAC في حالة cataract progressive
+
+184
+00:18:17,560 --> 00:18:26,560
+cataract في حالة vitreous bleeding
+
+185
+00:18:29,480 --> 00:18:36,240
+بختارش ان اشوف كويس فلو فاهمة ان التوسيق للبقبه
+
+186
+00:18:36,240 --> 00:18:43,860
+ساعدني على ان اعمل bypass لال opacity وقد لا يعمل
+
+187
+00:18:43,860 --> 00:18:47,880
+يعني المرحلة اللي معناها هي حين نكون massive
+
+188
+00:18:47,880 --> 00:18:51,920
+patriation في نفس ال diabetics massive ايش
+
+189
+00:18:51,920 --> 00:18:58,460
+massive؟ تحمل كل ال patriots في شمبا مليون ادم
+
+190
+00:19:01,810 --> 00:19:06,930
+فانا بوصي و بحاول من قران اشوف ماذا بعد اشواء هذا
+
+191
+00:19:06,930 --> 00:19:13,110
+بحاول مارضج احمر مارضج مثلا طب لو كان في complete
+
+192
+00:19:13,110 --> 00:19:18,510
+cataract انا
+
+193
+00:19:18,510 --> 00:19:23,670
+بتكلم عن التوسيع بتكلم عن ريتناسكوبي او
+
+194
+00:19:23,670 --> 00:19:25,430
+اوفراموسكوبي direct او oran direct
+
+195
+00:19:31,010 --> 00:19:34,910
+هو يعمل بالديرتوف تانيسكوب او بالديرتوف تانيسكوب
+
+196
+00:19:34,910 --> 00:19:43,450
+وفي وسيلة تالتة اللي هي وكس لينس ناينتي داوكتر
+
+197
+00:19:43,450 --> 00:19:51,350
+ودستيتلان وكس بسيكتوها عارفين؟ هو
+
+198
+00:19:51,350 --> 00:19:55,350
+بتالي انه لو في complete cataract مش هينفع حتى في
+
+199
+00:19:55,350 --> 00:20:00,690
+كل التوسيق وانا هانفع بحاجة إلى ليش الاترسال
+
+200
+00:20:03,220 --> 00:20:08,600
+و في غير كمان في CT طيب
+
+201
+00:20:08,600 --> 00:20:15,660
+diabetic patients anyway has a general role القادة
+
+202
+00:20:15,660 --> 00:20:23,680
+بقولي ان المريض السكري اللي لا يفتكي المفروض once
+
+203
+00:20:23,680 --> 00:20:25,980
+yearly
+
+204
+00:21:01,540 --> 00:21:04,400
+بالنسبة للدراسات الاجتماعية الاجتماعية الاجتماعية
+
+205
+00:21:04,400 --> 00:21:07,860
+الاجتماعية الاجتماعية الاجتماعية الاجتماعية
+
+206
+00:21:07,860 --> 00:21:08,000
+الاجتماعية الاجتماعية الاجتماعية الاجتماعية
+
+207
+00:21:08,000 --> 00:21:08,040
+الاجتماعية الاجتماعية الاجتماعية الاجتماعية
+
+208
+00:21:08,040 --> 00:21:08,040
+الاجتماعية الاجتماعية الاجتماعية الاجتماعية
+
+209
+00:21:08,040 --> 00:21:08,040
+الاجتماعية الاجتماعية الاجتماعية الاجتماعية
+
+210
+00:21:08,040 --> 00:21:08,140
+الاجتماعية
+
+211
+00:21:12,000 --> 00:21:16,360
+full palatation of the body وضف اليهم في الدياميتس
+
+212
+00:21:16,360 --> 00:21:31,360
+any session او PRP ايش PRP photo refractive photo
+
+213
+00:21:31,360 --> 00:21:38,080
+coagulation laser pan retinal pan retinal photo
+
+214
+00:21:38,080 --> 00:21:38,920
+coagulation
+
+215
+00:21:50,480 --> 00:21:56,580
+طيب فعبث photography تصوير الكاميرا على الرغم من
+
+216
+00:21:56,580 --> 00:22:01,860
+أنه الأن recently طلعت كاميرات ممكن تشتغل without
+
+217
+00:22:01,860 --> 00:22:07,000
+مدرياتيز لأن الكاميرات اللي هو ال universal
+
+218
+00:22:07,000 --> 00:22:12,280
+الموجودة بين إيدينا تحتاج إلى توسيع الحركة
+
+219
+00:22:23,690 --> 00:22:29,890
+surgery with a wavefront based procedure كل الناس
+
+220
+00:22:29,890 --> 00:22:35,110
+اللي نعملهم لازك وما بعد اللازك نطلع جديد شرحناهم
+
+221
+00:22:35,110 --> 00:22:41,610
+ال .. لو smile حضرتوا ال .. يوم العلم؟ شوفتوا
+
+222
+00:22:41,610 --> 00:22:44,810
+smile كيف طلع الكون الـ lenticule اسمه lenticule
+
+223
+00:22:44,810 --> 00:22:52,430
+extraction كل هذا بحتاج أن البقبه أقل شيء يكون six
+
+224
+00:22:52,430 --> 00:22:59,420
+millimeterوهذا يُفحص بجهاز اسمه Aperometer فهذا
+
+225
+00:22:59,420 --> 00:23:05,100
+أيضا يحتاج إلى توسيع كمان
+
+226
+00:23:05,100 --> 00:23:10,500
+Diagnostic Uses يعني Diagnostic Uses لأغراض اللي
+
+227
+00:23:10,500 --> 00:23:17,460
+هو التشخيص أغراض التشخيص يعني تشخيص tumor في
+
+228
+00:23:17,460 --> 00:23:21,780
+الشبكية tumor في الكورويد كلام زي هذا برضه
+
+229
+00:23:26,990 --> 00:23:32,170
+في أشياء علاجية و احنا شرحنا في ال cycle of
+
+230
+00:23:32,170 --> 00:23:36,930
+mentolate عشان يمنع البوستيرو سينيتيا و حتى جولنا
+
+231
+00:23:36,930 --> 00:23:41,290
+في ناس جايين بيعمل alternation between meiosis و
+
+232
+00:23:41,290 --> 00:23:46,230
+بيوزنز و مدريازز ميوزنز و مدريازز لأن حتى في
+
+233
+00:23:46,230 --> 00:23:50,590
+المدريازز لو فضل على هيئة يومين تلاتة ممكن يصير
+
+234
+00:23:50,590 --> 00:23:56,500
+بدل اتصاق فحق مثلا ال bio carbine يفكها برضهففي
+
+235
+00:23:56,500 --> 00:24:02,200
+حالة اليوبيايتس لازم احط اما psychological لو توفر
+
+236
+00:24:02,200 --> 00:24:06,840
+احسن واما magnetic ال psychological فوق انه بيوسع
+
+237
+00:24:06,840 --> 00:24:13,560
+نوعا ما انه بيعمل راحة لل celery muscle بيعمل راحة
+
+238
+00:24:13,560 --> 00:24:18,100
+لل celery muscle لانه بيكون في الاتهاب بتاع
+
+239
+00:24:18,100 --> 00:24:21,180
+اليوبيايتس في شيء من ال spasm في الcellar muscle
+
+240
+00:24:21,180 --> 00:24:26,360
+ال tropic emite لحاله ضعيفالسيكروفيجيكز يستخدمون
+
+241
+00:24:26,360 --> 00:24:33,860
+كتابة مصاحب وفي بعض الأحيان يستخدمونها كمجارات
+
+242
+00:24:33,860 --> 00:24:37,720
+كوليسيا بمجارات مجانية كوليسيا بمجارات مجانية
+
+243
+00:24:37,720 --> 00:24:38,020
+كوليسيا بمجارات مجانية كوليسيا بمجارات مجانية
+
+244
+00:24:38,020 --> 00:24:40,320
+كوليسيا بمجارات مجانية كوليسيا بمجارات مجانية
+
+245
+00:24:40,320 --> 00:24:40,320
+كوليسيا بمجارات مجانية كوليسيا بمجارات مجانية
+
+246
+00:24:40,320 --> 00:24:42,740
+كوليسيا بمجارات مجانية كوليسيا بمجارات مجانية
+
+247
+00:24:42,740 --> 00:24:48,620
+كوليسيا بمجارات مجانية كوليسيا بمجارات
+
+248
+00:24:48,620 --> 00:24:53,900
+مجانية كوليسيا بمجارات مجان
+
+249
+00:24:55,680 --> 00:24:59,100
+بسبب اهتمام باسي بالبقب لحاله بـSphincter Propelli
+
+250
+00:24:59,100 --> 00:25:09,220
+Muscle الان هانقل Indications 12 Indications طيب،
+
+251
+00:25:09,220 --> 00:25:14,980
+هل فيه side effects؟ هل فيه أثار جانبية للمضاتكس؟
+
+252
+00:25:14,980 --> 00:25:21,700
+مهما قلنا يعني ممكن تقليلها وممكن التغلب عليها إلى
+
+253
+00:25:21,700 --> 00:25:27,160
+تناولها بطريقة علمية واضحةوكان مرحبًا بأن
+
+254
+00:25:27,160 --> 00:25:33,000
+المدريازيات أتت من نظر مخطط وإزالة
+
+255
+00:25:33,000 --> 00:25:36,940
+الحماية لـ Glare فوتوفوبيا وهذا مافيش فرق لزمان،
+
+256
+00:25:36,940 --> 00:25:45,440
+طالما فتحنا الباب، دخل شمس كتيرة، عملت فوتوفوبيا،
+
+257
+00:25:45,440 --> 00:25:52,560
+اللي كانت مفاجئة ببعض المجالات من حياتهم اليوميةفي
+
+258
+00:25:52,560 --> 00:25:57,060
+حياته اليومية لو وسع بقوة، notably driving a motor
+
+259
+00:25:57,060 --> 00:26:02,100
+vehicle خاصة في قيادة السيارات والدرجات النارية
+
+260
+00:26:02,100 --> 00:26:07,120
+وما شابها. These authors considered that patients
+
+261
+00:26:07,120 --> 00:26:12,320
+should be informed قبل ما نحطه لنقطرة انه نبلغهم
+
+262
+00:26:12,320 --> 00:26:16,160
+about the visual disturbances that can be
+
+263
+00:26:16,160 --> 00:26:19,080
+associated with mid-reactors. مش هنقولش ضحكوا
+
+264
+00:26:19,080 --> 00:26:19,440
+عليها
+
+265
+00:26:23,900 --> 00:26:29,120
+بيجيبوا form معين مقبول و بيطلب من المريض او وريه
+
+266
+00:26:29,120 --> 00:26:33,300
+المريض ان كان طفل او قاصر ان هو يبقى عليه عشان في
+
+267
+00:26:33,300 --> 00:26:39,540
+اشي اسمه مسئولية قانونية legal responsibility فهو
+
+268
+00:26:39,540 --> 00:26:43,960
+عشان الجراح يحمي حاله و المبنج يحمي حاله بيخليه
+
+269
+00:26:43,960 --> 00:26:50,240
+يعمل توقيع على ان الجراح او المبنج لايتحملان اي
+
+270
+00:26:50,240 --> 00:26:54,810
+مسئولية قانونية عن النتائجيعني إيه فضلالي أنا وسعت
+
+271
+00:26:54,810 --> 00:27:00,390
+من بقبع ماشي بسيارة بعدها مباشرة و أعمل حدث تصادم
+
+272
+00:27:00,390 --> 00:27:06,310
+و أدوع الشرطة قال ما هم حطولي في عيني قطرات، من
+
+273
+00:27:06,310 --> 00:27:10,510
+اللي حطلك؟ فلانة أو فلان أو فلان
+
+274
+00:27:21,110 --> 00:27:24,410
+يعني اهد الدكاترة اللي كانوا يعني مسئوليني عني في
+
+275
+00:27:24,410 --> 00:27:30,310
+تعليمي نصحني كمان نصيحة بيقوللي اه دكتور محمد قبل
+
+276
+00:27:30,310 --> 00:27:40,510
+ان ترسل المريض الموسع حدقتاه الى البيت install one
+
+277
+00:27:40,510 --> 00:27:48,010
+drop of pyrocarbine in each eye to be relaxed in
+
+278
+00:27:48,010 --> 00:27:48,490
+your sleep
+
+279
+00:27:56,240 --> 00:28:00,900
+وماصيش إليك calling حطله
+
+280
+00:28:00,900 --> 00:28:05,760
+في كل عين نفت بلو كربين عشان ترجع الأمور للباب
+
+281
+00:28:05,760 --> 00:28:09,980
+اللي فتحته، ساكره تاني، وهذه نصيحة أنا مرتزف فيها،
+
+282
+00:28:09,980 --> 00:28:13,900
+وبقول الله يزيد الخير، من علمني الله يزيد الخير
+
+283
+00:28:27,830 --> 00:28:38,990
+يبقى ال information يبقى ال information
+
+284
+00:28:38,990 --> 00:28:41,450
+يبقى ال information يبقى ال information يبقى ال
+
+285
+00:28:41,450 --> 00:28:41,530
+information يبقى ال information يبقى ال
+
+286
+00:28:41,530 --> 00:28:41,590
+information يبقى ال information يبقى ال
+
+287
+00:28:41,590 --> 00:28:41,610
+information يبقى ال information يبقى ال
+
+288
+00:28:41,610 --> 00:28:41,650
+information يبقى ال information يبقى ال
+
+289
+00:28:41,650 --> 00:28:41,770
+information يبقى ال information يبقى ال
+
+290
+00:28:41,770 --> 00:28:41,770
+information يبقى ال information يبقى ال
+
+291
+00:28:41,770 --> 00:28:42,010
+information يبقى ال information يبقى ال
+
+292
+00:28:42,010 --> 00:28:44,030
+information يبقى ال information يبقى ال
+
+293
+00:28:44,030 --> 00:28:44,030
+information يبقى ال information يبقى ال
+
+294
+00:28:44,030 --> 00:28:44,030
+information يبقى ال information يبقى ال
+
+295
+00:28:44,030 --> 00:28:44,030
+information يبقى ال information يبقى ال
+
+296
+00:28:44,030 --> 00:28:44,030
+information يبقى ال information يبقى ال
+
+297
+00:28:44,030 --> 00:28:44,030
+information يبقى ال information يبقى ال
+
+298
+00:28:44,030 --> 00:28:45,010
+information يبقى ال information يبقى ال
+
+299
+00:28:45,010 --> 00:28:48,630
+information يبقى ال information يبقى ال
+
+300
+00:28:48,630 --> 00:28:52,730
+information يبقى ال information يبقى ال
+
+301
+00:28:52,730 --> 00:28:56,860
+information يبof near vision لقراية near vision
+
+302
+00:28:56,860 --> 00:29:04,600
+هان الساعة مدت ست ساعات مدت ست ساعات لو قوله هيك
+
+303
+00:29:04,600 --> 00:29:07,920
+هو يقول اه ما الدكتور قال ليه؟ هو يعني نفسيا بحاجة
+
+304
+00:29:07,920 --> 00:29:10,980
+الحلوة ست ساعات قاله مش حاجة الحلوة ليه؟ لكن
+
+305
+00:29:10,980 --> 00:29:14,880
+المشكلة اني انا ماقولهش شغلة وروح يفتح الكمبيوتر
+
+306
+00:29:14,880 --> 00:29:24,180
+وبده يقرأ مش على متصصشغل إضاءة، عينيه داخلتهم ضوء،
+
+307
+00:29:24,180 --> 00:29:27,920
+جالدي دي عالمين، جال عمالي، ممكن كتير يطلب الشرطة
+
+308
+00:29:27,920 --> 00:29:35,260
+عشان تقبل عليه، كل شيء بيصير، الدنيا هذه عجيبة طب
+
+309
+00:29:35,260 --> 00:29:39,040
+benefits of wearing sunglasses and or broad
+
+310
+00:29:39,040 --> 00:29:43,600
+brimmed hatto alleviate photophobia يعني انا كمان
+
+311
+00:29:43,600 --> 00:29:47,360
+اكلمه في الموضوع اني بقوله بعد ما تطلع من هنا من
+
+312
+00:29:47,360 --> 00:29:53,220
+العياذة او من المستشفى الأفضل تلبس نظارات شمسية او
+
+313
+00:29:53,220 --> 00:30:01,700
+تضع فاقية لها بقوله غفرف او حاجة يعني امامها و
+
+314
+00:30:01,700 --> 00:30:07,760
+برود حتى يمنع الإضاءة اتجاهك الحاجة
+
+315
+00:30:07,760 --> 00:30:15,160
+التانيةdesirability of avoiding riding يعني ان انا
+
+316
+00:30:15,160 --> 00:30:22,860
+عارف عن رغبتي ان انا اسوق سيارة او غير سيارة او
+
+317
+00:30:22,860 --> 00:30:25,740
+motor cycle حتى بسكلت او driving a car immediately
+
+318
+00:30:25,740 --> 00:30:33,340
+after ده مدرياتكية يبقى نفسها ان احنا هنوسع لرجل
+
+319
+00:30:33,340 --> 00:30:38,560
+او ست معاه سيارةإنه احنا أفضل قبل أن أبقى على
+
+320
+00:30:38,560 --> 00:30:45,440
+مقاطرة أن يتصل بمن يقود له السيارة فإلا يجد يعني
+
+321
+00:30:45,440 --> 00:30:50,140
+فالواجب postpone اليوم التالي جيب واحد يسوي سيارة
+
+322
+00:30:50,140 --> 00:30:55,940
+و اخر خاصة بالليل خاصة بالليل فبالليل أضواء
+
+323
+00:30:55,940 --> 00:31:02,340
+السيارات مرتفعة فممكن يعملوا dazzling و ممكن يعمل
+
+324
+00:31:02,340 --> 00:31:08,100
+car accidentsيبقى هاي أولا ال information اما من
+
+325
+00:31:08,100 --> 00:31:12,640
+ال information لأنه photophobia وcyclopedia
+
+326
+00:31:12,640 --> 00:31:18,440
+احتمالك ميريسيا Contra
+
+327
+00:31:18,440 --> 00:31:23,720
+indications طبعا هي هذه منها ال adverse يعني ال
+
+328
+00:31:23,720 --> 00:31:26,140
+side effects ال photophobia و loss of
+
+329
+00:31:26,140 --> 00:31:30,600
+accommodation و dazzling و كل هذا هو ال side
+
+330
+00:31:30,600 --> 00:31:33,400
+effects كويس هيك؟
+
+331
+00:31:36,670 --> 00:31:41,350
+ممنوع عليا ان انا استعمل هذه القطرات في اي عين من
+
+332
+00:31:41,350 --> 00:31:55,630
+العيون في اي مريض من المرضى يتأكد
+
+333
+00:31:55,630 --> 00:32:03,430
+ان مافيش معاناة الاستعمال يتأكد
+
+334
+00:32:03,430 --> 00:32:10,300
+وهذه مسئوليةمسؤوليته ان هو يسأل او يفحص قبل ايش
+
+335
+00:32:10,300 --> 00:32:17,300
+قبل أن يضع one patients using pyrocarbine for the
+
+336
+00:32:17,300 --> 00:32:22,000
+treatment of glaucoma طبعا هذه مدة قديمة قبل عشرين
+
+337
+00:32:22,000 --> 00:32:29,940
+سنة و اكتر كالpyrocarbine هو سيد او الخط الأول في
+
+338
+00:32:29,940 --> 00:32:37,020
+علاج ل open angle glaucoma بضيق الفوربشد ال iris
+
+339
+00:32:37,020 --> 00:32:41,480
+centrally فبيفتح ال angle اللي عند ال road تقفض ال
+
+340
+00:32:41,480 --> 00:32:45,080
+iris طبعا
+
+341
+00:32:45,080 --> 00:32:47,500
+لا يعني انه هذا التغلب ال biochemical بينهم بيفتح
+
+342
+00:32:47,500 --> 00:32:53,640
+سدريا لكن من يوم ما طلع ال تمولور والتمولين ال
+
+343
+00:32:53,640 --> 00:32:57,340
+beta blockers اسمهم تغلب عني ال beta blockers
+
+344
+00:32:57,340 --> 00:33:05,970
+مابيعملش ال meiosisلأن الميوز بيتبعوا artificial
+
+345
+00:33:05,970 --> 00:33:12,910
+myopia و increase of accommodation لأنه فيه شوية
+
+346
+00:33:12,910 --> 00:33:18,810
+share space و بعدين فيه ال visual field بيصير
+
+347
+00:33:18,810 --> 00:33:26,390
+narrow ال visual field بيصير narrow لكن ربما في
+
+348
+00:33:26,390 --> 00:33:27,350
+بعض الدول حتى الأقل
+
+349
+00:33:33,460 --> 00:33:40,340
+فكيف ان انا يعني واحد عنده pin hold pupil ان احطله
+
+350
+00:33:40,340 --> 00:33:48,800
+موسع مش هيشتغل يعني المقبض موصد مسكّن مش سهل اهالي
+
+351
+00:33:48,800 --> 00:33:55,300
+تفتحه لان سبق ال bio carbon سبق اللي هو المدرياتيك
+
+352
+00:33:55,300 --> 00:34:00,840
+نين narrow angle للمقمة يعني هو عنده أساسا ال
+
+353
+00:34:00,840 --> 00:34:07,340
+angle narrowوعشان هي كهو على حتفة من ناحية the
+
+354
+00:34:07,340 --> 00:34:13,600
+shutting of this angle يعني ممكن في لحظة تبقى
+
+355
+00:34:13,600 --> 00:34:20,300
+closure ونخش فيها attack خطيرة طب انا كيف اعرف انه
+
+356
+00:34:20,300 --> 00:34:29,180
+في narrow angle؟ شكرا لك بال reflection العادي
+
+357
+00:34:29,180 --> 00:34:33,200
+عملني hypermetroid فوق الخمسة مثلا او فوق الستة
+
+358
+00:34:34,700 --> 00:34:39,100
+طبعا يستفنى الأطفال الصغار تحت six سنين لأنه العين
+
+359
+00:34:39,100 --> 00:34:46,040
+flexible لكن واحد قضل و عنده narrow angle و
+
+360
+00:34:46,040 --> 00:34:53,760
+النضارة بتاعته واضح انه very thick فلما حطيتها على
+
+361
+00:34:53,760 --> 00:34:57,380
+الجهاز
+
+362
+00:34:57,380 --> 00:35:02,680
+طلعتلي plus six مثلا narrow angle
+
+363
+00:35:05,400 --> 00:35:10,040
+الهستوري تاخد أي علاج سبق أن عينك حمرت كده كده لو
+
+364
+00:35:10,040 --> 00:35:12,800
+اندليت أنا من الهستوري أنه صابوا أي بلوكومة قبل
+
+365
+00:35:12,800 --> 00:35:17,160
+هيك قد تاك حاجة كويس
+
+366
+00:35:17,160 --> 00:35:22,780
+ال نور مادي شلوق until ال chamber وهذا بتبين
+
+367
+00:35:22,780 --> 00:35:29,520
+بالlight العادي أو بالسلام optical section بيبان
+
+368
+00:35:29,520 --> 00:35:32,800
+المسافة ما بين الكورية
+
+369
+00:35:48,410 --> 00:35:54,230
+بركة مياه لو فيها مثلا تلاتين سانتي بمشي فيها
+
+370
+00:35:54,230 --> 00:35:59,830
+برجليا بيقول عنها ضحلة لك لو فيها متريال لأ عميق
+
+371
+00:35:59,830 --> 00:36:05,230
+بغرق فيه ف ال AC لما تكون الكورنيا وال آيروس
+
+372
+00:36:05,230 --> 00:36:11,070
+قريبين من بعض ليست ده يعني two millimeter بيقول
+
+373
+00:36:11,070 --> 00:36:16,690
+عنها shallow AC ضحلة قريبين عن بعض هيك يعني لكن
+
+374
+00:36:16,690 --> 00:36:20,730
+لما تكون بالعن بعضبقول deep زى مثلا من الناس اللى
+
+375
+00:36:20,730 --> 00:36:27,530
+عندهم الفاكهة مش الفاكهة اللذب مشهولة أكيد بيكون
+
+376
+00:36:27,530 --> 00:36:38,430
+فيه deep اسي اسي لذيذ يا عزيزي جدا جميل طيب أبضم
+
+377
+00:36:38,430 --> 00:36:41,170
+شلو until chamber يعني مش شلو بس
+
+378
+00:36:46,560 --> 00:36:52,560
+يبقى سواء فيه narrow angle أو shallow chamber هما
+
+379
+00:36:52,560 --> 00:36:59,580
+threatening signs for attack of acute اللي هو
+
+380
+00:36:59,580 --> 00:37:04,920
+العيبروكومة dislocation of the crystalline lens هو
+
+381
+00:37:04,920 --> 00:37:10,340
+an intraocular lens إيش يعني dislocation of the
+
+382
+00:37:10,340 --> 00:37:13,900
+crystalline lens؟
+
+383
+00:37:16,090 --> 00:37:22,670
+طبعا انا يعني بدي اوسع و في مشكلة في the news فيهم
+
+384
+00:37:22,670 --> 00:37:29,570
+تير قطر او حتى اتركوا الاسمازرواها لكن صارها
+
+385
+00:37:29,570 --> 00:37:39,450
+dislocation dislocation واجع فرح فيعني
+
+386
+00:37:39,450 --> 00:37:44,670
+هو في الناس اللي في الناس الصادر في kicksسيلوس في
+
+387
+00:37:44,670 --> 00:37:49,470
+الكيكس يعني في انتراكور لينز عامل كتراكت و
+
+388
+00:37:49,470 --> 00:37:53,630
+Artificial lens موجود poly مثال مث أكريليت لينز
+
+389
+00:37:53,630 --> 00:38:01,410
+جالر هل حقيقة أنه في رابط بين السيلري مواصل وبعد
+
+390
+00:38:01,410 --> 00:38:08,150
+اللينز هل هذه اللينز بتعمل accommodation لأ اذا
+
+391
+00:38:08,150 --> 00:38:11,730
+كانت بتعرف تجاوبى تجاوبى بتعرف تجاوبى قولي later
+
+392
+00:38:11,730 --> 00:38:18,120
+on و بديبرك تجاوبىلأن في بعض الناس شغلته يعني إيش
+
+393
+00:38:18,120 --> 00:38:26,080
+أن يمسك الأخطر يعني يا بناتي هذه شبكة هنا ال
+
+394
+00:38:26,080 --> 00:38:34,000
+muscle و هنا ال lens هاي ال muscle هيك و هنا ال
+
+395
+00:38:34,000 --> 00:38:38,800
+zinnius في ال equator و pre equator و post equator
+
+396
+00:38:38,800 --> 00:38:44,220
+و ده ال lens هاي ال lens و هاي ال muscleالآن الـ
+
+397
+00:38:44,220 --> 00:38:52,160
+zanules هدولة هم اللي بيوصلوا القوة من ال muscle
+
+398
+00:38:52,160 --> 00:38:56,480
+إلى الناس الآن
+
+399
+00:38:56,480 --> 00:39:01,540
+ال zanules صح موجودين في عملية ال extra capsula
+
+400
+00:39:01,540 --> 00:39:06,040
+extra capsula كtract extraction أنا الحقيقة
+
+401
+00:39:06,040 --> 00:39:08,020
+ماشيلتش ال zanules
+
+402
+00:39:11,780 --> 00:39:18,300
+انه خليت شي اسمه capsular bag بس
+
+403
+00:39:18,300 --> 00:39:23,920
+انا فتحت من امام وعملت removal للنزب مطر برا اللى
+
+404
+00:39:23,920 --> 00:39:29,660
+هى فى الكترين فالزنيوز اللى هنا فيضنوا فى المكان
+
+405
+00:39:29,660 --> 00:39:35,440
+وانا روح جب هى ال optic و هى ال haptic
+
+406
+00:39:41,520 --> 00:39:47,380
+الان لما ال muscle اللى هى هنا بتنكمش و بتجى هنا
+
+407
+00:39:47,380 --> 00:39:55,680
+اه و بتلف الضنيول ال
+
+408
+00:39:55,680 --> 00:40:00,500
+.. ال matter بتاع ال artificial lens البولي ميثايل
+
+409
+00:40:00,500 --> 00:40:09,140
+مثل اكريلية هى inert واحدة و بعدين solid مافيش
+
+410
+00:40:09,140 --> 00:40:12,690
+فيها accommodationin change in power or shape
+
+411
+00:40:12,690 --> 00:40:20,290
+وبالتالي سواء الناس عاملة contraction او عاملة
+
+412
+00:40:20,290 --> 00:40:27,810
+relaxation ما بيأثر مافي difference بتعمل
+
+413
+00:40:27,810 --> 00:40:34,850
+contraction او relaxation لأن الدنيا لا توصل ال
+
+414
+00:40:34,850 --> 00:40:39,170
+power للناس الناس هذا مش طبيعي الناس artificial
+
+415
+00:40:43,170 --> 00:40:47,990
+عشانك احنا هذا الـ sonofabric المسكين لاجب انه
+
+416
+00:40:47,990 --> 00:40:54,210
+نعطيه magnifier يجرى فيه plus three مثلا يجرى فيه
+
+417
+00:40:54,210 --> 00:41:00,070
+لأنه فيه complete loss و بقى combination فبالتالي
+
+418
+00:41:00,070 --> 00:41:06,410
+هذا يعني انا بدى وسّاله طبعا انا مانديش اوسع
+
+419
+00:41:06,410 --> 00:41:09,970
+الcellular muscle بدى واسع sphincter pupillary
+
+420
+00:41:09,970 --> 00:41:10,330
+muscle
+
+421
+00:41:13,000 --> 00:41:18,620
+بقدر امكان انا يعني ممكن انه استفيد وفش اي اثر على
+
+422
+00:41:18,620 --> 00:41:25,060
+السيري مصر فش اي اثر على السيري مصر يبقى ال ال ال
+
+423
+00:41:25,060 --> 00:41:26,340
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+424
+00:41:26,340 --> 00:41:27,540
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+425
+00:41:27,540 --> 00:41:29,460
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+426
+00:41:29,460 --> 00:41:29,460
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+427
+00:41:29,460 --> 00:41:30,840
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+428
+00:41:30,840 --> 00:41:30,840
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+429
+00:41:30,840 --> 00:41:30,840
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+430
+00:41:30,840 --> 00:41:30,840
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+431
+00:41:30,840 --> 00:41:30,840
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+432
+00:41:30,840 --> 00:41:30,840
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+433
+00:41:30,840 --> 00:41:30,900
+ال ال ال
+
+434
+00:41:39,200 --> 00:41:45,420
+فهنا في إتراك للفيديو Refraction مش صح يعني حطيت
+
+435
+00:41:45,420 --> 00:41:49,860
+الاتراك واللنز عشان تعملليه Refraction ساعتنا
+
+436
+00:41:49,860 --> 00:41:55,240
+بيصير ال dislocation تطلع من مكانها بيصير في إتراك
+
+437
+00:41:55,240 --> 00:42:04,900
+يعني مثلا هذا اللنز مثلا هاي ال AC وهي اللنز هنا
+
+438
+00:42:06,690 --> 00:42:13,010
+فلو أنا حاطط مثلا لين صناعية، هي هنا، مكانها، وهذه
+
+439
+00:42:13,010 --> 00:42:20,190
+مثلا طلعتلي صارت هنا، قعدتلي هنا أو قعدتلي هنا أو
+
+440
+00:42:20,190 --> 00:42:23,910
+هنا،
+
+441
+00:42:23,910 --> 00:42:28,800
+صار وضع كلهمشكلة يعني الناس هيعملها desinflation و
+
+442
+00:42:28,800 --> 00:42:33,200
+كلام زهيرة و reflection لخبط بتاع عينه لأ فهذا في
+
+443
+00:42:33,200 --> 00:42:36,380
+الأول يعني الحالة دي حالة جراحية انهم يعملوا
+
+444
+00:42:36,380 --> 00:42:39,780
+extraction للناس هذه في الأول و ذبطوا الموضوع
+
+445
+00:42:39,780 --> 00:42:44,540
+الجراحي في العين قبل أن انا أدور على ال dilatation
+
+446
+00:42:44,540 --> 00:42:47,740
+واضح؟
+
+447
+00:42:47,740 --> 00:42:52,700
+Interocular lens of the anterior chamber or iris
+
+448
+00:42:52,700 --> 00:42:58,970
+supported typeاحيانا في موانع تمنع من زراع العلسة
+
+449
+00:42:58,970 --> 00:43:06,690
+هنا مثلا هو بيشتغل بسكين بيشتغل في المنطقة هذه و
+
+450
+00:43:06,690 --> 00:43:08,010
+راح تهيأ المزاقة
+
+451
+00:43:25,190 --> 00:43:31,230
+يعملها في ال AC الامبلانتيشن المشكلة في ال AC
+
+452
+00:43:31,230 --> 00:43:36,610
+لينزيز انه لها علاقة بال أنجل و لها علاقة بال
+
+453
+00:43:36,610 --> 00:43:43,130
+ايريز ممكن تعمل friction مع ال ايريز و تطلع نوع من
+
+454
+00:43:43,130 --> 00:43:50,910
+الميلانين و من هذا يسكر ال أنجل او حتى يعمل نوع من
+
+455
+00:43:50,910 --> 00:43:52,530
+ال irritation و العيبيتس
+
+456
+00:43:57,710 --> 00:44:02,370
+والـ Hypopion والكلام هذا ففي الحالة هذه انا بتوقف
+
+457
+00:44:02,370 --> 00:44:05,410
+عن التوسيع خاصة في الـ Optometry خاصة في ال
+
+458
+00:44:05,410 --> 00:44:08,570
+Optometry المشاكل الحالية دي بدها Cortisone وبدها
+
+459
+00:44:08,570 --> 00:44:14,390
+جانب متابعة عبر اللي هو إيش الطبيب
+
+460
+00:44:22,860 --> 00:44:26,060
+by mechanical blockage of the angle of the iris
+
+461
+00:44:26,060 --> 00:44:30,360
+بقى a state of semi dilatation of the pupil might
+
+462
+00:44:30,360 --> 00:44:33,980
+initiate this rise by producing pupillary block
+
+463
+00:44:42,820 --> 00:44:46,620
+أمام الـ iris هذا لذيذ الشيء كمان. This can occur
+
+464
+00:44:46,620 --> 00:44:49,800
+in semi dilated eyes because of the shallow
+
+465
+00:44:49,800 --> 00:44:54,100
+anterior chamber and anterior place lens.يعني ال
+
+466
+00:44:54,100 --> 00:44:59,900
+lens هذه هي عملت narrowing و sharrowing للاسي و
+
+467
+00:44:59,900 --> 00:45:05,810
+narrowing للانجلالأيريز تكون أكثر مقارنة بمقارنة
+
+468
+00:45:05,810 --> 00:45:16,690
+الكابسول باللينز بمقارنة مقارنة بمقارنة الكابسول
+
+469
+00:45:16,690 --> 00:45:19,630
+باللينز بمقارنة مقارنة مقارنة مقارنة مقارنة مقارنة
+
+470
+00:45:19,630 --> 00:45:19,950
+مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة
+
+471
+00:45:19,950 --> 00:45:19,950
+مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة
+
+472
+00:45:19,950 --> 00:45:19,950
+مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة
+
+473
+00:45:19,950 --> 00:45:31,170
+مقارنة مقارنة مقارنة مقارنة مقارنة مقارنة مقارن
+
+474
+00:45:31,880 --> 00:45:36,220
+أيه سيدي؟ وفيه narrow angle ففي الحالة هذه تسميها
+
+475
+00:45:36,220 --> 00:45:38,100
+Contra Indication للتوسيع
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/HEgwN2Qfy0g_postprocess.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/HEgwN2Qfy0g_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..c9d7cac0d82bfb5cc428e9d222a9da0ebfd02d99
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/HEgwN2Qfy0g_postprocess.srt
@@ -0,0 +1,2000 @@
+1
+00:00:23,440 --> 00:00:26,820
+الحمد لله رب العالمين وأصلي و أسلم على النبي
+
+2
+00:00:26,820 --> 00:00:30,460
+الأمين محمد وعلى آله وأصحابه والتابعين السلام
+
+3
+00:00:30,460 --> 00:00:34,900
+عليكم ورحمة الله وبركاته في هذه المحاضرة سنكمل
+
+4
+00:00:34,900 --> 00:00:40,520
+ويكون قبلانا من selection of drugs and patients in
+
+5
+00:00:40,520 --> 00:00:45,220
+optometry اختيار المرضى واختيار الأدوية في تخصص
+
+6
+00:00:45,220 --> 00:00:52,740
+البصرية الآن انا هسأل العيان
+
+7
+00:00:56,660 --> 00:01:03,880
+أو أضع له Tropic A معي أو أضع له ال Pyrocarbine في
+
+8
+00:01:03,880 --> 00:01:10,900
+عينه قدت أسئلة for safety من قدر السلام first
+
+9
+00:01:10,900 --> 00:01:15,440
+question will the patient benefit from the use of
+
+10
+00:01:15,440 --> 00:01:19,880
+a particular diagnostic drug؟ بتقولهم انت هتستفيد
+
+11
+00:01:19,880 --> 00:01:25,960
+من هذا الدواء في التشخيصمثلا في الـ retinoscopy في
+
+12
+00:01:25,960 --> 00:01:33,160
+الحوار في التشخيص كمان بسأل has the particular
+
+13
+00:01:33,160 --> 00:01:37,000
+drug been applied to this patient before؟ بنقوله
+
+14
+00:01:37,000 --> 00:01:42,200
+هل سبق أن استخدم هذا الدواء في العين مثلا الموسع
+
+15
+00:01:42,200 --> 00:01:46,900
+مع كتير يعني الناس عندهم سكري في الشفاكية بيعملهم
+
+16
+00:01:46,900 --> 00:01:51,740
+توسيع بيقولوا هل سبق أنه حد وضع
+
+17
+00:01:55,690 --> 00:01:59,910
+يقول هل الطفل هذا وضعوله أتروبيل مثلا قبل هيك عشان
+
+18
+00:01:59,910 --> 00:02:02,390
+انا أفهم وإذا كان وضعوله أتروبيل طبعا بيجي كلام
+
+19
+00:02:02,390 --> 00:02:07,990
+بعد هيك if so إذا كان استخدم نفس العلاج و يدير
+
+20
+00:02:07,990 --> 00:02:11,430
+were there any adverse reactions or allergic
+
+21
+00:02:11,430 --> 00:02:16,710
+responses هل الحادثة له مضاعفات أو أثار جانبية من
+
+22
+00:02:16,710 --> 00:02:23,530
+هذا ال drug سواء صغيرة كانة أو كبيرة لأن إذا كان
+
+23
+00:02:23,530 --> 00:02:27,910
+هو عمله مضاعفات مش هعطيها تانيةحتى لو ده ورق
+
+24
+00:02:27,910 --> 00:02:32,090
+بالفم، يعني واحد أخد ورق بالفم وعمله رفع لقطة
+
+25
+00:02:32,090 --> 00:02:36,770
+الدم، سرعة، أول ما أشوفه لأ، بيقول هذا مفرطر الدم
+
+26
+00:02:36,770 --> 00:02:40,890
+ليه؟ ماخدهوش فاهم، خلاص، واحد انه حاجة البنسالين
+
+27
+00:02:40,890 --> 00:02:45,930
+مرة، و عنده حسية عمره ما برجع لبنسالين تانية، يبقى
+
+28
+00:02:45,930 --> 00:02:49,270
+قبل ما أخضع القطرة في عينه، بدي أسأل، هل هذه
+
+29
+00:02:49,270 --> 00:02:52,990
+القطرة استخدمت قبل ذلك؟ انه قال لأ، لأ
+
+30
+00:03:08,330 --> 00:03:12,610
+يعني condition يعني ايش disease that would make
+
+31
+00:03:12,610 --> 00:03:17,310
+the use of this drug inadvisable
+
+32
+00:03:17,310 --> 00:03:21,210
+بينصح بيه مثلا high intraocular pressure هذي يعني
+
+33
+00:03:21,210 --> 00:03:25,710
+مثال وهذا انه high intraocular pressure ومعروف ان
+
+34
+00:03:25,710 --> 00:03:32,570
+مركبات الكورتيزون ترفضر تلاقي ايه فانا لما سألتههل
+
+35
+00:03:32,570 --> 00:03:37,090
+إذا كنت عندك أي حاجة في العيد، تقول اللي هو ضغط
+
+36
+00:03:37,090 --> 00:03:43,850
+العلم مرتفع و باخده قطرة التيمولين مثلا، تمولول،
+
+37
+00:03:43,850 --> 00:03:50,150
+مابعودش انا اعطيه كورتيزان، لو كان ضغطه الآن مع
+
+38
+00:03:50,150 --> 00:03:54,970
+التيمولول control، مجرد ما اخده كورتيزان، حصير
+
+39
+00:03:54,970 --> 00:04:01,520
+uncontrol، هي للي 30 و أكتر من 305- Are there any
+
+40
+00:04:01,520 --> 00:04:03,840
+systemic conditions that would be
+
+41
+00:04:03,840 --> 00:04:09,800
+contraindications for the drugs used؟ هل بيعاني في
+
+42
+00:04:09,800 --> 00:04:16,980
+سكته؟ Systemic disease مثلا، diabetes mellitus
+
+43
+00:04:16,980 --> 00:04:24,780
+مثلا، hypertension بطن؟ Cardiac disease عنده حاجة
+
+44
+00:04:24,780 --> 00:04:27,140
+في سكته بحيث أن بعض القطرات
+
+45
+00:04:34,000 --> 00:04:36,520
+و هذا طبعا اللي بتستخدم العلاج زي اللي بتستخدم
+
+46
+00:04:36,520 --> 00:04:40,800
+السلاح اللي استخدم السلاح منه فمايكونش مدرب عليه و
+
+47
+00:04:40,800 --> 00:04:45,240
+عارف كيف يعني استخدامه و العلاج نفس الشيء زي
+
+48
+00:04:45,240 --> 00:04:50,600
+السلاح ممكن الإنسان اللي ماقعش في العلاج يأذي
+
+49
+00:04:50,600 --> 00:04:55,180
+المريض زي اللي ماقعش في السلاح يأذي نفسه و يأذي
+
+50
+00:04:55,180 --> 00:05:01,000
+الناس السلاح دو حتين يعني هذا العلاج إيه بس كان
+
+51
+00:05:01,000 --> 00:05:02,820
+عنده شيء في القلب
+
+52
+00:05:07,650 --> 00:05:12,310
+ممكن جدا الاتك لقومة باتكرار انه اتأثر على القلب
+
+53
+00:05:12,310 --> 00:05:17,870
+سالما Is the patient currently taking any medicine
+
+54
+00:05:17,870 --> 00:05:22,390
+that could interact with the diagnostic drug؟ الهي
+
+55
+00:05:22,390 --> 00:05:27,410
+drug interaction يعني هل هو يعني تعود على أخذ علاج
+
+56
+00:05:27,410 --> 00:05:32,210
+معين لعلاج حالة معينة وانا بدي أحطله القطرة قد
+
+57
+00:05:32,210 --> 00:05:36,470
+تتفاعل مع العلاج اللي هو بياخده باستمرار
+
+58
+00:05:47,660 --> 00:05:52,140
+بتكلم الان عن selection of drug and concentration
+
+59
+00:05:52,140 --> 00:05:57,120
+خلصنا المريض، فهمنا المريض، اذا انا drug؟ بيقوللي
+
+60
+00:05:57,120 --> 00:06:06,620
+في ال drug، في حاجتين اول حاجة concentration يعني
+
+61
+00:06:06,620 --> 00:06:13,000
+انا لازم اختار ال concentration المناسب للمريض حسب
+
+62
+00:06:13,000 --> 00:06:21,750
+وزنه وحسب سنهحسب وزنه و حسب سنه الان مثلا انا عندي
+
+63
+00:06:21,750 --> 00:06:34,270
+قطرة تمولين فيها 0.25 Pearson و في 0.5 0.25
+
+64
+00:06:34,270 --> 00:06:42,150
+Pearson for children و 0.5 for adults الان مانفعش
+
+65
+00:06:42,150 --> 00:06:43,750
+اعطي الرقم
+
+66
+00:06:51,040 --> 00:06:57,700
+هذه الحاجة الان لو انجد لصيدري في ال pharmacy
+
+67
+00:06:57,700 --> 00:07:06,860
+صيدرية وصفة تمناع القباس المفروض
+
+68
+00:07:06,860 --> 00:07:12,720
+ان هو حسب المعروف القبي يوصف الجوع الأصغر حفاظا
+
+69
+00:07:12,720 --> 00:07:16,720
+على صحت المريض طبيب
+
+70
+00:07:16,720 --> 00:07:24,200
+تاني كاتب AspirinTablets يعني أقراص و بس المفروض
+
+71
+00:07:24,200 --> 00:07:28,940
+أن الصيدري يعطي أصغر جرعة من الأسبرين اللي هي 100
+
+72
+00:07:28,940 --> 00:07:33,140
+ميلي جرام بتاعة ال baby aspirin ماعطوه مش إيش ال
+
+73
+00:07:33,140 --> 00:07:38,320
+500 يعني يبقى هيك الغرف يبقى ملي ملي مار
+
+74
+00:07:38,320 --> 00:07:41,260
+concentrations of drugs were made available in the
+
+75
+00:07:41,260 --> 00:07:45,750
+past في الماضيكانت الجمهورات المهيئة الصغيرة their
+
+76
+00:07:45,750 --> 00:07:49,310
+use was poor and their production was discontinued
+
+77
+00:07:49,310 --> 00:07:55,630
+يعني حاجة ربع بس هي مليون مانفعش if there is any
+
+78
+00:07:55,630 --> 00:07:59,510
+doubt as to which concentration to use then the
+
+79
+00:07:59,510 --> 00:08:03,090
+lower one should always be employed زي ما قلنا لو
+
+80
+00:08:03,090 --> 00:08:07,830
+كانت هو سمين بس ماحطوش كده يعني العيار بتاع و
+
+81
+00:08:07,830 --> 00:08:12,500
+بعطيها أجهزة في ال similaritybetween two drugs,
+
+82
+00:08:12,780 --> 00:08:15,440
+the weaker one with the shorter duration will
+
+83
+00:08:15,440 --> 00:08:30,100
+often be the drug of choice لذلك
+
+84
+00:08:30,100 --> 00:08:33,520
+الطبيب الحاضر هو اللي بيوصف ال concentration
+
+85
+00:08:33,520 --> 00:08:38,180
+والنسبة المقلية المظبوطةبس مش اللي هو ال .. ال ..
+
+86
+00:08:38,180 --> 00:08:43,400
+ال pharmacist الصيدري و ليس المريض محتر، اللي ما
+
+87
+00:08:43,400 --> 00:08:48,180
+طلعش تركيز معين أو اسم معينة، هم باعطوا أقل شيء،
+
+88
+00:08:48,180 --> 00:08:53,500
+حفظة على صحة المريض طيب، الآن هنكون في ال chapter
+
+89
+00:08:53,500 --> 00:08:58,580
+11، diagnostic drugs and products used in
+
+90
+00:08:58,580 --> 00:09:04,480
+optometry الأجوة التشخيصية التي تستخدم في عالم
+
+91
+00:09:04,480 --> 00:09:05,460
+البصرية
+
+92
+00:09:09,210 --> 00:09:16,390
+هنبدأ ب Cycloplegics هو أنا لما أقول Cycloplegia
+
+93
+00:09:16,390 --> 00:09:23,170
+معناه شلل العضلة الهدوية طيب لما أقول Hemiplegia
+
+94
+00:09:23,170 --> 00:09:30,310
+شلل نصف الإنسان، يبقى Plegia شلل، Hemi نصف يعني
+
+95
+00:09:40,790 --> 00:09:47,510
+فبنقول Paraplegia lower limbs، Paraplegia lower
+
+96
+00:09:47,510 --> 00:09:55,770
+limbs، Monoplegia و .. يبقى ال Psychopathicsبس
+
+97
+00:09:55,770 --> 00:09:59,910
+احنا مابيعملش شلل زي شلل الجلطات الدماغية مثلا،
+
+98
+00:09:59,910 --> 00:10:04,210
+شلل الدائم، لأ هذا شلل معقد، شلل سماعي يعني بقوله،
+
+99
+00:10:04,210 --> 00:10:07,650
+معقد. Psychopathics are drugs that paralyze the
+
+100
+00:10:07,650 --> 00:10:11,310
+cere muscle by blocking the muscular receptors
+
+101
+00:10:11,310 --> 00:10:16,070
+that are normally stimulated by the release of a
+
+102
+00:10:16,070 --> 00:10:18,910
+styproline from the nerve endings of the
+
+103
+00:10:18,910 --> 00:10:24,250
+parasympathetic system.طبعاً اللي هي الـ Muscular
+
+104
+00:10:24,250 --> 00:10:30,350
+Receptors زي ما تشايفين في الصورة هنا هذه الـ
+
+105
+00:10:30,350 --> 00:10:35,350
+Receptors مشتغل عليها الدوام وهي موجودة في الجسم،
+
+106
+00:10:35,350 --> 00:10:40,970
+في الـIris، في الـCellular Body احنا ننظر بهمنا
+
+107
+00:10:40,970 --> 00:10:44,830
+الآن في الـOptometer لكن موجودة في الـLateral
+
+108
+00:10:44,830 --> 00:10:47,470
+Malignant، في الـCellular Glands
+
+109
+00:10:59,090 --> 00:11:04,410
+هذه الـ Receptors اللي ما ممكن إنه الدعاء يدخل إلى
+
+110
+00:11:04,410 --> 00:11:10,430
+العضو إلا بعد أن تتفاعل بالدواء لتُفرِز أستايكولين
+
+111
+00:11:10,430 --> 00:11:16,730
+أستايكولين هذا اللي هو كيميكال تراسميتر اللي يعني
+
+112
+00:11:16,730 --> 00:11:20,570
+بيعمل ال initiation للنفد
+
+113
+00:11:20,570 --> 00:11:25,210
+العصبي في المكان هذا، هذا ماسكريك اللي هو Receptor
+
+114
+00:11:31,160 --> 00:11:35,780
+هذا البراسيمبتاتيك ليعمل system also renovates the
+
+115
+00:11:35,780 --> 00:11:42,300
+pupil sphincter muscle براسيمبتاتيك
+
+116
+00:11:42,300 --> 00:11:49,920
+وسايد muscle براسيمبتاتيك، يبقى اللي مع أنه أنا مش
+
+117
+00:11:49,920 --> 00:11:57,490
+هادف إلى ان اعمل sphincter muscle paralysisإلا إنه
+
+118
+00:11:57,490 --> 00:12:01,750
+بالمجوعة وراه، إيه ده وراه؟ يوثم على اللي هو
+
+119
+00:12:01,750 --> 00:12:04,910
+الـSphinctrapiopeli على شغل أساسي اللي
+
+120
+00:12:04,910 --> 00:12:09,690
+بالـcyclopidgic إيش؟ سرق المصر، طب إيش خاص اللي هو
+
+121
+00:12:09,690 --> 00:12:15,930
+الـsphinctrapiopeli؟ بالمجوعة، عشان البرسم مثلا،
+
+122
+00:12:15,930 --> 00:12:21,310
+لذا لو الـcyclopidgic مثلا بدورة من الـ8% على
+
+123
+00:12:21,310 --> 00:12:25,430
+السرق المصر، الحقيقة من الـ20% على الجارةاللي هي
+
+124
+00:12:25,430 --> 00:12:28,730
+إيش؟ Sphincter، Pupil muscle، و بُقى البُقى بُقى
+
+125
+00:12:28,730 --> 00:12:33,210
+إيش؟ موسّق، و سفيه aberrations، aberrations مش
+
+126
+00:12:33,210 --> 00:12:38,450
+تحمل بُقى طيب، should be noted that Mediasis is
+
+127
+00:12:38,450 --> 00:12:41,310
+not always evidence of an accompanying
+
+128
+00:12:41,310 --> 00:12:44,310
+psychopresia and mainly indicates paralysis of the
+
+129
+00:12:44,310 --> 00:12:45,190
+pupil sphincter
+
+130
+00:12:51,590 --> 00:12:55,690
+وصار توسية، هل هذا دليل على أنه صار Sacroblige؟
+
+131
+00:12:55,690 --> 00:13:04,710
+سؤال آخر، هل ممكن الموسى اللي هو مدرميل
+
+132
+00:13:13,060 --> 00:13:15,320
+وعالمرسل المفتكر أمامي اللي هي الـSphincter
+
+133
+00:13:15,320 --> 00:13:18,040
+Lupilli مش على السلان مش على السلان ايه ماسلان
+
+134
+00:13:18,040 --> 00:13:22,760
+قاعد يوصي بالسلان muscle نسبة 10-20% لكن غير كافية
+
+135
+00:13:22,760 --> 00:13:29,600
+انه اعمل انا petroscopy under cyclopedia it should
+
+136
+00:13:29,600 --> 00:13:32,780
+be noted that مدريازس is not always evidence of an
+
+137
+00:13:32,780 --> 00:13:34,680
+accompanying cyclopedia and mainly the case
+
+138
+00:13:34,680 --> 00:13:37,080
+present of the Sphincter Lupilli muscle
+
+139
+00:13:37,080 --> 00:13:40,240
+Cyclopedics are used to prevent or reduce
+
+140
+00:13:40,240 --> 00:13:44,740
+accommodation during refractionthus making latent
+
+141
+00:13:44,740 --> 00:13:49,640
+refractive error manifest مش نقول كفل، أنا بستخدم
+
+142
+00:13:49,640 --> 00:13:54,960
+psychromagic بستخدمه في حالات، هقولها بعد قليل،
+
+143
+00:13:54,960 --> 00:13:58,720
+شكرا indications
+
+144
+00:13:58,720 --> 00:14:04,420
+for psychromagic examination where
+
+145
+00:14:04,420 --> 00:14:09,800
+the use of psychromagics is indicated in the
+
+146
+00:14:09,800 --> 00:14:14,950
+following casesone, and the children with constant
+
+147
+00:14:14,950 --> 00:14:20,510
+or intermittent esotropy one and sometimes
+
+148
+00:14:20,510 --> 00:14:26,050
+subsequently initial presentation يعني إيش؟ يعني
+
+149
+00:14:26,050 --> 00:14:30,450
+الطفل دائما عنده إسوتروبي
+
+150
+00:14:40,060 --> 00:14:44,520
+يعني في الصباح، جاي من النوم، ماعنده ساكنة، ماعنده
+
+151
+00:14:44,520 --> 00:14:49,820
+إلتروبيا، بعد أهربا ده يبين، في المساء، بيان جدا،
+
+152
+00:14:49,820 --> 00:14:53,820
+لما ناموا الصباح، الصباح مافيش فيه، الناس بيقولوا،
+
+153
+00:14:53,820 --> 00:14:59,160
+قولوا، أيش؟ بيقولوا، أنا انت، او مين انت؟ ال tax
+
+154
+00:14:59,160 --> 00:15:02,420
+ال
+
+155
+00:15:02,420 --> 00:15:06,740
+indication التاني، ان ال children and young adults
+
+156
+00:15:06,740 --> 00:15:12,530
+with asthenopiaإجهاد العين and esophobia
+
+157
+00:15:12,530 --> 00:15:15,910
+especially when a latent refractive error is
+
+158
+00:15:15,910 --> 00:15:24,470
+suspected يعني الطفل في الحالة هذه أعمله لتنوسكبي
+
+159
+00:15:24,470 --> 00:15:29,210
+وده سايكروبريجيا طلع plus one في حد ما حطيتله
+
+160
+00:15:29,210 --> 00:15:36,650
+سايكروبريجيا طلع plus three يبقى في عنده latent في
+
+161
+00:15:36,650 --> 00:15:40,630
+عنده latentثالثًا، عندما تقوم الريتروسكوبية بإعطاء
+
+162
+00:15:40,630 --> 00:15:47,650
+تجارب التجارب تتجارب تجارب تجارب تجارب تجارب تجارب
+
+163
+00:15:47,650 --> 00:15:49,190
+تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب
+
+164
+00:15:49,190 --> 00:15:49,290
+تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب
+
+165
+00:15:49,290 --> 00:16:03,470
+تجارب تج
+
+166
+00:16:06,890 --> 00:16:11,170
+طيب ساكتنا، إيه معنى اسمه؟ طبعا plus one، هدس
+
+167
+00:16:11,170 --> 00:16:15,930
+مفلبتي و إتين، مفلبتي و إتين، بتطلع بنزل، سلري مصل
+
+168
+00:16:15,930 --> 00:16:20,490
+مش مستقرة، في الحالة دي أنا بتاخد قرار إن أنا عنه
+
+169
+00:16:20,490 --> 00:16:26,170
+إيش؟ psychopathy، حتى و لو كان adult، يعني وضع
+
+170
+00:16:26,170 --> 00:16:29,870
+السلري مصل بتاعته unstable، مش مستقل
+
+171
+00:16:32,600 --> 00:16:34,560
+الإبداع الرابع عندما تختلف إيجابات الريتينوسكو
+
+172
+00:16:34,560 --> 00:16:40,440
+بشكل كبير من إيجابات إتفاقية في حالة إتفاقات أو
+
+173
+00:16:40,440 --> 00:16:46,800
+إتفاقات يعني أنا
+
+174
+00:16:46,800 --> 00:16:55,840
+عملت كله ريتينو طلع مثلا plus one حطيته على شرط
+
+175
+00:16:55,840 --> 00:16:58,060
+سنانة شاشه
+
+176
+00:17:03,870 --> 00:17:10,290
+يعمل الـ plus one hypermetropia يعمل الـ 66 6 على
+
+177
+00:17:10,290 --> 00:17:16,890
+12 يبقى انا هتمضى دهني ان في شيء غلط احد امرين يا
+
+178
+00:17:16,890 --> 00:17:24,830
+اما الcell muscle hides لتن hypermetropia اكثر يا
+
+179
+00:17:24,830 --> 00:17:28,390
+اما في organic disease في organic disease من كترك
+
+180
+00:17:28,390 --> 00:17:34,590
+او في شيء في الاتنان او في شيء في النارلذلك انا
+
+181
+00:17:34,590 --> 00:17:39,050
+كautomatist في الحالة هذه لازم اعمله psychological
+
+182
+00:17:39,050 --> 00:17:43,090
+عشان اشوف ليش الفرق كبير عنده plus one ومشوف ستة ع
+
+183
+00:17:43,090 --> 00:17:48,510
+ستين مش معقولة في الأدبيات بتاعتنا مش موجودة يبقى
+
+184
+00:17:48,510 --> 00:17:52,370
+ال accommodation ممكن يكون عنده ايوة في ال
+
+185
+00:17:52,370 --> 00:17:57,910
+accommodation في anomalies زي insufficiency زي
+
+186
+00:17:57,910 --> 00:18:02,810
+fatigue زي inertia inertia ايش يعني خمولة
+
+187
+00:18:07,970 --> 00:18:11,730
+المهم كل الانمالي او الاجتماعات اللي أخدناها في
+
+188
+00:18:11,730 --> 00:18:18,470
+الـrefraction one كمأة كمان indication خامس ال
+
+189
+00:18:18,470 --> 00:18:21,290
+case where the endoscopy along the medial axis is
+
+190
+00:18:21,290 --> 00:18:26,930
+very difficult لدى و تلقى lack of cooperation من
+
+191
+00:18:26,930 --> 00:18:30,890
+ال patient يعني مش مساعدني other children or
+
+192
+00:18:30,890 --> 00:18:31,310
+mentors
+
+193
+00:18:37,430 --> 00:18:40,890
+يعني البقبق في الحالة العادية يعني بداية بتاعه
+
+194
+00:18:40,890 --> 00:18:47,790
+three to four اللي هو millimeter الحال لو فيش
+
+195
+00:18:47,790 --> 00:18:52,030
+cooperation صعب ان انا اركز في البقبق في المنتصف
+
+196
+00:18:52,030 --> 00:18:58,370
+في المركز بتاعي لكن لو انا وسعت البقبق صارت سبعة
+
+197
+00:18:58,370 --> 00:19:04,650
+او تمانية millimeter مكون هداياش افضل في ان انا
+
+198
+00:19:04,650 --> 00:19:10,740
+اعمل attendanceيعني حتى ال reflex بيكون أظهر في
+
+199
+00:19:10,740 --> 00:19:16,740
+الحالة هذه ال reflex بتاع الشبكية بيكون أسرع وأوضح
+
+200
+00:19:16,740 --> 00:19:21,440
+خاصة في الأطفال اللي هم مش متسائلين معايا أو مش
+
+201
+00:19:21,440 --> 00:19:27,260
+معطيني فرصة اني انا اعمل اللي هو التلسكوب الصحيح
+
+202
+00:19:27,260 --> 00:19:31,080
+طيب يبقى هذه ال five indications
+
+203
+00:19:36,930 --> 00:19:41,530
+أنا مش routine، خليني أقول أنا مش routine، في ناس
+
+204
+00:19:41,530 --> 00:19:44,170
+هتقول أول ما عمله أنا objective و بعدين
+
+205
+00:19:44,170 --> 00:19:49,650
+subjective، تشوف، full connection، خاصة في الكبار،
+
+206
+00:19:49,650 --> 00:19:54,470
+لأن الcyclopedia في الكبار هتعمل ضياء وقت و جهود،
+
+207
+00:19:54,470 --> 00:20:00,630
+مش هيقرأ ولا هو هيستخدم عينيه زي الناسلكن لو ال
+
+208
+00:20:00,630 --> 00:20:03,730
+indications هذه واحد منها موجود على طول انا مضطر
+
+209
+00:20:03,730 --> 00:20:08,550
+ان اعمل ايش؟ Cycloplasia طيب ما هي ال contra
+
+210
+00:20:08,550 --> 00:20:15,490
+indications for Cycloplasia examination؟ هو همشي
+
+211
+00:20:15,490 --> 00:20:23,130
+ايش؟ ان يكون عندي market narrowing of the angle of
+
+212
+00:20:23,130 --> 00:20:30,160
+EC ال angle of EC لو كانت marked انهأنا بخاف من ال
+
+213
+00:20:30,160 --> 00:20:39,800
+sacrifice ليش بخاف؟ هذا معروف
+
+214
+00:20:39,800 --> 00:20:50,240
+معروف هي الحقيقة يعني أحداث مع بعض ال sacrifice هي
+
+215
+00:20:50,240 --> 00:20:57,120
+ساحبها dilatation و ال dilatation هيكون ال ال ال
+
+216
+00:20:57,120 --> 00:20:58,220
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+217
+00:20:58,220 --> 00:20:58,260
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+218
+00:20:58,260 --> 00:20:58,280
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+219
+00:20:58,280 --> 00:20:58,300
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+220
+00:20:58,300 --> 00:20:58,320
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+221
+00:20:58,910 --> 00:21:04,370
+أو الـ IRIS يتغط على الزاوية و يوقع فإذا كانت هي
+
+222
+00:21:04,370 --> 00:21:09,170
+أساسا ضيقة فتغرق بسرعة و هيفدأ الـ Intraacral
+
+223
+00:21:09,170 --> 00:21:14,990
+pressure يصعب فلو كانت نار و ناره ممكن يصير acute
+
+224
+00:21:14,990 --> 00:21:23,210
+congestive glaucoma attack وهذه مصيبة في العين زي
+
+225
+00:21:23,210 --> 00:21:28,670
+مثلا مصيبةفي الـ coronary accidents بتاعة القلب
+
+226
+00:21:28,670 --> 00:21:35,350
+كيف اللي عنده attack في القلب نوة قلبيا خطيرة
+
+227
+00:21:35,350 --> 00:21:40,190
+بالنسبالي العين زيك يعني لو صابها انتفاع في الـ
+
+228
+00:21:40,190 --> 00:21:43,830
+intraocular pressure الى fifty او sixty اه يعني
+
+229
+00:21:43,830 --> 00:21:50,730
+العين بتتدمر شيء خطير هذا لبس ال conditions of
+
+230
+00:21:50,730 --> 00:21:54,250
+normally shallow anterior chamber طب كيف نتنبأ
+
+231
+00:22:00,300 --> 00:22:04,640
+يعني ان الانجل شروي عند العين هذا اذا كان الانجل
+
+232
+00:22:04,640 --> 00:22:12,160
+عيب او مترو اذا كان عيب يعني فوق الفور مثلا فور
+
+233
+00:22:12,160 --> 00:22:18,960
+فايف سيكس اه اه اكيد لان العين كلها ايش صغير فبدلا
+
+234
+00:22:18,960 --> 00:22:24,920
+من ان صغير هتكون الانجل صغير لذا الانجل مترو من
+
+235
+00:22:24,920 --> 00:22:33,220
+فور و اكتر هؤلاء عارفين لإيشالى ال attack حتى بدون
+
+236
+00:22:33,220 --> 00:22:40,460
+جرحى حتى بدون مدريازيس بدون مدريازيس هم مرضى لهذا
+
+237
+00:22:40,460 --> 00:22:49,340
+لكن المدريازيس risky عمل خطر to dislocation or
+
+238
+00:22:49,340 --> 00:22:57,000
+subluxation of the crystalline lens يعني لما يكون
+
+239
+00:22:57,000 --> 00:23:04,880
+ال lensdislocated واجعة او subluxated يعني الذريول
+
+240
+00:23:04,880 --> 00:23:12,500
+في تقاطعة كمان في الحالة هذه انا مابعطيه لانه انا
+
+241
+00:23:12,500 --> 00:23:17,280
+حتى لو اعملت psychological مافيش response مافيش
+
+242
+00:23:17,280 --> 00:23:25,220
+response من ورا الذريول يا مش موجودة في الحالة
+
+243
+00:23:25,220 --> 00:23:28,600
+الأولى مش موجودة في الحالة الأولىلما تكون في
+
+244
+00:23:28,600 --> 00:23:31,940
+dislocation، جاء الناس ضايعة، الذنوب مش تشتغل على
+
+245
+00:23:31,940 --> 00:23:36,920
+إيش، هنا الباقي الذنوب، لإن الذنوب بتوصل بنياش
+
+246
+00:23:36,920 --> 00:23:42,880
+سرري، بودي، وبيتس، لكويتر، أوف، ده ناس، from the
+
+247
+00:23:42,880 --> 00:23:47,140
+scattish lands، مافيش ذنوب، والحاجة التانية، لو في
+
+248
+00:23:47,140 --> 00:23:51,920
+تمزق في الذنوب، في بعض أركان، وفي decentralization
+
+249
+00:23:51,920 --> 00:23:54,300
+of the lands، كيف decentralization؟
+
+250
+00:23:57,200 --> 00:23:59,840
+مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش
+
+251
+00:23:59,840 --> 00:23:59,860
+مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش
+
+252
+00:23:59,860 --> 00:24:00,200
+مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش
+
+253
+00:24:00,200 --> 00:24:03,160
+مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش
+
+254
+00:24:03,160 --> 00:24:03,200
+مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش
+
+255
+00:24:03,200 --> 00:24:03,800
+مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش
+
+256
+00:24:03,800 --> 00:24:04,560
+مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش
+
+257
+00:24:04,560 --> 00:24:04,980
+مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش
+
+258
+00:24:04,980 --> 00:24:08,120
+مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش
+
+259
+00:24:08,120 --> 00:24:11,760
+مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش
+
+260
+00:24:11,760 --> 00:24:15,480
+مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش
+
+261
+00:24:15,480 --> 00:24:21,880
+مش مش
+
+262
+00:24:23,280 --> 00:24:26,540
+طبعا احنا ال psychological بنعملها لأطفال ليش؟
+
+263
+00:24:26,540 --> 00:24:33,280
+لأنهم عندهم powerful cellular muscle لكن الناس
+
+264
+00:24:33,280 --> 00:24:38,260
+كبار السن ليش نعملها؟ هي الcellular muscle الآن
+
+265
+00:24:38,260 --> 00:24:45,520
+weak، ضعيفة، لكن إن كان و لابد اني انا في حالة ما
+
+266
+00:24:45,520 --> 00:24:48,540
+حياتي بدي اعمل للناس بالنسبة و الناس الكبار السن
+
+267
+00:24:49,620 --> 00:24:53,360
+بدي أنا أراهي موضوع الـ angle of view و ربما أني
+
+268
+00:24:53,360 --> 00:24:57,500
+أشوفها بالـ Gonioscope عارفين فحص الـ Gonioscope؟
+
+269
+00:24:57,500 --> 00:25:00,400
+و الـ Scoping؟ ستة لا؟ و الـ Goniolase؟ و الـ
+
+270
+00:25:00,400 --> 00:25:03,620
+Goniolase؟
+
+271
+00:25:03,620 --> 00:25:07,120
+طيب، ideal properties of psychopathics ما هي
+
+272
+00:25:07,120 --> 00:25:12,840
+المثالية في عالم Psychopathics؟ يعني لو أنت بدك
+
+273
+00:25:12,840 --> 00:25:16,540
+مثلا جوال، بدك جوال مثالي
+
+274
+00:25:21,700 --> 00:25:25,420
+بس فيش جوال فيه تمام شروق تاعي ممكن يكون فيه تلاتة
+
+275
+00:25:25,420 --> 00:25:29,960
+اربع خمسة لكن الباقية لسه مستنة لان بس
+
+276
+00:25:29,960 --> 00:25:33,340
+psychopedics فعلا انا بدي psychopedic واحد كل
+
+277
+00:25:33,340 --> 00:25:40,140
+quick and awesome احطه في خلال دقائق يكون عامل
+
+278
+00:25:40,140 --> 00:25:41,520
+effect بتاعي واحد مش موجود
+
+279
+00:25:44,650 --> 00:25:47,810
+مثلا الاتروبيل بده ساعة وفوق الساعة بده ياخدوه في
+
+280
+00:25:47,810 --> 00:25:51,010
+البيت اللي لسه عايش يكملونه باقي الأيام فالاتروبيل
+
+281
+00:25:51,010 --> 00:25:57,550
+هي ورطة انا اعمل cyclopedia بالاتروبيل ايه هو لكن
+
+282
+00:25:57,550 --> 00:26:01,790
+حتى انا بده اعمل بالcycloventilate يعني قبل اربعين
+
+283
+00:26:01,790 --> 00:26:06,370
+دقيقة مش هقدر انا انفذ اللي هو الفحص بتاعي ثاني
+
+284
+00:26:06,370 --> 00:26:09,510
+فهو بيقولك و احنا بيجانب و بيقولك ليش هالسنة
+
+285
+00:26:09,510 --> 00:26:15,450
+اربعين دقيقة ليش بكلها اربع دقات مثلاالأسكان
+
+286
+00:26:15,450 --> 00:26:19,630
+المثالية المفروضة هو في عالم الإنسان، بعد الأنبياء
+
+287
+00:26:19,630 --> 00:26:26,190
+عليه المسلم، في المثالية المطلقة في البشر، مافيش،
+
+288
+00:26:26,190 --> 00:26:29,910
+فالأسكان مافيش مثالية مطلقة في البشر، كيف يكون في
+
+289
+00:26:29,910 --> 00:26:34,410
+مصانع البشر، مثلا في سيارة فيها كل facilities أو
+
+290
+00:26:34,410 --> 00:26:38,010
+فيها كل facility، ولا فيها رجل ولا امرأة، فيها كل
+
+291
+00:26:38,010 --> 00:26:42,910
+facilities، مافيش، لكن الأقل في المثالية إيه كويس؟
+
+292
+00:26:44,100 --> 00:26:49,320
+يعني انا برضه ال 70% وفوق يعني ماشي واضح طيب ال
+
+293
+00:26:49,320 --> 00:26:54,100
+quick onset too provides a equal depth of
+
+294
+00:26:54,100 --> 00:26:57,260
+cycloplasia يعني اذا حطب سيكلوبنتوليت مثلا
+
+295
+00:26:57,260 --> 00:27:05,000
+بيبنطينا 100% شلم للعضلة دي سيكلوبليزيا وهذا مش
+
+296
+00:27:05,000 --> 00:27:10,560
+موجود انا موجود مش موجود provides a equal duration
+
+297
+00:27:10,560 --> 00:27:12,300
+of cycloplasia
+
+298
+00:27:14,970 --> 00:27:24,050
+يعني هو يعطيني ال duration على جد الفحص، بعد
+
+299
+00:27:24,050 --> 00:27:28,790
+الفحص لازم ايش؟ ال time، فانا مجرد الحلقة على طول،
+
+300
+00:27:28,790 --> 00:27:34,530
+صح؟ does not cause me diarrheesis، وهذه الأخطريعني
+
+301
+00:27:34,530 --> 00:27:39,710
+أنا من دي cycle ندير كيشتغل على العضلة ال cycle
+
+302
+00:27:39,710 --> 00:27:44,550
+اللي هو العضلة ال celery muscle ومايشتغلش على
+
+303
+00:27:44,550 --> 00:27:48,610
+جهدها، وفادل سياق مشغول، لإنه بيشتركوا في الحدود
+
+304
+00:27:48,610 --> 00:27:55,110
+الجغرافية و الحدود العصبية، طرف العصبية، ف causes
+
+305
+00:27:56,040 --> 00:27:59,500
+لأنه ليش لما يفهم اللي هو مدريازيز بيعمل ال
+
+306
+00:27:59,500 --> 00:28:04,100
+operations من ال sunlight و الاشي هذا يعني بيصير
+
+307
+00:28:04,100 --> 00:28:08,740
+اه فيه فوتوفوبيا صعب انه يمشي صعب انه يتحرك او
+
+308
+00:28:08,740 --> 00:28:15,060
+يسوق سيارة طيب causes no other pharmacological
+
+309
+00:28:15,060 --> 00:28:20,900
+effect مالوحليش عن القلب اه و يعمل سخونة و يعمل
+
+310
+00:28:20,900 --> 00:28:26,830
+ايه في الدم اه يعني هذا بديش يعني ولا يعملlocal
+
+311
+00:28:26,830 --> 00:28:30,870
+toxicity in the eye مايعنيش allergy مايعنيش تأثير
+
+312
+00:28:30,870 --> 00:28:39,230
+bad effect على الكورية ويخليها transparent مثلا او
+
+313
+00:28:39,230 --> 00:28:45,130
+يخلي فيها إدينة أو يخلي فيها إدهار أو حاجة هذه
+
+314
+00:28:45,130 --> 00:28:48,550
+الأشياء في ال ideal properties اللي احنا بنتظر
+
+315
+00:28:48,550 --> 00:28:52,070
+العلم يحققها ان شاء الله
+
+316
+00:28:58,880 --> 00:29:01,520
+عند الـcyclopedia الـ full ecstatic refraction
+
+317
+00:29:01,520 --> 00:29:06,520
+يمكن أن يكون استمتع بدون انتفار من اي نوع من
+
+318
+00:29:06,520 --> 00:29:10,780
+الاقومديشن يعني انا لو عملت full of cyclopedia
+
+319
+00:29:10,780 --> 00:29:18,820
+باعرف ان كل الاقومديشن راح يكون أبسط وانا بريحني،
+
+320
+00:29:18,820 --> 00:29:22,480
+this is particularly important in the very young
+
+321
+00:29:22,480 --> 00:29:24,160
+ليش very young؟
+
+322
+00:29:30,510 --> 00:29:35,290
+يعني طفل عمره سنة أو سنة و نص أو سنتين و عنده شوية
+
+323
+00:29:35,290 --> 00:29:39,950
+ايزوتروفيا او ايزوفوريا كله هنا من العقل في direct
+
+324
+00:29:39,950 --> 00:29:44,590
+relation between the strength of the muscle and
+
+325
+00:29:44,590 --> 00:29:49,790
+the deviation of the ice يبقى
+
+326
+00:29:49,790 --> 00:29:51,350
+this is particular
+
+327
+00:30:08,520 --> 00:30:12,180
+وهذا يفيدني بالقطرة أني بقدر أعرف
+
+328
+00:30:23,220 --> 00:30:28,480
+يقول إن الـ Full Cyclopidic Correction Found is
+
+329
+00:30:28,480 --> 00:30:31,440
+not necessarily given in any subsequent
+
+330
+00:30:31,440 --> 00:30:35,660
+prescription that is deemed to be necessary يعني
+
+331
+00:30:35,660 --> 00:30:39,520
+أنا بدأ أقول إنه مش شاطر، إنه لو طلع عندي ليال
+
+332
+00:30:39,520 --> 00:30:45,340
+الهيتن، Hypermetropia-7، إنه أكتبله seven، لأ هذه
+
+333
+00:30:45,340 --> 00:30:46,240
+فيها درس
+
+334
+00:30:57,340 --> 00:31:04,100
+معرفة الاختصارات السيكروباليجية هي أكتر من أهمية
+
+335
+00:31:04,100 --> 00:31:08,140
+جدًا، خاصة أننا سنتحدث الآن عن الاختصارات
+
+336
+00:31:08,140 --> 00:31:12,940
+السيكروباليجية والأهمية بتاعتها.أولًا، الناس
+
+337
+00:31:12,940 --> 00:31:16,300
+الصغيرة في
+
+338
+00:31:16,300 --> 00:31:20,460
+موقع مستمر أو مستمر
+
+339
+00:31:41,190 --> 00:31:44,750
+لما يكون لديهم intermittent أو constant استردظمس
+
+340
+00:31:44,750 --> 00:31:54,730
+شيء ثابت أو شيء متقطع ولا كتير بيصير في طالبات
+
+341
+00:31:54,730 --> 00:32:03,090
+ثانوية شفير أسينوبيا وهي دي دوخة لإن السيارة دي
+
+342
+00:32:03,090 --> 00:32:05,350
+مصل مع الدراسة بتصير more active
+
+343
+00:32:12,020 --> 00:32:17,380
+الصبح لأ، في الحالة هذه مصير منها psychologic
+
+344
+00:32:17,380 --> 00:32:23,380
+reflection to medium to high heterophoria فوريا،
+
+345
+00:32:23,380 --> 00:32:33,680
+ايش فوريا؟ او latent squint اما ايزو او اكزو او
+
+346
+00:32:33,680 --> 00:32:41,030
+هايبرد او هايفوريا او سودو مايوبياسيدوميوبيا ايش
+
+347
+00:32:41,030 --> 00:32:49,250
+سيدوميوبيا؟ يعني هو
+
+348
+00:32:49,250 --> 00:32:55,910
+في وضع الراحة الراحة هو امترو لكن بعد ساعات من
+
+349
+00:32:55,910 --> 00:33:01,370
+التعب يبدأ لا يرى البعيد لا يرى البعيد ايوة بسبب
+
+350
+00:33:01,370 --> 00:33:04,610
+ال hyper activity يعني دي مش هقول spasm بقول hyper
+
+351
+00:33:04,610 --> 00:33:08,710
+activity او السنة المفصلة يبدأ مثلا نظرا هو six
+
+352
+00:33:08,710 --> 00:33:09,010
+six
+
+353
+00:33:17,090 --> 00:33:21,770
+و جيبي تاني اوم و ماشوف 66 يبقى مش true myopia
+
+354
+00:33:21,770 --> 00:33:27,730
+solo myopia زائفة three were marked as cumulative
+
+355
+00:33:27,730 --> 00:33:32,190
+asthmatic symptoms اول ما اقرا بالكتاب نصف ساعة
+
+356
+00:33:32,190 --> 00:33:41,610
+يبدأ blurring of vision pain in the eye headache
+
+357
+00:33:41,610 --> 00:33:43,610
+drowsiness
+
+358
+00:33:46,890 --> 00:33:52,470
+عن inability to read clearly، كل هذه complaints
+
+359
+00:33:52,470 --> 00:33:56,250
+بيجي العيان منها، في الastronomy example، تفضل في
+
+360
+00:33:56,250 --> 00:33:59,730
+حالة السودميوبيا، إنه إذا استمر الإرهاق، هتصير
+
+361
+00:33:59,730 --> 00:34:04,930
+ميوبيا عادية يعني؟ في ممكنية تصير؟ هو الحقيقة
+
+362
+00:34:26,680 --> 00:34:30,280
+و راح نشوف قريب مع الصداع الشديد والألم و عدم
+
+363
+00:34:30,280 --> 00:34:35,980
+القدر على استخدامه في أي useful work لذلك يعني
+
+364
+00:34:35,980 --> 00:34:39,580
+احنا لما واحد بيبدأ معا حديثة من ال .. ال .. اللي
+
+365
+00:34:39,580 --> 00:34:45,080
+هو ال anxiety و ال over work المفروض ال risk و
+
+366
+00:34:45,080 --> 00:34:45,920
+بعدين correction
+
+367
+00:35:00,700 --> 00:35:05,600
+لكن فيما بعد ممكن مرة يصيبه attack و بسبازة أو
+
+368
+00:35:05,600 --> 00:35:12,220
+celery muscle و يبقى احنا في ال attack شهور طيب
+
+369
+00:35:12,220 --> 00:35:17,640
+reflection under cyclopedia is unnatural because
+
+370
+00:35:17,640 --> 00:35:21,720
+the shape of the lens has been changed كيف ال lens
+
+371
+00:35:21,720 --> 00:35:22,620
+بصير فيها؟
+
+372
+00:35:37,400 --> 00:35:42,560
+لأ ب Syria Flat بس Psychopedia ب Syria Flat طب مين
+
+373
+00:35:42,560 --> 00:35:47,960
+يقول اليك ب Syria Flat؟ ماعشان ماعشان ماعشان
+
+374
+00:35:47,960 --> 00:35:52,320
+ماعشان ماعشان
+
+375
+00:35:52,320 --> 00:35:57,540
+ماعشان ماعشان ماعشان ماعشان
+
+376
+00:35:57,540 --> 00:36:00,740
+ماعشان ماعشان ماعشان ماعشان ماعشان ماعشان ماعشان
+
+377
+00:36:00,740 --> 00:36:01,400
+ماعشان ماعشان ماعشان ماعشان ماعشان ماعشان ماعشان
+
+378
+00:36:01,400 --> 00:36:02,700
+ماعشان ماعشان ماعشان ماعشان ماعشان ماعشان ماعشان
+
+379
+00:36:02,700 --> 00:36:05,700
+ماعشان ماعشان ماعشان ماعشان ماعشان ماعشان
+
+380
+00:36:16,160 --> 00:36:22,240
+رجعت بريفري هيك، شدت الزنيولز، لما شدت الزنيولز
+
+381
+00:36:22,240 --> 00:36:27,200
+شدوا على ال equator لما
+
+382
+00:36:27,200 --> 00:36:29,240
+شدت الزنيولز شدوا على ال equator لما شدت الزنيولز
+
+383
+00:36:29,240 --> 00:36:29,320
+شدوا على ال equator لما شدت الزنيولز شدوا على ال
+
+384
+00:36:29,320 --> 00:36:29,580
+equator لما شدت الزنيولز شدوا على ال equator لما
+
+385
+00:36:29,580 --> 00:36:29,620
+شدت الزنيولز شدوا على ال equator لما شدت الزنيولز
+
+386
+00:36:29,620 --> 00:36:29,720
+شدوا على ال equator لما شدت الزنيولز شدوا على ال
+
+387
+00:36:29,720 --> 00:36:30,760
+equator لما شدت الزنيولز شدوا على ال equator لما
+
+388
+00:36:30,760 --> 00:36:32,340
+شدت الزنيولز شدوا على ال equator لما شدت الزنيولز
+
+389
+00:36:32,340 --> 00:36:32,780
+شدت الزنيولز شدت الزنيولز شدت الزنيولز شدت
+
+390
+00:36:32,780 --> 00:36:33,440
+الزنيولز شدت ال
+
+391
+00:37:04,190 --> 00:37:14,010
+الوضع صار كتالي، اول كان اخر، الان هنا هنا حصلت
+
+392
+00:37:14,010 --> 00:37:15,750
+هنا، وانا
+
+393
+00:37:30,410 --> 00:37:35,790
+لما زميلون شغال عليها traction، الـ Lens أصبحت
+
+394
+00:37:35,790 --> 00:37:41,190
+more flat أو الـ Lens is fake، الـ Lens is fake
+
+395
+00:37:41,190 --> 00:37:49,090
+هذا الوضع طبعا مشهور وضع طبيعي، يعني صار تبير
+
+396
+00:37:49,090 --> 00:37:50,230
+تشريحي
+
+397
+00:37:57,680 --> 00:38:02,340
+فهذه العرسة بتستنى، زوال السبق عشان ترجع إلى
+
+398
+00:38:02,340 --> 00:38:07,600
+الأصلي، فعشان أيه بيقولك؟ Unnatural، مش غير طبيعي،
+
+399
+00:38:07,600 --> 00:38:12,520
+مش غير طبيعي، لأن شكل اللحظة تم تغييره، وهذا سيقوم
+
+400
+00:38:12,520 --> 00:38:22,300
+بإعادة شكلها في شكل عادل، عندما ينتهي،
+
+401
+00:38:22,300 --> 00:38:23,100
+ستستهيد شكلها.
+
+402
+00:38:37,270 --> 00:38:41,990
+عشان تعمل .. شايفك انا ان في ال latent hypertrophy
+
+403
+00:38:41,990 --> 00:38:51,070
+عالي، بعمل قمل فحص، precyclopidic refraction،
+
+404
+00:38:51,070 --> 00:38:55,290
+وبحطه في الملف، وبحط الققر على مدة كافية
+
+405
+00:39:06,060 --> 00:39:10,720
+وهي مقارنة في كل حاجة بقى من الاناء و هتستغرب أنت
+
+406
+00:39:10,720 --> 00:39:15,600
+من المقارنة لأن أحيانا يكون فيه فرق شاسع The
+
+407
+00:39:15,600 --> 00:39:18,340
+optical aberrations present with the widely
+
+408
+00:39:18,340 --> 00:39:22,620
+dilated pupil are then very much reduced لما يروح
+
+409
+00:39:22,620 --> 00:39:26,500
+أثر قطرة بالتدريج المدريازز هيختفي
+
+410
+00:39:40,030 --> 00:39:43,650
+في اللي هو العدسة و غير انها وسعت وعملت
+
+411
+00:39:43,650 --> 00:39:50,510
+aberrations وعملت .. لأ أثر على العين يعني تغيير
+
+412
+00:39:50,510 --> 00:39:54,550
+في العين او photophobia او اشي بقول ليه؟ فيه
+
+413
+00:39:54,550 --> 00:39:58,490
+additional اللي هو disadvantages one making an
+
+414
+00:39:58,490 --> 00:40:02,770
+allowance for the dependent tool of the cerebral
+
+415
+00:40:02,770 --> 00:40:11,810
+muscle يعني صار بقولك انه العين حقيقةمش هتشتغل صح
+
+416
+00:40:11,810 --> 00:40:16,830
+إلا بالقطرة، إزاي صار تعود على القطرة؟ اه تعود
+
+417
+00:40:16,830 --> 00:40:22,930
+يعني أنا بقول habituation صار إنه ال .. في ال ..
+
+418
+00:40:22,930 --> 00:40:28,410
+ال عبارة في hyper activity، ساعت ما خدت القطرة،
+
+419
+00:40:28,410 --> 00:40:35,150
+توقف ال hyper activity، لما راحت القطرة و قطرها،
+
+420
+00:40:35,150 --> 00:40:39,200
+already قتل hyper activityكانت بتقول مزيد من
+
+421
+00:40:39,200 --> 00:40:43,220
+القطرة، يعني إنه ما ستسكت، الفعالية بتاعتها إزاي
+
+422
+00:40:43,220 --> 00:40:47,500
+ده إلا من القطرة، وهذا شغل، يعني مش أنا حاطت
+
+423
+00:40:47,500 --> 00:40:54,220
+القطرة مرة forever، مش أنا حاطت القطرة وقطعت ده من
+
+424
+00:40:54,220 --> 00:40:58,880
+ال hyperactivity، لأ، ست سبع ساعات، تمام ساعات،
+
+425
+00:40:58,880 --> 00:41:03,970
+يوم، وبعدين بنرجع إحنا لل hyperactivityفصار الـ
+
+426
+00:41:03,970 --> 00:41:10,950
+tone هنا تعود على العضلة to the dangers of
+
+427
+00:41:10,950 --> 00:41:14,570
+psychomedia، طبعا الـ psychomedia تقولنا أكيد تكون
+
+428
+00:41:14,570 --> 00:41:19,990
+جيستر فاتك والكلام هنا، لكن بيقولني، but as this
+
+429
+00:41:19,990 --> 00:41:25,450
+can be successfully overcome يمكن التحكم فيها، the
+
+430
+00:41:25,450 --> 00:41:30,630
+advantage of psychomedic refraction far outweigh
+
+431
+00:41:41,660 --> 00:41:48,020
+الميزة تغلبت على السيئة
+
+432
+00:41:48,020 --> 00:41:52,740
+ال disadvantage بكتير يعني سعر المزيد مثلا تمارين
+
+433
+00:41:52,740 --> 00:41:57,460
+في المية وال disadvantage عشانين في المية مميزتها
+
+434
+00:41:57,460 --> 00:42:03,540
+أكتر من عيوبها اه ده ال disadvantage طيب احنا الان
+
+435
+00:42:03,540 --> 00:42:08,080
+صحيح يعني انا مابقول لكوا يعني ممكنزي ما علمني
+
+436
+00:42:08,080 --> 00:42:14,100
+دكتور يعني في ال .. انه انت لو عملت لو واحد أضلت
+
+437
+00:42:14,100 --> 00:42:21,580
+شويه مدريازز خاصة في موضوع ال .. ال .. diabetes
+
+438
+00:42:21,580 --> 00:42:24,600
+mellitus بيخافي كتير فيهم من درجة الكنوباتين
+
+439
+00:42:24,600 --> 00:42:34,040
+فالفحص بدون مدريازز inefficient مش كافي فاحنا
+
+440
+00:42:34,040 --> 00:42:42,410
+بنعطيهمن هنا يا عزيزي و بنعمله detail examination
+
+441
+00:42:42,410 --> 00:42:46,310
+of the fungus و
+
+442
+00:42:46,310 --> 00:42:50,110
+بعدين اقوله روح بيتك بقول لأ اياك تقوله روح بيتك
+
+443
+00:42:50,110 --> 00:42:51,110
+احد امرين
+
+444
+00:43:04,490 --> 00:43:07,790
+عشان لما انت تروح تنام في الليل تكون انت مرتاح
+
+445
+00:43:07,790 --> 00:43:12,730
+ضميرك، ما تقولش عنده تصرفية، هيروح مرضك، سجاق،
+
+446
+00:43:12,730 --> 00:43:17,950
+ألم، يعني بداية attack، لأ، تحطله ايش؟ بيرو
+
+447
+00:43:17,950 --> 00:43:22,910
+كاربين، يبقى بتخلي عندك في المكتب طول من تجاهد ال
+
+448
+00:43:22,910 --> 00:43:28,010
+supervision، يا إما أنت تعطي أبو يابو كاربين عشان
+
+449
+00:43:28,010 --> 00:43:32,550
+يعمل تضييق ويوجه الحالة للطبيعة
+
+450
+00:43:42,530 --> 00:43:47,530
+طب دكتور الفترة اللي دخلي قعد فيها عندي هتتروح من
+
+451
+00:43:47,530 --> 00:43:56,490
+ربع الساعة لقدت؟ أقل شي ساعتين ساعتين؟ اه طيب الان
+
+452
+00:43:56,490 --> 00:44:01,150
+احنا قولنا ان في pre-psychopathic و في post
+
+453
+00:44:01,150 --> 00:44:04,960
+-psychopathicكان الناس اللي بيعملوا طول
+
+454
+00:44:04,960 --> 00:44:10,200
+الـcyclomatic path لغالطين لأنه مش عارف قرن القطرة
+
+455
+00:44:10,200 --> 00:44:17,860
+إيش هو ده؟ بكفيش فحص واحد إلا فحص قرن القطرة و فحص
+
+456
+00:44:17,860 --> 00:44:21,660
+بعد القطرة خاصة في الـisotopes و خاصة في الناس
+
+457
+00:44:21,660 --> 00:44:27,900
+اللي لإنه مسباز أو أكملهم لذلك في الـprecyclomatic
+
+458
+00:44:27,900 --> 00:44:30,760
+examination such an examination will include the
+
+459
+00:44:30,760 --> 00:44:35,970
+flowيجب أن يحتوي على التقن، symptoms of the
+
+460
+00:44:35,970 --> 00:44:39,190
+disease،
+
+461
+00:44:39,190 --> 00:44:43,530
+يعني أنا مش بدأ أدخل إنسان هو يعني علبة أقوله good
+
+462
+00:44:43,530 --> 00:44:49,850
+عشان أتحصك، بدأ أسأل، إيش الأعراض، وإذا كان طفل
+
+463
+00:44:49,850 --> 00:44:53,930
+أسأل أمه، إيش الأعراض اللي انتم شايفينها؟
+
+464
+00:45:00,020 --> 00:45:08,580
+2 اوكلر و ميتيكال history التاريخ بتاع المرضى هل
+
+465
+00:45:08,580 --> 00:45:13,400
+سبب انه فحص سبب لبس نضارة؟ ايش القطرة اللى
+
+466
+00:45:13,400 --> 00:45:21,220
+استخدمها فى الفحص؟ كمان هل مازال بياخد قطرات؟ هل
+
+467
+00:45:21,220 --> 00:45:28,220
+بياخد أدوية؟ و لا كده 3 استخدم اي تاريخ تحريك
+
+468
+00:45:28,220 --> 00:45:32,870
+بالعينحساسية في العلم، سواء حساسية هادية،
+
+469
+00:45:32,870 --> 00:45:37,310
+spontaneous، لحالة، أو induced، induced يعني إيش؟
+
+470
+00:45:37,310 --> 00:45:41,530
+مسبرة، بأي قطرات، عشان أنا ما أضعش الاشي تاني هو
+
+471
+00:45:41,530 --> 00:45:46,630
+هو، manifest refraction with vision and visual
+
+472
+00:45:46,630 --> 00:45:48,670
+acuity at distance and distance يعني أنا بدي
+
+473
+00:45:48,670 --> 00:45:51,770
+أعمله، أنا manifest refraction، without drops،
+
+474
+00:45:51,770 --> 00:45:59,730
+وشوفله ال visual acuity، قبل كل شيءو دايما كانوا
+
+475
+00:45:59,730 --> 00:46:03,370
+أساسيتنا يقولوا اهو اتفرج ال video لك و كده فانت
+
+476
+00:46:03,370 --> 00:46:08,710
+اعمله reflection ليش؟
+
+477
+00:46:08,710 --> 00:46:14,210
+انا
+
+478
+00:46:14,210 --> 00:46:18,250
+لسه ماتكلمش عن قطرة، ماتكلمش عن قطرة، بس الكلام
+
+479
+00:46:18,250 --> 00:46:23,910
+عليها لسه precyclopathy هذا صحيح دعاية ممتازة،
+
+480
+00:46:23,910 --> 00:46:31,110
+ممتازة دعاية، انا لو حطيت اي نوق في عينهممكن إنه
+
+481
+00:46:31,110 --> 00:46:35,750
+يعمله شوية blurring وتغيير في قدرته على التركيز
+
+482
+00:46:35,750 --> 00:46:40,570
+لذلك أنا أجيب و أخار من الأول بسأله كام سؤال
+
+483
+00:46:40,570 --> 00:46:46,110
+وبعدين بجلسه ستة متر من أثنين right eye then left
+
+484
+00:46:46,110 --> 00:46:50,790
+eye separately طيب
+
+485
+00:46:50,790 --> 00:46:56,730
+determination أو binocular status يعني binocular
+
+486
+00:46:56,730 --> 00:46:56,990
+single
+
+487
+00:47:05,480 --> 00:47:10,600
+كفار تست وكفار انكفار تست وربما انا استخدم ال
+
+488
+00:47:10,600 --> 00:47:15,000
+Prism ال Prism كفار تست وكفار انكفار انكفار انكفار
+
+489
+00:47:15,000 --> 00:47:18,440
+انكفار انكفار انكفار انكفار انكفار انكفار انكفار
+
+490
+00:47:18,440 --> 00:47:18,560
+انكفار انكفار انكفار انكفار انكفار انكفار انكفار
+
+491
+00:47:18,560 --> 00:47:18,740
+انكفار انكفار انكفار انكفار انكفار انكفار انكفار
+
+492
+00:47:18,740 --> 00:47:31,040
+انكفار انك
+
+493
+00:47:32,240 --> 00:47:35,740
+كل الحاجات التالية اللي أسأل عنها اللي هو ال
+
+494
+00:47:35,740 --> 00:47:41,020
+history و ال symptoms و ال visual acuity اه و ال
+
+495
+00:47:41,020 --> 00:47:47,220
+cover test و locomotivity او اه كل كل هذا قبل ما
+
+496
+00:47:47,220 --> 00:47:53,520
+انا اضع قطرة طيب المرحلة التالية ان شاء الله
+
+497
+00:47:53,520 --> 00:47:58,320
+بتتكلم في external examination of the eye برضه
+
+498
+00:47:58,320 --> 00:47:59,700
+تابع precyclopathy
+
+499
+00:48:02,910 --> 00:48:05,190
+أراكم على خصم استماع وان شاء الله المرة القادمة
+
+500
+00:48:05,190 --> 00:48:06,850
+نكمل هذا بإذن الله
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/HEgwN2Qfy0g_raw.json b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/HEgwN2Qfy0g_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..a0817156838ad3106d32345eb2680fd7476b7ac1
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/HEgwN2Qfy0g_raw.json
@@ -0,0 +1 @@
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"end": 595.77, "word": "بس", "probability": 0.903076171875}, {"start": 595.77, "end": 596.03, "word": " احنا", "probability": 0.9026692708333334}, {"start": 596.03, "end": 596.53, "word": " مابيعملش", "probability": 0.6964925130208334}, {"start": 596.53, "end": 596.89, "word": " شلل", "probability": 0.9615885416666666}, {"start": 596.89, "end": 597.51, "word": " زي", "probability": 0.82421875}, {"start": 597.51, "end": 597.89, "word": " شلل", "probability": 0.9641927083333334}, {"start": 597.89, "end": 599.09, "word": " الجلطات", "probability": 0.9127197265625}, {"start": 599.09, "end": 599.77, "word": " الدماغية", "probability": 0.94931640625}, {"start": 599.77, "end": 599.91, "word": " مثلا،", "probability": 0.69970703125}, {"start": 599.91, "end": 600.13, "word": " شلل", "probability": 0.8525390625}, {"start": 600.13, "end": 601.03, "word": " الدائم،", "probability": 0.78314208984375}, {"start": 601.03, "end": 601.21, "word": " لأ", "probability": 0.84765625}, {"start": 601.21, 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"end": 607.15, "word": " paralyze", "probability": 0.911376953125}, {"start": 607.15, "end": 607.65, "word": " the", "probability": 0.9140625}, {"start": 607.65, "end": 607.85, "word": " cere", "probability": 0.305419921875}, {"start": 607.85, "end": 608.25, "word": " muscle", "probability": 0.65673828125}, {"start": 608.25, "end": 608.87, "word": " by", "probability": 0.962890625}, {"start": 608.87, "end": 609.55, "word": " blocking", "probability": 0.86279296875}, {"start": 609.55, "end": 610.09, "word": " the", "probability": 0.9208984375}, {"start": 610.09, "end": 610.59, "word": " muscular", "probability": 0.8131510416666666}, {"start": 610.59, "end": 611.31, "word": " receptors", "probability": 0.8564453125}, {"start": 611.31, "end": 611.97, "word": " that", "probability": 0.939453125}, {"start": 611.97, "end": 612.23, "word": " are", "probability": 0.94775390625}, {"start": 612.23, "end": 612.57, "word": " normally", "probability": 0.9169921875}, {"start": 612.57, "end": 613.19, "word": " stimulated", "probability": 0.9775390625}, {"start": 613.19, "end": 614.03, "word": " by", "probability": 0.970703125}, {"start": 614.03, "end": 614.27, "word": " the", "probability": 0.892578125}, {"start": 614.27, "end": 615.29, "word": " release", "probability": 0.82763671875}, {"start": 615.29, "end": 615.87, "word": " of", "probability": 0.97802734375}, {"start": 615.87, "end": 616.07, "word": " a", "probability": 0.431396484375}, {"start": 616.07, "end": 616.69, "word": " styproline", "probability": 0.319580078125}, {"start": 616.69, "end": 616.99, "word": " from", "probability": 0.8984375}, {"start": 616.99, "end": 617.23, "word": " the", "probability": 0.8056640625}, {"start": 617.23, "end": 617.37, "word": " nerve", "probability": 0.92626953125}, {"start": 617.37, "end": 618.43, "word": " endings", "probability": 0.98974609375}, {"start": 618.43, "end": 618.73, "word": " of", "probability": 0.96875}, {"start": 618.73, "end": 618.91, "word": " the", "probability": 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692.52, "end": 693.34, "word": " البراسيمبتاتيك", "probability": 0.6544596354166666}, {"start": 693.34, "end": 693.66, "word": " ليعمل", "probability": 0.4956868489583333}, {"start": 693.66, "end": 693.94, "word": " system", "probability": 0.1602783203125}, {"start": 693.94, "end": 694.4, "word": " also", "probability": 0.364013671875}, {"start": 694.4, "end": 695.16, "word": " renovates", "probability": 0.877197265625}, {"start": 695.16, "end": 695.78, "word": " the", "probability": 0.53955078125}, {"start": 695.78, "end": 696.26, "word": " pupil", "probability": 0.85791015625}, {"start": 696.26, "end": 697.48, "word": " sphincter", "probability": 0.751739501953125}, {"start": 697.48, "end": 697.86, "word": " muscle", "probability": 0.9384765625}, {"start": 697.86, "end": 702.3, "word": " براسيمبتاتيك", "probability": 0.8559027777777778}, {"start": 702.3, "end": 703.76, "word": " وسايد", "probability": 0.3830159505208333}, {"start": 703.76, "end": 704.46, "word": " muscle", 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784.71, "text": "وصار توسية، هل هذا دليل على أنه صار Sacroblige؟ سؤال آخر، هل ممكن الموسى اللي هو مدرميل", "tokens": [2407, 9381, 9640, 33427, 3794, 10632, 12399, 8032, 1211, 23758, 11778, 20292, 1211, 15844, 14739, 3224, 20328, 9640, 19356, 340, 5199, 3969, 22807, 8608, 33604, 6027, 19753, 34740, 12399, 8032, 1211, 3714, 43020, 9673, 41779, 7578, 13672, 1829, 31439, 3714, 3215, 2288, 2304, 26895], "avg_logprob": -0.34392361640930175, "compression_ratio": 1.2231404958677685, "no_speech_prob": 5.960464477539063e-08, "words": [{"start": 771.59, "end": 771.95, "word": "وصار", "probability": 0.7604166666666666}, {"start": 771.95, "end": 773.09, "word": " توسية،", "probability": 0.58233642578125}, {"start": 773.09, "end": 773.47, "word": " هل", "probability": 0.95361328125}, {"start": 773.47, "end": 773.77, "word": " هذا", "probability": 0.79736328125}, {"start": 773.77, "end": 774.19, "word": " دليل", "probability": 0.9798177083333334}, {"start": 774.19, "end": 774.35, "word": " على", 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"start": 793.06, "end": 822.56, "text": "وعالمرسل المفتكر أمامي اللي هي الـSphincter Lupilli مش على السلان مش على السلان ايه ماسلان قاعد يوصي بالسلان muscle نسبة 10-20% لكن غير كافية انه اعمل انا petroscopy under cyclopedia it should be noted that مدريازس is not always evidence of an accompanying cyclopedia and mainly the case present of the Sphincter Lupilli muscle Cyclopedics are used to prevent or reduce accommodation during refraction", "tokens": [2407, 3615, 45340, 2288, 3794, 1211, 9673, 5172, 2655, 4117, 2288, 5551, 2304, 10943, 1829, 13672, 1829, 39896, 2423, 39184, 50, 950, 5460, 260, 44319, 31922, 37893, 15844, 21136, 15040, 1863, 37893, 15844, 21136, 15040, 1863, 1975, 1829, 3224, 19446, 3794, 1211, 7649, 12174, 995, 22488, 7251, 2407, 9381, 1829, 20666, 3794, 15040, 1863, 8679, 8717, 35457, 3660, 1266, 12, 2009, 4, 44381, 32771, 13546, 9122, 31845, 10632, 16472, 3224, 1975, 25957, 1211, 1975, 8315, 3817, 38006, 88, 833, 19474, 47795, 309, 820, 312, 12964, 300, 3714, 3215, 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فحص سبب لبس نضارة؟ ايش القطرة اللى استخدمها فى الفحص؟ كمان هل مازال بياخد قطرات؟ هل بياخد أدوية؟ و لا كده 3 استخدم اي تاريخ تحريك بالعين", "tokens": [17, 1975, 2407, 28820, 2288, 4032, 3714, 1829, 31371, 4117, 6027, 2503, 16712, 9640, 1829, 9778, 39894, 45761, 9673, 43042, 7578, 8032, 1211, 8608, 3555, 3555, 16472, 3224, 6156, 5016, 9381, 8608, 3555, 3555, 5296, 3555, 3794, 8717, 11242, 9640, 3660, 22807, 1975, 1829, 8592, 25062, 9566, 25720, 13672, 7578, 44713, 9778, 40448, 11296, 6156, 7578, 27188, 5016, 9381, 22807, 9122, 2304, 7649, 8032, 1211, 3714, 31377, 6027, 4724, 1829, 47283, 3215, 12174, 9566, 2288, 9307, 22807, 8032, 1211, 4724, 1829, 47283, 3215, 5551, 3215, 2407, 10632, 22807, 4032, 20193, 9122, 3215, 3224, 805, 1975, 14851, 9778, 40448, 1975, 1829, 6055, 9640, 1829, 9778, 6055, 5016, 16572, 4117, 20666, 3615, 9957], "avg_logprob": -0.37806921106364044, "compression_ratio": 1.7085427135678393, "no_speech_prob": 0.0, "words": [{"start": 2700.02, "end": 2700.2, "word": "2", 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"probability": 0.982177734375}, {"start": 2838.74, "end": 2838.74, "word": " انكفار", "probability": 0.9818115234375}, {"start": 2838.74, "end": 2838.74, "word": " انكفار", "probability": 0.9814453125}, {"start": 2838.74, "end": 2851.04, "word": " انك", "probability": 0.961669921875}], "temperature": 1.0}, {"id": 95, "seek": 287970, "start": 2852.24, "end": 2879.7, "text": "كل الحاجات التالية اللي أسأل عنها اللي هو ال history و ال symptoms و ال visual acuity اه و ال cover test و locomotivity او اه كل كل هذا قبل ما انا اضع قطرة طيب المرحلة التالية ان شاء الله بتتكلم في external examination of the eye برضه تابع precyclopathy", "tokens": [28820, 21542, 26108, 9307, 16712, 6027, 10632, 13672, 1829, 5551, 3794, 10721, 1211, 18871, 11296, 13672, 1829, 31439, 2423, 2503, 4032, 2423, 8332, 4032, 2423, 5056, 696, 21757, 1975, 3224, 4032, 2423, 2060, 1500, 4032, 36369, 310, 4253, 1975, 2407, 1975, 3224, 28242, 28242, 23758, 12174, 36150, 19446, 1975, 8315, 1975, 11242, 3615, 12174, 9566, 25720, 23032, 1829, 3555, 9673, 2288, 5016, 37977, 16712, 6027, 10632, 16472, 13412, 16606, 21984, 39894, 2655, 4117, 19528, 8978, 8320, 23874, 295, 264, 3313, 4724, 43042, 3224, 6055, 16758, 3615, 659, 34080, 404, 9527], "avg_logprob": -0.34701235346741727, "compression_ratio": 1.6043478260869566, "no_speech_prob": 0.0, "words": [{"start": 2852.24, "end": 2852.54, "word": "كل", "probability": 0.403564453125}, {"start": 2852.54, "end": 2852.88, "word": " الحاجات", "probability": 0.7076822916666666}, {"start": 2852.88, "end": 2853.24, "word": " التالية", "probability": 0.6209309895833334}, {"start": 2853.24, "end": 2853.74, "word": " اللي", "probability": 0.44635009765625}, {"start": 2853.74, "end": 2854.7, "word": " أسأل", "probability": 0.801513671875}, {"start": 2854.7, "end": 2855.12, "word": " عنها", "probability": 0.60888671875}, {"start": 2855.12, "end": 2855.5, "word": " اللي", "probability": 0.6051025390625}, {"start": 2855.5, "end": 2855.64, "word": " هو", "probability": 0.90478515625}, {"start": 2855.64, "end": 2855.74, "word": " ال", "probability": 0.67236328125}, {"start": 2855.74, "end": 2856.1, "word": " history", "probability": 0.50146484375}, {"start": 2856.1, "end": 2856.7, "word": " و", "probability": 0.468017578125}, {"start": 2856.7, "end": 2856.8, "word": " ال", "probability": 0.9296875}, {"start": 2856.8, "end": 2857.36, "word": " symptoms", "probability": 0.92529296875}, {"start": 2857.36, "end": 2857.96, "word": " و", "probability": 0.96435546875}, {"start": 2857.96, "end": 2858.08, "word": " ال", "probability": 0.9326171875}, {"start": 2858.08, "end": 2858.42, "word": " visual", "probability": 0.97216796875}, {"start": 2858.42, "end": 2858.98, "word": " acuity", "probability": 0.852294921875}, {"start": 2858.98, "end": 2859.6, "word": " اه", "probability": 0.41326904296875}, {"start": 2859.6, "end": 2860.46, "word": " و", "probability": 0.7060546875}, {"start": 2860.46, "end": 2861.02, "word": " ال", "probability": 0.88232421875}, {"start": 2861.02, "end": 2861.56, "word": " cover", "probability": 0.8408203125}, {"start": 2861.56, "end": 2862.04, "word": " test", "probability": 0.83544921875}, {"start": 2862.04, "end": 2862.8, "word": " و", "probability": 0.97705078125}, {"start": 2862.8, "end": 2863.92, "word": " locomotivity", "probability": 0.65771484375}, {"start": 2863.92, "end": 2865.5, "word": " او", "probability": 0.737548828125}, {"start": 2865.5, "end": 2865.86, "word": " اه", "probability": 0.92822265625}, {"start": 2865.86, "end": 2866.1, "word": " كل", "probability": 0.77978515625}, {"start": 2866.1, "end": 2866.34, "word": " كل", "probability": 0.81396484375}, {"start": 2866.34, "end": 2866.68, "word": " هذا", "probability": 0.76220703125}, {"start": 2866.68, "end": 2867.02, "word": " قبل", "probability": 0.99169921875}, {"start": 2867.02, "end": 2867.22, "word": " ما", "probability": 0.74267578125}, {"start": 2867.22, "end": 2867.62, "word": " انا", "probability": 0.812255859375}, {"start": 2867.62, "end": 2868.1, "word": " اضع", "probability": 0.5215657552083334}, {"start": 2868.1, "end": 2868.82, "word": " قطرة", "probability": 0.9705403645833334}, {"start": 2868.82, "end": 2869.98, "word": " طيب", "probability": 0.7368570963541666}, {"start": 2869.98, "end": 2872.92, "word": " المرحلة", "probability": 0.890625}, {"start": 2872.92, "end": 2873.06, "word": " التالية", "probability": 0.7918294270833334}, {"start": 2873.06, "end": 2873.2, "word": " ان", "probability": 0.767578125}, {"start": 2873.2, "end": 2873.42, "word": " شاء", "probability": 0.942626953125}, {"start": 2873.42, "end": 2873.52, "word": " الله", "probability": 0.9599609375}, {"start": 2873.52, "end": 2874.18, "word": " بتتكلم", "probability": 0.7457275390625}, {"start": 2874.18, "end": 2874.52, "word": " في", "probability": 0.96142578125}, {"start": 2874.52, "end": 2876.88, "word": " external", "probability": 0.873046875}, {"start": 2876.88, "end": 2877.44, "word": " examination", "probability": 0.93994140625}, {"start": 2877.44, "end": 2877.64, "word": " of", "probability": 0.96875}, {"start": 2877.64, "end": 2877.74, "word": " the", "probability": 0.90185546875}, {"start": 2877.74, "end": 2877.94, "word": " eye", "probability": 0.9013671875}, {"start": 2877.94, "end": 2878.32, "word": " برضه", "probability": 0.9163411458333334}, {"start": 2878.32, "end": 2878.66, "word": " تابع", "probability": 0.5741373697916666}, {"start": 2878.66, "end": 2879.7, "word": " precyclopathy", "probability": 0.54290771484375}], "temperature": 1.0}, {"id": 96, "seek": 288685, "start": 2882.91, "end": 2886.85, "text": "أراكم على خصم استماع وان شاء الله المرة القادمة نكمل هذا بإذن الله", "tokens": [10721, 23557, 24793, 15844, 16490, 9381, 2304, 44713, 15042, 3615, 4032, 7649, 13412, 16606, 21984, 9673, 25720, 25062, 18513, 46007, 8717, 24793, 1211, 23758, 4724, 28814, 8848, 1863, 21984], "avg_logprob": -0.2815104285875956, "compression_ratio": 1.3186813186813187, "no_speech_prob": 7.748603820800781e-07, "words": [{"start": 2882.91, "end": 2883.03, "word": "أراكم", "probability": 0.4914957682291667}, {"start": 2883.03, "end": 2883.17, "word": " على", "probability": 0.84228515625}, {"start": 2883.17, "end": 2883.41, "word": " خصم", "probability": 0.5729573567708334}, {"start": 2883.41, "end": 2883.91, "word": " استماع", "probability": 0.8430989583333334}, {"start": 2883.91, "end": 2884.31, "word": " وان", "probability": 0.60986328125}, {"start": 2884.31, "end": 2884.41, "word": " شاء", "probability": 0.944091796875}, {"start": 2884.41, "end": 2884.49, "word": " الله", "probability": 0.74072265625}, {"start": 2884.49, "end": 2884.71, "word": " المرة", "probability": 0.838623046875}, {"start": 2884.71, "end": 2885.19, "word": " القادمة", "probability": 0.99365234375}, {"start": 2885.19, "end": 2886.03, "word": " نكمل", "probability": 0.9645182291666666}, {"start": 2886.03, "end": 2886.37, "word": " هذا", "probability": 0.8984375}, {"start": 2886.37, "end": 2886.69, "word": " بإذن", "probability": 0.8978271484375}, {"start": 2886.69, "end": 2886.85, "word": " الله", "probability": 0.94140625}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 2887.70325, "duration_after_vad": 2431.8018749999883}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/HEgwN2Qfy0g_raw.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/HEgwN2Qfy0g_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..ba114156303f8a34103211ba7f8836ce3472239d
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/HEgwN2Qfy0g_raw.srt
@@ -0,0 +1,2060 @@
+1
+00:00:23,440 --> 00:00:26,820
+الحمد لله رب العالمين وأصلي و أسلم على النبي
+
+2
+00:00:26,820 --> 00:00:30,460
+الأمين محمد وعلى آله وأصحابه والتابعين السلام
+
+3
+00:00:30,460 --> 00:00:34,900
+عليكم ورحمة الله وبركاته في هذه المحاضرة سنكمل
+
+4
+00:00:34,900 --> 00:00:40,520
+ويكون قبلانا من selection of drugs and patients in
+
+5
+00:00:40,520 --> 00:00:45,220
+optometry اختيار المرضى واختيار الأدوية في تخصص
+
+6
+00:00:45,220 --> 00:00:52,740
+البصرية الآن انا هسأل العيان
+
+7
+00:00:56,660 --> 00:01:03,880
+أو أضع له Tropic A معي أو أضع له ال Pyrocarbine في
+
+8
+00:01:03,880 --> 00:01:10,900
+عينه قدت أسئلة for safety من قدر السلام first
+
+9
+00:01:10,900 --> 00:01:15,440
+question will the patient benefit from the use of
+
+10
+00:01:15,440 --> 00:01:19,880
+a particular diagnostic drug؟ بتقولهم انت هتستفيد
+
+11
+00:01:19,880 --> 00:01:25,960
+من هذا الدواء في التشخيصمثلا في الـ retinoscopy في
+
+12
+00:01:25,960 --> 00:01:33,160
+الحوار في التشخيص كمان بسأل has the particular
+
+13
+00:01:33,160 --> 00:01:37,000
+drug been applied to this patient before؟ بنقوله
+
+14
+00:01:37,000 --> 00:01:42,200
+هل سبق أن استخدم هذا الدواء في العين مثلا الموسع
+
+15
+00:01:42,200 --> 00:01:46,900
+مع كتير يعني الناس عندهم سكري في الشفاكية بيعملهم
+
+16
+00:01:46,900 --> 00:01:51,740
+توسيع بيقولوا هل سبق أنه حد وضع
+
+17
+00:01:55,690 --> 00:01:59,910
+يقول هل الطفل هذا وضعوله أتروبيل مثلا قبل هيك عشان
+
+18
+00:01:59,910 --> 00:02:02,390
+انا أفهم وإذا كان وضعوله أتروبيل طبعا بيجي كلام
+
+19
+00:02:02,390 --> 00:02:07,990
+بعد هيك if so إذا كان استخدم نفس العلاج و يدير
+
+20
+00:02:07,990 --> 00:02:11,430
+were there any adverse reactions or allergic
+
+21
+00:02:11,430 --> 00:02:16,710
+responses هل الحادثة له مضاعفات أو أثار جانبية من
+
+22
+00:02:16,710 --> 00:02:23,530
+هذا ال drug سواء صغيرة كانة أو كبيرة لأن إذا كان
+
+23
+00:02:23,530 --> 00:02:27,910
+هو عمله مضاعفات مش هعطيها تانيةحتى لو ده ورق
+
+24
+00:02:27,910 --> 00:02:32,090
+بالفم، يعني واحد أخد ورق بالفم وعمله رفع لقطة
+
+25
+00:02:32,090 --> 00:02:36,770
+الدم، سرعة، أول ما أشوفه لأ، بيقول هذا مفرطر الدم
+
+26
+00:02:36,770 --> 00:02:40,890
+ليه؟ ماخدهوش فاهم، خلاص، واحد انه حاجة البنسالين
+
+27
+00:02:40,890 --> 00:02:45,930
+مرة، و عنده حسية عمره ما برجع لبنسالين تانية، يبقى
+
+28
+00:02:45,930 --> 00:02:49,270
+قبل ما أخضع القطرة في عينه، بدي أسأل، هل هذه
+
+29
+00:02:49,270 --> 00:02:52,990
+القطرة استخدمت قبل ذلك؟ انه قال لأ، لأ
+
+30
+00:03:08,330 --> 00:03:12,610
+يعني condition يعني ايش disease that would make
+
+31
+00:03:12,610 --> 00:03:17,310
+the use of this drug inadvisable
+
+32
+00:03:17,310 --> 00:03:21,210
+بينصح بيه مثلا high intraocular pressure هذي يعني
+
+33
+00:03:21,210 --> 00:03:25,710
+مثال وهذا انه high intraocular pressure ومعروف ان
+
+34
+00:03:25,710 --> 00:03:32,570
+مركبات الكورتيزون ترفضر تلاقي ايه فانا لما سألتههل
+
+35
+00:03:32,570 --> 00:03:37,090
+إذا كنت عندك أي حاجة في العيد، تقول اللي هو ضغط
+
+36
+00:03:37,090 --> 00:03:43,850
+العلم مرتفع و باخده قطرة التيمولين مثلا، تمولول،
+
+37
+00:03:43,850 --> 00:03:50,150
+مابعودش انا اعطيه كورتيزان، لو كان ضغطه الآن مع
+
+38
+00:03:50,150 --> 00:03:54,970
+التيمولول control، مجرد ما اخده كورتيزان، حصير
+
+39
+00:03:54,970 --> 00:04:01,520
+uncontrol، هي للي 30 و أكتر من 305- Are there any
+
+40
+00:04:01,520 --> 00:04:03,840
+systemic conditions that would be
+
+41
+00:04:03,840 --> 00:04:09,800
+contraindications for the drugs used؟ هل بيعاني في
+
+42
+00:04:09,800 --> 00:04:16,980
+سكته؟ Systemic disease مثلا، diabetes mellitus
+
+43
+00:04:16,980 --> 00:04:24,780
+مثلا، hypertension بطن؟ Cardiac disease عنده حاجة
+
+44
+00:04:24,780 --> 00:04:27,140
+في سكته بحيث أن بعض القطرات
+
+45
+00:04:34,000 --> 00:04:36,520
+و هذا طبعا اللي بتستخدم العلاج زي اللي بتستخدم
+
+46
+00:04:36,520 --> 00:04:40,800
+السلاح اللي استخدم السلاح منه فمايكونش مدرب عليه و
+
+47
+00:04:40,800 --> 00:04:45,240
+عارف كيف يعني استخدامه و العلاج نفس الشيء زي
+
+48
+00:04:45,240 --> 00:04:50,600
+السلاح ممكن الإنسان اللي ماقعش في العلاج يأذي
+
+49
+00:04:50,600 --> 00:04:55,180
+المريض زي اللي ماقعش في السلاح يأذي نفسه و يأذي
+
+50
+00:04:55,180 --> 00:05:01,000
+الناس السلاح دو حتين يعني هذا العلاج إيه بس كان
+
+51
+00:05:01,000 --> 00:05:02,820
+عنده شيء في القلب
+
+52
+00:05:07,650 --> 00:05:12,310
+ممكن جدا الاتك لقومة باتكرار انه اتأثر على القلب
+
+53
+00:05:12,310 --> 00:05:17,870
+سالما Is the patient currently taking any medicine
+
+54
+00:05:17,870 --> 00:05:22,390
+that could interact with the diagnostic drug؟ الهي
+
+55
+00:05:22,390 --> 00:05:27,410
+drug interaction يعني هل هو يعني تعود على أخذ علاج
+
+56
+00:05:27,410 --> 00:05:32,210
+معين لعلاج حالة معينة وانا بدي أحطله القطرة قد
+
+57
+00:05:32,210 --> 00:05:36,470
+تتفاعل مع العلاج اللي هو بياخده باستمرار
+
+58
+00:05:47,660 --> 00:05:52,140
+بتكلم الان عن selection of drug and concentration
+
+59
+00:05:52,140 --> 00:05:57,120
+خلصنا المريض، فهمنا المريض، اذا انا drug؟ بيقوللي
+
+60
+00:05:57,120 --> 00:06:06,620
+في ال drug، في حاجتين اول حاجة concentration يعني
+
+61
+00:06:06,620 --> 00:06:13,000
+انا لازم اختار ال concentration المناسب للمريض حسب
+
+62
+00:06:13,000 --> 00:06:21,750
+وزنه وحسب سنهحسب وزنه و حسب سنه الان مثلا انا عندي
+
+63
+00:06:21,750 --> 00:06:34,270
+قطرة تمولين فيها 0.25 Pearson و في 0.5 0.25
+
+64
+00:06:34,270 --> 00:06:42,150
+Pearson for children و 0.5 for adults الان مانفعش
+
+65
+00:06:42,150 --> 00:06:43,750
+اعطي الرقم
+
+66
+00:06:51,040 --> 00:06:57,700
+هذه الحاجة الان لو انجد لصيدري في ال pharmacy
+
+67
+00:06:57,700 --> 00:07:06,860
+صيدرية وصفة تمناع القباس المفروض
+
+68
+00:07:06,860 --> 00:07:12,720
+ان هو حسب المعروف القبي يوصف الجوع الأصغر حفاظا
+
+69
+00:07:12,720 --> 00:07:16,720
+على صحت المريض طبيب
+
+70
+00:07:16,720 --> 00:07:24,200
+تاني كاتب AspirinTablets يعني أقراص و بس المفروض
+
+71
+00:07:24,200 --> 00:07:28,940
+أن الصيدري يعطي أصغر جرعة من الأسبرين اللي هي 100
+
+72
+00:07:28,940 --> 00:07:33,140
+ميلي جرام بتاعة ال baby aspirin ماعطوه مش إيش ال
+
+73
+00:07:33,140 --> 00:07:38,320
+500 يعني يبقى هيك الغرف يبقى ملي ملي مار
+
+74
+00:07:38,320 --> 00:07:41,260
+concentrations of drugs were made available in the
+
+75
+00:07:41,260 --> 00:07:45,750
+past في الماضيكانت الجمهورات المهيئة الصغيرة their
+
+76
+00:07:45,750 --> 00:07:49,310
+use was poor and their production was discontinued
+
+77
+00:07:49,310 --> 00:07:55,630
+يعني حاجة ربع بس هي مليون مانفعش if there is any
+
+78
+00:07:55,630 --> 00:07:59,510
+doubt as to which concentration to use then the
+
+79
+00:07:59,510 --> 00:08:03,090
+lower one should always be employed زي ما قلنا لو
+
+80
+00:08:03,090 --> 00:08:07,830
+كانت هو سمين بس ماحطوش كده يعني العيار بتاع و
+
+81
+00:08:07,830 --> 00:08:12,500
+بعطيها أجهزة في ال similaritybetween two drugs,
+
+82
+00:08:12,780 --> 00:08:15,440
+the weaker one with the shorter duration will
+
+83
+00:08:15,440 --> 00:08:30,100
+often be the drug of choice لذلك
+
+84
+00:08:30,100 --> 00:08:33,520
+الطبيب الحاضر هو اللي بيوصف ال concentration
+
+85
+00:08:33,520 --> 00:08:38,180
+والنسبة المقلية المظبوطةبس مش اللي هو ال .. ال ..
+
+86
+00:08:38,180 --> 00:08:43,400
+ال pharmacist الصيدري و ليس المريض محتر، اللي ما
+
+87
+00:08:43,400 --> 00:08:48,180
+طلعش تركيز معين أو اسم معينة، هم باعطوا أقل شيء،
+
+88
+00:08:48,180 --> 00:08:53,500
+حفظة على صحة المريض طيب، الآن هنكون في ال chapter
+
+89
+00:08:53,500 --> 00:08:58,580
+11، diagnostic drugs and products used in
+
+90
+00:08:58,580 --> 00:09:04,480
+optometry الأجوة التشخيصية التي تستخدم في عالم
+
+91
+00:09:04,480 --> 00:09:05,460
+البصرية
+
+92
+00:09:09,210 --> 00:09:16,390
+هنبدأ ب Cycloplegics هو أنا لما أقول Cycloplegia
+
+93
+00:09:16,390 --> 00:09:23,170
+معناه شلل العضلة الهدوية طيب لما أقول Hemiplegia
+
+94
+00:09:23,170 --> 00:09:30,310
+شلل نصف الإنسان، يبقى Plegia شلل، Hemi نصف يعني
+
+95
+00:09:40,790 --> 00:09:47,510
+فبنقول Paraplegia lower limbs، Paraplegia lower
+
+96
+00:09:47,510 --> 00:09:55,770
+limbs، Monoplegia و .. يبقى ال Psychopathicsبس
+
+97
+00:09:55,770 --> 00:09:59,910
+احنا مابيعملش شلل زي شلل الجلطات الدماغية مثلا،
+
+98
+00:09:59,910 --> 00:10:04,210
+شلل الدائم، لأ هذا شلل معقد، شلل سماعي يعني بقوله،
+
+99
+00:10:04,210 --> 00:10:07,650
+معقد. Psychopathics are drugs that paralyze the
+
+100
+00:10:07,650 --> 00:10:11,310
+cere muscle by blocking the muscular receptors
+
+101
+00:10:11,310 --> 00:10:16,070
+that are normally stimulated by the release of a
+
+102
+00:10:16,070 --> 00:10:18,910
+styproline from the nerve endings of the
+
+103
+00:10:18,910 --> 00:10:24,250
+parasympathetic system.طبعاً اللي هي الـ Muscular
+
+104
+00:10:24,250 --> 00:10:30,350
+Receptors زي ما تشايفين في الصورة هنا هذه الـ
+
+105
+00:10:30,350 --> 00:10:35,350
+Receptors مشتغل عليها الدوام وهي موجودة في الجسم،
+
+106
+00:10:35,350 --> 00:10:40,970
+في الـIris، في الـCellular Body احنا ننظر بهمنا
+
+107
+00:10:40,970 --> 00:10:44,830
+الآن في الـOptometer لكن موجودة في الـLateral
+
+108
+00:10:44,830 --> 00:10:47,470
+Malignant، في الـCellular Glands
+
+109
+00:10:59,090 --> 00:11:04,410
+هذه الـ Receptors اللي ما ممكن إنه الدعاء يدخل إلى
+
+110
+00:11:04,410 --> 00:11:10,430
+العضو إلا بعد أن تتفاعل بالدواء لتُفرِز أستايكولين
+
+111
+00:11:10,430 --> 00:11:16,730
+أستايكولين هذا اللي هو كيميكال تراسميتر اللي يعني
+
+112
+00:11:16,730 --> 00:11:20,570
+بيعمل ال initiation للنفد
+
+113
+00:11:20,570 --> 00:11:25,210
+العصبي في المكان هذا، هذا ماسكريك اللي هو Receptor
+
+114
+00:11:31,160 --> 00:11:35,780
+هذا البراسيمبتاتيك ليعمل system also renovates the
+
+115
+00:11:35,780 --> 00:11:42,300
+pupil sphincter muscle براسيمبتاتيك
+
+116
+00:11:42,300 --> 00:11:49,920
+وسايد muscle براسيمبتاتيك، يبقى اللي مع أنه أنا مش
+
+117
+00:11:49,920 --> 00:11:57,490
+هادف إلى ان اعمل sphincter muscle paralysisإلا إنه
+
+118
+00:11:57,490 --> 00:12:01,750
+بالمجوعة وراه، إيه ده وراه؟ يوثم على اللي هو
+
+119
+00:12:01,750 --> 00:12:04,910
+الـSphinctrapiopeli على شغل أساسي اللي
+
+120
+00:12:04,910 --> 00:12:09,690
+بالـcyclopidgic إيش؟ سرق المصر، طب إيش خاص اللي هو
+
+121
+00:12:09,690 --> 00:12:15,930
+الـsphinctrapiopeli؟ بالمجوعة، عشان البرسم مثلا،
+
+122
+00:12:15,930 --> 00:12:21,310
+لذا لو الـcyclopidgic مثلا بدورة من الـ8% على
+
+123
+00:12:21,310 --> 00:12:25,430
+السرق المصر، الحقيقة من الـ20% على الجارةاللي هي
+
+124
+00:12:25,430 --> 00:12:28,730
+إيش؟ Sphincter، Pupil muscle، و بُقى البُقى بُقى
+
+125
+00:12:28,730 --> 00:12:33,210
+إيش؟ موسّق، و سفيه aberrations، aberrations مش
+
+126
+00:12:33,210 --> 00:12:38,450
+تحمل بُقى طيب، should be noted that Mediasis is
+
+127
+00:12:38,450 --> 00:12:41,310
+not always evidence of an accompanying
+
+128
+00:12:41,310 --> 00:12:44,310
+psychopresia and mainly indicates paralysis of the
+
+129
+00:12:44,310 --> 00:12:45,190
+pupil sphincter
+
+130
+00:12:51,590 --> 00:12:55,690
+وصار توسية، هل هذا دليل على أنه صار Sacroblige؟
+
+131
+00:12:55,690 --> 00:13:04,710
+سؤال آخر، هل ممكن الموسى اللي هو مدرميل
+
+132
+00:13:13,060 --> 00:13:15,320
+وعالمرسل المفتكر أمامي اللي هي الـSphincter
+
+133
+00:13:15,320 --> 00:13:18,040
+Lupilli مش على السلان مش على السلان ايه ماسلان
+
+134
+00:13:18,040 --> 00:13:22,760
+قاعد يوصي بالسلان muscle نسبة 10-20% لكن غير كافية
+
+135
+00:13:22,760 --> 00:13:29,600
+انه اعمل انا petroscopy under cyclopedia it should
+
+136
+00:13:29,600 --> 00:13:32,780
+be noted that مدريازس is not always evidence of an
+
+137
+00:13:32,780 --> 00:13:34,680
+accompanying cyclopedia and mainly the case
+
+138
+00:13:34,680 --> 00:13:37,080
+present of the Sphincter Lupilli muscle
+
+139
+00:13:37,080 --> 00:13:40,240
+Cyclopedics are used to prevent or reduce
+
+140
+00:13:40,240 --> 00:13:44,740
+accommodation during refractionthus making latent
+
+141
+00:13:44,740 --> 00:13:49,640
+refractive error manifest مش نقول كفل، أنا بستخدم
+
+142
+00:13:49,640 --> 00:13:54,960
+psychromagic بستخدمه في حالات، هقولها بعد قليل،
+
+143
+00:13:54,960 --> 00:13:58,720
+شكرا indications
+
+144
+00:13:58,720 --> 00:14:04,420
+for psychromagic examination where
+
+145
+00:14:04,420 --> 00:14:09,800
+the use of psychromagics is indicated in the
+
+146
+00:14:09,800 --> 00:14:14,950
+following casesone, and the children with constant
+
+147
+00:14:14,950 --> 00:14:20,510
+or intermittent esotropy one and sometimes
+
+148
+00:14:20,510 --> 00:14:26,050
+subsequently initial presentation يعني إيش؟ يعني
+
+149
+00:14:26,050 --> 00:14:30,450
+الطفل دائما عنده إسوتروبي
+
+150
+00:14:40,060 --> 00:14:44,520
+يعني في الصباح، جاي من النوم، ماعنده ساكنة، ماعنده
+
+151
+00:14:44,520 --> 00:14:49,820
+إلتروبيا، بعد أهربا ده يبين، في المساء، بيان جدا،
+
+152
+00:14:49,820 --> 00:14:53,820
+لما ناموا الصباح، الصباح مافيش فيه، الناس بيقولوا،
+
+153
+00:14:53,820 --> 00:14:59,160
+قولوا، أيش؟ بيقولوا، أنا انت، او مين انت؟ ال tax
+
+154
+00:14:59,160 --> 00:15:02,420
+ال
+
+155
+00:15:02,420 --> 00:15:06,740
+indication التاني، ان ال children and young adults
+
+156
+00:15:06,740 --> 00:15:12,530
+with asthenopiaإجهاد العين and esophobia
+
+157
+00:15:12,530 --> 00:15:15,910
+especially when a latent refractive error is
+
+158
+00:15:15,910 --> 00:15:24,470
+suspected يعني الطفل في الحالة هذه أعمله لتنوسكبي
+
+159
+00:15:24,470 --> 00:15:29,210
+وده سايكروبريجيا طلع plus one في حد ما حطيتله
+
+160
+00:15:29,210 --> 00:15:36,650
+سايكروبريجيا طلع plus three يبقى في عنده latent في
+
+161
+00:15:36,650 --> 00:15:40,630
+عنده latentثالثًا، عندما تقوم الريتروسكوبية بإعطاء
+
+162
+00:15:40,630 --> 00:15:47,650
+تجارب التجارب تتجارب تجارب تجارب تجارب تجارب تجارب
+
+163
+00:15:47,650 --> 00:15:49,190
+تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب
+
+164
+00:15:49,190 --> 00:15:49,290
+تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب
+
+165
+00:15:49,290 --> 00:15:49,290
+تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب
+
+166
+00:15:49,290 --> 00:15:49,290
+تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب
+
+167
+00:15:49,290 --> 00:15:49,290
+تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب
+
+168
+00:15:49,290 --> 00:16:03,470
+تجارب تج
+
+169
+00:16:06,890 --> 00:16:11,170
+طيب ساكتنا، إيه معنى اسمه؟ طبعا plus one، هدس
+
+170
+00:16:11,170 --> 00:16:15,930
+مفلبتي و إتين، مفلبتي و إتين، بتطلع بنزل، سلري مصل
+
+171
+00:16:15,930 --> 00:16:20,490
+مش مستقرة، في الحالة دي أنا بتاخد قرار إن أنا عنه
+
+172
+00:16:20,490 --> 00:16:26,170
+إيش؟ psychopathy، حتى و لو كان adult، يعني وضع
+
+173
+00:16:26,170 --> 00:16:29,870
+السلري مصل بتاعته unstable، مش مستقل
+
+174
+00:16:32,600 --> 00:16:34,560
+الإبداع الرابع عندما تختلف إيجابات الريتينوسكو
+
+175
+00:16:34,560 --> 00:16:40,440
+بشكل كبير من إيجابات إتفاقية في حالة إتفاقات أو
+
+176
+00:16:40,440 --> 00:16:46,800
+إتفاقات يعني أنا
+
+177
+00:16:46,800 --> 00:16:55,840
+عملت كله ريتينو طلع مثلا plus one حطيته على شرط
+
+178
+00:16:55,840 --> 00:16:58,060
+سنانة شاشه
+
+179
+00:17:03,870 --> 00:17:10,290
+يعمل الـ plus one hypermetropia يعمل الـ 66 6 على
+
+180
+00:17:10,290 --> 00:17:16,890
+12 يبقى انا هتمضى دهني ان في شيء غلط احد امرين يا
+
+181
+00:17:16,890 --> 00:17:24,830
+اما الcell muscle hides لتن hypermetropia اكثر يا
+
+182
+00:17:24,830 --> 00:17:28,390
+اما في organic disease في organic disease من كترك
+
+183
+00:17:28,390 --> 00:17:34,590
+او في شيء في الاتنان او في شيء في النارلذلك انا
+
+184
+00:17:34,590 --> 00:17:39,050
+كautomatist في الحالة هذه لازم اعمله psychological
+
+185
+00:17:39,050 --> 00:17:43,090
+عشان اشوف ليش الفرق كبير عنده plus one ومشوف ستة ع
+
+186
+00:17:43,090 --> 00:17:48,510
+ستين مش معقولة في الأدبيات بتاعتنا مش موجودة يبقى
+
+187
+00:17:48,510 --> 00:17:52,370
+ال accommodation ممكن يكون عنده ايوة في ال
+
+188
+00:17:52,370 --> 00:17:57,910
+accommodation في anomalies زي insufficiency زي
+
+189
+00:17:57,910 --> 00:18:02,810
+fatigue زي inertia inertia ايش يعني خمولة
+
+190
+00:18:07,970 --> 00:18:11,730
+المهم كل الانمالي او الاجتماعات اللي أخدناها في
+
+191
+00:18:11,730 --> 00:18:18,470
+الـrefraction one كمأة كمان indication خامس ال
+
+192
+00:18:18,470 --> 00:18:21,290
+case where the endoscopy along the medial axis is
+
+193
+00:18:21,290 --> 00:18:26,930
+very difficult لدى و تلقى lack of cooperation من
+
+194
+00:18:26,930 --> 00:18:30,890
+ال patient يعني مش مساعدني other children or
+
+195
+00:18:30,890 --> 00:18:31,310
+mentors
+
+196
+00:18:37,430 --> 00:18:40,890
+يعني البقبق في الحالة العادية يعني بداية بتاعه
+
+197
+00:18:40,890 --> 00:18:47,790
+three to four اللي هو millimeter الحال لو فيش
+
+198
+00:18:47,790 --> 00:18:52,030
+cooperation صعب ان انا اركز في البقبق في المنتصف
+
+199
+00:18:52,030 --> 00:18:58,370
+في المركز بتاعي لكن لو انا وسعت البقبق صارت سبعة
+
+200
+00:18:58,370 --> 00:19:04,650
+او تمانية millimeter مكون هداياش افضل في ان انا
+
+201
+00:19:04,650 --> 00:19:10,740
+اعمل attendanceيعني حتى ال reflex بيكون أظهر في
+
+202
+00:19:10,740 --> 00:19:16,740
+الحالة هذه ال reflex بتاع الشبكية بيكون أسرع وأوضح
+
+203
+00:19:16,740 --> 00:19:21,440
+خاصة في الأطفال اللي هم مش متسائلين معايا أو مش
+
+204
+00:19:21,440 --> 00:19:27,260
+معطيني فرصة اني انا اعمل اللي هو التلسكوب الصحيح
+
+205
+00:19:27,260 --> 00:19:31,080
+طيب يبقى هذه ال five indications
+
+206
+00:19:36,930 --> 00:19:41,530
+أنا مش routine، خليني أقول أنا مش routine، في ناس
+
+207
+00:19:41,530 --> 00:19:44,170
+هتقول أول ما عمله أنا objective و بعدين
+
+208
+00:19:44,170 --> 00:19:49,650
+subjective، تشوف، full connection، خاصة في الكبار،
+
+209
+00:19:49,650 --> 00:19:54,470
+لأن الcyclopedia في الكبار هتعمل ضياء وقت و جهود،
+
+210
+00:19:54,470 --> 00:20:00,630
+مش هيقرأ ولا هو هيستخدم عينيه زي الناسلكن لو ال
+
+211
+00:20:00,630 --> 00:20:03,730
+indications هذه واحد منها موجود على طول انا مضطر
+
+212
+00:20:03,730 --> 00:20:08,550
+ان اعمل ايش؟ Cycloplasia طيب ما هي ال contra
+
+213
+00:20:08,550 --> 00:20:15,490
+indications for Cycloplasia examination؟ هو همشي
+
+214
+00:20:15,490 --> 00:20:23,130
+ايش؟ ان يكون عندي market narrowing of the angle of
+
+215
+00:20:23,130 --> 00:20:30,160
+EC ال angle of EC لو كانت marked انهأنا بخاف من ال
+
+216
+00:20:30,160 --> 00:20:39,800
+sacrifice ليش بخاف؟ هذا معروف
+
+217
+00:20:39,800 --> 00:20:50,240
+معروف هي الحقيقة يعني أحداث مع بعض ال sacrifice هي
+
+218
+00:20:50,240 --> 00:20:57,120
+ساحبها dilatation و ال dilatation هيكون ال ال ال
+
+219
+00:20:57,120 --> 00:20:58,220
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+220
+00:20:58,220 --> 00:20:58,260
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+221
+00:20:58,260 --> 00:20:58,280
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+222
+00:20:58,280 --> 00:20:58,300
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+223
+00:20:58,300 --> 00:20:58,300
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+224
+00:20:58,300 --> 00:20:58,300
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+225
+00:20:58,300 --> 00:20:58,300
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+226
+00:20:58,300 --> 00:20:58,300
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+227
+00:20:58,300 --> 00:20:58,300
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+228
+00:20:58,300 --> 00:20:58,320
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+229
+00:20:58,910 --> 00:21:04,370
+أو الـ IRIS يتغط على الزاوية و يوقع فإذا كانت هي
+
+230
+00:21:04,370 --> 00:21:09,170
+أساسا ضيقة فتغرق بسرعة و هيفدأ الـ Intraacral
+
+231
+00:21:09,170 --> 00:21:14,990
+pressure يصعب فلو كانت نار و ناره ممكن يصير acute
+
+232
+00:21:14,990 --> 00:21:23,210
+congestive glaucoma attack وهذه مصيبة في العين زي
+
+233
+00:21:23,210 --> 00:21:28,670
+مثلا مصيبةفي الـ coronary accidents بتاعة القلب
+
+234
+00:21:28,670 --> 00:21:35,350
+كيف اللي عنده attack في القلب نوة قلبيا خطيرة
+
+235
+00:21:35,350 --> 00:21:40,190
+بالنسبالي العين زيك يعني لو صابها انتفاع في الـ
+
+236
+00:21:40,190 --> 00:21:43,830
+intraocular pressure الى fifty او sixty اه يعني
+
+237
+00:21:43,830 --> 00:21:50,730
+العين بتتدمر شيء خطير هذا لبس ال conditions of
+
+238
+00:21:50,730 --> 00:21:54,250
+normally shallow anterior chamber طب كيف نتنبأ
+
+239
+00:22:00,300 --> 00:22:04,640
+يعني ان الانجل شروي عند العين هذا اذا كان الانجل
+
+240
+00:22:04,640 --> 00:22:12,160
+عيب او مترو اذا كان عيب يعني فوق الفور مثلا فور
+
+241
+00:22:12,160 --> 00:22:18,960
+فايف سيكس اه اه اكيد لان العين كلها ايش صغير فبدلا
+
+242
+00:22:18,960 --> 00:22:24,920
+من ان صغير هتكون الانجل صغير لذا الانجل مترو من
+
+243
+00:22:24,920 --> 00:22:33,220
+فور و اكتر هؤلاء عارفين لإيشالى ال attack حتى بدون
+
+244
+00:22:33,220 --> 00:22:40,460
+جرحى حتى بدون مدريازيس بدون مدريازيس هم مرضى لهذا
+
+245
+00:22:40,460 --> 00:22:49,340
+لكن المدريازيس risky عمل خطر to dislocation or
+
+246
+00:22:49,340 --> 00:22:57,000
+subluxation of the crystalline lens يعني لما يكون
+
+247
+00:22:57,000 --> 00:23:04,880
+ال lensdislocated واجعة او subluxated يعني الذريول
+
+248
+00:23:04,880 --> 00:23:12,500
+في تقاطعة كمان في الحالة هذه انا مابعطيه لانه انا
+
+249
+00:23:12,500 --> 00:23:17,280
+حتى لو اعملت psychological مافيش response مافيش
+
+250
+00:23:17,280 --> 00:23:25,220
+response من ورا الذريول يا مش موجودة في الحالة
+
+251
+00:23:25,220 --> 00:23:28,600
+الأولى مش موجودة في الحالة الأولىلما تكون في
+
+252
+00:23:28,600 --> 00:23:31,940
+dislocation، جاء الناس ضايعة، الذنوب مش تشتغل على
+
+253
+00:23:31,940 --> 00:23:36,920
+إيش، هنا الباقي الذنوب، لإن الذنوب بتوصل بنياش
+
+254
+00:23:36,920 --> 00:23:42,880
+سرري، بودي، وبيتس، لكويتر، أوف، ده ناس، from the
+
+255
+00:23:42,880 --> 00:23:47,140
+scattish lands، مافيش ذنوب، والحاجة التانية، لو في
+
+256
+00:23:47,140 --> 00:23:51,920
+تمزق في الذنوب، في بعض أركان، وفي decentralization
+
+257
+00:23:51,920 --> 00:23:54,300
+of the lands، كيف decentralization؟
+
+258
+00:23:57,200 --> 00:23:59,840
+مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش
+
+259
+00:23:59,840 --> 00:23:59,860
+مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش
+
+260
+00:23:59,860 --> 00:24:00,200
+مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش
+
+261
+00:24:00,200 --> 00:24:03,160
+مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش
+
+262
+00:24:03,160 --> 00:24:03,200
+مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش
+
+263
+00:24:03,200 --> 00:24:03,800
+مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش
+
+264
+00:24:03,800 --> 00:24:04,560
+مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش
+
+265
+00:24:04,560 --> 00:24:04,980
+مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش
+
+266
+00:24:04,980 --> 00:24:08,120
+مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش
+
+267
+00:24:08,120 --> 00:24:11,760
+مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش
+
+268
+00:24:11,760 --> 00:24:11,760
+مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش
+
+269
+00:24:11,760 --> 00:24:15,480
+مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش
+
+270
+00:24:15,480 --> 00:24:15,480
+مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش مش
+
+271
+00:24:15,480 --> 00:24:21,880
+مش مش
+
+272
+00:24:23,280 --> 00:24:26,540
+طبعا احنا ال psychological بنعملها لأطفال ليش؟
+
+273
+00:24:26,540 --> 00:24:33,280
+لأنهم عندهم powerful cellular muscle لكن الناس
+
+274
+00:24:33,280 --> 00:24:38,260
+كبار السن ليش نعملها؟ هي الcellular muscle الآن
+
+275
+00:24:38,260 --> 00:24:45,520
+weak، ضعيفة، لكن إن كان و لابد اني انا في حالة ما
+
+276
+00:24:45,520 --> 00:24:48,540
+حياتي بدي اعمل للناس بالنسبة و الناس الكبار السن
+
+277
+00:24:49,620 --> 00:24:53,360
+بدي أنا أراهي موضوع الـ angle of view و ربما أني
+
+278
+00:24:53,360 --> 00:24:57,500
+أشوفها بالـ Gonioscope عارفين فحص الـ Gonioscope؟
+
+279
+00:24:57,500 --> 00:25:00,400
+و الـ Scoping؟ ستة لا؟ و الـ Goniolase؟ و الـ
+
+280
+00:25:00,400 --> 00:25:03,620
+Goniolase؟
+
+281
+00:25:03,620 --> 00:25:07,120
+طيب، ideal properties of psychopathics ما هي
+
+282
+00:25:07,120 --> 00:25:12,840
+المثالية في عالم Psychopathics؟ يعني لو أنت بدك
+
+283
+00:25:12,840 --> 00:25:16,540
+مثلا جوال، بدك جوال مثالي
+
+284
+00:25:21,700 --> 00:25:25,420
+بس فيش جوال فيه تمام شروق تاعي ممكن يكون فيه تلاتة
+
+285
+00:25:25,420 --> 00:25:29,960
+اربع خمسة لكن الباقية لسه مستنة لان بس
+
+286
+00:25:29,960 --> 00:25:33,340
+psychopedics فعلا انا بدي psychopedic واحد كل
+
+287
+00:25:33,340 --> 00:25:40,140
+quick and awesome احطه في خلال دقائق يكون عامل
+
+288
+00:25:40,140 --> 00:25:41,520
+effect بتاعي واحد مش موجود
+
+289
+00:25:44,650 --> 00:25:47,810
+مثلا الاتروبيل بده ساعة وفوق الساعة بده ياخدوه في
+
+290
+00:25:47,810 --> 00:25:51,010
+البيت اللي لسه عايش يكملونه باقي الأيام فالاتروبيل
+
+291
+00:25:51,010 --> 00:25:57,550
+هي ورطة انا اعمل cyclopedia بالاتروبيل ايه هو لكن
+
+292
+00:25:57,550 --> 00:26:01,790
+حتى انا بده اعمل بالcycloventilate يعني قبل اربعين
+
+293
+00:26:01,790 --> 00:26:06,370
+دقيقة مش هقدر انا انفذ اللي هو الفحص بتاعي ثاني
+
+294
+00:26:06,370 --> 00:26:09,510
+فهو بيقولك و احنا بيجانب و بيقولك ليش هالسنة
+
+295
+00:26:09,510 --> 00:26:15,450
+اربعين دقيقة ليش بكلها اربع دقات مثلاالأسكان
+
+296
+00:26:15,450 --> 00:26:19,630
+المثالية المفروضة هو في عالم الإنسان، بعد الأنبياء
+
+297
+00:26:19,630 --> 00:26:26,190
+عليه المسلم، في المثالية المطلقة في البشر، مافيش،
+
+298
+00:26:26,190 --> 00:26:29,910
+فالأسكان مافيش مثالية مطلقة في البشر، كيف يكون في
+
+299
+00:26:29,910 --> 00:26:34,410
+مصانع البشر، مثلا في سيارة فيها كل facilities أو
+
+300
+00:26:34,410 --> 00:26:38,010
+فيها كل facility، ولا فيها رجل ولا امرأة، فيها كل
+
+301
+00:26:38,010 --> 00:26:42,910
+facilities، مافيش، لكن الأقل في المثالية إيه كويس؟
+
+302
+00:26:44,100 --> 00:26:49,320
+يعني انا برضه ال 70% وفوق يعني ماشي واضح طيب ال
+
+303
+00:26:49,320 --> 00:26:54,100
+quick onset too provides a equal depth of
+
+304
+00:26:54,100 --> 00:26:57,260
+cycloplasia يعني اذا حطب سيكلوبنتوليت مثلا
+
+305
+00:26:57,260 --> 00:27:05,000
+بيبنطينا 100% شلم للعضلة دي سيكلوبليزيا وهذا مش
+
+306
+00:27:05,000 --> 00:27:10,560
+موجود انا موجود مش موجود provides a equal duration
+
+307
+00:27:10,560 --> 00:27:12,300
+of cycloplasia
+
+308
+00:27:14,970 --> 00:27:24,050
+يعني هو يعطيني ال duration على جد الفحص، بعد
+
+309
+00:27:24,050 --> 00:27:28,790
+الفحص لازم ايش؟ ال time، فانا مجرد الحلقة على طول،
+
+310
+00:27:28,790 --> 00:27:34,530
+صح؟ does not cause me diarrheesis، وهذه الأخطريعني
+
+311
+00:27:34,530 --> 00:27:39,710
+أنا من دي cycle ندير كيشتغل على العضلة ال cycle
+
+312
+00:27:39,710 --> 00:27:44,550
+اللي هو العضلة ال celery muscle ومايشتغلش على
+
+313
+00:27:44,550 --> 00:27:48,610
+جهدها، وفادل سياق مشغول، لإنه بيشتركوا في الحدود
+
+314
+00:27:48,610 --> 00:27:55,110
+الجغرافية و الحدود العصبية، طرف العصبية، ف causes
+
+315
+00:27:56,040 --> 00:27:59,500
+لأنه ليش لما يفهم اللي هو مدريازيز بيعمل ال
+
+316
+00:27:59,500 --> 00:28:04,100
+operations من ال sunlight و الاشي هذا يعني بيصير
+
+317
+00:28:04,100 --> 00:28:08,740
+اه فيه فوتوفوبيا صعب انه يمشي صعب انه يتحرك او
+
+318
+00:28:08,740 --> 00:28:15,060
+يسوق سيارة طيب causes no other pharmacological
+
+319
+00:28:15,060 --> 00:28:20,900
+effect مالوحليش عن القلب اه و يعمل سخونة و يعمل
+
+320
+00:28:20,900 --> 00:28:26,830
+ايه في الدم اه يعني هذا بديش يعني ولا يعملlocal
+
+321
+00:28:26,830 --> 00:28:30,870
+toxicity in the eye مايعنيش allergy مايعنيش تأثير
+
+322
+00:28:30,870 --> 00:28:39,230
+bad effect على الكورية ويخليها transparent مثلا او
+
+323
+00:28:39,230 --> 00:28:45,130
+يخلي فيها إدينة أو يخلي فيها إدهار أو حاجة هذه
+
+324
+00:28:45,130 --> 00:28:48,550
+الأشياء في ال ideal properties اللي احنا بنتظر
+
+325
+00:28:48,550 --> 00:28:52,070
+العلم يحققها ان شاء الله
+
+326
+00:28:58,880 --> 00:29:01,520
+عند الـcyclopedia الـ full ecstatic refraction
+
+327
+00:29:01,520 --> 00:29:06,520
+يمكن أن يكون استمتع بدون انتفار من اي نوع من
+
+328
+00:29:06,520 --> 00:29:10,780
+الاقومديشن يعني انا لو عملت full of cyclopedia
+
+329
+00:29:10,780 --> 00:29:18,820
+باعرف ان كل الاقومديشن راح يكون أبسط وانا بريحني،
+
+330
+00:29:18,820 --> 00:29:22,480
+this is particularly important in the very young
+
+331
+00:29:22,480 --> 00:29:24,160
+ليش very young؟
+
+332
+00:29:30,510 --> 00:29:35,290
+يعني طفل عمره سنة أو سنة و نص أو سنتين و عنده شوية
+
+333
+00:29:35,290 --> 00:29:39,950
+ايزوتروفيا او ايزوفوريا كله هنا من العقل في direct
+
+334
+00:29:39,950 --> 00:29:44,590
+relation between the strength of the muscle and
+
+335
+00:29:44,590 --> 00:29:49,790
+the deviation of the ice يبقى
+
+336
+00:29:49,790 --> 00:29:51,350
+this is particular
+
+337
+00:30:08,520 --> 00:30:12,180
+وهذا يفيدني بالقطرة أني بقدر أعرف
+
+338
+00:30:23,220 --> 00:30:28,480
+يقول إن الـ Full Cyclopidic Correction Found is
+
+339
+00:30:28,480 --> 00:30:31,440
+not necessarily given in any subsequent
+
+340
+00:30:31,440 --> 00:30:35,660
+prescription that is deemed to be necessary يعني
+
+341
+00:30:35,660 --> 00:30:39,520
+أنا بدأ أقول إنه مش شاطر، إنه لو طلع عندي ليال
+
+342
+00:30:39,520 --> 00:30:45,340
+الهيتن، Hypermetropia-7، إنه أكتبله seven، لأ هذه
+
+343
+00:30:45,340 --> 00:30:46,240
+فيها درس
+
+344
+00:30:57,340 --> 00:31:04,100
+معرفة الاختصارات السيكروباليجية هي أكتر من أهمية
+
+345
+00:31:04,100 --> 00:31:08,140
+جدًا، خاصة أننا سنتحدث الآن عن الاختصارات
+
+346
+00:31:08,140 --> 00:31:12,940
+السيكروباليجية والأهمية بتاعتها.أولًا، الناس
+
+347
+00:31:12,940 --> 00:31:16,300
+الصغيرة في
+
+348
+00:31:16,300 --> 00:31:20,460
+موقع مستمر أو مستمر
+
+349
+00:31:41,190 --> 00:31:44,750
+لما يكون لديهم intermittent أو constant استردظمس
+
+350
+00:31:44,750 --> 00:31:54,730
+شيء ثابت أو شيء متقطع ولا كتير بيصير في طالبات
+
+351
+00:31:54,730 --> 00:32:03,090
+ثانوية شفير أسينوبيا وهي دي دوخة لإن السيارة دي
+
+352
+00:32:03,090 --> 00:32:05,350
+مصل مع الدراسة بتصير more active
+
+353
+00:32:12,020 --> 00:32:17,380
+الصبح لأ، في الحالة هذه مصير منها psychologic
+
+354
+00:32:17,380 --> 00:32:23,380
+reflection to medium to high heterophoria فوريا،
+
+355
+00:32:23,380 --> 00:32:33,680
+ايش فوريا؟ او latent squint اما ايزو او اكزو او
+
+356
+00:32:33,680 --> 00:32:41,030
+هايبرد او هايفوريا او سودو مايوبياسيدوميوبيا ايش
+
+357
+00:32:41,030 --> 00:32:49,250
+سيدوميوبيا؟ يعني هو
+
+358
+00:32:49,250 --> 00:32:55,910
+في وضع الراحة الراحة هو امترو لكن بعد ساعات من
+
+359
+00:32:55,910 --> 00:33:01,370
+التعب يبدأ لا يرى البعيد لا يرى البعيد ايوة بسبب
+
+360
+00:33:01,370 --> 00:33:04,610
+ال hyper activity يعني دي مش هقول spasm بقول hyper
+
+361
+00:33:04,610 --> 00:33:08,710
+activity او السنة المفصلة يبدأ مثلا نظرا هو six
+
+362
+00:33:08,710 --> 00:33:09,010
+six
+
+363
+00:33:17,090 --> 00:33:21,770
+و جيبي تاني اوم و ماشوف 66 يبقى مش true myopia
+
+364
+00:33:21,770 --> 00:33:27,730
+solo myopia زائفة three were marked as cumulative
+
+365
+00:33:27,730 --> 00:33:32,190
+asthmatic symptoms اول ما اقرا بالكتاب نصف ساعة
+
+366
+00:33:32,190 --> 00:33:41,610
+يبدأ blurring of vision pain in the eye headache
+
+367
+00:33:41,610 --> 00:33:43,610
+drowsiness
+
+368
+00:33:46,890 --> 00:33:52,470
+عن inability to read clearly، كل هذه complaints
+
+369
+00:33:52,470 --> 00:33:56,250
+بيجي العيان منها، في الastronomy example، تفضل في
+
+370
+00:33:56,250 --> 00:33:59,730
+حالة السودميوبيا، إنه إذا استمر الإرهاق، هتصير
+
+371
+00:33:59,730 --> 00:34:04,930
+ميوبيا عادية يعني؟ في ممكنية تصير؟ هو الحقيقة
+
+372
+00:34:26,680 --> 00:34:30,280
+و راح نشوف قريب مع الصداع الشديد والألم و عدم
+
+373
+00:34:30,280 --> 00:34:35,980
+القدر على استخدامه في أي useful work لذلك يعني
+
+374
+00:34:35,980 --> 00:34:39,580
+احنا لما واحد بيبدأ معا حديثة من ال .. ال .. اللي
+
+375
+00:34:39,580 --> 00:34:45,080
+هو ال anxiety و ال over work المفروض ال risk و
+
+376
+00:34:45,080 --> 00:34:45,920
+بعدين correction
+
+377
+00:35:00,700 --> 00:35:05,600
+لكن فيما بعد ممكن مرة يصيبه attack و بسبازة أو
+
+378
+00:35:05,600 --> 00:35:12,220
+celery muscle و يبقى احنا في ال attack شهور طيب
+
+379
+00:35:12,220 --> 00:35:17,640
+reflection under cyclopedia is unnatural because
+
+380
+00:35:17,640 --> 00:35:21,720
+the shape of the lens has been changed كيف ال lens
+
+381
+00:35:21,720 --> 00:35:22,620
+بصير فيها؟
+
+382
+00:35:37,400 --> 00:35:42,560
+لأ ب Syria Flat بس Psychopedia ب Syria Flat طب مين
+
+383
+00:35:42,560 --> 00:35:47,960
+يقول اليك ب Syria Flat؟ ماعشان ماعشان ماعشان
+
+384
+00:35:47,960 --> 00:35:52,320
+ماعشان ماعشان
+
+385
+00:35:52,320 --> 00:35:57,540
+ماعشان ماعشان ماعشان ماعشان
+
+386
+00:35:57,540 --> 00:36:00,740
+ماعشان ماعشان ماعشان ماعشان ماعشان ماعشان ماعشان
+
+387
+00:36:00,740 --> 00:36:01,400
+ماعشان ماعشان ماعشان ماعشان ماعشان ماعشان ماعشان
+
+388
+00:36:01,400 --> 00:36:02,700
+ماعشان ماعشان ماعشان ماعشان ماعشان ماعشان ماعشان
+
+389
+00:36:02,700 --> 00:36:02,700
+ماعشان ماعشان ماعشان ماعشان ماعشان ماعشان ماعشان
+
+390
+00:36:02,700 --> 00:36:02,700
+ماعشان ماعشان ماعشان ماعشان ماعشان ماعشان ماعشان
+
+391
+00:36:02,700 --> 00:36:05,700
+ماعشان ماعشان ماعشان ماعشان ماعشان ماعشان
+
+392
+00:36:16,160 --> 00:36:22,240
+رجعت بريفري هيك، شدت الزنيولز، لما شدت الزنيولز
+
+393
+00:36:22,240 --> 00:36:27,200
+شدوا على ال equator لما
+
+394
+00:36:27,200 --> 00:36:29,240
+شدت الزنيولز شدوا على ال equator لما شدت الزنيولز
+
+395
+00:36:29,240 --> 00:36:29,320
+شدوا على ال equator لما شدت الزنيولز شدوا على ال
+
+396
+00:36:29,320 --> 00:36:29,580
+equator لما شدت الزنيولز شدوا على ال equator لما
+
+397
+00:36:29,580 --> 00:36:29,620
+شدت الزنيولز شدوا على ال equator لما شدت الزنيولز
+
+398
+00:36:29,620 --> 00:36:29,720
+شدوا على ال equator لما شدت الزنيولز شدوا على ال
+
+399
+00:36:29,720 --> 00:36:30,760
+equator لما شدت الزنيولز شدوا على ال equator لما
+
+400
+00:36:30,760 --> 00:36:32,340
+شدت الزنيولز شدوا على ال equator لما شدت الزنيولز
+
+401
+00:36:32,340 --> 00:36:32,780
+شدت الزنيولز شدت الزنيولز شدت الزنيولز شدت
+
+402
+00:36:32,780 --> 00:36:33,440
+الزنيولز شدت ال
+
+403
+00:37:04,190 --> 00:37:14,010
+الوضع صار كتالي، اول كان اخر، الان هنا هنا حصلت
+
+404
+00:37:14,010 --> 00:37:15,750
+هنا، وانا
+
+405
+00:37:30,410 --> 00:37:35,790
+لما زميلون شغال عليها traction، الـ Lens أصبحت
+
+406
+00:37:35,790 --> 00:37:41,190
+more flat أو الـ Lens is fake، الـ Lens is fake
+
+407
+00:37:41,190 --> 00:37:49,090
+هذا الوضع طبعا مشهور وضع طبيعي، يعني صار تبير
+
+408
+00:37:49,090 --> 00:37:50,230
+تشريحي
+
+409
+00:37:57,680 --> 00:38:02,340
+فهذه العرسة بتستنى، زوال السبق عشان ترجع إلى
+
+410
+00:38:02,340 --> 00:38:07,600
+الأصلي، فعشان أيه بيقولك؟ Unnatural، مش غير طبيعي،
+
+411
+00:38:07,600 --> 00:38:12,520
+مش غير طبيعي، لأن شكل اللحظة تم تغييره، وهذا سيقوم
+
+412
+00:38:12,520 --> 00:38:22,300
+بإعادة شكلها في شكل عادل، عندما ينتهي،
+
+413
+00:38:22,300 --> 00:38:23,100
+ستستهيد شكلها.
+
+414
+00:38:37,270 --> 00:38:41,990
+عشان تعمل .. شايفك انا ان في ال latent hypertrophy
+
+415
+00:38:41,990 --> 00:38:51,070
+عالي، بعمل قمل فحص، precyclopidic refraction،
+
+416
+00:38:51,070 --> 00:38:55,290
+وبحطه في الملف، وبحط الققر على مدة كافية
+
+417
+00:39:06,060 --> 00:39:10,720
+وهي مقارنة في كل حاجة بقى من الاناء و هتستغرب أنت
+
+418
+00:39:10,720 --> 00:39:15,600
+من المقارنة لأن أحيانا يكون فيه فرق شاسع The
+
+419
+00:39:15,600 --> 00:39:18,340
+optical aberrations present with the widely
+
+420
+00:39:18,340 --> 00:39:22,620
+dilated pupil are then very much reduced لما يروح
+
+421
+00:39:22,620 --> 00:39:26,500
+أثر قطرة بالتدريج المدريازز هيختفي
+
+422
+00:39:40,030 --> 00:39:43,650
+في اللي هو العدسة و غير انها وسعت وعملت
+
+423
+00:39:43,650 --> 00:39:50,510
+aberrations وعملت .. لأ أثر على العين يعني تغيير
+
+424
+00:39:50,510 --> 00:39:54,550
+في العين او photophobia او اشي بقول ليه؟ فيه
+
+425
+00:39:54,550 --> 00:39:58,490
+additional اللي هو disadvantages one making an
+
+426
+00:39:58,490 --> 00:40:02,770
+allowance for the dependent tool of the cerebral
+
+427
+00:40:02,770 --> 00:40:11,810
+muscle يعني صار بقولك انه العين حقيقةمش هتشتغل صح
+
+428
+00:40:11,810 --> 00:40:16,830
+إلا بالقطرة، إزاي صار تعود على القطرة؟ اه تعود
+
+429
+00:40:16,830 --> 00:40:22,930
+يعني أنا بقول habituation صار إنه ال .. في ال ..
+
+430
+00:40:22,930 --> 00:40:28,410
+ال عبارة في hyper activity، ساعت ما خدت القطرة،
+
+431
+00:40:28,410 --> 00:40:35,150
+توقف ال hyper activity، لما راحت القطرة و قطرها،
+
+432
+00:40:35,150 --> 00:40:39,200
+already قتل hyper activityكانت بتقول مزيد من
+
+433
+00:40:39,200 --> 00:40:43,220
+القطرة، يعني إنه ما ستسكت، الفعالية بتاعتها إزاي
+
+434
+00:40:43,220 --> 00:40:47,500
+ده إلا من القطرة، وهذا شغل، يعني مش أنا حاطت
+
+435
+00:40:47,500 --> 00:40:54,220
+القطرة مرة forever، مش أنا حاطت القطرة وقطعت ده من
+
+436
+00:40:54,220 --> 00:40:58,880
+ال hyperactivity، لأ، ست سبع ساعات، تمام ساعات،
+
+437
+00:40:58,880 --> 00:41:03,970
+يوم، وبعدين بنرجع إحنا لل hyperactivityفصار الـ
+
+438
+00:41:03,970 --> 00:41:10,950
+tone هنا تعود على العضلة to the dangers of
+
+439
+00:41:10,950 --> 00:41:14,570
+psychomedia، طبعا الـ psychomedia تقولنا أكيد تكون
+
+440
+00:41:14,570 --> 00:41:19,990
+جيستر فاتك والكلام هنا، لكن بيقولني، but as this
+
+441
+00:41:19,990 --> 00:41:25,450
+can be successfully overcome يمكن التحكم فيها، the
+
+442
+00:41:25,450 --> 00:41:30,630
+advantage of psychomedic refraction far outweigh
+
+443
+00:41:41,660 --> 00:41:48,020
+الميزة تغلبت على السيئة
+
+444
+00:41:48,020 --> 00:41:52,740
+ال disadvantage بكتير يعني سعر المزيد مثلا تمارين
+
+445
+00:41:52,740 --> 00:41:57,460
+في المية وال disadvantage عشانين في المية مميزتها
+
+446
+00:41:57,460 --> 00:42:03,540
+أكتر من عيوبها اه ده ال disadvantage طيب احنا الان
+
+447
+00:42:03,540 --> 00:42:08,080
+صحيح يعني انا مابقول لكوا يعني ممكنزي ما علمني
+
+448
+00:42:08,080 --> 00:42:14,100
+دكتور يعني في ال .. انه انت لو عملت لو واحد أضلت
+
+449
+00:42:14,100 --> 00:42:21,580
+شويه مدريازز خاصة في موضوع ال .. ال .. diabetes
+
+450
+00:42:21,580 --> 00:42:24,600
+mellitus بيخافي كتير فيهم من درجة الكنوباتين
+
+451
+00:42:24,600 --> 00:42:34,040
+فالفحص بدون مدريازز inefficient مش كافي فاحنا
+
+452
+00:42:34,040 --> 00:42:42,410
+بنعطيهمن هنا يا عزيزي و بنعمله detail examination
+
+453
+00:42:42,410 --> 00:42:46,310
+of the fungus و
+
+454
+00:42:46,310 --> 00:42:50,110
+بعدين اقوله روح بيتك بقول لأ اياك تقوله روح بيتك
+
+455
+00:42:50,110 --> 00:42:51,110
+احد امرين
+
+456
+00:43:04,490 --> 00:43:07,790
+عشان لما انت تروح تنام في الليل تكون انت مرتاح
+
+457
+00:43:07,790 --> 00:43:12,730
+ضميرك، ما تقولش عنده تصرفية، هيروح مرضك، سجاق،
+
+458
+00:43:12,730 --> 00:43:17,950
+ألم، يعني بداية attack، لأ، تحطله ايش؟ بيرو
+
+459
+00:43:17,950 --> 00:43:22,910
+كاربين، يبقى بتخلي عندك في المكتب طول من تجاهد ال
+
+460
+00:43:22,910 --> 00:43:28,010
+supervision، يا إما أنت تعطي أبو يابو كاربين عشان
+
+461
+00:43:28,010 --> 00:43:32,550
+يعمل تضييق ويوجه الحالة للطبيعة
+
+462
+00:43:42,530 --> 00:43:47,530
+طب دكتور الفترة اللي دخلي قعد فيها عندي هتتروح من
+
+463
+00:43:47,530 --> 00:43:56,490
+ربع الساعة لقدت؟ أقل شي ساعتين ساعتين؟ اه طيب الان
+
+464
+00:43:56,490 --> 00:44:01,150
+احنا قولنا ان في pre-psychopathic و في post
+
+465
+00:44:01,150 --> 00:44:04,960
+-psychopathicكان الناس اللي بيعملوا طول
+
+466
+00:44:04,960 --> 00:44:10,200
+الـcyclomatic path لغالطين لأنه مش عارف قرن القطرة
+
+467
+00:44:10,200 --> 00:44:17,860
+إيش هو ده؟ بكفيش فحص واحد إلا فحص قرن القطرة و فحص
+
+468
+00:44:17,860 --> 00:44:21,660
+بعد القطرة خاصة في الـisotopes و خاصة في الناس
+
+469
+00:44:21,660 --> 00:44:27,900
+اللي لإنه مسباز أو أكملهم لذلك في الـprecyclomatic
+
+470
+00:44:27,900 --> 00:44:30,760
+examination such an examination will include the
+
+471
+00:44:30,760 --> 00:44:35,970
+flowيجب أن يحتوي على التقن، symptoms of the
+
+472
+00:44:35,970 --> 00:44:39,190
+disease،
+
+473
+00:44:39,190 --> 00:44:43,530
+يعني أنا مش بدأ أدخل إنسان هو يعني علبة أقوله good
+
+474
+00:44:43,530 --> 00:44:49,850
+عشان أتحصك، بدأ أسأل، إيش الأعراض، وإذا كان طفل
+
+475
+00:44:49,850 --> 00:44:53,930
+أسأل أمه، إيش الأعراض اللي انتم شايفينها؟
+
+476
+00:45:00,020 --> 00:45:08,580
+2 اوكلر و ميتيكال history التاريخ بتاع المرضى هل
+
+477
+00:45:08,580 --> 00:45:13,400
+سبب انه فحص سبب لبس نضارة؟ ايش القطرة اللى
+
+478
+00:45:13,400 --> 00:45:21,220
+استخدمها فى الفحص؟ كمان هل مازال بياخد قطرات؟ هل
+
+479
+00:45:21,220 --> 00:45:28,220
+بياخد أدوية؟ و لا كده 3 استخدم اي تاريخ تحريك
+
+480
+00:45:28,220 --> 00:45:32,870
+بالعينحساسية في العلم، سواء حساسية هادية،
+
+481
+00:45:32,870 --> 00:45:37,310
+spontaneous، لحالة، أو induced، induced يعني إيش؟
+
+482
+00:45:37,310 --> 00:45:41,530
+مسبرة، بأي قطرات، عشان أنا ما أضعش الاشي تاني هو
+
+483
+00:45:41,530 --> 00:45:46,630
+هو، manifest refraction with vision and visual
+
+484
+00:45:46,630 --> 00:45:48,670
+acuity at distance and distance يعني أنا بدي
+
+485
+00:45:48,670 --> 00:45:51,770
+أعمله، أنا manifest refraction، without drops،
+
+486
+00:45:51,770 --> 00:45:59,730
+وشوفله ال visual acuity، قبل كل شيءو دايما كانوا
+
+487
+00:45:59,730 --> 00:46:03,370
+أساسيتنا يقولوا اهو اتفرج ال video لك و كده فانت
+
+488
+00:46:03,370 --> 00:46:08,710
+اعمله reflection ليش؟
+
+489
+00:46:08,710 --> 00:46:14,210
+انا
+
+490
+00:46:14,210 --> 00:46:18,250
+لسه ماتكلمش عن قطرة، ماتكلمش عن قطرة، بس الكلام
+
+491
+00:46:18,250 --> 00:46:23,910
+عليها لسه precyclopathy هذا صحيح دعاية ممتازة،
+
+492
+00:46:23,910 --> 00:46:31,110
+ممتازة دعاية، انا لو حطيت اي نوق في عينهممكن إنه
+
+493
+00:46:31,110 --> 00:46:35,750
+يعمله شوية blurring وتغيير في قدرته على التركيز
+
+494
+00:46:35,750 --> 00:46:40,570
+لذلك أنا أجيب و أخار من الأول بسأله كام سؤال
+
+495
+00:46:40,570 --> 00:46:46,110
+وبعدين بجلسه ستة متر من أثنين right eye then left
+
+496
+00:46:46,110 --> 00:46:50,790
+eye separately طيب
+
+497
+00:46:50,790 --> 00:46:56,730
+determination أو binocular status يعني binocular
+
+498
+00:46:56,730 --> 00:46:56,990
+single
+
+499
+00:47:05,480 --> 00:47:10,600
+كفار تست وكفار انكفار تست وربما انا استخدم ال
+
+500
+00:47:10,600 --> 00:47:15,000
+Prism ال Prism كفار تست وكفار انكفار انكفار انكفار
+
+501
+00:47:15,000 --> 00:47:18,440
+انكفار انكفار انكفار انكفار انكفار انكفار انكفار
+
+502
+00:47:18,440 --> 00:47:18,440
+انكفار انكفار انكفار انكفار انكفار انكفار انكفار
+
+503
+00:47:18,440 --> 00:47:18,560
+انكفار انكفار انكفار انكفار انكفار انكفار انكفار
+
+504
+00:47:18,560 --> 00:47:18,740
+انكفار انكفار انكفار انكفار انكفار انكفار انكفار
+
+505
+00:47:18,740 --> 00:47:18,740
+انكفار انكفار انكفار انكفار انكفار انكفار انكفار
+
+506
+00:47:18,740 --> 00:47:18,740
+انكفار انكفار انكفار انكفار انكفار انكفار انكفار
+
+507
+00:47:18,740 --> 00:47:31,040
+انكفار انك
+
+508
+00:47:32,240 --> 00:47:35,740
+كل الحاجات التالية اللي أسأل عنها اللي هو ال
+
+509
+00:47:35,740 --> 00:47:41,020
+history و ال symptoms و ال visual acuity اه و ال
+
+510
+00:47:41,020 --> 00:47:47,220
+cover test و locomotivity او اه كل كل هذا قبل ما
+
+511
+00:47:47,220 --> 00:47:53,520
+انا اضع قطرة طيب المرحلة التالية ان شاء الله
+
+512
+00:47:53,520 --> 00:47:58,320
+بتتكلم في external examination of the eye برضه
+
+513
+00:47:58,320 --> 00:47:59,700
+تابع precyclopathy
+
+514
+00:48:02,910 --> 00:48:05,190
+أراكم على خصم استماع وان شاء الله المرة القادمة
+
+515
+00:48:05,190 --> 00:48:06,850
+نكمل هذا بإذن الله
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/KFmDQ9bkFLw.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/KFmDQ9bkFLw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..1548cbe4f9d62333e41b90338077d3fbfac0dac7
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/KFmDQ9bkFLw.srt
@@ -0,0 +1,1823 @@
+1
+00:00:20,960 --> 00:00:23,040
+أعوذ بالله من الشيطان الرجيم باسم الله الرحمن
+
+2
+00:00:23,040 --> 00:00:26,440
+الرحيم الحمد لله رب العالمين وأصلي وأسلم على
+
+3
+00:00:26,440 --> 00:00:29,460
+النبي الأمين محمد وعلى آله وصحابه وأتباعهم
+
+4
+00:00:29,460 --> 00:00:33,580
+السلام عليكم ورحمة الله وبركاته. في هذا اليوم إن
+
+5
+00:00:33,580 --> 00:00:37,960
+شاء الله سأكمل المحاضرة السابقة حول اللي هو
+
+6
+00:00:37,960 --> 00:00:44,160
+موسعات بُؤبؤ العين موسعات بُؤبؤ العين في هذا
+
+7
+00:00:44,160 --> 00:00:46,980
+اليوم سأتكلم على choice of mydriatics
+
+8
+00:00:49,630 --> 00:00:56,710
+ماذا نختار من ال Mydriatics؟ في الحقيقة بعد ما تم
+
+9
+00:00:56,710 --> 00:01:04,830
+حذف الكثير من الموسعات، يعني زي الـ Ephedrine وزي
+
+10
+00:01:04,830 --> 00:01:10,490
+الـ Atropine، وحتى الـ Atropine نفسه كان موسع لا
+
+11
+00:01:10,490 --> 00:01:18,010
+يستخدم، فلم يعد الخيار إلا بين الثلاثة: Tropicamide
+
+12
+00:01:19,970 --> 00:01:24,570
+بنقول عنه مدرامايت، Phenylephrine 
+
+13
+00:01:24,570 --> 00:01:34,970
+هما الخط الأول. إذا لم يكفي، فيتم التعامل مع واحد
+
+14
+00:01:34,970 --> 00:01:39,990
+ثالث اسمه Cyclopentolate، مع أن Cyclopentolate له
+
+15
+00:01:39,990 --> 00:01:45,210
+effect كبير على اللي هو الـ ciliary muscle، يبقى
+
+16
+00:01:45,210 --> 00:01:48,270
+الأولى دي احنا بنرتب choice of mydriatics number one
+
+17
+00:01:48,270 --> 00:01:54,660
+Tropicamide more efficient, more rapid, shorter
+
+18
+00:01:54,660 --> 00:02:00,260
+duration هو Tropicamide إذا
+
+19
+00:02:00,260 --> 00:02:06,400
+لم يكفي ممكن أستعين في الفيناليفرين، إذا لم يكفي
+
+20
+00:02:06,400 --> 00:02:09,640
+في الـ Cyclopentolate، يعني الـ Cyclopentolate آخر اللي
+
+21
+00:02:09,640 --> 00:02:12,240
+هو خطوة من الخطوات
+
+22
+00:02:14,460 --> 00:02:17,580
+الـ Cyclopentolate يجب أن يكون اعتباره فقط إذا لم ينجح
+
+23
+00:02:17,580 --> 00:02:25,160
+هذه الأدوية بإنتاج مستوى مدرياتيكي كافي، مدرياتيكي 
+
+24
+00:02:25,160 --> 00:02:28,000
+كافي، مدرياتيكي كافي، مدرياتيكي كافي، مدرياتيكي كافي
+
+25
+00:02:28,000 --> 00:02:30,120
+مدرياتيكي كافي، مدرياتيكي كافي، مدرياتيكي كافي
+
+26
+00:02:30,120 --> 00:02:31,500
+مدرياتيكي كافي، مدرياتيكي كافي، مدرياتيكي كافي
+
+27
+00:02:31,500 --> 00:02:33,840
+مدرياتيكي كافي، مدرياتيكي كافي، مدرياتيكي كافي
+
+28
+00:02:33,840 --> 00:02:39,120
+مدرياتيكي كافي، مدرياتيكي كافي، مدرياتيكي كافي
+
+29
+00:02:39,120 --> 00:02:45,540
+مدرياتيكي كافي. يبقى الـ Tropicamide الأول بلا
+
+30
+00:02:45,540 --> 00:02:52,080
+منازع، مش لسرعته بس، لأ، لأنه الـ depth أو ما أدري يا
+
+31
+00:02:52,080 --> 00:02:58,400
+عزيزي، بيكون very good. أما قول depth يعني الـ effect
+
+32
+00:02:58,400 --> 00:03:06,260
+very good. الشيء الثالث أنه there is abolishing
+
+33
+00:03:06,260 --> 00:03:15,590
+يعني إلغاء الـ Phenylephrine. عيبه أنه صح بيوسع لكن
+
+34
+00:03:15,590 --> 00:03:19,770
+الساعة الثانية دي أعمل indirect ophthalmoscope أو
+
+35
+00:03:19,770 --> 00:03:27,130
+fundus photography، تصوير القاع، بيرجع بديك، وهذا من
+
+36
+00:03:27,130 --> 00:03:33,030
+العيوب بتاعته more
+
+37
+00:03:33,030 --> 00:03:36,370
+ideal
+
+38
+00:03:36,370 --> 00:03:38,690
+في 1986
+
+39
+00:03:41,200 --> 00:03:45,580
+بمقارنة بـ 0.1% في نهاية الفريق و10% في نهاية
+
+40
+00:03:45,580 --> 00:03:51,300
+الفريق كميدرياتيكس، قرر أن لا يكون أيضا أفضل بسبب
+
+41
+00:03:51,300 --> 00:03:59,860
+اختصار الاستجابة، يعني مقارنة 10% في نهاية الفريق مع
+
+42
+00:03:59,860 --> 00:04:07,620
+10% في نهاية الفريق، نهاية الفريق هي 1%، يعني 1%
+
+43
+00:04:08,990 --> 00:04:13,310
+أستخدم كمدرياتيك and Cyclopentolate، لكن four مدرياتيك 
+
+44
+00:04:13,310 --> 00:04:24,130
+Tropicamide only 0.5، هو قارن، مقارنة عشر في المئة
+
+45
+00:04:24,130 --> 00:04:28,570
+Tropicamide مع عشر في المئة Phenylephrine. قال ما حدش منهم 
+
+46
+00:04:28,570 --> 00:04:33,190
+كـ... يعني كثير، يعني أنا مقتنع فيه لأنه في الحالتين
+
+47
+00:04:33,190 --> 00:04:37,410
+في loss of accommodation مع إن الكلام هذا يعني كان 
+
+48
+00:04:37,410 --> 00:04:42,870
+موجود عليه الـ Phenylephrine، يشك إنه بيشتغل على
+
+49
+00:04:42,870 --> 00:04:47,290
+السيمباثيكي، مصر لإن هو بيشتغل على الـ sympathetic و
+
+50
+00:04:47,290 --> 00:04:49,830
+ليس على الـ parasympathetic والسيماثيكي مصر
+
+51
+00:04:49,830 --> 00:04:55,370
+parasympathetic. لكن هم وجدوا إنه في recession أو
+
+52
+00:04:55,370 --> 00:05:01,730
+blurring from their part، مش فاهمين ليش هم حتى ليش
+
+53
+00:05:01,730 --> 00:05:03,730
+فيه recession of reading من Phenylephrine؟ في
+
+54
+00:05:03,730 --> 00:05:08,270
+الـ Phenylephrine؟ هو بيقولك loss of accommodation، ناس
+
+55
+00:05:08,270 --> 00:05:10,970
+تانية بيقولك يعني depth of focus، ناس تانية بيقولك
+
+56
+00:05:10,970 --> 00:05:14,070
+عشان هو عمل aberrations والـ aberrations وكلام زي
+
+57
+00:05:14,070 --> 00:05:20,090
+هذا، لكن الحقيقة ولا مش معروفة لسه. طيب، Tropic
+
+58
+00:05:20,090 --> 00:05:23,010
+amide can cause an increase in intraocular
+
+59
+00:05:23,010 --> 00:05:26,560
+pressure in eyes with a deep anterior chamber، يعني
+
+60
+00:05:26,560 --> 00:05:30,380
+وجدوا قاسوا ضغط العين قبل الـ Tropicamide أو قاسوا
+
+61
+00:05:30,380 --> 00:05:33,160
+ضغط العين بعد الـ Tropicamide، وجدوا أن ضغط العين
+
+62
+00:05:33,160 --> 00:05:42,480
+بيعلق شوية مع الـ Tropicamide لكن هذا الارتفاع مش سبب
+
+63
+00:05:42,480 --> 00:05:48,320
+إن احنا نتركه لأنه ارتفاع وقتي وارتفاع نسبي، يعني
+
+64
+00:05:48,320 --> 00:05:52,140
+ممكن يرفع من 16
+
+65
+00:05:54,490 --> 00:06:01,470
+أو يرفع من سبعة عشر إلى ثمانية عشر أو ثمانية عشر ونصف لمدة
+
+66
+00:06:01,470 --> 00:06:05,870
+مثلاً عشر دقائق أو ربع ساعة. هل هذا سبب إن احنا
+
+67
+00:06:05,870 --> 00:06:12,350
+نترك الـ Tropicamide هو الـ main effective مدرياتك؟
+
+68
+00:06:12,350 --> 00:06:12,830
+طبعاً
+
+69
+00:06:16,990 --> 00:06:21,050
+ممكن يخاف منه، لكن هو بيقول يعني however the rise
+
+70
+00:06:21,050 --> 00:06:25,930
+in intraocular pressure is likely to be small and
+
+71
+00:06:25,930 --> 00:06:30,570
+transient. إيش transient؟ موقع موقع and unlikely to
+
+72
+00:06:30,570 --> 00:06:35,590
+cause a problem. فالـ Phenylephrine 
+
+73
+00:06:35,590 --> 00:06:39,810
+لأ، العيب بتاعه هو ما يرفعش ضغط العين، بل يمكن بينزل
+
+74
+00:06:39,810 --> 00:06:43,810
+ضغط العين شوية. فـ Phenylephrine مشكلته لو راح على الدم
+
+75
+00:06:51,330 --> 00:06:56,810
+كل عيد وراح على الدم، وفي واحد عنده cardiovascular
+
+76
+00:06:56,810 --> 00:07:06,430
+problem زي مثلاً الـ coronary artery يكون مثلاً narrow،
+
+77
+00:07:06,430 --> 00:07:11,810
+هيكون في انقطاع، ضربات القلب، احنا بنخاف أنه
+
+78
+00:07:11,810 --> 00:07:20,280
+ممكن يعمل لنا مشكلة بسيطة دماغية ومعرفة في المريض في
+
+79
+00:07:20,280 --> 00:07:23,540
+المشاكل الكاردوفسكالية وفي الذين يأخذوا حاجات
+
+80
+00:07:23,540 --> 00:07:28,400
+معينة. يعني احنا لما بنحط في 9-13 بنكون احنا فاهمين
+
+81
+00:07:28,400 --> 00:07:35,460
+يعني أنه له بعض المساواة، فممكن نحط صح نقطة وبعدين
+
+82
+00:07:35,460 --> 00:07:40,100
+نقطة هنا ونقطة وبعدين نقطة هنا، لكن ممكن أنه to
+
+83
+00:07:40,100 --> 00:07:44,500
+keep his eyes closed مثلاً
+
+84
+00:07:46,020 --> 00:07:58,080
+for مثلاً many minutes. ليش؟ to prevent the ... أيوة
+
+85
+00:07:58,080 --> 00:08:02,540
+passage of the drops through the nasal lacrimal
+
+86
+00:08:02,540 --> 00:08:07,280
+duct إلى الساق إلى mucous membrane of nasal
+
+87
+00:08:07,280 --> 00:08:08,000
+pharynx
+
+88
+00:08:11,820 --> 00:08:16,680
+طيب in summary، إجمالي يعني ملخص it would appear
+
+89
+00:08:16,680 --> 00:08:21,480
+that Tropicamide 0.5 is the first choice as a
+
+90
+00:08:21,480 --> 00:08:26,940
+مدرياتيك. هاي الخلاصة هنا عندي، الخلاصة. نبدا نوسع، أول
+
+91
+00:08:26,940 --> 00:08:32,440
+خط نصف المئة Tropicamide as a مدرياتيك but special
+
+92
+00:08:32,440 --> 00:08:37,840
+conditions require special considerations لكل حالة
+
+93
+00:08:37,840 --> 00:08:43,310
+عنها يحدث بعد ذلك، مثلاً اللي لم يكفل نص كنا نحط واحد
+
+94
+00:08:43,310 --> 00:08:48,330
+اللي لم يكفل واحد ممكن نحط Phenylephrine، اللي لم يكفل
+
+95
+00:08:48,330 --> 00:08:52,250
+Phenylephrine كنا نحط Cyclopentolate خاصة pre
+
+96
+00:08:52,250 --> 00:08:57,730
+-operatively لإن أنا أتركت extraction مثلاً وفي الـ
+
+97
+00:08:57,730 --> 00:09:03,190
+fundus photography، فانطس photography والـ direct فانطس
+
+98
+00:09:03,190 --> 00:09:07,990
+كله، ممكن تضطر إن احنا هنستخدم أو في بعض الناس
+
+99
+00:09:07,990 --> 00:09:09,410
+اللي البابا بتاعهم
+
+100
+00:09:14,330 --> 00:09:18,070
+الخط الأول هو النص وليس متوفر للأسف إننا نص أما
+
+101
+00:09:18,070 --> 00:09:22,610
+متوفر لنا الـ one percent لكن مالِك لكل حادث حديث أو
+
+102
+00:09:22,610 --> 00:09:32,290
+لكل مقام مقال. طيب، الآن لكل مقام مقال هنتكلم عنها
+
+103
+00:09:32,290 --> 00:09:38,120
+mixed mydriatics. أنا أضطر أحيانا إن أعمل يعني خلط بين
+
+104
+00:09:38,120 --> 00:09:41,820
+المدرياتك، أستعملهم مع بعض عشان أعدل أو أسرع أو
+
+105
+00:09:41,820 --> 00:09:46,700
+أعالج شيء والـ mydriatics، مدرياتيك produced by one or
+
+106
+00:09:46,700 --> 00:09:50,400
+other of the two types of مدرياتك will not produce
+
+107
+00:09:50,400 --> 00:09:55,240
+a sufficient depth of مدرياسي، إذا لم يكفي mixtures
+
+108
+00:09:55,240 --> 00:09:59,200
+of an antimuscarinic يعني Antimuscarinic Tropic
+
+109
+00:09:59,200 --> 00:10:04,520
+Amide يعني and it's sympathomimetic Phenyl، يبقى أنا
+
+110
+00:10:04,520 --> 00:10:07,340
+بدي أستخدم في الحالة هذه اللي لم يكفي Tropic Amide
+
+111
+00:10:07,340 --> 00:10:14,800
+بدي أستخدم Tropic Amide مع الفيناليفرين. The
+
+112
+00:10:14,800 --> 00:10:19,360
+following mixtures are some of the ones that have
+
+113
+00:10:19,360 --> 00:10:24,520
+been employed. هاي مقترحات مثلاً: هم Atropine and
+
+114
+00:10:24,520 --> 00:10:29,040
+Cocaine، هم Atropine and Ephedrine، وأنا كانت
+
+115
+00:10:29,040 --> 00:10:36,120
+obsolete now. فلس انتهى الآن في عالم الـ mydriatics انتهى
+
+116
+00:10:36,120 --> 00:10:42,240
+Tropicamide and Phenylephrine and Cyclopentolate
+
+117
+00:10:42,240 --> 00:10:46,360
+and Phenylephrine available الآن موجودين متقبل
+
+118
+00:10:46,360 --> 00:10:51,540
+معاهم. يبقى Tropicamide مع Phenylephrine أو
+
+119
+00:10:51,540 --> 00:10:54,720
+Cyclopentolate مع Phenylephrine، بس هنا بدي أعرف إن
+
+120
+00:10:54,720 --> 00:10:55,940
+هنا في Cycloplegia كثيرة
+
+121
+00:11:04,570 --> 00:11:13,350
+طيب، بدنا نشوف هل قوة الـ mixture اللي صار دائماً
+
+122
+00:11:13,350 --> 00:11:16,310
+ثابتة، بقول لأ. هل في variation according to the
+
+123
+00:11:16,310 --> 00:11:19,690
+degree of the exercises required؟ يعني أنا لما بدي
+
+124
+00:11:19,690 --> 00:11:24,870
+أعمل عملية جراحية، بدي توسيع أكثر من الـ
+
+125
+00:11:24,870 --> 00:11:28,270
+fundus photography، الـ fundus photography أكثر من الـ direct
+
+126
+00:11:28,270 --> 00:11:30,770
+ophthalmoscope، الـ direct ophthalmoscope... الـ
+
+127
+00:11:30,770 --> 00:11:33,370
+direct ophthalmoscope بدي توسيع أكثر من الـ direct
+
+128
+00:11:33,370 --> 00:11:39,280
+ophthalmoscope، يعني كل مرحلة من المراحل التشخيصية
+
+129
+00:11:39,280 --> 00:11:44,220
+أو العلاجية بدها توسيع أكثر مثلاً حسب. فهو بيقول
+
+130
+00:11:44,220 --> 00:11:51,100
+يعني إنه أنا لما أبدأ أستخدم الـ mixture ده، أبدأ
+
+131
+00:11:51,100 --> 00:11:55,100
+أستخدمه لشيء أنا عارفه إيش هو، يعني أنا لو أبدأ أعمل
+
+132
+00:11:55,100 --> 00:11:59,520
+دائرة تفتنبسكوب، لوحة يكفي نقطة Tropicamide لمدة
+
+133
+00:11:59,520 --> 00:12:04,330
+ربع ساعة أو نص ساعة لكتير واحدة، لكن إذا كنت بتعمل
+
+134
+00:12:04,330 --> 00:12:09,390
+عملية جراحية، كتراكت استراكشن أو repair أو retinal
+
+135
+00:12:09,390 --> 00:12:14,850
+tear detachment، لأ، ممكن أستخدم الثلاثة مع بعض
+
+136
+00:12:14,850 --> 00:12:20,990
+Tropicamide وأستعمل Phenylephrine وأستعمل
+
+137
+00:12:20,990 --> 00:12:24,990
+Cyclopentolate مع بعض لمدة لا تقل عن ساعة
+
+138
+00:12:24,990 --> 00:12:33,180
+Cyclopentolate 0.5 وPhenylephrine 2.5. الخطة الثانية
+
+139
+00:12:33,180 --> 00:12:42,940
+Tropicamide 0.5 Phenylephrine 2.5% يبقى الأولى
+
+140
+00:12:42,940 --> 00:12:45,240
+الـ Cyclopentolate مع الـ Phenylephrine، والثانية Tropic
+
+141
+00:12:45,240 --> 00:12:49,740
+amide مع الـ Phenylephrine، الثانية Tropicamide مع
+
+142
+00:12:49,740 --> 00:12:56,160
+الـ Phenylephrine 1%. يبقى هذه أقوى. They found no
+
+143
+00:12:56,160 --> 00:12:59,630
+significant difference between the mixtures، يعني
+
+144
+00:12:59,630 --> 00:13:04,410
+وجدوا واحد اثنين ثلاثة، الفرق قريب من بعضه. لأ، في
+
+145
+00:13:04,410 --> 00:13:09,290
+فرق بس قريب، آه، no significant difference ما فيش
+
+146
+00:13:09,290 --> 00:13:12,410
+يعني تقول يعني شيء خمسين في المئة وشيء مئة في
+
+147
+00:13:12,410 --> 00:13:16,590
+المئة مثلاً، شيء سبعين في المئة وشيء مثلاً تسعين في
+
+148
+00:13:16,590 --> 00:13:24,030
+المئة، لأ، يعني كله قريب. They recorded dilation of
+
+149
+00:13:24,030 --> 00:13:27,250
+around seven millimeter within six minutes
+
+150
+00:13:35,990 --> 00:13:41,830
+البؤبؤ ممكن يصل إلى كم؟ ثمانية. ممكن يصل إلى كم؟
+
+151
+00:13:41,830 --> 00:13:42,230
+ثمانية. ممكن يصل إلى كم؟ ثمانية. ممكن يصل إلى كم؟
+
+152
+00:13:42,230 --> 00:13:45,310
+ثمانية. ممكن يصل إلى كم؟ ثمانية. ممكن
+
+153
+00:13:45,310 --> 00:13:46,850
+يصل إلى كم؟ ثمانية. ممكن يصل إلى كم؟ ثمانية. ممكن
+
+154
+00:13:46,850 --> 00:13:48,150
+يصل إلى كم؟ ثمانية. ممكن يصل إلى كم؟ ثمانية. ممكن
+
+155
+00:13:48,150 --> 00:13:49,050
+يصل إلى كم؟ ثمانية. ممكن يصل إلى كم؟ ثمانية. ممكن
+
+156
+00:13:49,050 --> 00:13:50,090
+يصل إلى كم؟ ثمانية. ممكن يصل إلى كم؟ ثمانية. ممكن
+
+157
+00:13:50,090 --> 00:13:54,790
+يصل إلى كم؟ ثمانية. ممكن يصل إلى كم؟ ثمانية. ممكن
+
+158
+00:13:54,790 --> 00:13:59,190
+يصل إلى كم؟ ثمان
+
+159
+00:14:00,050 --> 00:14:05,430
+بيمر، متى يكون من الصعب توسيع الـ بؤبؤ، أولها أو
+
+160
+00:14:05,430 --> 00:14:12,810
+أهمها اللي هو iris pigmentation dark .. darkly
+
+161
+00:14:12,810 --> 00:14:21,290
+pigmented iris. واحد ثاني Diabetes Mellitus
+
+162
+00:14:21,290 --> 00:14:26,310
+Diabetes Mellitus. الثاني الأشياء المهمين
+
+163
+00:14:33,670 --> 00:14:37,550
+واللي في رأي Phenylephrine هو Sympathetic-mimetic، مش 
+
+164
+00:14:37,550 --> 00:14:40,350
+طبعاً sympathetic is this effective in highly
+
+165
+00:14:40,350 --> 00:14:44,070
+pigmented patients and will allow the light reflex
+
+166
+00:14:44,070 --> 00:14:47,830
+to remain. هاي المشكلة، المشكلة تقول إنه بيسكر و
+
+167
+00:14:47,830 --> 00:14:52,250
+capture بالميلانين واحد، الثاني إنه بيخلي الـ
+
+168
+00:14:52,250 --> 00:14:58,130
+light reflex لما بدي أفحص، بيبدأ يسكر. المدرياتيكس
+
+169
+00:14:58,130 --> 00:15:02,350
+هو المفروض عند الأطفال يكونون بالطبع صعبين لإدارة
+
+170
+00:15:02,350 --> 00:15:07,770
+واحدة من أكبر قوات المدرياتيكس
+
+171
+00:15:07,770 --> 00:15:12,710
+يعني مقصود
+
+172
+00:15:12,710 --> 00:15:16,510
+فيه Tropicamide مدرياتيكس يجب أن يكون استخدامه بدون
+
+173
+00:15:16,510 --> 00:15:24,150
+تردد، بدون تردد. ما أقولش أنا العين بتاعته سوداء وأحطه في 
+
+174
+00:15:24,150 --> 00:15:29,230
+العنفرين. أبدأ بتروبيكاميد فورًا. it is a
+
+175
+00:15:29,230 --> 00:15:32,550
+waste of the patient's and practitioners' time
+
+176
+00:15:32,550 --> 00:15:36,810
+بضايع وقتي، وقت العيال، to attempt to dilate such
+
+177
+00:15:36,810 --> 00:15:40,090
+pupils with one of the weaker sympathomimetic
+
+178
+00:15:40,090 --> 00:15:44,550
+drugs. بضايع وقتي. أنت دلت، أحط له Phenylephrine، Phenyle
+
+179
+00:15:44,550 --> 00:15:48,170
+phrine، Phenylephrine، Phen
+
+216
+00:18:45,480 --> 00:18:50,780
+فمية اللي هو الأتروبين مضيف اتنين فمية الفنلإفرين
+
+217
+00:18:50,780 --> 00:18:59,400
+عشرة فمية هو the myotropic amide بيضيف واحد وخمس
+
+218
+00:18:59,400 --> 00:19:05,480
+وسبعين دايمة واحد وخمس وسبعين يبقى ايش الشيء اللي
+
+219
+00:19:05,480 --> 00:19:12,460
+يستخدم typically the myotropic amide الانفراد
+
+220
+00:19:12,460 --> 00:19:15,120
+الانفراد الانفراد الانفراد الانفراد الانفراد
+
+221
+00:19:15,120 --> 00:19:15,460
+الانفراد الانفراد الانفراد الانفراد الانفراد
+
+222
+00:19:15,460 --> 00:19:16,740
+الانفراد الانفراد الانفراد الانفراد الانفراد
+
+223
+00:19:16,740 --> 00:19:19,720
+الانفراد الانفراد الانفراد الانفراد الانفراد
+
+224
+00:19:19,720 --> 00:19:22,160
+الانفراد الانفراد الان
+
+225
+00:19:24,310 --> 00:19:26,890
+القلب اللي ال cases in which dilatation is
+
+226
+00:19:26,890 --> 00:19:33,810
+difficult بتتكلم على speed of مدريازيس ايش speed
+
+227
+00:19:33,810 --> 00:19:44,370
+of مدريازيس سرعة سرعة و the cycle of انتوليت 0.5 was
+
+228
+00:19:44,370 --> 00:19:48,790
+surpassed by ايه surpassed by
+
+229
+00:19:51,930 --> 00:19:59,410
+تجاوز الهوم أتروبين 2% الهوم
+
+230
+00:19:59,410 --> 00:20:07,770
+أتروبين تجاوزنا بالفنلإفرين 10% يبقى
+
+231
+00:20:07,770 --> 00:20:14,070
+احنا بدنا نرتب السرعة ساكلو فنتوليد والهوم
+
+232
+00:20:14,070 --> 00:20:21,320
+أتروبين نوعا ما بطيئينبدهم يعني تلت ساعة لما
+
+233
+00:20:21,320 --> 00:20:25,300
+يعملوا ايش ده نتيجة اذا الفلايفريين عشرة فانهية
+
+234
+00:20:25,300 --> 00:20:30,240
+أسرع منهم طب the tropic amide أسرع كمان بقوللي في
+
+235
+00:20:30,240 --> 00:20:35,440
+نهاية الساعة الأولى سبتين minutes فلايفريين ran
+
+236
+00:20:35,440 --> 00:20:42,880
+first يكون المكتب الأول يعني بيكبه أكتر من اللي
+
+237
+00:20:42,880 --> 00:20:50,920
+جابوبعد هذا الوقت، اتجارات السيكوليبنتولية تنتج 7
+
+238
+00:20:50,920 --> 00:20:58,220
+.5 مليمتر في مجموعات أفرو كاريبيا
+
+239
+00:20:58,220 --> 00:21:08,190
+لفارقة مقارنة 7.5 مليمتر في مجموعات طوائية الـ
+
+240
+00:21:08,190 --> 00:21:12,630
+cycle of ventilation في النهاية السود في نهاية
+
+241
+00:21:12,630 --> 00:21:16,350
+الساعة عامل سبعة في حين في البيض عامل سبعة و نصف
+
+242
+00:21:16,350 --> 00:21:23,770
+مش فارق فارق بسيط صح؟ فارق بسيط طيب
+
+243
+00:21:23,770 --> 00:21:31,410
+أساس هو ال what's the cause of difficulty of
+
+244
+00:21:31,410 --> 00:21:36,950
+midriasis in darkly pigmented eye reads
+
+245
+00:21:42,600 --> 00:21:48,800
+ميلانين بيعمل مكبشر ميلانين بيعمل مكبشر مع
+
+246
+00:21:48,800 --> 00:21:57,440
+الدراجة اللي بيطرح إطلاق إطلاق الدراجة اللي بيطرح
+
+247
+00:21:57,440 --> 00:21:58,040
+إطلاق الدراجة اللي بيطرح إطلاق الدراجة اللي بيطرح
+
+248
+00:21:58,040 --> 00:22:00,920
+إطلاق الدراجة اللي بيطرح إطلاق الدراجة اللي بيطرح
+
+249
+00:22:00,920 --> 00:22:01,540
+إطلاق الدراجة اللي بيطرح إطلاق الدراجة اللي بيطرح
+
+250
+00:22:01,540 --> 00:22:01,700
+إطلاق الدراجة اللي بيطرح إطلاق الدراجة اللي بيطرح
+
+251
+00:22:01,700 --> 00:22:03,400
+إطلاق الدراجة اللي بيطرح إطلاق الدراجة اللي بيطرح
+
+252
+00:22:03,400 --> 00:22:11,400
+إطلاق الدراجة اللي بيطرح إططيب الشيء الثاني is
+
+253
+00:22:11,400 --> 00:22:15,180
+diabetes mellitus لشكلته في سنة رابعة ما شاء الله
+
+254
+00:22:15,180 --> 00:22:29,160
+كبار ايه السبب صعوبة التوسيع في ال diabetes يعني
+
+255
+00:22:29,160 --> 00:22:35,020
+اللي ال diabetes عندهم دائما neuro pupil من قلق
+
+256
+00:22:39,940 --> 00:22:45,240
+مش قادمة هو
+
+257
+00:22:45,240 --> 00:22:49,540
+الأعصاب اللي بتغذي .. بتغذي المنطقة بتلصق أكثر بيبر
+
+258
+00:22:49,540 --> 00:22:52,900
+العضلة وموصلهاش دم كثير و بتاع الساعات بتضارها
+
+259
+00:22:52,900 --> 00:22:57,780
+دايما قبلها موصلهاش دم كثير المفروض تكون أبدا
+
+260
+00:22:57,780 --> 00:23:02,380
+موصلهاش دم كثير ممكن تكون relaxed بالعكس ال
+
+261
+00:23:02,380 --> 00:23:09,370
+contraction بده دم contraction بده دم و ليش؟لكن
+
+262
+00:23:09,370 --> 00:23:14,490
+أنا اللي فاهمه إن في شيء اسمه الريدو pathy الريدو
+
+263
+00:23:14,490 --> 00:23:22,270
+pathy there is deposition of some carbohydrates
+
+264
+00:23:22,270 --> 00:23:30,730
+and other compounds on the stroma of the iris of
+
+265
+00:23:30,730 --> 00:23:36,710
+diabetics that will make the dilatation difficult
+
+266
+00:23:37,990 --> 00:23:42,970
+that will make the dilatation difficult وهذا كنا
+
+267
+00:23:42,970 --> 00:23:51,030
+نقول عنه احنا Diabetic Retinopathy بيخلي
+
+268
+00:23:51,030 --> 00:23:59,210
+اللي هو ال dilatation صعب طيب بيقول لي إنه هوغر
+
+269
+00:23:59,210 --> 00:24:03,270
+هذا found that diabetic patients responded poorly
+
+270
+00:24:03,270 --> 00:24:09,400
+to tropic amide and recommended a combination of
+
+271
+00:24:09,400 --> 00:24:13,400
+tropic amide and phenylephrine to give adequate
+
+272
+00:24:13,400 --> 00:24:17,880
+midriasis with a minimum of accommodative paralysis
+
+273
+00:24:17,880 --> 00:24:25,080
+يبقى هو باختصار وهذا يعني بدي أعطيكم بحث تعملوه
+
+274
+00:24:25,080 --> 00:24:31,080
+في cases of difficult dilatation difficult pupil
+
+275
+00:24:31,080 --> 00:24:35,860
+dilatation جيبولي بحث في هذا الموضوع عشان نثري اللي
+
+276
+00:24:35,860 --> 00:24:41,580
+هو القصة هذه كل
+
+277
+00:24:41,580 --> 00:24:45,020
+الحالات اللي فيها difficult dilatation و the computer
+
+278
+00:24:45,020 --> 00:24:52,880
+بستهلي منكم بحث جيبوليه على CD مش مطول أسبوعين بس
+
+279
+00:24:52,880 --> 00:24:58,260
+خلال أسبوعين طيب
+
+280
+00:24:58,260 --> 00:25:12,830
+sector dilatation sector لو أنا في دارسهم الآن
+
+281
+00:25:12,830 --> 00:25:20,470
+أنا عندي هاي ال iris وهي ال iris الآن في
+
+282
+00:25:20,470 --> 00:25:24,870
+الناس اللي عندهم narrow angle
+
+283
+00:25:24,870 --> 00:25:29,090
+of the AC
+
+284
+00:25:32,820 --> 00:25:39,240
+نروح أنت في risk إن أعمل dilatation بأتروبين TMI أو
+
+285
+00:25:39,240 --> 00:25:45,780
+حتى في the memory frame لأن باختصار هنا شيء اسمه the root
+
+286
+00:25:45,780 --> 00:25:54,360
+of the iris جد؟ جد؟ ليش؟ لا، the root of the iris اللي أنا
+
+287
+00:25:54,360 --> 00:26:00,360
+أعمل dilatation هيبدأ ال iris يتحرك من هنا إلى هنا
+
+288
+00:26:00,360 --> 00:26:07,000
+إلى هنا إلى هنا بتن
+
+289
+00:26:07,000 --> 00:26:12,400
+على بعضها بتتري في المحارب بتاعة ال fine بتن على
+
+290
+00:26:12,400 --> 00:26:17,300
+بعضها لو احنا نشرناها كده و أنا صغير مسكها و جري
+
+291
+00:26:17,300 --> 00:26:23,700
+فيها بيوصل عشرين متر صح صارت احنا بس بيصير أحيانا
+
+292
+00:26:23,700 --> 00:26:27,120
+مسكها و جري فيها ايه تقول ايه تكاد يا ابني في
+
+293
+00:26:27,120 --> 00:26:33,220
+العلبة ايش خلاك تعملها الآن ال iris زي ما نقوله شمر
+
+294
+00:26:33,220 --> 00:26:42,240
+حتى وصل هنا وصل هنا عمل هنا شيء اسمه over crowding
+
+295
+00:26:42,240 --> 00:26:46,940
+زحمة
+
+296
+00:26:46,940 --> 00:26:53,320
+شديدة على the root of the iris حيث ال angle ال angle هنا
+
+297
+00:26:53,320 --> 00:27:03,790
+هي هنا هي ال angle فهو هنا اللي صار فيه ايش over
+
+298
+00:27:03,790 --> 00:27:10,990
+crowding طيب لو ال angle هذه أساسا هي narrow angle
+
+299
+00:27:10,990 --> 00:27:19,430
+narrow angle حتم أهين و حتم أهين طيب الآن أنا ممكن
+
+300
+00:27:19,430 --> 00:27:26,030
+أقتله بواحد طيبتك و narrow angle أو بس يعني أنا مو
+
+301
+00:27:26,030 --> 00:27:33,480
+موصعلوشلأ .. لأ .. لأ .. بصرا .. بصرا .. بصرا ..
+
+302
+00:27:33,480 --> 00:27:34,100
+لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ
+
+303
+00:27:34,100 --> 00:27:34,880
+.. لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ ..
+
+304
+00:27:34,880 --> 00:27:35,180
+لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ
+
+305
+00:27:35,180 --> 00:27:35,360
+.. لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ ..
+
+306
+00:27:35,360 --> 00:27:35,440
+.. لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ ..
+
+307
+00:27:35,440 --> 00:27:44,640
+.. لأ .. لأ .. لأ .. لأ .. لأ .. لأ ..
+
+308
+00:27:44,640 --> 00:27:52,780
+لأ
+
+309
+00:27:52,780 --> 00:28:02,500
+.. لأخلّي لو .. لو ال micro organisms هذه أنا ما
+
+310
+00:28:02,500 --> 00:28:09,400
+شفتها ب laser ممكن تصير bloody تعمل دم مش هعمل ..
+
+311
+00:28:09,400 --> 00:28:14,340
+بقولي هنا بقولي
+
+312
+00:28:14,340 --> 00:28:22,720
+هنا جرب جيب سفنجة sponge
+
+313
+00:28:22,720 --> 00:28:30,640
+زي نكاشة بس مش قطن spongeو حط عليها هنا drops أو
+
+314
+00:28:30,640 --> 00:28:44,920
+مدرميل مدرميل و هاتها حط مثلا هنا هتعطيك
+
+315
+00:28:44,920 --> 00:28:54,880
+توسية هيك جزني هذا اسمه sector pupil dilatation
+
+316
+00:28:57,110 --> 00:29:03,290
+sector pupil dilatation كإني أنا عملت نافذة طبعا
+
+317
+00:29:03,290 --> 00:29:12,030
+هالهي وحاول زي ما قلته يعني أنظر منها إلى داخل
+
+318
+00:29:12,030 --> 00:29:16,190
+الشبكية هنا
+
+319
+00:29:16,190 --> 00:29:18,850
+مافيش خطر انغلاق كلي
+
+320
+00:29:21,600 --> 00:29:26,040
+يعني أنا تجاوزت حاولت أني أوسع جزئي و بقى أتييسر
+
+321
+00:29:26,040 --> 00:29:30,980
+أني أرسل ال light بتاعي إلى قاع العين بدون ما أخش
+
+322
+00:29:30,980 --> 00:29:34,940
+في ال risk الخطيرة بتاعة ال angle closure اللوكوم
+
+323
+00:29:34,940 --> 00:29:41,000
+هذا معناه ال sector dilatation إنه غير طريقة طبعا
+
+324
+00:29:41,000 --> 00:29:49,160
+طبعا أنتم حالكم مجربين تعالوا الإنسان العادي زينا و
+
+325
+00:29:49,160 --> 00:29:50,840
+جيب كوتون
+
+326
+00:29:52,670 --> 00:29:57,290
+أه ماعرفش اسمه قطن عادي وحط عليها مدنا ميد وحطيها
+
+327
+00:29:57,290 --> 00:30:02,930
+هنا على ال limbus limbus هنا تحت أو في الجنب مدة
+
+328
+00:30:02,930 --> 00:30:07,090
+مثلا عشر دقائق هتلاقي إنه صار ال بؤبؤ فعلا يعني
+
+329
+00:30:07,090 --> 00:30:16,030
+عامل ايه البؤبؤ عامل عامل ايه نافذة إضافية وأنا
+
+330
+00:30:16,030 --> 00:30:21,670
+بصير بس للحالات أن أنا شاك إن فيها narrow angle
+
+331
+00:30:21,670 --> 00:30:30,130
+narrow angle ممكن
+
+332
+00:30:30,130 --> 00:30:38,550
+طبعا أحط Tropic amide أو احط fly طيب الشيء الثالث
+
+333
+00:30:44,940 --> 00:30:47,460
+و the study has demonstrated that the efficacy of
+
+334
+00:30:47,460 --> 00:30:52,280
+a novel a novel method of Pediatrics pediatric drug
+
+335
+00:30:52,280 --> 00:30:57,060
+delivery in children of 22 healthy children جابوا
+
+336
+00:30:57,060 --> 00:31:03,120
+22 طفل صحتهم كويسة عمرهم 2 إلى 8 years were given
+
+337
+00:31:03,120 --> 00:31:11,480
+either جربونهم الطريقتين الطريقة الأولى word drop
+
+338
+00:31:12,820 --> 00:31:19,340
+Each eye of 1% tropicamide and 2% 2.5 filanifrine
+
+339
+00:31:19,340 --> 00:31:26,660
+in each eye يبقى مجموعة أطفال من 22 وضعوا لهم في
+
+340
+00:31:26,660 --> 00:31:35,000
+العين خليط من 1% tropicamide و2.5 filanifrine مع
+
+341
+00:31:35,000 --> 00:31:41,480
+بعض طيب إجوا العين الثانية حطوا
+
+342
+00:31:42,180 --> 00:31:51,940
+مدرياتيك سبريه بخار رش محتوى 0.5 tropicamide و 2.5
+
+343
+00:31:51,940 --> 00:32:00,440
+فيرانفرين لكل عين مفتوحة والعين مسكرة النتيجة أنه
+
+344
+00:32:00,440 --> 00:32:06,720
+لم يكن هناك اختلاف كبير في كبير الناس بين الاثنين
+
+345
+00:32:06,720 --> 00:32:10,860
+الأسلحة في 40 دقيقة
+
+346
+00:32:15,540 --> 00:32:21,420
+after application it is a disappointing that this
+
+347
+00:32:21,420 --> 00:32:27,480
+friendly mode of application has not become
+
+348
+00:32:27,480 --> 00:32:30,700
+commercially available يعني هو بيقول إن الطريقة
+
+349
+00:32:30,700 --> 00:32:39,180
+الثانية the spray اللي بتنحط على عين مغمضة أفضل و
+
+350
+00:32:39,180 --> 00:32:43,440
+هي صديقة للطفل لكنها مش commercially available مش
+
+351
+00:32:43,440 --> 00:32:50,850
+مسوقة في السوق هذا عندهم لما عندنا فالأمل في الله
+
+352
+00:32:50,850 --> 00:32:57,290
+يصير مصانع فلسطينية تنتج هذا الخليل من المرياتكس
+
+353
+00:32:57,290 --> 00:33:03,310
+إن شاء الله لسه الله بكثير وقعدونا زمان قالوا هو
+
+354
+00:33:03,310 --> 00:33:09,110
+سنغافورة الشرق الأوسط قالوا قطاع غزة سنغافورة
+
+355
+00:33:09,110 --> 00:33:14,410
+الشرق الأوسط وإن شاء الله بيجي يوم طيب
+
+356
+00:33:15,860 --> 00:33:21,160
+advance effects of midriatics يعني أنا بخاف من ايش لما
+
+357
+00:33:21,160 --> 00:33:26,740
+أعمل مدريازيس في أشياء أخرى منها هاي بقى أسألكم
+
+358
+00:33:26,740 --> 00:33:30,140
+يعني ايش
+
+359
+00:33:30,140 --> 00:33:35,020
+يعني ممكن تكون advance أشياء يعني خاطرة أو مكروهة
+
+360
+00:33:35,020 --> 00:33:40,340
+بيقول
+
+361
+00:33:40,340 --> 00:33:43,220
+لي هو يعني في أشياء بسيطة
+
+362
+00:33:46,670 --> 00:33:49,770
+وبعدين مورف الفوتوفوبيا و الكلام هذا و ال
+
+363
+00:33:49,770 --> 00:33:55,510
+angle closure glaucoma risk هذا هو الأهم بيقول
+
+364
+00:33:55,510 --> 00:33:58,290
+لي when any topically applied ophthalmic drug
+
+365
+00:33:58,290 --> 00:34:01,910
+there is a possibility of producing an undesirable
+
+366
+00:34:01,910 --> 00:34:07,430
+effect في أشياء غير مرغوبة either on the eye or on
+
+367
+00:34:07,430 --> 00:34:11,590
+the body as a whole Midriatics have the ability to
+
+368
+00:34:11,590 --> 00:34:15,980
+do both لأنه محتمال يعملوا على العين نفسها ومحتمال
+
+369
+00:34:15,980 --> 00:34:20,160
+يعملوه على الجسم Many of the potential problems
+
+370
+00:34:20,160 --> 00:34:23,860
+can be avoided by carrying out the following
+
+371
+00:34:23,860 --> 00:34:28,320
+precautions الاحتياطات اللازمة دي اما الاحتياطات
+
+372
+00:34:28,320 --> 00:34:33,820
+علاقة في the risk أو شيء explain to the patient the
+
+373
+00:34:33,820 --> 00:34:38,420
+reasons for dilating the pupils يعني أنا متعامل مع
+
+374
+00:34:38,420 --> 00:34:38,840
+إنسان
+
+375
+00:34:41,580 --> 00:34:44,820
+لما تعالوا لإنسان، الإنسان له عقل، مادخله لعقل، إن
+
+376
+00:34:44,820 --> 00:34:55,020
+أقنعته للقاد للعقل، لكن إن أكرهته، لا ينقعد، يعني
+
+377
+00:34:55,020 --> 00:35:04,780
+واحد رايح يعالج سنه، طبعا، إما حشوة،
+
+378
+00:35:04,780 --> 00:35:05,840
+وإما خلع
+
+379
+00:35:10,670 --> 00:35:17,250
+هيفهم يقولوا والله أنا وجدت هذا الدرس فيه سوسة و
+
+380
+00:35:17,250 --> 00:35:24,310
+سوسة بلغة مبلغ فاحنا مضطرين نعطيك بنج عشان نحفره و
+
+381
+00:35:24,310 --> 00:35:29,130
+نعمله حشوة و يمكن تكون حشوة عصابة لازم تصبر علينا
+
+382
+00:35:29,130 --> 00:35:34,890
+ساعة بعد ال بنج أو يقولوا هذا مافي أمل لازم الآن
+
+383
+00:35:34,890 --> 00:35:37,290
+أجعدك و أضربك إبرة بنج و أخلعه
+
+384
+00:35:40,710 --> 00:35:46,330
+ايش رأيك؟ بقولوا توكلوا على الله، اعملوا ده كده يالا،
+
+385
+00:35:46,330 --> 00:35:49,170
+نام على الكرسي، نام على الكرسي، رجع رأسك، افتح
+
+386
+00:35:49,170 --> 00:35:54,870
+تمك، بصير الإنسان ايش؟ تقرأ هنا، نافذ أوامر، ده
+
+387
+00:35:54,870 --> 00:36:02,150
+الطبيعي، لكن لو إجا، جروا هيك وعص عليه، أه، وسند
+
+388
+00:36:02,150 --> 00:36:06,730
+رأسه، فتحت تمه بالجوا، وبدأ ايش؟ أدخله أدوات في
+
+389
+00:36:06,730 --> 00:36:13,330
+تمه، بالتمس، بالخاتم، صح؟ هي بتعمل مع بشر و ال
+
+390
+00:36:13,330 --> 00:36:15,970
+optometry و the ophthalmology هم أرقى أخص من
+
+391
+00:36:15,970 --> 00:36:21,210
+الأسنان يعني في ناس بيعتبرهم طبيب .. طبيب العيون
+
+392
+00:36:21,210 --> 00:36:24,970
+وشيء إنه أرقى بقوله بضربش عبارة كثيرة و يعني و
+
+393
+00:36:24,970 --> 00:36:30,310
+رخيق شوية و the optometry لسه أرق أو شيء explain to
+
+394
+00:36:30,310 --> 00:36:30,790
+the
+
+431
+00:39:36,980 --> 00:39:40,700
+pediatric complications الآن بعد ما احنا سألنا
+
+432
+00:39:40,700 --> 00:39:46,660
+الأسئلة المعتادة وأنا بحب أنها تكون نمرا 5 نمرا 6
+
+433
+00:39:46,660 --> 00:39:55,400
+فاهم نمرا 6 الآن كيف أتجنب المشاكل والمضاعفات 
+
+434
+00:39:55,400 --> 00:40:03,540
+اللي بتشتغل في الدواء بتكون فاهمة مشاكل الدواء وأنا 
+
+435
+00:40:03,540 --> 00:40:09,280
+باستخدامه أنا باستخدام نقطة واحدة تكفي نقطة مثلاً
+
+436
+00:40:09,280 --> 00:40:14,720
+مدرى مائي نقطة هنا نقطة هنا however it might be
+
+437
+00:40:14,720 --> 00:40:18,420
+necessary to use two or three drops with older
+
+438
+00:40:18,420 --> 00:40:22,920
+patients and those with darkly pigmented eyelids
+
+439
+00:40:22,920 --> 00:40:26,740
+شباب
+
+440
+00:40:26,740 --> 00:40:33,090
+في هذا السن بيعمل نقطة واحدة كبير السن والـ
+
+441
+00:40:33,090 --> 00:40:36,430
+diabetes mellitus والـ darkly pigmented هذه 
+
+442
+00:40:36,430 --> 00:40:40,550
+المشاكل اللي هو eye reds ممكن ياخذ ثانية أو تلاتة 
+
+443
+00:40:40,550 --> 00:40:47,610
+بس أمره أن يفضل مغمض عينيه فترة عشر دقائق حتى
+
+444
+00:40:47,610 --> 00:40:55,110
+القطرة ما بتزلج تحت أو أن يوضع أصابعه في موضع هنا 
+
+445
+00:40:55,110 --> 00:41:00,010
+على الـ angle هنا تحت حتى يسكر نزول الدواء
+
+446
+00:41:03,930 --> 00:41:12,010
+ورق نشاف ينشف القطرة الزيادة بسرعة عدة أشياء المهم
+
+447
+00:41:12,010 --> 00:41:15,810
+أن أنا بدي القطرة تروح في العين ما تروح في الدم
+
+448
+00:41:15,810 --> 00:41:23,610
+أنا مقصد القطرة للدم ولا للعين؟ طيب المنفذ اللي 
+
+449
+00:41:23,610 --> 00:41:28,190
+القطرة بتروح منه على الدم الـcanaliculi اللي تحت وفوق
+
+450
+00:41:28,190 --> 00:41:42,030
+في ناس عندهم حاجة زي silicone أو زي كده تيوب بيحط
+
+451
+00:41:42,030 --> 00:41:46,190
+إيش في الـ cannaliculi بيسكر الـ cannaliculi أو حتى بخيط جراحي
+
+452
+00:41:46,190 --> 00:41:51,050
+بيسكر الـ cannaliculi اللي هنا واللي هنا بيسكر الـ cannaliculi
+
+453
+00:41:51,050 --> 00:41:57,590
+حتى أنه ما هي تروح بعد هيك على اللي هو الـ sac والـ
+
+454
+00:41:57,590 --> 00:42:01,430
+الـ nasolacrimal duct وترجع تحت على اللي هو إيش العين
+
+455
+00:42:04,330 --> 00:42:08,750
+وهنا major intraocular pressure was before and
+
+456
+00:42:08,750 --> 00:42:12,990
+upon completion of the midriatic examination قياس
+
+457
+00:42:12,990 --> 00:42:19,150
+ضغط العين قبل الـ midriasis وبعد الـ midriasis طب لو لاجناه
+
+458
+00:42:19,150 --> 00:42:22,910
+عالي نحن
+
+459
+00:42:22,910 --> 00:42:27,230
+لاجناه من الأساس عالي ما نحطش يعني لو لاجناه مثلاً 24
+
+460
+00:42:27,230 --> 00:42:29,550
+millimeter Hg زي بقية
+
+461
+00:42:36,160 --> 00:42:42,600
+border العين لاجناه 18 نحط وبعد نص ساعة القياس 
+
+462
+00:42:42,600 --> 00:42:49,420
+الاجناه مرتفعة يبقى بدنا نحط anti-hypertensive 
+
+463
+00:42:49,420 --> 00:42:57,640
+timoptol مثلاً timoptol مثلاً أي drug trust up غيره
+
+464
+00:42:57,640 --> 00:43:01,100
+trust up أي drug اللي نزل ضغط العين إذا كان
+
+465
+00:43:01,100 --> 00:43:05,610
+واجدناه بعد نص ساعة عليها مع إنهم بيقولوا يعني هذا
+
+466
+00:43:05,610 --> 00:43:10,690
+الاتفاق اتفاق transient اللي إنه برضه بده يقلل الـ
+
+467
+00:43:10,690 --> 00:43:17,790
+need for kill issue inaudible stating the mediatic
+
+468
+00:43:17,790 --> 00:43:21,470
+used and providing advice on what action the 
+
+469
+00:43:21,470 --> 00:43:24,930
+patient should be take in the event of an 
+
+470
+00:43:24,930 --> 00:43:29,970
+adverse action يبقى أكتر أنا hint هنا إنه في 
+
+471
+00:43:29,970 --> 00:43:32,490
+تاريخ كذا كذا وضعنا
+
+472
+00:43:33,920 --> 00:43:39,280
+رفس اسمها tropicamide لهذا المريض ساعة كده يوم كده 
+
+473
+00:43:39,280 --> 00:43:48,340
+أختمها وأطمئن هي أفرض في الليل حدث الـ angry closure
+
+474
+00:43:48,340 --> 00:43:54,760
+بيقولوا له هو مش عارف إن أنا وين أنا في مركز عملت له
+
+475
+00:43:54,760 --> 00:43:59,060
+في مركز عملت له في أي هذا هتحرك إيش لأقرب مستشفى
+
+476
+00:43:59,060 --> 00:44:05,250
+يفحص ويقولوا وقت إيش وكيف ويقولوا له هي أنا ساعدت و
+
+477
+00:44:05,250 --> 00:44:11,230
+ساعدت الـ medical team اللي هيكمل الفحص يعني أنا
+
+478
+00:44:11,230 --> 00:44:16,010
+بتعامل مع الإنسان كإنسان بتعامل مع الإنسان كإنسان
+
+479
+00:44:16,010 --> 00:44:27,070
+طيب في شيء آخر مش مكتوب عارفين إيش هو؟ نصحني دكتوري
+
+480
+00:44:27,070 --> 00:44:32,850
+اللي كان يدرسني الله يسهل عليه قال لي يا محمد عشان
+
+481
+00:44:32,850 --> 00:44:38,510
+تنام أنت مرتاح وrelaxed حط له نقطة pilocarpine في
+
+482
+00:44:38,510 --> 00:44:42,330
+كل عين خلاص
+
+483
+00:44:42,330 --> 00:44:47,410
+أنت خلاص تمام جامد قول مع السلامة شكراً حط له نقطة
+
+484
+00:44:47,410 --> 00:44:52,310
+مضيق هنا ونقطة مضيق هنا وأكل أمر إلى الله أروح
+
+485
+00:44:52,310 --> 00:44:58,350
+نام بعد هيك مرتاح عشان ما يصيرش الطلبات بعد ساعتين
+
+486
+00:44:58,350 --> 00:45:04,470
+ثلاثة أربعة في land كل جربكم يحدث أحياناً حط له 
+
+487
+00:45:04,470 --> 00:45:12,570
+نقطة مضيق وهذه اللي فوقها تثبيتها تثبيتها ت
+
+488
+00:45:12,570 --> 00:45:22,010
+install a drop أو miotic on
+
+489
+00:45:22,010 --> 00:45:26,550
+each eye after
+
+490
+00:45:26,550 --> 00:45:29,710
+the examination
+
+491
+00:45:33,170 --> 00:45:44,310
+من العيون بعد midriasis للتأكد
+
+492
+00:45:44,310 --> 00:45:50,030
+أن فرصة
+
+493
+00:45:50,030 --> 00:45:57,410
+إطلاق glaucoma عقلية قريبة أو
+
+494
+00:45:57,410 --> 00:46:00,010
+غير عادية أو نل
+
+495
+00:46:04,020 --> 00:46:12,000
+فهمتي يا بغداد؟ تقفي بيها من البنات طيب
+
+496
+00:46:12,000 --> 00:46:21,180
+قلنا أصعب شيء إن واجهها optometrist أو
+
+497
+00:46:21,180 --> 00:46:27,480
+ophthalmologist هو الـ angry closure هل 
+
+498
+00:46:27,480 --> 00:46:31,440
+الـ angry closure يمكن تعمل عمل؟ طبعاً ليش؟ 
+
+499
+00:46:47,990 --> 00:46:54,870
+طيب تفكرون أيام الـ ..  وأنتوا أشباه صغار يعني الـ
+
+500
+00:46:54,870 --> 00:47:03,160
+optic nerve مكون من one million two hundred thousand
+
+501
+00:47:03,160 --> 00:47:06,700
+fiber
+
+502
+00:47:06,700 --> 00:47:14,000
+fibrils إيش fibrils ليفات
+
+503
+00:47:14,000 --> 00:47:27,120
+الـ fiber ليفة الـ fibril ليف الآن كل اللي هو الـ .. الـ 
+
+504
+00:47:27,120 --> 00:47:39,860
+circle هذه لو أخذنا قطعة في الكلها 1.5
+
+505
+00:47:39,860 --> 00:47:45,320
+ملي متر القطر
+
+506
+00:47:45,320 --> 00:47:56,580
+محتوية dura mater و pia mater و arachnoid mater و
+
+507
+00:47:56,580 --> 00:48:01,840
+Central Retinal artery و Central Retinal vein كم 
+
+508
+00:48:01,840 --> 00:48:09,240
+فضل للمليون ومئتين ألف ليف من واحد ونصف؟ كم فضل؟
+
+509
+00:48:09,240 --> 00:48:21,420
+هذه الـ fibrils صعبة جداً وأي ضغط داخل العين سيكون
+
+510
+00:48:21,420 --> 00:48:28,020
+تأثيره على نفس الكمبيوتر العلوي للتحقيق
+
+511
+00:48:30,500 --> 00:48:37,360
+Blood supply to these fibrils and lead to death 
+
+512
+00:48:37,360 --> 00:48:42,720
+due to ischemia و
+
+513
+00:48:42,720 --> 00:48:49,020
+الانهيار بيكون سريع يعني مش بيبقى كل يوم مئة ألف
+
+514
+00:48:49,020 --> 00:48:55,240
+ليف يروح فكل ساعة من ساعات الـ angle closure glaucoma 
+
+515
+00:48:55,240 --> 00:49:03,970
+بتقطع عشرات أو مئات الألاف من الـ fibers واللي
+
+516
+00:49:03,970 --> 00:49:09,950
+بيروح بيرجع ولا لأ؟ بيرجعش اللي بيروح بيرجعش أبدًا
+
+517
+00:49:09,950 --> 00:49:16,410
+الله والخالق جعل الألم سلاحاً وبقايا هذا اللي 
+
+518
+00:49:16,410 --> 00:49:20,150
+يصيبه الـ angry closure الـ glaucoma ضغط العين فوق
+
+519
+00:49:20,150 --> 00:49:26,130
+الـ 60 أو الـ 70 ملليمتر ذئب يصرخ صراخاً غير عادي
+
+520
+00:49:26,130 --> 00:49:32,630
+غير عادي ما يعني عادي مما يعني يؤدي إلى أن يبحثوا له عن
+
+521
+00:49:32,630 --> 00:49:38,450
+علاج ولا وراء البحر ويُكتشف لما يلاقي ابن حلال زيكم
+
+522
+00:49:38,450 --> 00:49:45,790
+يفهم هذا الصراخ ويعطيه دواء ومحلول ويعمل له
+
+523
+00:49:45,790 --> 00:49:51,410
+procedures أثناء إتخاذ لازم ضغط العين بيكون أنقذ من
+
+524
+00:49:51,410 --> 00:49:57,780
+هذه الألاف أن تدخل كويسة المعلومة هذه؟ بس آخر حاجة 
+
+525
+00:49:57,780 --> 00:50:01,760
+هنا هو the property cautions are taken, the risk of
+
+526
+00:50:01,760 --> 00:50:04,820
+precipitating angle closure glaucoma is virtually none
+
+527
+00:50:04,820 --> 00:50:08,980
+لما نأخذ بالنا لما نأخذ بالنا والمرة الجاية إن
+
+528
+00:50:08,980 --> 00:50:14,040
+شاء الله بنكمل اللي هو الدرس شكراً لكم 
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/KFmDQ9bkFLw_raw.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/KFmDQ9bkFLw_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..08f5a5201095d533d8eace047c127f524f6adf63
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/KFmDQ9bkFLw_raw.srt
@@ -0,0 +1,2140 @@
+1
+00:00:20,960 --> 00:00:23,040
+أعوذ بالله من الشيطان الرجيم باسم الله الرحمن
+
+2
+00:00:23,040 --> 00:00:26,440
+الرحيم الحمد لله رب العالمين و أصلي و أصلم على
+
+3
+00:00:26,440 --> 00:00:29,460
+النبي الأمين محمد وعلى آله و أصحابه و اتابعين
+
+4
+00:00:29,460 --> 00:00:33,580
+السلام عليكم ورحمة الله وبركاته في هذا اليوم ان
+
+5
+00:00:33,580 --> 00:00:37,960
+شاء الله سأكمل المحاربة السابقة حول اللي هو
+
+6
+00:00:37,960 --> 00:00:44,160
+موسيعات بُق بُق العين موسيعات بُق بُق العين في هذا
+
+7
+00:00:44,160 --> 00:00:46,980
+اليوم سأتكلم على choice of mediatics
+
+8
+00:00:49,630 --> 00:00:56,710
+ماذا نختار من ال Mediatics؟ في الحقيقة بعد ما تم
+
+9
+00:00:56,710 --> 00:01:04,830
+حذف الكثير من الموسيعات يعني زي ال Ephedrine و زي
+
+10
+00:01:04,830 --> 00:01:10,490
+ال Atropine وحتى ال Atropine نفسه كان موسيع لا
+
+11
+00:01:10,490 --> 00:01:18,010
+يستخدم فلم يعد الخيار الا بين الثلاثة TropicMI
+
+12
+00:01:19,970 --> 00:01:24,570
+بنقول عنه مدرامايت فيناليفرين
+
+13
+00:01:24,570 --> 00:01:34,970
+هما الخط الأول إذا لم يكفي فيتم التعامل مع واحد
+
+14
+00:01:34,970 --> 00:01:39,990
+تالت اسمه Cyclopentolate مع أن Cyclopentolate له
+
+15
+00:01:39,990 --> 00:01:45,210
+effect كبير على اللي هو الcellular muscle يبقى
+
+16
+00:01:45,210 --> 00:01:48,270
+الألبط دي احنا برتب choice omnitics number one
+
+17
+00:01:48,270 --> 00:01:54,660
+tropical mindmore efficient, more rapid, shorter
+
+18
+00:01:54,660 --> 00:02:00,260
+duration هو tropical wind إذا
+
+19
+00:02:00,260 --> 00:02:06,400
+لم يكفي ممكن استعين في الفناء اللي فيه إذا لم يكفي
+
+20
+00:02:06,400 --> 00:02:09,640
+في ال cyclopetrate، يعني ال cyclopetrate آخر اللي
+
+21
+00:02:09,640 --> 00:02:12,240
+هو خط من الخطوة
+
+22
+00:02:14,460 --> 00:02:17,580
+السيتروبيتوليت يجب أن يكون اعتباره فقط إذا لم ينجح
+
+23
+00:02:17,580 --> 00:02:25,160
+هذه الدراجات بإنتاج مستوى مدرياتيكي كافي مدرياتيكي
+
+24
+00:02:25,160 --> 00:02:28,000
+كافي مدرياتيكي كافي مدرياتيكي كافي مدرياتيكي كافي
+
+25
+00:02:28,000 --> 00:02:30,120
+مدرياتيكي كافي مدرياتيكي كافي مدرياتيكي كافي
+
+26
+00:02:30,120 --> 00:02:31,500
+مدرياتيكي كافي مدرياتيكي كافي مدرياتيكي كافي
+
+27
+00:02:31,500 --> 00:02:33,840
+مدرياتيكي كافي مدرياتيكي كافي مدرياتيكي كافي
+
+28
+00:02:33,840 --> 00:02:39,120
+مدرياتيكي كافي مدرياتيكي كافي مدرياتيكي كافي
+
+29
+00:02:39,120 --> 00:02:45,540
+مدرياتيكي كافي ميبقى و Tropic Emile الأول بلا
+
+30
+00:02:45,540 --> 00:02:52,080
+منازع مش لسرقته بس لأ لأنه ال depth أو مادري يا
+
+31
+00:02:52,080 --> 00:02:58,400
+عزيزي بيكون very good اما قول depth يعني ال effect
+
+32
+00:02:58,400 --> 00:03:06,260
+very good الشيء التالت انه there is abolishing
+
+33
+00:03:06,260 --> 00:03:15,590
+يعني الغاء ofالفرنفرين عيبه انه صح بيوسع لكن
+
+34
+00:03:15,590 --> 00:03:19,770
+الساعة التانية دي اعمل indirect ophthalmoscope او
+
+35
+00:03:19,770 --> 00:03:27,130
+فندس photographي تصوير القيامة بيرجع بديك وهذا من
+
+36
+00:03:27,130 --> 00:03:33,030
+العيوب بتاعك more
+
+37
+00:03:33,030 --> 00:03:36,370
+deal
+
+38
+00:03:36,370 --> 00:03:38,690
+في 1986
+
+39
+00:03:41,200 --> 00:03:45,580
+بمقارنة بـ 0.1% في نهاية الفريق و 10% في نهاية
+
+40
+00:03:45,580 --> 00:03:51,300
+الفريق كمترياتيكس قرر ان لا يكن ايضا افضل بسبب
+
+41
+00:03:51,300 --> 00:03:59,860
+اختصار استجابة يعني مقارنة 10% في نهاية الفريق مع
+
+42
+00:03:59,860 --> 00:04:07,620
+10% في نهاية الفريق نهاية الفريق هي 1% يعني 1%
+
+43
+00:04:08,990 --> 00:04:13,310
+أستخدم كمدرياتيك and cyclopidic لكن four مدرياسي
+
+44
+00:04:13,310 --> 00:04:24,130
+تروبيك اميد only 0.5 هو قارن مقارنة عشر في المية
+
+45
+00:04:24,130 --> 00:04:28,570
+تروبيك اميد مع عشر في المية فنيفرين جال ماحدش منهم
+
+46
+00:04:28,570 --> 00:04:33,190
+ك .. يعني كتير يعني أنا مقتنع فيه لأن في الحالتين
+
+47
+00:04:33,190 --> 00:04:37,410
+في loss of accommodation مع إن الكلام هذا يعني كان
+
+48
+00:04:37,410 --> 00:04:42,870
+موجود عليهالفنان الفرين يشك إنه بيشتغل على
+
+49
+00:04:42,870 --> 00:04:47,290
+السيراني مصر لإن هو بيشتغل على ال sympathetic و
+
+50
+00:04:47,290 --> 00:04:49,830
+ليس على ال parasympathetic و السيراني مصر
+
+51
+00:04:49,830 --> 00:04:55,370
+parasympathetic لكن هم وجدوا إنه في recession أو
+
+52
+00:04:55,370 --> 00:05:01,730
+breathing from their part مش فاهمين ليش هم حتىليش
+
+53
+00:05:01,730 --> 00:05:03,730
+فيه recession of reading من نير بويند؟ في
+
+54
+00:05:03,730 --> 00:05:08,270
+الفنانيفرين؟ هو بيقولك روسم of accommodation، ناس
+
+55
+00:05:08,270 --> 00:05:10,970
+تانية بيقولك يعني depth of focus، ناس تانية بيقولك
+
+56
+00:05:10,970 --> 00:05:14,070
+عشان هو عمل aberrations وما aberrations وكلام زي
+
+57
+00:05:14,070 --> 00:05:20,090
+هذا، لكن الحقيقة ولا مش معروفة لسه، طيب Tropic
+
+58
+00:05:20,090 --> 00:05:23,010
+emite can cause an increase in intraocular
+
+59
+00:05:23,010 --> 00:05:26,560
+pressure in eyes with a deep anterior chamberيعني
+
+60
+00:05:26,560 --> 00:05:30,380
+وجدوا قاصوا ضفة العين قبل ال tropic imide او قاصوا
+
+61
+00:05:30,380 --> 00:05:33,160
+ضفة العين بعد ال tropic imide وجدوا ان ضفة العين
+
+62
+00:05:33,160 --> 00:05:42,480
+بيعلق شوية مع tropic imide لكن هذا الارتفاع مش سبب
+
+63
+00:05:42,480 --> 00:05:48,320
+انه احنا نتركه لانه ارتفاع وقتي وارتفاع نسبي يعني
+
+64
+00:05:48,320 --> 00:05:52,140
+ممكن يرفع من 16
+
+65
+00:05:54,490 --> 00:06:01,470
+أو يرفع من سبعتاش إلى تمانتاش أو تمانتاش و نص لمدة
+
+66
+00:06:01,470 --> 00:06:05,870
+مثلا عشر دقائق أو رابع ساعة هل هذا سبب ان احنا
+
+67
+00:06:05,870 --> 00:06:12,350
+نترك Tropic Emile هو ال main effective مدرياتك؟
+
+68
+00:06:12,350 --> 00:06:12,830
+طبعا
+
+69
+00:06:16,990 --> 00:06:21,050
+ممكن يخاف منه لكن هو بيقول يعني however the rise
+
+70
+00:06:21,050 --> 00:06:25,930
+in intraocular pressure is likely to be small and
+
+71
+00:06:25,930 --> 00:06:30,570
+transient ايش transient موقع موقع and unlikely to
+
+72
+00:06:30,570 --> 00:06:35,590
+cause a problem فالعنفرين
+
+73
+00:06:35,590 --> 00:06:39,810
+لأ العيب بتاعه هو مابرفعش ضغط العين بل يمكن بنزل
+
+74
+00:06:39,810 --> 00:06:43,810
+ضغط العين شوية فعنفرين مشكلته لو راح على الدم
+
+75
+00:06:51,330 --> 00:06:56,810
+كل عيد وراح على الدم و في واحد عنده cardiovascular
+
+76
+00:06:56,810 --> 00:07:06,430
+problem زي مثلا الكورني ارتري يكون مثلا نارو،
+
+77
+00:07:06,430 --> 00:07:11,810
+هيكون في الانتظام، ضربات القلب، احنا بنخاف انه
+
+78
+00:07:11,810 --> 00:07:20,280
+ممكن يعملنا مشكلةبسيطة دماغي ومعرفة في المريض في
+
+79
+00:07:20,280 --> 00:07:23,540
+المشاكل الكاردوبسكالية وفي الذين يأخذوا حاجات
+
+80
+00:07:23,540 --> 00:07:28,400
+معينة يعني احنا لما بنحط في 9-13 بنكون احنا فاهمين
+
+81
+00:07:28,400 --> 00:07:35,460
+يعني انه له بعض المساواة فممكن نحط صح نقطة و بعدين
+
+82
+00:07:35,460 --> 00:07:40,100
+نقطة هنا و نقطة و بعدين نقطة هنا لكن ممكن انه to
+
+83
+00:07:40,100 --> 00:07:44,500
+keep his eyes closed مثلا
+
+84
+00:07:46,020 --> 00:07:58,080
+for مثلا many minutes ليش؟ to prevent the .. أيوة
+
+85
+00:07:58,080 --> 00:08:02,540
+passage of the drops through the nasal lacrimal
+
+86
+00:08:02,540 --> 00:08:07,280
+duct إلى الساق إلى mucous membrane of nasal
+
+87
+00:08:07,280 --> 00:08:08,000
+pharynx
+
+88
+00:08:11,820 --> 00:08:16,680
+طيب in summary اجمالي يعني ملخص it would appear
+
+89
+00:08:16,680 --> 00:08:21,480
+that tropic emis 0.5 is the first choice as a
+
+90
+00:08:21,480 --> 00:08:26,940
+مدرياتيك هاي الخلاصة هنا عندي الخلاصة بدا نوسع أول
+
+91
+00:08:26,940 --> 00:08:32,440
+خط نصف المية tropic emis as a مدرياتيك but special
+
+92
+00:08:32,440 --> 00:08:37,840
+conditions require special considerations لكل حالة
+
+93
+00:08:37,840 --> 00:08:43,310
+عنها حدث بعد ذلكمثلا اللي لم يكفل نص كنا نحط واحد
+
+94
+00:08:43,310 --> 00:08:48,330
+اللي لم يكفل واحد ممكن نحط فنال افرين اللي لم يكفل
+
+95
+00:08:48,330 --> 00:08:52,250
+فنال افرين كنا نحط cyclopendolate خاصة pre
+
+96
+00:08:52,250 --> 00:08:57,730
+-operatively لان انا اتركت extraction مثلا وفي ال
+
+97
+00:08:57,730 --> 00:09:03,190
+photography فانطس photography و ال direct فانطس
+
+98
+00:09:03,190 --> 00:09:07,990
+كله ممكن تضطر ان واحنا هنستخدم او في بعض الناس
+
+99
+00:09:07,990 --> 00:09:09,410
+اللي البابا بتاعهم
+
+100
+00:09:14,330 --> 00:09:18,070
+الخط الأول هو النص و ليس متوفر للأسف أننا نص اما
+
+101
+00:09:18,070 --> 00:09:22,610
+متوفر لنا ال one person لكن مالك لكل حادث حديث أو
+
+102
+00:09:22,610 --> 00:09:32,290
+لكل مقام مقال طيب الان لكل مقام مقال هنتكلم عنها
+
+103
+00:09:32,290 --> 00:09:38,120
+mixed matrix انا اضطر احيانا ان اعمليعني خلط بين
+
+104
+00:09:38,120 --> 00:09:41,820
+المدرياتك أستعملهم مع بعض عشان أعدل أو أسرع أو
+
+105
+00:09:41,820 --> 00:09:46,700
+أعالج شيء و ال مدرياتك مدرياسي produced by one or
+
+106
+00:09:46,700 --> 00:09:50,400
+other of the two types of مدرياتك will not produce
+
+107
+00:09:50,400 --> 00:09:55,240
+a sufficient depth of مدرياسي إذا لم يكفي mixtures
+
+108
+00:09:55,240 --> 00:09:59,200
+of an antimascarinic يعني Antimascarinic Tropic
+
+109
+00:09:59,200 --> 00:10:04,520
+Amide يعني and it's about mimetic phenylيبقى انا
+
+110
+00:10:04,520 --> 00:10:07,340
+بدي استخدم في الحالة هذه اللي لم يكفي Tropic Amide
+
+111
+00:10:07,340 --> 00:10:14,800
+بدي استخدم Tropic Amide مع الفناليفرين The
+
+112
+00:10:14,800 --> 00:10:19,360
+following mixtures are some of the ones that have
+
+113
+00:10:19,360 --> 00:10:24,520
+been employed هاي مقترحات مثلا هم هتروبين and
+
+114
+00:10:24,520 --> 00:10:29,040
+cocaine هم هتروبين and Ephedrine وانا كانت
+
+115
+00:10:29,040 --> 00:10:36,120
+obsolete nowفلس انتهى الان في عالم الاسيان انتسوا
+
+116
+00:10:36,120 --> 00:10:42,240
+Tropic Emile and Phenylephrine and Cyclopentylate
+
+117
+00:10:42,240 --> 00:10:46,360
+and Phenylephrine available الان موجودين متقابل
+
+118
+00:10:46,360 --> 00:10:51,540
+معاهم يبقى Tropic Emile مع Phenylephrine او
+
+119
+00:10:51,540 --> 00:10:54,720
+Cyclopentylate مع Phenylephrine بس هنا بدي اعرف ان
+
+120
+00:10:54,720 --> 00:10:55,940
+هنا في Cycloblegia كتيرة
+
+121
+00:11:04,570 --> 00:11:13,350
+طيب، بدنا نشوف هل قوة ال mixture اللي صار دائما
+
+122
+00:11:13,350 --> 00:11:16,310
+ثابتة، بقول لأ هل في variation according to the
+
+123
+00:11:16,310 --> 00:11:19,690
+degree of the exercises required يعني أنا لما بدي
+
+124
+00:11:19,690 --> 00:11:24,870
+أعمل عملية جراحية، بدي توسية أكتر من ال
+
+125
+00:11:24,870 --> 00:11:28,270
+photography ال photography أكتر من ال direct
+
+126
+00:11:28,270 --> 00:11:30,770
+ophthalmoscope ال direct ophthalmoscope .. ال
+
+127
+00:11:30,770 --> 00:11:33,370
+direct ophthalmoscope بدي توسية أكتر من ال direct
+
+128
+00:11:33,370 --> 00:11:39,280
+ophthalmoscopeيعني كل مرحلة من المراحل التشخيصية
+
+129
+00:11:39,280 --> 00:11:44,220
+أو الإيالادية بدها توسيق أكتر مثلا حسب فهو بيقول
+
+130
+00:11:44,220 --> 00:11:51,100
+يعني أنه أنا لما بدأ أستخدم ال mixture ده بدأ
+
+131
+00:11:51,100 --> 00:11:55,100
+أستخدمه لشيء أنا عارفه إيش هو يعني أنا لو بدأ أعمل
+
+132
+00:11:55,100 --> 00:11:59,520
+دائرة تفتنبسكوب لوحة يكفي نقطة Tropic Amide لمدة
+
+133
+00:11:59,520 --> 00:12:04,330
+ربع ساعة أو نص ساعة لكتير واحدةلكن اذا كنت بتعمل
+
+134
+00:12:04,330 --> 00:12:09,390
+عملية تراحية كتراكت استراكشن او repair او retinal
+
+135
+00:12:09,390 --> 00:12:14,850
+tear detachment لأ ممكن استخدم التلاتة مع بعض
+
+136
+00:12:14,850 --> 00:12:20,990
+تروبيكاميد واستعمل الفيناليفرين واستعمل
+
+137
+00:12:20,990 --> 00:12:24,990
+سايكروبنتوليت مع بعض لمدة لا تقل عن ساعة
+
+138
+00:12:24,990 --> 00:12:33,180
+سايكروبنتوليت 0.5 وفيناليفرين 2.5الخطة التانية
+
+139
+00:12:33,180 --> 00:12:42,940
+تروبيكي ميل 0.5 انفلاليفرين 2.5% يبقى الأولى
+
+140
+00:12:42,940 --> 00:12:45,240
+الـcycloventolate مع الفلاليفرين والتانية تروبيكي
+
+141
+00:12:45,240 --> 00:12:49,740
+ميل مع الفلاليفرين التانية تروبيكي ميل مع
+
+142
+00:12:49,740 --> 00:12:56,160
+الفلاليفرين 1% يبقى هذه أقوى They found no
+
+143
+00:12:56,160 --> 00:12:59,630
+significant difference between the mixturesيعني
+
+144
+00:12:59,630 --> 00:13:04,410
+وجدوا واحد اتنين تلاتة الفرق قريب من بعضه لأ في
+
+145
+00:13:04,410 --> 00:13:09,290
+فرق بس قريب اه no significant difference مافيش
+
+146
+00:13:09,290 --> 00:13:12,410
+يعني تقول يعني اشي خمسين في المية و اشي مية في
+
+147
+00:13:12,410 --> 00:13:16,590
+المية مثلا اشي سبعين في المية و اشي مثلا تسعين في
+
+148
+00:13:16,590 --> 00:13:24,030
+المية لأ يعني كله كسورة they recorded dilation of
+
+149
+00:13:24,030 --> 00:13:27,250
+around seven millimeter within six minutes
+
+150
+00:13:35,990 --> 00:13:41,830
+البقبق ممكن يصل الي كم؟ تمانية ممكن يصل الي كم؟
+
+151
+00:13:41,830 --> 00:13:42,230
+تمانية ممكن يصل الي كم؟ تمانية ممكن يصل الي كم؟
+
+152
+00:13:42,230 --> 00:13:42,230
+تمانية ممكن يصل الي كم؟ تمانية ممكن يصل الي كم؟
+
+153
+00:13:42,230 --> 00:13:42,230
+تمانية ممكن يصل الي كم؟ تمانية ممكن يصل الي كم؟
+
+154
+00:13:42,230 --> 00:13:45,310
+تمانية ممكن يصل الي كم؟ تمانية ممكن
+
+155
+00:13:45,310 --> 00:13:46,850
+يصل الي كم؟ تمانية ممكن يصل الي كم؟ تمانية ممكن
+
+156
+00:13:46,850 --> 00:13:48,150
+يصل الي كم؟ تمانية ممكن يصل الي كم؟ تمانية ممكن
+
+157
+00:13:48,150 --> 00:13:49,050
+يصل الي كم؟ تمانية ممكن يصل الي كم؟ تمانية ممكن
+
+158
+00:13:49,050 --> 00:13:50,090
+يصل الي كم؟ تمانية ممكن يصل الي كم؟ تمانية ممكن
+
+159
+00:13:50,090 --> 00:13:54,790
+يصل الي كم؟ تمانية ممكن يصل الي كم؟ تمانية ممكن
+
+160
+00:13:54,790 --> 00:13:59,190
+يصل الي كم؟ تمان
+
+161
+00:14:00,050 --> 00:14:05,430
+بيمر متى يكون من الصعب توسيع ال بو بو اولها او
+
+162
+00:14:05,430 --> 00:14:12,810
+اهمها اللي هو iris pigmentation dark .. darkly
+
+163
+00:14:12,810 --> 00:14:21,290
+pigmented iris واحد تاني diabetes mellitus
+
+164
+00:14:21,290 --> 00:14:26,310
+diabetes mellitus التاني الأشياء المهمين
+
+165
+00:14:33,670 --> 00:14:37,550
+واللي في رأي الفرين هو sympathetic-mimetic، مش
+
+166
+00:14:37,550 --> 00:14:40,350
+طبعا sympathetic is this effective in highly
+
+167
+00:14:40,350 --> 00:14:44,070
+pigmented patients and will allow the light reflex
+
+168
+00:14:44,070 --> 00:14:47,830
+to remain، هاي المشكلة، المشكلة تقول إنه بيسجر و
+
+169
+00:14:47,830 --> 00:14:52,250
+capture بالميليانين واحد، التاني إنه بيخلي ال
+
+170
+00:14:52,250 --> 00:14:58,130
+light reflex لما بدي أفحص، بيبدأ يسكروالمدرياتيكس
+
+171
+00:14:58,130 --> 00:15:02,350
+هو المفروض عند أطفال يكونون بالطبع صعبين لإدارة
+
+172
+00:15:02,350 --> 00:15:07,770
+واحدة من أكبر قوات مدرياتيكس
+
+173
+00:15:07,770 --> 00:15:12,710
+يعني مقصود
+
+174
+00:15:12,710 --> 00:15:16,510
+فيه تروبيكاميت مدرياتيكس يجب أن يكون استخدامه بدون
+
+175
+00:15:16,510 --> 00:15:24,150
+تردد بدون تردد ماقولش انا واحد العيزة بتاعه أسود و
+
+176
+00:15:24,150 --> 00:15:29,230
+احطه في الانفرادأبدأت بتروحتي إيماني فورا it is a
+
+177
+00:15:29,230 --> 00:15:32,550
+waste of the patient's and practitioners' time
+
+178
+00:15:32,550 --> 00:15:36,810
+بضايع وقتي وقت العيال to attempt to dilate such
+
+179
+00:15:36,810 --> 00:15:40,090
+pupils with one of the weaker sympathomimetic
+
+180
+00:15:40,090 --> 00:15:44,550
+drugs بضايع وقتي انت دلت احطره فنع الفرين فنع
+
+181
+00:15:44,550 --> 00:15:48,170
+الفرين فنع الفرين فنع الفرين فنع الفرين فنع الفرين
+
+182
+00:15:48,170 --> 00:15:48,270
+فنع الفرين فنع الفرين فنع الفرين فنع الفرين فنع
+
+183
+00:15:48,270 --> 00:15:48,350
+الفرين فنع الفرين فنع الفرين فنع الفرين فنع الفرين
+
+184
+00:15:48,350 --> 00:15:48,350
+فنع الفرين فنع الفرين فنع الفرين فنع الفرين فنع
+
+185
+00:15:48,350 --> 00:15:49,390
+الفرين فنع الفرين فنع الفرين فنع الفرين فنع الفرين
+
+186
+00:15:49,390 --> 00:15:52,030
+فنع الفرين ف
+
+187
+00:15:57,220 --> 00:16:03,760
+الان في conclusion من سميث و باربي انه وجدوا ان
+
+188
+00:16:03,760 --> 00:16:09,500
+الفلانفرين relatively ineffective خاصة في الحالات
+
+189
+00:16:09,500 --> 00:16:15,900
+اللي هي في dark ice they found that only the
+
+190
+00:16:15,900 --> 00:16:19,020
+antimicrobial drugs and these encyclopedic
+
+191
+00:16:19,020 --> 00:16:22,280
+concentrations were really adequate in these
+
+192
+00:16:22,280 --> 00:16:25,900
+patients يعني وجدوا لابد باستخدام اللي هو
+
+193
+00:16:28,470 --> 00:16:37,410
+cyclopentolate 1psn ووجدوا انه بيعمل 1.5
+
+194
+00:16:37,410 --> 00:16:41,050
+millimeter mean increase in pupillary diameter
+
+195
+00:16:41,050 --> 00:16:48,570
+يعني احنا هنا استخدمنا إترابيكيمية لو أضفنا إلى
+
+196
+00:16:48,570 --> 00:16:54,090
+إترابيكيمية cyclopentolate حياتي plus 1.5 diameter
+
+197
+00:16:54,090 --> 00:16:55,410
+اش يعني؟
+
+198
+00:16:58,840 --> 00:17:02,360
+بقف واحد و نص يعني لو بتروحك اي مادة مثلا اعطا
+
+199
+00:17:02,360 --> 00:17:10,620
+five بيضع ستة و نص، هاي قصده، طيب اللي شوف
+
+200
+00:17:10,620 --> 00:17:12,860
+الـcyclopentolate، effect of cyclopentolate is
+
+201
+00:17:12,860 --> 00:17:16,900
+compared to the approximately three point
+
+202
+00:17:16,900 --> 00:17:19,640
+millimeter additive increase in pupillary diameter
+
+203
+00:17:19,640 --> 00:17:25,080
+obtained with atrogen يعني بيقولليلأن لو أنا مع
+
+204
+00:17:25,080 --> 00:17:31,260
+atropicemia أعطيت atropine هعطيني plus three ما هو
+
+205
+00:17:31,260 --> 00:17:35,700
+atropine مش هيخلي حاجة هيصل maximal dilatation
+
+206
+00:17:35,700 --> 00:17:41,640
+يعني لو ال atropine أنا يعني بستخدمه بس dilator هو
+
+207
+00:17:41,640 --> 00:17:48,400
+يعني كويس الأول هو رغم أنه يعني بيطول لما يعمل
+
+208
+00:17:48,400 --> 00:17:52,200
+recovery لكن المشكلة هي أنه هعمل full cyclopidemia
+
+209
+00:17:54,060 --> 00:18:00,040
+أنا جاي أوسع لمريد عشان أشوفله بس .. أشوفله الفندس
+
+210
+00:18:00,040 --> 00:18:03,900
+و أروح هو البيت يبقى تلت أسابيع و هو قاعد في
+
+211
+00:18:03,900 --> 00:18:08,200
+الظلام، مشكلة و اللي أتركين فاش شيء .. فاش أقوم
+
+212
+00:18:08,200 --> 00:18:15,620
+منه، لكن كل شيء .. لكل شيء إذا ما تم نقصان، فلا
+
+213
+00:18:15,620 --> 00:18:19,540
+يغروا طيب العيش الإنسان، فهذا إله نقصان بقى، فاش
+
+214
+00:18:19,540 --> 00:18:23,860
+شيء كامل عندنا إلا الله عز وجلوحبيبه محمد صلى الله
+
+215
+00:18:23,860 --> 00:18:31,520
+عليه وسلم اللي بنصلي عليه دايما طيب الأتروبيل
+
+216
+00:18:31,520 --> 00:18:36,580
+لو وضعناه مع tropic amide هيعمل plus three كمان
+
+217
+00:18:36,580 --> 00:18:41,640
+زيادة هتتبقى increase in pripary diameter طيب في
+
+218
+00:18:41,640 --> 00:18:45,480
+كان زمان يستخدموا شيء اسمه hyacinth هذا مضيف واحد
+
+219
+00:18:45,480 --> 00:18:50,780
+فمية اللي هو الأتروبيل مضيف اتنين فمية الفنانفرين
+
+220
+00:18:50,780 --> 00:18:59,400
+عشرة فميةاه هو myotropic amide بيضيف واحد وخمس
+
+221
+00:18:59,400 --> 00:19:05,480
+وسبعين دايمة واحد وخمس وسبعين يبقى ايش الشيء اللي
+
+222
+00:19:05,480 --> 00:19:12,460
+يستخدم typically myotropic amide الانفراد
+
+223
+00:19:12,460 --> 00:19:15,120
+الانفراد الانفراد الانفراد الانفراد الانفراد
+
+224
+00:19:15,120 --> 00:19:15,460
+الانفراد الانفراد الانفراد الانفراد الانفراد
+
+225
+00:19:15,460 --> 00:19:16,740
+الانفراد الانفراد الانفراد الانفراد الانفراد
+
+226
+00:19:16,740 --> 00:19:19,720
+الانفراد الانفراد الانفراد الانفراد الانفراد
+
+227
+00:19:19,720 --> 00:19:19,720
+الانفراد الانفراد الانفراد الانفراد الانفراد
+
+228
+00:19:19,720 --> 00:19:19,720
+الانفراد الانفراد الانفراد الانفراد الانفراد
+
+229
+00:19:19,720 --> 00:19:22,160
+الانفراد الانفراد الان
+
+230
+00:19:24,310 --> 00:19:26,890
+القلب اللي ال cases in which dietation is
+
+231
+00:19:26,890 --> 00:19:33,810
+difficult بتتكلم على speed of مدريازيس ايش speed
+
+232
+00:19:33,810 --> 00:19:44,370
+of مدريازيس سرعة سرعة و الcycle of انتوليت 0.5 was
+
+233
+00:19:44,370 --> 00:19:48,790
+surpassed by ايه surpassed by
+
+234
+00:19:51,930 --> 00:19:59,410
+تجاوز الهوم أتروبين 2% الهوم
+
+235
+00:19:59,410 --> 00:20:07,770
+أتروبين تجاوزنا بالفنارى فرين 10% يبقى
+
+236
+00:20:07,770 --> 00:20:14,070
+احنا بدنا نرتب السرعة ساكلو فنتوليد والهوم
+
+237
+00:20:14,070 --> 00:20:21,320
+أتروبين نوعا ما بطيئينبدهم يعني تلت ساعة لما
+
+238
+00:20:21,320 --> 00:20:25,300
+يعملوا ايش ده نتيجة اذا الفلايفريين عشرة فانهية
+
+239
+00:20:25,300 --> 00:20:30,240
+أسرع منهم طب ال tropic emite أسرع كمان بقوللي في
+
+240
+00:20:30,240 --> 00:20:35,440
+نهاية الساعة الأولى سبتين minutes فلايفريين ran
+
+241
+00:20:35,440 --> 00:20:42,880
+first يكون المكتب الأول يعني بيكبه أكتر من اللي
+
+242
+00:20:42,880 --> 00:20:50,920
+جابوبعد هذا الوقت، اتجارات السيكوليبنتولية تنتج 7
+
+243
+00:20:50,920 --> 00:20:58,220
+.5 مليمتر في مجموعات افرو كاريبيا
+
+244
+00:20:58,220 --> 00:21:08,190
+لفارقة مقارنة 7.5 مليمتر في مجموعات طوائيةالـ
+
+245
+00:21:08,190 --> 00:21:12,630
+cycle of ventilation في النهاية السود في نهاية
+
+246
+00:21:12,630 --> 00:21:16,350
+الساعة عامل سبعة في حين في البيض عامل سبعة و نصف
+
+247
+00:21:16,350 --> 00:21:23,770
+مش فارق فارق بسيط صح؟ فارق بسيط طيب
+
+248
+00:21:23,770 --> 00:21:31,410
+أساس هو ال what's the cause of difficulty of
+
+249
+00:21:31,410 --> 00:21:36,950
+midriasis in darkly pigmented eye reads
+
+250
+00:21:42,600 --> 00:21:48,800
+ميليانين بيعمل مكبشر ميليانين بيعمل مكبشر مع
+
+251
+00:21:48,800 --> 00:21:57,440
+الدراجة اللي بيطرح إطلاق إطلاق الدراجة اللي بيطرح
+
+252
+00:21:57,440 --> 00:21:58,040
+إطلاق الدراجة اللي بيطرح إطلاق الدراجة اللي بيطرح
+
+253
+00:21:58,040 --> 00:22:00,920
+إطلاق الدراجة اللي بيطرح إطلاق الدراجة اللي بيطرح
+
+254
+00:22:00,920 --> 00:22:01,540
+إطلاق الدراجة اللي بيطرح إطلاق الدراجة اللي بيطرح
+
+255
+00:22:01,540 --> 00:22:01,700
+إطلاق الدراجة اللي بيطرح إطلاق الدراجة اللي بيطرح
+
+256
+00:22:01,700 --> 00:22:03,400
+إطلاق الدراجة اللي بيطرح إطلاق الدراجة اللي بيطرح
+
+257
+00:22:03,400 --> 00:22:11,400
+إطلاق الدراجة اللي بيطرح إططيب الشيء التاني is
+
+258
+00:22:11,400 --> 00:22:15,180
+diabetes mellitus لشكلته في سنة رابعة ما شاء الله
+
+259
+00:22:15,180 --> 00:22:29,160
+كبار ايه السبب صعوبة التوسيع في ال diabetes يعني
+
+260
+00:22:29,160 --> 00:22:35,020
+اللي ال diabetes عندهم دائما neuro pupil من قلق
+
+261
+00:22:39,940 --> 00:22:45,240
+مش قادمة هو
+
+262
+00:22:45,240 --> 00:22:49,540
+الأعصاب اللي بتغضي .. بتغضي المنطقة بتلصيكتر بيبر
+
+263
+00:22:49,540 --> 00:22:52,900
+العضلة و موصلهاش دم كتير و بتاع الساعات بتضارها
+
+264
+00:22:52,900 --> 00:22:57,780
+دايما قبلها موصلهاش دم كتير المفروض تكون أبدا
+
+265
+00:22:57,780 --> 00:23:02,380
+موصلهاش دم كتير ممكن تكون relaxed بالعكس ال
+
+266
+00:23:02,380 --> 00:23:09,370
+contraction بده دم contraction بده دم و ليش؟لكن
+
+267
+00:23:09,370 --> 00:23:14,490
+انا اللي فاهمه ان في شيء اسمه الريدو pathy الريدو
+
+268
+00:23:14,490 --> 00:23:22,270
+pathy there is deposition of some carbohydrates
+
+269
+00:23:22,270 --> 00:23:30,730
+and other compounds on the stroma of the iris of
+
+270
+00:23:30,730 --> 00:23:36,710
+diabetics that will make the dilatation difficult
+
+271
+00:23:37,990 --> 00:23:42,970
+that will make the dilatation difficult وهذا كنا
+
+272
+00:23:42,970 --> 00:23:51,030
+نقول عنه احنا Diabetic Rhedopathy بيخلي
+
+273
+00:23:51,030 --> 00:23:59,210
+اللي هو ال dilatation صعب طيب بيقول لي انه هوغر
+
+274
+00:23:59,210 --> 00:24:03,270
+هذا found that diabetic patients responded poorly
+
+275
+00:24:03,270 --> 00:24:09,400
+to tropic EMIAnd recommended a combination of
+
+276
+00:24:09,400 --> 00:24:13,400
+tropic amide and phenylephrine to give adequate
+
+277
+00:24:13,400 --> 00:24:17,880
+mediases with a minimum of accommodative paralysis
+
+278
+00:24:17,880 --> 00:24:25,080
+يبقى هو باختصار وهذا يعني بدي اعطيكوا بحث تعملوه
+
+279
+00:24:25,080 --> 00:24:31,080
+في cases of difficult dilatation difficult pupil
+
+280
+00:24:31,080 --> 00:24:35,860
+dilatationجيبولي بحث في هذا الموضوع عشان نثري اللي
+
+281
+00:24:35,860 --> 00:24:41,580
+هو القصة هذه كل
+
+282
+00:24:41,580 --> 00:24:45,020
+الحالات اللي فيها difficult dilatation و computer
+
+283
+00:24:45,020 --> 00:24:52,880
+بستهلي منكم بحث جيبوليه على CD مش مطول اسبوعين بس
+
+284
+00:24:52,880 --> 00:24:58,260
+خلال اسبوعين طيب
+
+285
+00:24:58,260 --> 00:25:12,830
+sector dilatationsector لو أنا في دارسهم الان
+
+286
+00:25:12,830 --> 00:25:20,470
+انا عندي هاي البحر وهي الارس الارس هنا الان في
+
+287
+00:25:20,470 --> 00:25:24,870
+الناس اللي عندهم narrow angle
+
+288
+00:25:24,870 --> 00:25:29,090
+of AC
+
+289
+00:25:32,820 --> 00:25:39,240
+نروح انت في risk ان اعمل dilatation بتروبيه TMI او
+
+290
+00:25:39,240 --> 00:25:45,780
+حتى في memory frame لان باختصار هنا شي اسمه root
+
+291
+00:25:45,780 --> 00:25:54,360
+of iris جد؟ جد؟ ليش؟ لا، root of iris اللي انا
+
+292
+00:25:54,360 --> 00:26:00,360
+اعمل dilatation هيبدأ ال iris يتحرك من هنا إلى هنا
+
+293
+00:26:00,360 --> 00:26:07,000
+إلى هناالى هنا بتن
+
+294
+00:26:07,000 --> 00:26:12,400
+على بعضها بترى في المحارب بتاعة ال fine بتن على
+
+295
+00:26:12,400 --> 00:26:17,300
+بعضها لو احنا نشرناها كده و انا صغير مسكها و جري
+
+296
+00:26:17,300 --> 00:26:23,700
+فيها بيوصل عشرين متر صح صارت احنا بس بيصير احيانا
+
+297
+00:26:23,700 --> 00:26:27,120
+مسكها و جري فيها ايه تقول ايه تكاد يا ابني في
+
+298
+00:26:27,120 --> 00:26:33,220
+العلبة ايش خلاك تعملهاالان ال iris زي ما نقوله شمر
+
+299
+00:26:33,220 --> 00:26:42,240
+حتى وصل هنا وصل هنا عمل هنا شي اسمه over crowding
+
+300
+00:26:42,240 --> 00:26:46,940
+زحمة
+
+301
+00:26:46,940 --> 00:26:53,320
+شديدة على ال route of iris حيث الأنجل الأنجل هنا
+
+302
+00:26:53,320 --> 00:27:03,790
+هي هنا هي الأنجلفهو هنا اللي صار فيه ايش over
+
+303
+00:27:03,790 --> 00:27:10,990
+crowding طيب لو ال angle هذه أساسا هي narrow angle
+
+304
+00:27:10,990 --> 00:27:19,430
+narrow angle حتم أهين و حتم أهين طيب الآن انا ممكن
+
+305
+00:27:19,430 --> 00:27:26,030
+أقتله بواحد طيبتك و narrow angle أو بس يعني انا مو
+
+306
+00:27:26,030 --> 00:27:33,480
+موصعلوشلأ .. لأ .. لأ .. بصرا .. بصرا .. بصرا ..
+
+307
+00:27:33,480 --> 00:27:34,100
+لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ
+
+308
+00:27:34,100 --> 00:27:34,880
+.. لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ ..
+
+309
+00:27:34,880 --> 00:27:35,180
+لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ
+
+310
+00:27:35,180 --> 00:27:35,360
+.. لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ ..
+
+311
+00:27:35,360 --> 00:27:35,360
+لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ
+
+312
+00:27:35,360 --> 00:27:35,440
+.. لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ ..
+
+313
+00:27:35,440 --> 00:27:35,440
+لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ .. لأ
+
+314
+00:27:35,440 --> 00:27:44,640
+.. لأ .. لأ .. لأ .. لأ .. لأ .. لأ ..
+
+315
+00:27:44,640 --> 00:27:52,780
+لأ
+
+316
+00:27:52,780 --> 00:28:02,500
+.. لأخلّي لو .. لو ال micro organisms هذه أنا ما
+
+317
+00:28:02,500 --> 00:28:09,400
+شفتها ب laser ممكن تصير bloody تعمل دم مش هعمل ..
+
+318
+00:28:09,400 --> 00:28:14,340
+بقولي هنا بقولي
+
+319
+00:28:14,340 --> 00:28:22,720
+هنا جرب جيب سفنجة sponge
+
+320
+00:28:22,720 --> 00:28:30,640
+زي نكاشة بس مش قطن spongeو حط عليها هنا drops او
+
+321
+00:28:30,640 --> 00:28:44,920
+مدرميل مدرميل و هاتها حط مثلا هنا هتعطيك
+
+322
+00:28:44,920 --> 00:28:54,880
+توسية هيك جزني هذا اسمه sector pupil dilatation
+
+323
+00:28:57,110 --> 00:29:03,290
+sector pupil dilatation كإني أنا عملت نافدة طبعا
+
+324
+00:29:03,290 --> 00:29:12,030
+هالهي وحاول زي ما قلته يعني أنظر منها إلى داخل
+
+325
+00:29:12,030 --> 00:29:16,190
+الشبكية هنا
+
+326
+00:29:16,190 --> 00:29:18,850
+مافيش خطر انغلاق كلي
+
+327
+00:29:21,600 --> 00:29:26,040
+يعني انا تجاوزت حاولت اني اوسع جزئي و بقى اتيسر
+
+328
+00:29:26,040 --> 00:29:30,980
+اني ارسل ال light بتاعي الى قاع العين بدون ما اخش
+
+329
+00:29:30,980 --> 00:29:34,940
+في ال risk الخطيرة بتاعة ال angle closure اللوكوم
+
+330
+00:29:34,940 --> 00:29:41,000
+هذا معناه ال sector dilatation انه غير طريقة طبعا
+
+331
+00:29:41,000 --> 00:29:49,160
+طبعا انتوا حاليكوا مجربين تعالوا انسان عادي زينا و
+
+332
+00:29:49,160 --> 00:29:50,840
+جيبك كوتون
+
+333
+00:29:52,670 --> 00:29:57,290
+أه ماعرفش اسمه قطن عادي وحط عليها مدنا ميد وحطيها
+
+334
+00:29:57,290 --> 00:30:02,930
+هنا على ال limbus limbus هنا تحت او في الجنب مدة
+
+335
+00:30:02,930 --> 00:30:07,090
+مثلا عشر دقائق هتلاقي انه صار البؤبو فعلا يعني
+
+336
+00:30:07,090 --> 00:30:16,030
+عامل ايه البؤبو عامل عامل ايه نافذة اضافية وانا
+
+337
+00:30:16,030 --> 00:30:21,670
+بصير بس للحالات ان انا شاك ان فيها narrowAngle
+
+338
+00:30:21,670 --> 00:30:30,130
+narrow angle ممكن
+
+339
+00:30:30,130 --> 00:30:38,550
+طبعا احط Tropic mind او احط fly طيب الشيء التالت
+
+340
+00:30:44,940 --> 00:30:47,460
+و study has demonstrated that the efficacy of
+
+341
+00:30:47,460 --> 00:30:52,280
+novel a novel method of Pediatrics Pediatric drug
+
+342
+00:30:52,280 --> 00:30:57,060
+delivery in children of 22 healthy children جابوا
+
+343
+00:30:57,060 --> 00:31:03,120
+22 طفل صحتهم كويسة عمرهم 2 إلى 8 years were given
+
+344
+00:31:03,120 --> 00:31:11,480
+either جربونهم الطريقتين الطريقة الأولى word drop
+
+345
+00:31:12,820 --> 00:31:19,340
+Each eye of 1% tropicamide and 2% 2.5 filanifrine
+
+346
+00:31:19,340 --> 00:31:26,660
+in each eye يبقى مجموعة أطفال من 22 وضعوا لهم في
+
+347
+00:31:26,660 --> 00:31:35,000
+العين خليت من 1% filanifrine و2.5 filanifrine مع
+
+348
+00:31:35,000 --> 00:31:41,480
+بعض طيب ايجوا العين التانية حطوا
+
+349
+00:31:42,180 --> 00:31:51,940
+مدرياتيك سبريه بخار رشد محتوى 0.5 تروبيكاميت و 2.5
+
+350
+00:31:51,940 --> 00:32:00,440
+فيرانفرين لكل عين مفتوحة والعين مسكرة النتيجة أنه
+
+351
+00:32:00,440 --> 00:32:06,720
+لم يكن هناك اختلاف كبير في كبير الناس بين الاثنين
+
+352
+00:32:06,720 --> 00:32:10,860
+الأسلحة في 40 دقيقة
+
+353
+00:32:15,540 --> 00:32:21,420
+after application it is a disappointing that this
+
+354
+00:32:21,420 --> 00:32:27,480
+friendly mood of application has not become
+
+355
+00:32:27,480 --> 00:32:30,700
+commercially available يعني هو بيقول إن الطريقة
+
+356
+00:32:30,700 --> 00:32:39,180
+التانية ال display اللي بتنحط على عين مغمضة أفضل و
+
+357
+00:32:39,180 --> 00:32:43,440
+هي صديقة للطفل لكنها مش commercially available مش
+
+358
+00:32:43,440 --> 00:32:50,850
+مسوقة في السوقهذا عندهم لما عندنا فالأمل في الله
+
+359
+00:32:50,850 --> 00:32:57,290
+يصير مصانع فلسطينية تنتج هذا الخليل من المرياتكس
+
+360
+00:32:57,290 --> 00:33:03,310
+ان شاء الله لسه الله بكثير وقعدونا زمان قالوا هو
+
+361
+00:33:03,310 --> 00:33:09,110
+سنغافورة الشرق الأوسط قالوا قطاع غزة سنغافورة
+
+362
+00:33:09,110 --> 00:33:14,410
+الشرق الأوسط وان شاء الله بيجي يوم طيب
+
+363
+00:33:15,860 --> 00:33:21,160
+advance effects of medics يعني انا بخاف من ايش لما
+
+364
+00:33:21,160 --> 00:33:26,740
+اعمل مدريازيس في اشياء اخر منها هاي بقى اسألكوا
+
+365
+00:33:26,740 --> 00:33:30,140
+يعني ايش
+
+366
+00:33:30,140 --> 00:33:35,020
+يعني ممكن تكون advance اشياء يعني خاطرة او مكروها
+
+367
+00:33:35,020 --> 00:33:40,340
+بيقول
+
+368
+00:33:40,340 --> 00:33:43,220
+لي هو يعني في اشياء بسيطة
+
+369
+00:33:46,670 --> 00:33:49,770
+وبعدين مورف الفوتوفوبيا و الكلام هذا و ال
+
+370
+00:33:49,770 --> 00:33:55,510
+angioecological glaucoma risk هذا هو الأهم بيقول
+
+371
+00:33:55,510 --> 00:33:58,290
+لي when any topically applied ophthalmic drug
+
+372
+00:33:58,290 --> 00:34:01,910
+there is a possibility of producing an undesirable
+
+373
+00:34:01,910 --> 00:34:07,430
+effect في أشياء غير مرغوبة either on the eye or on
+
+374
+00:34:07,430 --> 00:34:11,590
+the body as a whole Mediatics have the ability to
+
+375
+00:34:11,590 --> 00:34:15,980
+do bothلأنه محتمال يعملوا على العين نفسها ومحتمال
+
+376
+00:34:15,980 --> 00:34:20,160
+يعملوه على الجسم Many of the potential problems
+
+377
+00:34:20,160 --> 00:34:23,860
+can be avoided by carrying out the following
+
+378
+00:34:23,860 --> 00:34:28,320
+precautions الاحتياطات اللازمة دي اما الاحتياطات
+
+379
+00:34:28,320 --> 00:34:33,820
+علاقة في ال risk اوشي explain to the patient the
+
+380
+00:34:33,820 --> 00:34:38,420
+reasons for dilating the pupils يعني انا متعامل مع
+
+381
+00:34:38,420 --> 00:34:38,840
+انسان
+
+382
+00:34:41,580 --> 00:34:44,820
+لما تعالوا لإنسان، الإنسان له عقل، مادخله لعقل، إن
+
+383
+00:34:44,820 --> 00:34:55,020
+أقنعته للقاد للعقل، لكن إن أكرهته، لا ينقعد، يعني
+
+384
+00:34:55,020 --> 00:35:04,780
+واحد رايح إعالج سنه، طبعا، إما حشوة،
+
+385
+00:35:04,780 --> 00:35:05,840
+وإما خلاق
+
+386
+00:35:10,670 --> 00:35:17,250
+هيفهم يقولوا و الله انا وجدت هذا الدرس فيه سوسة و
+
+387
+00:35:17,250 --> 00:35:24,310
+سوسة بلغة مبلغ فاحنا مضطرين نعطيك بنج عشان نحفره و
+
+388
+00:35:24,310 --> 00:35:29,130
+نعمله حشوة و يمكن تكون حشوة عصابة لازم تصبر علينا
+
+389
+00:35:29,130 --> 00:35:34,890
+ساعة بعد ال بنج او يقولوا هذا مافي امل لازم الآن
+
+390
+00:35:34,890 --> 00:35:37,290
+اجعدك و اضربك إبرة بنج و اخلقه
+
+391
+00:35:40,710 --> 00:35:46,330
+إيش رايك؟ بقولوا توكلوا الله، اعملوا ده كده يالا،
+
+392
+00:35:46,330 --> 00:35:49,170
+نام على الكرسي، نام على الكرسي، رجع راسك، افتح
+
+393
+00:35:49,170 --> 00:35:54,870
+تمك، بصير الإنسان إيش؟ تقرا هنا، نافد أوامر، ده
+
+394
+00:35:54,870 --> 00:36:02,150
+الطبيعي، لكن لو إجا، جروا هيك وعص عليه، أه، وسند
+
+395
+00:36:02,150 --> 00:36:06,730
+راسه، فتحت تمه بالجوا، وبدأ إيش؟ ادخله أدوات في
+
+396
+00:36:06,730 --> 00:36:13,330
+تمه، بالتمس، بالخاتم، صح؟هي بتعمل مع بشر و ال
+
+397
+00:36:13,330 --> 00:36:15,970
+optometry و ال ophthalmology هم أرقى اسا من
+
+398
+00:36:15,970 --> 00:36:21,210
+الأسنان يعني في ناس بيعتبرهم طبيب .. طبيب العيون
+
+399
+00:36:21,210 --> 00:36:24,970
+وشيء انه أراقي بقوله بضربش عبارة كتير و يعني و
+
+400
+00:36:24,970 --> 00:36:30,310
+رخيق شوية و ال optometry لسه أرق أوشي explain to
+
+401
+00:36:30,310 --> 00:36:30,790
+the patient
+
+402
+00:36:36,110 --> 00:36:39,590
+تحط اللي جواها القطرة نين for all patients that
+
+403
+00:36:39,590 --> 00:36:42,530
+photophobia is likely and that it can be
+
+404
+00:36:42,530 --> 00:36:46,990
+alleviated by wearing sunglasses and or broad
+
+405
+00:36:46,990 --> 00:36:50,590
+brimmed hat بدي أقوله بعد القطرة هالي ممنوع تتعرض
+
+406
+00:36:50,590 --> 00:36:54,370
+للشمس أو للضوء القوي وانا أقوله بحبك أنك تلبس
+
+407
+00:36:54,370 --> 00:37:00,790
+نضرات شمسية أو طاقية عريضة three patients should
+
+408
+00:37:00,790 --> 00:37:05,940
+betold that riding a motorcycle or driving a car
+
+409
+00:37:05,940 --> 00:37:09,880
+should be avoided for several hours because it
+
+410
+00:37:09,880 --> 00:37:18,840
+might be blurred لأن
+
+411
+00:37:18,840 --> 00:37:23,420
+هذا ممكن يعملك car accidents for evaluation of
+
+412
+00:37:23,420 --> 00:37:27,840
+anterior chamber depth prior to dilatation هذا
+
+413
+00:37:27,840 --> 00:37:33,560
+اللي قلناه طلع في ال depth هذا و ال depth هذاإذا
+
+414
+00:37:33,560 --> 00:37:37,040
+كده اللي جيت المسافة بين الـ iris و ال core يعني
+
+415
+00:37:37,040 --> 00:37:45,820
+قليل شالو ACE بتوقف اللي جيته normal او ديب بشتغل
+
+416
+00:37:45,820 --> 00:37:54,160
+بس في كمان حاجة ممكن أعملها أتأكد هو أنا بضوي في
+
+417
+00:37:54,160 --> 00:37:59,340
+عينه بجانب أو استثناء لكن كمان في حاجة تالتة
+
+418
+00:37:59,340 --> 00:38:06,210
+refraction سواء auto أو manualلو كان hypermetropia
+
+419
+00:38:06,210 --> 00:38:12,210
+focal four لأ لأ يبعد عنيه احسن انا ابعد عنه و هو
+
+420
+00:38:12,210 --> 00:38:20,450
+يبعد عنيه يروح لجانب كويس لأن هو في نار و انجل طيب
+
+421
+00:38:20,450 --> 00:38:23,290
+evaluation of anterior chamber gives proper
+
+422
+00:38:23,290 --> 00:38:26,870
+validation as with any other drug it is wise to
+
+423
+00:38:26,870 --> 00:38:29,950
+ask patients whether they have previously
+
+424
+00:38:29,950 --> 00:38:35,860
+undergone mediasis سبق ان وصة على بؤبهايوهل صار
+
+425
+00:38:35,860 --> 00:38:40,360
+مشاكل أو مضاعفات أو أثار جانبية وهل صار مشاكل أو
+
+426
+00:38:40,360 --> 00:38:46,240
+مضاعفات أو أثار جانبية It is particularly
+
+427
+00:38:46,240 --> 00:38:49,840
+important to establish whether the patient suffers
+
+428
+00:38:49,840 --> 00:38:54,140
+from any illness or is taking any prescribed
+
+429
+00:38:54,140 --> 00:38:57,840
+medication or other counter preparations
+
+430
+00:38:57,840 --> 00:39:03,670
+especially those that are anti-masculinicأسأله هل
+
+431
+00:39:03,670 --> 00:39:08,490
+مع مرض في القلب؟ هل مع ضغط درم عالي؟ هل بياخد
+
+432
+00:39:08,490 --> 00:39:14,070
+علاجات؟ أقراس و كده و كده و كده؟ كل هذا بيدخل في
+
+433
+00:39:14,070 --> 00:39:19,890
+شيء اسمه في ال history drug history اه drug
+
+434
+00:39:19,890 --> 00:39:26,210
+history بس كان بياخد baby aspirin بياخد
+
+435
+00:39:26,210 --> 00:39:30,430
+antihypertensive اشي لازم انا احط question mark
+
+436
+00:39:30,430 --> 00:39:31,870
+carry
+
+437
+00:39:34,400 --> 00:39:36,980
+carry out the following precautions to prevent
+
+438
+00:39:36,980 --> 00:39:40,700
+pediatric complications الان بعد ما احنا سألنا
+
+439
+00:39:40,700 --> 00:39:46,660
+الأسئلة المعتادة وانا بحب انها تكون نمرا 5 نمرا 6
+
+440
+00:39:46,660 --> 00:39:55,400
+فاهم نمرا 6 الان كيف اتفادى المشاكل والمضاعفات
+
+441
+00:39:55,400 --> 00:40:03,540
+اللي بتشتغل في الدواء بتكون فاهم مشاكل الدواء وانا
+
+442
+00:40:03,540 --> 00:40:09,280
+باستخدامهأنا باستخدام نقطة واحدة بكفي نقطة مثلا
+
+443
+00:40:09,280 --> 00:40:14,720
+مدرى مائي نقطة هنا نقطة هنا however it might be
+
+444
+00:40:14,720 --> 00:40:18,420
+necessary to use two or three drops with older
+
+445
+00:40:18,420 --> 00:40:22,920
+patients and those with darkly pigmented eyelids
+
+446
+00:40:22,920 --> 00:40:26,740
+شباب
+
+447
+00:40:26,740 --> 00:40:33,090
+في هذا السن بيعمل نقطة واحدةكبير السن و الـ
+
+448
+00:40:33,090 --> 00:40:36,430
+diabetes mellitus و الـ darkly pigmented هذي
+
+449
+00:40:36,430 --> 00:40:40,550
+المشاكل اللي هو eye reds ممكن ياخد تانية او تلاتة
+
+450
+00:40:40,550 --> 00:40:47,610
+بس امره ان يفضل مغمض عينيه فترة عشر دقيقة حتى
+
+451
+00:40:47,610 --> 00:40:55,110
+القطر ما بتزلج تحت او ان يوضع أصابعه في موضع هنا
+
+452
+00:40:55,110 --> 00:41:00,010
+على ال angle هنا تحت حتى يسكر نزولك الملدك
+
+453
+00:41:03,930 --> 00:41:12,010
+ورق نشاف ينسف القطرة الزيادة بسرعة عدة أشياء المهم
+
+454
+00:41:12,010 --> 00:41:15,810
+ان انا بدي القطرة تروح في العين ما تروح في الدم
+
+455
+00:41:15,810 --> 00:41:23,610
+انا مقعد القطرة للدم و لا للعين طيب المنفذ اللي
+
+456
+00:41:23,610 --> 00:41:28,190
+القطرة بتروح منه على الدم البنك تك اللي تحت و لفوق
+
+457
+00:41:28,190 --> 00:41:42,030
+في ناس عندهم حاجة زي سيليكومأه زي كده تيوب بيحط
+
+458
+00:41:42,030 --> 00:41:46,190
+ايش في البنك تا بيسكر البنك تا او حتى بخيط جرافي
+
+459
+00:41:46,190 --> 00:41:51,050
+بيسكر البنك تا اللي هنا و اللي هنا بيسكر البنك تا
+
+460
+00:41:51,050 --> 00:41:57,590
+حتى انه ماهي تروح بعد هيك على اللي هو الساك و
+
+461
+00:41:57,590 --> 00:42:01,430
+النيزولاكومبدكت و روحي تحت على اللي هو ايش عنوس
+
+462
+00:42:04,330 --> 00:42:08,750
+وهنا major intraocular pressure was before and
+
+463
+00:42:08,750 --> 00:42:12,990
+upon completion of the midriatic examination قسط
+
+464
+00:42:12,990 --> 00:42:19,150
+ضغط العين قبل المدريازز وبعد المدريازز طب لو لجناه
+
+465
+00:42:19,150 --> 00:42:22,910
+عالي نحن
+
+466
+00:42:22,910 --> 00:42:27,230
+لجناه من أساس عالي مانحطش يعني لو لجناه مثلا 24
+
+467
+00:42:27,230 --> 00:42:29,550
+millimeter HD زي بق
+
+468
+00:42:36,160 --> 00:42:42,600
+بوردر العين لاجنة 18 نحط و بعد نص ساعة القياس
+
+469
+00:42:42,600 --> 00:42:49,420
+اللاجنة مرتفعة يبقى بدنا نحاش Anti-hypertensive
+
+470
+00:42:49,420 --> 00:42:57,640
+تمولون مثلا تمولين مثلا اي drug trust up غيره
+
+471
+00:42:57,640 --> 00:43:01,100
+trust up اي drug اللي نزل ضغط العين اذا كان
+
+472
+00:43:01,100 --> 00:43:05,610
+واجدناه بعد نص ساعة عليهامع انهم بيقولوا يعني هذا
+
+473
+00:43:05,610 --> 00:43:10,690
+الاتفاق اتفاق transient اللي انه برضه بده kill ال
+
+474
+00:43:10,690 --> 00:43:17,790
+need for kill issue inaudible stating the mediatic
+
+475
+00:43:17,790 --> 00:43:21,470
+used and providing advice on what action the
+
+476
+00:43:21,470 --> 00:43:24,930
+patient should be take in the event of an
+
+477
+00:43:24,930 --> 00:43:29,970
+adversary action يبقى اكتر انا hint هنا انه في
+
+478
+00:43:29,970 --> 00:43:32,490
+تاريخ كذا كذا وضعنا
+
+479
+00:43:33,920 --> 00:43:39,280
+رفس اسمها tropic mi لهذا المرين ساعة كده يوم كده
+
+480
+00:43:39,280 --> 00:43:48,340
+اختمها واطية هي افرض في الليل حدث ال anger closure
+
+481
+00:43:48,340 --> 00:43:54,760
+بيقولهم هو مش عارف ان انا وين انا في مركز عملتله
+
+482
+00:43:54,760 --> 00:43:59,060
+في مركز عملتله في اي هدا هتحرك ايش لأقرب مستشفى
+
+483
+00:43:59,060 --> 00:44:05,250
+يفحص ويقولوا وقت ايش وكيف ويقولهم هيانا ساعدت و
+
+484
+00:44:05,250 --> 00:44:11,230
+ساعد ال medical team اللي هكمل الفحص يعني أنا
+
+485
+00:44:11,230 --> 00:44:16,010
+بتعامل مع الإنسان كإنسان بتعامل مع الإنسان كإنسان
+
+486
+00:44:16,010 --> 00:44:27,070
+طيب في شي أخر مش مكتوب عارفين إيش هو نصحني دكتوري
+
+487
+00:44:27,070 --> 00:44:32,850
+اللي كان يدرسني الله يسهل عليه مقولي يا محمدعشان
+
+488
+00:44:32,850 --> 00:44:38,510
+تنام انت مرتاح و relaxed حطله نقطة pyrocarbine في
+
+489
+00:44:38,510 --> 00:44:42,330
+كل عين خلاص
+
+490
+00:44:42,330 --> 00:44:47,410
+انت خلاص تمام جامد قول مع السلامة شكرا حطله نقطة
+
+491
+00:44:47,410 --> 00:44:52,310
+مضيق هنا و نقطة مضيق هنا و أكل أمر إلى الله اروح
+
+492
+00:44:52,310 --> 00:44:58,350
+نام بعد هيك مرتاح عشان مايصيرش الطلبات بعد ساعتين
+
+493
+00:44:58,350 --> 00:45:04,470
+تلاتة أربعة في لاند كلو جاربكمو يحدث احيانا حطله
+
+494
+00:45:04,470 --> 00:45:12,570
+نقطة مضايق وهذه اللي فوقها تثبيتها تثبيتها ت
+
+495
+00:45:12,570 --> 00:45:22,010
+install a drop او miotic on
+
+496
+00:45:22,010 --> 00:45:26,550
+each eye after
+
+497
+00:45:26,550 --> 00:45:29,710
+the examination
+
+498
+00:45:33,170 --> 00:45:44,310
+من عيون بعد مدريازيس لتأكد
+
+499
+00:45:44,310 --> 00:45:50,030
+ان فرصة
+
+500
+00:45:50,030 --> 00:45:57,410
+اطلاق جلوكومة عقلية قريبة او
+
+501
+00:45:57,410 --> 00:46:00,010
+غير عادية او نل
+
+502
+00:46:04,020 --> 00:46:12,000
+فهمتي يا بغداد؟ تقف بيها من البنات طيب
+
+503
+00:46:12,000 --> 00:46:21,180
+قلنا أصعب شيء ان واجهها optometrist او
+
+504
+00:46:21,180 --> 00:46:27,480
+ophthalmologist هو ال angry cruiser هل
+
+505
+00:46:27,480 --> 00:46:31,440
+ال angry cruiser يمكن تعمل عمل؟ طبعا ليش؟
+
+506
+00:46:47,990 --> 00:46:54,870
+طيب تفكرون أيام ال .. و أنتوا أشباه الصغار يعني ال
+
+507
+00:46:54,870 --> 00:47:03,160
+optic nerve مكون من one million two hundred1000
+
+508
+00:47:03,160 --> 00:47:06,700
+fiber
+
+509
+00:47:06,700 --> 00:47:14,000
+fibrils ايش fibrils ليفات
+
+510
+00:47:14,000 --> 00:47:27,120
+الفيبر ليفة الفيبرل ليف الان كل اللي هو ال .. ال
+
+511
+00:47:27,120 --> 00:47:39,860
+circle هذه لو أخدنا قطعة في الكلها 1.5
+
+512
+00:47:39,860 --> 00:47:45,320
+ملي متر القطر
+
+513
+00:47:45,320 --> 00:47:56,580
+محتويًا ديورا متر وورق نوعج متر و بايا متر و
+
+514
+00:47:56,580 --> 00:48:01,840
+Central Retinal artery و Central Retinal veinكام
+
+515
+00:48:01,840 --> 00:48:09,240
+فضل للمليون و متين ألف ليف من واحد و نص؟ كام فضل؟
+
+516
+00:48:09,240 --> 00:48:21,420
+هذه الفيبرالز صعبة جدا و أي ضغط داخل العين سيكون
+
+517
+00:48:21,420 --> 00:48:28,020
+تفكيره على نفس الكمبيوتر العلوي للتحقيق
+
+518
+00:48:30,500 --> 00:48:37,360
+Blood supply to these fibrils and lead to death
+
+519
+00:48:37,360 --> 00:48:42,720
+due to ischemia و
+
+520
+00:48:42,720 --> 00:48:49,020
+الانهيار بيكون سريع يعني مش بيبقى كل يوم مية الف
+
+521
+00:48:49,020 --> 00:48:55,240
+ريف يروح فكل ساعة من ساعات الانجلجلوجر Glucoma
+
+522
+00:48:55,240 --> 00:49:03,970
+بتكلف فقطعشرات أو مئات الألاف من الـFibers واللي
+
+523
+00:49:03,970 --> 00:49:09,950
+بيروح بيرجع ولا لأ؟ بيرجعش اللي بيروح بيرجعش عشريك
+
+524
+00:49:09,950 --> 00:49:16,410
+الله والخالق جعل الألم سلاحا و بقايا هذا اللي
+
+525
+00:49:16,410 --> 00:49:20,150
+يصيبه الـungry cruder الـglucoma ضغط العين فوق
+
+526
+00:49:20,150 --> 00:49:26,130
+الـ60 أو الـ70 ملي متر ذئبق يصرخ صراخا غير عادي
+
+527
+00:49:26,130 --> 00:49:32,630
+غير عادي مش عاديمما يعني يودى الى ان يبحثوا له عن
+
+528
+00:49:32,630 --> 00:49:38,450
+عناج ولا ورا البحر و اكتشف لما يلاقي ابن حلال زيكو
+
+529
+00:49:38,450 --> 00:49:45,790
+يفهم هذا الصراخ و يعطيه دواء و منتول و يعمله
+
+530
+00:49:45,790 --> 00:49:51,410
+procedures اتناء اتلازم ضغط العين بيكون انقذ من
+
+531
+00:49:51,410 --> 00:49:57,780
+هذه الآلاف أن تدخل كويسة المعلومة هذه؟بس اخر حاجة
+
+532
+00:49:57,780 --> 00:50:01,760
+هنا هو ال property cautions are taken, the risk of
+
+533
+00:50:01,760 --> 00:50:04,820
+precipitating ungluten programa is virtually none
+
+534
+00:50:04,820 --> 00:50:08,980
+لما ناخد بالنا لما ناخد بالنا و المرة الجاية ان
+
+535
+00:50:08,980 --> 00:50:14,040
+شاء الله بنكمل اللي هو الدرس شكرا لكم
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/MrKroRb2dpA_postprocess.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/MrKroRb2dpA_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..3d7452393786895a953ad054d5753db861e95d74
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/MrKroRb2dpA_postprocess.srt
@@ -0,0 +1,2068 @@
+1
+00:00:20,670 --> 00:00:23,250
+بسم الله الرحمن الرحيم الحمد لله رب العالمين و
+
+2
+00:00:23,250 --> 00:00:25,850
+أصلي و أسلم على نبي الأمين محمد و على أهلي وأصحابي
+
+3
+00:00:25,850 --> 00:00:28,970
+و التابعين السلام عليكم و رحمة الله و بركاته نكمل
+
+4
+00:00:28,970 --> 00:00:31,810
+فدأ اليوم كنا قد بدأنا في المحطة السابقة about
+
+5
+00:00:31,810 --> 00:00:36,530
+antibacterial drugs today we begin in
+
+6
+00:00:36,530 --> 00:00:41,990
+chloramphenicol chloramphenicol is a well-known
+
+7
+00:00:41,990 --> 00:00:43,830
+wild spectrum
+
+8
+00:00:48,110 --> 00:00:54,070
+acting on both gram
+
+9
+00:00:54,070 --> 00:00:58,670
+positive bacteria and gram negative bacteria
+
+10
+00:00:58,670 --> 00:01:05,030
+together and acts on chlamydia, rickettsia and
+
+11
+00:01:05,030 --> 00:01:11,690
+spirochetes يعني other organisms than gram
+
+12
+00:01:11,690 --> 00:01:16,410
+positive and gram negative bacteriaمن البكتيريا
+
+13
+00:01:16,410 --> 00:01:21,450
+اللى هو قدرة على قتلها
+
+14
+00:01:21,450 --> 00:01:27,190
+أنواع كورني بكتيريا كورني بكتيريا مجموعة يعني
+
+15
+00:01:27,190 --> 00:01:31,530
+محددة اسمها كورني بكتيريا ومنها ايشيراشيا كولاي
+
+16
+00:01:31,530 --> 00:01:35,590
+ايشيراشيا كولاي اللى بتعمل الإسهال و النزلات
+
+17
+00:01:35,590 --> 00:01:40,190
+المعاوية و Hemophilus بأنواعها species and
+
+18
+00:01:40,190 --> 00:01:44,430
+streptococci عموما streptococciطبعا مساقى ال
+
+19
+00:01:44,430 --> 00:01:47,530
+microbiology دلوقت بتدرس من السنة الثالثة لأنها
+
+20
+00:01:47,530 --> 00:01:50,350
+كانت في الخطة الجديدة اللى بعدكوا يعنى ال
+
+21
+00:01:50,350 --> 00:01:53,090
+microbiology حقيقة مفيدة كل هذا بياخدوه في ال
+
+22
+00:01:53,090 --> 00:01:59,710
+microbiology it has been recommended in treatment
+
+23
+00:01:59,710 --> 00:02:05,010
+of يعني يوصى باستعماله في الحالات التالية محدد
+
+24
+00:02:05,010 --> 00:02:08,150
+يعنى when routine treatment of ophthalmia
+
+25
+00:02:08,150 --> 00:02:13,440
+neonatura احنا عارفين ايش ophthalmia neonaturaاللي
+
+26
+00:02:13,440 --> 00:02:18,040
+بنولده وفق إيهم؟ اللي هو infection ممكن جدا هذه
+
+27
+00:02:18,040 --> 00:02:23,220
+infection تزيد وتعمل يعني keratitis وكلام two
+
+28
+00:02:23,220 --> 00:02:28,660
+against chlamydia chlamydia اللي بكتيريا causing
+
+29
+00:02:28,660 --> 00:02:35,680
+trachoma يبقى هو اشتغل في علاج trachomaأه it is
+
+30
+00:02:35,680 --> 00:02:39,720
+useful أو its usefulness for this condition is
+
+31
+00:02:39,720 --> 00:02:42,120
+probably in the treatment of secondary infections
+
+32
+00:02:42,120 --> 00:02:45,280
+that are responsible for many of the adverse
+
+33
+00:02:45,280 --> 00:02:48,540
+effects of the infection يعني تراكومة معها
+
+34
+00:02:48,540 --> 00:02:53,220
+secondary infection أخر بكتيريا بتيجي عليها كمان
+
+35
+00:02:53,220 --> 00:02:58,380
+فبتعمل mycoprolant conjunctivitis هو هذا المفيد
+
+36
+00:02:58,380 --> 00:03:03,940
+للهيعني مش بس التراكومة وبالكافة كمان secondary
+
+37
+00:03:03,940 --> 00:03:08,180
+infection trait it is not effective against most
+
+38
+00:03:08,180 --> 00:03:12,940
+strains of Sodomonas aeruginosa and Serratia
+
+39
+00:03:12,940 --> 00:03:18,000
+mesarinens Sodomonas aeruginosa هو خطير جدا
+
+40
+00:03:18,000 --> 00:03:21,480
+البكتيري هذه في كل الأرثر كل الأرثر هو مش
+
+41
+00:03:21,480 --> 00:03:22,140
+effective عليها
+
+42
+00:03:26,230 --> 00:03:30,670
+سوداموراس الجينوزا و لأ لأ اسمه سيراشيا ماسيراناس
+
+43
+00:03:30,670 --> 00:03:37,330
+اللى بتعمل بليفريتس طيب موضوع infection كيف يعمل
+
+44
+00:03:37,330 --> 00:03:43,170
+طريقة عمله لما احد كلام قال ال penicillin و
+
+45
+00:03:43,170 --> 00:03:45,250
+الكفالوسفورين كان يقول بيعمل على ال cell wall
+
+46
+00:03:45,250 --> 00:03:50,330
+بيكسر ال cell wall و يخلص ال enzymes تطلع برضه هذا
+
+47
+00:03:50,330 --> 00:03:55,490
+بقولك هو بكتيروستاتيك مش بكتيروسيدل أول شيء
+
+48
+00:03:55,880 --> 00:03:59,940
+باكتيريا بيستاتيك باستخدام الانهيبشن من البروتين
+
+49
+00:03:59,940 --> 00:04:03,320
+السيانتيسي بإتراكشن والبكتيريا غير البوزونز يبقى
+
+50
+00:04:03,320 --> 00:04:06,420
+بيشتغل على ريبوزونز تفق ريبوزونز في البكتيريا
+
+51
+00:04:06,420 --> 00:04:11,820
+بصانع البروتينات فلما البكتيريا لها تجد بروتين
+
+52
+00:04:11,820 --> 00:04:17,660
+جديد ممكن الوقت يتمول طيب ال resistance هل
+
+53
+00:04:17,660 --> 00:04:21,520
+البكتيريا شكلت .. كونت له مقاومة؟
+
+54
+00:04:26,140 --> 00:04:29,980
+البكتيريا اكتشفت تركيب كولورانفينيكل وعملته انزعيم
+
+55
+00:04:29,980 --> 00:04:35,260
+اسمه Ascetyltransferase Ascetyltransferase لما
+
+56
+00:04:35,260 --> 00:04:40,120
+يعني يوصل لكولورانفينيكل بيعمله تكسير كيميائي
+
+57
+00:04:40,120 --> 00:04:45,000
+بيكسر اللي هو التركيب الكيميائي بتاعه one of the
+
+58
+00:04:45,000 --> 00:04:49,300
+reasons for the popularity of كولورانفينيكل ليش هو
+
+59
+00:04:49,300 --> 00:04:53,850
+منتشر شعبياas an ophthalmic antibacterial is that
+
+60
+00:04:53,850 --> 00:04:59,430
+it is rarely used systemically ليش؟
+
+61
+00:04:59,430 --> 00:05:05,830
+لا يستخدمونه systemically مع أنه موجود across لأنه
+
+62
+00:05:05,830 --> 00:05:09,830
+بيعمل شي اسمه aplastic anemia يعني بيشتغل على ال
+
+63
+00:05:09,830 --> 00:05:14,410
+bone marrow بيخلي ال bone marrow مايعملش white
+
+64
+00:05:14,410 --> 00:05:19,090
+blood cells فبنزل منعه فالناس بتخاف منه طيب هذا
+
+65
+00:05:19,090 --> 00:05:24,100
+systemicطب لو كنت ممكن أخد بيها، مابتعملش، لإنه
+
+66
+00:05:24,100 --> 00:05:27,280
+يعني قيمة القطرة لما تخشش في النيل ولكن مالدكت و
+
+67
+00:05:27,280 --> 00:05:30,840
+تروح على ال nose و تروح على الدم قليلة جدا،
+
+68
+00:05:30,840 --> 00:05:36,520
+مابتعملش، عشان هيك هو شعبي جدا في استعماله كقطرة و
+
+69
+00:05:36,520 --> 00:05:41,620
+كمره، يعني بس there is little chance of a cross
+
+70
+00:05:41,620 --> 00:05:45,710
+distance developingلا يوجد علاقة بينه وبين تركيبته
+
+71
+00:05:45,710 --> 00:05:50,510
+الكيميائي لذلك لا نخاف أن يحدث اكترق المقامة عملوا
+
+72
+00:05:50,510 --> 00:05:55,890
+استدعيه على 738 حالة لاجئين اللي جوا ال resistance
+
+73
+00:05:55,890 --> 00:06:03,790
+بس في 6% 6% من 378 يعني بس حوالي 22 حالة من كل
+
+74
+00:06:03,790 --> 00:06:07,090
+المجموعات مقارنة ال resistance كانت أقل من مجموعات
+
+75
+00:06:07,090 --> 00:06:14,460
+أخرى استخدامتها الانتيبوتكيعني لو قررنا ان مثلا
+
+76
+00:06:14,460 --> 00:06:20,860
+التترا سايكلين او حتى السيبرو فلوكساسين جداش
+
+77
+00:06:20,860 --> 00:06:25,180
+مقاومة له اقل حتى 10 الى 15 الى 20%الورق المفيد
+
+78
+00:06:25,180 --> 00:06:30,600
+يكون عشان الناس بتخاف تاخده ويأثر على الدم وإشي
+
+79
+00:06:30,600 --> 00:06:34,700
+وعنبون مارو فهو يعني البكتيريا مش مكتشفاه، يعني
+
+80
+00:06:34,700 --> 00:06:39,840
+إحنا لو بدنا نعمل يعني مغامرة فريدة، بنعطي واحد
+
+81
+00:06:39,840 --> 00:06:43,160
+يكونا مثلا كل أقراس عشان مثلا علاج مثلا السلمونيلا
+
+82
+00:06:43,160 --> 00:06:47,300
+تيفوض والبارا تيفوض والكلام ده، أه بس بدنا نتابع
+
+83
+00:06:47,300 --> 00:06:51,140
+موضوع الدم، تحليل الدم وإشي، فهو في العين
+
+84
+00:06:58,600 --> 00:07:05,240
+بالإضافة إلى عملها توظيفه في التعامل مع حالتين مثل
+
+85
+00:07:05,240 --> 00:07:09,940
+الـ Typhoid, Salmonella, Infections وBacterial
+
+86
+00:07:09,940 --> 00:07:12,920
+Meningitis، يعني ممكن يعمل عليها الـ Systemic
+
+87
+00:07:12,920 --> 00:07:16,360
+Infections هذه، يعني خاصة الـ Typhoid والـ
+
+88
+00:07:16,360 --> 00:07:21,540
+Salmonellosis وحتى الـ Bacterial Meningitis،
+
+89
+00:07:21,540 --> 00:07:24,100
+التهاب الصحيحية، الـ Systemic Use of Chlorophyll
+
+90
+00:07:24,100 --> 00:07:29,530
+is very restricted today because of theplastic
+
+91
+00:07:29,530 --> 00:07:34,690
+anemia يعني يعمل suppression للجمهور مارو مخلوش
+
+92
+00:07:34,690 --> 00:07:37,730
+يطلع الوايات بلاتسيز producing agranulocytosis
+
+93
+00:07:37,730 --> 00:07:45,950
+agranulocytosis يعني ايه لنا فيه الخلايا المحاببة
+
+94
+00:07:45,950 --> 00:07:53,090
+ال isrophies و ال mesophies و ال neutrophiesووجدوا
+
+95
+00:07:53,090 --> 00:07:56,490
+from systematic treatment the incidence of about
+
+96
+00:07:56,490 --> 00:08:04,530
+one in fifty thousand واحد من خمسين الف حالة
+
+97
+00:08:04,530 --> 00:08:11,770
+صارلهم agranocytosis جاليه ولا كتير؟ جاليه، ومع
+
+98
+00:08:11,770 --> 00:08:14,750
+ذلك الناس خايفة، أقولك أنا أضاحف في واحد من خمسين
+
+99
+00:08:14,750 --> 00:08:18,710
+الف؟ أه، طب أنا في أوروبا وفي أمريكا يعني، from
+
+100
+00:08:18,710 --> 00:08:22,870
+tuberculosis, the incidence is much lowerلو بدهم
+
+101
+00:08:22,870 --> 00:08:28,970
+يحطوا في العين يعني عشرين يوم بصيرش اللي هو
+
+102
+00:08:28,970 --> 00:08:34,150
+aplastic anemia لأن القطرة انقطتت هو جزء من ال
+
+103
+00:08:34,150 --> 00:08:38,230
+topical use في ال systemic ولا جزء بس لأ اللي واحد
+
+104
+00:08:38,230 --> 00:08:42,650
+على الخمسين الف في ال systemic انما في ال topical
+
+105
+00:08:42,650 --> 00:08:48,010
+بقول لسه أقل much lower much lower much lower يعني
+
+106
+00:08:48,010 --> 00:08:50,650
+أقل من هيك يعني بقول واحد في ال ..
+
+107
+00:08:55,780 --> 00:09:00,580
+الاطفال ليش؟ عشان ال body weight صغير و ممكن انه
+
+108
+00:09:00,580 --> 00:09:04,820
+يحط اكتر نقطة في اليوم مثلا حطه عشر نقطة عشرين
+
+109
+00:09:04,820 --> 00:09:08,140
+نقطة في العينين جاي و الطفل صغير و هذا يعني ممكن
+
+110
+00:09:08,140 --> 00:09:14,140
+اه يتأثر ان ماني كبار معظمهم
+
+111
+00:09:14,140 --> 00:09:19,860
+طيب الان
+
+112
+00:09:19,860 --> 00:09:23,460
+use of chronophoricol in treatment treatment use
+
+113
+00:09:23,460 --> 00:09:29,060
+of chronophoricol has a highفهي حاجة اقفصية لان
+
+114
+00:09:29,060 --> 00:09:33,740
+كتير فيلم اول طبقة منه ال libid فهو بيدور في ال
+
+115
+00:09:33,740 --> 00:09:38,500
+libid و بتاريوم تص عملوا تجربة في ال ovine ice
+
+116
+00:09:38,500 --> 00:09:44,880
+عيون الغنم كانت محفظة في القرنية أعلى من ال
+
+117
+00:09:44,880 --> 00:09:49,440
+aqueous humor يعني عملوا تجربة على عيون الغنم كام
+
+118
+00:09:49,440 --> 00:09:52,740
+لجوا ان تركيزه في القرنية أعلى من تركيزه في ال
+
+119
+00:09:52,740 --> 00:09:53,840
+aqueous humor في ال AC
+
+120
+00:09:58,660 --> 00:10:01,740
+هو مستعمل لإنفكاشات صغيرة مثل بكتيريا الانفكشز
+
+121
+00:10:01,740 --> 00:10:07,680
+بليفريتس كيراتيتس
+
+122
+00:10:07,680 --> 00:10:17,420
+كودركتفيتس كورانفيكول كورانفيكول كورانفيكول
+
+123
+00:10:17,420 --> 00:10:20,780
+كورانفيكول كورانفيكول كورانفيكول كورانفيكول
+
+124
+00:10:20,780 --> 00:10:22,060
+كورانفيكول كورانفيكول كورانفيكول كورانفيكول
+
+125
+00:10:22,060 --> 00:10:23,380
+كورانفيكول كورانفيكول كورانفيكول كورانفيكول
+
+126
+00:10:23,380 --> 00:10:26,500
+كورانفيكول كورانفيكول كورانفيكول كورانفيكول
+
+127
+00:10:26,500 --> 00:10:32,120
+كورانفيكول كورانفيكولPearson's eye ointment يعني
+
+128
+00:10:32,120 --> 00:10:37,440
+فيه منه قطرة و فيه منه ماهر و فيه منه قطرة تنوضع
+
+129
+00:10:37,440 --> 00:10:43,000
+مع اللي هو كورتيزون زي ديكزا كول مثلا حطوا
+
+130
+00:10:43,000 --> 00:10:47,620
+كلورومفينيكول مع الايش و زي الماكسيترون حطوا
+
+131
+00:10:47,620 --> 00:10:51,640
+كلورومفينيكول مع كورتيزون اللي هو ديكزا ميثازون
+
+132
+00:10:53,450 --> 00:10:57,270
+الاستعمال التاني انه لو اعطوه Intramuscular
+
+133
+00:10:57,270 --> 00:11:01,570
+Injection يعني حقا في العضل منه هابي recommended
+
+134
+00:11:01,570 --> 00:11:06,150
+for treatment of Trachoma Trachoma هي محيرة الناس
+
+135
+00:11:06,150 --> 00:11:12,170
+كلها يعني لو كانت قدوت في أول هبقى اعطوه كلهم في
+
+136
+00:11:12,170 --> 00:11:15,750
+كل حقا طبعا من الخافة عليه في ال bone marrow خافة
+
+137
+00:11:15,750 --> 00:11:18,010
+عن ال bone marrow فعادة من فترة دي من ال Trachoma
+
+138
+00:11:18,010 --> 00:11:20,030
+نعطيها topical treatment خاصة
+
+139
+00:11:24,230 --> 00:11:28,150
+و لا في انفكشة منعمل كورونافانيكولمرها طيب
+
+140
+00:11:28,150 --> 00:11:31,830
+المجموعة الارتباطيكية التانية Flucroquinolones
+
+141
+00:11:31,830 --> 00:11:36,230
+فهذه كانت أحدث مجموعة و بذات مستطوعة في عالم
+
+142
+00:11:36,230 --> 00:11:39,310
+الوظائف الحيوية صحيح ال systemic ارتباطيكية
+
+143
+00:11:39,310 --> 00:11:42,450
+Flucroquinolones
+
+144
+00:11:42,450 --> 00:11:47,150
+this group of broad spectrum antibiotics includes
+
+145
+00:11:47,150 --> 00:11:50,010
+الأعضاء بتاعها norfluxacillin
+
+146
+00:11:58,820 --> 00:12:02,880
+مجموعة اللي هي أعضاء كتير الأخير اللي هو
+
+147
+00:12:02,880 --> 00:12:05,420
+superfluxicillin و ofloxicillin
+
+148
+00:12:16,740 --> 00:12:20,660
+الجمهور لهذه الجمهور كان ناليدكسيك أسد يعني أخدوه
+
+149
+00:12:20,660 --> 00:12:25,460
+من ناليدكسيك أسد و بعدين طوروه و كان مدعوم في ال
+
+150
+00:12:25,460 --> 00:12:32,300
+الهو 1960 في الستينيات من القرن الماضي طيب كيف
+
+151
+00:12:32,300 --> 00:12:35,580
+يعمل المجموعة هذه ال floriculones احنا قولنا كل
+
+152
+00:12:35,580 --> 00:12:39,720
+مجموعة من الانتيباتيكي بتعمل البكتيريا من جانب هذا
+
+153
+00:12:39,720 --> 00:12:44,680
+بيعمل في القطر على ال DNA DNA بيمنع ال formation
+
+154
+00:12:44,680 --> 00:12:55,520
+of DNAيبقى مدفعش ان الـfloriculose تتعرض وتوقف
+
+155
+00:12:55,520 --> 00:13:04,980
+بنشطة الـDNA بإستعمال الانزين المسؤول عن بنشطة
+
+156
+00:13:04,980 --> 00:13:12,560
+الـNucleic Acid في المحطة الأساسيةفيه اللي هو ال
+
+157
+00:13:12,560 --> 00:13:17,160
+coins الحلزونية بتاعة ال DNA وهذا طبعا بيكون فيه
+
+158
+00:13:17,160 --> 00:13:24,040
+amino acids فيها فال بكتيريا عشان إلها نوة فيها
+
+159
+00:13:24,040 --> 00:13:30,660
+DNA and RNA هي بتبنى الإنزيم اللي بيساعدها تكوين
+
+160
+00:13:30,660 --> 00:13:36,540
+ال DNA ف ال chains بتاعته هذي بتتكسر بتتكسر و هو
+
+161
+00:13:36,540 --> 00:13:37,740
+بتموت البكتيريا
+
+162
+00:13:42,370 --> 00:13:45,410
+هل البكتيريا اكتشفت شفرة بتاعته وتركيبه الكيميائي
+
+163
+00:13:45,410 --> 00:13:52,270
+وعملته بدأة؟ الوضع بقع مقاومة ضعف مقاومة ضعف
+
+164
+00:13:52,270 --> 00:13:53,490
+مقاومة ضعف مقاومة ضعف مقاومة ضعف مقاومة ضعف مقاومة
+
+165
+00:13:53,490 --> 00:13:55,570
+ضعف مقاومة ضعف مقاومة ضعف مقاومة ضعف مقاومة ضعف
+
+166
+00:13:55,570 --> 00:13:55,790
+مقاومة ضعف مقاومة ضعف مقاومة ضعف مقاومة ضعف مقاومة
+
+167
+00:13:55,790 --> 00:14:01,270
+ضعف مقاومة ضعف مقاومة ضعف مقاومة ضعف مقاومة ضعف
+
+168
+00:14:01,270 --> 00:14:10,530
+مقاومة ضعف مقاومة ضعف مق
+
+169
+00:14:12,320 --> 00:14:16,760
+لو البكتيريا عملت distance لواحد، تلقائيها بتعمل
+
+170
+00:14:16,760 --> 00:14:23,300
+التاني، الشبيه لو زي الواحد و أخوه، لو أخه عدو
+
+171
+00:14:23,300 --> 00:14:27,240
+لناس، التاني بيصير التلقائي عنهوبالتالي البكتيريا
+
+172
+00:14:27,240 --> 00:14:32,100
+لو اكتشفت مثلا لـ penicillin resistance بصير اللي
+
+173
+00:14:32,100 --> 00:14:36,540
+هو مثلا الكفليكس مجموعة كفارسقورين داخلة في ال
+
+174
+00:14:36,540 --> 00:14:39,920
+resistance يعني هنا في ال هوكولوناوز لأ بيقولك
+
+175
+00:14:39,920 --> 00:14:42,880
+مافيش cross resistance مافيش تركيب كيميائي أو شبهه
+
+176
+00:14:56,940 --> 00:15:03,000
+المضادة الحيوية على الإطلاق و منذ عشرين عامة و في
+
+177
+00:15:03,000 --> 00:15:08,620
+الآن حقيقة ان قطرة الـ Suprafluxacin و قطرة الـ
+
+178
+00:15:08,620 --> 00:15:16,400
+Oflux حتى الآن قوية و طوة ورا منها الوزايمر مثلا
+
+179
+00:15:16,400 --> 00:15:22,580
+اه يعني في حاجات كمان متقدمة اللي هو الجيل الرابع
+
+180
+00:15:25,880 --> 00:15:30,480
+أكشن طبعا جرام positive mainly و جرام negative
+
+181
+00:15:30,480 --> 00:15:34,760
+again بس بتشتغل broad spectrum على طيف واسع
+
+182
+00:15:34,760 --> 00:15:38,000
+بتستخدم
+
+183
+00:15:38,000 --> 00:15:41,720
+علاجيا في علاج ال upper and lower respiratory
+
+184
+00:15:41,720 --> 00:15:45,100
+tract infection ال upper respiratory tract
+
+185
+00:15:45,100 --> 00:15:49,980
+infection ال nose و
+
+186
+00:15:49,980 --> 00:15:54,720
+ال nasal sinuses و ال nasopharynx
+
+187
+00:15:57,230 --> 00:16:05,910
+ولان ال larynx ال larynx ايش؟ الحنجرة الحنجرة هذا
+
+188
+00:16:05,910 --> 00:16:10,710
+اسمه اكبر اسم في ال tract infection لو رينا في
+
+189
+00:16:10,710 --> 00:16:20,910
+التركيا، في ال bronchi، في ال bronchioles، وفي ال
+
+190
+00:16:20,910 --> 00:16:24,610
+alveoli، عارفين ال alveoli؟ الأكياس الهوائية؟
+
+191
+00:16:31,710 --> 00:16:37,930
+أعظم في الـ Nose و الـ Sinuses و الحق الاروانات و
+
+192
+00:16:37,930 --> 00:16:44,010
+الارنكس و الارنكس و يستخدم كمان في التهاب الرئوي و
+
+193
+00:16:44,010 --> 00:16:47,450
+التهاب الشعب الهوائي و الشعبات الهوائية و هذا شيء
+
+194
+00:16:47,450 --> 00:16:50,950
+عظيم أكتر ما يصيب الناس من Infection في رسم
+
+195
+00:16:50,950 --> 00:16:55,910
+التراكتينوفيكسيا و أكتر جهاز معرض للأسف لل
+
+196
+00:16:55,910 --> 00:16:58,690
+Infections هو رسم التراكتينوفيكسيا يعني
+
+197
+00:16:58,690 --> 00:17:00,230
+Cardiovascular Infection
+
+198
+00:17:02,780 --> 00:17:07,720
+الجنة تو urinary tract infection قليلة لأن أجسامها
+
+199
+00:17:07,720 --> 00:17:14,200
+مخبئة لكن هذا الجهاز الظاهر اللي في صدام الجو
+
+200
+00:17:14,200 --> 00:17:18,800
+المناخ البرد الشديد تلاقيت كل ناس بتكون حمرشة
+
+201
+00:17:18,800 --> 00:17:25,120
+والجو الساخن والربيع تلاقيت كل ناس ماليرجي وكلم زي
+
+202
+00:17:25,120 --> 00:17:29,720
+هذا طيب تو urinary tract infection including
+
+203
+00:17:29,720 --> 00:17:33,450
+gonorrheaوفي اللي قلت يا بنت جاهز يبقى قولي مما
+
+204
+00:17:33,450 --> 00:17:36,570
+فيه مرض السيالان المرض اللي هو sexually
+
+205
+00:17:36,570 --> 00:17:41,350
+transmitted they are effective against a wide
+
+206
+00:17:41,350 --> 00:17:44,590
+range of bacteria both gram boosted and gram
+
+207
+00:17:44,590 --> 00:17:49,790
+boosted for they are active against staphylococcus
+
+208
+00:17:49,790 --> 00:17:56,190
+species staphylococci منها oreous ومنها epidermids
+
+209
+00:17:56,190 --> 00:18:00,560
+ومنها البس بيشتغل عليها كلهاDose resistant to
+
+210
+00:18:00,560 --> 00:18:03,960
+penicillin حتى اللي بتقاوم بالبنسالين and
+
+211
+00:18:03,960 --> 00:18:07,440
+substrates of those resistant to Methicillin بعض
+
+212
+00:18:07,440 --> 00:18:10,840
+البنسالين راقي هذا حتى اللي هي بتعمل مقاومة
+
+213
+00:18:10,840 --> 00:18:15,800
+للبنسالين الراقي عند اللي هو الفروق و الاروز تتوقف
+
+214
+00:18:15,800 --> 00:18:26,140
+تستسلم لأنه جديد و expensive غالي، غالي جدا حتى
+
+215
+00:18:26,140 --> 00:18:29,730
+السيودا مرسأرجينوزا اللى كانت قبل شهورة بتتملى
+
+216
+00:18:29,730 --> 00:18:37,150
+لـChronic Resistance هنا تستسلم حتى اللى مجموعة
+
+217
+00:18:37,150 --> 00:18:42,890
+أمنغليكوسيات بتقومها
+
+218
+00:18:42,890 --> 00:18:47,170
+هنا تستسلم عند الـChronic Resistance شوف البشرية
+
+219
+00:18:47,170 --> 00:18:51,830
+دايما حائرة تبحث عن الأمان البشرية تبحث عن الأمان
+
+220
+00:18:51,830 --> 00:18:59,020
+بدها شيء يحمي يعني الحياة بتاعتهافكل ما تدد مجموعة
+
+221
+00:18:59,020 --> 00:19:04,980
+antibiotics يعني قوية البكتيريا تتلفها فتجعل
+
+222
+00:19:04,980 --> 00:19:09,560
+البشرية إلى بشروع جديد في ال antibiotics وتعتقد أن
+
+223
+00:19:09,560 --> 00:19:13,540
+هذا هو مركب الأمان فالبكتيريا هذه الحقيقة
+
+224
+00:19:13,540 --> 00:19:19,940
+المكتسكوية يعني تصل إلى السر وتحاول تكسير مبنى
+
+225
+00:19:19,940 --> 00:19:24,560
+الإنسان من علم في ال antibiotics تضطر البشرية يعيش
+
+226
+00:19:24,560 --> 00:19:32,690
+تبقى تجربةطيب هم أقل
+
+227
+00:19:32,690 --> 00:19:40,230
+من الهباقي البكتيريا سبرافلوكسين
+
+228
+00:19:40,230 --> 00:19:46,710
+يعني منه هذا الوربة وهي القطرة سبرافلوكسين يعني
+
+229
+00:19:46,710 --> 00:19:54,570
+موجود بصورة across وموجود بصورة drops وموجود بصورة
+
+230
+00:19:54,570 --> 00:19:58,350
+عندن في السوق موجودالناس بيقول سوبراكسين
+
+231
+00:19:58,350 --> 00:20:03,330
+سوبرافلوكسسين المهم أنه موجود Supraflucocin of
+
+232
+00:20:03,330 --> 00:20:07,490
+thalamic form في العين as a result of these
+
+233
+00:20:07,490 --> 00:20:10,630
+studies, an ophthalmic form of supraflucocin has
+
+234
+00:20:10,630 --> 00:20:16,390
+been introduced as 0.3 solution يعني قطرة
+
+235
+00:20:16,390 --> 00:20:19,510
+absorption into ocular tissues is gone leading to
+
+236
+00:20:19,510 --> 00:20:22,810
+upwards humor levels that exceed the mic of many
+
+237
+00:20:22,810 --> 00:20:26,830
+ocular pathogensيعني هو يمطس يبقى هو لايبوفيليك
+
+238
+00:20:26,830 --> 00:20:33,370
+ولا هيدروفيليك لايبوفيليك يمطس ويكون عالي جدا في
+
+239
+00:20:33,370 --> 00:20:37,770
+ال AC وهذا شيء كويس it also produced least
+
+240
+00:20:37,770 --> 00:20:42,090
+experimental damage to rabbit cornea يعني على عيول
+
+241
+00:20:42,090 --> 00:20:45,670
+الأرانب يعني ال least damage مايعملش toxicity يعني
+
+242
+00:20:45,670 --> 00:20:50,230
+المشي تيريبز are also maintained above مي
+
+243
+00:20:56,000 --> 00:21:01,060
+حتى في تير فيلم المايك بتاعه يعني و بيوقع أربع
+
+244
+00:21:01,060 --> 00:21:11,440
+ساعات طبعا دي قطرة كويسة كتير superfluous طيب
+
+245
+00:21:11,440 --> 00:21:16,800
+ال system issues يعني زي مثلا أقراس
+
+246
+00:21:16,800 --> 00:21:21,120
+gastrocystemsis being the most common adverse
+
+247
+00:21:21,120 --> 00:21:26,190
+reaction يعني حاجة من irritation للمعلقو ربما
+
+248
+00:21:26,190 --> 00:21:30,410
+للأمعاء other reactions include dizziness دوخة and
+
+249
+00:21:30,410 --> 00:21:34,590
+skin reactions و حاسسية طالع ان الناس ممكن تتغلب
+
+250
+00:21:34,590 --> 00:21:38,170
+عليها مش معناه دالك يعني انا شخصيا اخدت
+
+251
+00:21:38,170 --> 00:21:42,530
+superfluous من قبل شهر افكت و كويس ل chest
+
+252
+00:21:42,530 --> 00:21:50,270
+infection طب طول درعي قطرها و برهم they are
+
+253
+00:21:50,270 --> 00:21:53,370
+claimed to have better penetration of the cornea
+
+254
+00:21:53,370 --> 00:21:57,960
+لأنه ليبوفليكولا كتير طيبة وفى ال antero chamber
+
+255
+00:21:57,960 --> 00:22:03,600
+together و less tissue toxicity fantastic كويس
+
+256
+00:22:03,600 --> 00:22:09,260
+كتير قطر ال soprafloxacin الحقيقة هي القطرة
+
+257
+00:22:09,260 --> 00:22:13,480
+الموجودة بكفرها اننا احنا غير ال soprafloxacin ال
+
+258
+00:22:13,480 --> 00:22:19,620
+offlox ال offlox هي شركة Allergan وفي منها
+
+259
+00:22:19,620 --> 00:22:25,220
+Ultrasin بزت وفي منها عديد من الشركات اللي صنعوا
+
+260
+00:22:29,730 --> 00:22:34,630
+هذه المجموعة اللي فيها تابلت و أكسين نفس الأشياء
+
+261
+00:22:34,630 --> 00:22:39,310
+بس ده Systemic اه Systemic اه اه اه اه اه اه اه اه
+
+262
+00:22:39,310 --> 00:22:39,990
+اه اه اه اه اه اه اه اه اه اه اه اه اه اه اه اه اه
+
+263
+00:22:39,990 --> 00:22:40,050
+اه اه اه اه اه اه اه اه اه اه اه اه اه اه اه اه اه
+
+264
+00:22:40,050 --> 00:22:41,230
+اه اه اه اه اه اه اه اه اه اه اه اه اه اه اه اه اه
+
+265
+00:22:41,230 --> 00:22:41,390
+اه اه اه اه اه اه اه اه اه اه اه اه اه اه اه اه اه
+
+266
+00:22:41,390 --> 00:22:48,390
+اه اه اه اه اه اه اه اه اه اه اه اه اه اه اه اه اه
+
+267
+00:22:48,390 --> 00:22:48,450
+اه
+
+268
+00:23:17,060 --> 00:23:21,940
+بيطلع من وساطيه، الكثير حقيقة أنه القطرة هذه
+
+269
+00:23:21,940 --> 00:23:27,060
+والأقاس أحيانا اللي بنعطيها كويسة، in vitro في
+
+270
+00:23:27,060 --> 00:23:32,140
+المعمل، in vivo في الإنسان، in vitro toxicity of
+
+271
+00:23:34,900 --> 00:23:42,720
+وهو كوانالونز مجرد مجرد مجرد مجرد مجرد مجرد مجرد
+
+272
+00:23:42,720 --> 00:23:44,940
+مجرد مجرد مجرد مجرد مجرد مجرد مجرد مجرد مجرد مجرد
+
+273
+00:23:44,940 --> 00:23:47,740
+مجرد مجرد مجرد مجرد مجرد مجرد مجرد مجرد مجرد مجرد
+
+274
+00:23:47,740 --> 00:23:51,680
+مجرد مجرد مجرد مجرد مجرد مجرد
+
+275
+00:23:51,680 --> 00:24:03,880
+مجر
+
+276
+00:24:04,160 --> 00:24:08,380
+نورفلوكسين أقوى أحيانا نضطر نعطي systemic and
+
+277
+00:24:08,380 --> 00:24:17,980
+topical تراب لأطفال و نعطي drops الاستعمار
+
+278
+00:24:17,980 --> 00:24:24,660
+التاني بكتيريال كيروتايتس بكتيريال كيروتايتس حتى
+
+279
+00:24:24,660 --> 00:24:28,100
+الكوميا الألسفر كويس قوى كتير لأنواع
+
+280
+00:24:28,100 --> 00:24:30,880
+fluoroquinolose جيدة جدا
+
+281
+00:24:38,430 --> 00:24:44,210
+وكانت تعمل عبارة عن عملية مدموعة في بكتيريا
+
+282
+00:24:44,210 --> 00:24:47,330
+الكيروتكتس وكانت تعمل عبارة عن عملية مدموعة في
+
+283
+00:24:47,330 --> 00:24:49,390
+بكتيريا الكيروتكتس وكانت تعمل عبارة عن عملية
+
+284
+00:24:49,390 --> 00:24:50,830
+مدموعة في بكتيريا الكيروتكتس وكانت تعمل عبارة عن
+
+285
+00:24:50,830 --> 00:24:54,270
+عملية مدموعة في بكتيريا الكيروتكتس
+
+286
+00:25:06,560 --> 00:25:09,480
+المفروكس سيلين استخدموه في البكتيريا الكونيكتبيتس
+
+287
+00:25:09,480 --> 00:25:13,980
+و البلفريتس وهذه الشائعة و widespread يعني ان
+
+288
+00:25:13,980 --> 00:25:17,260
+البكتيريا الكونيكتبيتس اللي هو الفراز الصديدي في
+
+289
+00:25:17,260 --> 00:25:22,000
+العين والاتهاب حق الجفون كثير ملاقي ناس معاهم
+
+290
+00:25:22,000 --> 00:25:27,640
+اتهابات حق الجفون ف ال flora colorons أفضل من باقي
+
+291
+00:25:40,350 --> 00:25:43,790
+الـ Amino Glycosides طبعا قديمة لما كنا طلاب في
+
+292
+00:25:43,790 --> 00:25:48,570
+الجامعة كنا نسمع في الـ Amino Glycosides of الجن
+
+293
+00:25:48,570 --> 00:25:54,370
+تميسين اللي هو كان العضو الأولاني اللي اكتشفوه
+
+294
+00:25:54,370 --> 00:25:59,890
+اسمه جن تميسين الآن أضاعف الجن تميسين أضاعف أرقى
+
+295
+00:25:59,890 --> 00:26:07,070
+منه طبعا بالعلم زي اميكاسين اميكاسين هذا أحدث من
+
+296
+00:26:07,070 --> 00:26:10,530
+الجن تميسينالسلمتومايسين كنا نسمع عنه احنا اطفال
+
+297
+00:26:10,530 --> 00:26:16,230
+في علاج ال TB ال T B اللي هو ال Solar Rheosis
+
+298
+00:26:16,230 --> 00:26:21,270
+النيومايسين هذا كتير في القطرات و المراهب الموجودة
+
+299
+00:26:21,270 --> 00:26:24,950
+عندنا ال جنتامايسين و التوبرامايسين أعضاء
+
+300
+00:26:24,950 --> 00:26:29,250
+التوبرامايسين يمكن يكون هو أرقابهم التوبرامايسين و
+
+301
+00:26:29,250 --> 00:26:33,610
+أغلاقهم و الاميكاسين كمان أعضاء يعني أقوى من اللي
+
+302
+00:26:33,610 --> 00:26:37,200
+هو الجنتامايسين و السلمتومايسينطيب، mode of
+
+303
+00:26:37,200 --> 00:26:42,460
+infection .. of action .. mode of action كيف تعمل؟
+
+304
+00:26:42,460 --> 00:26:50,020
+تعمل Inhibition أو protein synthesis تمنع تكوين
+
+305
+00:26:50,020 --> 00:26:51,780
+البروتين، زيها زي إيش؟
+
+306
+00:27:02,530 --> 00:27:06,870
+by combining with the messenger RNA leading to
+
+307
+00:27:06,870 --> 00:27:13,170
+suppression of ribosomes function يبقى هم مشتغلوش
+
+308
+00:27:13,170 --> 00:27:17,530
+على ribosome على طول لأ اشتغلوا على messenger اللي
+
+309
+00:27:17,530 --> 00:27:21,210
+بامكر التعليمات لل ribosomes فribosomes أصبح من
+
+310
+00:27:21,210 --> 00:27:21,890
+غير تعليمات
+
+311
+00:27:42,970 --> 00:27:47,790
+المهم يعني ان كيف تشتغل؟ بتشتغل على ال messenger
+
+312
+00:27:47,790 --> 00:27:52,010
+RNA وبالتالي بتعطل شغل ال ribosomes
+
+313
+00:27:56,840 --> 00:27:59,300
+انتفاوتك يعني انتفاوتك انتفاوتك انتفاوتك انتفاوتك
+
+314
+00:27:59,300 --> 00:28:01,020
+انتفاوتك انتفاوتك انتفاوتك انتفاوتك انتفاوتك
+
+315
+00:28:01,020 --> 00:28:02,960
+انتفاوتك انتفاوتك انتفاوتك انتفاوتك انتفاوتك
+
+316
+00:28:02,960 --> 00:28:07,040
+انتفاوتك انتفاوتك انتفاوتك انتفاوتك انتفاوتك
+
+317
+00:28:07,040 --> 00:28:09,300
+انتفاوتك انتفاوتك انتفاوتك انتفاوتك انتفاوتك
+
+318
+00:28:09,300 --> 00:28:12,340
+انتفاوتك انتفاوتك انتفاوتك انتفاوتك انتفاوتك
+
+319
+00:28:12,340 --> 00:28:14,240
+انتفاوتك انتفاوتك
+
+320
+00:28:19,230 --> 00:28:24,570
+هذا أخيرًا يؤدي إلى تدمير ممبرنة السلوكية وقتل
+
+321
+00:28:24,570 --> 00:28:32,410
+البكتيرين، وقتل البكتيرين، وقتل البكتيرين، وقتل
+
+322
+00:28:32,410 --> 00:28:36,110
+البكتيرين، وقتل البكتيرين، وقتل البكتيرين، وقتل
+
+323
+00:28:36,110 --> 00:28:43,630
+البكتيرين، وقتل البكتيرين، وقتل البكتيرين، وقتل
+
+324
+00:28:43,630 --> 00:28:49,660
+البكتيرين،يعني في أكراس ليفو .. ليفو أكسسيلين يعني
+
+325
+00:28:49,660 --> 00:28:54,620
+يمكن بتاع الشكل تماما يعني ل .. ل .. مثلا خمس أيام
+
+326
+00:28:54,620 --> 00:28:59,140
+غالقة جدا مش كل الناس تستطيع أنه تشتري هذا و
+
+327
+00:28:59,140 --> 00:29:03,840
+بالتالي يعني ايضا الفقراء لهم أيش يعني Antibiotics
+
+328
+00:29:03,840 --> 00:29:09,900
+برضهطيب بقول ال resistance can be brought about by
+
+329
+00:29:09,900 --> 00:29:14,320
+the production of enzymes low affinity of the
+
+330
+00:29:14,320 --> 00:29:20,280
+ribosomes يعني بقولك ال resistance أصبحت يعني
+
+331
+00:29:20,280 --> 00:29:25,120
+متزايدة لها ده النوع عن طريق حماية ال ribosomes
+
+332
+00:29:25,120 --> 00:29:31,500
+يعني البكتيريا اكتشفت شفرة فعملت enzymes تحمي ال
+
+333
+00:29:31,500 --> 00:29:34,720
+ribosomes و ال messenger بتاعها
+
+334
+00:29:39,500 --> 00:29:45,860
+لا يؤثر فيها طيب العين هذه a mine of glycosides
+
+335
+00:29:45,860 --> 00:29:49,940
+منها نيومايسين وهذا حقيقة في العين قطرة ومرحب تمام
+
+336
+00:29:49,940 --> 00:29:54,920
+موجود دلوقتي نيومايسين كلورامفينيكول هو مدعوم
+
+337
+00:29:54,920 --> 00:30:01,920
+كانترابيكال لسبب استخدامه غير مستعمل بشكل عام يعني
+
+338
+00:30:01,920 --> 00:30:09,220
+مش كلورامفينيكول فشيء ان قرير التداولالأمعاء ليس
+
+339
+00:30:09,220 --> 00:30:13,220
+مستخدما من خلال قطع الأمعاء وكانت كثيرة من الضرورة
+
+340
+00:30:13,220 --> 00:30:17,520
+للمديرات التاريخية ليس مستخدما من خلال قطع الأمعاء
+
+341
+00:30:17,520 --> 00:30:19,600
+ليس مستخدما من خلال قطع الأمعاء ليس مستخدما من
+
+342
+00:30:19,600 --> 00:30:21,380
+خلال قطع الأمعاء ليس مستخدما من خلال قطع الأمعاء
+
+343
+00:30:21,380 --> 00:30:21,940
+ليس مستخدما من خلال قطع الأمعاء ليس مستخدما من
+
+344
+00:30:21,940 --> 00:30:22,280
+خلال قطع الأمعاء ليس مستخدما من خلال قطع الأمعاء
+
+345
+00:30:22,280 --> 00:30:27,900
+ليس مستخدما من خلال قطع الأمعاء ليس مستخدما من
+
+346
+00:30:27,900 --> 00:30:34,380
+خلال قطع الأمعاء ليس مستخدما من خلال قطع الأمعسبب
+
+347
+00:30:34,380 --> 00:30:39,280
+جدًا على الجسم، ماعطوهش، as if its use is
+
+348
+00:30:39,280 --> 00:30:43,320
+restricted to either disinfecting the gut، ال gut
+
+349
+00:30:43,320 --> 00:30:48,880
+الأمعاء يعني، و طهر الأمعاء prior
+
+350
+00:30:48,880 --> 00:30:51,240
+to surgery، جانونا يعملوا عملية جراحية في الأمعاء،
+
+351
+00:30:51,240 --> 00:30:54,140
+مثلًا في البطل، or as topical preparation for skin
+
+352
+00:30:54,140 --> 00:30:58,260
+or mucous membranes أو يحطوا مرحم للجلد، مرحم
+
+353
+00:30:58,260 --> 00:30:59,920
+للميوكاس مبرين، مرحم للعين
+
+354
+00:31:03,860 --> 00:31:07,900
+Like all aminoglycosides, neomycin can produce
+
+355
+00:31:07,900 --> 00:31:13,180
+nephrotoxicity لو أخدوا حقا مثلا لما تسموا بالكلة
+
+356
+00:31:13,180 --> 00:31:24,160
+and autotoxicity تسمم
+
+357
+00:31:24,160 --> 00:31:28,740
+لعصب الأذن العصب الثامن في الأذن في الستيبل
+
+358
+00:31:28,740 --> 00:31:33,720
+الكوكيرينممكن يتسمم فهذا ليس معروف ان تهتم
+
+359
+00:31:33,720 --> 00:31:39,740
+باستخدام طبيعي لكن حطانة في العين مايعملش حاجة شوف
+
+360
+00:31:39,740 --> 00:31:43,200
+سبحان الله يعني زي ما اقول انا بيت الشياطين بدرجة
+
+361
+00:31:43,200 --> 00:31:46,860
+قضية الايام و ما بينا اهلها مصايب قوم عند قوم
+
+362
+00:31:46,860 --> 00:31:52,820
+فوائد تاني يامان اللي هو استخدام systemic افضل
+
+363
+00:31:52,820 --> 00:31:57,520
+استخدام طبيعي لان البكتيريا مش عارفة سلو مش منتشر
+
+364
+00:32:01,170 --> 00:32:05,270
+هو مرهم و ماء الكورتزون يعني مثلا قطرة ديكزاميسين
+
+365
+00:32:05,270 --> 00:32:13,950
+المشهور ديكزاميسين و قطرة النيوميكسين
+
+366
+00:32:13,950 --> 00:32:19,650
+كل هذه فيها اللي هو اللي هو النيوميكسين نيوميكسين
+
+367
+00:32:19,650 --> 00:32:26,410
+however مستخدم في الكراته كوندركتفيتس can develop
+
+368
+00:32:26,410 --> 00:32:29,410
+as a result of hypersensivity to نيوميكسين after
+
+369
+00:32:29,410 --> 00:32:33,040
+ophthalmic useميومايسين لديه عرض عالمي بشكل عالمي
+
+370
+00:32:33,040 --> 00:32:34,260
+بشكل عالمي بشكل عالمي بشكل عالمي بشكل عالمي بشكل
+
+371
+00:32:34,260 --> 00:32:36,320
+عالمي بشكل عالمي بشكل عالمي بشكل عالمي بشكل عالمي
+
+372
+00:32:36,320 --> 00:32:39,360
+بشكل عالمي بشكل عالمي بشكل عالمي بشكل عالمي بشكل
+
+373
+00:32:39,360 --> 00:32:39,920
+عالمي بشكل عالمي بشكل عالمي بشكل عالمي بشكل عالمي
+
+374
+00:32:39,920 --> 00:32:41,840
+بشكل عالمي بشكل عالمي بشكل عالمي بشكل عالمي بشكل
+
+375
+00:32:41,840 --> 00:32:44,940
+عالمي بشكل عالمي بشكل عالمي بشكل عالمي بشكل عالمي
+
+376
+00:32:44,940 --> 00:32:50,420
+بشكل عالمي بشكل عالمي بشكل عالمي بشكل عالمي بشكل
+
+377
+00:32:50,420 --> 00:32:55,500
+عالمي بشكل عالمي بشكل
+
+378
+00:32:55,500 --> 00:32:55,920
+عالمي
+
+379
+00:33:01,230 --> 00:33:06,630
+فالتحضيرات اللي ميسين فقط تحضر من قطر أو مرهم
+
+380
+00:33:06,630 --> 00:33:12,690
+تستخدم معاها أكثر مرات معاها استيراويد كما لو حطوا
+
+381
+00:33:12,690 --> 00:33:17,410
+معاها أحيانا قطر اللي هو استيراويد يعني يصير معاها
+
+382
+00:33:17,410 --> 00:33:22,130
+كورتازون لتخلص
+
+383
+00:33:22,130 --> 00:33:23,290
+منه كورتازون لتخلص منه كورتازون لتخلص منه كورتازون
+
+384
+00:33:23,290 --> 00:33:25,450
+لتخلص منه كورتازون لتخلص منه كورتازون كورتازون
+
+385
+00:33:25,450 --> 00:33:27,010
+كورتازون كورتازون كورتازون كورتازون كورتازون
+
+386
+00:33:27,010 --> 00:33:30,010
+كورتازون كورتازون كورتازون كورتازون كورتازون
+
+387
+00:33:30,010 --> 00:33:30,540
+كورتازون كورتازون كورتازون كورتازون كورالليونكس
+
+388
+00:33:30,540 --> 00:33:34,620
+حتى صناعة عربية اللي هو المصنع الكيميائي الأردني
+
+389
+00:33:34,620 --> 00:33:40,980
+الشركة في رمالنا وعندي زميسين صناعات الكيانة
+
+390
+00:33:40,980 --> 00:33:47,180
+موجودتين موجودتين كتير واحد يعني بالطبع انه يستخدم
+
+391
+00:33:47,180 --> 00:33:51,140
+antibiotic مع anti-inflammatory كتير في العين
+
+392
+00:33:51,140 --> 00:33:57,910
+بيكون يعني عنصر infection وعنصر inflammationفالقطر
+
+393
+00:33:57,910 --> 00:34:01,910
+هذه بتحل انها إشكالية كبيرة بدل ما اعطيه انا two
+
+394
+00:34:01,910 --> 00:34:04,450
+bottles بقى اعطيه one bottle بدل ما ادفع two
+
+395
+00:34:04,450 --> 00:34:10,910
+prices بتدفع one price طيب
+
+396
+00:34:10,910 --> 00:34:15,810
+من العائلة هذه برضه الجنجرميسيو amino glycosides
+
+397
+00:34:15,810 --> 00:34:20,070
+هذا رضو في العائلة عشان هيك اكتبوا كويس عشان
+
+398
+00:34:20,070 --> 00:34:23,430
+تعرفوا ان كلها members في العائلة بتاعة ال amino
+
+399
+00:34:23,430 --> 00:34:30,920
+glycosidesيعني جنتا ميسين و نيو ميسين هاري أعضاء
+
+400
+00:34:30,920 --> 00:34:35,440
+بجانب التوبرا ميسين مش هتكلم عنه واميكاسين مش
+
+401
+00:34:35,440 --> 00:34:38,740
+هتكلم عنه والتريبتو ميسين اتكلمنا عنه شوية انه
+
+402
+00:34:38,740 --> 00:34:48,280
+يعني لتطهير الامعاق والاشياء الان الجنتا ميسين is
+
+403
+00:34:48,280 --> 00:34:52,200
+another amino glycoside antibiotic with the same
+
+404
+00:34:52,200 --> 00:34:58,380
+toxic effects as نيو ميسينو Autotoxicity هو واحد
+
+405
+00:34:58,380 --> 00:35:03,300
+من الأشخاص المفيدين في هذه الجماعة وهو سيقتل
+
+406
+00:35:03,300 --> 00:35:09,560
+مديرين البروجينوزا السودو مواز أقوى من أخوه
+
+407
+00:35:09,560 --> 00:35:14,530
+النيومايسيو اللي هو بيعمل اللي هو corneal ulcerit
+
+408
+00:35:14,530 --> 00:35:17,590
+is the treatment of choice for this organism حتى
+
+409
+00:35:17,590 --> 00:35:20,430
+انه الناس بيقول treatment of choice يعني الخيار
+
+410
+00:35:20,430 --> 00:35:23,610
+الأول في علاج السيدروموناس or the resistant
+
+411
+00:35:23,610 --> 00:35:27,910
+strains of pseudomonas have been found بدأت القاوم
+
+412
+00:35:27,910 --> 00:35:32,090
+البكتيريا ليها تستسلم أبدا شوفوا احنا جديش عندنا
+
+413
+00:35:32,090 --> 00:35:37,450
+إمكانيات عقلية ومالية وعلمية البكتيريا إمكانياتها
+
+414
+00:35:43,360 --> 00:35:48,500
+وانا يعني طالع بيت شعر زمان في شبابي قال لتحكمنا
+
+415
+00:35:48,500 --> 00:35:58,220
+صغيرا في مخاصمة إن البعوضة تدمي مقلة الأسد ماحدش
+
+416
+00:35:58,220 --> 00:36:06,400
+كتب ما بتحبه الاشياء هذه لتحكمنا صغيرا في مخاصمة
+
+417
+00:36:06,400 --> 00:36:13,730
+إن البعوضة تدمي مقلة الأسدالبكتيريا اللى .. اللى
+
+418
+00:36:13,730 --> 00:36:16,810
+.. اللى عاملة مصايب فى البشرية لأنا اراها في عيني
+
+419
+00:36:16,810 --> 00:36:22,270
+المجردة البنجين
+
+420
+00:36:22,270 --> 00:36:26,450
+التمييزين افضل من اللى جابله من العائلة فى انه
+
+421
+00:36:26,450 --> 00:36:29,290
+مشتغل على ال pseudomonas الجيوزة اللى افتهمها ال
+
+422
+00:36:29,290 --> 00:36:35,310
+Korean ايش أرثر مهم يقول كلنا أرثر طبعا اللى بضيع
+
+423
+00:36:35,310 --> 00:36:38,470
+القرانية و هي القرانية يعنى كلمة
+
+424
+00:36:43,780 --> 00:36:46,580
+وبتومتري يعني اللي ماعش قرانية او القرانية بتاعته
+
+425
+00:36:46,580 --> 00:36:50,140
+opaque انتهينا من ان هو كوبتومتريست خلاص مالاش مع
+
+426
+00:36:50,140 --> 00:36:54,020
+شغل صح ماهي اللي مع شغل احنا شغلنا ال contact
+
+427
+00:36:54,020 --> 00:36:56,920
+lenses و ال glasses و الكل كل و مركب على القرانية
+
+428
+00:36:56,920 --> 00:37:00,880
+مافي قرانية مافي شغل بتومتري
+
+429
+00:37:10,690 --> 00:37:13,090
+مثلا لو واحد عنده infection قوى كثير ممكن نعطيه
+
+430
+00:37:13,090 --> 00:37:16,190
+حقا صباح رمسان when the nature of the invading
+
+431
+00:37:16,190 --> 00:37:23,310
+organism is not known يعني مثلا واحد جاء
+
+432
+00:37:23,310 --> 00:37:28,510
+towards a urinary infectionمعاها مثلا أشياء في
+
+433
+00:37:28,510 --> 00:37:33,950
+الانتراتيس الحقيقة بيجيب نتائج قوية خاصة إيجرام
+
+434
+00:37:33,950 --> 00:37:38,550
+نينجاتيف اللي هو ال organism and therefore it
+
+435
+00:37:38,550 --> 00:37:42,550
+should be kept for serious infections of the eye
+
+436
+00:37:42,550 --> 00:37:46,510
+when other antibacterial agents are infected طبعا
+
+437
+00:37:46,510 --> 00:37:50,270
+هذا الكلام شايفه أنا قديم شوية إلى الحقيقة إحنا ال
+
+438
+00:37:50,270 --> 00:37:55,370
+gene تمييزين في العين بيجيبوا ليها باسم App gene
+
+439
+00:37:56,230 --> 00:38:00,510
+بعرفش من وين بيجيبوه مستوصفات وكالة باسم upgene
+
+440
+00:38:00,510 --> 00:38:05,370
+بقول مسيبكم انه على طول نبدأ في خطة floriculosis
+
+441
+00:38:05,370 --> 00:38:09,790
+اذا كان في بداية كرتيتس او شي مابستخدمه لكن انا
+
+442
+00:38:09,790 --> 00:38:14,750
+بقولك انه هذا خليه رصيد الان طبعا فلقم سنة يعني
+
+443
+00:38:14,750 --> 00:38:19,350
+over exceeded تم تجاوزهالعدد الكبير من التجارب
+
+444
+00:38:19,350 --> 00:38:20,190
+التمييزية التمييزية التمييزية التمييزية التمييزية
+
+445
+00:38:20,190 --> 00:38:21,250
+التمييزية التمييزية التمييزية التمييزية التمييزية
+
+446
+00:38:21,250 --> 00:38:24,130
+التمييزية التمييزية التمييزية التمييزية التمييزية
+
+447
+00:38:24,130 --> 00:38:25,110
+التمييزية التمييزية التمييزية التمييزية التمييزية
+
+448
+00:38:25,110 --> 00:38:29,170
+التمييزية التمييزية التمييزية التمييزية التمييزية
+
+449
+00:38:29,170 --> 00:38:30,810
+التمييزية التمييزية التمييزية التمييزية التمييزية
+
+450
+00:38:30,810 --> 00:38:41,130
+التمييزية التمييزية التمييزية التمييزية التمييزية
+
+451
+00:38:41,130 --> 00:38:42,810
+التم
+
+452
+00:38:48,210 --> 00:38:53,930
+فهو very poor و هذا الكلام يعني حتى في ال drops و
+
+453
+00:38:53,930 --> 00:39:01,010
+ال ointment بيستخدموه post operative في العين كصبب
+
+454
+00:39:01,010 --> 00:39:04,430
+كل متافة ال injection كنا يعني في العملية ع ال
+
+455
+00:39:04,430 --> 00:39:09,070
+table أول من جاب في العين انداجة على طول ال nurse
+
+456
+00:39:09,070 --> 00:39:17,850
+محضرانه لإيش الجيتاميسين في اللي هو القراععلى طول
+
+457
+00:39:17,850 --> 00:39:21,210
+ان يعمل صعب كورنيا الكتاب الانجيكشن طبعا هذا
+
+458
+00:39:21,210 --> 00:39:26,810
+profile axis يعني حتى ما لسه مش اندوفان ماكس يبقى
+
+459
+00:39:26,810 --> 00:39:29,950
+صعب كورنيا الكتاب الانجيكشن produced effective
+
+460
+00:39:29,950 --> 00:39:33,850
+coronal concentration in 2 hours and this were
+
+461
+00:39:33,850 --> 00:39:36,450
+maintained for 24 hours
+
+462
+00:39:40,100 --> 00:39:44,520
+تفضل 24 ساعة فما هي 24 ساعة بعد العملية مهمة عشان
+
+463
+00:39:44,520 --> 00:39:49,460
+نتجاوز الخطر بتاع ال endothelmitis if a deep
+
+464
+00:39:49,460 --> 00:39:54,640
+infection endothelmitis of the eye occurs it is
+
+465
+00:39:54,640 --> 00:39:57,500
+best treated by a slow intra intradentary
+
+466
+00:39:57,500 --> 00:40:01,020
+injection of dendrocyte يعني لو بداية
+
+467
+00:40:01,020 --> 00:40:06,120
+endothelmitis ممكن طبعا احنا نحكم Parziplana
+
+468
+00:40:06,120 --> 00:40:11,600
+antibiotic Parziplana antibiotic في الممكن نعطي
+
+469
+00:40:11,600 --> 00:40:18,000
+انتباتيك 123 كده واحد مع بعض عشان نخدي على الـ
+
+470
+00:40:18,000 --> 00:40:24,040
+Intrapetrial infection بقولوا
+
+471
+00:40:24,040 --> 00:40:29,000
+كمان مستعملوا لو كان فيه اندوثيليا القديمة يعني
+
+472
+00:40:29,000 --> 00:40:30,240
+بعد الأعمال الجراحية، انتوا عارفين الأعمال
+
+473
+00:40:30,240 --> 00:40:33,600
+الجراحية، بالذات في الـAC إلا سيلة الاندوثيليا
+
+474
+00:40:33,600 --> 00:40:38,120
+ماتتش عشان هيك الأثناء العامية بحطوا اللي هو
+
+475
+00:40:38,120 --> 00:40:43,240
+Helium أو Viscoelasticsubstance بيحطوا مادة مشحبة
+
+476
+00:40:43,240 --> 00:40:47,560
+عشان يحملش ال endothelium من ال injury و ال
+
+477
+00:40:47,560 --> 00:40:52,520
+contact و مع ذلك أحيان بيصير contact و بيصير
+
+478
+00:40:52,520 --> 00:40:57,560
+إيديمة فثبت أنه لو صاب كل يرتاب ال injection بعد
+
+479
+00:40:57,560 --> 00:41:01,320
+العملية بيفيد في الإيديمة هذه بتاعة ال endothelium
+
+480
+00:41:01,320 --> 00:41:04,840
+لأن ال endothelium بيكون مريض هيك و بيعملش ال
+
+481
+00:41:04,840 --> 00:41:09,230
+function بتاعه في حماية stromaSystemic injection
+
+482
+00:41:09,230 --> 00:41:11,890
+will not give rise to sufficient ocular release
+
+483
+00:41:11,890 --> 00:41:14,830
+because of its full ability to cross the blood
+
+484
+00:41:14,830 --> 00:41:18,830
+aqueous barrier عارفين blood aqueous barrier؟ و
+
+485
+00:41:18,830 --> 00:41:25,430
+retinal blood barrier؟ فهو الأي استراتيجي أنه لو
+
+486
+00:41:25,430 --> 00:41:29,210
+أعطينا حتى injection و IV أنه يدخل في العين في
+
+487
+00:41:29,210 --> 00:41:33,350
+حالة endothermitis ويعني ينقذ الوضع لو بدنا نعطيه
+
+488
+00:41:33,350 --> 00:41:36,890
+مصبوط نعطيه intravateral injection
+
+489
+00:41:39,930 --> 00:41:42,510
+طبعا هنا في treatment of bacteria common acid
+
+490
+00:41:42,510 --> 00:41:46,870
+معروف يعني ممكن اوضحه كل ساعتين او كل تلاتة عشان
+
+491
+00:41:46,870 --> 00:41:57,050
+تركيزه يكون لأن هو poorly absorbed وين في القرن طب
+
+492
+00:41:57,050 --> 00:42:00,850
+side effects جيد تماثين side effects احنا ازاي
+
+493
+00:42:00,850 --> 00:42:03,330
+بناخد ال advantage بناخد ال disadvantage جيد
+
+494
+00:42:03,330 --> 00:42:04,230
+تماثين is very
+
+495
+00:42:07,350 --> 00:42:10,750
+like other amino glycosides can cause damage of
+
+496
+00:42:10,750 --> 00:42:14,690
+the ears and
+
+497
+00:42:14,690 --> 00:42:20,750
+kidneys يعني يعني مش سهل أعطي حقا لمدة طويلة يعني
+
+498
+00:42:20,750 --> 00:42:26,130
+لعندي خمس أيام أو اسبوع ماشي لكن اعطي شهور يعني
+
+499
+00:42:26,130 --> 00:42:32,850
+عنصاب الصمم و الكلية تبدأ يعني ال function بتاع
+
+500
+00:42:32,850 --> 00:42:34,770
+التلسيلة ايش تلف
+
+501
+00:42:38,190 --> 00:42:42,670
+والذين يتأثرون على التكسيه بسبب تدمير الستيبولار
+
+502
+00:42:42,670 --> 00:42:48,330
+ودفنس من تدمير الكوكلار بسبب دوز التكسيه يعني لو
+
+503
+00:42:48,330 --> 00:42:55,310
+اعطينا مثلا فترة طويلة حقا مثلا لأنه مافيش منه
+
+504
+00:42:55,310 --> 00:42:59,410
+أقراص لو اعطينا حقا بعد فترة يسي الواحد معايا
+
+505
+00:42:59,410 --> 00:43:04,470
+التكسيه، إيش التكسيه؟ تركيز، مافيش تركيز عشان عصب
+
+506
+00:43:04,470 --> 00:43:09,460
+السماءاللي فيه عصب التوازن يعني هو العصب اللي
+
+507
+00:43:09,460 --> 00:43:13,500
+بيستي بيركوك يعمل تعمل فيه عصابين مع بعض فيه عصب
+
+508
+00:43:13,500 --> 00:43:17,260
+السماء وفيه عصب التوازن والله عليه واريكه ولمّا
+
+509
+00:43:17,260 --> 00:43:21,860
+التوازن بيروح يصير واحد ايش؟ بايم ويمشي شمال يوم
+
+510
+00:43:21,860 --> 00:43:26,980
+فا قاعد Streptomycin بيعمل كده و الجن تماثل بيعمل
+
+511
+00:43:26,980 --> 00:43:30,980
+كده يعني كده اش احنا اخدت فائد لكن لو انا اعطيه
+
+512
+00:43:30,980 --> 00:43:36,090
+حقا مدة طويلةهذا الـ System Reactions يعني تحسس،
+
+513
+00:43:36,090 --> 00:43:41,550
+لهذا برضه في حالة الحُقن ممكن اسهيل، طيب، هتوقف
+
+514
+00:43:41,550 --> 00:43:45,210
+عند Fucidic Acid، ان شاء الله، هتوقف عند Fucidic
+
+515
+00:43:45,210 --> 00:43:49,070
+Acid، حلوة ان شاء الله نكمل يوم الأربعة القادم،
+
+516
+00:43:49,070 --> 00:43:52,550
+شكرا لكم على فاسم الاستماع، والسلام عليكم ورحمة
+
+517
+00:43:52,550 --> 00:43:53,370
+الله وبركته
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/QJs1WI9_T2U.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/QJs1WI9_T2U.srt
new file mode 100644
index 0000000000000000000000000000000000000000..58b7125edb4b4b1bacfce0aa66b4cca1d4f9bd4d
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/QJs1WI9_T2U.srt
@@ -0,0 +1,1689 @@
+1
+00:00:19,930 --> 00:00:22,190
+بسم الله الرحمن الرحيم الحمد لله رب العالمين و
+
+2
+00:00:22,190 --> 00:00:25,270
+أصلي و أسلم على نبينا الأمين محمد وعلى آله وصحبه أجمعين، 
+
+3
+00:00:25,270 --> 00:00:29,250
+السلام عليكم ورحمة الله وبركاته. جمال اليوم إن شاء 
+
+4
+00:00:29,250 --> 00:00:34,110
+الله سنكمل موضوع الـ antibiotics, antibiotics used
+
+5
+00:00:34,110 --> 00:00:39,670
+in the eye, in treatment of eye infections today.
+
+6
+00:00:39,670 --> 00:00:46,610
+fucidic acid هو أيضا recently detected 
+
+7
+00:00:51,480 --> 00:01:00,200
+of simple eye infections, typically used as viscous
+
+8
+00:01:00,200 --> 00:01:10,760
+drops called fusidic acid eye drops هي 
+
+9
+00:01:10,760 --> 00:01:15,320
+drops, بس visible يعني ما بعرفش بيقول إن هذا
+
+10
+00:01:15,320 --> 00:01:18,920
+ointment هو مش ointment هو visible drops.
+
+11
+00:01:21,980 --> 00:01:28,120
+الحقيقة أنه يستخدم twice، لي مرتين في اليوم، وهو
+
+12
+00:01:28,120 --> 00:01:30,880
+very effective against mycoplasma 
+
+13
+00:01:30,880 --> 00:01:39,840
+conjunctivitis, blepharitis برضه فيه
+
+14
+00:01:39,840 --> 00:01:44,780
+منه tablets used for systemic infections, فيه منه
+
+15
+00:01:44,780 --> 00:01:49,840
+أقراص يعني في المائدة internally, the drug is well
+
+16
+00:01:49,840 --> 00:01:53,000
+tolerated, although it can cause liver damage and 
+
+17
+00:01:53,000 --> 00:01:55,800
+jaundice which is reversible on discontinuation.
+
+18
+00:01:55,800 --> 00:01:59,600
+يعني بياخد أقل عمر مدة طويلة ممكن يأثر على الكبد 
+
+19
+00:01:59,600 --> 00:02:05,860
+الكبير، لكن لو يعني تركوه فترة ممكن أنه يتحسن وضع 
+
+20
+00:02:16,820 --> 00:02:20,820
+In the form of a viscous drop that needs to be 
+
+21
+00:02:20,820 --> 00:02:24,880
+applied only twice daily، اسمها fusidic acid eye
+
+22
+00:02:24,880 --> 00:02:30,100
+drops، viscid, viscid يعني سميكة شوية. It has
+
+23
+00:02:30,100 --> 00:02:33,440
+potent bacterostatic or bactericidal activity
+
+24
+00:02:33,440 --> 00:02:37,180
+against gram-positive bacteria، خاصة gram-positive
+
+25
+00:02:37,180 --> 00:02:42,000
+bacteria، يشتغل على gram-negative إزاي بيعمل؟
+
+26
+00:02:42,000 --> 00:02:46,520
+بيعمل على الـ inhibition of protein synthesis، يعني
+
+27
+00:02:46,520 --> 00:02:51,240
+بيعمل على إيش؟ الريبوسومات، بيعمل على الريبوسومات،
+
+28
+00:02:51,240 --> 00:02:54,280
+لذلك دائما بتلاقيها بتشتغل على الريبوسومات عن طريق 
+
+29
+00:02:54,280 --> 00:02:59,920
+الإنزيمات، عن طريق الإنزيمات اللي بتنشط الريبوسومات، 
+
+30
+00:02:59,920 --> 00:03:03,240
+يعني بتحصفه بالريبوزوم نفسه، لكن بيعمل على تعطيل 
+
+31
+00:03:03,240 --> 00:03:05,620
+الإنزيمات اللي هي
+
+32
+00:03:15,170 --> 00:03:18,890
+Spectra, Mubarchin يعني الطيف بتاعه كده إيش بيشتغل؟
+
+33
+00:03:18,890 --> 00:03:23,110
+بيشتغل against gram-positive bacteria like
+
+34
+00:03:23,110 --> 00:03:28,350
+staphylococcus aureus، وهذه البكتيريا يعني virulent، 
+
+35
+000:03:28,350 --> 00:03:32,570
+شديدة الفكرة، including some strains of Methicillin
+
+36
+00:03:32,570 --> 00:03:37,830
+-resistant staff اللي هو aureus حتى اللي هي بتعمل 
+
+37
+00:03:37,830 --> 00:03:42,070
+إنزيم يحلل الميثيسلين، بعض أنواع البنسلين برضه هو 
+
+38
+00:03:42,070 --> 00:03:46,120
+يستطيع أن يفتك بها، الكثير من البكتيريا النسارية غير 
+
+39
+00:03:46,120 --> 00:03:53,620
+مقاومة، ولكنها تعمل مع نسارية تعمل مع نسارية تعمل 
+
+40
+00:03:53,620 --> 00:03:54,940
+مع نسارية تعمل مع نسارية تعمل مع نسارية تعمل
+
+41
+00:03:54,940 --> 00:03:55,960
+مع نسارية تعمل مع نسارية تعمل مع نسارية تعمل 
+
+42
+00:03:55,960 --> 00:03:56,020
+مع نسارية تعمل مع نسارية تعمل مع نسارية تعمل 
+
+43
+00:03:56,020 --> 00:03:57,000
+مع نسارية تعمل مع نسارية تعمل مع نسارية تعمل 
+
+44
+00:03:57,000 --> 00:03:57,820
+مع نسارية تعمل مع نسارية تعمل مع نسارية تعمل
+
+45
+00:03:57,820 --> 00:03:58,180
+مع نسارية تعمل مع نسارية تعمل مع نسارية تعمل
+
+46
+00:03:58,180 --> 00:04:02,420
+مع نسارية تعمل مع نسارية تعمل مع نسارية تعمل 
+
+47
+00:04:02,420 --> 00:04:05,660
+مع نسار
+
+48
+00:04:12,280 --> 00:04:16,460
+لأن معظم الـ .. الـ .. الـ conjunctivitis gram 
+
+49
+00:04:16,460 --> 00:04:22,460
+positive، فاحنا بنعطيه مثلا twice or thrice or four
+
+50
+00:04:22,460 --> 00:04:27,200
+times daily، بيشتغل كويس، إحنا بنعطيه مساند لقطرة
+
+51
+00:04:27,200 --> 00:04:31,400
+تانية كل .. كل .. اللي هو كل الـ .. الـ .. الـ .. الـ 
+
+52
+00:04:31,400 --> 00:04:31,960
+.. الـ .. الـ .. الـ .. الـ .. الـ .. الـ .. الـ .. الـ ..
+
+53
+00:04:31,960 --> 00:04:32,160
+الـ .. الـ .. الـ .. الـ .. الـ .. الـ .. الـ .. الـ .. ال
+
+54
+00:04:32,160 --> 00:04:32,540
+.. الـ .. الـ .. الـ .. الـ .. الـ .. الـ .. الـ .. ال
+
+55
+00:04:32,540 --> 00:04:32,560
+الـ .. الـ .. الـ .. الـ .. الـ .. الـ .. الـ .. الـ .. ال
+
+56
+00:04:42,650 --> 00:04:49,550
+سيكونوا اتنين مع بعض كويسين كثير، سبب الـ causes، it is 
+
+57
+00:04:49,550 --> 00:04:53,610
+now often used as the frontline treatment of
+
+58
+00:04:53,610 --> 00:04:56,550
+conjunctivitis، يعني الخط الأول في الـ conjunctivitis
+
+59
+00:04:56,550 --> 00:04:59,970
+في العالم اللي إحنا مستخدمينه لأنه نظيف وكويس 
+
+60
+00:04:59,970 --> 00:05:04,190
+و effective compared with clinical ointment, it has
+
+61
+00:05:04,190 --> 00:05:05,910
+a much better compliance.
+
+62
+00:05:12,590 --> 00:05:20,090
+عشان دولة شعبي، ثمنه وغالي شوية، يعني في حدود عشرين 
+
+63
+00:05:20,090 --> 00:05:27,270
+جنيه مثلا، يعني خمسة دولار الآن، resistance stress
+
+64
+00:05:27,270 --> 00:05:31,190
+بدأت البكتيريا طبعا، ضاربة عادتها إن تعمل resistance
+
+65
+00:05:32,200 --> 00:05:39,960
+كانت تتطور بسرعة، و همندين في 1995 وجدت إن عدد
+
+66
+00:05:39,960 --> 00:05:42,520
+كبير من السلالات البكتيرية الخاصة بالـ gram-negative
+
+67
+00:05:42,520 --> 00:05:48,040
+اللي كانت تتطور من كنيفتيبلس وأبس من مسحات 
+
+68
+00:05:48,040 --> 00:05:54,640
+البكتيريا، لإنه بدأت البكتيريا أيضا تعارض أو تقاوم 
+
+69
+00:05:54,640 --> 00:06:00,880
+بمخلوق هذا الـ antibiotic الجديد، الآن هنتكلم كلمة 
+
+70
+00:06:00,880 --> 00:06:04,920
+عامة Antibiotic resistance in bacteria يعني هذه
+
+71
+00:06:04,920 --> 00:06:11,100
+البكتيريا كيف تعمل على الـ mechanisms يمكن إحنا اتحدثنا 
+
+72
+00:06:11,100 --> 00:06:16,100
+قبل ذلك كيف يعمل المضاد الحيوي على البكتيريا.
+
+73
+00:06:19,640 --> 00:06:22,500
+قلنا إن كل دواء له أسلوب، إما بيشتغل على الـ cell 
+
+74
+00:06:22,500 --> 00:06:26,420
+wall أو بيشتغل على الـ cytoplasmic membrane أو
+
+75
+00:06:26,420 --> 00:06:30,760
+بيشتغل على الـ ribosomes أو بيشتغل على الـ DNA في 
+
+76
+00:06:30,760 --> 00:06:36,120
+nucleus of the bacteria، البكتيريا أنا بدي أشوف
+
+77
+00:06:36,120 --> 00:06:44,720
+إحنا يعني البكتيريا يعني how can bacteria make
+
+78
+00:06:44,720 --> 00:06:50,090
+resistance، تقري عن الـ antibiotic، الـ antibiotic تعمل تقري
+
+79
+00:06:50,090 --> 00:06:56,750
+عن الـ antibiotic تعمل تقري
+
+80
+00:06:56,750 --> 00:06:59,870
+عن الـ antibiotic تعمل تقري عن الـ antibiotic تعمل تقري عن 
+
+81
+00:06:59,870 --> 00:07:00,890
+الـ antibiotic تعمل تقري عن الـ antibiotic تعمل تقري عن 
+
+82
+00:07:00,890 --> 00:07:03,350
+الـ antibiotic تعمل تقري عن الـ antibiotic تعمل تقري عن
+
+83
+00:07:03,350 --> 00:07:05,370
+الـ antibiotic تعمل تقري عن الـ antibiotic تعمل تقري عن 
+
+84
+00:07:05,370 --> 00:07:10,290
+الـ antibiotic تعمل تقري عن الـ antibiotic تعمل تقري عن 
+
+85
+00:07:10,290 --> 00:07:16,920
+الـ antibiotic تعمل تقري عن الـ antibiotic تعمل، تو ياخد 
+
+86
+00:07:16,920 --> 00:07:23,220
+antibiotic مثلا ويكون useless، كيف الوضع؟ بيزيد
+
+87
+00:07:23,220 --> 00:07:30,920
+الحالة، بيزيد الحالة، والنفقات بتكون رايحة، وربما يدخل
+
+88
+00:07:30,920 --> 00:07:36,040
+في مرحلة أخطر من الأولى، أخدتوا بالكم؟ لذلك حقيقة
+
+89
+00:07:36,040 --> 00:07:41,020
+يعني إحنا ماشيين وقت بقى في حيرة من أمرنا، صحيح، ففي 
+
+90
+00:07:41,020 --> 00:07:46,330
+حيرة من أمرنا يعني في حالات إحنا بضطر نعطي two 
+
+91
+00:07:46,330 --> 00:07:51,150
+antibiotics مع بعض، عشان نتغلب على الـ infection، 
+
+92
+00:07:51,150 --> 00:07:54,650
+نتأكد إن واحد صار ما يكفيش، أنا شخصيا باخد two
+
+93
+00:07:54,650 --> 00:07:59,530
+antibiotics مع بعض، بضطر أتقفى إن فيه antibiotic 
+
+94
+00:07:59,530 --> 00:08:03,490
+واحد بياخد البكتيريا، لأن كل antibiotic له جثة مع
+
+95
+00:08:03,490 --> 00:08:08,550
+البكتيريا، the rapid reproduction rates of bacteria 
+
+96
+00:08:08,550 --> 00:08:11,810
+with divergence happening every twenty minutes.
+
+97
+00:08:11,810 --> 00:08:17,290
+يعني البكتيريا كل عشرين دقيقة بيطلع منها جيل جديد 
+
+98
+00:08:17,290 --> 00:08:24,110
+يعني مثلا بكتيريا واحدة، يعني خلية صارت اتنين بعد 
+
+99
+00:08:24,110 --> 00:08:26,870
+عشرين دقيقة بيصيروا أربعة، بعد عشرين دقيقة بيصيروا
+
+100
+00:08:26,870 --> 00:08:30,590
+ثمانية، بعد عشرين دقيقة بيصيروا ستاشر، يعني في 
+
+101
+00:08:30,590 --> 00:08:36,800
+الساعة بالقسم كام مرة؟ تلات مرات وبعدين بتضاعف العدد 
+
+102
+00:08:36,800 --> 00:08:44,220
+حتى يصبح مئات الآلاف في يوم واحد، طبعا يعني مهما
+
+103
+00:08:44,220 --> 00:08:49,700
+كان الموضوع الحيوي أمام هذا الزخم الشديد كان بيقتل 
+
+104
+00:08:49,700 --> 00:08:53,640
+من هذه البكتيريا أحيانا، الكثرة بترب الشديد، عزيزي ما 
+
+105
+00:08:53,640 --> 00:08:57,230
+أقوله يعني، والديموجين يحدث كل 20 دقيقة في بعض
+
+106
+00:08:57,230 --> 00:09:03,910
+الحالات، في حالات أكسجين وحرارة وطعام جيد سريع 
+
+107
+00:09:03,910 --> 00:09:09,410
+جدا، فممكنة التغيير الانتقالي يحدث بشكل عالي بشكل 
+
+108
+00:09:09,410 --> 00:09:16,610
+كبير، يبقى البكتيريا ستتعرض لانتفرتك في جينها. 
+
+109
+00:09:16,610 --> 00:09:17,710
+Intimal mutation.
+
+110
+00:09:23,180 --> 00:09:28,160
+التفرة هذه تجير في التكوين الجيني بتاعها، في الـ
+
+111
+00:09:28,160 --> 00:09:32,280
+DNA بتاعها، حتى إن الـ antibiotic اللي هو هيها لـ
+
+112
+00:09:32,280 --> 00:09:39,460
+DNA ما يجد DNA مختلف، Luckily، يقول يعني الـ
+
+113
+00:09:39,460 --> 00:09:42,060
+professional حق، under normal treatment 
+
+114
+00:09:42,060 --> 00:09:44,500
+conditions، the great majority of the sensitive
+
+115
+00:09:44,500 --> 00:09:48,090
+organisms are killed by the antibiotic leaving the 
+
+116
+00:09:48,090 --> 00:09:51,710
+body to cope with a few resistant bacteria، يعني
+
+117
+00:09:51,710 --> 00:09:55,290
+إحنا ما بننساش حاجة، إحنا بنعطي الـ antibiotic بيقتل 
+
+118
+00:09:55,290 --> 00:09:59,690
+80 أو 90% من البكتيريا الموجودة، العشرين أو العشرة
+
+119
+00:09:59,690 --> 00:10:04,750
+في المية الباقيين بتبقى لمناعة الجسم الشخصية
+
+120
+00:10:11,190 --> 00:10:15,210
+يستطيع أن يتخلص من هذا العدد اللي هو الباقي من
+
+121
+00:10:15,210 --> 00:10:23,010
+البكتيريا، وكانت مناعة المريض compromised يعني 
+
+122
+00:10:23,010 --> 00:10:28,710
+ضعيفة، فإنه ممكن البكتيريا تعود إلى التكاثر السريع 
+
+123
+00:10:28,710 --> 00:10:33,490
+وتقضي عليه، هذه المشكلة يعني دائما في نزاع بين 
+
+124
+00:10:33,490 --> 00:10:40,410
+مناعة الجسم وإيش والبكتيريا، by genetic information 
+
+125
+00:10:40,410 --> 00:10:46,310
+which calls for resistance can be passed to other 
+
+126
+00:10:46,310 --> 00:10:53,790
+organisms، يعني بيقول إن البكتيريا
+
+127
+00:10:53,790 --> 00:11:00,210
+إذا يعني تعلمت كيف تصنع 
+
+128
+00:11:03,480 --> 00:11:08,780
+مقاومة لـ antibiotics ممكن إن هذا يسري على إيش؟
+
+129
+00:11:08,780 --> 00:11:14,040
+على اللي هو antibiotics تانية وتالتة ورابعة و
+
+130
+00:11:14,040 --> 00:11:17,640
+هكذا، وهذا سر من أسرار البكتيريا بتعلموا بعضها يعني
+
+131
+00:11:17,640 --> 00:11:24,180
+طيب الآن هنشوف طرق حدود المقاومة البكتيريا، في طرق
+
+132
+00:11:24,180 --> 00:11:32,720
+الأولى، طريقة production of inactivating enzyme، إيش
+
+133
+00:11:32,720 --> 00:11:40,320
+يعني؟ يعني البكتيريا تكتشف التركيب الكيميائي لهذه
+
+134
+00:11:40,320 --> 00:11:47,660
+الدواء، فطول ما هي تصنع إنزيم يكسّر هذا التركيب 
+
+135
+00:11:47,660 --> 00:11:54,200
+الكيميائي، الأشهر كان في البنسلين كنا نسميه زمان
+
+136
+00:11:54,200 --> 00:11:57,020
+penicillinase enzyme.
+
+137
+00:12:00,110 --> 00:12:06,650
+بتطلع البنسلين يعني الآن عملوا أوسع beta-lactamase، كل 
+
+138
+00:12:06,650 --> 00:12:15,230
+مضاد حيوي حاوي في beta-lactam ring، البكتيريا تستطيع إن
+
+139
+00:12:15,230 --> 00:12:20,210
+تصنع لها إنزيم تكسير اسمه beta-lactamase، وهي المرة
+
+140
+00:12:20,210 --> 00:12:24,570
+الماضية، ورانا الـ ring هذه، شفتوا الـ ring؟ beta
+
+141
+00:12:24,570 --> 00:12:27,990
+-lactam، شكل كونه سينا
+
+142
+00:12:31,710 --> 00:12:38,770
+قبل أكتر من محطة، هي هي شايفين بالأحمر بيتا لاكتام؟
+
+143
+00:12:38,770 --> 00:12:43,530
+أي دواء مضاد حيوي فيه الـ beta-lactam، فيه أنواع من
+
+144
+00:12:43,530 --> 00:12:49,230
+البكتيريا مستعدة على طول تسلمه إلى التكسير، الآن 
+
+145
+00:12:49,230 --> 00:12:53,790
+التجربة هذه ابتدأت إلى antibiotics أخرى مثلا الـ 
+
+146
+00:12:53,790 --> 00:12:57,830
+chloramphenicol فيه حاجة اسمها acetyltransferase 
+
+147
+00:13:11,030 --> 00:13:14,890
+البكتيريا الـ gram-positive و gram-negative اللي 
+
+148
+00:13:14,890 --> 00:13:20,530
+هو بيعملها، يطلع chloramphenicol useless، هاي لسه طريقة 
+
+149
+00:13:20,530 --> 00:13:23,870
+واحدة، بعض البكتيريا شوفوا بكتيريا تانية اسمها كاملة 
+
+150
+00:13:23,870 --> 00:13:31,990
+alteration of the binding site، يعني جاي الـ 
+
+151
+00:13:31,990 --> 00:13:35,650
+antibiotic على منطقة معينة في الـ ribosome مثلا 
+
+152
+00:13:35,650 --> 00:13:41,910
+تروح البكتيريا هي مُغيّرة المنطقة بشكل آخر، فيجي بده 
+
+153
+00:13:41,910 --> 00:13:46,610
+يعني يتدهد معاها عشان يبدأ يفكّكها لجهة ثانية
+
+154
+00:13:46,610 --> 00:13:52,950
+تاني، زي مثلا هذه شفت الشكل هذا بس
+
+155
+00:13:52,950 --> 00:13:57,130
+الشكل هذا، هاي الـ antibiotic جاي على الـ ribosome 
+
+156
+00:13:57,130 --> 00:14:04,680
+هاي الـ ribosome هنا، هذا الوضع متغير، هذا الوضع
+
+157
+00:14:04,680 --> 00:14:10,180
+متغير، بطل السينوية بظهر الأولاني،
+
+158
+00:14:10,180 --> 00:14:18,680
+يعتمما زي إنسان جايه طلقة، هو شايف وضع معين إن 
+
+159
+00:14:18,680 --> 00:14:24,680
+القناص أطلق الطلقة، فهو غيّر في شكله، في وضعه، بس 
+
+160
+00:14:24,680 --> 00:14:30,610
+بدا من واجه جاهد، أو مثلا بدل مكان جاعد راح انبطح
+
+161
+00:14:30,610 --> 00:14:38,410
+أرضنا فطلع، طلع الـ age 12 هي تماما تغير أو تحس إن 
+
+162
+00:14:38,410 --> 00:14:44,050
+فيها انتفاخ، بجانب فهي بتغير مواقع التأثير، تصير غير 
+
+163
+00:14:44,050 --> 00:14:50,490
+مؤثر، The ribosome to which some aminoglycoside
+
+164
+00:14:50,490 --> 00:14:55,370
+like gentamicin can become altered in shape.
+
+165
+00:14:59,120 --> 00:15:06,240
+طريقة تانية، طريقة بيولوجية 
+
+166
+00:15:06,240 --> 00:15:11,980
+ولا طريقة عادية، طبعا نظرة طبعا نظرة ترقيمالية، صح.
+
+167
+00:15:11,980 --> 00:15:16,840
+طيب، طريقة تالتة alteration of the susceptible 
+
+168
+00:15:16,840 --> 00:15:24,700
+pathway، إيش pathway؟ المسار، آه المسار اتغير، المسار 
+
+169
+00:15:24,700 --> 00:15:31,980
+يعني أنت ماشي هيك، هي أتمنى لو يمشي هنا يمشي غلط
+
+170
+00:15:31,980 --> 00:15:38,740
+يعني. Organisms can become resistant to sulfonamides، 
+
+171
+00:15:38,740 --> 00:15:42,400
+أنواع الصلفة المختلفة، by developing pathways that
+
+172
+00:15:42,400 --> 00:15:48,580
+don't require paba effect، كانت force pathways، 
+
+173
+00:15:48,580 --> 00:15:53,020
+ممرات خاطئة، خاطئة، خاطئة، خاطئة، خاطئة، خاطئة، 
+
+174
+00:15:53,020 --> 00:15:53,940
+خاطئة،
+
+175
+00:16:04,420 --> 00:16:11,360
+Inactivating enzymes، blocking entry، alteration 
+
+176
+00:16:11,360 --> 00:16:14,600
+of target molecules.
+
+177
+00:16:25,7
+
+216
+00:20:00,650 --> 00:20:05,430
+عارفه ده؟ طيب،
+
+217
+00:20:05,430 --> 00:20:09,870
+الآن هنبدأ في الموضوع الجديد antiviral drugs
+
+218
+00:20:09,870 --> 00:20:16,870
+antiviral drugs مضادات فيروسية  وإحنا في العين في 
+
+219
+00:20:16,870 --> 00:20:17,650
+عندنا
+
+220
+00:20:34,620 --> 00:20:37,860
+الفرق بين البكتيريا اللي بتدخلها يعني والفيروس
+
+221
+00:20:37,860 --> 00:20:41,500
+البكتيريا بتشتغل خارج الـ cells
+
+222
+00:20:49,100 --> 00:20:55,360
+البكتيريا تهاجم لتأخذ غذاء، تهاجم لتأخذ غذاء، فهي 
+
+223
+00:20:55,360 --> 00:21:01,780
+ليست جزء من الـ cells زي جيش هاجم على بلد، الجيش
+
+224
+00:21:01,780 --> 00:21:06,160
+خارج البلد وهو بيقاتل، بيحاول يتقدم، بيحاول 
+
+225
+00:21:06,160 --> 00:21:09,020
+يتقدم، والناس بيقوموا، والناس بيقوموا، مين اللي 
+
+226
+00:21:09,020 --> 00:21:12,200
+هيجلب في الآخر؟ الجيش الغازي ولا المدافعين 
+
+227
+00:21:18,670 --> 00:21:22,430
+بتتكاثر وبتهاجم وبتحاول تغلب اللي هو الـ tissues
+
+228
+00:21:22,430 --> 00:21:26,910
+العيين زي القرنية مثلاً،  لأ الفيروس غير الفيروس هذا 
+
+229
+00:21:26,910 --> 00:21:36,150
+بيدخل داخل الـ cells وبيستخدم الـ DNA بتاعة الـ cells
+
+230
+00:21:36,150 --> 00:21:41,550
+نفسها في العين وبيتكاثر فيها وبعدين تنفجر الخلية
+
+231
+00:21:41,550 --> 00:21:48,720
+فتعطي آلاف من الفيروسات اللي بتدخل كمان ما  تروح 
+
+232
+00:21:48,720 --> 00:21:56,040
+الخلايا وبتتكاثر داخلها فعلاج الفيروس أصعب بكثير 
+
+233
+00:21:56,040 --> 00:22:00,420
+من علاج البكتيريا البكتيريا ناس شايفينهم يتردّوا
+
+234
+00:22:00,420 --> 00:22:06,320
+لكن الفيروس هنا بيحل في الخلية جوه وبالتالي ترده 
+
+235
+00:22:06,320 --> 00:22:11,100
+من داخل الخلية صعب عشان أقول intimate relationship
+
+236
+00:22:11,990 --> 00:22:17,870
+يعني العلاقة القريبة جدا بيصير جزء من خلية between
+
+237
+00:22:17,870 --> 00:22:21,750
+the infecting virus and the host cell الخلايا
+
+238
+00:22:21,750 --> 00:22:24,730
+العيال و خلايا الفيروسات virus deficient are more
+
+239
+00:22:24,730 --> 00:22:30,750
+difficult to treat صعب العلاج بتاعها than those
+
+240
+00:22:30,750 --> 00:22:36,130
+caused by bacteria يعني زي ما أقوله وقال يا عزيزي
+
+241
+00:22:36,130 --> 00:22:41,430
+يا حامي الفرار هو أورد هذا أبو فراس بيقول، وقال 
+
+242
+00:22:41,430 --> 00:22:45,430
+أصحابي فرّوا في الحرب أو الردّة، فقلت لهم أمراني
+
+243
+00:22:45,430 --> 00:22:51,630
+أهلاّ هم مروا، يا تشرد ولا ... ولا إيش تموت، جار 
+
+244
+00:22:51,630 --> 00:22:54,430
+والله هذا وهذا، لأ بس لأ شكّ الإشْراد
+
+245
+00:23:02,330 --> 00:23:05,730
+الله عزّ و جلّ قال يا أيها الذين آمنوا إذا لقيتم الذين 
+
+246
+00:23:05,730 --> 00:23:10,130
+كفروا زحفًا فلا تولّوهم الأدبار، ومن يولّهم يومئذٍ دوره 
+
+247
+00:23:10,130 --> 00:23:15,010
+إلّا متحرفًا نكتة أو متحيزًا إلّا فيه فقد بقى دفعة 
+
+248
+00:23:15,010 --> 00:23:17,790
+من الله وما هو جهنّم وبقصة مصيدة يبقى فيه رخصة
+
+249
+00:23:17,790 --> 00:23:25,150
+للهرب في حالات معينة ولو .. ولو فشي كان يعني كل 
+
+250
+00:23:25,150 --> 00:23:29,010
+استشهادية الحكاية لكن يعني فيه رخصة ويوم حنين
+
+251
+00:23:29,010 --> 00:23:36,150
+تعجّبتُمْ بخِرْانَتِهِمْ أيوة، وضغط عليكم الأرض بمناعهم، 
+
+252
+00:23:36,150 --> 00:23:39,890
+ثمّ والله ثمّ أكبرين وهم مين هم؟ الصحابة رضوان 
+
+253
+00:23:39,890 --> 00:23:42,510
+عليهم، يعني الصحابة رسول الله صلى الله عليه وسلم
+
+254
+00:23:42,510 --> 00:23:50,250
+لما رأوا الخطر الشديد، فولّوا وأكبرين ثمّ أنزل الله 
+
+255
+00:23:50,250 --> 00:23:54,110
+سكينته على رسوله وعلى المؤمنين، وأنزل جنودًا لم
+
+256
+00:23:54,110 --> 00:23:58,070
+تراوها، وعذب الذين كفروا، وإنفذوا الكافرين، الله
+
+257
+00:23:58,070 --> 00:24:02,710
+نصر هذه الفئة المؤمنة بإيمانها، بعد أن هربت على
+
+258
+00:24:02,710 --> 00:24:08,110
+جيش مالك بن عوف، اللي كان قد جمع النساء والذهب 
+
+259
+00:24:08,110 --> 00:24:12,530
+والفضة والغنم والبقر، وكان بعد ذلك هذا حظب كل حظّة
+
+260
+00:24:12,530 --> 00:24:17,170
+المسلمين في هذه الغنائم التي .. إيه المهم؟ هذه 
+
+261
+00:24:17,170 --> 00:24:17,990
+بداية البلوسة
+
+262
+00:24:29,560 --> 00:24:35,760
+معظم الفيروسات تقاوم الهلالة وتقاوم الهلالية
+
+263
+00:24:35,760 --> 00:24:40,000
+لا تستجيب للأسف عكس البكتيريا مؤتمر عمل عمل عمل عمل
+
+264
+00:24:40,000 --> 00:24:42,480
+عمل عمل عمل عمل عمل عمل عمل
+
+265
+00:24:50,360 --> 00:24:55,260
+حديثًا اهتمّ العلماء بالأدوية في إيجاد أدوية تقتل 
+
+266
+00:24:55,260 --> 00:25:01,480
+الفيروسات ونجحوا في ذلك in particular على أخص 
+
+267
+00:25:01,480 --> 00:25:05,640
+human immunodeficiency virus من يوم طلع في
+
+268
+00:25:05,640 --> 00:25:13,440
+الثمانينات إجا الـ HIV الفيروس اللي هو الـ AIDS هذا
+
+269
+00:25:13,440 --> 00:25:19,200
+يعني زاد البحث عن علاج الفيروسات بنسبة ألف في المئة
+
+270
+00:25:26,390 --> 00:25:35,210
+لأنه fatal لأنه fatal ما في كلام تاني widespread في 
+
+271
+00:25:35,210 --> 00:25:42,230
+كل البلاد في كل البلاد يعني يمكن أكثر من virus
+
+272
+00:25:42,230 --> 00:25:48,510
+influenza الشيء الثالث إنه chronic يعني كثير من
+
+273
+00:25:48,510 --> 00:25:54,330
+الفيروسات self-limited بيموت لحاله من ثلاثة إلى 
+
+274
+00:25:54,330 --> 00:25:58,410
+أسبوع إلى عشر أيام بيموت لحاله الفيروس له الفيروس
+
+275
+00:25:58,410 --> 00:26:03,030
+إذا دخل فإنه يقبل خروج إلى أن يخرج إلى القبر مع 
+
+276
+00:26:03,030 --> 00:26:09,530
+مين؟ مع الـ host وهذه .. هذه المشكلة يبقوا يقول لي الـ
+
+277
+00:26:09,530 --> 00:26:14,550
+HIV صار عليه دراسة خاصة one of the earliest viruses
+
+278
+00:26:14,550 --> 00:26:18,850
+to be treated was herpes simplex the causative
+
+279
+00:26:18,850 --> 00:26:22,450
+organism of dendritic ulcer in the colon هذا مثلاً
+
+280
+00:26:22,450 --> 00:26:26,750
+فيروس له خاصية لأنه إذا حال في قرنية معينة إيش
+
+281
+00:26:26,750 --> 00:26:33,650
+بيعمل؟ Blindness أنا شفت يعني كثير Recurrent
+
+282
+00:26:33,650 --> 00:26:38,910
+herpes simplex sclerotitis أدت إلى complete
+
+283
+00:26:38,910 --> 00:26:42,470
+opacification of القرنية يعني and loss of vision
+
+284
+00:26:42,470 --> 00:26:50,940
+يبقى الـ herpes simplex بالذات اللي هو اهتمام خاص الـ
+
+285
+00:26:50,940 --> 00:26:56,400
+keratoplasty هذا لما يكون يعني في اه specification
+
+286
+00:26:56,400 --> 00:27:00,540
+للقرنية طبعًا، لكن إحنا لو عرجناها على المكان لأنه 
+
+287
+00:27:00,540 --> 00:27:06,120
+اللي بنحط له وإحنا يعني transplantation للقرنية 
+
+288
+00:27:06,120 --> 00:27:10,660
+ممكن الجسم يعمل لها إيش؟ rejection، وهذه كمان جثة 
+
+289
+00:27:10,660 --> 00:27:16,950
+تانية كمان، بعد كل هالتعب كمان في cold source اللي 
+
+290
+00:27:16,950 --> 00:27:21,510
+هو في البروسات البرد والرشح والـ genital herpes
+
+291
+00:27:21,510 --> 00:27:30,110
+في اللي هو herpes يعني في الـ genital system civil
+
+292
+00:27:30,110 --> 00:27:33,870
+agents have been used as topical treatments for
+
+293
+00:27:33,870 --> 00:27:38,530
+these conditions يعني العديد من الـ antivirus
+
+294
+00:27:38,530 --> 00:27:39,810
+اكتشفوها
+
+295
+00:27:49,640 --> 00:27:55,420
+لكن كثير منها ما عمرت ولم تثبت نجاعتها زي مثلاً
+
+296
+00:27:55,420 --> 00:28:02,780
+إيدوكس يوردين هنا زمان كان شغال وبقى واجف خلاص زي
+
+297
+00:28:02,780 --> 00:28:09,320
+الفيت أرابين برضه خلص وزي إيري فلورو ثايميدين
+
+298
+00:28:09,320 --> 00:28:13,390
+برضه واجف، الآن النجمة اللي أفسدها is a cyclopid
+
+299
+00:28:13,390 --> 00:28:20,370
+اللي أنتم بتسمعوا فيه باسم zoberax كثير من الناس
+
+300
+00:28:20,370 --> 00:28:30,190
+مننا بعد fever attack بعد ما يسخنوا شوي بتطلع له في 
+
+301
+00:28:30,190 --> 00:28:36,170
+الشفايف شيء اسمه herpes leviitis herpes leviitis
+
+302
+00:28:36,170 --> 00:28:37,390
+فشا 
+
+303
+00:28:40,320 --> 00:28:48,560
+و burning و painful فيجي يحلّوا فيه cramps و brux 
+
+304
+00:28:48,560 --> 00:28:56,540
+twice daily for one week شوية شوية هذا الـ herpes
+
+305
+00:28:56,540 --> 00:29:00,720
+ليبيايتس هو اللي بيعمل herpes keratitis نفسه
+
+306
+00:29:05,820 --> 00:29:10,680
+The last two كمال جان ساكلوفير موجود في ملابس 
+
+307
+00:29:10,680 --> 00:29:15,260
+البيانات جان ساكلوفير والأسيكلوفير ملاحظين جان
+
+308
+00:29:15,260 --> 00:29:20,320
+ساكلوفير اسمه بالظبط زي الأسيكلوفير مختلف بسيط 
+
+309
+00:29:20,320 --> 00:29:26,120
+فالأسيكلوفير هو اللي أخذ الشهرة the last two are
+
+310
+00:29:26,120 --> 00:29:28,940
+the only ones in regular use موجودة
+
+311
+00:29:40,400 --> 00:29:46,020
+اكتسبوا له علماء إن هذا الفيروس ساعة بيجي على
+
+312
+00:29:46,020 --> 00:29:54,100
+الشفاه أو على الـ lips وبيبقى الـ infection بيجي
+
+313
+00:29:54,100 --> 00:29:59,900
+المريض بيوصف .. بيوصف له إيش؟ antiviral Zubirax أو 
+
+314
+00:29:59,900 --> 00:30:05,600
+الـ acyclovir بيبدأ يحط فيه الفيروس خبيث جدا يشعر
+
+315
+00:30:05,600 --> 00:30:08,360
+أنه سيقتل فيهرب
+
+316
+00:30:11,230 --> 00:30:12,870
+يا أهو بداخل اسم بقى Colby Europe
+
+317
+00:31:01,470 --> 00:31:11,390
+الفرع اللي فوق اسمه ophthalmic nerve الفرع 
+
+318
+00:31:11,390 --> 00:31:19,480
+اللي في النص اسمه maxillary maxillary نفس الفرع
+
+319
+00:31:19,480 --> 00:31:26,420
+تاريت هذا اسمه mandibular ماهو mandibular الفك
+
+320
+00:31:26,420 --> 00:31:32,480
+يعني نفس الفرع
+
+321
+00:31:32,480 --> 00:31:43,100
+الـ maxillary للوجه والـ fabric للعين وحولها يعني
+
+322
+00:31:43,100 --> 00:31:49,180
+العين وحول العين هذه الثانية ثمّ هنا ماجزالي
+
+323
+00:31:49,180 --> 00:31:56,000
+المنطقة هذه الفكية هذه المنطقة طيب الآن لو الإنسان
+
+324
+00:31:56,000 --> 00:32:02,920
+صار في الشفتين أو صار في القرنية كورنية وإحنا
+
+325
+00:32:02,920 --> 00:32:08,220
+حطينا علاج فيجي الفيروس يهرب هنا
+
+326
+00:32:13,370 --> 00:32:21,410
+عارف يصيب في الشفتين يهرب من العلاج ويختبئ هنا طب 
+
+327
+00:32:21,410 --> 00:32:31,510
+العلاج ما يبوسهوش طب يختبئ إلى ضعف مناعي كادر انف
+
+328
+00:32:31,510 --> 00:32:39,290
+لوانزا لواز تهبري أوي كده كده كده كده فأول ما يصير
+
+329
+00:32:39,290 --> 00:32:46,050
+نزول مناعي عند المريض هيخرج من هنا ويؤيد أدراجه
+
+330
+00:32:46,050 --> 00:32:52,650
+إلى هنا أو إلى هنا فإن
+
+331
+00:32:52,650 --> 00:32:56,550
+قويت المناعة وأخد الإنسان علاج، بيرجع يختفي، و
+
+332
+00:32:56,550 --> 00:33:01,710
+هكذا أنا وجدت ناس في القرنية صدّقوا إنه عشرين مرة 
+
+333
+00:33:01,710 --> 00:33:06,270
+على صدق نعم
+
+334
+00:33:06,270 --> 00:33:12,250
+بعض بيرجع وكل مرة في الأول كان Epithelial، بعدين
+
+335
+00:33:12,250 --> 00:33:16,360
+صار Stromal وشوية شوية الـ opacity لغاية ما بطل يشوف
+
+336
+00:33:16,360 --> 00:33:20,580
+ستة ع ستين من هذا اللي إيه؟ فممكن هو العلاج ما أخدش
+
+337
+00:33:20,580 --> 00:33:25,220
+على طول علشان .. ولو .. صح .. هل كانت اختباء
+
+338
+00:33:25,220 --> 00:33:29,880
+الفيروس .. يعني أنا أسألكم سؤال لا شكّ إن في بعضكم 
+
+339
+00:33:29,880 --> 00:33:34,220
+طلع له الـ .. اللي بيتسمّى .. اللي بيقولوا عنه الحمّ 
+
+340
+00:33:34,220 --> 00:33:36,660
+هذا .. هو الناس بيقولوا عنه في البلد الحم البطني
+
+341
+00:33:36,660 --> 00:33:41,140
+هذا .. مين فيكوا طلع له؟ مرة مرتين ثلاث أربع 
+
+342
+00:33:41,140 --> 00:33:41,340
+أصلًا؟
+
+343
+00:33:45,940 --> 00:33:52,680
+إذا أنت تقوي المناعة بشكل قوي جدًا ممكن يخدّ عليه 
+
+344
+00:33:52,680 --> 00:33:57,880
+المناعة يخدّ عليه في الـ nucleus هنا في الـ .. في الـ 
+
+345
+00:33:57,880 --> 00:34:02,160
+.. في الـ .. في الـ medibrain يعني حد المرض أقْرص
+
+346
+00:34:02,160 --> 00:34:04,940
+لتقوية المناعة عشان أتخلص من هذا؟ لأ لأ المناعة 
+
+347
+00:34:04,940 --> 00:34:08,960
+تقوى رحالها بالعيال .. بالطعام 
+
+348
+00:34:12,200 --> 00:34:16,980
+يعني واحد كان مريض وبعدين يعني الـ CPU واخد طعام
+
+349
+00:34:16,980 --> 00:34:19,340
+كويس وش وكده وكده وش وكده وش وكده وش وكده وش وكده
+
+350
+00:34:19,340 --> 00:34:19,900
+وكده وكده وكده وكده وكده وكده وكده وكده وكده وكده
+
+351
+00:34:19,900 --> 00:34:21,040
+وكده وكده وكده وكده وكده وكده وكده وكده وكده وكده
+
+352
+00:34:21,040 --> 00:34:23,260
+وكده وكده وكده وكده وكده وكده وكده وكده وكده وكده
+
+353
+00:34:23,260 --> 00:34:27,660
+وكده وكده وكده وكده وكده وكده وكده وكده وكده وكده
+
+354
+00:34:27,660 --> 00:34:31,160
+وكده
+
+355
+00:34:31,160 --> 00:34:31,480
+وك
+
+356
+00:34:40,500 --> 00:34:44,160
+طيب الـ mode of action كيف الـ acyclovir بيعمل على
+
+357
+00:34:44,160 --> 00:34:48,140
+الفيروس؟ الـ acyclovir only affects virus infected
+
+358
+00:34:48,140 --> 00:34:53,340
+cells يبقى إحنا لو خدنا على عينينا هيك ولا بيعمل 
+
+359
+00:34:53,340 --> 00:34:59,240
+حاجة هو ما بيعملش إلا على الخلية اللي داخلها فيروس 
+
+360
+00:34:59,240 --> 00:35:04,320
+هذا شيء كويس هذا selective action باسمه يعني 
+
+361
+00:35:04,320 --> 00:35:10,610
+انتقائي انتقائي because it utilizes an enzyme بيشتغل
+
+362
+00:35:10,610 --> 00:35:15,830
+على إنزيم اسمه thymidine kinase whose structure
+
+363
+00:35:15,830 --> 00:35:19,570
+and functioning is slightly different in viruses
+
+364
+00:35:19,570 --> 00:35:25,670
+to that found in uninfected host cells يبقى الـ 
+
+365
+00:35:25,670 --> 00:35:32,290
+thymidine kinase إنزيم هذا الأسيكلوفير حساس له بقول 
+
+366
+00:35:32,290 --> 00:35:38,370
+إن الـ thymidine kinase بتاع الفيروس بيختلف عن 
+
+367
+00:35:38,370 --> 00:35:42,930
+ثايمدين كيناز بتاع أي خلية من الخلايا إحنا فهو بيشتغل 
+
+368
+00:35:42,930 --> 00:35:48,070
+على ثايمدين كيناز بتاع الفيروس وبتاع الخلية من
+
+369
+00:35:48,070 --> 00:35:52,010
+خلايانا أو الخلايا بتاعتنا ما فيها فيروس بيشتغلش 
+
+370
+00:35:52,010 --> 00:35:59,970
+عليه مصمم وهذا طبعًا إنجاز بشري إن هو بيشمّ زي 
+
+371
+00:35:59,970 --> 00:36:04,730
+الصاروخ الحراري الصاروخ الحراري بده حرارة يتوجه
+
+372
+00:36:09,010 --> 00:36:14,410
+أو آلة شغالة أو حاجة بتربيوها عليها لو مثلاً ما فيش 
+
+373
+00:36:14,410 --> 00:36:17,410
+ما توح شغالة شيء ما بيجيش عليه وهذا هيك فيه ثاني
+
+374
+00:36:17,410 --> 00:36:20,530
+ثايمدين كيناز تاني الفيروس بتتوجه عليه شبه داخل
+
+375
+00:36:20,530 --> 00:36:27,430
+الخلية يعني هذا علاج ذكي بيقولوا عنه آه علاج ذكي
+
+376
+00:36:27,430 --> 00:36:31,690
+هو الـ structure and functioning إسرائيل طيب فيروس 
+
+377
+00:36:31,690 --> 00:36:35,890
+ثاني ثايمدين كيناز can metabolize أسيكلوفير هالين سينين
+
+378
+00:36:39,830 --> 00:36:43,630
+acycloguanosine الـ acycloguanosine هو اللي هو
+
+379
+00:36:43,630 --> 00:36:48,370
+Cyclovir أو زوفيركس among others the chemical name
+
+380
+00:36:48,370 --> 00:36:52,190
+acycloguanosine هو يعني الـ acyclovir هو
+
+381
+00:36:52,190 --> 00:36:55,730
+الـ acycloguanosine يبقى الفيروس الحلمي دي can
+
+382
+00:36:55,730 --> 00:37:04,730
+metabolize الـ acyclovir يعني كأنه الفيروس بياخد
+
+383
+00:37:04,730 --> 00:37:10,570
+الـ acyclovir في متابوليزمه تمامًا
+
+384
+00:37:10,570 --> 00:37:17,530
+كما بعض كانت تأخذ السمّ وتظن طعام فإذا به قاتل
+
+385
+00:37:17,530 --> 00:37:25,190
+فالفيروس لما يحس بالـ acyclovir هذا بيبدأ يستخدم إيش
+
+386
+00:37:25,190 --> 00:37:32,350
+في متابوليزمه وهو بيكون إيش قاتل له بعد ذلك طيب 
+
+387
+00:37:32,350 --> 00:37:34,170
+سمّ
+
+388
+00:37:36,440 --> 00:37:40,520
+بعد ذلك بعض الطفرات الفيروسية قامت بإصلاح هذه
+
+389
+00:37:40,520 --> 00:37:44,460
+الطفرات لإصلاح ثايمدين كيناز ولكنها لم تكن 
+
+390
+00:37:44,460 --> 00:37:45,
+
+431
+00:40:31,670 --> 00:40:33,590
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+432
+00:40:33,590 --> 00:40:34,150
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+433
+00:40:34,150 --> 00:40:36,530
+.. ال .. ال .. ال ..
+
+434
+00:40:39,700 --> 00:40:44,560
+حتى التهاب الملتحمة وحتى التهاب الـ IRIS جالان أول
+
+435
+00:40:44,560 --> 00:40:52,180
+هدري على إيش؟ على أنه في قتل الفيروس أو الفيروس
+
+436
+00:40:52,180 --> 00:41:00,240
+بدأ يهرب بدأ يهرب ثرابة الـ GFX ده أشوف إيش تأثيرك
+
+437
+00:41:00,240 --> 00:41:06,660
+الهلاجي بيقول لي ماك كيري وفريقه في الواحد والتمانين
+
+438
+00:41:06,660 --> 00:41:11,080
+compared aciclovir and vidarabine and found that
+
+439
+00:41:11,080 --> 00:41:15,300
+the former اللي هو aciclovir had a much better
+
+440
+00:41:15,300 --> 00:41:18,860
+rate of healing and reduction in symptoms of
+
+441
+00:41:18,860 --> 00:41:25,360
+corneal ulcer قارنوا في مرضى أعطوهم aciclovir وفي 
+
+442
+00:41:25,360 --> 00:41:28,780
+مرضى أعطوهم vidarabine vidarabine اللي هو
+
+443
+00:41:28,780 --> 00:41:33,540
+antiviral تاني بس تاني ويدروا إن الـ aciclovir تغلب
+
+444
+00:41:34,830 --> 00:41:38,590
+في العيون اللي وضع فيها على الـ Veterinarian بشكل
+
+445
+00:41:38,590 --> 00:41:43,810
+في موضوع الـ healing، إيش healing؟ التئام، التئام
+
+446
+00:41:43,810 --> 00:41:49,970
+اللي هو .. اللي هي القرحة الفيروسية، اه الـ red of
+
+447
+00:41:49,970 --> 00:41:53,530
+healing and reduction in symptoms، يعني حتى
+
+448
+00:41:53,530 --> 00:41:59,470
+الأعراض من الدمع وعرار الألم وعرار الـ photophobia،
+
+449
+00:41:59,470 --> 00:42:02,870
+اه والدمع الكثير قلة، أكتر من العيون
+
+450
+00:42:06,340 --> 00:42:10,240
+و فريقه found no difference between acyclovir and
+
+451
+00:42:10,240 --> 00:42:14,640
+idoxuridine هذا بحث تاني و قالوا انه مافي فارق
+
+452
+00:42:14,640 --> 00:42:19,080
+بين هذا الدواء و هذا الدواء طبعا عشان صد الفيكس
+
+453
+00:42:19,080 --> 00:42:23,380
+بتاعه طلعوه من السوق ايدوكس يوريدين بقى الكلب فالفضل
+
+454
+00:42:23,380 --> 00:42:27,640
+اللي قلت مين الملك اللي هو هذا الـ acyclovir هو
+
+455
+00:42:27,640 --> 00:42:32,860
+اللي بيعمل rapid healing و reduction of symptoms
+
+456
+00:42:33,370 --> 00:42:37,170
+تاني because of its very selective action يعني
+
+457
+00:42:37,170 --> 00:42:41,190
+قولنا لا يعمل إلا على الخلايا التي داخلها فيروس
+
+458
+00:42:41,190 --> 00:42:45,310
+فده very selective action اختياري جدا does not
+
+459
+00:42:45,310 --> 00:42:49,170
+interfere with corneal wound healing whether
+
+460
+00:42:49,170 --> 00:42:56,150
+epithelial or stromal يبقى هو بس بيشتغل على حالات
+
+461
+00:42:56,150 --> 00:43:04,310
+الفيروس يعني لو مثلا في bacterial ulcer مخصوش له في
+
+462
+00:43:04,310 --> 00:43:09,410
+post-operative wound ما خسوش، ما بيشتغلش عليه، بس
+
+463
+00:43:09,410 --> 00:43:15,890
+بيشتغل على الخلايا infected by virus 3. أسيكلوفرين
+
+464
+00:43:15,890 --> 00:43:19,590
+had no significant effect on the regenerating
+
+465
+00:43:19,590 --> 00:43:25,010
+epithelial RA re-epithelialization surface walls
+
+466
+00:43:25,010 --> 00:43:30,550
+or on the collagen content of the stromal walls
+
+467
+00:43:33,310 --> 00:43:39,270
+إلا بس في حالات الفيروس بس for it is effective on
+
+468
+00:43:39,270 --> 00:43:43,190
+its own against dendritic and some unaboid ulcers
+
+469
+00:43:43,190 --> 00:43:47,070
+but larger and stromal ones require the addition
+
+470
+00:43:47,070 --> 00:43:51,410
+of a topical steroid for complete resolution يعني
+
+471
+00:43:51,410 --> 00:43:55,910
+هو وجدنا إحنا بيشتغل أكتر إشي عن epithelial herpes
+
+472
+00:43:55,910 --> 00:43:57,690
+simplex sclerotitis
+
+473
+00:44:03,380 --> 00:44:09,880
+في حالات chronic لجينا الفيروس راح دخل استرومال،
+
+474
+00:44:09,880 --> 00:44:17,760
+حط الدواء هذا اللي هو الـ acyclovir، بطل يأثر، حطيه
+
+475
+00:44:17,760 --> 00:44:23,800
+مع استيرويد، صار في .. كإن استيرويد فتح للفيروس
+
+476
+00:44:23,800 --> 00:44:29,960
+استرومال، فدائما استرومال كيراتيتس
+
+477
+00:44:33,760 --> 00:44:36,720
+طب لو حطينا استيرويد على الـ epithelial keratitis
+
+478
+00:44:36,720 --> 00:44:41,620
+مارفوش Contra indication Contra indication لازم
+
+479
+00:44:41,620 --> 00:44:46,460
+على ال استيرويد طب إحنا كيف نعرف الفيروس هو stromal
+
+480
+00:44:46,460 --> 00:44:53,060
+ولا Epithelial إذا Epithelial هيكون ظاهر فقرانيا
+
+481
+00:44:53,060 --> 00:44:57,000
+بشكل مباشر كيف؟ لما نجربه على استيرويد اللي عملت
+
+482
+00:44:57,000 --> 00:45:00,280
+دورسيا اللي عملت دورسيا اللي عملت دورسيا اللي عملت
+
+483
+00:45:00,280 --> 00:45:00,960
+دورسيا اللي عملت دورسيا اللي عملت دورسيا اللي عملت
+
+484
+00:45:00,960 --> 00:45:01,400
+دورسيا اللي عملت دورسيا اللي عملت دورسيا اللي عملت
+
+485
+00:45:01,400 --> 00:45:04,440
+دورسيا اللي عملت لازم نحط fluorescent لو
+
+486
+00:45:04,440 --> 00:45:11,940
+إن إيبثيليال هيكون قرحة شجرية واضحة جدا، ذندر تتأثر،
+
+487
+00:45:11,940 --> 00:45:21,780
+ذندر تتأثر، لكن لو كانت في أعراض لكن ما فيش ذندر
+
+488
+00:45:21,780 --> 00:45:26,080
+تتأثر واضح على طول بنائها قنسترومل، بنائها
+
+489
+00:45:26,080 --> 00:45:31,800
+قنسترومل، بس كانت في obesification، obesity،
+
+490
+00:45:31,800 --> 00:45:36,120
+formation فهذا على طول اللي بيقوم الـ obesity هو
+
+491
+00:45:36,120 --> 00:45:42,420
+الكورتيزون، حط استيرويد مثلا استيرو ديكس مثلا، حط
+
+492
+00:45:42,420 --> 00:45:48,480
+مثلا predfor، maxdex، كل هذه الأدوية معروفة
+
+493
+00:45:48,480 --> 00:45:52,660
+بالإضافة إلى الـ antiviral، لازم الـ antiviral يخش
+
+494
+00:45:52,660 --> 00:45:52,840
+فيهم
+
+495
+00:45:57,590 --> 00:46:00,570
+اللي هو إيش؟ استيرويل اللي بيقولك استيرويل
+
+496
+00:46:00,570 --> 00:46:05,450
+فاليباتيرال بيعمل إيش؟ انتشار للفيروس، refreshment
+
+497
+00:46:05,450 --> 00:46:09,910
+للفيروس، لكن في stromal لأ لازم نحطه مع الـ
+
+498
+00:46:09,910 --> 00:46:15,010
+antiviral طيب، اللي بقوله هنا إنه في الحياة الـ
+
+499
+00:46:15,010 --> 00:46:17,850
+stromal و الحياة الكاميرة لازم الـ steroid يكون
+
+500
+00:46:17,850 --> 00:46:23,070
+موجود مع الـ antiviral، هاي مثال الكون الألسث طبعا
+
+501
+00:46:23,070 --> 00:46:24,470
+هناك بكتيريال هنا 
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/QJs1WI9_T2U_postprocess.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/QJs1WI9_T2U_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..713685a8be7ddee156fab8737266addabe3e98d9
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/QJs1WI9_T2U_postprocess.srt
@@ -0,0 +1,2004 @@
+1
+00:00:19,930 --> 00:00:22,190
+بسم الله الرحمن الرحيم الحمد لله يا رب العالمين و
+
+2
+00:00:22,190 --> 00:00:25,270
+أصلي و أسلم على نبي الأمين محمد و على أهلي وأصلي و
+
+3
+00:00:25,270 --> 00:00:29,250
+أتابعين السلام عليكم و رحمة الله جمال اليوم ان شاء
+
+4
+00:00:29,250 --> 00:00:34,110
+الله سنكمل موضوع ال antibiotics antibiotics used
+
+5
+00:00:34,110 --> 00:00:39,670
+in the eye in treatment of eye infections today
+
+6
+00:00:39,670 --> 00:00:46,610
+fucidic acid هو أيضا recently detected
+
+7
+00:00:51,480 --> 00:01:00,200
+of simple eye infections typically used as viscous
+
+8
+00:01:00,200 --> 00:01:10,760
+drops called pusythalamic eye drops هي
+
+9
+00:01:10,760 --> 00:01:15,320
+drops بس visible يعني ما بعرفاش بيقول ان هذا
+
+10
+00:01:15,320 --> 00:01:18,920
+ointment هو مش ointment هو visible drops
+
+11
+00:01:21,980 --> 00:01:28,120
+الحقيقة انه يستخدم twice لي مرتين في اليوم وهو
+
+12
+00:01:28,120 --> 00:01:30,880
+very effective against myocoperulant
+
+13
+00:01:30,880 --> 00:01:39,840
+congerativitis بليفريتس برضه فيه
+
+14
+00:01:39,840 --> 00:01:44,780
+منه tablets used for systemic infections فيه منه
+
+15
+00:01:44,780 --> 00:01:49,840
+أقراص يعنيفي المائدة internally the drug is well
+
+16
+00:01:49,840 --> 00:01:53,000
+tolerated although it can cause liver damage and
+
+17
+00:01:53,000 --> 00:01:55,800
+jaundice which is reversible on discontinuation
+
+18
+00:01:55,800 --> 00:01:59,600
+يعني بياخد أقل عصر مدة طويلة ممكن يأثر على مضايف
+
+19
+00:01:59,600 --> 00:02:05,860
+الكبير، لكن لو يعني تركوا فترة ممكن أنه يتحسن وضع
+
+20
+00:02:16,820 --> 00:02:20,820
+In the form of a viscous drop that needs to be
+
+21
+00:02:20,820 --> 00:02:24,880
+applied only twice daily اسمها Fusethalamic eye
+
+22
+00:02:24,880 --> 00:02:30,100
+drops، viscid، viscid يعني سميكة شوية It has
+
+23
+00:02:30,100 --> 00:02:33,440
+potent bacterostatic or bactericidal activity
+
+24
+00:02:33,440 --> 00:02:37,180
+against gram-positive bacteria خاصة gram-positive
+
+25
+00:02:37,180 --> 00:02:42,000
+bacteria اشتغل على gram-negative أجالي كيف يعمل؟
+
+26
+00:02:42,000 --> 00:02:46,520
+بيعمل على ال inhibition of protein synthesisيعني
+
+27
+00:02:46,520 --> 00:02:51,240
+بيعمل على إيش؟ ريبوزومس، بيعمل على الريبوزومس،
+
+28
+00:02:51,240 --> 00:02:54,280
+لذلك دايما ادارتلي على الريبوزومس ع طريق
+
+29
+00:02:54,280 --> 00:02:59,920
+الانزيمات، ع طريق الانزيمات اللي بتنشط الريبوزومس،
+
+30
+00:02:59,920 --> 00:03:03,240
+يعني بتحصفوه بالريبوزوم نفسه، لكن بيعمل على تعطيل
+
+31
+00:03:03,240 --> 00:03:05,620
+الانزيمات اللي هي
+
+32
+00:03:15,170 --> 00:03:18,890
+Spectra Mubarchin يعني الطيف بتاعه كده ايش بيشتغل؟
+
+33
+00:03:18,890 --> 00:03:23,110
+بيشتغل against gram-positive bacteria like
+
+34
+00:03:23,110 --> 00:03:28,350
+staphylococcus aureus وهذه البكتيريا يعني Virulent
+
+35
+00:03:28,350 --> 00:03:32,570
+شديد الفكرة، including some strains of Methicillin
+
+36
+00:03:32,570 --> 00:03:37,830
+-resistant stuff اللي هو Aureus حتى اللي هي بتعمل
+
+37
+00:03:37,830 --> 00:03:42,070
+أنزين يحلل متاسلين بعض أنواع البنسلين برضه هو
+
+38
+00:03:42,070 --> 00:03:46,120
+يستطيع أن يفتولهاالكثير من البكتيريات النسارية غير
+
+39
+00:03:46,120 --> 00:03:53,620
+مقاومة ولكنها تعمل مع نسارية تعمل مع نسارية تعمل
+
+40
+00:03:53,620 --> 00:03:54,940
+مع نسارية تعمل مع نسارية تعمل مع نسارية تعمل مع
+
+41
+00:03:54,940 --> 00:03:55,960
+نسارية تعمل مع نسارية تعمل مع نسارية تعمل مع
+
+42
+00:03:55,960 --> 00:03:56,020
+نسارية تعمل مع نسارية تعمل مع نسارية تعمل مع
+
+43
+00:03:56,020 --> 00:03:57,000
+نسارية تعمل مع نسارية تعمل مع نسارية تعمل مع
+
+44
+00:03:57,000 --> 00:03:57,820
+نسارية تعمل مع نسارية تعمل مع نسارية تعمل مع
+
+45
+00:03:57,820 --> 00:03:58,180
+نسارية تعمل مع نسارية تعمل مع نسارية تعمل مع
+
+46
+00:03:58,180 --> 00:04:02,420
+نسارية تعمل مع نسارية تعمل مع نسارية تعمل مع
+
+47
+00:04:02,420 --> 00:04:05,660
+نسارية تعمل مع نسار
+
+48
+00:04:12,280 --> 00:04:16,460
+لأن معظم ال .. ال .. ال contractivitis gram
+
+49
+00:04:16,460 --> 00:04:22,460
+positive فاحنا بنعطيه مثلا twice or thrice or four
+
+50
+00:04:22,460 --> 00:04:27,200
+times daily، بيشتغل كويس، أحنا بنعطيه مساند لجطرة
+
+51
+00:04:27,200 --> 00:04:31,400
+تانية كل .. كل .. اللي هو كل ال .. ال .. ال .. ال
+
+52
+00:04:31,400 --> 00:04:31,960
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+53
+00:04:31,960 --> 00:04:32,160
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+54
+00:04:32,160 --> 00:04:32,540
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+55
+00:04:32,540 --> 00:04:32,560
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+56
+00:04:42,650 --> 00:04:49,550
+سيكونوا اتنين مع بعض كويسين كثير سبب الكيوزز it is
+
+57
+00:04:49,550 --> 00:04:53,610
+now often used as the frontline treatment of
+
+58
+00:04:53,610 --> 00:04:56,550
+cognitive device يعني الخط الأول في ال cognitive
+
+59
+00:04:56,550 --> 00:04:59,970
+device في العالم اللي انا مستخدمه لأنه نظيف وكويس
+
+60
+00:04:59,970 --> 00:05:04,190
+و effective compared with clinical ointment it has
+
+61
+00:05:04,190 --> 00:05:05,910
+a much better compliance
+
+62
+00:05:12,590 --> 00:05:20,090
+عشان دولة شعبي ثمن و غالي شوية يعني في حدود عشرين
+
+63
+00:05:20,090 --> 00:05:27,270
+شكل مثلا يعني خمسة دولار الان resistance stress
+
+64
+00:05:27,270 --> 00:05:31,190
+بدات البكية طبعا ضارب عادتها ان تعملوا resistance
+
+65
+00:05:32,200 --> 00:05:39,960
+كانت تتطور بسرعة و هومندين في 1995 وجدت ان عدد
+
+66
+00:05:39,960 --> 00:05:42,520
+كبير من الأسلحة البريستانية الخاصة بالجرام نيجاتيب
+
+67
+00:05:42,520 --> 00:05:48,040
+اللي كانت تتطور من كنيفتيبلس وابس من مسحات
+
+68
+00:05:48,040 --> 00:05:54,640
+البكتيريا لإنه بدأت البكتيريا أيضا تعارض أو تقاوم
+
+69
+00:05:54,640 --> 00:06:00,880
+بمخلوق هذا الانتيبولاتيك الجديدالآن هنتكلم كلمة
+
+70
+00:06:00,880 --> 00:06:04,920
+عامة Antibiotic resistance in bacteria يعني هذه
+
+71
+00:06:04,920 --> 00:06:11,100
+البكتيريا كيف تعمل على الميكروم يمكن احنا اتحدثنا
+
+72
+00:06:11,100 --> 00:06:16,100
+قبل ذلك كيف يعمل المضاد الحقيقي على البكتيريا
+
+73
+00:06:19,640 --> 00:06:22,500
+قلنا ان كل دواء له اسلوب اما بيشتغل على ال cell
+
+74
+00:06:22,500 --> 00:06:26,420
+wall او بيشتغل على ال cytoplasmic membrane او
+
+75
+00:06:26,420 --> 00:06:30,760
+بيشتغل على ال ribosomes او بيشتغل على ال DNA في
+
+76
+00:06:30,760 --> 00:06:36,120
+nucleus of the bacterial bacteria انا بدى اشوف
+
+77
+00:06:36,120 --> 00:06:44,720
+احنا يعني البكتيريا يعني how can bacteria make
+
+78
+00:06:44,720 --> 00:06:50,090
+resistanceتقري عن التربيوتيك التربيوتيك تعمل تقري
+
+79
+00:06:50,090 --> 00:06:56,750
+عن تربيوتك تعمل تقري
+
+80
+00:06:56,750 --> 00:06:59,870
+عن تربيوتك تعمل تقري عن تربيوتك تعمل تقري عن
+
+81
+00:06:59,870 --> 00:07:00,890
+تربيوتك تعمل تقري عن تربيوتك تعمل تقري عن تربيوتك
+
+82
+00:07:00,890 --> 00:07:03,350
+تعمل تقري عن تربيوتك تعمل تقري عن تربيوتك تعمل
+
+83
+00:07:03,350 --> 00:07:05,370
+تربيوتك تعمل تقري عن تربيوتك تعمل تقري عن تربيوتك
+
+84
+00:07:05,370 --> 00:07:10,290
+تعمل تقري عن تربيوتك تعمل تقري عن تربيوتك تعمل
+
+85
+00:07:10,290 --> 00:07:16,920
+تقري عن تربيوتك تعمل تقري عن تربيوتك تعمل تو ياخد
+
+86
+00:07:16,920 --> 00:07:23,220
+antibiotic مثمن و يكون useless كيف الوضع؟ بزيد
+
+87
+00:07:23,220 --> 00:07:30,920
+الحالة بزيد الحالة و الانفاق بيكون راح و ربما يدخل
+
+88
+00:07:30,920 --> 00:07:36,040
+في مرحلة أخطر من الأولى أخدتوا ببعكوا؟ لذلك حقيقة
+
+89
+00:07:36,040 --> 00:07:41,020
+يعني احنا ماشي وقت بقى في حيرة من أمرنا صحيح ففي
+
+90
+00:07:41,020 --> 00:07:46,330
+حيرة من أمرنا يعني في حالاتأحنا بضطر نعطي two
+
+91
+00:07:46,330 --> 00:07:51,150
+antibiotics مع بعض، عشان نتغلب على ال infection،
+
+92
+00:07:51,150 --> 00:07:54,650
+نتقش أن واحد صار يكفي، أنا شخصيا باخد two
+
+93
+00:07:54,650 --> 00:07:59,530
+antibiotics مع بعض، بضطر أتقفى أنه في antibiotic
+
+94
+00:07:59,530 --> 00:08:03,490
+واحد بياخد البكتيرين، لأنه كل antibiotic له جثة مع
+
+95
+00:08:03,490 --> 00:08:08,550
+البكتيرينthe rapid reproduction rates of bacteria
+
+96
+00:08:08,550 --> 00:08:11,810
+with divergence happening every twenty minutes
+
+97
+00:08:11,810 --> 00:08:17,290
+يعني البكتيريا كل عشرين دقيقة بيطلع منها جيل جديد
+
+98
+00:08:17,290 --> 00:08:24,110
+يعني مثلا بكتيريا واحدة يعني خلية صارت اتنين بعد
+
+99
+00:08:24,110 --> 00:08:26,870
+عشرين دقيقة بيصيروا اربع بعد عشرين دقيقة بيصيروا
+
+100
+00:08:26,870 --> 00:08:30,590
+تمانية بعد عشرين دقيقة بيصيروا ستاشر يعني في
+
+101
+00:08:30,590 --> 00:08:36,800
+الساعة بالقسم كام مرة؟ تلات مرةوبعدين بتضاعف العدد
+
+102
+00:08:36,800 --> 00:08:44,220
+حتى يصبح مئات الآلاف في يوم واحد طبعا يعني مهما
+
+103
+00:08:44,220 --> 00:08:49,700
+كان الموضوع الحيوي أمام هذا الزخم الشديد كان بيقتل
+
+104
+00:08:49,700 --> 00:08:53,640
+من هذه البكتيريا أحيانا الكثرة ترب الشديد عزيزي ما
+
+105
+00:08:53,640 --> 00:08:57,230
+أقوله يعنيوالديموجين يحدث كل 20 دقيقة في بعض
+
+106
+00:08:57,230 --> 00:09:03,910
+المحطات، في حالات أكسيجين وحرارة وطعام جيد سريع
+
+107
+00:09:03,910 --> 00:09:09,410
+جدا، فممكنة التغيير الانتقالي يحدث بشكل عالي بشكل
+
+108
+00:09:09,410 --> 00:09:16,610
+كبير يبقى البكتيريا ستتعرض لانتفرتك في دهيلة
+
+109
+00:09:16,610 --> 00:09:17,710
+Intimal mutation
+
+110
+00:09:23,180 --> 00:09:28,160
+التفرة هذه تجير في التكوين الجيني بتاعها، في ال
+
+111
+00:09:28,160 --> 00:09:32,280
+DNA بتاعها، حتى إن ال Antibiotic اللي هو هيها ل
+
+112
+00:09:32,280 --> 00:09:39,460
+DNA، ما يجد DNA مختلف، Luckily، يقول يعني ال
+
+113
+00:09:39,460 --> 00:09:42,060
+professional حق، under normal treatment
+
+114
+00:09:42,060 --> 00:09:44,500
+conditions, the great majority of the sensitive
+
+115
+00:09:44,500 --> 00:09:48,090
+organisms are killedBy the antibiotic leaving the
+
+116
+00:09:48,090 --> 00:09:51,710
+body to cope with a few resistant bacteria يعني
+
+117
+00:09:51,710 --> 00:09:55,290
+احنا مابنساهاش حاجة احنا بنعطي ال antibiotic بيقتل
+
+118
+00:09:55,290 --> 00:09:59,690
+80 او 90% من البكتيريا الموجودة العشرين او العشرة
+
+119
+00:09:59,690 --> 00:10:04,750
+فالمية الباقين تبقى لمناعة الجسم الشخصية
+
+120
+00:10:11,190 --> 00:10:15,210
+يستطيع أن يتخلص من هذه العدد اللي هو الباقي من
+
+121
+00:10:15,210 --> 00:10:23,010
+البكتيريا وكانت مناقة المريض compromised يعني
+
+122
+00:10:23,010 --> 00:10:28,710
+ضعيفة فإنه ممكن البكتيريا تعود إلى التكافر السريع
+
+123
+00:10:28,710 --> 00:10:33,490
+وتقضي عليه، هذه المشكلة يعني دايما في نزاع بين
+
+124
+00:10:33,490 --> 00:10:40,410
+مناقة الجسم وإيش و البكتيرياby genetic information
+
+125
+00:10:40,410 --> 00:10:46,310
+which calls for resistance can be passed to other
+
+126
+00:10:46,310 --> 00:10:53,790
+organisms يعني بيقول ليه أنه البكتيريا
+
+127
+00:10:53,790 --> 00:11:00,210
+إذا يعني تعلمت كيف تصنع
+
+128
+00:11:03,480 --> 00:11:08,780
+مقاومة لـ Antibiotics ممكن ان هذا يسري على ايش؟
+
+129
+00:11:08,780 --> 00:11:14,040
+على اللي هو Antibiotics تانية و تالتة و رابعة و
+
+130
+00:11:14,040 --> 00:11:17,640
+هكذا وهذا سر من أصال البكتيريا بتعلموا بعضها يعني
+
+131
+00:11:17,640 --> 00:11:24,180
+طيب الآن هنشوف طرق حدود المقاومة البكتيريا في طرق
+
+132
+00:11:24,180 --> 00:11:32,720
+الأول طريقة production ofinactivating enzyme إيش
+
+133
+00:11:32,720 --> 00:11:40,320
+يعني؟ يعني البكتيريا تكتشف التركيب الكيميائي لهذه
+
+134
+00:11:40,320 --> 00:11:47,660
+الدواء فطول هي تصنع أنزيم يكسّم هذا التركيب
+
+135
+00:11:47,660 --> 00:11:54,200
+الكيميائي الأشهر كان في البنسالين كنا نسميه زمان
+
+136
+00:11:54,200 --> 00:11:57,020
+penicillinase enzyme
+
+137
+00:12:00,110 --> 00:12:06,650
+بنطب البلسة يعني الآن عملوا أوسع beta-lactamase كل
+
+138
+00:12:06,650 --> 00:12:15,230
+مضاعف حاوي في beta-lactam ring البكتيريا تستطيع ان
+
+139
+00:12:15,230 --> 00:12:20,210
+تصنع لها تكسير اسمه beta-lactamase وهي المرة
+
+140
+00:12:20,210 --> 00:12:24,570
+الماضية وراناك ال ring هذي شفتوا ال ring؟ beta
+
+141
+00:12:24,570 --> 00:12:27,990
+-lactam شكل كونه سينا
+
+142
+00:12:31,710 --> 00:12:38,770
+قبل أكتر من محطة هيا هيا شايفين بالأحمر بيتالاكتم؟
+
+143
+00:12:38,770 --> 00:12:43,530
+أي دواء مضحوة فيه البيتالاكتم فيه أنواع من
+
+144
+00:12:43,530 --> 00:12:49,230
+البكتيريا مستعدة على طول تسلمه إلى التكسير الآن
+
+145
+00:12:49,230 --> 00:12:53,790
+التجربة هذه مبتدأت إلى Antibiotics أخرى مثلا الـ
+
+146
+00:12:53,790 --> 00:12:57,830
+Chloramfericol فيه حاجة اسمها Acetyltransferase
+
+147
+00:13:11,030 --> 00:13:14,890
+البكتيريا الـ Gram-positive و Gram-negative اللي
+
+148
+00:13:14,890 --> 00:13:20,530
+هو بيعمله فيطلع كورنفيريكول يوزليس هاي لسه طريقة
+
+149
+00:13:20,530 --> 00:13:23,870
+واحدة بعض البكتيريا شوفوا بكتيريا تانية اسم كاملة
+
+150
+00:13:23,870 --> 00:13:31,990
+alteration of the binding site يعني جايالـ
+
+151
+00:13:31,990 --> 00:13:35,650
+Antibiotic على منطقة معينة في الـ ribosome مثلا
+
+152
+00:13:35,650 --> 00:13:41,910
+تروح البكتيريا هي مغيّر منطقة بشكل آخر فيجي بده
+
+153
+00:13:41,910 --> 00:13:46,610
+يعني يتدهد معاها عشان يبدأ يفكّكها إلى جهها اشي
+
+154
+00:13:46,610 --> 00:13:52,950
+تاني زي مثلا هذه شوفت الشكل هذا بس
+
+155
+00:13:52,950 --> 00:13:57,130
+الشكل هذا هاي ال antibiotic جاي على ال ribosome
+
+156
+00:13:57,130 --> 00:14:04,680
+هاي ال ribosome هناهذا الوضع متغير، هذا الوضع
+
+157
+00:14:04,680 --> 00:14:10,180
+متغير، بطل السينوية بظهر الأولان،
+
+158
+00:14:10,180 --> 00:14:18,680
+يعتمما زي إنسان جاية طلقة، هو شايف وضع معين إن
+
+159
+00:14:18,680 --> 00:14:24,680
+القناص أطلق الطلقة، فهو غيّب في شكله، في وضعه، بس
+
+160
+00:14:24,680 --> 00:14:30,610
+بدا من واجه جاهدأو مثلا بدل مكان جاعد راح انبطح
+
+161
+00:14:30,610 --> 00:14:38,410
+أرضنا فطلع طلع ال age 12 هي تماما تغير او تحس ان
+
+162
+00:14:38,410 --> 00:14:44,050
+فيها انتفت بجانب فهي بتغير مواعضة التأثير تصير غير
+
+163
+00:14:44,050 --> 00:14:50,490
+مؤثر The ribosome to which some amino glycoside
+
+164
+00:14:50,490 --> 00:14:55,370
+spine زي الديلتاميسين can become altered in shape
+
+165
+00:14:59,120 --> 00:15:06,240
+طريقة تانية طريقة تقليجية
+
+166
+00:15:06,240 --> 00:15:11,980
+و لا طريقة عادية طبعا نظرة طبعا نظرة ترظيمالي صح
+
+167
+00:15:11,980 --> 00:15:16,840
+طيب طريقة تالتة alteration of the susceptible
+
+168
+00:15:16,840 --> 00:15:24,700
+pathway ايش pathway المسار اه المسار اتغير المسار
+
+169
+00:15:24,700 --> 00:15:31,980
+يعني انت ماشي هيكهي أتمنى لو يمشي هنا، يمشي غلط
+
+170
+00:15:31,980 --> 00:15:38,740
+يعني. organs can become resistant to sulfonamides،
+
+171
+00:15:38,740 --> 00:15:42,400
+أنواع الصلفة المختلفة، by developing pathways that
+
+172
+00:15:42,400 --> 00:15:48,580
+don't require due to effect، كانت force pathways،
+
+173
+00:15:48,580 --> 00:15:53,020
+ممرات خاطية، خاطية، خاطية، خاطية، خاطية، خاطية،
+
+174
+00:15:53,020 --> 00:15:53,940
+خاطية،
+
+175
+00:16:04,420 --> 00:16:11,360
+Inactivating enzymes, blocking entry, alteration
+
+176
+00:16:11,360 --> 00:16:14,600
+of target molecules
+
+177
+00:16:25,750 --> 00:16:30,330
+Number four reduction in the intracellular levels
+
+178
+00:16:30,330 --> 00:16:34,710
+of agent احنا عندنا في العالم في طبقة اسمها
+
+179
+00:16:34,710 --> 00:16:41,890
+endothelium خالف الكورية ايش ال main function of
+
+180
+00:16:41,890 --> 00:16:51,050
+endothelium بم بم بم بم بم بم بم بم بم بم بم بم بم
+
+181
+00:16:51,050 --> 00:16:51,530
+بم بم بم بم
+
+182
+00:16:59,650 --> 00:17:03,090
+بيقول إنه كل ما الـ aqueous ضغطه بتعمل زيادة و
+
+183
+00:17:03,090 --> 00:17:09,670
+يبدأ يعمل entrance أو entry in the stroma الـ
+
+184
+00:17:09,670 --> 00:17:15,050
+endothelium يسحبه تاني يعمل pump شفط يرجع تاني to
+
+185
+00:17:15,050 --> 00:17:21,250
+keep the transparency of the colon الآن هذا
+
+186
+00:17:21,250 --> 00:17:26,530
+البكتيريا فيها ال pump تاني كل ما ال antibiotic
+
+187
+00:17:26,530 --> 00:17:28,730
+يدخل من الcell wall
+
+188
+00:17:34,740 --> 00:17:38,400
+شايفين كيف؟ هاي الـ Antibiotic دخل و هي ربط الباب،
+
+189
+00:17:38,400 --> 00:17:42,320
+هاي ال Antibiotic جزائي، كل ما يدخل يدخل يطلع من
+
+190
+00:17:42,320 --> 00:17:49,180
+هنا، شايف؟ كل محاول يدخلوا الباب، يدفعوا الخارج،
+
+191
+00:17:49,180 --> 00:17:52,360
+يدخلوا الباب، يدفعوا الخارج، بيخلوش يدخل في قلب
+
+192
+00:17:52,360 --> 00:17:54,040
+اللي هو يشغل غرفة
+
+193
+00:18:00,220 --> 00:18:03,880
+الصناعة في مستوى التراثيبرال لشركة أيجان، بعض
+
+194
+00:18:03,880 --> 00:18:06,980
+أسلحة Staphylococcus aureus مثلا يمكن أن تصبح
+
+195
+00:18:06,980 --> 00:18:11,860
+مقاومة لفلورقونراوس، الحديث جدا هذا، بسبب تسبب
+
+196
+00:18:11,860 --> 00:18:16,340
+إفلاك الشركة يعني هذه البكتيريا هي اللي بتساعد
+
+197
+00:18:16,340 --> 00:18:18,140
+تحسين أداء الاندوثيابان؟
+
+198
+00:18:25,630 --> 00:18:31,650
+لأ هذا مثل احنا قلنا في الإنسان فيه pump ال
+
+199
+00:18:31,650 --> 00:18:36,770
+endothelium كل ما الأكيوس بده يدخل بيروح ساحبه
+
+200
+00:18:36,770 --> 00:18:42,490
+لبرا ومراجعه على الأكيوس على ال AC فبتفضل ال
+
+201
+00:18:42,490 --> 00:18:47,350
+cornea transparent و لو ال endothelium صاروا
+
+202
+00:18:47,350 --> 00:18:53,000
+damaged لكان ال cornea صارها damagedعلى طول و كنا
+
+203
+00:18:53,000 --> 00:18:56,800
+احنا نعلم طالبات في سنة تانية دايما في ال anatomy
+
+204
+00:18:56,800 --> 00:19:00,900
+of the eye نقول الحارس و الأمين للقرانية و ال
+
+205
+00:19:00,900 --> 00:19:06,260
+endothelium ال bodyguard بتاعنا احنا عايزين نقولها
+
+206
+00:19:06,260 --> 00:19:14,140
+في البكتيريا عندها موضوع ال pump هذه عندها موضوع
+
+207
+00:19:14,140 --> 00:19:18,020
+ال pump من شمح تشبيه يعني في أي مكان؟ اه في
+
+208
+00:19:18,020 --> 00:19:18,540
+البكتيريا
+
+209
+00:19:26,500 --> 00:19:33,880
+وقاصد ان يدخل على ال DNA مثلا، اللي هو عشان يكسره،
+
+210
+00:19:33,880 --> 00:19:37,780
+ففي قدرة عند بعض أنواع البكتيريا زي الستفليوكوكاي
+
+211
+00:19:37,780 --> 00:19:42,540
+انها تدفع ال antibiotic اللي دخل من ال cell wall
+
+212
+00:19:42,540 --> 00:19:46,900
+إلى الخارج تاني، يعني زي ما قولنا هيها، مجرد ما
+
+213
+00:19:46,900 --> 00:19:47,340
+دخل
+
+214
+00:19:51,510 --> 00:19:55,770
+دخل من هنا و طالع من هنا او من هنا و طالع من هنا و
+
+215
+00:19:55,770 --> 00:20:00,650
+هكذا فبصيروش تركيز قاطل داخل جسم البكتيريا مش
+
+216
+00:20:00,650 --> 00:20:05,430
+عارفه ده؟ طيب،
+
+217
+00:20:05,430 --> 00:20:09,870
+الآن هنبدأ في الموضوع الجديد antiviral drugs
+
+218
+00:20:09,870 --> 00:20:16,870
+antiviral drugs مضادات فيروسية و احنا في العين في
+
+219
+00:20:16,870 --> 00:20:17,650
+عندنا
+
+220
+00:20:34,620 --> 00:20:37,860
+الفرق بين البكتيريا اللي بتدخلها يعني و الفيروس
+
+221
+00:20:37,860 --> 00:20:41,500
+البكتيريا بتشتغل خارج ال cells
+
+222
+00:20:49,100 --> 00:20:55,360
+البكتيريا تهاجم لتأخذ غذاء، تهاجم لتأخذ غذاء، فهي
+
+223
+00:20:55,360 --> 00:21:01,780
+ليست جزء من ال cells زي جيش هاجم على بلد، الجيش
+
+224
+00:21:01,780 --> 00:21:06,160
+خارج البلد و هو بيقاتل، بيحاول يتقدم، بيحاول
+
+225
+00:21:06,160 --> 00:21:09,020
+يتقدم، والناس بيقوموا، والناس بيقوموا، مين اللي
+
+226
+00:21:09,020 --> 00:21:12,200
+هجلب في الآخر؟ الجيش الغازي ولا المدافعين
+
+227
+00:21:18,670 --> 00:21:22,430
+بتكاتر وبتهجم وبتحاول تغلب اللي هو ال tissues
+
+228
+00:21:22,430 --> 00:21:26,910
+المعين زي القرانية مثلا لأ الفيروس غير الفيروس هذا
+
+229
+00:21:26,910 --> 00:21:36,150
+بيدخل داخل ال cells وبيستخدم ال DNA بتاعة ال cells
+
+230
+00:21:36,150 --> 00:21:41,550
+نفسها في العين وبيتكاتر فيها وبعدين تنفجر الخلية
+
+231
+00:21:41,550 --> 00:21:48,720
+فتعطي ألاف منالفيروسات اللي بتدخل كمان ماروها
+
+232
+00:21:48,720 --> 00:21:56,040
+الخلايا و بتتكفر داخلها فعلاج الفيروس أصعب بكتير
+
+233
+00:21:56,040 --> 00:22:00,420
+من علاج البكتيريا البكتيريا ناس شايفين هم يتردهم
+
+234
+00:22:00,420 --> 00:22:06,320
+لكن الفيروس هنا بيحل في الخلية جوه وبالتالي ترده
+
+235
+00:22:06,320 --> 00:22:11,100
+من داخل الخلية صعب عشان اقول intimate relationship
+
+236
+00:22:11,990 --> 00:22:17,870
+يعني الوراقة القريبة جدا بصير جزء من خلية between
+
+237
+00:22:17,870 --> 00:22:21,750
+the infecting virus and the host cell الخلايا
+
+238
+00:22:21,750 --> 00:22:24,730
+العيال وخلايا الفيروسات virus deficient are more
+
+239
+00:22:24,730 --> 00:22:30,750
+difficult to treat صعب العلاج بتاعها than those
+
+240
+00:22:30,750 --> 00:22:36,130
+caused by bacteria يعني زي ما أقوله وقال يا عزيزي
+
+241
+00:22:36,130 --> 00:22:41,430
+يا حامي الفرار هو أوردههذا أبو فراس بيقول، وقال
+
+242
+00:22:41,430 --> 00:22:45,430
+أصحابي فراروا في الحرب أو الردد، فقلتوا هم أمراني
+
+243
+00:22:45,430 --> 00:22:51,630
+أهلا هم مروا، يا تشرد ولا .. ولا إيش تموت، جار
+
+244
+00:22:51,630 --> 00:22:54,430
+والله هذا و هذا، لأ بس لأ شك الإشراد
+
+245
+00:23:02,330 --> 00:23:05,730
+الله عز و جل قال يأيوا الذين أملوا إذا لقيتم الذين
+
+246
+00:23:05,730 --> 00:23:10,130
+كفروا زحفا فلا تولهم الأدبار ومن يولهم يومين دوره
+
+247
+00:23:10,130 --> 00:23:15,010
+إلا متحرفا نكتان او متحيزا إلا فيها فقد بقى دفعة
+
+248
+00:23:15,010 --> 00:23:17,790
+من الله و ما هو جهنم و بقصة مصيدة يبقى فيه رخصة
+
+249
+00:23:17,790 --> 00:23:25,150
+للهرب في حالات معينة و لو .. و لو فشي كان يعني كل
+
+250
+00:23:25,150 --> 00:23:29,010
+استشهدية الحكاية لكن يعني فيه رخصة و يوم حنين
+
+251
+00:23:29,010 --> 00:23:36,150
+تتعجبتهم كخرانتهمأيوة، وضغط عليكم الأرض بمناعهم،
+
+252
+00:23:36,150 --> 00:23:39,890
+ثم و الله ثم اكبرين، و هم مين هم؟ الصحابة رضوان
+
+253
+00:23:39,890 --> 00:23:42,510
+عليهم، يعني الصحابة رسول الله صلى الله عليه و سلم
+
+254
+00:23:42,510 --> 00:23:50,250
+لما رأوا الخطر الشديد، فولوا و اكبرينثم أنزل الله
+
+255
+00:23:50,250 --> 00:23:54,110
+سكينته على رسوله وعلى المؤمنين، وأنزل جنود اللي لم
+
+256
+00:23:54,110 --> 00:23:58,070
+تراوها، وعذب الذين كفروا، وإنفذوا الكافرين، الله
+
+257
+00:23:58,070 --> 00:24:02,710
+نصر هذه الفئة المؤمنة بإيمانها، بعد أن هربت على
+
+258
+00:24:02,710 --> 00:24:08,110
+جيش مالك ابن عوف، اللي كان قد جمع النساء والذهب
+
+259
+00:24:08,110 --> 00:24:12,530
+والفضة والغنم والبقر، وكان بعد ذلك هذا حظب كل حظة
+
+260
+00:24:12,530 --> 00:24:17,170
+المسلمين في هذه الغنائم التي .. إيه المهم؟ هذه
+
+261
+00:24:17,170 --> 00:24:17,990
+بداية البلوسة
+
+262
+00:24:29,560 --> 00:24:35,760
+معظم الفيروسات تقاوم الهلالة وقاوم الهلالية
+
+263
+00:24:35,760 --> 00:24:40,000
+استأجيب للأسف عكس البكتيريا مؤتمر عمل عمل عمل عمل
+
+264
+00:24:40,000 --> 00:24:42,480
+عمل عمل عمل عمل عمل عمل عمل
+
+265
+00:24:50,360 --> 00:24:55,260
+حديثا اهتم العلماء الأدوية في إيجاد أدوية تقتل
+
+266
+00:24:55,260 --> 00:25:01,480
+الفيروسات ونجحوا في ذلك in particular على أخص
+
+267
+00:25:01,480 --> 00:25:05,640
+human immunodeficiency virus من يوم تادة في
+
+268
+00:25:05,640 --> 00:25:13,440
+الثمانينيات إجا ال HIV الفيروس اللي هو ال AIDS هذا
+
+269
+00:25:13,440 --> 00:25:19,200
+يعني زاد البحث عن علاج الفيروسات بنسبة ألف فالمئة
+
+270
+00:25:26,390 --> 00:25:35,210
+لأنه fatal لأنه fatal مافي كلام تاني widespread في
+
+271
+00:25:35,210 --> 00:25:42,230
+كل البلاد في كل البلاد يعني يمكن أكتر من virus
+
+272
+00:25:42,230 --> 00:25:48,510
+influenza الشيء التالت انه chronic يعني كتير من
+
+273
+00:25:48,510 --> 00:25:54,330
+الفيروسات self-limitedبيموت لحاله من تلاتة إلى
+
+274
+00:25:54,330 --> 00:25:58,410
+أسبوع إلى عشر أيام بيموت لحاله الفيروس لها الفيروس
+
+275
+00:25:58,410 --> 00:26:03,030
+إذا دخل فإنه يقبل خروج إلى أن يخرج إلى القبر مع
+
+276
+00:26:03,030 --> 00:26:09,530
+مين؟ مع ال host وهذه .. هذه المشكلة يبقوا يقولي ال
+
+277
+00:26:09,530 --> 00:26:14,550
+HIV صار علي دراسة خاصة one of the earliest viruses
+
+278
+00:26:14,550 --> 00:26:18,850
+to be treated was herpes simplex the causative
+
+279
+00:26:18,850 --> 00:26:22,450
+organism of dendritic ulcer in the colonهذا مثلا
+
+280
+00:26:22,450 --> 00:26:26,750
+فيروس له خاصية لأنه إذا حال في قرانية معينة إيش
+
+281
+00:26:26,750 --> 00:26:33,650
+بيعمل؟ Blindness أنا شوفت يعني كتير Recurrent
+
+282
+00:26:33,650 --> 00:26:38,910
+herpes simplex sclerotitis أدت إلى complete
+
+283
+00:26:38,910 --> 00:26:42,470
+opacification of القوة يعني and loss of vision
+
+284
+00:26:42,470 --> 00:26:50,940
+يبقى ال herpes simplex بالذاتاللي هو اهتمام خاص ال
+
+285
+00:26:50,940 --> 00:26:56,400
+keratoplasty هذا لما يكون يعني في اه specification
+
+286
+00:26:56,400 --> 00:27:00,540
+للكورية طبعا، لكن احنا لو عرجناها على المكان لانه
+
+287
+00:27:00,540 --> 00:27:06,120
+اللي بنحطله و احنا يعني transplantation للكورية
+
+288
+00:27:06,120 --> 00:27:10,660
+ممكن الجسم يعملها إيش؟ rejection، و هذه كمان جثة
+
+289
+00:27:10,660 --> 00:27:16,950
+تانية كمان، بعد كل هالتعةكمان في cold source اللي
+
+290
+00:27:16,950 --> 00:27:21,510
+هو في البروسات البرد و الرشح و ال genital herpes
+
+291
+00:27:21,510 --> 00:27:30,110
+في اللي هو herpes يعني في ال genital system civil
+
+292
+00:27:30,110 --> 00:27:33,870
+agents have been used as topical treatments for
+
+293
+00:27:33,870 --> 00:27:38,530
+these conditions يعني عديد من ال antivirus
+
+294
+00:27:38,530 --> 00:27:39,810
+اكتشفوها
+
+295
+00:27:49,640 --> 00:27:55,420
+لكن كثير منها ما عمرت ولم تثبت نجاعتها زي مثلا
+
+296
+00:27:55,420 --> 00:28:02,780
+ايدوكز يوردين هنا زمان كان شغال و بقى واجف خلاص زي
+
+297
+00:28:02,780 --> 00:28:09,320
+الفيت أرابين برضه خلص و زي إيري فلورو ثايميدين
+
+298
+00:28:09,320 --> 00:28:13,390
+برضه واجفالان النجمة اللى أفساها is a cyclopid
+
+299
+00:28:13,390 --> 00:28:20,370
+اللى انتوا بتسمعه فيه باسم zoberax كثير من الناس
+
+300
+00:28:20,370 --> 00:28:30,190
+مننا بعد fever attack بعد ما يسخنوا شي بتطلعله في
+
+301
+00:28:30,190 --> 00:28:36,170
+السفايف شي اسمه herpes leviitis herpes leviitis
+
+302
+00:28:36,170 --> 00:28:37,390
+فشا
+
+303
+00:28:40,320 --> 00:28:48,560
+و burning و painful فيجيب يحلوا فيه cramps و brux
+
+304
+00:28:48,560 --> 00:28:56,540
+twice daily for one week شوية شوية هذا ال herpes
+
+305
+00:28:56,540 --> 00:29:00,720
+ليبيايتس هو اللي بيعمل herpes keratitis نفسه
+
+306
+00:29:05,820 --> 00:29:10,680
+The last two كمال جان ساكلوفير موجود في ملابس
+
+307
+00:29:10,680 --> 00:29:15,260
+البيانات جان ساكلوفير والأساكلوفير ملاحظين جان
+
+308
+00:29:15,260 --> 00:29:20,320
+ساكلوفير اسمه بالظبط زي الاساكلفير مختلف بسيط
+
+309
+00:29:20,320 --> 00:29:26,120
+فالأساكلفير هو اللي أخد الشهرة the last two are
+
+310
+00:29:26,120 --> 00:29:28,940
+the only ones in regular use موجودة
+
+311
+00:29:40,400 --> 00:29:46,020
+اكتسبوله علماء انه هذا الفيروس ساعت بيجي على
+
+312
+00:29:46,020 --> 00:29:54,100
+الكمية او على ال lips و بيبقى ال infection بييجي
+
+313
+00:29:54,100 --> 00:29:59,900
+المريض بيوصف .. بيوصفله ايش؟ antiviral Zubirax او
+
+314
+00:29:59,900 --> 00:30:05,600
+الacyclovir بيبدأ يحط فيه الفيروس خبيث جدا يشعر
+
+315
+00:30:05,600 --> 00:30:08,360
+انه سيقتل فيهرب
+
+316
+00:30:11,230 --> 00:30:12,870
+يا أهو بداخل اسم بقى Colby Europe
+
+317
+00:31:01,470 --> 00:31:11,390
+البرانش اللي فوق اسمه ophthalmic nerve البرانش
+
+318
+00:31:11,390 --> 00:31:19,480
+اللي في النص اسمه maxillarymaxillary نفس ب brush
+
+319
+00:31:19,480 --> 00:31:26,420
+تاريت هذا اسمه mandibular ماهو mandibular الفك
+
+320
+00:31:26,420 --> 00:31:32,480
+يعني نفس الان
+
+321
+00:31:32,480 --> 00:31:43,100
+ال maxillary للوجه و ال fabric للعين و حولها يعني
+
+322
+00:31:43,100 --> 00:31:49,180
+العين و حول العينهذه الثانية ثم هنا ماجزيلالي
+
+323
+00:31:49,180 --> 00:31:56,000
+المنطقة هذه الفكية هذه المنطقة طيب الان لو الإنسان
+
+324
+00:31:56,000 --> 00:32:02,920
+صار في الشفتين او صار في القرانية كورنية و احنا
+
+325
+00:32:02,920 --> 00:32:08,220
+حطينا علاج فيجي الفيروس يهرب هنا
+
+326
+00:32:13,370 --> 00:32:21,410
+عارف أصاب في الشفتين يهرب من العلاج و اختبئ هنا طب
+
+327
+00:32:21,410 --> 00:32:31,510
+العلاج مابسهوش طب اختبئ الى ضعف مناعي كادر انف
+
+328
+00:32:31,510 --> 00:32:39,290
+لوانزا لواز تهبري أوي كده كده كده كده فأول مايصير
+
+329
+00:32:39,290 --> 00:32:46,050
+نزول مناعي عند المريضهيخرج من هنا و يؤيد أدراجه
+
+330
+00:32:46,050 --> 00:32:52,650
+إلى هنا أو إلى هنا فإن
+
+331
+00:32:52,650 --> 00:32:56,550
+قويت المناعة و أخد الإنسان علاج، بيرجع يختفى، و
+
+332
+00:32:56,550 --> 00:33:01,710
+هكذا أنا وجدت ناس في القرانية صدقوا إنه عشرين مرة
+
+333
+00:33:01,710 --> 00:33:06,270
+على صدق نعم
+
+334
+00:33:06,270 --> 00:33:12,250
+بعض برجع و كل مرة في الأول كان Epithelial، بعدين
+
+335
+00:33:12,250 --> 00:33:16,360
+صار Stromalو شويه شويه ال opacity لغاية بطل يشوف
+
+336
+00:33:16,360 --> 00:33:20,580
+ستة ع ستين من هذا اللي ايه؟ فممكن هو العلاج ما أخد
+
+337
+00:33:20,580 --> 00:33:25,220
+ع طول علشان .. و لو .. صح .. هل كانت اختباء
+
+338
+00:33:25,220 --> 00:33:29,880
+الفيروس .. يعني انا اسألكم سؤال لا شك ان في بعضكم
+
+339
+00:33:29,880 --> 00:33:34,220
+طلعلوا الاش .. اللي بيتسم .. اللي بيقولوا عنه الحم
+
+340
+00:33:34,220 --> 00:33:36,660
+هذا .. هو الناس بيقولوا عنه في البلد الحم البطني
+
+341
+00:33:36,660 --> 00:33:41,140
+هذا .. مين فيكوا طلعلوا؟ مارة مرتين تلاتة اربعة
+
+342
+00:33:41,140 --> 00:33:41,340
+اصلا؟
+
+343
+00:33:45,940 --> 00:33:52,680
+إذا انت تقوى المناعة بشكل قوي جدا ممكن يخد عليه
+
+344
+00:33:52,680 --> 00:33:57,880
+المناعة تخد عليه في ال nucleus هنا في ال .. في ال
+
+345
+00:33:57,880 --> 00:34:02,160
+.. في ال .. في ال medibrain يعني حد المرض أقرص
+
+346
+00:34:02,160 --> 00:34:04,940
+لتقوية المناعة عشان أتخلص من هذا؟ لأ لأ المناعة
+
+347
+00:34:04,940 --> 00:34:08,960
+تقوى رحالها بالعيالة .. بالطعام
+
+348
+00:34:12,200 --> 00:34:16,980
+يعني واحد كان مريض وبعدين يعني ال CPU واخد طعام
+
+349
+00:34:16,980 --> 00:34:19,340
+كويس وش وكده وكده وش وكده وش وكده وش وكده وش وكده
+
+350
+00:34:19,340 --> 00:34:19,900
+وكده وكده وكده وكده وكده وكده وكده وكده وكده وكده
+
+351
+00:34:19,900 --> 00:34:21,040
+وكده وكده وكده وكده وكده وكده وكده وكده وكده وكده
+
+352
+00:34:21,040 --> 00:34:23,260
+وكده وكده وكده وكده وكده وكده وكده وكده وكده وكده
+
+353
+00:34:23,260 --> 00:34:27,660
+وكده وكده وكده وكده وكده وكده وكده وكده وكده وكده
+
+354
+00:34:27,660 --> 00:34:31,160
+وكده
+
+355
+00:34:31,160 --> 00:34:31,480
+وك
+
+356
+00:34:40,500 --> 00:34:44,160
+طيب ال mode of action كيف ال acyclovir بيعمل على
+
+357
+00:34:44,160 --> 00:34:48,140
+الفيروس؟ ال acyclovir only affects virus infected
+
+358
+00:34:48,140 --> 00:34:53,340
+cells يبقى احنا لو خدتنا على عينينا هيك ولا بيعمل
+
+359
+00:34:53,340 --> 00:34:59,240
+حاجة هو مابعملش الا على الخلية اللي داخلها فيروس
+
+360
+00:34:59,240 --> 00:35:04,320
+هذا شيء كويس هذا selective action باسمه يعني
+
+361
+00:35:04,320 --> 00:35:10,610
+انتقائي انتقلي because it utilizes an enzymeبشتغل
+
+362
+00:35:10,610 --> 00:35:15,830
+على إنزايم اسمه thymidine kinase whose structure
+
+363
+00:35:15,830 --> 00:35:19,570
+and functioning is slightly different in viruses
+
+364
+00:35:19,570 --> 00:35:25,670
+to that found in uninfected host cells يبقى ال
+
+365
+00:35:25,670 --> 00:35:32,290
+thymidine kinase إنزايم هذا الأساقرفير حساسله بقول
+
+366
+00:35:32,290 --> 00:35:38,370
+انه ال thymidine kinaseبتاع الفيروس بيختلف عن
+
+367
+00:35:38,370 --> 00:35:42,930
+ثامدين كنز بتاع أي خلية من الخلايا نحنا فهو بيشتغل
+
+368
+00:35:42,930 --> 00:35:48,070
+على ثامدين كنز بتاع الفيروس وبتاع الخلية من
+
+369
+00:35:48,070 --> 00:35:52,010
+خلايانا أو الخلايا بتاعتنا مافيها فيروس بيشتغلش
+
+370
+00:35:52,010 --> 00:35:59,970
+عليه مصمم وهذا طبعا إنجاز بشري ان هو بيشم زي
+
+371
+00:35:59,970 --> 00:36:04,730
+الصاروخ الحلاري الصاروخ الحلاري بده حرارة يتوجه
+
+372
+00:36:09,010 --> 00:36:14,410
+أو آلة شغالة أو حاجة بتربيوها عليها لو مثلا مافيش
+
+373
+00:36:14,410 --> 00:36:17,410
+ماتوح شغاله شيء مابيجيش عليه وهذا هيك فيه تاني
+
+374
+00:36:17,410 --> 00:36:20,530
+مدين كيانيز تاني الفيروس بتتوجه عليه شبه داخل
+
+375
+00:36:20,530 --> 00:36:27,430
+الخلية يعني هذا علاج ذكي بيقولوا عنه أه علاج ذكي
+
+376
+00:36:27,430 --> 00:36:31,690
+هو ال structure and functioning إسرائيل طيب فيروس
+
+377
+00:36:31,690 --> 00:36:35,890
+تاني مدين كيانيز can metabolize أساقره جواله سينين
+
+378
+00:36:39,830 --> 00:36:43,630
+acycloguanosine الacycloguanosine هو اللي هو
+
+379
+00:36:43,630 --> 00:36:48,370
+Cyclovir أو ذوفيركس among others the chemical name
+
+380
+00:36:48,370 --> 00:36:52,190
+acycloguanosine هو يعني الacyclovir هو
+
+381
+00:36:52,190 --> 00:36:55,730
+الacycloguanosine يبقى الفيروس الحلمي دي can
+
+382
+00:36:55,730 --> 00:37:04,730
+metabolize الacyclovir يعني كأنه الفيروس بياخد
+
+383
+00:37:04,730 --> 00:37:10,570
+الacyclovirفي متابوليزمه تماما
+
+384
+00:37:10,570 --> 00:37:17,530
+كما بعض كانت تاخد السم و تظن طعام فإذا بيه قاتل
+
+385
+00:37:17,530 --> 00:37:25,190
+فالفيروس لما يحس بالacyclovir هذا بيبدأ يستخدم أيش
+
+386
+00:37:25,190 --> 00:37:32,350
+في متابوليزمه و هو بيكون أيش قاتل له بعد ذلك طيب
+
+387
+00:37:32,350 --> 00:37:34,170
+سم
+
+388
+00:37:36,440 --> 00:37:40,520
+بعد ذلك بعض الميوتانات الفيروسية قامت بإصلاح هذه
+
+389
+00:37:40,520 --> 00:37:44,460
+الميوتانات لإصلاح خمس ملاي كينايز ولكنها لم تكن
+
+390
+00:37:44,460 --> 00:37:45,800
+لديها عدد من عدد من عدد من عدد من عدد من عدد من
+
+391
+00:37:45,800 --> 00:37:47,000
+عدد من عدد من عدد من عدد من عدد من عدد من عدد من
+
+392
+00:37:47,000 --> 00:37:47,320
+عدد من عدد من عدد من عدد من عدد من عدد من عدد من
+
+393
+00:37:47,320 --> 00:37:48,780
+عدد من عدد من عدد من عدد من عدد من عدد من عدد من
+
+394
+00:37:48,780 --> 00:37:58,400
+عدد من عدد من عدد من عدد من عدد من عدد من عدد من
+
+395
+00:37:58,400 --> 00:38:05,880
+عدد من عد
+
+396
+00:38:06,000 --> 00:38:13,800
+يعني مش إيدائية كتير أو مش خطيرة كتير طيب أسائق
+
+397
+00:38:13,800 --> 00:38:18,500
+الأوكليين هي الصورة بتاعتهم كم
+
+398
+00:38:18,500 --> 00:38:23,980
+في المية؟ خمسة و خمسة و خمسة و خمسة و خمسة و خمسة
+
+399
+00:38:23,980 --> 00:38:24,440
+و خمسة و خمسة و خمسة و خمسة و خمسة و خمسة و خمسة و
+
+400
+00:38:24,440 --> 00:38:24,960
+خمسة و خمسة و خمسة و خمسة و خمسة و خمسة و خمسة و
+
+401
+00:38:24,960 --> 00:38:27,020
+خمسة و خمسة و خمسة و خمسة و خمسة و خمسة و خمسة و
+
+402
+00:38:27,020 --> 00:38:27,500
+خمسة و خمسة و خمسة و خمسة و خمسة و خمسة و خمسة و
+
+403
+00:38:27,500 --> 00:38:32,900
+خمسة و خمسة و
+
+404
+00:38:35,850 --> 00:38:39,390
+الهوكلي كريمات في السوق كتير كتير اي سيدارية
+
+405
+00:38:39,390 --> 00:38:43,950
+يقولوا بدي زوفي راكس للشفاية فهذا اللي بيطلع على
+
+406
+00:38:43,950 --> 00:38:48,570
+طول بيحكي يعنى او 100 الى 50 شكل تحقيقى اما ال
+
+407
+00:38:48,570 --> 00:38:54,210
+زوفي راكس بتاع العين فهو 100 شكل يعني ابو ايش؟ 25
+
+408
+00:38:54,210 --> 00:38:58,550
+دولار بتاع العين طيب
+
+409
+00:39:01,370 --> 00:39:04,570
+وكانت مستخدمة ضد المصابين اللي كانت مستخدمة من
+
+410
+00:39:04,570 --> 00:39:08,230
+الهيربس سيمبليكس اللي كانت مستخدمة من الهيربس
+
+411
+00:39:08,230 --> 00:39:08,630
+زيردين
+
+412
+00:39:17,660 --> 00:39:21,640
+اللي هو ال antivirals للعين انا بقول العين لان
+
+413
+00:39:21,640 --> 00:39:26,580
+الacyclovir was significantly more effective than
+
+414
+00:39:26,580 --> 00:39:30,460
+the other antivirals even on the drug resistant
+
+415
+00:39:30,460 --> 00:39:36,460
+strains يعني اذا فشل ال Xovirax او الacyclovir في
+
+416
+00:39:36,460 --> 00:39:42,270
+علاج dendritic ulcer فلا نجد له مبادئ حتى الآنيعني
+
+417
+00:39:42,270 --> 00:39:47,490
+هو الملك اللي احنا بنوصفه في حالات الـ Herpes
+
+418
+00:39:47,490 --> 00:39:51,850
+simplex sclerosis.acyclobate
+
+419
+00:39:51,850 --> 00:39:55,270
+-treated eyes showed less corneal epithelial
+
+420
+00:39:55,270 --> 00:39:59,910
+involvement and congenitivitis and exerted less
+
+421
+00:39:59,910 --> 00:40:06,230
+iritis and corneal clouding يعني بعد .. بعد العلاج
+
+422
+00:40:07,990 --> 00:40:12,610
+ليوم او اومين او تلاتة وجدوا ان وضع العين اللى
+
+423
+00:40:12,610 --> 00:40:17,550
+فيها infection بالفيروس تحسنت حتى ان الابيثيليام
+
+424
+00:40:17,550 --> 00:40:22,910
+صاروا less informant يعني مثلا في الأول كان مثلا
+
+425
+00:40:22,910 --> 00:40:28,770
+واحد ملم المربع مثلا اللى هو ال .. ال .. ال .. ال
+
+426
+00:40:28,770 --> 00:40:29,470
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+427
+00:40:29,470 --> 00:40:29,850
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+428
+00:40:29,850 --> 00:40:30,730
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+429
+00:40:30,730 --> 00:40:31,390
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+430
+00:40:31,390 --> 00:40:31,670
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+431
+00:40:31,670 --> 00:40:33,590
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+432
+00:40:33,590 --> 00:40:34,150
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+433
+00:40:34,150 --> 00:40:36,530
+.. ال .. ال .. ال ..
+
+434
+00:40:39,700 --> 00:40:44,560
+حتى التهاب الملتحمة وحتى التهاب ال IRIS جالان اول
+
+435
+00:40:44,560 --> 00:40:52,180
+هدري على ايش؟ على انه في قتل الفيروس او الفيروس
+
+436
+00:40:52,180 --> 00:41:00,240
+بدأ يهرب بدأ يهرب ثرابة ال GFX ده اشوف ايش تأثيرك
+
+437
+00:41:00,240 --> 00:41:06,660
+الهلاجي بقوللي ماك كيريوفريقه في الواحد والتمانين
+
+438
+00:41:06,660 --> 00:41:11,080
+compared aciclovir and vedarabine and found that
+
+439
+00:41:11,080 --> 00:41:15,300
+the former اللي هو aciclovir had a much better
+
+440
+00:41:15,300 --> 00:41:18,860
+rate of healing and reduction in symptoms of
+
+441
+00:41:18,860 --> 00:41:25,360
+corneal ulcer قارنوا في مرضى أعطوهم aciclovir وفي
+
+442
+00:41:25,360 --> 00:41:28,780
+مرضى أعطوهم vedarabine vedarabine اللي هو
+
+443
+00:41:28,780 --> 00:41:33,540
+antiviral تاني بس تاني ويدروا إن ال aciclovir تغلب
+
+444
+00:41:34,830 --> 00:41:38,590
+في العيون اللي وضع فيها على الـVeterinarian بشكل
+
+445
+00:41:38,590 --> 00:41:43,810
+في موضوع الـhealing، إيش healing؟ التئام، التئام
+
+446
+00:41:43,810 --> 00:41:49,970
+اللي هو .. اللي هي القرهة الفيروسية، اه الـred of
+
+447
+00:41:49,970 --> 00:41:53,530
+healing and reduction in symptoms، يعني حتى
+
+448
+00:41:53,530 --> 00:41:59,470
+الأعراض من الدمع وعرار الألم وعرار الـphotophobia،
+
+449
+00:41:59,470 --> 00:42:02,870
+اه والدمع الكثير قلة، أكتر من العيون
+
+450
+00:42:06,340 --> 00:42:10,240
+و فريقه found no difference between acyclobine and
+
+451
+00:42:10,240 --> 00:42:14,640
+idroxiridine هذا بحث تاني و قالوا انه مافي فارق
+
+452
+00:42:14,640 --> 00:42:19,080
+بين هذا الدواء و هذا الدواء طبعا عشان صد الفيكس
+
+453
+00:42:19,080 --> 00:42:23,380
+بتاعه طلعوه من السوق ايدروزيردين بقى الكلب فالفضل
+
+454
+00:42:23,380 --> 00:42:27,640
+اللي قلت مين الملك اللي هو هذا الacyclobine هو
+
+455
+00:42:27,640 --> 00:42:32,860
+اللي بيعمل rapid healing و reduction of symptoms
+
+456
+00:42:33,370 --> 00:42:37,170
+تاني because of its very selective action يعني
+
+457
+00:42:37,170 --> 00:42:41,190
+قولنا لا يعمل إلا على الخلايا التي داخلها فيروس
+
+458
+00:42:41,190 --> 00:42:45,310
+فده very selective action اختياري جدا does not
+
+459
+00:42:45,310 --> 00:42:49,170
+interfere with corneal wound healing whether
+
+460
+00:42:49,170 --> 00:42:56,150
+epithelial or stromal يبقى هو بس بيشتغل على حالات
+
+461
+00:42:56,150 --> 00:43:04,310
+الفيروس يعني لو مثلا في bacterial ulcer مخصوشلو في
+
+462
+00:43:04,310 --> 00:43:09,410
+post-operative wound ما خسوش، ما بيشتغلش عليه، بس
+
+463
+00:43:09,410 --> 00:43:15,890
+بيشتغل على الخلايا infected by virus 3. أساقروفين
+
+464
+00:43:15,890 --> 00:43:19,590
+had no significant effect on the regenerating
+
+465
+00:43:19,590 --> 00:43:25,010
+epithelial RA re-epithelialization surface walls
+
+466
+00:43:25,010 --> 00:43:30,550
+or on the collagen content of the stromal walls
+
+467
+00:43:33,310 --> 00:43:39,270
+إلا بس في حالات الفيروس بس for it is effective on
+
+468
+00:43:39,270 --> 00:43:43,190
+its own against dendritic and some unaboid ulcers
+
+469
+00:43:43,190 --> 00:43:47,070
+but larger and stromal ones require the addition
+
+470
+00:43:47,070 --> 00:43:51,410
+of a topical steroid for complete resolution يعني
+
+471
+00:43:51,410 --> 00:43:55,910
+هو وجدنا إحنا بيشتغل أكتر إشي عن epithelial herpes
+
+472
+00:43:55,910 --> 00:43:57,690
+simplex sclerotitis
+
+473
+00:44:03,380 --> 00:44:09,880
+في حالات chronic لجينا الفيروس راح دخل استرومال،
+
+474
+00:44:09,880 --> 00:44:17,760
+حط الدواء هذا اللي هو الacyclovir، بطل يأثر، حطيه
+
+475
+00:44:17,760 --> 00:44:23,800
+مع استيرويد، صار في .. كإن استيرويد فتح للفيروس
+
+476
+00:44:23,800 --> 00:44:29,960
+استرومال، فدائما استرومال كيلوتايتس
+
+477
+00:44:33,760 --> 00:44:36,720
+طب لو حطينا استرودة على الـ epithelial keratitis
+
+478
+00:44:36,720 --> 00:44:41,620
+مارفوش Contra indication Contra indication لازم
+
+479
+00:44:41,620 --> 00:44:46,460
+على ال استرودة طب احنا كيف نعرف الفيروس هو stromal
+
+480
+00:44:46,460 --> 00:44:53,060
+ولا Epithelial إذا Epithelial هيكون ظاهر فقرانيا
+
+481
+00:44:53,060 --> 00:44:57,000
+فشكل مباشر كيف؟ لما نجربه على استرودة اللي عملت
+
+482
+00:44:57,000 --> 00:45:00,280
+دورسيا اللي عملت دورسيا اللي عملت دورسيا اللي عملت
+
+483
+00:45:00,280 --> 00:45:00,960
+دورسيا اللي عملت دورسيا اللي عملت دورسيا اللي عملت
+
+484
+00:45:00,960 --> 00:45:01,400
+دورسيا اللي عملت دورسيا اللي عملت دورسيا اللي عملت
+
+485
+00:45:01,400 --> 00:45:04,440
+دورسيا اللي عملت دلازم نحط fluorescent لو
+
+486
+00:45:04,440 --> 00:45:11,940
+انويبثيليل هيكون قرحة شجرية واضحة جدا، ذندر تتأثر،
+
+487
+00:45:11,940 --> 00:45:21,780
+ذندر تتأثر، لكن لو كانت في أعراض لكن مافيش ذندر
+
+488
+00:45:21,780 --> 00:45:26,080
+تتأثر واضح على طول بنائها قنسترومل، بنائها
+
+489
+00:45:26,080 --> 00:45:31,800
+قنسترومل، بس كانت فيobesification، obesity،
+
+490
+00:45:31,800 --> 00:45:36,120
+formation فهذا على طول اللي بيقوم ال obesity هو
+
+491
+00:45:36,120 --> 00:45:42,420
+الكورتيزون، حط استيرايد مثلا استيرو ديكس مثلا، حط
+
+492
+00:45:42,420 --> 00:45:48,480
+مثلا predfor، maxdex، كل هذه الأدوية معروفة
+
+493
+00:45:48,480 --> 00:45:52,660
+بالإضافة إلى ال antiviral، لازم ال antiviral يخش
+
+494
+00:45:52,660 --> 00:45:52,840
+فيهم
+
+495
+00:45:57,590 --> 00:46:00,570
+اللي هو إيش؟ استيرويل اللي بيقولك استيرويل
+
+496
+00:46:00,570 --> 00:46:05,450
+فاليباتيرال بيعمل إيش؟ انتشار للفيروس، refreshment
+
+497
+00:46:05,450 --> 00:46:09,910
+للفيروس، لكن في stromal لأ لازم نحطه مع ال
+
+498
+00:46:09,910 --> 00:46:15,010
+antiviral طيب، اللي بقوله هنا إنه في الحياة ال
+
+499
+00:46:15,010 --> 00:46:17,850
+stromal و الحياة الكاميرة لازم ال asteroid يكون
+
+500
+00:46:17,850 --> 00:46:23,070
+موجود مع ال antiviral، هاي مثال الكون الألسث طبعا
+
+501
+00:46:23,070 --> 00:46:24,470
+هناك بكتيريال هنا
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/QJs1WI9_T2U_raw.json b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/QJs1WI9_T2U_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..3e02edb501bda30eefa991f32a999db71c6c10cb
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/QJs1WI9_T2U_raw.json
@@ -0,0 +1 @@
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أساقروفين had no significant effect on the regenerating epithelial RA re-epithelialization surface walls or on the collagen content of the stromal walls", "tokens": [1211, 2407, 8978, 2183, 12, 7192, 1166, 10999, 19446, 16490, 3794, 2407, 8592, 12399, 19446, 4724, 1829, 8592, 2655, 17082, 1211, 8592, 47356, 12399, 4724, 3794, 4724, 1829, 8592, 2655, 17082, 1211, 15844, 33962, 15040, 25528, 15414, 538, 5752, 805, 13, 5551, 3794, 995, 4587, 32887, 5172, 9957, 632, 572, 4776, 1802, 322, 264, 26358, 990, 2388, 355, 338, 831, 14626, 319, 12, 595, 355, 338, 831, 2144, 3753, 7920, 420, 322, 264, 40444, 2701, 295, 264, 1056, 298, 304, 7920], "avg_logprob": -0.34413110955459314, "compression_ratio": 1.345291479820628, "no_speech_prob": 0.0, "words": [{"start": 2583.71, "end": 2584.05, "word": "لو", "probability": 0.827392578125}, {"start": 2584.05, "end": 2584.31, "word": " في", "probability": 0.5986328125}, {"start": 2584.31, "end": 2584.83, "word": " post", "probability": 0.427734375}, 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\ No newline at end of file
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/Rbuq1T_8UdE_postprocess.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/Rbuq1T_8UdE_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..18a99f7451484f920d8e825dc66bdf296ca5003f
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/Rbuq1T_8UdE_postprocess.srt
@@ -0,0 +1,2048 @@
+1
+00:00:20,860 --> 00:00:25,380
+بسم الله الرحمن الرحيم، الحمد لله رب العالمين،
+
+2
+00:00:25,380 --> 00:00:31,420
+وابصلي وابسلم على حبيبنا وقرة أعيننا سيدنا محمد
+
+3
+00:00:31,420 --> 00:00:35,060
+صلى الله عليه وسلم وعلى آله واصحابي والتابعين
+
+4
+00:00:35,060 --> 00:00:40,520
+السلام عليكم ورحمة الله وبركاته في هذه المحاضرة
+
+5
+00:00:40,520 --> 00:00:47,600
+سنستكمل metabolism and elimination of drugs from
+
+6
+00:00:47,600 --> 00:00:48,260
+the eye
+
+7
+00:00:52,230 --> 00:01:00,790
+كما نعرف أن الانتباوتكات تتعلق بالدخول هم إما
+
+8
+00:01:00,790 --> 00:01:09,650
+الليكوفيليك أو الهيدروفيليك مثل الليكوفيليك
+
+9
+00:01:09,650 --> 00:01:11,570
+كلورانفينيكون
+
+10
+00:01:23,240 --> 00:01:29,180
+بسيطة بصورة كبيرة بسيطة بصورة كبيرة بسيطة بصورة
+
+11
+00:01:29,180 --> 00:01:31,700
+كبيرة بسيطة بصورة كبيرة بسيطة بصورة كبيرة بسيطة
+
+12
+00:01:31,700 --> 00:01:33,160
+بصورة كبيرة بسيطة بصورة كبيرة بسيطة بصورة كبيرة
+
+13
+00:01:33,160 --> 00:01:37,080
+بسيطة بصورة كبيرة بسيطة بصورة كبيرة بسيطة بصورة
+
+14
+00:01:37,080 --> 00:01:40,540
+كبيرة بسيطة بصورة كبيرة بسيطة بصورة كبيرة بسيطة
+
+15
+00:01:40,540 --> 00:01:40,580
+بصورة كبيرة بسيطة بصورة كبيرة بسيطة بصورة كبيرة
+
+16
+00:01:40,580 --> 00:01:52,580
+بسيطة بصورة كبيرة بسيطة بصورة كبيرة بسيطة
+
+17
+00:01:52,580 --> 00:01:59,200
+بصورسريع وعالى داخل الـ aqueous flow هو the
+
+18
+00:01:59,200 --> 00:02:02,980
+constant flow of aqueous from ciliary processes من
+
+19
+00:02:02,980 --> 00:02:06,980
+الخلف where it is secreted through the posterior
+
+20
+00:02:06,980 --> 00:02:13,180
+chamber, pupil and anterior chamber and out of the
+
+21
+00:02:13,180 --> 00:02:17,380
+eye via schlimps canal prevents the accumulation
+
+22
+00:02:17,380 --> 00:02:19,620
+of high concentrations of antibacterial
+
+23
+00:02:27,890 --> 00:02:37,050
+كلنا انه في المتوسط every 45 minutes the whole
+
+24
+00:02:37,050 --> 00:02:45,970
+aqueous chamber is turned over and replaced by new
+
+25
+00:02:45,970 --> 00:02:49,270
+aqueous from the celery processes
+
+26
+00:02:54,920 --> 00:03:01,060
+ما يمنع بقاء تركيز ال antibiotic inside the
+
+27
+00:03:01,060 --> 00:03:07,880
+aqueous humor for a long time عشان ما اشهر ممنع
+
+28
+00:03:07,880 --> 00:03:13,380
+انه يبقى ال antibiotic مركنا في ال aqueous لمدة
+
+29
+00:03:13,380 --> 00:03:17,880
+طويلة هو
+
+30
+00:03:17,880 --> 00:03:21,880
+بدور هو بدور هو بدخل و بيسأل ال antibiotic لكنه
+
+31
+00:03:21,880 --> 00:03:23,040
+مفضل يشعل peak
+
+32
+00:03:28,660 --> 00:03:38,040
+أبدا مش هيك عشان ترقب يعني كل .. بل ال antibody
+
+33
+00:03:38,040 --> 00:03:48,480
+مثلا هنا وصل كده ترقب و برد نزله لو هتركب انت و
+
+34
+00:03:48,480 --> 00:03:53,760
+تطلع فهي قد تطلعلو محطناش بنزل، لو تخرق، بنزل، لو
+
+35
+00:03:53,760 --> 00:03:57,440
+حطينا كمان قطرة، بتطلع هيك، وها كده، مجداش الوقت
+
+36
+00:03:57,440 --> 00:04:03,220
+يحافظ على ال peak، لأنه في عميل turn over، اخراج،
+
+37
+00:04:03,220 --> 00:04:08,080
+الدوة بياخد مع ال aqueous على برا، على الدم، واضح؟
+
+38
+00:04:08,080 --> 00:04:11,520
+إيهش الموضوع turn over؟ لذلك إحنا اسكبت نحافظ على
+
+39
+00:04:11,520 --> 00:04:16,300
+إنه ال drug يفضل على ال peak، بدنا نفضل كل every
+
+40
+00:04:16,300 --> 00:04:18,080
+one hour أو two hours
+
+41
+00:04:21,700 --> 00:04:27,240
+عشان انا احافظ على peak هيك stationary بيقضل every
+
+42
+00:04:27,240 --> 00:04:31,620
+hour حطله عشان اغلب الموضوع turnover of drugs
+
+43
+00:04:31,620 --> 00:04:40,500
+كويس؟ يعني عشان هيك حدات كله يعني تقتل أم إلى
+
+44
+00:04:40,500 --> 00:04:43,580
+الطبيب تقول والله اعطوني قطرة مثلا كلها في الكل
+
+45
+00:04:43,580 --> 00:04:48,600
+صباحا ومثلا ومادي ماتيش نتيجة ماريو قلتله صح
+
+46
+00:04:48,600 --> 00:04:54,960
+مابيجيه نتيجةالمفروض أن تقوم بعمله مرتين
+
+47
+00:04:54,960 --> 00:04:57,820
+في اليوم، مرتين في اليوم، مرتين في اليوم، مرتين في
+
+48
+00:04:57,820 --> 00:05:00,660
+اليوم، مرتين في اليوم، مرتين في اليوم، مرتين في
+
+49
+00:05:00,660 --> 00:05:00,700
+اليوم، مرتين في اليوم، مرتين في اليوم، مرتين في
+
+50
+00:05:00,700 --> 00:05:00,760
+اليوم، مرتين في اليوم، مرتين في اليوم، مرتين في
+
+51
+00:05:00,760 --> 00:05:00,860
+اليوم، مرتين في اليوم، مرتين في اليوم، مرتين في
+
+52
+00:05:00,860 --> 00:05:06,640
+اليوم، مرتين في اليوم، مرتين في اليوم، مرتين في
+
+53
+00:05:06,640 --> 00:05:09,340
+اليوم، مرتين في اليوم، مرتين في اليوم، مرتين
+
+54
+00:05:14,360 --> 00:05:17,840
+Some absorption of antibacterias from aqueous by
+
+55
+00:05:17,840 --> 00:05:24,000
+the anterior uvea. ايش uvea؟ Anterior uvea الـ I's
+
+56
+00:05:24,000 --> 00:05:30,300
+و ال anterior part of cellar body. هذا ال anterior
+
+57
+00:05:30,300 --> 00:05:34,420
+uvea و في المن ال uvea اللي هو ال posterior part
+
+58
+00:05:34,420 --> 00:05:37,400
+of cellar body and anterior part of chloride و ال
+
+59
+00:05:37,400 --> 00:05:43,060
+posterior uvea ال chloride من واحد نصه و برهبقول
+
+60
+00:05:43,060 --> 00:05:50,320
+انه في absorption inevitable راح يصير ال drug by
+
+61
+00:05:50,320 --> 00:05:57,200
+the uvea and lens كيف يعني؟ يعني الآن ال blood
+
+62
+00:05:57,200 --> 00:05:59,940
+بخلوين في ال anterior chamber و ال posterior
+
+63
+00:05:59,940 --> 00:06:04,380
+chamber و من الحاجات اللي في ال anterior chamber و
+
+64
+00:06:04,380 --> 00:06:07,900
+ال posterior chamber ال lens، the lens، the
+
+65
+00:06:07,900 --> 00:06:14,540
+nucleus، salivary body، والعيسفبيقول إنه حيصير
+
+66
+00:06:14,540 --> 00:06:24,860
+تسرب ماء للدواء في هذه المراكبات اللي داخلها يعني
+
+67
+00:06:24,860 --> 00:06:28,900
+كما إنه موقع التسريب للدواء بال turn over بيصير
+
+68
+00:06:28,900 --> 00:06:34,640
+عبر شلمس كانال وTropical مشوار أيضاً في شيء معين
+
+69
+00:06:34,640 --> 00:06:38,740
+ما لم يتسوج أكمل من الدواء بيصير عبر الcellular
+
+70
+00:06:38,740 --> 00:06:43,980
+body وعبر الionis وعبر اللنز وبروح الدمعشان هي
+
+71
+00:06:43,980 --> 00:06:50,860
+الدواء لابقى على peak لأنه فيه تسريب فيه leak فيه
+
+72
+00:06:50,860 --> 00:06:56,020
+leak طيب concentrations achieved in the vitreous
+
+73
+00:06:56,020 --> 00:06:59,420
+body following topical administration are
+
+74
+00:06:59,420 --> 00:07:05,640
+generally subtherapeutic هذا ال setting ال
+
+75
+00:07:05,640 --> 00:07:08,200
+administration of antibacterial by local
+
+76
+00:07:08,200 --> 00:07:09,540
+intravitreal injection
+
+77
+00:07:23,740 --> 00:07:28,960
+قورنيا وهنا آيلينز
+
+78
+00:07:28,960 --> 00:07:40,220
+آيلينز سيلاري بودي زوريول وهنا ال بتلس كل ال
+
+79
+00:07:40,220 --> 00:07:44,980
+chamber هذه بتلس الان انا اعطيه topical and
+
+80
+00:07:44,980 --> 00:07:45,440
+antibiotic
+
+81
+00:07:56,160 --> 00:08:00,620
+في الاتيوت الشمبا وبعدين في البستير الشمبا وبعدين
+
+82
+00:08:00,620 --> 00:08:07,560
+هنا stop ايش stop يعني؟ يبين مش هو ال barrier ال
+
+83
+00:08:07,560 --> 00:08:12,060
+lens ends on you ال lens ends on you barrier يبقى
+
+84
+00:08:12,060 --> 00:08:15,860
+انا كيف يدخل الدواء اللي انا وضعته هنا في العين
+
+85
+00:08:15,860 --> 00:08:21,820
+يدخل هنا و
+
+86
+00:08:21,820 --> 00:08:27,380
+لا يمكن هيك العلم بيقوللا يمكن لو اعطيك كل دقيقة
+
+87
+00:08:27,380 --> 00:08:33,620
+انه يستطيع انه يوصل هنا therapeutic level يعني
+
+88
+00:08:33,620 --> 00:08:46,480
+ممكن يصل 2% 3% من الدواء اللي دخلت يبقى هنا في
+
+89
+00:08:46,480 --> 00:08:52,100
+necessity ضرورة لو انا عندي هنا infection خاصة في
+
+90
+00:08:52,100 --> 00:08:53,240
+ال endothelmitis
+
+91
+00:08:55,440 --> 00:08:59,320
+Indothermic خطيرة ولا مش خطيرة هذه؟ هذه خطيرة
+
+92
+00:08:59,320 --> 00:09:06,640
+معناه انه لو انا صبرت يومين كل العين هصير bag of
+
+93
+00:09:06,640 --> 00:09:12,400
+pus كل العين هصير ايش؟ bag of pus و هتعمل
+
+94
+00:09:12,400 --> 00:09:14,900
+blindness و لا يشتغل .. حياته مجنون، blindness
+
+95
+00:09:14,900 --> 00:09:21,140
+العين كلها عايزة in equation او in isolation العين
+
+96
+00:09:21,140 --> 00:09:25,290
+عايزة غرف يعنيفالناس اللي بيفهموا على طول من أول
+
+97
+00:09:25,290 --> 00:09:29,350
+ما تفدي علامات ال endophthalmitis يعني blurring of
+
+98
+00:09:29,350 --> 00:09:36,130
+vision، pain و hazy cornea وقدرش انا اشوف ال ..
+
+99
+00:09:36,130 --> 00:09:39,310
+اللي هو ال retina على طول بقول هذه بداية
+
+100
+00:09:39,310 --> 00:09:43,250
+endophthalmitis تسريق ايش نعمل؟ على طول بجيبوا
+
+101
+00:09:43,250 --> 00:09:50,810
+syringe، syringe، اه جيبوا syringe فيها
+
+102
+00:09:56,600 --> 00:10:02,880
+وبروحوا هنا فى شىء اسمه هنا PARS PLANA فى حد يسمى
+
+103
+00:10:02,880 --> 00:10:06,480
+PARS PLANA الجزء الأمام من الـ Cerebellum فشلت
+
+104
+00:10:06,480 --> 00:10:09,160
+يعني أنا ديتنا ماتصلش هنا يعني ديتنا مثلا تبدأ هنا
+
+105
+00:10:09,160 --> 00:10:15,260
+ديتنا مثلا تبدأ هنا المنطقة هذه اسمها PARS PLANA
+
+106
+00:10:15,260 --> 00:10:21,700
+من ال PARS PLANA INJECTION Perfective Antibiotics
+
+107
+00:10:21,700 --> 00:10:27,410
+مرة و 12 ساعة مرة و 12 ساعة مرةلو بدنا .. احنا
+
+108
+00:10:27,410 --> 00:10:33,670
+ننقذ العين من الصليب، من العين أما أننا هنعطيه
+
+109
+00:10:33,670 --> 00:10:39,850
+topical أو حتى هنعطيه systemic intravenous يعني،
+
+110
+00:10:39,850 --> 00:10:43,750
+intravenous لأن في barrier آخر اسمه إيش ال barrier
+
+111
+00:10:43,750 --> 00:10:48,630
+الآخر؟ retinal blood barrier
+
+112
+00:10:52,960 --> 00:10:56,400
+فحتى لو انا اعطيت my way مش هكون effective زي
+
+113
+00:10:56,400 --> 00:11:01,540
+intravitreal injection of effective antibiotics
+
+114
+00:11:01,540 --> 00:11:07,020
+عايزة النقطة تكون clear عنكم؟ انا مش عايز انتوا
+
+115
+00:11:07,020 --> 00:11:10,680
+تنافسوا intravitreal injection بس لو في خيالكوا
+
+116
+00:11:10,680 --> 00:11:14,620
+انه في حالة خاصة post operative عمل عملية خاصة
+
+117
+00:11:14,620 --> 00:11:19,140
+cataract اكتر من عمليات cataract احيانا بيصير فيها
+
+118
+00:11:19,140 --> 00:11:25,320
+بداية infectionمريض بدأ يشهر بال .. بالقلم وبلايك
+
+119
+00:11:25,320 --> 00:11:33,520
+of vegan وهيزيكوميا على السريع لو في team of
+
+120
+00:11:33,520 --> 00:11:38,260
+ophthalmologists and surgeries to do intravitreal
+
+121
+00:11:38,260 --> 00:11:44,400
+injection طيب
+
+122
+00:11:44,400 --> 00:11:50,120
+الآن هنسى ال .. periocular injection
+
+123
+00:11:53,410 --> 00:11:59,730
+الانجبشن كما ترون انه ليس في الانترابتريا في أمام
+
+124
+00:11:59,730 --> 00:12:06,510
+العين يعني غالبا ساب كونجنهتائفل تحت المنتحمة يعني
+
+125
+00:12:06,510 --> 00:12:10,070
+عامة الهيدروفيلكاتراكس مفيدة أكتر عندما يتم
+
+126
+00:12:10,070 --> 00:12:17,350
+إعطائها ساب كونجنهتائفل روت يعني الابيثيليم و
+
+127
+00:12:17,350 --> 00:12:19,810
+الهندر الabsorption
+
+128
+00:12:23,650 --> 00:12:30,750
+فأنا كيف أتغلب؟ أعمل injection subconjunctiva هاي
+
+129
+00:12:30,750 --> 00:12:35,770
+المبتحمة اللي فيها ال blood vessels تحتها أعطي
+
+130
+00:12:35,770 --> 00:12:40,270
+مثلا دي طميسين absorption occurs from the residual
+
+131
+00:12:40,270 --> 00:12:43,270
+water أو ال drugs of the subconjunctiva الدي بط
+
+132
+00:12:43,270 --> 00:12:46,810
+which is not subject to precordial factors as in
+
+133
+00:12:46,810 --> 00:12:52,480
+topical application طبعا أنا لما بدي أعطيصحيح كنا
+
+134
+00:12:52,480 --> 00:12:59,140
+نكتب ال injection هنا هاي الملتحمة هنا في المطبخ
+
+135
+00:12:59,140 --> 00:13:05,140
+هذه بتعطي
+
+136
+00:13:05,140 --> 00:13:09,540
+جزء الأمام من ال sclera بدي انا اوضع هنا
+
+137
+00:13:09,540 --> 00:13:14,900
+antibiotic معين اللي هو خاصة ال hydrophilic طبعا
+
+138
+00:13:14,900 --> 00:13:19,580
+لما اعطي ال hydrophilic هصير swing ال drugs هتفصل
+
+139
+00:13:21,500 --> 00:13:27,780
+الوطن اللي انا حاجته الوطن اللي انا حاجته الوطن
+
+140
+00:13:27,780 --> 00:13:36,700
+اللي انا حاجته الوطن اللي انا حاجته الوطن
+
+141
+00:13:36,700 --> 00:13:37,560
+اللي انا حاجته الوطن اللي انا حاجته الوطن اللي انا
+
+142
+00:13:37,560 --> 00:13:37,600
+الوطن اللي انا حاجته الوطن اللي انا حاجته الوطن
+
+143
+00:13:37,600 --> 00:13:48,720
+اللي انا حاجته الوطن اللي انا حاجته الوطن
+
+144
+00:13:49,980 --> 00:13:54,360
+هي اتسلل البطارية او اخرى من هنا و من هنا الى داخل
+
+145
+00:13:54,360 --> 00:13:58,360
+الاكيواز اللى هون فالان تبقى symbol of restriction
+
+146
+00:13:58,360 --> 00:14:05,240
+طيب مين أسرع ان انا اعطيت الدواء المائي من هنا ولا
+
+147
+00:14:05,240 --> 00:14:11,780
+من هنا لأ بالحواجة أسرع بالحواجة أسرع و انا اكون
+
+148
+00:14:11,780 --> 00:14:17,240
+أحيان مضطر اضطرارا في حياة الكورة الألزر ان اعطي
+
+149
+00:14:18,010 --> 00:14:24,030
+Tropical lipophilic antibiotic drops and
+
+150
+00:14:24,030 --> 00:14:29,590
+subconjunctival hydrophilic injection، هنا
+
+151
+00:14:29,590 --> 00:14:33,730
+hydrophilic وهنا lipophilic، to save the cornea
+
+152
+00:14:33,730 --> 00:14:34,870
+from damage
+
+153
+00:14:57,630 --> 00:15:00,010
+الكنجلك تايبا الابيثيليام هو عبارة عن عبارة عن
+
+154
+00:15:00,010 --> 00:15:01,030
+عبارة عن عبارة عن عبارة عن عبارة عن عبارة عن عبارة
+
+155
+00:15:01,030 --> 00:15:01,690
+عن عبارة عن عبارة عن عبارة عن عبارة عن عبارة عن
+
+156
+00:15:01,690 --> 00:15:05,390
+عبارة عن عبارة عن عبارة عن عبارة عن عبارة عن عبارة
+
+157
+00:15:05,390 --> 00:15:11,610
+عن عبارة عن عبارة عن عبارة عن عبارة عن عبارة عن
+
+158
+00:15:11,610 --> 00:15:12,230
+عبارة عن عبارة عن عبارة عن عبارة عن عبارة عن عبارة
+
+159
+00:15:12,230 --> 00:15:18,650
+عبارة عن عبارة عن عبارة عن عبارة عن عبارة عن عبارة
+
+160
+00:15:18,650 --> 00:15:26,550
+عن عب
+
+161
+00:15:28,860 --> 00:15:32,740
+Advantages of peri-occurring injections ما هي
+
+162
+00:15:32,740 --> 00:15:39,560
+المزايا للحاقن تحت المتحنة؟ One, a clinical
+
+163
+00:15:39,560 --> 00:15:42,900
+approach of administration often provides therapy
+
+164
+00:15:42,900 --> 00:15:46,420
+to claim effective drug labels in aqueous for
+
+165
+00:15:46,420 --> 00:15:50,420
+eight to twelve hours after a single injection
+
+166
+00:15:50,420 --> 00:15:56,760
+يعني الحُب ده راح هتفضل من تمانية إلى اتناشر ساعة
+
+167
+00:16:04,670 --> 00:16:13,730
+عكس ال drops يمكن بدي ساعة كل ساعة مثلا طيب
+
+168
+00:16:13,730 --> 00:16:18,110
+flow in studies of subcontractable injections of
+
+169
+00:16:18,110 --> 00:16:23,610
+third generation kefalosporin مضاد حيوي زي keflix
+
+170
+00:16:23,610 --> 00:16:28,690
+injection the common levels achieved were four
+
+171
+00:16:28,690 --> 00:16:32,110
+fold higher than level in aqueous concentration
+
+172
+00:16:33,730 --> 00:16:37,990
+ولما أنا عملت الحقنة تحت المتحمة و قصد بعد فترة
+
+173
+00:16:37,990 --> 00:16:45,230
+لجيت التركيز داخل stroma مثلا أكتر
+
+174
+00:16:45,230 --> 00:16:49,590
+من ال aqueous تركيز دعا بارة مرة بارة تلت مرات
+
+175
+00:16:49,590 --> 00:16:56,830
+يعني يعني four في الكوميا to one في ال aqueous طيب
+
+176
+00:16:56,830 --> 00:17:02,710
+برضه بعض ال injection في المتحمة أيضا تحت المتحمة
+
+177
+00:17:03,870 --> 00:17:08,370
+ووجدوا أن تنكيز الدواء المضاد للحياة والماء في
+
+178
+00:17:08,370 --> 00:17:16,010
+الكوررويد أكتر من ال retina فى five-fourth of the
+
+179
+00:17:16,010 --> 00:17:22,110
+كوررويد و five-fourth خمس مرات to fifteen-fourth
+
+180
+00:17:22,110 --> 00:17:29,230
+خمسة إلى خمستاشر يعني than of the retina يعني ثلاث
+
+181
+00:17:29,230 --> 00:17:31,790
+أقاط الأقل وخمستاشر أكتر
+
+182
+00:17:33,840 --> 00:17:43,180
+اللي يبدو انه قرب المسافة .. ايوة يعني زي مثلا انا
+
+183
+00:17:43,180 --> 00:17:47,600
+ماجرة ميه، ماجرة ميه، انا متوقع ان جوانب الميه
+
+184
+00:17:47,600 --> 00:17:55,280
+المباشرة هتكون رطبة اكتر من الحواف الأبعاد، صحيح؟
+
+185
+00:17:55,280 --> 00:18:02,260
+يعني .. يعني لو في جدول ميه ماشيكل ما قررت أنا على
+
+186
+00:18:02,260 --> 00:18:06,320
+حواف الجدول هكون فيه مية أكتر وكل ما قعدت هيكون
+
+187
+00:18:06,320 --> 00:18:11,920
+مية أقل بالحقنة أكتر تركيز هيكون في القرن بقعده في
+
+188
+00:18:11,920 --> 00:18:16,340
+الأكواز، بقعده في القرن، بقعده في الريتينال، طب في
+
+189
+00:18:16,340 --> 00:18:24,140
+الفيترياس؟ نل، نل، تريس الريتينال
+
+190
+00:18:24,140 --> 00:18:31,010
+10 to 1 في الفيترياسلان انا ببيبين ليش انه very
+
+191
+00:18:31,010 --> 00:18:35,670
+poor concentration of periocar injection in the
+
+192
+00:18:35,670 --> 00:18:40,350
+petrius عشان اقولك انه ليس مديل عن البرزي بلانة
+
+193
+00:18:40,350 --> 00:18:42,750
+intra petrial injection
+
+194
+00:18:55,150 --> 00:18:58,270
+Thus there is a significant concentration gradient
+
+195
+00:18:58,270 --> 00:19:02,150
+تدوند يعني from coral to retina and from retina to
+
+196
+00:19:02,150 --> 00:19:06,210
+petrius يعني لو بدي أعملها نسبة و تناسب في جدول
+
+197
+00:19:06,210 --> 00:19:09,670
+بطل التركيز في القرانية
+
+198
+00:19:27,800 --> 00:19:34,280
+مقال هذا يشير إلى أن إستخدامات غير مستخدمة لا يمكن
+
+199
+00:19:34,280 --> 00:19:36,420
+تغيير إستخدامات إستخدامات إستخدامات إستخدامات
+
+200
+00:19:36,420 --> 00:19:37,800
+إستخدامات إستخدامات إستخدامات إستخدامات إستخدامات
+
+201
+00:19:37,800 --> 00:19:44,960
+إستخدامات إستخدامات إستخدامات
+
+202
+00:19:55,440 --> 00:19:59,660
+ويعني جهلا بعض الناس بيقولك يا شيخ حُط تختمر
+
+203
+00:19:59,660 --> 00:20:06,540
+التحمة و بعدين تمشي الأمور لأ تمشيش الأمور لأن حسب
+
+204
+00:20:06,540 --> 00:20:12,000
+التقارير العلمية ان ال vitreous ما بيصلوش بيفضل في
+
+205
+00:20:12,000 --> 00:20:19,600
+barrier من ال zaniole and lins similarly
+
+206
+00:20:19,600 --> 00:20:24,880
+psychotropic addictions are notand effective and
+
+207
+00:20:24,880 --> 00:20:27,780
+frequent topical application in treating keratitis
+
+208
+00:20:27,780 --> 00:20:30,600
+and should be limited to situations
+
+209
+00:20:54,080 --> 00:21:00,240
+than subglottal injection in the treatment of
+
+210
+00:21:00,240 --> 00:21:06,620
+endosalmitis العكس؟ العكس؟
+
+211
+00:21:06,620 --> 00:21:11,920
+ده صح؟ اه صح، endosalmitis
+
+212
+00:21:11,920 --> 00:21:21,920
+طيب النتيجة التانية اللي بنصلها انه frequent تبوه
+
+213
+00:21:21,920 --> 00:21:22,180
+هذه
+
+214
+00:21:27,650 --> 00:21:34,390
+Drug installation كترة كل ساعة is more effective
+
+215
+00:21:34,390 --> 00:21:40,670
+than subconjunctal injection in treatment of
+
+216
+00:21:40,670 --> 00:21:45,230
+keratitis ومنها الكورنالألثر مين أحسن؟ اعطيه إبرا
+
+217
+00:21:45,230 --> 00:21:49,270
+صباح ومساء للكورنالألثر
+
+218
+00:21:49,270 --> 00:21:57,680
+ولا اعطيه كل ساعة قطرة اتبعتك؟ لأ طيب العكسأنا في
+
+219
+00:21:57,680 --> 00:22:03,760
+عندي هنا حاجة اسمها acute radicyclitis تعرفون
+
+220
+00:22:03,760 --> 00:22:09,600
+radicyclitis؟ طب علاج الكورتيزون؟ Stimulix؟ و
+
+221
+00:22:09,600 --> 00:22:17,160
+الكلام هذا؟ كويس؟ Bradford؟ مين أفضل هنا؟ أعطي
+
+222
+00:22:17,160 --> 00:22:23,340
+frequent .. frequent اللي هو topical
+
+223
+00:22:49,540 --> 00:22:54,760
+الحالات اللي انا بدأ اختارها احقنها في العين تحت
+
+224
+00:22:54,760 --> 00:22:55,360
+المرتاحة
+
+225
+00:22:59,240 --> 00:23:05,980
+أو الطريقة الانتراثية للدراسة تعتمد على اولا،
+
+226
+00:23:05,980 --> 00:23:10,800
+قدرة الدراجات على التدخل في الكورية، لو كانت
+
+227
+00:23:10,800 --> 00:23:14,880
+الدراجة إيبوفيليكية أفضل اعطيها قطرة، لو كانت
+
+228
+00:23:14,880 --> 00:23:18,600
+هيدروفيليكية اعطيها دبشتين اثنان، موقع موقع
+
+229
+00:23:18,600 --> 00:23:26,690
+المواجهة، وين المرض، هل المرض سطحي ولا ديب؟بقول
+
+230
+00:23:26,690 --> 00:23:30,970
+ايه؟ ال general leads and lead margins، ال lead
+
+231
+00:23:30,970 --> 00:23:32,990
+infection و ال lead margins، عارفين ال lead
+
+232
+00:23:32,990 --> 00:23:36,670
+margins هنا؟ بيصير فيها seborrheic blepharitis،
+
+233
+00:23:36,670 --> 00:23:41,570
+اسمها blepharitis هنا، بكتيريا blepharitis، افضل
+
+234
+00:23:41,570 --> 00:23:46,850
+ان يعطيها ايش؟ ointment، لان ointment بيبقى على ال
+
+235
+00:23:46,850 --> 00:23:52,590
+lead و lead margins طيب، بيت، و الأزم .. كنت جدا
+
+236
+00:23:52,590 --> 00:24:00,050
+كتابةلينبس كوريا ال interior chamber اللي أفضل ان
+
+237
+00:24:00,050 --> 00:24:07,210
+اعطيهم topical frequent installation اما
+
+238
+00:24:07,210 --> 00:24:12,210
+solutions او اللي هو suspensions المهم قطرة لان
+
+239
+00:24:12,210 --> 00:24:16,930
+المنتج همال كوريا وحتى ال AC قطرة كل ساعة او كل
+
+240
+00:24:16,930 --> 00:24:17,350
+ساعتين
+
+241
+00:24:27,110 --> 00:24:32,090
+مش شايف اول 24 ساعة فيه من داخله للحجار مش صعبه ال
+
+242
+00:24:32,090 --> 00:24:36,010
+stuff in your stomach مش صعب طيب drugs
+
+243
+00:24:36,010 --> 00:24:38,890
+administered systemically systemically يعني
+
+244
+00:24:38,890 --> 00:24:43,590
+بالوريد مثلا او بالأقلاص penetrate the aqueous and
+
+245
+00:24:43,590 --> 00:24:50,050
+vitreous humor with difficulty لأن في عندي two
+
+246
+00:24:50,050 --> 00:24:53,970
+barriers blood aqueous barrier و blood retinal
+
+247
+00:24:53,970 --> 00:24:57,880
+barrier و هذا كله اتكلمنا فيهPenetration into the
+
+248
+00:24:57,880 --> 00:25:00,500
+aqueous humor is restricted by blood aqueous
+
+249
+00:25:00,500 --> 00:25:03,360
+barrier which exists between the endothelium
+
+250
+00:25:03,360 --> 00:25:05,200
+overlying the capillaries of the iris and cerebral
+
+251
+00:25:05,200 --> 00:25:11,240
+body which has a tie intracellular junctions
+
+252
+00:25:11,240 --> 00:25:17,780
+وPenetration
+
+253
+00:25:17,780 --> 00:25:22,240
+in the Petrius يشبه من الدوائل الخشبكية للبتريس
+
+254
+00:25:42,420 --> 00:25:53,460
+شال هنا شال الانس و الذنوب و وضع هنا دوة و قعدت ان
+
+255
+00:25:53,460 --> 00:25:57,880
+الدواء بيخش هنا راحزين؟
+
+256
+00:25:57,880 --> 00:26:05,560
+لما شال الانس و الذنوب و وضع قطرة و قاس بعد فترة
+
+257
+00:26:05,560 --> 00:26:08,200
+قبل aspiration يعني سحب
+
+258
+00:26:11,250 --> 00:26:15,790
+هو ايش اذا ال .. البرنامج العق .. اذا العق
+
+259
+00:26:15,790 --> 00:26:21,990
+التشريحي من أمام الدواء بس عادي يعني لما اشيل ال
+
+260
+00:26:21,990 --> 00:26:29,910
+lens و اشيل ال zonule هيصير ايش افكك افكك
+
+261
+00:26:29,910 --> 00:26:34,490
+افكك افكك افكك افكك افكك افكك افكك افكك افكك افكك
+
+262
+00:26:34,490 --> 00:26:38,850
+افكك افكك افكك افكك افكك افكك افكك افكك افكك افكك
+
+263
+00:26:38,850 --> 00:26:42,780
+افكك افكك افكك افكك افكك افكك افكك افكك افnear or
+
+264
+00:26:42,780 --> 00:26:47,360
+distant انت بشوف قريب ولا مش قريب؟ مافيش IO ايه؟
+
+265
+00:26:47,360 --> 00:26:57,140
+هو shallow عشان التجربة shallow مقول لي برضه هاي
+
+266
+00:26:57,140 --> 00:27:00,960
+الطريقة تدخل النوع ال matrius بس هاي الطريقة
+
+267
+00:27:00,960 --> 00:27:07,600
+التجاربية مش عمالية يعني وفي حالة ال inflammation
+
+268
+00:27:07,600 --> 00:27:10,240
+في
+
+269
+00:27:12,230 --> 00:27:15,870
+ال .. ال
+
+270
+00:27:15,870 --> 00:27:20,770
+.. ال blood vessels او ال retina يكون فيه نوع من
+
+271
+00:27:20,770 --> 00:27:27,970
+ال vasculitis فى ال vasculitis او ال retinitis ال
+
+272
+00:27:27,970 --> 00:27:31,770
+blood vessel اللى بيكون كده بيكون ال endothelium
+
+273
+00:27:31,770 --> 00:27:35,250
+tightly
+
+274
+00:27:35,250 --> 00:27:41,790
+lining the vesselلو صار باسكولاتس بصير ..
+
+275
+00:27:41,790 --> 00:27:42,930
+باسكولاتس بصير .. باسكولاتس بصير .. باسكولاتس بصير
+
+276
+00:27:42,930 --> 00:27:43,130
+.. باسكولاتس بصير .. باسكولاتس بصير .. باسكولاتس
+
+277
+00:27:43,130 --> 00:27:43,470
+بصير .. باسكولاتس بصير .. باسكولاتس بصير ..
+
+278
+00:27:43,470 --> 00:27:45,890
+باسكولاتس بصير .. باسكولاتس بصير .. باسكولاتس بصير
+
+279
+00:27:45,890 --> 00:27:47,410
+.. باسكولاتس بصير .. باسكولاتس بصير .. باسكولاتس
+
+280
+00:27:47,410 --> 00:27:52,270
+بصير .. باسكولاتس بصير .. باسكولاتس بصير ..
+
+281
+00:27:52,270 --> 00:27:56,350
+باسكولاتس بصير .. باسكولاتس بصير .. باسكولاتس بصير
+
+282
+00:27:56,350 --> 00:28:02,310
+.. باسكولاتس بصير
+
+283
+00:28:02,310 --> 00:28:06,030
+.. باسكولاتس بصير ..
+
+284
+00:28:12,660 --> 00:28:19,640
+الـ chapter 10 factors affecting the choice of
+
+285
+00:28:19,640 --> 00:28:28,140
+diagnostic drugs factors العوامل التي تؤثر على
+
+286
+00:28:28,140 --> 00:28:36,120
+اختيار الدواء التشخيصي في العين في العين في أدوية
+
+287
+00:28:36,120 --> 00:28:41,420
+تشخيصيةو هنشوف جيش الأدوات التشكيسية و كيف انا
+
+288
+00:28:41,420 --> 00:28:47,180
+اختارها في الآية او ده دواة تشكيسية Cyclopidics
+
+289
+00:28:47,180 --> 00:28:54,540
+تشكيس ليه؟ خاصة
+
+290
+00:28:54,540 --> 00:28:57,540
+للـ Latent Hyperloop
+
+291
+00:29:03,260 --> 00:29:06,480
+Esotropia. Children Esotropia. يبقى
+
+292
+00:29:06,480 --> 00:29:09,220
+Psychopolitics، this group has suffered some
+
+293
+00:29:09,220 --> 00:29:14,140
+attrition، تآكلة. And from an original list of
+
+294
+00:29:14,140 --> 00:29:19,560
+seven كانوا قبل عشرين سنة، seven psychopolitics.
+
+295
+00:29:21,280 --> 00:29:27,620
+Only four now remain. الآن في دلوقت أربعة. إيش ال
+
+296
+00:29:27,620 --> 00:29:29,540
+.. ال psychopolitics اللي أنتوا عارفينها؟
+
+297
+00:29:29,540 --> 00:29:30,260
+Psychopolitics
+
+298
+00:29:43,160 --> 00:30:00,520
+مدرياتك مدرياتك كانت مجموعة طويلة
+
+299
+00:30:00,520 --> 00:30:01,880
+من مجموعات مدرياتك
+
+300
+00:30:15,560 --> 00:30:21,060
+فاضل ان انا عندي مدرسين
+
+301
+00:30:21,060 --> 00:30:28,500
+يعني وفاضل ان انا عندي فلائل افرين more potent
+
+302
+00:30:28,500 --> 00:30:32,420
+genetics are used prior to surgery طبعا انا
+
+303
+00:30:32,420 --> 00:30:38,630
+مابعتبرش ان الاطرابينهو منرياتيك لوحده لأنه ان
+
+304
+00:30:38,630 --> 00:30:44,770
+حاطبنا عمل سيبير اياشترا فانما المدرياتيك اللي هو
+
+305
+00:30:44,770 --> 00:30:52,330
+شغال اللي هو المدرع معاه و الفلالفلي اللي مشتمش
+
+306
+00:30:52,330 --> 00:30:56,790
+على السينابودي إلا بنسبة قليلة ده هو التشخيص
+
+307
+00:30:56,790 --> 00:31:01,190
+التالت myotics المضيقات
+
+308
+00:31:05,680 --> 00:31:11,360
+الخطوات الأكبر حدثت من هذا الانتجاب بقول أكتر لسة
+
+309
+00:31:11,360 --> 00:31:17,300
+منهم فقدت لون يعني في أعضاها هي هذه ميوتيكس لديها
+
+310
+00:31:17,300 --> 00:31:20,540
+استعمال
+
+311
+00:31:20,540 --> 00:31:26,940
+يوميا يكون ثيرابيوتيكي ودياجنوستيكي تشخيزي وعلاجي
+
+312
+00:31:26,940 --> 00:31:33,780
+طبعا بالنسبة للعلاج يكون هنا open angle glaucoma
+
+313
+00:31:35,790 --> 00:31:44,270
+والتشخيص ايه؟ والتشخيص ايه؟ شوف ال pupil size وشوف
+
+314
+00:31:44,270 --> 00:31:48,450
+اللي هو ال muscle .. the muscle اللي هي ال spectro
+
+315
+00:31:48,450 --> 00:31:53,030
+-pili القوة بتاعك طب local anesthetics
+
+316
+00:32:08,770 --> 00:32:13,850
+أما من أن الـ Optometrist باستخدام قفل توروميتر
+
+317
+00:32:13,850 --> 00:32:18,810
+بقياس برطلعين ال range of local anesthetics has
+
+318
+00:32:18,810 --> 00:32:23,130
+remained fairly steady لكن لمزال استعمالها عند
+
+319
+00:32:23,130 --> 00:32:26,250
+Optometrist موجودة ثابتة cocaine
+
+320
+00:32:29,990 --> 00:32:33,830
+سايدينفكسي كتيرة بطلوا يستعملوه is now really used
+
+321
+00:32:33,830 --> 00:32:38,790
+medically because better agents are available يعني
+
+322
+00:32:38,790 --> 00:32:42,450
+زي ال bio carbine مثلا ال bio carbine هو ال
+
+323
+00:32:42,450 --> 00:32:48,790
+dominant قال هو ال .. أسف ال bio carbine اللي هو
+
+324
+00:32:48,790 --> 00:32:52,730
+ال myotic لكن ال local aesthetics لوكالين ليه
+
+325
+00:32:52,730 --> 00:32:58,400
+دوكايين؟ ليه دوكايين is dominantالكوكاين كان بيعمل
+
+326
+00:32:58,400 --> 00:33:04,040
+اللي هو شيء من التسكين وشيء، الآن obsolete. إيه
+
+327
+00:33:04,040 --> 00:33:09,980
+وصلة للإفلتس؟ الآن الليدو كيين. طبعا عند الأطباء
+
+328
+00:33:09,980 --> 00:33:15,720
+العيون مافيش طبيعو مستغنى عن اللي هو ال local
+
+329
+00:33:15,720 --> 00:33:18,420
+anesthetic أو ال topical anesthetic.
+
+330
+00:33:23,520 --> 00:33:31,180
+لأنه مهم جدا في أي .. يعني ال treatment ..
+
+331
+00:33:31,180 --> 00:33:35,880
+superficial treatment لكوابيرا كليرطية، مثلا إزالة
+
+332
+00:33:35,880 --> 00:33:43,160
+جسم غريب، قياس، اللي هو ضغط العين، أكوابير، أه، في
+
+333
+00:33:43,160 --> 00:33:45,740
+أش .. أكتر من أيه اللي هو استعمال ليه؟ اللي هو
+
+334
+00:33:45,740 --> 00:33:51,640
+local أو topical anestheticفي كمان drugs اللي
+
+335
+00:33:51,640 --> 00:33:58,100
+بتستخدم في الoptometry تشخيصية stains الأصبار ايضا
+
+336
+00:33:58,100 --> 00:34:05,340
+this is one area that at one time appeared to have
+
+337
+00:34:05,340 --> 00:34:10,520
+growth يعني قبل مثلا عشرين سنة كانت منتعشة في
+
+338
+00:34:10,520 --> 00:34:11,580
+أصبار زيادة
+
+339
+00:34:14,930 --> 00:34:19,990
+two stains are used routinely بس اتنين and the use
+
+340
+00:34:19,990 --> 00:34:25,210
+of one product cease ده ده هو ال king of stains
+
+341
+00:34:25,210 --> 00:34:29,850
+floating لكن
+
+342
+00:34:29,850 --> 00:34:35,950
+أشيل بلور وبعض ال drugs الآن أصبحت يعني قليلة
+
+343
+00:34:35,950 --> 00:34:43,390
+أصبحت قليلة فهي five groups of diagnostic
+
+344
+00:34:49,230 --> 00:34:56,250
+ماذا يعني مزايا دراجات دياجموستيكية دراجات
+
+345
+00:34:56,250 --> 00:34:56,970
+دياجموستيكية دراجات دياجموستيكية دراجات
+
+346
+00:34:56,970 --> 00:34:58,710
+دياجموستيكية دراجات دياجموستيكية دراجات
+
+347
+00:34:58,710 --> 00:35:01,550
+دياجموستيكية دراجات دياجموستيكية دراجات
+
+348
+00:35:01,550 --> 00:35:02,070
+دياجموستيكية دراجات دياجموستيكية دراجات
+
+349
+00:35:02,070 --> 00:35:02,090
+دياجموستيكية دراجات دياجموستيكية دراجات
+
+350
+00:35:02,090 --> 00:35:06,110
+دياجموستيكية دراجات دياج
+
+351
+00:35:10,670 --> 00:35:15,790
+يعني هذه الثلاثة مزايا غابت، فيعني إيش فادة
+
+352
+00:35:15,790 --> 00:35:23,530
+الدرجة؟ أول مزية easier under pressure سهل للمريض،
+
+353
+00:35:23,530 --> 00:35:27,930
+مايعمليش irritation، مايعمليش burning، مايعمليش
+
+354
+00:35:27,930 --> 00:35:28,950
+stinging
+
+355
+00:35:34,970 --> 00:35:40,510
+يكون سهل ما يلوث ثيابه ما يلوث جلده يعني easier to
+
+356
+00:35:40,510 --> 00:35:43,690
+another patient this certainly applies when the
+
+357
+00:35:43,690 --> 00:35:46,350
+procedure involves a local anesthetic خاصة في
+
+358
+00:35:46,350 --> 00:35:49,570
+الفنجر موضعي او for other agents if the use of
+
+359
+00:35:49,570 --> 00:35:52,270
+diagnostic drug will allow the examination to be
+
+360
+00:35:52,270 --> 00:35:56,670
+carried out quicker and more efficiently then this
+
+361
+00:35:56,670 --> 00:36:00,290
+will be to the patients advantage يعني انا بدي
+
+362
+00:36:00,290 --> 00:36:10,900
+سريع وسهلتحط ال drug تعملي القياس و امشي ال
+
+363
+00:36:10,900 --> 00:36:14,980
+patient مش عايز يطيب الأسنان يطيب الأسنان يعمل
+
+364
+00:36:14,980 --> 00:36:20,920
+اللي هو في الجامعة injection تنتظر نصف ساعة لغاية
+
+365
+00:36:20,920 --> 00:36:26,280
+ما يعملك خدل في نصف وجهك من أعلى من أسفل و أنت
+
+366
+00:36:26,280 --> 00:36:30,300
+طبعا خايف خوف لأنهم يقولك تعالي يعني معناه إيش
+
+367
+00:36:30,300 --> 00:36:35,830
+مابدو يخلع و يعملوكلام زي هذا، لأ احنا بدنا ال ..
+
+368
+00:36:35,830 --> 00:36:41,290
+ال .. ال optometrist يكون ايش؟ يعني سهل، مافيش فيه
+
+369
+00:36:41,290 --> 00:36:45,750
+يعني عقاب يعني، يبقى سهل للمريض، تعني easier for
+
+370
+00:36:45,750 --> 00:36:51,210
+practitioners الممارس، ال optometrist، فانا بقدرش
+
+371
+00:36:51,210 --> 00:36:56,870
+بقى احنا بحط نقطة ال .. ال .. ال .. ال الوكيينلأنه
+
+372
+00:36:56,870 --> 00:37:01,130
+على طول يتجاوب مايوش المريض يتقلق مثلا لما حط نقطة
+
+373
+00:37:01,130 --> 00:37:06,250
+الفيروسين تصبغ المكان على طول مايوش حط لأ حط كمان
+
+374
+00:37:06,250 --> 00:37:09,990
+واحدة أو كمان واحدة الانتجار من مجلس مجلس مجلس
+
+375
+00:37:09,990 --> 00:37:11,390
+مجلس مجلس مجلس مجلس مجلس مجلس مجلس مجلس مجلس مجلس
+
+376
+00:37:11,390 --> 00:37:11,550
+مجلس مجلس مجلس مجلس مجلس مجلس مجلس مجلس مجلس مجلس
+
+377
+00:37:11,550 --> 00:37:24,770
+مجلس مجلس مجلس مجلس مج
+
+378
+00:37:25,030 --> 00:37:28,950
+فلوريسين؟ طيب بتاريكزاميناشي ان و اما ال results
+
+379
+00:37:28,950 --> 00:37:34,870
+كويسة مكونش مرشوش ولا مخافر again in the case of
+
+380
+00:37:34,870 --> 00:37:37,990
+midletics and cyclopidics the results obtained
+
+381
+00:37:37,990 --> 00:37:42,490
+will often be more valuable يعني ايش more valuable
+
+382
+00:37:42,490 --> 00:37:50,270
+قيمة يعني تكون accurate مكونش
+
+383
+00:37:50,270 --> 00:37:51,370
+drug facet
+
+384
+00:37:54,710 --> 00:37:58,830
+في الرطوبة الحرارة المغيرة التركيزي بتاعهم اللي
+
+385
+00:37:58,830 --> 00:38:04,770
+يقول فيه؟ يبقى هذه تلات مزايا easy to patient easy
+
+386
+00:38:04,770 --> 00:38:07,710
+to practitioner or better examination
+
+387
+00:38:24,470 --> 00:38:30,030
+أيش مساوء أو العيوب؟ بيقول أولا ان الـ I is an
+
+388
+00:38:30,030 --> 00:38:35,130
+artificial state this must be allowed for when
+
+389
+00:38:35,130 --> 00:38:39,610
+carrying out certain tasks يعني أنا اللي حطيتله
+
+390
+00:38:39,610 --> 00:38:46,290
+مدريازيس الآن أنا هيرم في التشريح اللي عندي البقب
+
+391
+00:38:46,290 --> 00:38:53,490
+اللي كان Diameter بتاعه four أو fiveالـ Millimeter
+
+392
+00:38:53,490 --> 00:39:04,390
+صار 10 أو 9 غيرت من ما غيرت العضلة اللي كانت سورتا
+
+393
+00:39:04,390 --> 00:39:08,870
+بيوبيلي شغالة الآن صارت فتلة مافيه قطرة و هي مش
+
+394
+00:39:08,870 --> 00:39:16,110
+شغالة يبقى انا اهداف تغيير طب الآن انا لو حطيت
+
+395
+00:39:16,110 --> 00:39:17,450
+مثلا لطفلة
+
+396
+00:39:27,220 --> 00:39:32,680
+و انا مابنطلع في الشمس بس معناه ان انا ماعملش بس
+
+397
+00:39:32,680 --> 00:39:34,920
+معناه ان انا برضه اي نقطة و انا مابنطلع في الشمس
+
+398
+00:39:34,920 --> 00:39:39,280
+بس معناه ان انا مابنطلع في الشمس بس معناه ان انا
+
+399
+00:39:39,280 --> 00:39:44,100
+مابنطلع في الشمس بس معناه ان انا مابنطلع في الشمس
+
+400
+00:39:44,100 --> 00:39:47,660
+بس معناه ان انا مابنطلع في الشمس بس معناه ان انا
+
+401
+00:39:47,660 --> 00:39:48,380
+مابنطلع في الشمس بس معناه ان انا مابنطلع في الشمس
+
+402
+00:39:48,380 --> 00:39:52,500
+بس معناه ان انا مابنطلع في الشمس بس معناه ان انا
+
+403
+00:39:52,500 --> 00:39:56,080
+مابنطلع في الشمس بس معناه ان انا مابنطلع في الشمس
+
+404
+00:39:56,080 --> 00:39:59,840
+بس معناه ان انااللي هو إيش؟ اللي هو تأثير بتاعها
+
+405
+00:39:59,840 --> 00:40:06,160
+يظهر، this can be short يعني أحيان تبقى خلال دقيقة
+
+406
+00:40:06,160 --> 00:40:09,480
+زي ال local anaesthetic، local anaesthetic يعني
+
+407
+00:40:09,480 --> 00:40:13,300
+costotropic anaesthetic، خلال دقيقة ودقيقة تانية،
+
+408
+00:40:13,300 --> 00:40:18,940
+but sometimes long enough to inconvenience the
+
+409
+00:40:18,940 --> 00:40:23,140
+patient، تزعج المريض، زي حياة الأتروبيين،
+
+410
+00:40:23,140 --> 00:40:27,010
+الأتروبيين بدلوا ساعة لما يبدأوا يشتغلواو بعدين
+
+411
+00:40:27,010 --> 00:40:32,070
+بده أم تاخد القطرة ع البيت و تحطله صبح و مسأل و
+
+412
+00:40:32,070 --> 00:40:35,830
+بعد ما يخلص الأطرابين تلاتة أربعة أيام بده أسبوع
+
+413
+00:40:35,830 --> 00:40:42,370
+لما يبدأ يشوف الأشياء و بده أسبوع تاني لما يطلع في
+
+414
+00:40:42,370 --> 00:40:48,590
+الشمس طب هذي مثلا ال little pearl بدأ حساب مين؟ ال
+
+415
+00:40:48,590 --> 00:40:55,330
+micro فهذه تعتبر disadvantage طيب في كمان يعني عيب
+
+416
+00:40:55,330 --> 00:41:01,620
+تالفprolonged duration of action، ضربنا بالأتروبيل
+
+417
+00:41:01,620 --> 00:41:08,180
+مثلًا، والسيكرو بقى بقى ست ساعات، والأتروبيل أقل
+
+418
+00:41:08,180 --> 00:41:13,920
+شيء ست أيام، prolonged duration، الصح اللي كان هو
+
+419
+00:41:13,920 --> 00:41:20,660
+easy، إن مجرد أنتهي من التشخيص أو الفحص، اللي
+
+420
+00:41:20,660 --> 00:41:25,930
+ماكنش يروح في حالهقرروا إنه أنا خلصت الفحص، مافيش
+
+421
+00:41:25,930 --> 00:41:31,030
+ضرورة إن المرض يعاني بعد هيك، ليش المرض يعاني؟
+
+422
+00:41:31,030 --> 00:41:36,470
+إذاً هذا عيب، يعني البشرية لم تصل إلى الكمال، أنا
+
+423
+00:41:36,470 --> 00:41:40,750
+يعني خلاص أنا جستله الحوال و كتبتله النضارة، و هو
+
+424
+00:41:40,750 --> 00:41:43,870
+لسه فعلا و أتربيت، ليش يفضل الكمال أسبوع أو
+
+425
+00:41:43,870 --> 00:41:46,570
+أسبوعين و هو لوعني، ماطلع في الشمس ولا يقرأ ولا
+
+426
+00:41:46,570 --> 00:41:52,370
+يمسك حاجة، و يبقى عن الروضة الولدإذا هدايب ولا
+
+427
+00:41:52,370 --> 00:42:00,410
+ميزة؟ لسه يعني البشرية لازم يتحسن أدائها.طيب
+
+428
+00:42:00,410 --> 00:42:07,470
+adverse effects of ophthalmic drugs. adverse يعني
+
+429
+00:42:07,470 --> 00:42:12,690
+side effects. هل ال drugs هالي إليها side effects
+
+430
+00:42:12,690 --> 00:42:16,490
+ولا لأ؟ طبعا إليها. بيوضعوا بإيه؟ where is the
+
+431
+00:42:16,490 --> 00:42:20,210
+drug? if it is available might exacerbate that
+
+432
+00:42:20,210 --> 00:42:20,550
+problem.
+
+433
+00:42:27,850 --> 00:42:34,090
+الدراجات ممكن أن تنتهي منها، ليس أن تقطع القطرة
+
+434
+00:42:34,090 --> 00:42:40,430
+وتعمل تأثير دائم، طبعا هي القطرة مرميش reversible
+
+435
+00:42:40,430 --> 00:42:47,530
+أو الـ local adverse effects ع
+
+436
+00:42:47,530 --> 00:42:54,830
+العين بس، بينما التانية systemic على الجسمطب local
+
+437
+00:42:54,830 --> 00:42:59,270
+adverse if it's this can be as mild as stinging
+
+438
+00:42:59,270 --> 00:43:08,250
+يعني خفيفة زي التلخيز عارفين الورز اه او as severe
+
+439
+00:43:08,250 --> 00:43:12,310
+as angioecological angioecological
+
+440
+00:43:32,400 --> 00:43:38,100
+هذا الروت روت ايريس في السيارة البودي، يبقى
+
+441
+00:43:38,100 --> 00:43:40,540
+المسافة من هنا ل هنا حالة ال ايريس في الحالة
+
+442
+00:43:40,540 --> 00:43:40,860
+العادية
+
+443
+00:43:57,950 --> 00:44:02,910
+يعني أن الـ iris اللي كان واصل هنا تجمع من الـ
+
+444
+00:44:02,910 --> 00:44:07,710
+over grounding على ال angle of AC، angle of
+
+445
+00:44:07,710 --> 00:44:14,150
+anterior chamber، هسكر الزاوية، فلو الزاوية نارت،
+
+446
+00:44:14,150 --> 00:44:17,590
+سيبير
+
+447
+00:44:17,590 --> 00:44:17,950
+ال closure
+
+448
+00:44:26,690 --> 00:44:35,550
+على 50 إلى 70 ميلي متر زي اقل سيبير
+
+449
+00:44:35,550 --> 00:44:40,190
+دمج في العين سيبير دمج اوكتكنية هل الدمج هذا
+
+450
+00:44:40,190 --> 00:44:45,510
+reversible او irreversible هذا
+
+451
+00:44:45,510 --> 00:44:49,630
+الدمج irreversible يبقى احنا ملقنا من ال side
+
+452
+00:44:49,630 --> 00:44:52,350
+effects البسيطة حرجان
+
+453
+00:45:01,280 --> 00:45:10,900
+ولا حاجة، لكن الخبر هنا في بعض القطرات تعمل تلون
+
+454
+00:45:10,900 --> 00:45:15,960
+دائم في الـIris، الـIris حتى اللي نصف فاتح أو فاتح
+
+455
+00:45:15,960 --> 00:45:17,920
+شوية، ممكن يصير black
+
+456
+00:45:26,820 --> 00:45:32,220
+زلتان .. زلتان هرق .. انت جاهز لزلتان هرمونية خطر
+
+457
+00:45:32,220 --> 00:45:36,120
+للـ Antiglucoma .. Antiglucoma درجة في منها خطر
+
+458
+00:45:36,120 --> 00:45:46,580
+اسمها اليوميجان اليوميجان اليوميجان او زلتان ممكن
+
+459
+00:45:46,580 --> 00:45:51,940
+تسمى تلوين دائم في العيارات تلوين دائم في العيارات
+
+460
+00:46:06,670 --> 00:46:11,270
+الـ side effects بتكون systemic at this اللي هو
+
+461
+00:46:11,270 --> 00:46:15,710
+systemic في البلد يعني many diagnostic drugs are
+
+462
+00:46:15,710 --> 00:46:20,550
+potent قوية يعني modifiers of autonomic nervous
+
+463
+00:46:20,550 --> 00:46:24,150
+system and are capable of causing effects of
+
+464
+00:46:24,150 --> 00:46:26,970
+automatically innervated structures يعني عشان
+
+465
+00:46:26,970 --> 00:46:31,950
+أريهم مثلا لو أنا أعطيت إنفان أتروبيا عنده
+
+466
+00:46:31,950 --> 00:46:36,790
+أزوتروبيا أعطيته أتروبياطبعا ال atropine هيدخل من
+
+467
+00:46:36,790 --> 00:46:40,750
+العين نازل و لاكتم على ال duct و ينزل على ال nose
+
+468
+00:46:40,750 --> 00:46:44,190
+نازل من قسم ال brain rich of blood vessels و روح
+
+469
+00:46:44,190 --> 00:46:51,530
+على الدم بسألوني انا في التخرج الدكتورة، بقولها
+
+470
+00:46:51,530 --> 00:46:53,790
+الدكتور كان atropine
+
+471
+00:47:03,970 --> 00:47:11,390
+في عيني أو بصوت يعني اخططا اخذوا البلد بالتم
+
+472
+00:47:11,390 --> 00:47:16,490
+مقرمون شغلنا
+
+473
+00:47:16,490 --> 00:47:20,450
+احنا ال autonomous nervous system وعمل ليه
+
+474
+00:47:20,450 --> 00:47:24,750
+toxicity drug toxicity ولمّا ال infants وزنه قليل
+
+475
+00:47:24,750 --> 00:47:26,450
+ممكن يكون overdose مقرمون
+
+476
+00:47:30,040 --> 00:47:34,660
+تشوفوا العلب الدوام المكتوب عليها يحفظ عيدا عن عين
+
+477
+00:47:34,660 --> 00:47:40,960
+الأولاد أو الأطفال صحيح ممكن كورس واحد يختم وممكن
+
+478
+00:47:40,960 --> 00:47:45,140
+لو ال drug استخدم حتى في العين الأطفال ممكن يعملهم
+
+479
+00:47:45,140 --> 00:47:51,680
+systemic adverse effects طيب أخر شئ خلص منه
+
+480
+00:48:01,950 --> 00:48:12,890
+الشيء يجب أن يكون متوفر، يجب
+
+481
+00:48:12,890 --> 00:48:16,950
+أن يكون متوفر، يجب أن يكون متوفر، يجب أن يكون
+
+482
+00:48:16,950 --> 00:48:24,840
+متوفر، يجب أن يكون متوفر، يجب أن يكون متوفر3- its
+
+483
+00:48:24,840 --> 00:48:31,800
+action should be fast in answer 4
+
+484
+00:48:31,800 --> 00:48:35,960
+-
+
+485
+00:48:35,960 --> 00:48:38,420
+its action should be short in duration
+
+486
+00:48:50,610 --> 00:48:56,330
+الدراجة يجب أن لا تكون لديها افكار فارماروكوليجية
+
+487
+00:48:56,330 --> 00:49:00,130
+غير ادراسية،
+
+488
+00:49:00,130 --> 00:49:06,030
+لا تكون لديها افكار فارماروكوليجية غير ادراسية، لا
+
+489
+00:49:06,030 --> 00:49:09,430
+تكون
+
+490
+00:49:09,430 --> 00:49:12,950
+لديها افكار فارماروكوليجية غير ادراسية
+
+491
+00:49:18,000 --> 00:49:24,000
+Present يعني مفرح و easy to use till it should be
+
+492
+00:49:24,000 --> 00:49:28,560
+capable of being produced in stable and sterile
+
+493
+00:49:28,560 --> 00:49:33,120
+ophthalmic form that is appropriate to the use for
+
+494
+00:49:33,120 --> 00:49:37,680
+which is intended يعني انا حضرته مثلا
+
+495
+00:49:37,680 --> 00:49:41,560
+psychologically لمدة سنة مش خيال ساى يتحلل و يخرب
+
+496
+00:49:41,560 --> 00:49:43,960
+حضرت ال
+
+497
+00:49:53,930 --> 00:49:58,970
+مثلا احط مرهم في العين فاكداش ايه عمل ريتنوسكوبي و
+
+498
+00:49:58,970 --> 00:50:04,730
+هيوصل مشكلة، لأ مديش انا ايه، ليه ويه كل العمل
+
+499
+00:50:04,730 --> 00:50:05,250
+التالي؟
+
+500
+00:50:10,900 --> 00:50:14,460
+and the advantages and disadvantages of a proposed
+
+501
+00:50:14,460 --> 00:50:18,300
+drug must be weighed in the light of a particular
+
+502
+00:50:18,300 --> 00:50:21,720
+patient immediately prior to the examination يبقى
+
+503
+00:50:21,720 --> 00:50:24,940
+من عيان لعيان بيختلف في عيان بيمشي معاه للهلاجة
+
+504
+00:50:24,940 --> 00:50:28,400
+وعيان مابمشي معاه عيان بسرعة بيروح منه وعيان بيطول
+
+505
+00:50:28,400 --> 00:50:32,280
+معاه عيان بيأول عينه وعيان مابيأول عينه وكده لكن
+
+506
+00:50:32,280 --> 00:50:38,800
+انا في الآخر بحكم على إيش إمكانية الدواء المناسب
+
+507
+00:50:38,800 --> 00:50:39,320
+للفحص
+
+508
+00:50:42,660 --> 00:50:46,060
+بالنسبة لما حطوا يا مالستاني بدي Cycloblasia يا
+
+509
+00:50:46,060 --> 00:50:50,080
+مالي effective Cycloblasia بقعد نقدر على فلان حاجة
+
+510
+00:50:50,080 --> 00:50:54,160
+يعني في عنده حرفة فلان ما عنده حرفة وكلام زي هذا
+
+511
+00:50:54,160 --> 00:50:58,640
+المهم انه عمل effective and easy examination شكرا
+
+512
+00:50:58,640 --> 00:51:00,180
+لكم والسلام عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/Rbuq1T_8UdE_raw.json b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/Rbuq1T_8UdE_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..63b89fb3c05ee25ec94770000de26684dbe11575
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/Rbuq1T_8UdE_raw.json
@@ -0,0 +1 @@
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2581.75, "word": " زي", "probability": 0.8955078125}, {"start": 2581.75, "end": 2582.87, "word": " التلخيز", "probability": 0.85810546875}, {"start": 2582.87, "end": 2583.95, "word": " عارفين", "probability": 0.9100341796875}, {"start": 2583.95, "end": 2584.35, "word": " الورز", "probability": 0.6780598958333334}, {"start": 2584.35, "end": 2586.97, "word": " اه", "probability": 0.50048828125}, {"start": 2586.97, "end": 2587.61, "word": " او", "probability": 0.86083984375}, {"start": 2587.61, "end": 2587.93, "word": " as", "probability": 0.267822265625}, {"start": 2587.93, "end": 2588.25, "word": " severe", "probability": 0.76416015625}, {"start": 2588.25, "end": 2588.75, "word": " as", "probability": 0.9052734375}, {"start": 2588.75, "end": 2589.31, "word": " angioecological", "probability": 0.44683837890625}, {"start": 2589.31, "end": 2592.31, "word": " angioecological", "probability": 0.778167724609375}], "temperature": 1.0}, {"id": 88, "seek": 262086, "start": 2612.4, "end": 2620.86, "text": "هذا الروت روت ايريس في السيارة البودي، يبقى المسافة من هنا ل هنا حالة ال ايريس في الحالة العادية", "tokens": [3224, 15730, 2423, 32887, 2655, 12602, 35473, 1975, 13546, 1829, 3794, 8978, 21136, 1829, 9640, 3660, 29739, 2407, 16254, 12399, 7251, 3555, 4587, 7578, 9673, 3794, 31845, 3660, 9154, 34105, 5296, 34105, 11331, 6027, 3660, 2423, 1975, 13546, 1829, 3794, 8978, 21542, 6027, 3660, 18863, 18513, 10632], "avg_logprob": -0.5364583569268385, "compression_ratio": 1.7058823529411764, "no_speech_prob": 5.960464477539063e-08, "words": [{"start": 2612.4, "end": 2612.52, "word": "هذا", "probability": 0.69921875}, {"start": 2612.52, "end": 2612.9, "word": " الروت", "probability": 0.5462239583333334}, {"start": 2612.9, "end": 2613.32, "word": " روت", "probability": 0.428619384765625}, {"start": 2613.32, "end": 2613.94, "word": " ايريس", "probability": 0.4492340087890625}, {"start": 2613.94, "end": 2614.7, "word": " في", "probability": 0.68701171875}, {"start": 2614.7, "end": 2614.98, "word": " السيارة", "probability": 0.61383056640625}, {"start": 2614.98, "end": 2617.88, "word": " البودي،", "probability": 0.4185791015625}, {"start": 2617.88, "end": 2618.1, "word": " يبقى", "probability": 0.75592041015625}, {"start": 2618.1, "end": 2618.46, "word": " المسافة", "probability": 0.9342041015625}, {"start": 2618.46, "end": 2618.54, "word": " من", "probability": 0.96142578125}, {"start": 2618.54, "end": 2618.72, "word": " هنا", "probability": 0.98779296875}, {"start": 2618.72, "end": 2618.8, "word": " ل", "probability": 0.537109375}, {"start": 2618.8, "end": 2619.1, "word": " هنا", "probability": 0.393310546875}, {"start": 2619.1, "end": 2619.84, "word": " حالة", "probability": 0.6477864583333334}, {"start": 2619.84, "end": 2619.92, "word": " ال", "probability": 0.74365234375}, {"start": 2619.92, "end": 2620.18, "word": " ايريس", "probability": 0.770233154296875}, {"start": 2620.18, "end": 2620.28, "word": " في", "probability": 0.5654296875}, {"start": 2620.28, "end": 2620.54, "word": " الحالة", "probability": 0.8465169270833334}, {"start": 2620.54, "end": 2620.86, "word": " العادية", "probability": 0.9874674479166666}], "temperature": 1.0}, {"id": 89, "seek": 265795, "start": 2637.95, "end": 2657.95, "text": "يعني أن الـ iris اللي كان واصل هنا تجمع من الـ over grounding على ال angle of AC، angle of anterior chamber، هسكر الزاوية، فلو الزاوية نارت، سيبير ال closure", "tokens": [40228, 22653, 14739, 2423, 39184, 3418, 271, 13672, 1829, 25961, 4032, 33546, 1211, 34105, 6055, 7435, 2304, 3615, 9154, 2423, 39184, 670, 46727, 15844, 2423, 5802, 295, 8157, 12399, 5802, 295, 22272, 13610, 12399, 8032, 3794, 37983, 6024, 110, 995, 2407, 10632, 12399, 6156, 1211, 2407, 6024, 110, 995, 2407, 10632, 8717, 9640, 2655, 12399, 8608, 1829, 3555, 13546, 2423, 24653], "avg_logprob": -0.4458165322580645, "compression_ratio": 1.369047619047619, "no_speech_prob": 0.0, "words": [{"start": 2637.95, "end": 2638.29, "word": "يعني", "probability": 0.749755859375}, 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{"start": 2671.67, "end": 2675.55, "word": " سيبير", "probability": 0.48284912109375}, {"start": 2675.55, "end": 2675.91, "word": " دمج", "probability": 0.5426432291666666}, {"start": 2675.91, "end": 2676.07, "word": " في", "probability": 0.283203125}, {"start": 2676.07, "end": 2676.39, "word": " العين", "probability": 0.490234375}, {"start": 2676.39, "end": 2677.13, "word": " سيبير", "probability": 0.78057861328125}, {"start": 2677.13, "end": 2677.37, "word": " دمج", "probability": 0.958984375}, {"start": 2677.37, "end": 2678.01, "word": " اوكتكنية", "probability": 0.5967494419642857}, {"start": 2678.01, "end": 2679.59, "word": " هل", "probability": 0.456298828125}, {"start": 2679.59, "end": 2679.91, "word": " الدمج", "probability": 0.8191731770833334}, {"start": 2679.91, "end": 2680.19, "word": " هذا", "probability": 0.297607421875}, {"start": 2680.19, "end": 2680.57, "word": " reversible", "probability": 0.798828125}, {"start": 2680.57, "end": 2680.81, "word": " او", "probability": 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2691.59, "word": " البسيطة", "probability": 0.96220703125}, {"start": 2691.59, "end": 2692.35, "word": " حرجان", "probability": 0.85009765625}], "temperature": 1.0}, {"id": 91, "seek": 271792, "start": 2701.28, "end": 2717.92, "text": "ولا حاجة، لكن الخبر هنا في بعض القطرات تعمل تلون دائم في الـIris، الـIris حتى اللي نصف فاتح أو فاتح شوية، ممكن يصير black", "tokens": [12610, 995, 11331, 26108, 3660, 12399, 44381, 33962, 26890, 34105, 8978, 45030, 11242, 25062, 9566, 2288, 9307, 6055, 25957, 1211, 6055, 1211, 11536, 11778, 16373, 2304, 8978, 2423, 39184, 40, 5714, 12399, 2423, 39184, 40, 5714, 11331, 49975, 13672, 1829, 8717, 9381, 5172, 6156, 9307, 5016, 34051, 6156, 9307, 5016, 13412, 2407, 10632, 12399, 3714, 43020, 7251, 9381, 13546, 2211], "avg_logprob": -0.21887807572474244, "compression_ratio": 1.4305555555555556, "no_speech_prob": 1.7285346984863281e-06, "words": [{"start": 2701.28, "end": 2701.28, "word": "ولا", "probability": 0.485870361328125}, {"start": 2701.28, "end": 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زلتان هرق .. انت جاهز لزلتان هرمونية خطر للـ Antiglucoma .. Antiglucoma درجة في منها خطر اسمها اليوميجان اليوميجان اليوميجان او زلتان ممكن تسمى تلوين دائم في العيارات تلوين دائم في العيارات", "tokens": [11622, 1211, 2655, 7649, 4386, 30767, 1211, 2655, 7649, 8032, 2288, 4587, 4386, 16472, 2655, 10874, 995, 3224, 11622, 5296, 11622, 1211, 2655, 7649, 8032, 2288, 2304, 11536, 10632, 16490, 9566, 2288, 24976, 39184, 5130, 328, 75, 1311, 6440, 4386, 5130, 328, 75, 1311, 6440, 11778, 47341, 3660, 8978, 9154, 11296, 16490, 9566, 2288, 24525, 2304, 11296, 2423, 1829, 20498, 1829, 7435, 7649, 2423, 1829, 20498, 1829, 7435, 7649, 2423, 1829, 20498, 1829, 7435, 7649, 1975, 2407, 30767, 1211, 2655, 7649, 3714, 43020, 6055, 38251, 7578, 6055, 1211, 2407, 9957, 11778, 16373, 2304, 8978, 18863, 1829, 9640, 9307, 6055, 1211, 2407, 9957, 11778, 16373, 2304, 8978, 18863, 1829, 9640, 9307], "avg_logprob": -0.38372748069935014, "compression_ratio": 2.0180722891566263, "no_speech_prob": 0.0, "words": [{"start": 2726.82, "end": 2727.86, "word": "زلتان", 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3020.34, "word": " the", "probability": 0.7958984375}, {"start": 3020.34, "end": 3020.8, "word": " examination", "probability": 0.923828125}, {"start": 3020.8, "end": 3021.72, "word": " يبقى", "probability": 0.80950927734375}, {"start": 3021.72, "end": 3021.92, "word": " من", "probability": 0.97998046875}, {"start": 3021.92, "end": 3022.2, "word": " عيان", "probability": 0.82373046875}, {"start": 3022.2, "end": 3022.56, "word": " لعيان", "probability": 0.9591064453125}, {"start": 3022.56, "end": 3023.1, "word": " بيختلف", "probability": 0.81512451171875}, {"start": 3023.1, "end": 3023.98, "word": " في", "probability": 0.54345703125}, {"start": 3023.98, "end": 3024.24, "word": " عيان", "probability": 0.9812825520833334}, {"start": 3024.24, "end": 3024.54, "word": " بيمشي", "probability": 0.890625}, {"start": 3024.54, "end": 3024.66, "word": " معاه", "probability": 0.851318359375}, {"start": 3024.66, "end": 3024.94, "word": " للهلاجة", "probability": 0.649462890625}, {"start": 3024.94, 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3029.38, "end": 3029.72, "word": " عينه", "probability": 0.9368489583333334}, {"start": 3029.72, "end": 3030.22, "word": " وعيان", "probability": 0.885009765625}, {"start": 3030.22, "end": 3030.56, "word": " مابيأول", "probability": 0.94384765625}, {"start": 3030.56, "end": 3031.04, "word": " عينه", "probability": 0.9651692708333334}, {"start": 3031.04, "end": 3031.6, "word": " وكده", "probability": 0.7401123046875}, {"start": 3031.6, "end": 3032.28, "word": " لكن", "probability": 0.6416015625}, {"start": 3032.28, "end": 3032.72, "word": " انا", "probability": 0.75830078125}, {"start": 3032.72, "end": 3032.84, "word": " في", "probability": 0.8173828125}, {"start": 3032.84, "end": 3033.32, "word": " الآخر", "probability": 0.9539388020833334}, {"start": 3033.32, "end": 3033.78, "word": " بحكم", "probability": 0.97216796875}, {"start": 3033.78, "end": 3034.2, "word": " على", "probability": 0.736328125}, {"start": 3034.2, "end": 3035.08, "word": " إيش", "probability": 0.8829752604166666}, {"start": 3035.08, "end": 3035.98, "word": " إمكانية", "probability": 0.9747314453125}, {"start": 3035.98, "end": 3038.0, "word": " الدواء", "probability": 0.7721354166666666}, {"start": 3038.0, "end": 3038.8, "word": " المناسب", "probability": 0.98876953125}, {"start": 3038.8, "end": 3039.32, "word": " للفحص", "probability": 0.7056884765625}], "temperature": 1.0}, {"id": 103, "seek": 306018, "start": 3042.66, "end": 3060.18, "text": "بالنسبة لما حطوا يا مالستاني بدي Cycloblasia يا مالي effective Cycloblasia بقعد نقدر على فلان حاجة يعني في عنده حرفة فلان ما عنده حرفة وكلام زي هذا المهم انه عمل effective and easy examination شكرا لكم والسلام عليكم ورحمة الله وبركاته", "tokens": [3555, 6027, 1863, 35457, 3660, 5296, 15042, 11331, 9566, 14407, 35186, 3714, 6027, 14851, 7649, 1829, 4724, 16254, 10295, 66, 752, 5199, 25251, 35186, 3714, 6027, 1829, 4942, 10295, 66, 752, 5199, 25251, 4724, 4587, 22488, 8717, 28543, 2288, 15844, 6156, 1211, 7649, 11331, 26108, 3660, 37495, 22653, 8978, 43242, 3224, 11331, 28480, 3660, 6156, 1211, 7649, 19446, 43242, 3224, 11331, 28480, 3660, 4032, 28820, 10943, 30767, 1829, 23758, 9673, 16095, 16472, 3224, 6225, 42213, 4942, 293, 1858, 23874, 13412, 4117, 23557, 5296, 24793, 16070, 3794, 37440, 25894, 24793, 4032, 2288, 35571, 3660, 21984, 4032, 26890, 4117, 9307, 3224], "avg_logprob": -0.4118750005960464, "compression_ratio": 1.6591928251121075, "no_speech_prob": 5.245208740234375e-06, "words": [{"start": 3042.66, "end": 3042.72, "word": "بالنسبة", "probability": 0.508221435546875}, {"start": 3042.72, "end": 3042.84, "word": " لما", "probability": 0.238250732421875}, {"start": 3042.84, "end": 3043.14, "word": " حطوا", "probability": 0.50537109375}, {"start": 3043.14, "end": 3043.24, "word": " يا", "probability": 0.337158203125}, {"start": 3043.24, "end": 3044.6, "word": " مالستاني", "probability": 0.667138671875}, {"start": 3044.6, "end": 3045.3, "word": " بدي", "probability": 0.4522705078125}, {"start": 3045.3, "end": 3045.9, "word": " Cycloblasia", "probability": 0.50762939453125}, {"start": 3045.9, "end": 3046.06, "word": " يا", "probability": 0.64111328125}, {"start": 3046.06, "end": 3046.3, "word": " مالي", "probability": 0.5686848958333334}, {"start": 3046.3, "end": 3046.56, "word": " effective", "probability": 0.5703125}, {"start": 3046.56, "end": 3047.3, "word": " Cycloblasia", "probability": 0.88134765625}, {"start": 3047.3, "end": 3048.34, "word": " بقعد", "probability": 0.7561848958333334}, {"start": 3048.34, "end": 3048.72, "word": " نقدر", "probability": 0.5821533203125}, {"start": 3048.72, "end": 3049.02, "word": " على", "probability": 0.6455078125}, {"start": 3049.02, "end": 3049.68, "word": " فلان", "probability": 0.6422119140625}, {"start": 3049.68, "end": 3050.08, "word": " حاجة", "probability": 0.7644856770833334}, {"start": 3050.08, "end": 3050.4, "word": " يعني", "probability": 0.815185546875}, {"start": 3050.4, "end": 3050.56, "word": " في", "probability": 0.7490234375}, {"start": 3050.56, "end": 3050.88, "word": " عنده", "probability": 0.935546875}, {"start": 3050.88, "end": 3051.44, "word": " حرفة", "probability": 0.95263671875}, {"start": 3051.44, "end": 3052.08, "word": " فلان", "probability": 0.8033854166666666}, {"start": 3052.08, "end": 3052.16, "word": " ما", "probability": 0.427001953125}, {"start": 3052.16, "end": 3052.4, "word": " عنده", "probability": 0.9501953125}, {"start": 3052.4, "end": 3053.0, "word": " حرفة", "probability": 0.9933268229166666}, {"start": 3053.0, "end": 3053.9, "word": " وكلام", "probability": 0.7198893229166666}, {"start": 3053.9, "end": 3054.02, "word": " زي", "probability": 0.967041015625}, {"start": 3054.02, "end": 3054.16, "word": " هذا", "probability": 0.8916015625}, {"start": 3054.16, "end": 3054.5, "word": " المهم", "probability": 0.97119140625}, {"start": 3054.5, "end": 3054.68, "word": " انه", "probability": 0.63232421875}, {"start": 3054.68, "end": 3054.88, "word": " عمل", "probability": 0.853271484375}, {"start": 3054.88, "end": 3055.46, "word": " effective", "probability": 0.68896484375}, {"start": 3055.46, "end": 3056.22, "word": " and", "probability": 0.9306640625}, {"start": 3056.22, "end": 3056.8, "word": " easy", "probability": 0.96630859375}, {"start": 3056.8, "end": 3058.02, "word": " examination", "probability": 0.8916015625}, {"start": 3058.02, "end": 3058.64, "word": " شكرا", "probability": 0.837890625}, {"start": 3058.64, "end": 3058.92, "word": " لكم", "probability": 0.932373046875}, {"start": 3058.92, "end": 3059.3, "word": " والسلام", "probability": 0.77294921875}, {"start": 3059.3, "end": 3059.62, "word": " عليكم", "probability": 0.96240234375}, {"start": 3059.62, "end": 3059.84, "word": " ورحمة", "probability": 0.70697021484375}, {"start": 3059.84, "end": 3059.94, "word": " الله", "probability": 0.92626953125}, {"start": 3059.94, "end": 3060.18, "word": " وبركاته", "probability": 0.90732421875}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 3061.24925, 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\ No newline at end of file
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/Rbuq1T_8UdE_raw.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/Rbuq1T_8UdE_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..dbd10e83e282a706710492640253072f257a18fe
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/Rbuq1T_8UdE_raw.srt
@@ -0,0 +1,2096 @@
+1
+00:00:20,860 --> 00:00:25,380
+بسم الله الرحمن الرحيم، الحمد لله رب العالمين،
+
+2
+00:00:25,380 --> 00:00:31,420
+وابصلي وابسلم على حبيبنا وقرة أعيننا سيدنا محمد
+
+3
+00:00:31,420 --> 00:00:35,060
+صلى الله عليه وسلم وعلى آله واصحابي والتابعين
+
+4
+00:00:35,060 --> 00:00:40,520
+السلام عليكم ورحمة الله وبركاته في هذه المحاضرة
+
+5
+00:00:40,520 --> 00:00:47,600
+سنستكمل metabolism and elimination of drugs from
+
+6
+00:00:47,600 --> 00:00:48,260
+the eye
+
+7
+00:00:52,230 --> 00:01:00,790
+كما نعرف أن الانتباوتكات تتعلق بالدخول هم إما
+
+8
+00:01:00,790 --> 00:01:09,650
+الليكوفيليك أو الهيدروفيليك مثل الليكوفيليك
+
+9
+00:01:09,650 --> 00:01:11,570
+كلورانفينيكون
+
+10
+00:01:23,240 --> 00:01:29,180
+بسيطة بصورة كبيرة بسيطة بصورة كبيرة بسيطة بصورة
+
+11
+00:01:29,180 --> 00:01:31,700
+كبيرة بسيطة بصورة كبيرة بسيطة بصورة كبيرة بسيطة
+
+12
+00:01:31,700 --> 00:01:33,160
+بصورة كبيرة بسيطة بصورة كبيرة بسيطة بصورة كبيرة
+
+13
+00:01:33,160 --> 00:01:37,080
+بسيطة بصورة كبيرة بسيطة بصورة كبيرة بسيطة بصورة
+
+14
+00:01:37,080 --> 00:01:40,540
+كبيرة بسيطة بصورة كبيرة بسيطة بصورة كبيرة بسيطة
+
+15
+00:01:40,540 --> 00:01:40,580
+بصورة كبيرة بسيطة بصورة كبيرة بسيطة بصورة كبيرة
+
+16
+00:01:40,580 --> 00:01:52,580
+بسيطة بصورة كبيرة بسيطة بصورة كبيرة بسيطة
+
+17
+00:01:52,580 --> 00:01:59,200
+بصورسريع وعالى داخل الـ aqueous flow هو the
+
+18
+00:01:59,200 --> 00:02:02,980
+constant flow of aqueous from ciliary processes من
+
+19
+00:02:02,980 --> 00:02:06,980
+الخلف where it is secreted through the posterior
+
+20
+00:02:06,980 --> 00:02:13,180
+chamber, pupil and anterior chamber and out of the
+
+21
+00:02:13,180 --> 00:02:17,380
+eye via schlimps canal prevents the accumulation
+
+22
+00:02:17,380 --> 00:02:19,620
+of high concentrations of antibacterial
+
+23
+00:02:27,890 --> 00:02:37,050
+كلنا انه في المتوسط every 45 minutes the whole
+
+24
+00:02:37,050 --> 00:02:45,970
+aqueous chamber is turned over and replaced by new
+
+25
+00:02:45,970 --> 00:02:49,270
+aqueous from the celery processes
+
+26
+00:02:54,920 --> 00:03:01,060
+ما يمنع بقاء تركيز ال antibiotic inside the
+
+27
+00:03:01,060 --> 00:03:07,880
+aqueous humor for a long time عشان ما اشهر ممنع
+
+28
+00:03:07,880 --> 00:03:13,380
+انه يبقى ال antibiotic مركنا في ال aqueous لمدة
+
+29
+00:03:13,380 --> 00:03:17,880
+طويلة هو
+
+30
+00:03:17,880 --> 00:03:21,880
+بدور هو بدور هو بدخل و بيسأل ال antibiotic لكنه
+
+31
+00:03:21,880 --> 00:03:23,040
+مفضل يشعل peak
+
+32
+00:03:28,660 --> 00:03:38,040
+أبدا مش هيك عشان ترقب يعني كل .. بل ال antibody
+
+33
+00:03:38,040 --> 00:03:48,480
+مثلا هنا وصل كده ترقب و برد نزله لو هتركب انت و
+
+34
+00:03:48,480 --> 00:03:53,760
+تطلع فهي قد تطلعلو محطناش بنزل، لو تخرق، بنزل، لو
+
+35
+00:03:53,760 --> 00:03:57,440
+حطينا كمان قطرة، بتطلع هيك، وها كده، مجداش الوقت
+
+36
+00:03:57,440 --> 00:04:03,220
+يحافظ على ال peak، لأنه في عميل turn over، اخراج،
+
+37
+00:04:03,220 --> 00:04:08,080
+الدوة بياخد مع ال aqueous على برا، على الدم، واضح؟
+
+38
+00:04:08,080 --> 00:04:11,520
+إيهش الموضوع turn over؟ لذلك إحنا اسكبت نحافظ على
+
+39
+00:04:11,520 --> 00:04:16,300
+إنه ال drug يفضل على ال peak، بدنا نفضل كل every
+
+40
+00:04:16,300 --> 00:04:18,080
+one hour أو two hours
+
+41
+00:04:21,700 --> 00:04:27,240
+عشان انا احافظ على peak هيك stationary بيقضل every
+
+42
+00:04:27,240 --> 00:04:31,620
+hour حطله عشان اغلب الموضوع turnover of drugs
+
+43
+00:04:31,620 --> 00:04:40,500
+كويس؟ يعني عشان هيك حدات كله يعني تقتل أم إلى
+
+44
+00:04:40,500 --> 00:04:43,580
+الطبيب تقول والله اعطوني قطرة مثلا كلها في الكل
+
+45
+00:04:43,580 --> 00:04:48,600
+صباحا ومثلا ومادي ماتيش نتيجة ماريو قلتله صح
+
+46
+00:04:48,600 --> 00:04:54,960
+مابيجيه نتيجةالمفروض أن تقوم بعمله مرتين
+
+47
+00:04:54,960 --> 00:04:57,820
+في اليوم، مرتين في اليوم، مرتين في اليوم، مرتين في
+
+48
+00:04:57,820 --> 00:05:00,660
+اليوم، مرتين في اليوم، مرتين في اليوم، مرتين في
+
+49
+00:05:00,660 --> 00:05:00,700
+اليوم، مرتين في اليوم، مرتين في اليوم، مرتين في
+
+50
+00:05:00,700 --> 00:05:00,700
+اليوم، مرتين في اليوم، مرتين في اليوم، مرتين في
+
+51
+00:05:00,700 --> 00:05:00,760
+اليوم، مرتين في اليوم، مرتين في اليوم، مرتين في
+
+52
+00:05:00,760 --> 00:05:00,760
+اليوم، مرتين في اليوم، مرتين في اليوم، مرتين في
+
+53
+00:05:00,760 --> 00:05:00,760
+اليوم، مرتين في اليوم، مرتين في اليوم، مرتين في
+
+54
+00:05:00,760 --> 00:05:00,860
+اليوم، مرتين في اليوم، مرتين في اليوم، مرتين في
+
+55
+00:05:00,860 --> 00:05:06,640
+اليوم، مرتين في اليوم، مرتين في اليوم، مرتين في
+
+56
+00:05:06,640 --> 00:05:09,340
+اليوم، مرتين في اليوم، مرتين في اليوم، مرتين
+
+57
+00:05:14,360 --> 00:05:17,840
+Some absorption of antibacterias from aqueous by
+
+58
+00:05:17,840 --> 00:05:24,000
+the anterior uvea. ايش uvea؟ Anterior uvea الـ I's
+
+59
+00:05:24,000 --> 00:05:30,300
+و ال anterior part of cellar body. هذا ال anterior
+
+60
+00:05:30,300 --> 00:05:34,420
+uvea و في المن ال uvea اللي هو ال posterior part
+
+61
+00:05:34,420 --> 00:05:37,400
+of cellar body and anterior part of chloride و ال
+
+62
+00:05:37,400 --> 00:05:43,060
+posterior uvea ال chloride من واحد نصه و برهبقول
+
+63
+00:05:43,060 --> 00:05:50,320
+انه في absorption inevitable راح يصير ال drug by
+
+64
+00:05:50,320 --> 00:05:57,200
+the uvea and lens كيف يعني؟ يعني الآن ال blood
+
+65
+00:05:57,200 --> 00:05:59,940
+بخلوين في ال anterior chamber و ال posterior
+
+66
+00:05:59,940 --> 00:06:04,380
+chamber و من الحاجات اللي في ال anterior chamber و
+
+67
+00:06:04,380 --> 00:06:07,900
+ال posterior chamber ال lens، the lens، the
+
+68
+00:06:07,900 --> 00:06:14,540
+nucleus، salivary body، والعيسفبيقول إنه حيصير
+
+69
+00:06:14,540 --> 00:06:24,860
+تسرب ماء للدواء في هذه المراكبات اللي داخلها يعني
+
+70
+00:06:24,860 --> 00:06:28,900
+كما إنه موقع التسريب للدواء بال turn over بيصير
+
+71
+00:06:28,900 --> 00:06:34,640
+عبر شلمس كانال وTropical مشوار أيضاً في شيء معين
+
+72
+00:06:34,640 --> 00:06:38,740
+ما لم يتسوج أكمل من الدواء بيصير عبر الcellular
+
+73
+00:06:38,740 --> 00:06:43,980
+body وعبر الionis وعبر اللنز وبروح الدمعشان هي
+
+74
+00:06:43,980 --> 00:06:50,860
+الدواء لابقى على peak لأنه فيه تسريب فيه leak فيه
+
+75
+00:06:50,860 --> 00:06:56,020
+leak طيب concentrations achieved in the vitreous
+
+76
+00:06:56,020 --> 00:06:59,420
+body following topical administration are
+
+77
+00:06:59,420 --> 00:07:05,640
+generally subtherapeutic هذا ال setting ال
+
+78
+00:07:05,640 --> 00:07:08,200
+administration of antibacterial by local
+
+79
+00:07:08,200 --> 00:07:09,540
+intravitreal injection
+
+80
+00:07:23,740 --> 00:07:28,960
+قورنيا وهنا آيلينز
+
+81
+00:07:28,960 --> 00:07:40,220
+آيلينز سيلاري بودي زوريول وهنا ال بتلس كل ال
+
+82
+00:07:40,220 --> 00:07:44,980
+chamber هذه بتلس الان انا اعطيه topical and
+
+83
+00:07:44,980 --> 00:07:45,440
+antibiotic
+
+84
+00:07:56,160 --> 00:08:00,620
+في الاتيوت الشمبا وبعدين في البستير الشمبا وبعدين
+
+85
+00:08:00,620 --> 00:08:07,560
+هنا stop ايش stop يعني؟ يبين مش هو ال barrier ال
+
+86
+00:08:07,560 --> 00:08:12,060
+lens ends on you ال lens ends on you barrier يبقى
+
+87
+00:08:12,060 --> 00:08:15,860
+انا كيف يدخل الدواء اللي انا وضعته هنا في العين
+
+88
+00:08:15,860 --> 00:08:21,820
+يدخل هنا و
+
+89
+00:08:21,820 --> 00:08:27,380
+لا يمكن هيك العلم بيقوللا يمكن لو اعطيك كل دقيقة
+
+90
+00:08:27,380 --> 00:08:33,620
+انه يستطيع انه يوصل هنا therapeutic level يعني
+
+91
+00:08:33,620 --> 00:08:46,480
+ممكن يصل 2% 3% من الدواء اللي دخلت يبقى هنا في
+
+92
+00:08:46,480 --> 00:08:52,100
+necessity ضرورة لو انا عندي هنا infection خاصة في
+
+93
+00:08:52,100 --> 00:08:53,240
+ال endothelmitis
+
+94
+00:08:55,440 --> 00:08:59,320
+Indothermic خطيرة ولا مش خطيرة هذه؟ هذه خطيرة
+
+95
+00:08:59,320 --> 00:09:06,640
+معناه انه لو انا صبرت يومين كل العين هصير bag of
+
+96
+00:09:06,640 --> 00:09:12,400
+pus كل العين هصير ايش؟ bag of pus و هتعمل
+
+97
+00:09:12,400 --> 00:09:14,900
+blindness و لا يشتغل .. حياته مجنون، blindness
+
+98
+00:09:14,900 --> 00:09:21,140
+العين كلها عايزة in equation او in isolation العين
+
+99
+00:09:21,140 --> 00:09:25,290
+عايزة غرف يعنيفالناس اللي بيفهموا على طول من أول
+
+100
+00:09:25,290 --> 00:09:29,350
+ما تفدي علامات ال endophthalmitis يعني blurring of
+
+101
+00:09:29,350 --> 00:09:36,130
+vision، pain و hazy cornea وقدرش انا اشوف ال ..
+
+102
+00:09:36,130 --> 00:09:39,310
+اللي هو ال retina على طول بقول هذه بداية
+
+103
+00:09:39,310 --> 00:09:43,250
+endophthalmitis تسريق ايش نعمل؟ على طول بجيبوا
+
+104
+00:09:43,250 --> 00:09:50,810
+syringe، syringe، اه جيبوا syringe فيها
+
+105
+00:09:56,600 --> 00:10:02,880
+وبروحوا هنا فى شىء اسمه هنا PARS PLANA فى حد يسمى
+
+106
+00:10:02,880 --> 00:10:06,480
+PARS PLANA الجزء الأمام من الـ Cerebellum فشلت
+
+107
+00:10:06,480 --> 00:10:09,160
+يعني أنا ديتنا ماتصلش هنا يعني ديتنا مثلا تبدأ هنا
+
+108
+00:10:09,160 --> 00:10:15,260
+ديتنا مثلا تبدأ هنا المنطقة هذه اسمها PARS PLANA
+
+109
+00:10:15,260 --> 00:10:21,700
+من ال PARS PLANA INJECTION Perfective Antibiotics
+
+110
+00:10:21,700 --> 00:10:27,410
+مرة و 12 ساعة مرة و 12 ساعة مرةلو بدنا .. احنا
+
+111
+00:10:27,410 --> 00:10:33,670
+ننقذ العين من الصليب، من العين أما أننا هنعطيه
+
+112
+00:10:33,670 --> 00:10:39,850
+topical أو حتى هنعطيه systemic intravenous يعني،
+
+113
+00:10:39,850 --> 00:10:43,750
+intravenous لأن في barrier آخر اسمه إيش ال barrier
+
+114
+00:10:43,750 --> 00:10:48,630
+الآخر؟ retinal blood barrier
+
+115
+00:10:52,960 --> 00:10:56,400
+فحتى لو انا اعطيت my way مش هكون effective زي
+
+116
+00:10:56,400 --> 00:11:01,540
+intravitreal injection of effective antibiotics
+
+117
+00:11:01,540 --> 00:11:07,020
+عايزة النقطة تكون clear عنكم؟ انا مش عايز انتوا
+
+118
+00:11:07,020 --> 00:11:10,680
+تنافسوا intravitreal injection بس لو في خيالكوا
+
+119
+00:11:10,680 --> 00:11:14,620
+انه في حالة خاصة post operative عمل عملية خاصة
+
+120
+00:11:14,620 --> 00:11:19,140
+cataract اكتر من عمليات cataract احيانا بيصير فيها
+
+121
+00:11:19,140 --> 00:11:25,320
+بداية infectionمريض بدأ يشهر بال .. بالقلم وبلايك
+
+122
+00:11:25,320 --> 00:11:33,520
+of vegan وهيزيكوميا على السريع لو في team of
+
+123
+00:11:33,520 --> 00:11:38,260
+ophthalmologists and surgeries to do intravitreal
+
+124
+00:11:38,260 --> 00:11:44,400
+injection طيب
+
+125
+00:11:44,400 --> 00:11:50,120
+الآن هنسى ال .. periocular injection
+
+126
+00:11:53,410 --> 00:11:59,730
+الانجبشن كما ترون انه ليس في الانترابتريا في أمام
+
+127
+00:11:59,730 --> 00:12:06,510
+العين يعني غالبا ساب كونجنهتائفل تحت المنتحمة يعني
+
+128
+00:12:06,510 --> 00:12:10,070
+عامة الهيدروفيلكاتراكس مفيدة أكتر عندما يتم
+
+129
+00:12:10,070 --> 00:12:17,350
+إعطائها ساب كونجنهتائفل روت يعني الابيثيليم و
+
+130
+00:12:17,350 --> 00:12:19,810
+الهندر الabsorption
+
+131
+00:12:23,650 --> 00:12:30,750
+فأنا كيف أتغلب؟ أعمل injection subconjunctiva هاي
+
+132
+00:12:30,750 --> 00:12:35,770
+المبتحمة اللي فيها ال blood vessels تحتها أعطي
+
+133
+00:12:35,770 --> 00:12:40,270
+مثلا دي طميسين absorption occurs from the residual
+
+134
+00:12:40,270 --> 00:12:43,270
+water أو ال drugs of the subconjunctiva الدي بط
+
+135
+00:12:43,270 --> 00:12:46,810
+which is not subject to precordial factors as in
+
+136
+00:12:46,810 --> 00:12:52,480
+topical application طبعا أنا لما بدي أعطيصحيح كنا
+
+137
+00:12:52,480 --> 00:12:59,140
+نكتب ال injection هنا هاي الملتحمة هنا في المطبخ
+
+138
+00:12:59,140 --> 00:13:05,140
+هذه بتعطي
+
+139
+00:13:05,140 --> 00:13:09,540
+جزء الأمام من ال sclera بدي انا اوضع هنا
+
+140
+00:13:09,540 --> 00:13:14,900
+antibiotic معين اللي هو خاصة ال hydrophilic طبعا
+
+141
+00:13:14,900 --> 00:13:19,580
+لما اعطي ال hydrophilic هصير swing ال drugs هتفصل
+
+142
+00:13:21,500 --> 00:13:27,780
+الوطن اللي انا حاجته الوطن اللي انا حاجته الوطن
+
+143
+00:13:27,780 --> 00:13:36,700
+اللي انا حاجته الوطن اللي انا حاجته الوطن
+
+144
+00:13:36,700 --> 00:13:37,560
+اللي انا حاجته الوطن اللي انا حاجته الوطن اللي انا
+
+145
+00:13:37,560 --> 00:13:37,560
+حاجته الوطن اللي انا حاجته الوطن اللي انا حاجته
+
+146
+00:13:37,560 --> 00:13:37,560
+الوطن اللي انا حاجته الوطن اللي انا حاجته الوطن
+
+147
+00:13:37,560 --> 00:13:37,560
+اللي انا حاجته الوطن اللي انا حاجته الوطن اللي انا
+
+148
+00:13:37,560 --> 00:13:37,560
+حاجته الوطن اللي انا حاجته الوطن اللي انا حاجته
+
+149
+00:13:37,560 --> 00:13:37,600
+الوطن اللي انا حاجته الوطن اللي انا حاجته الوطن
+
+150
+00:13:37,600 --> 00:13:48,720
+اللي انا حاجته الوطن اللي انا حاجته الوطن
+
+151
+00:13:49,980 --> 00:13:54,360
+هي اتسلل البطارية او اخرى من هنا و من هنا الى داخل
+
+152
+00:13:54,360 --> 00:13:58,360
+الاكيواز اللى هون فالان تبقى symbol of restriction
+
+153
+00:13:58,360 --> 00:14:05,240
+طيب مين أسرع ان انا اعطيت الدواء المائي من هنا ولا
+
+154
+00:14:05,240 --> 00:14:11,780
+من هنا لأ بالحواجة أسرع بالحواجة أسرع و انا اكون
+
+155
+00:14:11,780 --> 00:14:17,240
+أحيان مضطر اضطرارا في حياة الكورة الألزر ان اعطي
+
+156
+00:14:18,010 --> 00:14:24,030
+Tropical lipophilic antibiotic drops and
+
+157
+00:14:24,030 --> 00:14:29,590
+subconjunctival hydrophilic injection، هنا
+
+158
+00:14:29,590 --> 00:14:33,730
+hydrophilic وهنا lipophilic، to save the cornea
+
+159
+00:14:33,730 --> 00:14:34,870
+from damage
+
+160
+00:14:57,630 --> 00:15:00,010
+الكنجلك تايبا الابيثيليام هو عبارة عن عبارة عن
+
+161
+00:15:00,010 --> 00:15:01,030
+عبارة عن عبارة عن عبارة عن عبارة عن عبارة عن عبارة
+
+162
+00:15:01,030 --> 00:15:01,690
+عن عبارة عن عبارة عن عبارة عن عبارة عن عبارة عن
+
+163
+00:15:01,690 --> 00:15:05,390
+عبارة عن عبارة عن عبارة عن عبارة عن عبارة عن عبارة
+
+164
+00:15:05,390 --> 00:15:11,610
+عن عبارة عن عبارة عن عبارة عن عبارة عن عبارة عن
+
+165
+00:15:11,610 --> 00:15:12,230
+عبارة عن عبارة عن عبارة عن عبارة عن عبارة عن عبارة
+
+166
+00:15:12,230 --> 00:15:12,230
+عن عبارة عن عبارة عن عبارة عن عبارة عن عبارة عن
+
+167
+00:15:12,230 --> 00:15:18,650
+عبارة عن عبارة عن عبارة عن عبارة عن عبارة عن عبارة
+
+168
+00:15:18,650 --> 00:15:26,550
+عن عب
+
+169
+00:15:28,860 --> 00:15:32,740
+Advantages of peri-occurring injections ما هي
+
+170
+00:15:32,740 --> 00:15:39,560
+المزايا للحاقن تحت المتحنة؟ One, a clinical
+
+171
+00:15:39,560 --> 00:15:42,900
+approach of administration often provides therapy
+
+172
+00:15:42,900 --> 00:15:46,420
+to claim effective drug labels in aqueous for
+
+173
+00:15:46,420 --> 00:15:50,420
+eight to twelve hours after a single injection
+
+174
+00:15:50,420 --> 00:15:56,760
+يعني الحُب ده راح هتفضل من تمانية إلى اتناشر ساعة
+
+175
+00:16:04,670 --> 00:16:13,730
+عكس ال drops يمكن بدي ساعة كل ساعة مثلا طيب
+
+176
+00:16:13,730 --> 00:16:18,110
+flow in studies of subcontractable injections of
+
+177
+00:16:18,110 --> 00:16:23,610
+third generation kefalosporin مضاد حيوي زي keflix
+
+178
+00:16:23,610 --> 00:16:28,690
+injection the common levels achieved were four
+
+179
+00:16:28,690 --> 00:16:32,110
+fold higher than level in aqueous concentration
+
+180
+00:16:33,730 --> 00:16:37,990
+ولما أنا عملت الحقنة تحت المتحمة و قصد بعد فترة
+
+181
+00:16:37,990 --> 00:16:45,230
+لجيت التركيز داخل stroma مثلا أكتر
+
+182
+00:16:45,230 --> 00:16:49,590
+من ال aqueous تركيز دعا بارة مرة بارة تلت مرات
+
+183
+00:16:49,590 --> 00:16:56,830
+يعني يعني four في الكوميا to one في ال aqueous طيب
+
+184
+00:16:56,830 --> 00:17:02,710
+برضه بعض ال injection في المتحمة أيضا تحت المتحمة
+
+185
+00:17:03,870 --> 00:17:08,370
+ووجدوا أن تنكيز الدواء المضاد للحياة والماء في
+
+186
+00:17:08,370 --> 00:17:16,010
+الكوررويد أكتر من ال retina فى five-fourth of the
+
+187
+00:17:16,010 --> 00:17:22,110
+كوررويد و five-fourth خمس مرات to fifteen-fourth
+
+188
+00:17:22,110 --> 00:17:29,230
+خمسة إلى خمستاشر يعني than of the retina يعني ثلاث
+
+189
+00:17:29,230 --> 00:17:31,790
+أقاط الأقل وخمستاشر أكتر
+
+190
+00:17:33,840 --> 00:17:43,180
+اللي يبدو انه قرب المسافة .. ايوة يعني زي مثلا انا
+
+191
+00:17:43,180 --> 00:17:47,600
+ماجرة ميه، ماجرة ميه، انا متوقع ان جوانب الميه
+
+192
+00:17:47,600 --> 00:17:55,280
+المباشرة هتكون رطبة اكتر من الحواف الأبعاد، صحيح؟
+
+193
+00:17:55,280 --> 00:18:02,260
+يعني .. يعني لو في جدول ميه ماشيكل ما قررت أنا على
+
+194
+00:18:02,260 --> 00:18:06,320
+حواف الجدول هكون فيه مية أكتر وكل ما قعدت هيكون
+
+195
+00:18:06,320 --> 00:18:11,920
+مية أقل بالحقنة أكتر تركيز هيكون في القرن بقعده في
+
+196
+00:18:11,920 --> 00:18:16,340
+الأكواز، بقعده في القرن، بقعده في الريتينال، طب في
+
+197
+00:18:16,340 --> 00:18:24,140
+الفيترياس؟ نل، نل، تريس الريتينال
+
+198
+00:18:24,140 --> 00:18:31,010
+10 to 1 في الفيترياسلان انا ببيبين ليش انه very
+
+199
+00:18:31,010 --> 00:18:35,670
+poor concentration of periocar injection in the
+
+200
+00:18:35,670 --> 00:18:40,350
+petrius عشان اقولك انه ليس مديل عن البرزي بلانة
+
+201
+00:18:40,350 --> 00:18:42,750
+intra petrial injection
+
+202
+00:18:55,150 --> 00:18:58,270
+Thus there is a significant concentration gradient
+
+203
+00:18:58,270 --> 00:19:02,150
+تدوند يعني from coral to retina and from retina to
+
+204
+00:19:02,150 --> 00:19:06,210
+petrius يعني لو بدي أعملها نسبة و تناسب في جدول
+
+205
+00:19:06,210 --> 00:19:09,670
+بطل التركيز في القرانية
+
+206
+00:19:27,800 --> 00:19:34,280
+مقال هذا يشير إلى أن إستخدامات غير مستخدمة لا يمكن
+
+207
+00:19:34,280 --> 00:19:36,420
+تغيير إستخدامات إستخدامات إستخدامات إستخدامات
+
+208
+00:19:36,420 --> 00:19:37,800
+إستخدامات إستخدامات إستخدامات إستخدامات إستخدامات
+
+209
+00:19:37,800 --> 00:19:44,960
+إستخدامات إستخدامات إستخدامات
+
+210
+00:19:55,440 --> 00:19:59,660
+ويعني جهلا بعض الناس بيقولك يا شيخ حُط تختمر
+
+211
+00:19:59,660 --> 00:20:06,540
+التحمة و بعدين تمشي الأمور لأ تمشيش الأمور لأن حسب
+
+212
+00:20:06,540 --> 00:20:12,000
+التقارير العلمية ان ال vitreous ما بيصلوش بيفضل في
+
+213
+00:20:12,000 --> 00:20:19,600
+barrier من ال zaniole and lins similarly
+
+214
+00:20:19,600 --> 00:20:24,880
+psychotropic addictions are notand effective and
+
+215
+00:20:24,880 --> 00:20:27,780
+frequent topical application in treating keratitis
+
+216
+00:20:27,780 --> 00:20:30,600
+and should be limited to situations
+
+217
+00:20:54,080 --> 00:21:00,240
+than subglottal injection in the treatment of
+
+218
+00:21:00,240 --> 00:21:06,620
+endosalmitis العكس؟ العكس؟
+
+219
+00:21:06,620 --> 00:21:11,920
+ده صح؟ اه صح، endosalmitis
+
+220
+00:21:11,920 --> 00:21:21,920
+طيب النتيجة التانية اللي بنصلها انه frequent تبوه
+
+221
+00:21:21,920 --> 00:21:22,180
+هذه
+
+222
+00:21:27,650 --> 00:21:34,390
+Drug installation كترة كل ساعة is more effective
+
+223
+00:21:34,390 --> 00:21:40,670
+than subconjunctal injection in treatment of
+
+224
+00:21:40,670 --> 00:21:45,230
+keratitis ومنها الكورنالألثر مين أحسن؟ اعطيه إبرا
+
+225
+00:21:45,230 --> 00:21:49,270
+صباح ومساء للكورنالألثر
+
+226
+00:21:49,270 --> 00:21:57,680
+ولا اعطيه كل ساعة قطرة اتبعتك؟ لأ طيب العكسأنا في
+
+227
+00:21:57,680 --> 00:22:03,760
+عندي هنا حاجة اسمها acute radicyclitis تعرفون
+
+228
+00:22:03,760 --> 00:22:09,600
+radicyclitis؟ طب علاج الكورتيزون؟ Stimulix؟ و
+
+229
+00:22:09,600 --> 00:22:17,160
+الكلام هذا؟ كويس؟ Bradford؟ مين أفضل هنا؟ أعطي
+
+230
+00:22:17,160 --> 00:22:23,340
+frequent .. frequent اللي هو topical
+
+231
+00:22:49,540 --> 00:22:54,760
+الحالات اللي انا بدأ اختارها احقنها في العين تحت
+
+232
+00:22:54,760 --> 00:22:55,360
+المرتاحة
+
+233
+00:22:59,240 --> 00:23:05,980
+أو الطريقة الانتراثية للدراسة تعتمد على اولا،
+
+234
+00:23:05,980 --> 00:23:10,800
+قدرة الدراجات على التدخل في الكورية، لو كانت
+
+235
+00:23:10,800 --> 00:23:14,880
+الدراجة إيبوفيليكية أفضل اعطيها قطرة، لو كانت
+
+236
+00:23:14,880 --> 00:23:18,600
+هيدروفيليكية اعطيها دبشتين اثنان، موقع موقع
+
+237
+00:23:18,600 --> 00:23:26,690
+المواجهة، وين المرض، هل المرض سطحي ولا ديب؟بقول
+
+238
+00:23:26,690 --> 00:23:30,970
+ايه؟ ال general leads and lead margins، ال lead
+
+239
+00:23:30,970 --> 00:23:32,990
+infection و ال lead margins، عارفين ال lead
+
+240
+00:23:32,990 --> 00:23:36,670
+margins هنا؟ بيصير فيها seborrheic blepharitis،
+
+241
+00:23:36,670 --> 00:23:41,570
+اسمها blepharitis هنا، بكتيريا blepharitis، افضل
+
+242
+00:23:41,570 --> 00:23:46,850
+ان يعطيها ايش؟ ointment، لان ointment بيبقى على ال
+
+243
+00:23:46,850 --> 00:23:52,590
+lead و lead margins طيب، بيت، و الأزم .. كنت جدا
+
+244
+00:23:52,590 --> 00:24:00,050
+كتابةلينبس كوريا ال interior chamber اللي أفضل ان
+
+245
+00:24:00,050 --> 00:24:07,210
+اعطيهم topical frequent installation اما
+
+246
+00:24:07,210 --> 00:24:12,210
+solutions او اللي هو suspensions المهم قطرة لان
+
+247
+00:24:12,210 --> 00:24:16,930
+المنتج همال كوريا وحتى ال AC قطرة كل ساعة او كل
+
+248
+00:24:16,930 --> 00:24:17,350
+ساعتين
+
+249
+00:24:27,110 --> 00:24:32,090
+مش شايف اول 24 ساعة فيه من داخله للحجار مش صعبه ال
+
+250
+00:24:32,090 --> 00:24:36,010
+stuff in your stomach مش صعب طيب drugs
+
+251
+00:24:36,010 --> 00:24:38,890
+administered systemically systemically يعني
+
+252
+00:24:38,890 --> 00:24:43,590
+بالوريد مثلا او بالأقلاص penetrate the aqueous and
+
+253
+00:24:43,590 --> 00:24:50,050
+vitreous humor with difficulty لأن في عندي two
+
+254
+00:24:50,050 --> 00:24:53,970
+barriers blood aqueous barrier و blood retinal
+
+255
+00:24:53,970 --> 00:24:57,880
+barrier و هذا كله اتكلمنا فيهPenetration into the
+
+256
+00:24:57,880 --> 00:25:00,500
+aqueous humor is restricted by blood aqueous
+
+257
+00:25:00,500 --> 00:25:03,360
+barrier which exists between the endothelium
+
+258
+00:25:03,360 --> 00:25:05,200
+overlying the capillaries of the iris and cerebral
+
+259
+00:25:05,200 --> 00:25:11,240
+body which has a tie intracellular junctions
+
+260
+00:25:11,240 --> 00:25:17,780
+وPenetration
+
+261
+00:25:17,780 --> 00:25:22,240
+in the Petrius يشبه من الدوائل الخشبكية للبتريس
+
+262
+00:25:42,420 --> 00:25:53,460
+شال هنا شال الانس و الذنوب و وضع هنا دوة و قعدت ان
+
+263
+00:25:53,460 --> 00:25:57,880
+الدواء بيخش هنا راحزين؟
+
+264
+00:25:57,880 --> 00:26:05,560
+لما شال الانس و الذنوب و وضع قطرة و قاس بعد فترة
+
+265
+00:26:05,560 --> 00:26:08,200
+قبل aspiration يعني سحب
+
+266
+00:26:11,250 --> 00:26:15,790
+هو ايش اذا ال .. البرنامج العق .. اذا العق
+
+267
+00:26:15,790 --> 00:26:21,990
+التشريحي من أمام الدواء بس عادي يعني لما اشيل ال
+
+268
+00:26:21,990 --> 00:26:29,910
+lens و اشيل ال zonule هيصير ايش افكك افكك
+
+269
+00:26:29,910 --> 00:26:34,490
+افكك افكك افكك افكك افكك افكك افكك افكك افكك افكك
+
+270
+00:26:34,490 --> 00:26:38,850
+افكك افكك افكك افكك افكك افكك افكك افكك افكك افكك
+
+271
+00:26:38,850 --> 00:26:38,850
+افكك افكك افكك افكك افكك افكك افكك افكك افكك افكك
+
+272
+00:26:38,850 --> 00:26:42,780
+افكك افكك افكك افكك افكك افكك افكك افكك افnear or
+
+273
+00:26:42,780 --> 00:26:47,360
+distant انت بشوف قريب ولا مش قريب؟ مافيش IO ايه؟
+
+274
+00:26:47,360 --> 00:26:57,140
+هو shallow عشان التجربة shallow مقول لي برضه هاي
+
+275
+00:26:57,140 --> 00:27:00,960
+الطريقة تدخل النوع ال matrius بس هاي الطريقة
+
+276
+00:27:00,960 --> 00:27:07,600
+التجاربية مش عمالية يعني وفي حالة ال inflammation
+
+277
+00:27:07,600 --> 00:27:10,240
+في
+
+278
+00:27:12,230 --> 00:27:15,870
+ال .. ال
+
+279
+00:27:15,870 --> 00:27:20,770
+.. ال blood vessels او ال retina يكون فيه نوع من
+
+280
+00:27:20,770 --> 00:27:27,970
+ال vasculitis فى ال vasculitis او ال retinitis ال
+
+281
+00:27:27,970 --> 00:27:31,770
+blood vessel اللى بيكون كده بيكون ال endothelium
+
+282
+00:27:31,770 --> 00:27:35,250
+tightly
+
+283
+00:27:35,250 --> 00:27:41,790
+lining the vesselلو صار باسكولاتس بصير ..
+
+284
+00:27:41,790 --> 00:27:42,930
+باسكولاتس بصير .. باسكولاتس بصير .. باسكولاتس بصير
+
+285
+00:27:42,930 --> 00:27:43,130
+.. باسكولاتس بصير .. باسكولاتس بصير .. باسكولاتس
+
+286
+00:27:43,130 --> 00:27:43,470
+بصير .. باسكولاتس بصير .. باسكولاتس بصير ..
+
+287
+00:27:43,470 --> 00:27:45,890
+باسكولاتس بصير .. باسكولاتس بصير .. باسكولاتس بصير
+
+288
+00:27:45,890 --> 00:27:47,410
+.. باسكولاتس بصير .. باسكولاتس بصير .. باسكولاتس
+
+289
+00:27:47,410 --> 00:27:52,270
+بصير .. باسكولاتس بصير .. باسكولاتس بصير ..
+
+290
+00:27:52,270 --> 00:27:56,350
+باسكولاتس بصير .. باسكولاتس بصير .. باسكولاتس بصير
+
+291
+00:27:56,350 --> 00:28:02,310
+.. باسكولاتس بصير
+
+292
+00:28:02,310 --> 00:28:06,030
+.. باسكولاتس بصير ..
+
+293
+00:28:12,660 --> 00:28:19,640
+الـ chapter 10 factors affecting the choice of
+
+294
+00:28:19,640 --> 00:28:28,140
+diagnostic drugs factors العوامل التي تؤثر على
+
+295
+00:28:28,140 --> 00:28:36,120
+اختيار الدواء التشخيصي في العين في العين في أدوية
+
+296
+00:28:36,120 --> 00:28:41,420
+تشخيصيةو هنشوف جيش الأدوات التشكيسية و كيف انا
+
+297
+00:28:41,420 --> 00:28:47,180
+اختارها في الآية او ده دواة تشكيسية Cyclopidics
+
+298
+00:28:47,180 --> 00:28:54,540
+تشكيس ليه؟ خاصة
+
+299
+00:28:54,540 --> 00:28:57,540
+للـ Latent Hyperloop
+
+300
+00:29:03,260 --> 00:29:06,480
+Esotropia. Children Esotropia. يبقى
+
+301
+00:29:06,480 --> 00:29:09,220
+Psychopolitics، this group has suffered some
+
+302
+00:29:09,220 --> 00:29:14,140
+attrition، تآكلة. And from an original list of
+
+303
+00:29:14,140 --> 00:29:19,560
+seven كانوا قبل عشرين سنة، seven psychopolitics.
+
+304
+00:29:21,280 --> 00:29:27,620
+Only four now remain. الآن في دلوقت أربعة. إيش ال
+
+305
+00:29:27,620 --> 00:29:29,540
+.. ال psychopolitics اللي أنتوا عارفينها؟
+
+306
+00:29:29,540 --> 00:29:30,260
+Psychopolitics
+
+307
+00:29:43,160 --> 00:30:00,520
+مدرياتك مدرياتك كانت مجموعة طويلة
+
+308
+00:30:00,520 --> 00:30:01,880
+من مجموعات مدرياتك
+
+309
+00:30:15,560 --> 00:30:21,060
+فاضل ان انا عندي مدرسين
+
+310
+00:30:21,060 --> 00:30:28,500
+يعني وفاضل ان انا عندي فلائل افرين more potent
+
+311
+00:30:28,500 --> 00:30:32,420
+genetics are used prior to surgery طبعا انا
+
+312
+00:30:32,420 --> 00:30:38,630
+مابعتبرش ان الاطرابينهو منرياتيك لوحده لأنه ان
+
+313
+00:30:38,630 --> 00:30:44,770
+حاطبنا عمل سيبير اياشترا فانما المدرياتيك اللي هو
+
+314
+00:30:44,770 --> 00:30:52,330
+شغال اللي هو المدرع معاه و الفلالفلي اللي مشتمش
+
+315
+00:30:52,330 --> 00:30:56,790
+على السينابودي إلا بنسبة قليلة ده هو التشخيص
+
+316
+00:30:56,790 --> 00:31:01,190
+التالت myotics المضيقات
+
+317
+00:31:05,680 --> 00:31:11,360
+الخطوات الأكبر حدثت من هذا الانتجاب بقول أكتر لسة
+
+318
+00:31:11,360 --> 00:31:17,300
+منهم فقدت لون يعني في أعضاها هي هذه ميوتيكس لديها
+
+319
+00:31:17,300 --> 00:31:20,540
+استعمال
+
+320
+00:31:20,540 --> 00:31:26,940
+يوميا يكون ثيرابيوتيكي ودياجنوستيكي تشخيزي وعلاجي
+
+321
+00:31:26,940 --> 00:31:33,780
+طبعا بالنسبة للعلاج يكون هنا open angle glaucoma
+
+322
+00:31:35,790 --> 00:31:44,270
+والتشخيص ايه؟ والتشخيص ايه؟ شوف ال pupil size وشوف
+
+323
+00:31:44,270 --> 00:31:48,450
+اللي هو ال muscle .. the muscle اللي هي ال spectro
+
+324
+00:31:48,450 --> 00:31:53,030
+-pili القوة بتاعك طب local anesthetics
+
+325
+00:32:08,770 --> 00:32:13,850
+أما من أن الـ Optometrist باستخدام قفل توروميتر
+
+326
+00:32:13,850 --> 00:32:18,810
+بقياس برطلعين ال range of local anesthetics has
+
+327
+00:32:18,810 --> 00:32:23,130
+remained fairly steady لكن لمزال استعمالها عند
+
+328
+00:32:23,130 --> 00:32:26,250
+Optometrist موجودة ثابتة cocaine
+
+329
+00:32:29,990 --> 00:32:33,830
+سايدينفكسي كتيرة بطلوا يستعملوه is now really used
+
+330
+00:32:33,830 --> 00:32:38,790
+medically because better agents are available يعني
+
+331
+00:32:38,790 --> 00:32:42,450
+زي ال bio carbine مثلا ال bio carbine هو ال
+
+332
+00:32:42,450 --> 00:32:48,790
+dominant قال هو ال .. أسف ال bio carbine اللي هو
+
+333
+00:32:48,790 --> 00:32:52,730
+ال myotic لكن ال local aesthetics لوكالين ليه
+
+334
+00:32:52,730 --> 00:32:58,400
+دوكايين؟ ليه دوكايين is dominantالكوكاين كان بيعمل
+
+335
+00:32:58,400 --> 00:33:04,040
+اللي هو شيء من التسكين وشيء، الآن obsolete. إيه
+
+336
+00:33:04,040 --> 00:33:09,980
+وصلة للإفلتس؟ الآن الليدو كيين. طبعا عند الأطباء
+
+337
+00:33:09,980 --> 00:33:15,720
+العيون مافيش طبيعو مستغنى عن اللي هو ال local
+
+338
+00:33:15,720 --> 00:33:18,420
+anesthetic أو ال topical anesthetic.
+
+339
+00:33:23,520 --> 00:33:31,180
+لأنه مهم جدا في أي .. يعني ال treatment ..
+
+340
+00:33:31,180 --> 00:33:35,880
+superficial treatment لكوابيرا كليرطية، مثلا إزالة
+
+341
+00:33:35,880 --> 00:33:43,160
+جسم غريب، قياس، اللي هو ضغط العين، أكوابير، أه، في
+
+342
+00:33:43,160 --> 00:33:45,740
+أش .. أكتر من أيه اللي هو استعمال ليه؟ اللي هو
+
+343
+00:33:45,740 --> 00:33:51,640
+local أو topical anestheticفي كمان drugs اللي
+
+344
+00:33:51,640 --> 00:33:58,100
+بتستخدم في الoptometry تشخيصية stains الأصبار ايضا
+
+345
+00:33:58,100 --> 00:34:05,340
+this is one area that at one time appeared to have
+
+346
+00:34:05,340 --> 00:34:10,520
+growth يعني قبل مثلا عشرين سنة كانت منتعشة في
+
+347
+00:34:10,520 --> 00:34:11,580
+أصبار زيادة
+
+348
+00:34:14,930 --> 00:34:19,990
+two stains are used routinely بس اتنين and the use
+
+349
+00:34:19,990 --> 00:34:25,210
+of one product cease ده ده هو ال king of stains
+
+350
+00:34:25,210 --> 00:34:29,850
+floating لكن
+
+351
+00:34:29,850 --> 00:34:35,950
+أشيل بلور وبعض ال drugs الآن أصبحت يعني قليلة
+
+352
+00:34:35,950 --> 00:34:43,390
+أصبحت قليلة فهي five groups of diagnostic
+
+353
+00:34:49,230 --> 00:34:56,250
+ماذا يعني مزايا دراجات دياجموستيكية دراجات
+
+354
+00:34:56,250 --> 00:34:56,970
+دياجموستيكية دراجات دياجموستيكية دراجات
+
+355
+00:34:56,970 --> 00:34:58,710
+دياجموستيكية دراجات دياجموستيكية دراجات
+
+356
+00:34:58,710 --> 00:35:01,550
+دياجموستيكية دراجات دياجموستيكية دراجات
+
+357
+00:35:01,550 --> 00:35:02,070
+دياجموستيكية دراجات دياجموستيكية دراجات
+
+358
+00:35:02,070 --> 00:35:02,070
+دياجموستيكية دراجات دياجموستيكية دراجات
+
+359
+00:35:02,070 --> 00:35:02,070
+دياجموستيكية دراجات دياجموستيكية دراجات
+
+360
+00:35:02,070 --> 00:35:02,090
+دياجموستيكية دراجات دياجموستيكية دراجات
+
+361
+00:35:02,090 --> 00:35:06,110
+دياجموستيكية دراجات دياج
+
+362
+00:35:10,670 --> 00:35:15,790
+يعني هذه الثلاثة مزايا غابت، فيعني إيش فادة
+
+363
+00:35:15,790 --> 00:35:23,530
+الدرجة؟ أول مزية easier under pressure سهل للمريض،
+
+364
+00:35:23,530 --> 00:35:27,930
+مايعمليش irritation، مايعمليش burning، مايعمليش
+
+365
+00:35:27,930 --> 00:35:28,950
+stinging
+
+366
+00:35:34,970 --> 00:35:40,510
+يكون سهل ما يلوث ثيابه ما يلوث جلده يعني easier to
+
+367
+00:35:40,510 --> 00:35:43,690
+another patient this certainly applies when the
+
+368
+00:35:43,690 --> 00:35:46,350
+procedure involves a local anesthetic خاصة في
+
+369
+00:35:46,350 --> 00:35:49,570
+الفنجر موضعي او for other agents if the use of
+
+370
+00:35:49,570 --> 00:35:52,270
+diagnostic drug will allow the examination to be
+
+371
+00:35:52,270 --> 00:35:56,670
+carried out quicker and more efficiently then this
+
+372
+00:35:56,670 --> 00:36:00,290
+will be to the patients advantage يعني انا بدي
+
+373
+00:36:00,290 --> 00:36:10,900
+سريع وسهلتحط ال drug تعملي القياس و امشي ال
+
+374
+00:36:10,900 --> 00:36:14,980
+patient مش عايز يطيب الأسنان يطيب الأسنان يعمل
+
+375
+00:36:14,980 --> 00:36:20,920
+اللي هو في الجامعة injection تنتظر نصف ساعة لغاية
+
+376
+00:36:20,920 --> 00:36:26,280
+ما يعملك خدل في نصف وجهك من أعلى من أسفل و أنت
+
+377
+00:36:26,280 --> 00:36:30,300
+طبعا خايف خوف لأنهم يقولك تعالي يعني معناه إيش
+
+378
+00:36:30,300 --> 00:36:35,830
+مابدو يخلع و يعملوكلام زي هذا، لأ احنا بدنا ال ..
+
+379
+00:36:35,830 --> 00:36:41,290
+ال .. ال optometrist يكون ايش؟ يعني سهل، مافيش فيه
+
+380
+00:36:41,290 --> 00:36:45,750
+يعني عقاب يعني، يبقى سهل للمريض، تعني easier for
+
+381
+00:36:45,750 --> 00:36:51,210
+practitioners الممارس، ال optometrist، فانا بقدرش
+
+382
+00:36:51,210 --> 00:36:56,870
+بقى احنا بحط نقطة ال .. ال .. ال .. ال الوكيينلأنه
+
+383
+00:36:56,870 --> 00:37:01,130
+على طول يتجاوب مايوش المريض يتقلق مثلا لما حط نقطة
+
+384
+00:37:01,130 --> 00:37:06,250
+الفيروسين تصبغ المكان على طول مايوش حط لأ حط كمان
+
+385
+00:37:06,250 --> 00:37:09,990
+واحدة أو كمان واحدة الانتجار من مجلس مجلس مجلس
+
+386
+00:37:09,990 --> 00:37:11,390
+مجلس مجلس مجلس مجلس مجلس مجلس مجلس مجلس مجلس مجلس
+
+387
+00:37:11,390 --> 00:37:11,550
+مجلس مجلس مجلس مجلس مجلس مجلس مجلس مجلس مجلس مجلس
+
+388
+00:37:11,550 --> 00:37:11,550
+مجلس مجلس مجلس مجلس مجلس مجلس مجلس مجلس مجلس مجلس
+
+389
+00:37:11,550 --> 00:37:24,770
+مجلس مجلس مجلس مجلس مج
+
+390
+00:37:25,030 --> 00:37:28,950
+فلوريسين؟ طيب بتاريكزاميناشي ان و اما ال results
+
+391
+00:37:28,950 --> 00:37:34,870
+كويسة مكونش مرشوش ولا مخافر again in the case of
+
+392
+00:37:34,870 --> 00:37:37,990
+midletics and cyclopidics the results obtained
+
+393
+00:37:37,990 --> 00:37:42,490
+will often be more valuable يعني ايش more valuable
+
+394
+00:37:42,490 --> 00:37:50,270
+قيمة يعني تكون accurate مكونش
+
+395
+00:37:50,270 --> 00:37:51,370
+drug facet
+
+396
+00:37:54,710 --> 00:37:58,830
+في الرطوبة الحرارة المغيرة التركيزي بتاعهم اللي
+
+397
+00:37:58,830 --> 00:38:04,770
+يقول فيه؟ يبقى هذه تلات مزايا easy to patient easy
+
+398
+00:38:04,770 --> 00:38:07,710
+to practitioner or better examination
+
+399
+00:38:24,470 --> 00:38:30,030
+أيش مساوء أو العيوب؟ بيقول أولا ان الـ I is an
+
+400
+00:38:30,030 --> 00:38:35,130
+artificial state this must be allowed for when
+
+401
+00:38:35,130 --> 00:38:39,610
+carrying out certain tasks يعني أنا اللي حطيتله
+
+402
+00:38:39,610 --> 00:38:46,290
+مدريازيس الآن أنا هيرم في التشريح اللي عندي البقب
+
+403
+00:38:46,290 --> 00:38:53,490
+اللي كان Diameter بتاعه four أو fiveالـ Millimeter
+
+404
+00:38:53,490 --> 00:39:04,390
+صار 10 أو 9 غيرت من ما غيرت العضلة اللي كانت سورتا
+
+405
+00:39:04,390 --> 00:39:08,870
+بيوبيلي شغالة الآن صارت فتلة مافيه قطرة و هي مش
+
+406
+00:39:08,870 --> 00:39:16,110
+شغالة يبقى انا اهداف تغيير طب الآن انا لو حطيت
+
+407
+00:39:16,110 --> 00:39:17,450
+مثلا لطفلة
+
+408
+00:39:27,220 --> 00:39:32,680
+و انا مابنطلع في الشمس بس معناه ان انا ماعملش بس
+
+409
+00:39:32,680 --> 00:39:34,920
+معناه ان انا برضه اي نقطة و انا مابنطلع في الشمس
+
+410
+00:39:34,920 --> 00:39:39,280
+بس معناه ان انا مابنطلع في الشمس بس معناه ان انا
+
+411
+00:39:39,280 --> 00:39:44,100
+مابنطلع في الشمس بس معناه ان انا مابنطلع في الشمس
+
+412
+00:39:44,100 --> 00:39:47,660
+بس معناه ان انا مابنطلع في الشمس بس معناه ان انا
+
+413
+00:39:47,660 --> 00:39:48,380
+مابنطلع في الشمس بس معناه ان انا مابنطلع في الشمس
+
+414
+00:39:48,380 --> 00:39:52,500
+بس معناه ان انا مابنطلع في الشمس بس معناه ان انا
+
+415
+00:39:52,500 --> 00:39:56,080
+مابنطلع في الشمس بس معناه ان انا مابنطلع في الشمس
+
+416
+00:39:56,080 --> 00:39:59,840
+بس معناه ان انااللي هو إيش؟ اللي هو تأثير بتاعها
+
+417
+00:39:59,840 --> 00:40:06,160
+يظهر، this can be short يعني أحيان تبقى خلال دقيقة
+
+418
+00:40:06,160 --> 00:40:09,480
+زي ال local anaesthetic، local anaesthetic يعني
+
+419
+00:40:09,480 --> 00:40:13,300
+costotropic anaesthetic، خلال دقيقة ودقيقة تانية،
+
+420
+00:40:13,300 --> 00:40:18,940
+but sometimes long enough to inconvenience the
+
+421
+00:40:18,940 --> 00:40:23,140
+patient، تزعج المريض، زي حياة الأتروبيين،
+
+422
+00:40:23,140 --> 00:40:27,010
+الأتروبيين بدلوا ساعة لما يبدأوا يشتغلواو بعدين
+
+423
+00:40:27,010 --> 00:40:32,070
+بده أم تاخد القطرة ع البيت و تحطله صبح و مسأل و
+
+424
+00:40:32,070 --> 00:40:35,830
+بعد ما يخلص الأطرابين تلاتة أربعة أيام بده أسبوع
+
+425
+00:40:35,830 --> 00:40:42,370
+لما يبدأ يشوف الأشياء و بده أسبوع تاني لما يطلع في
+
+426
+00:40:42,370 --> 00:40:48,590
+الشمس طب هذي مثلا ال little pearl بدأ حساب مين؟ ال
+
+427
+00:40:48,590 --> 00:40:55,330
+micro فهذه تعتبر disadvantage طيب في كمان يعني عيب
+
+428
+00:40:55,330 --> 00:41:01,620
+تالفprolonged duration of action، ضربنا بالأتروبيل
+
+429
+00:41:01,620 --> 00:41:08,180
+مثلًا، والسيكرو بقى بقى ست ساعات، والأتروبيل أقل
+
+430
+00:41:08,180 --> 00:41:13,920
+شيء ست أيام، prolonged duration، الصح اللي كان هو
+
+431
+00:41:13,920 --> 00:41:20,660
+easy، إن مجرد أنتهي من التشخيص أو الفحص، اللي
+
+432
+00:41:20,660 --> 00:41:25,930
+ماكنش يروح في حالهقرروا إنه أنا خلصت الفحص، مافيش
+
+433
+00:41:25,930 --> 00:41:31,030
+ضرورة إن المرض يعاني بعد هيك، ليش المرض يعاني؟
+
+434
+00:41:31,030 --> 00:41:36,470
+إذاً هذا عيب، يعني البشرية لم تصل إلى الكمال، أنا
+
+435
+00:41:36,470 --> 00:41:40,750
+يعني خلاص أنا جستله الحوال و كتبتله النضارة، و هو
+
+436
+00:41:40,750 --> 00:41:43,870
+لسه فعلا و أتربيت، ليش يفضل الكمال أسبوع أو
+
+437
+00:41:43,870 --> 00:41:46,570
+أسبوعين و هو لوعني، ماطلع في الشمس ولا يقرأ ولا
+
+438
+00:41:46,570 --> 00:41:52,370
+يمسك حاجة، و يبقى عن الروضة الولدإذا هدايب ولا
+
+439
+00:41:52,370 --> 00:42:00,410
+ميزة؟ لسه يعني البشرية لازم يتحسن أدائها.طيب
+
+440
+00:42:00,410 --> 00:42:07,470
+adverse effects of ophthalmic drugs. adverse يعني
+
+441
+00:42:07,470 --> 00:42:12,690
+side effects. هل ال drugs هالي إليها side effects
+
+442
+00:42:12,690 --> 00:42:16,490
+ولا لأ؟ طبعا إليها. بيوضعوا بإيه؟ where is the
+
+443
+00:42:16,490 --> 00:42:20,210
+drug? if it is available might exacerbate that
+
+444
+00:42:20,210 --> 00:42:20,550
+problem.
+
+445
+00:42:27,850 --> 00:42:34,090
+الدراجات ممكن أن تنتهي منها، ليس أن تقطع القطرة
+
+446
+00:42:34,090 --> 00:42:40,430
+وتعمل تأثير دائم، طبعا هي القطرة مرميش reversible
+
+447
+00:42:40,430 --> 00:42:47,530
+أو الـ local adverse effects ع
+
+448
+00:42:47,530 --> 00:42:54,830
+العين بس، بينما التانية systemic على الجسمطب local
+
+449
+00:42:54,830 --> 00:42:59,270
+adverse if it's this can be as mild as stinging
+
+450
+00:42:59,270 --> 00:43:08,250
+يعني خفيفة زي التلخيز عارفين الورز اه او as severe
+
+451
+00:43:08,250 --> 00:43:12,310
+as angioecological angioecological
+
+452
+00:43:32,400 --> 00:43:38,100
+هذا الروت روت ايريس في السيارة البودي، يبقى
+
+453
+00:43:38,100 --> 00:43:40,540
+المسافة من هنا ل هنا حالة ال ايريس في الحالة
+
+454
+00:43:40,540 --> 00:43:40,860
+العادية
+
+455
+00:43:57,950 --> 00:44:02,910
+يعني أن الـ iris اللي كان واصل هنا تجمع من الـ
+
+456
+00:44:02,910 --> 00:44:07,710
+over grounding على ال angle of AC، angle of
+
+457
+00:44:07,710 --> 00:44:14,150
+anterior chamber، هسكر الزاوية، فلو الزاوية نارت،
+
+458
+00:44:14,150 --> 00:44:17,590
+سيبير
+
+459
+00:44:17,590 --> 00:44:17,950
+ال closure
+
+460
+00:44:26,690 --> 00:44:35,550
+على 50 إلى 70 ميلي متر زي اقل سيبير
+
+461
+00:44:35,550 --> 00:44:40,190
+دمج في العين سيبير دمج اوكتكنية هل الدمج هذا
+
+462
+00:44:40,190 --> 00:44:45,510
+reversible او irreversible هذا
+
+463
+00:44:45,510 --> 00:44:49,630
+الدمج irreversible يبقى احنا ملقنا من ال side
+
+464
+00:44:49,630 --> 00:44:52,350
+effects البسيطة حرجان
+
+465
+00:45:01,280 --> 00:45:10,900
+ولا حاجة، لكن الخبر هنا في بعض القطرات تعمل تلون
+
+466
+00:45:10,900 --> 00:45:15,960
+دائم في الـIris، الـIris حتى اللي نصف فاتح أو فاتح
+
+467
+00:45:15,960 --> 00:45:17,920
+شوية، ممكن يصير black
+
+468
+00:45:26,820 --> 00:45:32,220
+زلتان .. زلتان هرق .. انت جاهز لزلتان هرمونية خطر
+
+469
+00:45:32,220 --> 00:45:36,120
+للـ Antiglucoma .. Antiglucoma درجة في منها خطر
+
+470
+00:45:36,120 --> 00:45:46,580
+اسمها اليوميجان اليوميجان اليوميجان او زلتان ممكن
+
+471
+00:45:46,580 --> 00:45:51,940
+تسمى تلوين دائم في العيارات تلوين دائم في العيارات
+
+472
+00:46:06,670 --> 00:46:11,270
+الـ side effects بتكون systemic at this اللي هو
+
+473
+00:46:11,270 --> 00:46:15,710
+systemic في البلد يعني many diagnostic drugs are
+
+474
+00:46:15,710 --> 00:46:20,550
+potent قوية يعني modifiers of autonomic nervous
+
+475
+00:46:20,550 --> 00:46:24,150
+system and are capable of causing effects of
+
+476
+00:46:24,150 --> 00:46:26,970
+automatically innervated structures يعني عشان
+
+477
+00:46:26,970 --> 00:46:31,950
+أريهم مثلا لو أنا أعطيت إنفان أتروبيا عنده
+
+478
+00:46:31,950 --> 00:46:36,790
+أزوتروبيا أعطيته أتروبياطبعا ال atropine هيدخل من
+
+479
+00:46:36,790 --> 00:46:40,750
+العين نازل و لاكتم على ال duct و ينزل على ال nose
+
+480
+00:46:40,750 --> 00:46:44,190
+نازل من قسم ال brain rich of blood vessels و روح
+
+481
+00:46:44,190 --> 00:46:51,530
+على الدم بسألوني انا في التخرج الدكتورة، بقولها
+
+482
+00:46:51,530 --> 00:46:53,790
+الدكتور كان atropine
+
+483
+00:47:03,970 --> 00:47:11,390
+في عيني أو بصوت يعني اخططا اخذوا البلد بالتم
+
+484
+00:47:11,390 --> 00:47:16,490
+مقرمون شغلنا
+
+485
+00:47:16,490 --> 00:47:20,450
+احنا ال autonomous nervous system وعمل ليه
+
+486
+00:47:20,450 --> 00:47:24,750
+toxicity drug toxicity ولمّا ال infants وزنه قليل
+
+487
+00:47:24,750 --> 00:47:26,450
+ممكن يكون overdose مقرمون
+
+488
+00:47:30,040 --> 00:47:34,660
+تشوفوا العلب الدوام المكتوب عليها يحفظ عيدا عن عين
+
+489
+00:47:34,660 --> 00:47:40,960
+الأولاد أو الأطفال صحيح ممكن كورس واحد يختم وممكن
+
+490
+00:47:40,960 --> 00:47:45,140
+لو ال drug استخدم حتى في العين الأطفال ممكن يعملهم
+
+491
+00:47:45,140 --> 00:47:51,680
+systemic adverse effects طيب أخر شئ خلص منه
+
+492
+00:48:01,950 --> 00:48:12,890
+الشيء يجب أن يكون متوفر، يجب
+
+493
+00:48:12,890 --> 00:48:16,950
+أن يكون متوفر، يجب أن يكون متوفر، يجب أن يكون
+
+494
+00:48:16,950 --> 00:48:24,840
+متوفر، يجب أن يكون متوفر، يجب أن يكون متوفر3- its
+
+495
+00:48:24,840 --> 00:48:31,800
+action should be fast in answer 4
+
+496
+00:48:31,800 --> 00:48:35,960
+-
+
+497
+00:48:35,960 --> 00:48:38,420
+its action should be short in duration
+
+498
+00:48:50,610 --> 00:48:56,330
+الدراجة يجب أن لا تكون لديها افكار فارماروكوليجية
+
+499
+00:48:56,330 --> 00:49:00,130
+غير ادراسية،
+
+500
+00:49:00,130 --> 00:49:06,030
+لا تكون لديها افكار فارماروكوليجية غير ادراسية، لا
+
+501
+00:49:06,030 --> 00:49:09,430
+تكون
+
+502
+00:49:09,430 --> 00:49:12,950
+لديها افكار فارماروكوليجية غير ادراسية
+
+503
+00:49:18,000 --> 00:49:24,000
+Present يعني مفرح و easy to use till it should be
+
+504
+00:49:24,000 --> 00:49:28,560
+capable of being produced in stable and sterile
+
+505
+00:49:28,560 --> 00:49:33,120
+ophthalmic form that is appropriate to the use for
+
+506
+00:49:33,120 --> 00:49:37,680
+which is intended يعني انا حضرته مثلا
+
+507
+00:49:37,680 --> 00:49:41,560
+psychologically لمدة سنة مش خيال ساى يتحلل و يخرب
+
+508
+00:49:41,560 --> 00:49:43,960
+حضرت ال
+
+509
+00:49:53,930 --> 00:49:58,970
+مثلا احط مرهم في العين فاكداش ايه عمل ريتنوسكوبي و
+
+510
+00:49:58,970 --> 00:50:04,730
+هيوصل مشكلة، لأ مديش انا ايه، ليه ويه كل العمل
+
+511
+00:50:04,730 --> 00:50:05,250
+التالي؟
+
+512
+00:50:10,900 --> 00:50:14,460
+and the advantages and disadvantages of a proposed
+
+513
+00:50:14,460 --> 00:50:18,300
+drug must be weighed in the light of a particular
+
+514
+00:50:18,300 --> 00:50:21,720
+patient immediately prior to the examination يبقى
+
+515
+00:50:21,720 --> 00:50:24,940
+من عيان لعيان بيختلف في عيان بيمشي معاه للهلاجة
+
+516
+00:50:24,940 --> 00:50:28,400
+وعيان مابمشي معاه عيان بسرعة بيروح منه وعيان بيطول
+
+517
+00:50:28,400 --> 00:50:32,280
+معاه عيان بيأول عينه وعيان مابيأول عينه وكده لكن
+
+518
+00:50:32,280 --> 00:50:38,800
+انا في الآخر بحكم على إيش إمكانية الدواء المناسب
+
+519
+00:50:38,800 --> 00:50:39,320
+للفحص
+
+520
+00:50:42,660 --> 00:50:46,060
+بالنسبة لما حطوا يا مالستاني بدي Cycloblasia يا
+
+521
+00:50:46,060 --> 00:50:50,080
+مالي effective Cycloblasia بقعد نقدر على فلان حاجة
+
+522
+00:50:50,080 --> 00:50:54,160
+يعني في عنده حرفة فلان ما عنده حرفة وكلام زي هذا
+
+523
+00:50:54,160 --> 00:50:58,640
+المهم انه عمل effective and easy examination شكرا
+
+524
+00:50:58,640 --> 00:51:00,180
+لكم والسلام عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/XaWFurSQ-zE.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/XaWFurSQ-zE.srt
new file mode 100644
index 0000000000000000000000000000000000000000..10cca15ad0b3f1c0b36083643cc9eab4cd3db340
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/XaWFurSQ-zE.srt
@@ -0,0 +1,1590 @@
+1
+00:00:21,510 --> 00:00:26,230
+بسم الله الرحمن الرحيم الحمد لله رب العالمين وأصلي 
+
+2
+00:00:26,230 --> 00:00:32,370
+وأسلم على النبي الأمين محمد صلى الله عليه وسلم
+
+3
+00:00:32,370 --> 00:00:36,290
+وعلى آله وأصحابه والتابعين السلام عليكم ورحمة 
+
+4
+00:00:36,290 --> 00:00:41,130
+الله جزاك الله خيرا في هذا اليوم سنكمل ما بدأنا من
+
+5
+00:00:41,130 --> 00:00:48,690
+pharmacology of the eye and today we will talk 
+
+6
+00:00:48,690 --> 00:00:49,250
+about
+
+7
+00:00:53,660 --> 00:00:59,220
+Target sites أي أين سيذهب الدواء في العين ما هي 
+
+8
+00:00:59,220 --> 00:01:05,460
+الأهداف التي داخل العين سيعمل عليها الدواء الدواء 
+
+9
+00:01:05,460 --> 00:01:10,440
+عند موضوعه في العين يتناول أربع مواضع أو أربعة 
+
+10
+00:01:10,440 --> 00:01:14,520
+مواضع، المواضع الأول الـ Preocular structures يعني
+
+11
+00:01:14,520 --> 00:01:19,140
+أشياء خارج العين يعني الـ Eyelids الكُجرة الطيبة 
+
+12
+00:01:25,770 --> 00:01:29,610
+تو قارية نفس القارية القارية صحيح هي superficial 
+
+13
+00:01:29,610 --> 00:01:33,630
+لكن تبتدئ إلى الداخل وبتشرف على ال anterior chamber 
+
+14
+00:01:33,630 --> 00:01:41,990
+ثلاثة قاريات anterior chamber و posterior chamber الحجر 
+
+15
+00:01:41,990 --> 00:01:47,730
+الأمامي والحجر الخلفي مليء بالسائل المائي aqueous humor 
+
+16
+00:01:47,730 --> 00:01:49,170
+aqueous humor aqueous humor aqueous humor aqueous humor aqueous humor aqueous humor aqueous humor aqueous humor
+
+17
+00:01:49,170 --> 00:01:49,610
+aqueous humor aqueous humor aqueous humor aqueous humor aqueous humor aqueous humor aqueous humor aqueous humor
+
+18
+00:01:49,610 --> 00:01:51,630
+aqueous humor aqueous humor aqueous humor aqueous humor aqueous humor aqueous humor aqueous humor aqueous humor
+
+19
+00:01:51,630 --> 00:01:54,090
+aqueous humor aqueous humor aqueous humor aqueous humor aqueous humor aqueous humor aqueous humor 
+
+20
+00:01:55,680 --> 00:02:01,000
+من الخارج إلى الخارج تبدأ بـ Preocular Structures, 
+
+21
+00:02:01,220 --> 00:02:05,340
+Cornea, Anterior chamber, Posterior chamber, then Vitreous
+
+22
+00:02:05,340 --> 00:02:09,780
+and Retina طبعا 
+
+23
+00:02:09,780 --> 00:02:14,180
+الادمنستراتيشن للأمام الظهر يعني سطح العين يمكن 
+
+24
+00:02:14,180 --> 00:02:19,400
+استخدامه لإعطاء الأدوية لـ Preocular, Cornea, 
+
+25
+00:02:19,840 --> 00:02:25,400
+Anterior and Posterior chamber و بعدين Vitreous عادةً، 
+
+26
+00:02:25,400 --> 00:02:28,200
+إدارة سيسيتماكية أو إدارة إنتراوكولية مستخدمة 
+
+27
+00:02:28,200 --> 00:02:30,760
+لتحضير الأدوية لتحقيق هذا الانتشار تتحرك مع
+
+28
+00:02:30,760 --> 00:02:35,940
+مترياز كيميتي يعني أنا مش محتاج عشان أعالج القرنية 
+
+29
+00:02:35,940 --> 00:02:40,700
+أو ال Iris أو أعالج ال Iris مثلا أو ال ciliary 
+
+30
+00:02:40,700 --> 00:02:46,780
+body أني أنا أحكم الوريدي هو ال Topical الأحسن و هو 
+
+31
+00:02:46,780 --> 00:02:51,220
+الأصل لأن مش ال direct على العين لكن هي المشكلة في
+
+32
+00:02:51,220 --> 00:02:58,240
+المتريازالـ topical .. the topical treatment can't 
+
+33
+00:02:58,240 --> 00:03:02,440
+reach the Vitreous لأن فيه barrier one, barrier 
+
+34
+00:03:02,440 --> 00:03:09,520
+two, barrier four, barrier five .. بين ال .. فال
+
+35
+00:03:09,520 --> 00:03:14,140
+.. ال Vitreous هنتكلم عنه إما systemic injection أو
+
+36
+00:03:14,140 --> 00:03:15,100
+intraocular
+
+37
+00:03:20,740 --> 00:03:25,500
+الشيء اللذي يؤثر على استخدام الحرارة للـ 3 أكثر
+
+38
+00:03:25,500 --> 00:03:32,180
+أكثر في المنطقة أكثر أكثر في المنطقة أكثر في 
+
+39
+00:03:32,180 --> 00:03:36,360
+المنطقة أكثر
+
+40
+00:03:36,360 --> 00:03:37,580
+في المنطقة أكثر في المنطقة أكثر في المنطقة
+
+41
+00:03:37,580 --> 00:03:38,240
+أكثر في المنطقة أكثر في المنطقة أكثر في
+
+42
+00:03:38,240 --> 00:03:41,560
+المنطقة أكثر في المنطقة أكثر في المنطقة أكثر 
+
+43
+00:03:41,560 --> 00:03:46,160
+في المنطقة أكثر في المنطقة أكثر 
+
+44
+00:03:53,670 --> 00:03:59,290
+بتحرقها إلى داخل العين، يبقى هنا لو أنا حطيت drops 
+
+45
+00:03:59,290 --> 00:04:05,290
+قطرة، القطرة خلال thirty minutes أو forty minutes، 
+
+46
+00:04:05,290 --> 00:04:09,970
+بعضها هيتبخر وبعدها هينزل في نزل ذاكر مالدكت وبعدها 
+
+47
+00:04:09,970 --> 00:04:11,130
+هيروح للقرنية وتنتهي
+
+48
+00:04:16,730 --> 00:04:19,150
+لازم أعطي frequently كل ساعة كل ساعة كل ساعة مثلا 
+
+49
+00:04:19,150 --> 00:04:25,350
+لإن بحطيك مارعم مثلا، المارعم بيقول أكثر even a
+
+50
+00:04:25,350 --> 00:04:31,770
+bullion of tears in the eye is approximately 5 
+
+51
+00:04:31,770 --> 00:04:39,130
+microliter كم يعني كيس الملتحمة الاتصال ده هو كم 
+
+52
+00:04:39,130 --> 00:04:45,980
+كيس الملتحمة ما بيسع كتير يعني أنا عشان أضع قطرة و
+
+53
+00:04:45,980 --> 00:04:51,740
+أعمل closure للعينية العين 
+
+54
+00:04:51,740 --> 00:04:58,340
+الواحدة ما بين القرنية والملتحمة و ال Fornix أو
+
+55
+00:04:58,340 --> 00:05:03,000
+ال Eyelids من الخلف تسعة مايكروم كام تسعة مايكروم
+
+56
+00:05:03,000 --> 00:05:11,880
+نقطة القطرة فيها حوالي خمسين مايكرو ليتر نقطة
+
+57
+00:05:11,880 --> 00:05:14,860
+القطرة اللي بنحطها يعني خمسها بيدخل
+
+58
+00:05:18,950 --> 00:05:24,130
+شوفوا كم يعني فيه خسارة يعني فبقوللي بس ال إيه لما
+
+59
+00:05:24,130 --> 00:05:28,450
+رمضت تسعة تسعة مايكرون موظف أبوش resides in the 
+
+60
+00:05:28,450 --> 00:05:34,670
+prefornical sac و one micron بس هو اللي بيكون مع ال
+
+61
+00:05:34,670 --> 00:05:39,210
+tear film على سطح القرنية وشوية على الملتحمة يعني
+
+62
+00:05:39,210 --> 00:05:44,790
+بيختلف بال tear film thickness بتاعه واحد micron و
+
+63
+00:05:44,790 --> 00:05:50,440
+ثمانية مايكرون في داخل ال والباقي بيطلع برة، والباقي 
+
+64
+00:05:50,440 --> 00:06:02,380
+بيطلع برة طيب،
+
+65
+00:06:02,380 --> 00:06:08,460
+الآن لو أنا وضعت antibiotic في القطرة، أنا بدي 
+
+66
+00:06:08,460 --> 00:06:08,940
+الآن
+
+67
+00:06:23,110 --> 00:06:27,630
+عشان يقوللي أي انتبايوتيك أنا بوضعه في العين must be 
+
+68
+00:06:27,630 --> 00:06:31,350
+present in the tear film in amounts above MIC. 
+
+69
+00:06:31,610 --> 00:06:36,770
+What is MIC? Minimum Inhibitory Concentration.
+
+70
+00:06:37,950 --> 00:06:41,830
+لازم يكون فوق ال MIC. مش تحت ال MIC. بس كان يبدو
+
+71
+00:06:41,830 --> 00:06:47,210
+يكون therapeutic. طيب أفضل تركيز for significant 
+
+72
+00:06:47,210 --> 00:06:53,740
+amount of time لمدة كافية من الوقت لمدة كافية من 
+
+73
+00:06:53,740 --> 00:06:57,360
+الوقت اه significant amount of time to produce
+
+74
+00:06:57,360 --> 00:07:01,440
+microbiological and clinical improvement or cure
+
+75
+00:07:01,440 --> 00:07:10,920
+of disease يبقى مش .. بس التركيز والوقت يكون 
+
+76
+00:07:10,920 --> 00:07:16,720
+تركيزه عالي فوق المايك يبقى إحنا تعدينا إنه أي 
+
+77
+00:07:16,720 --> 00:07:24,440
+antibiotic أضعه في العين لابد أن يكون فوق ال MIC
+
+78
+00:07:24,440 --> 00:07:30,920
+عشان يعمل تأثير علاجي ويكون الوقت الزمني كافي 
+
+79
+00:07:30,920 --> 00:07:37,080
+ليحدث شفاء أو علاج للمرض اللي هو داخل العين أو لا
+
+80
+00:07:37,080 --> 00:07:42,400
+في الملتحمة و if the target sight is intraocular 
+
+81
+00:07:42,400 --> 00:07:46,380
+مثلا العين is intraocular  السائل الزجاجي 
+
+82
+00:07:46,380 --> 00:07:50,590
+intraocular  السائل الزجاجي intraocular 
+
+83
+00:07:50,590 --> 00:07:50,790
+intraocular intraocular intraocular intraocular
+
+84
+00:07:50,790 --> 00:07:53,590
+intraocular intraocular intraocular intraocular 
+
+85
+00:07:53,590 --> 00:07:58,250
+intraocular intraocular intraocular intraocular 
+
+86
+00:07:58,250 --> 00:08:05,530
+intraocular intraocular 
+
+87
+00:08:05,530 --> 00:08:09,670
+intraocular 
+
+88
+00:08:09,670 --> 00:08:12,750
+ا
+
+89
+00:08:32,660 --> 00:08:35,800
+لو المرض في القرنية نفسها، هيكون في direct 
+
+90
+00:08:35,800 --> 00:08:40,780
+contact، direct contact، يا لو في قرحة هنا، هيكون 
+
+91
+00:08:40,780 --> 00:08:44,940
+في direct contact مع ال drugs طيب، وأنا المشكلة لو 
+
+92
+00:08:44,940 --> 00:08:50,300
+أنا بدأت أقعد مثلا في scenario D، scenario D، يبقى 
+
+93
+00:08:50,300 --> 00:08:56,760
+لازم نصير دخول لل drugs عبر القرنية، طبقات 
+
+94
+00:08:56,760 --> 00:09:03,640
+القرنية الخمسة و يخش في ال anterior chamber ومن ال
+
+95
+00:09:03,640 --> 00:09:08,160
+pupil يخش على ال posterior chamber ويصل إلى 
+
+96
+00:09:08,160 --> 00:09:14,060
+ال ciliary body وصل ال ciliary body يبقى مدى انتشار ال drug
+
+97
+00:09:14,060 --> 00:09:18,800
+عبر القرنية ويخش في ال aqueous humor إلى ال anterior ثم 
+
+98
+00:09:18,800 --> 00:09:21,940
+ال posterior chamber ما بيكون قادر على أن يعادي 
+
+99
+00:09:21,940 --> 00:09:24,680
+أشياء داخل القلعية أن يعادي أشياء 
+
+100
+00:09:31,220 --> 00:09:36,080
+طيب، ما هي ال barriers؟ Epithelium، barrier. 
+
+101
+00:09:38,200 --> 00:09:43,280
+Stroma، barrier. ال Endothelium، barrier. طيب،
+
+102
+00:09:43,280 --> 00:09:49,400
+طالب هتقولي الـ .. الـ .. ال Bowmans membrane و الـ
+
+103
+00:09:49,400 --> 00:09:53,320
+Descemet's membrane و أي حد ولا positive، مش active.
+
+104
+00:09:54,260 --> 00:09:58,220
+هذا ال anatomy ضد البكتيريا والفيروسات ممتاز، لكن 
+
+105
+00:09:58,220 --> 00:10:00,520
+في موضوع ال drugs ما لهمش 
+
+106
+00:10:02,450 --> 00:10:06,990
+البرير الأساسي لـ Epithelium و Epithelium وبينهم
+
+107
+00:10:06,990 --> 00:10:11,850
+Stroma إذا
+
+108
+00:10:11,850 --> 00:10:15,890
+كنت ترغب في ترتيب الـ Epithelium الخارجي إما
+
+109
+00:10:15,890 --> 00:10:23,930
+بمشاركة من الخلايا أو بمشاركة بين الخلايا Intercellular
+
+110
+00:10:23,930 --> 00:10:29,590
+أو Intracellular كيف؟ يعني أنا عندي الآن هذه ال
+
+111
+00:10:29,590 --> 00:10:34,560
+Epithelium طبعا ال Epithelium مكون من خمس طبقات أو
+
+112
+00:10:34,560 --> 00:10:39,180
+أربع طبقات Corneal epithelium هنا الـ polyhedral 
+
+113
+00:10:39,180 --> 00:10:43,400
+cells هنا الـ polyhedral cells وهنا بصير شوية Flat
+
+114
+00:10:43,400 --> 00:10:52,000
+وأو آخر طبقة اللي هي Flat Corneal epithelium كويس هذا 
+
+115
+00:10:52,000 --> 00:10:57,560
+Corneal epithelium لو أنا أعطيه Antibiotic هنا ولحسب
+
+116
+00:10:57,560 --> 00:11:05,060
+ال size of molecule molecular size إما يدخل الدواء
+
+117
+00:11:05,060 --> 00:11:14,180
+ما بين الخلايا يتسلل إلى هنا ما بين الخلايا أو عبر
+
+118
+00:11:14,180 --> 00:11:18,100
+الخلية لازم يخش بالخلية الأولى والخلية الثانية
+
+119
+00:11:18,100 --> 00:11:23,740
+والخلية الثالثة والخلية الرابعة يبقى أنا بقول إنه
+
+120
+00:11:23,740 --> 00:11:32,530
+إما through the cells اللي دخل في ال cells Intra
+
+121
+00:11:32,530 --> 00:11:38,810
+cellular  اختلف الخلية واللي between the cells Inter
+
+122
+00:11:38,810 --> 00:11:45,530
+cellular يعني هاي خلية وخلية هو يخش من بينهم فهذا 
+
+123
+00:11:45,530 --> 00:11:52,370
+Intercellular لكن التاني الـ .. الـ Intracellular لأ
+
+124
+00:11:52,370 --> 00:11:53,030
+بيجي هنا
+
+125
+00:11:57,880 --> 00:12:01,200
+حسب ال molecular size لما يكون ال molecular size 
+
+126
+00:12:01,200 --> 00:12:05,660
+very small يخش 
+
+127
+00:12:05,660 --> 00:12:15,820
+Intercellular يكون صغير لما يكون Intercellular Intercellular يكون 
+
+128
+00:12:15,820 --> 00:12:24,080
+كبير مافيش طريقة اللي يشكل مخلائهم طيب هنا 
+
+129
+00:12:24,080 --> 00:12:25,060
+تصوير
+
+130
+00:12:40,180 --> 00:12:44,140
+هتكلم على Topical Antibiotics ويعني بالـ Topical
+
+131
+00:12:44,140 --> 00:12:49,400
+كل موضع على سطح شيء اسمه Topical بيوضع على السطح
+
+132
+00:12:49,400 --> 00:12:54,600
+اسمه Topical موضع .. موضع .. لأ سطحي الموضع إيه لو
+
+133
+00:12:54,600 --> 00:12:59,980
+أنا جبت سن إبرة وحطيته تحت المنطقة مبقن هذا Local
+
+134
+00:12:59,980 --> 00:13:06,120
+لو أنا بدأت بندي أصبعي بحط أنا دي في الأصبع مبقن
+
+135
+00:13:06,120 --> 00:13:11,160
+هذا Local بدي أفتح دمّال وبيحط بين موضعيه، بتخيل
+
+136
+00:13:11,160 --> 00:13:14,720
+درجة وبيحط بين موضعيه، اه ده اللوكا، لكن لو وجود 
+
+137
+00:13:14,720 --> 00:13:19,240
+مرهم أنا على جلدي، على وجهي، أو قطرة في عيني، أو
+
+138
+00:13:19,240 --> 00:13:22,460
+مرهم في عيني، أو في داني، أو في عنفي، هذا اسمه 
+
+139
+00:13:22,460 --> 00:13:26,300
+الـ Topical، الـ Topical treatment، إذا أنا بتكلم 
+
+140
+00:13:26,300 --> 00:13:30,440
+على الأشياء الـ Topical اللي إحنا دائما مستعملها، 
+
+141
+00:13:30,440 --> 00:13:33,800
+بقول الـ Antibiotics اللي بتنحط على سطح العين، most
+
+142
+00:13:33,800 --> 00:13:37,720
+drugs infiltrate the cornea via the intracellular 
+
+143
+00:13:38,470 --> 00:13:43,770
+لازم يخش داخل كل خلية although the intercellular 
+
+144
+00:13:43,770 --> 00:13:49,110
+route predominates for hydrophilic drugs
+
+145
+00:13:49,110 --> 00:13:54,450
+hydrophilic soluble in water يبقى ال soluble in 
+
+146
+00:13:54,450 --> 00:14:00,370
+water بيكون ال molecule بتاعه very small بتسلل ما
+
+147
+00:14:00,370 --> 00:14:04,490
+بين الخلايا بالفديوهات بين الخلايا في بين خلايا
+
+148
+00:14:04,490 --> 00:14:11,300
+مفاصلة صغيرة مدخل بيهالكن الليبوفيليك اللي هو بدوق 
+
+149
+00:14:11,300 --> 00:14:15,660
+الدهون لازم يستأذن كل خلية يدق على الباب تفتحها 
+
+150
+00:14:15,660 --> 00:14:18,860
+الخلية وبعد الخلية البعدي يدق على الباب تفتحها
+
+151
+00:14:18,860 --> 00:14:22,020
+الخلية ويمشي في الستوكبلازم إلى الخلية البعدي و
+
+152
+00:14:22,020 --> 00:14:27,890
+إلى الخلية البعدي على بالكم أن أكثر صحيا ال drug
+
+153
+00:14:27,890 --> 00:14:33,150
+يمشي ما بين الخلايا؟ يتسلل ما بين الخلايا؟ ولا يدخل
+
+154
+00:14:33,150 --> 00:14:36,850
+باب كل خلية؟ يدخل باب كل خلية، لأ يمشي من أحسن
+
+155
+00:14:36,850 --> 00:14:39,990
+صحيا، بين الخلايا، داخل الخلايا، ممكن يأثر على
+
+156
+00:14:39,990 --> 00:14:44,290
+التركيز أحسن، ممكن يأثر على اللي هو ال nucleus و
+
+157
+00:14:44,290 --> 00:14:47,390
+على ال cytoplasm وعلى ال mitochondria بتاعة
+
+158
+00:14:47,390 --> 00:14:52,710
+الخلية، إنما لما يمر بجانب الباب ولا يفتح الباب،
+
+159
+00:14:52,710 --> 00:14:54,570
+مش هيكون side effects
+
+160
+00:15:02,110 --> 00:15:05,930
+الدهون المدابر في الـ Hom  لديه اكتشاف كبير لـ epithelium 
+
+161
+00:15:05,930 --> 00:15:10,390
+ومقاومة 
+
+162
+00:15:10,390 --> 00:15:11,770
+اكتشاف اكتشاف اكتشاف اكتشاف اكتشاف اكتشاف اكتشاف
+
+163
+00:15:11,770 --> 00:15:12,630
+اكتشاف اكتشاف اكتشاف اكتشاف اكتشاف اكتشاف اكتشاف
+
+164
+00:15:12,630 --> 00:15:13,670
+اكتشاف اكتشاف اكتشاف اكتشاف اكتشاف اكتشاف اكتشاف
+
+165
+00:15:13,670 --> 00:15:14,050
+اكتشاف اكتشاف اكتشاف اكتشاف اكتشاف اكتشاف اكتشاف
+
+166
+00:15:14,050 --> 00:15:16,310
+اكتشاف اكتشاف اكتشاف اكتشاف اكتشاف اكتشاف اكتشاف
+
+167
+00:15:16,310 --> 00:15:23,230
+اكتشاف اكتشاف اكت
+
+168
+00:15:31,620 --> 00:15:37,260
+هذا Endothelium وهذه الكبيرة اسمها Stroma
+
+169
+00:15:37,260 --> 00:15:40,500
+الليبوفيليك
+
+170
+00:15:40,500 --> 00:15:48,720
+الدرس سيختلف الليبوفيليك بسرعة لأن الليبوفيليك 
+
+171
+00:15:48,720 --> 00:15:49,740
+عالي دهون
+
+172
+00:16:03,190 --> 00:16:07,550
+اللي هو يعني high percentage of water بيصير الدواء
+
+173
+00:16:07,550 --> 00:16:12,930
+الدهني اللي قال حطيته هنا واشتغلت بسرعة هنا يتأخر، 
+
+174
+00:16:12,930 --> 00:16:18,890
+يتأخر، بيصير له بعد تعويق يعني بعد فترة يمر، بس
+
+175
+00:16:18,890 --> 00:16:23,230
+بسرعة، بشوية، فإذا وصل ال Endothelium، ال
+
+176
+00:16:23,230 --> 00:16:27,910
+Endothelium برد وسط الدهني هنا يمر بسرعة إلى ال 
+
+177
+00:16:27,910 --> 00:16:34,650
+AC، يمر بسرعة إلى ال AC يعني أنا في يدي التفاوت حتى
+
+178
+00:16:34,650 --> 00:16:40,130
+في طبقات القرنية والحوادث والمرور عبرها كل واحد
+
+179
+00:16:40,130 --> 00:16:48,010
+له نسبة من الدخول طيب يبقى ال Stroma عائق لل 
+
+180
+00:16:48,010 --> 00:16:52,030
+hydrophilic لإن بتمارن ال hydrophilic بسرعة بقولي
+
+181
+00:16:52,030 --> 00:16:59,590
+for hydrophilic compounds عكس اللي هو الليبوفيليك
+
+182
+00:16:59,590 --> 00:17:00,410
+انتبهوا معانا
+
+183
+00:17:05,600 --> 00:17:13,5
+
+216
+00:20:56,420 --> 00:21:03,580
+تمامًا زي الأرض مثلًا أنا لما بدي يعني أسقي نباتات
+
+217
+00:21:03,580 --> 00:21:08,860
+خفيفة سطحيّة لِشَك أن الميّة بتصل جذورها بسرعة لأنها 
+
+218
+00:21:08,860 --> 00:21:14,180
+عشر سنين تحت سطح الأرض لو بدي أسقيها يعني يكفيها 
+
+219
+00:21:14,180 --> 00:21:19,960
+كمية ثلاثة من الميّة لكن أنا لو بدي أسقي شجر عنب أو
+
+220
+00:21:19,960 --> 00:21:27,400
+بدي أسقي شجر زيتون يعني عميق، بدي كم الميّة؟ بدي 
+
+221
+00:21:27,400 --> 00:21:31,320
+برميل أو أكثر؟ وهكذا، يبقى لما يكون على سطح
+
+222
+00:21:31,320 --> 00:21:35,940
+القرنية، التركيزي، لما أخدت بالهيكون أعلى وشفاف 
+
+223
+00:21:35,940 --> 00:21:39,240
+أكثر، لكن الـ deep هيكون في مرحلة
+
+224
+00:21:56,170 --> 00:22:01,510
+بتكلمنا على الـ concentration وتكلمنا على الـ
+
+225
+00:22:01,510 --> 00:22:02,470
+significant type
+
+226
+00:22:06,370 --> 00:22:11,130
+وهنا نتكلم عن location of infection بدأ تجميع يعني
+
+227
+00:22:11,130 --> 00:22:15,870
+أمور مش بس نقرأ كل واحد لحاله عامل عاملين لأ لازم
+
+228
+00:22:15,870 --> 00:22:20,890
+نحط serial number لهذه الأعوام أنه خدتي في
+
+229
+00:22:20,890 --> 00:22:23,030
+الامتحان إيش؟
+
+230
+00:22:36,410 --> 00:22:41,650
+يبقى أنا بتكلم على الـ superficial والـ deep لِشَك أنه
+
+231
+00:22:41,650 --> 00:22:44,930
+التركيز الدواء في الـ superficial بيكون أكثر من 
+
+232
+00:22:44,930 --> 00:22:51,070
+تركيزه في الـ deep infection طيب the corneal root
+
+233
+00:22:51,070 --> 00:22:55,050
+has always been assumed to be the major route of
+
+234
+00:22:55,050 --> 00:23:01,450
+entering into the eye أي عامل سادس يجانب، route of
+
+235
+00:23:01,450 --> 00:23:07,460
+administration، طرف تقطعه بالنسبة للقرنية والعين
+
+236
+00:23:07,460 --> 00:23:13,100
+باعتمد الـ Corneal Road طريقة القرنية المبرجة 
+
+237
+00:23:13,100 --> 00:23:17,340
+أكثر ايه تلت أكثر however recent evidence بيقولوا 
+
+238
+00:23:17,340 --> 00:23:21,460
+الآن حديثًا أصبحوا بيفكروا في إيش أنه that
+
+239
+00:23:21,460 --> 00:23:24,080
+penetration across كلية الطيبة and sclera may
+
+240
+00:23:24,080 --> 00:23:26,980
+almost contribute significantly to penetration
+
+241
+00:23:26,980 --> 00:23:31,600
+into the anterior chamber يعني بيقولوا الآن ممكن
+
+242
+00:23:31,600 --> 00:23:33,420
+أنه 
+
+243
+00:23:37,090 --> 00:23:44,550
+في الملتحمة ممكن يصل الـ AC والـ PC مثلًا بالنسبة ل
+
+244
+00:23:44,550 --> 00:23:48,230
+30% فإن
+
+245
+00:23:48,230 --> 00:23:55,130
+أنا أعمل القرنية 70% فبقول لها ده السهل بالـ 30% 
+
+246
+00:23:55,130 --> 00:23:58,970
+يعني أنا في حالة الـ kernel ulcer اللي هيدمر
+
+247
+00:23:58,970 --> 00:24:04,090
+القرنية ممكن أعطي اللي هو drugs topical وأعطي
+
+248
+00:24:04,090 --> 00:24:06,630
+injection تحت الملتحمة لغة
+
+249
+00:24:25,540 --> 00:24:32,360
+ما هي العوامل التي تسريع في امتصاص الـ Antibiotics
+
+250
+00:24:32,360 --> 00:24:37,200
+من سطح العين one solubility ورحنا اتكلمنا عنها إما
+
+251
+00:24:37,200 --> 00:24:44,020
+Lipophilic زي الجنتاميسين مثلًا Lipophilic
+
+252
+00:24:44,020 --> 00:24:48,220
+زي Chloramphenicol أو Hydrophilic زي الجنتاميسين 
+
+253
+00:24:48,220 --> 00:24:50,860
+هذه الميكالي مثلًا إن الجنتاميسين يدوم في الماء 
+
+254
+00:24:51,610 --> 00:24:55,130
+عشانكي نحن حقًا نحن هذا تحتموا وتحتموا أما
+
+255
+00:24:55,130 --> 00:24:59,310
+chloramphenicol موجود في السوق بكثرة لازم تشوفوه
+
+256
+00:24:59,310 --> 00:25:03,310
+chloramphenicol في عشرين شركة تطلع وفي منهم مارهم
+
+257
+00:25:03,310 --> 00:25:08,050
+وفي منهم إيش خاطره chloramphenicol آه هنا
+
+258
+00:25:08,050 --> 00:25:13,030
+ليبوفيليك وبالتالي متعوق من البيفيليا فالعامل
+
+259
+00:25:13,030 --> 00:25:17,770
+الثاني pH of topical antibiotic pH اللي هو ضاد 
+
+260
+00:25:18,840 --> 00:25:25,940
+الحموضة أو القاعدية أو تركيز الهيدروجين هو بيقول
+
+261
+00:25:25,940 --> 00:25:31,100
+لي هنا إيه المشكلة أن الـ pH of the eye is neutral
+
+262
+00:25:31,100 --> 00:25:37,040
+يعني لو أخدنا الدمع بتاعنا وعملنا الـ pH بتاعه نجي
+
+263
+00:25:37,040 --> 00:25:45,560
+neutral about 7 الآن لو حطيت في عيني قطرة حمضية
+
+264
+00:25:45,560 --> 00:25:56,140
+مثلًا 4.5أو قاعدية هتعمل حاجتين الحاجة الأولى 
+
+265
+00:25:56,140 --> 00:25:59,500
+هتعمل irritation of the eye لأن الـ ph بتاعها مختلف 
+
+266
+00:25:59,500 --> 00:26:04,120
+عن الـ ph of the eye ثالث شيء مش هيكون ذائبة في 
+
+267
+00:26:04,120 --> 00:26:07,340
+الدموع كما يجب وممكن تعمل precipitation إيش
+
+268
+00:26:07,340 --> 00:26:12,020
+precipitation تفسير تفسير يبقى هذا الـ ph اللي أنا 
+
+269
+00:26:12,020 --> 00:26:16,660
+أقصده أنه مش هيكون ذائبيته كما يجب
+
+270
+00:26:21,540 --> 00:26:28,380
+بنسبة إيش؟ ثلاثة increasing the concentration يعني
+
+271
+00:26:28,380 --> 00:26:35,040
+عشان الـ antibiotic أنه اشتغل كويس بالتركيز بتاعه 
+
+272
+00:26:35,040 --> 00:26:39,320
+باطنق ده volume أنا باطنق .. يعني مش زيادة ال
+
+273
+00:26:39,320 --> 00:26:46,280
+volume مثلًا أنا قطر تركيزه واحد في المية لو
+
+274
+00:26:46,280 --> 00:26:49,820
+حطيت منها خمس .. خمس نقاط لا يزيد التركيز كثير لا
+
+275
+00:26:49,820 --> 00:26:53,320
+.. لا يزيد التركيز هي تركيزها واحد في المية فضلًا واحد 
+
+276
+00:26:53,320 --> 00:26:58,060
+في المية، بدي أنا أدي تركيزها إلى اثنين في المية هل يكون
+
+277
+00:26:58,060 --> 00:27:01,960
+more effective أني أخد نقطة اثنين في المية أخر من خمس 
+
+278
+00:27:01,960 --> 00:27:08,820
+نقطة واحد في المية يبقى if an antimicrobial eye drop
+
+279
+00:27:08,820 --> 00:27:12,220
+will increase the level of the drug in the
+
+280
+00:27:12,220 --> 00:27:15,300
+precorneal field and therefore in the aqueous
+
+281
+00:27:15,300 --> 00:27:16,780
+humor داخل العين
+
+282
+00:27:20,150 --> 00:27:24,610
+الآن هذا بالنسبة لـ Concentration بقول لي في قطرات
+
+283
+00:27:24,610 --> 00:27:30,610
+تكون hypertonic وفي قطرات hypotonic وهنا حوالي 
+
+284
+00:27:30,610 --> 00:27:34,710
+أربعة تيجي وهنا اللي هو osmotic pressure of the
+
+285
+00:27:34,710 --> 00:27:41,230
+drug ممكن نحطها خمسة ميانة hypertonic هنا هنا قضية 
+
+286
+00:27:41,230 --> 00:27:45,750
+ثانية غير الـ page hypertonic وقول هنا osmotic 
+
+287
+00:27:45,750 --> 00:27:46,510
+pressure
+
+288
+00:27:52,820 --> 00:28:00,080
+الآن معروف أن لو في يعني محلول ملحي عالي التركيز
+
+289
+00:28:00,080 --> 00:28:08,060
+وضعت أنا filter بينه وبين ميّة فأنّه الميّة هتسحب 
+
+290
+00:28:08,060 --> 00:28:15,080
+السائل من اللي هو الـ buslozmodel العالي إلى نصف 
+
+291
+00:28:15,080 --> 00:28:17,300
+تعادل يعني مثلًا 
+
+292
+00:28:22,380 --> 00:28:32,300
+محلول ملحي مثلًا تركيزه 5% وعندي أنا water الـ water 
+
+293
+00:28:32,300 --> 00:28:37,920
+الـ neutral صح؟ الآن هتفضل الماء هذه تسحب السائل من
+
+294
+00:28:37,920 --> 00:28:45,500
+هنا حتى تصير هنا 2.5% وأنا 2.5% حسب نظرية الدكتور
+
+295
+00:28:45,500 --> 00:28:49,720
+اسمه صح؟ يبقى هينقول هي hypertonic 
+
+296
+00:28:54,240 --> 00:28:58,740
+تتجه إلى الفيلم بسرعة أكثر من ذلك، ولكن بسرعة أكثر 
+
+297
+00:28:58,740 --> 00:28:59,520
+من ذلك، ولكن بسرعة أكثر من ذلك، ولكن بسرعة أكثر من
+
+298
+00:28:59,520 --> 00:29:02,180
+ذلك، ولكن بسرعة أكثر من ذلك، ولكن بسرعة أكثر من
+
+299
+00:29:02,180 --> 00:29:03,320
+ذلك، ولكن بسرعة أكثر من ذلك، ولكن بسرعة أكثر من
+
+300
+00:29:03,320 --> 00:29:03,540
+ذلك، ولكن بسرعة أكثر من ذلك، ولكن بسرعة أكثر من
+
+301
+00:29:03,540 --> 00:29:08,200
+ذلك، ولكن بسرعة أكثر من ذلك، ولكن بسرعة أكثر من
+
+302
+00:29:08,200 --> 00:29:12,940
+ذلك، ولكن بسرعة أكثر من ذلك، ولكن بسرعة أكثر من
+
+303
+00:29:12,940 --> 00:29:16,260
+ذلك،
+
+304
+00:29:16,260 --> 00:29:21,700
+ولكن بسرعة أكثر من ذلك، ولكن بسرعة أكثر يعني .. يعني
+
+305
+00:29:21,700 --> 00:29:26,100
+نضيط الدرك المجموزي تشتغل حتى داخل العين، حتى داخل
+
+306
+00:29:26,100 --> 00:29:31,380
+الجسم طيب، خمسة abrasion or inflammation of the
+
+307
+00:29:31,380 --> 00:29:38,140
+cornea، إيش abrasion؟ كشطة، كشطة Higher corneal
+
+308
+00:29:38,140 --> 00:29:41,780
+concentrations of drugs are achieved in abraded or
+
+309
+00:29:41,780 --> 00:29:45,400
+inflamed corneas than in normal ones
+
+310
+00:29:50,120 --> 00:29:55,380
+هنا صورناها في السينما هكذا وهنا شوية تبدأ الخلايا
+
+311
+00:29:55,380 --> 00:29:59,940
+تصير هكذا وبعدين في الآخر البيزا اللي هي اللي هي
+
+312
+00:29:59,940 --> 00:30:09,620
+خلايا شفه يعني مكعّبة الآن لو حطيت أنا دروس هنا هاي
+
+313
+00:30:09,620 --> 00:30:12,800
+الـ variant وبعدين
+
+314
+00:30:37,770 --> 00:30:42,130
+عشان أحد بيكحك عينه بالقدفة قدفة وهيك يعني event
+
+315
+00:30:42,130 --> 00:30:46,890
+معين أو accident معين بيكحك اللي هو ال .. ال ..
+
+316
+00:30:46,890 --> 00:30:51,750
+سطح القرنية بتاعه يكون تاكلينز users برضه بيصير
+
+317
+00:30:51,750 --> 00:30:57,550
+نفس الشيء بيصير أشياء زي هذه أو disease زي كون
+
+318
+00:30:57,550 --> 00:31:02,330
+الآثر مثلًا فالـ continuity of a helium بيصيرها
+
+319
+00:31:02,330 --> 00:31:07,330
+destruction وبالتالي فأنت القطرة على طول بتخش لأن 
+
+320
+00:31:07,330 --> 00:31:12,710
+الباب مفتوح، اللي بيدخل من الباب بيدخل، صح؟ هاي
+
+321
+00:31:12,710 --> 00:31:18,330
+معنى الـ abrasion أو الانفلامشين، التهاب أو كرشدة 
+
+322
+00:31:18,330 --> 00:31:22,210
+طيب،
+
+323
+00:31:22,210 --> 00:31:27,590
+however، when epithelium absent شرح هذا، as is the
+
+324
+00:31:27,590 --> 00:31:30,810
+case with most infectious corneal ulcers، the
+
+325
+00:31:30,810 --> 00:31:34,210
+epithelial barrier is eliminated and hydrophilic
+
+326
+00:31:34,210 --> 00:31:36,170
+antibiotics may enter the corneal
+
+327
+00:31:40,010 --> 00:31:47,090
+بسرعة شديدة، for instance مثلًا  ofloxacin هذه
+
+328
+00:31:47,090 --> 00:31:50,570
+Antibiotic بس هي Hydrophilic، قطرات موجودة في 
+
+329
+00:31:50,570 --> 00:31:56,270
+السوق ofloxacin أو ofloxacin موجودة بصورة
+
+330
+00:31:56,270 --> 00:31:59,810
+ofloxacin اسمها ofloxacin that achieves anterochemical
+
+331
+00:31:59,810 --> 00:32:02,530
+level two to three times greater than epithelium
+
+332
+00:32:02,530 --> 00:32:06,270
+is compromised than if it is intact.compromised
+
+333
+00:32:06,270 --> 00:32:13,160
+يعني فيه فكرة يعني الـ epithelium صار له الـ 
+
+334
+00:32:13,160 --> 00:32:17,660
+comparative بتاعته هنا راحت فـ مرتين إلى تلت مرات
+
+335
+00:32:17,660 --> 00:32:23,520
+أسرع من مكان الـ epithelium in that cell ودي يعني
+
+336
+00:32:23,520 --> 00:32:25,520
+شيء منطقي، logic يعني 
+
+337
+00:32:47,920 --> 00:32:54,480
+بس طبعًا هنا كل ما حط drops أكثر كل ما دخلت أكثر
+
+338
+00:32:54,480 --> 00:32:57,860
+لأنه ما فيش إيش ما فيش continuation continuation
+
+339
+00:32:57,860 --> 00:33:05,780
+يعني طيب الآن دخلت القطرة إلى الـ AC اجتازت الـ
+
+340
+00:33:05,780 --> 00:33:08,960
+barriers الثلاثة اللي في القرنية دخلت بزيادة الـ
+
+341
+00:33:08,960 --> 00:33:12,000
+distribution يبقى distribution factors interfering
+
+342
+00:33:12,000 --> 00:33:15,770
+with distribution of drops inside the eye إيش هي 
+
+343
+00:33:15,770 --> 00:33:22,570
+العوامل اللي تحد من سرعة توزيع القطرة عبر الـ ..
+
+344
+00:33:22,570 --> 00:33:25,910
+اللي هو الـ aqueous وتروح على الـ intraocular اللي
+
+345
+00:33:25,910 --> 00:33:30,910
+هو parts أو الواحد binding to melanin in the iris
+
+346
+00:33:30,910 --> 00:33:37,430
+عند سيارة البودي ثابت أنه كل ما كان الميلانين عالي
+
+347
+00:33:37,430 --> 00:33:42,910
+في القزحية وفي سيارة البودي كل ما عمل capture
+
+348
+00:33:46,950 --> 00:33:54,550
+خاصة الـ mydriatics والـ miotics أثرها إلى حين 
+
+349
+00:33:54,550 --> 00:34:01,730
+مش على طول الخط يعني لساعة لساعتين أو لنصف ساعة ثم 
+
+350
+00:34:01,730 --> 00:34:06,450
+أرسلها ببطء يبقى binding to melanin أو binding to
+
+351
+00:34:06,450 --> 00:34:12,870
+protein ممكن أنّه سيلو معلّب روتين معلّب روتين بعض 
+
+352
+00:34:12,870 --> 00:34:19,970
+البروتينات في العين أنّه بتعمل اتحاد أو complex و
+
+353
+00:34:19,970 --> 00:34:23,570
+شوية يصير يعني نوع من الـ .. يعني قولنا مثلًا أن هاي
+
+354
+00:34:23,570 --> 00:34:29,210
+البروتين مثلًا شكله هيك والدواء شكله هيك بتحت بعض
+
+355
+00:34:29,210 --> 00:34:34,350
+بعض بتعمل الـ complex الـ complex هذا مش سهل يستخدم
+
+356
+00:34:34,350 --> 00:34:40,190
+يتأخر إلى أن البروتين يمل علينا ويترك اللي هو 
+
+357
+00:34:41,070 --> 00:34:44,810
+الدواء اللي هو متحد معاه three rapid elimination
+
+358
+00:34:44,810 --> 00:34:48,730
+of drug to an inactive site that can act as a
+
+359
+00:34:48,730 --> 00:34:52,770
+biological reservoir releasing drug slowly over
+
+360
+00:34:52,770 --> 00:34:56,530
+time like pneumonia sac and fornix يعني هذا بس
+
+361
+00:34:56,530 --> 00:35:01,770
+بالاختصار احنا بنحط مثلًا مرهم المرهم بيدخل ما بين
+
+362
+00:35:01,770 --> 00:35:07,130
+سطح العين وما بين الجفون ما بين سطح العين و
+
+363
+00:35:07,130 --> 00:35:14,900
+fornix تحت وفوق وهنا عند الرموش حتى هنا هذه الجوعة
+
+364
+00:35:14,900 --> 00:35:19,900
+صارت reservoir يعني مخزن، من المخزن هنا بيبدأ
+
+365
+00:35:19,900 --> 00:35:24,660
+الدواء ينتقل بالتدريج عبر القرنية، بالتدريج عبر 
+
+366
+00:35:24,660 --> 00:35:29,820
+القرنية ويدخل، ما بتدخلش الجوعة الدواء كلها، أنا حاطط
+
+367
+00:35:29,820 --> 00:35:32,220
+مرهم خلال خمس دقائق بلاقيه في الـ 
+
+368
+00:35:37,410 --> 00:35:41,990
+فهذا برضه بيؤثر على الـ AHA distribution إلى داخل
+
+369
+00:35:41,990 --> 00:35:47,090
+العيون، توزيع الدواء يعني طيب، الآن الـ 
+
+370
+00:35:47,090 --> 00:35:50,710
+Metabolism، Drug Metabolism وExcretion أو
+
+371
+00:35:50,710 --> 00:35:54,970
+Elimination، سوف نتكلم على أشياء احنا عملناها
+
+372
+00:35:54,970 --> 00:35:59,750
+سيستميك قبل هيك، عشان تقولنا absorption للدواء
+
+373
+00:35:59,750 --> 00:36:04,240
+مثلًا من الـ .. من الـ AHA، لما دقيقة بعدين قولنا
+
+374
+00:36:04,240 --> 00:36:09,000
+بعد هيك مثلًا إيش distribution عن طريق الوريد البيع
+
+375
+00:36:09,000 --> 00:36:13,120
+بيه والكبد بعد هيك، بعدين مثلًا metabolism داخل 
+
+376
+00:36:13,120 --> 00:36:18,060
+الخلايا، بعدين مثلًا excretion عبر الـ kidney هناك،
+
+377
+00:36:18,060 --> 00:36:20,900
+رسمي، لكن احنا قولنا العين لأ العين جمهورية 
+
+378
+00:36:20,900 --> 00:36:25,040
+مستقلة، العين جمهورية مستقلة، بتشتغل مع الأدوية،
+
+379
+00:36:25,040 --> 00:36:31,410
+شغل، يعني كرتونات فلما نتكلم عن متابوليزم، نتكلمش 
+
+380
+00:36:31,410 --> 00:36:36,650
+عن متابوليزم في كل الجسم، لأ، بس في الـ lag. الوقت
+
+381
+00:36:36,650 --> 00:36:39,710
+بين وضع القطرة ووضع الدراجة ووضع القطرة ووضع القطرة
+
+382
+00:36:39,710 --> 00:36:41,230
+ووضع القطرة ووضع القطرة ووضع القطرة ووضع القطرة ووضع
+
+383
+00:36:41,230 --> 00:36:41,350
+القطرة ووضع القطرة ووضع القطرة ووضع القطرة ووضع القطرة
+
+384
+00:36:41,350 --> 00:36:43,130
+ووضع القطرة ووضع القطرة ووضع القطرة ووضع القطرة ووضع
+
+385
+00:36:43,130 --> 00:36:45,030
+القطرة ووضع القطرة ووضع القطرة ووضع القطرة ووضع القطرة
+
+386
+00:36:45,030 --> 00:36:52,710
+ووضع القطرة ووضع القطرة ووضع القطرة وو
+
+387
+00:37:03,140 --> 00:37:10,440
+وضعت هنا قطرة في العين الساعة ثمانية صباحًا وقيس
+
+388
+00:37:10,440 --> 00:37:18,480
+متى بدأ العلاج هنا يكون واضح مثلًا الساعة تسعة وثلاثين 
+
+389
+00:37:18,480 --> 00:37:23,320
+دقيقة صباحًا
+
+390
+00:37:23,320 --> 00:37:29,260
+في ساعة عينات معينة من RQS الساعة ونصف هذه اسمها
+
+391
+00:37:29,260 --> 00:37:39,530
+lag time زي واحد الآن سافر قول له لما اتصل بالسلامة 
+
+392
+00:37:39,530 --> 00:37:45,470
+مثلًا القدس اتصل فينا احنا ما ننتظر حتى تأتينا 
+
+393
+00:37:45,470 --> 00:37:49,790
+المكالمة ساعتنا
+
+431
+00:41:35,640 --> 00:41:43,720
+inside to outside علمكوا هذا بيقلل من فعالية 
+
+432
+00:41:43,720 --> 00:41:51,020
+الدواء أو دوامه في المكان في العين ولا بيزيد عامل
+
+433
+00:41:51,020 --> 00:41:56,940
+طرد، والعامل إضافة عامل طرد ها علمكوا الدواء
+
+434
+00:41:56,940 --> 00:42:05,970
+بيحاولوا يدخل وفي تيار جاهز ماليلا بقى عشان يتغلب
+
+435
+00:42:05,970 --> 00:42:12,850
+على هذا لازم أضيف دواء أكثر، لازم أضيف دواء أكثر يبقى
+
+436
+00:42:12,850 --> 00:42:18,290
+موضوع الآن بعض الممارسين اللي يعني مش كثير يعني في 
+
+437
+00:42:18,290 --> 00:42:21,270
+العلوم فاهمين يقولوا اخفض القطرات صباحًا ومساءً
+
+438
+00:42:21,270 --> 00:42:27,610
+طبعًا هذه نقطة، هذه نقطة حكيت صباحًا ومساءً معظم
+
+439
+00:42:27,610 --> 00:42:30,490
+القطرات لازم تكون frequent كل ساعتين أو ثلاث
+
+440
+00:42:34,470 --> 00:42:37,810
+كثير بيجيوني ناس إنها بيقول اللي أنا دكتور الجُطر 
+
+441
+00:42:37,810 --> 00:42:41,890
+اللي اخذناه وما استفدناش بفهم ليش ما هو ما استفاد لأن
+
+442
+00:42:41,890 --> 00:42:46,290
+مكتوب عنيها ثلاث ساعات ثلاث ساعات مفيش ساعة هو نايم
+
+443
+00:42:46,290 --> 00:42:50,330
+بيحطهاش بيقولوا أنا بحطها كل ساعتين أنا شوف في
+
+444
+00:42:50,330 --> 00:42:55,810
+خلال ثلاث أيام بتنقلب الصورة the fiction بتروح طيب 
+
+445
+00:42:55,810 --> 00:43:02,090
+فهمنا turnover؟ طيب when expressed as a half-life
+
+446
+00:43:02,090 --> 00:43:10,010
+aqueous turnover is اللي هو 46.2 minutes or 0.77 
+
+447
+00:43:10,010 --> 00:43:18,390
+hours. بيقول يعني لو أنت كسبت حساب كم كل حاجة أكواز 
+
+448
+00:43:18,390 --> 00:43:24,270
+في الـ AC بيقول لك في خلال 46 دقيقة المفروض كله
+
+449
+00:43:24,270 --> 00:43:28,910
+يتغير. ستة وأربعين دقيقة. يعني ثلاثين دقيقة
+
+450
+00:43:37,220 --> 00:43:41,220
+طيب، هذا برنامج جبته أنا في الثانية عشان تشوفوا 
+
+451
+00:43:41,220 --> 00:43:47,400
+كل ما الوقت يزيد هي عشرة جديش عشرين جال كمان ولو
+
+452
+00:43:47,400 --> 00:43:51,760
+نمشي بعد عشرين ثلاثين هزل كمان اللي هو إيش الـ
+
+453
+00:43:51,760 --> 00:43:58,120
+concentration بتاعة دواء في العين طيب،
+
+454
+00:43:58,120 --> 00:44:00,600
+therefore if drugs
+
+455
+00:44:07,790 --> 00:44:09,850
+بالنسبة للإيليمينات من العين، يمكن تفسير
+
+456
+00:44:09,850 --> 00:44:14,670
+الإيليمينات بشكل عادي، إيليمينات عادية يبقى أنا بدي
+
+457
+00:44:14,670 --> 00:44:19,870
+هدف الإيليمينات اللي في حدود 45 جيجا عادية، طب
+
+458
+00:44:19,870 --> 00:44:24,490
+الإيليمينات اللي أكثر من 45 جيجا عادية، طب
+
+459
+00:44:24,490 --> 00:44:27,690
+الإيليمينات اللي أكثر من 45 جيجا عادية، إيليمينات
+
+460
+00:44:27,690 --> 00:44:32,210
+يعني دخلت الـ 46 جيجا واتم العشرة تغيرت القياسة إذا
+
+461
+00:44:32,210 --> 00:44:35,910
+كانت دورة دورة في العين حوالي 45 جيجا بكون عادية
+
+462
+00:44:36,900 --> 00:44:41,400
+القادة أكثر ساعة ساعتين بيكون slow elimination،
+
+463
+00:44:41,400 --> 00:44:44,900
+الجان أقل من مثلًا ثلاثين دقيقة بيكون rapid 
+
+464
+00:44:44,900 --> 00:44:50,360
+elimination حقيقة في إشارة الله عندي اللي هو
+
+465
+00:44:50,360 --> 00:44:53,560
+number five في الـ metabolism and elimination
+
+466
+00:44:53,560 --> 00:44:57,340
+number five شكرًا لكم على قصة الاستماع والسلام
+
+467
+00:44:57,340 --> 00:44:59,260
+وعليكم السلام ورحمة الله وبركاته
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/XaWFurSQ-zE_raw.json b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/XaWFurSQ-zE_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..cfe93b04bbb6b61ba1e28bbdaa11c68a4e370236
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/XaWFurSQ-zE_raw.json
@@ -0,0 +1 @@
+{"segments": [{"id": 1, "seek": 4925, "start": 21.51, "end": 49.25, "text": "بسم الله الرحمن الرحيم الحمد لله رب العالمين وأصلي وأسلم على النبي الأمين محمد صلى الله عليه وسلم وعلى أهله وأصحابه والتابعين السلام عليكم ورحمة الله جزاك الله في هذا اليوم سنكمل ما بدأنا من pharmacology of the eye and today we will talk about", "tokens": [3555, 38251, 21984, 34892, 5016, 27842, 34892, 5016, 32640, 21542, 2304, 3215, 24976, 3224, 12602, 3555, 18863, 45340, 9957, 36725, 9381, 20292, 36725, 3794, 19528, 15844, 28239, 21292, 16247, 2304, 9957, 3714, 35571, 3215, 20328, 23942, 21984, 47356, 46952, 19528, 4032, 3615, 23942, 5551, 3224, 43761, 36725, 9381, 5016, 16758, 3224, 16070, 2655, 16758, 3615, 9957, 21136, 37440, 25894, 24793, 4032, 2288, 35571, 3660, 21984, 10874, 11622, 995, 4117, 21984, 8978, 23758, 45595, 20498, 8608, 1863, 24793, 1211, 19446, 47525, 10721, 8315, 9154, 31818, 1793, 295, 264, 3313, 293, 965, 321, 486, 751, 466], "avg_logprob": -0.1319078919134642, "compression_ratio": 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233.67, "end": 251.13, "text": "بتحرقك إلى داخل العين، يبقى هنا لو انا حطيت drops قطرة، القطرة خلال thirty minutes او forty minutes، بعض هيتبخر وبعدها هينزل في نزل ذاكر مالدكت وبعدها هيروح القرانية وتنتهي", "tokens": [3555, 2655, 5016, 2288, 4587, 4117, 30731, 11778, 47283, 1211, 18863, 9957, 12399, 7251, 3555, 4587, 7578, 34105, 45164, 1975, 8315, 11331, 9566, 36081, 11438, 12174, 9566, 25720, 12399, 25062, 9566, 25720, 16490, 1211, 6027, 11790, 2077, 1975, 2407, 15815, 2077, 12399, 45030, 11242, 8032, 36081, 3555, 34740, 46599, 22488, 11296, 8032, 9957, 11622, 1211, 8978, 8717, 11622, 1211, 29910, 995, 37983, 3714, 6027, 3215, 4117, 2655, 46599, 22488, 11296, 8032, 13546, 2407, 5016, 25062, 2288, 7649, 10632, 34683, 29399, 3224, 1829], "avg_logprob": -0.31626505305968133, "compression_ratio": 1.5833333333333333, "no_speech_prob": 0.0, "words": [{"start": 233.67, "end": 234.27, "word": "بتحرقك", "probability": 0.69891357421875}, {"start": 234.27, "end": 234.41, "word": " إلى", "probability": 0.63720703125}, {"start": 234.41, "end": 234.69, "word": " داخل", "probability": 0.9679361979166666}, {"start": 234.69, "end": 236.11, "word": " العين،", "probability": 0.765869140625}, {"start": 236.11, "end": 236.41, "word": " يبقى", "probability": 0.81121826171875}, {"start": 236.41, "end": 236.69, "word": " هنا", "probability": 0.91796875}, {"start": 236.69, "end": 238.25, "word": " لو", "probability": 0.82958984375}, {"start": 238.25, "end": 238.49, "word": " انا", "probability": 0.7841796875}, {"start": 238.49, "end": 238.79, "word": " حطيت", "probability": 0.61572265625}, {"start": 238.79, "end": 239.29, "word": " drops", "probability": 0.5361328125}, {"start": 239.29, "end": 240.85, "word": " قطرة،", "probability": 0.77630615234375}, {"start": 240.85, "end": 241.21, "word": " القطرة", "probability": 0.96044921875}, {"start": 241.21, "end": 241.69, "word": " خلال", "probability": 0.9853515625}, {"start": 241.69, "end": 242.61, "word": " thirty", "probability": 0.421630859375}, {"start": 242.61, "end": 243.21, "word": " minutes", "probability": 0.91650390625}, {"start": 243.21, "end": 243.91, "word": " او", "probability": 0.78271484375}, {"start": 243.91, "end": 244.29, "word": " forty", "probability": 0.72021484375}, {"start": 244.29, "end": 245.29, "word": " minutes،", "probability": 0.696044921875}, {"start": 245.29, "end": 246.21, "word": " بعض", "probability": 0.86328125}, {"start": 246.21, "end": 246.75, "word": " هيتبخر", "probability": 0.75457763671875}, {"start": 246.75, "end": 247.27, "word": " وبعدها", "probability": 0.7950032552083334}, {"start": 247.27, "end": 247.73, "word": " هينزل", "probability": 0.9239501953125}, {"start": 247.73, "end": 248.01, "word": " في", "probability": 0.7578125}, {"start": 248.01, "end": 248.31, "word": " نزل", "probability": 0.62841796875}, {"start": 248.31, "end": 248.55, "word": " ذاكر", "probability": 0.5869140625}, {"start": 248.55, "end": 249.21, "word": " مالدكت", "probability": 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"end": 265.35, "word": " a", "probability": 0.83740234375}, {"start": 265.35, "end": 265.69, "word": " bullion", "probability": 0.6551513671875}, {"start": 265.69, "end": 265.99, "word": " of", "probability": 0.9755859375}, {"start": 265.99, "end": 266.57, "word": " teas", "probability": 0.6279296875}, {"start": 266.57, "end": 267.45, "word": " in", "probability": 0.9296875}, {"start": 267.45, "end": 267.67, "word": " the", "probability": 0.896484375}, {"start": 267.67, "end": 268.23, "word": " eye", "probability": 0.748046875}, {"start": 268.23, "end": 269.01, "word": " is", "probability": 0.9462890625}, {"start": 269.01, "end": 270.05, "word": " approximately", "probability": 0.77880859375}, {"start": 270.05, "end": 271.77, "word": " 5", "probability": 0.493408203125}, {"start": 271.77, "end": 272.55, "word": " microliter", "probability": 0.5081787109375}, {"start": 272.55, "end": 274.21, "word": " كم", "probability": 0.7958984375}, {"start": 274.21, "end": 274.87, "word": " يعني", "probability": 0.969482421875}, {"start": 274.87, "end": 275.49, "word": " كيس", "probability": 0.951171875}, {"start": 275.49, "end": 276.47, "word": " المرتحمة", "probability": 0.8739013671875}, {"start": 276.47, "end": 278.61, "word": " الاتساب", "probability": 0.84423828125}, {"start": 278.61, "end": 278.81, "word": " ده", "probability": 0.911376953125}, {"start": 278.81, "end": 278.91, "word": " هو", "probability": 0.453857421875}, {"start": 278.91, "end": 279.13, "word": " كم", "probability": 0.97021484375}, {"start": 279.13, "end": 279.99, "word": " كيس", "probability": 0.853515625}, {"start": 279.99, "end": 280.57, "word": " المرتحمة", "probability": 0.9931640625}, {"start": 280.57, "end": 281.11, "word": " مابيسايع", "probability": 0.6563232421875}, {"start": 281.11, "end": 281.41, "word": " كتير", "probability": 0.9568684895833334}, {"start": 281.41, "end": 282.37, "word": " يعني", "probability": 0.96337890625}, {"start": 282.37, "end": 282.55, "word": " انا", "probability": 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مايكروم", "probability": 0.6388671875}, {"start": 301.72, "end": 302.46, "word": " كام", "probability": 0.5062255859375}, {"start": 302.46, "end": 302.72, "word": " تسعة", "probability": 0.9788411458333334}, {"start": 302.72, "end": 303.0, "word": " مايكروم", "probability": 0.91015625}, {"start": 303.0, "end": 305.68, "word": " نقطة", "probability": 0.8956705729166666}, {"start": 305.68, "end": 306.2, "word": " القطرة", "probability": 0.9607747395833334}, {"start": 306.2, "end": 307.4, "word": " فيها", "probability": 0.94140625}, {"start": 307.4, "end": 307.84, "word": " حوالي", "probability": 0.8992919921875}, {"start": 307.84, "end": 309.18, "word": " خمسين", "probability": 0.9853515625}, {"start": 309.18, "end": 310.16, "word": " مايكرو", "probability": 0.751708984375}, {"start": 310.16, "end": 310.6, "word": " ليتر", "probability": 0.76904296875}, {"start": 310.6, "end": 311.88, "word": " نقطة", "probability": 0.96728515625}, {"start": 311.88, "end": 312.2, "word": " القطرة", 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"word": " يعني", "probability": 0.88623046875}, {"start": 339.21, "end": 339.57, "word": " بيختلف", "probability": 0.681640625}, {"start": 339.57, "end": 339.75, "word": " بال", "probability": 0.72607421875}, {"start": 339.75, "end": 339.91, "word": " tear", "probability": 0.81591796875}, {"start": 339.91, "end": 340.29, "word": " film", "probability": 0.9287109375}, {"start": 340.29, "end": 341.47, "word": " thickness", "probability": 0.81787109375}, {"start": 341.47, "end": 341.91, "word": " بتاعه", "probability": 0.982421875}, {"start": 341.91, "end": 342.25, "word": " واحد", "probability": 0.90478515625}, {"start": 342.25, "end": 342.69, "word": " micron", "probability": 0.66357421875}, {"start": 342.69, "end": 344.79, "word": " و", "probability": 0.8671875}, {"start": 344.79, "end": 345.03, "word": " تمان", "probability": 0.83203125}, {"start": 345.03, "end": 345.69, "word": " مايكرون", "probability": 0.8118896484375}, {"start": 345.69, "end": 346.27, "word": " في", "probability": 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برا،", "probability": 0.6104736328125}, {"start": 350.0, "end": 350.44, "word": " والباقي", "probability": 0.813671875}, {"start": 350.44, "end": 350.74, "word": " بيطلع", "probability": 0.96162109375}, {"start": 350.74, "end": 351.02, "word": " برا", "probability": 0.988037109375}, {"start": 351.02, "end": 362.38, "word": " طيب،", "probability": 0.7315673828125}, {"start": 362.38, "end": 363.16, "word": " الآن", "probability": 0.67578125}, {"start": 363.16, "end": 363.74, "word": " لو", "probability": 0.8515625}, {"start": 363.74, "end": 363.92, "word": " أنا", "probability": 0.7294921875}, {"start": 363.92, "end": 364.22, "word": " وضعت", "probability": 0.9375}, {"start": 364.22, "end": 364.66, "word": " antibiotic", "probability": 0.68017578125}, {"start": 364.66, "end": 365.46, "word": " في", "probability": 0.8798828125}, {"start": 365.46, "end": 367.98, "word": " القطرة،", "probability": 0.75732421875}, {"start": 367.98, "end": 368.24, "word": " أنا", "probability": 0.7177734375}, 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What is Mike? Minimum in heptamine concentration. لازم يكون فوق ال Mike. مش تحت ال Mike. بس كان يبدو يكون therapeutic. طيب افضل كتروجين for significant amount of time لمدة", "tokens": [3615, 8592, 7649, 7251, 39648, 20292, 1975, 1829, 16472, 2655, 3555, 41193, 1829, 4117, 1975, 8315, 4724, 2407, 11242, 3615, 3224, 8978, 18863, 9957, 1633, 312, 1974, 294, 264, 12556, 2007, 294, 11663, 3673, 6602, 13, 708, 307, 6602, 30, 2829, 332, 449, 294, 415, 662, 18929, 9856, 13, 5296, 31377, 2304, 7251, 30544, 6156, 30543, 2423, 6602, 13, 37893, 6055, 33753, 2423, 6602, 13, 4724, 3794, 25961, 7251, 44510, 2407, 7251, 30544, 30395, 13, 23032, 1829, 3555, 1975, 5172, 11242, 1211, 9122, 2655, 2288, 29245, 9957, 337, 4776, 2372, 295, 565, 32767, 41891], "avg_logprob": -0.38223683708592465, "compression_ratio": 1.4412955465587045, "no_speech_prob": 0.0, "words": [{"start": 383.11, "end": 383.91, "word": "عشان", "probability": 0.6802978515625}, {"start": 383.91, "end": 384.45, "word": " يقوللي", "probability": 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Stroma، barrier. ال Endothelium، barrier. طيب، طالب هتقولي ال .. ال .. ال Bowers membrane و ال bismuth membrane و أي حد ولا positive، مش active. هذا ال anatomy ضد البكتيريا و الفيروسات ممتاز، لكن في موضوع ال drugs مالهمش", "tokens": [9566, 1829, 3555, 12399, 19446, 39896, 2423, 13565, 22807, 9970, 355, 338, 2197, 12399, 13357, 13, 8251, 6440, 12399, 13357, 13, 2423, 6967, 900, 338, 2197, 12399, 13357, 13, 23032, 1829, 3555, 12399, 23032, 6027, 3555, 8032, 2655, 39648, 1829, 2423, 4386, 2423, 4386, 2423, 12903, 433, 19651, 4032, 2423, 272, 1434, 2910, 19651, 4032, 36632, 11331, 3215, 49429, 3353, 12399, 37893, 4967, 13, 23758, 2423, 31566, 48812, 3215, 29739, 4117, 2655, 13546, 25528, 4032, 27188, 13546, 41779, 9307, 3714, 2304, 2655, 31377, 12399, 44381, 8978, 3714, 2407, 11242, 45367, 2423, 7766, 3714, 6027, 16095, 8592], "avg_logprob": -0.35019330880076616, "compression_ratio": 1.58008658008658, "no_speech_prob": 0.0, "words": [{"start": 571.22, "end": 571.84, "word": "طيب،", 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بين السلسل إتراسيلولر أو إتراسيلولر كيف؟ يعني أنا عندي الآن هذه ال Epithelium طبعا ال Epithelium", "tokens": [6027, 26890, 13546, 16247, 3794, 32277, 1829, 5296, 39184, 9970, 355, 338, 2197, 4032, 9970, 355, 338, 2197, 46599, 9957, 16095, 745, 4397, 64, 11933, 15730, 9122, 29399, 6055, 2288, 17082, 3555, 8978, 6055, 2288, 31371, 3555, 2423, 39184, 9970, 355, 338, 2197, 33962, 9640, 7435, 1829, 11933, 15042, 4724, 2304, 8592, 9640, 4117, 3660, 9154, 21136, 1211, 3794, 1211, 34051, 4724, 2304, 8592, 9640, 4117, 3660, 49374, 21136, 1211, 3794, 1211, 11933, 2655, 2288, 32277, 26895, 12610, 2288, 34051, 11933, 2655, 2288, 32277, 26895, 12610, 2288, 9122, 33911, 22807, 37495, 22653, 41850, 18871, 16254, 6024, 48506, 29538, 2423, 9970, 355, 338, 2197, 23032, 3555, 3615, 995, 2423, 9970, 355, 338, 2197], "avg_logprob": -0.49032080911957054, "compression_ratio": 1.835, "no_speech_prob": 0.0, "words": [{"start": 602.45, "end": 603.09, "word": "البرير", "probability": 0.5673828125}, {"start": 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"probability": 0.70745849609375}, {"start": 2699.26, "end": 2699.26, "word": " عليه", "probability": 0.54736328125}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 2700.17875, "duration_after_vad": 2318.421874999992}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/XaWFurSQ-zE_raw.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/XaWFurSQ-zE_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..4824c408a1852aadeba5a8418f165e2936ec93ac
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/XaWFurSQ-zE_raw.srt
@@ -0,0 +1,1880 @@
+1
+00:00:21,510 --> 00:00:26,230
+بسم الله الرحمن الرحيم الحمد لله رب العالمين وأصلي
+
+2
+00:00:26,230 --> 00:00:32,370
+وأسلم على النبي الأمين محمد صلى الله عليه وسلم
+
+3
+00:00:32,370 --> 00:00:36,290
+وعلى أهله وأصحابه والتابعين السلام عليكم ورحمة
+
+4
+00:00:36,290 --> 00:00:41,130
+الله جزاك الله في هذا اليوم سنكمل ما بدأنا من
+
+5
+00:00:41,130 --> 00:00:48,690
+pharmacology of the eye and today we will talk
+
+6
+00:00:48,690 --> 00:00:49,250
+about
+
+7
+00:00:53,660 --> 00:00:59,220
+Target sites أي أين سيذهب الدواء في العين ما هي
+
+8
+00:00:59,220 --> 00:01:05,460
+الأهداف التي داخل العين سيعمل عليها الدواء الدواء
+
+9
+00:01:05,460 --> 00:01:10,440
+عند موضوعه في العين يتناول أربع مواضع أو أربعة
+
+10
+00:01:10,440 --> 00:01:14,520
+مواضع المواضع الأول الـ Preocular structures يعني
+
+11
+00:01:14,520 --> 00:01:19,140
+أشياء خارج العين يعني الـ Eyelids الكُجرة الطيبة
+
+12
+00:01:25,770 --> 00:01:29,610
+تو قارية نفس القارية القارية صحيح هي superficial
+
+13
+00:01:29,610 --> 00:01:33,630
+لكن تبتد إلى الداخل وبتشرف على ال antelope chamber
+
+14
+00:01:33,630 --> 00:01:41,990
+ثلاثة قاريات انتيلوت شامبر وقستيلوت شامبر الحجر
+
+15
+00:01:41,990 --> 00:01:47,730
+أمامي والحجر خلفيه مليء بالمضحك الاكويس اكويس مضحك
+
+16
+00:01:47,730 --> 00:01:49,170
+اكويس اكويس اكويس اكويس اكويس اكويس اكويس اكويس
+
+17
+00:01:49,170 --> 00:01:49,610
+اكويس اكويس اكويس اكويس اكويس اكويس اكويس اكويس
+
+18
+00:01:49,610 --> 00:01:51,630
+اكويس اكويس اكويس اكويس اكويس اكويس اكويس اكويس
+
+19
+00:01:51,630 --> 00:01:54,090
+اكويس اكويس اكويس اكويس اكويس اكويس اكويس
+
+20
+00:01:55,680 --> 00:02:01,000
+من الخارج إلى الخارج تبدأ بـ Preocular Structures,
+
+21
+00:02:01,220 --> 00:02:05,340
+Cornea, Anterosperm, Posterior Sperm, then Petrius
+
+22
+00:02:05,340 --> 00:02:09,780
+and Retina طبعا
+
+23
+00:02:09,780 --> 00:02:14,180
+الادمستراتيشن لأمام الظهر يعني سطح الليل يمكن
+
+24
+00:02:14,180 --> 00:02:19,400
+استخدامه لإعطاء الدراجات لـ Preocular, Cornea,
+
+25
+00:02:19,840 --> 00:02:25,400
+Anterior and Posterior Sperm و بعدين Petriusعادةً،
+
+26
+00:02:25,400 --> 00:02:28,200
+إدارة سيستيماكية أو إدارة إنتراوكولية مستخدمة
+
+27
+00:02:28,200 --> 00:02:30,760
+لتحضير الدراجات لتحقيق هذا الانتجار تتحرك مع
+
+28
+00:02:30,760 --> 00:02:35,940
+مترياز كيميتي يعني أنا مش محتاج عشان أعالج الكورية
+
+29
+00:02:35,940 --> 00:02:40,700
+أو ال island أو أعالج ال iris مثلا أو الcellar
+
+30
+00:02:40,700 --> 00:02:46,780
+body أني أنا أحكم وريدي هو ال topic الأحسن و هو
+
+31
+00:02:46,780 --> 00:02:51,220
+الأصل لأن مش ال direct على العين لكن هي المشكلة في
+
+32
+00:02:51,220 --> 00:02:58,240
+المتريازالـ topical .. the topical treatment can't
+
+33
+00:02:58,240 --> 00:03:02,440
+reach the petrius لأن فيه barrier one, barrier
+
+34
+00:03:02,440 --> 00:03:09,520
+two, barrier four, barrier five .. بين ال .. فال
+
+35
+00:03:09,520 --> 00:03:14,140
+.. ال petrius هنتكلم عنه إما systemic injection أو
+
+36
+00:03:14,140 --> 00:03:15,100
+intraocular
+
+37
+00:03:20,740 --> 00:03:25,500
+الشيء اللذي يؤثر على إستخدام الحرارة للـ 3 أكتر
+
+38
+00:03:25,500 --> 00:03:32,180
+أكتر في المنطقة الأكتر أكتر في المنطقة الأكتر في
+
+39
+00:03:32,180 --> 00:03:36,360
+المنطقة الأكتر
+
+40
+00:03:36,360 --> 00:03:37,580
+في المنطقة الأكتر في المنطقة الأكتر في المنطقة
+
+41
+00:03:37,580 --> 00:03:38,240
+الأكتر في المنطقة الأكتر في المنطقة الأكتر في
+
+42
+00:03:38,240 --> 00:03:41,560
+المنطقة الأكتر في المنطقة الأكتر في المنطقة الأكتر
+
+43
+00:03:41,560 --> 00:03:46,160
+في المنطقة الأكتر في المنطقة الأكتر
+
+44
+00:03:53,670 --> 00:03:59,290
+بتحرقك إلى داخل العين، يبقى هنا لو انا حطيت drops
+
+45
+00:03:59,290 --> 00:04:05,290
+قطرة، القطرة خلال thirty minutes او forty minutes،
+
+46
+00:04:05,290 --> 00:04:09,970
+بعض هيتبخر وبعدها هينزل في نزل ذاكر مالدكت وبعدها
+
+47
+00:04:09,970 --> 00:04:11,130
+هيروح القرانية وتنتهي
+
+48
+00:04:16,730 --> 00:04:19,150
+لازم اعطي frequently كل ساعة كل ساعة كل ساعة مثلا
+
+49
+00:04:19,150 --> 00:04:25,350
+لإن بحطيك مارعم مثلا المارعم بيقول اكثر even a
+
+50
+00:04:25,350 --> 00:04:31,770
+bullion of teas in the eye is approximately 5
+
+51
+00:04:31,770 --> 00:04:39,130
+microliter كم يعني كيس المرتحمة الاتساب ده هو كم
+
+52
+00:04:39,130 --> 00:04:45,980
+كيس المرتحمة مابيسايع كتير يعني انا عشان اضع قطرةو
+
+53
+00:04:45,980 --> 00:04:51,740
+أعمل closure العينية العين
+
+54
+00:04:51,740 --> 00:04:58,340
+الواحدة ما بين القرنية و المتحمة و ال Formasis او
+
+55
+00:04:58,340 --> 00:05:03,000
+ال eyelids من الخلف تسعة مايكروم كام تسعة مايكروم
+
+56
+00:05:03,000 --> 00:05:11,880
+نقطة القطرة فيها حوالي خمسين مايكرو ليتر نقطة
+
+57
+00:05:11,880 --> 00:05:14,860
+القطرة اللي بنحطها يعني خمسها بيدخل
+
+58
+00:05:18,950 --> 00:05:24,130
+شوفوا كم يعني فيه خسار يعني فبقوللي بس ال ايه لما
+
+59
+00:05:24,130 --> 00:05:28,450
+رمضت تسعة تسعة مايكرون موظف أبوش resides in the
+
+60
+00:05:28,450 --> 00:05:34,670
+prefertile sex و one micron بس هو اللي بيكون مع ال
+
+61
+00:05:34,670 --> 00:05:39,210
+tear film على الصفحة القرنية و شوية ع مرتحب يعني
+
+62
+00:05:39,210 --> 00:05:44,790
+بيختلف بال tear film thickness بتاعه واحد micron و
+
+63
+00:05:44,790 --> 00:05:50,440
+تمان مايكرون في داخل الوالباقي بيطلع برا، والباقي
+
+64
+00:05:50,440 --> 00:06:02,380
+بيطلع برا طيب،
+
+65
+00:06:02,380 --> 00:06:08,460
+الآن لو أنا وضعت antibiotic في القطرة، أنا بدّي
+
+66
+00:06:08,460 --> 00:06:08,940
+الآن
+
+67
+00:06:23,110 --> 00:06:27,630
+عشان يقوللي اي انتباطيك انا بوضعه في العين must be
+
+68
+00:06:27,630 --> 00:06:31,350
+present in the tear film in amounts above Mike.
+
+69
+00:06:31,610 --> 00:06:36,770
+What is Mike? Minimum in heptamine concentration.
+
+70
+00:06:37,950 --> 00:06:41,830
+لازم يكون فوق ال Mike. مش تحت ال Mike. بس كان يبدو
+
+71
+00:06:41,830 --> 00:06:47,210
+يكون therapeutic. طيب افضل كتروجين for significant
+
+72
+00:06:47,210 --> 00:06:53,740
+amount of time لمدةكافية من الوقت لمدة كافية من
+
+73
+00:06:53,740 --> 00:06:57,360
+الوقت اه significant amount of time to produce
+
+74
+00:06:57,360 --> 00:07:01,440
+microbiological and clinical improvement or cure
+
+75
+00:07:01,440 --> 00:07:10,920
+of disease يبقى مش .. بس التركيز والوقت يكون
+
+76
+00:07:10,920 --> 00:07:16,720
+تركيزه عالي فوق المايك يبقى احنا تعدتنا انه اي
+
+77
+00:07:16,720 --> 00:07:24,440
+antibiotic اضعه في العين لابدان يكون فوق المايك
+
+78
+00:07:24,440 --> 00:07:30,920
+عشان يعمل تأثير آلاتي ويكون الوقت الزمني كافي
+
+79
+00:07:30,920 --> 00:07:37,080
+ليحدث شفاء او علاج للمرض اللي هو داخل العين او لا
+
+80
+00:07:37,080 --> 00:07:42,400
+في تلقرانيه و if the target sight is intraocular
+
+81
+00:07:42,400 --> 00:07:46,380
+مثلا العين is intraocular السلعب المديني
+
+82
+00:07:46,380 --> 00:07:50,590
+intraocularالنزل انترا او اكولا انترا او اكولا
+
+83
+00:07:50,590 --> 00:07:50,790
+انترا او اكولا انترا او اكولا انترا او اكولا انترا
+
+84
+00:07:50,790 --> 00:07:53,590
+او اكولا انترا او اكولا انترا او اكولا انترا او
+
+85
+00:07:53,590 --> 00:07:58,250
+اكولا انترا او اكولا انترا او اكولا انترا او اكولا
+
+86
+00:07:58,250 --> 00:07:58,250
+انترا او اكولا انترا او اكولا انترا او اكولا انترا
+
+87
+00:07:58,250 --> 00:07:58,250
+او اكولا انترا او اكولا انترا او اكولا انترا او
+
+88
+00:07:58,250 --> 00:07:58,250
+اكولا انترا او اكولا انترا او اكولا انترا او اكولا
+
+89
+00:07:58,250 --> 00:08:05,530
+انترا او اكولا انترا او اكولا
+
+90
+00:08:05,530 --> 00:08:09,670
+انترا
+
+91
+00:08:09,670 --> 00:08:12,750
+ا
+
+92
+00:08:32,660 --> 00:08:35,800
+لو المرض في القرانية نفسها، هيكون في direct
+
+93
+00:08:35,800 --> 00:08:40,780
+contact، direct contact، يا لو في قرحة هنا، هيكون
+
+94
+00:08:40,780 --> 00:08:44,940
+في direct contact مع ال drugs طيب، وانا المشكلة لو
+
+95
+00:08:44,940 --> 00:08:50,300
+انا بدأ اقعد مثلا في scenario D، scenario D، يبقى
+
+96
+00:08:50,300 --> 00:08:56,760
+لازم نصير دخول لل drugs عبر القرانية، طبقات
+
+97
+00:08:56,760 --> 00:09:03,640
+القرانية الخامسةوخش في ال anterior chamber ومن ال
+
+98
+00:09:03,640 --> 00:09:08,160
+pubis يخش على ال posterior chamber ويصل إلى
+
+99
+00:09:08,160 --> 00:09:14,060
+الcellarium وصل ال cellar يبقى مدى ينطص ال drug
+
+100
+00:09:14,060 --> 00:09:18,800
+عبر القرنية ويخش في ال aqueous إلى ال anterior ثم
+
+101
+00:09:18,800 --> 00:09:21,940
+ال posterior chamber مابيكون قادر على أن يعادى
+
+102
+00:09:21,940 --> 00:09:24,680
+أشياء داخل القلعية أن يعادى أشياء
+
+103
+00:09:31,220 --> 00:09:36,080
+طيب، ما هي ال barriers؟ Epithelium، barrier.
+
+104
+00:09:38,200 --> 00:09:43,280
+Stroma، barrier. ال Endothelium، barrier. طيب،
+
+105
+00:09:43,280 --> 00:09:49,400
+طالب هتقولي ال .. ال .. ال Bowers membrane و ال
+
+106
+00:09:49,400 --> 00:09:53,320
+bismuth membrane و أي حد ولا positive، مش active.
+
+107
+00:09:54,260 --> 00:09:58,220
+هذا ال anatomy ضد البكتيريا و الفيروسات ممتاز، لكن
+
+108
+00:09:58,220 --> 00:10:00,520
+في موضوع ال drugs مالهمش
+
+109
+00:10:02,450 --> 00:10:06,990
+البرير الأساسي لـ Epithelium و Epithelium وبينهم
+
+110
+00:10:06,990 --> 00:10:11,850
+Stroma إذا
+
+111
+00:10:11,850 --> 00:10:15,890
+كنت ترغب في ترتيب الـ Epithelium الخارجي إما
+
+112
+00:10:15,890 --> 00:10:23,930
+بمشاركة من السلسل أو بمشاركة بين السلسل إتراسيلولر
+
+113
+00:10:23,930 --> 00:10:29,590
+أو إتراسيلولر كيف؟ يعني أنا عندي الآن هذه ال
+
+114
+00:10:29,590 --> 00:10:34,560
+Epithelium طبعا ال Epitheliumمكوّن من خمس طبقات أو
+
+115
+00:10:34,560 --> 00:10:39,180
+أربع طبقات كورينا ليبيفينيا هنا الـ polyhedral
+
+116
+00:10:39,180 --> 00:10:43,400
+cells هنا الـ polyhedral cells وهنا بصير شوية Flat
+
+117
+00:10:43,400 --> 00:10:52,000
+وأو أخر طبقة اللي هي Flat ليبيفينيا كويس هذا
+
+118
+00:10:52,000 --> 00:10:57,560
+كورينا ليبيفينيا لو أنا أعطيه Antibiotic هنا ولحسب
+
+119
+00:10:57,560 --> 00:11:05,060
+ال size of molecule molecular sizeإما يدخل الدواء
+
+120
+00:11:05,060 --> 00:11:14,180
+ما بين الخلايا يتسلل إلى هنا ما بين الخلايا أو عبر
+
+121
+00:11:14,180 --> 00:11:18,100
+الخلية لازم يخش بالخلية الأولى والخلية الثانية
+
+122
+00:11:18,100 --> 00:11:23,740
+والخلية الثالثة والخلية الرابعة يبقى أنا بقول إنه
+
+123
+00:11:23,740 --> 00:11:32,530
+إما through the cellsاللي دخل في ال cells انترا
+
+124
+00:11:32,530 --> 00:11:38,810
+سيلولار اختلف الخلية واللي between the cells انترا
+
+125
+00:11:38,810 --> 00:11:45,530
+سيلولار يعني هاي خلية وخلية هو يخش من بينهم فهذا
+
+126
+00:11:45,530 --> 00:11:52,370
+انترا سيلولار لكن التاني ال .. ال انترا سيلولار لأ
+
+127
+00:11:52,370 --> 00:11:53,030
+بيجي هنا
+
+128
+00:11:57,880 --> 00:12:01,200
+حسب ال molecular size لما يكون ال molecular size
+
+129
+00:12:01,200 --> 00:12:05,660
+very small يخش
+
+130
+00:12:05,660 --> 00:12:15,820
+انترسلول يكون صغير لما يكون انترسلول انترسلول يكون
+
+131
+00:12:15,820 --> 00:12:24,080
+كبير مافيش طريقة اللي يشكل مخلائهم طيب هنا
+
+132
+00:12:24,080 --> 00:12:25,060
+تصوير
+
+133
+00:12:40,180 --> 00:12:44,140
+هتكلم على Topical Antibiotics ويعني بالـ Topical
+
+134
+00:12:44,140 --> 00:12:49,400
+كل موضع على سطح شيء اسمه Topical بيوضع على السطح
+
+135
+00:12:49,400 --> 00:12:54,600
+اسمه Topical موضع .. موضع .. لأ سطحي الموضع إيه لو
+
+136
+00:12:54,600 --> 00:12:59,980
+أنا جبت سن إبرة وحطيته تحت المنطقة مبقن هذا Local
+
+137
+00:12:59,980 --> 00:13:06,120
+لو أنا بدأ بندي أصبعي بحط أنا دي في الأصبع مبقن
+
+138
+00:13:06,120 --> 00:13:11,160
+هذا Localبدي افتح دمّال و بيحط بين موضعيه، بتخيل
+
+139
+00:13:11,160 --> 00:13:14,720
+درجة و بيحط بين موضعيه، اه ده الوكالي، لكن لو وجود
+
+140
+00:13:14,720 --> 00:13:19,240
+مرعب انا على جلدي، على وجهي، او قطرة في عيني، او
+
+141
+00:13:19,240 --> 00:13:22,460
+مرعب في عيني، او في داني، او في عنفي، هذا اسمه
+
+142
+00:13:22,460 --> 00:13:26,300
+الـtopical، الـtopical treatment، اذا انا بتكلم
+
+143
+00:13:26,300 --> 00:13:30,440
+على الأشياء الـtopical اللي احنا دائما مستعملها،
+
+144
+00:13:30,440 --> 00:13:33,800
+بقول الـantibiotics اللي بتنحط على سطح العين، most
+
+145
+00:13:33,800 --> 00:13:37,720
+drugs infiltrate the cornea via the intracellular
+
+146
+00:13:38,470 --> 00:13:43,770
+لازم يخش داخل كل خلية although the intercellular
+
+147
+00:13:43,770 --> 00:13:49,110
+rule predominates for hydrophilic drugs
+
+148
+00:13:49,110 --> 00:13:54,450
+hydrophilic soluble in water يبقى ال soluble in
+
+149
+00:13:54,450 --> 00:14:00,370
+water بيكون ال molecule بتاعه very small بتسلل ما
+
+150
+00:14:00,370 --> 00:14:04,490
+بين الخلايا بالفديوهات بين الخلايا في بين خلايا
+
+151
+00:14:04,490 --> 00:14:11,300
+مفاصلة صغيرة مدخل بيهالكن الليبوفيليك اللي هو بدوق
+
+152
+00:14:11,300 --> 00:14:15,660
+الدهون لازم يستأذن كل خلية تدق على الباب تفتحها
+
+153
+00:14:15,660 --> 00:14:18,860
+الخلية و بعد الخلية البعدي تدق على الباب تفتحها
+
+154
+00:14:18,860 --> 00:14:22,020
+الخلية و يمشي في الستوكبلازم إلى الخلية البعدي و
+
+155
+00:14:22,020 --> 00:14:27,890
+إلى الخلية البعدي على بالكم أن أكثر صحيًاال drug
+
+156
+00:14:27,890 --> 00:14:33,150
+يمشي مابين الخلايا؟ يتسلل مابين الخلايا؟ ولا يدخل
+
+157
+00:14:33,150 --> 00:14:36,850
+باب كل خلية؟ يدخل باب كل خلية، لأ يمشي من أحسن
+
+158
+00:14:36,850 --> 00:14:39,990
+صحيا، بين الخلايا، دايلة الخلايا، ممكن يأثر على
+
+159
+00:14:39,990 --> 00:14:44,290
+التلكيز أحسن، ممكن يأثر على اللي هو ال nucleus و
+
+160
+00:14:44,290 --> 00:14:47,390
+على ال cytoplasm و على ال mitochondria بتاعة
+
+161
+00:14:47,390 --> 00:14:52,710
+الخلية، إنما لما يمر بجانب الباب و لا يفتح الباب،
+
+162
+00:14:52,710 --> 00:14:54,570
+مش هيكون side effects
+
+163
+00:15:02,110 --> 00:15:05,930
+الدهون المدابر في الهوم لديه اكتشاف كبير لإبثاليوم
+
+164
+00:15:05,930 --> 00:15:10,390
+ومقاومة
+
+165
+00:15:10,390 --> 00:15:11,770
+أكتشاف أكتشاف أكتشاف أكتشاف أكتشاف أكتشاف أكتشاف
+
+166
+00:15:11,770 --> 00:15:12,630
+أكتشاف أكتشاف أكتشاف أكتشاف أكتشاف أكتشاف أكتشاف
+
+167
+00:15:12,630 --> 00:15:13,670
+أكتشاف أكتشاف أكتشاف أكتشاف أكتشاف أكتشاف أكتشاف
+
+168
+00:15:13,670 --> 00:15:14,050
+أكتشاف أكتشاف أكتشاف أكتشاف أكتشاف أكتشاف أكتشاف
+
+169
+00:15:14,050 --> 00:15:16,310
+أكتشاف أكتشاف أكتشاف أكتشاف أكتشاف أكتشاف أكتشاف
+
+170
+00:15:16,310 --> 00:15:23,230
+أكتشاف أكتشاف أكت
+
+171
+00:15:31,620 --> 00:15:37,260
+هذا endothelium وهذه الكبيرة اسمها stroma
+
+172
+00:15:37,260 --> 00:15:40,500
+الهيبوفليك
+
+173
+00:15:40,500 --> 00:15:48,720
+الدرس سيختلف الهيبوفليام بسرعة لأن الهيبوفليام
+
+174
+00:15:48,720 --> 00:15:49,740
+عالي دهون
+
+175
+00:16:03,190 --> 00:16:07,550
+اللي هو يعني high percentage of water بيصير الدواء
+
+176
+00:16:07,550 --> 00:16:12,930
+الدهني اللي قال حطيته هنا واشتغلت بسرعة هنا يتلكى،
+
+177
+00:16:12,930 --> 00:16:18,890
+يتلكى، بيصيروا بعد التعويق يعني بعد فترة يمر، بس
+
+178
+00:16:18,890 --> 00:16:23,230
+بسرعة، بس شوية، فإذا وصل ال endothelium، ال
+
+179
+00:16:23,230 --> 00:16:27,910
+endothelium برد وسط الدهني هنا يمر بسرعة إلى ال
+
+180
+00:16:27,910 --> 00:16:34,650
+AC، يمر بسرعة إلى ال ACيعني انا في يدي التفاوت حتى
+
+181
+00:16:34,650 --> 00:16:40,130
+في طبخات القرارية والحوادث والمرور عبرها كل واحد
+
+182
+00:16:40,130 --> 00:16:48,010
+له نسبة من الدخول طيب يبقى ال استرولة عائق لل
+
+183
+00:16:48,010 --> 00:16:52,030
+hydrophilic لإن بتمارن ال hydrophilic بسرعة بقولي
+
+184
+00:16:52,030 --> 00:16:59,590
+for hydrophilic compounds عكس اللي هو اخت ساحر
+
+185
+00:16:59,590 --> 00:17:00,410
+انتبهي معانا
+
+186
+00:17:05,600 --> 00:17:13,560
+الحاجز الأكتر هو الهيدروفليك الهيدروفليك هو عكس
+
+187
+00:17:13,560 --> 00:17:19,960
+الهيدروفليك فدراجس الهيدروفليك بيوقف الهيدروفليك و
+
+188
+00:17:19,960 --> 00:17:27,280
+الهيدروفليك عكس الأول يعني يبقى الأنوية المائية
+
+189
+00:17:27,280 --> 00:17:33,080
+بيوقفها الهيدروفليكإن وصلت لـ Strauma، إيش بصيت؟
+
+190
+00:17:33,080 --> 00:17:39,280
+تدخل بسرعة، طيب، بقول in reality، في حقيقة، a
+
+191
+00:17:39,280 --> 00:17:43,680
+gradient is established across the cornea، with
+
+192
+00:17:43,680 --> 00:17:46,960
+different concentrations of a drug in the
+
+193
+00:17:46,960 --> 00:17:50,780
+different layers of the cornea، يا سلام، يعني هو
+
+194
+00:17:50,780 --> 00:17:51,040
+بيقول
+
+195
+00:18:13,190 --> 00:18:19,970
+مارى صعب حاجة بتاخد بتاخد بس بتاور فانا سهل هي أنا
+
+196
+00:18:19,970 --> 00:18:26,930
+صعب شوية تقول يعني يمكن انا قدر التركيز هنا تلاتين
+
+197
+00:18:26,930 --> 00:18:33,850
+في المية هنا انا جى ستين في المية وهنا انا جى عشرة
+
+198
+00:18:33,850 --> 00:18:38,630
+في المية في
+
+199
+00:18:38,630 --> 00:18:40,010
+تدرج
+
+200
+00:18:42,860 --> 00:18:50,180
+أو ابتصاص طيب تاني لو حاطيت أنا دواء دهوني هي دوق
+
+201
+00:18:50,180 --> 00:18:57,480
+في الدهون ممكن أنا أجيه هنا خمسين في المية و هنا
+
+202
+00:18:57,480 --> 00:19:03,680
+أجيه عشرين في المية و هنا أجيه تلاتين في المية بس
+
+203
+00:19:03,680 --> 00:19:09,400
+هاي ال agreement في تدرج مش كل طبقات القرانية
+
+204
+00:19:09,400 --> 00:19:11,260
+التلاتة بنفس
+
+205
+00:19:20,640 --> 00:19:25,520
+التركيزات البكتيرية في موقع التأثير على الكمية
+
+206
+00:19:25,520 --> 00:19:29,720
+يمكن أن تكون إما أعلى بما يكون التركيزات الكومية
+
+207
+00:19:29,720 --> 00:19:37,120
+إذا كانت الجسم موجودة في الكومية أو تقليد
+
+208
+00:19:37,120 --> 00:19:40,360
+التركيزات الكومية في الجسم
+
+209
+00:19:51,510 --> 00:19:56,390
+في كيروتيكس كيروتيكس ممكن تكون بكتيريا ممكن تكون
+
+210
+00:19:56,390 --> 00:20:02,270
+فيران ممكن تكون فانجل طيب لو انا عندي ال infection
+
+211
+00:20:02,270 --> 00:20:10,630
+هنا في المطبخ هنا و انا بحثت رأسي في
+
+212
+00:20:10,630 --> 00:20:17,890
+مريض تاني ل infection هنا و انا بحثت رأسي اخبروني
+
+213
+00:20:17,890 --> 00:20:24,930
+شفاءالإنفيكشن السوبرفيكشن و لا ال deep infection
+
+214
+00:20:24,930 --> 00:20:31,630
+أسرع حسب نوع الدواء اللي احنا نتعامل معه طيب هذا
+
+215
+00:20:31,630 --> 00:20:37,210
+كلام كويس حسب نوع الذوبانية بتاعت الدواء وكمان حسب
+
+216
+00:20:37,210 --> 00:20:42,290
+نوع ال micro وكمان حسب تركيز الدواء وكمان حسب
+
+217
+00:20:42,290 --> 00:20:50,240
+المدة الزمنية وعدد القطرات لكن هو يقول عموماكل
+
+218
+00:20:50,240 --> 00:20:56,420
+مكان superficial كل مكان direct contact أكتر أقرب
+
+219
+00:20:56,420 --> 00:21:03,580
+تماما زي الأرض مثلا انا لما بدي يعني أسقي نباتات
+
+220
+00:21:03,580 --> 00:21:08,860
+خفيفة سطحية لشك أن الميه بتصل جذورها بسرعة لأنها
+
+221
+00:21:08,860 --> 00:21:14,180
+عشر سنة تحت سطح الأرض لو بدى أسكيها يعني يكفيها
+
+222
+00:21:14,180 --> 00:21:19,960
+كمية تلاتة من الميهلكن انا لو بدي أسقي شجر عنق أو
+
+223
+00:21:19,960 --> 00:21:27,400
+بدي أسقي شجر زيتون يعني عميق، بديه كم الميه؟ بديه
+
+224
+00:21:27,400 --> 00:21:31,320
+برميل أو أكتر؟ و هكذا، يبقى لما يكون على سطح
+
+225
+00:21:31,320 --> 00:21:35,940
+القرنية، التركيزي، لما أخدت باليه هيكون أعلى وشفاق
+
+226
+00:21:35,940 --> 00:21:39,240
+أكتر، لكن ال deep هيكون في مرحلة
+
+227
+00:21:56,170 --> 00:22:01,510
+بتكلمنا على ال concentration وتكلمنا على ال
+
+228
+00:22:01,510 --> 00:22:02,470
+significant type
+
+229
+00:22:06,370 --> 00:22:11,130
+وهنا نتكلم عن location of infection بدا تجميع يعني
+
+230
+00:22:11,130 --> 00:22:15,870
+أمور مش بس نقرأ كل واحد لحاله عامل عاملين لأ لازم
+
+231
+00:22:15,870 --> 00:22:20,890
+نحط serial number لهذه الأعوام انه خدتتي في
+
+232
+00:22:20,890 --> 00:22:23,030
+الامتحان ايش؟
+
+233
+00:22:36,410 --> 00:22:41,650
+يبقى أنا بتكلم على ال superficial وال deep لشك أنه
+
+234
+00:22:41,650 --> 00:22:44,930
+التركيز الدواء في ال superficial بيكون أكتر من
+
+235
+00:22:44,930 --> 00:22:51,070
+تركيزه في ال deep infection طيب the corner root
+
+236
+00:22:51,070 --> 00:22:55,050
+has always been assumed to be the major root of
+
+237
+00:22:55,050 --> 00:23:01,450
+entering into the eye أي عامل سادس يجانب، root of
+
+238
+00:23:01,450 --> 00:23:07,460
+administration، طرف تقطعهو بالنسبة للقرانية والعين
+
+239
+00:23:07,460 --> 00:23:13,100
+باعتمد الـ Corneal Road طريقة القرانية المبرجة
+
+240
+00:23:13,100 --> 00:23:17,340
+أكتر ايه تلت أكتر however recent evidence بيقولوا
+
+241
+00:23:17,340 --> 00:23:21,460
+الآن حديثا أصبحوا بيفكروا في إيش أنه that
+
+242
+00:23:21,460 --> 00:23:24,080
+penetration across كلية الطيبة and sclera may
+
+243
+00:23:24,080 --> 00:23:26,980
+almost contribute significantly to penetration
+
+244
+00:23:26,980 --> 00:23:31,600
+into the anterior chamber يعني بيقولوا الآن ممكن
+
+245
+00:23:31,600 --> 00:23:33,420
+أنه
+
+246
+00:23:37,090 --> 00:23:44,550
+في الملتحمة ممكن يصل ال AC و ال PC مثلا بالنسبة ل
+
+247
+00:23:44,550 --> 00:23:48,230
+30% فإن
+
+248
+00:23:48,230 --> 00:23:55,130
+أنا أعمل القرانية 70% فبقول لها ده السهل بال 30%
+
+249
+00:23:55,130 --> 00:23:58,970
+يعني أنا في حالة ال kernel ulcer اللي هيدمر
+
+250
+00:23:58,970 --> 00:24:04,090
+القرانية ممكن أعطي اللي هو drugs topical و أعطي
+
+251
+00:24:04,090 --> 00:24:06,630
+injection تحت الملتحمة لغة
+
+252
+00:24:25,540 --> 00:24:32,360
+ما هي الأوامل التي تسريع في امتصاص الـ Antibiotics
+
+253
+00:24:32,360 --> 00:24:37,200
+من سطح العين one solubility ورحنا اتكلمنا عنها إما
+
+254
+00:24:37,200 --> 00:24:44,020
+Lybophilic زي الجن تمييسين مثلا Lybophilic
+
+255
+00:24:44,020 --> 00:24:48,220
+زي Chloramphilic أو Hydrophilic زي الجن تمييسين
+
+256
+00:24:48,220 --> 00:24:50,860
+هذي الميكالي مثلا إن الجن تمييسين يدوم في الماء
+
+257
+00:24:51,610 --> 00:24:55,130
+عشانكي نحن حقا نحن هذا تحتموا وتحتموا اما
+
+258
+00:24:55,130 --> 00:24:59,310
+chloramphenicol موجود في السوق بكثرة لازم تشوفوه
+
+259
+00:24:59,310 --> 00:25:03,310
+chloramphenicol في عشرين شركات تطلع وفي منهم مارهم
+
+260
+00:25:03,310 --> 00:25:08,050
+وفي منهم ايش خاطره chloramphenicol اه هنا
+
+261
+00:25:08,050 --> 00:25:13,030
+ليبوفيليك وبالتالي متعوق من البيفيليا فالعامل
+
+262
+00:25:13,030 --> 00:25:17,770
+التاني pH of atopical antibiotic pH اللي هو ضاد
+
+263
+00:25:18,840 --> 00:25:25,940
+الحمودة او القائدية او تركيز الهيدروجين هو بيقول
+
+264
+00:25:25,940 --> 00:25:31,100
+لي هنا ايه المشكلة ان ال pH of the eye is neutral
+
+265
+00:25:31,100 --> 00:25:37,040
+يعني لو أخدنا الدمح بتاعنا وعملنا ال pH بتاعه نجيه
+
+266
+00:25:37,040 --> 00:25:45,560
+neutral about 7 الآن لو حطيت في عيني قطرة حمضية
+
+267
+00:25:45,560 --> 00:25:56,140
+مثلا 4.5أو قائمية ات هتعمل حاجتين الحاجة الأولى
+
+268
+00:25:56,140 --> 00:25:59,500
+هتعمل irritation of the eye لأن ال ph بتاعها مختلف
+
+269
+00:25:59,500 --> 00:26:04,120
+عن ال ph of the eye ثالث اشي مش هيكون دوبانة في
+
+270
+00:26:04,120 --> 00:26:07,340
+الدموع كما يجب وممكن تعمل precipitation ايش
+
+271
+00:26:07,340 --> 00:26:12,020
+precipitation تفسير تفسير يبقى هذا ال ph اللي انا
+
+272
+00:26:12,020 --> 00:26:16,660
+اقصده انه مش هيكون دوبانية بتاعته كما يجب
+
+273
+00:26:21,540 --> 00:26:28,380
+بنسبة ايش؟ ثلاثة increasing the concentration يعني
+
+274
+00:26:28,380 --> 00:26:35,040
+عشان ال antibiotic انه اشتغل كويس بالتركيز بتاعه
+
+275
+00:26:35,040 --> 00:26:39,320
+باطنق ده volume انا باطنق .. يعني مش زيادة ال
+
+276
+00:26:39,320 --> 00:26:46,280
+volume مثلا انا قطر التركيزة واحد فالمية لو
+
+277
+00:26:46,280 --> 00:26:49,820
+حطيت منها خمس .. خمس نقاط لا يزيد التركيزة كتير لا
+
+278
+00:26:49,820 --> 00:26:53,320
+.. لا يزيد التركيزةهي تركيزها واحد فلمية فضلا واحد
+
+279
+00:26:53,320 --> 00:26:58,060
+فلمية، بدي انا ادي تركيزها الى اتنين فلمية هل يكون
+
+280
+00:26:58,060 --> 00:27:01,960
+more effective اني اخد نقطة اتنين فلمية اخر من خمس
+
+281
+00:27:01,960 --> 00:27:08,820
+نقطة واحد فلمية يبقى if an antimicrobial eye drop
+
+282
+00:27:08,820 --> 00:27:12,220
+will increase the level of the drug in the
+
+283
+00:27:12,220 --> 00:27:15,300
+precognitive field and therefore in the aqueous
+
+284
+00:27:15,300 --> 00:27:16,780
+humor داخل العين
+
+285
+00:27:20,150 --> 00:27:24,610
+الان هذا بالنسبة لـ Concentration بقول لي في قطرات
+
+286
+00:27:24,610 --> 00:27:30,610
+تكون hypertonic وفي قطرات hypotonic وهنا حوالي
+
+287
+00:27:30,610 --> 00:27:34,710
+أربعة تيجي وهنا اللي هو automatic pressure of the
+
+288
+00:27:34,710 --> 00:27:41,230
+drug ممكن نحطها خمسة ميانة hypertonic هنا هنا قضية
+
+289
+00:27:41,230 --> 00:27:45,750
+تانية غير ال page hypertonic وقول هنا automatic
+
+290
+00:27:45,750 --> 00:27:46,510
+pressure
+
+291
+00:27:52,820 --> 00:28:00,080
+الان معروف ان لو في يعني محلول ملحي عالي التاكيز
+
+292
+00:28:00,080 --> 00:28:08,060
+وضعت انا filter بينه بين ميه فانه الميه هتسحب
+
+293
+00:28:08,060 --> 00:28:15,080
+السائل من اللي هو ال buslozmodel العالى الى نصف
+
+294
+00:28:15,080 --> 00:28:17,300
+تعادل يعني مثلا
+
+295
+00:28:22,380 --> 00:28:32,300
+محلول ملحي مثلا تركيزه 5% وعندي أنا water ال water
+
+296
+00:28:32,300 --> 00:28:37,920
+ال neutral صح؟ الآن هتفضل الماء هذه تسحب السائل من
+
+297
+00:28:37,920 --> 00:28:45,500
+هنا حتى تصير هنا 2.5% وانا 2.5% حسب نظرية الدكتور
+
+298
+00:28:45,500 --> 00:28:49,720
+اسمه صح؟ يبقى هينقول هي hypertonic
+
+299
+00:28:54,240 --> 00:28:58,740
+تتجه إلى الفيلم بسرعة أكتر من ذلك، ولكن بسرعة أكتر
+
+300
+00:28:58,740 --> 00:28:59,520
+من ذلك، ولكن بسرعة أكتر من ذلك، ولكن بسرعة أكتر من
+
+301
+00:28:59,520 --> 00:29:02,180
+ذلك، ولكن بسرعة أكتر من ذلك، ولكن بسرعة أكتر من
+
+302
+00:29:02,180 --> 00:29:03,320
+ذلك، ولكن بسرعة أكتر من ذلك، ولكن بسرعة أكتر من
+
+303
+00:29:03,320 --> 00:29:03,540
+ذلك، ولكن بسرعة أكتر من ذلك، ولكن بسرعة أكتر من
+
+304
+00:29:03,540 --> 00:29:08,200
+ذلك، ولكن بسرعة أكتر من ذلك، ولكن بسرعة أكتر من
+
+305
+00:29:08,200 --> 00:29:12,940
+ذلك، ولكن بسرعة أكتر من ذلك، ولكن بسرعة أكتر من
+
+306
+00:29:12,940 --> 00:29:16,260
+ذلك،
+
+307
+00:29:16,260 --> 00:29:21,700
+ولكن بسرعة أكتر من ذلك، ولكن بسرعة أكيعني .. يعني
+
+308
+00:29:21,700 --> 00:29:26,100
+نضيط الدرك المجموزي تشتغل حتى داخل العين، حتى داخل
+
+309
+00:29:26,100 --> 00:29:31,380
+الجسم طيب، خمسة abradion or inflammation of the
+
+310
+00:29:31,380 --> 00:29:38,140
+cornea، إيش abradion؟ كشرة، كشرة Higher corneal
+
+311
+00:29:38,140 --> 00:29:41,780
+concentrations of drugs are achieved in abraded or
+
+312
+00:29:41,780 --> 00:29:45,400
+inflamed corneas than in normal ones
+
+313
+00:29:50,120 --> 00:29:55,380
+هنا صورناها في السينما هكذا وهنا شوية تبدأ الخلايا
+
+314
+00:29:55,380 --> 00:29:59,940
+تصير هكذا وبعدين في الآخر البيزا اللي هي اللي هي
+
+315
+00:29:59,940 --> 00:30:09,620
+خلايا شفه يعني مكعبه الآن لو حطيت أنا دورس هنا هاي
+
+316
+00:30:09,620 --> 00:30:12,800
+ال variant و بعدين
+
+317
+00:30:37,770 --> 00:30:42,130
+عشان احد بيكحك عينه بالقدفة قدفة وهيك يعني event
+
+318
+00:30:42,130 --> 00:30:46,890
+معين او accident معين بيكحك اللي هو ال .. ال ..
+
+319
+00:30:46,890 --> 00:30:51,750
+سطح القرنية بتاعه يكون تاكلينز users برضه بيصير
+
+320
+00:30:51,750 --> 00:30:57,550
+نفس الاشي بيصير أشياء زي هذه او disease زي كون
+
+321
+00:30:57,550 --> 00:31:02,330
+الآثر مثلا فال continuity of a helium بيصيرها
+
+322
+00:31:02,330 --> 00:31:07,330
+destruction وبالتالي فانت القطرة على طول بتخشلأن
+
+323
+00:31:07,330 --> 00:31:12,710
+الباب مكتوب، اللي بيدخل من الباب بيدخل، صح؟ هاي
+
+324
+00:31:12,710 --> 00:31:18,330
+معنى الabradion أو الانفلامشين، التهاب أو كرشد
+
+325
+00:31:18,330 --> 00:31:22,210
+طيب،
+
+326
+00:31:22,210 --> 00:31:27,590
+however، when epithelium absent شرح هذا، as is the
+
+327
+00:31:27,590 --> 00:31:30,810
+case with most infectious corneal ulcers، the
+
+328
+00:31:30,810 --> 00:31:34,210
+epithelial barrier is eliminated and hydrophilic
+
+329
+00:31:34,210 --> 00:31:36,170
+antibiotics may enter the corneal
+
+330
+00:31:40,010 --> 00:31:47,090
+بسرعة شديدة، for instance مثلًا Suprafluxacin هذه
+
+331
+00:31:47,090 --> 00:31:50,570
+Antibiotic بس هي Hydrophilic، قطرات موجودة في
+
+332
+00:31:50,570 --> 00:31:56,270
+السوق Supruxin أو Suprafluxacin موجودة بصورة
+
+333
+00:31:56,270 --> 00:31:59,810
+Fluxin اسمها Fluxin that achieves anterochemical
+
+334
+00:31:59,810 --> 00:32:02,530
+level two to three times greater than epithelium
+
+335
+00:32:02,530 --> 00:32:06,270
+is compromised than if it is intact.compromised
+
+336
+00:32:06,270 --> 00:32:13,160
+يعني فيه فكرةيعني ال etherium صار ليه ال
+
+337
+00:32:13,160 --> 00:32:17,660
+comparative بتاعته هنا راحت ف مرتين إلى تلت مرات
+
+338
+00:32:17,660 --> 00:32:23,520
+أسرع من مكان ال etherium in that cell و دي يعني
+
+339
+00:32:23,520 --> 00:32:25,520
+شيء منطقي، logic يعني
+
+340
+00:32:47,920 --> 00:32:54,480
+بس طبعا هنا كل ما حط drops أكتر كل ما دخلت أكتر
+
+341
+00:32:54,480 --> 00:32:57,860
+لأنه مافيش ايش مافيش continuation continuation
+
+342
+00:32:57,860 --> 00:33:05,780
+يعني طيب الآن دخل القطرة إلى ال AC اجتازت ال
+
+343
+00:33:05,780 --> 00:33:08,960
+barriers التلاتة اللي في القرن دخل بزي ال
+
+344
+00:33:08,960 --> 00:33:12,000
+distribution يبقى distribution factors interfering
+
+345
+00:33:12,000 --> 00:33:15,770
+with distribution of drops inside the eyeايش هي
+
+346
+00:33:15,770 --> 00:33:22,570
+العوامل اللي تحد من سرعة توزيع القطرة عبر ال ..
+
+347
+00:33:22,570 --> 00:33:25,910
+اللي هو ال aqueous وتروح على ال intraocular اللي
+
+348
+00:33:25,910 --> 00:33:30,910
+هو parts او الواحد binding to ميليونين in the iris
+
+349
+00:33:30,910 --> 00:33:37,430
+عند سيارة البودي ثابت انه كل ما كان الميليون عالي
+
+350
+00:33:37,430 --> 00:33:42,910
+في القذحية وفي سيارة البودي كل ما عمل capture
+
+351
+00:33:46,950 --> 00:33:54,550
+خاصة الـpsychopolitics والمدرياتيكس أثرها إلى حين
+
+352
+00:33:54,550 --> 00:34:01,730
+مش على طول الخط يعني لساعة لساعتين او لنصف ساعة ثم
+
+353
+00:34:01,730 --> 00:34:06,450
+أرسلها ببطء يبقى binding to melanin أو binding to
+
+354
+00:34:06,450 --> 00:34:12,870
+protein ممكن انه سيلو معلب روتين معلب روتينبعض
+
+355
+00:34:12,870 --> 00:34:19,970
+البروتينات في العين انه بتعمل اتحاد او complex و
+
+356
+00:34:19,970 --> 00:34:23,570
+شوية يصير يعني نوع من ال .. يعني قولنا مثلا ان هاي
+
+357
+00:34:23,570 --> 00:34:29,210
+البروتين مثلا شكله هيك والدواء شكله هيك بتحت بعض
+
+358
+00:34:29,210 --> 00:34:34,350
+بعض بتعمل ال complex ال complex هذا مش سهل يستخدم
+
+359
+00:34:34,350 --> 00:34:40,190
+اتأخر إلى انه البروتين يمون علينا و يترك اللي هو
+
+360
+00:34:41,070 --> 00:34:44,810
+الدواء اللي هو التحد معاه three rapid elimination
+
+361
+00:34:44,810 --> 00:34:48,730
+of drug to an inactive site that can act as a
+
+362
+00:34:48,730 --> 00:34:52,770
+biological reservoir releasing drug story over
+
+363
+00:34:52,770 --> 00:34:56,530
+time like pneumonia sack and formesis يعني هذا بس
+
+364
+00:34:56,530 --> 00:35:01,770
+بالاختصار احنا بنحط مثلا مارهم المارهم يدخل ما بين
+
+365
+00:35:01,770 --> 00:35:07,130
+سطح العين و ما بين الجفون ما بين سطح العين و
+
+366
+00:35:07,130 --> 00:35:14,900
+فورنسس تحت و فوق و هناع الرموش حتى هنا هذه الجوعة
+
+367
+00:35:14,900 --> 00:35:19,900
+صارت reservoir يعني مخزن، من المخزن هنا بيبدأ
+
+368
+00:35:19,900 --> 00:35:24,660
+الدوة ينتقل بالتدريج عبر القرنية، بالتدريج عبر
+
+369
+00:35:24,660 --> 00:35:29,820
+القرنية و يدخل، مابتخلش جوعة الدوة كلها، أنا حاطيت
+
+370
+00:35:29,820 --> 00:35:32,220
+مرهق خلال خمس دقيقة بلقيها في ال
+
+371
+00:35:37,410 --> 00:35:41,990
+فهذا برضه يويغ الـ AHA distribution إلى داخل
+
+372
+00:35:41,990 --> 00:35:47,090
+العيون، توزيع الدواء يعني طيب، الآن الـ
+
+373
+00:35:47,090 --> 00:35:50,710
+Metabolism، Drug Metabolism وExecration أو
+
+374
+00:35:50,710 --> 00:35:54,970
+Elimination، سوف نتكلم على أشياء احنا عملناها
+
+375
+00:35:54,970 --> 00:35:59,750
+سيستميك قبل هيك، عشان تقولنا absorption للدواء
+
+376
+00:35:59,750 --> 00:36:04,240
+مثلا من ال .. من الـ AHA، لماع دقيقةبعدين قولنا
+
+377
+00:36:04,240 --> 00:36:09,000
+بعد هيك مثلا ايش distribution عن طريق الورد البيع
+
+378
+00:36:09,000 --> 00:36:13,120
+بيه والكبت بعد هيك، بعدين مثلا metabolism داخل
+
+379
+00:36:13,120 --> 00:36:18,060
+الخلايا، بعدين مثلا excretion عبر ال kidney هناك،
+
+380
+00:36:18,060 --> 00:36:20,900
+رسمي، لكن احنا قولنا العين لأ العين جمهورية
+
+381
+00:36:20,900 --> 00:36:25,040
+مستفلة، العين جمهورية مستفلة، بتشتغل مع الدوات،
+
+382
+00:36:25,040 --> 00:36:31,410
+شغل، يعني كارتوناتفلمّا اتكلم عن متابوليزم، اتكلمش
+
+383
+00:36:31,410 --> 00:36:36,650
+عن متابوليزم في كل الجسم، لأ، بس في الـ lag. الوقت
+
+384
+00:36:36,650 --> 00:36:39,710
+بين وضع القطر ووضع الدراجة ووضع القطر ووضع القطر
+
+385
+00:36:39,710 --> 00:36:41,230
+ووضع القطر ووضع القطر ووضع القطر ووضع القطر ووضع
+
+386
+00:36:41,230 --> 00:36:41,350
+القطر ووضع القطر ووضع القطر ووضع القطر ووضع القطر
+
+387
+00:36:41,350 --> 00:36:43,130
+ووضع القطر ووضع القطر ووضع القطر ووضع القطر ووضع
+
+388
+00:36:43,130 --> 00:36:45,030
+القطر ووضع القطر ووضع القطر ووضع القطر ووضع القطر
+
+389
+00:36:45,030 --> 00:36:52,710
+ووضع القطر ووضع القطر ووضع القطر وو
+
+390
+00:37:03,140 --> 00:37:10,440
+وضعت هنا قطرة في العين الساعة تمانية صباحا وقيس
+
+391
+00:37:10,440 --> 00:37:18,480
+متى بدأ العلاج هنا يكون واضح مثلا الساعة تسعة و
+
+392
+00:37:18,480 --> 00:37:23,320
+تلاتين دقيقة صباحا
+
+393
+00:37:23,320 --> 00:37:29,260
+في ساعة عينات معينة من RQS الساعة و نص هذه اسمها
+
+394
+00:37:29,260 --> 00:37:39,530
+lag time زي واحدالان سافر قولاله لما اتصل بالسلامة
+
+395
+00:37:39,530 --> 00:37:45,470
+مثلا القدس اتصل فينا احنا مانتظر حتى تأتينا
+
+396
+00:37:45,470 --> 00:37:49,790
+المكالمة ساعتنا رفعة قال الان وصلت هذا اسمه lag
+
+397
+00:37:49,790 --> 00:37:56,790
+time وقت السفر لسه مابنعش فعاليات وقت السفر مابين
+
+398
+00:37:56,790 --> 00:38:03,460
+مابنطلق الى ان وصل الوصول هذا اسمه lag timeزي شوفت
+
+399
+00:38:03,460 --> 00:38:09,660
+الطماطم أو اللي هو عدم ظهور نتيجة Once drugs are
+
+400
+00:38:09,660 --> 00:38:12,400
+absorbed into the anterior chamber, they are
+
+401
+00:38:12,400 --> 00:38:18,880
+eliminated primarily by aqueous humor turned over
+
+402
+00:38:18,880 --> 00:38:22,420
+Through a trapezoidal meshwork in the angle of the
+
+403
+00:38:22,420 --> 00:38:23,020
+anterior chamber
+
+404
+00:38:37,240 --> 00:38:45,600
+في الكورية هاي ال AC وهي اسمها angle of AC الآن
+
+405
+00:38:45,600 --> 00:38:53,140
+الأكوسموره اتكوّن هنا و بيموغ باستمرار عبر ال iris
+
+406
+00:38:53,140 --> 00:38:59,280
+إلى عبر ال pupil إلى ال AC و بعدين بيطلع وين؟ في
+
+407
+00:38:59,280 --> 00:39:05,080
+ال angle هات اسمها Trabecular مشهور الآن
+
+408
+00:39:05,080 --> 00:39:17,070
+المسألة أيه؟المسألة ان في كل دقيقة تقريبا 1.5% من
+
+409
+00:39:17,070 --> 00:39:24,990
+حجم الأكواز هذا بيغادر اسمه
+
+410
+00:39:24,990 --> 00:39:30,510
+turnover تغيير شفتات يعني زي موج البحر الموج اللي
+
+411
+00:39:30,510 --> 00:39:30,950
+بتيجي
+
+412
+00:39:34,400 --> 00:39:40,260
+لو قدّينا موج البحر وقولك كل يعني البحر هاني كل
+
+413
+00:39:40,260 --> 00:39:44,760
+أربع دقايق موجة لكن لو فيه ريح وغدا وقولك ايه؟ وهم
+
+414
+00:39:44,760 --> 00:39:51,940
+كل نص الجيجا موجة فهنا في تأتيب معين قولي one
+
+415
+00:39:51,940 --> 00:39:57,660
+point five pieces per minute of the anterior
+
+416
+00:39:57,660 --> 00:40:04,290
+chamber volume يعني هاي ال anterior chamberكانت
+
+417
+00:40:04,290 --> 00:40:11,570
+تسعة اكيواس في الدقيقة الواحدة في واحد و نص من
+
+418
+00:40:11,570 --> 00:40:17,590
+هالهالين يغالب عمر الهوترابيكو يمشي وراك او كانال
+
+419
+00:40:17,590 --> 00:40:22,470
+أوشلي يبقى
+
+420
+00:40:22,470 --> 00:40:29,410
+لو انا حدد دواعي هيك ودخل هنا في two forces
+
+421
+00:40:29,410 --> 00:40:35,230
+against othersيعني فيه two forces ال force الأول
+
+422
+00:40:35,230 --> 00:40:41,290
+ان الدواء داخل ينتهي و ال take over فعله المثامش
+
+423
+00:40:41,290 --> 00:40:46,030
+بفعلها الدواء يعني الدواء يحاول يدخل و ال take
+
+424
+00:40:46,030 --> 00:40:54,250
+over بحاول يطلقه بس من هنا و من هنا هنا معاكم؟ في
+
+425
+00:40:54,250 --> 00:40:58,890
+حالة في البحر اسمها سباحة ضد التيار في حالة بيكون
+
+426
+00:40:58,890 --> 00:41:00,210
+في تيار تيارمائي
+
+427
+00:41:02,730 --> 00:41:07,810
+السفاح بيتغلب كثير في انه هو يشتازه في سفاح بيقولك
+
+428
+00:41:07,810 --> 00:41:11,370
+امشي مع التيار و بعدين بتطلع وفعلا بيقولك لا انا
+
+429
+00:41:11,370 --> 00:41:16,750
+قوي بسبح عكس التيار مين اسهل؟ مع التيار اه السياسة
+
+430
+00:41:16,750 --> 00:41:21,530
+بيقولك اسبح مع التيار و في لحظة معينة بتفرقه وليه
+
+431
+00:41:21,530 --> 00:41:26,290
+بسبح عكس التيار؟ بيطلع بيطلع ممتاز يبقى هنا انا
+
+432
+00:41:26,290 --> 00:41:28,950
+ايدي two forces في force يعني drug
+
+433
+00:41:31,580 --> 00:41:35,640
+to inside from outside to inside وفي turnover from
+
+434
+00:41:35,640 --> 00:41:43,720
+inside to outside علمكوا هذا بيقلل من فعالية
+
+435
+00:41:43,720 --> 00:41:51,020
+الدواء او دوامه في المكان في العين ولا بزيد عامل
+
+436
+00:41:51,020 --> 00:41:56,940
+طرد والعامل إضافة عامل طرد ها علمكوا الدواء
+
+437
+00:41:56,940 --> 00:42:05,970
+بيحاولوا يدخل وفي تيار جاهز ماليلا بقى عشان اتغلب
+
+438
+00:42:05,970 --> 00:42:12,850
+على هذا لازم اضيف دوة اكتر لازم اضيف دوة اكتر يبقى
+
+439
+00:42:12,850 --> 00:42:18,290
+موضوع الان بعض الممارسين اللي يعني مش كتير يعني في
+
+440
+00:42:18,290 --> 00:42:21,270
+العلوم فاهمين يقولوا اخفت القطرات صباحا ومساوا
+
+441
+00:42:21,270 --> 00:42:27,610
+طبعا هذه نقطة هذه نقطة حكيت صباحا ومساوا معظم
+
+442
+00:42:27,610 --> 00:42:30,490
+القطرات لازم تكون frequent كل ساعتين او تلاتة
+
+443
+00:42:34,470 --> 00:42:37,810
+كثير بيجيوني ناس انها بيقول اللي أنا دكتور الجطر
+
+444
+00:42:37,810 --> 00:42:41,890
+اللي خدناه وماستفدناش بفهم ليش ما هو ما استفاد لإن
+
+445
+00:42:41,890 --> 00:42:46,290
+مكتوب عنيها تلت شحتار تلت شحتار مفيش شحتار هو نايم
+
+446
+00:42:46,290 --> 00:42:50,330
+بيحطهاش بيقولوا انا بيحطها كل ساعتين انا شوف في
+
+447
+00:42:50,330 --> 00:42:55,810
+خلال تلت أيام بتنقلب الصورة ال fiction بتروح طيب
+
+448
+00:42:55,810 --> 00:43:02,090
+فهمنا turnover؟ طيب when expressed as a half-life
+
+449
+00:43:02,090 --> 00:43:10,010
+aqueous turnover isاللي هو 46.2 minutes or 0.77
+
+450
+00:43:10,010 --> 00:43:18,390
+hours. بيقول يعني لو انت كسب حساب كم كل حاجة أكواز
+
+451
+00:43:18,390 --> 00:43:24,270
+في ال AC بيقول لك في خلال 46 دقيقة المفروض كله
+
+452
+00:43:24,270 --> 00:43:28,910
+يتغير. ستة و أربعين دقيقة. يعني تلتين ساعة
+
+453
+00:43:37,220 --> 00:43:41,220
+طيب، هذا برنامج جيبته انا في التانية عشان تشوفوا
+
+454
+00:43:41,220 --> 00:43:47,400
+كل ما الوقت يزيد هي عشرة جديش عشرين جال كمان و لو
+
+455
+00:43:47,400 --> 00:43:51,760
+نمشي بعد عشرين تلاتين هزل كمان اللي هو إيش ال
+
+456
+00:43:51,760 --> 00:43:58,120
+concentration بتاعة دوة في العين طيب،
+
+457
+00:43:58,120 --> 00:44:00,600
+therefore if drugs
+
+458
+00:44:07,790 --> 00:44:09,850
+بالنسبة للإيليمينات، من العين، يمكن تفسير
+
+459
+00:44:09,850 --> 00:44:14,670
+الإيليمينات بشكل عادى إيليمينات عادية يبقى أنا بدي
+
+460
+00:44:14,670 --> 00:44:19,870
+هدف الإيليمينات اللي في حدود 45 جيجا عادية طب
+
+461
+00:44:19,870 --> 00:44:24,490
+الإيليمينات اللي أكتر من 45 جيجا عادية طب
+
+462
+00:44:24,490 --> 00:44:27,690
+الإيليمينات اللي أكتر من 45 جيجا عادية إيليمينات
+
+463
+00:44:27,690 --> 00:44:32,210
+يعني دخلت ال 46 جيجا واتم العشرة تغيرت القياسة إذا
+
+464
+00:44:32,210 --> 00:44:35,910
+كانت دورة دورة في العين حوالي 45 جيجا بكون عادية
+
+465
+00:44:36,900 --> 00:44:41,400
+القادة أكتر ساعة ساعتين بيكون slow elimination،
+
+466
+00:44:41,400 --> 00:44:44,900
+الجان أقل من مثلا تلاتين دقيقة بيكون rapid
+
+467
+00:44:44,900 --> 00:44:50,360
+elimination حقيقة في إشارة الله عندي اللي هو
+
+468
+00:44:50,360 --> 00:44:53,560
+number five في ال metabolism and elimination
+
+469
+00:44:53,560 --> 00:44:57,340
+number five شكرا عليكم على قصة الاستماع والسلام
+
+470
+00:44:57,340 --> 00:44:59,260
+عليكم ورحمة الله يبارك عليه
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/XuEJ2AXHlQ4.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/XuEJ2AXHlQ4.srt
new file mode 100644
index 0000000000000000000000000000000000000000..6715caa43f7e624c9eadcccb0bc1777c52337bdd
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/XuEJ2AXHlQ4.srt
@@ -0,0 +1,1717 @@
+1
+00:00:20,810 --> 00:00:24,370
+بسم الله الرحمن الرحيم الحمد لله رب العالمين و
+
+2
+00:00:24,370 --> 00:00:27,470
+أصلي و أسلم على النبي الأمين محمد و على آله 
+
+3
+00:00:27,470 --> 00:00:31,030
+وأصحابه والتابعين السلام عليكم ورحمة الله وبركاته
+
+4
+00:00:31,030 --> 00:00:38,130
+انتهينا في المحاضرات السابقة من chapters of 
+
+5
+00:00:38,130 --> 00:00:43,770
+general pharmacology اللي هو علم الأدوية العامة
+
+6
+00:00:43,770 --> 00:00:49,910
+وكان هذا عبارة عن introduction ضرورية للجزء
+
+7
+00:00:49,910 --> 00:00:50,230
+الثاني
+
+8
+00:00:53,730 --> 00:01:00,470
+أو Pharmacology of the Eye اليوم سنبدأ بالـ
+
+9
+00:01:00,470 --> 00:01:05,330
+Antibacterial Agents Antibacterial Agents تعني بها
+
+10
+00:01:05,330 --> 00:01:11,510
+مضادات البكتيريا وهي في العين ضورية كما في سائر
+
+11
+00:01:11,510 --> 00:01:18,370
+الأعضاء الجسم لمقاومة البكتيريا وقتلها antibiotics 
+
+12
+00:01:18,370 --> 00:01:23,280
+للتعامل مع مصابة عقلية مستعمر على عدة أفعاليبقى
+
+13
+00:01:23,280 --> 00:01:32,200
+أنا عشان أنتقل مضادا حيويا أو أي مضاد للبكتيريا
+
+14
+00:01:32,200 --> 00:01:37,180
+فهذا يتوقف على بعض العوامل العوامل هذه تتعلق
+
+15
+00:01:37,180 --> 00:01:41,580
+بثلاثة أشياء تتعلق بالـ organism يعني الـ micro
+
+16
+00:01:41,580 --> 00:01:48,160
+organism أو نوع البكتيريا تتعلق بمناعة المضيف أو 
+
+17
+00:01:48,160 --> 00:01:53,110
+العائل host immunity، الثالثة properties of the drug
+
+18
+00:01:53,110 --> 00:01:57,550
+يعني هو موضوع العلاج من اللي اللي هو العنوان
+
+19
+00:01:57,550 --> 00:02:02,550
+البكتيرية يتوقف على ثلاثة أشياء الشيء الأول
+
+20
+00:02:02,550 --> 00:02:06,930
+هو البكتيريا، الشيء الثاني host، الشيء الثالث الـ
+
+21
+00:02:06,930 --> 00:02:11,650
+drug يعني هذه اللي هو الدائرة اللي بتحرك فيها علاج
+
+22
+00:02:11,650 --> 00:02:15,910
+اللي هو الـ infection، الـ all serious infections
+
+23
+00:02:21,440 --> 00:02:25,740
+through culture, all other methods should be
+
+24
+00:02:25,740 --> 00:02:29,000
+completed before initiating treatment يعني في 
+
+25
+00:02:29,000 --> 00:02:35,180
+الدول المتقدمة لا يُعطى المضاد الحيوي اجتهاديا أو
+
+26
+00:02:35,180 --> 00:02:39,160
+اعتباطيا لابد 
+
+27
+00:02:39,160 --> 00:02:45,040
+من إنه تُأخذ عينة من المكان المصاب وهذه العينة
+
+28
+00:02:45,040 --> 00:02:49,480
+تدخل في culture، bacterial culture، what is
+
+29
+00:02:49,480 --> 00:02:54,310
+bacterial culture؟ زراعة بكتيرية for two to
+
+30
+00:02:54,310 --> 00:02:59,050
+three days، بعد كده يتم isolation of the
+
+31
+00:02:59,050 --> 00:03:03,870
+microorganism يعني عزل الـ microorganism ويجرى
+
+32
+00:03:03,870 --> 00:03:11,270
+حاجة اسمها اللي هو test اللي هو على الـ antibiotic 
+
+33
+00:03:14,550 --> 00:03:19,170
+Antibiotic sensitivity test هي اللي بتفحص مدى تأثر 
+
+34
+00:03:19,170 --> 00:03:23,310
+هذا الـ microbe اللي تم عزله بهذه المضادات الحيوية
+
+35
+00:03:23,310 --> 00:03:27,330
+وهذه طبعا التجربة بتاعة الـ antibiotic sensitivity
+
+36
+00:03:27,330 --> 00:03:33,550
+test بتبين أي مضاد حيوي قوي جدا أو متوسط أو حتى له
+
+37
+00:03:33,550 --> 00:03:37,990
+resistance من الـ microbe هذا يا بناتي هو الأسلوب
+
+38
+00:03:37,990 --> 00:03:43,720
+العلمي الصحيح في معالجة الـ infections أما الطرق
+
+39
+00:03:43,720 --> 00:03:49,300
+التي يعني استعملوها البعض هي طرق اجتهابية يعني قد 
+
+40
+00:03:49,300 --> 00:03:53,520
+تؤدي إلى فشل عملية علاج البكتيريا أو العدوى
+
+41
+00:03:53,520 --> 00:03:59,900
+البكتيرية نبدأ في وصف المضيف هو الإنسان اللي حدث
+
+42
+00:03:59,900 --> 00:04:04,060
+فيه العدوى أي المريض يعني نبدأ يعني ما هي علاقة 
+
+43
+00:04:04,060 --> 00:04:09,250
+المريض بالـ micro و بالبكتيريا نقول الـ features of the
+
+44
+00:04:09,250 --> 00:04:13,590
+host، أول شيء الـ immune status، الـ immune status يعني
+
+45
+00:04:13,590 --> 00:04:16,690
+المستوى المناعي بتاعه، في ناس زي ما قلنا احنا 
+
+46
+00:04:16,690 --> 00:04:23,230
+مستوى المناعي عالي زي الشباب بيقولوا إنه 
+
+47
+00:04:23,230 --> 00:04:30,150
+immunocompetent patients يعني مستوى المناعي قوي
+
+48
+00:04:30,150 --> 00:04:36,390
+وفي ناس كبار السن أو كبار السن في سن بقية السبعين
+
+49
+00:04:36,390 --> 00:04:40,950
+أو مرضى السرطان أو مرضى الـ AIDS هؤلاء
+
+50
+00:04:40,950 --> 00:04:47,450
+immunocompromised patients، Incompetent هي بكت
+
+51
+00:04:47,450 --> 00:04:55,270
+competent يعني هم ضعفاء المناعة يبقى البكتيريا لو
+
+52
+00:04:55,270 --> 00:04:58,130
+أجت على واحد immunocompetent جاءت تيجي واحد
+
+53
+00:04:58,130 --> 00:04:59,550
+immunocompromised
+
+54
+00:05:08,030 --> 00:05:14,630
+ممكن تكون في الـ genital tract, urinary tract، ممكن 
+
+55
+00:05:14,630 --> 00:05:19,230
+تكون في central nervous system، ممكن تكون في أي
+
+56
+00:05:19,230 --> 00:05:25,610
+مكان يعني بالنسبة ليه اللي هو الإنسان، مكان طبعا
+
+57
+00:05:25,610 --> 00:05:30,870
+احنا معظم الناس شايفين عندهم throat, tonsils و
+
+58
+00:05:30,870 --> 00:05:32,590
+اللي هو bronchitis
+
+59
+00:05:39,430 --> 00:05:47,770
+يعني واحد عنده infection عنده resistance أو
+
+60
+00:05:47,770 --> 00:05:51,010
+allergy لـ drug allergy مثلا عنده penicillin
+
+61
+00:05:51,010 --> 00:05:55,330
+allergy أول ما أتكلم مع الطبيب أقول أنا عندي 
+
+62
+00:05:55,330 --> 00:06:01,050
+حساسية للموضوع يعني يبقى فيه هنا limitation أو
+
+63
+00:06:01,050 --> 00:06:04,570
+prevention to use the same drug اللي هو allergy
+
+64
+00:06:04,570 --> 00:06:05,470
+في هذا
+
+65
+00:06:18,540 --> 00:06:23,880
+وإيه اللي صار في الـ infection؟ بينفع إني أعطيه أي علاج بدون ما 
+
+66
+00:06:23,880 --> 00:06:28,660
+أسأله ما هو العلاج اللي هو بيتناوله؟ بينفعش لازم
+
+67
+00:06:28,660 --> 00:06:33,860
+أنا أسأله حاجة اسمها drug history، drug history
+
+68
+00:06:33,860 --> 00:06:39,360
+ليش؟ لأن أحيانا كثرة الـ drugs بتعمل interaction
+
+69
+00:06:39,360 --> 00:06:43,340
+بينها وبين بعضها، interaction تفاعل داخلي بين اللي
+
+70
+00:06:43,340 --> 00:06:45,380
+هو الأدوية، و لا تفاعل داخلي
+
+71
+00:06:51,710 --> 00:06:57,270
+أو قد يُعجّل ببعضه و بعضه، عشان إذا بدأنا 
+
+72
+00:06:57,270 --> 00:07:03,570
+نعطي أي drug جديد دواء جديد لازم أسأل المريض عن
+
+73
+00:07:03,570 --> 00:07:06,970
+إيش؟ عن الـ drug history، إيش الأدوية اللي هو بياخدها 
+
+74
+00:07:06,970 --> 00:07:12,250
+عشان ما يصيرش harmful effect أو interaction between
+
+75
+00:07:12,250 --> 00:07:17,610
+the drugs، special concerns such as age and 
+
+76
+00:07:17,610 --> 00:07:23,580
+pregnancy، آه يعني أنا برضه بدي آخد في بالي إنه هذا مثلا infant عمره سنة، إنه بخاف أنا من
+
+77
+00:07:23,580 --> 00:07:29,940
+الـ dose تقتله، أو هذا old patient عمره ثمانين سنة،
+
+78
+00:07:29,940 --> 00:07:36,560
+آه ما أتصرفش أنا فيه زي الشباب، كمان في
+
+79
+00:07:42,300 --> 00:07:50,250
+pregnancy، pregnant woman أو lady اللي هي حامل لازم
+
+80
+00:07:50,250 --> 00:07:53,030
+أنا آخد في بالي إنه يعني ...
+
+81
+00:07:53,030 --> 00:07:53,770
+...
+
+82
+00:07:53,770 --> 00:07:54,130
+...
+
+83
+00:07:54,130 --> 00:07:55,490
+...
+
+84
+00:07:55,490 --> 00:07:57,570
+...
+
+85
+00:07:57,570 --> 00:07:57,990
+...
+
+86
+00:07:57,990 --> 00:08:00,110
+...
+
+87
+00:08:00,110 --> 00:08:08,250
+...
+
+88
+00:08:16,920 --> 00:08:21,820
+ما أعطيش له أنا بالفعل عنده chronic disease في الـ
+
+89
+00:08:21,820 --> 00:08:25,600
+small intestine، الـ absorption مش تماما ما أعطيش له
+
+90
+00:08:25,600 --> 00:08:30,560
+بالفعل، والجوع قاعدت تتأثر واحد عنده مرض في الكبد
+
+91
+00:08:30,560 --> 00:08:36,160
+زي اللي بقول عنه يعني liver cirrhosis الوضع صعب ..
+
+92
+00:08:36,160 --> 00:08:41,100
+الوضع صعب يبقى أنا عمري ما أتصرف فيه متعلقة بالـ host اللي أنا 
+
+93
+00:08:41,100 --> 00:08:46,060
+بدأت أدرج، طيب نشوف العوامل المتعلقة بالـ drug نفسه
+
+94
+00:08:46,060 --> 00:08:54,780
+أول شيء pharmacodynamics بتاعة الـ drug or 
+
+95
+00:08:54,780 --> 00:08:58,000
+interaction between the drug and the infecting
+
+96
+00:08:58,000 --> 00:09:01,540
+organism، واحد درس في الجامعة pharmacology إن
+
+97
+00:09:01,540 --> 00:09:05,480
+pharmacodynamics تعني تأثير
+
+98
+00:09:11,510 --> 00:09:15,510
+الدواء على جسم الإنسان، طيب و الـ pharmacokinetics
+
+99
+00:09:15,510 --> 00:09:21,370
+تأثير جسم الإنسان على الدواء تأثير جسم 
+
+100
+00:09:21,370 --> 00:09:26,050
+الإنسان اللي هو يعني بيحلل هذا الدواء و بيعمله
+
+101
+00:09:26,050 --> 00:09:29,010
+metabolites وبعدين بيوضعه على الكلى عشان يصله 
+
+102
+00:09:29,010 --> 00:09:33,650
+للـ excretion، طيب its effects on immunity، في بعض drugs
+
+103
+00:09:33,650 --> 00:09:39,090
+بتنزل الـ immunity بتضعف الـ immunity، زي اللي هو الـ
+
+104
+00:09:39,090 --> 00:09:44,350
+cortisone و زي اللي هو cytotoxic drugs، مضادات 
+
+105
+00:09:44,350 --> 00:09:50,170
+السرطان، يعني هذه الأشياء المعروفة الكورتيزونات و
+
+106
+00:09:50,170 --> 00:09:54,050
+مضادات السرطان بتعمل immunosuppression
+
+107
+00:10:06,690 --> 00:10:10,030
+There's effects or side effects، وحنا لسه طالعين من
+
+108
+00:10:10,030 --> 00:10:15,050
+محاضرة طويلة في موضوع الآثار الجانبية للدواء، في 
+
+109
+00:10:15,050 --> 00:10:20,290
+آثار جانبية للدواء تعمل جلطات، تعمل سرطان، تعمل
+
+110
+00:10:20,290 --> 00:10:27,490
+الارتفاع لضغط الدم، تعمل تهييج المعدة للأمعاء، أشياء
+
+111
+00:10:27,490 --> 00:10:32,820
+كثيرة جدا، لازم أعرف إيش في اعتباري في ما يتعلق بهذا 
+
+112
+00:10:32,820 --> 00:10:39,380
+الدواء، بعدين treatment costs التكاليف تكاليف نفس
+
+113
+00:10:39,380 --> 00:10:44,180
+الدواء ما بين شركة و شركة ممكن يكون له إيش double
+
+114
+00:10:44,180 --> 00:10:52,560
+cost، بس يبقى أنا أراعي هذا المريض خاصة إذا كان أنا
+
+115
+00:10:52,560 --> 00:10:55,840
+هعطيه إياه لفترة طويلة مثلا
+
+116
+00:10:58,700 --> 00:11:03,620
+لعلاج الـ hypertension، في دواء ممكن إننا نجيبه بعشرة 
+
+117
+00:11:03,620 --> 00:11:12,100
+جنيهات وفي دواء العلبة بمئة جنيهات وكسر شكل، costs 
+
+118
+00:11:12,100 --> 00:11:19,660
+طبعا هي رعاية كويسة لكن برضه مستوى المريض المالي
+
+119
+00:11:19,660 --> 00:11:24,220
+مهم جدا في الموضوع، كمان آخر شئ الـ concerns for
+
+120
+00:11:24,220 --> 00:11:29,090
+antibiotic resistance، يعني أنا بأكتب علاج مثلا هي
+
+121
+00:11:29,090 --> 00:11:33,250
+علاج سبق إن أنا أخدت مثلا keflex مثلا وأقول آه 
+
+122
+00:11:33,250 --> 00:11:39,770
+والله أنا مابه بيأثرش فيه ما فيش استجابة، أو augmentin
+
+123
+00:11:39,770 --> 00:11:46,930
+كان جال نص نص، زينات لأ أحسن، شوف أنا يعني هل سبق 
+
+124
+00:11:46,930 --> 00:11:50,370
+المريض إنه أخد هذا العلاج وهل كان effective ولا
+
+125
+00:11:50,370 --> 00:11:55,820
+non effective، هذه الستة فيما يتعلق بالدواء بالنفسه
+
+126
+00:11:55,820 --> 00:12:05,380
+ستة للعائل وستة عوامل للدواء الآن نشوف البكتيريا
+
+127
+00:12:05,380 --> 00:12:10,540
+اللي هي بدي أوصل عليها الكلام، features of the 
+
+128
+00:12:10,540 --> 00:12:14,900
+organism أو microorganism يعني إيش هي البكتيريا
+
+129
+00:12:14,900 --> 00:12:19,570
+resistance is due to a variety of mechanisms، يعني
+
+130
+00:12:19,570 --> 00:12:28,050
+البكتيريا مع أنها هي يعني micro organism و مع أنها 
+
+131
+00:12:28,050 --> 00:12:34,990
+prokaryotic في البداية إلا أن معركة الحياة و حب الوجود
+
+132
+00:12:34,990 --> 00:12:42,430
+دفعتها إلى أن تقاوم الأدوية خاصة المضادة الحيوية
+
+133
+00:12:43,580 --> 00:12:48,040
+والعلماء والبكتيريا في معركة من مائة سنة حتى الآن
+
+134
+00:12:48,040 --> 00:12:53,020
+في حسم هذا الموضوع، لن نستطيع أن نخضع البكتيريا
+
+135
+00:12:53,020 --> 00:12:58,820
+تماماً، أن نخرج البكتيريا من العالم، لن نستطيع كلما
+
+136
+00:12:58,820 --> 00:13:06,440
+أتى العلماء بمضاد حيوي جديد وقوي ومرتفع الفعالية كلما
+
+137
+00:13:06,440 --> 00:13:07,980
+البكتيريا بعد قليل
+
+138
+00:13:12,500 --> 00:13:20,240
+وبدأت بإفراز إنزيمات مضادة ومحللة للتركيب الكيميائي
+
+139
+00:13:20,240 --> 00:13:24,480
+لهذا الدواء ويخرج من الخدمة فأتوا بآخر بـ
+
+140
+00:13:24,480 --> 00:13:28,520
+antibiotic جديد وبعد سنة أو سنتين أو ثلاثة يكون قد
+
+141
+00:13:28,520 --> 00:13:34,300
+انتهى وهكذا هي الحرب، حرب الوجود بين الإنسان وبين
+
+142
+00:13:34,300 --> 00:13:39,700
+الأعداء، يبقى كل الـ mechanisms هذه قد تكون نتيجة 
+
+143
+00:13:39,700 --> 00:13:41,360
+لـ overuse
+
+144
+00:13:45,830 --> 00:13:49,090
+ما هو لما الناس بيلاقوا مضاد حيوي جديد كله بيروح
+
+145
+00:13:49,090 --> 00:13:52,030
+بالتجاه إليه عشان يحمي حاله وأولاده من البكتيريا
+
+146
+00:13:52,030 --> 00:13:58,850
+العادية، كثرة انتشار هذا المضاد الحيوي ليس فقط في 
+
+147
+00:13:58,850 --> 00:14:04,110
+الإنسان بل في الحيوان في البيئة بل في النبات يعني
+
+148
+00:14:04,110 --> 00:14:08,630
+في مضادات حيوية في النبات ومضادات فيروسية 
+
+149
+00:14:08,630 --> 00:14:09,610
+ومضادات
+
+150
+00:14:16,160 --> 00:14:23,120
+وفي الإنسان انتشار هذا المضاد الحيوي في العالم على 
+
+151
+00:14:23,120 --> 00:14:28,940
+هذه المستويات يؤدي إلى اكتشاف السر، يبقى احنا
+
+152
+00:14:28,940 --> 00:14:33,020
+بتكلم عن الـ overuse، example of overuse the result 
+
+153
+00:14:33,020 --> 00:14:36,880
+of the overuse of antibiotics for
+
+154
+00:14:39,490 --> 00:14:45,890
+الجلد مثلا systemic use أو في العين قطرة ومرهم 
+
+155
+00:14:45,890 --> 00:14:50,570
+and in poultry الدواجن and livestock للبقر
+
+156
+00:14:50,570 --> 00:14:54,590
+الأنعام is an increasing number of bacterial
+
+157
+00:14:54,590 --> 00:14:57,850
+strains that are stronger than antibiotic being
+
+158
+00:14:57,850 --> 00:15:04,100
+used against them، overuse الإسراف في الشيء يؤدي إلى
+
+159
+00:15:04,100 --> 00:15:07,980
+اكتشاف السر بتاعه وإنها تبدأ المقاومة اللي هو
+
+160
+00:15:07,980 --> 00:15:11,420
+bacterial resistance for antibiotic، هذا مثال على 
+
+161
+00:15:11,420 --> 00:15:18,160
+الـ overuse، طب مثال على الـ underuse وإنا شائع 
+
+162
+00:15:18,160 --> 00:15:26,840
+common بين الناس خاصة الشباب يبدأ في تناول مضاد 
+
+163
+00:15:26,840 --> 00:15:34,260
+الحيوي مرتين أو ثلاث أو أربع بيصير improvement تحسن 
+
+164
+00:15:34,260 --> 00:15:38,060
+في الحالة اللي بيصير فيها أي improvement يضمن المسكين
+
+165
+00:15:38,060 --> 00:15:44,600
+إنه الـ infection خلصناه يلقي الـ antibiotics بتاعته و
+
+166
+00:15:44,600 --> 00:15:50,700
+يخرج إلى الشارع ويخرج إلى العمل فيعود بعد يومين 
+
+167
+00:15:50,700 --> 00:15:55,620
+أو ثلاثة أو أربعة في أسوأ من الماضي لأنه under use
+
+168
+00:15:55,620 --> 00:15:56,880
+of the drugs
+
+169
+00:16:03,090 --> 00:16:07,630
+الليش احنا بناخد الجرعة مثلاً خمس أيام أو لأسبوع؟
+
+170
+00:16:07,630 --> 00:16:11,270
+نقضي على البكتيريا تماماً، لأن البكتيريا لا تموت دفعة واحدة
+
+171
+00:16:11,270 --> 00:16:15,510
+البكتيريا بتتموتش من أول dose، البكتيريا كل dose
+
+172
+00:16:15,510 --> 00:16:18,930
+احنا بناخدها بيموت عدد منها، بيموت عدد منها، يعني
+
+173
+00:16:18,930 --> 00:16:22,310
+في أول جرعة مثلا خمسة مليون، بعدين بتصير عشرة
+
+174
+00:16:22,310 --> 00:16:25,730
+مليون كمان حيث التين، بعدين خمسة مليون، بعدين 
+
+175
+00:16:25,730 --> 00:16:29,750
+اتنين مليون، المهم لا تموت باقي البكتيريا تماما
+
+176
+00:16:29,750 --> 00:16:36,980
+إلا بانتهاء الجرعة كما وصفها الطبيب، بهذا المسألة 
+
+177
+00:16:36,980 --> 00:16:46,860
+إن الـ dose of antibiotic كما يحدث في الدول اللي هو
+
+178
+00:16:46,860 --> 00:16:52,040
+الـ developing countries يعني، developing countries 
+
+179
+00:16:52,040 --> 00:16:54,740
+the resistance often develops when people stop 
+
+180
+00:16:54,740 --> 00:16:59,460
+taking their medication العلاج as soon as they 
+
+181
+00:16:59,460 --> 00:17:05,040
+feel better تحسّن نوعياً، ظاهرياً، والسؤال اللي أنا
+
+182
+00:17:05,040 --> 00:17:10,200
+بطرحه نفسه، هل لو بقى أربعة أو خمس أيام وعاد المرض 
+
+183
+00:17:10,200 --> 00:17:14,840
+والحمى وعاد إلى نفس العلاج، مش هيأثر، مش هيأثر، مش
+
+184
+00:17:14,840
+
+216
+00:19:56,720 --> 00:19:59,720
+جاله ساعتين أو تلاتة. جاله خلال تلت ساعات، بيكون
+
+217
+00:19:59,720 --> 00:20:03,460
+العرش بتاعك الكثير عندك. واحد ثاني قال اللي عنده 
+
+218
+00:20:03,460 --> 00:20:07,860
+يعلمه من الكتاب. عالم هنا. أنا آتيك فيه قبل أن
+
+219
+00:20:07,860 --> 00:20:12,400
+يرتد إلى الكتابة. إيش يعني؟ بعمل بلينك. أنت اعمل
+
+220
+00:20:12,400 --> 00:20:17,260
+بلينك وافتح عينك، بيكون عندك. من الأعمامين اللي 
+
+221
+00:20:17,260 --> 00:20:18,520
+فيهم أقوى وأشطر.
+
+222
+00:20:25,700 --> 00:20:29,120
+يعني سنة، اتنين، تلاتة، أعطوهم أجيبهم ولا حتى في
+
+223
+00:20:29,120 --> 00:20:35,080
+تفكير الآن يعني بدأ العالم يتجه إلى نقل المادة عن
+
+224
+00:20:35,080 --> 00:20:40,620
+طريق الكهرباء أو عن طريق الهواء لسه هم ما استوش لأن
+
+225
+00:20:40,620 --> 00:20:45,120
+كان سليمان عليه السلام والجن بتاعهم يعني مستاهلين
+
+226
+00:20:45,120 --> 00:20:49,340
+يعني أن أي مادة أي مادة شايفينها ممكن جدا أنَّها
+
+227
+00:20:49,340 --> 00:20:53,160
+تحلل الذرات بتاعتها
+
+228
+00:21:05,170 --> 00:21:11,770
+المهم أن أقول أن كل مايك أقل كل مكان أقوى وكل مكان 
+
+229
+00:21:11,770 --> 00:21:17,390
+عالي النسبة كل مكان أضعف عشان هيك وحتى الـ MIC 90 
+
+230
+00:21:17,390 --> 00:21:24,110
+is the concentration at which 90% of the isolates
+
+231
+00:21:24,110 --> 00:21:25,490
+by genus and species
+
+232
+00:21:33,570 --> 00:21:38,590
+يبقى يقول إن الدواء هذا اسمه MIC-90 قعد يكون الـ 
+
+233
+00:21:38,590 --> 00:21:42,190
+MIC-90 اللي عمل تسعين في المئة Inhibition عمل
+
+234
+00:21:42,190 --> 00:21:45,870
+تسعين في المئة Inhibition For Antimicrobial
+
+235
+00:21:45,870 --> 00:21:48,510
+therapy to be effective عشان الـ Antibiotic هذا 
+
+236
+00:21:48,510 --> 00:21:53,150
+يكون effective يعني مؤثر It is believed that a
+
+237
+00:21:53,150 --> 00:21:56,910
+drug should at minimum reach a concentration that
+
+238
+00:21:56,910 --> 00:22:01,450
+at least exceeds MIC-90 أو اللي هو target
+
+239
+00:22:01,450 --> 00:22:06,600
+organism يعني واضح أنه لو أنا مناقش تسعين في المئة، 
+
+240
+00:22:06,600 --> 00:22:11,400
+هيبقى العشرة في المئة active، يبقى عشان أنا دوائي
+
+241
+00:22:11,400 --> 00:22:18,500
+يكون effective، لازم أتجاوز التسعين، لأن العشرة في
+
+242
+00:22:18,500 --> 00:22:22,460
+المئة هذه لسه في خطر منها، فلازم أنا أحاول أن أرفع
+
+243
+00:22:22,460 --> 00:22:24,860
+مستوى التأثيري عن إيه؟
+
+244
+00:22:35,800 --> 00:22:42,580
+الـ MIC break point هي النقطة الحاسمة التي تفرق
+
+245
+00:22:42,580 --> 00:22:50,160
+الدواء هل هو مؤثر أو غير مؤثر في البكتيريا، يبقى
+
+246
+00:22:50,160 --> 00:22:53,680
+بتفرق بين susceptibility القابلية إنك تموت البكتيريا أو تكون resistant، susceptibility يعني
+
+247
+00:22:53,680 --> 00:22:59,000
+أنه مؤثر و resistant غير مؤثر يبقى the MIC is that
+
+248
+00:22:59,000 --> 00:23:07,360
+MIC separating susceptibility from resistance and
+
+249
+00:23:07,360 --> 00:23:11,160
+is typically the concentration of a drug that is
+
+250
+00:23:11,160 --> 00:23:14,360
+achieved in the serum or tissue تركيزه في الدم أو
+
+251
+00:23:14,360 --> 00:23:21,120
+في الأنسجة كلما كانت الـ MIC break point
+
+252
+00:23:21,120 --> 00:23:26,140
+أعلى كل ما كان الوصول للعلاج أسرع أو
+
+253
+00:23:30,380 --> 00:23:35,900
+تخلصت من البكتيريا كل ما كان الـ MIC بطيئة أو
+
+254
+00:23:35,900 --> 00:23:39,800
+صغيرة كل ما كان فيه فشل في الوصول إلى العلاج
+
+255
+00:23:39,800 --> 00:23:47,060
+المناسب طيب اللي أنا هتكلم عليه الـ Minimal
+
+256
+00:23:47,060 --> 00:23:51,720
+Inhibitory Concentration كمان مرة بقول الـ Organism
+
+257
+00:23:51,720 --> 00:23:57,600
+أو البكتيريا is considered susceptible if its MIC
+
+258
+00:23:58,220 --> 00:24:04,540
+هو أربعة و أربعة مستوى مستوى
+
+259
+00:24:04,540 --> 00:24:10,000
+الدم الذي يتم إيقافه باستخدام الدوز المفروض أو دوز
+
+260
+00:24:10,000 --> 00:24:11,100
+كام أو دوز كام أو دوز كام أو دوز كام او دوز كام او
+
+261
+00:24:11,100 --> 00:24:11,120
+دوز كام او دوز كام او دوز كام او دوز كام او دوز
+
+262
+00:24:11,120 --> 00:24:11,780
+كام او دوز كام او دوز كام او دوز كام او دوز كام او
+
+263
+00:24:11,780 --> 00:24:15,500
+دوز كام او دوز كام او دوز كام او دوز كام او دوز
+
+264
+00:24:15,500 --> 00:24:19,180
+كام او دوز كام او دوز كام او دوز كام او دوز كام او
+
+265
+00:24:19,180 --> 00:24:26,470
+دوز كام او دوز كام او دوز كام او دوز حتى أن يعمل 
+
+266
+00:24:26,470 --> 00:24:34,950
+PHP، هذه اسمها الـDraw، بعد هيك بصاحب الإيال 
+
+267
+00:24:34,950 --> 00:24:40,850
+تدريجيًا هيبدأ ينزل ويعمل إيه؟ طيب، الـalcoholic
+
+268
+00:24:40,850 --> 00:24:45,710
+organism is considered susceptible، susceptible أي
+
+269
+00:24:45,710 --> 00:24:52,070
+قابلية القتل بهذا الموضوع الحيوي إذا كان الـ MIC
+
+270
+00:24:52,070 --> 00:24:57,650
+بتاعه is one fourth the peak؟ يعني مثلا نفترض إنَّنا 
+
+271
+00:24:57,650 --> 00:25:05,770
+وصلنا مستوى 100، بيكون هذا 25، إذا كان إحنا وصلنا
+
+272
+00:25:05,770 --> 00:25:06,210
+ل 25
+
+273
+00:25:26,990 --> 00:25:37,150
+والإسكالين المايك وصل هنا مثلا 8 1 على 6
+
+274
+00:25:37,150 --> 00:25:40,010
+عشر 8
+
+275
+00:25:42,270 --> 00:25:50,870
+أ بيكون resistant يبقى هذا الـ Peak أعلى نقطة وصلها
+
+276
+00:25:50,870 --> 00:25:57,770
+المضاد الحيوي في الدم إذا كان الـ MIC بتاعه صغير 
+
+277
+00:25:57,770 --> 00:26:04,870
+لدرجة 1 على 16 من الـ Peak بيكون resistant
+
+278
+00:26:11,720 --> 00:26:18,760
+فأكثر بيكون susceptible susceptible يعني قابل إيش 
+
+279
+00:26:18,760 --> 00:26:25,120
+أن يكون مضاد حيوي قوي ضد هذه البكتيريا بيقول لي
+
+280
+00:26:25,120 --> 00:26:28,300
+the break points in defining bacterial resistance
+
+281
+00:26:28,300 --> 00:26:31,280
+are based on what can be achieved with systemic
+
+282
+00:26:31,280 --> 00:26:36,420
+therapy and therefore may not always affect ocular
+
+283
+00:26:36,420 --> 00:26:36,760
+release
+
+284
+00:26:43,180 --> 00:26:46,720
+في حالة العين، بدي أتكلم عن المضاد الحيوي في الـ
+
+285
+00:26:46,720 --> 00:26:51,900
+Aqueous حمرة الـ Aqueous حمرة اللي في الـ Anterior
+
+286
+00:26:51,900 --> 00:26:55,780
+Chamber و الـ Posterior Chamber أو بدي أتكلم عنه في
+
+287
+00:26:55,780 --> 00:27:02,360
+الـ Vitreous أو في نسيج معين في القرنية، لأنه
+
+288
+00:27:02,360 --> 00:27:08,200
+العلاج في العين Local، العلاج في الدم Systemic أو عن
+
+289
+00:27:08,200 --> 00:27:08,640
+الدم
+
+290
+00:27:11,660 --> 00:27:16,580
+هي عندي الـ MIC اه و الـ Peak والحاجات اللي بتكلم
+
+291
+00:27:16,580 --> 00:27:28,420
+عنها هي فيه هنا مثلا هي Peak هنا وسط 24 فيه
+
+292
+00:27:28,420 --> 00:27:37,420
+مستويات أقل 17 فيه 20 فيه 12 فيه 8 فيه 3 ثلاثة
+
+293
+00:27:37,420 --> 00:27:38,720
+هأقول لك
+
+294
+00:27:47,450 --> 00:27:55,750
+بالنسبة للـ Peak اللي وصلوا لمضاد الحيوانات طيب
+
+295
+00:27:55,750 --> 00:28:02,350
+الآن كنا نتكلم عن الـ Inhibitory و الـ Inhibition
+
+296
+00:28:02,350 --> 00:28:05,770
+يعني Inhibition of growth and multiplication of
+
+297
+00:28:05,770 --> 00:28:08,670
+bacteria اللي هتكلم عن الـ Bactericidal
+
+298
+00:28:08,670 --> 00:28:15,150
+Concentration و لاصطلاح Lethal أو Fatal قاتل The
+
+299
+00:28:15,150 --> 00:28:19,710
+Minimal Bactericidal Concentration الآن إحنا بنتكلم
+
+300
+00:28:19,710 --> 00:28:22,550
+في الآخر على التخلص من البكتيريا تكلمنا عليهم 
+
+301
+00:28:22,550 --> 00:28:27,090
+همشل لكن إحنا حقيقة بدنا إيش؟ بدنا Bactericidal في
+
+302
+00:28:27,090 --> 00:28:30,410
+الآخر The Minimal Bactericidal Concentration اسمه
+
+303
+00:28:30,410 --> 00:28:35,950
+MBC مختصر MBC is the lowest concentration of
+
+304
+00:28:35,950 --> 00:28:41,350
+antimicrobial that totally suppresses هأقول Totally 
+
+305
+00:28:41,350 --> 00:28:46,590
+يعني Zero Percent المفترض يعني Totally suppresses
+
+306
+00:28:46,590 --> 00:28:50,430
+growth of antibiotic-free media or death results
+
+307
+00:28:50,430 --> 00:28:56,170
+in 99.9% reduction or a greater decline in colony
+
+308
+00:28:56,170 --> 00:28:59,630
+counts after overnight incubation. Invernite
+
+309
+00:28:59,630 --> 00:29:03,670
+incubation يعني حتى إذا البكتيريا في مزرعة طيرت
+
+310
+00:29:03,670 --> 00:29:10,250
+الليلة وضبط إليها الـ Antibiotic فالسفارة بس كانت 
+
+311
+00:29:10,250 --> 00:29:16,690
+هي الـ Bactericide الليتسعة عشر Inhibition و Death
+
+312
+00:29:16,690 --> 00:29:26,630
+كام فعلا يعني؟ واحد من مية على مية اللي هي فلتت من 
+
+313
+00:29:26,630 --> 00:29:30,410
+إيش؟ اللي هو الأثر بتاع الـ Antibiotic عشان كده
+
+314
+00:29:30,410 --> 00:29:37,660
+اسمه Cidal اسمه Cidal يبقى من هنا قسموا الأدوية الـ
+
+315
+00:29:37,660 --> 00:29:40,460
+Antibiotics أو الـ Antimicrobial إلى نوعين 
+
+316
+00:29:40,460 --> 00:29:45,800
+Bactericidal و Bacteriostatic Bactericidal القاتلة
+
+317
+00:29:45,800 --> 00:29:48,680
+Bacteriostatic الـ Inhibition اللي هي بتوقف نمو
+
+318
+00:29:48,680 --> 00:29:53,740
+البكتيريا Bactericidal الـ drugs are defined as drugs
+
+319
+00:29:53,740 --> 00:30:01,760
+whose minimal inhibitory point is very close to
+
+320
+00:30:03,310 --> 00:30:08,070
+minimal bactericidal اللي هو Concentration يعني كل 
+
+321
+00:30:08,070 --> 00:30:14,750
+ما كان الـ MIC قريب من الـ MBC يكون قوي و
+
+322
+00:30:14,750 --> 00:30:19,530
+Bactericidal كل ما كانت الـ MIC أقل من الـ MBC كل 
+
+323
+00:30:19,530 --> 00:30:24,550
+ما كان الـ Bacteriostatic Static يعني بس يوقف
+
+324
+00:30:24,550 --> 00:30:28,170
+البكتيريا عن النمو لكن لا يقتل البكتيريا لا يقتل
+
+325
+00:30:28,170 --> 00:30:31,150
+البكتيريا يبقى Bactericidal
+
+326
+00:30:47,620 --> 00:30:51,220
+الأفكار البكتيريسية للدواء تعتمد على الوصول لدرجة 
+
+327
+00:30:51,220 --> 00:30:55,100
+كافية لدرجة الدواء للطفولة الـ Target التشوية
+
+328
+00:30:55,100 --> 00:30:58,300
+الـ Target التشوية المدينة المدينة المدينة المدينة
+
+329
+00:30:58,300 --> 00:31:01,570
+المدينة المدينة المدينة المدينة المدينة المدينة كل
+
+330
+00:31:01,570 --> 00:31:06,910
+ما الدواء وصل إلى مستويات عالية في الـ Target
+
+331
+00:31:06,910 --> 00:31:11,870
+Tissue اللي فيه موضع أو موضع المرض كل ما كان هو
+
+332
+00:31:11,870 --> 00:31:18,570
+اللي هو أقوى كـ Bactericide طيب الـ Drug is the drug
+
+333
+00:31:18,570 --> 00:31:25,110
+whose MBC is more than 16 fold greater than MIC
+
+334
+00:31:25,110 --> 00:31:28,590
+شايفين؟ يعني الآن
+
+335
+00:31:31,970 --> 00:31:37,970
+دواء ادراج معين أنا أعطيته مثلا
+
+336
+00:31:37,970 --> 00:31:48,270
+50 مستوى في الدم MBC MBC لو كان الآن الـ MIC مثلا 
+
+337
+00:31:48,270 --> 00:31:57,190
+40 الـ MIC أعلى من الـ Inhibit و الـ بيت هالي Bactericidal هذا
+
+338
+00:31:57,190 --> 00:32:00,610
+الدواء يعتبر Bacterio
+
+339
+00:32:11,160 --> 00:32:19,340
+هنا الـ 50 الـ MBC وهنا الـ 20 الـ MIC هذا
+
+340
+00:32:19,340 --> 00:32:24,380
+Bacteriostatic Bacterio Bacteriostatic و يعني
+
+341
+00:32:24,380 --> 00:32:34,300
+Static بس يمنع النمو والتكاثر لكن لا يقتل لكن هذا
+
+342
+00:32:34,300 --> 00:32:41,610
+يمنع ويقتل البكتيريا طبعًا الإنسان ده هو البدوية على 
+
+343
+00:32:41,610 --> 00:32:44,510
+الأفضل، في بعض الناس علماء في الأدوية اللي بيبقوا
+
+344
+00:32:44,510 --> 00:32:49,270
+يأكلونه، طب وهي الـ Immunity اللي في جسم الإنسان،
+
+345
+00:32:49,270 --> 00:32:53,690
+إيش مهمتها؟ إذا كان أنت وصلت إلى أنَّ الـ Bacterium
+
+346
+00:32:53,690 --> 00:32:55,230
+هو Static، وقفت الـ Bacterium 
+
+347
+00:32:58,360 --> 00:33:01,820
+طب تقول مانع إيش خلايا ده من الضرر والإنفوية وإيش 
+
+348
+00:33:01,820 --> 00:33:05,560
+مهمتها؟ بتكمل، طب هذا بالنسبة للشباب، لكن
+
+349
+00:33:05,560 --> 00:33:10,260
+بالنسبة لصغار السن وكبار السن، بيقولوا Bacterio
+
+350
+00:33:10,260 --> 00:33:14,180
+static، بيقول لك أنت كده قتلت الشباب دائمًا Bacterio
+
+351
+00:33:14,180 --> 00:33:22,880
+static، أنت نيمت المناعة بتاعته، وبطلت المناعة طيب 
+
+352
+00:33:22,880 --> 00:33:26,340
+في ناس بيشتهون وبيقول لك أنه ممكن أنا أخلي الـ
+
+353
+00:33:26,340 --> 00:33:27,060
+Bacteriostatic
+
+354
+00:33:33,910 --> 00:33:36,710
+أنت الـ Bactericidal قلّلي الجهنمات وبصير الـ 
+
+355
+00:33:36,710 --> 00:33:39,870
+Bacteriostatic الـ Bacteriostatic كثر الجهنمات وبصير
+
+356
+00:33:39,870 --> 00:33:42,670
+الـ Bactericidal لكن أنا لأ .. لأ .. لأ مخاطرة، لأ 
+
+357
+00:33:42,670 --> 00:33:47,510
+أنا ببدأ أحسن طيب، هتكلم الآن في الـ I، drugs and I، 
+
+358
+00:33:47,510 --> 00:33:50,030
+نشوف إيه شو اللي ملقّبين الـ drugs و الـ I الـ I is
+
+359
+00:33:50,030 --> 00:33:53,570
+one of the few structures that can be considered
+
+360
+00:33:53,570 --> 00:33:59,290
+pharmacokinetically separate from the body يعني لا 
+
+361
+00:33:59,290 --> 00:34:06,730
+تخضع لقانون الـ Absorption و الـ Distribution و الـ
+
+362
+00:34:06,730 --> 00:34:13,290
+Metabolism و الـ Excretion بتاعة الدواء في الجسم
+
+363
+00:34:13,290 --> 00:34:19,250
+العين يعني بقول لك يعني كبسولة لحالها Villa لحالها 
+
+364
+00:34:19,250 --> 00:34:24,490
+منطقة لحالها غرفة مغلقة العين عشان هيك الدواء اللي
+
+365
+00:34:24,490 --> 00:34:30,030
+بدخل بدخل ميكانزم وبدخل ميكانزم صعب شوية في العين
+
+366
+00:34:40,890 --> 00:34:44,290
+Directly into the eye يعني أنا حطيت الإلاجة على
+
+367
+00:34:44,290 --> 00:34:49,650
+القرنية على طول دخل من القرنية على الـ Oculus of 
+
+368
+00:34:49,650 --> 00:34:53,390
+Humor وعلى الـ Iris وعلى الـ Cellular body صاروا
+
+369
+00:34:53,390 --> 00:34:57,430
+Absorption على طول ما شاء الله كونس لسه راح على المريض
+
+370
+00:34:57,430 --> 00:35:00,350
+وعلى الـ Media وعلى الأمعاء وعلى الخملات وعلى الكبير
+
+371
+00:35:00,350 --> 00:35:04,810
+لفة كبيرة يعني لأ هنا ضايقة على طول يبقى الـ
+
+372
+00:35:04,810 --> 00:35:08,610
+Absorption is directly into the eye
+
+373
+00:35:11,380 --> 00:35:18,740
+بالعكس عندما يخرج الدواء من العين إلى الدم بيكون
+
+374
+00:35:18,740 --> 00:35:24,660
+انتهى خلاص ودّ عليّ الانتقال
+
+375
+00:35:24,660 --> 00:35:31,520
+يحدث مباشرة وضبط يعني بعد أن الدواء يعمل في العين
+
+376
+00:35:31,520 --> 00:35:37,690
+تمام يبدأ يطلع في اللي هو الأوردة خارج العين، which
+
+377
+00:35:37,690 --> 00:35:40,970
+can be considered a large reservoir that can
+
+378
+00:35:40,970 --> 00:35:44,350
+dilute the drug concentration in plasma below the
+
+379
+00:35:44,350 --> 00:35:47,050
+therapeutic، اللي هو الـ Atrial. يعني بيقول الدواء
+
+380
+00:35:47,050 --> 00:35:52,210
+خارج من العين عشان يطلع إلى الدم، هيكون يعني
+
+381
+00:35:52,210 --> 00:35:57,050
+تركيزه قليل جدا بالنسبالي الدم. لو كبر في رابطك
+
+382
+00:35:57,050 --> 00:36:02,650
+. يعني إحنا ما نعتبرش أنه دواء العين، أنه فيه خطر 
+
+383
+00:36:03,460 --> 00:36:08,360
+يعني محدد على الجسم وإن كان إحنا في الأطفال الصغار
+
+384
+00:36:08,360 --> 00:36:12,120
+مثلا قطرة الأتروبين لو تعددت من خافي شوية على
+
+385
+00:36:12,120 --> 00:36:16,640
+الأطفال اللي هم الـ Low Weight، Body Weight، أه لكن
+
+386
+00:36:16,640 --> 00:36:19,620
+على الأمام قطرة عادية الـ Antibiotic خاصة نحطها
+
+387
+00:36:19,620 --> 00:36:23,340
+في العين إحنا ما خافين تصل في الدم إلى مستوى علاجي
+
+388
+00:36:23,340 --> 00:36:28,070
+وعلى يعني إشي في الجسم يعني لأن الدواء اللي هو طلع
+
+389
+00:36:28,070 --> 00:36:32,410
+من العين بكلّ هو صار لو Metabolism انتهى وهو طالع
+
+390
+00:36:32,410 --> 00:36:37,650
+للدم عشان بس يروح الكلّ ويخرج من الجسم تمامًا طيب
+
+391
+00:36:37,650 --> 00:36:44,490
+هنتكلم على الـ Barriers to the entry of drugs into
+
+392
+00:36:44,490 --> 00:36:51,570
+the eye يعني إحنا إذا نوضع الدواء في العين فيه خمس
+
+393
+00:36:51,570 --> 00:36:57,700
+حواجز بينه وبين مصورة أول حاجة كونيا الليبيثيليام
+
+394
+00:36:57,700 --> 
+
+431
+00:39:34,330 --> 00:39:38,170
+ملتحمة سميت ملتحمة لأنها التحمت بسرعة لكثرة ما فيها 
+
+432
+00:39:38,170 --> 00:39:42,330
+من الأوعية دي. فمثلا إحنا بنحط القطرات يعني هي
+
+433
+00:39:42,330 --> 00:39:43,750
+بتوديها للجزء اللي في العين
+
+434
+00:39:55,010 --> 00:39:59,250
+وأنا واضح جدا في يعني هذا الشكل واضح جدا يا بناتي
+
+435
+00:39:59,250 --> 00:40:07,430
+أن الـ lens والـ zonule عاملين في أفرادهم 
+
+436
+00:40:07,430 --> 00:40:11,890
+حجاب حاجز بين الـ posterior chamber والـ anterior
+
+437
+00:40:11,890 --> 00:40:13,830
+chamber من ناحية وبين الـ
+
+438
+00:40:22,930 --> 00:40:27,070
+وصل إلى الـ Lens وإلى الـ Zonule بيقول له stop مش
+
+439
+00:40:27,070 --> 00:40:32,810
+هيوصل للـ Petrius يعني حاجز حائل بقى اسمه barrier
+
+440
+00:40:32,810 --> 00:40:36,550
+يبقى الـ lens and zonule الناس بيسموه aqueous
+
+441
+00:40:36,550 --> 00:40:40,490
+petrius barrier ليه؟ لأن بين الـ aqueous أمام وبين
+
+442
+00:40:40,490 --> 00:40:44,350
+الـ petrius ورا bulk flow of aqueous humor from the
+
+443
+00:40:44,350 --> 00:40:48,770
+eye and the presence of an intact lens and zonules
+
+444
+00:40:48,770 --> 00:40:49,410
+retard
+
+445
+00:40:58,740 --> 00:41:03,200
+العين ليست سهلة تحط الجاتر على قصة الشبكية، لا، في
+
+446
+00:41:03,200 --> 00:41:07,700
+حوائز من أمام الـ epithelium، ثم كنا نختار الـ  hyaloid
+
+447
+00:41:07,700 --> 00:41:12,460
+والاثنين، ثم الـ lens والـ zonule، هنشوف الآن blood
+
+448
+00:41:12,460 --> 00:41:16,260
+aqueous barrier، الحقيقة blood aqueous barrier و
+
+449
+00:41:16,260 --> 00:41:19,340
+blood retinal barrier
+
+450
+00:41:29,000 --> 00:41:34,720
+الآن هاي مثلا الـ iris وهي الـ cornea وهي الـ iris
+
+451
+00:41:34,720 --> 00:41:42,040
+وهي برق العين الـ iris هذا طبعا فيه blood vessels
+
+452
+00:41:42,040 --> 00:41:52,900
+ده بلون أحمر أنا عندي blood vessels صح؟ طيب الآن
+
+453
+00:41:52,900 --> 00:41:54,780
+لو أخذنا علاج
+
+454
+00:42:01,610 --> 00:42:09,670
+الآن الـ iris الآن هل سهل أن الدواء يخرج من هنا من
+
+455
+00:42:09,670 --> 00:42:18,150
+داخل الـ vessel إلى برة هنا؟ لا مش سهل ليش؟ يقول
+
+456
+00:42:18,150 --> 00:42:23,370
+لي يعني هاي الـ blood vessel مبطن بـ endothelium
+
+457
+00:42:28,440 --> 00:42:32,060
+الآن بيقول لي أن هالخلايا ما فيش بينها أيش واسع
+
+458
+00:42:32,060 --> 00:42:37,400
+مافيها مكان مافيها مكان مافيها مكان الدواء هتبقى
+
+459
+00:42:37,400 --> 00:42:46,600
+هنا وهنا الـ tissue بتاع الـ iris وجود
+
+460
+00:42:46,600 --> 00:42:54,220
+الـ endothelial lining للـ capillaries والـ lung
+
+461
+00:42:54,220 --> 00:42:59,380
+vessels مثلا في الـ iris والشيء اللي بيقول إيه كمان؟
+
+462
+00:42:59,380 --> 00:43:05,780
+يمنع الدواء اللي ماشي في الدم من الخروج وبرضه
+
+463
+00:43:05,780 --> 00:43:11,600
+الـ tissue بتاعه في علاج الـ iris، خيسيك؟ عشان إيه كتير
+
+464
+00:43:11,600 --> 00:43:19,540
+إحنا كنا بنتكلم على إن إعطاء الدواء بصورة قطرة أو
+
+465
+00:43:19,540 --> 00:43:25,440
+مرهم أو حقن في العين أفضل بكثير من إعطاءه بالفم أو
+
+466
+00:43:25,440 --> 00:43:30,700
+حقن في العضل مثلا أو في الوريد لأن هنا في ما يمنع
+
+467
+00:43:30,700 --> 00:43:35,720
+حتى لو دخل لـ blood disease of the eye ونفس الـ
+
+468
+00:43:35,720 --> 00:43:39,860
+issue برضه فيها الـ blood disease بتاعتها هنا سيمنع
+
+469
+00:43:39,860 --> 00:43:45,800
+استفادة العين من الدواء العام، هذه العين هي
+
+470
+00:43:45,800 --> 00:43:52,260
+component خاص تعطي الدواء فيها مباشرة أفضل بكثير
+
+471
+00:43:52,260 --> 00:43:59,640
+من مناطق عبر الفم أو عبر العضلة واضح؟ طيب blood
+
+472
+00:43:59,640 --> 00:44:03,380
+aqueous barrier فبقول يا دي يا دي يا ماذا بقى
+
+473
+00:44:03,380 --> 00:44:09,800
+الكلتشر؟ اه الـ endothelial cells limit تمنع أو تقلل
+
+474
+00:44:09,800 --> 00:44:14,320
+entry into aqueous from blood or systemicTaken
+
+475
+00:44:14,320 --> 00:44:20,280
+drugs كده كمسؤولة مثلا الآن أنا جاي برغم هنا نفس
+
+476
+00:44:20,280 --> 00:44:26,220
+الحاجة كيف هنا يعني هاي الـ blood vessel هاي الـ
+
+477
+00:44:26,220 --> 00:44:33,120
+blood vessel كيف الدواء بيوافقوا هنا عشان يعالج
+
+478
+00:44:33,120 --> 00:44:38,300
+الـ iris مثلا في هنا صعوبة طبعا الأدوية بتختلف
+
+479
+00:44:46,790 --> 00:44:50,090
+الـ blood retina barrier نفس الشيء، أيضًا لـ blood
+
+480
+00:44:50,090 --> 00:44:58,750
+vessels in retina أو in choroid، أنتم عارفين أن 
+
+481
+00:44:58,750 --> 00:45:03,190
+retina يعني من ورا بتبدأ بـ retina بيجمع الـ
+
+482
+00:45:03,190 --> 00:45:06,150
+epithelium وبيجمع الـ epithelium هو الطبقة الأولى
+
+483
+00:45:06,150 --> 00:45:11,090
+من الشبكية، بينه وبين الـ choroid، بحيرة الدم، شيء اسمه
+
+484
+00:45:11,090 --> 00:45:15,630
+Bruch's membrane، والـ Bruch's membrane هذا ضرر كبير
+
+485
+00:45:16,380 --> 00:45:20,200
+يعني بيحدد دخول المواد النافعة من المواد الضارة
+
+486
+00:45:20,200 --> 00:45:24,640
+إلى داخل اللي هو الشبكية أيضًا الـ blood vessels
+
+487
+00:45:24,640 --> 00:45:27,940
+اللي بتيجي من الـ central retinal artery أنتم عارفين
+
+488
+00:45:27,940 --> 00:45:32,900
+الـ central retinal artery؟ هنا، هيه، بتدخل وبتفرع
+
+489
+00:45:32,900 --> 00:45:36,500
+في كل الشبكية، على سطح الشبكية، أيضًا هذا الـ
+
+490
+00:45:36,500 --> 00:45:40,400
+central retinal artery أيضًا فيه endothelium بيبطنه
+
+491
+00:45:41,110 --> 00:45:44,630
+في فترة كل فرع وبالتالي لو في دواء داخل الـ artery
+
+492
+00:45:44,630 --> 00:45:51,530
+أو داخل فرع مش سهل إنه يطلع لأنه في محددات وفي
+
+493
+00:45:51,530 --> 00:45:55,130
+الـ .. الـ .. الـ .. اللي هو الـ width أو الفجوات بين الـ
+
+494
+00:45:55,130 --> 00:45:56,850
+endothelium هي فجوات
+
+495
+00:46:07,970 --> 00:46:11,030
+لما إحنا بناخد الـ drug هو دي إيه في الأهداف التي
+
+496
+00:46:11,030 --> 00:46:15,490
+إحنا بنوصلها داخل العين شكرًا لكم على حسن الاستماع
+
+497
+00:46:15,490 --> 00:46:17,290
+والسلام عليكم ورحمة الله وبركاته
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/XuEJ2AXHlQ4_raw.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/XuEJ2AXHlQ4_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..132f5ee158f75196d125643d3ee1314f76b18ad2
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/XuEJ2AXHlQ4_raw.srt
@@ -0,0 +1,2000 @@
+1
+00:00:20,810 --> 00:00:24,370
+بسم الله الرحمن الرحيم الحمد لله رب العالمين و
+
+2
+00:00:24,370 --> 00:00:27,470
+أصلي و أسلم على النبي الأمين محمد و على آله
+
+3
+00:00:27,470 --> 00:00:31,030
+وأصحابه والتابعين السلام عليكم ورحمة الله وبركاته
+
+4
+00:00:31,030 --> 00:00:38,130
+انتهينا في المحاضرات السابقة من chapters of
+
+5
+00:00:38,130 --> 00:00:43,770
+general pharmacology اللي هو علم الأدوية العامة
+
+6
+00:00:43,770 --> 00:00:49,910
+وكان هذا عبارة عن introduction ضرورية للجزء
+
+7
+00:00:49,910 --> 00:00:50,230
+الثاني
+
+8
+00:00:53,730 --> 00:01:00,470
+أو Pharmacology of the Eye اليوم سنبدأ بالـ
+
+9
+00:01:00,470 --> 00:01:05,330
+Antibacterial Agents Antibacterial Agents تعني بها
+
+10
+00:01:05,330 --> 00:01:11,510
+مضادات البكتيريا وهي في العين ضورية كما في سائر
+
+11
+00:01:11,510 --> 00:01:18,370
+الأعضاء الجسم لمقامة البكتيريا وقتلها الانتباوتك
+
+12
+00:01:18,370 --> 00:01:23,280
+للتعامل مع مصابة عقلية مستعمر على عدة أفعاليبقى
+
+13
+00:01:23,280 --> 00:01:32,200
+أنا عشان أنتقل مضادا حيويا او اي مضاعد للبكتيريا
+
+14
+00:01:32,200 --> 00:01:37,180
+فهذا يتوقف على بعض العوامل العوامل هذه تتعلق
+
+15
+00:01:37,180 --> 00:01:41,580
+بثلاثة أشياء تتعلق بال organism يعني ال micro
+
+16
+00:01:41,580 --> 00:01:48,160
+organism أو نوع البكتيريا تتعلق بمناعة المضيف او
+
+17
+00:01:48,160 --> 00:01:53,110
+العائل host immunityالتالتة properties of the drug
+
+18
+00:01:53,110 --> 00:01:57,550
+يعني هو موضوع العلاج من اللي اللي هو العنوان
+
+19
+00:01:57,550 --> 00:02:02,550
+البактерية يتوقف على ثلاث ثانى أشياء الشيء الأول
+
+20
+00:02:02,550 --> 00:02:06,930
+هو البكتيريا الشيء الثاني الهواصف الشيء التالت ال
+
+21
+00:02:06,930 --> 00:02:11,650
+drug يعني هذه اللي هو الدائرة اللي بتحرك فيها علاج
+
+22
+00:02:11,650 --> 00:02:15,910
+اللي هو ال infection ال all serious infections
+
+23
+00:02:21,440 --> 00:02:25,740
+through culture all other methods should be
+
+24
+00:02:25,740 --> 00:02:29,000
+completed before initiating treatment يعني في
+
+25
+00:02:29,000 --> 00:02:35,180
+الدول المتقدمة لا يُعطى المضاد الحيوي اجتهاديا أو
+
+26
+00:02:35,180 --> 00:02:39,160
+اعتباطيا لابد
+
+27
+00:02:39,160 --> 00:02:45,040
+من إنه تُأخذ عينة من المكان المصعب وهذه العينة
+
+28
+00:02:45,040 --> 00:02:49,480
+تدخل في culture bacterial culture what is
+
+29
+00:02:49,480 --> 00:02:54,310
+bacterial culture؟زراع مزرعة بكتيرية for two to
+
+30
+00:02:54,310 --> 00:02:59,050
+three days بعد كده يتم isolation of the
+
+31
+00:02:59,050 --> 00:03:03,870
+microorganism يعني عزل ال microorganism و يجراء
+
+32
+00:03:03,870 --> 00:03:11,270
+حاجة اسمها اللي هو test اللي هو على ال antibiotic
+
+33
+00:03:14,550 --> 00:03:19,170
+Antibiotic sensitivity test هي اللي بتفحص مدى تأثر
+
+34
+00:03:19,170 --> 00:03:23,310
+هذا ال microbe اللي تم عزله بهذه المضادات الحيوية
+
+35
+00:03:23,310 --> 00:03:27,330
+وهذه طبعا التجربة بتاعة ال antibiotic sensitivity
+
+36
+00:03:27,330 --> 00:03:33,550
+test بتبين أي مضاد حيوي قوي جدا أو متوسط أو حتى له
+
+37
+00:03:33,550 --> 00:03:37,990
+resistance من ال microbe هذا يا بناتي هو الأسلوب
+
+38
+00:03:37,990 --> 00:03:43,720
+العلميالصحيح في معارضة ال infections أما الطرق
+
+39
+00:03:43,720 --> 00:03:49,300
+التي يعني استعملوها البعض هي طرق اجتهابية يعني قد
+
+40
+00:03:49,300 --> 00:03:53,520
+ود إلى فشل عملية علاج البكتيريا أو العدوى
+
+41
+00:03:53,520 --> 00:03:59,900
+البكتيرية نبدأ في الوصف المضيف هو الإنسان اللي حدث
+
+42
+00:03:59,900 --> 00:04:04,060
+فيه العدوى أي المريض يعني نبدأ يعني ماهي علاقة
+
+43
+00:04:04,060 --> 00:04:09,250
+المريض بال micro و بترابيقول ال features of the
+
+44
+00:04:09,250 --> 00:04:13,590
+host اول شي ال immune status ال immune status يعني
+
+45
+00:04:13,590 --> 00:04:16,690
+المستوى المناعي بتاعه في ناس زي ما قولنا احنا
+
+46
+00:04:16,690 --> 00:04:23,230
+مستوى المناعي عالي زي الشباب بيقولوا انه
+
+47
+00:04:23,230 --> 00:04:30,150
+immunocompetent patients يعني مستوى المناعي منافس
+
+48
+00:04:30,150 --> 00:04:36,390
+وفي ناس كبار السن او كبار السنفي سن بقية السبعين
+
+49
+00:04:36,390 --> 00:04:40,950
+او مرضى السرطان او مرضى ال AIDS هؤلاء
+
+50
+00:04:40,950 --> 00:04:47,450
+immunocompetent patients Incompetent هي بكت
+
+51
+00:04:47,450 --> 00:04:55,270
+competent يعني هم ضعيفوا المناخ يبقى البكتيريا لو
+
+52
+00:04:55,270 --> 00:04:58,130
+اجت على واحد immunocompetent جاءت تيجي واحد
+
+53
+00:04:58,130 --> 00:04:59,550
+immunocompetent
+
+54
+00:05:08,030 --> 00:05:14,630
+ممكن تكون في ال genital tract, urinary tract، ممكن
+
+55
+00:05:14,630 --> 00:05:19,230
+تكون في central nervous system، ممكن تكون في أي
+
+56
+00:05:19,230 --> 00:05:25,610
+مكان يعني بالنسبة ليه اللي هو الإنسان، مكان طبعا
+
+57
+00:05:25,610 --> 00:05:30,870
+احنا معظم الناس شايف انا عندهم throat, tonsils و
+
+58
+00:05:30,870 --> 00:05:32,590
+اللي هو bronchitis
+
+59
+00:05:39,430 --> 00:05:47,770
+يعني واحد عنده infection عنده resistance او
+
+60
+00:05:47,770 --> 00:05:51,010
+allergy ل drug allergy مثلا عنده penicillin
+
+61
+00:05:51,010 --> 00:05:55,330
+allergy اول ما اتكلم مع الطبيب اقول انا انجي
+
+62
+00:05:55,330 --> 00:06:01,050
+حاسيها الموضوع يعني يبقى فيه هنا limitation او
+
+63
+00:06:01,050 --> 00:06:04,570
+prevention to use the same drug اللي اهو allergy
+
+64
+00:06:04,570 --> 00:06:05,470
+في هذا
+
+65
+00:06:18,540 --> 00:06:23,880
+وإيه صار وينفكشن؟ بينفع إني أعطيه أي علاج بدون ما
+
+66
+00:06:23,880 --> 00:06:28,660
+أسأله ما هو العلاج اللي هو يهناوله؟ بينفعش لازم
+
+67
+00:06:28,660 --> 00:06:33,860
+أنا أسأله حاجة اسمها drug history drug history
+
+68
+00:06:33,860 --> 00:06:39,360
+ليش؟ لأن أحيانا كثرة ال drugs بتعمل interaction
+
+69
+00:06:39,360 --> 00:06:43,340
+بينها وبالمعضلة interaction تفاعل داخلي بين اللي
+
+70
+00:06:43,340 --> 00:06:45,380
+هو الأدوية و لا تفاعل داخلي
+
+71
+00:06:51,710 --> 00:06:57,270
+أو قد يعجل اكتر مفهوم بعضه و بعضه عشان اذا بدأ
+
+72
+00:06:57,270 --> 00:07:03,570
+اعطي اي drug جديد دواء جديد لازم اسأل المريض عن
+
+73
+00:07:03,570 --> 00:07:06,970
+ايش عن ال drug history ايش الليلة جاتله بياخدها
+
+74
+00:07:06,970 --> 00:07:12,250
+عشان ماسلش harmful effect او interaction between
+
+75
+00:07:12,250 --> 00:07:17,610
+the drugs special concerns such as age and
+
+76
+00:07:17,610 --> 00:07:23,580
+pregnancyأه يعني أنا برضه بدي أكتب لولاد و أاخد في
+
+77
+00:07:23,580 --> 00:07:29,940
+بالي إنه هذا مثلا infant عمره سنة، إنه بخاف أنا من
+
+78
+00:07:29,940 --> 00:07:36,560
+ال dose تقتله، أو هذا old patient عمره تمانين سنة،
+
+79
+00:07:36,560 --> 00:07:42,300
+أه مارتصرفش أنا في الجوعة زي الشباب، كمان في
+
+80
+00:07:42,300 --> 00:07:50,250
+pregnancy، pregnant woman أو لابتاتفي حامل لازم
+
+81
+00:07:50,250 --> 00:07:53,030
+انا انه يعني ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا
+
+82
+00:07:53,030 --> 00:07:53,770
+ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا
+
+83
+00:07:53,770 --> 00:07:54,130
+ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا
+
+84
+00:07:54,130 --> 00:07:55,490
+ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا
+
+85
+00:07:55,490 --> 00:07:57,570
+ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا
+
+86
+00:07:57,570 --> 00:07:57,990
+ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا
+
+87
+00:07:57,990 --> 00:08:00,110
+ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا
+
+88
+00:08:00,110 --> 00:08:08,250
+ا ا ا ا ا ا
+
+89
+00:08:08,250 --> 00:08:08,250
+ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا ا
+
+90
+00:08:08,250 --> 00:08:08,250
+ا ا ا ا ا ا ا ا ا ا ا
+
+91
+00:08:16,920 --> 00:08:21,820
+ماعطهوش أنا بالفعل عنده chronic disease في ال
+
+92
+00:08:21,820 --> 00:08:25,600
+small intestine ال absorption مش تماما ماعطهوش
+
+93
+00:08:25,600 --> 00:08:30,560
+بالفعل و الجوع قعدت تتعدل واحد عنده مرض في الكبن
+
+94
+00:08:30,560 --> 00:08:36,160
+زي اللي بقول عنه يعني liver cirrhosis الوضع صعب ..
+
+95
+00:08:36,160 --> 00:08:41,100
+الوضع صعب يبقى أنا عمري 6 متعلقة بالhost اللي انا
+
+96
+00:08:41,100 --> 00:08:46,060
+بدأت ادراج طيبنشوف العوامل المتعلقة بالدراج نفسه
+
+97
+00:08:46,060 --> 00:08:54,780
+اول شي فارماكو دايناميكس بتاعة الدراج or
+
+98
+00:08:54,780 --> 00:08:58,000
+interaction between the drug and the infecting
+
+99
+00:08:58,000 --> 00:09:01,540
+organism واحد دراسة في الجامعة فارماكوليجي ان
+
+100
+00:09:01,540 --> 00:09:05,480
+فارماكو دايناميكس تعني تأثير
+
+101
+00:09:11,510 --> 00:09:15,510
+جسم الإنسان على جسم الإنسان طيب و ال formaco
+
+102
+00:09:15,510 --> 00:09:21,370
+kinetic تأثير جسم الإنسان على الدواء تأثير جسم
+
+103
+00:09:21,370 --> 00:09:26,050
+الإنسان اللي هو يعني بيحلل هذا الدواء و بيعمله
+
+104
+00:09:26,050 --> 00:09:29,010
+metabolites و بعدين بيوضيه على الكده عشان يصله
+
+105
+00:09:29,010 --> 00:09:33,650
+execution طيب its effects on immunity في بعض drugs
+
+106
+00:09:33,650 --> 00:09:39,090
+بتنزل ال immunity بتثبت ال immunity زي اللي هو ال
+
+107
+00:09:39,090 --> 00:09:44,350
+cortisoneو زي اللي هو cytotoxic drugs مضادات
+
+108
+00:09:44,350 --> 00:09:50,170
+السرطان يعني هذه الأشياء المعروفة الكورتزونات و
+
+109
+00:09:50,170 --> 00:09:54,050
+مضادات السرطان بتعمل immunosuppression
+
+110
+00:10:06,690 --> 00:10:10,030
+There's effects or side effects وحنا لسه طالعين من
+
+111
+00:10:10,030 --> 00:10:15,050
+محاضرة طويلة في موضوع الأثار الجانبية للدواء، في
+
+112
+00:10:15,050 --> 00:10:20,290
+أثار جانبية للدواء تعمل جلطات، تعمل سرطان، تعمل
+
+113
+00:10:20,290 --> 00:10:27,490
+الدفع لضغط الدم، تعمل تهييب المعدة للأمعاء، أشياء
+
+114
+00:10:27,490 --> 00:10:32,820
+كثيرة جدامعرفة ايش في اعتباري في ما يتعلق بهذا
+
+115
+00:10:32,820 --> 00:10:39,380
+الدواء بعدين treatment costs التكاليف تكاليف نفس
+
+116
+00:10:39,380 --> 00:10:44,180
+الدواء ما بين شركة و شركة ممكن يكون له ايش double
+
+117
+00:10:44,180 --> 00:10:52,560
+cost بس يبقى انا اراني هذا المريض خاصة اذا كان انا
+
+118
+00:10:52,560 --> 00:10:55,840
+هعطيه ليلة لفترة طويلة مثلا
+
+119
+00:10:58,700 --> 00:11:03,620
+العالى hypertension فى دواء ممكن أننا نجيبه بعشرة
+
+120
+00:11:03,620 --> 00:11:12,100
+شكل وفى دواء العلبة بمئة وكسر شكل costs
+
+121
+00:11:12,100 --> 00:11:19,660
+طبعا هي رخمة كويسة لكن برضه مستوى المرين المالى
+
+122
+00:11:19,660 --> 00:11:24,220
+مهم جدا فى الموضوع كمان اخرش ال concerns for
+
+123
+00:11:24,220 --> 00:11:29,090
+antibiotic resistanceيعني انا باكتب علاج مثلا هي
+
+124
+00:11:29,090 --> 00:11:33,250
+علاج سبق ان انا خدت مثلا keflix مثلا و اقول اه
+
+125
+00:11:33,250 --> 00:11:39,770
+والله انا مابه بيأثرش فيه مافيش استجابة اوخلوكس
+
+126
+00:11:39,770 --> 00:11:46,930
+كان جال نص نص زينات لا احسن شوف انا يعني هل سبق
+
+127
+00:11:46,930 --> 00:11:50,370
+المريض انه اخد هذا العلاج و هل كان effective ولا
+
+128
+00:11:50,370 --> 00:11:55,820
+non effectiveهذه الستة فيما يتعلق بالدواء بالنفسه
+
+129
+00:11:55,820 --> 00:12:05,380
+ستة للعائل و ستة عوامل للدواء الآن نشوف البكتيريا
+
+130
+00:12:05,380 --> 00:12:10,540
+اللي هي بدي وقع عليها الكلام Features of the
+
+131
+00:12:10,540 --> 00:12:14,900
+organism او microorganism يعني اوشي بكتيريا
+
+132
+00:12:14,900 --> 00:12:19,570
+distanceis due to a variety of mechanisms يعني
+
+133
+00:12:19,570 --> 00:12:28,050
+البكتيريا مع أنها هي يعني micro organism و مع أنها
+
+134
+00:12:28,050 --> 00:12:34,990
+prokaryotic بداية إلا أن معركة الحياة و حب الوجود
+
+135
+00:12:34,990 --> 00:12:42,430
+دفعتها إلى أن تقاوم الأدوية خاصة المضادة الحيوانية
+
+136
+00:12:43,580 --> 00:12:48,040
+والعلماء والبكتيريا في معركة من مائة سنة حتى الآن
+
+137
+00:12:48,040 --> 00:12:53,020
+في حسم هذا الموضوع لن نستطيع أن نخضع البكتيريا
+
+138
+00:12:53,020 --> 00:12:58,820
+تماما أن نخرج البكتيريا من العالم لن نستطيع كلما
+
+139
+00:12:58,820 --> 00:13:06,440
+أتى العلماء بمضاد حيوي جديد وقوي ومرتفع السبق كلما
+
+140
+00:13:06,440 --> 00:13:07,980
+البكتيريا بعد خليل
+
+141
+00:13:12,500 --> 00:13:20,240
+وبدأت بإفراز إنزيمات مضادة ومحللة لتركيب كيماوي
+
+142
+00:13:20,240 --> 00:13:24,480
+لهذا الدواء ويخرج من الخدمة فأتوا برهما بـ
+
+143
+00:13:24,480 --> 00:13:28,520
+Antibiotic جليل وبعد سنة أو سنتين أو ثلاثة يكون قد
+
+144
+00:13:28,520 --> 00:13:34,300
+انتهى وهكذا هي الحرب، حرب الوجود بين الإنسان وبين
+
+145
+00:13:34,300 --> 00:13:39,700
+الأعداء.يبقى كل ال mechanisms هذه قد تكون نتيجة
+
+146
+00:13:39,700 --> 00:13:41,360
+لover lose
+
+147
+00:13:45,830 --> 00:13:49,090
+ما هو لما الناس بيلاقوا مضاد حيوي جديد كله بيروح
+
+148
+00:13:49,090 --> 00:13:52,030
+بالتجاه عليه عشان يحمي حاله وأولاده من الفكتيريا
+
+149
+00:13:52,030 --> 00:13:58,850
+العادية كثرة انتشار هذا المضاد الحيوي ليس فقط في
+
+150
+00:13:58,850 --> 00:14:04,110
+الإنسان بل في الحيوان في البيضة بل في النبات يعني
+
+151
+00:14:04,110 --> 00:14:08,630
+في المضادات الحيوية في النبات ومضادات فيروسية
+
+152
+00:14:08,630 --> 00:14:09,610
+ومضادات
+
+153
+00:14:16,160 --> 00:14:23,120
+وفي الإنسان انتشار هذا المضاد الحيوي في العالم على
+
+154
+00:14:23,120 --> 00:14:28,940
+هذه المستويات يؤدي إلى اكتشاف السر. يبقى احنا
+
+155
+00:14:28,940 --> 00:14:33,020
+بتكلم عن ال overuse. example of overuse the result
+
+156
+00:14:33,020 --> 00:14:36,880
+of the overuse of antibiotics for
+
+157
+00:14:39,490 --> 00:14:45,890
+والحقن مثلا systemic use أو في العين قطرة ومرهم
+
+158
+00:14:45,890 --> 00:14:50,570
+and in poultry الدوارن and livestock لبقاره
+
+159
+00:14:50,570 --> 00:14:54,590
+الأنعام is an increasing number of bacterial
+
+160
+00:14:54,590 --> 00:14:57,850
+strains that are stronger than antibiotic being
+
+161
+00:14:57,850 --> 00:15:04,100
+used against themoveruse الإسرار في الشيء يودي إلى
+
+162
+00:15:04,100 --> 00:15:07,980
+اكتشاف السر بتاعه وانه تبدأ المقاومة اللي هو
+
+163
+00:15:07,980 --> 00:15:11,420
+bacterial resistance for antibiotic هذا مثال على
+
+164
+00:15:11,420 --> 00:15:18,160
+ال overuse طب مثال على ال underuse وانا شائع
+
+165
+00:15:18,160 --> 00:15:26,840
+common بين الناس خاصة شباب يبدأ في تناول مضاد
+
+166
+00:15:26,840 --> 00:15:34,260
+الحيوي مرتين او ثلاث او اربعبيصير improvement تحسن
+
+167
+00:15:34,260 --> 00:15:38,060
+في المدينة اللي بيصير اي improvement يضمن المسكين
+
+168
+00:15:38,060 --> 00:15:44,600
+انه التهيزم خلصناه يلقي ال antibiotics بتاعته و
+
+169
+00:15:44,600 --> 00:15:50,700
+يخرج إلى الشارع و يخرج إلى العمل فيعود بعد يومين
+
+170
+00:15:50,700 --> 00:15:55,620
+او ثلاثة او اربعة في اسوأ من الماضي لانه under use
+
+171
+00:15:55,620 --> 00:15:56,880
+ال doors
+
+172
+00:16:03,090 --> 00:16:07,630
+الليش احنا بناخد الجرعة مثلا خمس أيام أو لأسبوع؟
+
+173
+00:16:07,630 --> 00:16:11,270
+البكتيريا تماما لأن البكتيريا لا تموت لفعة واحدة
+
+174
+00:16:11,270 --> 00:16:15,510
+البكتيريا بتموتش من أول dose البكتيريا كل dose
+
+175
+00:16:15,510 --> 00:16:18,930
+احنا بناخدها بيموت عدد منها، بيموت عدد منها، يعني
+
+176
+00:16:18,930 --> 00:16:22,310
+في أول جرعة مثلا خمسية فلمية، بعدين بتصير عشرة
+
+177
+00:16:22,310 --> 00:16:25,730
+فلمية كمان حيث التين، بعدين خمسة فلمية، بعدين
+
+178
+00:16:25,730 --> 00:16:29,750
+اتنين فلمية، المهم لا تموت باقي البكتيريا تماما
+
+179
+00:16:29,750 --> 00:16:36,980
+إلا بانتهاء الجرعةكما وصفها الطبيب. بهذا المسألة
+
+180
+00:16:36,980 --> 00:16:46,860
+ان ال dose of antibiotic كما يحدث في الدول اللي هو
+
+181
+00:16:46,860 --> 00:16:52,040
+ال النامية اذا ما يقولوا اه developing countries
+
+182
+00:16:52,040 --> 00:16:54,740
+the distance often develops when people stop
+
+183
+00:16:54,740 --> 00:16:59,460
+taking their medication العلاج as soon as they
+
+184
+00:16:59,460 --> 00:17:05,040
+feel better اتحسننوعيا، ظاهريا، والسؤال اللي انا
+
+185
+00:17:05,040 --> 00:17:10,200
+بطرح نفسه، هل لو بقى اربعة أو خمس أيام وعاد المرض
+
+186
+00:17:10,200 --> 00:17:14,840
+والحمة وعاد الى نفس العلاج، مش هيأثر، مش هيأثر، مش
+
+187
+00:17:14,840 --> 00:17:19,060
+هيأثر، لأنه عملت ال resistance، لازم يبدأ بمقاطع
+
+188
+00:17:19,060 --> 00:17:21,660
+حيوي جديد لم يأخذ قبل ذلك
+
+189
+00:17:29,540 --> 00:17:34,840
+شيء اسمه minimal inhibitory concentration وشيء
+
+190
+00:17:34,840 --> 00:17:39,940
+مسمى يعني، minimal لحد الأدنى، inhibitory بيعمل
+
+191
+00:17:39,940 --> 00:17:43,660
+inhibition، إيش inhibition؟ يمنع النمو، يمنع النمو
+
+192
+00:17:43,660 --> 00:17:48,760
+يعني منع، concentration تركز إيش؟ للدواء، اللي هو
+
+193
+00:17:48,760 --> 00:17:53,320
+جعله عنه Mike، اختصره بكلمة Mikeيبقى المايك هنا
+
+194
+00:17:53,320 --> 00:18:00,800
+بقول إن هذا أقل concentration للدواء الذي سيؤدي
+
+195
+00:18:00,800 --> 00:18:06,460
+إلى منع النمو الظاهري للبكتيريا بعد فترة من الزمن
+
+196
+00:18:06,460 --> 00:18:12,820
+في الطبق اللي هو المزرعة البكتيرية يبقى
+
+197
+00:18:12,820 --> 00:18:18,820
+هو أقل التركيز من الدواء يؤدي إلى منع نمو الظاهر
+
+198
+00:18:18,820 --> 00:18:25,160
+للبكتيريا في المزرعةفاهم انها ال mic؟ يعني انا
+
+199
+00:18:25,160 --> 00:18:31,700
+بقول انه ال concentration بتاع الدواء فلاني 90%
+
+200
+00:18:31,700 --> 00:18:38,900
+عشان يمنع النمو وفي دواء تاني 50% مين بيكون اقوى؟
+
+201
+00:18:38,900 --> 00:18:45,400
+ال 50% ولا ال 90%؟ ال 50% يعني بيقول اقل تركيز
+
+202
+00:18:45,400 --> 00:18:51,760
+للدواء منع النمو ال 50% طب لو اجانا دواء 25%؟
+
+203
+00:18:54,400 --> 00:18:58,340
+زي السم، واحد بيقولك أنا واحد milli، عارفين ال
+
+204
+00:18:58,340 --> 00:19:04,920
+milli؟ من السم هذا بقتل بعد ربع ساعة، واحد بيقول
+
+205
+00:19:04,920 --> 00:19:09,780
+لأ، أنا بدي أعطيك عشر ملي، يقتل بعد ربع ساعة، من
+
+206
+00:19:09,780 --> 00:19:13,320
+أقوى؟ عشر، عشر، عشر، عشر ملي، عشر ملي، عشر ملي،
+
+207
+00:19:13,320 --> 00:19:15,500
+عشر ملي، عشر ملي، عشر ملي، عشر ملي، عشر ملي، عشر
+
+208
+00:19:15,500 --> 00:19:15,900
+ملي، عشر ملي، عشر ملي، عشر ملي، عشر ملي، عشر ملي،
+
+209
+00:19:15,900 --> 00:19:15,900
+عشر ملي، عشر ملي، عشر ملي، عشر ملي، عشر ملي، عشر
+
+210
+00:19:15,900 --> 00:19:15,920
+ملي، عشر ملي، عشر ملي، عشر ملي، عشر ملي، عشر ملي،
+
+211
+00:19:15,920 --> 00:19:22,780
+عشر ملي، عشر ملي، عشر
+
+212
+00:19:22,780 --> 00:19:29,380
+مليقلتم دون اني بمال، فما آتاني الله خير مما
+
+213
+00:19:29,380 --> 00:19:35,160
+آتاكم، بل أنتم بهديتكم تفرحون، ارجع اليهم،
+
+214
+00:19:35,160 --> 00:19:39,220
+فلنأتينهم بجنود لا قبل لهم بها، و لنخرجنهم منها،
+
+215
+00:19:39,220 --> 00:19:43,840
+من اليمن يعني أدلتهم صادقهم، قرأ يا أيها الملأ،
+
+216
+00:19:43,840 --> 00:19:47,600
+الملأ يعني، أيه منكم يعتيلي بأرشيدها قبل أي أتون
+
+217
+00:19:47,600 --> 00:19:48,280
+لمسلمين؟
+
+218
+00:19:52,520 --> 00:19:56,720
+أنا أتيك فيه قبل أن تقوم بمقامك. انت كدهش جال هنا؟
+
+219
+00:19:56,720 --> 00:19:59,720
+جاله ساعتين او تلاتة. جاله خلال تلت ساعات، بيكون
+
+220
+00:19:59,720 --> 00:20:03,460
+العرش بتاعك الكثير عندك. واحد تاني قال اللي عنده
+
+221
+00:20:03,460 --> 00:20:07,860
+يعلمه من الكتاب. عالم هنا. أنا أتيك فيه قبل أن
+
+222
+00:20:07,860 --> 00:20:12,400
+يرتد إلى الكتابة. إيش يعني؟ بعمل بلينك. انت اعمل
+
+223
+00:20:12,400 --> 00:20:17,260
+بلينك وافتح عينك، بيكون عندك. من الأعمامين اللي
+
+224
+00:20:17,260 --> 00:20:18,520
+فيهم أقوى وأشطر.
+
+225
+00:20:25,700 --> 00:20:29,120
+يعني سنة، اتنين، تلاتة، اعطوهم باجيبهم ولا حتى في
+
+226
+00:20:29,120 --> 00:20:35,080
+تفكير الآن يعني بدأ العالم يتجه الى نقل المادة عن
+
+227
+00:20:35,080 --> 00:20:40,620
+طريق الكهرباء او عن طريق الهواء لسه هم مستوش لان
+
+228
+00:20:40,620 --> 00:20:45,120
+كان سوليمان عليه السلام والجن بتاعهم يعني مستهلون
+
+229
+00:20:45,120 --> 00:20:49,340
+يعني ان اي مادة اي مادة شايفينها ممكن جدا انها
+
+230
+00:20:49,340 --> 00:20:53,160
+تحلل الذرات بتاعتها
+
+231
+00:21:05,170 --> 00:21:11,770
+المهم ان اقول ان كل مايك أقل كل مكان أقوى وكل مكان
+
+232
+00:21:11,770 --> 00:21:17,390
+عالي النسبة كل مكان أضعف عشان هيك وحتى ال مايك 90
+
+233
+00:21:17,390 --> 00:21:24,110
+is the concentration at which 90% of the isolates
+
+234
+00:21:24,110 --> 00:21:25,490
+by genus and species
+
+235
+00:21:33,570 --> 00:21:38,590
+يبقى يقول إن الدواء هذا اسمه Mike-90 قعد يكون ال
+
+236
+00:21:38,590 --> 00:21:42,190
+Mike-90 اللي عمل تسعين في المية Inhibition عمل
+
+237
+00:21:42,190 --> 00:21:45,870
+تسعين في المية Inhibition For Antimicrobial
+
+238
+00:21:45,870 --> 00:21:48,510
+therapy to be effective عشان ال Antibiotic هذا
+
+239
+00:21:48,510 --> 00:21:53,150
+يكون effective يعني مؤثر It is believed that a
+
+240
+00:21:53,150 --> 00:21:56,910
+drug should at minimum reach a concentration that
+
+241
+00:21:56,910 --> 00:22:01,450
+at least exceeds Mike-90 أو اللي هو target
+
+242
+00:22:01,450 --> 00:22:06,600
+organismيعني واضح أنه لو أنا مناق تسعين في المية،
+
+243
+00:22:06,600 --> 00:22:11,400
+هيبقى العشرة في المية active، يبقى عشان أنا دوايا
+
+244
+00:22:11,400 --> 00:22:18,500
+يكون effective، لازم أتجاوز التسعين، لأن العشرة في
+
+245
+00:22:18,500 --> 00:22:22,460
+المية هذه لسه في خطر منها، فلازم أنا أحاول أن أرفع
+
+246
+00:22:22,460 --> 00:22:24,860
+مستوى التأثيري عن إيه؟
+
+247
+00:22:35,800 --> 00:22:42,580
+الـ mic break point هي النقطة الحاسمة التي تفرق
+
+248
+00:22:42,580 --> 00:22:50,160
+الدواء هل هو مؤثر أو غير مؤثر في البكتيريا، يبقى
+
+249
+00:22:50,160 --> 00:22:53,680
+بتفرق بين susceptibility القابلية إنك موت في
+
+250
+00:22:53,680 --> 00:22:59,000
+البكتيريا أو تكون resistant، susceptibility يعني
+
+251
+00:22:59,000 --> 00:23:07,360
+أنه مؤثر و resistant غير مؤثريبقى the mic is that
+
+252
+00:23:07,360 --> 00:23:11,160
+mic separating susceptibility from resistance and
+
+253
+00:23:11,160 --> 00:23:14,360
+is typically the concentration of a drug that is
+
+254
+00:23:14,360 --> 00:23:21,120
+achieved in the serum or tissue تركيزه في الدم أو
+
+255
+00:23:21,120 --> 00:23:26,140
+في الانسجار كلما كانت ال mic break point
+
+256
+00:23:30,380 --> 00:23:35,900
+أو تخلصت من البكتيريا كل ما كان ال mic بطيئة أو
+
+257
+00:23:35,900 --> 00:23:39,800
+صغيرة كل ما كان فيه فشل في الوصول إلى العلاج
+
+258
+00:23:39,800 --> 00:23:47,060
+المناسب طيب اللي انا هتكلم عليه ال minimal
+
+259
+00:23:47,060 --> 00:23:51,720
+inhibitory concentration كمان مرة بقول ال organism
+
+260
+00:23:51,720 --> 00:23:57,600
+او البكتيريا is considered susceptible if its mic
+
+261
+00:23:58,220 --> 00:24:04,540
+هو أربعة و أربعة مستوى مستوى
+
+262
+00:24:04,540 --> 00:24:10,000
+الدم الذي يتم إيقافه باستخدام الدوز المفروض أو دوز
+
+263
+00:24:10,000 --> 00:24:11,100
+كام أو دوز كام أو دوز كام أو دوز كام او دوز كام او
+
+264
+00:24:11,100 --> 00:24:11,120
+دوز كام او دوز كام او دوز كام او دوز كام او دوز
+
+265
+00:24:11,120 --> 00:24:11,780
+كام او دوز كام او دوز كام او دوز كام او دوز كام او
+
+266
+00:24:11,780 --> 00:24:15,500
+دوز كام او دوز كام او دوز كام او دوز كام او دوز
+
+267
+00:24:15,500 --> 00:24:19,180
+كام او دوز كام او دوز كام او دوز كام او دوز كام او
+
+268
+00:24:19,180 --> 00:24:26,470
+دوز كام او دوز كام او دوز كام او دوز كحتى ان يعمل
+
+269
+00:24:26,470 --> 00:24:34,950
+PHP، هذه اسمها الـDraw، بعد هيك بصحب الإيال
+
+270
+00:24:34,950 --> 00:24:40,850
+تدريجيًا هيبدأ ينزل ويعمل ايه؟ طيب، الـalcoholic
+
+271
+00:24:40,850 --> 00:24:45,710
+organism is considered susceptible، susceptible أي
+
+272
+00:24:45,710 --> 00:24:52,070
+قابلليه القتل بهذا الموضوع الحيوي إذا كان الـ mic
+
+273
+00:24:52,070 --> 00:24:57,650
+بتاعه is one fourth the peak؟ يعني مثلا نفترض إننا
+
+274
+00:24:57,650 --> 00:25:05,770
+وصلنا مستوى 100، بنيكون هذا 25، إذا كان إحنا وصلنا
+
+275
+00:25:05,770 --> 00:25:06,210
+ل 25
+
+276
+00:25:26,990 --> 00:25:37,150
+والاسكان المايك وصل هنا مثلا تمانية واحدة على ستة
+
+277
+00:25:37,150 --> 00:25:40,010
+عشر تمانية
+
+278
+00:25:42,270 --> 00:25:50,870
+أ بيكون resistant يبقى هذا ال peak أعلى نقطة وصلها
+
+279
+00:25:50,870 --> 00:25:57,770
+المضاد الحيوي في الدم إذا كان ال mic بتاعه صغير
+
+280
+00:25:57,770 --> 00:26:04,870
+لدرجة 1 على 16 من ال peak بيكون resistant
+
+281
+00:26:11,720 --> 00:26:18,760
+فأكتر بيكون susceptible susceptible يعني قابل إيش
+
+282
+00:26:18,760 --> 00:26:25,120
+أن يكون مضارب حيويا قويا ضد هذه البكتيريا بيقول لي
+
+283
+00:26:25,120 --> 00:26:28,300
+the break points in defining bacterial resistance
+
+284
+00:26:28,300 --> 00:26:31,280
+are based on what can be achieved with systemic
+
+285
+00:26:31,280 --> 00:26:36,420
+therapy and therefore may not always affect ocular
+
+286
+00:26:36,420 --> 00:26:36,760
+release
+
+287
+00:26:43,180 --> 00:26:46,720
+في حالة العين، بدي أتكلم عن المدارس الحيوي في ال
+
+288
+00:26:46,720 --> 00:26:51,900
+-aqueous حمرة ال-aqueous حمرة اللي في ال-antero
+
+289
+00:26:51,900 --> 00:26:55,780
+chamber و ال-posterior chamber أو بدي أتكلم عنه في
+
+290
+00:26:55,780 --> 00:27:02,360
+ال-vitreous أو في نسيج معين في القرنية، لأنه
+
+291
+00:27:02,360 --> 00:27:08,200
+العلاج في العين local، العلاج في الدم system او عن
+
+292
+00:27:08,200 --> 00:27:08,640
+الدم
+
+293
+00:27:11,660 --> 00:27:16,580
+هي عندى ال mic اه و ال peak و الحاجات اللى بتكلم
+
+294
+00:27:16,580 --> 00:27:28,420
+عنها هى فيه هنا مثلا هى peak هنا واسط 24 فيه
+
+295
+00:27:28,420 --> 00:27:37,420
+مستويات اقل 17 فيه 20 فيه 12 فيه 8 فيه 3 ثلاثة
+
+296
+00:27:37,420 --> 00:27:38,720
+هبقولك
+
+297
+00:27:47,450 --> 00:27:55,750
+بالنسبة للـ Peak اللي وصلوا لمضارب الحيوانات طيب
+
+298
+00:27:55,750 --> 00:28:02,350
+الان كنا نتكلم عن الـ inhibitory و ال inhibition
+
+299
+00:28:02,350 --> 00:28:05,770
+يعني inhibition of growth and multiplication of
+
+300
+00:28:05,770 --> 00:28:08,670
+bacteria اللي هتكلم عن ال bactericidal
+
+301
+00:28:08,670 --> 00:28:15,150
+concentration و لصيدل lethal او fatal قاتلThe
+
+302
+00:28:15,150 --> 00:28:19,710
+Minimal Bactericidal Concentration الان احنا بتكلم
+
+303
+00:28:19,710 --> 00:28:22,550
+في الآخر على التخلص من البكتيريا اتكلمنا عليهم
+
+304
+00:28:22,550 --> 00:28:27,090
+همشل لكن احنا حقيقة بدنا ايش؟ بدنا بكتيريسايدل في
+
+305
+00:28:27,090 --> 00:28:30,410
+الآخر The Minimal Bactericidal Concentration اسمه
+
+306
+00:28:30,410 --> 00:28:35,950
+MBC مختصر MBC is the lowest concentration of
+
+307
+00:28:35,950 --> 00:28:41,350
+antimicrobial that totally suppresses هقول totally
+
+308
+00:28:41,350 --> 00:28:46,590
+يعني zero percent المفتر يعنيTotally suppresses
+
+309
+00:28:46,590 --> 00:28:50,430
+growth of antibiotic-free media or death results
+
+310
+00:28:50,430 --> 00:28:56,170
+in 99.9% reduction or a greater decline in colony
+
+311
+00:28:56,170 --> 00:28:59,630
+counts after overnight incubation.Invernite
+
+312
+00:28:59,630 --> 00:29:03,670
+incubation يعني حتى إذا البكتيريا في مزرعة طيرت
+
+313
+00:29:03,670 --> 00:29:10,250
+الليلة وضبط إليها ال antibiotic فالسفارة بس كانت
+
+314
+00:29:10,250 --> 00:29:16,690
+هي ال bactericide الليتسعة عشر inhibition و death
+
+315
+00:29:16,690 --> 00:29:26,630
+كام فعلا يعني؟ واحد من مية على مية اللي هي فلتت من
+
+316
+00:29:26,630 --> 00:29:30,410
+إيش؟ اللي هو الأثر بتاع ال antibiotic عشان كده
+
+317
+00:29:30,410 --> 00:29:37,660
+اسمه Cidal اسمه Cidalيبقى من هنا قسموا الأدوية الـ
+
+318
+00:29:37,660 --> 00:29:40,460
+Antibiotics أو الـ Antimicrobial إلى نوعين
+
+319
+00:29:40,460 --> 00:29:45,800
+بكتيريسايدل و بكتيريوستاتيك بكتيريسايدل القاتلة
+
+320
+00:29:45,800 --> 00:29:48,680
+بكتيريوستاتيك الـ Inhibition اللي هي بتوقف نمو
+
+321
+00:29:48,680 --> 00:29:53,740
+البكتيري بكتيريسايدل ال drugs are defined as drugs
+
+322
+00:29:53,740 --> 00:30:01,760
+whose minimal inhibitory point is very close to
+
+323
+00:30:03,310 --> 00:30:08,070
+minimal bactericidal اللي هو concentration يعني كل
+
+324
+00:30:08,070 --> 00:30:14,750
+ما كان ال mic جريب من ال mimic يكون قوي و
+
+325
+00:30:14,750 --> 00:30:19,530
+bactericidal كل ما كانت ال mic أقل من ال mimic كل
+
+326
+00:30:19,530 --> 00:30:24,550
+ما كان ال bacterio static static يعني بس يوقف
+
+327
+00:30:24,550 --> 00:30:28,170
+البكتيريا عن النمو لكن لا يقتل البكتيريا لا يقتل
+
+328
+00:30:28,170 --> 00:30:31,150
+البكتيريا يبقى bactericidal
+
+329
+00:30:47,620 --> 00:30:51,220
+الأفكار البكتيريسية للدراجة تعتمد على الوصول لدرجة
+
+330
+00:30:51,220 --> 00:30:55,100
+كافية لدرجة الدراجة للطفولة التارجية التشوية
+
+331
+00:30:55,100 --> 00:30:58,300
+التارجية التشوية المدينة المدينة المدينة المدينة
+
+332
+00:30:58,300 --> 00:31:01,570
+المدينة المدينة المدينة المدينة المدينة المدينةكل
+
+333
+00:31:01,570 --> 00:31:06,910
+ما الدواء وصل إلى مستويات عالية في ال target
+
+334
+00:31:06,910 --> 00:31:11,870
+tissue اللي فيه موقة أو موضع المرض كل ما كان هو
+
+335
+00:31:11,870 --> 00:31:18,570
+اللي هو أقوى ك bactericide طيب ال drug is the drug
+
+336
+00:31:18,570 --> 00:31:25,110
+whose mimic is more than 16 fold greater than Mike
+
+337
+00:31:25,110 --> 00:31:28,590
+شايفين؟ يعني الآن
+
+338
+00:31:31,970 --> 00:31:37,970
+دواة ادراج معين انا اعطيته مثلا
+
+339
+00:31:37,970 --> 00:31:48,270
+50 مستوى في الدم مبك مبك لو كان الان ال mic مثلا
+
+340
+00:31:48,270 --> 00:31:57,190
+40 الميك اعلى انهيبتل و البيت هالي بكتيريسايتل هذا
+
+341
+00:31:57,190 --> 00:32:00,610
+الدواة يعتبر بكتيريو
+
+342
+00:32:11,160 --> 00:32:19,340
+هنا ال fifty ال mimic وهنا ال twenty الmic هذا
+
+343
+00:32:19,340 --> 00:32:24,380
+بكتيريو أستاتيك بكتيريو بكتيريو أستاتيك واعنى
+
+344
+00:32:24,380 --> 00:32:34,300
+أستاتيك بس يمنع النمو والتكاثر لكن لا يقتل لكن هذا
+
+345
+00:32:34,300 --> 00:32:41,610
+يمنع ويقتل البكتيرياطبعا الإنسان ده هو البدوية على
+
+346
+00:32:41,610 --> 00:32:44,510
+الأفضل، في بعض الناس علماء في الأدوية اللي بيبقوا
+
+347
+00:32:44,510 --> 00:32:49,270
+يأكلوها، طب و هي ال immunity اللي في جسم الإنسان،
+
+348
+00:32:49,270 --> 00:32:53,690
+إيش مهمتها؟ إذا كان أنت وصلت إلى أن ال bacterium
+
+349
+00:32:53,690 --> 00:32:55,230
+هو static، وقفت ال bacterium
+
+350
+00:32:58,360 --> 00:33:01,820
+طب تقول مانع إيش خلايا ده من البضار و الإنفوية و
+
+351
+00:33:01,820 --> 00:33:05,560
+إيش مهمتها؟ بتكمل، طب هذا بالنسبة للشباب، لكن
+
+352
+00:33:05,560 --> 00:33:10,260
+بالنسبة لصغار السن و كبار السن، بيقولوا بكتيريو
+
+353
+00:33:10,260 --> 00:33:14,180
+سايدل، بيقولك انت كده قطيت الشباب دايما بكتيرو
+
+354
+00:33:14,180 --> 00:33:22,880
+سايدل، انت نيمت المناعة بتاعته، و بطلت المناعة طيب
+
+355
+00:33:22,880 --> 00:33:26,340
+في ناس بيشتهدف و بيقولك أنه ممكن أنا أخلي ال
+
+356
+00:33:26,340 --> 00:33:27,060
+بكتريو سايدل
+
+357
+00:33:33,910 --> 00:33:36,710
+أنت الـ bactericidal قلّي الجهنمات و بصير ال
+
+358
+00:33:36,710 --> 00:33:39,870
+bacterostatic ال bacterostatic كثر الجهنمات و بصير
+
+359
+00:33:39,870 --> 00:33:42,670
+ال bactericidal لكن أنا لأ .. لأ .. لأ مخاطرة، لأ
+
+360
+00:33:42,670 --> 00:33:47,510
+أنا بدأ أحسن طيب، هتكلم الآن في الـI، drugs and I،
+
+361
+00:33:47,510 --> 00:33:50,030
+نشوف إيه شو اللي ملقبين ال drugs و ال I ال I is
+
+362
+00:33:50,030 --> 00:33:53,570
+one of the few structures that can be considered
+
+363
+00:33:53,570 --> 00:33:59,290
+pharmacokinetically separate from the body يعني لا
+
+364
+00:33:59,290 --> 00:34:06,730
+تقضى القانون ال absorptionو ال distribution و ال
+
+365
+00:34:06,730 --> 00:34:13,290
+metabolism و ال excretion بتاعة الدواء في الجسم
+
+366
+00:34:13,290 --> 00:34:19,250
+العين يعني بقولك يعني كابسولة لحالها villa لحالها
+
+367
+00:34:19,250 --> 00:34:24,490
+منطقة لحالها غرفة مغلقة العين عشان هيك الدواء اللي
+
+368
+00:34:24,490 --> 00:34:30,030
+بدخل بدخل ميكانزم و بدخل ميكانزم صعب شوية في العين
+
+369
+00:34:40,890 --> 00:34:44,290
+Directly into the eye يعني أنا حطيت الإلاجة على
+
+370
+00:34:44,290 --> 00:34:49,650
+القرانية على طول دخل من القرانية على الـoculus of
+
+371
+00:34:49,650 --> 00:34:53,390
+humor وعلى الـiris وعلى الـcellular body صاروا
+
+372
+00:34:53,390 --> 00:34:57,430
+absorption على طول ماشيال كونس لسه راح على المريض
+
+373
+00:34:57,430 --> 00:35:00,350
+وعلى الميدا وعلى الأمعاه وعلى الخملات وعلى الكبير
+
+374
+00:35:00,350 --> 00:35:04,810
+لفرة كبيرة يعني لأ هنا ضايقة على طول يبقى ال
+
+375
+00:35:04,810 --> 00:35:08,610
+absorption is directly into the eye
+
+376
+00:35:11,380 --> 00:35:18,740
+بالعكس عندما يخرج الدواء من الآية إلى الدم بيكون
+
+377
+00:35:18,740 --> 00:35:24,660
+انتهى خلاص ود عليا الانتقال
+
+378
+00:35:24,660 --> 00:35:31,520
+يحدث مباشرة وضبط يعني بعد أن الدواء يعمل في الآية
+
+379
+00:35:31,520 --> 00:35:37,690
+تمام يبدأ يطلعفي اللي هو الأوردة خارج العين، which
+
+380
+00:35:37,690 --> 00:35:40,970
+can be considered a large reservoir that can
+
+381
+00:35:40,970 --> 00:35:44,350
+dilute the drug concentration in plasma below the
+
+382
+00:35:44,350 --> 00:35:47,050
+therapeutic، اللي هو الـ atrial.يعني بيقول الدوائل
+
+383
+00:35:47,050 --> 00:35:52,210
+خارج من العين عشان يطلع إلى الدم، هيكون يعني
+
+384
+00:35:52,210 --> 00:35:57,050
+تركيزه قليل جدا بالنسبالي الدم.لو كبر في رابطك
+
+385
+00:35:57,050 --> 00:36:02,650
+.يعني إحنا ما نعتبرش أنه دواء العين، أنه فيه خطر
+
+386
+00:36:03,460 --> 00:36:08,360
+يعني محدد على الجسم وإن كان احنا في الأطفال الصغار
+
+387
+00:36:08,360 --> 00:36:12,120
+مثلا قطة الأتروبين لو تعدد من خافي شوية على
+
+388
+00:36:12,120 --> 00:36:16,640
+الأطفال اللي هم ال low weight، body weight، أه لكن
+
+389
+00:36:16,640 --> 00:36:19,620
+على الامام القطة العادية ال antibiotic خاصة نحطها
+
+390
+00:36:19,620 --> 00:36:23,340
+في العين احنا ماخافين تصل في الدم إلى مستوى علاجي
+
+391
+00:36:23,340 --> 00:36:28,070
+وعلى يعني إشي في الجسم يعنيلأن الدواء اللي هو طلع
+
+392
+00:36:28,070 --> 00:36:32,410
+من العين بكل هو صار لو متابوليزم انتهى و هو طالع
+
+393
+00:36:32,410 --> 00:36:37,650
+للدم عشان بس يروح الكلة و يخرج من الجسم تماما طيب
+
+394
+00:36:37,650 --> 00:36:44,490
+هنتكلم على ال barriers to the entry of drugs into
+
+395
+00:36:44,490 --> 00:36:51,570
+the eye يعني احنا إذا نوضع الدواء في العين فيه خمس
+
+396
+00:36:51,570 --> 00:36:57,700
+حواهل بينه و بينه مصورةأول حاجة كونهاليبيثيليام
+
+397
+00:36:57,700 --> 00:37:01,820
+تعرفين كونهاليبيثيليام من خمس طبقات والآن صارت ست
+
+398
+00:37:01,820 --> 00:37:07,040
+طبقات خمس طبقات أولها اللي هو الكونهاليبيثيليام
+
+399
+00:37:07,040 --> 00:37:11,540
+الكونهاليبيثيليام restricts يعني يحدد أو يقلل the
+
+400
+00:37:11,540 --> 00:37:15,220
+entry of water soluble drugs into the colon and up
+
+401
+00:37:15,220 --> 00:37:19,400
+your stomach يعني هذا الدواء اللي هو البيثيليام
+
+402
+00:37:19,400 --> 00:37:24,560
+يقلل اللي هو دخول الأدوية التي تدوب في الماء إلى
+
+403
+00:37:24,560 --> 00:37:30,160
+داخل القرنيةالغطاء محطم وممكن اختراقه وانتقال عليه
+
+404
+00:37:50,530 --> 00:37:54,250
+بقول it is bypassed by subconjunctival injection
+
+405
+00:37:54,250 --> 00:37:58,190
+يعني لما احنا مثلا عندنا دواء مائي زي مثلا جلتا
+
+406
+00:37:58,190 --> 00:38:01,710
+مايسين مضاد حيوسم الجلتا مايسين لو قطرنا قطرة
+
+407
+00:38:01,710 --> 00:38:05,490
+هيكون ضايق ايش بنعمل؟ في بعض الناس خاصة بعض
+
+408
+00:38:05,490 --> 00:38:08,470
+العمليات الجراحية في العين بيدي في سرنج صغير
+
+409
+00:38:08,470 --> 00:38:12,550
+وبيحيطنه تحت الملتحمة تحت الملتحمة subconjunctival
+
+410
+00:38:12,550 --> 00:38:14,390
+تحت الملتحمة subconjunctival تحت الملتحمة لأ هذا
+
+411
+00:38:14,390 --> 00:38:17,850
+على طول بيعمل bypass للابيثيليام و بدخل جوا ال
+
+412
+00:38:17,850 --> 00:38:23,300
+aqueousأو إضافة الدراجة إلى مبادرة الليبيد أو إن
+
+413
+00:38:23,300 --> 00:38:28,340
+هو الدراجة اللي أخدته في وسط دهني عشان يخترق
+
+414
+00:38:28,340 --> 00:38:31,640
+الحائن الأول أو الحاجز الأول اللي هو الـ corneal
+
+415
+00:38:31,640 --> 00:38:35,400
+epithelium الحائن الثاني الكنجرتايبا والسكلييرا
+
+416
+00:38:35,400 --> 00:38:40,760
+الكنجرتايبا والسكلييرا طيب إذا قررنا الكنجرتايبا
+
+417
+00:38:40,760 --> 00:38:44,260
+والسكلييرا مين أكبر في ال surface area؟ ال surface
+
+418
+00:38:44,260 --> 00:38:48,780
+area طبعا السكلييرا والكنجرتايبا أوسعيبقى كمبيوتر
+
+419
+00:38:48,780 --> 00:38:51,600
+كورينا الكنجرة الطيبة و ال .. اللي هو أنتيو سكليرة
+
+420
+00:38:51,600 --> 00:38:54,760
+لديها مجموعة أكتر من المنطقة السفسية و هم أكتر
+
+421
+00:38:54,760 --> 00:38:58,040
+مستعملين لدواء ماء و سوليو بولتركز يعني دواء مائي
+
+422
+00:38:58,040 --> 00:39:02,320
+.. دواء مائي زي ال .. ال أنتيو بولتركز اه بي ..
+
+423
+00:39:02,320 --> 00:39:06,560
+يعني ممكن ينفص ماء المن .. اللي هو ال .. ال .. ال
+
+424
+00:39:06,560 --> 00:39:07,100
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+425
+00:39:07,100 --> 00:39:09,160
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+426
+00:39:09,160 --> 00:39:09,780
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+427
+00:39:09,780 --> 00:39:10,360
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+428
+00:39:10,360 --> 00:39:15,900
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+429
+00:39:15,900 --> 00:39:20,070
+الThe fraction of drugs available for Korean
+
+430
+00:39:20,070 --> 00:39:23,010
+absorption هو للأسف الملتحمة هذه اللي شايفينها
+
+431
+00:39:23,010 --> 00:39:26,550
+الـPsychoderma ملتحمة اللي فيها الvisage هذي هي
+
+432
+00:39:26,550 --> 00:39:31,030
+بتاخد وتودّي على التمام تاخدش تودّي ع العين جوا،
+
+433
+00:39:31,030 --> 00:39:34,330
+ليه بتودّي عليها؟ هي هذي لأن جزء الـPsychoderma
+
+434
+00:39:34,330 --> 00:39:38,170
+ملتحمة سميت ملتحمة لانها التحم بسرعة لكثرة ما فيها
+
+435
+00:39:38,170 --> 00:39:42,330
+من الأويات ده. فمثلا احنا بحط القطرات يعني هي
+
+436
+00:39:42,330 --> 00:39:43,750
+بتودّي تلت في العين
+
+437
+00:39:55,010 --> 00:39:59,250
+وانا واضح جدا في يعني هذا الشكل واضح جدا يا بناتي
+
+438
+00:39:59,250 --> 00:40:07,430
+ان ال ال ال lens و ال zonule عاملين في افرادهم
+
+439
+00:40:07,430 --> 00:40:11,890
+حجاب حاجز بين ال posterior chamber و ال anterior
+
+440
+00:40:11,890 --> 00:40:13,830
+chamber من ناحية و بين ال
+
+441
+00:40:22,930 --> 00:40:27,070
+وصل إلى الـ Lens وإلى الـ Zonule بيقول له stop مش
+
+442
+00:40:27,070 --> 00:40:32,810
+هيوصل للـ Petrius يعني حاجز حائل بقى اسمه barrier
+
+443
+00:40:32,810 --> 00:40:36,550
+يبقى ال lens and zonule الناس بيسموه aqueous
+
+444
+00:40:36,550 --> 00:40:40,490
+petrius barrier ليه؟ لأن بين ال aqueous أمام وبين
+
+445
+00:40:40,490 --> 00:40:44,350
+ال petrius ورا bulk flow of aqueous humor from the
+
+446
+00:40:44,350 --> 00:40:48,770
+eye and the presence of an intact lens and zonules
+
+447
+00:40:48,770 --> 00:40:49,410
+retard
+
+448
+00:40:58,740 --> 00:41:03,200
+العين ليست سهل تحط الجاطر على قصة الشبكية، لأ، في
+
+449
+00:41:03,200 --> 00:41:07,700
+حوائز من أمام اليمتيليام، ثم كنا نختار الهسكريا
+
+450
+00:41:07,700 --> 00:41:12,460
+والاتنين، ثم الليلز والزونيول، حانشوف الآن blood
+
+451
+00:41:12,460 --> 00:41:16,260
+aqueous barrier، الحقيقة blood aqueous barrier و
+
+452
+00:41:16,260 --> 00:41:19,340
+blood retinal barrier
+
+453
+00:41:29,000 --> 00:41:34,720
+الان هاي مثلا ال iris وهي ال cornea وهي ال iris
+
+454
+00:41:34,720 --> 00:41:42,040
+وهي برق العين ال iris هذا طبعا فيه blood vessels
+
+455
+00:41:42,040 --> 00:41:52,900
+ده بلون أحمر انا عندي blood vessels صح؟ طيب الان
+
+456
+00:41:52,900 --> 00:41:54,780
+لو أخدنا علاج
+
+457
+00:42:01,610 --> 00:42:09,670
+الان ال IS الان هل سهل ان الدواء يخرج من هنا من
+
+458
+00:42:09,670 --> 00:42:18,150
+داخل ال vessel الى برهنا هنا؟ لأ مش سهل ليش؟ يقول
+
+459
+00:42:18,150 --> 00:42:23,370
+لي يعني هاي ال blood vessel مبطن بامدوثيليا
+
+460
+00:42:28,440 --> 00:42:32,060
+الان بيقوللي ان هالخلايا مافيش بينها ايش واسع
+
+461
+00:42:32,060 --> 00:42:37,400
+مافيها مكان مافيها مكان مافيها مكان الدوام هتبقى
+
+462
+00:42:37,400 --> 00:42:46,600
+هنا وهنا ال tissue بتاع ال ايش بتاع ال ايرس وجود
+
+463
+00:42:46,600 --> 00:42:54,220
+ال endothelial lining لل capillaries و ال lung
+
+464
+00:42:54,220 --> 00:42:59,380
+vessels مثلا في ال ايرسوالسيئ اللي بيقول أيه كمان؟
+
+465
+00:42:59,380 --> 00:43:05,780
+يمنع الدواء اللي ماشي في الدم من الخروج وبروغ
+
+466
+00:43:05,780 --> 00:43:11,600
+الأرض بتاعه في علاج ال iris، خيسيك؟ عشان ايه كتير
+
+467
+00:43:11,600 --> 00:43:19,540
+احنا كنا متكلم علىإن إعطاء الدواء بصورة قطرة أو
+
+468
+00:43:19,540 --> 00:43:25,440
+مرهم أو حقن في العين أفضل بكثير من إعطاءه بالفم أو
+
+469
+00:43:25,440 --> 00:43:30,700
+حقن في العضل مثلا أو في الوريدة لأن هنا في ما يمنع
+
+470
+00:43:30,700 --> 00:43:35,720
+حتى لو دخل ل blood disease of the eye ونفس ال
+
+471
+00:43:35,720 --> 00:43:39,860
+issue برضه فيها ال blood disease بتاعتها هنا سيمنع
+
+472
+00:43:39,860 --> 00:43:45,800
+استفادة العين من الدواء العامفهذه العين هي
+
+473
+00:43:45,800 --> 00:43:52,260
+component خاص تعطي الدواء فيها مباشرة أفضل بكتير
+
+474
+00:43:52,260 --> 00:43:59,640
+مناطقه عبر الفم أو عبر العضلة واضح؟ طيب blood
+
+475
+00:43:59,640 --> 00:44:03,380
+aqueous barrier فبقول يا دي يا دي يا ماذا بقى
+
+476
+00:44:03,380 --> 00:44:09,800
+الكلتشر؟ اه ال industrial cells limit تمنع او تقلل
+
+477
+00:44:09,800 --> 00:44:14,320
+entry into aqueous from blood or systemicTaken
+
+478
+00:44:14,320 --> 00:44:20,280
+drugs كده كمسولة مثلا الان انا جاي برغم هنا نفس
+
+479
+00:44:20,280 --> 00:44:26,220
+الحاجة كيف هنا يعني هاي ال blood vessel هاي ال
+
+480
+00:44:26,220 --> 00:44:33,120
+blood vessel كيف الدواء بيوافقوا هنا عشان يعالج
+
+481
+00:44:33,120 --> 00:44:38,300
+العيرز مثلا في هنا صعوبة طبعا الأدوية بتختلف
+
+482
+00:44:46,790 --> 00:44:50,090
+الـ blood retina البارية نفس الشيء، أيضًا لـ blood
+
+483
+00:44:50,090 --> 00:44:58,750
+vessels in retina أو in قراي، انتوا عارفين ان
+
+484
+00:44:58,750 --> 00:45:03,190
+رتina يعني من ورا بتبدأ بـretina بيجمع الـ
+
+485
+00:45:03,190 --> 00:45:06,150
+epithelium و بيجمع الـ epithelium هو الطلاق الأولى
+
+486
+00:45:06,150 --> 00:45:11,090
+من الشبكية، بينه وبين القراي، بحيرة الدم، شيء اسمه
+
+487
+00:45:11,090 --> 00:45:15,630
+proxy membrane، و الـ proxy membrane هذا ضرر كبير
+
+488
+00:45:16,380 --> 00:45:20,200
+يعني بيحدد دخول المواد النافعة من المواد الضارة
+
+489
+00:45:20,200 --> 00:45:24,640
+إلى داخل اللي هو الشبكية أيضا ال blood vessels
+
+490
+00:45:24,640 --> 00:45:27,940
+اللي بتيجي من ال central ventral artery انت عارفين
+
+491
+00:45:27,940 --> 00:45:32,900
+ال central ventral artery؟ هنا، هيه، بيدخل و بتفرع
+
+492
+00:45:32,900 --> 00:45:36,500
+في كل الشبكية، على سطح الشبكية، أيضا هذا ال
+
+493
+00:45:36,500 --> 00:45:40,400
+central ventral artery أيضا فيه endothelium بيبطنه
+
+494
+00:45:41,110 --> 00:45:44,630
+في فترة كل فروره وبالتالي لو في دوة داخل الارتري
+
+495
+00:45:44,630 --> 00:45:51,530
+او داخل فروره مش سهل انه يطلع لأنه في محددات وفي
+
+496
+00:45:51,530 --> 00:45:55,130
+ال .. ال .. ال .. اللي هو الوسع او الفجوات بين ال
+
+497
+00:45:55,130 --> 00:45:56,850
+endothelium هي فجوات
+
+498
+00:46:07,970 --> 00:46:11,030
+لما احنا بناخد ال drug هو دي ايه في الأهداف التي
+
+499
+00:46:11,030 --> 00:46:15,490
+احنا بناوها داخل العين شكرا لكم على حساس الاستماع
+
+500
+00:46:15,490 --> 00:46:17,290
+والسلام عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/aUnT5yLCp5U.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/aUnT5yLCp5U.srt
new file mode 100644
index 0000000000000000000000000000000000000000..b3d0f8ec3d27030a947b92e09653ac0b270ebf69
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/aUnT5yLCp5U.srt
@@ -0,0 +1,1864 @@
+1
+00:00:20,700 --> 00:00:22,720
+بسم الله الرحمن الرحيم الحمد لله رب العالمين و
+
+2
+00:00:22,720 --> 00:00:26,500
+أصلي و أسلم على نبي الأمين محمد و على أهله و 
+
+3
+00:00:26,500 --> 00:00:31,800
+أصحابه و أتباعه اليوم إن شاء الله سنكمل هذا الموضوع
+
+4
+00:00:31,800 --> 00:00:36,940
+الهام Anti-glucoma drugs Beta-blockers Beta-blockers
+
+5
+00:00:36,940 --> 00:00:43,380
+ويُضحك ناول الدواء الأخير اللي هو الدواء الهرموني 
+
+6
+00:00:51,590 --> 00:00:59,990
+هرمونية سحرية المفروض بتختلف عن سابقاتها بأنها 
+
+7
+00:00:59,990 --> 00:01:05,930
+تسهل the outflow of across the human بتأثرش على ال 
+
+8
+00:01:05,930 --> 00:01:12,150
+flow بتأثر على ال outflow و هنشوف احنا الطريقة و
+
+9
+00:01:12,150 --> 00:01:16,650
+هذا علاج سحري وغالب جدا ويعني إن شاء الله ربنا 
+
+10
+00:01:16,650 --> 00:01:21,210
+يعرف هنا لكن لازم نكون عند طلباتنا معلومة كويسة
+
+11
+00:01:26,480 --> 00:01:29,940
+بسم الله الرحمن الرحيم، اليوم إن شاء الله هنتكلم 
+
+12
+00:01:29,940 --> 00:01:32,420
+عن ال systemic adverse reaction of the carbon
+
+13
+00:01:32,420 --> 00:01:35,280
+monohydrate inhibitors carbonic carbonic
+
+14
+00:01:35,280 --> 00:01:38,020
+monohydrate inhibitors اللي بيتم تناولها orally
+
+15
+00:01:38,020 --> 00:01:41,460
+أول حاجة ويعملنا gastrointestinal tract irritation
+
+16
+00:01:41,460 --> 00:01:44,820
+in a form of nausea, vomiting and abdominal 
+
+17
+00:01:44,820 --> 00:01:48,350
+colitis هذا بيعملنا تهيج في ال gastro intestinal
+
+18
+00:01:48,350 --> 00:01:53,130
+tract إضافة إلى اللي بيعملنا غثيان وتقيؤ ومغص في 
+
+19
+00:01:53,130 --> 00:01:58,070
+البطن والأطراف Paraesthesia due to its effect on
+
+20
+00:01:58,070 --> 00:02:01,850
+the peripheral nerves بيصير في عندنا تخدير وتنميل و
+
+21
+00:02:01,850 --> 00:02:05,290
+فقدان جزء من الإحساس في الأعصاب الطرفية يعني في 
+
+22
+00:02:05,290 --> 00:02:10,350
+الأطراف العصبية، بعدين تالت حاجة دورز الأمد
+
+23
+00:02:10,350 --> 00:02:13,810
+binding to red blood cells may have a half life،
+
+24
+00:02:13,810 --> 00:02:19,430
+إيش يعني half life؟ في حد عارف؟ صحيح هو الفترة أو 
+
+25
+00:02:19,430 --> 00:02:23,290
+الوقت اللازم حتى يصل الدواء عندي لنصف الكمية 
+
+26
+00:02:23,290 --> 00:02:26,910
+تبعته، بيحكينا دورز الأمد اللي هو binding to red
+
+27
+00:02:26,910 --> 00:02:30,270
+blood cells اللي بيكون في علاقة مباشرة مع red 
+
+28
+00:02:30,270 --> 00:02:33,900
+blood cells بيكون نصف الحياة أو نصف العمر له
+
+29
+00:02:33,900 --> 00:02:37,800
+several months يعني العديد من الشهور prolongate 
+
+30
+00:02:37,800 --> 00:02:42,700
+action يعني فترة طويلة حتى يديني ال F7 ماشي الآن
+
+31
+00:02:42,700 --> 00:02:45,880
+أول فيلم اللي لها انه بينجو سينفو اوران
+
+32
+00:03:01,590 --> 00:03:08,310
+250 ملليجرام في اثنين أو 500 ملليجرام في اثنين اللي هو أو
+
+33
+00:03:08,310 --> 00:03:12,150
+sustain release كبسولة كبسولة في اليوم بناء على 
+
+34
+00:03:12,150 --> 00:03:17,510
+ضغط العين لكن عيبه واضح أنه بقشلة على نعدة ممنوعة
+
+35
+00:03:17,510 --> 00:03:21,910
+فيها بهيئة فارقة لذلك لازم يأخذ إيش فارقة فارقة 
+
+36
+00:03:21,910 --> 00:03:26,030
+والمهم أنه مامي باراستيزيا اللي واحد 
+
+37
+00:03:26,030 --> 00:03:29,970
+ياخده من تاني يوم يقول يا دكتور إيديا وإجليا
+
+38
+00:03:33,090 --> 00:03:41,270
+عشان إيه؟ احنا مقدرش نعطيه forever بأنه مفيد خاصة 
+
+39
+00:03:41,270 --> 00:03:46,730
+لو ضغط العين عالي لكن مش كويس أنه العيان بعد
+
+40
+00:03:46,730 --> 00:03:50,990
+شوية بيزيد مع الوضع كل دي relay يصير مقنّن منه
+
+41
+00:03:50,990 --> 00:03:55,030
+ياخده فمقدرش نعطيه أكثر من أسبوع أو أسبوعين بالكتير
+
+42
+00:03:55,030 --> 00:03:59,130
+في أسبوع أو أسبوعين لازم احنا نشوف حل أما نعمل قطرات
+
+43
+00:03:59,130 --> 00:04:04,510
+إضافية للقطرات أو نتعامل بأخرى هذا يكون فاهمينه
+
+44
+00:04:04,510 --> 00:04:08,150
+اللي هو ال carbon ion and risk inhibitor اللي هو
+
+45
+00:04:08,150 --> 00:04:09,710
+دورز الامين أو دورز الامين أو دورز الامين أو
+
+46
+00:04:09,710 --> 00:04:12,790
+دورز الامين أو دورز الامين أو دورز الامين أو
+
+47
+00:04:12,790 --> 00:04:12,870
+دورز الامين أو دورز الامين أو دورز الامين أو
+
+48
+00:04:12,870 --> 00:04:13,210
+دورز الامين أو دورز الامين أو دورز الامين أو
+
+49
+00:04:13,210 --> 00:04:13,590
+دورز الامين أو دورز الامين أو دورز الامين أو
+
+50
+00:04:13,590 --> 00:04:14,150
+دورز الامين أو دورز الامين أو دورز الامين أو
+
+51
+00:04:14,150 --> 00:04:17,270
+دورز الامين أو دورز الامين أو دورز الامين أو
+
+52
+00:04:17,270 --> 00:04:24,590
+دورز الامين أو دورز الامين أو دورز الامين أو
+
+53
+00:04:24,590 --> 00:04:29,810
+دورز الامين 
+
+54
+00:04:29,810 --> 00:04:34,200
+أو نيجي نحكي عن indications of topical acetylsol
+
+55
+00:04:34,200 --> 00:04:37,900
+amide إيش الدوافع اللي بتدفع لاستخدام acetylsol
+
+56
+00:04:37,900 --> 00:04:40,460
+amide أول حاجة Dorzolamide is indicated 
+
+57
+00:04:40,460 --> 00:04:45,840
+for acute or chronically Dorzolamide is
+
+58
+00:04:45,840 --> 00:04:48,620
+indicated to treat acute or chronically lowering
+
+59
+00:04:48,620 --> 00:04:51,700
+lower intraocular pressure in patients with open or
+
+60
+00:04:51,700 --> 00:04:55,040
+closed angle يعني أنا بستخدمه في الحالات لما يكون 
+
+61
+00:04:55,040 --> 00:04:58,540
+في عندي acute or chronic glaucoma وفي الأشخاص اللي 
+
+62
+00:04:58,540 --> 00:05:01,620
+بيكون عندهم open or closed angle glaucoma and
+
+63
+00:05:01,620 --> 00:05:04,900
+patients at risk for elevated pressures يعني
+
+64
+00:05:04,900 --> 00:05:09,060
+والأشخاص اللي في خطر التعرض لزيادة
+
+65
+00:05:09,060 --> 00:05:12,240
+في الضغط أنا بستخدم الدورز أو أي ماني مين هم .. 
+
+66
+00:05:12,240 --> 00:05:17,420
+مين هم الأشخاص اللي عندهم احتمالية ارتفاع العين
+
+67
+00:05:17,420 --> 00:05:22,220
+هيفروا..هيفروا المرض أو هيفروا المجلد؟ أو هيفروا 
+
+68
+00:05:22,220 --> 00:05:23,840
+المجلد؟ أو هيفروا المجلد؟ أو هيفروا المجلد؟ أو هيفروا
+
+69
+00:05:23,840 --> 00:05:26,050
+المجلد؟ أو هيفروا المجلد؟ أو الناس اللي بياخدوا
+
+70
+00:05:26,050 --> 00:05:33,230
+كورتيزونات يعني هو long term و ال secondary glaucoma
+
+71
+00:05:33,230 --> 00:05:39,110
+التانية اللي تعرفوها تمثل حاجة Dorzolamide drops
+
+72
+00:05:39,110 --> 00:05:41,570
+produce much of intraocular pressure lowering 
+
+73
+00:05:41,570 --> 00:05:44,170
+effect while eliminating most of the systemic
+
+74
+00:05:44,170 --> 00:05:48,230
+tolerability problems seen with tablets or on
+
+75
+00:05:48,230 --> 00:05:53,190
+carbonic anhydrase inhibitors برضه ال Dorzolamide 
+
+76
+00:05:53,190 --> 00:05:56,470
+بستخدمه في حالات اللي بيكون فيها زيادة عالية في ال 
+
+77
+00:05:56,470 --> 00:05:59,790
+intraocular pressure وأنا محتاجة تخفيضه في حال 
+
+78
+00:05:59,790 --> 00:06:04,130
+استخدمته بيحكي إنه ما بيأثر أو يقلل من التأثير على 
+
+79
+00:06:04,130 --> 00:06:07,810
+الجسم بشكل عام بالمقارنة مع ال oral carbonic 
+
+80
+00:06:07,810 --> 00:06:14,130
+anhydrase inhibitors يعني هو الكلام الآن إنه أنا 
+
+81
+00:06:14,130 --> 00:06:20,810
+بستخدم القطرة في حين أنا بكون ساهبة أو بصحب ال oral
+
+82
+00:06:21,390 --> 00:06:29,730
+أقراص القطرة كانت بتقنع الأقراص وبتنجي المريض من 
+
+83
+00:06:29,730 --> 00:06:34,630
+ال systemic effects اللي قلنا عنها يعني اللي 
+
+84
+00:06:34,630 --> 00:06:39,490
+باخد قطرة ما أصرش معاه اللي هو systemic effects في
+
+85
+00:06:39,490 --> 00:06:44,830
+الحقيقة أخد القطرة وساب الأقراص.  التالية as the 
+
+86
+00:06:44,830 --> 00:06:49,030
+risk of idiosyncratic blood dyscrasias have faded
+
+87
+00:06:49,030 --> 00:06:52,270
+يعني المخاطر أو الاختلالات اللي بتكون موجودة في
+
+88
+00:06:52,270 --> 00:06:55,430
+الدم أنا بقدر أنه أتلّشها أو أتغلب عليها ال
+
+89
+00:06:55,430 --> 00:06:59,090
+idiosyncratic هي mistaken ايدوباثيكية اختلاّلات 
+
+90
+00:06:59,090 --> 00:07:02,710
+بتكون موجودة مش معروفة الأسباب نتيجة التناول في
+
+91
+00:07:02,710 --> 00:07:06,490
+الغالب يكون إعطاء دواء جديد للإنسان typical Dorzolamide
+
+92
+00:07:06,490 --> 00:07:10,810
+and prostaglandin 
+
+93
+00:07:13,680 --> 00:07:17,180
+Prostaglandin analogs have replaced miotics
+
+94
+00:07:17,180 --> 00:07:20,840
+يعني تبدلوا ال miotics بالدورز الامين وبال Prostaglandin 
+
+95
+00:07:20,840 --> 00:07:25,240
+analogs لأنه التأثير أفضل والناس اللي 
+
+96
+00:07:25,240 --> 00:07:28,200
+كانوا بيفضلوا أكثر من الدورز الامين .. مش ال .. مش 
+
+97
+00:07:28,200 --> 00:07:28,740
+ال .. مش ال .. مش ال .. مش ال .. مش ال .. مش ال .. مش ال
+
+98
+00:07:28,740 --> 00:07:30,260
+.. مش ال .. مش ال .. مش ال .. مش ال .. مش ال .. مش ال
+
+99
+00:07:30,260 --> 00:07:30,500
+.. مش ال .. مش ال .. مش ال .. مش ال .. مش ال .. مش ال
+
+100
+00:07:30,500 --> 00:07:33,460
+.. مش ال .. مش ال .. مش ال .. مش ال .. مش ال ..
+
+101
+00:07:55,690 --> 00:07:59,570
+الخط الثاني في الأدوية اللي بتستخدم فيها ال beta
+
+102
+00:07:59,570 --> 00:08:05,940
+blockers لتانوبروست بصراحة أجنبي دين على لوجاس recently 
+
+103
+00:08:05,940 --> 00:08:10,400
+detected يعني هو تم اكتشافه مؤخرًا لتانوبروست is a
+
+104
+00:08:10,400 --> 00:08:13,360
+powerful ocular hypertensive agent بتاع اللوجس 
+
+105
+00:08:21,860 --> 00:08:26,240
+هو بيحكي لي هو بيخاف ضغط العين بشكل قوي بيعني 
+
+106
+00:08:26,240 --> 00:08:31,120
+تأثيره على الجسم بيكون قليل نوعًا ما  أوثر ده
+
+107
+00:08:31,120 --> 00:08:35,240
+دردميتشينز آيرس كالر ممكن يغير في لون الآيرس عنده
+
+108
+00:08:35,240 --> 00:08:38,360
+بيغير 
+
+109
+00:08:38,360 --> 00:08:45,340
+اللون بيخليه dark وهذا شيء عند الناس خوف لما
+
+110
+00:08:45,340 --> 00:08:52,070
+واحد يكون يعني عنده light iris color أزرق، أخضر،
+
+111
+00:08:52,070 --> 00:08:56,070
+عصري فارق يصير أسود طبيعًا واحد الناس عارفيله
+
+112
+00:08:56,070 --> 00:09:01,110
+أنه هيقللوا العين، لما يصير القطرة سوداء يعني
+
+113
+00:09:01,110 --> 00:09:06,300
+بيقولك مثلًا صار في شيء، طار.  Aggravating steroid 
+
+114
+00:09:06,300 --> 00:09:09,620
+macular edema هي بيصير كأنها في ال macula بيصير في
+
+115
+00:09:09,620 --> 00:09:12,680
+swelling أو وذمة وعلى شكل أكياس بتكون عنيفة
+
+116
+00:09:12,680 --> 00:09:16,360
+وشديدة مش كبيرة كتير عند المرضى and induce herpes
+
+117
+00:09:16,360 --> 00:09:20,120
+simplex keratitis التهاب القرنية على شكل herpes
+
+118
+00:09:20,120 --> 00:09:23,680
+simplex لتانوبروست used to treat glaucoma has 
+
+119
+00:09:23,680 --> 00:09:25,860
+grown rapidly over the past several years
+
+120
+00:09:25,860 --> 00:09:30,940
+الاستخدام لتانوبروست لعلاج ال glaucoma تطور أو 
+
+121
+00:09:30,940 --> 00:09:34,410
+نما في الفترة الأخيرة في السنوات الأخيرة بشكل كبير
+
+122
+00:09:34,410 --> 00:09:38,010
+أو بشكل كبير and it's now biased with non selective
+
+123
+00:09:38,010 --> 00:09:41,350
+beta blockers as a first line يعني هو الآن ينافس 
+
+124
+00:09:41,350 --> 00:09:45,690
+ال beta blockers non selective B1 وB2 كخط أولي في 
+
+125
+00:09:45,690 --> 00:09:49,570
+العلاج شايفين كده؟ يعني احنا بعد ما رحلنا على ال
+
+126
+00:09:49,570 --> 00:09:53,890
+bio-carbine رحلنا على ال beta blockers ال beta
+
+127
+00:09:53,890 --> 00:09:57,350
+blockers كانت بالنسبة لل bio-carbine قفزة كبيرة
+
+128
+00:09:57,350 --> 00:10:03,490
+يعني زي نقولك زي إيه؟ القاطرة كانت تمشي على الفحم و
+
+129
+00:10:03,490 --> 00:10:07,590
+بصرت تمشي على الديزل، جدّيش الفرق بين الفحم الحجري
+
+130
+00:10:07,590 --> 00:10:14,210
+وبين ال .. اللي هو ال solar قفزة كبيرة، الآن لما 
+
+131
+00:10:14,210 --> 00:10:18,630
+اجى اللاتنة crossed هذا ال harmony كأنه القطار
+
+132
+00:10:18,630 --> 00:10:24,110
+تمشي على الكهرباء، تمشي على الكهرباء ولا ديزل، عشان 
+
+133
+00:10:24,110 --> 00:10:27,870
+كده، قال الله عز وجل ويخلق ما لا تعلمه، دي كل
+
+134
+00:10:27,870 --> 00:10:32,500
+شيء، فعالم الإنسان ما له يعني ..يعني مين كان متصور أن
+
+135
+00:10:32,500 --> 00:10:37,960
+من الهرمونات تتطور الأمور إلى قطرة في العين فيها 
+
+136
+00:10:37,960 --> 00:10:43,080
+خمسة من الألف في التركيز لتجيب نتيجة أحسن من 
+
+137
+00:10:43,080 --> 00:10:48,340
+القطرات الحقيقة أن هذه قفزة للإنسانية لأن أجمل 
+
+138
+00:10:48,340 --> 00:10:54,620
+الإنسانية لما هي بتستخدم العلم والأموال في 
+
+139
+00:10:54,620 --> 00:10:58,120
+العلاج والخير ولا بتستخدمه في التدمير ولا
+
+140
+00:10:58,120 --> 00:11:02,670
+بتستخدمه في سرقة المال. أكثر الحياة هذه لصالح 
+
+141
+00:11:02,670 --> 00:11:06,610
+الإنسانية كويسة كتير أحسن كتير من الحروب ومن القصف 
+
+142
+00:11:06,610 --> 00:11:12,590
+ومن القتل و.. آه هي في عندنا أمثلة على ال ..
+
+143
+00:11:12,590 --> 00:11:18,230
+إيه زلتان؟ زلتان هو هذا اللي كان و نفسه تافين؟ في 
+
+144
+00:11:18,230 --> 00:11:24,510
+عندنا drugs منه أشكال مختلفة في نفس الشركة تانية 
+
+145
+00:11:24,510 --> 00:11:30,180
+بس بتصنعه اسم لوميجان لو ميجان تريد نام اه اه تريد 
+
+146
+00:11:30,180 --> 00:11:35,940
+نام لكن كله الآخر لتنبرس جدّاش خمسة من جدّاش؟ آه
+
+147
+00:11:35,940 --> 00:11:37,180
+خمسة من الألف
+
+148
+00:11:41,100 --> 00:11:44,920
+لتانوبروست أو زلتان  إنه يوانز لتانوبروست does not
+
+149
+00:11:44,920 --> 00:11:48,860
+affect aqueous flow and shows either no effect or
+
+150
+00:11:48,860 --> 00:11:52,560
+or slight increase in the conventional out of flow
+
+151
+00:11:52,560 --> 00:11:56,140
+facility يعني هنا بيحكي إن هو ما بيأثر على تدفق ال
+
+152
+00:11:56,140 --> 00:12:00,680
+aqueous أو بيأثر بشكل بسيط بيزيد بشكل بسيط تسهيل 
+
+153
+00:12:00,680 --> 00:12:05,040
+عملية التدفق اللي ال aqueous لأ هو يعني أنا بقول
+
+154
+00:12:05,040 --> 00:12:09,500
+بمفهوم هنا no effect 
+
+155
+00:12:12,230 --> 00:12:19,410
+انفلو يعني هو التصنيع على انفلو يعني
+
+156
+00:12:19,410 --> 00:12:26,650
+هو عكس اللي هو ال beta blockers وعكس ال carbonic 
+
+157
+00:12:26,650 --> 00:12:30,470
+anhydrase انفلو هذه بتشتغل عن طريق التأثير على 
+
+158
+00:12:30,470 --> 00:12:33,530
+تصنيع ال
+
+159
+00:12:38,720 --> 00:12:44,480
+لأ هذا بيقولي ولا بيأثر على التلفاز مشهور، ولا
+
+160
+00:12:44,480 --> 00:12:48,300
+بيأثر
+
+161
+00:12:48,300 --> 00:12:52,100
+على اليوبيوسكليرا ال outflow، إيش يعني 
+
+162
+00:12:52,100 --> 00:12:56,780
+يوبيوسكليرا؟
+
+163
+00:12:56,780 --> 00:13:06,150
+يعني ال ciliary body و ال iris بصيفة مثل قبو بس
+
+164
+00:13:06,150 --> 00:13:14,390
+وما ذا هي أنه اللي هو هذا الدواء بيفتح للأقواس منافذ 
+
+165
+00:13:14,390 --> 00:13:22,130
+عشان ينزل دق العين في الساحة يعني هتشوفوا إنه كما 
+
+166
+00:13:22,130 --> 00:13:26,190
+شوية في برش أكبر إنه في ثقوب معينة تحدث في السينية 
+
+167
+00:13:26,190 --> 00:13:31,550
+اليهودية والآيرس عبرها بيخرج الأقواس من
+
+168
+00:13:31,550 --> 00:13:32,450
+خارج العين 
+
+169
+00:13:38,890 --> 00:13:43,150
+مش زي ما يعمل ال bio-carbine ال bio-carbine بيعمل 
+
+170
+00:13:43,150 --> 00:13:50,870
+فتح ال AC angle لكن هنا لأ بيحاول يعمل ثقوب في ال
+
+171
+00:13:50,870 --> 00:13:56,630
+وبيا  ال tract وشوية فسكليرة حتى ينفذ بعض ال
+
+172
+00:13:56,630 --> 00:14:01,590
+aqueous وينزل بعض ال aqueous بحكينا عن استخدام تقنية 
+
+173
+00:14:01,590 --> 00:14:05,930
+فلورو فوتوماتريك مين بيعرف إيش الفلورو فوتوماتريك
+
+174
+00:14:05,930 --> 00:14:11,120
+تقنية؟ أنا على هوا مباحثة وجدت أنها عبارة عن تقنية
+
+175
+00:14:11,120 --> 00:14:15,500
+بيستخدموا فيها قياس المعدل تبع ال aqueous humor في 
+
+176
+00:14:15,500 --> 00:14:18,460
+العين من خلال ال fluorescein وهذا بتكون manual أو
+
+177
+00:14:18,460 --> 00:14:22,400
+من جهاز اسمه photometer بيتم إضافة ال fluorescein 
+
+178
+00:14:22,400 --> 00:14:25,640
+للعين وبيتم تبعّته من خمس أو ست أو ثمان ساعات و
+
+179
+00:14:25,640 --> 00:14:28,700
+بيشوفوا مدى انخفاض في التركيز تبع ال aqueous في 
+
+1
+
+216
+00:16:55,990 --> 00:17:01,230
+up to one month على الذين 
+
+217
+00:17:01,230 --> 00:17:05,970
+عندهم ضغط طبيعي كان تركيز الدواء خمسة من ألف و
+
+218
+00:17:05,970 --> 00:17:09,530
+أخذوه مرة أو مرتين في اليوم لمدة شهر وكانت
+
+219
+00:17:09,530 --> 00:17:13,710
+النتيجة أن reduction in IOP من عشرين إلى أربعين was
+
+220
+00:17:13,710 --> 00:17:18,080
+not as long as twenty-four hours after dosing كان 
+
+221
+00:17:18,080 --> 00:17:22,580
+الخطوط في ال IOP من عشرين إلى أربعين خلال بعد ما أخذ
+
+222
+00:17:22,580 --> 00:17:24,140
+الجرعة بعد أربع وعشرين ساعة
+
+223
+00:17:27,840 --> 00:17:30,760
+لِتانوبرست خمسة من ألف once daily has since been
+
+224
+00:17:30,760 --> 00:17:34,420
+compared with تناول نصف مليون twice daily in three
+
+225
+00:17:34,420 --> 00:17:37,140
+studies performed in the United States, the United Kingdom
+
+226
+00:17:37,140 --> 00:17:41,280
+and Scandinavia في ثلاث دول عملت مقارنة بين
+
+227
+00:17:41,280 --> 00:17:45,000
+لِتانوبرست خمسة من ألف وكانوا بياخدوها مرة واحدة
+
+228
+00:17:45,000 --> 00:17:48,920
+باليوم والتماول نصف مليون كانوا بياخدوها مرتين
+
+229
+00:17:48,920 --> 00:17:54,600
+باليوم آه النتيجة النتيجة كان فيها إن باختصار
+
+230
+00:17:54,600 --> 00:17:58,440
+بالأول أن two of these studies based conduction in 
+
+231
+00:17:58,440 --> 00:18:01,220
+the United States and Scandinavia found as
+
+232
+00:18:01,220 --> 00:18:06,920
+...substantial يعني  صغرية a greater efficacy was
+
+233
+00:18:06,920 --> 00:18:10,700
+lethanobrast than timolol لدواء اختلاف أنه
+
+234
+00:18:10,700 --> 00:18:14,880
+التأثير تبع lethanobrast أكبر من تأثير timolol
+
+235
+00:18:14,880 --> 00:18:17,500
+whereas the United Kingdom study found similar
+
+236
+00:18:17,500 --> 00:18:21,950
+results with the two agents لأ the United Kingdom
+
+237
+00:18:21,950 --> 00:18:27,050
+النتيجة أنه التأثير لدولتين متساوي مش يعني إن ليه 
+
+238
+00:18:27,050 --> 00:18:31,350
+بيقول ال team world أحسن لأ لأن ال team world 
+
+239
+00:18:31,350 --> 00:18:36,110
+بيساوي ولاتر برست يبقى النتيجة هاد ما هيّاش في ال
+
+240
+00:18:36,110 --> 00:18:40,030
+United States واسكندرالفيا كانت التفوق لمين؟ لأ
+
+241
+00:18:40,030 --> 00:18:41,610
+لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ
+
+242
+00:18:41,610 --> 00:18:43,490
+لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ
+
+243
+00:18:43,490 --> 00:18:44,670
+لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ
+
+244
+00:18:44,670 --> 00:18:46,570
+لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ
+
+245
+00:18:56,360 --> 00:19:00,100
+الثلاث دول اتفقوا أن لِتانوبرست كانت النتيجة اللي 
+
+246
+00:19:00,100 --> 00:19:04,120
+بيخفف من ال IOP من 25 إلى 30 من الضغط الطبيعي لو من
+
+247
+00:19:04,120 --> 00:19:05,200
+10 إلى 20
+
+248
+00:19:22,180 --> 00:19:26,700
+لو نحب الموضوع وبنفس الحالة ضغط الدم نزل 100% ضغط 
+
+249
+00:19:26,700 --> 00:19:32,200
+العين نزل 100% لأن العين سرق كلها يعني فيه بنزل 10
+
+250
+00:19:32,200 --> 00:19:38,360
+% 15% 20% اللي بنزل 30% وفوق كتير يعني كويس يعني 
+
+251
+00:19:38,360 --> 00:19:47,360
+لو ضغط العين 30% ونزل 30% يبقى قريب منها ال 20 شيء
+
+252
+00:19:47,360 --> 00:19:52,380
+كويس يعني لِتناوبرست لِتانوبرست has been studied
+
+253
+00:19:52,380 --> 00:19:56,220
+in several glaucoma subtypes، كان لِتانوبرست بتاع
+
+254
+00:19:56,220 --> 00:19:59,360
+بيعالج جميع أنواع الجلاكوما، الأكويد
+
+255
+00:19:59,360 --> 00:20:02,620
+والكونجينيتر، جميع أنواعها one study found 
+
+256
+00:20:02,620 --> 00:20:05,320
+Latana Prost more effective than terminal chronic
+
+257
+00:20:05,320 --> 00:20:09,020
+angioplasmic glaucoma كان هو أفضل أكتر في علاج
+
+258
+00:20:09,020 --> 00:20:15,080
+الأنغلوساكسون ال glaucoma هو أكتر خطورة من أكتر أنواع
+
+259
+00:20:15,080 --> 00:20:18,000
+ال glaucoma لأنه بيدي إلى blindness من غير ما يشعر
+
+260
+00:20:18,000 --> 00:20:23,120
+الأنغلوساكسون آه آه يعني ال beta blocker مابتدش فيه 
+
+261
+00:20:31,510 --> 00:20:38,830
+واللي فرق رسمي لأنه زود ال auto flow زود ال auto
+
+262
+00:20:38,830 --> 00:20:44,150
+flow فاشتغل صح آه another found effect تكتب من
+
+263
+00:20:44,150 --> 00:20:46,890
+اللي هو I interact with pressure and steroid
+
+264
+00:20:46,890 --> 00:20:49,990
+induced glaucoma لأن هو بيصلح جميع أنواع ال
+
+265
+00:20:49,990 --> 00:20:52,930
+glaucoma كمان بيصلح ال glaucoma الناتجة عن ال
+
+266
+00:20:52,930 --> 00:20:53,470
+steroid
+
+267
+00:21:10,300 --> 00:21:15,480
+فهنا عند بعض الناس اسمه steroid responders يعني في 
+
+268
+00:21:15,480 --> 00:21:19,800
+ناس تأثروا بكورتيزون يعني أكتر من ناس
+
+269
+00:21:19,800 --> 00:21:24,620
+عشان هيك إذا ما نعطي كورتيزون في بعض الناس اللي
+
+270
+00:21:24,620 --> 00:21:28,040
+يعملوا كورتيزون يعني لها systemic disease systemic 
+
+271
+00:21:28,040 --> 00:21:32,640
+disease فاحنا لازم نفضل نعمل check up لإيش؟
+
+272
+00:21:32,640 --> 00:21:40,040
+pressure وإلا بيروح العصب وبيعمق ومش داري يظهرني 
+
+273
+00:21:40,040 --> 00:21:44,100
+حاجات إن لو ضغط إنه بدأ يطلع ال Latana Prost سحري
+
+274
+00:21:44,100 --> 00:21:49,280
+الموضوع عشان السترويد الديوستيكلوكوما آه I went
+
+275
+00:21:49,280 --> 00:21:53,600
+near compression of Latana Prost vermins timolol and
+
+276
+00:21:53,600 --> 00:21:57,360
+pigmentary glaucoma found a better IOP reduction in 
+
+277
+00:21:57,360 --> 00:22:00,780
+the Latana Prost stage liasis ال pigmentary glaucoma
+
+278
+00:22:00,780 --> 00:22:07,080
+بتعمل gradual change in iris color بتتأثر ... نهدى 
+
+279
+00:22:07,080 --> 00:22:08,700
+يعني إيش هي ال pigmentary glaucoma؟ 
+
+280
+00:22:13,660 --> 00:22:20,360
+Iris Dispersion Syndrome Dispersion يعني الميلانين
+
+281
+00:22:20,360 --> 00:22:25,640
+بتاع ال iris كل شوية بتتقشر وبيروح بسلسلة وين؟
+
+282
+00:22:25,640 --> 00:22:29,760
+بالأنجل، بتحسب الأنجل، لأن عيون الأنجل بتاعة 
+
+283
+00:22:29,760 --> 00:22:35,740
+الترابيكمش هو لا تسمح لإيه؟ بالميلانين يمرّوا، يعني
+
+284
+00:22:35,740 --> 00:22:41,770
+هذا الموليكول بتاع ال ... اللي هو الميلانين أكبر 
+
+285
+00:22:41,770 --> 00:22:48,610
+حجمه من ال ... اللي هو إيش ثقوب هذة فبيصيروا إيش 
+
+286
+00:22:48,610 --> 00:22:56,810
+carving من حشر بسكت ثقوب لما يبقوا هنا يعني صعب 
+
+287
+00:22:56,810 --> 00:23:00,890
+نتصرف إلا نستخدم اللوزة هذة يزيد ال out of law
+
+288
+00:23:00,890 --> 00:23:04,790
+البديل إذا كان ال out of law بتاع ال angel سكة
+
+289
+00:23:04,790 --> 00:23:06,290
+فبنا out of law بديل
+
+290
+00:23:11,900 --> 00:23:14,660
+several studies of Latana Prost efficacy in child
+
+291
+00:23:14,660 --> 00:23:19,840
+born glaucoma have been published انتشرت
+
+292
+00:23:19,840 --> 00:23:25,420
+في العام الأخير الدراسات عن تأثير ال Latana Prost
+
+293
+00:23:25,420 --> 00:23:28,340
+على الأخوة اللي عندهم glaucoma اللي كنتوا تلاقوا 
+
+294
+00:23:28,340 --> 00:23:33,940
+glaucoma شوفتوها تبقى تلبّوا في الطّابّس these 
+
+295
+00:23:33,940 --> 00:23:36,960
+are reported by the researchers of Latana Prost 
+
+296
+00:23:36,960 --> 00:23:41,540
+when added to other therapies يعني النتيجة أكبر لما
+
+297
+00:23:41,540 --> 00:23:45,100
+نضيفوا ال ... ال little brush لل ... أكتر إيه؟ 
+
+298
+00:24:02,170 --> 00:24:06,270
+عملت دراسة على واحد وثلاثين عيال من أطفال اللي 
+
+299
+00:24:06,270 --> 00:24:10,310
+عندهم الجلاكوما بس ستة استجابوا للعلاج وخمسة وعشرين ده مايستجيبوا وهذا نوع من إيش؟ وكل استثناء
+
+300
+00:24:10,310 --> 00:24:14,310
+هذا فيه الإيش؟ في البيدياتيكلوكوما أو
+
+301
+00:24:14,310 --> 00:24:17,170
+الكنجيتريكلوكوما أسكت في ال response تقول لِتناوبرست 
+
+302
+00:24:17,170 --> 00:24:20,940
+treatment in sterish weber glaucoma was noted in
+
+303
+00:24:20,940 --> 00:24:24,240
+only 17 of all at 6 months إن sterish weber
+
+304
+00:24:24,240 --> 00:24:28,840
+glaucoma هي سيندروم بتابعة ال glaucoma وبيأتي إلى
+
+305
+00:24:28,840 --> 00:24:34,440
+تضيّق أوي الدموية بترفع ضغط ال ... تفتح الصّلمة
+
+306
+00:24:34,440 --> 00:24:38,180
+اللي بعدها يا جماعة؟ 
+
+307
+00:24:38,180 --> 00:24:38,880
+اللي بعدها يا جماعة؟
+
+308
+00:24:43,730 --> 00:24:50,310
+هذه الصورة كيف؟ عدة أمور من ضمنها اللي بوفي ال
+
+309
+00:24:50,310 --> 00:24:55,250
+face هي منزيوم شايفين؟ احنا مش هنخسر على طول أول
+
+310
+00:24:55,250 --> 00:25:00,650
+شوية لما نجيّز ضغط العين هناك ملاجئ طبعا إيه 
+
+311
+00:25:00,650 --> 00:25:02,310
+التأثيرات الأخرى على القلب وشيء
+
+312
+00:25:02,310 --> 00:25:03,690
+تمانعششششششششششششششششششششش
+
+313
+00:25:08,990 --> 00:25:17,810
+Lego 17% له response another report 
+
+314
+00:25:17,810 --> 00:25:20,190
+of treating sterish liver glaucoma with Lentin
+
+315
+00:25:20,190 --> 00:25:27,990
+address noted two patients with general value of 7
+
+316
+00:25:27,990 --> 00:25:33,590
+.6
+
+317
+00:25:38,860 --> 00:25:45,080
+يبدأ في الطفولة يعني يبدأ في الطفولة ممكن يبدأ سنة
+
+318
+00:25:45,080 --> 00:25:48,180
+أو سنتين أو تلاتة أو أربع أو خمسة يعني في الطفولة
+
+319
+00:25:48,180 --> 00:25:55,260
+بيبدأ اللي هو ال Taiwan هو juvenile onset وهذا
+
+320
+00:25:55,260 --> 00:26:03,540
+ناتج عن قتل اللي هو ال insulin secreting cells ال
+
+321
+00:26:03,540 --> 00:26:07,020
+B cells في البنكرياس حتى إنه في ناس بيقولوا عنه
+
+322
+00:26:07,020 --> 00:26:10,280
+autoimmune disease اسمه ما تقول autoimmune 
+
+323
+00:26:10,280 --> 00:26:17,840
+disease؟ مناعة لحاله إنه ... إنه بروتينه الشخص 
+
+324
+00:26:17,840 --> 00:26:23,240
+الإنسان يشكل antibodies لحاله وتصير معاها كمناعة 
+
+325
+00:26:23,240 --> 00:26:29,280
+داخل الدم اسمها antigen antibody reaction وتصير
+
+326
+00:26:29,280 --> 00:26:35,130
+في الجسم زي rheumatoid arthritis وفيه نوع من اللي 
+
+327
+00:26:35,130 --> 00:26:39,630
+هو ال disease بتاع ال ... بتكون type 1 كتير في 
+
+328
+00:26:39,630 --> 00:26:44,510
+autoimmune diseases في جسم الإنسان ففي ناس بيقولوا
+
+329
+00:26:44,510 --> 00:26:48,830
+إن ال type 1 اللي هو autoimmune disease في ال
+
+330
+00:26:48,830 --> 00:26:53,710
+diabetes في دراسة لأ بيقولوا قدرت قنصها يعني بعد
+
+331
+00:26:53,710 --> 00:26:58,690
+... بعد الأربعين قدرت قنصها هذه لا تتباني على قتل 
+
+332
+00:26:58,690 --> 00:27:00,270
+الخلايا بل على ضعف الإفراز
+
+333
+00:27:07,490 --> 00:27:12,750
+فهنا ال juvenile onset glaucoma لِـ glaucoma اللي بتبدأ
+
+334
+00:27:12,750 --> 00:27:18,190
+في الطفولة عكس ال other اللي بتبدأ بعد الأربعين طب
+
+335
+00:27:18,190 --> 00:27:25,250
+الخطيرة ده ده أحدا كان في استجابة للاستجابة 2 من
+
+336
+00:27:25,250 --> 00:27:30,250
+المرضى لِـ glaucoma اللي بتجي على الطفولة و4 من ال
+
+337
+00:27:30,250 --> 00:27:30,790
+congenital
+
+338
+00:27:38,320 --> 00:27:44,100
+ومن هنا ال concept ومن هنا جوناي ال concept جوناي 
+
+339
+00:27:44,100 --> 00:27:48,500
+ولد بيها ولد بيها وهذه خطيرة ال computer أكتر من
+
+340
+00:27:48,500 --> 00:27:52,020
+تشوف ناجبك أربع أو خمس سنين أو ست سنين بيبدأ معاك
+
+341
+00:27:52,020 --> 00:27:55,580
+بيقوم هذين الناس زي ما يقولون إن أنا developmental 
+
+342
+00:27:55,580 --> 00:28:03,850
+يعني في مراحل طويلة علم هذه مستخدم فيه pediatric وفيه
+
+343
+00:28:03,850 --> 00:28:07,310
+فيه steric و البرق المقومة juvenile و continental 
+
+344
+00:28:07,310 --> 00:28:11,290
+لكن لسه احنا ما عملناش addition شوف اللي بعد ما حدّده
+
+345
+00:28:11,290 --> 00:28:15,730
+بعد ما حكت عن تعالي المرض هحكي عن concentration و
+
+346
+00:28:15,730 --> 00:28:19,790
+ال doses للمرأة ... للمدرسة الزرقان has been tested 
+
+347
+00:28:19,790 --> 00:28:24,950
+in doses of 0.0005% and is more effective with
+
+348
+00:28:24,950 --> 00:28:29,060
+once daily than with twice daily dosing بعد ما 
+
+349
+00:28:29,060 --> 00:28:32,220
+عملوا دراسة على التركيز بالخمسة من ألف في المية
+
+350
+00:28:32,220 --> 00:28:36,340
+لِـ لتانوبرست وجدوا أنه بيكون effective أكتر لما نكون مرة 
+
+351
+00:28:36,340 --> 00:28:39,280
+يوميا أفضل من لما نكون اتنين يوميا طب هذا عاجب
+
+352
+00:28:39,280 --> 00:28:44,760
+ولا مش عاجب؟ عاجب عاجب لأن نعرفه إن كل ما زاد
+
+353
+00:28:44,760 --> 00:28:48,760
+الدوز كل ما زاد ال effect لكن كل ما زاد الدوز يقلّ
+
+354
+00:28:48,760 --> 00:28:53,160
+ال effect طب هذا شيء عاجب وكمل بنفس التركيز وهكذا
+
+355
+00:28:53,160 --> 00:28:54,180
+بنت الهرمونات
+
+356
+00:28:59,780 --> 00:29:03,760
+لأن هالي ال Cortisone بيرتز من إيش؟ من الغدة بتاعة 
+
+357
+00:29:03,760 --> 00:29:07,200
+السبراجين الأجلالت اللي أنتم بظهرها لك داري، 
+
+358
+00:29:07,200 --> 00:29:10,940
+سبراجين الأجلالت في الغدة يعني، هرمونية بتفرز
+
+359
+00:29:10,940 --> 00:29:15,500
+الأدرينالين وبتفرز إيش؟ ال Cortisone فاللي فانا
+
+360
+00:29:15,500 --> 00:29:22,580
+بروست هو متاخد من ال prostaglandin هرمون اللي 
+
+361
+00:29:22,580 --> 00:29:27,850
+موجود في عديد من ال orgasm بتاعة الجسم عشان تسهل
+
+362
+00:29:27,850 --> 00:29:31,570
+ال metabolism وتقفل الألم و ... و ... و وحدات كتير هم
+
+363
+00:29:31,570 --> 00:29:34,810
+ما خدوش خروف تاجلاندين لأ، أفادوا ... عملوا analog ...
+
+364
+00:29:34,810 --> 00:29:40,410
+analog نظير إلهم أو مشابه إلهم، لكن بضيع هرمونه،
+
+365
+00:29:40,410 --> 00:29:43,970
+كان فيه هرمون صناعي، فالآن هذا الهرمون الصناعي 
+
+366
+00:29:43,970 --> 00:29:44,730
+اللِتانوبرست
+
+367
+00:29:55,190 --> 00:29:59,470
+في اللي قطّره بحكي إن ال big effect اللي بتاخد على 
+
+368
+00:29:59,470 --> 00:30:04,150
+أقل 12 ساعة وفي دراسة حكت أنه في ال ... لما ناخد ال 
+
+369
+00:30:04,150 --> 00:30:07,670
+dosing في المساء بتعطي better day time pressure 
+
+370
+00:30:07,670 --> 00:30:10,170
+reduction compared with morning يعني لو أعطينا ال 
+
+371
+00:30:10,170 --> 00:30:13,290
+doses في المساء هتعطي effect ... هتكون effective
+
+372
+00:30:13,290 --> 00:30:20,870
+أكتر than morning dosing طبعا الموضوع إن هو وفيش
+
+373
+00:30:20,870 --> 00:30:25,800
+blanking والهدوء والميتابوليزم ضعيف شوية وشيء
+
+374
+00:30:25,800 --> 00:30:28,980
+شكله إنه عنده نوم أفضل من النهوض الصباح اللي بيكون 
+
+375
+00:30:28,980 --> 00:30:32,520
+فيه activity ... في surgical activity وإشي هالجيل 
+
+376
+00:30:32,520 --> 00:30:35,020
+اللي حاكي عن ال adaptivity لـ ال Latana Prost 
+
+377
+00:30:35,020 --> 00:30:38,360
+بيحكي one add of two الانانس اللي اتبت فيه تيمولول
+
+378
+00:30:38,360 --> 00:30:42,540
+... broker ... broker athenolol Latana Prost lowered 
+
+379
+00:30:42,540 --> 00:30:47,160
+in Russia more than dorzolamide بيحكي لما احنا 
+
+380
+00:30:47,160 --> 00:30:50,760
+نضيف لـ ... لـ ... لـ ... لـ Latana Prost الناس اللي 
+
+381
+00:30:50,760 --> 00:30:56,680
+نكتب بيها بلغة هيكون تخفيض لضغط الدم ... أي لضغط 
+
+382
+00:30:56,680 --> 00:31:00,900
+العين أفضل من ال dorzolamide أفضل من لو أضفنا 
+
+383
+00:31:00,900 --> 00:31:04,990
+dorzolamide ملاحظين يعني العبارة كده يعني دورزالاميد
+
+384
+00:31:04,990 --> 00:31:11,590
+مرتين بروست زي دورزالاميد أقل من مرتين بروست مقال فتن ولو
+
+385
+00:31:11,590 --> 00:31:11,630
+لو
+
+386
+00:31:16,450 --> 00:31:20,070
+هنا بيحكي إن ال patient اللي بيكون غير كافي إن ال
+
+387
+00:31:20,070 --> 00:31:24,270
+تيمولول اللي اتحقق في ضغط العين لهم هيحاول على طول
+
+388
+00:31:24,270 --> 00:31:27,610
+لِـ Latana Prost لوحده، هيكون effective زي كأنه
+
+389
+00:31:27,610 --> 00:31:33,450
+أضفنا له بيوكاربون أو زي كأنه حولنا لـ تيمولول مع
+
+390
+00:31:33,450 --> 00:31:37,610
+Dermalite، ال combination مع بعضهم هيكون أفضل من 
+
+391
+00:31:37,610 --> 00:31:40,730
+Latana Prost لوحده شايفين Latana Prost هنا equals
+
+392
+00:31:40,730
+
+431
+00:34:31,030 --> 00:34:35,190
+اللي خضعوا لعملية surgery وجدوا أن عندهم أكثر من
+
+432
+00:34:35,190 --> 00:34:40,710
+cystoid macular ديما في الأشخاص اللي تعالجوا بالـ
+
+433
+00:34:40,710 --> 00:34:45,170
+لاتانو بروست مقارنةً على علاجات بديلة للاتانو بروست
+
+434
+00:34:45,170 --> 00:34:49,090
+placebo عارفة إيش placebo؟ علاج بديل أو علاج وهمي
+
+435
+00:34:49,090 --> 00:34:52,610
+آه علاج وهمي، علاج وهمي psychological effect يعني
+
+436
+00:34:52,610 --> 00:34:55,610
+إحنا إحنا المستخدمين المعالجين مثلًا واحد
+
+437
+00:34:59,520 --> 00:35:02,900
+يعني يقول لك أنا ده .. رأسي بدي أقطعه .. أنا بصدع
+
+438
+00:35:02,900 --> 00:35:05,680
+جدا .. أنا بدي أموت .. أنا كده .. كده .. كده ..
+
+439
+00:35:05,680 --> 00:35:10,700
+يعني ما فيش شيء محدد .. نفسي على عصبي .. على .. زي
+
+440
+00:35:10,700 --> 00:35:14,740
+تكاني .. ممكن جدًا نقعد ونقعد فيها صراحة .. لأن
+
+441
+00:35:14,740 --> 00:35:19,780
+هنعطيك علاج مثالي .. بس أنت لو .. هتخلي الممرض ..
+
+442
+00:35:19,780 --> 00:35:23,620
+الممرض يضربك إبرة .. وتبقى كمان .. وممكن تكون
+
+443
+00:35:23,620 --> 00:35:25,180
+هذه الإبرة هذه ..
+
+444
+00:35:28,020 --> 00:35:33,880
+السراج مثل الموتى، فيه التمام والتمام، هذا اسمه 
+
+445
+00:35:33,880 --> 00:35:41,640
+placebo، ما فيه drug واحد، فأحيانًا الـ placebo في 
+
+446
+00:35:41,640 --> 00:35:44,360
+الحياة النفسية بيبدأ من قارن، نحن نحط في عين مثلًا
+
+447
+00:35:44,360 --> 00:35:49,760
+بيه تبلوكا وفعلا سراج، كل case، إذا كان في عامة
+
+448
+00:35:49,760 --> 00:35:52,360
+نفسية، بيلاقي أن السراج بيجي بتيجي
+
+449
+00:35:58,130 --> 00:36:01,170
+من لاتانو بروست، تجيب لاتانو بروست في حالة واحدة
+
+450
+00:36:01,170 --> 00:36:05,290
+أو في study واحد عامل عند المريض بتاع الـ cataract
+
+451
+00:36:05,290 --> 00:36:10,270
+surgery عامله سيدوت سيستول مخلوق قديم فقالوا الناس
+
+452
+00:36:10,270 --> 00:36:12,750
+أنه بيعمل سيستول مخلوق قديم، طب ما هي نفس الـ
+
+453
+00:36:12,750 --> 00:36:15,090
+surgery هي بيعمل سيستول مخلوق قديم، يعني الـ
+
+454
+00:36:15,090 --> 00:36:17,790
+complications بتاع الـ cataract surgery، سيستول
+
+455
+00:36:17,790 --> 00:36:23,070
+مخلوق قديم، ده يعني نتهم الـ latanoprost وهو وين
+
+456
+00:36:23,070 --> 00:36:23,530
+كان مريض
+
+457
+00:36:34,710 --> 00:36:37,830
+بنقف من جهة من بعد الكترات أو جبل ونحن نقف 
+
+458
+00:36:37,830 --> 00:36:43,590
+بأسكالة ونشوف جبل عوالد الكترات كلام كترات كترات
+
+459
+00:36:43,590 --> 00:36:45,290
+كترات كترات كترات كترات كترات كترات كترات كترات
+
+460
+00:36:45,290 --> 00:36:48,810
+كترات كترات كترات كترات كترات كترات كترات كترات
+
+461
+00:36:48,810 --> 00:36:52,130
+كترات كترات كترات كترات كترات كترات كترات كترات
+
+462
+00:36:52,130 --> 00:36:52,210
+كترات كترات كترات كترات كترات كترات كترات كترات
+
+463
+00:36:52,210 --> 00:36:52,890
+كترات كترات كترات كترات كترات كترات كترات كترات
+
+464
+00:36:52,890 --> 00:36:56,070
+كترات
+
+465
+00:36:56,070 --> 00:37:03,350
+كترات أكثر
+
+466
+00:37:04,560 --> 00:37:09,060
+يعني الآن وإن كان صحيح إحنا بنقسم أنه pre
+
+467
+00:37:09,060 --> 00:37:16,140
+-operative OCT لكل مريض مُكلِق ومُكلِق ومُكلِق ف ..
+
+468
+00:37:16,140 --> 00:37:19,500
+لكن الصحيح أنه في إطار دراسي بقى يعني في إطار
+
+469
+00:37:19,500 --> 00:37:23,720
+دراسي مثلًا أنا مثلًا أربعين أو خمسين مريض
+
+470
+00:37:23,720 --> 00:37:27,860
+بتعمل فيه بحث دكتوراه مثلًا أو بحث ماجستير أن كل
+
+471
+00:37:27,860 --> 00:37:31,800
+واحد أعمل OCT pre-operative و OCT post-operative
+
+472
+00:37:37,180 --> 00:37:42,180
+فعلا أن العملية بتعمل وجداشي بتعمل وهدأشي بيخدم
+
+473
+00:37:42,180 --> 00:37:47,020
+معاهم وغالي ومكلف ومضن عيال يعني مرتين يعملوا
+
+474
+00:37:47,020 --> 00:37:52,040
+OCT لكن أنا بأحترم هذا الرأي بالضبط مش نادرة جدًا
+
+475
+00:37:52,040 --> 00:37:55,660
+أنا جيت initial consensus that the IRS cannot
+
+476
+00:37:55,660 --> 00:37:59,920
+change were precursors of more or minus side of
+
+477
+00:37:59,920 --> 00:38:00,300
+the communists
+
+478
+00:38:08,860 --> 00:38:13,740
+والدراجة مستخدمة كشخصية أولى أو أخرى مستخدمة بحكي
+
+479
+00:38:13,740 --> 00:38:18,140
+أنه التركيز الأول هيكون على الـ side effect اللي
+
+480
+00:38:18,140 --> 00:38:22,320
+الصغير عنده Iris carotid change، إحنا هنتنفع أنه
+
+481
+00:38:22,320 --> 00:38:27,120
+وصل الـ .. الـ .. الـ side effect وصلت لمرحلة خطيرة،
+
+482
+00:38:27,120 --> 00:38:30,900
+بس بالرغم من هيك أنه يعني بتتم التغلب عليها بسهولة
+
+483
+00:38:30,900 --> 00:38:34,660
+وحاليًا لأن الـ drug اللي موجودة حاليًا تستخدم بشكل
+
+484
+00:38:34,660 --> 00:38:37,940
+واسع وما فيش أي side effect منها للناس
+
+485
+00:38:42,180 --> 00:38:46,280
+أنا يعني بنات كتير بتركوا عندي انطباعات كويسة جدًا
+
+486
+00:38:46,280 --> 00:38:50,120
+عن مستواهم العلمي ومستواهم البحثي و الله يزيدهم الخير
+
+487
+00:38:50,120 --> 00:38:57,640
+لكن طبعًا إحنا هنا بنحاول نحسن يعني هو في الأول لما
+
+488
+00:38:57,640 --> 00:39:02,340
+بدأ العيلز يتشكل ويصير dark الناس كانت بسبب أنها
+
+489
+00:39:02,340 --> 00:39:08,380
+لبداية خراب للعيلز يعني أن التغيير
+
+490
+00:39:15,610 --> 00:39:19,830
+فنقول لأ يعني أقصى شيء بيغيره العين لكن لا يؤدي
+
+491
+00:39:19,830 --> 00:39:24,650
+إلى أي شيء آخر يعني هي مجرد devotion of more
+
+492
+00:39:24,650 --> 00:39:31,090
+melanin granules وده إيش؟ وطبعًا أمر السنين ده ما فيش
+
+493
+00:39:31,090 --> 00:39:36,510
+حد ماشي أكثر يعني تقريبًا اللي هو إذا إحنا ما قررناه
+
+494
+00:39:36,510 --> 00:39:40,630
+مع أنه دراجة بناخده مرة واحدة على مدار السنين
+
+495
+00:39:40,630 --> 00:39:44,610
+وبيخدم العين وما لوش shift ولا drift
+
+496
+00:39:47,660 --> 00:39:52,400
+لأ يعني الـ glaucoma يبقى يعني glaucoma شعاقة،
+
+497
+00:39:52,400 --> 00:40:01,750
+glaucoma is يعني a blindness disease فإحنا أحيانًا
+
+498
+00:40:01,750 --> 00:40:05,310
+مستغنى عن بعض الشكليات، أخف الدرارية، أخف
+
+499
+00:40:05,310 --> 00:40:09,550
+الدرارية، فلأن بعد ما اقتنعنا أنه بيعملش severe
+
+500
+00:40:09,550 --> 00:40:12,810
+side effects يعني أخرى على عين غير التلوين، فصار
+
+501
+00:40:12,810 --> 00:40:17,030
+second line أو first or second line، يعني هو في
+
+502
+00:40:17,030 --> 00:40:18,850
+الحقيقة ما زال في عالم الفقراء
+
+503
+00:40:36,190 --> 00:40:45,510
+patients with iris color susceptible to change
+
+504
+00:40:45,510 --> 00:40:49,030
+iris darkening or should be warned of the
+
+505
+00:40:49,030 --> 00:40:51,350
+possibility of permanent iris darkening or
+
+506
+00:40:51,350 --> 00:40:55,390
+trochromia بحكي هنا الـ patient اللي بيصير عندهم
+
+507
+00:40:55,390 --> 00:40:59,370
+المحتمل أو المتوقع أن يصير عندهم iris color
+
+508
+00:40:59,370 --> 00:41:03,730
+changed إحنا بنحذرهم قبل ما يستخدموا الهدف أنه
+
+509
+00:41:03,730 --> 00:41:07,750
+ممكن يصير عندهم ت.. ت.. يعني تdarken للـ iris
+
+510
+00:41:07,750 --> 00:41:10,650
+بشكل دائم أو تصير فيه تغير في لون الـ iris لأ
+
+511
+00:41:10,650 --> 00:41:14,850
+heterochromia إيش؟ أكثر من لون الـ iris يعني تغير
+
+512
+00:41:14,850 --> 00:41:20,050
+في لون الـ iris أكثر من لون الـ iris كل عين لون هترو
+
+513
+00:41:20,050 --> 00:41:23,930
+كروميا تغير في لونها ثاني هترو كروميا يعني يكون
+
+514
+00:41:23,930 --> 00:41:27,990
+لون عين مثلًا أسود ولون عين أفتح شوية طبعًا عين
+
+515
+00:41:27,990 --> 00:41:31,570
+بيستخدم فيها تغير هي الصحيح أن هذه يعني مخرجة
+
+516
+00:41:31,570 --> 00:41:35,810
+شوية disfigurement يعني مش حلوة أن الـ .. يعني لو
+
+517
+00:41:35,810 --> 00:41:39,750
+تيراس وات ساعة تستخدم كوزماتك .. آه لكن .. آه
+
+518
+00:41:39,750 --> 00:41:43,750
+كوزماتك .. كوزماتك ليه؟ آه كوزماتك نفسه بس ودي
+
+519
+00:41:43,750 --> 00:41:47,390
+استخدمه آه يعني بس ان .. لأ هو قصده أن إحنا نقول
+
+520
+00:41:47,390 --> 00:41:52,870
+للمريض قبل ما يستخدمه القطع أن هلأ قد يحدث
+
+521
+00:41:52,870 --> 00:42:00,550
+darkening للـ eyes color أو ربما يعمل heterochrome
+
+522
+00:42:09,110 --> 00:42:10,190
+بملايين دولار
+
+523
+00:42:20,060 --> 00:42:23,500
+وفي بعض الـ first action بتأثر على الـ eyelashes و
+
+524
+00:42:23,500 --> 00:42:28,240
+الـ thickness لها والـ growth لها بحكي أن الـ drugs
+
+525
+00:42:28,240 --> 00:42:31,760
+should be used with caution in patients with
+
+526
+00:42:31,760 --> 00:42:35,180
+previously demonstrated iritis of the soil micro
+
+527
+00:42:35,180 --> 00:42:38,620
+edema or herpes simplex keratitis يجب أن الحذر الـ
+
+528
+00:42:38,620 --> 00:42:40,900
+patient هذه الأدوية لازم تستخدمها لتحذير الـ
+
+529
+00:42:40,900 --> 00:42:46,040
+patient لأ والـ caution يحدث تحذير لأ لأ لأ يحدث
+
+530
+00:42:46,040 --> 00:42:52,120
+في فرق بين تحذير ويحدث أنه الناس اللي عندهم
+
+531
+00:42:52,120 --> 00:42:56,100
+previous arthritis أو تستويت ما كنت رديمة أو
+
+532
+00:42:56,100 --> 00:43:03,860
+Hepatitis جامل ميت وراح أن أنا باستخدم ذلتان هالأ
+
+533
+00:43:03,860 --> 00:43:05,400
+اللي أنا بروسفش أستخدمه
+
+534
+00:43:23,970 --> 00:43:28,350
+كويس thank you thank you very much طيب إحنا نشكر
+
+535
+00:43:28,350 --> 00:43:32,510
+الأخوات الثلاث اللي قعدوا بهذا presentation الرائع
+
+536
+00:43:32,510 --> 00:43:40,050
+بختام هذا course وأنا أتمنى يعني أن هذا course
+
+537
+00:43:40,050 --> 00:43:47,790
+يكون أنتم حابينه وعلمكم يعني عرضنا لكم من الـ ..
+
+538
+00:43:47,790 --> 00:43:51,390
+هذا العلم المفيد اللي يسأل الله أن يكون .. يعني
+
+539
+00:43:51,390 --> 00:43:56,230
+بتخير لكم وراء .. لهذا المجتمع الغزي والمجتمع اللي
+
+540
+00:43:56,230 --> 00:43:59,170
+هو الفلسطيني، فيه تعليم 
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/aUnT5yLCp5U_postprocess.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/aUnT5yLCp5U_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..a2c6d10631a5c55fcc119252a87bc9c61a5ebd53
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/aUnT5yLCp5U_postprocess.srt
@@ -0,0 +1,2160 @@
+1
+00:00:20,700 --> 00:00:22,720
+بسم الله الرحمن الرحيم الحمد لله رب العالمين و
+
+2
+00:00:22,720 --> 00:00:26,500
+أصلي و أسلم على نبي الأمين محمد و على أهله و
+
+3
+00:00:26,500 --> 00:00:31,800
+أصحابي و اتباع اليوم ان شاء الله سنكمل هذا الموضوع
+
+4
+00:00:31,800 --> 00:00:36,940
+الهام Anti-glucoma drugs Beta-glucose Beta-glucose
+
+5
+00:00:36,940 --> 00:00:43,380
+و يُضحك ناول الدواء الأخير اللي هو الدواء الهرموني
+
+6
+00:00:51,590 --> 00:00:59,990
+هرمونية سحرية المفروض بتختلف عن سابقاتها بأنها
+
+7
+00:00:59,990 --> 00:01:05,930
+تسهل ال outflow of across the human بتأثرش على ال
+
+8
+00:01:05,930 --> 00:01:12,150
+flow بتأثر على ال outflow و هنشوف احنا الطريقة و
+
+9
+00:01:12,150 --> 00:01:16,650
+هذا علاج سحري و غالب جدا و يعني ان شاء الله ربنا
+
+10
+00:01:16,650 --> 00:01:21,210
+يعرف هنا لكن لازم نكون عند طلباتي معلومة كويسة
+
+11
+00:01:26,480 --> 00:01:29,940
+بسم الله الرحمن الرحيم، اليوم ان شاء الله هنتكلم
+
+12
+00:01:29,940 --> 00:01:32,420
+عن ال systemic adverse reaction of the carbon
+
+13
+00:01:32,420 --> 00:01:35,280
+monohydrate inhibitors carbonic carbonic
+
+14
+00:01:35,280 --> 00:01:38,020
+monohydrate inhibitors اللي بيتم تناولها orally
+
+15
+00:01:38,020 --> 00:01:41,460
+أول حاجة ويعملنا gastrointestinal tract irritation
+
+16
+00:01:41,460 --> 00:01:44,820
+is a form of nausea, vomiting and abdominal
+
+17
+00:01:44,820 --> 00:01:48,350
+colitisهذا بيعملنا تهيج في ال gastro intestinal
+
+18
+00:01:48,350 --> 00:01:53,130
+tract إضافة اللى بيعملنا غثيان و تقيق و مغص في
+
+19
+00:01:53,130 --> 00:01:58,070
+البضل و الأبعاد Parastezia due to its effect on
+
+20
+00:01:58,070 --> 00:02:01,850
+the peripheral nerves بيصير في عنا تخضير و تنميل و
+
+21
+00:02:01,850 --> 00:02:05,290
+فقدار جزء من الإحساس في الأعصاب الطرفية يعني في
+
+22
+00:02:05,290 --> 00:02:10,350
+الجفاز الطرفىالعصبي، بعدين تالت حاجة دورز الأمد
+
+23
+00:02:10,350 --> 00:02:13,810
+binding to red blood cells may have a hard life،
+
+24
+00:02:13,810 --> 00:02:19,430
+إيش يعني hard life؟ في حد عارف؟ صحيح هو الفترة أو
+
+25
+00:02:19,430 --> 00:02:23,290
+الوقت اللازم حتى يصل الدواء عندي لنصف الكمية
+
+26
+00:02:23,290 --> 00:02:26,910
+تبعته، بيحكينا دورز الأمد اللي هو binding to red
+
+27
+00:02:26,910 --> 00:02:30,270
+blood cells اللي بيكون في علاقة مباشرة مع red
+
+28
+00:02:30,270 --> 00:02:33,900
+blood cellsبيكون منتصف الحياة أو نصف العمر لإله
+
+29
+00:02:33,900 --> 00:02:37,800
+several months يعني العديد من الشهور prolongate
+
+30
+00:02:37,800 --> 00:02:42,700
+action يعني فترة طويلة حتى يديني ال F7 ماشي الان
+
+31
+00:02:42,700 --> 00:02:45,880
+اول فيلم اللي لها انه بينجو سينفو اوران
+
+32
+00:03:01,590 --> 00:03:08,310
+بجرح 250 في اتنين او 500 في اتنين اللي هو او
+
+33
+00:03:08,310 --> 00:03:12,150
+sustain release كبسولة كبسولة في اليوم بناء على
+
+34
+00:03:12,150 --> 00:03:17,510
+ضغط العين لكن عيبه واضح انه بقشلة على نعده ممنوذة
+
+35
+00:03:17,510 --> 00:03:21,910
+فيها بهيئة فارقة لذلك لازم يأخذ ايش فارقة فارقة
+
+36
+00:03:21,910 --> 00:03:26,030
+والمعنى مليء الأهم انه مامي باراستيزيا اللي واحد
+
+37
+00:03:26,030 --> 00:03:29,970
+ياخده من تاني يوم يقول يا دكتور إيديا و إجليا
+
+38
+00:03:33,090 --> 00:03:41,270
+عشان ايه احنا مقدرش نعطيه forever بانهم مفيد خاصة
+
+39
+00:03:41,270 --> 00:03:46,730
+لو ضاقت العيال العالي لكن مش كويس انه العيال بعد
+
+40
+00:03:46,730 --> 00:03:50,990
+شوية بزيد مع الوضع كل دي relay يصير مقنينة منه
+
+41
+00:03:50,990 --> 00:03:55,030
+يخده فمقدرش نعطيه اكتر من سبوع او سبوعين بالكتير
+
+42
+00:03:55,030 --> 00:03:59,130
+في سبوع او سبوعين لازم احنا نشوف حل اما نعمل قطرات
+
+43
+00:03:59,130 --> 00:04:04,510
+اضافية للقطرات او نتعامل اجارةهذا يكون فاهمينه
+
+44
+00:04:04,510 --> 00:04:08,150
+اللي هو ال carbon ion and risk inhibitor اللي هو
+
+45
+00:04:08,150 --> 00:04:09,710
+دورزر الإيمان أو دورزر الإيمان أو دورزر الإيمان أو
+
+46
+00:04:09,710 --> 00:04:12,790
+دورزر الإيمان أو دورزر الإيمان أو دورزر الإيمان أو
+
+47
+00:04:12,790 --> 00:04:12,870
+دورزر الإيمان أو دورزر الإيمان أو دورزر الإيمان أو
+
+48
+00:04:12,870 --> 00:04:13,210
+دورزر الإيمان أو دورزر الإيمان أو دورزر الإيمان أو
+
+49
+00:04:13,210 --> 00:04:13,590
+دورزر الإيمان أو دورزر الإيمان أو دورزر الإيمان أو
+
+50
+00:04:13,590 --> 00:04:14,150
+دورزر الإيمان أو دورزر الإيمان أو دورزر الإيمان أو
+
+51
+00:04:14,150 --> 00:04:17,270
+دورزر الإيمان أو دورزر الإيمان أو دورزر الإيمان أو
+
+52
+00:04:17,270 --> 00:04:24,590
+دورزر الإيمان أو دورزر الإيمان أو دورزر الإيمان أو
+
+53
+00:04:24,590 --> 00:04:29,810
+دورزر الإيمان
+
+54
+00:04:29,810 --> 00:04:34,200
+أو دنجي نحكي عن indications of topical acetylsol
+
+55
+00:04:34,200 --> 00:04:37,900
+amide ايش الدوافع اللى بتدفع لاستخدام acetylsol
+
+56
+00:04:37,900 --> 00:04:40,460
+amide اول حاجة Dorsal amide is indicated
+
+57
+00:04:40,460 --> 00:04:45,840
+accurately or chronically Dorsal amide is
+
+58
+00:04:45,840 --> 00:04:48,620
+indicated to accurately or chronically lowering
+
+59
+00:04:48,620 --> 00:04:51,700
+lower interocular pressure in patient with open or
+
+60
+00:04:51,700 --> 00:04:55,040
+closed angle يعني أنا بستخدمه في الحالات لما يكون
+
+61
+00:04:55,040 --> 00:04:58,540
+في عندي acute or chronicglucoma وفي الأشخاص اللي
+
+62
+00:04:58,540 --> 00:05:01,620
+بيكون عندهم open or closed angle glucoma and
+
+63
+00:05:01,620 --> 00:05:04,900
+patients at risk for elevated pressures يعني
+
+64
+00:05:04,900 --> 00:05:09,060
+والأشخاص اللي في وردة .. في وردة التعرض لأنه زيادة
+
+65
+00:05:09,060 --> 00:05:12,240
+في الضغط أنا بستخدم الدرزل او اي ماني مين هم ..
+
+66
+00:05:12,240 --> 00:05:17,420
+مين هم الأشخاص اللي عندهم احتمالية اتفاعدة العين
+
+67
+00:05:17,420 --> 00:05:22,220
+هيفره .. هيفره المرض او هيفره المجلد؟ او هيفره
+
+68
+00:05:22,220 --> 00:05:23,840
+المجلد؟ او هيفره المجلد؟ او هيفره المجلد؟ او هيفره
+
+69
+00:05:23,840 --> 00:05:26,050
+المجلد؟ او هيفره المجلد؟ او هيفالناس اللي بياخدوا
+
+70
+00:05:26,050 --> 00:05:33,230
+كورتزيونات يعني هو long term و ال secondary برقمات
+
+71
+00:05:33,230 --> 00:05:39,110
+التانية اللي تعرفينها تم حجة درزال إيماي دروبز
+
+72
+00:05:39,110 --> 00:05:41,570
+produce much of interocular pressure lowering
+
+73
+00:05:41,570 --> 00:05:44,170
+effect while eliminating most of the systemic
+
+74
+00:05:44,170 --> 00:05:48,230
+tolerability problems seen with tablets or on
+
+75
+00:05:48,230 --> 00:05:53,190
+carbonic anhydrate inhibitorsبرضه ال Dorsal Amide
+
+76
+00:05:53,190 --> 00:05:56,470
+بستخدمه في حالات اللي بيكون فيها زيادة عالية في ال
+
+77
+00:05:56,470 --> 00:05:59,790
+interocular pressure و أنا محتاجة تخفيضه في حال
+
+78
+00:05:59,790 --> 00:06:04,130
+استخدمته بيحكي إنه ما بيأثر أو يقلل من التأثير على
+
+79
+00:06:04,130 --> 00:06:07,810
+الجسم بشكل عام بالمقارنة مع ال oral carbonic
+
+80
+00:06:07,810 --> 00:06:14,130
+anhydrous inhibitors يعني هو الكلام الآن إنه أنا
+
+81
+00:06:14,130 --> 00:06:20,810
+بستخدم القطرة في حين أنا بكون ساهب أو بصحب ال ash
+
+82
+00:06:21,390 --> 00:06:29,730
+الأكراس القطرة كانت تقنع الأكراس و تتنجي المريض من
+
+83
+00:06:29,730 --> 00:06:34,630
+ال systemic effects اللي قلنا advanced يعني اللي
+
+84
+00:06:34,630 --> 00:06:39,490
+باخد قطرة ماصرش معاه اللي هو systemic effects في
+
+85
+00:06:39,490 --> 00:06:44,830
+الحقيقة أخد القطرة و ساب الأكراستالت حاجة as the
+
+86
+00:06:44,830 --> 00:06:49,030
+risk of idiosyncratic blood dyscrasias have faded
+
+87
+00:06:49,030 --> 00:06:52,270
+يعني المخاطر أو الإختلالات اللي بتكون موجودة في
+
+88
+00:06:52,270 --> 00:06:55,430
+الدم أنا بقدر أنه أتلشها أو أتغلب عليها ال
+
+89
+00:06:55,430 --> 00:06:59,090
+idiosyncrates هي mistaken ايديوباتيكية اختلالات
+
+90
+00:06:59,090 --> 00:07:02,710
+بتكون موجودة مش معروفة الأسباب نتيجة التناول في
+
+91
+00:07:02,710 --> 00:07:06,490
+الغالب يكون إعطاء دواء جديد لالبشر typical dorsal
+
+92
+00:07:06,490 --> 00:07:10,810
+amide and prostaglandin
+
+93
+00:07:13,680 --> 00:07:17,180
+gross aglandin analogous have replaced meiotics
+
+94
+00:07:17,180 --> 00:07:20,840
+يعني تبدلوا ال meiotics بالدرزال إماعبي لل gross
+
+95
+00:07:20,840 --> 00:07:25,240
+aglandin analogous لإنه التأثير أفضل والناس اللي
+
+96
+00:07:25,240 --> 00:07:28,200
+كانوا بتفضلوا أكتر من الدرزال إماعبي ..مش ال ..مش
+
+97
+00:07:28,200 --> 00:07:28,740
+ال ..مش ال ..مش ال ..مش ال ..مش ال ..مش ال ..مش ال
+
+98
+00:07:28,740 --> 00:07:30,260
+..مش ال ..مش ال ..مش ال ..مش ال ..مش ال ..مش ال
+
+99
+00:07:30,260 --> 00:07:30,500
+..مش ال ..مش ال ..مش ال ..مش ال ..مش ال ..مش ال
+
+100
+00:07:30,500 --> 00:07:33,460
+..مش ال ..مش ال ..مش ال ..مش ال ..مش ال ..
+
+101
+00:07:55,690 --> 00:07:59,570
+الخط الثاني في الأدوية اللي بتستخدم فيها ال beta
+
+102
+00:07:59,570 --> 00:08:05,940
+blockersلتانه بروست بص أجنب دين على لوجاس recently
+
+103
+00:08:05,940 --> 00:08:10,400
+detected يعني هو تم اكتشافه مؤخرا لتانه بروست is a
+
+104
+00:08:10,400 --> 00:08:13,360
+powerful ocular hypertensive agent بتاع اللوجس
+
+105
+00:08:21,860 --> 00:08:26,240
+هو بيحكي لي هو مخاف الضغط العين بشكل قوي بيعني
+
+106
+00:08:26,240 --> 00:08:31,120
+تأثيره على الجسم بيكون قليل نوعا ما أوثر ده
+
+107
+00:08:31,120 --> 00:08:35,240
+دردميتشينز عيرس كالر ممكن يغير في لون العيرس عنده
+
+108
+00:08:35,240 --> 00:08:38,360
+بيغير
+
+109
+00:08:38,360 --> 00:08:45,340
+اللون بيخليه dark و هذا اشي عند الناس خوفي لما
+
+110
+00:08:45,340 --> 00:08:52,070
+واحد يكون يعني عنده light iris colorأزرق، أخضر،
+
+111
+00:08:52,070 --> 00:08:56,070
+عصري فارق، مصير أسود، طبيخان، واحد الناس عارفيله
+
+112
+00:08:56,070 --> 00:09:01,110
+أنه هيكلوا العين، لما مصير القطرة أسود، يعني
+
+113
+00:09:01,110 --> 00:09:06,300
+بيقولك مثلًا صار في إشي، طاروaggravative steroid
+
+114
+00:09:06,300 --> 00:09:09,620
+macular edema هي بيصير كأنها في ال macula بيصير في
+
+115
+00:09:09,620 --> 00:09:12,680
+swelling أو ديما وعلى شكل أكياسه بتكون عنيفة
+
+116
+00:09:12,680 --> 00:09:16,360
+وشديدة مش كبيرها كتير المرضيين and induce herpes
+
+117
+00:09:16,360 --> 00:09:20,120
+simplex keratitis اتهاب القرنية على شكل herpes
+
+118
+00:09:20,120 --> 00:09:23,680
+simplex لتانو breast used to treat glaucoma has
+
+119
+00:09:23,680 --> 00:09:25,860
+grown rapidly over the past several years
+
+120
+00:09:25,860 --> 00:09:30,940
+الاستخدام لتانو breast لعلاج ال glaucoma تطور او
+
+121
+00:09:30,940 --> 00:09:34,410
+انما في الفترة الأخيرة في السنوات الأخيرة شكلراهيب
+
+122
+00:09:34,410 --> 00:09:38,010
+أو شكل كبير and it's now biased with non selective
+
+123
+00:09:38,010 --> 00:09:41,350
+beta blockers as a first line يعني هو الآن ينافس
+
+124
+00:09:41,350 --> 00:09:45,690
+ال beta blockers non selective B1 و B2 كخط أولي في
+
+125
+00:09:45,690 --> 00:09:49,570
+العلاج شايفين كده؟ يعني احنا بعد ما رحلنا على ال
+
+126
+00:09:49,570 --> 00:09:53,890
+bio carbine رحلنا على ال beta blockers ال beta
+
+127
+00:09:53,890 --> 00:09:57,350
+blockers كانت بالنسبة لل bio carbine قبصة كبيرة
+
+128
+00:09:57,350 --> 00:10:03,490
+يعني زي نقولك زي ايه؟القاكرة كانت تمشي على الفحم و
+
+129
+00:10:03,490 --> 00:10:07,590
+بصرا تمشي على الديزل، جديش الفرق بين الفحم الحذري
+
+130
+00:10:07,590 --> 00:10:14,210
+و بين ال .. اللي هو ال solar قمصة كبيرة، الآن لما
+
+131
+00:10:14,210 --> 00:10:18,630
+اجى اللاتنة crossed هذا ال harmony كأنه القطار
+
+132
+00:10:18,630 --> 00:10:24,110
+تمشي على الكهربا، تمشي على الكهربا ولا ديزل، عشان
+
+133
+00:10:24,110 --> 00:10:27,870
+كده، قال الله عز وجل و يخلق ما لا تعلمه، دي كل
+
+134
+00:10:27,870 --> 00:10:32,500
+شيء، فعالم الإنسان مالك يعنييعني مين كان متصور أن
+
+135
+00:10:32,500 --> 00:10:37,960
+من الهرمونات تتطور الأمور إلى قطرة في العين فاطيها
+
+136
+00:10:37,960 --> 00:10:43,080
+بخمسة من الف في التركيز لتجيب نتيجة أحسن من
+
+137
+00:10:43,080 --> 00:10:48,340
+القطرات الحقيقة أن هذه القفزة للبشرية لأن أجمل
+
+138
+00:10:48,340 --> 00:10:54,620
+البشرية لما هي تستخدم البعت العلمي و الأموال في
+
+139
+00:10:54,620 --> 00:10:58,120
+العلاد و الخير و لا تستخدمه في التدمير و لا
+
+140
+00:10:58,120 --> 00:11:02,670
+تستخدمه في سرقة المالاكتير الحياة هذه لصالح
+
+141
+00:11:02,670 --> 00:11:06,610
+البشرية كويسة كتير احسن كتير من الحروب و من القصف
+
+142
+00:11:06,610 --> 00:11:12,590
+و من القتل و .. اه هاي فى عندنا أمثلة على ال ..
+
+143
+00:11:12,590 --> 00:11:18,230
+إيه زلتان؟ زلتان هو هذا اللي كان و نفسه تافين؟ فى
+
+144
+00:11:18,230 --> 00:11:24,510
+عندنا drugs منه أشكال مختلفة في نفس الشركة تانية
+
+145
+00:11:24,510 --> 00:11:30,180
+بس بتصنعه اسم لوميجانلو ميجان تريد نام اه اه تريد
+
+146
+00:11:30,180 --> 00:11:35,940
+نام لكن كله الاخر لتنبرس جداش خمسة من جداش؟ اه
+
+147
+00:11:35,940 --> 00:11:37,180
+خمسة من خمسة
+
+148
+00:11:41,100 --> 00:11:44,920
+لتانابرست او زلتان انه يوانز لتانابرست does not
+
+149
+00:11:44,920 --> 00:11:48,860
+effect aqueous flow and shows either no effect and
+
+150
+00:11:48,860 --> 00:11:52,560
+or slight increase in the conventional out of flow
+
+151
+00:11:52,560 --> 00:11:56,140
+facility يعني هنا بيحكي ان هو ما بيأثر على تدفق ال
+
+152
+00:11:56,140 --> 00:12:00,680
+aqueous او بيأثر بشكل بسيط بزيد بشكل بسيط تسهير
+
+153
+00:12:00,680 --> 00:12:05,040
+عملية تدفق اللي ال aqueous لأ هو يعني انا بقول
+
+154
+00:12:05,040 --> 00:12:09,500
+بمفهوم هنا no effect
+
+155
+00:12:12,230 --> 00:12:19,410
+انفلو يعني هو التصنيع على انفلو يعني
+
+156
+00:12:19,410 --> 00:12:26,650
+هو عكس اللي هو ال beta blockers وعكس ال carbonic
+
+157
+00:12:26,650 --> 00:12:30,470
+anhydrate انفلو هذه بتشتغل عن طريق التأثير على
+
+158
+00:12:30,470 --> 00:12:33,530
+تصنيع ال
+
+159
+00:12:38,720 --> 00:12:44,480
+لأ هذا بقولي ولا بيأثر على التلفاز مشهور، ولا
+
+160
+00:12:44,480 --> 00:12:48,300
+بيأثر
+
+161
+00:12:48,300 --> 00:12:52,100
+على اليوبيوسكليرا ال outflow، إيش يعني
+
+162
+00:12:52,100 --> 00:12:56,780
+يوبيوسكليرا؟
+
+163
+00:12:56,780 --> 00:13:06,150
+يعني ال celery body و ال iris بصيفة مثل قبأو بس
+
+164
+00:13:06,150 --> 00:13:14,390
+وما دا هي انه اللي هو هذا الدواء يفتح للأقوس منافج
+
+165
+00:13:14,390 --> 00:13:22,130
+علشان ينزل دق العين في ساحة يعني هتشوفوا انه كما
+
+166
+00:13:22,130 --> 00:13:26,190
+شوية في برش أكبر انه في ثقوب معينة حدثة في السنة
+
+167
+00:13:26,190 --> 00:13:31,550
+اليهودي والايرس عبرها قرار تاني تمكن الأقوس منه
+
+168
+00:13:31,550 --> 00:13:32,450
+لغادر العين
+
+169
+00:13:38,890 --> 00:13:43,150
+مش زي ما يعمل ال bio-carbine ال bio-carbine بيعمل
+
+170
+00:13:43,150 --> 00:13:50,870
+فتح ال AC angle لكن هنا لأ بيحاول يعمل ثقوب في ال
+
+171
+00:13:50,870 --> 00:13:56,630
+وبيا ال track و شوية فسكليرة حتى ينفذ بعض ال
+
+172
+00:13:56,630 --> 00:14:01,590
+aqueous و ينزل بعض ال air بحكينا عن استخدام تقنية
+
+173
+00:14:01,590 --> 00:14:05,930
+فلورو فوتوماتريك من بيعرف اش الفلورو فوتوماتريك
+
+174
+00:14:05,930 --> 00:14:11,120
+تقنية؟أنا على هوا مباحثة وجدت أنها عبارة عن تقنية
+
+175
+00:14:11,120 --> 00:14:15,500
+بيستخدموا فيها قياس المعدد تبع ال aqueous humor في
+
+176
+00:14:15,500 --> 00:14:18,460
+العين من خلال ال fluorescein و هذا بتكون manual أو
+
+177
+00:14:18,460 --> 00:14:22,400
+من جهاز اسمه photometer بيتم إضافة ال fluorescein
+
+178
+00:14:22,400 --> 00:14:25,640
+للعين و بيتم تبعته من خمس أو ست أو تمان ساعات و
+
+179
+00:14:25,640 --> 00:14:28,700
+بيشوفوا مدى انخفاض في التركيز تبع ال aqueous في
+
+180
+00:14:28,700 --> 00:14:32,440
+العين و منها بيحددوا تدفقه في العين مع الدول
+
+181
+00:14:32,440 --> 00:14:36,410
+الألبديةلتانوبرست was found to elevate uvscleral
+
+182
+00:14:36,410 --> 00:14:39,670
+outflow زي ما حكى الدكتور بيصير فيه تغطقوب وبيتدفق
+
+183
+00:14:39,670 --> 00:14:43,570
+منها الأعديواطر ال mechanism underlying the
+
+184
+00:14:43,570 --> 00:14:47,250
+enhanced uvscleral outflow remains unclear ولكن
+
+185
+00:14:47,250 --> 00:14:50,250
+هاي التقنية مش كتير واضحة حتى الآن إيش بيصير و إيش
+
+186
+00:14:50,250 --> 00:14:54,590
+بيجرى مش كتير واضحة بتجري عليها الأبحاث حاليا one
+
+187
+00:14:54,590 --> 00:14:55,250
+hypothesis
+
+188
+00:15:01,070 --> 00:15:06,630
+Rostaglandin analogue هو
+
+189
+00:15:06,630 --> 00:15:09,230
+هرمون موجود في الديسن في كتير من أسات الديسن لبد
+
+190
+00:15:09,230 --> 00:15:15,570
+هو اكتر كبير مثل هرمونmaybe stimulate كلاجين ..
+
+191
+00:15:15,570 --> 00:15:19,630
+بتحفظ الألياف الكلاجين .. كلاجيناس .. كلاجيناس
+
+192
+00:15:19,630 --> 00:15:23,870
+يعني كلاجيناس enzyme يعني بتوقف الكلاجين and other
+
+193
+00:15:23,870 --> 00:15:26,110
+methylproteinases
+
+194
+00:15:29,470 --> 00:15:34,630
+أو محللة للبروتينات بتكون موجودة و منها بيتم ال
+
+195
+00:15:34,630 --> 00:15:37,830
+empirally في حلقة .. في المرحلة الجانينية بتكون
+
+196
+00:15:37,830 --> 00:15:41,370
+العضلة .. تكوين العضلة تبع الإنسان بيحكينا the
+
+197
+00:15:41,370 --> 00:15:43,850
+greatest extracellular matrix between cellular
+
+198
+00:15:43,850 --> 00:15:47,230
+muscles يعني بتعمل على تحليل المادة الخلوية بين
+
+199
+00:15:47,230 --> 00:15:50,510
+الخلايا تبع الcellular muscle bundles و بيحكينا
+
+200
+00:15:50,510 --> 00:15:53,650
+أخر إشي one study has not such related spaces يعني
+
+201
+00:15:53,650 --> 00:15:57,250
+انه فيه زي ما حكينا holes بتكون موجودة و أماكن
+
+202
+00:15:57,250 --> 00:16:02,960
+متوسعةبتطلع من ال .. او ال .. او ال .. او ال .. او
+
+203
+00:16:02,960 --> 00:16:07,340
+ال .. او
+
+204
+00:16:07,340 --> 00:16:09,220
+ال .. او ال .. او ال .. او ال .. او ال .. او ال ..
+
+205
+00:16:09,220 --> 00:16:09,520
+.. او ال .. او ال .. او ال .. او ال .. او ال .. او
+
+206
+00:16:09,520 --> 00:16:11,180
+ال .. او ال .. او ال .. او ال .. او ال .. او ال ..
+
+207
+00:16:11,180 --> 00:16:11,780
+او ال .. او ال .. او ال .. او ال .. او ال .. او ال
+
+208
+00:16:11,780 --> 00:16:12,180
+.. او ال .. او ال .. او ال .. او ال .. او ال .. او
+
+209
+00:16:12,180 --> 00:16:12,580
+ال .. او ال .. او ال .. او ال .. او ال .. او ال ..
+
+210
+00:16:12,580 --> 00:16:13,460
+او ال .. او ال .. او ال .. او ال .. او ال .. او ال
+
+211
+00:16:13,460 --> 00:16:17,380
+.. او ال .. او ال .. او ال .. او ال ..
+
+212
+00:16:31,780 --> 00:16:39,580
+الان هو بتقول انه هل انه لتن بروست هذا الهرموني
+
+213
+00:16:39,580 --> 00:16:45,340
+بأثر على ال pressure بنزله ولا انه بأثر بس على هاي
+
+214
+00:16:45,340 --> 00:16:46,280
+بر تنسب
+
+215
+00:16:52,790 --> 00:16:55,990
+خمسة من الف concentration once or twice daily for
+
+216
+00:16:55,990 --> 00:17:01,230
+up to one month على الذين
+
+217
+00:17:01,230 --> 00:17:05,970
+عندهم ضغط طبيعي كان تركيز الدواء خمسة من الف و
+
+218
+00:17:05,970 --> 00:17:09,530
+أخدوه مرة او ماتين في اليوم لمدة شهر و كانت
+
+219
+00:17:09,530 --> 00:17:13,710
+النتيجة ان reduction in IOP من عشرين لاربعين was
+
+220
+00:17:13,710 --> 00:17:18,080
+not as long as twenty four hoursafter dozing كان
+
+221
+00:17:18,080 --> 00:17:22,580
+الخطوط في ال IOP من عشرين لاربعين خلال بعد ما أخد
+
+222
+00:17:22,580 --> 00:17:24,140
+الجرعة بعد أربع و عشرين ساعة
+
+223
+00:17:27,840 --> 00:17:30,760
+لتنابرست خمسة من الف once daily has since been
+
+224
+00:17:30,760 --> 00:17:34,420
+compared with تماول نصف مليون twice daily in three
+
+225
+00:17:34,420 --> 00:17:37,140
+studies performed in United States, United Kingdom
+
+226
+00:17:37,140 --> 00:17:41,280
+and Scandinavia في ثلاث دول عملت مقارنة بين
+
+227
+00:17:41,280 --> 00:17:45,000
+لتنابرست خمسة من الف وكانوا بياخدوها مرة واحدة
+
+228
+00:17:45,000 --> 00:17:48,920
+باليوم والتماول نصف مليون كانوا بياخدوها مرتين
+
+229
+00:17:48,920 --> 00:17:54,600
+باليوم اه النتيجةالنتيجة كان فيها انت باختلاعك
+
+230
+00:17:54,600 --> 00:17:58,440
+بالأول ان two of this study based conduction in
+
+231
+00:17:58,440 --> 00:18:01,220
+the united states and scandinavia found as
+
+232
+00:18:01,220 --> 00:18:06,920
+..substantial يعني صغيرية a greater efficacy was
+
+233
+00:18:06,920 --> 00:18:10,700
+lethanobrast than rotimolol لدوا اختلاف انه
+
+234
+00:18:10,700 --> 00:18:14,880
+التأثير تبع lethanobrast أكبر من تأثير rotimolol
+
+235
+00:18:14,880 --> 00:18:17,500
+whereas the united kingdom study found similar
+
+236
+00:18:17,500 --> 00:18:21,950
+result with the two agentsلأ ال united kingdom
+
+237
+00:18:21,950 --> 00:18:27,050
+المجلد انه التأثير لدولين متساوي مش يعني ان ليه
+
+238
+00:18:27,050 --> 00:18:31,350
+بيقول ال team world أحسن لأ لإن ال team world
+
+239
+00:18:31,350 --> 00:18:36,110
+بيساوي ولاتر برست يبقى النتيجة هاد ما هياش في ال
+
+240
+00:18:36,110 --> 00:18:40,030
+united states واسكندرالفيا كانت التفاوق لمين؟ لأ
+
+241
+00:18:40,030 --> 00:18:41,610
+لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ
+
+242
+00:18:41,610 --> 00:18:43,490
+لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ
+
+243
+00:18:43,490 --> 00:18:44,670
+لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ
+
+244
+00:18:44,670 --> 00:18:46,570
+لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ لأ
+
+245
+00:18:56,360 --> 00:19:00,100
+الثلاث دول تفقوا أن الاتنابراز كانت النتيجة اللي
+
+246
+00:19:00,100 --> 00:19:04,120
+بيخفف من ال IOP من 25 ل 30 من الضغط الطبيعي لو من
+
+247
+00:19:04,120 --> 00:19:05,200
+10 ل 20
+
+248
+00:19:22,180 --> 00:19:26,700
+لو نحب الموضوع وبنفس الحالة ضرط الدم نزل 100% ضرط
+
+249
+00:19:26,700 --> 00:19:32,200
+العين نزل 100% لأن العين سرق كلها يعني فيه بنزل 10
+
+250
+00:19:32,200 --> 00:19:38,360
+% 15% 20% اللي بنزل 30% وفوق كتير يعني كويس يعني
+
+251
+00:19:38,360 --> 00:19:47,360
+لو ضرط العين 30% ونزل 30% يبقى قريب منها ال 20 شيء
+
+252
+00:19:47,360 --> 00:19:52,380
+كويس يعنيلتنا breast لتنا breast has been studied
+
+253
+00:19:52,380 --> 00:19:56,220
+in several glaucoma subtypes، كان لتنا breast بتاع
+
+254
+00:19:56,220 --> 00:19:59,360
+بيعالج جميع أنواع الجلاكومة، الأكوايد
+
+255
+00:19:59,360 --> 00:20:02,620
+والكونجينيتر، جميع أنواعهاone study found
+
+256
+00:20:02,620 --> 00:20:05,320
+retinobiosis more effective than terminal chronic
+
+257
+00:20:05,320 --> 00:20:09,020
+angioplasmic glaucoma كان هو تعالى اكتر في علاج
+
+258
+00:20:09,020 --> 00:20:15,080
+الانجليزي ال glaucoma هو اكتر خطورة من اكتر انواع
+
+259
+00:20:15,080 --> 00:20:18,000
+ال glaucoma لانه بدي الى blindness من غير ما يشعر
+
+260
+00:20:18,000 --> 00:20:23,120
+الانجليزي اه اه يعني ال beta blocker مابتدش فيه
+
+261
+00:20:31,510 --> 00:20:38,830
+واللي فرق رسمي لانه زود ال auto flow زود ال auto
+
+262
+00:20:38,830 --> 00:20:44,150
+flow فاشتغل صح آه another found effect تكتب من
+
+263
+00:20:44,150 --> 00:20:46,890
+اللي هو I interact with pressure and steroid
+
+264
+00:20:46,890 --> 00:20:49,990
+induced glaucoma لإن هو بيصلح جميع أنواع ال
+
+265
+00:20:49,990 --> 00:20:52,930
+glaucoma كمان بيصلح ال glaucoma الناتجة عن ال
+
+266
+00:20:52,930 --> 00:20:53,470
+steroid
+
+267
+00:21:10,300 --> 00:21:15,480
+فهنا عند بعض الناس اسمه steroid responders يعني في
+
+268
+00:21:15,480 --> 00:21:19,800
+ناس اتأثروا باستيرويد كورتيزون يعني اكتر من ناس
+
+269
+00:21:19,800 --> 00:21:24,620
+عشان هيك اذا ما نعطي استيرويد في بعض الناس اللي
+
+270
+00:21:24,620 --> 00:21:28,040
+يعملوا كورتيزون يعني لها systemic disease systemic
+
+271
+00:21:28,040 --> 00:21:32,640
+disease فاحنا لازم نفضل نعمل check up لإيش؟
+
+272
+00:21:32,640 --> 00:21:40,040
+pressure وإلا بيروح العصب وبيعمق ومش داريفظهرني
+
+273
+00:21:40,040 --> 00:21:44,100
+حاجات ان لو ضغط انه بدأ يطلع ال retinobrost سحري
+
+274
+00:21:44,100 --> 00:21:49,280
+الموضوع عشان السترويد الديوستيكلوكومة اه I went
+
+275
+00:21:49,280 --> 00:21:53,600
+near compression of retinobrostverminsetimolol and
+
+276
+00:21:53,600 --> 00:21:57,360
+pigmentaryglacoma found a better IOP reduction in
+
+277
+00:21:57,360 --> 00:22:00,780
+the retinobrostageliasis ال pigmentaryglacoma
+
+278
+00:22:00,780 --> 00:22:07,080
+بتعمل gradual change in iris color بتتأثر .. نهتر
+
+279
+00:22:07,080 --> 00:22:08,700
+يعني ايش هي ال pigmentaryglacoma؟
+
+280
+00:22:13,660 --> 00:22:20,360
+Iris Dispersion Syndrome Dispersion يعني الميلانين
+
+281
+00:22:20,360 --> 00:22:25,640
+بتاع ال aires كل شوية بتتقشر و بيروح بسلسله وين؟
+
+282
+00:22:25,640 --> 00:22:29,760
+بالأنجل، بتحسب الأنجل، لأن عيون الأنجل بتاعة
+
+283
+00:22:29,760 --> 00:22:35,740
+الترابيكمش هو لا تسمح لإيه؟ بالميلانين يمروا، يعني
+
+284
+00:22:35,740 --> 00:22:41,770
+هذا الموليكيومبتاع ال .. اللي هو الميلادين أكبر
+
+285
+00:22:41,770 --> 00:22:48,610
+حجمه من ال .. اللي هو إيش ثقوب هدق فبصيروا إيش
+
+286
+00:22:48,610 --> 00:22:56,810
+carving من حشر بسكت ثقوب لما يبقوا هنا يعني صعب
+
+287
+00:22:56,810 --> 00:23:00,890
+نتصرف إلا نستخدم اللوزة هدق يزيد ال out of law
+
+288
+00:23:00,890 --> 00:23:04,790
+البديل إذا كان ال out of law بتاع ال angel سكة
+
+289
+00:23:04,790 --> 00:23:06,290
+فبنا out of law بديل
+
+290
+00:23:11,900 --> 00:23:14,660
+several study of latina breast efficacy in child
+
+291
+00:23:14,660 --> 00:23:19,840
+born glaucoma have been published انتشرت
+
+292
+00:23:19,840 --> 00:23:25,420
+في العام الأخير الدراسات عن تأثير ال latina breast
+
+293
+00:23:25,420 --> 00:23:28,340
+على الأخوة اللي عندهم glaucoma اللي كنتين تلقوا
+
+294
+00:23:28,340 --> 00:23:33,940
+glaucoma شوفتوا إياها تبقى تلبو في الطابس these
+
+295
+00:23:33,940 --> 00:23:36,960
+are reported by the researchers of latina breast
+
+296
+00:23:36,960 --> 00:23:41,540
+when added to other therapiesيعني النتيجة أكبر لما
+
+297
+00:23:41,540 --> 00:23:45,100
+نضيفوا ال .. ال little brush لل .. أكتر ايه؟
+
+298
+00:24:02,170 --> 00:24:06,270
+عملت دراسة على واحد و تلاتين عيال من أطفال اللي
+
+299
+00:24:06,270 --> 00:24:10,310
+عندهم الليكومة بس ستة الاستجابوا للعلاج وخمسة و
+
+300
+00:24:10,310 --> 00:24:14,310
+عشرين ده مايستجبوا و هذا نوع من إياش و كل استثناء
+
+301
+00:24:14,310 --> 00:24:17,170
+هذا فيه الإياش في البيدياتيكلوكومة أو
+
+302
+00:24:17,170 --> 00:24:20,940
+الكنجيتريكلوكومةأسكت في ال response تقولتني breast
+
+303
+00:24:20,940 --> 00:24:24,240
+treatment in sterish weber glaucoma was noted in
+
+304
+00:24:24,240 --> 00:24:28,840
+only 17 of all at 6 month إن sterish weber
+
+305
+00:24:28,840 --> 00:24:34,440
+glaucoma هي سيندروم بتابع ال glaucoma و بيأتي إلى
+
+306
+00:24:34,440 --> 00:24:38,180
+تضييفة أوي الدموية بترفع ضغط ال .. تفتح الصلمة
+
+307
+00:24:38,180 --> 00:24:38,880
+اللي بعدها يا جماعة؟
+
+308
+00:24:43,730 --> 00:24:50,310
+هذه الصورة كيف؟ عدة أمرا من ضمنها اللي بو في ال
+
+309
+00:24:50,310 --> 00:24:55,250
+face هي منزيوم شايفين؟ احنا مش هتخسر على طول اول
+
+310
+00:24:55,250 --> 00:25:00,650
+شوية لما نجيس ضغط العين هناك ملاجئة طبعا ايه
+
+311
+00:25:00,650 --> 00:25:02,310
+التأثيرات أخرى على القلب وشيء
+
+312
+00:25:02,310 --> 00:25:03,690
+تمانعششششششششششششششششششششش
+
+313
+00:25:08,990 --> 00:25:17,810
+Lego 17% له response another report
+
+314
+00:25:17,810 --> 00:25:20,190
+of treating sterish liver glaucoma with lentin
+
+315
+00:25:20,190 --> 00:25:27,990
+address noted two patients with general value of 7
+
+316
+00:25:27,990 --> 00:25:33,590
+.6
+
+317
+00:25:38,860 --> 00:25:45,080
+يبدأ في الطفولة يعني يبدأ في الطفولة ممكن يبدأ سنة
+
+318
+00:25:45,080 --> 00:25:48,180
+او سنتين او تلاتة او اربع او خمسة يعني في الطفولة
+
+319
+00:25:48,180 --> 00:25:55,260
+بيبدأ اللي هو ال Taiwan هو juvenile onset وهذا
+
+320
+00:25:55,260 --> 00:26:03,540
+ناتج عن قتل اللي هو ال insulin secreting cells ال
+
+321
+00:26:03,540 --> 00:26:07,020
+B cells في المكريسحتى إنه في ناس بيقولوا عنه
+
+322
+00:26:07,020 --> 00:26:10,280
+autoimmune disease اسمه ما تقول autoimmune
+
+323
+00:26:10,280 --> 00:26:17,840
+disease؟ مناعة لحاله إنه .. إنه بروتينه الشخص
+
+324
+00:26:17,840 --> 00:26:23,240
+الإنسان يشكل antibodies لحاله و تصير معاها كمناعية
+
+325
+00:26:23,240 --> 00:26:29,280
+داخل الدم اسمها antigen antibody reaction و تصير
+
+326
+00:26:29,280 --> 00:26:35,130
+في الجسم زي rheumatoid arthritisوفيه روع من اللي
+
+327
+00:26:35,130 --> 00:26:39,630
+هو ال disease بتاع ال .. بتكون type 1 كتير في
+
+328
+00:26:39,630 --> 00:26:44,510
+autoimmune diseases في جسم الإنسان ففي ناس بيقولوا
+
+329
+00:26:44,510 --> 00:26:48,830
+انه ال type 1 اللي هو autoimmune disease في ال
+
+330
+00:26:48,830 --> 00:26:53,710
+diabetes في درسته لأ بيقولوا قدرت قُنصيه يعني بعد
+
+331
+00:26:53,710 --> 00:26:58,690
+.. بعد الأربعين قدرت قُنصيه هذه لاتتباني على قتل
+
+332
+00:26:58,690 --> 00:27:00,270
+الفلايا بل على ضعف الافراز
+
+333
+00:27:07,490 --> 00:27:12,750
+فهنا ال juvenile onset glucoma لglucoma اللى بتبدأ
+
+334
+00:27:12,750 --> 00:27:18,190
+فى الطفولة عكس ال other اللى بتبدأ بعد الاربعين طب
+
+335
+00:27:18,190 --> 00:27:25,250
+الخطيرة ده ده احدا كان فى استجابة للاستجابة 2 من
+
+336
+00:27:25,250 --> 00:27:30,250
+المرضى للglucoma اللى بتجي على الطفولة و 4 من ال
+
+337
+00:27:30,250 --> 00:27:30,790
+congenital
+
+338
+00:27:38,320 --> 00:27:44,100
+ومن هنا ال concept ومن هنا جوناي ال concept جوناي
+
+339
+00:27:44,100 --> 00:27:48,500
+ولد بيها ولد بيها وهذه خطيرة ال computer أكتر من
+
+340
+00:27:48,500 --> 00:27:52,020
+تشوف ناجبك أربع أو خمس سنين أو ست سنين بيبدأ معاك
+
+341
+00:27:52,020 --> 00:27:55,580
+بيقوم هذين الناس زي ما يقولون ان انا developmental
+
+342
+00:27:55,580 --> 00:28:03,850
+يعني في مراحل طويلة علم هذه مستخدمفيه pediatric و
+
+343
+00:28:03,850 --> 00:28:07,310
+فيه steric و البرق المقومة juvenile و continental
+
+344
+00:28:07,310 --> 00:28:11,290
+لكن لسه احنا ماعملاش addition شوف اللي بعد ما حددش
+
+345
+00:28:11,290 --> 00:28:15,730
+بعد ما حكت عن تعالية المرض هحكي عن concentration و
+
+346
+00:28:15,730 --> 00:28:19,790
+ال doses للمرأة .. للمدرسة الزرقان has been tested
+
+347
+00:28:19,790 --> 00:28:24,950
+in doses of 0.0005% and is more effective with
+
+348
+00:28:24,950 --> 00:28:29,060
+once daily than with twice daily dosingبعد ما
+
+349
+00:28:29,060 --> 00:28:32,220
+عملوا دراسة على التركيز بالخمسة من الف في المية
+
+350
+00:28:32,220 --> 00:28:36,340
+لزلتان وجدوا انه بكون effective اكتر لما نكون مرة
+
+351
+00:28:36,340 --> 00:28:39,280
+يوميا افضل من لما نكون اتنين يوميا طب هذا عاجيب
+
+352
+00:28:39,280 --> 00:28:44,760
+ولا مش عاجيب؟ عاجيب عاجيب لان نعرفه ان كل ما زاد
+
+353
+00:28:44,760 --> 00:28:48,760
+الدوز كل ما زاد ال effect لكن كل ما زاد الدوز يقل
+
+354
+00:28:48,760 --> 00:28:53,160
+ال effect طب هذا شيء عاجيب وكمل بنفس التركيز وهكذا
+
+355
+00:28:53,160 --> 00:28:54,180
+بنت الهرمونات
+
+356
+00:28:59,780 --> 00:29:03,760
+لأن هالى ال Cortisone بيرتز من إيش؟ المضالة بتاعة
+
+357
+00:29:03,760 --> 00:29:07,200
+السبراجينالإجلالت اللى انتوا بظهرها لك دارى،
+
+358
+00:29:07,200 --> 00:29:10,940
+سبراجينالإجلالت في المضالة يعنى، هرمونية بتفرز
+
+359
+00:29:10,940 --> 00:29:15,500
+الادريالين وبتفرز إيش؟ ال Cortisone فاللي فانا
+
+360
+00:29:15,500 --> 00:29:22,580
+بروست هو متاخد من ال prostaglandin هورمون اللى
+
+361
+00:29:22,580 --> 00:29:27,850
+موجودفي عديد من ال orgasm بتاعة الجسم عشان تسهل
+
+362
+00:29:27,850 --> 00:29:31,570
+الموتابوليزم و تقفل الألم و .. و .. و حدات كتير هم
+
+363
+00:29:31,570 --> 00:29:34,810
+ماخدوش خروف تاجلاندين لأ، أفدوا .. عملوا analog ..
+
+364
+00:29:34,810 --> 00:29:40,410
+analog نظير إلهم أو مشابه إلهم، لكن بضيع هرمونه،
+
+365
+00:29:40,410 --> 00:29:43,970
+كان فيه هرمون صناعي، فالآن هذا الهرمون الصناعي
+
+366
+00:29:43,970 --> 00:29:44,730
+الزلتان
+
+367
+00:29:55,190 --> 00:29:59,470
+في اللي قطرته بحكي أن ال big effect اللي بتاخد على
+
+368
+00:29:59,470 --> 00:30:04,150
+أقل 12 ساعة وفي دراسة حكت أنه في ال .. لما ناخد ال
+
+369
+00:30:04,150 --> 00:30:07,670
+dosing في المساء بتعطي better day time pressure
+
+370
+00:30:07,670 --> 00:30:10,170
+reduction compared with morning يعني لو أعطينا ال
+
+371
+00:30:10,170 --> 00:30:13,290
+doses في المساء هتعطي effect .. هتكون effective
+
+372
+00:30:13,290 --> 00:30:20,870
+أكتر than morning dosing طبعا الموضوع ان هو وفيش
+
+373
+00:30:20,870 --> 00:30:25,800
+blankingو الهدوء و الميتابوليزم ضعيف شويه وشيء
+
+374
+00:30:25,800 --> 00:30:28,980
+شكله انه عنده نوم افضل من النهوض الصباح اللي بيكون
+
+375
+00:30:28,980 --> 00:30:32,520
+فيه activity .. في surgical activity و إشي هالجيل
+
+376
+00:30:32,520 --> 00:30:35,020
+اللي حاكي عن ال adaptivity ل ال latent prostate
+
+377
+00:30:35,020 --> 00:30:38,360
+بيحكي one add of two الانانس اللي اتبت فيه تبروكر
+
+378
+00:30:38,360 --> 00:30:42,540
+.. broker .. broker athenolollatin breast lowered
+
+379
+00:30:42,540 --> 00:30:47,160
+in Russia more than druselamide بيحكي لما احنا
+
+380
+00:30:47,160 --> 00:30:50,760
+نضيف لل .. لل .. لل .. لل latin breast الناس اللي
+
+381
+00:30:50,760 --> 00:30:56,680
+نكتب بيها بلغة هيكون تخفيض للضغط الدم .. اي لضغط
+
+382
+00:30:56,680 --> 00:31:00,900
+العين افضل من ال druselamide افضل من لو اضفنا
+
+383
+00:31:00,900 --> 00:31:04,990
+druselamideملاحظين يعني العبارة كده يعني دورزل ماج
+
+384
+00:31:04,990 --> 00:31:11,590
+مرتين بروز زي دورزل م اقل من مرتين بروز مقال فتن و
+
+385
+00:31:11,590 --> 00:31:11,630
+لو
+
+386
+00:31:16,450 --> 00:31:20,070
+هنا بيحكي ان ال patient اللي بيكون غير كافي ان ال
+
+387
+00:31:20,070 --> 00:31:24,270
+تميلول اللي اتحقق في ضغط العين لهم هيحاول على طول
+
+388
+00:31:24,270 --> 00:31:27,610
+لل Latinobrost لوحده، هيكون effective زي كأنه
+
+389
+00:31:27,610 --> 00:31:33,450
+أضفنا له بالو كربين أو زي كأنه حولنا لل تميلول مع
+
+390
+00:31:33,450 --> 00:31:37,610
+Dermalite، ال combination مع بعضهم هيكون أفضل من
+
+391
+00:31:37,610 --> 00:31:40,730
+Latinobrost لوحده شايفين Latinobrost هنا equals
+
+392
+00:31:40,730 --> 00:31:41,550
+ايش؟ تميلول
+
+393
+00:31:50,470 --> 00:31:53,130
+فاهمان مين أحسن واحد ياخد جترا اتنين ولا جترا؟ لأ
+
+394
+00:31:53,130 --> 00:31:57,930
+جترا ياخد هنا اربع .. اربع نقط من كل واحد اتنين في
+
+395
+00:31:57,930 --> 00:32:00,670
+اليوم و لا ياخد نقطة واحدة في الاربعين ساعة اتنين
+
+396
+00:32:00,670 --> 00:32:03,570
+اشتغلت اتنين اشتغلت اتنين اشتغلت اتنين اشتغلت
+
+397
+00:32:03,570 --> 00:32:05,510
+اتنين اشتغلت اتنين اشتغلت اتنين اشتغلت اتنين
+
+398
+00:32:05,510 --> 00:32:06,110
+اشتغلت اتنين اشتغلت اتنين اشتغلت اتنين اشتغلت
+
+399
+00:32:06,110 --> 00:32:17,610
+اتنين اشتغلت اتنين اشتغلت اتنين اشتغلت اتنين
+
+400
+00:32:17,610 --> 00:32:23,940
+اشتغام ام HG هنا بيحكي ان ال .. لما نضيفناله ..
+
+401
+00:32:23,940 --> 00:32:27,720
+لما نضيفناله ابيو كربيني بتركيز اتنين بتركيز اتنين
+
+402
+00:32:27,720 --> 00:32:31,920
+في المية كان وعطيناه على المريض من تلت مرات في
+
+403
+00:32:31,920 --> 00:32:35,920
+اليوم عطانا additional reduction في ال IOP من 10.7
+
+404
+00:32:35,920 --> 00:32:44,180
+ل 3.3 يعني مثلا كان عنده ضغط 25 صار عنده مثلا 22
+
+405
+00:32:44,180 --> 00:32:51,500
+فقال اعطى فعليه اكترطبعا هذه مقارنات لمفاهية
+
+406
+00:32:51,500 --> 00:32:56,340
+لتانوبرست وaddition لحاجات تانية، اللي يقيل انه
+
+407
+00:32:56,340 --> 00:32:58,960
+احنا مش ممكن نوصل لو احنا لتانوبرست زي البيو
+
+408
+00:32:58,960 --> 00:33:02,860
+كاربين، لان البيو كاربين ابسلت، ابسلت يعني في
+
+409
+00:33:02,860 --> 00:33:07,020
+العالم، لكن هذه الدراسة، هذه الدراسة، وانا لو بدأ
+
+410
+00:33:07,020 --> 00:33:08,800
+اضيف للتانوبرست
+
+411
+00:33:16,950 --> 00:33:20,390
+فأقل و بعدين هم بسيجنوا مع بعض اكتر من موضوع الـ
+
+412
+00:33:20,390 --> 00:33:24,130
+myotic و myotic و الساعة نرجع لموضوع الاسفاز بتاع
+
+413
+00:33:24,130 --> 00:33:29,070
+ال celery muscle و الكلام دههنا بيحكي عن ال local
+
+414
+00:33:29,070 --> 00:33:31,410
+adverse reaction اللي بتصير على العين لما نحن
+
+415
+00:33:31,410 --> 00:33:34,450
+نستخدم ال lateral thrust area will be post
+
+416
+00:33:34,450 --> 00:33:37,490
+quarantine preparation demonstrated as a
+
+417
+00:33:37,490 --> 00:33:41,350
+propensity toward stinging, hyperemia and
+
+418
+00:33:41,350 --> 00:33:45,770
+irritation لما أول استخدام لل .. لل .. للذرة بتاعه
+
+419
+00:33:45,770 --> 00:33:48,970
+هيعمل stinging في العين و هيعمل hyperemia و هيعمل
+
+420
+00:33:48,970 --> 00:33:49,350
+irritation
+
+421
+00:33:55,240 --> 00:33:59,660
+و الهيبريم يعني بيصير ال dialetation في الفضل و ال
+
+422
+00:33:59,660 --> 00:34:02,780
+dialetation بيصير فيهاش بالعالم، there have been
+
+423
+00:34:02,780 --> 00:34:05,980
+several cases of cystoid macular edema associated
+
+424
+00:34:05,980 --> 00:34:09,230
+with methanobrostiosisفي بعض الحالات سجلوا انه
+
+425
+00:34:09,230 --> 00:34:12,250
+يعني بيصير عندهم micro-aridema، cystoid micro
+
+426
+00:34:12,250 --> 00:34:15,930
+-aridema مع استخدامهم للتاني البروست طبعا هذا نادر
+
+427
+00:34:15,930 --> 00:34:20,390
+جدا نادر one study of patients undergoing cataract
+
+428
+00:34:20,390 --> 00:34:24,350
+surgery found more than geographic cystoid micro
+
+429
+00:34:24,350 --> 00:34:27,310
+-aridema اللي تاني البروستit treated eye compared
+
+430
+00:34:27,310 --> 00:34:31,030
+with placebo بحكي في دراسة وضحت ان بعض ال patient
+
+431
+00:34:31,030 --> 00:34:35,190
+اللي خدعوا عملية surgery وجدوا ان عندهم اكتر من
+
+432
+00:34:35,190 --> 00:34:40,710
+cystoid macular ديما في الشخاص اللي تعالجوه بال
+
+433
+00:34:40,710 --> 00:34:45,170
+لتان بروست مقارنة على علاجات البديلة لتان بروست
+
+434
+00:34:45,170 --> 00:34:49,090
+placebo عارفة ايش placebo علاج البديل او علاج وهم
+
+435
+00:34:49,090 --> 00:34:52,610
+اه علاج وهم علاج وهم psychological effect يعني
+
+436
+00:34:52,610 --> 00:34:55,610
+احنا احنا المستخدمين المعلاجين مثلا واحد
+
+437
+00:34:59,520 --> 00:35:02,900
+يعني يقولك أنا ده .. راسي بدي اقطير .. انا بصدع
+
+438
+00:35:02,900 --> 00:35:05,680
+جدا .. انا بدي اموت .. انا كده .. كده .. كده ..
+
+439
+00:35:05,680 --> 00:35:10,700
+يعني مافيش اشي محدد .. نفسي على عصبي .. على .. زي
+
+440
+00:35:10,700 --> 00:35:14,740
+تكاني .. ممكن جدا نقعد و نقعد فيها سراحة .. لان
+
+441
+00:35:14,740 --> 00:35:19,780
+هنعطيك علاج مثالي .. بس انت لو .. هتخلي الممرض ..
+
+442
+00:35:19,780 --> 00:35:23,620
+الممرض يضربك إبرة .. و تيبقى كمان .. و ممكن تكون
+
+443
+00:35:23,620 --> 00:35:25,180
+هذه الإبرة هذه ..
+
+444
+00:35:28,020 --> 00:35:33,880
+السيراج مثل الموتى، فيه التمام والتمام، هذا اسمه
+
+445
+00:35:33,880 --> 00:35:41,640
+placebo، مافيه drug واحد فأحيانا ال placebo في
+
+446
+00:35:41,640 --> 00:35:44,360
+الحياة النفسية بيبدأ من قارن، نحن نحط في عين مثلا
+
+447
+00:35:44,360 --> 00:35:49,760
+بيه تبلوكا وفعلا سراج، كل case، إذا كان في عامة
+
+448
+00:35:49,760 --> 00:35:52,360
+نفسية، بيلاقي أن السراج بيجي بتيجي
+
+449
+00:35:58,130 --> 00:36:01,170
+من لاتانو بروست، تجيب لاتانو بروست في حالة واحدة
+
+450
+00:36:01,170 --> 00:36:05,290
+أو في study واحد عامل عند المريض بتاع ال cataract
+
+451
+00:36:05,290 --> 00:36:10,270
+surgery عامله سيدوت سيستول مخلوق قديم فقالوا الناس
+
+452
+00:36:10,270 --> 00:36:12,750
+إنه بيعمل سيستول مخلوق قديم، طب ما هي نفس ال
+
+453
+00:36:12,750 --> 00:36:15,090
+surgery هي بيعمل سيستول مخلوق قديم، يعني ال
+
+454
+00:36:15,090 --> 00:36:17,790
+complications بتاع ال cataract surgery، سيستول
+
+455
+00:36:17,790 --> 00:36:23,070
+مخلوق قديم، ده يعني نتهم اللاتانو بروست و هو وين
+
+456
+00:36:23,070 --> 00:36:23,530
+كان مريض
+
+457
+00:36:34,710 --> 00:36:37,830
+بنقف من جهة من بعد الكترات أو جبل و نحنا نقف
+
+458
+00:36:37,830 --> 00:36:43,590
+باسكالة و نشوف جبل عوالد الكترات كلام كترات كترات
+
+459
+00:36:43,590 --> 00:36:45,290
+كترات كترات كترات كترات كترات كترات كترات كترات
+
+460
+00:36:45,290 --> 00:36:48,810
+كترات كترات كترات كترات كترات كترات كترات كترات
+
+461
+00:36:48,810 --> 00:36:52,130
+كترات كترات كترات كترات كترات كترات كترات كترات
+
+462
+00:36:52,130 --> 00:36:52,210
+كترات كترات كترات كترات كترات كترات كترات كترات
+
+463
+00:36:52,210 --> 00:36:52,890
+كترات كترات كترات كترات كترات كترات كترات كترات
+
+464
+00:36:52,890 --> 00:36:56,070
+كترات
+
+465
+00:36:56,070 --> 00:37:03,350
+كترات كتر
+
+466
+00:37:04,560 --> 00:37:09,060
+يعني الان وإن كان صحيح احنا بنقسم انه pre
+
+467
+00:37:09,060 --> 00:37:16,140
+-operative OCT لكل عيان مُكلِق مُكلِق ومُكلِق ف ..
+
+468
+00:37:16,140 --> 00:37:19,500
+لكن الصحيح انه في اطار دراسي بقى يعني في اطار
+
+469
+00:37:19,500 --> 00:37:23,720
+دراسي مثلا انا مثلا اربعين اربعين او خمسين مريض
+
+470
+00:37:23,720 --> 00:37:27,860
+بتعمل فيه بحث دكتوراه مثلا او بحث ماجستير انه كل
+
+471
+00:37:27,860 --> 00:37:31,800
+واحد اعمل OCT pre-operative و OCT post-operative
+
+472
+00:37:37,180 --> 00:37:42,180
+فعلا انه العملية بتعمل و جداشي بتعمل و هدأشي بيخدم
+
+473
+00:37:42,180 --> 00:37:47,020
+معاهم و غالي و مكلف و مضن العيال يعني مرتين يعملوا
+
+474
+00:37:47,020 --> 00:37:52,040
+OCT لكن انا بحترم هذا الرأي بالضبط مش نادرة جدا
+
+475
+00:37:52,040 --> 00:37:55,660
+انا جيت initial consensus that the IRS cannot
+
+476
+00:37:55,660 --> 00:37:59,920
+change were precursors of more or minus side of
+
+477
+00:37:59,920 --> 00:38:00,300
+the communists
+
+478
+00:38:08,860 --> 00:38:13,740
+والدراجة مستخدمة كشخصية أولى أو أخرى مستخدمةبحكي
+
+479
+00:38:13,740 --> 00:38:18,140
+أنه التركيز الأول هيكون على ال side effect اللي
+
+480
+00:38:18,140 --> 00:38:22,320
+الصغير عنده Iris carotid change، احنا هنتنفع أنه
+
+481
+00:38:22,320 --> 00:38:27,120
+وصل ال .. ال .. ال side effect وصلت لمرحلة خطيرة،
+
+482
+00:38:27,120 --> 00:38:30,900
+بس بالرغم من هيك أنه يعني بتتم التغلب عليها بسهولة
+
+483
+00:38:30,900 --> 00:38:34,660
+و حاليا لأن ال drug اللي موجودة حاليا تستخدم بشكل
+
+484
+00:38:34,660 --> 00:38:37,940
+واسع و مافيش أي side effect منها للناس
+
+485
+00:38:42,180 --> 00:38:46,280
+انا يعني بنات كتير بتركوا عندي انطباعات كويسة جدا
+
+486
+00:38:46,280 --> 00:38:50,120
+عن مستوهم العلم ومستوهم البحث و الله يزيدهم الخير
+
+487
+00:38:50,120 --> 00:38:57,640
+لكن طبعا احنا هنا بنحاول نحسن يعني هو في الأول لما
+
+488
+00:38:57,640 --> 00:39:02,340
+بدأ العيلز يتشكل و يصير dark الناس كانت بسبب انها
+
+489
+00:39:02,340 --> 00:39:08,380
+لبداية خراب للعيلز يعني انه التغيير
+
+490
+00:39:15,610 --> 00:39:19,830
+فنقول لأ يعني أقصى شيء بيغيره العين لكن لا يؤدي
+
+491
+00:39:19,830 --> 00:39:24,650
+إلى أي شيء آخر يعني هي مجرد devotion of more
+
+492
+00:39:24,650 --> 00:39:31,090
+melanin granules وده إيش وطبعا أمر السنين ده مافيش
+
+493
+00:39:31,090 --> 00:39:36,510
+حد مامشيش أكتر يعني تقري اللي هو إذا احنا ماقررناه
+
+494
+00:39:36,510 --> 00:39:40,630
+مع إنه دراجة بناخده مرة واحدة على مدار السنين
+
+495
+00:39:40,630 --> 00:39:44,610
+وبيخدم العين ومالوش shift ولا drift
+
+496
+00:39:47,660 --> 00:39:52,400
+لأ يعني ال glaucoma يبقى يعني glaucoma شعاقة،
+
+497
+00:39:52,400 --> 00:40:01,750
+glaucoma is يعني a blindness diseaseفاحنا أحيانا
+
+498
+00:40:01,750 --> 00:40:05,310
+مستغنى عن بعض الشكليات، أخف الدرارية، أخف
+
+499
+00:40:05,310 --> 00:40:09,550
+الدرارية، فلأن بعد ما اختنعنا أنه بيعملش severe
+
+500
+00:40:09,550 --> 00:40:12,810
+side effects يعني أخرى على عين غير التلوين، فصار
+
+501
+00:40:12,810 --> 00:40:17,030
+second line او first or second line، يعني هو في
+
+502
+00:40:17,030 --> 00:40:18,850
+الحقيقة ما زال في عالم الفقراء
+
+503
+00:40:36,190 --> 00:40:45,510
+patients with iris color susceptible to change
+
+504
+00:40:45,510 --> 00:40:49,030
+iris darkening or should be warned of the
+
+505
+00:40:49,030 --> 00:40:51,350
+possibility of permanent iris darkening or
+
+506
+00:40:51,350 --> 00:40:55,390
+trochromia بحكي هنا ال patient اللي بيصير عندهم
+
+507
+00:40:55,390 --> 00:40:59,370
+المحتمل او المتوقع ان يصير عندهم iris color
+
+508
+00:40:59,370 --> 00:41:03,730
+changed احنا بنحذرهم قبل ما يستفدموا الهدف انه
+
+509
+00:41:03,730 --> 00:41:07,750
+ممكن يصير عندهمت .. ت .. يعني ت darken لل iris
+
+510
+00:41:07,750 --> 00:41:10,650
+بشكل دائم أو تصير فيه تغير في لون ال iris لأ
+
+511
+00:41:10,650 --> 00:41:14,850
+heterochromia ايش؟ اكتر من لون ال iris يعني تغير
+
+512
+00:41:14,850 --> 00:41:20,050
+في لون ال iris اكتر من لون ال iris كل عين لون هترو
+
+513
+00:41:20,050 --> 00:41:23,930
+كروميا تغير في لونها تاني هترو كروميا يعني يكون
+
+514
+00:41:23,930 --> 00:41:27,990
+لون عين مثلا أسود و لون عين أفتح شوية طبعا عين
+
+515
+00:41:27,990 --> 00:41:31,570
+بيستخدم فيها تغير هي الصحيح أنه هذه يعني مخرجة
+
+516
+00:41:31,570 --> 00:41:35,810
+شوية disfigurement يعنيمش حلوة انه ال .. يعني لو
+
+517
+00:41:35,810 --> 00:41:39,750
+تيراس وات ساعة تستخدم كوزماتك .. اه لكن .. اه
+
+518
+00:41:39,750 --> 00:41:43,750
+كوزماتك .. كوزماتك ليه؟ اه كوزماتك نفسه بس ودي
+
+519
+00:41:43,750 --> 00:41:47,390
+استخدمه اه يعني بس ان .. لأ هو قصده انه احنا نقول
+
+520
+00:41:47,390 --> 00:41:52,870
+للمريض قبل ما يستخدمه القطع انه هلأ قد يحدث
+
+521
+00:41:52,870 --> 00:42:00,550
+darkening لل-eyes color او ربما يعمل heterochrome
+
+522
+00:42:09,110 --> 00:42:10,190
+بملايين دولار
+
+523
+00:42:20,060 --> 00:42:23,500
+و في بعض ال first action بتأثر على ال eyelashes و
+
+524
+00:42:23,500 --> 00:42:28,240
+ال thickness لها و ال growth لها بيحكي ان ال drugs
+
+525
+00:42:28,240 --> 00:42:31,760
+should be used with caution in patients with
+
+526
+00:42:31,760 --> 00:42:35,180
+previously demonstrated iritis of the soil micro
+
+527
+00:42:35,180 --> 00:42:38,620
+edema or herpes simplex keratitis يجب ان الحذر ال
+
+528
+00:42:38,620 --> 00:42:40,900
+patient هذه الأدوية لازم تستخدمها لتحذير ال
+
+529
+00:42:40,900 --> 00:42:46,040
+patient لأ و ال caution بحدث تحذير لأ لأ لأ بحدث
+
+530
+00:42:46,040 --> 00:42:52,120
+في فرق بين تحذير و بحدثإنه الناس اللي عندهم
+
+531
+00:42:52,120 --> 00:42:56,100
+previous arthritis أو تستويت ما كنت رديمة أو
+
+532
+00:42:56,100 --> 00:43:03,860
+Hepatitis جامل ميت وراح إن أنا بتستخدم ذلتان هالأ
+
+533
+00:43:03,860 --> 00:43:05,400
+اللي انا بروسفش أستخدمه
+
+534
+00:43:23,970 --> 00:43:28,350
+كويس thank you thank you very much طيب احنا نشكر
+
+535
+00:43:28,350 --> 00:43:32,510
+الأخوات الثلاثة اللي قعوا بهذا presentation رائع
+
+536
+00:43:32,510 --> 00:43:40,050
+بختام هذا course و انا تمنى يعني ان هذا course
+
+537
+00:43:40,050 --> 00:43:47,790
+يكون انته حابته و علمكم يعني عرضنا لكم من ال ..
+
+538
+00:43:47,790 --> 00:43:51,390
+هذا العلم المفيداللي يسأل الله أن يكون .. يعني
+
+539
+00:43:51,390 --> 00:43:56,230
+بتخير لكم وراء .. لهذا المجتمع الغزي والمجتمع اللي
+
+540
+00:43:56,230 --> 00:43:59,170
+هو الفلسطيني، فيه تعليم
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/aUnT5yLCp5U_raw.json b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/aUnT5yLCp5U_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..0e35cd0466b4737908bd26934760b94a69155b83
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/aUnT5yLCp5U_raw.json
@@ -0,0 +1 @@
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يعني", "probability": 0.94677734375}, {"start": 2631.39, "end": 2632.03, "word": " بتخير", "probability": 0.5908203125}, {"start": 2632.03, "end": 2632.63, "word": " لكم", "probability": 0.824462890625}, {"start": 2632.63, "end": 2633.11, "word": " وراء", "probability": 0.5546061197916666}, {"start": 2633.11, "end": 2633.21, "word": " ..", "probability": 0.7919921875}, {"start": 2633.21, "end": 2633.45, "word": " لهذا", "probability": 0.60546875}, {"start": 2633.45, "end": 2633.97, "word": " المجتمع", "probability": 0.9932861328125}, {"start": 2633.97, "end": 2634.61, "word": " الغزي", "probability": 0.8154296875}, {"start": 2634.61, "end": 2635.97, "word": " والمجتمع", "probability": 0.9064453125}, {"start": 2635.97, "end": 2636.23, "word": " اللي", "probability": 0.97412109375}, {"start": 2636.23, "end": 2636.55, "word": " هو", "probability": 0.998046875}, {"start": 2636.55, "end": 2638.49, "word": " الفلسطيني،", "probability": 0.9029715401785714}, {"start": 2638.49, "end": 2638.67, 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\ No newline at end of file
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/fXPF6hfaJ5g_postprocess.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/fXPF6hfaJ5g_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..5a5d64b4b21725b2542f5153d11094b9f625702c
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/fXPF6hfaJ5g_postprocess.srt
@@ -0,0 +1,2272 @@
+1
+00:00:19,860 --> 00:00:22,600
+أعوذ بالله من الشيخ الردين بسم الله الرحمن الرحيم
+
+2
+00:00:22,600 --> 00:00:26,540
+الحمد لله رب العالمين وأصلي وأسلم على النبي الأمين
+
+3
+00:00:26,540 --> 00:00:30,980
+محمد وعلى آله وأصحابي والتابعين السلام عليكم ورحمة
+
+4
+00:00:30,980 --> 00:00:35,260
+الله وبركاته في هذا اليوم سنكملوا ما كنا قد بدأنا
+
+5
+00:00:35,260 --> 00:00:40,820
+في المحلقة السابقة من موضوع antiglucoma drugs
+
+6
+00:00:40,820 --> 00:00:47,750
+antiglucoma eye drops beta blockersو اليوم احنا
+
+7
+00:00:47,750 --> 00:00:55,210
+اتشرف ان الطالبة المميزة فاقمة مراز تقوم بعمل
+
+8
+00:00:55,210 --> 00:00:59,070
+presentation و احنا نعمل discussion و تعليق و هي
+
+9
+00:00:59,070 --> 00:00:59,910
+مشكورة طبعا
+
+10
+00:01:03,920 --> 00:01:07,520
+بسم الله الرحمن الرحيم اليوم راح نحكي عن الخصائص
+
+11
+00:01:07,520 --> 00:01:11,480
+اللي بتميز فيها ال beta-blockers أول شي بحكي ال
+
+12
+00:01:11,480 --> 00:01:13,980
+beta-blockers have varying degree of protein
+
+13
+00:01:13,980 --> 00:01:17,060
+binding capacity and lipid solubility إلها درجات
+
+14
+00:01:17,060 --> 00:01:21,920
+مختلفة من ارتباطها في ال protein و الدوابان إلها
+
+15
+00:01:21,920 --> 00:01:25,500
+some undergo a high first pass metabolism in the
+
+16
+00:01:25,500 --> 00:01:29,400
+liver, for example propranolol and some have
+
+17
+00:01:29,400 --> 00:01:33,480
+active metabolism and some are exert precipitate
+
+18
+00:01:35,630 --> 00:01:38,990
+execrated principally by the kidney example
+
+19
+00:01:38,990 --> 00:01:44,730
+الاتنول منها في من أنواعها اللي بيصير لها تفاعل
+
+20
+00:01:44,730 --> 00:01:50,470
+حيوي في ال liver و منها ال propranolol و في من
+
+21
+00:01:50,470 --> 00:01:55,090
+أنواعها بيصير لها تفاعل حيوي في ال kidney منها
+
+22
+00:01:55,090 --> 00:01:59,090
+الاتنول اتنول تخرج في الكلية تخرج في الكلية
+
+23
+00:01:59,090 --> 00:02:00,090
+executed يعني
+
+24
+00:02:03,100 --> 00:02:07,240
+هذا الجدول بوضح أن أنواع ال beta blockers في منها
+
+25
+00:02:07,240 --> 00:02:10,540
+non selective في منها selective، ال non selective
+
+26
+00:02:10,540 --> 00:02:16,300
+اللي بيشتغل على P1 و P2 و ال selective اللي بيشتغل
+
+27
+00:02:16,300 --> 00:02:21,150
+على P1هذه الأنواع انها بيعطوها للي عندهم أمراض
+
+28
+00:02:21,150 --> 00:02:24,810
+خاصة مثل الأمراض القلق أما هذه الأنواع من ال non
+
+29
+00:02:24,810 --> 00:02:29,310
+selective بيعطوها ل .. لل .. ايه .. لل .. لـ Anti
+
+30
+00:02:29,310 --> 00:02:34,010
+-glucoma تلاحظة هنا إيش عامل هو؟ يقول الواحدة في
+
+31
+00:02:34,010 --> 00:02:39,010
+القياس Pro, Prado هو كل .. كل دراجة من هذه كام
+
+32
+00:02:39,010 --> 00:02:43,730
+بيساوي من ال Prado زي ما قلتلكوا يعني قطعة شكل،
+
+33
+00:02:43,730 --> 00:02:45,710
+عشر شكل، خمس شكل، عشرين شكل
+
+34
+00:02:59,060 --> 00:03:02,720
+هذا ست مرات، ليه بيقول بيقول بيشتغل أقوى منه، من
+
+35
+00:03:02,720 --> 00:03:07,420
+هذا، ست مرات، هذا مثلا تمولول، ست مرات اللي هو
+
+36
+00:03:07,420 --> 00:03:10,460
+تمولين اللي احنا بستعمله في الحياة العادية، ست
+
+37
+00:03:10,460 --> 00:03:14,500
+مرات أقوى من الأساسي اللي بيكتشف زمان، هذا زي و
+
+38
+00:03:14,500 --> 00:03:19,100
+مرة و مرة، عشان يكمل أحلى أختي فاهمة إن ال
+
+39
+00:03:19,100 --> 00:03:20,840
+selective ضعاف
+
+40
+00:03:37,060 --> 00:03:41,080
+however the deciding factor in clinical system
+
+41
+00:03:41,080 --> 00:03:46,620
+effectivity العوامل اللي بتأثر على التأثير على
+
+42
+00:03:46,620 --> 00:03:50,760
+الجسم difference in potency, beta receptors,
+
+43
+00:03:50,980 --> 00:03:53,580
+subtypes, selectivity, metabolism passage through
+
+44
+00:03:53,580 --> 00:03:56,700
+the blood brain barrier, direct effect on the
+
+45
+00:03:56,700 --> 00:03:59,640
+membranes and degree of intrinsic
+
+46
+00:04:07,620 --> 00:04:27,940
+Symptomatic activity بيختلف
+
+47
+00:04:27,940 --> 00:04:30,460
+في ال beta blockers في تأثيره على ال anti-glaucoma
+
+48
+00:04:30,460 --> 00:04:34,610
+أنه يعمل تفعل أنه يعالج لل glaucomaفي ال
+
+49
+00:04:34,610 --> 00:04:38,270
+hypotensive .. العلاقة ما بين ال hypotensive اللي
+
+50
+00:04:38,270 --> 00:04:44,830
+بيصير لل ocular و تأثيرها على الجسم أه هنا بنتكلم
+
+51
+00:04:44,830 --> 00:04:50,130
+على تأثير ال beta blockers على الجسم عموما
+
+52
+00:05:06,060 --> 00:05:10,700
+زي ما قلنا قبل شوية في ال beta blockers نسبتها
+
+53
+00:05:10,700 --> 00:05:14,880
+برومنالولور جديش الفرق، في اشي عشرة واشي ثلاثة
+
+54
+00:05:14,880 --> 00:05:19,940
+واشي ستة واشي تلتة من عشرة، فمثلا واحد، فمثلها كل
+
+55
+00:05:19,940 --> 00:05:23,480
+ما كان قوته أكتر بكتير من برومنالولور كل ما عمل
+
+56
+00:05:23,480 --> 00:05:28,300
+عبدالاسم بطريقة أقوى، ولاقس صحيحمثلا بيطلب from
+
+57
+00:05:28,300 --> 00:05:31,580
+the subtype selectivity طبعا ال selective أضعف من
+
+58
+00:05:31,580 --> 00:05:35,280
+ال non-selective مثلا ال metabolism هل بيصير
+
+59
+00:05:35,280 --> 00:05:40,820
+متابوليزم سيء ولا متابوليزم بطيء في الجسم مثلا بس
+
+60
+00:05:40,820 --> 00:05:44,240
+بي throw blood brain barrier في بعضهم بيخشوا ال
+
+61
+00:05:44,240 --> 00:05:47,080
+blood brain barrier عارفين ال blood brain barrier؟
+
+62
+00:05:47,080 --> 00:05:49,500
+بتتكلم عن هذا؟ و في بعضهم يدخلوا .. يدخلوا .. أو
+
+63
+00:05:49,500 --> 00:05:54,620
+يدخلوا بطيء يعني هذا بي .. بي .. هو اللي محدد مدى
+
+64
+00:05:54,620 --> 00:05:56,120
+الفعلية بتاعته
+
+65
+00:05:59,910 --> 00:06:04,330
+يشبه الـ sympathetic يشبه الـ sympathetic فيه مشبه
+
+66
+00:06:04,330 --> 00:06:09,090
+وفيه مشبهش وبالتالي يعني هذه الأوامر المجتمعة هي
+
+67
+00:06:09,090 --> 00:06:12,570
+اللي بتحدد مدى فعل هذا ال beta blocker على خلايا
+
+68
+00:06:12,570 --> 00:06:16,570
+الاسم، لكن في العين فاقم، في مشكلة ربيع، treatment
+
+69
+00:06:16,570 --> 00:06:21,750
+of glaucoma يا أختي، فاقم، لأ الوضع بيختلف، لأن
+
+70
+00:06:21,750 --> 00:06:26,590
+العين جهاز خاص مش زي دورة دموية، لأن ال metabolism
+
+71
+00:06:26,590 --> 00:06:28,210
+بيصير في العين، وال
+
+72
+00:06:32,410 --> 00:06:35,510
+يعني اللي هو selective و non selective و الحياة
+
+73
+00:06:35,510 --> 00:06:38,750
+الكارية يعني ان انتوا راجبتيه مثلا لأ بستخدمه في
+
+74
+00:06:38,750 --> 00:06:43,570
+العين non selective لإرواحه بس بشرط انه كمان ما
+
+75
+00:06:43,570 --> 00:06:48,290
+خلوهش ينزل كتير و يام طبعا طبقوا فيه بعض ال beta
+
+76
+00:06:48,290 --> 00:06:50,970
+blockers انا بستعمله مرة في اليوم زي ال nylon gel
+
+77
+00:06:50,970 --> 00:06:53,270
+شفتوا ال nylon gel جبته انا هنا في ال ..
+
+78
+00:06:57,460 --> 00:07:00,360
+وانتهت هل ال knowledge اللي هدا بدنا نروح في خربة
+
+79
+00:07:00,360 --> 00:07:07,080
+دورة ذموية؟ بس هي تحرز خاصة في الأطفال احنا
+
+80
+00:07:07,080 --> 00:07:10,720
+متحرزين كتير لإن الأطفال و الأهل يعني بيكونوا أمية
+
+81
+00:07:10,720 --> 00:07:14,460
+مش فاهمين بيحطوا كمية كبيرة حسب منه إن القطب هذا
+
+82
+00:07:14,460 --> 00:07:18,340
+بيكون جوا العين زي الأطربيل مثلا ما كنا بناخد في
+
+83
+00:07:18,340 --> 00:07:21,680
+الأطربيل مثلا أو اللي هو ال ..
+
+84
+00:07:26,360 --> 00:07:29,460
+لكن الناس الكبار عندهم glaucoma بيحطوا للمرأة
+
+85
+00:07:29,460 --> 00:07:33,640
+مرتين في اليوم جيل او قتلة ما تعمل هذه المصايم
+
+86
+00:07:33,640 --> 00:07:37,980
+اللي هي بتصير في الجسم يبقى العين في جهاز ا
+
+87
+00:07:47,640 --> 00:07:52,120
+هنا رح نحكي عن ال .. ال beta blockers في العام
+
+88
+00:07:52,120 --> 00:07:57,340
+1987 فيه تلت أنواع من ال beta blockers كانوا في ال
+
+89
+00:07:57,340 --> 00:08:00,820
+united states في منها ocular و في منها systemic ال
+
+90
+00:08:00,820 --> 00:08:05,820
+ocular فيها timolol, betaxolol و levopinolol و في
+
+91
+00:08:05,820 --> 00:08:10,260
+من تلت أنواع beta blockers تشتغل على الجسم منها
+
+92
+00:08:10,260 --> 00:08:17,040
+atenolol و metoprolol و probenololهذه بتستخدم لما
+
+93
+00:08:17,040 --> 00:08:20,200
+يكون عندنا فيه mild أو moderate, hyper sensitive
+
+94
+00:08:20,200 --> 00:08:26,140
+في الجسم و للأشخاص اللي عندهم anemia .. anemia عند
+
+95
+00:08:26,140 --> 00:08:30,160
+.. أدعينا، عارفة أدعينا إيه؟ دلوقت صدرية
+
+96
+00:08:43,700 --> 00:08:48,520
+وبالتالي لما الواحد بيعمل اي مفعول ماشي او جري او
+
+97
+00:08:48,520 --> 00:08:54,020
+مجهود ماببدأش يستمر لأنه قيمة الدعم اللي بيكمله
+
+98
+00:08:54,020 --> 00:08:58,660
+فيه هتفهق قليلا فبيصير شيء من اسكيميا نقص ال ايش
+
+99
+00:08:58,660 --> 00:09:02,620
+نقص ال oxygen نقص ال oxygen انا متسلم شايفين الأكل
+
+100
+00:09:02,620 --> 00:09:05,280
+أقل أحمر وال system أكمل أحمر عشان انتوا
+
+101
+00:09:05,280 --> 00:09:08,780
+ماتتعاملوش فالانجليزيا معروفة طب والأراضي المياد
+
+102
+00:09:08,780 --> 00:09:17,130
+في دقات القلبو كده فهي قلب يعني عدم انتظام مرة
+
+103
+00:09:17,130 --> 00:09:21,290
+بزيد و مرة بجلد زيك المفروض ان القلب يكون منتظر
+
+104
+00:09:21,290 --> 00:09:25,810
+دقيقة القلب يكون منتظر عدم انتظام هذا بصورة ملحوظة
+
+105
+00:09:25,810 --> 00:09:32,490
+هذا بأثر او يأثر في الدوس فضل هاي ال beta blockers
+
+106
+00:09:32,490 --> 00:09:34,970
+بيعطيها ال hypertension بيكون عندهم hypertension
+
+107
+00:09:34,970 --> 00:09:36,750
+ليخفضوا من ال
+
+108
+00:09:39,540 --> 00:09:43,320
+هنا راح نحكي عن ال side effect لل beta blockers،
+
+109
+00:09:43,320 --> 00:09:47,120
+إيش تأثيرها على الجسم؟ فيه تلت تصنيفات في ال
+
+110
+00:09:47,120 --> 00:09:50,640
+cardiovascular system و في ال respiratory system و
+
+111
+00:09:50,640 --> 00:09:53,500
+على العين، تأثيراتها على العين على ال
+
+112
+00:09:53,500 --> 00:09:56,100
+cardiovascular system، body cardio ممكن تعمل
+
+113
+00:09:56,100 --> 00:10:01,420
+ارتفاع في زيادة نفضات القلب و ممكن تعمل جسم
+
+114
+00:10:01,420 --> 00:10:07,200
+hypotension، يعني تنزل ضغط الدم للجسمفي ال
+
+115
+00:10:07,200 --> 00:10:12,280
+respiratory system bronchospasm
+
+116
+00:10:12,280 --> 00:10:16,300
+in the asthmatic and patient with chronic
+
+117
+00:10:16,300 --> 00:10:22,200
+obstructive pulmonary disease يبقاش bronchospasm
+
+118
+00:10:22,200 --> 00:10:27,520
+تشغل في عضلات القصب الإبطائي فضيق خليف فيه اللي هو
+
+119
+00:10:27,520 --> 00:10:34,560
+عموما مجال النفس برونكاي and bronchus البرونكاية
+
+120
+00:10:34,560 --> 00:10:34,960
+كبيرة
+
+121
+00:10:40,540 --> 00:10:48,440
+بالنفس بتنتهي بال sex بتاعة النفس، يعني هي زي شجرة
+
+122
+00:10:48,440 --> 00:10:54,080
+سبحان الله، كيف القصب الهوية زي أصل الشجرة ال سا،
+
+123
+00:10:54,080 --> 00:10:58,860
+بعدين السا فوق بيبدأ يتفرع إلى المموعة الكبيرة
+
+124
+00:11:14,090 --> 00:11:18,510
+هي بتجيب من الأرض الميه و بتجيب الميه الغرقية و
+
+125
+00:11:18,510 --> 00:11:23,430
+السلق بيوصل و بيحمل و الغصون برضه بتوصل و بتحمل
+
+126
+00:11:23,430 --> 00:11:28,690
+لكن وراك هو الميتابوليزم الحقيقي يعني في تجربة
+
+127
+00:11:28,690 --> 00:11:31,290
+عملناها انه جيبنا شجرة
+
+128
+00:11:42,350 --> 00:11:46,010
+الورق على مهمتي الدنيا فالفرسلات الهوائية أو الكيس
+
+129
+00:11:46,010 --> 00:11:50,530
+الهوائية هذه اللي بتبتدعي هنا أحيانا لو أخدنا
+
+130
+00:11:50,530 --> 00:11:56,550
+أقراس تمولول الأقراس هذه إيش بتعمل؟ Propagation
+
+131
+00:11:56,550 --> 00:12:02,190
+تصير واحد خاصة مع أزمة بيزيد الأزمة الرابعة بيضيق
+
+132
+00:12:02,190 --> 00:12:03,470
+كمان كلموت يعني
+
+133
+00:12:18,400 --> 00:12:33,940
+نقص الإحساس يعني نقص الإحساس
+
+134
+00:12:33,940 --> 00:12:38,660
+يعني
+
+135
+00:12:38,660 --> 00:12:41,840
+نقص الإحساس
+
+136
+00:12:45,410 --> 00:12:48,370
+يعني هو المفروض الإشمع من الأساس بيخلّي يبطّر
+
+137
+00:12:48,370 --> 00:12:51,670
+الإنسان الكلام لكن هذا خطير على العين و لا مش
+
+138
+00:12:51,670 --> 00:12:57,810
+خطير؟ او انشري بالقرنية و ماحسش الانم .. اه يعني
+
+139
+00:12:57,810 --> 00:13:01,470
+الألم سلاح لأنكوا الألم اللي أنتوا بتحسوا فيه هذا
+
+140
+00:13:01,470 --> 00:13:05,810
+سلاح يعني أقولك إنه فيه خطر تهدد هذا الموضوع لإن
+
+141
+00:13:05,810 --> 00:13:11,230
+احنا الناس اللي عندهم سكري الظلمة تتفوت من خلف
+
+142
+00:13:11,230 --> 00:13:21,290
+عليهمعفاية السكري انه بيصير atrophy لنهايات
+
+143
+00:13:21,290 --> 00:13:25,710
+الأعصاب الترافية بيصير atrophy دموعه وبالتالي
+
+144
+00:13:25,710 --> 00:13:29,390
+بيبطل يعني لو العيال بتاع السكر اللي له عشر سنين
+
+145
+00:13:29,390 --> 00:13:34,950
+او اكتر لو ماشي على ناره مانبسش نهيج انه كمان فيه
+
+146
+00:13:34,950 --> 00:13:39,120
+تضيق في الشرايين فممكن انه يصير وردرينة بتبشمافيش
+
+147
+00:13:39,120 --> 00:13:43,900
+دم يعمل healing فاحنا بالنسبة للناس العين بهمنا
+
+148
+00:13:43,900 --> 00:13:48,320
+العين كتير انه بيعمل قلة إحساس و بيعمل dry eyes
+
+149
+00:13:48,320 --> 00:13:53,240
+يعني جفاف الـocular rotation مثل عينه حمرا و
+
+150
+00:13:53,240 --> 00:14:00,000
+متهيجر و بيعمل hyperemia انه توسع و فيه احتقال فضل
+
+151
+00:14:00,000 --> 00:14:04,560
+هنا بيحكي ان الـocular beta blockers بتختلف
+
+152
+00:14:04,560 --> 00:14:07,680
+خصائصها عن ال systemic beta blockers ده لما نشوف
+
+153
+00:14:07,680 --> 00:14:08,140
+العنوان
+
+154
+00:14:12,810 --> 00:14:16,250
+برضه نحكي انه كيف راح تعمل ال beta blockers
+
+155
+00:14:16,250 --> 00:14:20,430
+بتأثيرها على العين، بحكي انه في ال .. في ال beta
+
+156
+00:14:20,430 --> 00:14:24,510
+one blockers، selectivity, lower IP from animals
+
+157
+00:14:24,510 --> 00:14:28,410
+تتعملوا دراسة على الحيوانات، لقوا أنه لو أعطوه
+
+158
+00:14:28,410 --> 00:14:33,410
+beta one blockers، راح يعمل reduce information of
+
+159
+00:14:33,410 --> 00:14:38,630
+accurate human من خلالتقليل تغضي ال .. اللي بتصعر
+
+160
+00:14:38,630 --> 00:14:41,010
+لل ciliary body بما أنه ال ciliary body هي
+
+161
+00:14:41,010 --> 00:14:44,490
+المسؤولة عن ال aqueous إنتاج السيئة ال aqueous فلو
+
+162
+00:14:44,490 --> 00:14:47,050
+عملوا reduction of blood flow to the ciliary body
+
+163
+00:14:47,050 --> 00:14:50,950
+فمش راح ينتج aqueous يومان وهيك بعمل تقليل لل
+
+164
+00:14:50,950 --> 00:14:54,770
+intraocular pressure فلعين يعني مستنتج هذا شهو
+
+165
+00:14:54,770 --> 00:15:00,310
+طبعا غالبا صيني هم شعب شهو مثل هيك ولا سينيين ولا
+
+166
+00:15:00,310 --> 00:15:02,190
+كوريين ولا ..
+
+167
+00:15:05,380 --> 00:15:08,880
+والكليزي بتاعي انه استمتعت وانه فيه reduction of
+
+168
+00:15:08,880 --> 00:15:13,600
+blood clot formation by timolol نتج عن إيش؟
+
+169
+00:15:13,600 --> 00:15:17,200
+reduction of blood clot formation هذا هو استمتعته،
+
+170
+00:15:17,200 --> 00:15:23,580
+لكن طبعا بعض العلماء خلفوه بعدين، تفضل هنا راح
+
+171
+00:15:23,580 --> 00:15:27,340
+يحصل جيب نوع من ال non selective beta blockers
+
+172
+00:15:27,340 --> 00:15:30,640
+agent اللي هو ال Probanol Probanol was the first
+
+173
+00:15:30,640 --> 00:15:37,800
+beta blocking agent Pro-pro-no-lolwas the first
+
+174
+00:15:37,800 --> 00:15:40,420
+beta-blocking agent to be used in clinical
+
+175
+00:15:40,420 --> 00:15:43,400
+therapeutics and has become the standard against
+
+176
+00:15:43,400 --> 00:15:46,280
+which other beta-blocking drugs are measured يعني
+
+177
+00:15:46,280 --> 00:15:50,420
+هو كان أول ال beta-blockers استخدموا علاجه وبعد
+
+178
+00:15:50,420 --> 00:15:56,240
+هيك عملوا أنواع أخرى من ال beta-blockers هو الأساس
+
+179
+00:15:56,240 --> 00:16:00,040
+هو الأساس بطلنا نستعمله لكن هو واحدة في القياسي
+
+180
+00:16:00,040 --> 00:16:02,520
+بقولنا بنقول مثلا Timolol جالده ست مرات,
+
+181
+00:16:02,900 --> 00:16:04,180
+labofnalol جالده تلت مرات
+
+182
+00:16:21,640 --> 00:16:27,160
+ميض مرضى عملت اليهود تراجع من سنة سبع ستين لسنة
+
+183
+00:16:27,160 --> 00:16:29,740
+الخمس والتمانين أو التمانين
+
+184
+00:16:35,150 --> 00:16:40,310
+الدراجة السينيتاتيكية هي مصادرة لتعامل الهيبرتنشن
+
+185
+00:16:40,310 --> 00:16:43,210
+السيستيماكي والهيبرتنشن الهيبرتنشن الهيبرتنشن
+
+186
+00:16:43,210 --> 00:16:52,430
+الهيبرتنشن
+
+187
+00:16:52,670 --> 00:16:57,070
+كعلاج ال hypertension systemic و ال cardiac
+
+188
+00:16:57,070 --> 00:17:00,290
+problem، عدم انتظار ضربة القلب، both oral
+
+189
+00:17:00,290 --> 00:17:05,070
+propranolol and topical propranolol lower IOP in
+
+190
+00:17:05,070 --> 00:17:09,810
+the human، ال oral و ال topical كان اكراس و القطر
+
+191
+00:17:28,430 --> 00:17:31,690
+however use of tropical propranolol in the
+
+192
+00:17:31,690 --> 00:17:34,170
+treatment of glaucoma is limited because of its
+
+193
+00:17:34,170 --> 00:17:37,030
+side effects which is result corneal anesthesia
+
+194
+00:17:37,030 --> 00:17:40,130
+and ocular irritation زي ما حكينا إنه له side
+
+195
+00:17:40,130 --> 00:17:44,610
+effects للبيتر لوكرز فهيك عملوا إنه مش كتير
+
+196
+00:17:44,610 --> 00:17:50,250
+بيستخدموه في علاج اللي ..the mechanism of action
+
+197
+00:17:50,250 --> 00:17:53,550
+of propranolol by which IOP is lowered is still
+
+198
+00:17:53,550 --> 00:17:57,070
+uncertain يعني كيف بيعمل ال propranolol على تخفيض
+
+199
+00:17:57,070 --> 00:18:02,970
+IOP مش مارف كيفلقوا انه reported to the press IQ
+
+200
+00:18:02,970 --> 00:18:07,290
+was a human formation لأنه يقلل IQ was a human
+
+201
+00:18:07,290 --> 00:18:12,490
+formation it has also been accepted with the
+
+202
+00:18:12,490 --> 00:18:16,190
+increasing facility of outflow عمل في ال outflow
+
+203
+00:18:16,190 --> 00:18:19,730
+زيادة انه يسلف ال IQ was a human دي برنامج هم
+
+204
+00:18:19,730 --> 00:18:23,170
+مختلفين هم بيقولوا كده بيعمل uncertain لكن
+
+205
+00:18:23,170 --> 00:18:31,770
+الفراضيات لسه مش حقوقتها انه بيقللإفراز الأكبر سهم
+
+206
+00:18:31,770 --> 00:18:36,150
+من السيئة الريبودي، وفي ناس بيقولوا إيش؟ إنه بيزول
+
+207
+00:18:36,150 --> 00:18:40,190
+ال outflow من ال trabecular مشورة، لكن هذا كان لسه
+
+208
+00:18:40,190 --> 00:18:44,290
+في عليه شغل، خلصنا
+
+209
+00:18:44,290 --> 00:18:50,190
+هذا، هذا لآن مافيش منه، أنا على قهدي مثلا من ال 21
+
+210
+00:18:50,190 --> 00:18:53,730
+سنة ال 22 سنة الأخرانيات، لأ مافيش منهم،
+
+211
+00:19:01,310 --> 00:19:07,090
+أقوى منه ب 10 مرات و أقل منه في ال certificates ال
+
+212
+00:19:07,090 --> 00:19:09,890
+تمولول introduced for clinical use in the united
+
+213
+00:19:09,890 --> 00:19:18,250
+states in 1978 typical تمولول مليت اسمه تجارب تم
+
+214
+00:19:18,250 --> 00:19:21,450
+أبتك تم أبتك تم أبتك تم أبتك تم أبتك تم أبتك تم
+
+215
+00:19:21,450 --> 00:19:28,170
+أبتك تم أبتك تم أبتك تم أبتك تم أبتك تم أبتك تم
+
+216
+00:19:28,170 --> 00:19:28,930
+أبتك تم أبتك تم أبتك تم أبتك تم أبتك تم أبتك تم
+
+217
+00:19:28,930 --> 00:19:32,970
+أبتك تم أبتك تم أبتك تم أبتك تم أبتلأن ما حدش
+
+218
+00:19:32,970 --> 00:19:38,570
+Proprnalolol ما حدش بسمع فيه لأن هذا ال .. اللي هو
+
+219
+00:19:38,570 --> 00:19:42,850
+ال .. الولايات الشبعية لل Proprnalolol صار Timolol
+
+220
+00:19:42,850 --> 00:19:46,750
+ومنه شركات تصنع أشكال أولانية، أنا بتشوف الصورة،
+
+221
+00:19:46,750 --> 00:19:49,390
+أه برضه استخدموا ال Timolol في علاج
+
+222
+00:19:49,390 --> 00:19:52,530
+السكندريجلوكامة والأفاكيكليجلوكامة و ال ocular
+
+223
+00:19:52,530 --> 00:19:57,310
+hypertension القرن اللي هي Timolol لجوا أنه أحسن
+
+224
+00:19:57,310 --> 00:20:02,030
+بكتير ب5 مرات و 10 مرات من ال Proprnalolفي انه
+
+225
+00:20:02,030 --> 00:20:05,650
+بيتفادى ال anesthesia اللى بيبرد فقط انه القرن ال
+
+226
+00:20:05,650 --> 00:20:07,870
+anesthesia اللى بيصير فى اللى بيبرد دلوقت ال
+
+227
+00:20:07,870 --> 00:20:15,690
+timeline ما .. ما .. ماعمله بس هذا بعد ال .. هاي
+
+228
+00:20:15,690 --> 00:20:22,970
+الأقراس فى منها أقراس لداخل الدم و هاي منه شركات
+
+229
+00:20:22,970 --> 00:20:29,230
+هاي اسمه Timetable هناك إيش اسمه مشوعة
+
+230
+00:20:29,230 --> 00:20:33,130
+تحته من طول أو حاجةالمهم شركات كثيرة جدا يبتصرح في
+
+231
+00:20:33,130 --> 00:20:37,350
+كل بلد فيها دي شركات ففي مجموعة بلاد كتير يعني
+
+232
+00:20:37,350 --> 00:20:41,190
+احنا عندنا مثلا في الطرف الغربية اسمه شركة كوطس
+
+233
+00:20:41,190 --> 00:20:48,710
+بتطلعه تمولين شركة كبيرجات سين اوكتيك هذا أنا
+
+234
+00:20:48,710 --> 00:20:52,610
+بعرفه وفيه لغة إذا كانت الطرف الغربية فيها نوعين
+
+235
+00:20:52,610 --> 00:20:56,830
+فكيف الدول الكبرى فيها مئة دول لكن المهم المادة
+
+236
+00:20:56,830 --> 00:20:59,370
+الأساسية هي هل الأقراص
+
+237
+00:21:11,400 --> 00:21:14,440
+بعد هيك هتكمل ال background راح نكمل عن ال
+
+238
+00:21:14,440 --> 00:21:17,880
+temporal بيحكينا the attraction .. لأ فاله هو ال
+
+239
+00:21:17,880 --> 00:21:20,780
+إدراك اللي هو ال temporal advantage اللي هو فوائد
+
+240
+00:21:20,780 --> 00:21:25,350
+ال temporalThe attraction of stimuli lies in the
+
+241
+00:21:25,350 --> 00:21:29,910
+long term efficacy in the treatment of various
+
+242
+00:21:29,910 --> 00:21:33,010
+type of glaucoma, the low incidence of ocular side
+
+243
+00:21:33,010 --> 00:21:36,130
+effects and relatively long duration of action 12
+
+244
+00:21:36,130 --> 00:21:39,610
+-24 hours
+
+245
+00:21:40,030 --> 00:21:44,630
+بحكينا انه ال timoral يعتبر يكمن انجذابه في انه
+
+246
+00:21:44,630 --> 00:21:48,510
+يستخدم في ال long term يعني لفترة طويلة في علاج ال
+
+247
+00:21:48,510 --> 00:21:54,270
+glaucoma و يقل من ضغط العين و يستخدم لفترة طويلة
+
+248
+00:21:54,270 --> 00:21:58,670
+من حوال 12 ل 24 ساعة يبقى يقف العين يعني
+
+249
+00:22:10,680 --> 00:22:14,000
+فبحطه مرة و ما أمر فيه بحطه مرتين طبعا بيحكي ان ال
+
+250
+00:22:14,000 --> 00:22:17,640
+typical ocular administration من 25% ل 0.5%
+
+251
+00:22:17,640 --> 00:22:22,880
+Timolol مليت result in lowering IUP يعني لو حطينا
+
+252
+00:22:22,880 --> 00:22:29,280
+من ال Timolol من 25% ل 0.5% بتقلل من ال IUP في
+
+253
+00:22:29,280 --> 00:22:37,240
+النقل و الglagomitas I بس هذا معروف خلاص ال 0.25
+
+254
+00:22:37,240 --> 00:22:43,510
+فيه سنة للأطفال0.5 للأبد عشان تكون في السوق لأن
+
+255
+00:22:43,510 --> 00:22:47,430
+هذا و هذا موجودين في السوق لا نستحب أن نعطي
+
+256
+00:22:47,430 --> 00:22:50,870
+الأطفال نصف فلمية ولا نستحب أن نعطي الإخبار ربع
+
+257
+00:22:50,870 --> 00:22:54,630
+فلمية خلاص صارت مجسمة الآن يعني ماعرفوا السيد اللي
+
+258
+00:22:54,630 --> 00:22:55,570
+لو صرف هذا
+
+259
+00:23:01,250 --> 00:23:03,910
+بحكي إن ال typical turmoil is effective in
+
+260
+00:23:03,910 --> 00:23:07,670
+reducing IOP من عشرين لتلاتين فمية، طبعا ال
+
+261
+00:23:07,670 --> 00:23:12,250
+turmoil الموضعي بيقلل من IOP من .. بنسبة من عشرين
+
+262
+00:23:12,250 --> 00:23:15,750
+لتلاتين فمية compared with every treatment
+
+263
+00:23:15,750 --> 00:23:20,810
+بالمقارنة مع العياجات الأخرىthe maximum ocular
+
+264
+00:23:20,810 --> 00:23:26,130
+hypotensive effect of timolols is related with a
+
+265
+00:23:26,130 --> 00:23:31,250
+dose range of 3 من 10 الى 5 من 10% طبعا أقصى قيمة
+
+266
+00:23:31,250 --> 00:23:34,950
+تستخدم من ال timolol لتخفيد ال hypotensive من 3 من
+
+267
+00:23:34,950 --> 00:23:38,390
+10 الى 5 من 10% زي ما قولنا انهم منه ربع من 100
+
+268
+00:23:38,390 --> 00:23:42,570
+للأطفال و نصف من 100 للكبار يعني هي ال range اللي
+
+269
+00:23:42,570 --> 00:23:47,580
+بيصنعوه في المصانعgiven twice delay for up to one
+
+270
+00:23:47,580 --> 00:23:50,640
+year, tumour keeps pressure down throughout the
+
+271
+00:23:50,640 --> 00:23:53,640
+day بيحكينا اللي هو اعطانا .. اعطانا المريض انه
+
+272
+00:23:53,640 --> 00:23:57,900
+جدا في اليوم لمدة سنة بيحافظ على ضغط العين خلال
+
+273
+00:23:57,900 --> 00:24:03,000
+هذا السنة tumour is routinely used twice delay,
+
+274
+00:24:03,800 --> 00:24:07,260
+often there are several reports it's efficacy one
+
+275
+00:24:07,260 --> 00:24:13,320
+one on a once delayرجميل بيحكينا إنه بنستخدمها
+
+276
+00:24:13,320 --> 00:24:16,780
+العادة مرتين في اليوم بس بعد التقرير بتحكي إنه
+
+277
+00:24:16,780 --> 00:24:19,640
+لازم نستخدمها مرة واحدة في اليوم regime ايش regime
+
+278
+00:24:19,640 --> 00:24:25,000
+يعني؟ نظام .. نظام .. نظام .. regime .. اللي بيبقى
+
+279
+00:24:25,000 --> 00:24:26,400
+regime لإن الوزن واشهي
+
+280
+00:24:31,790 --> 00:24:34,650
+بيحكينا القرار تمر من عشرين ميلي متر twice delay
+
+281
+00:24:34,650 --> 00:24:38,930
+has also proved effect in reducing IOP in patient
+
+282
+00:24:38,930 --> 00:24:42,950
+with open angle glaucoma بيحكينا حتى مش ع جد تمر
+
+283
+00:24:42,950 --> 00:24:48,070
+الجترة في منه قرار يعني حبوب لو استخدمناها مرتين
+
+284
+00:24:48,070 --> 00:24:51,370
+في اليوم هتجلل برضه من ال .. تستخدم في حالة ال
+
+285
+00:24:51,370 --> 00:24:55,410
+open angle glaucomatypically applied timolol is
+
+286
+00:24:55,410 --> 00:24:59,050
+not metabolized in eye but undergoes extensive
+
+287
+00:24:59,050 --> 00:25:02,150
+hepatic elimination once it reaches the systemic
+
+288
+00:25:02,150 --> 00:25:05,370
+circulation بيحكينا ايضا كمان ان ال timolol
+
+289
+00:25:05,370 --> 00:25:10,450
+مابستخدمش عدة دنيا يعني لحالها لو استخدمت ممكن تصل
+
+290
+00:25:10,450 --> 00:25:14,110
+للجسم و تصل للدورة اللي هي دورة الجسم ال system of
+
+291
+00:25:14,110 --> 00:25:19,630
+circulation ايش hepatic elimination؟ كبد كبد اه
+
+292
+00:25:32,010 --> 00:25:34,290
+combined treatment و التيمولول طبعا هنقارن
+
+293
+00:25:34,290 --> 00:25:37,910
+التيمولول مع القطرات الأخرى بيحكينا أن نص
+
+294
+00:25:37,910 --> 00:25:40,530
+التيمولول doesn't appear significantly more
+
+295
+00:25:40,530 --> 00:25:45,490
+effective than 25% التيمولول لو استخدمنا نص .. من
+
+296
+00:25:45,490 --> 00:25:49,510
+التيمولول نص في المية مش هلاحظ فرق كبير عن 25%
+
+297
+00:25:49,510 --> 00:25:54,970
+يعني في فرق بس مش كبير يعني لو نكون 5% 6%
+
+298
+00:25:58,740 --> 00:26:02,400
+التمريل كان يجب أن ي further reduce IUP when added
+
+299
+00:26:02,400 --> 00:26:12,040
+to symptomatic agents like pyrocarbine
+
+300
+00:26:12,040 --> 00:26:19,660
+كمان كمان كربونيك انهيدرازين انهيبروه
+
+301
+00:26:19,660 --> 00:26:26,980
+انتقلوكومة فهو بقلي لو ضخنا هيقل من ال IUP هيقل
+
+302
+00:26:26,980 --> 00:26:34,270
+أفضلcombinate treatment بالثمورل and acetyl
+
+303
+00:26:34,270 --> 00:26:38,930
+azolimide هذا acetyl azolimide carbonic anhydrase
+
+304
+00:26:38,930 --> 00:26:43,230
+inhibitor اللي هناخده في عنه زيت روشوته هذا نوع من
+
+305
+00:26:43,230 --> 00:26:47,050
+اللي هو ال article of common لو ضفنا الثمورلول
+
+306
+00:26:47,050 --> 00:26:51,950
+إليه هيقلل أكتر لو كان كل واحد لها يعني التنين
+
+307
+00:26:57,500 --> 00:27:01,480
+يعني مثلا و احنا ضغط عين و تلاتين هو بنزله يالا
+
+308
+00:27:01,480 --> 00:27:06,440
+اربع و عشرين او لتلاتة و عشرين فقدرش اؤكد اهلي
+
+309
+00:27:06,440 --> 00:27:10,160
+اللي لانه تلاتة و عشرين عالي و العالي معناه انه
+
+310
+00:27:10,160 --> 00:27:14,300
+اللي يقف العصب البصري بصير اقرفي فاحنا لأ بدنا
+
+311
+00:27:14,300 --> 00:27:20,760
+كمان يعمل إضافة addition لتمولوج كانوا يحطوه بين
+
+312
+00:27:20,760 --> 00:27:23,400
+الكربيين و بعدين بين الكربيين كترت مشاكل لأنه
+
+313
+00:27:23,400 --> 00:27:27,960
+بيعمل اسبازف و بيعمل سلوميلوبيا و كلهافجابوا الـ
+
+314
+00:27:27,960 --> 00:27:31,980
+Acetazolamide والآن حقيقة هذا الـ fantastic الـ
+
+315
+00:27:31,980 --> 00:27:35,560
+Cosoptor work ويانا اللي قطرت ال Cosoptor قبل هي
+
+316
+00:27:35,560 --> 00:27:39,980
+تكلمنا فيها صارت standard الآن Cosoptor كتير يعني
+
+317
+00:27:39,980 --> 00:27:42,540
+شغالة كويس لأنه فيها التملول وفيها ال
+
+318
+00:27:42,540 --> 00:27:46,500
+Acetazolamide مع بعض اتنين أنتجلوكومة فبدا لما
+
+319
+00:27:46,500 --> 00:27:51,420
+ينزلوا من الـ 23 لـ 23 ينزلوا من سنة 19 لـ 18
+
+320
+00:27:52,560 --> 00:27:56,680
+فبيكون العيال في سيف بدل بخليه لعشرين border ليلة
+
+321
+00:27:56,680 --> 00:28:00,460
+انازل تحت العشرين تحت ساعتاش تحت عمانتاش يكون عصر
+
+322
+00:28:00,460 --> 00:28:01,160
+البصري محمي
+
+323
+00:28:05,610 --> 00:28:08,550
+محكينا كمان ال treatment من ال plus بالوكربين لو
+
+324
+00:28:08,550 --> 00:28:13,890
+ضفنا ال بالوكربين برضه هيقل من ال IOL من ال
+
+325
+00:28:13,890 --> 00:28:16,710
+reduction من إنتاج ال IOL أكتر من كل واحد استخدامه
+
+326
+00:28:16,710 --> 00:28:20,390
+لحالي ممتاز، بس أنا بأكد أن ال biocarbine الآن
+
+327
+00:28:20,390 --> 00:28:25,490
+شوية شوية بصير obsolete بالموضوع، يعني احنا لما
+
+328
+00:28:25,490 --> 00:28:29,970
+عملوا التجربة هذه عملوها عشان البحث
+
+329
+00:28:35,310 --> 00:28:38,690
+هذا هو الخط الأول البيبو كاربينة ما يعني مشاكل من
+
+330
+00:28:38,690 --> 00:28:43,770
+ال .. اللي هو Cyclospasm وعمل ال visual feed
+
+331
+00:28:43,770 --> 00:28:48,030
+والسيوميوبيا والكلام هنا وحتى ممكن ال cataract بدي
+
+332
+00:28:48,030 --> 00:28:50,570
+ننسيه، بس احنا هنا جايبه لإيش؟ لبلد البحث
+
+333
+00:28:53,790 --> 00:29:09,470
+بحكينا ان في دراسات
+
+334
+00:29:09,470 --> 00:29:21,950
+ديناميكية ان الورق
+
+335
+00:29:21,950 --> 00:29:28,680
+تصويرإذا بيحطوا كاميرز جوا العين فرق معين لحيث
+
+336
+00:29:28,680 --> 00:29:35,000
+تتصور الدورة بتاعك الأكيوز فوجدوا
+
+337
+00:29:35,000 --> 00:29:40,680
+أن محطه اللي هو Timolol أو Timoline اللي وجدوه
+
+338
+00:29:40,680 --> 00:29:43,900
+بيشتغل على اللي هو Secretion
+
+339
+00:29:52,750 --> 00:30:07,490
+التميلول لا يؤثر
+
+340
+00:30:07,490 --> 00:30:13,310
+على خروج السائل من الهيبوسكيليرال فلو أو
+
+341
+00:30:13,310 --> 00:30:18,170
+الهيبوسكيليرال فيناس بشرهو يعني ممكن تتمنع و ..
+
+342
+00:30:18,170 --> 00:30:19,710
+ممكن تتمنع و .. ممكن تتمنع و .. ممكن تتمنع و ..
+
+343
+00:30:19,710 --> 00:30:20,450
+ممكن تتمنع و .. ممكن تتمنع و .. ممكن تتمنع و ..
+
+344
+00:30:20,450 --> 00:30:21,030
+ممكن تتمنع و .. ممكن تتمنع و .. ممكن تتمنع و ..
+
+345
+00:30:21,030 --> 00:30:23,350
+ممكن تتمنع و .. ممكن تتمنع و .. ممكن تتمنع و ..
+
+346
+00:30:23,350 --> 00:30:23,790
+ممكن تتمنع و .. ممكن تتمنع و .. ممكن تتمنع و ..
+
+347
+00:30:23,790 --> 00:30:29,390
+ممكن تتمنع و .. ممكن
+
+348
+00:30:29,390 --> 00:30:31,590
+تتمنع و .. ممكن تتمنع و .. ممكن تتمنع و .. ممكن
+
+349
+00:30:31,590 --> 00:30:34,310
+تتمنع و .. ممكن تتمنع و .. ممكن تتمنع و .. ممكن
+
+350
+00:30:34,310 --> 00:30:41,030
+تتمنع و .. ممكن تتمنع و .. ممكن تتمنع و .. ممكن
+
+351
+00:30:41,030 --> 00:30:46,770
+تتمنع و ..
+
+352
+00:30:46,770 --> 00:30:50,240
+ممكن تتمتعرفين فينا الناس ال normal نورمالتينسب
+
+353
+00:30:50,240 --> 00:30:55,280
+اسمها نورمالتينسب يعني ال pressure داخلين متوازن
+
+354
+00:30:55,280 --> 00:31:02,460
+عن طريق حاجتين عن طريق ال normal flow ال flow و
+
+355
+00:31:02,460 --> 00:31:07,960
+normal outflow بيهم توازن اللي بيه دي بيطلع اللي
+
+356
+00:31:07,960 --> 00:31:11,720
+بيه دي بيطلع بيه غيره و كده كده لو صار اختلال في
+
+357
+00:31:11,720 --> 00:31:17,900
+واحدة منهم هتيجي بجلوبهم بيه اختلال يعنيخاصة إذا
+
+358
+00:31:17,900 --> 00:31:21,640
+كان الـ outflow قليل فهنا عشان outflow في
+
+359
+00:31:21,640 --> 00:31:26,940
+الجلوكومة في مشكلة في ال trabecular مشورة في ال
+
+360
+00:31:26,940 --> 00:31:32,320
+outflow، trabecular مشورة مريضة صار ال outflow
+
+361
+00:31:32,320 --> 00:31:39,140
+جليد والتصنيع normal فإيش بدوسين؟ بدوسين اتفضل،
+
+362
+00:31:39,140 --> 00:31:43,840
+يبقى الآن هم إيش هيعملوا؟ هيعطوا؟ يعملوا فلس،
+
+363
+00:31:43,840 --> 00:31:52,170
+يجلبوا التصنيعبما يساوي قلة الخروج تفكرتوا؟ لأنه
+
+364
+00:31:52,170 --> 00:31:57,570
+بيوطي ال inflow عشان ال outflow واقف مهلط يعني
+
+365
+00:31:57,570 --> 00:32:03,130
+والله صعب يعني اللي بقولكوا انه ممكن جدا يتحكم مية
+
+366
+00:32:03,130 --> 00:32:06,670
+في مية بيكون غلط يعني زي ضغط الدم الناس مرضى ضغط
+
+367
+00:32:06,670 --> 00:32:11,310
+الدم على ال bike و دايما لأن هو متنسف؟ لا لأ والله
+
+368
+00:32:11,310 --> 00:32:14,570
+في مرة اتنقض جاعة من الفزنونة ضغط بصار عالم تاني
+
+369
+00:32:16,540 --> 00:32:22,280
+رغم انه ماخد علاج يعني هو لو يعني بلق مرض في كومة
+
+370
+00:32:22,280 --> 00:32:28,940
+و لو جسدنا كل يوم هيكون متدفق لكن ان يكون دائما في
+
+371
+00:32:28,940 --> 00:32:32,920
+عليه support يعني احسن من تلق و يعدق و دمر عصب ليا
+
+372
+00:32:32,920 --> 00:32:37,280
+بيحكي ان ال dust is clear ده تمارزان انفلودراج
+
+373
+00:32:37,280 --> 00:32:41,400
+يعني يعتبر تدفق بيساعد في دخول ال
+
+374
+00:32:46,440 --> 00:32:47,520
+هو مصمم الدخول والتصنيع
+
+375
+00:32:57,600 --> 00:33:00,060
+بحكينا ال table is not associated with change in
+
+376
+00:33:00,060 --> 00:33:03,940
+table size, people reaction, accommodation or
+
+377
+00:33:03,940 --> 00:33:08,780
+visual acuity and patient tolerance in most
+
+378
+00:33:08,780 --> 00:33:12,700
+instances is excellent بحكينا أن ال table مابأثر
+
+379
+00:33:12,700 --> 00:33:15,580
+على التغيرات في اللي عندها ال people size ولا ال
+
+380
+00:33:15,580 --> 00:33:17,980
+people reaction ولا التفاعل ولا ال accommodation
+
+381
+00:33:17,980 --> 00:33:20,280
+ولا ال visual acuity يعني كل إشي بيظل زي ما حصل و
+
+382
+00:33:20,280 --> 00:33:21,620
+لا ال feel و لا ال visual acuity
+
+383
+00:33:29,960 --> 00:33:35,000
+لأ احنا انتقلنا نقلة كبيرة نحو ال safety، ال bio
+
+384
+00:33:35,000 --> 00:33:39,100
+-carbine كان اللي .. اللي بيحطه ماقدرش يشوف اللي
+
+385
+00:33:39,100 --> 00:33:42,140
+قدامه كويس ولا يسوق سيارة، ال weed was constructed
+
+386
+00:33:42,140 --> 00:33:47,780
+و ال people constructed و وضعه صحthe absence of
+
+387
+00:33:47,780 --> 00:33:50,420
+alteration in viewable size, accommodation or
+
+388
+00:33:50,420 --> 00:33:54,500
+refractive error avoids many of the unpleasant and
+
+389
+00:33:54,500 --> 00:33:58,680
+sometimes intolerable
+
+390
+00:33:58,680 --> 00:34:01,900
+visual effects seen with many other agents,
+
+391
+00:34:02,040 --> 00:34:06,100
+bilocarbine، بيحكينا هو على عكس ال .. يعني عكس ال
+
+392
+00:34:06,100 --> 00:34:08,740
+.. ال bilocarbine هو جمع هذه الأشياء كلها، على عكس
+
+393
+00:34:08,740 --> 00:34:09,480
+اللي اتمنها
+
+394
+00:34:17,820 --> 00:34:20,320
+قبل حوالي 100 سنة بتمشي على إيش؟ على فحم الحجر
+
+395
+00:34:20,320 --> 00:34:25,800
+يعني في القاطرة حجرة كبيرة و مولّأ فيها فحم و
+
+396
+00:34:25,800 --> 00:34:31,120
+الفحم هذا بيطلّع .. بيغلي ميّه و بيطلّع طاقة و ..
+
+397
+00:34:31,120 --> 00:34:34,620
+و هذه الطاقة هي اللي بتحرك القطار على فحم الحجر
+
+398
+00:34:34,620 --> 00:34:41,800
+بعدها صار قطار بيمشي على سلطة لأن القطار بيمشي على
+
+399
+00:34:41,800 --> 00:34:45,500
+الكعب بكرا بيمشي على الطاقة النووية حتة صغيرة
+
+400
+00:34:54,690 --> 00:34:58,030
+الكاس فاكرينها السنة الماضية؟ اه خلصناها، الإيسار
+
+401
+00:34:58,030 --> 00:35:03,750
+دائما بيبقى على الأريح و على الأحدث بيحكي إن التمر
+
+402
+00:35:03,750 --> 00:35:11,930
+بيقلل
+
+403
+00:35:11,930 --> 00:35:18,110
+.. بيخفض من ال IOP من خلال تفبيط ال .. افراز
+
+404
+00:35:18,110 --> 00:35:21,630
+وتكوين ال aqueous humor من الcellular bodyبيحكينا
+
+405
+00:35:21,630 --> 00:35:25,570
+ال new field has post-bestulated أنه أسعار من ال
+
+406
+00:35:25,570 --> 00:35:28,810
+new field هذا، افترض أن ال تميلول كان acts on
+
+407
+00:35:28,810 --> 00:35:31,910
+secretion or earth refiltration، بيعمل من خلال
+
+408
+00:35:31,910 --> 00:35:35,350
+الإفراز والترشيح أقل اتنين مع بعض، but couldn't
+
+409
+00:35:35,350 --> 00:35:41,410
+confirm on an ocular versus a constrictor action
+
+410
+00:35:41,410 --> 00:35:45,270
+of تميلول on the cerebellum، لكن ما أكد أن عضلات
+
+411
+00:35:45,270 --> 00:35:50,730
+العين أنها بتلقبت من خلال استخدام ال ..الفيزيو ..
+
+412
+00:35:50,730 --> 00:35:54,850
+القوية .. القوية .. القوية .. القوية .. ال .. ال
+
+413
+00:35:54,850 --> 00:35:56,910
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+414
+00:35:56,910 --> 00:35:57,070
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+415
+00:35:57,070 --> 00:35:57,150
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+416
+00:35:57,150 --> 00:35:57,350
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+417
+00:35:57,350 --> 00:35:57,750
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+418
+00:35:57,750 --> 00:35:57,830
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+419
+00:35:57,830 --> 00:36:04,250
+.. ال .. ال .. ال .. ال .. ال ..
+
+420
+00:36:04,250 --> 00:36:04,730
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+421
+00:36:04,730 --> 00:36:08,290
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+422
+00:36:08,290 --> 00:36:09,510
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+423
+00:36:09,510 --> 00:36:17,570
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+424
+00:36:17,570 --> 00:36:20,690
+ال .. ال ..لأنه بيجي الإفراز ال aqueous من الدم
+
+425
+00:36:20,690 --> 00:36:27,110
+فمدام الدم جليل يبقى الإفراز جليل هل أنت الآن تشعر
+
+426
+00:36:27,110 --> 00:36:32,030
+بقول لا بقول لا هذه نظرتك لبذل كونستريكتشن للإنسان
+
+427
+00:36:32,030 --> 00:36:39,010
+ليس لبذل كونستريكتور هذا لازم secretion او ultra
+
+428
+00:36:39,010 --> 00:36:43,430
+filtration او aqueous من الدم زمان كنت في studio
+
+429
+00:36:43,430 --> 00:36:46,330
+of the eye تحدثت عن كيف يتكون ال aqueous
+
+430
+00:36:53,090 --> 00:36:55,050
+مدوسة اللي بدوسة اللي بدوسة اللي بدوسة اللي بدوسة
+
+431
+00:36:55,050 --> 00:36:59,790
+اللي بدوسة اللي بدوسة اللي بدوسة اللي بدوسة اللي
+
+432
+00:36:59,790 --> 00:37:02,210
+بدوسة اللي بدوسة اللي بدوسة اللي بدوسة اللي بدوسة
+
+433
+00:37:02,210 --> 00:37:07,050
+اللي بدوسة اللي بدوسة اللي بدوسة اللي بدوسة اللي
+
+434
+00:37:07,050 --> 00:37:12,670
+بدوسة اللي بدوسة اللي بدوسة اللي بدوسة اللي بدوسة
+
+435
+00:37:12,670 --> 00:37:12,790
+اللي بدوسة اللي بدوسة اللي بدوسة اللي بدوسة اللي
+
+436
+00:37:12,790 --> 00:37:15,930
+بدوسة اللي بدوسة اللي بدوسة اللي بدوسة اللي بدوسة
+
+437
+00:37:15,930 --> 00:37:17,870
+اللي بدوسة اللي بدوسة اللي بدوسة اللي بدوسة
+
+438
+00:37:21,740 --> 00:37:24,920
+أكتر من الملف ونحن مركزة معينة أكتر من الملف بيسحب
+
+439
+00:37:24,920 --> 00:37:30,300
+منه، فالدولة كانت أن الـaqueous humor الموجود في
+
+440
+00:37:30,300 --> 00:37:34,440
+البستيرو chamber مركزة، أكتر من دندر فبيسحب منه،
+
+441
+00:37:34,440 --> 00:37:37,800
+هذا وقت ال filtration، لكن ال secretion لأ، ال
+
+442
+00:37:37,800 --> 00:37:44,480
+secretion الimperium تبثل ال body بيعمل زي glass،
+
+443
+00:37:44,480 --> 00:37:51,000
+هو بيفرزأكواس علاوة صورة عن أكواس secretion او
+
+444
+00:37:51,000 --> 00:37:53,420
+water filtration التمرون بجالي الاتنين
+
+445
+00:38:09,140 --> 00:38:11,420
+بحكينا most patient with the primer open-ended
+
+446
+00:38:11,420 --> 00:38:14,740
+glaucoma respond initially to .. to timolol يعني
+
+447
+00:38:14,740 --> 00:38:17,360
+بستخدمها برضه في ال open-ended glaucoma و بتقلل من
+
+448
+00:38:17,360 --> 00:38:22,460
+الدغت في بداية استخدامها بس جربة جيدة .. بحكينا
+
+449
+00:38:22,460 --> 00:38:27,490
+both ..disadvantage يعني تملول مناعيه، but both
+
+450
+00:38:27,490 --> 00:38:32,150
+short term escape هروب يعني and long term drift
+
+451
+00:38:32,150 --> 00:38:35,490
+اللي هو الإنجراف have been reported for تملول على
+
+452
+00:38:35,490 --> 00:38:39,050
+short term escape reversed to an act partial loss
+
+453
+00:38:39,050 --> 00:38:44,410
+of therapeutic effect on IOP during the first few
+
+454
+00:38:44,410 --> 00:38:49,450
+days of تملول treatment بيحكينا إنه بيفقد بعض
+
+455
+00:38:49,450 --> 00:38:54,610
+التأثيرات العلاجية من خلال استخدامهلا اول يعني اول
+
+456
+00:38:54,610 --> 00:39:00,330
+ايام استخدام مرتبه كعلاج لل IOP اه يعني دلوقت
+
+457
+00:39:00,330 --> 00:39:08,150
+الأرقام يعني الأسبوع الأول جوا
+
+458
+00:39:08,150 --> 00:39:15,010
+كمان نزل تلاتين فمية من ضد العين الأسبوع التاني
+
+459
+00:39:15,010 --> 00:39:22,610
+نزل عشرين فمية و بعد هي خمس عشر فمية
+
+460
+00:39:33,380 --> 00:39:40,980
+يعني أن ضغط العين هرق من تأثير التيمولول وخلّه
+
+461
+00:39:40,980 --> 00:39:46,180
+خلّه خمس طرح في خلال أيام أو أسابيع قصيرة عشان أيه
+
+462
+00:39:46,180 --> 00:39:51,560
+شهور ومدة قصيرة وهذا اللي أثير احنا خدنا في
+
+463
+00:39:51,560 --> 00:39:56,040
+المساكنات مثلا كده الواحد أول ما هو المساكن بكل
+
+464
+00:39:56,040 --> 00:39:58,020
+صداعه يروح ويشي وكده وكده لكن لو استمر يروح
+
+465
+00:39:58,020 --> 00:39:59,400
+المساكن ع طول وع طول وع طول
+
+466
+00:40:08,380 --> 00:40:14,000
+أول حبة بيسكن تاني أكتر أكتر بيصير متعلقة فال
+
+467
+00:40:14,000 --> 00:40:17,920
+timolol دي له القصة هذه لأنه بيصير يعني في
+
+468
+00:40:17,920 --> 00:40:23,120
+الأسابيع الأولى بيجاني تأثيره بشكل واضحالعيب
+
+469
+00:40:23,120 --> 00:40:26,340
+التاني؟ بيحكي إن possible explanation is the
+
+470
+00:40:26,340 --> 00:40:30,160
+finding in animal studies that the number of B B
+
+471
+00:40:30,160 --> 00:40:33,340
+-receptors molecules in ocular tissue increased
+
+472
+00:40:33,340 --> 00:40:37,120
+within day of the initiation of tumour treatment
+
+473
+00:40:37,120 --> 00:40:41,060
+بحكى إن بعد تم التفسيرات إن عملوا دراسات على
+
+474
+00:40:41,060 --> 00:40:45,480
+الحيوانات لاحقوا إن في أول استخدام التمول بتزيد ال
+
+475
+00:40:45,480 --> 00:40:52,490
+tissue بتاعة ال B-receptors في الocular tissueانا
+
+476
+00:40:52,490 --> 00:41:00,290
+عندى في السيارة يقولى فى افتراض خمسمية بيه
+
+477
+00:41:00,290 --> 00:41:06,070
+receptor اللى بيشتغل عليهم ايش بيتهملهم بيقولى بعد
+
+478
+00:41:06,070 --> 00:41:11,690
+أسبوع بيصيروا ألف بعد أسبوعين بيصيروا ألفين بصيروا
+
+479
+00:41:11,690 --> 00:41:15,590
+اخترت دوة اللى بيحطها اللى كانت تكفل الخمسمية و
+
+480
+00:41:15,590 --> 00:41:18,110
+بزيد بصيروا ماتكفلش الألفين
+
+481
+00:41:21,870 --> 00:41:28,830
+بما يرد إلى ان الهياري مستفيل انهيار بلوكينت
+
+482
+00:41:28,830 --> 00:41:34,790
+وبالتالي هي مش دارية انه في دوا خش وبالتالي
+
+483
+00:41:34,790 --> 00:41:42,290
+الافراز بيستغل فيش تقبيل الافراز من عديد من خلايا
+
+484
+00:41:42,290 --> 00:41:50,520
+الـcellular body الانفينيا دواكو يعني تمامالما
+
+485
+00:41:50,520 --> 00:41:55,840
+مثلا احنا أربع على صينية أكل، تجيبنا نقول أكل، في
+
+486
+00:41:55,840 --> 00:42:00,820
+فارخة، الفارخة جسمناها أربع والحمدلله شبعين، اجينا
+
+487
+00:42:00,820 --> 00:42:01,880
+اليوم التاني، جيبنا نفسنا
+
+488
+00:42:22,050 --> 00:42:24,490
+المفضة بتكفي للموجودين
+
+489
+00:42:35,160 --> 00:42:38,920
+بيحكينا this suggests a decreased efficacy of
+
+490
+00:42:38,920 --> 00:42:42,600
+timolol due to decreased substrate substance upon
+
+491
+00:42:42,600 --> 00:42:46,300
+which an enzyme acts for B blockers interaction
+
+492
+00:42:46,300 --> 00:42:50,140
+بيحكينا ان فعالية التمر التقل بالسبب ان ال subject
+
+493
+00:42:50,140 --> 00:42:53,060
+اللي هو المادة الانزيم الموجودة فيها بتكون ضعيفة
+
+494
+00:42:53,060 --> 00:42:57,280
+يعني مش .. مش منيحة كمان بيحكي ان other patients
+
+495
+00:42:57,280 --> 00:43:01,620
+who slow up word trend in IOP after month of
+
+496
+00:43:01,620 --> 00:43:03,320
+therapy بعض ال ..
+
+497
+00:43:10,600 --> 00:43:13,820
+بيحكي ان ال long term drift تأكل ال high potency
+
+498
+00:43:13,820 --> 00:43:17,360
+of efficacy of timolol may be decreased by up to
+
+499
+00:43:17,360 --> 00:43:23,440
+25% with long term treatment 25% مثلا بعد سنة، بعد
+
+500
+00:43:23,440 --> 00:43:28,320
+سنتين، المريض اللي بيقولك أن المريض اللي بيقولك أن
+
+501
+00:43:28,320 --> 00:43:29,840
+المريض اللي بيقولك أن المريض اللي بيقولك أن المريض
+
+502
+00:43:29,840 --> 00:43:31,240
+اللي بيقولك أن المريض اللي بيقولك أن المريض اللي
+
+503
+00:43:31,240 --> 00:43:32,280
+بيقولك أن المريض اللي بيقولك أن المريض اللي بيقولك
+
+504
+00:43:32,280 --> 00:43:32,680
+أن المريض اللي بيقولك أن المريض اللي بيقولك أن
+
+505
+00:43:32,680 --> 00:43:36,720
+المريض اللي بيقولك أن المريض اللي بيقولك أن المريض
+
+506
+00:43:36,720 --> 00:43:37,740
+اللي بيقولك أن المريض اللي بيقولك أن المريض اللي
+
+507
+00:43:37,740 --> 00:43:41,420
+بيقولك أن المريض اللي بيقولك أن المريض اللياما
+
+508
+00:43:41,420 --> 00:43:44,860
+بيعمل حملية جراحية اما بيضلوا مال الحياة على
+
+509
+00:43:48,600 --> 00:43:51,100
+محكينا أه clear side effects of timurol تأثيرها
+
+510
+00:43:51,100 --> 00:43:53,840
+على العين أولاشى allergic .. allergic
+
+511
+00:43:53,840 --> 00:43:57,900
+blepharocongenectivitis allergic to topical B
+
+512
+00:43:57,900 --> 00:44:02,740
+blockers as Epidans by blepharocongenectivitis of
+
+513
+00:44:02,740 --> 00:44:05,560
+occurs in some patient after long term use of
+
+514
+00:44:05,560 --> 00:44:09,200
+timurol يعني حساسية في العين في الكنجنكتابة، بلفاق
+
+515
+00:44:09,200 --> 00:44:12,720
+.. بلفاق بتشنش بالكنجنكتابة و بيصير أشياء كتير،
+
+516
+00:44:12,720 --> 00:44:16,120
+اتنين، كنجنكتابة الhyperemia الأوية الدموية نفسها
+
+517
+00:44:16,120 --> 00:44:20,100
+اللي في الكنجنكتابة بتتدخم .. تتدخمsuperficial
+
+518
+00:44:20,100 --> 00:44:23,700
+pancreatitis, blurred vision can't also cure,
+
+519
+00:44:23,980 --> 00:44:27,320
+decreased tear production in glaucoma patients was
+
+520
+00:44:27,320 --> 00:44:31,500
+also reported but was not deemed dangerous unless
+
+521
+00:44:31,500 --> 00:44:35,560
+the eye had abnormally low lacrimal secretion،
+
+522
+00:44:35,560 --> 00:44:38,340
+ماشي يعني هذا، decreased production of tears؟ هنا
+
+523
+00:44:38,340 --> 00:44:40,900
+بيحكي إن في الأشخاص اللي عندهم glaucoma ال tears
+
+524
+00:44:40,900 --> 00:44:44,060
+بتقل عندهم، هنا مابتكونش خطر إلا إذا كان .. إذا
+
+525
+00:44:44,060 --> 00:44:46,360
+كان في حد اللي ممنوع، بفعل إيه إيش بتقل؟ ال
+
+526
+00:44:46,360 --> 00:44:46,640
+temporal
+
+527
+00:44:56,920 --> 00:45:01,160
+في بعض الناس، بعض الناس هيبريم يتجي اللي فيه توسق
+
+528
+00:45:01,160 --> 00:45:04,400
+في الشعارات الدوامية اللي و بعض الناس عندهم شوية
+
+529
+00:45:04,400 --> 00:45:09,480
+keratase، punctate، شوية blurring of vision و بعض
+
+530
+00:45:09,480 --> 00:45:13,660
+الناس dryness، و طبعا هذه مختلفة من واحدة واحدة،
+
+531
+00:45:13,660 --> 00:45:16,720
+مافيش واحد يصير معاه خمسة، يصير معاه واحدة أو
+
+532
+00:45:16,720 --> 00:45:20,660
+تنتهي، في بعض الناس، و نسب واحد في الألف، واحد في
+
+533
+00:45:20,660 --> 00:45:22,100
+الخمسمية، واحد في المية
+
+534
+00:45:25,240 --> 00:45:26,660
+الـ Self-effects، الـ Self-effects بتاعة
+
+535
+00:45:26,660 --> 00:45:35,240
+البيوكربين من أصعب البيوكربين أحيانا
+
+536
+00:45:35,240 --> 00:45:42,700
+ممكن لو فيه opacity في ال lens يعمل blindness لأنه
+
+537
+00:45:42,700 --> 00:45:51,490
+فيه opacity على ال visual accessوقلنا انه بيعمل
+
+538
+00:45:51,490 --> 00:45:57,990
+visual field تيوبال فيديون نهيط على ال spasm بتاع
+
+539
+00:45:57,990 --> 00:46:02,630
+ال muscle وكلام زي هذا فإذا اتقررنا هذا بهذا كلام
+
+540
+00:46:02,630 --> 00:46:06,930
+انا بعرف ناس احنا شغالين معاهم من فترات طويلة اطلب
+
+541
+00:46:06,930 --> 00:46:13,010
+لول وماشي بارد وطيس ومافيش مشكلة بس صحيح ان موضوع
+
+542
+00:46:13,010 --> 00:46:19,100
+ال short scale و ال long drift انه بسيطعشان هيك
+
+543
+00:46:19,100 --> 00:46:23,560
+نضطر إنه إحنا ندعمه بإيش بهدوء أخرى وشوفت أنا ناس
+
+544
+00:46:23,560 --> 00:46:27,540
+في يعني الرحلة بعد مثلا عشر سنين اللي حصل معاها
+
+545
+00:46:27,540 --> 00:46:32,060
+three drugs أو أربع drugs جترا اللي هو قدر من
+
+546
+00:46:32,060 --> 00:46:39,320
+القوة so التأكل عجيب في مفعول الهدوء يعني فاضحة
+
+547
+00:46:39,320 --> 00:46:41,900
+mixed effects of stimulants تأثيرها على الجسم
+
+548
+00:46:41,900 --> 00:46:43,780
+slowing of the heart rate
+
+549
+00:46:48,170 --> 00:46:54,530
+Is that common systemic finding in clinical
+
+550
+00:46:54,530 --> 00:46:57,190
+studies with typical similarity؟
+
+551
+00:47:06,350 --> 00:47:09,850
+فانسيكو .. مع بعض بالزيدي و مع بعض بالجيزي اه
+
+552
+00:47:09,850 --> 00:47:15,790
+بيصير عنده اغمق طبعا تم الالمي اكذاجربت اكذاسيربيت
+
+553
+00:47:15,790 --> 00:47:20,910
+اكذاسيربيت اكذاسيربيت pre .. pre exciting pre
+
+554
+00:47:20,910 --> 00:47:24,250
+existing pre existing بيبقى مش ان انجليزيا ..
+
+555
+00:47:24,250 --> 00:47:27,830
+بيبقى مش .. احنا هنا بنتعلم احنا هنا يا بني انا
+
+556
+00:47:27,830 --> 00:47:28,570
+تمتعلم
+
+557
+00:47:35,380 --> 00:47:39,840
+هذا يجب أن أقول صح هنا متعلم يعني مرض موجود سابق
+
+558
+00:47:39,840 --> 00:47:43,200
+الوجود هدف الرابو مرض الرابو مرض الرابو يعني
+
+559
+00:47:43,200 --> 00:47:47,540
+ماعطيوش للناس انبوتانز
+
+560
+00:47:47,540 --> 00:47:50,840
+انبوتانز طب الانبوتانز في الذكورة and increased
+
+561
+00:47:50,840 --> 00:47:54,420
+libido ال central nervous system بأثر على ال
+
+562
+00:47:54,420 --> 00:47:58,320
+nervous system كومبلينت ريبارتو والتمريوز زي
+
+563
+00:47:58,320 --> 00:48:02,740
+headache, fatigue, dizziness, weakness, unexiety
+
+564
+00:48:02,740 --> 00:48:09,570
+and depressionخلاص نجرف عند خمسمية و تلاتاش ال new
+
+565
+00:48:09,570 --> 00:48:14,590
+world اللي هو beta because و انا بشكر بناتي يعني
+
+566
+00:48:14,590 --> 00:48:19,590
+فاقنا و بذات كتير و ادعوكم الى يعني هالي المشهورة
+
+567
+00:48:19,590 --> 00:48:26,290
+الفعالة لأن احنا هنا نحاول نعطي يعني إضافة للإلقاء
+
+568
+00:48:26,290 --> 00:48:26,770
+لل presentation
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/fXPF6hfaJ5g_raw.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/fXPF6hfaJ5g_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..7362d9dee221a2645b4da7a69eb6bf98fe8dded7
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/fXPF6hfaJ5g_raw.srt
@@ -0,0 +1,2292 @@
+1
+00:00:19,860 --> 00:00:22,600
+أعوذ بالله من الشيخ الردين بسم الله الرحمن الرحيم
+
+2
+00:00:22,600 --> 00:00:26,540
+الحمد لله رب العالمين وأصلي وأسلم على النبي الأمين
+
+3
+00:00:26,540 --> 00:00:30,980
+محمد وعلى آله وأصحابي والتابعين السلام عليكم ورحمة
+
+4
+00:00:30,980 --> 00:00:35,260
+الله وبركاته في هذا اليوم سنكملوا ما كنا قد بدأنا
+
+5
+00:00:35,260 --> 00:00:40,820
+في المحلقة السابقة من موضوع antiglucoma drugs
+
+6
+00:00:40,820 --> 00:00:47,750
+antiglucoma eye drops beta blockersو اليوم احنا
+
+7
+00:00:47,750 --> 00:00:55,210
+اتشرف ان الطالبة المميزة فاقمة مراز تقوم بعمل
+
+8
+00:00:55,210 --> 00:00:59,070
+presentation و احنا نعمل discussion و تعليق و هي
+
+9
+00:00:59,070 --> 00:00:59,910
+مشكورة طبعا
+
+10
+00:01:03,920 --> 00:01:07,520
+بسم الله الرحمن الرحيم اليوم راح نحكي عن الخصائص
+
+11
+00:01:07,520 --> 00:01:11,480
+اللي بتميز فيها ال beta-blockers أول شي بحكي ال
+
+12
+00:01:11,480 --> 00:01:13,980
+beta-blockers have varying degree of protein
+
+13
+00:01:13,980 --> 00:01:17,060
+binding capacity and lipid solubility إلها درجات
+
+14
+00:01:17,060 --> 00:01:21,920
+مختلفة من ارتباطها في ال protein و الدوابان إلها
+
+15
+00:01:21,920 --> 00:01:25,500
+some undergo a high first pass metabolism in the
+
+16
+00:01:25,500 --> 00:01:29,400
+liver, for example propranolol and some have
+
+17
+00:01:29,400 --> 00:01:33,480
+active metabolism and some are exert precipitate
+
+18
+00:01:35,630 --> 00:01:38,990
+execrated principally by the kidney example
+
+19
+00:01:38,990 --> 00:01:44,730
+الاتنول منها في من أنواعها اللي بيصير لها تفاعل
+
+20
+00:01:44,730 --> 00:01:50,470
+حيوي في ال liver و منها ال propranolol و في من
+
+21
+00:01:50,470 --> 00:01:55,090
+أنواعها بيصير لها تفاعل حيوي في ال kidney منها
+
+22
+00:01:55,090 --> 00:01:59,090
+الاتنول اتنول تخرج في الكلية تخرج في الكلية
+
+23
+00:01:59,090 --> 00:02:00,090
+executed يعني
+
+24
+00:02:03,100 --> 00:02:07,240
+هذا الجدول بوضح أن أنواع ال beta blockers في منها
+
+25
+00:02:07,240 --> 00:02:10,540
+non selective في منها selective، ال non selective
+
+26
+00:02:10,540 --> 00:02:16,300
+اللي بيشتغل على P1 و P2 و ال selective اللي بيشتغل
+
+27
+00:02:16,300 --> 00:02:21,150
+على P1هذه الأنواع انها بيعطوها للي عندهم أمراض
+
+28
+00:02:21,150 --> 00:02:24,810
+خاصة مثل الأمراض القلق أما هذه الأنواع من ال non
+
+29
+00:02:24,810 --> 00:02:29,310
+selective بيعطوها ل .. لل .. ايه .. لل .. لـ Anti
+
+30
+00:02:29,310 --> 00:02:34,010
+-glucoma تلاحظة هنا إيش عامل هو؟ يقول الواحدة في
+
+31
+00:02:34,010 --> 00:02:39,010
+القياس Pro, Prado هو كل .. كل دراجة من هذه كام
+
+32
+00:02:39,010 --> 00:02:43,730
+بيساوي من ال Prado زي ما قلتلكوا يعني قطعة شكل،
+
+33
+00:02:43,730 --> 00:02:45,710
+عشر شكل، خمس شكل، عشرين شكل
+
+34
+00:02:59,060 --> 00:03:02,720
+هذا ست مرات، ليه بيقول بيقول بيشتغل أقوى منه، من
+
+35
+00:03:02,720 --> 00:03:07,420
+هذا، ست مرات، هذا مثلا تمولول، ست مرات اللي هو
+
+36
+00:03:07,420 --> 00:03:10,460
+تمولين اللي احنا بستعمله في الحياة العادية، ست
+
+37
+00:03:10,460 --> 00:03:14,500
+مرات أقوى من الأساسي اللي بيكتشف زمان، هذا زي و
+
+38
+00:03:14,500 --> 00:03:19,100
+مرة و مرة، عشان يكمل أحلى أختي فاهمة إن ال
+
+39
+00:03:19,100 --> 00:03:20,840
+selective ضعاف
+
+40
+00:03:37,060 --> 00:03:41,080
+however the deciding factor in clinical system
+
+41
+00:03:41,080 --> 00:03:46,620
+effectivity العوامل اللي بتأثر على التأثير على
+
+42
+00:03:46,620 --> 00:03:50,760
+الجسم difference in potency, beta receptors,
+
+43
+00:03:50,980 --> 00:03:53,580
+subtypes, selectivity, metabolism passage through
+
+44
+00:03:53,580 --> 00:03:56,700
+the blood brain barrier, direct effect on the
+
+45
+00:03:56,700 --> 00:03:59,640
+membranes and degree of intrinsic
+
+46
+00:04:07,620 --> 00:04:27,940
+Symptomatic activity بيختلف
+
+47
+00:04:27,940 --> 00:04:30,460
+في ال beta blockers في تأثيره على ال anti-glaucoma
+
+48
+00:04:30,460 --> 00:04:34,610
+أنه يعمل تفعل أنه يعالج لل glaucomaفي ال
+
+49
+00:04:34,610 --> 00:04:38,270
+hypotensive .. العلاقة ما بين ال hypotensive اللي
+
+50
+00:04:38,270 --> 00:04:44,830
+بيصير لل ocular و تأثيرها على الجسم أه هنا بنتكلم
+
+51
+00:04:44,830 --> 00:04:50,130
+على تأثير ال beta blockers على الجسم عموما
+
+52
+00:05:06,060 --> 00:05:10,700
+زي ما قلنا قبل شوية في ال beta blockers نسبتها
+
+53
+00:05:10,700 --> 00:05:14,880
+برومنالولور جديش الفرق، في اشي عشرة واشي ثلاثة
+
+54
+00:05:14,880 --> 00:05:19,940
+واشي ستة واشي تلتة من عشرة، فمثلا واحد، فمثلها كل
+
+55
+00:05:19,940 --> 00:05:23,480
+ما كان قوته أكتر بكتير من برومنالولور كل ما عمل
+
+56
+00:05:23,480 --> 00:05:28,300
+عبدالاسم بطريقة أقوى، ولاقس صحيحمثلا بيطلب from
+
+57
+00:05:28,300 --> 00:05:31,580
+the subtype selectivity طبعا ال selective أضعف من
+
+58
+00:05:31,580 --> 00:05:35,280
+ال non-selective مثلا ال metabolism هل بيصير
+
+59
+00:05:35,280 --> 00:05:40,820
+متابوليزم سيء ولا متابوليزم بطيء في الجسم مثلا بس
+
+60
+00:05:40,820 --> 00:05:44,240
+بي throw blood brain barrier في بعضهم بيخشوا ال
+
+61
+00:05:44,240 --> 00:05:47,080
+blood brain barrier عارفين ال blood brain barrier؟
+
+62
+00:05:47,080 --> 00:05:49,500
+بتتكلم عن هذا؟ و في بعضهم يدخلوا .. يدخلوا .. أو
+
+63
+00:05:49,500 --> 00:05:54,620
+يدخلوا بطيء يعني هذا بي .. بي .. هو اللي محدد مدى
+
+64
+00:05:54,620 --> 00:05:56,120
+الفعلية بتاعته
+
+65
+00:05:59,910 --> 00:06:04,330
+يشبه الـ sympathetic يشبه الـ sympathetic فيه مشبه
+
+66
+00:06:04,330 --> 00:06:09,090
+وفيه مشبهش وبالتالي يعني هذه الأوامر المجتمعة هي
+
+67
+00:06:09,090 --> 00:06:12,570
+اللي بتحدد مدى فعل هذا ال beta blocker على خلايا
+
+68
+00:06:12,570 --> 00:06:16,570
+الاسم، لكن في العين فاقم، في مشكلة ربيع، treatment
+
+69
+00:06:16,570 --> 00:06:21,750
+of glaucoma يا أختي، فاقم، لأ الوضع بيختلف، لأن
+
+70
+00:06:21,750 --> 00:06:26,590
+العين جهاز خاص مش زي دورة دموية، لأن ال metabolism
+
+71
+00:06:26,590 --> 00:06:28,210
+بيصير في العين، وال
+
+72
+00:06:32,410 --> 00:06:35,510
+يعني اللي هو selective و non selective و الحياة
+
+73
+00:06:35,510 --> 00:06:38,750
+الكارية يعني ان انتوا راجبتيه مثلا لأ بستخدمه في
+
+74
+00:06:38,750 --> 00:06:43,570
+العين non selective لإرواحه بس بشرط انه كمان ما
+
+75
+00:06:43,570 --> 00:06:48,290
+خلوهش ينزل كتير و يام طبعا طبقوا فيه بعض ال beta
+
+76
+00:06:48,290 --> 00:06:50,970
+blockers انا بستعمله مرة في اليوم زي ال nylon gel
+
+77
+00:06:50,970 --> 00:06:53,270
+شفتوا ال nylon gel جبته انا هنا في ال ..
+
+78
+00:06:57,460 --> 00:07:00,360
+وانتهت هل ال knowledge اللي هدا بدنا نروح في خربة
+
+79
+00:07:00,360 --> 00:07:07,080
+دورة ذموية؟ بس هي تحرز خاصة في الأطفال احنا
+
+80
+00:07:07,080 --> 00:07:10,720
+متحرزين كتير لإن الأطفال و الأهل يعني بيكونوا أمية
+
+81
+00:07:10,720 --> 00:07:14,460
+مش فاهمين بيحطوا كمية كبيرة حسب منه إن القطب هذا
+
+82
+00:07:14,460 --> 00:07:18,340
+بيكون جوا العين زي الأطربيل مثلا ما كنا بناخد في
+
+83
+00:07:18,340 --> 00:07:21,680
+الأطربيل مثلا أو اللي هو ال ..
+
+84
+00:07:26,360 --> 00:07:29,460
+لكن الناس الكبار عندهم glaucoma بيحطوا للمرأة
+
+85
+00:07:29,460 --> 00:07:33,640
+مرتين في اليوم جيل او قتلة ما تعمل هذه المصايم
+
+86
+00:07:33,640 --> 00:07:37,980
+اللي هي بتصير في الجسم يبقى العين في جهاز ا
+
+87
+00:07:47,640 --> 00:07:52,120
+هنا رح نحكي عن ال .. ال beta blockers في العام
+
+88
+00:07:52,120 --> 00:07:57,340
+1987 فيه تلت أنواع من ال beta blockers كانوا في ال
+
+89
+00:07:57,340 --> 00:08:00,820
+united states في منها ocular و في منها systemic ال
+
+90
+00:08:00,820 --> 00:08:05,820
+ocular فيها timolol, betaxolol و levopinolol و في
+
+91
+00:08:05,820 --> 00:08:10,260
+من تلت أنواع beta blockers تشتغل على الجسم منها
+
+92
+00:08:10,260 --> 00:08:17,040
+atenolol و metoprolol و probenololهذه بتستخدم لما
+
+93
+00:08:17,040 --> 00:08:20,200
+يكون عندنا فيه mild أو moderate, hyper sensitive
+
+94
+00:08:20,200 --> 00:08:26,140
+في الجسم و للأشخاص اللي عندهم anemia .. anemia عند
+
+95
+00:08:26,140 --> 00:08:30,160
+.. أدعينا، عارفة أدعينا إيه؟ دلوقت صدرية
+
+96
+00:08:43,700 --> 00:08:48,520
+وبالتالي لما الواحد بيعمل اي مفعول ماشي او جري او
+
+97
+00:08:48,520 --> 00:08:54,020
+مجهود ماببدأش يستمر لأنه قيمة الدعم اللي بيكمله
+
+98
+00:08:54,020 --> 00:08:58,660
+فيه هتفهق قليلا فبيصير شيء من اسكيميا نقص ال ايش
+
+99
+00:08:58,660 --> 00:09:02,620
+نقص ال oxygen نقص ال oxygen انا متسلم شايفين الأكل
+
+100
+00:09:02,620 --> 00:09:05,280
+أقل أحمر وال system أكمل أحمر عشان انتوا
+
+101
+00:09:05,280 --> 00:09:08,780
+ماتتعاملوش فالانجليزيا معروفة طب والأراضي المياد
+
+102
+00:09:08,780 --> 00:09:17,130
+في دقات القلبو كده فهي قلب يعني عدم انتظام مرة
+
+103
+00:09:17,130 --> 00:09:21,290
+بزيد و مرة بجلد زيك المفروض ان القلب يكون منتظر
+
+104
+00:09:21,290 --> 00:09:25,810
+دقيقة القلب يكون منتظر عدم انتظام هذا بصورة ملحوظة
+
+105
+00:09:25,810 --> 00:09:32,490
+هذا بأثر او يأثر في الدوس فضل هاي ال beta blockers
+
+106
+00:09:32,490 --> 00:09:34,970
+بيعطيها ال hypertension بيكون عندهم hypertension
+
+107
+00:09:34,970 --> 00:09:36,750
+ليخفضوا من ال
+
+108
+00:09:39,540 --> 00:09:43,320
+هنا راح نحكي عن ال side effect لل beta blockers،
+
+109
+00:09:43,320 --> 00:09:47,120
+إيش تأثيرها على الجسم؟ فيه تلت تصنيفات في ال
+
+110
+00:09:47,120 --> 00:09:50,640
+cardiovascular system و في ال respiratory system و
+
+111
+00:09:50,640 --> 00:09:53,500
+على العين، تأثيراتها على العين على ال
+
+112
+00:09:53,500 --> 00:09:56,100
+cardiovascular system، body cardio ممكن تعمل
+
+113
+00:09:56,100 --> 00:10:01,420
+ارتفاع في زيادة نفضات القلب و ممكن تعمل جسم
+
+114
+00:10:01,420 --> 00:10:07,200
+hypotension، يعني تنزل ضغط الدم للجسمفي ال
+
+115
+00:10:07,200 --> 00:10:12,280
+respiratory system bronchospasm
+
+116
+00:10:12,280 --> 00:10:16,300
+in the asthmatic and patient with chronic
+
+117
+00:10:16,300 --> 00:10:22,200
+obstructive pulmonary disease يبقاش bronchospasm
+
+118
+00:10:22,200 --> 00:10:27,520
+تشغل في عضلات القصب الإبطائي فضيق خليف فيه اللي هو
+
+119
+00:10:27,520 --> 00:10:34,560
+عموما مجال النفس برونكاي and bronchus البرونكاية
+
+120
+00:10:34,560 --> 00:10:34,960
+كبيرة
+
+121
+00:10:40,540 --> 00:10:48,440
+بالنفس بتنتهي بال sex بتاعة النفس، يعني هي زي شجرة
+
+122
+00:10:48,440 --> 00:10:54,080
+سبحان الله، كيف القصب الهوية زي أصل الشجرة ال سا،
+
+123
+00:10:54,080 --> 00:10:58,860
+بعدين السا فوق بيبدأ يتفرع إلى المموعة الكبيرة
+
+124
+00:11:14,090 --> 00:11:18,510
+هي بتجيب من الأرض الميه و بتجيب الميه الغرقية و
+
+125
+00:11:18,510 --> 00:11:23,430
+السلق بيوصل و بيحمل و الغصون برضه بتوصل و بتحمل
+
+126
+00:11:23,430 --> 00:11:28,690
+لكن وراك هو الميتابوليزم الحقيقي يعني في تجربة
+
+127
+00:11:28,690 --> 00:11:31,290
+عملناها انه جيبنا شجرة
+
+128
+00:11:42,350 --> 00:11:46,010
+الورق على مهمتي الدنيا فالفرسلات الهوائية أو الكيس
+
+129
+00:11:46,010 --> 00:11:50,530
+الهوائية هذه اللي بتبتدعي هنا أحيانا لو أخدنا
+
+130
+00:11:50,530 --> 00:11:56,550
+أقراس تمولول الأقراس هذه إيش بتعمل؟ Propagation
+
+131
+00:11:56,550 --> 00:12:02,190
+تصير واحد خاصة مع أزمة بيزيد الأزمة الرابعة بيضيق
+
+132
+00:12:02,190 --> 00:12:03,470
+كمان كلموت يعني
+
+133
+00:12:18,400 --> 00:12:33,940
+نقص الإحساس يعني نقص الإحساس
+
+134
+00:12:33,940 --> 00:12:38,660
+يعني
+
+135
+00:12:38,660 --> 00:12:41,840
+نقص الإحساس
+
+136
+00:12:45,410 --> 00:12:48,370
+يعني هو المفروض الإشمع من الأساس بيخلّي يبطّر
+
+137
+00:12:48,370 --> 00:12:51,670
+الإنسان الكلام لكن هذا خطير على العين و لا مش
+
+138
+00:12:51,670 --> 00:12:57,810
+خطير؟ او انشري بالقرنية و ماحسش الانم .. اه يعني
+
+139
+00:12:57,810 --> 00:13:01,470
+الألم سلاح لأنكوا الألم اللي أنتوا بتحسوا فيه هذا
+
+140
+00:13:01,470 --> 00:13:05,810
+سلاح يعني أقولك إنه فيه خطر تهدد هذا الموضوع لإن
+
+141
+00:13:05,810 --> 00:13:11,230
+احنا الناس اللي عندهم سكري الظلمة تتفوت من خلف
+
+142
+00:13:11,230 --> 00:13:21,290
+عليهمعفاية السكري انه بيصير atrophy لنهايات
+
+143
+00:13:21,290 --> 00:13:25,710
+الأعصاب الترافية بيصير atrophy دموعه وبالتالي
+
+144
+00:13:25,710 --> 00:13:29,390
+بيبطل يعني لو العيال بتاع السكر اللي له عشر سنين
+
+145
+00:13:29,390 --> 00:13:34,950
+او اكتر لو ماشي على ناره مانبسش نهيج انه كمان فيه
+
+146
+00:13:34,950 --> 00:13:39,120
+تضيق في الشرايين فممكن انه يصير وردرينة بتبشمافيش
+
+147
+00:13:39,120 --> 00:13:43,900
+دم يعمل healing فاحنا بالنسبة للناس العين بهمنا
+
+148
+00:13:43,900 --> 00:13:48,320
+العين كتير انه بيعمل قلة إحساس و بيعمل dry eyes
+
+149
+00:13:48,320 --> 00:13:53,240
+يعني جفاف الـocular rotation مثل عينه حمرا و
+
+150
+00:13:53,240 --> 00:14:00,000
+متهيجر و بيعمل hyperemia انه توسع و فيه احتقال فضل
+
+151
+00:14:00,000 --> 00:14:04,560
+هنا بيحكي ان الـocular beta blockers بتختلف
+
+152
+00:14:04,560 --> 00:14:07,680
+خصائصها عن ال systemic beta blockers ده لما نشوف
+
+153
+00:14:07,680 --> 00:14:08,140
+العنوان
+
+154
+00:14:12,810 --> 00:14:16,250
+برضه نحكي انه كيف راح تعمل ال beta blockers
+
+155
+00:14:16,250 --> 00:14:20,430
+بتأثيرها على العين، بحكي انه في ال .. في ال beta
+
+156
+00:14:20,430 --> 00:14:24,510
+one blockers، selectivity, lower IP from animals
+
+157
+00:14:24,510 --> 00:14:28,410
+تتعملوا دراسة على الحيوانات، لقوا أنه لو أعطوه
+
+158
+00:14:28,410 --> 00:14:33,410
+beta one blockers، راح يعمل reduce information of
+
+159
+00:14:33,410 --> 00:14:38,630
+accurate human من خلالتقليل تغضي ال .. اللي بتصعر
+
+160
+00:14:38,630 --> 00:14:41,010
+لل ciliary body بما أنه ال ciliary body هي
+
+161
+00:14:41,010 --> 00:14:44,490
+المسؤولة عن ال aqueous إنتاج السيئة ال aqueous فلو
+
+162
+00:14:44,490 --> 00:14:47,050
+عملوا reduction of blood flow to the ciliary body
+
+163
+00:14:47,050 --> 00:14:50,950
+فمش راح ينتج aqueous يومان وهيك بعمل تقليل لل
+
+164
+00:14:50,950 --> 00:14:54,770
+intraocular pressure فلعين يعني مستنتج هذا شهو
+
+165
+00:14:54,770 --> 00:15:00,310
+طبعا غالبا صيني هم شعب شهو مثل هيك ولا سينيين ولا
+
+166
+00:15:00,310 --> 00:15:02,190
+كوريين ولا ..
+
+167
+00:15:05,380 --> 00:15:08,880
+والكليزي بتاعي انه استمتعت وانه فيه reduction of
+
+168
+00:15:08,880 --> 00:15:13,600
+blood clot formation by timolol نتج عن إيش؟
+
+169
+00:15:13,600 --> 00:15:17,200
+reduction of blood clot formation هذا هو استمتعته،
+
+170
+00:15:17,200 --> 00:15:23,580
+لكن طبعا بعض العلماء خلفوه بعدين، تفضل هنا راح
+
+171
+00:15:23,580 --> 00:15:27,340
+يحصل جيب نوع من ال non selective beta blockers
+
+172
+00:15:27,340 --> 00:15:30,640
+agent اللي هو ال Probanol Probanol was the first
+
+173
+00:15:30,640 --> 00:15:37,800
+beta blocking agent Pro-pro-no-lolwas the first
+
+174
+00:15:37,800 --> 00:15:40,420
+beta-blocking agent to be used in clinical
+
+175
+00:15:40,420 --> 00:15:43,400
+therapeutics and has become the standard against
+
+176
+00:15:43,400 --> 00:15:46,280
+which other beta-blocking drugs are measured يعني
+
+177
+00:15:46,280 --> 00:15:50,420
+هو كان أول ال beta-blockers استخدموا علاجه وبعد
+
+178
+00:15:50,420 --> 00:15:56,240
+هيك عملوا أنواع أخرى من ال beta-blockers هو الأساس
+
+179
+00:15:56,240 --> 00:16:00,040
+هو الأساس بطلنا نستعمله لكن هو واحدة في القياسي
+
+180
+00:16:00,040 --> 00:16:02,520
+بقولنا بنقول مثلا Timolol جالده ست مرات,
+
+181
+00:16:02,900 --> 00:16:04,180
+labofnalol جالده تلت مرات
+
+182
+00:16:21,640 --> 00:16:27,160
+ميض مرضى عملت اليهود تراجع من سنة سبع ستين لسنة
+
+183
+00:16:27,160 --> 00:16:29,740
+الخمس والتمانين أو التمانين
+
+184
+00:16:35,150 --> 00:16:40,310
+الدراجة السينيتاتيكية هي مصادرة لتعامل الهيبرتنشن
+
+185
+00:16:40,310 --> 00:16:43,210
+السيستيماكي والهيبرتنشن الهيبرتنشن الهيبرتنشن
+
+186
+00:16:43,210 --> 00:16:52,430
+الهيبرتنشن
+
+187
+00:16:52,670 --> 00:16:57,070
+كعلاج ال hypertension systemic و ال cardiac
+
+188
+00:16:57,070 --> 00:17:00,290
+problem، عدم انتظار ضربة القلب، both oral
+
+189
+00:17:00,290 --> 00:17:05,070
+propranolol and topical propranolol lower IOP in
+
+190
+00:17:05,070 --> 00:17:09,810
+the human، ال oral و ال topical كان اكراس و القطر
+
+191
+00:17:28,430 --> 00:17:31,690
+however use of tropical propranolol in the
+
+192
+00:17:31,690 --> 00:17:34,170
+treatment of glaucoma is limited because of its
+
+193
+00:17:34,170 --> 00:17:37,030
+side effects which is result corneal anesthesia
+
+194
+00:17:37,030 --> 00:17:40,130
+and ocular irritation زي ما حكينا إنه له side
+
+195
+00:17:40,130 --> 00:17:44,610
+effects للبيتر لوكرز فهيك عملوا إنه مش كتير
+
+196
+00:17:44,610 --> 00:17:50,250
+بيستخدموه في علاج اللي ..the mechanism of action
+
+197
+00:17:50,250 --> 00:17:53,550
+of propranolol by which IOP is lowered is still
+
+198
+00:17:53,550 --> 00:17:57,070
+uncertain يعني كيف بيعمل ال propranolol على تخفيض
+
+199
+00:17:57,070 --> 00:18:02,970
+IOP مش مارف كيفلقوا انه reported to the press IQ
+
+200
+00:18:02,970 --> 00:18:07,290
+was a human formation لأنه يقلل IQ was a human
+
+201
+00:18:07,290 --> 00:18:12,490
+formation it has also been accepted with the
+
+202
+00:18:12,490 --> 00:18:16,190
+increasing facility of outflow عمل في ال outflow
+
+203
+00:18:16,190 --> 00:18:19,730
+زيادة انه يسلف ال IQ was a human دي برنامج هم
+
+204
+00:18:19,730 --> 00:18:23,170
+مختلفين هم بيقولوا كده بيعمل uncertain لكن
+
+205
+00:18:23,170 --> 00:18:31,770
+الفراضيات لسه مش حقوقتها انه بيقللإفراز الأكبر سهم
+
+206
+00:18:31,770 --> 00:18:36,150
+من السيئة الريبودي، وفي ناس بيقولوا إيش؟ إنه بيزول
+
+207
+00:18:36,150 --> 00:18:40,190
+ال outflow من ال trabecular مشورة، لكن هذا كان لسه
+
+208
+00:18:40,190 --> 00:18:44,290
+في عليه شغل، خلصنا
+
+209
+00:18:44,290 --> 00:18:50,190
+هذا، هذا لآن مافيش منه، أنا على قهدي مثلا من ال 21
+
+210
+00:18:50,190 --> 00:18:53,730
+سنة ال 22 سنة الأخرانيات، لأ مافيش منهم،
+
+211
+00:19:01,310 --> 00:19:07,090
+أقوى منه ب 10 مرات و أقل منه في ال certificates ال
+
+212
+00:19:07,090 --> 00:19:09,890
+تمولول introduced for clinical use in the united
+
+213
+00:19:09,890 --> 00:19:18,250
+states in 1978 typical تمولول مليت اسمه تجارب تم
+
+214
+00:19:18,250 --> 00:19:21,450
+أبتك تم أبتك تم أبتك تم أبتك تم أبتك تم أبتك تم
+
+215
+00:19:21,450 --> 00:19:28,170
+أبتك تم أبتك تم أبتك تم أبتك تم أبتك تم أبتك تم
+
+216
+00:19:28,170 --> 00:19:28,930
+أبتك تم أبتك تم أبتك تم أبتك تم أبتك تم أبتك تم
+
+217
+00:19:28,930 --> 00:19:28,930
+أبتك تم أبتك تم أبتك تم أبتك تم أبتك تم أبتك تم
+
+218
+00:19:28,930 --> 00:19:28,930
+أبتك تم أبتك تم أبتك تم أبتك تم أبتك تم أبتك تم
+
+219
+00:19:28,930 --> 00:19:32,970
+أبتك تم أبتك تم أبتك تم أبتك تم أبتلأن ما حدش
+
+220
+00:19:32,970 --> 00:19:38,570
+Proprnalolol ما حدش بسمع فيه لأن هذا ال .. اللي هو
+
+221
+00:19:38,570 --> 00:19:42,850
+ال .. الولايات الشبعية لل Proprnalolol صار Timolol
+
+222
+00:19:42,850 --> 00:19:46,750
+ومنه شركات تصنع أشكال أولانية، أنا بتشوف الصورة،
+
+223
+00:19:46,750 --> 00:19:49,390
+أه برضه استخدموا ال Timolol في علاج
+
+224
+00:19:49,390 --> 00:19:52,530
+السكندريجلوكامة والأفاكيكليجلوكامة و ال ocular
+
+225
+00:19:52,530 --> 00:19:57,310
+hypertension القرن اللي هي Timolol لجوا أنه أحسن
+
+226
+00:19:57,310 --> 00:20:02,030
+بكتير ب5 مرات و 10 مرات من ال Proprnalolفي انه
+
+227
+00:20:02,030 --> 00:20:05,650
+بيتفادى ال anesthesia اللى بيبرد فقط انه القرن ال
+
+228
+00:20:05,650 --> 00:20:07,870
+anesthesia اللى بيصير فى اللى بيبرد دلوقت ال
+
+229
+00:20:07,870 --> 00:20:15,690
+timeline ما .. ما .. ماعمله بس هذا بعد ال .. هاي
+
+230
+00:20:15,690 --> 00:20:22,970
+الأقراس فى منها أقراس لداخل الدم و هاي منه شركات
+
+231
+00:20:22,970 --> 00:20:29,230
+هاي اسمه Timetable هناك إيش اسمه مشوعة
+
+232
+00:20:29,230 --> 00:20:33,130
+تحته من طول أو حاجةالمهم شركات كثيرة جدا يبتصرح في
+
+233
+00:20:33,130 --> 00:20:37,350
+كل بلد فيها دي شركات ففي مجموعة بلاد كتير يعني
+
+234
+00:20:37,350 --> 00:20:41,190
+احنا عندنا مثلا في الطرف الغربية اسمه شركة كوطس
+
+235
+00:20:41,190 --> 00:20:48,710
+بتطلعه تمولين شركة كبيرجات سين اوكتيك هذا أنا
+
+236
+00:20:48,710 --> 00:20:52,610
+بعرفه وفيه لغة إذا كانت الطرف الغربية فيها نوعين
+
+237
+00:20:52,610 --> 00:20:56,830
+فكيف الدول الكبرى فيها مئة دول لكن المهم المادة
+
+238
+00:20:56,830 --> 00:20:59,370
+الأساسية هي هل الأقراص
+
+239
+00:21:11,400 --> 00:21:14,440
+بعد هيك هتكمل ال background راح نكمل عن ال
+
+240
+00:21:14,440 --> 00:21:17,880
+temporal بيحكينا the attraction .. لأ فاله هو ال
+
+241
+00:21:17,880 --> 00:21:20,780
+إدراك اللي هو ال temporal advantage اللي هو فوائد
+
+242
+00:21:20,780 --> 00:21:25,350
+ال temporalThe attraction of stimuli lies in the
+
+243
+00:21:25,350 --> 00:21:29,910
+long term efficacy in the treatment of various
+
+244
+00:21:29,910 --> 00:21:33,010
+type of glaucoma, the low incidence of ocular side
+
+245
+00:21:33,010 --> 00:21:36,130
+effects and relatively long duration of action 12
+
+246
+00:21:36,130 --> 00:21:39,610
+-24 hours
+
+247
+00:21:40,030 --> 00:21:44,630
+بحكينا انه ال timoral يعتبر يكمن انجذابه في انه
+
+248
+00:21:44,630 --> 00:21:48,510
+يستخدم في ال long term يعني لفترة طويلة في علاج ال
+
+249
+00:21:48,510 --> 00:21:54,270
+glaucoma و يقل من ضغط العين و يستخدم لفترة طويلة
+
+250
+00:21:54,270 --> 00:21:58,670
+من حوال 12 ل 24 ساعة يبقى يقف العين يعني
+
+251
+00:22:10,680 --> 00:22:14,000
+فبحطه مرة و ما أمر فيه بحطه مرتين طبعا بيحكي ان ال
+
+252
+00:22:14,000 --> 00:22:17,640
+typical ocular administration من 25% ل 0.5%
+
+253
+00:22:17,640 --> 00:22:22,880
+Timolol مليت result in lowering IUP يعني لو حطينا
+
+254
+00:22:22,880 --> 00:22:29,280
+من ال Timolol من 25% ل 0.5% بتقلل من ال IUP في
+
+255
+00:22:29,280 --> 00:22:37,240
+النقل و الglagomitas I بس هذا معروف خلاص ال 0.25
+
+256
+00:22:37,240 --> 00:22:43,510
+فيه سنة للأطفال0.5 للأبد عشان تكون في السوق لأن
+
+257
+00:22:43,510 --> 00:22:47,430
+هذا و هذا موجودين في السوق لا نستحب أن نعطي
+
+258
+00:22:47,430 --> 00:22:50,870
+الأطفال نصف فلمية ولا نستحب أن نعطي الإخبار ربع
+
+259
+00:22:50,870 --> 00:22:54,630
+فلمية خلاص صارت مجسمة الآن يعني ماعرفوا السيد اللي
+
+260
+00:22:54,630 --> 00:22:55,570
+لو صرف هذا
+
+261
+00:23:01,250 --> 00:23:03,910
+بحكي إن ال typical turmoil is effective in
+
+262
+00:23:03,910 --> 00:23:07,670
+reducing IOP من عشرين لتلاتين فمية، طبعا ال
+
+263
+00:23:07,670 --> 00:23:12,250
+turmoil الموضعي بيقلل من IOP من .. بنسبة من عشرين
+
+264
+00:23:12,250 --> 00:23:15,750
+لتلاتين فمية compared with every treatment
+
+265
+00:23:15,750 --> 00:23:20,810
+بالمقارنة مع العياجات الأخرىthe maximum ocular
+
+266
+00:23:20,810 --> 00:23:26,130
+hypotensive effect of timolols is related with a
+
+267
+00:23:26,130 --> 00:23:31,250
+dose range of 3 من 10 الى 5 من 10% طبعا أقصى قيمة
+
+268
+00:23:31,250 --> 00:23:34,950
+تستخدم من ال timolol لتخفيد ال hypotensive من 3 من
+
+269
+00:23:34,950 --> 00:23:38,390
+10 الى 5 من 10% زي ما قولنا انهم منه ربع من 100
+
+270
+00:23:38,390 --> 00:23:42,570
+للأطفال و نصف من 100 للكبار يعني هي ال range اللي
+
+271
+00:23:42,570 --> 00:23:47,580
+بيصنعوه في المصانعgiven twice delay for up to one
+
+272
+00:23:47,580 --> 00:23:50,640
+year, tumour keeps pressure down throughout the
+
+273
+00:23:50,640 --> 00:23:53,640
+day بيحكينا اللي هو اعطانا .. اعطانا المريض انه
+
+274
+00:23:53,640 --> 00:23:57,900
+جدا في اليوم لمدة سنة بيحافظ على ضغط العين خلال
+
+275
+00:23:57,900 --> 00:24:03,000
+هذا السنة tumour is routinely used twice delay,
+
+276
+00:24:03,800 --> 00:24:07,260
+often there are several reports it's efficacy one
+
+277
+00:24:07,260 --> 00:24:13,320
+one on a once delayرجميل بيحكينا إنه بنستخدمها
+
+278
+00:24:13,320 --> 00:24:16,780
+العادة مرتين في اليوم بس بعد التقرير بتحكي إنه
+
+279
+00:24:16,780 --> 00:24:19,640
+لازم نستخدمها مرة واحدة في اليوم regime ايش regime
+
+280
+00:24:19,640 --> 00:24:25,000
+يعني؟ نظام .. نظام .. نظام .. regime .. اللي بيبقى
+
+281
+00:24:25,000 --> 00:24:26,400
+regime لإن الوزن واشهي
+
+282
+00:24:31,790 --> 00:24:34,650
+بيحكينا القرار تمر من عشرين ميلي متر twice delay
+
+283
+00:24:34,650 --> 00:24:38,930
+has also proved effect in reducing IOP in patient
+
+284
+00:24:38,930 --> 00:24:42,950
+with open angle glaucoma بيحكينا حتى مش ع جد تمر
+
+285
+00:24:42,950 --> 00:24:48,070
+الجترة في منه قرار يعني حبوب لو استخدمناها مرتين
+
+286
+00:24:48,070 --> 00:24:51,370
+في اليوم هتجلل برضه من ال .. تستخدم في حالة ال
+
+287
+00:24:51,370 --> 00:24:55,410
+open angle glaucomatypically applied timolol is
+
+288
+00:24:55,410 --> 00:24:59,050
+not metabolized in eye but undergoes extensive
+
+289
+00:24:59,050 --> 00:25:02,150
+hepatic elimination once it reaches the systemic
+
+290
+00:25:02,150 --> 00:25:05,370
+circulation بيحكينا ايضا كمان ان ال timolol
+
+291
+00:25:05,370 --> 00:25:10,450
+مابستخدمش عدة دنيا يعني لحالها لو استخدمت ممكن تصل
+
+292
+00:25:10,450 --> 00:25:14,110
+للجسم و تصل للدورة اللي هي دورة الجسم ال system of
+
+293
+00:25:14,110 --> 00:25:19,630
+circulation ايش hepatic elimination؟ كبد كبد اه
+
+294
+00:25:32,010 --> 00:25:34,290
+combined treatment و التيمولول طبعا هنقارن
+
+295
+00:25:34,290 --> 00:25:37,910
+التيمولول مع القطرات الأخرى بيحكينا أن نص
+
+296
+00:25:37,910 --> 00:25:40,530
+التيمولول doesn't appear significantly more
+
+297
+00:25:40,530 --> 00:25:45,490
+effective than 25% التيمولول لو استخدمنا نص .. من
+
+298
+00:25:45,490 --> 00:25:49,510
+التيمولول نص في المية مش هلاحظ فرق كبير عن 25%
+
+299
+00:25:49,510 --> 00:25:54,970
+يعني في فرق بس مش كبير يعني لو نكون 5% 6%
+
+300
+00:25:58,740 --> 00:26:02,400
+التمريل كان يجب أن ي further reduce IUP when added
+
+301
+00:26:02,400 --> 00:26:12,040
+to symptomatic agents like pyrocarbine
+
+302
+00:26:12,040 --> 00:26:19,660
+كمان كمان كربونيك انهيدرازين انهيبروه
+
+303
+00:26:19,660 --> 00:26:26,980
+انتقلوكومة فهو بقلي لو ضخنا هيقل من ال IUP هيقل
+
+304
+00:26:26,980 --> 00:26:34,270
+أفضلcombinate treatment بالثمورل and acetyl
+
+305
+00:26:34,270 --> 00:26:38,930
+azolimide هذا acetyl azolimide carbonic anhydrase
+
+306
+00:26:38,930 --> 00:26:43,230
+inhibitor اللي هناخده في عنه زيت روشوته هذا نوع من
+
+307
+00:26:43,230 --> 00:26:47,050
+اللي هو ال article of common لو ضفنا الثمورلول
+
+308
+00:26:47,050 --> 00:26:51,950
+إليه هيقلل أكتر لو كان كل واحد لها يعني التنين
+
+309
+00:26:57,500 --> 00:27:01,480
+يعني مثلا و احنا ضغط عين و تلاتين هو بنزله يالا
+
+310
+00:27:01,480 --> 00:27:06,440
+اربع و عشرين او لتلاتة و عشرين فقدرش اؤكد اهلي
+
+311
+00:27:06,440 --> 00:27:10,160
+اللي لانه تلاتة و عشرين عالي و العالي معناه انه
+
+312
+00:27:10,160 --> 00:27:14,300
+اللي يقف العصب البصري بصير اقرفي فاحنا لأ بدنا
+
+313
+00:27:14,300 --> 00:27:20,760
+كمان يعمل إضافة addition لتمولوج كانوا يحطوه بين
+
+314
+00:27:20,760 --> 00:27:23,400
+الكربيين و بعدين بين الكربيين كترت مشاكل لأنه
+
+315
+00:27:23,400 --> 00:27:27,960
+بيعمل اسبازف و بيعمل سلوميلوبيا و كلهافجابوا الـ
+
+316
+00:27:27,960 --> 00:27:31,980
+Acetazolamide والآن حقيقة هذا الـ fantastic الـ
+
+317
+00:27:31,980 --> 00:27:35,560
+Cosoptor work ويانا اللي قطرت ال Cosoptor قبل هي
+
+318
+00:27:35,560 --> 00:27:39,980
+تكلمنا فيها صارت standard الآن Cosoptor كتير يعني
+
+319
+00:27:39,980 --> 00:27:42,540
+شغالة كويس لأنه فيها التملول وفيها ال
+
+320
+00:27:42,540 --> 00:27:46,500
+Acetazolamide مع بعض اتنين أنتجلوكومة فبدا لما
+
+321
+00:27:46,500 --> 00:27:51,420
+ينزلوا من الـ 23 لـ 23 ينزلوا من سنة 19 لـ 18
+
+322
+00:27:52,560 --> 00:27:56,680
+فبيكون العيال في سيف بدل بخليه لعشرين border ليلة
+
+323
+00:27:56,680 --> 00:28:00,460
+انازل تحت العشرين تحت ساعتاش تحت عمانتاش يكون عصر
+
+324
+00:28:00,460 --> 00:28:01,160
+البصري محمي
+
+325
+00:28:05,610 --> 00:28:08,550
+محكينا كمان ال treatment من ال plus بالوكربين لو
+
+326
+00:28:08,550 --> 00:28:13,890
+ضفنا ال بالوكربين برضه هيقل من ال IOL من ال
+
+327
+00:28:13,890 --> 00:28:16,710
+reduction من إنتاج ال IOL أكتر من كل واحد استخدامه
+
+328
+00:28:16,710 --> 00:28:20,390
+لحالي ممتاز، بس أنا بأكد أن ال biocarbine الآن
+
+329
+00:28:20,390 --> 00:28:25,490
+شوية شوية بصير obsolete بالموضوع، يعني احنا لما
+
+330
+00:28:25,490 --> 00:28:29,970
+عملوا التجربة هذه عملوها عشان البحث
+
+331
+00:28:35,310 --> 00:28:38,690
+هذا هو الخط الأول البيبو كاربينة ما يعني مشاكل من
+
+332
+00:28:38,690 --> 00:28:43,770
+ال .. اللي هو Cyclospasm وعمل ال visual feed
+
+333
+00:28:43,770 --> 00:28:48,030
+والسيوميوبيا والكلام هنا وحتى ممكن ال cataract بدي
+
+334
+00:28:48,030 --> 00:28:50,570
+ننسيه، بس احنا هنا جايبه لإيش؟ لبلد البحث
+
+335
+00:28:53,790 --> 00:29:09,470
+بحكينا ان في دراسات
+
+336
+00:29:09,470 --> 00:29:21,950
+ديناميكية ان الورق
+
+337
+00:29:21,950 --> 00:29:28,680
+تصويرإذا بيحطوا كاميرز جوا العين فرق معين لحيث
+
+338
+00:29:28,680 --> 00:29:35,000
+تتصور الدورة بتاعك الأكيوز فوجدوا
+
+339
+00:29:35,000 --> 00:29:40,680
+أن محطه اللي هو Timolol أو Timoline اللي وجدوه
+
+340
+00:29:40,680 --> 00:29:43,900
+بيشتغل على اللي هو Secretion
+
+341
+00:29:52,750 --> 00:30:07,490
+التميلول لا يؤثر
+
+342
+00:30:07,490 --> 00:30:13,310
+على خروج السائل من الهيبوسكيليرال فلو أو
+
+343
+00:30:13,310 --> 00:30:18,170
+الهيبوسكيليرال فيناس بشرهو يعني ممكن تتمنع و ..
+
+344
+00:30:18,170 --> 00:30:19,710
+ممكن تتمنع و .. ممكن تتمنع و .. ممكن تتمنع و ..
+
+345
+00:30:19,710 --> 00:30:20,450
+ممكن تتمنع و .. ممكن تتمنع و .. ممكن تتمنع و ..
+
+346
+00:30:20,450 --> 00:30:21,030
+ممكن تتمنع و .. ممكن تتمنع و .. ممكن تتمنع و ..
+
+347
+00:30:21,030 --> 00:30:23,350
+ممكن تتمنع و .. ممكن تتمنع و .. ممكن تتمنع و ..
+
+348
+00:30:23,350 --> 00:30:23,790
+ممكن تتمنع و .. ممكن تتمنع و .. ممكن تتمنع و ..
+
+349
+00:30:23,790 --> 00:30:29,390
+ممكن تتمنع و .. ممكن
+
+350
+00:30:29,390 --> 00:30:31,590
+تتمنع و .. ممكن تتمنع و .. ممكن تتمنع و .. ممكن
+
+351
+00:30:31,590 --> 00:30:34,310
+تتمنع و .. ممكن تتمنع و .. ممكن تتمنع و .. ممكن
+
+352
+00:30:34,310 --> 00:30:41,030
+تتمنع و .. ممكن تتمنع و .. ممكن تتمنع و .. ممكن
+
+353
+00:30:41,030 --> 00:30:46,770
+تتمنع و ..
+
+354
+00:30:46,770 --> 00:30:50,240
+ممكن تتمتعرفين فينا الناس ال normal نورمالتينسب
+
+355
+00:30:50,240 --> 00:30:55,280
+اسمها نورمالتينسب يعني ال pressure داخلين متوازن
+
+356
+00:30:55,280 --> 00:31:02,460
+عن طريق حاجتين عن طريق ال normal flow ال flow و
+
+357
+00:31:02,460 --> 00:31:07,960
+normal outflow بيهم توازن اللي بيه دي بيطلع اللي
+
+358
+00:31:07,960 --> 00:31:11,720
+بيه دي بيطلع بيه غيره و كده كده لو صار اختلال في
+
+359
+00:31:11,720 --> 00:31:17,900
+واحدة منهم هتيجي بجلوبهم بيه اختلال يعنيخاصة إذا
+
+360
+00:31:17,900 --> 00:31:21,640
+كان الـ outflow قليل فهنا عشان outflow في
+
+361
+00:31:21,640 --> 00:31:26,940
+الجلوكومة في مشكلة في ال trabecular مشورة في ال
+
+362
+00:31:26,940 --> 00:31:32,320
+outflow، trabecular مشورة مريضة صار ال outflow
+
+363
+00:31:32,320 --> 00:31:39,140
+جليد والتصنيع normal فإيش بدوسين؟ بدوسين اتفضل،
+
+364
+00:31:39,140 --> 00:31:43,840
+يبقى الآن هم إيش هيعملوا؟ هيعطوا؟ يعملوا فلس،
+
+365
+00:31:43,840 --> 00:31:52,170
+يجلبوا التصنيعبما يساوي قلة الخروج تفكرتوا؟ لأنه
+
+366
+00:31:52,170 --> 00:31:57,570
+بيوطي ال inflow عشان ال outflow واقف مهلط يعني
+
+367
+00:31:57,570 --> 00:32:03,130
+والله صعب يعني اللي بقولكوا انه ممكن جدا يتحكم مية
+
+368
+00:32:03,130 --> 00:32:06,670
+في مية بيكون غلط يعني زي ضغط الدم الناس مرضى ضغط
+
+369
+00:32:06,670 --> 00:32:11,310
+الدم على ال bike و دايما لأن هو متنسف؟ لا لأ والله
+
+370
+00:32:11,310 --> 00:32:14,570
+في مرة اتنقض جاعة من الفزنونة ضغط بصار عالم تاني
+
+371
+00:32:16,540 --> 00:32:22,280
+رغم انه ماخد علاج يعني هو لو يعني بلق مرض في كومة
+
+372
+00:32:22,280 --> 00:32:28,940
+و لو جسدنا كل يوم هيكون متدفق لكن ان يكون دائما في
+
+373
+00:32:28,940 --> 00:32:32,920
+عليه support يعني احسن من تلق و يعدق و دمر عصب ليا
+
+374
+00:32:32,920 --> 00:32:37,280
+بيحكي ان ال dust is clear ده تمارزان انفلودراج
+
+375
+00:32:37,280 --> 00:32:41,400
+يعني يعتبر تدفق بيساعد في دخول ال
+
+376
+00:32:46,440 --> 00:32:47,520
+هو مصمم الدخول والتصنيع
+
+377
+00:32:57,600 --> 00:33:00,060
+بحكينا ال table is not associated with change in
+
+378
+00:33:00,060 --> 00:33:03,940
+table size, people reaction, accommodation or
+
+379
+00:33:03,940 --> 00:33:08,780
+visual acuity and patient tolerance in most
+
+380
+00:33:08,780 --> 00:33:12,700
+instances is excellent بحكينا أن ال table مابأثر
+
+381
+00:33:12,700 --> 00:33:15,580
+على التغيرات في اللي عندها ال people size ولا ال
+
+382
+00:33:15,580 --> 00:33:17,980
+people reaction ولا التفاعل ولا ال accommodation
+
+383
+00:33:17,980 --> 00:33:20,280
+ولا ال visual acuity يعني كل إشي بيظل زي ما حصل و
+
+384
+00:33:20,280 --> 00:33:21,620
+لا ال feel و لا ال visual acuity
+
+385
+00:33:29,960 --> 00:33:35,000
+لأ احنا انتقلنا نقلة كبيرة نحو ال safety، ال bio
+
+386
+00:33:35,000 --> 00:33:39,100
+-carbine كان اللي .. اللي بيحطه ماقدرش يشوف اللي
+
+387
+00:33:39,100 --> 00:33:42,140
+قدامه كويس ولا يسوق سيارة، ال weed was constructed
+
+388
+00:33:42,140 --> 00:33:47,780
+و ال people constructed و وضعه صحthe absence of
+
+389
+00:33:47,780 --> 00:33:50,420
+alteration in viewable size, accommodation or
+
+390
+00:33:50,420 --> 00:33:54,500
+refractive error avoids many of the unpleasant and
+
+391
+00:33:54,500 --> 00:33:58,680
+sometimes intolerable
+
+392
+00:33:58,680 --> 00:34:01,900
+visual effects seen with many other agents,
+
+393
+00:34:02,040 --> 00:34:06,100
+bilocarbine، بيحكينا هو على عكس ال .. يعني عكس ال
+
+394
+00:34:06,100 --> 00:34:08,740
+.. ال bilocarbine هو جمع هذه الأشياء كلها، على عكس
+
+395
+00:34:08,740 --> 00:34:09,480
+اللي اتمنها
+
+396
+00:34:17,820 --> 00:34:20,320
+قبل حوالي 100 سنة بتمشي على إيش؟ على فحم الحجر
+
+397
+00:34:20,320 --> 00:34:25,800
+يعني في القاطرة حجرة كبيرة و مولّأ فيها فحم و
+
+398
+00:34:25,800 --> 00:34:31,120
+الفحم هذا بيطلّع .. بيغلي ميّه و بيطلّع طاقة و ..
+
+399
+00:34:31,120 --> 00:34:34,620
+و هذه الطاقة هي اللي بتحرك القطار على فحم الحجر
+
+400
+00:34:34,620 --> 00:34:41,800
+بعدها صار قطار بيمشي على سلطة لأن القطار بيمشي على
+
+401
+00:34:41,800 --> 00:34:45,500
+الكعب بكرا بيمشي على الطاقة النووية حتة صغيرة
+
+402
+00:34:54,690 --> 00:34:58,030
+الكاس فاكرينها السنة الماضية؟ اه خلصناها، الإيسار
+
+403
+00:34:58,030 --> 00:35:03,750
+دائما بيبقى على الأريح و على الأحدث بيحكي إن التمر
+
+404
+00:35:03,750 --> 00:35:11,930
+بيقلل
+
+405
+00:35:11,930 --> 00:35:18,110
+.. بيخفض من ال IOP من خلال تفبيط ال .. افراز
+
+406
+00:35:18,110 --> 00:35:21,630
+وتكوين ال aqueous humor من الcellular bodyبيحكينا
+
+407
+00:35:21,630 --> 00:35:25,570
+ال new field has post-bestulated أنه أسعار من ال
+
+408
+00:35:25,570 --> 00:35:28,810
+new field هذا، افترض أن ال تميلول كان acts on
+
+409
+00:35:28,810 --> 00:35:31,910
+secretion or earth refiltration، بيعمل من خلال
+
+410
+00:35:31,910 --> 00:35:35,350
+الإفراز والترشيح أقل اتنين مع بعض، but couldn't
+
+411
+00:35:35,350 --> 00:35:41,410
+confirm on an ocular versus a constrictor action
+
+412
+00:35:41,410 --> 00:35:45,270
+of تميلول on the cerebellum، لكن ما أكد أن عضلات
+
+413
+00:35:45,270 --> 00:35:50,730
+العين أنها بتلقبت من خلال استخدام ال ..الفيزيو ..
+
+414
+00:35:50,730 --> 00:35:54,850
+القوية .. القوية .. القوية .. القوية .. ال .. ال
+
+415
+00:35:54,850 --> 00:35:56,910
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+416
+00:35:56,910 --> 00:35:57,070
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+417
+00:35:57,070 --> 00:35:57,150
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+418
+00:35:57,150 --> 00:35:57,350
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+419
+00:35:57,350 --> 00:35:57,750
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+420
+00:35:57,750 --> 00:35:57,830
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+421
+00:35:57,830 --> 00:36:04,250
+.. ال .. ال .. ال .. ال .. ال ..
+
+422
+00:36:04,250 --> 00:36:04,730
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+423
+00:36:04,730 --> 00:36:08,290
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+424
+00:36:08,290 --> 00:36:09,510
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+425
+00:36:09,510 --> 00:36:09,510
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+426
+00:36:09,510 --> 00:36:17,570
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+427
+00:36:17,570 --> 00:36:20,690
+ال .. ال ..لأنه بيجي الإفراز ال aqueous من الدم
+
+428
+00:36:20,690 --> 00:36:27,110
+فمدام الدم جليل يبقى الإفراز جليل هل أنت الآن تشعر
+
+429
+00:36:27,110 --> 00:36:32,030
+بقول لا بقول لا هذه نظرتك لبذل كونستريكتشن للإنسان
+
+430
+00:36:32,030 --> 00:36:39,010
+ليس لبذل كونستريكتور هذا لازم secretion او ultra
+
+431
+00:36:39,010 --> 00:36:43,430
+filtration او aqueous من الدم زمان كنت في studio
+
+432
+00:36:43,430 --> 00:36:46,330
+of the eye تحدثت عن كيف يتكون ال aqueous
+
+433
+00:36:53,090 --> 00:36:55,050
+مدوسة اللي بدوسة اللي بدوسة اللي بدوسة اللي بدوسة
+
+434
+00:36:55,050 --> 00:36:59,790
+اللي بدوسة اللي بدوسة اللي بدوسة اللي بدوسة اللي
+
+435
+00:36:59,790 --> 00:37:02,210
+بدوسة اللي بدوسة اللي بدوسة اللي بدوسة اللي بدوسة
+
+436
+00:37:02,210 --> 00:37:07,050
+اللي بدوسة اللي بدوسة اللي بدوسة اللي بدوسة اللي
+
+437
+00:37:07,050 --> 00:37:12,670
+بدوسة اللي بدوسة اللي بدوسة اللي بدوسة اللي بدوسة
+
+438
+00:37:12,670 --> 00:37:12,670
+اللي بدوسة اللي بدوسة اللي بدوسة اللي بدوسة اللي
+
+439
+00:37:12,670 --> 00:37:12,670
+بدوسة اللي بدوسة اللي بدوسة اللي بدوسة اللي بدوسة
+
+440
+00:37:12,670 --> 00:37:12,790
+اللي بدوسة اللي بدوسة اللي بدوسة اللي بدوسة اللي
+
+441
+00:37:12,790 --> 00:37:15,930
+بدوسة اللي بدوسة اللي بدوسة اللي بدوسة اللي بدوسة
+
+442
+00:37:15,930 --> 00:37:17,870
+اللي بدوسة اللي بدوسة اللي بدوسة اللي بدوسة
+
+443
+00:37:21,740 --> 00:37:24,920
+أكتر من الملف ونحن مركزة معينة أكتر من الملف بيسحب
+
+444
+00:37:24,920 --> 00:37:30,300
+منه، فالدولة كانت أن الـaqueous humor الموجود في
+
+445
+00:37:30,300 --> 00:37:34,440
+البستيرو chamber مركزة، أكتر من دندر فبيسحب منه،
+
+446
+00:37:34,440 --> 00:37:37,800
+هذا وقت ال filtration، لكن ال secretion لأ، ال
+
+447
+00:37:37,800 --> 00:37:44,480
+secretion الimperium تبثل ال body بيعمل زي glass،
+
+448
+00:37:44,480 --> 00:37:51,000
+هو بيفرزأكواس علاوة صورة عن أكواس secretion او
+
+449
+00:37:51,000 --> 00:37:53,420
+water filtration التمرون بجالي الاتنين
+
+450
+00:38:09,140 --> 00:38:11,420
+بحكينا most patient with the primer open-ended
+
+451
+00:38:11,420 --> 00:38:14,740
+glaucoma respond initially to .. to timolol يعني
+
+452
+00:38:14,740 --> 00:38:17,360
+بستخدمها برضه في ال open-ended glaucoma و بتقلل من
+
+453
+00:38:17,360 --> 00:38:22,460
+الدغت في بداية استخدامها بس جربة جيدة .. بحكينا
+
+454
+00:38:22,460 --> 00:38:27,490
+both ..disadvantage يعني تملول مناعيه، but both
+
+455
+00:38:27,490 --> 00:38:32,150
+short term escape هروب يعني and long term drift
+
+456
+00:38:32,150 --> 00:38:35,490
+اللي هو الإنجراف have been reported for تملول على
+
+457
+00:38:35,490 --> 00:38:39,050
+short term escape reversed to an act partial loss
+
+458
+00:38:39,050 --> 00:38:44,410
+of therapeutic effect on IOP during the first few
+
+459
+00:38:44,410 --> 00:38:49,450
+days of تملول treatment بيحكينا إنه بيفقد بعض
+
+460
+00:38:49,450 --> 00:38:54,610
+التأثيرات العلاجية من خلال استخدامهلا اول يعني اول
+
+461
+00:38:54,610 --> 00:39:00,330
+ايام استخدام مرتبه كعلاج لل IOP اه يعني دلوقت
+
+462
+00:39:00,330 --> 00:39:08,150
+الأرقام يعني الأسبوع الأول جوا
+
+463
+00:39:08,150 --> 00:39:15,010
+كمان نزل تلاتين فمية من ضد العين الأسبوع التاني
+
+464
+00:39:15,010 --> 00:39:22,610
+نزل عشرين فمية و بعد هي خمس عشر فمية
+
+465
+00:39:33,380 --> 00:39:40,980
+يعني أن ضغط العين هرق من تأثير التيمولول وخلّه
+
+466
+00:39:40,980 --> 00:39:46,180
+خلّه خمس طرح في خلال أيام أو أسابيع قصيرة عشان أيه
+
+467
+00:39:46,180 --> 00:39:51,560
+شهور ومدة قصيرة وهذا اللي أثير احنا خدنا في
+
+468
+00:39:51,560 --> 00:39:56,040
+المساكنات مثلا كده الواحد أول ما هو المساكن بكل
+
+469
+00:39:56,040 --> 00:39:58,020
+صداعه يروح ويشي وكده وكده لكن لو استمر يروح
+
+470
+00:39:58,020 --> 00:39:59,400
+المساكن ع طول وع طول وع طول
+
+471
+00:40:08,380 --> 00:40:14,000
+أول حبة بيسكن تاني أكتر أكتر بيصير متعلقة فال
+
+472
+00:40:14,000 --> 00:40:17,920
+timolol دي له القصة هذه لأنه بيصير يعني في
+
+473
+00:40:17,920 --> 00:40:23,120
+الأسابيع الأولى بيجاني تأثيره بشكل واضحالعيب
+
+474
+00:40:23,120 --> 00:40:26,340
+التاني؟ بيحكي إن possible explanation is the
+
+475
+00:40:26,340 --> 00:40:30,160
+finding in animal studies that the number of B B
+
+476
+00:40:30,160 --> 00:40:33,340
+-receptors molecules in ocular tissue increased
+
+477
+00:40:33,340 --> 00:40:37,120
+within day of the initiation of tumour treatment
+
+478
+00:40:37,120 --> 00:40:41,060
+بحكى إن بعد تم التفسيرات إن عملوا دراسات على
+
+479
+00:40:41,060 --> 00:40:45,480
+الحيوانات لاحقوا إن في أول استخدام التمول بتزيد ال
+
+480
+00:40:45,480 --> 00:40:52,490
+tissue بتاعة ال B-receptors في الocular tissueانا
+
+481
+00:40:52,490 --> 00:41:00,290
+عندى في السيارة يقولى فى افتراض خمسمية بيه
+
+482
+00:41:00,290 --> 00:41:06,070
+receptor اللى بيشتغل عليهم ايش بيتهملهم بيقولى بعد
+
+483
+00:41:06,070 --> 00:41:11,690
+أسبوع بيصيروا ألف بعد أسبوعين بيصيروا ألفين بصيروا
+
+484
+00:41:11,690 --> 00:41:15,590
+اخترت دوة اللى بيحطها اللى كانت تكفل الخمسمية و
+
+485
+00:41:15,590 --> 00:41:18,110
+بزيد بصيروا ماتكفلش الألفين
+
+486
+00:41:21,870 --> 00:41:28,830
+بما يرد إلى ان الهياري مستفيل انهيار بلوكينت
+
+487
+00:41:28,830 --> 00:41:34,790
+وبالتالي هي مش دارية انه في دوا خش وبالتالي
+
+488
+00:41:34,790 --> 00:41:42,290
+الافراز بيستغل فيش تقبيل الافراز من عديد من خلايا
+
+489
+00:41:42,290 --> 00:41:50,520
+الـcellular body الانفينيا دواكو يعني تمامالما
+
+490
+00:41:50,520 --> 00:41:55,840
+مثلا احنا أربع على صينية أكل، تجيبنا نقول أكل، في
+
+491
+00:41:55,840 --> 00:42:00,820
+فارخة، الفارخة جسمناها أربع والحمدلله شبعين، اجينا
+
+492
+00:42:00,820 --> 00:42:01,880
+اليوم التاني، جيبنا نفسنا
+
+493
+00:42:22,050 --> 00:42:24,490
+المفضة بتكفي للموجودين
+
+494
+00:42:35,160 --> 00:42:38,920
+بيحكينا this suggests a decreased efficacy of
+
+495
+00:42:38,920 --> 00:42:42,600
+timolol due to decreased substrate substance upon
+
+496
+00:42:42,600 --> 00:42:46,300
+which an enzyme acts for B blockers interaction
+
+497
+00:42:46,300 --> 00:42:50,140
+بيحكينا ان فعالية التمر التقل بالسبب ان ال subject
+
+498
+00:42:50,140 --> 00:42:53,060
+اللي هو المادة الانزيم الموجودة فيها بتكون ضعيفة
+
+499
+00:42:53,060 --> 00:42:57,280
+يعني مش .. مش منيحة كمان بيحكي ان other patients
+
+500
+00:42:57,280 --> 00:43:01,620
+who slow up word trend in IOP after month of
+
+501
+00:43:01,620 --> 00:43:03,320
+therapy بعض ال ..
+
+502
+00:43:10,600 --> 00:43:13,820
+بيحكي ان ال long term drift تأكل ال high potency
+
+503
+00:43:13,820 --> 00:43:17,360
+of efficacy of timolol may be decreased by up to
+
+504
+00:43:17,360 --> 00:43:23,440
+25% with long term treatment 25% مثلا بعد سنة، بعد
+
+505
+00:43:23,440 --> 00:43:28,320
+سنتين، المريض اللي بيقولك أن المريض اللي بيقولك أن
+
+506
+00:43:28,320 --> 00:43:29,840
+المريض اللي بيقولك أن المريض اللي بيقولك أن المريض
+
+507
+00:43:29,840 --> 00:43:31,240
+اللي بيقولك أن المريض اللي بيقولك أن المريض اللي
+
+508
+00:43:31,240 --> 00:43:32,280
+بيقولك أن المريض اللي بيقولك أن المريض اللي بيقولك
+
+509
+00:43:32,280 --> 00:43:32,680
+أن المريض اللي بيقولك أن المريض اللي بيقولك أن
+
+510
+00:43:32,680 --> 00:43:36,720
+المريض اللي بيقولك أن المريض اللي بيقولك أن المريض
+
+511
+00:43:36,720 --> 00:43:37,740
+اللي بيقولك أن المريض اللي بيقولك أن المريض اللي
+
+512
+00:43:37,740 --> 00:43:41,420
+بيقولك أن المريض اللي بيقولك أن المريض اللياما
+
+513
+00:43:41,420 --> 00:43:44,860
+بيعمل حملية جراحية اما بيضلوا مال الحياة على
+
+514
+00:43:48,600 --> 00:43:51,100
+محكينا أه clear side effects of timurol تأثيرها
+
+515
+00:43:51,100 --> 00:43:53,840
+على العين أولاشى allergic .. allergic
+
+516
+00:43:53,840 --> 00:43:57,900
+blepharocongenectivitis allergic to topical B
+
+517
+00:43:57,900 --> 00:44:02,740
+blockers as Epidans by blepharocongenectivitis of
+
+518
+00:44:02,740 --> 00:44:05,560
+occurs in some patient after long term use of
+
+519
+00:44:05,560 --> 00:44:09,200
+timurol يعني حساسية في العين في الكنجنكتابة، بلفاق
+
+520
+00:44:09,200 --> 00:44:12,720
+.. بلفاق بتشنش بالكنجنكتابة و بيصير أشياء كتير،
+
+521
+00:44:12,720 --> 00:44:16,120
+اتنين، كنجنكتابة الhyperemia الأوية الدموية نفسها
+
+522
+00:44:16,120 --> 00:44:20,100
+اللي في الكنجنكتابة بتتدخم .. تتدخمsuperficial
+
+523
+00:44:20,100 --> 00:44:23,700
+pancreatitis, blurred vision can't also cure,
+
+524
+00:44:23,980 --> 00:44:27,320
+decreased tear production in glaucoma patients was
+
+525
+00:44:27,320 --> 00:44:31,500
+also reported but was not deemed dangerous unless
+
+526
+00:44:31,500 --> 00:44:35,560
+the eye had abnormally low lacrimal secretion،
+
+527
+00:44:35,560 --> 00:44:38,340
+ماشي يعني هذا، decreased production of tears؟ هنا
+
+528
+00:44:38,340 --> 00:44:40,900
+بيحكي إن في الأشخاص اللي عندهم glaucoma ال tears
+
+529
+00:44:40,900 --> 00:44:44,060
+بتقل عندهم، هنا مابتكونش خطر إلا إذا كان .. إذا
+
+530
+00:44:44,060 --> 00:44:46,360
+كان في حد اللي ممنوع، بفعل إيه إيش بتقل؟ ال
+
+531
+00:44:46,360 --> 00:44:46,640
+temporal
+
+532
+00:44:56,920 --> 00:45:01,160
+في بعض الناس، بعض الناس هيبريم يتجي اللي فيه توسق
+
+533
+00:45:01,160 --> 00:45:04,400
+في الشعارات الدوامية اللي و بعض الناس عندهم شوية
+
+534
+00:45:04,400 --> 00:45:09,480
+keratase، punctate، شوية blurring of vision و بعض
+
+535
+00:45:09,480 --> 00:45:13,660
+الناس dryness، و طبعا هذه مختلفة من واحدة واحدة،
+
+536
+00:45:13,660 --> 00:45:16,720
+مافيش واحد يصير معاه خمسة، يصير معاه واحدة أو
+
+537
+00:45:16,720 --> 00:45:20,660
+تنتهي، في بعض الناس، و نسب واحد في الألف، واحد في
+
+538
+00:45:20,660 --> 00:45:22,100
+الخمسمية، واحد في المية
+
+539
+00:45:25,240 --> 00:45:26,660
+الـ Self-effects، الـ Self-effects بتاعة
+
+540
+00:45:26,660 --> 00:45:35,240
+البيوكربين من أصعب البيوكربين أحيانا
+
+541
+00:45:35,240 --> 00:45:42,700
+ممكن لو فيه opacity في ال lens يعمل blindness لأنه
+
+542
+00:45:42,700 --> 00:45:51,490
+فيه opacity على ال visual accessوقلنا انه بيعمل
+
+543
+00:45:51,490 --> 00:45:57,990
+visual field تيوبال فيديون نهيط على ال spasm بتاع
+
+544
+00:45:57,990 --> 00:46:02,630
+ال muscle وكلام زي هذا فإذا اتقررنا هذا بهذا كلام
+
+545
+00:46:02,630 --> 00:46:06,930
+انا بعرف ناس احنا شغالين معاهم من فترات طويلة اطلب
+
+546
+00:46:06,930 --> 00:46:13,010
+لول وماشي بارد وطيس ومافيش مشكلة بس صحيح ان موضوع
+
+547
+00:46:13,010 --> 00:46:19,100
+ال short scale و ال long drift انه بسيطعشان هيك
+
+548
+00:46:19,100 --> 00:46:23,560
+نضطر إنه إحنا ندعمه بإيش بهدوء أخرى وشوفت أنا ناس
+
+549
+00:46:23,560 --> 00:46:27,540
+في يعني الرحلة بعد مثلا عشر سنين اللي حصل معاها
+
+550
+00:46:27,540 --> 00:46:32,060
+three drugs أو أربع drugs جترا اللي هو قدر من
+
+551
+00:46:32,060 --> 00:46:39,320
+القوة so التأكل عجيب في مفعول الهدوء يعني فاضحة
+
+552
+00:46:39,320 --> 00:46:41,900
+mixed effects of stimulants تأثيرها على الجسم
+
+553
+00:46:41,900 --> 00:46:43,780
+slowing of the heart rate
+
+554
+00:46:48,170 --> 00:46:54,530
+Is that common systemic finding in clinical
+
+555
+00:46:54,530 --> 00:46:57,190
+studies with typical similarity؟
+
+556
+00:47:06,350 --> 00:47:09,850
+فانسيكو .. مع بعض بالزيدي و مع بعض بالجيزي اه
+
+557
+00:47:09,850 --> 00:47:15,790
+بيصير عنده اغمق طبعا تم الالمي اكذاجربت اكذاسيربيت
+
+558
+00:47:15,790 --> 00:47:20,910
+اكذاسيربيت اكذاسيربيت pre .. pre exciting pre
+
+559
+00:47:20,910 --> 00:47:24,250
+existing pre existing بيبقى مش ان انجليزيا ..
+
+560
+00:47:24,250 --> 00:47:27,830
+بيبقى مش .. احنا هنا بنتعلم احنا هنا يا بني انا
+
+561
+00:47:27,830 --> 00:47:28,570
+تمتعلم
+
+562
+00:47:35,380 --> 00:47:39,840
+هذا يجب أن أقول صح هنا متعلم يعني مرض موجود سابق
+
+563
+00:47:39,840 --> 00:47:43,200
+الوجود هدف الرابو مرض الرابو مرض الرابو يعني
+
+564
+00:47:43,200 --> 00:47:47,540
+ماعطيوش للناس انبوتانز
+
+565
+00:47:47,540 --> 00:47:50,840
+انبوتانز طب الانبوتانز في الذكورة and increased
+
+566
+00:47:50,840 --> 00:47:54,420
+libido ال central nervous system بأثر على ال
+
+567
+00:47:54,420 --> 00:47:58,320
+nervous system كومبلينت ريبارتو والتمريوز زي
+
+568
+00:47:58,320 --> 00:48:02,740
+headache, fatigue, dizziness, weakness, unexiety
+
+569
+00:48:02,740 --> 00:48:09,570
+and depressionخلاص نجرف عند خمسمية و تلاتاش ال new
+
+570
+00:48:09,570 --> 00:48:14,590
+world اللي هو beta because و انا بشكر بناتي يعني
+
+571
+00:48:14,590 --> 00:48:19,590
+فاقنا و بذات كتير و ادعوكم الى يعني هالي المشهورة
+
+572
+00:48:19,590 --> 00:48:26,290
+الفعالة لأن احنا هنا نحاول نعطي يعني إضافة للإلقاء
+
+573
+00:48:26,290 --> 00:48:26,770
+لل presentation
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/feRvl9gkHHc.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/feRvl9gkHHc.srt
new file mode 100644
index 0000000000000000000000000000000000000000..b4a773ab47ba000987f9af0c75dcb4706bbd53fd
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/feRvl9gkHHc.srt
@@ -0,0 +1,1865 @@
+1
+00:00:20,810 --> 00:00:24,070
+أولًا بسم الله الرحمن الرحيم بسم الله الرحمن الرحيم
+
+2
+00:00:24,070 --> 00:00:27,210
+الحمد لله رب العالمين وأصلي وأسلم على النبي الأمين
+
+3
+00:00:27,210 --> 00:00:31,570
+محمد وعلى آله وأصحابه واتباعه السلام عليكم ورحمة 
+
+4
+00:00:31,570 --> 00:00:36,650
+الله وبركاته في المحاضرة السابقة بدأنا بال
+
+5
+00:00:36,650 --> 00:00:40,130
+solutions of contact lenses
+
+6
+00:01:00,390 --> 00:01:02,910
+كل ساعة فينا أتمنى أنه لبس contact lenses
+
+7
+00:01:31,430 --> 00:01:35,550
+تبليل، تبليل العدسة اللاصقة كانوا يعني لما بدهم 
+
+8
+00:01:35,550 --> 00:01:41,150
+يعني يعملوا العدسة اللاصقة في العين ويحطوها على
+
+9
+00:01:41,150 --> 00:01:44,770
+الأصبع ويحطوا عليها الـ wetting يعني نوع من 
+
+10
+00:01:44,770 --> 00:01:48,750
+الترتيب عشان يتسهل يعني الموضوع التعامل معها على 
+
+11
+00:01:48,750 --> 00:01:52,270
+الأصبع أو في العين يعني وهي كمان فيها نوع من الـ
+
+12
+00:01:52,270 --> 00:01:56,250
+disinfection بيقول الـ wetting solutions were
+
+13
+00:01:56,250 --> 00:01:58,170
+developed in 1950
+
+14
+00:02:04,150 --> 00:02:08,730
+contact lens relatively hydrophilic يعني أنه إيش؟ 
+
+15
+00:02:08,730 --> 00:02:14,030
+hydrophilic أنه قابل لتعامل أو امتصاص الماء they
+
+16
+00:02:14,030 --> 00:02:16,310
+were applied to the lens following its removal
+
+17
+00:02:16,310 --> 00:02:19,850
+from the storage case يعني هي الـ lens بتكون في الـ
+
+18
+00:02:19,850 --> 00:02:25,310
+case الآن حط على إصبع تمهيدة ناضحة في العين يفهم
+
+19
+00:02:25,310 --> 00:02:28,930
+حطوة solutions they contained self-sufficient
+
+20
+00:02:28,930 --> 00:02:29,450
+agent
+
+21
+00:02:33,140 --> 00:02:36,200
+الـ Surface had provided a viscous coating that
+
+22
+00:02:36,200 --> 00:02:39,320
+encouraged the lens to adhere to the finger during
+
+23
+00:02:39,320 --> 00:02:42,700
+insertion يعني هي مهمتها ساعة ما نحط إحنا الـ wetting
+
+24
+00:02:42,700 --> 00:02:49,560
+solution على الـ contact lens يعني بتخلي الـ surface 
+
+25
+00:02:49,560 --> 00:02:57,480
+قابلة للاتساق مع الدموع اه والـ angle في أقل درجة الـ
+
+26
+00:02:57,480 --> 00:02:58,720
+angle التي تفصل 
+
+27
+00:03:06,150 --> 00:03:11,210
+أنقل وكما أنها تعمل نوع من الـ coating لها يعني
+
+28
+00:03:11,210 --> 00:03:17,530
+تبليل وتغليف لها حتى تجلس على الأصبع قبل وضعها في
+
+29
+00:03:17,530 --> 00:03:27,590
+العين حقيقة كثيرة اللي هو أنواع الـ wetting والـ
+
+30
+00:03:27,590 --> 00:03:29,850
+solutions عمومًا كثيرة هي الأنواع
+
+31
+00:03:44,080 --> 00:03:49,840
+أو fixed lens on the corner يجب أن تكون الـ corner
+
+32
+00:03:49,840 --> 00:03:55,360
+movable on the surface of the lens يعني الـ user
+
+33
+00:03:55,360 --> 00:04:00,140
+when يعني wants to look
+
+34
+00:04:13,750 --> 00:04:19,990
+Downward and laterally لازم تتحرك اللينز متحركة 
+
+35
+00:04:19,990 --> 00:04:24,850
+الكاميرا ما تفضلش ثابتة لازم تتحرك وتكون شوية
+
+36
+00:04:24,850 --> 00:04:28,650
+floating وهذا مهمة الـ solutions اللي بيحطها اليوم
+
+37
+00:04:28,650 --> 00:04:35,350
+تبقى مهمة للشباب ليس كل اللينز تفرز مادة غير
+
+38
+00:04:35,350 --> 00:04:40,190
+مستخدمة يعني أصعب شيء تتخيلي أن واحد بإصبع يقعد
+
+39
+00:04:40,190 --> 00:04:44,590
+يكحكح اللينز اللينز عشان يشيل منها أي front body أو
+
+40
+00:04:44,590 --> 00:04:51,470
+غبار لأن الأصابع دائمًا عن الـ clean يعني مش هنضعف 
+
+41
+00:04:51,470 --> 00:04:57,770
+هذه حاجة لازم يعرف الـ user أنّه مش طريقة تقليدية أن
+
+42
+00:04:57,770 --> 00:05:01,730
+أنا أحط العنصر على أي سطح وأنا أنظفها بصبيّة لـ
+
+43
+00:05:01,730 --> 00:05:08,850
+solution اللي هي عاملها إحنا بندرس عنها هي تتولى
+
+44
+00:05:08,850 --> 00:05:15,370
+الموضوع هذا إذا أبت وأزالت أي جسم التصاق به اللي 
+
+45
+00:05:15,370 --> 00:05:20,410
+هو الناس wetting solutions contain a wetting agent
+
+46
+00:05:20,410 --> 00:05:23,890
+a viscosity increasing agent such as polyvinyl
+
+47
+00:05:23,890 --> 00:05:28,390
+alcohol and a preservative يبقى الـ wetting
+
+48
+00:05:28,390 --> 00:05:30,450
+solutions فيها تلات حاجات
+
+49
+00:05:33,080 --> 00:05:37,460
+increasing agent يعني فيها عامل يزيد اللزوجة وأنا
+
+50
+00:05:37,460 --> 00:05:46,280
+مطلوب اللزوجة مطلوبة كمان فيها عامل اللي
+
+51
+00:05:46,280 --> 00:05:52,960
+هو polyvinyl alcohol اللي هو اللي بيزيد اللزوجة في
+
+52
+00:05:52,960 --> 00:06:00,220
+عامل آخر اللي هو preservative preservative يعني
+
+53
+00:06:00,220 --> 00:06:06,080
+for food or for any solution أو drink هو to prevent
+
+54
+00:06:06,080 --> 00:06:13,260
+bacteria from damaging or spoiling that اللي هو
+
+55
+00:06:13,260 --> 00:06:19,180
+medium يعني دائمًا إحنا مثلًا عصير برتقال fresh
+
+56
+00:06:19,180 --> 00:06:23,880
+ممتاز جدًّا نتركه ساعتين حتى لو في الثلاجة بيبدأ
+
+57
+00:06:23,880 --> 00:06:27,040
+يُطير طب نتركه 24 ساعة نلاقي deficits
+
+58
+00:06:34,990 --> 00:06:37,310
+يعني نضعها أكثر من 24 ساعة يعني وأنا ما زال في الـ
+
+59
+00:06:37,310 --> 00:06:41,570
+festival أي مشكلة طيب أُتفعار محفوظ أو شهر محفوظ
+
+60
+00:06:41,570 --> 00:06:47,150
+الشرايط في الجياجات طبعًا عليهم مدة حفظ تحفظهم حتى
+
+61
+00:06:47,150 --> 00:06:51,210
+لو بقية أسوانيا مغلقة لشهر أو شهرين أو ثلاثة أو
+
+62
+00:06:51,210 --> 00:06:52,190
+أربعة أو خمسة أو ستة
+
+63
+00:07:01,760 --> 00:07:05,740
+لها disadvantages من الـ allergy ومن الـ
+
+64
+00:07:05,740 --> 00:07:10,600
+carcinogenic effects commonly the preserved abuse
+
+65
+00:07:10,600 --> 00:07:14,120
+was benzalkonium chloride يعني المادة الحافظة في
+
+66
+00:07:14,120 --> 00:07:18,800
+المحلول اسمها benzalkonium chloride وهذا من أشهر
+
+67
+00:07:18,800 --> 00:07:24,780
+اللي هو الحافظات الموجودة في عالم الدواء في عالم
+
+68
+00:07:24,780 --> 00:07:29,280
+الدواء مش بس في العين في عالم الدواء معظم المشروبات 
+
+69
+00:07:29,280 --> 00:07:36,040
+اللي هي في السيراب والـ solutions والكلام هذا كله 
+
+70
+00:07:36,040 --> 00:07:38,900
+علي مواد حافظة بالذات قولوا if you write the
+
+71
+00:07:38,900 --> 00:07:42,400
+efficacy of what was enhanced by the addition of
+
+72
+00:07:42,400 --> 00:07:47,100
+the chelating agent chelating agent يعني هي مادة
+
+73
+00:07:47,100 --> 00:07:54,920
+تحاول أن تسحب اللي هو أي ميتال خاصة هي بميتال
+
+74
+00:08:03,450 --> 00:08:13,170
+ليه هذا الوسط من أي harmful heavy metals اللي
+
+75
+00:08:13,170 --> 00:08:17,690
+هو الـ  بزارك هنا قلت أنه هو المهم في موضوع الـ عنصر 
+
+76
+00:08:17,690 --> 00:08:24,190
+اللاصقة solutions اه وفي أي حاجة في الدوام طيب الـ
+
+77
+00:08:24,190 --> 00:08:28,490
+cleaning طيب الـ surfactant cleaners اللي هو
+
+78
+00:08:28,490 --> 00:08:31,790
+cleaning of the surface of
+
+79
+00:08:37,330 --> 00:08:43,950
+يعني أنا قبل ما أزيل الـ protein وقبل ما أزيل الـ
+
+80
+00:08:43,950 --> 00:08:49,730
+fat عن سطح العدسة بدي شيء في الأول ينظف السطح قبل
+
+81
+00:08:49,730 --> 00:08:54,110
+إذابة قبل إذابة المواد المتراكمة بدي شيء ينظف السطح 
+
+82
+00:08:54,110 --> 00:08:58,830
+وهذا يصبح الـ fact and cleaners except daily
+
+83
+00:08:58,830 --> 00:09:01,510
+disposable lenses which are simply discarded after
+
+84
+00:09:01,510 --> 00:09:06,190
+use يعني أنا العدسة اللي disposable بلبسها أربع أو
+
+85
+00:09:06,190 --> 00:09:13,010
+خمس أو ست أو عشر ساعات هذه غير يعني يعني مطلوب
+
+86
+00:09:13,010 --> 00:09:17,190
+تنظيفها لأنّها disposable زي السيرنج بقدر أنا 
+
+87
+00:09:17,190 --> 00:09:20,710
+أضرب فيها مرة وdisposable once وأنا دي once 
+
+88
+00:09:20,710 --> 00:09:25,870
+ألبسها عشر أو اثنتي عشرة ساعة وبعدين برميها فمن الـ ..
+
+89
+00:09:25,870 --> 00:09:29,090
+يعني أنا مش مطلوب حتى لو تلبسها أن أنا أضرب فلان 
+
+90
+00:09:29,090 --> 00:09:32,690
+هي هتكون disposed although multipurpose solutions
+
+91
+00:09:32,690 --> 00:09:34,610
+can perform both of these
+
+92
+00:09:37,870 --> 00:09:40,450
+هي لديها تجارب تجارب تجارب تجارب تجارب تجارب تجارب
+
+93
+00:09:40,450 --> 00:09:41,650
+تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب
+
+94
+00:09:41,650 --> 00:09:46,470
+تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب
+
+95
+00:09:46,470 --> 00:09:50,570
+تجارب تجارب
+
+96
+00:09:50,570 --> 00:09:53,970
+تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب
+
+97
+00:09:53,970 --> 00:09:59,510
+تجارب تجارب تجارب تجارب تجارب
+
+98
+00:09:59,510 --> 00:10:03,770
+تجارب
+
+99
+00:10:04,850 --> 00:10:11,550
+يعني وضع إنه الشيء تطور عن الماضي Contaminants
+
+100
+00:10:11,550 --> 00:10:14,710
+attract a variety of contaminants إيش 
+
+101
+00:10:14,710 --> 00:10:19,910
+Contaminants؟ ملوثات يبقى إيه أول ما فتحت الـ
+
+102
+00:10:19,910 --> 00:10:24,930
+Contaminants بعد ساعة أو ساعتين بتبدأ إيش؟ تترسب
+
+103
+00:10:24,930 --> 00:10:33,930
+عليها جزئيات يعني هذه جزئيات محطوطة فأي Contaminant
+
+104
+00:10:38,110 --> 00:10:45,390
+أيّ dead cells التي تجيء عليه fats عندي proteins خاصة
+
+105
+00:10:45,390 --> 00:10:48,570
+اللي هي موجودة في الترقيب في fats وفي proteins
+
+106
+00:10:48,570 --> 00:10:54,490
+عندي في الترقيب ساحق طبقة lipid وطبقة mucus طبقة
+
+107
+00:10:54,490 --> 00:10:59,030
+وفي الـ protein دا يتراكم آخر كنت بتسوي اقرار
+
+108
+00:10:59,030 --> 00:11:04,160
+depending on the patients lifestyle يعني ممكن أنّه 
+
+109
+00:11:04,160 --> 00:11:08,380
+يعني اللابس اللي عنده العدسات أنّه عنده طريقة حياة 
+
+110
+00:11:08,380 --> 00:11:13,580
+تختلف عن الآخر فمثلًا جاب لك الـ nicotine يعني واحد 
+
+111
+00:11:13,580 --> 00:11:17,400
+بيلاقي أنّه يدخّن كثير أو الشيشة اللي رجليه عنده
+
+112
+00:11:17,400 --> 00:11:24,020
+كثير ممكن واحد أنّه يعني قريب من معمل كيمياويات مثلًا
+
+113
+00:11:24,020 --> 00:11:30,800
+أبخرة وكلام زي هذا يعني أو عطور مثلًا في معمل عطور
+
+114
+00:11:30,800 --> 00:11:31,440
+مثلًا
+
+115
+00:11:39,320 --> 00:11:44,800
+لكنه مجرد نيكوتين اللي مستَجرّ كنول يعني أنّه يتصرف 
+
+116
+00:11:44,800 --> 00:11:50,260
+في الهواء ويضعف إلى البروتين والفاكس في تلويث H تلويث
+
+117
+00:11:50,260 --> 00:11:52,740
+H تلويث H تلويث H تلويث H تلويث H تلويث H تلويث H
+
+118
+00:11:52,740 --> 00:11:53,180
+تلويث H تلويث H تلويث H تلويث H تلويث H تلويث H
+
+119
+00:11:53,180 --> 00:11:53,300
+تلويس H تلويس H تلويس H تلويس H تلويس H تلويس H
+
+120
+00:11:53,300 --> 00:11:56,260
+تلويس H تلويس H تلويس H تلويس H تلويس H تلويس H
+
+121
+00:11:56,260 --> 00:12:01,480
+تلويس H تلويس
+
+122
+00:12:01,480 --> 00:12:07,100
+H تلويث
+
+123
+00:12:09,910 --> 00:12:14,490
+بين الـ water content بتاع العدسة اللاصقة وبين الـ 
+
+124
+00:12:14,490 --> 00:12:18,070
+pollutants أو الـ contaminants and is also
+
+125
+00:12:18,070 --> 00:12:22,110
+influenced by the source surface charge of the 
+
+126
+00:12:22,110 --> 00:12:25,870
+hydrogen طيب يعني هو بيقول لك القاعدة أنّه كل ما زاد
+
+127
+00:12:25,870 --> 00:12:30,350
+الـ water content كل ما زاد الـ contaminants والعكس 
+
+128
+00:12:30,350 --> 00:12:37,290
+صحيح كانت الميّه عاليه لما تسحب وتساعد في عدسات
+
+129
+00:12:40,500 --> 00:12:46,540
+وفينا Ionic في متأينة سطح بتاعها وفي مش متأينة
+
+130
+00:12:46,540 --> 00:12:51,140
+لأن ك higher water content lenses have a greater
+
+131
+00:12:51,140 --> 00:12:56,300
+affinity for protein deposits يبقى هذه المتأينة 
+
+132
+00:12:56,300 --> 00:13:02,480
+لسطحها فيها شحنة يعني خاصة negative charge أنّه
+
+133
+00:13:02,480 --> 00:13:07,090
+بيسحب الـ protein أو تسحب الـ protein فينا الـ Ionic 
+
+134
+00:13:07,090 --> 00:13:12,270
+غير متأينة ما بتحمل شحنة سطحها أما الـ Ionic low
+
+135
+00:13:12,270 --> 00:13:16,970
+water content lenses attract least protein الغير
+
+136
+00:13:16,970 --> 00:13:21,750
+متأينة وفيها مياه قليلة تسحب protein أقل من
+
+137
+00:13:21,750 --> 00:13:25,670
+المتأينة أنا حاولت أن أجد المتأينة وغير متأينة 
+
+138
+00:13:29,290 --> 00:13:34,290
+أنّه كيف non-ionic surface أكثر
+
+139
+00:13:34,290 --> 00:13:42,550
+كيف يعني كيف يكون السطح وكيف هذا السطح يقع عليه
+
+140
+00:13:42,550 --> 00:13:46,370
+اللي هي الـ contaminated هاي الـ contaminated هنا 
+
+141
+00:13:46,370 --> 00:13:50,430
+هاي الـ contaminated كيف يقع على هذا السطح
+
+142
+00:14:05,080 --> 00:14:09,320
+الكل بيجاوز عليه ما هي المزايا من تنظيف العدسة
+
+143
+00:14:09,320 --> 00:14:14,760
+اللي نستخدمها كل يوم زي إيش يعني أنّه بيحسوا إنّه  
+
+144
+00:14:14,760 --> 00:14:24,500
+كلية vision فيزيال فيكشن أو بتطول من حياتها اللاصقة؟
+
+145
+00:14:24,500 --> 00:14:28,060
+آه هي بتطول من اللي هو العمر بتاع العدسة اللاصقة 
+
+146
+00:14:28,060 --> 00:14:31,340
+خيار بتاعك أن هذا بيكون أحسن وبنخطّط بكثيرية لما
+
+147
+00:14:31,340 --> 00:14:35,700
+الـ disinfection والـ comfort لعيان ممتازة يبقى 
+
+148
+00:14:35,700 --> 00:14:38,260
+improve the clarity of the lens clarity شفافية
+
+149
+00:14:40,520 --> 00:14:43,260
+Hair Cleaning Removes Endogenous Contaminants
+
+150
+00:14:43,260 --> 00:14:47,740
+Endogenous اللي بتيجي من نفس الـ tear film من اللي
+
+151
+00:14:47,740 --> 00:14:52,480
+هو وسط العين يعني tear film constituents such as
+
+152
+00:14:52,480 --> 00:14:55,360
+mucus, lipids and proteins together with exogenous
+
+153
+00:14:55,360 --> 00:14:58,680
+Exogenous Contaminants اللي بتيجي من الهواء بتيجي
+
+154
+00:14:58,680 --> 00:15:02,300
+من برة such as cosmetics اللي هو أدوات الـ make-up 
+
+155
+00:15:02,300 --> 00:15:07,360
+التجميل and environmental pollutants زي الغبار و
+
+156
+00:15:07,360 --> 00:15:11,750
+زي النيكوتين وزي العطور وأي شيء موجود في الهواء
+
+157
+00:15:11,750 --> 00:15:15,850
+الهواء مليان طيب الشيء الثاني في الـ clarity 
+
+158
+00:15:16,590 --> 00:15:22,030
+prolongs the successful wearing time يبقى الوقت
+
+159
+00:15:22,030 --> 00:15:29,950
+بتاع اللبس بيكون successful مريح يعني آه وأطول
+
+160
+00:15:29,950 --> 00:15:32,930
+طيب في reduces the level of microbiological
+
+161
+00:15:32,930 --> 00:15:33,790
+contamination
+
+162
+00:15:44,860 --> 00:15:48,800
+ما هو موضوع الـ microbiology مهم جدًّا وكثير الآن
+
+163
+00:15:48,800 --> 00:15:55,020
+يعني إخواننا في الـ .. اللي هو شركائنا في التحاليل
+
+164
+00:15:55,020 --> 00:15:59,540
+الطبية .. آه الطب المخبري يعني بدهم يعملوا معانا
+
+165
+00:15:59,540 --> 00:16:01,300
+أبحاث على أدسات العيون
+
+166
+00:16:10,180 --> 00:16:16,300
+إحنا نعمل عدسات لاصقة بدون دراسة بكتريا خاطئة وهم
+
+167
+00:16:16,300 --> 00:16:20,120
+يعملوا عدسات بكتريا على أشياء لكن ليس فيها
+
+168
+00:16:20,120 --> 00:16:23,620
+عدسات لاصقة التي تهم عين الإنسان وهذا عنصر حيوي
+
+169
+00:16:23,620 --> 00:16:29,060
+يعني العين عنصر حيوي يعني مش زي مثلًا أني بس أنا
+
+170
+00:16:29,060 --> 00:16:33,280
+أعمل أبحاث على الـ urine والـ stool الـ urine والـ
+
+171
+00:16:33,280 --> 00:16:36,900
+الـ stool مهمين لأنهم مبينين إيش في المريض لكن عين
+
+172
+00:16:36,900 --> 00:16:41,800
+الإنسان لو ضاعت تصفي أعمى من حياته أنه أراد أن هو
+
+173
+00:16:41,800 --> 00:16:48,640
+يعني يعمل correction لنظره أو أن هو يعني يبدو في
+
+174
+00:16:48,640 --> 00:16:52,480
+مظهر لائق يعني وجميل أن هو يجيب له contamination 
+
+175
+00:16:52,480 --> 00:16:55,160
+فبقول reduce the level of microbiological 
+
+176
+00:16:55,160 --> 00:16:58,440
+contamination daily cleaning physically removes
+
+177
+00:16:58,440 --> 00:17:02,560
+contaminant debris والفضلات the preservatives 
+
+178
+00:17:02,560 --> 00:17:05,180
+in the solution are capable of achieving some
+
+179
+00:17:05,180 --> 00:17:07,270
+disinfection الميزة الـ benzalkonium chloride اللي
+
+180
+00:17:07,270 --> 00:17:13,570
+نقول عنه ممكن أنّه ساعد في قتل نسبة البكتيريا ليس
+
+181
+00:17:13,570 --> 00:17:19,970
+مثل الـ Antibiotic لأ أقل 50% أو 40% كمان ميزة
+
+182
+00:17:19,970 --> 00:17:24,050
+تحسين فعالية الانتقال من الانتقال من الانتقال من
+
+183
+00:17:24,050 --> 00:17:25,910
+ال
+
+216
+00:19:52,630 --> 00:19:56,530
+الـ lens إيه دولة ضخمة It has been shown that 
+
+217
+00:19:56,530 --> 00:20:00,370
+tear components adsorbed onto the lens surface
+
+218
+00:20:00,370 --> 00:20:04,510
+enhance the adherence of microorgan**isms** to the lens but
+
+219
+00:20:04,510 --> 00:20:09,420
+some might adhere even to clean lenses يبقى .. لما
+
+220
+00:20:09,420 --> 00:20:14,720
+يكون فيه protein أو يكون فيه fat أو أي contaminant
+
+221
+00:20:14,720 --> 00:20:20,780
+على سطح الـ contaminated تيجي البكتيريا بالذات تعيش
+
+222
+00:20:20,780 --> 00:20:25,840
+فيه تحس أنه بعيد عن مجرى الدموع اللي .. اللي هي
+
+223
+00:20:25,840 --> 00:20:30,780
+بتحركه وترسوه على هذه الصخرة البكتيريا عشان تبدأ
+
+224
+00:20:30,780 --> 00:20:34,560
+تعمل ايش في اليوم التاني؟ **multiply** تتكعثر وتعمل 
+
+225
+00:20:34,560 --> 00:20:35,520
+مئات وآلاف
+
+226
+00:20:41,070 --> 00:20:46,630
+أو فات أو يعني debris أو حاجة معناه أن أنا فوّرت
+
+227
+00:20:46,630 --> 00:20:51,510
+البكتيريا أن تختبئ فوّرت البكتيريا أن تختبئ في هذه
+
+228
+00:20:51,510 --> 00:20:56,670
+اللي هو النطوئات الصغيرة failure to remove tear
+
+229
+00:20:56,670 --> 00:20:59,410
+proteins before the infection with hydrogen
+
+230
+00:20:59,410 --> 00:21:02,870
+peroxide or heat allowed the protein to become
+
+231
+00:21:02,870 --> 00:21:07,150
+denaturated and acts as an antigen هذه كمان حاجة
+
+232
+00:21:07,150 --> 00:21:12,840
+المفروض تكون تمالية الـ .. الـ .. الـ protein اللي هو
+
+233
+00:21:12,840 --> 00:21:16,980
+من الدموع وترسّب على سلاسفة يبدأ في عمل الـ
+
+234
+00:21:16,980 --> 00:21:21,200
+denaturation، denaturation تغيير طبيعي .. طبيعي،
+
+235
+00:21:21,200 --> 00:21:27,100
+تغيير طبيعي زي مثلًا مثال الـ denaturation البيضة
+
+236
+00:21:27,100 --> 00:21:29,240
+لما نحطها في النار
+
+237
+00:21:39,930 --> 00:21:43,370
+وأصلح طبيعتها وضّر اللطة هل ممكن أعد البيض إلى 
+
+238
+00:21:43,370 --> 00:21:49,770
+سابقتها؟ خلاص بيقول لك في الـ cataract يعني أكتر شيء في
+
+239
+00:21:49,770 --> 00:21:52,470
+الـ cataract خاصة سينان الـ cataract أنه بيصير
+
+240
+00:21:52,470 --> 00:21:56,530
+denaturation of the protein of the crystalline lens
+
+241
+00:21:56,530 --> 00:22:02,430
+denaturation يعني تغير الطبيعة بتاعها وبالتالي أصبح
+
+242
+00:22:02,430 --> 00:22:08,150
+opaque بدل transparent هنا بيقول لي إن الـ protein
+
+243
+00:22:08,150 --> 00:22:13,960
+اللي للشخص اللى بيستخدم العدسة اللاصقة إذا لم أَنَظِّفها أو أغيرها
+
+244
+00:22:13,960 --> 00:22:19,020
+له بسرعة مناسبة بيصير له دي ناتوريشن داخل العدسة
+
+245
+00:22:19,020 --> 00:22:26,480
+اللاصقة وهذا الـ toxic بيعمل انتيجين انتيجين يعني
+
+246
+00:22:26,480 --> 00:22:32,860
+ايش؟ بروتين غريب عن الجسم أن الـ antigen يتكوّن
+
+247
+00:22:32,860 --> 00:22:36,260
+Antibodie**s** تتكوّن Antibodies بتصير Antigen
+
+248
+00:22:36,260 --> 00:22:42,280
+Antibody وهذا اللي بيقول عنه Immunity Response،
+
+249
+00:22:42,280 --> 00:22:45,560
+استجابة مناعية واحنا بدنا نقول اقعد نعمل حرب في 
+
+250
+00:22:45,560 --> 00:22:50,340
+سطح العين، بنفع نعمل حرب؟
+
+251
+00:22:53,170 --> 00:22:57,950
+فهنا كنا إنه نظفنا العدسة اللي لها صفة ما سمحناش 
+
+252
+00:22:57,950 --> 00:23:02,610
+للـ protein إنه يبدأ يعمل denaturation ويعمل غزو بـ
+
+253
+00:23:02,610 --> 00:23:09,970
+immune response للإيش؟ لسطح العين كمان تسعة هنا
+
+254
+00:23:09,970 --> 00:23:16,070
+سالت daily cleaners contain a surface active agent
+
+255
+00:23:23,690 --> 00:23:27,290
+وهو يقوم بتنظيف تجارب المنظف ويقوم بتنظيف تجارب
+
+256
+00:23:27,290 --> 00:23:31,230
+المنظف و
+
+257
+00:23:31,230 --> 00:23:35,990
+يقوم بتنظيف تجارب المنظف ويقوم بتنظيف تجارب المنظف و
+
+258
+00:23:35,990 --> 00:23:40,510
+يقوم بتنظيف تجارب المنظف ويقوم بتنظيف تجارب المنظف و
+
+259
+00:23:40,510 --> 00:23:41,930
+يقوم بتنظيف تجارب المنظف ويقوم بتنظيف تجارب المنظف و
+
+260
+00:23:41,930 --> 00:23:41,970
+يقوم بتنظيف تجارب المنظف ويقوم بتنظيف تجارب المنظف و
+
+261
+00:23:41,970 --> 00:23:45,530
+يقوم بتنظيف تجارب المنظف ويقوم بتنظيف تجارب المنظف و
+
+262
+00:23:45,530 --> 00:23:46,510
+يقوم بتنظيف تجارب 
+
+263
+00:23:56,180 --> 00:24:05,600
+تسعة فوائد للـ daily cleaning of contact lenses  داي
+
+264
+00:24:05,600 --> 00:24:11,280
+الآن هتكلم على disinfecting solutions كلمة
+
+265
+00:24:11,280 --> 00:24:14,520
+disinfection تطهير مش تعقيم
+
+266
+00:24:21,120 --> 00:24:24,360
+في البداية لما تيجي من المصنع لكن بعد ما تموضها في
+
+267
+00:24:24,360 --> 00:24:27,400
+العين كل اللي أنا بعمله أعمله disinfection والفرق
+
+268
+00:24:27,400 --> 00:24:31,680
+بين sterilization and disinfection أن
+
+269
+00:24:31,680 --> 00:24:37,700
+sterilization can kill all forms of bacteria all
+
+270
+00:24:37,700 --> 00:24:42,120
+forms بيقول بيجي تايت الـ form اللي ابتدت عليها and 
+
+271
+00:24:42,120 --> 00:24:48,000
+spore forms كمان المحوصلة لكن الـ disinfection
+
+272
+00:24:48,000 --> 00:24:57,340
+are just لقتل الـ vegetative forms ليس الـ spores
+
+273
+00:24:57,340 --> 00:25:01,020
+يبقى الـ disinfectant solutions with the exception
+
+274
+00:25:01,020 --> 00:25:04,440
+of daily disposable hydrogel lenses or contact
+
+275
+00:25:04,440 --> 00:25:07,560
+lenses need to be disinfected after their removal
+
+276
+00:25:07,560 --> 00:25:12,400
+and cleaning their removal from the eye يعني الآن
+
+277
+00:25:12,400 --> 00:25:17,640
+أنا عندي التخزين التخزين على ثلاثة بيصير نوعية في
+
+278
+00:25:17,640 --> 00:25:21,440
+dry storage وفي wet storage الـ dry يعني وده الـ
+
+279
+00:25:21,440 --> 00:25:25,180
+solution و wet يعني with solutions وشوف ايش الفرق
+
+280
+00:25:25,180 --> 00:25:29,300
+بين الـ dry storage والـ wet storage طبعًا واضح أن 
+
+281
+00:25:29,300 --> 00:25:38,220
+الـ dry storage أنه bad storage لأنه هيغير في الـ
+
+282
+00:25:38,220 --> 00:25:41,340
+physical properties والـ optical properties of
+
+283
+00:25:41,340 --> 00:25:41,700
+اللنز
+
+284
+00:25:45,970 --> 00:25:49,430
+أو حتى في الـ case بتاعها وتكون جافة أنا حاجة
+
+285
+00:25:49,430 --> 00:25:56,150
+أجيها rigid وأجيها dull ومش transparent إذا
+
+286
+00:25:56,150 --> 00:26:00,570
+كانت الـ lenses جافة جافة جافة جافة جافة جافة جافة
+
+287
+00:26:00,570 --> 00:26:02,110
+جافة جافة جافة جافة جافة جافة جافة جافة جافة جافة
+
+288
+00:26:02,110 --> 00:26:04,170
+جافة جافة جافة جافة جافة جافة جافة جافة جافة جافة
+
+289
+00:26:04,170 --> 00:26:07,670
+جافة جافة جافة جافة جافة جافة جافة جافة جافة جافة
+
+290
+00:26:07,670 --> 00:26:08,150
+جافة جافة جافة جافة جافة جافة جافة جافة جافة جافة
+
+291
+00:26:08,150 --> 00:26:16,240
+جافة جافة جافة جافة والـ optical properties والـ 
+
+292
+00:26:16,240 --> 00:26:22,160
+physical properties هتفقد فالإنها هتكون واسط مناسب
+
+293
+00:26:22,160 --> 00:26:27,820
+لنمو البكتيريا الـ micro organisms فحدش متصور أنه
+
+294
+00:26:27,820 --> 00:26:32,540
+يطلع الـ contact lens من عينه ويحطها dry في الـ
+
+295
+00:26:32,540 --> 00:26:38,140
+case بتاعها بيصير هذا؟ لأ بس أنا بقول هذا يعني
+
+296
+00:26:38,140 --> 00:26:44,260
+كَدراسة الـ wet storage في الماء أو في المحلول من
+
+297
+00:26:44,260 --> 00:26:47,880
+الهيدروجين لينزيز هي أساسية ليس فقط لتأكيد هذه
+
+298
+00:26:47,880 --> 00:26:54,060
+الِانْفِكَار ولكن أيضًا لتحفزهم لأنهم يمتلكوا محتوى
+
+299
+00:26:54,060 --> 00:26:58,080
+ماء يمكنه أن يتجاوز من 38% إلى 80%
+
+300
+00:27:02,160 --> 00:27:06,760
+مكوّنها من مكوّنها في إعادة ثلاثية فإن كان أنا
+
+301
+00:27:06,760 --> 00:27:12,800
+أبعدت الإعادة الثلاثية عن الـ solution كأني سلبتها
+
+302
+00:27:12,800 --> 00:27:18,400
+مكوّن من مكوّناتها الماء اللي هو بشكل من 38% إلى 80%
+
+303
+00:27:18,400 --> 00:27:23,180
+من المكون غير أنه بتحافظ على الـ properties of the
+
+304
+00:27:23,180 --> 00:27:27,360
+contact lens الـ solutions اللي بتعمل this
+
+305
+00:27:27,360 --> 00:27:34,750
+infection two types فيه solution stable وفيه
+
+306
+00:27:34,750 --> 00:27:39,050
+solution transient فيه solution ثابت وفيه solution 
+
+307
+00:27:39,050 --> 00:27:44,790
+متغير سوليوشن الثابت فيه Preservative زي بنزال
+
+308
+00:27:44,790 --> 00:27:49,570
+الكونيوم الذي تم تصميمه لإستخدام إذا كان الوضع
+
+309
+00:27:49,570 --> 00:27:56,130
+مرتبط أو هيدروجين عن سيليكون هيدروجين الأساسي يعني
+
+310
+00:27:56,130 --> 00:28:02,510
+هذا مشهور أن تتنم أعمال حقأما الـ Transient لأ، 
+
+311
+00:28:02,510 --> 00:28:06,850
+الـ Transient فيه Antimicrobial agent زي الـ 
+
+312
+00:28:06,850 --> 00:28:13,290
+Antibiotic أو زي اللي هو الـ Detergents
+
+313
+00:28:43,170 --> 00:28:44,310
+أنت مجرد مجرد مجرد مجرد مجرد مجرد مجرد مجرد مجرد
+
+314
+00:28:44,310 --> 00:28:44,850
+مجرد مجرد مجرد مجرد مجرد مجرد مجرد مجرد مجرد
+
+315
+00:28:44,850 --> 00:28:48,690
+مجرد مجرد عبس استيول ممكن استعمال لفترة طويلة لكن
+
+316
+00:28:48,690 --> 00:28:54,110
+هذا يستعمل لفترة قصيرة نسبيًا such solutions were
+
+317
+00:28:54,110 --> 00:28:58,430
+originally introduced for use with hydrogel lenses
+
+318
+00:28:58,430 --> 00:29:02,710
+but can also be used with rigid and silicone لجميع
+
+319
+00:29:02,710 --> 00:29:07,310
+الأنواع بتاعت الـ contact lenses طيب أي سيستم of
+
+320
+00:29:07,310 --> 00:29:10,190
+the infection should be filtered not only against
+
+321
+00:29:10,190 --> 00:29:15,840
+commonly used challenge bacteria البكتيريا بتعمل
+
+322
+00:29:15,840 --> 00:29:19,480
+challenge للي اللي هو العين، such as
+
+323
+00:29:19,480 --> 00:29:23,500
+Staphylococcus aureus، Pseudomonas aeruginosa،
+
+324
+00:29:23,500 --> 00:29:26,600
+Escherichia coli, but also on many types of 
+
+325
+00:29:26,600 --> 00:29:31,060
+bacteria and other organisms such as fungi and
+
+326
+00:29:31,060 --> 00:29:36,020
+Acanthamoeba يبقى احنا لما جينا نجيب محلول فيه
+
+327
+00:29:36,020 --> 00:29:40,120
+antimicrobial agents، بدي مش كونه selective لبعض
+
+328
+00:29:40,120 --> 00:29:45,260
+أنواع البكتيريا، بل يشمل البكتيريا والفنجاعي اللي
+
+329
+00:29:45,260 --> 00:29:52,280
+هو الـ amoeba التي تقزو سطح العين وتدمر القرنية إذا
+
+330
+00:29:52,280 --> 00:29:53,460
+ما عملتلها invasion
+
+331
+00:29:58,690 --> 00:30:02,490
+الآن الكلام على الـ multi-purpose solutions استقر
+
+332
+00:30:02,490 --> 00:30:11,670
+الأمور على بحلول واحد متعدد الأدوار أصبح بدأ الـ
+
+333
+00:30:11,670 --> 00:30:16,010
+wetting والـ surfactant والـ disinfection سنة من
+
+334
+00:30:16,010 --> 00:30:25,510
+استخدام one solution for many purposes solutions
+
+335
+00:30:25,510 --> 00:30:27,750
+intended مصممة لإيش؟
+
+336
+00:30:30,450 --> 00:30:35,230
+وكانت تقدمت في 1994، في سنة ألف وتسعمائة وأربعة
+
+337
+00:30:35,230 --> 00:30:46,110
+وتسعين، وفي عام 2005، وكانت تقدمت كير سيستم
+
+338
+00:30:46,110 --> 00:30:51,850
+استخدام 91% من الأشخاص في الولايات المتحدة بعد
+
+339
+00:30:51,850 --> 00:30:55,950
+2005 من 2005 وجاي أصبح واحد وتسعين 
+
+340
+00:30:55,950 --> 00:30:58,510
+في المية من الناس اللي بيبقوا يستخدموا عدسات لاصقة
+
+341
+00:30:58,510 --> 00:31:05,230
+يستخدمون هذا النوع من المحاولات ده popularity ايش 
+
+342
+00:31:05,230 --> 00:31:09,850
+popularity؟ الشعبية الشعبية صار شائع والـ multi
+
+343
+00:31:09,850 --> 00:31:12,990
+-purpose solutions as you know the fact that they
+
+344
+00:31:12,990 --> 00:31:17,970
+simplify contact lens care صار يعني ما فيش تعقيد
+
+345
+00:31:19,910 --> 00:31:24,070
+بيصير الـ care العناية بالعدسة سهلة for the patient
+
+346
+00:31:24,070 --> 00:31:28,230
+and this is .. it is help enhances compliance
+
+347
+00:31:28,230 --> 00:31:34,310
+ويصير يعني كل الناس تتحمل هذا الموضوع يعني مش معقد
+
+348
+00:31:34,310 --> 00:31:38,670
+ولا صعب the most recent development in the request
+
+349
+00:31:38,670 --> 00:31:42,630
+for simplification is no-rub multi-purpose
+
+350
+00:31:42,630 --> 00:31:46,610
+solution يعني أنا حط العدسة وأطلع المحلول هو
+
+351
+00:31:46,610 --> 00:31:51,500
+ينظف الحاجة ما فيش حاجة تجيب فرشاية ولا أصبعي وأقحك
+
+352
+00:31:51,500 --> 00:31:57,940
+أه no rub لأنه دايمًا الأصابع والإضافة الناس هذه
+
+353
+00:31:57,940 --> 00:32:02,840
+متهمة بالإيش؟ بتخلق infection اللي بيفضل يامل في
+
+354
+00:32:02,840 --> 00:32:05,740
+عينه يامل كل شوية يامل في عينه عارف عينه دايمًا
+
+355
+00:32:05,740 --> 00:32:11,480
+معمصة وفيها infection لأن هذه الأصابع يعني زي
+
+356
+00:32:11,480 --> 00:32:15,960
+زوائد الإيش؟ تتحرك في كل تجاه وتسلم وتلمس وتأكل
+
+357
+00:32:15,960 --> 00:32:22,040
+وتشرب غيره يعني فيعني احنا لو وصلنا لـ touch less
+
+358
+00:32:22,040 --> 00:32:26,360
+زي ما يقولون بيكون أفضل على ثلاثة which eliminates
+
+359
+00:32:26,360 --> 00:32:32,060
+the rub and rinse step يعني هي المحلول هي the time
+
+360
+00:32:32,060 --> 00:32:36,680
+of rubbing والـ time of rinse .. rinse تشربه يعني زي
+
+361
+00:32:36,680 --> 00:32:41,040
+ما يقولوا برنجة أو بتشربه nevertheless one study
+
+362
+00:32:41,040 --> 00:32:44,980
+indicated that the greater the number of steps in 
+
+363
+00:32:44,980 --> 00:32:50,700
+a regime the greater its disinfecting efficacy ايش
+
+364
+00:32:50,700 --> 00:32:54,800
+يعني القاعدة
+
+365
+00:32:54,800 --> 00:33:02,480
+كانت بتقول كلما زادت الخطوات في تطهير العدسة اللاصقة أ
+
+366
+00:33:02,480 --> 00:33:07,140
+greater the number of steps in the regime the
+
+367
+00:33:07,140 --> 00:33:11,300
+greater its disinfecting efficacy يعني كانوا
+
+368
+00:33:11,300 --> 00:33:11,620
+بيقولوا
+
+369
+00:33:16,730 --> 00:33:20,830
+على الطيارة بتكون أفضل لأنها بتاخد وقت أكتر، هذه
+
+370
+00:33:20,830 --> 00:33:23,930
+القاعدة اللي كانت بتقول هيك، بقول rising the
+
+371
+00:33:23,930 --> 00:33:27,850
+lenses prior to the infection was considered to
+
+372
+00:33:27,850 --> 00:33:31,670
+assist this process، يعني هو بيقول لي احنا بنستعوض
+
+373
+00:33:31,670 --> 00:33:37,230
+عن هذا أن احنا بننقع، عارفة عم تنقع، العدسة اللي
+
+374
+00:33:37,230 --> 00:33:42,650
+عارفة في الـ container الـ case بتاعها طول الليل في 
+
+375
+00:33:42,650 --> 00:33:48,670
+الـ night طول الليل هذا بوقف كتير علينا ما أعرفش إلى 
+
+376
+00:33:48,670 --> 00:33:57,270
+أي مدى سمعين أنتم كل زمان يعني الملابس المتسخة ده
+
+377
+00:33:57,270 --> 00:34:02,670
+خلاص من الجثة المتسخة كتير لأ بيحطها في ماء دافئ و
+
+378
+00:34:02,670 --> 00:34:09,450
+بيحط عليها بودر معين بيقول له محلول نجا جدر نقع دم
+
+379
+00:34:09,450 --> 00:34:14,500
+الغسيل بيحطها مثلًا اتناشر ساعة وبعدين ساعتها بس
+
+380
+00:34:14,500 --> 00:34:20,200
+ضعف خفيف تلاقيها تلاقيها نظيفة نظيفة خاصة اللي
+
+381
+00:34:20,200 --> 00:34:24,280
+فيها البقعة وفيها الـ .. يعني الـ .. الـ .. الوساخة
+
+382
+00:34:24,280 --> 00:34:28,440
+الكتيرة ما بتدخل في الغسالة مع الملابس اللي أنت 
+
+383
+00:34:28,440 --> 00:34:35,280
+سايبة خفيف فكل عمل ثلاثة تفضل طول الليل في الكيس
+
+384
+00:34:35,280 --> 00:34:41,950
+هذا كتير ايش بي .. بي .. بي .. بي .. بي .. بيشبش
+
+385
+00:34:41,950 --> 00:34:46,050
+الـ .. الـ .. الوساخة وبيخليها قابلة عن الغسل بالظبط
+
+386
+00:34:46,050 --> 00:34:52,970
+الحقيقة في كتير يعني high of the free مثلًا high
+
+387
+00:34:52,970 --> 00:34:58,690
+sustain مثلًا high اللي هو الـ comfort complete هناك
+
+388
+00:34:58,690 --> 00:35:05,910
+أه high moist هنا كتير كتير راجعة أنا يعني من هذه 
+
+389
+00:35:05,910 --> 00:35:09,930
+المنتجات المحلية الـ market products طيب
+
+390
+00:35:10,500 --> 00:35:14,520
+multipurpose solutions preserve tips ايش هي في حال
+
+391
+00:35:14,520 --> 00:35:19,880
+تحتاج إلى مادة حافظة لمنع من التلخم ولا هيتعيش
+
+392
+00:35:19,880 --> 00:35:23,780
+بدون اللي هو مادة حافظة، these solutions
+
+393
+00:35:23,780 --> 00:35:28,440
+incorporate preservatives regarded as novel in the 
+
+394
+00:35:28,440 --> 00:35:32,020
+
+431
+00:38:31,810 --> 00:38:42,530
+هتجي بيعمل ايش؟ Bubbles، Frost، رهوة، هذه معناها 
+
+432
+00:38:42,530 --> 00:38:48,770
+أنه بدأ يخرج أكسجين، السائل صار رغوي و الأكسجين هو
+
+433
+00:38:48,770 --> 00:38:54,130
+اللي ابتدى قدامك فيه فقاعة، الحقيقة إن حطه على
+
+434
+00:38:54,130 --> 00:38:57,890
+الجروح العميقة، مش على الجروح السطحية، هذه الجروح
+
+435
+00:38:57,890 --> 00:39:04,950
+العميقة اللي يعني فيها هواء كثير، هيقتل الـ 
+
+436
+00:39:04,950 --> 00:39:10,090
+anaerobic bacteria، وحقيقة إنه كان effective و الـ
+
+437
+00:39:10,090 --> 00:39:16,130
+crust اللي كان على الجرح إنه بينخر، ونخر يعني كويس 
+
+438
+00:39:16,130 --> 00:39:18,530
+جدا في إزالة الـ crust، والحقيقة اللي معرفة أنه
+
+439
+00:39:18,530 --> 00:39:23,360
+يعني مش فالآن، أما انتبهوا إن موضوع الـ hydrogen
+
+440
+00:39:23,360 --> 00:39:30,180
+peroxide إنه ممكن يستخدم solution في تقشير العدسة
+
+441
+00:39:30,180 --> 00:39:35,480
+اللاصقة، بس طبعا في مرحلة إنه بعد وضع الـ hydrogen
+
+442
+00:39:35,480 --> 00:39:39,000
+peroxide لازم نعمل elimination له أو
+
+443
+00:39:39,000 --> 00:43,800
+neutralization له حتى ما يعمل للعين أي hydrogen أو
+444
+00:39:43,800 --> 00:39:44,120
+أضرار
+
+445
+00:39:47,710 --> 00:39:52,090
+هذا مش يعني، مش، ما احنا هنقول هنا فيه نوعين، فيه
+
+446
+00:39:52,090 --> 00:39:58,670
+نوع stable وفيه نوع transient، الآن احنا بنتكلم على 
+
+447
+00:39:58,670 --> 00:40:03,970
+transient إنه فيه antimicrobial agents، وإنه بعد 
+
+448
+00:40:03,970 --> 00:40:10,570
+شوية بيروح وبيفضلش منه حاجة، الآن بنتكلم على
+
+449
+00:40:10,570 --> 00:40:15,530
+transient الـ hydrogen peroxide، لإن الـ hydrogen
+
+450
+00:40:15,530 --> 00:40:25,830
+peroxide بعد دقائق من وضعه ينتهي، هو transient مش ثابت 
+
+451
+00:40:25,830 --> 00:40:34,230
+يعني الـ time consuming هو ايه؟ احنا هنا؟ اه 
+
+452
+00:40:34,230 --> 00:40:38,110
+Hydrogen peroxide was the first chemical means of
+
+453
+00:40:38,110 --> 00:40:41,710
+disinfection of hydrogen lenses to be introduced
+
+454
+00:40:41,710 --> 00:40:45,390
+as an alternative to heat disinfection، يعني هو
+
+455
+00:40:45,390 --> 00:40:46,970
+بديل للحرارة
+
+456
+00:40:54,870 --> 00:41:02,930
+نفسه الحرارة، يعني وسيلة جيدة جدا في تطهير وتعقيم 
+
+457
+00:41:02,930 --> 00:41:10,030
+هذا مافيه كلام، لكن حسب مكون العدسة اللاصقة، الـ
+
+458
+00:41:10,030 --> 00:41:13,750
+poly methyl مثلاً، ممكن يصير لها أي damage
+
+459
+00:41:13,750 --> 00:41:17,550
+بالإصابة بالحرارة، فعم بيتحارب عليها، فجاء لها ايش بارد
+
+460
+00:41:17,550 --> 00:41:21,210
+فهي
+
+461
+00:41:21,210 --> 00:41:25,660
+بديل للحرارة و التطهير بالحرارة، and the extent of
+
+462
+00:41:25,660 --> 00:41:31,400
+its usage has varied over the years، في الـ 2005 it
+
+463
+00:41:31,400 --> 00:41:36,800
+was used by only 10% of patients in the UK، يعني في
+
+464
+00:41:36,800 --> 00:41:41,060
+اللي هو المملكة المتحدة كان بيستخدم 10% في الـ 2005
+
+465
+00:41:41,060 --> 00:41:44,420
+وبعدها إزالة، advantage of hydrogen peroxide، كل
+
+466
+00:41:44,420 --> 00:41:47,440
+شيء له advantage وله disadvantage، شوفوا في ما هي 
+
+467
+00:41:47,440 --> 00:41:53,980
+مزايا ماء الأكسجين، أنا مكرر ثاني لازم تجيبوا ماء 
+
+468
+00:41:53,980 --> 00:41:57,500
+أكسجين وتحطوه على الجلد شوية وتحطوا منه على 
+
+469
+00:41:57,500 --> 00:42:02,620
+البلات شوية وتشوفوا بلغة اربع خمس شكل، مش هتكون
+
+470
+00:42:02,620 --> 00:42:07,200
+تأثيره على الجلد؟ مش هيأثر ايش على الجلد؟ لأ خفيف
+
+471
+00:42:07,200 --> 00:42:13,330
+هو يعني على الـ bare areas الجروح خاصةً، الجروح ولا
+
+472
+00:42:13,330 --> 00:42:16,350
+.. لأ ما بيحرجوش يعني، جاسدك أنه بيحرج وبيعمل burn؟ لأ،
+
+473
+00:42:16,350 --> 00:42:23,070
+لا بعملش burn، بس هتحسي بألم معك يعني طيب، 
+
+474
+00:42:23,070 --> 00:42:31,510
+أنت بس حطي اصبع فيه وشوفي، جرّاتي؟ إصراري؟ اه، انت 
+
+475
+00:42:31,510 --> 00:42:37,590
+هتحسي بألم ولا بأي شيء، شوية بس مش سلخ، مش هتسلخ خفيف،
+
+476
+00:42:37,590 --> 00:42:42,250
+اه انما .. لكن حطيه على الـ .. حطيه على منطقة مجروحة
+
+477
+00:42:42,250 --> 00:42:42,850
+فيها crust
+
+478
+00:43:00,790 --> 00:43:06,070
+لأ لأ بقولك كثير كنا نجيب ماء الأكسجين الجديدة بعد
+
+479
+00:43:06,070 --> 00:43:10,550
+ثلاث أيام نستعملها نلاقيها مية، طعم منها الأكسجين خاصةً 
+
+480
+00:43:10,550 --> 00:43:15,190
+إذا كانت رابطة للشمس أو للهواء على طول بتفقد الأكسجين 
+
+481
+00:43:15,190 --> 00:43:18,770
+بيصير .. الطعم من الأكسجين بتبقى مية ممكن اشربها 
+
+482
+00:43:18,770 --> 00:43:19,650
+يعني نخلص منها
+
+483
+00:43:33,140 --> 00:43:38,300
+المواد الحافظة اللي بتعمل نوع من الـ energy بتعمل
+
+484
+00:43:38,300 --> 00:43:47,520
+نوع من toxicity، لأ هذا يعني خالي من المواد الحافظة
+
+485
+00:43:47,520 --> 00:43:51,320
+to which some patients expect an allergic or toxic
+
+486
+00:43:51,320 --> 00:43:55,740
+response، بعد المرضى فعلاً بتحسسهم من المواد الحافظة
+
+487
+00:43:55,740 --> 00:43:58,680
+كثير احنا بنحط قطرة في العين قطرة antibiotic
+
+488
+00:44:04,190 --> 00:44:09,790
+يا دكتور حنطي هذا القطرة، طيب مفتح العين والـ 
+
+489
+00:44:09,790 --> 00:44:13,330
+infection راح، الـ infection، الـ friction والجدر والـ
+
+490
+00:44:13,330 --> 00:44:16,930
+الهادي الافرازيات راح، لكن ايش ليه المول مو حمران صار
+
+491
+00:44:16,930 --> 00:44:22,690
+allergy، صار allergy للمراهم فعلاً 
+
+492
+00:44:22,690 --> 00:44:25,590
+بيقولوا له ولا يهمك، إن شاء الله هنعطيك قطرة يعني
+
+493
+00:44:25,590 --> 00:44:26,970
+قطرة للـ allergy وماتفتش
+
+494
+00:44:34,120 --> 00:44:37,440
+يعني لا يحملنا واحد من الف، إن واحد ما بيستخدم هذا
+
+495
+00:44:37,440 --> 00:44:42,680
+القطب، لإنه ممكن في نفس الـ family واحد يتأثر والـ 
+
+496
+00:44:42,680 --> 00:44:48,120
+الباقية ما يتأثروش، وحظك ونصيبك للدنيا، ممكن الشركة
+
+497
+00:44:48,120 --> 00:44:52,140
+تكون زودت الـ preservative شوية، يعني الكمية بتاعتها 
+
+498
+00:44:52,140 --> 00:44:56,100
+فهذا الـ hydrogen peroxide مافيه preservative، هذي ميزة
+
+499
+00:44:56,100 --> 00:44:58,060
+ولا عيب؟ ميزة
+
+500
+00:44:59,950 --> 00:45:03,410
+It's broad spectrum of antimicrobial action
+
+501
+00:45:03,410 --> 00:45:08,210
+against bacteria, viruses and yeast، هذا إنه الفطر
+
+502
+00:45:08,210 --> 00:45:13,030
+الخميرة، In three Pearson's solution can kill
+
+503
+00:45:13,030 --> 00:45:17,210
+tropozoids, acanthioba, castellani after three
+
+504
+00:45:17,210 --> 00:45:23,490
+minutes and cysts after nine hours، يعني له ميزة
+
+505
+00:45:23,490 --> 00:45:31,490
+إنه له broad spectrum طيف واسع، يعمل على العديد من
+
+506
+00:45:31,490 --> 00:45:35,970
+أنواع البكتيريا أو الفطريات والفيروسات وحتى الـ
+
+507
+00:45:35,970 --> 00:45:44,570
+spores، وشيء كويس يعني بيساعدنا الإنسان يطمئن إنه 
+
+508
+00:45:44,570 --> 00:45:48,770
+لما ينظف العنصر اللاصق بماء الأكسجين إنه عن تكون
+
+509
+00:45:48,770 --> 00:45:53,670
+يعني 90% في مأمن من ايش؟ الغزاة، من غزاة 
+
+510
+00:45:58,220 --> 00:46:20,700
+طيب كيف نستعمل؟ كيف نستعمل؟ كيف 
+
+511
+00:46:20,700 --> 00:46:25,500
+نستعمل؟ كيف نستعمل؟ كيف نستعمل؟ كيف نستعمل؟ 
+
+512
+00:46:27,060 --> 00:46:31,240
+كانوا متواجدين لـ Sodium Bicarbonate لإزالة
+
+513
+00:46:31,240 --> 00:46:31,660
+الـ residual
+
+514
+00:46:54,850 --> 00:47:02,370
+عشان تاخد ما تبقى من الهيدروجين عشان الهيدروجين من
+
+515
+00:47:02,370 --> 00:47:09,190
+الأوكسايد حامضي، الوقت بتاعه بس about four pH
+
+516
+00:47:09,190 --> 00:47:18,750
+والكربونات قاعدة، فالقاعدة زي القلوي بيطلع ملح زين مع
+
+517
+00:47:18,750 --> 00:47:19,770
+ملح زين
+
+518
+00:47:25,090 --> 00:47:29,610
+و حمض ملح زي الماء، اه ملح زي الماء، فانا حتى لو كان 
+
+519
+00:47:29,610 --> 00:47:32,670
+الهيدروجين الملوكسايد لسه في الجفنة وحطينا له شوية
+
+520
+00:47:32,670 --> 00:47:39,990
+بودرة، يعني دايمًا البودرة في الأشياء الحساسة، حاسّة إنه 
+
+521
+00:47:39,990 --> 00:47:45,430
+أما الآن إن الـ contact lens وسطها مش حامضي، ما هو
+
+522
+00:47:45,430 --> 00:47:49,090
+المشكلة لما نحطها وسطها حامضي ووسط العين neutral
+
+523
+00:47:49,090 --> 00:47:52,890
+الـ TS حاسة نوع من contradiction 
+
+524
+00:47:56,210 --> 00:48:06,030
+بنخلّيها يعني neutral neutral
+
+525
+00:48:06,030 --> 00:48:07,010
+neutral neutral neutral neutral neutral neutral neutral neutral 
+
+526
+00:48:07,010 --> 00:48:08,990
+neutral neutral neutral neutral neutral neutral neutral neutral
+
+527
+00:48:08,990 --> 00:48:10,210
+neutral neutral neutral neutral neutral neutral neutral neutral
+
+528
+00:48:10,210 --> 00:48:11,750
+neutral neutral neutral neutral neutral neutral neutral neutral
+
+529
+00:48:11,750 --> 00:48:16,150
+neutral neutral neutral neutral neutral neutral neutral neutral
+
+530
+00:48:16,150 --> 00:48:19,510
+neutral
+
+531
+00:48:19,510 --> 00:48:23,570
+neutral neutral neutral
+
+532
+00:48:40,790 --> 00:48:46,010
+وهي جفنة موجودة وهي على الأصبع .. حاطة على الأصبع
+
+533
+00:48:46,010 --> 00:48:49,990
+جاهزة لإيش؟ للـ initiation، طيب بارك الله فيكم في
+
+534
+00:48:49,990 --> 00:48:54,350
+المحاضرة القادمة إن شاء الله يعني نكمل هذا الشيء
+
+535
+00:48:54,350 --> 00:48:58,050
+الشيء عن المحاليل اللي بيستخدموها
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/feRvl9gkHHc_raw.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/feRvl9gkHHc_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..e07133ff46ff92bbfd0a3f3fb04d869d93d3e481
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/feRvl9gkHHc_raw.srt
@@ -0,0 +1,2168 @@
+1
+00:00:20,810 --> 00:00:24,070
+أول بسم الله الرحمن الرحيم بسم الله الرحمن الرحيم
+
+2
+00:00:24,070 --> 00:00:27,210
+الحمد لله رب العالمين وأصلي وأسلم على النبي الأمين
+
+3
+00:00:27,210 --> 00:00:31,570
+محمد وعلى آله وأصحابه واتابعينه السلام عليكم ورحمة
+
+4
+00:00:31,570 --> 00:00:36,650
+الله وبركاته في المحاضرة السابقة بدأنا بال
+
+5
+00:00:36,650 --> 00:00:40,130
+solutions of contact lenses
+
+6
+00:01:00,390 --> 00:01:02,910
+كل ساعة فينا اتمنى انه لبس contact lenses
+
+7
+00:01:31,430 --> 00:01:35,550
+تبليل، تبليل العدسة اللاسقة كانوا يعني لما بدهم
+
+8
+00:01:35,550 --> 00:01:41,150
+يعني يعملوا العدسة اللاسقة في العين و يحطوها على
+
+9
+00:01:41,150 --> 00:01:44,770
+الأصبع و يحطوا عليها ال wetting يعني نوع من
+
+10
+00:01:44,770 --> 00:01:48,750
+الترتيب عشان يتسهل يعني الموضوع التعامل معها على
+
+11
+00:01:48,750 --> 00:01:52,270
+الأصبع أو في العين يعني و هي كمان فيها نوع من ال
+
+12
+00:01:52,270 --> 00:01:56,250
+disinfection بيقول ال wetting solutions were
+
+13
+00:01:56,250 --> 00:01:58,170
+developed in 1950
+
+14
+00:02:04,150 --> 00:02:08,730
+contact lens relatively hydrophilic يعني انه ايش؟
+
+15
+00:02:08,730 --> 00:02:14,030
+hydrophilic انه قابل لتعامل او انفجار الماء they
+
+16
+00:02:14,030 --> 00:02:16,310
+were applied to the lens following its removal
+
+17
+00:02:16,310 --> 00:02:19,850
+from the storage case يعني هي ال lens بتكون في ال
+
+18
+00:02:19,850 --> 00:02:25,310
+case الآن حط على أصبع تمهيدة ناضحة في العين فهم
+
+19
+00:02:25,310 --> 00:02:28,930
+حطوة solutions they contained self-sufficient
+
+20
+00:02:28,930 --> 00:02:29,450
+agent
+
+21
+00:02:33,140 --> 00:02:36,200
+الـ Surface had provided a viscous coating that
+
+22
+00:02:36,200 --> 00:02:39,320
+encouraged the lens to adhere to the finger during
+
+23
+00:02:39,320 --> 00:02:42,700
+insertion يعني هي مهمتها ساعة ما نحط احنا الواتينج
+
+24
+00:02:42,700 --> 00:02:49,560
+solution على ال contact lens يعني بتخلي ال surface
+
+25
+00:02:49,560 --> 00:02:57,480
+قابل الاتساق بالدموع اه و ال angle في اقل درجة ال
+
+26
+00:02:57,480 --> 00:02:58,720
+angle اللتي تفصل
+
+27
+00:03:06,150 --> 00:03:11,210
+أنقل وكما انها تعمل نوع من ال coating لها يعني
+
+28
+00:03:11,210 --> 00:03:17,530
+تبليل وتغليف لها حتى تجلس على الأصبع قبل وضعها في
+
+29
+00:03:17,530 --> 00:03:27,590
+العين حقيقة كثيرة اللي هو أنواع ال wetting و ال
+
+30
+00:03:27,590 --> 00:03:29,850
+solutions عموما كثيرة هي الأنواع
+
+31
+00:03:44,080 --> 00:03:49,840
+أو fixed lens on the corner تجب أن تكون ال corner
+
+32
+00:03:49,840 --> 00:03:55,360
+movable on the surface of the lens يعني ال user
+
+33
+00:03:55,360 --> 00:04:00,140
+when يعني wants to look
+
+34
+00:04:13,750 --> 00:04:19,990
+Downward and laterally لازم تتحرك اللينز محركة
+
+35
+00:04:19,990 --> 00:04:24,850
+الكامية ماتفضلش ثابتة لازم تتحرك وتكون شوية
+
+36
+00:04:24,850 --> 00:04:28,650
+floating وهذا مهمة ال solutions اللي بيحطها اليوم
+
+37
+00:04:28,650 --> 00:04:35,350
+تبقى مهمة للشباب ليس لك اللينز تحرر مادة غير
+
+38
+00:04:35,350 --> 00:04:40,190
+مستخدمها يعني أصعب شي تتصوري أن واحد بأصبع يقعد
+
+39
+00:04:40,190 --> 00:04:44,590
+يكحط اللينزاللينز عشان يشيل منها اي front body او
+
+40
+00:04:44,590 --> 00:04:51,470
+دوزة لان الأصابع دائما عن ال clean يعني مش هنضعف
+
+41
+00:04:51,470 --> 00:04:57,770
+هذه حاجة لازم يعرف ال user انه مش طريقة تقليدية ان
+
+42
+00:04:57,770 --> 00:05:01,730
+انا حط العنصر على اي سطح و انا انظفها بصبيه ل
+
+43
+00:05:01,730 --> 00:05:08,850
+solution اللي هي عاملا احنابندرس عنها هي اتولى
+
+44
+00:05:08,850 --> 00:05:15,370
+الموضوع هذا اذا ابت و ازالت اي جسم التسق بيه اللي
+
+45
+00:05:15,370 --> 00:05:20,410
+هو الناس wetting solutions contain a wetting agent
+
+46
+00:05:20,410 --> 00:05:23,890
+a viscosity increasing agent such as polyvinyl
+
+47
+00:05:23,890 --> 00:05:28,390
+alcohol and a preservative يبقى ال wetting
+
+48
+00:05:28,390 --> 00:05:30,450
+solutions فيها تلات حاجات
+
+49
+00:05:33,080 --> 00:05:37,460
+increasing agent يعني فيها عامل يزيد اللزوجة وانا
+
+50
+00:05:37,460 --> 00:05:46,280
+مطلوب اللزوجة مطلوبة كمان فيها عامل اللي
+
+51
+00:05:46,280 --> 00:05:52,960
+هو polyvinyl alcohol اللي هو اللي بيزيد اللزوجة في
+
+52
+00:05:52,960 --> 00:06:00,220
+عامل آخر اللي هو preservative preservative يعني
+
+53
+00:06:00,220 --> 00:06:06,080
+for food or for any solutionأو drink هو to prevent
+
+54
+00:06:06,080 --> 00:06:13,260
+bacteria from damaging or spoiling that اللي هو
+
+55
+00:06:13,260 --> 00:06:19,180
+medium يعني دايما احنا مثلا عصير برتقال fresh
+
+56
+00:06:19,180 --> 00:06:23,880
+ممتاز جدا نتركه ساعتين حتى لو في التلالة بيبدأ
+
+57
+00:06:23,880 --> 00:06:27,040
+يطير طب نتركه 24 ساعة نلاقي deficits
+
+58
+00:06:34,990 --> 00:06:37,310
+يعني نضع اكبر من 24 ساعة يعني و انا مازال في ال
+
+59
+00:06:37,310 --> 00:06:41,570
+festival، اي مشكلة طيب اتفعار محفوظ او شهر محفوظ
+
+60
+00:06:41,570 --> 00:06:47,150
+الشراوط في الجياجات طبعا عليهم مدح حفظ تحفظهم حتى
+
+61
+00:06:47,150 --> 00:06:51,210
+لو بقية أسوانيا مغلقة لشهر او شهرين او تلاتة او
+
+62
+00:06:51,210 --> 00:06:52,190
+اربع او خمسة او ستة
+
+63
+00:07:01,760 --> 00:07:05,740
+الها disadvantages من ال allergy و من ال
+
+64
+00:07:05,740 --> 00:07:10,600
+carcinogenic effects commonly the preserved abuse
+
+65
+00:07:10,600 --> 00:07:14,120
+was benzalkinum و chloride يعني المادة الحافظة في
+
+66
+00:07:14,120 --> 00:07:18,800
+المحليل اسمها benzalkinum و chloride وهذا من أشهر
+
+67
+00:07:18,800 --> 00:07:24,780
+اللي هو الحوافظ الموجودة في عالم الدواء في عالم
+
+68
+00:07:24,780 --> 00:07:29,280
+الدواء مش بس في العين في عالم الدواءمعظم المشروبات
+
+69
+00:07:29,280 --> 00:07:36,040
+اللي هي في السيراب و ال solutions و الكلام هذا كله
+
+70
+00:07:36,040 --> 00:07:38,900
+علي مواد حافظة بالذات قولهم if you write the
+
+71
+00:07:38,900 --> 00:07:42,400
+efficacy of what was enhanced by the addition of
+
+72
+00:07:42,400 --> 00:07:47,100
+the chelating agent chelating agent يعني هي مادة
+
+73
+00:07:47,100 --> 00:07:54,920
+تحاول ان تسحب اللي هو اي متل خاصة هي بميتل
+
+74
+00:08:03,450 --> 00:08:13,170
+ليه هذا الوسط من أي harmful heavy metals اللي
+
+75
+00:08:13,170 --> 00:08:17,690
+هو ال .. بزارك هنا قلت انه هو المهم في موضوع لعنصر
+
+76
+00:08:17,690 --> 00:08:24,190
+الاسقى solutions اه و في اي حاجة في الدوام طيب ال
+
+77
+00:08:24,190 --> 00:08:28,490
+cleaning طيب ال surfactant cleaners اللي هو
+
+78
+00:08:28,490 --> 00:08:31,790
+cleaning of the surface of
+
+79
+00:08:37,330 --> 00:08:43,950
+يعني أنا قبل ما أزيل ال protein و قبل ما أزيل ال
+
+80
+00:08:43,950 --> 00:08:49,730
+fat عن سطح العدسة بدي شيء في الأول ينظف السطح قبل
+
+81
+00:08:49,730 --> 00:08:54,110
+إذابة قبل إذابة المواد المتسقة بدي شيء ينظف السطح
+
+82
+00:08:54,110 --> 00:08:58,830
+وهذا يصبح ال fact and cleaners except daily
+
+83
+00:08:58,830 --> 00:09:01,510
+disposable lenses which are simply discarded after
+
+84
+00:09:01,510 --> 00:09:06,190
+use يعني أنا العدسة اللي disposable بلبسها أربع أو
+
+85
+00:09:06,190 --> 00:09:13,010
+خمسأو ست أو عشر ساعات هذه غير يعني يعني مطلوب
+
+86
+00:09:13,010 --> 00:09:17,190
+تنظيفها لأن هي disposable زي السيرينج بقدر انا
+
+87
+00:09:17,190 --> 00:09:20,710
+اضرب فيها مرة و disposable once وانا دي once
+
+88
+00:09:20,710 --> 00:09:25,870
+بلبسها عشر او اتناشر ساعة و بعدين برميها فمن ال ..
+
+89
+00:09:25,870 --> 00:09:29,090
+يعني انا مش مطلوب حتى لو تلبسها ان انا اضرب فلان
+
+90
+00:09:29,090 --> 00:09:32,690
+هي هتكون disposed although multipurpose solutions
+
+91
+00:09:32,690 --> 00:09:34,610
+can perform both of these
+
+92
+00:09:37,870 --> 00:09:40,450
+هي لديها تجارب تجارب تجارب تجارب تجارب تجارب تجارب
+
+93
+00:09:40,450 --> 00:09:41,650
+تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب
+
+94
+00:09:41,650 --> 00:09:46,470
+تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب
+
+95
+00:09:46,470 --> 00:09:50,570
+تجارب تجارب
+
+96
+00:09:50,570 --> 00:09:53,970
+تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب
+
+97
+00:09:53,970 --> 00:09:53,970
+تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب
+
+98
+00:09:53,970 --> 00:09:53,970
+تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب
+
+99
+00:09:53,970 --> 00:09:59,510
+تجارب تجارب تجارب تجارب تجارب
+
+100
+00:09:59,510 --> 00:10:03,770
+تجار
+
+101
+00:10:04,850 --> 00:10:11,550
+يعني وضع إنه الشيء تطور عن الماضي Contaminants
+
+102
+00:10:11,550 --> 00:10:14,710
+attract a variety of contaminants إيش
+
+103
+00:10:14,710 --> 00:10:19,910
+Contaminants؟ ملوثات يبقى إيه أول ما فتحت ال
+
+104
+00:10:19,910 --> 00:10:24,930
+Contaminants بعد ساعة أو ساعتين بتبدأ إيش؟ تترسم
+
+105
+00:10:24,930 --> 00:10:33,930
+عليها جزيرة يعني هذه جزيرة محطوطة فأي Contaminant
+
+106
+00:10:38,110 --> 00:10:45,390
+أي dead cells تي وين عليه فاتس عندي proteins خاصة
+
+107
+00:10:45,390 --> 00:10:48,570
+اللي هي موجودة في الترفيب في فاتس و في proteins
+
+108
+00:10:48,570 --> 00:10:54,490
+عندي في الترفيب ساحق طبقة ريبد و طبقة نيوكاس طبقة
+
+109
+00:10:54,490 --> 00:10:59,030
+و في ال protein دا يتفين اخر كنت بتسوي اقرار
+
+110
+00:10:59,030 --> 00:11:04,160
+depending on the patients lifestyleيعني ممكن انه
+
+111
+00:11:04,160 --> 00:11:08,380
+يعني اللابس اللي عنده السلازقة انه عنده طريقة حياة
+
+112
+00:11:08,380 --> 00:11:13,580
+تختلف عن الأخر فمثلا جابلك ال nicotine يعني واحد
+
+113
+00:11:13,580 --> 00:11:17,400
+بيلاقي انه بدخن كتير او الشيشة اللي رجيلة عنده
+
+114
+00:11:17,400 --> 00:11:24,020
+كتير ممكن واحد انه يعني جريب من معمل كيمويات مثلا
+
+115
+00:11:24,020 --> 00:11:30,800
+ابخرة وكلام زي هذا يعني او عطور مثلا في معمل عطور
+
+116
+00:11:30,800 --> 00:11:31,440
+مثلا
+
+117
+00:11:39,320 --> 00:11:44,800
+لكنه مجرد نيكوتين اللي مستجار كنول يعني انه يتصرف
+
+118
+00:11:44,800 --> 00:11:50,260
+الهواء ويضعف إلى البروتين والفاكس في تلويث H تلويث
+
+119
+00:11:50,260 --> 00:11:52,740
+H تلويث H تلويث H تلويث H تلويث H تلويث H تلويث H
+
+120
+00:11:52,740 --> 00:11:53,180
+تلويث H تلويث H تلويث H تلويث H تلويث H تلويث H
+
+121
+00:11:53,180 --> 00:11:53,180
+تلويث H تلويث H تلويث H تلويس H تلويس H تلويس H
+
+122
+00:11:53,180 --> 00:11:53,300
+تلويس H تلويس H تلويس H تلويس H تلويس H تلويس H
+
+123
+00:11:53,300 --> 00:11:56,260
+تلويس H تلويس H تلويس H تلويس H تلويس H تلويس H
+
+124
+00:11:56,260 --> 00:12:01,480
+تلويس H تلويس
+
+125
+00:12:01,480 --> 00:12:07,100
+H تل
+
+126
+00:12:09,910 --> 00:12:14,490
+بين ال water content بتاع العدسة اللاسقة وبين ال
+
+127
+00:12:14,490 --> 00:12:18,070
+pollutants أو ال contaminants and is also
+
+128
+00:12:18,070 --> 00:12:22,110
+influenced by the source surface charge of the
+
+129
+00:12:22,110 --> 00:12:25,870
+hydrogen طيب يعني هو بيقولك القاعدة انه كل ما زاد
+
+130
+00:12:25,870 --> 00:12:30,350
+ال water content كل ما زاد ال contaminants والعكس
+
+131
+00:12:30,350 --> 00:12:37,290
+صحيح كانوا الميه عايشة لما تسحب وتساعد في عدسات
+
+132
+00:12:40,500 --> 00:12:46,540
+وفينا Ionic في متأيينة سطح بتاعها وفي مش متأيينة
+
+133
+00:12:46,540 --> 00:12:51,140
+لأن ك higher water content lenses have a greater
+
+134
+00:12:51,140 --> 00:12:56,300
+affinity for protein deposits يبقى هذه المتأيينة
+
+135
+00:12:56,300 --> 00:13:02,480
+لسطحة فيها تشعر يعني خاصة negative charge انه
+
+136
+00:13:02,480 --> 00:13:07,090
+بيسحب ال protein او تسحب ال proteinفينا الـ Ionic
+
+137
+00:13:07,090 --> 00:13:12,270
+غير متأيينة ما بتحمل شحنة سطحها، اما الـ Ionic low
+
+138
+00:13:12,270 --> 00:13:16,970
+water content lenses attract least protein، الغير
+
+139
+00:13:16,970 --> 00:13:21,750
+متأيينة وفيها مياه جليل تسحب protein أقل من
+
+140
+00:13:21,750 --> 00:13:25,670
+المتأيينة، أنا حاولت أن أجد المتأيينة وغير متأيينة
+
+141
+00:13:29,290 --> 00:13:34,290
+إنه كيف non-ionic surface أكتر
+
+142
+00:13:34,290 --> 00:13:42,550
+كيف يعني كيف يكون السطح و كيف هذا السطح يقع عليه
+
+143
+00:13:42,550 --> 00:13:46,370
+اللي هي ال contaminated هاي ال contaminated هنا
+
+144
+00:13:46,370 --> 00:13:50,430
+هاي ال contaminated كيف يقع على هذا السطح
+
+145
+00:14:05,080 --> 00:14:09,320
+الكل بيجاوز عليه، ما هي المزايا من تنظيف العصر
+
+146
+00:14:09,320 --> 00:14:14,760
+اللي نصرفه كل يوم؟ زي ايش يعني؟ ان بيحسوا انجلة
+
+147
+00:14:14,760 --> 00:14:24,500
+كليه فيجن، فيزيال فيكشنأو بتطول من حياته اللاصفة؟
+
+148
+00:14:24,500 --> 00:14:28,060
+أه يوا بتطول من اللي هو العمر بتاع العدسة اللاصفة،
+
+149
+00:14:28,060 --> 00:14:31,340
+خيار بتاعك أن هذا بيكون أحسن و بنخطط بكتيريا لما
+
+150
+00:14:31,340 --> 00:14:35,700
+ال disinfection و comfort لعيان ممتازة، يبقى
+
+151
+00:14:35,700 --> 00:14:38,260
+improve the clarity of the lens، clarity شفافية
+
+152
+00:14:40,520 --> 00:14:43,260
+Hair Cleaning Removes Endogenous Contaminants
+
+153
+00:14:43,260 --> 00:14:47,740
+Endogenous اللي بتيجي من نفس الـ tear film من اللي
+
+154
+00:14:47,740 --> 00:14:52,480
+هو وسط العين يعني tear film constituents such as
+
+155
+00:14:52,480 --> 00:14:55,360
+mucus, lipids and proteins together with exogenous
+
+156
+00:14:55,360 --> 00:14:58,680
+Exogenous Contaminants اللي بتيجي من الهوار بتيجي
+
+157
+00:14:58,680 --> 00:15:02,300
+من برا such as cosmetics اللي هو أدوات ال make-up،
+
+158
+00:15:02,300 --> 00:15:07,360
+التجميل and environmental pollutants زي الغبار و
+
+159
+00:15:07,360 --> 00:15:11,750
+زي الليكوتين و زي العطورو أي شيء موجود في الهواء،
+
+160
+00:15:11,750 --> 00:15:15,850
+الهواء ملياني، طيب الشيء التاني في ال clarity,
+
+161
+00:15:16,590 --> 00:15:22,030
+prolongs the successful wearing time، يبقى الوقت
+
+162
+00:15:22,030 --> 00:15:29,950
+بتاع اللبس بيكون successful، مريح يعني، أه و أطول،
+
+163
+00:15:29,950 --> 00:15:32,930
+طيب في reduces the level of microbiological
+
+164
+00:15:32,930 --> 00:15:33,790
+contamination
+
+165
+00:15:44,860 --> 00:15:48,800
+ما هي موضوع ال microbiology مهم جدا و كتير الأن
+
+166
+00:15:48,800 --> 00:15:55,020
+يعني إخواننا في ال .. اللي هو شركاءنا في التحالية
+
+167
+00:15:55,020 --> 00:15:59,540
+الطبية .. أه الطب المخبري يعني بدهم يعملوا معانا
+
+168
+00:15:59,540 --> 00:16:01,300
+أبحاث على أدسات الأسخة
+
+169
+00:16:10,180 --> 00:16:16,300
+إحنا نعمل عنصرات لصقة بدون دراسة بكتيريا خاطئة و
+
+170
+00:16:16,300 --> 00:16:20,120
+هم يعملوا عنصرات بكتيريا على أشياء لكن ليس فيها
+
+171
+00:16:20,120 --> 00:16:23,620
+عنصرات لصقة التي تهم عين الإنسان وهذا عنصر حيوي
+
+172
+00:16:23,620 --> 00:16:29,060
+يعني العين عنصر حيوي يعني مش زي مثلا أني بس أنا
+
+173
+00:16:29,060 --> 00:16:33,280
+أعمل أبحاث على ال urine و الstool ال urine و
+
+174
+00:16:33,280 --> 00:16:36,900
+الstool المهمان لإن ماببينوا إيش في العيان لكن عين
+
+175
+00:16:36,900 --> 00:16:41,800
+الإنسان لو ضاعتهيصفي اعمى من حياته انه اراد ان هو
+
+176
+00:16:41,800 --> 00:16:48,640
+يعني يعمل correction لنظره او ان هو يعني يبدو في
+
+177
+00:16:48,640 --> 00:16:52,480
+مظهر لايق يعني و جميل ان هو يجيبله contamination
+
+178
+00:16:52,480 --> 00:16:55,160
+فبقول reduce the level of microbiological
+
+179
+00:16:55,160 --> 00:16:58,440
+contamination daily cleaning physically removes
+
+180
+00:16:58,440 --> 00:17:02,560
+contaminant debris الو الفضلات the preservatives
+
+181
+00:17:02,560 --> 00:17:05,180
+in the solution are capable of achieving some
+
+182
+00:17:05,180 --> 00:17:07,270
+disinfectionالميزاية الـ Colonic Chloride اللي
+
+183
+00:17:07,270 --> 00:17:13,570
+نقول عنه ممكن أنه ساعد في قتل نسبة البكتيريا، ليس
+
+184
+00:17:13,570 --> 00:17:19,970
+مثل الـ Antibiotic، لأ، أقل 50% أو 40% كمان ميزاية
+
+185
+00:17:19,970 --> 00:17:24,050
+تحسن إفعالة الانتقال من الانتقال من الانتقال من
+
+186
+00:17:24,050 --> 00:17:25,910
+الانتقال من الانتقال من الانتقال من الانتقال من
+
+187
+00:17:25,910 --> 00:17:27,490
+الانتقال من الانتقال من الانتقال من الانتقال من
+
+188
+00:17:27,490 --> 00:17:27,950
+الانتقال من الانتقال من الانتقال من الانتقال من
+
+189
+00:17:27,950 --> 00:17:28,550
+الانتقال من الانتقال من الانتقال من الانتقال من
+
+190
+00:17:28,550 --> 00:17:32,810
+الانتقال من الانتقال من الانتقال من الانتقال من
+
+191
+00:17:32,810 --> 00:17:34,030
+الانتقال من الان
+
+192
+00:17:40,240 --> 00:17:45,400
+و يجي التنظيف يهزيل زي الريح لما يعني وقع بدورنا
+
+193
+00:17:45,400 --> 00:17:50,200
+زمان كان ايه كومة من الرمال او كومة من ال .. ايه
+
+194
+00:17:50,200 --> 00:17:53,660
+يقولون معايا ال quartz او اي حاجة و يجي الريح
+
+195
+00:17:53,660 --> 00:17:57,260
+يشيله كل ما يكوم يشيله البكتيريا بتحاول تعملها
+
+196
+00:17:57,260 --> 00:18:03,370
+مستعمرة و يجي التنظيف بيشيلهقال كمان removes
+
+197
+00:18:03,370 --> 00:18:07,530
+possible nutrients on which organisms can grow
+
+198
+00:18:07,530 --> 00:18:13,410
+يعني البكتيريا مثلا عشان تنمو بدها nutrients بدها
+
+199
+00:18:13,410 --> 00:18:17,790
+مواد الطعام يعني بدها غذاء فقولوا إن أنا بردف
+
+200
+00:18:17,790 --> 00:18:22,710
+العنسة اللي أسقى أول بأول مابخليش إليها فضلات يعني
+
+201
+00:18:22,710 --> 00:18:25,130
+على واحد بيقولي يعني لماذا يعني
+
+202
+00:18:29,730 --> 00:18:34,130
+بقوله الغداء اكتر من بيوت في المطبخ طب و ماذا بيوت
+
+203
+00:18:34,130 --> 00:18:37,450
+في الحمام؟ بيقوله ان المصافي الماء اللى بتعيش بيها
+
+204
+00:18:37,450 --> 00:18:44,010
+الثلاثين في الحمام، صحيح؟ يعني فالبكتيريا اللى لم
+
+205
+00:18:44,010 --> 00:18:49,390
+تجد نيوتريانس مابتعيش، مطلباتها دي، حياتيها يعني،
+
+206
+00:18:49,390 --> 00:18:52,150
+فهذه ال advantage of daily cleaning
+
+207
+00:18:56,280 --> 00:18:59,060
+أيضًا يمكن استخدام أفعال مخلوقات مخلوقات مخلوقات
+
+208
+00:18:59,060 --> 00:19:01,960
+مخلوقات مخلوقات مخلوقات مخلوقات مخلوقات مخلوقات
+
+209
+00:19:01,960 --> 00:19:04,780
+مخلوقات مخلوقات مخلوقات مخلوقات مخلوقات مخلوقات
+
+210
+00:19:04,780 --> 00:19:05,860
+مخلوقات مخلوقات مخلوقات مخلوقات مخلوقات مخلوقات
+
+211
+00:19:05,860 --> 00:19:10,620
+مخلوقات مخلوقات مخلوقات مخلوقات
+
+212
+00:19:10,620 --> 00:19:14,740
+مخلوقات
+
+213
+00:19:14,740 --> 00:19:20,260
+مخلوقات مخلوقات
+
+214
+00:19:21,050 --> 00:19:27,070
+فكورم كورم مزيد يجيب كورم جديد بدل ان انا مالاجيش
+
+215
+00:19:27,070 --> 00:19:33,790
+مال ايش يسوي عليها او يعمل مها compounds فبرجوع
+
+216
+00:19:33,790 --> 00:19:40,250
+انا كاني بحمل عين بإزالة اي فضلة يمسك بها ال
+
+217
+00:19:40,250 --> 00:19:45,470
+preservative كمان seven reduces the adherence of
+
+218
+00:19:45,470 --> 00:19:52,630
+organisms to the lensكل ما الميكروعجنز بده يمسك في
+
+219
+00:19:52,630 --> 00:19:56,530
+الـ lens إله إيه دولة ضخمة It has been shown that
+
+220
+00:19:56,530 --> 00:20:00,370
+tear components adsorbed onto the lens surface
+
+221
+00:20:00,370 --> 00:20:04,510
+enhance the adherence of microorgan to lens but
+
+222
+00:20:04,510 --> 00:20:09,420
+some might adhere even to clean lensesيبقى .. لما
+
+223
+00:20:09,420 --> 00:20:14,720
+يكون فيه protein او يكون فيه fat او اي contaminant
+
+224
+00:20:14,720 --> 00:20:20,780
+على سطح ال contaminated تيجي البكتيريا بالذات تعيش
+
+225
+00:20:20,780 --> 00:20:25,840
+فيه تحس انه بعيد عن مجرى الدموع اللي .. اللي هي
+
+226
+00:20:25,840 --> 00:20:30,780
+بتحركه يرسوه على هذه الصخرة البكتيريا عشان تبدأ
+
+227
+00:20:30,780 --> 00:20:34,560
+تعمل ايش في اليوم التاني؟ culinary تتكعثر وتعمل
+
+228
+00:20:34,560 --> 00:20:35,520
+مئات و آلاف
+
+229
+00:20:41,070 --> 00:20:46,630
+أو فات او يعني debris او حاجة معناه ان انا فوّرت
+
+230
+00:20:46,630 --> 00:20:51,510
+البكتيريا ان تختبئ فوّرت البكتيريا ان تختبئ في هذه
+
+231
+00:20:51,510 --> 00:20:56,670
+اللي هو النطوئات الصغيرة failure to remove tear
+
+232
+00:20:56,670 --> 00:20:59,410
+proteins before this infection with hydrogen
+
+233
+00:20:59,410 --> 00:21:02,870
+peroxide or heat allowed a protein to become
+
+234
+00:21:02,870 --> 00:21:07,150
+denaturated and acts as antigen هذه كمان حاجة
+
+235
+00:21:07,150 --> 00:21:12,840
+المفروض تكون تماليةال .. ال .. ال protein اللي هو
+
+236
+00:21:12,840 --> 00:21:16,980
+من الدموع و ترسّب على سلاسفة يبدأ في عمل ال
+
+237
+00:21:16,980 --> 00:21:21,200
+denaturation، denaturation تغيير طبيعي .. طبيعي،
+
+238
+00:21:21,200 --> 00:21:27,100
+تغيير طبيعي زي مثلا مثال ال denaturation البيضة
+
+239
+00:21:27,100 --> 00:21:29,240
+لما نحطها في النار
+
+240
+00:21:39,930 --> 00:21:43,370
+و أصلح طبيعه و ضيّر اللطة هل ممكن أعد البيض إلى
+
+241
+00:21:43,370 --> 00:21:49,770
+سابقه؟ خلاص بيقولك في ال cataract يعني أكتر شيء في
+
+242
+00:21:49,770 --> 00:21:52,470
+ال cataract خاصة سينان ال cataract أنه بيصير
+
+243
+00:21:52,470 --> 00:21:56,530
+denaturation of the protein of the crystal alloys
+
+244
+00:21:56,530 --> 00:22:02,430
+denaturation يعني تغير الطبيعة بتاعك وبالتالي أصبح
+
+245
+00:22:02,430 --> 00:22:08,150
+opaque بدل transparent هنا بيقوللي إن ال protein
+
+246
+00:22:08,150 --> 00:22:13,960
+الليالشخص التسك بالعدسة اللاصقة اذا لم انا او زيه
+
+247
+00:22:13,960 --> 00:22:19,020
+له بسرعة مناسبة بيصير له دي ناتوريشن داخل العدسة
+
+248
+00:22:19,020 --> 00:22:26,480
+اللاصقة وهذا الـtoxic بيعمل انتيجين انتيجين يعني
+
+249
+00:22:26,480 --> 00:22:32,860
+ايش؟ بروتين غريب عن الجسم ان الانتيجين يتكوّل
+
+250
+00:22:32,860 --> 00:22:36,260
+انتيبوتسلو تكوّنوا Antibodies بتصير Antigen
+
+251
+00:22:36,260 --> 00:22:42,280
+Antibody وهذا اللي بيقول عنه Immunity Response،
+
+252
+00:22:42,280 --> 00:22:45,560
+سيجارة مناعية و احنا بدنا نقول اقعد نعمل حرب في
+
+253
+00:22:45,560 --> 00:22:50,340
+سطح العين، بنفع نعمل حرب؟
+
+254
+00:22:53,170 --> 00:22:57,950
+فهنا كنا إنه نظفنا العدسة اللي لها صفة ماسمحناش
+
+255
+00:22:57,950 --> 00:23:02,610
+للبوتين إنه يبدأ يعمل denaturation ويعمل غزو ب
+
+256
+00:23:02,610 --> 00:23:09,970
+immune response للإيش لسطح العين كمان تسعة هنا
+
+257
+00:23:09,970 --> 00:23:16,070
+سالت daily cleaners contain a surface active agent
+
+258
+00:23:23,690 --> 00:23:27,290
+وهو يقوم بتنظيف تجارب منظف و يقوم بتنظيف تجارب
+
+259
+00:23:27,290 --> 00:23:31,230
+منظف و
+
+260
+00:23:31,230 --> 00:23:35,990
+يقوم بتنظيف تجارب منظف و يقوم بتنظيف تجارب منظف و
+
+261
+00:23:35,990 --> 00:23:40,510
+يقوم بتنظيف تجارب منظف و يقوم بتنظيف تجارب منظف و
+
+262
+00:23:40,510 --> 00:23:41,930
+يقوم بتنظيف تجارب منظف و يقوم بتنظيف تجارب منظف و
+
+263
+00:23:41,930 --> 00:23:41,930
+يقوم بتنظيف تجارب منظف و يقوم بتنظيف تجارب منظف و
+
+264
+00:23:41,930 --> 00:23:41,970
+يقوم بتنظيف تجارب منظف و يقوم بتنظيف تجارب منظف و
+
+265
+00:23:41,970 --> 00:23:45,530
+يقوم بتنظيف تجارب منظف و يقوم بتنظيف تجارب منظف و
+
+266
+00:23:45,530 --> 00:23:46,510
+يقوم بتنظيف تجارب
+
+267
+00:23:56,180 --> 00:24:05,600
+تسعة فوائد لل daily cleaning of contact lenses داي
+
+268
+00:24:05,600 --> 00:24:11,280
+الآن هتكلم على disinfecting solutions كلمة
+
+269
+00:24:11,280 --> 00:24:14,520
+disinfection تطهير مش تعقيم
+
+270
+00:24:21,120 --> 00:24:24,360
+في البداية لما تيجي من المصنع لكن بعد ما تموضها في
+
+271
+00:24:24,360 --> 00:24:27,400
+العين كل اللي انا بعمله اعمله disinfection والفرق
+
+272
+00:24:27,400 --> 00:24:31,680
+بين sterilization and disinfection ان
+
+273
+00:24:31,680 --> 00:24:37,700
+sterilization can kill all forms of bacteria all
+
+274
+00:24:37,700 --> 00:24:42,120
+forms بيقول بيجي تايت ال form اللي ابتدت عليها and
+
+275
+00:24:42,120 --> 00:24:48,000
+sparing forms كمان المحوصلة لكن ال disinfection
+
+276
+00:24:48,000 --> 00:24:57,340
+are justلقتل الـ vegetative forms ليس الـ sports
+
+277
+00:24:57,340 --> 00:25:01,020
+يبقى الـ disinfectant solutions with the exception
+
+278
+00:25:01,020 --> 00:25:04,440
+of daily disposable hydrogel lenses or contact
+
+279
+00:25:04,440 --> 00:25:07,560
+lenses need to be disinfected after their removal
+
+280
+00:25:07,560 --> 00:25:12,400
+and cleaning their removal from the eye يعني الان
+
+281
+00:25:12,400 --> 00:25:17,640
+انا عندى التخزين التخزين على ثلاثة بصير نوعيةفي
+
+282
+00:25:17,640 --> 00:25:21,440
+dry storage و في wet storage ال dry يعني و ده ال
+
+283
+00:25:21,440 --> 00:25:25,180
+solution و wet يعني with solutions وشوف ايش الفرق
+
+284
+00:25:25,180 --> 00:25:29,300
+بين ال dry storage و ال wet storage طبعا واضح ان
+
+285
+00:25:29,300 --> 00:25:38,220
+ال dry storage انه bad storage لانه هيغير في ال
+
+286
+00:25:38,220 --> 00:25:41,340
+physical properties و ال optical properties of
+
+287
+00:25:41,340 --> 00:25:41,700
+الناس
+
+288
+00:25:45,970 --> 00:25:49,430
+أو حتى في ال case بتاعها و تكون جافة أنا حاجة
+
+289
+00:25:49,430 --> 00:25:56,150
+أجيها rigid و أجيها dull و مش transparent اذا
+
+290
+00:25:56,150 --> 00:26:00,570
+كانت ال lenses جافة جافة جافة جافة جافة جافة جافة
+
+291
+00:26:00,570 --> 00:26:02,110
+جافة جافة جافة جافة جافة جافة جافة جافة جافة جافة
+
+292
+00:26:02,110 --> 00:26:04,170
+جافة جافة جافة جافة جافة جافة جافة جافة جافة جافة
+
+293
+00:26:04,170 --> 00:26:07,670
+جافة جافة جافة جافة جافة جافة جافة جافة جافة جافة
+
+294
+00:26:07,670 --> 00:26:08,150
+جافة جافة جافة جافة جافة جافة جافة جافة جافة جافة
+
+295
+00:26:08,150 --> 00:26:08,150
+جافة جافة جافة جافة جافة جافة جافة جافة جافة جافة
+
+296
+00:26:08,150 --> 00:26:16,240
+جافة جافة جافة جافةوالـ optical properties و الـ
+
+297
+00:26:16,240 --> 00:26:22,160
+physical properties هتفقد فالإنها هتكون واسط مناسب
+
+298
+00:26:22,160 --> 00:26:27,820
+لنمو البكتيريا ال micro organisms فحدش متصور انه
+
+299
+00:26:27,820 --> 00:26:32,540
+يطلع ال contact lens من عينه و يحطها dry في ال
+
+300
+00:26:32,540 --> 00:26:38,140
+case بتاعها بصير هذا؟ لأ بس انا بقول هذا يعني
+
+301
+00:26:38,140 --> 00:26:44,260
+كدراسةالـ wet storage في الماء او في المحلول من
+
+302
+00:26:44,260 --> 00:26:47,880
+الهيدروجين لينزيز هي أساسية ليس فقط لتأكيد هذه
+
+303
+00:26:47,880 --> 00:26:54,060
+الانفكار ولكن أيضًا لتحفزهم لأنهم يمتلكوا محتوى
+
+304
+00:26:54,060 --> 00:26:58,080
+ماء يمكنه أن يتجاوز من 38% إلى 80%
+
+305
+00:27:02,160 --> 00:27:06,760
+مكوّنها من مكوّنها في إعادة ثلاثية فإن كان أنا
+
+306
+00:27:06,760 --> 00:27:12,800
+أبعدت الإعادة ثلاثية عن ال solution كأني سلبتها
+
+307
+00:27:12,800 --> 00:27:18,400
+مكون من مكونتها الماء اللي هو بشكل من 38% إلى 80%
+
+308
+00:27:18,400 --> 00:27:23,180
+من المكون غير أنه بتحافظ على ال properties of the
+
+309
+00:27:23,180 --> 00:27:27,360
+contact lens ال solutions اللي بتعمل this
+
+310
+00:27:27,360 --> 00:27:34,750
+infection two typesفيه solution stable وفيه
+
+311
+00:27:34,750 --> 00:27:39,050
+solution transient فيه solution ثابت وفيه solution
+
+312
+00:27:39,050 --> 00:27:44,790
+متغير سوليوشن الثابت فيه Preservative زي بزاي
+
+313
+00:27:44,790 --> 00:27:49,570
+الكونيوم الذي تم تصميمه لإستخدام إذا كان الوضع
+
+314
+00:27:49,570 --> 00:27:56,130
+مرتبط أو حيبروجين عن سيليكون حيبروجين الاساسي يعني
+
+315
+00:27:56,130 --> 00:28:02,510
+هذا مشهور أن تتنم أعمال حقأما الـ Transient لأ،
+
+316
+00:28:02,510 --> 00:28:06,850
+الـ Transient فيه Antimicrobial agent زي الـ
+
+317
+00:28:06,850 --> 00:28:13,290
+Antibiotic أو زي اللي هو الـ Detergents
+
+318
+00:28:43,170 --> 00:28:44,310
+أنت مجرد مجرد مجرد مجرد مجرد مجرد مجرد مجرد مجرد
+
+319
+00:28:44,310 --> 00:28:44,850
+مجرد مجرد مجرد مجرد مجرد مجرد مجرد مجرد مجرد مجرد
+
+320
+00:28:44,850 --> 00:28:48,690
+مجرد مجردعبس استيول ممكن استعمال لفترة طويلة لكن
+
+321
+00:28:48,690 --> 00:28:54,110
+هذا يستعمل لفترة قصيرة نسبيا such solutions were
+
+322
+00:28:54,110 --> 00:28:58,430
+originally introduced for use with hydrogel lenses
+
+323
+00:28:58,430 --> 00:29:02,710
+but can also be used with rigid and silicone لجميع
+
+324
+00:29:02,710 --> 00:29:07,310
+الأنواع بتاعت ال contact lenses طيب اي سيستم of
+
+325
+00:29:07,310 --> 00:29:10,190
+this infection should be filtered not only against
+
+326
+00:29:10,190 --> 00:29:15,840
+commonly used challenge bacteriaالبكتيريا بتعمل
+
+327
+00:29:15,840 --> 00:29:19,480
+challenge للي اللي هو العين، such as
+
+328
+00:29:19,480 --> 00:29:23,500
+Staphylococcus aureus، Pseudomonas الجنوزة،
+
+329
+00:29:23,500 --> 00:29:26,600
+Escherichia colari, but also on many types of
+
+330
+00:29:26,600 --> 00:29:31,060
+bacteria and other organisms such as fungi and
+
+331
+00:29:31,060 --> 00:29:36,020
+aquatumيبقى احنا لما جينا جيب محلول في
+
+332
+00:29:36,020 --> 00:29:40,120
+antimicrobial agents، بدّي مش كونه selective لبعض
+
+333
+00:29:40,120 --> 00:29:45,260
+أنواع البكتيريا، بل يشمل البكتيريا والفنجاعي اللي
+
+334
+00:29:45,260 --> 00:29:52,280
+هو ال amoeba التي تقزو سطح العين وتدمر القرنية إذا
+
+335
+00:29:52,280 --> 00:29:53,460
+ما عملتلها invasion
+
+336
+00:29:58,690 --> 00:30:02,490
+الان الكلام على ال multi-purpose solutions استقر
+
+337
+00:30:02,490 --> 00:30:11,670
+الأمور على بحلول واحد متعدد الأداف أصبح بدأ ال
+
+338
+00:30:11,670 --> 00:30:16,010
+wetting و ال surfactant و ال disinfection سنة من
+
+339
+00:30:16,010 --> 00:30:25,510
+استخدام one solution for many objects solutions
+
+340
+00:30:25,510 --> 00:30:27,750
+intended مصممة لإيش؟
+
+341
+00:30:30,450 --> 00:30:35,230
+وكانت تقدمت في 1994، في سنة ألف سمية وأربعة
+
+342
+00:30:35,230 --> 00:30:46,110
+وتسعين، وفي عام الفين وخمسة، وكانت تقدمت كير سيستم
+
+343
+00:30:46,110 --> 00:30:51,850
+استخدام 91% من الأشخاص في الولايات المتحدةبعد
+
+344
+00:30:51,850 --> 00:30:55,950
+الفين و خمسة من الفين و خمسة و جاي أصبح واحد و
+
+345
+00:30:55,950 --> 00:30:58,510
+تسعين في المية من الناس اللي بيبقوا شرسات لصقة
+
+346
+00:30:58,510 --> 00:31:05,230
+يستخدمون هذا النوع من المحاوليات ده popularity ايش
+
+347
+00:31:05,230 --> 00:31:09,850
+popularity؟ الشعبية الشعبية صار شائع و multi
+
+348
+00:31:09,850 --> 00:31:12,990
+-purpose solutions as you know the fact that they
+
+349
+00:31:12,990 --> 00:31:17,970
+simplify contact lens scale صار يعني مافيش تعقيد
+
+350
+00:31:19,910 --> 00:31:24,070
+بصير ال care العناية بالعادة سلسقة for the patient
+
+351
+00:31:24,070 --> 00:31:28,230
+and this is .. it is help enhances compliance
+
+352
+00:31:28,230 --> 00:31:34,310
+ويصير يعني كل الناس تتحمل هذا الموضوع يعني مش معقد
+
+353
+00:31:34,310 --> 00:31:38,670
+ولا صعب the most recent development in the request
+
+354
+00:31:38,670 --> 00:31:42,630
+for simplification is non-rob multi purpose
+
+355
+00:31:42,630 --> 00:31:46,610
+service يعني انا حط العادة سلسقة و طالع المحلول هو
+
+356
+00:31:46,610 --> 00:31:51,500
+ينظف الحاجةمافي حاجة تجيب فرشاية ولا أصبعي و أقحك
+
+357
+00:31:51,500 --> 00:31:57,940
+اه no rub لأنه دايما الأصابع والأضافة الناس هذه
+
+358
+00:31:57,940 --> 00:32:02,840
+متهمة بالإياش بتخلع infection اللي بيفضل يامل في
+
+359
+00:32:02,840 --> 00:32:05,740
+عينه يامل كل شوية يامل في عينه عارف عينه دايما
+
+360
+00:32:05,740 --> 00:32:11,480
+معمصة وفيها infection لأن هذه الأصابع يعني زي
+
+361
+00:32:11,480 --> 00:32:15,960
+زوائد الإياش تتحرك في كل تجاه و تسلم وتلمس وتأكل
+
+362
+00:32:15,960 --> 00:32:22,040
+وتشربوغيره يعني فيعني احنا لو وصلنا ل touch less
+
+363
+00:32:22,040 --> 00:32:26,360
+زي ما يقولون بكون افضل على ثلاثة which eliminates
+
+364
+00:32:26,360 --> 00:32:32,060
+the rub and rise step يعني هي المحلل هي the time
+
+365
+00:32:32,060 --> 00:32:36,680
+of rubbing و ال time of rise .. rise تشربه يعني زي
+
+366
+00:32:36,680 --> 00:32:41,040
+ما يقول برنجة او بتشربه nevertheless one study
+
+367
+00:32:41,040 --> 00:32:44,980
+indicated that the greater the number of steps in
+
+368
+00:32:44,980 --> 00:32:50,700
+a regimethe greater its disinfecting efficacy إيش
+
+369
+00:32:50,700 --> 00:32:54,800
+يعني القاعدة
+
+370
+00:32:54,800 --> 00:33:02,480
+كانت بتقول كافرة الخطوات في تطهير العنصر اللاسقة أ
+
+371
+00:33:02,480 --> 00:33:07,140
+greater the number of steps in the regime the
+
+372
+00:33:07,140 --> 00:33:11,300
+greater its disinfecting efficacy يعني كانوا
+
+373
+00:33:11,300 --> 00:33:11,620
+بيقولوا
+
+374
+00:33:16,730 --> 00:33:20,830
+على الطيارة بتكون أفضل لإنها بتاخد وقت أكتر، هذه
+
+375
+00:33:20,830 --> 00:33:23,930
+القاعدة اللي كانت بتقول هيك، بقول rising the
+
+376
+00:33:23,930 --> 00:33:27,850
+lenses prior to this infection was considered to
+
+377
+00:33:27,850 --> 00:33:31,670
+assist this process، يعني هو بيقولي إحنا بنستعوض
+
+378
+00:33:31,670 --> 00:33:37,230
+عن هذا إنه إحنا بنقى، عارفة عم تنقى، العدسة اللي
+
+379
+00:33:37,230 --> 00:33:42,650
+عارفة في ال container ال case بتاعها طول الليلفي
+
+380
+00:33:42,650 --> 00:33:48,670
+ال night يونج نايت هذا بوقف كتير علينا ماعرفش إلى
+
+381
+00:33:48,670 --> 00:33:57,270
+أي مدى سمعين انتوا كل زمان يعني الملابس المتسخة ده
+
+382
+00:33:57,270 --> 00:34:02,670
+خلاص من الجثة المتسخة كتير لأ بيحطها في ماء دافع و
+
+383
+00:34:02,670 --> 00:34:09,450
+بيحط عليها بودر معين بيقوله محلول نجا جدر نقع دم
+
+384
+00:34:09,450 --> 00:34:14,500
+الغسيل بيحطها مثلا اتناشر ساعةو بعدين ساعتها بس
+
+385
+00:34:14,500 --> 00:34:20,200
+ضعف خفيف تلاقيها تلاقى انظيفة انظيفة خاصة اللي
+
+386
+00:34:20,200 --> 00:34:24,280
+فيها البقعة و فيها ال .. يعني ال .. ال .. الوساخة
+
+387
+00:34:24,280 --> 00:34:28,440
+الكتيرة ما بتدخل في الغسالة مع الملابس اللي انت
+
+388
+00:34:28,440 --> 00:34:35,280
+ساخة خفيف فكل عمل ثلاثة فتفضل طول الليل في الكيس
+
+389
+00:34:35,280 --> 00:34:41,950
+هذا كتير ايش بي .. بي .. بي .. بي .. بي ..بيبشبش
+
+390
+00:34:41,950 --> 00:34:46,050
+ال .. ال .. الوساقة و بيخليها قابل عنها بالظبط
+
+391
+00:34:46,050 --> 00:34:52,970
+الحقيقة في كتير يعني high of the free مثلا high
+
+392
+00:34:52,970 --> 00:34:58,690
+sustain مثلا high اللي هو ال comfort complete هناك
+
+393
+00:34:58,690 --> 00:35:05,910
+اه high moist هنا كتير كتير راجيت انا يعني من هذه
+
+394
+00:35:05,910 --> 00:35:09,930
+المحلية ال market products طيب
+
+395
+00:35:10,500 --> 00:35:14,520
+multipurpose solutions preserve tips إيش هي في حال
+
+396
+00:35:14,520 --> 00:35:19,880
+تحتاج إلى مادة حافظةلمانع من التلخم و لا هيتعيش
+
+397
+00:35:19,880 --> 00:35:23,780
+بدون اللي هو مادة حفظة، these solutions
+
+398
+00:35:23,780 --> 00:35:28,440
+incorporate preservatives regarded as novel in the
+
+399
+00:35:28,440 --> 00:35:32,020
+sense that they have not been in general used in
+
+400
+00:35:32,020 --> 00:35:37,460
+other ophthalmic products of high molecular weight
+
+401
+00:35:37,460 --> 00:35:40,840
+يبقى بنزامها بنزال كونيوم
+
+402
+00:35:44,370 --> 00:35:49,730
+الإمثالات هى بواسطة الهيجزالين بواسطة الهيجزالين
+
+403
+00:35:49,730 --> 00:35:52,450
+بواسطة الهيجزالين بواسطة الهيجزالين بواسطة
+
+404
+00:35:52,450 --> 00:35:58,370
+الهيجزالين بواسطة الهيجزالين بواسطة الهيجزالين
+
+405
+00:35:58,370 --> 00:35:59,630
+بواسطة الهيجزالين بواسطة الهيجزالين بواسطة
+
+406
+00:35:59,630 --> 00:35:59,630
+الهيجزالين بواسطة الهيجزالين بواسطة الهيجزالين
+
+407
+00:35:59,630 --> 00:35:59,650
+بواسطة الهيجزالين بواسطة الهيجزالين بواسطة
+
+408
+00:35:59,650 --> 00:36:03,570
+الهيجزالين بواسطة الهيجزالين بواسطة الهيجزالين
+
+409
+00:36:03,570 --> 00:36:06,690
+بواسطة الهيجزالين
+
+410
+00:36:09,030 --> 00:36:14,770
+zero point zero one one zero zero zero one وانا
+
+411
+00:36:14,770 --> 00:36:22,530
+على .. على الف .. على الف عشر تلاف .. هانا بيت ألف
+
+412
+00:36:22,530 --> 00:36:29,570
+.. هانا بيت ألف وانا عشر تلاف .. عشر تلاف الوضع هو
+
+413
+00:36:29,570 --> 00:36:32,850
+sufficient antimicrobial action يعني البوليهيكسدين
+
+414
+00:36:32,850 --> 00:36:39,860
+له antimicrobial actionكان هو يعني من التطهير لإيش
+
+415
+00:36:39,860 --> 00:36:43,640
+بالبكتيريا even in high dilution حتى في dilution
+
+416
+00:36:43,640 --> 00:36:49,860
+الخامسة عالمية ألف polymetric biguanides have
+
+417
+00:36:49,860 --> 00:36:53,880
+produced a general disinfectant agents in the food
+
+418
+00:36:53,880 --> 00:36:56,580
+industry يعني في عالم حفظ الطعام
+
+419
+00:37:00,430 --> 00:37:05,230
+مشروبات اللي هو البرتقال و المانجا و الجواكا و ال
+
+420
+00:37:05,230 --> 00:37:09,050
+.. and for that this infection of swimming pools
+
+421
+00:37:09,050 --> 00:37:15,110
+حتى في اللي هو أحواض السباحة، حطوا نسب عليه قليل
+
+422
+00:37:15,110 --> 00:37:19,490
+زي هيك، فيقتل البكتيريا أو بيقلل من نمو البكتيريا،
+
+423
+00:37:19,490 --> 00:37:22,710
+all it needs is a membrane activation that also
+
+424
+00:37:22,710 --> 00:37:26,090
+impairs the integrity of the outer membrane of the
+
+425
+00:37:26,090 --> 00:37:28,940
+ground negative bacteriaبيعمل على ال membrane
+
+426
+00:37:28,940 --> 00:37:34,300
+بيكسر ال membrane بتاع ال gram negative بكتير يعني
+
+427
+00:37:34,300 --> 00:37:41,200
+طيب الآن هتكلم شوية عن transient solutions
+
+428
+00:37:41,200 --> 00:37:46,100
+transient solutions اللي منها ال hydrogen في
+
+429
+00:37:46,100 --> 00:37:51,220
+الأكسيد hydrogen بتكون بتاع في ماء الأكسجين بتعرف
+
+430
+00:37:51,220 --> 00:37:56,460
+ماء الأكسجين؟ مشهور، popular تروح للسيدرية تقوله
+
+431
+00:37:56,460 --> 00:38:03,810
+بدي ماء الأكسجينبحضرها fresh لما اعطيك إياها في ال
+
+432
+00:38:03,810 --> 00:38:09,890
+bottle بتاعها تتصور إنك تحمل ميه إنك انت حاملة ميه
+
+433
+00:38:09,890 --> 00:38:15,050
+وهي فعلا يعني الميه هي الأساس فيها بس فيها ضرر
+
+434
+00:38:15,050 --> 00:38:22,910
+اكسجين زيادة زي ما ال H2O طيب اعملي test و ارجو
+
+435
+00:38:22,910 --> 00:38:26,270
+انك تعملوا ال test هذي جيبي اللي هو ال hardened
+
+436
+00:38:26,270 --> 00:38:28,090
+peroxide جديد هذا و كوب بيه
+
+437
+00:38:31,810 --> 00:38:42,530
+هتجي بيعمل ايش؟ Bubbles، Frost، رهوة، هذه معناها
+
+438
+00:38:42,530 --> 00:38:48,770
+انه بدأ يخرج أكسجين، السائل صار مرية و الأكسجين هو
+
+439
+00:38:48,770 --> 00:38:54,130
+اللي ابتلى قدامك فيه فقاعةالحقيقة إن حطه على
+
+440
+00:38:54,130 --> 00:38:57,890
+الجروح العميقة مش على الجروح السطحية هذه الجروح
+
+441
+00:38:57,890 --> 00:39:04,950
+العميقة اللي يعني فيها هوا جليل حيتمه الاش ال
+
+442
+00:39:04,950 --> 00:39:10,090
+anaerobic bacteria وحقيقة إنه كان effective و ال
+
+443
+00:39:10,090 --> 00:39:16,130
+crust اللي كان على الجرح إنه بينخر و نخر يعني كويس
+
+444
+00:39:16,130 --> 00:39:18,530
+جدا في إزالة ال crust و الحقيقة اللي معرفة أنه
+
+445
+00:39:18,530 --> 00:39:23,360
+يعني مشفالان اما انتبهوا ان موضوع ال hydrogen
+
+446
+00:39:23,360 --> 00:39:30,180
+peroxide انه ممكن يستخدم solution في تقهير العدسة
+
+447
+00:39:30,180 --> 00:39:35,480
+اللاسنة بس طبعا في مرحلة انه بعد وضع ال hydrogen
+
+448
+00:39:35,480 --> 00:39:39,000
+peroxide لازم نعمل elimination له او
+
+449
+00:39:39,000 --> 00:39:43,800
+neutralization له حتى ما يعمل للعين اي hydrogen او
+
+450
+00:39:43,800 --> 00:39:44,120
+عم
+
+451
+00:39:47,710 --> 00:39:52,090
+هذا مش يعني مش ما احنا هقولنا هنا فيه نوعين فيه
+
+452
+00:39:52,090 --> 00:39:58,670
+نوع stable وفيه نوع transient الان احنا بتكلم على
+
+453
+00:39:58,670 --> 00:40:03,970
+transient انه فيه antimicrobial agents وانه بعد
+
+454
+00:40:03,970 --> 00:40:10,570
+شوية بيروح وبيفضلش منه حاجة الان بتكلم على
+
+455
+00:40:10,570 --> 00:40:15,530
+transient ال hydrogen peroxide لإن ال hydrogen
+
+456
+00:40:15,530 --> 00:40:25,830
+peroxide بعددقائق من وضعه ينتهي هو transit مش ثابت
+
+457
+00:40:25,830 --> 00:40:34,230
+يعني ال time consuming هو ايه احنا؟ هنا؟ اه
+
+458
+00:40:34,230 --> 00:40:38,110
+hydrogen dioxide was the first chemical means of
+
+459
+00:40:38,110 --> 00:40:41,710
+disinfection of hydrogen lenses to be introduced
+
+460
+00:40:41,710 --> 00:40:45,390
+as an alternative to heat disinfection يعني هو
+
+461
+00:40:45,390 --> 00:40:46,970
+بديل للحرارة
+
+462
+00:40:54,870 --> 00:41:02,930
+مفسه الحرارة يعني وسيلة جيدة جدا في تطهير وتعقيد
+
+463
+00:41:02,930 --> 00:41:10,030
+هذا مافي كلام لكن حسب المكوّن العدسة اللازقة ال
+
+464
+00:41:10,030 --> 00:41:13,750
+poly methyl مثأكلت يعني بيصير لها أي damage
+
+465
+00:41:13,750 --> 00:41:17,550
+بالإياش بالحرارة فعم اتحارب عليها فجبالها إش بارد
+
+466
+00:41:17,550 --> 00:41:21,210
+فهي
+
+467
+00:41:21,210 --> 00:41:25,660
+بديل للحرارةوالتطهير بالحرارة and the extent of
+
+468
+00:41:25,660 --> 00:41:31,400
+its usage has varied over the years في ال 2005 it
+
+469
+00:41:31,400 --> 00:41:36,800
+was used by only 10% of patients in the UK يعني في
+
+470
+00:41:36,800 --> 00:41:41,060
+اللي هو المملكة المتحدة كان بيستخدم 10% في ال 2005
+
+471
+00:41:41,060 --> 00:41:44,420
+و بعدها إزالة advantage of hydrogen peroxide كل
+
+472
+00:41:44,420 --> 00:41:47,440
+شيء له advantage و له disadvantage شوف في ما هي
+
+473
+00:41:47,440 --> 00:41:53,980
+مزايا ماء الأكسجينو انا مكرر تاني لازم تجيبوا ماء
+
+474
+00:41:53,980 --> 00:41:57,500
+اكسجين و تحطوه على الجلد شوية و تحطوه منه على
+
+475
+00:41:57,500 --> 00:42:02,620
+البلات شوية و تشوفوا بلغة اربع خمس شكل مش هتكون
+
+476
+00:42:02,620 --> 00:42:07,200
+تأثيره على الجلد؟ مش هيأثر ايش على الجلد؟ لأ خفيف
+
+477
+00:42:07,200 --> 00:42:13,330
+هو يعني على ال bare areas الجروح خاصةأه الجروح ولا
+
+478
+00:42:13,330 --> 00:42:16,350
+.. لا بحرجوش يعني، جاسدك انه بحرج و بعمل burn؟ لأ،
+
+479
+00:42:16,350 --> 00:42:23,070
+لا بعملش burn، بس هتحسي نامنة معاك يعني طيب،
+
+480
+00:42:23,070 --> 00:42:31,510
+انت بس حطي أصبع فيه و شوفي جراتي؟ إسرق؟ أه، انت
+
+481
+00:42:31,510 --> 00:42:37,590
+هتحسي بلا ولا ده، شوية، بس مش سلخ، مش هنسلخخفيف،
+
+482
+00:42:37,590 --> 00:42:42,250
+اه انما .. لكن حطيه على ال .. حطيه على مطلة مجروحة
+
+483
+00:42:42,250 --> 00:42:42,850
+فيها crust
+
+484
+00:43:00,790 --> 00:43:06,070
+لأ لأ بقولك كتير كنا نجيب ميت وكسجين ان جديدة بعد
+
+485
+00:43:06,070 --> 00:43:10,550
+تلت أيام نستعملها نلاقيها مية طعم منها وكسجين خاصة
+
+486
+00:43:10,550 --> 00:43:15,190
+اذا كانت رابطة للشمس او للهواء على طول البطكسي
+
+487
+00:43:15,190 --> 00:43:18,770
+يصير .. الطعم من الوكسجين تبقى مية ممكن اشربها
+
+488
+00:43:18,770 --> 00:43:19,650
+يعني نخلص منها
+
+489
+00:43:33,140 --> 00:43:38,300
+المواد الحافظة اللى بتعمل نوع من ال energy بتعمل
+
+490
+00:43:38,300 --> 00:43:47,520
+نوع من toxicity لأ هذا يعني خالي من المواد الحافظة
+
+491
+00:43:47,520 --> 00:43:51,320
+to which some patients except an allergic or toxic
+
+492
+00:43:51,320 --> 00:43:55,740
+response بعد المرضى فعلا بتحسسهم من المرضى الحافظة
+
+493
+00:43:55,740 --> 00:43:58,680
+كتير احنا بنحط قطرة في العين قطرة antibiotic
+
+494
+00:44:04,190 --> 00:44:09,790
+يا دكتور الحني حطي هذا الجطر طيب مفتح العين و ال
+
+495
+00:44:09,790 --> 00:44:13,330
+infection راح ال infection ال fiction و الجدر و
+
+496
+00:44:13,330 --> 00:44:16,930
+الهاد الأفرازيات راح لكنيش لايه الموال مو حمرن صار
+
+497
+00:44:16,930 --> 00:44:22,690
+allergy صار allergy للمزارقن فعلا
+
+498
+00:44:22,690 --> 00:44:25,590
+يقولوا له و لا يهمك ان شاء الله هنعطيك جطر يعني
+
+499
+00:44:25,590 --> 00:44:26,970
+جطر لل allergy و ماتفتش
+
+500
+00:44:34,120 --> 00:44:37,440
+يعني لا يحملنا واحد من الف ان واحد مايستخدم هذا
+
+501
+00:44:37,440 --> 00:44:42,680
+القطب لإنه ممكن في نفس ال family واحد يتأثر و
+
+502
+00:44:42,680 --> 00:44:48,120
+الباقية مايتأثرش و حظك نصيبك للدنيا ممكن الشركة
+
+503
+00:44:48,120 --> 00:44:52,140
+تكون زودة ال preservative شوية يعني الكمية بتاعتها
+
+504
+00:44:52,140 --> 00:44:56,100
+فهذا ال carbon dioxide مافيه preservative هذي ميزة
+
+505
+00:44:56,100 --> 00:44:58,060
+ولا عيب؟ ميزة
+
+506
+00:44:59,950 --> 00:45:03,410
+It's broad spectrum of antimicrobial action
+
+507
+00:45:03,410 --> 00:45:08,210
+against bacteria, viruses and yeast.هذا أنه الفطر
+
+508
+00:45:08,210 --> 00:45:13,030
+الخميرة.In three Pearson's solution can kill
+
+509
+00:45:13,030 --> 00:45:17,210
+tropozoids, acanthioba, castellani after three
+
+510
+00:45:17,210 --> 00:45:23,490
+minutes and cysts after nine hours.يعني إله ميزة
+
+511
+00:45:23,490 --> 00:45:31,490
+إنه إله broad spectrumطيف واسع يعمل على العديد من
+
+512
+00:45:31,490 --> 00:45:35,970
+أنواع البكتيريا أو البيوزات والفلتريات وحتى ال
+
+513
+00:45:35,970 --> 00:45:44,570
+sports وانشي كويس يعني بيساعدنا الإنسان ياطمأن انه
+
+514
+00:45:44,570 --> 00:45:48,770
+لما ينظف العنصر اللاسقار بماء أكسجين انه عنها تكون
+
+515
+00:45:48,770 --> 00:45:53,670
+يعني تسعين فيمية في مأمن من إيش الغزاة من غزاة
+
+516
+00:45:58,220 --> 00:46:20,700
+طيب كيف نستعمل كيف نستعمل كيف
+
+517
+00:46:20,700 --> 00:46:25,500
+نستعمل كيف نستعمل كيف نستعمل كيف نستعمل
+
+518
+00:46:27,060 --> 00:46:31,240
+كانوا متواجدين لـ Sodium Bicarbonate لإنهيار
+
+519
+00:46:31,240 --> 00:46:31,660
+الانترال
+
+520
+00:46:54,850 --> 00:47:02,370
+عشان تاخد ما تبقى من الهيبوين عشان الهيبوين من
+
+521
+00:47:02,370 --> 00:47:09,190
+الوكسايد حامضي الوقت بتاعه بس about four pH
+
+522
+00:47:09,190 --> 00:47:18,750
+والكربونة قاعدة فقاعدة زي القلوي بيطلع ملح زين مع
+
+523
+00:47:18,750 --> 00:47:19,770
+ملح زين
+
+524
+00:47:25,090 --> 00:47:29,610
+و حم ملح زي الماء اه ملح زي الماء فانا حتى لو كان
+
+525
+00:47:29,610 --> 00:47:32,670
+الهانو الملوكسايد لسه في الجفنة و حطينا له شوية
+
+526
+00:47:32,670 --> 00:47:39,990
+بودرة يعني دايما البودرة في الاشهة حاسية حاسية انه
+
+527
+00:47:39,990 --> 00:47:45,430
+امانا الان ان الcontact lens وسطها مش حامضى ماهو
+
+528
+00:47:45,430 --> 00:47:49,090
+المشكلة لما نحطها وسطها حامضى و وسط العين neutral
+
+529
+00:47:49,090 --> 00:47:52,890
+ال TS حاسية نوع من contradiction
+
+530
+00:47:56,210 --> 00:48:06,030
+بنخلّي يعني نترال نترال
+
+531
+00:48:06,030 --> 00:48:07,010
+نترال نترال نترال نترال نترال نترال نترال نترال
+
+532
+00:48:07,010 --> 00:48:08,990
+نترال نترال نترال نترال نترال نترال نترال نترال
+
+533
+00:48:08,990 --> 00:48:10,210
+نترال نترال نترال نترال نترال نترال نترال نترال
+
+534
+00:48:10,210 --> 00:48:10,210
+نترال نترال نترال نترال نترال نترال نترال نترال
+
+535
+00:48:10,210 --> 00:48:11,750
+نترال نترال نترال نترال نترال نترال نترال نترال
+
+536
+00:48:11,750 --> 00:48:16,150
+نترال نترال نترال نترال نترال نترال نترال نترال
+
+537
+00:48:16,150 --> 00:48:19,510
+نترال
+
+538
+00:48:19,510 --> 00:48:23,570
+نترال نترال نترال
+
+539
+00:48:40,790 --> 00:48:46,010
+وهي جفنة موجودة وهي على الأصبع .. حاطة على الأصبع
+
+540
+00:48:46,010 --> 00:48:49,990
+جاهزة لإيش لل initiation طيب بارك الله فيكم في
+
+541
+00:48:49,990 --> 00:48:54,350
+المحاضرة القادمة ان شاء الله يعني نكمل هذا الشيخ
+
+542
+00:48:54,350 --> 00:48:58,050
+الشيخ عن المحاليل اللي بيستخدم
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/fqWIOlL-xIg.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/fqWIOlL-xIg.srt
new file mode 100644
index 0000000000000000000000000000000000000000..373044d853db73bd0d1435c6cb69514cceaaa64d
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/fqWIOlL-xIg.srt
@@ -0,0 +1,1920 @@
+1
+00:00:20,750 --> 00:00:24,350
+بسم الله الرحمن الرحيم والحمد لله رب العالمين
+
+2
+00:00:24,350 --> 00:00:29,270
+واصلي واسلم على النبي الأمين محمد وعلى آله وأصحابه
+
+3
+00:00:29,270 --> 00:00:32,990
+والتابعين السلام عليكم ورحمة الله وبركاته في هذا
+
+4
+00:00:32,990 --> 00:00:38,270
+اليوم إن شاء الله سنكمل ما بدأنا من صعيد effects
+
+5
+00:00:38,270 --> 00:00:43,870
+of drug toxicity الآثار الجانبية وسمية الدواء
+
+6
+00:00:51,820 --> 00:00:56,360
+بنعمل مع الأدوية إن شاء الله بنقول بسم الله الرحمن
+
+7
+00:00:56,360 --> 00:01:02,380
+الرحيم  the side effects اللي هو السالس هو اللي
+
+8
+00:01:02,380 --> 00:01:08,080
+بيأثر على the central nervous system وممكن يؤثر على
+
+9
+00:01:08,080 --> 00:01:13,080
+الذاكرة ويعمل شيء اسمه amnesia، amnesia فقدان
+
+10
+00:01:13,080 --> 00:01:17,480
+الذاكرة طبعا هذا بيأثر على the central nervous
+
+11
+00:01:17,480 --> 00:01:22,600
+system وممكن يعمل hallucinationsو ممكن يعمل بعض
+
+12
+00:01:22,600 --> 00:01:28,200
+التشنجات للإنسان لو أثر على the central nervous
+
+13
+00:01:28,200 --> 00:01:34,820
+system لكن برضه ممكن بعض الأدوية أنه تعمل loss of
+
+14
+00:01:34,820 --> 00:01:39,860
+the sense of taste يعني الذوق، التذوق، التذوق برضه 
+
+15
+00:01:39,860 --> 00:01:47,320
+هذا طبعا آثار عصبية طبعا للإنسان النصيحة أنه يقرأ
+
+16
+00:01:47,320 --> 00:01:50,560
+اللي هو the label ويقرأ اللي هو
+
+17
+00:01:57,890 --> 00:02:02,210
+لكن الآثار الجانبية في نوع ثاني هي على الـ
+
+18
+00:02:02,210 --> 00:02:05,750
+gastrointestinal tract فهذه متعلقة بالأدوية التي
+
+19
+00:02:05,750 --> 00:02:11,230
+ تؤخذ أقراصا والكبسولات كثير من الأدوية ملاحظة تعمل
+
+20
+00:02:11,230 --> 00:02:12,710
+غثيان قيء
+
+21
+00:02:21,900 --> 00:02:27,320
+وممكن constipation ممكن يكون إمساك أو عكس الإمساك
+
+22
+00:02:27,320 --> 00:02:32,120
+الإسهال بيقولوا most of drugs go through the
+
+23
+00:02:32,120 --> 00:02:37,920
+digestive system الأقراص والكبسولات يعني absorbed
+
+24
+00:02:37,920 --> 00:02:43,140
+معظمها absorbed وفي كلمتها بيكونش absorption
+
+25
+00:02:43,140 --> 00:02:49,120
+بيصبح absorption يعني في مصمم أنه يعمل بس على
+
+26
+00:02:49,120 --> 00:02:56,090
+المعدة والأمعاء زي sulfaguanadine مثلا بيكون بس للعلاج
+
+27
+00:02:56,090 --> 00:02:59,810
+شيء في القولون أو شيء خاص لكن باقي الأدوية طبعا
+
+28
+00:02:59,810 --> 00:03:03,910
+هتنتقل من الـ gastrointestinal tract ليش
+
+29
+00:03:03,910 --> 00:03:07,810
+أنه بصير nausea أو vomiting؟ غالبا بصير تهيج في
+
+30
+00:03:07,810 --> 00:03:13,750
+المعدة غالبا بصير تهيج في المعدة ليش بصير تهيج؟
+
+31
+00:03:13,750 --> 00:03:19,690
+بصير تهيج في المعدة إن صار تهيج في المعدة بصير
+
+32
+00:03:19,690 --> 00:03:23,970
+اللي هو إسهال من ساعة في المعدة بصير nausea and
+
+33
+00:03:23,970 --> 00:03:30,810
+vomiting طبعا ممكن هذا يعني مع ألم في المعدة وألم
+
+34
+00:03:30,810 --> 00:03:35,670
+في الأمعاء يعني مش بس يعني ألم في المعدة وألم في
+
+35
+00:03:35,670 --> 00:03:40,550
+الأمعاء طيب في أثر جانبي مهم اللي هو the dizziness
+
+36
+00:03:40,550 --> 00:03:46,890
+الْدُّوَخَة كثير من الأدوية لما ناخدها بتعمل دوخة والدوخة
+
+37
+00:03:46,890 --> 00:03:55,150
+ليه؟ لا يبدو كإتفاق جديد، يمكن أن يكون لديه توابع
+
+38
+00:03:55,150 --> 00:03:59,590
+خاطرة، خاصة 
+
+39
+00:03:59,590 --> 00:04:02,990
+لكبار
+
+40
+00:04:02,990 --> 00:04:08,340
+السّنّين أو الذين بالفعل لا يدرسوا في مجالهم أو
+
+41
+00:04:08,340 --> 00:04:12,200
+الناس اللي هم أساسا عندهم أمراض يعني الهيكل
+
+42
+00:04:12,200 --> 00:04:16,820
+العظمي بتاعتهم مش ثابت كتير ويصيبوا دوخة ممكن أنه يؤدي
+
+43
+00:04:16,820 --> 00:04:20,940
+إلى كسر العظام the breakdown of bones أو broken
+
+44
+00:04:20,940 --> 00:04:26,640
+bones ممكن الواحد لو مشي في الشارع يقع ممكن
+
+45
+00:04:26,640 --> 00:04:32,240
+يكسر أي حاجة في اللي هو الهيكل العظمي بتاعه لكن
+
+46
+00:04:32,240 --> 00:04:39,270
+الشيء اللي معتاد وخطير في كبار السن هو كسر عنق
+
+47
+00:04:39,270 --> 00:04:48,430
+الفخذ الصورة دي بتوضح neck
+
+48
+00:04:48,430 --> 00:04:53,990
+of femur معروف أن الفخذ هي الفخذ قدامك الفخذ
+
+49
+00:04:53,990 --> 00:05:00,350
+بيعمل articulation تمفصل مع الفخذ أمام الفخذ في
+
+50
+00:05:00,350 --> 00:05:02,490
+مفصل كبير اسمه hip joint
+
+51
+00:05:23,530 --> 00:05:30,910
+ال .. العمر الطويلة الآن أضعف شيء في ضعف الإنسان
+
+52
+00:05:30,910 --> 00:05:37,230
+في كبار السن هو the neck العظمة اللي هي هنا بينا
+
+53
+00:05:37,230 --> 00:05:45,030
+مكسورة يعني هنا بينا صح؟ أيه؟ هنا مكسورة هذه في
+
+54
+00:05:45,030 --> 00:05:49,310
+كبار السن بعد السبعين تصبح قريبة من الختف أو
+
+55
+00:05:49,310 --> 00:05:54,570
+الزوجاج يعني زي الزوجاج أي ورقة على الجَمْع ورقة يعني
+
+56
+00:05:54,570 --> 00:06:03,690
+ممكن أنه تكسر هذا اللي هو المفصل وبالتالي ما يجدش
+
+57
+00:06:03,690 --> 00:06:09,270
+الإنسان يقف أبدا عليه وحتى لو عملوا عملية جراحية
+
+58
+00:06:09,270 --> 00:06:14,790
+وحطّوا له nail بلاتين، مش معنى بلاتين، من الصعب أن
+
+59
+00:06:14,790 --> 00:06:18,930
+يستطيع يمشي فيه كبير السنّ عشان هيك في شيء شائع
+
+60
+00:06:18,930 --> 00:06:25,490
+بيقول لك أن هذا قصر الموت إحنا
+
+61
+00:06:25,490 --> 00:06:29,350
+بنخاف على كبار السن اللي بعد السبعين كتير بنخافهم
+
+62
+00:06:29,350 --> 00:06:32,770
+من الدوخة بنخافهم يتعثرون بنخافهم يمشوا في الظلام
+
+63
+00:06:32,770 --> 00:06:38,810
+نضوي لهم بنحبّش يمشوا في منطقة مش معبّدة كويس فيها
+
+64
+00:06:38,810 --> 00:06:42,970
+يعني حجارة أو مرتفعات من قليلة هذا وهذا طبعا
+
+65
+00:06:42,970 --> 00:06:47,610
+لحياة كوا تعرفوا يبقى الخوف بس مش من الداخل الـ
+
+66
+00:06:47,610 --> 00:06:53,050
+dizziness الخوف ممكن يكون sequences خاصة أكثر في أي 
+
+67
+00:06:53,050 --> 00:06:57,870
+عالم من البشر لكن أكثر شيوعا فيه كبار السن الـ
+
+68
+00:06:57,870 --> 00:07:03,410
+neck of femur لأنه بيكون يعني fragile و weak
+
+69
+00:07:03,410 --> 00:07:11,390
+وبينكسر كسر لا يجبر قد لا يجبر طيب نتكلم عن nausea
+
+70
+00:07:11,390 --> 00:07:15,670
+شوية هو أن nausea و vomiting are not considered
+
+71
+00:07:15,670 --> 00:07:19,550
+deadly side effects they can cause a cascade of
+
+72
+00:07:19,550 --> 00:07:24,410
+medical problems يعني ممكن أي واحد فينا يقوم أنه مع
+
+73
+00:07:24,410 --> 00:07:29,990
+شوية nausea ومع شوية vomiting وكلّه بلدان لكن لما
+
+74
+00:07:29,990 --> 00:07:32,670
+أنه ما يكونش معاه nausea ولا vomiting اللي بعدين
+
+75
+00:07:32,670 --> 00:07:39,990
+أخد علاج وكلّه المتهمين علاج عشان هيك بيقولوا they
+
+76
+00:07:39,990 --> 00:07:43,930
+can cause a cascade الأسكت يعني شيء متتابع أو
+
+77
+00:07:43,930 --> 00:07:46,750
+medical problems especially in the elderly or
+
+78
+00:07:46,750 --> 00:07:50,730
+those already weakened by a disease اللي هو أتعب
+
+79
+00:07:50,730 --> 00:07:53,010
+من ال disease أو ضعيف من ال disease، the resulting
+
+80
+00:07:53,010 --> 00:07:57,290
+dehydration، واحد معاه vomiting أو مش قادر يستخدم
+
+81
+00:07:57,290 --> 00:08:00,650
+معاه nausea أو vomiting، مش حياته، إيش حاسسه بعد
+
+82
+00:08:00,650 --> 00:08:04,950
+هيك؟ جفاف، إيش معنى الجفاف؟ Hypotension
+
+83
+00:08:10,570 --> 00:08:16,070
+مش هنقدر يمشي، ما فيش دم يوصل، أكسجين بالتالي، ليش؟
+
+84
+00:08:16,070 --> 00:08:19,950
+تلاقيه طاقة، يبقى الهيموجلوبين، ممكن أحيانا ينتهي من الـ
+
+85
+00:08:19,950 --> 00:08:24,090
+bleeding، يصير نزيف داخلي أو حاجة، and oesophageal
+
+86
+00:08:24,090 --> 00:08:30,230
+rupture ينزل يندفع، يبقى أنه زي هو vomiting، بينهم
+
+87
+00:08:30,970 --> 00:08:35,150
+سمك أوعية، خاصة لو اللوحة أخذت drug، لو أخذت drug
+
+88
+00:08:35,150 --> 00:08:41,350
+وهذا كان يعني relative خاصة للمعدة أو للأمعاء،
+
+89
+00:08:41,350 --> 00:08:46,170
+ممكن يبقى التهاب بيدي، ممكن يبقى قرحة، صح؟ ممكن
+
+90
+00:08:46,170 --> 00:08:51,530
+يخرم المعدة أو يخرم المريء أو يخرم الأمعاء خاصة
+
+91
+00:08:51,530 --> 00:08:56,530
+المعدة وهذا مقيّد إلى الوفاة إذا لم يُشخص تماما فمثلا
+
+92
+00:08:56,530 --> 00:09:00,450
+جايب مثال chemotherapy العلاج الكيميائي مثلًا مثلًا
+
+93
+00:09:00,450 --> 00:09:09,510
+مثلًا مثلًا مثلًا مثلًا مثلًا مثلًا مثلًا مثلًا
+
+94
+00:09:09,510 --> 00:09:11,230
+مثلًا مثلًا مثلًا مثلًا مثلًا مثلًا مثلًا مثلًا
+
+95
+00:09:11,230 --> 00:09:12,170
+مثلًا مثلًا مثلًا مثلًا مثلًا مثلًا مثلًا مثلًا
+
+96
+00:09:12,170 --> 00:09:15,770
+مثلًا مثلًا مثلًا مثلن مثلن مثلن مثلن مثلن مثلن
+
+97
+00:09:15,770 --> 00:09:17,510
+مثلن مثلن مثلن مثلن مثلن مثلن مثلن مثلن مثلن مثلن
+
+98
+00:09:17,510 --> 00:09:23,330
+مثلن مثلن مثلن مثلن لذا يكون بعضها في الوريد وحتى
+
+99
+00:09:23,330 --> 00:09:28,290
+في الوريد هي irritative و painful ولها يعني أثر
+
+100
+00:09:28,290 --> 00:09:32,710
+نسأل الله اللي عرفه على عقل أنا ونفسي يبقى الـ
+
+101
+00:09:32,710 --> 00:09:36,390
+chemotherapy كل أنواع ال drugs اللي بتستخدم في
+
+102
+00:09:36,390 --> 00:09:41,150
+علاج السرطان قطع بالمعدة لأن لو قطعت خاطئ بالمعدة
+
+103
+00:09:41,150 --> 00:09:47,390
+فسوف تؤدي إيش لنزيف وتهيج شديد الشيء الشيء اللي
+
+104
+00:09:47,390 --> 00:09:52,880
+عندنا هنا اللي هو مضاد الروماتيزم وهذه الحقيقة في الـ
+
+105
+00:09:52,880 --> 00:09:58,440
+pharmacy في الصيدلية أكثر أدوية شائعة Antibiotics
+
+106
+00:09:58,440 --> 00:10:05,060
+ده مجموعات بيسموها non-steroidal anti inflammatory
+
+107
+00:10:05,060 --> 00:10:05,520
+drugs
+
+108
+00:10:32,520 --> 00:10:43,080
+نعم ال S تساوي  non-steroidal ال A anti anti
+
+109
+00:10:43,080 --> 00:10:51,960
+يعني ال I inflammatory inflammatory
+
+110
+00:10:51,960 --> 00:10:53,580
+وال D drugs
+
+111
+00:10:57,090 --> 00:11:01,930
+عايز من حضراتكم أن هذا غمز أينما رأيتموه تعرفوا
+
+112
+00:11:01,930 --> 00:11:08,390
+أن هذا فيه مئات من ال drugs اللي كانت واللي جاية
+
+113
+00:11:08,390 --> 00:11:15,370
+قرص واحد من ال naproxen أو من ال diclofen أو من الـ
+
+114
+00:11:15,370 --> 00:11:19,770
+piroxicam أو من ال aspirin أو من ال acetaminophen
+
+115
+00:11:24,750 --> 00:11:29,190
+ممكن جدا على معدة فارغة ممكن جدا تعمل لك كارثة صحية
+
+116
+00:11:29,190 --> 00:11:36,350
+كارثة صحية يعني واحد بيكون في أولها يعني الألم
+
+117
+00:11:36,350 --> 00:11:40,330
+كتير ولما يخف بيزيد وبيأخذ العلاج كمان وبيكمل
+
+118
+00:11:40,330 --> 00:11:47,270
+فجأة تاجمته قرحة بقلم شديد واللي هو تقرح وممكن
+
+119
+00:11:47,270 --> 00:11:54,080
+ينزل دم وممكن تصير مصيبة داخل المعدة لذلك لكم واني
+
+120
+00:11:54,080 --> 00:12:00,400
+من ورائكم لا يُؤخذ دواء من non-steroidal anti
+
+121
+00:12:00,400 --> 00:12:05,380
+-inflammatory على معدة فارغة بقول لك على معدة فارغة أنا
+
+122
+00:12:05,380 --> 00:12:08,620
+أنا لكن حتى في بعض الناس لأ بقول لك لأ لازم آخذ
+
+123
+00:12:08,620 --> 00:12:10,560
+شيء يعمل حماية للمعدة
+
+124
+00:12:15,870 --> 00:12:19,110
+حاجة اسمها Nexium مثلا فيه أقراص معينة بتعمل فيلم
+
+125
+00:12:19,110 --> 00:12:23,650
+على المعدة بتحمي المعدة أجالها راتدين ورانيدين وGIK
+
+126
+00:12:23,650 --> 00:12:28,930
+عارفين ال GIK ورانيدين وراتدين مشهور هذا راتدين
+
+127
+00:12:28,930 --> 00:12:32,190
+في كل حتة بيقول لك كده يا عم وضح لحنودة وأنا بأريح
+
+128
+00:12:32,190 --> 00:12:36,730
+مات فيه راتدين ورانيدين وGIK أو فاموتدين و .. برضه
+
+129
+00:12:36,730 --> 00:12:42,070
+عائلة عائلة ثانية هذه ال antacids عائلة الغثيان والـ
+
+130
+00:12:42,070 --> 00:12:42,790
+vomiting هالي
+
+131
+00:12:50,770 --> 00:12:56,950
+لأن كنت يعني familiar بالارتكالية بتاعة الأطفال،
+
+132
+00:12:56,950 --> 00:13:00,470
+ارتكالية بتاعة الأطفال الطفل أكل بيض مقلي مثلا،
+
+133
+00:13:00,470 --> 00:13:06,310
+أكل نوع من البروتين، حصل طفح جلدي في صورة دوائر
+
+134
+00:13:06,310 --> 00:13:12,770
+حمراء مرتفعة، مع severe itching، إيش itching؟ حركة
+
+135
+00:13:12,770 --> 00:13:16,410
+شديدة هذا بيقول ارتكالية، حساسية الأطفال دي الجلب
+
+136
+00:13:16,410 --> 00:13:20,960
+اسمه ارتكالية، ما فيش واحد يمكن البشر إلا مع أنواع
+
+137
+00:13:20,960 --> 00:13:26,420
+من الحساسية سواء في الـconjunctivitis، سواء في
+
+138
+00:13:26,420 --> 00:13:30,920
+الـnasal mucous membrane، سواء في الـthorax، سواء
+
+139
+00:13:30,920 --> 00:13:38,240
+في الـchest، سواء في الجلد، آه في أي حتة ممكن تيجي
+
+140
+00:13:38,240 --> 00:13:43,320
+الحساسية لكن الحساسية دي لما تكون جاية بسبب طعام
+
+141
+00:13:43,320 --> 00:13:49,000
+شيء، وتكون بعد ما أخذنا drug شيء آخر، يبقى
+
+142
+00:13:49,000 --> 00:13:51,860
+allergic reactions can happen within a drug or
+
+143
+00:13:51,860 --> 00:13:58,960
+food and can range تتفاوت من itching and rash أقل
+
+144
+00:13:58,960 --> 00:14:01,560
+يعني راش، اِطّلع الحجير دي زي ما أنتم شايفين في
+
+145
+00:14:01,560 --> 00:14:05,940
+الصورة؟ شايفين ال rash كيف؟ شايفين هنا؟ شايفين
+
+146
+00:14:05,940 --> 00:14:12,960
+هنا؟ آه بثور على الجلد، حِسَّاسِيَّة هذه بيقول لك أقل أنواع
+
+147
+00:14:12,960 --> 00:14:17,980
+الحساسية لكن فيه حساسية ممكن تتصاعد إلى أن تقتل
+
+148
+00:14:17,980 --> 00:14:23,220
+الإنسان طبعا حساسية البنسلين أنا حددت كونها اللي سبق
+
+149
+00:14:23,220 --> 00:14:25,680
+أنه أخذ بنسلين وصارت عنده antibodies للبنسلين
+
+150
+00:14:25,680 --> 00:14:30,000
+وعند أخذ البنسلين ثاني حصله anaphylactic shock
+
+151
+00:14:30,000 --> 00:14:34,780
+مات على المكان مات على المكان إذا لم يتداركه أطباء
+
+152
+00:14:34,780 --> 00:14:40,450
+يعني بالسرعة الشديدة عنده اللي هو the antidotes لكن
+
+153
+00:14:40,450 --> 00:14:46,330
+أنا أقول لكم مثال شيء في حساسية تؤدي في ال larynx،
+
+154
+00:14:46,330 --> 00:14:53,290
+إيش ال larynx؟ ده الحنجرة، ده الحنجرة الحنجرة
+
+155
+00:14:53,290 --> 00:15:00,270
+مبطّنة mucous من ال brain أحيانا تؤدي حساسية في الـ
+
+156
+00:15:00,270 --> 00:15:03,950
+larynx mucous من ال brain وcell swelling و تسكر مجرد
+
+157
+00:15:03,950 --> 00:15:05,550
+النفس ويبقى suffocation
+
+158
+00:15:09,540 --> 00:15:14,360
+هذا شائع شائع فيه أكثر من طفل حصلهم اللي هو
+
+159
+00:15:14,360 --> 00:15:18,940
+الموضوع هذا من بعض أدوية أو شيء suffocation فإحنا
+
+160
+00:15:18,940 --> 00:15:23,360
+بنقولها أساسا الحساسية تتفاوت من القليل للمتوسط لـ
+
+161
+00:15:23,360 --> 00:15:28,900
+الخطير دي قدامنا زي حساسية البنسلين مثلا عشان هيك
+
+162
+00:15:28,900 --> 00:15:33,860
+إحنا لما نقرأ في النشرة المصاحبة للدواء هنقرأ اللي
+
+163
+00:15:33,860 --> 00:15:37,960
+هو الآثار الجانبية بيقول لك بيعمل حساسية يعني في
+
+164
+00:15:37,960 --> 00:15:44,740
+الجلد أو حساسية في الحلق أو حساسية في الصدر يعني
+
+165
+00:15:44,740 --> 00:15:50,140
+لازم نأخذ بأنه من هذه التوجهة طيب بعض الأدوية في
+
+166
+00:15:50,140 --> 00:15:53,400
+الآثار الجانبية بتعمل appetite loss أو loss of
+
+167
+00:15:53,400 --> 00:15:58,240
+appetite في كلمة بيه معنى loss of appetite اسمها
+
+168
+00:16:01,090 --> 00:16:07,170
+Anorexia لو جتك كلمة Anorexia ال A هالي عالية
+
+169
+00:16:07,170 --> 00:16:14,230
+الحدث يعني لأن ده فيه هالي فقر فقر الشهية إذا تجي
+
+170
+00:16:14,230 --> 00:16:20,770
+واحد بعد الولادة جات له رياضة بسيطة نفسه loss of
+
+171
+00:16:20,770 --> 00:16:24,470
+interest in eating ما فيش اهتمام بالأكل can come from
+
+172
+00:16:24,470 --> 00:16:28,370
+many different tracks when they either directly
+
+173
+00:16:28,370 --> 00:16:32,510
+suppress appetite عن طريق المخ طبعا central و
+
+174
+00:16:32,510 --> 00:16:36,790
+create changes in the sense of smell or taste أو
+
+175
+00:16:36,790 --> 00:16:43,370
+تؤثر على التذوق والشم والناس بيبطلوا شم ويتذوقوا
+
+176
+00:16:43,370 --> 00:16:47,070
+الطعام which indirectly cause the disinterest،
+
+177
+00:16:47,070 --> 00:16:49,730
+يعني loss of interest في الطعام
+
+178
+00:16:53,490 --> 00:16:
+
+216
+00:20:30,790 --> 00:20:33,370
+lowering of arterial blood pressure، يعني
+
+217
+00:20:33,370 --> 00:20:36,490
+Hypotension، والـ Hypotension هي أهم شيء خطير
+
+218
+00:20:41,740 --> 00:20:46,540
+وانتقال في صحيحة الطوابق يمكن أن يسبب فيها برايب
+
+219
+00:20:46,540 --> 00:20:56,620
+كثيرة انترو أو انتفيروس طيب الآن عشان أقول هذا أنه
+
+220
+00:20:56,620 --> 00:21:04,100
+ذيارية في حاجة ثانية أن ال number of motions يذهب
+
+221
+00:21:04,100 --> 00:21:08,000
+للحمام يزيد يعني واحد يذهب للحمام مرة في اليوم أو
+
+222
+00:21:08,000 --> 00:21:13,090
+مرتين في اليوم for a stool لو صار يبقى فيها أربعة 
+
+223
+00:21:13,090 --> 00:21:17,470
+أو خمسة يبقى زادة بإيش ال number of motions مش هو
+
+224
+00:21:17,470 --> 00:21:21,710
+بقى في إيه هذا بعدين إشي ثاني ال consistency
+
+225
+00:21:21,710 --> 00:21:28,210
+المكوّن بتاع ال stool إنه المكوّن يصير more liquid
+
+226
+00:21:28,210 --> 00:21:34,010
+less hard عشان أقول أنا أسهل مش معقول واحد بينزل
+
+227
+00:21:34,010 --> 00:21:36,570
+hard stool بقول عنه إيش
+
+228
+00:21:40,500 --> 00:21:47,180
+إدارية معروفة لأنه يعني لكل شوية آه ال consistency
+
+229
+00:21:47,180 --> 00:21:53,280
+بتاعه شوية لأكس طيب this is an important side
+
+230
+00:21:53,280 --> 00:21:58,160
+effect to keep in check يعني بدنا احنا نراجع
+
+231
+00:21:58,160 --> 00:22:02,500
+الموضوع أن إدارية ده is frequent آه is kinda
+
+232
+00:22:02,500 --> 00:22:08,130
+frequent كل ساعة مثلا و أتري ملاقى or last for more
+
+233
+00:22:08,130 --> 00:22:13,190
+than a couple of days يومين يعني should always be
+
+234
+00:22:13,190 --> 00:22:19,310
+reported to your doctor. طب يبقى الآن إذا كان ال
+
+235
+00:22:19,310 --> 00:22:27,130
+frequency واضح وإذا كان ال two days or more than
+
+236
+00:22:27,130 --> 00:22:33,850
+two days واضح و watery strong لابد أن يصير report
+
+237
+00:22:33,850 --> 00:22:40,360
+على طول على المستشفى أقصده الأطفال والأطفال ليش
+
+238
+00:22:40,360 --> 00:22:47,720
+الأطفال والأطفال؟ بيفقد كمية ده هو كل ال size و
+
+239
+00:22:47,720 --> 00:22:51,900
+blood عنده رسميًا قليل فهو لما يفقد هذه الكمية
+
+240
+00:22:51,900 --> 00:22:59,140
+المهولة ممكن يخش في shock باسكولر شك The two
+
+241
+00:22:59,140 --> 00:23:02,080
+medications most commonly reported to cause
+
+242
+00:23:02,080 --> 00:23:06,350
+diarrhea are the protease inhibitors اللي هو
+
+243
+00:23:06,350 --> 00:23:13,570
+مضادات للفيروس، بعض الفيروسات مثلًا نلفين أفير و
+
+244
+00:23:13,570 --> 00:23:19,930
+رايتون أفير أفير يعني virus، antivirus يعني نلفين
+
+245
+00:23:19,930 --> 00:23:25,590
+أفير و رايتون أفير Antihermis, drugs, كمان
+
+246
+00:23:25,590 --> 00:23:30,330
+Zubirax، Zubirax هذا إيه Zubirax؟
+
+247
+00:23:34,640 --> 00:23:39,540
+القرنية Herpes, Simplex, Keratitis القرحة
+
+248
+00:23:39,540 --> 00:23:44,920
+القرنية وإذا أعطيه إيه؟ زوغيراكس ماريش مراكز
+
+249
+00:23:44,920 --> 00:23:48,300
+زوغيراكس؟ مارها خمس مراكز في اليوم يفضل يحط خمس
+
+250
+00:23:48,300 --> 00:23:52,400
+مراكز أسبوع وبعدين يقللها ثلاث مراكز كمان أسبوع
+
+251
+00:23:52,400 --> 00:23:56,120
+ثاني عشان القرحة، يفال زوغيراكس هو antivirus في
+
+252
+00:23:56,120 --> 00:23:56,680
+female tablets
+
+253
+00:24:04,870 --> 00:24:07,930
+هذا ال medications يعني في كمان antibiotics بتعمل
+
+254
+00:24:07,930 --> 00:24:12,970
+إسهال مثلًا الكوليشيسين هذا الجوت، الجوت مرض
+
+255
+00:24:12,970 --> 00:24:16,690
+الملوك، عارفين الجوت؟ آه الجوت معروف مع مرض
+
+256
+00:24:16,690 --> 00:24:20,070
+الملوك، الكوليشيسين بياخدو اليه forever يعني، هذا
+
+257
+00:24:20,070 --> 00:24:23,590
+بيعمل إسهال مثلًا، في أدوية على طول بتعمل من أول
+
+258
+00:24:23,590 --> 00:24:29,010
+course يعني إذا كانت أولوية أو أولوية أو أولوية أو
+
+259
+00:24:29,010 --> 00:24:31,150
+أولوية أو أولوية أو أولوية أو أولوية أو أولوية أو
+
+260
+00:24:31,150 --> 00:24:31,530
+أولوية أو أولوية أو أولوية أو أولوية أو أولوية أو
+
+261
+00:24:31,530 --> 00:24:32,090
+أولوية أو أولوية أو أولوية أو أولوية أو أولوية أو
+
+262
+00:24:32,090 --> 00:24:34,650
+أولوية أو أولوية أو أولوية أو أولوية أو أولوية أو
+
+263
+00:24:34,650 --> 00:24:37,790
+أولوية أو أولوية أو أولوية أو أولوية أو أولوية أو
+
+264
+00:24:37,790 --> 00:24:39,690
+أولوية أو أولوية أو أولوية أو أولوية أو أولوية أو
+
+265
+00:24:39,690 --> 00:24:42,030
+أولوية أو أولوية أو أولوية أو أولوية أو أولوية أو
+
+266
+00:24:42,030 --> 00:24:51,230
+أولوية أو أولوية أو أولوية أو أولوية أو أولوية أو
+
+267
+00:24:51,230 --> 00:24:53,050
+أولوية أو
+
+268
+00:24:55,110 --> 00:25:00,070
+أو أي drug ثاني وبدأ معاه ال motion يزيد ويصبح
+
+269
+00:25:00,070 --> 00:25:04,490
+liquid ويبقى اليوم يومين ثلاثة لا نستناشي لازم
+
+270
+00:25:04,490 --> 00:25:09,730
+نوقف الدواء و نذهب إلى الطبيب وكمان هو هذا
+
+271
+00:25:09,730 --> 00:25:15,230
+لحياتكم هذا لحياتكم لازم تعرفوا يبقى الإسهال سهل
+
+272
+00:25:15,230 --> 00:25:18,590
+و ممتنع هو ممكن الإسهال من غير ال drug يصير معاه
+
+273
+00:25:18,590 --> 00:25:25,540
+إسهال لو اتبرد خاصة اللي بتعشى أكلة سمينة و بينام و
+
+274
+00:25:25,540 --> 00:25:29,320
+إشي بيصبح دي سبيبس يوم على رياريه وكلام زي هذا،
+
+275
+00:25:29,320 --> 00:25:32,880
+مش هذا كثير بخوف، إما إذا الطعام حالك بالذهب في
+
+276
+00:25:32,880 --> 00:25:36,920
+عيد الفطر، عارفين في عيد الفطر ده إيش؟ بيصير؟ ذهريت؟
+
+277
+00:25:36,920 --> 00:25:40,200
+وإحنا vomiting؟ لأن المهدأ بتكون تعولت ثلاثين
+
+278
+00:25:40,200 --> 00:25:45,140
+يومًا، ثلاثين يومًا على إيش؟ رجيم معين، فإذا كان
+
+279
+00:25:45,140 --> 00:25:46,620
+الإنسان أول نوم
+
+280
+00:25:51,100 --> 00:25:56,680
+خاصة بالحلويات واللحوم، فإنه طبعًا يصير dyspepsia
+
+281
+00:25:56,680 --> 00:26:01,260
+و maldigation، رشد الحضن وكلام زي هذا، وصيروا إيش؟
+
+282
+00:26:01,260 --> 00:26:05,740
+vomiting وإسهال ورفقة وكلام زي هذا عشان كثير
+
+283
+00:26:05,740 --> 00:26:11,300
+كانوا حاضرينه وأنا واقفال إياكم من يوم الإيد، خلي
+
+284
+00:26:11,300 --> 00:26:17,150
+الإيد تساعد، إياكم من يوم الإيد خاصة أن في عادة طيبة
+
+285
+00:26:17,150 --> 00:26:22,830
+في مجتمعنا، أنه يعني الرجال يقوفون على البلود،
+
+286
+00:26:22,830 --> 00:26:26,190
+الأرحام، صرف الأرحام، صرف الأرحام والعينية
+
+287
+00:26:29,890 --> 00:26:34,490
+ففي كل بيت لو يعني تلقوا القريمة الحلوة والبيت
+
+288
+00:26:34,490 --> 00:26:38,850
+بتلقوا الحلوة عشرين بيت بيكون صارعد وكمية ضخمة
+
+289
+00:26:38,850 --> 00:26:43,250
+وهذه بتعمل لكم التخمة، بتعمل لكم الإسهال والتقريب،
+
+290
+00:26:43,250 --> 00:26:47,690
+لذلك يعني كل واحد ياخذها في يده وهو ماشي يعني
+
+291
+00:26:47,690 --> 00:26:50,530
+يعني يعطيها لطفل في الشارع أو حاجة، المهم أنه ما
+
+292
+00:26:50,530 --> 00:26:50,710
+يكون 
+
+293
+00:27:01,670 --> 00:27:07,630
+لشك أنه شيء ملعب لما يحكي نفخة بيجي معاها كوليك
+
+294
+00:27:07,630 --> 00:27:14,450
+إيش كوليك؟ مرس O L I C فبعد كوليك من وأنا وأنا
+
+295
+00:27:14,450 --> 00:27:17,270
+في منه Intestinal
+
+296
+00:27:37,240 --> 00:27:46,560
+هذه أشياء من اللي هو البطل فهو بيقول في ال gas and
+
+297
+00:27:46,560 --> 00:27:51,900
+bloating the smelly intestinal gas يعني الغاز اللي
+
+298
+00:27:51,900 --> 00:27:55,880
+إيه له رائحة كريهة وأبقوا معناه بلووتينج والنفخة
+
+299
+00:27:55,880 --> 00:28:00,860
+that any of the protease inhibitors مضاد الفيروسات
+
+300
+00:28:00,860 --> 00:28:05,260
+هذه can cause what usually disappear quickly if
+
+301
+00:28:05,260 --> 00:28:09,060
+the offending drugs are descriptor كنت قبل يعني
+
+302
+00:28:09,060 --> 00:28:12,140
+إذا كان إحنا بدأنا في علاج أول حبة وثاني حبة و
+
+303
+00:28:12,140 --> 00:28:16,740
+عملنا نفخة ومرس موقف العلاج يوم
+
+304
+00:28:28,860 --> 00:28:33,060
+أفضل أن تستمر في الاستمرار في الاستمرار في
+
+305
+00:28:33,060 --> 00:28:33,860
+الاستمرار في الاستمرار في الاستمرار في الاستمرار
+
+306
+00:28:33,860 --> 00:28:42,200
+في الاستمرار في الاستمرار في الاستمرار
+
+307
+00:28:42,200 --> 00:28:50,820
+في الاستمرار
+
+308
+00:28:50,820 --> 00:28:56,700
+في الاستمرار
+
+309
+00:29:01,620 --> 00:29:07,840
+وDigestine وكلام زي هذا بتخفف الغازات، بتخفف
+
+310
+00:29:07,840 --> 00:29:14,020
+النفخة والغازات It was also that taking pancreatic
+
+311
+00:29:14,020 --> 00:29:18,420
+enzymes one or more taken with every meal can open
+
+312
+00:29:18,420 --> 00:29:24,000
+eliminate the problem لكن عليا النفخة والغازات
+
+313
+00:29:24,000 --> 00:29:27,580
+أحيانًا بتأتي من البرد وأحيانًا بتأتي من ال
+
+314
+00:29:27,580 --> 00:29:28,140
+parasites
+
+315
+00:29:35,870 --> 00:29:42,730
+هيعمل أموات طفيلية داخل الأمعاء بتعمل gas بتعمل
+
+316
+00:29:42,730 --> 00:29:47,730
+floating بتعمل كلّه لكن
+
+317
+00:29:47,730 --> 00:29:51,570
+لو إحنا كنا مرتاحين وأخدنا ال drug وال drug هو
+
+318
+00:29:51,570 --> 00:29:56,030
+اللي عملنا بيكون الإشارة له أنه المسبب لما نحن
+
+319
+00:29:56,030 --> 00:29:56,250
+فيه
+
+320
+00:30:02,720 --> 00:30:06,540
+بعض الناس تستخدم الهليكز كميزة من مصادر الحرارة
+
+321
+00:30:06,540 --> 00:30:12,920
+.طبعًا واحد ما ينام ليلة للصباح بيصبح مسطنان، واحد
+
+322
+00:30:12,920 --> 00:30:19,560
+همه وغمه، موضوع بيصبح مسطنان، واحد ترسل 4 ساعات
+
+323
+00:30:19,560 --> 00:30:22,860
+زيادة ومع شوية الـstigmatism
+
+324
+00:30:32,080 --> 00:30:35,960
+مش حق بس ال drugs هو التفكير في الحياة أو نشرت
+
+325
+00:30:35,960 --> 00:30:41,100
+أخبار في أعمار السوداء ناهيك أن يكون فيه يعني
+
+326
+00:30:41,100 --> 00:30:52,400
+أشياء شخصية يعني
+
+327
+00:30:52,400 --> 00:30:58,490
+بعد علاج معين عام السوداء والأسباب التالية هيما
+
+328
+00:30:58,490 --> 00:31:02,570
+الصداع، and others they may remain long term للأسف
+
+329
+00:31:02,570 --> 00:31:07,390
+أنه أحيانًا بده يفضل الصداع هذا بدأ ب drug لكن ممكن
+
+330
+00:31:07,390 --> 00:31:12,290
+يفضل سنين and the only solution may be a drug
+
+331
+00:31:12,290 --> 00:31:14,750
+switch يعني أن أغير العلاج
+
+332
+00:31:22,590 --> 00:31:25,650
+الإيهيلك قد بدأت عندما بدأت مجرد صداع جديد لدراسة
+
+333
+00:31:25,650 --> 00:31:43,950
+مجرد صداع جديد لدراسة مجرد صداع جديد لدراسة
+
+334
+00:31:43,950 --> 00:31:45,890
+مجرد صداع جديد
+
+335
+00:31:52,660 --> 00:31:57,600
+of using a particular drug يعني ممكن أن واحد يبدأ
+
+336
+00:31:57,600 --> 00:32:01,860
+بدراك ما يصليش معاه صداعه بعد شهر أو أسبوعين أو
+
+337
+00:32:01,860 --> 00:32:05,980
+ثلاثة يبدأ معاه الصداعه يضايق أنه عمله تحسس
+
+338
+00:32:05,980 --> 00:32:10,820
+ميكروفه headaches can also be a symptom of many
+
+339
+00:32:10,820 --> 00:32:15,600
+different infections and conditions يعني أنا سنجلو
+
+340
+00:32:15,600 --> 00:32:17,400
+في أي واحد مع صينوسايتس
+
+341
+00:32:21,790 --> 00:32:28,390
+بيعمله صداع واحد مع dental case تسوس الأسنان بيعمله
+
+342
+00:32:28,390 --> 00:32:33,970
+صداع واحد مع chronic constipation اللي هو إمساك
+
+343
+00:32:33,970 --> 00:32:38,830
+مزمن بيعمله صداع في أشرفين بيعمله صداع كانوا في
+
+344
+00:32:38,830 --> 00:32:43,050
+كرة الطب يقولون في مئة وواحد سبب لصداع مش مئة
+
+345
+00:32:43,050 --> 00:32:49,180
+مئة وواحد سبب لصداع طبعًا العين إلها الأنف إلها،
+
+346
+00:32:49,180 --> 00:32:54,440
+الأسنان إلها، المعدة إلها، الأمعاء إلها، البرد
+
+347
+00:32:54,440 --> 00:32:59,920
+إلها، البرد إلها في موضوع الصداع، أشياء كثيرة،
+
+348
+00:32:59,920 --> 00:33:04,180
+الهم، الغم، الصحراء، عدم انتظام النوم، يعني واحد مش
+
+349
+00:33:04,180 --> 00:33:06,900
+منتظم في نومه، بيفتح الصفر على الساعة ثلاثة وما بي
+
+350
+00:33:06,900 --> 00:33:13,220
+ينام لساعة ثمانية الصباح، بيقوم برقم صدر، some of
+
+351
+00:33:13,220 --> 00:33:18,270
+which could be fatal if a diagnosis آه يعني في صداع
+
+352
+00:33:18,270 --> 00:33:23,430
+واحد مرتفع ضغط دمه لـ 200 مثلًا وهو مش داري ممكن
+
+353
+00:33:23,430 --> 00:33:27,490
+يموت يكمل
+
+354
+00:33:27,490 --> 00:33:31,030
+ال headaches بندرقس can induce acute headache
+
+355
+00:33:31,030 --> 00:33:36,030
+including زي ما إيش نيترو غليسرين نيترو غليسرين
+
+356
+00:33:36,030 --> 00:33:42,130
+هالي spray أو tablets تتاخد لإيش؟ تتاخد لتوسيع
+
+357
+00:33:42,130 --> 00:33:45,670
+الشرايين عشان ينزل الدم فيها وينزل الدم فيها يعني
+
+358
+00:33:45,670 --> 00:33:51,590
+مثلًا واحد حاسس ب angina pain ضمة صدرية الضمة
+
+359
+00:33:51,590 --> 00:33:55,470
+الصدرية بتيجي هاني من قلة الدم إلى عضلة القلب
+
+360
+00:33:55,470 --> 00:34:03,410
+angina pectus فهو يعني الرجل أو المريض ماشي وحاسس
+
+361
+00:34:03,410 --> 00:34:07,270
+لما تيجي الألم شديد هي يطبق على صدره ويمسك حتة
+
+362
+00:34:07,270 --> 00:34:12,830
+هوفة تحت اللسان صعب لينجيت يصير على تحت اللسان
+
+363
+00:34:12,830 --> 00:34:16,030
+وبتروح على الدم بتوسيعه الشرايين الشرايين اللي كان
+
+364
+00:34:16,030 --> 00:34:23,030
+قواري ضايق بتوسعه بيجي دم بيروح للقلب للأسف اللي
+
+365
+00:34:23,030 --> 00:34:28,430
+على ال Nitroglycerin دي عمل super headache دي
+
+366
+00:34:28,430 --> 00:34:32,610
+عمل لأنه بيستغر فيه نقاط ال people who have
+
+367
+00:34:32,610 --> 00:34:36,790
+coronary heart disease كمان زي ال Nitroglycerin
+
+368
+00:34:36,790 --> 00:34:38,950
+Antihypertensive agents
+
+369
+00:34:48,250 --> 00:34:57,410
+خمسين نوع لهو تنزيل ضغط الدم في اللي هو حاجة اسمها
+
+370
+00:34:57,410 --> 00:35:01,010
+راتدين والراندين والسيميتدين في عيلة ثانية اسمها
+
+371
+00:35:01,010 --> 00:35:06,190
+ACE receptor antagonist الراتدين
+
+372
+00:35:06,190 --> 00:35:10,270
+والراندين والجي اي كير المرة القادمة إن شاء الله
+
+373
+00:35:10,270 --> 00:35:14,850
+بدي كل طالبة منكم تكون جايبالي ورق الداخلية بتاعة
+
+374
+00:35:14,850 --> 00:35:15,250
+العلبة
+
+375
+00:35:18,350 --> 00:35:23,890
+أسألوا في قصة درية عندكم، قولوا بدنا .. ده هو
+
+376
+00:35:23,890 --> 00:35:29,130
+المعنى راتدين شركة ثانية اسمها RANDIN تسمي الشركة
+
+377
+00:35:29,130 --> 00:35:34,110
+الثالثة بتسمي DI CARE, gastrointestinal care وفي
+
+378
+00:35:34,110 --> 00:35:39,230
+قريب منه فامودين لازم تجيبولي .. يعني تقرأوها و
+
+379
+00:35:39,230 --> 00:35:44,210
+تجيبولي إياها وحطها هنا عشان هذا نشاطنا أنا بدي
+
+380
+00:35:44,210 --> 00:35:47,290
+أكوا ماش تاخدوا كلام بيقولوا يعني أنه إحنا متكلم
+
+381
+00:35:47,290 --> 00:35:51,270
+في كوكب آخر، لأ، هذا شيء في حياتكم العملية راح
+
+382
+00:35:51,270 --> 00:35:56,910
+يكون موجود، هذه الأدوية، أدوية ضبط الدم، أدوية
+
+383
+00:35:56,910 --> 00:36:01,330
+اللي هو الـNitroglycerin، أدوية الراتدين والميدا
+
+384
+00:36:01,330 --> 00:36:05,630
+والكلام هذا، حتى من ضبط المدرس والكلام هذا، مافي
+
+385
+00:36:05,630 --> 00:36:09,510
+إنسان متعلم زيكم هيستغني عن هذه الأدوية يكون عنده
+
+386
+00:36:09,510 --> 00:36:15,770
+صداع في البيئة، طب لو استخدمها خطأ مش هسي استخدام
+
+387
+00:36:15,770 --> 00:36:20,250
+الخطأ استخدام الخطأ الأدوية ممكن يعمل كمان بيعمل
+
+388
+00:36:20,250 --> 00:36:24,090
+صداع الـ non-steroidal anti-inflammatory drugs
+
+389
+00:36:24,090 --> 00:36:30,170
+اللي جبتها الـ N-A هذي non-steroidal في منها بيعمل
+
+390
+00:36:30,170 --> 00:36:36,230
+صداع خاصة كبسولات اسمها endometazine اندوسيد أو
+
+391
+00:36:36,230 --> 00:36:41,550
+اندولين تعمل صداع في الأدوية تحت سلطات
+
+392
+00:36:41,550 --> 00:36:46,700
+Cyclosporine وبعض الـ Antibiotics من الـ
+
+393
+00:36:46,700 --> 00:36:51,760
+Antibiotics تتراسيكلين
+
+431
+00:40:47,830 --> 00:40:52,670
+وفضلناهم على كثير ممن خلقنا يبقى بعض ال drugs
+
+432
+00:40:52,670 --> 00:40:59,090
+بتعمل loss of sexual interest ما فيش اهتمام 
+
+433
+00:40:59,090 --> 00:41:03,790
+بالموضوع يعني بيثبت فمثلا ران دين و رات دين هذا 
+
+434
+00:41:03,790 --> 00:41:08,370
+الآخر يقول فامو دين هذا بيثبت الـ ارجانسيين ما فيش
+
+435
+00:41:08,370 --> 00:41:15,170
+ميل عند الذكر أو الأنثى. انتصار بعض الأدوية تعمل
+
+436
+00:41:15,170 --> 00:41:23,630
+erectile difficulties الانتصاب بيصير صعب خلاص
+
+437
+00:41:23,630 --> 00:41:29,390
+ما فيش في difficulties in reaching orgasm in both
+
+438
+00:41:29,390 --> 00:41:33,690
+men and women orgasm قمة الـ رغبة  قمة الـ رغبة
+
+439
+00:41:33,690 --> 00:41:38,690
+اسمها orgasm يعني في بعض الأدوية لا تجعل
+
+440
+00:41:42,140 --> 00:41:45,280
+الذين يتقبلون فعلياً are frequently grown side effects
+
+441
+00:41:45,280 --> 00:41:49,380
+of some medications يعني الناس بيكونوا مش عارفين 
+
+442
+00:41:49,380 --> 00:41:53,360
+أن هذا صار عدم الرغبة الجنسية والـ orgasm ما يوصلش 
+
+443
+00:41:53,360 --> 00:41:58,080
+لها أن من علاج كذا هو بياخده خاصة إن كان بياخده 
+
+444
+00:41:58,080 --> 00:42:03,480
+بشكل دائم. أنتوا عارفين كبار السن؟ إن شاء الله
+
+445
+00:42:03,480 --> 00:42:08,540
+تُصبحوا كبار السن وأنتم سالمين. كبار السن أجهزتهم
+
+446
+00:42:08,540 --> 00:42:13,210
+كثير بتبدأ عندهم شكاوى سواء الجهاز الهضمي، الجهاز 
+
+447
+00:42:13,210 --> 00:42:19,430
+العصبي، المفاصل، المعدة
+
+448
+00:42:19,430 --> 00:42:25,970
+تبدأ تشتكي مع طول الأمد، فيصفوا علاج ياخده خلاص، 
+
+449
+00:42:25,970 --> 00:42:30,510
+يعني على المدى، القلق، والقلب وما القلب والكلام
+
+450
+00:42:30,510 --> 00:42:37,130
+هذا، وضغط الدم. بعض هذه العلاجات تسبب تأخرًا في
+
+451
+00:42:37,130 --> 00:42:40,770
+الوظائف الجنسية عند الجنسين أو الجنسية 
+
+452
+00:42:45,230 --> 00:42:50,650
+أشخاص يأخذون مضادات الفيروسية خاصة الـ AIDS، ولكن
+
+453
+00:42:50,650 --> 00:42:55,490
+يحتاج المزيد من المحاولة لتوضيح إذا كانت الدروس 
+
+454
+00:42:55,490 --> 00:43:01,350
+حقيقية أسباب المشاكل. هو أحيانًا يعني بيصير حتى كبار
+
+455
+00:43:01,350 --> 00:43:07,490
+السن خاصة النساء في سن بعد الـ 45 حتى هذه الوظائف
+
+456
+00:43:07,490 --> 00:43:12,440
+تبدأ تتراجع بشكل خطير. مش شرط يكون يعني بيأكل دواء 
+
+457
+00:43:12,440 --> 00:43:17,020
+حتى بعض الناس بعد الخمسين لو ما أخذش دواء يعني .. 
+
+458
+00:43:17,020 --> 00:43:24,740
+يعني هو بيخلق في هذه الوظائف. طيب في متوقع من وقت 
+
+459
+00:43:24,740 --> 00:43:30,200
+حلال كورب نبض عن general guidelines for handling 
+
+460
+00:43:30,200 --> 00:43:33,020
+.. اه والـ medications handling medications 
+
+461
+00:43:42,000 --> 00:43:48,680
+طبيبة أو مساعد طبي. اه كل ما فيه حق للطبيب لأنه 
+
+462
+00:43:48,680 --> 00:43:55,440
+الأدوية زي ما قلنا سلاح ذو حدين إما يعني يشفي وإما 
+
+463
+00:43:55,440 --> 00:44:03,300
+إما يُعمي يعني سلاح ذو حدين. فالآن هأتكلم بسرعة اللي
+
+464
+00:44:03,300 --> 00:44:06,900
+هو الـ general guidelines الخطوط العريضة للتعامل مع
+
+465
+00:44:06,900 --> 00:44:10,020
+الأدوية. أول شيء هو الـ preparing or giving
+
+466
+00:44:13,110 --> 00:44:18,250
+Concentrate your whole attention on what are you
+
+467
+00:44:18,250 --> 00:44:24,610
+doing يعني أنا عندي تلات أربع أدوية يعني على المكتب
+
+468
+00:44:24,610 --> 00:44:28,070
+والآن أنا نفسي بدي آكل دواء أو بدي أعطي غيري دواء
+
+469
+00:44:28,070 --> 00:44:33,830
+بيقول لك أنّه concentrate بكله attention في الدواء 
+
+470
+00:44:33,830 --> 00:44:37,810
+تعطي دواء بدل دواء. أغلق جوعك 
+
+471
+00:44:44,880 --> 00:44:51,160
+تعطي الدواء فاعتنى، تعطيّه وأنت نائم، تعطيّه يعني
+
+472
+00:44:51,160 --> 00:44:55,820
+بدون اهتمام، لأ تمامًا لأنّ الدواء زي كارت السيارة،
+
+473
+00:44:55,820 --> 00:44:58,780
+بينفع واحد ويقول السيارة مضللة ويطلع ورا و.. وبعد
+
+474
+00:44:58,780 --> 00:45:03,600
+كذلك قدامه ممكن إيش يقتل الناس، والدواء نفس الشيء، 
+
+475
+00:45:03,600 --> 00:45:05,960
+فهو بيقول concentrate your 
+
+476
+00:45:10,390 --> 00:45:16,510
+أقوم بالتأكيد بأنّ لديك رسالة مكتوبة لكل مريض
+
+477
+00:45:16,510 --> 00:45:22,550
+التي ستتبعها. يعني في وصفة ومكتوبة على العلبة بقى
+
+478
+00:45:22,550 --> 00:45:28,970
+الطريقة والجُرعة والعدد الجُرعات والجُرعة قد إيش 
+
+479
+00:45:28,970 --> 00:45:35,130
+بالضبط. كأنّ واحد ما بيشتغل في هذه الحالة. كأنّ واحد بدل ما 
+
+480
+00:45:35,130 --> 00:45:38,210
+يروح يجيب ماءِلة ويحط في الماءِلة مثلًا. يملأ الماءِلة
+
+481
+00:45:38,210 --> 00:45:44,150
+يروح ياخذ في غطاء السائل في الغطاء مليانه ويَشربها 
+
+482
+00:45:44,150 --> 00:45:50,270
+يمكن تلات معالجات. رجع اقرأ
+
+483
+00:45:50,270 --> 00:45:54,430
+الـ label المُلصق اللي عليه before taking, using
+
+484
+00:45:54,430 --> 00:46:00,730
+and returning the drug to its place. بعد هذا بنحط
+
+485
+00:46:11,770 --> 00:46:15,590
+الـ label should be clear لازم كل علبة يكون عليها 
+
+486
+00:46:15,590 --> 00:46:21,230
+ملصق وملصق الـ direction عليه clear مش أنا أجيب
+
+487
+00:46:21,230 --> 00:46:26,490
+دواء ممسوح لي عليه وجاي عليها سائل وممسوحة أقول
+
+488
+00:46:26,490 --> 00:46:31,110
+الجطر هادي يا ولادي ليش والله يبينها أتربيول لأ
+
+489
+00:46:31,110 --> 00:46:34,090
+مش أتربيول يا شيخ المرض حيوي بنحط ملصق .. بنفعش
+
+490
+00:46:34,090 --> 00:46:39,430
+هذا الكلام الإنسان مش لتجارب. تجارب لها حيوانات 
+
+491
+00:46:39,430 --> 00:46:45,090
+أخرى غير الإنسان. Never give medicines from
+
+492
+00:46:45,090 --> 00:46:49,570
+unlabeled container أي كنت هنا سواء علبة سواء 
+
+493
+00:46:49,570 --> 00:46:56,030
+زجاجة بلاستيك ما فيش عليه label أنت طبّ بوش six major 
+
+494
+00:46:56,030 --> 00:46:59,730
+quantities and calculate doses as ordered in
+
+495
+00:46:59,730 --> 00:47:06,250
+proper way لأجل حيال أطفال كم نُعطي الطفل الدكتور
+
+496
+00:47:06,250 --> 00:47:11,910
+مثلًا كاتب عشرة ملي جرام لكل كيلو جرام 
+
+497
+00:47:16,510 --> 00:47:23,530
+عشرة ملي جرام في عشرة ملي جرام في عشرة كيلو
+
+498
+00:47:23,530 --> 00:47:25,810
+في عشرة ملي جرام في عشرة ملي جرام في عشرة ملي جرام
+
+499
+00:47:25,810 --> 00:47:29,230
+في عشرة ملي جرام في عشرة ملي جرام في عشرة ملي جرام
+
+500
+00:47:29,230 --> 00:47:34,810
+في عشرة ملي جرام في عشرة
+
+501
+00:47:34,810 --> 00:47:35,110
+ملي جرام 
+
+502
+00:47:39,030 --> 00:47:42,610
+يبقى الـ calculation للجسم مهم جداً باش معقول واحد
+
+503
+00:47:42,610 --> 00:47:48,470
+وزن الخمسين زي واحد وزنه مية لأ مهم زي بعضها 
+
+504
+00:47:48,470 --> 00:47:55,190
+Handling tablets, capsules and pills properly and 
+
+505
+00:47:55,190 --> 00:47:59,790
+don't touch with fingers يعني أنا ما أجيش أنا أفتح
+
+506
+00:47:59,790 --> 00:48:04,450
+الـ رولبك وأحط أصابعي وأفضل واحدة وأعمل أهي يمكن
+
+507
+00:48:04,450 --> 00:48:11,340
+أصابعي ملطخة فيه لأ في الـ cup الغطاء بنزل واحدة و
+
+508
+00:48:11,340 --> 00:48:16,540
+بعدين باخدها بستخدم أيدي إلا إذا أنا متأكد إن
+
+509
+00:48:16,540 --> 00:48:22,920
+يدي نظيفة مية في المية. Avoid wastage of medicines
+
+510
+00:48:22,920 --> 00:48:28,380
+شخص بيحط للطفل في الملعقة بيكوب أكثر من الملعقة
+
+511
+00:48:28,380 --> 00:48:33,580
+بره wastage يعني خسارة بره من غير فائض some
+
+512
+00:48:33,580 --> 00:48:37,820
+preparations as insulin vaccines عن الـ subcutaries
+
+513
+00:48:37,820 --> 00:48:42,900
+must be kept in the refrigerator في الثلاجة احنا
+
+514
+00:48:42,900 --> 00:48:48,220
+قلنا الـ subcutaries بتسيح اه بيصير .. لا تُستعمل 
+
+515
+00:48:48,220 --> 00:48:54,820
+كمان الـ maxins والـ insulin وأشياء أخرى في 
+
+516
+00:48:54,820 --> 00:48:58,160
+الثلاجة لابد تكون .. أنا أسكن في الثلاجة في كهرباء
+
+517
+00:48:58,160 --> 00:49:02,780
+stay with the patient until he takes his medicine 
+
+518
+00:49:02,780 --> 00:49:04,880
+يعني أنا ما أدّيش له الوضع الصغير أقوله خذ الحبة 
+
+519
+00:49:04,880 --> 00:49:11,250
+هنبلعها ودي ظهري يمكن يرميها فعلاً أقول لكم احنا
+
+520
+00:49:11,250 --> 00:49:16,290
+الطفل أنت بتعطيه الشراب وتروح كده تجيء عامل 
+
+521
+00:49:16,290 --> 00:49:21,790
+vomiting طلعها ثاني مش محسوبة مش محسوبة أقول لكم 
+
+522
+00:49:21,790 --> 00:49:25,230
+حاجة ثانية استيقظوا ابنتكم ليه لو حاطّينه في الـ هين
+
+523
+00:49:25,230 --> 00:49:29,930
+أو لأ ربما حاطّينه في الـ هين وبكى دمه طلع مش محسوبة 
+
+524
+00:49:29,930 --> 00:49:32,170
+طيب 
+
+525
+00:49:34,510 --> 00:49:38,450
+All mixtures should be made immediately before
+
+526
+00:49:38,450 --> 00:49:41,610
+use. أحيانًا خلطات دواء دواء مع دواء دواء مع دواء
+
+527
+00:49:41,610 --> 00:49:45,490
+ما يكونش محضرة من زمان، لأ أحضرها في الحال. Never 
+
+528
+00:49:45,490 --> 00:49:50,830
+return unused drug to stock. يعني مثلًا في دواء زاد
+
+529
+00:49:50,830 --> 00:49:53,250
+بره، من الجرعة، مع كروب 
+
+530
+00:49:57,120 --> 00:50:03,300
+Don't use clear solutions which has been cloudy or 
+
+531
+00:50:03,300 --> 00:50:08,540
+has sediment. إيش يعني؟ يعني أنا مثلًا الآن فتحت
+
+532
+00:50:08,540 --> 00:50:13,660
+إجازة الدواء وجيتها sedimented، مترسب، الـ color
+
+533
+00:50:13,660 --> 00:50:19,360
+بتاعها كانت clean، صار أسود، تكون خربانة، فاسدة،
+
+534
+00:50:19,360 --> 00:50:23,340
+كان في sedimentation أو تغير في اللون، لأ، كمان الـ
+
+535
+00:50:23,340 --> 00:50:27,500
+expire date أجرة، لازم أجرة الـ expire date مقرر من 
+
+536
+00:50:27,500 --> 00:50:32,400
+الـ antibiotic سنتين وغالباً آخر شهرين الناس بقوا
+
+537
+00:50:32,400 --> 00:50:35,680
+ياخذوا الـ antibiotic اللي يفضله شهرين لأنه بيكون
+
+538
+00:50:35,680 --> 00:50:39,940
+الجو والتخزين وخرب خلاص. يبقى الـ expiring day مهم
+
+539
+00:50:39,940 --> 00:50:46,020
+نقرأ الأهم السكر والملح والسيرج والزيوتر كلها عليه 
+
+540
+00:50:46,020 --> 00:50:49,280
+expiring day يعني الناس تعلموا حاجات كثيرة كله 
+
+541
+00:50:49,280 --> 00:50:55,280
+عليه expiring day كمان أي change in color بتاخدوش 
+
+542
+00:50:55,840 --> 00:50:59,300
+أي داوت in mind بيصير شركة تاخدوش أو شاور فيه 
+
+543
+00:50:59,300 --> 00:51:07,080
+بعدين الأقراص المخدرة والمنومة لازم تكون في رقم
+
+544
+00:51:07,080 --> 00:51:12,420
+كربورت كربورت يعني دولار مغلق لأنّ كثير ناس بتربي 
+
+545
+00:51:12,420 --> 00:51:17,620
+المخدرات أترمال وغير أترمال وكلام زي هذا الأشياء 
+
+546
+00:51:17,620 --> 00:51:20,400
+اللي هي المسكنات القوية هذه لازم تكون مغلق عليها
+
+547
+00:51:20,400 --> 00:51:22,600
+حتى لو في البيت حتى لو في البيت الناس اللي عليها
+
+548
+00:51:22,600 --> 00:51:32,920
+أحد. آخر شيء بتقول أنا الـ four أو five rights وهذا
+
+549
+00:51:32,920 --> 00:51:39,740
+بتهمني كثير أنّ أنا أعطي right patient ما تعطي دواء 
+
+550
+00:51:39,740 --> 00:51:47,240
+لوحد غير واحد. right drug right dose right road of
+
+551
+00:51:47,240 --> 00:51:50,700
+administration فرد تقتل الدواء و right time في
+
+552
+00:51:50,700 --> 00:51:52,780
+الوقت المناسب. five rights
+
+553
+00:52:03,580 --> 00:52:07,460
+بالطريقة المناسبة أو المكتوبة وأعطي في الوقت 
+
+554
+00:52:07,460 --> 00:52:10,640
+المناسب. شكرًا لكم على قسم الاستماع
+
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/fuo-IOgcd38_raw.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/fuo-IOgcd38_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..38738b4fbb3c1940aabff2e41baddf5cce13cdae
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/fuo-IOgcd38_raw.srt
@@ -0,0 +1,2048 @@
+1
+00:00:20,720 --> 00:00:23,740
+أعوذ بالله من الشيطان الرجيم بسم الله الرحمن
+
+2
+00:00:23,740 --> 00:00:28,120
+الرحيم الحمد لله يا رب العالمين و أصلي و أسلم على
+
+3
+00:00:28,120 --> 00:00:32,260
+النبي الأمين محمد و على أهله و أصحابه والتابعين
+
+4
+00:00:32,260 --> 00:00:37,040
+السلام عليكم و رحمة الله وبركاته هذا اليوم سنكمل
+
+5
+00:00:37,040 --> 00:00:42,900
+ما كنا قد بدأنا من قطرة Cyclopentolite as a
+
+6
+00:00:42,900 --> 00:00:45,180
+cycloplegic rocks
+
+7
+00:00:52,580 --> 00:00:56,120
+لأن في جميع الحالات، الـ Residual accommodation
+
+8
+00:00:56,120 --> 00:01:04,560
+يكون حوالي 1.5 أو أقل بعد 40 إلى 60 دقيقة بعد
+
+9
+00:01:04,560 --> 00:01:11,420
+الإنسلاك، يعني الـ Residual accommodation 1.5
+
+10
+00:01:11,420 --> 00:01:17,620
+دقيقة أو أقل بعد 40 إلى 60 دقيقة في موقعنا نفسنا،
+
+11
+00:01:17,620 --> 00:01:21,000
+وهذا الـ Depth of accommodation هو
+
+12
+00:01:22,790 --> 00:01:29,410
+Death for retinoscopy under sacrifice.اللي هشوف
+
+13
+00:01:29,410 --> 00:01:34,030
+بعض ال drugs بيسيب اربعة او كمس او ستة residual
+
+14
+00:01:34,030 --> 00:01:38,710
+accommodation. Residual accommodation يعني the
+
+15
+00:01:38,710 --> 00:01:42,830
+contractility of the ciliary muscle او ability to
+
+16
+00:01:42,830 --> 00:01:48,210
+contract. هنا ability to contract very low. One
+
+17
+00:01:48,210 --> 00:01:52,820
+point five or less.فهذا بيُختار إنه strong
+
+18
+00:01:52,820 --> 00:01:56,220
+cyclopidic
+
+19
+00:01:56,220 --> 00:02:02,360
+بغض النطق على الأتروبين، فعلا، فعلا Although not
+
+20
+00:02:02,360 --> 00:02:06,200
+infrequently a second drop of solution might be
+
+21
+00:02:06,200 --> 00:02:08,700
+necessary to reduce the accommodation to this
+
+22
+00:02:08,700 --> 00:02:12,340
+level يعني هذا level مابتيهش بس من نقطة واحدة، إنه
+
+23
+00:02:12,340 --> 00:02:15,900
+قد نحتاج نقطة أخرى بعد عشرة دقائق
+
+24
+00:02:24,360 --> 00:02:29,280
+تقوم بتقومية تقومية
+
+25
+00:02:29,280 --> 00:02:29,860
+تقومية تقومية تقومية تقومية تقومية تقومية تقومية
+
+26
+00:02:29,860 --> 00:02:31,980
+تقومية تقومية تقومية تقومية تقومية تقومية تقومية
+
+27
+00:02:31,980 --> 00:02:33,980
+تقومية تقومية تقومية تقومية تقومية تقومية تقومية
+
+28
+00:02:33,980 --> 00:02:34,860
+تقومية تقومية تقومية تقومية تقومية تقومية تقومية
+
+29
+00:02:34,860 --> 00:02:36,020
+تقومية تقومية تقومية تقومية تقومية تقومية تقومية
+
+30
+00:02:36,020 --> 00:02:38,360
+تقومية تقومية تقومية تقومية تقومية تقومية تقومية
+
+31
+00:02:38,360 --> 00:02:39,360
+تقومية تقومية تقومية تقومية تقومية تقومية تقومية
+
+32
+00:02:39,360 --> 00:02:46,700
+تقومية تقومية تقومية تقومية ت
+
+33
+00:02:48,780 --> 00:02:53,040
+لسه بيكون فيه accommodation ممكن يقل كمان consider
+
+34
+00:02:53,040 --> 00:02:56,400
+that cyclopentolate monocloses approximated their
+
+35
+00:02:56,400 --> 00:02:59,300
+ideal criteria for a cyclopentolate or amniotic
+
+36
+00:02:59,300 --> 00:03:03,740
+than any other drug discovered up to that time
+
+37
+00:03:03,740 --> 00:03:10,040
+يعني لو افترضنا انه ال cyclopentolate هو الموجود
+
+38
+00:03:10,040 --> 00:03:16,300
+مع اخر يعني drugs غيره بغض النظر عن الأتروبيين هو
+
+39
+00:03:16,300 --> 00:03:23,070
+الأولك Cycloblegic وحتى مدرياتك عنده قدرة على
+
+40
+00:03:23,070 --> 00:03:26,910
+المدريازيز يعني جيدة هذا بعد الأتروبين؟ بعد
+
+41
+00:03:26,910 --> 00:03:32,450
+الأتروبين لأنه مناسب اتروبينا لصفحة لحاجة نعم صح
+
+42
+00:03:32,450 --> 00:03:37,250
+راجل له وعليه احنا بنتكلم الآن في حاجات short
+
+43
+00:03:37,250 --> 00:03:42,810
+acting مناسب لكل الأعمار هو هذا مناسب لكل الأعمار
+
+44
+00:03:42,810 --> 00:03:47,240
+إلا لإنفانتالإيزوتروبياصح الانفطار إزاتروبيا هو مش
+
+45
+00:03:47,240 --> 00:03:54,680
+مناسب، في عام تلت سنوات مثلا طيب، الآن بريسلي و
+
+46
+00:03:54,680 --> 00:03:59,500
+ميداين علموا comparison، إيش comparison؟ مقارنة،
+
+47
+00:03:59,500 --> 00:04:04,120
+بال depths of Sacroblegia reached one hour between
+
+48
+00:04:04,120 --> 00:04:07,440
+Sacroventolato ومقاتلوبيا، عشان يقايدوا إن
+
+49
+00:04:07,440 --> 00:04:08,440
+Sacroventolato أقوى
+
+50
+00:04:15,570 --> 00:04:20,350
+في عين اليمين، وعملوا في العين الشمال نقطة واحدة
+
+51
+00:04:20,350 --> 00:04:26,210
+من 5% هوماتروبين، بدهم يقارنوا ده يعني، مين أقوى؟
+
+52
+00:04:26,210 --> 00:04:29,430
+الـcyclopentrolate نصف فلمية والـhomotropin خمسة
+
+53
+00:04:29,430 --> 00:04:33,850
+فلمية، in a group of fifty patients which included
+
+54
+00:04:33,850 --> 00:04:39,490
+children and young adults، أطفال وبلغين سعر السنة،
+
+55
+00:04:39,490 --> 00:04:42,770
+the cyclopentrolate was installed in the right eye
+
+56
+00:04:42,770 --> 00:04:47,260
+and the homotropin in the left eyeوالتعاملات تظهر
+
+57
+00:04:47,260 --> 00:04:50,620
+أن التعاملات الاجتماعية لـ Sacramentolate تقريبا
+
+58
+00:04:50,620 --> 00:05:01,500
+بين 0.5 و 1.75 والمعادلة 1.25 ديكتر واحد و ربع
+
+59
+00:05:01,500 --> 00:05:04,080
+ديكتر للعين اليمين اللي حاط فيها عيش
+
+60
+00:05:04,080 --> 00:05:09,260
+Sacramentolate فنما هم أضربين one to three
+
+61
+00:05:20,080 --> 00:05:23,900
+فرض كبير كله في الآخر بنعكس على النتيجة بتاعت ال
+
+62
+00:05:23,900 --> 00:05:30,000
+prescription of glasses طيب،
+
+63
+00:05:30,000 --> 00:05:34,700
+الآن هنكمل على cyclopentolate يعني خلصنا الجراسة
+
+64
+00:05:34,700 --> 00:05:38,500
+هذه cyclopentolate full recovery of accommodation
+
+65
+00:05:38,500 --> 00:05:44,480
+يعني احنا حطينا نقطة او نقطتين cyclopentolate فيها
+
+66
+00:05:44,480 --> 00:05:49,330
+أثرين الأثر الأولهو psychopathy و الأخر الثاني هو
+
+67
+00:05:49,330 --> 00:05:53,770
+مدريازي هتشوف متى بيشفى الإنسان متى يعود إلى حالته
+
+68
+00:05:53,770 --> 00:05:59,250
+الطبيعية بيقوللي انه بالنسبة لل accommodation يعني
+
+69
+00:05:59,250 --> 00:06:03,990
+ال psychopathy تحتاج four to twelve hours طبعا في
+
+70
+00:06:03,990 --> 00:06:08,310
+variation بين البشر في واحد ممكن بعد أربع ساعات
+
+71
+00:06:08,310 --> 00:06:12,270
+يكون طبيعي ال accommodation مية في المية و في واحد
+
+72
+00:06:12,270 --> 00:06:17,240
+يمر بكل الساعة إلى اتناشر ساعةحسب لون ال ايريس
+
+73
+00:06:17,240 --> 00:06:19,820
+وحسب ال age وحسب ال activity و ال cellular muscle
+
+74
+00:06:19,820 --> 00:06:24,200
+فى حاجات كتيرة يعنى و ممكن واحد يكون يعني حط
+
+75
+00:06:24,200 --> 00:06:30,140
+القطرة خطأ ومادخلتش هى كما يعنى but in a few cases
+
+76
+00:06:30,140 --> 00:06:37,340
+this was delayed for 24 hours يعني 24 ساعة والطفل
+
+77
+00:06:37,340 --> 00:06:41,900
+او هذا اللى هو البالغ الصغير لاستطيع ان اترك 24
+
+78
+00:06:41,900 --> 00:06:42,140
+ساعة
+
+79
+00:06:45,130 --> 00:06:49,630
+من اربعة الى اتناش و افضل اقول ان هي ستة الى
+
+80
+00:06:49,630 --> 00:06:53,010
+تمانية يعني معظم الناس بياخد ستة الى تمان ساعات
+
+81
+00:06:53,010 --> 00:07:00,430
+full recovery of accumulation يعني الشفاء التام من
+
+82
+00:07:00,430 --> 00:07:03,930
+ال accumulation ان يتحرر تماما مية مية من اثر
+
+83
+00:07:03,930 --> 00:07:10,470
+الوثيقلوبنتوليت طيب الاخر ثاني reading متى يستطيع
+
+84
+00:07:10,470 --> 00:07:15,690
+ان يقرأطبعا ايش المناقبين ال reading و ال full
+
+85
+00:07:15,690 --> 00:07:20,750
+recovery و ال accommodation بيقوللي انه الانسان
+
+86
+00:07:20,750 --> 00:07:26,170
+ممكن انه يقرأ الخط الكبير بنصف accommodation او
+
+87
+00:07:26,170 --> 00:07:31,430
+تلتين accommodation يعني ال full recovery هياخد
+
+88
+00:07:31,430 --> 00:07:35,310
+وقت اكول من انه يقرأ بس الخط الكبير لأ يقرأ يعني
+
+89
+00:07:35,310 --> 00:07:39,740
+ممكن تروح في المدة ال practiceفي التمرين اللي صار
+
+90
+00:07:39,740 --> 00:07:42,300
+a more important consideration that for
+
+91
+00:07:42,300 --> 00:07:44,920
+restoration of accommodation was usually possible
+
+92
+00:07:44,920 --> 00:07:49,060
+a reading after three to four hours، يعني بغض
+
+93
+00:07:49,060 --> 00:07:52,960
+النظر عن ال full recovery، المية المية، يعني احنا
+
+94
+00:07:52,960 --> 00:07:57,100
+ممكن خمسين في المية accommodation إن ماشي حالنا
+
+95
+00:07:57,830 --> 00:08:00,850
+كأنه .. يعني الطفل هذا اللي عمره عشر سنوات أو تمام
+
+96
+00:08:00,850 --> 00:08:05,650
+سنوات كأنه شيخ عمره خمسين سنة الشيخ اللي عمره
+
+97
+00:08:05,650 --> 00:08:10,550
+خمسين سنة بيقرأ خاصة الخط الكبير شوية، بيمشي ..
+
+98
+00:08:10,550 --> 00:08:14,230
+يمشي حاله، لكن under such a pentulate أو المحطة
+
+99
+00:08:14,230 --> 00:08:19,250
+صعب جدا، مستحيل، بس يعني في تلات إلى أربع ساعات،
+
+100
+00:08:19,250 --> 00:08:22,670
+نص المدة، بدأ يقرأ الخط الكبير نسبيا، الطفل
+
+101
+00:08:24,430 --> 00:08:27,470
+recovery from the diseases طب البوابو كبير بسبب
+
+102
+00:08:27,470 --> 00:08:34,110
+فوتوفوبيا ايش فوتوفوبيا يعني خاف من الضوء لإنه
+
+103
+00:08:34,110 --> 00:08:37,930
+البوابو كبير بيصير عبارات و بيدخل إضاءة كبيرة في
+
+104
+00:08:37,930 --> 00:08:43,050
+البوابو بتاعه was shown as occurring between 24 to
+
+105
+00:08:43,050 --> 00:08:50,050
+48 hours يعني هان بده يوم كامل إلى يومين حسب هو
+
+106
+00:08:50,050 --> 00:08:56,130
+النصيب بس كان يعني الارزة بتاعه أسودممكن انه ايش
+
+107
+00:08:56,130 --> 00:09:02,270
+طول نسبالي لأنه release وكده السن بتاعه activity
+
+108
+00:09:02,270 --> 00:09:06,270
+وسائل muscle in all instances كل أمثلة without the
+
+109
+00:09:06,270 --> 00:09:10,030
+aid of a myotic يعني نتكلم احنا على واحد اتنين
+
+110
+00:09:10,030 --> 00:09:17,850
+تلاتة بدون اللجوم الى الميوتك اللي هو بيضاد فعل
+
+111
+00:09:17,850 --> 00:09:21,810
+psychopathy انتوا ليه؟ على مستوى ال psychopleia
+
+112
+00:09:21,810 --> 00:09:23,150
+وعلى مستوى
+
+113
+00:09:29,480 --> 00:09:34,400
+فشوفنا إنه كام الـ Sacramentolate لطيف إذا مقارناه
+
+114
+00:09:34,400 --> 00:09:39,200
+بالأترومين، صح؟ أسبوعين أو أكتر من أسبوعين، حاجة
+
+115
+00:09:39,200 --> 00:09:44,620
+صعبة يعني طيب، في عامة الـcloses of Sacramentolate
+
+116
+00:09:44,620 --> 00:09:49,040
+الاستخدامات العلاجية للـSacramentolate one
+
+117
+00:09:49,040 --> 00:09:52,300
+treatment of colon ulceration يعني أي واحد عنده
+
+118
+00:09:52,300 --> 00:09:55,000
+كونة الأسس هو في الفيروس
+
+119
+00:09:58,910 --> 00:10:05,650
+or fungus كون ال ulcer لازم نعطيه مال
+
+120
+00:10:05,650 --> 00:10:10,890
+antimicrobial sacromentolytic
+
+121
+00:10:10,890 --> 00:10:16,890
+ليه؟
+
+122
+00:10:16,890 --> 00:10:21,270
+عشان يعمل ال الوضع تقسير مدرسة عشان مستخدمش
+
+123
+00:10:21,270 --> 00:10:22,170
+assigning
+
+124
+00:10:29,170 --> 00:10:33,370
+أنت لما شوفت قد تلاقى صيدك يافالة تلاقى صيدك و
+
+125
+00:10:33,370 --> 00:10:38,550
+ممكن تلقى صيدك حين نحن؟ أه و الأهم .. مستشفت لها
+
+126
+00:10:38,550 --> 00:10:44,650
+في الحضور الأمنية؟ أه الأهم من ذلك .. الأهم من ذلك
+
+127
+00:10:44,650 --> 00:10:49,930
+أنه put ciliary muscle on wrist صحيح عشان ال legs
+
+128
+00:10:49,930 --> 00:10:55,830
+are .. أه كل ال legs و legs اللي بتسير كله بيعمل
+
+129
+00:10:55,830 --> 00:10:59,700
+إثارة و بيعمل spasm of the ciliary muscleوبما
+
+130
+00:10:59,700 --> 00:11:04,440
+القلم شديد فاكونوا اني انا حطيت supplementary diet
+
+131
+00:11:04,440 --> 00:11:08,580
+مع ال antibiotic مثلا او ال antiviral اني انا عملت
+
+132
+00:11:08,580 --> 00:11:14,840
+relief، راحة للسلم مثلا، to antiretrovirates،
+
+133
+00:11:14,840 --> 00:11:17,520
+واحنا كلنا ليش antiretrovirates ما نحط في
+
+134
+00:11:17,520 --> 00:11:19,800
+supplementary diet؟
+
+135
+00:11:45,930 --> 00:11:52,670
+حسب الحد ده نحن بنحط عادة صباح ومساء لكلوشة دي ده
+
+136
+00:11:52,670 --> 00:11:56,250
+نحن بنحط تلت مرات في اليوم عشان نحط أربع مرات في
+
+137
+00:11:56,250 --> 00:11:56,510
+اليوم
+
+138
+00:12:06,800 --> 00:12:10,800
+بريح الـ ciliary muscle لأنه أكيد طالما فيه
+
+139
+00:12:10,800 --> 00:12:14,600
+uveitis حصيرها spasm و التاني اللي مصيرها الـ
+
+140
+00:12:14,600 --> 00:12:18,660
+spasm الجارة مش هي الجارة الـ sphincter pupillary
+
+141
+00:12:18,660 --> 00:12:22,900
+muscle فكلها تتساقر من تلت السيرمس صار
+
+142
+00:12:22,900 --> 00:12:25,100
+سايكروبليجيا و ال sphincter pupillary صار اللي لها
+
+143
+00:12:25,100 --> 00:12:29,320
+dilatation و ال dilatation هذا هيؤدى ال relaxation
+
+144
+00:12:29,320 --> 00:12:32,880
+هيؤدى إلى انه ال dilator pupillary تكون أنشط من ال
+
+145
+00:12:32,880 --> 00:12:37,690
+sphincter pupillary فبتوسع الجمعBy relaxing the
+
+146
+00:12:37,690 --> 00:12:40,810
+cellular muscle and immobilizing the iris، يعني
+
+147
+00:12:40,810 --> 00:12:45,250
+الارس إنه بيصير كبير ولا يتحرك، مافيش reflex يعني،
+
+148
+00:12:45,250 --> 00:12:51,210
+يتضوق، sacromental aid، all opiates، يقلل
+
+149
+00:12:58,940 --> 00:13:06,400
+على مدى شهور طويلة في هذه الوضعات لا تقارن بأكتر
+
+150
+00:13:06,400 --> 00:13:11,700
+مخدرات كأتروبين أو كوماتروبين يعني لو انا انتوا
+
+151
+00:13:11,700 --> 00:13:14,220
+عارفين أحيانا الكون الأرثة خاصة البكتيريا أو
+
+152
+00:13:14,220 --> 00:13:18,720
+الفانجل بده شهور يمكن الفيرل أهور شوية سبعين تلاتة
+
+153
+00:13:18,720 --> 00:13:23,460
+بخلص من الفيرل لكن لو يكون فانجل أو بكتيريا أحيانا
+
+154
+00:13:23,460 --> 00:13:24,000
+بده شهور
+
+155
+00:13:28,520 --> 00:13:35,360
+فهنا الـ cyclopentolate يعني أهون و أخف و أقل ضرر
+
+156
+00:13:35,360 --> 00:13:38,340
+من إيه أنا أحطه على الترابين و أحطه على
+
+157
+00:13:38,340 --> 00:13:42,440
+الأنجلوكلوجيا و الأنجلوكوما probability يعني أهون
+
+158
+00:13:42,440 --> 00:13:48,320
+حميد أكتر في الحالات اللي عايزها يعني شغل طويل
+
+159
+00:13:48,320 --> 00:13:52,780
+يعنى طيب في الثالث news of cyclopentolate و ال
+
+160
+00:13:52,780 --> 00:13:56,400
+breaking down اللي هو بوستريو ساينيكيا لما كسس
+
+161
+00:13:56,400 --> 00:14:00,880
+بوستريو ساينيكيا الذكارةكسّرها في بدايتها one or
+
+162
+00:14:00,880 --> 00:14:03,700
+two drops of 0.5 cyclopentane solution are
+
+163
+00:14:03,700 --> 00:14:10,500
+installed يعني مش نقطة نقطتين كل ست ساعات ا buy
+
+164
+00:14:10,500 --> 00:14:13,580
+one or two drops of a two percent solution of
+
+165
+00:14:13,580 --> 00:14:17,300
+bicarbonate this alternative treatment is repeated
+
+166
+00:14:17,300 --> 00:14:24,520
+daily هنقول الان بيقوللي
+
+167
+00:14:24,520 --> 00:14:24,740
+هنا
+
+168
+00:14:28,620 --> 00:14:32,280
+بساكره من طولية وصلت الى هذا المستوى في البابا
+
+169
+00:14:32,280 --> 00:14:37,980
+الان
+
+170
+00:14:37,980 --> 00:14:45,840
+اذا اخرنا section يعني انا عملت كده طبعا
+
+171
+00:14:45,840 --> 00:14:53,420
+الخوف من الانس تلتسق في ال ايرس يبقى انا الان عملت
+
+172
+00:14:53,420 --> 00:14:56,960
+dilatation هنا بيقوللي
+
+173
+00:14:57,560 --> 00:15:01,880
+عمله تجربة جابه في الحالة التانية بايو كاربين عمله
+
+174
+00:15:01,880 --> 00:15:06,540
+تجربة بايو
+
+175
+00:15:06,540 --> 00:15:12,420
+كاربين بايو كاربين drops ال بايو كاربين هو مردك
+
+176
+00:15:12,420 --> 00:15:19,020
+مضيق مضيق من البُبُب فبقوللي ان انا في الحالة
+
+177
+00:15:19,020 --> 00:15:27,760
+الأولى حطيت Cyclo pentolate حطيت Cycloبينتوليت
+
+178
+00:15:27,760 --> 00:15:34,600
+موسع و حتى انا حاطيت bio carbine مضيق فكنت اعملت
+
+179
+00:15:34,600 --> 00:15:42,720
+حاجة اسمها alternation alternation of pupil size
+
+180
+00:15:42,720 --> 00:15:50,260
+ايش pupil size؟ في حجم البقه مرة بوسه و مرة بدأيه
+
+181
+00:15:50,260 --> 00:15:59,240
+مرة بوسه mechanical ال alternation هذابيقول لي انه
+
+182
+00:15:59,240 --> 00:16:04,740
+ثبت انه اكثر مجاهة في مانع الاسم السينيكية ليش؟
+
+183
+00:16:04,740 --> 00:16:09,640
+بيقول لي لو انا دلوقتي خلت البور بور تلتين موسقى
+
+184
+00:16:09,640 --> 00:16:21,460
+فبيقول لي هنا في احتمالية يعني خليني اقول كده في
+
+185
+00:16:21,460 --> 00:16:29,190
+بعض الاحتمالية لتكوينشيء قليل من الوصولى الصينيكى
+
+186
+00:16:29,190 --> 00:16:34,010
+شيء قليل فيبدأ
+
+187
+00:16:34,010 --> 00:16:38,250
+شيء قليل الوصولى الصينيكى يتكوّن اجي انا اعمله
+
+188
+00:16:38,250 --> 00:16:45,910
+تضييق ادخل البوب والماما غالق يمشي هنا كسرتها
+
+189
+00:16:45,910 --> 00:16:50,730
+دولة الان مرة تانية دوله يبدأ بال sales اللي هنا و
+
+190
+00:16:50,730 --> 00:16:53,930
+ال flare اللي هو الوصولى الصينيكى روحت عملتله
+
+191
+00:16:53,930 --> 00:16:54,090
+توصيلة
+
+192
+00:17:00,140 --> 00:17:05,200
+يعني ال iris لا يستقر على سطح العدسة، كل ما
+
+193
+00:17:05,200 --> 00:17:11,140
+بيستقر، تيجي القطر هيش؟ اتكسر إلى العمل جديد، كيف
+
+194
+00:17:11,140 --> 00:17:16,920
+تفكر هذا؟ على ما تبره ابتكار يعني، شوف ربنا سبحانه
+
+195
+00:17:16,920 --> 00:17:22,860
+وتعالى أعطى الإنسان عقل إن هو يفكر في مصلحته، يعني
+
+196
+00:17:22,860 --> 00:17:27,060
+مثلا من الأشياء اللي أنا شوفتها ابتكارية الآن، إنه
+
+197
+00:17:27,060 --> 00:17:31,040
+في الإلاج الطبيعي في التهاب من المفاصل،هيقولك اعمل
+
+198
+00:17:31,040 --> 00:17:37,520
+alternation لفومنس فومنس كمادات مرة warm فومنس و
+
+199
+00:17:37,520 --> 00:17:43,940
+مرة cold فومنس يعني تلت مرات في اليوم اعمل مرة
+
+200
+00:17:43,940 --> 00:17:47,560
+كمادة ساخنة بس هروبع الساعة و بعد بساعة اعمل كمادة
+
+201
+00:17:47,560 --> 00:17:51,600
+باردة بس هنبعد ست ساعات اعمل كمادة سخنة و بعد
+
+202
+00:17:51,600 --> 00:17:55,420
+بساعة اعمل كمادة باردة يقال ان الطريقة هذه أنجع من
+
+203
+00:17:55,420 --> 00:17:59,260
+اني اضع السخن على طول او البارد على طول
+
+204
+00:18:02,020 --> 00:18:07,740
+هذا هو التفكير التفكيرية أو fermentation فهذا يعني
+
+205
+00:18:07,740 --> 00:18:13,300
+تفكير لا أقول انه تفكير ميال ميال لكن هي فكرة
+
+206
+00:18:13,300 --> 00:18:19,000
+وانتثمت نجاعتها كثيرا في بعض الأحوال انه مرة موسع
+
+207
+00:18:19,000 --> 00:18:24,960
+ومرة مضيق اللي اتكون هنا كسر هنا من ثانيكا وبعادل
+
+208
+00:18:24,960 --> 00:18:29,180
+اللي بدأ يتكون هنا يتكسر هناوالـ Hydrocortisone
+
+209
+00:18:29,180 --> 00:18:35,520
+شغال أو الـ Antibiotic شغال في اليوبيايتس كورتيزون
+
+210
+00:18:35,520 --> 00:18:39,640
+و في ال .. اللي هو ال Alzheimer's في Antibiotic أو
+
+211
+00:18:39,640 --> 00:18:45,860
+Antiviral شغال مش مبطل لغاية مثل ال dry virus و
+
+212
+00:18:45,860 --> 00:18:48,940
+يبطل يطلع منه ال Exudate و ال inflammatory cells
+
+213
+00:18:48,940 --> 00:18:51,380
+اللي بتعمل الصينكي بعدها
+
+214
+00:19:05,860 --> 00:19:12,180
+عشان تشتروا يعني انتوا كoptometrist لو خيّرناكوا
+
+215
+00:19:12,180 --> 00:19:14,460
+بين الcyclobentrolate و الأتروبيل
+
+216
+00:19:14,460 --> 00:19:19,340
+الcyclobentrolate أسهمه أعلى و خطره أقل إلا في
+
+217
+00:19:19,340 --> 00:19:23,460
+حالات قليلة و أرجوكوا أن تتشابهوا مقارنة
+
+218
+00:19:26,620 --> 00:19:30,860
+لا ترش على طول من أول الحلقة تروبيه عشان تكون
+
+219
+00:19:30,860 --> 00:19:42,420
+protected عشان تكون
+
+220
+00:19:42,420 --> 00:19:45,140
+protected عشان تكون protected عشان تكون protected
+
+221
+00:19:45,140 --> 00:19:45,180
+عشان تكون protected عشان تكون protected عشان تكون
+
+222
+00:19:45,180 --> 00:19:45,180
+protected عشان تكون protected عشان تكون protected
+
+223
+00:19:45,180 --> 00:19:45,280
+عشان تكون protected عشان تكون protected عشان تكون
+
+224
+00:19:45,280 --> 00:19:45,280
+protected عشان تكون protected عشان تكون protected
+
+225
+00:19:45,280 --> 00:19:45,280
+عشان تكون protected عشان تكون protected عشان تكون
+
+226
+00:19:45,280 --> 00:19:45,280
+protected عشان تكون protected عشان تكون protected
+
+227
+00:19:45,280 --> 00:19:45,280
+عشان تكون protected عشان تكون protected عشان تكون
+
+228
+00:19:45,280 --> 00:19:45,280
+protected عشان تكون protected عشان تكون protected
+
+229
+00:19:45,280 --> 00:19:49,340
+عشان تكون protected عشان تكون protected عشان تكون
+
+230
+00:19:49,340 --> 00:19:53,280
+protected عشان تكون protected عشان تكون protected
+
+231
+00:19:53,280 --> 00:19:55,940
+عشان تكون protected عشان تكون protected عشان تكون
+
+232
+00:19:55,940 --> 00:19:56,120
+protected عشان تكون protected عشان تكون protected
+
+233
+00:19:56,120 --> 00:20:03,730
+عشانيعني هو نفس drops نصف المية مدرياتيك one
+
+234
+00:20:03,730 --> 00:20:11,110
+percent cyclogenic بس طبعا الكلام فيه تفاصيل لسه
+
+235
+00:20:11,110 --> 00:20:18,230
+تاخدهوش على عواقب لسه as emetic لما بنوصل لرجل أو
+
+236
+00:20:18,230 --> 00:20:23,240
+لامرأة بنحط two drops of the weaker solutionاللي
+
+237
+00:20:23,240 --> 00:20:27,280
+هو نصف فلمية يعني، مدرياتك نصف فلمية، it's told
+
+238
+00:20:27,280 --> 00:20:30,200
+انتوا لو كنتوا يرتبطوا الساق، produce a full
+
+239
+00:20:30,200 --> 00:20:35,040
+مدريازز in about fifty minutes، سريع جدا، في خلال
+
+240
+00:20:35,040 --> 00:20:40,500
+ربع ساعة بيعمل full مدريازز، خاصة في ال light
+
+241
+00:20:40,500 --> 00:20:43,220
+colored iris
+
+242
+00:20:49,930 --> 00:20:55,850
+و لا من الساعة. الناس ترجع للعادة، يعني مادة نقطة
+
+243
+00:20:55,850 --> 00:20:59,530
+أو نقطتين هاني، نص في المية، و اكتشف البوكبربرد
+
+244
+00:20:59,530 --> 00:21:04,730
+على حجمه العادى eight to nine hours if normally
+
+245
+00:21:04,730 --> 00:21:05,150
+you take
+
+246
+00:21:16,930 --> 00:21:21,250
+و احنا كنا تمانى ان في خلال ساعة نرجع للاصل لكن
+
+247
+00:21:21,250 --> 00:21:28,430
+لسه ما وجدتاش ال ideal drug لسه مافيش ideal to
+
+248
+00:21:28,430 --> 00:21:31,450
+produce psychoplasia و هذا الأهم احنا درسنا في
+
+249
+00:21:31,450 --> 00:21:36,050
+psychoplasia لان two drops of one piercing
+
+250
+00:21:36,050 --> 00:21:41,270
+solution مالكافيش النص لازم يكون one piercing و هو
+
+251
+00:21:41,270 --> 00:21:45,250
+الاقوى ال one piercing الاقوى من النصI've
+
+252
+00:21:45,250 --> 00:21:48,030
+installed into the eye نقطتين مع بعض allowing a
+
+253
+00:21:48,030 --> 00:21:51,010
+five minute interval between each drop.يعني
+
+254
+00:21:51,010 --> 00:21:54,810
+بيقوللي أول نقطة أثناء خمس دقات أو حتى عشر دقات
+
+255
+00:21:54,810 --> 00:21:57,770
+واضيف نقطة تانية. The full psychometric effect is
+
+256
+00:21:57,770 --> 00:22:01,770
+achieved in about thirty minutes.شوف في المدرياتك
+
+257
+00:22:01,770 --> 00:22:06,270
+أو مدريازي كان ربع ساعة.في الpsychokinesia بتدوم
+
+258
+00:22:06,270 --> 00:22:09,990
+نصف ساعة.When the telescopy is performed عشان تعمل
+
+259
+00:22:09,990 --> 00:22:13,390
+ايه؟The telescopy.If the examination has to be
+
+260
+00:22:13,390 --> 00:22:19,890
+delayedBeyond 35 minutes يعني لو انا بدي اعمل فحص
+
+261
+00:22:19,890 --> 00:22:24,370
+من اول نقطة بقى ب 35 جيجا وجب ان اخد كمان نقطة
+
+262
+00:22:24,370 --> 00:22:29,830
+تالتة لان هو بنقشع بسرعة، ايش بنقشع؟ بيروح بسرعة،
+
+263
+00:22:29,830 --> 00:22:34,750
+فبدي اعمل addition لنقطة تالتة ثالث drop of the
+
+264
+00:22:34,750 --> 00:22:36,450
+one percent I should be using
+
+265
+00:22:43,300 --> 00:22:48,000
+قبل الفحص لأسكان بينزل بدراجة هنا ال creek عشان
+
+266
+00:22:48,000 --> 00:22:52,900
+اخد الفايدة على الاخر ف complete recovery of
+
+267
+00:22:52,900 --> 00:22:55,520
+accommodation شوف يعني بعد ما نحط القطرة
+
+268
+00:22:55,520 --> 00:23:00,680
+tropicimide اللي هو مدرمعي كنا بيقولها ميدرياسيل
+
+269
+00:23:00,680 --> 00:23:04,820
+بعض الشركات بيسميه ميدرياسيل وبعض الشركات ميدرمعي
+
+270
+00:23:04,820 --> 00:23:08,980
+واختارش ال complete recovery أو ال full recovery
+
+271
+00:23:08,980 --> 00:23:13,930
+of accommodation six hoursلكن لا يعني انه مش هيقرأ
+
+272
+00:23:13,930 --> 00:23:17,370
+الا بعد ست ساعات، ممكن يقرأ بعد ساعتين الى أربع
+
+273
+00:23:17,370 --> 00:23:24,290
+ساعات من وقت الوضع الأول،
+
+274
+00:23:24,290 --> 00:23:29,850
+ممكن يقرأ. بس طبعا بس هو الخط الكبير.External
+
+275
+00:23:29,850 --> 00:23:33,670
+sacroblasia with residual accommodation below to
+
+276
+00:23:33,670 --> 00:23:36,590
+the uterus is usually obtained according to the
+
+277
+00:23:36,590 --> 00:23:38,990
+following other procedures outlined
+
+278
+00:23:42,610 --> 00:23:45,690
+وقررناها في الـcyclopentrolate كامل زي دورة
+
+279
+00:23:45,690 --> 00:23:48,210
+accommodation بالنسبة للـcyclopentrolate however
+
+280
+00:23:48,210 --> 00:23:52,290
+due to the very brief duration of a plasma effect,
+
+281
+00:23:52,390 --> 00:23:56,030
+third group is not infrequently seen قلنا محتر نحط
+
+282
+00:23:56,030 --> 00:24:03,930
+ثلاث نقط منه لأنه ينتشر بسرعة الآن عملنا دراسة
+
+283
+00:24:03,930 --> 00:24:05,770
+الدراسة هذه
+
+284
+00:24:10,240 --> 00:24:13,040
+193 مريضان
+
+285
+00:24:17,780 --> 00:24:22,560
+في ال 61 طبعاً زمان were able to examine only 60%
+
+286
+00:24:22,560 --> 00:24:29,100
+of this during the 20 to 35 minutes يعني هم عملوا
+
+287
+00:24:29,100 --> 00:24:35,620
+بعد ما حطوا المدراميت او tropic imide بعد 20 الى
+
+288
+00:24:35,620 --> 00:24:40,620
+35 دقيقة كانوا بيعملوا تنسكوبي بعد 20 دقيقة من
+
+289
+00:24:40,620 --> 00:24:46,340
+التنجيت الى 35 في ربع الساعة هذه كان الشغل على
+
+290
+00:24:46,340 --> 00:24:46,700
+العيني
+
+291
+00:24:51,010 --> 00:24:57,790
+و فقط 60% من هؤلاء في الانتقال من 20 إلى 30 دقيقة
+
+292
+00:24:57,790 --> 00:25:02,790
+عندما كانت سيكوبيجيا مقصودة، السيكوبيجيا كانت
+
+293
+00:25:02,790 --> 00:25:08,190
+عندهم مقصودة على مستوى الدراج هذا، بينما ال 40%
+
+294
+00:25:08,190 --> 00:25:14,480
+كانوا يحصلون على ثلوجيعني 40% من 193 احتجتوا الى
+
+295
+00:25:14,480 --> 00:25:19,280
+تمام نقطة يعني قصر فيهم ال drug هذا ال drug مستمرش
+
+296
+00:25:19,280 --> 00:25:24,900
+لما وصل نص ساعة بدأ decline بدأ ينزل عن ال peak
+
+297
+00:25:24,900 --> 00:25:27,120
+فلاجئنا انه لازم نحط
+
+298
+00:25:32,050 --> 00:25:36,970
+هفنر هذي أكد عن دراسة الأولانية وهو يؤكد بأن أفضل
+
+299
+00:25:36,970 --> 00:25:44,910
+ميزة تروبيك إيماين هو عملها بسرعة و بطولة، بسرعة و
+
+300
+00:25:44,910 --> 00:25:50,970
+بطولة، بسرعة
+
+301
+00:25:50,970 --> 00:25:59,850
+و بطولة، بسرعة و بطولة، بسرعة و بطولة، بسرعة
+
+302
+00:25:59,850 --> 00:26:04,870
+و بطولةالطبيب يتم إيقافه تمامًا من السيكولوميجيا
+
+303
+00:26:04,870 --> 00:26:09,230
+خلال 2 إلى 6 ساعت يعني انا الساعتين، الناس تلاتة،
+
+304
+00:26:09,230 --> 00:26:12,810
+الناس أربعة، الناس خمسة، اه اخرشي ستة، ست ساعات،
+
+305
+00:26:12,810 --> 00:26:19,470
+كل إيقاف السيكولوميجيا يكون انتهى و هذه القوات
+
+306
+00:26:19,470 --> 00:26:23,700
+الكبيرة أيضًا تجعلهاThe most useful magnetic in
+
+307
+00:26:23,700 --> 00:26:28,420
+its weaker concentration 0.5 يعني لو انا بدي موسع
+
+308
+00:26:28,420 --> 00:26:33,340
+كموسع هو اللي موجودة لأ انا بشتغل بسرعة و بعمل
+
+309
+00:26:33,340 --> 00:26:39,540
+examination بسرعة لل fondus of the eye و بعدها
+
+310
+00:26:39,540 --> 00:26:43,160
+ساعتين تلاتة اربعة قمتها مافيش مشاكل كثيرة من ال
+
+311
+00:26:43,160 --> 00:26:49,780
+photophobia طيب في ال ألف سمية و سبعين اه
+
+312
+00:26:49,780 --> 00:26:57,220
+hardeningهو عامل جراسة to see more patients in his
+
+313
+00:26:57,220 --> 00:27:00,260
+working day and the short duration of action
+
+314
+00:27:00,260 --> 00:27:02,900
+allows patients to return to work within two
+
+315
+00:27:02,900 --> 00:27:05,600
+hours. يرجع شغله على عمله.
+
+316
+00:27:16,430 --> 00:27:19,990
+بأكد على ذلك الـ 61% did not find using two drops
+
+317
+00:27:19,990 --> 00:27:23,310
+of tropic imide one piercing solution to be a
+
+318
+00:27:23,310 --> 00:27:28,770
+satisfactory as cycloplastic as the same number of
+
+319
+00:27:28,770 --> 00:27:33,330
+drops of one piercing cyclopentolate or a five
+
+320
+00:27:33,330 --> 00:27:34,810
+homotropin solution
+
+321
+00:27:46,760 --> 00:27:51,740
+أو الحق هم أطربيين عمل دراسة الآن احنا بدنا نبني
+
+322
+00:27:51,740 --> 00:27:55,100
+حال اللي هم أطربيين ك psychological نعتمد و لنا
+
+323
+00:27:55,100 --> 00:27:58,120
+هذا
+
+324
+00:27:58,120 --> 00:28:02,200
+اللي احنا بدنا نسأله في الآخر مدرياتك اعتمدناها
+
+325
+00:28:02,200 --> 00:28:06,300
+بشتغل بسرعة و بنتهي بسرعة لكن ك psychological بدنا
+
+326
+00:28:06,300 --> 00:28:09,740
+نعمل الآن الدراسة هذه واحد في المية
+
+327
+00:28:16,040 --> 00:28:23,320
+أو هم ماتروبين او هم ماتروبين و ندرس residual أو
+
+328
+00:28:23,320 --> 00:28:30,920
+accommodation طيب شوفوا النتيجة بيقول لي من خمسين
+
+329
+00:28:30,920 --> 00:28:36,860
+حالة اه consecutive cases خمسين حالة يعني مائة عين
+
+330
+00:28:36,860 --> 00:28:41,100
+كل إنسان يبقى عينتين مافيش ولا واحد فيهم فاقد عين
+
+331
+00:28:41,100 --> 00:28:48,420
+الحمد لله مائة عينهي فعلا الباحث بتر
+
+332
+00:28:48,420 --> 00:28:54,480
+Cyclopentolate produced by Cyclopentolate in 23
+
+333
+00:28:54,480 --> 00:29:05,540
+out of 25 cases عارفين يعني؟ انه في 23 من 25 أيان،
+
+334
+00:29:05,540 --> 00:29:10,380
+يعني 46 أيان من 50 أيان، ال Cyclopentolate تغلب
+
+335
+00:29:10,380 --> 00:29:12,920
+على التربيكيمية ك Cyclopentolate
+
+336
+00:29:22,270 --> 00:29:28,190
+يعني .. يعني احنا بيقول 92 إلى 8 92 cyclopentolate
+
+337
+00:29:28,190 --> 00:29:39,650
+إلى 8 tropical mice كيف جيبناها دي؟ إذا كان .. إذا
+
+338
+00:29:39,650 --> 00:29:45,730
+كان خمسين عين .. خمسين عين في ستة واربعين عين تغلب
+
+339
+00:29:45,730 --> 00:29:49,310
+ال cyclopentolate وفي أربع عين
+
+340
+00:30:01,240 --> 00:30:10,240
+كيف نسمع؟ حسب صلة مين؟ الـ Sacramento Olympia، الـ
+
+341
+00:30:10,240 --> 00:30:11,080
+Sacramento Olympia، الـ Sacramento Olympia، الـ
+
+342
+00:30:11,080 --> 00:30:11,120
+Sacramento Olympia، الـ Sacramento Olympia، الـ
+
+343
+00:30:11,120 --> 00:30:11,140
+Sacramento Olympia، الـ Sacramento Olympia، الـ
+
+344
+00:30:11,140 --> 00:30:11,400
+Sacramento Olympia، الـ Sacramento Olympia، الـ
+
+345
+00:30:11,400 --> 00:30:15,220
+Sacramento Olympia، الـ Sacramento Olympia، الـ
+
+346
+00:30:15,220 --> 00:30:15,660
+Sacramento Olympia، الـ Sacramento Olympia، الـ
+
+347
+00:30:15,660 --> 00:30:17,240
+Sacramento Olympia، الـ Sacramento Olympia، الـ
+
+348
+00:30:17,240 --> 00:30:17,240
+Sacramento Olympia، الـ Sacramento Olympia، الـ
+
+349
+00:30:17,240 --> 00:30:17,240
+Sacramento Olympia، الـ Sacramento Olympia، الـ
+
+350
+00:30:17,240 --> 00:30:17,240
+Sacramento Olympia، الـ Sacramento Olympia، الـ
+
+351
+00:30:17,240 --> 00:30:17,240
+Sacramento Olympia، الـ Sacramento Olympia، الـ
+
+352
+00:30:17,240 --> 00:30:19,420
+Sacramento Olympia، الـ Sacramento Olympia، الـ
+
+353
+00:30:19,420 --> 00:30:25,190
+Sacramento Olympia، الـ Sacramento OTropic mud أخد
+
+354
+00:30:25,190 --> 00:30:30,530
+خمسة وين هم إله؟ و ال .. و ال .. ال homotropic أخد
+
+355
+00:30:30,530 --> 00:30:34,470
+إيش؟ عشرين عيال، يعني أربعين عيال، يعني تسعين إلى
+
+356
+00:30:34,470 --> 00:30:39,830
+عشر، يعني أقوى منه التسع مرات، أو إنه في تسعين ..
+
+357
+00:30:39,830 --> 00:30:43,850
+في تسع .. بتسع أضعاف، العيالين كان أقوى
+
+358
+00:30:43,850 --> 00:30:48,070
+كcyclologic طيب،
+
+359
+00:30:48,070 --> 00:30:54,010
+thusIn only seven, five are with homotropin in the
+
+360
+00:30:54,010 --> 00:30:57,650
+other eye and two with cyclopentolate in the other
+
+361
+00:30:57,650 --> 00:31:00,750
+eye of hundred eyes, whilst tropic amide superior
+
+362
+00:31:00,750 --> 00:31:03,750
+in its psychological effect to these other drugs
+
+363
+00:31:03,750 --> 00:31:09,670
+حسب حسبة حسبة جالك اتنين أيانين غلب فيهم ال tropic
+
+364
+00:31:09,670 --> 00:31:14,110
+amide مقابل ال cyclopentolate وخمسة مقابل ال
+
+365
+00:31:14,110 --> 00:31:19,180
+homotropin صاروا سبعةيعني متبلب في سبعة من
+
+366
+00:31:19,180 --> 00:31:22,660
+الخمسين،
+
+367
+00:31:22,660 --> 00:31:29,640
+الخمسين عيال، سبعة مقابل خمسين، حسابية يعني، نقطة
+
+368
+00:31:29,640 --> 00:31:35,160
+حسابية، عشان يظهر ضعف الـtropic amide مقابل
+
+369
+00:31:35,160 --> 00:31:41,100
+الـcyclopentolate ومقابل اللي هم التروبين طب in
+
+370
+00:31:41,100 --> 00:31:45,800
+children in particular على وجه القصوص
+
+371
+00:32:02,380 --> 00:32:08,100
+يا سلام يعني
+
+372
+00:32:08,100 --> 00:32:12,860
+احنا في الناس العشر سنين وفوق شغلة و في تحت العشر
+
+373
+00:32:12,860 --> 00:32:16,480
+سنين شغلة يعني بيقوللي ان
+
+374
+00:32:20,100 --> 00:32:25,480
+في Tropic Emite في الأطفال الصغار لأقل من 9 سنوات
+
+375
+00:32:25,480 --> 00:32:35,780
+كان 6.25% يعني لسه الcell muscle شغالة كويس شغالة
+
+376
+00:32:35,780 --> 00:32:41,680
+كويس فيه يعني أنا ماأضحك على الحقيقة أنه في
+
+377
+00:32:41,680 --> 00:32:46,780
+الأطفال الصغار Tropic Emite is markedly weak
+
+378
+00:32:52,960 --> 00:32:59,440
+هذا بعد تلاتين دقائق and in twenty cases from
+
+379
+00:32:59,440 --> 00:33:07,560
+twenty to fourteen years سم غير السم هنا وجدوا انه
+
+380
+00:33:07,560 --> 00:33:14,020
+residual three point sixty-five بيوت طبعا السنة من
+
+381
+00:33:14,020 --> 00:33:16,320
+السنة السادسة أضعف بعد عشر سنين عشرة او اتنا اخر
+
+382
+00:33:16,320 --> 00:33:23,250
+سنة أضعف من قبل تسعة سنوات وما داركالـ 63% رزقيا و
+
+383
+00:33:23,250 --> 00:33:28,190
+لا accommodation طيب هذا شغلة أعطتنا اقتباع bad
+
+384
+00:33:28,190 --> 00:33:30,990
+ولا good؟ bad bad bad bad bad bad bad bad bad bad
+
+385
+00:33:30,990 --> 00:33:31,390
+bad bad bad bad bad bad bad bad bad bad bad bad
+
+386
+00:33:31,390 --> 00:33:32,130
+bad bad bad bad bad bad bad bad bad bad bad bad
+
+387
+00:33:32,130 --> 00:33:33,290
+bad bad bad bad bad bad bad bad bad bad bad bad
+
+388
+00:33:33,290 --> 00:33:33,290
+bad bad bad bad bad bad bad bad bad bad bad bad
+
+389
+00:33:33,290 --> 00:33:36,350
+bad bad bad bad bad bad bad bad bad bad bad bad
+
+390
+00:33:36,350 --> 00:33:36,350
+bad bad bad bad bad bad bad bad bad bad bad bad
+
+391
+00:33:36,350 --> 00:33:36,350
+bad bad bad bad bad bad bad bad bad bad bad bad
+
+392
+00:33:36,350 --> 00:33:36,350
+bad bad bad bad bad bad bad bad bad bad bad bad
+
+393
+00:33:36,350 --> 00:33:39,150
+bad bad bad bad bad bad bad bad bad bad bad bad
+
+394
+00:33:39,150 --> 00:33:41,170
+bad bad bad bad bad bad bad bad bad bad bad bad
+
+395
+00:33:41,170 --> 00:33:41,450
+bad bad bad bad bad bad bad bad bad bad bad bad
+
+396
+00:33:41,450 --> 00:33:41,450
+bad bad bad bad bad bad bad bad bad bad bad bad
+
+397
+00:33:41,450 --> 00:33:41,450
+bad bad bad bad bad bad bad bad bad bad bad bad
+
+398
+00:33:41,450 --> 00:33:41,450
+bad bad bad bad bad bad bad bad bad bad bad bad
+
+399
+00:33:41,450 --> 00:33:41,450
+bad bad bad bad bad bad bad bad bad bad bad bad
+
+400
+00:33:41,450 --> 00:33:42,770
+bad bad bad
+
+401
+00:33:56,370 --> 00:34:01,430
+لكن إذا كنت أستخدمه في الأطفال لحد وحده
+
+402
+00:34:01,430 --> 00:34:06,610
+كcycloblegic، فأنا أكون ظلمت المهندس، وظلمت
+
+403
+00:34:06,610 --> 00:34:11,490
+الوحوش، ده ما يفوز الوحوش، خاصة في الحوال، الحوال
+
+404
+00:34:11,490 --> 00:34:15,310
+هذا بنوع الحوال بشكل واضح، بنوع الحوال
+
+405
+00:34:22,390 --> 00:34:27,770
+اللي هو Diagnostic uses اللي هو Diagnostic
+
+406
+00:34:27,770 --> 00:34:30,110
+uses اللي هو Diagnostic uses اللي هو Diagnostic
+
+407
+00:34:30,110 --> 00:34:32,790
+uses اللي هو Diagnostic uses اللي هو Diagnostic
+
+408
+00:34:32,790 --> 00:34:33,950
+uses اللي هو Diagnostic uses اللي هو Diagnostic
+
+409
+00:34:33,950 --> 00:34:33,950
+uses اللي هو Diagnostic uses اللي هو Diagnostic
+
+410
+00:34:33,950 --> 00:34:33,950
+uses اللي هو Diagnostic uses اللي هو Diagnostic
+
+411
+00:34:33,950 --> 00:34:33,950
+uses اللي هو Diagnostic uses اللي هو Diagnostic
+
+412
+00:34:33,950 --> 00:34:33,950
+uses اللي هو Diagnostic uses اللي هو Diagnostic
+
+413
+00:34:33,950 --> 00:34:33,950
+uses اللي هو Diagnostic uses اللي هو Diagnostic
+
+414
+00:34:33,950 --> 00:34:33,950
+uses اللي هو Diagnostic uses اللي هو Diagnostic
+
+415
+00:34:33,950 --> 00:34:33,950
+uses اللي هو Diagnostic uses اللي هو Diagnostic
+
+416
+00:34:33,950 --> 00:34:33,950
+uses اللي هو Diagnostic uses اللي هو Diagnostic
+
+417
+00:34:33,950 --> 00:34:33,950
+uses اللي هو Diagnostic uses اللي هو Diagnostic
+
+418
+00:34:33,950 --> 00:34:33,950
+uses اللي هو Diagnostic uses اللي هو Diagnostic
+
+419
+00:34:33,950 --> 00:34:36,330
+uses اللي هو Diagnostic uses اللي هو Diagnostic
+
+420
+00:34:36,330 --> 00:34:44,590
+uses اللي هو Diagnostic uses اللي هو Diagnostic
+
+421
+00:34:56,010 --> 00:35:03,730
+ال .. ال .. ال .. ديتنا ال detachment اه في ال
+
+422
+00:35:03,730 --> 00:35:10,150
+laser اللي هو PRP عارفين PRP؟
+
+423
+00:35:22,370 --> 00:35:27,910
+فان ريتينال فوتو كارجوليشن كله هاد ممتاز لو انا
+
+424
+00:35:27,910 --> 00:35:32,690
+ملاقيت حتى في القوانين الأعظم انا السينيكيا cycle
+
+425
+00:35:32,690 --> 00:35:38,070
+of ventilation بحطه بحطه يعني كويك psychological
+
+426
+00:35:38,070 --> 00:35:42,450
+بدل cycle of ventilation يعني احنا انتهينا في
+
+427
+00:35:42,450 --> 00:35:47,110
+القوانين الأعظم في ال uveitis في البيت فيش فيها
+
+428
+00:35:47,110 --> 00:35:52,020
+cycle of ventilationلكن أنا بس أبعده عن الأطفال
+
+429
+00:35:52,020 --> 00:35:55,420
+تحت عشر سنين خاصة اللي معهم ازوتروبيا و
+
+430
+00:35:55,420 --> 00:35:58,060
+hyperactivity of cell muscle و spasm of cell
+
+431
+00:35:58,060 --> 00:36:03,720
+muscle لازم أبعده اللي هو tropical mind واضح؟ فهذه
+
+432
+00:36:03,720 --> 00:36:07,640
+النقطة لازم تكون تجذرت، هذه النقطة لازم تكون
+
+433
+00:36:07,640 --> 00:36:12,060
+تبينت، واضح؟ لأن في بعض المراكز البصرية و أنا مارس
+
+434
+00:36:12,060 --> 00:36:15,140
+عليها حاطين tropical mind معتمد للحول
+
+435
+00:36:18,590 --> 00:36:22,910
+لكن أنا لا أمر على كل المراكز ولا أدري ماذا يفعلون
+
+436
+00:36:22,910 --> 00:36:29,070
+فانتوا رسول ما إلهم إنه علميا هذا خطأ تظلمونا
+
+437
+00:36:29,070 --> 00:36:32,590
+الأطفال و تقولوا مش عندهم حوالي و ماعندهم حوالي لأ
+
+438
+00:36:32,590 --> 00:36:37,490
+ماتحطوهش Tropic المعادلة اللي حوالي هذا أكتر إشي
+
+439
+00:36:37,490 --> 00:36:40,830
+يعني لل weak psychopathy في كبار السن
+
+440
+00:36:44,750 --> 00:36:48,790
+الـ Homotropin مع أنه بدأ يختفي إلا إنه في مقاطع
+
+441
+00:36:48,790 --> 00:36:52,530
+في العالم ما زال شغال و قد يقول Homotropin is a
+
+442
+00:36:52,530 --> 00:36:56,890
+synthetic alkaloid prepared from Atropin يعني هو
+
+443
+00:36:56,890 --> 00:37:02,010
+مشتق من Atropin بالهيدروليزيس بضعف المياله The
+
+444
+00:37:02,010 --> 00:37:05,330
+homotropin-based tropine obtained by hydrolysis of
+
+445
+00:37:05,330 --> 00:37:09,470
+Atropin is chemically combined with mandelic acid
+
+446
+00:37:09,470 --> 00:37:12,310
+موجود يعني كتركيب في المعامل
+
+447
+00:37:39,550 --> 00:37:40,950
+HbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHbHb
+
+448
+00:37:47,630 --> 00:37:53,490
+as a routine mediatic and cycloplegic كان إله وأنا
+
+449
+00:37:53,490 --> 00:37:57,790
+أذكر اشتغلت عليه، يعني هذا اللي هم طلبينه، but its
+
+450
+00:37:57,790 --> 00:38:03,130
+use has declined بالعربي cyclopentoliet يعني طرق
+
+451
+00:38:03,130 --> 00:38:06,650
+عليه it does not produce satisfactory cycloplegia
+
+452
+00:38:06,650 --> 00:38:10,750
+in children برضه مشكلته، لإنه في ال children اللي
+
+453
+00:38:10,750 --> 00:38:14,270
+فيهم over activity أو spasm أو cell muscle برضه
+
+454
+00:38:14,270 --> 00:38:20,180
+insufficientو استخدامه لهذا السبب كان عادى ان يقضي
+
+455
+00:38:20,180 --> 00:38:25,660
+15 سنة على الناس بزايد تروبيكامية صار بعد ال 15
+
+456
+00:38:25,660 --> 00:38:31,720
+تحت العشرة مقطع بيستعملوه لانه لم يثبت الكفاءة
+
+457
+00:38:32,910 --> 00:38:36,510
+الدرجة التقليدية لـ I Drops هي واحدة درجة من
+
+458
+00:38:36,510 --> 00:38:39,230
+الانتجارات الاثنين مرتبطة مرتبطة مرتبطة مرتبطة
+
+459
+00:38:39,230 --> 00:38:41,090
+مرتبطة مرتبطة مرتبطة مرتبطة مرتبطة مرتبطة مرتبطة
+
+460
+00:38:41,090 --> 00:38:43,590
+مرتبطة مرتبطة مرتبطة مرتبطة مرتبطة مرتبطة مرتبطة
+
+461
+00:38:43,590 --> 00:38:45,430
+مرتبطة مرتبطة مرتبطة مرتبطة مرتبطة مرتبطة مرتبطة
+
+462
+00:38:45,430 --> 00:38:45,910
+مرتبطة مرتبطة مرتبطة مرتبطة مرتبطة مرتبطة مرتبطة
+
+463
+00:38:45,910 --> 00:38:49,870
+مرتبطة مرتبطة مرتبطة مرتبطة
+
+464
+00:38:49,870 --> 00:38:53,090
+مرتبطة
+
+465
+00:38:53,090 --> 00:38:54,170
+مرتبطة م
+
+466
+00:39:01,030 --> 00:39:04,670
+لأ هنا بيبدأ
+
+467
+00:39:04,670 --> 00:39:12,850
+الانسجل بعد 8 ساعة لما
+
+468
+00:39:12,850 --> 00:39:17,190
+يصل المدريازز اللي هم أتروا بينه و ال complete
+
+469
+00:39:17,190 --> 00:39:20,870
+accumulation of pupil reflex يعني بطل ال reflex to
+
+470
+00:39:20,870 --> 00:39:24,650
+light أه under accommodation complete recovery of
+
+471
+00:39:24,650 --> 00:39:27,390
+the pupil can take between 24
+
+472
+00:39:34,750 --> 00:39:38,490
+الثلاث نقطة مثلا ناخده تمانية و أربعين سيبقى
+
+473
+00:39:38,490 --> 00:39:42,410
+الفوتوفوبيا و لا يقرأ شيء تمانية و أربعين ساعة
+
+474
+00:39:42,410 --> 00:39:47,750
+تقريبا. The amplitude نشوف السيكروبليزيا يعني نشوف
+
+475
+00:39:47,750 --> 00:39:51,450
+السيكروبليزيا. يعني احنا ك نتركز عليش؟
+
+476
+00:39:51,450 --> 00:39:54,110
+السيكروبليزيا. The amplitude of accommodation
+
+477
+00:39:54,110 --> 00:39:57,530
+begins to fall in fifteen minutes من ال
+
+478
+00:39:57,530 --> 00:40:04,040
+commencement. Fifteen و بيصلالى اعلى في التلاتين
+
+479
+00:40:04,040 --> 00:40:08,300
+الى اربعين and is usually at lowest level between
+
+480
+00:40:08,300 --> 00:40:12,740
+forty five and eighty minutes يعني بعد الخمسة
+
+481
+00:40:12,740 --> 00:40:16,760
+واربعين بيبدأ يعمل decline لما اصل تسعين دقيقة
+
+482
+00:40:16,760 --> 00:40:22,420
+بيكون انتهى therefore psychotic retroscopic
+
+483
+00:40:22,420 --> 00:40:23,620
+refraction should
+
+484
+00:40:47,960 --> 00:40:53,580
+عند ازيد والاكمداشن يجب ان يكون ميجر لتأكد انه برو
+
+485
+00:40:53,580 --> 00:40:58,620
+2 يعني نفضل احنا نعمل لغاية ما يسبب ازيد
+
+486
+00:40:58,620 --> 00:40:59,400
+والاكمداشن
+
+487
+00:41:02,790 --> 00:41:07,630
+يجب ان يتم اكماله قبل 90 دقيقة قبل ما ينزل قبل
+
+488
+00:41:07,630 --> 00:41:13,570
+ساعة و نص يكون خلصنا اللي هو فيلترسكوب بل اذا قمنا
+
+489
+00:41:13,570 --> 00:41:17,730
+بالتحقق من مدينة سيكلويجيا في عمر أقل من 20 سنة
+
+490
+00:41:17,730 --> 00:41:23,050
+فالجروب لا يتخلص الكثير من اللوتو يعني حتى في
+
+491
+00:41:23,050 --> 00:41:27,470
+العشرين سنة ما ينزل الا اتنين بيفضل فوق اتنين
+
+492
+00:41:36,380 --> 00:41:43,700
+يعني بيقوللي المحاولات بتكرار القطرة قد تأتي
+
+493
+00:41:43,700 --> 00:41:48,400
+بـresidual accommodation حوال اتنين او اكتر شويه
+
+494
+00:41:51,470 --> 00:41:56,090
+التراسكوبي السياسي يمكن أن يكون بشكل عام مع
+
+495
+00:41:56,090 --> 00:41:58,890
+المستخدم اللي ينظر و يبقى بعيد عنه يعني لسه انا
+
+496
+00:41:58,890 --> 00:42:03,490
+بعمل تراسكوب و هو عامل fixation في ال distance لان
+
+497
+00:42:03,490 --> 00:42:09,510
+انا مش مركز انه full relaxation و ثاني muscle لسه
+
+498
+00:42:09,510 --> 00:42:15,850
+بيقوللي في الآخر they found no difference
+
+499
+00:42:18,880 --> 00:42:23,640
+وانتجوا تجربة في ال 95 عملوا combination هم اتربيت
+
+500
+00:42:23,640 --> 00:42:27,940
+4 person وcyclopentolate 1 person to examine one
+
+501
+00:42:27,940 --> 00:42:30,340
+of the children and compare the refractions
+
+502
+00:42:30,340 --> 00:42:35,660
+between under cyclopentolate لحالهيعني في عين حطوا
+
+503
+00:42:35,660 --> 00:42:38,020
+Cyclobentrolate مع اللي هم أضربينه، وفي عين
+
+504
+00:42:38,020 --> 00:42:42,460
+التانية حطوا فقط Cyclobentrolate 1% ووجدوا لا
+
+505
+00:42:42,460 --> 00:42:45,720
+مختلفة بين الاتنين Cyclobentrolates يعني اللي هم
+
+506
+00:42:45,720 --> 00:42:49,580
+أضربينه في العين اليمين، مابقى مش لCyclobentrolate
+
+507
+00:42:49,580 --> 00:42:56,080
+حد كتير، حاجة خفيفةهنا سيكروبنتريت فقط، هنا
+
+508
+00:42:56,080 --> 00:43:00,440
+سيكروبنتريت plus H كماتروبين، وعملوا مقارنة وددوا
+
+509
+00:43:00,440 --> 00:43:06,860
+إنه مافيش فرق ملموس بين العين تانية أشكركم على حسن
+
+510
+00:43:06,860 --> 00:43:10,820
+الإستماع، وإن شاء الله نكمل يوم السبت في المقارنة
+
+511
+00:43:10,820 --> 00:43:13,420
+القادمة إن شاء الله والسلام عليكم ورحمة الله
+
+512
+00:43:13,420 --> 00:43:13,840
+وبركاته
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/hyN2fKMRfMo.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/hyN2fKMRfMo.srt
new file mode 100644
index 0000000000000000000000000000000000000000..8df47416d7227b70950ccf4d239351e0ee6025ae
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/hyN2fKMRfMo.srt
@@ -0,0 +1,1438 @@
+1
+00:00:23,680 --> 00:00:29,980
+كيف تعمل المدرياتكس؟ نعرف هنا أن العين تحتوي على 2
+
+2
+00:00:29,980 --> 00:00:36,260
+عضلات، عضلة سفنتر بيوبيلي التي تدفع من خلال عضلة 
+
+3
+00:00:36,260 --> 00:00:44,320
+باراسمبتاتيكناب وعضلة ديليتور بيوبيلي التي تدفع من خلال
+
+4
+00:00:44,320 --> 00:00:45,520
+عضلة باراسمبتاتيكناب 
+
+5
+00:00:55,620 --> 00:01:03,200
+لا يعملان في نفس الوقت إذا استفدت اشتغلت 
+
+6
+00:01:03,200 --> 00:01:09,060
+constriction فالبقالة تربيو كلي ترخي وإذا استفدت
+
+7
+00:01:09,060 --> 00:01:10,680
+تربيو كلي ترخي وإذا استفدت تربيو كلي ترخي وإذا 
+
+8
+00:01:10,680 --> 00:01:12,220
+استفدت تربيو كلي ترخي وإذا استفدت تربيو كلي ترخي
+
+9
+00:01:12,220 --> 00:01:17,700
+وإذا استفدت تربيو كلي ترخي وإذا 
+
+10
+00:01:17,700 --> 00:01:21,080
+استفدت تربيو كلي ترخي وإذا استفدت تربيو كلي ترخي
+
+11
+00:01:21,080 --> 00:01:21,240
+وإذا استفدت تربيو كلي ترخي وإذا استفدت تربيو كلي
+
+12
+00:01:21,240 --> 00:01:23,980
+ترخي وإذا استفدت تربيو كلي ترخي وإذا استفدت تربيو
+
+13
+00:01:23,980 --> 00:01:31,220
+كلي .. ال .. ال .. اللي هي ال midriatics قعد أمرك 
+
+14
+00:01:31,220 --> 00:01:38,860
+يبدو هي بتشتغل على ال inhibition of the sphincter
+
+15
+00:01:38,860 --> 00:01:45,760
+pupillary muscle تخيلها يعني وابتدى the retro
+
+16
+00:01:45,760 --> 00:01:51,960
+pupillary هتكون active و توسعة البؤبؤ يا إما العكس
+
+17
+00:01:51,960 --> 00:02:00,770
+أنه في midriatic بدو يشتغل على stimulation of the
+
+18
+00:02:00,770 --> 00:02:05,470
+dilator pupillae يخليها هي اتوسع و ال sphincter pupillae
+
+19
+00:02:05,470 --> 00:02:09,590
+تفضل silent أخذتو
+
+20
+00:02:09,590 --> 00:02:17,090
+بركة ولا عيد ثاني يعني أنا عندي الآن هنا
+
+21
+00:02:17,090 --> 00:02:25,770
+ايه الموضوع في عندي في ال iris هنا في ال iris هنا
+
+22
+00:02:26,740 --> 00:02:32,400
+في عضلة اسمها sphincter pupillary في 
+
+23
+00:02:32,400 --> 00:02:40,300
+ال iris هنا في dilator pupillary ويقولوا
+
+24
+00:02:40,300 --> 00:02:44,660
+أن .. و ال sphincter pupillary يعني الاسم
+
+25
+00:02:44,660 --> 00:02:54,100
+contracts the pupil will be small و
+
+26
+00:02:54,100 --> 00:02:58,670
+ال dilator pupillary contracts it will take the
+
+27
+00:02:58,670 --> 00:03:03,370
+eyes peripherally يبقى البوابة بحيث هي كبيرة هيك
+
+28
+00:03:03,370 --> 00:03:07,030
+الآن
+
+29
+00:03:07,030 --> 00:03:14,950
+أي drops بنحطها و بنقصد فيها التوسية هيكون واحد من
+
+30
+00:03:14,950 --> 00:03:17,510
+اثنين إما stimulation
+
+31
+00:03:35,950 --> 00:03:48,610
+Inhibition of sphincter pupillae. أو اثنين stimulation of 
+
+32
+00:03:48,610 --> 00:03:54,350
+dilator pupillary muscle. وهنا هيؤدي إلى
+
+33
+00:03:54,350 --> 00:03:56,410
+dilatation.
+
+34
+00:04:01,430 --> 00:04:03,730
+آسف، في نقطة هنا 
+
+35
+00:04:14,300 --> 00:04:17,180
+Inhibition of Sphincter Pupillary؟ الحقيقة ما تبقى
+
+36
+00:04:17,180 --> 00:04:25,960
+مفروضة، الحقيقة ما بتتداخلش أه؟ شايفين كيف؟
+
+37
+00:04:25,960 --> 00:04:34,260
+Dilatation، انتبهوا معايا، dilatation أو
+
+38
+00:04:34,260 --> 00:04:37,340
+stimulation، أو stimulation
+
+39
+00:04:43,450 --> 00:04:49,790
+هو الـ Vertex of Euclidean هو الـ Vertex بس هذا
+
+40
+00:04:49,790 --> 00:04:53,490
+الطريقة وهذا الطريقة هذا ال mechanism of action أو
+
+41
+00:04:53,490 --> 00:04:59,830
+mode of action طبعاً المشهور في هذا اللي هو ال
+
+42
+00:04:59,830 --> 00:05:09,010
+tropic amide tropic amide زي
+
+43
+00:05:09,010 --> 00:05:12,530
+التروبيكاميد
+
+44
+00:05:19,190 --> 00:05:23,710
+كل هؤلاء بيشتغلوا على inhibition أو sphincter pupillary
+
+45
+00:05:23,710 --> 00:05:30,170
+مثلاً، فإن كل بيشتغلوا على sphincter pupillary يرخوه، 
+
+46
+00:05:30,170 --> 00:05:36,650
+فيُرخوه، يبقى البرادير pupillary جاهزة، الوحيد اللي
+
+47
+00:05:36,650 --> 00:05:39,450
+بيشتغل على stimulation وبرادير pupillary وبيختلف
+
+48
+00:05:39,450 --> 00:05:39,870
+عنهم 
+
+49
+00:05:50,730 --> 00:05:56,690
+البرفيريين موثق للـ robot خاص بيشتغلش زيهم على 
+
+50
+00:05:56,690 --> 00:06:01,030
+sphincter لأ بيشتغل ال operator بإنه يقويها تفتح 
+
+51
+00:06:01,030 --> 00:06:04,590
+ال robot فالsphincter بتفتح
+
+52
+00:06:24,310 --> 00:06:29,870
+والإيمينرياتيك يتم استخدامه في عين واحدة يعني، الـ
+
+53
+00:06:29,870 --> 00:06:35,810
+light reflex in the other eye is unaffected، و
+
+54
+00:06:35,810 --> 00:06:39,930
+الرياجز in the treated eye is accompanied by a 
+
+55
+00:06:39,930 --> 00:06:42,170
+consensual miosis in the other eye 
+
+56
+00:06:49,910 --> 00:06:54,730
+أو فرعان فرعان فرعان هاي البوبو إيه شامل؟ بتوسع، 
+
+57
+00:06:54,730 --> 00:06:58,810
+طب هاي البوبو بهيانة بتوسع، محبت شامل ده برهانة، 
+
+58
+00:06:58,810 --> 00:07:05,930
+بتوسع، أه لأن هو لغة، you are not one، لكن ال light 
+
+59
+00:07:05,930 --> 00:07:06,450
+reflects
+
+60
+00:07:22,150 --> 00:07:25,970
+هنلاقي هلامة من ال construction اللي تاني، اللي
+
+61
+00:07:25,970 --> 00:07:26,750
+مافيش video ع طريقه، هنلاقي هلامة من ال 
+
+62
+00:07:26,750 --> 00:07:30,010
+construction وهنا، طريق ال video، هنلاقي هلامة من 
+
+63
+00:07:30,010 --> 00:07:32,610
+ال pathway، هنلاقي هلامة من ال pathway، هنلاقي
+
+64
+00:07:32,610 --> 00:07:34,370
+هلامة من ال pathway، هنلاقي هلامة من ال pathway،
+
+65
+00:07:34,370 --> 00:07:34,570
+هنلاقي هلامة من ال pathway، هنلاقي هلامة من ال
+
+66
+00:07:34,570 --> 00:07:36,070
+pathway، هنلاقي هلامة من ال pathway، هنلاقي هلامة
+
+67
+00:07:36,070 --> 00:07:39,250
+من ال pathway،
+
+68
+00:07:39,250 --> 00:07:39,330
+هنلاقي هلامة من ال pathway، هنلاقي هلامة من ال
+
+69
+00:07:39,330 --> 00:07:40,250
+من ال pathway، هنلاقي هلامة من ال pathway، هنلاقي
+
+70
+00:07:40,250 --> 00:07:44,810
+هلامة من ال pathway،
+
+71
+00:07:44,810 --> 00:07:47,670
+هنلاقي هلام
+
+72
+00:07:52,030 --> 00:07:56,330
+الميوزس المستقبلي لا يظهر عندما يكون الوضع ديامتر 
+
+73
+00:07:56,330 --> 00:08:03,910
+في الظلام يعني هو حتى لو حاطيت في التنتين بميزجش
+
+74
+00:08:03,910 --> 00:08:09,870
+بال .. بال .. يعني بالديامتر
+
+75
+00:08:19,110 --> 00:08:24,310
+لو حاطيت في الاتنينتين ما اعرفش يعني الفرق بينهم إلا
+
+76
+00:08:24,310 --> 00:08:28,710
+في ال light عجيز ال diameter مين تأثرت اتنينتين It 
+
+77
+00:08:28,710 --> 00:08:32,790
+is usual practice
+
+78
+00:08:32,790 --> 00:08:37,030
+to dilate both eyes and this effect will have 
+
+79
+00:08:37,030 --> 00:08:40,970
+little significance unless the clinician is trying 
+
+80
+00:08:40,970 --> 00:08:44,870
+to assess the amount of anisocoria
+
+81
+00:09:01,620 --> 00:09:05,160
+وبالتالي يعني أنا بس لأهداف الدراسة لو بدي أعرف
+
+82
+00:09:05,160 --> 00:09:10,580
+مدى تأثير عضلات بال .. بال .. بالمنطقة اللي هي
+
+83
+00:09:10,580 --> 00:09:16,420
+اسمها ال anisocloria حجم البؤبؤ ده ما ترى اللي هو
+
+84
+00:09:16,420 --> 00:09:22,220
+ال .. اللي هو the pupils أه يعني أنا بقيسه وبعدين 
+
+85
+00:09:22,220 --> 00:09:25,860
+أشوف كده شهر اتأثر وفجأة أنا في بعض الناس بحطلهم
+
+86
+00:09:25,860 --> 00:09:29,500
+فأنا باجي عين سنة وقتين في التبسيط
+
+87
+00:09:40,900 --> 00:09:43,440
+الآن احنا تكلمنا قبل ذلك عن tropic amide
+
+88
+00:09:43,440 --> 00:09:47,880
+كـcycloplegic وقلنا أن هو weak cycloplegic لكن very 
+
+89
+00:09:47,880 --> 00:09:52,680
+effective من نفسه يعني أنا على وجه الكرة الأرضية
+
+90
+00:09:52,680 --> 00:10:01,000
+لو قلنا مين أكثر مدرياتكس بتفضله، بتفهم؟ يعني 
+
+91
+00:10:01,000 --> 00:10:04,240
+هنا المكان اللي يدرس فيه، اللي مدرسه هو cycloplegic 
+
+92
+00:10:04,240 --> 00:10:06,680
+عشان بس يعملوا comparison بينه وبين
+
+93
+00:10:06,680 --> 00:10:11,830
+الـcyclopentolate وبينه وبين هم atropine Tropical
+
+94
+00:10:11,830 --> 00:10:15,650
+mind is the anti-muscarinic مدرياتكس أو ال choice
+
+95
+00:10:15,650 --> 00:10:22,830
+اليوم هو الخيار الأول في هذه الأيام بعمل يقبلهم أن 
+
+96
+00:10:22,830 --> 00:10:27,490
+.. ليش؟
+
+97
+00:10:27,490 --> 00:10:30,170
+ليش؟ لحرف؟ 
+
+98
+00:10:37,400 --> 00:10:42,120
+عادةً تكون متوفرة في 0.5% و 1% يعني متوفرة في
+
+99
+00:10:42,120 --> 00:10:48,520
+السوق نص واحد نص واحد احنا في جزا بس 1% دكتور فشل 
+
+100
+00:10:48,520 --> 00:10:54,400
+مافيش نص هنا، بل لكن الصيدلي ممكن يعمل بلاتي،
+
+101
+00:10:54,400 --> 00:10:58,060
+dilation أو dilation، أقل شروع السيداني، the
+
+102
+00:10:58,060 --> 00:11:00,680
+weaker solution is normally most often for
+
+103
+00:11:00,680 --> 00:11:06,860
+المدريازي، هو ال 1% for sexual abuse يعني أن ال 0.5
+
+104
+00:11:06,860 --> 00:11:10,840
+نصف المية فارغ رياضي لأنه العضلة اللي هيستخدم
+
+105
+00:11:10,840 --> 00:11:14,440
+عليها sphincter of glucoly inhibition هتيجي بقى ..
+
+106
+00:11:14,440 --> 00:11:21,320
+لكن لو بدي أرسل استخدام muscle بخطه one piece أعضب
+
+107
+00:11:21,320 --> 00:11:23,960
+استخدام ال body ورا العيش صح؟ 
+
+108
+00:11:26,860 --> 00:11:30,000
+دافنسون في السنة السادسة وسبع سنة من الماضي اكتشف
+
+109
+00:11:30,000 --> 00:11:35,300
+أن مدرياتكس افكت هو اكتشف اكتشف أن مدرياتكس افكت هو
+
+110
+00:11:35,300 --> 00:11:39,400
+اكتشف أن مدرياتكس 
+
+111
+00:11:39,400 --> 00:11:41,620
+افكت هو اكتشف أن مدرياتكس افكت هو اكتشف أن مدرياتكس 
+
+112
+00:11:41,620 --> 00:11:42,360
+افكت هو اكتشف أن مدرياتكس افكت هو اكتشف أن مدرياتكس
+
+113
+00:11:42,360 --> 00:11:44,420
+افكت هو اكتشف أن مدرياتكس افكت هو اكتشف أن مدرياتكس
+
+114
+00:11:44,420 --> 00:11:48,060
+افكت هو اكتشف أن مدرياتكس افكت هو اكتشف أن مدرياتكس
+
+115
+00:11:48,060 --> 00:11:56,370
+افكت هو اكتشف أن مدرياتكس افكت هو اكتشف ومع ذلك هو
+
+116
+00:11:56,370 --> 00:12:01,050
+quick in onset and short in duration وهذه ميزة فيه
+
+117
+00:12:01,050 --> 00:12:06,390
+لما كنا نقول ideal properties ومدرياتكس كنا نقول 
+
+118
+00:12:06,390 --> 00:12:13,830
+اللي هو rapid onset and short duration هو مثال من
+
+119
+00:12:13,830 --> 00:12:17,650
+الأشياء هذا and the depth of mydriasis is unequal 
+
+120
+00:12:17,650 --> 00:12:21,390
+for most examinations because the pupil light
+
+121
+00:12:21,390 --> 00:12:22,090
+reflex is 
+
+122
+00:12:29,100 --> 00:12:35,800
+أنا هدفي لما أنا أوسع البؤبؤ لو إن استطعت أعمل 
+
+123
+00:12:35,800 --> 00:12:41,220
+الفحوص اللازمة أو الجراح اللازمة يعني أنا عايز
+
+124
+00:12:41,220 --> 00:12:45,460
+أعمل indirect ophthalmoscopy وهذا في bright light 
+
+125
+00:12:45,460 --> 00:12:52,200
+عكس ال direct ال direct اللي بتاعه شوية ضوء لكن ال 
+
+126
+00:12:52,200 --> 00:12:58,490
+indirect ophthalmoscopy عنده bright light يبقى أنا
+
+127
+00:12:58,490 --> 00:13:03,210
+ما بديش و أنا بعمل invite to a sandwich كده أن ال 
+
+128
+00:13:03,210 --> 00:13:04,210
+buffet يضايق
+
+129
+00:13:24,700 --> 00:13:28,140
+و الحقيقة احنا في ال practice عادي يعني واحد عنده
+
+130
+00:13:28,140 --> 00:13:31,420
+حتى شوية cataract مش أنا مش .. مش باينالي ب .. ب
+
+131
+00:13:31,420 --> 00:13:35,220
+slit lamp بعمله dilatation بتربي الكيماوية بحوطه
+
+132
+00:13:35,220 --> 00:13:38,780
+على slit lamp بعد نفس الساعة برجعه على الشمعة ببان
+
+133
+00:13:38,780 --> 00:13:46,220
+ال periphery of the lens لو فيه cataract بيبين أه
+
+134
+00:13:46,220 --> 00:13:53,750
+بيبين لو أنا بدي أعمل كمان fundus photography يعني 
+
+135
+00:13:53,750 --> 00:13:57,830
+تصوير بالكاميرا برضه أناقش بدني بدي أصور ال fundus
+
+136
+00:13:57,830 --> 00:14:03,190
+بس ثانيش حاجة نادر الآن بدأ تطلع كاميرات ولا
+
+137
+00:14:03,190 --> 00:14:08,010
+validation of the fundus لكن وين ده مستخدم فال ..
+
+138
+00:14:08,010 --> 00:14:11,930
+ال .. ال .. ال routine أن أنا أعمل validation عشان
+
+139
+00:14:11,930 --> 00:14:18,070
+أعمل ال photography تصوير photography ليش للشبكية
+
+140
+00:14:18,070 --> 00:14:27,010
+إيش أخيرانه لو احنا بنعمل cataract extraction أو
+
+141
+00:14:27,010 --> 00:14:32,890
+بدنا نعمل retinal repair بدي ألحم الشبكية اللي 
+
+142
+00:14:32,890 --> 00:14:38,990
+فيها ال detachment لازم full dilatation عشان يخش 
+
+143
+00:14:38,990 --> 00:14:43,230
+من غير full dilatation وأحيانا بتقرر يحط ال 
+
+144
+00:14:43,230 --> 00:14:46,950
+tropic amide مع أي خلاية free عشان يعمل full
+
+145
+00:14:46,950 --> 00:14:49,610
+dilatation عشان لما يخش على ال lens
+
+146
+00:14:56,360 --> 00:15:01,160
+ويبدأ يشتغل في ال cataract لو أنه مش موسع مش هعرف 
+
+147
+00:15:01,160 --> 00:15:05,380
+يشتغل ولو بده يعمل repair ل retinal detachment
+
+148
+00:15:05,380 --> 00:15:12,780
+ما أقدرش يقول لأ اقفل ده يلاتيش حياتي كتيرة سواء
+
+149
+00:15:12,780 --> 00:15:17,320
+تشخيصية أو علاجية لكن ال tropic amide في طلب
+
+150
+00:15:17,320 --> 00:15:20,680
+العيون وفي ال optometry كمان هذا موجود
+
+151
+00:15:27,620 --> 00:15:33,480
+فولارك في عام 1981 قام بإستخدام القواعد لإرسال 
+
+152
+00:15:33,480 --> 00:15:39,460
+علاقة بين مدريازيس وسيكوفيجيا تحت مستوى واحد من
+
+153
+00:15:39,460 --> 00:15:46,440
+الإضاءة يعني عمل الإضاءة باقت وعمل 
+
+154
+00:15:46,440 --> 00:15:47,160
+الإضاءة
+
+155
+00:16:25,860 --> 00:16:30,240
+ومرضى ثانيين تحت ال direct of them score أو 
+
+156
+00:16:30,240 --> 00:16:40,220
+الاثنان أقل ثقوعاً ومرضى هنا حق مرضى بنص فلمية و
+
+157
+00:16:40,220 --> 00:16:44,480
+ناس واحد فلمية وهنا نص فلمية وواحد فلمية وحاولوا 
+
+158
+00:16:44,480 --> 00:16:49,120
+يشوفوا إيه النتيجة they found that the mydriatic
+
+159
+00:16:49,120 --> 00:16:50,920
+effect was independent
+
+160
+00:17:02,410 --> 00:17:05,590
+سواء خطيئة ربع في المية أو خطيئة واحد في المية
+
+161
+00:17:05,590 --> 00:17:11,810
+تروبيكاميد لو بوسع اتوسع ما لوش عراقة بليش بالتركيز
+
+162
+00:17:11,810 --> 00:17:16,270
+ال level of illumination ولا مستوى ال illumination
+
+163
+00:17:16,270 --> 00:17:21,930
+تحط له قوي أو ضعيف يستطيع أن ايش يمسك اللي هو ال
+
+164
+00:17:21,930 --> 00:17:24,930
+بُبُب وايه ال psychological effect والغراء ي
+
+165
+00:17:24,930 --> 00:17:28,490
+return for the stronger concentrations بينما ال
+
+166
+00:17:28,490 --> 00:17:34,660
+psychological ما لهاش .. أه .. ما لهاش .. أه .. يعني
+
+167
+00:17:34,660 --> 00:17:37,400
+إلها ورقة بالواحد في المية أكثر من نصف في المية
+
+168
+00:17:37,400 --> 00:17:40,900
+تتمد على التركيز لكن ال mydriasis ما بتتدش على
+
+169
+00:17:40,900 --> 00:17:46,360
+التركيز because the finding confirms that 0.5
+
+170
+00:17:46,360 --> 00:17:50,220
+tropic amide should be used for mydriasis and 1%
+
+171
+00:17:50,220 --> 00:17:53,320
+for cycloplegia يبقى طالع بال .. إيه؟ باللون
+
+172
+00:17:53,320 --> 00:17:57,200
+الأحمر؟ أنه عشان هيك نصف في المية للتوسيع وواحد في 
+
+173
+00:17:57,200 --> 00:18:00,020
+المية لcycloplegia
+
+174
+00:18:07,040 --> 00:18:14,000
+نتيجة أن الـ Tropic amide فيما يتعلق بالديلاتيشن لا
+
+175
+00:18:14,000 --> 00:18:19,680
+يعتمد على التركيز ولا على strength of illumination
+
+176
+00:18:19,680 --> 00:18:24,960
+أو brightness of illumination بينما كمدريازيس على
+
+177
+00:18:24,960 --> 00:18:28,960
+ال ciliary muscle لا يعتمد على التركيز يعتمد على
+
+178
+00:18:28,960 --> 00:18:35,720
+التركيز يعتمد على التركيز عشان ذلك مختارين فيلم
+
+179
+00:18:35,720 --> 00:18:42,400
+الرياضي واحد person أحسن نفس ال person طب قول لك 
+
+180
+00:18:42,400 --> 00:18:46,900
+studied patients with a range of eye colors but
+
+181
+00:18:46,900 --> 00:18:51,660
+did not collate the findings for different degrees
+
+182
+00:18:51,660 --> 00:18:56,220
+of illumination pigmentation يعني هو معروف
+
+216
+00:22:38,620 --> 00:22:44,900
+بأضعف concentration أقوى من البيلو كاربين طبعًا
+
+217
+00:22:44,900 --> 00:22:49,440
+البيلو كاربين بيشتغل لكن الفايسوستيجمين أسرع لحين
+
+218
+00:22:49,440 --> 00:22:53,000
+دي أسرع يفعل ال dilatation هذا بتاع ال tropical
+
+219
+00:22:53,000 --> 00:22:54,680
+mind reversible ولا irreversible؟
+
+220
+00:22:57,840 --> 00:23:01,740
+أهو الشيء اللي احنا بنقدر ن... ن... نلحقه بيكون إيش
+
+221
+00:23:01,740 --> 00:23:05,800
+reversible اللي مالحقه مش ضاع أبو بكر الصديق رضي 
+
+222
+00:23:05,800 --> 00:23:16,580
+الله عنه في مكة عاد ليلاً فقدم له خادمه طعامًا فكر
+
+223
+00:23:16,580 --> 00:23:25,320
+لقمتين أو ثلاثًا ثم سأل بعد ما بدأ يصحو من أين هذا
+
+224
+00:23:25,320 --> 00:23:33,020
+الطعام؟ قال من عرس بني فلان فأبو بكر عرف أنهم شركاء
+
+225
+00:23:33,020 --> 00:23:42,660
+فوضع أصبعيه في حلقه وأخذ يقيه ويقيه ويقيه فخادم
+
+226
+00:23:42,660 --> 00:23:46,080
+مسلم يقول له يا رحمة الله يا أبا بكر يعني لقد شققت
+
+227
+00:23:46,080 --> 00:23:47,420
+على نفسك، إيش اللي عملته يعني؟
+
+228
+00:23:57,410 --> 00:24:04,930
+هذا irreversible إن راح في الخملات وراح على الـ cable
+
+229
+00:24:04,930 --> 00:24:08,390
+على ال portal circulation وراح على الدم، هذا إيش؟
+
+230
+00:24:08,390 --> 00:24:14,930
+هذا irreversible لكن في المعدد reversible ورايح و
+
+231
+00:24:14,930 --> 00:24:18,830
+في رواية قال والله لو لم تخرج إلا ونفسي معها
+
+232
+00:24:18,830 --> 00:24:20,950
+لفعلت ودوش ياكل حرام
+
+233
+00:24:27,920 --> 00:24:35,380
+هل قطرة أو drug له side effects يبقى قرار نفسي من 
+
+234
+00:24:35,380 --> 00:24:41,300
+الأتروبيل ليه بسيط وطبعًا سيكلوبنتوليت حتى بطبق
+
+235
+00:24:41,300 --> 00:24:46,660
+بسيط more safe ليه مش مانع more safe مية بالمية طبق
+
+236
+00:24:46,660 --> 00:24:50,360
+كيميائي يمكن يسبب فيه initial stinging يعني شوية
+
+237
+00:24:50,360 --> 00:24:55,600
+حرقة وتنخيز في العين شيء عادي few allergic
+
+238
+00:24:59,700 --> 00:25:05,700
+يعني شوية حساسية وقليلًا ما في أطفال صغار عملت 
+
+239
+00:25:05,700 --> 00:25:11,820
+systemic effect يعني تأثيرات على الجسم if the
+
+240
+00:25:11,820 --> 00:25:15,460
+patient is taking any systemic drug with an
+
+241
+00:25:15,460 --> 00:25:19,140
+antimuscarinic tropicamide يعني the effect of
+
+242
+00:25:19,140 --> 00:25:23,960
+tropicamide might be augmented  سنة الجسم يعني أنا
+
+243
+00:25:23,960 --> 00:25:28,180
+راح أحط قطرة ومثلاً باخد aspirin أو باخد
+
+244
+00:25:34,370 --> 00:25:39,050
+تروبيكاميد قوي أثر الدواء الثاني اللي أنا باخده
+
+245
+00:25:39,050 --> 00:25:44,630
+لكن إحنا عاملين عشرات السنين نستخدم تروبيكاميد 
+
+246
+00:25:44,630 --> 00:25:51,350
+أكثر شكوى منا الـ photo phobia الـ photo phobia
+
+247
+00:25:51,350 --> 00:25:58,510
+شوية حرقة شوية sting بيحرق العين
+
+248
+00:26:05,180 --> 00:26:09,460
+فاللي قال حاليًا الـ cycle of ventilate اللي هو عكس
+
+249
+00:26:09,460 --> 00:26:13,240
+tropical mine ليه شغال عكسه الـ cycle of ventilate
+
+250
+00:26:13,240 --> 00:26:19,760
+عكس tropical mine أهو
+
+251
+00:26:19,760 --> 00:26:26,660
+التانين أهو
+
+252
+00:26:26,660 --> 00:26:30,440
+رواح جاي ضغطه هو عكسه
+
+253
+00:26:43,120 --> 00:26:49,780
+مدريات قوية؟ أيوة
+
+254
+00:26:49,780 --> 00:26:56,620
+طالب الفهمانة طيب all psychopathics can be used as
+
+255
+00:26:56,620 --> 00:26:59,540
+medriatics but the effect is usually too long
+
+256
+00:26:59,540 --> 00:27:04,300
+lasting the following have been used in the past
+
+257
+00:27:04,300 --> 00:27:10,040
+وقول لي إن الوثائق اللي بنتكلم عليه بيعمل توسيع لكن 
+
+258
+00:27:10,040 --> 00:27:11,200
+توسيع ضعيف واحد
+
+259
+00:27:21,400 --> 00:27:31,040
+والتركيز هو 0.1% فتفتيزه تفتيزه بالـ 0.5% و1% لـ
+
+260
+00:27:31,040 --> 00:27:36,360
+Cycloplasia يبقى
+
+261
+00:27:36,360 --> 00:27:41,640
+الأقل تركيزه 0.1% يكفي للتوسيع لأن العضلة قريبة
+
+262
+00:27:41,640 --> 00:27:47,680
+بينما Cycloplasia أقل إش نصف بالمية أو واحد بالمية
+
+263
+00:27:53,020 --> 00:28:01,800
+القوة لا تزال متوفرة 0.1 1 على 10 مفيش منه أنا و
+
+264
+00:28:01,800 --> 00:28:06,020
+حتى إحنا إحنا لما بيجي 1% مفيش لنا نصف بالمية إيه
+
+265
+00:28:06,020 --> 00:28:12,120
+التركيب في الـ pharmacy طيب
+
+266
+00:28:12,120 --> 00:28:19,010
+يقول لي الـ cycle been too late is used as emetic, the
+
+267
+00:28:19,010 --> 00:28:22,310
+significant Cyclopidia will accompany its use هاي
+
+268
+00:28:22,310 --> 00:28:30,370
+عيوبه أن احنا بنستخدمه للتوسيع ضعف الـ systemic مثلاً يعني 
+
+269
+00:28:30,370 --> 00:28:38,470
+هيعمل strong Cyclopidia لأن هو مصمم لـ cyclopidia صح
+
+270
+00:28:38,470 --> 00:28:46,050
+بيوسع ضعيف لكن بيعمل Cyclopidia أضعاف التوسيع الناس
+
+271
+00:28:46,050 --> 00:28:52,970
+بتتغدى في استعماله وكان توسيع مدريازي يبدأ بعد نص
+
+272
+00:28:52,970 --> 00:28:59,570
+دقيقة وهو عامل في حوالي ثلاث دقائق الفك يستمر
+
+273
+00:28:59,570 --> 00:29:05,350
+فيها حتى 24 ساعة طبعًا ترميكي مايت كان ست ساعات بس 
+
+274
+00:29:05,350 --> 00:29:10,970
+ست ساعات نكون عاملين هنا ممكن ياخد 24 ساعة
+
+275
+00:29:36,550 --> 00:29:41,630
+وهذا ما قلناه أنه يعمل عملية نفصل الشبكة بحث
+
+276
+00:29:41,630 --> 00:29:50,670
+تروبيك ميت باليه وصل 80% توسيع بس خاصة في ال... في
+
+277
+00:29:50,670 --> 00:29:56,950
+ال... في ال Iris العربية فبضطر أنا أحط له 
+
+278
+00:29:56,950 --> 00:30:02,190
+cyclopentolate أحط له cyclopentolate ما هو أنا بقول
+
+279
+00:30:02,190 --> 00:30:08,070
+يعني هذه العين لما تجي العملية مش قاعدة تجري ولا 
+
+280
+00:30:08,070 --> 00:30:13,250
+قاعدة إيش ترد على الجوان بالاختلاف عن كون بس يعني
+
+281
+00:30:13,250 --> 00:30:18,460
+واحد لكن أنا أعمل إيه راح يعني ساعة وثلث أيام هنا
+
+282
+00:30:18,460 --> 00:30:21,760
+في السريع بحطه في ساعة وثلث وثلث بالإضافة ليه
+
+283
+00:30:21,760 --> 00:30:26,960
+إيش الـ tropic amide عشان أعمل full dilatation full 
+
+284
+00:30:26,960 --> 00:30:32,500
+dilatation طيب في ريق وبراتب ليه أنا قبل العملية
+
+285
+00:30:32,500 --> 00:30:39,220
+نيجي للموسوعة التالت ذكرنا الـ tropic amide واحد
+
+286
+00:30:39,220 --> 00:30:43,720
+ساعة وثلث وثلث اثنين وشوفنا واحد إيش الوش عليه
+
+287
+00:30:45,080 --> 00:30:48,920
+لأ مش هم أطباء، هم أطباء دلوقتِ حقيقة من عشر
+
+288
+00:30:48,920 --> 00:30:53,860
+سنين بيتبطى ليه جنة at one time هم أطباء was that
+
+289
+00:30:53,860 --> 00:30:59,400
+principle مدريات كان هو الأول and was often used
+
+290
+00:30:59,400 --> 00:31:03,800
+in mixtures such as هم أطباء and cocaine or هم
+
+291
+00:31:03,800 --> 00:31:07,740
+أطباء and Ephedrine كانوا بيحطوا خلطة ما غيره
+
+292
+00:31:07,740 --> 00:31:12,230
+زمان بس إحنا ممكن نقول history يعني التأثير
+
+293
+00:31:12,230 --> 00:31:18,070
+المدرياتيكي يبدأ من عشر إلى عشرين دقيقة ومقصده في
+
+294
+00:31:18,070 --> 00:31:24,570
+أربعين دقيقة يعني هذا شوية slower بقول في دقيقة
+
+295
+00:31:24,570 --> 00:31:30,370
+ثلاثين ثلاثين كما لو كان هناك ارتباط عالي ولا 
+
+296
+00:31:30,370 --> 00:31:32,590
+ارتباط عالي ولا ارتباط عالي ولا ارتباط عالي ولا
+
+297
+00:31:32,590 --> 00:31:33,690
+ارتباط عالي ولا ارتباط عالي ولا ارتباط عالي ولا
+
+298
+00:31:33,690 --> 00:31:34,850
+ارتباط عالي ولا ارتباط عالي ولا ارتبط عالي ولا
+
+299
+00:31:34,850 --> 00:31:34,910
+ارتبط عالي ولا ارتبط عالي ولا ارتبط عالي ولا
+
+300
+00:31:34,910 --> 00:31:38,470
+ارتبط عالي ولا ارتبط عالي ولا ارتبط عالي ولا
+
+301
+00:31:38,470 --> 00:31:40,410
+ارتبط عالي ولا ارتبط ع
+
+302
+00:32:05,380 --> 00:32:11,280
+عشان يرجع البقبق إلى حاجة مضطرية بس it can be as
+
+303
+00:32:11,280 --> 00:32:14,020
+prolonged as three days في بعض المرضى أخذ
+
+304
+00:32:19,070 --> 00:32:25,030
+هما متروبين يمكن استخدام 0.25 أو 0.5 ولكن هذه
+
+305
+00:32:25,030 --> 00:32:28,630
+المقاومات ليست مفتوحة بشكل شركة شركة شركة شركة
+
+306
+00:32:28,630 --> 00:32:29,470
+شركة شركة شركة شركة شركة شركة شركة شركة شركة شركة
+
+307
+00:32:29,470 --> 00:32:38,010
+شركة 
+
+308
+00:32:47,130 --> 00:32:54,630
+مزار التركيز مزار التركيز مزار التركيز مزار
+
+309
+00:32:54,630 --> 00:32:58,490
+التركيز مزار التركيز مزار التركيز مزار
+
+310
+00:32:58,490 --> 00:33:02,890
+التركيز مزار التركيز
+
+311
+00:33:12,130 --> 00:33:19,210
+بتناسب تردي مع Cyclo سأتكلم 
+
+312
+00:33:19,210 --> 00:33:23,530
+عن الفناليفرين اللي اتكلمنا عنه هنا هذا يعني قليل
+
+313
+00:33:23,530 --> 00:33:26,430
+تغير مختلف عادة بيشتغل على بيليتر وبيوكيلي مثلاً
+
+314
+00:33:26,430 --> 00:33:30,650
+هذا الـ height بيقول لك أن أنفا one agonist بيشتغل على
+
+315
+00:33:30,650 --> 00:33:36,610
+ريسبتر مش اللي شغال في الاسفينتر لأ اللي شغال وين
+
+316
+00:33:36,610 --> 00:33:50,190
+البيوتير البيوتيرفنافل هو الوحيد
+
+317
+00:33:50,190 --> 00:33:54,510
+اللي بيستخدم على طريقة
+
+318
+00:33:54,510 --> 00:34:05,710
+مدرياتك
+
+319
+00:34:05,710 --> 00:34:07,550
+مستخدم مستخدم مستخدم مستخدم مستخدم مستخدم مستخدم
+
+320
+00:34:07,550 --> 00:34:08,580
+مستخدم مستخدم مستخدم مستخدم مستخدم مستخدم مستخدم من
+
+321
+00:34:08,580 --> 00:34:15,260
+0.5 إلى 10% لأن في العالم منه من 2.5% وفيه 5% وفيه
+
+322
+00:34:15,260 --> 00:34:25,260
+7.5% وفيه 10% فاسم الشركة مدرياز يبدأ في 10 دقائق
+
+323
+00:34:25,260 --> 00:34:31,580
+وهو أكثر من 30 دقيقة ممتاز فمدرياز يستمر في عدة
+
+324
+00:34:31,580 --> 00:34:34,180
+ساعات خمسة أو ستة أو سبع ساعات
+
+325
+00:34:37,190 --> 00:34:40,990
+مقارنة مع الفدرين الفدرين كان زمان بيوسع بطل والآن
+
+326
+00:34:40,990 --> 00:34:46,450
+which it has replaced اللي هو حال ما كانوا as the
+
+327
+00:34:46,450 --> 00:34:50,410
+most commonly used مدرسة الفدرين اللي ما أجا شكها 
+
+328
+00:34:50,410 --> 00:34:54,730
+على الفدرين وشكها على الكوكاين the right reflex
+
+329
+00:34:54,730 --> 00:35:02,870
+is retained هيعني أنه لو أنا وسعت البوبة ودي بوير
+
+330
+00:35:02,870 --> 00:35:11,350
+في عينه هيرجع لنصها معناه بينفعش في bright light
+
+331
+00:35:11,350 --> 00:35:15,810
+examination زي الـ indirect ophthalmoscope وزي
+
+332
+00:35:15,810 --> 00:35:20,230
+الكاميرا بينفعناش وش
+
+333
+00:35:20,230 --> 00:35:24,850
+اتهاد بقول إن it is unsuitable والـ indirect
+
+334
+00:35:24,850 --> 00:35:28,590
+ophthalmoscope is carried out وبدأ أبحث شبكية في
+
+335
+00:35:28,590 --> 00:35:32,910
+الـ indirect ophthalmoscope وأكون مش ناجح لأنش
+
+336
+00:35:32,910 --> 00:35:33,290
+الناس بيحب
+
+337
+00:35:37,940 --> 00:35:42,940
+فناليفريني يستخدم تصميم كنجلة الطيبر وهو نمر
+
+338
+00:35:42,940 --> 00:35:46,920
+اثنين لذلك هو قش الموسع لكن عيبه أنه يجعل الـ light
+
+339
+00:35:46,920 --> 00:35:54,180
+reflex شغال الشيء الثاني أنه يجعله تضيق في الشوحات
+
+340
+00:35:54,180 --> 00:35:57,580
+الدموية والاوية الدموية للكنجلة الطيبر
+
+341
+00:36:10,580 --> 00:36:14,800
+بيعمل عيون بالمية بيعمل عيون بالمية بيعمل عيون
+
+342
+00:36:14,800 --> 00:36:15,740
+بالمية بيعمل عيون بالمية بيعمل عيون بالمية
+
+343
+00:36:15,740 --> 00:36:16,860
+بيعمل عيون بالمية بيعمل عيون بالمية بيعمل عيون
+
+344
+00:36:16,860 --> 00:36:20,400
+بالمية بيعمل عيون بالمية بيعمل عيون بالمية
+
+345
+00:36:20,400 --> 00:36:28,840
+بيعمل عيون بالمية بيعمل عيون
+
+346
+00:36:28,840 --> 00:36:31,460
+بالمية بيعمل عيون بالمية بيعمل عيون بالمية
+
+347
+00:36:31,460 --> 00:36:35,580
+بيعمل عيون بالمية بيعمل عيون بالمية بيعمل عيون
+
+348
+00:36:35,580 --> 00:36:43,340
+بالمية بيعمل عا... السيليو ما صد قولت ربيع السي
+
+349
+00:36:43,340 --> 00:36:47,320
+ناس 
+
+350
+00:36:47,320 --> 00:36:51,400
+قالوا بيشتغل كمان على السيليو ما صد بس ضعيف وناس
+
+351
+00:36:51,400 --> 00:36:57,120
+بيقولوا بيشتغلش بالمرة بيقولوا بيشتغلش بالمرة
+
+352
+00:36:57,120 --> 00:37:03,860
+بس حقيقة اللي قالوا بيشتغل معهم حاجة إن هو you
+
+353
+00:37:03,860 --> 00:37:05,380
+decreases
+
+354
+00:37:07,210 --> 00:37:11,770
+near point accommodation يعني اللي كان يقرأ من
+
+355
+00:37:11,770 --> 00:37:16,190
+ثلاثين مثلاً من عشر سنتي سيقرأ من ثلاثين أو أربعين
+
+356
+00:37:16,190 --> 00:37:19,490
+اللي
+
+357
+00:37:19,490 --> 00:37:21,810
+كان يقرأ رسالة للجوال من عشر سنتي في ال near
+
+358
+00:37:21,810 --> 00:37:27,590
+point الامد وأربعين عشان يشوفها يعني هو weak
+
+359
+00:37:27,590 --> 00:37:35,200
+psychological عند رأيه هو لاعند رأيها ولا... لأ و
+
+360
+00:37:35,200 --> 00:37:38,920
+without any psychological effect at all قالوا
+
+361
+00:37:38,920 --> 00:37:44,820
+فشايف أنا كذب إيش هنا؟ كنت أدرس إيش؟ مبوضة اختلاف،
+
+362
+00:37:44,820 --> 00:37:50,060
+مبوضة اختلاف طب الشيء الواقعي عند الواقعي الواقعي
+
+363
+00:37:50,060 --> 00:37:51,660
+الواقعي الواقعي الواقعي الواقعي الواقعي الواقعي
+
+364
+00:37:51,660 --> 00:37:53,360
+الواقعي الواقعي الواقعي الواقعي الواقعي الواقعي
+
+365
+00:37:53,360 --> 00:37:55,980
+الواقعي الواقعي الواقعي الواقعي الواقعي الواقعي
+
+366
+00:37:55,980 --> 00:37:56,440
+الواقعي الواقعي الواقعي الواقعي
+
+367
+00:38:03,630 --> 00:38:09,710
+ووجدوا إن الفناليفرين بيعمل widening أو جهة 
+
+368
+00:38:09,710 --> 00:38:13,810
+palpebral fissure فلو بيحطوا فلان واحدة أو واحدة
+
+369
+00:38:13,810 --> 00:38:20,750
+تلاقي ال palpebral fissure صار واسع كأنه اشتغل نشط
+
+370
+00:38:20,750 --> 00:38:26,090
+الـ elevator palpebral fissure أو الـ iris اشتغل على
+
+371
+00:38:26,090 --> 00:38:28,970
+إيش يعني في الحلقة تلاقي إيش يعني واسعين
+
+372
+00:38:45,310 --> 00:38:48,730
+فلايفرين is less effective in highly pigmented
+
+373
+00:38:48,730 --> 00:38:54,110
+patients اللي يعني إيه سود؟ تأثيره قليل مش
+
+374
+00:38:54,110 --> 00:38:57,670
+تأثيره قليل that disparity in midriachis was
+
+375
+00:38:57,670 --> 00:39:01,930
+greater for darkly pigmented eyes as opposed to
+
+376
+00:39:01,930 --> 00:39:06,290
+lightly colored eyes اشتغل على الناس اللي بقبهم
+
+377
+00:39:06,290 --> 00:39:08,990
+فاتح الـ iris فاتح أحسن
+
+378
+00:39:13,540 --> 00:39:19,760
+هناك محادثة عن فعالية الـ 0.5 بالنسبة للتركيز و
+
+379
+00:39:19,760 --> 00:39:29,300
+10% بالنسبة للتركيز و10% بالنسبة للتركيز و10%
+
+380
+00:39:29,300 --> 00:39:39,390
+بالنسبة للتركيز و10% بالنسبة للتركيز دوفين الـ 1983
+
+381
+00:39:39,390 --> 00:39:43,630
+found a greater effect from 10% fire free than
+
+382
+00:39:43,630 --> 00:39:48,930
+from 2.5 it must be pointed out that they were
+
+383
+00:39:48,930 --> 00:39:54,550
+using viscolyzed 10% solution against an aqueous 2
+
+384
+00:39:54,550 --> 00:39:59,830
+.5 solution and that this difference in vehicles
+
+385
+00:39:59,830 --> 00:40:02,610
+could have in France ده من مدرياتك
+
+386
+00:40:05,930 --> 00:40:14,050
+هما جابوا اثنين ونص قطرة مائية وجابوا ten
+
+387
+00:40:14,050 --> 00:40:20,010
+present أهو جابوا two point five infact vesiculate
+
+388
+00:40:20,010 --> 00:40:27,150
+infact يعني زي تية زي تية وجابوا ten solution
+
+389
+00:40:35,520 --> 00:40:40,200
+يبقى العشرة دهنية أو زيتية مضاربة في الزيون وجاهوا
+
+390
+00:40:40,200 --> 00:40:44,040
+اللي في الماء 2.5% solution and that this
+
+391
+00:40:44,040 --> 00:40:48,780
+difference ال vehicles يعني أوسط المضار فيه مائي 
+
+392
+00:40:48,780 --> 00:40:52,100
+أو زيتي could have influenced the mediatic action
+
+393
+00:40:52,100 --> 0
\ No newline at end of file
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/hyN2fKMRfMo_raw.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/hyN2fKMRfMo_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..65433a971989fae360cc06895126f6ae017f15de
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/hyN2fKMRfMo_raw.srt
@@ -0,0 +1,1624 @@
+1
+00:00:23,680 --> 00:00:29,980
+كيف تعمل مدرياتكس؟ نعرف هناك أن العيرس يحتوي على 2
+
+2
+00:00:29,980 --> 00:00:36,260
+عضلات، عضلة سفينتر بيوبيلي التي تدفع من خلال عضلة
+
+3
+00:00:36,260 --> 00:00:44,320
+باراسمبتاتيكناب وعضلة بيوبيلي التي تدفع من خلال
+
+4
+00:00:44,320 --> 00:00:45,520
+عضلة باراسمبتاتيكناب
+
+5
+00:00:55,620 --> 00:01:03,200
+لا يعملان في نفس الوقت إذا استفدت اشتغلت
+
+6
+00:01:03,200 --> 00:01:09,060
+constriction فالبقالة تربيو كلي ترخي وإذا استفدت
+
+7
+00:01:09,060 --> 00:01:10,680
+تربيو كلي ترخي وإذا استفدت تربيو كلي ترخي وإذا
+
+8
+00:01:10,680 --> 00:01:12,220
+استفدت تربيو كلي ترخي وإذا استفدت تربيو كلي ترخي
+
+9
+00:01:12,220 --> 00:01:17,700
+وإذا استفدت تربيو كلي ترخي وإذا
+
+10
+00:01:17,700 --> 00:01:21,080
+استفدت تربيو كلي ترخي وإذا استفدت تربيو كلي ترخي
+
+11
+00:01:21,080 --> 00:01:21,240
+وإذا استفدت تربيو كلي ترخي وإذا استفدت تربيو كلي
+
+12
+00:01:21,240 --> 00:01:23,980
+ترخي وإذا استفدت تربيو كلي ترخي وإذا استفدت تربيو
+
+13
+00:01:23,980 --> 00:01:31,220
+كلال .. ال .. ال .. اللي هي ال midriatics قعد أمرك
+
+14
+00:01:31,220 --> 00:01:38,860
+يبدو هي بتشتغل على ال inhibition of sphincter
+
+15
+00:01:38,860 --> 00:01:45,760
+pupillary muscle تخيلها يعني و ابتدى the retro
+
+16
+00:01:45,760 --> 00:01:51,960
+pupillary هتكون active و توسعة جمهور يا إما العكس
+
+17
+00:01:51,960 --> 00:02:00,770
+أنه في midriaticبدو يشتغل على stimulation of the
+
+18
+00:02:00,770 --> 00:02:05,470
+retro pupilla يخليها هي اتوسع و ال filter pupilla
+
+19
+00:02:05,470 --> 00:02:09,590
+تفضل silent اخدتوا
+
+20
+00:02:09,590 --> 00:02:17,090
+بركة و لا عيد تاني يعني انا عندى الآن هنا
+
+21
+00:02:17,090 --> 00:02:25,770
+ايه الموضوع في عندي في ال iris هنا في ال iris هنا
+
+22
+00:02:26,740 --> 00:02:32,400
+في عبرة اسمها sphincter pupillary في
+
+23
+00:02:32,400 --> 00:02:40,300
+ال ILS هنا في dilator pupillary ويقولوا
+
+24
+00:02:40,300 --> 00:02:44,660
+ان .. و ال sphincter pupillary يعني الاسم
+
+25
+00:02:44,660 --> 00:02:54,100
+contracts the pupil will be small و
+
+26
+00:02:54,100 --> 00:02:58,670
+ال dilator pupillary contractsit will take the
+
+27
+00:02:58,670 --> 00:03:03,370
+eyes peripherally يبقى البوابة بحيث هي كبيرة هيك
+
+28
+00:03:03,370 --> 00:03:07,030
+الان
+
+29
+00:03:07,030 --> 00:03:14,950
+اي drops بنحطها و بنقصد فيها التوسية هيكون واحد من
+
+30
+00:03:14,950 --> 00:03:17,510
+اثنين اما stimulation
+
+31
+00:03:35,950 --> 00:03:48,610
+Restriction of pubis. او اثنين stimulation of
+
+32
+00:03:48,610 --> 00:03:54,350
+dilator pupillary muscle. وهنا هيأدي الى
+
+33
+00:03:54,350 --> 00:03:56,410
+dilatation.
+
+34
+00:04:01,430 --> 00:04:03,730
+آسف، في بقطة هنا
+
+35
+00:04:14,300 --> 00:04:17,180
+Inhibition of Spectral Pupillary؟ الحقيقة ما تبقى
+
+36
+00:04:17,180 --> 00:04:25,960
+مجروح، الحقيقة مابتدوش اه؟ شايفين كيف؟
+
+37
+00:04:25,960 --> 00:04:34,260
+Dilatation، انتبهوا معايا، dilatation او
+
+38
+00:04:34,260 --> 00:04:37,340
+stimulation، او stimulation
+
+39
+00:04:43,450 --> 00:04:49,790
+هو الـ Vertex of Euclidean هو الـ Vertex بس هذا
+
+40
+00:04:49,790 --> 00:04:53,490
+الطريقة وهذا الطريقة هذا ال mechanism of action او
+
+41
+00:04:53,490 --> 00:04:59,830
+mode of action طبعا المشهور في هذا اللي هو ال
+
+42
+00:04:59,830 --> 00:05:09,010
+tropic emite tropic emite زي
+
+43
+00:05:09,010 --> 00:05:12,530
+التروكين
+
+44
+00:05:19,190 --> 00:05:23,710
+كل هؤلاء بيشتغلوا على inhibition أو سكتر بيو كلي
+
+45
+00:05:23,710 --> 00:05:30,170
+مثلا، فإن كل بيشتغلوا على سكتر بيو كلي يرخوه،
+
+46
+00:05:30,170 --> 00:05:36,650
+فيرخوها، يبقى البرادير بيو كلي جاهزة، الوحيد اللي
+
+47
+00:05:36,650 --> 00:05:39,450
+بيشتغل على stimulation وبرادير بيو كلي وبيختلف
+
+48
+00:05:39,450 --> 00:05:39,870
+عنهم
+
+49
+00:05:50,730 --> 00:05:56,690
+البرفيريين موثق للـ robot خاص بيشتغلش زيهم على
+
+50
+00:05:56,690 --> 00:06:01,030
+sphincter لأ بيشتغل ال operator بإنه يقويها تفتح
+
+51
+00:06:01,030 --> 00:06:04,590
+ال robot فالsphincter بتفتح
+
+52
+00:06:24,310 --> 00:06:29,870
+والإيمنرياتيك يتم استخدامه في عين واحدة يعني، الـ
+
+53
+00:06:29,870 --> 00:06:35,810
+right reflex in the other eye is unaffected، و
+
+54
+00:06:35,810 --> 00:06:39,930
+الرياجز in the treated eye is accompanied by a
+
+55
+00:06:39,930 --> 00:06:42,170
+consensual meiosis in the other eye
+
+56
+00:06:49,910 --> 00:06:54,730
+أو فرعان فرعان فرعان هاي البوبو إيه شامل؟ بتوسع،
+
+57
+00:06:54,730 --> 00:06:58,810
+طب هاي البوبو بهيانة بتوسع، محبت شامل ده برهانة،
+
+58
+00:06:58,810 --> 00:07:05,930
+بتوسع، أه لأن هو لغة، you're not one، لكن ال light
+
+59
+00:07:05,930 --> 00:07:06,450
+reflects
+
+60
+00:07:22,150 --> 00:07:25,970
+هنلاقي هلامة من ال construction اللي تاني، اللي
+
+61
+00:07:25,970 --> 00:07:26,750
+مافيش video ع طريقه، هنلاقي هلامة من ال
+
+62
+00:07:26,750 --> 00:07:30,010
+construction وهنا، طريق ال video، هنلاقي هلامة من
+
+63
+00:07:30,010 --> 00:07:32,610
+ال pathway، هنلاقي هلامة من ال pathway، هنلاقي
+
+64
+00:07:32,610 --> 00:07:34,370
+هلامة من ال pathway، هنلاقي هلامة من ال pathway،
+
+65
+00:07:34,370 --> 00:07:34,570
+هنلاقي هلامة من ال pathway، هنلاقي هلامة من ال
+
+66
+00:07:34,570 --> 00:07:36,070
+pathway، هنلاقي هلامة من ال pathway، هنلاقي هلامة
+
+67
+00:07:36,070 --> 00:07:39,250
+من ال pathway،
+
+68
+00:07:39,250 --> 00:07:39,330
+هنلاقي هلامة من ال pathway، هنلاقي هلامة من ال
+
+69
+00:07:39,330 --> 00:07:39,330
+pathway، هنلاقي هلامة من ال pathway، هنلاقي هلامة
+
+70
+00:07:39,330 --> 00:07:40,250
+من ال pathway، هنلاقي هلامة من ال pathway، هنلاقي
+
+71
+00:07:40,250 --> 00:07:44,810
+هلامة من ال pathway،
+
+72
+00:07:44,810 --> 00:07:47,670
+هنلاقي هلام
+
+73
+00:07:52,030 --> 00:07:56,330
+الميوزس المستقبلي لا يظهر عندما يكون الوضع ديامترا
+
+74
+00:07:56,330 --> 00:08:03,910
+في الظلام يعني هو حتى لو حاطيت في التنتين بميزجش
+
+75
+00:08:03,910 --> 00:08:09,870
+بال .. بال .. يعني بالديامتر
+
+76
+00:08:19,110 --> 00:08:24,310
+لو حاطيت في الاتنينتين ماعرفش يعني الفرق بينهم إلا
+
+77
+00:08:24,310 --> 00:08:28,710
+في ال light عجيز ال diameter مين تأثرت اتنينتين It
+
+78
+00:08:28,710 --> 00:08:32,790
+is usual practice
+
+79
+00:08:32,790 --> 00:08:37,030
+to dilate both eyes and this effect will have
+
+80
+00:08:37,030 --> 00:08:40,970
+light significance unless the clinician is trying
+
+81
+00:08:40,970 --> 00:08:44,870
+to assess the amount of anisocorticoid
+
+82
+00:09:01,620 --> 00:09:05,160
+وبالتالي يعني أنا بس لأهداف الدراسة لو بدي أعرف
+
+83
+00:09:05,160 --> 00:09:10,580
+مدى تأثير عضلات بال .. بال .. بالمنطقة اللي هي
+
+84
+00:09:10,580 --> 00:09:16,420
+اسمها ال anisocloria حجم البقرة ده ما ترى اللي هو
+
+85
+00:09:16,420 --> 00:09:22,220
+ال .. اللي هو the pupils اه يعني انا بقيثه و بعدين
+
+86
+00:09:22,220 --> 00:09:25,860
+اشوف كده شهر اتأثر و فجأة انا في بعض الناس بحطلهم
+
+87
+00:09:25,860 --> 00:09:29,500
+فانا باجي عين سنة وقتين في التبسيط
+
+88
+00:09:40,900 --> 00:09:43,440
+الان احنا اتكلمنا قبل ذلك عن atrophic amide
+
+89
+00:09:43,440 --> 00:09:47,880
+كـcyclopigic وقلنا ان هو weak cyclopigic لكن very
+
+90
+00:09:47,880 --> 00:09:52,680
+effective من نفسه يعني انا على وجه الكورة الأرضية
+
+91
+00:09:52,680 --> 00:10:01,000
+لو قلنا مين اكثر مدرياتك بتفضله، بتفهم؟ يعني
+
+92
+00:10:01,000 --> 00:10:04,240
+هنا المكان اللي يدرس فيه، اللي مدرسه هو cyclopigic
+
+93
+00:10:04,240 --> 00:10:06,680
+عشان بس يعملوا comparison بينه بين
+
+94
+00:10:06,680 --> 00:10:11,830
+الـcyclopentolate و بينه بين هم أتروبينTropical
+
+95
+00:10:11,830 --> 00:10:15,650
+mind is the anti-masculinic مدرياتك أو ال choice
+
+96
+00:10:15,650 --> 00:10:22,830
+اليوم هو الخيار الأول في هذه الأيام بعمل يقبلهم ان
+
+97
+00:10:22,830 --> 00:10:27,490
+.. ليش؟
+
+98
+00:10:27,490 --> 00:10:30,170
+ليش؟ لحرف؟
+
+99
+00:10:37,400 --> 00:10:42,120
+عادةً تكون متوفرة في 0.5% و 1% يعني متوفرة في
+
+100
+00:10:42,120 --> 00:10:48,520
+السوق نص واحد نص واحد احنا في جزا بس 1% دكتور فشل
+
+101
+00:10:48,520 --> 00:10:54,400
+مافيش نص هنا، بل لكن السيداني ممكن يعمل بلاتي،
+
+102
+00:10:54,400 --> 00:10:58,060
+dilation او dilation، اقل شروع السيداني، the
+
+103
+00:10:58,060 --> 00:11:00,680
+weaker solution is normally most often for
+
+104
+00:11:00,680 --> 00:11:06,860
+المدريازي، هو ال 1% for sexual abuseيعني ان ال 0.5
+
+105
+00:11:06,860 --> 00:11:10,840
+نصف المية فارغ رياضي لأنه العضلة اللي هيستخدم
+
+106
+00:11:10,840 --> 00:11:14,440
+عليها filter of glucoly inhibition هتيجي بقى ..
+
+107
+00:11:14,440 --> 00:11:21,320
+لكن لو بدي ارسل استخدام muscle بخطه one piece أعضب
+
+108
+00:11:21,320 --> 00:11:23,960
+استخدام ال body ورا العيش صح؟
+
+109
+00:11:26,860 --> 00:11:30,000
+دافنسون في السنة السادسة وسبع سنة من الماضي اكتشف
+
+110
+00:11:30,000 --> 00:11:35,300
+ان مدرياتك افكت هو اكتشف اكتشف ان مدرياتك افكت هو
+
+111
+00:11:35,300 --> 00:11:39,400
+اكتشف ان مدرياتك
+
+112
+00:11:39,400 --> 00:11:41,620
+افكت هو اكتشف ان مدرياتك افكت هو اكتشف ان مدرياتك
+
+113
+00:11:41,620 --> 00:11:42,360
+افكت هو اكتشف ان مدرياتك افكت هو اكتشف ان مدرياتك
+
+114
+00:11:42,360 --> 00:11:44,420
+افكت هو اكتشف ان مدرياتك افكت هو اكتشف ان مدرياتك
+
+115
+00:11:44,420 --> 00:11:48,060
+افكت هو اكتشف ان مدرياتك افكت هو اكتشف ان مدرياتك
+
+116
+00:11:48,060 --> 00:11:56,370
+افكت هو اكتشف ان مدرياتك افكت هو اكتشومع ذلك هو
+
+117
+00:11:56,370 --> 00:12:01,050
+quick in onset and short in duration وهذه ميزة فيه
+
+118
+00:12:01,050 --> 00:12:06,390
+لما كنا نقول ideal properties ومدرياتك كنا نقول
+
+119
+00:12:06,390 --> 00:12:13,830
+اللي هو rapid onset and short duration هو مثال من
+
+120
+00:12:13,830 --> 00:12:17,650
+الاشياء هذا and the depth of mediasis is unequal
+
+121
+00:12:17,650 --> 00:12:21,390
+for most examinations because the pupil light
+
+122
+00:12:21,390 --> 00:12:22,090
+reflex is
+
+123
+00:12:29,100 --> 00:12:35,800
+أنا هدفي لما انا اوسع البواب لو ان استطيع اعمل
+
+124
+00:12:35,800 --> 00:12:41,220
+الفحوص اللازمة او الجراح اللازمة يعني انا عايز
+
+125
+00:12:41,220 --> 00:12:45,460
+اعمل indirect of thermoscopy و هذا في bright light
+
+126
+00:12:45,460 --> 00:12:52,200
+عكس ال direct ال direct اللي بتاعه شوية ذنب لكن ال
+
+127
+00:12:52,200 --> 00:12:58,490
+indirect of thermoscopy عنده bright lightيبقى انا
+
+128
+00:12:58,490 --> 00:13:03,210
+مابديش و انا بعمل invite to a sandwich كده انه ال
+
+129
+00:13:03,210 --> 00:13:04,210
+buffet يضايق
+
+130
+00:13:24,700 --> 00:13:28,140
+و الحقيقة احنا في ال practice عادى يعني واحد عنده
+
+131
+00:13:28,140 --> 00:13:31,420
+حتى شوية cataract مش انا مش .. مش باينالي ب .. ب
+
+132
+00:13:31,420 --> 00:13:35,220
+slit lamp بعمله dilatation بتربي الكيماية بحوطه
+
+133
+00:13:35,220 --> 00:13:38,780
+على slit lamp بعد نفس الساعة برجعه على الشمعة بيان
+
+134
+00:13:38,780 --> 00:13:46,220
+ال periphery of the lens لو فيه cataract بيبين اه
+
+135
+00:13:46,220 --> 00:13:53,750
+بيبين لو انا بدي اعمل كمان fun bus photographyيعني
+
+136
+00:13:53,750 --> 00:13:57,830
+تصوير بالكاميرا برضه أناقش بدني بدي أصور بوكيموية
+
+137
+00:13:57,830 --> 00:14:03,190
+بس تانيش حاجة نادر الآن بدأ تطلع كاميرات و لا
+
+138
+00:14:03,190 --> 00:14:08,010
+validation of the people لكن وين ده مستخدم فال ..
+
+139
+00:14:08,010 --> 00:14:11,930
+ال .. ال .. ال routine أن أنا أعمل validation عشان
+
+140
+00:14:11,930 --> 00:14:18,070
+أعمل ال photography تصوير photography لليش لشبكية
+
+141
+00:14:18,070 --> 00:14:27,010
+إش أخيرانه لو احنا بنعمل cataract extraction او
+
+142
+00:14:27,010 --> 00:14:32,890
+بدنا نعمل retinal repair بدي ألحم الشبكية اللي
+
+143
+00:14:32,890 --> 00:14:38,990
+فيها ال detachment لازم full dilatation عشان يخش
+
+144
+00:14:38,990 --> 00:14:43,230
+من غير full dilatation و أحيانا بتقرر يحط ال
+
+145
+00:14:43,230 --> 00:14:46,950
+trophic amide مع اي خلاية free عشان يعمل full
+
+146
+00:14:46,950 --> 00:14:49,610
+dilatation عشان لما يخش على ال lens
+
+147
+00:14:56,360 --> 00:15:01,160
+و يبدأ يشتغل في ال cataract لو انه مش موسع مش هعرف
+
+148
+00:15:01,160 --> 00:15:05,380
+يشتغل و لو بده يعمل repair ل retinal detachment
+
+149
+00:15:05,380 --> 00:15:12,780
+مابقدرش يقول لأ اقفل ده يلاتيش حياتي كتيرة سواء
+
+150
+00:15:12,780 --> 00:15:17,320
+تشخصية او علاجية لكن ال tropical mild في طلب
+
+151
+00:15:17,320 --> 00:15:20,680
+العيون و في الoptometry كمان هذا موجود
+
+152
+00:15:27,620 --> 00:15:33,480
+فولارك في عام 1981 قام بإستخدام القواعد لإرسال
+
+153
+00:15:33,480 --> 00:15:39,460
+علاقة بين مدريزين وسيكوفيجيا تحت مستوى واحد من
+
+154
+00:15:39,460 --> 00:15:46,440
+الاليومانيشن يعني عمل اليومانيشن باقت وعمل
+
+155
+00:15:46,440 --> 00:15:47,160
+اليومانيشن
+
+156
+00:16:25,860 --> 00:16:30,240
+و مرضى تانيين تحت ال direct of them score او
+
+157
+00:16:30,240 --> 00:16:40,220
+الاثنان اقل ثقوعا و مرضى هنا حق مرضى بنص فلمية و
+
+158
+00:16:40,220 --> 00:16:44,480
+ناس واحد فلمية وهنا نص فلمية و واحد فلمية و حاولوا
+
+159
+00:16:44,480 --> 00:16:49,120
+يشوف ايه النتيجة they found that the magnetic
+
+160
+00:16:49,120 --> 00:16:50,920
+effect was independent
+
+161
+00:17:02,410 --> 00:17:05,590
+سواء خطيئة ربع في المية او خطيئة واحد في المية
+
+162
+00:17:05,590 --> 00:17:11,810
+ترابيكيمية لو بوسع اتوسع مالوش عراقة بليش بالتركيز
+
+163
+00:17:11,810 --> 00:17:16,270
+ال level of illumination ولا مستوى ال illumination
+
+164
+00:17:16,270 --> 00:17:21,930
+تحطله قوي او ضعيف يستطيع ان ايش يمسك اللي هو ال
+
+165
+00:17:21,930 --> 00:17:24,930
+بُبُب و ايه ال psychological effect والغراء ي
+
+166
+00:17:24,930 --> 00:17:28,490
+return for the stronger concentrations بينما ال
+
+167
+00:17:28,490 --> 00:17:34,660
+psychologicalمالهاش .. اه .. مالهاش .. اه .. يعني
+
+168
+00:17:34,660 --> 00:17:37,400
+إلها ورقة بالواحد في المية أكتر من نصف في المية
+
+169
+00:17:37,400 --> 00:17:40,900
+تتمد على التركيز لكن ال verification مابتدش على
+
+170
+00:17:40,900 --> 00:17:46,360
+التركيز because the finding confirms that 0.5
+
+171
+00:17:46,360 --> 00:17:50,220
+tropic amide should be used for materials and 1%
+
+172
+00:17:50,220 --> 00:17:53,320
+for cycloplasia يبقى طالع بال .. إيه؟ باللون
+
+173
+00:17:53,320 --> 00:17:57,200
+الأحمر؟ إنه عشان هيك نصف في المية للتوسيع وواحد في
+
+174
+00:17:57,200 --> 00:18:00,020
+المية لcycloplasia
+
+175
+00:18:07,040 --> 00:18:14,000
+لنتيجة أن الـ Tropic MI في ما يتعلق بالديلاتيشن لا
+
+176
+00:18:14,000 --> 00:18:19,680
+يعتمد على التركيز ولا على strength of illumination
+
+177
+00:18:19,680 --> 00:18:24,960
+أو brightness of illumination بينما كمدريازيس على
+
+178
+00:18:24,960 --> 00:18:28,960
+الcellary muscle لا يعتمد على التركيز يعتمد على
+
+179
+00:18:28,960 --> 00:18:35,720
+التركيز يعتمد على التركيز عشان ذلك مختارهفيلم
+
+180
+00:18:35,720 --> 00:18:42,400
+الرياضي واحد person احسن نفس ال person طب قولك
+
+181
+00:18:42,400 --> 00:18:46,900
+studied patients with a range of eye colors but
+
+182
+00:18:46,900 --> 00:18:51,660
+did not collate the findings for different degrees
+
+183
+00:18:51,660 --> 00:18:56,220
+of illumination pigmentation يعني هو معروف ان
+
+184
+00:18:56,220 --> 00:18:59,860
+الناس اللي darkly pigmented eyes
+
+185
+00:19:04,140 --> 00:19:09,180
+و more slow than a light .. lightly pigmented يبقى
+
+186
+00:19:09,180 --> 00:19:15,200
+اللي هو iris iridescent لكن أسف انه اللي هو
+
+187
+00:19:15,200 --> 00:19:23,860
+Polarkara ماعملش تصنيف و ربط لون ال iris بالتدريج
+
+188
+00:19:23,860 --> 00:19:28,800
+بقوة التوسيع، يعني انت عمل .. او بدنا نبحث
+
+189
+00:19:28,800 --> 00:19:36,960
+محاولاتك ولا هذاتقدروا مثلا ست دردات من ألوان ال I
+
+190
+00:19:36,960 --> 00:19:42,640
+-Rates ال I-Rates ست دردات منهم و تبدأوا تحطوا
+
+191
+00:19:42,640 --> 00:19:48,820
+Topic MI و تاسموها الساعة Stock Watch حالة واحدة
+
+192
+00:19:48,820 --> 00:19:53,100
+من كله لازم تكون في قياس؟ والله كويس مبين جيبوا
+
+193
+00:19:53,100 --> 00:19:54,880
+حالة جيبوا حالة
+
+194
+00:19:59,780 --> 00:20:01,720
+و تلاتة تانية بيشتغلوا شغل و تلاتة تانية بيشتغلوا
+
+195
+00:20:01,720 --> 00:20:07,240
+شغل هو مقام الدراسات تاعتوا
+
+196
+00:20:07,240 --> 00:20:10,740
+تقيسوا الببو الدياموتاب؟ اه اه اه اه و
+
+197
+00:20:10,740 --> 00:20:17,380
+دستروبيكمايز موجودة هنا شوفولي مثلا خمسة او ستة من
+
+198
+00:20:17,380 --> 00:20:23,540
+القطيار اللي هو ال ice وانجدوه قويس اشلونه تدعم
+
+199
+00:20:23,540 --> 00:20:29,200
+الأسود وحتى الأخضر و الأزرق more or less وعملوا
+
+200
+00:20:30,190 --> 00:20:38,090
+وشوفوا مدى التوسيع والوقت الزمني والبقية
+
+201
+00:20:38,090 --> 00:20:43,910
+من هذا الكلام انا عندي ايه درجات؟ البقية من هذا
+
+202
+00:20:43,910 --> 00:20:50,430
+الكلام ايه درجات؟ طبعا ان هذا 10 طيب hence it is
+
+203
+00:20:50,430 --> 00:20:52,430
+possible that the strength
+
+204
+00:21:02,400 --> 00:21:06,520
+العنصر pigmentation if necessary a second drop can
+
+205
+00:21:06,520 --> 00:21:08,960
+be applied five minutes after the first
+
+206
+00:21:28,250 --> 00:21:35,310
+النقطة الأولى أثيرت .. إيش يا جنان أثيرت؟ البلانين
+
+207
+00:21:35,310 --> 00:21:39,210
+أثرها .. أخر
+
+208
+00:21:39,210 --> 00:21:43,150
+عمل الدولة الشاشية .. فإحنا بنأكد بنقطة تانية ..
+
+209
+00:21:43,150 --> 00:21:48,730
+حتى نستعمل و نسرع ال material caused by tropic
+
+210
+00:21:48,730 --> 00:21:52,750
+emite can be reversed if necessary with weak
+
+211
+00:21:52,750 --> 00:21:55,390
+solutions of physostigmia
+
+212
+00:21:57,180 --> 00:22:03,840
+لنفرض ان احنا جينا نوصل لواحد بعد شوية بدأت عنده
+
+213
+00:22:03,840 --> 00:22:09,560
+معالم شوية قلم حمار او
+
+214
+00:22:09,560 --> 00:22:18,800
+قليل وخفنا احنا من ال glucoma attack of اللي هو
+
+215
+00:22:18,800 --> 00:22:25,680
+closure of the glucoma لان هل بيمكن نستدرك
+
+216
+00:22:32,480 --> 00:22:38,620
+فايسوستيجمين هو الأمثل فيسوستيجمين فيسوستيجمين
+
+217
+00:22:38,620 --> 00:22:44,900
+بأضعف concentration أقوى من البيلو كاربين طبعا
+
+218
+00:22:44,900 --> 00:22:49,440
+البيلو كاربين بيشتغل لكن الفايسوستيجمين أسرع لحين
+
+219
+00:22:49,440 --> 00:22:53,000
+دي أسرع يفه ال dilatation هذا بتاع ال tropical
+
+220
+00:22:53,000 --> 00:22:54,680
+mind reversible ولا irreversible؟
+
+221
+00:22:57,840 --> 00:23:01,740
+اه الشي اللي احنا بنقدر ن .. ن .. نلحقه بكون ايش
+
+222
+00:23:01,740 --> 00:23:05,800
+reversible اللي مالحقه مش ضاع ابو بكر الصديق رضي
+
+223
+00:23:05,800 --> 00:23:16,580
+الله عنه في مكة عاد ليلا فقدمله خادمه طعام فكر
+
+224
+00:23:16,580 --> 00:23:25,320
+لقمتين او ثلاثا ثم سأل بعد ما بدأ يصحى من اين هذا
+
+225
+00:23:25,320 --> 00:23:33,020
+الطعام؟قال من عرس لبني فلان فابو بكر عرف هم شركين
+
+226
+00:23:33,020 --> 00:23:42,660
+فوضع أصبعيه في حلقه و أخد يقيه و يقيه و يقيه فخادم
+
+227
+00:23:42,660 --> 00:23:46,080
+مسلم يقول له يا رحمه الله يا ابا بكر يعني لقد شققت
+
+228
+00:23:46,080 --> 00:23:47,420
+على نفسك، ايش اللي عملته يعني؟
+
+229
+00:23:57,410 --> 00:24:04,930
+هذا irreversible ان راح في الخملات و راح على الكبل
+
+230
+00:24:04,930 --> 00:24:08,390
+على ال portal circulation و راح ع الدم، هذا ايش؟
+
+231
+00:24:08,390 --> 00:24:14,930
+هذا irreversible لكن في المعدد reversible و راحي و
+
+232
+00:24:14,930 --> 00:24:18,830
+في رواية قال و الله لو لم تخرج الا و نفسي معها
+
+233
+00:24:18,830 --> 00:24:20,950
+لفعلت ودوش ياكل حرام
+
+234
+00:24:27,920 --> 00:24:35,380
+هل قطرة او drug له side effects يبقى قرار نفسي من
+
+235
+00:24:35,380 --> 00:24:41,300
+الأتروبيل لأ بسيط و قبعا سيكلو بنتوليت حتى بطبق
+
+236
+00:24:41,300 --> 00:24:46,660
+بسيط more safe ليه مش مانع more safe مية لمية طبق
+
+237
+00:24:46,660 --> 00:24:50,360
+كيميائي يمكن يسبب فيه initial stinging يعني شوية
+
+238
+00:24:50,360 --> 00:24:55,600
+حرجان و تنخيز في العلم شي عادي few allergic
+
+239
+00:24:59,700 --> 00:25:05,700
+يعني شوية حسية و قليلا ما في أطفال صغار عملت
+
+240
+00:25:05,700 --> 00:25:11,820
+systemic effect يعني تأثيرات على الجسم if the
+
+241
+00:25:11,820 --> 00:25:15,460
+patient is taking any systemic drug with an
+
+242
+00:25:15,460 --> 00:25:19,140
+antimascarinic tropicamide يعني the effect of
+
+243
+00:25:19,140 --> 00:25:23,960
+tropicamide might be augmented سنة الجسم يعني انا
+
+244
+00:25:23,960 --> 00:25:28,180
+راح احط قطرة و مثلا باخد aspirin او باخد
+
+245
+00:25:34,370 --> 00:25:39,050
+تروبيكامالي قوى أثر الدراجة التانى اللى أنا رغمها
+
+246
+00:25:39,050 --> 00:25:44,630
+لكن احنا عاملنا عشرات السنين نستخدم تروبيكامال
+
+247
+00:25:44,630 --> 00:25:51,350
+اكتر اشتاقه مننا ال photo phobia ال photo phobia
+
+248
+00:25:51,350 --> 00:25:58,510
+شوية حمار شوية sting بيحرق اهل
+
+249
+00:26:05,180 --> 00:26:09,460
+فاللي قال حالي ال cycle of ventilate اللي هو عكس
+
+250
+00:26:09,460 --> 00:26:13,240
+tropical mine ليه شغال عكسه ال cycle of ventilate
+
+251
+00:26:13,240 --> 00:26:19,760
+عكس tropical mine اه
+
+252
+00:26:19,760 --> 00:26:26,660
+التانين اه
+
+253
+00:26:26,660 --> 00:26:30,440
+رواح جاذي ريشه هو عكسه
+
+254
+00:26:43,120 --> 00:26:49,780
+مدرياتية قوية؟ ايوة
+
+255
+00:26:49,780 --> 00:26:56,620
+طالب الفهمانة طيب all psychopathics can be used as
+
+256
+00:26:56,620 --> 00:26:59,540
+medriatics but the effect is usually too long
+
+257
+00:26:59,540 --> 00:27:04,300
+lasting the following have been used in the past
+
+258
+00:27:04,300 --> 00:27:10,040
+وقوللي ان الوثائق اللي بنتقوليه بيعمل توسيق لكن
+
+259
+00:27:10,040 --> 00:27:11,200
+توسيق ضعيف واحد
+
+260
+00:27:21,400 --> 00:27:31,040
+والتركيز هو 0.1% تفتيزه تفتيزه بالـ 0.5% و 1% لـ
+
+261
+00:27:31,040 --> 00:27:36,360
+Cycloplasia يبقى
+
+262
+00:27:36,360 --> 00:27:41,640
+الأقل تركيزه 0.1% يكفي للتوسيع لأن العضلة قريبة
+
+263
+00:27:41,640 --> 00:27:47,680
+بينما Cycloplasia أقل إش نصف فلمية أو واحد فالمية
+
+264
+00:27:53,020 --> 00:28:01,800
+القوة لا تزال متوفرة 0.1 1 على 10 مافيش منه انا و
+
+265
+00:28:01,800 --> 00:28:06,020
+حتى احنا احنا لما بيجي 1% مافيش لنا نصف فالمين ايه
+
+266
+00:28:06,020 --> 00:28:12,120
+التركيب في ال pharmacy طيب
+
+267
+00:28:12,120 --> 00:28:19,010
+يقولي ال cycle been too lateis used as emetic, the
+
+268
+00:28:19,010 --> 00:28:22,310
+significant Cyclopidia will accompany its use هاي
+
+269
+00:28:22,310 --> 00:28:30,370
+عيوبة انحطنها للتوسية ضعف السلمي مثلا يعني
+
+270
+00:28:30,370 --> 00:28:38,470
+هيعمل strong Cyclopidia لأن هو مصمم لcyclopidia صح
+
+271
+00:28:38,470 --> 00:28:46,050
+بيوسع ضعيف لكن بيعمل Cyclopidia أضعاف التوسيةالناس
+
+272
+00:28:46,050 --> 00:28:52,970
+تتغدى في استعمال وكان وسع مدريازي يبدأ بعد نص
+
+273
+00:28:52,970 --> 00:28:59,570
+دقائق و هو عامل في حوالي ثلاثة دقائق الفك يستمر
+
+274
+00:28:59,570 --> 00:29:05,350
+فيها حتى 24 ساعات طبعا ترميكي مايت كان ست ساعات بس
+
+275
+00:29:05,350 --> 00:29:10,970
+ست ساعات نكون عاملين هنا ممكن ياخد 24 ساعات
+
+276
+00:29:36,550 --> 00:29:41,630
+وهذا ما قلناه انه يعمل عملية نفصل الشبكة بحث
+
+277
+00:29:41,630 --> 00:29:50,670
+تروبيك ميت باليه وصل 80%توسيع بس خاصة في ال .. في
+
+278
+00:29:50,670 --> 00:29:56,950
+ال .. في ال Iris العربية فبضطر انا احطله
+
+279
+00:29:56,950 --> 00:30:02,190
+cyclopentolate بحطله cyclopentolate ما هو انا بقول
+
+280
+00:30:02,190 --> 00:30:08,070
+يعني هذا العينان لما يجوم العملية مش قاعد يجرى ولا
+
+281
+00:30:08,070 --> 00:30:13,250
+قاعد ايش يرد على الجوان بالاختلاف عن كون بس يعني
+
+282
+00:30:13,250 --> 00:30:18,460
+واحدلكن انا اعمل ايه راح يعني ساعة و تلت ايام هنا
+
+283
+00:30:18,460 --> 00:30:21,760
+في السريع بحطه في ساعة و تلت و تلت بالاضافة ليه
+
+284
+00:30:21,760 --> 00:30:26,960
+ايش ال tropic amide عشان اعمل full dilatation full
+
+285
+00:30:26,960 --> 00:30:32,500
+dilatation طيب في ريق و براتب ليه انا قبل العملية
+
+286
+00:30:32,500 --> 00:30:39,220
+نيجي للموسأة التالت ذكرنا ال tropic amide واحد
+
+287
+00:30:39,220 --> 00:30:43,720
+ساعة و تلت و تلت اتنين و شوفنا واحد ايش الوش عليه
+
+288
+00:30:45,080 --> 00:30:48,920
+لأ مش هم أطربيين، هم أطربيين دلوقت حقيقة من عشر
+
+289
+00:30:48,920 --> 00:30:53,860
+سنة أتبطى ليه جنة at one time هم أطربيين was that
+
+290
+00:30:53,860 --> 00:30:59,400
+principle مدرياتك كان هو الأول and was often used
+
+291
+00:30:59,400 --> 00:31:03,800
+in mixtures such as هم أطربيين and cocaine or هم
+
+292
+00:31:03,800 --> 00:31:07,740
+أطربيين and Ephedrine كانوا بيحطوا خلطة ما غيره
+
+293
+00:31:07,740 --> 00:31:12,230
+زمان بس احنا ممكن نقول history يعنيالتأثير
+
+294
+00:31:12,230 --> 00:31:18,070
+المدرياتيكي يبدأ من عشر إلى عشرين دقيقة ومقصدا في
+
+295
+00:31:18,070 --> 00:31:24,570
+أربعين دقيقة يعني هذا شوية slower بقول في دقيقة
+
+296
+00:31:24,570 --> 00:31:30,370
+تلاتين تلاتين كما لو كان هناك ارتباط عالي و لا
+
+297
+00:31:30,370 --> 00:31:32,590
+ارتباط عالي و لا ارتباط عالي و لا ارتباط عالي و لا
+
+298
+00:31:32,590 --> 00:31:33,690
+ارتباط عالي و لا ارتباط عالي و لا ارتباط عالي و لا
+
+299
+00:31:33,690 --> 00:31:34,850
+ارتباط عالي و لا ارتباط عالي و لا ارتبط عالي و لا
+
+300
+00:31:34,850 --> 00:31:34,910
+ارتبط عالي و لا ارتبط عالي و لا ارتبط عالي و لا
+
+301
+00:31:34,910 --> 00:31:38,470
+ارتبط عالي و لا ارتبط عالي و لا ارتبط عالي و لا
+
+302
+00:31:38,470 --> 00:31:40,410
+ارتبط عالي و لا ارتبط ع
+
+303
+00:32:05,380 --> 00:32:11,280
+عشان يرجع البقبق إلى حاجة مضطرية بس it can be as
+
+304
+00:32:11,280 --> 00:32:14,020
+prolonged as three days في بعض المرضى أخذ
+
+305
+00:32:19,070 --> 00:32:25,030
+هما متروبين يمكن استخدام 0.25 أو 0.5 ولكن هذه
+
+306
+00:32:25,030 --> 00:32:28,630
+المقاومات ليست مفتوحة بشكل شركة شركة شركة شركة
+
+307
+00:32:28,630 --> 00:32:29,470
+شركة شركة شركة شركة شركة شركة شركة شركة شركة شركة
+
+308
+00:32:29,470 --> 00:32:38,010
+شركة
+
+309
+00:32:47,130 --> 00:32:54,630
+مزار التركيز مزار التركيز مزار التركيز مزار
+
+310
+00:32:54,630 --> 00:32:58,490
+التركيز مزار التركيز مزار التركيز مزار
+
+311
+00:32:58,490 --> 00:33:02,890
+التركيز مزار التركيز
+
+312
+00:33:12,130 --> 00:33:19,210
+بتناسب تردي مع Cyclo سأتكلم
+
+313
+00:33:19,210 --> 00:33:23,530
+عن الفناليفرين اللي اتكلمنا عنه هنا هذا يعني قليل
+
+314
+00:33:23,530 --> 00:33:26,430
+تغير مختلف عادة بيشتغل على بيليتر و بيوكيلي مثلا
+
+315
+00:33:26,430 --> 00:33:30,650
+هذا الهايت بيقولك أن أنفا one agonist بيشتغل على
+
+316
+00:33:30,650 --> 00:33:36,610
+ريسبتر مش اللي شغال في الاسفينتر لأ اللي شغال وين
+
+317
+00:33:36,610 --> 00:33:50,190
+البيوتر البيوترفنافل هو الوحيد
+
+318
+00:33:50,190 --> 00:33:54,510
+اللي بيستخدم على طريقة
+
+319
+00:33:54,510 --> 00:34:05,710
+مدرياتيك
+
+320
+00:34:05,710 --> 00:34:07,550
+مستخدم مستخدم مستخدم مستخدم مستخدم مستخدم مستخدم
+
+321
+00:34:07,550 --> 00:34:08,580
+مستخدم مستخدم مستخدم مستخدم مستخدم مستخدم مستخدممن
+
+322
+00:34:08,580 --> 00:34:15,260
+0.5 إلى 10% لأن في العالم منه من 2.5% وفيه 5% وفيه
+
+323
+00:34:15,260 --> 00:34:25,260
+7.5% وفيه 10% فاسم الشركة مدرياز يبدأ في 10 دقائق
+
+324
+00:34:25,260 --> 00:34:31,580
+وهو أكثر من 30 دقائق ممتاز فمدرياز يستمر في عدة
+
+325
+00:34:31,580 --> 00:34:34,180
+ساعات خمسة أو ستة أو سبعة ساعات
+
+326
+00:34:37,190 --> 00:34:40,990
+مقارنة مع الفدرين الفدرين كان زمان بوسع بطل والآن
+
+327
+00:34:40,990 --> 00:34:46,450
+which it has replaced اللي هو حال ما كانوا as the
+
+328
+00:34:46,450 --> 00:34:50,410
+most commonly used مدرسة الفدرين اللي ما إجا سكها
+
+329
+00:34:50,410 --> 00:34:54,730
+على الفدرين و سكها على الكوكاين the right reflex
+
+330
+00:34:54,730 --> 00:35:02,870
+is retained هيعني انه لو انا وسعي البوبه ودي بوير
+
+331
+00:35:02,870 --> 00:35:11,350
+في عينه هيرجع لنصمهمعناه بينفعش في bright light
+
+332
+00:35:11,350 --> 00:35:15,810
+examination زي ال indirect ophthalmoscope و زي
+
+333
+00:35:15,810 --> 00:35:20,230
+الكاميرا بينفعناش وش
+
+334
+00:35:20,230 --> 00:35:24,850
+اتهاد بقول ان it is unsuitable و ال indirect
+
+335
+00:35:24,850 --> 00:35:28,590
+ophthalmoscope is carried out و بدأ أبحث شبكية في
+
+336
+00:35:28,590 --> 00:35:32,910
+ال indirect ophthalmoscope و أكون مش ناجح لإنش
+
+337
+00:35:32,910 --> 00:35:33,290
+الناس بيحب
+
+338
+00:35:37,940 --> 00:35:42,940
+فنائي الفريني يستخدم تصميم كنجلة الطيبر وهو نمر
+
+339
+00:35:42,940 --> 00:35:46,920
+اثنين لذلك هو قش الموسع لكن عيبه انه يجعل ال light
+
+340
+00:35:46,920 --> 00:35:54,180
+reflex شغال الشيء التاني انه يجعله تضيق في الشوحات
+
+341
+00:35:54,180 --> 00:35:57,580
+الدموية والاوية الدموية للكنجلة الطيبر
+
+342
+00:36:10,580 --> 00:36:14,800
+يعمل عيون في المية بيعمل عيون في المية بيعمل عيون
+
+343
+00:36:14,800 --> 00:36:15,740
+في المية بيعمل عيون في المية بيعمل عيون في المية
+
+344
+00:36:15,740 --> 00:36:16,860
+بيعمل عيون في المية بيعمل عيون في المية بيعمل عيون
+
+345
+00:36:16,860 --> 00:36:20,400
+في المية بيعمل عيون في المية بيعمل عيون في المية
+
+346
+00:36:20,400 --> 00:36:28,840
+بيعمل عيون في المية بيعمل عيون
+
+347
+00:36:28,840 --> 00:36:31,460
+في المية بيعمل عيون في المية بيعمل عيون في المية
+
+348
+00:36:31,460 --> 00:36:31,460
+بيعمل عيون في المية بيعمل عيون في المية بيعمل عيون
+
+349
+00:36:31,460 --> 00:36:31,460
+في المية بيعمل عيون في المية بيعمل عيون في المية
+
+350
+00:36:31,460 --> 00:36:35,580
+بيعمل عيون في المية بيعمل عيون في المية بيعمل عيون
+
+351
+00:36:35,580 --> 00:36:43,340
+في المية بيعمل عال .. السيليو ماصد قولت ربيع السي
+
+352
+00:36:43,340 --> 00:36:47,320
+ناس
+
+353
+00:36:47,320 --> 00:36:51,400
+جالوا بيشتغل كمان على السيليو ماصد بس ضعيف و ناس
+
+354
+00:36:51,400 --> 00:36:57,120
+بيقولوا بيشتغلش بالمرة ناس بيقولوا بيشتغلش بالمرة
+
+355
+00:36:57,120 --> 00:37:03,860
+بس حقيقة اللي جالوا بيشتغل معهم حاجة ان هو you
+
+356
+00:37:03,860 --> 00:37:05,380
+decreases
+
+357
+00:37:07,210 --> 00:37:11,770
+near point accommodation يعني اللي كان يقرأ من
+
+358
+00:37:11,770 --> 00:37:16,190
+تلاتين مثلا من عشر سانتي سيقرأ من تلاتين او اربعين
+
+359
+00:37:16,190 --> 00:37:19,490
+اللي
+
+360
+00:37:19,490 --> 00:37:21,810
+كان يقرأ رسالة للجوال من عشر سانتي في ال near
+
+361
+00:37:21,810 --> 00:37:27,590
+point الامد و اربعين عشان يشوفها يعني هو weak
+
+362
+00:37:27,590 --> 00:37:35,200
+psychological عند رأيه هو لاعند رأيها و لا .. لأ و
+
+363
+00:37:35,200 --> 00:37:38,920
+without any psychological effect at all قالوا
+
+364
+00:37:38,920 --> 00:37:44,820
+فشايف أنا كذب إيش هنا؟ كنت أدرس إيش؟ مبوضة اختلاف،
+
+365
+00:37:44,820 --> 00:37:50,060
+مبوضة اختلاف طب الشيء الواقعي عند الواقعي الواقعي
+
+366
+00:37:50,060 --> 00:37:51,660
+الواقعي الواقعي الواقعي الواقعي الواقعي الواقعي
+
+367
+00:37:51,660 --> 00:37:53,360
+الواقعي الواقعي الواقعي الواقعي الواقعي الواقعي
+
+368
+00:37:53,360 --> 00:37:53,360
+الواقعي الواقعي الواقعي الواقعي الواقعي الواقعي
+
+369
+00:37:53,360 --> 00:37:55,980
+الواقعي الواقعي الواقعي الواقعي الواقعي الواقعي
+
+370
+00:37:55,980 --> 00:37:56,440
+الواقعي الواقعي الواقعي الواقعي
+
+371
+00:38:03,630 --> 00:38:09,710
+ووجدوا ان الفلايفرين بيعمل widening او جهة
+
+372
+00:38:09,710 --> 00:38:13,810
+palpebral fissure فلو بيحطوا فلان واحدة او واحدة
+
+373
+00:38:13,810 --> 00:38:20,750
+تلاقي ال palpebral fissure صار واسع كأنه اشتغل نشط
+
+374
+00:38:20,750 --> 00:38:26,090
+ال elevator palpebral fissure او اليورس اشتغل على
+
+375
+00:38:26,090 --> 00:38:28,970
+اش يعني في الحلقة تلاقي اش يعني واسعين
+
+376
+00:38:45,310 --> 00:38:48,730
+فلا يفعيل is less effective in highly pigmented
+
+377
+00:38:48,730 --> 00:38:54,110
+patients اللي يعني ايه سود؟ اغتأسير قليل مش
+
+378
+00:38:54,110 --> 00:38:57,670
+اغتأسير قليل that disparity in midriachis was
+
+379
+00:38:57,670 --> 00:39:01,930
+greater for darkly pigmented eyes as opposed to
+
+380
+00:39:01,930 --> 00:39:06,290
+lightly colored eyes اشتغل على الناس اللي بقبهم
+
+381
+00:39:06,290 --> 00:39:08,990
+فاتح العيرس فاتح احسن
+
+382
+00:39:13,540 --> 00:39:19,760
+هناك محادثة عن إفعالية الـ 0.5 بالنسبة للتركيز و
+
+383
+00:39:19,760 --> 00:39:29,300
+10% بالنسبة للتركيز و 10% بالنسبة للتركيز و 10%
+
+384
+00:39:29,300 --> 00:39:39,390
+بالنسبة للتركيز و 10% بالنسبة للتركيزدوفين ال 1983
+
+385
+00:39:39,390 --> 00:39:43,630
+found a greater effect from 10% fire free than
+
+386
+00:39:43,630 --> 00:39:48,930
+from 2.5 it must be pointed out that they were
+
+387
+00:39:48,930 --> 00:39:54,550
+using viscolyzed 10% solution against an aqueous 2
+
+388
+00:39:54,550 --> 00:39:59,830
+.5 solution and that this difference in vehicles
+
+389
+00:39:59,830 --> 00:40:02,610
+could have in France ده من درياتك
+
+390
+00:40:05,930 --> 00:40:14,050
+هما جابوا اتنين و نص قطرة مائية و جابوا ten
+
+391
+00:40:14,050 --> 00:40:20,010
+present اه جابوا two point five infact vesiculate
+
+392
+00:40:20,010 --> 00:40:27,150
+infact يعني زي تية زي تية و جابوا ten solution
+
+393
+00:40:35,520 --> 00:40:40,200
+يبقى العشرة دهنية أو زيتية مضاربة في الزيون و
+
+394
+00:40:40,200 --> 00:40:44,040
+جاهوا اللي في الماء 2.5% solution and that this
+
+395
+00:40:44,040 --> 00:40:48,780
+difference ال vehicles يعني أوسط المضار فيه مائي
+
+396
+00:40:48,780 --> 00:40:52,100
+أو زيتي could have influenced the mediatic action
+
+397
+00:40:52,100 --> 00:40:56,040
+طبعا احنا عارفين ان ال epithelium of القومية
+
+398
+00:41:01,910 --> 00:41:05,210
+المهم هم في الآخر فانهم يصبحوا نتيجة ان ال
+
+399
+00:41:05,210 --> 00:41:09,970
+concentration مش بس لحاله بيعتمد فضوح عليه على ال
+
+400
+00:41:09,970 --> 00:41:14,390
+behavior بيعتمد على ال behavior آخر حاجة
+
+401
+00:41:14,390 --> 00:41:21,730
+phenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenylphenyl
+
+402
+00:41:34,900 --> 00:41:39,700
+بسبب فرق نشاط الغدادرقية قضائية سوالا بالسكري،
+
+403
+00:41:39,700 --> 00:41:46,400
+بسبب هذا، طيب، الـpair system reactions، إيش هي؟
+
+404
+00:41:46,400 --> 00:41:51,040
+إن واحد ضار على الجسم، بيعمل cardiac arrhymias،
+
+405
+00:41:51,040 --> 00:41:51,620
+عدم انتظامه
+
+406
+00:42:04,850 --> 00:42:08,170
+بس يشوف ال choice و يشوف ال mix شهره
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/kB9wtqdRLdw.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/kB9wtqdRLdw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..eb07b6cc5347100727a0bce36ed38acb02053e3e
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/kB9wtqdRLdw.srt
@@ -0,0 +1,1632 @@
+1
+00:00:20,080 --> 00:00:21,920
+بسم الله الرحمن الرحيم الحمد لله رب العالمين و
+
+2
+00:00:21,920 --> 00:00:25,580
+أصلي و أسلم على النبي الأمين محمد صلى الله عليه و 
+
+3
+00:00:25,580 --> 00:00:28,940
+سلم عليه أهله و أصحابه أجمعين في المحاضرة
+
+4
+00:00:28,940 --> 00:00:33,600
+السابقة تكلمنا عن the hydrogen peroxide في تطهير
+
+5
+00:00:33,600 --> 00:00:37,300
+العدسات اللاصقة و كنا أن the hydrogen peroxide لأنه
+
+6
+00:00:37,300 --> 00:00:42,520
+لا لون له و أنه هو corrosive يعني 
+
+7
+00:00:49,530 --> 00:00:53,830
+و أنه فيه أكسجين و بيلمع العدسة اللاصقة الحقيقة
+
+8
+00:00:53,830 --> 00:00:58,750
+أنه يعني fantastic للعدسة اللاصقة جميع الأنواع و
+
+9
+00:00:58,750 --> 00:01:02,970
+نفسه يعني من عيوبه أن هو طويل شوية و الطريقة بدها
+
+10
+00:01:02,970 --> 00:01:10,130
+neutralization by carbonate ويعني بده saline
+
+11
+00:01:10,130 --> 00:01:14,030
+مرتين تلاتة لذا أتمنى نوترود اللي هو اللي
+
+12
+00:01:19,340 --> 00:01:34,640
+على القرنية بتعمل و irritation و يعني ضارة يعني
+
+13
+00:01:34,640 --> 00:01:38,920
+هو مع أنه مفيد جدا لكن الناس متهاش أربع أو خمس
+
+14
+00:01:38,920 --> 00:01:39,380
+فطوات
+
+15
+00:01:42,630 --> 00:01:47,070
+فعشان كده قل لهانة من شعبية في تطهير العدسات
+
+16
+00:01:47,070 --> 00:01:50,130
+اللاصقة until simpler means of neutralization was
+
+17
+00:01:50,130 --> 00:01:54,190
+developed لغاية ما طلعوا على وسائل جديدة لطرد
+
+18
+00:01:54,190 --> 00:01:57,150
+the hydrogen peroxide بعمل neutralization أبسط من
+
+19
+00:01:57,150 --> 00:02:00,150
+أولى the hydrogen peroxide has been used for many
+
+20
+00:02:00,150 --> 00:02:03,890
+years as a surface disinfectant and for its
+
+21
+00:02:03,890 --> 00:02:08,810
+bleaching effect يعني هو مطهر لسطح العدسة ومبيض
+
+22
+00:02:11,370 --> 00:02:15,150
+الـ bleaching strength can be
+
+23
+00:02:15,150 --> 00:02:20,050
+described in terms of volumes يعني في مثلا volume
+
+24
+00:02:20,050 --> 00:02:28,510
+10 volume وفي 20 volume اللي هي الأبواب حجم 10
+
+25
+00:02:28,510 --> 00:02:31,450
+volume solutions processes processes
+
+26
+00:02:38,660 --> 00:02:44,760
+يعني لما بتتحلل إلى مياه و أكسجين بتطلع نيت مثلا
+
+27
+00:02:44,760 --> 00:02:51,840
+mainly أكسجين العشرة بتطلع نية أكسجين عشر أضعافها
+
+28
+00:02:51,840 --> 00:02:57,140
+يعني فعمل ده was very effective against all the
+
+29
+00:02:57,140 --> 00:03:03,160
+organisms used in the beasts يبقى هو يعني ثبت أنه
+
+30
+00:03:03,160 --> 00:03:03,740
+effective على
+
+31
+00:03:09,470 --> 00:03:18,040
+الـ Amoeba أكلتموه يعني إله فعل واضح جداالأنفل أو
+
+32
+00:03:18,040 --> 00:03:22,140
+two step disinfection خطوة تانية خطوة أولى وخطوة
+
+33
+00:03:22,140 --> 00:03:26,200
+تانية when used to disinfect contact lenses it is
+
+34
+00:03:26,200 --> 00:03:29,420
+very it is necessary to neutralize the peroxide
+
+35
+00:03:29,420 --> 00:03:32,960
+after an interval of time and yearly products were
+
+36
+00:03:32,960 --> 00:03:36,400
+described as two step which means that the patient
+
+37
+00:03:36,400 --> 00:03:39,160
+carries out disinfection and neutralization at
+
+38
+00:03:39,160 --> 00:03:40,720
+separate stages in the body
+
+39
+00:03:51,720 --> 00:03:56,440
+advantages of a two-step system ماهي
+
+40
+00:03:56,440 --> 00:03:59,740
+المزايا اللي أفضل يفعلها يعني there is a situation
+
+41
+00:03:59,740 --> 00:04:03,280
+of antimicrobial action that can for example be
+
+42
+00:04:03,280 --> 00:04:08,580
+overnight يعني إحنا بدنا نحط العدسة في الhydrogen
+
+43
+00:04:08,580 --> 00:04:12,020
+oxide مثلا طول الليل، طول الليل مش هتموت الميكروبات
+
+44
+00:04:14,350 --> 00:04:18,790
+فتناسب المفروض أن الميكروبات تناسب تأخير مع الزمن
+
+45
+00:04:18,790 --> 00:04:24,450
+الزمنية كل المفروض أن العدسات الأصغر في المحلول كل
+
+46
+00:04:24,450 --> 00:04:28,490
+ما أثرت أكثر على الميكروبات قتلتها وهذا اللي إحنا
+
+47
+00:04:28,490 --> 00:04:32,170
+بنده إليه بأن عادة خالية من الميكروبات لأن الميكروبات
+
+48
+00:04:32,170 --> 00:04:36,890
+ممكن تعمل corneal abscess تعمل infection طيب التانية
+
+49
+00:04:36,890 --> 00:04:41,010
+in hot human climates that favor microbial
+
+50
+00:04:41,010 --> 00:04:42,310
+proliferation overnight
+
+51
+00:04:46,470 --> 00:04:50,770
+في جو دافئ زي جو من الأربع عام ماضية هذا الجو
+
+52
+00:04:50,770 --> 00:04:57,410
+الدافئ أو الساخن كثير بنعش البكتيريا للتكاثر عكس
+
+53
+00:04:57,410 --> 00:05:03,230
+الجو البارد امبارح امبارح أول امبارح مثلا فبقول في
+
+54
+00:05:03,230 --> 00:05:08,650
+الجو the humid and hot يعني the hybrid من the oxide
+
+55
+00:05:08,650 --> 00:05:13,270
+المفروض على العدسات وعلى الميكروبات بيكون
+
+56
+00:05:13,270 --> 00:05:14,050
+preferable
+
+57
+00:05:20,320 --> 00:05:23,480
+إحنا جابونا طبعا غالبا معتدل لا بالبارد ولا
+
+58
+00:05:23,480 --> 00:05:31,120
+بالساخن three suitable the hydrogen peroxide one contact
+
+59
+00:05:31,120 --> 00:05:36,880
+lens wear is intermittent rather than daily يعني
+
+60
+00:05:36,880 --> 00:05:40,860
+واحد أو واحدة بتلبس العدسة ساعة ساعتين تلاتة و
+
+61
+00:05:40,860 --> 00:05:45,540
+بتشيلها و الباقي بيحطها في المحلول في الـ case
+
+62
+00:05:45,540 --> 00:05:51,190
+هذا في المحلول هذه النقطة تماما يعني بيقدر يقول أنه
+
+63
+00:05:51,190 --> 00:05:57,970
+ماخد عدسة نقية أو طاهرة عكس اللي بيستعملها كل ليلة
+
+64
+00:05:57,970 --> 00:06:03,850
+نهار يعني مش فاضل وقت أن هو يعيش يضاعف ال
+
+65
+00:06:03,850 --> 00:06:07,210
+the hydroperoxide it is important that neutralization
+
+66
+00:06:07,210 --> 00:06:12,050
+of the peroxide is not undertaken too rapidly يعني
+
+67
+00:06:12,050 --> 00:06:16,690
+هو مش تجيه جودي كثير ويطلع خلاص لا عشانك إحنا
+
+68
+00:06:16,690 --> 00:06:18,630
+لما نحط الكحول
+
+69
+00:06:22,900 --> 00:06:27,360
+بنعمل كده؟ آه ده بره يعني هي مش سحر يعني مش إحنا
+
+70
+00:06:27,360 --> 00:06:31,980
+حاطين الكحول لأ مسيت الجلد أن كل بكتيريا تطهرت لأ
+
+71
+00:06:31,980 --> 00:06:35,720
+أنا يعني بقى جبني اللي فاهم الحقيقة يعني بيفضل على
+
+72
+00:06:35,720 --> 00:06:40,120
+مكان بده يعمل injection أنه يفضل طالع نازل طالع
+
+73
+00:06:40,120 --> 00:06:44,500
+نازل يعني أربع خمس دخائف يعني بيحمر الجلد من كثر
+
+74
+00:06:44,500 --> 00:06:49,640
+قياسه ما حكوا ودخل اللي هو الكحول كويس في الجلد
+
+75
+00:06:49,640 --> 00:06:55,390
+أفضل من اللي عمل كدهو أفضل من اللي ما حطش كحول صورة
+
+76
+00:06:55,390 --> 00:06:58,370
+فيها ناس بيقولوا بإيه؟ من غير ما نحط كحول؟ شوفت
+
+77
+00:06:58,370 --> 00:07:04,030
+أنا؟ ما لاقيتش فايدة يعني، مش كثير يبقى هذه ال
+
+78
+00:07:04,030 --> 00:07:09,250
+advantages  of the two step in one system a
+
+79
+00:07:09,250 --> 00:07:13,070
+solution containing the enzyme catalase
+
+80
+00:07:19,400 --> 00:07:22,840
+الخطوة الأولى هي الهيدروجين بالإكسايد طول الليل
+
+81
+00:07:22,840 --> 00:07:33,340
+الخطوة التانية انزين catalase زي تابليك قصه although
+
+82
+00:07:33,340 --> 00:07:37,820
+a two-step system is compatible with non-ionic
+
+83
+00:07:37,820 --> 00:07:41,900
+high water content hydrogen lenses, ionic high
+
+84
+00:07:41,900 --> 00:07:46,080
+water content lenses undergo marked hydration يعني
+
+85
+00:07:46,080 --> 00:07:49,580
+هو بيقول ليه بيقارن بين نوعين من العدسات بين
+
+86
+00:07:49,580 --> 00:07:55,180
+العدسات اللي هي the non-ionic وبين the ionic بيقول
+
+87
+00:07:55,180 --> 00:07:59,600
+ليه الاتنين بنفع بس the ionic بيصيرلها market
+
+88
+00:07:59,600 --> 00:08:05,420
+hydration changes تنفش أكثر تاخد مياه أكثر as a
+
+89
+00:08:05,420 --> 00:08:09,200
+consequence of the length immersion نقا in
+
+90
+00:08:09,200 --> 00:08:12,140
+the hydrogen peroxide عشان هيك له
+
+91
+00:08:16,530 --> 00:08:21,430
+اللي هي the ionic lenses should not be used with
+
+92
+00:08:21,430 --> 00:08:25,790
+this peroxide metal يعني دي هنخليها لليه اللي هو
+
+93
+00:08:25,790 --> 00:08:34,010
+العدسات the non-ionic lenses طيب
+
+94
+00:08:34,010 --> 00:08:37,650
+هنشوف هل وقت فيه حاجات تانية غير كده كمان العلم
+
+95
+00:08:37,650 --> 00:08:43,150
+تقدم كده the disadvantage of this two step process
+
+96
+00:08:43,150 --> 00:08:47,530
+هل وقت إيه the disadvantage؟ Is the need for the
+
+97
+00:08:47,530 --> 00:08:50,690
+patient to remember to initiate neutralization
+
+98
+00:08:50,690 --> 00:08:55,230
+يعني لازم يحط اللي هو إيش اللي هو the enzyme catalase
+
+99
+00:08:55,230 --> 00:08:59,410
+عشان يشيل the hydrogen peroxide طب لو ما .. لو
+
+100
+00:08:59,410 --> 00:09:04,710
+ما تفقرش أو ما حطش ال .. الكتاليز بيبدأ the hydrogen
+
+101
+00:09:04,710 --> 00:09:09,350
+peroxide في العدسة وله اللي بيثبت براهين هذا
+
+102
+00:09:09,350 --> 00:09:13,530
+الموضوع يبقى تحتاج من المريض to remember
+
+103
+00:09:16,540 --> 00:09:20,220
+الحصول على neutralization the BH-Hydrogen Peroxide في
+
+104
+00:09:20,220 --> 00:09:27,860
+عدد من 3.5 إلى 4.5 والطبيعي الذي قرر Neutralizationه
+
+105
+00:09:27,860 --> 00:09:33,460
+قبل إضافة عين لعينه كان يفعل هذا الخطأ فقط مرة
+
+106
+00:09:33,460 --> 00:09:37,460
+بسبب درجة المشكلة
+
+107
+00:09:44,770 --> 00:09:48,090
+فإنحط أربعة على سبعة بينما the irritation و ال
+
+108
+00:09:48,090 --> 00:09:51,330
+energy و the congestion و الكلام مش مناسب يبقى ال
+
+109
+00:09:51,330 --> 00:09:56,630
+catalase بيعمل Neutralization ليه؟ اللي هو ال
+
+110
+00:09:56,630 --> 00:10:01,630
+hypersensory علشان يكفيها two steps يعني لو ليس هي
+
+111
+00:10:01,630 --> 00:10:06,010
+هتكون مشكلة طيب، الآن فلو أنا one step
+
+112
+00:10:17,470 --> 00:10:24,150
+وهي العلم، العلم بيبني على بعض، في الزمن يعني كان
+
+113
+00:10:24,150 --> 00:10:30,190
+السيارة والطيارة عجيبة، والكمبيوتر كان عجيب،
+
+114
+00:10:30,190 --> 00:10:33,610
+جنياته جالية وحجمه كبير وشغله ومستهلكه، فده و
+
+115
+00:10:33,610 --> 00:10:38,090
+زهر وزهر وزهر ولجاته، مثلا، وحتى الجوالات قبل
+
+116
+00:10:38,090 --> 00:10:44,690
+عشرين عام كيف كانت، كانت اسمها بريزما، بريزما
+
+117
+00:10:51,170 --> 00:10:55,950
+ففي تطوير the one step system were introduced to
+
+118
+00:10:55,950 --> 00:11:00,130
+simplify the procedure for the patient. إيه
+
+119
+00:11:00,130 --> 00:11:05,410
+simplify؟ تبسيط تبسيط. And have the advantage that
+
+120
+00:11:05,410 --> 00:11:08,230
+the vital step of neutralization can't be
+
+121
+00:11:08,230 --> 00:11:08,690
+overlooked.
+
+122
+00:11:15,670 --> 00:11:19,250
+الفرصة المفيدة في ال one step هي دورة عملية تحرير
+
+123
+00:11:19,250 --> 00:11:23,330
+الانفكاش يتعني بطريقة وانتشار بطريقة وانتشار
+
+124
+00:11:23,330 --> 00:11:25,510
+بطريقة وانتشار بطريقة وانتشار بطريقة وانتشار
+
+125
+00:11:25,510 --> 00:11:27,970
+بطريقة وانتشار بطريقة وانتشار بطريقة وانتشار
+
+126
+00:11:27,970 --> 00:11:30,550
+بطريقة وانتشار بطريقة وانتشار بطريقة وانتشار
+
+127
+00:11:30,550 --> 00:11:31,030
+بطريقة وانتشار بطريقة وانتشار بطريقة وانتشار
+
+128
+00:11:31,030 --> 00:11:31,550
+بطريقة وانتشار بطريقة وانتشار بطريقة وانتشار
+
+129
+00:11:31,550 --> 00:11:38,030
+بطريقة وانتشار بطريقة وانتشار بطريقة وانتشار
+
+130
+00:11:38,030 --> 00:11:44,350
+بطريقة وان
+
+131
+00:11:45,220 --> 00:11:50,920
+أو شهور مش مناسب، ممكن تتضرر، تكسر الأولى، الأولى
+
+132
+00:11:50,920 --> 00:11:53,140
+كل ما حطيت في the hydrogen dioxide نموذج أطول، كل
+
+133
+00:11:53,140 --> 00:11:56,780
+ما كان أحسن، لا هذه الخطوة لا، حطها ساعة، ساعتين
+
+134
+00:11:56,780 --> 00:12:00,860
+وامشي، about 90% of the hydrogen peroxide systems
+
+135
+00:12:00,860 --> 00:12:05,440
+now used are one step، الآن the hydrogen peroxide
+
+136
+00:12:05,440 --> 00:12:14,260
+90% one step، والـ 10% the two steps اللي فات، أو
+
+137
+00:12:14,260 --> 00:12:19,000
+أكثر وفي واحدة من هذه الأساسيات ما يسمونه
+
+138
+00:12:19,000 --> 00:12:25,220
+platinum disk in the storage case يعني حطه في نفس
+
+139
+00:12:25,220 --> 00:12:29,940
+الـ case اللي فيه العدسة حديدة صغيرة هي من platinum
+
+140
+00:12:29,940 --> 00:12:39,800
+platinum disk صغير يعني يشبه البطاية الساعة صغيرة
+
+141
+00:12:46,120 --> 00:12:50,500
+the hydrogen peroxide وأكسجين  أندهو يبقى هذا موجود في
+
+142
+00:12:50,500 --> 00:12:55,920
+نفس الـ container بتاعك حط the hydrogen من the oxide
+
+143
+00:12:55,920 --> 00:13:02,640
+أول ما تهرصها شوية يبدأ هو يحلل فيه يبقى التلومدسكي
+
+144
+00:13:02,640 --> 00:13:09,980
+يحلل the hydrogen من the oxide إلى مكوناته ماء ودرة
+
+145
+00:13:09,980 --> 00:13:12,140
+أكسجين جزء ماء ودرة أكسجين
+
+146
+00:13:17,600 --> 00:13:22,320
+مش مضطر أخبره إنزيم وإنزيم خلاص منه فيه one step
+
+147
+00:13:22,320 --> 00:13:29,660
+فقط طيب having
+
+148
+00:13:29,660 --> 00:13:36,540
+filled the case with 3% peroxide there is an
+
+149
+00:13:36,540 --> 00:13:40,300
+initial rapid phase of neutralization resulting in
+
+150
+00:13:40,300 --> 00:13:45,860
+a concentration of 0.9% after two minutes يعني بعد
+
+151
+00:13:45,860 --> 00:13:53,740
+دقيقتين بيحلله وبيخليك التركيز 0.9 بس هو تركيز
+
+152
+00:13:53,740 --> 00:14:00,120
+السبعة تركيز السبع هذا مثلا the Aussie sept شايفين
+
+153
+00:14:00,120 --> 00:14:04,540
+الجزازة هالي the Aussie sept؟ الجزازة هالي هالي one step
+
+154
+00:14:04,540 --> 00:14:11,320
+disinfection تحط المحلول في الـ case وبعد شوية هو
+
+155
+00:14:11,320 --> 00:14:15,360
+لحاله بيعمل neutralization منه مطهر وهو بيعمل
+
+156
+00:14:15,360 --> 00:14:21,520
+neutralization بس عيبه أنه ماخدش وقت كافي يعني
+
+157
+00:14:21,520 --> 00:14:26,740
+العنصر ما ارتاحت كثير في الهدف البيروكسايد، يمكن
+
+158
+00:14:26,740 --> 00:14:32,140
+بعض الناس يقولك أنا يا عمي لسه أحطه في جفنة فيها
+
+159
+00:14:32,140 --> 00:14:36,700
+هدف البيروكسايد ساعتين وبعدين أرجله هالي عشان
+
+160
+00:14:36,700 --> 00:14:41,140
+إيش؟ يعملوا Neutralization ما هو بعض الناس يعني
+
+161
+00:14:41,140 --> 00:14:46,460
+عندهم أفكار وحريص أكثر وفي بعض الناس بتاعة ال
+
+162
+00:14:46,460 --> 00:14:56,200
+American way سريع شغل .. شغل سريع فهذا
+
+163
+00:14:56,200 --> 00:15:01,000
+بعد ما حطيته في الـ case واتحلل which is followed
+
+164
+00:15:01,000 --> 00:15:06,680
+by a slow phase to approximately fifteen parts per
+
+165
+00:15:06,680 --> 00:15:14,430
+million after six hours يعني بعد ست ساعات وجدوا ال
+
+166
+00:15:14,430 --> 00:15:22,890
+the hydrogen peroxide خمسة عشر في المليون كثير ولا
+
+167
+00:15:22,890 --> 00:15:29,550
+قليل؟ قليل، صح؟ خمسة عشر في المليون، هذا بعد ست
+
+168
+00:15:29,550 --> 00:15:36,090
+ساعات يعني هو صحيح حصل Neutralization، لكن مش مية
+
+169
+00:15:36,090 --> 00:15:39,900
+في المية في هذا الجزء من the hydrogen peroxide تركيز
+
+170
+00:15:39,900 --> 00:15:47,260
+خفيف بيعمل في التطهير طبعا هنا فيه بكتيريا غير
+
+171
+00:15:47,260 --> 00:15:52,800
+كافية طيب such a level is below the threshold of
+
+172
+00:15:52,800 --> 00:15:55,920
+subjective sensitivity يعني بيقول أنه عشان يشترط
+
+173
+00:15:55,920 --> 00:16:03,220
+البكتيريا بيكون أقل من 50 إلى 300 per million
+
+174
+00:16:04,240 --> 00:16:09,060
+يعني 50 إلى 300 جزء في المليون من ال
+
+175
+00:16:09,060 --> 00:16:13,600
+the hydrogen peroxide عشان يكون active as يعني
+
+176
+00:16:13,600 --> 00:16:22,420
+bactericidal أو bacteriostatic أو اللي هو and
+
+177
+00:16:22,420 --> 00:16:26,200
+that at which adverse effects on the mitotic
+
+178
+00:16:26,200 --> 00:16:32,200
+activity and movement of bacterial cells occur يعني
+
+179
+00:16:32,200 --> 00:16:36,800
+الـ 300 مثلا ممكن يعني يؤثر على اللي هو ال
+
+180
+00:16:36,800 --> 00:16:42,580
+material cells بتاعة القرنية لكن the 15 parts اللي في
+
+181
+00:16:42,580 --> 00:16:49,080
+الأول ما بيأثروش في
+
+182
+00:16:49,080 --> 00:16:54,000
+طريقة أخرى لل one step غير the platinum disk على الـ
+
+183
+00:16:54,000 --> 00:16:58,180
+one step system used a tablet coated with
+
+184
+00:16:58,180 --> 00:17:06,940
+hydroxypropyl methyl
+
+185
+00:17:06,940 --> 00:17:11,960
+cellulose مركب كيميائي which contains a catalase
+
+186
+
+216
+00:19:59,460 --> 00:20:04,240
+وفريقه في سنة وتسعين مقال ماضي found that cases
+
+217
+00:20:04,240 --> 00:20:09,040
+disinfected with peroxide systems showed a lower
+
+218
+00:20:09,040 --> 00:20:11,960
+level of microbial contamination than those in
+
+219
+00:20:11,960 --> 00:20:16,960
+which other methods of disinfection had been used
+
+220
+00:20:16,960 --> 00:20:24,980
+يعني وجدت بالتجربة اللي فيها H2O2 من أقل تلوثا
+
+221
+00:20:24,980 --> 00:20:31,760
+من غيرها من اللي بيحطوا فيها أشياء أخرى زي مثلًا ال
+
+222
+00:20:31,760 --> 00:20:37,620
+chlorine و زي اليود زي ما هنشوف يعني وأنا مبكر إن
+
+223
+00:20:37,620 --> 00:20:42,660
+الـ H2O2 يعني هذا السائل الممتنق إن كان هو fresh و
+
+224
+00:20:42,660 --> 00:20:47,480
+معكب تمام وتركيزه تمام حقيقة إنه يعني effective
+
+225
+00:20:47,480 --> 00:20:50,340
+effective حتى الجروح العميقة كنا نحطه على الجروح
+
+226
+00:20:50,340 --> 00:20:54,860
+العميقة بعمر الله إنه يشيل كل ما فيها من الصديد و
+
+227
+00:20:54,860 --> 00:20:59,960
+من الـ crust ومن الـ debris والكلام هذا سهل ممتنّة
+
+228
+00:20:59,960 --> 00:21:04,640
+وأفضل تشتروه وتجربوه ماشي؟ بقى أنا جاي أَبقى
+
+229
+00:21:04,640 --> 00:21:05,340
+أسألكم إن شاء الله
+
+230
+00:21:14,600 --> 00:21:19,560
+أي سطح، شوفوا إيش بيصير، ماشي؟ تفضلوش.. هيفي
+
+231
+00:21:19,560 --> 00:21:24,300
+قاعدين؟ بدنا.. احنا نطلب الـ .. الـ .. الإشارة
+
+232
+00:21:24,300 --> 00:21:28,480
+الكاربة، إنه احنا بتوع النضارات وبس، لأن ده نقطة
+
+233
+00:21:28,480 --> 00:21:34,300
+وسط رجلينا، علم الـ Optometry من أوسع العلوم،
+
+234
+00:21:34,300 --> 00:21:39,660
+ واسألوا اللي درسه، واسألوا اللي أنت رايح تشوفه، إيه
+
+235
+00:21:39,660 --> 00:21:44,300
+الشغل الـ Optometrist؟ شوف شغل اللي بتـ interest ليه 
+
+236
+00:21:44,300 --> 00:21:48,860
+أقول لكم إنه هنا الوظيفة معتادة سوف يأتي أيام إن
+
+237
+00:21:48,860 --> 00:21:53,600
+شاء الله تكون أمور منفتحة تكون أنتم رواد زي ما جينا
+
+238
+00:21:53,600 --> 00:21:59,520
+احنا عاملين قسم البصرية وعملنا معامل هيجي ناس يفتحوا
+
+239
+00:21:59,520 --> 00:22:05,040
+ماجستير ودكتوراه ودخلوا المهنة بقوة في كل حي في
+
+240
+00:22:05,040 --> 00:22:09,020
+غزة إن شاء الله بس بدكم تكونوا عندكم قصار
+
+241
+00:22:23,420 --> 00:22:28,040
+المنطقة التي تتحرك على أدسات  الأسخة أكثر من غيرها،
+
+242
+00:22:28,040 --> 00:22:31,500
+أكثر من الطهريات الأخرى، مواجهة مواجهة مواجهة
+
+243
+00:22:31,500 --> 00:22:32,620
+مواجهة مواجهة مواجهة مواجهة مواجهة مواجهة مواجهة
+
+244
+00:22:32,620 --> 00:22:34,520
+مواجهة مواجهة مواجهة مواجهة مواجهة مواجهة مواجهة
+
+245
+00:22:34,520 --> 00:22:36,200
+مواجهة مواجهة مواجهة مواجهة مواجهة مواجهة مواجهة
+
+246
+00:22:36,200 --> 00:22:36,800
+مواجهة مواجهة مواجهة مواجهة مواجهة مواجهة مواجهة
+
+247
+00:22:36,800 --> 00:22:43,140
+مواجهة مواجهة مواجهة مواجهة مواجهة
+
+248
+00:22:43,140 --> 00:22:47,960
+مواجه
+
+249
+00:22:48,460 --> 00:22:55,940
+تغيير المحلول frequently بيكون هو الطريقة الأولى،
+
+250
+00:22:55,940 --> 00:22:59,660
+يعني مثلًا في ناس كل ثلاث أيام، في ناس كل أسبوع،
+
+251
+00:22:59,660 --> 00:23:03,900
+بيغير محلول، بيشيله وبيحط غيره، بيخلهموش يعني، هو
+
+252
+00:23:03,900 --> 00:23:09,640
+هو، لأنهم تعرفين، هذا من الـ oxide في الآخر فيه
+
+253
+00:23:09,640 --> 00:23:12,960
+oxygen، لو طلع الـ oxygen وصارت مية، صار مية
+
+254
+00:23:19,290 --> 00:23:22,630
+the frequent receipt of the storage case صح ممتاز
+
+255
+00:23:22,630 --> 00:23:26,550
+remains the best means ممتاز أغير أنا ساي المحلول
+
+256
+00:23:26,550 --> 00:23:31,250
+وأغير الـ case صحيح شكرًا لاسـمك أغير نفس الـ case و
+
+257
+00:23:31,250 --> 00:23:38,830
+هو مش مكلف يعني هو الـ case أصلًا مجانية
+
+258
+00:23:38,830 --> 00:23:43,450
+يعني فـ .. وبعدين بقى أنا كمان ضاغط المهم إنه ما
+
+259
+00:23:43,450 --> 00:23:46,370
+ما يضلش أنا على نفس الـ..
+
+260
+00:24:00,510 --> 00:24:01,670
+الهيدروجين الهيدروجين الهيدروجين الهيدروجين
+
+261
+00:24:01,670 --> 00:24:03,070
+الهيدروجين الهيدروجين الهيدروجين الهيدروجين
+
+262
+00:24:03,070 --> 00:24:06,530
+الهيدروجين الهيدروجين الهيدروجين الهيدروجين
+
+263
+00:24:06,530 --> 00:24:07,390
+الهيدروجين الهيدروجين الهيدروجين الهيدروجين
+
+264
+00:24:07,390 --> 00:24:07,730
+الهيدروجين الهيدروجين الهيدروجين الهيدروجين
+
+265
+00:24:07,730 --> 00:24:11,550
+الهيدروجين الهيدروجين الهيدروجين الهيدروجين
+
+266
+00:24:11,550 --> 00:24:16,210
+الهيدروجين الهيدروجين الهيدروجين الهيدروجين
+
+267
+00:24:16,210 --> 00:24:17,130
+الهيدروجين الهيدروجين الهيدروجين الهيدروجين
+
+268
+00:24:17,130 --> 00:24:23,070
+الهيدروجين ال
+
+269
+00:24:24,290 --> 00:24:29,390
+يعني حدث له تغيرات في المواصفات، يعني الـ H2O2 من
+
+270
+00:24:29,390 --> 00:24:34,330
+الـ  وكساين أدخل يعني إلى الأسوأ يعني، ففي الحالة
+
+271
+00:24:34,330 --> 00:24:39,290
+H2O2 بيكون بعض، يعني إذا كان أدخل أي شيء في الـ
+
+272
+00:24:39,290 --> 00:24:44,230
+.. مثلًا الـ diameters أو الـ base curve أو أي حاجة
+
+273
+00:24:44,230 --> 00:24:50,410
+فطبعًا بيكون إيش؟ في هنا شيء منع الـ سلسلات
+
+274
+00:24:50,410 --> 00:24:54,630
+الـ ترانزيالية كانت 
+
+275
+00:24:54,630 --> 00:25:02,130
+تدخل من وقت لوقت سلسلات انفكاطية ولكنها فقدت في
+
+276
+00:25:02,130 --> 00:25:06,410
+الانفكاطية يعني يطلعوا مثلًا اليود والكلورين بدل
+
+277
+00:25:06,410 --> 00:25:09,730
+الهيدروجين بالـ بيروكسايد وهو معروف حتى في الحياة العملية
+
+278
+00:25:09,730 --> 00:25:15,710
+إن الجلد والجروح إن اليودين والكلورين من
+
+279
+00:25:15,710 --> 00:25:22,230
+المطاهرات المعروفة مثلًا الـ iodine اليود معروف
+
+280
+00:25:22,230 --> 00:25:27,610
+بلونه البني هو دورم الـ povidone اللي بيستخدم في تطهير
+
+281
+00:25:27,610 --> 00:25:32,750
+الجروح was produced by a neutralizing agent to the
+
+282
+00:25:32,750 --> 00:25:36,650
+infective colorless iodine iodide the reaction
+
+283
+00:25:36,650 --> 00:25:40,410
+producing a mixture of electrolytes none of which
+
+284
+00:25:40,410 --> 00:25:45,770
+were foreign to the eye يعني هو بيقول لي إن بعض
+
+285
+00:25:45,770 --> 00:25:50,140
+الناس استخدموا الـ iodine Vinyl الهدوء اللي بتكسب
+
+286
+00:25:50,140 --> 00:25:56,600
+لكن يحدث بعد ما اشتهروا اللون البني وأصبح كارلنس
+
+287
+00:25:56,600 --> 00:26:02,220
+لكن باعتقادهم إنه مش كفاية الهدوء اللي بتكسب
+
+288
+00:26:02,220 --> 00:26:05,700
+المطارد
+
+289
+00:26:05,700 --> 00:26:08,880
+التاني chlorine الكلور اللي بيحطوه على اللي هو الـ
+
+290
+00:26:08,880 --> 00:26:14,010
+water supply على المية والتي مثل الـ halogens أخرى
+
+291
+00:26:14,010 --> 00:26:17,250
+كانت مطهرة
+
+292
+00:26:17,250 --> 00:26:22,850
+ومنظفة وكانت مستخدمة في اتجاه اتجاه اتجاه اتجاه
+
+293
+00:26:22,850 --> 00:26:25,470
+اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه
+
+294
+00:26:25,470 --> 00:26:25,970
+اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه
+
+295
+00:26:25,970 --> 00:26:26,110
+اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه
+
+296
+00:26:26,110 --> 00:26:38,790
+اتجاه اتجاه اتج
+
+297
+00:26:39,700 --> 00:26:45,600
+بعضهم الكلوريين مع إنه قدرة لكن على إنساء الأسقاط
+
+298
+00:26:45,600 --> 00:26:50,080
+ما استمروا زي الهدف من الـ بروجساين ما حصلش له
+
+299
+00:26:50,080 --> 00:26:57,900
+استقبال وشعبية طيب الآن عاملين بنستجد احنا
+
+300
+00:26:57,900 --> 00:27:02,020
+limitations of present methods of contact lens
+
+301
+00:27:02,020 --> 00:27:14,810
+disinfection ما هي يعني بتقول أنا المحددات التي تحد
+
+302
+00:27:14,810 --> 00:27:22,690
+من استخدام الطرق السابقة في تطهير عدسات الاصقرة،
+
+303
+00:27:22,690 --> 00:27:30,670
+limitations، شيء تحديدات، يعني عدم نجاح كافي
+
+304
+00:27:31,440 --> 00:27:35,260
+الثلاثة أمثلة يمكن أن تعملوا لتوضيح إعادة إعادة
+
+305
+00:27:35,260 --> 00:27:36,240
+إعادة إعادة إعادة إعادة إعادة إعادة إعادة إعادة
+
+306
+00:27:36,240 --> 00:27:36,660
+إعادة إعادة إعادة إعادة إعادة إعادة إعادة إعادة
+
+307
+00:27:36,660 --> 00:27:38,740
+إعادة إعادة إعادة إعادة إعادة إعادة إعادة إعادة
+
+308
+00:27:38,740 --> 00:27:39,580
+إعادة إعادة إعادة إعادة إعادة إعادة إعادة إعادة
+
+309
+00:27:39,580 --> 00:27:40,940
+إعادة إعادة إعادة إعادة إعادة إعادة إعادة إعادة
+
+310
+00:27:40,940 --> 00:27:53,520
+إعادة إعادة إعادة إعادة إعادة إعادة إعادة إعادة إع
+
+311
+00:27:57,490 --> 00:28:00,390
+هي  kind of soft contact lens disinfecting
+
+312
+00:28:00,390 --> 00:28:04,230
+solutions appeared to be effective in eradicating bacillus
+
+313
+00:28:04,230 --> 00:28:08,970
+cereus للأسف لا بالحرارة ولا بالغليان ولا
+
+314
+00:28:08,970 --> 00:28:15,070
+بالهيدروجين بيروكسايد بتروح bacillus cereus from
+
+315
+00:28:15,070 --> 00:28:18,130
+contaminated contact lens cases whereas hydrogen
+
+316
+00:28:18,130 --> 00:28:22,930
+peroxide was sporicidal يعني تقول إن الهيدروجين
+
+317
+00:28:22,930 --> 00:28:28,970
+بيروكسايد يعمل على Spores بتاعته قاتل Spores بتاعة
+
+318
+00:28:28,970 --> 00:28:34,730
+bacillus cereus هي يعني حاجة هي بكتير مقاومة لما الحرارة
+
+319
+00:28:34,730 --> 00:28:40,670
+ولا لدرجة الحرارة نستطيع نزيلها من الكاس أو من
+
+320
+00:28:40,670 --> 00:28:46,890
+العدسة الاصلية إنو فيروس الـ  فيروس بتاعة الـ Simplex
+
+321
+00:28:46,890 --> 00:28:53,220
+والزفتروهو يظهر إنه ممكن إن يبقى على قيد الحياة كيميائية
+
+322
+00:28:53,220 --> 00:28:58,500
+و hydrogen peroxide في هذه الانفكاشات، ليش في المواد
+
+323
+00:28:58,500 --> 00:29:05,200
+الكيميائية وفي الهيدروجين بيروكسايد ولا يقتل،
+
+324
+00:29:05,200 --> 00:29:09,620
+لكن ليس بشكل محروم، بده حرارة، ولو كان الناس قبل
+
+325
+00:29:09,620 --> 00:29:12,920
+الدارسين مضت عليها حرارة، لا غليان ولا حرارة محروم
+
+326
+00:29:14,040 --> 00:29:17,100
+عندما يكون الـ sterilization عام غير متوفر في
+
+327
+00:29:17,100 --> 00:29:22,020
+عملية، يجب
+
+328
+00:29:22,020 --> 00:29:31,840
+أن يتخلص الناس اللي عندهم الانفكاشات من الانفكاشات
+
+329
+00:29:31,840 --> 00:29:38,400
+ويحطها حتى حين العلاج اللي لها، يعمل  irrigation في
+
+330
+00:29:38,400 --> 00:29:41,120
+الأول الانفكاش اللي في عينه، ثم نزيلها على السلطة
+
+331
+00:29:42,540 --> 00:29:49,480
+مش امكانية ينظف العدسات من إيش هو الأمون لو العين
+
+332
+00:29:49,480 --> 00:29:53,180
+بتاعة الـ user بتاع الـ contactless صفر بكتير الـ
+
+333
+00:29:53,180 --> 00:29:57,400
+infection أو غرار الـ infection أو severe allergy
+
+334
+00:29:57,400 --> 00:30:03,180
+أو impairment of vision أو أي حاجة من هذه لازم ما
+
+335
+00:30:03,180 --> 00:30:07,920
+لا يجب discard العدسات لغاية ما نعالج الـ disease
+
+336
+00:30:07,920 --> 00:30:08,520
+أو الـ infection
+
+337
+00:30:12,200 --> 00:30:17,720
+لأن العنصر اللازقة كانها يعني من الفضول أو من
+
+338
+00:30:17,720 --> 00:30:23,140
+الزين أو من التكميل، لكن العين هي أهم، احنا نهتم
+
+339
+00:30:23,140 --> 00:30:28,920
+بصحة العين أولًا لغاية ما نصحح العين للـ function
+
+340
+00:30:28,920 --> 00:30:32,760
+بتاعك مظبوط وبعدين نبقى للعدسة، أما لو
+
+341
+00:30:32,760 --> 00:30:36,960
+استمرار في وضع العدسة رغم الـ infection
+
+342
+00:30:36,960 --> 00:30:41,360
+أو الـ allergy أو impairment of vision ممكن تدمر
+
+343
+00:30:41,360 --> 00:30:45,960
+العين ممكن تدمر العين وتصير irreversible damage to
+
+344
+00:30:45,960 --> 00:30:51,260
+the function of the eyes الـ
+
+345
+00:30:51,260 --> 00:30:55,410
+eyes جربوا شيء اسمه preserved saline يعني جربوا
+
+346
+00:30:55,410 --> 00:31:02,250
+سرعة hydrogen peroxide 0.9%  solution أفيل السرعة
+
+347
+00:31:02,250 --> 00:31:07,030
+المحلول الملحّي اللي بيحطوا للمرضى في حالات النزلات
+
+348
+00:31:07,030 --> 00:31:10,310
+المعوية بس أضافوا عليه
+
+349
+00:31:16,920 --> 00:31:21,060
+تأثير ولد سلسلة، هل هو يساوي الهيدروجين بيروكسايد أو
+
+350
+00:31:21,060 --> 00:31:24,680
+أقل أو أكثر؟ Preserved saline has been used to
+
+351
+00:31:24,680 --> 00:31:30,520
+enhance the efficacy of heat disinfection but is
+
+352
+00:31:30,520 --> 00:31:34,160
+usually used today to rinse contact lenses, to rinse
+
+353
+00:31:34,160 --> 00:31:42,980
+نقّي، لينقّيها يعني فيه، to rinse يعني تنقيع لها،
+
+354
+00:31:42,980 --> 00:31:47,620
+تنقيع للعدسة، على وجه التحديد طبعًا الفعالية
+
+355
+00:31:47,620 --> 00:31:51,820
+للحافظات في المصادر الصحية هي تحفظ المصادر الصحية
+
+356
+00:31:51,820 --> 00:31:56,920
+استراليا وليس لإعطاء مصادر التعامل مع هذه
+
+357
+00:31:56,920 --> 00:32:04,700
+الانفكاشات يبقى احنا لما نحط أي مادة حافظة على
+
+358
+00:32:04,700 --> 00:32:11,060
+المحلول الملحّي ونحط في العدسات احنا بنقصد فعلاً
+
+359
+00:32:11,060 --> 00:32:13,640
+نعمل استراليزيشن
+
+360
+00:32:16,420 --> 00:32:20,300
+وجود يعني محلول ملحي مع المواد الحافظة نقطة لأي
+
+361
+00:32:20,300 --> 00:32:23,120
+بكتيريا تكون في الـ case أو في العدسة اللازقة
+
+362
+00:32:23,120 --> 00:32:27,260
+Preservatives can pose the risk of allergic and
+
+363
+00:32:27,260 --> 00:32:36,760
+toxic reactions للأسف إن المواد الحافظة لها يعني
+
+364
+00:32:36,760 --> 00:32:37,940
+عالقين حاجتين
+
+365
+00:32:43,110 --> 00:32:47,930
+الـ allergic reactions والـ toxic تعمل الـ allergic والآخر
+
+366
+00:32:47,930 --> 00:32:55,070
+التاني إيش؟ toxicity  أَظهروا في سنة الثمانين ديمونستريت
+
+367
+00:32:55,070 --> 00:32:57,510
+الـ relationship between preservatives and the
+
+368
+00:32:57,510 --> 00:33:01,350
+incidence of solution allergy solution allergy
+
+369
+00:33:01,350 --> 00:33:05,450
+يعني solution induced allergy اللي يسببها
+
+370
+00:33:05,450 --> 00:33:09,250
+الـ allergic اللي يسببها المحاليل الـ double mask
+
+371
+00:33:09,250 --> 00:33:15,810
+randomized crossover study في الدراسة six subjects
+
+372
+00:33:15,810 --> 00:33:19,430
+used
+
+373
+00:33:19,430 --> 00:33:22,430
+an unpreserved saline solution and a preserved
+
+374
+00:33:22,430 --> 00:33:26,310
+saline solution في ناس استخدموا الـ preserved
+
+375
+00:33:26,310 --> 00:33:29,450
+saline اللي في المادة الحافظة وفي ناس استخدموا
+
+376
+00:33:29,450 --> 00:33:33,930
+اللي unpreserved اللي ما فيش فيه these subjects had a
+
+377
+00:33:33,930 --> 00:33:36,470
+probable history of sensitivity to preserved
+
+378
+00:33:36,470 --> 00:33:39,050
+solutions which was confirmed
+
+379
+00:33:42,230 --> 00:33:48,110
+عارف إثبات إن الـ saline اللي فيه المواد الحافظة
+
+380
+00:33:48,110 --> 00:33:57,110
+يحفظ وجود الـ hydrogen في عيون الناس هذه  برهير الـ
+
+381
+00:33:57,110 --> 00:34:00,630
+saline solutions containing ethyldiamine
+
+382
+00:34:00,630 --> 00:34:05,330
+tetraacetic acid EDTA يعني
+
+383
+00:34:05,330 --> 00:34:08,050
+اختصاره كمادة حافظة طبعًا
+
+384
+00:34:19,530 --> 00:34:30,010
+أش يعني المادة الحافظة في العدسات مفيدة في مقاومة
+
+385
+00:34:30,010 --> 00:34:37,230
+الـ deposit أو تمنع الـ deposit على العدسة أكثر من
+
+386
+00:34:38,050 --> 00:34:46,390
+الغير محفوظة، العدسات الغير المحفوظة طيب
+
+387
+00:34:46,390 --> 00:34:49,550
+بريشيريزد
+
+388
+00:34:49,550 --> 00:34:56,630
+كنتينر هي طريقة جديدة بريشيريزد كونتينر الـ case
+
+389
+00:34:56,630 --> 00:35:01,350
+يعني both buffered and unbuffered forms of sterile
+
+390
+00:35:01,350 --> 00:35:05,430
+saline have been made available in aerosol type
+
+391
+00:35:05,430 --> 00:35:11,960
+containers الـ container فيه مادة اسمها aerosol this
+
+392
+00:35:11,960 --> 00:35:16,360
+mode of preservation of saline requires no
+
+393
+00:35:16,360 --> 00:35:21,540
+preservatives يعني قال إن الـ container نفسه ما فيش
+
+394
+00:35:21,540 --> 00:35:26,160
+فيه مادة حافظة الـ container هو من aerosol حتى لو
+
+395
+00:35:26,160 --> 00:35:32,040
+أحط له إيش، saline مش محفوظ، بيشتغل على بكتيريا، كف
+
+396
+00:
+
+431
+00:38:38,470 --> 00:38:41,630
+دون العالمين أو القبر، تهون علينا في المعالي
+
+432
+00:38:41,630 --> 00:38:46,630
+نفوسنا، ومن خطط الأسناء لم يوليها المحروم، بدون 
+
+433
+00:38:46,630 --> 00:38:50,910
+مساعدة سرسخة، بدون الدفع، صح؟ زي ما تسوق سيارة
+
+434
+00:38:50,910 --> 00:38:55,110
+جديدة، بدون الدفع يعني، هي هيك، احنا بدأنا نضحك مع
+
+435
+00:38:55,110 --> 00:39:00,850
+ناس ادفع، يعني هي الآية ادفع بداتي أحسن، يعني أنت
+
+436
+00:39:00,850 --> 00:39:04,570
+إيش؟ جدي من الحسنات و الخير، جدي من الخير و اتواضع
+
+437
+00:39:04,570 --> 00:39:09,350
+على الناس و أصلح الحام و يعني و أصلح بين الناس و
+
+438
+00:39:09,350 --> 00:39:13,230
+واقفوا عن الظالم و زهير، الآية هيك يعني عشان .. بس
+
+439
+00:39:13,230 --> 00:39:16,410
+احنا بنعملها إيش؟ نقطة، مولد فبداتي أحسن اني ممكن
+
+440
+00:39:16,410 --> 00:39:23,070
+مصاري تعيش إيش؟ طيب،
+
+441
+00:39:23,070 --> 00:39:25,170
+يبقى .. أنا في single-use containers 
+
+442
+00:39:27,750 --> 00:39:31,550
+طريقة رعية عشان تفادى إيش؟ الـ Infection يعني
+
+443
+00:39:31,550 --> 00:39:35,170
+الوقت القرانية بتاعه تغارى عليه، بدل ما تسيبها في
+
+444
+00:39:35,170 --> 00:39:38,750
+مرضى غلط أو حاجة، لهذا اللي يعني هو بياخد تمام
+
+445
+00:39:38,750 --> 00:39:42,390
+نظيف، أول ضوء يعني، و الشركات بيشجع فاهم
+
+446
+00:39:50,210 --> 00:39:54,210
+نانا كلايكال يوز نشوف نانا كلايكال يوز when a saline
+
+447
+00:39:54,210 --> 00:39:58,150
+solution is used specifically to undertake
+
+448
+00:39:58,150 --> 00:40:02,450
+standardized saline for contact lens to determine
+
+449
+00:40:02,450 --> 00:40:06,310
+dimensions, physical, chemical and biological lens
+
+450
+00:40:06,310 --> 00:40:09,390
+testing characteristics of contact lens and
+
+451
+00:40:09,390 --> 00:40:13,130
+contact lens materials it should be formulated in
+
+452
+00:40:13,130 --> 00:40:16,850
+strict accordance with the relevant international
+
+453
+00:40:16,850 --> 00:40:25,070
+standards عارفين إيش حكاية المعايرة؟ المعايرة يعني
+
+454
+00:40:25,070 --> 00:40:33,130
+مثلا عندي جهاز ضغط و حاسس إنه يعني مش ضعيف بروح
+
+455
+00:40:33,130 --> 00:40:38,770
+أنا عايره بجهاز ثاني عشان أعرف مقارنة يعني أو جهاز
+
+456
+00:40:38,770 --> 00:40:39,210
+ثاني
+
+457
+00:41:06,430 --> 00:41:12,270
+فاحنا دائما يعني بدنا برضه إن العدسة اللي أصلا
+
+458
+00:41:12,270 --> 00:41:17,270
+و المادة بتاعتها و المحلول بتاعنا و الكيس بتاعنا
+
+459
+00:41:17,270 --> 00:41:21,850
+بالمعايير العالمية لإن أحياناً تكون معايير محلية
+
+460
+00:41:21,850 --> 00:41:28,090
+رديئة ثانوية محلية في بلد معين رديئة فهذه ممكن هي
+
+461
+00:41:28,090 --> 00:41:33,110
+تؤدي للعالم و ممكن تعمل Infection أكثر و تكون يعني
+
+462
+00:41:33,110 --> 00:41:38,560
+التجار هدفهم الربح فقط لذلك في العالم اللبناني في
+
+463
+00:41:38,560 --> 00:41:43,660
+حاجة اسمها الـ ISO الـ ISO علامة معينة علامة الجودة
+
+464
+00:41:43,660 --> 00:41:50,340
+و يطلب من شركات في العالم إنه تحقق الـ ISO و
+
+465
+00:41:50,340 --> 00:41:57,280
+الشركة اللي ما بتحقق الـ ISO ممكن مرتخض أو إنه يعني
+
+466
+00:41:57,280 --> 00:42:01,580
+ضيع حقها في التسويق لذلك الآن سألتقوا كلمة مش حاجة
+
+467
+00:42:01,580 --> 00:42:07,810
+بسيطة حاجة يعني مش حاجة أنا بتحط لاصق للمفصل أو
+
+468
+00:42:07,810 --> 00:42:13,170
+للكعب، هدى أو شيء، لأ فهالشيء ليش؟ للعين، للعين،
+
+469
+00:42:13,170 --> 00:42:16,830
+لعينه من أغلب ما يملك الأسعار، من أغلب ما يملك
+
+470
+00:42:16,830 --> 00:42:22,290
+الأسعار عشان هيك بيكون فيه نوع من standardization
+
+471
+00:42:22,290 --> 00:42:29,590
+يعني standard اللي هو إيش؟ criterion طيب
+
+472
+00:42:29,590 --> 00:42:31,810
+المرة الجاية إن شاء الله بتكلم على الـ enzymatic 
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/kB9wtqdRLdw_postprocess.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/kB9wtqdRLdw_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..325f3a98e50ddc4416dfcd2eb3607e49a22010cb
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/kB9wtqdRLdw_postprocess.srt
@@ -0,0 +1,1888 @@
+1
+00:00:20,080 --> 00:00:21,920
+بسم الله الرحمن الرحيم الحمد لله رب العالمين و
+
+2
+00:00:21,920 --> 00:00:25,580
+أصلي و أسلم على النبي الأمين محمد صلى الله عليه و
+
+3
+00:00:25,580 --> 00:00:28,940
+أسلم عليه أهلي و أصحابيه أجمعين في المحاضرة
+
+4
+00:00:28,940 --> 00:00:33,600
+السابقة تكلمنا عن ال hydrogen peroxide في تطهير
+
+5
+00:00:33,600 --> 00:00:37,300
+الأدسات اللاصقة و كنا أن ال hydrogen peroxide لأنه
+
+6
+00:00:37,300 --> 00:00:42,520
+لا لون له و أنه هو corrosive يعني
+
+7
+00:00:49,530 --> 00:00:53,830
+و انه فيه اكسجين و بيلمع العلسة اللاصقة الحقيقة
+
+8
+00:00:53,830 --> 00:00:58,750
+انه يعني fantastic للعلسة اللاصقة جميع الأنواع و
+
+9
+00:00:58,750 --> 00:01:02,970
+نفسي يعني من عيوبه ان هو طويل شوية و الطريقة بدها
+
+10
+00:01:02,970 --> 00:01:10,130
+neutralization ب by carbonate ويعني بده saline
+
+11
+00:01:10,130 --> 00:01:14,030
+مرتين تلاتة لذا اتمنى نوترود اللي هو اللي
+
+12
+00:01:19,340 --> 00:01:34,640
+على القرنية بتمال و irritation و يعني ضارة يعني
+
+13
+00:01:34,640 --> 00:01:38,920
+هو مع انه فائد جدا لكن الناس متهاش اربع او خمس
+
+14
+00:01:38,920 --> 00:01:39,380
+فطوات
+
+15
+00:01:42,630 --> 00:01:47,070
+فعشان يك قل لهانة من شعبياته في تطهير الأدسات
+
+16
+00:01:47,070 --> 00:01:50,130
+اللاسقة until simpler means of neutralization was
+
+17
+00:01:50,130 --> 00:01:54,190
+developed لغاية مدورة على وسائل جديدة لطرد
+
+18
+00:01:54,190 --> 00:01:57,150
+الhydrogen peroxide بعمل neutralization أبسط من
+
+19
+00:01:57,150 --> 00:02:00,150
+أولى hydrogen peroxide has been used for many
+
+20
+00:02:00,150 --> 00:02:03,890
+years as a surface disinfectant and for its
+
+21
+00:02:03,890 --> 00:02:08,810
+bleaching effect يعني هو مطهر لسطح العدسة ومبيض
+
+22
+00:02:11,370 --> 00:02:15,150
+الـ Bleaching تنمية الـ S strength can be
+
+23
+00:02:15,150 --> 00:02:20,050
+described in terms of volumes يعني في مثلا volume
+
+24
+00:02:20,050 --> 00:02:28,510
+10 volume وفي 20 volume اللي هي الأبواب الحجم 10
+
+25
+00:02:28,510 --> 00:02:31,450
+volume solutions process processes
+
+26
+00:02:38,660 --> 00:02:44,760
+يعني لما بتتحلل الى مياه و أكسجين بتطلع نيت مثلا
+
+27
+00:02:44,760 --> 00:02:51,840
+mainly أكسجين العشرة بتطلع نية أكسجين عشر أضعفها
+
+28
+00:02:51,840 --> 00:02:57,140
+يعني فعمل ده was very effective against all the
+
+29
+00:02:57,140 --> 00:03:03,160
+organisms used in the beasts يبقى هو يعني ثمت انه
+
+30
+00:03:03,160 --> 00:03:03,740
+effective على
+
+31
+00:03:09,470 --> 00:03:18,040
+الـ Amoeba أكلتموه يعني إله فعل واضح جداالأنفل أو
+
+32
+00:03:18,040 --> 00:03:22,140
+two step disinfection خطوة تانية خطوة أولى وخطوة
+
+33
+00:03:22,140 --> 00:03:26,200
+تانية when used to disinfect contact lenses it is
+
+34
+00:03:26,200 --> 00:03:29,420
+very it is necessary to neutralize the peroxide
+
+35
+00:03:29,420 --> 00:03:32,960
+after an interval of time and yearly products were
+
+36
+00:03:32,960 --> 00:03:36,400
+described as two step which means that the patient
+
+37
+00:03:36,400 --> 00:03:39,160
+carries out disinfection and neutralization at
+
+38
+00:03:39,160 --> 00:03:40,720
+separate stages in the body
+
+39
+00:03:51,720 --> 00:03:56,440
+advantages of a two-step الهو system R ماهي
+
+40
+00:03:56,440 --> 00:03:59,740
+المزايا اللي افضل يفعلها يعني there is a situation
+
+41
+00:03:59,740 --> 00:04:03,280
+of antimicrobial action that can for example be
+
+42
+00:04:03,280 --> 00:04:08,580
+overnight يعني احنا بدنا نحط العدسة في الherbal
+
+43
+00:04:08,580 --> 00:04:12,020
+oxide مثلا طول الليل، طول الليل مش هتمو اللامسين
+
+44
+00:04:14,350 --> 00:04:18,790
+فيتناسب المفروض ان الميكروبات تناسب تاردي مع المدن
+
+45
+00:04:18,790 --> 00:04:24,450
+الزمنية كل مفروض ان الأسلحة الأصغر في المحلول كل
+
+46
+00:04:24,450 --> 00:04:28,490
+ما أثرت اكتر على ميكروبات قتلتها وهذا اللي احنا
+
+47
+00:04:28,490 --> 00:04:32,170
+بندهيه بان عادة خالية من الميكروبات لان الميكروبات
+
+48
+00:04:32,170 --> 00:04:36,890
+ممكن تعمل كورنال أبسس تعمل infection طيب التانية
+
+49
+00:04:36,890 --> 00:04:41,010
+in hot human climates that favor microbial
+
+50
+00:04:41,010 --> 00:04:42,310
+proliferation overnight
+
+51
+00:04:46,470 --> 00:04:50,770
+في جو دافع زي جو من الأربع عام ماضي هذا الجو
+
+52
+00:04:50,770 --> 00:04:57,410
+الدافع او الساخن كتير بنعش البكتيريا للتكافئة عكس
+
+53
+00:04:57,410 --> 00:05:03,230
+الجو البارد امبارح امبارح اول امبارح مثلا فبقول في
+
+54
+00:05:03,230 --> 00:05:08,650
+الجو ال humid و hot يعني ال hybrid من ال oxide
+
+55
+00:05:08,650 --> 00:05:13,270
+المفروض على العدسات وعلى الميكروبات بكون
+
+56
+00:05:13,270 --> 00:05:14,050
+preferable
+
+57
+00:05:20,320 --> 00:05:23,480
+أحنا جابونا طبعا غالبا مفتدل لا بالبارد ولا
+
+58
+00:05:23,480 --> 00:05:31,120
+بالساخن three suitable الهيدرالبيوكسيد one contact
+
+59
+00:05:31,120 --> 00:05:36,880
+lens wear is intermittent rather than daily يعني
+
+60
+00:05:36,880 --> 00:05:40,860
+واحد أو واحدة بتلبس ساعة سلسلة ساعتين تلاتة و
+
+61
+00:05:40,860 --> 00:05:45,540
+بتشيلها و الباقى بيحطها في الاش محلول في ال case
+
+62
+00:05:45,540 --> 00:05:51,190
+هذا في المحلول هذا النقطة تماميعني بيقدر يقول انه
+
+63
+00:05:51,190 --> 00:05:57,970
+ماخد عدسة نقية او طاهرة عكس اللي بيستعمل أنفلاس كل
+
+64
+00:05:57,970 --> 00:06:03,850
+ليلة نهار يعني مش فاضل وقت ان هو يعيش يضاحف ال
+
+65
+00:06:03,850 --> 00:06:07,210
+hydroperoxide it is important that neutralization
+
+66
+00:06:07,210 --> 00:06:12,050
+of the peroxide is not undertaken too rapidly يعني
+
+67
+00:06:12,050 --> 00:06:16,690
+هو مش اتجيه جودي كتير و يطلع خلاص لأ عشانك احنا
+
+68
+00:06:16,690 --> 00:06:18,630
+لما نحط الكحول
+
+69
+00:06:22,900 --> 00:06:27,360
+بنعمل كده؟ اه ده بره يعني هى مش سحر يعني مش احنا
+
+70
+00:06:27,360 --> 00:06:31,980
+حاطينا كحول لأ مسيت الجلد ان كل بكتيريا بتطهرت لأ
+
+71
+00:06:31,980 --> 00:06:35,720
+انا يعني بقى جبنى اللى فاهم الحقيقة يعنى بيفضل على
+
+72
+00:06:35,720 --> 00:06:40,120
+مكان بده يعمل injection انه يفضل طالع نازل طالع
+
+73
+00:06:40,120 --> 00:06:44,500
+نازل يعني اربع خمس دخائف يعني بحمر الجلد من كتر
+
+74
+00:06:44,500 --> 00:06:49,640
+قياسى ما حكوا ودخل اللى هو الكحول كويس فى الجلد
+
+75
+00:06:49,640 --> 00:06:55,390
+أفضل من اللى عمل كدهو أفضل من اللي ماحطش كحوة صورة
+
+76
+00:06:55,390 --> 00:06:58,370
+فيها ناس بيقولوا بإيه؟ من غير ما نحط كحوة؟ شوفت
+
+77
+00:06:58,370 --> 00:07:04,030
+أنا؟ مولاك مش فادرتها يعني، مش كتير يبقى هذه ال
+
+78
+00:07:04,030 --> 00:07:09,250
+advantages تات ال two step in one system a
+
+79
+00:07:09,250 --> 00:07:13,070
+solution containing the enzyme catalase
+
+80
+00:07:19,400 --> 00:07:22,840
+الخطوة الأولى هي الهيدروجين بالإكسايد طول الليل
+
+81
+00:07:22,840 --> 00:07:33,340
+الخطوة التانية انزين كتاليز زي تابليك قصه although
+
+82
+00:07:33,340 --> 00:07:37,820
+a two-step system is compatible with non-ionic
+
+83
+00:07:37,820 --> 00:07:41,900
+high water content hydrogen lenses, ionic high
+
+84
+00:07:41,900 --> 00:07:46,080
+water content lenses undergo marked hydrationيعني
+
+85
+00:07:46,080 --> 00:07:49,580
+هو بيقول ليه بيقارن بين نوعين من العدسات بين
+
+86
+00:07:49,580 --> 00:07:55,180
+العدسات اللي هي ال non-ionic وبين ال ionic بيقول
+
+87
+00:07:55,180 --> 00:07:59,600
+ليه التنين بنفع بس ال ionic بيصيرلها market
+
+88
+00:07:59,600 --> 00:08:05,420
+hydration changes تنفش أكتر تاخد مياه أكتر as a
+
+89
+00:08:05,420 --> 00:08:09,200
+consequence of the length immersion نقا in
+
+90
+00:08:09,200 --> 00:08:12,140
+hydrogen peroxide عشان هيك له
+
+91
+00:08:16,530 --> 00:08:21,430
+اللي هي الـ Ionic lenses should not be used with
+
+92
+00:08:21,430 --> 00:08:25,790
+this peroxide metal يعني دي هنخليها ليه اللي هو
+
+93
+00:08:25,790 --> 00:08:34,010
+العدسات الـ Non-ionic lenses طيب
+
+94
+00:08:34,010 --> 00:08:37,650
+هنشوف هل وقت فيه حاجات تانية غير كده كمان العلم
+
+95
+00:08:37,650 --> 00:08:43,150
+تقدم كده ال disadvantage of this two step process
+
+96
+00:08:43,150 --> 00:08:47,530
+هل وقت إيه ال disadvantage؟Is the need for the
+
+97
+00:08:47,530 --> 00:08:50,690
+patient to remember to initiate neutralization
+
+98
+00:08:50,690 --> 00:08:55,230
+يعني لازم يحط اللي هو إيش اللي هو ال enzyme كتاليز
+
+99
+00:08:55,230 --> 00:08:59,410
+عشان يشيل ال hydrogen peroxide طب لو ما .. لو
+
+100
+00:08:59,410 --> 00:09:04,710
+ماتفكرش أو ماحطش ال .. الكتاليز بيبدأ ال hydrogen
+
+101
+00:09:04,710 --> 00:09:09,350
+peroxide في العدسة وله اللي بيثبت براهين هذا
+
+102
+00:09:09,350 --> 00:09:13,530
+الموضوع يبقى تحتاج من المريض to remember
+
+103
+00:09:16,540 --> 00:09:20,220
+الحصول على نترالزيشن الـ BH-Hydrogen Peroxide في
+
+104
+00:09:20,220 --> 00:09:27,860
+عدد من 3.5 إلى 4.5 والطبيعي اللذي قرر نترالزيشنه
+
+105
+00:09:27,860 --> 00:09:33,460
+قبل إضافة عين لعينه كان يفعل هذا الخطأ فقط مرة
+
+106
+00:09:33,460 --> 00:09:37,460
+بسبب درجة المشكلة
+
+107
+00:09:44,770 --> 00:09:48,090
+فانحط اربعة على سبعة بينما ال irritation و ال
+
+108
+00:09:48,090 --> 00:09:51,330
+energy و ال congestion و الكلام مش مناسب يبقى ال
+
+109
+00:09:51,330 --> 00:09:56,630
+catalase بيعمل neutralization ليه؟ اللي هو ال
+
+110
+00:09:56,630 --> 00:10:01,630
+hypersensory علشان يكفيها two steps يعني لو ليس هي
+
+111
+00:10:01,630 --> 00:10:06,010
+هتكون مشكلة طيب، الآن فلو أنا one step
+
+112
+00:10:17,470 --> 00:10:24,150
+وهي العلم، العلم بيبني على بعض، في الزمن يعني كان
+
+113
+00:10:24,150 --> 00:10:30,190
+السيارة و الطيارة عجيبة، و الكمبيوتر كان عجيب،
+
+114
+00:10:30,190 --> 00:10:33,610
+جنياته جالية و حجمه كبير و شغله و مستهلكه، فده و
+
+115
+00:10:33,610 --> 00:10:38,090
+زهر و زهر و زهر و لجاته، مثلا، و حتى الجوالات قبل
+
+116
+00:10:38,090 --> 00:10:44,690
+عشرين عامل كيف كانت، كانت اسمها بريزما، بريزما
+
+117
+00:10:51,170 --> 00:10:55,950
+ففي تطوير و ال step system were introduced to
+
+118
+00:10:55,950 --> 00:11:00,130
+simplify the procedure for the patient. إيه
+
+119
+00:11:00,130 --> 00:11:05,410
+simplify؟ تبسيط تبسيط. And have the advantage that
+
+120
+00:11:05,410 --> 00:11:08,230
+the vital step of neutralization can't be
+
+121
+00:11:08,230 --> 00:11:08,690
+overlooked.
+
+122
+00:11:15,670 --> 00:11:19,250
+الفرصة المفيدة في الوان اس تيب هي دورة عملية تحرير
+
+123
+00:11:19,250 --> 00:11:23,330
+الانفكاش يتعني بطريقة وانتشار بطريقة وانتشار
+
+124
+00:11:23,330 --> 00:11:25,510
+بطريقة وانتشار بطريقة وانتشار بطريقة وانتشار
+
+125
+00:11:25,510 --> 00:11:27,970
+بطريقة وانتشار بطريقة وانتشار بطريقة وانتشار
+
+126
+00:11:27,970 --> 00:11:30,550
+بطريقة وانتشار بطريقة وانتشار بطريقة وانتشار
+
+127
+00:11:30,550 --> 00:11:31,030
+بطريقة وانتشار بطريقة وانتشار بطريقة وانتشار
+
+128
+00:11:31,030 --> 00:11:31,550
+بطريقة وانتشار بطريقة وانتشار بطريقة وانتشار
+
+129
+00:11:31,550 --> 00:11:38,030
+بطريقة وانتشار بطريقة وانتشار بطريقة وانتشار
+
+130
+00:11:38,030 --> 00:11:44,350
+بطريقة وان
+
+131
+00:11:45,220 --> 00:11:50,920
+أو شهور مش مناسب، ممكن تتضرر، أكسر الأولى، الأولى
+
+132
+00:11:50,920 --> 00:11:53,140
+كل ما حطيت في ال hydrogen dioxide نموذج أطوى، كل
+
+133
+00:11:53,140 --> 00:11:56,780
+ما كان أحسن، لأ هذا الخطوة لأ، حطها ساعة، ساعتين
+
+134
+00:11:56,780 --> 00:12:00,860
+وامشي، about 90% of the hydrogen peroxide systems
+
+135
+00:12:00,860 --> 00:12:05,440
+now used are one step، الآن ال hydrogen peroxide
+
+136
+00:12:05,440 --> 00:12:14,260
+90% one step، وال10% ال two steps اللي فات، أو
+
+137
+00:12:14,260 --> 00:12:19,000
+أكترو في واحدة من هذه الأساسيات ما يسمونه
+
+138
+00:12:19,000 --> 00:12:25,220
+بلاتينيوم ديسك in the storage case يعني حطه في نفس
+
+139
+00:12:25,220 --> 00:12:29,940
+ال case اللي فيه العدسة حديدة صغيرة هي من بلاتين
+
+140
+00:12:29,940 --> 00:12:39,800
+بلاتين ديسك صغير يعني يشبه البطاية الساعة صغيرة
+
+141
+00:12:46,120 --> 00:12:50,500
+Hydroxide أندهو و أكسجين أندهو يبقى هذا موجود في
+
+142
+00:12:50,500 --> 00:12:55,920
+نفس ال container بتاعك حط ال hydrogen من ال Oxide
+
+143
+00:12:55,920 --> 00:13:02,640
+أول ما تهرصها شوية يبدأ هو يحلل فيه يبقى تلومدسكي
+
+144
+00:13:02,640 --> 00:13:09,980
+يحلل ال hydrogen من ال Oxide إلى مكوناته ماء و درة
+
+145
+00:13:09,980 --> 00:13:12,140
+أكسجين جزء ماء و درة أكسجين
+
+146
+00:13:17,600 --> 00:13:22,320
+مش مضطر اخبره انزيم وانزيم خلاص منه فيه one step
+
+147
+00:13:22,320 --> 00:13:29,660
+فقط طيب having
+
+148
+00:13:29,660 --> 00:13:36,540
+filled the case with 3% peroxide there is an
+
+149
+00:13:36,540 --> 00:13:40,300
+initial rapid phase of neutralization resulting in
+
+150
+00:13:40,300 --> 00:13:45,860
+a concentration of 0.9% after two minutes يعني بعد
+
+151
+00:13:45,860 --> 00:13:53,740
+دقيقتينبحللك اياه و بيخليك التركيز 0.9 بس هو تركيز
+
+152
+00:13:53,740 --> 00:14:00,120
+السبع تركيز السبع هذا مثلا ال اوزي سيبت شايفين
+
+153
+00:14:00,120 --> 00:14:04,540
+الجزازة هالي اوزي سيبت؟ الجزازة هالي هالي one step
+
+154
+00:14:04,540 --> 00:14:11,320
+disinfection تحط المحلول في ال case و بعد شوية هو
+
+155
+00:14:11,320 --> 00:14:15,360
+لحاله بيعمل neutralization منه مطهر و هو بيعمل
+
+156
+00:14:15,360 --> 00:14:21,520
+neutralizationبس عيبه انه ماخدش وقت كافي يعني
+
+157
+00:14:21,520 --> 00:14:26,740
+العنصر ماترتاحش كثير في الهدف البيلوكسايت، يمكن
+
+158
+00:14:26,740 --> 00:14:32,140
+بعض الناس يقولك انا يا عمي لسه احطه في جفنة فيها
+
+159
+00:14:32,140 --> 00:14:36,700
+هدف البيلوكسايت ساعتين و بعدين ارجله هالي عشان
+
+160
+00:14:36,700 --> 00:14:41,140
+ايش؟ يعملوا neutralizationما هو بعض الناس يعني
+
+161
+00:14:41,140 --> 00:14:46,460
+عندهم أفكار وحريص أكتر وفي بعض الناس بتاعة ال
+
+162
+00:14:46,460 --> 00:14:56,200
+American way سريع شغل .. شغل سريع فهذا
+
+163
+00:14:56,200 --> 00:15:01,000
+بعد ما أحطته في ال case و اتحلل which is followed
+
+164
+00:15:01,000 --> 00:15:06,680
+by a slow phase to approximately fifteen parts per
+
+165
+00:15:06,680 --> 00:15:14,430
+million after six hoursيعني بعد ست ساعات وجدوا ال
+
+166
+00:15:14,430 --> 00:15:22,890
+hydrogen peroxide خمستاشر في المليون كتير ولا
+
+167
+00:15:22,890 --> 00:15:29,550
+جالين؟ جالين، صح؟ خمستاشر في المليون، هذا بعد ست
+
+168
+00:15:29,550 --> 00:15:36,090
+ساعات يعني هو صحيح حصل neutralization، لكن مش مية
+
+169
+00:15:36,090 --> 00:15:39,900
+في الميةفي هذا الجزء من الهيبرميل اكسايد تركيز
+
+170
+00:15:39,900 --> 00:15:47,260
+خفيف يعمل في التطهير طبعا هنا فيه بكتيريا غير
+
+171
+00:15:47,260 --> 00:15:52,800
+كافية طيب such a level is below the threshold of
+
+172
+00:15:52,800 --> 00:15:55,920
+subjective sensitivity يعني بيقول انه عشان يشترع
+
+173
+00:15:55,920 --> 00:16:03,220
+البكتيريا بيكون اقل من 50 إلى 300 per million
+
+174
+00:16:04,240 --> 00:16:09,060
+يعني خمسين إلى ثلاثمائة جزء في المليون من الـ
+
+175
+00:16:09,060 --> 00:16:13,600
+hydrogen peroxide عشان يكون active as يعني
+
+176
+00:16:13,600 --> 00:16:22,420
+bactericidal او bacterostatic او اللي هو and
+
+177
+00:16:22,420 --> 00:16:26,200
+that at which adverse effects on the mitotic
+
+178
+00:16:26,200 --> 00:16:32,200
+activity and movement of bacterial cells occurيعني
+
+179
+00:16:32,200 --> 00:16:36,800
+الـ 300 مثلا ممكن يعني يؤثر على اللي هو ال
+
+180
+00:16:36,800 --> 00:16:42,580
+material cells بتاعة القرن لكن ال 15 parts اللي في
+
+181
+00:16:42,580 --> 00:16:49,080
+الأول مابيأثروش في
+
+182
+00:16:49,080 --> 00:16:54,000
+طريقة أخرى لل one step غير platinum diskعلى الـ
+
+183
+00:16:54,000 --> 00:16:58,180
+one step system used a tablet coated with
+
+184
+00:16:58,180 --> 00:17:06,940
+hydroxypropyl methyl
+
+185
+00:17:06,940 --> 00:17:11,960
+cellulose مراكب كيميائي which contains a catalase
+
+186
+00:17:11,960 --> 00:17:15,940
+يعني هنا في انزيم اسمه catalase which is slowly
+
+187
+00:17:15,940 --> 00:17:21,860
+released after 30 minutes من المراكب الكيميائيعند
+
+188
+00:17:21,860 --> 00:17:24,560
+استخدام نفراليزيات عامة لإيقاف مستوى البروكسينات
+
+189
+00:17:24,560 --> 00:17:31,820
+من 1.4 مليون بعد حوالي 2 ساعات طريقة تانية الطريقة
+
+190
+00:17:31,820 --> 00:17:37,660
+الأولى ميتاليك ديسك يكون في ال case مثلا بقى يحلل
+
+191
+00:17:37,660 --> 00:17:41,560
+الهدوء من البروكسينات إلى المركبات طريقة تانية
+
+192
+00:17:41,560 --> 00:17:46,020
+كيميائية تعملت هيدروكسي بروفايل مثلا سيليوليز
+
+193
+00:17:46,020 --> 00:17:51,890
+بيطلع منه كتاليز في خلال ساعتينبيكون محلل
+
+194
+00:17:51,890 --> 00:17:57,650
+البريوكسايد و بلاجيش يمكن إلا one part per million
+
+195
+00:17:57,650 --> 00:18:04,830
+تركيزه في البريوكسايد في المحدود من أفضل تاني
+
+196
+00:18:04,830 --> 00:18:12,910
+أفضل؟ بس التاني يعني .. لأ الأولى أفضل ليش الأولى
+
+197
+00:18:12,910 --> 00:18:17,960
+أحسن؟ لأنه أنا مابدخلش فيهالأولى انا مابدخلها انا
+
+198
+00:18:17,960 --> 00:18:20,840
+بحط الهيلو من البروكسايد و بعدين بدي أجيها لبسها
+
+199
+00:18:20,840 --> 00:18:25,140
+على ثلاثة بعد ساعة ساعتين بدي ألبسها على ثلاثة لكن
+
+200
+00:18:25,140 --> 00:18:29,980
+هنا انا لازم أحطله ايش tablet tablet ايش tablet
+
+201
+00:18:29,980 --> 00:18:34,680
+يعني course course بحطه course اتفقد ان سي تحطه
+
+202
+00:18:34,680 --> 00:18:41,240
+course لان فيه الكتاريز في المطارقة الأولى يعني
+
+203
+00:18:41,240 --> 00:18:44,380
+يعني
+
+204
+00:18:44,380 --> 00:18:45,100
+more easy
+
+205
+00:18:53,430 --> 00:18:57,190
+microbiological contamination of the contact lens
+
+206
+00:18:57,190 --> 00:19:02,650
+storage case regularly receives attention as a
+
+207
+00:19:02,650 --> 00:19:08,570
+possible source of infection in virus يعني صاحب
+
+208
+00:19:08,570 --> 00:19:13,270
+الام ثلاثة كان بياخد باله ان مع الأيام ال case
+
+209
+00:19:14,200 --> 00:19:18,900
+الcontainer تلت تلت تلت حيصير هو المباقه هو مصدر
+
+210
+00:19:18,900 --> 00:19:25,940
+ال infection وانا لأ ممكن اني بسير يعني اي اناء
+
+211
+00:19:25,940 --> 00:19:30,400
+احنا ان ما طهرنا كويس حتى انت الطعام اشي و كده كده
+
+212
+00:19:30,400 --> 00:19:34,180
+حتى لو شات الأسنان بقى الأيام بتصير هي مستودع ال
+
+213
+00:19:34,180 --> 00:19:42,200
+infection مش بريئة يعني لأن فيها بصير الحثالات
+
+214
+00:19:50,160 --> 00:19:53,840
+أكبر شيء الإنسان يعني بيقفل عنه تيجي لأعداء
+
+215
+00:19:53,840 --> 00:19:59,460
+البكتيريا والفيروسات والفطريات تقول فيه ويلسون
+
+216
+00:19:59,460 --> 00:20:04,240
+وفريقه في سنة وتسعين مقال ماضي found that cases
+
+217
+00:20:04,240 --> 00:20:09,040
+disinfected with peroxide systems showed a lower
+
+218
+00:20:09,040 --> 00:20:11,960
+level of microbial contamination than those in
+
+219
+00:20:11,960 --> 00:20:16,960
+which other methods of disinfection had been used
+
+220
+00:20:16,960 --> 00:20:24,980
+يعني وجدت بالتجربةاللي فيها H2O من حد الأقل تلوثا
+
+221
+00:20:24,980 --> 00:20:31,760
+من غيرها من اللي بيحطوا فيها أشياء أخرى زي مثلا ال
+
+222
+00:20:31,760 --> 00:20:37,620
+chlorine و زي اليود زي ما هنشوف يعني و أنا مبكر إن
+
+223
+00:20:37,620 --> 00:20:42,660
+ال H2O يعني هذا السائل الممتنق إن كان هو fresh و
+
+224
+00:20:42,660 --> 00:20:47,480
+معكّب تمام و تركيزي تمام حقيقةإنه يعني effective
+
+225
+00:20:47,480 --> 00:20:50,340
+effective حتى الجروح العميقة كنا نحطه على الجروح
+
+226
+00:20:50,340 --> 00:20:54,860
+العميقة بعمر الله إنه يشيل كل ما فيها من الصديد و
+
+227
+00:20:54,860 --> 00:20:59,960
+من ال crust و من ال debris و الكلام هذا سهل ممتنة
+
+228
+00:20:59,960 --> 00:21:04,640
+و أفضل تشتروه و تجربوه ماشي؟ بقى أنا جاي ابقى
+
+229
+00:21:04,640 --> 00:21:05,340
+أسألكوا ان شاء الله
+
+230
+00:21:14,600 --> 00:21:19,560
+أي سطح، شوفون أيش بيصير، ماشي؟ تفضلوش .. هيفي
+
+231
+00:21:19,560 --> 00:21:24,300
+قاعدين؟ بدنا .. احنا نطلب ال .. ال .. الإشارة
+
+232
+00:21:24,300 --> 00:21:28,480
+الكاربة، انه احنا بتاعي النضارات و بس، لأن ده نقطة
+
+233
+00:21:28,480 --> 00:21:34,300
+وسط رجلينا، علم الـ Optometry من أوسع العلم،
+
+234
+00:21:34,300 --> 00:21:39,660
+واسأله اللي درسه، واسأله اللي انت رايح تشوفه، ايه
+
+235
+00:21:39,660 --> 00:21:44,300
+الشغل الـ Optometrist؟شوف شغل اللي بت interest ليه
+
+236
+00:21:44,300 --> 00:21:48,860
+اقولكوا انه هنا الوظيفة معتودة سوف يأتي أيام ان
+
+237
+00:21:48,860 --> 00:21:53,600
+شاء الله تكون أمور منفتحة تكون انت رواد زي ما جينا
+
+238
+00:21:53,600 --> 00:21:59,520
+احنا عامل قسم البصرية وعمله معامل هيجي ناس يفتحوا
+
+239
+00:21:59,520 --> 00:22:05,040
+ماجستير ودكتورات ودخلوا المهنة بقوة في كل حي في
+
+240
+00:22:05,040 --> 00:22:09,020
+غزة ان شاء الله بس بدكوا تكونوا عندكوا قصار
+
+241
+00:22:23,420 --> 00:22:28,040
+المنطقة التي تتحرك على أدسات الأسخة أكتر من غيرها،
+
+242
+00:22:28,040 --> 00:22:31,500
+أكتر من الطهيرات الأخرى، مواجهة مواجهة مواجهة
+
+243
+00:22:31,500 --> 00:22:32,620
+مواجهة مواجهة مواجهة مواجهة مواجهة مواجهة مواجهة
+
+244
+00:22:32,620 --> 00:22:34,520
+مواجهة مواجهة مواجهة مواجهة مواجهة مواجهة مواجهة
+
+245
+00:22:34,520 --> 00:22:36,200
+مواجهة مواجهة مواجهة مواجهة مواجهة مواجهة مواجهة
+
+246
+00:22:36,200 --> 00:22:36,800
+مواجهة مواجهة مواجهة مواجهة مواجهة مواجهة مواجهة
+
+247
+00:22:36,800 --> 00:22:43,140
+مواجهة مواجهة مواجهة مواجهة مواجهة
+
+248
+00:22:43,140 --> 00:22:47,960
+مواجه
+
+249
+00:22:48,460 --> 00:22:55,940
+تغيير المحلول frequently بيكون هو الطريقة الأولى،
+
+250
+00:22:55,940 --> 00:22:59,660
+يعني مثلا في ناس كل تلات أيام، في ناس كل أسبوع،
+
+251
+00:22:59,660 --> 00:23:03,900
+بيغير محلول، بيشيله و بيحط غيره، بيخلهمش يعني، هو
+
+252
+00:23:03,900 --> 00:23:09,640
+هو، لأنهم تعرفين، هذا من ال oxide في الآخر فيه
+
+253
+00:23:09,640 --> 00:23:12,960
+oxygen، لو طلع ال oxygen و صارت مية، صار مية
+
+254
+00:23:19,290 --> 00:23:22,630
+the frequent receipt of the storage case صح ممتاز
+
+255
+00:23:22,630 --> 00:23:26,550
+remains the best means ممتاز اغير انا ساي المحلول
+
+256
+00:23:26,550 --> 00:23:31,250
+و اغير ال case صحيح شكرا لاسمك اغير نفس ال case و
+
+257
+00:23:31,250 --> 00:23:38,830
+هو مش مكلف يعني هو ال case اصلا مجانية
+
+258
+00:23:38,830 --> 00:23:43,450
+يعني ف .. و بعدين بقى انا كمان ضاقى المهم انواش
+
+259
+00:23:43,450 --> 00:23:46,370
+مابضلش انا على نفس ال ..
+
+260
+00:24:00,510 --> 00:24:01,670
+الهيدروجين الهيدروجين الهيدروجين الهيدروجين
+
+261
+00:24:01,670 --> 00:24:03,070
+الهيدروجين الهيدروجين الهيدروجين الهيدروجين
+
+262
+00:24:03,070 --> 00:24:06,530
+الهيدروجين الهيدروجين الهيدروجين الهيدروجين
+
+263
+00:24:06,530 --> 00:24:07,390
+الهيدروجين الهيدروجين الهيدروجين الهيدروجين
+
+264
+00:24:07,390 --> 00:24:07,730
+الهيدروجين الهيدروجين الهيدروجين الهيدروجين
+
+265
+00:24:07,730 --> 00:24:11,550
+الهيدروجين الهيدروجين الهيدروجين الهيدروجين
+
+266
+00:24:11,550 --> 00:24:16,210
+الهيدروجين الهيدروجين الهيدروجين الهيدروجين
+
+267
+00:24:16,210 --> 00:24:17,130
+الهيدروجين الهيدروجين الهيدروجين الهيدروجين
+
+268
+00:24:17,130 --> 00:24:23,070
+الهيدروجين اله
+
+269
+00:24:24,290 --> 00:24:29,390
+يعني حدث له تغيرات في المواصفات، يعني الهانفين من
+
+270
+00:24:29,390 --> 00:24:34,330
+الوكساين أدخل يعني إلى الأسوأ يعني، ففي الحالة
+
+271
+00:24:34,330 --> 00:24:39,290
+هانفين بيكون بعض، يعني إذا كان أدخل أي شيء في ال
+
+272
+00:24:39,290 --> 00:24:44,230
+.. مثلا ال diameters أو ال base curve أو أي حاجة
+
+273
+00:24:44,230 --> 00:24:50,410
+فطبعا بيكون إيش؟ في هنا شيء منعوالسلسلات
+
+274
+00:24:50,410 --> 00:24:54,630
+الترانزيالية كانت
+
+275
+00:24:54,630 --> 00:25:02,130
+تدخل من وقت لوقت سلسلات الانفكاطية ولكنها فقدت في
+
+276
+00:25:02,130 --> 00:25:06,410
+الانفكاطية يعني طلعون مثلا اليود والكلورين بدل
+
+277
+00:25:06,410 --> 00:25:09,730
+الهيدروجينبالكسيد وهو معروف حتى في الحياة العملية
+
+278
+00:25:09,730 --> 00:25:15,710
+ان الجلد والجروح ان الأيودين والكلورين من
+
+279
+00:25:15,710 --> 00:25:22,230
+المطاهرات المعروفةمثلًا الـ iodine اليوت معروف
+
+280
+00:25:22,230 --> 00:25:27,610
+لونه بوني هو دورم البوليدين اللي بيستخدم في تطهير
+
+281
+00:25:27,610 --> 00:25:32,750
+الجروح was produced by a neutralizing agent to the
+
+282
+00:25:32,750 --> 00:25:36,650
+infective colorless iodine iodide the reaction
+
+283
+00:25:36,650 --> 00:25:40,410
+producing a mixture of electrolytes none of which
+
+284
+00:25:40,410 --> 00:25:45,770
+were foreign to the ice يعني هو بيقوللي أن بعض
+
+285
+00:25:45,770 --> 00:25:50,140
+الناس استخدموا ال iodineVinyl الهدوء اللي بتكسب
+
+286
+00:25:50,140 --> 00:25:56,600
+لكن يحدث بعد ما اشهروا اللون البني و أصبح كارلنس
+
+287
+00:25:56,600 --> 00:26:02,220
+لكن باعتقادهم انه مش كفائت الهدوء اللي بتكسب
+
+288
+00:26:02,220 --> 00:26:05,700
+المطارد
+
+289
+00:26:05,700 --> 00:26:08,880
+التاني chlorine الكون اللي بيحطوه على اللي هو ال
+
+290
+00:26:08,880 --> 00:26:14,010
+water supply على الميهوالتي مثل الهيلو جينات أخرى
+
+291
+00:26:14,010 --> 00:26:17,250
+كانت مطهرة
+
+292
+00:26:17,250 --> 00:26:22,850
+ومنظرة وكانت مستخدمة في اتجاه اتجاه اتجاه اتجاه
+
+293
+00:26:22,850 --> 00:26:25,470
+اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه
+
+294
+00:26:25,470 --> 00:26:25,970
+اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه
+
+295
+00:26:25,970 --> 00:26:26,110
+اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه
+
+296
+00:26:26,110 --> 00:26:38,790
+اتجاه اتجاه اتج
+
+297
+00:26:39,700 --> 00:26:45,600
+بعضهم الكلوريين مع انه قدرة لكن على أنساء الاسقاط
+
+298
+00:26:45,600 --> 00:26:50,080
+ما استمروا زي الهدف من البروجساين ماحصلش إله
+
+299
+00:26:50,080 --> 00:26:57,900
+استقبال و شعبية طيب الآن عاملا بنستجد احنا
+
+300
+00:26:57,900 --> 00:27:02,020
+limitations of present methods of contact lens
+
+301
+00:27:02,020 --> 00:27:14,810
+disinfection ما هي يعني بتقول اناالمحددات التي تحد
+
+302
+00:27:14,810 --> 00:27:22,690
+من استخدام الطرق السابقة في تبتيل عدسات الاصقر،
+
+303
+00:27:22,690 --> 00:27:30,670
+limitations، شيء تحديدات، يعني عدم نجاح كافي
+
+304
+00:27:31,440 --> 00:27:35,260
+الثلاثة مثالين يمكن أن تعملوا لتوضيح إعادة إعادة
+
+305
+00:27:35,260 --> 00:27:36,240
+إعادة إعادة إعادة إعادة إعادة إعادة إعادة إعادة
+
+306
+00:27:36,240 --> 00:27:36,660
+إعادة إعادة إعادة إعادة إعادة إعادة إعادة إعادة
+
+307
+00:27:36,660 --> 00:27:38,740
+إعادة إعادة إعادة إعادة إعادة إعادة إعادة إعادة
+
+308
+00:27:38,740 --> 00:27:39,580
+إعادة إعادة إعادة إعادة إعادة إعادة إعادة إعادة
+
+309
+00:27:39,580 --> 00:27:40,940
+إعادة إعادة إعادة إعادة إعادة إعادة إعادة إعادة
+
+310
+00:27:40,940 --> 00:27:53,520
+إعادة إعادة إعادة إعادة إعادة إعادة إعادة إعادة إع
+
+311
+00:27:57,490 --> 00:28:00,390
+هي تاند ميه تايب سوب كونتاكت لينز دي سينفيفتين
+
+312
+00:28:00,390 --> 00:28:04,230
+سوليوشيز أبيرت تبين افكتف انها مابيكاتينغ باسيلاس
+
+313
+00:28:04,230 --> 00:28:08,970
+سيرياس لأسف لا بالحرارة ولا بالغر حرارة ولا
+
+314
+00:28:08,970 --> 00:28:15,070
+بالهيدرجميل اكسايد بتروح باسيلاس سيرياس from
+
+315
+00:28:15,070 --> 00:28:18,130
+كونتمانيت الكونتاكت لينز cases where as hydrogen
+
+316
+00:28:18,130 --> 00:28:22,930
+peroxide was sporocybin يعني تقول انه الهيدرجميل
+
+317
+00:28:22,930 --> 00:28:28,970
+اكسايديعمل على Spores بتاعته قاطل Spores بتاعت
+
+318
+00:28:28,970 --> 00:28:34,730
+باسلسلسل هي يعني حاجة هي بكتير مقاومة لما الحرارة
+
+319
+00:28:34,730 --> 00:28:40,670
+و لا مدينة الحرارة نستطيع نزيلها من الكاس او من
+
+320
+00:28:40,670 --> 00:28:46,890
+العدسة الاصلة انو فيروس ال فيروس بتاعة ال Simplex
+
+321
+00:28:46,890 --> 00:28:53,220
+والزفتروهو يظهر انه ممكن ان يبقى على حياة كيميائية
+
+322
+00:28:53,220 --> 00:28:58,500
+وهيدروجين بيروكسيد في هذه الانفكاشة، ليش في المواد
+
+323
+00:28:58,500 --> 00:29:05,200
+الكيميائية وفي الهيدروجين بيروكسيد ولا يقتل،
+
+324
+00:29:05,200 --> 00:29:09,620
+لكن ليس بشكل محروم، بيده حرارة، ولو كان الناس قبل
+
+325
+00:29:09,620 --> 00:29:12,920
+الدارس مضت عليها حرارة، لا غليان ولا حرارة محروم
+
+326
+00:29:14,040 --> 00:29:17,100
+عندما يكون الهيستراليزيون عامًا غير متوفر في
+
+327
+00:29:17,100 --> 00:29:22,020
+عملية، يجب
+
+328
+00:29:22,020 --> 00:29:31,840
+أن يتخلص الناس اللي عندهم الانفكاشات من الانفكاشات
+
+329
+00:29:31,840 --> 00:29:38,400
+ويحطها حتى حين العلاج اللي لها، يعمل إرتيكيش في
+
+330
+00:29:38,400 --> 00:29:41,120
+الأول الانفكاش اللي في عينه، ثم نزيلها على السلطة
+
+331
+00:29:42,540 --> 00:29:49,480
+مش امكاني ينظف الأسلاسقة من إيش هو الأمون لو العين
+
+332
+00:29:49,480 --> 00:29:53,180
+بتاعة ال user بتاع ال contactless صفر بكتير ال
+
+333
+00:29:53,180 --> 00:29:57,400
+infection أو غرار ال infection أو severe allergy
+
+334
+00:29:57,400 --> 00:30:03,180
+أو impairment of vision أو أي حاجة من هذه لازم ما
+
+335
+00:30:03,180 --> 00:30:07,920
+لايجيش discard الأسلاسقة لغاية ما نعالج ال disease
+
+336
+00:30:07,920 --> 00:30:08,520
+أو ال infection
+
+337
+00:30:12,200 --> 00:30:17,720
+لأن العنصر اللازقة كانها يعني من الفضول أو من
+
+338
+00:30:17,720 --> 00:30:23,140
+الزينا أو من التكميل، لكن العين هي أهم، احنا نهتم
+
+339
+00:30:23,140 --> 00:30:28,920
+بصحة العين أولا لغاية ما نصف العينللـ function
+
+340
+00:30:28,920 --> 00:30:32,760
+بتاعك مظبوط و بعدين نبقى العدس ثلاثقة اما لو
+
+341
+00:30:32,760 --> 00:30:36,960
+استمرار في وضع العدس ثلاثقة وصرار رغم ال infection
+
+342
+00:30:36,960 --> 00:30:41,360
+او ال allergy او impairment of vision ممكن دمر
+
+343
+00:30:41,360 --> 00:30:45,960
+العين ممكن دمر العين وصير irreversible damage to
+
+344
+00:30:45,960 --> 00:30:51,260
+the function of the eyes ال
+
+345
+00:30:51,260 --> 00:30:55,410
+eyes جرأوا شيء اسمه preserved salineيعني جاهوا
+
+346
+00:30:55,410 --> 00:31:02,250
+سرعي Hydrogen Peroxide 0.9 Pearson أفيل السرعي
+
+347
+00:31:02,250 --> 00:31:07,030
+المحلو الملحن اللي بيحطوا للمرضى في حالات النزلات
+
+348
+00:31:07,030 --> 00:31:10,310
+المعوية بس أضافوا عليه
+
+349
+00:31:16,920 --> 00:31:21,060
+تأثير ولد سلسلة، هل هو يساوي الهزيمة بالإكسايد أو
+
+350
+00:31:21,060 --> 00:31:24,680
+أقل أو أكتر؟ Preserved saline has been used to
+
+351
+00:31:24,680 --> 00:31:30,520
+enhance the efficacy of heat disinfection but is
+
+352
+00:31:30,520 --> 00:31:34,160
+usually used today to rise contact with, to rise
+
+353
+00:31:34,160 --> 00:31:42,980
+نقا، لينجعها يعني فيه، to rise يعني تنقيع لها،
+
+354
+00:31:42,980 --> 00:31:47,620
+تنقيع لعدة سلسلة، على وجه التطير طبعاالفعالية
+
+355
+00:31:47,620 --> 00:31:51,820
+للحفاظات في المصادر الصحية هي تحفظ مصادر الصحية
+
+356
+00:31:51,820 --> 00:31:56,920
+استراليا وليس لإعطاء مصادر التعامل مع هذه
+
+357
+00:31:56,920 --> 00:32:04,700
+الانفكاشة يبقى احنا لما نحط اي مادة حافظة على
+
+358
+00:32:04,700 --> 00:32:11,060
+المحلول الملحى ونحط في الاسلسفة احنا بنقصد فعلا
+
+359
+00:32:11,060 --> 00:32:13,640
+نعمل استراليزيش
+
+360
+00:32:16,420 --> 00:32:20,300
+وجود يعني محلول ملحي مع المواد الحافظة نقطة لأي
+
+361
+00:32:20,300 --> 00:32:23,120
+بكتيريا تكون في ال case او في العدسة اللازقة
+
+362
+00:32:23,120 --> 00:32:27,260
+Preservatives can pose the risk of allergic and
+
+363
+00:32:27,260 --> 00:32:36,760
+toxic reaction دلأسف انه المواد الحافظة لها يعني
+
+364
+00:32:36,760 --> 00:32:37,940
+عالقين حاجتين
+
+365
+00:32:43,110 --> 00:32:47,930
+الالياجيالكوجعالطيبة والكوميا تعمل الالياجي والاخر
+
+366
+00:32:47,930 --> 00:32:55,070
+التاني ايش؟ toxicity شاو في سنة التمانين ديموسترشت
+
+367
+00:32:55,070 --> 00:32:57,510
+ال relationship between preservatives and the
+
+368
+00:32:57,510 --> 00:33:01,350
+incidence of solution allergy solution allergy
+
+369
+00:33:01,350 --> 00:33:05,450
+يعني solution induced allergy اللي يسببها
+
+370
+00:33:05,450 --> 00:33:09,250
+الالياجيال اللي يسببها المحليين ال double mask
+
+371
+00:33:09,250 --> 00:33:15,810
+randomized crossover studyفي الدراسة six subjects
+
+372
+00:33:15,810 --> 00:33:19,430
+used
+
+373
+00:33:19,430 --> 00:33:22,430
+an unpreserved saline solution and a preserved
+
+374
+00:33:22,430 --> 00:33:26,310
+saline solution في ناس استخدموا ال preserved
+
+375
+00:33:26,310 --> 00:33:29,450
+saline اللي في المادة الحافظة و في ناس استخدموا
+
+376
+00:33:29,450 --> 00:33:33,930
+اللي unpreserved اللي فيش فيه these subjects had a
+
+377
+00:33:33,930 --> 00:33:36,470
+probable history of sensitivity to preserved
+
+378
+00:33:36,470 --> 00:33:39,050
+solutions which was confirmed
+
+379
+00:33:42,230 --> 00:33:48,110
+عارف اثبات ان ال saline اللى فيه الموارد الحاضرة
+
+380
+00:33:48,110 --> 00:33:57,110
+يحفظ وجود ال الهجيم في عينين الناس هذه برهير ال
+
+381
+00:33:57,110 --> 00:34:00,630
+saline solutions containing ethyldiamine
+
+382
+00:34:00,630 --> 00:34:05,330
+tetraacetic acid اي ايه ده ات ايه ده تب يعني
+
+383
+00:34:05,330 --> 00:34:08,050
+اختصاره كمادة حافظ طبعا
+
+384
+00:34:19,530 --> 00:34:30,010
+أش يعني المادة الحافظة في الصلاعين مفيدة في مقاومة
+
+385
+00:34:30,010 --> 00:34:37,230
+الدبوزيت أو تمنع الدبوزيت على احدة سلسلة اكتر من
+
+386
+00:34:38,050 --> 00:34:46,390
+الغير محفوظة، السلعن غير المحفوظ طيب
+
+387
+00:34:46,390 --> 00:34:49,550
+بريشيرايز
+
+388
+00:34:49,550 --> 00:34:56,630
+كنتينر هي طريقة جديدة بريشيرايز كنتينر ال case
+
+389
+00:34:56,630 --> 00:35:01,350
+يعني both buffered and unbuffered forms of sterile
+
+390
+00:35:01,350 --> 00:35:05,430
+saline have been made available in aerosol type
+
+391
+00:35:05,430 --> 00:35:11,960
+containersالcontainer فيه مادة اسمها aerosol this
+
+392
+00:35:11,960 --> 00:35:16,360
+mode of preservation of saline requires no
+
+393
+00:35:16,360 --> 00:35:21,540
+preservatives يعني قال إن ال container نفسه مافيش
+
+394
+00:35:21,540 --> 00:35:26,160
+فيه مادة حافظة ال container هو من aerosol حتى لو
+
+395
+00:35:26,160 --> 00:35:32,040
+أحطله إيش، سلان مش محفوظ، بشتغل عن بكتيريا، كف
+
+396
+00:35:32,040 --> 00:35:36,600
+سلان محفوظ يعني أنا صارت أطوير في ال case
+
+397
+00:35:40,560 --> 00:35:46,520
+هو ال case ال case نفسه case صحي غير او لا يسمح
+
+398
+00:35:46,520 --> 00:35:52,600
+بنموه اش الميكروبات فيه هو ال aerosol هذا مش
+
+399
+00:35:52,600 --> 00:35:55,620
+بقولكوا العلم الآن بتبني على بعضه الناس بتبحث
+
+400
+00:35:55,620 --> 00:36:00,500
+دائما والدول بتشجع الباحثين على إيجاد الجديد لعاجز
+
+401
+00:36:00,500 --> 00:36:05,200
+صحة الإنسان ومصلحة يبقى ال control of disease هذا
+
+402
+00:36:05,200 --> 00:36:13,160
+بتاع ال aerosolهو صحي الى درجة ان العجز اللذكر
+
+403
+00:36:13,160 --> 00:36:20,360
+يكون فيه مأمن من التلوث فيه طيب
+
+404
+00:36:20,360 --> 00:36:26,820
+نشور single one containers available both
+
+405
+00:36:26,820 --> 00:36:31,400
+preserved and unpreserved are sachets have the
+
+406
+00:36:31,400 --> 00:36:35,900
+major advantage of remaining sterile until open
+
+407
+00:36:36,580 --> 00:36:40,800
+their disadvantage is the greater cost حاجة بتقول
+
+408
+00:36:40,800 --> 00:36:49,260
+يعني إيش مره موشي بده افتحته و حاطيت فيلة على
+
+409
+00:36:49,260 --> 00:36:56,220
+سلاسقة يرم أحدها يرمي بس المشكلة إيش ال high cost
+
+410
+00:36:56,220 --> 00:37:01,600
+و great cost و يعني في بعض الناس بيقولك لأ يا عمي
+
+411
+00:37:01,600 --> 00:37:08,490
+و أنا يعني كل الدولارات مش أحسن مساعدتيف single
+
+412
+00:37:08,490 --> 00:37:15,890
+use container لمرة واحدة حد مثلا عن سلاسقة في طول
+
+413
+00:37:15,890 --> 00:37:20,530
+الليل و الصبح أشيلها و ألبسها و أرميها و المره دي
+
+414
+00:37:20,530 --> 00:37:25,190
+لما بدي أنا أجل على سلاسقة يكون عندي .. يكون عندي
+
+415
+00:37:25,190 --> 00:37:29,950
+يعني سلسلة بجيب التانية أفتح و أحط محلول و أحط
+
+416
+00:37:29,950 --> 00:37:32,570
+عليه على السلاسقة من أفضل هو و هو اللي دي
+
+417
+00:37:32,570 --> 00:37:38,740
+disposable lensيعني يكون disposable ال container و
+
+418
+00:37:38,740 --> 00:37:43,680
+لا disposable ال lens افضل
+
+419
+00:37:43,680 --> 00:37:48,040
+افضل افضل افضل افضل افضل افضل افضل افضل افضل افضل
+
+420
+00:37:48,040 --> 00:37:48,060
+افضل افضل افضل افضل افضل افضل افضل افضل افضل افضل
+
+421
+00:37:48,060 --> 00:37:48,160
+افضل افضل افضل افضل افضل افضل افضل افضل افضل افضل
+
+422
+00:37:48,160 --> 00:37:48,640
+افضل افضل افضل افضل افضل افضل افضل افضل افضل افضل
+
+423
+00:37:48,640 --> 00:37:51,120
+افضل افضل افضل افضل افضل افضل افضل افضل افضل افضل
+
+424
+00:37:51,120 --> 00:37:54,960
+افضل
+
+425
+00:37:54,960 --> 00:38:00,200
+افضل
+
+426
+00:38:04,280 --> 00:38:07,940
+لكن في ال .. يعني السوق فرميه ماشي، لأنه مش وكلي
+
+427
+00:38:07,940 --> 00:38:11,340
+فكتير، عشتين شيكل مع السلامة، تلاتين شيكل مع
+
+428
+00:38:11,340 --> 00:38:16,900
+السلامة، لكن ال .. ال container يمكنها يكون تمانه
+
+429
+00:38:16,900 --> 00:38:22,460
+خمس شيكل، أربع شيكل، بقى واضلة، يعني أنا بجيبني
+
+430
+00:38:22,460 --> 00:38:27,360
+الشعب الإيجاري يعني ومن خطب الحسان
+
+431
+00:38:38,470 --> 00:38:41,630
+دون العالمين أو القبر، تهون علينا في المعالي
+
+432
+00:38:41,630 --> 00:38:46,630
+نفوسنا، ومن خطط الأسناء لم يوليها المحروم، بدون
+
+433
+00:38:46,630 --> 00:38:50,910
+مساعدة سرسخة، بدون الدفع، صح؟ زي ما تسوق سيارة
+
+434
+00:38:50,910 --> 00:38:55,110
+جديدة، بدون الدفع يعني، هي هيك، احنا بدأنا نضحك مع
+
+435
+00:38:55,110 --> 00:39:00,850
+ناسإدفع، يعني هي الآية ادفع بداتي أحسن، يعني انت
+
+436
+00:39:00,850 --> 00:39:04,570
+ايش؟ جدي من الحسنات و الخير، جدي من الخير و اتواضع
+
+437
+00:39:04,570 --> 00:39:09,350
+علي الناس و اصلع الحام و يعني و أصلح بين الناس و
+
+438
+00:39:09,350 --> 00:39:13,230
+واقفوا عن الظالم و زهير، الآية هيك يعني عشان .. بس
+
+439
+00:39:13,230 --> 00:39:16,410
+احنا بنعملها ايش؟ نقطة، مولد فبداتي أحسن اني ممكن
+
+440
+00:39:16,410 --> 00:39:23,070
+مصاري تعيش ايش؟ طيب،
+
+441
+00:39:23,070 --> 00:39:25,170
+يبقى .. انا في single use containers
+
+442
+00:39:27,750 --> 00:39:31,550
+طريقة رعية عشان تفادى إيش؟ الـ Infection يعني
+
+443
+00:39:31,550 --> 00:39:35,170
+الوقت القرانية بتاعه تغارى عليه، بدل ما تسيبها في
+
+444
+00:39:35,170 --> 00:39:38,750
+مرضى غلط أو حاجة، لهذا اللي يعني هو بياخد تمام
+
+445
+00:39:38,750 --> 00:39:42,390
+نظيف، أول ضوء يعني، و الشركات بيشجع فاهم
+
+446
+00:39:50,210 --> 00:39:54,210
+نانا كليكال يوز نشوف نانا كليكال يوز when a saline
+
+447
+00:39:54,210 --> 00:39:58,150
+solution is used specifically to undertake
+
+448
+00:39:58,150 --> 00:40:02,450
+standardized saline for contact lens to determine
+
+449
+00:40:02,450 --> 00:40:06,310
+dimensions, physical, chemical and biological lens
+
+450
+00:40:06,310 --> 00:40:09,390
+testing characteristics of contact lens and
+
+451
+00:40:09,390 --> 00:40:13,130
+contact lens materials it should be formulated in
+
+452
+00:40:13,130 --> 00:40:16,850
+strict accordance with the relevant international
+
+453
+00:40:16,850 --> 00:40:25,070
+standardsعارفين ايش حكاية المعايرة؟ المعايرة يعني
+
+454
+00:40:25,070 --> 00:40:33,130
+مثلا عندي جهاز ضغط و حاسس انه يعني مش ضخيف بروح
+
+455
+00:40:33,130 --> 00:40:38,770
+انا عايره بجهاز تاني عشان اعرف مقارنة يعني او جهاز
+
+456
+00:40:38,770 --> 00:40:39,210
+تاني
+
+457
+00:41:06,430 --> 00:41:12,270
+فاحنا دايما يعني بدنا برضه انعار العدسة اللي أصلا
+
+458
+00:41:12,270 --> 00:41:17,270
+و المادة بتاعتها و المحلول بتاعنا و الكيس بتاعنا
+
+459
+00:41:17,270 --> 00:41:21,850
+بالمعايير العالمية لإن أحيان تكون معايير محلية
+
+460
+00:41:21,850 --> 00:41:28,090
+رديقة ثانوية محلية في بلد معين رديقة فهذه ممكن هي
+
+461
+00:41:28,090 --> 00:41:33,110
+تئدي العالم و ممكن تعمل infection أكتر و تكون يعني
+
+462
+00:41:33,110 --> 00:41:38,560
+التجار هدفهم الربح فقطلذلك في العالم البناني في
+
+463
+00:41:38,560 --> 00:41:43,660
+حاجة اسمها ال ISO ال ISO علامة معينة علامة الجودة
+
+464
+00:41:43,660 --> 00:41:50,340
+و يطلب من شركات في العالم انهي تحقق ال ISO و
+
+465
+00:41:50,340 --> 00:41:57,280
+الشركة اللي ما بتحقق ال ISO ممكن مرتخص او انه يعني
+
+466
+00:41:57,280 --> 00:42:01,580
+ضيع حقها في التسويق لذلك الآن سألتقوا كلمة مش حاجة
+
+467
+00:42:01,580 --> 00:42:07,810
+بسيطةحاجة يعني مش حاجة انا بتحط لاصق للمفصل او
+
+468
+00:42:07,810 --> 00:42:13,170
+للكعب، هدى او شيء، لأ فهالشيء ليش؟ لعينه، لعينه،
+
+469
+00:42:13,170 --> 00:42:16,830
+لعينه من اغلب ما يملك الإسعار، من اغلب ما يملك
+
+470
+00:42:16,830 --> 00:42:22,290
+الإسعار عشان هيك بيكون فيه نوع من standardization
+
+471
+00:42:22,290 --> 00:42:29,590
+يعني standard اللي هو إيش؟ criterion طيب
+
+472
+00:42:29,590 --> 00:42:31,810
+المرة الجاية ان شاء الله بتكلم على ال enzymatic
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/kB9wtqdRLdw_raw.json b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/kB9wtqdRLdw_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..8aa6ca7b6c6b455bdfc94c1dfea0d0a038600578
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/kB9wtqdRLdw_raw.json
@@ -0,0 +1 @@
+{"segments": [{"id": 1, "seek": 4252, "start": 20.08, "end": 42.52, "text": "بسم الله الرحمن الرحيم الحمد لله رب العالمين و أصلي و أسلم على النبي الأمين محمد صلى الله عليه و أسلم عليه أهلي و أصحابيه أجمعين في المحاضرة السابقة تكلمنا عن ال hydrogen peroxide في تطهير الأدسات اللاصقة و كنا أن ال hydrogen peroxide لأنه لا لون له و أنه هو corrosive يعني", "tokens": [3555, 38251, 21984, 34892, 5016, 27842, 34892, 5016, 32640, 21542, 2304, 3215, 24976, 3224, 12602, 3555, 18863, 45340, 9957, 4032, 5551, 9381, 20292, 4032, 5551, 3794, 19528, 15844, 28239, 21292, 16247, 2304, 9957, 3714, 35571, 3215, 20328, 23942, 21984, 47356, 4032, 5551, 3794, 19528, 47356, 5551, 3224, 20292, 4032, 5551, 9381, 5016, 16758, 1829, 3224, 5551, 7435, 2304, 3615, 9957, 8978, 9673, 5016, 46958, 25720, 21136, 16758, 28671, 6055, 4117, 19528, 8315, 18871, 2423, 12697, 4768, 34454, 8978, 6055, 9566, 3224, 13546, 16247, 3215, 3794, 9307, 13672, 33546, 28671, 4032, 9122, 8315, 14739, 2423, 12697, 4768, 34454, 5296, 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"end": 878.58, "text": "بس عيبه انه ماخدش وقت كافي يعني العنصر ماترتاحش كثير في الهدف البيلوكسايت، يمكن بعض الناس يقولك انا يا عمي لسه احطه في جفنة فيها هدف البيلوكسايت ساعتين و بعدين ارجله هالي عشان ايش؟ يعملوا neutralization", "tokens": [3555, 3794, 6225, 1829, 3555, 3224, 16472, 3224, 3714, 47283, 3215, 8592, 4032, 38149, 9122, 31845, 1829, 37495, 22653, 18863, 1863, 9381, 2288, 3714, 9307, 43500, 39319, 8592, 9122, 12984, 13546, 8978, 2423, 3224, 3215, 5172, 2423, 21292, 1211, 2407, 4117, 3794, 995, 36081, 12399, 7251, 43020, 45030, 11242, 2423, 8315, 3794, 7251, 39648, 4117, 1975, 8315, 35186, 6225, 2304, 1829, 5296, 3794, 3224, 1975, 5016, 9566, 3224, 8978, 10874, 5172, 1863, 3660, 8978, 11296, 8032, 3215, 5172, 2423, 21292, 1211, 2407, 4117, 3794, 995, 36081, 8608, 995, 34268, 9957, 4032, 39182, 9957, 1975, 47341, 1211, 3224, 8032, 6027, 1829, 6225, 8592, 7649, 1975, 1829, 8592, 22807, 7251, 25957, 1211, 14407, 10598, 2144], "avg_logprob": -0.2635690661375983, 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\ No newline at end of file
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/kB9wtqdRLdw_raw.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/kB9wtqdRLdw_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..6b5f09c3f26ca96c8599735913443638419b2acc
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/kB9wtqdRLdw_raw.srt
@@ -0,0 +1,1900 @@
+1
+00:00:20,080 --> 00:00:21,920
+بسم الله الرحمن الرحيم الحمد لله رب العالمين و
+
+2
+00:00:21,920 --> 00:00:25,580
+أصلي و أسلم على النبي الأمين محمد صلى الله عليه و
+
+3
+00:00:25,580 --> 00:00:28,940
+أسلم عليه أهلي و أصحابيه أجمعين في المحاضرة
+
+4
+00:00:28,940 --> 00:00:33,600
+السابقة تكلمنا عن ال hydrogen peroxide في تطهير
+
+5
+00:00:33,600 --> 00:00:37,300
+الأدسات اللاصقة و كنا أن ال hydrogen peroxide لأنه
+
+6
+00:00:37,300 --> 00:00:42,520
+لا لون له و أنه هو corrosive يعني
+
+7
+00:00:49,530 --> 00:00:53,830
+و انه فيه اكسجين و بيلمع العلسة اللاصقة الحقيقة
+
+8
+00:00:53,830 --> 00:00:58,750
+انه يعني fantastic للعلسة اللاصقة جميع الأنواع و
+
+9
+00:00:58,750 --> 00:01:02,970
+نفسي يعني من عيوبه ان هو طويل شوية و الطريقة بدها
+
+10
+00:01:02,970 --> 00:01:10,130
+neutralization ب by carbonate ويعني بده saline
+
+11
+00:01:10,130 --> 00:01:14,030
+مرتين تلاتة لذا اتمنى نوترود اللي هو اللي
+
+12
+00:01:19,340 --> 00:01:34,640
+على القرنية بتمال و irritation و يعني ضارة يعني
+
+13
+00:01:34,640 --> 00:01:38,920
+هو مع انه فائد جدا لكن الناس متهاش اربع او خمس
+
+14
+00:01:38,920 --> 00:01:39,380
+فطوات
+
+15
+00:01:42,630 --> 00:01:47,070
+فعشان يك قل لهانة من شعبياته في تطهير الأدسات
+
+16
+00:01:47,070 --> 00:01:50,130
+اللاسقة until simpler means of neutralization was
+
+17
+00:01:50,130 --> 00:01:54,190
+developed لغاية مدورة على وسائل جديدة لطرد
+
+18
+00:01:54,190 --> 00:01:57,150
+الhydrogen peroxide بعمل neutralization أبسط من
+
+19
+00:01:57,150 --> 00:02:00,150
+أولى hydrogen peroxide has been used for many
+
+20
+00:02:00,150 --> 00:02:03,890
+years as a surface disinfectant and for its
+
+21
+00:02:03,890 --> 00:02:08,810
+bleaching effect يعني هو مطهر لسطح العدسة ومبيض
+
+22
+00:02:11,370 --> 00:02:15,150
+الـ Bleaching تنمية الـ S strength can be
+
+23
+00:02:15,150 --> 00:02:20,050
+described in terms of volumes يعني في مثلا volume
+
+24
+00:02:20,050 --> 00:02:28,510
+10 volume وفي 20 volume اللي هي الأبواب الحجم 10
+
+25
+00:02:28,510 --> 00:02:31,450
+volume solutions process processes
+
+26
+00:02:38,660 --> 00:02:44,760
+يعني لما بتتحلل الى مياه و أكسجين بتطلع نيت مثلا
+
+27
+00:02:44,760 --> 00:02:51,840
+mainly أكسجين العشرة بتطلع نية أكسجين عشر أضعفها
+
+28
+00:02:51,840 --> 00:02:57,140
+يعني فعمل ده was very effective against all the
+
+29
+00:02:57,140 --> 00:03:03,160
+organisms used in the beasts يبقى هو يعني ثمت انه
+
+30
+00:03:03,160 --> 00:03:03,740
+effective على
+
+31
+00:03:09,470 --> 00:03:18,040
+الـ Amoeba أكلتموه يعني إله فعل واضح جداالأنفل أو
+
+32
+00:03:18,040 --> 00:03:22,140
+two step disinfection خطوة تانية خطوة أولى وخطوة
+
+33
+00:03:22,140 --> 00:03:26,200
+تانية when used to disinfect contact lenses it is
+
+34
+00:03:26,200 --> 00:03:29,420
+very it is necessary to neutralize the peroxide
+
+35
+00:03:29,420 --> 00:03:32,960
+after an interval of time and yearly products were
+
+36
+00:03:32,960 --> 00:03:36,400
+described as two step which means that the patient
+
+37
+00:03:36,400 --> 00:03:39,160
+carries out disinfection and neutralization at
+
+38
+00:03:39,160 --> 00:03:40,720
+separate stages in the body
+
+39
+00:03:51,720 --> 00:03:56,440
+advantages of a two-step الهو system R ماهي
+
+40
+00:03:56,440 --> 00:03:59,740
+المزايا اللي افضل يفعلها يعني there is a situation
+
+41
+00:03:59,740 --> 00:04:03,280
+of antimicrobial action that can for example be
+
+42
+00:04:03,280 --> 00:04:08,580
+overnight يعني احنا بدنا نحط العدسة في الherbal
+
+43
+00:04:08,580 --> 00:04:12,020
+oxide مثلا طول الليل، طول الليل مش هتمو اللامسين
+
+44
+00:04:14,350 --> 00:04:18,790
+فيتناسب المفروض ان الميكروبات تناسب تاردي مع المدن
+
+45
+00:04:18,790 --> 00:04:24,450
+الزمنية كل مفروض ان الأسلحة الأصغر في المحلول كل
+
+46
+00:04:24,450 --> 00:04:28,490
+ما أثرت اكتر على ميكروبات قتلتها وهذا اللي احنا
+
+47
+00:04:28,490 --> 00:04:32,170
+بندهيه بان عادة خالية من الميكروبات لان الميكروبات
+
+48
+00:04:32,170 --> 00:04:36,890
+ممكن تعمل كورنال أبسس تعمل infection طيب التانية
+
+49
+00:04:36,890 --> 00:04:41,010
+in hot human climates that favor microbial
+
+50
+00:04:41,010 --> 00:04:42,310
+proliferation overnight
+
+51
+00:04:46,470 --> 00:04:50,770
+في جو دافع زي جو من الأربع عام ماضي هذا الجو
+
+52
+00:04:50,770 --> 00:04:57,410
+الدافع او الساخن كتير بنعش البكتيريا للتكافئة عكس
+
+53
+00:04:57,410 --> 00:05:03,230
+الجو البارد امبارح امبارح اول امبارح مثلا فبقول في
+
+54
+00:05:03,230 --> 00:05:08,650
+الجو ال humid و hot يعني ال hybrid من ال oxide
+
+55
+00:05:08,650 --> 00:05:13,270
+المفروض على العدسات وعلى الميكروبات بكون
+
+56
+00:05:13,270 --> 00:05:14,050
+preferable
+
+57
+00:05:20,320 --> 00:05:23,480
+أحنا جابونا طبعا غالبا مفتدل لا بالبارد ولا
+
+58
+00:05:23,480 --> 00:05:31,120
+بالساخن three suitable الهيدرالبيوكسيد one contact
+
+59
+00:05:31,120 --> 00:05:36,880
+lens wear is intermittent rather than daily يعني
+
+60
+00:05:36,880 --> 00:05:40,860
+واحد أو واحدة بتلبس ساعة سلسلة ساعتين تلاتة و
+
+61
+00:05:40,860 --> 00:05:45,540
+بتشيلها و الباقى بيحطها في الاش محلول في ال case
+
+62
+00:05:45,540 --> 00:05:51,190
+هذا في المحلول هذا النقطة تماميعني بيقدر يقول انه
+
+63
+00:05:51,190 --> 00:05:57,970
+ماخد عدسة نقية او طاهرة عكس اللي بيستعمل أنفلاس كل
+
+64
+00:05:57,970 --> 00:06:03,850
+ليلة نهار يعني مش فاضل وقت ان هو يعيش يضاحف ال
+
+65
+00:06:03,850 --> 00:06:07,210
+hydroperoxide it is important that neutralization
+
+66
+00:06:07,210 --> 00:06:12,050
+of the peroxide is not undertaken too rapidly يعني
+
+67
+00:06:12,050 --> 00:06:16,690
+هو مش اتجيه جودي كتير و يطلع خلاص لأ عشانك احنا
+
+68
+00:06:16,690 --> 00:06:18,630
+لما نحط الكحول
+
+69
+00:06:22,900 --> 00:06:27,360
+بنعمل كده؟ اه ده بره يعني هى مش سحر يعني مش احنا
+
+70
+00:06:27,360 --> 00:06:31,980
+حاطينا كحول لأ مسيت الجلد ان كل بكتيريا بتطهرت لأ
+
+71
+00:06:31,980 --> 00:06:35,720
+انا يعني بقى جبنى اللى فاهم الحقيقة يعنى بيفضل على
+
+72
+00:06:35,720 --> 00:06:40,120
+مكان بده يعمل injection انه يفضل طالع نازل طالع
+
+73
+00:06:40,120 --> 00:06:44,500
+نازل يعني اربع خمس دخائف يعني بحمر الجلد من كتر
+
+74
+00:06:44,500 --> 00:06:49,640
+قياسى ما حكوا ودخل اللى هو الكحول كويس فى الجلد
+
+75
+00:06:49,640 --> 00:06:55,390
+أفضل من اللى عمل كدهو أفضل من اللي ماحطش كحوة صورة
+
+76
+00:06:55,390 --> 00:06:58,370
+فيها ناس بيقولوا بإيه؟ من غير ما نحط كحوة؟ شوفت
+
+77
+00:06:58,370 --> 00:07:04,030
+أنا؟ مولاك مش فادرتها يعني، مش كتير يبقى هذه ال
+
+78
+00:07:04,030 --> 00:07:09,250
+advantages تات ال two step in one system a
+
+79
+00:07:09,250 --> 00:07:13,070
+solution containing the enzyme catalase
+
+80
+00:07:19,400 --> 00:07:22,840
+الخطوة الأولى هي الهيدروجين بالإكسايد طول الليل
+
+81
+00:07:22,840 --> 00:07:33,340
+الخطوة التانية انزين كتاليز زي تابليك قصه although
+
+82
+00:07:33,340 --> 00:07:37,820
+a two-step system is compatible with non-ionic
+
+83
+00:07:37,820 --> 00:07:41,900
+high water content hydrogen lenses, ionic high
+
+84
+00:07:41,900 --> 00:07:46,080
+water content lenses undergo marked hydrationيعني
+
+85
+00:07:46,080 --> 00:07:49,580
+هو بيقول ليه بيقارن بين نوعين من العدسات بين
+
+86
+00:07:49,580 --> 00:07:55,180
+العدسات اللي هي ال non-ionic وبين ال ionic بيقول
+
+87
+00:07:55,180 --> 00:07:59,600
+ليه التنين بنفع بس ال ionic بيصيرلها market
+
+88
+00:07:59,600 --> 00:08:05,420
+hydration changes تنفش أكتر تاخد مياه أكتر as a
+
+89
+00:08:05,420 --> 00:08:09,200
+consequence of the length immersion نقا in
+
+90
+00:08:09,200 --> 00:08:12,140
+hydrogen peroxide عشان هيك له
+
+91
+00:08:16,530 --> 00:08:21,430
+اللي هي الـ Ionic lenses should not be used with
+
+92
+00:08:21,430 --> 00:08:25,790
+this peroxide metal يعني دي هنخليها ليه اللي هو
+
+93
+00:08:25,790 --> 00:08:34,010
+العدسات الـ Non-ionic lenses طيب
+
+94
+00:08:34,010 --> 00:08:37,650
+هنشوف هل وقت فيه حاجات تانية غير كده كمان العلم
+
+95
+00:08:37,650 --> 00:08:43,150
+تقدم كده ال disadvantage of this two step process
+
+96
+00:08:43,150 --> 00:08:47,530
+هل وقت إيه ال disadvantage؟Is the need for the
+
+97
+00:08:47,530 --> 00:08:50,690
+patient to remember to initiate neutralization
+
+98
+00:08:50,690 --> 00:08:55,230
+يعني لازم يحط اللي هو إيش اللي هو ال enzyme كتاليز
+
+99
+00:08:55,230 --> 00:08:59,410
+عشان يشيل ال hydrogen peroxide طب لو ما .. لو
+
+100
+00:08:59,410 --> 00:09:04,710
+ماتفكرش أو ماحطش ال .. الكتاليز بيبدأ ال hydrogen
+
+101
+00:09:04,710 --> 00:09:09,350
+peroxide في العدسة وله اللي بيثبت براهين هذا
+
+102
+00:09:09,350 --> 00:09:13,530
+الموضوع يبقى تحتاج من المريض to remember
+
+103
+00:09:16,540 --> 00:09:20,220
+الحصول على نترالزيشن الـ BH-Hydrogen Peroxide في
+
+104
+00:09:20,220 --> 00:09:27,860
+عدد من 3.5 إلى 4.5 والطبيعي اللذي قرر نترالزيشنه
+
+105
+00:09:27,860 --> 00:09:33,460
+قبل إضافة عين لعينه كان يفعل هذا الخطأ فقط مرة
+
+106
+00:09:33,460 --> 00:09:37,460
+بسبب درجة المشكلة
+
+107
+00:09:44,770 --> 00:09:48,090
+فانحط اربعة على سبعة بينما ال irritation و ال
+
+108
+00:09:48,090 --> 00:09:51,330
+energy و ال congestion و الكلام مش مناسب يبقى ال
+
+109
+00:09:51,330 --> 00:09:56,630
+catalase بيعمل neutralization ليه؟ اللي هو ال
+
+110
+00:09:56,630 --> 00:10:01,630
+hypersensory علشان يكفيها two steps يعني لو ليس هي
+
+111
+00:10:01,630 --> 00:10:06,010
+هتكون مشكلة طيب، الآن فلو أنا one step
+
+112
+00:10:17,470 --> 00:10:24,150
+وهي العلم، العلم بيبني على بعض، في الزمن يعني كان
+
+113
+00:10:24,150 --> 00:10:30,190
+السيارة و الطيارة عجيبة، و الكمبيوتر كان عجيب،
+
+114
+00:10:30,190 --> 00:10:33,610
+جنياته جالية و حجمه كبير و شغله و مستهلكه، فده و
+
+115
+00:10:33,610 --> 00:10:38,090
+زهر و زهر و زهر و لجاته، مثلا، و حتى الجوالات قبل
+
+116
+00:10:38,090 --> 00:10:44,690
+عشرين عامل كيف كانت، كانت اسمها بريزما، بريزما
+
+117
+00:10:51,170 --> 00:10:55,950
+ففي تطوير و ال step system were introduced to
+
+118
+00:10:55,950 --> 00:11:00,130
+simplify the procedure for the patient. إيه
+
+119
+00:11:00,130 --> 00:11:05,410
+simplify؟ تبسيط تبسيط. And have the advantage that
+
+120
+00:11:05,410 --> 00:11:08,230
+the vital step of neutralization can't be
+
+121
+00:11:08,230 --> 00:11:08,690
+overlooked.
+
+122
+00:11:15,670 --> 00:11:19,250
+الفرصة المفيدة في الوان اس تيب هي دورة عملية تحرير
+
+123
+00:11:19,250 --> 00:11:23,330
+الانفكاش يتعني بطريقة وانتشار بطريقة وانتشار
+
+124
+00:11:23,330 --> 00:11:25,510
+بطريقة وانتشار بطريقة وانتشار بطريقة وانتشار
+
+125
+00:11:25,510 --> 00:11:27,970
+بطريقة وانتشار بطريقة وانتشار بطريقة وانتشار
+
+126
+00:11:27,970 --> 00:11:30,550
+بطريقة وانتشار بطريقة وانتشار بطريقة وانتشار
+
+127
+00:11:30,550 --> 00:11:31,030
+بطريقة وانتشار بطريقة وانتشار بطريقة وانتشار
+
+128
+00:11:31,030 --> 00:11:31,550
+بطريقة وانتشار بطريقة وانتشار بطريقة وانتشار
+
+129
+00:11:31,550 --> 00:11:38,030
+بطريقة وانتشار بطريقة وانتشار بطريقة وانتشار
+
+130
+00:11:38,030 --> 00:11:44,350
+بطريقة وان
+
+131
+00:11:45,220 --> 00:11:50,920
+أو شهور مش مناسب، ممكن تتضرر، أكسر الأولى، الأولى
+
+132
+00:11:50,920 --> 00:11:53,140
+كل ما حطيت في ال hydrogen dioxide نموذج أطوى، كل
+
+133
+00:11:53,140 --> 00:11:56,780
+ما كان أحسن، لأ هذا الخطوة لأ، حطها ساعة، ساعتين
+
+134
+00:11:56,780 --> 00:12:00,860
+وامشي، about 90% of the hydrogen peroxide systems
+
+135
+00:12:00,860 --> 00:12:05,440
+now used are one step، الآن ال hydrogen peroxide
+
+136
+00:12:05,440 --> 00:12:14,260
+90% one step، وال10% ال two steps اللي فات، أو
+
+137
+00:12:14,260 --> 00:12:19,000
+أكترو في واحدة من هذه الأساسيات ما يسمونه
+
+138
+00:12:19,000 --> 00:12:25,220
+بلاتينيوم ديسك in the storage case يعني حطه في نفس
+
+139
+00:12:25,220 --> 00:12:29,940
+ال case اللي فيه العدسة حديدة صغيرة هي من بلاتين
+
+140
+00:12:29,940 --> 00:12:39,800
+بلاتين ديسك صغير يعني يشبه البطاية الساعة صغيرة
+
+141
+00:12:46,120 --> 00:12:50,500
+Hydroxide أندهو و أكسجين أندهو يبقى هذا موجود في
+
+142
+00:12:50,500 --> 00:12:55,920
+نفس ال container بتاعك حط ال hydrogen من ال Oxide
+
+143
+00:12:55,920 --> 00:13:02,640
+أول ما تهرصها شوية يبدأ هو يحلل فيه يبقى تلومدسكي
+
+144
+00:13:02,640 --> 00:13:09,980
+يحلل ال hydrogen من ال Oxide إلى مكوناته ماء و درة
+
+145
+00:13:09,980 --> 00:13:12,140
+أكسجين جزء ماء و درة أكسجين
+
+146
+00:13:17,600 --> 00:13:22,320
+مش مضطر اخبره انزيم وانزيم خلاص منه فيه one step
+
+147
+00:13:22,320 --> 00:13:29,660
+فقط طيب having
+
+148
+00:13:29,660 --> 00:13:36,540
+filled the case with 3% peroxide there is an
+
+149
+00:13:36,540 --> 00:13:40,300
+initial rapid phase of neutralization resulting in
+
+150
+00:13:40,300 --> 00:13:45,860
+a concentration of 0.9% after two minutes يعني بعد
+
+151
+00:13:45,860 --> 00:13:53,740
+دقيقتينبحللك اياه و بيخليك التركيز 0.9 بس هو تركيز
+
+152
+00:13:53,740 --> 00:14:00,120
+السبع تركيز السبع هذا مثلا ال اوزي سيبت شايفين
+
+153
+00:14:00,120 --> 00:14:04,540
+الجزازة هالي اوزي سيبت؟ الجزازة هالي هالي one step
+
+154
+00:14:04,540 --> 00:14:11,320
+disinfection تحط المحلول في ال case و بعد شوية هو
+
+155
+00:14:11,320 --> 00:14:15,360
+لحاله بيعمل neutralization منه مطهر و هو بيعمل
+
+156
+00:14:15,360 --> 00:14:21,520
+neutralizationبس عيبه انه ماخدش وقت كافي يعني
+
+157
+00:14:21,520 --> 00:14:26,740
+العنصر ماترتاحش كثير في الهدف البيلوكسايت، يمكن
+
+158
+00:14:26,740 --> 00:14:32,140
+بعض الناس يقولك انا يا عمي لسه احطه في جفنة فيها
+
+159
+00:14:32,140 --> 00:14:36,700
+هدف البيلوكسايت ساعتين و بعدين ارجله هالي عشان
+
+160
+00:14:36,700 --> 00:14:41,140
+ايش؟ يعملوا neutralizationما هو بعض الناس يعني
+
+161
+00:14:41,140 --> 00:14:46,460
+عندهم أفكار وحريص أكتر وفي بعض الناس بتاعة ال
+
+162
+00:14:46,460 --> 00:14:56,200
+American way سريع شغل .. شغل سريع فهذا
+
+163
+00:14:56,200 --> 00:15:01,000
+بعد ما أحطته في ال case و اتحلل which is followed
+
+164
+00:15:01,000 --> 00:15:06,680
+by a slow phase to approximately fifteen parts per
+
+165
+00:15:06,680 --> 00:15:14,430
+million after six hoursيعني بعد ست ساعات وجدوا ال
+
+166
+00:15:14,430 --> 00:15:22,890
+hydrogen peroxide خمستاشر في المليون كتير ولا
+
+167
+00:15:22,890 --> 00:15:29,550
+جالين؟ جالين، صح؟ خمستاشر في المليون، هذا بعد ست
+
+168
+00:15:29,550 --> 00:15:36,090
+ساعات يعني هو صحيح حصل neutralization، لكن مش مية
+
+169
+00:15:36,090 --> 00:15:39,900
+في الميةفي هذا الجزء من الهيبرميل اكسايد تركيز
+
+170
+00:15:39,900 --> 00:15:47,260
+خفيف يعمل في التطهير طبعا هنا فيه بكتيريا غير
+
+171
+00:15:47,260 --> 00:15:52,800
+كافية طيب such a level is below the threshold of
+
+172
+00:15:52,800 --> 00:15:55,920
+subjective sensitivity يعني بيقول انه عشان يشترع
+
+173
+00:15:55,920 --> 00:16:03,220
+البكتيريا بيكون اقل من 50 إلى 300 per million
+
+174
+00:16:04,240 --> 00:16:09,060
+يعني خمسين إلى ثلاثمائة جزء في المليون من الـ
+
+175
+00:16:09,060 --> 00:16:13,600
+hydrogen peroxide عشان يكون active as يعني
+
+176
+00:16:13,600 --> 00:16:22,420
+bactericidal او bacterostatic او اللي هو and
+
+177
+00:16:22,420 --> 00:16:26,200
+that at which adverse effects on the mitotic
+
+178
+00:16:26,200 --> 00:16:32,200
+activity and movement of bacterial cells occurيعني
+
+179
+00:16:32,200 --> 00:16:36,800
+الـ 300 مثلا ممكن يعني يؤثر على اللي هو ال
+
+180
+00:16:36,800 --> 00:16:42,580
+material cells بتاعة القرن لكن ال 15 parts اللي في
+
+181
+00:16:42,580 --> 00:16:49,080
+الأول مابيأثروش في
+
+182
+00:16:49,080 --> 00:16:54,000
+طريقة أخرى لل one step غير platinum diskعلى الـ
+
+183
+00:16:54,000 --> 00:16:58,180
+one step system used a tablet coated with
+
+184
+00:16:58,180 --> 00:17:06,940
+hydroxypropyl methyl
+
+185
+00:17:06,940 --> 00:17:11,960
+cellulose مراكب كيميائي which contains a catalase
+
+186
+00:17:11,960 --> 00:17:15,940
+يعني هنا في انزيم اسمه catalase which is slowly
+
+187
+00:17:15,940 --> 00:17:21,860
+released after 30 minutes من المراكب الكيميائيعند
+
+188
+00:17:21,860 --> 00:17:24,560
+استخدام نفراليزيات عامة لإيقاف مستوى البروكسينات
+
+189
+00:17:24,560 --> 00:17:31,820
+من 1.4 مليون بعد حوالي 2 ساعات طريقة تانية الطريقة
+
+190
+00:17:31,820 --> 00:17:37,660
+الأولى ميتاليك ديسك يكون في ال case مثلا بقى يحلل
+
+191
+00:17:37,660 --> 00:17:41,560
+الهدوء من البروكسينات إلى المركبات طريقة تانية
+
+192
+00:17:41,560 --> 00:17:46,020
+كيميائية تعملت هيدروكسي بروفايل مثلا سيليوليز
+
+193
+00:17:46,020 --> 00:17:51,890
+بيطلع منه كتاليز في خلال ساعتينبيكون محلل
+
+194
+00:17:51,890 --> 00:17:57,650
+البريوكسايد و بلاجيش يمكن إلا one part per million
+
+195
+00:17:57,650 --> 00:18:04,830
+تركيزه في البريوكسايد في المحدود من أفضل تاني
+
+196
+00:18:04,830 --> 00:18:12,910
+أفضل؟ بس التاني يعني .. لأ الأولى أفضل ليش الأولى
+
+197
+00:18:12,910 --> 00:18:17,960
+أحسن؟ لأنه أنا مابدخلش فيهالأولى انا مابدخلها انا
+
+198
+00:18:17,960 --> 00:18:20,840
+بحط الهيلو من البروكسايد و بعدين بدي أجيها لبسها
+
+199
+00:18:20,840 --> 00:18:25,140
+على ثلاثة بعد ساعة ساعتين بدي ألبسها على ثلاثة لكن
+
+200
+00:18:25,140 --> 00:18:29,980
+هنا انا لازم أحطله ايش tablet tablet ايش tablet
+
+201
+00:18:29,980 --> 00:18:34,680
+يعني course course بحطه course اتفقد ان سي تحطه
+
+202
+00:18:34,680 --> 00:18:41,240
+course لان فيه الكتاريز في المطارقة الأولى يعني
+
+203
+00:18:41,240 --> 00:18:44,380
+يعني
+
+204
+00:18:44,380 --> 00:18:45,100
+more easy
+
+205
+00:18:53,430 --> 00:18:57,190
+microbiological contamination of the contact lens
+
+206
+00:18:57,190 --> 00:19:02,650
+storage case regularly receives attention as a
+
+207
+00:19:02,650 --> 00:19:08,570
+possible source of infection in virus يعني صاحب
+
+208
+00:19:08,570 --> 00:19:13,270
+الام ثلاثة كان بياخد باله ان مع الأيام ال case
+
+209
+00:19:14,200 --> 00:19:18,900
+الcontainer تلت تلت تلت حيصير هو المباقه هو مصدر
+
+210
+00:19:18,900 --> 00:19:25,940
+ال infection وانا لأ ممكن اني بسير يعني اي اناء
+
+211
+00:19:25,940 --> 00:19:30,400
+احنا ان ما طهرنا كويس حتى انت الطعام اشي و كده كده
+
+212
+00:19:30,400 --> 00:19:34,180
+حتى لو شات الأسنان بقى الأيام بتصير هي مستودع ال
+
+213
+00:19:34,180 --> 00:19:42,200
+infection مش بريئة يعني لأن فيها بصير الحثالات
+
+214
+00:19:50,160 --> 00:19:53,840
+أكبر شيء الإنسان يعني بيقفل عنه تيجي لأعداء
+
+215
+00:19:53,840 --> 00:19:59,460
+البكتيريا والفيروسات والفطريات تقول فيه ويلسون
+
+216
+00:19:59,460 --> 00:20:04,240
+وفريقه في سنة وتسعين مقال ماضي found that cases
+
+217
+00:20:04,240 --> 00:20:09,040
+disinfected with peroxide systems showed a lower
+
+218
+00:20:09,040 --> 00:20:11,960
+level of microbial contamination than those in
+
+219
+00:20:11,960 --> 00:20:16,960
+which other methods of disinfection had been used
+
+220
+00:20:16,960 --> 00:20:24,980
+يعني وجدت بالتجربةاللي فيها H2O من حد الأقل تلوثا
+
+221
+00:20:24,980 --> 00:20:31,760
+من غيرها من اللي بيحطوا فيها أشياء أخرى زي مثلا ال
+
+222
+00:20:31,760 --> 00:20:37,620
+chlorine و زي اليود زي ما هنشوف يعني و أنا مبكر إن
+
+223
+00:20:37,620 --> 00:20:42,660
+ال H2O يعني هذا السائل الممتنق إن كان هو fresh و
+
+224
+00:20:42,660 --> 00:20:47,480
+معكّب تمام و تركيزي تمام حقيقةإنه يعني effective
+
+225
+00:20:47,480 --> 00:20:50,340
+effective حتى الجروح العميقة كنا نحطه على الجروح
+
+226
+00:20:50,340 --> 00:20:54,860
+العميقة بعمر الله إنه يشيل كل ما فيها من الصديد و
+
+227
+00:20:54,860 --> 00:20:59,960
+من ال crust و من ال debris و الكلام هذا سهل ممتنة
+
+228
+00:20:59,960 --> 00:21:04,640
+و أفضل تشتروه و تجربوه ماشي؟ بقى أنا جاي ابقى
+
+229
+00:21:04,640 --> 00:21:05,340
+أسألكوا ان شاء الله
+
+230
+00:21:14,600 --> 00:21:19,560
+أي سطح، شوفون أيش بيصير، ماشي؟ تفضلوش .. هيفي
+
+231
+00:21:19,560 --> 00:21:24,300
+قاعدين؟ بدنا .. احنا نطلب ال .. ال .. الإشارة
+
+232
+00:21:24,300 --> 00:21:28,480
+الكاربة، انه احنا بتاعي النضارات و بس، لأن ده نقطة
+
+233
+00:21:28,480 --> 00:21:34,300
+وسط رجلينا، علم الـ Optometry من أوسع العلم،
+
+234
+00:21:34,300 --> 00:21:39,660
+واسأله اللي درسه، واسأله اللي انت رايح تشوفه، ايه
+
+235
+00:21:39,660 --> 00:21:44,300
+الشغل الـ Optometrist؟شوف شغل اللي بت interest ليه
+
+236
+00:21:44,300 --> 00:21:48,860
+اقولكوا انه هنا الوظيفة معتودة سوف يأتي أيام ان
+
+237
+00:21:48,860 --> 00:21:53,600
+شاء الله تكون أمور منفتحة تكون انت رواد زي ما جينا
+
+238
+00:21:53,600 --> 00:21:59,520
+احنا عامل قسم البصرية وعمله معامل هيجي ناس يفتحوا
+
+239
+00:21:59,520 --> 00:22:05,040
+ماجستير ودكتورات ودخلوا المهنة بقوة في كل حي في
+
+240
+00:22:05,040 --> 00:22:09,020
+غزة ان شاء الله بس بدكوا تكونوا عندكوا قصار
+
+241
+00:22:23,420 --> 00:22:28,040
+المنطقة التي تتحرك على أدسات الأسخة أكتر من غيرها،
+
+242
+00:22:28,040 --> 00:22:31,500
+أكتر من الطهيرات الأخرى، مواجهة مواجهة مواجهة
+
+243
+00:22:31,500 --> 00:22:32,620
+مواجهة مواجهة مواجهة مواجهة مواجهة مواجهة مواجهة
+
+244
+00:22:32,620 --> 00:22:34,520
+مواجهة مواجهة مواجهة مواجهة مواجهة مواجهة مواجهة
+
+245
+00:22:34,520 --> 00:22:36,200
+مواجهة مواجهة مواجهة مواجهة مواجهة مواجهة مواجهة
+
+246
+00:22:36,200 --> 00:22:36,800
+مواجهة مواجهة مواجهة مواجهة مواجهة مواجهة مواجهة
+
+247
+00:22:36,800 --> 00:22:43,140
+مواجهة مواجهة مواجهة مواجهة مواجهة
+
+248
+00:22:43,140 --> 00:22:47,960
+مواجه
+
+249
+00:22:48,460 --> 00:22:55,940
+تغيير المحلول frequently بيكون هو الطريقة الأولى،
+
+250
+00:22:55,940 --> 00:22:59,660
+يعني مثلا في ناس كل تلات أيام، في ناس كل أسبوع،
+
+251
+00:22:59,660 --> 00:23:03,900
+بيغير محلول، بيشيله و بيحط غيره، بيخلهمش يعني، هو
+
+252
+00:23:03,900 --> 00:23:09,640
+هو، لأنهم تعرفين، هذا من ال oxide في الآخر فيه
+
+253
+00:23:09,640 --> 00:23:12,960
+oxygen، لو طلع ال oxygen و صارت مية، صار مية
+
+254
+00:23:19,290 --> 00:23:22,630
+the frequent receipt of the storage case صح ممتاز
+
+255
+00:23:22,630 --> 00:23:26,550
+remains the best means ممتاز اغير انا ساي المحلول
+
+256
+00:23:26,550 --> 00:23:31,250
+و اغير ال case صحيح شكرا لاسمك اغير نفس ال case و
+
+257
+00:23:31,250 --> 00:23:38,830
+هو مش مكلف يعني هو ال case اصلا مجانية
+
+258
+00:23:38,830 --> 00:23:43,450
+يعني ف .. و بعدين بقى انا كمان ضاقى المهم انواش
+
+259
+00:23:43,450 --> 00:23:46,370
+مابضلش انا على نفس ال ..
+
+260
+00:24:00,510 --> 00:24:01,670
+الهيدروجين الهيدروجين الهيدروجين الهيدروجين
+
+261
+00:24:01,670 --> 00:24:03,070
+الهيدروجين الهيدروجين الهيدروجين الهيدروجين
+
+262
+00:24:03,070 --> 00:24:06,530
+الهيدروجين الهيدروجين الهيدروجين الهيدروجين
+
+263
+00:24:06,530 --> 00:24:07,390
+الهيدروجين الهيدروجين الهيدروجين الهيدروجين
+
+264
+00:24:07,390 --> 00:24:07,730
+الهيدروجين الهيدروجين الهيدروجين الهيدروجين
+
+265
+00:24:07,730 --> 00:24:11,550
+الهيدروجين الهيدروجين الهيدروجين الهيدروجين
+
+266
+00:24:11,550 --> 00:24:16,210
+الهيدروجين الهيدروجين الهيدروجين الهيدروجين
+
+267
+00:24:16,210 --> 00:24:17,130
+الهيدروجين الهيدروجين الهيدروجين الهيدروجين
+
+268
+00:24:17,130 --> 00:24:17,130
+الهيدروجين الهيدروجين الهيدروجين الهيدروجين
+
+269
+00:24:17,130 --> 00:24:23,070
+الهيدروجين اله
+
+270
+00:24:24,290 --> 00:24:29,390
+يعني حدث له تغيرات في المواصفات، يعني الهانفين من
+
+271
+00:24:29,390 --> 00:24:34,330
+الوكساين أدخل يعني إلى الأسوأ يعني، ففي الحالة
+
+272
+00:24:34,330 --> 00:24:39,290
+هانفين بيكون بعض، يعني إذا كان أدخل أي شيء في ال
+
+273
+00:24:39,290 --> 00:24:44,230
+.. مثلا ال diameters أو ال base curve أو أي حاجة
+
+274
+00:24:44,230 --> 00:24:50,410
+فطبعا بيكون إيش؟ في هنا شيء منعوالسلسلات
+
+275
+00:24:50,410 --> 00:24:54,630
+الترانزيالية كانت
+
+276
+00:24:54,630 --> 00:25:02,130
+تدخل من وقت لوقت سلسلات الانفكاطية ولكنها فقدت في
+
+277
+00:25:02,130 --> 00:25:06,410
+الانفكاطية يعني طلعون مثلا اليود والكلورين بدل
+
+278
+00:25:06,410 --> 00:25:09,730
+الهيدروجينبالكسيد وهو معروف حتى في الحياة العملية
+
+279
+00:25:09,730 --> 00:25:15,710
+ان الجلد والجروح ان الأيودين والكلورين من
+
+280
+00:25:15,710 --> 00:25:22,230
+المطاهرات المعروفةمثلًا الـ iodine اليوت معروف
+
+281
+00:25:22,230 --> 00:25:27,610
+لونه بوني هو دورم البوليدين اللي بيستخدم في تطهير
+
+282
+00:25:27,610 --> 00:25:32,750
+الجروح was produced by a neutralizing agent to the
+
+283
+00:25:32,750 --> 00:25:36,650
+infective colorless iodine iodide the reaction
+
+284
+00:25:36,650 --> 00:25:40,410
+producing a mixture of electrolytes none of which
+
+285
+00:25:40,410 --> 00:25:45,770
+were foreign to the ice يعني هو بيقوللي أن بعض
+
+286
+00:25:45,770 --> 00:25:50,140
+الناس استخدموا ال iodineVinyl الهدوء اللي بتكسب
+
+287
+00:25:50,140 --> 00:25:56,600
+لكن يحدث بعد ما اشهروا اللون البني و أصبح كارلنس
+
+288
+00:25:56,600 --> 00:26:02,220
+لكن باعتقادهم انه مش كفائت الهدوء اللي بتكسب
+
+289
+00:26:02,220 --> 00:26:05,700
+المطارد
+
+290
+00:26:05,700 --> 00:26:08,880
+التاني chlorine الكون اللي بيحطوه على اللي هو ال
+
+291
+00:26:08,880 --> 00:26:14,010
+water supply على الميهوالتي مثل الهيلو جينات أخرى
+
+292
+00:26:14,010 --> 00:26:17,250
+كانت مطهرة
+
+293
+00:26:17,250 --> 00:26:22,850
+ومنظرة وكانت مستخدمة في اتجاه اتجاه اتجاه اتجاه
+
+294
+00:26:22,850 --> 00:26:25,470
+اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه
+
+295
+00:26:25,470 --> 00:26:25,970
+اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه
+
+296
+00:26:25,970 --> 00:26:26,110
+اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه
+
+297
+00:26:26,110 --> 00:26:26,110
+اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه
+
+298
+00:26:26,110 --> 00:26:26,110
+اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه اتجاه
+
+299
+00:26:26,110 --> 00:26:38,790
+اتجاه اتجاه اتج
+
+300
+00:26:39,700 --> 00:26:45,600
+بعضهم الكلوريين مع انه قدرة لكن على أنساء الاسقاط
+
+301
+00:26:45,600 --> 00:26:50,080
+ما استمروا زي الهدف من البروجساين ماحصلش إله
+
+302
+00:26:50,080 --> 00:26:57,900
+استقبال و شعبية طيب الآن عاملا بنستجد احنا
+
+303
+00:26:57,900 --> 00:27:02,020
+limitations of present methods of contact lens
+
+304
+00:27:02,020 --> 00:27:14,810
+disinfection ما هي يعني بتقول اناالمحددات التي تحد
+
+305
+00:27:14,810 --> 00:27:22,690
+من استخدام الطرق السابقة في تبتيل عدسات الاصقر،
+
+306
+00:27:22,690 --> 00:27:30,670
+limitations، شيء تحديدات، يعني عدم نجاح كافي
+
+307
+00:27:31,440 --> 00:27:35,260
+الثلاثة مثالين يمكن أن تعملوا لتوضيح إعادة إعادة
+
+308
+00:27:35,260 --> 00:27:36,240
+إعادة إعادة إعادة إعادة إعادة إعادة إعادة إعادة
+
+309
+00:27:36,240 --> 00:27:36,660
+إعادة إعادة إعادة إعادة إعادة إعادة إعادة إعادة
+
+310
+00:27:36,660 --> 00:27:38,740
+إعادة إعادة إعادة إعادة إعادة إعادة إعادة إعادة
+
+311
+00:27:38,740 --> 00:27:39,580
+إعادة إعادة إعادة إعادة إعادة إعادة إعادة إعادة
+
+312
+00:27:39,580 --> 00:27:40,940
+إعادة إعادة إعادة إعادة إعادة إعادة إعادة إعادة
+
+313
+00:27:40,940 --> 00:27:53,520
+إعادة إعادة إعادة إعادة إعادة إعادة إعادة إعادة إع
+
+314
+00:27:57,490 --> 00:28:00,390
+هي تاند ميه تايب سوب كونتاكت لينز دي سينفيفتين
+
+315
+00:28:00,390 --> 00:28:04,230
+سوليوشيز أبيرت تبين افكتف انها مابيكاتينغ باسيلاس
+
+316
+00:28:04,230 --> 00:28:08,970
+سيرياس لأسف لا بالحرارة ولا بالغر حرارة ولا
+
+317
+00:28:08,970 --> 00:28:15,070
+بالهيدرجميل اكسايد بتروح باسيلاس سيرياس from
+
+318
+00:28:15,070 --> 00:28:18,130
+كونتمانيت الكونتاكت لينز cases where as hydrogen
+
+319
+00:28:18,130 --> 00:28:22,930
+peroxide was sporocybin يعني تقول انه الهيدرجميل
+
+320
+00:28:22,930 --> 00:28:28,970
+اكسايديعمل على Spores بتاعته قاطل Spores بتاعت
+
+321
+00:28:28,970 --> 00:28:34,730
+باسلسلسل هي يعني حاجة هي بكتير مقاومة لما الحرارة
+
+322
+00:28:34,730 --> 00:28:40,670
+و لا مدينة الحرارة نستطيع نزيلها من الكاس او من
+
+323
+00:28:40,670 --> 00:28:46,890
+العدسة الاصلة انو فيروس ال فيروس بتاعة ال Simplex
+
+324
+00:28:46,890 --> 00:28:53,220
+والزفتروهو يظهر انه ممكن ان يبقى على حياة كيميائية
+
+325
+00:28:53,220 --> 00:28:58,500
+وهيدروجين بيروكسيد في هذه الانفكاشة، ليش في المواد
+
+326
+00:28:58,500 --> 00:29:05,200
+الكيميائية وفي الهيدروجين بيروكسيد ولا يقتل،
+
+327
+00:29:05,200 --> 00:29:09,620
+لكن ليس بشكل محروم، بيده حرارة، ولو كان الناس قبل
+
+328
+00:29:09,620 --> 00:29:12,920
+الدارس مضت عليها حرارة، لا غليان ولا حرارة محروم
+
+329
+00:29:14,040 --> 00:29:17,100
+عندما يكون الهيستراليزيون عامًا غير متوفر في
+
+330
+00:29:17,100 --> 00:29:22,020
+عملية، يجب
+
+331
+00:29:22,020 --> 00:29:31,840
+أن يتخلص الناس اللي عندهم الانفكاشات من الانفكاشات
+
+332
+00:29:31,840 --> 00:29:38,400
+ويحطها حتى حين العلاج اللي لها، يعمل إرتيكيش في
+
+333
+00:29:38,400 --> 00:29:41,120
+الأول الانفكاش اللي في عينه، ثم نزيلها على السلطة
+
+334
+00:29:42,540 --> 00:29:49,480
+مش امكاني ينظف الأسلاسقة من إيش هو الأمون لو العين
+
+335
+00:29:49,480 --> 00:29:53,180
+بتاعة ال user بتاع ال contactless صفر بكتير ال
+
+336
+00:29:53,180 --> 00:29:57,400
+infection أو غرار ال infection أو severe allergy
+
+337
+00:29:57,400 --> 00:30:03,180
+أو impairment of vision أو أي حاجة من هذه لازم ما
+
+338
+00:30:03,180 --> 00:30:07,920
+لايجيش discard الأسلاسقة لغاية ما نعالج ال disease
+
+339
+00:30:07,920 --> 00:30:08,520
+أو ال infection
+
+340
+00:30:12,200 --> 00:30:17,720
+لأن العنصر اللازقة كانها يعني من الفضول أو من
+
+341
+00:30:17,720 --> 00:30:23,140
+الزينا أو من التكميل، لكن العين هي أهم، احنا نهتم
+
+342
+00:30:23,140 --> 00:30:28,920
+بصحة العين أولا لغاية ما نصف العينللـ function
+
+343
+00:30:28,920 --> 00:30:32,760
+بتاعك مظبوط و بعدين نبقى العدس ثلاثقة اما لو
+
+344
+00:30:32,760 --> 00:30:36,960
+استمرار في وضع العدس ثلاثقة وصرار رغم ال infection
+
+345
+00:30:36,960 --> 00:30:41,360
+او ال allergy او impairment of vision ممكن دمر
+
+346
+00:30:41,360 --> 00:30:45,960
+العين ممكن دمر العين وصير irreversible damage to
+
+347
+00:30:45,960 --> 00:30:51,260
+the function of the eyes ال
+
+348
+00:30:51,260 --> 00:30:55,410
+eyes جرأوا شيء اسمه preserved salineيعني جاهوا
+
+349
+00:30:55,410 --> 00:31:02,250
+سرعي Hydrogen Peroxide 0.9 Pearson أفيل السرعي
+
+350
+00:31:02,250 --> 00:31:07,030
+المحلو الملحن اللي بيحطوا للمرضى في حالات النزلات
+
+351
+00:31:07,030 --> 00:31:10,310
+المعوية بس أضافوا عليه
+
+352
+00:31:16,920 --> 00:31:21,060
+تأثير ولد سلسلة، هل هو يساوي الهزيمة بالإكسايد أو
+
+353
+00:31:21,060 --> 00:31:24,680
+أقل أو أكتر؟ Preserved saline has been used to
+
+354
+00:31:24,680 --> 00:31:30,520
+enhance the efficacy of heat disinfection but is
+
+355
+00:31:30,520 --> 00:31:34,160
+usually used today to rise contact with, to rise
+
+356
+00:31:34,160 --> 00:31:42,980
+نقا، لينجعها يعني فيه، to rise يعني تنقيع لها،
+
+357
+00:31:42,980 --> 00:31:47,620
+تنقيع لعدة سلسلة، على وجه التطير طبعاالفعالية
+
+358
+00:31:47,620 --> 00:31:51,820
+للحفاظات في المصادر الصحية هي تحفظ مصادر الصحية
+
+359
+00:31:51,820 --> 00:31:56,920
+استراليا وليس لإعطاء مصادر التعامل مع هذه
+
+360
+00:31:56,920 --> 00:32:04,700
+الانفكاشة يبقى احنا لما نحط اي مادة حافظة على
+
+361
+00:32:04,700 --> 00:32:11,060
+المحلول الملحى ونحط في الاسلسفة احنا بنقصد فعلا
+
+362
+00:32:11,060 --> 00:32:13,640
+نعمل استراليزيش
+
+363
+00:32:16,420 --> 00:32:20,300
+وجود يعني محلول ملحي مع المواد الحافظة نقطة لأي
+
+364
+00:32:20,300 --> 00:32:23,120
+بكتيريا تكون في ال case او في العدسة اللازقة
+
+365
+00:32:23,120 --> 00:32:27,260
+Preservatives can pose the risk of allergic and
+
+366
+00:32:27,260 --> 00:32:36,760
+toxic reaction دلأسف انه المواد الحافظة لها يعني
+
+367
+00:32:36,760 --> 00:32:37,940
+عالقين حاجتين
+
+368
+00:32:43,110 --> 00:32:47,930
+الالياجيالكوجعالطيبة والكوميا تعمل الالياجي والاخر
+
+369
+00:32:47,930 --> 00:32:55,070
+التاني ايش؟ toxicity شاو في سنة التمانين ديموسترشت
+
+370
+00:32:55,070 --> 00:32:57,510
+ال relationship between preservatives and the
+
+371
+00:32:57,510 --> 00:33:01,350
+incidence of solution allergy solution allergy
+
+372
+00:33:01,350 --> 00:33:05,450
+يعني solution induced allergy اللي يسببها
+
+373
+00:33:05,450 --> 00:33:09,250
+الالياجيال اللي يسببها المحليين ال double mask
+
+374
+00:33:09,250 --> 00:33:15,810
+randomized crossover studyفي الدراسة six subjects
+
+375
+00:33:15,810 --> 00:33:19,430
+used
+
+376
+00:33:19,430 --> 00:33:22,430
+an unpreserved saline solution and a preserved
+
+377
+00:33:22,430 --> 00:33:26,310
+saline solution في ناس استخدموا ال preserved
+
+378
+00:33:26,310 --> 00:33:29,450
+saline اللي في المادة الحافظة و في ناس استخدموا
+
+379
+00:33:29,450 --> 00:33:33,930
+اللي unpreserved اللي فيش فيه these subjects had a
+
+380
+00:33:33,930 --> 00:33:36,470
+probable history of sensitivity to preserved
+
+381
+00:33:36,470 --> 00:33:39,050
+solutions which was confirmed
+
+382
+00:33:42,230 --> 00:33:48,110
+عارف اثبات ان ال saline اللى فيه الموارد الحاضرة
+
+383
+00:33:48,110 --> 00:33:57,110
+يحفظ وجود ال الهجيم في عينين الناس هذه برهير ال
+
+384
+00:33:57,110 --> 00:34:00,630
+saline solutions containing ethyldiamine
+
+385
+00:34:00,630 --> 00:34:05,330
+tetraacetic acid اي ايه ده ات ايه ده تب يعني
+
+386
+00:34:05,330 --> 00:34:08,050
+اختصاره كمادة حافظ طبعا
+
+387
+00:34:19,530 --> 00:34:30,010
+أش يعني المادة الحافظة في الصلاعين مفيدة في مقاومة
+
+388
+00:34:30,010 --> 00:34:37,230
+الدبوزيت أو تمنع الدبوزيت على احدة سلسلة اكتر من
+
+389
+00:34:38,050 --> 00:34:46,390
+الغير محفوظة، السلعن غير المحفوظ طيب
+
+390
+00:34:46,390 --> 00:34:49,550
+بريشيرايز
+
+391
+00:34:49,550 --> 00:34:56,630
+كنتينر هي طريقة جديدة بريشيرايز كنتينر ال case
+
+392
+00:34:56,630 --> 00:35:01,350
+يعني both buffered and unbuffered forms of sterile
+
+393
+00:35:01,350 --> 00:35:05,430
+saline have been made available in aerosol type
+
+394
+00:35:05,430 --> 00:35:11,960
+containersالcontainer فيه مادة اسمها aerosol this
+
+395
+00:35:11,960 --> 00:35:16,360
+mode of preservation of saline requires no
+
+396
+00:35:16,360 --> 00:35:21,540
+preservatives يعني قال إن ال container نفسه مافيش
+
+397
+00:35:21,540 --> 00:35:26,160
+فيه مادة حافظة ال container هو من aerosol حتى لو
+
+398
+00:35:26,160 --> 00:35:32,040
+أحطله إيش، سلان مش محفوظ، بشتغل عن بكتيريا، كف
+
+399
+00:35:32,040 --> 00:35:36,600
+سلان محفوظ يعني أنا صارت أطوير في ال case
+
+400
+00:35:40,560 --> 00:35:46,520
+هو ال case ال case نفسه case صحي غير او لا يسمح
+
+401
+00:35:46,520 --> 00:35:52,600
+بنموه اش الميكروبات فيه هو ال aerosol هذا مش
+
+402
+00:35:52,600 --> 00:35:55,620
+بقولكوا العلم الآن بتبني على بعضه الناس بتبحث
+
+403
+00:35:55,620 --> 00:36:00,500
+دائما والدول بتشجع الباحثين على إيجاد الجديد لعاجز
+
+404
+00:36:00,500 --> 00:36:05,200
+صحة الإنسان ومصلحة يبقى ال control of disease هذا
+
+405
+00:36:05,200 --> 00:36:13,160
+بتاع ال aerosolهو صحي الى درجة ان العجز اللذكر
+
+406
+00:36:13,160 --> 00:36:20,360
+يكون فيه مأمن من التلوث فيه طيب
+
+407
+00:36:20,360 --> 00:36:26,820
+نشور single one containers available both
+
+408
+00:36:26,820 --> 00:36:31,400
+preserved and unpreserved are sachets have the
+
+409
+00:36:31,400 --> 00:36:35,900
+major advantage of remaining sterile until open
+
+410
+00:36:36,580 --> 00:36:40,800
+their disadvantage is the greater cost حاجة بتقول
+
+411
+00:36:40,800 --> 00:36:49,260
+يعني إيش مره موشي بده افتحته و حاطيت فيلة على
+
+412
+00:36:49,260 --> 00:36:56,220
+سلاسقة يرم أحدها يرمي بس المشكلة إيش ال high cost
+
+413
+00:36:56,220 --> 00:37:01,600
+و great cost و يعني في بعض الناس بيقولك لأ يا عمي
+
+414
+00:37:01,600 --> 00:37:08,490
+و أنا يعني كل الدولارات مش أحسن مساعدتيف single
+
+415
+00:37:08,490 --> 00:37:15,890
+use container لمرة واحدة حد مثلا عن سلاسقة في طول
+
+416
+00:37:15,890 --> 00:37:20,530
+الليل و الصبح أشيلها و ألبسها و أرميها و المره دي
+
+417
+00:37:20,530 --> 00:37:25,190
+لما بدي أنا أجل على سلاسقة يكون عندي .. يكون عندي
+
+418
+00:37:25,190 --> 00:37:29,950
+يعني سلسلة بجيب التانية أفتح و أحط محلول و أحط
+
+419
+00:37:29,950 --> 00:37:32,570
+عليه على السلاسقة من أفضل هو و هو اللي دي
+
+420
+00:37:32,570 --> 00:37:38,740
+disposable lensيعني يكون disposable ال container و
+
+421
+00:37:38,740 --> 00:37:43,680
+لا disposable ال lens افضل
+
+422
+00:37:43,680 --> 00:37:48,040
+افضل افضل افضل افضل افضل افضل افضل افضل افضل افضل
+
+423
+00:37:48,040 --> 00:37:48,060
+افضل افضل افضل افضل افضل افضل افضل افضل افضل افضل
+
+424
+00:37:48,060 --> 00:37:48,160
+افضل افضل افضل افضل افضل افضل افضل افضل افضل افضل
+
+425
+00:37:48,160 --> 00:37:48,640
+افضل افضل افضل افضل افضل افضل افضل افضل افضل افضل
+
+426
+00:37:48,640 --> 00:37:51,120
+افضل افضل افضل افضل افضل افضل افضل افضل افضل افضل
+
+427
+00:37:51,120 --> 00:37:54,960
+افضل
+
+428
+00:37:54,960 --> 00:38:00,200
+افضل
+
+429
+00:38:04,280 --> 00:38:07,940
+لكن في ال .. يعني السوق فرميه ماشي، لأنه مش وكلي
+
+430
+00:38:07,940 --> 00:38:11,340
+فكتير، عشتين شيكل مع السلامة، تلاتين شيكل مع
+
+431
+00:38:11,340 --> 00:38:16,900
+السلامة، لكن ال .. ال container يمكنها يكون تمانه
+
+432
+00:38:16,900 --> 00:38:22,460
+خمس شيكل، أربع شيكل، بقى واضلة، يعني أنا بجيبني
+
+433
+00:38:22,460 --> 00:38:27,360
+الشعب الإيجاري يعني ومن خطب الحسان
+
+434
+00:38:38,470 --> 00:38:41,630
+دون العالمين أو القبر، تهون علينا في المعالي
+
+435
+00:38:41,630 --> 00:38:46,630
+نفوسنا، ومن خطط الأسناء لم يوليها المحروم، بدون
+
+436
+00:38:46,630 --> 00:38:50,910
+مساعدة سرسخة، بدون الدفع، صح؟ زي ما تسوق سيارة
+
+437
+00:38:50,910 --> 00:38:55,110
+جديدة، بدون الدفع يعني، هي هيك، احنا بدأنا نضحك مع
+
+438
+00:38:55,110 --> 00:39:00,850
+ناسإدفع، يعني هي الآية ادفع بداتي أحسن، يعني انت
+
+439
+00:39:00,850 --> 00:39:04,570
+ايش؟ جدي من الحسنات و الخير، جدي من الخير و اتواضع
+
+440
+00:39:04,570 --> 00:39:09,350
+علي الناس و اصلع الحام و يعني و أصلح بين الناس و
+
+441
+00:39:09,350 --> 00:39:13,230
+واقفوا عن الظالم و زهير، الآية هيك يعني عشان .. بس
+
+442
+00:39:13,230 --> 00:39:16,410
+احنا بنعملها ايش؟ نقطة، مولد فبداتي أحسن اني ممكن
+
+443
+00:39:16,410 --> 00:39:23,070
+مصاري تعيش ايش؟ طيب،
+
+444
+00:39:23,070 --> 00:39:25,170
+يبقى .. انا في single use containers
+
+445
+00:39:27,750 --> 00:39:31,550
+طريقة رعية عشان تفادى إيش؟ الـ Infection يعني
+
+446
+00:39:31,550 --> 00:39:35,170
+الوقت القرانية بتاعه تغارى عليه، بدل ما تسيبها في
+
+447
+00:39:35,170 --> 00:39:38,750
+مرضى غلط أو حاجة، لهذا اللي يعني هو بياخد تمام
+
+448
+00:39:38,750 --> 00:39:42,390
+نظيف، أول ضوء يعني، و الشركات بيشجع فاهم
+
+449
+00:39:50,210 --> 00:39:54,210
+نانا كليكال يوز نشوف نانا كليكال يوز when a saline
+
+450
+00:39:54,210 --> 00:39:58,150
+solution is used specifically to undertake
+
+451
+00:39:58,150 --> 00:40:02,450
+standardized saline for contact lens to determine
+
+452
+00:40:02,450 --> 00:40:06,310
+dimensions, physical, chemical and biological lens
+
+453
+00:40:06,310 --> 00:40:09,390
+testing characteristics of contact lens and
+
+454
+00:40:09,390 --> 00:40:13,130
+contact lens materials it should be formulated in
+
+455
+00:40:13,130 --> 00:40:16,850
+strict accordance with the relevant international
+
+456
+00:40:16,850 --> 00:40:25,070
+standardsعارفين ايش حكاية المعايرة؟ المعايرة يعني
+
+457
+00:40:25,070 --> 00:40:33,130
+مثلا عندي جهاز ضغط و حاسس انه يعني مش ضخيف بروح
+
+458
+00:40:33,130 --> 00:40:38,770
+انا عايره بجهاز تاني عشان اعرف مقارنة يعني او جهاز
+
+459
+00:40:38,770 --> 00:40:39,210
+تاني
+
+460
+00:41:06,430 --> 00:41:12,270
+فاحنا دايما يعني بدنا برضه انعار العدسة اللي أصلا
+
+461
+00:41:12,270 --> 00:41:17,270
+و المادة بتاعتها و المحلول بتاعنا و الكيس بتاعنا
+
+462
+00:41:17,270 --> 00:41:21,850
+بالمعايير العالمية لإن أحيان تكون معايير محلية
+
+463
+00:41:21,850 --> 00:41:28,090
+رديقة ثانوية محلية في بلد معين رديقة فهذه ممكن هي
+
+464
+00:41:28,090 --> 00:41:33,110
+تئدي العالم و ممكن تعمل infection أكتر و تكون يعني
+
+465
+00:41:33,110 --> 00:41:38,560
+التجار هدفهم الربح فقطلذلك في العالم البناني في
+
+466
+00:41:38,560 --> 00:41:43,660
+حاجة اسمها ال ISO ال ISO علامة معينة علامة الجودة
+
+467
+00:41:43,660 --> 00:41:50,340
+و يطلب من شركات في العالم انهي تحقق ال ISO و
+
+468
+00:41:50,340 --> 00:41:57,280
+الشركة اللي ما بتحقق ال ISO ممكن مرتخص او انه يعني
+
+469
+00:41:57,280 --> 00:42:01,580
+ضيع حقها في التسويق لذلك الآن سألتقوا كلمة مش حاجة
+
+470
+00:42:01,580 --> 00:42:07,810
+بسيطةحاجة يعني مش حاجة انا بتحط لاصق للمفصل او
+
+471
+00:42:07,810 --> 00:42:13,170
+للكعب، هدى او شيء، لأ فهالشيء ليش؟ لعينه، لعينه،
+
+472
+00:42:13,170 --> 00:42:16,830
+لعينه من اغلب ما يملك الإسعار، من اغلب ما يملك
+
+473
+00:42:16,830 --> 00:42:22,290
+الإسعار عشان هيك بيكون فيه نوع من standardization
+
+474
+00:42:22,290 --> 00:42:29,590
+يعني standard اللي هو إيش؟ criterion طيب
+
+475
+00:42:29,590 --> 00:42:31,810
+المرة الجاية ان شاء الله بتكلم على ال enzymatic
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/lXfPYz-IKg0_postprocess.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/lXfPYz-IKg0_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..b4724a44077993cc3763515b1e10e030baf31da1
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/lXfPYz-IKg0_postprocess.srt
@@ -0,0 +1,2496 @@
+1
+00:00:21,770 --> 00:00:24,170
+الحمد لله يا رب العالمين و أصلي و أسلم علي النبي
+
+2
+00:00:24,170 --> 00:00:27,510
+الأمين محمد وليالي و أصحابي و اتباعيين السلام
+
+3
+00:00:27,510 --> 00:00:31,030
+عليكم و رحمة الله وبركاته في هذا اليوم سنبدأ موضوع
+
+4
+00:00:31,030 --> 00:00:35,670
+جديد هو Contact Lens Induced Giant Papillary
+
+5
+00:00:35,670 --> 00:00:43,010
+Congerativitis أي المرض الملتحمة الذي تسببه
+
+6
+00:00:43,010 --> 00:00:50,630
+العنصرات الأصغر تسبب التهاب و تفاعل ما في الملتحمة
+
+7
+00:00:52,010 --> 00:00:56,770
+وهذا الموضوع يغطي هذا الجانب الهام في حياة البشرية
+
+8
+00:00:56,770 --> 00:01:01,230
+التي أصبحت في هذه الأيام تستعمل العلاسات اللاصقة
+
+9
+00:01:01,230 --> 00:01:04,590
+بكثرة في جميع أنحاء العالم
+
+10
+00:01:23,750 --> 00:01:26,050
+contact trends induce giant papillary
+
+11
+00:01:26,050 --> 00:01:29,370
+congenitivitis giant papillary congenitivitis
+
+12
+00:01:29,370 --> 00:01:33,410
+affect approximately 1% في 5% of 30 million
+
+13
+00:01:33,410 --> 00:01:37,830
+contact trends readers in neurotic statesهنا بيحكي
+
+14
+00:01:37,830 --> 00:01:40,970
+لإن ال giant papillary congenitivitis بتأثر حوالي
+
+15
+00:01:40,970 --> 00:01:43,950
+واحد في المية لخمسة في المية من تلاتين مليون من
+
+16
+00:01:43,950 --> 00:01:48,170
+اللابس العبثات اللاصقة في ال USA جي بي سي كان أكر
+
+17
+00:01:48,170 --> 00:01:51,470
+اندووس وي .. وي رينغ هارد جي بي سي يعني هو اسم
+
+18
+00:01:51,470 --> 00:01:53,410
+المرض وده ال giant papillary congenitivitis
+
+19
+00:01:56,050 --> 00:01:59,070
+It can occur in those wearing hard semi-rigid and
+
+20
+00:01:59,070 --> 00:02:02,650
+soft hydrogel lenses بيحكي إن هذا المرض بيحدث في
+
+21
+00:02:02,650 --> 00:02:05,310
+الأشخاص اللي بيبصوا العدسات اللي بيبصوا العدسات
+
+22
+00:02:05,310 --> 00:02:05,730
+بيبصوا العدسات اللي بيبصوا العدسات اللي بيبصوا
+
+23
+00:02:05,730 --> 00:02:07,550
+العدسات اللي بيبصوا العدسات اللي بيبصوا العدسات
+
+24
+00:02:07,550 --> 00:02:08,310
+اللي بيبصوا العدسات اللي بيبصوا العدسات اللي
+
+25
+00:02:08,310 --> 00:02:10,130
+بيبصوا العدسات اللي بيبصوا العدسات اللي بيبصوا
+
+26
+00:02:10,130 --> 00:02:16,330
+العدسات اللي بيبصوا العدسات اللي بيبصوا العدسات
+
+27
+00:02:16,330 --> 00:02:21,750
+اللي بيبصوا العدسات
+
+28
+00:02:29,920 --> 00:02:37,660
+contactless virus، ليش؟ لأنها بتنتص ال .. كثير
+
+29
+00:02:37,660 --> 00:02:44,620
+بيصير adherent للكارنين لش؟ لأن بتكون عليها .. هي
+
+30
+00:02:44,620 --> 00:02:49,760
+movable يعني كتير تعمل .. تعمل إيش؟ floating هي
+
+31
+00:02:49,760 --> 00:02:55,400
+كتير فهي بتعمل حركة، شوية friction يعني شوية
+
+32
+00:02:55,400 --> 00:03:01,560
+friction في القرانية و الملتحةالـ Soft بتيجي بقى
+
+33
+00:03:01,560 --> 00:03:07,440
+floating العادى، فهي كتير بتعمل شوية friction، ال
+
+34
+00:03:07,440 --> 00:03:13,610
+hard أسبق منها شويةcontact lens induce giant
+
+35
+00:03:13,610 --> 00:03:16,070
+papillary conjunctivitis اللي لها clinical feature
+
+36
+00:03:16,070 --> 00:03:19,530
+ده هنحكي عن ال symptoms اللي بيحكيها المريض او
+
+37
+00:03:19,530 --> 00:03:22,750
+بيشعر فيها المريض اول symptoms عندي the earliest
+
+38
+00:03:22,750 --> 00:03:26,630
+symptoms are itching on lens removal يعني اول
+
+39
+00:03:26,630 --> 00:03:30,090
+مراحل اتدائية من المرض بيكون يشعر المريض في حكة
+
+40
+00:03:30,090 --> 00:03:33,570
+بالعين لما نشيل العدسة تاني issue هو ال mucus
+
+41
+00:03:33,570 --> 00:03:38,220
+formation بيكون تكون مادة ال mucus في العينو ال
+
+42
+00:03:38,220 --> 00:03:40,720
+latery ال patient complain of contact lens
+
+43
+00:03:40,720 --> 00:03:45,820
+intolerance بيشعر المريض لما .. انه مابي ..
+
+44
+00:03:45,820 --> 00:03:49,420
+مابيتلقى العدسة معاه، انه مابيتحملها و ال
+
+45
+00:03:49,420 --> 00:03:51,840
+irritation اللي هي التهيوج العين و ال itching و ال
+
+46
+00:03:51,840 --> 00:03:55,460
+redness اللي يحكى و يحمرها العين و زيادة ال
+
+47
+00:03:55,460 --> 00:03:57,900
+tearing او زيادة افراز الدموع و ال mucous
+
+48
+00:03:57,900 --> 00:04:00,860
+discharge بيكون انا عندي افراز لمادة مخطية من
+
+49
+00:04:00,860 --> 00:04:04,390
+العينbluriness of vision while wearing these
+
+50
+00:04:04,390 --> 00:04:07,070
+lenses كمان بيكون انا عندي تغبيش في الرؤية لما
+
+51
+00:04:07,070 --> 00:04:11,630
+نلبس العدسات طب ليش؟ من ال Lucas discharge Lucas
+
+52
+00:04:11,630 --> 00:04:13,730
+discharge بيصير انديدوسبوذبت على العدسة من ال ..
+
+53
+00:04:13,730 --> 00:04:17,970
+من ال irritation يعني العين واقفة و حمرة ديسم غريب
+
+54
+00:04:17,970 --> 00:04:23,730
+يعني اه فال .. العين مش بتحملها فبتبدأ الرؤية تصير
+
+55
+00:04:23,730 --> 00:04:30,180
+فيها blurring يعني غباش مش صافية يعني اهال sounds
+
+56
+00:04:30,180 --> 00:04:32,940
+اللى انا لازم اشوفها في ال examination لعين المريض
+
+57
+00:04:32,940 --> 00:04:36,020
+ايه اللى ده .. ايه اللى .. ايه اللى there is
+
+58
+00:04:36,020 --> 00:04:38,960
+bulbar and bulbiparal conjunctival hyperemia بيكون
+
+59
+00:04:38,960 --> 00:04:41,040
+انا عندي احتقاق في ال bulbar .. في ال bulbar و ال
+
+60
+00:04:41,040 --> 00:04:43,700
+bulbiparal في ال conjunctiva occasionally mucous
+
+61
+00:04:43,700 --> 00:04:48,340
+strands may be present بيكون انا عندي خلوط مخاطية
+
+62
+00:04:48,340 --> 00:04:51,520
+في العين على ال conjunctiva with progression مع
+
+63
+00:04:51,520 --> 00:04:53,680
+تطور هذا المرض بيكون انا عندي conjunctival
+
+64
+00:04:53,680 --> 00:04:56,490
+thickeningبتزيد ال thickness تبع ال conjunctiva
+
+65
+00:04:56,490 --> 00:05:00,190
+بيأثرلي انه بيعملي loss of translucency a curse
+
+66
+00:05:00,190 --> 00:05:04,950
+بيصير ان انا عندي عدم شبه فيا ل ال conjunctiva the
+
+67
+00:05:04,950 --> 00:05:07,710
+other types يكون ال conjunctiva will demonstrate
+
+68
+00:05:07,710 --> 00:05:12,650
+macropapilla ديامتر لإنها من 310 ل 1 مليو giant
+
+69
+00:05:12,650 --> 00:05:16,010
+papillae الديامتر اللي لها واحد ملي ديامتر او اكتر
+
+70
+00:05:16,010 --> 00:05:19,810
+بيحكيلي مع هذا المرض بيصير انا عندي macro papilla
+
+71
+00:05:19,810 --> 00:05:24,770
+يعني زي انتوا اكتر كبيرة ديامترا لعشرة او واحد ملي
+
+72
+00:05:24,770 --> 00:05:29,290
+بيكون انا عندي احيانا giant papilla نوتي اكتر اكبر
+
+73
+00:05:29,290 --> 00:05:31,830
+ضخمة يعني ديامترا اللي لها اكتر من واحد ملي يعني
+
+74
+00:05:31,830 --> 00:05:36,870
+هي تبدأ بيعمل مايكرو مايكرو و بعد ما تصير giant
+
+75
+00:05:36,870 --> 00:05:42,550
+الان ال size هذه الأربعةو يمكن فيه غيرها، مش شرط
+
+76
+00:05:42,550 --> 00:05:46,890
+اللي ألاجيها كلها، لإني ألاجي بعضها، يعني مثلا أنا
+
+77
+00:05:46,890 --> 00:05:51,330
+لاجيت عينه فيها hyperemia الملتحمة ال vulva البيضة
+
+78
+00:05:51,330 --> 00:05:55,450
+هذه اللي ماشوفها أو التراثل كونها متطيبة، ألاجتها
+
+79
+00:05:55,450 --> 00:06:00,650
+يعني فيها condition أو hyperemia، الحمران، و
+
+80
+00:06:00,650 --> 00:06:06,700
+strandsممكن تخيلها ليكون بداية، لكن وسط ال papilla
+
+81
+00:06:06,700 --> 00:06:11,520
+بكون الوضع صعب، بكون الوضع .. يعني المريض تحمل على
+
+82
+00:06:11,520 --> 00:06:15,140
+نفسه كتير لموسط ال papilla، يعني ال papilla ال
+
+83
+00:06:15,140 --> 00:06:18,280
+complication بتصير صعبة، حتى إزالتها صعبة
+
+84
+00:06:22,420 --> 00:06:25,420
+بحكيلي البابيلي often have a dome shape appearance
+
+85
+00:06:25,420 --> 00:06:28,140
+with fibrotic white yellow tops، بيحكيلي أن
+
+86
+00:06:28,140 --> 00:06:30,600
+البابيلي بتكون على شكل .. على شكل ال dome shape
+
+87
+00:06:30,600 --> 00:06:33,820
+يعني بهذا الشكل مثلا كده و بيكون في الطب اللي هي
+
+88
+00:06:33,820 --> 00:06:38,360
+في قمة البابيلي fibrotic white yellow tops يعني زي
+
+89
+00:06:38,360 --> 00:06:43,800
+مادة في fiber رايحة لون أبيض أو أصفر زي كأنه صديق
+
+90
+00:06:43,800 --> 00:06:48,230
+على رأس النطوقهنا الترانس ده dot may bc هون
+
+91
+00:06:48,230 --> 00:06:50,490
+الترانس اللي موجودة في college of taiwan ممكن تبين
+
+92
+00:06:50,490 --> 00:06:55,310
+عن ليه هون ال trans ترانس ترانتس اه وقتش شفناها دي
+
+93
+00:06:55,310 --> 00:07:05,090
+هون ترانتس في ال Bernal هنا في ال Bernal يعني
+
+94
+00:07:05,090 --> 00:07:10,190
+تقريبا دائما موجودة لكن هنا يعني بتكون وجودها
+
+95
+00:07:10,190 --> 00:07:14,330
+occasional جليل يعني ربما يعني جليل يكون موجودة
+
+96
+00:07:15,170 --> 00:07:17,270
+fluorescein staining of the papilla which
+
+97
+00:07:17,270 --> 00:07:20,250
+indicates ulceration of the congenital papilla the
+
+98
+00:07:20,250 --> 00:07:23,250
+cell base reflects severity إذا أنا استخدمت ال
+
+99
+00:07:23,250 --> 00:07:26,570
+fluorescein في العين فواجدت إن هنا في ulceration
+
+100
+00:07:26,570 --> 00:07:29,710
+في ال congenital papilla بيكون أنا .. بيدل على
+
+101
+00:07:29,710 --> 00:07:32,570
+خطورة ال giant papillary congenital papilla ال
+
+102
+00:07:32,570 --> 00:07:36,470
+congenital papillus أو إن مادة تحمل المريض زيادة
+
+103
+00:07:36,470 --> 00:07:41,290
+على حالي يعني صارت تقدم في المرضو بعدها أصبح الـ
+
+104
+00:07:41,290 --> 00:07:48,750
+ulceration في البابيلي يعني بابيلي بدت تدوء هذا
+
+105
+00:07:48,750 --> 00:07:52,170
+مؤشر على أن المرض صار خطير و هناك infection و كلام
+
+106
+00:07:52,170 --> 00:07:56,850
+زي هذا الان علاجه هتكون صعب اللي وصل حاله لهذا
+
+107
+00:07:56,850 --> 00:08:03,050
+المرحلة الان علاجه بده تعب شديد عشان البابيلي
+
+108
+00:08:03,050 --> 00:08:07,880
+هتروح وعشان ال infection هتروحthere may also be
+
+109
+00:08:07,880 --> 00:08:11,040
+corneal staining but this is uncommon بيحكيلي كمان
+
+110
+00:08:11,040 --> 00:08:14,380
+انه ممكن من أعراضها للمرض اللي انا أشوفها يكون ان
+
+111
+00:08:14,380 --> 00:08:16,900
+انا عندي corneal staining بس الشغل مش شائع كتير
+
+112
+00:08:16,900 --> 00:08:19,440
+ايش يعني corneal staining يعني معناها؟ بالفلورسية
+
+113
+00:08:19,440 --> 00:08:25,720
+يعني ايش معناها الكلاكايتس؟ يعني فيها نوع من
+
+114
+00:08:25,720 --> 00:08:28,900
+الكلاكايتس او في نوع من
+
+115
+00:08:32,530 --> 00:08:37,170
+هو في نتفة معينة، الصحيح ان الكل هو proficient في
+
+116
+00:08:37,170 --> 00:08:41,650
+ذلك ال answer، لكن معناه ان انا الان في خطر مش بس
+
+117
+00:08:41,650 --> 00:08:42,910
+على ال control of type
+
+118
+00:08:47,730 --> 00:08:50,890
+ممكن انا الاحظ كمان ال pseudotoxins اللي occur in
+
+119
+00:08:50,890 --> 00:08:54,490
+more severe cases، ال pseudotoxins ممكن يظهرلي من
+
+120
+00:08:54,490 --> 00:08:57,810
+ال macro papillae انجار، ال papillae اللي بتعمل
+
+121
+00:08:57,810 --> 00:09:01,170
+ثقة في الجفر، فانا بحس انه فيه انفتاطس، بس هو رح
+
+122
+00:09:01,170 --> 00:09:04,090
+يكون كذب، there is often significant doubles of
+
+123
+00:09:04,090 --> 00:09:07,070
+formation on the surface of the contact lenses،
+
+124
+00:09:07,070 --> 00:09:10,470
+كمان رح يكون لعندي لواصف على سطح الخارج و لعدسات
+
+125
+00:09:10,470 --> 00:09:13,370
+اللاصقة، و الخارج يعني؟ سطح ال .. ال .. ورا ولا
+
+126
+00:09:13,370 --> 00:09:14,490
+قدام؟ القدام
+
+127
+00:09:22,190 --> 00:09:26,530
+مش يعني بقيت الفيلم هو فاير انا دوستش كيف اشوفها؟
+
+128
+00:09:26,530 --> 00:09:30,810
+من الشرق بس لإن لو حطينا ضوء ساطع بتبين زي نقطة
+
+129
+00:09:30,810 --> 00:09:34,230
+صغيرة على العدس بس يعني جاسها بده magnifier اه
+
+130
+00:09:34,230 --> 00:09:40,850
+لازم ها مجنفير plus five plus six plus ten لازم
+
+131
+00:09:40,850 --> 00:09:46,430
+اشوف انها نتوقع على سطح العدسة الخلفيةطب يلتقى
+
+132
+00:09:46,430 --> 00:09:52,110
+تانى يعنى ضربة ولا مش ضربة ده ده ضربة هي اللى
+
+133
+00:09:52,110 --> 00:09:58,810
+هتعمل averaging لالمثيلة مثلا كورنة ايوة طيب احنا
+
+134
+00:09:58,810 --> 00:10:05,530
+الان بدا هناك اربع a و b عن ال papilla كمان لخمسة
+
+135
+00:10:05,530 --> 00:10:11,190
+و ستة و سبعة عن ال science نصحى لبعض يعني اللي كان
+
+136
+00:10:11,190 --> 00:10:17,870
+احنا بنطلب مباشر في امتحانCommit on signs and
+
+137
+00:10:17,870 --> 00:10:23,310
+symptoms of contactless-induced gyrepopenicosis كل
+
+138
+00:10:23,310 --> 00:10:26,830
+ال symptoms و كل ال signs دي هالسنة الرابعة و كل
+
+139
+00:10:26,830 --> 00:10:35,930
+هم مكبين مش معكم دكتور دكتور
+
+140
+00:10:35,930 --> 00:10:36,090
+دكتور دكتور دكتور دكتور دكتور دكتور دكتور دكتور
+
+141
+00:10:36,090 --> 00:10:41,550
+دكتور دكتور دكتور دكتور دكتور دكتور دكتور دكتور
+
+142
+00:10:41,550 --> 00:10:44,650
+دكتور دكتور دكتور دكتور دكتور دكتور دكتور دكتور
+
+143
+00:10:44,650 --> 00:10:47,620
+دكتور دكتور دكاللي هي البابلة .. جاية البابلة كانت
+
+144
+00:10:47,620 --> 00:10:50,340
+.. هي ال .. هي ال .. هي ال .. هي ال .. هي ال .. هي
+
+145
+00:10:50,340 --> 00:10:50,920
+ال .. هي ال .. هي ال .. هي ال .. هي ال .. هي ال ..
+
+146
+00:10:50,920 --> 00:10:54,080
+هي ال .. هي ال .. هي ال .. هي ال .. هي ال .. هي ال
+
+147
+00:10:54,080 --> 00:10:57,120
+.. هي ال .. هي ال .. هي ال .. هي ال .. هي ال .. هي
+
+148
+00:10:57,120 --> 00:10:58,580
+ال .. هي ال .. هي ال .. هي ال .. هي ال .. هي ال ..
+
+149
+00:10:58,580 --> 00:10:58,700
+هي ال .. هي ال .. هي ال .. هي ال .. هي ال .. هي ال
+
+150
+00:10:58,700 --> 00:10:58,980
+.. هي ال .. هي ال .. هي ال .. هي ال .. هي ال .. هي
+
+151
+00:10:58,980 --> 00:11:00,320
+ال .. هي ال .. هي ال .. هي ال .. هي ال .. هي ال ..
+
+152
+00:11:00,320 --> 00:11:01,800
+هي ال .. هي ال .. هي ال .. هي ال .. هي ال .. هي ال
+
+153
+00:11:01,800 --> 00:11:11,480
+..
+
+154
+00:11:11,480 --> 00:11:14,450
+هي ال .. هيواحد يستخدم disposable lenses لمدة
+
+155
+00:11:14,450 --> 00:11:18,930
+أسبوعية وماساكش أي ديموزيت فبكيف؟
+
+156
+00:11:18,930 --> 00:11:23,690
+ممكن واحد يعني اللي بعمل الcleaning في ال enzymes
+
+157
+00:11:23,690 --> 00:11:26,330
+.. ال .. ال .. ال contact lenses مايشيس ديموزيت
+
+158
+00:11:26,330 --> 00:11:30,630
+يعني الديموزيت هي دليل على الإهمال في النظارة
+
+159
+00:11:30,630 --> 00:11:36,710
+ودليل على طول المدة الزمنية يعني هذا مش .. يعني لو
+
+160
+00:11:36,710 --> 00:11:40,950
+لجين احنا في contact lenses عليها ديموزيت ديموزيتز
+
+161
+00:11:40,950 --> 00:11:46,380
+لازم يحيطيعني معناها أن وضعها محترق، unhealthy
+
+162
+00:11:46,380 --> 00:11:54,820
+يعني، مش healthy شوفوا هنا إيش فيه هنا ال
+
+163
+00:11:54,820 --> 00:12:01,020
+diet
+
+164
+00:12:01,020 --> 00:12:05,180
+وهذه برضه ال macro، شوفين هذه ال diet؟ أكتر من
+
+165
+00:12:05,180 --> 00:12:10,200
+واحد مني، كتر بتاعها، هنا أقل من واحد مني، هنا أقل
+
+166
+00:12:10,200 --> 00:12:17,860
+من واحد منيبس هيك؟ ده هحكي حاجات عن ال treatment ل
+
+167
+00:12:17,860 --> 00:12:21,620
+.. ل drug cavillary-conjunctivitis أول إشي بيحكيلي
+
+168
+00:12:21,620 --> 00:12:25,420
+asymptomatic patient with sign or or they are
+
+169
+00:12:25,420 --> 00:12:28,880
+those with minimal symptoms and sign of a big knot
+
+170
+00:12:28,880 --> 00:12:31,900
+in it و بيستخدموا lens wave بيحكيلي هنا الأشخاص
+
+171
+00:12:31,900 --> 00:12:36,750
+اللي ما .. انهم ..اللي مابيشكم ان واجع في عيونهم
+
+172
+00:12:36,750 --> 00:12:40,510
+او ان انا بشوف عليهم بس ال signs او ان ال signs و
+
+173
+00:12:40,510 --> 00:12:45,450
+ال symptom قليلة هنا مابحتاج ان اعمل discontinue
+
+174
+00:12:45,450 --> 00:12:50,450
+خلّي .. خلّي .. خلّي اللي حصلت لحظة اه discontinue
+
+175
+00:12:50,450 --> 00:12:56,290
+اه اللي هو let's wait يعني خلّي العدسة يعني اقول
+
+176
+00:12:56,290 --> 00:13:04,830
+الكلمة الأعراض خفيفة يعني مجرد شعور بالتعبأو
+
+177
+00:13:04,830 --> 00:13:09,970
+إحمرار بسيط فهو أنا بس أعطيه ماس ال stabilizer
+
+178
+00:13:09,970 --> 00:13:15,730
+أربعة ثانية أعطيه ماس ال stabilizer و هو نفس
+
+179
+00:13:15,730 --> 00:13:23,150
+العنصر يعني إيه ليه؟ يعني الإنسان الذكي بيخليش
+
+180
+00:13:23,150 --> 00:13:29,330
+الأمور توصل بعيد مش بس في العنصر اللي أصبح
+
+181
+00:13:33,020 --> 00:13:37,400
+يعني في واحد في الزيادة الدودية يعني من ساعتين
+
+182
+00:13:37,400 --> 00:13:43,700
+تلاتة مصر في ال right اندوان ال region هناك أسفل
+
+183
+00:13:43,700 --> 00:13:49,400
+البطن على اليمين تحت يحس انه في اشي غلط بسرعة
+
+184
+00:13:49,400 --> 00:13:54,820
+كهاتف emergency سرعة وفي واحد اخر تلات ايام هلاني
+
+185
+00:13:54,820 --> 00:14:03,030
+لما تصل سخونة تصل تقايل و تصل قدم قدر الماشيو بقى
+
+186
+00:14:03,030 --> 00:14:11,290
+يقولوا حاجه مين أحسن؟ مع حدث أن الموضوع التوهم،
+
+187
+00:14:11,290 --> 00:14:14,130
+يعني ان واحد بتوهم مين؟ في واحد بتوهم، بتوسوس
+
+188
+00:14:14,130 --> 00:14:18,610
+يعني، يعني لو صابوا شوية خصية بيقولوا يمكن سرقة،
+
+189
+00:14:18,610 --> 00:14:21,550
+لو صابوا لا أبدا اش توهم، لكن الحقيقة واحد بيلبس
+
+190
+00:14:21,550 --> 00:14:24,730
+contact lens و بقى على أشياء حالية، ولان هذه
+
+191
+00:14:24,730 --> 00:14:25,230
+المانوات موجودة
+
+192
+00:14:35,350 --> 00:14:40,830
+يبدأ الكرمولين في وجود العدسة، النفع الكرمولي مدة
+
+193
+00:14:40,830 --> 00:14:45,050
+أسبوع أو أسبوع أو تلاتة، يبدأ الكرمولين عشان يفعل،
+
+194
+00:14:45,050 --> 00:14:48,750
+اللي ما نفعش، يبدأ يعمل خطوة تانية، خطةبيحكيلي هنا
+
+195
+00:14:48,750 --> 00:14:51,990
+انه انا ما بنفع او انه انا عادي اخلي الاستثناء
+
+196
+00:14:51,990 --> 00:14:55,270
+بالعدسة اذا كان الهياجين عنده ممتازة الحفاظ على
+
+197
+00:14:55,270 --> 00:14:59,190
+صحة العدسة منيحة باستخدام له ال tobacco chromoline
+
+198
+00:14:59,190 --> 00:15:05,130
+2% 2% او 4% تلتيزه مع نفسه للعدسات اللاصقة عشان
+
+199
+00:15:05,130 --> 00:15:08,870
+احافظ عليها طيب ايش خاطر ال chromoline؟ ايش هي
+
+200
+00:15:08,870 --> 00:15:12,330
+بالنظرية؟ ايش هي بتعمل؟ بتحفظ على المرضى بتشيل ال
+
+201
+00:15:12,330 --> 00:15:18,460
+infection اذا؟ لأ لأ مابتشيلش انتبتمنعه و لا
+
+202
+00:15:18,460 --> 00:15:25,240
+بتمنعه و لا ترطيب في
+
+203
+00:15:25,240 --> 00:15:29,800
+البرنامج شرفتها كويس كروماليون بيعمل stabilizer
+
+204
+00:15:29,800 --> 00:15:35,280
+للسلز عشان ترطيبه اي سلز ماصد سلز stabilizers
+
+205
+00:15:35,280 --> 00:15:38,880
+يقولوا يا جماعة ماصد سلز هي bags of histamine
+
+206
+00:15:38,880 --> 00:15:42,820
+والهستامين لو طالع بيعمل severe irritation زي
+
+207
+00:15:42,820 --> 00:15:47,610
+الفلفل والسولين زي الفلفلقالوا إنه أنا بحط ماء
+
+208
+00:15:47,610 --> 00:15:51,710
+السلم لمدة أسبوعين، ثلاثة، شهر، شهرين، إنه بعمل
+
+209
+00:15:51,710 --> 00:15:55,310
+Stabilization لماء السلم، بيخلّيش ال bag هاد يطلع
+
+210
+00:15:55,310 --> 00:16:00,470
+هستامين، بيعمل Thickening للاقياش ال water بتاعي،
+
+211
+00:16:00,470 --> 00:16:04,330
+يعني الواحد حاكي عينه وفيها ماء السلم، ماتنفتش،
+
+212
+00:16:04,330 --> 00:16:08,590
+يكون قوية شوية، فقول إن أنا منعت الهستامين يطلع،
+
+213
+00:16:08,590 --> 00:16:14,520
+منعت الرجنس والسولينجو والإتشينجو وكل اللخ آخريبقى
+
+214
+00:16:14,520 --> 00:16:19,180
+أنا لو إلحقت حالي أو إلحقت المريض اللي باني يشتكي
+
+215
+00:16:19,180 --> 00:16:23,420
+من minimal symptoms في السطر التالي muscle
+
+216
+00:16:23,420 --> 00:16:27,200
+stabilizer بيشتغل شخصيا من أول يوم أقل شيء من
+
+217
+00:16:27,200 --> 00:16:33,020
+أسبوع ما يبدأ يشتغل ال muscle أقلش أسبوع و بيبدأ
+
+218
+00:16:33,020 --> 00:16:36,600
+يزهق أحسن في أسبوعين و أحسن تلت أسبين و أحسن في
+
+219
+00:16:36,600 --> 00:16:41,700
+شهر مش سريع زي الكورتازون كورتازون بعد ساعة بتلاقي
+
+220
+00:16:41,700 --> 00:16:48,250
+بدأ يشتغلبدوا أسابيع إلى ما يستخدمونه طب عالمين
+
+221
+00:16:48,250 --> 00:16:52,050
+يفققوا الله قلت في القرآن وخُلق الإنسان وعجوزه
+
+222
+00:16:52,050 --> 00:16:57,290
+وخُلق الإنسان من عدمه سأريكم آياتي فلا تستعجلونه
+
+223
+00:16:57,290 --> 00:17:03,570
+فلا تستعجلونه يبقى لما أعطي العيان كرومولين أو
+
+224
+00:17:03,570 --> 00:17:07,990
+بتانول هتكلم عن بتانول اللي مش أحدث و أحسن من
+
+225
+00:17:07,990 --> 00:17:14,050
+كرومولين بتانول بس الاستابلازيةأول و أحسن بيبدأوا
+
+226
+00:17:14,050 --> 00:17:17,090
+بيقولوا ان هادوا بدو صبر و بدو اسمه عين ثلاثة لما
+
+227
+00:17:17,090 --> 00:17:22,770
+تلاقي منه خير لكن ما احتفظ بالعدسة في العين انا
+
+228
+00:17:22,770 --> 00:17:25,930
+ماخرجتش لإن في بعض الناس لو شفت العدسة من عينه
+
+229
+00:17:25,930 --> 00:17:32,470
+بصير blind blind يعني مش عينه بتضيع يعني واحد مش
+
+230
+00:17:32,470 --> 00:17:36,490
+في تلاتة ع ستين اربعة ستين و كرته كوروناس و وضعه
+
+231
+00:17:36,490 --> 00:17:41,320
+صعبلا ماعرف ايه العدسة منه بصير ايش يعني
+
+232
+00:17:41,320 --> 00:17:45,940
+deteriorated vision فلا اخضر طب انا اخليه العدسة
+
+233
+00:17:45,940 --> 00:17:49,100
+يعني انا باقي لسان ده و هو اللي بتحرك و هو يسوفي
+
+234
+00:17:49,100 --> 00:17:53,220
+السيارة و يروح على المدرسة و .. و .. و بيعمل عمل
+
+235
+00:17:53,220 --> 00:17:57,260
+يعني انا ساعة ما اقولله انه لازم تعمل
+
+236
+00:17:57,260 --> 00:18:01,000
+discontinuation ال .. ال .. ال way of contactless
+
+237
+00:18:01,000 --> 00:18:04,140
+يعني معناه ايش عملتله انا احجطته في البيت يعني
+
+238
+00:18:04,140 --> 00:18:10,030
+احجطه في البيت اعقلته يعنييعني لو إيدي أشكيلي من
+
+239
+00:18:10,030 --> 00:18:14,790
+أولها، ممكن إني ألحقه، أخيك و أترس في عينه، و
+
+240
+00:18:14,790 --> 00:18:17,930
+أعطيك رومو دي، بس أقوله، دي البالك، هذي بدها، سواء
+
+241
+00:18:17,930 --> 00:18:21,270
+إلى سواء، لما يبدأ يأثر، أصفر شوية، و بعد سواء،
+
+242
+00:18:21,270 --> 00:18:26,270
+بنشوفك، عشان نشوف مدى الراحة بتاعك، أي عامةinitial
+
+243
+00:18:26,270 --> 00:18:30,410
+treatment of a symptomatic patient is a
+
+244
+00:18:30,410 --> 00:18:33,330
+discontinuation of contact lens wear، اذا كان انا
+
+245
+00:18:33,330 --> 00:18:37,590
+عندي اول علاج لاشخاص بيشكم العدسات الناصقة او
+
+246
+00:18:37,590 --> 00:18:39,890
+بيشكم هذا المرض جانا تابل ال congenital hepatitis
+
+247
+00:18:39,890 --> 00:18:44,590
+فانا هعمل قطع لنفس العدسات الناصقةOcular
+
+248
+00:18:44,590 --> 00:18:47,730
+lubricants are helpful during this time period
+
+249
+00:18:47,730 --> 00:18:52,910
+لازم اعطيه مرتبات للعين قطرات مرتبة للعين بتساعد
+
+250
+00:18:52,910 --> 00:18:59,350
+في هذه الفترة Artificial tears, refresh, oatmeal,
+
+251
+00:19:00,130 --> 00:19:11,530
+gin tea, natural tears اللي هو tears naturalISO
+
+252
+00:19:11,530 --> 00:19:19,350
+كده كتير الآن موجودة قطرات كويسة ايه هذا التعامل
+
+253
+00:19:19,350 --> 00:19:26,230
+بتخفف الاحتكاك الاحتكاك
+
+254
+00:19:26,230 --> 00:19:31,570
+هو اللي بيعمل ال papilla يعني كيف احنا مثلا نعرف
+
+255
+00:19:31,570 --> 00:19:38,570
+ان الاحتكاك بيعمل ال papilla الان لو مثلا بيمسك
+
+256
+00:19:38,570 --> 00:19:43,720
+مثلا آلةاللي بتعمل احتكاك كنا زمان لما نمسك مثلا
+
+257
+00:19:43,720 --> 00:19:48,280
+كريب طوية نعمل مثلا عمل يدوي نشيل جرادر نشيل حاجة
+
+258
+00:19:48,280 --> 00:19:52,820
+و احنا صغار ايدي .. ايدي واحد يتبردك اللي بيعمل
+
+259
+00:19:52,820 --> 00:19:56,540
+على مفرط اللحمة هذه اليدوية مفرط الفلازم اليدوية
+
+260
+00:19:56,540 --> 00:20:02,940
+اه حياة كتيرة يعني بقى نحط ريش بلاقي ايدي و قلبك
+
+261
+00:20:02,940 --> 00:20:09,100
+تلقائية تلقائية فإن كان فيه friction في ال eye
+
+262
+00:20:09,100 --> 00:20:14,680
+surfacesبعمل اللي هو ال papilla يبقى كون أنا أعطيه
+
+263
+00:20:14,680 --> 00:20:21,720
+lubricants مزحليقات بين ال eyelids و بين كنيفتيبما
+
+264
+00:20:21,720 --> 00:20:26,920
+مع الكورية أنا مانعت ال friction أي واحد الفائدة
+
+265
+00:20:26,920 --> 00:20:31,160
+التانية أن ال lubricants هي الدموع الصناعية ال ال
+
+266
+00:20:31,160 --> 00:20:36,280
+alertness ال alertness لو دخلت العين يعني نوع من
+
+267
+00:20:36,280 --> 00:20:42,630
+الشطف للعين قصير للعينيعني لو فيه داصل تحت اللعب
+
+268
+00:20:42,630 --> 00:20:45,950
+السلاسل او اذا كانت، لو فيه ديرتي، لو في حاجة، هذه
+
+269
+00:20:45,950 --> 00:20:51,530
+بتسهل على إيش؟ في محاولة، لكن أحيانًا هذه .. هذه
+
+270
+00:20:51,530 --> 00:20:55,970
+لا فيها anti-infection ولا فيها anti-allergy ولا
+
+271
+00:20:55,970 --> 00:20:59,970
+حاجة، أحيانًا تنفع و أحيانًا إشي بيكون أكبر منها،
+
+272
+00:20:59,970 --> 00:21:04,710
+فضليهsymptoms may improve within من اتنين لتلاتة
+
+273
+00:21:04,710 --> 00:21:08,110
+days بيحكيلي ان هاي ال symptoms ممكن تزيد في خلال
+
+274
+00:21:08,110 --> 00:21:12,870
+من تلت .. تتحسن من يومين لتلت أيام but lens should
+
+275
+00:21:12,870 --> 00:21:17,450
+not be resumed until about one week بس مش لازم انا
+
+276
+00:21:17,450 --> 00:21:21,510
+استقنف لبس العدسات اللاصقة قبل الاسبوع after all
+
+277
+00:21:21,510 --> 00:21:24,310
+the mucus, redness, irritation are gone مش لازم
+
+278
+00:21:24,310 --> 00:21:27,710
+ارجع ألبس العدسات إلا لما ال redness و ال mucus و
+
+279
+00:21:27,710 --> 00:21:31,510
+ال irritation يكون راح من عندكعشان مايعيشوش كمان
+
+280
+00:21:31,510 --> 00:21:33,990
+مرضى؟ يعني ان انا مرضى يعني ان انا مرضى يعني ان
+
+281
+00:21:33,990 --> 00:21:35,470
+انا مرضى يعني ان انا مرضى يعني ان انا مرضى يعني ان
+
+282
+00:21:35,470 --> 00:21:42,870
+انا مرضى يعني ان انا مرضى يعني
+
+283
+00:21:42,870 --> 00:21:46,390
+ان انا مرضى
+
+284
+00:21:48,600 --> 00:21:51,900
+Papilla may last longer but contact lens can be
+
+285
+00:21:51,900 --> 00:21:54,700
+resumed if there is no fluorescein staining.إذا
+
+286
+00:21:54,700 --> 00:21:57,360
+أنا اتفحصت المريض بعد العلاجات وما كان عندي
+
+287
+00:21:57,360 --> 00:22:00,580
+fluorescein staining ممكن ألبس العدسات اللاصقة بس
+
+288
+00:22:00,580 --> 00:22:03,780
+بيكونها أن ال papilla ممكن تكون موجودة كمان أه بس
+
+289
+00:22:03,780 --> 00:22:08,280
+ال staining ليه؟ للكوريا و لل papilla
+
+290
+00:22:22,980 --> 00:22:27,300
+Staining ال .. ال .. ال macro papillary أو الجناد
+
+291
+00:22:27,300 --> 00:22:30,520
+ال papillary و لا فيه staining للكورية Epithelium
+
+292
+00:22:30,520 --> 00:22:35,400
+في بعض الدرجة اللي عايزة ألحظه لكن لو فيه staining
+
+293
+00:22:35,400 --> 00:22:43,260
+لأنه لسه لازم يقولوا إيه إيش اللي كان موجود أو ال
+
+294
+00:22:43,260 --> 00:22:47,640
+.. ال .. ال .. ال necrosis اللي صار في ال
+
+295
+00:22:47,640 --> 00:22:51,490
+papillary موجودأو الـ Cortex موضوعي، ماخدش لعنصر
+
+296
+00:22:51,490 --> 00:22:52,790
+لعزفك على الألم، لو لعنصر لعزفك على التايمة،
+
+297
+00:22:52,790 --> 00:22:58,070
+افتكارك، هزيد الألم و هزيد الـSymptoms، تفضلي
+
+298
+00:23:00,390 --> 00:23:03,070
+typical corticosteroids are usually not required
+
+299
+00:23:03,070 --> 00:23:05,930
+if lens wear is stopped but may be helpful in more
+
+300
+00:23:05,930 --> 00:23:07,950
+severe cases بيحكي إن أنا ممكن أستخدم ال
+
+301
+00:23:07,950 --> 00:23:11,330
+corticosteroids في الحالات الصعبة، ال severe cases
+
+302
+00:23:11,330 --> 00:23:16,710
+بس مش مهمة كتير إذا كان العدسة يعني توقف لبسها
+
+303
+00:23:16,710 --> 00:23:22,390
+ممتاز، يعني هو استيرويدز، مفكبات كورتيزيون، سلاح
+
+304
+00:23:22,390 --> 00:23:27,910
+دو حتين، لازم نكون نعرف إنه سلاح دو حتين، لذلك أنا
+
+305
+00:23:27,910 --> 00:23:33,730
+لا أغامرباستخدام ال Corticosteroids إلا إن شعب إنه
+
+306
+00:23:33,730 --> 00:23:38,890
+فيه خطر عليه يعني مثلا واحد أعمل عاملة دراحية من
+
+307
+00:23:38,890 --> 00:23:44,230
+الكتراب أو جلوكومة أو حتى الإتلانديتاش لازم يعطيه
+
+308
+00:23:44,230 --> 00:23:49,130
+كورتيزون لأنه لو ماعطيتش كورتيزون كل أمور تفلت مني
+
+309
+00:23:49,130 --> 00:23:55,450
+ال inflammation زي واحد مع سيبيرقالات و بابيلي مش
+
+310
+00:23:55,450 --> 00:23:57,050
+لازم يفتحني لازم يعطيه كورتيزون
+
+311
+00:24:01,490 --> 00:24:07,050
+في أجهاد بابيلي لازم انا اعطيه كورتزون وقتها بنوضه
+
+312
+00:24:07,050 --> 00:24:11,990
+في حد بدأ يتحسن بجلل الكورتزون اتحسن كويس بشيل
+
+313
+00:24:11,990 --> 00:24:15,390
+الكورتزون وبيفضل على ال master cell stabilizer بل
+
+314
+00:24:15,390 --> 00:24:18,510
+ان ال master cell stabilizer المفضل انه من اول هو
+
+315
+00:24:18,510 --> 00:24:23,730
+الموجود و الكورتزون يدخل بقوة و يطلع و يفضل ال
+
+316
+00:24:23,730 --> 00:24:26,950
+master cell stabilizer موجود يعني موجود .. حتى
+
+317
+00:24:26,950 --> 00:24:30,650
+موجود ال contact lens في مبعد يعني ممكن انا خطل
+
+318
+00:24:33,740 --> 00:24:37,320
+عشان احطوا six شهور احطوا سنة في عدل عيال وماخافش
+
+319
+00:24:37,320 --> 00:24:41,040
+safe يعني safe ماروش يعني انا on a side that fixed
+
+320
+00:24:41,040 --> 00:24:45,420
+كتير كويس بس ال cortisol برجعش يعطيك اكتر من
+
+321
+00:24:45,420 --> 00:24:49,280
+أسبوعين او تلاتة ال cortisol اللي بحطه لغاية ماشية
+
+322
+00:24:49,280 --> 00:24:52,180
+ال redness و القديمة و الفهم و الاشي هذا
+
+323
+00:24:55,060 --> 00:25:00,420
+فترة مرتين سبوع سبوع فانت بشيله وبخلي الكرمولين او
+
+324
+00:25:00,420 --> 00:25:04,880
+البتانول اخليه لفترة اكتر و اكتر و اكتر حتى العيان
+
+325
+00:25:04,880 --> 00:25:07,780
+يبتدي تعايش مع العنصر الأثقال وهي في عينه حتى وانا
+
+326
+00:25:07,780 --> 00:25:12,640
+احطه must cell stabilizer واضح؟ يبقى انتوا بتاخدوا
+
+327
+00:25:12,640 --> 00:25:17,060
+فكرة الآن ان كثير من الناس اللي بستعملوا العنصر
+
+328
+00:25:17,060 --> 00:25:21,900
+الأثقال ماعندهم مش هذا العلم دوركوا انتوا تكونوا
+
+329
+00:25:21,900 --> 00:25:26,690
+انتوا تروحوا السلامالذين يريدون إستعمال عدسة لاصقة
+
+330
+00:25:26,690 --> 00:25:32,290
+يريدون أن يعرفون ما هي الـhealth بتاع عدسة اللاصقة
+
+331
+00:25:32,290 --> 00:25:35,830
+وكيف نظفت عدسة اللاصقة وما هي ال complications
+
+332
+00:25:35,830 --> 00:25:38,810
+التي تمناها عدسة اللاصقة تعمل مشاكل كثيرة وانتوا
+
+333
+00:25:38,810 --> 00:25:41,850
+في سنة رابعة لان أخدت عدسة اللاصقة مافيه الكفاية
+
+334
+00:25:41,850 --> 00:25:46,330
+بس احنا في الفرقة الكلية ميتأكد على ذلك يعني احنا
+
+335
+00:25:46,330 --> 00:25:51,330
+مش درس ندرس عدسة اللاصقة بس درس كيف نعالج بالانوية
+
+336
+00:25:52,280 --> 00:25:55,000
+الـ complications اللي عمتها لسه تسقى في العيش
+
+337
+00:25:55,000 --> 00:25:57,020
+وملاحظين احنا لسه ما جيبناش ال infection يعني
+
+338
+00:25:57,020 --> 00:25:59,880
+ماتكلملاش إنها بدها antibiotics وكده طبعا لو في
+
+339
+00:25:59,880 --> 00:26:03,420
+infection بدها antibiotics ده شك يعني تفضلي الخطوة
+
+340
+00:26:03,420 --> 00:26:06,020
+السابعة على علاج ضرن استيرويد ال anti-inflammatory
+
+341
+00:26:06,020 --> 00:26:10,340
+agent supraphine used specially has also been
+
+342
+00:26:10,340 --> 00:26:13,880
+shown to be affected by N-germ N-germ capillary
+
+343
+00:26:13,880 --> 00:26:17,260
+congenitivitis هعطي أنا ال anti-inflammatory اللي
+
+344
+00:26:17,260 --> 00:26:21,090
+هو ال supraphineأه بس هذا الناس انفلماتوري مش
+
+345
+00:26:21,090 --> 00:26:27,930
+كورتيزون ال كورتيزون هرمونال انتي انفلماتوري هذا
+
+346
+00:26:27,930 --> 00:26:32,770
+اللي هنا ناستردام يعني non-hormonal مش هرموني
+
+347
+00:26:32,770 --> 00:26:38,480
+العلاج الهرموني هو لإله المشاكل على الصحةأنا بضطر
+
+348
+00:26:38,480 --> 00:26:44,780
+ان اعطيه لفترة محددة و بلبسها لكن السوبروفين و
+
+349
+00:26:44,780 --> 00:26:49,960
+الولترين و الايزوفين و .. و .. و .. هذه اللي هو
+
+350
+00:26:49,960 --> 00:26:54,440
+أخدوها من الأقراس اللي بتعمل Anti-inflammation في
+
+351
+00:26:54,440 --> 00:26:59,540
+العضلات أو في المفاصلةالطفل بتاكل ذيكلوفين لأن في
+
+352
+00:26:59,540 --> 00:27:03,660
+ذيكلوفين ايدروس والسوبرفين هو قريب من زي تروفين
+
+353
+00:27:03,660 --> 00:27:07,440
+الطفل بتاكل تروفين و ايزوفين بتاكل الصدارة بتاكل
+
+354
+00:27:07,440 --> 00:27:10,600
+الألم وشيء ايزوفين و تروفين هي هي ايزوفين و تروفين
+
+355
+00:27:10,600 --> 00:27:15,920
+في منها قطرة فهذه القطرة صح مش سحرية زي الكورتازون
+
+356
+00:27:15,920 --> 00:27:22,210
+لكن بتهمن ال inflammation وعملها كويسة يعني اهwhen
+
+357
+00:27:22,210 --> 00:27:25,470
+contact lenses are zoomed proper lens هيجين must
+
+358
+00:27:25,470 --> 00:27:28,850
+be stressed لما أنا أستخدم ال clips اللي عدي ساعة
+
+359
+00:27:28,850 --> 00:27:32,190
+اللاصقة لازم يكون عندي حفاظ على ال هيجين lens
+
+360
+00:27:38,360 --> 00:27:41,960
+This is especially important because as a group
+
+361
+00:27:41,960 --> 00:27:44,880
+contact lens wearers with germs papillary
+
+362
+00:27:44,880 --> 00:27:48,300
+congestive arthritis are neglectful with lens care
+
+363
+00:27:48,300 --> 00:27:51,080
+بيحكي إن أنا لازم أحافظ على صحة العدسات اللاصقة
+
+364
+00:27:51,080 --> 00:27:53,180
+لأن معظم اللي بيصير عندهم germ papillary
+
+365
+00:27:53,180 --> 00:27:55,600
+congestive arthritis كانوا مهملين في الحفاظ على
+
+366
+00:27:55,600 --> 00:27:59,040
+نظافة العدسات Hydrogen peroxide cleaning system
+
+367
+00:27:59,040 --> 00:28:04,020
+preferably non-perceived and non-perceived saline
+
+368
+00:28:04,260 --> 00:28:06,700
+are best for patients with giant papillary
+
+369
+00:28:06,700 --> 00:28:10,340
+congenitivitis عشان أحافظ على صحة العدسات باستخدام
+
+370
+00:28:10,340 --> 00:28:13,440
+ال hydrogen peroxide وال saline solution حتى أراضي
+
+371
+00:28:13,440 --> 00:28:17,840
+الأرض ممتازة ممتازة ال cold disinfection system
+
+372
+00:28:17,840 --> 00:28:20,220
+increase the possibility of exposure to
+
+373
+00:28:20,220 --> 00:28:25,780
+sensitizing agent and should be avoided بيحكيلي
+
+374
+00:28:25,780 --> 00:28:29,820
+هنا تطهير بيارة العدسات لازم أجنبه لأنه بيعمل
+
+375
+00:28:29,820 --> 00:28:33,230
+زيادة في حساسية ال agent في العينالـ enzymatic
+
+376
+00:28:33,230 --> 00:28:36,410
+cleaning particularly في pain enzyme is superior
+
+377
+00:28:36,410 --> 00:28:39,150
+to superfective .. to superfective سيرفاكتن
+
+378
+00:28:39,150 --> 00:28:42,290
+سيرفاكتن تكلين .. زي سيرفاكتن تلاقي الشياطين
+
+379
+00:28:42,290 --> 00:28:45,290
+السطحية زي الهالويجبالوكسايد و احنا خارجنا من
+
+380
+00:28:45,290 --> 00:28:47,750
+الهالويجبالوكسايد افضل من الهالويجبالوكسايد اقل من
+
+381
+00:28:47,750 --> 00:28:51,910
+ال saline ليه ايش لأنه فعالة على سطح العدسة بس
+
+382
+00:28:51,910 --> 00:28:55,310
+احنا ماقدرش نحط العدسة كلها في ال enzyme بنحطها
+
+383
+00:28:55,310 --> 00:28:58,090
+إيصويًا في ال enzyme و في الأيام في ال helioxybin
+
+384
+00:28:59,610 --> 00:29:02,690
+بين أي مدن بالإكسيد، فاحنا بنعمل جمعنا بين
+
+385
+00:29:02,690 --> 00:29:07,350
+المصنعين ال .. ال .. ال .. ال daily .. ال daily
+
+386
+00:29:07,350 --> 00:29:12,950
+cleaning بالعمل بالإكسيد، و ال .. و ال weekly ..
+
+387
+00:29:12,950 --> 00:29:13,850
+weekly cleaning
+
+388
+00:29:17,460 --> 00:29:24,080
+إذا كان هناك
+
+389
+00:29:24,080 --> 00:29:29,620
+مراجعية
+
+390
+00:29:29,620 --> 00:29:34,800
+لرجال يقولوا لك ان انا لازم اعمل قطع للبس عدسات
+
+391
+00:29:34,800 --> 00:29:38,900
+اللاسحة من شهر و الأفضل اللي يكون 3 أشهر مرة مرة
+
+392
+00:29:38,900 --> 00:29:42,960
+مرة مرة
+
+393
+00:29:42,960 --> 00:29:43,180
+مرة مرة مرة مرة مرة مرة مرة مرة مرة مرة مرة مرة
+
+394
+00:29:43,180 --> 00:29:43,240
+مرة مرة مرة مرة مرة مرة مرة مرة مرة مرة مرة مرة
+
+395
+00:29:43,240 --> 00:29:45,530
+مرة مرة مرة مرة مرة مرةall the patient can switch
+
+396
+00:29:45,530 --> 00:29:50,270
+to gas permeable semi rigid lenses انا بيحكيلي هنا
+
+397
+00:29:50,270 --> 00:29:54,470
+انه اختلاف ال polymer او مركبة عباسات اللاصقة ممكن
+
+398
+00:29:54,470 --> 00:29:59,170
+انا اجربها لأ هتكون مطيبة لل patient فانا باستخدم
+
+399
+00:29:59,170 --> 00:30:02,350
+ال gas permeable semi rigid lens اللي هي ال semi
+
+400
+00:30:02,350 --> 00:30:05,470
+rigid اللي بتعمل نفاذية للغازات في العالم شكرا يا
+
+401
+00:30:05,470 --> 00:30:09,990
+عزيزي طيب ليشإنه من فترة تلات شهور لا يستيقظ عن
+
+402
+00:30:09,990 --> 00:30:14,810
+سرسخة حتى تلات شهور، إذا كان صار recurrence لل
+
+403
+00:30:14,810 --> 00:30:18,890
+symptoms كان
+
+404
+00:30:18,890 --> 00:30:23,410
+إحنا الآن مرضى، وشيلنا ال .. ال .. ال .. ال lens
+
+405
+00:30:23,410 --> 00:30:28,610
+لما بطل يصير ال second أسبوعين أو تلاتة، عملناه
+
+406
+00:30:28,610 --> 00:30:29,970
+ورجعناه لوراسة اللصحة
+
+407
+00:30:37,620 --> 00:30:43,960
+لو انا يعني اجريشي انا هعمل شهر و احسن تلات شغل
+
+408
+00:30:43,960 --> 00:30:56,220
+لان الوضع بخوف because رجول المرض دليل على انه صار
+
+409
+00:30:56,220 --> 00:31:01,460
+أفضل لذلك
+
+410
+00:31:01,460 --> 00:31:05,830
+هو كل في الحالة هذهإني أقل شيء بدي أترك العدسة
+
+411
+00:31:05,830 --> 00:31:11,610
+الاسكاملية هذا مدة شهر و الأطلع تلت شهور، لأن صحة
+
+412
+00:31:11,610 --> 00:31:14,810
+العين أهم العدسة الاسكاملية، تلابس نضارة أو يلبس
+
+413
+00:31:14,810 --> 00:31:20,430
+أي شيء بنيه، لكن هنا في اتناشر أسوان لجأت كلام
+
+414
+00:31:20,430 --> 00:31:24,970
+جديدقال إن بتغير إيش؟ هغير ال polymers اللي
+
+415
+00:31:24,970 --> 00:31:28,790
+أستخدمه لل .. ال polymers يعني المادة المفتوحة
+
+416
+00:31:28,790 --> 00:31:31,370
+نعملها .. المادة المفتوحة من العدس هغيرها فالمادة
+
+417
+00:31:31,370 --> 00:31:35,070
+تجلب أنه إيه احتمال تكون عامله إيش؟ هقلق .. هقلق
+
+418
+00:31:35,070 --> 00:31:36,030
+.. هقلق .. هقلق .. هقلق .. هقلق .. هقلق .. هقلق ..
+
+419
+00:31:36,030 --> 00:31:36,450
+هقلق .. هقلق .. هقلق .. هقلق .. هقلق .. هقلق ..
+
+420
+00:31:36,450 --> 00:31:37,250
+هقلق .. هقلق .. هقلق .. هقلق .. هقلق .. هقلق ..
+
+421
+00:31:37,250 --> 00:31:47,350
+هقلق .. هقلق .. هقلق .. هقلق .. هقلق .. هقلق
+
+422
+00:31:47,350 --> 00:32:03,570
+.. هقلق .. هقلالعين بالعين بالعين بالعين
+
+423
+00:32:03,570 --> 00:32:12,750
+بالعين
+
+424
+00:32:12,750 --> 00:32:16,470
+بالعين بالعين بالعين بالعين بالعين بالعين بالعين
+
+425
+00:32:16,470 --> 00:32:16,970
+بالعين بالعين بالعين بالعين بالعين بالعين بالعين
+
+426
+00:32:16,970 --> 00:32:20,550
+بالعين بالعين بالعين بالعين بالعين بالعين بالعين
+
+427
+00:32:23,190 --> 00:32:28,110
+أخليه من غير حالة ولا إنه يفضل عينه ميتة، صحيح؟
+
+428
+00:32:28,110 --> 00:32:32,090
+صحيح رقم 13 بيحكي إنه أنا ممكن أستفيد من ال
+
+429
+00:32:32,090 --> 00:32:38,290
+tropical chromoline 2% أو 4% أربع مرات يوميا، عشان
+
+430
+00:32:38,290 --> 00:32:43,930
+أمنع ال recurance اللي ممكن يصير للعدسات اللاصقة،
+
+431
+00:32:43,930 --> 00:32:50,110
+لل symptoms بالعدسات اللاصقة وده مفتوحة، ممكن طول
+
+432
+00:32:50,110 --> 00:32:50,430
+العام
+
+433
+00:32:54,170 --> 00:32:59,510
+اللي كان انه نحس ان ال muscle ال stabilizers جابت
+
+434
+00:32:59,510 --> 00:33:07,690
+نتيجة و خلت العين under control ممكن نخليها طبعا
+
+435
+00:33:07,690 --> 00:33:10,930
+حسب استعمالها الاساس و في واحد استعملها ساعة في
+
+436
+00:33:10,930 --> 00:33:14,570
+الأسبوع و واحد دي بيستعملها سبع ساعات في اليوم كل
+
+437
+00:33:14,570 --> 00:33:17,850
+ما استعملها أكتر كل ما المشكلة كانت أكبر المشكلة
+
+438
+00:33:17,850 --> 00:33:19,950
+كانت ان هنا في friction و في كلام ذلك
+
+439
+00:33:23,330 --> 00:33:25,950
+ان شاء الله هنكمل في chapter جديد اللي هو
+
+440
+00:33:25,950 --> 00:33:29,410
+pharmacology of ocular beta receptors antagonist
+
+441
+00:33:29,410 --> 00:33:34,190
+يعني انه انا اعالج أجزاء بالعين في ان اعمل block ل
+
+442
+00:33:34,190 --> 00:33:38,970
+ال beta receptors هي دي مستقبلات عصبية موجودة في
+
+443
+00:33:38,970 --> 00:33:43,830
+العينفى العين و فى الجسم؟ فى الجسم فى سيستيماكه فى
+
+444
+00:33:43,830 --> 00:33:47,190
+اوكيونات فحندخل فى اوكيونات the introduction of
+
+445
+00:33:47,190 --> 00:33:49,810
+the beta adrenoceptors antagonus completely
+
+446
+00:33:49,810 --> 00:33:53,590
+changed the drug's preference in the glucoma drug
+
+447
+00:33:53,590 --> 00:33:56,150
+therapy يعني هنا فى العين بشكل أساس اللى احنا
+
+448
+00:33:56,150 --> 00:33:59,710
+بنستخدمها لجلوكوما therapy لعلاش الجلوكومازي ما
+
+449
+00:33:59,710 --> 00:34:01,970
+احنا عارفين في التيمولول احنا مشهورين جدا، يعني
+
+450
+00:34:01,970 --> 00:34:05,130
+العلاج للجلوكامة هو واحد من ال beta blockers هذه،
+
+451
+00:34:05,130 --> 00:34:09,130
+فإنها بتعمل block لل .. ال adrenoreceptors اللي هو
+
+452
+00:34:09,130 --> 00:34:11,990
+من نوع B، احنا في عنا alpha blockers، في beta
+
+453
+00:34:11,990 --> 00:34:15,730
+blockers، هذا المسئول هنا اللي هو نوع B، إنه نعمل
+
+454
+00:34:15,730 --> 00:34:20,130
+block لل receptors هنا لعلاج الجلوكامةThe size for
+
+455
+00:34:20,130 --> 00:34:22,690
+receptors interaction of these drugs are suggested
+
+456
+00:34:22,690 --> 00:34:26,530
+to be beta-adrogenic receptors in the iris and
+
+457
+00:34:26,530 --> 00:34:29,490
+ciliary body بحكيها عن مواقع الريسبتورز في العيال
+
+458
+00:34:29,490 --> 00:34:32,070
+لل beta blockers موجودة في العيارس وفي الcellary
+
+459
+00:34:32,070 --> 00:34:36,850
+bodythe pharmacologic properties of these drugs
+
+460
+00:34:36,850 --> 00:34:39,890
+are referred to a beta hydro receptors antagonist
+
+461
+00:34:39,890 --> 00:34:43,770
+these drugs are called beta blockers بحكي انه
+
+462
+00:34:43,770 --> 00:34:47,650
+مشهورة بالاسم الدائلها اللي هي ال beta blockers
+
+463
+00:34:47,650 --> 00:34:52,610
+بتسمى كلمة beta blockers يعني أدي غلوكومة احنا هنا
+
+464
+00:34:52,610 --> 00:34:56,870
+في الoptometry ايش موقع للغلوكومة في الoptometry
+
+465
+00:34:56,870 --> 00:35:02,030
+top to bottom يعني الoptometry موضوع
+
+466
+00:35:10,740 --> 00:35:16,860
+عندي أقلأ او hypertension فى خطر على الكوميا عندي
+
+467
+00:35:16,860 --> 00:35:24,500
+أقلأ او hypertension عندي خطر على وقت الناس أقلأ
+
+468
+00:35:24,500 --> 00:35:27,660
+او hypertension او كوميا عندي خطر على الفجر على
+
+469
+00:35:27,660 --> 00:35:33,340
+الفجر على الفجر والفيل يعني الوضع حقوقته متوسط
+
+470
+00:35:33,340 --> 00:35:40,710
+يعني هل معقول انهالخريج ال اكتومتري يكون خالد ذهن
+
+471
+00:35:40,710 --> 00:35:45,030
+عن حاجة اسم انغروكومة؟ خالد ذهن عن حاجة اسم
+
+472
+00:35:45,030 --> 00:35:49,390
+Cochlear hypertension؟ لأ مانفعش إلا سكنوتركنيشن
+
+473
+00:36:00,570 --> 00:36:04,350
+الـ visual field بيفهم loss of vision بيفهم
+
+474
+00:36:04,350 --> 00:36:08,150
+effects on optic nerve و حاجات
+
+475
+00:36:12,200 --> 00:36:14,860
+The focus of the majority of the studies have been
+
+476
+00:36:14,860 --> 00:36:17,300
+on increased fluid dynamics and intraocular
+
+477
+00:36:17,300 --> 00:36:24,620
+pressure, but other functions of the eye have also
+
+478
+00:36:24,620 --> 00:36:28,300
+been explored، هم بيحكوا أن أغلب الدراسات ركزت على
+
+479
+00:36:28,300 --> 00:36:34,000
+حركة السائل وعلى ارتفاع الضغط، ومحكينا أن ال beta
+
+480
+00:36:34,000 --> 00:36:36,600
+-blockers هم بتشتغل زي medical treatment لل high
+
+481
+00:36:36,600 --> 00:36:38,520
+intraocular pressure، بشكل أساسي
+
+482
+00:36:41,160 --> 00:36:46,640
+اللي هو ال circulation او aqueous circulation
+
+483
+00:36:46,640 --> 00:36:51,620
+بيطلع من وين أساساً؟ من ال helium أو الcellular
+
+484
+00:36:51,620 --> 00:36:57,700
+body، من ورا وبعدين بيبقى لي hostilior chamber و
+
+485
+00:36:57,700 --> 00:37:03,140
+بعدين بيطلع من ال pubic و بيملأ ال anterior
+
+486
+00:37:03,140 --> 00:37:08,020
+chamber طبعا هو بيغذي ال zonules، بيغذي ال lens
+
+487
+00:37:13,730 --> 00:37:17,170
+Avascular organs of the eye وبعدين بيطلع من ال ..
+
+488
+00:37:17,170 --> 00:37:20,950
+Trabecular مشوار على stress كانال وبيطلع بكرة
+
+489
+00:37:20,950 --> 00:37:25,610
+وبيتي غيره وبيتي غيره فهي ال circulation القالي
+
+490
+00:37:25,610 --> 00:37:30,830
+Glucoma عبارة عن error في ال circulation Glucoma
+
+491
+00:37:30,830 --> 00:37:33,670
+error في ال circulation يعني احنا في الناس اللي
+
+492
+00:37:33,670 --> 00:37:38,070
+أصدرها الحمد لله ال grow الحمد لله زينا انه ال
+
+493
+00:37:38,070 --> 00:37:38,650
+income
+
+494
+00:37:41,250 --> 00:37:44,930
+خلات يوزن، يعني اللي .. اللي .. اللي منتج جديد
+
+495
+00:37:44,930 --> 00:37:49,130
+تساوي اللي بيطلع لبرنامج، فيه balance يعني، ال
+
+496
+00:37:49,130 --> 00:37:53,490
+income و ال outcome بيساوي بعض، الآن المشكلة اللي
+
+497
+00:37:53,490 --> 00:38:00,910
+بتصير انه بيصير في النقومة في invest، بيصير ال
+
+498
+00:38:00,910 --> 00:38:05,190
+income زيادة عن ال outcomeالمنتج أكتر من اللي
+
+499
+00:38:05,190 --> 00:38:07,970
+بيطلع، يعني اللي بيطلع فيه مشكلة في Tropical
+
+500
+00:38:07,970 --> 00:38:11,350
+Meshwork هو بالفعل بارتفاع ضغط العين، ارتفاع ضغط
+
+501
+00:38:11,350 --> 00:38:17,650
+العين يؤدي إلى ضمور في عليا في العصب البشري، ويؤدي
+
+502
+00:38:17,650 --> 00:38:21,070
+إلى loss of visual field، وبعدين في مشاكل تانية
+
+503
+00:38:21,070 --> 00:38:26,250
+بتيجي بتلقى، بس يعني الglucoma يعني مشكلتها إن ال
+
+504
+00:38:26,250 --> 00:38:32,170
+dynamics بتاعة ال fluids فيها error معينهو ممكن
+
+505
+00:38:32,170 --> 00:38:36,130
+يكون زيادة في إنتاج السائل أو مشكلة في التصريف
+
+506
+00:38:36,130 --> 00:38:40,350
+نفسي و هذا بسبب زيادة الضغط اللي جوه اللي عندك.
+
+507
+00:38:40,450 --> 00:38:42,870
+Unlike bilocarbine, the drugs of the glaucoma
+
+508
+00:38:42,870 --> 00:38:46,070
+treatment for the last 100 years, people who can't
+
+509
+00:38:46,070 --> 00:38:49,110
+generally don't contract the pupil and thus don't
+
+510
+00:38:49,110 --> 00:38:52,240
+interfere with visioneven the patients with
+
+511
+00:38:52,240 --> 00:38:55,020
+central lens opacities هنا بحكي أنه ال beta
+
+512
+00:38:55,020 --> 00:38:57,680
+blockers مميزاتها عن البيولوكربين احنا حكينا
+
+513
+00:38:57,680 --> 00:39:00,820
+البيولوكربين من ال indications لها انها بتوقف ..
+
+514
+00:39:00,820 --> 00:39:06,260
+انها بتعمل او بتعالج ال closure anguish locoma بس
+
+515
+00:39:06,260 --> 00:39:08,680
+.. بس لها بتأثر على ال pupil فانها بتعمل meiosis
+
+516
+00:39:08,680 --> 00:39:11,700
+لكن هذا ال beta blockers بدون ما يؤثر على ال ..
+
+517
+00:39:11,700 --> 00:39:14,120
+مابتفعلش مع ال pupil أو بدون ما يؤثر على ال pupil
+
+518
+00:39:14,120 --> 00:39:20,060
+طيب حتى لو في lens opacities حتى لو في .. اه بأثرش
+
+519
+00:39:20,060 --> 00:39:29,620
+النقربنعمل ping-holing لو فيه في ال .. في الناس اي
+
+520
+00:39:29,620 --> 00:39:30,040
+روم الكتابة
+
+521
+00:39:37,310 --> 00:39:41,550
+الـ size عادي وبالتالي هو ماشوفش من حتة مش هو من
+
+522
+00:39:41,550 --> 00:39:45,530
+التانية مش هو من ال .. ال .. ال .. ال .. ال .. ال
+
+523
+00:39:45,530 --> 00:39:48,710
+.. المناطق اللي في الناس transparent لسه مش ال
+
+524
+00:39:48,710 --> 00:39:52,750
+opaque لكن لو ال viral carbon ماعمل pain هون وإيجا
+
+525
+00:39:52,750 --> 00:39:58,230
+ال center حتة opaque بصير أعمىكمان حاجة ان ال bio
+
+526
+00:39:58,230 --> 00:40:01,450
+-carbine بتكون contra-indication للناس اللي عندهم
+
+527
+00:40:01,450 --> 00:40:03,910
+اسباز من الcellar muscle اللي هتعملهم artificial
+
+528
+00:40:03,910 --> 00:40:07,710
+myopia لكن هنا ال beta-blockers الميزة التانية انه
+
+529
+00:40:07,710 --> 00:40:10,410
+بيسببش اي اسباز من الcellar muscle اللي ممكن
+
+530
+00:40:10,410 --> 00:40:13,470
+تعملني transient myopia اللي هي pseudo-myopia او
+
+531
+00:40:13,470 --> 00:40:16,770
+انه تعطيل ال accumulation اه بزيد ال accumulation،
+
+532
+00:40:16,770 --> 00:40:20,890
+ال bio-carbine بيد ال accumulationو لما دي ال
+
+533
+00:40:20,890 --> 00:40:23,770
+accommodation بيعمل solo myopia، لأ ال .. ال .. ال
+
+534
+00:40:23,770 --> 00:40:26,110
+.. البيت عابله كرز و بتعملش الاشياء، و الشيء
+
+535
+00:40:26,110 --> 00:40:29,990
+التالت اللي هو ال visual field، لما يكون ال .. ال
+
+536
+00:40:29,990 --> 00:40:31,050
+.. ال people contracted
+
+537
+00:40:58,130 --> 00:41:02,390
+البروبرانول البروبرانول البروبرانول البروبرانول
+
+538
+00:41:02,800 --> 00:41:06,060
+Propranolol is the prototypes, ideal example of
+
+539
+00:41:06,060 --> 00:41:10,140
+drugs that can antagonize beta adrenoceptors يعني
+
+540
+00:41:10,140 --> 00:41:14,300
+هنا بتكلمك أن المثال أو النموذج من الأمثلة يعني ال
+
+541
+00:41:14,300 --> 00:41:17,560
+beta blockers الشائعة اللي هو اسمه ال Propranolol
+
+542
+00:41:17,560 --> 00:41:26,160
+هذا أول beta blockers اكتشفوه، الآن لا يستخدم زي
+
+543
+00:41:26,160 --> 00:41:30,440
+ال penicillin و ال protein اللي زمان مستكشفوه، له
+
+544
+00:41:30,440 --> 00:41:34,540
+قيمة تاريخيةالان هاي ال risk في التاريخية اللي
+
+545
+00:41:34,540 --> 00:41:41,400
+بيقوله مثلا timolol مثلا يقاس كم مرة أقوى من ال
+
+546
+00:41:41,400 --> 00:41:46,560
+pronolol مثلا القطعة هذه خمس شكل فيها خمس مرات
+
+547
+00:41:46,560 --> 00:41:51,040
+أكتر من الشكل القطعة هذه عشرة شكل عشر مرات أقوى من
+
+548
+00:41:51,040 --> 00:41:53,860
+الشكل عشرين شكل عشرين مرات أقوى من الشكل
+
+549
+00:42:00,420 --> 00:42:04,040
+ليه الاشي اللي اجت جديد بعد هي في مجال ال beta
+
+550
+00:42:04,040 --> 00:42:12,000
+blockers بحكي
+
+551
+00:42:12,000 --> 00:42:15,680
+ان هنا التفاعل مع ال beta blockers مع المستقبلات
+
+552
+00:42:15,680 --> 00:42:21,560
+اشي يعني محافظ او اشي منافس يعني منافس يعني هم
+
+553
+00:42:21,560 --> 00:42:30,040
+الدول اللي انا بقطه بنافس مواد داخل الجسمبتملة هذه
+
+554
+00:42:30,040 --> 00:42:35,620
+هي ال receptors يعني كائن بسيط يعني الممر ضايق مين
+
+555
+00:42:35,620 --> 00:42:40,320
+يسبق القطر اللي حطيتها ولا المواد الطبيعية في
+
+556
+00:42:40,320 --> 00:42:44,560
+العين مين يسبق ال receptor اللي يسبق ال receptor
+
+557
+00:42:44,560 --> 00:42:50,310
+هو اللي بيفتح ال receptors و بيخليه يشتغلفاحنا
+
+558
+00:42:50,310 --> 00:42:53,850
+يعني لما نحط القطرات هي competitive و ال natural
+
+559
+00:42:53,850 --> 00:42:58,890
+substances in the body عموما يعني competitive اه
+
+560
+00:42:58,890 --> 00:43:01,670
+the potency of the drug in the cardiovascular
+
+561
+00:43:01,670 --> 00:43:04,310
+system is not always indicative of the ocular
+
+562
+00:43:04,310 --> 00:43:08,870
+effect بحكيها ان فعلية الدواء او قوته على ال
+
+563
+00:43:08,870 --> 00:43:11,650
+cardiovascular system مش معناه انها مؤشر انها
+
+564
+00:43:11,650 --> 00:43:14,410
+هتأثر تأثير كويس على العين يعني لو أثرتلي على ال
+
+565
+00:43:14,410 --> 00:43:17,090
+cardiovascular system مش معناه انها هتعمل تأثير
+
+566
+00:43:17,090 --> 00:43:18,790
+على العين يعني هنا في بي تبكر
+
+567
+00:43:23,830 --> 00:43:29,170
+في ال beta receptors في العين بيقول لي طريقة العمل
+
+568
+00:43:29,170 --> 00:43:35,170
+بتاعة القلب تختلف عنها لأن دلوقتي نحط القطرة دائرة
+
+569
+00:43:35,170 --> 00:43:38,590
+بينما القلب نهروم systemically
+
+570
+00:43:44,480 --> 00:43:48,540
+هنا بحكي إنه في نوع من ال beta blockers receptors
+
+571
+00:43:48,540 --> 00:43:53,460
+B1 وB2 blockers أثات هي one heart تاني lungs هنا
+
+572
+00:43:53,460 --> 00:43:56,280
+في ال beta blockers إلها أنواع في selective و non
+
+573
+00:43:56,280 --> 00:44:00,760
+-selective ال selective اللي هي بكون تأثيرها قليل
+
+574
+00:44:00,760 --> 00:44:03,040
+على ال hearts و ال lungs يعني على ال
+
+575
+00:44:03,040 --> 00:44:05,400
+cardiovascular بكون تأثيرها قليل لكن ال non
+
+576
+00:44:05,400 --> 00:44:09,300
+-selective بكون تأثيرها كتير ليش؟ لأن ال non
+
+577
+00:44:09,300 --> 00:44:13,240
+-selective بتشتغل على ال both B1 و B2 على ال
+
+578
+00:44:13,240 --> 00:44:16,430
+receptorين التمامينلكن ال selective تشتغل إما على
+
+579
+00:44:16,430 --> 00:44:21,050
+B1 أو على B2 شوفين أنا مثال وين ال receptors
+
+580
+00:44:21,050 --> 00:44:26,010
+موجودة ال one في ال heart في القلب او في ال lungs
+
+581
+00:44:26,010 --> 00:44:33,850
+الدول حتى ناخدوا across يعني لو اشتغل عموما بيشتغل
+
+582
+00:44:33,850 --> 00:44:36,590
+على كام لو selective زمان جات الأخر بيشتغل على ال
+
+583
+00:44:36,590 --> 00:44:40,670
+B1 بس ايش على ال heart لو على ال B2 مثلا على ال
+
+584
+00:44:40,670 --> 00:44:45,560
+lungو المرأة تجي اسم زيكي، هاي بس مثال يعني، اه
+
+585
+00:44:48,860 --> 00:44:51,340
+Beta blockers are classified as relatively
+
+586
+00:44:51,340 --> 00:44:53,720
+selective or non-selective زي ما حكينا فيه منه
+
+587
+00:44:53,720 --> 00:44:56,260
+selective ومنه non-selective with receptors to
+
+588
+00:44:56,260 --> 00:45:00,040
+their actions at beta 1 and beta 2 at the receptor
+
+589
+00:45:00,040 --> 00:45:03,240
+subtypes قسم ل beta 1 و beta 2 some drugs can
+
+590
+00:45:03,240 --> 00:45:08,340
+block both beta 1 and beta 2 receptors activity في
+
+591
+00:45:08,340 --> 00:45:12,380
+بحكي بعض الأدوية بتعمل block ل beta 1 and beta 2
+
+592
+00:45:12,380 --> 00:45:15,440
+التنين مع بعض اللي هي بنسميها non-selective يعني
+
+593
+00:45:15,440 --> 00:45:17,520
+عن ال hairs و ال lungs تستخدم تنين؟
+
+594
+00:45:21,510 --> 00:45:25,770
+others predominantly or almost exclusively block
+
+595
+00:45:25,770 --> 00:45:29,070
+only one of the two types at low concentrations
+
+596
+00:45:29,070 --> 00:45:32,930
+بيكون بتركيز أقل يعني إما بتشتغل على beta 1 أو
+
+597
+00:45:32,930 --> 00:45:35,610
+beta 2 هذه اللي هي selective اللي بيكون تأثيرها
+
+598
+00:45:35,610 --> 00:45:38,330
+أقل سواء على الhertz أو على الmax شوفوا الآن
+
+599
+00:45:38,330 --> 00:45:43,250
+القطرة اللي .. اللي .. اللي إنها selective ممكن
+
+600
+00:45:43,250 --> 00:45:47,350
+تكون تمانها عشر شكل القطرة ال selective تمانت ستين
+
+601
+00:45:47,350 --> 00:45:53,540
+شكل لإنها تصنيحها خاطرأغلب كتير لتشتغل selected
+
+602
+00:45:53,540 --> 00:46:03,640
+ليش يعني احنا واحد عنده مشاكل في القلب احنا بدلاش
+
+603
+00:46:03,640 --> 00:46:09,740
+ان نعطل على مثلا سيمبر مايه اه اه يعني انا باختيار
+
+604
+00:46:09,740 --> 00:46:12,640
+اللي بيكون حكاية فهذه شركات مصنعة قليلة في العالم
+
+605
+00:46:12,640 --> 00:46:16,540
+ال selected وقطر لإن ايضا فيها non selected و فيها
+
+606
+00:46:16,540 --> 00:46:19,910
+selectedالقطرة الـ Selective عشرة شكل، الـ Non
+
+607
+00:46:19,910 --> 00:46:24,110
+Selective عشرة شكل، الـ Selective خمسين أو ستين أو
+
+608
+00:46:24,110 --> 00:46:24,770
+سبعين شكل
+
+609
+00:46:29,470 --> 00:46:33,110
+the selectivity of either beta 1 and beta 2 is not
+
+610
+00:46:33,110 --> 00:46:37,750
+absolute at high doses all beta adrenoceptors can
+
+611
+00:46:37,750 --> 00:46:41,970
+be antagonized يعني انه مش .. يعني مش انه مطلق
+
+612
+00:46:41,970 --> 00:46:45,470
+دايما خلاص نعطي select يعني في .. في كل الأحوال
+
+613
+00:46:45,470 --> 00:46:48,690
+high doses جرعات كتيرة منها لازم نعملها inhibit
+
+614
+00:46:48,690 --> 00:46:51,790
+يعني لازم نجلبها ممتاز أيضا يعني ال selectivity
+
+615
+00:46:51,790 --> 00:46:58,710
+هذه مش مطلقة يعني لو أنت تاخد الأقراصسيلكتيف دلها
+
+616
+00:46:58,710 --> 00:47:05,990
+او دلان بجواه صديرة اه ممكن لو كانت جواه كبيرة كله
+
+617
+00:47:05,990 --> 00:47:13,270
+خاصية شغل ال B1 وB2 وبالتالي السيلكتيف دي مش مطلقة
+
+618
+00:47:13,270 --> 00:47:17,890
+دائما حسب الدوز الدوز الصغيرة تعمل سيلكتيف اكشن و
+
+619
+00:47:17,890 --> 00:47:20,670
+الدوز الكبيرة تعمل non selective action
+
+620
+00:47:30,930 --> 00:47:34,530
+survive دخلت على ال .. على ال sector و دخلت على
+
+621
+00:47:34,530 --> 00:47:39,550
+المكان المكتوب؟ هاي ال hard talent و ال receptors
+
+622
+00:47:39,550 --> 00:47:46,130
+بتاعه هى يعني محاولة تفنين كيف ال .. ال .. ال beta
+
+623
+00:47:46,130 --> 00:47:50,390
+blockers تشتغل في الجسم أو في الاشي أو في ال ..
+
+624
+00:47:50,390 --> 00:47:52,410
+شكرا ليك يا سهولة مباركة لك
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/lXfPYz-IKg0_raw.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/lXfPYz-IKg0_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..5b45f63dba08e48e1e7f45e740e12817d2789172
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/lXfPYz-IKg0_raw.srt
@@ -0,0 +1,2548 @@
+1
+00:00:21,770 --> 00:00:24,170
+الحمد لله يا رب العالمين و أصلي و أسلم علي النبي
+
+2
+00:00:24,170 --> 00:00:27,510
+الأمين محمد وليالي و أصحابي و اتباعيين السلام
+
+3
+00:00:27,510 --> 00:00:31,030
+عليكم و رحمة الله وبركاته في هذا اليوم سنبدأ موضوع
+
+4
+00:00:31,030 --> 00:00:35,670
+جديد هو Contact Lens Induced Giant Papillary
+
+5
+00:00:35,670 --> 00:00:43,010
+Congerativitis أي المرض الملتحمة الذي تسببه
+
+6
+00:00:43,010 --> 00:00:50,630
+العنصرات الأصغر تسبب التهاب و تفاعل ما في الملتحمة
+
+7
+00:00:52,010 --> 00:00:56,770
+وهذا الموضوع يغطي هذا الجانب الهام في حياة البشرية
+
+8
+00:00:56,770 --> 00:01:01,230
+التي أصبحت في هذه الأيام تستعمل العلاسات اللاصقة
+
+9
+00:01:01,230 --> 00:01:04,590
+بكثرة في جميع أنحاء العالم
+
+10
+00:01:23,750 --> 00:01:26,050
+contact trends induce giant papillary
+
+11
+00:01:26,050 --> 00:01:29,370
+congenitivitis giant papillary congenitivitis
+
+12
+00:01:29,370 --> 00:01:33,410
+affect approximately 1% في 5% of 30 million
+
+13
+00:01:33,410 --> 00:01:37,830
+contact trends readers in neurotic statesهنا بيحكي
+
+14
+00:01:37,830 --> 00:01:40,970
+لإن ال giant papillary congenitivitis بتأثر حوالي
+
+15
+00:01:40,970 --> 00:01:43,950
+واحد في المية لخمسة في المية من تلاتين مليون من
+
+16
+00:01:43,950 --> 00:01:48,170
+اللابس العبثات اللاصقة في ال USA جي بي سي كان أكر
+
+17
+00:01:48,170 --> 00:01:51,470
+اندووس وي .. وي رينغ هارد جي بي سي يعني هو اسم
+
+18
+00:01:51,470 --> 00:01:53,410
+المرض وده ال giant papillary congenitivitis
+
+19
+00:01:56,050 --> 00:01:59,070
+It can occur in those wearing hard semi-rigid and
+
+20
+00:01:59,070 --> 00:02:02,650
+soft hydrogel lenses بيحكي إن هذا المرض بيحدث في
+
+21
+00:02:02,650 --> 00:02:05,310
+الأشخاص اللي بيبصوا العدسات اللي بيبصوا العدسات
+
+22
+00:02:05,310 --> 00:02:05,310
+اللي بيبصوا العدسات اللي بيبصوا العدسات اللي
+
+23
+00:02:05,310 --> 00:02:05,730
+بيبصوا العدسات اللي بيبصوا العدسات اللي بيبصوا
+
+24
+00:02:05,730 --> 00:02:07,550
+العدسات اللي بيبصوا العدسات اللي بيبصوا العدسات
+
+25
+00:02:07,550 --> 00:02:08,310
+اللي بيبصوا العدسات اللي بيبصوا العدسات اللي
+
+26
+00:02:08,310 --> 00:02:10,130
+بيبصوا العدسات اللي بيبصوا العدسات اللي بيبصوا
+
+27
+00:02:10,130 --> 00:02:16,330
+العدسات اللي بيبصوا العدسات اللي بيبصوا العدسات
+
+28
+00:02:16,330 --> 00:02:21,750
+اللي بيبصوا العدسات
+
+29
+00:02:21,750 --> 00:02:21,750
+اللي
+
+30
+00:02:29,920 --> 00:02:37,660
+contactless virus، ليش؟ لأنها بتنتص ال .. كثير
+
+31
+00:02:37,660 --> 00:02:44,620
+بيصير adherent للكارنين لش؟ لأن بتكون عليها .. هي
+
+32
+00:02:44,620 --> 00:02:49,760
+movable يعني كتير تعمل .. تعمل إيش؟ floating هي
+
+33
+00:02:49,760 --> 00:02:55,400
+كتير فهي بتعمل حركة، شوية friction يعني شوية
+
+34
+00:02:55,400 --> 00:03:01,560
+friction في القرانية و الملتحةالـ Soft بتيجي بقى
+
+35
+00:03:01,560 --> 00:03:07,440
+floating العادى، فهي كتير بتعمل شوية friction، ال
+
+36
+00:03:07,440 --> 00:03:13,610
+hard أسبق منها شويةcontact lens induce giant
+
+37
+00:03:13,610 --> 00:03:16,070
+papillary conjunctivitis اللي لها clinical feature
+
+38
+00:03:16,070 --> 00:03:19,530
+ده هنحكي عن ال symptoms اللي بيحكيها المريض او
+
+39
+00:03:19,530 --> 00:03:22,750
+بيشعر فيها المريض اول symptoms عندي the earliest
+
+40
+00:03:22,750 --> 00:03:26,630
+symptoms are itching on lens removal يعني اول
+
+41
+00:03:26,630 --> 00:03:30,090
+مراحل اتدائية من المرض بيكون يشعر المريض في حكة
+
+42
+00:03:30,090 --> 00:03:33,570
+بالعين لما نشيل العدسة تاني issue هو ال mucus
+
+43
+00:03:33,570 --> 00:03:38,220
+formation بيكون تكون مادة ال mucus في العينو ال
+
+44
+00:03:38,220 --> 00:03:40,720
+latery ال patient complain of contact lens
+
+45
+00:03:40,720 --> 00:03:45,820
+intolerance بيشعر المريض لما .. انه مابي ..
+
+46
+00:03:45,820 --> 00:03:49,420
+مابيتلقى العدسة معاه، انه مابيتحملها و ال
+
+47
+00:03:49,420 --> 00:03:51,840
+irritation اللي هي التهيوج العين و ال itching و ال
+
+48
+00:03:51,840 --> 00:03:55,460
+redness اللي يحكى و يحمرها العين و زيادة ال
+
+49
+00:03:55,460 --> 00:03:57,900
+tearing او زيادة افراز الدموع و ال mucous
+
+50
+00:03:57,900 --> 00:04:00,860
+discharge بيكون انا عندي افراز لمادة مخطية من
+
+51
+00:04:00,860 --> 00:04:04,390
+العينbluriness of vision while wearing these
+
+52
+00:04:04,390 --> 00:04:07,070
+lenses كمان بيكون انا عندي تغبيش في الرؤية لما
+
+53
+00:04:07,070 --> 00:04:11,630
+نلبس العدسات طب ليش؟ من ال Lucas discharge Lucas
+
+54
+00:04:11,630 --> 00:04:13,730
+discharge بيصير انديدوسبوذبت على العدسة من ال ..
+
+55
+00:04:13,730 --> 00:04:17,970
+من ال irritation يعني العين واقفة و حمرة ديسم غريب
+
+56
+00:04:17,970 --> 00:04:23,730
+يعني اه فال .. العين مش بتحملها فبتبدأ الرؤية تصير
+
+57
+00:04:23,730 --> 00:04:30,180
+فيها blurring يعني غباش مش صافية يعني اهال sounds
+
+58
+00:04:30,180 --> 00:04:32,940
+اللى انا لازم اشوفها في ال examination لعين المريض
+
+59
+00:04:32,940 --> 00:04:36,020
+ايه اللى ده .. ايه اللى .. ايه اللى there is
+
+60
+00:04:36,020 --> 00:04:38,960
+bulbar and bulbiparal conjunctival hyperemia بيكون
+
+61
+00:04:38,960 --> 00:04:41,040
+انا عندي احتقاق في ال bulbar .. في ال bulbar و ال
+
+62
+00:04:41,040 --> 00:04:43,700
+bulbiparal في ال conjunctiva occasionally mucous
+
+63
+00:04:43,700 --> 00:04:48,340
+strands may be present بيكون انا عندي خلوط مخاطية
+
+64
+00:04:48,340 --> 00:04:51,520
+في العين على ال conjunctiva with progression مع
+
+65
+00:04:51,520 --> 00:04:53,680
+تطور هذا المرض بيكون انا عندي conjunctival
+
+66
+00:04:53,680 --> 00:04:56,490
+thickeningبتزيد ال thickness تبع ال conjunctiva
+
+67
+00:04:56,490 --> 00:05:00,190
+بيأثرلي انه بيعملي loss of translucency a curse
+
+68
+00:05:00,190 --> 00:05:04,950
+بيصير ان انا عندي عدم شبه فيا ل ال conjunctiva the
+
+69
+00:05:04,950 --> 00:05:07,710
+other types يكون ال conjunctiva will demonstrate
+
+70
+00:05:07,710 --> 00:05:12,650
+macropapilla ديامتر لإنها من 310 ل 1 مليو giant
+
+71
+00:05:12,650 --> 00:05:16,010
+papillae الديامتر اللي لها واحد ملي ديامتر او اكتر
+
+72
+00:05:16,010 --> 00:05:19,810
+بيحكيلي مع هذا المرض بيصير انا عندي macro papilla
+
+73
+00:05:19,810 --> 00:05:24,770
+يعني زي انتوا اكتر كبيرة ديامترا لعشرة او واحد ملي
+
+74
+00:05:24,770 --> 00:05:29,290
+بيكون انا عندي احيانا giant papilla نوتي اكتر اكبر
+
+75
+00:05:29,290 --> 00:05:31,830
+ضخمة يعني ديامترا اللي لها اكتر من واحد ملي يعني
+
+76
+00:05:31,830 --> 00:05:36,870
+هي تبدأ بيعمل مايكرو مايكرو و بعد ما تصير giant
+
+77
+00:05:36,870 --> 00:05:42,550
+الان ال size هذه الأربعةو يمكن فيه غيرها، مش شرط
+
+78
+00:05:42,550 --> 00:05:46,890
+اللي ألاجيها كلها، لإني ألاجي بعضها، يعني مثلا أنا
+
+79
+00:05:46,890 --> 00:05:51,330
+لاجيت عينه فيها hyperemia الملتحمة ال vulva البيضة
+
+80
+00:05:51,330 --> 00:05:55,450
+هذه اللي ماشوفها أو التراثل كونها متطيبة، ألاجتها
+
+81
+00:05:55,450 --> 00:06:00,650
+يعني فيها condition أو hyperemia، الحمران، و
+
+82
+00:06:00,650 --> 00:06:06,700
+strandsممكن تخيلها ليكون بداية، لكن وسط ال papilla
+
+83
+00:06:06,700 --> 00:06:11,520
+بكون الوضع صعب، بكون الوضع .. يعني المريض تحمل على
+
+84
+00:06:11,520 --> 00:06:15,140
+نفسه كتير لموسط ال papilla، يعني ال papilla ال
+
+85
+00:06:15,140 --> 00:06:18,280
+complication بتصير صعبة، حتى إزالتها صعبة
+
+86
+00:06:22,420 --> 00:06:25,420
+بحكيلي البابيلي often have a dome shape appearance
+
+87
+00:06:25,420 --> 00:06:28,140
+with fibrotic white yellow tops، بيحكيلي أن
+
+88
+00:06:28,140 --> 00:06:30,600
+البابيلي بتكون على شكل .. على شكل ال dome shape
+
+89
+00:06:30,600 --> 00:06:33,820
+يعني بهذا الشكل مثلا كده و بيكون في الطب اللي هي
+
+90
+00:06:33,820 --> 00:06:38,360
+في قمة البابيلي fibrotic white yellow tops يعني زي
+
+91
+00:06:38,360 --> 00:06:43,800
+مادة في fiber رايحة لون أبيض أو أصفر زي كأنه صديق
+
+92
+00:06:43,800 --> 00:06:48,230
+على رأس النطوقهنا الترانس ده dot may bc هون
+
+93
+00:06:48,230 --> 00:06:50,490
+الترانس اللي موجودة في college of taiwan ممكن تبين
+
+94
+00:06:50,490 --> 00:06:55,310
+عن ليه هون ال trans ترانس ترانتس اه وقتش شفناها دي
+
+95
+00:06:55,310 --> 00:07:05,090
+هون ترانتس في ال Bernal هنا في ال Bernal يعني
+
+96
+00:07:05,090 --> 00:07:10,190
+تقريبا دائما موجودة لكن هنا يعني بتكون وجودها
+
+97
+00:07:10,190 --> 00:07:14,330
+occasional جليل يعني ربما يعني جليل يكون موجودة
+
+98
+00:07:15,170 --> 00:07:17,270
+fluorescein staining of the papilla which
+
+99
+00:07:17,270 --> 00:07:20,250
+indicates ulceration of the congenital papilla the
+
+100
+00:07:20,250 --> 00:07:23,250
+cell base reflects severity إذا أنا استخدمت ال
+
+101
+00:07:23,250 --> 00:07:26,570
+fluorescein في العين فواجدت إن هنا في ulceration
+
+102
+00:07:26,570 --> 00:07:29,710
+في ال congenital papilla بيكون أنا .. بيدل على
+
+103
+00:07:29,710 --> 00:07:32,570
+خطورة ال giant papillary congenital papilla ال
+
+104
+00:07:32,570 --> 00:07:36,470
+congenital papillus أو إن مادة تحمل المريض زيادة
+
+105
+00:07:36,470 --> 00:07:41,290
+على حالي يعني صارت تقدم في المرضو بعدها أصبح الـ
+
+106
+00:07:41,290 --> 00:07:48,750
+ulceration في البابيلي يعني بابيلي بدت تدوء هذا
+
+107
+00:07:48,750 --> 00:07:52,170
+مؤشر على أن المرض صار خطير و هناك infection و كلام
+
+108
+00:07:52,170 --> 00:07:56,850
+زي هذا الان علاجه هتكون صعب اللي وصل حاله لهذا
+
+109
+00:07:56,850 --> 00:08:03,050
+المرحلة الان علاجه بده تعب شديد عشان البابيلي
+
+110
+00:08:03,050 --> 00:08:07,880
+هتروح وعشان ال infection هتروحthere may also be
+
+111
+00:08:07,880 --> 00:08:11,040
+corneal staining but this is uncommon بيحكيلي كمان
+
+112
+00:08:11,040 --> 00:08:14,380
+انه ممكن من أعراضها للمرض اللي انا أشوفها يكون ان
+
+113
+00:08:14,380 --> 00:08:16,900
+انا عندي corneal staining بس الشغل مش شائع كتير
+
+114
+00:08:16,900 --> 00:08:19,440
+ايش يعني corneal staining يعني معناها؟ بالفلورسية
+
+115
+00:08:19,440 --> 00:08:25,720
+يعني ايش معناها الكلاكايتس؟ يعني فيها نوع من
+
+116
+00:08:25,720 --> 00:08:28,900
+الكلاكايتس او في نوع من
+
+117
+00:08:32,530 --> 00:08:37,170
+هو في نتفة معينة، الصحيح ان الكل هو proficient في
+
+118
+00:08:37,170 --> 00:08:41,650
+ذلك ال answer، لكن معناه ان انا الان في خطر مش بس
+
+119
+00:08:41,650 --> 00:08:42,910
+على ال control of type
+
+120
+00:08:47,730 --> 00:08:50,890
+ممكن انا الاحظ كمان ال pseudotoxins اللي occur in
+
+121
+00:08:50,890 --> 00:08:54,490
+more severe cases، ال pseudotoxins ممكن يظهرلي من
+
+122
+00:08:54,490 --> 00:08:57,810
+ال macro papillae انجار، ال papillae اللي بتعمل
+
+123
+00:08:57,810 --> 00:09:01,170
+ثقة في الجفر، فانا بحس انه فيه انفتاطس، بس هو رح
+
+124
+00:09:01,170 --> 00:09:04,090
+يكون كذب، there is often significant doubles of
+
+125
+00:09:04,090 --> 00:09:07,070
+formation on the surface of the contact lenses،
+
+126
+00:09:07,070 --> 00:09:10,470
+كمان رح يكون لعندي لواصف على سطح الخارج و لعدسات
+
+127
+00:09:10,470 --> 00:09:13,370
+اللاصقة، و الخارج يعني؟ سطح ال .. ال .. ورا ولا
+
+128
+00:09:13,370 --> 00:09:14,490
+قدام؟ القدام
+
+129
+00:09:22,190 --> 00:09:26,530
+مش يعني بقيت الفيلم هو فاير انا دوستش كيف اشوفها؟
+
+130
+00:09:26,530 --> 00:09:30,810
+من الشرق بس لإن لو حطينا ضوء ساطع بتبين زي نقطة
+
+131
+00:09:30,810 --> 00:09:34,230
+صغيرة على العدس بس يعني جاسها بده magnifier اه
+
+132
+00:09:34,230 --> 00:09:40,850
+لازم ها مجنفير plus five plus six plus ten لازم
+
+133
+00:09:40,850 --> 00:09:46,430
+اشوف انها نتوقع على سطح العدسة الخلفيةطب يلتقى
+
+134
+00:09:46,430 --> 00:09:52,110
+تانى يعنى ضربة ولا مش ضربة ده ده ضربة هي اللى
+
+135
+00:09:52,110 --> 00:09:58,810
+هتعمل averaging لالمثيلة مثلا كورنة ايوة طيب احنا
+
+136
+00:09:58,810 --> 00:10:05,530
+الان بدا هناك اربع a و b عن ال papilla كمان لخمسة
+
+137
+00:10:05,530 --> 00:10:11,190
+و ستة و سبعة عن ال science نصحى لبعض يعني اللي كان
+
+138
+00:10:11,190 --> 00:10:17,870
+احنا بنطلب مباشر في امتحانCommit on signs and
+
+139
+00:10:17,870 --> 00:10:23,310
+symptoms of contactless-induced gyrepopenicosis كل
+
+140
+00:10:23,310 --> 00:10:26,830
+ال symptoms و كل ال signs دي هالسنة الرابعة و كل
+
+141
+00:10:26,830 --> 00:10:35,930
+هم مكبين مش معكم دكتور دكتور
+
+142
+00:10:35,930 --> 00:10:36,090
+دكتور دكتور دكتور دكتور دكتور دكتور دكتور دكتور
+
+143
+00:10:36,090 --> 00:10:41,550
+دكتور دكتور دكتور دكتور دكتور دكتور دكتور دكتور
+
+144
+00:10:41,550 --> 00:10:44,650
+دكتور دكتور دكتور دكتور دكتور دكتور دكتور دكتور
+
+145
+00:10:44,650 --> 00:10:44,650
+دكتور دكتور دكتور دكتور دكتور دكتور دكتور دكتور
+
+146
+00:10:44,650 --> 00:10:44,650
+دكتور دكتور دكتور دكتور دكتور دكتور دكتور دكتور
+
+147
+00:10:44,650 --> 00:10:47,620
+دكتور دكتور دكاللي هي البابلة .. جاية البابلة كانت
+
+148
+00:10:47,620 --> 00:10:50,340
+.. هي ال .. هي ال .. هي ال .. هي ال .. هي ال .. هي
+
+149
+00:10:50,340 --> 00:10:50,920
+ال .. هي ال .. هي ال .. هي ال .. هي ال .. هي ال ..
+
+150
+00:10:50,920 --> 00:10:54,080
+هي ال .. هي ال .. هي ال .. هي ال .. هي ال .. هي ال
+
+151
+00:10:54,080 --> 00:10:57,120
+.. هي ال .. هي ال .. هي ال .. هي ال .. هي ال .. هي
+
+152
+00:10:57,120 --> 00:10:58,580
+ال .. هي ال .. هي ال .. هي ال .. هي ال .. هي ال ..
+
+153
+00:10:58,580 --> 00:10:58,700
+هي ال .. هي ال .. هي ال .. هي ال .. هي ال .. هي ال
+
+154
+00:10:58,700 --> 00:10:58,980
+.. هي ال .. هي ال .. هي ال .. هي ال .. هي ال .. هي
+
+155
+00:10:58,980 --> 00:11:00,320
+ال .. هي ال .. هي ال .. هي ال .. هي ال .. هي ال ..
+
+156
+00:11:00,320 --> 00:11:01,800
+هي ال .. هي ال .. هي ال .. هي ال .. هي ال .. هي ال
+
+157
+00:11:01,800 --> 00:11:01,800
+.. هي ال .. هي ال .. هي ال .. هي ال .. هي ال .. هي
+
+158
+00:11:01,800 --> 00:11:01,800
+ال .. هي ال .. هي ال .. هي ال .. هي ال .. هي ال ..
+
+159
+00:11:01,800 --> 00:11:01,800
+هي ال .. هي ال .. هي ال .. هي ال .. هي ال .. هي ال
+
+160
+00:11:01,800 --> 00:11:11,480
+..
+
+161
+00:11:11,480 --> 00:11:14,450
+هي ال .. هيواحد يستخدم disposable lenses لمدة
+
+162
+00:11:14,450 --> 00:11:18,930
+أسبوعية وماساكش أي ديموزيت فبكيف؟
+
+163
+00:11:18,930 --> 00:11:23,690
+ممكن واحد يعني اللي بعمل الcleaning في ال enzymes
+
+164
+00:11:23,690 --> 00:11:26,330
+.. ال .. ال .. ال contact lenses مايشيس ديموزيت
+
+165
+00:11:26,330 --> 00:11:30,630
+يعني الديموزيت هي دليل على الإهمال في النظارة
+
+166
+00:11:30,630 --> 00:11:36,710
+ودليل على طول المدة الزمنية يعني هذا مش .. يعني لو
+
+167
+00:11:36,710 --> 00:11:40,950
+لجين احنا في contact lenses عليها ديموزيت ديموزيتز
+
+168
+00:11:40,950 --> 00:11:46,380
+لازم يحيطيعني معناها أن وضعها محترق، unhealthy
+
+169
+00:11:46,380 --> 00:11:54,820
+يعني، مش healthy شوفوا هنا إيش فيه هنا ال
+
+170
+00:11:54,820 --> 00:12:01,020
+diet
+
+171
+00:12:01,020 --> 00:12:05,180
+وهذه برضه ال macro، شوفين هذه ال diet؟ أكتر من
+
+172
+00:12:05,180 --> 00:12:10,200
+واحد مني، كتر بتاعها، هنا أقل من واحد مني، هنا أقل
+
+173
+00:12:10,200 --> 00:12:17,860
+من واحد منيبس هيك؟ ده هحكي حاجات عن ال treatment ل
+
+174
+00:12:17,860 --> 00:12:21,620
+.. ل drug cavillary-conjunctivitis أول إشي بيحكيلي
+
+175
+00:12:21,620 --> 00:12:25,420
+asymptomatic patient with sign or or they are
+
+176
+00:12:25,420 --> 00:12:28,880
+those with minimal symptoms and sign of a big knot
+
+177
+00:12:28,880 --> 00:12:31,900
+in it و بيستخدموا lens wave بيحكيلي هنا الأشخاص
+
+178
+00:12:31,900 --> 00:12:36,750
+اللي ما .. انهم ..اللي مابيشكم ان واجع في عيونهم
+
+179
+00:12:36,750 --> 00:12:40,510
+او ان انا بشوف عليهم بس ال signs او ان ال signs و
+
+180
+00:12:40,510 --> 00:12:45,450
+ال symptom قليلة هنا مابحتاج ان اعمل discontinue
+
+181
+00:12:45,450 --> 00:12:50,450
+خلّي .. خلّي .. خلّي اللي حصلت لحظة اه discontinue
+
+182
+00:12:50,450 --> 00:12:56,290
+اه اللي هو let's wait يعني خلّي العدسة يعني اقول
+
+183
+00:12:56,290 --> 00:13:04,830
+الكلمة الأعراض خفيفة يعني مجرد شعور بالتعبأو
+
+184
+00:13:04,830 --> 00:13:09,970
+إحمرار بسيط فهو أنا بس أعطيه ماس ال stabilizer
+
+185
+00:13:09,970 --> 00:13:15,730
+أربعة ثانية أعطيه ماس ال stabilizer و هو نفس
+
+186
+00:13:15,730 --> 00:13:23,150
+العنصر يعني إيه ليه؟ يعني الإنسان الذكي بيخليش
+
+187
+00:13:23,150 --> 00:13:29,330
+الأمور توصل بعيد مش بس في العنصر اللي أصبح
+
+188
+00:13:33,020 --> 00:13:37,400
+يعني في واحد في الزيادة الدودية يعني من ساعتين
+
+189
+00:13:37,400 --> 00:13:43,700
+تلاتة مصر في ال right اندوان ال region هناك أسفل
+
+190
+00:13:43,700 --> 00:13:49,400
+البطن على اليمين تحت يحس انه في اشي غلط بسرعة
+
+191
+00:13:49,400 --> 00:13:54,820
+كهاتف emergency سرعة وفي واحد اخر تلات ايام هلاني
+
+192
+00:13:54,820 --> 00:14:03,030
+لما تصل سخونة تصل تقايل و تصل قدم قدر الماشيو بقى
+
+193
+00:14:03,030 --> 00:14:11,290
+يقولوا حاجه مين أحسن؟ مع حدث أن الموضوع التوهم،
+
+194
+00:14:11,290 --> 00:14:14,130
+يعني ان واحد بتوهم مين؟ في واحد بتوهم، بتوسوس
+
+195
+00:14:14,130 --> 00:14:18,610
+يعني، يعني لو صابوا شوية خصية بيقولوا يمكن سرقة،
+
+196
+00:14:18,610 --> 00:14:21,550
+لو صابوا لا أبدا اش توهم، لكن الحقيقة واحد بيلبس
+
+197
+00:14:21,550 --> 00:14:24,730
+contact lens و بقى على أشياء حالية، ولان هذه
+
+198
+00:14:24,730 --> 00:14:25,230
+المانوات موجودة
+
+199
+00:14:35,350 --> 00:14:40,830
+يبدأ الكرمولين في وجود العدسة، النفع الكرمولي مدة
+
+200
+00:14:40,830 --> 00:14:45,050
+أسبوع أو أسبوع أو تلاتة، يبدأ الكرمولين عشان يفعل،
+
+201
+00:14:45,050 --> 00:14:48,750
+اللي ما نفعش، يبدأ يعمل خطوة تانية، خطةبيحكيلي هنا
+
+202
+00:14:48,750 --> 00:14:51,990
+انه انا ما بنفع او انه انا عادي اخلي الاستثناء
+
+203
+00:14:51,990 --> 00:14:55,270
+بالعدسة اذا كان الهياجين عنده ممتازة الحفاظ على
+
+204
+00:14:55,270 --> 00:14:59,190
+صحة العدسة منيحة باستخدام له ال tobacco chromoline
+
+205
+00:14:59,190 --> 00:15:05,130
+2% 2% او 4% تلتيزه مع نفسه للعدسات اللاصقة عشان
+
+206
+00:15:05,130 --> 00:15:08,870
+احافظ عليها طيب ايش خاطر ال chromoline؟ ايش هي
+
+207
+00:15:08,870 --> 00:15:12,330
+بالنظرية؟ ايش هي بتعمل؟ بتحفظ على المرضى بتشيل ال
+
+208
+00:15:12,330 --> 00:15:18,460
+infection اذا؟ لأ لأ مابتشيلش انتبتمنعه و لا
+
+209
+00:15:18,460 --> 00:15:25,240
+بتمنعه و لا ترطيب في
+
+210
+00:15:25,240 --> 00:15:29,800
+البرنامج شرفتها كويس كروماليون بيعمل stabilizer
+
+211
+00:15:29,800 --> 00:15:35,280
+للسلز عشان ترطيبه اي سلز ماصد سلز stabilizers
+
+212
+00:15:35,280 --> 00:15:38,880
+يقولوا يا جماعة ماصد سلز هي bags of histamine
+
+213
+00:15:38,880 --> 00:15:42,820
+والهستامين لو طالع بيعمل severe irritation زي
+
+214
+00:15:42,820 --> 00:15:47,610
+الفلفل والسولين زي الفلفلقالوا إنه أنا بحط ماء
+
+215
+00:15:47,610 --> 00:15:51,710
+السلم لمدة أسبوعين، ثلاثة، شهر، شهرين، إنه بعمل
+
+216
+00:15:51,710 --> 00:15:55,310
+Stabilization لماء السلم، بيخلّيش ال bag هاد يطلع
+
+217
+00:15:55,310 --> 00:16:00,470
+هستامين، بيعمل Thickening للاقياش ال water بتاعي،
+
+218
+00:16:00,470 --> 00:16:04,330
+يعني الواحد حاكي عينه وفيها ماء السلم، ماتنفتش،
+
+219
+00:16:04,330 --> 00:16:08,590
+يكون قوية شوية، فقول إن أنا منعت الهستامين يطلع،
+
+220
+00:16:08,590 --> 00:16:14,520
+منعت الرجنس والسولينجو والإتشينجو وكل اللخ آخريبقى
+
+221
+00:16:14,520 --> 00:16:19,180
+أنا لو إلحقت حالي أو إلحقت المريض اللي باني يشتكي
+
+222
+00:16:19,180 --> 00:16:23,420
+من minimal symptoms في السطر التالي muscle
+
+223
+00:16:23,420 --> 00:16:27,200
+stabilizer بيشتغل شخصيا من أول يوم أقل شيء من
+
+224
+00:16:27,200 --> 00:16:33,020
+أسبوع ما يبدأ يشتغل ال muscle أقلش أسبوع و بيبدأ
+
+225
+00:16:33,020 --> 00:16:36,600
+يزهق أحسن في أسبوعين و أحسن تلت أسبين و أحسن في
+
+226
+00:16:36,600 --> 00:16:41,700
+شهر مش سريع زي الكورتازون كورتازون بعد ساعة بتلاقي
+
+227
+00:16:41,700 --> 00:16:48,250
+بدأ يشتغلبدوا أسابيع إلى ما يستخدمونه طب عالمين
+
+228
+00:16:48,250 --> 00:16:52,050
+يفققوا الله قلت في القرآن وخُلق الإنسان وعجوزه
+
+229
+00:16:52,050 --> 00:16:57,290
+وخُلق الإنسان من عدمه سأريكم آياتي فلا تستعجلونه
+
+230
+00:16:57,290 --> 00:17:03,570
+فلا تستعجلونه يبقى لما أعطي العيان كرومولين أو
+
+231
+00:17:03,570 --> 00:17:07,990
+بتانول هتكلم عن بتانول اللي مش أحدث و أحسن من
+
+232
+00:17:07,990 --> 00:17:14,050
+كرومولين بتانول بس الاستابلازيةأول و أحسن بيبدأوا
+
+233
+00:17:14,050 --> 00:17:17,090
+بيقولوا ان هادوا بدو صبر و بدو اسمه عين ثلاثة لما
+
+234
+00:17:17,090 --> 00:17:22,770
+تلاقي منه خير لكن ما احتفظ بالعدسة في العين انا
+
+235
+00:17:22,770 --> 00:17:25,930
+ماخرجتش لإن في بعض الناس لو شفت العدسة من عينه
+
+236
+00:17:25,930 --> 00:17:32,470
+بصير blind blind يعني مش عينه بتضيع يعني واحد مش
+
+237
+00:17:32,470 --> 00:17:36,490
+في تلاتة ع ستين اربعة ستين و كرته كوروناس و وضعه
+
+238
+00:17:36,490 --> 00:17:41,320
+صعبلا ماعرف ايه العدسة منه بصير ايش يعني
+
+239
+00:17:41,320 --> 00:17:45,940
+deteriorated vision فلا اخضر طب انا اخليه العدسة
+
+240
+00:17:45,940 --> 00:17:49,100
+يعني انا باقي لسان ده و هو اللي بتحرك و هو يسوفي
+
+241
+00:17:49,100 --> 00:17:53,220
+السيارة و يروح على المدرسة و .. و .. و بيعمل عمل
+
+242
+00:17:53,220 --> 00:17:57,260
+يعني انا ساعة ما اقولله انه لازم تعمل
+
+243
+00:17:57,260 --> 00:18:01,000
+discontinuation ال .. ال .. ال way of contactless
+
+244
+00:18:01,000 --> 00:18:04,140
+يعني معناه ايش عملتله انا احجطته في البيت يعني
+
+245
+00:18:04,140 --> 00:18:10,030
+احجطه في البيت اعقلته يعنييعني لو إيدي أشكيلي من
+
+246
+00:18:10,030 --> 00:18:14,790
+أولها، ممكن إني ألحقه، أخيك و أترس في عينه، و
+
+247
+00:18:14,790 --> 00:18:17,930
+أعطيك رومو دي، بس أقوله، دي البالك، هذي بدها، سواء
+
+248
+00:18:17,930 --> 00:18:21,270
+إلى سواء، لما يبدأ يأثر، أصفر شوية، و بعد سواء،
+
+249
+00:18:21,270 --> 00:18:26,270
+بنشوفك، عشان نشوف مدى الراحة بتاعك، أي عامةinitial
+
+250
+00:18:26,270 --> 00:18:30,410
+treatment of a symptomatic patient is a
+
+251
+00:18:30,410 --> 00:18:33,330
+discontinuation of contact lens wear، اذا كان انا
+
+252
+00:18:33,330 --> 00:18:37,590
+عندي اول علاج لاشخاص بيشكم العدسات الناصقة او
+
+253
+00:18:37,590 --> 00:18:39,890
+بيشكم هذا المرض جانا تابل ال congenital hepatitis
+
+254
+00:18:39,890 --> 00:18:44,590
+فانا هعمل قطع لنفس العدسات الناصقةOcular
+
+255
+00:18:44,590 --> 00:18:47,730
+lubricants are helpful during this time period
+
+256
+00:18:47,730 --> 00:18:52,910
+لازم اعطيه مرتبات للعين قطرات مرتبة للعين بتساعد
+
+257
+00:18:52,910 --> 00:18:59,350
+في هذه الفترة Artificial tears, refresh, oatmeal,
+
+258
+00:19:00,130 --> 00:19:11,530
+gin tea, natural tears اللي هو tears naturalISO
+
+259
+00:19:11,530 --> 00:19:19,350
+كده كتير الآن موجودة قطرات كويسة ايه هذا التعامل
+
+260
+00:19:19,350 --> 00:19:26,230
+بتخفف الاحتكاك الاحتكاك
+
+261
+00:19:26,230 --> 00:19:31,570
+هو اللي بيعمل ال papilla يعني كيف احنا مثلا نعرف
+
+262
+00:19:31,570 --> 00:19:38,570
+ان الاحتكاك بيعمل ال papilla الان لو مثلا بيمسك
+
+263
+00:19:38,570 --> 00:19:43,720
+مثلا آلةاللي بتعمل احتكاك كنا زمان لما نمسك مثلا
+
+264
+00:19:43,720 --> 00:19:48,280
+كريب طوية نعمل مثلا عمل يدوي نشيل جرادر نشيل حاجة
+
+265
+00:19:48,280 --> 00:19:52,820
+و احنا صغار ايدي .. ايدي واحد يتبردك اللي بيعمل
+
+266
+00:19:52,820 --> 00:19:56,540
+على مفرط اللحمة هذه اليدوية مفرط الفلازم اليدوية
+
+267
+00:19:56,540 --> 00:20:02,940
+اه حياة كتيرة يعني بقى نحط ريش بلاقي ايدي و قلبك
+
+268
+00:20:02,940 --> 00:20:09,100
+تلقائية تلقائية فإن كان فيه friction في ال eye
+
+269
+00:20:09,100 --> 00:20:14,680
+surfacesبعمل اللي هو ال papilla يبقى كون أنا أعطيه
+
+270
+00:20:14,680 --> 00:20:21,720
+lubricants مزحليقات بين ال eyelids و بين كنيفتيبما
+
+271
+00:20:21,720 --> 00:20:26,920
+مع الكورية أنا مانعت ال friction أي واحد الفائدة
+
+272
+00:20:26,920 --> 00:20:31,160
+التانية أن ال lubricants هي الدموع الصناعية ال ال
+
+273
+00:20:31,160 --> 00:20:36,280
+alertness ال alertness لو دخلت العين يعني نوع من
+
+274
+00:20:36,280 --> 00:20:42,630
+الشطف للعين قصير للعينيعني لو فيه داصل تحت اللعب
+
+275
+00:20:42,630 --> 00:20:45,950
+السلاسل او اذا كانت، لو فيه ديرتي، لو في حاجة، هذه
+
+276
+00:20:45,950 --> 00:20:51,530
+بتسهل على إيش؟ في محاولة، لكن أحيانًا هذه .. هذه
+
+277
+00:20:51,530 --> 00:20:55,970
+لا فيها anti-infection ولا فيها anti-allergy ولا
+
+278
+00:20:55,970 --> 00:20:59,970
+حاجة، أحيانًا تنفع و أحيانًا إشي بيكون أكبر منها،
+
+279
+00:20:59,970 --> 00:21:04,710
+فضليهsymptoms may improve within من اتنين لتلاتة
+
+280
+00:21:04,710 --> 00:21:08,110
+days بيحكيلي ان هاي ال symptoms ممكن تزيد في خلال
+
+281
+00:21:08,110 --> 00:21:12,870
+من تلت .. تتحسن من يومين لتلت أيام but lens should
+
+282
+00:21:12,870 --> 00:21:17,450
+not be resumed until about one week بس مش لازم انا
+
+283
+00:21:17,450 --> 00:21:21,510
+استقنف لبس العدسات اللاصقة قبل الاسبوع after all
+
+284
+00:21:21,510 --> 00:21:24,310
+the mucus, redness, irritation are gone مش لازم
+
+285
+00:21:24,310 --> 00:21:27,710
+ارجع ألبس العدسات إلا لما ال redness و ال mucus و
+
+286
+00:21:27,710 --> 00:21:31,510
+ال irritation يكون راح من عندكعشان مايعيشوش كمان
+
+287
+00:21:31,510 --> 00:21:33,990
+مرضى؟ يعني ان انا مرضى يعني ان انا مرضى يعني ان
+
+288
+00:21:33,990 --> 00:21:35,470
+انا مرضى يعني ان انا مرضى يعني ان انا مرضى يعني ان
+
+289
+00:21:35,470 --> 00:21:42,870
+انا مرضى يعني ان انا مرضى يعني
+
+290
+00:21:42,870 --> 00:21:46,390
+ان انا مرضى
+
+291
+00:21:48,600 --> 00:21:51,900
+Papilla may last longer but contact lens can be
+
+292
+00:21:51,900 --> 00:21:54,700
+resumed if there is no fluorescein staining.إذا
+
+293
+00:21:54,700 --> 00:21:57,360
+أنا اتفحصت المريض بعد العلاجات وما كان عندي
+
+294
+00:21:57,360 --> 00:22:00,580
+fluorescein staining ممكن ألبس العدسات اللاصقة بس
+
+295
+00:22:00,580 --> 00:22:03,780
+بيكونها أن ال papilla ممكن تكون موجودة كمان أه بس
+
+296
+00:22:03,780 --> 00:22:08,280
+ال staining ليه؟ للكوريا و لل papilla
+
+297
+00:22:22,980 --> 00:22:27,300
+Staining ال .. ال .. ال macro papillary أو الجناد
+
+298
+00:22:27,300 --> 00:22:30,520
+ال papillary و لا فيه staining للكورية Epithelium
+
+299
+00:22:30,520 --> 00:22:35,400
+في بعض الدرجة اللي عايزة ألحظه لكن لو فيه staining
+
+300
+00:22:35,400 --> 00:22:43,260
+لأنه لسه لازم يقولوا إيه إيش اللي كان موجود أو ال
+
+301
+00:22:43,260 --> 00:22:47,640
+.. ال .. ال .. ال necrosis اللي صار في ال
+
+302
+00:22:47,640 --> 00:22:51,490
+papillary موجودأو الـ Cortex موضوعي، ماخدش لعنصر
+
+303
+00:22:51,490 --> 00:22:52,790
+لعزفك على الألم، لو لعنصر لعزفك على التايمة،
+
+304
+00:22:52,790 --> 00:22:58,070
+افتكارك، هزيد الألم و هزيد الـSymptoms، تفضلي
+
+305
+00:23:00,390 --> 00:23:03,070
+typical corticosteroids are usually not required
+
+306
+00:23:03,070 --> 00:23:05,930
+if lens wear is stopped but may be helpful in more
+
+307
+00:23:05,930 --> 00:23:07,950
+severe cases بيحكي إن أنا ممكن أستخدم ال
+
+308
+00:23:07,950 --> 00:23:11,330
+corticosteroids في الحالات الصعبة، ال severe cases
+
+309
+00:23:11,330 --> 00:23:16,710
+بس مش مهمة كتير إذا كان العدسة يعني توقف لبسها
+
+310
+00:23:16,710 --> 00:23:22,390
+ممتاز، يعني هو استيرويدز، مفكبات كورتيزيون، سلاح
+
+311
+00:23:22,390 --> 00:23:27,910
+دو حتين، لازم نكون نعرف إنه سلاح دو حتين، لذلك أنا
+
+312
+00:23:27,910 --> 00:23:33,730
+لا أغامرباستخدام ال Corticosteroids إلا إن شعب إنه
+
+313
+00:23:33,730 --> 00:23:38,890
+فيه خطر عليه يعني مثلا واحد أعمل عاملة دراحية من
+
+314
+00:23:38,890 --> 00:23:44,230
+الكتراب أو جلوكومة أو حتى الإتلانديتاش لازم يعطيه
+
+315
+00:23:44,230 --> 00:23:49,130
+كورتيزون لأنه لو ماعطيتش كورتيزون كل أمور تفلت مني
+
+316
+00:23:49,130 --> 00:23:55,450
+ال inflammation زي واحد مع سيبيرقالات و بابيلي مش
+
+317
+00:23:55,450 --> 00:23:57,050
+لازم يفتحني لازم يعطيه كورتيزون
+
+318
+00:24:01,490 --> 00:24:07,050
+في أجهاد بابيلي لازم انا اعطيه كورتزون وقتها بنوضه
+
+319
+00:24:07,050 --> 00:24:11,990
+في حد بدأ يتحسن بجلل الكورتزون اتحسن كويس بشيل
+
+320
+00:24:11,990 --> 00:24:15,390
+الكورتزون وبيفضل على ال master cell stabilizer بل
+
+321
+00:24:15,390 --> 00:24:18,510
+ان ال master cell stabilizer المفضل انه من اول هو
+
+322
+00:24:18,510 --> 00:24:23,730
+الموجود و الكورتزون يدخل بقوة و يطلع و يفضل ال
+
+323
+00:24:23,730 --> 00:24:26,950
+master cell stabilizer موجود يعني موجود .. حتى
+
+324
+00:24:26,950 --> 00:24:30,650
+موجود ال contact lens في مبعد يعني ممكن انا خطل
+
+325
+00:24:33,740 --> 00:24:37,320
+عشان احطوا six شهور احطوا سنة في عدل عيال وماخافش
+
+326
+00:24:37,320 --> 00:24:41,040
+safe يعني safe ماروش يعني انا on a side that fixed
+
+327
+00:24:41,040 --> 00:24:45,420
+كتير كويس بس ال cortisol برجعش يعطيك اكتر من
+
+328
+00:24:45,420 --> 00:24:49,280
+أسبوعين او تلاتة ال cortisol اللي بحطه لغاية ماشية
+
+329
+00:24:49,280 --> 00:24:52,180
+ال redness و القديمة و الفهم و الاشي هذا
+
+330
+00:24:55,060 --> 00:25:00,420
+فترة مرتين سبوع سبوع فانت بشيله وبخلي الكرمولين او
+
+331
+00:25:00,420 --> 00:25:04,880
+البتانول اخليه لفترة اكتر و اكتر و اكتر حتى العيان
+
+332
+00:25:04,880 --> 00:25:07,780
+يبتدي تعايش مع العنصر الأثقال وهي في عينه حتى وانا
+
+333
+00:25:07,780 --> 00:25:12,640
+احطه must cell stabilizer واضح؟ يبقى انتوا بتاخدوا
+
+334
+00:25:12,640 --> 00:25:17,060
+فكرة الآن ان كثير من الناس اللي بستعملوا العنصر
+
+335
+00:25:17,060 --> 00:25:21,900
+الأثقال ماعندهم مش هذا العلم دوركوا انتوا تكونوا
+
+336
+00:25:21,900 --> 00:25:26,690
+انتوا تروحوا السلامالذين يريدون إستعمال عدسة لاصقة
+
+337
+00:25:26,690 --> 00:25:32,290
+يريدون أن يعرفون ما هي الـhealth بتاع عدسة اللاصقة
+
+338
+00:25:32,290 --> 00:25:35,830
+وكيف نظفت عدسة اللاصقة وما هي ال complications
+
+339
+00:25:35,830 --> 00:25:38,810
+التي تمناها عدسة اللاصقة تعمل مشاكل كثيرة وانتوا
+
+340
+00:25:38,810 --> 00:25:41,850
+في سنة رابعة لان أخدت عدسة اللاصقة مافيه الكفاية
+
+341
+00:25:41,850 --> 00:25:46,330
+بس احنا في الفرقة الكلية ميتأكد على ذلك يعني احنا
+
+342
+00:25:46,330 --> 00:25:51,330
+مش درس ندرس عدسة اللاصقة بس درس كيف نعالج بالانوية
+
+343
+00:25:52,280 --> 00:25:55,000
+الـ complications اللي عمتها لسه تسقى في العيش
+
+344
+00:25:55,000 --> 00:25:57,020
+وملاحظين احنا لسه ما جيبناش ال infection يعني
+
+345
+00:25:57,020 --> 00:25:59,880
+ماتكلملاش إنها بدها antibiotics وكده طبعا لو في
+
+346
+00:25:59,880 --> 00:26:03,420
+infection بدها antibiotics ده شك يعني تفضلي الخطوة
+
+347
+00:26:03,420 --> 00:26:06,020
+السابعة على علاج ضرن استيرويد ال anti-inflammatory
+
+348
+00:26:06,020 --> 00:26:10,340
+agent supraphine used specially has also been
+
+349
+00:26:10,340 --> 00:26:13,880
+shown to be affected by N-germ N-germ capillary
+
+350
+00:26:13,880 --> 00:26:17,260
+congenitivitis هعطي أنا ال anti-inflammatory اللي
+
+351
+00:26:17,260 --> 00:26:21,090
+هو ال supraphineأه بس هذا الناس انفلماتوري مش
+
+352
+00:26:21,090 --> 00:26:27,930
+كورتيزون ال كورتيزون هرمونال انتي انفلماتوري هذا
+
+353
+00:26:27,930 --> 00:26:32,770
+اللي هنا ناستردام يعني non-hormonal مش هرموني
+
+354
+00:26:32,770 --> 00:26:38,480
+العلاج الهرموني هو لإله المشاكل على الصحةأنا بضطر
+
+355
+00:26:38,480 --> 00:26:44,780
+ان اعطيه لفترة محددة و بلبسها لكن السوبروفين و
+
+356
+00:26:44,780 --> 00:26:49,960
+الولترين و الايزوفين و .. و .. و .. هذه اللي هو
+
+357
+00:26:49,960 --> 00:26:54,440
+أخدوها من الأقراس اللي بتعمل Anti-inflammation في
+
+358
+00:26:54,440 --> 00:26:59,540
+العضلات أو في المفاصلةالطفل بتاكل ذيكلوفين لأن في
+
+359
+00:26:59,540 --> 00:27:03,660
+ذيكلوفين ايدروس والسوبرفين هو قريب من زي تروفين
+
+360
+00:27:03,660 --> 00:27:07,440
+الطفل بتاكل تروفين و ايزوفين بتاكل الصدارة بتاكل
+
+361
+00:27:07,440 --> 00:27:10,600
+الألم وشيء ايزوفين و تروفين هي هي ايزوفين و تروفين
+
+362
+00:27:10,600 --> 00:27:15,920
+في منها قطرة فهذه القطرة صح مش سحرية زي الكورتازون
+
+363
+00:27:15,920 --> 00:27:22,210
+لكن بتهمن ال inflammation وعملها كويسة يعني اهwhen
+
+364
+00:27:22,210 --> 00:27:25,470
+contact lenses are zoomed proper lens هيجين must
+
+365
+00:27:25,470 --> 00:27:28,850
+be stressed لما أنا أستخدم ال clips اللي عدي ساعة
+
+366
+00:27:28,850 --> 00:27:32,190
+اللاصقة لازم يكون عندي حفاظ على ال هيجين lens
+
+367
+00:27:38,360 --> 00:27:41,960
+This is especially important because as a group
+
+368
+00:27:41,960 --> 00:27:44,880
+contact lens wearers with germs papillary
+
+369
+00:27:44,880 --> 00:27:48,300
+congestive arthritis are neglectful with lens care
+
+370
+00:27:48,300 --> 00:27:51,080
+بيحكي إن أنا لازم أحافظ على صحة العدسات اللاصقة
+
+371
+00:27:51,080 --> 00:27:53,180
+لأن معظم اللي بيصير عندهم germ papillary
+
+372
+00:27:53,180 --> 00:27:55,600
+congestive arthritis كانوا مهملين في الحفاظ على
+
+373
+00:27:55,600 --> 00:27:59,040
+نظافة العدسات Hydrogen peroxide cleaning system
+
+374
+00:27:59,040 --> 00:28:04,020
+preferably non-perceived and non-perceived saline
+
+375
+00:28:04,260 --> 00:28:06,700
+are best for patients with giant papillary
+
+376
+00:28:06,700 --> 00:28:10,340
+congenitivitis عشان أحافظ على صحة العدسات باستخدام
+
+377
+00:28:10,340 --> 00:28:13,440
+ال hydrogen peroxide وال saline solution حتى أراضي
+
+378
+00:28:13,440 --> 00:28:17,840
+الأرض ممتازة ممتازة ال cold disinfection system
+
+379
+00:28:17,840 --> 00:28:20,220
+increase the possibility of exposure to
+
+380
+00:28:20,220 --> 00:28:25,780
+sensitizing agent and should be avoided بيحكيلي
+
+381
+00:28:25,780 --> 00:28:29,820
+هنا تطهير بيارة العدسات لازم أجنبه لأنه بيعمل
+
+382
+00:28:29,820 --> 00:28:33,230
+زيادة في حساسية ال agent في العينالـ enzymatic
+
+383
+00:28:33,230 --> 00:28:36,410
+cleaning particularly في pain enzyme is superior
+
+384
+00:28:36,410 --> 00:28:39,150
+to superfective .. to superfective سيرفاكتن
+
+385
+00:28:39,150 --> 00:28:42,290
+سيرفاكتن تكلين .. زي سيرفاكتن تلاقي الشياطين
+
+386
+00:28:42,290 --> 00:28:45,290
+السطحية زي الهالويجبالوكسايد و احنا خارجنا من
+
+387
+00:28:45,290 --> 00:28:47,750
+الهالويجبالوكسايد افضل من الهالويجبالوكسايد اقل من
+
+388
+00:28:47,750 --> 00:28:51,910
+ال saline ليه ايش لأنه فعالة على سطح العدسة بس
+
+389
+00:28:51,910 --> 00:28:55,310
+احنا ماقدرش نحط العدسة كلها في ال enzyme بنحطها
+
+390
+00:28:55,310 --> 00:28:58,090
+إيصويًا في ال enzyme و في الأيام في ال helioxybin
+
+391
+00:28:59,610 --> 00:29:02,690
+بين أي مدن بالإكسيد، فاحنا بنعمل جمعنا بين
+
+392
+00:29:02,690 --> 00:29:07,350
+المصنعين ال .. ال .. ال .. ال daily .. ال daily
+
+393
+00:29:07,350 --> 00:29:12,950
+cleaning بالعمل بالإكسيد، و ال .. و ال weekly ..
+
+394
+00:29:12,950 --> 00:29:13,850
+weekly cleaning
+
+395
+00:29:17,460 --> 00:29:24,080
+إذا كان هناك
+
+396
+00:29:24,080 --> 00:29:29,620
+مراجعية
+
+397
+00:29:29,620 --> 00:29:34,800
+لرجال يقولوا لك ان انا لازم اعمل قطع للبس عدسات
+
+398
+00:29:34,800 --> 00:29:38,900
+اللاسحة من شهر و الأفضل اللي يكون 3 أشهر مرة مرة
+
+399
+00:29:38,900 --> 00:29:42,960
+مرة مرة
+
+400
+00:29:42,960 --> 00:29:43,180
+مرة مرة مرة مرة مرة مرة مرة مرة مرة مرة مرة مرة
+
+401
+00:29:43,180 --> 00:29:43,180
+مرة مرة مرة مرة مرة مرة مرة مرة مرة مرة مرة مرة
+
+402
+00:29:43,180 --> 00:29:43,180
+مرة مرة مرة مرة مرة مرة مرة مرة مرة مرة مرة مرة
+
+403
+00:29:43,180 --> 00:29:43,180
+مرة مرة مرة مرة مرة مرة مرة مرة مرة مرة مرة مرة
+
+404
+00:29:43,180 --> 00:29:43,180
+مرة مرة مرة مرة مرة مرة مرة مرة مرة مرة مرة مرة
+
+405
+00:29:43,180 --> 00:29:43,240
+مرة مرة مرة مرة مرة مرة مرة مرة مرة مرة مرة مرة
+
+406
+00:29:43,240 --> 00:29:45,530
+مرة مرة مرة مرة مرة مرةall the patient can switch
+
+407
+00:29:45,530 --> 00:29:50,270
+to gas permeable semi rigid lenses انا بيحكيلي هنا
+
+408
+00:29:50,270 --> 00:29:54,470
+انه اختلاف ال polymer او مركبة عباسات اللاصقة ممكن
+
+409
+00:29:54,470 --> 00:29:59,170
+انا اجربها لأ هتكون مطيبة لل patient فانا باستخدم
+
+410
+00:29:59,170 --> 00:30:02,350
+ال gas permeable semi rigid lens اللي هي ال semi
+
+411
+00:30:02,350 --> 00:30:05,470
+rigid اللي بتعمل نفاذية للغازات في العالم شكرا يا
+
+412
+00:30:05,470 --> 00:30:09,990
+عزيزي طيب ليشإنه من فترة تلات شهور لا يستيقظ عن
+
+413
+00:30:09,990 --> 00:30:14,810
+سرسخة حتى تلات شهور، إذا كان صار recurrence لل
+
+414
+00:30:14,810 --> 00:30:18,890
+symptoms كان
+
+415
+00:30:18,890 --> 00:30:23,410
+إحنا الآن مرضى، وشيلنا ال .. ال .. ال .. ال lens
+
+416
+00:30:23,410 --> 00:30:28,610
+لما بطل يصير ال second أسبوعين أو تلاتة، عملناه
+
+417
+00:30:28,610 --> 00:30:29,970
+ورجعناه لوراسة اللصحة
+
+418
+00:30:37,620 --> 00:30:43,960
+لو انا يعني اجريشي انا هعمل شهر و احسن تلات شغل
+
+419
+00:30:43,960 --> 00:30:56,220
+لان الوضع بخوف because رجول المرض دليل على انه صار
+
+420
+00:30:56,220 --> 00:31:01,460
+أفضل لذلك
+
+421
+00:31:01,460 --> 00:31:05,830
+هو كل في الحالة هذهإني أقل شيء بدي أترك العدسة
+
+422
+00:31:05,830 --> 00:31:11,610
+الاسكاملية هذا مدة شهر و الأطلع تلت شهور، لأن صحة
+
+423
+00:31:11,610 --> 00:31:14,810
+العين أهم العدسة الاسكاملية، تلابس نضارة أو يلبس
+
+424
+00:31:14,810 --> 00:31:20,430
+أي شيء بنيه، لكن هنا في اتناشر أسوان لجأت كلام
+
+425
+00:31:20,430 --> 00:31:24,970
+جديدقال إن بتغير إيش؟ هغير ال polymers اللي
+
+426
+00:31:24,970 --> 00:31:28,790
+أستخدمه لل .. ال polymers يعني المادة المفتوحة
+
+427
+00:31:28,790 --> 00:31:31,370
+نعملها .. المادة المفتوحة من العدس هغيرها فالمادة
+
+428
+00:31:31,370 --> 00:31:35,070
+تجلب أنه إيه احتمال تكون عامله إيش؟ هقلق .. هقلق
+
+429
+00:31:35,070 --> 00:31:36,030
+.. هقلق .. هقلق .. هقلق .. هقلق .. هقلق .. هقلق ..
+
+430
+00:31:36,030 --> 00:31:36,450
+هقلق .. هقلق .. هقلق .. هقلق .. هقلق .. هقلق ..
+
+431
+00:31:36,450 --> 00:31:37,250
+هقلق .. هقلق .. هقلق .. هقلق .. هقلق .. هقلق ..
+
+432
+00:31:37,250 --> 00:31:47,350
+هقلق .. هقلق .. هقلق .. هقلق .. هقلق .. هقلق
+
+433
+00:31:47,350 --> 00:32:03,570
+.. هقلق .. هقلالعين بالعين بالعين بالعين
+
+434
+00:32:03,570 --> 00:32:12,750
+بالعين
+
+435
+00:32:12,750 --> 00:32:16,470
+بالعين بالعين بالعين بالعين بالعين بالعين بالعين
+
+436
+00:32:16,470 --> 00:32:16,970
+بالعين بالعين بالعين بالعين بالعين بالعين بالعين
+
+437
+00:32:16,970 --> 00:32:16,970
+بالعين بالعين بالعين بالعين بالعين بالعين بالعين
+
+438
+00:32:16,970 --> 00:32:16,970
+بالعين بالعين بالعين بالعين بالعين بالعين بالعين
+
+439
+00:32:16,970 --> 00:32:20,550
+بالعين بالعين بالعين بالعين بالعين بالعين بالعين
+
+440
+00:32:23,190 --> 00:32:28,110
+أخليه من غير حالة ولا إنه يفضل عينه ميتة، صحيح؟
+
+441
+00:32:28,110 --> 00:32:32,090
+صحيح رقم 13 بيحكي إنه أنا ممكن أستفيد من ال
+
+442
+00:32:32,090 --> 00:32:38,290
+tropical chromoline 2% أو 4% أربع مرات يوميا، عشان
+
+443
+00:32:38,290 --> 00:32:43,930
+أمنع ال recurance اللي ممكن يصير للعدسات اللاصقة،
+
+444
+00:32:43,930 --> 00:32:50,110
+لل symptoms بالعدسات اللاصقة وده مفتوحة، ممكن طول
+
+445
+00:32:50,110 --> 00:32:50,430
+العام
+
+446
+00:32:54,170 --> 00:32:59,510
+اللي كان انه نحس ان ال muscle ال stabilizers جابت
+
+447
+00:32:59,510 --> 00:33:07,690
+نتيجة و خلت العين under control ممكن نخليها طبعا
+
+448
+00:33:07,690 --> 00:33:10,930
+حسب استعمالها الاساس و في واحد استعملها ساعة في
+
+449
+00:33:10,930 --> 00:33:14,570
+الأسبوع و واحد دي بيستعملها سبع ساعات في اليوم كل
+
+450
+00:33:14,570 --> 00:33:17,850
+ما استعملها أكتر كل ما المشكلة كانت أكبر المشكلة
+
+451
+00:33:17,850 --> 00:33:19,950
+كانت ان هنا في friction و في كلام ذلك
+
+452
+00:33:23,330 --> 00:33:25,950
+ان شاء الله هنكمل في chapter جديد اللي هو
+
+453
+00:33:25,950 --> 00:33:29,410
+pharmacology of ocular beta receptors antagonist
+
+454
+00:33:29,410 --> 00:33:34,190
+يعني انه انا اعالج أجزاء بالعين في ان اعمل block ل
+
+455
+00:33:34,190 --> 00:33:38,970
+ال beta receptors هي دي مستقبلات عصبية موجودة في
+
+456
+00:33:38,970 --> 00:33:43,830
+العينفى العين و فى الجسم؟ فى الجسم فى سيستيماكه فى
+
+457
+00:33:43,830 --> 00:33:47,190
+اوكيونات فحندخل فى اوكيونات the introduction of
+
+458
+00:33:47,190 --> 00:33:49,810
+the beta adrenoceptors antagonus completely
+
+459
+00:33:49,810 --> 00:33:53,590
+changed the drug's preference in the glucoma drug
+
+460
+00:33:53,590 --> 00:33:56,150
+therapy يعني هنا فى العين بشكل أساس اللى احنا
+
+461
+00:33:56,150 --> 00:33:59,710
+بنستخدمها لجلوكوما therapy لعلاش الجلوكومازي ما
+
+462
+00:33:59,710 --> 00:34:01,970
+احنا عارفين في التيمولول احنا مشهورين جدا، يعني
+
+463
+00:34:01,970 --> 00:34:05,130
+العلاج للجلوكامة هو واحد من ال beta blockers هذه،
+
+464
+00:34:05,130 --> 00:34:09,130
+فإنها بتعمل block لل .. ال adrenoreceptors اللي هو
+
+465
+00:34:09,130 --> 00:34:11,990
+من نوع B، احنا في عنا alpha blockers، في beta
+
+466
+00:34:11,990 --> 00:34:15,730
+blockers، هذا المسئول هنا اللي هو نوع B، إنه نعمل
+
+467
+00:34:15,730 --> 00:34:20,130
+block لل receptors هنا لعلاج الجلوكامةThe size for
+
+468
+00:34:20,130 --> 00:34:22,690
+receptors interaction of these drugs are suggested
+
+469
+00:34:22,690 --> 00:34:26,530
+to be beta-adrogenic receptors in the iris and
+
+470
+00:34:26,530 --> 00:34:29,490
+ciliary body بحكيها عن مواقع الريسبتورز في العيال
+
+471
+00:34:29,490 --> 00:34:32,070
+لل beta blockers موجودة في العيارس وفي الcellary
+
+472
+00:34:32,070 --> 00:34:36,850
+bodythe pharmacologic properties of these drugs
+
+473
+00:34:36,850 --> 00:34:39,890
+are referred to a beta hydro receptors antagonist
+
+474
+00:34:39,890 --> 00:34:43,770
+these drugs are called beta blockers بحكي انه
+
+475
+00:34:43,770 --> 00:34:47,650
+مشهورة بالاسم الدائلها اللي هي ال beta blockers
+
+476
+00:34:47,650 --> 00:34:52,610
+بتسمى كلمة beta blockers يعني أدي غلوكومة احنا هنا
+
+477
+00:34:52,610 --> 00:34:56,870
+في الoptometry ايش موقع للغلوكومة في الoptometry
+
+478
+00:34:56,870 --> 00:35:02,030
+top to bottom يعني الoptometry موضوع
+
+479
+00:35:10,740 --> 00:35:16,860
+عندي أقلأ او hypertension فى خطر على الكوميا عندي
+
+480
+00:35:16,860 --> 00:35:24,500
+أقلأ او hypertension عندي خطر على وقت الناس أقلأ
+
+481
+00:35:24,500 --> 00:35:27,660
+او hypertension او كوميا عندي خطر على الفجر على
+
+482
+00:35:27,660 --> 00:35:33,340
+الفجر على الفجر والفيل يعني الوضع حقوقته متوسط
+
+483
+00:35:33,340 --> 00:35:40,710
+يعني هل معقول انهالخريج ال اكتومتري يكون خالد ذهن
+
+484
+00:35:40,710 --> 00:35:45,030
+عن حاجة اسم انغروكومة؟ خالد ذهن عن حاجة اسم
+
+485
+00:35:45,030 --> 00:35:49,390
+Cochlear hypertension؟ لأ مانفعش إلا سكنوتركنيشن
+
+486
+00:36:00,570 --> 00:36:04,350
+الـ visual field بيفهم loss of vision بيفهم
+
+487
+00:36:04,350 --> 00:36:08,150
+effects on optic nerve و حاجات
+
+488
+00:36:12,200 --> 00:36:14,860
+The focus of the majority of the studies have been
+
+489
+00:36:14,860 --> 00:36:17,300
+on increased fluid dynamics and intraocular
+
+490
+00:36:17,300 --> 00:36:24,620
+pressure, but other functions of the eye have also
+
+491
+00:36:24,620 --> 00:36:28,300
+been explored، هم بيحكوا أن أغلب الدراسات ركزت على
+
+492
+00:36:28,300 --> 00:36:34,000
+حركة السائل وعلى ارتفاع الضغط، ومحكينا أن ال beta
+
+493
+00:36:34,000 --> 00:36:36,600
+-blockers هم بتشتغل زي medical treatment لل high
+
+494
+00:36:36,600 --> 00:36:38,520
+intraocular pressure، بشكل أساسي
+
+495
+00:36:41,160 --> 00:36:46,640
+اللي هو ال circulation او aqueous circulation
+
+496
+00:36:46,640 --> 00:36:51,620
+بيطلع من وين أساساً؟ من ال helium أو الcellular
+
+497
+00:36:51,620 --> 00:36:57,700
+body، من ورا وبعدين بيبقى لي hostilior chamber و
+
+498
+00:36:57,700 --> 00:37:03,140
+بعدين بيطلع من ال pubic و بيملأ ال anterior
+
+499
+00:37:03,140 --> 00:37:08,020
+chamber طبعا هو بيغذي ال zonules، بيغذي ال lens
+
+500
+00:37:13,730 --> 00:37:17,170
+Avascular organs of the eye وبعدين بيطلع من ال ..
+
+501
+00:37:17,170 --> 00:37:20,950
+Trabecular مشوار على stress كانال وبيطلع بكرة
+
+502
+00:37:20,950 --> 00:37:25,610
+وبيتي غيره وبيتي غيره فهي ال circulation القالي
+
+503
+00:37:25,610 --> 00:37:30,830
+Glucoma عبارة عن error في ال circulation Glucoma
+
+504
+00:37:30,830 --> 00:37:33,670
+error في ال circulation يعني احنا في الناس اللي
+
+505
+00:37:33,670 --> 00:37:38,070
+أصدرها الحمد لله ال grow الحمد لله زينا انه ال
+
+506
+00:37:38,070 --> 00:37:38,650
+income
+
+507
+00:37:41,250 --> 00:37:44,930
+خلات يوزن، يعني اللي .. اللي .. اللي منتج جديد
+
+508
+00:37:44,930 --> 00:37:49,130
+تساوي اللي بيطلع لبرنامج، فيه balance يعني، ال
+
+509
+00:37:49,130 --> 00:37:53,490
+income و ال outcome بيساوي بعض، الآن المشكلة اللي
+
+510
+00:37:53,490 --> 00:38:00,910
+بتصير انه بيصير في النقومة في invest، بيصير ال
+
+511
+00:38:00,910 --> 00:38:05,190
+income زيادة عن ال outcomeالمنتج أكتر من اللي
+
+512
+00:38:05,190 --> 00:38:07,970
+بيطلع، يعني اللي بيطلع فيه مشكلة في Tropical
+
+513
+00:38:07,970 --> 00:38:11,350
+Meshwork هو بالفعل بارتفاع ضغط العين، ارتفاع ضغط
+
+514
+00:38:11,350 --> 00:38:17,650
+العين يؤدي إلى ضمور في عليا في العصب البشري، ويؤدي
+
+515
+00:38:17,650 --> 00:38:21,070
+إلى loss of visual field، وبعدين في مشاكل تانية
+
+516
+00:38:21,070 --> 00:38:26,250
+بتيجي بتلقى، بس يعني الglucoma يعني مشكلتها إن ال
+
+517
+00:38:26,250 --> 00:38:32,170
+dynamics بتاعة ال fluids فيها error معينهو ممكن
+
+518
+00:38:32,170 --> 00:38:36,130
+يكون زيادة في إنتاج السائل أو مشكلة في التصريف
+
+519
+00:38:36,130 --> 00:38:40,350
+نفسي و هذا بسبب زيادة الضغط اللي جوه اللي عندك.
+
+520
+00:38:40,450 --> 00:38:42,870
+Unlike bilocarbine, the drugs of the glaucoma
+
+521
+00:38:42,870 --> 00:38:46,070
+treatment for the last 100 years, people who can't
+
+522
+00:38:46,070 --> 00:38:49,110
+generally don't contract the pupil and thus don't
+
+523
+00:38:49,110 --> 00:38:52,240
+interfere with visioneven the patients with
+
+524
+00:38:52,240 --> 00:38:55,020
+central lens opacities هنا بحكي أنه ال beta
+
+525
+00:38:55,020 --> 00:38:57,680
+blockers مميزاتها عن البيولوكربين احنا حكينا
+
+526
+00:38:57,680 --> 00:39:00,820
+البيولوكربين من ال indications لها انها بتوقف ..
+
+527
+00:39:00,820 --> 00:39:06,260
+انها بتعمل او بتعالج ال closure anguish locoma بس
+
+528
+00:39:06,260 --> 00:39:08,680
+.. بس لها بتأثر على ال pupil فانها بتعمل meiosis
+
+529
+00:39:08,680 --> 00:39:11,700
+لكن هذا ال beta blockers بدون ما يؤثر على ال ..
+
+530
+00:39:11,700 --> 00:39:14,120
+مابتفعلش مع ال pupil أو بدون ما يؤثر على ال pupil
+
+531
+00:39:14,120 --> 00:39:20,060
+طيب حتى لو في lens opacities حتى لو في .. اه بأثرش
+
+532
+00:39:20,060 --> 00:39:29,620
+النقربنعمل ping-holing لو فيه في ال .. في الناس اي
+
+533
+00:39:29,620 --> 00:39:30,040
+روم الكتابة
+
+534
+00:39:37,310 --> 00:39:41,550
+الـ size عادي وبالتالي هو ماشوفش من حتة مش هو من
+
+535
+00:39:41,550 --> 00:39:45,530
+التانية مش هو من ال .. ال .. ال .. ال .. ال .. ال
+
+536
+00:39:45,530 --> 00:39:48,710
+.. المناطق اللي في الناس transparent لسه مش ال
+
+537
+00:39:48,710 --> 00:39:52,750
+opaque لكن لو ال viral carbon ماعمل pain هون وإيجا
+
+538
+00:39:52,750 --> 00:39:58,230
+ال center حتة opaque بصير أعمىكمان حاجة ان ال bio
+
+539
+00:39:58,230 --> 00:40:01,450
+-carbine بتكون contra-indication للناس اللي عندهم
+
+540
+00:40:01,450 --> 00:40:03,910
+اسباز من الcellar muscle اللي هتعملهم artificial
+
+541
+00:40:03,910 --> 00:40:07,710
+myopia لكن هنا ال beta-blockers الميزة التانية انه
+
+542
+00:40:07,710 --> 00:40:10,410
+بيسببش اي اسباز من الcellar muscle اللي ممكن
+
+543
+00:40:10,410 --> 00:40:13,470
+تعملني transient myopia اللي هي pseudo-myopia او
+
+544
+00:40:13,470 --> 00:40:16,770
+انه تعطيل ال accumulation اه بزيد ال accumulation،
+
+545
+00:40:16,770 --> 00:40:20,890
+ال bio-carbine بيد ال accumulationو لما دي ال
+
+546
+00:40:20,890 --> 00:40:23,770
+accommodation بيعمل solo myopia، لأ ال .. ال .. ال
+
+547
+00:40:23,770 --> 00:40:26,110
+.. البيت عابله كرز و بتعملش الاشياء، و الشيء
+
+548
+00:40:26,110 --> 00:40:29,990
+التالت اللي هو ال visual field، لما يكون ال .. ال
+
+549
+00:40:29,990 --> 00:40:31,050
+.. ال people contracted
+
+550
+00:40:58,130 --> 00:41:02,390
+البروبرانول البروبرانول البروبرانول البروبرانول
+
+551
+00:41:02,800 --> 00:41:06,060
+Propranolol is the prototypes, ideal example of
+
+552
+00:41:06,060 --> 00:41:10,140
+drugs that can antagonize beta adrenoceptors يعني
+
+553
+00:41:10,140 --> 00:41:14,300
+هنا بتكلمك أن المثال أو النموذج من الأمثلة يعني ال
+
+554
+00:41:14,300 --> 00:41:17,560
+beta blockers الشائعة اللي هو اسمه ال Propranolol
+
+555
+00:41:17,560 --> 00:41:26,160
+هذا أول beta blockers اكتشفوه، الآن لا يستخدم زي
+
+556
+00:41:26,160 --> 00:41:30,440
+ال penicillin و ال protein اللي زمان مستكشفوه، له
+
+557
+00:41:30,440 --> 00:41:34,540
+قيمة تاريخيةالان هاي ال risk في التاريخية اللي
+
+558
+00:41:34,540 --> 00:41:41,400
+بيقوله مثلا timolol مثلا يقاس كم مرة أقوى من ال
+
+559
+00:41:41,400 --> 00:41:46,560
+pronolol مثلا القطعة هذه خمس شكل فيها خمس مرات
+
+560
+00:41:46,560 --> 00:41:51,040
+أكتر من الشكل القطعة هذه عشرة شكل عشر مرات أقوى من
+
+561
+00:41:51,040 --> 00:41:53,860
+الشكل عشرين شكل عشرين مرات أقوى من الشكل
+
+562
+00:42:00,420 --> 00:42:04,040
+ليه الاشي اللي اجت جديد بعد هي في مجال ال beta
+
+563
+00:42:04,040 --> 00:42:12,000
+blockers بحكي
+
+564
+00:42:12,000 --> 00:42:15,680
+ان هنا التفاعل مع ال beta blockers مع المستقبلات
+
+565
+00:42:15,680 --> 00:42:21,560
+اشي يعني محافظ او اشي منافس يعني منافس يعني هم
+
+566
+00:42:21,560 --> 00:42:30,040
+الدول اللي انا بقطه بنافس مواد داخل الجسمبتملة هذه
+
+567
+00:42:30,040 --> 00:42:35,620
+هي ال receptors يعني كائن بسيط يعني الممر ضايق مين
+
+568
+00:42:35,620 --> 00:42:40,320
+يسبق القطر اللي حطيتها ولا المواد الطبيعية في
+
+569
+00:42:40,320 --> 00:42:44,560
+العين مين يسبق ال receptor اللي يسبق ال receptor
+
+570
+00:42:44,560 --> 00:42:50,310
+هو اللي بيفتح ال receptors و بيخليه يشتغلفاحنا
+
+571
+00:42:50,310 --> 00:42:53,850
+يعني لما نحط القطرات هي competitive و ال natural
+
+572
+00:42:53,850 --> 00:42:58,890
+substances in the body عموما يعني competitive اه
+
+573
+00:42:58,890 --> 00:43:01,670
+the potency of the drug in the cardiovascular
+
+574
+00:43:01,670 --> 00:43:04,310
+system is not always indicative of the ocular
+
+575
+00:43:04,310 --> 00:43:08,870
+effect بحكيها ان فعلية الدواء او قوته على ال
+
+576
+00:43:08,870 --> 00:43:11,650
+cardiovascular system مش معناه انها مؤشر انها
+
+577
+00:43:11,650 --> 00:43:14,410
+هتأثر تأثير كويس على العين يعني لو أثرتلي على ال
+
+578
+00:43:14,410 --> 00:43:17,090
+cardiovascular system مش معناه انها هتعمل تأثير
+
+579
+00:43:17,090 --> 00:43:18,790
+على العين يعني هنا في بي تبكر
+
+580
+00:43:23,830 --> 00:43:29,170
+في ال beta receptors في العين بيقول لي طريقة العمل
+
+581
+00:43:29,170 --> 00:43:35,170
+بتاعة القلب تختلف عنها لأن دلوقتي نحط القطرة دائرة
+
+582
+00:43:35,170 --> 00:43:38,590
+بينما القلب نهروم systemically
+
+583
+00:43:44,480 --> 00:43:48,540
+هنا بحكي إنه في نوع من ال beta blockers receptors
+
+584
+00:43:48,540 --> 00:43:53,460
+B1 وB2 blockers أثات هي one heart تاني lungs هنا
+
+585
+00:43:53,460 --> 00:43:56,280
+في ال beta blockers إلها أنواع في selective و non
+
+586
+00:43:56,280 --> 00:44:00,760
+-selective ال selective اللي هي بكون تأثيرها قليل
+
+587
+00:44:00,760 --> 00:44:03,040
+على ال hearts و ال lungs يعني على ال
+
+588
+00:44:03,040 --> 00:44:05,400
+cardiovascular بكون تأثيرها قليل لكن ال non
+
+589
+00:44:05,400 --> 00:44:09,300
+-selective بكون تأثيرها كتير ليش؟ لأن ال non
+
+590
+00:44:09,300 --> 00:44:13,240
+-selective بتشتغل على ال both B1 و B2 على ال
+
+591
+00:44:13,240 --> 00:44:16,430
+receptorين التمامينلكن ال selective تشتغل إما على
+
+592
+00:44:16,430 --> 00:44:21,050
+B1 أو على B2 شوفين أنا مثال وين ال receptors
+
+593
+00:44:21,050 --> 00:44:26,010
+موجودة ال one في ال heart في القلب او في ال lungs
+
+594
+00:44:26,010 --> 00:44:33,850
+الدول حتى ناخدوا across يعني لو اشتغل عموما بيشتغل
+
+595
+00:44:33,850 --> 00:44:36,590
+على كام لو selective زمان جات الأخر بيشتغل على ال
+
+596
+00:44:36,590 --> 00:44:40,670
+B1 بس ايش على ال heart لو على ال B2 مثلا على ال
+
+597
+00:44:40,670 --> 00:44:45,560
+lungو المرأة تجي اسم زيكي، هاي بس مثال يعني، اه
+
+598
+00:44:48,860 --> 00:44:51,340
+Beta blockers are classified as relatively
+
+599
+00:44:51,340 --> 00:44:53,720
+selective or non-selective زي ما حكينا فيه منه
+
+600
+00:44:53,720 --> 00:44:56,260
+selective ومنه non-selective with receptors to
+
+601
+00:44:56,260 --> 00:45:00,040
+their actions at beta 1 and beta 2 at the receptor
+
+602
+00:45:00,040 --> 00:45:03,240
+subtypes قسم ل beta 1 و beta 2 some drugs can
+
+603
+00:45:03,240 --> 00:45:08,340
+block both beta 1 and beta 2 receptors activity في
+
+604
+00:45:08,340 --> 00:45:12,380
+بحكي بعض الأدوية بتعمل block ل beta 1 and beta 2
+
+605
+00:45:12,380 --> 00:45:15,440
+التنين مع بعض اللي هي بنسميها non-selective يعني
+
+606
+00:45:15,440 --> 00:45:17,520
+عن ال hairs و ال lungs تستخدم تنين؟
+
+607
+00:45:21,510 --> 00:45:25,770
+others predominantly or almost exclusively block
+
+608
+00:45:25,770 --> 00:45:29,070
+only one of the two types at low concentrations
+
+609
+00:45:29,070 --> 00:45:32,930
+بيكون بتركيز أقل يعني إما بتشتغل على beta 1 أو
+
+610
+00:45:32,930 --> 00:45:35,610
+beta 2 هذه اللي هي selective اللي بيكون تأثيرها
+
+611
+00:45:35,610 --> 00:45:38,330
+أقل سواء على الhertz أو على الmax شوفوا الآن
+
+612
+00:45:38,330 --> 00:45:43,250
+القطرة اللي .. اللي .. اللي إنها selective ممكن
+
+613
+00:45:43,250 --> 00:45:47,350
+تكون تمانها عشر شكل القطرة ال selective تمانت ستين
+
+614
+00:45:47,350 --> 00:45:53,540
+شكل لإنها تصنيحها خاطرأغلب كتير لتشتغل selected
+
+615
+00:45:53,540 --> 00:46:03,640
+ليش يعني احنا واحد عنده مشاكل في القلب احنا بدلاش
+
+616
+00:46:03,640 --> 00:46:09,740
+ان نعطل على مثلا سيمبر مايه اه اه يعني انا باختيار
+
+617
+00:46:09,740 --> 00:46:12,640
+اللي بيكون حكاية فهذه شركات مصنعة قليلة في العالم
+
+618
+00:46:12,640 --> 00:46:16,540
+ال selected وقطر لإن ايضا فيها non selected و فيها
+
+619
+00:46:16,540 --> 00:46:19,910
+selectedالقطرة الـ Selective عشرة شكل، الـ Non
+
+620
+00:46:19,910 --> 00:46:24,110
+Selective عشرة شكل، الـ Selective خمسين أو ستين أو
+
+621
+00:46:24,110 --> 00:46:24,770
+سبعين شكل
+
+622
+00:46:29,470 --> 00:46:33,110
+the selectivity of either beta 1 and beta 2 is not
+
+623
+00:46:33,110 --> 00:46:37,750
+absolute at high doses all beta adrenoceptors can
+
+624
+00:46:37,750 --> 00:46:41,970
+be antagonized يعني انه مش .. يعني مش انه مطلق
+
+625
+00:46:41,970 --> 00:46:45,470
+دايما خلاص نعطي select يعني في .. في كل الأحوال
+
+626
+00:46:45,470 --> 00:46:48,690
+high doses جرعات كتيرة منها لازم نعملها inhibit
+
+627
+00:46:48,690 --> 00:46:51,790
+يعني لازم نجلبها ممتاز أيضا يعني ال selectivity
+
+628
+00:46:51,790 --> 00:46:58,710
+هذه مش مطلقة يعني لو أنت تاخد الأقراصسيلكتيف دلها
+
+629
+00:46:58,710 --> 00:47:05,990
+او دلان بجواه صديرة اه ممكن لو كانت جواه كبيرة كله
+
+630
+00:47:05,990 --> 00:47:13,270
+خاصية شغل ال B1 وB2 وبالتالي السيلكتيف دي مش مطلقة
+
+631
+00:47:13,270 --> 00:47:17,890
+دائما حسب الدوز الدوز الصغيرة تعمل سيلكتيف اكشن و
+
+632
+00:47:17,890 --> 00:47:20,670
+الدوز الكبيرة تعمل non selective action
+
+633
+00:47:30,930 --> 00:47:34,530
+survive دخلت على ال .. على ال sector و دخلت على
+
+634
+00:47:34,530 --> 00:47:39,550
+المكان المكتوب؟ هاي ال hard talent و ال receptors
+
+635
+00:47:39,550 --> 00:47:46,130
+بتاعه هى يعني محاولة تفنين كيف ال .. ال .. ال beta
+
+636
+00:47:46,130 --> 00:47:50,390
+blockers تشتغل في الجسم أو في الاشي أو في ال ..
+
+637
+00:47:50,390 --> 00:47:52,410
+شكرا ليك يا سهولة مباركة لك
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/oZEJKmYBiE0_raw.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/oZEJKmYBiE0_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..c1aa98a077e0d79e767bc4cec5c9fc6492ae0442
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/oZEJKmYBiE0_raw.srt
@@ -0,0 +1,1972 @@
+1
+00:00:20,860 --> 00:00:23,860
+أعوذ بالله من الشيطان الدين بسم الله الرحمن الرحيم
+
+2
+00:00:23,860 --> 00:00:29,340
+الحمد لله رب العالمين و أصلي و أسلم على النبي
+
+3
+00:00:29,340 --> 00:00:33,080
+الأمين محمد و على آله و أصحابه و التابعين و هو
+
+4
+00:00:33,080 --> 00:00:39,180
+اللذي أمرنا بأن اتعلم و قال اطلبوا العلم من المهن
+
+5
+00:00:39,180 --> 00:00:42,720
+إلى اللحم نكمل اليوم ان شاء الله في طرق اعطاء
+
+6
+00:00:42,720 --> 00:00:46,840
+الدواء للإنسان طرق اعطاء الدواء للإنسان هذه
+
+7
+00:00:46,840 --> 00:00:47,380
+الطريقة
+
+8
+00:00:54,590 --> 00:01:00,310
+السابونيب تريس بديل على ال oral route و بديل على
+
+9
+00:01:00,310 --> 00:01:05,590
+ال injection يبقى ال oral route can't be used لو
+
+10
+00:01:05,590 --> 00:01:12,150
+العيار مابقدرش ياخد بالفم زى مثلا يكون طفل صغير او
+
+11
+00:01:12,150 --> 00:01:15,710
+يكون عنده vomiting او يكون
+
+12
+00:01:23,140 --> 00:01:29,040
+الثانية أن المريض أو الطبيب لا يوجد facilities
+
+13
+00:01:29,040 --> 00:01:32,320
+للإيجيكشن،
+
+14
+00:01:32,320 --> 00:01:36,440
+الإيجيكشن عايز facilities، إمكانيات، الطريقة
+
+15
+00:01:36,440 --> 00:01:45,460
+التالتة أنه لما أنا بدي أوصف دواء غير الفم يُخل في
+
+16
+00:01:45,460 --> 00:01:50,920
+البيت، يُخل في البيت، يعني المريض يستعمله بنفسه أو
+
+17
+00:01:50,920 --> 00:01:52,300
+أهله يستعمله زي الأطفال
+
+18
+00:01:55,880 --> 00:02:01,620
+يبقى و بديل عن الفم و بديل عن الحقر وهذه حاجات
+
+19
+00:02:01,620 --> 00:02:07,380
+advantages advantage ان المريض ياخد تحميل و روحه
+
+20
+00:02:07,380 --> 00:02:12,320
+على البيت و يحقق مثلا كل اتناشر ساعة ميزانة فتلزم
+
+21
+00:02:12,320 --> 00:02:14,640
+مثلا injection يروح على المستوصف على ال ..
+
+22
+00:02:17,990 --> 00:02:21,870
+و لو مثلا في مياه منع عنده vomiting عنده حاجة اه
+
+23
+00:02:21,870 --> 00:02:27,130
+طيب التحميل يعني بديل جيد بس هات ال disadvantages
+
+24
+00:02:27,130 --> 00:02:35,510
+اول حاجة انه لو الجرعة حدث فيها خطأ يعني مثلا تفضل
+
+25
+00:02:35,510 --> 00:02:41,370
+اعطيته تحميلت واحد كبير راحت في جسمه مش سهل اطلعها
+
+26
+00:02:41,370 --> 00:02:45,130
+عشان اقولك erratic absorption from the rectal area
+
+27
+00:02:46,610 --> 00:02:51,010
+Inaccurate are predicted blood level of a drug
+
+28
+00:02:51,010 --> 00:02:55,550
+يعني بيرفع اللي هو blood level of a drug زي ال
+
+29
+00:02:55,550 --> 00:02:59,190
+injection التانية
+
+30
+00:02:59,190 --> 00:03:04,590
+a regular route is ineffective in case of ديارية
+
+31
+00:03:04,590 --> 00:03:09,230
+ديارية الإسهال يعني ممكن جدا ان طفل انا اعطيته
+
+32
+00:03:09,230 --> 00:03:13,850
+تحميله في الشرق وبعد دقايق نزلها لإن هو عنده
+
+33
+00:03:13,850 --> 00:03:18,590
+ديارية عنده إسهالليه ملموش بسرعة؟ بعضه هذه قبل
+
+34
+00:03:18,590 --> 00:03:22,750
+الشيء التالت و اللي لازم احنا نذكره هنا لعلمه في
+
+35
+00:03:22,750 --> 00:03:31,150
+الحياة أن أحيانا يحدث خطأ في أن التحميل مخصص على
+
+36
+00:03:31,150 --> 00:03:36,430
+ال charge تات الأم التي تجهل فتضع للطفلة التحميلة
+
+37
+00:03:36,430 --> 00:03:44,150
+بالخطأ في الفتحة الأمامية فقد تؤدي إلى ضرر بريء في
+
+38
+00:03:44,150 --> 00:03:48,440
+هذا الموضوعيعني بعض الأمهات ممن يجهل هذا الاستعمال
+
+39
+00:03:48,440 --> 00:03:53,020
+لإن الفرق بين فتحة الشاج وفتحة المهبل يعني هي
+
+40
+00:03:53,020 --> 00:03:57,440
+something قليلة فممكن انه تاخد فالو في this
+
+41
+00:03:57,440 --> 00:04:02,020
+advantage رابع انه في ال hot weather hot weather
+
+42
+00:04:02,020 --> 00:04:07,680
+يعني في الجو الساخن هي يعني بتجبه unsuitable for
+
+43
+00:04:07,680 --> 00:04:15,500
+you لو تجبه يعني شوية lacks طريقة يعنيفاستعمالها
+
+44
+00:04:15,500 --> 00:04:20,000
+في الجو الساخن صعب هي عايزة refrigeration عايزة
+
+45
+00:04:20,000 --> 00:04:24,520
+اللي هو تتليج عايزة تتليج عشان تكون solid و تكون
+
+46
+00:04:24,520 --> 00:04:30,760
+مطاورة طيب طبعا انا عندي التحميل انواع في تحميل
+
+47
+00:04:30,760 --> 00:04:35,160
+rectal و هي الأشهر شرقية for children and for
+
+48
+00:04:35,160 --> 00:04:40,360
+adults تحميل تحميل تحميل و متعددة الأنواع يعني ان
+
+49
+00:04:40,360 --> 00:04:42,040
+في antipyrexia
+
+50
+00:04:47,940 --> 00:04:53,920
+تحميل أشكال و أرواح تحط في الشراكة الفيميلز اللي
+
+51
+00:04:53,920 --> 00:05:00,620
+هو vagina sublaterals كتير ال married men بيتعرضوا
+
+52
+00:05:00,620 --> 00:05:06,600
+ل infection في ال vagina فهذه ال infection فيها
+
+53
+00:05:06,600 --> 00:05:11,450
+تحميل طبعا ممكن تكون bacterialأو تكون candidial
+
+54
+00:05:11,450 --> 00:05:15,590
+fungal infection fungal يعني فطرية أو تكون mixed
+
+55
+00:05:15,590 --> 00:05:19,650
+او تكون mixed ففي احنا عندنا suppositories لل
+
+56
+00:05:19,650 --> 00:05:24,630
+infection هذه يعني بتنحط اللي هو vaginal في عند
+
+57
+00:05:24,630 --> 00:05:31,510
+النوم في ال bed time في بعض الناس اللي عنده
+
+58
+00:05:31,510 --> 00:05:36,910
+infection في المثالة الدورية urine bladder
+
+59
+00:05:52,260 --> 00:05:56,640
+انا احنا نحط فيه فرغات في التحمينا نحط فيه فرغات
+
+60
+00:05:56,640 --> 00:06:01,940
+اما في ال rectum عن طريق الان ال orifice او ال
+
+61
+00:06:01,940 --> 00:06:05,660
+vagina ال orifice او ال orifice هاي ال orifices
+
+62
+00:06:05,660 --> 00:06:12,100
+اللي احنا بنعطي فيها التحمينا طبعا الموضوع دي هي
+
+63
+00:06:12,100 --> 00:06:16,600
+أنواع التحمينا المختلفة وهي طريقة ال rectum
+
+64
+00:06:16,600 --> 00:06:20,800
+بالأصبع هنا حاطها بالأصبع هنا
+
+65
+00:06:22,860 --> 00:06:30,120
+في جهاز زي applicator هيك زي مكبس بلاستيك بيحط
+
+66
+00:06:30,120 --> 00:06:37,160
+اللي هو التحميلة هي التحميلة المفتاحة تكون شوية
+
+67
+00:06:37,160 --> 00:06:44,400
+hard مش لازم تكون flex اه و هكده و انا بعتبر ان
+
+68
+00:06:44,400 --> 00:06:46,460
+التحميل طريقة يعني
+
+69
+00:06:52,310 --> 00:06:59,870
+فان دي طريقة اخرى اللي هي topical road واضح ان
+
+70
+00:06:59,870 --> 00:07:10,470
+كثير مننا بيصيبوا التهاب الجلد التهاب المتحمق ممكن
+
+71
+00:07:10,470 --> 00:07:13,130
+التهاب ال mucus break of the nose
+
+72
+00:07:21,940 --> 00:07:25,960
+أو حتى اللسان كل شيء انا بحطه على السطح اسمه
+
+73
+00:07:25,960 --> 00:07:30,640
+topical كل شيء بحطه على السطح الاسطح الجلد أو
+
+74
+00:07:30,640 --> 00:07:35,420
+ميوكاس ميرزيز هذا topical سطح يعني بقولش لغة لأ
+
+75
+00:07:35,420 --> 00:07:40,840
+بقول topical is intended for use at the site of
+
+76
+00:07:40,840 --> 00:07:45,160
+administration two topical preparations are
+
+77
+00:07:45,160 --> 00:07:49,540
+frequently confused with each other عندي شيء اسمه
+
+78
+00:07:49,540 --> 00:07:56,730
+ointmentوعندي شيء اسمه cream، والحقيقة انا اشتهدت
+
+79
+00:07:56,730 --> 00:08:00,870
+يعني ان شاء الله الاقي انا اش جايب معايا .. اش
+
+80
+00:08:00,870 --> 00:08:03,170
+جايب معايا هاي .. هاي cream
+
+81
+00:08:14,280 --> 00:08:21,480
+يعني انا عندي نفس المادة اه في shedic acid في منه
+
+82
+00:08:21,480 --> 00:08:27,020
+ointment و في منه cream الان ماه هتفتحوا هتمروا
+
+83
+00:08:27,020 --> 00:08:32,640
+عليكم هتلاحظوا ان ال ointment في oily base او
+
+84
+00:08:32,640 --> 00:08:40,020
+fatty base لبنى هنا لأ في watery liquid watery
+
+85
+00:08:40,020 --> 00:08:44,300
+اللي هو base watery baseهتقفوا عليكم و تشوفوا إيش
+
+86
+00:08:44,300 --> 00:08:48,900
+الفرق، يعني بين هذا و هذا، مع إنه نفس المادة، نفس
+
+87
+00:08:48,900 --> 00:08:59,300
+المادة ال .. ال equipment made of a petroleum
+
+88
+00:08:59,300 --> 00:09:09,260
+base، petroleum base يعني مادة بترولية، زيتية،
+
+89
+00:09:09,260 --> 00:09:14,720
+they are quite greasy، greasy، زيتيةهتحسوه as
+
+90
+00:09:14,720 --> 00:09:18,220
+intended for prolonged contact on the skin لفا لما
+
+91
+00:09:18,220 --> 00:09:23,580
+انا احطه على skin بيمكن ساعات حتى لو انا حاولت اني
+
+92
+00:09:23,580 --> 00:09:29,380
+ازيله بالماء بس شوية بجلب، ماتدلبش في الميه،
+
+93
+00:09:29,380 --> 00:09:34,080
+المادة ازلتها ماتدلبش في الميه و
+
+94
+00:09:34,080 --> 00:09:37,720
+هذه فيها تطبيق في وضعه في الصلاة، لإن واحد حاط
+
+95
+00:09:37,720 --> 00:09:41,020
+مارنة مثلا عوشه، و بعد ساعة عبده اتولد
+
+96
+00:09:46,470 --> 00:09:52,690
+بالصابون او بخشونة
+
+97
+00:09:52,690 --> 00:10:00,910
+يعني
+
+98
+00:10:00,910 --> 00:10:08,230
+المرغم مش مصمم انه على الدم وان كان جزء منه ممكن
+
+99
+00:10:08,230 --> 00:10:13,990
+فحتة مرغم في الانف مثلا ممكن جزء منه انه ينفذ لكن
+
+100
+00:10:13,990 --> 00:10:23,760
+في العين مثلا صعبلأن هو شوية busy يعني كميل عكس ال
+
+101
+00:10:23,760 --> 00:10:29,260
+cream made of viscous water soluble اه اللي هو
+
+102
+00:10:29,260 --> 00:10:34,100
+chemicals مواد مائية بتدخل الميه و should not
+
+103
+00:10:34,100 --> 00:10:36,860
+disappear after being placed on the skin حط ال
+
+104
+00:10:36,860 --> 00:10:42,660
+cream ع الوش او على الجل بعد يعني هناها او لو
+
+105
+00:10:42,660 --> 00:10:48,610
+انمسح بشيء بيزول طعام افضلالإنسان فينا يحط فرفر
+
+106
+00:10:48,610 --> 00:10:59,530
+ولا يحط كريم، كريم، هو الكريم أول شيء يعني بيشتغل
+
+107
+00:10:59,530 --> 00:11:03,570
+أسرع واحدة، تاني شيء لأ يلور في الملابس، ولو أنا
+
+108
+00:11:03,570 --> 00:11:08,790
+بتزيينه إزالته سهل، لكن المرحلة إلو ميزة إنه أطول
+
+109
+00:11:08,790 --> 00:11:15,160
+من الأول، لكن يلور في الملابس وصعب الإزالةيبقى
+
+110
+00:11:15,160 --> 00:11:19,000
+الطريقة الخاصة في العيون، يعني في العيون، أن أحنا
+
+111
+00:11:19,000 --> 00:11:24,720
+كتير بنستخدم الـointments الـointments يعني تبقى
+
+112
+00:11:24,720 --> 00:11:29,600
+في العين لفترة أطول بكثير من القطرات، قطرة يعني
+
+113
+00:11:29,600 --> 00:11:33,220
+نصف ساعة أو ساعة تنجلي، لكن المرء ممكن تلاتة،
+
+114
+00:11:33,220 --> 00:11:37,280
+أربع، خمس ساعات يجلس في العين فيعطي أثر علاجيا
+
+115
+00:11:37,280 --> 00:11:41,380
+أطول، وبعده اسمه Topical، المرعن في العين والقطر
+
+116
+00:11:41,380 --> 00:11:42,200
+في العين اسمه Topical
+
+117
+00:11:45,470 --> 00:11:51,670
+الـ Chapter 5 How Do Drugs Work طريقة أو قليات عمل
+
+118
+00:11:51,670 --> 00:11:58,110
+اللي هو الأدوية كيف تعمل الأدوية حقيقة
+
+119
+00:11:58,110 --> 00:12:03,970
+و أنا أكثر من طريقة لعمل أدوية وسأحاول أن ألخص
+
+120
+00:12:03,970 --> 00:12:11,850
+الطريقة الأولى Receptor Theory يعني في الأضاءة
+
+121
+00:12:11,850 --> 00:12:18,450
+والخلايافي على سطح الخلية سطح العضو شيء اسمه
+
+122
+00:12:18,450 --> 00:12:26,170
+receptor أي مستقبل ال receptor هذا مخصص يعني هي
+
+123
+00:12:26,170 --> 00:12:30,790
+مثلا ال receptor هنا ال receptor هنا هذا مخصص إذا
+
+124
+00:12:30,790 --> 00:12:32,690
+دخل فيه
+
+125
+00:12:45,820 --> 00:12:50,960
+سوف تحدث تجييرا على كل خلية وتدخل إلى داخل الخلية
+
+126
+00:12:50,960 --> 00:12:59,120
+تماما كما المفتاح وقلون الباب او المفتاح والكفل
+
+127
+00:12:59,120 --> 00:13:05,640
+ممكن انا اتي من عشرين مفتاح يفتحوا
+
+128
+00:13:05,640 --> 00:13:13,760
+الكفل لكن في مفتاح معين مصمم لهذا الكفل ان اتى هذا
+
+129
+00:13:13,760 --> 00:13:18,700
+المفتاح فان الكفل او الباب يفتحوبالتالي الذين
+
+130
+00:13:18,700 --> 00:13:23,860
+يصنعونا الدواء يعلمونا the latest receptor إذا كان
+
+131
+00:13:23,860 --> 00:13:28,580
+الدواء هذا صمم فحيث أنه لما يدخل إلى الخلايا
+
+132
+00:13:28,580 --> 00:13:36,760
+يتفاعل مع ال receptor تطابقا بنفس اللي هو الشكل
+
+133
+00:13:36,760 --> 00:13:39,520
+فإنه سيفدث أثران علاجي
+
+134
+00:13:43,090 --> 00:13:46,690
+يبقى هنا الـ Receptor it is believed that the cell
+
+135
+00:13:46,690 --> 00:13:49,890
+in certain tissues contain structures called
+
+136
+00:13:49,890 --> 00:13:53,210
+receptors. These receptors combine with substances
+
+137
+00:13:53,210 --> 00:13:56,810
+which are produced naturally in the body as well
+
+138
+00:13:56,810 --> 00:14:01,190
+as certain drugs يعني في .. في الجسم نا بعض المواد
+
+139
+00:14:01,190 --> 00:14:04,570
+الكيميائية العادية الطبيعية ممكن تتفاعل مع
+
+140
+00:14:04,570 --> 00:14:07,650
+receptors و اللي مش بيها اللي جاي من البرا اللي هو
+
+141
+00:14:07,650 --> 00:14:07,970
+الدواء
+
+142
+00:14:14,580 --> 00:14:19,940
+الخلية تتفاعل الخلية تتفاعل الخلية تتفاعل الخلية
+
+143
+00:14:19,940 --> 00:14:23,080
+تتفاعل الخلية تتفاعل الخلية تتفاعل الخلية تتفاعل
+
+144
+00:14:23,080 --> 00:14:26,160
+الخلية تتفاعل الخلية تتفاعل الخلية تتفاعل الخلية
+
+145
+00:14:26,160 --> 00:14:26,160
+تتفاعل الخلية تتفاعل الخلية تتفاعل الخلية تتفاعل
+
+146
+00:14:26,160 --> 00:14:26,160
+الخلية تتفاعل الخلية تتفاعل الخلية تتفاعل الخلية
+
+147
+00:14:26,160 --> 00:14:26,160
+تتفاعل الخلية تتفاعل الخلية تتفاعل الخلية تتفاعل
+
+148
+00:14:26,160 --> 00:14:26,180
+الخلية تتفاعل الخلية تتفاعل الخلية تتفاعل الخلية
+
+149
+00:14:26,180 --> 00:14:29,000
+تتفاعل الخلية تتفاعل الخلية تتفاعل الخلية تتفا
+
+150
+00:14:35,170 --> 00:14:38,270
+وخصص لـ Astral Cholera فلو احنا اعطينا اي دواء
+
+151
+00:14:38,270 --> 00:14:42,610
+يشبه لـ Astral Cholera وإيه جراء الاسبتور، أعظم ال
+
+152
+00:14:42,610 --> 00:14:47,910
+contractions. The drug is thought to fit into a
+
+153
+00:14:47,910 --> 00:14:52,130
+receptor rather than a key that fits a lock
+
+154
+00:15:00,790 --> 00:15:04,530
+يمكن أن يبقى دواء يدفع الرسيبتور ويجعله يحصل على
+
+155
+00:15:04,530 --> 00:15:09,290
+نفس الشيء مثل ما يحدث بالطبيعي مثل الاستايكولين
+
+156
+00:15:09,290 --> 00:15:14,730
+مثلا بالضبط يبقى الدواء يحصل على الرسيبتور بدون أن
+
+157
+00:15:14,730 --> 00:15:16,950
+يجعله يحصل على نفس الشيء بمجرد أنه يحصل على نفس
+
+158
+00:15:16,950 --> 00:15:18,130
+الشيء بمجرد أنه يحصل على نفس الشيء بمجرد أنه يحصل
+
+159
+00:15:18,130 --> 00:15:20,170
+على نفس الشيء بمجرد أنه يحصل على نفس الشيء بمجرد
+
+160
+00:15:20,170 --> 00:15:20,890
+أنه يحصل على نفس الشيء بمجرد أنه يحصل على نفس
+
+161
+00:15:20,890 --> 00:15:23,550
+الشيء بمجرد أنه يحصل على نفس الشيء بمجرد أنه يحصل
+
+162
+00:15:23,550 --> 00:15:29,750
+على نفس الشيء بمجروبمنع اي مادة طبيعية او طبيعية
+
+163
+00:15:29,750 --> 00:15:37,250
+تحتل طالما انه جال في ريسبتور زى مثلا بعض
+
+164
+00:15:37,250 --> 00:15:41,490
+الأدوية اللى هى بتعمل blocking للاستايكولين مثلا
+
+165
+00:15:41,490 --> 00:15:45,990
+الاتروبيل اذا الاتروبيل جال مكان الاستايكولين في
+
+166
+00:15:45,990 --> 00:15:49,110
+الريسبتورز هذه اللى في الخلايا طالما ان الاتروبيل
+
+167
+00:15:49,110 --> 00:15:51,170
+جال الاستايكولن مشتغلش
+
+168
+00:15:56,810 --> 00:16:00,330
+فهذه نظرية الـ Receptors نظرية واسعة وكبيرة لكن
+
+169
+00:16:00,330 --> 00:16:04,890
+مقترح بها دوليا ان الـ stimulation of receptor
+
+170
+00:16:04,890 --> 00:16:08,050
+will lead to stimulation of the cells
+
+171
+00:16:21,230 --> 00:16:24,690
+اللي بتعمل هيك Closely simple substances which are
+
+172
+00:16:24,690 --> 00:16:28,850
+used by the cells for its nutrition and when
+
+173
+00:16:28,850 --> 00:16:33,310
+absorbed the cells can't use them and so fail to
+
+174
+00:16:33,310 --> 00:16:39,430
+multiply اه والله انا عندي مثال Drug الصلفة
+
+175
+00:16:39,430 --> 00:16:46,630
+Sulfonamide هذا drug عجيب هذا مش طبيعي هذا يصنع مش
+
+176
+00:16:46,630 --> 00:16:55,170
+طبيعي هذا يصنعهذا يشبه في شكله مادة طبيعية في
+
+177
+00:16:55,170 --> 00:16:59,310
+جسمنا اسمها تارا امينو بنزيوكاسيد تارا امينو
+
+178
+00:16:59,310 --> 00:17:03,510
+بنزيوكاسيد الان
+
+179
+00:17:03,510 --> 00:17:08,710
+الصرفة هذه لو اجت عرسبتر بتشتغل
+
+180
+00:17:08,710 --> 00:17:09,950
+عرسبتر مثلا بتاع
+
+181
+00:17:13,860 --> 00:17:19,540
+الان البكتيريا مابتفرق انها لا صلفة ولا قارة امينو
+
+182
+00:17:19,540 --> 00:17:24,540
+بيزيوك أسد هذه مادتش فرق على السبتر بالتالي
+
+183
+00:17:24,540 --> 00:17:28,260
+البكتيريا هتاخد الصلفة ضالا منها ان هي قارة امينو
+
+184
+00:17:28,260 --> 00:17:34,320
+بيزيوك أسد وتعمل effect تطبيل misleading يعني لها
+
+185
+00:17:34,320 --> 00:17:40,480
+يبقى the second mice which are used to stop the
+
+186
+00:17:40,480 --> 00:17:44,280
+multiplication of bacteria are a good exampleهي
+
+187
+00:17:44,280 --> 00:17:47,820
+متشابهة جدًا لإنهيار مبتارعة من ميروبينزويك أسد و
+
+188
+00:17:47,820 --> 00:17:52,760
+بعض البكتيريا لا يستطيع تفرق بينهم و تتفرق بينهم و
+
+189
+00:17:52,760 --> 00:17:52,840
+تتفرق بينهم و تتفرق بينهم و تتفرق بينهم و تتفرق
+
+190
+00:17:52,840 --> 00:17:53,840
+بينهم و تتفرق بينهم و تتفرق بينهم و تتفرق بينهم و
+
+191
+00:17:53,840 --> 00:17:56,820
+تتفرق بينهم و تتفرق بينهم و تتفرق بينهم و تتفرق
+
+192
+00:17:56,820 --> 00:17:56,820
+بينهم و تتفرق بينهم و تتفرق بينهم و تتفرق بينهم و
+
+193
+00:17:56,820 --> 00:17:58,420
+تتفرق بينهم و تتفرق بينهم و تتفرق بينهم و تتفرق
+
+194
+00:17:58,420 --> 00:18:09,680
+بينهم و تتفرق بينهم و تتفرق بينهم و
+
+195
+00:18:09,680 --> 00:18:13,770
+تتيعني بتعمل inhalation لبعض ال enzymes مثلًا
+
+196
+00:18:13,770 --> 00:18:19,770
+بتاعت البكتيريا ال enzymes are substances that are
+
+197
+00:18:19,770 --> 00:18:24,450
+speed to agile up many chemical processes within
+
+198
+00:18:24,450 --> 00:18:28,390
+the body بتعجل التفاؤلات، الانزيمات فينا احنا في
+
+199
+00:18:28,390 --> 00:18:32,570
+البكتيريا كله فيه شغل انزيماتSome of these enzymes
+
+200
+00:18:32,570 --> 00:18:35,750
+activated processes are concerned with the
+
+201
+00:18:35,750 --> 00:18:40,130
+transport of chemicals in and out of the cell يعني
+
+202
+00:18:40,130 --> 00:18:44,210
+في أنا عندى جدار الخلية او cell wall cell membrane
+
+203
+00:18:44,210 --> 00:18:49,410
+هنا في ionic exchange من جوا و من برا
+
+204
+00:18:52,670 --> 00:18:57,550
+بتطلع من جوا لفره باستمرار اي خلية حية في تبادل
+
+205
+00:18:57,550 --> 00:19:02,190
+ايوني بين .. داخلها و من الخارج ما .. ما .. ما ..
+
+206
+00:19:02,190 --> 00:19:06,370
+هذا معروف لكم بيقول certain drugs have the
+
+207
+00:19:06,370 --> 00:19:10,110
+property of inhibiting their action and thus
+
+208
+00:19:10,110 --> 00:19:14,150
+interfere with some of these processes فانا اعطيت
+
+209
+00:19:14,150 --> 00:19:18,210
+ال drug مثلا عشان اقتل بكتيريا معينة البكتيريا هي
+
+210
+00:19:18,210 --> 00:19:25,520
+دلوقت انزيمات اللي داخل الخليةالان لما توقفت
+
+211
+00:19:25,520 --> 00:19:30,920
+الانزيمات توقف ال ionic exchange من داخل الخلية و
+
+212
+00:19:30,920 --> 00:19:35,580
+خارجها و خارجها يبقى توقف كل النشاط و كل العمل و
+
+213
+00:19:35,580 --> 00:19:39,940
+كل الذكاء ففي بعض ال drugs انا بعطيها ببعتها لإن
+
+214
+00:19:39,940 --> 00:19:47,900
+البكتيريا توقف الانزيمات و هنقول مثلا انا عندي في
+
+215
+00:19:47,900 --> 00:19:50,540
+مجموعة من الدواء كبيرة اسمها diuretics
+
+216
+00:19:56,840 --> 00:20:01,320
+مدرعة البول معترف فيها دوليا لما انسان بتكون ضغط
+
+217
+00:20:01,320 --> 00:20:08,920
+الدم بتاعه عالي مثلا مية و ستين على مية و عشرة مية
+
+218
+00:20:08,920 --> 00:20:15,920
+و تمانين على مية و عشرين مثلا لان القلب بتعب لانه
+
+219
+00:20:15,920 --> 00:20:20,800
+عالي الضغط ولا يستطيع انه يشدخ كمية كبيرة من الدم
+
+220
+00:20:20,800 --> 00:20:27,270
+يعني مضغوطة بهافيروح للأطباء كان هو يعني بيعطيه
+
+221
+00:20:27,270 --> 00:20:34,530
+حاجتين بيعطيه أولا شيء أقراص تقوي القلب فقدر القلب
+
+222
+00:20:34,530 --> 00:20:41,490
+على الانتباه و أنه يعني يبقى يعني قوي و أقراس تخرج
+
+223
+00:20:41,490 --> 00:20:48,970
+الماء من الجسم عبر البون يعني تقلل حجم الدم عشان
+
+224
+00:20:48,970 --> 00:20:52,270
+نفس الأصدار اللي كانت ال output تكون يعني نوعا ما
+
+225
+00:20:52,270 --> 00:20:56,360
+محتاجةوهذا بيهانه منه كتير كبار السن نسأل الله على
+
+226
+00:20:56,360 --> 00:21:00,180
+العافية لنا وعلى المسلمين العافية كتير بيقولك انا
+
+227
+00:21:00,180 --> 00:21:04,800
+مجرد ما اخد الحب هادا عن رجل مالاحق حلاق الحمام
+
+228
+00:21:04,800 --> 00:21:14,100
+وكلام زي هذا فهو إيش اللي بيصير بالظبط؟ بيصير انه
+
+229
+00:21:14,100 --> 00:21:17,540
+انا عندي الأحمر هادا النفرون
+
+230
+00:21:22,300 --> 00:21:37,400
+طبعا فيها شريان اسمه afrin افرين افرين
+
+231
+00:21:37,400 --> 00:21:37,400
+افرين افرين افرين افرين افرين افرين افرين افرين
+
+232
+00:21:37,400 --> 00:21:37,400
+افرين افرين افرين افرين افرين افرين افرين افرين
+
+233
+00:21:37,400 --> 00:21:37,540
+افرين افرين افرين افرين افرين افرين افرين افرين
+
+234
+00:21:37,540 --> 00:21:37,540
+افرين افرين افرين افرين افرين افرين افرين افرين
+
+235
+00:21:37,540 --> 00:21:37,540
+افرين افرين افرين افرين افرين افرين افرين افرين
+
+236
+00:21:37,540 --> 00:21:38,880
+افرين افرين افرين افرين افرين افرين افرين افرين
+
+237
+00:21:38,880 --> 00:21:48,520
+افرين افرين اف
+
+238
+00:21:49,580 --> 00:21:55,960
+Proximal convoluted tubules وفي Distal convoluted
+
+239
+00:21:55,960 --> 00:22:04,280
+tubules في الحالة الأعادية ان في انزيمات في هذه
+
+240
+00:22:04,280 --> 00:22:13,460
+الأجزاء تعيد الماء بعد ما استخلص منه السموم تعيده
+
+241
+00:22:13,460 --> 00:22:15,800
+إلى النفران و إلى الدم
+
+242
+00:22:19,650 --> 00:22:22,830
+يعني بيمروا اللي .. اللي هو الماء زي في ال
+
+243
+00:22:22,830 --> 00:22:25,770
+radiator في ال tubes هالي و بيحكي على الدم تاني
+
+244
+00:22:25,770 --> 00:22:30,450
+بعد استخلاص اليوريا و uric acid و بعض الفضلات من
+
+245
+00:22:30,450 --> 00:22:36,010
+ال bowl إلى الخارج لما أنا باخد ديوتك الديوتك هذا
+
+246
+00:22:36,010 --> 00:22:40,470
+حتى ال egg هالي بتعطل هذه المثالة بتعطل هذه
+
+247
+00:22:40,470 --> 00:22:45,270
+المثالة فبصير ال .. ال .. ال bowl اللي طالع يتفلكر
+
+248
+00:22:46,150 --> 00:22:50,770
+في ال convoluted tubules هاني بصير ايه؟ طلع برا،
+
+249
+00:22:50,770 --> 00:22:55,410
+فيش enzymes تردوه تاني، فيش enzymes تردوه تاني،
+
+250
+00:22:55,410 --> 00:23:00,930
+ماشي؟ يعني احنا فينا العادي اللي بروح على ال
+
+251
+00:23:00,930 --> 00:23:04,410
+convoluted tubules اللي عامله هيك هاني بتفلتره
+
+252
+00:23:04,410 --> 00:23:12,760
+وبترجع السائل صافي لجسمنالما أخذ الأقاس هانى عقبت
+
+253
+00:23:12,760 --> 00:23:18,560
+الإنزيمات اللى بترجع السائل لجسمنا وبالتالي الميه
+
+254
+00:23:18,560 --> 00:23:22,920
+هادى طلعت برا وهذا فى صالح المريض لأنه بدل ما ضغطه
+
+255
+00:23:22,920 --> 00:23:28,340
+كان عالى جدا او عالى متوسط بصير عادي عادي يعني فى
+
+256
+00:23:28,340 --> 00:23:30,960
+حدود مائة وعشرين على تمانين مائة وعشرين على تمانين
+
+257
+00:23:30,960 --> 00:23:32,560
+هى موضوع ال diuretics
+
+258
+00:23:38,890 --> 00:23:43,970
+طبعا. Action of cell membrane. فعال ال enzymes
+
+259
+00:23:43,970 --> 00:23:47,030
+action of cell membrane وقولنا انه عبر ال cell
+
+260
+00:23:47,030 --> 00:23:51,170
+membrane فيه تبادل ايوني. تبادل ايوني عبر
+
+261
+00:23:51,170 --> 00:23:56,070
+الانزيمات و لو الهلاجة ده عطل الانزيمات ايضا فانه
+
+262
+00:23:56,070 --> 00:24:02,790
+ايش؟ لا يحدث تبادل داخل وخرج الخلية ويودي الى وقف
+
+263
+00:24:02,790 --> 00:24:04,090
+الوظيفة وانا
+
+264
+00:24:09,380 --> 00:24:13,220
+يعني هاي انا مثلا عندي قيومات كثيرة من داخل الخلية
+
+265
+00:24:13,220 --> 00:24:17,480
+و خارج الخلية، هاي الـ Intracellular Medium و هاي
+
+266
+00:24:17,480 --> 00:24:20,520
+اللي هو الـ Extracellular Medium و هذا الـ Cell
+
+267
+00:24:20,520 --> 00:24:24,820
+Membrane شوفوا أنا عندي Challenge، عندي أنا قروات
+
+268
+00:24:24,820 --> 00:24:28,060
+في الـ Cell Membrane، شوفوا المكبر سبحان الله،
+
+269
+00:24:28,060 --> 00:24:34,080
+شوفوا يعني على طول الوقت قيومات داخلة جوا و انا
+
+270
+00:24:34,080 --> 00:24:37,730
+اتخرج الى براو برضه هيس ال membrane white channels
+
+271
+00:24:37,730 --> 00:24:42,210
+شايفين ال channels يعني شيء مرتب جدا و لو هي تتعطل
+
+272
+00:24:42,210 --> 00:24:47,770
+سوف تتعطل وظيفة الخلية سوف تتعطل وظيفة الخلية هذا
+
+273
+00:24:47,770 --> 00:24:51,290
+اللي هو الايونات اللي طالعة و نازلة سالبة و موجبة
+
+274
+00:24:51,290 --> 00:24:59,830
+تعتبر الانزيمة بعض الأدوية إذا أخدها الإنسان هتعطل
+
+275
+00:24:59,830 --> 00:25:03,030
+هذه الوظيفة في بعض الخلايا أو في ال bacteria اللي
+
+276
+00:25:03,030 --> 00:25:03,890
+هي إيش داخلة
+
+277
+00:25:09,370 --> 00:25:13,230
+من داخل الخلية إلى خارجها ومن خارجها إلى داخلها
+
+278
+00:25:13,230 --> 00:25:20,470
+فهذه احدى طرق عمل الدواء احدى طرق عمل الدواء طيب
+
+279
+00:25:20,470 --> 00:25:23,850
+في كمان طريقة خامسة لعمل الدواء
+
+280
+00:25:39,430 --> 00:25:46,550
+دراجات مستخدمة لقتل بكتيريا أو خلال خلال خلال
+
+281
+00:25:46,550 --> 00:25:50,930
+السلطان خفيفة بدون تدمير غير محدود للخلال
+
+282
+00:26:04,210 --> 00:26:08,970
+وهذا ما قلتي اسمه selective action اختيار اختياريا
+
+283
+00:26:08,970 --> 00:26:13,690
+selective action يعني مثلا الأدوية الكيموية اللي
+
+284
+00:26:13,690 --> 00:26:16,310
+انتوا بتسمعها زي ال methotrexate مثلا اه radiation
+
+285
+00:26:16,310 --> 00:26:23,910
+اه ال methotrexate مثلا يعني هو بيقتل الخلايا
+
+286
+00:26:23,910 --> 00:26:27,570
+السرطانية ولا يقتل خلايا الإنسان العادية
+
+287
+00:26:33,170 --> 00:26:36,650
+هو بيقول في ال site of toxic ان these are just a
+
+288
+00:26:36,650 --> 00:26:40,090
+few of the ways in which drugs may work. It is
+
+289
+00:26:40,090 --> 00:26:43,610
+probable that all drug action depends on their
+
+290
+00:26:43,610 --> 00:26:48,450
+interference with cell activity. And when more is
+
+291
+00:26:48,450 --> 00:26:51,870
+known about the process within the cell, then more
+
+292
+00:26:51,870 --> 00:26:55,250
+will be discovered about how do drugs work.يعني
+
+293
+00:26:55,250 --> 00:26:57,070
+لسه بيقولك هذه مجال
+
+294
+00:27:02,140 --> 00:27:05,680
+Selective action على الخلايا البكتيرية أو الخلايا
+
+295
+00:27:05,680 --> 00:27:10,940
+البيروسية أو على الخلايا السرطانية بأقل قدر من ال
+
+296
+00:27:10,940 --> 00:27:16,740
+harm لخلايا الإنسان اللي هو في هذا المرض في هذا
+
+297
+00:27:16,740 --> 00:27:20,680
+المرض طيب
+
+298
+00:27:20,680 --> 00:27:27,040
+الآن هنتكلم على side effects of drugs
+
+299
+00:27:33,240 --> 00:27:37,760
+للأدوية مع drug toxicity مع السمية الدوائية أو
+
+300
+00:27:37,760 --> 00:27:42,480
+تسمم الدوائية وهذا مامحة كبيرة حقيقة ومهمة يعني
+
+301
+00:27:42,480 --> 00:27:48,320
+مهم جدا ان الإنسان قبل ما ياخد أي علاج انه يقرأ
+
+302
+00:27:48,320 --> 00:27:57,700
+التأثيرات الجانبية مهمة جدا يعني مثال وقال انه
+
+303
+00:27:57,700 --> 00:28:05,440
+رينوريا رشح رينوريا رشح running noseالآن هو رأى
+
+304
+00:28:05,440 --> 00:28:10,220
+على السيدارية بيقول له اعطيني دوة للراشح، اعطاه
+
+305
+00:28:10,220 --> 00:28:13,900
+كبسولات، قال له بتاخد كل اتناشر ساعة كبسولة، هو
+
+306
+00:28:13,900 --> 00:28:17,100
+الشئ العجيب انه اخد اول كبسولة، راح نام اتناشر
+
+307
+00:28:17,100 --> 00:28:22,760
+ساعة و رابعها، و لما صحوه، عاوز ينام تاني، يبقى
+
+308
+00:28:22,760 --> 00:28:28,140
+هذا فيه تأثير جانبي اللي هو sleeping tendency أثر
+
+309
+00:28:28,140 --> 00:28:31,970
+على central nervous systemطيب هذا لو أخد الكبسولة
+
+310
+00:28:31,970 --> 00:28:36,490
+و راح سلك سيارة عشوار بعيد مية كيلو او متين كيلو،
+
+311
+00:28:36,490 --> 00:28:40,450
+ايش هسيه في الطريق؟ حيعمل حوادث؟ ولا ينام في
+
+312
+00:28:40,450 --> 00:28:44,930
+الطريق؟ يعني هذه المشكلة، و لو راح العمل مش هيعمل
+
+313
+00:28:44,930 --> 00:28:50,370
+مثلا هذه من ال side effects في حاجات كتيرة في
+
+314
+00:28:50,370 --> 00:28:54,310
+الأدوية بدها مراعاة الإنسان قبل ما ياخد الدواء، ان
+
+315
+00:28:54,310 --> 00:28:59,010
+يكون عليم بالأثار الجانبية للدواء، حتى يكون هو في
+
+316
+00:29:04,860 --> 00:29:09,220
+بقول في الأول في serious side effects يعني في side
+
+317
+00:29:09,220 --> 00:29:13,380
+effects يعني ممكن تكون صعبة كتير يعني ممكن تقتل
+
+318
+00:29:13,380 --> 00:29:18,720
+الإنسان أو تعمله يعني دوة يعني تعمله يعني أثر جنبي
+
+319
+00:29:18,720 --> 00:29:22,120
+خطيرة أو مرض خطير in addition to common side
+
+320
+00:29:22,120 --> 00:29:24,940
+effects many drugs cause dangerous side effects
+
+321
+00:29:24,940 --> 00:29:29,720
+يعني أثر جنبي خطيرة if a drug has numerous
+
+322
+00:29:29,720 --> 00:29:30,520
+problems
+
+323
+00:29:33,210 --> 00:29:36,830
+فده في وضع Drug Administration بتاعة أمريكا بتتذكر
+
+324
+00:29:36,830 --> 00:29:42,850
+Can add warming to the drugs label تحذير تحذير
+
+325
+00:29:42,850 --> 00:29:46,070
+بيكلف الشركة لازم تكتب عليه تحذير أن هذا الدواء
+
+326
+00:29:46,070 --> 00:29:51,990
+يسبب كده و كده و كدهبيقول لي تحذير can add warning
+
+327
+00:29:51,990 --> 00:29:58,130
+to the drugs label including its stringent blood
+
+328
+00:29:58,130 --> 00:30:03,270
+box warning يعني صندوق أسود انتم عليا انه يحذر هذا
+
+329
+00:30:03,270 --> 00:30:09,770
+الدواء كوشن بيعمل كده و كده و كده لكن في حالات ان
+
+330
+00:30:09,770 --> 00:30:15,390
+يكون الدواء عنده شيء خطير خطير فانه يأمره بسحبه من
+
+331
+00:30:15,390 --> 00:30:20,220
+الأسواق يصحب من الأسواقلو قدام الهالة خطير بيصحى
+
+332
+00:30:20,220 --> 00:30:24,580
+في نفسه، وانا أقول كانوا في الزمن يعني اللي هو
+
+333
+00:30:24,580 --> 00:30:28,580
+السجاهد اللي بيكون الصراع في أمريكا كان بعض
+
+334
+00:30:28,580 --> 00:30:36,750
+المزارع اللي ..ال .. ال tobacco هذي فيه بجانب يعني
+
+335
+00:30:36,750 --> 00:30:39,830
+أجزة
+
+336
+00:30:39,830 --> 00:30:47,210
+نوية اه و مفاعل نوية إشعية فكان يعني بعض الإشعات
+
+337
+00:30:47,210 --> 00:30:52,130
+بتخرج إلى اللي هو النبات بتاع ال tobacco هذا و
+
+338
+00:30:52,130 --> 00:30:59,230
+اكتشف هذا وسحبسحب قبل ذلك يعني في حماية المواطن من
+
+339
+00:30:59,230 --> 00:31:04,590
+الأعضاء الخطيرة لإيه اللي هو الأدوية from deadly
+
+340
+00:31:04,590 --> 00:31:08,010
+cancer or fatal heart attacks يعني ممكن بعض ال
+
+341
+00:31:08,010 --> 00:31:13,470
+drugs تم ال cancer او تم ال heart attackبعض
+
+342
+00:31:13,470 --> 00:31:21,450
+الدراجات الاسبابية كانت معروفة لسبب او موت بطيء او
+
+343
+00:31:21,450 --> 00:31:26,150
+موت بسرعة بسرعة بعض الدراجات الاسبابية مثل بنسيلين
+
+344
+00:31:26,150 --> 00:31:30,610
+تشجع ايجابات الهيجوم الهيجوم الهيجوم الهيجوم
+
+345
+00:31:30,610 --> 00:31:32,570
+الهيجوم
+
+346
+00:31:43,060 --> 00:31:47,120
+إن ربنا تحدث ال shock في أي لحظة وبالتالي يكونوا
+
+347
+00:31:47,120 --> 00:31:51,900
+محضروا حاله للعراضة الجرمية ويتصرفوا سريعا بأفعال
+
+348
+00:31:51,900 --> 00:31:57,360
+كورتيزون مع أدنالين مع أنتيستامين آه سريعا جدا
+
+349
+00:31:57,360 --> 00:32:02,540
+وينقلوا إلى اللولسعة other drugs may cause
+
+350
+00:32:02,540 --> 00:32:06,480
+patients to do things they would not ordinarily
+
+351
+00:32:06,480 --> 00:32:10,400
+consider including suicide يعني بيقول في بعض
+
+352
+00:32:10,400 --> 00:32:15,850
+الأدويةالإنسان ممكن يفكر في الانتحار وتحمل واحد
+
+353
+00:32:15,850 --> 00:32:20,770
+انتحار such as Acutane Acutane هذا antidepressant
+
+354
+00:32:20,770 --> 00:32:25,290
+مضاد الاكتئاب ممكن ان يعمل suicidal thoughts يعني
+
+355
+00:32:25,290 --> 00:32:30,410
+الإنسان فعلا يفكر في الانتحار فمثل هذه الأدوية
+
+356
+00:32:30,410 --> 00:32:33,410
+لازم الإنسان ياخدها في حضر أو نطاق
+
+357
+00:32:38,040 --> 00:32:42,400
+طيب فى ضامن اوى بتعمل physical debilitation،
+
+358
+00:32:42,400 --> 00:32:46,620
+debilitation اللى هو الوهن الجسدي، من الدراجس can
+
+359
+00:32:46,620 --> 00:32:50,800
+be physically and emotionally debilitating، بتعمل
+
+360
+00:32:50,800 --> 00:32:57,160
+وهن عاطفي ووهن اللى هو اجتسمالى including total or
+
+361
+00:32:57,160 --> 00:33:00,720
+partial paralysis or severe pain، ممكن تعمل severe
+
+362
+00:33:00,720 --> 00:33:04,560
+pain او يعني وهن ممكن شبه الشجر يعنى
+
+363
+00:33:14,670 --> 00:33:19,990
+Joint and muscle pain and decreased control of
+
+364
+00:33:19,990 --> 00:33:23,290
+bodily functions.يعني هو مثلا بده يمشي، بده مثلا
+
+365
+00:33:23,290 --> 00:33:25,650
+يتحرك، بده سيف بيت، تطبخ
+
+366
+00:33:32,430 --> 00:33:35,730
+Sometimes these side effects are caused by the
+
+367
+00:33:35,730 --> 00:33:38,810
+drug's numbing effect on the area of the brain
+
+368
+00:33:38,810 --> 00:33:42,810
+responsible for pain perception.يعني في بعض
+
+369
+00:33:42,810 --> 00:33:47,250
+الأدوية بتأثر على مركز الإحساس بالألم في المخ، إما
+
+370
+00:33:47,250 --> 00:33:51,970
+بتثبته و إما بتزوده، إما تثبته أو بتزوده.مثلا في
+
+371
+00:33:51,970 --> 00:33:56,500
+الهيل اسمه Lipitor.Lipitor هذا المكتوب؟هذا بياخدوه
+
+372
+00:33:56,500 --> 00:34:00,920
+عشان ينزلوا الدهنيات في الدم اللي بتروح الكلسترول
+
+373
+00:34:00,920 --> 00:34:04,040
+والدهنيات الثلاثية اللي نزلوها في الدم Commonly
+
+374
+00:34:04,040 --> 00:34:12,060
+prescribed as hypo cholesterol medication يعني
+
+375
+00:34:12,060 --> 00:34:18,960
+ينزل الكوليسترول في الدم is linked to unexpected
+
+376
+00:34:18,960 --> 00:34:23,710
+muscle pain and loss of muscle coordinationطب ال
+
+377
+00:34:23,710 --> 00:34:26,370
+muscle pair عارفينه؟ و ال muscle coordination؟
+
+378
+00:34:26,370 --> 00:34:32,370
+التناصق يعني واحد بيمشي و هيقف المشي العادية لأ
+
+379
+00:34:32,370 --> 00:34:38,470
+ممكن أبدا تلاقي هذا يعني بيتأرجح مثلا يحرك يديه
+
+380
+00:34:38,470 --> 00:34:44,430
+إلى الخارج مثلا أو يمشي يعني برجلين يعني بدون
+
+381
+00:34:44,430 --> 00:34:48,230
+انتظام اللي بتهور هاي مثلا side effect
+
+382
+00:34:51,320 --> 00:34:57,960
+في بعض الأدوية تعمل على القلب بعض الـ side effects
+
+383
+00:34:57,960 --> 00:35:01,120
+Problems related to heart, including heart attacks
+
+384
+00:35:01,120 --> 00:35:04,520
+او congestive heart failure، فشل القلب، lifelong
+
+385
+00:35:04,520 --> 00:35:11,000
+heart damage، and cardiomyopathy احتلال القلب Have
+
+386
+00:35:11,000 --> 00:35:13,940
+been linked to many prescription drugs, sometimes
+
+387
+00:35:13,940 --> 00:35:17,980
+the drugs cause an increase in water weight gain
+
+388
+00:35:22,110 --> 00:35:30,590
+ميا داخل الجسم طب حقس الميا داخل الجسم هيؤدى الى
+
+389
+00:35:30,590 --> 00:35:35,450
+ارتفاع ضعف الدم طيب ارتفاع ضعف الدم بدون علاج
+
+390
+00:35:35,450 --> 00:35:40,490
+هيؤدى الى heart failure يقولوا بالكوا هدى .. هدى
+
+391
+00:35:40,490 --> 00:35:46,950
+معروفة هدى معروفة بقولك الكورتيزون كورتيزون برفع
+
+392
+00:35:46,950 --> 00:35:50,070
+ضعف الدم كيف الكورتيزون برفع ضعف الدم؟
+
+393
+00:36:01,180 --> 00:36:07,760
+وإذا كان ماكانش فيه follow up و supervision من
+
+394
+00:36:07,760 --> 00:36:15,680
+الدكتور ممكن انه heart failure وirreversible يبقى
+
+395
+00:36:15,680 --> 00:36:19,600
+such as caused with avandia avandia هو اللي كان
+
+396
+00:36:19,600 --> 00:36:26,610
+يعني علاجو ايه اللي وقع اسمه اكتوس زيه يعني لغاية
+
+397
+00:36:26,610 --> 00:36:32,650
+بتعمل heart failure و ال اكتوس بيعمل heart failure
+
+398
+00:36:32,650 --> 00:36:40,310
+في حاجة اسمها celibax هذا بياخدوا للألم الشديد و
+
+399
+00:36:40,310 --> 00:36:44,670
+الصداع الشديد بيقولوا pain killer قاتل الألم
+
+400
+00:36:44,670 --> 00:36:48,070
+تعرفين المرحلة اللي حصلت مع ألم شديد صداع شديد
+
+401
+00:36:48,070 --> 00:36:54,050
+بيقولك خد أكمليقولك بسرش فيا خد التروفين بسرش فيا
+
+402
+00:36:54,050 --> 00:36:59,670
+بيبقى أقوى لغاية بعض الناس بيصير يلجأ إلى الأقاس
+
+403
+00:36:59,670 --> 00:37:06,490
+المخدرة زي القرمال حتى إيش يقلل الألم او احتمال
+
+404
+00:37:06,490 --> 00:37:11,830
+الألم يعني صعب فcelbraxana have been proven to be
+
+405
+00:37:11,830 --> 00:37:14,450
+so risky ايش risky؟
+
+406
+00:37:17,810 --> 00:37:21,250
+The doctors refused to prescribe it for long term
+
+407
+00:37:21,250 --> 00:37:26,570
+use يعني في دوة كانت اسمها Algonal أقراص مسكنة
+
+408
+00:37:26,570 --> 00:37:33,250
+مظبطة بس فيها كدين مادة مخدرة لما الحكومة هنا إجت
+
+409
+00:37:33,250 --> 00:37:38,290
+يعني ووجدت إن الشباب بيستهلك Algonal كثير قالت
+
+410
+00:37:38,290 --> 00:37:42,270
+مموع إلا بوصفة طبيعية ويكون الطبيب
+
+411
+00:37:48,000 --> 00:37:51,720
+نفسها اللي مصابتها منه جدارة الصحة أو من أي أدم
+
+412
+00:37:51,720 --> 00:37:58,220
+لأنه وجدوا أن هذا مدخل للإدمان هو في الظاهر
+
+413
+00:37:58,220 --> 00:38:03,460
+بياخدها لألم لكنه بياخدها لـCare أقراص الـ
+
+414
+00:38:03,460 --> 00:38:08,060
+Tramadol ترمدل نفسي بالقصةهو يعني الناس كانت
+
+415
+00:38:08,060 --> 00:38:11,740
+تاخدها للألم الشديد، مسكّن أقوى من الأوتروفين
+
+416
+00:38:11,740 --> 00:38:17,200
+والبرستامول والاسبرين والكلام هذا، لكن إساءة
+
+417
+00:38:17,200 --> 00:38:22,660
+استعمالها أدت إلى الإدمان، فرق أنا ما أعطي مريض في
+
+418
+00:38:22,660 --> 00:38:29,450
+مستشفى مثلا يومين أو تلاتةمثلا قص مرتين او تلاتة
+
+419
+00:38:29,450 --> 00:38:32,590
+في اليوم و لغاية مرتين لم نستخدمها ليومين تلاتة و
+
+420
+00:38:32,590 --> 00:38:36,130
+مش عارف هي ايش الأقراص هالي و انتهينا هنا و بينشه
+
+421
+00:38:36,130 --> 00:38:40,030
+بيروح عارفها و بيستعمل و بيروح بيشتريها بفلوسه و
+
+422
+00:38:40,030 --> 00:38:44,330
+بيخبيها و بيتعاطعها سرعا تعاطعها سرعا حتي يعملوا
+
+423
+00:38:44,330 --> 00:38:48,470
+addiction و لما تعملوا addiction أصبحت مصيبة
+
+424
+00:38:48,470 --> 00:38:52,450
+فمصيبة مصيبة فمصيبة أصبحت بدل زيادة بدل زيادة بدل
+
+425
+00:38:52,450 --> 00:38:57,210
+زيادة strokeالـ stroke السكتر الدماغي هو أحد
+
+426
+00:38:57,210 --> 00:39:01,750
+الأخطر ما يواجه الانسان ان يصيبه stroke described
+
+427
+00:39:01,750 --> 00:39:09,180
+as the rapid loss of brain functionيعني يتوقف المخ
+
+428
+00:39:09,180 --> 00:39:14,080
+عن العمل due to a blood flow disturbance التراب في
+
+429
+00:39:14,080 --> 00:39:19,360
+اللي هو الدم عنده خاصة الديالطات Strokes have been
+
+430
+00:39:19,360 --> 00:39:23,900
+linked to several kinds of prescription drugs طعم
+
+431
+00:39:23,900 --> 00:39:26,800
+الوصفات الدوائية in some cases the drugs cause
+
+432
+00:39:26,800 --> 00:39:31,280
+blood clots to form كيف يعني؟يعني في بعض الأدوية
+
+433
+00:39:31,280 --> 00:39:36,700
+تحفظ تجيلة الدم داخل الشراين طبعا الشراين الكبيرة
+
+434
+00:39:37,850 --> 00:39:41,510
+يعني بتبتبتمشيه، لكن مثلا الشراير الصغير زي الـ
+
+435
+00:39:41,510 --> 00:39:44,770
+cerebral arteries في المخ بتقعد تبقى الembolism
+
+436
+00:39:44,770 --> 00:39:49,730
+سدالة طيب، هذا شرار الصغير في ال brain اللي هو
+
+437
+00:39:49,730 --> 00:39:55,390
+تتكر، معناه إنه فيش دم هيمر ورا، إيه النسيج المخي
+
+438
+00:39:55,390 --> 00:40:00,550
+هذا؟ جزء من المخ مثلا في خلال دقيقتين أو تلات
+
+439
+00:40:00,550 --> 00:40:06,770
+عصير، brain infarction، infarction mode في المنطقة
+
+440
+00:40:06,770 --> 00:40:13,710
+هذهوحاسيب stroke كل او جزء من المخ يمكن ان يحركوا
+
+441
+00:40:13,710 --> 00:40:16,110
+برنامج برنامج برنامج برنامج
+
+442
+00:40:39,800 --> 00:40:44,000
+بيجلّط الدم و بيروح عشرين صغيرة بيسكّلها وبالتالي
+
+443
+00:40:44,000 --> 00:40:48,660
+بيصير stroke في ال brain other drugs including the
+
+444
+00:40:48,660 --> 00:40:54,900
+pain killer Viox قاطل الألم هنا Viox برضه linked
+
+445
+00:40:54,900 --> 00:41:00,060
+to stroke فالإنسان لما بيقرأ الحاجة تانية و بيفهم
+
+446
+00:41:00,060 --> 00:41:05,980
+الحاجة تانية مابيقع في المحدودةالإنسان عشان يعالج
+
+447
+00:41:05,980 --> 00:41:11,440
+حاجة نفسية يروح يوقف مخه يعني معناها الموت معناها
+
+448
+00:41:11,440 --> 00:41:16,800
+الموت خاصة على فترة طويلة تتصرفوا ان شعار الدراكسي
+
+449
+00:41:16,800 --> 00:41:25,980
+بتعمل cancer بتعمل سرطان أثر جنبية كل إله ما طول
+
+450
+00:41:25,980 --> 00:41:29,700
+استعماله لفترة أطول أطول أطول كل ما كان على فترة
+
+451
+00:41:29,700 --> 00:41:32,700
+أعلى probably one of the most shocking
+
+452
+00:41:41,650 --> 00:41:45,190
+الشيء الوحيد اللي يجعلنا نفسنا نفسنا نفسنا نفسنا
+
+453
+00:41:45,190 --> 00:41:45,190
+نفسنا نفسنا نفسنا نفسنا نفسنا نفسنا نفسنا نفسنا
+
+454
+00:41:45,190 --> 00:41:46,790
+نفسنا نفسنا نفسنا نفسنا نفسنا نفسنا نفسنا نفسنا
+
+455
+00:41:46,790 --> 00:41:46,790
+نفسنا نفسنا نفسنا نفسنا نفسنا نفسنا نفسنا نفسنا
+
+456
+00:41:46,790 --> 00:41:47,510
+نفسنا نفسنا نفسنا نفسنا نفسنا نفسنا نفسنا نفسنا
+
+457
+00:41:47,510 --> 00:41:47,970
+نفسنا نفسنا نفسنا نفسنا نفسنا نفسنا نفسنا نفسنا
+
+458
+00:41:47,970 --> 00:41:54,650
+نفسانا نفسانا نفسانا نفسانا نفسانا نفسانا
+
+459
+00:41:54,650 --> 00:42:04,150
+نفسا
+
+460
+00:42:04,580 --> 00:42:10,960
+مصيبة شوكنج تجبارها شوكنج such as cigarette
+
+461
+00:42:10,960 --> 00:42:17,010
+smoking مثلااللي قلته بقى سواء التدخين ال direct
+
+462
+00:42:17,010 --> 00:42:20,690
+الإيجابي أو السلبي واحد بيقعد معاه مدخنين ع شيشة
+
+463
+00:42:20,690 --> 00:42:25,750
+ممكن ينصاب سرطان واحد بيروح في سيارة رايح جاي في
+
+464
+00:42:25,750 --> 00:42:30,230
+السيارة كلها مغلقة في الشتاء ودخان ممكن ينصاب
+
+465
+00:42:30,230 --> 00:42:36,090
+سرطان بعض الناس بيقولك أنه التدخين السلبي بيعمل
+
+466
+00:42:36,090 --> 00:42:39,970
+سرطان أكتر من الإيجابي ليش؟ اللي بياخد السيجارة
+
+467
+00:42:39,970 --> 00:42:40,610
+إلها filter
+
+468
+00:42:46,110 --> 00:42:50,050
+كثير من القار و من المواد السامة لكن الناس اللي
+
+469
+00:42:50,050 --> 00:42:54,650
+حوليه في إطاره سيارة صغيرة مغلقة بياخدوه بدون
+
+470
+00:42:54,650 --> 00:43:00,490
+فلترة وبالتالي ايش؟ بيكون عرضة ان هو يتسرطن مع
+
+471
+00:43:00,490 --> 00:43:03,910
+الايام ان كانت الايام طويلة بهذه الطريقة طبعا
+
+472
+00:43:03,910 --> 00:43:06,710
+انتوا هتخافوا تقولوا ايش نعمل؟ ممكن تشتريوا سيارات
+
+473
+00:43:11,280 --> 00:43:16,440
+عندما يتعرف الشخص ان مصاباته يمكن ان تكون
+
+474
+00:43:16,440 --> 00:43:20,260
+كانسوريجينية يشعرون غاضبين ومخاطبين، اول ما يتقرأ
+
+475
+00:43:20,260 --> 00:43:24,400
+ان هذا بيعمل ممكن يعمل كانسر، اه بيصير غاضب وزعلان
+
+476
+00:43:24,400 --> 00:43:28,380
+ومشي، واحدة من الموضوعات الشخصية اه كانسر
+
+477
+00:43:28,380 --> 00:43:33,580
+الاتصالات تسمى تماكسيفين، للأسف تماكسيفين هو
+
+478
+00:43:33,580 --> 00:43:39,470
+المستخدم لعلاج برست كانسر في النساءوهو سرطان
+
+479
+00:43:39,470 --> 00:43:43,670
+التهديد. هذا ويقولون علاقة بـ Neutral Cancer،
+
+480
+00:43:43,670 --> 00:43:50,090
+سرطان الرحمة. ركزي فيه. مثلا، هذه واحدة. In
+
+481
+00:43:50,090 --> 00:43:53,630
+addition to Actus اللي قلنا قبل هيك، a drug that
+
+482
+00:43:53,630 --> 00:43:55,410
+is a support to
+
+483
+00:43:58,730 --> 00:44:04,270
+هو عرض اللي اللي هو السكري is linked to eighty
+
+484
+00:44:04,270 --> 00:44:08,370
+percent increased risk of bladder cancer بلادر
+
+485
+00:44:08,370 --> 00:44:11,050
+البطهانة البورية سرطان البطهانة البورية in those
+
+486
+00:44:11,050 --> 00:44:15,730
+taking the drug two years or longer سنتين او اكتر
+
+487
+00:44:15,730 --> 00:44:19,430
+عشان هيك مدة تأخذ العلاج والجوع العلاجية الها في
+
+488
+00:44:19,430 --> 00:44:23,730
+الموضوع الها في الموضوع طيب حاني اقف ان شاء الله
+
+489
+00:44:23,730 --> 00:44:23,830
+عن
+
+490
+00:44:29,170 --> 00:44:33,550
+يعني في نهاية المحاضرة نشكر الطلبات و .. على
+
+491
+00:44:33,550 --> 00:44:38,930
+الحضور و نتمنى يعني أن تقراوا أول بأول حتى نستطيع
+
+492
+00:44:38,930 --> 00:44:44,390
+أننا نكمل يعني ب .. بثبات و المناقشة يعني التي
+
+493
+00:44:44,390 --> 00:44:47,850
+أجرناها اليوم ربما .. ربما نجري مثلها في المحاضرة
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/prxHShweAH8_postprocess.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/prxHShweAH8_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..a425833c6e784ec93e5722a4207e358a0f83b721
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/prxHShweAH8_postprocess.srt
@@ -0,0 +1,2088 @@
+1
+00:00:20,670 --> 00:00:26,030
+بسم الله الرحمن الرحيم الحمد لله كما علمنا نحمد و
+
+2
+00:00:26,030 --> 00:00:31,430
+نصلي و نسلم على خير خلق الله سيدنا محمد طالباتي
+
+3
+00:00:31,430 --> 00:00:38,310
+العزيزات في هذا اليوم سنكمل ما كنا قد بدأنا من
+
+4
+00:00:38,310 --> 00:00:46,870
+drug metabolism drug metabolism التمثيل الغذائي
+
+5
+00:00:56,990 --> 00:01:02,770
+نسميه metabolism ونسميه bio transformation
+
+6
+00:01:02,770 --> 00:01:11,350
+التحول الحيوي للدواء to be effective inside the
+
+7
+00:01:11,350 --> 00:01:15,230
+tissues of the body يبقى it is a process that
+
+8
+00:01:15,230 --> 00:01:19,290
+chemically inactivates a drug by converting it
+
+9
+00:01:29,150 --> 00:01:33,830
+أو نتائج التمثيل الغذائي for excretion from the
+
+10
+00:01:33,830 --> 00:01:40,470
+body حتى يخرج من اللي هو الجسم بعد ذلك The main
+
+11
+00:01:40,470 --> 00:01:43,690
+site of biotransformation or metabolism is the
+
+12
+00:01:43,690 --> 00:01:49,870
+liver because the liver is full of enzymes that
+
+13
+00:01:49,870 --> 00:01:51,930
+can dissociate the drugs
+
+14
+00:01:55,200 --> 00:02:01,480
+بالنسبة للعضلات الروحانية تعمل ميتابولات للدراجات
+
+15
+00:02:01,480 --> 00:02:09,040
+مثل البلازما، الكدنس، البلانز، وميوكاس مبرين أوبرا
+
+16
+00:02:09,040 --> 00:02:13,640
+الانتستان، الانتستان الصغير، ولكن بقيمة أقل
+
+17
+00:02:22,840 --> 00:02:28,760
+التغييرات الكيميائية تنتج من نظام نظام موجود كبير
+
+18
+00:02:28,760 --> 00:02:33,800
+في الجلد، من هذا البروكسس التغييرات تتحول إلى أكتر
+
+19
+00:02:33,800 --> 00:02:42,100
+مطبخ ومطبخ مياه أكتر مطبخ لتدخل الجلد
+
+20
+00:02:53,550 --> 00:03:00,390
+In some persons, the process of metabolism will be
+
+21
+00:03:00,390 --> 00:03:09,510
+impaired or delayed in
+
+22
+00:03:09,510 --> 00:03:10,990
+five conditions
+
+23
+00:03:17,520 --> 00:03:27,700
+Liver cirrhosis liver inflammation liver viral
+
+24
+00:03:27,700 --> 00:03:31,020
+infection زي Hepatitis B
+
+25
+00:03:44,690 --> 00:03:47,050
+يعني طالما الليفر هو ال main organ of metabolism،
+
+26
+00:03:47,050 --> 00:03:52,190
+لو الليفر نفسه صلوا disease or damage، طلع ان
+
+27
+00:03:52,190 --> 00:03:56,970
+عملية الميتابوليزم بتتأخر او بتتوقف Two renal
+
+28
+00:03:56,970 --> 00:04:02,050
+problems، renal problems، ايضا قلنا ان الكيدنس
+
+29
+00:04:02,050 --> 00:04:04,530
+فيها enzymes وكلام برضه
+
+30
+00:04:07,370 --> 00:04:13,070
+معالجة الأدوى اه فممكن الأمور تتأخر وبتاعي كمان ال
+
+31
+00:04:13,070 --> 00:04:16,230
+execution يعني ال kids بتعمل متابوليزم و بتعمل
+
+32
+00:04:16,230 --> 00:04:20,870
+execution فيتأخروا اتنين طيب cardiovascular
+
+33
+00:04:20,870 --> 00:04:26,830
+dysfunction cardiovascular dysfunction يعني ال
+
+34
+00:04:26,830 --> 00:04:31,430
+heart و ال blood vessels طبعا بيكون فيه heart
+
+35
+00:04:31,430 --> 00:04:36,170
+failure بيكون فيه slow circulation و irregular
+
+36
+00:04:36,170 --> 00:04:43,760
+circulationوبالتاني يعني تتأجر العملية أو تتأخر
+
+37
+00:04:43,760 --> 00:04:48,760
+العملية بتاعة ال متابوليزم أيضا in infants and old
+
+38
+00:04:48,760 --> 00:04:54,640
+age ال infants الإنظام في اللغة بتكون immature
+
+39
+00:04:54,640 --> 00:05:01,000
+نفسها بينما ال old age بتكون دي generation يعني
+
+40
+00:05:01,000 --> 00:05:01,820
+خلاص اهترت
+
+41
+00:05:06,210 --> 00:05:11,570
+يبقى في الأطفال دول السنة أو دول السنتين ممكن تبقى
+
+42
+00:05:11,570 --> 00:05:18,110
+أنه ال metabolism بتاعهم يكون less than normal وفي
+
+43
+00:05:18,110 --> 00:05:22,910
+كبار السن يكون less than normal الله هو اللي خلقكم
+
+44
+00:05:22,910 --> 00:05:31,040
+من ضعفثم جعل من بعد ضعف قوة، شباب، ثم جعل من بعد
+
+45
+00:05:31,040 --> 00:05:37,880
+قوة ضعف وشيبة، يخلق ما يشاء وهو العليم القادر، وهو
+
+46
+00:05:37,880 --> 00:05:42,260
+العليم القادر، يعود الإنسان بعد مرحلة الشباب إلى
+
+47
+00:05:42,260 --> 00:05:49,580
+اللي هو الشيخوخة وإلى الضعف.طيب Execretion،
+
+48
+00:05:49,580 --> 00:05:55,520
+الإخراج، خالد هو، كان من بصر، خالد إن كانIs a
+
+49
+00:05:55,520 --> 00:05:59,680
+process by which drugs and active or inactive drug
+
+50
+00:05:59,680 --> 00:06:01,840
+metabolites are eliminated from the body.
+
+51
+00:06:01,900 --> 00:06:10,840
+Eliminated أي أنها تذهب الخارج، تذهب من الجسم أي
+
+52
+00:06:10,840 --> 00:06:16,820
+طعام أو دواء يدخل الجسم المفروض بعد فترة أن يخرج
+
+53
+00:06:16,820 --> 00:06:21,080
+إلى الخارج إذا لم يخرج إلى الخارج فهناك مشكلة،
+
+54
+00:06:21,080 --> 00:06:25,890
+هناك مشكلةبالتالي، هذا البرنامج يقلل مستوى الدواء
+
+55
+00:06:25,890 --> 00:06:31,870
+بشكل مباشر، يعني لو احنا أخدنا دواء وصل مستوى مية
+
+56
+00:06:31,870 --> 00:06:39,490
+أو مستوى متين في الدم ثم أوقفنا دراج انتيج، فانه
+
+57
+00:06:39,490 --> 00:06:43,530
+سوف ينزل إلى الصفر، المفروض ينزل إلى الصفر
+
+58
+00:06:47,180 --> 00:06:50,440
+من اين يزال؟ الراهنة الطرق اللتي يزال بواسطسها
+
+59
+00:06:50,440 --> 00:06:56,340
+الدواء من الجسم اول شيء و ال main site of drug
+
+60
+00:06:56,340 --> 00:07:01,760
+elimination هي ال kidneys الكليتان ال majority of
+
+61
+00:07:01,760 --> 00:07:02,760
+drug and or
+
+62
+00:07:27,410 --> 00:07:35,950
+هواء الزفير بجاسس جاسس and volatile liquids and
+
+63
+00:07:35,950 --> 00:07:36,950
+general anaesthesia
+
+64
+00:07:54,390 --> 00:07:57,310
+مش بعيد لو واحد جربله كتير شوية و هو كمان اتمنى
+
+65
+00:07:57,310 --> 00:08:04,990
+جدا يعني كثير من الناس في نفسه بيطلع اللي .. اللي
+
+66
+00:08:04,990 --> 00:08:06,190
+هو ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+67
+00:08:06,190 --> 00:08:06,270
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+68
+00:08:06,270 --> 00:08:06,390
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+69
+00:08:06,390 --> 00:08:07,890
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+70
+00:08:07,890 --> 00:08:08,190
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+71
+00:08:08,190 --> 00:08:09,070
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+72
+00:08:09,070 --> 00:08:09,490
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+73
+00:08:09,490 --> 00:08:12,450
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+74
+00:08:12,450 --> 00:08:15,730
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+75
+00:08:15,730 --> 00:08:19,770
+ال ..
+
+76
+00:08:19,770 --> 00:08:25,300
+ال .. الin feces في البواس many areas are innate
+
+77
+00:08:25,300 --> 00:08:29,980
+through the intestine in the feces by biliary
+
+78
+00:08:29,980 --> 00:08:37,780
+excretion افراز المنعرة والمنعرة هي ال gallbladder
+
+79
+00:08:37,780 --> 00:08:43,940
+اللي هي تابعة للكبت في بعض الجمهور الكبت بيعطيها
+
+80
+00:08:45,750 --> 00:08:49,890
+للمرارة و المرارة بتعطيها للأمعاء و الأمعاء
+
+81
+00:08:49,890 --> 00:08:57,090
+بتخرجها في المراسل مش كل شي يعني بعض الأشياء أفضل
+
+82
+00:08:57,090 --> 00:09:04,130
+sweet and salivary glands secretion العرق و
+
+83
+00:09:04,130 --> 00:09:08,410
+إفرازات الغدد اللعبية و الغدد
+
+84
+00:09:18,930 --> 00:09:23,930
+اللي هو بعض الأدوية و الشيء المشهور اللي يخرج في
+
+85
+00:09:23,930 --> 00:09:29,430
+العراق ال arena ال arena اللي هي الحلبة كثير احنا
+
+86
+00:09:29,430 --> 00:09:32,990
+جربنا هذا الموضوع و بعض الناس اللي هو .. اللي هو
+
+87
+00:09:32,990 --> 00:09:37,430
+يعني نشاط اجتماعي زي كويس بطلع و بنزل و يرفض انه
+
+88
+00:09:37,430 --> 00:09:40,970
+يشرب حلبة او يأكل حلبة لأن رائحتها
+
+89
+00:09:45,430 --> 00:09:52,910
+memory glands، memory glands اللي هو اللبن
+
+90
+00:09:52,910 --> 00:09:57,350
+اللي يخرج من الثدى عند المرضى، عند المرضيات
+
+91
+00:09:57,350 --> 00:10:01,470
+transfer drugs with milk from mother to body baby
+
+92
+00:10:01,470 --> 00:10:06,230
+to baby from mother to baby كتير يعني في
+
+93
+00:10:06,230 --> 00:10:11,910
+precautions اللي هو إيش تحذيرات يومنا أخد هذا
+
+94
+00:10:11,910 --> 00:10:14,650
+الدواء للحوامل و المرضيات
+
+95
+00:10:16,930 --> 00:10:19,990
+لأن من الحوام اللي بيخش من ال placental blood
+
+96
+00:10:19,990 --> 00:10:25,510
+barrier اللي قلناه المرمجة إلى اللي هو الجهل و
+
+97
+00:10:25,510 --> 00:10:30,270
+خلال ال lactation اللي هو الإرضاع يصل من السمي عن
+
+98
+00:10:30,270 --> 00:10:35,730
+طريق اللبن إلى اللوم يعني في زي البنسين وبعض المدن
+
+99
+00:10:35,730 --> 00:10:39,550
+الحيوية تصل إلى الطفل وبالتالي يعني لو كان
+
+100
+00:10:51,460 --> 00:10:54,780
+the risk of drug accumulation and drug toxicity is
+
+101
+00:10:54,780 --> 00:11:00,320
+increased يعني لو احنا بناخد الدواء و الدواء فيه
+
+102
+00:11:00,320 --> 00:11:05,460
+الدم بيطلع و ال excretion من ال kidneys impaired
+
+103
+00:11:05,460 --> 00:11:10,460
+فيه مشكلة مش ماشي بالجامعة بالجامعة بس هو
+
+104
+00:11:10,460 --> 00:11:16,680
+accumulation in blood و in tissues و هذا شيء بيخوف
+
+105
+00:11:16,680 --> 00:11:23,960
+لأن الدواء انتوا عارفين الدواء و دهالحالة هذه
+
+106
+00:11:23,960 --> 00:11:31,400
+المفروض احنا نعمل تحليلات معينة لنسبة الدواء في ال
+
+107
+00:11:31,400 --> 00:11:34,860
+urine في ال bowl و نعرف اذا كان ال urine بتاعه
+
+108
+00:11:34,860 --> 00:11:38,460
+جالين في ال bowl لازم احنا احد امرين يا نوقف نعطي
+
+109
+00:11:38,460 --> 00:11:43,120
+الدواء يا نخفض الجرعة يا نعطي الجرعة قليلا عشان
+
+110
+00:11:43,120 --> 00:11:47,840
+مانضرش الجسم يا اما نوقف اذا كان الموضوع .. يعني
+
+111
+00:11:47,840 --> 00:11:52,190
+دخلت بالمرضة واقف مفروض مانعطيش الدواءفي حالة
+
+112
+00:11:52,190 --> 00:11:56,430
+كهذه، الدوس يعني الجوعة تتقلل في معظم الدروس في
+
+113
+00:11:56,430 --> 00:11:57,590
+حالة عملية عملية عملية عملية عملية عملية عملية
+
+114
+00:11:57,590 --> 00:11:58,250
+عملية عملية عملية عملية عملية عملية عملية عملية
+
+115
+00:11:58,250 --> 00:12:00,890
+عملية عملية عملية عملية عملية عملية عملية عملية
+
+116
+00:12:00,890 --> 00:12:01,430
+عملية عملية عملية عملية عملية عملية عملية عملية
+
+117
+00:12:01,430 --> 00:12:08,790
+عملية عملية عملية عملية عملية عملية عملية عملية
+
+118
+00:12:08,790 --> 00:12:09,130
+عملية عملية عملية عملية عملية عملية عملية عملية
+
+119
+00:12:09,130 --> 00:12:09,230
+عملية عملية عملية عملية عملية عملية عملية عملية
+
+120
+00:12:09,230 --> 00:12:10,230
+عملية عملية عملية عملية عملية عملية عملية عملية
+
+121
+00:12:10,230 --> 00:12:16,750
+عملية
+
+122
+00:12:16,750 --> 00:12:16,950
+ع
+
+123
+00:12:30,560 --> 00:12:36,100
+الـ onset of action بتناول المدة الزمنية time
+
+124
+00:12:36,100 --> 00:12:42,680
+interval between administration and notation of
+
+125
+00:12:42,680 --> 00:12:46,700
+the past therapeutic effect in body fluids يعني
+
+126
+00:12:46,700 --> 00:12:54,540
+أنا أعطيت أقراس مثلا مضاد حيوان ستمر فترة إلى أن
+
+127
+00:12:54,540 --> 00:12:58,400
+يصل إلى الدم و يبدأ بالارتفاع إلى مستوى علاجي
+
+128
+00:12:59,220 --> 00:13:05,160
+اللحظة اللي بدأ فيها مستوى الهدى في الدم هي بدء
+
+129
+00:13:05,160 --> 00:13:09,620
+الدواء البدء يبقى انكسر المسافة ما بين اعطار هذه
+
+130
+00:13:09,620 --> 00:13:14,000
+الأقراس او الكمسولات واتفاقه الى therapeutic level
+
+131
+00:13:14,000 --> 00:13:19,480
+ساعتين، تلاتة، اربعة، حسب حسب ال drug وحسب المعدو
+
+132
+00:13:19,480 --> 00:13:26,380
+وحسب الطعام وحسب حالة الأمعاء وكذا it depends on
+
+133
+00:13:26,380 --> 00:13:33,550
+تتمنى أعلىthe road of administration كيف أعطي
+
+134
+00:13:33,550 --> 00:13:36,610
+الدواء؟ من أين أعطي الدواء؟ عن أي طريقة؟ هل طريقة
+
+135
+00:13:36,610 --> 00:13:43,190
+سريعة زي ال IV الوريد ولا أبطأ زي ال IM ولا أبطأ
+
+136
+00:13:43,190 --> 00:13:47,490
+زي اللي هو ال suppositories أو ال subcutaneous تحت
+
+137
+00:13:47,490 --> 00:13:53,150
+الدول ولا أبطأ أبطأ أبطأ أبطأك الفامطبعا كله
+
+138
+00:13:53,150 --> 00:13:58,230
+بتناسب ان اعطيته عن داخل الفم رحلة طويلة وبالتالي
+
+139
+00:13:58,230 --> 00:14:04,090
+ال onset هيكون طويل ان اعطيته تحت الجلب هيكون يعني
+
+140
+00:14:04,090 --> 00:14:10,430
+متوسط ان اعطيته في العضل هيكون سريع ان كان في
+
+141
+00:14:10,430 --> 00:14:12,190
+الوريد أسرع أسرع
+
+142
+00:14:29,800 --> 00:14:35,520
+الدراج اللي بيكون soluble هيكون اللي هو ال onset
+
+143
+00:14:35,520 --> 00:14:41,080
+بتاعه أسرع بينما ال insoluble ممكن يتأخر جدا جدا
+
+144
+00:14:41,080 --> 00:14:46,100
+بينما ال size ممكن كل ما كان ال size كبير كل ما
+
+145
+00:14:46,100 --> 00:14:51,980
+كان أكتر وكل ما كان ال size أصغر كل ما كان أسرع
+
+146
+00:14:51,980 --> 00:14:58,180
+طيب كمان بيحتمل ال onset على ال rate of absorption
+
+147
+00:15:06,410 --> 00:15:11,870
+وكل ما كان ال rate of absorption اكتر بيكون
+
+148
+00:15:11,870 --> 00:15:16,510
+absorption ايضا formulation of the drug
+
+149
+00:15:16,510 --> 00:15:20,290
+formulation التركيبة بتاعة الدواء هل هو اقراس؟ هل
+
+150
+00:15:20,290 --> 00:15:24,330
+هو كبسولات؟ هل هو سائل؟ هل هو زي هيك يعني؟ او ا
+
+151
+00:15:24,330 --> 00:15:28,330
+بقول ال fluid form of the drug التركيبة السائلة
+
+152
+00:15:28,330 --> 00:15:32,350
+اللي بيخلوها الأطفال المضحايا مثلا او الكحة has a
+
+153
+00:15:32,350 --> 00:15:34,550
+more rapid onset of action
+
+154
+00:15:44,560 --> 00:15:49,760
+عطيهم إيش؟ سائل سائل يعني على حاجتين أول شي هو
+
+155
+00:15:49,760 --> 00:15:54,280
+يعني بيقدرش يبلع الأقراس مش متعود يبلع .. يبلع
+
+156
+00:15:54,280 --> 00:16:00,160
+الأقراس بيخاف من الأقراس لإنه يعني يرجعها تاني شي
+
+157
+00:16:00,160 --> 00:16:06,640
+للسرعة لإنه احنا حياة الطفل عندنا غالية طيب
+
+158
+00:16:07,710 --> 00:16:11,250
+بقول لي العوامل الأخرى اللي تؤثر في ال onset ال
+
+159
+00:16:11,250 --> 00:16:14,610
+onset fraction drug is especially variable from
+
+160
+00:16:14,610 --> 00:16:19,150
+person to person من شخص لشخص اثر oral
+
+161
+00:16:19,150 --> 00:16:22,690
+administration الان تكلمنا عن ال oral على الفم
+
+162
+00:16:22,690 --> 00:16:28,870
+depending on مرتمدا على one presence of food in
+
+163
+00:16:28,870 --> 00:16:34,730
+the stomach يعني معروف ال stomach هي اللي هييعني
+
+164
+00:16:34,730 --> 00:16:42,470
+دائمة الحركة continuous movement الآن إذا كان يعني
+
+165
+00:16:42,470 --> 00:16:48,970
+أخدنا drug on empty stomach this drug will go
+
+166
+00:16:48,970 --> 00:16:55,750
+rapidly to intestine لأنه فاضي المدى، ع طول،
+
+167
+00:16:55,750 --> 00:16:58,850
+بتعمله short digestion و إشي، بتدوّو و إشي و
+
+168
+00:16:58,850 --> 00:17:04,180
+بتتفعل إيش، ليه اللي عم نعرف؟وإذا كان المدى مليء
+
+169
+00:17:04,180 --> 00:17:10,740
+بالطعام بعد واجبة ثقيلة مثل الغداء أو اللانش أو
+
+170
+00:17:10,740 --> 00:17:17,340
+العشاء واجبة ثقيلة طبعا الدواء هيتأخر هيتأخر ال
+
+171
+00:17:17,340 --> 00:17:20,620
+digestion وبعدين هيتأخر ال absorption وبعدين
+
+172
+00:17:20,620 --> 00:17:23,500
+هيتأخر ال onset of action عشان يصل في الدم إلى
+
+173
+00:17:23,500 --> 00:17:30,060
+مستوى علاج بس المدى الفاضية لو أخدناها يعني
+
+174
+00:17:30,060 --> 00:17:31,120
+أعطيناها irritating
+
+175
+00:17:36,640 --> 00:17:42,100
+أو جسرك إرتيشن أو جسرك inflammation حسب لو كل شيء
+
+176
+00:17:42,100 --> 00:17:47,940
+له ثمن طيب موترتي أو gastroenteritis أحيانا ال
+
+177
+00:17:47,940 --> 00:17:53,200
+gastroenteritis كما يحدث في أخر يوم الصيام تتحرك
+
+178
+00:17:53,200 --> 00:17:57,500
+بسرعة فائقة و احنا بنسمع ال peristalsis اسمه
+
+179
+00:17:57,500 --> 00:18:02,320
+peristalsis حاجة لما نسمع ال peristalsis يقولك انا
+
+180
+00:18:02,320 --> 00:18:10,100
+يعني المعدة بتاعتي عمل إيش؟سوق القالب من الجول و
+
+181
+00:18:10,100 --> 00:18:13,220
+أحيانا في موضوع البرد أو موضوع كذا يعني بعض
+
+182
+00:18:13,220 --> 00:18:19,660
+الحالات تكون بطيقة فكل ما زاد حركة المعدة والأمقات
+
+183
+00:18:19,660 --> 00:18:24,060
+كل ما كان ال onset of action أسرع على طول الماكينة
+
+184
+00:18:24,060 --> 00:18:27,840
+شغالة الخلطة شغالة عطل البني توديه بينما كانت
+
+185
+00:18:27,840 --> 00:18:30,720
+بطيقة زي موضوع البرد ليش احنا في البرد أحيانا و
+
+186
+00:18:30,720 --> 00:18:32,040
+بنحدد ان احنا من
+
+187
+00:18:37,550 --> 00:18:42,810
+ومعها vomiting ومعها نوزية ومعها vomiting اه ومعها
+
+188
+00:18:42,810 --> 00:18:47,330
+drowsiness ودوخة وكلام زي هذا لأن المعدة تتوقف في
+
+189
+00:18:47,330 --> 00:18:51,790
+الحال هذي الفرق يعني يوقف نسبية حركة المعدة
+
+190
+00:18:51,790 --> 00:18:56,430
+والطعام لا يهضم فإن لم يهضم الطعام لفترة فإنه يعود
+
+191
+00:18:56,430 --> 00:19:02,870
+إلى الخارج عن طريق الفرق طيب other factors عوام
+
+192
+00:19:02,870 --> 00:19:07,420
+أخرى زي health state of intestinal villiخمالات
+
+193
+00:19:07,420 --> 00:19:10,220
+الأماعات الدقيقة خمالات الأماعات الدقيقة هي
+
+194
+00:19:10,220 --> 00:19:17,040
+مراكبات ماكروسكوبية يعني تستطيع أن تنتص أو الجسم
+
+195
+00:19:17,040 --> 00:19:23,060
+ينتص من خلالها الطعام المداب القاهم الطعام المداب
+
+196
+00:19:23,060 --> 00:19:27,980
+هذه الخمالات إذا التهبط زي عديد من الأمراض
+
+197
+00:19:32,570 --> 00:19:36,890
+فإنها سوف تعجز بنسبة كبيرة عن امتصاص الطعام المدار
+
+198
+00:19:36,890 --> 00:19:42,090
+يعني الهضم تم وكده وكده ووصل الطعام المدار إلى
+
+199
+00:19:42,090 --> 00:19:46,550
+الخملات لكن الخملات لم تكن جاهزة فهذه ستأخر ال
+
+200
+00:19:46,550 --> 00:19:52,630
+onset of drug action يبقى من شخص لشخص حسب الطعام
+
+201
+00:19:52,630 --> 00:19:56,910
+في الميدا وحركة الميدا و لا معاه وحسب اللي هو
+
+202
+00:19:56,910 --> 00:20:00,390
+الفلاعي هله جاهزة لامتصاصه
+
+203
+00:20:09,980 --> 00:20:17,340
+الدواء على معدة فارغة هذا القاعدة لأن كثير أو معظم
+
+204
+00:20:17,340 --> 00:20:23,380
+الأدوية تهيد جدار المعدة وقد تؤدي إلى خرق المعدة
+
+205
+00:20:23,380 --> 00:20:27,960
+كما يحدث في الناس اللي في جنوب شرق أسيا
+
+206
+00:20:38,030 --> 00:20:40,090
+و أنا زي ما حدثت مع الأطباء إنه شائع هناك اللي
+
+207
+00:20:40,090 --> 00:20:46,250
+اتعلموا هناك فإحنا القاعدة إنه ناخد أي دواء على
+
+208
+00:20:46,250 --> 00:20:51,990
+معدة مليئة بالطعام أو نصف مليئة بالطعام إلا في
+
+209
+00:20:51,990 --> 00:20:57,850
+exceptions إذا كان جالك تُاخد قبل الأكل يعني في
+
+210
+00:20:57,850 --> 00:21:03,430
+مثلا دواء زي ال antacids و الحيات هذه اللي هي
+
+211
+00:21:03,430 --> 00:21:06,950
+تُاخد لعلاج المعدة
+
+212
+00:21:19,750 --> 00:21:24,070
+لأ هالي قبل الطعم فانجلب قبل الطعم مثلا بنصف ساعة
+
+213
+00:21:24,070 --> 00:21:29,610
+او تلت ساعة اه هالي ناخدها لكن ما كتبش لوصف الوصفة
+
+214
+00:21:29,610 --> 00:21:35,390
+كله بعد الطعم يعني القاعدة انه كل بعد الطعم الدواء
+
+215
+00:21:35,390 --> 00:21:43,380
+اللي ما نص عليه رشيدة طبيبالمشكلة في بعض السيارات
+
+216
+00:21:43,380 --> 00:21:49,140
+هي بيبيع الدواء بس بيقولوا اعطيني مات بتحرجني او
+
+217
+00:21:49,140 --> 00:21:54,300
+بتجعلي او كده بيصرفوا الدواء شفاهية بدون
+
+218
+00:21:54,300 --> 00:21:58,940
+prescription انتوا في وصفة النضارة بس يازا بتكتب
+
+219
+00:21:58,940 --> 00:21:59,420
+prescription
+
+220
+00:22:07,520 --> 00:22:11,460
+أما مهم نصحة الإنسان بحيث أنه يكون فيه
+
+221
+00:22:11,460 --> 00:22:15,740
+prescription و ال prescription هذا أيه؟ هو دلالة
+
+222
+00:22:15,740 --> 00:22:20,780
+قانونية في المحاكم .. اه في المحاكم بتحسب عليها لو
+
+223
+00:22:20,780 --> 00:22:24,660
+كانت خطأ أو عملت مضاعفات للمريض أو عملت إجهاد عند
+
+224
+00:22:24,660 --> 00:22:29,020
+مرأة أو عملت قتل لطفل معين أما بيع الدواء
+
+225
+00:22:29,020 --> 00:22:34,080
+currently يعني مش هفه هيك، اعطيه نشريتانة كده كده،
+
+226
+00:22:34,080 --> 00:22:37,660
+يعني مثل مثال واحدواحد فرص شريط فى البطن راح
+
+227
+00:22:37,660 --> 00:22:41,300
+لسيدريه فالعين اللى فرص شريط راح اعطاه Spasmin
+
+228
+00:22:41,300 --> 00:22:48,780
+Spasmin يعني مهدق لل .. لل .. للأبعاد و المعدى و
+
+229
+00:22:48,780 --> 00:22:54,540
+.. ومسكن لألم اللى هو gastrocentral فال 24 ساعة هو
+
+230
+00:22:54,540 --> 00:23:00,400
+ياخد أخلاص ساعته disaster و ناس ماتوا فيها انفجار
+
+231
+00:23:00,400 --> 00:23:01,280
+ازايد الدنيا
+
+232
+00:23:05,930 --> 00:23:11,610
+يا بناتي القلم لما بيصير بيصير بسبت وهل في انذار
+
+233
+00:23:11,610 --> 00:23:15,970
+لصاحب القلم انه في مشكلة معاه؟ اذا كان المشكلة
+
+234
+00:23:15,970 --> 00:23:17,530
+شخصت وقُلت صح
+
+235
+00:23:22,610 --> 00:23:26,870
+تسكين بجاهل .. اه .. كت .. يعني تغلي الحصار و
+
+236
+00:23:26,870 --> 00:23:32,330
+تقوله الطعام و هذا بس نام نام و تلهيه .. هذا خطأ،
+
+237
+00:23:32,330 --> 00:23:36,730
+في عالم فيه الآن علم و علماء و فيه أخصائيين .. فيه
+
+238
+00:23:36,730 --> 00:23:41,990
+أخصائيين في كل مجال، لذلك أنا بحدد تاني أن الدواء
+
+239
+00:23:41,990 --> 00:23:47,000
+جداش هو مفيد جداش هو ضرروالدواء له قانون لازم
+
+240
+00:23:47,000 --> 00:23:52,520
+يُخدهيه ومن العبث بيع الدواء في الصيدلية مشافهة
+
+241
+00:23:52,520 --> 00:23:56,840
+كانت فيه كده بدون توثيق لازم يُكتب الوصفة يكون هو
+
+242
+00:23:56,840 --> 00:24:01,560
+المسؤول عنها و لا ما يكتبها أما لو صار ومات مثلا
+
+243
+00:24:01,560 --> 00:24:05,560
+عيانه وراه الصيدلية يقول لا أنا بعلمش ماشوفتشانا
+
+244
+00:24:05,560 --> 00:24:09,340
+ماعندكوش دليل ان انا سويت ولا بقت ولا عملت ولا
+
+245
+00:24:09,340 --> 00:24:13,640
+عملت وهذا من الخطأ القانوني المفروض للوزارة الصحية
+
+246
+00:24:13,640 --> 00:24:17,420
+وللناس المختصين في اللي هو القانون انه يشتغلوا
+
+247
+00:24:17,420 --> 00:24:24,100
+عليه طيب peak of activity يعني احنا في الأول وصلنا
+
+248
+00:24:24,100 --> 00:24:29,020
+لل onset بالثيرابوتكليفل بسيط طيب في فوق
+
+249
+00:24:29,020 --> 00:24:30,340
+الثيرابوتكليفل اشي أعلى
+
+250
+00:24:35,530 --> 00:24:38,750
+بقول لك peak of activity when the drug reaches its
+
+251
+00:24:38,750 --> 00:24:46,910
+maximum effect, concise, often يتطرف مع peak serum
+
+252
+00:24:46,910 --> 00:24:51,550
+concentration، القمة في ال serum of الدم، high
+
+253
+00:24:51,550 --> 00:24:55,990
+drug dose causes this peak to exceed the optimally
+
+254
+00:24:55,990 --> 00:25:00,590
+effective level، يعني ممكن ان ال peak يكون
+
+255
+00:25:06,050 --> 00:25:11,150
+أخد جوعة كبسولات مثلا اتنين او تلاتة راح يعمل peak
+
+256
+00:25:11,150 --> 00:25:16,330
+لكن هل هو هيفضل ياخد جوعة كبيرة على طول؟ لأ فال
+
+257
+00:25:16,330 --> 00:25:19,230
+peak ده بينزل الى therapeutic level لو أخد جوعة
+
+258
+00:25:19,230 --> 00:25:22,850
+منطلقة مدد هيك to exceed the optimally effective
+
+259
+00:25:22,850 --> 00:25:28,230
+level but the concentration can fall rapidly below
+
+260
+00:25:28,230 --> 00:25:29,710
+this level as it is
+
+261
+00:25:33,890 --> 00:25:41,430
+في شيء بدخل اللي هو الدم وفي شيء بخرج من الدم ال
+
+262
+00:25:41,430 --> 00:25:46,450
+execution فمهما كان ال بيكوصل بعد فترة ال
+
+263
+00:25:46,450 --> 00:25:53,810
+execution ده نزله مابيبقالش محبوس في الجسم this
+
+264
+00:25:53,810 --> 00:25:58,750
+drop او fall occurs especially often when a short
+
+265
+00:25:58,750 --> 00:26:00,070
+acting drug
+
+266
+00:26:04,580 --> 00:26:09,600
+يعني مثلا و اعني انه سلطة عشان ايه؟ مش قاعد ينام
+
+267
+00:26:09,600 --> 00:26:15,740
+ولا قاعد يدرس ولا هتقلد يتكلم بقوله اخدلك course
+
+268
+00:26:15,740 --> 00:26:20,540
+اكمل بقول لأ هتقولي تلاتة الواحد ماكفيش ليش بقولهم
+
+269
+00:26:20,540 --> 00:26:24,900
+انا تعبان جدا هاجر باخد اتنين او تلاتة بصار ال
+
+270
+00:26:24,900 --> 00:26:28,480
+peak هو اخد التلاتة و مااخدش غيرهم طبعا ال peak
+
+271
+00:26:28,480 --> 00:26:31,880
+بال execution راح ينزل ينزل ينزل ينزل لما يصار
+
+272
+00:26:31,880 --> 00:26:35,840
+الصفرمثلًا، في التعامل مع الانسونات الانسونات
+
+273
+00:26:35,840 --> 00:26:39,880
+بطولات مختلفة من الاتصال قصيرة وطولة تعمل معاهم
+
+274
+00:26:39,880 --> 00:26:43,680
+لإبقاء مستوى الانسونات في مستوى مفيد في التعامل مع
+
+275
+00:26:43,680 --> 00:26:50,040
+الانسونات حالة مثل آخر يعني مرضى السكري فيه سكري
+
+276
+00:26:50,040 --> 00:26:56,540
+قصيرة انسوان وفيه انسوان طويل انسوان لو أعطوا
+
+277
+00:26:56,540 --> 00:26:59,140
+قصيرة انسوان معاهم أعطوه
+
+278
+00:27:07,930 --> 00:27:11,670
+دوز من هنا و دوز من هنا بقدر معين و بعطوه حتى يفضل
+
+279
+00:27:11,670 --> 00:27:16,330
+بعد ما يقتلفوا يفضل منتظم على مدار الساعة و قليل
+
+280
+00:27:16,330 --> 00:27:21,250
+من المرضى السكري اللي يستطيعون انه ينقموا اللي هو
+
+281
+00:27:21,250 --> 00:27:26,290
+مستوى السكر عندهم في وجود الانسولين المحقوم على
+
+282
+00:27:26,290 --> 00:27:30,310
+مدار الساعة الا يطلع او ينزل لإنما ان في عوامل
+
+283
+00:27:30,310 --> 00:27:34,910
+نفسية في عوامل اجتماعية و في عوامل عصبية و في
+
+284
+00:27:34,910 --> 00:27:36,690
+عوامل stress او اشي تؤثر
+
+285
+00:27:41,780 --> 00:27:45,900
+خلصنا الورسة و ال peak نتكلم عن ال duration و طبعا
+
+286
+00:27:45,900 --> 00:27:48,960
+ال duration من البداية للنهاية من البداية للنهاية
+
+287
+00:27:48,960 --> 00:27:51,600
+شئ اسمه duration زى مثلا المحاضرة بدأ الساعة تسعة
+
+288
+00:27:51,600 --> 00:27:54,960
+و عشرة و انتهى مثلا الساعة تسعة الخمسة فضرب خمسة و
+
+289
+00:27:54,960 --> 00:27:57,720
+ربعين جيجا بيقول هاي ال duration بتاع ال lecture و
+
+290
+00:27:57,720 --> 00:28:00,820
+الدعوة زى دي ال duration is the period between the
+
+291
+00:28:00,820 --> 00:28:05,300
+administration اعطاء يعنيof the drug and the
+
+292
+00:28:05,300 --> 00:28:11,600
+excretion of the entire dose of that drug or its
+
+293
+00:28:11,600 --> 00:28:15,700
+metabolites يعني انا اللحظة اللي انا اخد عين الدم
+
+294
+00:28:15,700 --> 00:28:20,620
+و لاجي zero drug بقول هاي ال duration ال duration
+
+295
+00:28:20,620 --> 00:28:27,680
+بدأ ساعة مثلا تمانية صباحا ساعة تمانية ليلة مالجتش
+
+296
+00:28:27,680 --> 00:28:30,320
+اي اثر اللي في الدم بقول خلاص هاي ال duration عشر
+
+297
+00:28:30,320 --> 00:28:35,540
+ساعةهما كيف بيحددوا انه اطلع الدواء 6 ساعات او 8
+
+298
+00:28:35,540 --> 00:28:41,600
+ساعات او 12 ساعات او 24 ساعات بال duration يعني مش
+
+299
+00:28:41,600 --> 00:28:44,340
+هبهزر ع مزاج الدكتور ابوه اللي يقول خد لهذا يكون
+
+300
+00:28:44,340 --> 00:28:48,480
+24 ساعات لأ بيكون انه جربوا يعني انه عرفوا ان ال
+
+301
+00:28:48,480 --> 00:28:51,440
+duration بتاع ال drug هو 24 ساعات بينما في drug
+
+302
+00:28:51,440 --> 00:28:55,920
+shorter 6 ساعات في drug 8 ساعات في drug 12 ساعات
+
+303
+00:28:55,920 --> 00:28:57,780
+احسن دوة اقول 24 صح؟
+
+304
+00:29:02,600 --> 00:29:06,200
+مش هو بيختلف من شخص لشخص؟ يعني في عوامل عند ال ..
+
+305
+00:29:06,200 --> 00:29:10,100
+في ال professional يعني؟ اه ماشي يعني انا مراعي
+
+306
+00:29:10,100 --> 00:29:13,640
+العوامل انا مراعي العوامل لكن ال .. ال .. الاختلاف
+
+307
+00:29:13,640 --> 00:29:17,720
+بيصلش انه الاربع عشرين يصيروا اتناش ممكن اربع
+
+308
+00:29:17,720 --> 00:29:23,040
+عشرين يصيروا تمانتاش يصيروا يعني ستة و عشرين يعني
+
+309
+00:29:23,040 --> 00:29:27,420
+مصلش دوا انه بيشتغل مثلا اربع عشرين ساعة انه يصير
+
+310
+00:29:27,420 --> 00:29:33,010
+مثلا اتناشر ساعة مع أخذ الاعتبار للعوامليعني مثلا
+
+311
+00:29:33,010 --> 00:29:36,290
+الواحد صاحي ممكن يعني يعني يلعب في الجرعة مثلا انا
+
+312
+00:29:36,290 --> 00:29:42,390
+بدي مثلا دوة طول، واحد يعني مستعشع عشان كويس و
+
+313
+00:29:42,390 --> 00:29:45,870
+بعدين بياخد الدوات، بقولك هي ساعتين زي هذا، انا
+
+314
+00:29:45,870 --> 00:29:50,270
+بطوله يعني عشان ال .. الطعام في المعيدة، لكن لو
+
+315
+00:29:50,270 --> 00:29:55,750
+انا مثلا بدي يا يشتغل بسرعة، باخد مثلا يعني small
+
+316
+00:29:55,750 --> 00:29:58,350
+.. meat يعني واجبة
+
+317
+00:30:18,770 --> 00:30:23,650
+نصف الوقت نصف الوقت البيولوجي للدواء the time in
+
+318
+00:30:23,650 --> 00:30:28,410
+which half the drug has been eliminated يعني مثلا
+
+319
+00:30:28,410 --> 00:30:38,850
+انا اعطيت كابسولة مثلا واحد جرام ألف ملي جرام الان
+
+320
+00:30:38,850 --> 00:30:44,190
+بدي اشوف انا كام سيمضي من الوقت حتى الاجي
+
+321
+00:30:44,190 --> 00:30:48,650
+therapeutic level بتاعها في الدمنصف المطلوب يعني
+
+322
+00:30:48,650 --> 00:30:53,990
+نص الجرعة هذه تلعب في اللي هو ال kidneys في ال ..
+
+323
+00:30:53,990 --> 00:30:59,850
+عن طريق ال kidneys نصف الوقر البيولوجي هو الوقر
+
+324
+00:30:59,850 --> 00:31:06,010
+المستغرق في إخراج نصف كمية العلاج من الجسم عن طريق
+
+325
+00:31:06,010 --> 00:31:17,510
+الكلمة باختصار طيب بيو أفعمليعني ميسر موجود ويفعل
+
+326
+00:31:17,510 --> 00:31:25,570
+في الجسم it measures the concentration of the
+
+327
+00:31:25,570 --> 00:31:30,090
+pharmacological active substances at the target
+
+328
+00:31:30,090 --> 00:31:30,810
+site
+
+329
+00:31:39,850 --> 00:31:44,830
+هيبقى هدفي من إعطاء الدواء drug intake أن يكون bio
+
+330
+00:31:44,830 --> 00:31:50,430
+available في ال target site يفعل
+
+331
+00:31:50,430 --> 00:31:54,350
+فعل وين؟ في ال target site، مكان الألم، مثلا
+
+332
+00:31:54,350 --> 00:32:00,850
+اللوزتين، ملتقبات فأنا بعطي مثلا مضار حيوي زي ال
+
+333
+00:32:00,850 --> 00:32:07,710
+ultracin مثلا كل 12 ساعة في النهاية كم من ال
+
+334
+00:32:07,710 --> 00:32:08,610
+ultracin
+
+335
+00:32:12,640 --> 00:32:16,140
+لأن هي مكان الألم يعني مكان التهاب target site
+
+336
+00:32:16,140 --> 00:32:19,020
+وطبعا ال target site هي اللي يتأثر بالمستوى
+
+337
+00:32:19,020 --> 00:32:22,320
+الإيجابي الصحيح في الدم لأن الدم بيرف بالدوة
+
+338
+00:32:22,320 --> 00:32:27,440
+وبيعطي ال answer يعني مثلا زي أحنا بيقولنا مثلا في
+
+339
+00:32:27,440 --> 00:32:32,980
+يعني مكان طرفي في الأصابع مثلا تحت أو دم في الظهر
+
+340
+00:32:32,980 --> 00:32:40,160
+طبعا صعب إنه الدوة يكون bio available في target
+
+341
+00:32:40,160 --> 00:32:46,670
+siteيعني ان وجود level او effective level لان
+
+342
+00:32:46,670 --> 00:32:52,050
+الباقي ده ودمل ومكبسل وكلام زي هذا عكس مثلا يكون
+
+343
+00:32:52,050 --> 00:32:57,070
+شيء في الحرق قريب القلب يعني او في الرأس او في
+
+344
+00:32:57,070 --> 00:33:02,510
+رقبك في المناطق هذه بيكون فيه دورة دموية ناشطة
+
+345
+00:33:02,510 --> 00:33:08,290
+يبدو يكون bio أغلبه ان يكون في ال target الصعي في
+
+346
+00:33:08,290 --> 00:33:13,120
+therapeutic level كافيلعلاج المرض اللي انا اعطيته
+
+347
+00:33:13,120 --> 00:33:16,180
+بقول
+
+348
+00:33:16,180 --> 00:33:20,040
+لي ال bio availability هي function of .. function
+
+349
+00:33:20,040 --> 00:33:24,640
+of ايش؟ اول اشي ال drug function of ال drug لازم
+
+350
+00:33:24,640 --> 00:33:28,320
+ال drug يكون فعال مالكوش expired من سنتين تلاتة
+
+351
+00:33:29,440 --> 00:33:33,360
+مايكونش فاسد فرطوغا أو حلوة شديدة لازم ال drug
+
+352
+00:33:33,360 --> 00:33:38,540
+يكون اتأكد من تاريخه و اتأكد انه تخزينه صح مش
+
+353
+00:33:38,540 --> 00:33:42,700
+مرميل في الشمس و نعطيه ولد الناس منه ال drug يكون
+
+354
+00:33:42,700 --> 00:33:48,260
+drug صعب لعمل واحد to metabolism of the patient
+
+355
+00:33:48,260 --> 00:33:51,260
+يكون طبعا ال metabolism يكون ال liver يكون ال
+
+356
+00:33:51,260 --> 00:33:55,320
+liver ابتدا صحي سليم مايكونش هالكان ولا يكون الفتى
+
+357
+00:33:55,320 --> 00:34:00,790
+صغير عمره ست شهور لسهثلاثة، درجة التي تحرر الدواء
+
+358
+00:34:00,790 --> 00:34:10,790
+من خلق دوائها كمان معدل وصول الدواء للعمل يعني
+
+359
+00:34:10,790 --> 00:34:15,810
+مايكونش الدواء هنا بيتتحد مع blood proteins مثلا،
+
+360
+00:34:15,810 --> 00:34:20,970
+albumin و globulin، بتأخر أنا مستنى الولد انه
+
+361
+00:34:20,970 --> 00:34:24,970
+اتنشط و سخوت و تروح لهوشي و الدواء محبوس ليه مع
+
+362
+00:34:24,970 --> 00:34:29,640
+اللي هو بروتينات في الدم مثلابعض الأجوية كانت
+
+363
+00:34:29,640 --> 00:34:36,120
+بتنحبس في العظم تترا ساكلين يعني الكالسيوم بتاعة
+
+364
+00:34:36,120 --> 00:34:42,380
+العظم بيمسك كان بعض تترا ساكلين بطل بخته لأنه
+
+365
+00:34:42,380 --> 00:34:46,560
+بيأخر اللي هو ال bio availability يبقى ال drug
+
+366
+00:34:46,560 --> 00:34:50,360
+واحد المتابلزم اتنين وكمان ال rate of drug
+
+367
+00:34:50,360 --> 00:34:56,040
+liberation يعني يكون يصل بسرعة ومايتأخرش example
+
+368
+00:34:57,430 --> 00:35:00,550
+عشان أعرف من الراكس فيمتو سيرام بروتين زي
+
+369
+00:35:00,550 --> 00:35:06,330
+البيومينات، from which they are released slowly،
+
+370
+00:35:06,330 --> 00:35:12,050
+ببطء، يبقى هذا بيأخر ال bioavailability، يعني وصول
+
+371
+00:35:12,050 --> 00:35:13,410
+الدواء إلى
+
+372
+00:35:19,380 --> 00:35:22,200
+و تروح الحرارة بتاعته و يبدأ يتكلم و يأكل هو لسه
+
+373
+00:35:22,200 --> 00:35:27,300
+اياه و الدواء يا دواء فاسد يا دواء يعني متحد مع ال
+
+374
+00:35:27,300 --> 00:35:31,760
+women و مش راضي يمشي from which they are released
+
+375
+00:35:31,760 --> 00:35:36,540
+gradually or slowly اذا بعض الأدوية الأخرى stormed
+
+376
+00:35:36,540 --> 00:35:42,020
+at specific site as bone العدم عشان هيك انت تترى
+
+377
+00:35:42,020 --> 00:35:46,940
+سايتين كان ملون أسنان بلون أصفر أو بنيكل زمان احنا
+
+378
+00:35:46,940 --> 00:35:50,640
+نتراثاكلين هذا مهم عندنا و شوية شوية سبناه لأنه
+
+379
+00:35:50,640 --> 00:35:53,780
+صار يواثر على الحوامل و على الأطفال و يلون الأسنان
+
+380
+00:35:53,780 --> 00:35:57,440
+بطلاناته from which also it is released gradually
+
+381
+00:35:57,440 --> 00:36:03,860
+or slowly هاي ال bio availability ال drug is not
+
+382
+00:36:03,860 --> 00:36:09,340
+to be bio available or for use in some cases يعني
+
+383
+00:36:09,340 --> 00:36:13,720
+لو كتيش ال drug بيكون غير ميثر بيولوجيا في ال
+
+384
+00:36:13,720 --> 00:36:14,320
+target site
+
+385
+00:36:17,580 --> 00:36:21,320
+باعطه بروتين اللى قولنا عنه قبل شوية اجوين مثلا or
+
+386
+00:36:21,320 --> 00:36:25,980
+to any other substances in the body زى المدرمين
+
+387
+00:36:25,980 --> 00:36:32,640
+لمّا اتتحت من ايش؟ من الميلانين هاي الميلانين يعني
+
+388
+00:36:32,640 --> 00:36:37,560
+هذا pigment سبجه مسك اللى اللى هو المدرياتك و أخره
+
+389
+00:36:37,560 --> 00:36:43,740
+أخره اللى ال iris بتاعه لونه فاتح بتوسع في دقائق و
+
+390
+00:36:43,740 --> 00:36:47,720
+اللى ال iris بتاعه ده كان بتوسع في ساعاتthat
+
+391
+00:36:47,720 --> 00:36:50,860
+renders يجعل ال drug permanently inactive مثلا
+
+392
+00:36:50,860 --> 00:36:56,620
+ممكن التاري اللي مايعملش bioavailability not
+
+393
+00:36:56,620 --> 00:36:59,700
+released from its dotted form or site of
+
+394
+00:36:59,700 --> 00:37:04,640
+administration يعني أنا صحيح أعطيته دوة لكن في
+
+395
+00:37:04,640 --> 00:37:09,640
+الهاي مش نافعين بيبتسوش الدوة و لا يقطعها مثلا
+
+396
+00:37:09,640 --> 00:37:16,500
+مثلا أنا أعطيته حقنة في العضل إجت فكم دمو دهون
+
+397
+00:37:18,420 --> 00:37:21,960
+السمين كتير وال لبرا صغيرة ال needle ال needle
+
+398
+00:37:21,960 --> 00:37:27,020
+صغيرة عملت كده عملت كده و حاطيت حاطيت فى دهون فى
+
+399
+00:37:27,020 --> 00:37:33,400
+الدهون مواصلش فى ال يعني العي والصيصين انا اعطيته
+
+400
+00:37:33,400 --> 00:37:36,600
+العيلاج لكن مامواصلش لجهل اللي اعطاه اللبرا
+
+401
+00:37:36,600 --> 00:37:40,280
+المفروض السمين هنا بدهوا اطول جوج عارفين الجوج ال
+
+402
+00:37:40,280 --> 00:37:44,760
+needle اه اطول واحد فى ال needles فاعطيته ثلاثة
+
+403
+00:37:44,760 --> 00:37:51,030
+partial or totally drug degradationتكسر تكسر
+
+404
+00:37:51,030 --> 00:38:01,950
+الدواء كليا أو جزئيا بسبب مثلا حمضية المعدة بسبب
+
+405
+00:38:01,950 --> 00:38:07,210
+تلف في انزيمات اللي اللي هو ال .. اه تلف في
+
+406
+00:38:07,210 --> 00:38:11,970
+انزيمات الكابيت مثلا اشي راح صار تكسر بنسبة 50%
+
+407
+00:38:11,970 --> 00:38:16,270
+مثلا علاجيا فال target site هيفضل يستنى بأقل كمية
+
+408
+00:38:16,270 --> 00:38:16,870
+و مش هي
+
+409
+00:38:31,590 --> 00:38:37,050
+وعلى مفعول الدواء، كويس؟ it is important for the
+
+410
+00:38:37,050 --> 00:38:42,530
+user، من ال user المريض to be oriented of
+
+411
+00:38:42,530 --> 00:38:46,390
+characteristics that modify cell conditions and
+
+412
+00:38:46,390 --> 00:38:50,890
+therefore modify the activity of the drug، بده
+
+413
+00:38:50,890 --> 00:38:57,570
+مثلا الطبيب المعالج يكون قادر علىانه يعني يدرس او
+
+414
+00:38:57,570 --> 00:39:03,750
+يسأل عن او يفقص ايش هي الحالات اللى بتعمل
+
+415
+00:39:03,750 --> 00:39:11,310
+modification لل cells من أمراض مثلا او بتعمل
+
+416
+00:39:11,310 --> 00:39:15,330
+modification لل activity of drug في جسم هذا المريض
+
+417
+00:39:15,330 --> 00:39:20,950
+حد تكون منها ال age واحد ال age ال age معروف انه
+
+418
+00:39:20,950 --> 00:39:27,420
+children و ال adultsبقولوا الأطراف، أطراف الأمور،
+
+419
+00:39:27,420 --> 00:39:35,000
+الطفل لولة ثانية والشيخ بعد السبعين، أطراف الأمور،
+
+420
+00:39:35,000 --> 00:39:39,720
+هذه أطراف الأمور أطراف الأمور are highly
+
+421
+00:39:39,720 --> 00:39:45,440
+responsive to drugs عندهم استجابة غريبة للدواء،
+
+422
+00:39:45,440 --> 00:39:52,080
+ليش؟ ال infants عندهم immature hepatic and renal
+
+423
+00:39:52,080 --> 00:39:57,970
+functionsلسه ما اتطورش الكبل و انزيماته ولا ال
+
+424
+00:39:57,970 --> 00:40:02,470
+kidney و ال function بتاعه ما اتطورش للعلاج عشان
+
+425
+00:40:02,470 --> 00:40:10,070
+يكون هناك نسبة تسمم نسبة تسمم عند الأطفال وايضا
+
+426
+00:40:10,070 --> 00:40:16,690
+كبار السن ال old عندهم شئ اسمه enzymatic
+
+427
+00:40:16,690 --> 00:40:17,990
+degeneration
+
+428
+00:40:22,420 --> 00:40:26,860
+هو لأ هذا تآكل، طرف العمر التاني التآكل. يبقى الـ
+
+429
+00:40:26,860 --> 00:40:29,880
+Old-aged individuals may demonstrate different
+
+430
+00:40:29,880 --> 00:40:33,300
+responses to drug therapy because of deterioration
+
+431
+00:40:33,300 --> 00:40:38,240
+تقخر يعني أو تأخر of hepatic and renal function
+
+432
+00:40:38,240 --> 00:40:41,560
+which is often accompanied by concurrent disease
+
+433
+00:40:41,560 --> 00:40:46,500
+process such as cardiovascular disease، slow
+
+434
+00:40:46,500 --> 00:40:52,270
+circulationيبقى احنا مابقدرش نعتبر انه قانون
+
+435
+00:40:52,270 --> 00:40:58,090
+الدواء يسري على كل الأعمار بنفس الكفاءة لأ دائما
+
+436
+00:40:58,090 --> 00:41:02,530
+لأطراف الأصغر من سنتين والأكبر من سبعين او خمسين
+
+437
+00:41:02,530 --> 00:41:07,650
+سبعين لأولئك اللي لهم شغل خاص وكل ما كان الانسان
+
+438
+00:41:07,650 --> 00:41:13,330
+شباب من مثلا ست عشر الى اربعين او خمسة واربعين
+
+439
+00:41:13,330 --> 00:41:17,070
+بيكون قانون الدواء يسري عليه بصورة احسن
+
+440
+00:41:22,110 --> 00:41:26,950
+تغيير من الشخص لشخص يقول لي the greater the weight
+
+441
+00:41:26,950 --> 00:41:33,090
+the greater must be the dose الجرعة تتناسب
+
+442
+00:41:33,090 --> 00:41:39,190
+تعرضيا مع وزن الجسم however body weight due to fat
+
+443
+00:41:39,190 --> 00:41:44,510
+or edema يعني واحد عنده fat obese او عنده edema
+
+444
+00:41:44,510 --> 00:41:48,390
+ايش edema accumulation of fluids
+
+445
+00:41:51,250 --> 00:41:57,870
+ممكن نتيجة allergy مثلا، نتيجة cancer، نتيجة liver
+
+446
+00:41:57,870 --> 00:42:02,670
+failure، الناس اللي عندهم تشمع الكبد، اه إديمة،
+
+447
+00:42:02,670 --> 00:42:08,810
+اه، وشعار المتعب يخال oil ونظرات ملكة صائبة أن
+
+448
+00:42:08,810 --> 00:42:14,110
+تحسب الشحمة في من شحمه وراه، زمان قالها، تحسب
+
+449
+00:42:14,110 --> 00:42:19,550
+الشحمة في من شحمه وراه، يبقى اللي عنده إديمة، في
+
+450
+00:42:19,550 --> 00:42:25,590
+ناس بيطلعلهمعشرات اللترات من تنجوف بطنه من السوطان
+
+451
+00:42:25,590 --> 00:42:30,970
+او من الكبك الفاشق ولا يعني بالله بيسموه ascites
+
+452
+00:42:30,970 --> 00:42:36,190
+ايش ال ascites الاستثقار مرات زي هذه يعني شوفناهم
+
+453
+00:42:36,190 --> 00:42:41,670
+بيطلعوا كميات مهولة من السوائل ولا يعني بالله من
+
+454
+00:42:41,670 --> 00:42:46,290
+تنجوف البطن الواحد فيه نانا ما يعني بسيبه احيان
+
+455
+00:42:46,290 --> 00:42:49,930
+ورم في مكان او شي بتلاقي ايه فيه سوائل في المفصل
+
+456
+00:42:49,930 --> 00:42:53,970
+او شيIf our body weight due to fat or edema fluid
+
+457
+00:42:53,970 --> 00:42:58,150
+should not be taken into consideration.بنحسبش في
+
+458
+00:42:58,150 --> 00:43:02,750
+الوزن اللي بنحسب اللي هو ال flesh و ال organs،
+
+459
+00:43:02,750 --> 00:43:08,610
+flesh يعني اللحم، for very lean يعني إيش lean نحيف
+
+460
+00:43:09,840 --> 00:43:12,140
+I am very obese in the old days was a drug is
+
+461
+00:43:12,140 --> 00:43:15,520
+frequently determined on the basis of a drug per
+
+462
+00:43:15,520 --> 00:43:19,380
+kilogram of body weight or body surface area يعني
+
+463
+00:43:19,380 --> 00:43:22,520
+الأطباء خاصة بتاع الأطفال انهم حاسبة بيحط الطفل
+
+464
+00:43:22,520 --> 00:43:27,100
+عالنزان و بيحسب عنده قانون الدول خلاني كده ملي
+
+465
+00:43:27,100 --> 00:43:30,600
+جرام لكل كيلو كده ملي جرام لكل كيلو بيقول هذه مثلا
+
+466
+00:43:30,600 --> 00:43:33,740
+الجوعة كذا كذا تنجسمها اتنين مثلا في اليوم بدوا
+
+467
+00:43:33,740 --> 00:43:40,540
+ياخد شراب بالمعلجة كده او بالسيرنجة كدهبقى لإنسان
+
+468
+00:43:40,540 --> 00:43:44,600
+الأضلال ال obese مايقولناش ال obesity بتاعتهم
+
+469
+00:43:44,600 --> 00:43:48,080
+بيقدر مثلا انه في عشرين فمية مايوزنوا دهون و
+
+470
+00:43:48,080 --> 00:43:54,700
+بعطيها أكتر من الفمية six ال genes بيقوللي
+
+471
+00:43:54,700 --> 00:43:59,600
+الفيميلز بيختلفوا عن ال males فيها أكتر من شيء
+
+472
+00:43:59,600 --> 00:44:04,640
+فيميلز don't always respond to action of drugs in
+
+473
+00:44:04,640 --> 00:44:10,320
+the same mannerAs women استجابة النساء للدواء أقل
+
+474
+00:44:10,320 --> 00:44:13,180
+من الرجال Women are usually smaller in weight
+
+475
+00:44:13,180 --> 00:44:18,520
+غالبا خفر وزن؟ طبعا فيه كل قاعدة إلها استثناء،
+
+476
+00:44:18,520 --> 00:44:21,600
+صحيح؟ ذهب منه، which lead to high drug
+
+477
+00:44:21,600 --> 00:44:25,600
+concentration if dose is prescribed indifferently
+
+478
+00:44:26,500 --> 00:44:29,960
+ما نفرج، ما نقولش القانون السريع التانين إلا لما
+
+479
+00:44:29,960 --> 00:44:34,100
+نشوف الوضع. في males body is composed of higher
+
+480
+00:44:34,100 --> 00:44:37,940
+percent of adipose tissue، adipose tissue فات
+
+481
+00:44:37,940 --> 00:44:43,940
+يعني، يعني دهون، then males، حتى المرأة النحيفة،
+
+482
+00:44:43,940 --> 00:44:49,620
+تحت الجلد بتاعها، هناك طبقة من الدهون سبحان الله،
+
+483
+00:44:49,620 --> 00:44:57,220
+أه ليش؟ لأنه يعني هذه حابن الأطفالحرن أطفال الدهون
+
+484
+00:44:57,220 --> 00:45:02,240
+حتى في المرأة النحيفة هناك دهون عكس الرجل الرجل
+
+485
+00:45:02,240 --> 00:45:06,320
+أقل بكتير في هذا الموضوع فال body of males is
+
+486
+00:45:06,320 --> 00:45:08,840
+composed of higher percent of adipose tissue than
+
+487
+00:45:08,840 --> 00:45:12,180
+males يبقى ال absorption rate of that are slower
+
+488
+00:45:12,180 --> 00:45:16,520
+in fatty tissue than in splited tissue يبقى أنا
+
+489
+00:45:16,520 --> 00:45:19,900
+لما بدي أعطي جوعة الجوع اللي هتروح عن الدهون هتموت
+
+490
+00:45:19,900 --> 00:45:28,210
+مش هتصدقين بسSo the effect of a drug will be more
+
+491
+00:45:28,210 --> 00:45:32,610
+pronounced and prolonged في النساء.يعني الدواء في
+
+492
+00:45:32,610 --> 00:45:38,650
+الرجال أسرع من النساء.The only pregnancy، الحمض،
+
+493
+00:45:38,650 --> 00:45:42,510
+lactation، الإرضاء، menstruation، الأعادة الشهرية،
+
+494
+00:45:42,510 --> 00:45:47,720
+many drugs are stopped.هذا اختلاف آخرفيش في الرجال
+
+495
+00:45:47,720 --> 00:45:50,480
+pregnancy ولا في lactation ولا في menstruation
+
+496
+00:45:50,480 --> 00:45:55,000
+وبالتالي في النساء في أشياء لازم ناخد بنا منها أول
+
+497
+00:45:55,000 --> 00:46:00,140
+شي الأسبرين اللي بياخده راجل عادي لأ في النساء
+
+498
+00:46:00,140 --> 00:46:03,000
+بيقولك not used during menstruation as it
+
+499
+00:46:03,000 --> 00:46:08,580
+increases blood fluidity يعني او حاجة تاخد أسبرين
+
+500
+00:46:08,580 --> 00:46:12,880
+دم الحيط هيزيد بشكل لذلك اللي انا بعمل
+
+501
+00:46:18,150 --> 00:46:22,130
+والكمودين و أي مشيلات للدمع في فترة قليل ال
+
+502
+00:46:22,130 --> 00:46:28,210
+menstruation طيب الان في ال lactation ال lactation
+
+503
+00:46:28,210 --> 00:46:33,230
+نبعي ان في بعض الأدوية تدخل في اللبن زي مثلا ال
+
+504
+00:46:33,230 --> 00:46:37,050
+penicillins مراكبة البنسلين كلها مثلا لكن في غيرها
+
+505
+00:46:37,050 --> 00:46:45,450
+برضه بيدخل وادحان pregnant اي دواء بيعمل
+
+506
+00:46:49,970 --> 00:46:52,150
+لأن الحيوانة لها abortion، لذلك يجب أن يبقى
+
+507
+00:46:52,150 --> 00:46:59,390
+الهيوتيراس مقفل و الحامل بأمان، يبقى الهيوتيران
+
+508
+00:46:59,390 --> 00:47:05,650
+الذي يعمل تحريك للهيوتيراس الرحم يجب أن يتم إيقافه
+
+509
+00:47:05,650 --> 00:47:09,950
+خلال الابتكار كما يمكن أن ينتجوا الابورشين، ما هي
+
+510
+00:47:09,950 --> 00:47:11,070
+الابورشين؟
+
+511
+00:47:25,920 --> 00:47:30,400
+that might affect development of fetus and
+
+512
+00:47:30,400 --> 00:47:34,080
+placenta اه يعني انا عارف ال drug فلا يعني لو
+
+513
+00:47:34,080 --> 00:47:39,320
+اعطيته مشكلة يموت الجنين او يتأثر الجنين او ال
+
+514
+00:47:39,320 --> 00:47:42,960
+inspiration بتاعه pseudo depression او يعني يؤثر
+
+515
+00:47:42,960 --> 00:47:46,120
+على نفسه لأ انا كمال بعقوش أثناء الحمض يبقى انا
+
+516
+00:47:46,120 --> 00:47:50,340
+اقنعت اختلافات بين الجنسين بين النكر والأنثى في
+
+517
+00:47:50,340 --> 00:47:54,740
+موضوع الجوعة الدوائية احنا الأجهزةفنتوقف ان شاء
+
+518
+00:47:54,740 --> 00:48:01,100
+الله يعني في موضوع جرعة الدواء ومفروض الدواء ونكمل
+
+519
+00:48:01,100 --> 00:48:04,800
+هذه العوامل اللي بتتواثر على الجرعة وعلى اللي هو
+
+520
+00:48:04,800 --> 00:48:08,200
+مفروض الدواء في المحاطق القادمة ان شاء الله نسأل
+
+521
+00:48:08,200 --> 00:48:12,700
+الله عز و جل أن يبارك لنا في علمنا وأن يزيدنا علما
+
+522
+00:48:12,700 --> 00:48:15,540
+شكرا لكم والسلام عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/prxHShweAH8_raw.json b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/prxHShweAH8_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..bd35620ade63338e19ac58073e42394f12be557b
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/prxHShweAH8_raw.json
@@ -0,0 +1 @@
+{"segments": [{"id": 1, "seek": 4687, "start": 20.67, "end": 46.87, "text": "بسم الله الرحمن الرحيم الحمد لله كما علمنا نحمد و نصلي و نسلم على خير خلق الله سيدنا محمد طالباتي العزيزات في هذا اليوم سنكمل ما كنا قد بدأنا من drug metabolism drug metabolism التمثيل الغذائي", "tokens": [3555, 38251, 21984, 34892, 5016, 27842, 34892, 5016, 32640, 21542, 2304, 3215, 24976, 3224, 9122, 15042, 11203, 2304, 8315, 8717, 35571, 3215, 4032, 8717, 9381, 20292, 4032, 8717, 3794, 19528, 15844, 16490, 13546, 16490, 1211, 4587, 21984, 8608, 25708, 8315, 3714, 35571, 3215, 23032, 6027, 3555, 9307, 1829, 18863, 11622, 1829, 11622, 9307, 8978, 23758, 45595, 20498, 8608, 1863, 24793, 1211, 19446, 9122, 8315, 12174, 3215, 47525, 10721, 8315, 9154, 4110, 31190, 4110, 31190, 16712, 2304, 12984, 26895, 6024, 118, 8848, 16373, 1829], "avg_logprob": -0.11458333182547774, "compression_ratio": 1.7637362637362637, "no_speech_prob": 7.152557373046875e-07, "words": [{"start": 20.67, "end": 21.01, "word": "بسم", 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2849.06, "word": " of", "probability": 0.9716796875}, {"start": 2849.06, "end": 2849.64, "word": " fetus", "probability": 0.8525390625}, {"start": 2849.64, "end": 2850.4, "word": " and", "probability": 0.9375}, {"start": 2850.4, "end": 2850.96, "word": " placenta", "probability": 0.91748046875}, {"start": 2850.96, "end": 2852.5, "word": " اه", "probability": 0.4803466796875}, {"start": 2852.5, "end": 2852.74, "word": " يعني", "probability": 0.950927734375}, {"start": 2852.74, "end": 2852.9, "word": " انا", "probability": 0.865234375}, {"start": 2852.9, "end": 2853.16, "word": " عارف", "probability": 0.9597981770833334}, {"start": 2853.16, "end": 2853.28, "word": " ال", "probability": 0.60205078125}, {"start": 2853.28, "end": 2853.52, "word": " drug", "probability": 0.70166015625}, {"start": 2853.52, "end": 2853.82, "word": " فلا", "probability": 0.4237060546875}, {"start": 2853.82, "end": 2853.98, "word": " يعني", "probability": 0.7069091796875}, {"start": 2853.98, "end": 2854.08, 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2860.52, "end": 2861.1, "word": " pseudo", "probability": 0.048828125}, {"start": 2861.1, "end": 2861.5, "word": " depression", "probability": 0.95263671875}, {"start": 2861.5, "end": 2862.42, "word": " او", "probability": 0.9482421875}, {"start": 2862.42, "end": 2862.74, "word": " يعني", "probability": 0.915283203125}, {"start": 2862.74, "end": 2862.96, "word": " يؤثر", "probability": 0.8216145833333334}, {"start": 2862.96, "end": 2863.1, "word": " على", "probability": 0.6953125}, {"start": 2863.1, "end": 2863.42, "word": " نفسه", "probability": 0.9519856770833334}, {"start": 2863.42, "end": 2863.8, "word": " لأ", "probability": 0.68212890625}, {"start": 2863.8, "end": 2864.08, "word": " انا", "probability": 0.90673828125}, {"start": 2864.08, "end": 2864.36, "word": " كمال", "probability": 0.6961263020833334}, {"start": 2864.36, "end": 2864.72, "word": " بعقوش", "probability": 0.66058349609375}, {"start": 2864.72, "end": 2865.02, "word": " أثناء", "probability": 0.8306884765625}, {"start": 2865.02, "end": 2865.36, "word": " الحمض", "probability": 0.8186848958333334}, {"start": 2865.36, "end": 2866.02, "word": " يبقى", "probability": 0.8836669921875}, {"start": 2866.02, "end": 2866.12, "word": " انا", "probability": 0.5264892578125}, {"start": 2866.12, "end": 2866.4, "word": " اقنعت", "probability": 0.45062255859375}, {"start": 2866.4, "end": 2867.12, "word": " اختلافات", "probability": 0.94453125}, {"start": 2867.12, "end": 2867.62, "word": " بين", "probability": 0.990234375}, {"start": 2867.62, "end": 2868.2, "word": " الجنسين", "probability": 0.981201171875}, {"start": 2868.2, "end": 2868.8, "word": " بين", "probability": 0.802734375}, {"start": 2868.8, "end": 2869.26, "word": " النكر", "probability": 0.254150390625}, {"start": 2869.26, "end": 2870.12, "word": " والأنثى", "probability": 0.8123779296875}, {"start": 2870.12, "end": 2870.34, "word": " في", "probability": 0.958984375}, {"start": 2870.34, "end": 2870.72, "word": " موضوع", "probability": 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"end": 2875.92, "word": " يعني", "probability": 0.6461181640625}, {"start": 2875.92, "end": 2876.46, "word": " في", "probability": 0.96240234375}, {"start": 2876.46, "end": 2877.02, "word": " موضوع", "probability": 0.9923095703125}, {"start": 2877.02, "end": 2877.64, "word": " جرعة", "probability": 0.8201497395833334}, {"start": 2877.64, "end": 2878.34, "word": " الدواء", "probability": 0.8898111979166666}, {"start": 2878.34, "end": 2879.26, "word": " ومفروض", "probability": 0.892578125}, {"start": 2879.26, "end": 2879.76, "word": " الدواء", "probability": 0.9138997395833334}, {"start": 2879.76, "end": 2881.1, "word": " ونكمل", "probability": 0.9635009765625}, {"start": 2881.1, "end": 2881.58, "word": " هذه", "probability": 0.96923828125}, {"start": 2881.58, "end": 2882.1, "word": " العوامل", "probability": 0.97802734375}, {"start": 2882.1, "end": 2882.26, "word": " اللي", "probability": 0.84814453125}, {"start": 2882.26, "end": 2882.7, "word": " بتتواثر", "probability": 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{"start": 2891.7, "end": 2892.28, "word": " يزيدنا", "probability": 0.9805908203125}, {"start": 2892.28, "end": 2892.7, "word": " علما", "probability": 0.677490234375}, {"start": 2892.7, "end": 2893.68, "word": " شكرا", "probability": 0.91796875}, {"start": 2893.68, "end": 2894.0, "word": " لكم", "probability": 0.957275390625}, {"start": 2894.0, "end": 2894.38, "word": " والسلام", "probability": 0.7860514322916666}, {"start": 2894.38, "end": 2894.74, "word": " عليكم", "probability": 0.960205078125}, {"start": 2894.74, "end": 2895.0, "word": " ورحمة", "probability": 0.69757080078125}, {"start": 2895.0, "end": 2895.06, "word": " الله", "probability": 0.96923828125}, {"start": 2895.06, "end": 2895.54, "word": " وبركاته", "probability": 0.8849609375}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 2896.2715, "duration_after_vad": 2493.579999999989}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/prxHShweAH8_raw.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/prxHShweAH8_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..ce6e44b9f9e9bf2a29c8ff3ce76ea87dfa341122
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/prxHShweAH8_raw.srt
@@ -0,0 +1,2092 @@
+1
+00:00:20,670 --> 00:00:26,030
+بسم الله الرحمن الرحيم الحمد لله كما علمنا نحمد و
+
+2
+00:00:26,030 --> 00:00:31,430
+نصلي و نسلم على خير خلق الله سيدنا محمد طالباتي
+
+3
+00:00:31,430 --> 00:00:38,310
+العزيزات في هذا اليوم سنكمل ما كنا قد بدأنا من
+
+4
+00:00:38,310 --> 00:00:46,870
+drug metabolism drug metabolism التمثيل الغذائي
+
+5
+00:00:56,990 --> 00:01:02,770
+نسميه metabolism ونسميه bio transformation
+
+6
+00:01:02,770 --> 00:01:11,350
+التحول الحيوي للدواء to be effective inside the
+
+7
+00:01:11,350 --> 00:01:15,230
+tissues of the body يبقى it is a process that
+
+8
+00:01:15,230 --> 00:01:19,290
+chemically inactivates a drug by converting it
+
+9
+00:01:29,150 --> 00:01:33,830
+أو نتائج التمثيل الغذائي for excretion from the
+
+10
+00:01:33,830 --> 00:01:40,470
+body حتى يخرج من اللي هو الجسم بعد ذلك The main
+
+11
+00:01:40,470 --> 00:01:43,690
+site of biotransformation or metabolism is the
+
+12
+00:01:43,690 --> 00:01:49,870
+liver because the liver is full of enzymes that
+
+13
+00:01:49,870 --> 00:01:51,930
+can dissociate the drugs
+
+14
+00:01:55,200 --> 00:02:01,480
+بالنسبة للعضلات الروحانية تعمل ميتابولات للدراجات
+
+15
+00:02:01,480 --> 00:02:09,040
+مثل البلازما، الكدنس، البلانز، وميوكاس مبرين أوبرا
+
+16
+00:02:09,040 --> 00:02:13,640
+الانتستان، الانتستان الصغير، ولكن بقيمة أقل
+
+17
+00:02:22,840 --> 00:02:28,760
+التغييرات الكيميائية تنتج من نظام نظام موجود كبير
+
+18
+00:02:28,760 --> 00:02:33,800
+في الجلد، من هذا البروكسس التغييرات تتحول إلى أكتر
+
+19
+00:02:33,800 --> 00:02:42,100
+مطبخ ومطبخ مياه أكتر مطبخ لتدخل الجلد
+
+20
+00:02:53,550 --> 00:03:00,390
+In some persons, the process of metabolism will be
+
+21
+00:03:00,390 --> 00:03:09,510
+impaired or delayed in
+
+22
+00:03:09,510 --> 00:03:10,990
+five conditions
+
+23
+00:03:17,520 --> 00:03:27,700
+Liver cirrhosis liver inflammation liver viral
+
+24
+00:03:27,700 --> 00:03:31,020
+infection زي Hepatitis B
+
+25
+00:03:44,690 --> 00:03:47,050
+يعني طالما الليفر هو ال main organ of metabolism،
+
+26
+00:03:47,050 --> 00:03:52,190
+لو الليفر نفسه صلوا disease or damage، طلع ان
+
+27
+00:03:52,190 --> 00:03:56,970
+عملية الميتابوليزم بتتأخر او بتتوقف Two renal
+
+28
+00:03:56,970 --> 00:04:02,050
+problems، renal problems، ايضا قلنا ان الكيدنس
+
+29
+00:04:02,050 --> 00:04:04,530
+فيها enzymes وكلام برضه
+
+30
+00:04:07,370 --> 00:04:13,070
+معالجة الأدوى اه فممكن الأمور تتأخر وبتاعي كمان ال
+
+31
+00:04:13,070 --> 00:04:16,230
+execution يعني ال kids بتعمل متابوليزم و بتعمل
+
+32
+00:04:16,230 --> 00:04:20,870
+execution فيتأخروا اتنين طيب cardiovascular
+
+33
+00:04:20,870 --> 00:04:26,830
+dysfunction cardiovascular dysfunction يعني ال
+
+34
+00:04:26,830 --> 00:04:31,430
+heart و ال blood vessels طبعا بيكون فيه heart
+
+35
+00:04:31,430 --> 00:04:36,170
+failure بيكون فيه slow circulation و irregular
+
+36
+00:04:36,170 --> 00:04:43,760
+circulationوبالتاني يعني تتأجر العملية أو تتأخر
+
+37
+00:04:43,760 --> 00:04:48,760
+العملية بتاعة ال متابوليزم أيضا in infants and old
+
+38
+00:04:48,760 --> 00:04:54,640
+age ال infants الإنظام في اللغة بتكون immature
+
+39
+00:04:54,640 --> 00:05:01,000
+نفسها بينما ال old age بتكون دي generation يعني
+
+40
+00:05:01,000 --> 00:05:01,820
+خلاص اهترت
+
+41
+00:05:06,210 --> 00:05:11,570
+يبقى في الأطفال دول السنة أو دول السنتين ممكن تبقى
+
+42
+00:05:11,570 --> 00:05:18,110
+أنه ال metabolism بتاعهم يكون less than normal وفي
+
+43
+00:05:18,110 --> 00:05:22,910
+كبار السن يكون less than normal الله هو اللي خلقكم
+
+44
+00:05:22,910 --> 00:05:31,040
+من ضعفثم جعل من بعد ضعف قوة، شباب، ثم جعل من بعد
+
+45
+00:05:31,040 --> 00:05:37,880
+قوة ضعف وشيبة، يخلق ما يشاء وهو العليم القادر، وهو
+
+46
+00:05:37,880 --> 00:05:42,260
+العليم القادر، يعود الإنسان بعد مرحلة الشباب إلى
+
+47
+00:05:42,260 --> 00:05:49,580
+اللي هو الشيخوخة وإلى الضعف.طيب Execretion،
+
+48
+00:05:49,580 --> 00:05:55,520
+الإخراج، خالد هو، كان من بصر، خالد إن كانIs a
+
+49
+00:05:55,520 --> 00:05:59,680
+process by which drugs and active or inactive drug
+
+50
+00:05:59,680 --> 00:06:01,840
+metabolites are eliminated from the body.
+
+51
+00:06:01,900 --> 00:06:10,840
+Eliminated أي أنها تذهب الخارج، تذهب من الجسم أي
+
+52
+00:06:10,840 --> 00:06:16,820
+طعام أو دواء يدخل الجسم المفروض بعد فترة أن يخرج
+
+53
+00:06:16,820 --> 00:06:21,080
+إلى الخارج إذا لم يخرج إلى الخارج فهناك مشكلة،
+
+54
+00:06:21,080 --> 00:06:25,890
+هناك مشكلةبالتالي، هذا البرنامج يقلل مستوى الدواء
+
+55
+00:06:25,890 --> 00:06:31,870
+بشكل مباشر، يعني لو احنا أخدنا دواء وصل مستوى مية
+
+56
+00:06:31,870 --> 00:06:39,490
+أو مستوى متين في الدم ثم أوقفنا دراج انتيج، فانه
+
+57
+00:06:39,490 --> 00:06:43,530
+سوف ينزل إلى الصفر، المفروض ينزل إلى الصفر
+
+58
+00:06:47,180 --> 00:06:50,440
+من اين يزال؟ الراهنة الطرق اللتي يزال بواسطسها
+
+59
+00:06:50,440 --> 00:06:56,340
+الدواء من الجسم اول شيء و ال main site of drug
+
+60
+00:06:56,340 --> 00:07:01,760
+elimination هي ال kidneys الكليتان ال majority of
+
+61
+00:07:01,760 --> 00:07:02,760
+drug and or
+
+62
+00:07:27,410 --> 00:07:35,950
+هواء الزفير بجاسس جاسس and volatile liquids and
+
+63
+00:07:35,950 --> 00:07:36,950
+general anaesthesia
+
+64
+00:07:54,390 --> 00:07:57,310
+مش بعيد لو واحد جربله كتير شوية و هو كمان اتمنى
+
+65
+00:07:57,310 --> 00:08:04,990
+جدا يعني كثير من الناس في نفسه بيطلع اللي .. اللي
+
+66
+00:08:04,990 --> 00:08:06,190
+هو ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+67
+00:08:06,190 --> 00:08:06,270
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+68
+00:08:06,270 --> 00:08:06,390
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+69
+00:08:06,390 --> 00:08:07,890
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+70
+00:08:07,890 --> 00:08:08,190
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+71
+00:08:08,190 --> 00:08:09,070
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+72
+00:08:09,070 --> 00:08:09,490
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+73
+00:08:09,490 --> 00:08:12,450
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+74
+00:08:12,450 --> 00:08:12,450
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+75
+00:08:12,450 --> 00:08:15,730
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+76
+00:08:15,730 --> 00:08:19,770
+ال ..
+
+77
+00:08:19,770 --> 00:08:25,300
+ال .. الin feces في البواس many areas are innate
+
+78
+00:08:25,300 --> 00:08:29,980
+through the intestine in the feces by biliary
+
+79
+00:08:29,980 --> 00:08:37,780
+excretion افراز المنعرة والمنعرة هي ال gallbladder
+
+80
+00:08:37,780 --> 00:08:43,940
+اللي هي تابعة للكبت في بعض الجمهور الكبت بيعطيها
+
+81
+00:08:45,750 --> 00:08:49,890
+للمرارة و المرارة بتعطيها للأمعاء و الأمعاء
+
+82
+00:08:49,890 --> 00:08:57,090
+بتخرجها في المراسل مش كل شي يعني بعض الأشياء أفضل
+
+83
+00:08:57,090 --> 00:09:04,130
+sweet and salivary glands secretion العرق و
+
+84
+00:09:04,130 --> 00:09:08,410
+إفرازات الغدد اللعبية و الغدد
+
+85
+00:09:18,930 --> 00:09:23,930
+اللي هو بعض الأدوية و الشيء المشهور اللي يخرج في
+
+86
+00:09:23,930 --> 00:09:29,430
+العراق ال arena ال arena اللي هي الحلبة كثير احنا
+
+87
+00:09:29,430 --> 00:09:32,990
+جربنا هذا الموضوع و بعض الناس اللي هو .. اللي هو
+
+88
+00:09:32,990 --> 00:09:37,430
+يعني نشاط اجتماعي زي كويس بطلع و بنزل و يرفض انه
+
+89
+00:09:37,430 --> 00:09:40,970
+يشرب حلبة او يأكل حلبة لأن رائحتها
+
+90
+00:09:45,430 --> 00:09:52,910
+memory glands، memory glands اللي هو اللبن
+
+91
+00:09:52,910 --> 00:09:57,350
+اللي يخرج من الثدى عند المرضى، عند المرضيات
+
+92
+00:09:57,350 --> 00:10:01,470
+transfer drugs with milk from mother to body baby
+
+93
+00:10:01,470 --> 00:10:06,230
+to baby from mother to baby كتير يعني في
+
+94
+00:10:06,230 --> 00:10:11,910
+precautions اللي هو إيش تحذيرات يومنا أخد هذا
+
+95
+00:10:11,910 --> 00:10:14,650
+الدواء للحوامل و المرضيات
+
+96
+00:10:16,930 --> 00:10:19,990
+لأن من الحوام اللي بيخش من ال placental blood
+
+97
+00:10:19,990 --> 00:10:25,510
+barrier اللي قلناه المرمجة إلى اللي هو الجهل و
+
+98
+00:10:25,510 --> 00:10:30,270
+خلال ال lactation اللي هو الإرضاع يصل من السمي عن
+
+99
+00:10:30,270 --> 00:10:35,730
+طريق اللبن إلى اللوم يعني في زي البنسين وبعض المدن
+
+100
+00:10:35,730 --> 00:10:39,550
+الحيوية تصل إلى الطفل وبالتالي يعني لو كان
+
+101
+00:10:51,460 --> 00:10:54,780
+the risk of drug accumulation and drug toxicity is
+
+102
+00:10:54,780 --> 00:11:00,320
+increased يعني لو احنا بناخد الدواء و الدواء فيه
+
+103
+00:11:00,320 --> 00:11:05,460
+الدم بيطلع و ال excretion من ال kidneys impaired
+
+104
+00:11:05,460 --> 00:11:10,460
+فيه مشكلة مش ماشي بالجامعة بالجامعة بس هو
+
+105
+00:11:10,460 --> 00:11:16,680
+accumulation in blood و in tissues و هذا شيء بيخوف
+
+106
+00:11:16,680 --> 00:11:23,960
+لأن الدواء انتوا عارفين الدواء و دهالحالة هذه
+
+107
+00:11:23,960 --> 00:11:31,400
+المفروض احنا نعمل تحليلات معينة لنسبة الدواء في ال
+
+108
+00:11:31,400 --> 00:11:34,860
+urine في ال bowl و نعرف اذا كان ال urine بتاعه
+
+109
+00:11:34,860 --> 00:11:38,460
+جالين في ال bowl لازم احنا احد امرين يا نوقف نعطي
+
+110
+00:11:38,460 --> 00:11:43,120
+الدواء يا نخفض الجرعة يا نعطي الجرعة قليلا عشان
+
+111
+00:11:43,120 --> 00:11:47,840
+مانضرش الجسم يا اما نوقف اذا كان الموضوع .. يعني
+
+112
+00:11:47,840 --> 00:11:52,190
+دخلت بالمرضة واقف مفروض مانعطيش الدواءفي حالة
+
+113
+00:11:52,190 --> 00:11:56,430
+كهذه، الدوس يعني الجوعة تتقلل في معظم الدروس في
+
+114
+00:11:56,430 --> 00:11:57,590
+حالة عملية عملية عملية عملية عملية عملية عملية
+
+115
+00:11:57,590 --> 00:11:58,250
+عملية عملية عملية عملية عملية عملية عملية عملية
+
+116
+00:11:58,250 --> 00:12:00,890
+عملية عملية عملية عملية عملية عملية عملية عملية
+
+117
+00:12:00,890 --> 00:12:01,430
+عملية عملية عملية عملية عملية عملية عملية عملية
+
+118
+00:12:01,430 --> 00:12:08,790
+عملية عملية عملية عملية عملية عملية عملية عملية
+
+119
+00:12:08,790 --> 00:12:09,130
+عملية عملية عملية عملية عملية عملية عملية عملية
+
+120
+00:12:09,130 --> 00:12:09,230
+عملية عملية عملية عملية عملية عملية عملية عملية
+
+121
+00:12:09,230 --> 00:12:10,230
+عملية عملية عملية عملية عملية عملية عملية عملية
+
+122
+00:12:10,230 --> 00:12:16,750
+عملية
+
+123
+00:12:16,750 --> 00:12:16,950
+ع
+
+124
+00:12:30,560 --> 00:12:36,100
+الـ onset of action بتناول المدة الزمنية time
+
+125
+00:12:36,100 --> 00:12:42,680
+interval between administration and notation of
+
+126
+00:12:42,680 --> 00:12:46,700
+the past therapeutic effect in body fluids يعني
+
+127
+00:12:46,700 --> 00:12:54,540
+أنا أعطيت أقراس مثلا مضاد حيوان ستمر فترة إلى أن
+
+128
+00:12:54,540 --> 00:12:58,400
+يصل إلى الدم و يبدأ بالارتفاع إلى مستوى علاجي
+
+129
+00:12:59,220 --> 00:13:05,160
+اللحظة اللي بدأ فيها مستوى الهدى في الدم هي بدء
+
+130
+00:13:05,160 --> 00:13:09,620
+الدواء البدء يبقى انكسر المسافة ما بين اعطار هذه
+
+131
+00:13:09,620 --> 00:13:14,000
+الأقراس او الكمسولات واتفاقه الى therapeutic level
+
+132
+00:13:14,000 --> 00:13:19,480
+ساعتين، تلاتة، اربعة، حسب حسب ال drug وحسب المعدو
+
+133
+00:13:19,480 --> 00:13:26,380
+وحسب الطعام وحسب حالة الأمعاء وكذا it depends on
+
+134
+00:13:26,380 --> 00:13:33,550
+تتمنى أعلىthe road of administration كيف أعطي
+
+135
+00:13:33,550 --> 00:13:36,610
+الدواء؟ من أين أعطي الدواء؟ عن أي طريقة؟ هل طريقة
+
+136
+00:13:36,610 --> 00:13:43,190
+سريعة زي ال IV الوريد ولا أبطأ زي ال IM ولا أبطأ
+
+137
+00:13:43,190 --> 00:13:47,490
+زي اللي هو ال suppositories أو ال subcutaneous تحت
+
+138
+00:13:47,490 --> 00:13:53,150
+الدول ولا أبطأ أبطأ أبطأ أبطأك الفامطبعا كله
+
+139
+00:13:53,150 --> 00:13:58,230
+بتناسب ان اعطيته عن داخل الفم رحلة طويلة وبالتالي
+
+140
+00:13:58,230 --> 00:14:04,090
+ال onset هيكون طويل ان اعطيته تحت الجلب هيكون يعني
+
+141
+00:14:04,090 --> 00:14:10,430
+متوسط ان اعطيته في العضل هيكون سريع ان كان في
+
+142
+00:14:10,430 --> 00:14:12,190
+الوريد أسرع أسرع
+
+143
+00:14:29,800 --> 00:14:35,520
+الدراج اللي بيكون soluble هيكون اللي هو ال onset
+
+144
+00:14:35,520 --> 00:14:41,080
+بتاعه أسرع بينما ال insoluble ممكن يتأخر جدا جدا
+
+145
+00:14:41,080 --> 00:14:46,100
+بينما ال size ممكن كل ما كان ال size كبير كل ما
+
+146
+00:14:46,100 --> 00:14:51,980
+كان أكتر وكل ما كان ال size أصغر كل ما كان أسرع
+
+147
+00:14:51,980 --> 00:14:58,180
+طيب كمان بيحتمل ال onset على ال rate of absorption
+
+148
+00:15:06,410 --> 00:15:11,870
+وكل ما كان ال rate of absorption اكتر بيكون
+
+149
+00:15:11,870 --> 00:15:16,510
+absorption ايضا formulation of the drug
+
+150
+00:15:16,510 --> 00:15:20,290
+formulation التركيبة بتاعة الدواء هل هو اقراس؟ هل
+
+151
+00:15:20,290 --> 00:15:24,330
+هو كبسولات؟ هل هو سائل؟ هل هو زي هيك يعني؟ او ا
+
+152
+00:15:24,330 --> 00:15:28,330
+بقول ال fluid form of the drug التركيبة السائلة
+
+153
+00:15:28,330 --> 00:15:32,350
+اللي بيخلوها الأطفال المضحايا مثلا او الكحة has a
+
+154
+00:15:32,350 --> 00:15:34,550
+more rapid onset of action
+
+155
+00:15:44,560 --> 00:15:49,760
+عطيهم إيش؟ سائل سائل يعني على حاجتين أول شي هو
+
+156
+00:15:49,760 --> 00:15:54,280
+يعني بيقدرش يبلع الأقراس مش متعود يبلع .. يبلع
+
+157
+00:15:54,280 --> 00:16:00,160
+الأقراس بيخاف من الأقراس لإنه يعني يرجعها تاني شي
+
+158
+00:16:00,160 --> 00:16:06,640
+للسرعة لإنه احنا حياة الطفل عندنا غالية طيب
+
+159
+00:16:07,710 --> 00:16:11,250
+بقول لي العوامل الأخرى اللي تؤثر في ال onset ال
+
+160
+00:16:11,250 --> 00:16:14,610
+onset fraction drug is especially variable from
+
+161
+00:16:14,610 --> 00:16:19,150
+person to person من شخص لشخص اثر oral
+
+162
+00:16:19,150 --> 00:16:22,690
+administration الان تكلمنا عن ال oral على الفم
+
+163
+00:16:22,690 --> 00:16:28,870
+depending on مرتمدا على one presence of food in
+
+164
+00:16:28,870 --> 00:16:34,730
+the stomach يعني معروف ال stomach هي اللي هييعني
+
+165
+00:16:34,730 --> 00:16:42,470
+دائمة الحركة continuous movement الآن إذا كان يعني
+
+166
+00:16:42,470 --> 00:16:48,970
+أخدنا drug on empty stomach this drug will go
+
+167
+00:16:48,970 --> 00:16:55,750
+rapidly to intestine لأنه فاضي المدى، ع طول،
+
+168
+00:16:55,750 --> 00:16:58,850
+بتعمله short digestion و إشي، بتدوّو و إشي و
+
+169
+00:16:58,850 --> 00:17:04,180
+بتتفعل إيش، ليه اللي عم نعرف؟وإذا كان المدى مليء
+
+170
+00:17:04,180 --> 00:17:10,740
+بالطعام بعد واجبة ثقيلة مثل الغداء أو اللانش أو
+
+171
+00:17:10,740 --> 00:17:17,340
+العشاء واجبة ثقيلة طبعا الدواء هيتأخر هيتأخر ال
+
+172
+00:17:17,340 --> 00:17:20,620
+digestion وبعدين هيتأخر ال absorption وبعدين
+
+173
+00:17:20,620 --> 00:17:23,500
+هيتأخر ال onset of action عشان يصل في الدم إلى
+
+174
+00:17:23,500 --> 00:17:30,060
+مستوى علاج بس المدى الفاضية لو أخدناها يعني
+
+175
+00:17:30,060 --> 00:17:31,120
+أعطيناها irritating
+
+176
+00:17:36,640 --> 00:17:42,100
+أو جسرك إرتيشن أو جسرك inflammation حسب لو كل شيء
+
+177
+00:17:42,100 --> 00:17:47,940
+له ثمن طيب موترتي أو gastroenteritis أحيانا ال
+
+178
+00:17:47,940 --> 00:17:53,200
+gastroenteritis كما يحدث في أخر يوم الصيام تتحرك
+
+179
+00:17:53,200 --> 00:17:57,500
+بسرعة فائقة و احنا بنسمع ال peristalsis اسمه
+
+180
+00:17:57,500 --> 00:18:02,320
+peristalsis حاجة لما نسمع ال peristalsis يقولك انا
+
+181
+00:18:02,320 --> 00:18:10,100
+يعني المعدة بتاعتي عمل إيش؟سوق القالب من الجول و
+
+182
+00:18:10,100 --> 00:18:13,220
+أحيانا في موضوع البرد أو موضوع كذا يعني بعض
+
+183
+00:18:13,220 --> 00:18:19,660
+الحالات تكون بطيقة فكل ما زاد حركة المعدة والأمقات
+
+184
+00:18:19,660 --> 00:18:24,060
+كل ما كان ال onset of action أسرع على طول الماكينة
+
+185
+00:18:24,060 --> 00:18:27,840
+شغالة الخلطة شغالة عطل البني توديه بينما كانت
+
+186
+00:18:27,840 --> 00:18:30,720
+بطيقة زي موضوع البرد ليش احنا في البرد أحيانا و
+
+187
+00:18:30,720 --> 00:18:32,040
+بنحدد ان احنا من
+
+188
+00:18:37,550 --> 00:18:42,810
+ومعها vomiting ومعها نوزية ومعها vomiting اه ومعها
+
+189
+00:18:42,810 --> 00:18:47,330
+drowsiness ودوخة وكلام زي هذا لأن المعدة تتوقف في
+
+190
+00:18:47,330 --> 00:18:51,790
+الحال هذي الفرق يعني يوقف نسبية حركة المعدة
+
+191
+00:18:51,790 --> 00:18:56,430
+والطعام لا يهضم فإن لم يهضم الطعام لفترة فإنه يعود
+
+192
+00:18:56,430 --> 00:19:02,870
+إلى الخارج عن طريق الفرق طيب other factors عوام
+
+193
+00:19:02,870 --> 00:19:07,420
+أخرى زي health state of intestinal villiخمالات
+
+194
+00:19:07,420 --> 00:19:10,220
+الأماعات الدقيقة خمالات الأماعات الدقيقة هي
+
+195
+00:19:10,220 --> 00:19:17,040
+مراكبات ماكروسكوبية يعني تستطيع أن تنتص أو الجسم
+
+196
+00:19:17,040 --> 00:19:23,060
+ينتص من خلالها الطعام المداب القاهم الطعام المداب
+
+197
+00:19:23,060 --> 00:19:27,980
+هذه الخمالات إذا التهبط زي عديد من الأمراض
+
+198
+00:19:32,570 --> 00:19:36,890
+فإنها سوف تعجز بنسبة كبيرة عن امتصاص الطعام المدار
+
+199
+00:19:36,890 --> 00:19:42,090
+يعني الهضم تم وكده وكده ووصل الطعام المدار إلى
+
+200
+00:19:42,090 --> 00:19:46,550
+الخملات لكن الخملات لم تكن جاهزة فهذه ستأخر ال
+
+201
+00:19:46,550 --> 00:19:52,630
+onset of drug action يبقى من شخص لشخص حسب الطعام
+
+202
+00:19:52,630 --> 00:19:56,910
+في الميدا وحركة الميدا و لا معاه وحسب اللي هو
+
+203
+00:19:56,910 --> 00:20:00,390
+الفلاعي هله جاهزة لامتصاصه
+
+204
+00:20:09,980 --> 00:20:17,340
+الدواء على معدة فارغة هذا القاعدة لأن كثير أو معظم
+
+205
+00:20:17,340 --> 00:20:23,380
+الأدوية تهيد جدار المعدة وقد تؤدي إلى خرق المعدة
+
+206
+00:20:23,380 --> 00:20:27,960
+كما يحدث في الناس اللي في جنوب شرق أسيا
+
+207
+00:20:38,030 --> 00:20:40,090
+و أنا زي ما حدثت مع الأطباء إنه شائع هناك اللي
+
+208
+00:20:40,090 --> 00:20:46,250
+اتعلموا هناك فإحنا القاعدة إنه ناخد أي دواء على
+
+209
+00:20:46,250 --> 00:20:51,990
+معدة مليئة بالطعام أو نصف مليئة بالطعام إلا في
+
+210
+00:20:51,990 --> 00:20:57,850
+exceptions إذا كان جالك تُاخد قبل الأكل يعني في
+
+211
+00:20:57,850 --> 00:21:03,430
+مثلا دواء زي ال antacids و الحيات هذه اللي هي
+
+212
+00:21:03,430 --> 00:21:06,950
+تُاخد لعلاج المعدة
+
+213
+00:21:19,750 --> 00:21:24,070
+لأ هالي قبل الطعم فانجلب قبل الطعم مثلا بنصف ساعة
+
+214
+00:21:24,070 --> 00:21:29,610
+او تلت ساعة اه هالي ناخدها لكن ما كتبش لوصف الوصفة
+
+215
+00:21:29,610 --> 00:21:35,390
+كله بعد الطعم يعني القاعدة انه كل بعد الطعم الدواء
+
+216
+00:21:35,390 --> 00:21:43,380
+اللي ما نص عليه رشيدة طبيبالمشكلة في بعض السيارات
+
+217
+00:21:43,380 --> 00:21:49,140
+هي بيبيع الدواء بس بيقولوا اعطيني مات بتحرجني او
+
+218
+00:21:49,140 --> 00:21:54,300
+بتجعلي او كده بيصرفوا الدواء شفاهية بدون
+
+219
+00:21:54,300 --> 00:21:58,940
+prescription انتوا في وصفة النضارة بس يازا بتكتب
+
+220
+00:21:58,940 --> 00:21:59,420
+prescription
+
+221
+00:22:07,520 --> 00:22:11,460
+أما مهم نصحة الإنسان بحيث أنه يكون فيه
+
+222
+00:22:11,460 --> 00:22:15,740
+prescription و ال prescription هذا أيه؟ هو دلالة
+
+223
+00:22:15,740 --> 00:22:20,780
+قانونية في المحاكم .. اه في المحاكم بتحسب عليها لو
+
+224
+00:22:20,780 --> 00:22:24,660
+كانت خطأ أو عملت مضاعفات للمريض أو عملت إجهاد عند
+
+225
+00:22:24,660 --> 00:22:29,020
+مرأة أو عملت قتل لطفل معين أما بيع الدواء
+
+226
+00:22:29,020 --> 00:22:34,080
+currently يعني مش هفه هيك، اعطيه نشريتانة كده كده،
+
+227
+00:22:34,080 --> 00:22:37,660
+يعني مثل مثال واحدواحد فرص شريط فى البطن راح
+
+228
+00:22:37,660 --> 00:22:41,300
+لسيدريه فالعين اللى فرص شريط راح اعطاه Spasmin
+
+229
+00:22:41,300 --> 00:22:48,780
+Spasmin يعني مهدق لل .. لل .. للأبعاد و المعدى و
+
+230
+00:22:48,780 --> 00:22:54,540
+.. ومسكن لألم اللى هو gastrocentral فال 24 ساعة هو
+
+231
+00:22:54,540 --> 00:23:00,400
+ياخد أخلاص ساعته disaster و ناس ماتوا فيها انفجار
+
+232
+00:23:00,400 --> 00:23:01,280
+ازايد الدنيا
+
+233
+00:23:05,930 --> 00:23:11,610
+يا بناتي القلم لما بيصير بيصير بسبت وهل في انذار
+
+234
+00:23:11,610 --> 00:23:15,970
+لصاحب القلم انه في مشكلة معاه؟ اذا كان المشكلة
+
+235
+00:23:15,970 --> 00:23:17,530
+شخصت وقُلت صح
+
+236
+00:23:22,610 --> 00:23:26,870
+تسكين بجاهل .. اه .. كت .. يعني تغلي الحصار و
+
+237
+00:23:26,870 --> 00:23:32,330
+تقوله الطعام و هذا بس نام نام و تلهيه .. هذا خطأ،
+
+238
+00:23:32,330 --> 00:23:36,730
+في عالم فيه الآن علم و علماء و فيه أخصائيين .. فيه
+
+239
+00:23:36,730 --> 00:23:41,990
+أخصائيين في كل مجال، لذلك أنا بحدد تاني أن الدواء
+
+240
+00:23:41,990 --> 00:23:47,000
+جداش هو مفيد جداش هو ضرروالدواء له قانون لازم
+
+241
+00:23:47,000 --> 00:23:52,520
+يُخدهيه ومن العبث بيع الدواء في الصيدلية مشافهة
+
+242
+00:23:52,520 --> 00:23:56,840
+كانت فيه كده بدون توثيق لازم يُكتب الوصفة يكون هو
+
+243
+00:23:56,840 --> 00:24:01,560
+المسؤول عنها و لا ما يكتبها أما لو صار ومات مثلا
+
+244
+00:24:01,560 --> 00:24:05,560
+عيانه وراه الصيدلية يقول لا أنا بعلمش ماشوفتشانا
+
+245
+00:24:05,560 --> 00:24:09,340
+ماعندكوش دليل ان انا سويت ولا بقت ولا عملت ولا
+
+246
+00:24:09,340 --> 00:24:13,640
+عملت وهذا من الخطأ القانوني المفروض للوزارة الصحية
+
+247
+00:24:13,640 --> 00:24:17,420
+وللناس المختصين في اللي هو القانون انه يشتغلوا
+
+248
+00:24:17,420 --> 00:24:24,100
+عليه طيب peak of activity يعني احنا في الأول وصلنا
+
+249
+00:24:24,100 --> 00:24:29,020
+لل onset بالثيرابوتكليفل بسيط طيب في فوق
+
+250
+00:24:29,020 --> 00:24:30,340
+الثيرابوتكليفل اشي أعلى
+
+251
+00:24:35,530 --> 00:24:38,750
+بقول لك peak of activity when the drug reaches its
+
+252
+00:24:38,750 --> 00:24:46,910
+maximum effect, concise, often يتطرف مع peak serum
+
+253
+00:24:46,910 --> 00:24:51,550
+concentration، القمة في ال serum of الدم، high
+
+254
+00:24:51,550 --> 00:24:55,990
+drug dose causes this peak to exceed the optimally
+
+255
+00:24:55,990 --> 00:25:00,590
+effective level، يعني ممكن ان ال peak يكون
+
+256
+00:25:06,050 --> 00:25:11,150
+أخد جوعة كبسولات مثلا اتنين او تلاتة راح يعمل peak
+
+257
+00:25:11,150 --> 00:25:16,330
+لكن هل هو هيفضل ياخد جوعة كبيرة على طول؟ لأ فال
+
+258
+00:25:16,330 --> 00:25:19,230
+peak ده بينزل الى therapeutic level لو أخد جوعة
+
+259
+00:25:19,230 --> 00:25:22,850
+منطلقة مدد هيك to exceed the optimally effective
+
+260
+00:25:22,850 --> 00:25:28,230
+level but the concentration can fall rapidly below
+
+261
+00:25:28,230 --> 00:25:29,710
+this level as it is
+
+262
+00:25:33,890 --> 00:25:41,430
+في شيء بدخل اللي هو الدم وفي شيء بخرج من الدم ال
+
+263
+00:25:41,430 --> 00:25:46,450
+execution فمهما كان ال بيكوصل بعد فترة ال
+
+264
+00:25:46,450 --> 00:25:53,810
+execution ده نزله مابيبقالش محبوس في الجسم this
+
+265
+00:25:53,810 --> 00:25:58,750
+drop او fall occurs especially often when a short
+
+266
+00:25:58,750 --> 00:26:00,070
+acting drug
+
+267
+00:26:04,580 --> 00:26:09,600
+يعني مثلا و اعني انه سلطة عشان ايه؟ مش قاعد ينام
+
+268
+00:26:09,600 --> 00:26:15,740
+ولا قاعد يدرس ولا هتقلد يتكلم بقوله اخدلك course
+
+269
+00:26:15,740 --> 00:26:20,540
+اكمل بقول لأ هتقولي تلاتة الواحد ماكفيش ليش بقولهم
+
+270
+00:26:20,540 --> 00:26:24,900
+انا تعبان جدا هاجر باخد اتنين او تلاتة بصار ال
+
+271
+00:26:24,900 --> 00:26:28,480
+peak هو اخد التلاتة و مااخدش غيرهم طبعا ال peak
+
+272
+00:26:28,480 --> 00:26:31,880
+بال execution راح ينزل ينزل ينزل ينزل لما يصار
+
+273
+00:26:31,880 --> 00:26:35,840
+الصفرمثلًا، في التعامل مع الانسونات الانسونات
+
+274
+00:26:35,840 --> 00:26:39,880
+بطولات مختلفة من الاتصال قصيرة وطولة تعمل معاهم
+
+275
+00:26:39,880 --> 00:26:43,680
+لإبقاء مستوى الانسونات في مستوى مفيد في التعامل مع
+
+276
+00:26:43,680 --> 00:26:50,040
+الانسونات حالة مثل آخر يعني مرضى السكري فيه سكري
+
+277
+00:26:50,040 --> 00:26:56,540
+قصيرة انسوان وفيه انسوان طويل انسوان لو أعطوا
+
+278
+00:26:56,540 --> 00:26:59,140
+قصيرة انسوان معاهم أعطوه
+
+279
+00:27:07,930 --> 00:27:11,670
+دوز من هنا و دوز من هنا بقدر معين و بعطوه حتى يفضل
+
+280
+00:27:11,670 --> 00:27:16,330
+بعد ما يقتلفوا يفضل منتظم على مدار الساعة و قليل
+
+281
+00:27:16,330 --> 00:27:21,250
+من المرضى السكري اللي يستطيعون انه ينقموا اللي هو
+
+282
+00:27:21,250 --> 00:27:26,290
+مستوى السكر عندهم في وجود الانسولين المحقوم على
+
+283
+00:27:26,290 --> 00:27:30,310
+مدار الساعة الا يطلع او ينزل لإنما ان في عوامل
+
+284
+00:27:30,310 --> 00:27:34,910
+نفسية في عوامل اجتماعية و في عوامل عصبية و في
+
+285
+00:27:34,910 --> 00:27:36,690
+عوامل stress او اشي تؤثر
+
+286
+00:27:41,780 --> 00:27:45,900
+خلصنا الورسة و ال peak نتكلم عن ال duration و طبعا
+
+287
+00:27:45,900 --> 00:27:48,960
+ال duration من البداية للنهاية من البداية للنهاية
+
+288
+00:27:48,960 --> 00:27:51,600
+شئ اسمه duration زى مثلا المحاضرة بدأ الساعة تسعة
+
+289
+00:27:51,600 --> 00:27:54,960
+و عشرة و انتهى مثلا الساعة تسعة الخمسة فضرب خمسة و
+
+290
+00:27:54,960 --> 00:27:57,720
+ربعين جيجا بيقول هاي ال duration بتاع ال lecture و
+
+291
+00:27:57,720 --> 00:28:00,820
+الدعوة زى دي ال duration is the period between the
+
+292
+00:28:00,820 --> 00:28:05,300
+administration اعطاء يعنيof the drug and the
+
+293
+00:28:05,300 --> 00:28:11,600
+excretion of the entire dose of that drug or its
+
+294
+00:28:11,600 --> 00:28:15,700
+metabolites يعني انا اللحظة اللي انا اخد عين الدم
+
+295
+00:28:15,700 --> 00:28:20,620
+و لاجي zero drug بقول هاي ال duration ال duration
+
+296
+00:28:20,620 --> 00:28:27,680
+بدأ ساعة مثلا تمانية صباحا ساعة تمانية ليلة مالجتش
+
+297
+00:28:27,680 --> 00:28:30,320
+اي اثر اللي في الدم بقول خلاص هاي ال duration عشر
+
+298
+00:28:30,320 --> 00:28:35,540
+ساعةهما كيف بيحددوا انه اطلع الدواء 6 ساعات او 8
+
+299
+00:28:35,540 --> 00:28:41,600
+ساعات او 12 ساعات او 24 ساعات بال duration يعني مش
+
+300
+00:28:41,600 --> 00:28:44,340
+هبهزر ع مزاج الدكتور ابوه اللي يقول خد لهذا يكون
+
+301
+00:28:44,340 --> 00:28:48,480
+24 ساعات لأ بيكون انه جربوا يعني انه عرفوا ان ال
+
+302
+00:28:48,480 --> 00:28:51,440
+duration بتاع ال drug هو 24 ساعات بينما في drug
+
+303
+00:28:51,440 --> 00:28:55,920
+shorter 6 ساعات في drug 8 ساعات في drug 12 ساعات
+
+304
+00:28:55,920 --> 00:28:57,780
+احسن دوة اقول 24 صح؟
+
+305
+00:29:02,600 --> 00:29:06,200
+مش هو بيختلف من شخص لشخص؟ يعني في عوامل عند ال ..
+
+306
+00:29:06,200 --> 00:29:10,100
+في ال professional يعني؟ اه ماشي يعني انا مراعي
+
+307
+00:29:10,100 --> 00:29:13,640
+العوامل انا مراعي العوامل لكن ال .. ال .. الاختلاف
+
+308
+00:29:13,640 --> 00:29:17,720
+بيصلش انه الاربع عشرين يصيروا اتناش ممكن اربع
+
+309
+00:29:17,720 --> 00:29:23,040
+عشرين يصيروا تمانتاش يصيروا يعني ستة و عشرين يعني
+
+310
+00:29:23,040 --> 00:29:27,420
+مصلش دوا انه بيشتغل مثلا اربع عشرين ساعة انه يصير
+
+311
+00:29:27,420 --> 00:29:33,010
+مثلا اتناشر ساعة مع أخذ الاعتبار للعوامليعني مثلا
+
+312
+00:29:33,010 --> 00:29:36,290
+الواحد صاحي ممكن يعني يعني يلعب في الجرعة مثلا انا
+
+313
+00:29:36,290 --> 00:29:42,390
+بدي مثلا دوة طول، واحد يعني مستعشع عشان كويس و
+
+314
+00:29:42,390 --> 00:29:45,870
+بعدين بياخد الدوات، بقولك هي ساعتين زي هذا، انا
+
+315
+00:29:45,870 --> 00:29:50,270
+بطوله يعني عشان ال .. الطعام في المعيدة، لكن لو
+
+316
+00:29:50,270 --> 00:29:55,750
+انا مثلا بدي يا يشتغل بسرعة، باخد مثلا يعني small
+
+317
+00:29:55,750 --> 00:29:58,350
+.. meat يعني واجبة
+
+318
+00:30:18,770 --> 00:30:23,650
+نصف الوقت نصف الوقت البيولوجي للدواء the time in
+
+319
+00:30:23,650 --> 00:30:28,410
+which half the drug has been eliminated يعني مثلا
+
+320
+00:30:28,410 --> 00:30:38,850
+انا اعطيت كابسولة مثلا واحد جرام ألف ملي جرام الان
+
+321
+00:30:38,850 --> 00:30:44,190
+بدي اشوف انا كام سيمضي من الوقت حتى الاجي
+
+322
+00:30:44,190 --> 00:30:48,650
+therapeutic level بتاعها في الدمنصف المطلوب يعني
+
+323
+00:30:48,650 --> 00:30:53,990
+نص الجرعة هذه تلعب في اللي هو ال kidneys في ال ..
+
+324
+00:30:53,990 --> 00:30:59,850
+عن طريق ال kidneys نصف الوقر البيولوجي هو الوقر
+
+325
+00:30:59,850 --> 00:31:06,010
+المستغرق في إخراج نصف كمية العلاج من الجسم عن طريق
+
+326
+00:31:06,010 --> 00:31:17,510
+الكلمة باختصار طيب بيو أفعمليعني ميسر موجود ويفعل
+
+327
+00:31:17,510 --> 00:31:25,570
+في الجسم it measures the concentration of the
+
+328
+00:31:25,570 --> 00:31:30,090
+pharmacological active substances at the target
+
+329
+00:31:30,090 --> 00:31:30,810
+site
+
+330
+00:31:39,850 --> 00:31:44,830
+هيبقى هدفي من إعطاء الدواء drug intake أن يكون bio
+
+331
+00:31:44,830 --> 00:31:50,430
+available في ال target site يفعل
+
+332
+00:31:50,430 --> 00:31:54,350
+فعل وين؟ في ال target site، مكان الألم، مثلا
+
+333
+00:31:54,350 --> 00:32:00,850
+اللوزتين، ملتقبات فأنا بعطي مثلا مضار حيوي زي ال
+
+334
+00:32:00,850 --> 00:32:07,710
+ultracin مثلا كل 12 ساعة في النهاية كم من ال
+
+335
+00:32:07,710 --> 00:32:08,610
+ultracin
+
+336
+00:32:12,640 --> 00:32:16,140
+لأن هي مكان الألم يعني مكان التهاب target site
+
+337
+00:32:16,140 --> 00:32:19,020
+وطبعا ال target site هي اللي يتأثر بالمستوى
+
+338
+00:32:19,020 --> 00:32:22,320
+الإيجابي الصحيح في الدم لأن الدم بيرف بالدوة
+
+339
+00:32:22,320 --> 00:32:27,440
+وبيعطي ال answer يعني مثلا زي أحنا بيقولنا مثلا في
+
+340
+00:32:27,440 --> 00:32:32,980
+يعني مكان طرفي في الأصابع مثلا تحت أو دم في الظهر
+
+341
+00:32:32,980 --> 00:32:40,160
+طبعا صعب إنه الدوة يكون bio available في target
+
+342
+00:32:40,160 --> 00:32:46,670
+siteيعني ان وجود level او effective level لان
+
+343
+00:32:46,670 --> 00:32:52,050
+الباقي ده ودمل ومكبسل وكلام زي هذا عكس مثلا يكون
+
+344
+00:32:52,050 --> 00:32:57,070
+شيء في الحرق قريب القلب يعني او في الرأس او في
+
+345
+00:32:57,070 --> 00:33:02,510
+رقبك في المناطق هذه بيكون فيه دورة دموية ناشطة
+
+346
+00:33:02,510 --> 00:33:08,290
+يبدو يكون bio أغلبه ان يكون في ال target الصعي في
+
+347
+00:33:08,290 --> 00:33:13,120
+therapeutic level كافيلعلاج المرض اللي انا اعطيته
+
+348
+00:33:13,120 --> 00:33:16,180
+بقول
+
+349
+00:33:16,180 --> 00:33:20,040
+لي ال bio availability هي function of .. function
+
+350
+00:33:20,040 --> 00:33:24,640
+of ايش؟ اول اشي ال drug function of ال drug لازم
+
+351
+00:33:24,640 --> 00:33:28,320
+ال drug يكون فعال مالكوش expired من سنتين تلاتة
+
+352
+00:33:29,440 --> 00:33:33,360
+مايكونش فاسد فرطوغا أو حلوة شديدة لازم ال drug
+
+353
+00:33:33,360 --> 00:33:38,540
+يكون اتأكد من تاريخه و اتأكد انه تخزينه صح مش
+
+354
+00:33:38,540 --> 00:33:42,700
+مرميل في الشمس و نعطيه ولد الناس منه ال drug يكون
+
+355
+00:33:42,700 --> 00:33:48,260
+drug صعب لعمل واحد to metabolism of the patient
+
+356
+00:33:48,260 --> 00:33:51,260
+يكون طبعا ال metabolism يكون ال liver يكون ال
+
+357
+00:33:51,260 --> 00:33:55,320
+liver ابتدا صحي سليم مايكونش هالكان ولا يكون الفتى
+
+358
+00:33:55,320 --> 00:34:00,790
+صغير عمره ست شهور لسهثلاثة، درجة التي تحرر الدواء
+
+359
+00:34:00,790 --> 00:34:10,790
+من خلق دوائها كمان معدل وصول الدواء للعمل يعني
+
+360
+00:34:10,790 --> 00:34:15,810
+مايكونش الدواء هنا بيتتحد مع blood proteins مثلا،
+
+361
+00:34:15,810 --> 00:34:20,970
+albumin و globulin، بتأخر أنا مستنى الولد انه
+
+362
+00:34:20,970 --> 00:34:24,970
+اتنشط و سخوت و تروح لهوشي و الدواء محبوس ليه مع
+
+363
+00:34:24,970 --> 00:34:29,640
+اللي هو بروتينات في الدم مثلابعض الأجوية كانت
+
+364
+00:34:29,640 --> 00:34:36,120
+بتنحبس في العظم تترا ساكلين يعني الكالسيوم بتاعة
+
+365
+00:34:36,120 --> 00:34:42,380
+العظم بيمسك كان بعض تترا ساكلين بطل بخته لأنه
+
+366
+00:34:42,380 --> 00:34:46,560
+بيأخر اللي هو ال bio availability يبقى ال drug
+
+367
+00:34:46,560 --> 00:34:50,360
+واحد المتابلزم اتنين وكمان ال rate of drug
+
+368
+00:34:50,360 --> 00:34:56,040
+liberation يعني يكون يصل بسرعة ومايتأخرش example
+
+369
+00:34:57,430 --> 00:35:00,550
+عشان أعرف من الراكس فيمتو سيرام بروتين زي
+
+370
+00:35:00,550 --> 00:35:06,330
+البيومينات، from which they are released slowly،
+
+371
+00:35:06,330 --> 00:35:12,050
+ببطء، يبقى هذا بيأخر ال bioavailability، يعني وصول
+
+372
+00:35:12,050 --> 00:35:13,410
+الدواء إلى
+
+373
+00:35:19,380 --> 00:35:22,200
+و تروح الحرارة بتاعته و يبدأ يتكلم و يأكل هو لسه
+
+374
+00:35:22,200 --> 00:35:27,300
+اياه و الدواء يا دواء فاسد يا دواء يعني متحد مع ال
+
+375
+00:35:27,300 --> 00:35:31,760
+women و مش راضي يمشي from which they are released
+
+376
+00:35:31,760 --> 00:35:36,540
+gradually or slowly اذا بعض الأدوية الأخرى stormed
+
+377
+00:35:36,540 --> 00:35:42,020
+at specific site as bone العدم عشان هيك انت تترى
+
+378
+00:35:42,020 --> 00:35:46,940
+سايتين كان ملون أسنان بلون أصفر أو بنيكل زمان احنا
+
+379
+00:35:46,940 --> 00:35:50,640
+نتراثاكلين هذا مهم عندنا و شوية شوية سبناه لأنه
+
+380
+00:35:50,640 --> 00:35:53,780
+صار يواثر على الحوامل و على الأطفال و يلون الأسنان
+
+381
+00:35:53,780 --> 00:35:57,440
+بطلاناته from which also it is released gradually
+
+382
+00:35:57,440 --> 00:36:03,860
+or slowly هاي ال bio availability ال drug is not
+
+383
+00:36:03,860 --> 00:36:09,340
+to be bio available or for use in some cases يعني
+
+384
+00:36:09,340 --> 00:36:13,720
+لو كتيش ال drug بيكون غير ميثر بيولوجيا في ال
+
+385
+00:36:13,720 --> 00:36:14,320
+target site
+
+386
+00:36:17,580 --> 00:36:21,320
+باعطه بروتين اللى قولنا عنه قبل شوية اجوين مثلا or
+
+387
+00:36:21,320 --> 00:36:25,980
+to any other substances in the body زى المدرمين
+
+388
+00:36:25,980 --> 00:36:32,640
+لمّا اتتحت من ايش؟ من الميلانين هاي الميلانين يعني
+
+389
+00:36:32,640 --> 00:36:37,560
+هذا pigment سبجه مسك اللى اللى هو المدرياتك و أخره
+
+390
+00:36:37,560 --> 00:36:43,740
+أخره اللى ال iris بتاعه لونه فاتح بتوسع في دقائق و
+
+391
+00:36:43,740 --> 00:36:47,720
+اللى ال iris بتاعه ده كان بتوسع في ساعاتthat
+
+392
+00:36:47,720 --> 00:36:50,860
+renders يجعل ال drug permanently inactive مثلا
+
+393
+00:36:50,860 --> 00:36:56,620
+ممكن التاري اللي مايعملش bioavailability not
+
+394
+00:36:56,620 --> 00:36:59,700
+released from its dotted form or site of
+
+395
+00:36:59,700 --> 00:37:04,640
+administration يعني أنا صحيح أعطيته دوة لكن في
+
+396
+00:37:04,640 --> 00:37:09,640
+الهاي مش نافعين بيبتسوش الدوة و لا يقطعها مثلا
+
+397
+00:37:09,640 --> 00:37:16,500
+مثلا أنا أعطيته حقنة في العضل إجت فكم دمو دهون
+
+398
+00:37:18,420 --> 00:37:21,960
+السمين كتير وال لبرا صغيرة ال needle ال needle
+
+399
+00:37:21,960 --> 00:37:27,020
+صغيرة عملت كده عملت كده و حاطيت حاطيت فى دهون فى
+
+400
+00:37:27,020 --> 00:37:33,400
+الدهون مواصلش فى ال يعني العي والصيصين انا اعطيته
+
+401
+00:37:33,400 --> 00:37:36,600
+العيلاج لكن مامواصلش لجهل اللي اعطاه اللبرا
+
+402
+00:37:36,600 --> 00:37:40,280
+المفروض السمين هنا بدهوا اطول جوج عارفين الجوج ال
+
+403
+00:37:40,280 --> 00:37:44,760
+needle اه اطول واحد فى ال needles فاعطيته ثلاثة
+
+404
+00:37:44,760 --> 00:37:51,030
+partial or totally drug degradationتكسر تكسر
+
+405
+00:37:51,030 --> 00:38:01,950
+الدواء كليا أو جزئيا بسبب مثلا حمضية المعدة بسبب
+
+406
+00:38:01,950 --> 00:38:07,210
+تلف في انزيمات اللي اللي هو ال .. اه تلف في
+
+407
+00:38:07,210 --> 00:38:11,970
+انزيمات الكابيت مثلا اشي راح صار تكسر بنسبة 50%
+
+408
+00:38:11,970 --> 00:38:16,270
+مثلا علاجيا فال target site هيفضل يستنى بأقل كمية
+
+409
+00:38:16,270 --> 00:38:16,870
+و مش هي
+
+410
+00:38:31,590 --> 00:38:37,050
+وعلى مفعول الدواء، كويس؟ it is important for the
+
+411
+00:38:37,050 --> 00:38:42,530
+user، من ال user المريض to be oriented of
+
+412
+00:38:42,530 --> 00:38:46,390
+characteristics that modify cell conditions and
+
+413
+00:38:46,390 --> 00:38:50,890
+therefore modify the activity of the drug، بده
+
+414
+00:38:50,890 --> 00:38:57,570
+مثلا الطبيب المعالج يكون قادر علىانه يعني يدرس او
+
+415
+00:38:57,570 --> 00:39:03,750
+يسأل عن او يفقص ايش هي الحالات اللى بتعمل
+
+416
+00:39:03,750 --> 00:39:11,310
+modification لل cells من أمراض مثلا او بتعمل
+
+417
+00:39:11,310 --> 00:39:15,330
+modification لل activity of drug في جسم هذا المريض
+
+418
+00:39:15,330 --> 00:39:20,950
+حد تكون منها ال age واحد ال age ال age معروف انه
+
+419
+00:39:20,950 --> 00:39:27,420
+children و ال adultsبقولوا الأطراف، أطراف الأمور،
+
+420
+00:39:27,420 --> 00:39:35,000
+الطفل لولة ثانية والشيخ بعد السبعين، أطراف الأمور،
+
+421
+00:39:35,000 --> 00:39:39,720
+هذه أطراف الأمور أطراف الأمور are highly
+
+422
+00:39:39,720 --> 00:39:45,440
+responsive to drugs عندهم استجابة غريبة للدواء،
+
+423
+00:39:45,440 --> 00:39:52,080
+ليش؟ ال infants عندهم immature hepatic and renal
+
+424
+00:39:52,080 --> 00:39:57,970
+functionsلسه ما اتطورش الكبل و انزيماته ولا ال
+
+425
+00:39:57,970 --> 00:40:02,470
+kidney و ال function بتاعه ما اتطورش للعلاج عشان
+
+426
+00:40:02,470 --> 00:40:10,070
+يكون هناك نسبة تسمم نسبة تسمم عند الأطفال وايضا
+
+427
+00:40:10,070 --> 00:40:16,690
+كبار السن ال old عندهم شئ اسمه enzymatic
+
+428
+00:40:16,690 --> 00:40:17,990
+degeneration
+
+429
+00:40:22,420 --> 00:40:26,860
+هو لأ هذا تآكل، طرف العمر التاني التآكل. يبقى الـ
+
+430
+00:40:26,860 --> 00:40:29,880
+Old-aged individuals may demonstrate different
+
+431
+00:40:29,880 --> 00:40:33,300
+responses to drug therapy because of deterioration
+
+432
+00:40:33,300 --> 00:40:38,240
+تقخر يعني أو تأخر of hepatic and renal function
+
+433
+00:40:38,240 --> 00:40:41,560
+which is often accompanied by concurrent disease
+
+434
+00:40:41,560 --> 00:40:46,500
+process such as cardiovascular disease، slow
+
+435
+00:40:46,500 --> 00:40:52,270
+circulationيبقى احنا مابقدرش نعتبر انه قانون
+
+436
+00:40:52,270 --> 00:40:58,090
+الدواء يسري على كل الأعمار بنفس الكفاءة لأ دائما
+
+437
+00:40:58,090 --> 00:41:02,530
+لأطراف الأصغر من سنتين والأكبر من سبعين او خمسين
+
+438
+00:41:02,530 --> 00:41:07,650
+سبعين لأولئك اللي لهم شغل خاص وكل ما كان الانسان
+
+439
+00:41:07,650 --> 00:41:13,330
+شباب من مثلا ست عشر الى اربعين او خمسة واربعين
+
+440
+00:41:13,330 --> 00:41:17,070
+بيكون قانون الدواء يسري عليه بصورة احسن
+
+441
+00:41:22,110 --> 00:41:26,950
+تغيير من الشخص لشخص يقول لي the greater the weight
+
+442
+00:41:26,950 --> 00:41:33,090
+the greater must be the dose الجرعة تتناسب
+
+443
+00:41:33,090 --> 00:41:39,190
+تعرضيا مع وزن الجسم however body weight due to fat
+
+444
+00:41:39,190 --> 00:41:44,510
+or edema يعني واحد عنده fat obese او عنده edema
+
+445
+00:41:44,510 --> 00:41:48,390
+ايش edema accumulation of fluids
+
+446
+00:41:51,250 --> 00:41:57,870
+ممكن نتيجة allergy مثلا، نتيجة cancer، نتيجة liver
+
+447
+00:41:57,870 --> 00:42:02,670
+failure، الناس اللي عندهم تشمع الكبد، اه إديمة،
+
+448
+00:42:02,670 --> 00:42:08,810
+اه، وشعار المتعب يخال oil ونظرات ملكة صائبة أن
+
+449
+00:42:08,810 --> 00:42:14,110
+تحسب الشحمة في من شحمه وراه، زمان قالها، تحسب
+
+450
+00:42:14,110 --> 00:42:19,550
+الشحمة في من شحمه وراه، يبقى اللي عنده إديمة، في
+
+451
+00:42:19,550 --> 00:42:25,590
+ناس بيطلعلهمعشرات اللترات من تنجوف بطنه من السوطان
+
+452
+00:42:25,590 --> 00:42:30,970
+او من الكبك الفاشق ولا يعني بالله بيسموه ascites
+
+453
+00:42:30,970 --> 00:42:36,190
+ايش ال ascites الاستثقار مرات زي هذه يعني شوفناهم
+
+454
+00:42:36,190 --> 00:42:41,670
+بيطلعوا كميات مهولة من السوائل ولا يعني بالله من
+
+455
+00:42:41,670 --> 00:42:46,290
+تنجوف البطن الواحد فيه نانا ما يعني بسيبه احيان
+
+456
+00:42:46,290 --> 00:42:49,930
+ورم في مكان او شي بتلاقي ايه فيه سوائل في المفصل
+
+457
+00:42:49,930 --> 00:42:53,970
+او شيIf our body weight due to fat or edema fluid
+
+458
+00:42:53,970 --> 00:42:58,150
+should not be taken into consideration.بنحسبش في
+
+459
+00:42:58,150 --> 00:43:02,750
+الوزن اللي بنحسب اللي هو ال flesh و ال organs،
+
+460
+00:43:02,750 --> 00:43:08,610
+flesh يعني اللحم، for very lean يعني إيش lean نحيف
+
+461
+00:43:09,840 --> 00:43:12,140
+I am very obese in the old days was a drug is
+
+462
+00:43:12,140 --> 00:43:15,520
+frequently determined on the basis of a drug per
+
+463
+00:43:15,520 --> 00:43:19,380
+kilogram of body weight or body surface area يعني
+
+464
+00:43:19,380 --> 00:43:22,520
+الأطباء خاصة بتاع الأطفال انهم حاسبة بيحط الطفل
+
+465
+00:43:22,520 --> 00:43:27,100
+عالنزان و بيحسب عنده قانون الدول خلاني كده ملي
+
+466
+00:43:27,100 --> 00:43:30,600
+جرام لكل كيلو كده ملي جرام لكل كيلو بيقول هذه مثلا
+
+467
+00:43:30,600 --> 00:43:33,740
+الجوعة كذا كذا تنجسمها اتنين مثلا في اليوم بدوا
+
+468
+00:43:33,740 --> 00:43:40,540
+ياخد شراب بالمعلجة كده او بالسيرنجة كدهبقى لإنسان
+
+469
+00:43:40,540 --> 00:43:44,600
+الأضلال ال obese مايقولناش ال obesity بتاعتهم
+
+470
+00:43:44,600 --> 00:43:48,080
+بيقدر مثلا انه في عشرين فمية مايوزنوا دهون و
+
+471
+00:43:48,080 --> 00:43:54,700
+بعطيها أكتر من الفمية six ال genes بيقوللي
+
+472
+00:43:54,700 --> 00:43:59,600
+الفيميلز بيختلفوا عن ال males فيها أكتر من شيء
+
+473
+00:43:59,600 --> 00:44:04,640
+فيميلز don't always respond to action of drugs in
+
+474
+00:44:04,640 --> 00:44:10,320
+the same mannerAs women استجابة النساء للدواء أقل
+
+475
+00:44:10,320 --> 00:44:13,180
+من الرجال Women are usually smaller in weight
+
+476
+00:44:13,180 --> 00:44:18,520
+غالبا خفر وزن؟ طبعا فيه كل قاعدة إلها استثناء،
+
+477
+00:44:18,520 --> 00:44:21,600
+صحيح؟ ذهب منه، which lead to high drug
+
+478
+00:44:21,600 --> 00:44:25,600
+concentration if dose is prescribed indifferently
+
+479
+00:44:26,500 --> 00:44:29,960
+ما نفرج، ما نقولش القانون السريع التانين إلا لما
+
+480
+00:44:29,960 --> 00:44:34,100
+نشوف الوضع. في males body is composed of higher
+
+481
+00:44:34,100 --> 00:44:37,940
+percent of adipose tissue، adipose tissue فات
+
+482
+00:44:37,940 --> 00:44:43,940
+يعني، يعني دهون، then males، حتى المرأة النحيفة،
+
+483
+00:44:43,940 --> 00:44:49,620
+تحت الجلد بتاعها، هناك طبقة من الدهون سبحان الله،
+
+484
+00:44:49,620 --> 00:44:57,220
+أه ليش؟ لأنه يعني هذه حابن الأطفالحرن أطفال الدهون
+
+485
+00:44:57,220 --> 00:45:02,240
+حتى في المرأة النحيفة هناك دهون عكس الرجل الرجل
+
+486
+00:45:02,240 --> 00:45:06,320
+أقل بكتير في هذا الموضوع فال body of males is
+
+487
+00:45:06,320 --> 00:45:08,840
+composed of higher percent of adipose tissue than
+
+488
+00:45:08,840 --> 00:45:12,180
+males يبقى ال absorption rate of that are slower
+
+489
+00:45:12,180 --> 00:45:16,520
+in fatty tissue than in splited tissue يبقى أنا
+
+490
+00:45:16,520 --> 00:45:19,900
+لما بدي أعطي جوعة الجوع اللي هتروح عن الدهون هتموت
+
+491
+00:45:19,900 --> 00:45:28,210
+مش هتصدقين بسSo the effect of a drug will be more
+
+492
+00:45:28,210 --> 00:45:32,610
+pronounced and prolonged في النساء.يعني الدواء في
+
+493
+00:45:32,610 --> 00:45:38,650
+الرجال أسرع من النساء.The only pregnancy، الحمض،
+
+494
+00:45:38,650 --> 00:45:42,510
+lactation، الإرضاء، menstruation، الأعادة الشهرية،
+
+495
+00:45:42,510 --> 00:45:47,720
+many drugs are stopped.هذا اختلاف آخرفيش في الرجال
+
+496
+00:45:47,720 --> 00:45:50,480
+pregnancy ولا في lactation ولا في menstruation
+
+497
+00:45:50,480 --> 00:45:55,000
+وبالتالي في النساء في أشياء لازم ناخد بنا منها أول
+
+498
+00:45:55,000 --> 00:46:00,140
+شي الأسبرين اللي بياخده راجل عادي لأ في النساء
+
+499
+00:46:00,140 --> 00:46:03,000
+بيقولك not used during menstruation as it
+
+500
+00:46:03,000 --> 00:46:08,580
+increases blood fluidity يعني او حاجة تاخد أسبرين
+
+501
+00:46:08,580 --> 00:46:12,880
+دم الحيط هيزيد بشكل لذلك اللي انا بعمل
+
+502
+00:46:18,150 --> 00:46:22,130
+والكمودين و أي مشيلات للدمع في فترة قليل ال
+
+503
+00:46:22,130 --> 00:46:28,210
+menstruation طيب الان في ال lactation ال lactation
+
+504
+00:46:28,210 --> 00:46:33,230
+نبعي ان في بعض الأدوية تدخل في اللبن زي مثلا ال
+
+505
+00:46:33,230 --> 00:46:37,050
+penicillins مراكبة البنسلين كلها مثلا لكن في غيرها
+
+506
+00:46:37,050 --> 00:46:45,450
+برضه بيدخل وادحان pregnant اي دواء بيعمل
+
+507
+00:46:49,970 --> 00:46:52,150
+لأن الحيوانة لها abortion، لذلك يجب أن يبقى
+
+508
+00:46:52,150 --> 00:46:59,390
+الهيوتيراس مقفل و الحامل بأمان، يبقى الهيوتيران
+
+509
+00:46:59,390 --> 00:47:05,650
+الذي يعمل تحريك للهيوتيراس الرحم يجب أن يتم إيقافه
+
+510
+00:47:05,650 --> 00:47:09,950
+خلال الابتكار كما يمكن أن ينتجوا الابورشين، ما هي
+
+511
+00:47:09,950 --> 00:47:11,070
+الابورشين؟
+
+512
+00:47:25,920 --> 00:47:30,400
+that might affect development of fetus and
+
+513
+00:47:30,400 --> 00:47:34,080
+placenta اه يعني انا عارف ال drug فلا يعني لو
+
+514
+00:47:34,080 --> 00:47:39,320
+اعطيته مشكلة يموت الجنين او يتأثر الجنين او ال
+
+515
+00:47:39,320 --> 00:47:42,960
+inspiration بتاعه pseudo depression او يعني يؤثر
+
+516
+00:47:42,960 --> 00:47:46,120
+على نفسه لأ انا كمال بعقوش أثناء الحمض يبقى انا
+
+517
+00:47:46,120 --> 00:47:50,340
+اقنعت اختلافات بين الجنسين بين النكر والأنثى في
+
+518
+00:47:50,340 --> 00:47:54,740
+موضوع الجوعة الدوائية احنا الأجهزةفنتوقف ان شاء
+
+519
+00:47:54,740 --> 00:48:01,100
+الله يعني في موضوع جرعة الدواء ومفروض الدواء ونكمل
+
+520
+00:48:01,100 --> 00:48:04,800
+هذه العوامل اللي بتتواثر على الجرعة وعلى اللي هو
+
+521
+00:48:04,800 --> 00:48:08,200
+مفروض الدواء في المحاطق القادمة ان شاء الله نسأل
+
+522
+00:48:08,200 --> 00:48:12,700
+الله عز و جل أن يبارك لنا في علمنا وأن يزيدنا علما
+
+523
+00:48:12,700 --> 00:48:15,540
+شكرا لكم والسلام عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/qDBpve4bOnI.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/qDBpve4bOnI.srt
new file mode 100644
index 0000000000000000000000000000000000000000..70a332f77f13aaecd7f2e9d682a686a3bff8abdf
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/qDBpve4bOnI.srt
@@ -0,0 +1,1363 @@
+1
+00:00:20,890 --> 00:00:24,650
+بسم الله الرحمن الرحيم الحمد لله رب العالمين و
+
+2
+00:00:24,650 --> 00:00:29,930
+أصلي و أسلم على النبي الأمين و أرحب بكم في مطلع 
+
+3
+00:00:29,930 --> 00:00:36,710
+هذا الفصل في هذا المساق المفيد و الهام لكل من عمل
+
+4
+00:00:36,710 --> 00:00:44,510
+في السلك الطبي هذا المساق هو مساق علم الأدوية و
+
+5
+00:00:44,510 --> 00:00:49,570
+أدوية العين يحتوي على جزءين جزء عام General و جزء
+
+6
+00:00:49,570 --> 00:00:50,090
+خاص
+
+7
+00:00:56,210 --> 00:01:03,630
+اليوم سوف نبدأ في الحلقة الأولى التي تتكلم عن
+
+8
+00:01:03,630 --> 00:01:08,510
+مصادر الدواء مصادر 
+
+9
+00:01:08,510 --> 00:01:16,070
+الدواء مصادر الدواء and Preparations يعني
+
+10
+00:01:16,070 --> 00:01:20,250
+تعريفات ما هو الدواء ما هي مصادر الدواء كيف يعمل
+
+11
+00:01:20,250 --> 00:01:21,790
+الدواء والتحضيرات
+
+12
+00:01:27,420 --> 00:01:32,660
+Pharmacology means a Latin word meaning drug
+
+13
+00:01:32,660 --> 00:01:38,900
+knowledge دراسة الدواء أو معرفة الدواء Pharmaco أي
+
+14
+00:01:38,900 --> 00:01:43,840
+Drugology science science of drug أي Drug
+
+15
+00:01:43,840 --> 00:01:49,420
+knowledge كيف نعرف أو نتعرف على الدواء Definition
+
+16
+00:01:49,420 --> 00:01:51,500
+of drug تعريف الدواء
+
+17
+00:02:07,390 --> 00:02:15,210
+الحكومة تقول إن لا يوجد Drug أو طعام يمكن أن يكون
+
+18
+00:02:15,210 --> 00:02:23,750
+استخدامه في المجتمع بدون إقرار أو فضاء إذا كان
+
+19
+00:02:23,750 --> 00:02:30,070
+استخدامه بدون ذلك الإقرار، فسيكون محرر أو مقاوم
+
+20
+00:02:37,040 --> 00:02:46,340
+Use in Diagnosis وصف ال Diagnosis تشخيص Cure علاج 
+
+21
+00:02:46,340 --> 00:02:50,920
+Prevention Mitigation
+
+22
+00:02:50,920 --> 00:02:59,360
+or Treatment of a disease Condition كلها 
+
+23
+00:02:59,360 --> 00:03:05,950
+تعريف الدواء الدواء هو عامل أو مادة استعمل في
+
+24
+00:03:05,950 --> 00:03:12,950
+التشخيص في إشفاء في مانع في تخفيف في علاج Disease 
+
+25
+00:03:12,950 --> 00:03:19,290
+Condition أي حالة مرضية هذا بتخش الدواء هنا حتى لو 
+
+26
+00:03:19,290 --> 00:03:24,710
+كان الدواء الطبيعي اللذي يعني يأخذونه من هنا فارت 
+
+27
+00:03:24,710 --> 00:03:30,690
+بعد في العلاج فهذا
+
+28
+00:03:30,690 --> 00:03:33,970
+Definition of Drug also includes
+
+29
+00:03:40,470 --> 00:03:53,210
+USP فارماكوبيا فارماكوبيا فارماكوبيا
+
+30
+00:03:53,210 --> 00:03:54,530
+فارماكوبيا فارماكوبيا فارماكوبيا فارماكوبيا
+
+31
+00:03:54,530 --> 00:03:54,990
+فارماكوبيا فارماكوبيا فارماكوبيا فارماكوبيا
+
+32
+00:03:54,990 --> 00:03:58,990
+فارماكوبيا فارماكوبيا فارماكوبيا فارماكوبيا
+
+33
+00:03:58,990 --> 00:04:00,950
+فارماكو
+
+34
+00:04:05,160 --> 00:04:09,020
+كيف ده ليه التليفونات؟ أي تليفون مضطر فيه لازم يخش
+
+35
+00:04:09,020 --> 00:04:15,100
+فيه دفتر التليفونات هنا هذا Pharmacopia كتاب يجتمل
+
+36
+00:04:15,100 --> 00:04:22,480
+على كل أسماء الأدوية اسمه Pharmacopia أيضا ال
+
+37
+00:04:22,480 --> 00:04:29,580
+English في بريطانيا في Bridge Pharmacopia بريطانيا
+
+38
+00:04:29,580 --> 00:04:38,250
+زي America أنها برضه Special Pharmacopia And all
+
+39
+00:04:38,250 --> 00:04:43,010
+Substances other than food or devices capable of
+
+40
+00:04:43,010 --> 00:04:51,950
+altering body structure مش بس الأدوية والأطعمة وكل
+
+41
+00:04:51,950 --> 00:04:58,410
+ما يؤثر على الجسم في الوظيفة يدخل في هذا الكتاب
+
+42
+00:04:58,410 --> 00:05:04,150
+شغل الهوان المسمم شغل الجازات 
+
+43
+00:05:08,690 --> 00:05:11,930
+Pharmacopia is a book containing formulas which are
+
+44
+00:05:11,930 --> 00:05:15,190
+standard for preparation and dispensation
+
+45
+00:05:15,190 --> 00:05:22,890
+.Dispensation تعني توزيع.أي أدوية تصنع وتوزع لازم
+
+46
+00:05:22,890 --> 00:05:26,790
+تخش في الأول وين؟ في ال Pharmacopia.في Pharmacopia
+
+47
+00:05:26,790 --> 00:05:29,530
+الأمريكية و Pharmacopia البريطانية
+
+48
+00:05:46,700 --> 00:05:53,500
+أول فرع اسمه Pharmacotherapeutic وكلمة Therapeutic 
+
+49
+00:05:53,500 --> 00:05:57,880
+أو Therapy معرفة عن علاج لذلك ال Pharmacology 
+
+50
+00:05:57,880 --> 00:06:04,080
+العلاجية ال Pharmacology العلاجية في الأول حتى 
+
+51
+00:06:04,080 --> 00:06:06,820
+الناس بيسموها Clinical Pharmacology السريرية 
+
+52
+00:06:13,900 --> 00:06:19,960
+بتعريف ال Pharmacotherapeutics it deals with
+
+53
+00:06:19,960 --> 00:06:29,980
+relative effect of Drugs in the human system ده 
+
+54
+00:06:29,980 --> 00:06:39,360
+ثيرات النسمية للأدوية داخل الجسم البشري الحي For 
+
+55
+00:06:39,360 --> 00:06:39,860
+various
+
+56
+00:06:46,190 --> 00:06:53,830
+بأخذ دواء اللي هي بسببه في ناس عمل فيه تعليف ثاني
+
+57
+00:06:53,830 --> 00:06:57,930
+يمكن يكون أسهل it deals with فهمكوا Therapeutic
+
+58
+00:06:57,930 --> 00:07:03,250
+the effect of a Drug that Doctor orders for
+
+59
+00:07:03,250 --> 00:07:08,250
+treating a human Patient يعني اللي بيقولي هذا 
+
+60
+00:07:08,250 --> 00:07:10,490
+الجزء أو ال Branch من 
+
+61
+00:07:13,300 --> 00:07:20,540
+الدواء اللي يكتبه الطبيب لعلاج في المريض في هم ال 
+
+62
+00:07:20,540 --> 00:07:26,920
+Patient يعني في المريض طب لو كان مريض حيوان اسمه
+
+63
+00:07:26,920 --> 00:07:33,060
+Drug اه اسمه Drug لو كان حيوان أو كان حتى طير طب
+
+64
+00:07:33,060 --> 00:07:38,600
+لو كان نبات فهو اسمه Drug النبات مش أي مرض 
+
+65
+00:07:42,040 --> 00:07:46,740
+و الطيور والحيوانات و الإنسان بس ساعد الإنسان عليهم
+
+66
+00:07:46,740 --> 00:07:54,940
+جميعا فاخد الشهرة صار الدواء للإنسان لكن فيه دواء
+
+67
+00:07:54,940 --> 00:08:00,240
+للنبات ودواء للطيور ودواء للحيوانات يبقى هذا الفرق 
+
+68
+00:08:00,240 --> 00:08:07,560
+Therapeutic يتناول تأثير الدواء اللي يصفه الطبيب 
+
+69
+00:08:07,560 --> 00:08:14,160
+للمريض التعريف سهل مبسط سهل Simple or the study of 
+
+70
+00:08:14,160 --> 00:08:18,600
+Drug action in diseased man أو دراسة أثر الدواء
+
+71
+00:08:18,600 --> 00:08:26,560
+على المريض كتابه طبيب أو راح على الصيدلية و قالوا
+
+72
+00:08:26,560 --> 00:08:33,200
+أعطيني شريط أكامول أو شريط مضاد حيوي أو شريط يعني
+
+73
+00:08:33,200 --> 00:08:37,560
+للصداع أو للمغص أو أي شيء المهم أن هذا الدواء لما
+
+74
+00:08:37,560 --> 00:08:45,910
+أخذه أثر على إيش؟ على المرض طيب
+
+75
+00:08:45,910 --> 00:08:50,590
+الفرق الثاني Pharmacodynamic البراشر الثاني 
+
+76
+00:08:50,590 --> 00:08:54,990
+Pharmacodynamic كلمة Dynamic حركة يعني، Dynamic
+
+77
+00:08:54,990 --> 00:08:58,310
+يعني حركة which deals with experimental
+
+78
+00:08:58,310 --> 00:09:02,990
+Pharmacology يعني هذه ال Pharmacology التجريبية
+
+79
+00:09:02,990 --> 00:09:06,230
+التي تجرى في المعامل
+
+80
+00:09:09,580 --> 00:09:17,440
+و يا بناتي قبل أن يخرج الدواء ليستخدم على الإنسان
+
+81
+00:09:17,440 --> 00:09:25,140
+فإنه يمر بمراحل طويلة من التجريب على الحيوانات
+
+82
+00:09:25,140 --> 00:09:31,640
+والطيور خاصة الحيوانات و هناك حاجات كثيرة اسمها
+
+83
+00:09:31,640 --> 00:09:37,140
+حيوانات التجارب فيه 
+
+84
+00:09:38,790 --> 00:09:46,670
+الفقراء يعني Mice فيه Rabbits وفيه
+
+85
+00:09:46,670 --> 00:09:53,170
+طيور حمام وغيره موجودة Or it deals with تعريف 
+
+86
+00:09:53,170 --> 00:09:57,390
+مشابه يعني the interactions between components of 
+
+87
+00:09:57,390 --> 00:10:00,550
+living system and foreign chemical including Drugs 
+
+88
+00:10:00,550 --> 00:10:06,090
+that enter living organism يعني الحيوانات تجارب 
+
+89
+00:10:06,090 --> 00:10:15,330
+هذا اللي بدخل الدواء في جسمه ببدأ كباحث في هذا
+
+90
+00:10:15,330 --> 00:10:21,570
+المجال، أني أبحث في مدى التأثير اللي أحدثه الدواء
+
+91
+00:10:21,570 --> 00:10:26,130
+على أنسجة هذا الطائرة و هذا الحيوان طب بنفع أجرب
+
+92
+00:10:26,130 --> 00:10:32,590
+في الإنسان؟ لا، بنفعش، الإنسان، الإنسان أكرم، 
+
+93
+00:10:32,590 --> 00:10:35,770
+الإنسان أكرم من أن يكون للتجربة 
+
+94
+00:10:40,890 --> 00:10:44,990
+وقد يؤدي إلى الصراع وقد يؤدي إلى الشلل ما فعلش أني 
+
+95
+00:10:44,990 --> 00:10:48,550
+أنا أبدأ في الإنسان الإنسان اللي هو أنه شيء كريم
+
+96
+00:10:48,550 --> 00:10:53,070
+كما قال الله عز وجل وقال قد كرمنا بني آدم وحملناهم
+
+97
+00:10:53,070 --> 00:10:57,850
+في البر والبحر ورضقناهم من الطيبات وفضلناهم عليها
+
+98
+00:10:57,850 --> 00:11:02,530
+كثير من من خلقنا تفضيلة ما فعلش نبدأ في الإنسان لما 
+
+99
+00:11:02,530 --> 00:11:10,030
+إحنا نعرف تفاصيل عن آثار هذا الدواء وأن هذا الدواء 
+
+100
+00:11:10,030 --> 00:11:16,870
+يعني له Advantages كثيرة جدا و له Disadvantages
+
+101
+00:11:16,870 --> 00:11:22,510
+قليلة جدا ممكن نبدأ نستعمله في الإنسان بحدها هذا
+
+102
+00:11:22,510 --> 00:11:25,930
+الفرع الثاني Pharmacodynamic بظل أن
+
+103
+00:11:25,930 --> 00:11:31,490
+Pharmacokinetic هو
+
+104
+00:11:31,490 --> 00:11:35,150
+أثر الأنسجة
+
+105
+00:11:38,810 --> 00:11:44,070
+لما ناخد الدواء إحنا كبسولة هل هذا الدواء سيبقى في
+
+106
+00:11:44,070 --> 00:11:51,450
+الجسم كبسولة لآخر؟ لأ هذا الجسم راح يفتفت ويحلل
+
+107
+00:11:51,450 --> 00:11:56,990
+الكبسولة وينشر معاها من مادة وهذه المادة يصير لها
+
+108
+00:11:56,990 --> 00:12:03,210
+امتصاص ويصير لها توزيع ويصير لها Metabolism وفي الأخص
+
+109
+00:12:03,210 --> 00:12:03,670
+ال Execution
+
+110
+00:12:06,500 --> 00:12:12,240
+سوف يتعامل مع هذا الدواء اللي دخل في هذا الفعل
+
+111
+00:12:12,240 --> 00:12:17,200
+بالـ Pharmacology لتناول أثر و أثر الجسم على أي
+
+112
+00:12:17,200 --> 00:12:21,840
+شيء يبقى it is the study of Drugs alteration
+
+113
+00:12:21,840 --> 00:12:25,580
+تغيرات في الدواء During its way through the body
+
+114
+00:12:25,580 --> 00:12:31,000
+في الرحلة من أولها لآخرها Or it is the study of the 
+
+115
+00:12:31,000 --> 00:12:32,800
+fate of Drugs in the body
+
+116
+00:12:38,410 --> 00:12:43,750
+إيش بيصير فيه في الآخر في الفيل؟ يبقى اللي بده
+
+117
+00:12:43,750 --> 00:12:49,490
+يقرأ Pharmacology بده يقرأ Pharmacotherapeutic و
+
+118
+00:12:49,490 --> 00:13:00,950
+Pharmacodynamic و Pharmacokinetic Clear؟
+
+119
+00:13:00,950 --> 00:13:08,800
+طيب Parameters of the reaction إيه المعيار؟ عمل 
+
+120
+00:13:08,800 --> 00:13:16,720
+الدواء تقول الدواء هذا بيعمل إيه المعيار؟ أول معيار
+
+121
+00:13:16,720 --> 00:13:23,660
+دواء Absorption and Distribution Absorption from 
+
+122
+00:13:23,660 --> 00:13:32,160
+the small intestine أي دواء لا ينتصر
+
+123
+00:13:36,800 --> 00:13:42,240
+فهو المحلي العمل، بس على جد الـ GIT، 
+
+124
+00:13:42,240 --> 00:13:46,300
+Gastrointestinal Tract بروحش على الدم، بروحش على 
+
+125
+00:13:46,300 --> 00:13:52,080
+الليفار، متوزعش على الأنسجة بتاعت الجسم Drug 
+
+126
+00:13:52,080 --> 00:13:57,260
+Absorption and Distribution يبقى هذا معيار ومعيار 
+
+127
+00:13:57,260 --> 00:14:04,800
+عمل الدواء من ناحية الامتصاص وتوزيع To Drug Plasma 
+
+128
+00:14:04,800 --> 00:14:05,860
+Concentration
+
+129
+00:14:10,460 --> 00:14:15,700
+في العين وجيت بعد ساعة أجيس أنه وصلت لبلازمة 
+
+130
+00:14:15,700 --> 00:14:20,420
+عليها ما هو وصلت لبلازمة الدم يعني نقطة دوام هو 
+
+131
+00:14:20,420 --> 00:14:24,760
+أنا بنوصل شيء طلع بره وشيء انطصب لكورنر تايبا
+
+132
+00:14:24,760 --> 00:14:31,320
+كوريا اه وشيء نزل في الساكو لكن لو أنا أخدت حتتين
+
+133
+00:14:31,320 --> 00:14:35,600
+أكامول وبعد ساعتين أخدت من الدم عشان أدور عن
+
+134
+00:14:35,600 --> 00:14:40,080
+أكامول فرع سيتامول فراح أنا جاي كده كده كده واصل
+
+135
+00:14:42,160 --> 00:14:47,460
+يبقى عمل أما القطرة أو المطعم ما عمل في دمي Drug
+
+136
+00:14:47,460 --> 00:14:50,720
+Plasma Concentration Three Therapeutic Plasma 
+
+137
+00:14:50,720 --> 00:15:02,720
+Level يعني المضاد الحيوي مثلا حتى يعمل كعلاج
+
+138
+00:15:02,720 --> 00:15:03,280
+لمرض 
+
+139
+00:15:08,780 --> 00:15:17,640
+إلى مستوى معين ليحدث الأثر العلاجي تحت هذا Level 
+
+140
+00:15:17,640 --> 00:15:23,100
+لا يحدث أثر علاجي وفوق هذا Level ممكن يحدث
+
+141
+00:15:23,100 --> 00:15:27,920
+Overdose يبقى 
+
+142
+00:15:27,920 --> 00:15:34,780
+حتى أقول إنه في Action صحيح للدواء لابد أن يبلغ
+
+143
+00:15:34,780 --> 00:15:40,550
+مستوى علاجي مجروس مستوى علاجي مش أي أهم مجتمع، لا 
+
+144
+00:15:40,550 --> 00:15:45,710
+فوقه ولا تحته For Concentration of the active Drug 
+
+145
+00:15:45,710 --> 00:15:52,070
+at the Target Site Target Site؟ What's Target؟ هدف
+
+146
+00:15:52,070 --> 00:16:01,010
+يعني الطفل عنده التهاب رئوي و
+
+147
+00:16:01,010 --> 00:16:03,650
+أخذ علاقة المناطق الحيوية لعلاج التهاب الرئوي 
+
+148
+00:16:03,650 --> 00:16:12,100
+البكتيري لكن العلاج لم يصل لسبب أو آخر بنسبة مناسبة
+
+149
+00:16:12,100 --> 00:16:19,660
+أو معدل مناسب إلى 200 هل سيحدث Action أو Action 
+
+150
+00:16:19,660 --> 00:16:25,180
+قليل يبقى أنا ما قصدته في ال Target Site مكان
+
+151
+00:16:25,180 --> 00:16:31,820
+الهدف يعني أنا بيعطاه العلاج Systematic حتى يدور
+
+152
+00:16:31,820 --> 00:16:36,920
+في كل جسم كنت أقصد شيء معين للعلاج لكن أنا كلفت 
+
+153
+00:16:36,920 --> 00:16:42,460
+الجسم كله أنه يشترك في العلاج يعني مثلا واحد عنده
+
+154
+00:16:42,460 --> 00:16:49,180
+اللوزتين وأنا أعطيته حقنة مثلا مضاد حيوي ف أنا ما
+
+155
+00:16:49,180 --> 00:16:54,460
+قصدت علاج أصابيه ولا قصد علاج ركبه ولا علاج بطنه
+
+156
+00:16:54,460 --> 00:16:59,900
+قصدت علاج ال Target Site المريض ما فائدته أن 
+
+157
+00:16:59,900 --> 00:17:02,460
+العلاج يصل إلى كل الجسم ولا يصل إلى اللوزتين
+
+158
+00:17:08,230 --> 00:17:11,070
+شغالة كل الجسم بالدواء يعني الدواء توازن على كل
+
+159
+00:17:11,070 --> 00:17:17,730
+جسم وبدون فائدة للجسم إلا اللي هو الجزء المريض 
+
+160
+00:17:17,730 --> 00:17:20,550
+فإذا كان الدواء لم يصل إلى الجزء المريض إيش
+
+161
+00:17:20,550 --> 00:17:26,190
+الفائدة؟ Rate of 
+
+162
+00:17:26,190 --> 00:17:32,850
+Metabolism معدل الـ IOD أو التنفيذ الغذائي للدواء 
+
+163
+00:17:32,850 --> 00:17:39,710
+في أدوية تمثل سريعة وفي أدوية تمثل بطيئة وفي أدوية
+
+164
+00:17:39,710 --> 00:17:46,950
+بصورة متوسطة أيضا هذا يدرس كفرامتر لإيش للأثر
+
+165
+00:17:46,950 --> 00:17:51,870
+العلاجي لهذا الدواء و أخيرا Date of Execution
+
+166
+00:17:51,870 --> 00:17:57,750
+الإخراج هنا الدواء أخذت في البول بسرعة سريعة في 
+
+167
+00:17:57,750 --> 00:18:01,230
+دواء بطيء جدا حتى أنه ممكن يصل له Accumulation
+
+168
+00:18:13,480 --> 00:18:21,620
+عمل الدواء تتأثر ال Parameters الأخرى في Drug Action
+
+169
+00:18:21,620 --> 00:18:26,200
+These Parameters in turn are affected by يعني أو
+
+170
+00:18:26,200 --> 00:18:31,500
+الأثر على ال Parameters الأخرى أول شيء اسمه Physical
+
+171
+00:18:31,500 --> 00:18:35,740
+Chemical Nature of the Drug what is Physical
+
+172
+00:18:35,740 --> 00:18:36,420
+Chemical
+
+173
+00:18:40,450 --> 00:18:47,210
+الطبيعة الفيزيوكيميائية للعلاج مثل بعد مثل Lipid
+
+174
+00:18:47,210 --> 00:18:53,730
+يعني هذا الدواء فيه مركب دهني أو Water Solubility
+
+175
+00:18:53,730 --> 00:18:58,890
+فيه دواء يدوب في الدهون وفيه دواء يدوب في الماء
+
+176
+00:18:58,890 --> 00:19:03,370
+اللي بدوب في الدهون لازم أحطه أنا وسط دهني واللي 
+
+177
+00:19:03,370 --> 00:19:09,420
+بدوب في الماء أحطه وسط ماء طبعا واضح أن الدواء
+
+178
+00:19:09,420 --> 00:19:14,500
+اللي مدوب في وسط الدهني صعب الامتصاص واللي مدوب 
+
+179
+00:19:14,500 --> 00:19:21,360
+في وسط الماء إيه سهل الامتصاص هذا في الأمعاء لكن في 
+
+180
+00:19:21,360 --> 00:19:27,880
+العين العكس صحيح الدهني سريع الامتصاص لأن في عندنا
+
+181
+00:19:27,880 --> 00:19:32,360
+High Layer of the Precarnial Tear فيه 
+
+182
+00:19:36,140 --> 00:19:41,080
+بينما الدواء المائي يقل امتصاصه من اللي اللي هو
+
+183
+00:19:41,080 --> 00:19:43,820
+اللي اللي هو اللي اللي اللي اللي اللي اللي اللي
+
+184
+00:19:43,820 --> 00:19:44,400
+اللي اللي اللي اللي اللي اللي اللي اللي اللي
+
+185
+00:19:44,400 --> 00:19:44,560
+اللي اللي اللي اللي اللي اللي اللي اللي اللي
+
+186
+00:19:44,560 --> 00:19:45,080
+اللي اللي اللي
+
+216
+00:23:15,760 --> 00:23:25,100
+أخوة ثلاثة واحد بتتأثر بمخفض حرارة والثاني لا يتأثر 
+
+217
+00:23:25,100 --> 00:23:29,460
+به والثالث لا يتأثر باتنين كل واحد بمخفض حرارة شكل
+
+218
+00:23:29,460 --> 00:23:35,590
+واحد عنده المضاد الحيوي هذا البسيط Effective واحد
+
+219
+00:23:35,590 --> 00:23:40,210
+نقطة في النموذج الحيوي روسوفين عالي جدا حتى يؤثر
+
+220
+00:23:40,210 --> 00:23:44,190
+فيه لذلك لا يجب أن يكون واحد من البشر في الaction
+
+221
+00:23:44,190 --> 00:23:50,450
+of the drug كل واحد منا يعني هيئة مستقلة في
+
+222
+00:23:50,450 --> 00:23:58,670
+الاستجابة للأدوية Clear؟ وواحد منا عنده خصائص
+
+223
+00:23:58,670 --> 00:24:02,210
+خاصة في المناعة
+
+224
+00:24:06,490 --> 00:24:11,230
+الدواء Concomitant diseases فيه هناك أدوية مصاحبة
+
+225
+00:24:11,230 --> 00:24:18,350
+يعني في واحد فيه أكثر من مرض الآن كل مرض له
+
+226
+00:24:18,350 --> 00:24:24,230
+أدوية، الأدوية هذه ممكن تؤثر سلبا أو إيجابا على بعض
+
+227
+00:24:24,230 --> 00:24:31,810
+الأدوية قد تؤثر سلبا أو إيجابا على بعض يعني واحد
+
+228
+00:24:31,810 --> 00:24:38,020
+عنده سكري وضربت باختلاف عن اللي عنده سكري لحال أو
+
+229
+00:24:38,020 --> 00:24:43,980
+ضربت لحال ده ارتفاع ضبط الدم بدلوا ايش السكري و
+
+230
+00:24:43,980 --> 00:24:48,080
+الضربت مع بعض بدلوا ياخد أنواع أدوية للسكري و
+
+231
+00:24:48,080 --> 00:24:52,440
+للضربت وهذه بتأثر على بعضها آخر شيء concomitant
+
+232
+00:24:52,440 --> 00:24:58,500
+administration of food or other drugs يعني بيجي
+
+233
+00:24:58,500 --> 00:25:02,240
+إنسان بيقاني من التهاب معين
+
+234
+00:25:04,980 --> 00:25:11,020
+بتقول إن أنت عندك أمراض تانية أو بتاخد أدوية تانية
+
+235
+00:25:11,020 --> 00:25:15,800
+بيقولك ليش؟ بيقوله عشان ده اللي عندك و بخاف إنه
+
+236
+00:25:15,800 --> 00:25:20,980
+يعمل interaction مع الأدوية اللي بتاخدها drug 
+
+237
+00:25:20,980 --> 00:25:24,540
+interaction
+
+238
+00:25:24,540 --> 00:25:32,930
+والأدوية لو أُخدت كثيرا مع بعضها ممكن تؤثر بشكل سلبي
+
+239
+00:25:32,930 --> 00:25:39,330
+أو إيجابيا وهذا اتكلم عنه فيه بيعملوا synergism و
+
+240
+00:25:39,330 --> 00:25:44,190
+بيعملوا antagonism antagonism يعني و التضاد و
+
+241
+00:25:44,190 --> 00:25:50,350
+synergism أيش تقوية أو تسريعة يبقى أنا لما بدي
+
+242
+00:25:50,350 --> 00:25:54,550
+أعرف أكثر عن الدواء بدي أعرف ال parameters و بدي أعرف
+
+243
+00:25:54,550 --> 00:25:59,550
+العوامل اللي بتأثر على ال parameters نفسها السابعة
+
+244
+00:25:59,550 --> 00:25:59,790
+هذه
+
+245
+00:26:02,840 --> 00:26:07,420
+Sources of drugs طب
+
+246
+00:26:07,420 --> 00:26:15,500
+على شكل أن الله عز وجل لما خلق الإنسان سخر له ما
+
+247
+00:26:15,500 --> 00:26:21,600
+يفيده في هذه الدنيا والله عز وجل الذي يسر للإنسان
+
+248
+00:26:21,600 --> 00:26:25,860
+اليسرة علم أنه سيصيبه أمراض لأنه أيضا خلق
+
+249
+00:26:25,860 --> 00:26:31,000
+الميكروبات وخلق الطفيليات وخلق الفيروسات
+
+250
+00:26:33,770 --> 00:26:42,250
+Yes؟ وبالتالي الله سخر الأدوية أو مصادر دوائية لكي
+
+251
+00:26:42,250 --> 00:26:49,090
+يستخرج الإنسان منها الأدوية ويتعالج ونبي محمد صلى
+
+252
+00:26:49,090 --> 00:26:55,190
+الله عليه وسلم كان يأمر بالدواء قال شفاء أمتي في
+
+253
+00:26:55,190 --> 00:27:08,000
+ثلاثة: شربة عسل، ضربة محجم، جراحة وكيّ بنار ولا أحب
+
+254
+00:27:08,000 --> 00:27:15,060
+أن أكتوي وفي حديث و أن أمتي عن الكيّ
+
+255
+00:27:15,060 --> 00:27:21,040
+ابن قيم الجوزية رحم الله له كتاب جيد اسمه الطب
+
+256
+00:27:21,040 --> 00:27:24,040
+النبوي الطب النبوي
+
+257
+00:27:26,900 --> 00:27:32,120
+ومعظم ما ذكره ابن قيم الجوزية مبني على أحاديث
+
+258
+00:27:32,120 --> 00:27:34,860
+النبي محمد صلى الله عليه وسلم وعلى وصفات استخدام
+
+259
+00:27:34,860 --> 00:27:40,060
+الصحابة والتابعون رضوان الله عليهم وكذلك على ما
+
+260
+00:27:40,060 --> 00:27:44,820
+كان في عهده من أدوات تعرفها العرب من الأعشاب
+
+261
+00:27:47,450 --> 00:27:51,130
+وحتى الآن وبعد هذه القرون أكثر من سبعمائة عام على
+
+262
+00:27:51,130 --> 00:27:56,290
+ابن قيم الجوزية ما زلنا نعتمد النباتات كمصدر
+
+263
+00:27:56,290 --> 00:28:05,330
+رئيسي للأدوية نستخدم الصناعات لكن لا يستغني أو لا
+
+264
+00:28:05,330 --> 00:28:13,290
+يستغني صناعة دوائية عن الأعشاب والنباتات طيب drugs
+
+265
+00:28:13,290 --> 00:28:17,310
+and biotic products الأدوية والمنتجات البيولوجية
+
+266
+00:28:17,310 --> 00:28:21,670
+are derived from four main sources في أربع مصادر
+
+267
+00:28:21,670 --> 00:28:27,450
+أساسية، المصدر الأول plants النباتات
+
+268
+00:28:44,930 --> 00:28:50,030
+مثل الانسولين والأدرينالين يتم استخراج الانسولين
+
+269
+00:28:50,030 --> 00:28:58,030
+معروف أنه في علاج السكر، آخر يبقى الحيوانات ثالثا
+
+270
+00:28:58,030 --> 00:29:05,290
+مواد معدنية مثل زي اليود Iodine والحديد في
+
+271
+00:29:05,290 --> 00:29:11,070
+أشياء اللي هو معدنية أخيرا Chemicals made in labs
+
+272
+00:29:13,310 --> 00:29:23,590
+Synthetic Synthetic يعني ايش؟ صناعية تصنيعية أشوف
+
+273
+00:29:23,590 --> 00:29:28,250
+الـ Plants المصدر الرئيسي الـ Plants active
+
+274
+00:29:28,250 --> 00:29:34,490
+constituents of plant drugs هأشوف المصدر النباتي
+
+275
+00:29:34,490 --> 00:29:39,990
+ليه اللي هو المواد المختلفة في الدواء بقول بتأخذ
+
+276
+00:29:39,990 --> 00:29:46,250
+من الـ Leaves الأوراق من الـ Roots الجذور، من الـ
+
+277
+00:29:46,250 --> 00:29:52,670
+Seeds البذور، And other parts of the plant حتى من
+
+278
+00:29:52,670 --> 00:30:01,070
+قشور السيقان، May be dried تجفف أو Otherwise
+
+279
+00:30:01,070 --> 00:30:07,950
+processed أو تصنع for use as medicine كعلاج And
+
+280
+00:30:07,950 --> 00:30:13,690
+they are known as crude drugs. اضرب لي مثال لبيت 
+
+281
+00:30:13,690 --> 00:30:19,330
+في البيت عندك ايش فيه .. آه ايه البابونج؟ واحد عنده
+
+282
+00:30:19,330 --> 00:30:24,550
+سعلة، عنده برد، بيقولك اغلِ البابونج والزعتر
+
+283
+00:30:24,550 --> 00:30:36,090
+والمرمرية للبرد وورد الجرافة ليش؟ للسعال أما
+
+284
+00:30:36,090 --> 00:30:39,130
+النفخة للأطفال كمون
+
+285
+00:30:41,530 --> 00:30:46,670
+بس الباقي، ايه الجبل اللي وجع البطل؟ اه عادي احنا
+
+286
+00:30:46,670 --> 00:30:51,690
+الحقيقة كتاب الطب النبوي وأنا يعني حقيقة بقول حملوه
+
+287
+00:30:51,690 --> 00:30:55,610
+.. حملوه من الـ Net الطب النبوي ليه؟ من ابن قيم
+
+288
+00:30:55,610 --> 00:31:00,130
+الجوزية، العلامة الإسلامي، وفي كتاب لابن سينا
+
+289
+00:31:00,130 --> 00:31:05,080
+اسمه القانون في الطب، هو القانون في الطب؟ في كتاب
+
+290
+00:31:05,080 --> 00:31:09,600
+في الطب لابن سينا أنا بدأت يعني المطالعة في
+
+291
+00:31:09,600 --> 00:31:14,780
+كتب الأولين عما وصلوا إليه في عهدهم من الـ .. اللي
+
+292
+00:31:14,780 --> 00:31:19,280
+هو الأدوية طيب هذا المصدر النباتي يؤخذ من الأوراق
+
+293
+00:31:19,280 --> 00:31:26,240
+يؤخذ من الجذور يؤخذ من البذور آه ويستخدم يعني
+
+294
+00:31:26,240 --> 00:31:31,920
+كبودرة أو أوراق تُغلى واشربوها اسمه crude drug
+
+295
+00:31:39,330 --> 00:31:45,590
+دخلش مصانع كبسولات ولا صار أقراص لا طبيعي يعني
+
+296
+00:31:45,590 --> 00:31:51,750
+يأخذ منها الزهور البابونج ويغلي ويشرب في البيت
+
+297
+00:31:51,750 --> 00:32:00,190
+يأخذ من المرمرية والزعتر ويشرب عشان بطنه طيب
+
+298
+00:32:00,190 --> 00:32:08,030
+الآن لما تخش المصانع التصنيعية بصير pure drug 
+4
+
+299
+00:32:10,920 --> 00:32:14,260
+مصنع On separation of these active plant
+
+300
+00:32:14,260 --> 00:32:18,400
+constituents المكونات النباتية the resulting pure
+
+301
+00:32:18,400 --> 00:32:29,280
+drug بصفة أ purer are more potent أكثر لأن ربما أخذ من
+
+302
+00:32:29,280 --> 00:32:36,200
+البابونج يعني وزن معين عشان يعمل منه كبسولة أو
+
+303
+00:32:36,200 --> 00:32:36,300
+حاجة
+
+304
+00:32:51,880 --> 00:32:59,900
+لأن الجرعة أكبر ومركزة بل مش مركزة بس موزونة و
+
+305
+00:32:59,900 --> 00:33:03,680
+عليها رقم مكتوب عليها خمسمائة أو مائتين وخمسين أو
+
+306
+00:33:03,680 --> 00:33:12,420
+ألف على علبة ثلاثة More poisonous أكثر سمية And
+
+307
+00:33:12,420 --> 00:33:17,560
+the dose must be smaller يعني لو واحد مثلا تبدّله
+
+308
+00:33:17,560 --> 00:33:21,460
+لأنه عشان يسكن ألمه ياخد مثلا
+
+309
+00:33:25,290 --> 00:33:32,510
+يكون تحت التراب هو poisonous يعني لو احنا شربنا ال
+
+310
+00:33:32,510 --> 00:33:38,830
+crude drug اللي هنا جد ما نشرب منه مطلقا للسمية
+
+311
+00:33:38,830 --> 00:33:47,070
+لأنه شيء طبيعي ويعني معروف يعني مثلا حتى القهوة
+
+312
+00:33:47,070 --> 00:33:51,370
+نشرب القهوة الصّحرا احنا وشيء يعني لو واحد مثلا أخذ
+
+313
+00:33:51,370 --> 00:33:57,110
+في فنجان قهوة أو اثنين أو ثلاثة شوية ضغط وارتفع
+
+314
+00:33:57,110 --> 00:34:01,310
+شيء وشيء يعني ماشيها لكن لو أخذ شيء مصنع من
+
+315
+00:34:01,310 --> 00:34:06,670
+الكافيين بحجم كبير ممكن أنه يصير له يعني تغيرات
+
+316
+00:34:06,670 --> 00:34:10,630
+كبيرة في دقة القلب وفي ارتفاع درجة الدم وممكن في
+
+317
+00:34:10,630 --> 00:34:15,010
+الوعي كمان يبقى more poisonous أن تأخذه بجرعة كبيرة
+
+318
+00:34:15,010 --> 00:34:19,210
+عشان هيك لازم الجرعات تكون موزونة وصغيرة مافيش
+
+319
+00:34:19,210 --> 00:34:24,950
+واحد يملأ يده أدوية ويبلعهم هيك بدون دوز لازم
+
+320
+00:34:24,950 --> 00:34:25,290
+يكون
+321
+00:34:35,620 --> 00:34:41,560
+أمثلة، هي كثيرة لأننا نعمل أمثلة، منها الـ
+
+322
+00:34:41,560 --> 00:34:47,460
+الـ Alkaloids، واحد الـ Alkaloids اللي هو القلويات، أنوية
+
+323
+00:34:47,460 --> 00:34:51,860
+وسطها قلوي، نباتية قلوية، منها الأتروبين،
+
+324
+00:34:52,620 --> 00:34:56,700
+والأتروبين في عالم الأبتومتري؟ معروف، Most
+
+325
+00:34:56,700 --> 00:35:00,720
+important and most important
+
+326
+00:35:07,380 --> 00:35:11,160
+بنتين بهذه القوة غير أتروبين الـ Belladonna نبات اسمه
+
+327
+00:35:11,160 --> 00:35:15,080
+بيلادونا، يبنى جمهور النبات بس بيصنعون بصورة قطرة
+
+328
+00:35:15,080 --> 00:35:25,000
+أو مرهم المورفين، المورفين هو أقوى عقار مسكن في
+
+329
+00:35:25,000 --> 00:35:30,840
+العالم لأنه مقوم من نبتة اسمها أفيون، ايش أفيون؟
+
+330
+00:35:40,200 --> 00:35:46,480
+الـ Morphine يعني الـ most potent sedative. كويس؟
+
+331
+00:35:46,480 --> 00:35:52,900
+الكودايين اللي هو بيقتل الكحة الشديدة، والهيروين
+
+332
+00:35:52,900 --> 00:35:59,680
+هم مخدرات، يبقى المورفين والكودايين والهيروين هم
+
+333
+00:35:59,680 --> 00:36:03,840
+مخدرات، ولا إنكم بتسمعوا نبات الحشيش الخشخاش، هذه
+
+334
+00:36:03,840 --> 00:36:07,800
+الأشياء اللي هي الآن العالم كله بيطاردها لأن هي
+
+335
+00:36:07,800 --> 00:36:09,500
+ضارة بالصحة.
+
+336
+00:36:15,710 --> 00:36:20,370
+طيب يجمع الأتروبين والمورفين والكودايين والهيروين
+
+337
+00:36:20,370 --> 00:36:28,730
+حاجات قواسم مشتركة، أولا كلها Toxic سمّية وكلها لها
+
+338
+00:36:28,730 --> 00:36:36,810
+Bitter taste طعم مر وكلها Putted in small doses
+
+339
+00:36:42,100 --> 00:36:46,420
+وInsoluble in water لا تذوب في الماء وأخيرا الـ
+
+340
+00:36:46,420 --> 00:36:51,700
+Suffix الأخير بتاعها INA INA يعني الأتروبين بتنتهي بـ
+
+341
+00:36:51,700 --> 00:36:56,300
+INA المورفين INA كودايين والهيروين INA يبقى هذه
+
+342
+00:36:56,300 --> 00:37:01,980
+القواسم المشتركة بين الأدوية القلوية نباتية الأدوية
+
+343
+00:37:01,980 --> 00:37:07,560
+القلوية نباتية Alkaloids الأربع هذه في Glycosides
+
+344
+00:37:08,780 --> 00:37:13,480
+أدوية سكرية أدوية سكرية Such as Digoxin لعلاج
+
+345
+00:37:13,480 --> 00:37:20,180
+القلب، علاج فشل القلب اسمه Digoxin أيضا يؤخذ من
+
+346
+00:37:20,180 --> 00:37:24,760
+النبات وهو وسطه يعني هو التركيب بتاعه من السكريات
+
+347
+00:37:24,760 --> 00:37:29,460
+المعقدة في Jams يعني بيقول القلب اسمر من النبات زي
+
+348
+00:37:29,460 --> 00:37:36,160
+الأجار، الأجار هو وسط لنمو البكتيريا والمزارع
+
+349
+00:37:36,160 --> 00:37:36,920
+البكتيرية
+
+350
+00:37:39,310 --> 00:37:42,970
+واستخدم فيه أجار بكثرة لنمو البكتيريا وعمل
+
+351
+00:37:42,970 --> 00:37:51,990
+الأبحاث عليها في Resins في أدوية نباتية ذهنية Fatty
+
+352
+00:37:51,990 --> 00:37:58,330
+Like substances زي الـ Laxatives الملينات اللي عندهم
+
+353
+00:37:58,330 --> 00:38:04,050
+إمساك تعطوه ملينات، هذه في ملينات نباتية من النبات
+
+354
+00:38:04,050 --> 00:38:09,500
+ويعني زيت الخروع هو واحد منهم اللي عنده إمساك شديد
+
+355
+00:38:09,500 --> 00:38:13,780
+بياخد كبسولة عيون زيوت الخروع، في ناس كانوا يردّغوا
+
+356
+00:38:13,780 --> 00:38:18,320
+الخروع على نفسه، بدور الخروع عشان يعمل Flexation
+
+357
+00:38:18,320 --> 00:38:27,440
+يعني يعني مقيّئين آخر شيء من نبات Oils زيوت ال
+
+358
+00:38:27,440 --> 00:38:31,120
+Oils نوعين طيارة وغير طيارة Volatile و Non
+
+359
+00:38:31,120 --> 00:38:35,600
+Volatile زيوت نباتية فيها طيارة Volatile وغير
+
+360
+00:38:35,600 --> 00:38:41,750
+طيارة، الزيوت الطيارة زي الـ Clove oil زيت القرنفل و
+
+361
+00:38:41,750 --> 00:38:48,090
+الـ Peppermint oil زيت النعناع هذا وضعتها يعني
+
+362
+00:38:48,090 --> 00:38:54,530
+ملابسها هواء بتطير زي البنزين زي الكحول في
+
+363
+00:38:54,530 --> 00:39:00,510
+نباتاتنا Such as Olive oil زيت الزيتون هذا هو
+
+364
+00:39:00,510 --> 00:39:04,530
+خدمة النبات زيت الزيتون صح؟ هذا ما يطير وزي الـ
+
+365
+00:39:04,530 --> 00:39:10,280
+Castor oil وزيت الخروع خير طيب احنا يعني في هذه
+
+366
+00:39:10,280 --> 00:39:14,520
+المحاضرة أنا بشكركم إلى هنا يعني في بيان اللي هو
+
+367
+00:39:14,520 --> 00:39:18,120
+مصادر النباتات، المصادر الأدوية من النباتات أو
+
+368
+00:39:18,120 --> 00:39:23,260
+المصادر النباتية للأدوية وأنا هو أكبر مصدر
+
+369
+00:39:23,260 --> 00:39:27,360
+للنباتات للأدوية حتى الآن من النبات والمرة القادمة
+
+370
+00:39:27,360 --> 00:39:29,160
+إن شاء الله سنستكمل
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/qDBpve4bOnI_raw.json b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/qDBpve4bOnI_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..24d3768738fd6051e6b898b813c796683c9b07c1
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/qDBpve4bOnI_raw.json
@@ -0,0 +1 @@
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1980.54, "end": 1981.28, "word": " مكتوب", "probability": 0.959716796875}, {"start": 1981.28, "end": 1981.5, "word": " عليها", "probability": 0.89453125}, {"start": 1981.5, "end": 1982.04, "word": " خمسمية", "probability": 0.91455078125}, {"start": 1982.04, "end": 1982.58, "word": " او", "probability": 0.67724609375}, {"start": 1982.58, "end": 1982.8, "word": " متين", "probability": 0.56817626953125}, {"start": 1982.8, "end": 1982.86, "word": " و", "probability": 0.9912109375}, {"start": 1982.86, "end": 1983.32, "word": " خمسين", "probability": 0.9468994140625}, {"start": 1983.32, "end": 1983.68, "word": " او", "probability": 0.89990234375}, {"start": 1983.68, "end": 1984.02, "word": " الف", "probability": 0.66015625}, {"start": 1984.02, "end": 1986.42, "word": " علي", "probability": 0.182373046875}, {"start": 1986.42, "end": 1986.76, "word": " علبة", "probability": 0.796875}, {"start": 1986.76, "end": 1988.96, "word": " تلاتة", "probability": 0.93798828125}, {"start": 1988.96, "end": 1989.48, "word": " more", "probability": 0.193603515625}, {"start": 1989.48, "end": 1990.08, "word": " poisonous", "probability": 0.78173828125}, {"start": 1990.08, "end": 1991.18, "word": " اكثر", "probability": 0.8069661458333334}, {"start": 1991.18, "end": 1991.62, "word": " ثمية", "probability": 0.6819661458333334}, {"start": 1991.62, "end": 1992.42, "word": " and", "probability": 0.88916015625}, {"start": 1992.42, "end": 1992.54, "word": " the", "probability": 0.4951171875}, {"start": 1992.54, "end": 1992.78, "word": " dose", "probability": 0.6328125}, {"start": 1992.78, "end": 1993.08, "word": " must", "probability": 0.88623046875}, {"start": 1993.08, "end": 1993.38, "word": " be", "probability": 0.96923828125}, {"start": 1993.38, "end": 1994.22, "word": " smaller", "probability": 0.8193359375}, {"start": 1994.22, "end": 1995.68, "word": " يعني", "probability": 0.94287109375}, {"start": 1995.68, "end": 1995.8, "word": " لو", "probability": 0.8408203125}, {"start": 1995.8, "end": 1996.02, "word": " واحد", "probability": 0.97216796875}, {"start": 1996.02, "end": 1996.42, "word": " مثلا", "probability": 0.95849609375}, {"start": 1996.42, "end": 1997.56, "word": " تبداله", "probability": 0.881591796875}, {"start": 1997.56, "end": 1998.7, "word": " لأنه", "probability": 0.7781575520833334}, {"start": 1998.7, "end": 1998.94, "word": " عشان", "probability": 0.9558919270833334}, {"start": 1998.94, "end": 1999.48, "word": " يسكن", "probability": 0.8489583333333334}, {"start": 1999.48, "end": 2000.08, "word": " ألمه", "probability": 0.8707682291666666}, {"start": 2000.08, "end": 2001.12, "word": " ياخد", "probability": 0.8797200520833334}, {"start": 2001.12, "end": 2001.46, "word": " مثلا", "probability": 0.97607421875}], "temperature": 1.0}, {"id": 67, "seek": 203337, "start": 2005.29, "end": 2033.37, "text": "يكون تحت التراب هو poisonous يعني لو احنا شربنا ال crude drug اللي هنا جد ما نشرب منه مطرش للسمية لإنه شيء طبيعي ويعني معروف يعني مثلا حتى القهوة نشرب القهوة 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ال الواتس. واحد ال الواتس اللي هو القلوية. أنوية وسطها قلوي. نباتية قلوية. منها الأتروبين. والأتروبين في عالم الأبتومتري؟ معروف. 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"word": " INA", "probability": 0.869873046875}, {"start": 2212.16, "end": 2212.88, "word": " المورفيض", "probability": 0.48345947265625}, {"start": 2212.88, "end": 2213.4, "word": " INA", "probability": 0.92529296875}, {"start": 2213.4, "end": 2214.08, "word": " كودايين", "probability": 0.50579833984375}, {"start": 2214.08, "end": 2214.72, "word": " والورويل", "probability": 0.55975341796875}, {"start": 2214.72, "end": 2215.34, "word": " INA", "probability": 0.95263671875}, {"start": 2215.34, "end": 2216.18, "word": " يبقى", "probability": 0.58642578125}, {"start": 2216.18, "end": 2216.3, "word": " هذه", "probability": 0.70947265625}, {"start": 2216.3, "end": 2216.58, "word": " القوات", "probability": 0.639892578125}, {"start": 2216.58, "end": 2217.2, "word": " المشتركة", "probability": 0.99033203125}, {"start": 2217.2, "end": 2217.66, "word": " بين", "probability": 0.759765625}, {"start": 2217.66, "end": 2218.42, "word": " الأدوية", "probability": 0.9925537109375}, {"start": 2218.42, "end": 2220.18, "word": " القلوية", "probability": 0.973388671875}, {"start": 2220.18, "end": 2221.34, "word": " أنمتية", "probability": 0.74951171875}, {"start": 2221.34, "end": 2221.98, "word": " الأدوية", "probability": 0.93701171875}, {"start": 2221.98, "end": 2222.52, "word": " القلوية", "probability": 0.9873046875}, {"start": 2222.52, "end": 2222.92, "word": " أنمتية", "probability": 0.983154296875}, {"start": 2222.92, "end": 2223.72, "word": " alkalites", "probability": 0.4156494140625}, {"start": 2223.72, "end": 2224.5, "word": " الأربع", "probability": 0.8219401041666666}, {"start": 2224.5, "end": 2224.96, "word": " هذه", "probability": 0.71728515625}, {"start": 2224.96, "end": 2226.4, "word": " في", "probability": 0.9443359375}, {"start": 2226.4, "end": 2227.56, "word": " glycosides", "probability": 0.90576171875}], "temperature": 1.0}, {"id": 74, "seek": 225692, "start": 2228.78, "end": 2256.92, "text": "أدوية سكرية أدوية سكرية such as didoxin لعلاج القلب علاج فشل القلب اسمه didoxin أيضا يُاخد من النبات وهو وسطه يعني هو التركيب بتاعه من السكريات المعقدة في جمس يعني بيقول القلب أسمر من النبات زي الأجار الأجار هو وسط لنمو البكتيريا والمزارع البكتيرية", "tokens": [10721, 3215, 2407, 10632, 8608, 37983, 10632, 5551, 3215, 2407, 10632, 8608, 37983, 10632, 1270, 382, 630, 5230, 259, 5296, 30241, 26108, 25062, 46152, 11203, 26108, 6156, 8592, 1211, 25062, 46152, 24525, 2304, 3224, 630, 5230, 259, 36632, 11242, 995, 7251, 10859, 47283, 3215, 9154, 28239, 3555, 9307, 37037, 2407, 46952, 9566, 3224, 37495, 22653, 31439, 16712, 31747, 1829, 3555, 39894, 45761, 3224, 9154, 21136, 4117, 16572, 9307, 9673, 3615, 28543, 3660, 8978, 10874, 2304, 3794, 37495, 22653, 4724, 1829, 39648, 25062, 46152, 5551, 3794, 29973, 9154, 28239, 3555, 9307, 30767, 1829, 16247, 7435, 9640, 16247, 7435, 9640, 31439, 46952, 9566, 5296, 1863, 2304, 2407, 29739, 4117, 2655, 13546, 25528, 16070, 2304, 11622, 9640, 3615, 29739, 4117, 2655, 13546, 10632], "avg_logprob": -0.19473140397347694, 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"probability": 0.8873697916666666}, {"start": 2249.26, "end": 2249.46, "word": " زي", "probability": 0.938720703125}, {"start": 2249.46, "end": 2249.86, "word": " الأجار", "probability": 0.90576171875}, {"start": 2249.86, "end": 2250.52, "word": " الأجار", "probability": 0.9098307291666666}, {"start": 2250.52, "end": 2251.26, "word": " هو", "probability": 0.98291015625}, {"start": 2251.26, "end": 2252.8, "word": " وسط", "probability": 0.9833984375}, {"start": 2252.8, "end": 2253.92, "word": " لنمو", "probability": 0.9896240234375}, {"start": 2253.92, "end": 2255.0, "word": " البكتيريا", "probability": 0.94404296875}, {"start": 2255.0, "end": 2256.16, "word": " والمزارع", "probability": 0.88818359375}, {"start": 2256.16, "end": 2256.92, "word": " البكتيرية", "probability": 0.9751953125}], "temperature": 1.0}, {"id": 75, "seek": 228765, "start": 2259.31, "end": 2287.65, "text": "واستخدم فيها أجار بكثرة لنمو البكتيريا وعمل الأبحاث عليها في ريزلز في أدوية نباتية ذهنية فاتي لايك سبستانسز زي ال laxatives الملينات اللي عندهم إمساك تعطوه ملينات هذه في ملينات نباتية من النبات ويعني زيت الخشب هو واحد منهم", "tokens": [2407, 995, 14851, 9778, 40448, 8978, 11296, 5551, 7435, 9640, 4724, 4117, 12984, 25720, 5296, 1863, 2304, 2407, 29739, 4117, 2655, 13546, 25528, 4032, 25957, 1211, 16247, 49628, 5718, 104, 25894, 11296, 8978, 12602, 1829, 11622, 1211, 11622, 8978, 5551, 3215, 2407, 10632, 8717, 3555, 9307, 10632, 29910, 3224, 1863, 10632, 6156, 9307, 1829, 20193, 1829, 4117, 8608, 3555, 14851, 7649, 3794, 11622, 30767, 1829, 2423, 635, 87, 4884, 2423, 42213, 9957, 9307, 13672, 1829, 43242, 16095, 11933, 2304, 3794, 995, 4117, 6055, 3615, 9566, 2407, 3224, 3714, 20292, 8315, 2655, 29538, 8978, 3714, 20292, 8315, 2655, 8717, 3555, 9307, 10632, 9154, 28239, 3555, 9307, 4032, 40228, 22653, 30767, 36081, 33962, 8592, 3555, 31439, 36764, 24401, 9154, 16095], "avg_logprob": -0.2833508393343757, "compression_ratio": 1.7723214285714286, "no_speech_prob": 0.0, "words": [{"start": 2259.31, 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{"start": 2311.6, "end": 2312.82, "word": " زيوت", "probability": 0.93017578125}, {"start": 2312.82, "end": 2313.54, "word": " النباتية", "probability": 0.968017578125}, {"start": 2313.54, "end": 2314.18, "word": " فيها", "probability": 0.759765625}, {"start": 2314.18, "end": 2314.8, "word": " طيارة", "probability": 0.9779052734375}, {"start": 2314.8, "end": 2315.1, "word": " volatile", "probability": 0.97705078125}, {"start": 2315.1, "end": 2315.46, "word": " و", "probability": 0.9794921875}, {"start": 2315.46, "end": 2315.6, "word": " غير", "probability": 0.9423828125}, {"start": 2315.6, "end": 2316.04, "word": " طيارة", "probability": 0.9927978515625}], "temperature": 1.0}, {"id": 77, "seek": 234623, "start": 2316.77, "end": 2346.23, "text": "الزيوت الطيارة زي الـ clove oil زيت الجرنفل و ال pepper mint oil زيت النعناع هذا وضعتها يعني ملابس الهواء بطير زي البنزين زي الكحول في نانبولاتاعي such as olive oil زيت الزتون هذا هو خدمة النبات زيت الزتون صح؟ هذا ما بطير و زي ال castor oil و زيت الخروع", "tokens": [6027, 11622, 1829, 35473, 41950, 1829, 9640, 3660, 30767, 1829, 2423, 39184, 596, 1682, 3184, 30767, 36081, 25724, 2288, 1863, 5172, 1211, 4032, 2423, 8532, 18189, 3184, 30767, 36081, 28239, 3615, 8315, 3615, 23758, 4032, 11242, 34268, 11296, 37495, 22653, 3714, 15040, 3555, 3794, 2423, 3224, 2407, 16606, 4724, 9566, 13546, 30767, 1829, 29739, 1863, 11622, 9957, 30767, 1829, 33251, 5016, 12610, 8978, 8717, 7649, 3555, 12610, 9307, 45761, 1829, 1270, 382, 15981, 3184, 30767, 36081, 6024, 110, 2655, 11536, 23758, 31439, 16490, 40448, 3660, 28239, 3555, 9307, 30767, 36081, 6024, 110, 2655, 11536, 20328, 5016, 22807, 23758, 19446, 4724, 9566, 13546, 4032, 30767, 1829, 2423, 4193, 284, 3184, 4032, 30767, 36081, 33962, 32887, 3615], "avg_logprob": -0.31492456922243384, "compression_ratio": 1.8311111111111111, "no_speech_prob": 0.0, "words": [{"start": 2316.77, "end": 2317.25, "word": "الزيوت", "probability": 0.76629638671875}, {"start": 2317.25, "end": 2317.91, "word": " الطيارة", "probability": 0.9508056640625}, {"start": 2317.91, "end": 2318.35, "word": " زي", "probability": 0.87158203125}, {"start": 2318.35, "end": 2319.09, "word": " الـ", "probability": 0.4100341796875}, {"start": 2319.09, "end": 2319.59, "word": " clove", "probability": 0.640380859375}, {"start": 2319.59, "end": 2320.35, "word": " oil", "probability": 0.93017578125}, {"start": 2320.35, "end": 2320.95, "word": " زيت", "probability": 0.5797119140625}, {"start": 2320.95, "end": 2321.49, "word": " الجرنفل", "probability": 0.705126953125}, {"start": 2321.49, "end": 2321.75, "word": " و", "probability": 0.732421875}, {"start": 2321.75, "end": 2321.83, "word": " ال", "probability": 0.529296875}, {"start": 2321.83, "end": 2321.95, "word": " pepper", "probability": 0.145751953125}, {"start": 2321.95, "end": 2322.47, "word": " mint", "probability": 0.80517578125}, {"start": 2322.47, "end": 2323.15, "word": " oil", "probability": 0.8193359375}, {"start": 2323.15, "end": 2323.79, "word": " زيت", "probability": 0.87548828125}, {"start": 2323.79, "end": 2324.97, "word": " النعناع", "probability": 0.67132568359375}, {"start": 2324.97, "end": 2325.55, "word": " هذا", "probability": 0.151123046875}, {"start": 2325.55, "end": 2326.61, "word": " وضعتها", "probability": 0.7698974609375}, {"start": 2326.61, "end": 2328.09, "word": " يعني", "probability": 0.6773681640625}, {"start": 2328.09, "end": 2328.41, "word": " ملابس", "probability": 0.939208984375}, {"start": 2328.41, "end": 2328.79, "word": " الهواء", "probability": 0.83831787109375}, {"start": 2328.79, "end": 2329.29, "word": " بطير", "probability": 0.5811360677083334}, {"start": 2329.29, "end": 2330.87, "word": " زي", "probability": 0.97265625}, {"start": 2330.87, "end": 2331.41, "word": " البنزين", "probability": 0.9683837890625}, {"start": 2331.41, "end": 2332.89, "word": " زي", "probability": 0.90087890625}, {"start": 2332.89, "end": 2333.35, "word": " الكحول", "probability": 0.9176432291666666}, {"start": 2333.35, "end": 2334.53, "word": " في", "probability": 0.712890625}, {"start": 2334.53, "end": 2335.77, "word": " نانبولاتاعي", "probability": 0.6148507254464286}, {"start": 2335.77, "end": 2337.39, "word": " such", "probability": 0.7255859375}, {"start": 2337.39, "end": 2337.81, "word": " as", "probability": 0.98388671875}, {"start": 2337.81, "end": 2338.17, "word": " olive", "probability": 0.7568359375}, {"start": 2338.17, "end": 2338.69, "word": " oil", "probability": 0.9833984375}, {"start": 2338.69, "end": 2339.15, "word": " زيت", "probability": 0.93408203125}, {"start": 2339.15, "end": 2339.57, "word": " الزتون", "probability": 0.808349609375}, {"start": 2339.57, "end": 2340.41, "word": " هذا", "probability": 0.68115234375}, {"start": 2340.41, "end": 2340.51, "word": " هو", "probability": 0.72802734375}, {"start": 2340.51, "end": 2340.79, "word": " خدمة", "probability": 0.6593831380208334}, {"start": 2340.79, "end": 2341.07, "word": " النبات", "probability": 0.7379557291666666}, {"start": 2341.07, "end": 2341.43, "word": " زيت", "probability": 0.803955078125}, {"start": 2341.43, "end": 2341.75, "word": " الزتون", "probability": 0.9736328125}, {"start": 2341.75, "end": 2342.67, "word": " صح؟", "probability": 0.84619140625}, {"start": 2342.67, "end": 2342.93, "word": " هذا", "probability": 0.85205078125}, {"start": 2342.93, "end": 2343.33, "word": " ما", "probability": 0.4892578125}, {"start": 2343.33, "end": 2343.75, "word": " بطير", "probability": 0.9248046875}, {"start": 2343.75, "end": 2344.31, "word": " و", "probability": 0.71875}, {"start": 2344.31, "end": 2344.41, "word": " زي", "probability": 0.9296875}, {"start": 2344.41, "end": 2344.53, "word": " ال", "probability": 0.640625}, {"start": 2344.53, "end": 2344.81, "word": " castor", "probability": 0.5697021484375}, {"start": 2344.81, "end": 2345.03, "word": " oil", "probability": 0.98681640625}, {"start": 2345.03, "end": 2345.19, "word": " و", "probability": 0.92724609375}, {"start": 2345.19, "end": 2345.53, "word": " زيت", "probability": 0.89111328125}, {"start": 2345.53, "end": 2346.23, "word": " الخروع", "probability": 0.8154296875}], "temperature": 1.0}, {"id": 78, "seek": 236916, "start": 2346.92, "end": 2369.16, "text": "خير طيب احنا يعني في هذه المحاضرة انا بشكركوا الى هنا يعني في بيان اللي هو مصادر النباتات المصادر الأدوية من النباتات او المصادر النباتية للأدوية وانا هو اكبر مصدر للنباتات للأدوية حتى الان من النبات والمرة القادمة ان شاء الله سنستكمل", "tokens": [9778, 13546, 23032, 1829, 3555, 1975, 5016, 8315, 37495, 22653, 8978, 29538, 9673, 5016, 46958, 25720, 1975, 8315, 4724, 8592, 37983, 4117, 14407, 2423, 7578, 34105, 37495, 22653, 8978, 4724, 1829, 7649, 13672, 1829, 31439, 3714, 9381, 18513, 2288, 28239, 3555, 9307, 9307, 9673, 9381, 18513, 2288, 16247, 3215, 2407, 10632, 9154, 28239, 3555, 9307, 9307, 1975, 2407, 9673, 9381, 18513, 2288, 28239, 3555, 9307, 10632, 24976, 10721, 3215, 2407, 10632, 4032, 7649, 995, 31439, 1975, 4117, 26890, 3714, 9381, 3215, 2288, 24976, 1863, 3555, 9307, 9307, 24976, 10721, 3215, 2407, 10632, 11331, 49975, 2423, 7649, 9154, 28239, 3555, 9307, 16070, 29973, 3660, 25062, 18513, 46007, 16472, 13412, 16606, 21984, 8608, 1863, 14851, 24793, 1211], "avg_logprob": -0.13543910957102118, "compression_ratio": 2.2473684210526317, "no_speech_prob": 4.76837158203125e-07, "words": [{"start": 2346.92, "end": 2347.4, "word": "خير", "probability": 0.3463134765625}, {"start": 2347.4, "end": 2347.8, "word": " طيب", "probability": 0.9138997395833334}, {"start": 2347.8, "end": 2349.48, "word": " احنا", "probability": 0.8395182291666666}, {"start": 2349.48, "end": 2349.98, "word": " يعني", "probability": 0.7421875}, {"start": 2349.98, "end": 2350.1, "word": " في", "probability": 0.953125}, {"start": 2350.1, "end": 2350.28, "word": " هذه", "probability": 0.48828125}, {"start": 2350.28, "end": 2350.66, "word": " المحاضرة", "probability": 0.9781494140625}, {"start": 2350.66, "end": 2350.8, "word": " انا", "probability": 0.810546875}, {"start": 2350.8, "end": 2351.22, "word": " بشكركوا", "probability": 0.85185546875}, {"start": 2351.22, "end": 2351.42, "word": " الى", "probability": 0.45458984375}, {"start": 2351.42, "end": 2351.62, "word": " هنا", "probability": 0.94580078125}, {"start": 2351.62, "end": 2352.64, "word": " يعني", "probability": 0.73681640625}, {"start": 2352.64, "end": 2352.98, "word": " في", "probability": 0.95703125}, {"start": 2352.98, "end": 2353.62, "word": " بيان", "probability": 0.9479166666666666}, {"start": 2353.62, "end": 2354.3, "word": " اللي", "probability": 0.939697265625}, {"start": 2354.3, "end": 2354.52, "word": " هو", "probability": 0.99072265625}, {"start": 2354.52, "end": 2355.12, "word": " مصادر", "probability": 0.9937744140625}, {"start": 2355.12, "end": 2356.22, "word": " النباتات", "probability": 0.9849853515625}, {"start": 2356.22, "end": 2356.86, "word": " المصادر", "probability": 0.8900146484375}, {"start": 2356.86, "end": 2357.16, "word": " الأدوية", "probability": 0.977783203125}, {"start": 2357.16, "end": 2357.3, "word": " من", "probability": 0.9765625}, {"start": 2357.3, "end": 2357.94, "word": " النباتات", "probability": 0.991943359375}, {"start": 2357.94, "end": 2358.12, "word": " او", "probability": 0.8837890625}, {"start": 2358.12, "end": 2358.44, "word": " المصادر", "probability": 0.990478515625}, {"start": 2358.44, "end": 2358.92, "word": " النباتية", "probability": 0.9610595703125}, {"start": 2358.92, "end": 2359.64, "word": " للأدوية", "probability": 0.92265625}, {"start": 2359.64, "end": 2360.64, "word": " وانا", "probability": 0.7357584635416666}, {"start": 2360.64, "end": 2360.92, "word": " هو", "probability": 0.98779296875}, {"start": 2360.92, "end": 2362.08, "word": " اكبر", "probability": 0.9200846354166666}, {"start": 2362.08, "end": 2363.26, "word": " مصدر", "probability": 0.998291015625}, {"start": 2363.26, "end": 2363.92, "word": " للنباتات", "probability": 0.87939453125}, {"start": 2363.92, "end": 2364.62, "word": " للأدوية", "probability": 0.9294921875}, {"start": 2364.62, "end": 2364.94, "word": " حتى", "probability": 0.906005859375}, {"start": 2364.94, "end": 2365.24, "word": " الان", "probability": 0.7291259765625}, {"start": 2365.24, "end": 2365.38, "word": " من", "probability": 0.9892578125}, {"start": 2365.38, "end": 2365.8, "word": " النبات", "probability": 0.97021484375}, {"start": 2365.8, "end": 2366.76, "word": " والمرة", "probability": 0.640625}, {"start": 2366.76, "end": 2367.36, "word": " القادمة", "probability": 0.9930013020833334}, {"start": 2367.36, "end": 2367.54, "word": " ان", "probability": 0.89111328125}, {"start": 2367.54, "end": 2367.74, "word": " شاء", "probability": 0.948974609375}, {"start": 2367.74, "end": 2368.0, "word": " الله", "probability": 0.9609375}, {"start": 2368.0, "end": 2369.16, "word": " سنستكمل", "probability": 0.9767578125}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 2377.2125, "duration_after_vad": 2052.6487499999907}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/qmYiIybOs3Q_postprocess.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/qmYiIybOs3Q_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..f92380811161a7f9d3a6e26b6692c4bdf5333330
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/qmYiIybOs3Q_postprocess.srt
@@ -0,0 +1,1656 @@
+1
+00:00:26,570 --> 00:00:32,750
+سلام عليكم ورحمة الله وبركاته في هذا اليوم سنستكمل
+
+2
+00:00:32,750 --> 00:00:36,650
+ما كنا قد بدأنا في المحاضرة السابقة حول مضايقات
+
+3
+00:00:36,650 --> 00:00:42,770
+البرج ميوتيكس ميوتيكس الميوتيكس
+
+4
+00:00:42,770 --> 00:00:49,770
+تعمل بأكثر من طريقة الطريقة اللي احنا عارفينها
+
+5
+00:00:50,660 --> 00:00:57,400
+أولها و أبسطها هي إنها تعمل inhibition of the
+
+6
+00:00:57,400 --> 00:01:01,980
+sphincter pupillary muscle العضلة
+
+7
+00:01:01,980 --> 00:01:08,260
+القلعة ببريل بوربو هي تلخيها، آسف، العكس هي تعمل
+
+8
+00:01:08,260 --> 00:01:12,820
+stimulation، آسف، شكرا لكم، تعمل stimulation of
+
+9
+00:01:12,820 --> 00:01:17,040
+the sphincter pupillary muscle، شكرا، stimulation
+
+10
+00:01:17,040 --> 00:01:21,620
+of the sphincter pupillary muscleزيد في قوتها
+
+11
+00:01:21,620 --> 00:01:25,940
+فتعمل contraction وبتعمل meiosis اللي هو تضييق
+
+12
+00:01:25,940 --> 00:01:31,020
+البقوة هذا شيء كويس هذا في ثوم عن طريقه عن طريق
+
+13
+00:01:31,020 --> 00:01:37,900
+العمل على ال receptors الموجودة في العضلة وبالتالي
+
+14
+00:01:37,900 --> 00:01:43,360
+لما تعمل على ال receptors بيصير افراز للاسيتيكوليه
+
+15
+00:01:43,360 --> 00:01:49,630
+والاسيتيكوليه هو ميوتيققهيبقى لما هي تيجي على
+
+16
+00:01:49,630 --> 00:01:55,730
+receptors المتخصصة في العضرة تعمل stimulation
+
+17
+00:01:55,730 --> 00:02:03,370
+بيبدأ الأستايكولين يفرز ما بين العضرة و العصب هنا
+
+18
+00:02:03,370 --> 00:02:08,990
+الاستايكولين بيعمل stimulation للعضرة وبتالي تبكمش
+
+19
+00:02:08,990 --> 00:02:16,650
+و يبصر الطريقة التانية هي أن تعمل anti colon
+
+20
+00:02:16,650 --> 00:02:21,440
+stressقلنا في المحاضرة السادسة انه في انزين جاهز
+
+21
+00:02:21,440 --> 00:02:26,460
+اسمه كوليستريز لما الإنسان يكون بيقدي أي مهمة في
+
+22
+00:02:26,460 --> 00:02:35,740
+عضلك ثم يرتاح أو قد يرتاح بيطلع انزين من العضلة
+
+23
+00:02:35,740 --> 00:02:43,280
+بيمحى الأستاركولين الموجود فمدينة الأستاركولين
+
+24
+00:02:43,280 --> 00:02:49,570
+انتهى بالكوليستريزبنروح اثره لما نروح اثره ترتاح
+
+25
+00:02:49,570 --> 00:02:55,490
+العضلة في انزيم تاني اسمه anticholin stress انزيم
+
+26
+00:02:55,490 --> 00:03:00,950
+بيحطم الانزيم انزيم بيحطم الانزيم يبقى الانزيم هذا
+
+27
+00:03:00,950 --> 00:03:03,450
+ال anticholin stress بيحطم الcholin stress
+
+28
+00:03:03,450 --> 00:03:08,170
+وبالتالي بيخلوه شيء عمال يبقى العضلة بيظل في حالة
+
+29
+00:03:08,170 --> 00:03:15,980
+انكماش كل ما بدها العضلة ترتاحي هوبيجي الكوليستراز
+
+30
+00:03:15,980 --> 00:03:18,620
+اللي دخل بيمنعه ال Anti-cholesterase أعلى منه
+
+31
+00:03:18,620 --> 00:03:23,140
+بيمنعه على العامل هذه الطريقة المشهورة ال Anti
+
+32
+00:03:23,140 --> 00:03:27,280
+-cholesterase يبقى إما الأمل بيكون بالقرع سينباته
+
+33
+00:03:27,280 --> 00:03:32,560
+myelitic كإنه نبض عصبي جاية على ال receptors أو
+
+34
+00:03:32,560 --> 00:03:37,220
+بيمنع الكوليستراز إنه اشتغل، ضالها ال sphincter,
+
+35
+00:03:37,240 --> 00:03:41,460
+pupillary, muscle, air, contracted والبوة بوة، yes
+
+36
+00:03:41,460 --> 00:03:48,460
+or noفي نوع آخر من ال myotics بيعملش على ال filter
+
+37
+00:03:48,460 --> 00:03:54,600
+pupillary لأ بيعمل stimulation of the lateral
+
+38
+00:03:54,600 --> 00:03:59,260
+pupillary muscle فبيعمل inhibition .. عكسها ..
+
+39
+00:03:59,260 --> 00:04:01,780
+inhibition لدى ال lateral pupillary muscle واحدة
+
+40
+00:04:01,780 --> 00:04:08,400
+المرة الماضية رسمنا رسمة تقولنا كذا هاي الcellar
+
+41
+00:04:08,400 --> 00:04:15,350
+muscle هاي الآن البُبُبهنا في الـ iris فى
+
+42
+00:04:15,350 --> 00:04:21,430
+sphincter pupillary muscle وهنا فى dilatoral
+
+43
+00:04:21,430 --> 00:04:25,290
+pupillary muscle قولنا إذا كان sphincter pupillary
+
+44
+00:04:25,290 --> 00:04:33,030
+قثيرة بيظهر لبابه ولمّا
+
+45
+00:04:33,030 --> 00:04:39,730
+هي تتعب تركمش ال dilatoral pupillary ترتخى الآن
+
+46
+00:04:39,730 --> 00:04:43,980
+هدّيكوا نقول اللي شرحناهاالطريقة التانية لأ، إنه
+
+47
+00:04:43,980 --> 00:04:48,800
+في نوع من الـ Miotics، إيش تعمل؟ تعمل stimulation
+
+48
+00:04:48,800 --> 00:04:54,100
+للـDilateral Pupil، اللي هنا، تعمل inhibition
+
+49
+00:04:54,100 --> 00:04:56,540
+للـDilateral Pupil لـMuscle، لما تعمل inhibition
+
+50
+00:04:56,540 --> 00:05:00,340
+للـDilateral Pupil لـMuscle، يعني السير هي
+
+51
+00:05:00,340 --> 00:05:04,180
+relaxed، اللي عضلها هي تلقائيًا بزا غلبها،
+
+52
+00:05:04,180 --> 00:05:06,480
+Sphincter Pupil، يعني بدور الـSphincter Pupil اللي
+
+53
+00:05:06,480 --> 00:05:12,320
+ما ييجي عليها عمل، بييجي على ضد بتاعه،يبقى هم
+
+54
+00:05:12,320 --> 00:05:15,120
+اكتشفوا عن طريقين الطريقة الأولى اللي قولناها
+
+55
+00:05:15,120 --> 00:05:23,580
+stimulation stimulation ونشير stimulation بهكذا او
+
+56
+00:05:23,580 --> 00:05:31,740
+sphincter pupillary او inhibition inhibition ونقول
+
+57
+00:05:31,740 --> 00:05:38,040
+inhibition هكذا او dilator pupillary muscle وهذه
+
+58
+00:05:38,040 --> 00:05:42,810
+الفنات ايه؟تماماً ضد أو عكس اللي قلناه في
+
+59
+00:05:42,810 --> 00:05:49,450
+المدرياتكس المدرياتكس عكس إما بنعمل inhibition
+
+60
+00:05:49,450 --> 00:05:55,290
+لـSphincter أو بنعمل stimulation للـdilation يبقى
+
+61
+00:05:55,290 --> 00:06:01,310
+في المدرياتكس، ها هي المدرياتكس وهي الميتكس
+
+62
+00:06:01,310 --> 00:06:04,610
+الموسيقية
+
+63
+00:06:04,610 --> 00:06:07,830
+هو المضيقة هنا نفس الكلام بس
+
+64
+00:06:32,660 --> 00:06:39,200
+يقولني ان المادة بتاع المضايقات يعني في منها أقراس
+
+65
+00:06:39,200 --> 00:06:43,960
+تعمل على ال circulation على الجسم على اللي هو عايش
+
+66
+00:06:43,960 --> 00:06:50,380
+الدورة الدموية فمثلا عندي general medicine من مادة
+
+67
+00:06:50,380 --> 00:06:56,120
+الميوتكس تعمل ع treatment of hypertension and
+
+68
+00:06:56,120 --> 00:06:59,460
+peripheral vasospastic conditions
+
+69
+00:07:04,610 --> 00:07:09,990
+وفي علاج تضيق الأوية الدموية الطرفية اللي في
+
+70
+00:07:09,990 --> 00:07:14,430
+الأقرب بيقوللي
+
+71
+00:07:14,430 --> 00:07:22,950
+انه اكتشفوا مضيق اسمه
+
+72
+00:07:22,950 --> 00:07:30,590
+Dabiprasol هشوف Dabiprasol available to eye care
+
+73
+00:07:30,590 --> 00:07:34,270
+practitioners ايش eye care practitioners؟
+
+74
+00:07:36,790 --> 00:07:42,150
+In United States of America under the name trade
+
+75
+00:07:42,150 --> 00:07:48,030
+name اللي هو trade name يعني الاسم في السوق يعني
+
+76
+00:07:48,030 --> 00:07:58,170
+Red Ice هنا بيشتغل على العلم هنا من نفس مادة ال
+
+77
+00:07:58,170 --> 00:08:05,420
+general medical centerأخدوا من هنا وعملوا ده في
+
+78
+00:08:05,420 --> 00:08:10,380
+برازول وحطوا في العين بدا هو بضيق العين بضيق العين
+
+79
+00:08:10,380 --> 00:08:14,360
+طبعا أنا مولود في أمريكا لكن مش موجود في بريطانيا
+
+80
+00:08:14,360 --> 00:08:17,640
+طبعا
+
+81
+00:08:17,640 --> 00:08:22,320
+انا حاط ان اجيب هنا ال dialetropiopeli و ال
+
+82
+00:08:22,320 --> 00:08:26,160
+sphincteropiopeli muscle و ال receptors اللي فيهم
+
+83
+00:08:26,160 --> 00:08:31,330
+و الأقراس اللي بتعمل او القطر اللي بتعمل عليهمهذه
+
+84
+00:08:31,330 --> 00:08:35,990
+الصورة تمت فيها اكتر عشان افهمكم كيف
+
+85
+00:08:35,990 --> 00:08:41,550
+neurotransmitter neurotransmitter
+
+86
+00:08:41,550 --> 00:08:52,010
+اللي هو استايكولين لما ييجي السيل العصبي nerve
+
+87
+00:08:52,010 --> 00:08:59,430
+impulse هنا وهذا العضلةلابد في الأول أنه فيه
+
+88
+00:08:59,430 --> 00:09:03,710
+Receptors معينة و Receptors عن طريق الإفراز لـ
+
+89
+00:09:03,710 --> 00:09:07,710
+Acetylcholine إذا أُفرز Acetylcholine الـ
+
+90
+00:09:07,710 --> 00:09:12,790
+Receptors هتتفتح للسيلع عصبي تفتح للسيلع عصبي و
+
+91
+00:09:12,790 --> 00:09:17,510
+بيخش عشان يعملش stimulation أو Inhibition
+
+92
+00:09:17,510 --> 00:09:22,850
+stimulation أو Inhibition فهذا في كل جسم موضوع الـ
+
+93
+00:09:22,850 --> 00:09:29,030
+Receptors و Acetylcholine Releaseوإنه ال release
+
+94
+00:09:29,030 --> 00:09:36,130
+بتاعه بين العصب وبين العضلة مهم جدا لإنه تفتح
+
+95
+00:09:36,130 --> 00:09:41,070
+قنوات معينة في سطح العضلة يدخل انها ال impulse
+
+96
+00:09:41,070 --> 00:09:47,530
+ويعمل اما stimulation او inhibition صورة بني مهمة
+
+97
+00:09:47,530 --> 00:09:52,970
+انا جبتها حتى تعرفوا ايش اللي بصير طيب
+
+98
+00:09:52,970 --> 00:10:00,670
+ال .. ال filokerin لما اتكلم عنههو الآن ال miotic
+
+99
+00:10:00,670 --> 00:10:08,850
+الواحد الموجود اللى موجود commercially available
+
+100
+00:10:08,850 --> 00:10:12,590
+اللى موجود فى السوق يبقى ال biocarbين هم جابوه من
+
+101
+00:10:12,590 --> 00:10:20,110
+نبتة اسمها biocarbus microfilas من نبع معين زى وزى
+
+102
+00:10:20,110 --> 00:10:23,690
+مثل ال atropine جابوه من بين الأدنى
+
+103
+00:10:27,240 --> 00:10:36,260
+فايلو كابين فايلو
+
+104
+00:10:36,260 --> 00:10:39,460
+كابين فايلو كابين فايلو كابين فايلو كابين فايلو
+
+105
+00:10:39,460 --> 00:10:39,740
+كابين فايلو كابين فايلو كابين فايلو كابين فايلو
+
+106
+00:10:39,740 --> 00:10:42,040
+كابين فايلو كابين فايلو كابين فايلو كابين فايلو
+
+107
+00:10:42,040 --> 00:10:42,860
+كابين فايلو كابين فايلو كابين فايلو كابين فايلو
+
+108
+00:10:42,860 --> 00:10:49,080
+كابين فايلو كابين فايلو كابين فايلو
+
+109
+00:10:49,080 --> 00:10:56,610
+كابين فايلو كابين فايلو كابين فايلو كابينأه بيكون
+
+110
+00:10:56,610 --> 00:11:02,630
+اه freely soluble in less than one part of water
+
+111
+00:11:02,630 --> 00:11:09,830
+بيكون سهل الدوابان ويله خاصية Antibacterial أه
+
+112
+00:11:09,830 --> 00:11:13,510
+اللي هو advantage Antibacterial advantage فهذا
+
+113
+00:11:13,510 --> 00:11:18,610
+بافتسار Pyrocarbine Mechanism of action طبعا ال
+
+114
+00:11:18,610 --> 00:11:21,150
+mechanism of action هيعمل على ال filter pupillary
+
+115
+00:11:21,150 --> 00:11:22,770
+muscle stimulation
+
+116
+00:11:28,300 --> 00:11:31,480
+indirect acting para-sympathomimetic agent
+
+117
+00:11:31,480 --> 00:11:34,080
+compared with the indirect
+
+118
+00:11:43,470 --> 00:11:48,570
+الكولين كلام يعني بقارن بالمعنى لكن its primary
+
+119
+00:11:48,570 --> 00:11:53,790
+action هنا is stimulation or inhibition of the
+
+120
+00:11:53,790 --> 00:11:56,970
+autonomic effector cells in a similar manner to
+
+121
+00:11:56,970 --> 00:11:59,870
+accomplish by أسطايع الكولين يبقى هذا ال
+
+122
+00:11:59,870 --> 00:12:06,090
+pyrocarbine هو الشبيه بالأسطايع الكولين بس
+
+123
+00:12:06,090 --> 00:12:11,190
+الأسطايع الكولين طبيعي هنا و هذا صناعيالاستال
+
+124
+00:12:11,190 --> 00:12:16,610
+الكولين هنا طبيعي وهذا صناعي الاستال الكولين هو
+
+125
+00:12:16,610 --> 00:12:24,510
+احنا نعتقد انه ال most powerful biotic المضيق
+
+126
+00:12:24,510 --> 00:12:31,050
+الاقوى للوغو بيجيبوا الاستال الكولين في انبول بعد
+
+127
+00:12:31,050 --> 00:12:34,530
+ما يعملوا عملية ال cataract سيريون بيعمل عملية
+
+128
+00:12:34,530 --> 00:12:41,190
+cataract بيجيب شوية من الانبوليعني two milliliter
+
+129
+00:12:41,190 --> 00:12:48,170
+صغار و بيحطهم في ال AC في ال anterior chamber بعد
+
+130
+00:12:48,170 --> 00:12:54,850
+العملية مباشرة إيش بيعمل لما يحطه في ال AC؟ sudden
+
+131
+00:12:54,850 --> 00:12:57,310
+meiosis
+
+132
+00:13:04,100 --> 00:13:13,880
+هو يغطي ويثبت ال inside لما يضيق عليها خلاص عملت
+
+133
+00:13:13,880 --> 00:13:18,820
+العملية وانا حاطيت شوية أستالكولين على طول بيشد ال
+
+134
+00:13:18,820 --> 00:13:21,980
+iris centrally وبيثبت ال IOLA
+
+135
+00:13:27,260 --> 00:13:31,920
+هو بيعمل simulation لـ stylocholine released by
+
+136
+00:13:31,920 --> 00:13:34,220
+stimulation of postganglionic parasympathetic
+
+137
+00:13:34,220 --> 00:13:37,760
+nerves that is attached primarily at muscular
+
+138
+00:13:37,760 --> 00:13:41,340
+receptors of the atomic effect cells يعني في الـ
+
+139
+00:13:41,340 --> 00:13:44,340
+sphincter pupillary muscle يبقى هو بيعمل
+
+140
+00:13:44,340 --> 00:13:49,140
+stimulation of the sphincter pupillary muscle
+
+141
+00:13:49,140 --> 00:13:55,760
+بيشتغل على ال receptors بتاعته in pastفي الماضي،
+
+142
+00:13:55,760 --> 00:14:00,520
+تاريخي كان الإختيار بين ثلاثة، بين الـ Pyrocarbine
+
+143
+00:14:00,520 --> 00:14:09,140
+و Physostigmine و Moxicilliate وكل هذا كان في
+
+144
+00:14:09,140 --> 00:14:14,760
+إختيار قبل عشرين سنة، الآن مافيش خيار إلا ال
+
+145
+00:14:14,760 --> 00:14:19,000
+Pyrocarbine، ال Pyrocarbine، بس، لذلك الآن
+
+146
+00:14:19,000 --> 00:14:21,880
+الإختيار اليوم، هنا اليوم
+
+147
+00:14:24,390 --> 00:14:31,850
+الشخص يجب أن يختار بين البيوكربين والنوتك، الفيسوك
+
+148
+00:14:31,850 --> 00:14:37,050
+بطل والمجزي سايلايت بطل، فالان بس البيوكربين هو
+
+149
+00:14:37,050 --> 00:14:41,990
+موجود و هنقول بعدين حتى البيوكربين نفسه ساعة
+
+150
+00:14:41,990 --> 00:14:48,050
+الحياة ده قليلة، إله حاجة بس مش زي زمان، مش زي
+
+151
+00:14:48,050 --> 00:14:53,610
+زمانبقول و ال new legislation even pyrocarbine
+
+152
+00:14:53,610 --> 00:14:57,950
+will not be available في بعد فترة because of the
+
+153
+00:14:57,950 --> 00:15:02,850
+short duration of action of mediatics عشان
+
+154
+00:15:02,850 --> 00:15:05,330
+الميدياتيكس اللي سيلها استخدامها diatrophic amide
+
+155
+00:15:05,330 --> 00:15:09,810
+short duration for short duration أربعة إلى ست
+
+156
+00:15:09,810 --> 00:15:16,010
+ساعات مثلا and the recognition of the reality ايش
+
+157
+00:15:16,010 --> 00:15:16,810
+reality؟
+
+158
+00:15:32,740 --> 00:15:39,600
+الخوف بطل باستخدامات أتروبيا both patients can be
+
+159
+00:15:39,600 --> 00:15:44,410
+safe if they are the discomfort of a myopicهو انا
+
+160
+00:15:44,410 --> 00:15:47,910
+بحط ال myotic ما هنقول ال myotic إيه مشاكله بيعمل
+
+161
+00:15:47,910 --> 00:15:56,950
+spasm وبيعمل ال field of vision بيصير constricted
+
+162
+00:15:56,950 --> 00:16:01,750
+و ال accommodation بيزيد و بيصير سلو ميوبيا وكتاب
+
+163
+00:16:01,750 --> 00:16:06,250
+زي هذا فهو بيقول يعني انه احنا مش غريبا نستخدم ال
+
+164
+00:16:06,250 --> 00:16:09,690
+myocarbine إلا في حالات نادرة لأنه هيك احنا برايها
+
+165
+00:16:09,690 --> 00:16:16,960
+المرضى طيبmixed meiotics يعني انا لو بدى انا اخلق
+
+166
+00:16:16,960 --> 00:16:19,880
+ما بين اكتر من meiotic و احنا بيقول عاملا انه ال
+
+167
+00:16:19,880 --> 00:16:25,580
+pyrocarbine undoing زمان كانوا بيخلطوا، الآن أصبح
+
+168
+00:16:25,580 --> 00:16:31,130
+هذا من التاريخ، it was the practice in the pastفي
+
+169
+00:16:31,130 --> 00:16:35,350
+الماضي to use mixed midretics containing agents
+
+170
+00:16:35,350 --> 00:16:38,170
+with different modes of action to produce synergy
+
+171
+00:16:38,170 --> 00:16:41,570
+mixed midretics have also been employed whereas
+
+172
+00:16:41,570 --> 00:16:46,030
+mixed midretics are always contained يبقى احنا كنا
+
+173
+00:16:46,030 --> 00:16:51,930
+بنستخدم mixed share of midretics ففي ناس جالو
+
+174
+00:16:51,930 --> 00:16:55,270
+استخدموا برضه mixed share of midretics لكن
+
+175
+00:16:55,270 --> 00:16:55,950
+midretics
+
+176
+00:17:01,290 --> 00:17:05,150
+مقدرت نستغنى عنها يعني مش شايفين إنه حين يوم اللي
+
+177
+00:17:05,150 --> 00:17:09,690
+نبطل احنا نوسع جوابه للfundus copy و للcyclopedia
+
+178
+00:17:09,690 --> 00:17:12,730
+وكلام زي هذا لكن ممكن يجي يوم اللي ال biotics
+
+179
+00:17:12,730 --> 00:17:17,990
+نفسها نستغنى عنها يعني ال biotics لاترقع في
+
+180
+00:17:17,990 --> 00:17:23,290
+الأهمية العملية إلى مكان المدرسة و بعد ذلك احنا
+
+181
+00:17:23,290 --> 00:17:28,500
+لازم نقول إنه كنا نستعمل هذا يقول ليand agent
+
+182
+00:17:28,500 --> 00:17:32,360
+acting on the pupal dilator muscle and an agent
+
+183
+00:17:32,360 --> 00:17:36,680
+acting on the pupal sphincter muscle إذا إحنا زي
+
+184
+00:17:36,680 --> 00:17:40,800
+ما قولنا القالية بتشغل فيها الbiotics إما بتحفز
+
+185
+00:17:40,800 --> 00:17:45,600
+sphincter pupally أو بتثبت الدالتر pupally هذا
+
+186
+00:17:45,600 --> 00:17:49,740
+الفيانة mixed biotics have tended to contain a
+
+187
+00:17:49,740 --> 00:17:54,400
+phylo-symbiotic وmyimetic and an anticholesterase
+
+188
+00:17:54,400 --> 00:17:58,290
+اللي هو الpylocarbene and phycostigmataمن احنا مش
+
+189
+00:17:58,290 --> 00:18:01,390
+قادرين نتكلم عنه لو هو موجود في السوق نتكلم عنه
+
+190
+00:18:01,390 --> 00:18:06,010
+ابصريت الان لكن ال bio carbon بتلاقيه حتى الان one
+
+191
+00:18:06,010 --> 00:18:08,750
+of which are active on the sphincter muscle يعني
+
+192
+00:18:08,750 --> 00:18:14,770
+بيشتغلوا على الطريقة اللي هو هام تاني ال use has
+
+193
+00:18:14,770 --> 00:18:18,870
+been based on evidence rather than pharmacological
+
+194
+00:18:18,870 --> 00:18:22,390
+evidence يعني احنا ما نخلطهم نخلطهم من أجل التجارب
+
+195
+00:18:22,390 --> 00:18:23,130
+على الأرانب
+
+196
+00:18:30,950 --> 00:18:34,570
+أه مش قاعدين احنا نخلط ندسة لإنه ال bio carbon
+
+197
+00:18:34,570 --> 00:18:40,810
+لحاله قوى جدا فكيف لما نحطه فيسوستيجمين ممكن يعمل
+
+198
+00:18:40,810 --> 00:18:47,690
+closure of the pupil نسكّن ال pupil من المرض طيب
+
+199
+00:18:47,690 --> 00:18:52,230
+اللي بهمنا أكتر advanced reactions of matrix ايش
+
+200
+00:18:52,230 --> 00:18:57,930
+اللي هي أثارة ضرر لل matrix بقولوا باختصار لما
+
+201
+00:18:57,930 --> 00:19:00,190
+كانوا استخدموا الموكزيد
+
+202
+00:19:07,940 --> 00:19:12,560
+بحيث انه severe burning في العينين بلعنة مستعملوش
+
+203
+00:19:12,560 --> 00:19:16,420
+biotics with principle actually is when the
+
+204
+00:19:16,420 --> 00:19:20,300
+sphincter propylene تحفيز ال sphincter might also
+
+205
+00:19:20,300 --> 00:19:25,020
+cause a spasm of accommodation وهذا مهم even in
+
+206
+00:19:25,020 --> 00:19:30,720
+some dysbiotic patients يعني بيقوللي ان هو لما انا
+
+207
+00:19:30,720 --> 00:19:31,780
+حطه هيحفظ
+
+208
+00:19:36,890 --> 00:19:42,690
+مين الجارة؟ الcellary muscle صح انه مش بالقدر
+
+209
+00:19:42,690 --> 00:19:47,510
+المية المية و لسه بينقلنيه لكن بالتأكيد انه في نوع
+
+210
+00:19:47,510 --> 00:19:51,250
+من الإثارة ليه اللي هو الcellary muscle وبالتالي
+
+211
+00:19:51,250 --> 00:19:55,570
+increase accommodation طبعا ال increase
+
+212
+00:19:55,570 --> 00:20:00,150
+accommodation ايه المشاكله؟ لأنه في نوع من اسفازه
+
+213
+00:20:00,150 --> 00:20:06,330
+عامل اسفازه في أقل شيءحملي شوية يدك، يعني واحد ما
+
+214
+00:20:06,330 --> 00:20:11,370
+قصدك سبان، عنده عدة أمور بتتغير في حياته، حتى
+
+215
+00:20:11,370 --> 00:20:17,530
+القراعة من القريب تصبح صعبة، اه، طيب، بيقولي كمان
+
+216
+00:20:17,530 --> 00:20:24,970
+decrease in anterior chamber depth in about 70 and
+
+217
+00:20:24,970 --> 00:20:30,250
+80 years of age، طيب ليش decrease in anterior
+
+218
+00:20:30,250 --> 00:20:40,940
+chamber depth؟لأن العرزة specific يعني الآن هاي
+
+219
+00:20:40,940 --> 00:20:50,360
+الـ anterior chamber وهي الاسم وهي باقي الامر على
+
+220
+00:20:50,360 --> 00:20:54,500
+سبيل المحطة البيلو كربيل زاد ال accommodation ع
+
+221
+00:20:54,500 --> 00:21:02,060
+طريق انه رقم الزنيوز رقمها فالان تلقائياعصر ال ..
+
+222
+00:21:02,060 --> 00:21:06,000
+العظم .. العظم عصر ال .. العظم عصر ال .. العظم عصر
+
+223
+00:21:06,000 --> 00:21:07,100
+ال .. العظم عصر ال .. العظم عصر ال .. العظم عصر ال
+
+224
+00:21:07,100 --> 00:21:11,880
+.. العظم عصر ال .. العظم عصر ال .. العظم عصر ال ..
+
+225
+00:21:11,880 --> 00:21:15,460
+العظم عصر ال .. العظم عصر ال .. العظم
+
+226
+00:21:15,460 --> 00:21:19,440
+عصر ال .. العظم عصر ال .. العظم عصر ال .. العظم
+
+227
+00:21:19,440 --> 00:21:24,680
+عصر ال .. العظم عصر ال .. العظم عصر ال .. العظم
+
+228
+00:21:24,680 --> 00:21:31,080
+عصر الو هم السابقين ال 80 years ال lens بتاعتهم هي
+
+229
+00:21:31,080 --> 00:21:37,620
+فيها مشكلة هي فيها sclerosis و هي thick اه و فيها
+
+230
+00:21:37,620 --> 00:21:42,240
+hardness فكمان انا بعطيهم فيروكامير كأن انا بزيد
+
+231
+00:21:42,240 --> 00:21:47,680
+التقدم الامام و بخل السير muscle و بخل ال AC
+
+232
+00:21:47,680 --> 00:21:52,660
+shallow طبعا
+
+233
+00:21:52,660 --> 00:21:53,720
+ال shallow AC
+
+234
+00:22:05,210 --> 00:22:12,630
+أو أكل وسبرة بقى يعني ممكن الضغط يزيد طيب four in
+
+235
+00:22:12,630 --> 00:22:17,590
+the miotic is much stronger than the midriotic if
+
+236
+00:22:17,590 --> 00:22:21,130
+the miotic is much stronger than the midriotic
+
+237
+00:22:21,130 --> 00:22:25,470
+then the patient will have smaller than normal
+
+238
+00:22:25,470 --> 00:22:31,170
+pupils with some dimness over it يعني الآن أنا كنت
+
+239
+00:22:31,170 --> 00:22:34,490
+حاطتله tropic MI في عينيه
+
+240
+00:22:37,290 --> 00:22:40,230
+و بعد ما انتهيت من ال examination هعطيتله
+
+241
+00:22:40,230 --> 00:22:45,770
+Pyrocarbine الأن
+
+242
+00:22:45,770 --> 00:22:50,870
+بقولي إذا كان ال Pyrocarbine في أثره اللي بضيق
+
+243
+00:22:50,870 --> 00:22:56,570
+أكتر من أثر trophic amide في أثره اللي بوسع سعيش
+
+244
+00:22:56,570 --> 00:23:05,590
+المريض ساعات من خفوة النظر dimness of it يعني
+
+245
+00:23:23,990 --> 00:23:31,530
+عشان انا ابقى قلبه الموسع بقى بخلص ال examination
+
+246
+00:23:31,530 --> 00:23:37,370
+حطيت myotic خدم seven hours
+
+247
+00:23:55,480 --> 00:24:05,560
+مش هيقدر يسوق شيارة مثلا مش هيقدر يمشي يعنيفي
+
+248
+00:24:05,560 --> 00:24:12,860
+الضوء كويس مش هقدر يعني اه يتفاعل في جواب مفتوح مش
+
+249
+00:24:12,860 --> 00:24:16,660
+هكون مشارك لأنه في dimness of vision خفوت في النظر
+
+250
+00:24:16,660 --> 00:24:19,780
+لكن
+
+251
+00:24:19,780 --> 00:24:24,240
+هذا مش forever temporary صح لكنه يعتبر adverse
+
+252
+00:24:24,240 --> 00:24:29,840
+reaction او adverse effect هذا
+
+253
+00:24:29,840 --> 00:24:33,440
+dimness of vision صعبه ال
+
+254
+00:24:36,480 --> 00:24:44,900
+و شولما يوفي ايه ات من وين؟ من ال college يعني
+
+255
+00:24:44,900 --> 00:24:52,960
+اي طالب اي مترو وضبطلها
+
+256
+00:24:52,960 --> 00:25:01,240
+انا plus three lens علي عينيها شولما؟
+
+257
+00:25:01,240 --> 00:25:03,120
+هذا اسم artificial
+
+258
+00:25:13,440 --> 00:25:20,240
+فيعني ال image موجودة in front of the macula،
+
+259
+00:25:20,240 --> 00:25:23,420
+أمامي،
+
+260
+00:25:23,420 --> 00:25:28,520
+pseudo-myopia، فال plus two و ال three إجوا من ال
+
+261
+00:25:28,520 --> 00:25:32,660
+accumulation، اللي عملوا إيش؟ ال mioting
+
+262
+00:25:48,330 --> 00:25:52,790
+I'm not contraction contraction هنا two two three
+
+263
+00:25:52,790 --> 00:25:59,210
+plus الان
+
+264
+00:25:59,210 --> 00:26:08,070
+بدو نشوف اي منظر هو مثلا نقول قلم هو
+
+265
+00:26:08,070 --> 00:26:13,330
+حاط المنطق ايه الميوز؟ القلم جاي
+
+266
+00:26:18,080 --> 00:26:23,800
+مش جاي على ال map لأ هاد اسمه Sodomyopia سودو
+
+267
+00:26:23,800 --> 00:26:28,380
+مايوبيا أرجو أن الكورونا ده يعني طب وقت إيش هيقعد
+
+268
+00:26:28,380 --> 00:26:33,560
+يشوف ال كويس لما يروح الأثر بتاع الموضوع السنة
+
+269
+00:26:33,560 --> 00:26:40,860
+ماصلة راح تطلع وراك و تشد الزنوز زنوز هدرا حاسوب
+
+270
+00:26:40,860 --> 00:26:44,860
+المجدودين بينها و بين ال إيش لكويت القدالينز
+
+271
+00:26:44,860 --> 00:26:51,360
+وبالتالي صورة القلمهتيجي على الشبكات السودو
+
+272
+00:26:51,360 --> 00:26:55,540
+مايوبيا الأجيال
+
+273
+00:26:55,540 --> 00:27:02,680
+اللي قبل هذا الجيل كتير كان هذا بيعانوا منه كان ال
+
+274
+00:27:02,680 --> 00:27:06,760
+bio carbine هو ال first line in treatment of a
+
+275
+00:27:06,760 --> 00:27:12,040
+chronic simple glaucoma open angle glaucoma الخط
+
+276
+00:27:12,040 --> 00:27:19,630
+الأول في العلاج كان عشان يشيلالعير السنترالي ويفتح
+
+277
+00:27:19,630 --> 00:27:24,390
+العجل five
+
+278
+00:27:24,390 --> 00:27:29,950
+في كوليوكتيبا ال injection what is injection of
+
+279
+00:27:29,950 --> 00:27:37,410
+كوليوكتيبا؟ احتيقاة تلاقي المتحمة حمرة حمرة حتى
+
+280
+00:27:37,410 --> 00:27:39,130
+يظنها الجاهل
+
+281
+00:27:58,390 --> 00:28:02,790
+بس انا درسية للأوية الدموية فعلا انا مفهوم ايش كان
+
+282
+00:28:02,790 --> 00:28:10,150
+بيعمل انا بتذكرها في الحانة السابقة هنوريكوا انا
+
+283
+00:28:10,150 --> 00:28:17,010
+بس نحفظها انا اتنين و عشرين هوريكوا انا ال
+
+284
+00:28:17,010 --> 00:28:21,290
+congestion او ال injection نرجع لل
+
+285
+00:28:29,200 --> 00:28:32,620
+closed angle glucoma لكن الفنان الفرين انا ذاكر
+
+286
+00:28:32,620 --> 00:28:37,140
+انه بيعمل constriction مش direction فعلا اه الفنان
+
+287
+00:28:37,140 --> 00:28:46,960
+الفرين ارجع الفنان الفرين وينه؟ الفنان الفرين كان
+
+288
+00:28:46,960 --> 00:28:52,120
+بيعمل .. ايه؟ اه ايش بيعمل هنا هيو؟ الفنان الفرين
+
+289
+00:28:52,120 --> 00:28:56,100
+a little bit ineffective، بدرياتك؟ ماعرفش، بيعمل
+
+290
+00:28:56,100 --> 00:28:58,020
+constriction اكتر و انا فاكر انه بيعمل
+
+291
+00:28:58,020 --> 00:28:58,880
+constriction
+
+292
+00:29:14,660 --> 00:29:18,180
+يبقى هنا الميوتك بيعمل اتقان للأولى دموية في
+
+293
+00:29:18,180 --> 00:29:29,340
+المتحمة في أحيانا Pyrocarbine some patients might
+
+294
+00:29:29,340 --> 00:29:33,360
+be allergic to pyrocarbine و هم ال allergic يعني
+
+295
+00:29:33,360 --> 00:29:37,780
+اللي ممكن تعمل ال injection برضه of congenital
+
+296
+00:29:37,780 --> 00:29:41,420
+blood vessels لأن هم حسيسية التحسس و أي حسيسية
+
+297
+00:29:41,420 --> 00:29:47,390
+بتبقى او ايش dilatationما هي السيجة في جسمنا؟ توسع
+
+298
+00:29:47,390 --> 00:29:54,650
+أوى، توسع أوى قد ما بيبقى، في سمن في بعض المضيقات
+
+299
+00:29:54,650 --> 00:30:01,350
+بتعمل led-twitching إيش led-twitching؟ ارتعاش في
+
+300
+00:30:01,350 --> 00:30:06,670
+ال eyelids، وهذا كنا نسميها myochemiaالكتير هالي
+
+301
+00:30:06,670 --> 00:30:11,530
+بتيجي spontaneously للناس و بيخافي، بيقولك انا
+
+302
+00:30:11,530 --> 00:30:17,290
+خاصة الجفن العلوي، برجف، هالي رايسة الجفن اسمها
+
+303
+00:30:17,290 --> 00:30:21,070
+myochemia،
+
+304
+00:30:21,070 --> 00:30:24,810
+myochemia
+
+305
+00:30:24,810 --> 00:30:31,850
+طبعا هالي مرتفعة يعني ببعض الأنواع من drugs أو
+
+306
+00:30:31,850 --> 00:30:38,150
+حساسية أو قلة نوم، الطلاب النومبعضه بيعمل حسية أو
+
+307
+00:30:38,150 --> 00:30:46,830
+قلق نفسي anxiety بيعمل myokamia ثبت ان بعض ال
+
+308
+00:30:46,830 --> 00:30:50,290
+biotics بيعمل cataract formation cataract
+
+309
+00:30:50,290 --> 00:30:55,090
+formation تعجب محدوث السؤال الأبيض على العين
+
+310
+00:30:55,090 --> 00:30:59,950
+cataract formation وانا مابعرف ليش ال cataract
+
+311
+00:30:59,950 --> 00:31:04,530
+formation يعني هو نتيجة لكافة التماس مع ال virus
+
+312
+00:31:09,770 --> 00:31:16,110
+ال .. ال .. ال iris يعني بيقعد على وجه ال .. ال
+
+313
+00:31:16,110 --> 00:31:21,210
+lens اه فترة يعني هو مابيبقى صحيح سينيكيا لكن كإنه
+
+314
+00:31:21,210 --> 00:31:25,570
+بيأثر في ال physiology بتاعها بيأثر في ال
+
+315
+00:31:25,570 --> 00:31:30,450
+physiology of the lens فكبسولفة بيبدأ هيعمل إيه؟
+
+316
+00:31:30,450 --> 00:31:34,590
+cataract طبعا هذا مش يوم ولا يومين، شهر ولا شهرين
+
+317
+00:31:34,590 --> 00:31:38,070
+الناس اللي كانوا بياخدوا بير و كرميلة، اللي كانوا
+
+318
+00:31:38,070 --> 00:31:42,490
+بياخدوه foreverكانوا بياخدوه forever مدى الحياة،
+
+319
+00:31:42,490 --> 00:31:46,310
+طبعا هذا بيأجل، بيأجل بموضوع إياش كترة في ال
+
+320
+00:31:46,310 --> 00:31:52,270
+information في شيء مهم في ناس اللي عندهم overdose،
+
+321
+00:31:52,270 --> 00:31:56,630
+يعني بيحط في كل مرة تلاتة هنا تلاتة هنا قطرة نقاط
+
+322
+00:31:56,630 --> 00:32:00,350
+فيروكاربين، بيقولوا ممكن نعمل systemic effect
+
+323
+00:32:01,710 --> 00:32:04,610
+Systemic Effect خاصة ناس المرضى ب Respiratory
+
+324
+00:32:04,610 --> 00:32:09,190
+Tract او Cardiovascular System او بال Gastric
+
+325
+00:32:09,190 --> 00:32:15,250
+Style System وحنشوف ايش الاثر هذا صحيح انه هذا
+
+326
+00:32:15,250 --> 00:32:21,930
+نادر الحدوط لكن ممكن فمثلا بيقوللي في ايه ال drugs
+
+327
+00:32:21,930 --> 00:32:24,570
+that stimulate masculinic receptors will cause
+
+328
+00:32:24,570 --> 00:32:31,280
+bronchoconstriction ايش Bronchoconstriction؟أيوة
+
+329
+00:32:31,280 --> 00:32:36,460
+تقلص في شعب .. شعب .. شعيبات الهوائية and could
+
+330
+00:32:36,460 --> 00:32:41,120
+cause respiratory embarrassment embarrassment ضيق
+
+331
+00:32:41,120 --> 00:32:47,280
+نوع من الضيق في التنفس to asthmatic patients
+
+332
+00:32:47,280 --> 00:32:50,200
+asthmatic اللي عندهم الأزمة بتعرفوا اللي عندهم
+
+333
+00:32:50,200 --> 00:32:55,080
+الأزمة؟ الوضع الصغير يكون صدره بيصفر يكون معاها
+
+334
+00:32:55,080 --> 00:32:59,080
+أزمة but it is a theoretical possibility rather
+
+335
+00:32:59,080 --> 00:33:05,890
+thanactual danger يعني ايه اللي احنا جاعدين بس نحط
+
+336
+00:33:05,890 --> 00:33:10,950
+نقط ورا بعض في عين العيان عنده أزمة بنفير الأزمة
+
+337
+00:33:10,950 --> 00:33:17,330
+عشان هيك هو شيء نضري لإنه مش متصورين إنه واقع كل
+
+338
+00:33:17,330 --> 00:33:19,930
+ساعتين جاعل يفتبل ويكربل في عينه
+
+339
+00:33:35,330 --> 00:33:43,350
+و في القلب ادمان انتظام ممكن يعمله bradycardia و
+
+340
+00:33:43,350 --> 00:33:48,350
+بعض ال dilation لا تبدو مشكلة المهم بيخففه ضربات
+
+341
+00:33:48,350 --> 00:33:55,490
+القلب slowing of the heart rate هذا ال heart طيب
+
+342
+00:33:55,490 --> 00:33:59,630
+هذا الجرس السيطرات اللي هو اللي يجب ان يعمل ديارية
+
+343
+00:34:02,590 --> 00:34:06,630
+وهذا النتيجة لأنه بيعمل reduction لل label of
+
+344
+00:34:06,630 --> 00:34:13,350
+plasma cooling stress plasma cooling stress يعني
+
+345
+00:34:13,350 --> 00:34:21,550
+بيمنع ال acetylcholine انه اشتغل كتير ال
+
+346
+00:34:21,550 --> 00:34:26,580
+acetylcholine هو الميزة contraction لل musclesفلما
+
+347
+00:34:26,580 --> 00:34:29,600
+مايش contraction كاف ال muscles بصير الطعام
+
+348
+00:34:29,600 --> 00:34:34,860
+ماينهفمش ولا ينفس زي الناس و بيطلع ديارية بطلع
+
+349
+00:34:34,860 --> 00:34:40,040
+ديارية ماشي
+
+350
+00:34:40,040 --> 00:34:45,160
+هذا gastrointestinal tract system such as ديارية
+
+351
+00:34:45,160 --> 00:34:47,800
+and vomiting and disparity problems have been
+
+352
+00:34:47,800 --> 00:34:50,180
+reported following large doses
+
+353
+00:34:54,220 --> 00:34:58,920
+وقلنا إن هذا شبه مستحيل يحصل إلا في بعض الأخطاء
+
+354
+00:34:58,920 --> 00:35:01,780
+يعني في واحد يظن إن هذا القطرة artificial tears
+
+355
+00:35:01,780 --> 00:35:07,860
+مثلا في بعض الناس يكون عنده صيندالية في ال corner
+
+356
+00:35:07,860 --> 00:35:11,980
+بياخد قطرة بدل قطرة فلو أخد مثلا بدل artificial
+
+357
+00:35:11,980 --> 00:35:16,260
+tears بيو كاربين كل ساعتين تلاتة عشان يرطب عينيه
+
+358
+00:35:16,260 --> 00:35:20,920
+ممكن يخش في ال dilemma هذه خاصة إذا كان برس بيوم
+
+359
+00:35:20,920 --> 00:35:23,280
+ومعلومش يقرأ اللي هو الخط
+
+360
+00:35:28,880 --> 00:35:36,560
+precautions يعني ما هي تحذيرات اللي بنعطيها للناس
+
+361
+00:35:36,560 --> 00:35:43,960
+اللي بيستخدموا ال biotics بعد المدريازس هو يعني
+
+362
+00:35:43,960 --> 00:35:48,940
+الآن اللي هفيكم عمل المضيقات
+
+363
+00:36:01,080 --> 00:36:04,820
+وعديد من القطرات الأخرى اللى مابتعملش pseudomyopia
+
+364
+00:36:04,820 --> 00:36:08,520
+ولا بتعمل accommodation ولا بتعمل pupil
+
+365
+00:36:08,520 --> 00:36:15,020
+constriction فهي قتلت ال bio carbine كعلاج انتهينا
+
+366
+00:36:15,020 --> 00:36:20,220
+منه فاضل ال bio carbine فقط الوحيد اللى يشتغل في
+
+367
+00:36:20,220 --> 00:36:23,540
+عالم الطبيق بس اللى وادر التوسيع
+
+368
+00:36:30,290 --> 00:36:36,070
+و بعد ذلك بدنا نحذر المريض، نقول له explain to the
+
+369
+00:36:36,070 --> 00:36:42,010
+patient or parents لو كان هو قاسم، نقول لل parents
+
+370
+00:36:42,010 --> 00:36:47,350
+the reason for losing a money، ليش؟ نقول بدل ما
+
+371
+00:36:47,350 --> 00:36:54,770
+تطلع براسيارة ماتقدرش فوتوفيا بيتخاف عليك مش هتقدر
+
+372
+00:36:54,770 --> 00:36:58,710
+يعني توجه الشمس ولا ضوء ولا كده بتقعد في dim light
+
+373
+00:36:58,710 --> 00:37:02,970
+لأ احطلك نقطة هنا ونقطة هنا عشان ارجعلك البؤبو لما
+
+374
+00:37:02,970 --> 00:37:08,670
+كان لازم افهمه ليش to ask whether the patient has
+
+375
+00:37:08,670 --> 00:37:16,090
+previously had a mantic storm هل سبق له انه حق في
+
+376
+00:37:16,090 --> 00:37:17,350
+عينيه قطرة مضيقة
+
+377
+00:37:20,860 --> 00:37:26,580
+أي مضاعفات أو أثر جانبي شوفوا
+
+378
+00:37:26,580 --> 00:37:32,040
+يا بناتي الإنسان إنسان لازم احنا يعني نهتم
+
+379
+00:37:32,040 --> 00:37:37,460
+بالإنسان خاصة في مجاله بتاعنا، مجال الدورة يعني
+
+380
+00:37:37,460 --> 00:37:42,100
+اللي سبق إن واخد baby aspirin وحدث معامل أي
+
+381
+00:37:42,100 --> 00:37:46,060
+مضاعفات لازم نسأله سبق إن أخدت baby aspirin انجل
+
+382
+00:37:46,060 --> 00:37:51,440
+أو سبق مضاعفات مابتبلوش إياهأي قطرة تحطها في حينها
+
+383
+00:37:51,440 --> 00:37:54,560
+خاصة الـcyclopedic و الـmindretic و الكلام بهذا
+
+384
+00:37:54,560 --> 00:38:01,200
+لازم أسأله و إلا أنا بكون يعني امشيت خطأ صعب من
+
+385
+00:38:01,200 --> 00:38:05,760
+غيري كررت الخطأ و اللي بكرر الخطأ بكون مختلف أكتر
+
+386
+00:38:05,760 --> 00:38:12,580
+لذا باسأله هل سبقلك أن أخد مضيق ان قال yes طيب
+
+387
+00:38:12,580 --> 00:38:16,780
+what's the effect what was the effect إذا كان في
+
+388
+00:38:16,780 --> 00:38:24,720
+adverse effectأو side effect خمس ماحطوش three اشهر
+
+389
+00:38:24,720 --> 00:38:32,960
+انه اكتبي ملاحظة موقعة which identifies the
+
+390
+00:38:32,960 --> 00:38:37,720
+meiotic used الميوتك اللي انت حاطتيه في العين and
+
+391
+00:38:37,720 --> 00:38:42,640
+provides advice on what action the patient should
+
+392
+00:38:42,640 --> 00:38:45,200
+take in the event of an adverse
+
+393
+00:38:52,360 --> 00:38:55,480
+يعني المريض هو مش عارف طب سرّه سجن مايوم يعني مثلا
+
+394
+00:38:55,480 --> 00:39:02,120
+جالك هذا جا طعمتني راح لأقرب طبيب في الحي أو أقرب
+
+395
+00:39:02,120 --> 00:39:07,960
+مستشفى أو أقرب عيادة بليل و جال أنا بطلت أشوف هو
+
+396
+00:39:07,960 --> 00:39:12,680
+يظن أنه .. يعني بارح كان مشوف تلفزيون مية لمية و
+
+397
+00:39:12,680 --> 00:39:16,620
+بيقرأ الخط اللي بيقول الخط اللي تحتها أخبار أخبار
+
+398
+00:39:16,620 --> 00:39:23,490
+و بعد ال .. البرتقال أصبح ليه؟ايه؟ احنا بنتوقعها
+
+399
+00:39:23,490 --> 00:39:34,270
+في يوم بعد واحدة ليلة ضرب عيالي واسمة خير جال
+
+400
+00:39:34,270 --> 00:39:39,150
+دكتور انا انعميت نعم جال والله انا عينيا اكلوني
+
+401
+00:39:39,150 --> 00:39:45,570
+بعد العشاء وفي التلاجة في جاطرة حطيت الجاطرة
+
+402
+00:39:45,570 --> 00:39:50,290
+انعميت وبعدين
+
+403
+00:39:50,290 --> 00:39:55,770
+سألتأهل البيت قالوا انه جابوها من مستشفى الجطر
+
+404
+00:39:55,770 --> 00:40:03,150
+للولد و الجطر معاه أول مسكتها قوالي لجيتها cycle
+
+405
+00:40:03,150 --> 00:40:10,050
+من طوليته طبعا هو كدهش متقلم و أنا كدهش نفسي أضحك
+
+406
+00:40:10,050 --> 00:40:14,710
+أنا أصبحت نفسي أضحك لأن هو الكلام هنا بتدرسه و
+
+407
+00:40:14,710 --> 00:40:19,470
+احنا الكلام فأنا أخدته ابتسامة بسيطة قلت له يا أخي
+
+408
+00:40:31,420 --> 00:40:37,220
+نوم طويلة قُلتله يعني اجلس في ست ساعات الصبح حتصبح
+
+409
+00:40:37,220 --> 00:40:41,160
+انت كويس هتجرأ و تشوف الكويس قال يعني قلتله خلاص و
+
+410
+00:40:41,160 --> 00:40:47,500
+الراجل ما قاللي و ما عرفته بعدين كويس فهي الموضوع
+
+411
+00:40:47,500 --> 00:40:51,640
+ان وفرد هو صار معا سودو مايوبيا هذا العكس صار معا
+
+412
+00:40:51,640 --> 00:40:56,360
+سودو مايوبيا بطل يشوف البعيد و كلام زي هذا ظن ان
+
+413
+00:40:56,360 --> 00:40:58,020
+القطرة يعني عند
+
+414
+00:41:01,810 --> 00:41:06,810
+رشتة صغيرة و كتبله إيش اللي صار و مبيها و ختمها
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/rKh8uPCUfw8.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/rKh8uPCUfw8.srt
new file mode 100644
index 0000000000000000000000000000000000000000..249ef05e0c06efe8cf177250614a8878c2489105
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/rKh8uPCUfw8.srt
@@ -0,0 +1,1553 @@
+1
+00:00:20,750 --> 00:00:24,090
+بسم الله الرحمن الرحيم الحمد لله وكفى و أصلّي  وأسلم 
+
+2
+00:00:24,090 --> 00:00:28,090
+على نبينا المصطفى في هذا اليوم إن شاء الله سنبدأ 
+
+3
+00:00:28,090 --> 00:00:33,770
+chapter 2 في drug absorption, distribution,
+
+4
+00:00:34,270 --> 00:00:40,010
+metabolism and excretion في امتصاص الدواء وفي 
+
+5
+00:00:40,010 --> 00:00:45,090
+توزيع الدواء وفي التمثيل الغذائي للدواء وفي إخراج 
+
+6
+00:00:45,090 --> 00:00:48,170
+الدواء من الجسم وسنبدأ إن شاء الله بالـ absorption
+
+7
+00:00:49,980 --> 00:00:55,600
+absorption is defined as the process that involves 
+
+8
+00:00:55,600 --> 00:00:59,440
+the movement of the drug molecules from the site 
+
+9
+00:00:59,440 --> 00:01:05,460
+of entry into the body to the secretion of blood 
+
+10
+00:01:05,460 --> 00:01:12,420
+or body fluids to be distributed يعني تحرك الدواء 
+
+11
+00:01:12,420 --> 00:01:18,000
+من مكان إعطائه نحو الدورة الدموية كي يوزع 
+
+12
+00:01:20,800 --> 00:01:26,720
+الـ process of absorption بدا في مكان إعطائي الدواء، 
+
+13
+00:01:26,720 --> 00:01:32,340
+إعطائي في العضلة يعني هيبدأ من العضلة، إعطائي في الوريد 
+
+14
+00:01:32,340 --> 00:01:35,740
+هيبدأ من الوريد، إعطائي التحميلة هيبدأ من مكان 
+
+15
+00:01:35,740 --> 00:01:42,460
+التحميلة، إعطائي عن طريق الفم هيبدأ من القناة الهضمية، هيبدأ 
+
+16
+00:01:42,460 --> 00:01:46,740
+امتصاصه من القناة الهضمية، and is essential to subsequent 
+
+17
+00:01:46,740 --> 00:01:50,830
+processes distribution metabolism excretion يعني الـ
+
+18
+00:01:50,830 --> 00:01:58,770
+absorption is very important for other steps if no 
+
+19
+00:01:58,770 --> 00:02:02,930
+absorption, no distribution if no absorption, no 
+
+20
+00:02:02,930 --> 00:02:07,030
+metabolism if no absorption, no excretion يعني هو 
+
+21
+00:02:07,030 --> 00:02:11,630
+الأساس في العملية يقولها الـ absorption absorption 
+
+22
+00:02:11,630 --> 00:02:16,370
+varies according يعني يختلف من إنسان لآخر 
+
+23
+00:02:16,370 --> 00:02:18,850
+according to three factors
+
+24
+00:02:27,860 --> 00:02:30,660
+هي بتاعت الـ drug اللي أخذناها قبل كده هي في ده دوز أو 
+
+25
+00:02:30,660 --> 00:02:36,240
+جرعة كبيرة أو جرعة صغيرة طبعا أنا هنا بأُبَسّط يعني 
+
+26
+00:02:36,240 --> 00:02:41,200
+route of administration واضح أنه إن أعطيتها  IV في 
+
+27
+00:02:41,200 --> 00:02:46,360
+الوريد سيكون الاشتراك سريع جدا لأن واحد ده معطوب 
+
+28
+00:02:46,360 --> 00:02:50,260
+مش بده لنفسه يلف على المعدة وعلى الأمعاء وبعدين 
+
+29
+00:02:50,260 --> 00:02:54,220
+يتصمّ بالخملات لأ معاملة يروح لده احنا اللي هنشوفها 
+
+30
+00:02:54,220 --> 00:03:01,370
+يبقى كل مكان الـ route طريق الإعطاء قريب كل ما كان 
+
+31
+00:03:01,370 --> 00:03:06,290
+أسرع اللي اللي هو الـ absorption والعكس هي أطول 
+
+32
+00:03:06,290 --> 00:03:11,010
+مدة للـ absorption هي طعم، مع طعم، عن طريق الفم 
+
+33
+00:03:11,010 --> 00:03:16,770
+الفور طبعا لما أعطي سائل، حتى عن طريق الفم، يمتص 
+
+34
+00:03:16,770 --> 00:03:20,050
+أسرع من أقراص اللي هي بدها ساق، دوبانية وشيء وكده 
+
+35
+00:03:20,050 --> 00:03:25,370
+وكده لما أعطي يعني أشياء محاليل أسرع من أشياء 
+
+36
+00:03:25,370 --> 00:03:29,590
+الصلبة والـ drug كل مكان الـ drug أكبر كل مكان امتصاص 
+
+37
+00:03:29,590 --> 00:03:36,710
+أكبر والعكس صحيح طيب الآن factors affecting drug 
+
+38
+00:03:36,710 --> 00:03:40,130
+absorption ما هي العوامل التي تؤثر في امتصاص 
+
+39
+00:03:40,130 --> 00:03:44,210
+الدواء أول شيء الـ nature of the absorbing surface 
+
+40
+00:03:44,210 --> 00:03:50,030
+nature طبيعة السطح الماص طبيعة السطح الماص 
+
+41
+00:03:58,120 --> 00:04:05,740
+في مادة علاجية على جلدي ولا 
+
+42
+00:04:05,740 --> 00:04:13,360
+أخذ كورس تحت لساني؟ من أسرع؟ بالنسبة لي المرحلة من 
+
+43
+00:04:13,360 --> 00:04:19,740
+جلدي والكورس تحت لساني كورس تحت لساني أسرع كورس 
+
+44
+00:04:19,740 --> 00:04:24,360
+تحت لساني ليش؟ لأن تحت لساني اللي بأخذه الله 
+
+45
+00:04:24,360 --> 00:04:25,900
+يعفوهم اللي هو مرض القلب 
+
+46
+00:04:31,620 --> 00:04:36,840
+اللسان sublingual على طول تعمل توصيل للأوعية 
+
+47
+00:04:36,840 --> 00:04:42,400
+الدموية لأن ميوكاس ميمبراين ميوكاس ميمبراين very 
+
+48
+00:04:42,400 --> 00:04:46,360
+thin بينما الجلد very thick بينما الجلد very thick 
+
+49
+00:04:46,360 --> 00:04:50,880
+الجلد very thick يبقى الـ membrane من خلال اللي يجب أن 
+
+50
+00:04:50,880 --> 00:04:56,790
+يترابس الـ drug في الـ drug molecules may pass through a 
+
+51
+00:04:56,790 --> 00:05:01,750
+single layer of cells زي Epithelium of Villi Villi 
+
+52
+00:05:01,750 --> 00:05:06,150
+خملات الأمعاء الدقيقة التي بتصميم الطعام هي single 
+
+53
+00:05:06,150 --> 00:05:11,490
+layer أسرع من الـ skin اللي هو multiple layers skin 
+
+54
+00:05:11,490 --> 00:05:15,430
+multiple layers طبعا في الـ skin فيه epidermis و 
+
+55
+00:05:15,430 --> 00:05:19,410
+فيه dermis و subcutaneous و tissue في الـ hysteria 
+
+56
+00:05:19,410 --> 00:05:20,710
+بتاعة الخمل 
+
+57
+00:05:29,990 --> 00:05:33,070
+أسرع، واحد، يبقى هذا العامل الأول اللي يؤثر في 
+
+58
+00:05:33,070 --> 00:05:36,250
+سرعة الامتصاص العامل الثاني surface area of the 
+
+59
+00:05:36,250 --> 00:05:41,930
+absorbing surface تكون قاعدة كل ما كان الـ surface 
+
+60
+00:05:41,930 --> 00:05:46,670
+area للسطح الماص أكبر، فإن الامتصاص يكون أسرع ولكن 
+
+61
+00:05:46,670 --> 00:05:50,130
+صحيح، العكس صحيح، يبقى the more extensive the 
+
+62
+00:05:50,130 --> 00:05:52,690
+absorbing surface, the greater the absorption rate 
+
+63
+00:05:52,690 --> 00:05:57,190
+and more rapid effect of the used drug، والعكس 
+
+64
+00:05:57,190 --> 00:06:03,060
+صحيح طيب احنا يعني جبنا بعض الـ demonstrations
+
+65
+00:06:03,060 --> 00:06:10,780
+فمثلا هي الأمعاء الدقيقة اللي بيصير منها الامتصاص هي 
+
+66
+00:06:10,780 --> 00:06:14,780
+الـ human open intestine اللي هو فرج الأمعاء نفسه 
+
+67
+00:06:14,780 --> 00:06:19,820
+بإن هي الـ mucus layer of small intestine هي الـ 
+
+68
+00:06:19,820 --> 00:06:20,400
+epithelial layer
+
+69
+00:06:26,180 --> 00:06:30,380
+الدواء أن يدخل إلى الدم كي يمتص إذا لم يدخل إلى 
+
+70
+00:06:30,380 --> 00:06:34,840
+الدم في هذه الحالة فإنه لن يمتص كيف يعني في الآخر؟ 
+
+71
+00:06:34,840 --> 00:06:38,180
+بمعنى الشعيرات الدوائية اللي هي في جدار الأمهات 
+
+72
+00:06:38,180 --> 00:06:42,200
+الدقيقة وأنا برضه راسم لكم الخملات من ناحية 
+
+73
+00:06:42,200 --> 00:06:48,220
+الثانية وكيف الخملات بتكون وهنا بس يعني مُفَسّرة طيب 
+
+74
+00:06:48,220 --> 00:06:52,700
+العامل الثالث blood supply of the absorbing area
+
+75
+00:07:01,230 --> 00:07:05,450
+ولا poor in blood business، إذا كان المنطقة اللي 
+
+76
+00:07:05,450 --> 00:07:11,870
+بيجي عليها الدواء غنية فالاتصال سيكون rapid، إذا 
+
+77
+00:07:11,870 --> 00:07:18,350
+كان poor يعني مثل إحنا 
+
+78
+00:07:18,350 --> 00:07:22,710
+ضربنا حقنة في واحد أُبَيّض تحت الجلد 
+
+79
+00:07:33,730 --> 00:07:38,730
+بينما إحنا ضربنا في العضل واحد ثاني على طول ماشية 
+
+80
+00:07:38,730 --> 00:07:47,850
+ليش؟ لأنه العضل غني in blood vessels بينما اللي 
+
+81
+00:07:47,850 --> 00:07:54,390
+قد يكون أبيض هو أوي فقليل in blood vessels حسناً، 
+
+82
+00:07:54,390 --> 00:07:57,410
+هذا يعني واضح، الحكاية اللي هو الـ blood vessels
+
+83
+00:08:02,470 --> 00:08:08,650
+دوبانية أو القدرة على الدوبان لدى هذا الـ drug in 
+
+84
+00:08:08,650 --> 00:08:13,430
+order to be absorbed drug must be soluble in 
+
+85
+00:08:13,430 --> 00:08:17,970
+solutions يبقى هذا الدواء لازم يكون قادر على 
+
+86
+00:08:17,970 --> 00:08:23,130
+الدوبان في المحاليل the more soluble the drug the 
+
+87
+00:08:23,130 --> 00:08:29,550
+more rapid it will be absorbed والعكس صحيح لما كان 
+
+88
+00:08:29,550 --> 00:08:36,040
+لا يذوب أو ذوبانه أقل كل ما تأخر امتصاصه من السطح 
+
+89
+00:08:36,040 --> 00:08:39,380
+فالمثال دلوقتي هنا مثال chemicals and minerals 
+
+90
+00:08:39,380 --> 00:08:46,380
+that form insoluble precipitates ترسيب in the 
+
+91
+00:08:46,380 --> 00:08:50,540
+gastrointestinal tract or the tracts that are 
+
+92
+00:08:50,540 --> 00:08:54,680
+insoluble in water or lipids can't be absorbed 
+
+93
+00:08:54,680 --> 00:09:00,100
+يعني في بعض الأدوية 
+
+94
+00:09:02,660 --> 00:09:08,080
+كبيرة الجزيئات ولا تذوب لا في الماء ولا في وسط 
+
+95
+00:09:08,080 --> 00:09:14,700
+الدهون لو أخذناها أقراصًا فإنها تخرج مع البراز ولا 
+
+96
+00:09:14,700 --> 00:09:21,840
+تمتص لأنها قابلة أو صعب أن تذوب فإذا لم تذوب كيف 
+
+97
+00:09:21,840 --> 00:09:22,340
+ستصل 
+
+98
+00:09:30,310 --> 00:09:34,070
+و قابل للذوبان في الماء أو في الوسط الدهني فإنه يمتص 
+
+99
+00:09:34,070 --> 00:09:40,150
+بسهولة فمثلاً voluntarily administered drugs زي 
+
+100
+00:09:40,150 --> 00:09:46,010
+مثلاً الحقن التي نحطيها في العضل أو في الـ muscle في part 
+
+101
+00:09:46,010 --> 00:09:51,620
+in any vehicle، vehicle وسيلة يعني ليه تمريض الدواء 
+
+102
+00:09:51,620 --> 00:09:55,500
+أو تدويب الدواء will be more slowly absorbed from 
+
+103
+00:09:55,500 --> 00:10:00,620
+the muscle than drugs dissolved in water أو اللي 
+
+104
+00:10:00,620 --> 00:10:05,780
+هو isotonic sodium chloride solution يعني في ناس 
+
+105
+00:10:05,780 --> 00:10:11,660
+بيقولوا في حقن زيت بيقولوا حقن الزيت وفي حقن 
+
+106
+00:10:11,660 --> 00:10:15,680
+عادية اللي فيها ماء بيقول لك لو حقنة حقن الزيت 
+
+107
+00:10:15,680 --> 00:10:17,700
+هتتأخر 
+
+108
+00:10:18,990 --> 00:10:24,050
+في دم فترة في العضلة يعني في العضلة هتنتظر فترة و 
+
+109
+00:10:24,050 --> 00:10:30,570
+تمتص تدريجيًا وبصعوبة وهي لزجة كمان حتى تصل كلها 
+
+110
+00:10:30,570 --> 00:10:35,550
+إلى الدم بينما الحقنة اللي هي مائية اللي بيبلّغ في 
+
+111
+00:10:35,550 --> 00:10:40,090
+الماء حقنها في العضل على السريع راح تجي الطريقة 
+
+112
+00:10:40,090 --> 00:10:43,810
+إلى اللي هو مجرد دم في خلال دقائق 
+
+113
+00:10:56,000 --> 00:11:02,120
+يعني العلاقات الكيميائية أما حامضية Acidic أو 
+
+114
+00:11:02,120 --> 00:11:06,800
+قلوية Alkaline أو neutral أو متعادلة لا حامضية ولا 
+
+115
+00:11:06,800 --> 00:11:12,580
+قلوية طبعًا واضح أنه كل ما نزل عن السبعة بيصير حامضي 
+
+116
+00:11:12,580 --> 00:11:15,900
+أكثر وكل ما طلع عن السبعة بيصير قلوي أكثر وعند 
+
+117
+00:11:15,900 --> 00:11:18,800
+السبعة 7.2 بتكون الـ neutral
+
+118
+00:11:30,240 --> 00:11:33,680
+لما الوسط الحامضي هذا بتاع الـ Aspirin بيدي في 
+
+119
+00:11:33,680 --> 00:11:38,480
+المعنى فإنه لا يتأثر سلبًا 
+
+120
+00:12:07,110 --> 00:12:11,790
+Remains active يبقى الـ Aspirin عشان هو حامضي ويجي 
+
+121
+00:12:11,790 --> 00:12:17,390
+على المريء يحافظ على التركيب بتاعه وبقي remains
+
+122
+00:12:17,390 --> 00:12:23,330
+active الـ environment في الـ Stomach فالدواء can
+
+123
+00:12:23,330 --> 00:12:25,230
+easily diffuse across the intestinal cells 
+
+124
+00:12:25,230 --> 00:12:29,820
+membrane into the circulation يبقى .. لم .. لم يتلف 
+
+125
+00:12:29,820 --> 00:12:33,760
+اللي هو الـ Aspirin بالحمضية بتاعته اللي هو إيش؟ 
+
+126
+00:12:33,760 --> 00:12:39,100
+المعدة، وبعد إيه؟ ماشي إلى اللي هو الأمعاء الـ 
+
+127
+00:12:39,100 --> 00:12:44,460
+contrast على النقيض عن الـ crime drugs الـ crime 
+
+128
+00:12:44,460 --> 00:12:47,820
+drugs زي الـ antacids، antacids أقراص رينيه 
+
+129
+00:12:47,820 --> 00:12:50,720
+بتأخذوها عارفين أقراص رينيه؟ لما تحس بحرقان في 
+
+130
+00:12:50,720 --> 00:12:55,420
+المريء؟ المريء بيحرجك وبيقول لك اعطيني رينيه بنانية
+
+131
+00:12:55,420 --> 00:13:01,040
+يعني إن أنا حموضة بأقرص حبة بيلاقي حاجة بره في فم 
+
+132
+00:13:01,040 --> 00:13:05,660
+المريء بتاعة هذه كلها اسمها مجموعة antacids وضدات 
+
+133
+00:13:05,660 --> 00:13:09,440
+الحامض وضدات الحامض لما راح تحس مع حموضة بيأخذ 
+
+134
+00:13:09,440 --> 00:13:16,480
+أشياء فهذه قلوية القلوي متفاعل مع الحامض وبيطلع 
+
+135
+00:13:16,480 --> 00:13:21,730
+الحموضة زيادة حمض زائد قلوي يساوي ملح زائد ماء 
+
+136
+00:13:21,730 --> 00:13:26,730
+يعني بس هذا عند المعدة وبرتاح خلاص بيعمل دوره في 
+
+137
+00:13:26,730 --> 00:13:30,530
+المعدة بيمشي بعدين خلاص لإنه هيتلف في المعدة 
+
+138
+00:13:30,530 --> 00:13:36,810
+بتفاعل .. بتفاعل إيه؟ الكيميائي يبقى الـ antacids
+
+139
+00:13:36,810 --> 00:13:39,890
+tend to dissociate أو inactivated in the stomach 
+
+140
+00:13:39,890 --> 00:13:44,650
+اللي هو acidic environment and not absorb through 
+
+141
+00:13:44,650 --> 00:13:45,350
+the gastric membrane
+
+142
+00:13:49,980 --> 00:13:53,800
+المعدة هذه الحالة قلوية عشانك أنا لو أنا بدي 
+
+143
+00:13:53,800 --> 00:14:00,520
+أعطي قلوي لازم capsule لازم أعمل كبسولة ما تجبش 
+
+144
+00:14:00,520 --> 00:14:04,140
+في المعدة وأروح على الاثني عشر وأروح على الأمعاء 
+
+145
+00:14:04,140 --> 00:14:08,400
+الدقيقة زي إحنا بتكلمنا قبل كده لكن الدواء اللي وسطه 
+
+146
+00:14:08,400 --> 00:14:16,630
+حامضي أنا بأعطيه مُرَخّف من موضوع المعدة الفيروس يحدث 
+
+147
+00:14:16,630 --> 00:14:22,590
+عندما هؤلاء الدواء في مصطلح غير مذاب. المصطلح مثلا 
+
+148
+00:14:22,590 --> 00:14:27,330
+اللي هو الاثني عشر والامعاء الدقيقة وسطها قلوي 
+
+149
+00:14:27,330 --> 00:14:34,170
+وسطها قلوي. الدواء غير مذاب في الماء هو الليبيد 
+
+150
+00:14:34,170 --> 00:14:35,630
+الليبيد الليبيد الليبيد الليبيد الليبيد الليبيد
+
+151
+00:14:35,630 --> 00:14:36,130
+الليبيد الليبيد الليبيد الليبيد الليبيد الليبيد
+
+152
+00:14:36,130 --> 00:14:38,510
+الليبيد الليبيد الليبيد الليبيد الليبيد الليبيد
+
+153
+00:14:38,510 --> 00:14:38,610
+الليبيد الليبيد الليبيد الليبيد الليبيد الليبيد
+
+154
+00:14:38,610 --> 00:14:39,490
+الليبيد الليبيد الليبيد الليبيد الليب
+
+155
+00:14:51,100 --> 00:14:59,620
+باختصار إن غير حكاية حامضي وحكاية قلوي في مواد 
+
+156
+00:14:59,620 --> 00:15:07,820
+تذوب في الماء وفي مواد تذوب في الدهون فهو بيقول لي 
+
+157
+00:15:09,140 --> 00:15:16,760
+الدواء الذي لا يذوب في الدهون 
+
+158
+00:15:16,760 --> 00:15:20,580
+يخترق 
+
+159
+00:15:20,580 --> 00:15:23,320
+جدار الأمعاء بسهولة 
+
+160
+00:15:32,480 --> 00:15:39,160
+يبدأ أن ionized اللي لم يتم تحليله أو تكسيره في 
+
+161
+00:15:39,160 --> 00:15:46,900
+الماء ده، آه وهو لا يذوب في الماء، يستطيع أن يدخل 
+
+162
+00:15:46,900 --> 00:15:51,460
+عبر الخملات في الأمعاء الدقيقة بسهولة، هو اللي ده 
+
+163
+00:15:51,460 --> 00:15:56,780
+ionized water soluble الذي نام في الماء أو تحلل في 
+
+164
+00:15:56,780 --> 00:16:05,140
+الماء is lipid 
+
+165
+00:16:05,140 --> 00:16:09,140
+insoluble and non-disable across the cell membrane 
+
+166
+00:16:09,140 --> 00:16:14,180
+or intestine عشان ما نخشش في اللي هو التناقض يعني 
+
+167
+00:16:14,180 --> 00:16:18,340
+الـ drugs اللي بناخدها فيه شيء بيذوب في الماء وشيء 
+
+168
+00:16:18,340 --> 00:16:25,910
+بيذوب في الدهون اللي بيذوب في الدهون سهل أنه يروح على 
+
+169
+00:16:25,910 --> 00:16:30,530
+الأمعاء وينفذ في الأمعاء بينما اللي يعني ذائب في 
+
+170
+00:16:30,530 --> 00:16:35,330
+الماء صعب إنه يدخل في جدار اللي هو الأمعاء وينفذ 
+
+171
+00:16:35,330 --> 00:16:41,710
+في الأمعاء طيب في عامل سادس وهذا مهم تركيز الدواء 
+
+172
+00:16:41,710 --> 00:16:46,710
+هذا عامل مهم في الامتصاص تركيز الدواء عامل مهم في 
+
+173
+00:16:46,710 --> 00:16:50,010
+الامتصاص بقول لي كلما 
+
+174
+00:16:55,970 --> 00:17:02,310
+فإن الامتصاص أعلى والعكس صحيح كل ما كان تركيز 
+
+175
+00:17:02,310 --> 00:17:06,850
+الدواء أقل فإن الامتصاص يكون أقل وهذه نتيجة منطقية 
+
+176
+00:17:06,850 --> 00:17:13,270
+يعني الدواء لما يكون مثلاً ألف ملي جرام مثلاً أو 
+
+177
+00:17:13,270 --> 00:
+
+216
+00:20:27,850 --> 00:20:31,930
+اثنان و خمسون وفي منه خمسمائة أقل زياده أعطينا
+
+217
+00:20:31,930 --> 00:20:38,430
+الخمسمائة الآن الخمسمية هذه المفروض تشتغل لانتشار
+
+218
+00:20:38,430 --> 00:20:41,450
+ساعة وبعدين تبدأ تعمل decline 
+
+219
+00:20:45,530 --> 00:20:50,810
+ليش؟ لأن الخلية طلعت الدواء الـ metoxication عشان
+
+220
+00:20:50,810 --> 00:20:56,010
+هيك بقول لك يعني جرعة مرتين يوميًا مدة مثلًا خمس أيام
+
+221
+00:20:56,010 --> 00:21:02,630
+إيش يعني في الخمس أيام؟ في الخمس أيام أن أنا أجعل 
+
+222
+00:21:02,630 --> 00:21:13,510
+المعدل الدوائي أو العلاجي للدواء في الدم ثابت وهذا
+
+223
+00:21:13,510 --> 00:21:18,870
+إيش بفيد؟ بفيد معدل علاجي في الـ target site اللي
+
+224
+00:21:18,870 --> 00:21:23,510
+فيه المرض ثابت لمدة خمس أيام، هذا بفيد إيش؟ قتل 
+
+225
+00:21:23,510 --> 00:21:31,910
+الميكروبات في هذا الموضوع لمدة خمس أيام، انتهى، طب
+
+226
+00:21:31,910 --> 00:21:36,850
+في يعني واحد بيحس ببعض الراحة، لو زي تامة بيجاوبه
+
+227
+00:21:50,580 --> 00:21:54,040
+الماكروبنة إتراجة بالنسبة لـ 30%، 40%
+
+228
+00:21:54,040 --> 00:21:58,540
+أو 50%، لكن ما انتهتش، بدّها لسه 
+
+229
+00:21:58,540 --> 00:22:01,640
+maintenance dose لباقي الأيام
+
+230
+00:22:16,530 --> 00:22:20,690
+ولو رجعنا بعد الخمس أيام ناخد نفس الدواء فأنا
+
+231
+00:22:20,690 --> 00:22:27,750
+الميكروب سوف يسخر من الدواء لأن هو حلل الشفرة بتاعتي
+
+232
+00:22:27,750 --> 00:22:33,050
+حلل الشفرة يبقى الآن أنا بتكلم على نوعين من
+
+233
+00:22:33,050 --> 00:22:40,010
+الجرعات، في نوع اسمه primary or initial dose اللي
+
+234
+00:22:40,010 --> 00:22:44,370
+بأخده ده في الأول وفي شيء اسمه maintenance dose
+
+235
+00:22:44,370 --> 00:22:48,930
+maintenance هي في اللغة الصيانة لكن احنا بنقول
+
+236
+00:22:48,930 --> 00:22:54,330
+الجرعة المحافظة اللي هي بتحافظ على مستوى الدواء
+
+237
+00:22:54,330 --> 00:22:59,170
+يبقى أنا الجرعة اللي خذتها في الأول هي جرعة بداية
+
+238
+00:22:59,170 --> 00:23:06,070
+تفعيل لكن باقي الجرعات maintenance dose، وكتير احنا
+
+239
+00:23:06,070 --> 00:23:10,550
+بنقولها الأطباء إذا كان أنت نسيت الجرعة خذها أول ما
+
+240
+00:23:10,550 --> 00:23:15,250
+تتفكر لأن مثلًا أنا كل اثنا عشر ساعة نام وراه ست
+
+241
+00:23:15,250 --> 00:23:15,690
+ساعات
+
+242
+00:23:20,580 --> 00:23:28,020
+البكتيريا تبدأ يصيلها refreshment تصحى
+
+243
+00:23:28,020 --> 00:23:32,980
+البكتيريا و تعود إلى التكاثر خذها بسرعة واجب إكمال
+
+244
+00:23:32,980 --> 00:23:39,720
+الجرعات حتى النهاية في الـ maintenance dose طيب
+
+245
+00:23:39,720 --> 00:23:46,520
+الآن انتهينا من drug absorption الآن الدواء سواء إن 
+
+246
+00:23:46,520 --> 00:23:54,320
+أنا أعطيته حقنة أو أقراص أو تحميلة أو حتى تحت
+
+247
+00:23:54,320 --> 00:24:02,360
+اللسان أو في البخاخة في الجذب التنافسي أو السطحي على
+
+248
+00:24:02,360 --> 00:24:08,660
+الجذب سواء بطيء أو سريع الملال بتاعه هو absorption
+
+249
+00:24:13,610 --> 00:24:19,850
+وأنا هنا جبت شكل لطيف جميل يعني بيبين حقيقة موضوع
+
+250
+00:24:19,850 --> 00:24:23,290
+الـ absorption و الـ distribution فمثلًا يعني معظم
+
+251
+00:24:23,290 --> 00:24:28,190
+الدواء اللي يُخد يُخد عن طريق الفم يعني الإنسان
+
+252
+00:24:28,190 --> 00:24:36,530
+كتير باستخفاف أنه ياخد الدواء عن طريق الفم أنه 
+
+253
+00:24:36,530 --> 00:24:43,110
+يأخذه حقنًا أو تحميلة أو يعني طريق آخر تحت الجلد مثلًا
+
+254
+00:25:01,180 --> 00:25:06,860
+الـ lumen of small intestine لما
+
+255
+00:25:06,860 --> 00:25:16,520
+الدواء دخل هنا كان مُستهلك ذائب كالحليب والطعام
+
+256
+00:25:16,520 --> 00:25:23,120
+كذلك يعني اللي بيجي على الماء دقيقة طاعة زي
+
+257
+00:25:23,120 --> 00:25:26,760
+اليوجينم والإيليم بيجي على
+
+258
+00:25:32,830 --> 00:25:40,510
+الآن بيجي هذا عن الخملات، الخملات هذه يعني تراكيب
+
+259
+00:25:40,510 --> 00:25:48,190
+ميكروسكوبية مخصصة لامتصاص هذا المستحلب، فإذا دخله 
+
+260
+00:25:48,190 --> 00:25:53,970
+عليها فإنه يذهب إلى الدورة الدموية، أقصد يذهب إلى
+
+261
+00:25:53,970 --> 00:25:57,050
+جدار الأمعاء، الشعيرات اللي في جدار الأمعاء
+
+262
+00:25:57,050 --> 00:25:59,370
+الشعيرات اللي في جدار الأمعاء
+
+263
+00:26:05,390 --> 00:26:10,770
+وتجمع وترسل الطعام إلى شيء اسمه الوريد البابى
+
+264
+00:26:10,770 --> 00:26:19,030
+portal vein، هذا الـ portal vein هو
+
+265
+00:26:19,030 --> 00:26:25,630
+اسمه vein لكن هو حقيقة أن هو يأخذ كل ما يأتي من
+
+266
+00:26:25,630 --> 00:26:30,950
+المعدة معاه ياخده إلى الـ liver
+
+267
+00:26:35,060 --> 00:26:41,880
+اللي بقى الحقيقة هو المصنع اللي فيه بتكون معالجة 
+
+268
+00:26:41,880 --> 00:26:48,840
+مبدئية مناسبة
+
+269
+00:26:48,840 --> 00:26:59,060
+للدم ثم يقوم الكبد بدخه إلى القلب، بدخه 
+
+270
+00:26:59,060 --> 00:27:02,800
+إلى القلب ومن القلب
+
+271
+00:27:06,140 --> 00:27:13,960
+البطين الأيسر فيضخه إلى الأورطة حيث يعني يبرو كل 
+
+272
+00:27:13,960 --> 00:27:18,460
+خلية في الجسم وهذا اللي بنقصد فيه اللي هو الـ
+
+273
+00:27:18,460 --> 00:27:23,300
+distribution يبقى مصيرش distribution إلا لما يصل
+
+274
+00:27:23,300 --> 00:27:31,000
+الكبد ويصل القلب من الأمعاء إلى الوريد البابى إلى
+
+275
+00:27:31,000 --> 00:27:37,600
+الكبد إلى القلب إلى سائر أعضاء الجسم، هنا صاروا
+
+276
+00:27:37,600 --> 00:27:42,500
+distribution، صاروا distribution، أبو بكر صديقه اللي
+
+277
+00:27:42,500 --> 00:27:50,320
+قالوا عنه في ليلة ذهب إلى
+
+278
+00:27:50,320 --> 00:27:56,560
+البيت أو عاد إلى البيت متأخرًا فوجد خادمه قد أعد له
+
+279
+00:27:56,560 --> 00:28:00,460
+طعامًا، قال من أين؟
+
+280
+00:28:03,970 --> 00:28:08,550
+ثم سأل الخادم من أين لك هذا؟ من وين جبت الأكل؟ قال
+
+281
+00:28:08,550 --> 00:28:14,170
+من عروس بني فلان في
+
+282
+00:28:14,170 --> 00:28:22,510
+مكة، فتبين أنهم مشركون لم يسلموا بعد، فوضع أبو بكر
+
+283
+00:28:22,510 --> 00:28:33,040
+قصابعه في حلقه فقع وقع وقع ليتخلص من طعام الجاهلية
+
+284
+00:28:33,040 --> 00:28:39,440
+اللي لم يذكر اسم الله عليه، ثم قال واعتذروا اللهم 
+
+285
+00:28:39,440 --> 00:28:50,760
+إليك مما حملت الأوردة أو الشرير أو العلق فالخانين
+
+286
+00:28:50,760 --> 00:28:53,220
+يقولوا يا رحمك الله يا رحمك الله يعني هي لقمتين أو 
+
+287
+00:28:53,220 --> 00:28:57,020
+ثلاث، إيش يعني بدورهم؟ خليهم وروحوا قال والله لو
+
+288
+00:28:57,020 --> 00:29:03,420
+لم تخرج الطعم هذا إلا ونفسي معها لفعلت عشان يأكل
+
+289
+00:29:03,420 --> 00:29:08,940
+حلال بس عشان يأكل حلال بس أبقى صديق ما .. ما كانش
+
+290
+00:29:08,940 --> 00:29:12,310
+قرأ تشريح حد اللي احنا بنخمنه إنه جاب المصير بالـ
+
+291
+00:29:12,310 --> 00:29:18,530
+distribution في الدم لحجة من المادة، يعني المادة
+
+292
+00:29:18,530 --> 00:29:24,650
+بتودي للدم، فهو أبو بكر لحج الطعام يطلق قبل أن يصل
+
+293
+00:29:24,650 --> 00:29:29,990
+وين؟ إلى الدم، ويقول واعتذر اللهم إليك عما حملت
+
+294
+00:29:29,990 --> 00:29:37,230
+العروق، وهذه العروق قدامكوا بتشوفوها ده، طيب يبقى 
+
+295
+00:29:37,230 --> 00:29:41,470
+كلمة distribution of drugs is defined as the
+
+296
+00:29:41,470 --> 00:29:46,070
+transport of a drug in body fluids from the blood
+
+297
+00:29:46,070 --> 00:29:50,370
+stream to various tissues of the body and 
+
+298
+00:29:50,370 --> 00:29:55,750
+ultimately to its site of action يعني دائمًا احنا 
+
+299
+00:29:55,750 --> 00:30:01,650
+بناخد drugs في علاج disorder أو disease معين إيه 
+
+300
+00:30:01,650 --> 00:30:07,740
+الـ disease هذا بيكون له target site؟ مثلًا الناس
+
+301
+00:30:07,740 --> 00:30:14,060
+اللي عندهم مرض القلب، الناس اللي عندهم السكري،
+
+302
+00:30:14,060 --> 00:30:18,780
+الناس اللي عندهم التهاب رئوي، الناس اللي عندهم
+
+303
+00:30:18,780 --> 00:30:23,580
+التهاب النقرس وغيره،
+
+304
+00:30:23,580 --> 00:30:29,890
+هو صح بدي أقول أقراص، لكن هو فاهم هذه الأقراص سوف
+
+305
+00:30:29,890 --> 00:30:34,610
+تذهب في النهاية إلى مكان الـ disorder أو الـ disease
+
+306
+00:30:34,610 --> 00:30:41,690
+أو الـ pain عشان تعمل relief عشان تعمل cure شفاء
+
+307
+00:30:41,690 --> 00:30:48,930
+بإذن الله يبقى ما لم يحصل distribution لن يكون
+
+308
+00:30:48,930 --> 00:30:55,410
+هناك شفاء، والدواء مش حيث بقولي most of drugs are
+
+309
+00:30:55,410 --> 00:30:56,850
+distributed initially
+
+310
+00:31:08,040 --> 00:31:14,980
+العضو اللي فيه المرض rich يعني blood supply فإن 
+
+311
+00:31:14,980 --> 00:31:19,440
+كمية العلاج اللي هتتواجد له تكون أكبر، والدهن صحيح
+
+312
+00:31:19,440 --> 00:31:26,820
+يعني ندرم مثلًا مثال في بعض المناطق في جسم الإنسان
+
+313
+00:31:26,820 --> 00:31:36,220
+هي دهن، بعض الـ .. اه هي دهن في ظهر الإنسان أول شيء
+
+314
+00:31:36,220 --> 00:31:43,930
+فيه دهن، الآن الدهن هذا صعب شديد أن الدواء يصله 
+
+315
+00:31:43,930 --> 00:31:49,290
+بكمية كافية لسبب أن الدهون وأنت شوفته الدهون
+
+316
+00:31:49,290 --> 00:31:54,550
+الحيوانات ليس فيها أوعية دموية وليس فيها دم، هو اللي
+
+317
+00:31:54,550 --> 00:32:02,250
+بيحمل الدواء إلى الأعضاء، الدم كل مكان، العضو فيه دم 
+
+318
+00:32:02,250 --> 00:32:05,850
+أكثر كل مكان أصحى
+
+319
+00:32:13,540 --> 00:32:18,220
+احنا بنتكلم الآن إن أعضاء مركزية زي القلب و زي
+
+320
+00:32:18,220 --> 00:32:26,600
+الكبد وزي المعدة أو زي الـ kidney فيها دم كافي
+
+321
+00:32:26,600 --> 00:32:30,220
+التوزيع بيصير له أسرع، delivery of drugs to
+
+322
+00:32:30,220 --> 00:32:36,840
+extremities، extremities يعني الأطراف، يعني مثلًا الـ
+
+323
+00:32:36,840 --> 00:32:39,900
+hand extremity، الـ food extremity
+
+324
+00:32:42,700 --> 00:32:47,720
+ولا الـ skin ولا الـ adipose tissue الدهن هو أصعب
+
+325
+00:32:47,720 --> 00:32:55,020
+بسبب إمداد دم ضعيف، إمداد دم ضعيف في مناطق في الجلد
+
+326
+00:32:55,020 --> 00:33:03,600
+في القدر مثلًا شفاء صعب بس إمداد دم ضعيف، الـ 
+
+327
+00:33:03,600 --> 00:33:07,380
+distribution phase can be extremely slow for drugs
+
+328
+00:33:07,380 --> 00:33:10,820
+that bind strongly to serum proteins هذه القضية
+
+329
+00:33:10,820 --> 00:33:11,200
+الأخرى
+
+330
+00:33:17,680 --> 00:33:22,060
+وبيعمل معها compound، والـ compound هذا حجم كبير،
+
+331
+00:33:22,060 --> 00:33:27,740
+هل صعب إنه يلف الدم ويروح على الخلايا؟ صعب، إلا 
+
+332
+00:33:27,740 --> 00:33:33,400
+لما يفضل بروتين الدم يطلق ما لديه من دواء، يعني
+
+333
+00:33:33,400 --> 00:33:38,780
+بروتين الدم بيأثر بعض الأدوية، مش كل الأدوية، فإن 
+
+334
+00:33:38,780 --> 00:33:43,730
+أثرها، فإن أثرها الآن هيتأخر احنا عندنا في العين
+
+335
+00:33:43,730 --> 00:33:51,070
+المثال الصارخ اللي هو الـ .. الـ .. الـ .. الـ ..
+
+336
+00:33:51,070 --> 00:33:55,750
+الموسعات العينية زي الـ تروبيكاميد، تروبيكاميد، تروبيكاميد 
+
+337
+00:33:55,750 --> 00:33:55,970
+تروبيكاميد، تروبيكاميد، تروبيكاميد، تروبيكاميد، تروبيكاميد
+
+338
+00:33:55,970 --> 00:33:55,990
+تروبيكاميد، تروبيكاميد، تروبيكاميد، تروبيكاميد، تروبيكاميد
+
+339
+00:33:55,990 --> 00:33:56,070
+تروبيكاميد، تروبيكاميد، تروبيكاميد، تروبيكاميد، تروبيكاميد
+
+340
+00:33:56,070 --> 00:33:56,330
+تروبيكاميد، تروبيكاميد، تروبيكاميد، تروبيكاميد، تروبيكاميد
+
+341
+00:33:56,330 --> 00:34:11,590
+تروبيكاميد، تروبيكاميد، تروبيكاميد، تروبيكاميد
+
+342
+00:34:13,500 --> 00:34:18,600
+will be dilated within minutes بينما a darkly
+
+343
+00:34:18,600 --> 00:34:23,440
+colored iris
+
+344
+00:34:23,440 --> 00:34:28,380
+will take long time ممكن one hour or more to be
+
+345
+00:34:28,380 --> 00:34:36,520
+fully dilated طيب أنا
+
+346
+00:34:36,520 --> 00:34:41,100
+هنا برضه حاولت أجيب لكم هاي الـ oral administration
+
+347
+00:34:41,100 --> 00:34:46,100
+من الفم ونزل اللي هو الدواء إلى الأمعاء وبعد
+
+348
+00:34:46,100 --> 00:34:54,440
+الأمعاء ذهب إلى اللي هو الدم برغم عندي محلول هاييو
+
+349
+00:34:54,440 --> 00:35:00,720
+واحد مركز محلول هاييو وراح على الوريد رايح الدم
+
+350
+00:35:00,720 --> 00:35:09,720
+يعني هذه أمثلة كيف الدواء لازم في النهاية يذهب إلى
+
+351
+00:35:09,720 --> 00:35:10,700
+اللي هو الدم
+
+352
+00:35:17,660 --> 00:35:23,420
+في شيء اسمه distribution barriers برياز حواجز في
+
+353
+00:35:23,420 --> 00:35:31,260
+حواجز في الجسم تحول دون وصول الدم لبعض الأعضاء
+
+354
+00:35:31,260 --> 00:35:35,440
+الحاجز
+
+355
+00:35:35,440 --> 00:35:42,080
+الأول blood brain barrier بيقول لك أنه يعني ما بين
+
+356
+00:35:42,080 --> 00:35:44,540
+الدم وما بين المخ
+
+357
+00:35:47,980 --> 00:35:57,020
+اسمه blood brain barrier، هذا بِخُلُط يمنع
+
+358
+00:35:57,020 --> 00:36:03,860
+دخول الدواء إليه
+
+359
+00:36:03,860 --> 00:36:09,860
+يبقى special anatomic arrangement هو ترتيب تشريحي
+
+360
+00:36:09,860 --> 00:36:15,280
+معين that aims to distribute only lipid soluble
+
+361
+00:36:15,280 --> 00:36:21,630
+drugs التي تذوب في الدهون تعبر من هذا الـ variable
+
+362
+00:36:21,630 --> 00:36:25,670
+أو الـ filter أما الأدوية التي تذوب في الماء فلا 
+
+363
+00:36:25,670 --> 00:36:31,170
+تدخل، فلا تدخل حتى لو كان الـ brain المخ في حاجة
+
+364
+00:36:31,170 --> 00:36:38,270
+إليها، فبقول مثلًا الـ general anesthesia هي أدوية 
+
+365
+00:36:38,270 --> 00:36:42,610
+مائية صعب أن تدخل المخ عشان هيك الـ general
+
+366
+00:36:42,610 --> 00:36:43,890
+anesthesia بنعطيها وين؟
+
+367
+00:36:49,120 --> 00:36:54,540
+الأدوية اللي هي مائية مقصودة ومقصودة، مقصودة في الحقيقة 
+
+368
+00:36:54,540 --> 00:36:59,980
+مُمنعها من دخول بسهولة للعقل، بسهولة للدخول بسهولة 
+
+369
+00:36:59,980 --> 00:37:09,240
+للعقل، أنا
+
+370
+00:37:09,240 --> 00:37:11,460
+هنا جاي صورة
+
+371
+00:37:26,820 --> 00:37:36,280
+junction شايفين كيف الفلتر هنا؟ كيف هنا؟ tight بس
+
+372
+00:37:36,280 --> 00:37:41,920
+ما هيش بسهولة لدخول الأدوية المائية، اه بينما 
+
+373
+00:37:41,920 --> 00:37:47,680
+الأدوية اللي هو دهنية سهلة أنها تدخل 
+
+374
+00:37:58,110 --> 00:38:03,090
+blood brain barrier الحاجات الدهنية زي هذه تدخل
+
+375
+00:38:03,090 --> 00:38:09,490
+بأسهل من الأدوية المائية، طيب الـ antibiotics
+
+376
+00:38:09,490 --> 00:38:13,250
+مضادات حيوية that cross the blood brain barrier
+
+377
+00:38:13,250 --> 00:38:17,530
+difficulty can't be used for treatment of central
+
+378
+00:38:17,530 --> 00:38:22,310
+nervous system يبقى صح لو واحد عنده التهاب في المخ
+
+379
+00:38:22,310 --> 00:38:29,980
+أو عنده سحايا، التهاب السحايا أنا بجد أعطيه مضادات 
+
+380
+00:38:29,980 --> 00:38:36,860
+حيوية تذوب في الماء، يبقى أعطيه تذوب في الدهون، يا
+
+381
+00:38:36,860 --> 00:38:41,680
+إما أحقله المضادات الحيوية في الـ Cerebral Spinal
+
+382
+00:38:41,680 --> 00:38:49,420
+Fluid في دماغه، يعني إن أنا أخد الدواء في الـ
+
+383
+00:38:49,420 --> 00:38:54,300
+Cerebral Spinal Fluid مش في النخاع، طبعًا هو واضح 
+
+384
+00:38:54,300 --> 00:39:00,760
+أنه في عندي الدورة الدماغية عندي arachnoid matter وعندي
+
+385
+00:39:00,760 --> 00:39:06,380
+pyramid بين الـ pyramid والـ arachnoid في حالة اسمها 
+
+386
+00:39:06,380 --> 00:39:11,020
+subarachnoid space وهذا subarachnoid space هو اللي
+
+387
+00:39:11,020 --> 00:39:15,740
+فيه سائل السبلينوفلوان من المخ ومن نخاعه الشوكي من
+
+388
+00:39:15,740 --> 00:39:23,580
+المخ ومن نخاعه الشوكي، فلو أنا ضربت حقنة فيها مضاد
+
+389
+00:39:23,580 --> 00:39:27,220
+حيوي مائي بضرب في الظهر
+
+390
+00:39:40,330 --> 00:39:45,630
+بيدخل ويحط في سن الإبرة ويشيل الـ thread لما ينقط 
+
+391
+00:39:45,630 --> 00:39:47,830
+
+431
+00:43:06,050 --> 00:43:11,590
+دارية، بتشوّه الجنين بفعل جهل الأم في المحافظة
+
+432
+00:43:17,040 --> 00:43:22,620
+يبقى هي ال barriers اللي هي بتحول دول دخول الدواء
+
+433
+00:43:22,620 --> 00:43:28,820
+إلى اللي هو بعض اللي هو التراكيب
+
+434
+00:43:28,820 --> 00:43:31,940
+في الجسم أو الحواجز في الجسم اللي هي في ال brain و
+
+435
+00:43:31,940 --> 00:43:36,320
+في ال fetus طيب
+
+436
+00:43:36,320 --> 00:43:43,680
+يتعلق بال placenta دخول الأدوية دخول الأدوية خطير 
+
+437
+00:43:43,680 --> 00:43:46,400
+جدا من الأم
+
+438
+00:43:49,710 --> 00:43:54,070
+خاصة في ال first trimester
+
+439
+00:44:05,210 --> 00:44:10,190
+لأنه ممكن أن الدواء يدخل في تركيب الطفل ويعمل
+
+440
+00:44:10,190 --> 00:44:15,850
+تشويه اسمه teratogenic effects والأدوية اسمها
+
+441
+00:44:15,850 --> 00:44:19,810
+teratogenic drugs which are defined as agents that
+
+442
+00:44:19,810 --> 00:44:22,550
+cause physical effects in developing embryo
+
+443
+00:44:33,830 --> 00:44:40,210
+تشوّه الأعضاء كثير اللي هو ال malformations هذا
+
+444
+00:44:40,210 --> 00:44:44,750
+بيكون بسبب جهل الأم في تناول الدواء في اللي هو
+
+445
+00:44:44,750 --> 00:44:50,290
+الجزء الأول من الحمل في بعض الأطباء بيمنع الأم
+
+446
+00:44:50,290 --> 00:44:54,730
+تاخد أي نوع من العلاج حتى الفيتامين حتى الفيتامين
+
+447
+00:44:54,730 --> 00:45:00,630
+لكن في بعض الأطباء يتهاون في بعض الفيتامينات
+
+448
+00:45:00,630 --> 00:45:06,150
+والحديد والمقوية لأن الأم بصير عندها نوع من ال
+
+449
+00:45:06,150 --> 00:45:10,490
+anorexia اللي هو فقد الشهية يعني بيعطيها أشياء
+
+450
+00:45:10,490 --> 00:45:14,750
+محددة، لكن إنه تاخد أسبرين أو تاخد دايكلفين أو
+
+451
+00:45:14,750 --> 00:45:20,170
+تاخد أكامول أو تاخد يعني هذه الأدوية الشديدة ممكن
+
+452
+00:45:20,170 --> 00:45:25,410
+تشوّه الجنين بيقول لي في النصف الثاني من الحمل،
+
+453
+00:45:25,410 --> 00:45:30,680
+الواضح أحسن، لكن على الأم ألا تاخد دواء يعني بجوعات
+
+454
+00:45:30,680 --> 00:45:36,720
+كبيرة لأنه ممكن هنا ان الطفل أو الجنين بدأ فيه
+
+455
+00:45:36,720 --> 00:45:40,140
+الحياة وبدأ يتنفس فممكن يصله respiratory
+
+456
+00:45:40,140 --> 00:45:47,780
+depression أو من الفشل للتنفس وممكن يموت في البطن
+
+457
+00:45:47,780 --> 00:45:52,820
+إذا كان الأم تنفست من غازات أو أبخرة أو قطر
+
+458
+00:45:52,820 --> 00:46:00,140
+كحوليات أو tobacco أو أقراص بجوعات كبيرة فإنها قد
+
+459
+00:46:00,140 --> 00:46:05,300
+تقضي على جنينها، لذلك الأفضل تقليص أي نوع من
+
+460
+00:46:05,300 --> 00:46:10,720
+الأدوية خلال فترة الحمل حفاظ المرأة على جنينها.
+
+461
+00:46:11,040 --> 00:46:16,400
+احنا هيك الحمد لله في هذا اليوم أنجزنا يعني الفرد
+
+462
+00:46:16,400 --> 00:46:22,720
+الأول اللي هو ال absorption of drugs و الفرد الثاني
+
+463
+00:46:22,720 --> 00:46:26,720
+اللي هو metabolism of drugs و إن شاء الله يعني ال
+
+464
+00:46:26,720 --> 00:46:30,260
+distribution of drugs و المرة الجاية إن شاء الله
+
+465
+00:46:30,260 --> 00:46:34,200
+هنبدأ بال metabolism of drugs شكرا لكم على حسن
+
+466
+00:46:34,200 --> 00:46:36,940
+الاستماع و السلام عليكم و رحمة الله و بركاته
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/rKh8uPCUfw8_postprocess.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/rKh8uPCUfw8_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..5d3fb44d8c5c7007901ba8d981b89c3ccc7ce213
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/rKh8uPCUfw8_postprocess.srt
@@ -0,0 +1,1864 @@
+1
+00:00:20,750 --> 00:00:24,090
+بسم الله الرحمن الرحيم الحمد لله وكفا واصلي واسلم
+
+2
+00:00:24,090 --> 00:00:28,090
+على نبي المصطفى في هذا اليوم ان شاء الله سنبدأ
+
+3
+00:00:28,090 --> 00:00:33,770
+chapter 2 في drug absorption, distribution,
+
+4
+00:00:34,270 --> 00:00:40,010
+metabolism and excretion في امتصاص الدواء وفي
+
+5
+00:00:40,010 --> 00:00:45,090
+توزيع الدواء وفي التمثيل الغذائي للدواء وفي إخراج
+
+6
+00:00:45,090 --> 00:00:48,170
+الدواء من الجسم وسنبدأ ان شاء الله بال absorption
+
+7
+00:00:49,980 --> 00:00:55,600
+absorption is defined as the process that involves
+
+8
+00:00:55,600 --> 00:00:59,440
+the movement of the drug molecules from the site
+
+9
+00:00:59,440 --> 00:01:05,460
+of entry into the body to the secretion of blood
+
+10
+00:01:05,460 --> 00:01:12,420
+or body fluids to be distributed يعني تحرك الدواء
+
+11
+00:01:12,420 --> 00:01:18,000
+من مكان إعطائه نحو الدورة الدموية كي يوزع
+
+12
+00:01:20,800 --> 00:01:26,720
+الprocess of absorption بدا في مكان إعطائي الدواء،
+
+13
+00:01:26,720 --> 00:01:32,340
+إعطائي الحكمة يعني هيبدأ من العضلة، إعطائي الوريد
+
+14
+00:01:32,340 --> 00:01:35,740
+هيبدأ من الوريد، إعطائي التحميلة هيبدأ من مكان
+
+15
+00:01:35,740 --> 00:01:42,460
+التحميلة، إعطائي الفم هيبدأ من القمعة، هيبدأ
+
+16
+00:01:42,460 --> 00:01:46,740
+انتصاصه من القمعة، and is essential to subsequent
+
+17
+00:01:46,740 --> 00:01:50,830
+processes distribution metabolism executionيعني ال
+
+18
+00:01:50,830 --> 00:01:58,770
+absorption is very important for other steps if no
+
+19
+00:01:58,770 --> 00:02:02,930
+absorption, no distribution if no absorption, no
+
+20
+00:02:02,930 --> 00:02:07,030
+metabolism if no absorption, no secretion يعني هو
+
+21
+00:02:07,030 --> 00:02:11,630
+الأساس في العمل يقولها ال absorption absorption
+
+22
+00:02:11,630 --> 00:02:16,370
+varies according يعني يختلف من إنسان لإنسان
+
+23
+00:02:16,370 --> 00:02:18,850
+according to three factors
+
+24
+00:02:27,860 --> 00:02:30,660
+هي بتاعت الدواء اللي أخدناها قبل هى في ده دوز او
+
+25
+00:02:30,660 --> 00:02:36,240
+دوز كبيرة او دوز صغيرة طبعا انا هنا براخص يعنى
+
+26
+00:02:36,240 --> 00:02:41,200
+route of administration واضح انه ان اعطيتها IV في
+
+27
+00:02:41,200 --> 00:02:46,360
+الوريد سيكون الاشتراك شنساني جدا لأن واحد ده معطوب
+
+28
+00:02:46,360 --> 00:02:50,260
+مش بده نفسه يلف على المعدة وعلى الأمعاء وبعدين
+
+29
+00:02:50,260 --> 00:02:54,220
+يتصم الخملات لأ معاملة يروح لده احنا اللي هشوفها
+
+30
+00:02:54,220 --> 00:03:01,370
+يبقى كل مكان ال routeطريق الإعطاء قريب كل ما كان
+
+31
+00:03:01,370 --> 00:03:06,290
+أسرع اللي اللي هو ال absorption والعكس هي أطول
+
+32
+00:03:06,290 --> 00:03:11,010
+دورة لل absorption هي طعم، مع طعم، عن طريق الفم
+
+33
+00:03:11,010 --> 00:03:16,770
+الفور طبعا لما أعطي سائل، حتى عن طريق الفم، ممتص
+
+34
+00:03:16,770 --> 00:03:20,050
+أسرع من أقاص اللي هي بدها الساق، دوابان وشي وكده
+
+35
+00:03:20,050 --> 00:03:25,370
+وكده لما أعطي يعني أشياء محلين أسرع من أشياء
+
+36
+00:03:25,370 --> 00:03:29,590
+الصلبةو الدواز كل مكان الدواز أكبر كل مكان امتصاص
+
+37
+00:03:29,590 --> 00:03:36,710
+أكبر والعكس صحيح طيب الان factors affecting drug
+
+38
+00:03:36,710 --> 00:03:40,130
+absorption ما هي العوامل التي تؤثر في امتصاص
+
+39
+00:03:40,130 --> 00:03:44,210
+الدواء اول شيء ال nature of the absorbing surface
+
+40
+00:03:44,210 --> 00:03:50,030
+nature طبيعة السطح المعص طبيعة السطح المعص
+
+41
+00:03:58,120 --> 00:04:05,740
+في مادة علاجية على جلبي ولا
+
+42
+00:04:05,740 --> 00:04:13,360
+أخد كورس تحت لساني؟ مين أسرع؟ بالنسبالي المرحلة من
+
+43
+00:04:13,360 --> 00:04:19,740
+جلبي والكورس تحت لساني كورس تحت لساني أسرع كورس
+
+44
+00:04:19,740 --> 00:04:24,360
+تحت لساني ليش؟ لأن تحت لساني اللي باخدوها الله
+
+45
+00:04:24,360 --> 00:04:25,900
+يعفوهم اللي هو مرض القلب
+
+46
+00:04:31,620 --> 00:04:36,840
+اللسان sublingual على طول تعمل توصية للأوراق
+
+47
+00:04:36,840 --> 00:04:42,400
+الدموية لأن ميوكاس ميمبراين ميوكاس ميمبراين very
+
+48
+00:04:42,400 --> 00:04:46,360
+thick بينما الجلد very thin بينما الجلد very thick
+
+49
+00:04:46,360 --> 00:04:50,880
+الجلد very thick يبقى ميمبراين من خلال اللي يجب أن
+
+50
+00:04:50,880 --> 00:04:56,790
+يترابس الدراجةفي drug monkeys may pass through a
+
+51
+00:04:56,790 --> 00:05:01,750
+single layer of cells زي Epithelium of Villi Villi
+
+52
+00:05:01,750 --> 00:05:06,150
+خملات الأمعاق الدقيقة التي بتصميم الطعام هي single
+
+53
+00:05:06,150 --> 00:05:11,490
+layer أسرع من ال skin اللي هو multiple layers skin
+
+54
+00:05:11,490 --> 00:05:15,430
+multiple layers طبعا في ال skin فيه epidermis و
+
+55
+00:05:15,430 --> 00:05:19,410
+فيه dermis و subcutaneous و tissue في ال hysteria
+
+56
+00:05:19,410 --> 00:05:20,710
+بتاعه الخميل
+
+57
+00:05:29,990 --> 00:05:33,070
+أسرع، واحد، يبقى هذا العامل الأول اللي يؤثر في
+
+58
+00:05:33,070 --> 00:05:36,250
+سرعة الإمتصاص العامل الثاني surface area of the
+
+59
+00:05:36,250 --> 00:05:41,930
+absorbing surface تكون قاعدة كل ما كان ال surface
+
+60
+00:05:41,930 --> 00:05:46,670
+area للسطح المعص أكبر، فإن الإمتصاص يكون أسرع ولكن
+
+61
+00:05:46,670 --> 00:05:50,130
+صحيح، العكس صحيح، يبقى the more extensive the
+
+62
+00:05:50,130 --> 00:05:52,690
+absorbing surface, the greater the absorption rate
+
+63
+00:05:52,690 --> 00:05:57,190
+and more rapid effect of the used drug، والعكس
+
+64
+00:05:57,190 --> 00:06:03,060
+صحيحطيب احنا يعني جيبنا بعض ال demonstrations
+
+65
+00:06:03,060 --> 00:06:10,780
+فمثلا هي الأمعاء الدقيقة اللي بصير منها الدصاص هي
+
+66
+00:06:10,780 --> 00:06:14,780
+ال human open intestine اللي هو فرج الأمعاء نفسه
+
+67
+00:06:14,780 --> 00:06:19,820
+بإن هي ال mucus layer of small intestine هي ال
+
+68
+00:06:19,820 --> 00:06:20,400
+epithelial layer
+
+69
+00:06:26,180 --> 00:06:30,380
+الدواء ان يدخل الى الدم كي يمطس اذا لم يدخل الى
+
+70
+00:06:30,380 --> 00:06:34,840
+الدم في هذه الحالة فانه لن يمطس كيف يعني في الآخر؟
+
+71
+00:06:34,840 --> 00:06:38,180
+بمعنى الشوارع الدوائية اللي هي في جدار الأمهات
+
+72
+00:06:38,180 --> 00:06:42,200
+الدقيقة وانا برضه رسمي لكم الخملات من ناحية
+
+73
+00:06:42,200 --> 00:06:48,220
+التانية وكيف الخملات بتكون وهنا بس يعني مفسرة طيب
+
+74
+00:06:48,220 --> 00:06:52,700
+العمل الثالث blood supply of the absorbing area
+
+75
+00:07:01,230 --> 00:07:05,450
+ولا poor in blood business، إذا كان المنطقة اللي
+
+76
+00:07:05,450 --> 00:07:11,870
+إيجي عليها الدواء ريحي فالاتصال سيكون rapid، إذا
+
+77
+00:07:11,870 --> 00:07:18,350
+كان poor يعني مثل احنا
+
+78
+00:07:18,350 --> 00:07:22,710
+ضربنا خجلنا في واحد أوبيس تحت الجلد
+
+79
+00:07:33,730 --> 00:07:38,730
+بينما احنا ضربنا في العضل واحد ثاني على طول ماشية
+
+80
+00:07:38,730 --> 00:07:47,850
+ليش؟ لأنه العضل ريشي in blood vessels بينما اللي
+
+81
+00:07:47,850 --> 00:07:54,390
+قد يبوستش هو أوي فاق poor in blood vessels حسنا،
+
+82
+00:07:54,390 --> 00:07:57,410
+هذا يعني واضح، الحكاية اللي هو ال blood vessels
+
+83
+00:08:02,470 --> 00:08:08,650
+دوبانية او القدرة على الدوبان لدى هذا ال drug in
+
+84
+00:08:08,650 --> 00:08:13,430
+order to be absorbed drug must be soluble in
+
+85
+00:08:13,430 --> 00:08:17,970
+solutions يبقى هذا الدواء لازم يكون قادر على
+
+86
+00:08:17,970 --> 00:08:23,130
+الدوبان في المحانين the more soluble the drug the
+
+87
+00:08:23,130 --> 00:08:29,550
+more rapid it will be absorbed والعكس صحيح لما كان
+
+88
+00:08:29,550 --> 00:08:36,040
+لا يدوبأو دفعه أقل كل ما اتأخر انتصاره من السطح
+
+89
+00:08:36,040 --> 00:08:39,380
+فالمثال دلوقتي هنا مثال chemicals and minerals
+
+90
+00:08:39,380 --> 00:08:46,380
+that form insoluble precipitates ترسيب in the
+
+91
+00:08:46,380 --> 00:08:50,540
+gastrointestinal tract or the tracts that are
+
+92
+00:08:50,540 --> 00:08:54,680
+insoluble in water or lipids can't be absorbed
+
+93
+00:08:54,680 --> 00:09:00,100
+يعني في بعض الأياجوية
+
+94
+00:09:02,660 --> 00:09:08,080
+كبيرة المركول ولا تدوب لا في الماء ولا في وسط
+
+95
+00:09:08,080 --> 00:09:14,700
+الدوران لو أخذناها أقراسا فإنها تخرج مع البرازج لا
+
+96
+00:09:14,700 --> 00:09:21,840
+تنطس لأنها قابلة أو صعب أن تدوب فإذا لم تدوب كيف
+
+97
+00:09:21,840 --> 00:09:22,340
+ستصل
+
+98
+00:09:30,310 --> 00:09:34,070
+و قابل دوام في الماء أو في الوسط الدوني فإنه ينتص
+
+99
+00:09:34,070 --> 00:09:40,150
+بصراحة فمثلا voluntarily administered drugs زي
+
+100
+00:09:40,150 --> 00:09:46,010
+مثلا الحقن اللتي نحطيها في العضل أو المريض في part
+
+101
+00:09:46,010 --> 00:09:51,620
+in any vehicle، vehicle وسيلةيعني ليه تمريض الدواء
+
+102
+00:09:51,620 --> 00:09:55,500
+أو تدويب الدواء will be more slowly absorbed from
+
+103
+00:09:55,500 --> 00:10:00,620
+the muscle than drugs dissolved in water او اللي
+
+104
+00:10:00,620 --> 00:10:05,780
+هو isotonic sodium chloride solution يعني في ناس
+
+105
+00:10:05,780 --> 00:10:11,660
+بيقولوا في حقن زيت في بيقولوا حقن الزيت وفي حقن
+
+106
+00:10:11,660 --> 00:10:15,680
+عادية اللي فيها ميز بيقولك لو حققنا حقن الزيت
+
+107
+00:10:15,680 --> 00:10:17,700
+هتنتدر
+
+108
+00:10:18,990 --> 00:10:24,050
+في دم فترة في العضلة يعني في العضلة هتنتظر فترة و
+
+109
+00:10:24,050 --> 00:10:30,570
+تمتص بالتدريج و بصعوبة وهي مهلمة كمان حتى تصل كلها
+
+110
+00:10:30,570 --> 00:10:35,550
+إلى الدم بينما الحقنة اللي هي مائية اللي بيبلوغ في
+
+111
+00:10:35,550 --> 00:10:40,090
+الميه حقنها في العضل على السريع راح تجي الطريقة
+
+112
+00:10:40,090 --> 00:10:43,810
+الى اللي هو مجرد دم في خلال دقائق
+
+113
+00:10:56,000 --> 00:11:02,120
+يعني العلاقات الكيميائية اما حانضية اسيدية او
+
+114
+00:11:02,120 --> 00:11:06,800
+قلوية alkaline او neutral او متعادلة لا حانضية ولا
+
+115
+00:11:06,800 --> 00:11:12,580
+قلوية طبعا واضح انه كل ما نزل عن السبعة بصير حانضي
+
+116
+00:11:12,580 --> 00:11:15,900
+اكتر وكل ما طلع عن السبعة بصير قلوي اكتر و عند
+
+117
+00:11:15,900 --> 00:11:18,800
+السبعة سبعة و اتنين و عشرة بتكون ال neutral
+
+118
+00:11:30,240 --> 00:11:33,680
+لما الوفق الحامضي هذا بتاع ال اسبريل بيدي في
+
+119
+00:11:33,680 --> 00:11:38,480
+المعنى فإنه لا يتأثر سلبًا
+
+120
+00:12:07,110 --> 00:12:11,790
+Remains active يبقى الاسبلين عشان هو حامضي ويجي
+
+121
+00:12:11,790 --> 00:12:17,390
+على المائدة حافظ على التركيب بتاعه و بقي remains
+
+122
+00:12:17,390 --> 00:12:23,330
+active ال environment في الستمكة فالدفوع can
+
+123
+00:12:23,330 --> 00:12:25,230
+really diffuse across the intestinal cells
+
+124
+00:12:25,230 --> 00:12:29,820
+membrane into the circulationيبقى .. لم .. لم يتلف
+
+125
+00:12:29,820 --> 00:12:33,760
+اللي هو الأسبانين بالحمضية بتاعه اللي هو إيش؟
+
+126
+00:12:33,760 --> 00:12:39,100
+الميدا، و بعد إيه؟ ماشي إلى اللي هو الأمعة ال
+
+127
+00:12:39,100 --> 00:12:44,460
+contrast على النقيد عن ال crime drugs ال crime
+
+128
+00:12:44,460 --> 00:12:47,820
+drugs زي ال antacids، antacids أقراص رينيه
+
+129
+00:12:47,820 --> 00:12:50,720
+بتاخدوها عارفين أقراص رينيه؟ لما سمع حرقان في
+
+130
+00:12:50,720 --> 00:12:55,420
+الميدا؟ الميدا بتحرجه و بيقوله اعطيني رينيهبنانية
+
+131
+00:12:55,420 --> 00:13:01,040
+يعني ان انا حموضة بقرشوا حبا بيلاقي حاجة برا في فم
+
+132
+00:13:01,040 --> 00:13:05,660
+المعنى بتاعه هذه كلها اسم المنوعة antacids وضدات
+
+133
+00:13:05,660 --> 00:13:09,440
+الحامض وضدات الحامض لما راح تحس مع حموضة بياخد
+
+134
+00:13:09,440 --> 00:13:16,480
+اشياء فهذه قلوية القلوي متفاعل مع الحامض وبيطلع
+
+135
+00:13:16,480 --> 00:13:21,730
+الحامضية زيادةحمض زي القروي يساوي ملح زي الماء
+
+136
+00:13:21,730 --> 00:13:26,730
+يعني بس هذا عند المعدة و برتاح خلاص بيعمل دوره في
+
+137
+00:13:26,730 --> 00:13:30,530
+المعدة بيمشيش بعدين خلاص لإنه يتلف في المعدة
+
+138
+00:13:30,530 --> 00:13:36,810
+بتفاعل .. بتفاعل إيه؟ الكيميائي يبقى ال antacids
+
+139
+00:13:36,810 --> 00:13:39,890
+tend to dissociate أو inactivated in the stomach
+
+140
+00:13:39,890 --> 00:13:44,650
+اللي هو acidic environment and not absorb through
+
+141
+00:13:44,650 --> 00:13:45,350
+the gastric membrane
+
+142
+00:13:49,980 --> 00:13:53,800
+المعدة هذه الحالة القلوية عشانك انا لو انا بدي
+
+143
+00:13:53,800 --> 00:14:00,520
+اعطي قلوي لازم ا capsule لازم اعمل كابسولة ميجبش
+
+144
+00:14:00,520 --> 00:14:04,140
+في المعدة و اروح على الاثنى عشر و اروح على الأمعاء
+
+145
+00:14:04,140 --> 00:14:08,400
+الدقيقة زي احنا بتكلمنا قبلها لكن الدواء اللي وسطه
+
+146
+00:14:08,400 --> 00:14:16,630
+حامضي انا بعطيه مرخف من موضوع المعدةالفيروس يحدث
+
+147
+00:14:16,630 --> 00:14:22,590
+عندما هؤلاء الدروس في مصطلح غير ملحوظ.المصطلح مثلا
+
+148
+00:14:22,590 --> 00:14:27,330
+اللي هو الاتنين عشر والعمارة الدقيقة وسطها قلوي
+
+149
+00:14:27,330 --> 00:14:34,170
+وسطها قلوي.الدروس غير ملحوظ في الماء هو الليبيد
+
+150
+00:14:34,170 --> 00:14:35,630
+الليبيد الليبود الليبود الليبود الليبود الليبود
+
+151
+00:14:35,630 --> 00:14:36,130
+الليبود الليبود الليبود الليبود الليبود الليبود
+
+152
+00:14:36,130 --> 00:14:38,510
+الليبود الليبود الليبود الليبود الليبود الليبود
+
+153
+00:14:38,510 --> 00:14:38,610
+الليبود الليبود الليبود الليبود الليبود الليبود
+
+154
+00:14:38,610 --> 00:14:39,490
+الليبود الليبود الليبود الليبود الليب
+
+155
+00:14:51,100 --> 00:14:59,620
+باختصار انه غير احكاية حمضي و احكاية قلوي في مواد
+
+156
+00:14:59,620 --> 00:15:07,820
+تدوب في الماء وفي مواد تدوب في الدهون فهو بيقوللي
+
+157
+00:15:09,140 --> 00:15:16,760
+الدراج اللذي لا يدوب في الدهون
+
+158
+00:15:16,760 --> 00:15:20,580
+يخترق
+
+159
+00:15:20,580 --> 00:15:23,320
+قدار الأمعاق بسهولة
+
+160
+00:15:32,480 --> 00:15:39,160
+يبدأ ان ionized اللي لم يتم تحليله او تكسيره في
+
+161
+00:15:39,160 --> 00:15:46,900
+الماء ده، اه وهو لا يدوب في الماء، يستطيع ان يدخل
+
+162
+00:15:46,900 --> 00:15:51,460
+عبر الخملات في الماء الدقيقة بسهولة، هو اللي ده
+
+163
+00:15:51,460 --> 00:15:56,780
+ionized water solubleالذي نام في الماء او تحلل في
+
+164
+00:15:56,780 --> 00:16:05,140
+الماء is lipid
+
+165
+00:16:05,140 --> 00:16:09,140
+insoluble and non-disable across the cell membrane
+
+166
+00:16:09,140 --> 00:16:14,180
+or intestine عشان ما نخشش في اللي هو التناقض يعني
+
+167
+00:16:14,180 --> 00:16:18,340
+ال drugs اللي بناخدها فيه شيء بدوق في الماء وشيء
+
+168
+00:16:18,340 --> 00:16:25,910
+بدوق في الدهوناللي بدور في الدهون سهله انه روح على
+
+169
+00:16:25,910 --> 00:16:30,530
+الأمعاء وينفسم الأمعاء بينما اللي يعني ذابه في
+
+170
+00:16:30,530 --> 00:16:35,330
+الماء صعب انه يدخل في يدار اللي هو الأمعاء وينفسم
+
+171
+00:16:35,330 --> 00:16:41,710
+الأمعاء طيب في factor سادس و هذا مهم تركيز الدواء
+
+172
+00:16:41,710 --> 00:16:46,710
+هذا عامل مهم في الامتصاص تركيز الدواء عامل مهم في
+
+173
+00:16:46,710 --> 00:16:50,010
+الامتصاص بقول لي كلما
+
+174
+00:16:55,970 --> 00:17:02,310
+فإن الامتصاص أعلى والعكس صحيح كل ما كان تركيز
+
+175
+00:17:02,310 --> 00:17:06,850
+الدواء أقل فإن الامتصاص يكون أقل وهذه نتيجة هنطقية
+
+176
+00:17:06,850 --> 00:17:13,270
+يعني الدواء لما يكون مثلا ألف ميلي جرام مثلا أو
+
+177
+00:17:13,270 --> 00:17:17,430
+يكون ميت ميلي جرام واضح إنه الألف ميلي جرام مكثفة
+
+178
+00:17:17,910 --> 00:17:22,410
+وامتصاصها هيكون اعلى بكتير من ال 100 ميلي جرام ال
+
+179
+00:17:22,410 --> 00:17:28,330
+drug may be initially administer in large doses
+
+180
+00:17:28,330 --> 00:17:33,570
+that temporarily exceeds the body capacity for
+
+181
+00:17:33,570 --> 00:17:36,730
+excretion
+
+182
+00:17:36,730 --> 00:17:43,230
+of the drug يعني احيانا في واحد بياخد دمع فوق طبقه
+
+183
+00:17:43,230 --> 00:17:51,090
+جمعة كبيرة جداالجوعة الكبيرة جدا هذه هترفع مستوى
+
+184
+00:17:51,090 --> 00:17:55,210
+الدواء في الدم إلى شيء غير طبيعي، عالي خالص،
+
+185
+00:17:55,210 --> 00:18:04,670
+الكلية لكن هذا بقول ايه؟ مش هيدوم طويلا، ليش؟ لأن
+
+186
+00:18:04,670 --> 00:18:14,910
+الكلية ستبدأ بإخراج سريع لهذا الدواءوبالتالي هذا
+
+187
+00:18:14,910 --> 00:18:21,110
+المستوى العالي جدا اللي أخده المريض في الدمسة سوف
+
+188
+00:18:21,110 --> 00:18:26,530
+ينزل بالتدريج إذا لم ياخد هو جوعة تانية و تاكت حتى
+
+189
+00:18:26,530 --> 00:18:30,210
+في حالات التسامم يعني الواحد مثلا أخد عشر أقلاص
+
+190
+00:18:30,210 --> 00:18:33,530
+أكمول أسبرين كده كده كده كده صح أن هذه emergency و
+
+191
+00:18:33,530 --> 00:18:37,690
+كده لكن متوقع خلال 24 ساعة أن الوضع هيتغير فتبدأ
+
+192
+00:18:37,690 --> 00:18:41,530
+الكلية في التعامل مع الزائد وترميه إلى الخارج
+
+193
+00:18:41,870 --> 00:18:47,590
+التركيز العالي يعتمد على تركيز
+
+194
+00:18:47,590 --> 00:18:52,090
+الدواء اللي أخذناها كلما زادة تركيز الدواء اللي
+
+195
+00:18:52,090 --> 00:18:57,650
+أخذناها كلما معدل الامتصاص كان أعلى وأسرع في هذه
+
+196
+00:18:57,650 --> 00:19:00,550
+الطريقة في التركيز العالي تركيز الدواء اللي
+
+197
+00:19:00,550 --> 00:19:02,510
+أخذناها كلما زادت تركيز الدواء اللي أخذناها كلما
+
+198
+00:19:02,510 --> 00:19:03,670
+زادت تركيز الدواء اللي أخذناها كلما زادت تركيز
+
+199
+00:19:03,670 --> 00:19:05,270
+أخذناها كلما زادت تركيز الدواء اللي أخذناها كلما
+
+200
+00:19:05,270 --> 00:19:09,430
+زادت تركيز الدواء اللي أخذناها كلما زادت تركيز
+
+201
+00:19:09,430 --> 00:19:11,470
+الدواء اللي أخذناها
+
+202
+00:19:13,590 --> 00:19:17,030
+فكانوا يعني هم يخلصوا بسرعة من الموضوع يجيبك اربع
+
+203
+00:19:17,030 --> 00:19:21,190
+او ست اقراء كابسولات تترا سايتليين ويقولوا خدهم مع
+
+204
+00:19:21,190 --> 00:19:28,870
+بعض على امل ان هو يعني يخضي على ال Vibrio cholera
+
+205
+00:19:28,870 --> 00:19:34,630
+السبب بسرعة يعني زي ما بقولك يعني shock dose dose
+
+206
+00:19:34,630 --> 00:19:45,460
+صادمة للميكروفون في الحالة هذه في ال target siteكل
+
+207
+00:19:45,460 --> 00:19:50,900
+ما كانت الجرعة الأعلى كل ما صار تركيز الدولة في ال
+
+208
+00:19:50,900 --> 00:19:55,040
+target site اللي فيه المرض أعلى وأسرع، أعلى وأسرع،
+
+209
+00:19:55,040 --> 00:20:01,620
+والأقصى هي لو أعطيت جرعة خفيفة أو جرعة صغيرة. Once
+
+210
+00:20:01,620 --> 00:20:04,260
+active drug level is established by such
+
+211
+00:20:04,260 --> 00:20:07,780
+accumulating effects, similar doses of drug can be
+
+212
+00:20:07,780 --> 00:20:10,680
+administered to replace only the amount of the
+
+213
+00:20:10,680 --> 00:20:14,220
+drug executed since the previous dose. كيف يعني؟
+
+214
+00:20:15,150 --> 00:20:21,770
+الان واحد ان بيذهب للنوز التاني احنا كتبناله اقراس
+
+215
+00:20:21,770 --> 00:20:27,850
+مثلا cifadrox كل اتناشر ساعة cifadrox هذا في منه
+
+216
+00:20:27,850 --> 00:20:31,930
+متان و خمسين و في منه خمسمية اقل زيكوا اعطينا
+
+217
+00:20:31,930 --> 00:20:38,430
+الخمسمية الان الخمسمية هذه المفروض تشتغل لاتناشر
+
+218
+00:20:38,430 --> 00:20:41,450
+ساعة و بعدين تبدأ تعمل decline
+
+219
+00:20:45,530 --> 00:20:50,810
+ليش؟ لإن الكيليا طلعت الدواء ال metoxication عشان
+
+220
+00:20:50,810 --> 00:20:56,010
+هيك بقولك يعني قص مرتين يوميا مدة مثلا خمس أيام
+
+221
+00:20:56,010 --> 00:21:02,630
+إيش يعني في الخمس أيام؟ في الخمس أيام إن أنا أجعل
+
+222
+00:21:02,630 --> 00:21:13,510
+المعدل الدوائي أو العناجي للدواء في الدم ثابت وهذا
+
+223
+00:21:13,510 --> 00:21:18,870
+إيش بفيد؟بفيد معدل علاجي في ال target site اللي
+
+224
+00:21:18,870 --> 00:21:23,510
+فيه المرض ثابت لمدة خمس أيام، هذا بفيد إيش؟ قتل
+
+225
+00:21:23,510 --> 00:21:31,910
+الميكروبات في هذا الموضوع لمدة خمس أيام، انتهى، طب
+
+226
+00:21:31,910 --> 00:21:36,850
+في يعني واحد بيحس ببعض الراحة، لو زي تامة بيجاوبه
+
+227
+00:21:50,580 --> 00:21:54,040
+الماكروبنة إتراجة بالنسبة لتلاتين اربعين في المية
+
+228
+00:21:54,040 --> 00:21:58,540
+أو خمسين في المية، لكن ما انتهاش، بدّوا لسه
+
+229
+00:21:58,540 --> 00:22:01,640
+maintenance dose لباقي الأيام
+
+230
+00:22:16,530 --> 00:22:20,690
+و لو أرجعنا بعد الخمس أيام ناخد نفس الدواء فانا
+
+231
+00:22:20,690 --> 00:22:27,750
+مكروب سوف يسخر من الدواء لأن هو حلل الشفرة بتاعي
+
+232
+00:22:27,750 --> 00:22:33,050
+حلل الشفرة يبقى الآن أنا بتكلم على نوعين من
+
+233
+00:22:33,050 --> 00:22:40,010
+الجرعات في نوع اسمه primary or initial dose اللي
+
+234
+00:22:40,010 --> 00:22:44,370
+باخده ده في الأول وفي شيء اسمه maintenance dose
+
+235
+00:22:44,370 --> 00:22:48,930
+maintenanceهي في اللغة الصيانة لكن احنا بيقول
+
+236
+00:22:48,930 --> 00:22:54,330
+الجرعة المحافظة اللي هي بتحافظ على مستوى الدواء
+
+237
+00:22:54,330 --> 00:22:59,170
+يبقى انا الجرعة اللي خدتها في الأول هي جرعة بداية
+
+238
+00:22:59,170 --> 00:23:06,070
+تفعيل لكن باقى الجرعات maintenance dose وكتير احنا
+
+239
+00:23:06,070 --> 00:23:10,550
+بيقولها الأيان إذا كان انت نسيت الجرعة خدها أول ما
+
+240
+00:23:10,550 --> 00:23:15,250
+تتفكر لأن مثلا انا كل اتناشر ساعة نام وراه ست
+
+241
+00:23:15,250 --> 00:23:15,690
+ساعات
+
+242
+00:23:20,580 --> 00:23:28,020
+البكتيريا تبدأ يصيلها refreshment تصحى
+
+243
+00:23:28,020 --> 00:23:32,980
+البكتيريا وتعود إلى التكاثر خدها بسرعة واجب اكمال
+
+244
+00:23:32,980 --> 00:23:39,720
+الجرعات حتى النهاية في ال maintenance dose طيب
+
+245
+00:23:39,720 --> 00:23:46,520
+الان انتهينا من drug absorptionالان الدواء سواء ان
+
+246
+00:23:46,520 --> 00:23:54,320
+انا اعطيته حقنة او اقلاص او تحميلة او حتى تحت
+
+247
+00:23:54,320 --> 00:24:02,360
+اللسان او في البخاخة في الجذب التنافسي او سطحي على
+
+248
+00:24:02,360 --> 00:24:08,660
+الجذب سواء بطيء او سريع الملال بتاعه هو absorption
+
+249
+00:24:13,610 --> 00:24:19,850
+وانا هنا جبت شكل لطيف جميل يعني بيبين حقيقة موضوع
+
+250
+00:24:19,850 --> 00:24:23,290
+ال absorption و ال distribution فمثلا يعني معظم
+
+251
+00:24:23,290 --> 00:24:28,190
+الدواء اللي يُخد يُخد عن طريق الفم يعني الإسان
+
+252
+00:24:28,190 --> 00:24:36,530
+كتير باستهون انه ياخد الدواء عن طريق الفم انه
+
+253
+00:24:36,530 --> 00:24:43,110
+ياخده حقا او تحميل او يعني طريق اخر تحت الجلب مثلا
+
+254
+00:25:01,180 --> 00:25:06,860
+اليومن of small intestine لما
+
+255
+00:25:06,860 --> 00:25:16,520
+الدواء دخل هنا كان مستهلك ذائب كالحليب والطعام
+
+256
+00:25:16,520 --> 00:25:23,120
+كذلك يعني اللي بيجي على إلماء دقيقة طاعة زي
+
+257
+00:25:23,120 --> 00:25:26,760
+اليوجينم والإليم بيجي على
+
+258
+00:25:32,830 --> 00:25:40,510
+الان بيجي هذا عن الخملات الخملات هذه يعني تراكيب
+
+259
+00:25:40,510 --> 00:25:48,190
+مايكروسكوبية مخصصة لامتصاص هذا المستحلب فإذا دخله
+
+260
+00:25:48,190 --> 00:25:53,970
+عليها فإنه يذهب إلى الدورة الدموية اقصد يذهب إلى
+
+261
+00:25:53,970 --> 00:25:57,050
+جدار الأمعاء الشعيرات اللي في جدار الأمعاء
+
+262
+00:25:57,050 --> 00:25:59,370
+الشعيرات اللي في جدار الأمعاء
+
+263
+00:26:05,390 --> 00:26:10,770
+وتجمع و ترسل الطعام إلى شيء اسمه الوريد البابى
+
+264
+00:26:10,770 --> 00:26:19,030
+portal vein هذا ال portal vein هو
+
+265
+00:26:19,030 --> 00:26:25,630
+اسمه vein لكن هو حقيقة ان هو يأخذ كل ما يأتي من
+
+266
+00:26:25,630 --> 00:26:30,950
+المعدونة معاه ياخده إلى ال liver
+
+267
+00:26:35,060 --> 00:26:41,880
+اللي بقى الحقيقة هو المصنع اللي فيه بتكون معالجة
+
+268
+00:26:41,880 --> 00:26:48,840
+مبدئية مناسبة
+
+269
+00:26:48,840 --> 00:26:59,060
+للدم ثم يقوم الكبد بدخه إلى القلب بدخه
+
+270
+00:26:59,060 --> 00:27:02,800
+إلى القلب ومن القلب
+
+271
+00:27:06,140 --> 00:27:13,960
+البطاين الأيسر فيضخه إلى الأورطة حيث يعني يبرو كل
+
+272
+00:27:13,960 --> 00:27:18,460
+خلية في الجسم وهذا اللي بنقصد فيه اللي هو ال
+
+273
+00:27:18,460 --> 00:27:23,300
+distribution يبقى مصيرش distribution إلا لما يصل
+
+274
+00:27:23,300 --> 00:27:31,000
+الكبد ويصل القلب من الأمعاق إلى البريد الفابى إلى
+
+275
+00:27:31,000 --> 00:27:37,600
+الكبد إلى القلب إلىسائر أعضاء الجسم هنا صاروا
+
+276
+00:27:37,600 --> 00:27:42,500
+distribution صاروا distribution أبو بكر صديقه اللي
+
+277
+00:27:42,500 --> 00:27:50,320
+قالوا عنه في ليلة ذهب إلى
+
+278
+00:27:50,320 --> 00:27:56,560
+البيت أو عاد إلى البيت متأخرا فوجد خادمه قد أعد له
+
+279
+00:27:56,560 --> 00:28:00,460
+طعام قال من أين؟
+
+280
+00:28:03,970 --> 00:28:08,550
+ثم سأل الخادم من أين لك هذا؟ من وين جبت الأكل؟ قال
+
+281
+00:28:08,550 --> 00:28:14,170
+من عروس بني فلان في
+
+282
+00:28:14,170 --> 00:28:22,510
+مكة فتبين أنهم مشركون لم يسلموا بعد فوضع أبو بكر
+
+283
+00:28:22,510 --> 00:28:33,040
+قصابعه في حلقه فقع وقع وقعليتخلص من طعام الجاهلية
+
+284
+00:28:33,040 --> 00:28:39,440
+اللي لم يذكر اسم الله عليه ثم قال واعتذروا اللهم
+
+285
+00:28:39,440 --> 00:28:50,760
+إليك مما حملت الأوردة أو الشرير أو العلوق فالخانين
+
+286
+00:28:50,760 --> 00:28:53,220
+يقولوا يا رحمك الله يا رحمك الله يعني هي لقمتين او
+
+287
+00:28:53,220 --> 00:28:57,020
+ثلاثة ايش يعني بدورهم؟ خليهم وروحواقال و الله لو
+
+288
+00:28:57,020 --> 00:29:03,420
+لم تخرج الطعم هذا إلا و نفسي معها لفعلت عشان ياكل
+
+289
+00:29:03,420 --> 00:29:08,940
+حلال بس عشان ياكل حلال بس أبقى صديق ما .. ماكانش
+
+290
+00:29:08,940 --> 00:29:12,310
+قرأ تشريح حد اللي احنا بنخمنهإنه جاب المصير بالـ
+
+291
+00:29:12,310 --> 00:29:18,530
+distribution في الدم لحجه من المادة، يعني المادة
+
+292
+00:29:18,530 --> 00:29:24,650
+بتودي للدم، فهو أبو بكر لحج الطعم يطلق قبل أن يصل
+
+293
+00:29:24,650 --> 00:29:29,990
+وين؟ إلى الدم، ويقول واعتذر اللهم إليك عما حملت
+
+294
+00:29:29,990 --> 00:29:37,230
+العروق، وهذه العروق قدامكوا بتشوفوها ده، طيبيبقى
+
+295
+00:29:37,230 --> 00:29:41,470
+كلمة distribution of drugs is defined as the
+
+296
+00:29:41,470 --> 00:29:46,070
+transport of a drug in body fluids from the blood
+
+297
+00:29:46,070 --> 00:29:50,370
+stream to various tissues of the body and
+
+298
+00:29:50,370 --> 00:29:55,750
+ultimately to its site of action يعني دائما احنا
+
+299
+00:29:55,750 --> 00:30:01,650
+بناخد drugs في علاج disorder او disease معين ايه
+
+300
+00:30:01,650 --> 00:30:07,740
+ال disease هذا بيكون له target site؟مثلا الناس
+
+301
+00:30:07,740 --> 00:30:14,060
+اللي عندهم مرض القلب، الناس اللي عندهم السوكريا،
+
+302
+00:30:14,060 --> 00:30:18,780
+الناس اللي عندهم اتهاب رئوي، الناس اللي عندهم
+
+303
+00:30:18,780 --> 00:30:23,580
+اتهاب النقرص وغيره،
+
+304
+00:30:23,580 --> 00:30:29,890
+هو صح بدي أقول أقراص، لكن هو فاهمهذه الأقراص سوف
+
+305
+00:30:29,890 --> 00:30:34,610
+تذهب في النهاية الى مكان ال disorder او ال disease
+
+306
+00:30:34,610 --> 00:30:41,690
+او ال pain عشان تعمل relief عشان تعمل cure شفاء
+
+307
+00:30:41,690 --> 00:30:48,930
+بإذن الله يبقى ما لم يحصل distribution لن يكون
+
+308
+00:30:48,930 --> 00:30:55,410
+هناك شفاء و الدواء مش حيث بقولي most of drugs are
+
+309
+00:30:55,410 --> 00:30:56,850
+distributed initially
+
+310
+00:31:08,040 --> 00:31:14,980
+العضو اللي فيه المرض ريتشي يعني blood supply فإن
+
+311
+00:31:14,980 --> 00:31:19,440
+كمية العلاج اللي هتتوازله تكون أكبر و العدس صحيح
+
+312
+00:31:19,440 --> 00:31:26,820
+يعني ندرم مثلا مثال في بعض المناطق في جسم الإنسان
+
+313
+00:31:26,820 --> 00:31:36,220
+هي فاتة بعض ال .. اه هي فاتة في ظهر الإنسان أول شي
+
+314
+00:31:36,220 --> 00:31:43,930
+فيه فاتةالان الفئة هذا صعبة شديد ان الدواء يصله
+
+315
+00:31:43,930 --> 00:31:49,290
+بكمية كافية لسبب ان الدهون وانت شوفته الدهون
+
+316
+00:31:49,290 --> 00:31:54,550
+الحيوانات ليس فيها اوها دموية وليس فيها دم هو اللي
+
+317
+00:31:54,550 --> 00:32:02,250
+بيحمل الدواء الى الأعضاء الدم كل مكان العضو فيه دم
+
+318
+00:32:02,250 --> 00:32:05,850
+اكتر كل مكان اصحى
+
+319
+00:32:13,540 --> 00:32:18,220
+أحنا بتتكلم الآن إن أعضاء مركزية زي القلب و زي
+
+320
+00:32:18,220 --> 00:32:26,600
+الكبل و زي المعدة أو زي ال kidney فيها دم كافي
+
+321
+00:32:26,600 --> 00:32:30,220
+التوزيع بيصير له أسرع delivery of drugs to
+
+322
+00:32:30,220 --> 00:32:36,840
+extremities extremities يعني الأعطراف يعني مثلا ال
+
+323
+00:32:36,840 --> 00:32:39,900
+hand extremity ال food extremity
+
+324
+00:32:42,700 --> 00:32:47,720
+ولا الـ skin ولا الـ adipose tissue الفات هو أصعب
+
+325
+00:32:47,720 --> 00:32:55,020
+بسبب مصالح دم ضعيف مصالح دم ضعيف في مناطق في الجلب
+
+326
+00:32:55,020 --> 00:33:03,600
+في القدر مثلا شفاء صعب بس صالح دم ضعيف الـ
+
+327
+00:33:03,600 --> 00:33:07,380
+distribution phase can be extremely slow for drugs
+
+328
+00:33:07,380 --> 00:33:10,820
+that bind strongly to serum proteins هذه القضية
+
+329
+00:33:10,820 --> 00:33:11,200
+الأخرى
+
+330
+00:33:17,680 --> 00:33:22,060
+وبيعمل معها compound، و ال compound هذا حجم كبير،
+
+331
+00:33:22,060 --> 00:33:27,740
+هل صعب إنه يلف الدم و يروح على الخلايا؟ صعب، إلا
+
+332
+00:33:27,740 --> 00:33:33,400
+لما يفضل بروتين الدم يطلق ما لديه من أشرة، يعني
+
+333
+00:33:33,400 --> 00:33:38,780
+بروتين الدم بيأثر بعض الأجوية، مش كل الأجوية، فإن
+
+334
+00:33:38,780 --> 00:33:43,730
+أثرها، فإن أثرها الآن هيتأخراحنا عندنا في العين
+
+335
+00:33:43,730 --> 00:33:51,070
+المثال الصارخ اللي هو ال .. ال .. ال .. ال ..
+
+336
+00:33:51,070 --> 00:33:55,750
+الموسيعات العينية زي المدرامايت مدرامايت مدرامايت
+
+337
+00:33:55,750 --> 00:33:55,970
+مدرامايت مدرامايت مدرامايت مدرامايت مدرامايت
+
+338
+00:33:55,970 --> 00:33:55,990
+مدرامايت مدرامايت مدرامايت مدرامايت مدرامايت
+
+339
+00:33:55,990 --> 00:33:56,070
+مدرامايت مدرامايت مدرامايت مدرامايت مدرامايت
+
+340
+00:33:56,070 --> 00:33:56,330
+مدرامايت مدرامايت مدرامايت مدرامايت مدرامايت
+
+341
+00:33:56,330 --> 00:34:11,590
+مدرامايت مدرامايت مدرامايت مدرام
+
+342
+00:34:13,500 --> 00:34:18,600
+will be dilated within minutes بينما a darkly
+
+343
+00:34:18,600 --> 00:34:23,440
+colored iris
+
+344
+00:34:23,440 --> 00:34:28,380
+will take long time ممكن one hour or more to be
+
+345
+00:34:28,380 --> 00:34:36,520
+fully dilated طيب انا
+
+346
+00:34:36,520 --> 00:34:41,100
+هنا برضه حاولت اجيبلكم هاي ال oral administration
+
+347
+00:34:41,100 --> 00:34:46,100
+من الفهمو نزل اللي هو الدواء إلى الأمعاء و بعد
+
+348
+00:34:46,100 --> 00:34:54,440
+الأمعاء ذهب إلى اللي هو الدم برغم عندي محلول هايو
+
+349
+00:34:54,440 --> 00:35:00,720
+واحد مركز محلول هايو و راح على الوريد راع الدم
+
+350
+00:35:00,720 --> 00:35:09,720
+يعني هذه أمثلة كيف الدواء لازم في النهاية يذهب إلى
+
+351
+00:35:09,720 --> 00:35:10,700
+اللي هو الدم
+
+352
+00:35:17,660 --> 00:35:23,420
+في شيء اسمه distribution barriers برياز حواجز في
+
+353
+00:35:23,420 --> 00:35:31,260
+حواجز في الجسم تحول دول مروح الدم لبعض الأعضاء
+
+354
+00:35:31,260 --> 00:35:35,440
+الحاجز
+
+355
+00:35:35,440 --> 00:35:42,080
+الأول blood brain barrier بيقولك انه يعني ما بين
+
+356
+00:35:42,080 --> 00:35:44,540
+الدم و ما بين المخ
+
+357
+00:35:47,980 --> 00:35:57,020
+اسمه blood brain barrier هذا خلطر يمنع
+
+358
+00:35:57,020 --> 00:36:03,860
+دخول الدواء إلىه
+
+359
+00:36:03,860 --> 00:36:09,860
+يبقى special anatomic arrangement هو ترتيب تشريح
+
+360
+00:36:09,860 --> 00:36:15,280
+معين that aims to distribute only lipid soluble
+
+361
+00:36:15,280 --> 00:36:21,630
+drugsالتي تدوب في الدهون تعبر من هذا ال variable
+
+362
+00:36:21,630 --> 00:36:25,670
+أو ال filter أما الأدوية التي تدوب في الماء فلا
+
+363
+00:36:25,670 --> 00:36:31,170
+تدخل فلا تدخل حتى لو كان ال brain المخ في حاجة
+
+364
+00:36:31,170 --> 00:36:38,270
+إليها فبقول مثلا ال general anesthesia هي أدوية
+
+365
+00:36:38,270 --> 00:36:42,610
+مائية صعب أن تدخل المخ عشان هيك ال general
+
+366
+00:36:42,610 --> 00:36:43,890
+anesthesia بنعطيها وين؟
+
+367
+00:36:49,120 --> 00:36:54,540
+الدروس اللي هم مياه مقصدة ومقصدة مقصدة في الحقيقة
+
+368
+00:36:54,540 --> 00:36:59,980
+ممنعها من دخول بسهولة للعقل بسهولة للدخول بسهولة
+
+369
+00:36:59,980 --> 00:37:09,240
+للعقل انا
+
+370
+00:37:09,240 --> 00:37:11,460
+هنا جاي صورة
+
+371
+00:37:26,820 --> 00:37:36,280
+junction شايفين كيف الفلتر هنا؟ كيف هنا؟ tight بس
+
+372
+00:37:36,280 --> 00:37:41,920
+ماهش بسهولة لدخول الأدوية المائية، اه بينما
+
+373
+00:37:41,920 --> 00:37:47,680
+الأدوية اللي هو دهنية سهلة انها تدخل
+
+374
+00:37:58,110 --> 00:38:03,090
+blood brain barrier الحاجات الدهنية زي هذه تدخل
+
+375
+00:38:03,090 --> 00:38:09,490
+بأسهل من اللاجوية المائية طيب ال antifortics
+
+376
+00:38:09,490 --> 00:38:13,250
+مضادات حيوية that cross the blood brain barrier
+
+377
+00:38:13,250 --> 00:38:17,530
+difficulty can't be used for treatment of central
+
+378
+00:38:17,530 --> 00:38:22,310
+nervous system يبقى صح لو واحد عنده تهيبط في المخ
+
+379
+00:38:22,310 --> 00:38:29,980
+أو عنده سحاية تهيبط السحايةأنا بجد أعطيه مضادات
+
+380
+00:38:29,980 --> 00:38:36,860
+حيوية تدوب في الماء، يبقى أعطيه تدوب في الدهون، يا
+
+381
+00:38:36,860 --> 00:38:41,680
+إما أحقله المضادات الحيوية في الـ Cerebral Spinal
+
+382
+00:38:41,680 --> 00:38:49,420
+Fluid في ذهبه، يعني إن أنا أخد الدماء في الـ
+
+383
+00:38:49,420 --> 00:38:54,300
+Cerebral Spinal Fluid، مش في النخاء، طبعا، هو واضح
+
+384
+00:38:54,300 --> 00:39:00,760
+إنه في عند الديورة متروعندي arachnoid matter وعندي
+
+385
+00:39:00,760 --> 00:39:06,380
+pyramid بين الـ pyra و ال arachnoid في حالة اسمها
+
+386
+00:39:06,380 --> 00:39:11,020
+subarachnoid space وهذا subarachnoid space هو اللي
+
+387
+00:39:11,020 --> 00:39:15,740
+في دورة السبلوسبانفلون من المخ و من نخها الشوكة من
+
+388
+00:39:15,740 --> 00:39:23,580
+المخ و من نخها الشوكة فلو انا اضرب حقنة فيها مضارة
+
+389
+00:39:23,580 --> 00:39:27,220
+حيوي مائي بضرب في الظهر
+
+390
+00:39:40,330 --> 00:39:45,630
+بيدخل ويحط في سن الإبرة ويشيل ال thread لما ينقط
+
+391
+00:39:45,630 --> 00:39:47,830
+ال silver spinal fluid لما يبدأ ينقط ال silver
+
+392
+00:39:47,830 --> 00:39:52,870
+spinal fluid ينقص الإبرة وين؟ في ال subarachnoid
+
+393
+00:39:52,870 --> 00:39:59,630
+spaces بحط الدور بتاعي في سن الإبرة و بروح ايش؟
+
+394
+00:39:59,630 --> 00:40:05,750
+داربه، بيلفيعني انا بعمل bypass لل blood brain
+
+395
+00:40:05,750 --> 00:40:12,370
+barrier بعمل bypass أي متجاوزه اتجاوز اللي هو ال
+
+396
+00:40:12,370 --> 00:40:17,670
+barrier بالحقن المباشر اتجاوز ال barrier بالحقن
+
+397
+00:40:17,670 --> 00:40:25,010
+المباشر فقول هنا the installation of water soluble
+
+398
+00:40:25,010 --> 00:40:30,230
+drugsIntraphically ومعنى انترافيكالي قاى في الـ
+
+399
+00:40:30,230 --> 00:40:33,230
+cerebrospinal في الـ subarachnoid space
+
+400
+00:40:33,230 --> 00:40:37,650
+Intraphical وين يعني؟ subarachnoid space وين
+
+401
+00:40:37,650 --> 00:40:40,730
+السائل بيلفه، أحطه في السائل، على طول الدواء وإن
+
+402
+00:40:40,730 --> 00:40:45,170
+كان باقي، فإن .. فإنه سوف يتجاوز إيش؟ ال barrier
+
+403
+00:40:45,170 --> 00:40:49,290
+is a .. is done to bypass the blood brain barrier
+
+404
+00:40:49,290 --> 00:40:53,970
+and provides different او direct effect يعني أثر
+
+405
+00:40:53,970 --> 00:40:55,110
+علاجي against
+
+406
+00:40:57,630 --> 00:41:01,950
+فمع المعارض التهيأب في الصحية وضعه صعب جدا، لا
+
+407
+00:41:01,950 --> 00:41:05,790
+بيقدرش ياخد أقراس وكلام زي هذا، مافيش إلا نلحقه في
+
+408
+00:41:05,790 --> 00:41:11,890
+أسرع لقت في الحُقن هذه طيب، في شيء اسمه placental
+
+409
+00:41:11,890 --> 00:41:16,830
+blood barrier، معروف يا بناتي أن الـ placenta هي
+
+410
+00:41:16,830 --> 00:41:22,890
+تركيب الله سبحانه وتعالى بيخلقه في جدار الرحم، ما
+
+411
+00:41:22,890 --> 00:41:28,380
+بين الأم الحامل وبين الجنين اللي تكوّناسمها
+
+412
+00:41:28,380 --> 00:41:34,360
+placenta أو المشيمة فالان
+
+413
+00:41:34,360 --> 00:41:40,620
+لو الأم ريدا ببعض الأمراض او بتاعة بعض الأدوية فإن
+
+414
+00:41:40,620 --> 00:41:47,280
+هذا ال barrier قد يحول اقول أنا قد يحول بين دخول
+
+415
+00:41:47,280 --> 00:41:54,260
+ال micro أو الدواء الظهر إلى الجنين لكن مش دائما
+
+416
+00:41:55,620 --> 00:42:00,880
+ثبت إن الـ placental brain barrier أقل تخصوصية و
+
+417
+00:42:00,880 --> 00:42:06,160
+أقل منع من الـ blood brain barrier يعني ممكن
+
+418
+00:42:06,160 --> 00:42:11,600
+يصيروا بعض الاختراف، بعض الاختراف فبقولّي الـ
+
+419
+00:42:11,600 --> 00:42:15,460
+membrane is a membrane layer that separates the
+
+420
+00:42:15,460 --> 00:42:18,200
+blood vessels of the mother from the blood vessels
+
+421
+00:42:18,200 --> 00:42:24,150
+of the fetusUnlike blood brain barrier, the non
+
+422
+00:42:24,150 --> 00:42:27,630
+selective passage of drugs across the placenta to
+
+423
+00:42:27,630 --> 00:42:31,890
+the fetus is well established.الآن يعني معروف انه
+
+424
+00:42:31,890 --> 00:42:35,290
+ال .. ال .. ال placental brain barrier ينفل بعض
+
+425
+00:42:35,290 --> 00:42:40,370
+الأشياء و يمنع بعض الأشياء فمثلا فيروس ال AIDS
+
+426
+00:42:40,370 --> 00:42:46,570
+بيدخل مثلا فيروس الحصب الألمانية German measles
+
+427
+00:42:46,570 --> 00:42:49,410
+بيدخل و الملاريا مثلا بتدخل
+
+428
+00:42:53,270 --> 00:42:56,610
+خاصة البكتيريا، لكن كمان الأدية لا ممنع، اللي هو
+
+429
+00:42:56,610 --> 00:43:02,470
+الدواء، يعني ست مثلا مدخن، ست مثلا بتاخد
+
+430
+00:43:02,470 --> 00:43:06,050
+بايكلوفونات سوديوم باستمرار عشان مفاصلها، وهي مش
+
+431
+00:43:06,050 --> 00:43:11,590
+دارية، بتشوّه الجنين بفعل جهل الأم في المحافظة
+
+432
+00:43:17,040 --> 00:43:22,620
+يبقى هي ال barriers اللي هي بتحول دول دخول الدواء
+
+433
+00:43:22,620 --> 00:43:28,820
+إلى اللي هو بعض اللي هو التراكيب
+
+434
+00:43:28,820 --> 00:43:31,940
+في الجسم أو الواخرز في الجسم اللي هي في ال brain و
+
+435
+00:43:31,940 --> 00:43:36,320
+في ال fetus طيب
+
+436
+00:43:36,320 --> 00:43:43,680
+يتعلق بال placenta دخول الأدوية دخول الأدوية خطير
+
+437
+00:43:43,680 --> 00:43:46,400
+جدا من الأم
+
+438
+00:43:49,710 --> 00:43:54,070
+خاصة في ال first trimester
+
+439
+00:44:05,210 --> 00:44:10,190
+لأنه ممكن أن الدواء يدخل في تركيب الطفل ويعمل
+
+440
+00:44:10,190 --> 00:44:15,850
+تشويه اسمه teratogenic effects والأدوية اسمها
+
+441
+00:44:15,850 --> 00:44:19,810
+teratogenic drugs which are defined as agents that
+
+442
+00:44:19,810 --> 00:44:22,550
+cause physical effects in developing embryo
+
+443
+00:44:33,830 --> 00:44:40,210
+تشويف الأعضاء كثير اللي هو ال malformations هذا
+
+444
+00:44:40,210 --> 00:44:44,750
+بيكون بسبب جهل الأم في تنام الدواء في اللي هو
+
+445
+00:44:44,750 --> 00:44:50,290
+الجزء الأول من الحمض في بعض الأطباء بيمنع الأم
+
+446
+00:44:50,290 --> 00:44:54,730
+تاخد أي نوع من العلاج حتى البيتامين حتى البيتامين
+
+447
+00:44:54,730 --> 00:45:00,630
+لكن في بعض الأطباء يتهاونفي بعض البيتامينات
+
+448
+00:45:00,630 --> 00:45:06,150
+والحديد والمقوية لأن الأم بصير عندها نوع من ال
+
+449
+00:45:06,150 --> 00:45:10,490
+anorexia اللي هو فقد الشهيريعني بيعطيها أشياء
+
+450
+00:45:10,490 --> 00:45:14,750
+محددة، لكن إنه تاخد أسبرين أو تاخد دايكلفين أو
+
+451
+00:45:14,750 --> 00:45:20,170
+تاخد أكامور أو تاخد يعني هذه الأجوية الشديدة ممكن
+
+452
+00:45:20,170 --> 00:45:25,410
+تشول الجنة بيقول لي في النصف التاني من الحمل،
+
+453
+00:45:25,410 --> 00:45:30,680
+الواضح أحسن، لكن على الأم ألا تاخد دواءيعني بجوعات
+
+454
+00:45:30,680 --> 00:45:36,720
+كبيرة لأنه ممكن هنا ان الطفل او الجنيل بدأ فيه
+
+455
+00:45:36,720 --> 00:45:40,140
+الحياة و بدأ يتنفس فممكن يصله respiratory
+
+456
+00:45:40,140 --> 00:45:47,780
+depression او من الفشل للتنفس و ممكن يموت في البطن
+
+457
+00:45:47,780 --> 00:45:52,820
+اذا كان الأم تنفست من غازات او ابخرة او قطر
+
+458
+00:45:52,820 --> 00:46:00,140
+كحوليات او tobaccoأو أقراس بجوعات كبيرة فإنها قد
+
+459
+00:46:00,140 --> 00:46:05,300
+تقضي على جلينها، لذلك الأفضل تقليص أي نوع من
+
+460
+00:46:05,300 --> 00:46:10,720
+الأدوية خلال فترة الحملحرف المرأة على جارينها.
+
+461
+00:46:11,040 --> 00:46:16,400
+احنا هيك الحمد لله في هذا اليوم أنجزنا يعني الفد
+
+462
+00:46:16,400 --> 00:46:22,720
+الأول اللي هو ال absorption of drugs و الفد التاني
+
+463
+00:46:22,720 --> 00:46:26,720
+اللي هو metabolism of drugs و ان شاء الله يعني ال
+
+464
+00:46:26,720 --> 00:46:30,260
+distribution of drugs و المرة الجاية ان شاء الله
+
+465
+00:46:30,260 --> 00:46:34,200
+هنبدأ بال metabolism of drugs شكرا لكم على قصتنا
+
+466
+00:46:34,200 --> 00:46:36,940
+الاستماع و السلام عليكم و رحمة الله و ببركاته
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/rKh8uPCUfw8_raw.json b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/rKh8uPCUfw8_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..8627ac90b56bf4aacc0dcf2f99b773a2497e88d3
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/rKh8uPCUfw8_raw.json
@@ -0,0 +1 @@
+{"segments": [{"id": 1, "seek": 4817, "start": 20.75, "end": 48.17, "text": "بسم الله الرحمن الرحيم الحمد لله وكفا واصلي واسلم على نبي المصطفى في هذا اليوم ان شاء الله سنبدأ chapter 2 في drug absorption, distribution, metabolism and excretion في امتصاص الدواء وفي توزيع الدواء وفي التمثيل الغذائي للدواء وفي إخراج الدواء من الجسم وسنبدأ ان شاء الله بال absorption", "tokens": [3555, 38251, 21984, 34892, 5016, 27842, 34892, 5016, 32640, 21542, 2304, 3215, 24976, 3224, 4032, 4117, 5172, 995, 4032, 33546, 20292, 4032, 32277, 19528, 15844, 8717, 21292, 9673, 9381, 9566, 5172, 7578, 8978, 23758, 45595, 20498, 16472, 13412, 16606, 21984, 8608, 1863, 44510, 10721, 7187, 568, 8978, 4110, 27557, 11, 7316, 11, 31190, 293, 1624, 1505, 313, 8978, 1975, 2304, 2655, 9381, 33546, 32748, 2407, 16606, 4032, 41185, 33427, 11622, 40228, 32748, 2407, 16606, 4032, 41185, 16712, 2304, 12984, 26895, 6024, 118, 8848, 16373, 1829, 24976, 3215, 2407, 16606, 4032, 41185, 11933, 34740, 26108, 32748, 2407, 16606, 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على", "probability": 0.8466796875}, {"start": 24.27, "end": 24.45, "word": " نبي", "probability": 0.806640625}, {"start": 24.45, "end": 24.95, "word": " المصطفى", "probability": 0.93974609375}, {"start": 24.95, "end": 26.21, "word": " في", "probability": 0.84716796875}, {"start": 26.21, "end": 26.47, "word": " هذا", "probability": 0.9052734375}, {"start": 26.47, "end": 26.79, "word": " اليوم", "probability": 0.970947265625}, {"start": 26.79, "end": 26.99, "word": " ان", "probability": 0.60302734375}, {"start": 26.99, "end": 27.13, "word": " شاء", "probability": 0.982666015625}, {"start": 27.13, "end": 27.29, "word": " الله", "probability": 0.9521484375}, {"start": 27.29, "end": 28.09, "word": " سنبدأ", "probability": 0.975341796875}, {"start": 28.09, "end": 29.47, "word": " chapter", "probability": 0.398193359375}, {"start": 29.47, "end": 30.15, "word": " 2", "probability": 0.4814453125}, {"start": 30.15, "end": 31.65, "word": " في", "probability": 0.8876953125}, {"start": 31.65, 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"probability": 0.9189453125}, {"start": 107.6, "end": 108.46, "word": " distribution", "probability": 0.60205078125}, {"start": 108.46, "end": 109.08, "word": " metabolism", "probability": 0.88623046875}, {"start": 109.08, "end": 109.64, "word": " execution", "probability": 0.47119140625}], "temperature": 1.0}, {"id": 4, "seek": 13885, "start": 110.29, "end": 138.85, "text": "يعني ال absorption is very important for other steps if no absorption, no distribution if no absorption, no metabolism if no absorption, no secretion يعني هو الأساس في العمل يقولها ال absorption absorption varies according يعني يختلف من إنسان لإنسان according to three factors", "tokens": [40228, 22653, 2423, 27557, 307, 588, 1021, 337, 661, 4439, 498, 572, 27557, 11, 572, 7316, 498, 572, 27557, 11, 572, 31190, 498, 572, 27557, 11, 572, 4054, 313, 37495, 22653, 31439, 16247, 3794, 32277, 8978, 18863, 42213, 7251, 39648, 11296, 2423, 27557, 27557, 21716, 4650, 37495, 22653, 7251, 46456, 46538, 9154, 36145, 3794, 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"probability": 0.743408203125}, {"start": 434.49, "end": 434.83, "word": " مثل", "probability": 0.91259765625}, {"start": 434.83, "end": 438.35, "word": " احنا", "probability": 0.7471110026041666}, {"start": 438.35, "end": 439.43, "word": " ضربنا", "probability": 0.89990234375}, {"start": 439.43, "end": 440.01, "word": " خجلنا", "probability": 0.4822998046875}, {"start": 440.01, "end": 440.33, "word": " في", "probability": 0.97607421875}, {"start": 440.33, "end": 440.59, "word": " واحد", "probability": 0.983642578125}, {"start": 440.59, "end": 441.49, "word": " أوبيس", "probability": 0.6730143229166666}, {"start": 441.49, "end": 442.25, "word": " تحت", "probability": 0.99658203125}, {"start": 442.25, "end": 442.71, "word": " الجلد", "probability": 0.8136393229166666}], "temperature": 1.0}, {"id": 15, "seek": 47741, "start": 453.73, "end": 477.41, "text": "بينما احنا ضربنا في العضل واحد ثاني على طول ماشية ليش؟ لأنه العضل ريشي in blood vessels بينما اللي قد يبوستش هو أوي فاق poor in blood vessels حسنا، هذا يعني واضح، الحكاية اللي هو ال blood vessels", "tokens": [3555, 9957, 15042, 1975, 5016, 8315, 48812, 25513, 8315, 8978, 18863, 11242, 1211, 36764, 24401, 38637, 7649, 1829, 15844, 23032, 12610, 3714, 33599, 10632, 32239, 8592, 22807, 5296, 33456, 3224, 18863, 11242, 1211, 12602, 1829, 8592, 1829, 294, 3390, 20117, 49374, 15042, 13672, 1829, 12174, 3215, 7251, 3555, 2407, 14851, 8592, 31439, 34051, 1829, 6156, 995, 4587, 4716, 294, 3390, 20117, 11331, 3794, 8315, 12399, 23758, 37495, 22653, 4032, 46958, 5016, 12399, 21542, 4117, 995, 10632, 13672, 1829, 31439, 2423, 3390, 20117], "avg_logprob": -0.3045933627220522, "compression_ratio": 1.6702702702702703, "no_speech_prob": 0.0, "words": [{"start": 453.73, "end": 454.11, "word": "بينما", "probability": 0.8543294270833334}, {"start": 454.11, "end": 454.47, "word": " احنا", "probability": 0.8759765625}, {"start": 454.47, "end": 454.87, "word": " ضربنا", "probability": 0.96630859375}, {"start": 454.87, "end": 454.99, 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blood", "probability": 0.96826171875}, {"start": 466.05, "end": 466.41, "word": " vessels", "probability": 0.8515625}, {"start": 466.41, "end": 467.17, "word": " بينما", "probability": 0.847412109375}, {"start": 467.17, "end": 467.85, "word": " اللي", "probability": 0.778076171875}, {"start": 467.85, "end": 467.97, "word": " قد", "probability": 0.4632568359375}, {"start": 467.97, "end": 468.45, "word": " يبوستش", "probability": 0.8341796875}, {"start": 468.45, "end": 468.53, "word": " هو", "probability": 0.472900390625}, {"start": 468.53, "end": 468.77, "word": " أوي", "probability": 0.3255615234375}, {"start": 468.77, "end": 469.51, "word": " فاق", "probability": 0.7526041666666666}, {"start": 469.51, "end": 470.11, "word": " poor", "probability": 0.94970703125}, {"start": 470.11, "end": 470.81, "word": " in", "probability": 0.97021484375}, {"start": 470.81, "end": 471.17, "word": " blood", "probability": 0.953125}, {"start": 471.17, "end": 471.79, "word": " vessels", "probability": 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كابسولة ميجبش في المعدة و اروح على الاثنى عشر و اروح على الأمعاء الدقيقة زي احنا بتكلمنا قبلها لكن الدواء اللي وسطه حامضي انا بعطيه مرخف من موضوع المعدة", "tokens": [45340, 3615, 41891, 29538, 21542, 6027, 3660, 25062, 1211, 2407, 10632, 6225, 8592, 7649, 4117, 1975, 8315, 45164, 1975, 8315, 4724, 16254, 1975, 3615, 9566, 1829, 12174, 1211, 45865, 5296, 31377, 2304, 1975, 29247, 5296, 31377, 2304, 1975, 25957, 1211, 9122, 16758, 3794, 12610, 3660, 3714, 1829, 7435, 3555, 8592, 8978, 9673, 3615, 41891, 4032, 1975, 32887, 5016, 15844, 2423, 5718, 104, 1863, 7578, 6225, 46309, 4032, 1975, 32887, 5016, 15844, 16247, 2304, 3615, 16606, 32748, 38436, 28671, 30767, 1829, 1975, 5016, 8315, 39894, 4117, 19528, 8315, 12174, 36150, 11296, 44381, 32748, 2407, 16606, 13672, 1829, 46952, 9566, 3224, 11331, 10943, 11242, 1829, 1975, 8315, 4724, 3615, 9566, 1829, 3224, 3714, 2288, 9778, 5172, 9154, 3714, 2407, 11242, 45367, 9673, 3615, 41891], "avg_logprob": -0.24657011807449464, "compression_ratio": 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لا يدوب في الماء، يستطيع ان يدخل عبر الخملات في الماء الدقيقة بسهولة، هو اللي ده ionized water soluble", "tokens": [1829, 44510, 10721, 16472, 17437, 1602, 13672, 1829, 32767, 7251, 39237, 6055, 5016, 20292, 43761, 1975, 2407, 6055, 4117, 3794, 13546, 3224, 8978, 9673, 16606, 11778, 3224, 12399, 1975, 3224, 37037, 2407, 20193, 7251, 3215, 37746, 8978, 9673, 16606, 12399, 7251, 14851, 9566, 40228, 16472, 7251, 3215, 9778, 1211, 6225, 26890, 33962, 42213, 9307, 8978, 9673, 16606, 32748, 38436, 28671, 4724, 3794, 3224, 12610, 3660, 12399, 31439, 13672, 1829, 11778, 3224, 17437, 1602, 1281, 24807, 638], "avg_logprob": -0.1955154189815769, "compression_ratio": 1.5953757225433527, "no_speech_prob": 0.0, "words": [{"start": 932.48, "end": 932.92, "word": "يبدأ", "probability": 0.7550455729166666}, {"start": 932.92, "end": 933.1, "word": " ان", "probability": 0.290283203125}, {"start": 933.1, "end": 933.74, "word": " ionized", "probability": 0.52880859375}, {"start": 933.74, "end": 934.38, 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"seek": 251426, "start": 2487.96, "end": 2514.26, "text": "اسمها placenta أو المشيمة فالان لو الأم ريدا ببعض الأمراض او بتاعة بعض الأدوية فإن هذا ال barrier قد يحول اقول أنا قد يحول بين دخول ال micro أو الدواء الظهر إلى الجنين لكن مش دائما", "tokens": [32277, 2304, 11296, 20831, 8938, 34051, 9673, 8592, 32640, 3660, 6156, 6027, 7649, 45164, 16247, 2304, 12602, 25708, 995, 4724, 3555, 3615, 11242, 16247, 29973, 46958, 1975, 2407, 39894, 995, 27884, 45030, 11242, 16247, 3215, 2407, 10632, 6156, 28814, 1863, 23758, 2423, 13357, 12174, 3215, 7251, 5016, 12610, 1975, 39648, 41850, 12174, 3215, 7251, 5016, 12610, 49374, 11778, 9778, 12610, 2423, 4532, 34051, 32748, 2407, 16606, 6024, 116, 3224, 2288, 30731, 25724, 1863, 9957, 44381, 37893, 11778, 16373, 15042], "avg_logprob": -0.2681640710681677, "compression_ratio": 1.6397849462365592, "no_speech_prob": 0.0, "words": [{"start": 2487.96, "end": 2488.38, "word": "اسمها", "probability": 0.7630208333333334}, {"start": 2488.38, "end": 2488.88, 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او ابخرة او قطر كحوليات او tobacco", "tokens": [40228, 22653, 4724, 7435, 45367, 9307, 9122, 3555, 48923, 5296, 33456, 3224, 3714, 43020, 34105, 16472, 41950, 5172, 1211, 1975, 2407, 25724, 22653, 1211, 47525, 10721, 8978, 3224, 21542, 25528, 3660, 4032, 47525, 10721, 7251, 2655, 1863, 36178, 6156, 2304, 43020, 7251, 36520, 3224, 27038, 10799, 1975, 2407, 9154, 27188, 8592, 1211, 24976, 2655, 1863, 36178, 4032, 3714, 43020, 7251, 2304, 35473, 8978, 29739, 9566, 1863, 1975, 15730, 25961, 16247, 2304, 6055, 1863, 36178, 2655, 9154, 32771, 31377, 9307, 1975, 2407, 48127, 9778, 25720, 1975, 2407, 12174, 9566, 2288, 9122, 5016, 12610, 1829, 9307, 1975, 2407, 22994], "avg_logprob": -0.2158801056900803, "compression_ratio": 1.6854460093896713, "no_speech_prob": 0.0, "words": [{"start": 2729.72, "end": 2730.18, "word": "يعني", "probability": 0.761962890625}, {"start": 2730.18, "end": 2730.68, "word": " بجوعات", "probability": 0.7840576171875}, {"start": 2730.68, "end": 2731.26, "word": " 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2775.8, "end": 2776.4, "word": " الفد", "probability": 0.4263916015625}, {"start": 2776.4, "end": 2776.96, "word": " الأول", "probability": 0.89794921875}, {"start": 2776.96, "end": 2777.82, "word": " اللي", "probability": 0.972900390625}, {"start": 2777.82, "end": 2778.14, "word": " هو", "probability": 0.994140625}, {"start": 2778.14, "end": 2778.68, "word": " ال", "probability": 0.9755859375}, {"start": 2778.68, "end": 2780.22, "word": " absorption", "probability": 0.701171875}, {"start": 2780.22, "end": 2780.98, "word": " of", "probability": 0.97509765625}, {"start": 2780.98, "end": 2781.38, "word": " drugs", "probability": 0.89697265625}, {"start": 2781.38, "end": 2781.98, "word": " و", "probability": 0.330322265625}, {"start": 2781.98, "end": 2782.26, "word": " الفد", "probability": 0.97802734375}, {"start": 2782.26, "end": 2782.72, "word": " التاني", "probability": 0.9518229166666666}, {"start": 2782.72, "end": 2782.92, "word": " اللي", "probability": 0.988037109375}, {"start": 2782.92, "end": 2783.02, "word": " هو", "probability": 0.9912109375}, {"start": 2783.02, "end": 2783.44, "word": " metabolism", "probability": 0.88720703125}, {"start": 2783.44, "end": 2783.96, "word": " of", "probability": 0.97412109375}, {"start": 2783.96, "end": 2784.32, "word": " drugs", "probability": 0.88623046875}, {"start": 2784.32, "end": 2784.84, "word": " و", "probability": 0.919921875}, {"start": 2784.84, "end": 2784.92, "word": " ان", "probability": 0.64697265625}, {"start": 2784.92, "end": 2785.1, "word": " شاء", "probability": 0.982177734375}, {"start": 2785.1, "end": 2785.28, "word": " الله", "probability": 0.95947265625}, {"start": 2785.28, "end": 2786.28, "word": " يعني", "probability": 0.9765625}, {"start": 2786.28, "end": 2786.72, "word": " ال", "probability": 0.96826171875}, {"start": 2786.72, "end": 2787.76, "word": " distribution", "probability": 0.544921875}, {"start": 2787.76, "end": 2788.0, "word": " of", "probability": 0.984375}, {"start": 2788.0, "end": 2788.34, "word": " drugs", "probability": 0.85205078125}, {"start": 2788.34, "end": 2788.86, "word": " و", "probability": 0.76611328125}, {"start": 2788.86, "end": 2789.32, "word": " المرة", "probability": 0.972412109375}, {"start": 2789.32, "end": 2789.86, "word": " الجاية", "probability": 0.9391276041666666}, {"start": 2789.86, "end": 2790.04, "word": " ان", "probability": 0.859375}, {"start": 2790.04, "end": 2790.16, "word": " شاء", "probability": 0.9931640625}, {"start": 2790.16, "end": 2790.26, "word": " الله", "probability": 0.9580078125}, {"start": 2790.26, "end": 2790.84, "word": " هنبدأ", "probability": 0.966552734375}, {"start": 2790.84, "end": 2791.1, "word": " بال", "probability": 0.427490234375}, {"start": 2791.1, "end": 2791.56, "word": " metabolism", "probability": 0.59765625}, {"start": 2791.56, "end": 2792.58, "word": " of", "probability": 0.9716796875}, {"start": 2792.58, "end": 2792.98, "word": " drugs", "probability": 0.89404296875}, {"start": 2792.98, "end": 2793.32, "word": " شكرا", "probability": 0.9197591145833334}, {"start": 2793.32, "end": 2793.62, "word": " لكم", "probability": 0.916259765625}, {"start": 2793.62, "end": 2793.9, "word": " على", "probability": 0.72265625}, {"start": 2793.9, "end": 2794.2, "word": " قصتنا", "probability": 0.7841796875}, {"start": 2794.2, "end": 2794.72, "word": " الاستماع", "probability": 0.8311767578125}, {"start": 2794.72, "end": 2795.06, "word": " و", "probability": 0.568359375}, {"start": 2795.06, "end": 2795.26, "word": " السلام", "probability": 0.96630859375}, {"start": 2795.26, "end": 2795.76, "word": " عليكم", "probability": 0.950439453125}, {"start": 2795.76, "end": 2796.1, "word": " و", "probability": 0.91259765625}, {"start": 2796.1, "end": 2796.32, "word": " رحمة", "probability": 0.94091796875}, {"start": 2796.32, "end": 2796.46, "word": " الله", "probability": 0.97265625}, {"start": 2796.46, "end": 2796.58, "word": " و", "probability": 0.888671875}, {"start": 2796.58, "end": 2796.94, 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\ No newline at end of file
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/rKh8uPCUfw8_raw.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/rKh8uPCUfw8_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..2064b71f34749396268ce09f4c2944820d65f7a8
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/rKh8uPCUfw8_raw.srt
@@ -0,0 +1,1876 @@
+1
+00:00:20,750 --> 00:00:24,090
+بسم الله الرحمن الرحيم الحمد لله وكفا واصلي واسلم
+
+2
+00:00:24,090 --> 00:00:28,090
+على نبي المصطفى في هذا اليوم ان شاء الله سنبدأ
+
+3
+00:00:28,090 --> 00:00:33,770
+chapter 2 في drug absorption, distribution,
+
+4
+00:00:34,270 --> 00:00:40,010
+metabolism and excretion في امتصاص الدواء وفي
+
+5
+00:00:40,010 --> 00:00:45,090
+توزيع الدواء وفي التمثيل الغذائي للدواء وفي إخراج
+
+6
+00:00:45,090 --> 00:00:48,170
+الدواء من الجسم وسنبدأ ان شاء الله بال absorption
+
+7
+00:00:49,980 --> 00:00:55,600
+absorption is defined as the process that involves
+
+8
+00:00:55,600 --> 00:00:59,440
+the movement of the drug molecules from the site
+
+9
+00:00:59,440 --> 00:01:05,460
+of entry into the body to the secretion of blood
+
+10
+00:01:05,460 --> 00:01:12,420
+or body fluids to be distributed يعني تحرك الدواء
+
+11
+00:01:12,420 --> 00:01:18,000
+من مكان إعطائه نحو الدورة الدموية كي يوزع
+
+12
+00:01:20,800 --> 00:01:26,720
+الprocess of absorption بدا في مكان إعطائي الدواء،
+
+13
+00:01:26,720 --> 00:01:32,340
+إعطائي الحكمة يعني هيبدأ من العضلة، إعطائي الوريد
+
+14
+00:01:32,340 --> 00:01:35,740
+هيبدأ من الوريد، إعطائي التحميلة هيبدأ من مكان
+
+15
+00:01:35,740 --> 00:01:42,460
+التحميلة، إعطائي الفم هيبدأ من القمعة، هيبدأ
+
+16
+00:01:42,460 --> 00:01:46,740
+انتصاصه من القمعة، and is essential to subsequent
+
+17
+00:01:46,740 --> 00:01:50,830
+processes distribution metabolism executionيعني ال
+
+18
+00:01:50,830 --> 00:01:58,770
+absorption is very important for other steps if no
+
+19
+00:01:58,770 --> 00:02:02,930
+absorption, no distribution if no absorption, no
+
+20
+00:02:02,930 --> 00:02:07,030
+metabolism if no absorption, no secretion يعني هو
+
+21
+00:02:07,030 --> 00:02:11,630
+الأساس في العمل يقولها ال absorption absorption
+
+22
+00:02:11,630 --> 00:02:16,370
+varies according يعني يختلف من إنسان لإنسان
+
+23
+00:02:16,370 --> 00:02:18,850
+according to three factors
+
+24
+00:02:27,860 --> 00:02:30,660
+هي بتاعت الدواء اللي أخدناها قبل هى في ده دوز او
+
+25
+00:02:30,660 --> 00:02:36,240
+دوز كبيرة او دوز صغيرة طبعا انا هنا براخص يعنى
+
+26
+00:02:36,240 --> 00:02:41,200
+route of administration واضح انه ان اعطيتها IV في
+
+27
+00:02:41,200 --> 00:02:46,360
+الوريد سيكون الاشتراك شنساني جدا لأن واحد ده معطوب
+
+28
+00:02:46,360 --> 00:02:50,260
+مش بده نفسه يلف على المعدة وعلى الأمعاء وبعدين
+
+29
+00:02:50,260 --> 00:02:54,220
+يتصم الخملات لأ معاملة يروح لده احنا اللي هشوفها
+
+30
+00:02:54,220 --> 00:03:01,370
+يبقى كل مكان ال routeطريق الإعطاء قريب كل ما كان
+
+31
+00:03:01,370 --> 00:03:06,290
+أسرع اللي اللي هو ال absorption والعكس هي أطول
+
+32
+00:03:06,290 --> 00:03:11,010
+دورة لل absorption هي طعم، مع طعم، عن طريق الفم
+
+33
+00:03:11,010 --> 00:03:16,770
+الفور طبعا لما أعطي سائل، حتى عن طريق الفم، ممتص
+
+34
+00:03:16,770 --> 00:03:20,050
+أسرع من أقاص اللي هي بدها الساق، دوابان وشي وكده
+
+35
+00:03:20,050 --> 00:03:25,370
+وكده لما أعطي يعني أشياء محلين أسرع من أشياء
+
+36
+00:03:25,370 --> 00:03:29,590
+الصلبةو الدواز كل مكان الدواز أكبر كل مكان امتصاص
+
+37
+00:03:29,590 --> 00:03:36,710
+أكبر والعكس صحيح طيب الان factors affecting drug
+
+38
+00:03:36,710 --> 00:03:40,130
+absorption ما هي العوامل التي تؤثر في امتصاص
+
+39
+00:03:40,130 --> 00:03:44,210
+الدواء اول شيء ال nature of the absorbing surface
+
+40
+00:03:44,210 --> 00:03:50,030
+nature طبيعة السطح المعص طبيعة السطح المعص
+
+41
+00:03:58,120 --> 00:04:05,740
+في مادة علاجية على جلبي ولا
+
+42
+00:04:05,740 --> 00:04:13,360
+أخد كورس تحت لساني؟ مين أسرع؟ بالنسبالي المرحلة من
+
+43
+00:04:13,360 --> 00:04:19,740
+جلبي والكورس تحت لساني كورس تحت لساني أسرع كورس
+
+44
+00:04:19,740 --> 00:04:24,360
+تحت لساني ليش؟ لأن تحت لساني اللي باخدوها الله
+
+45
+00:04:24,360 --> 00:04:25,900
+يعفوهم اللي هو مرض القلب
+
+46
+00:04:31,620 --> 00:04:36,840
+اللسان sublingual على طول تعمل توصية للأوراق
+
+47
+00:04:36,840 --> 00:04:42,400
+الدموية لأن ميوكاس ميمبراين ميوكاس ميمبراين very
+
+48
+00:04:42,400 --> 00:04:46,360
+thick بينما الجلد very thin بينما الجلد very thick
+
+49
+00:04:46,360 --> 00:04:50,880
+الجلد very thick يبقى ميمبراين من خلال اللي يجب أن
+
+50
+00:04:50,880 --> 00:04:56,790
+يترابس الدراجةفي drug monkeys may pass through a
+
+51
+00:04:56,790 --> 00:05:01,750
+single layer of cells زي Epithelium of Villi Villi
+
+52
+00:05:01,750 --> 00:05:06,150
+خملات الأمعاق الدقيقة التي بتصميم الطعام هي single
+
+53
+00:05:06,150 --> 00:05:11,490
+layer أسرع من ال skin اللي هو multiple layers skin
+
+54
+00:05:11,490 --> 00:05:15,430
+multiple layers طبعا في ال skin فيه epidermis و
+
+55
+00:05:15,430 --> 00:05:19,410
+فيه dermis و subcutaneous و tissue في ال hysteria
+
+56
+00:05:19,410 --> 00:05:20,710
+بتاعه الخميل
+
+57
+00:05:29,990 --> 00:05:33,070
+أسرع، واحد، يبقى هذا العامل الأول اللي يؤثر في
+
+58
+00:05:33,070 --> 00:05:36,250
+سرعة الإمتصاص العامل الثاني surface area of the
+
+59
+00:05:36,250 --> 00:05:41,930
+absorbing surface تكون قاعدة كل ما كان ال surface
+
+60
+00:05:41,930 --> 00:05:46,670
+area للسطح المعص أكبر، فإن الإمتصاص يكون أسرع ولكن
+
+61
+00:05:46,670 --> 00:05:50,130
+صحيح، العكس صحيح، يبقى the more extensive the
+
+62
+00:05:50,130 --> 00:05:52,690
+absorbing surface, the greater the absorption rate
+
+63
+00:05:52,690 --> 00:05:57,190
+and more rapid effect of the used drug، والعكس
+
+64
+00:05:57,190 --> 00:06:03,060
+صحيحطيب احنا يعني جيبنا بعض ال demonstrations
+
+65
+00:06:03,060 --> 00:06:10,780
+فمثلا هي الأمعاء الدقيقة اللي بصير منها الدصاص هي
+
+66
+00:06:10,780 --> 00:06:14,780
+ال human open intestine اللي هو فرج الأمعاء نفسه
+
+67
+00:06:14,780 --> 00:06:19,820
+بإن هي ال mucus layer of small intestine هي ال
+
+68
+00:06:19,820 --> 00:06:20,400
+epithelial layer
+
+69
+00:06:26,180 --> 00:06:30,380
+الدواء ان يدخل الى الدم كي يمطس اذا لم يدخل الى
+
+70
+00:06:30,380 --> 00:06:34,840
+الدم في هذه الحالة فانه لن يمطس كيف يعني في الآخر؟
+
+71
+00:06:34,840 --> 00:06:38,180
+بمعنى الشوارع الدوائية اللي هي في جدار الأمهات
+
+72
+00:06:38,180 --> 00:06:42,200
+الدقيقة وانا برضه رسمي لكم الخملات من ناحية
+
+73
+00:06:42,200 --> 00:06:48,220
+التانية وكيف الخملات بتكون وهنا بس يعني مفسرة طيب
+
+74
+00:06:48,220 --> 00:06:52,700
+العمل الثالث blood supply of the absorbing area
+
+75
+00:07:01,230 --> 00:07:05,450
+ولا poor in blood business، إذا كان المنطقة اللي
+
+76
+00:07:05,450 --> 00:07:11,870
+إيجي عليها الدواء ريحي فالاتصال سيكون rapid، إذا
+
+77
+00:07:11,870 --> 00:07:18,350
+كان poor يعني مثل احنا
+
+78
+00:07:18,350 --> 00:07:22,710
+ضربنا خجلنا في واحد أوبيس تحت الجلد
+
+79
+00:07:33,730 --> 00:07:38,730
+بينما احنا ضربنا في العضل واحد ثاني على طول ماشية
+
+80
+00:07:38,730 --> 00:07:47,850
+ليش؟ لأنه العضل ريشي in blood vessels بينما اللي
+
+81
+00:07:47,850 --> 00:07:54,390
+قد يبوستش هو أوي فاق poor in blood vessels حسنا،
+
+82
+00:07:54,390 --> 00:07:57,410
+هذا يعني واضح، الحكاية اللي هو ال blood vessels
+
+83
+00:08:02,470 --> 00:08:08,650
+دوبانية او القدرة على الدوبان لدى هذا ال drug in
+
+84
+00:08:08,650 --> 00:08:13,430
+order to be absorbed drug must be soluble in
+
+85
+00:08:13,430 --> 00:08:17,970
+solutions يبقى هذا الدواء لازم يكون قادر على
+
+86
+00:08:17,970 --> 00:08:23,130
+الدوبان في المحانين the more soluble the drug the
+
+87
+00:08:23,130 --> 00:08:29,550
+more rapid it will be absorbed والعكس صحيح لما كان
+
+88
+00:08:29,550 --> 00:08:36,040
+لا يدوبأو دفعه أقل كل ما اتأخر انتصاره من السطح
+
+89
+00:08:36,040 --> 00:08:39,380
+فالمثال دلوقتي هنا مثال chemicals and minerals
+
+90
+00:08:39,380 --> 00:08:46,380
+that form insoluble precipitates ترسيب in the
+
+91
+00:08:46,380 --> 00:08:50,540
+gastrointestinal tract or the tracts that are
+
+92
+00:08:50,540 --> 00:08:54,680
+insoluble in water or lipids can't be absorbed
+
+93
+00:08:54,680 --> 00:09:00,100
+يعني في بعض الأياجوية
+
+94
+00:09:02,660 --> 00:09:08,080
+كبيرة المركول ولا تدوب لا في الماء ولا في وسط
+
+95
+00:09:08,080 --> 00:09:14,700
+الدوران لو أخذناها أقراسا فإنها تخرج مع البرازج لا
+
+96
+00:09:14,700 --> 00:09:21,840
+تنطس لأنها قابلة أو صعب أن تدوب فإذا لم تدوب كيف
+
+97
+00:09:21,840 --> 00:09:22,340
+ستصل
+
+98
+00:09:30,310 --> 00:09:34,070
+و قابل دوام في الماء أو في الوسط الدوني فإنه ينتص
+
+99
+00:09:34,070 --> 00:09:40,150
+بصراحة فمثلا voluntarily administered drugs زي
+
+100
+00:09:40,150 --> 00:09:46,010
+مثلا الحقن اللتي نحطيها في العضل أو المريض في part
+
+101
+00:09:46,010 --> 00:09:51,620
+in any vehicle، vehicle وسيلةيعني ليه تمريض الدواء
+
+102
+00:09:51,620 --> 00:09:55,500
+أو تدويب الدواء will be more slowly absorbed from
+
+103
+00:09:55,500 --> 00:10:00,620
+the muscle than drugs dissolved in water او اللي
+
+104
+00:10:00,620 --> 00:10:05,780
+هو isotonic sodium chloride solution يعني في ناس
+
+105
+00:10:05,780 --> 00:10:11,660
+بيقولوا في حقن زيت في بيقولوا حقن الزيت وفي حقن
+
+106
+00:10:11,660 --> 00:10:15,680
+عادية اللي فيها ميز بيقولك لو حققنا حقن الزيت
+
+107
+00:10:15,680 --> 00:10:17,700
+هتنتدر
+
+108
+00:10:18,990 --> 00:10:24,050
+في دم فترة في العضلة يعني في العضلة هتنتظر فترة و
+
+109
+00:10:24,050 --> 00:10:30,570
+تمتص بالتدريج و بصعوبة وهي مهلمة كمان حتى تصل كلها
+
+110
+00:10:30,570 --> 00:10:35,550
+إلى الدم بينما الحقنة اللي هي مائية اللي بيبلوغ في
+
+111
+00:10:35,550 --> 00:10:40,090
+الميه حقنها في العضل على السريع راح تجي الطريقة
+
+112
+00:10:40,090 --> 00:10:43,810
+الى اللي هو مجرد دم في خلال دقائق
+
+113
+00:10:56,000 --> 00:11:02,120
+يعني العلاقات الكيميائية اما حانضية اسيدية او
+
+114
+00:11:02,120 --> 00:11:06,800
+قلوية alkaline او neutral او متعادلة لا حانضية ولا
+
+115
+00:11:06,800 --> 00:11:12,580
+قلوية طبعا واضح انه كل ما نزل عن السبعة بصير حانضي
+
+116
+00:11:12,580 --> 00:11:15,900
+اكتر وكل ما طلع عن السبعة بصير قلوي اكتر و عند
+
+117
+00:11:15,900 --> 00:11:18,800
+السبعة سبعة و اتنين و عشرة بتكون ال neutral
+
+118
+00:11:30,240 --> 00:11:33,680
+لما الوفق الحامضي هذا بتاع ال اسبريل بيدي في
+
+119
+00:11:33,680 --> 00:11:38,480
+المعنى فإنه لا يتأثر سلبًا
+
+120
+00:12:07,110 --> 00:12:11,790
+Remains active يبقى الاسبلين عشان هو حامضي ويجي
+
+121
+00:12:11,790 --> 00:12:17,390
+على المائدة حافظ على التركيب بتاعه و بقي remains
+
+122
+00:12:17,390 --> 00:12:23,330
+active ال environment في الستمكة فالدفوع can
+
+123
+00:12:23,330 --> 00:12:25,230
+really diffuse across the intestinal cells
+
+124
+00:12:25,230 --> 00:12:29,820
+membrane into the circulationيبقى .. لم .. لم يتلف
+
+125
+00:12:29,820 --> 00:12:33,760
+اللي هو الأسبانين بالحمضية بتاعه اللي هو إيش؟
+
+126
+00:12:33,760 --> 00:12:39,100
+الميدا، و بعد إيه؟ ماشي إلى اللي هو الأمعة ال
+
+127
+00:12:39,100 --> 00:12:44,460
+contrast على النقيد عن ال crime drugs ال crime
+
+128
+00:12:44,460 --> 00:12:47,820
+drugs زي ال antacids، antacids أقراص رينيه
+
+129
+00:12:47,820 --> 00:12:50,720
+بتاخدوها عارفين أقراص رينيه؟ لما سمع حرقان في
+
+130
+00:12:50,720 --> 00:12:55,420
+الميدا؟ الميدا بتحرجه و بيقوله اعطيني رينيهبنانية
+
+131
+00:12:55,420 --> 00:13:01,040
+يعني ان انا حموضة بقرشوا حبا بيلاقي حاجة برا في فم
+
+132
+00:13:01,040 --> 00:13:05,660
+المعنى بتاعه هذه كلها اسم المنوعة antacids وضدات
+
+133
+00:13:05,660 --> 00:13:09,440
+الحامض وضدات الحامض لما راح تحس مع حموضة بياخد
+
+134
+00:13:09,440 --> 00:13:16,480
+اشياء فهذه قلوية القلوي متفاعل مع الحامض وبيطلع
+
+135
+00:13:16,480 --> 00:13:21,730
+الحامضية زيادةحمض زي القروي يساوي ملح زي الماء
+
+136
+00:13:21,730 --> 00:13:26,730
+يعني بس هذا عند المعدة و برتاح خلاص بيعمل دوره في
+
+137
+00:13:26,730 --> 00:13:30,530
+المعدة بيمشيش بعدين خلاص لإنه يتلف في المعدة
+
+138
+00:13:30,530 --> 00:13:36,810
+بتفاعل .. بتفاعل إيه؟ الكيميائي يبقى ال antacids
+
+139
+00:13:36,810 --> 00:13:39,890
+tend to dissociate أو inactivated in the stomach
+
+140
+00:13:39,890 --> 00:13:44,650
+اللي هو acidic environment and not absorb through
+
+141
+00:13:44,650 --> 00:13:45,350
+the gastric membrane
+
+142
+00:13:49,980 --> 00:13:53,800
+المعدة هذه الحالة القلوية عشانك انا لو انا بدي
+
+143
+00:13:53,800 --> 00:14:00,520
+اعطي قلوي لازم ا capsule لازم اعمل كابسولة ميجبش
+
+144
+00:14:00,520 --> 00:14:04,140
+في المعدة و اروح على الاثنى عشر و اروح على الأمعاء
+
+145
+00:14:04,140 --> 00:14:08,400
+الدقيقة زي احنا بتكلمنا قبلها لكن الدواء اللي وسطه
+
+146
+00:14:08,400 --> 00:14:16,630
+حامضي انا بعطيه مرخف من موضوع المعدةالفيروس يحدث
+
+147
+00:14:16,630 --> 00:14:22,590
+عندما هؤلاء الدروس في مصطلح غير ملحوظ.المصطلح مثلا
+
+148
+00:14:22,590 --> 00:14:27,330
+اللي هو الاتنين عشر والعمارة الدقيقة وسطها قلوي
+
+149
+00:14:27,330 --> 00:14:34,170
+وسطها قلوي.الدروس غير ملحوظ في الماء هو الليبيد
+
+150
+00:14:34,170 --> 00:14:35,630
+الليبيد الليبود الليبود الليبود الليبود الليبود
+
+151
+00:14:35,630 --> 00:14:36,130
+الليبود الليبود الليبود الليبود الليبود الليبود
+
+152
+00:14:36,130 --> 00:14:38,510
+الليبود الليبود الليبود الليبود الليبود الليبود
+
+153
+00:14:38,510 --> 00:14:38,610
+الليبود الليبود الليبود الليبود الليبود الليبود
+
+154
+00:14:38,610 --> 00:14:38,610
+الليبود الليبود الليبود الليبود الليبود الليبود
+
+155
+00:14:38,610 --> 00:14:39,490
+الليبود الليبود الليبود الليبود الليب
+
+156
+00:14:51,100 --> 00:14:59,620
+باختصار انه غير احكاية حمضي و احكاية قلوي في مواد
+
+157
+00:14:59,620 --> 00:15:07,820
+تدوب في الماء وفي مواد تدوب في الدهون فهو بيقوللي
+
+158
+00:15:09,140 --> 00:15:16,760
+الدراج اللذي لا يدوب في الدهون
+
+159
+00:15:16,760 --> 00:15:20,580
+يخترق
+
+160
+00:15:20,580 --> 00:15:23,320
+قدار الأمعاق بسهولة
+
+161
+00:15:32,480 --> 00:15:39,160
+يبدأ ان ionized اللي لم يتم تحليله او تكسيره في
+
+162
+00:15:39,160 --> 00:15:46,900
+الماء ده، اه وهو لا يدوب في الماء، يستطيع ان يدخل
+
+163
+00:15:46,900 --> 00:15:51,460
+عبر الخملات في الماء الدقيقة بسهولة، هو اللي ده
+
+164
+00:15:51,460 --> 00:15:56,780
+ionized water solubleالذي نام في الماء او تحلل في
+
+165
+00:15:56,780 --> 00:16:05,140
+الماء is lipid
+
+166
+00:16:05,140 --> 00:16:09,140
+insoluble and non-disable across the cell membrane
+
+167
+00:16:09,140 --> 00:16:14,180
+or intestine عشان ما نخشش في اللي هو التناقض يعني
+
+168
+00:16:14,180 --> 00:16:18,340
+ال drugs اللي بناخدها فيه شيء بدوق في الماء وشيء
+
+169
+00:16:18,340 --> 00:16:25,910
+بدوق في الدهوناللي بدور في الدهون سهله انه روح على
+
+170
+00:16:25,910 --> 00:16:30,530
+الأمعاء وينفسم الأمعاء بينما اللي يعني ذابه في
+
+171
+00:16:30,530 --> 00:16:35,330
+الماء صعب انه يدخل في يدار اللي هو الأمعاء وينفسم
+
+172
+00:16:35,330 --> 00:16:41,710
+الأمعاء طيب في factor سادس و هذا مهم تركيز الدواء
+
+173
+00:16:41,710 --> 00:16:46,710
+هذا عامل مهم في الامتصاص تركيز الدواء عامل مهم في
+
+174
+00:16:46,710 --> 00:16:50,010
+الامتصاص بقول لي كلما
+
+175
+00:16:55,970 --> 00:17:02,310
+فإن الامتصاص أعلى والعكس صحيح كل ما كان تركيز
+
+176
+00:17:02,310 --> 00:17:06,850
+الدواء أقل فإن الامتصاص يكون أقل وهذه نتيجة هنطقية
+
+177
+00:17:06,850 --> 00:17:13,270
+يعني الدواء لما يكون مثلا ألف ميلي جرام مثلا أو
+
+178
+00:17:13,270 --> 00:17:17,430
+يكون ميت ميلي جرام واضح إنه الألف ميلي جرام مكثفة
+
+179
+00:17:17,910 --> 00:17:22,410
+وامتصاصها هيكون اعلى بكتير من ال 100 ميلي جرام ال
+
+180
+00:17:22,410 --> 00:17:28,330
+drug may be initially administer in large doses
+
+181
+00:17:28,330 --> 00:17:33,570
+that temporarily exceeds the body capacity for
+
+182
+00:17:33,570 --> 00:17:36,730
+excretion
+
+183
+00:17:36,730 --> 00:17:43,230
+of the drug يعني احيانا في واحد بياخد دمع فوق طبقه
+
+184
+00:17:43,230 --> 00:17:51,090
+جمعة كبيرة جداالجوعة الكبيرة جدا هذه هترفع مستوى
+
+185
+00:17:51,090 --> 00:17:55,210
+الدواء في الدم إلى شيء غير طبيعي، عالي خالص،
+
+186
+00:17:55,210 --> 00:18:04,670
+الكلية لكن هذا بقول ايه؟ مش هيدوم طويلا، ليش؟ لأن
+
+187
+00:18:04,670 --> 00:18:14,910
+الكلية ستبدأ بإخراج سريع لهذا الدواءوبالتالي هذا
+
+188
+00:18:14,910 --> 00:18:21,110
+المستوى العالي جدا اللي أخده المريض في الدمسة سوف
+
+189
+00:18:21,110 --> 00:18:26,530
+ينزل بالتدريج إذا لم ياخد هو جوعة تانية و تاكت حتى
+
+190
+00:18:26,530 --> 00:18:30,210
+في حالات التسامم يعني الواحد مثلا أخد عشر أقلاص
+
+191
+00:18:30,210 --> 00:18:33,530
+أكمول أسبرين كده كده كده كده صح أن هذه emergency و
+
+192
+00:18:33,530 --> 00:18:37,690
+كده لكن متوقع خلال 24 ساعة أن الوضع هيتغير فتبدأ
+
+193
+00:18:37,690 --> 00:18:41,530
+الكلية في التعامل مع الزائد وترميه إلى الخارج
+
+194
+00:18:41,870 --> 00:18:47,590
+التركيز العالي يعتمد على تركيز
+
+195
+00:18:47,590 --> 00:18:52,090
+الدواء اللي أخذناها كلما زادة تركيز الدواء اللي
+
+196
+00:18:52,090 --> 00:18:57,650
+أخذناها كلما معدل الامتصاص كان أعلى وأسرع في هذه
+
+197
+00:18:57,650 --> 00:19:00,550
+الطريقة في التركيز العالي تركيز الدواء اللي
+
+198
+00:19:00,550 --> 00:19:02,510
+أخذناها كلما زادت تركيز الدواء اللي أخذناها كلما
+
+199
+00:19:02,510 --> 00:19:03,670
+زادت تركيز الدواء اللي أخذناها كلما زادت تركيز
+
+200
+00:19:03,670 --> 00:19:03,670
+الدواء اللي أخذناها كلما زادت تركيز الدواء اللي
+
+201
+00:19:03,670 --> 00:19:05,270
+أخذناها كلما زادت تركيز الدواء اللي أخذناها كلما
+
+202
+00:19:05,270 --> 00:19:09,430
+زادت تركيز الدواء اللي أخذناها كلما زادت تركيز
+
+203
+00:19:09,430 --> 00:19:11,470
+الدواء اللي أخذناها
+
+204
+00:19:13,590 --> 00:19:17,030
+فكانوا يعني هم يخلصوا بسرعة من الموضوع يجيبك اربع
+
+205
+00:19:17,030 --> 00:19:21,190
+او ست اقراء كابسولات تترا سايتليين ويقولوا خدهم مع
+
+206
+00:19:21,190 --> 00:19:28,870
+بعض على امل ان هو يعني يخضي على ال Vibrio cholera
+
+207
+00:19:28,870 --> 00:19:34,630
+السبب بسرعة يعني زي ما بقولك يعني shock dose dose
+
+208
+00:19:34,630 --> 00:19:45,460
+صادمة للميكروفون في الحالة هذه في ال target siteكل
+
+209
+00:19:45,460 --> 00:19:50,900
+ما كانت الجرعة الأعلى كل ما صار تركيز الدولة في ال
+
+210
+00:19:50,900 --> 00:19:55,040
+target site اللي فيه المرض أعلى وأسرع، أعلى وأسرع،
+
+211
+00:19:55,040 --> 00:20:01,620
+والأقصى هي لو أعطيت جرعة خفيفة أو جرعة صغيرة. Once
+
+212
+00:20:01,620 --> 00:20:04,260
+active drug level is established by such
+
+213
+00:20:04,260 --> 00:20:07,780
+accumulating effects, similar doses of drug can be
+
+214
+00:20:07,780 --> 00:20:10,680
+administered to replace only the amount of the
+
+215
+00:20:10,680 --> 00:20:14,220
+drug executed since the previous dose. كيف يعني؟
+
+216
+00:20:15,150 --> 00:20:21,770
+الان واحد ان بيذهب للنوز التاني احنا كتبناله اقراس
+
+217
+00:20:21,770 --> 00:20:27,850
+مثلا cifadrox كل اتناشر ساعة cifadrox هذا في منه
+
+218
+00:20:27,850 --> 00:20:31,930
+متان و خمسين و في منه خمسمية اقل زيكوا اعطينا
+
+219
+00:20:31,930 --> 00:20:38,430
+الخمسمية الان الخمسمية هذه المفروض تشتغل لاتناشر
+
+220
+00:20:38,430 --> 00:20:41,450
+ساعة و بعدين تبدأ تعمل decline
+
+221
+00:20:45,530 --> 00:20:50,810
+ليش؟ لإن الكيليا طلعت الدواء ال metoxication عشان
+
+222
+00:20:50,810 --> 00:20:56,010
+هيك بقولك يعني قص مرتين يوميا مدة مثلا خمس أيام
+
+223
+00:20:56,010 --> 00:21:02,630
+إيش يعني في الخمس أيام؟ في الخمس أيام إن أنا أجعل
+
+224
+00:21:02,630 --> 00:21:13,510
+المعدل الدوائي أو العناجي للدواء في الدم ثابت وهذا
+
+225
+00:21:13,510 --> 00:21:18,870
+إيش بفيد؟بفيد معدل علاجي في ال target site اللي
+
+226
+00:21:18,870 --> 00:21:23,510
+فيه المرض ثابت لمدة خمس أيام، هذا بفيد إيش؟ قتل
+
+227
+00:21:23,510 --> 00:21:31,910
+الميكروبات في هذا الموضوع لمدة خمس أيام، انتهى، طب
+
+228
+00:21:31,910 --> 00:21:36,850
+في يعني واحد بيحس ببعض الراحة، لو زي تامة بيجاوبه
+
+229
+00:21:50,580 --> 00:21:54,040
+الماكروبنة إتراجة بالنسبة لتلاتين اربعين في المية
+
+230
+00:21:54,040 --> 00:21:58,540
+أو خمسين في المية، لكن ما انتهاش، بدّوا لسه
+
+231
+00:21:58,540 --> 00:22:01,640
+maintenance dose لباقي الأيام
+
+232
+00:22:16,530 --> 00:22:20,690
+و لو أرجعنا بعد الخمس أيام ناخد نفس الدواء فانا
+
+233
+00:22:20,690 --> 00:22:27,750
+مكروب سوف يسخر من الدواء لأن هو حلل الشفرة بتاعي
+
+234
+00:22:27,750 --> 00:22:33,050
+حلل الشفرة يبقى الآن أنا بتكلم على نوعين من
+
+235
+00:22:33,050 --> 00:22:40,010
+الجرعات في نوع اسمه primary or initial dose اللي
+
+236
+00:22:40,010 --> 00:22:44,370
+باخده ده في الأول وفي شيء اسمه maintenance dose
+
+237
+00:22:44,370 --> 00:22:48,930
+maintenanceهي في اللغة الصيانة لكن احنا بيقول
+
+238
+00:22:48,930 --> 00:22:54,330
+الجرعة المحافظة اللي هي بتحافظ على مستوى الدواء
+
+239
+00:22:54,330 --> 00:22:59,170
+يبقى انا الجرعة اللي خدتها في الأول هي جرعة بداية
+
+240
+00:22:59,170 --> 00:23:06,070
+تفعيل لكن باقى الجرعات maintenance dose وكتير احنا
+
+241
+00:23:06,070 --> 00:23:10,550
+بيقولها الأيان إذا كان انت نسيت الجرعة خدها أول ما
+
+242
+00:23:10,550 --> 00:23:15,250
+تتفكر لأن مثلا انا كل اتناشر ساعة نام وراه ست
+
+243
+00:23:15,250 --> 00:23:15,690
+ساعات
+
+244
+00:23:20,580 --> 00:23:28,020
+البكتيريا تبدأ يصيلها refreshment تصحى
+
+245
+00:23:28,020 --> 00:23:32,980
+البكتيريا وتعود إلى التكاثر خدها بسرعة واجب اكمال
+
+246
+00:23:32,980 --> 00:23:39,720
+الجرعات حتى النهاية في ال maintenance dose طيب
+
+247
+00:23:39,720 --> 00:23:46,520
+الان انتهينا من drug absorptionالان الدواء سواء ان
+
+248
+00:23:46,520 --> 00:23:54,320
+انا اعطيته حقنة او اقلاص او تحميلة او حتى تحت
+
+249
+00:23:54,320 --> 00:24:02,360
+اللسان او في البخاخة في الجذب التنافسي او سطحي على
+
+250
+00:24:02,360 --> 00:24:08,660
+الجذب سواء بطيء او سريع الملال بتاعه هو absorption
+
+251
+00:24:13,610 --> 00:24:19,850
+وانا هنا جبت شكل لطيف جميل يعني بيبين حقيقة موضوع
+
+252
+00:24:19,850 --> 00:24:23,290
+ال absorption و ال distribution فمثلا يعني معظم
+
+253
+00:24:23,290 --> 00:24:28,190
+الدواء اللي يُخد يُخد عن طريق الفم يعني الإسان
+
+254
+00:24:28,190 --> 00:24:36,530
+كتير باستهون انه ياخد الدواء عن طريق الفم انه
+
+255
+00:24:36,530 --> 00:24:43,110
+ياخده حقا او تحميل او يعني طريق اخر تحت الجلب مثلا
+
+256
+00:25:01,180 --> 00:25:06,860
+اليومن of small intestine لما
+
+257
+00:25:06,860 --> 00:25:16,520
+الدواء دخل هنا كان مستهلك ذائب كالحليب والطعام
+
+258
+00:25:16,520 --> 00:25:23,120
+كذلك يعني اللي بيجي على إلماء دقيقة طاعة زي
+
+259
+00:25:23,120 --> 00:25:26,760
+اليوجينم والإليم بيجي على
+
+260
+00:25:32,830 --> 00:25:40,510
+الان بيجي هذا عن الخملات الخملات هذه يعني تراكيب
+
+261
+00:25:40,510 --> 00:25:48,190
+مايكروسكوبية مخصصة لامتصاص هذا المستحلب فإذا دخله
+
+262
+00:25:48,190 --> 00:25:53,970
+عليها فإنه يذهب إلى الدورة الدموية اقصد يذهب إلى
+
+263
+00:25:53,970 --> 00:25:57,050
+جدار الأمعاء الشعيرات اللي في جدار الأمعاء
+
+264
+00:25:57,050 --> 00:25:59,370
+الشعيرات اللي في جدار الأمعاء
+
+265
+00:26:05,390 --> 00:26:10,770
+وتجمع و ترسل الطعام إلى شيء اسمه الوريد البابى
+
+266
+00:26:10,770 --> 00:26:19,030
+portal vein هذا ال portal vein هو
+
+267
+00:26:19,030 --> 00:26:25,630
+اسمه vein لكن هو حقيقة ان هو يأخذ كل ما يأتي من
+
+268
+00:26:25,630 --> 00:26:30,950
+المعدونة معاه ياخده إلى ال liver
+
+269
+00:26:35,060 --> 00:26:41,880
+اللي بقى الحقيقة هو المصنع اللي فيه بتكون معالجة
+
+270
+00:26:41,880 --> 00:26:48,840
+مبدئية مناسبة
+
+271
+00:26:48,840 --> 00:26:59,060
+للدم ثم يقوم الكبد بدخه إلى القلب بدخه
+
+272
+00:26:59,060 --> 00:27:02,800
+إلى القلب ومن القلب
+
+273
+00:27:06,140 --> 00:27:13,960
+البطاين الأيسر فيضخه إلى الأورطة حيث يعني يبرو كل
+
+274
+00:27:13,960 --> 00:27:18,460
+خلية في الجسم وهذا اللي بنقصد فيه اللي هو ال
+
+275
+00:27:18,460 --> 00:27:23,300
+distribution يبقى مصيرش distribution إلا لما يصل
+
+276
+00:27:23,300 --> 00:27:31,000
+الكبد ويصل القلب من الأمعاق إلى البريد الفابى إلى
+
+277
+00:27:31,000 --> 00:27:37,600
+الكبد إلى القلب إلىسائر أعضاء الجسم هنا صاروا
+
+278
+00:27:37,600 --> 00:27:42,500
+distribution صاروا distribution أبو بكر صديقه اللي
+
+279
+00:27:42,500 --> 00:27:50,320
+قالوا عنه في ليلة ذهب إلى
+
+280
+00:27:50,320 --> 00:27:56,560
+البيت أو عاد إلى البيت متأخرا فوجد خادمه قد أعد له
+
+281
+00:27:56,560 --> 00:28:00,460
+طعام قال من أين؟
+
+282
+00:28:03,970 --> 00:28:08,550
+ثم سأل الخادم من أين لك هذا؟ من وين جبت الأكل؟ قال
+
+283
+00:28:08,550 --> 00:28:14,170
+من عروس بني فلان في
+
+284
+00:28:14,170 --> 00:28:22,510
+مكة فتبين أنهم مشركون لم يسلموا بعد فوضع أبو بكر
+
+285
+00:28:22,510 --> 00:28:33,040
+قصابعه في حلقه فقع وقع وقعليتخلص من طعام الجاهلية
+
+286
+00:28:33,040 --> 00:28:39,440
+اللي لم يذكر اسم الله عليه ثم قال واعتذروا اللهم
+
+287
+00:28:39,440 --> 00:28:50,760
+إليك مما حملت الأوردة أو الشرير أو العلوق فالخانين
+
+288
+00:28:50,760 --> 00:28:53,220
+يقولوا يا رحمك الله يا رحمك الله يعني هي لقمتين او
+
+289
+00:28:53,220 --> 00:28:57,020
+ثلاثة ايش يعني بدورهم؟ خليهم وروحواقال و الله لو
+
+290
+00:28:57,020 --> 00:29:03,420
+لم تخرج الطعم هذا إلا و نفسي معها لفعلت عشان ياكل
+
+291
+00:29:03,420 --> 00:29:08,940
+حلال بس عشان ياكل حلال بس أبقى صديق ما .. ماكانش
+
+292
+00:29:08,940 --> 00:29:12,310
+قرأ تشريح حد اللي احنا بنخمنهإنه جاب المصير بالـ
+
+293
+00:29:12,310 --> 00:29:18,530
+distribution في الدم لحجه من المادة، يعني المادة
+
+294
+00:29:18,530 --> 00:29:24,650
+بتودي للدم، فهو أبو بكر لحج الطعم يطلق قبل أن يصل
+
+295
+00:29:24,650 --> 00:29:29,990
+وين؟ إلى الدم، ويقول واعتذر اللهم إليك عما حملت
+
+296
+00:29:29,990 --> 00:29:37,230
+العروق، وهذه العروق قدامكوا بتشوفوها ده، طيبيبقى
+
+297
+00:29:37,230 --> 00:29:41,470
+كلمة distribution of drugs is defined as the
+
+298
+00:29:41,470 --> 00:29:46,070
+transport of a drug in body fluids from the blood
+
+299
+00:29:46,070 --> 00:29:50,370
+stream to various tissues of the body and
+
+300
+00:29:50,370 --> 00:29:55,750
+ultimately to its site of action يعني دائما احنا
+
+301
+00:29:55,750 --> 00:30:01,650
+بناخد drugs في علاج disorder او disease معين ايه
+
+302
+00:30:01,650 --> 00:30:07,740
+ال disease هذا بيكون له target site؟مثلا الناس
+
+303
+00:30:07,740 --> 00:30:14,060
+اللي عندهم مرض القلب، الناس اللي عندهم السوكريا،
+
+304
+00:30:14,060 --> 00:30:18,780
+الناس اللي عندهم اتهاب رئوي، الناس اللي عندهم
+
+305
+00:30:18,780 --> 00:30:23,580
+اتهاب النقرص وغيره،
+
+306
+00:30:23,580 --> 00:30:29,890
+هو صح بدي أقول أقراص، لكن هو فاهمهذه الأقراص سوف
+
+307
+00:30:29,890 --> 00:30:34,610
+تذهب في النهاية الى مكان ال disorder او ال disease
+
+308
+00:30:34,610 --> 00:30:41,690
+او ال pain عشان تعمل relief عشان تعمل cure شفاء
+
+309
+00:30:41,690 --> 00:30:48,930
+بإذن الله يبقى ما لم يحصل distribution لن يكون
+
+310
+00:30:48,930 --> 00:30:55,410
+هناك شفاء و الدواء مش حيث بقولي most of drugs are
+
+311
+00:30:55,410 --> 00:30:56,850
+distributed initially
+
+312
+00:31:08,040 --> 00:31:14,980
+العضو اللي فيه المرض ريتشي يعني blood supply فإن
+
+313
+00:31:14,980 --> 00:31:19,440
+كمية العلاج اللي هتتوازله تكون أكبر و العدس صحيح
+
+314
+00:31:19,440 --> 00:31:26,820
+يعني ندرم مثلا مثال في بعض المناطق في جسم الإنسان
+
+315
+00:31:26,820 --> 00:31:36,220
+هي فاتة بعض ال .. اه هي فاتة في ظهر الإنسان أول شي
+
+316
+00:31:36,220 --> 00:31:43,930
+فيه فاتةالان الفئة هذا صعبة شديد ان الدواء يصله
+
+317
+00:31:43,930 --> 00:31:49,290
+بكمية كافية لسبب ان الدهون وانت شوفته الدهون
+
+318
+00:31:49,290 --> 00:31:54,550
+الحيوانات ليس فيها اوها دموية وليس فيها دم هو اللي
+
+319
+00:31:54,550 --> 00:32:02,250
+بيحمل الدواء الى الأعضاء الدم كل مكان العضو فيه دم
+
+320
+00:32:02,250 --> 00:32:05,850
+اكتر كل مكان اصحى
+
+321
+00:32:13,540 --> 00:32:18,220
+أحنا بتتكلم الآن إن أعضاء مركزية زي القلب و زي
+
+322
+00:32:18,220 --> 00:32:26,600
+الكبل و زي المعدة أو زي ال kidney فيها دم كافي
+
+323
+00:32:26,600 --> 00:32:30,220
+التوزيع بيصير له أسرع delivery of drugs to
+
+324
+00:32:30,220 --> 00:32:36,840
+extremities extremities يعني الأعطراف يعني مثلا ال
+
+325
+00:32:36,840 --> 00:32:39,900
+hand extremity ال food extremity
+
+326
+00:32:42,700 --> 00:32:47,720
+ولا الـ skin ولا الـ adipose tissue الفات هو أصعب
+
+327
+00:32:47,720 --> 00:32:55,020
+بسبب مصالح دم ضعيف مصالح دم ضعيف في مناطق في الجلب
+
+328
+00:32:55,020 --> 00:33:03,600
+في القدر مثلا شفاء صعب بس صالح دم ضعيف الـ
+
+329
+00:33:03,600 --> 00:33:07,380
+distribution phase can be extremely slow for drugs
+
+330
+00:33:07,380 --> 00:33:10,820
+that bind strongly to serum proteins هذه القضية
+
+331
+00:33:10,820 --> 00:33:11,200
+الأخرى
+
+332
+00:33:17,680 --> 00:33:22,060
+وبيعمل معها compound، و ال compound هذا حجم كبير،
+
+333
+00:33:22,060 --> 00:33:27,740
+هل صعب إنه يلف الدم و يروح على الخلايا؟ صعب، إلا
+
+334
+00:33:27,740 --> 00:33:33,400
+لما يفضل بروتين الدم يطلق ما لديه من أشرة، يعني
+
+335
+00:33:33,400 --> 00:33:38,780
+بروتين الدم بيأثر بعض الأجوية، مش كل الأجوية، فإن
+
+336
+00:33:38,780 --> 00:33:43,730
+أثرها، فإن أثرها الآن هيتأخراحنا عندنا في العين
+
+337
+00:33:43,730 --> 00:33:51,070
+المثال الصارخ اللي هو ال .. ال .. ال .. ال ..
+
+338
+00:33:51,070 --> 00:33:55,750
+الموسيعات العينية زي المدرامايت مدرامايت مدرامايت
+
+339
+00:33:55,750 --> 00:33:55,970
+مدرامايت مدرامايت مدرامايت مدرامايت مدرامايت
+
+340
+00:33:55,970 --> 00:33:55,970
+مدرامايت مدرامايت مدرامايت مدرامايت مدرامايت
+
+341
+00:33:55,970 --> 00:33:55,990
+مدرامايت مدرامايت مدرامايت مدرامايت مدرامايت
+
+342
+00:33:55,990 --> 00:33:56,070
+مدرامايت مدرامايت مدرامايت مدرامايت مدرامايت
+
+343
+00:33:56,070 --> 00:33:56,330
+مدرامايت مدرامايت مدرامايت مدرامايت مدرامايت
+
+344
+00:33:56,330 --> 00:34:11,590
+مدرامايت مدرامايت مدرامايت مدرام
+
+345
+00:34:13,500 --> 00:34:18,600
+will be dilated within minutes بينما a darkly
+
+346
+00:34:18,600 --> 00:34:23,440
+colored iris
+
+347
+00:34:23,440 --> 00:34:28,380
+will take long time ممكن one hour or more to be
+
+348
+00:34:28,380 --> 00:34:36,520
+fully dilated طيب انا
+
+349
+00:34:36,520 --> 00:34:41,100
+هنا برضه حاولت اجيبلكم هاي ال oral administration
+
+350
+00:34:41,100 --> 00:34:46,100
+من الفهمو نزل اللي هو الدواء إلى الأمعاء و بعد
+
+351
+00:34:46,100 --> 00:34:54,440
+الأمعاء ذهب إلى اللي هو الدم برغم عندي محلول هايو
+
+352
+00:34:54,440 --> 00:35:00,720
+واحد مركز محلول هايو و راح على الوريد راع الدم
+
+353
+00:35:00,720 --> 00:35:09,720
+يعني هذه أمثلة كيف الدواء لازم في النهاية يذهب إلى
+
+354
+00:35:09,720 --> 00:35:10,700
+اللي هو الدم
+
+355
+00:35:17,660 --> 00:35:23,420
+في شيء اسمه distribution barriers برياز حواجز في
+
+356
+00:35:23,420 --> 00:35:31,260
+حواجز في الجسم تحول دول مروح الدم لبعض الأعضاء
+
+357
+00:35:31,260 --> 00:35:35,440
+الحاجز
+
+358
+00:35:35,440 --> 00:35:42,080
+الأول blood brain barrier بيقولك انه يعني ما بين
+
+359
+00:35:42,080 --> 00:35:44,540
+الدم و ما بين المخ
+
+360
+00:35:47,980 --> 00:35:57,020
+اسمه blood brain barrier هذا خلطر يمنع
+
+361
+00:35:57,020 --> 00:36:03,860
+دخول الدواء إلىه
+
+362
+00:36:03,860 --> 00:36:09,860
+يبقى special anatomic arrangement هو ترتيب تشريح
+
+363
+00:36:09,860 --> 00:36:15,280
+معين that aims to distribute only lipid soluble
+
+364
+00:36:15,280 --> 00:36:21,630
+drugsالتي تدوب في الدهون تعبر من هذا ال variable
+
+365
+00:36:21,630 --> 00:36:25,670
+أو ال filter أما الأدوية التي تدوب في الماء فلا
+
+366
+00:36:25,670 --> 00:36:31,170
+تدخل فلا تدخل حتى لو كان ال brain المخ في حاجة
+
+367
+00:36:31,170 --> 00:36:38,270
+إليها فبقول مثلا ال general anesthesia هي أدوية
+
+368
+00:36:38,270 --> 00:36:42,610
+مائية صعب أن تدخل المخ عشان هيك ال general
+
+369
+00:36:42,610 --> 00:36:43,890
+anesthesia بنعطيها وين؟
+
+370
+00:36:49,120 --> 00:36:54,540
+الدروس اللي هم مياه مقصدة ومقصدة مقصدة في الحقيقة
+
+371
+00:36:54,540 --> 00:36:59,980
+ممنعها من دخول بسهولة للعقل بسهولة للدخول بسهولة
+
+372
+00:36:59,980 --> 00:37:09,240
+للعقل انا
+
+373
+00:37:09,240 --> 00:37:11,460
+هنا جاي صورة
+
+374
+00:37:26,820 --> 00:37:36,280
+junction شايفين كيف الفلتر هنا؟ كيف هنا؟ tight بس
+
+375
+00:37:36,280 --> 00:37:41,920
+ماهش بسهولة لدخول الأدوية المائية، اه بينما
+
+376
+00:37:41,920 --> 00:37:47,680
+الأدوية اللي هو دهنية سهلة انها تدخل
+
+377
+00:37:58,110 --> 00:38:03,090
+blood brain barrier الحاجات الدهنية زي هذه تدخل
+
+378
+00:38:03,090 --> 00:38:09,490
+بأسهل من اللاجوية المائية طيب ال antifortics
+
+379
+00:38:09,490 --> 00:38:13,250
+مضادات حيوية that cross the blood brain barrier
+
+380
+00:38:13,250 --> 00:38:17,530
+difficulty can't be used for treatment of central
+
+381
+00:38:17,530 --> 00:38:22,310
+nervous system يبقى صح لو واحد عنده تهيبط في المخ
+
+382
+00:38:22,310 --> 00:38:29,980
+أو عنده سحاية تهيبط السحايةأنا بجد أعطيه مضادات
+
+383
+00:38:29,980 --> 00:38:36,860
+حيوية تدوب في الماء، يبقى أعطيه تدوب في الدهون، يا
+
+384
+00:38:36,860 --> 00:38:41,680
+إما أحقله المضادات الحيوية في الـ Cerebral Spinal
+
+385
+00:38:41,680 --> 00:38:49,420
+Fluid في ذهبه، يعني إن أنا أخد الدماء في الـ
+
+386
+00:38:49,420 --> 00:38:54,300
+Cerebral Spinal Fluid، مش في النخاء، طبعا، هو واضح
+
+387
+00:38:54,300 --> 00:39:00,760
+إنه في عند الديورة متروعندي arachnoid matter وعندي
+
+388
+00:39:00,760 --> 00:39:06,380
+pyramid بين الـ pyra و ال arachnoid في حالة اسمها
+
+389
+00:39:06,380 --> 00:39:11,020
+subarachnoid space وهذا subarachnoid space هو اللي
+
+390
+00:39:11,020 --> 00:39:15,740
+في دورة السبلوسبانفلون من المخ و من نخها الشوكة من
+
+391
+00:39:15,740 --> 00:39:23,580
+المخ و من نخها الشوكة فلو انا اضرب حقنة فيها مضارة
+
+392
+00:39:23,580 --> 00:39:27,220
+حيوي مائي بضرب في الظهر
+
+393
+00:39:40,330 --> 00:39:45,630
+بيدخل ويحط في سن الإبرة ويشيل ال thread لما ينقط
+
+394
+00:39:45,630 --> 00:39:47,830
+ال silver spinal fluid لما يبدأ ينقط ال silver
+
+395
+00:39:47,830 --> 00:39:52,870
+spinal fluid ينقص الإبرة وين؟ في ال subarachnoid
+
+396
+00:39:52,870 --> 00:39:59,630
+spaces بحط الدور بتاعي في سن الإبرة و بروح ايش؟
+
+397
+00:39:59,630 --> 00:40:05,750
+داربه، بيلفيعني انا بعمل bypass لل blood brain
+
+398
+00:40:05,750 --> 00:40:12,370
+barrier بعمل bypass أي متجاوزه اتجاوز اللي هو ال
+
+399
+00:40:12,370 --> 00:40:17,670
+barrier بالحقن المباشر اتجاوز ال barrier بالحقن
+
+400
+00:40:17,670 --> 00:40:25,010
+المباشر فقول هنا the installation of water soluble
+
+401
+00:40:25,010 --> 00:40:30,230
+drugsIntraphically ومعنى انترافيكالي قاى في الـ
+
+402
+00:40:30,230 --> 00:40:33,230
+cerebrospinal في الـ subarachnoid space
+
+403
+00:40:33,230 --> 00:40:37,650
+Intraphical وين يعني؟ subarachnoid space وين
+
+404
+00:40:37,650 --> 00:40:40,730
+السائل بيلفه، أحطه في السائل، على طول الدواء وإن
+
+405
+00:40:40,730 --> 00:40:45,170
+كان باقي، فإن .. فإنه سوف يتجاوز إيش؟ ال barrier
+
+406
+00:40:45,170 --> 00:40:49,290
+is a .. is done to bypass the blood brain barrier
+
+407
+00:40:49,290 --> 00:40:53,970
+and provides different او direct effect يعني أثر
+
+408
+00:40:53,970 --> 00:40:55,110
+علاجي against
+
+409
+00:40:57,630 --> 00:41:01,950
+فمع المعارض التهيأب في الصحية وضعه صعب جدا، لا
+
+410
+00:41:01,950 --> 00:41:05,790
+بيقدرش ياخد أقراس وكلام زي هذا، مافيش إلا نلحقه في
+
+411
+00:41:05,790 --> 00:41:11,890
+أسرع لقت في الحُقن هذه طيب، في شيء اسمه placental
+
+412
+00:41:11,890 --> 00:41:16,830
+blood barrier، معروف يا بناتي أن الـ placenta هي
+
+413
+00:41:16,830 --> 00:41:22,890
+تركيب الله سبحانه وتعالى بيخلقه في جدار الرحم، ما
+
+414
+00:41:22,890 --> 00:41:28,380
+بين الأم الحامل وبين الجنين اللي تكوّناسمها
+
+415
+00:41:28,380 --> 00:41:34,360
+placenta أو المشيمة فالان
+
+416
+00:41:34,360 --> 00:41:40,620
+لو الأم ريدا ببعض الأمراض او بتاعة بعض الأدوية فإن
+
+417
+00:41:40,620 --> 00:41:47,280
+هذا ال barrier قد يحول اقول أنا قد يحول بين دخول
+
+418
+00:41:47,280 --> 00:41:54,260
+ال micro أو الدواء الظهر إلى الجنين لكن مش دائما
+
+419
+00:41:55,620 --> 00:42:00,880
+ثبت إن الـ placental brain barrier أقل تخصوصية و
+
+420
+00:42:00,880 --> 00:42:06,160
+أقل منع من الـ blood brain barrier يعني ممكن
+
+421
+00:42:06,160 --> 00:42:11,600
+يصيروا بعض الاختراف، بعض الاختراف فبقولّي الـ
+
+422
+00:42:11,600 --> 00:42:15,460
+membrane is a membrane layer that separates the
+
+423
+00:42:15,460 --> 00:42:18,200
+blood vessels of the mother from the blood vessels
+
+424
+00:42:18,200 --> 00:42:24,150
+of the fetusUnlike blood brain barrier, the non
+
+425
+00:42:24,150 --> 00:42:27,630
+selective passage of drugs across the placenta to
+
+426
+00:42:27,630 --> 00:42:31,890
+the fetus is well established.الآن يعني معروف انه
+
+427
+00:42:31,890 --> 00:42:35,290
+ال .. ال .. ال placental brain barrier ينفل بعض
+
+428
+00:42:35,290 --> 00:42:40,370
+الأشياء و يمنع بعض الأشياء فمثلا فيروس ال AIDS
+
+429
+00:42:40,370 --> 00:42:46,570
+بيدخل مثلا فيروس الحصب الألمانية German measles
+
+430
+00:42:46,570 --> 00:42:49,410
+بيدخل و الملاريا مثلا بتدخل
+
+431
+00:42:53,270 --> 00:42:56,610
+خاصة البكتيريا، لكن كمان الأدية لا ممنع، اللي هو
+
+432
+00:42:56,610 --> 00:43:02,470
+الدواء، يعني ست مثلا مدخن، ست مثلا بتاخد
+
+433
+00:43:02,470 --> 00:43:06,050
+بايكلوفونات سوديوم باستمرار عشان مفاصلها، وهي مش
+
+434
+00:43:06,050 --> 00:43:11,590
+دارية، بتشوّه الجنين بفعل جهل الأم في المحافظة
+
+435
+00:43:17,040 --> 00:43:22,620
+يبقى هي ال barriers اللي هي بتحول دول دخول الدواء
+
+436
+00:43:22,620 --> 00:43:28,820
+إلى اللي هو بعض اللي هو التراكيب
+
+437
+00:43:28,820 --> 00:43:31,940
+في الجسم أو الواخرز في الجسم اللي هي في ال brain و
+
+438
+00:43:31,940 --> 00:43:36,320
+في ال fetus طيب
+
+439
+00:43:36,320 --> 00:43:43,680
+يتعلق بال placenta دخول الأدوية دخول الأدوية خطير
+
+440
+00:43:43,680 --> 00:43:46,400
+جدا من الأم
+
+441
+00:43:49,710 --> 00:43:54,070
+خاصة في ال first trimester
+
+442
+00:44:05,210 --> 00:44:10,190
+لأنه ممكن أن الدواء يدخل في تركيب الطفل ويعمل
+
+443
+00:44:10,190 --> 00:44:15,850
+تشويه اسمه teratogenic effects والأدوية اسمها
+
+444
+00:44:15,850 --> 00:44:19,810
+teratogenic drugs which are defined as agents that
+
+445
+00:44:19,810 --> 00:44:22,550
+cause physical effects in developing embryo
+
+446
+00:44:33,830 --> 00:44:40,210
+تشويف الأعضاء كثير اللي هو ال malformations هذا
+
+447
+00:44:40,210 --> 00:44:44,750
+بيكون بسبب جهل الأم في تنام الدواء في اللي هو
+
+448
+00:44:44,750 --> 00:44:50,290
+الجزء الأول من الحمض في بعض الأطباء بيمنع الأم
+
+449
+00:44:50,290 --> 00:44:54,730
+تاخد أي نوع من العلاج حتى البيتامين حتى البيتامين
+
+450
+00:44:54,730 --> 00:45:00,630
+لكن في بعض الأطباء يتهاونفي بعض البيتامينات
+
+451
+00:45:00,630 --> 00:45:06,150
+والحديد والمقوية لأن الأم بصير عندها نوع من ال
+
+452
+00:45:06,150 --> 00:45:10,490
+anorexia اللي هو فقد الشهيريعني بيعطيها أشياء
+
+453
+00:45:10,490 --> 00:45:14,750
+محددة، لكن إنه تاخد أسبرين أو تاخد دايكلفين أو
+
+454
+00:45:14,750 --> 00:45:20,170
+تاخد أكامور أو تاخد يعني هذه الأجوية الشديدة ممكن
+
+455
+00:45:20,170 --> 00:45:25,410
+تشول الجنة بيقول لي في النصف التاني من الحمل،
+
+456
+00:45:25,410 --> 00:45:30,680
+الواضح أحسن، لكن على الأم ألا تاخد دواءيعني بجوعات
+
+457
+00:45:30,680 --> 00:45:36,720
+كبيرة لأنه ممكن هنا ان الطفل او الجنيل بدأ فيه
+
+458
+00:45:36,720 --> 00:45:40,140
+الحياة و بدأ يتنفس فممكن يصله respiratory
+
+459
+00:45:40,140 --> 00:45:47,780
+depression او من الفشل للتنفس و ممكن يموت في البطن
+
+460
+00:45:47,780 --> 00:45:52,820
+اذا كان الأم تنفست من غازات او ابخرة او قطر
+
+461
+00:45:52,820 --> 00:46:00,140
+كحوليات او tobaccoأو أقراس بجوعات كبيرة فإنها قد
+
+462
+00:46:00,140 --> 00:46:05,300
+تقضي على جلينها، لذلك الأفضل تقليص أي نوع من
+
+463
+00:46:05,300 --> 00:46:10,720
+الأدوية خلال فترة الحملحرف المرأة على جارينها.
+
+464
+00:46:11,040 --> 00:46:16,400
+احنا هيك الحمد لله في هذا اليوم أنجزنا يعني الفد
+
+465
+00:46:16,400 --> 00:46:22,720
+الأول اللي هو ال absorption of drugs و الفد التاني
+
+466
+00:46:22,720 --> 00:46:26,720
+اللي هو metabolism of drugs و ان شاء الله يعني ال
+
+467
+00:46:26,720 --> 00:46:30,260
+distribution of drugs و المرة الجاية ان شاء الله
+
+468
+00:46:30,260 --> 00:46:34,200
+هنبدأ بال metabolism of drugs شكرا لكم على قصتنا
+
+469
+00:46:34,200 --> 00:46:36,940
+الاستماع و السلام عليكم و رحمة الله و ببركاته
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/rs42TpcOFPQ.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/rs42TpcOFPQ.srt
new file mode 100644
index 0000000000000000000000000000000000000000..ef0e90a8b14b20d8abb4f712d6fc7c63063783a5
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/rs42TpcOFPQ.srt
@@ -0,0 +1,1637 @@
+1
+00:00:20,920 --> 00:00:22,800
+أعوذ بالله من الشيطان الرجيم، بسم الله الرحمن
+
+2
+00:00:22,800 --> 00:00:28,340
+الرحيم، الحمد لله رب العالمين، وأسلم على النبي 
+
+3
+00:00:28,340 --> 00:00:31,500
+الأمين وعلى آله وصحابه والتابعين
+
+4
+00:00:52,090 --> 00:00:55,590
+الدراجة كتابة كتابة كتابة كتابة كتابة كتابة كتابة
+
+5
+00:00:55,590 --> 00:00:59,570
+كتابة كتابة كتابة كتابة كتابة كتابة كتابة كتابة
+
+6
+00:00:59,570 --> 00:01:00,130
+كتابة كتابة كتابة كتابة كتابة كتابة كتابة كتابة
+
+7
+00:01:00,130 --> 00:01:00,150
+كتابة كتابة كتابة كتابة كتابة كتابة كتابة كتابة
+
+8
+00:01:00,150 --> 00:01:03,250
+كتابة كتابة كتابة كتابة كتابة كتابة
+
+9
+00:01:03,250 --> 00:01:19,990
+كتابة كتاب
+
+10
+00:01:20,680 --> 00:01:41,240
+تشخيص تشخيص
+
+11
+00:01:41,240 --> 00:01:46,680
+تشخيص تشخيص تشخيص تشخيص تشخيص تشخيص تشخيص تشخيص
+
+12
+00:01:46,680 --> 00:01:46,900
+تشخيص تشخيص تشخيص تشخيص تشخيص تشخيص تشخيص تشخيص
+
+13
+00:01:46,900 --> 00:01:50,430
+تشخيص تشخيص تشخيص Characterized by redness, hotness,
+
+14
+00:01:51,690 --> 00:02:02,350
+pain, loss of function. Yes؟ طيب.  Iritis is a
+
+15
+00:02:02,350 --> 00:02:10,410
+serious disease that will affect vision. يعني
+
+16
+00:02:10,410 --> 00:02:18,150
+the vision in iritis will be affected أعمى كتب. ثم
+
+17
+00:02:18,150 --> 00:02:20,770
+أتروبين مفيد جدًا في التعامل مع الالتهاب
+
+18
+00:02:20,770 --> 00:02:27,610
+الانترويوبيال A. أتروبين يقلل الألم يقلل الألم 
+
+19
+00:02:27,610 --> 00:02:30,510
+associated with the inflammatory process by
+
+20
+00:02:30,510 --> 00:02:35,630
+relaxing the ciliary muscle spasm يبقى
+
+21
+00:02:35,630 --> 00:02:40,590
+الالتهاب، العضلة بتحصل على سباز سم، السباز بيعمل
+
+22
+00:02:40,590 --> 00:02:49,360
+pain هنا لما نحط العضلة في حالة استرخاء أو relaxed
+
+23
+00:02:49,360 --> 00:02:54,900
+position this will lead to loss of pain أي واحد
+
+24
+00:02:54,900 --> 00:03:03,120
+بيه and helps to prevent posterior synechiae
+
+25
+00:03:03,120 --> 00:03:09,700
+الاتصاقات by dilating the pupil وأنا جبت لكم صورة
+
+26
+00:03:11,920 --> 00:03:16,740
+شايفين ال pupil هذا البني أو الأصفر لما صار
+
+27
+00:03:16,740 --> 00:03:21,440
+violated ابتعد عن ايش؟ عن ال surface of the lens
+
+28
+00:03:21,440 --> 00:03:25,500
+في الالتهاب
+
+29
+00:03:25,500 --> 00:03:32,020
+العنبية بيكون sticky sticky يعني بيلصق عارفين
+
+30
+00:03:32,020 --> 00:03:33,560
+الرغيب؟
+
+31
+00:03:39,930 --> 00:03:45,930
+الأتروبين بيعمل على تجفيف ال iris بيجففه كيف
+
+32
+00:03:45,930 --> 00:03:53,090
+السشوار والشعر بينشف الشعر هذا الأتروبين بينشف ال
+
+33
+00:03:53,090 --> 00:03:57,930
+iris أي بيمنع ال exudation  ال inflammation له
+
+34
+00:03:57,930 --> 00:04:01,970
+إفرازات اسمها exudation لما الواقع فينا بيرشح أو
+
+35
+00:04:01,970 --> 00:04:06,150
+زربيا أو كل شوية بتطلع اه exudation فيه
+
+36
+00:04:06,150 --> 00:04:09,980
+inflammatory cells الأتروبين هنا بينشف ال iris
+
+37
+00:04:09,980 --> 00:04:17,380
+بيخلي أقل التصاق من ايه؟ من ال surface of the lens
+
+38
+00:04:17,380 --> 00:04:23,540
+لهيك إنه كمان بيفتح ال pupil pupil على الآخر بيبعد ال
+
+39
+00:04:23,540 --> 00:04:30,460
+contact بين ال iris و بين ال lens بيخلقش فيه contact
+
+40
+00:04:30,460 --> 00:04:35,940
+بيسحبوا بعيد يعني ال pupil pupil هيك وال iris بيروح
+
+41
+00:04:35,940 --> 00:04:42,210
+periphery وال lens هي هنا فبيصير في الاتصال زي
+
+42
+00:04:42,210 --> 00:04:52,830
+هيك في الحالة الأولى كده وكده وهي ال lens يبقى
+
+43
+00:04:52,830 --> 00:04:59,030
+هنا في contact مع ال iris بين ايش؟ ال anterior
+
+44
+00:04:59,030 --> 00:05:02,390
+surface of the lens طيب الحالة حطينا أتروبين
+
+45
+00:05:06,870 --> 00:05:17,390
+بس هي العيوب هي الناس هيك أو بتكون flat ما فيش
+
+46
+00:05:17,390 --> 00:05:23,910
+contact في الحالة الأولى لو ما حطيناش أتروبين أو
+
+47
+00:05:23,910 --> 00:05:29,250
+cypermetroid على الأقل هتصير هنا الاتصال الاتصال هذا
+
+48
+00:05:29,250 --> 00:05:36,970
+اسمه posterior synechiae الاتصال هو اتصال اتصال حقيقي
+
+49
+00:05:36,970 --> 00:05:45,250
+المشكلة في الاتصال هذا إنه بيصير تأثير هنا طيب الآن
+
+50
+00:05:45,250 --> 00:05:51,890
+ال ... ال aqueous بيطلع من هنا و بيرهق و بدو يطلع 
+
+51
+00:05:51,890 --> 00:05:57,130
+من البحر عشان يطلع على ال angle of AC لما نيجي هنا 
+
+52
+00:05:57,130 --> 00:06:07,370
+في حاجة اسمها IRIS POMPEI أو أكلوزيو بيوبيلي عارفين 
+
+53
+00:06:07,370 --> 00:06:13,990
+أكلوزيو بيوبيلي يعني ال pupil مسكر يبقى هتصير ال ...
+
+54
+00:06:13,990 --> 00:06:15,770
+ال ... ال ... ال ... ال ... ال ... ال ... ال ... ال ... ال
+
+55
+00:06:15,770 --> 00:06:15,850
+.. ال ... ال ... ال ... ال ... ال ... ال ... ال ... ال ...
+
+56
+00:06:15,850 --> 00:06:15,870
+ال ... ال ... ال ... ال ... ال ... ال ... ال ... ال ... ال
+
+57
+00:06:15,870 --> 00:06:15,990
+.. ال ... ال ... ال ... ال ... ال ... ال ... ال ... ال ...
+
+58
+00:06:15,990 --> 00:06:16,470
+ال ... ال ... ال ... ال ... ال ... ال ... ال ... ال ... ال
+
+59
+00:06:16,470 --> 00:06:17,070
+.. ال ... ال ... ال ... ال ... ال ... ال ... ال ... ال ...
+
+60
+00:06:17,070 --> 00:06:17,630
+ال ... ال ... ال ... ال ... ال ... ال ... ال ... ال ... ال
+
+61
+00:06:17,630 --> 00:06:18,130
+.. ال ... ال ... ال ... ال ... ال ... ال ... ال ... ال ...
+
+62
+00:06:18,130 --> 00:06:20,430
+ال ... ال ... ال ... ال ... ال ... ال ... ال ... ال ... ال
+
+63
+00:06:20,430 --> 00:06:24,150
+ال ... ال ...
+
+64
+00:06:24,150 --> 00:06:29,670
+ال ... ال ...
+
+65
+00:06:31,950 --> 00:06:37,050
+من كثر الضغط عليه لكن مهما كان مُوثوق، مع ايش، مع 
+
+66
+00:06:37,050 --> 00:06:43,990
+الذي، يبقى أنا علاجي بالأتروبين علاج علمي، أنا
+
+67
+00:06:43,990 --> 00:06:48,530
+عارف ايش بحط أتروبين، عشان ما أعملش لمصيبة هذه، طبعًا
+
+68
+00:06:48,530 --> 00:06:52,530
+في الآخر كل هذا هينعكس على ال optic nerve سلبًا
+
+69
+00:07:10,740 --> 00:07:14,960
+بالتالي، عندما يتحرر الجلد في المنطقة المستيقظة، 
+
+70
+00:07:14,960 --> 00:07:19,880
+الاتصال بالكبسولة الأمامية يتخلص، واضح؟ لأنه ليس
+
+71
+00:07:19,880 --> 00:07:25,560
+هناك التصاق. طب سي في العلاج، moreover، أكثر من
+
+72
+00:07:25,560 --> 00:07:30,720
+ذلك، السيكلوبليجيا اللي تم إنتاجه من الأتروبين هو
+
+73
+00:07:30,720 --> 00:07:36,320
+مقيّم إضافي ويقوم بتقليم كامة ومعمومة من ال lens
+
+74
+00:07:37,160 --> 00:07:40,460
+البوستيريور سينيكيا يجب أن يتطور حتى عند انفجار
+
+75
+00:07:40,460 --> 00:07:43,860
+الناس انفجار الناس انفجار الناس انفجار الناس
+
+76
+00:07:43,860 --> 00:07:45,900
+انفجار الناس انفجار الناس انفجار الناس انفجار
+
+77
+00:07:45,900 --> 00:07:50,360
+الناس انفجار الناس انفجار الناس انفجار الناس
+
+78
+00:07:50,360 --> 00:07:51,100
+انفجار الناس انفجار الناس انفجار الناس انفجار
+
+79
+00:07:51,100 --> 00:08:00,940
+انفجار الناس انفجار الناس انفجار الناس انفجار
+
+80
+00:08:00,940 --> 00:08:06,300
+ال
+
+81
+00:08:07,420 --> 00:08:13,320
+و less convex الحالة الرابعة Atropine may also
+
+82
+00:08:13,320 --> 00:08:18,080
+help decrease the excessive permeability of the
+
+83
+00:08:18,080 --> 00:08:22,400
+inflamed blood vessels in the iris طبعًا and
+
+84
+00:08:22,400 --> 00:08:25,900
+thereby reduce cells and protein in the anterior
+
+85
+00:08:25,900 --> 00:08:31,460
+chamber زي ما قلنا احنا لما بيصير inflammation
+
+86
+00:08:31,460 --> 00:08:38,920
+لل iris، ال iris بيصير congested نفس ال iris بيصير
+
+87
+00:08:38,920 --> 00:08:42,540
+congested و بيصير ال blood vessels بتاعته dilated
+
+88
+00:08:42,540 --> 00:08:47,000
+ولما ال blood vessels بيصير dilated بيصير سهلة 
+
+89
+00:08:47,000 --> 00:08:53,900
+solution يعني مثلًا هي ال iris هيك وهي ال blood
+
+90
+00:08:53,900 --> 00:08:59,580
+vessels بدا إن كانت صغيرة كده صارت كبيرة كده
+
+91
+00:08:59,580 --> 00:09:05,860
+يعني مثلًا inflammation في الحالة الأولى كانت ال
+
+92
+00:09:05,860 --> 00:09:09,700
+endothelial cells مغطية الوضع، هنا اللي فيها ال
+
+93
+00:09:09,700 --> 00:09:15,140
+cells مش مغطية الوضع صار فيه فجوات يسهل أن يخرج
+
+94
+00:09:15,140 --> 00:09:20,480
+منها ال water flow ال cells والكلبها، مع سائل 
+
+95
+00:09:20,480 --> 00:09:25,020
+اسمه exudate، exudate هذا يعني fluid و
+
+96
+00:09:25,020 --> 00:09:29,820
+inflammation، هذا هيروح وين؟ هيجي في ال AC
+
+97
+00:09:34,660 --> 00:09:40,500
+هذا اللي احنا بنقول عنه في الليل وبنقول هنا اللي
+
+98
+00:09:40,500 --> 00:09:43,120
+بيكون على ظهر ال ... ال ... ال ... ال ... في ال
+
+99
+00:09:43,120 --> 00:09:45,400
+endothelium of the KP
+
+100
+00:09:59,350 --> 00:10:05,070
+يبقى شوفوا الفوائد اللي احنا يعني بنعملها من وضع 
+
+101
+00:10:05,070 --> 00:10:10,870
+الأتروبين في حالة ال iritis شيء مهم جدًا أي يعني
+
+102
+00:10:10,870 --> 00:10:15,370
+تعالج كل الكورتيزون هو علاج هنا الكورتيزون without
+
+103
+00:10:15,370 --> 00:10:22,930
+Cycloplegic يعني تكبر fifty percent useless يعني
+
+104
+00:10:22,930 --> 00:10:27,050
+أنا بقعد أستخدم الكورتيزون عشان anti inflammatory لكن
+
+105
+00:10:27,050 --> 00:10:28,390
+الالتصاق
+
+106
+00:10:30,740 --> 00:10:34,580
+بين ال Iris وبين ال Lens ما يكفيش فيه ال
+
+107
+00:10:34,580 --> 00:10:39,040
+Cortisone لازم cycloplegic  وقاعدة ما بيعرفها 
+
+108
+00:10:39,040 --> 00:10:44,860
+إلا الممارس لهذا العالم يعني هذه الصورة حبيت أجيبها 
+
+109
+00:10:44,860 --> 00:10:51,580
+عشان تشوفوا يعني كيف قبل الأتروبين وكيف بعد 
+
+110
+00:10:51,580 --> 00:10:56,240
+الأتروبين شوفوا ال Iris هنا شوفوا ال thickness
+
+111
+00:10:56,240 --> 00:11:02,260
+انتوا بتشوفوا ال axis و شوفوا هنا وأنا ال iris صارت
+
+112
+00:11:02,260 --> 00:11:07,220
+peripheral بالأتروبين وال thickness جاية صارت 
+
+113
+00:11:07,220 --> 00:11:17,000
+less convex و more flat اللي هو ال lens واضح؟ طيب
+
+114
+00:11:17,000 --> 00:11:21,120
+الاستعمال الثالث للأتروبين غير ال refraction
+
+115
+00:11:27,960 --> 00:11:31,700
+أو طالب قد قال Penalization Penalization الإجابة
+
+116
+00:11:31,700 --> 00:11:39,960
+إجابة ايش؟ إجابة العين القوية بالعين السليمة للطفل
+
+117
+00:11:39,960 --> 00:11:46,720
+كل ما حط له patch غطاء بيشيله وبيبكي ما بيديله الخطأ
+
+118
+00:11:46,720 --> 00:11:52,020
+حط له على العين السليمة غطاء عشان أعمل activation
+
+119
+00:11:52,020 --> 00:11:56,720
+لل isotropic
+
+120
+00:11:56,720 --> 00:11:57,140
+eye
+
+121
+00:12:01,730 --> 00:12:05,470
+مش عاوز فبيقولوا
+
+122
+00:12:05,470 --> 00:12:09,750
+والله ما في لا ثقة إنه واقف على عينه أبدًا إلا يشيله
+
+123
+00:12:09,750 --> 00:12:14,230
+ويعيده ويقولوا طيب هنعمله Penalization حطوا ال
+
+124
+00:12:14,230 --> 00:12:23,190
+atropine يعني ممكن once daily ال atropine لما نضعه 
+
+125
+00:12:23,190 --> 00:12:28,070
+في العين بيخلي some eye فيها impaired vision for
+
+126
+00:12:28,070 --> 00:12:31,820
+near and for distance for near and far distance
+
+127
+00:12:31,820 --> 00:12:38,020
+وبالتالي الطفل يصبح شيئًا فشيئًا يعتمد على عينه ال
+
+128
+00:12:38,020 --> 00:12:45,220
+amblyopia على عينه الكسولة lazy eye ممكن هذا يقوم
+
+129
+00:12:45,220 --> 00:12:49,920
+شهر شهرين ثلاثة اه بس هو بيحذر من شيء في ال
+
+130
+00:12:49,920 --> 00:12:57,520
+Penalization إنه بعد ما يروح تأثير الأتروبين ممكن
+
+131
+00:12:57,520 --> 00:13:02,850
+يصير reversed amblyopia في العين السليمة ايه يعني
+
+132
+00:13:02,850 --> 00:13:09,130
+أنا كسلت ال eye ال ... ال ... lazy وكسلت العين اللي مش
+
+133
+00:13:09,130 --> 00:13:12,850
+lazy لكن أنا ما أخاف أكثر من هذا لأن بعد ذلك ممكن
+
+134
+00:13:12,850 --> 00:13:17,770
+نعمل balance شوية دي بطاقة وحاجة ممكن إن الطفل
+
+135
+00:13:17,770 --> 00:13:23,230
+يفوز بنتيجة طب تكون أذية تكون زي 14؟ لا أنا 
+
+136
+00:13:23,230 --> 00:13:26,870
+حاسب نفسي إن ... وبعدين هي يجب أن تدرس برصاعية 16
+
+137
+00:13:26,870 --> 00:13:28,190
+-24
+
+138
+00:13:32,260 --> 00:13:37,460
+هي يعني أنا بقول نوع من العلاج أنا مارسته ويعني 
+
+139
+00:13:37,460 --> 00:13:42,940
+الحقيقة ال patching أحسن ليش؟ ال patching بيعطي zero
+
+140
+00:13:42,940 --> 00:13:49,240
+percent vision لكن ال atropine لا بيعطي أكثر من
+
+141
+00:13:49,240 --> 00:13:54,640
+zero أكثر من 10% أو أكثر من 20% لكن أنا بقول في 
+
+142
+00:13:54,640 --> 00:13:56,020
+حالة ال failure
+
+143
+00:14:04,750 --> 00:14:11,990
+ما تنفعش طيب treatment هو Myopia علاج ال Myopia أنتم
+
+144
+00:14:11,990 --> 00:14:15,670
+عارفين في الأطفال نادر يكون فيه Myopia لكن لو كان
+
+145
+00:14:15,670 --> 00:14:18,270
+فيه Myopia بتكون progressive Myopia progressive
+
+146
+00:14:18,270 --> 00:14:24,430
+Myopia في الحقيقة بالتجربة وجدوا أن الأتروبين may
+
+147
+00:14:24,430 --> 00:14:27,470
+prevent or slow على قدرة progression of Myopia by
+
+148
+00:14:27,470 --> 00:14:30,650
+placing the ciliary muscle at rest وال
+
+149
+00:14:30,650 --> 00:14:34,120
+accommodation بيكون relaxed Annotation that
+
+150
+00:14:34,120 --> 00:14:39,020
+produces elongation of the eye may be reduced شوية
+
+151
+00:14:39,020 --> 00:14:42,800
+شوية وال administration of one percent atropine for
+
+152
+00:14:42,800 --> 00:14:48,680
+one to eight years وهذا الشيء الصعب يعني فات 
+
+153
+00:14:48,680 --> 00:14:54,840
+أتروبين في عينين الطفل أقل شيء سنة أو أكثر شيء سنة
+
+154
+00:14:54,840 --> 00:14:57,520
+أو أكثر سنة The decrease in Myopia in treated eyes
+
+155
+00:14:57,520 --> 00:15:00,020
+of children has usually been less than
+
+156
+00:15:04,650 --> 00:15:10,510
+عندما أجهزت الـ I أظهرت زيادة في الميوبيا تقريبًا 0
+
+157
+00:15:10,510 --> 00:15:20,330
+.91 دقيقة في السنة يعني في الأطفال اللي ما وضعنا
+
+158
+00:15:20,330 --> 00:15:25,770
+لهم أتروبين كان progress of Myopia
+
+159
+00:15:32,810 --> 00:15:37,330
+يعني في خلال عشر سنوات هيكون تقدم حوالي ثمانية
+
+160
+00:15:37,330 --> 00:15:43,890
+ديوبتر اه صح اه عشر سنة اه ثمانية ديوبتر كل عشر
+
+161
+00:15:43,890 --> 00:15:47,210
+سنة لكن اللي عيزينه هو أبعدنا عن الأتروبين وجدنا
+
+162
+00:15:47,210 --> 00:15:54,110
+أنه تقدم حوالي أربعة ديوبتر النص النص هذا بالتجربة
+
+163
+00:15:54,110 --> 00:16:01,710
+لكن مين يتحمل الأتروبين هذه السنوات مش بس هيك بقول
+
+164
+00:16:03,070 --> 00:16:10,750
+ولكن في تجارب الانتقالات، فقط 12% من الأطفال كانوا
+
+165
+00:16:10,750 --> 00:16:15,770
+يحافظوا على تحسين أكبر من 6 أشهر، للأسف بعد وقف
+
+166
+00:16:15,770 --> 00:16:24,110
+الأتروبين، يعود الانتقال ثانيًا، فقط 12% من الناس
+
+167
+00:16:24,110 --> 00:16:27,530
+اللي كانوا يحافظوا على الانتقال، فقط 12% من الناس
+
+168
+00:16:27,530 --> 00:16:28,290
+اللي كانوا يحافظوا على انتقال
+
+169
+00:16:36,590 --> 00:16:42,950
+هو Myopia. فهيبقى فيها discussion. كيف رأيكم 
+
+170
+00:16:42,950 --> 00:16:48,330
+أنتم لو في أنتم في ال progressive Myopia؟ You will
+
+171
+00:16:48,330 --> 00:16:53,650
+go to administer Atropine for one year؟ كنتين
+
+172
+00:16:53,650 --> 00:17:01,750
+تواصلي؟ ليه؟ وعدتي؟ إن iris ساعتها هتبتدي تأثر على الـ healthy
+
+173
+00:17:01,750 --> 00:17:05,300
+اللي هو ال school اللي هو ال islam ده مش كويس طب
+
+174
+00:17:05,300 --> 00:17:08,180
+هي كل ما نومي بيصير Myopic يعني هي كده ... لا بعد 
+
+175
+00:17:08,180 --> 00:17:11,100
+فاهمة أوي لأ لما نحط له حبة عينه هتبقى غابشة مش 
+
+176
+00:17:11,100 --> 00:17:14,640
+هيشوف فيها كويس هتأثر على النظر في حالات تانية
+
+177
+00:17:14,640 --> 00:17:17,840
+بتقدر تعمل لها ال preparation تبع ال ... ايش حالات 
+
+178
+00:17:17,840 --> 00:17:21,000
+تانية؟ زي ال bifocal lens وال contact lens هذا
+
+179
+00:17:21,000 --> 00:17:25,680
+الطفل عمره سنتين؟ اه فضل يا سهير ايش احنا أخذنا إنه 
+
+180
+00:17:25,680 --> 00:17:29,760
+لما يكون يعني لحد السنة وهيك إنه في دراسات كانت
+
+181
+00:17:29,760 --> 00:17:33,630
+تحكي إن ال myopic بعدها بتختفي بيصير hyper فالأحسن
+
+182
+00:17:33,6
+
+216
+00:20:44,230 --> 00:20:49,010
+إن كان هو Adult كبير و عنده Narrow Angle مش في أي
+
+217
+00:20:49,010 --> 00:20:52,550
+واحد خاصة إن ال Angle يكون Narrow أو High
+
+218
+00:20:52,550 --> 00:20:55,510
+Hypermetroid مش هينفع الـ High Hypermetroid بيبدع ما 
+
+219
+00:20:55,510 --> 00:21:00,970
+بحط له Atropine أبدا طيب for elevation of uteral 
+
+220
+00:21:00,970 --> 00:21:03,730
+pressure if patients with open Angle أحيانا حتى في
+
+221
+00:21:03,730 --> 00:21:07,330
+الـ open Angle بيرفع الضغط مش شرط إنه يعمل Angle
+
+222
+00:21:07,330 --> 00:21:08,050
+Closure Glaucoma
+
+223
+00:21:17,620 --> 00:21:23,940
+طبعا واحدة حطت Atropine في عينيه عليه أن يلزم الغرفة
+
+224
+00:21:23,940 --> 00:21:30,420
+اللي فيها ضوء ضوء Atropine 
+
+225
+00:21:30,420 --> 00:21:34,220
+إذا طيب في الشمس أو في ضوء جوي أحيانا ما لهوش تفوت 
+
+226
+00:21:45,250 --> 00:21:48,690
+والـ Blepharitis حكّى. إيش في الجانب؟ كانت دي ديما
+
+227
+00:21:48,690 --> 00:21:54,870
+تورّم، تورّم في الجفون زي اللي هو الـ .. الـ .. الـ
+
+228
+00:21:54,870 --> 00:21:58,210
+.. الست هذه، شايفين؟ في .. في تورّم في الجفون،
+
+229
+00:21:58,210 --> 00:22:05,170
+صحيح؟ واضح، في تورّم في الجفون، وفي رَثْيَمة؟ أكيد،
+
+230
+00:22:05,170 --> 00:22:07,310
+رثيمة الحمار هذا في الكودينالطيبة
+
+231
+00:22:13,340 --> 00:22:18,740
+الـ Atropine في العين قطرة كما وكذلك Cholinergic
+
+232
+00:22:18,740 --> 00:22:22,840
+Anticholinesterase وكل الـ Miotics اللي زيه أو أي شيء يزيد
+
+233
+00:22:22,840 --> 00:22:28,300
+حرارة الـ Angle Closure Glaucoma في المريض فالحرارة اللي تزيد
+
+234
+00:22:28,300 --> 00:22:32,380
+حرارة Angle Closure Glaucoma في العين بدون تاريخ تاريخ
+
+235
+00:22:32,380 --> 00:22:38,340
+تاريخ يعني قليل يعني اللي ما عندوش تاريخ تاريخ
+
+236
+00:22:38,340 --> 00:22:39,980
+تاريخ
+
+237
+00:22:42,250 --> 00:22:46,410
+يعني استعمال قليل أكثر أكثر فرصة إن نستعمل
+
+238
+00:22:46,410 --> 00:22:51,410
+الـ Atropine مرة مرتين تلاتة قبل ذلك ولم يحدث له طالما 
+
+239
+00:22:51,410 --> 00:22:55,530
+إن الصعب يحدث له في هذه المرة أما اللي حدث له مرة 
+
+240
+00:22:55,530 --> 00:23:00,630
+قد يحدث له كل مرة إن حدث إن حطيت Atropine وصار أنا 
+
+241
+00:23:00,630 --> 00:23:06,830
+أنا كنت التالت ما بحط له شيء أتنى راضي؟ طيب دكتور 
+
+242
+00:23:06,830 --> 00:23:11,430
+يعني الـ Dermatitis هي مش هنعرفها إلا لما نستخدم
+
+243
+00:23:16,220 --> 00:23:22,340
+عين تتحمر والجلد يحمر وكل ملفات تزيد وتتوسع و
+
+244
+00:23:22,340 --> 00:23:26,220
+يصير إدمة و Weakness نعرف إنه Contact Dermatitis
+
+245
+00:23:26,220 --> 00:23:32,160
+وقف الـ Atropine بيروح بعد يومين تلاتة بيروح، طبعا بده
+
+246
+00:23:32,160 --> 00:23:39,200
+علاج يعني، بده إيش؟ Antihistamine، بده علاجه هنا
+
+247
+00:23:39,200 --> 00:23:42,800
+Allergic Papillary Conjunctivitis and Keratitis هي
+
+248
+00:23:42,800 --> 00:23:48,440
+الْمَلْتحمة وفيها احمرار واتهاب والقرنية كذلك 
+
+249
+00:23:48,440 --> 00:23:53,160
+سطح القرنية خاصة الـ Epithelium طيب Systemic
+
+250
+00:23:53,160 --> 00:23:57,860
+Reactions of Atropine in Children الآن احنا قولنا 
+
+251
+00:23:57,860 --> 00:24:02,440
+إن الـ Children are more liable to side effects
+
+252
+00:24:10,150 --> 00:24:15,510
+Small body weight يعني الـ Adult نحط له أنا نقطتين 
+
+253
+00:24:15,510 --> 00:24:22,270
+Atropine صباحا ونقطتين مساءا وراحوا على الدم كم
+
+254
+00:24:22,270 --> 00:24:27,550
+هتأثره؟ كم هتأثره في جسم الـ Adult اللي زينا، لكن
+
+255
+00:24:27,550 --> 00:24:29,230
+إذا كنت Baby عمره سنة 
+
+256
+00:24:35,750 --> 00:24:39,710
+يضرّوا .. يضرّوا جسمه، يعملوا له مشاكل كثيرة داخل
+
+257
+00:24:39,710 --> 00:24:44,690
+جسمه خاصة على الـ Nervous System يبقى في الـ
+
+258
+00:24:44,690 --> 00:24:48,670
+Children Diffuse Cutaneous Flush
+
+259
+00:25:05,280 --> 00:25:12,940
+Depressed Respiration and Thirst جفاف في الفم
+
+260
+00:25:12,940 --> 00:25:20,620
+والوعي لأنه أثر على الـ Nervous System Fever
+
+261
+00:25:27,050 --> 00:25:34,710
+أشهد أنه يستخدم أقراص الـ Atropine لعلاج التبول
+
+262
+00:25:34,710 --> 00:25:45,710
+الليلي عند الأطفال Tachycardia
+
+263
+00:25:45,710 --> 00:25:49,150
+يبقى Sympathetic بـ Serostimulation
+
+264
+00:25:53,430 --> 00:25:56,410
+Excitement and Restlessness and Hallucinations
+
+265
+00:25:56,410 --> 00:26:02,230
+تلاقي الطفل Excited و
+
+266
+00:26:02,230 --> 00:26:08,410
+Restless بيجي ينام وبيقوم ودايما كده بيبكي و يعني
+
+267
+00:26:08,410 --> 00:26:11,990
+بيقول هو يعني مش مستوعب ويوم كده مال
+
+268
+00:26:11,990 --> 00:26:16,050
+Hallucinations يعني يتكلم كلام ما لهوش معنى Speech
+
+269
+00:26:16,050 --> 00:26:17,250
+Disturbances
+
+270
+00:26:21,420 --> 00:26:23,940
+لو يجي يمشي بترانة ذات اليمين وذات الشمال
+
+271
+00:26:23,940 --> 00:26:26,620
+التكسيه، ما هو تأثير على الـ Nervous System؟
+
+272
+00:26:26,620 --> 00:26:32,300
+Convergence، لو زاد الأمر قصر، ما هي؟ تشنجات
+
+273
+00:26:32,300 --> 00:26:37,840
+طبعا احنا كناس Users لـ Atropine، Practitioners،
+
+274
+00:26:37,840 --> 00:26:41,580
+المفروض ما نصيحش الحاجة هذه طبعا الـ Atropine هو
+
+275
+00:26:41,580 --> 00:26:47,950
+Home Use، استخدام بيتي يعني احنا بنكتب للأم للطفل
+
+276
+00:26:47,950 --> 00:26:53,730
+الـ Infant أو Small Child بنكتب لها Atropine Twice
+
+277
+00:26:53,730 --> 00:27:01,630
+Daily فهو مثلا Four Days المفروض إنه ننبهها للأم
+
+278
+00:27:01,630 --> 00:27:12,050
+إذا كان الطفل أصبح Febrile سخن أو Flush ولم يش
+
+279
+00:27:21,580 --> 00:27:25,040
+والأم اللي هي متعلمة وواعية تقول يا دكتور نعم
+
+280
+00:27:25,040 --> 00:27:32,620
+الولد سخن سخن بس ولا ممكن تقول لك إيه إنه في حمار 
+
+281
+00:27:32,620 --> 00:27:36,940
+في عينيه حمار في جلده واقف العلاج اللي بديه طبعا
+
+282
+00:27:36,940 --> 00:27:44,740
+أنا ممكن أعمل له Reflection لو أنا وصلت يعني فرشة
+
+283
+00:27:44,740 --> 00:27:47,340
+Psychopathy أفضل إن بلاش ما حصل أنا حاطين القطر 
+
+284
+00:27:49,190 --> 00:27:52,450
+يعني العين ما حطيناها اليوم أو يومين لسه أقوى من الـ 
+
+285
+00:27:52,450 --> 00:27:57,910
+Cycle بنفلات صحيح إنه Partial لكن مثلا هيكون وصف
+
+286
+00:27:57,910 --> 00:28:02,450
+الـ 80% من اللي أنا عايزه فبعمل له Reflection و
+
+287
+00:28:02,450 --> 00:28:06,830
+بنوقفه وممكن أعطيه بعض شراب للحساسية بعض شراب
+
+288
+00:28:06,830 --> 00:28:15,810
+للحساسية يبقى الـ Atropine هو Safe لو حد يجيب الحد
+
+289
+00:28:16,730 --> 00:28:23,190
+يعني قاطع وحد غير قاطع فالإنسان يستخدم فواته
+
+290
+00:28:23,190 --> 00:28:31,750
+ويحاول أن يعني يتجنب المساوئ بتاعة الأطراف. فبت
+
+291
+00:28:31,750 --> 00:28:35,130
+Cyclopentolate Cyclopentolate is the most widely used
+
+292
+00:28:35,130 --> 00:28:40,150
+Cycloplegic today في أهل الأيام يعني أقدر أقول أقل 
+
+293
+00:28:40,150 --> 00:28:45,230
+شيء Seventy Percent من الحالات الـ Cycloplegia اللي
+
+294
+00:28:45,230 --> 00:28:54,830
+بتستخدم في العالم هي الـ Cyclopentolate وهو الاختيار 
+
+295
+00:28:54,830 --> 00:28:59,150
+الخير الأول الـ Paralysis of Accommodation is not
+
+296
+00:28:59,150 --> 00:29:03,910
+Complete صحيح احنا لازم نكون عارفين إنه ما بيعملش
+
+297
+00:29:03,910 --> 00:29:07,270
+Hundred Percent Paralysis of Ciliary Muscle
+
+298
+00:29:12,500 --> 00:29:16,820
+It gives a depth of Cycloplegia that is 
+
+299
+00:29:16,820 --> 00:29:20,600
+Sufficient for the majority of cases يعني بيعطيني
+
+300
+00:29:20,600 --> 00:29:31,200
+عمق Cycloplegia كافية للعمل بشكل مرضي لأقل 100% و
+
+301
+00:29:31,200 --> 00:29:35,960
+لأقل 90% وأنا طبعا بعملها حسبة في الآخر بعمل
+
+302
+00:29:35,960 --> 00:29:44,990
+Adjustment بيقول لي هفنروفاقه على إنه وجدوا إن الـ
+
+303
+00:29:44,990 --> 00:29:48,990
+Great Value of Cyclopentolate when he describes 
+
+304
+00:29:48,990 --> 00:29:51,670
+Its effects in the field of Cycloplegia as 
+
+305
+00:29:51,670 --> 00:29:57,070
+Superior to Homatropine أقوى 
+
+306
+00:29:57,070 --> 00:30:01,870
+من Homatropine، Even the 5% concentration of the
+
+307
+00:30:01,870 --> 00:30:06,270
+Latter، حتى لو فضلنا أقوى تركيز في Homatropine، ما 
+
+308
+00:30:06,270 --> 00:30:11,340
+بيظهروا إن Homatropine برضه Cycloplegic ومن الـ One,
+
+309
+00:30:11,480 --> 00:30:15,340
+Two, Three, Four, Five خمس اللي هو درجات اللي هم
+
+310
+00:30:15,340 --> 00:30:20,560
+Atropine حتى لو حطينا خمسة في المية هم Atropine بيفضل الـ 
+
+311
+00:30:20,560 --> 00:30:24,500
+One Percent Cyclopentolate أقوى منها جدا Its
+
+312
+00:30:24,500 --> 00:30:31,180
+Rapidity of Onset في سرعة البدء في Cycloplegia
+
+313
+00:30:31,180 --> 00:30:36,700
+وشوفت الـ Duration اللي هو الوقت اللي بيشتغلوا من
+
+314
+00:30:36,700 --> 00:30:37,880
+أول لأخر أقصر
+
+315
+00:30:41,180 --> 00:30:44,360
+والـ Effect بتاعته أقوى، يبقى الـ Cyclopentolate
+
+316
+00:30:44,360 --> 00:30:49,400
+فاق اللي هم Atropine في تلات نواحي، إيش هم الثلاث نواحي؟
+
+317
+00:30:49,400 --> 00:30:55,820
+البدء، وقصر المدة الزمنية، يعني مش لو مثلا ست
+
+318
+00:30:55,820 --> 00:31:00,260
+ساعات فقط، اللي هم Atropine تلات أيام مثلا، وأخيرا الـ
+
+319
+00:31:00,260 --> 00:31:07,380
+Effect كـ Cyclopentolate أقوى، الـ Effect أقوى، طيب 
+
+320
+00:31:07,380 --> 00:31:12,250
+الـ Cyclopentolate is available متوفر في Single
+
+321
+00:31:12,250 --> 00:31:16,630
+Dose Four يعني فيه منه بلاستيكة عارفين Single
+
+322
+00:31:16,630 --> 00:31:19,810
+Dose؟ بيحط نقطة هنا وبس وهنا نقطة هنا وبس و
+
+323
+00:31:19,810 --> 00:31:24,730
+بيرميها And in Multi Dose ما فيه Bottle، زجاج فاحنا
+
+324
+00:31:24,730 --> 00:31:28,970
+اللي عندنا هنا زجاج، بلاستيكية، ما فيش الكبيرة
+
+325
+00:31:28,970 --> 00:31:34,410
+الصغيرة، أصبح، لأ في Single Dose في اللي هو 
+
+326
+00:31:34,410 --> 00:31:40,200
+Multiple أو Multi Dose وفي العالم توفر 0.5% و 1%
+
+327
+00:31:40,200 --> 00:31:46,260
+احنا عندنا بس 1% لو بدنا احنا نعمل 0.5% بدنا نعمله
+
+328
+00:31:46,260 --> 00:31:50,440
+بـ Distilled Water أو نخففها بالماء An interesting
+
+329
+00:31:50,440 --> 00:31:52,880
+Alternative Application Method for Cyclopentolate
+
+330
+00:31:52,880 --> 00:31:55,940
+Has been evaluated by إسماعيل
+
+331
+00:32:02,110 --> 00:32:06,830
+وهو Used a Spray Application to the Closed Eye
+
+332
+00:32:06,830 --> 00:32:13,850
+يعني اسمه إسماعيل هذا في الـ 94 عمل Spray رشّة وقارن 
+
+333
+00:32:13,850 --> 00:32:20,490
+بين الـ Spray وبين الـ Drops ووجد إنه الأثر واحد 
+
+334
+00:32:20,490 --> 00:32:25,030
+مالـ Spray في عين الطفل حتى وهو نائم
+
+335
+00:32:30,630 --> 00:32:33,330
+أو حط Drops في العين التانية جال إنه في Reflection
+
+336
+00:32:33,330 --> 00:32:38,850
+ساعة بعض بسأله Accept حاجة إن ما أخرّ الطفل الطفل
+
+337
+00:32:38,850 --> 00:32:44,730
+لما احنا سبناه عشان نقطّر له نقطة بيعمل مشكلة ولو بكى
+
+338
+00:32:44,730 --> 00:32:51,610
+Wash out of Drops هتطلع Useless ودرّبنا في 
+
+339
+00:32:51,610 --> 00:32:56,570
+عملنا اللي كليكي من هذه النقطة يا بناتي أي قطرة
+
+340
+00:32:56,570 --> 00:33:03,530
+مش بس الـ Settling تقضى واتبعها بكاء فقد فقدت 
+
+341
+00:33:03,530 --> 00:33:07,290
+المفهوم خاصة
+
+342
+00:33:07,290 --> 00:33:10,790
+في الأطفال فقدت المفهوم لذلك أنا الطفل لازم إني
+
+343
+00:33:10,790 --> 00:33:17,630
+أكون أنا Patient صبور يعني معاه أزهى Patient هو 
+
+344
+00:33:17,630 --> 00:33:21,870
+مريض وأنا صبور حقيقة
+
+345
+00:33:21,870 --> 00:33:25,510
+أنا أفضل تقيّة وزَبَطْها إن أنا 
+
+346
+00:33:34,770 --> 00:33:39,830
+لو دي أنا أفتح له هنا بالـ .. Strongly يعني بالـ .. 
+
+347
+00:33:39,830 --> 00:33:44,470
+Manually بدي هنا، هيعيد، ولما هيعيد، هتكون خلص،
+
+348
+00:33:44,470 --> 00:33:49,310
+لكن أنا بدي أغمض هنا، أنا أغمض هنا، لأ ما لهوش، ما لهوش،
+
+349
+00:33:49,310 --> 00:33:53,170
+ما لهوش يا بابا، ما لهوش يا بابا، بحطه هنا، وأقول له خلاص
+
+350
+00:33:53,170 --> 00:33:56,570
+خلصنا، هيفتح هنا، هتنزل جترات بدون مقاومة
+
+351
+00:34:00,660 --> 00:34:05,040
+لكن إسماعيل قامت بعمل الـ Spray ووجدت أن الـ Spray
+
+352
+00:34:05,040 --> 00:34:10,100
+كان أسهل
+
+353
+00:34:10,100 --> 00:34:14,520
+في وضعها في العين وكان أكثر مقبولًا للمريض ومقبول
+
+354
+00:34:14,520 --> 00:34:20,200
+عنه، طبعا ليس هناك Spray دعونا نشوف الـ
+
+355
+00:34:20,200 --> 00:34:26,180
+Cyclopentolate Internationally Used في سن من 1 إلى
+
+356
+00:34:26,180 --> 00:34:26,900
+12 سنة
+
+357
+00:34:31,270 --> 00:34:36,770
+الواحد إلى يعني مع عمر سنة وأقل شوية Only One Drop
+
+358
+00:34:36,770 --> 00:34:41,290
+of One Percent Solution Solution يعني محلول قطرة
+
+359
+00:34:41,290 --> 00:34:46,650
+is usually necessary but a bigger drop should be
+
+360
+00:34:46,650 --> 00:34:50,750
+installed if little if it is measurable after 15
+
+361
+00:34:50,750 --> 00:34:54,490
+Minutes طبعا مش هي الـ Ideal إن أخطط لنقطة وأعمل
+
+362
+00:34:54,490 --> 00:34:54,950
+Reflection
+
+363
+00:35:02,390 --> 00:35:06,550
+نقطة مثلا الساعة تسعة ونقطة الساعة تسعة وربع و
+
+364
+00:35:06,550 --> 00:35:11,770
+نقطة الساعة تسعة ونصف وعشرة إلا ربع تربع ساعة
+
+365
+00:35:11,770 --> 00:35:19,770
+أعملوا Reflection هذا One Person والـ Factor in
+
+366
+00:35:19,770 --> 00:35:21,970
+Determining the Appropriate Concentration is the
+
+367
+00:35:21,970 --> 00:35:26,030
+Degree of Iris Pigmentation آه بقول في عامل بيدخل
+
+368
+00:35:26,030 --> 00:35:30,430
+عن خطة اللي هو لون الـ Iris
+
+369
+00:35:47,070 --> 00:35:53,730
+هذا جدا بسيط، ممكن 0.5 يكفي بالنسبة لي، يعني لو إن 
+
+370
+00:35:53,730 --> 00:35:59,490
+الـ Iris بتاعه بسيط، زي الخوجات، بيكفي 0.5 
+
+371
+00:35:59,490 --> 00:36:06,090
+Retinoscopic الـ Refraction يمكن تعمل في 40 إلى 60
+
+372
+00:36:06,090 --> 00:36:10,750
+دقيقة، يعني نحط له هذه نقطة، وبعد 40 إلى 60 دقيقة
+
+373
+00:36:10,750 --> 00:36:15,800
+أعمل الـ Refraction، لكن لو عندك ضعف بما إنه احنا
+
+374
+00:36:15,800 --> 00:36:21,740
+العرب عندنا Dark Iris غالبا، معظمنا، أقلنا الـ
+
+375
+00:36:21,740 --> 00:36:26,940
+Honey، فهو بعدين بيبدأ شوية Dark وDark اللي هو 
+
+376
+00:36:26,940 --> 00:36:29,940
+Strongly Dark
+
+377
+00:36:48,870 --> 00:36:54,310
+With Fifteen to Twenty Minutes and Above there is 
+
+378
+00:36:54,310 --> 00:36:57,690
+No Significant Measurable Reduction in the 
+
+379
+00:36:57,690 --> 00:37:01,330
+Amplitude of the Accommodation طيب يعني أنا بدي 
+
+380
+00:37:01,330 --> 00:37:06,930
+أقول إن أنا الآن احنا جربنا على النوع الأول Up to 
+
+381
+00:37:06,930 --> 00:37:12,970
+Twelve الآن بدي أفترض إن احنا تعدينا الـ 12 
+
+382
+00:37:12,970 --> 00:37:18,810
+13، 14، 15 بيقول لي ها أخلي النقطة مش 1
+
+383
+00:37:18,810 --> 00:37:27,810
+Percent 0.5 نص في المية ما أجيلش
+
+384
+00:37:27,810 --> 00:37:31,070
+الـ Accommodation الـ Activity بالسنة ما أجيلش 
+
+385
+00:37:31,070 --> 00:37:36,250
+فأنا هنا بدي أخطّره نص وبعد ربع ساعة مثلا أخطّره 
+
+386
+00:37:36,250 --> 00:37:41,490
+نقطة تانية The Second Drop من نص Percent Solution
+
+387
+00:37:41,490 --> 00:37:45,350
+is sometimes we say unfair skin patients
+
+388
+00:37:53,060 --> 00:37:59,800
+الشعر أسود والبوغبغ أسود والعيال أسود وكمان مرة 
+
+389
+00:37:59,800 --> 00:38:06,720
+يعني الكلب بيقول لي إن الناس اللي عيال أسود واحدة 
+
+390
+00:38:06,720 --> 00:38:11,220
+متكافئة مع إنه الـ  تن تن أحسن لكن في الـ Dark
+
+391
+00:38:16,320 --> 00:38:21,560
+والـ Dark Hair Type وأنها تعتبر ضرورية تستخدم اتصال
+
+392
+00:38:21,56
+
+431
+00:42:33,560 --> 00:42:37,520
+أنا residual متبقى يعني السلمس مش مش paralyzed على
+
+432
+00:42:37,520 --> 00:42:41,740
+الأرض وبالتالي فردر فيها plus two هنا أنا لما بدي 
+
+433
+00:42:41,740 --> 00:42:46,380
+أعمل subtraction بدي أخصم بدي أحسب حساب أنه فيه
+
+434
+00:42:46,380 --> 00:42:51,840
+شوية residual مثل الأتروبيل الأتروبيل بيخلي zero
+
+435
+00:42:51,840 --> 00:42:56,760
+أنا بيخلي اتنين فبالحسبة بتاعة prescription بدي
+
+436
+00:42:56,760 --> 00:43:00,300
+أنا أحسب حساب أنه السلمس مش fully paralyzed
+
+437
+00:43:14,870 --> 00:43:18,910
+الترابير يبدأ بعد ربع ساعة أو نصف ساعة، لأ هنا
+
+438
+00:43:18,910 --> 00:43:24,990
+يقول few minutes خلال دقائق، ممكن يكون خمسة أو ست
+
+439
+00:43:24,990 --> 00:43:30,420
+دقائق، I'm becoming maximum من خلال 30 إلى 60
+
+440
+00:43:30,420 --> 00:43:34,780
+دقيقة، ولكن في بعض الأحيان بسرعة مثل 15 دقيقة،
+
+441
+00:43:34,780 --> 00:43:38,340
+يعني خلال بقية ساعة ممكن تكون وصلي، لكن في الغالب
+
+442
+00:43:38,340 --> 00:43:44,200
+نصف ساعة، في الغالب نصف ساعة، حتى في الناس اللي ال
+
+443
+00:43:44,200 --> 00:43:46,400
+... ال ... ال ... ال pupil بتاعهم light في خلال 10
+
+444
+00:43:46,400 --> 00:43:48,720
+دقائق، في special cases where light appears
+
+445
+00:43:53,610 --> 00:43:55,450
+بالنسبة للمدرسة الروبليزية، وكذلك بالنسبة للمدرسة
+
+446
+00:43:55,450 --> 00:43:56,270
+الروبليزية، وكذلك بالنسبة للمدرسة الروبليزية،
+
+447
+00:43:56,270 --> 00:43:56,790
+وكذلك بالنسبة للمدرسة الروبليزية، وكذلك بالنسبة
+
+448
+00:43:56,790 --> 00:43:57,470
+للمدرسة الروبليزية، وكذلك بالنسبة للمدرسة
+
+449
+00:43:57,470 --> 00:43:59,230
+الروبليزية، وكذلك بالنسبة للمدرسة الروبليزية،
+
+450
+00:43:59,230 --> 00:44:01,050
+وكذلك بالنسبة للمدرسة الروبليزية، وكذلك بالنسبة
+
+451
+00:44:01,050 --> 00:44:03,330
+للمدرسة الروبليزية، وكذلك بالنسبة للمدرسة
+
+452
+00:44:03,330 --> 00:44:14,810
+الروبليزية، وكذلك
+
+453
+00:44:14,810 --> 00:44:21,950
+بالنسبة للمدرسة الروب
+
+454
+00:44:22,220 --> 00:44:27,000
+المقاومة يجب أن تكون مباشرة كل 10 دقائق. كل 10
+
+455
+00:44:27,000 --> 00:44:31,780
+دقائق أقيص المقاومة. بعد مقاومة الوقت من 20 دقائق.
+
+456
+00:44:31,960 --> 00:44:35,820
+مقاومة الوقت يعني أعطي فترة سماعة. من الرحلة اللي
+
+457
+00:44:35,820 --> 00:44:40,380
+أنا حطيت النقطة لحد التأثير. وعدد عشرين دقيقة. بعد
+
+458
+00:44:40,380 --> 00:44:45,520
+عشرين دقيقة أبدأ أقيص المقاومة وأتبع حلولها. حتى
+
+459
+00:44:45,520 --> 00:44:48,500
+لا يكون هناك تأثير في المقاومة.
+
+460
+00:44:53,280 --> 00:44:57,680
+بعمله Refraction وبعد تلاتين دقيقة بعمله
+
+461
+00:44:57,680 --> 00:45:01,680
+Refraction وبعد أربعين دقيقة بعمله Refraction وبعد
+
+462
+00:45:01,680 --> 00:45:05,600
+خمسين دقيقة بعمله Refraction وإن ثبت ال
+
+463
+00:45:05,600 --> 00:45:10,560
+accommodation وبطل اجيب زيادة بيكون أنا وصلت تماما
+
+464
+00:45:10,560 --> 00:45:14,620
+يعني ماخدش أول Refraction ومساعدته هو description
+
+465
+00:45:14,620 --> 00:45:19,340
+لسه لغاية ما هيجب تصير أعمل انا Refraction اللي
+
+466
+00:45:19,340 --> 00:45:21,300
+بقاله يكون ثابت مابتحركش
+
+467
+00:45:41,410 --> 00:45:47,050
+انجاب نتيجة غير في الـ Dynamic لسه شغالة Like most
+
+468
+00:45:47,050 --> 00:45:50,270
+drugs that affect accommodation and the pupil the
+
+469
+00:45:50,270 --> 00:45:53,730
+time cost of the materials is different to that of
+
+470
+00:45:53,730 --> 00:45:56,270
+the circulation and pupil diameter should not be
+
+471
+00:45:56,270 --> 00:45:59,110
+relied on to get a measure of the remaining
+
+472
+00:45:59,110 --> 00:46:03,650
+accommodation يعني مش معناه ان البحب توشع ان هو
+
+473
+00:46:03,650 --> 00:46:06,750
+مقياس للpsychoplegia، لأ مقياس الpsychoplegia هو
+
+474
+00:46:06,750 --> 00:46:10,850
+ال accommodation، البحب مثلا لسه ضيق، مثلا البحب
+
+475
+00:46:10,850 --> 00:46:14,890
+لسه ضيق يعني ماصارش اثر على الcell and muscle، او
+
+476
+00:46:14,890 --> 00:46:20,530
+الpsychoplegia كالأ، مااخدش حجم البحب مقياس
+
+477
+00:46:20,530 --> 00:46:24,840
+للpsychoplegia، الpsychoplegia شيءواللي هو celery
+
+478
+00:46:24,840 --> 00:46:28,460
+muscle ال ... ال ... ال pupil ديامتها شيء شكرا لكم
+
+479
+00:46:28,460 --> 00:46:30,940
+على خصم الاستماع وان شاء الله في المرة القادمة
+
+480
+00:46:30,940 --> 00:46:35,140
+نكمل تدائما اتين و تمانية و تلاتين شكرا و السلام
+
+481
+00:46:35,140 --> 00:46:36,180
+عليكم و رحمة الله و بركاته
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/rs42TpcOFPQ_postprocess.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/rs42TpcOFPQ_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..560468fc145fee790531732985fa8fdb9d109b67
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/rs42TpcOFPQ_postprocess.srt
@@ -0,0 +1,1924 @@
+1
+00:00:20,920 --> 00:00:22,800
+أعوذ بالله من الشيطان الرجيم، بسم الله الرحمن
+
+2
+00:00:22,800 --> 00:00:28,340
+الرحيم، الحمد لله يا رب العالمين، وأسلم على النبي
+
+3
+00:00:28,340 --> 00:00:31,500
+الأمين وعلى آله واصحابه والتابعين
+
+4
+00:00:52,090 --> 00:00:55,590
+الدراجة كتابة كتابة كتابة كتابة كتابة كتابة كتابة
+
+5
+00:00:55,590 --> 00:00:59,570
+كتابة كتابة كتابة كتابة كتابة كتابة كتابة كتابة
+
+6
+00:00:59,570 --> 00:01:00,130
+كتابة كتابة كتابة كتابة كتابة كتابة كتابة كتابة
+
+7
+00:01:00,130 --> 00:01:00,150
+كتابة كتابة كتابة كتابة كتابة كتابة كتابة كتابة
+
+8
+00:01:00,150 --> 00:01:03,250
+كتابة كتابة كتابة كتابة كتابة كتابة
+
+9
+00:01:03,250 --> 00:01:19,990
+كتابة كتاب
+
+10
+00:01:20,680 --> 00:01:41,240
+تشخيص تشخيص
+
+11
+00:01:41,240 --> 00:01:46,680
+تشخيص تشخيص تشخيص تشخيص تشخيص تشخيص تشخيص تشخيص
+
+12
+00:01:46,680 --> 00:01:46,900
+تشخيص تشخيص تشخيص تشخيص تشخيص تشخيص تشخيص تشخيص
+
+13
+00:01:46,900 --> 00:01:50,430
+تشخيص تشخيص تشخيCharacterized by redness, hotness,
+
+14
+00:01:51,690 --> 00:02:02,350
+pain, loss of function. Yes؟ طيب. Ureitis is a
+
+15
+00:02:02,350 --> 00:02:10,410
+serious disease that will affect vision.يعني
+
+16
+00:02:10,410 --> 00:02:18,150
+ال vision in ureitis will be affected أعمى كتب.ثم
+
+17
+00:02:18,150 --> 00:02:20,770
+أتروبيل مفيد جدًا في التعامل بالإنفلام
+
+18
+00:02:20,770 --> 00:02:27,610
+الانترويوبيال A. أتروبيل يقلل الألم يقلل الألم
+
+19
+00:02:27,610 --> 00:02:30,510
+associated with the inflammatory process by
+
+20
+00:02:30,510 --> 00:02:35,630
+relaxing the ciliary muscle spasm يبقى
+
+21
+00:02:35,630 --> 00:02:40,590
+الانفلامشين، السلامصل بيحصل على إسباز إسباز بيعمل
+
+22
+00:02:40,590 --> 00:02:49,360
+painهنا لما نحط ال muscle in relaxation او relaxed
+
+23
+00:02:49,360 --> 00:02:54,900
+position this will lead to loss of pain اي واحد
+
+24
+00:02:54,900 --> 00:03:03,120
+بيه and helps to prevent posterior synechiae
+
+25
+00:03:03,120 --> 00:03:09,700
+الاتساقات by dilating the pupil وانا جابكوا صورة
+
+26
+00:03:11,920 --> 00:03:16,740
+شايفين ال pupil هذا البني او الأصفر لما صار
+
+27
+00:03:16,740 --> 00:03:21,440
+violated ابتعد عن ايش؟ عن ال surface of the lens
+
+28
+00:03:21,440 --> 00:03:25,500
+الايراتيس
+
+29
+00:03:25,500 --> 00:03:32,020
+اليمناني بيكون sticky sticky يعني بلسق عارفين
+
+30
+00:03:32,020 --> 00:03:33,560
+الرغيب؟
+
+31
+00:03:39,930 --> 00:03:45,930
+الاتروبيل بيعمل على تجفيف ال iris بيجففه كيف
+
+32
+00:03:45,930 --> 00:03:53,090
+السشوار والشعر بينشف الشعر هذا الاتروبيل بينشف ال
+
+33
+00:03:53,090 --> 00:03:57,930
+iris أي بيمنع ال exudation ال inflammation له
+
+34
+00:03:57,930 --> 00:04:01,970
+إفرازات اسمها exudation لما الواقع فينا بيرشح أو
+
+35
+00:04:01,970 --> 00:04:06,150
+زربيا أو كل شوية بتطلع اه exudation فيه
+
+36
+00:04:06,150 --> 00:04:09,980
+inflammatory cellsالارتروبين هنا بينشف ال IRS
+
+37
+00:04:09,980 --> 00:04:17,380
+بيخلق أقل تلسق من إيه؟ من ال surface of the lens
+
+38
+00:04:17,380 --> 00:04:23,540
+لهيك إنه كمان بيفتح البوء بوء على الآخر بيبني ال
+
+39
+00:04:23,540 --> 00:04:30,460
+contact بين ال IRS و بين ال lens بيخلقش في contact
+
+40
+00:04:30,460 --> 00:04:35,940
+بيسحبوا بعيد يعني البوء بوء هيك وال IRS بيروح
+
+41
+00:04:35,940 --> 00:04:42,210
+peripheryو ال lens هي هنا فبصير في الشي اتساق زي
+
+42
+00:04:42,210 --> 00:04:52,830
+هيك في الحالة الأولى كده و كده وهي ال lens يبقى
+
+43
+00:04:52,830 --> 00:04:59,030
+هنا في contact بال iris بين ايش ال arterial
+
+44
+00:04:59,030 --> 00:05:02,390
+surface of the lens طيب الحالة حطينا متروبين
+
+45
+00:05:06,870 --> 00:05:17,390
+بس هاي العيبس هاي الناس هيك او بتكون flat مافيش
+
+46
+00:05:17,390 --> 00:05:23,910
+contact في الحياة الأولى لو ماحطيناش أتروبيل أو
+
+47
+00:05:23,910 --> 00:05:29,250
+cypermetroid على الأقل هصير هنا التساق الاتساق هذا
+
+48
+00:05:29,250 --> 00:05:36,970
+اسمه posterior-cynicia التساقهو اتصاق اتصاق حقيقي
+
+49
+00:05:36,970 --> 00:05:45,250
+المشكلة في الاتصاق هذا انه بيصير تلير هنا طيب الآن
+
+50
+00:05:45,250 --> 00:05:51,890
+ال .. ال aqueous بيطلع من هنا و بمرهق و بدو يطلع
+
+51
+00:05:51,890 --> 00:05:57,130
+من البحر عشان يطلع على ال angle او AC لما ناجي هنا
+
+52
+00:05:57,130 --> 00:06:07,370
+فى حاجة اسمها IRIS POMPEIأو أكلوزيو بيوبيلي أعرفين
+
+53
+00:06:07,370 --> 00:06:13,990
+أكلوزيو بيوبيلي يعني البوبيو مسكر يبقى هصير ال ..
+
+54
+00:06:13,990 --> 00:06:15,770
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+55
+00:06:15,770 --> 00:06:15,850
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+56
+00:06:15,850 --> 00:06:15,870
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+57
+00:06:15,870 --> 00:06:15,990
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+58
+00:06:15,990 --> 00:06:16,470
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+59
+00:06:16,470 --> 00:06:17,070
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+60
+00:06:17,070 --> 00:06:17,630
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+61
+00:06:17,630 --> 00:06:18,130
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+62
+00:06:18,130 --> 00:06:20,430
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+63
+00:06:20,430 --> 00:06:24,150
+ال .. ال ..
+
+64
+00:06:24,150 --> 00:06:29,670
+ال .. ال ..
+
+65
+00:06:31,950 --> 00:06:37,050
+من كتر الضغط عليه لكن مهالة مالكثقة، مع الإيش، مع
+
+66
+00:06:37,050 --> 00:06:43,990
+اللذي، يبقى أنا علاجي بالأتروبيل علاج علمي، أنا
+
+67
+00:06:43,990 --> 00:06:48,530
+عارف إيش بحط أتروبيل، عشان ماعملش لمصيبة هذه، طبعا
+
+68
+00:06:48,530 --> 00:06:52,530
+في الآخر كل هذا هنعكس على ال optic nerve سلبة
+
+69
+00:07:10,740 --> 00:07:14,960
+بالتالي، عندما يتحرر الجلد في المنطقة المستيقظية،
+
+70
+00:07:14,960 --> 00:07:19,880
+الاتصال بالكابسولة الأمامية تتخلص، واضح؟ لأنه ليس
+
+71
+00:07:19,880 --> 00:07:25,560
+هناك إلتصاق. طب سي في العلاج، moreover، أكتر من
+
+72
+00:07:25,560 --> 00:07:30,720
+ذلك، السيكروبليزيا اللي تم إنتاجه من هاتروبيل هو
+
+73
+00:07:30,720 --> 00:07:36,320
+مقيم إضافي ويقوم بتقليم كامة ومعمومة من اللينز
+
+74
+00:07:37,160 --> 00:07:40,460
+البوصيروس سيانيكي يجب أن يتطور حتى عند انفجار
+
+75
+00:07:40,460 --> 00:07:43,860
+الناس انفجار الناس انفجار الناس انفجار الناس
+
+76
+00:07:43,860 --> 00:07:45,900
+انفجار الناس انفجار الناس انفجار الناس انفجار
+
+77
+00:07:45,900 --> 00:07:50,360
+الناس انفجار الناس انفجار الناس انفجار الناس
+
+78
+00:07:50,360 --> 00:07:51,100
+انفجار الناس انفجار الناس انفجار الناس انفجار
+
+79
+00:07:51,100 --> 00:08:00,940
+انفجار الناس انفجار الناس انفجار الناس انفجار
+
+80
+00:08:00,940 --> 00:08:06,300
+ال
+
+81
+00:08:07,420 --> 00:08:13,320
+و less convex الحالة الرابعة atropine may also
+
+82
+00:08:13,320 --> 00:08:18,080
+help decrease the excessive permeability of the
+
+83
+00:08:18,080 --> 00:08:22,400
+inflamed blood vessels in the iris طبعا and
+
+84
+00:08:22,400 --> 00:08:25,900
+thereby reduce cells and protein in the anterior
+
+85
+00:08:25,900 --> 00:08:31,460
+chamber زي ما قلنا احنا لما بيصير inflammation
+
+86
+00:08:31,460 --> 00:08:38,920
+للعيرز، العيرز بيصير congestedنفس ال ILS بيصير
+
+87
+00:08:38,920 --> 00:08:42,540
+congested و بيصير ال blood vessels بتاعته dilated
+
+88
+00:08:42,540 --> 00:08:47,000
+و لما ال blood vessels بيصير dilated بيصير سهلة
+
+89
+00:08:47,000 --> 00:08:53,900
+solution يعني مثلا هاي ال ILS هيك و هاي ال blood
+
+90
+00:08:53,900 --> 00:08:59,580
+vessels بدا انها كانت صغيرة كده عصير كبيرة كده
+
+91
+00:08:59,580 --> 00:09:05,860
+يعني مثلا inflammation في الحالة الأولى كانت ال
+
+92
+00:09:05,860 --> 00:09:09,700
+endothelial cellsمغطية الوضع، هنا اللي فيها ال
+
+93
+00:09:09,700 --> 00:09:15,140
+cells مش مغطية الوضع صار فيه فجوات يسهل أن يخرج
+
+94
+00:09:15,140 --> 00:09:20,480
+منها ال water flow ال cells و الكلبها، مع سائل
+
+95
+00:09:20,480 --> 00:09:25,020
+اسمه exudate، exudate هذا يعني fluid و
+
+96
+00:09:25,020 --> 00:09:29,820
+inflammation، هذا هيروح وين؟ هييجي في ال AC
+
+97
+00:09:34,660 --> 00:09:40,500
+هذا اللي احنا بيقول عنه في الليل و بيقول هنا اللي
+
+98
+00:09:40,500 --> 00:09:43,120
+بيكون على ظهر ال .. ال .. ال .. ال .. في ال
+
+99
+00:09:43,120 --> 00:09:45,400
+endothelium of the KP
+
+100
+00:09:59,350 --> 00:10:05,070
+يبقى شوفوا الفوائد اللي احنا يعني بنعملها من وضع
+
+101
+00:10:05,070 --> 00:10:10,870
+الأتروبيل في حالة العيوريتس شيء مهم جدا أي يعني
+
+102
+00:10:10,870 --> 00:10:15,370
+تعالج كل الكورتيزون هو علاج هنا كورتيزون without
+
+103
+00:10:15,370 --> 00:10:22,930
+Cycloblegic يعني تكبر fifty percent useless يعني
+
+104
+00:10:22,930 --> 00:10:27,050
+انا بقعد صحي كورتيزون عشان anti inflammatory لكن
+
+105
+00:10:27,050 --> 00:10:28,390
+الالتساق
+
+106
+00:10:30,740 --> 00:10:34,580
+بين الـ Iris و بين الـ Lens مابيكفيش فيه ال
+
+107
+00:10:34,580 --> 00:10:39,040
+Cortisone لازم psychological و لقاعدة مابيعرفها
+
+108
+00:10:39,040 --> 00:10:44,860
+إلا الممارس لهذا العالم يعني هذه الصورة حبت أجيبها
+
+109
+00:10:44,860 --> 00:10:51,580
+عشان أشوفوا يعني كيف قبل الأتروبيل و كيف بعد
+
+110
+00:10:51,580 --> 00:10:56,240
+الأتروبيل شوفوا الـIris هنا شوفوا ال thickness
+
+111
+00:10:56,240 --> 00:11:02,260
+انتوا بيشوفوا ال axisوشوفوا هنا و انا ال iris صارت
+
+112
+00:11:02,260 --> 00:11:07,220
+peripheral بالاتروبيين و ال thickness جاي صارت
+
+113
+00:11:07,220 --> 00:11:17,000
+less convex و more flat اللي هو ال lens واضح؟ طيب
+
+114
+00:11:17,000 --> 00:11:21,120
+الاستعمال الثالث لاتروبيين غير ال refraction
+
+115
+00:11:27,960 --> 00:11:31,700
+أو طالب قد قال Penalization Penalization الأقابة
+
+116
+00:11:31,700 --> 00:11:39,960
+أقاب إيه؟ أقاب العين القوية بالعين السليمة الطفل
+
+117
+00:11:39,960 --> 00:11:46,720
+كل ما حطله patch غطاء بيشيله و يبكي ما بيدلو الخطأ
+
+118
+00:11:46,720 --> 00:11:52,020
+حطله على العين السليمة غطاء عشان أعمل activation
+
+119
+00:11:52,020 --> 00:11:56,720
+للisotropic
+
+120
+00:11:56,720 --> 00:11:57,140
+eye
+
+121
+00:12:01,730 --> 00:12:05,470
+مش عاوز فبيقولوا
+
+122
+00:12:05,470 --> 00:12:09,750
+والله مافي لا ثق أنه واقف على عينه أبدا إلا يشيله
+
+123
+00:12:09,750 --> 00:12:14,230
+ويعيده ويقولوا طيب هنعمله penalization حطوا ال
+
+124
+00:12:14,230 --> 00:12:23,190
+atropine يعني ممكن once daily ال atropine لما نضعه
+
+125
+00:12:23,190 --> 00:12:28,070
+في العين بيخلي some eye فيها impaired vision for
+
+126
+00:12:28,070 --> 00:12:31,820
+near and for distancefor near and far distance
+
+127
+00:12:31,820 --> 00:12:38,020
+وبالتالي الطفل يصبح شيئا فشيئا يعتبد على عينه ال
+
+128
+00:12:38,020 --> 00:12:45,220
+amblyopia على عينه الكسولة lazy eye ممكن هذا يقتوم
+
+129
+00:12:45,220 --> 00:12:49,920
+شهر شهرين تلاتة اه بس هو بيحدر من شيء في ال
+
+130
+00:12:49,920 --> 00:12:57,520
+penalization انه بعد ما يروح تأثير الاتروبيل ممكن
+
+131
+00:12:57,520 --> 00:13:02,850
+يصير reversed amblyopiaفي العين الساود ايه يعني
+
+132
+00:13:02,850 --> 00:13:09,130
+انا شطت ال eye ال ال ال lazy و كسلت العين اللي مش
+
+133
+00:13:09,130 --> 00:13:12,850
+lazy لكن انا مابخاف اكتر من هذا لان بعد ذلك ممكن
+
+134
+00:13:12,850 --> 00:13:17,770
+نعمل balance شوية دي بطاقة و حاجة ممكن انه الطفل
+
+135
+00:13:17,770 --> 00:13:23,230
+يفوز بتنتيجة طب تكون ات اذية بتكون زي 14؟ لأ انا
+
+136
+00:13:23,230 --> 00:13:26,870
+حاسب نفسي ان .. و بعدين هي يجب ان تدرس برصاعية 16
+
+137
+00:13:26,870 --> 00:13:28,190
+-24
+
+138
+00:13:32,260 --> 00:13:37,460
+هي يعني انا بقول نوع من العلاج انا مارسته و يعني
+
+139
+00:13:37,460 --> 00:13:42,940
+الحقيقة ال patching احسن ليش ال patching بعطي zero
+
+140
+00:13:42,940 --> 00:13:49,240
+percent vision لكن ال atropine لأ بيعطي اكتر من
+
+141
+00:13:49,240 --> 00:13:54,640
+zero اكتر من 10% او اكتر من 20% لكن انا بقول في
+
+142
+00:13:54,640 --> 00:13:56,020
+حالة ال failure
+
+143
+00:14:04,750 --> 00:14:11,990
+تنفعش طيب treatment هو myopia علاج ال myopia انتوا
+
+144
+00:14:11,990 --> 00:14:15,670
+عارفين في الأطفال نادر يكون فيه myopia لكن لو كان
+
+145
+00:14:15,670 --> 00:14:18,270
+فيه myopia بتكون progressive myopia progressive
+
+146
+00:14:18,270 --> 00:14:24,430
+myopia فحقيقة بالتجربة وجدوا ان الأطربيين may
+
+147
+00:14:24,430 --> 00:14:27,470
+prevent or slow على قدرة progression of myopia by
+
+148
+00:14:27,470 --> 00:14:30,650
+placing the cerebral muscle at rest و ال
+
+149
+00:14:30,650 --> 00:14:34,120
+accommodation بيكون relaxedAnnotation that
+
+150
+00:14:34,120 --> 00:14:39,020
+produces elongation of the eye may be reduced شوية
+
+151
+00:14:39,020 --> 00:14:42,800
+شوية والadministration of one percent atropine for
+
+152
+00:14:42,800 --> 00:14:48,680
+one to eight years وهذا الشيء الصعب يعني فات
+
+153
+00:14:48,680 --> 00:14:54,840
+أتروبين في عينين الطفل أقل شيء سنة أو أكتر شيء سنة
+
+154
+00:14:54,840 --> 00:14:57,520
+أو أكتر سنة The decrease in myopia in treated eyes
+
+155
+00:14:57,520 --> 00:15:00,020
+of children has usually been less than
+
+156
+00:15:04,650 --> 00:15:10,510
+عندما اجهزت الـ I أظهر زيادة في الميوبيا تقريبًا 0
+
+157
+00:15:10,510 --> 00:15:20,330
+.91 دقيقة في السنة يعني في الأطفال اللي ما وضعنا
+
+158
+00:15:20,330 --> 00:15:25,770
+لهم أتروبيل كان progress of myopia
+
+159
+00:15:32,810 --> 00:15:37,330
+يعني في خلال عشر سنوات هيكون تقدم حوالي تمانية
+
+160
+00:15:37,330 --> 00:15:43,890
+ديوبتر اه صح اه عشر سنة اه تمانية ديوبتر كل عشر
+
+161
+00:15:43,890 --> 00:15:47,210
+سنة لكن اللي عيزينا هو أبعدنا على الأتروبين وجدنا
+
+162
+00:15:47,210 --> 00:15:54,110
+انه تقدم حوالي أربعة ديوبتر النص النص هذا بالتجربة
+
+163
+00:15:54,110 --> 00:16:01,710
+لكن مين يتحمل الأتروبين هذه السنوات مش بس هيك بقول
+
+164
+00:16:03,070 --> 00:16:10,750
+ولكن في تجارب الانتقالات، فقط 12% من الأطفال كانوا
+
+165
+00:16:10,750 --> 00:16:15,770
+يحافظوا على تحسين أكبر من 6 أشهر، للأسف بعد وقف
+
+166
+00:16:15,770 --> 00:16:24,110
+الاترومين، يعود الانتقال تانيًا، فقط 12% من الناس
+
+167
+00:16:24,110 --> 00:16:27,530
+اللي كانوا يحافظوا على الانتقال، فقط 12% من الناس
+
+168
+00:16:27,530 --> 00:16:28,290
+اللي كانوا يحافظوا على انتقال
+
+169
+00:16:36,590 --> 00:16:42,950
+هو ميوبيا. فهيبقى فيها discussion. كيف رأيكوا
+
+170
+00:16:42,950 --> 00:16:48,330
+انتوا لو في انت في ال progressive ميوبيا؟ you will
+
+171
+00:16:48,330 --> 00:16:53,650
+go to administer at romaine for one year؟ كنتين
+
+172
+00:16:53,650 --> 00:17:01,750
+واصلي؟ ليه؟ وعدت؟ ان ريس ساعتش يبتدل على الصحي
+
+173
+00:17:01,750 --> 00:17:05,300
+اللي هو ال school اللي هو ال islam، ده ماتش كويسطب
+
+174
+00:17:05,300 --> 00:17:08,180
+هي كل ماتومي بيصير myopic يعني هي كده .. لأ بعد
+
+175
+00:17:08,180 --> 00:17:11,100
+فاهمة أوي لأ لما نحطوا حبطانها عينهم غابشة مش
+
+176
+00:17:11,100 --> 00:17:14,640
+هيشوف فيها كويس هيأثر على النظر في حالات تانية
+
+177
+00:17:14,640 --> 00:17:17,840
+بتقدر تعملها ال preparation تبع ال .. ايش حالات
+
+178
+00:17:17,840 --> 00:17:21,000
+تانية؟ زي ال bifocal lens وال contact lens هذا
+
+179
+00:17:21,000 --> 00:17:25,680
+الطفل عمره سنتين؟ اه فضل يا سهرائش احنا أخدنا انه
+
+180
+00:17:25,680 --> 00:17:29,760
+لما يكون يعني لحد السنة و هيك انه في دراسات كانت
+
+181
+00:17:29,760 --> 00:17:33,630
+تحكي ان ال myopic بعدها بتختفي بيصير hyperفالأحسن
+
+182
+00:17:33,630 --> 00:17:36,570
+يقول لأ لأ سيبها ل .. ل .. يعني ال .. ال natural
+
+183
+00:17:36,570 --> 00:17:39,990
+development of the eye سيبها ل natural development
+
+184
+00:17:39,990 --> 00:17:43,830
+of the eye بس هو بوسعه .. بس هو عنده ما يوم يعني
+
+185
+00:17:43,830 --> 00:17:47,250
+بس هو عنده حض يعني اه هو سابق عنده ما يوم و يعني
+
+186
+00:17:47,250 --> 00:17:51,590
+هذه الدراسة يعني ممكن يبنى عليها صحيح بس انا اللي
+
+187
+00:17:51,590 --> 00:17:54,130
+مش عاجبني ان الكون في continuous weather problem
+
+188
+00:17:54,130 --> 00:17:58,830
+لأن الاطفل هيعاني معانا شديدة من أي ضوء او من
+
+189
+00:17:58,830 --> 00:18:06,650
+الشمسمش هيقدر يستخدم نظره بأي طريقة ولا يتعلمه اي
+
+190
+00:18:06,650 --> 00:18:18,330
+حاجة و 88% لما يعمل stop ممكن يعمل recast طيب side
+
+191
+00:18:18,330 --> 00:18:24,650
+effects of الأتروبيل الأتروبيل زي أي درجة له و
+
+192
+00:18:24,650 --> 00:18:28,170
+عليه قسمنا
+
+193
+00:18:28,170 --> 00:18:32,670
+side effects إلى ocular و generalع مستوى الليين؟
+
+194
+00:18:32,670 --> 00:18:38,230
+وع مستوى الجسم كله open reactions include in the
+
+195
+00:18:38,230 --> 00:18:41,990
+eye when؟ the eye irritation from the drug
+
+196
+00:18:41,990 --> 00:18:47,130
+preparation itself يعني في بعض الدراج تحطي في عينك
+
+197
+00:18:47,130 --> 00:18:51,930
+تشعر ب severe burning حلقان في أحيان دراج تاني
+
+198
+00:18:51,930 --> 00:18:55,930
+يعمل severe stinging تنخيذ ممكن دراج تاني يعمل
+
+199
+00:18:55,930 --> 00:19:00,320
+severe rednessقاليل ما دراجس تحط offline لعين
+
+200
+00:19:00,320 --> 00:19:05,780
+حساسة حساسة جدا لدراجس فهال يعني ال goal target
+
+201
+00:19:05,780 --> 00:19:11,020
+irritation ممكن بعد شوية يعني تخف شوية تخف يعني
+
+202
+00:19:11,020 --> 00:19:15,220
+قاليلتي contact dermatitis جبتلكوا صورة انا على
+
+203
+00:19:15,220 --> 00:19:21,400
+هالي هالي contact dermatitis شوف العلوزة هالي حطت
+
+204
+00:19:21,400 --> 00:19:25,420
+قطره بينه والبنت اللي في جانبها حطت قطره بينه
+
+205
+00:19:25,420 --> 00:19:33,270
+contact dermatitis أي جيتالتهاب في الجيل ناتج عن
+
+206
+00:19:33,270 --> 00:19:40,050
+تحسس للاتروبيا، طب عامة مش مع الكل، مش مع الكل،
+
+207
+00:19:40,050 --> 00:19:46,290
+بقى بعض الحلال، بعض الحلال، لكن صحيح، هذا بيصير
+
+208
+00:19:46,290 --> 00:19:51,670
+أحيانًا لإنسان بيمسك مادة حمضية أو قلوية أو حتى
+
+209
+00:20:01,500 --> 00:20:04,620
+بتكون زائد بيعمل كده، ماشي على المتروبيل يعني
+
+210
+00:20:04,620 --> 00:20:11,100
+المختص يعني في جهة الموضوع، لأ بيعمل كسائر لأشياء،
+
+211
+00:20:11,100 --> 00:20:14,960
+share contact لكلوهر بتاع الغسيل، بيعمل، لما ييجي
+
+212
+00:20:14,960 --> 00:20:20,480
+على الجد بيعمل يعني طب elevation اه risk of
+
+213
+00:20:20,480 --> 00:20:23,660
+angioecological glaucoma وانا دي بتبقى الصورة هذه،
+
+214
+00:20:23,660 --> 00:20:24,840
+ايه الشيء في الفعل الصورة؟
+
+215
+00:20:40,530 --> 00:20:44,230
+كل هذا من علامات Angle Closure Glucoma طبعا خاصة
+
+216
+00:20:44,230 --> 00:20:49,010
+إن كان هو Adult كبير و عنده Narrow Angle مش في أى
+
+217
+00:20:49,010 --> 00:20:52,550
+واحد خاصة ال Angle يكون Narrow أو High
+
+218
+00:20:52,550 --> 00:20:55,510
+Hypermetroid مش هيك ال High Hypermetroid بيبدعن ما
+
+219
+00:20:55,510 --> 00:21:00,970
+بحطله Atropine أبدا طيب for elevation of uteral
+
+220
+00:21:00,970 --> 00:21:03,730
+pressure if patients with open Angle أحيانا حتى في
+
+221
+00:21:03,730 --> 00:21:07,330
+ال open Angle بيرفع الدكتورة مش شرط إنه يعمل Angle
+
+222
+00:21:07,330 --> 00:21:08,050
+Closure Glucoma
+
+223
+00:21:17,620 --> 00:21:23,940
+طبعا واحدة حط اتروبيل في عينيه عليه ان يلزم الغرفة
+
+224
+00:21:23,940 --> 00:21:30,420
+اللي فيها ضوء ضوء اتروبيل
+
+225
+00:21:30,420 --> 00:21:34,220
+اذا طيب في الشمس او في ضوء جوي احيانا مالوياش تفوت
+
+226
+00:21:45,250 --> 00:21:48,690
+والـ pleuritis حكّى. إيش في الجانب؟ كانت دي ديما
+
+227
+00:21:48,690 --> 00:21:54,870
+تورّم، تورّم في الجفون زي اللي هو ال .. ال .. ال
+
+228
+00:21:54,870 --> 00:21:58,210
+.. الست هذه، شايفين؟ في .. في تورّم في الجفون،
+
+229
+00:21:58,210 --> 00:22:05,170
+صحيح؟ واضح، في تورّم في الجفون، وفي رثيمة؟ أكيد،
+
+230
+00:22:05,170 --> 00:22:07,310
+رثيمة الحمار هذا في الكودينالطيبة
+
+231
+00:22:13,340 --> 00:22:18,740
+الـ Atropine في العين القطرأ كما وكذلك كوليرجيك
+
+232
+00:22:18,740 --> 00:22:22,840
+أنتجمس وكل المندرياتيكس اللي زيه او اي شيه يزيد
+
+233
+00:22:22,840 --> 00:22:28,300
+حرارة الانجليكلوجركوم في المريض فالحرارة اللي يزيد
+
+234
+00:22:28,300 --> 00:22:32,380
+حرارة انجليكلوجركوم في العين بدون تاريخ تاريخ
+
+235
+00:22:32,380 --> 00:22:38,340
+تاريخ يعني قليل يعني اللي ما عندهوش تاريخ تاريخ
+
+236
+00:22:38,340 --> 00:22:39,980
+تاريخ
+
+237
+00:22:42,250 --> 00:22:46,410
+يعني استعمال قليل اكتر اكتر حصة ان استعمل
+
+238
+00:22:46,410 --> 00:22:51,410
+الاتروبين مرة مرتين تلتة قبل ذلك ولم يحدث له طالما
+
+239
+00:22:51,410 --> 00:22:55,530
+ان الصعب يحدث له في هذه المرة اما اللي حدث له مرة
+
+240
+00:22:55,530 --> 00:23:00,630
+قد يحدث له كل مرة ان حدث ان حطيت اتروبين وصار انا
+
+241
+00:23:00,630 --> 00:23:06,830
+انا كنت التالت مابحطله شي اتنى راضي؟ طيب دكتور
+
+242
+00:23:06,830 --> 00:23:11,430
+يعني الdermatitis هي مش هنعرفها الا لما نستخدم
+
+243
+00:23:16,220 --> 00:23:22,340
+عين تتحمر و الجلد يحمر و كل ملفات يزيد و يتوسع و
+
+244
+00:23:22,340 --> 00:23:26,220
+يصير اديمة و weakness نعرف انه contact dermatitis
+
+245
+00:23:26,220 --> 00:23:32,160
+وقف الاتروبيل بيروح بعد يومين تلتة بيروح، طبعا بده
+
+246
+00:23:32,160 --> 00:23:39,200
+علاج يعني، بده ايش؟ Anti-stamine، بده علاجهي هنا
+
+247
+00:23:39,200 --> 00:23:42,800
+allergic papillary congeratopite and keratitis هى
+
+248
+00:23:42,800 --> 00:23:48,440
+الملتحمة و فيها احمرار و اتهام و القرانية كذلك
+
+249
+00:23:48,440 --> 00:23:53,160
+سطحة القرانية خاصة الابثليام طيب systemic
+
+250
+00:23:53,160 --> 00:23:57,860
+reactions of a probine in children الان احنا قولنا
+
+251
+00:23:57,860 --> 00:24:02,440
+ال children are more liable to side effects
+
+252
+00:24:10,150 --> 00:24:15,510
+small body weight يعني ال adult نحطله انا نقطتين
+
+253
+00:24:15,510 --> 00:24:22,270
+اترابين صباحا و نقطتين مساءا و راحوا على الدم كام
+
+254
+00:24:22,270 --> 00:24:27,550
+هيأثره؟ كام هيأثره في جسم ال adult اللي زينا، لكن
+
+255
+00:24:27,550 --> 00:24:29,230
+اذا كنت baby عمره سنة
+
+256
+00:24:35,750 --> 00:24:39,710
+يحرجوا .. يحرجوا جسمه، يعملوله مشاكل كتيرة داخل
+
+257
+00:24:39,710 --> 00:24:44,690
+جسمه خاصة على ال nervous system يبقى في ال
+
+258
+00:24:44,690 --> 00:24:48,670
+children diffuse cutaneous flash
+
+259
+00:25:05,280 --> 00:25:12,940
+depressed celebration and thirst جفاف في الغدل
+
+260
+00:25:12,940 --> 00:25:20,620
+الوعبية لأنه أثر على ال nervous system fever
+
+261
+00:25:27,050 --> 00:25:34,710
+أشهد أنه يستخدم أقراس الأتروبيين لعلاج التبول
+
+262
+00:25:34,710 --> 00:25:45,710
+الليلي عند الأطفال تاكيكارديا
+
+263
+00:25:45,710 --> 00:25:49,150
+يبقى sympathetic بـ Serostimulation
+
+264
+00:25:53,430 --> 00:25:56,410
+excitement and restlessness and hallucinations
+
+265
+00:25:56,410 --> 00:26:02,230
+تلاقي الطفل excited و
+
+266
+00:26:02,230 --> 00:26:08,410
+restless بيجي نام و بيجوم و دايما كده بيبكي و يعني
+
+267
+00:26:08,410 --> 00:26:11,990
+بيقول هو يعني مش مستقبل و يوم كده مال
+
+268
+00:26:11,990 --> 00:26:16,050
+hallucinations يعني يتكلم كلام مالش معناه speech
+
+269
+00:26:16,050 --> 00:26:17,250
+disturbances
+
+270
+00:26:21,420 --> 00:26:23,940
+لو إيجى يمشي بترانة ذات اليمين و ذات الشمال
+
+271
+00:26:23,940 --> 00:26:26,620
+التكسيه، ماهو تأثير على ال nervous system؟
+
+272
+00:26:26,620 --> 00:26:32,300
+convergence، لو زاد الأمر قصير، ماهيش؟ تشننجات
+
+273
+00:26:32,300 --> 00:26:37,840
+طبعا احنا كناس users لAtropine، practitioners،
+
+274
+00:26:37,840 --> 00:26:41,580
+المفروض مانصيحش الحاجة هذه طبعا ال Atropine هو
+
+275
+00:26:41,580 --> 00:26:47,950
+home use، استخدام بيتييعني احنا بنكتب للأم للطفل
+
+276
+00:26:47,950 --> 00:26:53,730
+ال infant او small child بنكتب لها تربين twice
+
+277
+00:26:53,730 --> 00:27:01,630
+daily فهو مثلا four days المفروض انه ننبيها للأم
+
+278
+00:27:01,630 --> 00:27:12,050
+اذا كان الطفل أصبح feverish سخن او flashy ولموش
+
+279
+00:27:21,580 --> 00:27:25,040
+و الأم اللي هي متعلمة و عاية تقول يا دكتور نعم
+
+280
+00:27:25,040 --> 00:27:32,620
+الولد سخر سخر بس و لا ممكن يقولك ايه انه في حمار
+
+281
+00:27:32,620 --> 00:27:36,940
+في عينيه حمار في جلده واقف العلاج اللي بديه طبعا
+
+282
+00:27:36,940 --> 00:27:44,740
+انا ممكن اعمله reflection لو انا وصله يعني فرشة
+
+283
+00:27:44,740 --> 00:27:47,340
+psychopathy افضل ان بلاش ماحصل انا حاطين القاطرة
+
+284
+00:27:49,190 --> 00:27:52,450
+يعني العين ما حطينا اليوم او يومين لسه اقوى من ال
+
+285
+00:27:52,450 --> 00:27:57,910
+cycle بنفلات صحيح انه partial لكن مثلا هيكون وصف
+
+286
+00:27:57,910 --> 00:28:02,450
+ال 80% من اللي انا عايزه فبعمله reflection و
+
+287
+00:28:02,450 --> 00:28:06,830
+بنوقفله و ممكن اعطيه بعض شراب للحسية بعض شراب
+
+288
+00:28:06,830 --> 00:28:15,810
+للحسية يبقى الأتروبيل هو safe لو حد يجيب الحد
+
+289
+00:28:16,730 --> 00:28:23,190
+يعني قاطة وحد غير قاطة فالإنسان يستخدم فواته
+
+290
+00:28:23,190 --> 00:28:31,750
+ويحاول أن يعني يتجنب المساوية بتاعة الأطراف.فبت
+
+291
+00:28:31,750 --> 00:28:35,130
+ساكروبنتوليت ساكروبنتوليت is the most widely used
+
+292
+00:28:35,130 --> 00:28:40,150
+psychologic today في أهل الأيام يعني أقدر أقول أقل
+
+293
+00:28:40,150 --> 00:28:45,230
+شيء seventy percentمن الحلال السيكلوبليجيا اللى
+
+294
+00:28:45,230 --> 00:28:54,830
+بتستخدم في العالم هي السيكلوبليجيا وهو الاختيار
+
+295
+00:28:54,830 --> 00:28:59,150
+الخير الأول الـparalysis of accommodation is not
+
+296
+00:28:59,150 --> 00:29:03,910
+complete صحيح احنا لازم نكون عارفين انه مابعملش
+
+297
+00:29:03,910 --> 00:29:07,270
+hundred percent paralysis of cellular muscle
+
+298
+00:29:12,500 --> 00:29:16,820
+it gives a depth of psychoplegia that is
+
+299
+00:29:16,820 --> 00:29:20,600
+sufficient for the majority of cases يعني بيعطيني
+
+300
+00:29:20,600 --> 00:29:31,200
+عمق psychoplegia كافية للعمل بشكل مرضى لأقل 100% و
+
+301
+00:29:31,200 --> 00:29:35,960
+لأقل 9% و أنا طبعا بعملها حسبة في الآخر بعمل
+
+302
+00:29:35,960 --> 00:29:44,990
+adjustment بيقوللي هفنروفاقه على انه وجدوا ان الـ
+
+303
+00:29:44,990 --> 00:29:48,990
+Great Value of Cyclopentolate when he describes
+
+304
+00:29:48,990 --> 00:29:51,670
+its effects in the field of Cycloplegia as
+
+305
+00:29:51,670 --> 00:29:57,070
+superior to Homotropin اكوى
+
+306
+00:29:57,070 --> 00:30:01,870
+من Homotropin، even the 5% concentration of the
+
+307
+00:30:01,870 --> 00:30:06,270
+latter، حتى لو فضتنا اكوى تركيز في Homotropin، ما
+
+308
+00:30:06,270 --> 00:30:11,340
+بيظهروا ان Homotropin برضه Cycloplegicومن الـ one,
+
+309
+00:30:11,480 --> 00:30:15,340
+two, three, four, five خمس اللي هو درجات اللي هم
+
+310
+00:30:15,340 --> 00:30:20,560
+أطربين حتى لو حطب خمسة في المية هم أطربين بيفضل ال
+
+311
+00:30:20,560 --> 00:30:24,500
+one percent cyclopentylate أقوى منها جدًا ال its
+
+312
+00:30:24,500 --> 00:30:31,180
+rapidity of onset في سرعة البدء في cycloplegia
+
+313
+00:30:31,180 --> 00:30:36,700
+شوقت ال duration اللي هو الوقت اللي بيشتغلوا من
+
+314
+00:30:36,700 --> 00:30:37,880
+أول لأخر أقصر
+
+315
+00:30:41,180 --> 00:30:44,360
+والـ effect بتاعته أقوى، يبقى الـcyclopentrolate
+
+316
+00:30:44,360 --> 00:30:49,400
+فاق اللي هم أضربين في تلت نواحي، إيش هم صراعات
+
+317
+00:30:49,400 --> 00:30:55,820
+البدء، وقصر المدة الزمنية، يعني مش لو مثلا ست
+
+318
+00:30:55,820 --> 00:31:00,260
+ساعات فقط، اللي هم أضربين تلت أيام مثلا، وأخيرا ال
+
+319
+00:31:00,260 --> 00:31:07,380
+effect كcyclopentrate أقوى، ال effect أقوى، طيب
+
+320
+00:31:07,380 --> 00:31:12,250
+الـcyclopentrolate is availableمتوفر in single
+
+321
+00:31:12,250 --> 00:31:16,630
+dose four يعني فيه منه بلاستيكه عارفين single
+
+322
+00:31:16,630 --> 00:31:19,810
+dose؟ بيحط نقطه هنا و بس و هنا نقطه هنا و بس و
+
+323
+00:31:19,810 --> 00:31:24,730
+بيرميها and in multi dose مافيه bottle، زجاج فاحنا
+
+324
+00:31:24,730 --> 00:31:28,970
+اللي عندنا هنا زجاج، بلاستيكية، مافيش الكبيرة
+
+325
+00:31:28,970 --> 00:31:34,410
+الصغيرة، الأصبح، لأ في single dose في اللي هو
+
+326
+00:31:34,410 --> 00:31:40,200
+multiple أو multi doseو في العالم توفر 0.5% و 1%
+
+327
+00:31:40,200 --> 00:31:46,260
+احنا عندنا بس 1% لو بدنا احنا نعمل 0.5% بدنا نعمله
+
+328
+00:31:46,260 --> 00:31:50,440
+distilled water او مكسلها بالمية An interesting
+
+329
+00:31:50,440 --> 00:31:52,880
+alternative application method for cyclopentolate
+
+330
+00:31:52,880 --> 00:31:55,940
+has been evaluated by إسماعيل
+
+331
+00:32:02,110 --> 00:32:06,830
+و هو used a spray application to the closed eye
+
+332
+00:32:06,830 --> 00:32:13,850
+يعني اسمه عيد هذا في ال 94 عمل spray رشبه و قارن
+
+333
+00:32:13,850 --> 00:32:20,490
+بين ال spray و بين ال drops و وجد انه الأثر واحد
+
+334
+00:32:20,490 --> 00:32:25,030
+لمال ال spray في عين الطفل حتى و هو نائم
+
+335
+00:32:30,630 --> 00:32:33,330
+أو حط drops في العين التانية جال انه في reflection
+
+336
+00:32:33,330 --> 00:32:38,850
+ساعة بعض بسألة accept حاجة ان ما اخرت الطفل الطفل
+
+337
+00:32:38,850 --> 00:32:44,730
+لما احنا سبته عشان نقطله نقطة بيعمل مشكلة و لو بكى
+
+338
+00:32:44,730 --> 00:32:51,610
+wash out of drops هتطلع useless و درباتكوا في
+
+339
+00:32:51,610 --> 00:32:56,570
+عملكوا اللي كليكي من هذه النقطة يا بناتي اي قطرة
+
+340
+00:32:56,570 --> 00:33:03,530
+مش بس ال settlementتقضى واتبعها بكاء فقد فقدت
+
+341
+00:33:03,530 --> 00:33:07,290
+المفهوم خاصة
+
+342
+00:33:07,290 --> 00:33:10,790
+في الأطفال فقدت المفهوم لذلك انا الطفل لازم اني
+
+343
+00:33:10,790 --> 00:33:17,630
+اكون انا patient صبور يعني معاه ازهى patient هو
+
+344
+00:33:17,630 --> 00:33:21,870
+مريض وانا صبور حقيقة
+
+345
+00:33:21,870 --> 00:33:25,510
+انا افضل تقيقة وزبطها ان انا
+
+346
+00:33:34,770 --> 00:33:39,830
+لو دي انا افتحله هنا بال .. strongly يعني بال ..
+
+347
+00:33:39,830 --> 00:33:44,470
+manually بدي هنا، هيعيد، و لما هيعيد، هتهو خلص،
+
+348
+00:33:44,470 --> 00:33:49,310
+لكن انا بدي اغمض هنا، انا اغمض هنا، لأ مالش، مالش،
+
+349
+00:33:49,310 --> 00:33:53,170
+مالش يا بابا، مالش يا بابا، بحطه هنا، و اقوله خلاص
+
+350
+00:33:53,170 --> 00:33:56,570
+خلصنا، هيفتح هنا، هتنزل جترا بدون مقاومة
+
+351
+00:34:00,660 --> 00:34:05,040
+لكن إسماعيل قامت بعمل الـ Spray ووجدت أن الـ Spray
+
+352
+00:34:05,040 --> 00:34:10,100
+كان أسهل
+
+353
+00:34:10,100 --> 00:34:14,520
+في وضعها في العين وكان أكثر مقبولًا للمريض ومقبول
+
+354
+00:34:14,520 --> 00:34:20,200
+عنه، طبعًا ليس هناك Spray دعونا نشوف الـ
+
+355
+00:34:20,200 --> 00:34:26,180
+Sacroventolate internationally used في سن من 1 إلى
+
+356
+00:34:26,180 --> 00:34:26,900
+12 سنة
+
+357
+00:34:31,270 --> 00:34:36,770
+الواحد إلى يعني معخر سنة وأقل شويه only one drop
+
+358
+00:34:36,770 --> 00:34:41,290
+of one percent solution solution يعني محلول قطرة
+
+359
+00:34:41,290 --> 00:34:46,650
+is usually necessary but a bigger drop should be
+
+360
+00:34:46,650 --> 00:34:50,750
+installed if little if it is measurable after 15
+
+361
+00:34:50,750 --> 00:34:54,490
+minutes طبعا مش هي ال ideal ان اخطط لنقطة و اعمل
+
+362
+00:34:54,490 --> 00:34:54,950
+reflection
+
+363
+00:35:02,390 --> 00:35:06,550
+نقطة مثلا الساعة تسعة و نقطة الساعة تسعة و رابع و
+
+364
+00:35:06,550 --> 00:35:11,770
+نقطة الساعة تسعة و نص و عشرة الا رابع تربع ساعة
+
+365
+00:35:11,770 --> 00:35:19,770
+اعملوا reflection هذا one person و ال factor in
+
+366
+00:35:19,770 --> 00:35:21,970
+determining the appropriate concentration is the
+
+367
+00:35:21,970 --> 00:35:26,030
+degree of iris pigmentation اه بقول في عامل بدخل
+
+368
+00:35:26,030 --> 00:35:30,430
+عن خطة اللي هو اللون ال iris
+
+369
+00:35:47,070 --> 00:35:53,730
+هذا جدًا بسيط، ممكن 0.5 يكفي بالنسبالي، يعني لو أن
+
+370
+00:35:53,730 --> 00:35:59,490
+الـIris بتاعه بسيط، زي الخوجات، بيكفي 0.5
+
+371
+00:35:59,490 --> 00:36:06,090
+رتنوسكوبيك الـ Refraction يمكن تعمل في 40 إلى 60
+
+372
+00:36:06,090 --> 00:36:10,750
+دقيقة، يعني نحطله هذا نقطة، و بعد 40 إلى 60 دقيقة
+
+373
+00:36:10,750 --> 00:36:15,800
+أعمل الـ Refraction، لكن لو عندك ضعفو بما أنه احنا
+
+374
+00:36:15,800 --> 00:36:21,740
+العرب عندنا dark اي reads غالبا، عظمنا، اقلنا ال
+
+375
+00:36:21,740 --> 00:36:26,940
+honey، فهو بعدين بدأ شويه dark و dark اللي هو
+
+376
+00:36:26,940 --> 00:36:29,940
+strongly dark
+
+377
+00:36:48,870 --> 00:36:54,310
+with fifteen to twenty minutes and above there is
+
+378
+00:36:54,310 --> 00:36:57,690
+no significant measurable reduction in the
+
+379
+00:36:57,690 --> 00:37:01,330
+amplitude of the accommodation طيب يعني انا بدي
+
+380
+00:37:01,330 --> 00:37:06,930
+اقول ان انا الان احنا جربنا على النوع الاول up to
+
+381
+00:37:06,930 --> 00:37:12,970
+twelve الان بدي اقترض ان احنا تعدينا الاتناشر
+
+382
+00:37:12,970 --> 00:37:18,810
+تلاتاشر اربعتاشر خمستاشربقوللي هاخل النقطة مش واحد
+
+383
+00:37:18,810 --> 00:37:27,810
+percent 0.5 نص في المياليش اجلل
+
+384
+00:37:27,810 --> 00:37:31,070
+ال accommodation ال activity بالسنة مصالي اجلل
+
+385
+00:37:31,070 --> 00:37:36,250
+فانا هنا بدي اخطره نص وبعد ربع ساعة مثلا اخطره
+
+386
+00:37:36,250 --> 00:37:41,490
+نقطة تانية the second drop من نص percent solution
+
+387
+00:37:41,490 --> 00:37:45,350
+is sometimes we say unfair skin patients
+
+388
+00:37:53,060 --> 00:37:59,800
+الشعر أسود والبوغبغ أسود والعيال أسود وكمان مرة
+
+389
+00:37:59,800 --> 00:38:06,720
+يعني الكلب بيقول لي إن الناس اللي عيال أسود واحدة
+
+390
+00:38:06,720 --> 00:38:11,220
+متكافأة مع إنه التن تن أحسن لكن في ال dark
+
+391
+00:38:16,320 --> 00:38:21,560
+والدارك هير تايب وانها تعتبر ضرورية تستخدم اتصال
+
+392
+00:38:21,560 --> 00:38:21,760
+اتصال اتصال اتصال اتصال اتصال اتصال اتصال اتصال
+
+393
+00:38:21,760 --> 00:38:24,780
+اتصال اتصال اتصال اتصال اتصال اتصال اتصال اتصال
+
+394
+00:38:24,780 --> 00:38:29,440
+اتصال اتصال اتصال اتصال اتصال اتصال اتصال اتصال
+
+395
+00:38:29,440 --> 00:38:29,560
+اتصال اتصال اتصال اتصال اتصال اتصال اتصال اتصال
+
+396
+00:38:29,560 --> 00:38:31,040
+اتصال اتصال اتصال اتصال اتصال اتصال اتصال اتصال
+
+397
+00:38:31,040 --> 00:38:31,760
+اتصال
+
+398
+00:38:44,510 --> 00:38:49,490
+over a dose of peroxide effect الزيارة هتطلع بعضها
+
+399
+00:38:49,490 --> 00:38:55,110
+كونجرتال الساك لا يتسع لنقطتين احنا بقول لك
+
+400
+00:38:55,110 --> 00:39:01,090
+كونجرتال الساك بيسع five microliter لما تجمد عليه
+
+401
+00:39:01,090 --> 00:39:06,070
+بس بيسع ten microliter ال drop الواحدة من ال drop
+
+402
+00:39:06,070 --> 00:39:10,630
+فيها خمسين microliter drop اللي مفتط القطرة هذه
+
+403
+00:39:10,630 --> 00:39:17,130
+خمسين fiftyفما نحط 100 microliter اللي هي انا
+
+404
+00:39:17,130 --> 00:39:23,170
+هتاخد عشرة و تاخد تسعة، لكن اذا ما احط اول نقطة و
+
+405
+00:39:23,170 --> 00:39:30,110
+اخلي يصير absorption عبر ال core يعني، والنقطة
+
+406
+00:39:30,110 --> 00:39:35,310
+الأولى في رمضان الساعة تسع الوين، ال iris، و تأثر
+
+407
+00:39:35,310 --> 00:39:41,440
+على the ciliary muscleاللي ورا ال IRIS Cellular
+
+408
+00:39:41,440 --> 00:39:44,720
+Muscle و طبعا هي هتقفل علي Sphincter Pupillary
+
+409
+00:39:44,720 --> 00:39:47,100
+Muscle وعالي Cellular Muscle انهم بارة sympathetic
+
+410
+00:39:47,100 --> 00:39:54,120
+و بعد ربم ساعة اوبع كمان نقطة بيكون نقطة اولى وصلت
+
+411
+00:39:54,120 --> 00:39:59,520
+او بدي اتصل الى Cellular Muscle وحط النقطة التانية
+
+412
+00:39:59,520 --> 00:40:04,940
+في ال STI كويس؟ شاب مش فاهمين
+
+413
+00:40:37,190 --> 00:40:40,450
+بالعكس ممكن انا ادخل على الدم على طريق ال .. اذا
+
+414
+00:40:40,450 --> 00:40:44,350
+نزلت دا قبل الدكتورة هدخل على عكس .. عكس ما داشت
+
+415
+00:40:44,350 --> 00:40:44,690
+في العين
+
+416
+00:40:48,780 --> 00:40:55,400
+لو فيه driver صغير كان بنزل نصف النقطة، لكن
+
+417
+00:40:55,400 --> 00:41:01,660
+الشركات لحسابات economical، اقتصادية، بتوسع
+
+418
+00:41:01,660 --> 00:41:07,540
+الفتحة، حتى يهرب عشان يخلص ويشتري رياضة، فاهمين
+
+419
+00:41:07,540 --> 00:41:12,320
+كده؟ أه الشركات ماربح مالي يعني، أغنى ناس في
+
+420
+00:41:12,320 --> 00:41:16,760
+العالم pharmaceuticals، مصانع الدوائية أغنى ناس في
+
+421
+00:41:16,760 --> 00:41:17,200
+كل العالم
+
+422
+00:41:21,230 --> 00:41:35,930
+أولاد الناس جاءوا وقالوا
+
+423
+00:41:35,930 --> 00:41:45,550
+وضعوا
+
+424
+00:41:45,550 --> 00:41:52,570
+وضعوا وضعوا وضعوا وضعوا وضعوا وضعوا وضعواانه بعد
+
+425
+00:41:52,570 --> 00:41:58,030
+ساعة و اعملت reflection انه وجدوا انه residual
+
+426
+00:41:58,030 --> 00:42:01,230
+accommodation
+
+427
+00:42:01,230 --> 00:42:07,910
+فاضل plus two يعني في الطفل مثلا في العادي ال
+
+428
+00:42:07,910 --> 00:42:14,410
+accommodation مثلا eight او اكتر و بعد ما قلت
+
+429
+00:42:14,410 --> 00:42:17,450
+recycle و بنقول ات مرة و بعد كمان مرة و بعد ساعة
+
+430
+00:42:17,450 --> 00:42:19,990
+عملت reflection فاضل plus two
+
+431
+00:42:33,560 --> 00:42:37,520
+أنا residual متبقى يعني السلمس مش مش paralyzed على
+
+432
+00:42:37,520 --> 00:42:41,740
+الأرض وبالتالي فردر فيها plus two هنا أنا لما بدي
+
+433
+00:42:41,740 --> 00:42:46,380
+أعمل subtraction بدي أخصم بدي أحسب حساب أنه فيه
+
+434
+00:42:46,380 --> 00:42:51,840
+شوية residual مثل الأتروبيل الأتروبيل بيخلي zero
+
+435
+00:42:51,840 --> 00:42:56,760
+انا بيخلي اتنين فبالحسبة بتاعة prescription بدي
+
+436
+00:42:56,760 --> 00:43:00,300
+انا أحسب حساب أنه السلمس مش fully paralyzed
+
+437
+00:43:14,870 --> 00:43:18,910
+الترابير يبدأ بعد ربع ساعة أو نصف ساعة، لأ هنا
+
+438
+00:43:18,910 --> 00:43:24,990
+يقول few minutes خلال دقائق، ممكن يكون خمسة أو ست
+
+439
+00:43:24,990 --> 00:43:30,420
+دقائق، I'm becoming maximumمن خلال 30 إلى 60
+
+440
+00:43:30,420 --> 00:43:34,780
+دقيقة، ولكن في بعض الأحيان بسرعة مثل 15 دقيقة،
+
+441
+00:43:34,780 --> 00:43:38,340
+يعني خلال بقية ساعة ممكن تكون وصلي، لكن في الغالب
+
+442
+00:43:38,340 --> 00:43:44,200
+نصف ساعة، في الغالب نصف ساعة، حتى في الناس اللي ال
+
+443
+00:43:44,200 --> 00:43:46,400
+.. ال .. ال .. ال pupil بتاعهم light في خلال 10
+
+444
+00:43:46,400 --> 00:43:48,720
+دقائق، في special cases where light appears
+
+445
+00:43:53,610 --> 00:43:55,450
+بالنسبة للمدرسة الروبليزية، وكذلك بالنسبة للمدرسة
+
+446
+00:43:55,450 --> 00:43:56,270
+الروبليزية، وكذلك بالنسبة للمدرسة الروبليزية،
+
+447
+00:43:56,270 --> 00:43:56,790
+وكذلك بالنسبة للمدرسة الروبليزية، وكذلك بالنسبة
+
+448
+00:43:56,790 --> 00:43:57,470
+للمدرسة الروبليزية، وكذلك بالنسبة للمدرسة
+
+449
+00:43:57,470 --> 00:43:59,230
+الروبليزية، وكذلك بالنسبة للمدرسة الروبليزية،
+
+450
+00:43:59,230 --> 00:44:01,050
+وكذلك بالنسبة للمدرسة الروبليزية، وكذلك بالنسبة
+
+451
+00:44:01,050 --> 00:44:03,330
+للمدرسة الروبليزية، وكذلك بالنسبة للمدرسة
+
+452
+00:44:03,330 --> 00:44:14,810
+الروبليزية، وكذلك
+
+453
+00:44:14,810 --> 00:44:21,950
+بالنسبة للمدرسة الروب
+
+454
+00:44:22,220 --> 00:44:27,000
+المقاومة يجب أن تكون مباشرة كل 10 دقائق. كل 10
+
+455
+00:44:27,000 --> 00:44:31,780
+دقائق أقيص المقاومة. بعد مقاومة الوقت من 20 دقائق.
+
+456
+00:44:31,960 --> 00:44:35,820
+مقاومة الوقت يعني أعطي فترة سماعة. من الرحلة اللي
+
+457
+00:44:35,820 --> 00:44:40,380
+أنا حطيت النقطة لحد التأثير. وعدد عشرين دقيقة. بعد
+
+458
+00:44:40,380 --> 00:44:45,520
+عشرين دقيقة أبدأ أقيص المقاومة وأتبع حلولها. حتى
+
+459
+00:44:45,520 --> 00:44:48,500
+لا يكون هناك تأثير في المقاومة.
+
+460
+00:44:53,280 --> 00:44:57,680
+بعمله Refraction وبعد تلاتين دقيقة بعمله
+
+461
+00:44:57,680 --> 00:45:01,680
+Refraction وبعد أربعين دقيقة بعمله Refraction وبعد
+
+462
+00:45:01,680 --> 00:45:05,600
+خمسين دقيقة بعمله Refraction وإن ثبت ال
+
+463
+00:45:05,600 --> 00:45:10,560
+accommodation وبطل اجيب زيادة بيكون أنا وصلت تماما
+
+464
+00:45:10,560 --> 00:45:14,620
+يعني ماخدش أول Refraction ومساعدته هو description
+
+465
+00:45:14,620 --> 00:45:19,340
+لسه لغاية ما هيجب تصير أعمل انا Refraction اللي
+
+466
+00:45:19,340 --> 00:45:21,300
+بقاله يكون ثابت مابتحركش
+
+467
+00:45:41,410 --> 00:45:47,050
+انجاب نتيجة غير في الـ Dynamic لسه شغالة Like most
+
+468
+00:45:47,050 --> 00:45:50,270
+drugs that affect accommodation and the pupil the
+
+469
+00:45:50,270 --> 00:45:53,730
+time cost of the materials is different to that of
+
+470
+00:45:53,730 --> 00:45:56,270
+the circulation and pupil diameter should not be
+
+471
+00:45:56,270 --> 00:45:59,110
+relied on to get a measure of the remaining
+
+472
+00:45:59,110 --> 00:46:03,650
+accommodationيعني مش معناه ان البحب توشع ان هو
+
+473
+00:46:03,650 --> 00:46:06,750
+مقياس للpsychoplegia، لأ مقياس الpsychoplegia هو
+
+474
+00:46:06,750 --> 00:46:10,850
+ال accommodation، البحب مثلا لسه ضيق، مثلا البحب
+
+475
+00:46:10,850 --> 00:46:14,890
+لسه ضيق يعني ماصارش اثر على الcell and muscle، او
+
+476
+00:46:14,890 --> 00:46:20,530
+الpsychoplegia كالأ، مااخدش حجم البحب مقياس
+
+477
+00:46:20,530 --> 00:46:24,840
+للpsychoplegia، الpsychoplegia شيءواللي هو celery
+
+478
+00:46:24,840 --> 00:46:28,460
+muscle ال .. ال .. ال pupil ديامتها شيء شكرا لكم
+
+479
+00:46:28,460 --> 00:46:30,940
+على خصم الاستماع وان شاء الله في المرة القادمة
+
+480
+00:46:30,940 --> 00:46:35,140
+نكمل تدائما اتين و تمانية و تلاتين شكرا و السلام
+
+481
+00:46:35,140 --> 00:46:36,180
+عليكم و رحمة الله و بركاته
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/rs42TpcOFPQ_raw.json b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/rs42TpcOFPQ_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..45b8d5066545e05b470fdc34b15f8a5e5d7d8405
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/rs42TpcOFPQ_raw.json
@@ -0,0 +1 @@
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Yes؟ طيب. Ureitis is a serious disease that will affect vision.يعني ال vision in ureitis will be affected أعمى كتب.", "tokens": [25291, 14125, 1602, 538, 2182, 1287, 11, 2368, 1287, 11, 1822, 11, 4470, 295, 2445, 13, 1079, 22807, 23032, 1829, 3555, 13, 624, 265, 16074, 307, 257, 3156, 4752, 300, 486, 3345, 5201, 13, 40228, 22653, 2423, 5201, 294, 344, 265, 16074, 486, 312, 8028, 5551, 25957, 7578, 9122, 2655, 3555, 13], "avg_logprob": -0.36143868374374677, "compression_ratio": 1.21656050955414, "no_speech_prob": 0.0, "words": [{"start": 107.17, "end": 107.81, "word": "Characterized", "probability": 0.58172607421875}, {"start": 107.81, "end": 108.09, "word": " by", "probability": 0.96044921875}, {"start": 108.09, "end": 108.65, "word": " redness,", "probability": 0.871337890625}, {"start": 109.73, "end": 110.43, "word": " hotness,", "probability": 0.925048828125}, {"start": 111.69, "end": 112.09, "word": " pain,", "probability": 0.85400390625}, {"start": 114.33, "end": 114.49, "word": " loss", 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"ثم أتروبيل مفيد جدًا في التعامل بالإنفلام الانترويوبيال A. أتروبيل يقلل الألم يقلل الألم associated with the inflammatory process by relaxing the ciliary muscle spasm يبقى الانفلامشين، السلامصل بيحصل على إسباز إسباز بيعمل pain", "tokens": [12984, 2304, 5551, 2655, 2288, 2407, 21292, 1211, 3714, 5172, 25708, 10874, 3215, 14111, 995, 8978, 16712, 3615, 10943, 1211, 20666, 28814, 1863, 5172, 1211, 10943, 2423, 7649, 2655, 2288, 2407, 1829, 2407, 21292, 6027, 316, 13, 5551, 2655, 2288, 2407, 21292, 1211, 7251, 4587, 1211, 1211, 16247, 19528, 7251, 4587, 1211, 1211, 16247, 19528, 6615, 365, 264, 38199, 1399, 538, 20103, 264, 269, 38550, 8679, 637, 14774, 7251, 3555, 4587, 7578, 2423, 7649, 5172, 1211, 10943, 8592, 9957, 12399, 2423, 3794, 15040, 2304, 9381, 1211, 4724, 1829, 5016, 36520, 15844, 11933, 35457, 31377, 11933, 35457, 31377, 4724, 1829, 25957, 1211, 1822], "avg_logprob": -0.5561286546651599, "compression_ratio": 1.5944700460829493, "no_speech_prob": 0.0, "words": [{"start": 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inflammatory", "probability": 0.9111328125}, {"start": 246.45, "end": 247.03, "word": " cells", "probability": 0.90478515625}], "temperature": 1.0}, {"id": 9, "seek": 27660, "start": 248.06, "end": 276.6, "text": "الارتروبين هنا بينشف ال IRS بيخلق أقل تلسق من إيه؟ من ال surface of the lens لهيك إنه كمان بيفتح البوء بوء على الآخر بيبني ال contact بين ال IRS و بين ال lens بيخلقش في contact بيسحبوا بعيد يعني البوء بوء هيك وال IRS بيروح periphery", "tokens": [6027, 9640, 2655, 2288, 2407, 21292, 1863, 34105, 4724, 1829, 1863, 8592, 5172, 2423, 33848, 4724, 1829, 9778, 1211, 4587, 5551, 4587, 1211, 6055, 1211, 3794, 4587, 9154, 11933, 1829, 3224, 22807, 9154, 2423, 3753, 295, 264, 6765, 46740, 1829, 4117, 36145, 3224, 9122, 2304, 7649, 4724, 33911, 2655, 5016, 29739, 2407, 38207, 4724, 2407, 38207, 15844, 6024, 95, 34740, 4724, 1829, 3555, 22653, 2423, 3385, 49374, 2423, 33848, 4032, 49374, 2423, 6765, 4724, 1829, 9778, 1211, 4587, 8592, 8978, 3385, 4724, 1829, 3794, 5016, 3555, 14407, 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انا بدي اقول ان انا الان احنا جربنا على النوع الاول up to twelve الان بدي اقترض ان احنا تعدينا الاتناشر تلاتاشر اربعتاشر خمستاشر", "tokens": [11820, 18126, 281, 7699, 2077, 293, 3673, 456, 307, 572, 4776, 43615, 11004, 294, 264, 27433, 295, 264, 27363, 23032, 1829, 3555, 37495, 22653, 1975, 8315, 4724, 16254, 1975, 39648, 16472, 1975, 8315, 2423, 7649, 1975, 5016, 8315, 10874, 25513, 8315, 15844, 28239, 45367, 42963, 12610, 493, 281, 14390, 2423, 7649, 4724, 16254, 1975, 38149, 43042, 16472, 1975, 5016, 8315, 37279, 16254, 8315, 2423, 9307, 1863, 33599, 2288, 6055, 1211, 9307, 33599, 2288, 1975, 25513, 34268, 33599, 2288, 16490, 2304, 14851, 33599, 2288], "avg_logprob": -0.23177082676972663, "compression_ratio": 1.672811059907834, "no_speech_prob": 0.0, "words": [{"start": 2208.87, "end": 2209.31, "word": "with", "probability": 0.1541748046875}, {"start": 2209.31, "end": 2210.73, "word": " fifteen", "probability": 0.359375}, {"start": 2210.73, "end": 2211.59, "word": " to", 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الان", "probability": 0.6568603515625}, {"start": 2222.77, "end": 2223.69, "word": " احنا", "probability": 0.94970703125}, {"start": 2223.69, "end": 2224.19, "word": " جربنا", "probability": 0.9791666666666666}, {"start": 2224.19, "end": 2224.69, "word": " على", "probability": 0.91357421875}, {"start": 2224.69, "end": 2225.01, "word": " النوع", "probability": 0.886474609375}, {"start": 2225.01, "end": 2225.41, "word": " الاول", "probability": 0.856689453125}, {"start": 2225.41, "end": 2226.43, "word": " up", "probability": 0.88525390625}, {"start": 2226.43, "end": 2226.93, "word": " to", "probability": 0.97265625}, {"start": 2226.93, "end": 2227.29, "word": " twelve", "probability": 0.89697265625}, {"start": 2227.29, "end": 2230.17, "word": " الان", "probability": 0.822509765625}, {"start": 2230.17, "end": 2230.65, "word": " بدي", "probability": 0.90380859375}, {"start": 2230.65, "end": 2230.99, "word": " اقترض", "probability": 0.8748372395833334}, {"start": 2230.99, "end": 2231.15, 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\ No newline at end of file
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/rs42TpcOFPQ_raw.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/rs42TpcOFPQ_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..51e7bae91a33345f6349e7a2d379fc97af94f0d6
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/rs42TpcOFPQ_raw.srt
@@ -0,0 +1,1964 @@
+1
+00:00:20,920 --> 00:00:22,800
+أعوذ بالله من الشيطان الرجيم، بسم الله الرحمن
+
+2
+00:00:22,800 --> 00:00:28,340
+الرحيم، الحمد لله يا رب العالمين، وأسلم على النبي
+
+3
+00:00:28,340 --> 00:00:31,500
+الأمين وعلى آله واصحابه والتابعين
+
+4
+00:00:52,090 --> 00:00:55,590
+الدراجة كتابة كتابة كتابة كتابة كتابة كتابة كتابة
+
+5
+00:00:55,590 --> 00:00:59,570
+كتابة كتابة كتابة كتابة كتابة كتابة كتابة كتابة
+
+6
+00:00:59,570 --> 00:01:00,130
+كتابة كتابة كتابة كتابة كتابة كتابة كتابة كتابة
+
+7
+00:01:00,130 --> 00:01:00,130
+كتابة كتابة كتابة كتابة كتابة كتابة كتابة كتابة
+
+8
+00:01:00,130 --> 00:01:00,130
+كتابة كتابة كتابة كتابة كتابة كتابة كتابة كتابة
+
+9
+00:01:00,130 --> 00:01:00,150
+كتابة كتابة كتابة كتابة كتابة كتابة كتابة كتابة
+
+10
+00:01:00,150 --> 00:01:03,250
+كتابة كتابة كتابة كتابة كتابة كتابة
+
+11
+00:01:03,250 --> 00:01:19,990
+كتابة كتاب
+
+12
+00:01:20,680 --> 00:01:41,240
+تشخيص تشخيص
+
+13
+00:01:41,240 --> 00:01:46,680
+تشخيص تشخيص تشخيص تشخيص تشخيص تشخيص تشخيص تشخيص
+
+14
+00:01:46,680 --> 00:01:46,900
+تشخيص تشخيص تشخيص تشخيص تشخيص تشخيص تشخيص تشخيص
+
+15
+00:01:46,900 --> 00:01:46,900
+تشخيص تشخيص تشخيص تشخيص تشخيص تشخيص تشخيص تشخيص
+
+16
+00:01:46,900 --> 00:01:46,900
+تشخيص تشخيص تشخيص تشخيص تشخيص تشخيص تشخيص تشخيص
+
+17
+00:01:46,900 --> 00:01:46,900
+تشخيص تشخيص تشخيص تشخيص تشخيص تشخيص تشخيص تشخيص
+
+18
+00:01:46,900 --> 00:01:50,430
+تشخيص تشخيص تشخيCharacterized by redness, hotness,
+
+19
+00:01:51,690 --> 00:02:02,350
+pain, loss of function. Yes؟ طيب. Ureitis is a
+
+20
+00:02:02,350 --> 00:02:10,410
+serious disease that will affect vision.يعني
+
+21
+00:02:10,410 --> 00:02:18,150
+ال vision in ureitis will be affected أعمى كتب.ثم
+
+22
+00:02:18,150 --> 00:02:20,770
+أتروبيل مفيد جدًا في التعامل بالإنفلام
+
+23
+00:02:20,770 --> 00:02:27,610
+الانترويوبيال A. أتروبيل يقلل الألم يقلل الألم
+
+24
+00:02:27,610 --> 00:02:30,510
+associated with the inflammatory process by
+
+25
+00:02:30,510 --> 00:02:35,630
+relaxing the ciliary muscle spasm يبقى
+
+26
+00:02:35,630 --> 00:02:40,590
+الانفلامشين، السلامصل بيحصل على إسباز إسباز بيعمل
+
+27
+00:02:40,590 --> 00:02:49,360
+painهنا لما نحط ال muscle in relaxation او relaxed
+
+28
+00:02:49,360 --> 00:02:54,900
+position this will lead to loss of pain اي واحد
+
+29
+00:02:54,900 --> 00:03:03,120
+بيه and helps to prevent posterior synechiae
+
+30
+00:03:03,120 --> 00:03:09,700
+الاتساقات by dilating the pupil وانا جابكوا صورة
+
+31
+00:03:11,920 --> 00:03:16,740
+شايفين ال pupil هذا البني او الأصفر لما صار
+
+32
+00:03:16,740 --> 00:03:21,440
+violated ابتعد عن ايش؟ عن ال surface of the lens
+
+33
+00:03:21,440 --> 00:03:25,500
+الايراتيس
+
+34
+00:03:25,500 --> 00:03:32,020
+اليمناني بيكون sticky sticky يعني بلسق عارفين
+
+35
+00:03:32,020 --> 00:03:33,560
+الرغيب؟
+
+36
+00:03:39,930 --> 00:03:45,930
+الاتروبيل بيعمل على تجفيف ال iris بيجففه كيف
+
+37
+00:03:45,930 --> 00:03:53,090
+السشوار والشعر بينشف الشعر هذا الاتروبيل بينشف ال
+
+38
+00:03:53,090 --> 00:03:57,930
+iris أي بيمنع ال exudation ال inflammation له
+
+39
+00:03:57,930 --> 00:04:01,970
+إفرازات اسمها exudation لما الواقع فينا بيرشح أو
+
+40
+00:04:01,970 --> 00:04:06,150
+زربيا أو كل شوية بتطلع اه exudation فيه
+
+41
+00:04:06,150 --> 00:04:09,980
+inflammatory cellsالارتروبين هنا بينشف ال IRS
+
+42
+00:04:09,980 --> 00:04:17,380
+بيخلق أقل تلسق من إيه؟ من ال surface of the lens
+
+43
+00:04:17,380 --> 00:04:23,540
+لهيك إنه كمان بيفتح البوء بوء على الآخر بيبني ال
+
+44
+00:04:23,540 --> 00:04:30,460
+contact بين ال IRS و بين ال lens بيخلقش في contact
+
+45
+00:04:30,460 --> 00:04:35,940
+بيسحبوا بعيد يعني البوء بوء هيك وال IRS بيروح
+
+46
+00:04:35,940 --> 00:04:42,210
+peripheryو ال lens هي هنا فبصير في الشي اتساق زي
+
+47
+00:04:42,210 --> 00:04:52,830
+هيك في الحالة الأولى كده و كده وهي ال lens يبقى
+
+48
+00:04:52,830 --> 00:04:59,030
+هنا في contact بال iris بين ايش ال arterial
+
+49
+00:04:59,030 --> 00:05:02,390
+surface of the lens طيب الحالة حطينا متروبين
+
+50
+00:05:06,870 --> 00:05:17,390
+بس هاي العيبس هاي الناس هيك او بتكون flat مافيش
+
+51
+00:05:17,390 --> 00:05:23,910
+contact في الحياة الأولى لو ماحطيناش أتروبيل أو
+
+52
+00:05:23,910 --> 00:05:29,250
+cypermetroid على الأقل هصير هنا التساق الاتساق هذا
+
+53
+00:05:29,250 --> 00:05:36,970
+اسمه posterior-cynicia التساقهو اتصاق اتصاق حقيقي
+
+54
+00:05:36,970 --> 00:05:45,250
+المشكلة في الاتصاق هذا انه بيصير تلير هنا طيب الآن
+
+55
+00:05:45,250 --> 00:05:51,890
+ال .. ال aqueous بيطلع من هنا و بمرهق و بدو يطلع
+
+56
+00:05:51,890 --> 00:05:57,130
+من البحر عشان يطلع على ال angle او AC لما ناجي هنا
+
+57
+00:05:57,130 --> 00:06:07,370
+فى حاجة اسمها IRIS POMPEIأو أكلوزيو بيوبيلي أعرفين
+
+58
+00:06:07,370 --> 00:06:13,990
+أكلوزيو بيوبيلي يعني البوبيو مسكر يبقى هصير ال ..
+
+59
+00:06:13,990 --> 00:06:15,770
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+60
+00:06:15,770 --> 00:06:15,850
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+61
+00:06:15,850 --> 00:06:15,870
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+62
+00:06:15,870 --> 00:06:15,990
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+63
+00:06:15,990 --> 00:06:16,470
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+64
+00:06:16,470 --> 00:06:17,070
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+65
+00:06:17,070 --> 00:06:17,630
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+66
+00:06:17,630 --> 00:06:18,130
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+67
+00:06:18,130 --> 00:06:20,430
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+68
+00:06:20,430 --> 00:06:20,430
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+69
+00:06:20,430 --> 00:06:24,150
+ال .. ال ..
+
+70
+00:06:24,150 --> 00:06:29,670
+ال .. ال ..
+
+71
+00:06:31,950 --> 00:06:37,050
+من كتر الضغط عليه لكن مهالة مالكثقة، مع الإيش، مع
+
+72
+00:06:37,050 --> 00:06:43,990
+اللذي، يبقى أنا علاجي بالأتروبيل علاج علمي، أنا
+
+73
+00:06:43,990 --> 00:06:48,530
+عارف إيش بحط أتروبيل، عشان ماعملش لمصيبة هذه، طبعا
+
+74
+00:06:48,530 --> 00:06:52,530
+في الآخر كل هذا هنعكس على ال optic nerve سلبة
+
+75
+00:07:10,740 --> 00:07:14,960
+بالتالي، عندما يتحرر الجلد في المنطقة المستيقظية،
+
+76
+00:07:14,960 --> 00:07:19,880
+الاتصال بالكابسولة الأمامية تتخلص، واضح؟ لأنه ليس
+
+77
+00:07:19,880 --> 00:07:25,560
+هناك إلتصاق. طب سي في العلاج، moreover، أكتر من
+
+78
+00:07:25,560 --> 00:07:30,720
+ذلك، السيكروبليزيا اللي تم إنتاجه من هاتروبيل هو
+
+79
+00:07:30,720 --> 00:07:36,320
+مقيم إضافي ويقوم بتقليم كامة ومعمومة من اللينز
+
+80
+00:07:37,160 --> 00:07:40,460
+البوصيروس سيانيكي يجب أن يتطور حتى عند انفجار
+
+81
+00:07:40,460 --> 00:07:43,860
+الناس انفجار الناس انفجار الناس انفجار الناس
+
+82
+00:07:43,860 --> 00:07:45,900
+انفجار الناس انفجار الناس انفجار الناس انفجار
+
+83
+00:07:45,900 --> 00:07:50,360
+الناس انفجار الناس انفجار الناس انفجار الناس
+
+84
+00:07:50,360 --> 00:07:51,100
+انفجار الناس انفجار الناس انفجار الناس انفجار
+
+85
+00:07:51,100 --> 00:07:51,100
+الناس انفجار الناس انفجار الناس انفجار الناس
+
+86
+00:07:51,100 --> 00:07:51,100
+انفجار الناس انفجار الناس انفجار الناس انفجار
+
+87
+00:07:51,100 --> 00:07:51,100
+الناس انفجار الناس انفجار الناس انفجار الناس
+
+88
+00:07:51,100 --> 00:08:00,940
+انفجار الناس انفجار الناس انفجار الناس انفجار
+
+89
+00:08:00,940 --> 00:08:06,300
+ال
+
+90
+00:08:07,420 --> 00:08:13,320
+و less convex الحالة الرابعة atropine may also
+
+91
+00:08:13,320 --> 00:08:18,080
+help decrease the excessive permeability of the
+
+92
+00:08:18,080 --> 00:08:22,400
+inflamed blood vessels in the iris طبعا and
+
+93
+00:08:22,400 --> 00:08:25,900
+thereby reduce cells and protein in the anterior
+
+94
+00:08:25,900 --> 00:08:31,460
+chamber زي ما قلنا احنا لما بيصير inflammation
+
+95
+00:08:31,460 --> 00:08:38,920
+للعيرز، العيرز بيصير congestedنفس ال ILS بيصير
+
+96
+00:08:38,920 --> 00:08:42,540
+congested و بيصير ال blood vessels بتاعته dilated
+
+97
+00:08:42,540 --> 00:08:47,000
+و لما ال blood vessels بيصير dilated بيصير سهلة
+
+98
+00:08:47,000 --> 00:08:53,900
+solution يعني مثلا هاي ال ILS هيك و هاي ال blood
+
+99
+00:08:53,900 --> 00:08:59,580
+vessels بدا انها كانت صغيرة كده عصير كبيرة كده
+
+100
+00:08:59,580 --> 00:09:05,860
+يعني مثلا inflammation في الحالة الأولى كانت ال
+
+101
+00:09:05,860 --> 00:09:09,700
+endothelial cellsمغطية الوضع، هنا اللي فيها ال
+
+102
+00:09:09,700 --> 00:09:15,140
+cells مش مغطية الوضع صار فيه فجوات يسهل أن يخرج
+
+103
+00:09:15,140 --> 00:09:20,480
+منها ال water flow ال cells و الكلبها، مع سائل
+
+104
+00:09:20,480 --> 00:09:25,020
+اسمه exudate، exudate هذا يعني fluid و
+
+105
+00:09:25,020 --> 00:09:29,820
+inflammation، هذا هيروح وين؟ هييجي في ال AC
+
+106
+00:09:34,660 --> 00:09:40,500
+هذا اللي احنا بيقول عنه في الليل و بيقول هنا اللي
+
+107
+00:09:40,500 --> 00:09:43,120
+بيكون على ظهر ال .. ال .. ال .. ال .. في ال
+
+108
+00:09:43,120 --> 00:09:45,400
+endothelium of the KP
+
+109
+00:09:59,350 --> 00:10:05,070
+يبقى شوفوا الفوائد اللي احنا يعني بنعملها من وضع
+
+110
+00:10:05,070 --> 00:10:10,870
+الأتروبيل في حالة العيوريتس شيء مهم جدا أي يعني
+
+111
+00:10:10,870 --> 00:10:15,370
+تعالج كل الكورتيزون هو علاج هنا كورتيزون without
+
+112
+00:10:15,370 --> 00:10:22,930
+Cycloblegic يعني تكبر fifty percent useless يعني
+
+113
+00:10:22,930 --> 00:10:27,050
+انا بقعد صحي كورتيزون عشان anti inflammatory لكن
+
+114
+00:10:27,050 --> 00:10:28,390
+الالتساق
+
+115
+00:10:30,740 --> 00:10:34,580
+بين الـ Iris و بين الـ Lens مابيكفيش فيه ال
+
+116
+00:10:34,580 --> 00:10:39,040
+Cortisone لازم psychological و لقاعدة مابيعرفها
+
+117
+00:10:39,040 --> 00:10:44,860
+إلا الممارس لهذا العالم يعني هذه الصورة حبت أجيبها
+
+118
+00:10:44,860 --> 00:10:51,580
+عشان أشوفوا يعني كيف قبل الأتروبيل و كيف بعد
+
+119
+00:10:51,580 --> 00:10:56,240
+الأتروبيل شوفوا الـIris هنا شوفوا ال thickness
+
+120
+00:10:56,240 --> 00:11:02,260
+انتوا بيشوفوا ال axisوشوفوا هنا و انا ال iris صارت
+
+121
+00:11:02,260 --> 00:11:07,220
+peripheral بالاتروبيين و ال thickness جاي صارت
+
+122
+00:11:07,220 --> 00:11:17,000
+less convex و more flat اللي هو ال lens واضح؟ طيب
+
+123
+00:11:17,000 --> 00:11:21,120
+الاستعمال الثالث لاتروبيين غير ال refraction
+
+124
+00:11:27,960 --> 00:11:31,700
+أو طالب قد قال Penalization Penalization الأقابة
+
+125
+00:11:31,700 --> 00:11:39,960
+أقاب إيه؟ أقاب العين القوية بالعين السليمة الطفل
+
+126
+00:11:39,960 --> 00:11:46,720
+كل ما حطله patch غطاء بيشيله و يبكي ما بيدلو الخطأ
+
+127
+00:11:46,720 --> 00:11:52,020
+حطله على العين السليمة غطاء عشان أعمل activation
+
+128
+00:11:52,020 --> 00:11:56,720
+للisotropic
+
+129
+00:11:56,720 --> 00:11:57,140
+eye
+
+130
+00:12:01,730 --> 00:12:05,470
+مش عاوز فبيقولوا
+
+131
+00:12:05,470 --> 00:12:09,750
+والله مافي لا ثق أنه واقف على عينه أبدا إلا يشيله
+
+132
+00:12:09,750 --> 00:12:14,230
+ويعيده ويقولوا طيب هنعمله penalization حطوا ال
+
+133
+00:12:14,230 --> 00:12:23,190
+atropine يعني ممكن once daily ال atropine لما نضعه
+
+134
+00:12:23,190 --> 00:12:28,070
+في العين بيخلي some eye فيها impaired vision for
+
+135
+00:12:28,070 --> 00:12:31,820
+near and for distancefor near and far distance
+
+136
+00:12:31,820 --> 00:12:38,020
+وبالتالي الطفل يصبح شيئا فشيئا يعتبد على عينه ال
+
+137
+00:12:38,020 --> 00:12:45,220
+amblyopia على عينه الكسولة lazy eye ممكن هذا يقتوم
+
+138
+00:12:45,220 --> 00:12:49,920
+شهر شهرين تلاتة اه بس هو بيحدر من شيء في ال
+
+139
+00:12:49,920 --> 00:12:57,520
+penalization انه بعد ما يروح تأثير الاتروبيل ممكن
+
+140
+00:12:57,520 --> 00:13:02,850
+يصير reversed amblyopiaفي العين الساود ايه يعني
+
+141
+00:13:02,850 --> 00:13:09,130
+انا شطت ال eye ال ال ال lazy و كسلت العين اللي مش
+
+142
+00:13:09,130 --> 00:13:12,850
+lazy لكن انا مابخاف اكتر من هذا لان بعد ذلك ممكن
+
+143
+00:13:12,850 --> 00:13:17,770
+نعمل balance شوية دي بطاقة و حاجة ممكن انه الطفل
+
+144
+00:13:17,770 --> 00:13:23,230
+يفوز بتنتيجة طب تكون ات اذية بتكون زي 14؟ لأ انا
+
+145
+00:13:23,230 --> 00:13:26,870
+حاسب نفسي ان .. و بعدين هي يجب ان تدرس برصاعية 16
+
+146
+00:13:26,870 --> 00:13:28,190
+-24
+
+147
+00:13:32,260 --> 00:13:37,460
+هي يعني انا بقول نوع من العلاج انا مارسته و يعني
+
+148
+00:13:37,460 --> 00:13:42,940
+الحقيقة ال patching احسن ليش ال patching بعطي zero
+
+149
+00:13:42,940 --> 00:13:49,240
+percent vision لكن ال atropine لأ بيعطي اكتر من
+
+150
+00:13:49,240 --> 00:13:54,640
+zero اكتر من 10% او اكتر من 20% لكن انا بقول في
+
+151
+00:13:54,640 --> 00:13:56,020
+حالة ال failure
+
+152
+00:14:04,750 --> 00:14:11,990
+تنفعش طيب treatment هو myopia علاج ال myopia انتوا
+
+153
+00:14:11,990 --> 00:14:15,670
+عارفين في الأطفال نادر يكون فيه myopia لكن لو كان
+
+154
+00:14:15,670 --> 00:14:18,270
+فيه myopia بتكون progressive myopia progressive
+
+155
+00:14:18,270 --> 00:14:24,430
+myopia فحقيقة بالتجربة وجدوا ان الأطربيين may
+
+156
+00:14:24,430 --> 00:14:27,470
+prevent or slow على قدرة progression of myopia by
+
+157
+00:14:27,470 --> 00:14:30,650
+placing the cerebral muscle at rest و ال
+
+158
+00:14:30,650 --> 00:14:34,120
+accommodation بيكون relaxedAnnotation that
+
+159
+00:14:34,120 --> 00:14:39,020
+produces elongation of the eye may be reduced شوية
+
+160
+00:14:39,020 --> 00:14:42,800
+شوية والadministration of one percent atropine for
+
+161
+00:14:42,800 --> 00:14:48,680
+one to eight years وهذا الشيء الصعب يعني فات
+
+162
+00:14:48,680 --> 00:14:54,840
+أتروبين في عينين الطفل أقل شيء سنة أو أكتر شيء سنة
+
+163
+00:14:54,840 --> 00:14:57,520
+أو أكتر سنة The decrease in myopia in treated eyes
+
+164
+00:14:57,520 --> 00:15:00,020
+of children has usually been less than
+
+165
+00:15:04,650 --> 00:15:10,510
+عندما اجهزت الـ I أظهر زيادة في الميوبيا تقريبًا 0
+
+166
+00:15:10,510 --> 00:15:20,330
+.91 دقيقة في السنة يعني في الأطفال اللي ما وضعنا
+
+167
+00:15:20,330 --> 00:15:25,770
+لهم أتروبيل كان progress of myopia
+
+168
+00:15:32,810 --> 00:15:37,330
+يعني في خلال عشر سنوات هيكون تقدم حوالي تمانية
+
+169
+00:15:37,330 --> 00:15:43,890
+ديوبتر اه صح اه عشر سنة اه تمانية ديوبتر كل عشر
+
+170
+00:15:43,890 --> 00:15:47,210
+سنة لكن اللي عيزينا هو أبعدنا على الأتروبين وجدنا
+
+171
+00:15:47,210 --> 00:15:54,110
+انه تقدم حوالي أربعة ديوبتر النص النص هذا بالتجربة
+
+172
+00:15:54,110 --> 00:16:01,710
+لكن مين يتحمل الأتروبين هذه السنوات مش بس هيك بقول
+
+173
+00:16:03,070 --> 00:16:10,750
+ولكن في تجارب الانتقالات، فقط 12% من الأطفال كانوا
+
+174
+00:16:10,750 --> 00:16:15,770
+يحافظوا على تحسين أكبر من 6 أشهر، للأسف بعد وقف
+
+175
+00:16:15,770 --> 00:16:24,110
+الاترومين، يعود الانتقال تانيًا، فقط 12% من الناس
+
+176
+00:16:24,110 --> 00:16:27,530
+اللي كانوا يحافظوا على الانتقال، فقط 12% من الناس
+
+177
+00:16:27,530 --> 00:16:28,290
+اللي كانوا يحافظوا على انتقال
+
+178
+00:16:36,590 --> 00:16:42,950
+هو ميوبيا. فهيبقى فيها discussion. كيف رأيكوا
+
+179
+00:16:42,950 --> 00:16:48,330
+انتوا لو في انت في ال progressive ميوبيا؟ you will
+
+180
+00:16:48,330 --> 00:16:53,650
+go to administer at romaine for one year؟ كنتين
+
+181
+00:16:53,650 --> 00:17:01,750
+واصلي؟ ليه؟ وعدت؟ ان ريس ساعتش يبتدل على الصحي
+
+182
+00:17:01,750 --> 00:17:05,300
+اللي هو ال school اللي هو ال islam، ده ماتش كويسطب
+
+183
+00:17:05,300 --> 00:17:08,180
+هي كل ماتومي بيصير myopic يعني هي كده .. لأ بعد
+
+184
+00:17:08,180 --> 00:17:11,100
+فاهمة أوي لأ لما نحطوا حبطانها عينهم غابشة مش
+
+185
+00:17:11,100 --> 00:17:14,640
+هيشوف فيها كويس هيأثر على النظر في حالات تانية
+
+186
+00:17:14,640 --> 00:17:17,840
+بتقدر تعملها ال preparation تبع ال .. ايش حالات
+
+187
+00:17:17,840 --> 00:17:21,000
+تانية؟ زي ال bifocal lens وال contact lens هذا
+
+188
+00:17:21,000 --> 00:17:25,680
+الطفل عمره سنتين؟ اه فضل يا سهرائش احنا أخدنا انه
+
+189
+00:17:25,680 --> 00:17:29,760
+لما يكون يعني لحد السنة و هيك انه في دراسات كانت
+
+190
+00:17:29,760 --> 00:17:33,630
+تحكي ان ال myopic بعدها بتختفي بيصير hyperفالأحسن
+
+191
+00:17:33,630 --> 00:17:36,570
+يقول لأ لأ سيبها ل .. ل .. يعني ال .. ال natural
+
+192
+00:17:36,570 --> 00:17:39,990
+development of the eye سيبها ل natural development
+
+193
+00:17:39,990 --> 00:17:43,830
+of the eye بس هو بوسعه .. بس هو عنده ما يوم يعني
+
+194
+00:17:43,830 --> 00:17:47,250
+بس هو عنده حض يعني اه هو سابق عنده ما يوم و يعني
+
+195
+00:17:47,250 --> 00:17:51,590
+هذه الدراسة يعني ممكن يبنى عليها صحيح بس انا اللي
+
+196
+00:17:51,590 --> 00:17:54,130
+مش عاجبني ان الكون في continuous weather problem
+
+197
+00:17:54,130 --> 00:17:58,830
+لأن الاطفل هيعاني معانا شديدة من أي ضوء او من
+
+198
+00:17:58,830 --> 00:18:06,650
+الشمسمش هيقدر يستخدم نظره بأي طريقة ولا يتعلمه اي
+
+199
+00:18:06,650 --> 00:18:18,330
+حاجة و 88% لما يعمل stop ممكن يعمل recast طيب side
+
+200
+00:18:18,330 --> 00:18:24,650
+effects of الأتروبيل الأتروبيل زي أي درجة له و
+
+201
+00:18:24,650 --> 00:18:28,170
+عليه قسمنا
+
+202
+00:18:28,170 --> 00:18:32,670
+side effects إلى ocular و generalع مستوى الليين؟
+
+203
+00:18:32,670 --> 00:18:38,230
+وع مستوى الجسم كله open reactions include in the
+
+204
+00:18:38,230 --> 00:18:41,990
+eye when؟ the eye irritation from the drug
+
+205
+00:18:41,990 --> 00:18:47,130
+preparation itself يعني في بعض الدراج تحطي في عينك
+
+206
+00:18:47,130 --> 00:18:51,930
+تشعر ب severe burning حلقان في أحيان دراج تاني
+
+207
+00:18:51,930 --> 00:18:55,930
+يعمل severe stinging تنخيذ ممكن دراج تاني يعمل
+
+208
+00:18:55,930 --> 00:19:00,320
+severe rednessقاليل ما دراجس تحط offline لعين
+
+209
+00:19:00,320 --> 00:19:05,780
+حساسة حساسة جدا لدراجس فهال يعني ال goal target
+
+210
+00:19:05,780 --> 00:19:11,020
+irritation ممكن بعد شوية يعني تخف شوية تخف يعني
+
+211
+00:19:11,020 --> 00:19:15,220
+قاليلتي contact dermatitis جبتلكوا صورة انا على
+
+212
+00:19:15,220 --> 00:19:21,400
+هالي هالي contact dermatitis شوف العلوزة هالي حطت
+
+213
+00:19:21,400 --> 00:19:25,420
+قطره بينه والبنت اللي في جانبها حطت قطره بينه
+
+214
+00:19:25,420 --> 00:19:33,270
+contact dermatitis أي جيتالتهاب في الجيل ناتج عن
+
+215
+00:19:33,270 --> 00:19:40,050
+تحسس للاتروبيا، طب عامة مش مع الكل، مش مع الكل،
+
+216
+00:19:40,050 --> 00:19:46,290
+بقى بعض الحلال، بعض الحلال، لكن صحيح، هذا بيصير
+
+217
+00:19:46,290 --> 00:19:51,670
+أحيانًا لإنسان بيمسك مادة حمضية أو قلوية أو حتى
+
+218
+00:20:01,500 --> 00:20:04,620
+بتكون زائد بيعمل كده، ماشي على المتروبيل يعني
+
+219
+00:20:04,620 --> 00:20:11,100
+المختص يعني في جهة الموضوع، لأ بيعمل كسائر لأشياء،
+
+220
+00:20:11,100 --> 00:20:14,960
+share contact لكلوهر بتاع الغسيل، بيعمل، لما ييجي
+
+221
+00:20:14,960 --> 00:20:20,480
+على الجد بيعمل يعني طب elevation اه risk of
+
+222
+00:20:20,480 --> 00:20:23,660
+angioecological glaucoma وانا دي بتبقى الصورة هذه،
+
+223
+00:20:23,660 --> 00:20:24,840
+ايه الشيء في الفعل الصورة؟
+
+224
+00:20:40,530 --> 00:20:44,230
+كل هذا من علامات Angle Closure Glucoma طبعا خاصة
+
+225
+00:20:44,230 --> 00:20:49,010
+إن كان هو Adult كبير و عنده Narrow Angle مش في أى
+
+226
+00:20:49,010 --> 00:20:52,550
+واحد خاصة ال Angle يكون Narrow أو High
+
+227
+00:20:52,550 --> 00:20:55,510
+Hypermetroid مش هيك ال High Hypermetroid بيبدعن ما
+
+228
+00:20:55,510 --> 00:21:00,970
+بحطله Atropine أبدا طيب for elevation of uteral
+
+229
+00:21:00,970 --> 00:21:03,730
+pressure if patients with open Angle أحيانا حتى في
+
+230
+00:21:03,730 --> 00:21:07,330
+ال open Angle بيرفع الدكتورة مش شرط إنه يعمل Angle
+
+231
+00:21:07,330 --> 00:21:08,050
+Closure Glucoma
+
+232
+00:21:17,620 --> 00:21:23,940
+طبعا واحدة حط اتروبيل في عينيه عليه ان يلزم الغرفة
+
+233
+00:21:23,940 --> 00:21:30,420
+اللي فيها ضوء ضوء اتروبيل
+
+234
+00:21:30,420 --> 00:21:34,220
+اذا طيب في الشمس او في ضوء جوي احيانا مالوياش تفوت
+
+235
+00:21:45,250 --> 00:21:48,690
+والـ pleuritis حكّى. إيش في الجانب؟ كانت دي ديما
+
+236
+00:21:48,690 --> 00:21:54,870
+تورّم، تورّم في الجفون زي اللي هو ال .. ال .. ال
+
+237
+00:21:54,870 --> 00:21:58,210
+.. الست هذه، شايفين؟ في .. في تورّم في الجفون،
+
+238
+00:21:58,210 --> 00:22:05,170
+صحيح؟ واضح، في تورّم في الجفون، وفي رثيمة؟ أكيد،
+
+239
+00:22:05,170 --> 00:22:07,310
+رثيمة الحمار هذا في الكودينالطيبة
+
+240
+00:22:13,340 --> 00:22:18,740
+الـ Atropine في العين القطرأ كما وكذلك كوليرجيك
+
+241
+00:22:18,740 --> 00:22:22,840
+أنتجمس وكل المندرياتيكس اللي زيه او اي شيه يزيد
+
+242
+00:22:22,840 --> 00:22:28,300
+حرارة الانجليكلوجركوم في المريض فالحرارة اللي يزيد
+
+243
+00:22:28,300 --> 00:22:32,380
+حرارة انجليكلوجركوم في العين بدون تاريخ تاريخ
+
+244
+00:22:32,380 --> 00:22:38,340
+تاريخ يعني قليل يعني اللي ما عندهوش تاريخ تاريخ
+
+245
+00:22:38,340 --> 00:22:39,980
+تاريخ
+
+246
+00:22:42,250 --> 00:22:46,410
+يعني استعمال قليل اكتر اكتر حصة ان استعمل
+
+247
+00:22:46,410 --> 00:22:51,410
+الاتروبين مرة مرتين تلتة قبل ذلك ولم يحدث له طالما
+
+248
+00:22:51,410 --> 00:22:55,530
+ان الصعب يحدث له في هذه المرة اما اللي حدث له مرة
+
+249
+00:22:55,530 --> 00:23:00,630
+قد يحدث له كل مرة ان حدث ان حطيت اتروبين وصار انا
+
+250
+00:23:00,630 --> 00:23:06,830
+انا كنت التالت مابحطله شي اتنى راضي؟ طيب دكتور
+
+251
+00:23:06,830 --> 00:23:11,430
+يعني الdermatitis هي مش هنعرفها الا لما نستخدم
+
+252
+00:23:16,220 --> 00:23:22,340
+عين تتحمر و الجلد يحمر و كل ملفات يزيد و يتوسع و
+
+253
+00:23:22,340 --> 00:23:26,220
+يصير اديمة و weakness نعرف انه contact dermatitis
+
+254
+00:23:26,220 --> 00:23:32,160
+وقف الاتروبيل بيروح بعد يومين تلتة بيروح، طبعا بده
+
+255
+00:23:32,160 --> 00:23:39,200
+علاج يعني، بده ايش؟ Anti-stamine، بده علاجهي هنا
+
+256
+00:23:39,200 --> 00:23:42,800
+allergic papillary congeratopite and keratitis هى
+
+257
+00:23:42,800 --> 00:23:48,440
+الملتحمة و فيها احمرار و اتهام و القرانية كذلك
+
+258
+00:23:48,440 --> 00:23:53,160
+سطحة القرانية خاصة الابثليام طيب systemic
+
+259
+00:23:53,160 --> 00:23:57,860
+reactions of a probine in children الان احنا قولنا
+
+260
+00:23:57,860 --> 00:24:02,440
+ال children are more liable to side effects
+
+261
+00:24:10,150 --> 00:24:15,510
+small body weight يعني ال adult نحطله انا نقطتين
+
+262
+00:24:15,510 --> 00:24:22,270
+اترابين صباحا و نقطتين مساءا و راحوا على الدم كام
+
+263
+00:24:22,270 --> 00:24:27,550
+هيأثره؟ كام هيأثره في جسم ال adult اللي زينا، لكن
+
+264
+00:24:27,550 --> 00:24:29,230
+اذا كنت baby عمره سنة
+
+265
+00:24:35,750 --> 00:24:39,710
+يحرجوا .. يحرجوا جسمه، يعملوله مشاكل كتيرة داخل
+
+266
+00:24:39,710 --> 00:24:44,690
+جسمه خاصة على ال nervous system يبقى في ال
+
+267
+00:24:44,690 --> 00:24:48,670
+children diffuse cutaneous flash
+
+268
+00:25:05,280 --> 00:25:12,940
+depressed celebration and thirst جفاف في الغدل
+
+269
+00:25:12,940 --> 00:25:20,620
+الوعبية لأنه أثر على ال nervous system fever
+
+270
+00:25:27,050 --> 00:25:34,710
+أشهد أنه يستخدم أقراس الأتروبيين لعلاج التبول
+
+271
+00:25:34,710 --> 00:25:45,710
+الليلي عند الأطفال تاكيكارديا
+
+272
+00:25:45,710 --> 00:25:49,150
+يبقى sympathetic بـ Serostimulation
+
+273
+00:25:53,430 --> 00:25:56,410
+excitement and restlessness and hallucinations
+
+274
+00:25:56,410 --> 00:26:02,230
+تلاقي الطفل excited و
+
+275
+00:26:02,230 --> 00:26:08,410
+restless بيجي نام و بيجوم و دايما كده بيبكي و يعني
+
+276
+00:26:08,410 --> 00:26:11,990
+بيقول هو يعني مش مستقبل و يوم كده مال
+
+277
+00:26:11,990 --> 00:26:16,050
+hallucinations يعني يتكلم كلام مالش معناه speech
+
+278
+00:26:16,050 --> 00:26:17,250
+disturbances
+
+279
+00:26:21,420 --> 00:26:23,940
+لو إيجى يمشي بترانة ذات اليمين و ذات الشمال
+
+280
+00:26:23,940 --> 00:26:26,620
+التكسيه، ماهو تأثير على ال nervous system؟
+
+281
+00:26:26,620 --> 00:26:32,300
+convergence، لو زاد الأمر قصير، ماهيش؟ تشننجات
+
+282
+00:26:32,300 --> 00:26:37,840
+طبعا احنا كناس users لAtropine، practitioners،
+
+283
+00:26:37,840 --> 00:26:41,580
+المفروض مانصيحش الحاجة هذه طبعا ال Atropine هو
+
+284
+00:26:41,580 --> 00:26:47,950
+home use، استخدام بيتييعني احنا بنكتب للأم للطفل
+
+285
+00:26:47,950 --> 00:26:53,730
+ال infant او small child بنكتب لها تربين twice
+
+286
+00:26:53,730 --> 00:27:01,630
+daily فهو مثلا four days المفروض انه ننبيها للأم
+
+287
+00:27:01,630 --> 00:27:12,050
+اذا كان الطفل أصبح feverish سخن او flashy ولموش
+
+288
+00:27:21,580 --> 00:27:25,040
+و الأم اللي هي متعلمة و عاية تقول يا دكتور نعم
+
+289
+00:27:25,040 --> 00:27:32,620
+الولد سخر سخر بس و لا ممكن يقولك ايه انه في حمار
+
+290
+00:27:32,620 --> 00:27:36,940
+في عينيه حمار في جلده واقف العلاج اللي بديه طبعا
+
+291
+00:27:36,940 --> 00:27:44,740
+انا ممكن اعمله reflection لو انا وصله يعني فرشة
+
+292
+00:27:44,740 --> 00:27:47,340
+psychopathy افضل ان بلاش ماحصل انا حاطين القاطرة
+
+293
+00:27:49,190 --> 00:27:52,450
+يعني العين ما حطينا اليوم او يومين لسه اقوى من ال
+
+294
+00:27:52,450 --> 00:27:57,910
+cycle بنفلات صحيح انه partial لكن مثلا هيكون وصف
+
+295
+00:27:57,910 --> 00:28:02,450
+ال 80% من اللي انا عايزه فبعمله reflection و
+
+296
+00:28:02,450 --> 00:28:06,830
+بنوقفله و ممكن اعطيه بعض شراب للحسية بعض شراب
+
+297
+00:28:06,830 --> 00:28:15,810
+للحسية يبقى الأتروبيل هو safe لو حد يجيب الحد
+
+298
+00:28:16,730 --> 00:28:23,190
+يعني قاطة وحد غير قاطة فالإنسان يستخدم فواته
+
+299
+00:28:23,190 --> 00:28:31,750
+ويحاول أن يعني يتجنب المساوية بتاعة الأطراف.فبت
+
+300
+00:28:31,750 --> 00:28:35,130
+ساكروبنتوليت ساكروبنتوليت is the most widely used
+
+301
+00:28:35,130 --> 00:28:40,150
+psychologic today في أهل الأيام يعني أقدر أقول أقل
+
+302
+00:28:40,150 --> 00:28:45,230
+شيء seventy percentمن الحلال السيكلوبليجيا اللى
+
+303
+00:28:45,230 --> 00:28:54,830
+بتستخدم في العالم هي السيكلوبليجيا وهو الاختيار
+
+304
+00:28:54,830 --> 00:28:59,150
+الخير الأول الـparalysis of accommodation is not
+
+305
+00:28:59,150 --> 00:29:03,910
+complete صحيح احنا لازم نكون عارفين انه مابعملش
+
+306
+00:29:03,910 --> 00:29:07,270
+hundred percent paralysis of cellular muscle
+
+307
+00:29:12,500 --> 00:29:16,820
+it gives a depth of psychoplegia that is
+
+308
+00:29:16,820 --> 00:29:20,600
+sufficient for the majority of cases يعني بيعطيني
+
+309
+00:29:20,600 --> 00:29:31,200
+عمق psychoplegia كافية للعمل بشكل مرضى لأقل 100% و
+
+310
+00:29:31,200 --> 00:29:35,960
+لأقل 9% و أنا طبعا بعملها حسبة في الآخر بعمل
+
+311
+00:29:35,960 --> 00:29:44,990
+adjustment بيقوللي هفنروفاقه على انه وجدوا ان الـ
+
+312
+00:29:44,990 --> 00:29:48,990
+Great Value of Cyclopentolate when he describes
+
+313
+00:29:48,990 --> 00:29:51,670
+its effects in the field of Cycloplegia as
+
+314
+00:29:51,670 --> 00:29:57,070
+superior to Homotropin اكوى
+
+315
+00:29:57,070 --> 00:30:01,870
+من Homotropin، even the 5% concentration of the
+
+316
+00:30:01,870 --> 00:30:06,270
+latter، حتى لو فضتنا اكوى تركيز في Homotropin، ما
+
+317
+00:30:06,270 --> 00:30:11,340
+بيظهروا ان Homotropin برضه Cycloplegicومن الـ one,
+
+318
+00:30:11,480 --> 00:30:15,340
+two, three, four, five خمس اللي هو درجات اللي هم
+
+319
+00:30:15,340 --> 00:30:20,560
+أطربين حتى لو حطب خمسة في المية هم أطربين بيفضل ال
+
+320
+00:30:20,560 --> 00:30:24,500
+one percent cyclopentylate أقوى منها جدًا ال its
+
+321
+00:30:24,500 --> 00:30:31,180
+rapidity of onset في سرعة البدء في cycloplegia
+
+322
+00:30:31,180 --> 00:30:36,700
+شوقت ال duration اللي هو الوقت اللي بيشتغلوا من
+
+323
+00:30:36,700 --> 00:30:37,880
+أول لأخر أقصر
+
+324
+00:30:41,180 --> 00:30:44,360
+والـ effect بتاعته أقوى، يبقى الـcyclopentrolate
+
+325
+00:30:44,360 --> 00:30:49,400
+فاق اللي هم أضربين في تلت نواحي، إيش هم صراعات
+
+326
+00:30:49,400 --> 00:30:55,820
+البدء، وقصر المدة الزمنية، يعني مش لو مثلا ست
+
+327
+00:30:55,820 --> 00:31:00,260
+ساعات فقط، اللي هم أضربين تلت أيام مثلا، وأخيرا ال
+
+328
+00:31:00,260 --> 00:31:07,380
+effect كcyclopentrate أقوى، ال effect أقوى، طيب
+
+329
+00:31:07,380 --> 00:31:12,250
+الـcyclopentrolate is availableمتوفر in single
+
+330
+00:31:12,250 --> 00:31:16,630
+dose four يعني فيه منه بلاستيكه عارفين single
+
+331
+00:31:16,630 --> 00:31:19,810
+dose؟ بيحط نقطه هنا و بس و هنا نقطه هنا و بس و
+
+332
+00:31:19,810 --> 00:31:24,730
+بيرميها and in multi dose مافيه bottle، زجاج فاحنا
+
+333
+00:31:24,730 --> 00:31:28,970
+اللي عندنا هنا زجاج، بلاستيكية، مافيش الكبيرة
+
+334
+00:31:28,970 --> 00:31:34,410
+الصغيرة، الأصبح، لأ في single dose في اللي هو
+
+335
+00:31:34,410 --> 00:31:40,200
+multiple أو multi doseو في العالم توفر 0.5% و 1%
+
+336
+00:31:40,200 --> 00:31:46,260
+احنا عندنا بس 1% لو بدنا احنا نعمل 0.5% بدنا نعمله
+
+337
+00:31:46,260 --> 00:31:50,440
+distilled water او مكسلها بالمية An interesting
+
+338
+00:31:50,440 --> 00:31:52,880
+alternative application method for cyclopentolate
+
+339
+00:31:52,880 --> 00:31:55,940
+has been evaluated by إسماعيل
+
+340
+00:32:02,110 --> 00:32:06,830
+و هو used a spray application to the closed eye
+
+341
+00:32:06,830 --> 00:32:13,850
+يعني اسمه عيد هذا في ال 94 عمل spray رشبه و قارن
+
+342
+00:32:13,850 --> 00:32:20,490
+بين ال spray و بين ال drops و وجد انه الأثر واحد
+
+343
+00:32:20,490 --> 00:32:25,030
+لمال ال spray في عين الطفل حتى و هو نائم
+
+344
+00:32:30,630 --> 00:32:33,330
+أو حط drops في العين التانية جال انه في reflection
+
+345
+00:32:33,330 --> 00:32:38,850
+ساعة بعض بسألة accept حاجة ان ما اخرت الطفل الطفل
+
+346
+00:32:38,850 --> 00:32:44,730
+لما احنا سبته عشان نقطله نقطة بيعمل مشكلة و لو بكى
+
+347
+00:32:44,730 --> 00:32:51,610
+wash out of drops هتطلع useless و درباتكوا في
+
+348
+00:32:51,610 --> 00:32:56,570
+عملكوا اللي كليكي من هذه النقطة يا بناتي اي قطرة
+
+349
+00:32:56,570 --> 00:33:03,530
+مش بس ال settlementتقضى واتبعها بكاء فقد فقدت
+
+350
+00:33:03,530 --> 00:33:07,290
+المفهوم خاصة
+
+351
+00:33:07,290 --> 00:33:10,790
+في الأطفال فقدت المفهوم لذلك انا الطفل لازم اني
+
+352
+00:33:10,790 --> 00:33:17,630
+اكون انا patient صبور يعني معاه ازهى patient هو
+
+353
+00:33:17,630 --> 00:33:21,870
+مريض وانا صبور حقيقة
+
+354
+00:33:21,870 --> 00:33:25,510
+انا افضل تقيقة وزبطها ان انا
+
+355
+00:33:34,770 --> 00:33:39,830
+لو دي انا افتحله هنا بال .. strongly يعني بال ..
+
+356
+00:33:39,830 --> 00:33:44,470
+manually بدي هنا، هيعيد، و لما هيعيد، هتهو خلص،
+
+357
+00:33:44,470 --> 00:33:49,310
+لكن انا بدي اغمض هنا، انا اغمض هنا، لأ مالش، مالش،
+
+358
+00:33:49,310 --> 00:33:53,170
+مالش يا بابا، مالش يا بابا، بحطه هنا، و اقوله خلاص
+
+359
+00:33:53,170 --> 00:33:56,570
+خلصنا، هيفتح هنا، هتنزل جترا بدون مقاومة
+
+360
+00:34:00,660 --> 00:34:05,040
+لكن إسماعيل قامت بعمل الـ Spray ووجدت أن الـ Spray
+
+361
+00:34:05,040 --> 00:34:10,100
+كان أسهل
+
+362
+00:34:10,100 --> 00:34:14,520
+في وضعها في العين وكان أكثر مقبولًا للمريض ومقبول
+
+363
+00:34:14,520 --> 00:34:20,200
+عنه، طبعًا ليس هناك Spray دعونا نشوف الـ
+
+364
+00:34:20,200 --> 00:34:26,180
+Sacroventolate internationally used في سن من 1 إلى
+
+365
+00:34:26,180 --> 00:34:26,900
+12 سنة
+
+366
+00:34:31,270 --> 00:34:36,770
+الواحد إلى يعني معخر سنة وأقل شويه only one drop
+
+367
+00:34:36,770 --> 00:34:41,290
+of one percent solution solution يعني محلول قطرة
+
+368
+00:34:41,290 --> 00:34:46,650
+is usually necessary but a bigger drop should be
+
+369
+00:34:46,650 --> 00:34:50,750
+installed if little if it is measurable after 15
+
+370
+00:34:50,750 --> 00:34:54,490
+minutes طبعا مش هي ال ideal ان اخطط لنقطة و اعمل
+
+371
+00:34:54,490 --> 00:34:54,950
+reflection
+
+372
+00:35:02,390 --> 00:35:06,550
+نقطة مثلا الساعة تسعة و نقطة الساعة تسعة و رابع و
+
+373
+00:35:06,550 --> 00:35:11,770
+نقطة الساعة تسعة و نص و عشرة الا رابع تربع ساعة
+
+374
+00:35:11,770 --> 00:35:19,770
+اعملوا reflection هذا one person و ال factor in
+
+375
+00:35:19,770 --> 00:35:21,970
+determining the appropriate concentration is the
+
+376
+00:35:21,970 --> 00:35:26,030
+degree of iris pigmentation اه بقول في عامل بدخل
+
+377
+00:35:26,030 --> 00:35:30,430
+عن خطة اللي هو اللون ال iris
+
+378
+00:35:47,070 --> 00:35:53,730
+هذا جدًا بسيط، ممكن 0.5 يكفي بالنسبالي، يعني لو أن
+
+379
+00:35:53,730 --> 00:35:59,490
+الـIris بتاعه بسيط، زي الخوجات، بيكفي 0.5
+
+380
+00:35:59,490 --> 00:36:06,090
+رتنوسكوبيك الـ Refraction يمكن تعمل في 40 إلى 60
+
+381
+00:36:06,090 --> 00:36:10,750
+دقيقة، يعني نحطله هذا نقطة، و بعد 40 إلى 60 دقيقة
+
+382
+00:36:10,750 --> 00:36:15,800
+أعمل الـ Refraction، لكن لو عندك ضعفو بما أنه احنا
+
+383
+00:36:15,800 --> 00:36:21,740
+العرب عندنا dark اي reads غالبا، عظمنا، اقلنا ال
+
+384
+00:36:21,740 --> 00:36:26,940
+honey، فهو بعدين بدأ شويه dark و dark اللي هو
+
+385
+00:36:26,940 --> 00:36:29,940
+strongly dark
+
+386
+00:36:48,870 --> 00:36:54,310
+with fifteen to twenty minutes and above there is
+
+387
+00:36:54,310 --> 00:36:57,690
+no significant measurable reduction in the
+
+388
+00:36:57,690 --> 00:37:01,330
+amplitude of the accommodation طيب يعني انا بدي
+
+389
+00:37:01,330 --> 00:37:06,930
+اقول ان انا الان احنا جربنا على النوع الاول up to
+
+390
+00:37:06,930 --> 00:37:12,970
+twelve الان بدي اقترض ان احنا تعدينا الاتناشر
+
+391
+00:37:12,970 --> 00:37:18,810
+تلاتاشر اربعتاشر خمستاشربقوللي هاخل النقطة مش واحد
+
+392
+00:37:18,810 --> 00:37:27,810
+percent 0.5 نص في المياليش اجلل
+
+393
+00:37:27,810 --> 00:37:31,070
+ال accommodation ال activity بالسنة مصالي اجلل
+
+394
+00:37:31,070 --> 00:37:36,250
+فانا هنا بدي اخطره نص وبعد ربع ساعة مثلا اخطره
+
+395
+00:37:36,250 --> 00:37:41,490
+نقطة تانية the second drop من نص percent solution
+
+396
+00:37:41,490 --> 00:37:45,350
+is sometimes we say unfair skin patients
+
+397
+00:37:53,060 --> 00:37:59,800
+الشعر أسود والبوغبغ أسود والعيال أسود وكمان مرة
+
+398
+00:37:59,800 --> 00:38:06,720
+يعني الكلب بيقول لي إن الناس اللي عيال أسود واحدة
+
+399
+00:38:06,720 --> 00:38:11,220
+متكافأة مع إنه التن تن أحسن لكن في ال dark
+
+400
+00:38:16,320 --> 00:38:21,560
+والدارك هير تايب وانها تعتبر ضرورية تستخدم اتصال
+
+401
+00:38:21,560 --> 00:38:21,760
+اتصال اتصال اتصال اتصال اتصال اتصال اتصال اتصال
+
+402
+00:38:21,760 --> 00:38:24,780
+اتصال اتصال اتصال اتصال اتصال اتصال اتصال اتصال
+
+403
+00:38:24,780 --> 00:38:29,440
+اتصال اتصال اتصال اتصال اتصال اتصال اتصال اتصال
+
+404
+00:38:29,440 --> 00:38:29,560
+اتصال اتصال اتصال اتصال اتصال اتصال اتصال اتصال
+
+405
+00:38:29,560 --> 00:38:29,560
+اتصال اتصال اتصال اتصال اتصال اتصال اتصال اتصال
+
+406
+00:38:29,560 --> 00:38:31,040
+اتصال اتصال اتصال اتصال اتصال اتصال اتصال اتصال
+
+407
+00:38:31,040 --> 00:38:31,760
+اتصال
+
+408
+00:38:44,510 --> 00:38:49,490
+over a dose of peroxide effect الزيارة هتطلع بعضها
+
+409
+00:38:49,490 --> 00:38:55,110
+كونجرتال الساك لا يتسع لنقطتين احنا بقول لك
+
+410
+00:38:55,110 --> 00:39:01,090
+كونجرتال الساك بيسع five microliter لما تجمد عليه
+
+411
+00:39:01,090 --> 00:39:06,070
+بس بيسع ten microliter ال drop الواحدة من ال drop
+
+412
+00:39:06,070 --> 00:39:10,630
+فيها خمسين microliter drop اللي مفتط القطرة هذه
+
+413
+00:39:10,630 --> 00:39:17,130
+خمسين fiftyفما نحط 100 microliter اللي هي انا
+
+414
+00:39:17,130 --> 00:39:23,170
+هتاخد عشرة و تاخد تسعة، لكن اذا ما احط اول نقطة و
+
+415
+00:39:23,170 --> 00:39:30,110
+اخلي يصير absorption عبر ال core يعني، والنقطة
+
+416
+00:39:30,110 --> 00:39:35,310
+الأولى في رمضان الساعة تسع الوين، ال iris، و تأثر
+
+417
+00:39:35,310 --> 00:39:41,440
+على the ciliary muscleاللي ورا ال IRIS Cellular
+
+418
+00:39:41,440 --> 00:39:44,720
+Muscle و طبعا هي هتقفل علي Sphincter Pupillary
+
+419
+00:39:44,720 --> 00:39:47,100
+Muscle وعالي Cellular Muscle انهم بارة sympathetic
+
+420
+00:39:47,100 --> 00:39:54,120
+و بعد ربم ساعة اوبع كمان نقطة بيكون نقطة اولى وصلت
+
+421
+00:39:54,120 --> 00:39:59,520
+او بدي اتصل الى Cellular Muscle وحط النقطة التانية
+
+422
+00:39:59,520 --> 00:40:04,940
+في ال STI كويس؟ شاب مش فاهمين
+
+423
+00:40:37,190 --> 00:40:40,450
+بالعكس ممكن انا ادخل على الدم على طريق ال .. اذا
+
+424
+00:40:40,450 --> 00:40:44,350
+نزلت دا قبل الدكتورة هدخل على عكس .. عكس ما داشت
+
+425
+00:40:44,350 --> 00:40:44,690
+في العين
+
+426
+00:40:48,780 --> 00:40:55,400
+لو فيه driver صغير كان بنزل نصف النقطة، لكن
+
+427
+00:40:55,400 --> 00:41:01,660
+الشركات لحسابات economical، اقتصادية، بتوسع
+
+428
+00:41:01,660 --> 00:41:07,540
+الفتحة، حتى يهرب عشان يخلص ويشتري رياضة، فاهمين
+
+429
+00:41:07,540 --> 00:41:12,320
+كده؟ أه الشركات ماربح مالي يعني، أغنى ناس في
+
+430
+00:41:12,320 --> 00:41:16,760
+العالم pharmaceuticals، مصانع الدوائية أغنى ناس في
+
+431
+00:41:16,760 --> 00:41:17,200
+كل العالم
+
+432
+00:41:21,230 --> 00:41:35,930
+أولاد الناس جاءوا وقالوا
+
+433
+00:41:35,930 --> 00:41:45,550
+وضعوا
+
+434
+00:41:45,550 --> 00:41:52,570
+وضعوا وضعوا وضعوا وضعوا وضعوا وضعوا وضعواانه بعد
+
+435
+00:41:52,570 --> 00:41:58,030
+ساعة و اعملت reflection انه وجدوا انه residual
+
+436
+00:41:58,030 --> 00:42:01,230
+accommodation
+
+437
+00:42:01,230 --> 00:42:07,910
+فاضل plus two يعني في الطفل مثلا في العادي ال
+
+438
+00:42:07,910 --> 00:42:14,410
+accommodation مثلا eight او اكتر و بعد ما قلت
+
+439
+00:42:14,410 --> 00:42:17,450
+recycle و بنقول ات مرة و بعد كمان مرة و بعد ساعة
+
+440
+00:42:17,450 --> 00:42:19,990
+عملت reflection فاضل plus two
+
+441
+00:42:33,560 --> 00:42:37,520
+أنا residual متبقى يعني السلمس مش مش paralyzed على
+
+442
+00:42:37,520 --> 00:42:41,740
+الأرض وبالتالي فردر فيها plus two هنا أنا لما بدي
+
+443
+00:42:41,740 --> 00:42:46,380
+أعمل subtraction بدي أخصم بدي أحسب حساب أنه فيه
+
+444
+00:42:46,380 --> 00:42:51,840
+شوية residual مثل الأتروبيل الأتروبيل بيخلي zero
+
+445
+00:42:51,840 --> 00:42:56,760
+انا بيخلي اتنين فبالحسبة بتاعة prescription بدي
+
+446
+00:42:56,760 --> 00:43:00,300
+انا أحسب حساب أنه السلمس مش fully paralyzed
+
+447
+00:43:14,870 --> 00:43:18,910
+الترابير يبدأ بعد ربع ساعة أو نصف ساعة، لأ هنا
+
+448
+00:43:18,910 --> 00:43:24,990
+يقول few minutes خلال دقائق، ممكن يكون خمسة أو ست
+
+449
+00:43:24,990 --> 00:43:30,420
+دقائق، I'm becoming maximumمن خلال 30 إلى 60
+
+450
+00:43:30,420 --> 00:43:34,780
+دقيقة، ولكن في بعض الأحيان بسرعة مثل 15 دقيقة،
+
+451
+00:43:34,780 --> 00:43:38,340
+يعني خلال بقية ساعة ممكن تكون وصلي، لكن في الغالب
+
+452
+00:43:38,340 --> 00:43:44,200
+نصف ساعة، في الغالب نصف ساعة، حتى في الناس اللي ال
+
+453
+00:43:44,200 --> 00:43:46,400
+.. ال .. ال .. ال pupil بتاعهم light في خلال 10
+
+454
+00:43:46,400 --> 00:43:48,720
+دقائق، في special cases where light appears
+
+455
+00:43:53,610 --> 00:43:55,450
+بالنسبة للمدرسة الروبليزية، وكذلك بالنسبة للمدرسة
+
+456
+00:43:55,450 --> 00:43:56,270
+الروبليزية، وكذلك بالنسبة للمدرسة الروبليزية،
+
+457
+00:43:56,270 --> 00:43:56,790
+وكذلك بالنسبة للمدرسة الروبليزية، وكذلك بالنسبة
+
+458
+00:43:56,790 --> 00:43:57,470
+للمدرسة الروبليزية، وكذلك بالنسبة للمدرسة
+
+459
+00:43:57,470 --> 00:43:59,230
+الروبليزية، وكذلك بالنسبة للمدرسة الروبليزية،
+
+460
+00:43:59,230 --> 00:44:01,050
+وكذلك بالنسبة للمدرسة الروبليزية، وكذلك بالنسبة
+
+461
+00:44:01,050 --> 00:44:03,330
+للمدرسة الروبليزية، وكذلك بالنسبة للمدرسة
+
+462
+00:44:03,330 --> 00:44:14,810
+الروبليزية، وكذلك
+
+463
+00:44:14,810 --> 00:44:21,950
+بالنسبة للمدرسة الروب
+
+464
+00:44:22,220 --> 00:44:27,000
+المقاومة يجب أن تكون مباشرة كل 10 دقائق. كل 10
+
+465
+00:44:27,000 --> 00:44:31,780
+دقائق أقيص المقاومة. بعد مقاومة الوقت من 20 دقائق.
+
+466
+00:44:31,960 --> 00:44:35,820
+مقاومة الوقت يعني أعطي فترة سماعة. من الرحلة اللي
+
+467
+00:44:35,820 --> 00:44:40,380
+أنا حطيت النقطة لحد التأثير. وعدد عشرين دقيقة. بعد
+
+468
+00:44:40,380 --> 00:44:45,520
+عشرين دقيقة أبدأ أقيص المقاومة وأتبع حلولها. حتى
+
+469
+00:44:45,520 --> 00:44:48,500
+لا يكون هناك تأثير في المقاومة.
+
+470
+00:44:53,280 --> 00:44:57,680
+بعمله Refraction وبعد تلاتين دقيقة بعمله
+
+471
+00:44:57,680 --> 00:45:01,680
+Refraction وبعد أربعين دقيقة بعمله Refraction وبعد
+
+472
+00:45:01,680 --> 00:45:05,600
+خمسين دقيقة بعمله Refraction وإن ثبت ال
+
+473
+00:45:05,600 --> 00:45:10,560
+accommodation وبطل اجيب زيادة بيكون أنا وصلت تماما
+
+474
+00:45:10,560 --> 00:45:14,620
+يعني ماخدش أول Refraction ومساعدته هو description
+
+475
+00:45:14,620 --> 00:45:19,340
+لسه لغاية ما هيجب تصير أعمل انا Refraction اللي
+
+476
+00:45:19,340 --> 00:45:21,300
+بقاله يكون ثابت مابتحركش
+
+477
+00:45:41,410 --> 00:45:47,050
+انجاب نتيجة غير في الـ Dynamic لسه شغالة Like most
+
+478
+00:45:47,050 --> 00:45:50,270
+drugs that affect accommodation and the pupil the
+
+479
+00:45:50,270 --> 00:45:53,730
+time cost of the materials is different to that of
+
+480
+00:45:53,730 --> 00:45:56,270
+the circulation and pupil diameter should not be
+
+481
+00:45:56,270 --> 00:45:59,110
+relied on to get a measure of the remaining
+
+482
+00:45:59,110 --> 00:46:03,650
+accommodationيعني مش معناه ان البحب توشع ان هو
+
+483
+00:46:03,650 --> 00:46:06,750
+مقياس للpsychoplegia، لأ مقياس الpsychoplegia هو
+
+484
+00:46:06,750 --> 00:46:10,850
+ال accommodation، البحب مثلا لسه ضيق، مثلا البحب
+
+485
+00:46:10,850 --> 00:46:14,890
+لسه ضيق يعني ماصارش اثر على الcell and muscle، او
+
+486
+00:46:14,890 --> 00:46:20,530
+الpsychoplegia كالأ، مااخدش حجم البحب مقياس
+
+487
+00:46:20,530 --> 00:46:24,840
+للpsychoplegia، الpsychoplegia شيءواللي هو celery
+
+488
+00:46:24,840 --> 00:46:28,460
+muscle ال .. ال .. ال pupil ديامتها شيء شكرا لكم
+
+489
+00:46:28,460 --> 00:46:30,940
+على خصم الاستماع وان شاء الله في المرة القادمة
+
+490
+00:46:30,940 --> 00:46:35,140
+نكمل تدائما اتين و تمانية و تلاتين شكرا و السلام
+
+491
+00:46:35,140 --> 00:46:36,180
+عليكم و رحمة الله و بركاته
+
diff --git a/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/xwJXoIYBWCM.srt b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/xwJXoIYBWCM.srt
new file mode 100644
index 0000000000000000000000000000000000000000..71329adabfe96b8908dd6204c3a8aa899946bbcb
--- /dev/null
+++ b/PL9fwy3NUQKwYMK-0NioI4Rd-E0a5uvTm9/xwJXoIYBWCM.srt
@@ -0,0 +1,2113 @@
+1
+00:00:20,060 --> 00:00:22,760
+أعوذ بالله من الشيطان الرجيم بسم الله الرحمن
+
+2
+00:00:22,760 --> 00:00:27,100
+الرحيم الحمد لله رب العالمين و أصلي و أسلم على 
+
+3
+00:00:27,100 --> 00:00:30,720
+النبي الأمين محمد و على آله و أصحابه و التابعين
+
+4
+00:00:30,720 --> 00:00:34,360
+السلام عليكم و رحمة الله و بركاته في هذا اليوم
+
+5
+00:00:34,360 --> 00:00:37,920
+سنبدأ موضوع جديد هو topical eye medication in
+
+6
+00:00:37,920 --> 00:00:43,340
+infants and children استعمال الأدوية سطحياً في عيون 
+
+7
+00:00:44,230 --> 00:00:49,030
+الرضع والأطفال هذا الموضوع مهم جدا لما هو مُلاصق
+
+8
+00:00:49,030 --> 00:00:56,050
+بالـ general toxicity of drugs on the
+
+9
+00:00:56,050 --> 00:01:05,150
+infants and children because of the small blood 
+
+10
+00:01:05,150 --> 00:01:09,070
+volume and small weight
+
+11
+00:01:11,260 --> 00:01:18,260
+يعني الـ drugs في العين ممكن تؤدي إلى سمية في جسم 
+
+12
+00:01:18,260 --> 00:01:23,800
+هؤلاء الرضع و هؤلاء الأطفال، لذلك لابد للذي يعمل
+
+13
+00:01:23,800 --> 00:01:31,670
+في مجال العيون أن يكون له إدراك بكيفية تفادي هذه
+
+14
+00:01:31,670 --> 00:01:37,650
+المشاكل في هؤلاء الرضع  الخلافة أختكم سارة محمد
+
+15
+00:01:37,650 --> 00:01:43,190
+العسكري طالبة مُشتغلة أبدأ استعداداً على أن تقوم 
+
+16
+00:01:43,190 --> 00:01:47,110
+بعمل presentation for you regarding the topical
+
+17
+00:01:47,110 --> 00:01:51,130
+eye medication in infants and children تفضلي يا
+
+18
+00:01:51,130 --> 00:01:55,110
+أخت سارة concerning adverse reactions to topical
+
+19
+00:01:55,110 --> 00:01:58,770
+ophthalmic drugs. It is evident that infants and
+
+20
+00:01:58,770 --> 00:02:04,230
+children are particularly prone to toxic reactions
+
+21
+00:02:04,230 --> 00:02:09,530
+بيحكي إنه فيه عدد كبير من التقارير اللي هو اللي
+
+22
+00:02:09,530 --> 00:02:13,970
+وجدوا إنه اللي هو مضار و الآثار الجانبية للـ ophthalmic
+
+23
+00:02:13,970 --> 00:02:17,470
+drugs بتكون تحدث للـ infants و لل
+
+24
+00:02:17,470 --> 00:02:22,090
+children خاصة إنها بتسبب لهم toxic reaction يعني
+
+25
+00:02:22,090 --> 00:02:25,950
+سمية نسميها multiple ophthalmic drugs frequently
+
+26
+00:02:25,950 --> 00:02:29,350
+used in children are commonly prescribed by
+
+27
+00:02:29,350 --> 00:02:32,210
+ophthalmologists. بيحكي إن عديد من multiple
+
+28
+00:02:32,210 --> 00:02:37,150
+ophthalmic drugs غالباً بتوصف للأطفال بشكل شيء طبعاً
+
+29
+00:02:37,150 --> 00:02:40,830
+من خلال ophthalmologists اللي هو الـ infants with 
+
+30
+00:02:40,830 --> 00:02:46,670
+children و بتكون آمنة فيما لو ما يكون لها serious
+
+31
+00:02:46,670 --> 00:02:50,830
+side effect ما لهاش آثار جانبية و مضار خاصة 
+
+32
+00:02:52,650 --> 00:02:57,030
+في الـ pediatric population اللي هو الأطفال يعني
+
+33
+00:02:57,030 --> 00:03:02,430
+الـ السكان الصغار
+
+34
+00:03:02,430 --> 00:03:05,410
+infant and children have increased potential for
+
+35
+00:03:05,410 --> 00:03:08,490
+ocular and systemic drug-induced adverse reaction
+
+36
+00:03:08,490 --> 00:03:11,950
+for several reasons. الوحيد أن الـ infant و ال
+
+37
+00:03:11,950 --> 00:03:15,490
+children في عندهم اللي هو بيصير يعني أكثر من غيرهم
+
+38
+00:03:15,490 --> 00:03:18,190
+من اللي هو الـ infant و الـ children بيصير عندهم
+
+39
+00:03:18,190 --> 00:03:22,070
+أكثر من غيرهم العمار اللي هو adverse reaction لعدة 
+
+40
+00:03:22,070 --> 00:03:25,910
+أسباب اللي هي أول واحدة they mainly receive
+
+41
+00:03:25,910 --> 00:03:31,550
+excessive dose اللي هو الـ mainly يمكن أنهم يستلموا
+
+42
+00:03:31,550 --> 00:03:35,670
+excessive dose يعني جرعة زائدة coming to اللي هو
+
+43
+00:03:35,670 --> 00:03:41,270
+بسبب صعوبة في installing drugs or ointment
+
+44
+00:03:41,270 --> 00:03:45,310
+particularly if they are uncooperative. خاصة إحنا 
+
+45
+00:03:45,310 --> 00:03:48,290
+عندنا الأطفال الغير متعاونين بيصير مثلاً لما
+
+46
+00:03:48,290 --> 00:03:50,950
+نشتحط لهم المرة الأولى بيصير الواحد يعني بصعوبة 
+
+47
+00:03:50,950 --> 00:03:53,990
+لما يحط لهم الشغلة، فهذا الشيء بيعمل excess of those
+
+48
+00:03:53,990 --> 00:03:59,010
+يعني هو أيوة بصعوبة يعني بتتكبر بيصير يوضع أول
+
+49
+00:03:59,010 --> 00:04:03,370
+نقطة ما تثبت ثاني نقطة تاريت نقطة واحدة مغربية
+
+50
+00:04:03,370 --> 00:04:07,950
+بتاكر أن النقطة إجت في الـ center في العين لكن
+
+51
+00:04:07,950 --> 00:04:15,330
+حقيقة أن خطرات المحيطة اللي إجت ممكن تلقوها المدالة
+
+52
+00:04:15,330 --> 00:04:18,490
+النقطة خمسة هنا وخمسة هنا صار في overdose 
+
+53
+00:04:18,490 --> 00:04:22,530
+overdose إيش يعني جرعة زائدة أيضاً اه فضلاً
+
+54
+00:04:22,530 --> 00:04:26,870
+administration of a drug may be continued by a
+
+55
+00:04:26,870 --> 00:04:32,030
+parent or nurse who does not recognize early signs
+
+56
+00:04:32,030 --> 00:04:36,110
+of the drug toxicity. بيحكي إن إعطاء الدواء ممكن
+
+57
+00:04:36,110 --> 00:04:39,610
+اللي هو يتم عن طريق الأب أو اللي هو المرضى اللي هو
+
+58
+00:04:39,610 --> 00:04:43,770
+الـ nurse ويكون يعني هو بيعطيه الدواء وعنده آثار 
+
+59
+00:04:43,770 --> 00:04:47,670
+بتدل إنه في عنده هدف سمية آثار مبكرة لكن هو اللي 
+
+60
+00:04:47,670 --> 00:04:50,210
+بيعطيه الدواء سواء الولد أو الـ nurse مش عارف هذه
+
+61
+00:04:50,210 --> 00:04:53,770
+الآثار المبكرة.. يعني علامات المبكرة للسمية ويستمر 
+
+62
+00:04:53,770 --> 00:04:56,450
+يعطيه بالدواء ويصير عند الـ toxicity differences
+
+63
+00:04:56,450 --> 00:05:01,670
+exist between children and adults in their 
+
+64
+00:05:01,670 --> 00:05:05,410
+physiological response to the same drug. بيحكي 
+
+65
+00:05:05,410 --> 00:05:08,760
+الاختلافات الموجودة بين children و adults في
+
+66
+00:05:08,760 --> 00:05:11,140
+physiological response طبعاً احنا حكينا استجابة 
+
+67
+00:05:11,140 --> 00:05:16,480
+لأطفال أكثر من الأدوية drug 
+
+68
+00:05:16,480 --> 00:05:20,900
+absorption through the conjunctival epithelium and
+
+69
+00:05:20,900 --> 00:05:24,740
+skin may be more rapid in infants. الامتصاص للدواء
+
+70
+00:05:24,740 --> 00:05:28,640
+احنا عارفين إنه أصلاً الطفل مساحة امتصاصه صغيرة وكل
+
+71
+00:05:28,640 --> 00:05:33,120
+شيء عنده يعني اللي هو بيكون أسرع وأكثر يعني عنده 
+
+72
+00:05:33,120 --> 00:05:37,980
+كل يعني كل اللي موجود عنده بيخلي إنه امتصاص للدواء 
+
+73
+00:05:37,980 --> 00:05:41,120
+أسرع من الـ.. adults، بالسبب اللي بيحكيه لإن ال
+
+74
+00:05:41,120 --> 00:05:43,320
+conjunctiva of the epithelia عند الأطفال و الـ skin
+
+75
+00:05:43,320 --> 00:05:48,160
+بتكون more rapid absorption للدواء لإن فيها بتكون
+
+76
+00:05:48,160 --> 00:05:52,780
+too thin، يعني هاي الموضوع فأيوة ممتاز، أيوة تكون 
+
+77
+00:05:52,780 --> 00:05:57,300
+too thin، يعني حتى لو أنا بدي أدهن للطفل على جلده، 
+
+78
+00:05:57,300 --> 00:06:00,560
+مثلاً دواء حساسية أو حاجة، بدي أعمل إحسامي إنه جلده
+
+79
+00:06:08,210 --> 00:06:11,890
+اللي هو عنده thick skin وكذلك اللي هو 
+
+80
+00:06:11,890 --> 00:06:16,450
+الـ conjunctiva والـ corneal epithelium عند الطفل هذا 
+
+81
+00:06:16,450 --> 00:06:21,670
+لسه thin فتكرار الدواء يعني ما يعطيه إلا more
+
+82
+00:06:21,670 --> 00:06:27,190
+absorption. Metabolic enzyme systems are immature
+
+83
+00:06:27,190 --> 00:06:32,330
+especially in neonates and may prolong half-life
+
+84
+00:06:32,330 --> 00:06:36,480
+of a drug. بحكي لإن اللي هو الـ.. الانزيمات الأيضية
+
+85
+00:06:36,480 --> 00:06:40,140
+بتكون immature خاصة في الـ neonates اللي هو يعني ال
+
+86
+00:06:40,140 --> 00:06:44,860
+.. حديثي الولادة، هذا بيكون إنه بيزيد عمر الدواء، 
+
+87
+00:06:44,860 --> 00:06:47,400
+يعني لو مثلاً.. لو هالوقت احنا إيش بيصير عندنا،
+
+88
+00:06:47,400 --> 00:06:50,140
+الدواء هيدفع.. مثلاً أنا باخد توتر لقطرة، الدواء 
+
+89
+00:06:50,140 --> 00:06:52,280
+هي.. الدواء هيدخل.. الدواء هيدخل داخل العين،
+
+90
+00:06:52,280 --> 00:06:55,180
+هيصير عندنا انزيمات أيضية، هذه الانزيمات هتعمل..
+
+91
+00:06:55,180 --> 00:06:57,440
+هت.. هتكسر الدواء وهيتحلل وهيدخل جوا الجسم و
+
+92
+00:06:57,440 --> 00:07:00,940
+هيصير الأشياء اللي هو تأثيره، لكن عند الأطفال عندهم 
+
+93
+00:07:00,940 --> 00:07:04,020
+immature، يعني هيصير اللي هو تفكيك وتكسير وتحليل
+
+94
+00:07:04,020 --> 00:07:06,920
+بطيء للدواء، بسبب أن الانزيمات هذه اللي هو غير 
+
+95
+00:07:06,920 --> 00:07:10,700
+ناضجة، غير ناضجة بشكل تام، بالتالي بيصير اللي هو
+
+96
+00:07:10,700 --> 00:07:13,760
+عنده طول عمر الدواء، يعني لما نقعد مثلاً ربع ساعة
+
+97
+00:07:13,760 --> 00:07:18,040
+المفروض، يصير مثلاً نص أو ساعة، حسب اللي هو الـ doctor
+
+98
+00:07:18,040 --> 00:07:22,660
+تبعه، بيحكي لإن the dose relative to blood 
+
+99
+00:07:22,660 --> 00:07:27,930
+volume, body weight and surface area is greater for
+
+100
+00:07:27,930 --> 00:07:32,010
+infants and children. بيقول إن الجرعة لها علاقة
+
+101
+00:07:32,010 --> 00:07:39,070
+بحجم الدم ووزن الجسم ومساحة السطح بتكون طبعاً هادة
+
+102
+00:07:39,070 --> 00:07:41,490
+إنها.. بتكون عظيمة في الـ infants و الـ children
+
+103
+00:07:41,490 --> 00:07:44,630
+يعني لإن إيش؟ احنا عارفين في الصغار اللي هو دمهم 
+
+104
+00:07:44,630 --> 00:07:46,690
+يعني مش زي الكبير مش زي الـ adults أو الكبار اللي
+
+105
+00:07:46,690 --> 00:07:49,850
+هو حجم الدم تبعهم الجسم من كله صغير يعني أقل من 
+
+106
+00:07:49,850 --> 00:07:54,050
+غيرهم الـ.. الوزن تبعهم وموزونهم قليل مساحة سطح 
+
+107
+00:07:54,050 --> 00:07:56,890
+الجسم قليل هادة بيخلي إن الجرعة تصير إنها أضعاف اللي
+
+108
+00:07:56,890 --> 00:08:02,110
+موجودة في أي جسم أكبر منها. Blood in adults dilutes
+
+109
+00:08:02,110 --> 00:08:05,690
+absorbed اللي هو drug عشرين times more than in 
+
+110
+00:08:05,690 --> 00:08:10,070
+humans. إنه بيستوعب الدواء أكثر بعشرين مرة من 
+
+111
+00:08:10,070 --> 00:08:13,590
+الأطفال، يعني مثلاً حديث الولادة، صحيح اللي هو
+
+112
+00:08:13,590 --> 00:08:19,210
+حديث الولادة، بيحكي 
+
+113
+00:08:19,210 --> 00:08:22,830
+له this factor number six اللي هو حكيناه قبل شوية،
+
+114
+00:08:22,830 --> 00:08:27,930
+اللي هو حجم الدم والوزن و الـ surface area of the 
+
+115
+00:08:27,930 --> 00:08:32,930
+relationship، كانت فيها علاقة بين الـ dose to blood 
+
+116
+00:08:32,930 --> 00:08:36,740
+volume, body weight and surface area is
+
+117
+00:08:36,740 --> 00:08:41,600
+particularly important and causing toxicity. هدول 
+
+118
+00:08:41,600 --> 00:08:47,020
+الأشياء الثلاثة الموجودين بيعملوا لي السمية. If 
+
+119
+00:08:47,020 --> 00:08:50,840
+drugs لو القطرات اللي هو only are considered an 
+
+120
+00:08:50,840 --> 00:08:55,660
+approximation can be made of the total dose
+
+121
+00:08:55,660 --> 00:08:59,720
+delivered to the eyes following a routine 
+
+122
+00:08:59,720 --> 00:09:04,740
+instillation by releasing of the children dose. نحكي
+
+123
+00:09:04,740 --> 00:09:10,400
+لإن في من هنا اعتبارات إنه كيف نقلل اللي
+
+124
+00:09:10,400 --> 00:09:14,580
+هو الـ dose نقل 
+
+125
+00:09:14,580 --> 00:09:20,180
+الـ dose إنه نعمل دوز أقل صحيح اللي بتأثر مع طول زي 
+
+126
+00:09:20,180 --> 00:09:27,140
+ما نعطيه للكبير a child born in which هو twenty
+
+127
+00:09:27,140 --> 00:09:33,920
+kilogram received almost twice twice value هو القدد
+
+128
+00:09:33,920 --> 00:09:41,220
+perinatral يعني بالفم اللي هو perinatral صحيح أو
+
+129
+00:09:41,220 --> 00:09:45,140
+غير perinatral اللي هو غير الفم أي دولة
+
+130
+00:09:45,140 --> 00:09:50,920
+subcutaneous أو intramuscular antibiotic dose اللي هو 
+
+131
+00:09:50,920 --> 00:09:54,800
+الـ حل اللي هو الأول الـ  الجنود بيحكي لإن الأطفال اللي
+
+132
+00:09:54,800 --> 00:10:00,060
+وزنهم عشرين كيلوجرام هدول بيكون اللي هو تأثير ال
+
+133
+00:10:00,060 --> 00:10:02,960
+Varendra اللي هي دي subcutaneous or intramuscular 
+
+134
+00:10:02,960 --> 00:10:06,980
+اللي هو بتكون يعني أدوية غير الفم بتكون ضعف 
+
+135
+00:10:06,980 --> 00:10:11,880
+تأثيرها في الأطفال عندهم. أما بالنسبة اللي بيحكي لإن
+
+136
+00:10:11,880 --> 00:10:16,100
+الـ.. أو بتكون تسعة أضعافها لو كانت intravenous،
+
+137
+00:10:16,100 --> 00:10:19,400
+احنا عارفين أول شيء اللي هو أخذنا دواء subcutaneous,
+
+138
+00:10:19,880 --> 00:10:23,730
+intramuscular في أول شطر هذه الدواء حكينا إنه بيكون
+
+139
+00:10:23,730 --> 00:10:26,210
+اللي هو غير الفم وبيكون هذا أبطأ في اللي هو 
+
+140
+00:10:26,210 --> 00:10:30,010
+انتشاره وامتصاصه في الجسم، أما الـ intravenous 
+
+141
+00:10:30,010 --> 00:10:34,330
+حكينا أسرع أسرع طريقة اللي هو يعني يعني إعطاء
+
+142
+00:10:34,330 --> 00:10:38,470
+الدواء تأثيره، ظهور تأثيره، فبحكيه لإن في اللي
+
+143
+00:10:38,470 --> 00:10:40,970
+هو الطريقة الأولى اللي هي subcutaneous و
+
+144
+00:10:40,970 --> 00:10:45,130
+intramuscular حكيناها إنها بتكون ضعف، ضعف وجودها في
+
+145
+00:10:45,130 --> 00:10:48,570
+الـ adult عند الأطفال، الـ infant و الـ children، ضعف
+
+146
+00:10:48,570 --> 00:10:51,750
+وجودها في الـ adult لكن بالنسبة اللي هو أسرع طريقة 
+
+147
+00:10:51,750 --> 00:10:56,910
+الـ intravenous بكون تسعة أضعاف في الـ adults بالنسبة
+
+148
+00:10:56,910 --> 00:10:58,990
+اللي هو عند الـ infants و الـ children وكمان تبقى 
+
+149
+00:10:58,990 --> 00:11:03,550
+الـ adults بيحكي لي blood in adult dilutes absorb
+
+150
+00:11:03,550 --> 00:11:07,450
+drug 20 اللي هو twenty times more than in units
+
+151
+00:11:07,450 --> 00:11:10,210
+نفس الشيء رجع يحكي لي إنه بتتم اللي هو تخفيفها
+
+152
+00:11:10,210 --> 00:11:14,930
+عشرين مرة أكثر من الأطفال حديثي الولادة، أبو الشهر 
+
+153
+00:11:14,930 --> 00:11:15,670
+زمان هيك يعني
+
+154
+00:11:33,900 --> 00:11:45,080
+ما هي المعايير المتبعة لتقليل السمية 
+
+155
+00:11:47,470 --> 00:11:51,910
+في عيون الأطفال، في الدياتري في عموماً أطفال، صغار و 
+
+156
+00:11:51,910 --> 00:11:55,890
+رجال أطفال، في الدياتري، الـ H معين لإن عندي حوالي 
+
+157
+00:11:55,890 --> 00:12:03,110
+سبع عشر مية، وهدول مطلوبين، لإن يعني أول شيء نبدأ 
+
+158
+00:12:03,110 --> 00:12:08,110
+على التوبة، بعدين نجيب الفائدة، واحنا عايزين في
+
+159
+00:12:08,110 --> 00:12:09,570
+الإسلام نقول التخلية
+
+160
+00:12:24,860 --> 00:12:28,800
+يجي هو يصير صالح، أول شيء لازم يترك رذيله، ما ينفعش 
+
+161
+00:12:28,800 --> 00:12:34,320
+إنه يجي يصير صالح وهو مش تارك رذيله، ما ينفعش، وهو هتعمل
+
+162
+00:12:34,320 --> 00:12:38,160
+مُبيقار، مخدرات، أول شيء يتوب من هذا، وبعدين يصير 
+
+163
+00:12:38,160 --> 00:12:44,100
+صالح، التخلية قبل التخلية، وهنا أول شيء ليه بنعدد
+
+164
+00:12:44,100 --> 00:12:49,060
+الضرر؟ في الطب عموماً، أول شيء كيف نتفادي الأضرار، 
+
+165
+00:12:49,060 --> 00:12:52,460
+بعدين لما تمام نفهم كيف نتفادي الأضرار، بيصير نسعى 
+
+166
+00:12:52,460 --> 00:12:56,960
+لجلب الفائدة. أما نكون نجيب الفائدة أو نجيب الضرر مع 
+
+167
+00:12:56,960 --> 00:13:00,720
+بعض ما نفعلش، فالآن بدنا كيف ننقد الأطفال من أي
+
+168
+00:13:00,720 --> 00:13:06,640
+خطأ دوائي، تفضلي. Resisting أو الطريقة الأولى أو 
+
+169
+00:13:06,640 --> 00:13:10,340
+اللي هو.. عندي اللي هو واحد Resisting, draining
+
+170
+00:13:10,340 --> 00:13:15,100
+into the nasal lacrimal system، بيحكي لإن اللي هو
+
+171
+00:13:15,100 --> 00:13:18,870
+.. اللي هاد الـ.. الـ.. اللي نزلها فيما الـ system
+
+172
+00:13:18,870 --> 00:13:23,010
+اللي هي إيش بتعمل؟ تشفيفة بتاخد القطرة هذه بتعملها
+
+173
+00:13:23,010 --> 00:13:27,050
+إيش اللي هو مقاومة لها أو إنه في الأخير نجينة طرق 
+
+174
+00:13:27,050 --> 00:13:31,030
+بتعطينا نجاها إنه أقل من تأثيرها أو انتشارها ليش؟
+
+175
+00:13:31,030 --> 00:13:33,290
+لإن نزلها فيما الـ.. ده كانت أين تروح؟ هي اللي
+
+176
+00:13:33,290 --> 00:13:36,130
+بتوديها للـ system اللي هو عن طريق القنوات الدموية
+
+177
+00:13:36,130 --> 00:13:42,630
+ وغيره تلو عن نص صحيح تزل من هنا عن نص نص من ورا الـ
+
+178
+00:13:42,630 --> 00:13:49,400
+nasopharynx  nasopharynx ريتشي أو توريتشي in blood
+
+179
+00:13:49,400 --> 00:13:53,700
+capillaries blood vessels هذا علاقة بتنتصه بتوديها
+
+180
+00:13:53,700 -->
+
+216
+00:16:46,160 --> 00:16:51,320
+will increase absorption and possibly deliver a
+
+217
+00:16:51,320 --> 00:16:55,670
+larger toxic systemic dose لإن هو وراء بعض و وراء بعض
+
+218
+00:16:55,670 --> 00:16:58,370
+و هنا و هنا و هنا و كله بالذي في العين و كله وراء
+
+219
+00:16:58,370 --> 00:17:04,450
+عنه نفس التأثير اه digital pressure هم بيحكي أنه
+
+220
+00:17:04,450 --> 00:17:08,590
+بيصير له periphery of the nasolacrimal system at
+
+221
+00:17:08,590 --> 00:17:14,730
+the medial… medial… medial canthus for اللي
+
+222
+00:17:14,730 --> 00:17:19,960
+هو تلاتة لخمسة minutes to abstract يعني بدي أخلق من
+
+223
+00:17:19,960 --> 00:17:25,200
+تلاتة لخمسة ال draining to vascular nasopharyngeal
+
+224
+00:17:25,200 --> 00:17:28,620
+mucous and this reduced potentially rapid systemic
+
+225
+00:17:28,620 --> 00:17:32,780
+absorption بيحكي إنه في تقارير أو دراسة قالت إنه
+
+226
+00:17:32,780 --> 00:17:38,800
+67% هتقلل اللي هو ال… اللي هو draining by اللي
+
+227
+00:17:38,800 --> 00:17:43,040
+هو nasal lacrimal nasal lacrimal اللي هو تبتدأ
+
+228
+00:17:43,040 --> 00:17:47,120
+nasopharyngeal هيقل فيها اللي هو الامتصاص ماشي هي
+
+229
+00:17:47,120 --> 00:17:51,540
+عامة digital pressure؟ يعني بدي… أفهم بأصبع أنه
+
+230
+00:17:51,540 --> 00:17:55,600
+اه بأصبع بدي… دخلت أصابعي هنا أصابعي هنا كنت
+
+231
+00:17:55,600 --> 00:17:59,280
+أفكر اللي هو الـ punctum من هنا و من هنا تحتها
+
+232
+00:17:59,280 --> 00:18:04,000
+وبالتالي الـ ducts اللي بناقشين يمنع أن الدواء من الـ punctum
+
+233
+00:18:04,000 --> 00:18:11,420
+يتم لل… للـ ducts اللي هو الـ ducts اللي بتروح أوي
+
+234
+00:18:11,420 --> 00:18:18,010
+على اللي هو ال… الـ sac بس احنا اللي عارفينه كيف
+
+235
+00:18:18,010 --> 00:18:22,210
+الـ punctum تم في دكت و دكت و في common duct و في الـ
+
+236
+00:18:22,210 --> 00:18:25,890
+sac و في nasolacrimal duct فانا هنا على ال briefly
+
+237
+00:18:25,890 --> 00:18:31,430
+بقول لي periphery و nasolacrimal system هنا اضغط هنا
+
+238
+00:18:31,430 --> 00:18:35,330
+تضغط أصابعك هنا لو لأ طفل تلاتة إلى خمس دقائق
+
+239
+00:18:35,330 --> 00:18:40,390
+عشان الـ drug يروح جوا العين يمتص جوا العين ما ينزلش
+
+240
+00:18:40,390 --> 00:18:45,810
+في الـ nose هذا تبقى انه بيقلل سبعة وستين في المئة من
+
+241
+00:18:45,810 --> 00:18:52,590
+خطر اللي هو الـ systemic toxicity يعني نفضل تلاتة و
+
+242
+00:18:52,590 --> 00:18:58,130
+تلاتين في المئة أقل طبعا يعني خطورة gently and quietly
+
+243
+00:18:58,130 --> 00:19:02,830
+eyelid closure for تلاتة minutes after the drug
+
+244
+00:19:02,830 --> 00:19:07,170
+installation صورة اللي هو بلطف بلطف و هدوء نروح
+
+245
+00:19:07,170 --> 00:19:12,170
+نعمل eyelid closure لمدة تلاتة دقائق طبعا بيحكي لإن
+
+246
+00:19:12,170 --> 00:19:15,630
+في اللي هو دراسة بتحكي لـ 65% من اللي هو من
+
+247
+00:19:15,630 --> 00:19:19,510
+الامتصاص و الـ system toxicity بتقل بهذه الطريقة
+
+248
+00:19:19,510 --> 00:19:26,570
+أربعة a quick blotting away of any excess drug to
+
+249
+00:19:26,570 --> 00:19:30,290
+reduce the volume of the drug administered and
+
+250
+00:19:30,290 --> 00:19:34,350
+encourage the eyelids to stay closed for a short
+
+251
+00:19:34,350 --> 00:19:38,790
+time بيحكي لإن بيقالوا أنا الشيف بعد ما أنا قطرت
+
+252
+00:19:39,110 --> 00:19:42,570
+أنشف اللي هو الزائد اللي طلع مثلا هو بعيط و كذا
+
+253
+00:19:42,570 --> 00:19:47,870
+لإنها انساق و يخليه اللي هو شوية يغمض عيناه لمدة من
+
+254
+00:19:47,870 --> 00:19:52,130
+الوقت، بعدين اللي هو هذا… هذه الخطوة الخامسة
+
+255
+00:19:52,130 --> 00:19:56,430
+بيحكي لي placement… placement… placement of an
+
+256
+00:19:56,430 --> 00:20:02,570
+absorption placed at the punctum prior to drug
+
+257
+00:20:02,570 --> 00:20:05,870
+instillation to restrict absorption by the conjunctiva
+
+258
+00:20:05,870 --> 00:20:10,940
+type إنه بدي أضع زي مصاصة في مكان ال… مكان
+
+259
+00:20:10,940 --> 00:20:16,220
+الـ punctum مصاصة أول هو إنه… إنه شيء يمسك اللي
+
+260
+00:20:16,220 --> 00:20:18,180
+الدواء ما يروح عن الـ punctum أو يعيقه اللي يروح عن
+
+261
+00:20:18,180 --> 00:20:22,000
+الـ punctum بيحكي لي مثلا بنحط شاشة مصاصة هذه الشاشة
+
+262
+00:20:22,000 --> 00:20:25,140
+هتسكن الـ punctum لمدة اللي الدواء ما يمتص من خلالها
+
+263
+00:20:25,140 --> 00:20:31,340
+يعني… يعني أنا أحصلها طريقة حول العين و أكون كثير
+
+264
+00:20:31,340 --> 00:20:35,680
+مزجة في الـ punctum فبقول يعني كل ما الدواء بيجي
+
+265
+00:20:41,880 --> 00:20:47,760
+مو أو شاش المهم أنه يعني يكون في احتياط إنه drug من
+
+266
+00:20:47,760 --> 00:20:54,700
+زمان يمكن صعب شوية لكن نحاول نخبطه اه كثير لو هاسي
+
+267
+00:20:54,700 --> 00:20:59,660
+drug مدة كثير؟ خمس دقائق خمس دقائق مش هيطلع بعد
+
+268
+00:20:59,660 --> 00:21:05,640
+كثير دواء و فترة؟ شوفي هو يعني هتشوفوا أنتو ال
+
+269
+00:21:05,640 --> 00:21:11,450
+capacity of… كنت أختبر الـ dose كلها توا ten to
+
+270
+00:21:11,450 --> 00:21:19,810
+fifteen nano ml يعني تسع عشر كثير يعني فاللي بيطلع
+
+271
+00:21:19,810 --> 00:21:24,610
+هو بيكون زيادة، اللي بيطلع برا بيكون زيادة، المهم
+
+272
+00:21:24,610 --> 00:21:29,670
+اللي بيبقى في العين هو اللي هيشتغل عليه يعني dose
+
+273
+00:21:29,670 --> 00:21:53,470
+cutaneous؟ cutaneous جلد يعني instill
+
+274
+00:21:53,470 --> 00:21:57,490
+و instill و instill و instill و instill و instill و instill و
+
+275
+00:21:57,490 --> 00:21:57,650
+instill و instill و instill و instill و instill و instill و
+
+276
+00:21:57,650 --> 00:21:57,730
+instill و instill و instill و instill و instill و instill و
+
+277
+00:21:57,730 --> 00:21:59,090
+instill و instill و instill و instill و instill و instill و
+
+278
+00:21:59,090 --> 00:21:59,350
+instill و instill و instill و instill و instill و
+
+279
+00:21:59,350 --> 00:21:59,930
+instill و instill و instill و instill و instill و
+
+280
+00:21:59,930 --> 00:22:00,010
+instill و instill و instill و instill و instill و
+
+281
+00:22:00,010 --> 00:22:01,500
+instill و instill و instill و instill inner canthus
+
+282
+00:22:01,500 --> 00:22:07,180
+with eyes closed followed by immediate opening of
+
+283
+00:22:07,180 --> 00:22:10,920
+the eye إيه يعني؟ إن أخليه يفتح عينيه و بعدين أحط
+
+284
+00:22:10,920 --> 00:22:15,000
+فيه اللي هو طبعا من غير ما يوصل inner canthus إن
+
+285
+00:22:15,000 --> 00:22:18,320
+أحط له في ال… اللي هو الدواء و بعدين أخليه يغلق
+
+286
+00:22:18,320 --> 00:22:28,960
+عينيه طب إيش معناتك؟ شاركت؟
+
+287
+00:22:29,460 --> 00:22:32,800
+إنّه مثلاً يكون مغمض عليهم و انحط له الـ drop هنا و أول
+
+288
+00:22:32,800 --> 00:22:37,100
+ما يفتح هتدخل الـ drop، هذا هو الصح يعني الطفل هو
+
+289
+00:22:37,100 --> 00:22:41,360
+خايف و بيبكي و بعدين يعني أنا بدأت ألفت نظر
+
+290
+00:22:41,360 --> 00:22:47,040
+حضراتكم لحالي و لما هو إن الطفل لو بكى أو ضاعت
+
+291
+00:22:47,040 --> 00:22:51,340
+القطرة و هو بيبكي القطر بتصير useless، مش… مش… مش…
+
+292
+00:22:51,340 --> 00:22:53,540
+مش… مش… مش… مش… مش… مش… مش… مش… مش… مش… مش… مش
+
+293
+00:22:53,540 --> 00:22:55,540
+مش… مش… مش… مش… مش… مش… مش… مش… مش… مش… مش… مش
+
+294
+00:22:55,540 --> 00:22:55,580
+مش… مش… مش… مش… مش… مش… مش… مش… مش… مش… مش… مش
+
+295
+00:22:55,580 --> 00:22:55,640
+مش… مش… مش… مش… مش… مش… مش… مش… مش… مش… مش… مش
+
+296
+00:22:58,990 --> 00:23:04,090
+فأنا كمان بدي أتحايل على الطفل بحيث إنه لا يبكي
+
+297
+00:23:04,090 --> 00:23:07,690
+و أنا بقول لهم ما تخليش الطفل يبكي ولو بكى لازم
+
+298
+00:23:07,690 --> 00:23:11,270
+أعيد النقطة ولو بكى ثاني أعيد النقطة إلى إنه
+
+299
+00:23:11,270 --> 00:23:15,530
+يعني أتأكد إنّ القطرة أخدت راحتها في العين و اشتغلت
+
+300
+00:23:15,530 --> 00:23:21,650
+وبالتالي إحدى الطرق و هذه يعني فيها نوع من التحايل
+
+301
+00:23:21,650 --> 00:23:25,830
+إنّه هو الطفل خايف يعني إيه ثاني ثاني كده و هو
+
+302
+00:23:25,830 --> 00:23:29,570
+مغمض إنّي خايف يعني إنّي أفتح عينه لبنانيّة أحط له النقطة هنا
+
+303
+00:23:29,570 --> 00:23:33,310
+و النقطة هنا و هو مغمض بقول له خلاص خلاصنا خلاصنا
+
+304
+00:23:33,310 --> 00:23:38,330
+ما فيش حاجة ما فيش حاجة بيه هو افتح عينه مش ها يحس
+
+305
+00:23:38,330 --> 00:23:44,230
+فيه إنك تخشّ النقطة و بتشتغل كمان helicutaneous drug
+
+306
+00:23:44,230 --> 00:23:49,270
+delivery إنّي أحط له الـ drop في الـ gel يعني و احنا سابق
+
+307
+00:23:49,270 --> 00:23:54,730
+قبل فترة اتحدثنا عن حاجة ثانية على الـ spray بخار
+
+308
+00:23:56,260 --> 00:24:00,460
+في الـ gel بيقول لك غمض عينه بيقول له فعلاً بتطلع القطرة
+
+309
+00:24:00,460 --> 00:24:04,520
+surfactant spray، ولا مقارنة، و دي دورة كثير كثير جريئة
+
+310
+00:24:04,520 --> 00:24:10,700
+من الـ drops العادية، هاي الـ gel نزلت، نزلت، إنه
+
+311
+00:24:10,700 --> 00:24:16,200
+الطفل اللي بيبكي، هو أثناء القطرة مش محسوسة
+
+312
+00:24:30,220 --> 00:24:35,900
+ما داعي إنّي أنا أصحي منه أعمل عروش، لأ، هو نايم
+
+313
+00:24:35,900 --> 00:24:40,180
+هكذا، أحط له النقطة هنا، و نقف هنا، و هي إما هتتسلل
+
+314
+00:24:40,180 --> 00:24:44,220
+لـ inside تسلل، تقع فيه الـ ميه، سهلة إنّها ناشطة،
+
+315
+00:24:44,220 --> 00:24:48,080
+ستتسلل، وإما هو هيحس إنّه يفتح عينه، لما يفتح عينه،
+
+316
+00:24:48,080 --> 00:24:52,360
+هي هتطفو، مش هلاقي إنّه احنا بنحاول نتدخل فيه و
+
+317
+00:24:52,360 --> 00:24:56,920
+نفتح عينيه و نعمله يعني إرغام، إنّه نتذكر وصف
+
+318
+00:24:56,920 --> 00:25:00,730
+العالم، أنا أعتقد إنّ هذه الطريقة اللي بتمنع البكاء
+
+319
+00:25:00,730 --> 00:25:04,550
+طرق زي هذه لو احنا في الأول بقولنا إيه ال
+
+320
+00:25:04,550 --> 00:25:09,550
+mobilization إنّه لازم واحد يثبت رأسه مظبوط عشان
+
+321
+00:25:09,550 --> 00:25:13,550
+الموضوع يعيش إنّه يكون فيه يعني نقطة تيدي في الـ
+
+322
+00:25:13,550 --> 00:25:19,610
+center in يعني داخل العين فـ أنا لما أخليه نايم و
+
+323
+00:25:19,610 --> 00:25:23,290
+أحط له النقطة و بعدين هو بيصحى على مهله يعني لما أنا
+
+324
+00:25:23,290 --> 00:25:29,400
+بدي أعمله فحص أو بصحي بيكون مثلاً المريض بيسأل
+
+325
+00:25:29,400 --> 00:25:34,680
+psychologically حدثت، كويس هيك؟ أنا أعتبر هذه من
+
+326
+00:25:34,680 --> 00:25:42,860
+أهم النقاط، لكن هذا لا يعني أنّ هذه بتحمي من الـ
+
+327
+00:25:42,860 --> 00:25:49,300
+toxicity، اه يعني كمان هذه طريقة كويسة في أني أمنع
+
+328
+00:25:49,300 --> 00:25:49,740
+البكاء
+
+329
+00:25:56,380 --> 00:25:59,800
+الـ toxicity، system of toxicity، وبالتالي أنا برضه
+
+330
+00:25:59,800 --> 00:26:04,120
+معها دي بدي أضع أصابعي، بالهم بتضعوا أصابعي هنا،
+
+331
+00:26:04,120 --> 00:26:09,780
+خفيفة داخل أو نخليه مغلفة هنا، هو حقيقة طالما الطفل
+
+332
+00:26:09,780 --> 00:26:13,120
+مثلا نايم،
+
+333
+00:26:13,120 --> 00:26:16,100
+ما فيش يعني تسرب واضح
+
+334
+00:26:23,750 --> 00:26:26,590
+بعدين هو فيه ميكانيزم اسمه يعني suction mechanism
+
+335
+00:26:26,590 --> 00:26:33,310
+يعني ال… الـ nasolacrimal الـ duct ساعة ما يفضي ال…
+
+336
+00:26:33,310 --> 00:26:37,330
+الـ duct ساعة… ساعة ما يفضي و يصير فاضي في الـ
+
+337
+00:26:37,330 --> 00:26:40,630
+nose بيعمل عملية suction زي الجلم اللي زمان كنا
+
+338
+00:26:40,630 --> 00:26:46,290
+نستخدمه لشفة الحبر بيعمل suction فهو يعني طالما إن
+
+339
+00:26:46,290 --> 00:26:52,110
+ما فيش عملية تفريغ له و هو بيعمل الـ suction طالما الطفل
+
+340
+00:26:52,110 --> 00:26:57,660
+يعني قد وضع النوم وضع النوم زي وضع إنّي أخدت قصب
+
+341
+00:26:57,660 --> 00:27:00,960
+يعني لكن
+
+342
+00:27:00,960 --> 00:27:03,600
+الولايات المتحدة اللي هو بيعمل blinking هيك معناه
+
+343
+00:27:03,600 --> 00:27:08,500
+إنّ فيه suction فـ وضع يعني مثل الحكاية اللي بتقول لنا
+
+344
+00:27:08,500 --> 00:27:12,700
+هدهد التقنية اللي هو من الأطواق الجرعة بتعمل لي
+
+345
+00:27:12,700 --> 00:27:15,680
+effect اللي هو التأثير اللي بتديه on safety بتكون
+
+346
+00:27:15,680 --> 00:27:18,780
+آمنة بيحكي لي هذا يمكن أن يكون helpful يعني
+
+347
+00:27:18,780 --> 00:27:22,100
+بيساعدنا في الـ children فمن فضل اللي يعني مش أعلى
+
+348
+00:27:22,100 --> 00:27:27,210
+مشاركة بتعملها هنا هو كشوية قاعدة من إنه lacrimal
+
+349
+00:27:27,210 --> 00:27:32,790
+apparatus بيحكي لي إنه… اللي هو بيحكي لي كيف
+
+350
+00:27:32,790 --> 00:27:35,870
+هناك ال… كيف ال… يعني ال… الـ nasolacrimal
+
+351
+00:27:35,870 --> 00:27:40,670
+system إنه هنا الـ sac و ال… هنا الـ canthus، الـ
+
+352
+00:27:40,670 --> 00:27:45,830
+punctum، ال… يعني الـ lacrimal duct، أهم شيء،
+
+353
+00:27:45,830 --> 00:27:49,230
+اللي بينزل منك، اه، فضل
+
+354
+00:27:52,500 --> 00:27:59,340
+seven occlusion of the lacrimal puncta and puncta by
+
+355
+00:27:59,340 --> 00:28:05,800
+collagen punctal plugs اللي هي السداد أو… يعني
+
+356
+00:28:05,800 --> 00:28:10,780
+إيش بتسكر؟ Silicon punctal plugs or suture to
+
+357
+00:28:10,780 --> 00:28:14,080
+block draining of the eye drops through the
+
+358
+00:28:14,080 --> 00:28:18,400
+nasolacrimal system. This also keeps medication in
+
+359
+00:28:18,400 --> 00:28:23,930
+contact with the cornea for a longer duration and
+
+360
+00:28:23,930 --> 00:28:27,670
+improves therapeutic index administered بحيث هنا
+
+361
+00:28:27,670 --> 00:28:30,690
+إنّه بسكر الـ lacrimal punctum كثير من خلال اللي هو plugs
+
+362
+00:28:30,690 --> 00:28:34,850
+اللي هي هال بيحكي أنواع كلّ جين أو سيليكون أو بعمل بودي
+
+363
+00:28:34,850 --> 00:28:41,270
+زي اللي هال كلّ هال شايفين كيف مدببة طبعا يعني
+
+364
+00:28:41,270 --> 00:28:45,530
+أهلية بيدها experience يعني بحيث إنه هي بتبقى زي
+
+365
+00:28:45,530 --> 00:28:49,750
+الـ plastic شايفين مدببة كيف بحيث إنه يعني بس هيعمل
+
+366
+00:28:49,750 --> 00:28:56,860
+كده هتسدّ الـ punctum ثاني من هنا و خلاص بتقفل و اللي
+
+367
+00:28:56,860 --> 00:29:01,840
+فوق نفس الحاجة الآن هتبقى إنّي أنا مدى لطفلي يعني
+
+368
+00:29:01,840 --> 00:29:07,980
+أعمله علاج لمدة أسبوع أو شهر مثلاً post operative
+
+369
+00:29:07,980 --> 00:29:14,020
+مثلاً أو حاجة فبلزم إنّي أعمل حاجة لكن إذا كنت بتعمل
+
+370
+00:29:14,020 --> 00:29:14,840
+cycloplegia
+
+371
+00:29:20,480 --> 00:29:25,400
+نقطة و نقطة و بعد ربع ساعة نقطة و نقطة و بالكثير
+
+372
+00:29:25,400 --> 00:29:28,500
+كمان ربع ساعة نقطة و نقطة يعني لو عملت الـ
+
+373
+00:29:28,500 --> 00:29:32,220
+immobilization و شوية ضغط هنا بيكفي ست مرات مش هي
+
+374
+00:29:32,220 --> 00:29:35,300
+الخوف من الستّ خوف مش من ستّ مرات إنّه تماماً لهم
+
+375
+00:29:35,300 --> 00:29:41,660
+لكن الخوف من طفل إنّي بعالجه يعني… يعني لمدة
+
+376
+00:29:41,660 --> 00:29:49,830
+من الزمن مدة من الزمن مثلاً أنا بعطي مثلاً فترة
+
+377
+00:29:49,830 --> 00:29:55,970
+antibiotic أو كورتيزون post operative مثلاً أسبوعين
+
+378
+00:29:55,970 --> 00:30:00,530
+تلاتة اه بصير أنا بدي silicone أو collagen plugs
+
+379
+00:30:00,530 --> 00:30:05,650
+سدادات جاهزة و هذه السدادات يعني commercially اه
+
+380
+00:30:05,650 --> 00:30:11,070
+marketed يعني موجودة في الأسواق في شبيه لها كان
+
+381
+00:30:11,070 --> 00:30:17,170
+زمان أي قدر تلتهب يقول لك ما تحطش عليها ميه كان واحد
+
+382
+00:30:17,170 --> 00:30:20,630
+من معاصريني بيقول إنّ دي سدادات قطن بلاستيكية فبتصب
+
+383
+00:30:20,630 --> 00:30:26,930
+بقطنة وبعد الحمام بيسحب يعني أنا حاجات محتوي
+
+384
+00:30:26,930 --> 00:30:34,470
+سيليكون اللي بتقدر وإن كان الـ punctal اللي هو plugs
+
+385
+00:30:34,470 --> 00:30:39,350
+يمكن تطبيقها أصعب شوية يعني بدها شوية experience
+
+386
+00:30:39,350 --> 00:30:43,470
+ممكن تتعملوها لو شفتم وياكم يعني كيف نعملها تنعمل
+
+387
+00:30:44,030 --> 00:30:46,150
+في… يعني أسوأ الأحوال اللي هو من الـ
+
+388
+00:30:46,150 --> 
+
+431
+00:34:20,730 --> 00:34:26,890
+صحيح لما تظلم و تقول لأ اكمل وزن بالقصة في كل شيء
+
+432
+00:34:26,890 --> 00:34:32,330
+في كل شيء مع نفسك و مع الناس و مع ربك و في العبادة
+
+433
+00:34:32,330 --> 00:34:36,930
+و حتى في الكلام لازم يكون الكلام ايش بالميزان
+
+434
+00:34:36,930 --> 00:34:44,330
+الكلام يكون ايش بالميزان واحد يقول أنا كلامي كوزن
+
+435
+00:34:44,330 --> 00:34:51,770
+الذهب فعلاً الكلام كأنه بيزن الذهب حرف زيادة لأ حرف
+
+436
+00:34:51,770 --> 00:34:57,610
+نصف آه فضل هذه الطريقة هتحفظ العالم أن الدواء
+
+437
+00:34:57,610 --> 00:35:02,870
+يتعامل contact with القرنية أنه هيبقى مع القرنية 
+
+438
+00:35:02,870 --> 00:35:06,930
+longer duration هو هذا اللي بدي أؤكده عن القرنية
+
+439
+00:35:06,930 --> 00:35:10,810
+ويأثر لي عليها and improves اللي هو يكون يحسن اللي
+
+440
+00:35:10,810 --> 00:35:11,770
+هو therapeutic index
+
+441
+00:35:15,350 --> 00:35:18,930
+ثمانية decreasing administration of the eyedropper
+
+442
+00:35:18,930 --> 00:35:23,130
+tip since the volume delivered by a commercial
+
+443
+00:35:23,130 --> 00:35:28,530
+eyedropper  commercial commercial  سوقي سوقي آه
+
+444
+00:35:28,530 --> 00:35:33,890
+تجاري أو سوقي أنه نقلل أبعاد الـ eyedropper اللي هي 
+
+445
+00:35:33,890 --> 00:35:37,510
+القطارة اللي هي القطار نستخدمها الـ tip الـ tip تبعها
+
+446
+00:35:37,510 --> 00:35:41,570
+باين هنا فيه فرق بيبقى موجود كيف هتتغلب وهتوسع
+
+447
+00:35:41,570 --> 00:35:47,590
+شايفين؟ لسه الـ الـ الـ الـ الـ mono-dose
+
+448
+00:35:47,590 --> 00:35:51,190
+شوفت الـ refresh في mono-dose البلاستيكية الصغيرة
+
+449
+00:35:51,190 --> 00:35:56,030
+هذه لسه الـ dropper بتاعها أصغر كمان آه فطبيب بيحكي
+
+450
+00:35:56,030 --> 00:35:59,410
+أن اللي موجود اللي هو سوقياً من خمسة وعشرين point
+
+451
+00:35:59,410 --> 00:36:02,930
+واحد two اللي هو استخـ استخدم خمسة وعشرين point أربعة الواحد
+
+452
+00:36:02,930 --> 00:36:07,810
+ملي لتر micro micro أنا قلت قبل شوية nano وهي مش
+
+453
+00:36:07,810 --> 00:36:09,050
+nano هي micro
+
+454
+00:36:13,550 --> 00:36:16,930
+وإحنا لقالك ملي ميلي فشوف أقول لك قد إيش اللي العين
+
+455
+00:36:16,930 --> 00:36:22,050
+بتتساق هي العين الحالة بتتساق عشر إلى خمسة عشر هم
+
+456
+00:36:22,050 --> 00:36:27,330
+بيعملونا ستة وخمسين الفرق بين الستة والخمسين وبين
+
+457
+00:36:27,330 --> 00:36:31,610
+الخمسة عشر قد إيش؟ واحد وثلاثين واحد وثلاثين
+
+458
+00:36:31,610 --> 00:36:36,130
+microliter waste زيادة برة اللي بيطلع برة أخذتنا
+
+459
+00:36:36,130 --> 00:36:40,590
+اللي بيطلع برة اللي بيطلع برة هذه زيادة
+
+460
+00:36:44,520 --> 00:36:48,820
+لو هم حدوا dropper صغير صغير صغير كان بس تنزليه
+
+461
+00:36:48,820 --> 00:36:51,980
+خمسة عشر هو وزّكوه لو كان بيجينا بيطلع على الـ cheek
+
+462
+00:36:51,980 --> 00:36:55,680
+ولا على الـ skin أي حاجة فضل هو بيحكي لأنه زي ما
+
+463
+00:36:55,680 --> 00:36:58,360
+قال الدكتور أن أي دي الـ volume للـ drop أنها تكون
+
+464
+00:36:58,360 --> 00:37:02,480
+من عشر إلى خمسة عشر microliter هذه اللي هي الكمية
+
+465
+00:37:02,480 --> 00:37:07,000
+المناسبة للعين في الأطفال طبعاً التسعة اللي هو
+
+466
+00:37:07,000 --> 00:37:11,500
+استخدام single eyedrop combination of two drugs،
+
+467
+00:37:11,500 --> 00:37:15,110
+يعني هي تكون عبارة عن دوائين في قطرة الواحدة to
+
+468
+00:37:15,110 --> 00:37:18,950
+reduce the number of drug installations and amount
+
+469
+00:37:18,950 --> 00:37:27,650
+of drug delivered to a life مثل مثل أنـ cosopt أكثر
+
+470
+00:37:27,650 --> 00:37:31,530
+ألمانية لغلوكوما هذا يكون عبارة عن timolol and
+
+471
+00:37:31,530 --> 00:37:35,150
+trisopt اللي هو الدواء إيه؟ قطرة الـ timolol
+
+472
+00:37:46,210 --> 00:37:53,590
+التانية هو بيحكي لي أنه ماكسيترول ماكسيترول هذه أنا
+
+473
+00:37:53,590 --> 00:37:57,510
+شايفها آه أنا دي بقول لك مثال هذه اتبين الـ ماكسيترول
+
+474
+00:37:57,510 --> 00:38:01,950
+فيها ثلاث أدوية يعني إيش فيها نيوميسين سالفات و
+
+475
+00:38:01,950 --> 00:38:06,550
+بولي مايسين سالفات وديكساميثازون
+
+476
+00:38:21,090 --> 00:38:24,470
+طب أنتم عارفين ليش فيها two antibiotics and
+
+477
+00:38:24,470 --> 00:38:30,810
+ستيرويد كورتيزون؟ يعني أن هذه الجزئية عبارة عن
+
+478
+00:38:30,810 --> 00:38:35,930
+ثلاث جزايز مع بعض الـ antibiotic الأول ممكن
+
+479
+00:38:35,930 --> 00:38:40,910
+ما يجاوبش مع البكتيريا الـ antibiotic الثاني بيتعمل
+
+480
+00:38:40,910 --> 00:38:46,290
+two antibiotics more effective against بكتيريا two
+
+481
+00:38:46,290 --> 00:38:48,770
+antibiotics ومعهم الـ
+
+482
+00:38:56,750 --> 00:39:01,150
+I have two anti-infective antibiotics and one anti
+
+483
+00:39:01,150 --> 00:39:08,790
+-inflammatory أنا عامل installation لثلاث جزايز
+
+484
+00:39:08,790 --> 00:39:18,030
+فعمل فورمة وأنا معتبر هذا يعني شيء يعني راقي وشيء
+
+485
+00:39:18,030 --> 00:39:21,690
+يعني يعبر على احترام الإنسان لأن الإنسان يحط ثلاث
+
+486
+00:39:21,690 --> 00:39:28,440
+جزايز وكل أربع ساعات بعد العملية يقطر لأ هذه كده
+
+487
+00:39:28,440 --> 00:39:32,120
+بينها وبين الثانية لازم يكون أقل شيء ربع ساعة،
+
+488
+00:39:32,120 --> 00:39:36,420
+ما نفعش أني أحط قطرة وأحط قطرة ثانية بعدها فوراً،
+
+489
+00:39:36,420 --> 00:39:40,920
+لأ أقل شيء ربع ساعة إلى نصف ساعة غلطنا في هذه،
+
+490
+00:39:40,920 --> 00:39:45,880
+لازم نرجع لهذه هذه كده شوف كده ضاعت هذه مش
+
+491
+00:39:45,880 --> 00:39:49,840
+لا جينها لازم تكون one bottle عند رأس عيان
+
+492
+00:39:54,660 --> 00:39:59,580
+يعني عمال بتحسن عندنا شركة بيرزيت مشكورة صنعت
+
+493
+00:39:59,580 --> 00:40:06,840
+ماكسيترول باسم chlorozone نفس التركيب chlorozone في
+
+494
+00:40:06,840 --> 00:40:11,400
+نيوميسين وبولامكزين وDexamethasone صينية عربية
+
+495
+00:40:11,400 --> 00:40:16,900
+في رام الله وهي حقيقة أنه fantastic كويسة فهذه طريقة
+
+496
+00:40:16,900 --> 00:40:22,320
+إيش أن الطفل عاد أن بدل ما نخط له مثلاً antibiotic
+
+497
+00:40:22,320 --> 00:40:30,940
+وsteroid و dilator في حال تكون الأثر مثلاً نحط له
+
+498
+00:40:30,940 --> 00:40:38,940
+يعني حاجة مجمعة معها وكون أفضل عشرة use of
+
+499
+00:40:38,940 --> 00:40:45,020
+preceding topical anesthetic such as مثلاً اللي هو
+
+500
+00:40:45,020 --> 00:40:48,760
+الـ grow barricade to enhance effect of drug by
+
+501
+00:40:48,760 --> 00:40:53,160
+increase transcorneal absorption and decreased
+
+502
+00:40:53,160 --> 00:40:57,000
+dilution if it reflects urine caused by the
+
+503
+00:40:57,000 --> 00:41:00,940
+staining sensation أنه بيستخدم اللي هو topical and
+
+504
+00:41:00,940 --> 00:41:05,940
+synthetic اللي هو المخدر يعني مخدر موضعي مش موضعي
+
+505
+00:41:05,940 --> 00:41:11,040
+إيه سطحي إيه سطحي drop أو drop أو drop أما الـ
+
+506
+00:41:11,040 --> 00:41:14,420
+local عايز أفرق عايز injection الـ local عايز
+
+507
+00:41:14,420 --> 00:41:18,580
+injection أي حاجة topical حتى على الجلد حتى في الـ
+
+508
+00:41:18,580 --> 00:41:22,750
+nose spray والحاجة كلها topical لأن اتكلمت على
+
+509
+00:41:22,750 --> 00:41:27,070
+local معناها فيه إبرة بدها تحط في الموضوع بيصير
+
+510
+00:41:27,070 --> 00:41:31,970
+local أصلاً الأساسية الثالثة الـ جنرال اللي هي الجنرال
+
+511
+00:41:31,970 --> 00:41:36,870
+اللي هي عن طريق الـ nose وعن طريق الـ trachea أو
+
+512
+00:41:36,870 --> 00:41:46,690
+الأساسية وين في الـ lower back اللي إحنا حدثناكم
+
+513
+00:41:46,690 --> 00:41:48,690
+عنها في الـ general pharmacology
+
+514
+00:41:54,230 --> 00:41:58,850
+خبر الفقراء في الفيلم الفقراء؟ آه آه في الـ number
+
+515
+00:41:58,850 --> 00:42:06,090
+vertebra وبحطها عشان اللي هو الـ anesthesia في الـ
+
+516
+00:42:06,090 --> 00:42:11,070
+lower half لو بدي أعمل لواحد مثلاً عملية في الرقبة
+
+517
+00:42:11,070 --> 00:42:17,030
+بتاعته عملية بواسط حالة يعني تتعلق بالفوضى ممكن أن
+
+518
+00:42:17,030 --> 00:42:19,370
+أعمله إيش؟
+
+519
+00:42:28,180 --> 00:42:32,620
+طبعاً هذا هيحسن اللي هو تأثير الدواء من خلاله أنه
+
+520
+00:42:32,620 --> 00:42:36,820
+هيزيد الانتشار بالقرنية وهيقلل اللي هو الـ
+
+521
+00:42:36,820 --> 00:42:39,200
+dilution اللي هي يعني التخفيف تبعه من خلال الـ
+
+522
+00:42:39,200 --> 00:42:42,500
+tearing اللي هو بيصير البكاء أو غيره من خلال من الـ
+
+523
+00:42:42,500 --> 00:42:47,620
+staining اللي هو التنخيز هذا لما الواحد يحط اللي
+
+524
+00:42:47,620 --> 00:42:50,750
+هو أي قطرة وفي قطرات كتير بتعمل تنخيز الـ اللي
+
+525
+00:42:50,750 --> 00:42:54,550
+هو المخدر أو الـ الـ anesthetic هذا هيقلل هذا
+
+526
+00:42:54,550 --> 00:42:57,150
+التنخيز أو مش هيحس فيها أصلاً بالتالي التأثير رح
+
+527
+00:42:57,150 --> 00:43:02,550
+يكون أفضل قبل مقدش قبل الـ يعني خمس دقائق يعني
+
+528
+00:43:02,550 --> 00:43:07,910
+نحط التخدير قبل خمس دقائق سطحي وبعدين نحط
+
+529
+00:43:07,910 --> 00:43:12,470
+القطرة مثلاً الـ psychological أو الـ mydriatic كتير
+
+530
+00:43:12,470 --> 00:43:14,710
+القطرة فعلاً هذه مفضلة اختي وساعة رقص
+
+531
+00:43:25,840 --> 00:43:29,320
+هذه الفكرة فأنا أدركت بداخلي أنا الـ artificial
+
+532
+00:43:29,320 --> 00:43:34,340
+tears في عيني فوجدت أني حاطط إيش مدرية أدركت
+
+533
+00:43:34,340 --> 00:43:38,740
+بالحرقة الغير عادي فلحقت المية المية المية بسرعة
+
+534
+00:43:38,740 --> 00:43:43,020
+بسرعة بسرعة خففنا إلى حد كبير الموضوع فلو في
+
+535
+00:43:43,020 --> 00:43:51,520
+قابلة الأطفال في local topical anesthetic آه إيش
+
+536
+00:43:51,520 --> 00:43:55,910
+بيعمل؟ بيحسش لأ بالـ stinging وبالـ burning
+
+537
+00:43:55,910 --> 00:43:59,730
+sensation شوف الصورة هي الصورة الجميلة هي Cosopt
+
+538
+00:43:59,730 --> 00:44:07,650
+دروس هي Cosopt تمانها 150 شركة في الصورة فيها
+
+539
+00:44:07,650 --> 00:44:12,610
+لغلوكوما two drugs لأن بيحط تيمولول وتروسopt بيحط
+
+540
+00:44:12,610 --> 00:44:17,750
+واحد وهنا الـ Maxitrol هي في point
+
+541
+00:44:20,780 --> 00:44:24,660
+قد كتير هاي drops هناك وهي لغات من هناك كتير هذه
+
+542
+00:44:24,660 --> 00:44:28,860
+شائعة في السوق popular and effective الحقيقة أنا
+
+543
+00:44:28,860 --> 00:44:33,820
+بستخدمها بكثرة يعني كتير بكثرة والحقيقة بتجيب
+
+544
+00:44:33,820 --> 00:44:36,800
+نتائج كويسة بستخدمها في حياتي الـ mixed
+
+545
+00:44:36,800 --> 00:44:42,500
+conjunctivitis mixed يعني يكون في ميوكو بيرولاند conjunctivitis
+
+546
+00:44:42,500 --> 00:44:47,380
+وفي allergic conjunctivitis allergic
+
+547
+00:44:47,380 --> 00:44:52,880
+بتاع مع بعض فالالتهابات دي هو نوع من inflammation والـ
+
+548
+00:44:52,880 --> 00:44:56,160
+myocardial inflammation هو نوع من infection يبقى
+
+549
+00:44:56,160 --> 00:44:59,260
+فيه anti-infective وفيه anti-inflammatory مع بعض
+
+550
+00:44:59,260 --> 00:45:05,740
+بدل ما أوصف له ثلاث قطرات وبيجي فعلاً بعد كام يوم
+
+551
+00:45:05,740 --> 00:45:14,040
+عينه يعني وضعها calm و cure وحاجة كويسة بدل ما
+
+552
+00:45:14,040 --> 00:45:18,670
+نحط له من ثلاثة ونترخبط شوف يعني دي ديش اللي قدر
+
+553
+00:45:18,670 --> 00:45:24,130
+البشرية بدأت تخطو نحو الـ الـ تقدم يعني فيه إعلان
+
+554
+00:45:24,130 --> 00:45:28,110
+يعني أنا بعتذر اللي بصنع الهاتف هالي ولو أنه هو
+
+555
+00:45:28,110 --> 00:45:33,010
+أجنبي وبياخد يعني مكافئة كبيرة لكن هو خدم البشر
+
+556
+00:45:33,010 --> 00:45:37,530
+هذا أشياء أحسن اللي بيصنع السلاح المتفجرات ولا
+
+557
+00:45:37,530 --> 00:45:40,650
+السحر الكيميائي اللي بتقتل البشر هؤلاء الناس اللي
+
+558
+00:45:40,650 --> 00:45:45,570
+بيبنوا البشرية ولو كانوا مش على دين لكن الله عز وجل
+
+559
+00:45:45,570 --> 00:45:48,920
+كفاهم بطريقة أما إحنا ناخذ الفائدة بتاعتنا والـ
+
+560
+00:45:48,920 --> 00:45:54,600
+الحكمة ضالة المؤمن أينما وجدها فهو أولى الناس بها
+
+561
+00:45:54,600 --> 00:45:57,020
+فهو أولى الناس بها آه تفضلي اقتصادك ما شاء الله
+
+562
+00:45:57,020 --> 00:46:00,760
+صار اليوم متقلفة كمان ما شاء الله يعني تعبانة عن
+
+563
+00:46:00,760 --> 00:46:04,220
+الموضوع الله يزيدها تفكيرها تفكيرك كمان أنتم آه
+
+564
+00:46:04,220 --> 00:46:08,160
+تفضلي increasing the viscosity of the eye drop by
+
+565
+00:46:08,160 --> 00:46:15,940
+dissolving the drug in MI or emulsion emulsion يعني
+
+566
+00:46:15,940 --> 00:46:23,080
+مستحلب أو مستحلب مستحلب أو مستحلب أو
+
+567
+00:46:23,080 --> 00:46:27,440
+مستحلب أو مستحلب أو مستحلب أو مستحلب أو مستحلب أو
+
+568
+00:46:27,440 --> 00:46:28,760
+مستحلب أو مستحلب أو مستحلب أو مستحلب أو مستحلب أو
+
+569
+00:46:28,760 --> 00:46:28,820
+مستحلب أو مستحلب أو مستحلب أو مستحلب أو مستحلب أو
+
+570
+00:46:28,820 --> 00:46:28,880
+مستحلب أو مستحلب أو مستحلب أو مستحلب أو مستحلب أو
+
+571
+00:46:28,880 --> 00:46:28,900
+مستحلب أو مستحلب أو مستحلب أو مستحلب أو مستحلب أو
+
+572
+00:46:28,900 --> 00:46:30,560
+مستحلب أو مستحلب أو مستحلب أو مستحلب أو مستحلب أو
+
+573
+00:46:30,560 --> 00:46:37,760
+مستحلب أو مستحلب أو مستحلب أو
+
+574
+00:46:38,920 --> 00:46:42,820
+هذه بس بيسكس الدروس أما الـ emulsion بيكون جل زي
+
+575
+00:46:42,820 --> 00:46:46,440
+الجل اللي بيحطه للعين في الـ artificial tears جل
+
+576
+00:46:46,440 --> 00:46:50,640
+آه هذا هي اللي هو retention اللي هو هيخلي احتفاظ
+
+577
+00:46:50,640 --> 00:46:55,160
+in تيفن هيخليه أكثر وجد أو هيحفظ في تيفن أكثر لأنه
+
+578
+00:46:55,160 --> 00:46:59,440
+بيكس تيفن وهذا هيقلل اللي هو lost in knows اللي
+
+579
+00:46:59,440 --> 00:47:03,220
+هو فقدرة بالأرض يعني هم شكراً إليك يعني هم إجوا
+
+580
+00:47:03,220 --> 00:47:03,660
+على الـ diameter
+
+581
+00:47:29,950 --> 00:47:33,850
+employing drug suspension instead of drug solution
+
+582
+00:47:33,850 --> 00:47:37,770
+يعني الموظف في الـ suspension بدل من الـ solution
+
+583
+00:47:38,660 --> 00:47:44,380
+بيحكي لي suspended drop particles are retained in
+
+584
+00:47:44,380 --> 00:47:51,900
+the corneal fiber cell longer than solution بس هذا
+
+585
+00:47:51,900 --> 00:47:57,500
+النقطة ماشي إحنا يمكن اخذنا هدف في biological
+
+586
+00:47:57,500 --> 00:48:01,080
+graph لازم ناخذها لأن أي دور
+
+587
+00:48:15,110 --> 00:48:19,950
+عشان يوزع الـ particles في كل المهلول كان فيه يعني
+
+588
+00:48:19,950 --> 00:48:24,570
+نقطة يعني واحد يشرب دواء مثلاً الكحة وفيه الـ
+
+589
+00:48:24,570 --> 00:48:29,070
+suspension يعني الـ particles فهو يعني كل مرة يحط
+
+590
+00:48:29,070 --> 00:48:33,290
+في المعلقة ويشرب ما يحطش يشرب في الآخر اكتشف
+
+591
+00:48:33,290 --> 00:48:38,350
+أن تلتزق جدياً تحت كل particles وشديدة يعني مش
+
+592
+00:48:38,350 --> 00:48:42,650
+عارف ينزلها فيقولش هاد دواء هذا هو شرب المية
+
+593
+00:48:46,850 --> 00:48:49,230
+فبقولش هالدواء هذا اللي خربانه ولا ما بصريش هو مش
+
+594
+00:48:49,230 --> 00:48:53,290
+فاهم أنه إيش هو ما عملش آه ما عملش رج كل مرة أو
+
+595
+00:48:53,290 --> 00:48:58,910
+ما بيوصلوش الرج فلو كان في أي دواء سواء شراب أو قطرة
+
+596
+00:48:58,910 --> 00:49:03,210
+أو غيره في particles لازم يرج جيداً وبكل مكتوب
+
+597
+00:49:03,210 --> 00:49:07,750
+عليه رج جيداً قبل كل استعمال طبعاً أنا هذا ما أحبته
+
+598
+00:49:07,750 --> 00:49:12,190
+في العين أنا ما بستعمله لأن هذه الـ particles أحياناً
+
+599
+00:49:12,190 --> 00:49:13,690
+ممكن تكون
+
+600
+00:49:19,320 --> 00:49:22,860
+وما تدومش وهذه مشكلة يعني طب إحنا نهي يعني بهذه
+
+601
+00:49:22,860 --> 00:49:25,920
+السنة الأخيرة في حياة النبي صلى الله عليه وسلم
+
+602
+00:49:25,920 --> 00:49:31,920
+وكان في بيته صلى الله عليه وسلم حين مرضه سبعة
+
+603
+00:49:31,920 --> 00:49:38,880
+دنانير فإنه يومي عليهم من المرض ثم قال يا عائشة
+
+604
+00:49:38,880 --> 00:49:44,200
+تصدقي بهذه الدنانير فده ساكر قال ما فعلتم بالمال؟
+
+605
+00:49:44,200 --> 00:49:47,800
+يقولوا يا رسول الله شغلنا بك إحنا فاضيين نروح
+
+606
+00:49:47,800 --> 00:49:53,300
+نصد
\ No newline at end of file
diff --git a/PL9fwy3NUQKwZ2K6wMRTZMEoGVTbELxinF/5fsgkItxEyw_raw.json b/PL9fwy3NUQKwZ2K6wMRTZMEoGVTbELxinF/5fsgkItxEyw_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..ef2fe0b148ccedad46a84e16c51317458a1892e3
--- /dev/null
+++ b/PL9fwy3NUQKwZ2K6wMRTZMEoGVTbELxinF/5fsgkItxEyw_raw.json
@@ -0,0 +1 @@
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"text": "الcreator nerve احنا حاكيناها في المحاضرة الأولى، هي عبارة عن العصب الأساسي اللي مغداش العضلات العامة، كلها تقريبا تغدى من أثاث الcreator nerve اللي هو أكيلومتر نيرب مع عدد superior rectus basal كلها تلقى أثبات اللي هو من العصب الرابع، فمن الcreator nerve اللي هو التوكلين، أما الثالث فهو ال absent nerve، لذلك احنا ما نذكر احنا ال absent فهو abduction، صحيح؟ وها كده", "tokens": [6027, 35546, 284, 16355, 1975, 5016, 8315, 11331, 995, 4117, 1829, 8315, 11296, 8978, 9673, 5016, 46958, 25720, 16247, 12610, 7578, 12399, 39896, 6225, 3555, 9640, 3660, 18871, 18863, 9381, 3555, 16247, 3794, 32277, 1829, 13672, 1829, 3714, 17082, 3215, 33599, 18863, 11242, 1211, 9307, 18863, 10943, 3660, 12399, 28242, 11296, 6055, 4587, 16572, 3555, 995, 6055, 17082, 3215, 7578, 9154, 5551, 12984, 5718, 104, 2423, 35546, 284, 16355, 13672, 1829, 31439, 5551, 4117, 26895, 20498, 2655, 2288, 8717, 13546, 3555, 20449, 6225, 3215, 3215, 13028, 11048, 301, 987, 304, 28242, 11296, 6055, 1211, 4587, 7578, 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واحد", "probability": 0.9892578125}, {"start": 2574.02, "end": 2574.18, "word": " في", "probability": 0.6904296875}, {"start": 2574.18, "end": 2574.72, "word": " العوامل", "probability": 0.82275390625}, {"start": 2574.72, "end": 2575.14, "word": " السلسلة", "probability": 0.6922607421875}, {"start": 2575.14, "end": 2575.34, "word": " هذه", "probability": 0.619140625}, {"start": 2575.34, "end": 2575.7, "word": " بالتالي", "probability": 0.84716796875}, {"start": 2575.7, "end": 2576.14, "word": " هيتأثر", "probability": 0.86175537109375}, {"start": 2576.14, "end": 2576.32, "word": " في", "probability": 0.98974609375}, {"start": 2576.32, "end": 2576.58, "word": " يدي", "probability": 0.95751953125}, {"start": 2576.58, "end": 2576.7, "word": " ال", "probability": 0.681640625}, {"start": 2576.7, "end": 2577.24, "word": " binocular", "probability": 0.5813802083333334}, {"start": 2577.24, "end": 2578.1, "word": " single", "probability": 0.88427734375}, {"start": 2578.1, "end": 2578.64, "word": " project", "probability": 0.27392578125}], "temperature": 1.0}, {"id": 110, "seek": 259857, "start": 2580.81, "end": 2598.57, "text": "هذه تقريبا بالنسبة لتكمل المحاضرة السابقة، في عندك أي أسئلة بالنسبة لمصطلحات؟ بدون مصطلحات، بالنسبة لأسكتك iMovement أو حتى password iMovement؟ كمان ال layers in relation to iMovement؟ في عن أي سؤال؟ حاجة تترى فوق؟", "tokens": [3224, 24192, 6055, 4587, 16572, 3555, 995, 20666, 1863, 35457, 3660, 5296, 2655, 24793, 1211, 9673, 5016, 46958, 25720, 21136, 16758, 28671, 12399, 8978, 43242, 4117, 36632, 5551, 3794, 19986, 37977, 20666, 1863, 35457, 3660, 32767, 9381, 9566, 1211, 5016, 9307, 22807, 47525, 11536, 3714, 9381, 9566, 1211, 5016, 9307, 12399, 20666, 1863, 35457, 3660, 5296, 10721, 3794, 4117, 2655, 4117, 741, 44, 1682, 518, 34051, 11331, 49975, 11524, 741, 44, 1682, 518, 22807, 9122, 2304, 7649, 2423, 7914, 294, 9721, 281, 741, 44, 1682, 518, 22807, 8978, 18871, 36632, 8608, 33604, 6027, 22807, 11331, 26108, 3660, 6055, 2655, 2288, 7578, 6156, 30543, 22807], "avg_logprob": -0.2933035759698777, "compression_ratio": 1.6394230769230769, "no_speech_prob": 0.0, "words": [{"start": 2580.81, "end": 2581.19, "word": "هذه", "probability": 0.418212890625}, {"start": 2581.19, "end": 2581.61, "word": " تقريبا", "probability": 0.89404296875}, {"start": 2581.61, "end": 2582.01, "word": " بالنسبة", "probability": 0.8922119140625}, {"start": 2582.01, "end": 2582.57, "word": " لتكمل", "probability": 0.8409423828125}, {"start": 2582.57, "end": 2583.29, "word": " المحاضرة", "probability": 0.9654541015625}, {"start": 2583.29, "end": 2584.21, "word": " السابقة،", "probability": 0.906982421875}, {"start": 2584.21, "end": 2584.33, "word": " في", "probability": 0.485107421875}, {"start": 2584.33, "end": 2584.55, "word": " عندك", "probability": 0.5587158203125}, {"start": 2584.55, "end": 2584.67, "word": " أي", "probability": 0.7373046875}, {"start": 2584.67, "end": 2585.03, "word": " أسئلة", "probability": 0.966552734375}, {"start": 2585.03, "end": 2586.89, "word": " بالنسبة", "probability": 0.9127197265625}, {"start": 2586.89, "end": 2588.53, "word": " لمصطلحات؟", "probability": 0.8634905133928571}, {"start": 2588.53, "end": 2590.31, "word": " بدون", "probability": 0.387939453125}, {"start": 2590.31, "end": 2590.77, "word": " مصطلحات،", "probability": 0.92578125}, {"start": 2590.77, "end": 2591.11, "word": " بالنسبة", "probability": 0.9915771484375}, {"start": 2591.11, "end": 2591.63, "word": " لأسكتك", "probability": 0.6776631673177084}, {"start": 2591.63, "end": 2592.09, "word": " iMovement", "probability": 0.690826416015625}, {"start": 2592.09, "end": 2592.21, "word": " أو", "probability": 0.81201171875}, {"start": 2592.21, "end": 2592.45, "word": " حتى", "probability": 0.943359375}, {"start": 2592.45, "end": 2592.81, "word": " password", "probability": 0.83740234375}, {"start": 2592.81, "end": 2594.11, "word": " iMovement؟", "probability": 0.784423828125}, {"start": 2594.11, "end": 2594.39, "word": " كمان", "probability": 0.5568440755208334}, {"start": 2594.39, "end": 2594.55, "word": " ال", "probability": 0.53173828125}, {"start": 2594.55, "end": 2594.75, "word": " layers", "probability": 0.708984375}, {"start": 2594.75, "end": 2594.93, "word": " in", "probability": 0.8564453125}, {"start": 2594.93, "end": 2595.25, "word": " relation", "probability": 0.98486328125}, {"start": 2595.25, "end": 2595.39, "word": " to", "probability": 0.98193359375}, {"start": 2595.39, "end": 2596.31, "word": " iMovement؟", "probability": 0.9240234375}, {"start": 2596.31, "end": 2596.41, "word": " في", "probability": 0.83203125}, {"start": 2596.41, "end": 2596.51, "word": " عن", "probability": 0.305908203125}, {"start": 2596.51, "end": 2596.63, "word": " أي", "probability": 0.9140625}, {"start": 2596.63, "end": 2597.35, "word": " سؤال؟", "probability": 0.931884765625}, {"start": 2597.35, "end": 2597.73, "word": " حاجة", "probability": 0.8468424479166666}, {"start": 2597.73, "end": 2598.09, "word": " تترى", "probability": 0.57049560546875}, {"start": 2598.09, "end": 2598.57, "word": " فوق؟", "probability": 0.7012532552083334}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 2605.07, "duration_after_vad": 2464.9974999999904}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwZ2K6wMRTZMEoGVTbELxinF/Aq2UrgroNE4.srt b/PL9fwy3NUQKwZ2K6wMRTZMEoGVTbELxinF/Aq2UrgroNE4.srt
new file mode 100644
index 0000000000000000000000000000000000000000..2d6298a5cfed3f504fd32ddfda444922a66a6f58
--- /dev/null
+++ b/PL9fwy3NUQKwZ2K6wMRTZMEoGVTbELxinF/Aq2UrgroNE4.srt
@@ -0,0 +1,2836 @@
+1
+00:00:20,540 --> 00:00:24,020
+طيب السلام عليكم ورحمة الله دي أفضل هنواصل اللي هو
+
+2
+00:00:24,020 --> 00:00:27,460
+راقب محاضرات physiology of the eye دي أفضل هنكمل 
+
+3
+00:00:27,460 --> 00:00:31,250
+على physiology of the cornea أو اللي هو وظائف القرنية
+
+4
+00:00:31,250 --> 00:00:34,790
+طب فيه عدة خصائص إحنا عارفين فيها إن في الصورة هذه
+
+5
+00:00:34,790 --> 00:00:38,410
+القرنية جزء الـ apparent لو تقريبا سدس العين من
+
+6
+00:00:38,410 --> 00:00:42,770
+بداية من الخارج هذا الجزء transparent شفاف طلع فيه
+
+7
+00:00:42,770 --> 00:00:48,230
+الجهة اليمنى هي القرنية تم تشريحها أو استخلاصها من 
+
+8
+00:00:48,230 --> 00:00:51,130
+كورة العين كلها ككل حيث القرنية تستخدم في زراعة
+
+9
+00:00:51,130 --> 00:00:55,730
+قرنية يعني أنت نقلت من شخص ربما مريض أو متوفي أو
+
+10
+00:00:55,730 --> 00:01:00,070
+العين عنده عمياء ثم يعني من الـ donors ثم تنقل إلى
+
+11
+00:01:00,070 --> 00:01:04,710
+اللي هو صاحب الشكوى هذه قرنية عبارة عن transparent 
+
+12
+00:01:04,710 --> 00:01:09,250
+تنقل ثم تزرع في العين الأخرى حتى يرى الإنسان بها
+
+13
+00:01:09,250 --> 00:01:14,030
+طيب فيه نعدد مواصفات للقرنية اللي هي عبارة عن
+
+14
+00:01:14,030 --> 00:01:17,230
+characteristics أو مزايا للقرنية هذه المزايا إحنا
+
+15
+00:01:17,230 --> 00:01:21,730
+بنعرفها مش كتيرة، الميزة الأولى تكون يا forms until
+
+16
+00:01:21,730 --> 00:01:26,150
+most one-sixth of the eyeball يتكون تقريبا سدس
+
+17
+00:01:26,150 --> 00:01:30,490
+الجزء الأمامي من كرة .. أو سدس الكرة العين كلها
+
+18
+00:01:30,490 --> 00:01:33,790
+ككل صحيح؟ و هذا السدس يقع وين؟ في المقدمة، اللي
+
+19
+00:01:33,790 --> 00:01:39,150
+هو الـ anterior surface رقم اثنين، it's clear، clear
+
+20
+00:01:39,150 --> 00:01:41,490
+معناته مش عنده ولا نوع من الـ opacity صحيح؟ بعض
+
+21
+00:01:41,490 --> 00:01:45,030
+حاجة جدا، بما أن الآخر هي transparent، شفافة،
+
+22
+00:01:45,030 --> 00:01:49,900
+صحيح؟ It's essentially colorless، مش معنى colorless،
+
+23
+00:01:49,900 --> 00:01:54,420
+يعني نفس المعنى، هي أيضا مرة أخرى عيش transparent،
+
+24
+00:01:54,420 --> 00:01:58,800
+الميزة رقم ثلاثة of vascular structure، عادية مهمة
+
+25
+00:01:58,800 --> 00:02:02,420
+جدا، اللي هو لا وجود الأوعية الدموية في هذا العضو،
+
+26
+00:02:02,420 --> 00:02:07,250
+اللي هو في القرنية، الميزة رقم أربعة richly
+
+27
+00:02:07,250 --> 00:02:09,330
+supplied with nerve endings، إحنا حكيناها
+
+28
+00:02:09,330 --> 00:02:11,970
+مرارا وتكرارا لما تكلمنا على reflex arc و corneal
+
+29
+00:02:11,970 --> 00:02:14,970
+reflex اللي أخذنا في الـ sulcus و اتعالجت، مزوداش 
+
+30
+00:02:14,970 --> 00:02:18,230
+كميات ضخمة من أو كميات هائلة من nerve endings
+
+31
+00:02:18,230 --> 00:02:22,620
+متوجهين في القرنية that are generally subject of
+
+32
+00:02:22,620 --> 00:02:24,780
+touch and pain طبعا وظيفة هذا الـ .. الـ nerve
+
+33
+00:02:24,780 --> 00:02:27,980
+endings وظيفة الأساسية اللي هي touch pain هناخد
+
+34
+00:02:27,980 --> 00:02:30,740
+إحنا فيه وبعد إن شاء الله فيه إنه كمان اللي هو الـ
+
+35
+00:02:30,740 --> 00:02:34,300
+cold أو الـ warm تعمل عليها شعور بالـ .. بالحرارة
+
+36
+00:02:34,300 --> 00:02:38,080
+سواء كان بارد أو كانت حارة، القلم فيه إنه أيضا
+
+37
+00:02:38,080 --> 00:02:42,500
+الإحساس، آخر شيء آخر ميزة عليا there are no lymph
+
+38
+00:02:42,500 --> 00:02:45,860
+vessels فش عندي أوعية لنفاوية لإنه either فش عندي
+
+39
+00:02:45,860 --> 00:02:49,580
+أوعية دموية صحيح، بالتالي حركة اللي هي البروتينات
+
+40
+00:02:49,580 --> 00:02:53,320
+فينهم الصلاحة اسمها bulk fluid flow اللي هو تدفق
+
+41
+00:02:53,320 --> 00:02:57,080
+البروتينات المقصود بتدفق البروتينات أو تدفق السائل
+
+42
+00:02:57,080 --> 00:03:00,080
+إن بالحالة الطبيعية في الأنسجة اللي متوجد فيها
+
+43
+00:03:00,080 --> 00:03:02,860
+أوعية دموية يتم تدفق البروتينات هذا من أوعية دموية
+
+44
+00:03:02,860 --> 00:03:06,300
+نفسها صحيح عبر نسيج بينما القرنية لأنها خالية من
+
+45
+00:03:06,300 --> 00:03:11,200
+أوعية دموية أو avascular فيتم تدفق هذه البروتينات
+
+46
+00:03:11,200 --> 00:03:14,460
+من وين؟ من أوعية الدموية المحيطة بالقرنية اللي إحنا
+
+47
+00:03:14,460 --> 00:03:17,940
+نسميها perilimbal أو limbal blood vessels صحيح؟
+
+48
+00:03:17,940 --> 00:03:20,760
+ومنها أيضا يتم نزع الأكسجين وبعض المواد الغذائية
+
+49
+00:03:20,760 --> 00:03:23,880
+لذلك مافيش هناك أي طريقة أخرى لا أوعية دموية ولا
+
+50
+00:03:23,880 --> 00:03:27,200
+حتى أوعية لنفاوية تعمل على نقل البروتينات فقط
+
+51
+00:03:27,200 --> 00:03:30,440
+في عنده اللي هو يتم نقل هذه البروتينات أو المواد
+
+52
+00:03:30,440 --> 00:03:34,200
+المغذية من اللي هو الـ .. الـ .. الـ blood vessels
+
+53
+00:03:34,200 --> 00:03:36,440
+اللي تحيط بالـ limbus اللي اسمها limbal blood
+
+54
+00:03:36,440 --> 00:03:39,400
+vessels اللي إحنا هناخدها بعد قليل إن شاء الله
+
+55
+00:03:47,460 --> 00:03:52,080
+الانتفاز بين كونيا الـ tear film و ال atmosphere
+
+56
+00:03:52,080 --> 00:03:57,000
+النارية يقدم حوالي 2 ثورة من قوة الهيومال أي نحن 
+
+57
+00:03:57,000 --> 00:03:59,920
+ربما تخدوا حتى في الـ refraction إنه قريب تقريبا ..
+
+58
+00:03:59,920 --> 00:04:03,360
+كم يساوي إن نعدلها من كل اللي هو refraction of the
+
+59
+00:04:03,360 --> 00:04:09,280
+eyeball؟ تقريبا كم؟ يعني ما يقارب ثلثان صح؟ هو
+
+60
+00:04:09,280 --> 00:04:11,420
+ثلثان الـ refraction of the normal eye صح؟ هذا اللي 
+
+61
+00:04:11,420 --> 00:04:15,980
+إحنا بنعيه، المقصود بـ atmosphere اللي هو غير
+
+62
+00:04:15,980 --> 00:04:19,060
+في جو المحيط أو الهواء المحيط بالقرنية أو المحيط
+
+63
+00:04:19,060 --> 00:04:23,620
+بنا دا كون يفسر بالـ existence و هذه أيضا أحد
+
+64
+00:04:23,620 --> 00:04:26,520
+الخصائص القرنية بالـ existence إيش معناه أو
+
+65
+00:04:26,520 --> 00:04:33,400
+resilient مع إنها قابلة للتمدد أو المضي يعني زي ما
+
+66
+00:04:33,400 --> 00:04:35,580
+تكلمنا أحد الخصائص اللي كنت جاي بتعرف إنه عيش
+
+67
+00:04:36,700 --> 00:04:40,200
+elastic صحيح مرنة و هذه شريط المرونة أيضا لكن طبعا
+
+68
+00:04:40,200 --> 00:04:42,960
+مرونتها أقل بكثير من الكنجة بتاعتها لأنها thick 
+
+69
+00:04:42,960 --> 00:04:47,140
+بينما الكنجة بتاعتها بتعتبر very thin and maybe
+
+70
+00:04:47,140 --> 00:04:50,020
+described as viscoelastic in its response to
+
+71
+00:04:50,020 --> 00:04:53,320
+stretching forces viscoelastic معناها مرن soft
+
+72
+00:04:53,320 --> 00:04:57,320
+يعني soft أو marine بالنسبة لإيش، يعني عندما يتم
+
+73
+00:04:57,320 --> 00:05:02,120
+جذبها أو شدها أو تتابع لقوة تعمل على جذبها إيطالي
+
+74
+00:05:02,120 --> 00:05:06,000
+إيش، تساعد فيه اللي هو الـ softness، ثم عند تركها
+
+75
+00:05:06,000 --> 00:05:09,200
+ترتد من الأخرى، يعني فيه هنا بشكل مختصر اسم الـ
+
+76
+00:05:09,200 --> 00:05:13,730
+elastic، marine أو ليناهذا أيضا أحد خصائصها the
+
+77
+00:05:13,730 --> 00:05:16,390
+size, shape and optical properties of the cornea
+
+78
+00:05:16,390 --> 00:05:19,630
+change little with age وهذا التغيير يعتبر تغيير
+
+79
+00:05:19,630 --> 00:05:24,970
+طبيعي تابع لعملية الـ aging process يتغير سواء كان
+
+80
+00:05:24,970 --> 00:05:28,230
+بالـ diffraction أو بالـ thickness لأن كل ما زاد
+
+81
+00:05:28,230 --> 00:05:31,950
+العمر كل ما قل الـ stroma كلها هي الـ thickness ويتغير
+
+82
+00:05:31,950 --> 00:05:36,730
+أيضا بالـ shape optical properties هيتغير لأنه مدى
+
+83
+00:05:36,730 --> 00:05:41,160
+ما حدث عندي تغير على اللي هو القرنية نفسها على 
+
+84
+00:05:41,160 --> 00:05:43,960
+الـ stroma نفسها اللي بدي حصل عندي اللي هو optical
+
+85
+00:05:43,960 --> 00:05:48,280
+properties بتصير فيه انخفاض decrease طيب due to
+
+86
+00:05:48,280 --> 00:05:50,400
+the adversarial nature of the cornea much of its
+
+87
+00:05:50,400 --> 00:05:52,580
+oxygen requirement for metabolic activities comes
+
+88
+00:05:52,580 --> 00:05:55,260
+from atmospheric oxygen dissolved in the tear film
+
+89
+00:05:55,260 --> 00:05:58,200
+فأنتوا ذاكرين حكينا من وظائف
+
+90
+00:06:00,810 --> 00:06:03,390
+عندنا طبقات الـ tear film في المكان طبقة، إحنا حكينا
+
+91
+00:06:03,390 --> 00:06:07,270
+عنها، أكثر طبقة خارجية الـ outer most layer اللي
+
+92
+00:06:07,270 --> 00:06:09,470
+بدها، لحد اللي بدها ليا بقى إيش بتساعد إيش، إحدى 
+
+93
+00:06:09,470 --> 00:06:13,850
+وظائفها، حكينا عنها إحنا بشكل مختصر، طب الأكسجين
+
+94
+00:06:13,850 --> 00:06:22,790
+يعمل
+
+95
+00:06:22,790 --> 00:06:25,470
+على غلاف الخارج الصحيح من الهواء ثم يعمل على
+
+96
+00:06:25,470 --> 00:06:27,970
+تنبيهه وين؟ على القرنية لأن القرنية أصلا هي
+
+97
+00:06:27,970 --> 00:06:31,650
+avascular، avascular يعني مافيش عندها أي أكسجين،
+
+98
+00:06:31,650 --> 00:06:35,210
+تحصل على أكسجين من وين؟ أولا تحصل من الهواء صحيح؟
+
+99
+00:06:35,210 --> 00:06:40,060
+المحيط، بكرة العين أو المحيط بها بالقرنية اللي نيده
+
+100
+00:06:40,060 --> 00:06:42,240
+في الـ tear film فأي طبقة في الـ tear film اللي هو
+
+101
+00:06:42,240 --> 00:06:45,680
+outermost اللي حكينا عنها قبل قليل صحيح، ثم بعد ذلك
+
+102
+00:06:45,680 --> 00:06:50,040
+يمر عبرها اللي هو الـ epithelium اللي يصل إلى طبقات
+
+103
+00:06:50,040 --> 00:06:52,900
+القرنية
+
+104
+00:06:53,320 --> 00:06:57,200
+طيب هذه الحالة طبعا بالإنسان يكون في وقت النوم أو
+
+105
+00:06:57,200 --> 00:07:00,760
+عندما يغلق الجفن الحالة خلاص أنت قاعد مافيش Oxygen طب
+
+106
+00:07:00,760 --> 00:07:03,040
+الإنسان يعمل عدد النوم تقريبا 6-8 ساعات يوميا
+
+107
+00:07:03,040 --> 00:07:06,580
+صحيح؟ أنا في هنا 6-8 ساعات يا خاطر أقعد معايا عن
+
+108
+00:07:06,580 --> 00:07:09,380
+الـ Oxygen أستحقش إن أقعد وأتحمل صحيح؟ لأن حتى
+
+109
+00:07:09,380 --> 00:07:12,080
+أثناء النوم عملية الـ metabolism اللي الـ catabolism و
+
+110
+00:07:12,080 --> 00:07:16,050
+الـ anabolism في حدوث مستمر، لا تنقطع، صحيح؟ إذا
+
+111
+00:07:16,050 --> 00:07:20,870
+مقارنة تحصل القرنية على الـ oxygen وقت النوم، هذه
+
+112
+00:07:20,870 --> 00:07:23,390
+واحدة من الـ aqueous humor صحيح؟ اللي هو داخل
+
+113
+00:07:23,390 --> 00:07:29,210
+العين، ثاني حاجة، اللي هو عيال دموية تتوحيد بالـ
+
+114
+00:07:29,210 --> 00:07:32,930
+limbus، صحيح؟ هذه مقمتينة، طبعا باللسان يكون الـ
+
+115
+00:07:32,930 --> 00:07:35,150
+eyes open، تحصل عليها من أين؟ من الـ atmosphere،
+
+116
+00:07:35,150 --> 00:07:38,540
+هذه اللغة اللي بيه العظمى من نسبة الـ oxygen when
+
+117
+00:07:38,540 --> 00:07:41,100
+the eyelids are closed, oxygen enters the tear film
+
+118
+00:07:41,100 --> 00:07:43,740
+from the superficial conjunctival capillaries فيه
+
+119
+00:07:43,740 --> 00:07:48,700
+إنه كمان مصطلح آخر غير المصطلح اللي حاكيناها الـ
+
+120
+00:07:48,700 --> 00:07:51,860
+aqueous humor, perilimbal blood vessels فيه إن
+
+121
+00:07:51,860 --> 00:07:55,180
+الـ atmosphere فيه إنه الـ superficial conjunctival
+
+122
+00:07:55,180 --> 00:07:58,280
+capillaries اللي هو عبارة عن أوعية دموية اللي هي
+
+123
+00:07:58,280 --> 00:08:03,520
+السطحية تم عملها أيضا بتزود القرنية بالأكسجين
+
+124
+00:08:03,520 --> 00:08:06,260
+nutrients اللي هي المواد الغذائية مقصود بالـ
+
+125
+00:08:06,260 --> 00:08:09,290
+nutrients هي كل المواد الغذائية بما فيها الـ glucose و
+
+126
+00:08:09,290 --> 00:08:11,430
+الدهون و الـ proteins و الـ amino acids و حمض
+
+127
+00:08:11,430 --> 00:08:15,110
+الاميني إلى خير هي مواد أخرى عادة تم الحصول عليها
+
+128
+00:08:15,110 --> 00:08:19,630
+من خلال الـ avascular arcades هجريت تحط تحتها خط
+
+129
+00:08:19,630 --> 00:08:24,050
+avascular arcades المقصود بالـ avascular arcades هي
+
+130
+00:08:24,050 --> 00:08:30,740
+أبراج ناشر قطب تشريه همته avascular arcades مش
+
+131
+00:08:30,740 --> 00:08:33,700
+واحدة عن كده، قوس صحيح؟ يعني هي أبدا الأوعية
+
+132
+00:08:33,700 --> 00:08:36,280
+الدموية اللي تحيط بالـ .. بس مش الحاجة أو تحيط
+
+133
+00:08:36,280 --> 00:08:39,380
+بالقرنية، لأن القرنية هي أبدا a vascular organ،
+
+134
+00:08:39,380 --> 00:08:42,000
+مافيش فيها صحيح؟ بتاني هيتم نقل زي ما حد قال حتة و
+
+135
+00:08:42,000 --> 00:08:45,040
+قبل شوية، هيتم نقل كل الأوعية .. كل المواد
+
+136
+00:08:45,040 --> 00:08:47,180
+الغذائية، بينما فيها البروتينات والفيتامينات
+
+137
+00:08:47,180 --> 00:08:51,480
+والكربوهيدرات الآخرين، وأيضا بعض من الـ oxygen كله
+
+138
+00:08:51,480 --> 00:08:53,540
+عبر عيش هذه الأوعية الدموية
+
+139
+00:09:00,540 --> 00:09:03,740
+أيضا يتم عبورها من خلال الـ endothelial cells by
+
+140
+00:09:03,740 --> 00:09:06,500
+diffusion أو active transport تماما زي ما حكينا
+
+141
+00:09:06,500 --> 00:09:11,400
+على يعتبر الـ aqueous مصدر مصادر الأكسجين للقرنية أيضا
+
+142
+00:09:11,400 --> 00:09:16,160
+يعتبر مصدر المصادر تغذية أو الموارد الغذائية من في
+
+143
+00:09:16,160 --> 00:09:19,480
+الـ aqueous humor إلى اللي هو القرنية حاجة أيضا 
+
+144
+00:09:19,480 --> 00:09:23,200
+مهمة جدا حاجة إحنا عارفينها باستخدام بوسطة diffusion
+
+145
+00:09:23,200 --> 00:09:25,180
+اللي هو الـ simple diffusion اللي هو لا يحتاج الـ
+
+146
+00:09:25,180 --> 00:09:28,420
+energy صحيح send to the cornea أو بوسطة الـ active
+
+147
+00:09:28,420 --> 00:09:31,380
+transport اللي هو يحتاج الـ energy صحيح، الـ
+
+148
+00:09:31,380 --> 00:09:34,940
+diffusion هو مجرد فقط انتشار بسيط من الـ aqueous
+
+149
+00:09:34,940 --> 00:09:39,620
+humor عبر مسامات الموجودة أو البصور الموجودة ما بين
+
+150
+00:09:39,620 --> 00:09:44,640
+الـ endothelial cells إلى الـ stroma أو القرنية أو أما
+
+151
+00:09:44,640 --> 00:09:48,760
+عبر الـ active transport عبر ممرات معينة بتحدد
+
+152
+00:09:48,760 --> 00:09:52,940
+جزيئات معينة طبعا ده تحكم جزء معين تنتقل من الـ
+
+153
+00:09:52,940 --> 00:10:00,080
+aqueous إلى القرنية حتى تعمل على تغذيتها، بعض
+
+154
+00:10:00,080 --> 00:10:03,400
+المركبات مثل Oxygen و Retinal، Retinal المقصود
+
+155
+00:10:03,400 --> 00:10:06,860
+فيها Vitamin A، إحدى مشتقات Vitamin A، مش علاقة 
+
+156
+00:10:06,860 --> 00:10:10,880
+بالشبكية، مش الحاجة، هذا المصطلح مش علاقة بالشبكية
+
+157
+00:10:10,880 --> 00:10:14,860
+Retinal المقصود فيها إنه إحدى مشتقات الشبكية، are
+
+158
+00:10:14,860 --> 00:10:19,640
+found in the tear film and provide nutrition to
+
+159
+00:10:19,640 --> 00:10:22,460
+the cornea، هذا إحنا سابق وحكيناها قبلها، موجود
+
+160
+00:10:22,460 --> 00:10:25,720
+أيضا في الـ tear film طبعا اللي يعتبر مصدر أساسي،
+
+161
+00:10:25,720 --> 00:10:31,780
+رئيسي، بذات أثناء النهار اللي هو توصيل أو اكتفاء
+
+162
+00:10:31,780 --> 00:10:36,380
+القرنية من احتياجها بالـ .. اللي هو الـ oxygen طيب،
+
+163
+00:10:36,380 --> 00:10:40,020
+فينا لما نبحث اتكلمنا على إيش الفرق بين catabolism
+
+164
+00:10:40,020 --> 00:10:41,360
+و anabolism قبل ما نكمل؟
+
+165
+00:10:44,290 --> 00:10:46,950
+معنى فيهم الهدم catabolism ولا anabolism؟ الـ
+
+166
+00:10:46,950 --> 00:10:51,110
+catabolism هي الهدم بينما الـ anabolism طيب بصول كل
+
+167
+00:10:51,110 --> 00:10:53,710
+المواد الغذائية عادية بما فيها الـ oxygen و الـ
+
+168
+00:10:53,710 --> 00:10:56,370
+carbohydrates و الـ vitamins و الـ amino acids كلها
+
+169
+00:10:56,370 --> 00:11:00,290
+اللي حاكينا عنها سواء كان إحدى مصادرها كان من الـ
+
+170
+00:11:00,290 --> 00:11:02,370
+aqueous humor أو كان حتى من الـ superficial
+
+171
+00:11:02,370 --> 00:11:04,930
+capillaries of the conjunctiva أو كان الـ oxygen من
+
+172
+00:11:04,930 --> 00:11:09,030
+الـ atmosphere الآخر هنا، هذا كله اللي حدث عملتهاشال
+
+173
+00:11:09,030 --> 00:11:12,310
+anabolism صحيح؟ طيب حدثت عند الـ anabolism تم تجديد
+
+174
+00:11:12,310 --> 00:11:14,810
+الخلايا الأخرى، الآن عملية الـ catabolism بيبقى
+
+175
+00:11:14,810 --> 00:11:17,750
+فيها اللي هو التخلص من هذه الخلايا أو التخلص من
+
+176
+00:11:17,750 --> 00:11:21,390
+بقايا عملية اللي هو الـ anabolism، وين بدها تروح؟
+
+177
+00:11:25,110 --> 00:11:28,830
+و بتساعد عليها لكن بشكل أساسي طبعا بيبقى فيها
+
+178
+00:11:28,830 --> 00:11:30,830
+الأكسجين مدى .. عفوا بيبقى فيها الـ carbon ..
+
+179
+00:11:30,830 --> 0
+
+216
+00:13:49,320 --> 00:13:54,020
+من القمع بينما من الخلف تبدو دائرية هنتكلم
+
+217
+00:13:54,020 --> 00:13:57,920
+على اللي هو الاختلاع في الموجود حالة فيه أن بعض
+
+218
+00:13:57,920 --> 00:14:00,300
+الأبعاد أو بعض الmeasurements القياصات هذه اللي
+
+219
+00:14:00,300 --> 00:14:02,840
+احنا لازم نعرفها لأن احنا مطالبين فيها the
+
+220
+00:14:02,840 --> 00:14:05,800
+greatest measurement is horizontal هي يعني
+
+221
+00:14:05,800 --> 00:14:09,060
+elliptical أو بيضاوية لأن دائما ال horizontal
+
+222
+00:14:09,060 --> 00:14:13,020
+ميريديان أطول من ال vertical ميريديان صحيح؟ طب أبعاد ال
+
+223
+00:14:13,020 --> 00:14:17,540
+horizontal ميريديان تقريبا كده؟ هو 11.7% يعني أنا
+
+224
+00:14:17,540 --> 00:14:23,420
+آخذها ك average number بينما في عندك من 11 ل 12.5
+
+225
+00:14:23,420 --> 00:14:26,720
+ملي متر هذا احنا نعرفه هذا بالنسبة لمجرمية ال
+
+226
+00:14:26,720 --> 00:14:30,960
+meridian الهريزونتال وvertical meridians تقريبا 10
+
+227
+00:14:30,960 --> 00:14:35,080
+.5 أيضاً هذا اعتبر ال average بينما ال limit اللي
+
+228
+00:14:35,080 --> 00:14:38,000
+موجودة عندنا هي عشرة إلى أحد عشر ونص تقريبا في عند
+
+229
+00:14:38,000 --> 00:14:40,480
+واحد ملي متر فرق ما بين ال vertical و ال
+
+230
+00:14:40,480 --> 00:14:43,500
+horizontal صحيح؟ يعني لو شخص معين وجدناها هي فعلاً
+
+231
+00:14:43,500 --> 00:14:45,620
+أحد عشر من ال horizontal هنلاقي ال vertical يعني
+
+232
+00:14:45,620 --> 00:14:49,280
+فقط عشرة وواحدة كده هنلاقي أن الفرق دائماً هو واحد
+
+233
+00:14:49,280 --> 00:14:54,500
+ملي متر لكن عندما ننظر إليها من جهة الخلفية يعني
+
+234
+00:14:54,500 --> 00:14:58,100
+تم this section أو تم اللي هو نزع القرنية من عين..
+
+235
+00:14:58,100 --> 00:15:02,880
+كرة.. عين معينة.. من كرة معينة.. من عين معينة
+
+236
+00:15:02,880 --> 00:15:06,480
+عفر ثم نضلها إلى هنا من الأمام مش لأنها تبدو
+
+237
+00:15:06,480 --> 00:15:11,380
+elliptical بينما من الخلف تبدو دائرية ذلك لأن
+
+238
+00:15:11,380 --> 00:15:14,520
+تبدو ال vertical meridian مع ال horizontal
+
+239
+00:15:14,520 --> 00:15:17,440
+meridian مش بدو يتساوى.. تبدو بدو يصبح تقريبا
+
+240
+00:15:20,410 --> 00:15:24,370
+عشرة هذه لأحد عشر وسبعة من عشرة ال vertical قولها
+
+241
+00:15:24,370 --> 00:15:28,250
+ايش ال horizontal لذلك from بصية surface تبدو
+
+242
+00:15:28,250 --> 00:15:33,770
+round في أنها quite round يعني دائرية تماماً القليل
+
+243
+00:15:33,770 --> 00:15:38,810
+من الخلف تبدو أيش دائرية تماماً طيب the radius of
+
+244
+00:15:38,810 --> 00:15:43,110
+curvature هي نحط خط تحت radius of curvature مش
+
+245
+00:15:43,110 --> 00:15:48,890
+معناها قطر التحدب بقى واش
+
+246
+00:15:52,000 --> 00:15:57,640
+نصف قطر التحدب هو اللي هنا نصف
+
+247
+00:15:57,640 --> 00:16:02,000
+قطر التحدب for the anterior conial surface تقريباً
+
+248
+00:16:02,000 --> 00:16:06,420
+سبعة وثمانية مليمتر نصف قطر التحدب for the
+
+249
+00:16:06,420 --> 00:16:07,480
+anterior conial surface تقريباً سبعة وثمانية
+
+250
+00:16:07,480 --> 00:16:10,320
+مليمتر نصف قطر التحدب for the anterior conial
+
+251
+00:16:10,320 --> 00:16:14,540
+surface تقريباً سبعة وثمانية مليمتر نصف قطر التحدب
+
+252
+00:16:14,540 --> 00:16:15,740
+ثمانية مليمتر نصف قطر التحدب for the anterior
+
+253
+00:16:15,740 --> 00:16:17,540
+conial surface تقريباً سبعة وثمانية مليمتر نصف قطر
+
+254
+00:16:17,540 --> 00:16:17,720
+التحدب for the anterior conial surface تقريباً سبعة
+
+255
+00:16:17,720 --> 00:16:18,740
+وثمانية مليمتر نصف قطر التحدب for the anterior
+
+256
+00:16:18,740 --> 00:16:21,350
+conial surface تقريباً سبعة وثمانية هذا ال range
+
+257
+00:16:21,350 --> 00:16:26,650
+عندك بس نتذكر ال ratio كثير مرة أخرى على الشيء ال
+
+258
+00:16:26,650 --> 00:16:34,190
+range هنا كده إيش؟ 6 أبوين 8 إلى 7 أبوين 8 إلى 7
+
+259
+00:16:34,190 --> 00:16:35,150
+أبوين 8 أبوين 8 أبوين 8 أبوين 8 أبوين 8 أبوين 8
+
+260
+00:16:35,150 --> 00:16:38,270
+أبوين 8 أبوين 8 أبوين 8 أبوين 8 أبوين 8 أبوين 8
+
+261
+00:16:38,270 --> 00:16:38,590
+أبوين 8 أبوين 8 أبوين 8 أبوين
+
+262
+00:16:49,170 --> 00:16:53,270
+ما هي هذه أخذتها؟ فالrefraction المفروض أخذتها، هذه
+
+263
+00:16:53,270 --> 00:16:56,230
+أساسية ال refraction، planet المعلنة، planet
+
+264
+00:16:56,230 --> 00:16:57,150
+الrefraction المعلنة
+
+265
+00:17:00,560 --> 00:17:03,920
+which is somewhat shorter إذا.. طيب لو حسبنا اللي
+
+266
+00:17:03,920 --> 00:17:07,200
+هو ال anterior تقريباً هيطلع جداش سبعة ثمانية ملي
+
+267
+00:17:07,200 --> 00:17:12,760
+متر وهذا كله بدي.. بدي يكون أقل من أيش؟ من نصف قطر
+
+268
+00:17:12,760 --> 00:17:17,600
+التحدب بالعين كلها اللي هو بالك جداش تقريباً، ده أيش
+
+269
+00:17:17,600 --> 00:17:20,800
+و نص، طبعاً هذه القياصات كلها رفلة يعني ما نتطقعش
+
+270
+00:17:20,800 --> 00:17:24,320
+على شخص معين، لا يعني بشكل عامي تقريباً بشكل هذا،
+
+271
+00:17:24,320 --> 00:17:28,690
+أصبح فيه end وكأنه مش فيه end كورتين صحيح كورتين
+
+272
+00:17:28,690 --> 00:17:34,430
+هتكون متحدين مع بعض بالشكل هذا ال range هذا بنعرفه
+
+273
+00:17:34,430 --> 00:17:39,650
+أصبح فيه أن احنا هاي طبعاً بالشكل هذا هي ال optic
+
+274
+00:17:39,650 --> 00:17:43,830
+nerve صحيح أصبح فيه اندي كورة ليه هذه الكورة أصبح
+
+275
+00:17:43,830 --> 00:17:46,430
+فيه اندي كورة ليه كرة تبدو ال sclera صحيح أنهم
+
+276
+00:17:46,430 --> 00:17:50,550
+أكثر تحدبها هذا اللي هان احنا هانسميه anterior أو
+
+277
+00:17:50,550 --> 00:17:54,410
+الواحد أو هذا اللي هان احنا هانسميه exterior الواحد
+
+278
+00:17:54,410 --> 00:17:59,350
+أنهم أكثر تحدبهم ايه يا ابني أنا أحكي ايه؟ ليش؟ هو
+
+279
+00:17:59,350 --> 00:18:04,450
+اللي أكثر تحدب هو اللي هو مش متر أو أكثر تحدي اللي
+
+280
+00:18:04,450 --> 00:18:06,930
+هو هذا ال risk اللي هو صحيح؟ هذا أفضل تحدب اللي
+
+281
+00:18:06,930 --> 00:18:09,870
+بقي هنا معاك؟ هذا أقل تحدب؟ أيش بده يعني لي هذا؟
+
+282
+00:18:09,870 --> 00:18:15,090
+ايش بتخطيني؟ أيش بده تخطيني أنت البعض؟ لما ده فيه
+
+283
+00:18:15,090 --> 00:18:18,750
+عنده كورتين كلهم بتحدب مختلف معاك فيه عنده growth
+
+284
+00:18:18,750 --> 00:18:22,190
+فيه عنده خدود صح؟ هذه تحدب مختلفة وهذه تحدب
+
+285
+00:18:22,190 --> 00:18:24,850
+مختلفة معاك ومش هيك تقعد نفس النقطة، مستحيل، اللي
+
+286
+00:18:24,850 --> 00:18:28,140
+يكون فيه عندك، ما كنت عايش الواحدة القاصدة منها اللي
+
+287
+00:18:28,140 --> 00:18:32,220
+واحد يسميها هذا المقطع إيش يسميها؟ اللي هي ال
+
+288
+00:18:32,220 --> 00:18:36,560
+limbus، هذا ال sulcus أو ال limbus هي عبارة عن أيش
+
+289
+00:18:36,560 --> 00:18:39,760
+مقدرتك تقرأ تحدب كرة العين ومقدرتك تقرأ تحدب
+
+290
+00:18:39,760 --> 00:18:44,260
+باش اللي هو القرنية،
+
+291
+00:18:44,260 --> 00:18:46,800
+طيب جالسة هذه المقطع أيضاً نحط تحتها خط نعرفها
+
+292
+00:18:46,800 --> 00:18:50,740
+which is somewhat shorter than the radius of
+
+293
+00:18:50,740 --> 00:18:53,120
+curvature of the eyeball طبعاً هنا بالنسبة للـ
+
+294
+00:18:53,120 --> 00:18:55,800
+anterior surface تقريباً سبعة وثمانية وعشرة صحيح
+
+295
+00:18:55,800 --> 00:19:00,940
+هيكون أقل شيء بسيط من اللي هو تحدب أو نصف قطر التحدب
+
+296
+00:19:00,940 --> 00:19:05,980
+اللي هو كرة العين كل حاجة كل طيب
+
+297
+00:19:05,980 --> 00:19:11,440
+this results in a small groove where the shorter
+
+298
+00:19:11,440 --> 00:19:15,400
+radius of curvature of the cornea meets that of
+
+299
+00:19:15,400 --> 00:19:19,990
+the larger curvature of the sclera صحيح يكون الأكبر
+
+300
+00:19:19,990 --> 00:19:23,790
+larger بينما لا يكون الأصغر الالتقاء الأصغر مع
+
+301
+00:19:23,790 --> 00:19:25,750
+الأكبر أو الأكبر مع الأصغر في ال radius وفي
+
+302
+00:19:25,750 --> 00:19:29,430
+الcurvature بده يخلق ال groove مهم مكتوب مع اقوهن
+
+303
+00:19:29,430 --> 00:19:34,530
+groove اللي هم عنقاش خدود صحية؟ اللي عبارة عن منطقة
+
+304
+00:19:34,530 --> 00:19:38,150
+التقاء أو هو ال limb بس بشكل عام هذا الخدود أو ال
+
+305
+00:19:38,150 --> 00:19:42,680
+sulcus هذا موجود معه كلمة أخرى هذه هي كلمة هذه نضع
+
+306
+00:19:42,680 --> 00:19:45,780
+تحتها خط سلكة في سلاتي أو ال groove نحنا علمياً
+
+307
+00:19:45,780 --> 00:19:48,680
+نسميها اللي هو ال limbus صحيح؟ وهذا ال limbus
+
+308
+00:19:48,680 --> 00:19:53,700
+يعتبر علامة مهمة جداً جداً جداً سواء كان تحديد
+
+309
+00:19:53,700 --> 00:19:56,760
+foreign body مثلاً أجعل على العين، نحدده، نحكي away
+
+310
+00:19:56,760 --> 00:19:59,260
+from the limbus a few millimeters صحيح؟ away from
+
+311
+00:19:59,260 --> 00:20:01,720
+the limbus a few millimeters أو عند إجراء عملية
+
+312
+00:20:01,720 --> 00:20:05,520
+معينة، احنا ممكن ندخل حتى مثلاً إجراء عملية مياه
+
+313
+00:20:05,520 --> 00:20:08,440
+البيضاء إلى آخره، صحيح؟ بالشكل هذا ندخل تقريباً
+
+314
+00:20:08,440 --> 00:20:11,900
+اثنين من اللي بتبقى خلف ال limbus إذا أصبحت عند ال
+
+315
+00:20:11,900 --> 00:20:16,760
+limbus نقرأ عن geographic landmark صحيح نضع تحت
+
+316
+00:20:16,760 --> 00:20:19,980
+هذه الجملة خط constant geographic reference أيش
+
+317
+00:20:19,980 --> 00:20:24,500
+معناها معلمة جغرافية ثابتة يعني أصبح في عندي
+
+318
+00:20:24,500 --> 00:20:27,180
+landmark هذه ال landmark ثابتة ما بتتغيرش على أساس
+
+319
+00:20:27,180 --> 00:20:30,920
+أني بدي أعمل إجراءاتي سواء كان إجراءات فحص معين أو
+
+320
+00:20:30,920 --> 00:20:34,760
+إجراءات جراحية للآخر أو أني مثلاً بدي أوصف شيء معين
+
+321
+00:20:34,760 --> 00:20:38,360
+سواء كان.. سواء كان tumor أو كان foreign body بدي
+
+322
+00:20:38,360 --> 00:20:41,360
+أوصف مسافته أو المساحة أو المسافة اللي بتبعد بينه
+
+323
+00:20:41,360 --> 00:20:44,540
+وما بين ال limbus بالضبط تحديده، بتعتبر هذه اللي
+
+324
+00:20:44,540 --> 00:20:47,180
+هو ال limbus أو السلكس اللي هنتكلمنا عنه اللي ناتج
+
+325
+00:20:47,180 --> 00:20:50,240
+عن اختلاف تحت دُب اللي هو ال antireceptive
+
+326
+00:20:50,240 --> 00:20:52,800
+subdaconia واللي هو ال..
+
+327
+00:20:57,050 --> 00:21:01,470
+radius of curvature of the eyeball هذا ال groove
+
+328
+00:21:01,470 --> 00:21:05,070
+يتكون ل landmark احنا بنسميها ال sun castle و
+
+329
+00:21:05,070 --> 00:21:06,150
+بنسميها ال lamp post
+
+330
+00:21:13,170 --> 00:21:16,310
+طيب the limbus is definitely not make a landmark
+
+331
+00:21:16,310 --> 00:21:20,510
+بنى عبارة عن علامة تشريحية مهمة for planning
+
+332
+00:21:20,510 --> 00:21:24,790
+surgical entry اللي هو حتى تتم التخطيط لايش..
+
+333
+00:21:24,790 --> 00:21:27,650
+لإجراء عملية للدخول داخل العين، سواء كان إلى
+
+334
+00:21:27,650 --> 00:21:30,750
+الشبكية أو كان إلى الغرفة الأمامية، طبعاً بدي حد
+
+335
+00:21:30,750 --> 00:21:33,830
+أنا بالmillimeters جديش حتى أيش أكون قادر على أدخل
+
+336
+00:21:33,830 --> 00:21:37,500
+داخل العين، سبب رأي ذلك حتى يعني لو عملت واحد اللي
+
+337
+00:21:37,500 --> 00:21:40,360
+مفهوم اللي بقى معا شر اصيب ال zonules أو اصيب اللي
+
+338
+00:21:40,360 --> 00:21:43,420
+اللي هو ال lens بشكل مباشر بينما لو عملت اثنين لا
+
+339
+00:21:43,420 --> 00:21:46,800
+هذه المنطقة اشتت بدقة منها ولا كده يعني بشكل
+
+340
+00:21:46,800 --> 00:21:50,520
+مختصر احنا اخذنا ال lens بس ك landmark أو ك network
+
+341
+00:21:50,520 --> 00:21:58,150
+landmark لتحديد ايه هو ال هو neoplasm أو tumor معين
+
+342
+00:21:58,150 --> 00:22:01,650
+أو foreign body معين صحيح أو تحديد دخولنا إلى داخل
+
+343
+00:22:01,650 --> 00:22:04,450
+العين أثناء إجراء العملية بدنا مسافة لوسها فهذه
+
+344
+00:22:04,450 --> 00:22:07,890
+الشيء المحيط اللي ممكن نصفها اللي هو بدنا مرجعية
+
+345
+00:22:07,890 --> 00:22:11,150
+ثابتة جغرافية على كرة العين اللي هي أيش ال limbus
+
+346
+00:22:11,150 --> 00:22:16,930
+فهذا ال limbus مهم جداً ده
+
+347
+00:22:16,930 --> 00:22:19,730
+قرنية السموات thinner in the center ممكنش تقريباً
+
+348
+00:22:19,730 --> 00:22:22,530
+thickness of ده قرنية تحكي أحلى في محاطة ال
+
+349
+00:22:22,530 --> 00:22:22,910
+instrument
+
+350
+00:22:25,930 --> 00:22:31,870
+thickness of the cornea في ال center 490
+
+351
+00:22:31,870 --> 00:22:39,850
+micro إلى 560 micro بينما في ال periphery 0.7 إلى
+
+352
+00:22:39,850 --> 00:22:44,630
+0.9 millimeter نحن اخذناها قياس رفلي بشكل يعني
+
+353
+00:22:44,630 --> 00:22:49,810
+مختصر هذا مش معانا في السيولوجيا بس نعرف أنه بال
+
+354
+00:22:49,810 --> 00:22:53,330
+center دائماً هي ثخينة ده ال periphery
+
+355
+00:22:58,450 --> 00:23:02,410
+طيب هذه الصورة التشريحية لتكوين طبقات اللي هو اللام
+
+356
+00:23:02,410 --> 00:23:06,490
+اللي أقرى تكونيه طبقات اللي هو القرنية وال
+
+357
+00:23:06,490 --> 00:23:12,150
+fibrils اللي هو الألياف
+
+358
+00:23:12,150 --> 00:23:14,550
+اللي بتكون منها قرنية هذا هناخده فيه مبعثر إن شاء
+
+359
+00:23:14,550 --> 00:23:19,030
+الله لكن طبعاً في أن التقاء اللي انبسط طلع اللي
+
+360
+00:23:19,030 --> 00:23:22,010
+احنا حكينا فيه مسبقاً يعني صعب جداً تحديد هذه الألياف
+
+361
+00:23:22,010 --> 00:23:25,030
+هل هي تابعة إلى ال sclera أم هي تابعة إلى القرنية
+
+362
+00:23:25,030 --> 00:23:28,750
+التشابك اللي يحدث هنا تشابك يعني عميق جداً حتى
+
+363
+00:23:28,750 --> 00:23:33,290
+تشابك المنطقة الالتقاء هذه الألياف بشكل معقد تسمى
+
+364
+00:23:33,290 --> 00:23:35,830
+ال limbus بينما هنا في القرنية اللي أطلعوا بسيطة
+
+365
+00:23:35,830 --> 00:23:38,390
+جداً وفي مسافة تحكم بهم هنا بينما في ال sclera
+
+366
+00:23:38,390 --> 00:23:41,990
+اللي الها non transparent فعلي شديدة الداخل مع
+
+367
+00:23:41,990 --> 00:23:42,670
+بعضها البعض
+
+368
+00:23:47,490 --> 00:23:50,350
+طيب the center of four millimeters of the cornea
+
+369
+00:23:50,350 --> 00:23:53,110
+overlying the pupil is the optical center احنا
+
+370
+00:23:53,110 --> 00:23:56,130
+حكينا عن ايه تقريباً أربعة إلى خمسة ملي متر صحيح لكن
+
+371
+00:23:56,130 --> 00:24:01,010
+ايش المنطقة المركزية الأربعة ملي متر مباشرة تأتي أيش
+
+372
+00:24:01,010 --> 00:24:04,570
+أو تغطي وتأتي فوق اللي هو ال pupil صحيح اللي هو
+
+373
+00:24:04,570 --> 00:24:08,610
+أصلًا ال optical center أو اللي يمر من عبر ال
+
+374
+00:24:08,610 --> 00:24:12,870
+visual axis صحيح أكثر منطقة مهمة اللي هو الرؤية it
+
+375
+00:24:12,870 --> 00:24:16,530
+has a regular surface and structure and is near
+
+376
+00:24:17,750 --> 00:24:23,310
+exact in the spherical configuration لما درسنا ال
+
+377
+00:24:23,310 --> 00:24:25,290
+center of cornea thickness حكينا المنطقة هذه
+
+378
+00:24:25,290 --> 00:24:28,970
+خصصناها لأن تقريباً ال thickness فيها مش متساوي صح
+
+379
+00:24:28,970 --> 00:24:33,010
+حافظي أن دي كمان نقطة إضافية أن تقريباً كل منطقة دي
+
+380
+00:24:33,010 --> 00:24:36,390
+الأربعة ملي أو three point five millimeter of the
+
+381
+00:24:36,390 --> 00:24:39,370
+center of cornea thickness تعتبر مش regular يعني مش
+
+382
+00:24:39,370 --> 00:24:43,890
+منتظمة حتى أن المنطقة هذه شكلها لو اخذناها احنا
+
+383
+00:24:43,890 --> 00:24:50,920
+فصلناها عن القرنية كروية أكثر من البرفرال قرنية هي
+
+384
+00:24:50,920 --> 00:24:55,860
+خاصية أول شيء أن هي thin في ال center ثاني خاصية
+
+385
+00:24:55,860 --> 00:24:59,800
+اللي هو تغطي أربعة ملي متر over the pupil اللي
+
+386
+00:24:59,800 --> 00:25:02,660
+تعتبر ال optical center ثالث شيء اللي هي regular
+
+387
+00:25:02,660 --> 00:25:05,460
+surface and structure طبعاً السطح ليه يبدو أيش
+
+388
+00:25:05,460 --> 00:25:09,400
+منتظم جداً مش هاندي أي تعرجات and is near exact in
+
+389
+00:25:09,400 --> 00:25:12,220
+the spherical configuration تقريباً شكلها من خارج
+
+390
+00:25:12,220 --> 00:25:17,560
+يبدو أيش كأنه كروية تميل البرفرال portions of the
+
+391
+00:25:17,560 --> 00:25:21,100
+cornea are often slightly irregular and toroidal،
+
+392
+00:25:21,100 --> 00:25:26,660
+ايش نقصد بال toroidal؟  استواني، استواني، استواني، استواني، استواني،
+
+393
+00:25:26,660 --> 00:25:
+
+431
+00:27:47,030 --> 00:27:50,290
+ناخد ال topography ناخد قياسات معينة هتفيدنا يعني
+
+432
+00:27:51,550 --> 00:27:53,890
+when viewed in a cross-section, the cornea is
+
+433
+00:27:53,890 --> 00:27:56,990
+thinner in the center than in the periphery وهذه
+
+434
+00:27:56,990 --> 00:28:00,170
+الحكاية اللي هنتحدث عنها طبعًا أن ناخد صورة مقطعية
+
+435
+00:28:00,170 --> 00:28:04,010
+القرنية تبدو في المنتصف أقل thickness من البريفرا
+
+436
+00:28:04,010 --> 00:28:07,670
+وهذه طبعًا حقيقة كان صورة مقطعية وكلها ككل
+
+437
+00:28:07,670 --> 00:28:11,050
+thickness in the center دائماً thinner than in the
+
+438
+00:28:11,050 --> 00:28:14,610
+periphery إلا في حالات اللي هو إيش ال pathology
+
+439
+00:28:14,610 --> 00:28:17,570
+الصحية إلا بحالات مرضية ممكن يوصل ال center يكون
+
+440
+00:28:17,570 --> 00:28:22,350
+أكثر thicker than the periphery, typical هنتقل
+
+441
+00:28:22,350 --> 00:28:26,830
+لموضوع آخر أو جزئية أخرى typical lipophilic, 
+
+442
+00:28:26,830 --> 00:28:31,290
+lipophilic نحط تحتها خط صغير، ماذا يعني lipophilic؟
+
+443
+00:28:31,290 --> 00:28:35,850
+محبب للدهون، محبب للدهون صح؟ المقصود محبب أو محب
+
+444
+00:28:35,850 --> 00:28:38,870
+للدهون يعني يذوب في الدهون، يعني كل الأدوية لازم 
+
+445
+00:28:38,870 --> 00:28:43,750
+تذوب في الدهون، بينما hydrophilic هننتقل من ذلك، محبب
+
+446
+00:28:43,750 --> 00:28:47,010
+للماء يعني لازم تذوب في الماء صحيح؟ طيب نحن أفضل
+
+447
+00:28:47,010 --> 00:28:52,730
+لها أن تكون hydrophilic ولا lipophilic؟ تذكرني 
+
+448
+00:28:52,730 --> 00:28:54,730
+ماذا يعني؟
+
+449
+00:28:57,010 --> 00:29:03,630
+هو عشان ما اكتبه معانا يعني؟ لا لا لا لا لا لا لا 
+
+450
+00:29:03,630 --> 00:29:03,750
+لا لا لا لا لا لا لا لا لا لا لا لا لا لا لا لا
+
+451
+00:29:03,750 --> 00:29:04,890
+لا لا لا لا لا لا لا لا لا لا لا لا لا لا لا لا 
+
+452
+00:29:04,890 --> 00:29:05,110
+لا لا لا لا لا لا لا لا لا لا لا لا لا لا لا لا
+
+453
+00:29:05,110 --> 00:29:21,490
+لا لا لا لا لا لا لا لا لا لا لا لا 
+
+454
+00:29:21,870 --> 00:29:25,690
+تكون محبة للـ .. للـ .. الدهون أو تذوب في الدهون هي
+
+455
+00:29:25,690 --> 00:29:29,110
+المقصود فيها أو سريعًا تذوبان في الدهون to the
+
+456
+00:29:29,110 --> 00:29:31,050
+anterior chamber or case primarily through the
+
+457
+00:29:31,050 --> 00:29:34,410
+cornea يحدث طبعًا بشكل أساسي من خلال القرنية طبعًا
+
+458
+00:29:34,410 --> 00:29:39,550
+ممكن أيضًا بعض من هذا الدواء كمية معينة تنتقل أيضًا
+
+459
+00:29:39,550 --> 00:29:42,670
+الكونجكتيفا ويدخل أيضًا داخل العين لكن غالبًا العظمة
+
+460
+00:29:42,670 --> 00:29:46,030
+تعتمد .. تعتمد أساسًا على إيش؟ على اللي هو القرنية
+
+461
+00:29:46,030 --> 00:29:50,040
+صحيح؟ أما يالا secondary delivery route طبعًا 
+
+462
+00:29:50,040 --> 00:29:53,960
+بالنسبة لـ .. اللي هو الـ .. ال conjunctiva surface
+
+463
+00:29:53,960 --> 00:29:57,260
+area of the corneal conjunctiva are important to
+
+464
+00:29:57,260 --> 00:30:01,120
+lipophilic drug delivery في اللي على مصطلح يجب نحط
+
+465
+00:30:01,120 --> 00:30:04,060
+تحت الخط اللي هو conjunctival corneal surface area
+
+466
+00:30:04,060 --> 00:30:07,980
+ratio كل الخط هذا تقريبًا اللي نحن هنشرحه
+
+467
+00:30:07,980 --> 00:30:12,880
+conjunctival corneal surface area ratio اللي هي
+
+468
+00:30:12,880 --> 00:30:17,260
+نسبة إيش؟ مساحة الكونجنكتيفا على نسبة مساحة
+
+469
+00:30:17,260 --> 00:30:21,680
+القرنية صحيح؟ طب هذه النسبة إيش هو أهميتها يعني
+
+470
+00:30:21,680 --> 00:30:24,580
+بالنسبة للأدوية اللي نحن بنستخدمها؟ هل كل ما زادت
+
+471
+00:30:24,580 --> 00:30:28,280
+هذه النسبة بدي يزداد عندي انتقال الدواء ويدخل
+
+472
+00:30:28,280 --> 00:30:31,540
+داخل العين؟ أو أنه كل ما قلت هتزيد؟ يعني هل
+
+473
+00:30:31,540 --> 00:30:38,200
+علاقة طردية أم علاقة عكسية؟ طيب نشوف بالإنسان
+
+474
+00:30:38,200 --> 00:30:41,320
+الكونجنكتيفا surface area has been measured at
+
+475
+00:30:41,320 --> 00:30:42,320
+تقريبًا 18
+
+476
+00:30:45,120 --> 00:30:48,440
+هذه الأرقام مش معانا حفظها بس نحن بدنا نعرف اللي
+
+477
+00:30:48,440 --> 00:30:53,540
+هو التعريف conjunctival corneal area surface ratio
+
+478
+00:30:53,540 --> 00:30:57,360
+هذه لازم نعرفها لازم نعرف إيش الهدف منها أو الهدف
+
+479
+00:30:57,360 --> 00:31:02,550
+من وراء دراستها، طبعًا اللي متكلم هو على مساحة الـ ..
+
+480
+00:31:02,550 --> 00:31:06,610
+ال conjunctiva كلها ككل سواء كانت superior,
+
+481
+00:31:06,830 --> 00:31:09,730
+inferior, lateral, medial كلها ككل .. كل الـ
+
+482
+00:31:09,730 --> 00:31:12,630
+conjunctiva تم قياسها بقياسها تقريبًا طبعًا في إيه
+
+483
+00:31:12,630 --> 00:31:15,150
+range معين لأنها تتبع قياس مش roughly أو كده لا
+
+484
+00:31:15,150 --> 00:31:18,250
+كانت القياسة أخذت roughly صحيح فتقريبًا فيها هنا 18
+
+485
+00:31:18,250 --> 00:31:21,350
+سم مربع أو 17 قصر تلاتة آخرين
+
+486
+00:31:36,660 --> 00:31:41,040
+الحسابات عالية وضعنا نسبة ال corneal area أو da
+
+487
+00:31:41,040 --> 00:31:43,800
+conjunctiva وقسمناها على corneal area أو da
+
+488
+00:31:43,800 --> 00:31:45,980
+conjunctiva وضعنا نسبة ال corneal area أو da conjunctiva
+
+489
+00:31:45,980 --> 00:31:46,400
+وقسمناها على corneal area أو da conjunctiva وضعنا
+
+490
+00:31:46,400 --> 00:31:46,420
+نسبة ال corneal area أو da conjunctiva وقسمناها على
+
+491
+00:31:46,420 --> 00:31:47,220
+corneal area أو da conjunctiva وضعنا نسبة ال 
+
+492
+00:31:47,220 --> 00:31:48,960
+corneal area أو da conjunctiva وضعنا نسبة ال corneal area أو
+
+493
+00:31:48,960 --> 00:31:49,600
+da conjunctiva وضعنا نسبة ال corneal area أو da conjunctiva
+
+494
+00:31:49,600 --> 00:31:53,560
+وننتقل إلى نفس النسبة هذه لكن مش على الإنسان
+
+495
+00:31:53,560 --> 00:31:58,200
+أخذناها مثلًا على حيوانات تجريبية مثلًا ال rabbits أو
+
+496
+00:31:58,200 --> 00:32:01,300
+ال dogs أو ال pigs أخذناها على rabbits  نجدها
+
+497
+00:32:01,300 --> 00:32:08,160
+إيش؟ أقل صحيح؟ أقل لأن حجم ال conjunction تابع في
+
+498
+00:32:08,160 --> 00:32:11,980
+ال human أكبر كثير من إيش؟ من ال rabbits صحيح؟ طب
+
+499
+00:32:11,980 --> 00:32:14,780
+إيش أصبح فيه هنا؟ this difference in ratio helps
+
+500
+00:32:14,780 --> 00:32:17,840
+explain why the lipophilic attraction in rabbit is
+
+501
+00:32:17,840 --> 00:32:21,930
+generally greater than in man يعني كل ما قلت عندي 
+
+502
+00:32:21,930 --> 00:32:25,930
+نسبة هذه صحيح كل ما زاد عندي امتصاص في الدراسة
+
+503
+00:32:26,120 --> 00:32:28,840
+والدليل وراء ذلك أنه في الحيوان تقريبًا فيه عنده
+
+504
+00:32:28,840 --> 00:32:32,840
+نسبة قد .. قداش 12 صحيح؟ بينما نفس النسبة دي أو
+
+505
+00:32:32,840 --> 00:32:35,720
+نفس التركيبة عند ال rabbits أو عند الحيوانات الأخرى
+
+506
+00:32:35,720 --> 00:32:39,200
+تكون 9 صحيح؟ لما أعطي الدواء نفس المقدار للإنسان
+
+507
+00:32:39,200 --> 00:32:42,680
+لل rabbits ورغم أنه في ال rabbits  لأتيه نسبة كبيرة
+
+508
+00:32:42,680 --> 00:32:46,080
+الدواء اللي دخلت فيه  أكثر السبب وراء ذلك أنه
+
+509
+00:32:46,080 --> 00:32:48,720
+أصبح فيه عنده اختلاف في النسبة هذه في النسبة هذه
+
+510
+00:32:48,720 --> 00:32:52,200
+بدأت تولد لي علاقة عكسية ما بين كمية الدواء اللي
+
+511
+00:32:52,200 --> 00:32:56,250
+ممتص أو اللي تم دخوله داخل كرة العين وما بين اللي
+
+512
+00:32:56,250 --> 00:33:01,770
+هو CC Surface Ratio CC Area Surface Ratio هذه 
+
+513
+00:33:01,770 --> 00:33:06,650
+العلاقة بدنا نعرفها عشان نستخدمها يعني كل ما زادت كل
+
+514
+00:33:06,650 --> 00:33:11,510
+ما زادت مساحة يعني أعرفها السطح القرنية اللي هي
+
+515
+00:33:11,510 --> 00:33:15,370
+Surface Area صحيح كل ما قلت عندي ال penetration هتقل
+
+516
+00:33:15,370 --> 00:33:19,730
+penetration صحيح لما أصبح قليل بينما كل ما زادت اللي
+
+517
+00:33:19,730 --> 00:33:24,750
+هو ال cornea .. عفواً ال conjunctiva ال area وكان ده
+
+518
+00:33:24,750 --> 00:33:27,610
+هو هينتشر فيها بشكل أكبر صحيح مع تحيط اللي عندهاش
+
+519
+00:33:27,610 --> 00:33:31,890
+.. هيزيد عندي ال penetration، فهي علاقة عكسية خذوا
+
+520
+00:33:31,890 --> 00:33:35,690
+بالعلم، ما بين مساحة أو مساحة عفواً، ما بين مساحة ال
+
+521
+00:33:35,690 --> 00:33:38,390
+conjunctiva وما بين اللي هو ال drug penetration
+
+522
+00:33:38,390 --> 00:33:42,430
+بتعني أكتشفنا بالعلاقة ما بين conjunctiva وإيه تاني؟
+
+523
+00:33:42,430 --> 00:33:45,910
+ما بين و اللي هو drug penetration إذا زاد أحداهما 
+
+524
+00:33:45,910 --> 00:33:49,010
+يقل الآخر وإذا قل أحداهما يزداد الآخر، هذه العلاقة
+
+525
+00:33:49,010 --> 00:33:49,970
+العكسية بينهما
+
+526
+00:33:55,560 --> 00:33:58,400
+طيب هنكمل على ال optical properties اللي هي
+
+527
+00:33:58,400 --> 00:34:02,500
+الخصائص العشان البصرية القرنية تقريبًا هذه أهم شيء في
+
+528
+00:34:02,500 --> 00:34:07,260
+المحاضرة اليوم خصائص العشان البصرية القرنية index of 
+
+529
+00:34:07,260 --> 00:34:09,660
+refraction of the cornea يقال في الفيلم taken as a
+
+530
+00:34:09,660 --> 00:34:14,980
+whole average about 1.376 شو index of refraction
+
+531
+00:34:14,980 --> 00:34:20,210
+معناها؟ معامل انكسار صحيح؟ طيب معامل الانكسار لما
+
+532
+00:34:20,210 --> 00:34:25,050
+نحسبه نحن بشكل عام للقرنية ول tear film، في an
+
+533
+00:34:25,050 --> 00:34:27,210
+average معين، هذا نحن تقريبًا الفقر اللي كنتوا
+
+534
+00:34:27,210 --> 00:34:31,030
+بتعتبروه constant، ثابت، 1.376 مش عارف أخذتوها أنتم 
+
+535
+00:34:31,030 --> 00:34:33,590
+في refraction وده لأ، هذا معامل الانكسار، أخذتوها 
+
+536
+00:34:33,590 --> 00:34:36,390
+صحيح، معامل الانكسار for the cornea of the tear
+
+537
+00:34:36,390 --> 00:34:40,290
+film، هذا ثابت تقريبًا and for the human طبعًا، 1
+
+538
+00:34:40,290 --> 00:34:41,690
+.376
+
+539
+00:34:43,980 --> 00:34:46,720
+نحن لما ناخذ هذه حتى نحسب الـ dioptric power للـ
+
+540
+00:34:46,720 --> 00:34:49,900
+anterior surface of the cornea وال posterior
+
+541
+00:34:49,900 --> 00:34:53,380
+surface of the cornea وبنشوف أنه أكثر يعني بدي
+
+542
+00:34:53,380 --> 00:34:55,900
+للعين أكثر عيش dioptric power يعني العين بتعتمد
+
+543
+00:34:55,900 --> 00:34:58,300
+أساسًا على عيش أو ال refraction على ال anterior
+
+544
+00:34:58,300 --> 00:35:01,740
+surface ولا ال posterior surface لنشوفها لازم
+
+545
+00:35:01,740 --> 00:35:07,350
+نحسبها لازم نحسبها The refractive power of the
+
+546
+00:35:07,350 --> 00:35:09,850
+anterior surface of the cornea may be computed by
+
+547
+00:35:09,850 --> 00:35:13,210
+the following form. هذا المعادل المعنى.D معدل
+
+548
+00:35:13,210 --> 00:35:15,510
+ديوبترك باور of the anterior surface of the cornea
+
+549
+00:35:15,510 --> 00:35:19,950
+where D equals diopters of optical power بس فقط 
+
+550
+00:35:19,950 --> 00:35:24,010
+للـ anterior.L is the index of refraction of the air
+
+551
+00:35:24,010 --> 00:35:30,540
+.هذه للمفش عليها شرطة اللي بدون بحراللي هي أتعود
+
+552
+00:35:30,540 --> 00:35:33,960
+عنها إيش؟ بواحد تقريبًا، and بينما أنه الأولى اللي
+
+553
+00:35:33,960 --> 00:35:36,080
+عليه الشرطة is the intensive refraction of the
+
+554
+00:35:36,080 --> 00:35:39,930
+whole cornea andأو ده الكورنية معاش اللي هم
+
+555
+00:35:39,930 --> 00:35:44,210
+تقريبًا تقريبًا تقريبًا تقريبًا تقريبًا تقريبًا تقريبًا
+
+556
+00:35:44,210 --> 00:35:49,250
+تقريبًا تقريبًا
+
+557
+00:35:49,250 --> 00:35:52,970
+تقريبًا تقريبًا تقريبًا تقريبًا تقريبًا تقريبًا تقريبًا
+
+558
+00:35:52,970 --> 00:35:53,350
+تقريبًا تقريبًا تقريبًا تقريبًا تقريبًا تقريبًا تقريبًا
+
+559
+00:35:53,350 --> 00:35:56,650
+تقريبًا تقريبًا تقريبًا تقريبًا تقريبًا تقريبًا تقريبًا
+
+560
+00:35:56,650 --> 00:35:58,350
+تقريبًا تقريبًا تقريبًا تقريبًا تقريبًا تقريبًا تقريبًا
+
+561
+00:35:58,350 --> 00:36:01,010
+تقريبًا تقريبًا تقريبًا تقريبًا تقريبًا
+
+562
+00:36:01,820 --> 00:36:04,740
+أصبحت 1.376 من الـ cornea، صحيح؟ طيب، لو عوضنا العلاقة 
+
+563
+00:36:04,740 --> 00:36:09,040
+من هذا، D بيساوي N شرطة ناقص N على R، the optic
+
+564
+00:36:09,040 --> 00:36:11,540
+power of the anterior surface of the cornea بيساوي
+
+565
+00:36:11,540 --> 00:36:16,460
+نعوض عليها، الشرطة اللي عبارة عن إيش؟ index
+
+566
+00:36:16,460 --> 00:36:21,100
+refraction of the cornea زي ال tear film، صحيح؟
+
+567
+00:36:21,100 --> 00:36:27,660
+اللي هي 1.376 ناقص أو minus، اللي هو إيش؟ refresh
+
+568
+00:36:27,660 --> 00:36:36,050
+index صحيح؟ تقسيم اللي هو posterior صحيح؟ radius of
+
+569
+00:36:36,050 --> 00:36:39,270
+curvature of the posterior أو التقانير الكورنية
+
+570
+00:36:39,270 --> 00:36:41,850
+surface in meters بالمتر وهذه قررنا أن نضعها تحت
+
+571
+00:36:41,850 --> 00:36:45,190
+الخط لأن حسابها أحيانًا بتخربط فطلع عندي تقريبًا
+
+572
+00:36:45,190 --> 00:36:50,750
+كده؟ 48.2 هو دي الأكثر هذه كيف أوجدت؟ واضحة ولا
+
+573
+00:36:50,750 --> 00:36:55,910
+نعيدها؟ واضحة؟ طيب، نحن حتى ناخذ الرقم كل رفلة يبدأ
+
+574
+00:36:55,910 --> 00:36:59,010
+ب 16 عشان نعتبره كده؟ 48.2
+
+575
+00:37:03,630 --> 00:37:06,890
+طيب نشوف ال PCR Surface كده بتكبر ال PCR Surface 
+
+576
+00:37:06,890 --> 00:37:12,210
+كلها بتطلع نفس الشيء في أندر القانون الـ D هلأ ليه
+
+577
+00:37:12,210 --> 00:37:15,590
+بتختلف part of the posterior surface بينما هذه كانت 
+
+578
+00:37:15,590 --> 00:37:17,990
+anterior ما فيش عندها اختلافات هادل ال posterior
+
+579
+00:37:17,990 --> 00:37:21,050
+ما فيش عندها يعني شيء بميز ده ال D عن ال D فقط إنه 
+
+580
+00:37:21,050 --> 00:37:26,010
+اللي هو نصًا D بتساوي N شرطة ناقص N على R نفس
+
+581
+00:37:26,010 --> 00:37:30,250
+تقريبًا من القانون هو هو لكن الاختلافات وين في ال R
+
+582
+00:37:30,250 --> 00:37:35,070
+ده أول شيء ثاني حاجة في ال N شرطة صحيح اللي هو 
+
+583
+00:37:35,070 --> 00:37:40,200
+معامل الانكسار الـ Aqueous humor صحيح لأن القرنية anterior
+
+584
+00:37:40,200 --> 00:37:43,560
+surface يبقى يعمل تلامس مباشر معاش التير وال air
+
+585
+00:37:43,560 --> 00:37:47,740
+صحيح بينما ال posterior surface مع ال aqueous humor only
+
+586
+00:37:47,740 --> 00:37:50,760
+صحيح نحن عوضنا عنها بدل ال air اللي في ال aqueous
+
+587
+00:37:50,760 --> 00:37:54,080
+humor معامل الانكسار ال fraction index في aqueous
+
+588
+00:37:54,080 --> 00:38:00,040
+humor هو 7 تقريبًا 1.336 هذا هو معامل الانكسار فعوضنا
+
+589
+00:38:00,040 --> 00:38:04,950
+عنه نفس القانون ناقص اللي هو معامل انكسار التيار
+
+590
+00:38:04,950 --> 00:38:08,210
+فان وان كورب التير فان وان كورب التير فان وان كورب 
+
+591
+00:38:08,210 --> 00:38:11,250
+التير
+
+592
+00:38:11,250 --> 00:38:15,510
+فان وان كورب التير فان وان كورب التير فان وان كورب 
+
+593
+00:38:15,510 --> 00:38:17,830
+التير فان وان كورب التير فان وان كورب التير فان
+
+594
+00:38:17,830 --> 00:38:18,550
+وان كورب التير فان وان كورب التير فان وان كورب 
+
+595
+00:38:18,550 --> 00:38:19,630
+التير فان وان كورب التير فان وان كورب التير فان
+
+596
+00:38:19,630 --> 00:38:20,090
+وان كورب التير فان وان كورب التير فان وان كورب
+
+597
+00:38:20,090 --> 00:38:20,710
+التير فان وان كورب التير فان وان كورب التير فان
+
+598
+00:38:20,710 --> 00:38:30,940
+وان كورب التير فان وان تقريبًا تقريبًا تقريبًا
+
+599
+00:38:30,940 --> 00:38:34,820
+تقريبًا
+
+600
+00:38:34,820 --> 00:38:40,940
+تقريبًا
+
+601
+00:38:40,940 --> 00:38:45,420
+تقريبًا
+
+602
+00:38:45,420 --> 00:38:50,700
+تقريبًا تقريبًا تقريبًا تقريبًا تقريبًا تقريبًا تقريبًا
+
+603
+00:38:50,700 --> 00:38:50,860
+تقريبًا تقريبًا تقريبًا تقريبًا تقريبًا تقريبًا تقريبًا
+
+604
+00:38:55,180 --> 00:38:58,460
+مش هذا الـ minus؟ طلعتها لو حسبناها أحلى بالحاسبة
+
+605
+00:38:58,460 --> 00:39:01,320
+أو أوجدناها، ما هيطلعش بالـ minus النقل صار من
+
+606
+00:39:01,320 --> 00:39:04,080
+الأربعين، بيطلع عليه ال total power لكل القرنية،
+
+607
+00:39
+
+646
+00:41:17,650 --> 00:41:18,930
+بس بس بس بس بس بس بس بس بس بس بس بس بس بس بس بس
+
+647
+00:41:18,930 --> 00:41:19,930
+بس بس بس بس بس بس بس بس بس بس بس بس بس بس بس بس
+
+648
+00:41:19,930 --> 00:41:23,250
+بس
+
+649
+00:41:23,250 --> 00:41:28,530
+بس in the air احنا عكسنا الآن صحيح المفروض أن ال
+
+650
+00:41:28,530 --> 00:41:31,290
+power ده في السيارات كونها ال surface واللي هيكون
+
+651
+00:41:31,290 --> 00:41:35,030
+في ال atmosphere مش معناه صحيح طيب احنا لو أسنان
+
+652
+00:41:35,030 --> 00:41:38,330
+العملية حققنا air bubble اللي هو عبارة عن كمية
+
+653
+00:41:38,330 --> 00:41:42,890
+من الغاز داخلاش القرق الأمامية أو الغرفة الأمامية
+
+654
+00:41:42,890 --> 00:41:47,530
+حيث بحث كائن تلامس مباشر مبان اللي هو ال استيريا
+
+655
+00:41:47,530 --> 00:41:51,010
+والهواء مش عند ال atmosphere صحيح هذا بحث صغير من
+
+656
+00:41:51,010 --> 00:41:56,010
+العمليات صحيح طب احنا لو حسبنا ال doctoric power of
+
+657
+00:41:56,010 --> 00:41:57,870
+the posterior surface أو anterior surface هيطلع،
+
+658
+00:41:57,870 --> 00:42:00,570
+هيختلف عنده اختلاف كامل، صحيح؟ وكأنه عكس من
+
+659
+00:42:00,570 --> 00:42:05,450
+الشيء، صح؟ أو أن الإنسان غلط في مياه في بركة معينة
+
+660
+00:42:05,450 --> 00:42:08,290
+أو في البحر وفتح عيني جوا، أصبحش فيه عنده ..
+
+661
+00:42:08,290 --> 00:42:11,210
+بيصير التلامس السطحي الأمام .. وكأنه أصبح في عند
+
+662
+00:42:11,210 --> 00:42:13,850
+الـ ال anterior surface ملامس ماعيش معاك، بس هو،
+
+663
+00:42:13,850 --> 00:42:17,670
+صح؟ فهذه العكسات احنا بنحسبها وعلى أساسها بتلعب
+
+664
+00:42:17,670 --> 00:42:21,590
+نتيجة طيب أول شي خالكم معايا if we compute the
+
+665
+00:42:21,590 --> 00:42:23,690
+power of the posterior corneal surface in air
+
+666
+00:42:23,690 --> 00:42:26,550
+عكسناها لو حسبنا اللي هو the dielectric power of
+
+667
+00:42:26,550 --> 00:42:29,670
+the posterior surface في الهواء we would find the
+
+668
+00:42:29,670 --> 00:42:32,350
+following طلعها هذا الديهان اللي هي the dielectric
+
+669
+00:42:32,350 --> 00:42:36,130
+power of the posterior surface in the air فقط ماشي
+
+670
+00:42:36,130 --> 00:42:36,370
+الحل
+
+671
+00:42:40,490 --> 00:42:46,230
+عوض عليها طبعا ال R اللي هي 65 لكن
+
+672
+00:42:46,230 --> 00:42:49,050
+في ال meter صحيح؟ صح ولا؟ اللي هي radius of
+
+673
+00:42:49,050 --> 00:42:52,470
+curvature of the posterior surface in meters N
+
+674
+00:42:52,470 --> 00:42:56,550
+واحد ناقص N اتنين اللي هو عوض عليها N واحد اللي هي
+
+675
+00:42:56,550 --> 00:43:02,920
+الهواء صحيح ناقص اللي هو index of refraction of
+
+676
+00:43:02,920 --> 00:43:06,840
+the conia ده تيرفل، حد كله راح، صحيح؟ العدسة للهند
+
+677
+00:43:06,840 --> 00:43:11,400
+تقريبا ناقص 96، هذا ليش؟ ده ال posterior surface،
+
+678
+00:43:11,400 --> 00:43:16,360
+هذا لو كافي العراق، صحيح؟ طيب، لو احنا طرحنا من
+
+679
+00:43:16,360 --> 00:43:21,500
+الـ 48، اللي هي أساساً للقوة للهند الانتقال ال
+
+680
+00:43:21,500 --> 00:43:23,560
+surface، صحيح؟ أو دول تركبوم الانتقال ال surface
+
+681
+00:43:23,560 --> 00:43:25,520
+اللي احنا خدناها في المعادلة الأولى، صح؟ العدسة من
+
+682
+00:43:25,520 --> 00:43:33,050
+دل الهند؟ من دل الهند 48 أيضا، صح؟ ملعقة صح ولا؟ مش
+
+683
+00:43:33,050 --> 00:43:37,890
+طلع عندنا 96؟ صحيح؟ هدل احنا حسبنا، خليكم معاه،
+
+684
+00:43:37,890 --> 00:43:41,610
+لو حسبنا في النقطة هدى احنا ال posterior of the
+
+685
+00:43:41,610 --> 00:43:45,650
+posterior surface of the cone فقط in the air،
+
+686
+00:43:45,650 --> 00:43:50,070
+صحيح؟ وكل عكسله يعني القرنية، صحيح؟ بيسود ويحدث
+
+687
+00:43:50,070 --> 00:43:54,730
+عنده؟ إيش دوسي فيه عنده؟ ننتحق، نشيل اللي هو the
+
+688
+00:43:54,730 --> 00:43:57,590
+perpetrate part of the anterior surface، صحيح؟ صح
+
+689
+00:43:57,590 --> 00:43:58,930
+ولا؟ غيرش تفضل عنده؟
+
+690
+00:44:03,860 --> 00:44:08,880
+كل drop in power بتاع الجداش هي ستين هي من سبعة و
+
+691
+00:44:08,880 --> 00:44:12,040
+خمسين إلى اتنين وستين وحسب دور الجداش ثمانية و
+
+692
+00:44:12,040 --> 00:44:16,390
+خمسين أصبح في اندفع الجداش -10 يعني أصبحت هي minus
+
+693
+00:44:16,390 --> 00:44:22,050
+less لكن بتعتبراش تعمل كاش plus less كيف أجدت هذه
+
+694
+00:44:22,050 --> 00:44:26,150
+minus less، minus عشرة، بدنا نعرفها، ماشي الحاجة
+
+695
+00:44:26,150 --> 00:44:28,570
+حسبنا اللي هو the dielectric power of the bassia
+
+696
+00:44:28,570 --> 00:44:32,270
+coniar surface، صحيح، طلعناه، بعدين نقسمها أو
+
+697
+00:44:32,270 --> 00:44:35,910
+طرحناها من إيش؟ من ال Antida، صحيح، dielectric
+
+698
+00:44:35,910 --> 00:44:41,760
+power of the conia، صح ولا لا؟ واضحة هذه النقطة؟ اه
+
+699
+00:44:41,760 --> 00:44:49,940
+minus 96 زي 48 minus 47 زي 58 بس هو حلها بطريقة
+
+700
+00:44:49,940 --> 00:44:50,320
+أخرى
+
+701
+00:44:53,110 --> 00:44:55,590
+حلها بطريقة أخرى جدًا من الـ minus، بس طبعًا كانت
+
+702
+00:44:55,590 --> 00:44:58,970
+بالنهاية minus عشرة، ماضح؟ فأصبح ال minus عشرة
+
+703
+00:44:58,970 --> 00:45:07,290
+يبقى ما عندناش powerful minus lens هو حلها
+
+704
+00:45:07,290 --> 00:45:11,570
+على أساس إنه ناقص في ناقص ثمانية وأربعين، يعني إحنا
+
+705
+00:45:11,570 --> 00:45:15,390
+طرحنا منها طرحنا منها، طرحنا من ناقص، طرحنا من
+
+706
+00:45:15,390 --> 00:45:18,330
+ناقص، طرحنا من ناقص، طرحنا من ناقص، طرحنا من ناقص،
+
+707
+00:45:18,330 --> 00:45:19,130
+طرحنا من ناقص، طرحنا من ناقص، طرحنا من ناقص، طرحنا
+
+708
+00:45:19,130 --> 00:45:21,310
+من ناقص، طرحنا من ناقص، طرحنا من ناقص، طرحنا من
+
+709
+00:45:27,320 --> 00:45:32,340
+من كل حسابات اللي احنا عملناها تقريبا اللي هو أهم
+
+710
+00:45:32,340 --> 00:45:37,920
+surface reflective اللي هو الانترال الانترال
+
+711
+00:45:37,920 --> 00:45:43,160
+التقريبا باحتمال عليه بشكل أساسي للروحية الانترال
+
+712
+00:45:43,160 --> 00:45:46,240
+الكونية and ambient atmosphere ال ambient مخصوص
+
+713
+00:45:46,240 --> 00:45:50,750
+فيها المحيط اللي هو مغلق الجو أو الهواء المحيطهذه
+
+714
+00:45:50,750 --> 00:45:53,330
+نفس المثال اللي احنا ضربناه قبل قليل if a large
+
+715
+00:45:53,330 --> 00:45:56,910
+air bubble در فقعة من الهواء كبيرة تم حققها داخل
+
+716
+00:45:56,910 --> 00:46:00,490
+غرفة الأمامية للعين، صحيح؟ بالتالي أصبح في عند ال
+
+717
+00:46:00,490 --> 00:46:03,210
+.. ال index of refraction كله اختلف، بالتالي
+
+718
+00:46:03,210 --> 00:46:05,430
+الإنسان مش هشوفه بشكل واضح، هتكون هيش blood
+
+719
+00:46:05,430 --> 00:46:07,890
+pressure، صحيح؟ لأن اختلافات دورة ال bubble، دورة
+
+720
+00:46:07,890 --> 00:46:10,530
+ال surface اختلفت عن انت، ال surface، صحيح؟ بفضل
+
+721
+00:46:10,530 --> 00:46:14,860
+نتجدش هيطبعا بده يعتمد على عيش، جديش أنا بده أحقن
+
+722
+00:46:14,860 --> 00:46:17,720
+داخل ال anti air chamber، حال مثلا حجم ال air
+
+723
+00:46:17,720 --> 00:46:20,280
+bubble دي واحد من الأثنين من الأترات من اللي إيه
+
+724
+00:46:20,280 --> 00:46:21,880
+الآخر، اللي هو the thickness of the air bubble
+
+725
+00:46:21,880 --> 00:46:24,860
+بيؤثر ليه في ال blurring، حال احنا بس مجنون
+
+726
+00:46:24,860 --> 00:46:28,740
+ضربناها على سبيل المثال أو في حالة أخرى، الإنسان
+
+727
+00:46:28,740 --> 00:46:32,180
+يشملها في التعليق تحت عيش، تحت الوعي، وكأنه أيضا
+
+728
+00:46:32,180 --> 00:46:35,010
+أصبح فيه indigestion تأثر فيه عند الـreflection،
+
+729
+00:46:35,010 --> 00:46:37,570
+أصبح فيش عند الـair صح؟ لأن الـreflection of the
+
+730
+00:46:37,570 --> 00:46:40,790
+air راح و الـtear film أيضًا إيش اختفت قريبًا أصبح
+
+731
+00:46:40,790 --> 00:46:43,970
+كإن الموترسا قد ساكه مفيهاش في الـaquischema صحيح؟
+
+732
+00:46:43,970 --> 00:46:49,410
+فأصبح فيه عند أيضًا قضاع إيش اختلفت طيب
+
+733
+00:46:49,410 --> 00:46:53,270
+when the eye is open underwater، هدل مثال، تبعوا
+
+734
+00:46:53,270 --> 00:46:57,050
+when
+
+735
+00:46:57,050 --> 00:47:01,010
+the eye is open underwater, the optical imagery is
+
+736
+00:47:01,010 --> 00:47:04,860
+extremely blurred تبقى من نفس الشيء سواء عندي حق ال
+
+737
+00:47:04,860 --> 00:47:08,340
+air bubble داخل العيق أو الإنسان يفتح عيناه يعني
+
+738
+00:47:08,340 --> 00:47:11,320
+تحت الماء ويحدث فيه عندي .. لأن الخلف .. اختلف
+
+739
+00:47:11,320 --> 00:47:12,960
+عندي ال doctor's power of the anterior and
+
+740
+00:47:12,960 --> 00:47:15,820
+posterior surface of the cornea، بالتالي هتختلف
+
+741
+00:47:15,820 --> 00:47:18,440
+عندي الرؤية، حيث في عندي الانكسار أيضا اختلف،
+
+742
+00:47:18,440 --> 00:47:21,100
+الإنسان دائما هيكون فيه عنده إيش extremely blurred
+
+743
+00:47:21,100 --> 00:47:25,740
+vision، اللي هو تقريبا الرؤية عنده هيكون إيش مغبشة
+
+744
+00:47:25,740 --> 00:47:31,510
+أو غير واضحة The index of refraction of water بسبب
+
+745
+00:47:31,510 --> 00:47:34,130
+ورقة ذلك is quite similar to that of taquaria
+
+746
+00:47:34,130 --> 00:47:38,660
+صحيح؟ يعني أصبح في عندي معامل انكسار بالقرنية و
+
+747
+00:47:38,660 --> 00:47:42,820
+نفسه يساوي معامل انكسار لإيش؟ لإنسان اللي فاتيه فيه
+
+748
+00:47:42,820 --> 00:47:46,400
+الغصي، بالتالي إيش هيعمل؟ وكأنه هيعمل ليه delete،
+
+749
+00:47:46,400 --> 00:47:49,560
+هيعمل ليه محو لكل إيش؟ للديوبتريك power of دي إيش
+
+750
+00:47:49,560 --> 00:47:52,840
+أنتيها ال surface، بالتالي إيش هيصبح أنده إيش
+
+751
+00:47:52,840 --> 00:47:56,920
+الرؤية مجبشة، ها دي من هنا، خليني معايا، المهم في
+
+752
+00:47:56,920 --> 00:48:01,540
+الفقر هذه، نحط احتياقة إلى نهاية lost
+
+753
+00:48:03,450 --> 00:48:06,230
+يعني عندما ينزل الإنسان تحت الماء ويفتحي تحت
+
+754
+00:48:06,230 --> 00:48:09,670
+الماء تصبح عنده ال index of fraction of the conia
+
+755
+00:48:09,670 --> 00:48:12,110
+صحيح أو ال anterior surface of the conia مثلا و ال
+
+756
+00:48:12,110 --> 00:48:15,030
+index of fraction of the water يعني احنا دائما
+
+757
+00:48:15,030 --> 00:48:18,730
+ممكن اللغة الأخرى بالتالي الإنسان هشوف الشياش مغبش
+
+758
+00:48:18,730 --> 00:48:22,480
+طيب إذا أنت بتشوفه أغلب ال .. في ال national
+
+759
+00:48:22,480 --> 00:48:25,880
+geography في كتير بتبتصيروا تحت الماء، صحيح؟ أو
+
+760
+00:48:25,880 --> 00:48:28,900
+حتى بجرم مخوصي يعني يكونوا مهرين جدا تحت الماء في
+
+761
+00:48:28,900 --> 00:48:31,700
+الـ سواء كان بالحفر، في الرسم، إيه الآخر، تحت
+
+762
+00:48:31,700 --> 00:48:34,480
+الماء أو في جلسية معينة، يكونوا إيش حامل؟ ال
+
+763
+00:48:34,480 --> 00:48:37,760
+google صحيح؟ اللي هي النضارات أو إيه الآخر، يعني
+
+764
+00:48:37,760 --> 00:48:44,150
+حاجة بتعمل واش ساتر ما بين الماء وما بين وكأنه لابس
+
+765
+00:48:44,150 --> 00:48:47,390
+نضارة بس نضارة دم حيطة يعني مغلقة من الجهة على
+
+766
+00:48:47,390 --> 00:48:50,990
+الجهات، هذا وكأنه حفظت تماما علاش اللي هو
+
+767
+00:48:50,990 --> 00:48:52,950
+refraction index of the anterior surface of the
+
+768
+00:48:52,950 --> 00:48:56,710
+conya مع الair مع التيلفانهذه واضحة، لذلك الإنسان
+
+769
+00:48:56,710 --> 00:49:00,770
+عندما يعني يرتدي هذه النظارات أو إيه لأخره أو
+
+770
+00:49:00,770 --> 00:49:04,890
+الجوجلز، هسميها تحت الماء، بدي يكون عنده نظر مسوو
+
+771
+00:49:04,890 --> 00:49:08,330
+تماما وكأنه على normal terrestrial vision وكأنه
+
+772
+00:49:08,330 --> 00:49:11,570
+يعني زي ما هو على سطح كورة الأرض، هيشوف الحاجات
+
+773
+00:49:11,570 --> 00:49:14,810
+طبيعتها تحت الماء، طبعا إلا إذا كان الماء نفسه في
+
+774
+00:49:14,810 --> 00:49:20,430
+شوائب أو إيه لأخره، حد شيء آخر، حد شيء ثاني طيب،
+
+775
+00:49:20,430 --> 00:49:24,130
+ناخد مثال آخر أو contact lenses placed on the
+
+776
+00:49:24,130 --> 00:49:27,030
+cornea surface is an efficient way of correcting
+
+777
+00:49:27,030 --> 00:49:30,950
+optical errors in the dielectric system of the eye
+
+778
+00:49:30,950 --> 00:49:35,190
+.الآن عندما يقع الإنسان أو ارتداء ال contact
+
+779
+00:49:35,190 --> 00:49:39,250
+lenses حالي يعتبر مثل Aquis Hema لأن هالتطبع اللي
+
+780
+00:49:39,250 --> 00:49:42,570
+هي و كان لسان فاتح داخل الماء مثلا ال index
+
+781
+00:49:42,570 --> 00:49:45,390
+refraction هيلغي بعضه وبالتالي لسان مش هشوف شكل
+
+782
+00:49:45,390 --> 00:49:50,410
+واضح إيش حاسس فيه عندي هي أول شي اللي كنت هتلازم
+
+783
+00:49:50,410 --> 00:49:54,410
+هي مش ماء صحيح؟ وهي تكوين index refraction مثل
+
+784
+00:49:54,410 --> 00:49:58,210
+إيش؟ خدوا بالك هذا السؤال مهم، حتى في الامتحان
+
+785
+00:49:58,210 --> 00:50:03,110
+مهم، تابعوا معانا this is particularly true for
+
+786
+00:50:03,110 --> 00:50:05,290
+errors that are caused by abnormalities of the
+
+787
+00:50:05,290 --> 00:50:08,270
+cornea curvature حد بالنسبة لاستخدامات اللي هو ال
+
+788
+00:50:08,270 --> 00:50:12,510
+contact lenses استخدام عادة لتصحيح تعرجها الصحيح
+
+789
+00:50:12,510 --> 00:50:14,930
+اللي هو اللي أخطأ أو الـ سواء كان myopic أو
+
+790
+00:50:14,930 --> 00:50:19,920
+hyper hyperobic اللي هو نتجاها القرنية القرنية
+
+791
+00:50:19,920 --> 00:50:26,480
+الموجودة على الجسم الكورنيا لديها نفس
+
+792
+00:50:26,480 --> 00:50:29,700
+معامل انكسار القرنية وكأنني أنا مسكت قرنية جديدة
+
+793
+00:50:29,700 --> 00:50:33,420
+وضعتها على عين الإنسان صحيح؟ طبعا هذا فقط تضع
+
+794
+00:50:33,420 --> 00:50:36,380
+لكميات معينة لأن زي ما حكينا القرنية العظمى من
+
+795
+00:50:36,380 --> 00:50:39,360
+الأكسجين حصل عليه من وين؟ من الهواتف أصبح الآن في
+
+796
+00:50:39,360 --> 00:50:42,840
+صناعة ال contact lenses إيش مالها؟ gas permeable
+
+797
+00:50:42,840 --> 00:50:46,800
+إيش يعني؟ ممكن من خلالها تدخل .. يعني مايدخلاش ال
+
+798
+00:50:46,800 --> 00:50:50,280
+oxygen عبر .. برغم من ذلك إنه منح استخدامها لفترات
+
+799
+00:50:50,280 --> 00:50:54,200
+معينة أو النوم فيها أو آخر طيب and becomes covered
+
+800
+00:50:54,200 --> 00:50:57,920
+in media of the normal quantity of film أصبح الـ
+
+801
+00:50:57,920 --> 00:51:00,120
+tear film عندي موجود صحيح مكان مقارنة جديدة،
+
+802
+00:51:00,120 --> 00:51:02,740
+مقارنة جديدة عنده وضعها مباشرة، لو مثلا بدي أغمض
+
+803
+00:51:02,740 --> 00:51:05,320
+عيني، صحيح أنها تريحها، صحيح أنها درجة فعل لا
+
+804
+00:51:05,320 --> 00:51:08,180
+عراضية، بدي أصبح ال tear film أيضا بدي أبطل عيش ال
+
+805
+00:51:08,180 --> 00:51:11,280
+contact lens دافسة، ودي الورق ده، ورق ده، لأن لمّا
+
+806
+00:51:11,280 --> 00:51:13,580
+أشيل عيش ال contact lens وأضعها أمام ال set lab،
+
+807
+00:51:13,580 --> 00:51:15,640
+حاسوب فيه بعض الشوائب، بليئ الشوائب اللي بورتينية
+
+808
+00:51:15,640 --> 00:51:18,460
+الـmucin layer الآخر هي بعض الطبقات اللي عيشت
+
+809
+00:51:18,460 --> 00:51:21,920
+ال tear film هذه تعمل وكأنها في يد القرن الجديد
+
+810
+00:51:21,920 --> 00:51:24,840
+اللي وضعناها على القرنية الأصلية بنفس معامل
+
+811
+00:51:24,840 --> 00:51:27,860
+الإنكسار صحيح بالإضافة إلى ذلك في عدد الفيلم كما
+
+812
+00:51:27,860 --> 00:51:31,040
+هو أغطى هذه القرنية الجديدة أو هي الcontactless
+
+813
+00:51:31,040 --> 00:51:33,900
+بالتالي الإنسان ليس مش هبشكل واضح بقى ليش عليه
+
+814
+00:51:33,900 --> 00:51:37,100
+ترمز بالإنسان مثلا يفتح داخل الماء أو يتمحق إنه
+
+815
+00:51:37,100 --> 00:51:44,060
+كمية غاز معينة داخل الغرفة الأمامية في أي سؤال؟
+
+816
+00:51:44,060 --> 00:51:50,450
+نعيد أي نقطة بالاسم المعدلات اللي حكيناها هذه واضحة
+
+817
+00:51:50,450 --> 00:51:54,130
+ولا لأ؟ واضحة؟ هذه مهمة جدا، في عندنا سؤال آخر
+
+818
+00:51:54,130 --> 00:51:59,810
+ونقطة مهمة اللي هي اللي احنا حاكينا عنها هنا
+
+819
+00:51:59,810 --> 00:52:03,650
+بالضبط يعني
+
+820
+00:52:03,650 --> 00:52:06,850
+هي minus this تعمل ك plus this وبدنا السبب وراء
+
+821
+00:52:06,850 --> 00:52:09,950
+ذلك، في أي سؤال؟
\ No newline at end of file
diff --git a/PL9fwy3NUQKwZ2K6wMRTZMEoGVTbELxinF/D5JjsqUOYCs_postprocess.srt b/PL9fwy3NUQKwZ2K6wMRTZMEoGVTbELxinF/D5JjsqUOYCs_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..a49ba86d1c7d82e05dfe8a1b2de56f526bc72b41
--- /dev/null
+++ b/PL9fwy3NUQKwZ2K6wMRTZMEoGVTbELxinF/D5JjsqUOYCs_postprocess.srt
@@ -0,0 +1,4076 @@
+1
+00:00:20,970 --> 00:00:24,670
+السلام عليكم و رحمة الله هي اليوم باسمكم ان شاء
+
+2
+00:00:24,670 --> 00:00:28,730
+الله اللي هو باقي نهار محاضرة ثانية من sociology
+
+3
+00:00:28,730 --> 00:00:31,590
+of the Aquis humor عن IOP انتوا عارفين الأكبر
+
+4
+00:00:31,590 --> 00:00:35,370
+شغلنا احنا وصلنا لحد ايه ان شاء الله لإن هو
+
+5
+00:00:35,370 --> 00:00:39,050
+formation of Aquis humor صحيح؟ بتكلمنا إن في عندي
+
+6
+00:00:39,050 --> 00:00:41,530
+two main processes ال process الأولى اللي هو
+
+7
+00:00:41,530 --> 00:00:44,490
+passive transport حكينا عن passive transport إنه
+
+8
+00:00:44,490 --> 00:00:48,210
+في قسم لشقين الشق الأول اللي هو diffusion اللي هو
+
+9
+00:00:48,210 --> 00:00:51,880
+بيكون تقريبا 10% منبساهم في عشر فمية من تكوين
+
+10
+00:00:51,880 --> 00:00:55,180
+أكويسيهيومار production، فيه إنه كمان ما هو ال
+
+11
+00:00:55,180 --> 00:00:57,760
+filtration، بساهم تقريبا في عشرين فمية من
+
+12
+00:00:57,760 --> 00:00:59,620
+أكويسيهيومار production، وحكينا في ال filtration
+
+13
+00:00:59,620 --> 00:01:02,360
+في نقطة مهمة إن فقط يحدث هذا في ال capillary
+
+14
+00:01:02,360 --> 00:01:06,380
+walls، ماحدثش يعني في ما بين ال membranesاليوم
+
+15
+00:01:06,380 --> 00:01:10,020
+هنيجي على الأهم من اللي هو ال passive transport او
+
+16
+00:01:10,020 --> 00:01:13,780
+من ال diffusion و ال .. و ال filtration هو عبارة
+
+17
+00:01:13,780 --> 00:01:16,760
+عن ال active transport processes طبعا بدنا نذكر
+
+18
+00:01:16,760 --> 00:01:19,580
+انه ال passive transport does not ATP .. it does
+
+19
+00:01:19,580 --> 00:01:21,920
+not need ATP وبالتالي it does not require energy
+
+20
+00:01:21,920 --> 00:01:26,000
+بينما ال active transport process requires energy
+
+21
+00:01:26,000 --> 00:01:29,060
+لإنه ما بعرف أزاى .. فاضليا ذاكريني يعنى إيه حكينا
+
+22
+00:01:29,060 --> 00:01:32,590
+احنا؟دائما ال passive transport from high
+
+23
+00:01:32,590 --> 00:01:35,330
+concentration to low concentration هذا في ال
+
+24
+00:01:35,330 --> 00:01:38,510
+diffusion صحيح بينما في ال active ربما تنقلب
+
+25
+00:01:38,510 --> 00:01:42,250
+المعادلة و يصبح من low إلى high وبالتالي يحتاج إلى
+
+26
+00:01:42,250 --> 00:01:46,480
+ما هو الطاقةو أي عملية تنقل تحدث ما بين الخلايا
+
+27
+00:01:46,480 --> 00:01:51,360
+تحتاج اللي هو تدخل الوسائط لوسائط البروتين اللي هي
+
+28
+00:01:51,360 --> 00:01:54,360
+ميديات ال transport system هذا بالتأكيد انه يحتاج
+
+29
+00:01:54,360 --> 00:01:57,100
+إلى طاقة اليوم هناخد ان شاء الله اللي هو active
+
+30
+00:01:57,100 --> 00:02:00,460
+transport process او system اللي هو بتشير تقريبا
+
+31
+00:02:00,460 --> 00:02:03,920
+في ال 70% من ال whole production of the aqueous
+
+32
+00:02:03,920 --> 00:02:08,630
+humor وهذه احنا بطالبين فيهاعندما يستخدم الخلية
+
+33
+00:02:08,630 --> 00:02:14,130
+جزيئات ATB لتحريك مصادر من خلطة عبر ممبرنة، يستخدم
+
+34
+00:02:14,130 --> 00:02:17,310
+هذا
+
+35
+00:02:17,310 --> 00:02:22,630
+البرنامج عملية
+
+36
+00:02:22,630 --> 00:02:25,890
+عملية Active Transport
+
+37
+00:02:37,800 --> 00:02:41,780
+substances move actively are usually unable to
+
+38
+00:02:41,780 --> 00:02:44,660
+pass in the desired direction by diffusion فهذه
+
+39
+00:02:44,660 --> 00:02:49,820
+يعني ريت من هنا بس نحط علامة معينة substances أو
+
+40
+00:02:49,820 --> 00:02:53,540
+سطرين هدولة يعني أقارن كل المواد أخد نظر شهية كان
+
+41
+00:02:53,540 --> 00:02:57,360
+شوية منها بروتينات منها electrolytes منها بعض ال
+
+42
+00:02:57,360 --> 00:03:01,420
+lipids الاخرى أو ال vitamins كل المواد القادرة على
+
+43
+00:03:01,420 --> 00:03:05,990
+النفاذية من خلال اللي هو ال membraneبواسطة طريقتها
+
+44
+00:03:05,990 --> 00:03:09,070
+اللي هو ال diffusion أو حتى ال filtration بالتالي
+
+45
+00:03:09,070 --> 00:03:11,290
+لابد يكون خلاصي عندي active transport اللي هي غير
+
+46
+00:03:11,290 --> 00:03:16,250
+قادرة على اللي هو نفاذية ال membrane اما بكون بسبب
+
+47
+00:03:17,120 --> 00:03:21,320
+إن حجمها جزئي كبير مرة أخرى أو إما بيكون إنه هي
+
+48
+00:03:21,320 --> 00:03:24,580
+مضطرة تمشي عكس التركيز اللي هي فيه يعني بدل من
+
+49
+00:03:24,580 --> 00:03:26,780
+high concentration to low concentration حد أصبح من
+
+50
+00:03:26,780 --> 00:03:29,140
+low concentration إلى high concentration بالتالي
+
+51
+00:03:29,140 --> 00:03:33,060
+الطريقة هذه مضطرة تستخدم أو تستهلك كمية كبيرة من
+
+52
+00:03:33,060 --> 00:03:38,100
+ال ATP لذلك نسميها active transport system they
+
+53
+00:03:38,100 --> 00:03:41,540
+may be too large to pass through the pores pores
+
+54
+00:03:41,540 --> 00:03:45,520
+معناها الثغور أو الفتحات المسمات الموجودة في
+
+55
+00:03:45,520 --> 00:03:48,920
+الcell membraneبالتالي يعني ممكن المقصود فيه علاج
+
+56
+00:03:48,920 --> 00:03:51,820
+و الحجم من الجزايا يكون كبير، بالتالي غير قادر على
+
+57
+00:03:51,820 --> 00:03:56,330
+اختراق هذا الجدار بواسطة ال diffusionأو أنها تكون
+
+58
+00:03:56,330 --> 00:03:59,830
+غير قادرة على أن تذوق فيه اللي هو الدهون، صحيح؟
+
+59
+00:03:59,830 --> 00:04:04,130
+حكينا أحنا آخر مرة فيه أن أكتر زي مثلا ال oxygen
+
+60
+00:04:04,130 --> 00:04:08,430
+هو يعتبر شفاعة سوليابا، صحيح؟ لإنه يذوق فيه اللي
+
+61
+00:04:08,430 --> 00:04:12,670
+هو ال recent layer of the tear film، بالتالي يصل
+
+62
+00:04:12,670 --> 00:04:16,530
+إلى القرنية و they may have to move against their
+
+63
+00:04:16,530 --> 00:04:18,530
+concentration gradient و had against their
+
+64
+00:04:18,530 --> 00:04:21,270
+concentration gradient اللي أخد فيها عكس التركيز
+
+65
+00:04:21,270 --> 00:04:25,140
+اللي هو فيه، يعنيfrom low to high عكس عملية ال
+
+66
+00:04:25,140 --> 00:04:28,160
+diffusion و هذه العملية بتطلب فعلا كمية كبيرة من
+
+67
+00:04:28,160 --> 00:04:33,800
+ال ATP it may occur by two mechanisms solute
+
+68
+00:04:33,800 --> 00:04:37,320
+pumping and bulk transport و زي ما موجود معانا
+
+69
+00:04:37,320 --> 00:04:40,380
+تحدث كل عملية ال active transport بس تاشر طريقة
+
+70
+00:04:40,380 --> 00:04:45,280
+تانية الطريقة الأولىهي salute pumping هي هذه اللي
+
+71
+00:04:45,280 --> 00:04:50,400
+يقع علي تشكيل وظيفة اكبر من ال bulk transport او
+
+72
+00:04:50,400 --> 00:04:53,520
+ال bulk transport اللي هو عبارة عن النقل بالجملة
+
+73
+00:04:53,520 --> 00:04:59,320
+خليني نبدأ اول شي ب salute pumping ال salute ايه
+
+74
+00:04:59,320 --> 00:05:04,880
+مع ال salute؟ المذاب ولا المذيب؟المذايب على العكس
+
+75
+00:05:04,880 --> 00:05:07,860
+ال solvent صحيح؟ المذايب يقصد فيها كل الأيونات
+
+76
+00:05:07,860 --> 00:05:11,960
+المقصود هنا فيها كل الأيونات أو الأملح اللي غير
+
+77
+00:05:11,960 --> 00:05:14,400
+قادرة على اجتياز غشاء باس ال diffusion اللي الحين
+
+78
+00:05:14,400 --> 00:05:17,960
+بتتكلم عنه علاش ال active transport، ماشي الحاجة؟
+
+79
+00:05:17,960 --> 00:05:21,740
+من ضمن هذه الأشياء، خلّيكم معايا، uses ATP to
+
+80
+00:05:21,740 --> 00:05:26,200
+energize، تنشط ال protein carriers، مش مقصد ال
+
+81
+00:05:26,200 --> 00:05:26,780
+protein carriers
+
+82
+00:05:37,140 --> 00:05:41,780
+ماشي الحاجة حكيها عن بعض أيونات الصوديوم تتقلب
+
+83
+00:05:41,780 --> 00:05:48,200
+from high concentration
+
+84
+00:05:48,200 --> 00:05:54,780
+to low concentration مش
+
+85
+00:05:54,780 --> 00:05:58,340
+عندي وسيط هنا does not require ATP، بدهاش أياش
+
+86
+00:05:58,340 --> 00:06:02,900
+energy، صحيح؟ صح ولا لا؟ طيب، هذا تعتبر passive
+
+87
+00:06:02,900 --> 00:06:03,380
+transport
+
+88
+00:06:06,320 --> 00:06:09,240
+سوف أفضل على طاقة، نفسها الإكشناقة، بما أننا في
+
+89
+00:06:09,240 --> 00:06:14,820
+حالة الـ active ينتقل بالعكس، ال low concentration
+
+90
+00:06:14,820 --> 00:06:19,860
+ليش؟
+
+91
+00:06:19,860 --> 00:06:23,980
+ل high concentration، صحيح؟ هذا رقم واحد، تاني
+
+92
+00:06:23,980 --> 00:06:27,360
+الشيء اللي يكون فيه عند ال protein carrier ال
+
+93
+00:06:27,360 --> 00:06:30,940
+protein carrier بالشكل هذا على سطح أيش؟ ال
+
+94
+00:06:30,940 --> 00:06:35,560
+membrane، صحيح؟ لأن حكينا حجم الجزية كبير جدا و
+
+95
+00:06:35,560 --> 00:06:39,940
+بسرعة ذلكهي جزئات الأحمار الأمنية والسكريات الأخرى
+
+96
+00:06:39,940 --> 00:06:42,900
+وبعد ال labors غير قادرة على اجتياز اللي هو جدار
+
+97
+00:06:42,900 --> 00:06:46,120
+الخلية وبالتالي محتاج إلى وسيط اللي يحصل منها
+
+98
+00:06:46,120 --> 00:06:49,180
+mediated transport system صحيح؟ يعني في عندى وسيط
+
+99
+00:06:49,180 --> 00:06:55,920
+الوسيط هذا حتى يتحرك contact الشكل هذا عندى
+
+100
+00:06:55,920 --> 00:06:58,940
+شكل ال protein هذا عبارة عن نمر وهذا ال passage
+
+101
+00:06:58,940 --> 00:07:01,980
+protein ال protein هذا ال confirmation تبعه شكله
+
+102
+00:07:01,980 --> 00:07:06,480
+بتغير صح ولا؟فمضطر ان الخلية تفرز اكتر من ATP
+
+103
+00:07:06,480 --> 00:07:10,220
+تستهلك اكتر من ATP حتى تتحفظ هذا الوسيط اللي هو ال
+
+104
+00:07:10,220 --> 00:07:14,340
+protein carrier بالنقاش يتغير شكله، عند تغير شكله
+
+105
+00:07:14,340 --> 00:07:17,480
+بدأت تنتقل بعض البروتينات و أجزاء السكر من خارج
+
+106
+00:07:17,480 --> 00:07:21,460
+الخلية إلى داخل الخلية، على نفس النمط، الأجزاء هذه
+
+107
+00:07:21,460 --> 00:07:24,920
+غير قادرة على اجتياز هذا الغشاء، صحيح؟ لأن حجمها
+
+108
+00:07:24,920 --> 00:07:29,560
+جثية أشماله كبيرة جدا، فالمنطقة هذه نسميها protein
+
+109
+00:07:29,560 --> 00:07:29,880
+carrier
+
+110
+00:07:33,460 --> 00:07:36,300
+و هذه تقسمها كتير جدا من ال physiological احنا
+
+111
+00:07:36,300 --> 00:07:38,840
+بغينا عنها بس لإنا عارف ان شكل ال protein curry
+
+112
+00:07:38,840 --> 00:07:44,660
+يتغير صحيح بتدفق جزيئات اللي هو سواء كانت السكر او
+
+113
+00:07:44,660 --> 00:07:47,400
+الأحمار الأمانية او الجزيئات اللي غير قادرة على
+
+114
+00:07:47,400 --> 00:07:50,620
+اجتياز الغشاء الوسطى اللي هو ال diffusion method،
+
+115
+00:07:50,620 --> 00:07:52,300
+هذه احنا بدنا نعرفها، ماشي الحل
+
+116
+00:07:56,950 --> 00:07:59,370
+هذا بالنسبة انا ارجع و اروح لل salute pumping،
+
+117
+00:07:59,370 --> 00:08:02,350
+salute pumping uses ATP to energize its protein
+
+118
+00:08:02,350 --> 00:08:04,390
+carrier، يعني تنشط ال protein carrier اللي احنا
+
+119
+00:08:04,390 --> 00:08:07,870
+بصرا زمان عملناها، minor acids، some sugar and
+
+120
+00:08:07,870 --> 00:08:12,070
+most of ions are transported by salute pumps، and
+
+121
+00:08:12,070 --> 00:08:14,410
+in most cases these substances move against its
+
+122
+00:08:14,410 --> 00:08:16,710
+concentration gradient، والمقصود فيها from low
+
+123
+00:08:16,710 --> 00:08:18,930
+concentration to high concentration، وأغلب
+
+124
+00:08:18,930 --> 00:08:22,450
+العمليات أو الحياوية اللي تحدث في جسم الاسد تحتاج
+
+125
+00:08:22,450 --> 00:08:24,490
+إلى against its concentration، يعني from low
+
+126
+00:08:24,490 --> 00:08:26,890
+concentration to high concentration،كلها بتكون
+
+127
+00:08:26,890 --> 00:08:30,090
+تقريبا عايش active transport system بغض النظر كانت
+
+128
+00:08:30,090 --> 00:08:35,630
+direct أو بيكون فيه ND اللي هو protein carrier the
+
+129
+00:08:35,630 --> 00:08:40,790
+NA, the potassium sodium ATPs مورد معانا هذه
+
+130
+00:08:40,790 --> 00:08:47,510
+الجملة صحيح؟ أو هذا المقطع وين؟ ال pump في ال
+
+131
+00:08:47,510 --> 00:08:51,000
+endothelium صحيح؟ في ال endotheliumIt's a membrane
+
+132
+00:08:51,000 --> 00:08:54,640
+bound enzyme وعبارة عن إنزيم مرتبط بغشاء الخلية،
+
+133
+00:08:54,640 --> 00:08:58,240
+يعني لا يتحرك، هذا الإنزيم مش موجود مثلا في الدم
+
+134
+00:08:58,240 --> 00:09:04,020
+أو يسري بشكل حر، لأ إنما هو مرتبط بخلايا، بغشاء
+
+135
+00:09:04,020 --> 00:09:07,260
+الخلايا، لكن بأي غشاء، بالضبط أي membrane عبارة عن
+
+136
+00:09:07,260 --> 00:09:09,520
+ال non-pigmented epithelium، لأن هو المسؤول بالجهة
+
+137
+00:09:09,520 --> 00:09:12,660
+الأساسية على Aquisemetic production، صحيح؟
+
+138
+00:09:15,300 --> 00:09:17,180
+present in the mantic-mental epithelium of the
+
+139
+00:09:17,180 --> 00:09:19,180
+cellular body aids in solute pumping of many
+
+140
+00:09:19,180 --> 00:09:22,020
+molecules يساهم هذا الإنزين في عملية اللي هو
+
+141
+00:09:22,020 --> 00:09:25,160
+solute pumping بغض النظر اللي كان فيه عنده solute
+
+142
+00:09:25,160 --> 00:09:28,360
+pumping من ناحية أجزاء السكر أو المينو أسد كل
+
+143
+00:09:28,360 --> 00:09:31,120
+عملية هذه هو واحد الإنزين اللي لابد يكون موجود
+
+144
+00:09:31,120 --> 00:09:36,580
+يساهم أو يشارك فيها أخش أن solute pumping provides
+
+145
+00:09:36,580 --> 00:09:39,320
+a way for a cell to be very selective in cases
+
+146
+00:09:39,320 --> 00:09:42,380
+where successes cannot pass by the future في أن
+
+147
+00:09:42,380 --> 00:09:47,210
+الهجوم المكتوبةNo Pump, No Transport هاد الـ No
+
+148
+00:09:47,210 --> 00:09:50,630
+Pump, No Transport خاصة فقط بأجزاء معينة أو
+
+149
+00:09:50,630 --> 00:09:55,010
+بجزيئات معينة في الجسم خاصة بجزيئات معينة وهي
+
+150
+00:09:55,010 --> 00:10:00,170
+عبارة عن الجزيئات الغير قادرة على الانتقال من غشاء
+
+151
+00:10:00,170 --> 00:10:04,290
+الخلية باستخدام طريقة اللي هو الانتشار البسيط اللي
+
+152
+00:10:04,290 --> 00:10:07,590
+هي ال diffusion بحكينا لأسباب إما بكون حجم الجزائي
+
+153
+00:10:07,590 --> 00:10:11,850
+كبير أو إما بتكون تمشي أو تنتقل من low
+
+154
+00:10:11,850 --> 00:10:14,950
+concentration to high concentrationو هكذا إذا هذه
+
+155
+00:10:14,950 --> 00:10:17,390
+الجملة تعني no pump و no transport بالنسبة لهذه
+
+156
+00:10:17,390 --> 00:10:19,930
+الجزئات إذا ما كان عندى solute pumping هذا ال
+
+157
+00:10:19,930 --> 00:10:23,470
+method لن ينتقل نهائيا هذه المقصود no pump و no
+
+158
+00:10:23,470 --> 00:10:30,190
+transport طيب نجي على الطريقة الأخرى هي تعتبر و
+
+159
+00:10:30,190 --> 00:10:34,170
+تسمى ال bank transport أو النقل بالجملة فانت عتقد
+
+160
+00:10:34,170 --> 00:10:39,170
+أغلبنا ع الفيلة ال bank transport
+
+161
+00:10:51,610 --> 00:11:03,670
+فيه طرق دان هم ال endocytosis و
+
+162
+00:11:03,670 --> 00:11:09,230
+ال endocytosis أيهم يحتاج ال ATP؟ ال eggs فقط اللي
+
+163
+00:11:09,230 --> 00:11:11,630
+يحتاج لأنه بدي ماشي عكس الاتجاه صحيح ال endo لا
+
+164
+00:11:11,630 --> 00:11:13,350
+يحتاج انا بده ATP
+
+165
+00:11:19,270 --> 00:11:22,830
+بعدين فينا شئ معين انا هي فيه دي جدار الخلية
+
+166
+00:11:22,830 --> 00:11:28,250
+المقصود بالنقل بالجملة يعني مش هيختار مثلا اجزاء
+
+167
+00:11:28,250 --> 00:11:31,290
+معينة من الايونات او فقط السكريات او الحمض او ايه
+
+168
+00:11:31,290 --> 00:11:34,950
+لأ بالجملة مرة واحدة ربما كل هذه الفقاعة او احنا
+
+169
+00:11:34,950 --> 00:11:38,790
+بسميها her body physical اذا ذاكرين صحيح؟ يعني انت
+
+170
+00:11:38,790 --> 00:11:44,310
+عندك كمية سائل حالة بحوط عليها جسم صحيح؟ بعدين
+
+171
+00:11:44,310 --> 00:11:48,810
+تصبح من فقاعة الجسمفي قطعة فى الخلية حتى يتخلص من
+
+172
+00:11:48,810 --> 00:11:54,370
+هذه المواد بغض الوضع كانت سكريات او كانت حماض
+
+173
+00:11:54,370 --> 00:11:57,930
+أميونية الاخرى بتحاول يتهمها من خارج الخلية إلى
+
+174
+00:11:57,930 --> 00:12:01,370
+داخل الخلية حيث تصبح ايش من ضمن جزء لا جزء من
+
+175
+00:12:01,370 --> 00:12:05,190
+الخلية هذا احنا بنسميه endocytosis صحيح؟ هذا لا
+
+176
+00:12:05,190 --> 00:12:10,190
+يحتاج الاطاقة هذا endocytosis لأن
+
+177
+00:12:10,190 --> 00:12:14,040
+لو كان العكس في عنده بعض الموادبالذات ال end
+
+178
+00:12:14,040 --> 00:12:16,000
+products او ال waste products اللي اتخلصت منها
+
+179
+00:12:16,000 --> 00:12:19,340
+الخلية اثناء عملية الايد بيتخلص منها كده هتتصبح
+
+180
+00:12:19,340 --> 00:12:22,620
+كثيرة جدا صعب عن عملية ال diffusion لان ال
+
+181
+00:12:22,620 --> 00:12:25,360
+diffusion دايما من الحيو كونسنتشن لكونسنتشن صعب
+
+182
+00:12:25,360 --> 00:12:28,720
+جدا وانخلال اللي هو ال protein carrier بالتالي مش
+
+183
+00:12:28,720 --> 00:12:32,000
+هتعمل هتطر هذا فقعات وسميها budding physical
+
+184
+00:12:32,000 --> 00:12:41,780
+الالتئاب
+
+185
+00:12:41,780 --> 00:12:42,720
+جدار الخلية
+
+186
+00:12:48,280 --> 00:12:53,700
+بعدين حتى تصبح جزء من هذا بعدين
+
+187
+00:12:53,700 --> 00:12:57,600
+تبطل هذه الجزئات خارج جزء عنده شكل خلية بالشكل
+
+188
+00:12:57,600 --> 00:13:03,060
+العام هي تسمى exo-cytosis وهذه هي الطريقة اللى
+
+189
+00:13:03,060 --> 00:13:05,280
+تحتاج ATP بكثرة
+
+190
+00:13:07,840 --> 00:13:11,240
+هو عبارة عن النقل بالجملة يتفرع إلى فرعين الفرع
+
+191
+00:13:11,240 --> 00:13:15,620
+الأول هو endocytosis و الأخر فهو exocytosis ال
+
+192
+00:13:15,620 --> 00:13:19,280
+endocytosis لا يحتاج إلى ATP بينما ال exocytosis
+
+193
+00:13:19,280 --> 00:13:22,620
+يحتاج إلى ATP صحيح؟ و حكي مرة أخرى النقل بالجملة
+
+194
+00:13:22,620 --> 00:13:26,180
+تعني أن فيه عندنا أكتر نوع من العنصر أكتر نوع يعني
+
+195
+00:13:26,180 --> 00:13:28,920
+من العناصر ربما يكون إجزاء السكر ربما يكون أحماض
+
+196
+00:13:28,920 --> 00:13:33,660
+أمينية ربما يكون مكونات أخرى lipids الأخرى بالتالي
+
+197
+00:13:33,660 --> 00:13:38,870
+يسمونها احنااللي هو bulk transport طيب باعدة هي
+
+198
+00:13:38,870 --> 00:13:41,610
+لهم ATP may be exocytosis when transport
+
+199
+00:13:41,610 --> 00:13:44,410
+substances out of the cell سمنها العامل هي هذا
+
+200
+00:13:44,410 --> 00:13:47,650
+exocytosis او endocytosis طبعا هذه ال ATP فقط لل
+
+201
+00:13:47,650 --> 00:13:52,510
+exocytosis صح اللي عشان يلعب بال endocytosis طيب
+
+202
+00:13:52,510 --> 00:13:57,710
+تقريبا احنا ممكن خلصنا ان اهم الطرق لانتقال او
+
+203
+00:13:57,710 --> 00:14:00,920
+عفوا الافرازأو تكوين ال aqueous humor production
+
+204
+00:14:00,920 --> 00:14:05,760
+فى هنا بعض الألحظات تحت ال bulk transport اللى هى
+
+205
+00:14:05,760 --> 00:14:09,900
+قدش معدل تقريبا ال out of flow لاللي هو ال aqueous
+
+206
+00:14:09,900 --> 00:14:13,060
+humor المعدل حتى احنا ما نتقلمش فيه و معاهم طلبين
+
+207
+00:14:13,060 --> 00:14:16,240
+بيحفظوا هذا الرقم هو تقريبا تلاتة ملي انا مكتوب 2
+
+208
+00:14:16,240 --> 00:14:23,790
+.5% تلاتة تقريبا تلاتة ملي لتر لكل دقيقةبالساعة
+
+209
+00:14:23,790 --> 00:14:27,170
+سوف يغادر يعني عن جهاز التصريف في كرة العين،
+
+210
+00:14:27,170 --> 00:14:31,950
+فالخلط المعين كمية معينة بتقدر ب 150 ملي لتر، هذه
+
+211
+00:14:31,950 --> 00:14:36,290
+احنا بيكون عادلين، it's slower during sleeping،
+
+212
+00:14:36,290 --> 00:14:43,510
+ليش طيب؟ يعني بجل هو هذا ال out of flow في حالة
+
+213
+00:14:43,510 --> 00:14:43,990
+النوم
+
+214
+00:14:50,710 --> 00:14:55,370
+النمو بلغ؟ لأ
+
+215
+00:14:55,370 --> 00:14:58,210
+لإن هتتكلم احنا على أكويسيهيمر، هذه الكيمية
+
+216
+00:14:58,210 --> 00:15:02,070
+لأكويسيهيمر داخل العين بتتغادرى عن طريق الترابيكا
+
+217
+00:15:02,070 --> 00:15:05,350
+مشواك، صحيح عن طريق الآنجل، صح ولا؟ طب ليش بتزيد
+
+218
+00:15:05,350 --> 00:15:09,290
+بالنهار و بتطلع؟ فورا
+
+219
+00:15:12,610 --> 00:15:15,030
+بحالة .. لأ مالعش علاقتنا نفسنا و ايه اللي هو ايه؟
+
+220
+00:15:15,030 --> 00:15:17,330
+بحالة ان هو شو بيصير في عندي انا construction of
+
+221
+00:15:17,330 --> 00:15:19,870
+the pubis صحيح؟ construction of the pubis بيعمل
+
+222
+00:15:19,870 --> 00:15:22,550
+على اللي هو construction or contraction of the
+
+223
+00:15:22,550 --> 00:15:25,050
+sphincter muscle، هذا المفروض انه يزود ال
+
+224
+00:15:25,050 --> 00:15:28,510
+production، صح ولا؟ لإن ماكواس .. الا عيندي اللي
+
+225
+00:15:28,510 --> 00:15:32,490
+عندي هتتوسع وحاسب ان في عندي another passage مش
+
+226
+00:15:32,490 --> 00:15:35,170
+فقط أو another path يعني مش فقط التبريك المشوية،
+
+227
+00:15:35,170 --> 00:15:39,570
+في عندي حاجة اسمها uvial sclera، هناخدها كمان شوية
+
+228
+00:15:39,570 --> 00:15:43,200
+ان شاء اللهطيب مرة أخرى with an average reduction
+
+229
+00:15:43,200 --> 00:15:47,760
+during sleep تقريبا بتقل بنسبة 45% أثناء النوم من
+
+230
+00:15:47,760 --> 00:15:51,700
+المعدل الطبيعي عنه في النهار مابي contribute to
+
+231
+00:15:51,700 --> 00:15:54,600
+the diurnal variation of intraocular pressure تحت
+
+232
+00:15:54,600 --> 00:15:57,400
+ال diurnal variation هتعرف معانا اللي ماعرفش معاها
+
+233
+00:15:57,400 --> 00:16:01,500
+ال diurnal variation اللي هي التغيراتاو اذا انتوا
+
+234
+00:16:01,500 --> 00:16:03,780
+ذاكرين ال circadian rhythm مش فاهم ال circadian
+
+235
+00:16:03,780 --> 00:16:06,840
+rhythm، ساعة بيولوجية أيضا، كل نظام عندى بجسم
+
+236
+00:16:06,840 --> 00:16:09,640
+الإنسان يعني ساعة بيولوجية، بيولوجية، من ضمن ذلك
+
+237
+00:16:09,640 --> 00:16:13,520
+ضغط الدم، ضغط العين، ومثلا معدل الهرمونات،
+
+238
+00:16:13,520 --> 00:16:16,200
+السرتونين، الكراتينيين، الاخرين، بجسم الإنسان
+
+239
+00:16:16,200 --> 00:16:19,900
+يختلف عنه في ال life، يختلف عنه ..بالنهار، المعدل
+
+240
+00:16:19,900 --> 00:16:22,080
+اللى هو the during reparation اللى متعتبر الساعة
+
+241
+00:16:22,080 --> 00:16:25,400
+البرولوجية لضغط العين بدي ارتفع أثناء الفجر و
+
+242
+00:16:25,400 --> 00:16:28,600
+أثناء وقته ظاهرة، باقى الأوقات بدي انخفض زى ما حنا
+
+243
+00:16:28,600 --> 00:16:32,420
+حكينا وقت ال during sleep بدي انزل بمعدة تقريبا 45
+
+244
+00:16:32,420 --> 00:16:36,940
+% طب
+
+245
+00:16:36,940 --> 00:16:41,930
+وقت الفجر بديكون تقريبا أعلى قياسات لضغط العينو
+
+246
+00:16:41,930 --> 00:16:46,110
+ايضا في وقت الظاهرة طبعا استخدام هذا الفحص الكثرة
+
+247
+00:16:46,110 --> 00:16:49,690
+الدمال برا للتعرف على المريض كل ما زاد عنده ال
+
+248
+00:16:49,690 --> 00:16:53,010
+variation كل ما زاد احتمالية المريض انه يعاني مثلا
+
+249
+00:16:53,010 --> 00:16:56,470
+من ضغط العين يعني احنا على سبيل المثال هاخد مثال
+
+250
+00:16:56,470 --> 00:17:04,710
+بسيط ناخد
+
+251
+00:17:04,710 --> 00:17:08,470
+مثال بسيط يعني لو احنا على التسعة الصباحة اصلا
+
+252
+00:17:08,470 --> 00:17:18,320
+مثلا كان خمستاشرباق الدهار او واحدة مثلا طلع لنا
+
+253
+00:17:18,320 --> 00:17:24,260
+اربم .. تمانت عشر .. عشر عشرين، باق الأوقات طلع
+
+254
+00:17:24,260 --> 00:17:28,020
+سبعت عشر و ست عشر و اربع عشر و تلت عشر و اربم يطلع
+
+255
+00:17:28,020 --> 00:17:31,720
+عشرة، بدنا ناخد أقل قيمة و أكتر قيمة، أقل قيمة
+
+256
+00:17:31,720 --> 00:17:37,540
+كدهاش؟ عشر18 صحيح ماجدش الفرق بينهم تمانية هذا
+
+257
+00:17:37,540 --> 00:17:40,060
+الفرق يعتبر سبعة تمانية مقبول في بعض القرارات تحكي
+
+258
+00:17:40,060 --> 00:17:43,200
+بعد سبعة لأ ماعادوا فيه المرضي عنده مشكلة مش
+
+259
+00:17:43,200 --> 00:17:46,320
+المفروض انه ال journal variation في ال normal eye
+
+260
+00:17:46,320 --> 00:17:50,740
+انه يكون too high عارف واحدة بعدين الفارق ما بينها
+
+261
+00:17:50,740 --> 00:17:53,360
+بين العين اليسرى يعني مش المفروض العين اليوم يكون
+
+262
+00:17:53,360 --> 00:17:57,440
+15 وعين اليسرى فجأة لاجيها 9 او تمانية او لاجيها
+
+263
+00:17:57,440 --> 00:18:00,920
+مثلا 23 مافيه هذه المشكلة لازم الفرق بين العين
+
+264
+00:18:00,920 --> 00:18:04,560
+الييمين وعين اليسرى لايتعدىخمس درجات يعني five I
+
+265
+00:18:04,560 --> 00:18:09,520
+and P معناه لنفس العام اللي ضمن الفريشة مايزدش عن
+
+266
+00:18:09,520 --> 00:18:16,090
+تمانية هذا وحتى الآن بس في جلاء أهم تقريباالشيء
+
+267
+00:18:16,090 --> 00:18:18,290
+احنا ذكرناه واتكلمنا عنه في physiological of the
+
+268
+00:18:18,290 --> 00:18:21,070
+aqueous humor اللي هو functions of the aqueous
+
+269
+00:18:21,070 --> 00:18:24,650
+humor ما هي الفائدة الفيسيولوجية من اللي هو ال
+
+270
+00:18:24,650 --> 00:18:28,670
+aqueous humor أول شي هو المظيفة عندي supply
+
+271
+00:18:28,670 --> 00:18:32,050
+nutrition يعمل على تزويد اللي هو ال lens و ال
+
+272
+00:18:32,050 --> 00:18:35,250
+cornea و ال anterior vitreous فقط لإن ال aqueous
+
+273
+00:18:35,250 --> 00:18:37,890
+humor لا يصل إلى ال posterior vitreous فقط لل
+
+274
+00:18:37,890 --> 00:18:42,340
+anterior vitreous يزودهم ب اللي هوالمواد الغذائية
+
+275
+00:18:42,340 --> 00:18:45,020
+لإن كل المراكب بتاعي تعتبر a vascular tissue،
+
+276
+00:18:45,020 --> 00:18:48,020
+تعتبر إيش؟ اللي هي النسيج اللي يصل إليه العويع
+
+277
+00:18:48,020 --> 00:18:51,650
+الدموي اللي هو العويعيthe peripheral cornea can
+
+278
+00:18:51,650 --> 00:18:54,270
+receive some nutritional needs from limbal
+
+279
+00:18:54,270 --> 00:18:56,870
+vasculature وهذا كلما عليها احنا في research of
+
+280
+00:18:56,870 --> 00:18:59,670
+the cornea لان ال research of the cornea تصل اليها
+
+281
+00:18:59,670 --> 00:19:02,490
+بعض المغاديرات عن طريق ال perilimbal vasculature
+
+282
+00:19:02,490 --> 00:19:05,310
+لو عندهم يرتحو حياته بياشي من حياته الليمبال صحيح
+
+283
+00:19:05,310 --> 00:19:07,930
+حتى بالنسبة لل peripheral cornea بينما ال central
+
+284
+00:19:07,930 --> 00:19:12,270
+لابد حق طبعا الرقم يصل بعض منها ال central لكن
+
+285
+00:19:12,270 --> 00:19:15,470
+غالبيا العظمى او المتعرف عليه ان ال central cornea
+
+286
+00:19:15,470 --> 00:19:19,130
+needs or requires nutrition from the aqueous humor
+
+287
+00:19:19,130 --> 00:19:24,040
+عادي بال centralلذلك احنا لو لاحظنا اشخاص اللي
+
+288
+00:19:24,040 --> 00:19:27,260
+بيعانوا مثلا من الاتهابات او الخدوش لو كانت في
+
+289
+00:19:27,260 --> 00:19:31,540
+الطرف هيكون افضل من الكون بال center، ليش؟ لأن
+
+290
+00:19:31,540 --> 00:19:35,180
+التفضية او المبادئة اللي واصلة من ال limbus هتكون
+
+291
+00:19:35,180 --> 00:19:39,060
+اكثر يعني فيها بروتينات او معدلة اكتر بكتير من ال
+
+292
+00:19:39,060 --> 00:19:42,740
+aqueous تحيبر، بالتالي سرعة التقامة هتكون عيش اكتر
+
+293
+00:19:42,740 --> 00:19:49,320
+او المناعة هتكون فيها بشكل افضلطيب البريفرال كونيا
+
+294
+00:19:49,320 --> 00:19:52,140
+ممكن تحصل على بعض المحتاجات الناقصية من الليمبال و
+
+295
+00:19:52,140 --> 00:19:56,740
+هذا بالنسبة للبريفرال بينما البريفرال يجب أن تحصل
+
+296
+00:19:56,740 --> 00:20:01,860
+على مغذياتها من الاكويس الحمر المتواجد في الانترال
+
+297
+00:20:01,860 --> 00:20:05,980
+وسيرة شمبا طيب
+
+298
+00:20:05,980 --> 00:20:10,340
+في ان هنا سؤال حتى انا ما علمت صفها removal of the
+
+299
+00:20:10,340 --> 00:20:12,660
+limbs causes increased glucose in the aqueous
+
+300
+00:20:12,660 --> 00:20:16,860
+limer and decreased lactic acidأظن مره معانا هذا
+
+301
+00:20:16,860 --> 00:20:23,320
+المصطلح ال lactic acid وين؟ بعتبر
+
+302
+00:20:23,320 --> 00:20:26,340
+one of the products صحيح؟ فيه ان كمان مصطلح غيره
+
+303
+00:20:26,340 --> 00:20:31,200
+ال pyruvic acid و ال lactic acid اي زيادتهم بتعمل
+
+304
+00:20:31,200 --> 00:20:34,560
+حمضية يعني اي زيادتهم بتعمل ايش acidification of
+
+305
+00:20:34,560 --> 00:20:38,000
+the lens هو نفسه هذا، لاتيش عموية أيضا لل lens
+
+306
+00:20:38,000 --> 00:20:40,670
+نفسها، احنا لما ناخد physiology of the lensحمشد
+
+307
+00:20:40,670 --> 00:20:43,590
+انه انا اتش عملية ايضا ال lens نفس الشيء في اندي
+
+308
+00:20:43,590 --> 00:20:46,150
+ايضا pyruvic acid و في اندي ايضا اللي هو ال lactic
+
+309
+00:20:46,150 --> 00:20:48,730
+acid طب ليش بعد عملية ال cataract او بعد ما احنا
+
+310
+00:20:48,730 --> 00:20:52,910
+نشيل ال lens كلها هلاج نسبة ال lactic acid اشملها؟
+
+311
+00:20:52,910 --> 00:20:58,390
+ليش عملية ايه إذا ال lens كلها راحت و ماظلش عندي
+
+312
+00:20:58,390 --> 00:21:00,670
+عملية ايه ده أصلا في عندي أسس صناعية فقط صحيح؟
+
+313
+00:21:00,670 --> 00:21:03,470
+بالتالي ال lactic acid طبيعي جدا لإنه ايش كل كميته
+
+314
+00:21:03,470 --> 00:21:07,460
+قليلةطب فى عندى كمان حاجة أخرى، احنا حاكي إن
+
+315
+00:21:07,460 --> 00:21:10,880
+اللاكتك أسد و ال بيربك أسد القراية لابد تتخلص منهم
+
+316
+00:21:10,880 --> 00:21:14,440
+حتى لا يحدث عنده إيش؟ اللي هو acidification كيف
+
+317
+00:21:14,440 --> 00:21:17,940
+تخلص منهم؟ ع طريق الاندوستيليان، صحيح؟ بتلاقي ده
+
+318
+00:21:17,940 --> 00:21:20,840
+فيه عندك كميات معتبر، احنا هناخدها كمان شوية من
+
+319
+00:21:20,840 --> 00:21:24,020
+اللاكتك أسد داخلك وسيما، لكن غياب الليز كل مرة
+
+320
+00:21:24,020 --> 00:21:27,140
+واحدة خلال تقريبا غياب النصر، صحيح؟ لإن انا أصلا
+
+321
+00:21:27,140 --> 00:21:32,300
+مش عندى اللي هو metabolism for the less نفس الشيء
+
+322
+00:21:32,300 --> 00:21:36,480
+عن طبيق علاق للجلوكوزليش الجلوكوز بده يزداد عملية
+
+323
+00:21:36,480 --> 00:21:39,160
+عكسية لإنه أفضل الجلوكوز دي يدخل داخل ال aqueous
+
+324
+00:21:39,160 --> 00:21:42,960
+humor لتقضية اللي هو ال center cornea زائد ال lens
+
+325
+00:21:42,960 --> 00:21:45,260
+في عملية ال metabolism إذا راحت ال lens بالتالي
+
+326
+00:21:45,260 --> 00:21:48,740
+أيضا راحت عند الاحتياج الأساسي بالتالي هيزداد معدل
+
+327
+00:21:48,740 --> 00:21:54,640
+اللي هو الجلوكوز في ال aqueous humor هذا الوظيفة
+
+328
+00:21:54,640 --> 00:21:57,520
+الأولى، الوظائفة الأولى معانا، كما عرفوها، طلبين
+
+329
+00:21:57,520 --> 00:22:01,450
+فيهارقم 2 maintain the intraocular pressure تعمل
+
+330
+00:22:01,450 --> 00:22:07,670
+الحفاظ على طاقة الدم وهو هذه الوظيفة الأساسية طب
+
+331
+00:22:07,670 --> 00:22:10,190
+لما نحكي احنا maintain الحفاظ على طاقة الدم الحالة
+
+332
+00:22:10,190 --> 00:22:14,770
+الطبيعية it's
+
+333
+00:22:14,770 --> 00:22:18,110
+a transparent medium to pass light تدورتنا أيضا هو
+
+334
+00:22:18,110 --> 00:22:20,430
+يعتبر جزء من اللي هو الocular media صحيح؟
+
+335
+00:22:20,430 --> 00:22:26,100
+transparent ocular media انه شفافهيعمل على مرور
+
+336
+00:22:26,100 --> 00:22:29,280
+الضوء بشكل ايش سليم without scattering مش هيحدث
+
+337
+00:22:29,280 --> 00:22:32,440
+عندنا فيه diffraction لكن في بعض الأمراض هلاجي
+
+338
+00:22:32,440 --> 00:22:36,260
+احنا القرانية لو اعتبرنا انه هذا قرانية واخدنا
+
+339
+00:22:36,260 --> 00:22:39,800
+مقطع عدل بالاسلتلانة صحيح؟ وهنا فيه عند الابيثيليا
+
+340
+00:22:39,800 --> 00:22:43,660
+وهنا فيه عند الاندروثيليا صحيح؟ لك نشوف احنا على
+
+341
+00:22:43,660 --> 00:22:48,160
+الاسلتلانة في حياة الاتهابات هلاجي فيه اندهان ايش؟
+
+342
+00:22:48,160 --> 00:22:50,240
+اكويسيبر المفروض انه transparent المفروض انه
+
+343
+00:22:50,240 --> 00:22:52,630
+invisible صحيح او لأ؟لك حالات كثيرة دي بعض
+
+344
+00:22:52,630 --> 00:22:55,450
+الخلايا، بعض البروتينات، احنا هنحكيها كمان شوية،
+
+345
+00:22:55,450 --> 00:22:57,650
+هذه البروتينات لما يدخلوا الضوء، إيش هيعملها؟ إيش
+
+346
+00:22:57,650 --> 00:23:02,770
+هتعمل إيه؟ تصيب ال fracture، صح ولا؟ فهذا يعني إنه
+
+347
+00:23:02,770 --> 00:23:06,990
+بالحالة الطبيعية، لكوسيمر بده يشارك بعملية نفاذية
+
+348
+00:23:06,990 --> 00:23:10,690
+الضوء بشكل إيش سليم، اللي هو transparent medium
+
+349
+00:23:13,270 --> 00:23:16,550
+أخر شئ احنا خدناه بالقرنية هو مظيفة أساسية او
+
+350
+00:23:16,550 --> 00:23:19,770
+function of the iris حمره بيعمل على abolish the
+
+351
+00:23:19,770 --> 00:23:22,010
+minus power of the posterior surface of the cornea
+
+352
+00:23:22,010 --> 00:23:25,350
+هذه احنا خدناها مش على إيدة مرة تانية صحيح بيعمل
+
+353
+00:23:25,350 --> 00:23:27,630
+على abolishment ان اصلا مافيش عند ال surface
+
+354
+00:23:27,630 --> 00:23:31,650
+مباشرة يعني لغاية اللي هو ال posterior ال minus
+
+355
+00:23:31,650 --> 00:23:34,070
+power لل posterior surface في ان كمان تزيه مش
+
+356
+00:23:34,070 --> 00:23:39,890
+موجودة هنا رقم خمسة يحافظ على or maintains the
+
+357
+00:23:39,890 --> 00:23:44,970
+architecture of the eyeballهيكلية العين، بدون ضغط
+
+358
+00:23:44,970 --> 00:23:47,850
+العين مايوجد عندها هيكلية، صحيح؟ حتى وإن كان كل
+
+359
+00:23:47,850 --> 00:23:50,610
+الأجزاء اللي اتكلمنا عليها من واحد إلى أربعة كلها
+
+360
+00:23:50,610 --> 00:23:52,550
+سليمة، لكن بيضل فيها عندها هيكلية العين وما
+
+361
+00:23:52,550 --> 00:23:56,730
+تتعرضاش للدمور، عشان يحافظ على هيكلية العين،
+
+362
+00:23:56,730 --> 00:24:02,750
+architecture of the eyeball بدون ما نكتبها طيب
+
+363
+00:24:03,320 --> 00:24:07,240
+يجي مرة أخرى composition of أكويسي حمر، مما يحتوي
+
+364
+00:24:07,240 --> 00:24:10,200
+أو على أي شيء يحتوي الأكويسي حمر، ما هي مركبات
+
+365
+00:24:10,200 --> 00:24:16,560
+الأكويسي حمر أو مكوناته، يجي مرة أخرى، أكويسي حمر
+
+366
+00:24:16,560 --> 00:24:22,020
+هو عبارة عن جزء من أشهر، كله ككله، زي دموع العين،
+
+367
+00:24:22,020 --> 00:24:25,780
+صحيح؟ أو زي حليب الأم، أو مثلا على ذلك البول في
+
+368
+00:24:25,780 --> 00:24:29,180
+المثال البولية، كله أصل مشتق من وين؟من الساقل
+
+369
+00:24:29,180 --> 00:24:31,660
+الدموي؟ أه يبقى، من الساقل الدموي، وهذا نفس الشيء،
+
+370
+00:24:31,660 --> 00:24:34,500
+composition of aqueous humor بيعتبر أصل جسم ناشط
+
+371
+00:24:34,500 --> 00:24:36,820
+أو مشطق ممين من الساقل الدموي، هي من الأوعي
+
+372
+00:24:36,820 --> 00:24:39,820
+الدموية اللي هتوحيد بال .. اللي هو ال celiabody،
+
+373
+00:24:39,820 --> 00:24:43,920
+صح ولا؟ ودليل على ذلك أن أغلب مشطقات هادي ال
+
+374
+00:24:43,920 --> 00:24:46,520
+aqueous humor هي نفسها بنسبة مختلفة موجودة في
+
+375
+00:24:46,520 --> 00:24:51,040
+البلازمة، صحيح؟ وحدة للآخرة أنه فعلا ال aqueous
+
+376
+00:24:51,040 --> 00:24:55,500
+humor مرده أو أصله هو عبارة من الدمThe electrolyte
+
+377
+00:24:55,500 --> 00:24:57,940
+composition of the aqueous humor is similar to
+
+378
+00:24:57,940 --> 00:25:00,540
+that of the plasma. Electrolyte شو معناها؟
+
+379
+00:25:00,540 --> 00:25:07,180
+Electrolyte؟ شو هي ال electrolyte؟ عبارة عن أي
+
+380
+00:25:07,180 --> 00:25:12,140
+أيونات أو عبارة عن أي أيونات و عبارة عن أي مادة
+
+381
+00:25:12,140 --> 00:25:20,020
+لها أيونات حرة تعمل على توصيل التيار الكهربىمثل
+
+382
+00:25:20,020 --> 00:25:22,360
+عزالة أغلبها الصادم والبوتاسيوم والمغنيسوم
+
+383
+00:25:22,360 --> 00:25:29,060
+والكالسيوم كلها يتعتبر إياش Electrolysed حكينا
+
+384
+00:25:29,060 --> 00:25:33,460
+في مساق أنه تقريبا ال aquisimer المحتوى المقفي
+
+385
+00:25:33,460 --> 00:25:40,000
+تقريبا 98 صحيح 98 هو نايف تقريبا 99.9% من حجمه
+
+386
+00:25:40,000 --> 00:25:45,890
+الأساسي هو يعتبر إياش water componentباقي ال 1 الى
+
+387
+00:25:45,890 --> 00:25:50,390
+2% بيكون لباقي المركبات تقريبا 12 مركب او 11 مركب
+
+388
+00:25:50,390 --> 00:25:53,750
+اول شئ في عندى ال sodium و ال potassium بس نعرف ان
+
+389
+00:25:53,750 --> 00:25:58,550
+ال sodium حجمه تقريبا ضعف الحجم الموجود في الكون
+
+390
+00:25:58,550 --> 00:26:02,870
+ال ابستريام تالى شئ في عندى ال potassium بدون حفظه
+
+391
+00:26:02,870 --> 00:26:06,170
+القيمة القيمة هذه صعبة احنا نحفظها في عندنا ال
+
+392
+00:26:06,170 --> 00:26:07,650
+sodium و ال potassium اللى احنا حكينا عنه بالاصل
+
+393
+00:26:07,650 --> 00:26:10,130
+هو مياشي ال electrolyte صح او لا هذا يعتبر ال
+
+394
+00:26:10,130 --> 00:26:13,610
+electrolyte لإن في عنده شحنة حرة بالتلقاء قابلة
+
+395
+00:26:13,610 --> 00:26:17,880
+توصيل تيار كهرميالتالت حاجة لجلوكاز وهذا مهم جدا
+
+396
+00:26:17,880 --> 00:26:21,300
+لعملية ال mechanism صحيح أو عملية رايدل اللتي تحدث
+
+397
+00:26:21,300 --> 00:26:24,480
+في ال lens في ال central core يعني اه خدوا بقى
+
+398
+00:26:24,480 --> 00:26:28,640
+لكوا هذا مهمة الكمية تاعة دي احنا مش معانا يعني مش
+
+399
+00:26:28,640 --> 00:26:33,070
+مطالبين نحفظهابس فينا نقطة مهمة تقريبا جديش
+
+400
+00:26:33,070 --> 00:26:36,650
+لجلكوزها، 80% نفس الناس اللي متواجهوها بلازمة
+
+401
+00:26:36,650 --> 00:26:39,530
+الدم، عشان الحقيقة تدلع إن هاد الجزايات السكر
+
+402
+00:26:39,530 --> 00:26:43,570
+انتقلت من ال non-pigmented epithelia عبر عملية ال
+
+403
+00:26:43,570 --> 00:26:45,670
+active transport اللي هتكلمنا عليها إما ال bulk
+
+404
+00:26:45,670 --> 00:26:49,810
+flow أو اللي هي solute pumping، ثم وصلت إلى داخل
+
+405
+00:26:49,810 --> 00:26:54,740
+اللي هو الأكياس الهيمة، الactic acidوها ده الطبيعي
+
+406
+00:26:54,740 --> 00:26:57,220
+هو ال acetic acid هى بدون ما نشوفه عبارة عن حجم
+
+407
+00:26:57,220 --> 00:27:00,840
+يعني مضاعف عن ال plasma الدم السبب برضه ذلك انه
+
+408
+00:27:00,840 --> 00:27:04,560
+بسبب وجود عملية العيد صحيح انها اتيجة من ال lens
+
+409
+00:27:04,560 --> 00:27:08,160
+ال .. ال .. ال metabolism of the lens بعدين فينا
+
+410
+00:27:08,160 --> 00:27:11,860
+metabolism of the cone لإن بداية كله راح يتسرب عبر
+
+411
+00:27:11,860 --> 00:27:14,340
+ال endothelia ويسن ال aqueous هنا وبالتالي فينا
+
+412
+00:27:14,340 --> 00:27:17,520
+كميات كبيرة جدا حتى أكتر من المتواجدة في ال plasma
+
+413
+00:27:17,520 --> 00:27:21,740
+الدمبالضبط هذي is twice as the plasma يعني حجم
+
+414
+00:27:21,740 --> 00:27:25,860
+تقريبا او ضعف حجم المتواجد هو كمية متواجدة في ال
+
+415
+00:27:25,860 --> 00:27:32,320
+plasma الدم سبرا دالك بالقرنية و الناس أثناء عملية
+
+416
+00:27:32,320 --> 00:27:36,880
+ال metabolism تتخلص من كيمية كبيرة صحيح باستخدامها
+
+417
+00:27:36,880 --> 00:27:39,480
+الأكسجين من اللي هو ال lactic acid و ال biopic
+
+418
+00:27:39,480 --> 00:27:46,270
+acid رقم خمسة ascorbic acidالاسكوربيك أسد تقريبا
+
+419
+00:27:46,270 --> 00:27:51,710
+حجمه خمسين مرة أكتر من الموجود في البلازمات دموع
+
+420
+00:27:51,710 --> 00:27:57,070
+السبب لأ ذلك أن الاسكوربيك أسد يعمل على انتصاص
+
+421
+00:27:57,070 --> 00:28:01,830
+أشعة ال ultraviolet الدارة بالتالي يقلل قدر
+
+422
+00:28:01,830 --> 00:28:06,010
+الإمكان من كمية ال ultraviolet اللي هتصل إلى ال
+
+423
+00:28:06,010 --> 00:28:10,170
+lens اللي ربما مستقبلا أو قصدا تعرض لها يسبب
+
+424
+00:28:10,170 --> 00:28:15,060
+لكاتاراكتاللي ربما ممكن يعمللي degeneration او تلف
+
+425
+00:28:15,060 --> 00:28:18,360
+في شبكية العين وهذه الأطرافير دايما بترجع السحل
+
+426
+00:28:18,360 --> 00:28:21,720
+بشكل كبير صحيح؟ مثلا متواجدة بالحالات الطبيعية لكن
+
+427
+00:28:21,720 --> 00:28:25,780
+بسبب .. بسبب خرط طبقة ال ozone صح يقولوا لك؟ و
+
+428
+00:28:25,780 --> 00:28:29,100
+أصبح تسريبها بشكل كبير بالذات على المناطق السحلية
+
+429
+00:28:29,100 --> 00:28:33,200
+مثل ذلك على قطع غزاة اللي جاء ايضا في ضفر العين
+
+430
+00:28:33,200 --> 00:28:36,690
+اللي هو Teresiaأيضا من ضمنها هنجيب شكل كبير
+
+431
+00:28:36,690 --> 00:28:39,470
+immaculate generation أيضا من ضمنها حدث عملية
+
+432
+00:28:39,470 --> 00:28:43,090
+cataract في السيادين والعمال اللى بتجري على شطر
+
+433
+00:28:43,090 --> 00:28:45,510
+البحر أيضا هتكون من ضمنها السبب بعد ذلك اللى هو
+
+434
+00:28:45,510 --> 00:28:48,890
+الإنسان بتعرض لجميات كبيرة من ال ultraviolet light
+
+435
+00:28:48,890 --> 00:28:51,510
+اللى هو أصلا نفسه ascorbic acid غير قادر على
+
+436
+00:28:51,510 --> 00:28:54,010
+التخلص منها وانتصاصها كلها بشكل كبير إذا وظيفة
+
+437
+00:28:54,010 --> 00:28:57,750
+الascorbic acid هنا يعمل على انتصاص اللى هو ال
+
+438
+00:28:57,750 --> 00:28:59,390
+ultraviolet light
+
+439
+00:29:08,960 --> 00:29:15,480
+الأساس من وين؟الاكواسفير، صح ولا؟ مافيش أندي، طبعا
+
+440
+00:29:15,480 --> 00:29:17,900
+حكينا احنا العين أو القرية تعتمد اعتماد أساسي على
+
+441
+00:29:17,900 --> 00:29:20,320
+ال oxygen من وين؟ من ال атмосفيرة أو ال
+
+442
+00:29:20,320 --> 00:29:23,060
+environmental oxygen، صح ولا؟ لو حدث أنه في أندي
+
+443
+00:29:23,060 --> 00:29:25,280
+احنا حاطينا contact lens لفترة كبيرة أو هاد ال
+
+444
+00:29:25,280 --> 00:29:28,240
+contact lens ماكنتش oxygen permeable، بالتالي مش
+
+445
+00:29:28,240 --> 00:29:31,340
+هنحدث .. يعني الصح هيكون في أندي كمية معينة من ال
+
+446
+00:29:31,340 --> 00:29:34,240
+oxygen في ال aqueous humorلكن الغالب يا العظمى طول
+
+447
+00:29:34,240 --> 00:29:39,880
+وان ال .. ايوة و حكى ان لو حدث و انا كنت اتلازز
+
+448
+00:29:39,880 --> 00:29:42,740
+حيث ان في عندي حاجة اسمها Noxia صحيح؟ أو Hypoxia
+
+449
+00:29:42,740 --> 00:29:47,860
+كلنا عرفنا بقى طيب extension مافيش عندي اقصر في
+
+450
+00:29:47,860 --> 00:29:52,100
+اصر extension ان اكوي سحب ال range between 13 الى
+
+451
+00:29:52,100 --> 00:29:57,420
+80 و هاد احنا مش معانا يعني النسبة كانت في .. في
+
+452
+00:29:57,420 --> 00:30:01,990
+ال corner كانت اقل من ذلكطيب، بعندي فيه هنا طالب
+
+453
+00:30:01,990 --> 00:30:06,150
+مثال على ال contact lens polymethyl metacrylate
+
+454
+00:30:06,150 --> 00:30:09,270
+المقصود فيها PMMA فنلاقي أنواع من أنواع ال contact
+
+455
+00:30:09,270 --> 00:30:18,350
+lenses المتصنع منها بيهانها، نذكرها هنا PMMA
+
+456
+00:30:19,240 --> 00:30:24,340
+PWM, كله كبتر, a corneal contact lens may produce
+
+457
+00:30:24,340 --> 00:30:27,900
+corneal hypoxia ممكن تسبب ليه ال hypoxia لأنها
+
+458
+00:30:27,900 --> 00:30:31,280
+هتخططي لغالبية سطح القرنية، فبالتالي هسبح في عندي
+
+459
+00:30:31,280 --> 00:30:33,880
+border، في عندي barrier ما بين اللي هو ال oxygen
+
+460
+00:30:33,880 --> 00:30:36,720
+from the atmosphere صحيح و ما بين اللي هو
+
+461
+00:30:36,720 --> 00:30:39,800
+الأبثاليا، فبالتالي هيكون ال oxygen غير قادر على
+
+462
+00:30:39,800 --> 00:30:42,200
+اختراق اللي هو أو الدوابان فيه، الميوسين اللي هي
+
+463
+00:30:42,200 --> 00:30:45,320
+ربطي الفيلم مش هيصل إلى القرنية، فبالتالي الحدث في
+
+464
+00:30:45,320 --> 00:30:46,660
+عندي اللي هو الhypoxia
+
+465
+00:30:52,870 --> 00:30:57,790
+البروتينة البروتينات بشكل طبيعي هناك فقط كيميات
+
+466
+00:30:57,790 --> 00:31:01,730
+قليلة جدا من البروتينات طبعا مقارنة ببلازما الدم
+
+467
+00:31:01,730 --> 00:31:04,690
+البلازما الدم تحتوي على عدد كبير جدا من البروتينات
+
+468
+00:31:04,690 --> 00:31:08,070
+صحيح هو أهمية إليه أهمية أيضا اللي هو مناعية لكن
+
+469
+00:31:08,070 --> 00:31:11,110
+في ال aqueous humor فقط كيميات ضئيلة جدا وهذه
+
+470
+00:31:11,110 --> 00:31:14,530
+كيميات ضئيلة سبرا ده لكن ال aqueous humor barrier
+
+471
+00:31:14,530 --> 00:31:17,810
+اللي احنا اتكلمنا عنه يمنع تدفق البروتينة ده في
+
+472
+00:31:17,810 --> 00:31:20,770
+الحجم الكبير صحيح حتى تصل إلى اللي هو ال aqueous
+
+473
+00:31:20,770 --> 00:31:22,110
+humor why؟ ليش؟
+
+474
+00:31:27,040 --> 00:31:30,400
+عشان لما يمر اليوم بقى تعملش .. عيبا، حتى يحافظ
+
+475
+00:31:30,400 --> 00:31:33,860
+على clear media، صح؟ حتى يحافظ على clear accuracy،
+
+476
+00:31:33,860 --> 00:31:36,260
+معناه ده أول شيء، تاني شيء، لو دخل أصبح في ال exam
+
+477
+00:31:36,260 --> 00:31:38,620
+الحكاية اللي حكيناها قبل شوية، هم هذا كلها ..
+
+478
+00:31:38,620 --> 00:31:43,000
+هتعتبر مقتنع، عشان الحقيقةهتعمل a diffraction of
+
+479
+00:31:43,000 --> 00:31:45,440
+the light بالتالي اللى هتأثرلى على اللى هو ال
+
+480
+00:31:45,440 --> 00:31:48,180
+normal imaging of the eye هتأثرلى على ال optics of
+
+481
+00:31:48,180 --> 00:31:52,520
+the eye هتطلع على حجمه مقارنة ببلازمة الدم واحد
+
+482
+00:31:52,520 --> 00:31:55,860
+فلمية تقريبا او اقل واحد على خمسمية من حجم
+
+483
+00:31:55,860 --> 00:31:58,540
+البروتنات المتوجدة او مساوا البروتنات المتوجدة في
+
+484
+00:31:58,540 --> 00:32:02,020
+بلازمة الدم فهي حتة مقالية جدا جدا لكن هناك بعض
+
+485
+00:32:02,020 --> 00:32:05,780
+الأمراض زى مثلا الاتحان القزحي او الاتحان القزحي
+
+486
+00:32:05,780 --> 00:32:09,360
+صحيه؟ وبدوا يصير فيه عند ال aqueous humor barrier
+
+487
+00:32:09,360 --> 00:32:12,050
+اللى حكينا عن blood aqueous humor barrierلذات فيه
+
+488
+00:32:12,050 --> 00:32:14,710
+اندوهاش breakdown اللي احنا حكيناها اخر محاضرة
+
+489
+00:32:14,710 --> 00:32:18,110
+صحيح؟ بده الحاجز حاجة ده مش حياتين بشكل طبيعي، حيث
+
+490
+00:32:18,110 --> 00:32:20,730
+بقى فيه اندوهاش نفاذية لكميات كبيرة جدا من ال
+
+491
+00:32:20,730 --> 00:32:24,010
+plasma .. ال .. البروتينات الموجودة في ال plasma
+
+492
+00:32:24,010 --> 00:32:27,630
+الدم تتدفق عبر ال aqueous hema، بالتالي المولد
+
+493
+00:32:27,630 --> 00:32:31,690
+هيعاني من قباشة فى الرؤية، توحج إلى أخرى، هذا كله
+
+494
+00:32:31,690 --> 00:32:34,510
+سببه اللي هو تراكم ببروتينات الدم اللي أصلا مش
+
+495
+00:32:34,510 --> 00:32:37,810
+مفروض بالحالة طبيعتكوا متواجدة .. تواجدت في ال
+
+496
+00:32:37,810 --> 00:32:42,520
+aqueous hema أو الهيفي أننا حاكيناها disruption
+
+497
+00:32:42,520 --> 00:32:46,040
+يعني هي نفسها كلمة break down, disruption يعني
+
+498
+00:32:46,040 --> 00:32:50,180
+break down يعني دمار أو تلف للنظام كله هذا اللي هو
+
+499
+00:32:50,180 --> 00:32:53,700
+blood of this hammer باريه صحيح و الطبقات اللي حنا
+
+500
+00:32:53,700 --> 00:32:58,080
+اتكلمنا عليها كلها بداية من اللي هو ال capillaries
+
+501
+00:32:58,080 --> 00:33:00,980
+اللي هيتن بال non pigmented epithelia .. epithelia
+
+502
+00:33:00,980 --> 00:33:05,920
+صحيح كلها حيسبح فيها تلف بالتالي ممكن تتدفق بعض
+
+503
+00:33:05,920 --> 00:33:08,860
+كميات اللي هو البروتينات الى الاندراج أكبر
+
+504
+00:33:09,440 --> 00:33:14,320
+myoglobulin levels هو مناعي
+
+505
+00:33:14,320 --> 00:33:19,040
+صحيح يحافظ على ما هو مناعة ال anterior chamber او
+
+506
+00:33:19,040 --> 00:33:23,520
+ال eyeball كلها ككل وبالتالي يعني يعمل ضد ما هو ال
+
+507
+00:33:23,520 --> 00:33:26,640
+micro bud طب ما هو ال antibody هذا ال IgE اعتبر
+
+508
+00:33:26,640 --> 00:33:31,210
+ايضا ايشمعتبر زي بلتين طب ليش يعني يسمح لو بتدافع
+
+509
+00:33:31,210 --> 00:33:34,130
+بكميات كبيرة جدا حتى لو اتمنى اللي يكون بيتمل
+
+510
+00:33:34,130 --> 00:33:36,930
+يعتبر كميات كبيرة جدا؟ بحجم الجزائي؟ اي لأن حجم
+
+511
+00:33:36,930 --> 00:33:41,030
+الجزائي الصغير جدا ممكن عن طريق اللي هو ال active
+
+512
+00:33:41,030 --> 00:33:43,990
+transport أن ينتقل بكميات كبيرة بينما لبروتينات
+
+513
+00:33:43,990 --> 00:33:47,530
+الدم حجم الجزائي كبير جدا واصلا احنا مش مطالب يعني
+
+514
+00:33:47,530 --> 00:33:51,030
+الجسم غير معنى بيتزويدها بينما في الأكبيسيومر حجم
+
+515
+00:33:51,030 --> 00:33:54,390
+الجزائي صغير جدا تقريبا لا يرى بالعين المجردة
+
+516
+00:33:57,180 --> 00:34:01,360
+المكتوف يانا سبها because of its small size رقم
+
+517
+00:34:01,360 --> 00:34:06,240
+تسعة they are plasminogen and proactivator plasmin
+
+518
+00:34:06,240 --> 00:34:11,000
+كلا ال plasminogen مادتين هذوله و ال proactivator
+
+519
+00:34:11,000 --> 00:34:15,840
+plasminتشارك او تسايم هذه المواد او هذه العوامل في
+
+520
+00:34:15,840 --> 00:34:19,180
+عملية ال micro-abulation system كي تذكرين ان انتوا
+
+521
+00:34:19,180 --> 00:34:22,780
+في عملية تخسر الدم او تخسير الدم اتكلمنا عن
+
+522
+00:34:22,780 --> 00:34:26,000
+المركبين هدولة هدول المركبين بيعمل على تخسير الدم
+
+523
+00:34:26,000 --> 00:34:28,960
+هذا المظيفة الاولى المظيفة التانية بيعمل على منع
+
+524
+00:34:28,960 --> 00:34:34,540
+تكون الفبرينأقولكوا مع أنه دول مثلين يعني حتى توضح
+
+525
+00:34:34,540 --> 00:34:37,440
+الصورة، في بعض الأشخاص اللي بعرضوا لضربة معينة،
+
+526
+00:34:37,440 --> 00:34:40,960
+كرة قدم أو ضربة معينة، ممكن نلاقي فيه عنده نزيف في
+
+527
+00:34:40,960 --> 00:34:44,240
+الغرفة الأمامية، صحيح؟ الوضع الطبيعي مش المفروض
+
+528
+00:34:44,240 --> 00:34:46,580
+يكون فيه عنده ساقل دموي و لا كرة دم حمراء و لا
+
+529
+00:34:46,580 --> 00:34:49,760
+يكون فيه عنده بروتينات، صحيح؟ ليش؟ لأن ال blood
+
+530
+00:34:49,760 --> 00:34:53,510
+-oxyhemal barrier هو حفاظة على المظيفة هذهفقل
+
+531
+00:34:53,510 --> 00:34:55,810
+يتعرض إلى ضربة معينة، ال barrier هداش ما اللي
+
+532
+00:34:55,810 --> 00:34:59,430
+صارله break down أو disruption، مش الحاجة، بالتالي
+
+533
+00:34:59,430 --> 00:35:03,130
+أصبح في عندى الدم، السقل الدمو هذا الصراحة ماياش،
+
+534
+00:35:03,130 --> 00:35:07,590
+ميتجلط، ليش؟ لإن هناك humor في عندى، plasma gene
+
+535
+00:35:07,590 --> 00:35:09,690
+في عندى، proactivity، و هدول التانية العاملة بتعمل
+
+536
+00:35:09,690 --> 00:35:13,730
+ساعدة على تجلط الدم حتى مايضلش ايش، اللي هو يظل
+
+537
+00:35:13,730 --> 00:35:18,980
+متجمع أو متزن في منطقة معينة، هذا رقم واحدرقم
+
+538
+00:35:18,980 --> 00:35:22,660
+اتنين، نرجع من الأخرى لرقم سبعة، في انديوهيتس،
+
+539
+00:35:22,660 --> 00:35:26,060
+اللي هي الانتهاب القذحي، صحيح؟ في إن مصطلف آخر
+
+540
+00:35:26,060 --> 00:35:33,460
+اللي حكينا عنه،
+
+541
+00:35:33,460 --> 00:35:41,120
+اللي هو ساينيكيا، بتاع ساينيكيا،
+
+542
+00:35:41,120 --> 00:35:45,920
+حكينا في قصيرة ساينيكيا، عبارة عن التساقات، صحيح؟
+
+543
+00:35:48,440 --> 00:35:52,680
+هي أنا وهي في عند ال lens بالخلف صح ولا لأ فأصبح
+
+544
+00:35:52,680 --> 00:35:57,940
+في عندي سقط على نوعين في عندي حدث اسمها anterior
+
+545
+00:35:57,940 --> 00:36:00,980
+synechia اللي هي الأمامية تحدث ما بين ال
+
+546
+00:36:00,980 --> 00:36:04,340
+peripheral iris مع ال anterior chamber angle صحيح
+
+547
+00:36:04,340 --> 00:36:07,480
+هذا ال anterior ال posterior تحدث ما بين ال
+
+548
+00:36:07,480 --> 00:36:10,220
+posterior surface of the iris مع ال anterior
+
+549
+00:36:10,220 --> 00:36:16,320
+surface of the lens فهذه posterior synechia ثانية
+
+550
+00:36:16,320 --> 00:36:24,220
+بالأخرىبصيرة surface of the lens of the virus مع
+
+551
+00:36:24,220 --> 00:36:32,680
+ال anterior surface of the lens طيب لما نسمح لنا
+
+552
+00:36:32,680 --> 00:36:34,540
+في لحظة ثانية يعني حاجة ثانية كام ممكن تكون
+
+553
+00:36:34,540 --> 00:36:40,060
+permanentعبادية صحيح؟ سينيكيا بشكل هذا هتعمل على
+
+554
+00:36:40,060 --> 00:36:42,760
+توقفها في آيالس ال trimmer اللي احنا اتكلمنا عنه
+
+555
+00:36:42,760 --> 00:36:45,260
+مش هحدث فيه عند القبال المصابر، حد هو ثابت على
+
+556
+00:36:45,260 --> 00:36:49,460
+طول، صحيح؟ تاني حاجة، المنفذ الوحيد اللي أكوي
+
+557
+00:36:49,460 --> 00:36:51,300
+سيهيمور من ال posterior chamber لل anterior
+
+558
+00:36:51,300 --> 00:36:54,640
+chamber، شو هو؟ ال pupil، لو حدث فيه عندي complete
+
+559
+00:36:54,640 --> 00:36:59,960
+سينيكيا، مش حدث عندي، ضبط ده مش حاسس فيه، هيرتفع،
+
+560
+00:36:59,960 --> 00:37:04,220
+فحتى الأكوي سيهيمور يحاول قصار جهده أنه يمنع تكوين
+
+561
+00:37:04,220 --> 00:37:09,240
+هذه السينيكيافي ند مادة ده في حالات الأكل اللي هو
+
+562
+00:37:09,240 --> 00:37:17,080
+Leviitis اسمها Febrile، انت موجودة معاكوها؟ ايوة
+
+563
+00:37:17,080 --> 00:37:22,000
+هذه هي، حد مادة ال Febrile يتم اتواجدها في حال
+
+564
+00:37:22,000 --> 00:37:25,360
+وجود التهابات داخل العين، اه في حال وجود التهابات
+
+565
+00:37:25,360 --> 00:37:31,060
+داخل العين مثلا على ذلك الاتهاب القزحيسيتم تكوين
+
+566
+00:37:31,060 --> 00:37:34,640
+مادة الفبرا، هذه مادة الفبرا تساعد على إيش؟ على
+
+567
+00:37:34,640 --> 00:37:38,180
+الالتصاق، عشان الحاجة تساعد على الالتصاق، هي أكيد
+
+568
+00:37:38,180 --> 00:37:40,700
+يعني تحديد فقط البصيرة سانيكية أو كإدرس اللي عندها
+
+569
+00:37:40,700 --> 00:37:44,120
+ينتقل لسانيكية، احنا فقط درسناها كمثال، بقعد نظر،
+
+570
+00:37:44,120 --> 00:37:47,540
+بصيرة سانيكية أو إدرس لسانيكية، الهدف أنه كل
+
+571
+00:37:47,540 --> 00:37:50,140
+سانيكية بشكل عام، التصاقات هذه، بديوا يحاولوا
+
+572
+00:37:50,140 --> 00:37:51,620
+يحاولوا يحاولوا يحاولوا يحاولوا يحاولوا يحاولوا
+
+573
+00:37:51,620 --> 00:37:56,660
+يحاولوا يحاولوا يحاولوا يحاولوا
+
+574
+00:37:56,660 --> 00:38:01,310
+يحهذا الصينيكيا مش راح تحدث، ماشي الحق، طبعا في
+
+575
+00:38:01,310 --> 00:38:04,790
+حالات كثيرة الأكويسيمر لوحده لايستطيع، بالذات لو
+
+576
+00:38:04,790 --> 00:38:08,090
+كان فيه عنده إتهابات مشاكل أيش كبيرة، لكن بالحالة
+
+577
+00:38:08,090 --> 00:38:10,010
+الطبيعية لو حدث عنده إتهابات وما أحصلش على
+
+578
+00:38:10,010 --> 00:38:13,630
+الإنسان، لأن الإنسان كثير جدا، يعني على مدى 24
+
+579
+00:38:13,630 --> 00:38:16,530
+ساعات ليه عنده إتهابات من جسده، صحيح ولا لأ؟ صح
+
+580
+00:38:16,530 --> 00:38:19,190
+ولا لأ؟ طب إحنا ليه نحكي؟ طب إحنا ليه لازم نخروا
+
+581
+00:38:19,190 --> 00:38:23,170
+العقلين في وقت الإتهابات أو الفيروسات؟تكون زيادة
+
+582
+00:38:23,170 --> 00:38:25,670
+على الجسم شكل كبير؟ لأ الجسم غير متحملها
+
+583
+00:38:25,670 --> 00:38:28,770
+بالاكويسهيمر بحالة طبيعية يحتفظ على مادة اللي هو
+
+584
+00:38:28,770 --> 00:38:31,450
+ال plasma gene و ال proactivator حتى يمنع حدوث
+
+585
+00:38:31,450 --> 00:38:35,450
+التساقات فشخص معين بدون أي سبب حدث عنده التساقات
+
+586
+00:38:35,450 --> 00:38:39,310
+إلا يكون عنده إتهابات هادئ زيادة حتى على حجم أو
+
+587
+00:38:39,310 --> 00:38:42,330
+على نشاط ال plasma gene و ال proactivator متوجد في
+
+588
+00:38:42,330 --> 00:38:46,810
+الاكويسهيمر بالتالي يبدو حدث عندي اللي هو عملية
+
+589
+00:38:46,810 --> 00:38:50,210
+الصينيكية سواء كانتريا صينيكية أو بستيريا صينيكية
+
+590
+00:38:53,200 --> 00:38:57,160
+طيب رقم عشرة لبنز، لبنز طبعا معدلها أقل بكثير من
+
+591
+00:38:57,160 --> 00:39:02,160
+موجودة باللي هو بلازمة الدم لإن وظيفتها جدا محدودة
+
+592
+00:39:02,160 --> 00:39:05,560
+تماما مثل البروتينات مش مطالبين أيضا ولا المطالب
+
+593
+00:39:05,560 --> 00:39:08,500
+لكي سيمان يكون في كمية كبيرة حتى يعمل على clear
+
+594
+00:39:08,500 --> 00:39:11,510
+media وبالتالي يعمليمنع عملية hot diffraction of
+
+595
+00:39:11,510 --> 00:39:14,550
+light، آخر شي فيه إن في كميات كتيرة أيضا مش بذكورة
+
+596
+00:39:14,550 --> 00:39:17,470
+حقا من ضمنها ال heleronic acid و من ضمنها ال
+
+597
+00:39:17,470 --> 00:39:20,510
+vitamin B12 و من ضمنها ال corticosteroids و في
+
+598
+00:39:20,510 --> 00:39:22,970
+عندى مراكبات أخرى من الفيتامينات لكن كميات دقيقة
+
+599
+00:39:22,970 --> 00:39:26,290
+جدا جدا جدا لإحنا لما نتكلم على ال metabolism of
+
+600
+00:39:26,290 --> 00:39:28,270
+the lens نحن نذكر بعضها إن شاء الله
+
+601
+00:39:31,430 --> 00:39:33,850
+اتكلموا عليا Aquis Dynamics اللى هى ال Dynamics
+
+602
+00:39:33,850 --> 00:39:37,530
+حكى ان احنا حركة عيش الخلط المائي داخل كرة العين،
+
+603
+00:39:37,530 --> 00:39:41,710
+حكينا أخر مرة فى عنده ايضا بعض فلادوية صحيح ممكن
+
+604
+00:39:41,710 --> 00:39:45,070
+تأثرلى او تساهفى تغيير حوارات ال dynamica في Aquis
+
+605
+00:39:45,070 --> 00:39:51,520
+حمر، تذكرينه ولا لا؟ مش ذاكرينه، صحيح؟The
+
+606
+00:39:51,520 --> 00:39:54,100
+maintenance of the stable shape of the eye globe
+
+607
+00:39:54,100 --> 00:39:57,040
+is necessary for the important optical properties
+
+608
+00:39:57,040 --> 00:40:00,180
+of the eye هو المحافظة على هيكلية العين اللي احنا
+
+609
+00:40:00,180 --> 00:40:03,660
+حكيناها architecture of the eyeball صحيح مهمة جدا
+
+610
+00:40:03,660 --> 00:40:07,680
+حتى تمام اللي هو عملية كل ال optical properties
+
+611
+00:40:07,680 --> 00:40:10,640
+لكورة العين بغض النظر كانت القرن القرنية for the
+
+612
+00:40:10,640 --> 00:40:14,300
+cornea for the lens for the petrius الاخرين The
+
+613
+00:40:14,300 --> 00:40:16,440
+pressure of intraocular contents is called
+
+614
+00:40:16,440 --> 00:40:21,010
+intraocular pressure اللي هو IOP صحيحعبارة عن
+
+615
+00:40:21,010 --> 00:40:24,770
+ثلاثة حروف capital لا يتخلّلها نقاط، this is
+
+616
+00:40:24,770 --> 00:40:27,430
+maintained by dynamic equilibrium، نحط خط تحت
+
+617
+00:40:27,430 --> 00:40:31,790
+dynamic equilibrium عبارة عن توازن هذه الحركة
+
+618
+00:40:31,790 --> 00:40:37,210
+المقصود فيها أن معدل ال outflow مايكون بعيد جدا من
+
+619
+00:40:37,210 --> 00:40:40,110
+معدل ال production، و العكس هو اللي حيحدث عند
+
+620
+00:40:40,110 --> 00:40:42,070
+مصطلحين، مصطلح الأول
+
+621
+00:40:55,800 --> 00:41:05,960
+هذا يعني ازدياد ضغط العين او اذا
+
+622
+00:41:05,960 --> 00:41:14,860
+كان لدي
+
+623
+00:41:14,860 --> 00:41:18,940
+معدل production rate اقل من ال outflow
+
+624
+00:41:23,880 --> 00:41:26,880
+مافيش عندى equilibrium، هاي المقصود بـ Dynamic
+
+625
+00:41:26,880 --> 00:41:30,020
+Equilibrium، أن يكون في عندى معدل إنتاج أكويسيه
+
+626
+00:41:30,020 --> 00:41:33,560
+مار، صحيح؟ مايكونش أقل بكتير من اللي هو ال
+
+627
+00:41:33,560 --> 00:41:37,040
+outflow، لو كان أنا مثلا عند العين تلتج، مثلا أجدش
+
+628
+00:41:37,040 --> 00:41:39,880
+فيه أن ال outflow تقريبا حاكينا في الدقيقة؟ تلعب
+
+629
+00:41:39,880 --> 00:41:44,590
+ساعة، صحيح؟لكل ما يتانية اتنية و خمس و سبعين صح
+
+630
+00:41:44,590 --> 00:41:47,450
+ولا؟ هذا معدل ليش ال out of flow إذا اللي مضي يكون
+
+631
+00:41:47,450 --> 00:41:50,570
+في عند ال production ما يسوي أو أكتر منه، مافيحش
+
+632
+00:41:50,570 --> 00:41:54,070
+يكون أقل، صح ولا؟ طبعا في ال .. during ال
+
+633
+00:41:54,070 --> 00:41:56,630
+variation ربما يحدث اختلافات باسمها، أقل من اللي
+
+634
+00:41:56,630 --> 00:41:59,730
+لمشي ضالين و سرعان و يرجع مرة أخرى، لكن لو طال فيه
+
+635
+00:41:59,730 --> 00:42:02,310
+عنده اللي محافظش على ال constant أو ال stability،
+
+636
+00:42:02,310 --> 00:42:06,390
+ثبوتية هذا الإنتاج أو التوازن، ححدثش فيه عنده خلل،
+
+637
+00:42:06,390 --> 00:42:08,770
+طيب، لو كان فيه عند الإفراز أكتر بكتير من ال out
+
+638
+00:42:08,770 --> 00:42:13,780
+of flow system ..الشيء فيه عنده اتفاعة في دقة
+
+639
+00:42:13,780 --> 00:42:17,740
+العلم هو يؤدي الاجبكامة أو أمورات أخرى وهنا لو كان
+
+640
+00:42:17,740 --> 00:42:21,180
+فيه عنده اختلال في النظام اللي هو سمن احنا Dynamic
+
+641
+00:42:21,180 --> 00:42:23,540
+Equilibrium وهذا التعليف اللي احنا مطالبين فيه حتى
+
+642
+00:42:23,540 --> 00:42:27,180
+بتفسيره وش معناته هيحدث عنده اما hypotenia او حدث
+
+643
+00:42:27,180 --> 00:42:29,840
+عنده الهو okay our habit action
+
+644
+00:42:34,100 --> 00:42:36,680
+small varieties in production of our art of flow
+
+645
+00:42:36,680 --> 00:42:39,180
+of aqueous can result in a large changes in
+
+646
+00:42:39,180 --> 00:42:40,000
+intraocular pressure
+
+647
+00:42:43,970 --> 00:42:46,770
+يعني اختلاف بين كمية ال production و كمية ال
+
+648
+00:42:46,770 --> 00:42:49,370
+outflow هو هذا مطلب فيه هذا من ناحية فستولوجية
+
+649
+00:42:49,370 --> 00:42:51,890
+طبيعية جدا حتى يحدث عنده اياش ال circadian rhythm
+
+650
+00:42:51,890 --> 00:42:55,190
+أو IUP مش هنجيه دايما 18 ولا دايما 15 ولا دايما 14
+
+651
+00:42:55,190 --> 00:42:58,730
+صحيح؟ لأن في بعض الأحيان هيزداد .. هيقل في عند ال
+
+652
+00:42:58,730 --> 00:43:01,810
+production و هيزداد ال outflow أو العكس هيزداد ال
+
+653
+00:43:01,810 --> 00:43:04,910
+production و يقل ال outflow وبالتالي عنده اللي هو
+
+654
+00:43:04,910 --> 00:43:09,890
+الملحنة هذا بالشكل هذا صحيح؟ يعني هنجيه 18
+
+655
+00:43:16,880 --> 00:43:23,960
+الحل هاذيش حدث هان ربما زاد ال production صحيح؟
+
+656
+00:43:23,960 --> 00:43:28,040
+زاد بينما ال out of law اشبهله قلق هان العكس زاد
+
+657
+00:43:28,040 --> 00:43:31,760
+ال out of law و قن ال production صحيح؟ لكن كله
+
+658
+00:43:31,760 --> 00:43:34,540
+بقاش بالواضح ايش؟ بقى بال range الطبيعي عشان
+
+659
+00:43:34,540 --> 00:43:38,780
+الحاجة هذه نسميها احلى dynamic equilibrium بشكل
+
+660
+00:43:38,780 --> 00:43:43,320
+مختصر و عبارة عن الحفاظ و عبارة عن الحفاظ على
+
+661
+00:43:46,510 --> 00:43:56,010
+ضغط العين طبيعي بحيث لا ينتج عنه انخفاض شديد في
+
+662
+00:43:56,010 --> 00:44:01,970
+ضغط العين ولا ارتفاع شديد في ضغط العين ويكون
+
+663
+00:44:01,970 --> 00:44:06,530
+الارتفاع وانخفاض ضغط العين من ضمن اللي هو الساعة
+
+664
+00:44:06,530 --> 00:44:10,510
+البيولوجية لكرة العين او الساعة البيولوجية لضغط
+
+665
+00:44:10,510 --> 00:44:15,510
+العين طبعا ممكن تسوؤها بلغتكم بس هذا هو يعني
+
+666
+00:44:15,510 --> 00:44:16,030
+المضمون
+
+667
+00:44:19,770 --> 00:44:27,270
+بعدين نستخدم الـ circular dynamism نستخدم اللي
+
+668
+00:44:27,270 --> 00:44:31,970
+هو دولين ال variation نتكلم على dynamic
+
+669
+00:44:31,970 --> 00:44:32,530
+equilibrium
+
+670
+00:44:35,850 --> 00:44:38,910
+Dynamic equilibrium Aqueous leaves the eye by two
+
+671
+00:44:38,910 --> 00:44:42,690
+pathways هذي احدى ال dynamic equilibrium كفيت او
+
+672
+00:44:42,690 --> 00:44:46,310
+كيف يكيه هتكلم عن ال production نتكلم على ال out
+
+673
+00:44:46,310 --> 00:44:52,290
+of law كيف يتم تصريف ال aqueous humor من خلال كرة
+
+674
+00:44:52,290 --> 00:44:56,060
+العينطبعا احنا عايزين نقوله من خلال الترابيكولا
+
+675
+00:44:56,060 --> 00:44:58,780
+مشواك لكن في عندي other بعاصمه ايضا هناخد أول شي
+
+676
+00:44:58,780 --> 00:45:01,660
+بشكل أساسي اللي هو الترابيكولا outflow اللي هو
+
+677
+00:45:01,660 --> 00:45:04,580
+التفصيل في عبر اللي هو الترابيكولا مشواك صحيح اللي
+
+678
+00:45:04,580 --> 00:45:08,720
+أصلا متواجدة في ال anterior chamber angle aqueous
+
+679
+00:45:08,720 --> 00:45:13,180
+humor is formed from plasma by the cellular
+
+680
+00:45:13,180 --> 00:45:16,000
+epithelium هم aqueous humor is formed by the
+
+681
+00:45:16,000 --> 00:45:18,200
+plasma صحيح فعلا من ال plasma الدم هو ما حكينا
+
+682
+00:45:18,200 --> 00:45:22,740
+احنا جثمه أصلا من السائل الدمويby the cellular
+
+683
+00:45:22,740 --> 00:45:24,820
+epithelium وهذا قصدنا الcellular epithelium اللي
+
+684
+00:45:24,820 --> 00:45:27,600
+هو ال non-pigmented epithelium مش الحق بس احنا
+
+685
+00:45:27,600 --> 00:45:30,780
+وجدنا بالاختبار طبعا يعتبر صح اكيد لان ما خصصناش
+
+686
+00:45:30,780 --> 00:45:31,820
+يعني اعتبر صح
+
+687
+00:45:34,810 --> 00:45:37,730
+خلال هو عملية معقدة then pass to the posterior
+
+688
+00:45:37,730 --> 00:45:41,790
+chamber then pass through the pupil هذه هي يعني
+
+689
+00:45:41,790 --> 00:45:45,010
+بعد تكوين ال aqueous humor هتعتبر ال pathway
+
+690
+00:45:45,010 --> 00:45:47,730
+التخطوة ده بتشريح of the aqueous humor واخدها حنا
+
+691
+00:45:47,730 --> 00:45:50,810
+نفصل الأول يعني بعد يتم تكوينه من السلية للبستريان
+
+692
+00:45:50,810 --> 00:45:53,730
+في ال posterior chamber ينتقل إلى إيش ال anterior
+
+693
+00:45:53,730 --> 00:45:55,970
+chamber عبر اللي هو ال pupil اللي هتكلمنا عنه قبل
+
+694
+00:45:55,970 --> 00:45:59,030
+قليل ومن ثم عبر ال anterior chamber بعد أن يصل إلى
+
+695
+00:45:59,030 --> 00:46:01,570
+ال anterior chamber بيصل إلى ال anterior chamber
+
+696
+00:46:01,570 --> 00:46:06,550
+angle ثم إلى اللي هول typical مشواج هتذكرين بال ..
+
+697
+00:46:06,550 --> 00:46:08,690
+لما خدنا احنا ال gyroscope ايه؟ حكينا فيه ان
+
+698
+00:46:08,690 --> 00:46:12,890
+المركبات أو ال structures اللي احنا خلاص نضيفها لو
+
+699
+00:46:12,890 --> 00:46:15,250
+نتطلع على ال .. على ال anterior chamber angle
+
+700
+00:46:15,250 --> 00:46:20,190
+صحيح؟ ال structures مشواج صحيح أول شيء، بعدين؟
+
+701
+00:46:20,190 --> 00:46:24,890
+typical مشواج و حكينا typical مشواج قبل .. قبل
+
+702
+00:46:24,890 --> 00:46:28,290
+typical مشواج، ايه؟ و فيها لها قسمين ال Syria اللي
+
+703
+00:46:28,290 --> 00:46:32,350
+هو functional و بال Syria صحيح؟الكم الكبير يقع على
+
+704
+00:46:32,350 --> 00:46:36,550
+عيش؟ ايه الجزء الاول ولا التاني؟ اللي هو ال
+
+705
+00:46:36,550 --> 00:46:39,390
+posterior صح ولا؟ اه ده الجزء الاهم جزءه، فهذا هو
+
+706
+00:46:39,390 --> 00:46:42,570
+اللي احنا هنتكلم عنه ان شاء الله، فلما نقصد احنا
+
+707
+00:46:42,570 --> 00:46:44,710
+ال trapico-machoic اللي هو ال posterior trapico
+
+708
+00:46:44,710 --> 00:46:45,230
+-machoic
+
+709
+00:46:55,070 --> 00:46:57,890
+طيب,tropical meshwork into the canal of the sling
+
+710
+00:46:57,890 --> 00:47:00,610
+and passes بعد وصولها ال anterior chamber حتى تصل
+
+711
+00:47:00,610 --> 00:47:03,350
+ال anterior chamber angle و من ثم إلى اللي هو
+
+712
+00:47:03,350 --> 00:47:05,010
+حكيناه احنا الأجزاء المختلفة من ال anterior
+
+713
+00:47:05,010 --> 00:47:07,510
+chamber و الخصوص بالذلك اللي هو posterior chamber,
+
+714
+00:47:08,030 --> 00:47:10,630
+posterior tropical meshwork اللي هي تعتبر
+
+715
+00:47:10,630 --> 00:47:15,470
+functionalinto the canal of a slant and passes
+
+716
+00:47:15,470 --> 00:47:18,510
+through the collector channel and the episcleral
+
+717
+00:47:18,510 --> 00:47:21,870
+veins نرجع مرة أخرى، حيفي عندي تكوين، عندي معايا
+
+718
+00:47:21,870 --> 00:47:25,350
+هنا، تكوين اللي هو ال aqueous humor من الcellary
+
+719
+00:47:25,350 --> 00:47:29,390
+processes أو الcellary بيثيليا، صحيح، اللي هي
+
+720
+00:47:29,390 --> 00:47:32,130
+process أيضا من النتوءات، ما هو أيضا النتوءات وحيط
+
+721
+00:47:32,130 --> 00:47:34,790
+بيها البيثيليا من كل الجهات، تتم تكوين aqueous
+
+722
+00:47:34,790 --> 00:47:37,890
+humor ومن ثم يتدفق عبر، من ال aqueous humor عبر ال
+
+723
+00:47:37,890 --> 00:47:44,130
+pupil إلى ال anterior chamber، من الو من ثم بعد
+
+724
+00:47:44,130 --> 00:47:47,790
+وصولي ال Antigua Chamber ينحاز على كل الأطراف اللي
+
+725
+00:47:47,790 --> 00:47:52,170
+هو ال angle صحيح؟ ال angle في مبركباتها بداية تنحي
+
+726
+00:47:52,170 --> 00:47:54,970
+أصل إلى اللي هو ال tropical meshwag بشكل أساسي هو
+
+727
+00:47:54,970 --> 00:47:57,770
+ال posterior tropical meshwag طبعا ال Antigua أيضا
+
+728
+00:47:57,770 --> 00:48:01,610
+بتسهل لكن بشكل قليل جدا مقارة بال posterior
+
+729
+00:48:01,610 --> 00:48:04,210
+tropical meshwag وبعد أن نصل لل posterior tropical
+
+730
+00:48:04,210 --> 00:48:07,870
+meshwagهيصل الى slams canal اللى حكيناه عبارة عن
+
+731
+00:48:07,870 --> 00:48:12,270
+قناة دائرية صحيح تحيط بكل اللى هو ال angle بتعمل
+
+732
+00:48:12,270 --> 00:48:15,710
+عليها استيعاب كميات كبيرة من ال aqueous humor بعد
+
+733
+00:48:15,710 --> 00:48:18,030
+وصوله الى ال interior of the chamber بعد وصوله الى
+
+734
+00:48:18,030 --> 00:48:22,910
+tropical meshwork ومن ثم هيصل الى slams canal و
+
+735
+00:48:22,910 --> 00:48:25,930
+مرة أخرى عبر اللى هو ال collector عشان الناس مافيش
+
+736
+00:48:25,930 --> 00:48:28,670
+رصمها عندنا هنا و مرة أخرى هيصل الى lipsclera
+
+737
+00:48:28,670 --> 00:48:31,970
+الويز اللى هي الويز المتوجدة في ال lipsclera ثم
+
+738
+00:48:31,970 --> 00:48:35,800
+مرة أخرى ال conjunctiva الويزرزويرجع لدورة دموية
+
+739
+00:48:35,800 --> 00:48:40,600
+مرة أخرى to the ophthalmic vein to the general
+
+740
+00:48:40,600 --> 00:48:44,380
+circulation هذه كل ال pathway احنا مطالبين فيه حرف
+
+741
+00:48:44,380 --> 00:48:48,180
+حرف نعرف بالضبط مصار و اين راحت كيف تم انتاجه و
+
+742
+00:48:48,180 --> 00:48:49,100
+حتى تم تصريفه
+
+743
+00:48:51,740 --> 00:48:55,520
+this pathway اللى عنه مقصده ال pathway اللى هو ال
+
+744
+00:48:55,520 --> 00:48:57,820
+out of flow system اللى حدث عندي بالنسبة
+
+745
+00:48:57,820 --> 00:49:02,620
+للاكنسهيمة ال out of flow تقريبا تسعين ل 95% يعني
+
+746
+00:49:02,620 --> 00:49:06,460
+هيعتمد كورة الإنهي اعتمد أساسي على تصريف الخلط
+
+747
+00:49:06,460 --> 00:49:11,440
+المائي باستخدام أو بطريقة اللى هو لل trapicular مش
+
+748
+00:49:11,440 --> 00:49:17,940
+بال out of flow طيب
+
+749
+00:49:17,940 --> 00:49:21,760
+إذا لابدوا يكون في عندىو جهات أخرى بتسهب و بدأت في
+
+750
+00:49:21,760 --> 00:49:26,500
+95% في جهة طرف أخرى بس قبل ما تترف عليها ناخد أخر
+
+751
+00:49:26,500 --> 00:49:30,560
+نقطة increase IOP will increase tropical outflow
+
+752
+00:49:30,560 --> 00:49:34,300
+until 50 mmHg after this pause of tropical
+
+753
+00:49:34,300 --> 00:49:38,280
+meshwork will be closed بقصد بالعبارة هذه أنه كلما
+
+754
+00:49:38,280 --> 00:49:41,360
+ارتفع ضغط العين بالتالي من ناحية طبيعية من ناحية
+
+755
+00:49:41,360 --> 00:49:45,600
+فسيولوجيةإذا اتفقد اقتلعين عندك لابد يزداد مقابله
+
+756
+00:49:45,600 --> 00:49:48,900
+إيش؟ اللي هو ال outflow مش الحق، هذه حالة طبيعية،
+
+757
+00:49:48,900 --> 00:49:51,860
+طب لمتى هيظل يزداد؟ إذا وصل لخمسين، هذا أصبح مش
+
+758
+00:49:51,860 --> 00:49:55,140
+حالة طبيعية، هذه حالة مرضية قطعا، صح ولا لا؟ إذا
+
+759
+00:49:55,140 --> 00:49:58,920
+وصل لدرجة خمسين، مش هيظل يزداد، لأ بالعكس، حاسس
+
+760
+00:49:58,920 --> 00:50:01,180
+إيه عندك complete blockage، هيسمح فيه عندك إنسان
+
+761
+00:50:01,180 --> 00:50:04,160
+داد كامل، اللي هو الألترابيكالمشوير، فبالتالي في
+
+762
+00:50:04,160 --> 00:50:06,540
+مرضى كثير يعامج ده من اتفقد اقتلعين، بوصل حتى
+
+763
+00:50:06,540 --> 00:50:12,670
+عندهم سبعين، ستين إلى سبعين، حتىبالتالي هذا المريض
+
+764
+00:50:12,670 --> 00:50:15,890
+حتى لو بدناه .. ليش بدناه الأدوية؟ عفوة لإنه عنده
+
+765
+00:50:15,890 --> 00:50:19,390
+اللي هو cliques ال typical مشوار force كل هذا ما
+
+766
+00:50:19,390 --> 00:50:22,610
+سمعته يعني إغلاقها، بتالي مافيش عنده ردد فعل هو
+
+767
+00:50:22,610 --> 00:50:26,750
+استخدام الأدوية طيب،
+
+768
+00:50:26,750 --> 00:50:29,590
+فينا طريقة أخرىزي ما اتكلمنا عن ال tropical
+
+769
+00:50:29,590 --> 00:50:32,650
+outflow في هنا أيضا uvascular outflow ال tropical
+
+770
+00:50:32,650 --> 00:50:36,530
+outflow بت .. بتساهم أو بتشارك في تقريبا تسعين الى
+
+771
+00:50:36,530 --> 00:50:39,410
+خمسة وتسعين في المية و كثير هالناجم المقالات بتحكي
+
+772
+00:50:39,410 --> 00:50:41,750
+ان فقط مشاركة في تقريبا تسعين او تنتين و تسعين في
+
+773
+00:50:41,750 --> 00:50:45,390
+المية بينما ال uvascular outflow بده يساهم تقريبا
+
+774
+00:50:45,390 --> 00:50:49,370
+مقدار يصل لها لا يزيد عن عشرة بالمائة لا يزيد عن
+
+775
+00:50:49,370 --> 00:50:53,850
+عشرة بالمائة the aqueous passes to the supracoldal
+
+776
+00:50:53,850 --> 00:50:56,950
+space اين هي .. يعني وين موجود هذا المركب؟ ال
+
+777
+00:51:00,750 --> 00:51:05,150
+مابين؟ مابين الكورونات و الاسكليرا، في حكينا إذا
+
+778
+00:51:05,150 --> 00:51:08,490
+ذكرينا في الفصل الأول إنها تعتمد .. الشبكية اعتمد
+
+779
+00:51:08,490 --> 00:51:12,730
+أساسي من التخضي على إيش؟ قسمناها إلى anterior one
+
+780
+00:51:12,730 --> 00:51:15,230
+third و posterior two third، صحيح؟ اللي هو التلت
+
+781
+00:51:15,230 --> 00:51:19,910
+الأمامي و التلت الخلفية، التلت الأمامي من وين؟ لأ
+
+782
+00:51:19,910 --> 00:51:24,590
+أبدأالطولة الخالفة اللى بدى يعتمد على ال
+
+783
+00:51:24,590 --> 00:51:27,170
+filtration أو الترشيح الرشح اللى بدى يحدث من
+
+784
+00:51:27,170 --> 00:51:30,690
+الكورويد صح ولا لا؟ بتاع المسافة ما بين الكورويد
+
+785
+00:51:30,690 --> 00:51:34,150
+وما بين ال sclera فى عندي فرق سمناها supercorridor
+
+786
+00:51:34,150 --> 00:51:37,730
+space وهذا أيضا فرق جسم احنا بعد مرور الرشح
+
+787
+00:51:37,730 --> 00:51:41,250
+وعمليات المواد اللى بتتم تخلص منها أثناء ال waste
+
+788
+00:51:41,250 --> 00:51:45,030
+products بتتمر عبر ال space هذا ثم عبر ال .. في
+
+789
+00:51:45,030 --> 00:51:48,950
+ساعة مكفين حتى يتخلص منها الجسم طب إيش دخل يعني ما
+
+790
+00:51:48,950 --> 00:51:52,310
+علاقة لأquis humor في هذه الحالة؟انه في عندى انا
+
+791
+00:51:52,310 --> 00:51:57,190
+بنهاية او المسافة ما بين الcellular body و ما بين
+
+792
+00:51:57,190 --> 00:52:00,310
+اللى هو ال sclera في عندى ايضا اللى هو المساحة
+
+793
+00:52:00,310 --> 00:52:03,550
+اللى بدى توصللى ال supercorridor space بدى يتقل من
+
+794
+00:52:03,550 --> 00:52:06,570
+خلال ال aqueous humor عبر ال supercorridor space
+
+795
+00:52:06,570 --> 00:52:10,610
+بعدين مرة أخرى يرجع اللى هو الأفثامك فيه بالتالي
+
+796
+00:52:10,610 --> 00:52:14,770
+بس بدى يشارك بعشرة يعني أكتر شي عشرة فمية لذلك
+
+797
+00:52:14,770 --> 00:52:18,910
+احتمالنا يعني احنا الطبيب لما يحاول يستخدم أدوية
+
+798
+00:52:19,080 --> 00:52:23,960
+تقلص من إنتاج الـ aqueous hema هذه هتكون أخر شئ
+
+799
+00:52:23,960 --> 00:52:28,480
+تقريبا لإن كمية تقلصها 10% فقط مش هتأثر يعني كتير
+
+800
+00:52:28,480 --> 00:52:32,920
+بينما الأساسية اللى هى ال cellar epithelia طيب the
+
+801
+00:52:32,920 --> 00:52:37,040
+aqueous passed to the superchordal space between
+
+802
+00:52:37,040 --> 00:52:41,700
+the uvral tract مابين ال uvral tract كلها and the
+
+803
+00:52:41,700 --> 00:52:44,860
+sclera اللى هو مابين ال cellary body ومابين ال
+
+804
+00:52:44,860 --> 00:52:50,590
+sclera أيضا موجودة عند الالسبراكرويدر الاسباس او
+
+805
+00:52:50,590 --> 00:52:54,490
+ليك من خلال الاسكليرة بولا في جزء من الاسكليرة
+
+806
+00:52:54,490 --> 00:52:57,490
+الاسكليرة الاسكليرة الاسكليرة الاسكليرة الاسكليرة
+
+807
+00:52:57,490 --> 00:53:00,530
+الاسكليرة الاسكليرة الاسكليرة الاسكليرة الاسكليرة
+
+808
+00:53:00,530 --> 00:53:07,570
+الاسكليرة الاسكليرة الاسكليرة الاسكليرة الاسكليرة
+
+809
+00:53:07,570 --> 00:53:07,930
+الاسكليرة الاسكليرة الاسكليرة الاسكليرة الاسكليرة
+
+810
+00:53:07,930 --> 00:53:08,090
+الاسكليرة الاسكليرة الاسكليرة الاسكليرة الاسكليرة
+
+811
+00:53:08,090 --> 00:53:08,610
+الاسكليرة الاسكليرة الاسكليرة الاسكليرة الاسكليرة
+
+812
+00:53:08,610 --> 00:53:11,800
+الاسكليرة الاسكليرة الفي انا في اندي هذا الشي
+
+813
+00:53:11,800 --> 00:53:15,000
+حكينا سلري بادي هدى parsipilicata و هدى
+
+814
+00:53:15,000 --> 00:53:18,040
+parsipilana صحيح عندى مابين كل ال euretract في
+
+815
+00:53:18,040 --> 00:53:23,700
+عندى مسافة صغيرة جدا هي مابين ال euretract و مابين
+
+816
+00:53:23,700 --> 00:53:26,260
+ال sclera صحيح هدى المسافة سبناها احنا
+
+817
+00:53:26,260 --> 00:53:32,580
+supergeralda space صحيح هدى هي من خلال وصول اكتس
+
+818
+00:53:32,580 --> 00:53:35,980
+همار عبر ال pantera في ال .. الطبيب كان مش بارق
+
+819
+00:53:35,980 --> 00:53:41,990
+تقريبا تسعين الى 95% صح ولافي بضالة ان فقط 10% من
+
+820
+00:53:41,990 --> 00:53:47,110
+5 إلى 10 هي فقط اللى تنتقل عبر المنصفة ما بين
+
+821
+00:53:47,110 --> 00:53:49,830
+الcellular body اللى سمّاها supercorridor space
+
+822
+00:53:49,830 --> 00:54:01,310
+حتى يتم رشحها ووصولها إلى الأفثال مكبين صحيح؟
+
+823
+00:54:01,310 --> 00:54:04,770
+او ان اما قبل حتى وصولها إلى الأفثال مكبين من خلال
+
+824
+00:54:04,770 --> 00:54:05,630
+scleral wall
+
+825
+00:54:09,350 --> 00:54:11,910
+و من دون ترشيحها للخارج بالتالي أناش فيه اندعانة
+
+826
+00:54:11,910 --> 00:54:17,730
+فات صحيح للعام؟ اللي هي تدهون اللغش الناسيجي اللذي
+
+827
+00:54:17,730 --> 00:54:21,490
+يحيط بكرة العين للخارج بعدين هيتم تصاصة مرة أخرى و
+
+828
+00:54:21,490 --> 00:54:25,010
+ترجع مرة أخرى مع اللي هو ال body circulation عشان
+
+829
+00:54:25,010 --> 00:54:28,330
+هذا الطريقة و غير مختلفة طبعا أي هم أكثر في الحالة
+
+830
+00:54:28,330 --> 00:54:31,450
+هذه فقط في ال uv .. في ال uv sclera flow هيكون عن
+
+831
+00:54:31,450 --> 00:54:36,220
+طريق هوالسكلير الوار و لا عن طريق السبراكويدر
+
+832
+00:54:36,220 --> 00:54:39,340
+السباس؟ لأ عن طريق السبراكويدر السباس و أكثر من عن
+
+833
+00:54:39,340 --> 00:54:44,260
+طريق السكلير الوار لكن كلهم موجود يعني و تم تتبع
+
+834
+00:54:44,260 --> 00:54:47,480
+هذا باستخدام ال fluorescent اللي احنا ذكرناه في
+
+835
+00:54:47,480 --> 00:54:52,100
+البداية this
+
+836
+00:54:52,100 --> 00:54:54,360
+flow is independent of intraocular pressure and
+
+837
+00:54:54,360 --> 00:54:57,300
+represents five to ten percent of the duration of
+
+838
+00:54:57,300 --> 00:55:00,240
+aqueous hemorrhage و يعني تحط خط بيه تحت
+
+839
+00:55:00,240 --> 00:55:04,210
+independent of intraocular pressureمش واحد
+
+840
+00:55:04,210 --> 00:55:08,210
+independent ذاته؟ يعني مستقل بحد ذاته بينما
+
+841
+00:55:08,210 --> 00:55:11,070
+الترابيكال مش والك لا يعتمد اعتماد أساسي على ال
+
+842
+00:55:11,070 --> 00:55:12,690
+intraocular pressure إذا زاد عند ال intraocular
+
+843
+00:55:12,690 --> 00:55:17,230
+pressure بدها تقل بده يزاد ال aqueous humor out of
+
+844
+00:55:17,230 --> 00:55:20,650
+flow صح ولا لا لكن بده يقل الإنتاج بينما في الحالة
+
+845
+00:55:20,650 --> 00:55:23,830
+هذي زاد أو قل مافيش علاقة هو عند هذي العلاقة دايما
+
+846
+00:55:23,830 --> 00:55:27,330
+ثابتة أو الكمية هذي ثابتة 5-10% فهذه سواء ارتفع عن
+
+847
+00:55:27,330 --> 00:55:30,430
+ضغط العين او قل عن ضغط العين هي بدها تظهر تصريف
+
+848
+00:55:30,430 --> 00:55:36,230
+هذا الشكل دائمطيب ناخد النقطة الأخيرة ان شاء الله
+
+849
+00:55:36,230 --> 00:55:39,690
+هي intracral pressure fluctuations fluctuations
+
+850
+00:55:39,690 --> 00:55:49,630
+معناها تقل بقى يعني أصبح في عندك تغيرات the
+
+851
+00:55:49,630 --> 00:55:55,330
+number of IOP is between 12 to 20 هي ما بين عشرة
+
+852
+00:55:55,330 --> 00:56:00,030
+تسعة إلى واحد وعشرين هعدلها شويةطبعا في بعض
+
+853
+00:56:00,030 --> 00:56:05,460
+الدراسات تقول انه في الجنس اليابانيعامة في الحالة
+
+854
+00:56:05,460 --> 00:56:14,340
+الطبيعية لن يصل ضغط العين 20 نهائيا بسول 18 طبعا
+
+855
+00:56:14,340 --> 00:56:19,200
+حكينا ان في بعض القرى في الهند تقريبا ما يزيد على
+
+856
+00:56:19,200 --> 00:56:22,860
+60% من أصحاب هذه القرية كلهم ضغط العين عندهم فوق
+
+857
+00:56:22,860 --> 00:56:28,140
+ال 25،25،25،24 وطبعا ماعندهم مجلوكم ولا مرض آخر
+
+858
+00:56:28,140 --> 00:56:33,600
+فأصبح ان هذا تغيرات طبيعيةin most people IOP
+
+859
+00:56:33,600 --> 00:56:36,600
+exhibits during the variation في الحالة الطبيعية
+
+860
+00:56:36,600 --> 00:56:39,920
+في أغلب الناس فيها نسعة بيولوجية أو تغير اللي هو
+
+861
+00:56:39,920 --> 00:56:42,540
+arithmetic variation ما بين ال IOP زى ما حكينا
+
+862
+00:56:42,540 --> 00:56:46,380
+احنا يزداد في وقت اللي هو الفجر ووقت الظهيرة ويقل
+
+863
+00:56:46,380 --> 00:56:50,620
+في وقت النار بمعدل 45% من قياسه الأساسي all
+
+864
+00:56:50,620 --> 00:56:53,520
+breathing this variation is exaggerated in a
+
+865
+00:56:53,520 --> 00:56:56,500
+glaucoma معدل exaggerated يعني يتم المبالغة فيه
+
+866
+00:56:56,500 --> 00:57:01,210
+يعني يزداد هذا الفارق في حالة إيش ال glaucomaزي ما
+
+867
+00:57:01,210 --> 00:57:04,630
+حكيت أنا، بده يصبح ال .. ال .. ال .. ال .. ال
+
+868
+00:57:04,630 --> 00:57:06,550
+general variation فارق ما بين القراءة اللي هو
+
+869
+00:57:06,550 --> 00:57:09,090
+القراءة التانية و القراءة الأخيرة كبير جدا، ربما
+
+870
+00:57:09,090 --> 00:57:11,150
+أكتر من تمانية و ربما أكتر من تسعة، أحيانا أكتر من
+
+871
+00:57:11,150 --> 00:57:15,270
+عشرة It's high in the morning and low in the early
+
+872
+00:57:15,270 --> 00:57:20,290
+night.طيب IOP is higher in winter and lower in
+
+873
+00:57:20,290 --> 00:57:24,330
+summer.حط قناة السفحان Y IOP is higher in winter
+
+874
+00:57:24,330 --> 00:57:28,830
+and lower in summerإذا كنا حكينا في ال mechanism
+
+875
+00:57:28,830 --> 00:57:31,890
+of the cone يحكينا إيش temperature dependent صحيح
+
+876
+00:57:31,890 --> 00:57:36,110
+تعتمد على الحرارة إذا كانت الدرجة الحرارة قليلة في
+
+877
+00:57:36,110 --> 00:57:39,130
+ال coldness اللي بيصيح فيه عندك بتزايد ال
+
+878
+00:57:39,130 --> 00:57:41,690
+thickness هتتحافظ علي إيش كمية كبيرة من السائل و
+
+879
+00:57:41,690 --> 00:57:45,630
+العكس صحيح هي أن في ال IOP نفس الشيء اللي يساعد
+
+880
+00:57:45,630 --> 00:57:48,690
+بالسيف بتحافظ خمس مكيمات كبيرة من السائل صحيح
+
+881
+00:57:48,690 --> 00:57:52,270
+بالتالي هيكون فيه عنده ال out of flow أكتر صحيح
+
+882
+00:57:52,270 --> 00:57:53,130
+بينما بالشتاء
+
+883
+00:57:56,620 --> 00:58:00,100
+هيحتفظ لأن اصلا تناول كمية المعفش تاع هيكون قليل،
+
+884
+00:58:00,100 --> 00:58:03,080
+صحيح؟ و هكذا، إلا بالعلاقة اللي هو العلاقة العامة
+
+885
+00:58:03,080 --> 00:58:07,580
+لجسم الإنسان بما يتعلق بدرجة الحرارة IOP is equal
+
+886
+00:58:07,580 --> 00:58:14,300
+in males and females until years of 4040 years
+
+887
+00:58:14,300 --> 00:58:18,300
+يعني مساوى مبضغط العين بال .. بالذكور والإنار لكن
+
+888
+00:58:18,300 --> 00:58:21,720
+بعد ذلك بصبح أقل في الإنار لإنها دي كلها حطوا
+
+889
+00:58:21,720 --> 00:58:25,760
+عليها خطين يعني تحتي لإنها دي عليها حتى الآن في
+
+890
+00:58:25,760 --> 00:58:29,900
+controversy ايش معنى controversy يعني في .. في
+
+891
+00:58:29,900 --> 00:58:33,120
+جدال عليها بشكل كبير في كثير من الدراسات بتحكي لأ
+
+892
+00:58:33,120 --> 00:58:36,080
+ال males في ضغط العين أكتر بين مدرسات أخرى بتحكي
+
+893
+00:58:36,080 --> 00:58:38,900
+لأ أنا وجدت أنه فيه males في الدراسات الأسترالية
+
+894
+00:58:38,900 --> 00:58:42,400
+في الدراسات الجنو .. الأمريكية الجنوبية بتحكي لأ
+
+895
+00:58:42,400 --> 00:58:46,270
+انه العكسو في وجدوا انه متقاربة جدا فاحنا مش
+
+896
+00:58:46,270 --> 00:58:49,550
+هنجيبها بالاختبار و ناخدها بشكل صمت لأ هي تقريبا
+
+897
+00:58:49,550 --> 00:58:55,470
+متقاربة اه متقاربة
+
+898
+00:58:55,470 --> 00:59:00,770
+طيب IOP tends to increase with advance ليش كلما
+
+899
+00:59:00,770 --> 00:59:06,400
+تقدم الإنسان السن بدو إيش ازاد عنده اللي هوده بطلع
+
+900
+00:59:06,400 --> 00:59:11,340
+يعني لإنه عامل التلابيك لمشواك نوعا ما مش .. مش
+
+901
+00:59:11,340 --> 00:59:14,920
+هيقدر الوظيفة لكن في بعض الدراسات بتحكي إنه بعد سن
+
+902
+00:59:14,920 --> 00:59:18,700
+الأربعين مودي يبدأش .. مودي يقل لإن الصحيح هو بعمل
+
+903
+00:59:18,700 --> 00:59:21,560
+التلابيك لمشواك مش هتلبيله كل الطلبات هذا لكن على
+
+904
+00:59:21,560 --> 00:59:24,800
+بشكل مقابل إن ال .. السلية اللي بسلية مش هيقدرها
+
+905
+00:59:24,800 --> 00:59:28,580
+يفرز بشكل كبير أكوية صحيمة زي ما كان في العشرينات
+
+906
+00:59:28,580 --> 00:59:33,510
+أو المقدمات اللي عنوانIopie decreases in sleep
+
+907
+00:59:33,510 --> 00:59:36,310
+وهذه حكينا عنها احنا and in general anaesthesia،
+
+908
+00:59:36,310 --> 00:59:42,550
+حطوا تحت general anaesthesia خط، ليش؟
+
+909
+00:59:42,550 --> 00:59:47,570
+لأن التخدير بشكل عام شبه النوم، التخدير فيه أن
+
+910
+00:59:47,570 --> 00:59:50,570
+التخدير في بعض الأدوية باستخدام حمال كتمين ممكن
+
+911
+00:59:50,570 --> 00:59:53,910
+تعمل حبود في ضغط العين، تاني حاجة التخدير عام يعمل
+
+912
+00:59:53,910 --> 00:59:57,720
+reduction in excess of your muscle stoneمش يعني؟
+
+913
+00:59:57,720 --> 01:00:01,140
+هو احنا في اي حركة مانتحرك فيها، في عندي اللي هو
+
+914
+01:00:01,140 --> 01:00:03,880
+exertion او contraction of the axilla أو axilla
+
+915
+01:00:03,880 --> 01:00:07,580
+كلمة صحيح، هذه بدها تساعد او تساهم فيش؟ في اللي هو
+
+916
+01:00:07,580 --> 01:00:13,080
+زيادة ضغط العين، بينما عند الاسترخاء حلق اللي عنده
+
+917
+01:00:13,080 --> 01:00:18,050
+ضغط على العين حلق اللي عنده ضغط العينIopie may be
+
+918
+01:00:18,050 --> 01:00:22,190
+increased in extreme case بس نرجع مرة أخر هذه تحدو
+
+919
+01:00:22,190 --> 01:00:25,510
+أمام general anaesthesia هنضع علامة الشفاة لأنها
+
+920
+01:00:25,510 --> 01:00:29,430
+مهمة هتعمل على relaxation of the muscles وبالتالي
+
+921
+01:00:29,430 --> 01:00:36,210
+هتقلل ضغط العين Iopie
+
+922
+01:00:36,210 --> 01:00:38,950
+may be increased in extreme case
+
+923
+01:00:41,020 --> 01:00:44,960
+يعني السنة دلت باتجاه معين طلع فترة معينة طب أكيد
+
+924
+01:00:44,960 --> 01:00:48,300
+هتكون في عندي contraction و هتزاد عندي إيش العضلات
+
+925
+01:00:48,300 --> 01:00:51,800
+ذالك نرجع مرة أخرى عند قياس اللي هو ال IOP في
+
+926
+01:00:51,800 --> 01:00:53,680
+استخدام ال gun metamoramia إيش حاجة كده ال eyeball
+
+927
+01:00:53,680 --> 01:00:57,040
+must be in the primary position حتى نمنع اللي هو
+
+928
+01:00:57,040 --> 01:00:59,960
+the structures of the extra carotid muscle بتالي
+
+929
+01:00:59,960 --> 01:01:02,980
+هتسر في عندي contraction فهي عندي ضغط العين مباشرة
+
+930
+01:01:02,980 --> 01:01:06,120
+كيف هنفهمها؟ خليكم معايااحنا حكينا فيانا potential
+
+931
+01:01:06,120 --> 01:01:09,000
+errors صح فيانا بعض الأخطاء اللي هي سببها من ضمنها
+
+932
+01:01:09,000 --> 01:01:11,720
+وكأن أنا بدأ ضغط على كورة العين ونفس الشيء بهذا
+
+933
+01:01:11,720 --> 01:01:15,300
+السبب هو ال extra kerosis وكأن انا ضعفت ايش ضقت او
+
+934
+01:01:15,300 --> 01:01:19,240
+حمل ثقيل اخر على كورة العين اخر شي فيانا increase
+
+935
+01:01:19,240 --> 01:01:22,960
+vascular venous pressure with increase IOP by
+
+936
+01:01:22,960 --> 01:01:28,350
+changing posture by valsalva maneuverEpiscleral
+
+937
+01:01:28,350 --> 01:01:31,910
+pressure حتى وحكينا Episcleral veins بعد ما يتخلص
+
+938
+01:01:31,910 --> 01:01:34,570
+الأكويسهيومر يعني عفوا كنتوا يعامل أكويسهيومر عمله
+
+939
+01:01:34,570 --> 01:01:39,270
+طيب يكرم شويه حيذهب أو يتطرق لوين كان لو شلمك صحيح
+
+940
+01:01:39,270 --> 01:01:42,870
+بعدين collector channels بعدين فيه هنا Episcleral
+
+941
+01:01:42,870 --> 01:01:45,870
+veins صحيح طب لو الضغط داخل ال Episcleral veins
+
+942
+01:01:45,870 --> 01:01:51,510
+ارتفع التدفق هذا راح يقل الأكويسهيومر صحيح بالتالي
+
+943
+01:01:51,510 --> 01:01:58,340
+اكتب هذا نقطة بس آخر نقطة ارتفاع اللي هوto
+
+944
+01:01:58,340 --> 01:02:05,000
+increase vascular venous pressure EVP تكتفى
+
+945
+01:02:05,000 --> 01:02:09,800
+على الضغط الداخل اللى هو ال vascular veins سوف
+
+946
+01:02:09,800 --> 01:02:16,120
+يؤدي إلى زياد في ضغط العين يقلل
+
+947
+01:02:16,120 --> 01:02:20,340
+تصريف او يحد من ال out of flow اللى هو ال aqueous
+
+948
+01:02:20,340 --> 01:02:25,020
+hemorrha فالظل فمانيوفر طلع عليها مش معاناها دى بس
+
+949
+01:02:25,020 --> 01:02:29,470
+نحكيها بشكل مقتصر طلع عليهافي بعض ال potential
+
+950
+01:02:29,470 --> 01:02:32,190
+earnings احنا لسه ماخدنهاش كمان يعني لإنه كثيرة
+
+951
+01:02:32,190 --> 01:02:37,750
+جدا باستخدام ال IOP لإنسان يكتب نفسه بشكل هذا
+
+952
+01:02:37,750 --> 01:02:41,890
+صحيح، هيك و كإنه بشكل dynamical أو متعمد، خلال ال
+
+953
+01:02:41,890 --> 01:02:45,230
+Venus بروشارش معله عالي أزداد، هو الإنسان اللي
+
+954
+01:02:45,230 --> 01:02:48,760
+بيحط الجرعبة بشكلكتير ضيق جدا و بالعارف يوما
+
+955
+01:02:48,760 --> 01:02:52,140
+بتتكلم او بتنفس صحيح بالشكل هذا ايش ممكن يصير فيه
+
+956
+01:02:52,140 --> 01:02:54,720
+عنده False Alpha Manoeuvre، بدي يستخدم عند ال Vena
+
+957
+01:02:54,720 --> 01:02:57,880
+17، بدالة هي على عند ضغط العين، لكن ضغط العين هذا
+
+958
+01:02:57,880 --> 01:03:00,040
+اللي بيعمل على .. بدي يديه ال false impression، مش
+
+959
+01:03:00,040 --> 01:03:04,240
+هو ال true I أو V، فبالنسبة لقياس ضغط العين احنا
+
+960
+01:03:04,240 --> 01:03:07,240
+كنا يعني اتكلمنا عليها بشكل اش كتير
+
+961
+01:03:18,630 --> 01:03:22,050
+طيب ان في بعض الأدوية .. هناك بعض الأدوية
+
+962
+01:03:22,050 --> 01:03:24,710
+pharmacology of the eye و P هناك بعض الأدوية اللتي
+
+963
+01:03:24,710 --> 01:03:28,370
+تؤثر .. هناك بعض الأدوية اللتي تؤثر على اللي هو
+
+964
+01:03:28,370 --> 01:03:31,750
+انخفاض او ارتفاع طبق العين من هذه الأدوية اول شيء
+
+965
+01:03:31,750 --> 01:03:34,250
+انها ال meiotics ال meiotics هي كل الأدوية اللي
+
+966
+01:03:34,250 --> 01:03:38,230
+بتعمل على اللي هو meiosis of the iris هذه من ال
+
+967
+01:03:38,230 --> 01:03:42,130
+meiotics حكيناها احنافجوزز اف دا عيارس بيعمل لي
+
+968
+01:03:42,130 --> 01:03:46,170
+produce demolition of IOP ويقلل لي من ضغط العين
+
+969
+01:03:46,170 --> 01:03:48,910
+بواسطة contraction of the iris sphincter muscle
+
+970
+01:03:48,910 --> 01:03:52,230
+وبالتالي هيسمح عليهش بعد ما يكون لديه contraction
+
+971
+01:03:52,230 --> 01:03:54,850
+of the sphincter muscle هيفتح لديه الزاوية هصير
+
+972
+01:03:54,850 --> 01:03:58,770
+موقفة وبالتالي هيتفق عن ضغط اجوز الهيومار بشكل
+
+973
+01:03:58,770 --> 01:04:02,230
+أكبر وهذا هو السبب اللي حكينا عنه during sleep
+
+974
+01:04:02,230 --> 01:04:08,170
+هيحدث لديه reduction of IOP بمعدل 45% من حالة
+
+975
+01:04:08,170 --> 01:04:12,590
+اللحق صحيح؟بينما على العكس من ذلك اللي هو
+
+976
+01:04:12,590 --> 01:04:15,330
+Mediatics اخدوا بعض القصة اخر حاجة في الميوتيكس
+
+977
+01:04:15,330 --> 01:04:18,670
+مهم they produce increase in tropical airflow
+
+978
+01:04:18,670 --> 01:04:22,270
+facility فهذا مهم جدا بيسهل لعمل تصريف اللي هو ال
+
+979
+01:04:22,270 --> 01:04:26,070
+ACPS الحمر بينما ال Mediatics produce increase IAP
+
+980
+01:04:26,070 --> 01:04:31,810
+تتعمل على زيادة دبط العين بالضبط في أيش؟ في العين
+
+981
+01:04:31,810 --> 01:04:34,050
+اللي بيكون فيها أصلا ال interior chamber angle
+
+982
+01:04:34,050 --> 01:04:38,030
+shallow أو narrow ليش؟بعد ال dilatation بدي اتجه
+
+983
+01:04:38,030 --> 01:04:40,570
+كل عضلات الدالات اللي ماصلناها تهاشم ال periphery،
+
+984
+01:04:40,570 --> 01:04:45,470
+صحيح؟ بتالع هيضغط على اللي هو ال angle، طبيعي أنه
+
+985
+01:04:45,470 --> 01:04:47,970
+يتقل نسبة عندي ال out of law، بتالع هيبتفع ضغط
+
+986
+01:04:47,970 --> 01:04:53,530
+العين تالت شئ أدريناجيك بيتا blockers agents like
+
+987
+01:04:53,530 --> 01:04:59,930
+Timolane، هذه بعض الأدوية اللي هتتقلل من ضغط العين
+
+988
+01:05:04,180 --> 01:05:06,940
+تانى شىء Carburetor هيدراز ال inhibitors ايضا
+
+989
+01:05:06,940 --> 01:05:11,580
+هيقلل لضغط العين فعلا طلعت و أربع بصناعة ان هاد
+
+990
+01:05:11,580 --> 01:05:14,220
+الأدوية بتعمل على تقليل ضغط العين بدون يعني ما
+
+991
+01:05:14,220 --> 01:05:15,940
+اقلتل ال mechanism اللى انا فيه و بعد احنا هاخدها
+
+992
+01:05:15,940 --> 01:05:19,970
+بشكل مفصل ان شاء اللهأخر حاجة قبل اخرى هي hyper
+
+993
+01:05:19,970 --> 01:05:23,850
+osmotic solutions بتعمل على تقليل منطقة العين
+
+994
+01:05:23,850 --> 01:05:26,650
+بتخفيض ال osmolarity اللي هيتكلمنا عنها آخر مرة،
+
+995
+01:05:26,650 --> 01:05:30,310
+هذا مش حقيقي ده صح ولا؟ حكينا فيها أن المنطقة اللي
+
+996
+01:05:30,310 --> 01:05:32,150
+بيكون فيها high concentration of water زي ال
+
+997
+01:05:32,150 --> 01:05:36,050
+aquisima هيكون osmotic pressure اللي هيش low صحيح؟
+
+998
+01:05:36,190 --> 01:05:39,790
+على العكس من ذلك في القوية الدموية حيكون في عندى
+
+999
+01:05:39,790 --> 01:05:42,690
+high osmotic pressure فاحنا لما ندى علاجة تكون
+
+1000
+01:05:42,690 --> 01:05:45,410
+high osmotic pressure حينتقل عند السائل من ال
+
+1001
+01:05:45,410 --> 01:05:47,650
+aqueous hemawa عبر عيش اللي هو القوية الدموية
+
+1002
+01:05:53,410 --> 01:05:57,810
+طيب hypotonic solutions هذي بتعمل على ارتفاع في
+
+1003
+01:05:57,810 --> 01:06:00,810
+ضغط العين مثلا على ذلك اللي هو شرب الماء بشكل او
+
+1004
+01:06:00,810 --> 01:06:05,170
+بكثرة ممكن ترفع ضغط العين لدرجة تمانية ملي متر اذا
+
+1005
+01:06:05,170 --> 01:06:09,390
+ابقى اخر شئ في عندنا ال cortisonate اللي هي
+
+1006
+01:06:09,390 --> 01:06:14,830
+corticosteroids تعمل على ارتفاع ضغط العين وهذا
+
+1007
+01:06:14,830 --> 01:06:18,620
+اللي اما انا فيه يعنيالموضوع حد ذاته بده يعني بده
+
+1008
+01:06:18,620 --> 01:06:20,460
+محاضرة او اكتر او ما يزيد اللي هو علاقة
+
+1009
+01:06:20,460 --> 01:06:23,680
+الكورتسينات و ضغط العين تعمل او تساعد الكورتسينات
+
+1010
+01:06:23,680 --> 01:06:27,580
+هذه سواء كانت تعطى بشكل local او systemic يعني
+
+1011
+01:06:27,580 --> 01:06:30,200
+تعطى اما عن طريق العين بشكل مباشر او حتى عن طريق
+
+1012
+01:06:30,200 --> 01:06:33,880
+الجسم او اللي هو عبارة عن حبوب تبلع عن طريق الفم
+
+1013
+01:06:33,880 --> 01:06:40,170
+تعمل على ازيادة في ضغط العين عن طريق استثقاءفي ال
+
+1014
+01:06:40,170 --> 01:06:42,630
+tropical meshwar و المقصود استثقائي يعني ممكن يحدث
+
+1015
+01:06:42,630 --> 01:06:45,750
+عندي ادمة او في ال tropical meshwar وبالتالي هي
+
+1016
+01:06:45,750 --> 01:06:49,310
+ارتفاع عندى ضغط العين طبعا ممكن يكون الارتفاع حادث
+
+1017
+01:06:49,310 --> 01:06:51,870
+بشكل دائم او ممكن يكون بشكل transient يعني مؤقت
+
+1018
+01:06:51,870 --> 01:06:55,750
+مديوعة ما يعتمد أساسي على اللي هو مدة استخدام هذه
+
+1019
+01:06:55,750 --> 01:07:00,050
+الكورتسونات، كانت كأثرة؟ طيب السلام عليكم
+
diff --git a/PL9fwy3NUQKwZ2K6wMRTZMEoGVTbELxinF/D5JjsqUOYCs_raw.srt b/PL9fwy3NUQKwZ2K6wMRTZMEoGVTbELxinF/D5JjsqUOYCs_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..dc21639a7d4c3085106427676a4c4c480ea787a3
--- /dev/null
+++ b/PL9fwy3NUQKwZ2K6wMRTZMEoGVTbELxinF/D5JjsqUOYCs_raw.srt
@@ -0,0 +1,4080 @@
+1
+00:00:20,970 --> 00:00:24,670
+السلام عليكم و رحمة الله هي اليوم باسمكم ان شاء
+
+2
+00:00:24,670 --> 00:00:28,730
+الله اللي هو باقي نهار محاضرة ثانية من sociology
+
+3
+00:00:28,730 --> 00:00:31,590
+of the Aquis humor عن IOP انتوا عارفين الأكبر
+
+4
+00:00:31,590 --> 00:00:35,370
+شغلنا احنا وصلنا لحد ايه ان شاء الله لإن هو
+
+5
+00:00:35,370 --> 00:00:39,050
+formation of Aquis humor صحيح؟ بتكلمنا إن في عندي
+
+6
+00:00:39,050 --> 00:00:41,530
+two main processes ال process الأولى اللي هو
+
+7
+00:00:41,530 --> 00:00:44,490
+passive transport حكينا عن passive transport إنه
+
+8
+00:00:44,490 --> 00:00:48,210
+في قسم لشقين الشق الأول اللي هو diffusion اللي هو
+
+9
+00:00:48,210 --> 00:00:51,880
+بيكون تقريبا 10% منبساهم في عشر فمية من تكوين
+
+10
+00:00:51,880 --> 00:00:55,180
+أكويسيهيومار production، فيه إنه كمان ما هو ال
+
+11
+00:00:55,180 --> 00:00:57,760
+filtration، بساهم تقريبا في عشرين فمية من
+
+12
+00:00:57,760 --> 00:00:59,620
+أكويسيهيومار production، وحكينا في ال filtration
+
+13
+00:00:59,620 --> 00:01:02,360
+في نقطة مهمة إن فقط يحدث هذا في ال capillary
+
+14
+00:01:02,360 --> 00:01:06,380
+walls، ماحدثش يعني في ما بين ال membranesاليوم
+
+15
+00:01:06,380 --> 00:01:10,020
+هنيجي على الأهم من اللي هو ال passive transport او
+
+16
+00:01:10,020 --> 00:01:13,780
+من ال diffusion و ال .. و ال filtration هو عبارة
+
+17
+00:01:13,780 --> 00:01:16,760
+عن ال active transport processes طبعا بدنا نذكر
+
+18
+00:01:16,760 --> 00:01:19,580
+انه ال passive transport does not ATP .. it does
+
+19
+00:01:19,580 --> 00:01:21,920
+not need ATP وبالتالي it does not require energy
+
+20
+00:01:21,920 --> 00:01:26,000
+بينما ال active transport process requires energy
+
+21
+00:01:26,000 --> 00:01:29,060
+لإنه ما بعرف أزاى .. فاضليا ذاكريني يعنى إيه حكينا
+
+22
+00:01:29,060 --> 00:01:32,590
+احنا؟دائما ال passive transport from high
+
+23
+00:01:32,590 --> 00:01:35,330
+concentration to low concentration هذا في ال
+
+24
+00:01:35,330 --> 00:01:38,510
+diffusion صحيح بينما في ال active ربما تنقلب
+
+25
+00:01:38,510 --> 00:01:42,250
+المعادلة و يصبح من low إلى high وبالتالي يحتاج إلى
+
+26
+00:01:42,250 --> 00:01:46,480
+ما هو الطاقةو أي عملية تنقل تحدث ما بين الخلايا
+
+27
+00:01:46,480 --> 00:01:51,360
+تحتاج اللي هو تدخل الوسائط لوسائط البروتين اللي هي
+
+28
+00:01:51,360 --> 00:01:54,360
+ميديات ال transport system هذا بالتأكيد انه يحتاج
+
+29
+00:01:54,360 --> 00:01:57,100
+إلى طاقة اليوم هناخد ان شاء الله اللي هو active
+
+30
+00:01:57,100 --> 00:02:00,460
+transport process او system اللي هو بتشير تقريبا
+
+31
+00:02:00,460 --> 00:02:03,920
+في ال 70% من ال whole production of the aqueous
+
+32
+00:02:03,920 --> 00:02:08,630
+humor وهذه احنا بطالبين فيهاعندما يستخدم الخلية
+
+33
+00:02:08,630 --> 00:02:14,130
+جزيئات ATB لتحريك مصادر من خلطة عبر ممبرنة، يستخدم
+
+34
+00:02:14,130 --> 00:02:17,310
+هذا
+
+35
+00:02:17,310 --> 00:02:22,630
+البرنامج عملية
+
+36
+00:02:22,630 --> 00:02:25,890
+عملية Active Transport
+
+37
+00:02:37,800 --> 00:02:41,780
+substances move actively are usually unable to
+
+38
+00:02:41,780 --> 00:02:44,660
+pass in the desired direction by diffusion فهذه
+
+39
+00:02:44,660 --> 00:02:49,820
+يعني ريت من هنا بس نحط علامة معينة substances أو
+
+40
+00:02:49,820 --> 00:02:53,540
+سطرين هدولة يعني أقارن كل المواد أخد نظر شهية كان
+
+41
+00:02:53,540 --> 00:02:57,360
+شوية منها بروتينات منها electrolytes منها بعض ال
+
+42
+00:02:57,360 --> 00:03:01,420
+lipids الاخرى أو ال vitamins كل المواد القادرة على
+
+43
+00:03:01,420 --> 00:03:05,990
+النفاذية من خلال اللي هو ال membraneبواسطة طريقتها
+
+44
+00:03:05,990 --> 00:03:09,070
+اللي هو ال diffusion أو حتى ال filtration بالتالي
+
+45
+00:03:09,070 --> 00:03:11,290
+لابد يكون خلاصي عندي active transport اللي هي غير
+
+46
+00:03:11,290 --> 00:03:16,250
+قادرة على اللي هو نفاذية ال membrane اما بكون بسبب
+
+47
+00:03:17,120 --> 00:03:21,320
+إن حجمها جزئي كبير مرة أخرى أو إما بيكون إنه هي
+
+48
+00:03:21,320 --> 00:03:24,580
+مضطرة تمشي عكس التركيز اللي هي فيه يعني بدل من
+
+49
+00:03:24,580 --> 00:03:26,780
+high concentration to low concentration حد أصبح من
+
+50
+00:03:26,780 --> 00:03:29,140
+low concentration إلى high concentration بالتالي
+
+51
+00:03:29,140 --> 00:03:33,060
+الطريقة هذه مضطرة تستخدم أو تستهلك كمية كبيرة من
+
+52
+00:03:33,060 --> 00:03:38,100
+ال ATP لذلك نسميها active transport system they
+
+53
+00:03:38,100 --> 00:03:41,540
+may be too large to pass through the pores pores
+
+54
+00:03:41,540 --> 00:03:45,520
+معناها الثغور أو الفتحات المسمات الموجودة في
+
+55
+00:03:45,520 --> 00:03:48,920
+الcell membraneبالتالي يعني ممكن المقصود فيه علاج
+
+56
+00:03:48,920 --> 00:03:51,820
+و الحجم من الجزايا يكون كبير، بالتالي غير قادر على
+
+57
+00:03:51,820 --> 00:03:56,330
+اختراق هذا الجدار بواسطة ال diffusionأو أنها تكون
+
+58
+00:03:56,330 --> 00:03:59,830
+غير قادرة على أن تذوق فيه اللي هو الدهون، صحيح؟
+
+59
+00:03:59,830 --> 00:04:04,130
+حكينا أحنا آخر مرة فيه أن أكتر زي مثلا ال oxygen
+
+60
+00:04:04,130 --> 00:04:08,430
+هو يعتبر شفاعة سوليابا، صحيح؟ لإنه يذوق فيه اللي
+
+61
+00:04:08,430 --> 00:04:12,670
+هو ال recent layer of the tear film، بالتالي يصل
+
+62
+00:04:12,670 --> 00:04:16,530
+إلى القرنية و they may have to move against their
+
+63
+00:04:16,530 --> 00:04:18,530
+concentration gradient و had against their
+
+64
+00:04:18,530 --> 00:04:21,270
+concentration gradient اللي أخد فيها عكس التركيز
+
+65
+00:04:21,270 --> 00:04:25,140
+اللي هو فيه، يعنيfrom low to high عكس عملية ال
+
+66
+00:04:25,140 --> 00:04:28,160
+diffusion و هذه العملية بتطلب فعلا كمية كبيرة من
+
+67
+00:04:28,160 --> 00:04:33,800
+ال ATP it may occur by two mechanisms solute
+
+68
+00:04:33,800 --> 00:04:37,320
+pumping and bulk transport و زي ما موجود معانا
+
+69
+00:04:37,320 --> 00:04:40,380
+تحدث كل عملية ال active transport بس تاشر طريقة
+
+70
+00:04:40,380 --> 00:04:45,280
+تانية الطريقة الأولىهي salute pumping هي هذه اللي
+
+71
+00:04:45,280 --> 00:04:50,400
+يقع علي تشكيل وظيفة اكبر من ال bulk transport او
+
+72
+00:04:50,400 --> 00:04:53,520
+ال bulk transport اللي هو عبارة عن النقل بالجملة
+
+73
+00:04:53,520 --> 00:04:59,320
+خليني نبدأ اول شي ب salute pumping ال salute ايه
+
+74
+00:04:59,320 --> 00:05:04,880
+مع ال salute؟ المذاب ولا المذيب؟المذايب على العكس
+
+75
+00:05:04,880 --> 00:05:07,860
+ال solvent صحيح؟ المذايب يقصد فيها كل الأيونات
+
+76
+00:05:07,860 --> 00:05:11,960
+المقصود هنا فيها كل الأيونات أو الأملح اللي غير
+
+77
+00:05:11,960 --> 00:05:14,400
+قادرة على اجتياز غشاء باس ال diffusion اللي الحين
+
+78
+00:05:14,400 --> 00:05:17,960
+بتتكلم عنه علاش ال active transport، ماشي الحاجة؟
+
+79
+00:05:17,960 --> 00:05:21,740
+من ضمن هذه الأشياء، خلّيكم معايا، uses ATP to
+
+80
+00:05:21,740 --> 00:05:26,200
+energize، تنشط ال protein carriers، مش مقصد ال
+
+81
+00:05:26,200 --> 00:05:26,780
+protein carriers
+
+82
+00:05:37,140 --> 00:05:41,780
+ماشي الحاجة حكيها عن بعض أيونات الصوديوم تتقلب
+
+83
+00:05:41,780 --> 00:05:48,200
+from high concentration
+
+84
+00:05:48,200 --> 00:05:54,780
+to low concentration مش
+
+85
+00:05:54,780 --> 00:05:58,340
+عندي وسيط هنا does not require ATP، بدهاش أياش
+
+86
+00:05:58,340 --> 00:06:02,900
+energy، صحيح؟ صح ولا لا؟ طيب، هذا تعتبر passive
+
+87
+00:06:02,900 --> 00:06:03,380
+transport
+
+88
+00:06:06,320 --> 00:06:09,240
+سوف أفضل على طاقة، نفسها الإكشناقة، بما أننا في
+
+89
+00:06:09,240 --> 00:06:14,820
+حالة الـ active ينتقل بالعكس، ال low concentration
+
+90
+00:06:14,820 --> 00:06:19,860
+ليش؟
+
+91
+00:06:19,860 --> 00:06:23,980
+ل high concentration، صحيح؟ هذا رقم واحد، تاني
+
+92
+00:06:23,980 --> 00:06:27,360
+الشيء اللي يكون فيه عند ال protein carrier ال
+
+93
+00:06:27,360 --> 00:06:30,940
+protein carrier بالشكل هذا على سطح أيش؟ ال
+
+94
+00:06:30,940 --> 00:06:35,560
+membrane، صحيح؟ لأن حكينا حجم الجزية كبير جدا و
+
+95
+00:06:35,560 --> 00:06:39,940
+بسرعة ذلكهي جزئات الأحمار الأمنية والسكريات الأخرى
+
+96
+00:06:39,940 --> 00:06:42,900
+وبعد ال labors غير قادرة على اجتياز اللي هو جدار
+
+97
+00:06:42,900 --> 00:06:46,120
+الخلية وبالتالي محتاج إلى وسيط اللي يحصل منها
+
+98
+00:06:46,120 --> 00:06:49,180
+mediated transport system صحيح؟ يعني في عندى وسيط
+
+99
+00:06:49,180 --> 00:06:55,920
+الوسيط هذا حتى يتحرك contact الشكل هذا عندى
+
+100
+00:06:55,920 --> 00:06:58,940
+شكل ال protein هذا عبارة عن نمر وهذا ال passage
+
+101
+00:06:58,940 --> 00:07:01,980
+protein ال protein هذا ال confirmation تبعه شكله
+
+102
+00:07:01,980 --> 00:07:06,480
+بتغير صح ولا؟فمضطر ان الخلية تفرز اكتر من ATP
+
+103
+00:07:06,480 --> 00:07:10,220
+تستهلك اكتر من ATP حتى تتحفظ هذا الوسيط اللي هو ال
+
+104
+00:07:10,220 --> 00:07:14,340
+protein carrier بالنقاش يتغير شكله، عند تغير شكله
+
+105
+00:07:14,340 --> 00:07:17,480
+بدأت تنتقل بعض البروتينات و أجزاء السكر من خارج
+
+106
+00:07:17,480 --> 00:07:21,460
+الخلية إلى داخل الخلية، على نفس النمط، الأجزاء هذه
+
+107
+00:07:21,460 --> 00:07:24,920
+غير قادرة على اجتياز هذا الغشاء، صحيح؟ لأن حجمها
+
+108
+00:07:24,920 --> 00:07:29,560
+جثية أشماله كبيرة جدا، فالمنطقة هذه نسميها protein
+
+109
+00:07:29,560 --> 00:07:29,880
+carrier
+
+110
+00:07:33,460 --> 00:07:36,300
+و هذه تقسمها كتير جدا من ال physiological احنا
+
+111
+00:07:36,300 --> 00:07:38,840
+بغينا عنها بس لإنا عارف ان شكل ال protein curry
+
+112
+00:07:38,840 --> 00:07:44,660
+يتغير صحيح بتدفق جزيئات اللي هو سواء كانت السكر او
+
+113
+00:07:44,660 --> 00:07:47,400
+الأحمار الأمانية او الجزيئات اللي غير قادرة على
+
+114
+00:07:47,400 --> 00:07:50,620
+اجتياز الغشاء الوسطى اللي هو ال diffusion method،
+
+115
+00:07:50,620 --> 00:07:52,300
+هذه احنا بدنا نعرفها، ماشي الحل
+
+116
+00:07:56,950 --> 00:07:59,370
+هذا بالنسبة انا ارجع و اروح لل salute pumping،
+
+117
+00:07:59,370 --> 00:08:02,350
+salute pumping uses ATP to energize its protein
+
+118
+00:08:02,350 --> 00:08:04,390
+carrier، يعني تنشط ال protein carrier اللي احنا
+
+119
+00:08:04,390 --> 00:08:07,870
+بصرا زمان عملناها، minor acids، some sugar and
+
+120
+00:08:07,870 --> 00:08:12,070
+most of ions are transported by salute pumps، and
+
+121
+00:08:12,070 --> 00:08:14,410
+in most cases these substances move against its
+
+122
+00:08:14,410 --> 00:08:16,710
+concentration gradient، والمقصود فيها from low
+
+123
+00:08:16,710 --> 00:08:18,930
+concentration to high concentration، وأغلب
+
+124
+00:08:18,930 --> 00:08:22,450
+العمليات أو الحياوية اللي تحدث في جسم الاسد تحتاج
+
+125
+00:08:22,450 --> 00:08:24,490
+إلى against its concentration، يعني from low
+
+126
+00:08:24,490 --> 00:08:26,890
+concentration to high concentration،كلها بتكون
+
+127
+00:08:26,890 --> 00:08:30,090
+تقريبا عايش active transport system بغض النظر كانت
+
+128
+00:08:30,090 --> 00:08:35,630
+direct أو بيكون فيه ND اللي هو protein carrier the
+
+129
+00:08:35,630 --> 00:08:40,790
+NA, the potassium sodium ATPs مورد معانا هذه
+
+130
+00:08:40,790 --> 00:08:47,510
+الجملة صحيح؟ أو هذا المقطع وين؟ ال pump في ال
+
+131
+00:08:47,510 --> 00:08:51,000
+endothelium صحيح؟ في ال endotheliumIt's a membrane
+
+132
+00:08:51,000 --> 00:08:54,640
+bound enzyme وعبارة عن إنزيم مرتبط بغشاء الخلية،
+
+133
+00:08:54,640 --> 00:08:58,240
+يعني لا يتحرك، هذا الإنزيم مش موجود مثلا في الدم
+
+134
+00:08:58,240 --> 00:09:04,020
+أو يسري بشكل حر، لأ إنما هو مرتبط بخلايا، بغشاء
+
+135
+00:09:04,020 --> 00:09:07,260
+الخلايا، لكن بأي غشاء، بالضبط أي membrane عبارة عن
+
+136
+00:09:07,260 --> 00:09:09,520
+ال non-pigmented epithelium، لأن هو المسؤول بالجهة
+
+137
+00:09:09,520 --> 00:09:12,660
+الأساسية على Aquisemetic production، صحيح؟
+
+138
+00:09:15,300 --> 00:09:17,180
+present in the mantic-mental epithelium of the
+
+139
+00:09:17,180 --> 00:09:19,180
+cellular body aids in solute pumping of many
+
+140
+00:09:19,180 --> 00:09:22,020
+molecules يساهم هذا الإنزين في عملية اللي هو
+
+141
+00:09:22,020 --> 00:09:25,160
+solute pumping بغض النظر اللي كان فيه عنده solute
+
+142
+00:09:25,160 --> 00:09:28,360
+pumping من ناحية أجزاء السكر أو المينو أسد كل
+
+143
+00:09:28,360 --> 00:09:31,120
+عملية هذه هو واحد الإنزين اللي لابد يكون موجود
+
+144
+00:09:31,120 --> 00:09:36,580
+يساهم أو يشارك فيها أخش أن solute pumping provides
+
+145
+00:09:36,580 --> 00:09:39,320
+a way for a cell to be very selective in cases
+
+146
+00:09:39,320 --> 00:09:42,380
+where successes cannot pass by the future في أن
+
+147
+00:09:42,380 --> 00:09:47,210
+الهجوم المكتوبةNo Pump, No Transport هاد الـ No
+
+148
+00:09:47,210 --> 00:09:50,630
+Pump, No Transport خاصة فقط بأجزاء معينة أو
+
+149
+00:09:50,630 --> 00:09:55,010
+بجزيئات معينة في الجسم خاصة بجزيئات معينة وهي
+
+150
+00:09:55,010 --> 00:10:00,170
+عبارة عن الجزيئات الغير قادرة على الانتقال من غشاء
+
+151
+00:10:00,170 --> 00:10:04,290
+الخلية باستخدام طريقة اللي هو الانتشار البسيط اللي
+
+152
+00:10:04,290 --> 00:10:07,590
+هي ال diffusion بحكينا لأسباب إما بكون حجم الجزائي
+
+153
+00:10:07,590 --> 00:10:11,850
+كبير أو إما بتكون تمشي أو تنتقل من low
+
+154
+00:10:11,850 --> 00:10:14,950
+concentration to high concentrationو هكذا إذا هذه
+
+155
+00:10:14,950 --> 00:10:17,390
+الجملة تعني no pump و no transport بالنسبة لهذه
+
+156
+00:10:17,390 --> 00:10:19,930
+الجزئات إذا ما كان عندى solute pumping هذا ال
+
+157
+00:10:19,930 --> 00:10:23,470
+method لن ينتقل نهائيا هذه المقصود no pump و no
+
+158
+00:10:23,470 --> 00:10:30,190
+transport طيب نجي على الطريقة الأخرى هي تعتبر و
+
+159
+00:10:30,190 --> 00:10:34,170
+تسمى ال bank transport أو النقل بالجملة فانت عتقد
+
+160
+00:10:34,170 --> 00:10:39,170
+أغلبنا ع الفيلة ال bank transport
+
+161
+00:10:51,610 --> 00:11:03,670
+فيه طرق دان هم ال endocytosis و
+
+162
+00:11:03,670 --> 00:11:09,230
+ال endocytosis أيهم يحتاج ال ATP؟ ال eggs فقط اللي
+
+163
+00:11:09,230 --> 00:11:11,630
+يحتاج لأنه بدي ماشي عكس الاتجاه صحيح ال endo لا
+
+164
+00:11:11,630 --> 00:11:13,350
+يحتاج انا بده ATP
+
+165
+00:11:19,270 --> 00:11:22,830
+بعدين فينا شئ معين انا هي فيه دي جدار الخلية
+
+166
+00:11:22,830 --> 00:11:28,250
+المقصود بالنقل بالجملة يعني مش هيختار مثلا اجزاء
+
+167
+00:11:28,250 --> 00:11:31,290
+معينة من الايونات او فقط السكريات او الحمض او ايه
+
+168
+00:11:31,290 --> 00:11:34,950
+لأ بالجملة مرة واحدة ربما كل هذه الفقاعة او احنا
+
+169
+00:11:34,950 --> 00:11:38,790
+بسميها her body physical اذا ذاكرين صحيح؟ يعني انت
+
+170
+00:11:38,790 --> 00:11:44,310
+عندك كمية سائل حالة بحوط عليها جسم صحيح؟ بعدين
+
+171
+00:11:44,310 --> 00:11:48,810
+تصبح من فقاعة الجسمفي قطعة فى الخلية حتى يتخلص من
+
+172
+00:11:48,810 --> 00:11:54,370
+هذه المواد بغض الوضع كانت سكريات او كانت حماض
+
+173
+00:11:54,370 --> 00:11:57,930
+أميونية الاخرى بتحاول يتهمها من خارج الخلية إلى
+
+174
+00:11:57,930 --> 00:12:01,370
+داخل الخلية حيث تصبح ايش من ضمن جزء لا جزء من
+
+175
+00:12:01,370 --> 00:12:05,190
+الخلية هذا احنا بنسميه endocytosis صحيح؟ هذا لا
+
+176
+00:12:05,190 --> 00:12:10,190
+يحتاج الاطاقة هذا endocytosis لأن
+
+177
+00:12:10,190 --> 00:12:14,040
+لو كان العكس في عنده بعض الموادبالذات ال end
+
+178
+00:12:14,040 --> 00:12:16,000
+products او ال waste products اللي اتخلصت منها
+
+179
+00:12:16,000 --> 00:12:19,340
+الخلية اثناء عملية الايد بيتخلص منها كده هتتصبح
+
+180
+00:12:19,340 --> 00:12:22,620
+كثيرة جدا صعب عن عملية ال diffusion لان ال
+
+181
+00:12:22,620 --> 00:12:25,360
+diffusion دايما من الحيو كونسنتشن لكونسنتشن صعب
+
+182
+00:12:25,360 --> 00:12:28,720
+جدا وانخلال اللي هو ال protein carrier بالتالي مش
+
+183
+00:12:28,720 --> 00:12:32,000
+هتعمل هتطر هذا فقعات وسميها budding physical
+
+184
+00:12:32,000 --> 00:12:41,780
+الالتئاب
+
+185
+00:12:41,780 --> 00:12:42,720
+جدار الخلية
+
+186
+00:12:48,280 --> 00:12:53,700
+بعدين حتى تصبح جزء من هذا بعدين
+
+187
+00:12:53,700 --> 00:12:57,600
+تبطل هذه الجزئات خارج جزء عنده شكل خلية بالشكل
+
+188
+00:12:57,600 --> 00:13:03,060
+العام هي تسمى exo-cytosis وهذه هي الطريقة اللى
+
+189
+00:13:03,060 --> 00:13:05,280
+تحتاج ATP بكثرة
+
+190
+00:13:07,840 --> 00:13:11,240
+هو عبارة عن النقل بالجملة يتفرع إلى فرعين الفرع
+
+191
+00:13:11,240 --> 00:13:15,620
+الأول هو endocytosis و الأخر فهو exocytosis ال
+
+192
+00:13:15,620 --> 00:13:19,280
+endocytosis لا يحتاج إلى ATP بينما ال exocytosis
+
+193
+00:13:19,280 --> 00:13:22,620
+يحتاج إلى ATP صحيح؟ و حكي مرة أخرى النقل بالجملة
+
+194
+00:13:22,620 --> 00:13:26,180
+تعني أن فيه عندنا أكتر نوع من العنصر أكتر نوع يعني
+
+195
+00:13:26,180 --> 00:13:28,920
+من العناصر ربما يكون إجزاء السكر ربما يكون أحماض
+
+196
+00:13:28,920 --> 00:13:33,660
+أمينية ربما يكون مكونات أخرى lipids الأخرى بالتالي
+
+197
+00:13:33,660 --> 00:13:38,870
+يسمونها احنااللي هو bulk transport طيب باعدة هي
+
+198
+00:13:38,870 --> 00:13:41,610
+لهم ATP may be exocytosis when transport
+
+199
+00:13:41,610 --> 00:13:44,410
+substances out of the cell سمنها العامل هي هذا
+
+200
+00:13:44,410 --> 00:13:47,650
+exocytosis او endocytosis طبعا هذه ال ATP فقط لل
+
+201
+00:13:47,650 --> 00:13:52,510
+exocytosis صح اللي عشان يلعب بال endocytosis طيب
+
+202
+00:13:52,510 --> 00:13:57,710
+تقريبا احنا ممكن خلصنا ان اهم الطرق لانتقال او
+
+203
+00:13:57,710 --> 00:14:00,920
+عفوا الافرازأو تكوين ال aqueous humor production
+
+204
+00:14:00,920 --> 00:14:05,760
+فى هنا بعض الألحظات تحت ال bulk transport اللى هى
+
+205
+00:14:05,760 --> 00:14:09,900
+قدش معدل تقريبا ال out of flow لاللي هو ال aqueous
+
+206
+00:14:09,900 --> 00:14:13,060
+humor المعدل حتى احنا ما نتقلمش فيه و معاهم طلبين
+
+207
+00:14:13,060 --> 00:14:16,240
+بيحفظوا هذا الرقم هو تقريبا تلاتة ملي انا مكتوب 2
+
+208
+00:14:16,240 --> 00:14:23,790
+.5% تلاتة تقريبا تلاتة ملي لتر لكل دقيقةبالساعة
+
+209
+00:14:23,790 --> 00:14:27,170
+سوف يغادر يعني عن جهاز التصريف في كرة العين،
+
+210
+00:14:27,170 --> 00:14:31,950
+فالخلط المعين كمية معينة بتقدر ب 150 ملي لتر، هذه
+
+211
+00:14:31,950 --> 00:14:36,290
+احنا بيكون عادلين، it's slower during sleeping،
+
+212
+00:14:36,290 --> 00:14:43,510
+ليش طيب؟ يعني بجل هو هذا ال out of flow في حالة
+
+213
+00:14:43,510 --> 00:14:43,990
+النوم
+
+214
+00:14:50,710 --> 00:14:55,370
+النمو بلغ؟ لأ
+
+215
+00:14:55,370 --> 00:14:58,210
+لإن هتتكلم احنا على أكويسيهيمر، هذه الكيمية
+
+216
+00:14:58,210 --> 00:15:02,070
+لأكويسيهيمر داخل العين بتتغادرى عن طريق الترابيكا
+
+217
+00:15:02,070 --> 00:15:05,350
+مشواك، صحيح عن طريق الآنجل، صح ولا؟ طب ليش بتزيد
+
+218
+00:15:05,350 --> 00:15:09,290
+بالنهار و بتطلع؟ فورا
+
+219
+00:15:12,610 --> 00:15:15,030
+بحالة .. لأ مالعش علاقتنا نفسنا و ايه اللي هو ايه؟
+
+220
+00:15:15,030 --> 00:15:17,330
+بحالة ان هو شو بيصير في عندي انا construction of
+
+221
+00:15:17,330 --> 00:15:19,870
+the pubis صحيح؟ construction of the pubis بيعمل
+
+222
+00:15:19,870 --> 00:15:22,550
+على اللي هو construction or contraction of the
+
+223
+00:15:22,550 --> 00:15:25,050
+sphincter muscle، هذا المفروض انه يزود ال
+
+224
+00:15:25,050 --> 00:15:28,510
+production، صح ولا؟ لإن ماكواس .. الا عيندي اللي
+
+225
+00:15:28,510 --> 00:15:32,490
+عندي هتتوسع وحاسب ان في عندي another passage مش
+
+226
+00:15:32,490 --> 00:15:35,170
+فقط أو another path يعني مش فقط التبريك المشوية،
+
+227
+00:15:35,170 --> 00:15:39,570
+في عندي حاجة اسمها uvial sclera، هناخدها كمان شوية
+
+228
+00:15:39,570 --> 00:15:43,200
+ان شاء اللهطيب مرة أخرى with an average reduction
+
+229
+00:15:43,200 --> 00:15:47,760
+during sleep تقريبا بتقل بنسبة 45% أثناء النوم من
+
+230
+00:15:47,760 --> 00:15:51,700
+المعدل الطبيعي عنه في النهار مابي contribute to
+
+231
+00:15:51,700 --> 00:15:54,600
+the diurnal variation of intraocular pressure تحت
+
+232
+00:15:54,600 --> 00:15:57,400
+ال diurnal variation هتعرف معانا اللي ماعرفش معاها
+
+233
+00:15:57,400 --> 00:16:01,500
+ال diurnal variation اللي هي التغيراتاو اذا انتوا
+
+234
+00:16:01,500 --> 00:16:03,780
+ذاكرين ال circadian rhythm مش فاهم ال circadian
+
+235
+00:16:03,780 --> 00:16:06,840
+rhythm، ساعة بيولوجية أيضا، كل نظام عندى بجسم
+
+236
+00:16:06,840 --> 00:16:09,640
+الإنسان يعني ساعة بيولوجية، بيولوجية، من ضمن ذلك
+
+237
+00:16:09,640 --> 00:16:13,520
+ضغط الدم، ضغط العين، ومثلا معدل الهرمونات،
+
+238
+00:16:13,520 --> 00:16:16,200
+السرتونين، الكراتينيين، الاخرين، بجسم الإنسان
+
+239
+00:16:16,200 --> 00:16:19,900
+يختلف عنه في ال life، يختلف عنه ..بالنهار، المعدل
+
+240
+00:16:19,900 --> 00:16:22,080
+اللى هو the during reparation اللى متعتبر الساعة
+
+241
+00:16:22,080 --> 00:16:25,400
+البرولوجية لضغط العين بدي ارتفع أثناء الفجر و
+
+242
+00:16:25,400 --> 00:16:28,600
+أثناء وقته ظاهرة، باقى الأوقات بدي انخفض زى ما حنا
+
+243
+00:16:28,600 --> 00:16:32,420
+حكينا وقت ال during sleep بدي انزل بمعدة تقريبا 45
+
+244
+00:16:32,420 --> 00:16:36,940
+% طب
+
+245
+00:16:36,940 --> 00:16:41,930
+وقت الفجر بديكون تقريبا أعلى قياسات لضغط العينو
+
+246
+00:16:41,930 --> 00:16:46,110
+ايضا في وقت الظاهرة طبعا استخدام هذا الفحص الكثرة
+
+247
+00:16:46,110 --> 00:16:49,690
+الدمال برا للتعرف على المريض كل ما زاد عنده ال
+
+248
+00:16:49,690 --> 00:16:53,010
+variation كل ما زاد احتمالية المريض انه يعاني مثلا
+
+249
+00:16:53,010 --> 00:16:56,470
+من ضغط العين يعني احنا على سبيل المثال هاخد مثال
+
+250
+00:16:56,470 --> 00:17:04,710
+بسيط ناخد
+
+251
+00:17:04,710 --> 00:17:08,470
+مثال بسيط يعني لو احنا على التسعة الصباحة اصلا
+
+252
+00:17:08,470 --> 00:17:18,320
+مثلا كان خمستاشرباق الدهار او واحدة مثلا طلع لنا
+
+253
+00:17:18,320 --> 00:17:24,260
+اربم .. تمانت عشر .. عشر عشرين، باق الأوقات طلع
+
+254
+00:17:24,260 --> 00:17:28,020
+سبعت عشر و ست عشر و اربع عشر و تلت عشر و اربم يطلع
+
+255
+00:17:28,020 --> 00:17:31,720
+عشرة، بدنا ناخد أقل قيمة و أكتر قيمة، أقل قيمة
+
+256
+00:17:31,720 --> 00:17:37,540
+كدهاش؟ عشر18 صحيح ماجدش الفرق بينهم تمانية هذا
+
+257
+00:17:37,540 --> 00:17:40,060
+الفرق يعتبر سبعة تمانية مقبول في بعض القرارات تحكي
+
+258
+00:17:40,060 --> 00:17:43,200
+بعد سبعة لأ ماعادوا فيه المرضي عنده مشكلة مش
+
+259
+00:17:43,200 --> 00:17:46,320
+المفروض انه ال journal variation في ال normal eye
+
+260
+00:17:46,320 --> 00:17:50,740
+انه يكون too high عارف واحدة بعدين الفارق ما بينها
+
+261
+00:17:50,740 --> 00:17:53,360
+بين العين اليسرى يعني مش المفروض العين اليوم يكون
+
+262
+00:17:53,360 --> 00:17:57,440
+15 وعين اليسرى فجأة لاجيها 9 او تمانية او لاجيها
+
+263
+00:17:57,440 --> 00:18:00,920
+مثلا 23 مافيه هذه المشكلة لازم الفرق بين العين
+
+264
+00:18:00,920 --> 00:18:04,560
+الييمين وعين اليسرى لايتعدىخمس درجات يعني five I
+
+265
+00:18:04,560 --> 00:18:09,520
+and P معناه لنفس العام اللي ضمن الفريشة مايزدش عن
+
+266
+00:18:09,520 --> 00:18:16,090
+تمانية هذا وحتى الآن بس في جلاء أهم تقريباالشيء
+
+267
+00:18:16,090 --> 00:18:18,290
+احنا ذكرناه واتكلمنا عنه في physiological of the
+
+268
+00:18:18,290 --> 00:18:21,070
+aqueous humor اللي هو functions of the aqueous
+
+269
+00:18:21,070 --> 00:18:24,650
+humor ما هي الفائدة الفيسيولوجية من اللي هو ال
+
+270
+00:18:24,650 --> 00:18:28,670
+aqueous humor أول شي هو المظيفة عندي supply
+
+271
+00:18:28,670 --> 00:18:32,050
+nutrition يعمل على تزويد اللي هو ال lens و ال
+
+272
+00:18:32,050 --> 00:18:35,250
+cornea و ال anterior vitreous فقط لإن ال aqueous
+
+273
+00:18:35,250 --> 00:18:37,890
+humor لا يصل إلى ال posterior vitreous فقط لل
+
+274
+00:18:37,890 --> 00:18:42,340
+anterior vitreous يزودهم ب اللي هوالمواد الغذائية
+
+275
+00:18:42,340 --> 00:18:45,020
+لإن كل المراكب بتاعي تعتبر a vascular tissue،
+
+276
+00:18:45,020 --> 00:18:48,020
+تعتبر إيش؟ اللي هي النسيج اللي يصل إليه العويع
+
+277
+00:18:48,020 --> 00:18:51,650
+الدموي اللي هو العويعيthe peripheral cornea can
+
+278
+00:18:51,650 --> 00:18:54,270
+receive some nutritional needs from limbal
+
+279
+00:18:54,270 --> 00:18:56,870
+vasculature وهذا كلما عليها احنا في research of
+
+280
+00:18:56,870 --> 00:18:59,670
+the cornea لان ال research of the cornea تصل اليها
+
+281
+00:18:59,670 --> 00:19:02,490
+بعض المغاديرات عن طريق ال perilimbal vasculature
+
+282
+00:19:02,490 --> 00:19:05,310
+لو عندهم يرتحو حياته بياشي من حياته الليمبال صحيح
+
+283
+00:19:05,310 --> 00:19:07,930
+حتى بالنسبة لل peripheral cornea بينما ال central
+
+284
+00:19:07,930 --> 00:19:12,270
+لابد حق طبعا الرقم يصل بعض منها ال central لكن
+
+285
+00:19:12,270 --> 00:19:15,470
+غالبيا العظمى او المتعرف عليه ان ال central cornea
+
+286
+00:19:15,470 --> 00:19:19,130
+needs or requires nutrition from the aqueous humor
+
+287
+00:19:19,130 --> 00:19:24,040
+عادي بال centralلذلك احنا لو لاحظنا اشخاص اللي
+
+288
+00:19:24,040 --> 00:19:27,260
+بيعانوا مثلا من الاتهابات او الخدوش لو كانت في
+
+289
+00:19:27,260 --> 00:19:31,540
+الطرف هيكون افضل من الكون بال center، ليش؟ لأن
+
+290
+00:19:31,540 --> 00:19:35,180
+التفضية او المبادئة اللي واصلة من ال limbus هتكون
+
+291
+00:19:35,180 --> 00:19:39,060
+اكثر يعني فيها بروتينات او معدلة اكتر بكتير من ال
+
+292
+00:19:39,060 --> 00:19:42,740
+aqueous تحيبر، بالتالي سرعة التقامة هتكون عيش اكتر
+
+293
+00:19:42,740 --> 00:19:49,320
+او المناعة هتكون فيها بشكل افضلطيب البريفرال كونيا
+
+294
+00:19:49,320 --> 00:19:52,140
+ممكن تحصل على بعض المحتاجات الناقصية من الليمبال و
+
+295
+00:19:52,140 --> 00:19:56,740
+هذا بالنسبة للبريفرال بينما البريفرال يجب أن تحصل
+
+296
+00:19:56,740 --> 00:20:01,860
+على مغذياتها من الاكويس الحمر المتواجد في الانترال
+
+297
+00:20:01,860 --> 00:20:05,980
+وسيرة شمبا طيب
+
+298
+00:20:05,980 --> 00:20:10,340
+في ان هنا سؤال حتى انا ما علمت صفها removal of the
+
+299
+00:20:10,340 --> 00:20:12,660
+limbs causes increased glucose in the aqueous
+
+300
+00:20:12,660 --> 00:20:16,860
+limer and decreased lactic acidأظن مره معانا هذا
+
+301
+00:20:16,860 --> 00:20:23,320
+المصطلح ال lactic acid وين؟ بعتبر
+
+302
+00:20:23,320 --> 00:20:26,340
+one of the products صحيح؟ فيه ان كمان مصطلح غيره
+
+303
+00:20:26,340 --> 00:20:31,200
+ال pyruvic acid و ال lactic acid اي زيادتهم بتعمل
+
+304
+00:20:31,200 --> 00:20:34,560
+حمضية يعني اي زيادتهم بتعمل ايش acidification of
+
+305
+00:20:34,560 --> 00:20:38,000
+the lens هو نفسه هذا، لاتيش عموية أيضا لل lens
+
+306
+00:20:38,000 --> 00:20:40,670
+نفسها، احنا لما ناخد physiology of the lensحمشد
+
+307
+00:20:40,670 --> 00:20:43,590
+انه انا اتش عملية ايضا ال lens نفس الشيء في اندي
+
+308
+00:20:43,590 --> 00:20:46,150
+ايضا pyruvic acid و في اندي ايضا اللي هو ال lactic
+
+309
+00:20:46,150 --> 00:20:48,730
+acid طب ليش بعد عملية ال cataract او بعد ما احنا
+
+310
+00:20:48,730 --> 00:20:52,910
+نشيل ال lens كلها هلاج نسبة ال lactic acid اشملها؟
+
+311
+00:20:52,910 --> 00:20:58,390
+ليش عملية ايه إذا ال lens كلها راحت و ماظلش عندي
+
+312
+00:20:58,390 --> 00:21:00,670
+عملية ايه ده أصلا في عندي أسس صناعية فقط صحيح؟
+
+313
+00:21:00,670 --> 00:21:03,470
+بالتالي ال lactic acid طبيعي جدا لإنه ايش كل كميته
+
+314
+00:21:03,470 --> 00:21:07,460
+قليلةطب فى عندى كمان حاجة أخرى، احنا حاكي إن
+
+315
+00:21:07,460 --> 00:21:10,880
+اللاكتك أسد و ال بيربك أسد القراية لابد تتخلص منهم
+
+316
+00:21:10,880 --> 00:21:14,440
+حتى لا يحدث عنده إيش؟ اللي هو acidification كيف
+
+317
+00:21:14,440 --> 00:21:17,940
+تخلص منهم؟ ع طريق الاندوستيليان، صحيح؟ بتلاقي ده
+
+318
+00:21:17,940 --> 00:21:20,840
+فيه عندك كميات معتبر، احنا هناخدها كمان شوية من
+
+319
+00:21:20,840 --> 00:21:24,020
+اللاكتك أسد داخلك وسيما، لكن غياب الليز كل مرة
+
+320
+00:21:24,020 --> 00:21:27,140
+واحدة خلال تقريبا غياب النصر، صحيح؟ لإن انا أصلا
+
+321
+00:21:27,140 --> 00:21:32,300
+مش عندى اللي هو metabolism for the less نفس الشيء
+
+322
+00:21:32,300 --> 00:21:36,480
+عن طبيق علاق للجلوكوزليش الجلوكوز بده يزداد عملية
+
+323
+00:21:36,480 --> 00:21:39,160
+عكسية لإنه أفضل الجلوكوز دي يدخل داخل ال aqueous
+
+324
+00:21:39,160 --> 00:21:42,960
+humor لتقضية اللي هو ال center cornea زائد ال lens
+
+325
+00:21:42,960 --> 00:21:45,260
+في عملية ال metabolism إذا راحت ال lens بالتالي
+
+326
+00:21:45,260 --> 00:21:48,740
+أيضا راحت عند الاحتياج الأساسي بالتالي هيزداد معدل
+
+327
+00:21:48,740 --> 00:21:54,640
+اللي هو الجلوكوز في ال aqueous humor هذا الوظيفة
+
+328
+00:21:54,640 --> 00:21:57,520
+الأولى، الوظائفة الأولى معانا، كما عرفوها، طلبين
+
+329
+00:21:57,520 --> 00:22:01,450
+فيهارقم 2 maintain the intraocular pressure تعمل
+
+330
+00:22:01,450 --> 00:22:07,670
+الحفاظ على طاقة الدم وهو هذه الوظيفة الأساسية طب
+
+331
+00:22:07,670 --> 00:22:10,190
+لما نحكي احنا maintain الحفاظ على طاقة الدم الحالة
+
+332
+00:22:10,190 --> 00:22:14,770
+الطبيعية it's
+
+333
+00:22:14,770 --> 00:22:18,110
+a transparent medium to pass light تدورتنا أيضا هو
+
+334
+00:22:18,110 --> 00:22:20,430
+يعتبر جزء من اللي هو الocular media صحيح؟
+
+335
+00:22:20,430 --> 00:22:26,100
+transparent ocular media انه شفافهيعمل على مرور
+
+336
+00:22:26,100 --> 00:22:29,280
+الضوء بشكل ايش سليم without scattering مش هيحدث
+
+337
+00:22:29,280 --> 00:22:32,440
+عندنا فيه diffraction لكن في بعض الأمراض هلاجي
+
+338
+00:22:32,440 --> 00:22:36,260
+احنا القرانية لو اعتبرنا انه هذا قرانية واخدنا
+
+339
+00:22:36,260 --> 00:22:39,800
+مقطع عدل بالاسلتلانة صحيح؟ وهنا فيه عند الابيثيليا
+
+340
+00:22:39,800 --> 00:22:43,660
+وهنا فيه عند الاندروثيليا صحيح؟ لك نشوف احنا على
+
+341
+00:22:43,660 --> 00:22:48,160
+الاسلتلانة في حياة الاتهابات هلاجي فيه اندهان ايش؟
+
+342
+00:22:48,160 --> 00:22:50,240
+اكويسيبر المفروض انه transparent المفروض انه
+
+343
+00:22:50,240 --> 00:22:52,630
+invisible صحيح او لأ؟لك حالات كثيرة دي بعض
+
+344
+00:22:52,630 --> 00:22:55,450
+الخلايا، بعض البروتينات، احنا هنحكيها كمان شوية،
+
+345
+00:22:55,450 --> 00:22:57,650
+هذه البروتينات لما يدخلوا الضوء، إيش هيعملها؟ إيش
+
+346
+00:22:57,650 --> 00:23:02,770
+هتعمل إيه؟ تصيب ال fracture، صح ولا؟ فهذا يعني إنه
+
+347
+00:23:02,770 --> 00:23:06,990
+بالحالة الطبيعية، لكوسيمر بده يشارك بعملية نفاذية
+
+348
+00:23:06,990 --> 00:23:10,690
+الضوء بشكل إيش سليم، اللي هو transparent medium
+
+349
+00:23:13,270 --> 00:23:16,550
+أخر شئ احنا خدناه بالقرنية هو مظيفة أساسية او
+
+350
+00:23:16,550 --> 00:23:19,770
+function of the iris حمره بيعمل على abolish the
+
+351
+00:23:19,770 --> 00:23:22,010
+minus power of the posterior surface of the cornea
+
+352
+00:23:22,010 --> 00:23:25,350
+هذه احنا خدناها مش على إيدة مرة تانية صحيح بيعمل
+
+353
+00:23:25,350 --> 00:23:27,630
+على abolishment ان اصلا مافيش عند ال surface
+
+354
+00:23:27,630 --> 00:23:31,650
+مباشرة يعني لغاية اللي هو ال posterior ال minus
+
+355
+00:23:31,650 --> 00:23:34,070
+power لل posterior surface في ان كمان تزيه مش
+
+356
+00:23:34,070 --> 00:23:39,890
+موجودة هنا رقم خمسة يحافظ على or maintains the
+
+357
+00:23:39,890 --> 00:23:44,970
+architecture of the eyeballهيكلية العين، بدون ضغط
+
+358
+00:23:44,970 --> 00:23:47,850
+العين مايوجد عندها هيكلية، صحيح؟ حتى وإن كان كل
+
+359
+00:23:47,850 --> 00:23:50,610
+الأجزاء اللي اتكلمنا عليها من واحد إلى أربعة كلها
+
+360
+00:23:50,610 --> 00:23:52,550
+سليمة، لكن بيضل فيها عندها هيكلية العين وما
+
+361
+00:23:52,550 --> 00:23:56,730
+تتعرضاش للدمور، عشان يحافظ على هيكلية العين،
+
+362
+00:23:56,730 --> 00:24:02,750
+architecture of the eyeball بدون ما نكتبها طيب
+
+363
+00:24:03,320 --> 00:24:07,240
+يجي مرة أخرى composition of أكويسي حمر، مما يحتوي
+
+364
+00:24:07,240 --> 00:24:10,200
+أو على أي شيء يحتوي الأكويسي حمر، ما هي مركبات
+
+365
+00:24:10,200 --> 00:24:16,560
+الأكويسي حمر أو مكوناته، يجي مرة أخرى، أكويسي حمر
+
+366
+00:24:16,560 --> 00:24:22,020
+هو عبارة عن جزء من أشهر، كله ككله، زي دموع العين،
+
+367
+00:24:22,020 --> 00:24:25,780
+صحيح؟ أو زي حليب الأم، أو مثلا على ذلك البول في
+
+368
+00:24:25,780 --> 00:24:29,180
+المثال البولية، كله أصل مشتق من وين؟من الساقل
+
+369
+00:24:29,180 --> 00:24:31,660
+الدموي؟ أه يبقى، من الساقل الدموي، وهذا نفس الشيء،
+
+370
+00:24:31,660 --> 00:24:34,500
+composition of aqueous humor بيعتبر أصل جسم ناشط
+
+371
+00:24:34,500 --> 00:24:36,820
+أو مشطق ممين من الساقل الدموي، هي من الأوعي
+
+372
+00:24:36,820 --> 00:24:39,820
+الدموية اللي هتوحيد بال .. اللي هو ال celiabody،
+
+373
+00:24:39,820 --> 00:24:43,920
+صح ولا؟ ودليل على ذلك أن أغلب مشطقات هادي ال
+
+374
+00:24:43,920 --> 00:24:46,520
+aqueous humor هي نفسها بنسبة مختلفة موجودة في
+
+375
+00:24:46,520 --> 00:24:51,040
+البلازمة، صحيح؟ وحدة للآخرة أنه فعلا ال aqueous
+
+376
+00:24:51,040 --> 00:24:55,500
+humor مرده أو أصله هو عبارة من الدمThe electrolyte
+
+377
+00:24:55,500 --> 00:24:57,940
+composition of the aqueous humor is similar to
+
+378
+00:24:57,940 --> 00:25:00,540
+that of the plasma. Electrolyte شو معناها؟
+
+379
+00:25:00,540 --> 00:25:07,180
+Electrolyte؟ شو هي ال electrolyte؟ عبارة عن أي
+
+380
+00:25:07,180 --> 00:25:12,140
+أيونات أو عبارة عن أي أيونات و عبارة عن أي مادة
+
+381
+00:25:12,140 --> 00:25:20,020
+لها أيونات حرة تعمل على توصيل التيار الكهربىمثل
+
+382
+00:25:20,020 --> 00:25:22,360
+عزالة أغلبها الصادم والبوتاسيوم والمغنيسوم
+
+383
+00:25:22,360 --> 00:25:29,060
+والكالسيوم كلها يتعتبر إياش Electrolysed حكينا
+
+384
+00:25:29,060 --> 00:25:33,460
+في مساق أنه تقريبا ال aquisimer المحتوى المقفي
+
+385
+00:25:33,460 --> 00:25:40,000
+تقريبا 98 صحيح 98 هو نايف تقريبا 99.9% من حجمه
+
+386
+00:25:40,000 --> 00:25:45,890
+الأساسي هو يعتبر إياش water componentباقي ال 1 الى
+
+387
+00:25:45,890 --> 00:25:50,390
+2% بيكون لباقي المركبات تقريبا 12 مركب او 11 مركب
+
+388
+00:25:50,390 --> 00:25:53,750
+اول شئ في عندى ال sodium و ال potassium بس نعرف ان
+
+389
+00:25:53,750 --> 00:25:58,550
+ال sodium حجمه تقريبا ضعف الحجم الموجود في الكون
+
+390
+00:25:58,550 --> 00:26:02,870
+ال ابستريام تالى شئ في عندى ال potassium بدون حفظه
+
+391
+00:26:02,870 --> 00:26:06,170
+القيمة القيمة هذه صعبة احنا نحفظها في عندنا ال
+
+392
+00:26:06,170 --> 00:26:07,650
+sodium و ال potassium اللى احنا حكينا عنه بالاصل
+
+393
+00:26:07,650 --> 00:26:10,130
+هو مياشي ال electrolyte صح او لا هذا يعتبر ال
+
+394
+00:26:10,130 --> 00:26:13,610
+electrolyte لإن في عنده شحنة حرة بالتلقاء قابلة
+
+395
+00:26:13,610 --> 00:26:17,880
+توصيل تيار كهرميالتالت حاجة لجلوكاز وهذا مهم جدا
+
+396
+00:26:17,880 --> 00:26:21,300
+لعملية ال mechanism صحيح أو عملية رايدل اللتي تحدث
+
+397
+00:26:21,300 --> 00:26:24,480
+في ال lens في ال central core يعني اه خدوا بقى
+
+398
+00:26:24,480 --> 00:26:28,640
+لكوا هذا مهمة الكمية تاعة دي احنا مش معانا يعني مش
+
+399
+00:26:28,640 --> 00:26:33,070
+مطالبين نحفظهابس فينا نقطة مهمة تقريبا جديش
+
+400
+00:26:33,070 --> 00:26:36,650
+لجلكوزها، 80% نفس الناس اللي متواجهوها بلازمة
+
+401
+00:26:36,650 --> 00:26:39,530
+الدم، عشان الحقيقة تدلع إن هاد الجزايات السكر
+
+402
+00:26:39,530 --> 00:26:43,570
+انتقلت من ال non-pigmented epithelia عبر عملية ال
+
+403
+00:26:43,570 --> 00:26:45,670
+active transport اللي هتكلمنا عليها إما ال bulk
+
+404
+00:26:45,670 --> 00:26:49,810
+flow أو اللي هي solute pumping، ثم وصلت إلى داخل
+
+405
+00:26:49,810 --> 00:26:54,740
+اللي هو الأكياس الهيمة، الactic acidوها ده الطبيعي
+
+406
+00:26:54,740 --> 00:26:57,220
+هو ال acetic acid هى بدون ما نشوفه عبارة عن حجم
+
+407
+00:26:57,220 --> 00:27:00,840
+يعني مضاعف عن ال plasma الدم السبب برضه ذلك انه
+
+408
+00:27:00,840 --> 00:27:04,560
+بسبب وجود عملية العيد صحيح انها اتيجة من ال lens
+
+409
+00:27:04,560 --> 00:27:08,160
+ال .. ال .. ال metabolism of the lens بعدين فينا
+
+410
+00:27:08,160 --> 00:27:11,860
+metabolism of the cone لإن بداية كله راح يتسرب عبر
+
+411
+00:27:11,860 --> 00:27:14,340
+ال endothelia ويسن ال aqueous هنا وبالتالي فينا
+
+412
+00:27:14,340 --> 00:27:17,520
+كميات كبيرة جدا حتى أكتر من المتواجدة في ال plasma
+
+413
+00:27:17,520 --> 00:27:21,740
+الدمبالضبط هذي is twice as the plasma يعني حجم
+
+414
+00:27:21,740 --> 00:27:25,860
+تقريبا او ضعف حجم المتواجد هو كمية متواجدة في ال
+
+415
+00:27:25,860 --> 00:27:32,320
+plasma الدم سبرا دالك بالقرنية و الناس أثناء عملية
+
+416
+00:27:32,320 --> 00:27:36,880
+ال metabolism تتخلص من كيمية كبيرة صحيح باستخدامها
+
+417
+00:27:36,880 --> 00:27:39,480
+الأكسجين من اللي هو ال lactic acid و ال biopic
+
+418
+00:27:39,480 --> 00:27:46,270
+acid رقم خمسة ascorbic acidالاسكوربيك أسد تقريبا
+
+419
+00:27:46,270 --> 00:27:51,710
+حجمه خمسين مرة أكتر من الموجود في البلازمات دموع
+
+420
+00:27:51,710 --> 00:27:57,070
+السبب لأ ذلك أن الاسكوربيك أسد يعمل على انتصاص
+
+421
+00:27:57,070 --> 00:28:01,830
+أشعة ال ultraviolet الدارة بالتالي يقلل قدر
+
+422
+00:28:01,830 --> 00:28:06,010
+الإمكان من كمية ال ultraviolet اللي هتصل إلى ال
+
+423
+00:28:06,010 --> 00:28:10,170
+lens اللي ربما مستقبلا أو قصدا تعرض لها يسبب
+
+424
+00:28:10,170 --> 00:28:15,060
+لكاتاراكتاللي ربما ممكن يعمللي degeneration او تلف
+
+425
+00:28:15,060 --> 00:28:18,360
+في شبكية العين وهذه الأطرافير دايما بترجع السحل
+
+426
+00:28:18,360 --> 00:28:21,720
+بشكل كبير صحيح؟ مثلا متواجدة بالحالات الطبيعية لكن
+
+427
+00:28:21,720 --> 00:28:25,780
+بسبب .. بسبب خرط طبقة ال ozone صح يقولوا لك؟ و
+
+428
+00:28:25,780 --> 00:28:29,100
+أصبح تسريبها بشكل كبير بالذات على المناطق السحلية
+
+429
+00:28:29,100 --> 00:28:33,200
+مثل ذلك على قطع غزاة اللي جاء ايضا في ضفر العين
+
+430
+00:28:33,200 --> 00:28:36,690
+اللي هو Teresiaأيضا من ضمنها هنجيب شكل كبير
+
+431
+00:28:36,690 --> 00:28:39,470
+immaculate generation أيضا من ضمنها حدث عملية
+
+432
+00:28:39,470 --> 00:28:43,090
+cataract في السيادين والعمال اللى بتجري على شطر
+
+433
+00:28:43,090 --> 00:28:45,510
+البحر أيضا هتكون من ضمنها السبب بعد ذلك اللى هو
+
+434
+00:28:45,510 --> 00:28:48,890
+الإنسان بتعرض لجميات كبيرة من ال ultraviolet light
+
+435
+00:28:48,890 --> 00:28:51,510
+اللى هو أصلا نفسه ascorbic acid غير قادر على
+
+436
+00:28:51,510 --> 00:28:54,010
+التخلص منها وانتصاصها كلها بشكل كبير إذا وظيفة
+
+437
+00:28:54,010 --> 00:28:57,750
+الascorbic acid هنا يعمل على انتصاص اللى هو ال
+
+438
+00:28:57,750 --> 00:28:59,390
+ultraviolet light
+
+439
+00:29:08,960 --> 00:29:15,480
+الأساس من وين؟الاكواسفير، صح ولا؟ مافيش أندي، طبعا
+
+440
+00:29:15,480 --> 00:29:17,900
+حكينا احنا العين أو القرية تعتمد اعتماد أساسي على
+
+441
+00:29:17,900 --> 00:29:20,320
+ال oxygen من وين؟ من ال атмосفيرة أو ال
+
+442
+00:29:20,320 --> 00:29:23,060
+environmental oxygen، صح ولا؟ لو حدث أنه في أندي
+
+443
+00:29:23,060 --> 00:29:25,280
+احنا حاطينا contact lens لفترة كبيرة أو هاد ال
+
+444
+00:29:25,280 --> 00:29:28,240
+contact lens ماكنتش oxygen permeable، بالتالي مش
+
+445
+00:29:28,240 --> 00:29:31,340
+هنحدث .. يعني الصح هيكون في أندي كمية معينة من ال
+
+446
+00:29:31,340 --> 00:29:34,240
+oxygen في ال aqueous humorلكن الغالب يا العظمى طول
+
+447
+00:29:34,240 --> 00:29:39,880
+وان ال .. ايوة و حكى ان لو حدث و انا كنت اتلازز
+
+448
+00:29:39,880 --> 00:29:42,740
+حيث ان في عندي حاجة اسمها Noxia صحيح؟ أو Hypoxia
+
+449
+00:29:42,740 --> 00:29:47,860
+كلنا عرفنا بقى طيب extension مافيش عندي اقصر في
+
+450
+00:29:47,860 --> 00:29:52,100
+اصر extension ان اكوي سحب ال range between 13 الى
+
+451
+00:29:52,100 --> 00:29:57,420
+80 و هاد احنا مش معانا يعني النسبة كانت في .. في
+
+452
+00:29:57,420 --> 00:30:01,990
+ال corner كانت اقل من ذلكطيب، بعندي فيه هنا طالب
+
+453
+00:30:01,990 --> 00:30:06,150
+مثال على ال contact lens polymethyl metacrylate
+
+454
+00:30:06,150 --> 00:30:09,270
+المقصود فيها PMMA فنلاقي أنواع من أنواع ال contact
+
+455
+00:30:09,270 --> 00:30:18,350
+lenses المتصنع منها بيهانها، نذكرها هنا PMMA
+
+456
+00:30:19,240 --> 00:30:24,340
+PWM, كله كبتر, a corneal contact lens may produce
+
+457
+00:30:24,340 --> 00:30:27,900
+corneal hypoxia ممكن تسبب ليه ال hypoxia لأنها
+
+458
+00:30:27,900 --> 00:30:31,280
+هتخططي لغالبية سطح القرنية، فبالتالي هسبح في عندي
+
+459
+00:30:31,280 --> 00:30:33,880
+border، في عندي barrier ما بين اللي هو ال oxygen
+
+460
+00:30:33,880 --> 00:30:36,720
+from the atmosphere صحيح و ما بين اللي هو
+
+461
+00:30:36,720 --> 00:30:39,800
+الأبثاليا، فبالتالي هيكون ال oxygen غير قادر على
+
+462
+00:30:39,800 --> 00:30:42,200
+اختراق اللي هو أو الدوابان فيه، الميوسين اللي هي
+
+463
+00:30:42,200 --> 00:30:45,320
+ربطي الفيلم مش هيصل إلى القرنية، فبالتالي الحدث في
+
+464
+00:30:45,320 --> 00:30:46,660
+عندي اللي هو الhypoxia
+
+465
+00:30:52,870 --> 00:30:57,790
+البروتينة البروتينات بشكل طبيعي هناك فقط كيميات
+
+466
+00:30:57,790 --> 00:31:01,730
+قليلة جدا من البروتينات طبعا مقارنة ببلازما الدم
+
+467
+00:31:01,730 --> 00:31:04,690
+البلازما الدم تحتوي على عدد كبير جدا من البروتينات
+
+468
+00:31:04,690 --> 00:31:08,070
+صحيح هو أهمية إليه أهمية أيضا اللي هو مناعية لكن
+
+469
+00:31:08,070 --> 00:31:11,110
+في ال aqueous humor فقط كيميات ضئيلة جدا وهذه
+
+470
+00:31:11,110 --> 00:31:14,530
+كيميات ضئيلة سبرا ده لكن ال aqueous humor barrier
+
+471
+00:31:14,530 --> 00:31:17,810
+اللي احنا اتكلمنا عنه يمنع تدفق البروتينة ده في
+
+472
+00:31:17,810 --> 00:31:20,770
+الحجم الكبير صحيح حتى تصل إلى اللي هو ال aqueous
+
+473
+00:31:20,770 --> 00:31:22,110
+humor why؟ ليش؟
+
+474
+00:31:27,040 --> 00:31:30,400
+عشان لما يمر اليوم بقى تعملش .. عيبا، حتى يحافظ
+
+475
+00:31:30,400 --> 00:31:33,860
+على clear media، صح؟ حتى يحافظ على clear accuracy،
+
+476
+00:31:33,860 --> 00:31:36,260
+معناه ده أول شيء، تاني شيء، لو دخل أصبح في ال exam
+
+477
+00:31:36,260 --> 00:31:38,620
+الحكاية اللي حكيناها قبل شوية، هم هذا كلها ..
+
+478
+00:31:38,620 --> 00:31:43,000
+هتعتبر مقتنع، عشان الحقيقةهتعمل a diffraction of
+
+479
+00:31:43,000 --> 00:31:45,440
+the light بالتالي اللى هتأثرلى على اللى هو ال
+
+480
+00:31:45,440 --> 00:31:48,180
+normal imaging of the eye هتأثرلى على ال optics of
+
+481
+00:31:48,180 --> 00:31:52,520
+the eye هتطلع على حجمه مقارنة ببلازمة الدم واحد
+
+482
+00:31:52,520 --> 00:31:55,860
+فلمية تقريبا او اقل واحد على خمسمية من حجم
+
+483
+00:31:55,860 --> 00:31:58,540
+البروتنات المتوجدة او مساوا البروتنات المتوجدة في
+
+484
+00:31:58,540 --> 00:32:02,020
+بلازمة الدم فهي حتة مقالية جدا جدا لكن هناك بعض
+
+485
+00:32:02,020 --> 00:32:05,780
+الأمراض زى مثلا الاتحان القزحي او الاتحان القزحي
+
+486
+00:32:05,780 --> 00:32:09,360
+صحيه؟ وبدوا يصير فيه عند ال aqueous humor barrier
+
+487
+00:32:09,360 --> 00:32:12,050
+اللى حكينا عن blood aqueous humor barrierلذات فيه
+
+488
+00:32:12,050 --> 00:32:14,710
+اندوهاش breakdown اللي احنا حكيناها اخر محاضرة
+
+489
+00:32:14,710 --> 00:32:18,110
+صحيح؟ بده الحاجز حاجة ده مش حياتين بشكل طبيعي، حيث
+
+490
+00:32:18,110 --> 00:32:20,730
+بقى فيه اندوهاش نفاذية لكميات كبيرة جدا من ال
+
+491
+00:32:20,730 --> 00:32:24,010
+plasma .. ال .. البروتينات الموجودة في ال plasma
+
+492
+00:32:24,010 --> 00:32:27,630
+الدم تتدفق عبر ال aqueous hema، بالتالي المولد
+
+493
+00:32:27,630 --> 00:32:31,690
+هيعاني من قباشة فى الرؤية، توحج إلى أخرى، هذا كله
+
+494
+00:32:31,690 --> 00:32:34,510
+سببه اللي هو تراكم ببروتينات الدم اللي أصلا مش
+
+495
+00:32:34,510 --> 00:32:37,810
+مفروض بالحالة طبيعتكوا متواجدة .. تواجدت في ال
+
+496
+00:32:37,810 --> 00:32:42,520
+aqueous hema أو الهيفي أننا حاكيناها disruption
+
+497
+00:32:42,520 --> 00:32:46,040
+يعني هي نفسها كلمة break down, disruption يعني
+
+498
+00:32:46,040 --> 00:32:50,180
+break down يعني دمار أو تلف للنظام كله هذا اللي هو
+
+499
+00:32:50,180 --> 00:32:53,700
+blood of this hammer باريه صحيح و الطبقات اللي حنا
+
+500
+00:32:53,700 --> 00:32:58,080
+اتكلمنا عليها كلها بداية من اللي هو ال capillaries
+
+501
+00:32:58,080 --> 00:33:00,980
+اللي هيتن بال non pigmented epithelia .. epithelia
+
+502
+00:33:00,980 --> 00:33:05,920
+صحيح كلها حيسبح فيها تلف بالتالي ممكن تتدفق بعض
+
+503
+00:33:05,920 --> 00:33:08,860
+كميات اللي هو البروتينات الى الاندراج أكبر
+
+504
+00:33:09,440 --> 00:33:14,320
+myoglobulin levels هو مناعي
+
+505
+00:33:14,320 --> 00:33:19,040
+صحيح يحافظ على ما هو مناعة ال anterior chamber او
+
+506
+00:33:19,040 --> 00:33:23,520
+ال eyeball كلها ككل وبالتالي يعني يعمل ضد ما هو ال
+
+507
+00:33:23,520 --> 00:33:26,640
+micro bud طب ما هو ال antibody هذا ال IgE اعتبر
+
+508
+00:33:26,640 --> 00:33:31,210
+ايضا ايشمعتبر زي بلتين طب ليش يعني يسمح لو بتدافع
+
+509
+00:33:31,210 --> 00:33:34,130
+بكميات كبيرة جدا حتى لو اتمنى اللي يكون بيتمل
+
+510
+00:33:34,130 --> 00:33:36,930
+يعتبر كميات كبيرة جدا؟ بحجم الجزائي؟ اي لأن حجم
+
+511
+00:33:36,930 --> 00:33:41,030
+الجزائي الصغير جدا ممكن عن طريق اللي هو ال active
+
+512
+00:33:41,030 --> 00:33:43,990
+transport أن ينتقل بكميات كبيرة بينما لبروتينات
+
+513
+00:33:43,990 --> 00:33:47,530
+الدم حجم الجزائي كبير جدا واصلا احنا مش مطالب يعني
+
+514
+00:33:47,530 --> 00:33:51,030
+الجسم غير معنى بيتزويدها بينما في الأكبيسيومر حجم
+
+515
+00:33:51,030 --> 00:33:54,390
+الجزائي صغير جدا تقريبا لا يرى بالعين المجردة
+
+516
+00:33:57,180 --> 00:34:01,360
+المكتوف يانا سبها because of its small size رقم
+
+517
+00:34:01,360 --> 00:34:06,240
+تسعة they are plasminogen and proactivator plasmin
+
+518
+00:34:06,240 --> 00:34:11,000
+كلا ال plasminogen مادتين هذوله و ال proactivator
+
+519
+00:34:11,000 --> 00:34:15,840
+plasminتشارك او تسايم هذه المواد او هذه العوامل في
+
+520
+00:34:15,840 --> 00:34:19,180
+عملية ال micro-abulation system كي تذكرين ان انتوا
+
+521
+00:34:19,180 --> 00:34:22,780
+في عملية تخسر الدم او تخسير الدم اتكلمنا عن
+
+522
+00:34:22,780 --> 00:34:26,000
+المركبين هدولة هدول المركبين بيعمل على تخسير الدم
+
+523
+00:34:26,000 --> 00:34:28,960
+هذا المظيفة الاولى المظيفة التانية بيعمل على منع
+
+524
+00:34:28,960 --> 00:34:34,540
+تكون الفبرينأقولكوا مع أنه دول مثلين يعني حتى توضح
+
+525
+00:34:34,540 --> 00:34:37,440
+الصورة، في بعض الأشخاص اللي بعرضوا لضربة معينة،
+
+526
+00:34:37,440 --> 00:34:40,960
+كرة قدم أو ضربة معينة، ممكن نلاقي فيه عنده نزيف في
+
+527
+00:34:40,960 --> 00:34:44,240
+الغرفة الأمامية، صحيح؟ الوضع الطبيعي مش المفروض
+
+528
+00:34:44,240 --> 00:34:46,580
+يكون فيه عنده ساقل دموي و لا كرة دم حمراء و لا
+
+529
+00:34:46,580 --> 00:34:49,760
+يكون فيه عنده بروتينات، صحيح؟ ليش؟ لأن ال blood
+
+530
+00:34:49,760 --> 00:34:53,510
+-oxyhemal barrier هو حفاظة على المظيفة هذهفقل
+
+531
+00:34:53,510 --> 00:34:55,810
+يتعرض إلى ضربة معينة، ال barrier هداش ما اللي
+
+532
+00:34:55,810 --> 00:34:59,430
+صارله break down أو disruption، مش الحاجة، بالتالي
+
+533
+00:34:59,430 --> 00:35:03,130
+أصبح في عندى الدم، السقل الدمو هذا الصراحة ماياش،
+
+534
+00:35:03,130 --> 00:35:07,590
+ميتجلط، ليش؟ لإن هناك humor في عندى، plasma gene
+
+535
+00:35:07,590 --> 00:35:09,690
+في عندى، proactivity، و هدول التانية العاملة بتعمل
+
+536
+00:35:09,690 --> 00:35:13,730
+ساعدة على تجلط الدم حتى مايضلش ايش، اللي هو يظل
+
+537
+00:35:13,730 --> 00:35:18,980
+متجمع أو متزن في منطقة معينة، هذا رقم واحدرقم
+
+538
+00:35:18,980 --> 00:35:22,660
+اتنين، نرجع من الأخرى لرقم سبعة، في انديوهيتس،
+
+539
+00:35:22,660 --> 00:35:26,060
+اللي هي الانتهاب القذحي، صحيح؟ في إن مصطلف آخر
+
+540
+00:35:26,060 --> 00:35:33,460
+اللي حكينا عنه،
+
+541
+00:35:33,460 --> 00:35:41,120
+اللي هو ساينيكيا، بتاع ساينيكيا،
+
+542
+00:35:41,120 --> 00:35:45,920
+حكينا في قصيرة ساينيكيا، عبارة عن التساقات، صحيح؟
+
+543
+00:35:48,440 --> 00:35:52,680
+هي أنا وهي في عند ال lens بالخلف صح ولا لأ فأصبح
+
+544
+00:35:52,680 --> 00:35:57,940
+في عندي سقط على نوعين في عندي حدث اسمها anterior
+
+545
+00:35:57,940 --> 00:36:00,980
+synechia اللي هي الأمامية تحدث ما بين ال
+
+546
+00:36:00,980 --> 00:36:04,340
+peripheral iris مع ال anterior chamber angle صحيح
+
+547
+00:36:04,340 --> 00:36:07,480
+هذا ال anterior ال posterior تحدث ما بين ال
+
+548
+00:36:07,480 --> 00:36:10,220
+posterior surface of the iris مع ال anterior
+
+549
+00:36:10,220 --> 00:36:16,320
+surface of the lens فهذه posterior synechia ثانية
+
+550
+00:36:16,320 --> 00:36:24,220
+بالأخرىبصيرة surface of the lens of the virus مع
+
+551
+00:36:24,220 --> 00:36:32,680
+ال anterior surface of the lens طيب لما نسمح لنا
+
+552
+00:36:32,680 --> 00:36:34,540
+في لحظة ثانية يعني حاجة ثانية كام ممكن تكون
+
+553
+00:36:34,540 --> 00:36:40,060
+permanentعبادية صحيح؟ سينيكيا بشكل هذا هتعمل على
+
+554
+00:36:40,060 --> 00:36:42,760
+توقفها في آيالس ال trimmer اللي احنا اتكلمنا عنه
+
+555
+00:36:42,760 --> 00:36:45,260
+مش هحدث فيه عند القبال المصابر، حد هو ثابت على
+
+556
+00:36:45,260 --> 00:36:49,460
+طول، صحيح؟ تاني حاجة، المنفذ الوحيد اللي أكوي
+
+557
+00:36:49,460 --> 00:36:51,300
+سيهيمور من ال posterior chamber لل anterior
+
+558
+00:36:51,300 --> 00:36:54,640
+chamber، شو هو؟ ال pupil، لو حدث فيه عندي complete
+
+559
+00:36:54,640 --> 00:36:59,960
+سينيكيا، مش حدث عندي، ضبط ده مش حاسس فيه، هيرتفع،
+
+560
+00:36:59,960 --> 00:37:04,220
+فحتى الأكوي سيهيمور يحاول قصار جهده أنه يمنع تكوين
+
+561
+00:37:04,220 --> 00:37:09,240
+هذه السينيكيافي ند مادة ده في حالات الأكل اللي هو
+
+562
+00:37:09,240 --> 00:37:17,080
+Leviitis اسمها Febrile، انت موجودة معاكوها؟ ايوة
+
+563
+00:37:17,080 --> 00:37:22,000
+هذه هي، حد مادة ال Febrile يتم اتواجدها في حال
+
+564
+00:37:22,000 --> 00:37:25,360
+وجود التهابات داخل العين، اه في حال وجود التهابات
+
+565
+00:37:25,360 --> 00:37:31,060
+داخل العين مثلا على ذلك الاتهاب القزحيسيتم تكوين
+
+566
+00:37:31,060 --> 00:37:34,640
+مادة الفبرا، هذه مادة الفبرا تساعد على إيش؟ على
+
+567
+00:37:34,640 --> 00:37:38,180
+الالتصاق، عشان الحاجة تساعد على الالتصاق، هي أكيد
+
+568
+00:37:38,180 --> 00:37:40,700
+يعني تحديد فقط البصيرة سانيكية أو كإدرس اللي عندها
+
+569
+00:37:40,700 --> 00:37:44,120
+ينتقل لسانيكية، احنا فقط درسناها كمثال، بقعد نظر،
+
+570
+00:37:44,120 --> 00:37:47,540
+بصيرة سانيكية أو إدرس لسانيكية، الهدف أنه كل
+
+571
+00:37:47,540 --> 00:37:50,140
+سانيكية بشكل عام، التصاقات هذه، بديوا يحاولوا
+
+572
+00:37:50,140 --> 00:37:51,620
+يحاولوا يحاولوا يحاولوا يحاولوا يحاولوا يحاولوا
+
+573
+00:37:51,620 --> 00:37:56,660
+يحاولوا يحاولوا يحاولوا يحاولوا
+
+574
+00:37:56,660 --> 00:38:01,310
+يحهذا الصينيكيا مش راح تحدث، ماشي الحق، طبعا في
+
+575
+00:38:01,310 --> 00:38:04,790
+حالات كثيرة الأكويسيمر لوحده لايستطيع، بالذات لو
+
+576
+00:38:04,790 --> 00:38:08,090
+كان فيه عنده إتهابات مشاكل أيش كبيرة، لكن بالحالة
+
+577
+00:38:08,090 --> 00:38:10,010
+الطبيعية لو حدث عنده إتهابات وما أحصلش على
+
+578
+00:38:10,010 --> 00:38:13,630
+الإنسان، لأن الإنسان كثير جدا، يعني على مدى 24
+
+579
+00:38:13,630 --> 00:38:16,530
+ساعات ليه عنده إتهابات من جسده، صحيح ولا لأ؟ صح
+
+580
+00:38:16,530 --> 00:38:19,190
+ولا لأ؟ طب إحنا ليه نحكي؟ طب إحنا ليه لازم نخروا
+
+581
+00:38:19,190 --> 00:38:23,170
+العقلين في وقت الإتهابات أو الفيروسات؟تكون زيادة
+
+582
+00:38:23,170 --> 00:38:25,670
+على الجسم شكل كبير؟ لأ الجسم غير متحملها
+
+583
+00:38:25,670 --> 00:38:28,770
+بالاكويسهيمر بحالة طبيعية يحتفظ على مادة اللي هو
+
+584
+00:38:28,770 --> 00:38:31,450
+ال plasma gene و ال proactivator حتى يمنع حدوث
+
+585
+00:38:31,450 --> 00:38:35,450
+التساقات فشخص معين بدون أي سبب حدث عنده التساقات
+
+586
+00:38:35,450 --> 00:38:39,310
+إلا يكون عنده إتهابات هادئ زيادة حتى على حجم أو
+
+587
+00:38:39,310 --> 00:38:42,330
+على نشاط ال plasma gene و ال proactivator متوجد في
+
+588
+00:38:42,330 --> 00:38:46,810
+الاكويسهيمر بالتالي يبدو حدث عندي اللي هو عملية
+
+589
+00:38:46,810 --> 00:38:50,210
+الصينيكية سواء كانتريا صينيكية أو بستيريا صينيكية
+
+590
+00:38:53,200 --> 00:38:57,160
+طيب رقم عشرة لبنز، لبنز طبعا معدلها أقل بكثير من
+
+591
+00:38:57,160 --> 00:39:02,160
+موجودة باللي هو بلازمة الدم لإن وظيفتها جدا محدودة
+
+592
+00:39:02,160 --> 00:39:05,560
+تماما مثل البروتينات مش مطالبين أيضا ولا المطالب
+
+593
+00:39:05,560 --> 00:39:08,500
+لكي سيمان يكون في كمية كبيرة حتى يعمل على clear
+
+594
+00:39:08,500 --> 00:39:11,510
+media وبالتالي يعمليمنع عملية hot diffraction of
+
+595
+00:39:11,510 --> 00:39:14,550
+light، آخر شي فيه إن في كميات كتيرة أيضا مش بذكورة
+
+596
+00:39:14,550 --> 00:39:17,470
+حقا من ضمنها ال heleronic acid و من ضمنها ال
+
+597
+00:39:17,470 --> 00:39:20,510
+vitamin B12 و من ضمنها ال corticosteroids و في
+
+598
+00:39:20,510 --> 00:39:22,970
+عندى مراكبات أخرى من الفيتامينات لكن كميات دقيقة
+
+599
+00:39:22,970 --> 00:39:26,290
+جدا جدا جدا لإحنا لما نتكلم على ال metabolism of
+
+600
+00:39:26,290 --> 00:39:28,270
+the lens نحن نذكر بعضها إن شاء الله
+
+601
+00:39:31,430 --> 00:39:33,850
+اتكلموا عليا Aquis Dynamics اللى هى ال Dynamics
+
+602
+00:39:33,850 --> 00:39:37,530
+حكى ان احنا حركة عيش الخلط المائي داخل كرة العين،
+
+603
+00:39:37,530 --> 00:39:41,710
+حكينا أخر مرة فى عنده ايضا بعض فلادوية صحيح ممكن
+
+604
+00:39:41,710 --> 00:39:45,070
+تأثرلى او تساهفى تغيير حوارات ال dynamica في Aquis
+
+605
+00:39:45,070 --> 00:39:51,520
+حمر، تذكرينه ولا لا؟ مش ذاكرينه، صحيح؟The
+
+606
+00:39:51,520 --> 00:39:54,100
+maintenance of the stable shape of the eye globe
+
+607
+00:39:54,100 --> 00:39:57,040
+is necessary for the important optical properties
+
+608
+00:39:57,040 --> 00:40:00,180
+of the eye هو المحافظة على هيكلية العين اللي احنا
+
+609
+00:40:00,180 --> 00:40:03,660
+حكيناها architecture of the eyeball صحيح مهمة جدا
+
+610
+00:40:03,660 --> 00:40:07,680
+حتى تمام اللي هو عملية كل ال optical properties
+
+611
+00:40:07,680 --> 00:40:10,640
+لكورة العين بغض النظر كانت القرن القرنية for the
+
+612
+00:40:10,640 --> 00:40:14,300
+cornea for the lens for the petrius الاخرين The
+
+613
+00:40:14,300 --> 00:40:16,440
+pressure of intraocular contents is called
+
+614
+00:40:16,440 --> 00:40:21,010
+intraocular pressure اللي هو IOP صحيحعبارة عن
+
+615
+00:40:21,010 --> 00:40:24,770
+ثلاثة حروف capital لا يتخلّلها نقاط، this is
+
+616
+00:40:24,770 --> 00:40:27,430
+maintained by dynamic equilibrium، نحط خط تحت
+
+617
+00:40:27,430 --> 00:40:31,790
+dynamic equilibrium عبارة عن توازن هذه الحركة
+
+618
+00:40:31,790 --> 00:40:37,210
+المقصود فيها أن معدل ال outflow مايكون بعيد جدا من
+
+619
+00:40:37,210 --> 00:40:40,110
+معدل ال production، و العكس هو اللي حيحدث عند
+
+620
+00:40:40,110 --> 00:40:42,070
+مصطلحين، مصطلح الأول
+
+621
+00:40:55,800 --> 00:41:05,960
+هذا يعني ازدياد ضغط العين او اذا
+
+622
+00:41:05,960 --> 00:41:14,860
+كان لدي
+
+623
+00:41:14,860 --> 00:41:18,940
+معدل production rate اقل من ال outflow
+
+624
+00:41:23,880 --> 00:41:26,880
+مافيش عندى equilibrium، هاي المقصود بـ Dynamic
+
+625
+00:41:26,880 --> 00:41:30,020
+Equilibrium، أن يكون في عندى معدل إنتاج أكويسيه
+
+626
+00:41:30,020 --> 00:41:33,560
+مار، صحيح؟ مايكونش أقل بكتير من اللي هو ال
+
+627
+00:41:33,560 --> 00:41:37,040
+outflow، لو كان أنا مثلا عند العين تلتج، مثلا أجدش
+
+628
+00:41:37,040 --> 00:41:39,880
+فيه أن ال outflow تقريبا حاكينا في الدقيقة؟ تلعب
+
+629
+00:41:39,880 --> 00:41:44,590
+ساعة، صحيح؟لكل ما يتانية اتنية و خمس و سبعين صح
+
+630
+00:41:44,590 --> 00:41:47,450
+ولا؟ هذا معدل ليش ال out of flow إذا اللي مضي يكون
+
+631
+00:41:47,450 --> 00:41:50,570
+في عند ال production ما يسوي أو أكتر منه، مافيحش
+
+632
+00:41:50,570 --> 00:41:54,070
+يكون أقل، صح ولا؟ طبعا في ال .. during ال
+
+633
+00:41:54,070 --> 00:41:56,630
+variation ربما يحدث اختلافات باسمها، أقل من اللي
+
+634
+00:41:56,630 --> 00:41:59,730
+لمشي ضالين و سرعان و يرجع مرة أخرى، لكن لو طال فيه
+
+635
+00:41:59,730 --> 00:42:02,310
+عنده اللي محافظش على ال constant أو ال stability،
+
+636
+00:42:02,310 --> 00:42:06,390
+ثبوتية هذا الإنتاج أو التوازن، ححدثش فيه عنده خلل،
+
+637
+00:42:06,390 --> 00:42:08,770
+طيب، لو كان فيه عند الإفراز أكتر بكتير من ال out
+
+638
+00:42:08,770 --> 00:42:13,780
+of flow system ..الشيء فيه عنده اتفاعة في دقة
+
+639
+00:42:13,780 --> 00:42:17,740
+العلم هو يؤدي الاجبكامة أو أمورات أخرى وهنا لو كان
+
+640
+00:42:17,740 --> 00:42:21,180
+فيه عنده اختلال في النظام اللي هو سمن احنا Dynamic
+
+641
+00:42:21,180 --> 00:42:23,540
+Equilibrium وهذا التعليف اللي احنا مطالبين فيه حتى
+
+642
+00:42:23,540 --> 00:42:27,180
+بتفسيره وش معناته هيحدث عنده اما hypotenia او حدث
+
+643
+00:42:27,180 --> 00:42:29,840
+عنده الهو okay our habit action
+
+644
+00:42:34,100 --> 00:42:36,680
+small varieties in production of our art of flow
+
+645
+00:42:36,680 --> 00:42:39,180
+of aqueous can result in a large changes in
+
+646
+00:42:39,180 --> 00:42:40,000
+intraocular pressure
+
+647
+00:42:43,970 --> 00:42:46,770
+يعني اختلاف بين كمية ال production و كمية ال
+
+648
+00:42:46,770 --> 00:42:49,370
+outflow هو هذا مطلب فيه هذا من ناحية فستولوجية
+
+649
+00:42:49,370 --> 00:42:51,890
+طبيعية جدا حتى يحدث عنده اياش ال circadian rhythm
+
+650
+00:42:51,890 --> 00:42:55,190
+أو IUP مش هنجيه دايما 18 ولا دايما 15 ولا دايما 14
+
+651
+00:42:55,190 --> 00:42:58,730
+صحيح؟ لأن في بعض الأحيان هيزداد .. هيقل في عند ال
+
+652
+00:42:58,730 --> 00:43:01,810
+production و هيزداد ال outflow أو العكس هيزداد ال
+
+653
+00:43:01,810 --> 00:43:04,910
+production و يقل ال outflow وبالتالي عنده اللي هو
+
+654
+00:43:04,910 --> 00:43:09,890
+الملحنة هذا بالشكل هذا صحيح؟ يعني هنجيه 18
+
+655
+00:43:16,880 --> 00:43:23,960
+الحل هاذيش حدث هان ربما زاد ال production صحيح؟
+
+656
+00:43:23,960 --> 00:43:28,040
+زاد بينما ال out of law اشبهله قلق هان العكس زاد
+
+657
+00:43:28,040 --> 00:43:31,760
+ال out of law و قن ال production صحيح؟ لكن كله
+
+658
+00:43:31,760 --> 00:43:34,540
+بقاش بالواضح ايش؟ بقى بال range الطبيعي عشان
+
+659
+00:43:34,540 --> 00:43:38,780
+الحاجة هذه نسميها احلى dynamic equilibrium بشكل
+
+660
+00:43:38,780 --> 00:43:43,320
+مختصر و عبارة عن الحفاظ و عبارة عن الحفاظ على
+
+661
+00:43:46,510 --> 00:43:56,010
+ضغط العين طبيعي بحيث لا ينتج عنه انخفاض شديد في
+
+662
+00:43:56,010 --> 00:44:01,970
+ضغط العين ولا ارتفاع شديد في ضغط العين ويكون
+
+663
+00:44:01,970 --> 00:44:06,530
+الارتفاع وانخفاض ضغط العين من ضمن اللي هو الساعة
+
+664
+00:44:06,530 --> 00:44:10,510
+البيولوجية لكرة العين او الساعة البيولوجية لضغط
+
+665
+00:44:10,510 --> 00:44:15,510
+العين طبعا ممكن تسوؤها بلغتكم بس هذا هو يعني
+
+666
+00:44:15,510 --> 00:44:16,030
+المضمون
+
+667
+00:44:19,770 --> 00:44:27,270
+بعدين نستخدم الـ circular dynamism نستخدم اللي
+
+668
+00:44:27,270 --> 00:44:31,970
+هو دولين ال variation نتكلم على dynamic
+
+669
+00:44:31,970 --> 00:44:32,530
+equilibrium
+
+670
+00:44:35,850 --> 00:44:38,910
+Dynamic equilibrium Aqueous leaves the eye by two
+
+671
+00:44:38,910 --> 00:44:42,690
+pathways هذي احدى ال dynamic equilibrium كفيت او
+
+672
+00:44:42,690 --> 00:44:46,310
+كيف يكيه هتكلم عن ال production نتكلم على ال out
+
+673
+00:44:46,310 --> 00:44:52,290
+of law كيف يتم تصريف ال aqueous humor من خلال كرة
+
+674
+00:44:52,290 --> 00:44:56,060
+العينطبعا احنا عايزين نقوله من خلال الترابيكولا
+
+675
+00:44:56,060 --> 00:44:58,780
+مشواك لكن في عندي other بعاصمه ايضا هناخد أول شي
+
+676
+00:44:58,780 --> 00:45:01,660
+بشكل أساسي اللي هو الترابيكولا outflow اللي هو
+
+677
+00:45:01,660 --> 00:45:04,580
+التفصيل في عبر اللي هو الترابيكولا مشواك صحيح اللي
+
+678
+00:45:04,580 --> 00:45:08,720
+أصلا متواجدة في ال anterior chamber angle aqueous
+
+679
+00:45:08,720 --> 00:45:13,180
+humor is formed from plasma by the cellular
+
+680
+00:45:13,180 --> 00:45:16,000
+epithelium هم aqueous humor is formed by the
+
+681
+00:45:16,000 --> 00:45:18,200
+plasma صحيح فعلا من ال plasma الدم هو ما حكينا
+
+682
+00:45:18,200 --> 00:45:22,740
+احنا جثمه أصلا من السائل الدمويby the cellular
+
+683
+00:45:22,740 --> 00:45:24,820
+epithelium وهذا قصدنا الcellular epithelium اللي
+
+684
+00:45:24,820 --> 00:45:27,600
+هو ال non-pigmented epithelium مش الحق بس احنا
+
+685
+00:45:27,600 --> 00:45:30,780
+وجدنا بالاختبار طبعا يعتبر صح اكيد لان ما خصصناش
+
+686
+00:45:30,780 --> 00:45:31,820
+يعني اعتبر صح
+
+687
+00:45:34,810 --> 00:45:37,730
+خلال هو عملية معقدة then pass to the posterior
+
+688
+00:45:37,730 --> 00:45:41,790
+chamber then pass through the pupil هذه هي يعني
+
+689
+00:45:41,790 --> 00:45:45,010
+بعد تكوين ال aqueous humor هتعتبر ال pathway
+
+690
+00:45:45,010 --> 00:45:47,730
+التخطوة ده بتشريح of the aqueous humor واخدها حنا
+
+691
+00:45:47,730 --> 00:45:50,810
+نفصل الأول يعني بعد يتم تكوينه من السلية للبستريان
+
+692
+00:45:50,810 --> 00:45:53,730
+في ال posterior chamber ينتقل إلى إيش ال anterior
+
+693
+00:45:53,730 --> 00:45:55,970
+chamber عبر اللي هو ال pupil اللي هتكلمنا عنه قبل
+
+694
+00:45:55,970 --> 00:45:59,030
+قليل ومن ثم عبر ال anterior chamber بعد أن يصل إلى
+
+695
+00:45:59,030 --> 00:46:01,570
+ال anterior chamber بيصل إلى ال anterior chamber
+
+696
+00:46:01,570 --> 00:46:06,550
+angle ثم إلى اللي هول typical مشواج هتذكرين بال ..
+
+697
+00:46:06,550 --> 00:46:08,690
+لما خدنا احنا ال gyroscope ايه؟ حكينا فيه ان
+
+698
+00:46:08,690 --> 00:46:12,890
+المركبات أو ال structures اللي احنا خلاص نضيفها لو
+
+699
+00:46:12,890 --> 00:46:15,250
+نتطلع على ال .. على ال anterior chamber angle
+
+700
+00:46:15,250 --> 00:46:20,190
+صحيح؟ ال structures مشواج صحيح أول شيء، بعدين؟
+
+701
+00:46:20,190 --> 00:46:24,890
+typical مشواج و حكينا typical مشواج قبل .. قبل
+
+702
+00:46:24,890 --> 00:46:28,290
+typical مشواج، ايه؟ و فيها لها قسمين ال Syria اللي
+
+703
+00:46:28,290 --> 00:46:32,350
+هو functional و بال Syria صحيح؟الكم الكبير يقع على
+
+704
+00:46:32,350 --> 00:46:36,550
+عيش؟ ايه الجزء الاول ولا التاني؟ اللي هو ال
+
+705
+00:46:36,550 --> 00:46:39,390
+posterior صح ولا؟ اه ده الجزء الاهم جزءه، فهذا هو
+
+706
+00:46:39,390 --> 00:46:42,570
+اللي احنا هنتكلم عنه ان شاء الله، فلما نقصد احنا
+
+707
+00:46:42,570 --> 00:46:44,710
+ال trapico-machoic اللي هو ال posterior trapico
+
+708
+00:46:44,710 --> 00:46:45,230
+-machoic
+
+709
+00:46:55,070 --> 00:46:57,890
+طيب,tropical meshwork into the canal of the sling
+
+710
+00:46:57,890 --> 00:47:00,610
+and passes بعد وصولها ال anterior chamber حتى تصل
+
+711
+00:47:00,610 --> 00:47:03,350
+ال anterior chamber angle و من ثم إلى اللي هو
+
+712
+00:47:03,350 --> 00:47:05,010
+حكيناه احنا الأجزاء المختلفة من ال anterior
+
+713
+00:47:05,010 --> 00:47:07,510
+chamber و الخصوص بالذلك اللي هو posterior chamber,
+
+714
+00:47:08,030 --> 00:47:10,630
+posterior tropical meshwork اللي هي تعتبر
+
+715
+00:47:10,630 --> 00:47:15,470
+functionalinto the canal of a slant and passes
+
+716
+00:47:15,470 --> 00:47:18,510
+through the collector channel and the episcleral
+
+717
+00:47:18,510 --> 00:47:21,870
+veins نرجع مرة أخرى، حيفي عندي تكوين، عندي معايا
+
+718
+00:47:21,870 --> 00:47:25,350
+هنا، تكوين اللي هو ال aqueous humor من الcellary
+
+719
+00:47:25,350 --> 00:47:29,390
+processes أو الcellary بيثيليا، صحيح، اللي هي
+
+720
+00:47:29,390 --> 00:47:32,130
+process أيضا من النتوءات، ما هو أيضا النتوءات وحيط
+
+721
+00:47:32,130 --> 00:47:34,790
+بيها البيثيليا من كل الجهات، تتم تكوين aqueous
+
+722
+00:47:34,790 --> 00:47:37,890
+humor ومن ثم يتدفق عبر، من ال aqueous humor عبر ال
+
+723
+00:47:37,890 --> 00:47:44,130
+pupil إلى ال anterior chamber، من الو من ثم بعد
+
+724
+00:47:44,130 --> 00:47:47,790
+وصولي ال Antigua Chamber ينحاز على كل الأطراف اللي
+
+725
+00:47:47,790 --> 00:47:52,170
+هو ال angle صحيح؟ ال angle في مبركباتها بداية تنحي
+
+726
+00:47:52,170 --> 00:47:54,970
+أصل إلى اللي هو ال tropical meshwag بشكل أساسي هو
+
+727
+00:47:54,970 --> 00:47:57,770
+ال posterior tropical meshwag طبعا ال Antigua أيضا
+
+728
+00:47:57,770 --> 00:48:01,610
+بتسهل لكن بشكل قليل جدا مقارة بال posterior
+
+729
+00:48:01,610 --> 00:48:04,210
+tropical meshwag وبعد أن نصل لل posterior tropical
+
+730
+00:48:04,210 --> 00:48:07,870
+meshwagهيصل الى slams canal اللى حكيناه عبارة عن
+
+731
+00:48:07,870 --> 00:48:12,270
+قناة دائرية صحيح تحيط بكل اللى هو ال angle بتعمل
+
+732
+00:48:12,270 --> 00:48:15,710
+عليها استيعاب كميات كبيرة من ال aqueous humor بعد
+
+733
+00:48:15,710 --> 00:48:18,030
+وصوله الى ال interior of the chamber بعد وصوله الى
+
+734
+00:48:18,030 --> 00:48:22,910
+tropical meshwork ومن ثم هيصل الى slams canal و
+
+735
+00:48:22,910 --> 00:48:25,930
+مرة أخرى عبر اللى هو ال collector عشان الناس مافيش
+
+736
+00:48:25,930 --> 00:48:28,670
+رصمها عندنا هنا و مرة أخرى هيصل الى lipsclera
+
+737
+00:48:28,670 --> 00:48:31,970
+الويز اللى هي الويز المتوجدة في ال lipsclera ثم
+
+738
+00:48:31,970 --> 00:48:35,800
+مرة أخرى ال conjunctiva الويزرزويرجع لدورة دموية
+
+739
+00:48:35,800 --> 00:48:40,600
+مرة أخرى to the ophthalmic vein to the general
+
+740
+00:48:40,600 --> 00:48:44,380
+circulation هذه كل ال pathway احنا مطالبين فيه حرف
+
+741
+00:48:44,380 --> 00:48:48,180
+حرف نعرف بالضبط مصار و اين راحت كيف تم انتاجه و
+
+742
+00:48:48,180 --> 00:48:49,100
+حتى تم تصريفه
+
+743
+00:48:51,740 --> 00:48:55,520
+this pathway اللى عنه مقصده ال pathway اللى هو ال
+
+744
+00:48:55,520 --> 00:48:57,820
+out of flow system اللى حدث عندي بالنسبة
+
+745
+00:48:57,820 --> 00:49:02,620
+للاكنسهيمة ال out of flow تقريبا تسعين ل 95% يعني
+
+746
+00:49:02,620 --> 00:49:06,460
+هيعتمد كورة الإنهي اعتمد أساسي على تصريف الخلط
+
+747
+00:49:06,460 --> 00:49:11,440
+المائي باستخدام أو بطريقة اللى هو لل trapicular مش
+
+748
+00:49:11,440 --> 00:49:17,940
+بال out of flow طيب
+
+749
+00:49:17,940 --> 00:49:21,760
+إذا لابدوا يكون في عندىو جهات أخرى بتسهب و بدأت في
+
+750
+00:49:21,760 --> 00:49:26,500
+95% في جهة طرف أخرى بس قبل ما تترف عليها ناخد أخر
+
+751
+00:49:26,500 --> 00:49:30,560
+نقطة increase IOP will increase tropical outflow
+
+752
+00:49:30,560 --> 00:49:34,300
+until 50 mmHg after this pause of tropical
+
+753
+00:49:34,300 --> 00:49:38,280
+meshwork will be closed بقصد بالعبارة هذه أنه كلما
+
+754
+00:49:38,280 --> 00:49:41,360
+ارتفع ضغط العين بالتالي من ناحية طبيعية من ناحية
+
+755
+00:49:41,360 --> 00:49:45,600
+فسيولوجيةإذا اتفقد اقتلعين عندك لابد يزداد مقابله
+
+756
+00:49:45,600 --> 00:49:48,900
+إيش؟ اللي هو ال outflow مش الحق، هذه حالة طبيعية،
+
+757
+00:49:48,900 --> 00:49:51,860
+طب لمتى هيظل يزداد؟ إذا وصل لخمسين، هذا أصبح مش
+
+758
+00:49:51,860 --> 00:49:55,140
+حالة طبيعية، هذه حالة مرضية قطعا، صح ولا لا؟ إذا
+
+759
+00:49:55,140 --> 00:49:58,920
+وصل لدرجة خمسين، مش هيظل يزداد، لأ بالعكس، حاسس
+
+760
+00:49:58,920 --> 00:50:01,180
+إيه عندك complete blockage، هيسمح فيه عندك إنسان
+
+761
+00:50:01,180 --> 00:50:04,160
+داد كامل، اللي هو الألترابيكالمشوير، فبالتالي في
+
+762
+00:50:04,160 --> 00:50:06,540
+مرضى كثير يعامج ده من اتفقد اقتلعين، بوصل حتى
+
+763
+00:50:06,540 --> 00:50:12,670
+عندهم سبعين، ستين إلى سبعين، حتىبالتالي هذا المريض
+
+764
+00:50:12,670 --> 00:50:15,890
+حتى لو بدناه .. ليش بدناه الأدوية؟ عفوة لإنه عنده
+
+765
+00:50:15,890 --> 00:50:19,390
+اللي هو cliques ال typical مشوار force كل هذا ما
+
+766
+00:50:19,390 --> 00:50:22,610
+سمعته يعني إغلاقها، بتالي مافيش عنده ردد فعل هو
+
+767
+00:50:22,610 --> 00:50:26,750
+استخدام الأدوية طيب،
+
+768
+00:50:26,750 --> 00:50:29,590
+فينا طريقة أخرىزي ما اتكلمنا عن ال tropical
+
+769
+00:50:29,590 --> 00:50:32,650
+outflow في هنا أيضا uvascular outflow ال tropical
+
+770
+00:50:32,650 --> 00:50:36,530
+outflow بت .. بتساهم أو بتشارك في تقريبا تسعين الى
+
+771
+00:50:36,530 --> 00:50:39,410
+خمسة وتسعين في المية و كثير هالناجم المقالات بتحكي
+
+772
+00:50:39,410 --> 00:50:41,750
+ان فقط مشاركة في تقريبا تسعين او تنتين و تسعين في
+
+773
+00:50:41,750 --> 00:50:45,390
+المية بينما ال uvascular outflow بده يساهم تقريبا
+
+774
+00:50:45,390 --> 00:50:49,370
+مقدار يصل لها لا يزيد عن عشرة بالمائة لا يزيد عن
+
+775
+00:50:49,370 --> 00:50:53,850
+عشرة بالمائة the aqueous passes to the supracoldal
+
+776
+00:50:53,850 --> 00:50:56,950
+space اين هي .. يعني وين موجود هذا المركب؟ ال
+
+777
+00:51:00,750 --> 00:51:05,150
+مابين؟ مابين الكورونات و الاسكليرا، في حكينا إذا
+
+778
+00:51:05,150 --> 00:51:08,490
+ذكرينا في الفصل الأول إنها تعتمد .. الشبكية اعتمد
+
+779
+00:51:08,490 --> 00:51:12,730
+أساسي من التخضي على إيش؟ قسمناها إلى anterior one
+
+780
+00:51:12,730 --> 00:51:15,230
+third و posterior two third، صحيح؟ اللي هو التلت
+
+781
+00:51:15,230 --> 00:51:19,910
+الأمامي و التلت الخلفية، التلت الأمامي من وين؟ لأ
+
+782
+00:51:19,910 --> 00:51:24,590
+أبدأالطولة الخالفة اللى بدى يعتمد على ال
+
+783
+00:51:24,590 --> 00:51:27,170
+filtration أو الترشيح الرشح اللى بدى يحدث من
+
+784
+00:51:27,170 --> 00:51:30,690
+الكورويد صح ولا لا؟ بتاع المسافة ما بين الكورويد
+
+785
+00:51:30,690 --> 00:51:34,150
+وما بين ال sclera فى عندي فرق سمناها supercorridor
+
+786
+00:51:34,150 --> 00:51:37,730
+space وهذا أيضا فرق جسم احنا بعد مرور الرشح
+
+787
+00:51:37,730 --> 00:51:41,250
+وعمليات المواد اللى بتتم تخلص منها أثناء ال waste
+
+788
+00:51:41,250 --> 00:51:45,030
+products بتتمر عبر ال space هذا ثم عبر ال .. في
+
+789
+00:51:45,030 --> 00:51:48,950
+ساعة مكفين حتى يتخلص منها الجسم طب إيش دخل يعني ما
+
+790
+00:51:48,950 --> 00:51:52,310
+علاقة لأquis humor في هذه الحالة؟انه في عندى انا
+
+791
+00:51:52,310 --> 00:51:57,190
+بنهاية او المسافة ما بين الcellular body و ما بين
+
+792
+00:51:57,190 --> 00:52:00,310
+اللى هو ال sclera في عندى ايضا اللى هو المساحة
+
+793
+00:52:00,310 --> 00:52:03,550
+اللى بدى توصللى ال supercorridor space بدى يتقل من
+
+794
+00:52:03,550 --> 00:52:06,570
+خلال ال aqueous humor عبر ال supercorridor space
+
+795
+00:52:06,570 --> 00:52:10,610
+بعدين مرة أخرى يرجع اللى هو الأفثامك فيه بالتالي
+
+796
+00:52:10,610 --> 00:52:14,770
+بس بدى يشارك بعشرة يعني أكتر شي عشرة فمية لذلك
+
+797
+00:52:14,770 --> 00:52:18,910
+احتمالنا يعني احنا الطبيب لما يحاول يستخدم أدوية
+
+798
+00:52:19,080 --> 00:52:23,960
+تقلص من إنتاج الـ aqueous hema هذه هتكون أخر شئ
+
+799
+00:52:23,960 --> 00:52:28,480
+تقريبا لإن كمية تقلصها 10% فقط مش هتأثر يعني كتير
+
+800
+00:52:28,480 --> 00:52:32,920
+بينما الأساسية اللى هى ال cellar epithelia طيب the
+
+801
+00:52:32,920 --> 00:52:37,040
+aqueous passed to the superchordal space between
+
+802
+00:52:37,040 --> 00:52:41,700
+the uvral tract مابين ال uvral tract كلها and the
+
+803
+00:52:41,700 --> 00:52:44,860
+sclera اللى هو مابين ال cellary body ومابين ال
+
+804
+00:52:44,860 --> 00:52:50,590
+sclera أيضا موجودة عند الالسبراكرويدر الاسباس او
+
+805
+00:52:50,590 --> 00:52:54,490
+ليك من خلال الاسكليرة بولا في جزء من الاسكليرة
+
+806
+00:52:54,490 --> 00:52:57,490
+الاسكليرة الاسكليرة الاسكليرة الاسكليرة الاسكليرة
+
+807
+00:52:57,490 --> 00:53:00,530
+الاسكليرة الاسكليرة الاسكليرة الاسكليرة الاسكليرة
+
+808
+00:53:00,530 --> 00:53:07,570
+الاسكليرة الاسكليرة الاسكليرة الاسكليرة الاسكليرة
+
+809
+00:53:07,570 --> 00:53:07,570
+الاسكليرة الاسكليرة الاسكليرة الاسكليرة الاسكليرة
+
+810
+00:53:07,570 --> 00:53:07,930
+الاسكليرة الاسكليرة الاسكليرة الاسكليرة الاسكليرة
+
+811
+00:53:07,930 --> 00:53:08,090
+الاسكليرة الاسكليرة الاسكليرة الاسكليرة الاسكليرة
+
+812
+00:53:08,090 --> 00:53:08,610
+الاسكليرة الاسكليرة الاسكليرة الاسكليرة الاسكليرة
+
+813
+00:53:08,610 --> 00:53:11,800
+الاسكليرة الاسكليرة الفي انا في اندي هذا الشي
+
+814
+00:53:11,800 --> 00:53:15,000
+حكينا سلري بادي هدى parsipilicata و هدى
+
+815
+00:53:15,000 --> 00:53:18,040
+parsipilana صحيح عندى مابين كل ال euretract في
+
+816
+00:53:18,040 --> 00:53:23,700
+عندى مسافة صغيرة جدا هي مابين ال euretract و مابين
+
+817
+00:53:23,700 --> 00:53:26,260
+ال sclera صحيح هدى المسافة سبناها احنا
+
+818
+00:53:26,260 --> 00:53:32,580
+supergeralda space صحيح هدى هي من خلال وصول اكتس
+
+819
+00:53:32,580 --> 00:53:35,980
+همار عبر ال pantera في ال .. الطبيب كان مش بارق
+
+820
+00:53:35,980 --> 00:53:41,990
+تقريبا تسعين الى 95% صح ولافي بضالة ان فقط 10% من
+
+821
+00:53:41,990 --> 00:53:47,110
+5 إلى 10 هي فقط اللى تنتقل عبر المنصفة ما بين
+
+822
+00:53:47,110 --> 00:53:49,830
+الcellular body اللى سمّاها supercorridor space
+
+823
+00:53:49,830 --> 00:54:01,310
+حتى يتم رشحها ووصولها إلى الأفثال مكبين صحيح؟
+
+824
+00:54:01,310 --> 00:54:04,770
+او ان اما قبل حتى وصولها إلى الأفثال مكبين من خلال
+
+825
+00:54:04,770 --> 00:54:05,630
+scleral wall
+
+826
+00:54:09,350 --> 00:54:11,910
+و من دون ترشيحها للخارج بالتالي أناش فيه اندعانة
+
+827
+00:54:11,910 --> 00:54:17,730
+فات صحيح للعام؟ اللي هي تدهون اللغش الناسيجي اللذي
+
+828
+00:54:17,730 --> 00:54:21,490
+يحيط بكرة العين للخارج بعدين هيتم تصاصة مرة أخرى و
+
+829
+00:54:21,490 --> 00:54:25,010
+ترجع مرة أخرى مع اللي هو ال body circulation عشان
+
+830
+00:54:25,010 --> 00:54:28,330
+هذا الطريقة و غير مختلفة طبعا أي هم أكثر في الحالة
+
+831
+00:54:28,330 --> 00:54:31,450
+هذه فقط في ال uv .. في ال uv sclera flow هيكون عن
+
+832
+00:54:31,450 --> 00:54:36,220
+طريق هوالسكلير الوار و لا عن طريق السبراكويدر
+
+833
+00:54:36,220 --> 00:54:39,340
+السباس؟ لأ عن طريق السبراكويدر السباس و أكثر من عن
+
+834
+00:54:39,340 --> 00:54:44,260
+طريق السكلير الوار لكن كلهم موجود يعني و تم تتبع
+
+835
+00:54:44,260 --> 00:54:47,480
+هذا باستخدام ال fluorescent اللي احنا ذكرناه في
+
+836
+00:54:47,480 --> 00:54:52,100
+البداية this
+
+837
+00:54:52,100 --> 00:54:54,360
+flow is independent of intraocular pressure and
+
+838
+00:54:54,360 --> 00:54:57,300
+represents five to ten percent of the duration of
+
+839
+00:54:57,300 --> 00:55:00,240
+aqueous hemorrhage و يعني تحط خط بيه تحت
+
+840
+00:55:00,240 --> 00:55:04,210
+independent of intraocular pressureمش واحد
+
+841
+00:55:04,210 --> 00:55:08,210
+independent ذاته؟ يعني مستقل بحد ذاته بينما
+
+842
+00:55:08,210 --> 00:55:11,070
+الترابيكال مش والك لا يعتمد اعتماد أساسي على ال
+
+843
+00:55:11,070 --> 00:55:12,690
+intraocular pressure إذا زاد عند ال intraocular
+
+844
+00:55:12,690 --> 00:55:17,230
+pressure بدها تقل بده يزاد ال aqueous humor out of
+
+845
+00:55:17,230 --> 00:55:20,650
+flow صح ولا لا لكن بده يقل الإنتاج بينما في الحالة
+
+846
+00:55:20,650 --> 00:55:23,830
+هذي زاد أو قل مافيش علاقة هو عند هذي العلاقة دايما
+
+847
+00:55:23,830 --> 00:55:27,330
+ثابتة أو الكمية هذي ثابتة 5-10% فهذه سواء ارتفع عن
+
+848
+00:55:27,330 --> 00:55:30,430
+ضغط العين او قل عن ضغط العين هي بدها تظهر تصريف
+
+849
+00:55:30,430 --> 00:55:36,230
+هذا الشكل دائمطيب ناخد النقطة الأخيرة ان شاء الله
+
+850
+00:55:36,230 --> 00:55:39,690
+هي intracral pressure fluctuations fluctuations
+
+851
+00:55:39,690 --> 00:55:49,630
+معناها تقل بقى يعني أصبح في عندك تغيرات the
+
+852
+00:55:49,630 --> 00:55:55,330
+number of IOP is between 12 to 20 هي ما بين عشرة
+
+853
+00:55:55,330 --> 00:56:00,030
+تسعة إلى واحد وعشرين هعدلها شويةطبعا في بعض
+
+854
+00:56:00,030 --> 00:56:05,460
+الدراسات تقول انه في الجنس اليابانيعامة في الحالة
+
+855
+00:56:05,460 --> 00:56:14,340
+الطبيعية لن يصل ضغط العين 20 نهائيا بسول 18 طبعا
+
+856
+00:56:14,340 --> 00:56:19,200
+حكينا ان في بعض القرى في الهند تقريبا ما يزيد على
+
+857
+00:56:19,200 --> 00:56:22,860
+60% من أصحاب هذه القرية كلهم ضغط العين عندهم فوق
+
+858
+00:56:22,860 --> 00:56:28,140
+ال 25،25،25،24 وطبعا ماعندهم مجلوكم ولا مرض آخر
+
+859
+00:56:28,140 --> 00:56:33,600
+فأصبح ان هذا تغيرات طبيعيةin most people IOP
+
+860
+00:56:33,600 --> 00:56:36,600
+exhibits during the variation في الحالة الطبيعية
+
+861
+00:56:36,600 --> 00:56:39,920
+في أغلب الناس فيها نسعة بيولوجية أو تغير اللي هو
+
+862
+00:56:39,920 --> 00:56:42,540
+arithmetic variation ما بين ال IOP زى ما حكينا
+
+863
+00:56:42,540 --> 00:56:46,380
+احنا يزداد في وقت اللي هو الفجر ووقت الظهيرة ويقل
+
+864
+00:56:46,380 --> 00:56:50,620
+في وقت النار بمعدل 45% من قياسه الأساسي all
+
+865
+00:56:50,620 --> 00:56:53,520
+breathing this variation is exaggerated in a
+
+866
+00:56:53,520 --> 00:56:56,500
+glaucoma معدل exaggerated يعني يتم المبالغة فيه
+
+867
+00:56:56,500 --> 00:57:01,210
+يعني يزداد هذا الفارق في حالة إيش ال glaucomaزي ما
+
+868
+00:57:01,210 --> 00:57:04,630
+حكيت أنا، بده يصبح ال .. ال .. ال .. ال .. ال
+
+869
+00:57:04,630 --> 00:57:06,550
+general variation فارق ما بين القراءة اللي هو
+
+870
+00:57:06,550 --> 00:57:09,090
+القراءة التانية و القراءة الأخيرة كبير جدا، ربما
+
+871
+00:57:09,090 --> 00:57:11,150
+أكتر من تمانية و ربما أكتر من تسعة، أحيانا أكتر من
+
+872
+00:57:11,150 --> 00:57:15,270
+عشرة It's high in the morning and low in the early
+
+873
+00:57:15,270 --> 00:57:20,290
+night.طيب IOP is higher in winter and lower in
+
+874
+00:57:20,290 --> 00:57:24,330
+summer.حط قناة السفحان Y IOP is higher in winter
+
+875
+00:57:24,330 --> 00:57:28,830
+and lower in summerإذا كنا حكينا في ال mechanism
+
+876
+00:57:28,830 --> 00:57:31,890
+of the cone يحكينا إيش temperature dependent صحيح
+
+877
+00:57:31,890 --> 00:57:36,110
+تعتمد على الحرارة إذا كانت الدرجة الحرارة قليلة في
+
+878
+00:57:36,110 --> 00:57:39,130
+ال coldness اللي بيصيح فيه عندك بتزايد ال
+
+879
+00:57:39,130 --> 00:57:41,690
+thickness هتتحافظ علي إيش كمية كبيرة من السائل و
+
+880
+00:57:41,690 --> 00:57:45,630
+العكس صحيح هي أن في ال IOP نفس الشيء اللي يساعد
+
+881
+00:57:45,630 --> 00:57:48,690
+بالسيف بتحافظ خمس مكيمات كبيرة من السائل صحيح
+
+882
+00:57:48,690 --> 00:57:52,270
+بالتالي هيكون فيه عنده ال out of flow أكتر صحيح
+
+883
+00:57:52,270 --> 00:57:53,130
+بينما بالشتاء
+
+884
+00:57:56,620 --> 00:58:00,100
+هيحتفظ لأن اصلا تناول كمية المعفش تاع هيكون قليل،
+
+885
+00:58:00,100 --> 00:58:03,080
+صحيح؟ و هكذا، إلا بالعلاقة اللي هو العلاقة العامة
+
+886
+00:58:03,080 --> 00:58:07,580
+لجسم الإنسان بما يتعلق بدرجة الحرارة IOP is equal
+
+887
+00:58:07,580 --> 00:58:14,300
+in males and females until years of 4040 years
+
+888
+00:58:14,300 --> 00:58:18,300
+يعني مساوى مبضغط العين بال .. بالذكور والإنار لكن
+
+889
+00:58:18,300 --> 00:58:21,720
+بعد ذلك بصبح أقل في الإنار لإنها دي كلها حطوا
+
+890
+00:58:21,720 --> 00:58:25,760
+عليها خطين يعني تحتي لإنها دي عليها حتى الآن في
+
+891
+00:58:25,760 --> 00:58:29,900
+controversy ايش معنى controversy يعني في .. في
+
+892
+00:58:29,900 --> 00:58:33,120
+جدال عليها بشكل كبير في كثير من الدراسات بتحكي لأ
+
+893
+00:58:33,120 --> 00:58:36,080
+ال males في ضغط العين أكتر بين مدرسات أخرى بتحكي
+
+894
+00:58:36,080 --> 00:58:38,900
+لأ أنا وجدت أنه فيه males في الدراسات الأسترالية
+
+895
+00:58:38,900 --> 00:58:42,400
+في الدراسات الجنو .. الأمريكية الجنوبية بتحكي لأ
+
+896
+00:58:42,400 --> 00:58:46,270
+انه العكسو في وجدوا انه متقاربة جدا فاحنا مش
+
+897
+00:58:46,270 --> 00:58:49,550
+هنجيبها بالاختبار و ناخدها بشكل صمت لأ هي تقريبا
+
+898
+00:58:49,550 --> 00:58:55,470
+متقاربة اه متقاربة
+
+899
+00:58:55,470 --> 00:59:00,770
+طيب IOP tends to increase with advance ليش كلما
+
+900
+00:59:00,770 --> 00:59:06,400
+تقدم الإنسان السن بدو إيش ازاد عنده اللي هوده بطلع
+
+901
+00:59:06,400 --> 00:59:11,340
+يعني لإنه عامل التلابيك لمشواك نوعا ما مش .. مش
+
+902
+00:59:11,340 --> 00:59:14,920
+هيقدر الوظيفة لكن في بعض الدراسات بتحكي إنه بعد سن
+
+903
+00:59:14,920 --> 00:59:18,700
+الأربعين مودي يبدأش .. مودي يقل لإن الصحيح هو بعمل
+
+904
+00:59:18,700 --> 00:59:21,560
+التلابيك لمشواك مش هتلبيله كل الطلبات هذا لكن على
+
+905
+00:59:21,560 --> 00:59:24,800
+بشكل مقابل إن ال .. السلية اللي بسلية مش هيقدرها
+
+906
+00:59:24,800 --> 00:59:28,580
+يفرز بشكل كبير أكوية صحيمة زي ما كان في العشرينات
+
+907
+00:59:28,580 --> 00:59:33,510
+أو المقدمات اللي عنوانIopie decreases in sleep
+
+908
+00:59:33,510 --> 00:59:36,310
+وهذه حكينا عنها احنا and in general anaesthesia،
+
+909
+00:59:36,310 --> 00:59:42,550
+حطوا تحت general anaesthesia خط، ليش؟
+
+910
+00:59:42,550 --> 00:59:47,570
+لأن التخدير بشكل عام شبه النوم، التخدير فيه أن
+
+911
+00:59:47,570 --> 00:59:50,570
+التخدير في بعض الأدوية باستخدام حمال كتمين ممكن
+
+912
+00:59:50,570 --> 00:59:53,910
+تعمل حبود في ضغط العين، تاني حاجة التخدير عام يعمل
+
+913
+00:59:53,910 --> 00:59:57,720
+reduction in excess of your muscle stoneمش يعني؟
+
+914
+00:59:57,720 --> 01:00:01,140
+هو احنا في اي حركة مانتحرك فيها، في عندي اللي هو
+
+915
+01:00:01,140 --> 01:00:03,880
+exertion او contraction of the axilla أو axilla
+
+916
+01:00:03,880 --> 01:00:07,580
+كلمة صحيح، هذه بدها تساعد او تساهم فيش؟ في اللي هو
+
+917
+01:00:07,580 --> 01:00:13,080
+زيادة ضغط العين، بينما عند الاسترخاء حلق اللي عنده
+
+918
+01:00:13,080 --> 01:00:18,050
+ضغط على العين حلق اللي عنده ضغط العينIopie may be
+
+919
+01:00:18,050 --> 01:00:22,190
+increased in extreme case بس نرجع مرة أخر هذه تحدو
+
+920
+01:00:22,190 --> 01:00:25,510
+أمام general anaesthesia هنضع علامة الشفاة لأنها
+
+921
+01:00:25,510 --> 01:00:29,430
+مهمة هتعمل على relaxation of the muscles وبالتالي
+
+922
+01:00:29,430 --> 01:00:36,210
+هتقلل ضغط العين Iopie
+
+923
+01:00:36,210 --> 01:00:38,950
+may be increased in extreme case
+
+924
+01:00:41,020 --> 01:00:44,960
+يعني السنة دلت باتجاه معين طلع فترة معينة طب أكيد
+
+925
+01:00:44,960 --> 01:00:48,300
+هتكون في عندي contraction و هتزاد عندي إيش العضلات
+
+926
+01:00:48,300 --> 01:00:51,800
+ذالك نرجع مرة أخرى عند قياس اللي هو ال IOP في
+
+927
+01:00:51,800 --> 01:00:53,680
+استخدام ال gun metamoramia إيش حاجة كده ال eyeball
+
+928
+01:00:53,680 --> 01:00:57,040
+must be in the primary position حتى نمنع اللي هو
+
+929
+01:00:57,040 --> 01:00:59,960
+the structures of the extra carotid muscle بتالي
+
+930
+01:00:59,960 --> 01:01:02,980
+هتسر في عندي contraction فهي عندي ضغط العين مباشرة
+
+931
+01:01:02,980 --> 01:01:06,120
+كيف هنفهمها؟ خليكم معايااحنا حكينا فيانا potential
+
+932
+01:01:06,120 --> 01:01:09,000
+errors صح فيانا بعض الأخطاء اللي هي سببها من ضمنها
+
+933
+01:01:09,000 --> 01:01:11,720
+وكأن أنا بدأ ضغط على كورة العين ونفس الشيء بهذا
+
+934
+01:01:11,720 --> 01:01:15,300
+السبب هو ال extra kerosis وكأن انا ضعفت ايش ضقت او
+
+935
+01:01:15,300 --> 01:01:19,240
+حمل ثقيل اخر على كورة العين اخر شي فيانا increase
+
+936
+01:01:19,240 --> 01:01:22,960
+vascular venous pressure with increase IOP by
+
+937
+01:01:22,960 --> 01:01:28,350
+changing posture by valsalva maneuverEpiscleral
+
+938
+01:01:28,350 --> 01:01:31,910
+pressure حتى وحكينا Episcleral veins بعد ما يتخلص
+
+939
+01:01:31,910 --> 01:01:34,570
+الأكويسهيومر يعني عفوا كنتوا يعامل أكويسهيومر عمله
+
+940
+01:01:34,570 --> 01:01:39,270
+طيب يكرم شويه حيذهب أو يتطرق لوين كان لو شلمك صحيح
+
+941
+01:01:39,270 --> 01:01:42,870
+بعدين collector channels بعدين فيه هنا Episcleral
+
+942
+01:01:42,870 --> 01:01:45,870
+veins صحيح طب لو الضغط داخل ال Episcleral veins
+
+943
+01:01:45,870 --> 01:01:51,510
+ارتفع التدفق هذا راح يقل الأكويسهيومر صحيح بالتالي
+
+944
+01:01:51,510 --> 01:01:58,340
+اكتب هذا نقطة بس آخر نقطة ارتفاع اللي هوto
+
+945
+01:01:58,340 --> 01:02:05,000
+increase vascular venous pressure EVP تكتفى
+
+946
+01:02:05,000 --> 01:02:09,800
+على الضغط الداخل اللى هو ال vascular veins سوف
+
+947
+01:02:09,800 --> 01:02:16,120
+يؤدي إلى زياد في ضغط العين يقلل
+
+948
+01:02:16,120 --> 01:02:20,340
+تصريف او يحد من ال out of flow اللى هو ال aqueous
+
+949
+01:02:20,340 --> 01:02:25,020
+hemorrha فالظل فمانيوفر طلع عليها مش معاناها دى بس
+
+950
+01:02:25,020 --> 01:02:29,470
+نحكيها بشكل مقتصر طلع عليهافي بعض ال potential
+
+951
+01:02:29,470 --> 01:02:32,190
+earnings احنا لسه ماخدنهاش كمان يعني لإنه كثيرة
+
+952
+01:02:32,190 --> 01:02:37,750
+جدا باستخدام ال IOP لإنسان يكتب نفسه بشكل هذا
+
+953
+01:02:37,750 --> 01:02:41,890
+صحيح، هيك و كإنه بشكل dynamical أو متعمد، خلال ال
+
+954
+01:02:41,890 --> 01:02:45,230
+Venus بروشارش معله عالي أزداد، هو الإنسان اللي
+
+955
+01:02:45,230 --> 01:02:48,760
+بيحط الجرعبة بشكلكتير ضيق جدا و بالعارف يوما
+
+956
+01:02:48,760 --> 01:02:52,140
+بتتكلم او بتنفس صحيح بالشكل هذا ايش ممكن يصير فيه
+
+957
+01:02:52,140 --> 01:02:54,720
+عنده False Alpha Manoeuvre، بدي يستخدم عند ال Vena
+
+958
+01:02:54,720 --> 01:02:57,880
+17، بدالة هي على عند ضغط العين، لكن ضغط العين هذا
+
+959
+01:02:57,880 --> 01:03:00,040
+اللي بيعمل على .. بدي يديه ال false impression، مش
+
+960
+01:03:00,040 --> 01:03:04,240
+هو ال true I أو V، فبالنسبة لقياس ضغط العين احنا
+
+961
+01:03:04,240 --> 01:03:07,240
+كنا يعني اتكلمنا عليها بشكل اش كتير
+
+962
+01:03:18,630 --> 01:03:22,050
+طيب ان في بعض الأدوية .. هناك بعض الأدوية
+
+963
+01:03:22,050 --> 01:03:24,710
+pharmacology of the eye و P هناك بعض الأدوية اللتي
+
+964
+01:03:24,710 --> 01:03:28,370
+تؤثر .. هناك بعض الأدوية اللتي تؤثر على اللي هو
+
+965
+01:03:28,370 --> 01:03:31,750
+انخفاض او ارتفاع طبق العين من هذه الأدوية اول شيء
+
+966
+01:03:31,750 --> 01:03:34,250
+انها ال meiotics ال meiotics هي كل الأدوية اللي
+
+967
+01:03:34,250 --> 01:03:38,230
+بتعمل على اللي هو meiosis of the iris هذه من ال
+
+968
+01:03:38,230 --> 01:03:42,130
+meiotics حكيناها احنافجوزز اف دا عيارس بيعمل لي
+
+969
+01:03:42,130 --> 01:03:46,170
+produce demolition of IOP ويقلل لي من ضغط العين
+
+970
+01:03:46,170 --> 01:03:48,910
+بواسطة contraction of the iris sphincter muscle
+
+971
+01:03:48,910 --> 01:03:52,230
+وبالتالي هيسمح عليهش بعد ما يكون لديه contraction
+
+972
+01:03:52,230 --> 01:03:54,850
+of the sphincter muscle هيفتح لديه الزاوية هصير
+
+973
+01:03:54,850 --> 01:03:58,770
+موقفة وبالتالي هيتفق عن ضغط اجوز الهيومار بشكل
+
+974
+01:03:58,770 --> 01:04:02,230
+أكبر وهذا هو السبب اللي حكينا عنه during sleep
+
+975
+01:04:02,230 --> 01:04:08,170
+هيحدث لديه reduction of IOP بمعدل 45% من حالة
+
+976
+01:04:08,170 --> 01:04:12,590
+اللحق صحيح؟بينما على العكس من ذلك اللي هو
+
+977
+01:04:12,590 --> 01:04:15,330
+Mediatics اخدوا بعض القصة اخر حاجة في الميوتيكس
+
+978
+01:04:15,330 --> 01:04:18,670
+مهم they produce increase in tropical airflow
+
+979
+01:04:18,670 --> 01:04:22,270
+facility فهذا مهم جدا بيسهل لعمل تصريف اللي هو ال
+
+980
+01:04:22,270 --> 01:04:26,070
+ACPS الحمر بينما ال Mediatics produce increase IAP
+
+981
+01:04:26,070 --> 01:04:31,810
+تتعمل على زيادة دبط العين بالضبط في أيش؟ في العين
+
+982
+01:04:31,810 --> 01:04:34,050
+اللي بيكون فيها أصلا ال interior chamber angle
+
+983
+01:04:34,050 --> 01:04:38,030
+shallow أو narrow ليش؟بعد ال dilatation بدي اتجه
+
+984
+01:04:38,030 --> 01:04:40,570
+كل عضلات الدالات اللي ماصلناها تهاشم ال periphery،
+
+985
+01:04:40,570 --> 01:04:45,470
+صحيح؟ بتالع هيضغط على اللي هو ال angle، طبيعي أنه
+
+986
+01:04:45,470 --> 01:04:47,970
+يتقل نسبة عندي ال out of law، بتالع هيبتفع ضغط
+
+987
+01:04:47,970 --> 01:04:53,530
+العين تالت شئ أدريناجيك بيتا blockers agents like
+
+988
+01:04:53,530 --> 01:04:59,930
+Timolane، هذه بعض الأدوية اللي هتتقلل من ضغط العين
+
+989
+01:05:04,180 --> 01:05:06,940
+تانى شىء Carburetor هيدراز ال inhibitors ايضا
+
+990
+01:05:06,940 --> 01:05:11,580
+هيقلل لضغط العين فعلا طلعت و أربع بصناعة ان هاد
+
+991
+01:05:11,580 --> 01:05:14,220
+الأدوية بتعمل على تقليل ضغط العين بدون يعني ما
+
+992
+01:05:14,220 --> 01:05:15,940
+اقلتل ال mechanism اللى انا فيه و بعد احنا هاخدها
+
+993
+01:05:15,940 --> 01:05:19,970
+بشكل مفصل ان شاء اللهأخر حاجة قبل اخرى هي hyper
+
+994
+01:05:19,970 --> 01:05:23,850
+osmotic solutions بتعمل على تقليل منطقة العين
+
+995
+01:05:23,850 --> 01:05:26,650
+بتخفيض ال osmolarity اللي هيتكلمنا عنها آخر مرة،
+
+996
+01:05:26,650 --> 01:05:30,310
+هذا مش حقيقي ده صح ولا؟ حكينا فيها أن المنطقة اللي
+
+997
+01:05:30,310 --> 01:05:32,150
+بيكون فيها high concentration of water زي ال
+
+998
+01:05:32,150 --> 01:05:36,050
+aquisima هيكون osmotic pressure اللي هيش low صحيح؟
+
+999
+01:05:36,190 --> 01:05:39,790
+على العكس من ذلك في القوية الدموية حيكون في عندى
+
+1000
+01:05:39,790 --> 01:05:42,690
+high osmotic pressure فاحنا لما ندى علاجة تكون
+
+1001
+01:05:42,690 --> 01:05:45,410
+high osmotic pressure حينتقل عند السائل من ال
+
+1002
+01:05:45,410 --> 01:05:47,650
+aqueous hemawa عبر عيش اللي هو القوية الدموية
+
+1003
+01:05:53,410 --> 01:05:57,810
+طيب hypotonic solutions هذي بتعمل على ارتفاع في
+
+1004
+01:05:57,810 --> 01:06:00,810
+ضغط العين مثلا على ذلك اللي هو شرب الماء بشكل او
+
+1005
+01:06:00,810 --> 01:06:05,170
+بكثرة ممكن ترفع ضغط العين لدرجة تمانية ملي متر اذا
+
+1006
+01:06:05,170 --> 01:06:09,390
+ابقى اخر شئ في عندنا ال cortisonate اللي هي
+
+1007
+01:06:09,390 --> 01:06:14,830
+corticosteroids تعمل على ارتفاع ضغط العين وهذا
+
+1008
+01:06:14,830 --> 01:06:18,620
+اللي اما انا فيه يعنيالموضوع حد ذاته بده يعني بده
+
+1009
+01:06:18,620 --> 01:06:20,460
+محاضرة او اكتر او ما يزيد اللي هو علاقة
+
+1010
+01:06:20,460 --> 01:06:23,680
+الكورتسينات و ضغط العين تعمل او تساعد الكورتسينات
+
+1011
+01:06:23,680 --> 01:06:27,580
+هذه سواء كانت تعطى بشكل local او systemic يعني
+
+1012
+01:06:27,580 --> 01:06:30,200
+تعطى اما عن طريق العين بشكل مباشر او حتى عن طريق
+
+1013
+01:06:30,200 --> 01:06:33,880
+الجسم او اللي هو عبارة عن حبوب تبلع عن طريق الفم
+
+1014
+01:06:33,880 --> 01:06:40,170
+تعمل على ازيادة في ضغط العين عن طريق استثقاءفي ال
+
+1015
+01:06:40,170 --> 01:06:42,630
+tropical meshwar و المقصود استثقائي يعني ممكن يحدث
+
+1016
+01:06:42,630 --> 01:06:45,750
+عندي ادمة او في ال tropical meshwar وبالتالي هي
+
+1017
+01:06:45,750 --> 01:06:49,310
+ارتفاع عندى ضغط العين طبعا ممكن يكون الارتفاع حادث
+
+1018
+01:06:49,310 --> 01:06:51,870
+بشكل دائم او ممكن يكون بشكل transient يعني مؤقت
+
+1019
+01:06:51,870 --> 01:06:55,750
+مديوعة ما يعتمد أساسي على اللي هو مدة استخدام هذه
+
+1020
+01:06:55,750 --> 01:07:00,050
+الكورتسونات، كانت كأثرة؟ طيب السلام عليكم
+
diff --git a/PL9fwy3NUQKwZ2K6wMRTZMEoGVTbELxinF/DOQOVPLWq1s_raw.srt b/PL9fwy3NUQKwZ2K6wMRTZMEoGVTbELxinF/DOQOVPLWq1s_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..e7b26db006bf247e8c9cf07c7f44b9c4e74eca4f
--- /dev/null
+++ b/PL9fwy3NUQKwZ2K6wMRTZMEoGVTbELxinF/DOQOVPLWq1s_raw.srt
@@ -0,0 +1,4748 @@
+1
+00:00:20,700 --> 00:00:22,660
+عايز أقولها إن الشيطان الرجيم بسم الله الرحمن
+
+2
+00:00:22,660 --> 00:00:26,840
+الرحيم سنبدأ عدة محاضرات في physiology العين أو
+
+3
+00:00:26,840 --> 00:00:29,340
+علم وظائف العين المحاضرة الأولى بعنوان physiology
+
+4
+00:00:29,340 --> 00:00:32,900
+of the eyelid سنبدأها أبعد إن شاء الله although
+
+5
+00:00:32,900 --> 00:00:35,140
+relatively small the eyelids have a complex
+
+6
+00:00:35,140 --> 00:00:37,720
+structure to allow the various essential functions
+
+7
+00:00:37,720 --> 00:00:42,300
+مع إن جسم العين يعتبر عضو صغير جدا بالنسبة لعضاء
+
+8
+00:00:42,300 --> 00:00:45,440
+الجسد طبعة كورة العين تحتوي على عضاء كثيرة مع إنها
+
+9
+00:00:45,440 --> 00:00:50,290
+ككل يعني تعتبر عضو صغير جدا صحيح؟لكن أيضا كرة
+
+10
+00:00:50,290 --> 00:00:53,110
+العين نفسها بيبقى أعضاء و الأدنسة بما فيها ال
+
+11
+00:00:53,110 --> 00:00:56,850
+eyelids و ال external muscles كل منهم يعتبر قده
+
+12
+00:00:56,850 --> 00:01:01,690
+بحد ذاته لكن ليش يعمل مع بعض أو بشكل متزامن لإثمام
+
+13
+00:01:01,690 --> 00:01:05,190
+عملية فيستيولوجية معينة مع أن ال eyelids صغير
+
+14
+00:01:05,190 --> 00:01:09,470
+الحجم بشكل يعني طبعا لا يضاهي أعضاء أخرى في جسد
+
+15
+00:01:09,470 --> 00:01:13,410
+الإنسان إلا إنه يحتوي على خصائص فيستيولوجية معقدة،
+
+16
+00:01:13,410 --> 00:01:17,450
+معقدة التركيب بما فيها حفاظ على القرانيةوطعمها
+
+17
+00:01:17,450 --> 00:01:20,130
+جمالي إلى العين و الاخره سنتكلم عن الموضوع في هذه
+
+18
+00:01:20,130 --> 00:01:23,750
+التحديد ان شاء الله سنبدأ أولا بالتركيب التشريحي
+
+19
+00:01:23,750 --> 00:01:27,350
+لل eyelid او للجثة العين التركيب التشريحي لل
+
+20
+00:01:27,350 --> 00:01:30,250
+eyelid يتكون من anterior lamella اللي هي طبقة
+
+21
+00:01:30,250 --> 00:01:33,190
+أمامية و posterior lamella ال anterior lamella لل
+
+22
+00:01:33,190 --> 00:01:37,590
+eyelid تتكون من عدة أجزة skill اللي هي الطبقة
+
+23
+00:01:37,590 --> 00:01:40,930
+الجلدية muscle الطبقة العضلية فينا ال glands اللي
+
+24
+00:01:40,930 --> 00:01:44,580
+هي الغددطبعا الموضوع ده اللي هي ال .. ال .. في
+
+25
+00:01:44,580 --> 00:01:46,400
+الacrobatics اللي محن حدثتها بالتفصيل ان شاء الله
+
+26
+00:01:46,400 --> 00:01:49,240
+بصحى على سبيل الذكر اما posterior lamella طبعا
+
+27
+00:01:49,240 --> 00:01:51,180
+احنا قسمناها anterior lamella و posterior lamella
+
+28
+00:01:51,180 --> 00:01:54,100
+تباع مناشر من ال margin صح اللي هو ال grey line
+
+29
+00:01:54,100 --> 00:01:56,520
+اللي حدرستها بالتشريح ال posterior lamella
+
+30
+00:01:56,520 --> 00:02:00,080
+المكونات تبعتها من ال torsos palate فمدون ان ال
+
+31
+00:02:00,080 --> 00:02:04,100
+torso plate او torsos باختصار فيه المركب الاخر
+
+32
+00:02:04,100 --> 00:02:07,290
+kunshan tava و اخر شي فيه لنا leg linesإذا أصبح
+
+33
+00:02:07,290 --> 00:02:09,850
+فيه أن عضو مشترك لانترالاميلا والبوستيريولاميلا
+
+34
+00:02:09,850 --> 00:02:12,350
+اللي هو إيش ال glands اللي إحنا هنتكلم عنه إن شاء
+
+35
+00:02:12,350 --> 00:02:17,590
+الله في ال lacrimal system طيب the eyelid skin is
+
+36
+00:02:17,590 --> 00:02:20,630
+among the thinnest and most mobile skin in the
+
+37
+00:02:20,630 --> 00:02:25,110
+body المعروف إنه جلد الإنسان ال cutaneous أو ال
+
+38
+00:02:25,110 --> 00:02:28,290
+skin نفسه فيه endisubcutaneous tissue صحيح؟ اللي
+
+39
+00:02:28,290 --> 00:02:32,460
+هو طبقات دهنية لأسفلالجلد اللى تعمل عليه support
+
+40
+00:02:32,460 --> 00:02:37,540
+لل skin بالشكل العام صحيح؟ أما عندنا في ال eyelid
+
+41
+00:02:37,540 --> 00:02:41,440
+فهنا نقص في ال tissue اللى هو ال fat tissue مش
+
+42
+00:02:41,440 --> 00:02:43,880
+موجودة عندنا بكثرة مش موجودة عندنا very very few
+
+43
+00:02:43,880 --> 00:02:48,140
+very very few only fat tissue this few fat tissue
+
+44
+00:02:48,140 --> 00:02:51,860
+will provide fluid accumulation يعني بمعنى عندنا
+
+45
+00:02:51,860 --> 00:02:56,660
+ال eyelid كما نرابخو جدا جدا جدا ذلك بيعطيني ايش
+
+46
+00:02:56,660 --> 00:03:00,220
+خاصة .. خاصية فسيولوجية لسرعة ال blanking سرعة ال
+
+47
+00:03:00,220 --> 00:03:02,840
+blanking صحيح تقميد العين وحركة العين اعلى الاسفل
+
+48
+00:03:02,840 --> 00:03:05,660
+يمين اليسار او سواء كان بشكل اقفق او horizontally
+
+49
+00:03:05,660 --> 00:03:09,820
+لو كان في عندي انا فاتش و هيكون في عندي ال eyelid
+
+50
+00:03:09,820 --> 00:03:12,780
+متسق لتساق تم بالorbicular circular muscle اللي هي
+
+51
+00:03:12,780 --> 00:03:16,560
+اللي ايش طبقة العضلية صحيح فبالتالي مش هيديلي حركة
+
+52
+00:03:18,050 --> 00:03:23,350
+رخوة أو حركة حرة للعيلة ففي عند أسفل ال skin layer
+
+53
+00:03:23,350 --> 00:03:25,610
+اللي هي الطبقة الجلدية في عند aerial air tissue
+
+54
+00:03:25,610 --> 00:03:28,610
+اللي هو النسيج الهوائي مكثر الفجوات هذه متوجدة
+
+55
+00:03:28,610 --> 00:03:32,530
+subcutaneous under أيش الطبقة أو أسفل الطبقة
+
+56
+00:03:32,530 --> 00:03:36,930
+الجلدية حاجة بيدينا خاصية أخرى أثناء رسالة بيتعرض
+
+57
+00:03:36,930 --> 00:03:39,910
+إلى كدمات أو ضربات أو يصحر من النوم فجأة في عند
+
+58
+00:03:39,910 --> 00:03:43,590
+التهيبات و لعينه تورمة صحيح التورم هذا ناتج عن أيش
+
+59
+00:03:43,590 --> 00:03:46,990
+هو تورم ممكن يحدث في أي منطقة بالجسدلكن التورب
+
+60
+00:03:46,990 --> 00:03:50,310
+الايليد يحرص بكثافة اكتر من اي جزء اخر السبب وراء
+
+61
+00:03:50,310 --> 00:03:53,810
+ذلك انه في عندى اسفل الطبقة الجذبية في عندى
+
+62
+00:03:53,810 --> 00:03:56,430
+areolar tissue ال areolar tissue هذا اكتباره
+
+63
+00:03:56,430 --> 00:04:01,350
+potential space يسمح ليه بتدفق او تواكم اللي هو
+
+64
+00:04:01,350 --> 00:04:05,430
+السواء الناتجة عن التهاب او ضربة معينة او مرض معين
+
+65
+00:04:05,430 --> 00:04:09,980
+هذه هي الكلام اللي عليها احناطيب بالنسبة للعيلات
+
+66
+00:04:09,980 --> 00:04:13,440
+في انديسينسور انيربيشن ال انيربيشن اللي هو من ال
+
+67
+00:04:13,440 --> 00:04:15,300
+first and second division اللي هو الفرع الأول
+
+68
+00:04:15,300 --> 00:04:19,460
+والفرع الثاني من ال trigeminal nerve اللي هو أصلا
+
+69
+00:04:19,460 --> 00:04:23,080
+ال trigeminal nerve بتدي انيربيشن للعديد من أكيلار
+
+70
+00:04:23,080 --> 00:04:27,390
+ال structure صحيح؟هو تقريبا الوحيد بالذات لقرنية،
+
+71
+00:04:27,390 --> 00:04:30,110
+في إيه ال ideal melanocytes الموجودة على .. طبعا
+
+72
+00:04:30,110 --> 00:04:32,770
+ال melanocytes موجودة في كل الجسد، في الطبقة
+
+73
+00:04:32,770 --> 00:04:35,310
+الجلدية، لكن ال ideal melanocytes اللي هي أصلا
+
+74
+00:04:35,310 --> 00:04:38,290
+تعملي على إنتاج ال pigmented barriers اللي هي
+
+75
+00:04:39,680 --> 00:04:43,440
+الصبغيات صحيح او حبيبات الصبغيات اللى بتكسب للبشرة
+
+76
+00:04:43,440 --> 00:04:46,820
+اللون الأسود او تجعله أكثر دكانا موجودة عنده بال
+
+77
+00:04:46,820 --> 00:04:51,220
+eyelid ماتت تنتج هذا بشكل سريع حين تعرض او اثر
+
+78
+00:04:51,220 --> 00:04:56,220
+تعرض الإنسان لضربة معينة او الشمس ال UV light صحيح
+
+79
+00:04:56,220 --> 00:04:58,880
+ال ultraviolet light هذا فيه ان كمان بعض الأدوية
+
+80
+00:04:58,880 --> 00:05:02,180
+نستخدم احنا اللى علاج الضغط مثل على ذلك ال
+
+81
+00:05:02,180 --> 00:05:07,060
+prostaglandin analogues هذا بتثبت لزيادة إنتاجاللي
+
+82
+00:05:07,060 --> 00:05:10,340
+هو ال pigment granules مما يكسب للأعين أو من ناحية
+
+83
+00:05:10,340 --> 00:05:15,120
+هذه تظهر كإنها حالة سوداء صحيح يكسب لياها اللي هو
+
+84
+00:05:15,120 --> 00:05:18,900
+مقل أسود ففي أن ال skin is a loose area of the
+
+85
+00:05:18,900 --> 00:05:21,540
+tissue اللي اتكلمنا عنه قبل قليل هذا ال area of
+
+86
+00:05:21,540 --> 00:05:25,920
+the tissue هو أساس المشكلة أو هو السبب براء تدفق
+
+87
+00:05:25,920 --> 00:05:29,020
+أو تكدس السائل في حالة المرض أو في حالة تعرض
+
+88
+00:05:29,020 --> 00:05:34,720
+للسائل لضربة معينة أسفل الجفنينطيب سنتكلم عن
+
+89
+00:05:34,720 --> 00:05:39,400
+الطبقة الجددية سنتكلم عن الطبقة العضلية the
+
+90
+00:05:39,400 --> 00:05:41,700
+largest muscle of the eyelid is the orbicularis
+
+91
+00:05:41,700 --> 00:05:46,020
+oculi muscle لأن أكبر عضلة موجودة في ال eyelid أو
+
+92
+00:05:46,020 --> 00:05:48,900
+في ال structure of the eyelid اللي هي orbicularis
+
+93
+00:05:48,900 --> 00:05:52,280
+oculi muscle اللي هي أساسا تتكون من ثلاث segment،
+
+94
+00:05:52,280 --> 00:05:55,500
+three segment صحيح؟ from outermost to innermost to
+
+95
+00:05:55,500 --> 00:05:59,610
+innermost اشي هماالأوربيتال portion بعدين فيه
+
+96
+00:05:59,610 --> 00:06:02,370
+ending ال preceptal portion و ال pretarsal portion
+
+97
+00:06:02,370 --> 00:06:06,830
+الصحيح؟ الجزء اللى مشترك اشتراك مباشر مع ال island
+
+98
+00:06:06,830 --> 00:06:09,950
+اللى هو ال pretarsal صحيح؟ اللى هو اخر جزء من ال
+
+99
+00:06:09,950 --> 00:06:13,050
+inner segment اللى احنا شايفينه عندنا هنا هذا اللى
+
+100
+00:06:13,050 --> 00:06:16,350
+ال orbital segment او orbital portion of the
+
+101
+00:06:16,350 --> 00:06:18,850
+orbital circulation muscle فيه ending pretarsal و
+
+102
+00:06:18,850 --> 00:06:21,750
+اخر حاجة فيه ending preceptal عفر وهو انه فيه
+
+103
+00:06:21,750 --> 00:06:24,630
+ending لل pretarsal اللى هو muscle of the ocular
+
+104
+00:06:24,630 --> 00:06:25,370
+circulation muscle
+
+105
+00:06:28,120 --> 00:06:31,440
+طبعا مجددا بذكر ان احكي ان كيله الاستيقظ سيجمنس
+
+106
+00:06:31,440 --> 00:06:35,240
+هذي بدي يحيط بال eye lid كل نواحي بشكل دائري كل
+
+107
+00:06:35,240 --> 00:06:38,020
+نواحي بشكل دائري يعني مش فقط على حجم ال eye lid لو
+
+108
+00:06:38,020 --> 00:06:40,500
+كان على حجم ال eye lid فقط مش هيساعدني بال
+
+109
+00:06:40,500 --> 00:06:46,400
+blinking او بغمض العين بشكل فيسيولوجي يعني بصفة
+
+110
+00:06:46,400 --> 00:06:49,820
+عامة لكن هو يحيط بكل ال eye lid من كل الاتجاهات و
+
+111
+00:06:49,820 --> 00:06:52,900
+الشكلها زي ما احنا شايفنا هنا حتى يعمل او يساعد
+
+112
+00:06:52,900 --> 00:06:56,040
+على زيادة غمض العين بشكل هاش سليم
+
+113
+00:06:58,990 --> 00:07:01,930
+هي في عندنا العضلات، تركيب العضلات، في عندنا
+
+114
+00:07:01,930 --> 00:07:03,350
+الـAnterior Lamella، في عندنا الـPosterior
+
+115
+00:07:03,350 --> 00:07:07,090
+Lamella، مش هنتكلم عليها.Orbicularis Oculi muscle
+
+116
+00:07:07,090 --> 00:07:09,290
+is considerably larger than the perimeter of the
+
+117
+00:07:09,290 --> 00:07:12,830
+eyelid، زي ما اتكلمنا قبل قليل، ان كل Orbicularis
+
+118
+00:07:12,830 --> 00:07:15,850
+Oculi muscle طبعا أكيد حجمه يزاد على حجم ال eyelid
+
+119
+00:07:15,850 --> 00:07:20,990
+كله ككل، حتى يسمح ليه بـfunctionally Orbicularis
+
+120
+00:07:20,990 --> 00:07:24,710
+Oculi muscleطبعا لما يحدث في عنده انقباض العضلة
+
+121
+00:07:24,710 --> 00:07:29,050
+هذه بالتالي هيحدث في عنده وميب او انغلاق او انطباق
+
+122
+00:07:29,050 --> 00:07:32,270
+للجفن العيني وجفن السفلي الخفاض على العين من الضوء
+
+123
+00:07:32,270 --> 00:07:36,190
+من الأغراء من الغبار مغطاير من الهواء الاخرين فلو
+
+124
+00:07:36,190 --> 00:07:38,990
+كان مرة أخرى حجم العضلة هذه or precursor client
+
+125
+00:07:38,990 --> 00:07:43,760
+muscle فقطالمكدس أو المركز على حجم ال eyelids اللي
+
+126
+00:07:43,760 --> 00:07:47,040
+هي ال Tarsus كان ممكن يصير عنده ايضا انطباق لكن
+
+127
+00:07:47,040 --> 00:07:49,840
+انطباقها درجة من العلمع السفلي مش هيكون بالشكل
+
+128
+00:07:49,840 --> 00:07:51,880
+التام مش هيحدث حتى بشكل كبير
+
+129
+00:07:54,730 --> 00:07:57,510
+أتكلم أيضًا على الأقسام اللي اتكوّن عليها from
+
+130
+00:07:57,510 --> 00:08:00,810
+outermost to innermost اللي هي فيها أنه الـ
+
+131
+00:08:00,810 --> 00:08:03,790
+orbital, preceptal and pretersal portions وهذه
+
+132
+00:08:03,790 --> 00:08:06,650
+المهمة جدًا معناها three segments of the orbicular
+
+133
+00:08:06,650 --> 00:08:08,930
+circulation muscle the deep heads of the
+
+134
+00:08:08,930 --> 00:08:12,170
+pretersocal muscle join together near the conical
+
+135
+00:08:12,170 --> 00:08:16,280
+osteoform hornus muscleفيه انهانه horner muscle
+
+136
+00:08:16,280 --> 00:08:18,380
+اللي هي عضلة horner تبع اسم العالم اللي تم
+
+137
+00:08:18,380 --> 00:08:21,640
+اكتشافها وهذا العضلة المهم جدا احنا بدراستنا
+
+138
+00:08:21,640 --> 00:08:24,500
+لعضلات العين او عضلات الجسد كلها ككل فيه انه
+
+139
+00:08:24,500 --> 00:08:29,870
+حاجتين نعرفها، الحاجة الأولىأولشيات مون يعني بدأت
+
+140
+00:08:29,870 --> 00:08:33,230
+البثاقة صحيح و تاني حاجة insertion يعني من أين
+
+141
+00:08:33,230 --> 00:08:35,850
+قدرت و أين ذهبت إذا احنا عارفنا عن الطفولة هدولة
+
+142
+00:08:35,850 --> 00:08:38,530
+بالتالي احنا عارفنا إيش وضبطها على أقل بشكل نسبي
+
+143
+00:08:38,530 --> 00:08:41,970
+صحيح ففي عنا ال horn of muscle كماشي و هناخد ان
+
+144
+00:08:41,970 --> 00:08:45,270
+شاء الله لنا ال muscle horn of muscle عبارة عن إيش
+
+145
+00:08:45,270 --> 00:08:49,650
+عبارة عن تجمعات من الألياف العضلية اللي منبثقة
+
+146
+00:08:49,650 --> 00:08:52,590
+أصلا من ال pretorsal muscle في عنا three segments
+
+147
+00:08:52,590 --> 00:08:55,770
+احنا لأربع كيلو سيكلاي muscle صحيحأخر ال segment
+
+148
+00:08:55,770 --> 00:08:58,770
+اللي هو ال most او inner most segment of the upper
+
+149
+00:08:58,770 --> 00:09:03,050
+cuirse و كلها المصر اللي هو يعتبر ال preferable
+
+150
+00:09:03,050 --> 00:09:08,260
+portionبدي نبثق منه بعض الألياف العضلية هذه
+
+151
+00:09:08,260 --> 00:09:11,180
+الألياف تذهب مباشرة ال common colliculus ال common
+
+152
+00:09:11,180 --> 00:09:14,300
+colliculus اللي هي احد التركيبات ال lacrimal
+
+153
+00:09:14,300 --> 00:09:17,520
+system هناخدها ان شاء الله بالتفصيل حتى يعمل على
+
+154
+00:09:17,520 --> 00:09:21,180
+تثبيت حتى يعمل على تثبيت ال lacrimal sac اللي هو
+
+155
+00:09:21,180 --> 00:09:24,400
+الكيس الدمعي هذا اللي عضلة نبثق من ال precursor
+
+156
+00:09:24,400 --> 00:09:27,720
+portion of the orbicularis oculi muscle طبعا اللي
+
+157
+00:09:27,720 --> 00:09:30,400
+هو ضعيف اكتر من هذه هناخدها ان شاء الله بالتفصيل
+
+158
+00:09:30,400 --> 00:09:34,130
+لما ناخد ال lacrimal systemوالتي تدخل على بوصية
+
+159
+00:09:34,130 --> 00:09:37,610
+القلعب الكريسط الأوربكيلس أوركولاي يساعد على حماية
+
+160
+00:09:37,610 --> 00:09:45,330
+أو إغلاق أعلى وأسفل الجفن العالمي مع السفل بشكل
+
+161
+00:09:45,330 --> 00:09:48,710
+شديد احنا كنا عارفين وظيفة أساسية للأوربكيلس
+
+162
+00:09:48,710 --> 00:09:52,430
+أوركولاي مثلا هي عبارة عناش تعمل على غلق الجفن
+
+163
+00:09:52,430 --> 00:09:55,450
+العالمي مع السفل بشكل شديد صحيح؟ طب أيضا في عنا
+
+164
+00:09:55,450 --> 00:09:59,050
+وظيفة أخرى لأنه أثناء غلق العش بتحس عندي ال upper
+
+165
+00:09:59,050 --> 00:10:04,130
+eyelidالأسفل صحيح و ال lower eyelid إلى الأعلى لكن
+
+166
+00:10:04,130 --> 00:10:06,590
+في انت خاصية أخرى ال lower eyelid بدي أذهب إلى
+
+167
+00:10:06,590 --> 00:10:10,670
+الأعلى upward and nasally الشكل هذا صحيح بدي أذهب
+
+168
+00:10:10,670 --> 00:10:15,590
+إلى الشكل هذا السبب ورا ذلك حتى يعمل على كل أثناء
+
+169
+00:10:15,590 --> 00:10:19,830
+غلق العين أو أثناء ال ومتن أو الرمش ال lacrimal
+
+170
+00:10:20,480 --> 00:10:23,420
+Tiers أو الـTiers أو الـTier Film لن يتم تكوينه
+
+171
+00:10:23,420 --> 00:10:27,700
+على القرنية بشكل متناسق أو توزيعه إلا بعد إغلاق
+
+172
+00:10:27,700 --> 00:10:30,420
+الرمش، صح؟ بعد اللوم بالشكل هذا، بعد الرمش هذه،
+
+173
+00:10:30,420 --> 00:10:33,020
+يعتبر involuntary reflex، هناخدها إن شاء الله بعد
+
+174
+00:10:33,020 --> 00:10:36,960
+قليل فبعد ما تم عندي توزيع كل ال tiers هذا، طب في
+
+175
+00:10:36,960 --> 00:10:40,440
+عندي tiers إزيادة، هل هيخرج خارج الجسم؟ لأ، حركة
+
+176
+00:10:40,440 --> 00:10:43,100
+الرمش هذه أو إغلاق الـTier Film بشكل إرادي أو لا
+
+177
+00:10:43,100 --> 00:10:46,560
+إرادي، بتساعدلي على ضخ ما تبقى من الـTier هذا،
+
+178
+00:10:46,560 --> 00:10:52,150
+ناحية عياش اللاكمالكانال وبنهاية تنقل لـ lacrimal
+
+179
+00:10:52,150 --> 00:10:56,970
+sac ان شاء الله طيب في إن العضل الأخرى عم نتكلم عن
+
+180
+00:10:56,970 --> 00:11:00,370
+هوناز muscle في إنه muscle of thyroid gland muscle
+
+181
+00:11:00,370 --> 00:11:03,710
+of thyroid gland مهم أيضا جدا عبارة عن تجمع من
+
+182
+00:11:03,710 --> 00:11:08,970
+قليات ال orbicularis oculi muscle يعني هي أساسا
+
+183
+00:11:08,970 --> 00:11:11,690
+تاب على orbicularis oculi muscle كما تتكلمنا عن
+
+184
+00:11:11,690 --> 00:11:17,990
+هوناز muscle لكن هي من بثقة منمتفصل عنه بوصلة يعني
+
+185
+00:11:17,990 --> 00:11:21,530
+هي أصلا من بثقة برع اليافع عضلية و من بثقة من the
+
+186
+00:11:21,530 --> 00:11:26,230
+arbitrary class مصل كلها ككل لكن تفاصل عنها بحدود
+
+187
+00:11:26,230 --> 00:11:29,250
+اللي هو eyelashes bulbs eyelashes bulbs اللي هي
+
+188
+00:11:29,250 --> 00:11:36,030
+بويصلة الشعرات الرموش صحيه بويصلة الشعر the muscle
+
+189
+00:11:36,030 --> 00:11:39,270
+of a man is visible through a thin lid margin skin
+
+190
+00:11:39,270 --> 00:11:43,740
+as a grey lineبداية بتكلمنا عن التشريح ان حكينا ال
+
+191
+00:11:43,740 --> 00:11:45,860
+islets و اذا كان ال superior islet او ال inferior
+
+192
+00:11:45,860 --> 00:11:48,660
+islet بتتم تقسيمه الى anterior lamella و posterior
+
+193
+00:11:48,660 --> 00:11:51,840
+lamella صحيح؟ شو الحدود؟ هي هذه اللي بنقسمها على
+
+194
+00:11:51,840 --> 00:11:55,060
+أساسها إلى anterior lamella جزء أمامي او طبقة
+
+195
+00:11:55,060 --> 00:11:59,060
+خلفية او طبقة أمامية هي ال grey line هذه ال
+
+196
+00:11:59,060 --> 00:12:03,220
+landmark صحيح؟ هذه هي ال landmark او المؤشر او
+
+197
+00:12:03,220 --> 00:12:05,940
+الإشارة اللي بنقسمها على أساسها إلى anterior
+
+198
+00:12:05,940 --> 00:12:08,460
+lamella او posterior lamella طب هو ال grey line
+
+199
+00:12:08,460 --> 00:12:12,360
+عبارة عن ايش؟هو عبارة عن نفسي صحيح؟ هو عبارة عن
+
+200
+00:12:12,360 --> 00:12:16,820
+تجمع الألياف العضلية المنبثقة أصلا من ال
+
+201
+00:12:16,820 --> 00:12:21,560
+orbiculous equilibrium حتى تتكون لكل على طول جفن
+
+202
+00:12:21,560 --> 00:12:25,560
+العيناللي هو ال grey line، ال grey line هذا عبارة
+
+203
+00:12:25,560 --> 00:12:29,160
+عن إيش؟ هو أصلا تكوّن من muscle of ray line، هي
+
+204
+00:12:29,160 --> 00:12:31,440
+muscle of ray line هي عبارة عن ال grey line، و ال
+
+205
+00:12:31,440 --> 00:12:34,140
+grey line هو عبارة عن muscle of ray line، لكن احنا
+
+206
+00:12:34,140 --> 00:12:36,920
+أثناء يعني لو نظرنا إلى المدقق و وجدنا ال grey
+
+207
+00:12:36,920 --> 00:12:39,860
+line و يفصلنا بين ال anterior و ال posterior lemon
+
+208
+00:12:39,860 --> 00:12:44,320
+of the eyelid، هو هذا عبارة عن انطباعنا عن إيش؟ عن
+
+209
+00:12:44,320 --> 00:12:48,040
+تجمع بعض القليل في العضلية، صحيح؟ المضافقة أساسا،
+
+210
+00:12:48,040 --> 00:12:51,550
+من أين؟الأربوكاروس الكلائي ماصل تفصل بينها، ما بين
+
+211
+00:12:51,550 --> 00:12:53,730
+الاربوكاروس والكلائي ماصل، في عندي فاصل، اللي هو
+
+212
+00:12:53,730 --> 00:12:58,630
+فاصل عبارة عن عيش، on eyelash، باصالوظيفة الأساسية
+
+213
+00:12:58,630 --> 00:13:04,270
+لها muscle of riolane أثناء غمض العين ستلاحظ أن
+
+214
+00:13:04,270 --> 00:13:07,990
+الريموشانده لن يدخل داخل العين بالعكس ستترد إلى
+
+215
+00:13:07,990 --> 00:13:12,630
+الداخل فأحد وظيفتها الوظيفة الأولى تعمل على تثبيت
+
+216
+00:13:12,630 --> 00:13:17,370
+حركة ال eyelashes تثبيت حركة ال eyelashes حتى تحدث
+
+217
+00:13:17,370 --> 00:13:23,520
+داخل العين الوظيفة الأخرى تعمل على طردبتعمل على
+
+218
+00:13:23,520 --> 00:13:27,600
+طرد المحتوى الغدى دى بتعمل على طرد المحتوى الغدى
+
+219
+00:13:27,600 --> 00:13:31,360
+دى المفرز من مين مبوميان الجلانز صحيح؟ لإن أساسا
+
+220
+00:13:31,360 --> 00:13:34,100
+ال orifices of the مبوميان الجلانز اللي موجودة
+
+221
+00:13:34,100 --> 00:13:37,900
+عنده موجودة في ال anterior surface of the أو ال
+
+222
+00:13:37,900 --> 00:13:41,100
+anterior لملة صحيح؟ orifices اللى هى الصخور اللى
+
+223
+00:13:41,100 --> 00:13:43,960
+بتفرز منها المبوميان الجلانز هذا المحتوى موجود عند
+
+224
+00:13:43,960 --> 00:13:47,400
+وين؟ في ال anterior لملة صحيح؟ فاللي يعمل على
+
+225
+00:13:47,400 --> 00:13:53,140
+طردها دى هيالـ glandular contents هو هذا ما يسمى
+
+226
+00:13:53,140 --> 00:13:54,220
+muscle of biolog
+
+227
+00:13:57,790 --> 00:14:00,930
+في ال slide اللي بعديها على ال upper eyelid
+
+228
+00:14:00,930 --> 00:14:05,390
+retractors PND2 retractors يعني أثناء حركتنا و
+
+229
+00:14:05,390 --> 00:14:08,830
+أثناء كلامنا الإنسان بشكل لا إيه بقى ينظر إلى
+
+230
+00:14:08,830 --> 00:14:12,590
+الأعلى أو الأسفل ما هي العضلات المسؤولة على جذب أو
+
+231
+00:14:12,590 --> 00:14:16,370
+retraction of the upper eyelid PND2 muscles العضلة
+
+232
+00:14:16,370 --> 00:14:20,090
+الأولى هي superior أو levator herpebral superior
+
+233
+00:14:20,090 --> 00:14:23,370
+muscle أو اختصرا نسميها levator muscle لقصرها
+
+234
+00:14:24,250 --> 00:14:27,490
+العضلة الثانية هي Meuller's muscle أو muscle of
+
+235
+00:14:27,490 --> 00:14:30,690
+Meuller. The levator shafts are common shafts with
+
+236
+00:14:30,690 --> 00:14:33,750
+superior vectors. All are innervated by superior
+
+237
+00:14:33,750 --> 00:14:36,940
+division of the oculomotor nerveأثناء دراستنا
+
+238
+00:14:36,940 --> 00:14:40,200
+للتشريح احنا عارفين كل ال external muscles أو كل
+
+239
+00:14:40,200 --> 00:14:44,320
+ال muscles بشكل الإنسان ككل في عنده غشاء شيف محيط
+
+240
+00:14:44,320 --> 00:14:46,820
+فيه صحيح؟ هذا الغشاء مكوّن من ال connective tissue
+
+241
+00:14:46,820 --> 00:14:50,180
+حتي يعمل على حفاظ على العضلة هذه و ال external
+
+242
+00:14:50,180 --> 00:14:53,440
+muscles تماما نفس الشيء ال liver muscle أيضا تخضع
+
+243
+00:14:53,440 --> 00:14:56,980
+على نفس القانون يحيط حولها أو يغلفها اللي هو الشيف
+
+244
+00:14:56,980 --> 00:14:59,440
+هذا الشيف مكوّن من ايش؟ من ال connective tissue
+
+245
+00:14:59,440 --> 00:15:02,500
+حدث و أن ال connective tissue هذا الشيف اللي متكلم
+
+246
+00:15:02,500 --> 00:15:06,350
+عليه هو أيضا يغلفلي ال superior rectusone of the
+
+247
+00:15:06,350 --> 00:15:09,930
+extraocular muscles يعني أصبح هم لهم نفسه مشتركين
+
+248
+00:15:09,930 --> 00:15:14,530
+بنفس الشيف فهذا بدينا انتباه أخر انه لابد ان هم
+
+249
+00:15:14,530 --> 00:15:18,690
+أهدا مشتركين بنفسه innervation صحيح؟ ولا اصلا لو
+
+250
+00:15:18,690 --> 00:15:21,570
+كان لهم innervation مختلفة مش هتحرك بنفس الشي حدث
+
+251
+00:15:21,570 --> 00:15:24,630
+انت مشكلة معينة اللي هم لهم نفسه innervation فنجد
+
+252
+00:15:24,630 --> 00:15:29,030
+أن ال superior rectus زائد ال levator rectus لهم
+
+253
+00:15:29,030 --> 00:15:31,770
+نفس الشيف اللي هو مكان ال connective tissue هم
+
+254
+00:15:31,770 --> 00:15:36,560
+ايضا simultaneously بنفس الوقتفي اللي هم motor
+
+255
+00:15:36,560 --> 00:15:39,020
+innervation from the superior division of the
+
+256
+00:15:39,020 --> 00:15:41,640
+oculomotor nerve يعني هم أيضا يأتيهم ال motor
+
+257
+00:15:41,640 --> 00:15:45,120
+innervation ماشي الحالة تعصيب الحركة بواسطة
+
+258
+00:15:45,120 --> 00:15:47,660
+superior division of the oculomotor nerve احنا
+
+259
+00:15:47,660 --> 00:15:49,880
+عارفين oculomotor nerve أثناء دخولنا الأول بيتقسم
+
+260
+00:15:49,880 --> 00:15:52,680
+إلى superior division و inferior division ال
+
+261
+00:15:52,680 --> 00:15:57,450
+superior division مسئولة علىتعصيب اللي هو liver
+
+262
+00:15:57,450 --> 00:16:01,270
+tumor muscle زائد superior rectus يعمل علاج جذب
+
+263
+00:16:01,270 --> 00:16:03,770
+العين، بالذات إحنا لما نطلع الأعلى، لما نطلع
+
+264
+00:16:03,770 --> 00:16:06,470
+الأعلى هو أكيد superior rectus داخلة في ال
+
+265
+00:16:06,470 --> 00:16:08,410
+physiology الصحيح، و احنا هناخدها ان شاء الله ندرس
+
+266
+00:16:08,410 --> 00:16:11,310
+ال extra ocular muscles و أيضا لما ننظر إلى
+
+267
+00:16:11,310 --> 00:16:13,830
+الأعلى، في عنده liver tumor muscle فكلها هما يتم
+
+268
+00:16:13,830 --> 00:16:17,210
+تعصيبهم من ال superior division of the oculomotor
+
+269
+00:16:17,210 --> 00:16:20,150
+nerve أو اختصارا من العصب الجمجمي الثالث
+
+270
+00:16:24,100 --> 00:16:27,580
+زي ما اتكلمنا على ال origin and insertion of
+
+271
+00:16:27,580 --> 00:16:30,260
+Horner's muscle وتكلمنا عن ال origin and insertion
+
+272
+00:16:30,260 --> 00:16:32,940
+of the rail line muscle كلها مهم و خاصياتهم في
+
+273
+00:16:32,940 --> 00:16:37,220
+فسيولوجيا ايضا مهمة نتكلم على اللي هو ال origin of
+
+274
+00:16:37,220 --> 00:16:40,760
+the levator muscleالحكومة لما درستا تشريح بال
+
+275
+00:16:40,760 --> 00:16:44,420
+orbit في ان dysphenoid bone زي ما أخدنا lesmoidal
+
+276
+00:16:44,420 --> 00:16:47,200
+bone و درستا المجزر لل bone dysphenoid bone هي
+
+277
+00:16:47,200 --> 00:16:51,760
+تقريب الأخر bone يتكون منها ال apex صحيح of the
+
+278
+00:16:51,760 --> 00:16:55,480
+orbit صحيح؟ dysphenoid bone تتكون عندى من lesser
+
+279
+00:16:55,480 --> 00:16:58,820
+wing و greater wing يعني الجناح الأصغر أو الجناح
+
+280
+00:16:58,820 --> 00:17:02,360
+الأكبر أو الأعظم ال origin of the levator muscle
+
+281
+00:17:02,360 --> 00:17:05,520
+ينشأ من ال lesser wing من الجناح الأصغر فوق
+
+282
+00:17:05,520 --> 00:17:08,950
+dysphenoid bone طب بالنهاية هي وين هتروح؟الـ
+
+283
+00:17:08,950 --> 00:17:13,150
+Limiter muscle الـ
+
+284
+00:17:13,150 --> 00:17:16,990
+A-ball لأ خلاص هو ال origin تبعها وجودها في ال
+
+285
+00:17:16,990 --> 00:17:20,350
+lesser wing هذا تحديدا مهمة في ال lesser wing of
+
+286
+00:17:20,350 --> 00:17:22,390
+the sphenoid bone هذا ال origin إذا بتكلمنا عن ال
+
+287
+00:17:22,390 --> 00:17:25,510
+origin أخر من هذا muscle أبراع ناش يتبثق أبراع
+
+288
+00:17:25,510 --> 00:17:29,770
+الألياف تتبثق من ال pretarsal muscle of the ocular
+
+289
+00:17:29,770 --> 00:17:32,970
+muscle صحيح؟ يعني عبارة عن سجن مت معين يدها مباشرة
+
+290
+00:17:32,970 --> 00:17:36,790
+ال insertion way في ال lacrimal crest هناخدها إن
+
+291
+00:17:36,790 --> 00:17:41,200
+شاء الله كمان بعد قليلففيها أن الـlevator
+
+292
+00:17:41,200 --> 00:17:44,700
+originates from the lesser wing of the sphenoid
+
+293
+00:17:44,700 --> 00:17:47,580
+bone in the spheroid، the spiromedial orbital
+
+294
+00:17:47,580 --> 00:17:53,360
+apex. The distal 14 to 20 mm of the muscle are
+
+295
+00:17:53,360 --> 00:17:55,580
+tendinous and are referred to as the levator
+
+296
+00:17:55,580 --> 00:17:58,660
+aponeurosis أن التعريف هذا مهم جدا، what is the
+
+297
+00:17:58,660 --> 00:18:04,160
+levator aponeurosis؟ is the part or the segment هو
+
+298
+00:18:04,160 --> 00:18:09,210
+عبارة عن الجزءمن ال levator muscle تقريبا من 14
+
+299
+00:18:09,210 --> 00:18:12,430
+الى 20 ملي متر اصلا كل العجل لطولها تقريبا 20 ملي
+
+300
+00:18:12,430 --> 00:18:18,070
+متر يعني 2 سانتي فعينا اخر 6 ملي مترهذا الـ 6 ملي
+
+301
+00:18:18,070 --> 00:18:21,350
+متر ليس مكونا من ألياف عضلية من نفس المكون فيها
+
+302
+00:18:21,350 --> 00:18:23,690
+الـ Levator muscle لأ عبارة عن تندنستيشو عبارة عن
+
+303
+00:18:23,690 --> 00:18:27,930
+ألياف أو عبارة عن نسيج ليفي لأ دي عبارة عن نسيج
+
+304
+00:18:27,930 --> 00:18:31,290
+ليفي مرتبط مع بعض البعض بيكوّن اللي التندنستيشو
+
+305
+00:18:31,290 --> 00:18:34,370
+بيكوّن اللي Levator Apaneosis و Levator Apaneosis
+
+306
+00:18:34,370 --> 00:18:39,170
+تختلف ال Papiculus Oculi muscle حتى تشتبك معاه مع
+
+307
+00:18:39,170 --> 00:18:42,470
+Superior Powder أو Anterior Powder of the Tarsus
+
+308
+00:18:42,470 --> 00:18:46,540
+بالتالي أثناء حركة الجفن إلى الأعلىهيحدث عندى ايش؟
+
+309
+00:18:46,540 --> 00:18:50,260
+Retraction او يحدث عندى stimulation اه اذا حدث
+
+310
+00:18:50,260 --> 00:18:52,300
+عندى stimulation ال superior division of the
+
+311
+00:18:52,300 --> 00:18:56,060
+oculomotor nerve العصب الجمجم الثالث طبعا الفرع
+
+312
+00:18:56,060 --> 00:18:58,800
+الاول العلوي ايش بيحدث عندى؟ بيحدث عندى
+
+313
+00:18:58,800 --> 00:19:01,420
+stimulation for the superior rectus stimulation
+
+314
+00:19:01,420 --> 00:19:04,520
+for the levator muscle صحيح؟ كلهم مع بعض بالتالي
+
+315
+00:19:04,520 --> 00:19:07,820
+هيحدث عندى retraction of the upper eyelid هيتم صحب
+
+316
+00:19:07,820 --> 00:19:11,320
+ال upper eyelid إلى الأعلى صحيح؟ بالتالي العين حتى
+
+317
+00:19:11,320 --> 00:19:14,240
+بتوقع انها ايش اكثر ال bipolar fissure المسافة هذه
+
+318
+00:19:14,240 --> 00:19:15,420
+هتتوسع عينها
+
+319
+00:19:25,270 --> 00:19:28,170
+الطبقة العضلية اللى تتكلم عنها اللى هو ال tarsal
+
+320
+00:19:28,170 --> 00:19:30,670
+plate ال tarsal plate باختصار هنسميها ال tarsal
+
+321
+00:19:30,670 --> 00:19:35,470
+style اللى يعني من ضمن محتوها تحتوي على مبومين
+
+322
+00:19:35,470 --> 00:19:37,450
+glans هنعربهم بالتشريح
+
+323
+00:19:40,930 --> 00:19:43,150
+عبارة عن نسيج ليفي connective tissue مثلا
+
+324
+00:19:43,150 --> 00:19:45,350
+connective tissue عبارة عن dance connective tissue
+
+325
+00:19:45,350 --> 00:19:46,110
+يعني حتى
+
+326
+00:19:48,890 --> 00:19:53,550
+هيكون مهم جدا زي أهمية ال skeleton اللي هو الجهاز
+
+327
+00:19:53,550 --> 00:19:57,130
+الهيكل العظمى للإنسان هذا مهم جدا بنفس الأهمية
+
+328
+00:19:57,130 --> 00:20:00,050
+الهيكل العظمى للإنسان بديه ليش؟ بيعطيلي وظيفة
+
+329
+00:20:00,050 --> 00:20:03,530
+بيعطيلي support لحركة العضاء ال torsos نفس الشيء
+
+330
+00:20:03,530 --> 00:20:07,030
+بيعطيلي وظيفة لحركة العين بيعطيلي support للعيلد
+
+331
+00:20:07,030 --> 00:20:09,670
+بدون ال torsos هذا مافيش عنده شكل معين أو شكل
+
+332
+00:20:09,670 --> 00:20:14,510
+مستقيم حيبدو متعرج حيبدو مقل وحتى أثناء فتحأو غلق
+
+333
+00:20:14,510 --> 00:20:18,170
+العين مش هتبدو بخاصية تستيولوجية المطلبة فهي عندى
+
+334
+00:20:18,170 --> 00:20:21,470
+من أحد وظائف اللى هو Tarsus اللى هو support of the
+
+335
+00:20:21,470 --> 00:20:25,530
+eyelid functionally حتى من ناحية وظيفية Normal
+
+336
+00:20:25,530 --> 00:20:30,010
+Lipitor Extrusion هفضل فى البعد هد ان شاء الله طيب
+
+337
+00:20:30,010 --> 00:20:32,650
+أنه ميولاز muscle زى ما اتكلمنا عن ال lipitor
+
+338
+00:20:32,650 --> 00:20:38,230
+muscle كأنه ميولاز muscleorigin originates from
+
+339
+00:20:38,230 --> 00:20:41,310
+the undersurface of the levator and inserts into
+
+340
+00:20:41,310 --> 00:20:43,850
+the superior border of the upper eyelid تأسس
+
+341
+00:20:43,850 --> 00:20:47,830
+الجديد بنتكر أن نفس العضلة mueller's muscle تمشأ
+
+342
+00:20:47,830 --> 00:20:52,270
+من ال levator muscleلكن ليس لها نفس التعصيب بمعنى
+
+343
+00:20:52,270 --> 00:20:55,290
+أن ال superior rectus وال superior أو ال liver to
+
+344
+00:20:55,290 --> 00:20:57,170
+the papilla superior muscle اللي هي liver to the
+
+345
+00:20:57,170 --> 00:21:00,810
+muscle يتم تعصيبه من وين من ال superior division
+
+346
+00:21:00,810 --> 00:21:02,910
+of the oculometer nerve صحيح؟ اللي هو ال third
+
+347
+00:21:02,910 --> 00:21:05,890
+cranial nerve لكن مع أن ال Mueller's muscle هي
+
+348
+00:21:05,890 --> 00:21:08,870
+أصلا تنشأ أو تبدأ من وين تلبط من ال liver to the
+
+349
+00:21:08,870 --> 00:21:12,340
+muscle لكن تعصيبها لا يأتي من نفس العصبإنما يأتي
+
+350
+00:21:12,340 --> 00:21:14,560
+ال motor nerve احنا نتكلم عن ال motor nerve fibers
+
+351
+00:21:14,560 --> 00:21:17,320
+يأتي من ال sympathetic nerve fibers يعني لها
+
+352
+00:21:17,320 --> 00:21:21,040
+sympathetic nerve مستقلة لتتبينها، لو حدث لي عندي
+
+353
+00:21:21,040 --> 00:21:24,580
+مشكلة مثلا في العصب الثالث، الحدث عندي سيدأ للجفن
+
+354
+00:21:24,580 --> 00:21:28,520
+أكيد، لكن عندي ما زالت ال sympathetic هذه فعالة،
+
+355
+00:21:28,520 --> 00:21:34,160
+لأنه لسه لها نفس ال sympathetic واقفة، صحيح؟Into
+
+356
+00:21:34,160 --> 00:21:36,240
+the superior border of the upper eyelid tarsus.
+
+357
+00:21:36,580 --> 00:21:38,880
+It's composed of sympathetically innervated smooth
+
+358
+00:21:38,880 --> 00:21:43,900
+muscle fibers تتكون من إيش؟ من عضلات و من ألياف
+
+359
+00:21:43,900 --> 00:21:48,180
+عضلية يتم تغذيتها و تعصيبها من sympathetic pathway
+
+360
+00:21:49,300 --> 00:21:51,480
+Muller's muscle provides two millimeters of
+
+361
+00:21:51,480 --> 00:21:54,940
+additional elevation of the upper eyelid اذا احنا
+
+362
+00:21:54,940 --> 00:21:57,400
+اتكلمنا عن ال retractor of the upper eyelid وحكينا
+
+363
+00:21:57,400 --> 00:22:00,600
+levator muscle صحيح وحكينا superior rectus لكن هو
+
+364
+00:22:00,600 --> 00:22:04,700
+بالاصل ال retractor of the upper eyelid only the
+
+365
+00:22:04,700 --> 00:22:06,520
+levator muscle and the muller muscle ال superior
+
+366
+00:22:06,520 --> 00:22:09,740
+rectus مالهاش علاقة خالص بالretraction صحيح لما هي
+
+367
+00:22:09,740 --> 00:22:13,640
+تساعد على حركة العين الأعلى اللي هو elevation اذا
+
+368
+00:22:13,640 --> 00:22:14,660
+كان انا في عندى
+
+369
+00:22:33,630 --> 00:22:39,690
+الوظيفة الميولار هي وظيفة إضافيةتعمل على ايش؟ رفع
+
+370
+00:22:39,690 --> 00:22:43,350
+او elevation of the upper island كمجرد 2 mm زيادة
+
+371
+00:22:43,350 --> 00:22:45,890
+على ال .. ال .. ال purple pressure احنا عارفين
+
+372
+00:22:45,890 --> 00:22:49,450
+كلنا ال purple pressure قدش في عندنا مساحته ال
+
+373
+00:22:49,450 --> 00:22:51,630
+purple pressure هي مسافة بين جفن العلوي و جفن
+
+374
+00:22:51,630 --> 00:22:54,430
+السفلي سواء من ناحية أفقيه او من ناحية عموديه من
+
+375
+00:22:54,430 --> 00:22:59,790
+ناحية .. ايوة ممتاز
+
+376
+00:22:59,790 --> 00:23:03,250
+العدل 14-15 او من 10-12 تختلف باختلاف الأجناس
+
+377
+00:23:03,250 --> 00:23:07,430
+دايما بالجنس الأصفر او بالجنس الهندي الاخرينلكن
+
+378
+00:23:07,430 --> 00:23:11,750
+المهم حتى لو اختلفت باختلاف العرق عندي، بغض نظر اي
+
+379
+00:23:11,750 --> 00:23:15,450
+جسم نتكلم احنا، عند ال muscle of the mule هتزود ل
+
+380
+00:23:15,450 --> 00:23:18,010
+additional two millimeters، حاجة ده نعرفها احنا،
+
+381
+00:23:18,010 --> 00:23:20,170
+يعني وظيفة ال muscle of the mule عبارة عن
+
+382
+00:23:20,170 --> 00:23:23,070
+additional elevation of the upper eyelid for
+
+383
+00:23:23,070 --> 00:23:26,290
+another two millimeters، هذه النقطة مش مهمة جدا،
+
+384
+00:23:26,290 --> 00:23:29,390
+طبعا بتسهم لتقريبا اتنين مليمتر من اللي هو ال
+
+385
+00:23:29,390 --> 00:23:32,150
+elevation إضافي لل upper eyelidit may be
+
+386
+00:23:32,150 --> 00:23:35,810
+stimulated sympathetically responses such as فيه
+
+387
+00:23:35,810 --> 00:23:38,350
+pharmacologically by the installation of
+
+388
+00:23:38,350 --> 00:23:42,250
+phenylephrine hydrochloride drops احنا كلنا أخدنا
+
+389
+00:23:42,250 --> 00:23:45,190
+الفرق ما بين ال sympathetic و ال parasympathetic
+
+390
+00:23:45,190 --> 00:23:49,530
+ال sympathetic في طياته يحمياش الضعر و الخوف و
+
+391
+00:23:49,530 --> 00:23:52,710
+القلق و الأرحل اخرى اما عن مقيد من ذلك ال
+
+392
+00:23:52,710 --> 00:23:57,110
+parasympathetic في طياته يحمياشالرحمة والأمان
+
+393
+00:23:57,110 --> 00:24:01,110
+والأمان والأخرى، ففي أحد الأثناء تعرض الإنسان
+
+394
+00:24:01,110 --> 00:24:05,210
+لحالة .. حالة ضرر أو حالة خوف أو حالة مفاجأة أو
+
+395
+00:24:05,210 --> 00:24:10,360
+أمر طارق، أول حاجة بيعملها هاشرمعناه اللي قلتلك
+
+396
+00:24:10,360 --> 00:24:12,140
+طبعا، ده ال sympathetic اللي هيحجز عندك في ال
+
+397
+00:24:12,140 --> 00:24:15,660
+cardiovascular system، هيتطلع بشكل هذا، صحيح؟
+
+398
+00:24:15,660 --> 00:24:19,280
+فهذه، كل ال sympathetic هذا stimulation، هتعتبر
+
+399
+00:24:19,280 --> 00:24:22,820
+تحفيز، صح؟ هو إذا اتعرض لمنظر معين، هتعتبر تحفيز
+
+400
+00:24:22,820 --> 00:24:27,080
+أو مصدق أو عرفة منظر مفاجئ أو صادق، هتعتبر تحفيز،
+
+401
+00:24:27,080 --> 00:24:30,360
+التحفيز هذا هو بحد ذاته ال sympathetic، بدون يفعلي
+
+402
+00:24:30,360 --> 00:24:35,500
+sympathetic nervous system، صحيح؟طيب ال muscles of
+
+403
+00:24:35,500 --> 00:24:38,400
+the muller من أين بتتم تفعلها؟ من السبب نفسه
+
+404
+00:24:38,400 --> 00:24:40,920
+بالتالي ال two millimeters اللي احنا حكينا عنها
+
+405
+00:24:40,920 --> 00:24:44,300
+هتبدو واضحة جدا صحيح؟ يعني لما انا .. انا .. نحن
+
+406
+00:24:44,300 --> 00:24:48,360
+نعمل ال .. او نلاحظ الحركة هذه .. بشكل هذا ال
+
+407
+00:24:48,360 --> 00:24:51,460
+liver to land لسه ما زال ثابتة لكن هو اللي يعملها
+
+408
+00:24:51,460 --> 00:24:56,680
+بشكل أساسي اللي هو muscles of mullerطبعا نذكر أننا
+
+409
+00:24:56,680 --> 00:24:59,580
+بعض الأدوية زى ال fly-free نستخدمها أطفال العمليات
+
+410
+00:24:59,580 --> 00:25:01,980
+في إدنى إضاءة ال atropine أو إثناء ال cyclo
+
+411
+00:25:01,980 --> 00:25:05,180
+الأطفال، صحيح؟ فيبدو التحفيز هذه في ال top-dose
+
+412
+00:25:05,180 --> 00:25:10,080
+العيب أكثر في تحيه،
+
+413
+00:25:10,080 --> 00:25:13,050
+this is called the prepressureلحظة الأرقام اللي
+
+414
+00:25:13,050 --> 00:25:16,170
+ذكرناها مع الأرقام اللي موجودة هنا مختلفة شوية
+
+415
+00:25:16,170 --> 00:25:19,890
+صحيح نوعا ما لكن كلها صحيح ان انا ال paper
+
+416
+00:25:19,890 --> 00:25:22,250
+pressure of the average adult لو اتكلم انا عن ال
+
+417
+00:25:22,250 --> 00:25:26,130
+average adult بشكل عام لما نطلق يعني لجنس معين
+
+418
+00:25:26,130 --> 00:25:29,870
+كالجنس الأصفر او لما نطلق لفئة معينة كالاطفال او
+
+419
+00:25:29,870 --> 00:25:32,290
+لما نطلق حتى الفرق ما بين ال man و ال female لأ
+
+420
+00:25:32,290 --> 00:25:36,290
+بشكل معين عندي في ال others approximately 10 to 12
+
+421
+00:25:36,290 --> 00:25:39,330
+millimeters حتى من ناحية ال vertical صحيح اما
+
+422
+00:25:39,330 --> 00:25:43,880
+horizontal هو الأوسع والأكبرتقريبا تصل الى تلاتين
+
+423
+00:25:43,880 --> 00:25:48,260
+مليمتر تقريبا
+
+424
+00:25:48,260 --> 00:25:53,860
+تصل الى تلاتين مليمتر تقريبا تصل الى تلاتين مليمتر
+
+425
+00:25:53,860 --> 00:25:54,060
+تقريبا تصل الى تلاتين مليمتر تقريبا تصل الى تلاتين
+
+426
+00:25:54,060 --> 00:25:55,320
+مليمتر تقريبا تصل الى تلاتين مليمتر تقريبا تصل الى
+
+427
+00:25:55,320 --> 00:25:55,820
+تلاتين مليمتر تقريبا تصل الى تلاتين مليمتر تقريبا
+
+428
+00:25:55,820 --> 00:25:56,480
+تصل الى تلاتين مليمتر تقريبا تصل الى تلاتين مليمتر
+
+429
+00:25:56,480 --> 00:26:01,040
+تقريبا تصل الى تلاتين مليمتر تقريبا تصل الى تلاتين
+
+430
+00:26:01,040 --> 00:26:05,620
+مليمتر تقريبا تصل ال
+
+431
+00:26:07,750 --> 00:26:11,790
+انسدال الجفن الصفلي انسدال الجفن العلوي صحيح؟ دكر
+
+432
+00:26:11,790 --> 00:26:16,670
+صحيح ماشي بقى دكر انسدال الجفن العلوي إيش بيكون
+
+433
+00:26:16,670 --> 00:26:19,810
+فيه يعني إيش .. إيش بترتب عليها؟ إيش السبب ورائد
+
+434
+00:26:19,810 --> 00:26:23,890
+عليك؟ الليفات المواصلة بيكون فيها إما ضعف أو بيصير
+
+435
+00:26:23,890 --> 00:26:28,040
+في عندك damage إلها بشكل كبيرطيب، بالشكل الطبيعي،
+
+436
+00:26:28,040 --> 00:26:30,120
+وين المفروض الـ superior border of the other
+
+437
+00:26:30,120 --> 00:26:32,980
+islands؟ وين المفروض تكون؟ يعني الحدود العلوية،
+
+438
+00:26:32,980 --> 00:26:37,320
+الجفن العلوي، وين أكتر الشيء المفروض تكون؟ تتقط من
+
+439
+00:26:37,320 --> 00:26:41,720
+واحد لواحد و نص أو اتنين millimeter maximum of the
+
+440
+00:26:41,720 --> 00:26:43,980
+cone، of the superior border of the cone، معادلون
+
+441
+00:26:43,980 --> 00:26:48,230
+ذلك، ايش بيعتبروا؟انسدال طبعا الانسدال يلو عدة
+
+442
+00:26:48,230 --> 00:26:51,250
+درجات هناخدوها ان شاء الله فين وبعد بس حتى ليش
+
+443
+00:26:51,250 --> 00:26:53,890
+هنحكي انهايك لإنه لو ال instagram وصل حتى إلى ال
+
+444
+00:26:53,890 --> 00:26:58,190
+approval معناته عمل عندي functional دصة يعني عق
+
+445
+00:26:58,190 --> 00:27:01,550
+عندي رؤية أمامي مش هشوف بشكل واضح هنحط رفع نفسي
+
+446
+00:27:01,550 --> 00:27:04,950
+حتى أشوف ايش بشكل واضح ففي عندي بالحالة الطبيعي
+
+447
+00:27:04,950 --> 00:27:08,220
+عندي one point five to two millimetersاللي هو drop
+
+448
+00:27:08,220 --> 00:27:11,900
+of the superior border of the upper eyelid عن إيش
+
+449
+00:27:11,900 --> 00:27:15,700
+ال borders of the cornea طب من ناحية سفلية بيعمل
+
+450
+00:27:15,700 --> 00:27:19,040
+تماث معاها أو ممكن بيمسها أي ممكن يعمل تماث معاها
+
+451
+00:27:19,040 --> 00:27:22,300
+على نفس الحدود أو أصلا مايصبحاش يعني حتى في
+
+452
+00:27:22,300 --> 00:27:25,710
+الأرقام اللي ذكرناها احنا في كثير من الناسأثناء
+
+453
+00:27:25,710 --> 00:27:28,270
+حتى الحديث معاه بدون انفعالات أو بدون انفعالات
+
+454
+00:27:28,270 --> 00:27:30,990
+بشكل طبيعي، all the borders of the cornea,
+
+455
+00:27:31,130 --> 00:27:33,950
+superior and inferior, are visible، صحيح؟ هه، مش
+
+456
+00:27:33,950 --> 00:27:36,650
+مرض، مش حلق، يعني مانحكيش مثلا أن هذا في عنده
+
+457
+00:27:36,650 --> 00:27:39,530
+ثيرود أو في عنده جحوظ العين، لأ، هو لا يعاني من أي
+
+458
+00:27:39,530 --> 00:27:42,550
+شيء، لكن فيه دي بتظهر فيه فروقات فردية، زي ما فيه
+
+459
+00:27:42,550 --> 00:27:45,950
+عنده فروقات أرقية، و هذا أيضا مضمن عيش الطبيعي،
+
+460
+00:27:45,950 --> 00:27:50,970
+لكنها أكثر عرضة لجفاف العين من غيرهاماشي الحاجة،
+
+461
+00:27:50,970 --> 00:27:52,970
+في عندنا lateral canthus، و ال canthus أنا
+
+462
+00:27:52,970 --> 00:27:56,590
+تعريفها، أي lateral canthus أو ال canthal angle،
+
+463
+00:27:56,590 --> 00:27:59,890
+نفسها هي التقاء الجفن العلوي مع السفلي، إذا كان
+
+464
+00:27:59,890 --> 00:28:03,630
+التقاء الجفن العلوي مع السفلي من ناحية ال lateral،
+
+465
+00:28:03,630 --> 00:28:06,650
+فبتكون في عندى ال lateral أوسع من ال media أو
+
+466
+00:28:07,450 --> 00:28:11,030
+الميزل تقريبا 2 ملي متر زي ما احنا شايفينه بالرسمة
+
+467
+00:28:11,030 --> 00:28:14,850
+المنطقة هذه المشغلها هي الزاوية هذه كلها حوصها
+
+468
+00:28:14,850 --> 00:28:18,350
+تقريبا ب 2 ملي عن هذه الزاوية وزي ما اتكلمنا ايضا
+
+469
+00:28:18,350 --> 00:28:21,070
+هناك فروقات طب احنا هنتبقى الأرقام هذه على ال
+
+470
+00:28:21,070 --> 00:28:24,370
+pediatric subjects مش هنتبق عليها الأطفال لهم
+
+471
+00:28:24,370 --> 00:28:27,310
+قياسات معينة حتى في كل قياسة اللي احنا ذكرناها
+
+472
+00:28:27,310 --> 00:28:32,090
+الأطفال اللي هماش قياسات معينة The islet margins
+
+473
+00:28:32,090 --> 00:28:34,930
+are the surface of the lakes that oppose each
+
+474
+00:28:34,930 --> 00:28:38,880
+other during closureالـ eyelid margins اللي هي
+
+475
+00:28:38,880 --> 00:28:42,460
+إيش؟ إيش معات margin؟ اللي هي الحواف الحواف الجفن
+
+476
+00:28:42,460 --> 00:28:45,820
+العلوي مع السفلي هي أصلا تنتقي مع بعضها و تكون
+
+477
+00:28:45,820 --> 00:28:48,960
+مضادة مع بعضها لبعض أثناء إيش الإطباق السليم
+
+478
+00:28:48,960 --> 00:28:52,560
+ليكونش الإنسان يغمض عينه بشكل قوي جدا و ربما تخرج
+
+479
+00:28:52,560 --> 00:28:57,100
+عن هذه الطبيعة فوظيفة ال eyelid يحافظ على إيش؟
+
+480
+00:28:57,100 --> 00:29:00,760
+الإطباق السليم الإطباق الكامل لجفن العين السفلي و
+
+481
+00:29:00,760 --> 00:29:05,140
+العلوي بالذات وقت النوم حتى يعمل على إيش؟ منح جفاف
+
+482
+00:29:05,140 --> 00:29:08,130
+سطح العين لأن لو كان العينفي حالة ال lag of
+
+483
+00:29:08,130 --> 00:29:11,430
+thalamus أو في حالة كبار السن أو يسموها احنا
+
+484
+00:29:11,430 --> 00:29:15,310
+بالعامية النوم غزالي صحيح؟ اللي هو عدم إطباق كامل،
+
+485
+00:29:15,310 --> 00:29:17,810
+هنا مافيش عنده ارتقاء بين ال superior margin و ال
+
+486
+00:29:17,810 --> 00:29:20,690
+inferior margin مع بعض، بالتالي سهل جدا أن العين
+
+487
+00:29:20,690 --> 00:29:27,570
+يشكو فيها جفاف، لكن فيه برغم من ذلك الإنسان أو ال
+
+488
+00:29:27,570 --> 00:29:32,270
+physiology of the human بترقلي بحالة معينة نسميها،
+
+489
+00:29:32,270 --> 00:29:35,370
+احنا هتبلس في نمنا، هناخدها قبل قليل للحماية أيضا
+
+490
+00:29:35,370 --> 00:29:38,640
+من جفاف العينThe anterior most distinguishing
+
+491
+00:29:38,640 --> 00:29:41,400
+feature of the eyelid margin is the lashes طبعا
+
+492
+00:29:41,400 --> 00:29:44,300
+أهم شيء موجود في اللي هو ال anterior margin في ال
+
+493
+00:29:44,300 --> 00:29:45,920
+margin of the eyelids و أنا كان في superior و
+
+494
+00:29:45,920 --> 00:29:51,480
+inferior هي عبارة عن ال lashes رموش العين دعبر lid
+
+495
+00:29:51,480 --> 00:29:54,480
+contain five to six rows of this cellia cellia
+
+496
+00:29:54,480 --> 00:30:00,620
+معناها شعيرة أو eyelashes بشكل بشكل سهل أو بسيطفي
+
+497
+00:30:00,620 --> 00:30:03,420
+تقريبا في ال upper eyelid في عندي five to six rows
+
+498
+00:30:03,420 --> 00:30:08,460
+في عندي خمس أو ست صفوف أو أسطور من هذه السلية أما
+
+499
+00:30:08,460 --> 00:30:12,640
+في ال inferior فقط في عندي three to four eyes طب
+
+500
+00:30:12,640 --> 00:30:16,640
+يعني لو شفنا احنا شخص معين في عنده six أو سته هو
+
+501
+00:30:16,640 --> 00:30:19,860
+على المجمل يعني مش هيزيده على حياته
+
+502
+00:30:32,900 --> 00:30:36,000
+ما هي المطيفة في هذه ال eyelashes؟ هل فقط هي مجرد
+
+503
+00:30:36,000 --> 00:30:36,740
+جمالية؟
+
+504
+00:30:52,240 --> 00:30:57,190
+Loss of lifeمزال هو flashes مزال تكلمنا على أهمية
+
+505
+00:30:57,190 --> 00:31:00,510
+هذه ال eyelashes معناته في أنها أمراض متخصة وإلا
+
+506
+00:31:00,510 --> 00:31:03,570
+ما تكلمنا عنها في أنها مصطلحين مهمين جدا الأول
+
+507
+00:31:03,570 --> 00:31:08,050
+مادروسس والتالي فليوسس مادروسس معناه lots of
+
+508
+00:31:08,050 --> 00:31:11,730
+eyelashesيعني شخص loss of eyelashes لإن مثلا فقد
+
+509
+00:31:11,730 --> 00:31:14,830
+رموشه، طبعا مشاكل جسمي مش هيكون مشاكل كله، حتى في
+
+510
+00:31:14,830 --> 00:31:18,170
+بعض الأحيان بشكل كله في بعض الأطفال إذا بتلاحظوهم
+
+511
+00:31:18,170 --> 00:31:21,490
+اللي بتعاطوا أو بياخدوا عفن أو بياخدوا تحت ال
+
+512
+00:31:21,490 --> 00:31:24,110
+chemotherapy اللي هو العلاج الكيميائي الناتج عن
+
+513
+00:31:24,110 --> 00:31:27,150
+أمراض سرطانية أو اللي خلافه، وبالتالي بوصف الشعر
+
+514
+00:31:27,150 --> 00:31:29,870
+اللي احنا اتكلمنا عليها قبل شوية هذي، تتحملش ولا
+
+515
+00:31:29,870 --> 00:31:35,110
+تتفعل الدواء الكيميائي هذا، فإيش بصير فيها؟damage
+
+516
+00:31:35,110 --> 00:31:38,630
+صح و ال damage هذا الدمار يحدث كله في كل المصيلة و
+
+517
+00:31:38,630 --> 00:31:41,650
+يجعله not reversible يعني حتى لو الإنسان تمقف عن
+
+518
+00:31:41,650 --> 00:31:45,990
+علاج كميائي هذا مش هتجعل بيصلة مرة أخرى فين أيضا
+
+519
+00:31:45,990 --> 00:31:50,530
+هذا بشكل كله طبعا هذا خاص بكل جسمك ككل طب لو كان
+
+520
+00:31:50,530 --> 00:31:53,730
+في عندي partial يعني فقط بشكل جثي زي أش مثلا
+
+521
+00:31:55,210 --> 00:31:58,290
+بالتهاب ل blepharitis التهاب جفن العين أو وجود ورم
+
+522
+00:31:58,290 --> 00:32:01,770
+معين في شق معين في جفن العين سواء كان بال superior
+
+523
+00:32:01,770 --> 00:32:05,470
+او ال inferior طبعا هذا حسببله مشكلة كبيرة بالذات
+
+524
+00:32:05,470 --> 00:32:08,870
+لو كان الجزء اللي اتم في التلف هذا كبير جدا لأنه
+
+525
+00:32:08,870 --> 00:32:11,770
+مستحيل فقط على ال borders of the lashes ايضا
+
+526
+00:32:11,770 --> 00:32:15,190
+حيطرقل إلى المبينic lines الاخرى فحسبله مشاكل
+
+527
+00:32:15,190 --> 00:32:18,750
+كبيرة اولها مشكلة نفسية لأنه cosmetically not
+
+528
+00:32:18,750 --> 00:32:22,050
+acceptable صحيح؟ في المجتمع ان هو ما بين الأفراد
+
+529
+00:32:22,050 --> 00:32:26,140
+يعني طبعيا هيكون ملفد للانتباه بشكل كبيرعند أول
+
+530
+00:32:26,140 --> 00:32:29,140
+تعريف مهم جدا، الـ Neoplasm اللي هي عبارة عن
+
+531
+00:32:29,140 --> 00:32:32,680
+الأورام كلها، ممكن المادولاز يكون ناتج عن الورام
+
+532
+00:32:32,680 --> 00:32:38,460
+أو ممكن يكون ناتج عن اللي هو التحاباتطيب بالنسبة
+
+533
+00:32:38,460 --> 00:32:41,480
+للتعريف الآخر اللي هو pulses او widening of
+
+534
+00:32:41,480 --> 00:32:44,620
+eyelashes احنا عارفين بالغانبية العظمة ال
+
+535
+00:32:44,620 --> 00:32:48,580
+eyelashes عادة never go gray شو يعني؟ ال eyelashes
+
+536
+00:32:48,580 --> 00:32:53,000
+عادة حتى عند كبار السن نادم نشوف ال eyelashes صارت
+
+537
+00:32:53,000 --> 00:32:56,480
+مقلة لونها البياضي صحيح؟ حتى عند كبار السن ففي بعض
+
+538
+00:32:56,480 --> 00:33:00,320
+الأمرات عندى يكون لون ال eyelashes مقل إلى البياضي
+
+539
+00:33:00,320 --> 00:33:02,860
+او اصلا عادي من الصبغيات زى في حالات مثلا ال
+
+540
+00:33:02,860 --> 00:33:08,760
+albinism ال albinism شو هو هالحالة؟ بحق صحيح؟الجسم
+
+541
+00:33:08,760 --> 00:33:11,360
+كله ككل نصف pigmentation ليس فيه أي نوع من ال
+
+542
+00:33:11,360 --> 00:33:15,140
+pigmentation بما فيها أيضا ال .. ال .. ال .. ال ..
+
+543
+00:33:15,140 --> 00:33:16,280
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+544
+00:33:16,280 --> 00:33:16,340
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+545
+00:33:16,340 --> 00:33:17,120
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+546
+00:33:17,120 --> 00:33:20,800
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+547
+00:33:20,800 --> 00:33:21,140
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+548
+00:33:21,140 --> 00:33:23,060
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+549
+00:33:23,060 --> 00:33:23,360
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+550
+00:33:23,360 --> 00:33:23,360
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+551
+00:33:23,360 --> 00:33:23,360
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+552
+00:33:23,360 --> 00:33:24,360
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+553
+00:33:24,360 --> 00:33:27,480
+ال .. ال .. ال .. ال .. ال .. ال ..
+
+554
+00:33:27,480 --> 00:33:28,160
+ال .. ال ..
+
+555
+00:33:36,490 --> 00:33:41,110
+وهي يعني مقللة البياطة وكأنه يعني كانوا عمانة
+
+556
+00:33:41,110 --> 00:33:45,910
+الشايب لكن هو حق الأمر هو يدلوا على المرض هو محدد
+
+557
+00:33:45,910 --> 00:33:49,950
+و جزء من الحدث يكون مشكلة مدلين لعمرض اما موجود في
+
+558
+00:33:49,950 --> 00:33:53,910
+كل العين ككل او في كل الجسد في عندنا بكل العين او
+
+559
+00:33:53,910 --> 00:33:56,850
+جزء معين من العين زي التهابة ل ال plepharitis ممكن
+
+560
+00:33:56,850 --> 00:34:01,790
+عمق امد بعيد بتسبب له اختلاف لون ال eyelashes بسبب
+
+561
+00:34:01,790 --> 00:34:06,740
+هش غياب اللي هو ال pigments الموجودة فيه صحيحيكون
+
+562
+00:34:06,740 --> 00:34:09,780
+عندى ناتجة عن مرض مثلا VKH syndrome او متلازمة
+
+563
+00:34:09,780 --> 00:34:13,780
+معينة تخص العين كلها ككل كالتهاب فيه ال yuvial
+
+564
+00:34:13,780 --> 00:34:17,180
+tract ال yuvial tract التكون من اللي هو ال iris و
+
+565
+00:34:17,180 --> 00:34:21,800
+ال choroid و الاخره ممكن يحدث لي عندى اختلاف للون
+
+566
+00:34:21,800 --> 00:34:24,980
+ال eyelashes طبعا في ناحية معينة مش هيكون كله ككل
+
+567
+00:34:24,980 --> 00:34:28,500
+posterior to the cilia is the grey line described
+
+568
+00:34:28,500 --> 00:34:32,820
+previouslyطبعا posterior to the cilia اللي هو مابع
+
+569
+00:34:32,820 --> 00:34:35,980
+دستيليا في عنده اللي هو ال grey line اللي حكينا
+
+570
+00:34:35,980 --> 00:34:40,180
+عنه ال grey line عبارة عن مسابق عيش ال grey line و
+
+571
+00:34:40,180 --> 00:34:43,400
+مسابق مصر اللي احنا خدناها طبقة ليه اللي هي مصر
+
+572
+00:34:43,400 --> 00:34:48,700
+الريولان من نفس الاتجاه هذا و نفس النقطة هذه هيحدث
+
+573
+00:34:48,700 --> 00:34:52,100
+في عنده انسلاق او انقسام لل eyelid ال anterior
+
+574
+00:34:52,100 --> 00:34:54,420
+lamella و ال posterior lamella و اتكلمنا على
+
+575
+00:34:54,420 --> 00:34:58,340
+تركيبة كل منهمالان تارسل بلايت of the upper
+
+576
+00:34:58,340 --> 00:35:00,860
+eyelids and lower eyelids contain approximately 30
+
+577
+00:35:00,860 --> 00:35:04,820
+to 40 and 20 to 30 طبعا في ان ال mobile implants
+
+578
+00:35:04,820 --> 00:35:08,760
+هي أساس موجودة بقى داخل التارسل داخل التارسل بلايت
+
+579
+00:35:08,760 --> 00:35:11,680
+اللي اتكلمنا عليها احنا احد مجموعات البستيرو لمنه
+
+580
+00:35:11,680 --> 00:35:14,620
+of the eyelids صحيح؟ موجودة بالداخل عالتها في
+
+581
+00:35:14,620 --> 00:35:18,920
+الأعلى دائما أكثر بكثير من الأسفل طبعا الأرقام هذه
+
+582
+00:35:18,920 --> 00:35:21,880
+معانا ومعانا حبط لازم نعرفها احنا لكن أيضا في
+
+583
+00:35:21,880 --> 00:35:25,360
+الاختلافات أخرى مش الحق بس احنا هناخدها بالبنج هذا
+
+584
+00:35:25,620 --> 00:35:29,340
+التلاتين والاربعين لأ تلاتين والاربعين منهم من
+
+585
+00:35:29,340 --> 00:35:34,520
+gland و قده موجودة في superior tarsus وعشان تلاتين
+
+586
+00:35:34,520 --> 00:35:36,820
+موجودة في inferior tarsus
+
+587
+00:35:40,860 --> 00:35:44,800
+They are about 100 to 150 lashes in the upper lid
+
+588
+00:35:44,800 --> 00:35:48,280
+and 50 to 70 lashes in the lower eyelid هذه الأقام
+
+589
+00:35:48,280 --> 00:35:51,280
+مش معانا يا حبوب لكن فقط لسبب ما عارفان حكينا بال
+
+590
+00:35:51,280 --> 00:35:54,280
+superior eyelid المخروج يكون في عندي five to six
+
+591
+00:35:54,280 --> 00:35:57,980
+rows of the lashes صحيح أما في ال inferior عندي
+
+592
+00:35:57,980 --> 00:36:01,420
+فقط three to four هذا enough أما عدد ال eyelashes
+
+593
+00:36:01,420 --> 00:36:06,140
+مش مهم بالدرجة هذه لأنه يختلف اختلاف كبير from
+
+594
+00:36:06,140 --> 00:36:09,400
+male to female from adult to pediatric to children
+
+595
+00:36:09,400 --> 00:36:13,930
+الاخرينPosterior to the cilia نفس الشيء بس بيرو ان
+
+596
+00:36:13,930 --> 00:36:17,450
+في رأيك posterior to the cilia اللي هو خلف السلية
+
+597
+00:36:17,450 --> 00:36:19,570
+اللي اتكلمنا عليها احنا و ال lashes اللي عددها
+
+598
+00:36:19,570 --> 00:36:22,690
+مذكور امامنا is the grey line which divides the
+
+599
+00:36:22,690 --> 00:36:25,890
+lid margin into anterior lamella اللي تتكون من
+
+600
+00:36:25,890 --> 00:36:31,210
+طبقة جلدية و طبقة عضلية و هذه تتكون من غداد و يقسم
+
+601
+00:36:31,210 --> 00:36:35,290
+ايضا إلى posterior lamella تتكون من التارسل plate
+
+602
+00:36:35,290 --> 00:36:40,380
+و conjunctiva و أستاشيات ال glandsبعد ما اتكلمنا
+
+603
+00:36:40,380 --> 00:36:43,940
+على تركيبة ال eyelids بعض الوظائف اللى اتكلمنا
+
+604
+00:36:43,940 --> 00:36:49,020
+عليها و اتكلمنا ايضا على عضلات بما يخص عضلات يفن
+
+605
+00:36:49,020 --> 00:36:51,860
+العادى like horners muscle و muscle of brailla و
+
+606
+00:36:51,860 --> 00:36:54,860
+اتكلمنا عن ال eyelid أو superior eyelid retractors
+
+607
+00:36:54,860 --> 00:36:59,640
+طب عند ال inferior eyelid في عنده retractor ال
+
+608
+00:36:59,640 --> 00:37:01,880
+inferior eyelid تقول لإن ال muscles موجودة فيه إيش
+
+609
+00:37:01,880 --> 00:37:06,560
+هي تقريبااللي هي uppercase class muscle بس الجزء
+
+610
+00:37:06,560 --> 00:37:11,640
+اللي موجود innermost هنا segment اللي هو pretarsal
+
+611
+00:37:11,640 --> 00:37:14,580
+segment صحيح هو ده uppercase class muscle أما ال
+
+612
+00:37:14,580 --> 00:37:18,440
+retractors فقط متواجدة في superior eyelid وهذا مهم
+
+613
+00:37:18,440 --> 00:37:20,980
+جدا وال retractors اللي متواجدة في superior eyelid
+
+614
+00:37:20,980 --> 00:37:23,900
+هي عبارة عن levator muscle زي the meolars muscle
+
+615
+00:37:26,720 --> 00:37:30,080
+حنواصر ان شاء الله وظيفة function of the eyelid من
+
+616
+00:37:30,080 --> 00:37:34,080
+ناحية فسيولوجية ماهي وظيفة ال eyelid بشكل حق يعني
+
+617
+00:37:34,080 --> 00:37:40,360
+قبل ما نتطلق لمرهج الموجود معانا أقل
+
+618
+00:37:40,360 --> 00:37:45,080
+شيء .. أقل شيء إيش بديكون؟ وظيفة جمالي أقل ما يمكن
+
+619
+00:37:45,080 --> 00:37:48,640
+بدي .. يعني يشارك في التعبيرات الوجهية و ده يشارك
+
+620
+00:37:48,640 --> 00:37:53,010
+صح؟ أقل شيء في عندناprotection الحماية .. حماية
+
+621
+00:37:53,010 --> 00:37:55,450
+كرة العين كلها .. طبعا الإنسان لما يتعرض للضوء
+
+622
+00:37:55,450 --> 00:37:58,390
+شديد أو ضوء الكشاف مش بده يامان .. يضيء مقعين أو
+
+623
+00:37:58,390 --> 00:38:01,090
+يضع ساتر أمامه ويحفظ عليهش .. علي العين .. هذا
+
+624
+00:38:01,090 --> 00:38:05,010
+حركة لا إيرادية .. صحيح؟ يعني نشر الدمع على كرة
+
+625
+00:38:05,010 --> 00:38:08,900
+العينعلى جزء الذنب من العين بيعمل على نشر الدمع،
+
+626
+00:38:08,900 --> 00:38:13,120
+الدمع يدور في ديرات .. صح .. صحيح بدون غلق جفن
+
+627
+00:38:13,120 --> 00:38:15,560
+العين بيمكن أبدا يحدث ال distribution و ال
+
+628
+00:38:15,560 --> 00:38:17,840
+distribution هذه بيكون متساوي في كل أجزاء القرنية
+
+629
+00:38:17,840 --> 00:38:20,760
+ل .. ل .. ل .. ل tier film على كل أجزاء القرنية
+
+630
+00:38:20,760 --> 00:38:23,580
+حتى على سطح العين، كواة العين كلها ككلها، كونش
+
+631
+00:38:23,580 --> 00:38:26,960
+التنفس بها فيها بيحتوي على غضب ال mebromine بت ..
+
+632
+00:38:26,960 --> 00:38:30,940
+بتعمل .. تفرز ال .. الفرزة الدغنية فهي برضه بتكون
+
+633
+00:38:30,940 --> 00:38:35,440
+ال .. في ال tier film مختبق على ال ..يوكاس، طبعا
+
+634
+00:38:35,440 --> 00:38:39,780
+قدهنية، صحيح، قد أن وجود هو الموميا نجلانز في ال
+
+635
+00:38:39,780 --> 00:38:43,200
+tire size بدي يشارك ليه بشكل حال في تكوين أو
+
+636
+00:38:43,200 --> 00:38:45,520
+ثبوتية ال tear film اللي احنا هناخدها ان شاء الله
+
+637
+00:38:45,520 --> 00:38:49,840
+في ال lacrimal system طيب هناخدها بالتفاصيل، ده من
+
+638
+00:38:49,840 --> 00:38:52,680
+رقم واحد eyelids contribute significantly to
+
+639
+00:38:52,680 --> 00:38:55,940
+facial pH يعني يشارك عند ال eyelids في التعبيرات
+
+640
+00:38:55,940 --> 00:39:00,940
+المجهية طبعا إذا بتعرف في حد مشهور جدا عن الصينيين
+
+641
+00:39:00,940 --> 00:39:04,370
+أو اليابانين أنه عليه ماشيصغار لكن حق تلاعب الأمر
+
+642
+00:39:04,370 --> 00:39:07,310
+هم كرة لعين ككل مش صغيرة، طبعا في بعض دراسات تحكي
+
+643
+00:39:07,310 --> 00:39:11,690
+.. تقول يعني أو تؤشر لإنه ال actual length for the
+
+644
+00:39:11,690 --> 00:39:15,770
+Chinese eyes little bit smaller than other races،
+
+645
+00:39:15,770 --> 00:39:19,430
+يعني أصغر شوية من باقي العراق اللي موجودة، لكن حتى
+
+646
+00:39:19,430 --> 00:39:22,770
+الأمر هي لسه صغيرة كرة لعين، هي طبيعية زينا زي ..
+
+647
+00:39:22,770 --> 00:39:27,090
+حجمها زي .. زي أي عرق آخر، يعني زي جنس الأحمر أو
+
+648
+00:39:27,090 --> 00:39:30,520
+الأوروبيين أو العرب الاخرينلكن هو الاختلاف
+
+649
+00:39:30,520 --> 00:39:34,900
+الكرموسال الموجود انه في عندى سحبة بسيطة لجفن
+
+650
+00:39:34,900 --> 00:39:37,900
+العين صحيح فيبدو عندى .. احنا لو اخدنا ال
+
+651
+00:39:37,900 --> 00:39:40,640
+perpebral fissure هو المسافر بين الجفنين .. الجفن
+
+652
+00:39:40,640 --> 00:39:43,920
+العلوي و الجفن السفلي عند ال horizontal fissure
+
+653
+00:39:43,920 --> 00:39:47,160
+أكبر من باقي العراق بشوية فتبدو العين و كأنهم
+
+654
+00:39:47,160 --> 00:39:50,540
+السحبة عايشة horizontally مش vertically أما عند
+
+655
+00:39:50,540 --> 00:39:56,060
+الأفارقةالعكس ال vertical عين دي أطول لذلك تبدو
+
+656
+00:39:56,060 --> 00:39:59,540
+عند الأفارقة لون شكل العين مش شكلها ده عند الصينية
+
+657
+00:39:59,540 --> 00:40:04,820
+مش شكلها ده صحيح؟ أه يبدو مش شكلها ده أما عند
+
+658
+00:40:04,820 --> 00:40:11,440
+الأفارقة تبدو إيش؟ مش شكلها ده السبب أنه الجنس
+
+659
+00:40:11,440 --> 00:40:14,660
+الأصفر في عين دي horizontally العين بصحى مش شكلها
+
+660
+00:40:14,660 --> 00:40:18,140
+ده أكبر ده كتير من عين ليش الأفارقة أما الأفارقة
+
+661
+00:40:18,540 --> 00:40:22,860
+ورديس بلا سوات بيبند بشكل vertically أكبر بكتير من
+
+662
+00:40:22,860 --> 00:40:27,720
+المعتاد حتى بالنسبة لل islands طيب they are
+
+663
+00:40:27,720 --> 00:40:30,460
+important in expression of emotions طبعا مهمين جدا
+
+664
+00:40:30,460 --> 00:40:35,620
+حتى بالحركة أحيان الحركة يعني بشارك كلها ككل في
+
+665
+00:40:35,620 --> 00:40:40,400
+تعبيرات الوجه أو إداء إشارة معينة زي ما نحكي احنا
+
+666
+00:40:40,400 --> 00:40:43,080
+guns أو ومض كله يأخذ أمنياش من ال island
+
+667
+00:40:47,390 --> 00:40:49,770
+maintain the integrity of the cornea surface
+
+668
+00:40:49,770 --> 00:40:52,190
+المقصود بالجملة العادية كلها maintain the
+
+669
+00:40:52,190 --> 00:40:54,890
+integrity of the cornea surface اللي هو أثناء ال
+
+670
+00:40:54,890 --> 00:40:57,630
+blanking أو أثناء ال wound بديوا تم توزيع ال tear
+
+671
+00:40:57,630 --> 00:41:03,450
+film أو منتج ال lacrimal gland على شطح القرنية
+
+672
+00:41:03,450 --> 00:41:09,580
+بشكل ايش متناسخ مما يمنع من جفارف العينووصف الـ
+
+673
+00:41:09,580 --> 00:41:14,940
+planking action نحن نتصور أحيانا الإنسان بينسى أنه
+
+674
+00:41:14,940 --> 00:41:17,460
+يغمض أو ينسى أنه يومض صحيح؟
+
+675
+00:41:20,050 --> 00:41:24,550
+كيف؟ الفرد مننا او شخص مننا أثناء متابعته لفيلم
+
+676
+00:41:24,550 --> 00:41:27,190
+سائق معين على ال televise أو متابعته على ال laptop
+
+677
+00:41:27,190 --> 00:41:31,170
+أو موضوع معين بيكون شديد التركيز، شديد التركيز هذا
+
+678
+00:41:31,170 --> 00:41:34,970
+حتى بتنصي انه لا إراديا انه human، بتضل بشكل هذا
+
+679
+00:41:34,970 --> 00:41:37,610
+مستقيم، يلاحظ، يلاحظ، حتى ماروحش عليه اي مقطع
+
+680
+00:41:37,610 --> 00:41:41,660
+معين، صحيح؟فحاجة ده يعني حتى بترد الأشخاص كتير على
+
+681
+00:41:41,660 --> 00:41:44,720
+عيالتها في المستشفى أنه فيه اندو جفاف بالعين مثلا
+
+682
+00:41:44,720 --> 00:41:47,860
+فقط في أوقات معينة مثلا عند قراءة القرآن أو عند
+
+683
+00:41:47,860 --> 00:41:51,140
+قراءة كتاب معين ينسى الإنسان نفسه من شدة التركيز
+
+684
+00:41:51,140 --> 00:41:57,090
+إنه عيش حتى يرمش أو يومل فهذا بده يسبب العيشالجفاف
+
+685
+00:41:57,090 --> 00:42:00,450
+بالعين هو ده الوحيد حتى اللي هو بيمنعلي integrity
+
+686
+00:42:00,450 --> 00:42:04,070
+هو كمعنية corneal surface ال integrity of corneal
+
+687
+00:42:04,070 --> 00:42:06,570
+surface لأ تتم إلا في ال blinking لإن هو ال
+
+688
+00:42:06,570 --> 00:42:09,910
+blinking هو الوحيد أو هو تقريبا ال physiological
+
+689
+00:42:09,910 --> 00:42:13,370
+action الوحيد اللي بيعمل على توزيع أو distribution
+
+690
+00:42:13,370 --> 00:42:15,890
+of the tear film شكر equal
+
+691
+00:42:20,180 --> 00:42:22,880
+وظيفة رقم تلاتة serve to maintain a proper
+
+692
+00:42:22,880 --> 00:42:26,600
+position of the globe within the orbital contents
+
+693
+00:42:26,600 --> 00:42:31,800
+يعني
+
+694
+00:42:31,800 --> 00:42:35,420
+أقل شيء يجب أن يحفظه على وضع كرة العين السليم في
+
+695
+00:42:35,420 --> 00:42:39,740
+ال orbit نفسه الآن نحن نتكلم عن تركيب ال eyelid هل
+
+696
+00:42:39,740 --> 00:42:44,940
+ال eyelid يعتبر يعني عضو مستقل بذاته؟ لأ طبعا حفظة
+
+697
+00:42:44,940 --> 00:42:50,080
+كل مركبات ال eyelid أساسا منبسطةمن بساطة من ال
+
+698
+00:42:50,080 --> 00:42:52,960
+orbit صحيح؟ ال origins يعني أو the levator muscle
+
+699
+00:42:52,960 --> 00:42:57,840
+أو superior او هوناز muscle أو myolas muscle أساسا
+
+700
+00:42:57,840 --> 00:43:02,350
+كلها من وينو في عندى ايضا ال tarsus و في عندنا ال
+
+701
+00:43:02,350 --> 00:43:05,670
+orbital septum كله تلبسق من الأرض صحيح؟ فمستقل
+
+702
+00:43:05,670 --> 00:43:10,410
+يعني صح هو صحيح ان هو عضو صغير جدا لكن غير مستقل
+
+703
+00:43:10,410 --> 00:43:13,450
+يعمل جربة بجانب لإتمام ايش ال fixation او ال
+
+704
+00:43:13,450 --> 00:43:16,930
+support لكل أقلاء تكسب لأن فيها أيضا كرة العين
+
+705
+00:43:16,930 --> 00:43:21,940
+فيعمل لأ فقط يعني بشكل مختصر supportSave to
+
+706
+00:43:21,940 --> 00:43:24,940
+regulate the amount of light entering the eye يعمل
+
+707
+00:43:24,940 --> 00:43:28,780
+على تحديد أو تنظيم كمية الضوء الداخلة إلى العين
+
+708
+00:43:28,780 --> 00:43:34,020
+طبعا هو الوظيفة الأساسية لهذا العوض الاساسي
+
+709
+00:43:34,020 --> 00:43:38,400
+المسئول على هذا الوظيفة ال pupil هو اللي يتحكم
+
+710
+00:43:38,400 --> 00:43:40,880
+بشكل فسيولوجي بكمية الضوء الداخل إلى العين
+
+711
+00:43:43,740 --> 00:43:48,820
+ساكر شويه او بده يعدمها نهائيا ثم اتكلمنا احنا قبل
+
+712
+00:43:48,820 --> 00:43:51,180
+قليل ان تعرض الانسان لشيء متوحد او شديد
+
+713
+00:43:51,180 --> 00:43:54,580
+الوهجان،بالتالي اما هيقفل عينه خوفا من انه يأثر
+
+714
+00:43:54,580 --> 00:43:58,620
+على الشبكية طبعا بدون دراية شو هيصير او اما هيضعاش
+
+715
+00:43:58,620 --> 00:44:04,960
+ساتر امامه protection from airborne particles اللي
+
+716
+00:44:04,960 --> 00:44:11,840
+هو الحماية من رداد او المتطاير في الهوا او ذرات او
+
+717
+00:44:11,840 --> 00:44:17,930
+رداد المتطاير في الهواممكن يسبب فيه أيضا مشاكل في
+
+718
+00:44:17,930 --> 00:44:22,130
+سطح العين كيعمل يخدش في القرنية مثلا أو يخدش في ال
+
+719
+00:44:22,130 --> 00:44:24,290
+content تابع بالتالي يحصل فيه اندو spontaneous
+
+720
+00:44:24,290 --> 00:44:29,510
+reflex اللي هو انعكاس لا إرادي أو وميدل العين بشكل
+
+721
+00:44:29,510 --> 00:44:33,550
+لا إرادي للحماية على القرنية أو الحماية على سطح
+
+722
+00:44:33,550 --> 00:44:36,830
+العين blinking eliminates the discomfort of the
+
+723
+00:44:36,830 --> 00:44:42,830
+dryness of the eyeالـ planking بدي ساعدني على
+
+724
+00:44:42,830 --> 00:44:50,010
+ترتيب سطح كرة الأحيان حتى في الكثير من الأحيان
+
+725
+00:44:50,010 --> 00:44:53,250
+يشعر بالجفاف مجرد أنه يومد عندي تقريبا او تقريبا
+
+726
+00:44:53,250 --> 00:44:56,230
+اشياء يشعر بالراحة ان هذا اشي اشي خلاص اختفت
+
+727
+00:44:56,230 --> 00:45:00,290
+تقريبا eyelid opening is produced primarily by the
+
+728
+00:45:00,290 --> 00:45:02,830
+levator papilloma superior muscle which is
+
+729
+00:45:02,830 --> 00:45:04,970
+innervated by the superior division of the
+
+730
+00:45:04,970 --> 00:45:10,610
+oculometer nerveفتح الجفن او retraction of the
+
+731
+00:45:10,610 --> 00:45:13,910
+eyelid يعتمد اعتماد أساسي على ال levator muscle
+
+732
+00:45:13,910 --> 00:45:17,410
+ولا يعتمد على الorbicular muscular muscle الفرق
+
+733
+00:45:17,410 --> 00:45:21,130
+بين ال levator muscle بس فيه .. و عفوا الفرق بين
+
+734
+00:45:21,130 --> 00:45:24,350
+ال levator muscle اختصارا ما بين ال orbicular
+
+735
+00:45:24,350 --> 00:45:28,850
+muscular muscle من ناحية موظفية صحيح مع انه بعض او
+
+736
+00:45:28,850 --> 00:45:32,250
+حكينا احنا قاليا في الأمامية او جزء البعيد من ال
+
+737
+00:45:32,250 --> 00:45:35,510
+levator muscle اللي احنا سمينا ال aponeosis بيخترق
+
+738
+00:45:35,510 --> 00:45:39,150
+الاشالأوربكية و ال circular muscle لكن وظيفة كل
+
+739
+00:45:39,150 --> 00:45:44,590
+منهم يعني تختلف لاختلاف كله، إذا عندى كانت فعالة
+
+740
+00:45:44,590 --> 00:45:47,390
+الأوربكية و ال circular muscle صحيح، إيش هيحدث
+
+741
+00:45:47,390 --> 00:45:50,410
+عندى؟ contraction of the eyelid، يحدث في عند مم أو
+
+742
+00:45:50,410 --> 00:45:54,390
+غضب العين، في نفس الوقت هذا، في عند إحباط أو إثبات
+
+743
+00:45:54,390 --> 00:45:57,790
+لعملية إيش؟ ده contraction أو ده levator muscle،
+
+744
+00:45:57,790 --> 00:46:01,130
+مستحيل يعملوا بنفس الاتجاه، إحداهم مصابت للآخر
+
+745
+00:46:03,480 --> 00:46:06,360
+Island closure is attained by the action of three
+
+746
+00:46:06,360 --> 00:46:08,840
+segments of the orbicular circular muscle طبعا
+
+747
+00:46:08,840 --> 00:46:12,460
+احنا حكيناها ال orbicular circular muscle مع انها
+
+748
+00:46:12,460 --> 00:46:15,780
+تنقسم إلى three segments لأن أثناء ال contraction
+
+749
+00:46:15,780 --> 00:46:19,080
+كلها مع بعيداش يحدث لها contraction يعني مش ما ..
+
+750
+00:46:19,080 --> 00:46:21,360
+لا يحدث ال contraction فقط في جزء اللي هو ال
+
+751
+00:46:21,360 --> 00:46:24,680
+precursor أو ال preceptor أو فقط في ال orbital
+
+752
+00:46:24,680 --> 00:46:27,520
+segment لأ كلها ككل لإن لها نفس ال innervation
+
+753
+00:46:27,520 --> 00:46:32,220
+بنفس الدعوجةduring closure the upper lid moves
+
+754
+00:46:32,220 --> 00:46:36,560
+down and the lower lid moves up both up and
+
+755
+00:46:36,560 --> 00:46:39,100
+nasally in the normal patients or in normal
+
+756
+00:46:39,100 --> 00:46:43,840
+subjects في حركة العين أثناء إحنا يعني retraction
+
+757
+00:46:43,840 --> 00:46:46,000
+of the upper eyelid لو ننظر إلى الأعلى، إيش بدي
+
+758
+00:46:46,000 --> 00:46:49,380
+يحدث عندي؟ أه بالشكل هذا، في end retraction
+
+759
+00:46:49,380 --> 00:46:53,160
+للأعلى، للأعلى عالية صحيح؟ طبعا إحنا حكينا liver
+
+760
+00:46:53,160 --> 00:46:55,840
+to muscle مع superior nectars كلها هم هيعمل جنبك
+
+761
+00:46:55,840 --> 00:46:58,560
+بجانب، لأن حركة العين إلى الأعلى لابد منه لازم
+
+762
+00:46:58,560 --> 00:47:03,050
+أكثر muscleففي نفس الوقت اللي احنا بنتكلم عليه، في
+
+763
+00:47:03,050 --> 00:47:05,110
+عند elevation of the upper eyelid، ال low eyelid
+
+764
+00:47:05,110 --> 00:47:09,230
+إيش بتصير فيه؟ في عند استرخاء للأوربا كريستركلين
+
+765
+00:47:09,230 --> 00:47:12,550
+نسل، مش هيحدث في عند stimulation for both muscles
+
+766
+00:47:12,550 --> 00:47:15,470
+بنفس الوقت، لأ، في عند ال upper eyelid only moves
+
+767
+00:47:15,470 --> 00:47:19,850
+upward، صحيح؟ يعني ال low eyelid moves either ..
+
+768
+00:47:19,850 --> 00:47:22,290
+لما أنا أبدأ أقولها different، either upward، لكن
+
+769
+00:47:22,290 --> 00:47:26,080
+في عندي nasallyفي انها نازل لو طلعنا احنا دفعنا
+
+770
+00:47:26,080 --> 00:47:31,280
+الانبعاد بشكل بسيط و غمضنا العين بشكل هادر او
+
+771
+00:47:31,280 --> 00:47:34,680
+طلعنا الى فارق هنلاحظ ان ال upper eyelid فقط عنده
+
+772
+00:47:34,680 --> 00:47:38,120
+elevation صحيح حتى في عنده ايضا closure لكن ال
+
+773
+00:47:38,120 --> 00:47:41,060
+lower eyelid في عنده closure لكن في عنده slightly
+
+774
+00:47:41,060 --> 00:47:44,920
+nasal movement حتى اشتغل هاد هاد مهم جدا nasal
+
+775
+00:47:44,920 --> 00:47:47,700
+movement of the lower eyelid أهمية تكمل في ash
+
+776
+00:47:47,700 --> 00:47:52,500
+بإنها بتساعدلي على تحريك ال tear film او ال tears
+
+777
+00:47:52,500 --> 00:47:56,560
+صحيح ال ashالـ Pankta أو الـ lacrimal apparatus
+
+778
+00:47:56,560 --> 00:47:59,740
+احنا
+
+779
+00:47:59,740 --> 00:48:03,100
+عارفين طبعا كلنا انه الـ T في الفيلم كيف يتم
+
+780
+00:48:03,100 --> 00:48:07,380
+التخلص منه يعني ايش السبب اللي بيخليه يندرج الى
+
+781
+00:48:07,380 --> 00:48:09,500
+ناحية ال lower pankta فيه عندنا ال pankta فيه
+
+782
+00:48:09,500 --> 00:48:10,980
+عندنا ال superior pankta فيه عندنا ال lower pankta
+
+783
+00:48:10,980 --> 00:48:16,020
+صحيح تقريبا 80% او ما فوق 80% 85% كلها ذهبت الى ال
+
+784
+00:48:16,020 --> 00:48:19,740
+lower pankta طبعا غير تأثير الجذبية الأرضية فيه
+
+785
+00:48:19,740 --> 00:48:23,990
+عنده تأثير ايش ال blinking الرمشعفا ال .. ال ..
+
+786
+00:48:23,990 --> 00:48:30,450
+الوضع طب فينا three types of blanking, blanking is
+
+787
+00:48:30,450 --> 00:48:33,330
+the most common form of eyelid closure طبعا هي
+
+788
+00:48:33,330 --> 00:48:38,870
+أكثر شيء ظاهر بانغلاق العين طبعا هو الرمش طبعا هذا
+
+789
+00:48:38,870 --> 00:48:41,650
+رمش فسيولوجي احنا لما اتكلم مع شخص معين اتنا ..
+
+790
+00:48:41,650 --> 00:48:45,010
+اتكلمنا معاه عشان نلاحظملاحظة لسان لا إيراديا،
+
+791
+00:48:45,010 --> 00:48:47,190
+يبدو يرمش، حتى على ترتب العين، هذا حركة لا
+
+792
+00:48:47,190 --> 00:48:51,650
+إيرادية، صح، نحن نتحكم فيها، لكن معظم الأحيان لسان
+
+793
+00:48:51,650 --> 00:48:55,350
+ما .. بقصودش يعني أن مثلا كل دقيقة يغمض أربعتاشر
+
+794
+00:48:55,350 --> 00:48:57,430
+مرة أو خمستاشر مرة أو عشرين مرة، لأ، هذه حركة لا
+
+795
+00:48:57,430 --> 00:49:01,850
+إيراديةAlthough most blinks do not result in
+
+796
+00:49:01,850 --> 00:49:05,170
+complete eyelid closure, blinks rate decrease with
+
+797
+00:49:05,170 --> 00:49:08,330
+visual attention and increase with stress and
+
+798
+00:49:08,330 --> 00:49:12,390
+decrease attention وهذه الفقرة مهمة جدا البلينك
+
+799
+00:49:12,390 --> 00:49:17,190
+لايعني إطباق كام لجفن العلمي واسف لإنها باشا بشكل
+
+800
+00:49:17,190 --> 00:49:22,250
+سريع وهذا البلينك لايؤثر على أي وظيفةلايأثر على
+
+801
+00:49:22,250 --> 00:49:25,470
+الوظيفة ايش ال visual field function لايأثر عليها
+
+802
+00:49:25,470 --> 00:49:29,390
+ناقية حتى لو انسان يعني تابع حدث معين هو و هو
+
+803
+00:49:29,390 --> 00:49:32,570
+بتابع حدث معين صحيح معدل ال blinking عندك بيقل صح
+
+804
+00:49:32,570 --> 00:49:36,510
+مع شدة التركيز لكن ايضا حتى لو زاد معدل ال
+
+805
+00:49:36,510 --> 00:49:38,630
+blinking مش هيأثر على ال visual function الا
+
+806
+00:49:38,630 --> 00:49:48,070
+بحالات معينة ففي ان ال blink عفوا ال blink rates
+
+807
+00:49:48,070 --> 00:49:50,530
+بيزداد في حالة ايش
+
+808
+00:49:54,170 --> 00:49:59,630
+بدي يقل بشكل ملحوظ في حالة عدم التركيز في ال
+
+809
+00:49:59,630 --> 00:50:02,430
+attention بدي يقل بشكل ملحوظ، اذا متابعتنا حاجة
+
+810
+00:50:02,430 --> 00:50:06,510
+كده احنا لمقطع معين او لحدث معين اذا و كأنه يخاف
+
+811
+00:50:06,510 --> 00:50:09,370
+ان يفوتوا شيء معين او حدث معين من المظهر اللي
+
+812
+00:50:09,370 --> 00:50:12,670
+امامه، بالتالي بيضلوا عايش بشكل case بشكل مباشر
+
+813
+00:50:25,780 --> 00:50:29,820
+العدل الأساسي المسؤول عن الـ Blinking هوهي ال
+
+814
+00:50:29,820 --> 00:50:34,420
+orbicular muscle three segments كل الأجزاء الثلاثة
+
+815
+00:50:34,420 --> 00:50:38,080
+المكونة للorbicular muscle مسئولة على اللي هو ال
+
+816
+00:50:38,080 --> 00:50:40,540
+blanking أما بنفس الوقت اللي يحدث فيه blanking
+
+817
+00:50:40,540 --> 00:50:43,920
+يحدث فيه اندي inhibition أو تثبيت for the levator
+
+818
+00:50:43,920 --> 00:50:47,300
+muscle احنا حكينا مش معقول يعني بناحية في ال
+
+819
+00:50:47,300 --> 00:50:50,160
+surgery حتى أن يحدث لهم stimulation بنفس الدرجة أو
+
+820
+00:50:50,160 --> 00:50:52,400
+بنفس الوقت لأن مش simultaneous هم مختلفين
+
+821
+00:50:55,280 --> 00:50:57,360
+فيه أن الـ three types of objects are generally
+
+822
+00:50:57,360 --> 00:51:01,060
+described spontaneous, reflex and voluntary وهذه
+
+823
+00:51:01,060 --> 00:51:04,140
+ال reflex مسمى عكس أو ميد
+
+824
+00:51:07,010 --> 00:51:10,230
+وعن ال three blanks هذه مهمة جدا طبعا هي بالأساس
+
+825
+00:51:10,230 --> 00:51:13,610
+اللي تظهرنا الوظيفة التسيولوجية الصحيحة لل islet
+
+826
+00:51:13,610 --> 00:51:18,030
+واللي احنا اصلا عشانها يعني اخدناها دي محاضرة اول
+
+827
+00:51:18,030 --> 00:51:22,090
+نوع من ال blanks اللي هو spontaneous blank are the
+
+828
+00:51:22,090 --> 00:51:24,550
+base involuntary blanks that have no external
+
+829
+00:51:24,550 --> 00:51:29,230
+stimulus بنحكي فقرة معينة عن تعريف هذا spontaneous
+
+830
+00:51:29,230 --> 00:51:32,610
+blank اللي هو الوميذ اللا إرادي العفوي اللي ساعة
+
+831
+00:51:32,610 --> 00:51:39,010
+بقصدهش يعنيحتى اذا احنا شريحنا وثقة تسجيلها لبعض
+
+832
+00:51:39,010 --> 00:51:41,710
+ال notes، نلاحظ ان الإنسان في عنده plaguing، هذا
+
+833
+00:51:41,710 --> 00:51:43,770
+ال plague هو هذا ال spontaneous اللي هو أصلا مش
+
+834
+00:51:43,770 --> 00:51:47,070
+عنده أي مؤثر خارجي، هذا من ناحية السيولوجيا، بدون
+
+835
+00:51:47,070 --> 00:51:50,990
+أي مؤثر خارجي، اي حدث بشكل يومي أو بشكلاش متكرر،
+
+836
+00:51:50,990 --> 00:51:53,310
+the rate of spontaneous plaguing varies among
+
+837
+00:51:53,310 --> 00:51:55,390
+individuals and may be influenced by the
+
+838
+00:51:55,390 --> 00:51:59,650
+environmentinfluenced by the environment احنا نضرب
+
+839
+00:51:59,650 --> 00:52:03,710
+مثلًا يعني هال spontaneous plague هتتأثر بالبيئة
+
+840
+00:52:03,710 --> 00:52:10,930
+الخارجية ولا لأ؟ بأي شكل، بدا باكيد يعني، لابد و
+
+841
+00:52:10,930 --> 00:52:14,770
+تتأثر،
+
+842
+00:52:14,770 --> 00:52:18,670
+يعني لو في المناطق مثلًا اللي تكثر فيها الغبار
+
+843
+00:52:19,740 --> 00:52:22,640
+الانسان بدى يزداد عنده معدل البلاي كينج صحيح؟
+
+844
+00:52:22,640 --> 00:52:25,380
+مناطق شديدة زى الحرارة في عند التبخر هذا ال
+
+845
+00:52:25,380 --> 00:52:29,600
+vaporation أو بداتي الفيلم بشكل كبير صح فبالتالي
+
+846
+00:52:29,600 --> 00:52:31,920
+عند البلاي كينج بده يعول هذا، هذا الطبيعة في
+
+847
+00:52:31,920 --> 00:52:35,160
+السيولوجيا، لو في عندنا في القطب الشمالي مثلا أو
+
+848
+00:52:35,160 --> 00:52:38,080
+في المناطق البيضة زى سيبيريا وروسيا الاخره، معدل
+
+849
+00:52:38,080 --> 00:52:41,060
+البلاي كينج بده يقل بشكل عيش ملاحظ، لكن هذا انه
+
+850
+00:52:41,060 --> 00:52:43,420
+يزداد أو يقل مش حياة السيولوجيا، هو وظيفة العين،
+
+851
+00:52:43,420 --> 00:52:47,340
+هذا وظيفة الطبيعية بالعيلة دىأهم شيء أن أذكر أن ال
+
+852
+00:52:47,340 --> 00:52:51,740
+spontaneous blink ليهدوس بسبب أي مؤثر خارجي لأ
+
+853
+00:52:51,740 --> 00:52:57,180
+إنما هو وميضة عفوية أو action عفوية أو حركة عفوية
+
+854
+00:52:57,180 --> 00:53:02,620
+لجسم العين لحمية أو ترطيب اللي هو سطح العين بما في
+
+855
+00:53:02,620 --> 00:53:06,760
+ذلك القرنية عندي معدل موجود هنا بكل دقيقة تقريبا
+
+856
+00:53:06,760 --> 00:53:10,840
+خمس عشر مرة بالحالة الطبيعية طبعا يزاد أو يقل
+
+857
+00:53:10,840 --> 00:53:14,840
+حكينا في عندنا مؤثرات بيئيةطبعا غير مؤثرة الخارجية
+
+858
+00:53:14,840 --> 00:53:20,040
+من ناحية طبيعية احنا نراقب شخص معين بيعمل عمل معين
+
+859
+00:53:20,040 --> 00:53:23,420
+اليومي و عدّين اكتر مرة هنلاقيها بالغضب هذا ربما
+
+860
+00:53:23,420 --> 00:53:26,920
+تزاد او تقل عند الأطفال تزاد او تقل عند وجود
+
+861
+00:53:26,920 --> 00:53:30,680
+التعابات تزاد او تقل بسبب تقير المناخ الاخر لكن من
+
+862
+00:53:30,680 --> 00:53:36,460
+ناحية طبيعية تقل مش المفروض تقل عن 15 مرة reflex
+
+863
+00:53:36,460 --> 00:53:38,280
+الاخر اللي هو reflex black
+
+864
+00:53:50,690 --> 00:53:56,870
+الفرق بين spontaneous reflex و reflex blank ان ال
+
+865
+00:53:56,870 --> 00:54:00,810
+spontaneous reflex عصوي لا يتبع اي مؤثر خارجي هذا
+
+866
+00:54:00,810 --> 00:54:03,470
+الطبيعة العادية هذا الوظيفة الفيسيولوجية أما
+
+867
+00:54:03,470 --> 00:54:06,050
+reflex blank لأ resulting from contraction of the
+
+868
+00:54:06,050 --> 00:54:07,330
+preterisal ocularis muscle
+
+869
+00:54:10,100 --> 00:54:13,580
+وهذا كنت أشربه يكون سيفير بقعد في عندي مؤثر خارج
+
+870
+00:54:13,580 --> 00:54:19,620
+الـ corneal reflex بلينك بارثويه بدا من أفراد
+
+871
+00:54:19,620 --> 00:54:23,600
+الفيبرز من أولية ترجمة الناف الترجمالية التي عبرت
+
+872
+00:54:23,600 --> 00:54:25,880
+من خلال البرنستيم و اكتبت ناف التراجمالية
+
+873
+00:54:25,880 --> 00:54:27,240
+التراجمالية الترجمالية الترجمالية الترجمالية
+
+874
+00:54:27,240 --> 00:54:32,780
+الترجمالية الترجمالية الترجمالية الترجمالية
+
+875
+00:54:32,780 --> 00:54:32,780
+الترجمالية الترجمالية الترجمالية الترجمالية
+
+876
+00:54:32,780 --> 00:54:32,780
+الترجمالية الترجمالية الترجمالية الترجمالية
+
+877
+00:54:32,780 --> 00:54:32,780
+الترجمالية الترجمالية الترجمالية الترجمالية
+
+878
+00:54:32,780 --> 00:54:32,780
+الترجمالية الترجمالية الترجمالية الترجمالية
+
+879
+00:54:32,780 --> 00:54:36,690
+الترجمالية الترجمالإنسان لما يدخل في عينه، في
+
+880
+00:54:36,690 --> 00:54:40,010
+العين نفسها، في الجثن عبارة عن ضبط قبار أو جسم
+
+881
+00:54:40,010 --> 00:54:42,890
+غريب أو حتى eyelashes أحيانا تسقط داخل العين أو
+
+882
+00:54:42,890 --> 00:54:46,530
+شعر معينة، إيش الإنسان بيديه؟ بيحبس في عنده أول
+
+883
+00:54:46,530 --> 00:54:51,110
+شيء يغمض عينه، هذايعني تبع عن ال protective action
+
+884
+00:54:51,110 --> 00:54:54,830
+صحيح؟ يعني تبع على إيش؟ ردد فعل وقعية طبيعية جدا،
+
+885
+00:54:54,830 --> 00:54:58,050
+حتى للتخلص من هذا الجسم اللي بيعمل احتكاك شديد مع
+
+886
+00:54:58,050 --> 00:55:01,030
+القرنية، ربما يعمل ال degradation لحل city-ship of
+
+887
+00:55:01,030 --> 00:55:03,510
+zirconia أو يعمل ال degradation لحل city-ship of
+
+888
+00:55:03,510 --> 00:55:06,070
+zirconia وكذلك، فبالنهاية هو جسم غريب، بده يعيق
+
+889
+00:55:06,070 --> 00:55:09,870
+ليش الحالة الطبيعية له وقياتتخلص منه قرنية بشكل
+
+890
+00:55:09,870 --> 00:55:14,150
+سري عن طريق إغلاق العين أو فتح العين يعني هي تجبر
+
+891
+00:55:14,150 --> 00:55:18,430
+الإنسان للوجوء لأي مساعد أخر لتخلص من الجسم الغريب
+
+892
+00:55:18,430 --> 00:55:23,620
+اللي دخل في سطح العين، شو حدث عنده بالضبط؟يعني إيش
+
+893
+00:55:23,620 --> 00:55:26,220
+هو ال nerve pathway اللي حدث عندي؟ زي ما اتكلمنا
+
+894
+00:55:26,220 --> 00:55:28,660
+احنا على ال puber construction أو ال dilatation،
+
+895
+00:55:28,660 --> 00:55:31,260
+في عندي pathway متبعه صحيح؟ و أيضا في ال cornea
+
+896
+00:55:31,260 --> 00:55:33,900
+reflex في عندي pathway، و ال pathway هذا مهم جدا،
+
+897
+00:55:33,900 --> 00:55:36,900
+إن الدخول لل foreign body عملنا contact معاه، مع
+
+898
+00:55:36,900 --> 00:55:40,140
+ال cornea، لذلك اسمه cornea reflex صحيح؟ ال cornea
+
+899
+00:55:40,140 --> 00:55:44,520
+انتباهش الأساسا من وين؟من اللي ترايجيه من الرناب،
+
+900
+00:55:44,520 --> 00:55:49,220
+صحيح؟ لو أصلا كل ال sensory .. طبعا ال Konya تعتبر
+
+901
+00:55:49,220 --> 00:55:53,220
+sensory أونجا، مافيش فيها أي موتورناب، فكله يعتمد
+
+902
+00:55:53,220 --> 00:55:57,320
+الغالبية العظمى من ال Oculi للدنكسا، ال sensory
+
+903
+00:55:57,320 --> 00:56:01,580
+innovation يأتي من اللي ترايجيه من الرناب، صحيح؟
+
+904
+00:56:01,580 --> 00:56:06,230
+بعد أن تذهب الإشارة اللي هي أفرد ولا إفرادالأفرا
+
+905
+00:56:06,230 --> 00:56:09,410
+صحيح؟ afferent stimulus إلى اللي ترجمنا ال nerve
+
+906
+00:56:09,410 --> 00:56:12,510
+تذهب إلى ال brain stem و من ال brain stem تنعكس
+
+907
+00:56:12,510 --> 00:56:16,010
+مرة أخرى عبر اللي هو سمك ال cranial nerve اللي هو
+
+908
+00:56:16,010 --> 00:56:19,750
+بيعمللي على إيش؟ غلق الجفن، أصلا المسئولة على
+
+909
+00:56:19,750 --> 00:56:22,510
+innervation أو motor innervation of the organs و
+
+910
+00:56:22,510 --> 00:56:25,450
+كلها مثلا شو هو؟ facial nerve اللي هو سمك ال
+
+911
+00:56:25,450 --> 00:56:28,370
+cranial nerve، فبالتالي بيحدثلي عنده اللي هو غلق
+
+912
+00:56:28,370 --> 00:56:31,690
+لجفن العين، و هذا ال corner reflex مهم جدا لأن
+
+913
+00:56:31,690 --> 00:56:34,290
+أصلا بحياتنا اليومية احنا نلاحظه بشكل يومي
+
+914
+00:56:36,180 --> 00:56:38,440
+القوتينيز الاستموليشن أو الدوتوري استموليشن
+
+915
+00:56:38,440 --> 00:56:39,740
+والقوتينيز الاستموليشن والدوتوري استموليشن
+
+916
+00:56:39,740 --> 00:56:39,880
+والدوتوري استموليشن والدوتوري استموليشن والدوتوري
+
+917
+00:56:39,880 --> 00:56:41,160
+استموليشن والدوتوري استموليشن والدوتوري استموليشن
+
+918
+00:56:41,160 --> 00:56:43,240
+والدوتوري استموليشن والدوتوري استموليشن والدوتوري
+
+919
+00:56:43,240 --> 00:56:43,560
+استموليشن والدوتوري استموليشن والدوتوري استموليشن
+
+920
+00:56:43,560 --> 00:56:44,320
+والدوتوري استموليشن والدوتوري استموليشن والدوتوري
+
+921
+00:56:44,320 --> 00:56:53,600
+استموليشن والدوتوري
+
+922
+00:56:53,600 --> 00:56:59,240
+استموليشن والد
+
+923
+00:57:01,390 --> 00:57:04,070
+ايش الفرق بين .. قبل ما اتكلم عن ال voluntary
+
+924
+00:57:04,070 --> 00:57:07,610
+blank، الفرق بين voluntary blank والفرق بين اللي
+
+925
+00:57:07,610 --> 00:57:10,070
+هو reflex blank؟
+
+926
+00:57:11,770 --> 00:57:16,070
+هو لما الإنسان بإرادة تفضل نقطة العلم لأي أداء
+
+927
+00:57:16,070 --> 00:57:19,710
+بتاعه مثلا ال DNA ممتازة بشكل إرادي أما ال reflex
+
+928
+00:57:19,710 --> 00:57:24,250
+بيكون متأثير خارج من البيئة يعني عينقها لحماية
+
+929
+00:57:24,250 --> 00:57:26,850
+المعرفة تتفاهم يعني طيب بالنسبة لغرض الفعل هاذ ايش
+
+930
+00:57:26,850 --> 00:57:29,970
+و العضلات اللي بتنتج عنها؟ يعني هل مثلا عند بال
+
+931
+00:57:29,970 --> 00:57:33,670
+involant replic هي نفس العضلات الفعالة في الvolant
+
+932
+00:57:33,670 --> 00:57:38,270
+replic؟ هي المسؤولة عن الأداء بشكل عام
+
+933
+00:57:42,020 --> 00:57:44,720
+Voluntary بس بيشتغل ال orbital في هدات بس بيشتغل
+
+934
+00:57:44,720 --> 00:57:44,960
+ال volantary بس بيشتغل ال orbital في هدات بس
+
+935
+00:57:44,960 --> 00:57:46,900
+بيشتغل ال volantary بس بيشتغل ال volantary بس
+
+936
+00:57:46,900 --> 00:57:47,860
+بيشتغل ال volantary بس بيشتغل ال volantary بس
+
+937
+00:57:47,860 --> 00:57:48,840
+بيشتغل ال volantary بس بيشتغل ال volantary بس
+
+938
+00:57:48,840 --> 00:57:48,840
+بيشتغل ال volantary بس بيشتغل ال volantary بس
+
+939
+00:57:48,840 --> 00:57:48,840
+بيشتغل ال volantary بس بيشتغل ال volantary بس
+
+940
+00:57:48,840 --> 00:57:51,620
+بيشتغل ال volantary بس بيشتغل ال volantary بس
+
+941
+00:57:51,620 --> 00:57:55,000
+بيشتغل ال volantary
+
+942
+00:57:55,000 --> 00:58:04,020
+بس بيشتغل ال volantary بس بيشتغل ال volantary
+
+943
+00:58:07,270 --> 00:58:10,650
+معينة للشخص اللي أمامنا vertical eyelid movement
+
+944
+00:58:10,650 --> 00:58:13,450
+induce vertical movement in the upper eyelid and
+
+945
+00:58:13,450 --> 00:58:16,510
+in up gaze the upper eyelid moves upward as a
+
+946
+00:58:16,510 --> 00:58:18,810
+result of the contraction of the levator along
+
+947
+00:58:18,810 --> 00:58:21,330
+with the superior cercus the lower eyelid also
+
+948
+00:58:21,330 --> 00:58:25,330
+moves upward during up gaze هذه كلنا اتكلمنا عليها
+
+949
+00:58:25,330 --> 00:58:30,190
+فيما سبق في اندي ظاهرة مهمة جدا اسمها Bell's
+
+950
+00:58:30,190 --> 00:58:33,670
+phenomenon اللي هي ظاهرة Bell تبع اسم العالم اللي
+
+951
+00:58:33,670 --> 00:58:39,870
+اشهد واضحها او درسهاتلاحظوا أنتوا أثناء احناإجبار
+
+952
+00:58:39,870 --> 00:58:44,630
+الطفل أثناء إجبار الطفل على إجراء فحص معين بالعين،
+
+953
+00:58:44,630 --> 00:58:47,770
+يعني انا أبلسل اتلعب مثلا أو نعمله فاندسكوبي أو
+
+954
+00:58:47,770 --> 00:58:50,890
+ريتنسكوبي، الطفل في بعض المكان متعامل،
+
+955
+00:58:50,890 --> 00:58:53,530
+incooperative، بتالي بدي يرفض، لإنه بيعتبر تدخل في
+
+956
+00:58:53,530 --> 00:58:57,390
+.. إيش؟ في حالته الخاصة، صحيح؟ إيش بدي يصير عنده؟
+
+957
+00:58:57,390 --> 00:59:00,890
+أول .. أول مدت في عقله أثناء إجباره، بدي يغمض عينه
+
+958
+00:59:00,890 --> 00:59:04,410
+بشكل كبير، صحيح؟ حتى عند إجباره على فتح جفن العين،
+
+959
+00:59:04,410 --> 00:59:09,750
+العين بيوصف ليه إيش هنلاقي إحنا كورة العين؟في عندى
+
+960
+00:59:09,750 --> 00:59:12,870
+upward rotation of the eyeball في عندى تقريبا دورة
+
+961
+00:59:12,870 --> 00:59:15,890
+عندنا العين متجهلة لحدث أعلى حتى احنا في الحالة
+
+962
+00:59:15,890 --> 00:59:19,230
+هذه الصعبة بتشوفوا او اللي في حصة الفندس بيحدث
+
+963
+00:59:19,230 --> 00:59:21,790
+عندى upward rotation of all the eyeball اللي
+
+964
+00:59:21,790 --> 00:59:26,710
+حمايتاشالقرانية طبعا القرانية هي الوضع الأساسي
+
+965
+00:59:26,710 --> 00:59:29,670
+للرؤية صحيح فالحماية القرانية يحدث عند upward
+
+966
+00:59:29,670 --> 00:59:32,430
+rotation في الحالة هذه اللي بيحدث فيها severe
+
+967
+00:59:32,430 --> 00:59:36,450
+constriction of the eyelid مسحوبة مع upward
+
+968
+00:59:36,450 --> 00:59:40,370
+rotation of the eyeball ككل لحفاظ القرانية خاد
+
+969
+00:59:40,370 --> 00:59:43,870
+الفنومنا تسمى ظاهرة Bell أو Bell's Phenomena احنا
+
+970
+00:59:43,870 --> 00:59:46,670
+مشوفها كتير يعني بشكل يوم تقريبا عند الأطفال لما
+
+971
+00:59:46,670 --> 00:59:50,700
+نعملهمنقطلهم ال cyclo أو نعملهم فحص ال cyclo، إيش
+
+972
+00:59:50,700 --> 00:59:54,300
+بده يعمل الطفل؟ مع كثر البكاء أو عدم التعاون، بدهش
+
+973
+00:59:54,300 --> 00:59:57,360
+حد يدخل فيه، بده يضطر إنه يغلق عينه بشكل هادر،
+
+974
+00:59:57,360 --> 00:59:59,940
+بشكل شديد، بتالي، حتى لو احنا حاولنا نفتح دفن
+
+975
+00:59:59,940 --> 01:00:02,180
+العين و قطر قطر، هلاجي، مش هشوف إلا ال sclera أو
+
+976
+01:00:02,180 --> 01:00:04,760
+ال conjunctival tissue، غير هيك لأ كل upward
+
+977
+01:00:04,760 --> 01:00:09,160
+rotation of the eyeball، وهي طبعا تستخدم يعني أو
+
+978
+01:00:09,160 --> 01:00:12,440
+يستخدمها الجسم كردد فعل طبيعية، للحفاظة على عيش
+
+979
+01:00:12,440 --> 01:00:15,940
+كورة العينفي ان ايضا بحالة اخرى زي ما احنا حكيناها
+
+980
+01:00:15,940 --> 01:00:19,160
+Lagos Thomas هاد ايضا تعريف اللي احنا عايزينه
+
+981
+01:00:19,160 --> 01:00:23,380
+معانا Lagos Thomas هو عبارة عن اش عدم اطباق او
+
+982
+01:00:23,380 --> 01:00:27,140
+inability of eye closure بشكل كله عدم اطباق الجفن
+
+983
+01:00:27,140 --> 01:00:29,920
+العيوني مع الجفن السفلي بشكل كله يعني زي ما احنا
+
+984
+01:00:29,920 --> 01:00:32,700
+.. زي ما ذكرنا احنا بلغة عامية احنا بنحكي no ash
+
+985
+01:00:32,700 --> 01:00:37,060
+أو no مغزال يعني في عندي فج و لسه ما زالتهذه
+
+986
+01:00:37,060 --> 01:00:42,320
+الفجوة إذا كانت كبيرة ممكن تحدثلي severe ih درع
+
+987
+01:00:42,320 --> 01:00:46,260
+يعني، صحيح؟ بشكل كبير، فعندي ظاهرة ال pill هذه أو
+
+988
+01:00:46,260 --> 01:00:48,300
+ال pills في النوم اللي هي ظاهرة في السيولوجيا من
+
+989
+01:00:48,300 --> 01:00:52,380
+عكس لإرادة تحدث عند الإنسان للحفاظ على القرانية أو
+
+990
+01:00:52,380 --> 01:00:55,760
+الحفاظ علىعدم حدوث إتفاق القرنية وتصير في عندي
+
+991
+01:00:55,760 --> 01:00:59,200
+upward rotation of the eyeball during sleep حتى في
+
+992
+01:00:59,200 --> 01:01:02,720
+وقت النوم الفرق ما بينها ما بين المثال اللي احنا
+
+993
+01:01:02,720 --> 01:01:06,080
+ذكرناها قبل شوية عند الأطفال ان هدولها مثلنا عند
+
+994
+01:01:06,080 --> 01:01:08,940
+النوم فقط يعني مافيش عندي closure of the eyelids
+
+995
+01:01:08,940 --> 01:01:11,700
+صحيح؟ ال eyelids عندي منبسط طبيعي جدا مافيش عندي
+
+996
+01:01:11,700 --> 01:01:14,260
+closure لكن في عندي عدم إطباق الإطباق اللي عندي
+
+997
+01:01:14,260 --> 01:01:17,400
+ماحدثش إياش بشكل كله أو نغلط لجفن العلم على جفن
+
+998
+01:01:17,400 --> 01:01:23,750
+الصفلية في أننا هناخد بعض الأمثلة فقطاللي تعكس
+
+999
+01:01:23,750 --> 01:01:27,810
+لشيء مضارب في ال sociology اللي احنا درسناه مادام
+
+1000
+01:01:27,810 --> 01:01:30,930
+احنا درسنا في sociology of the eyelid واهتمين بشكل
+
+1001
+01:01:30,930 --> 01:01:33,850
+هذا واتكلمنا على التشريح و ال innovation of the
+
+1002
+01:01:33,850 --> 01:01:37,010
+muscles و اتكلمنا ايضا على ال origin و ال
+
+1003
+01:01:37,010 --> 01:01:40,030
+insertion of each muscle معناه ان في اندي حاجات
+
+1004
+01:01:40,030 --> 01:01:43,230
+بصر وجه بتأثر عليها اللي تركي احنا درسناها مبين ان
+
+1005
+01:01:43,230 --> 01:01:46,250
+هذه الأشياء احنا ناخد few examples اول شي في عندى
+
+1006
+01:01:46,250 --> 01:01:51,350
+skin laxity شو هي laxity؟مرولة أو رخاوة صحيح لكن
+
+1007
+01:01:51,350 --> 01:01:58,090
+هذه الرخاوة فوق الحد الطبيعي او اترحلت بهذا المعنى
+
+1008
+01:01:58,090 --> 01:02:00,850
+the skin laxity associated with Asian causes
+
+1009
+01:02:00,850 --> 01:02:04,650
+dermatocalysis هذا تعريف بنا يعرفه معانا
+
+1010
+01:02:04,650 --> 01:02:09,090
+dermatocalysis معناهاIt's the identity of the
+
+1011
+01:02:09,090 --> 01:02:11,370
+superior eyelid فطبعا معناته على الصورة اللي هال
+
+1012
+01:02:11,370 --> 01:02:14,790
+إيش فيه عنده؟ فيه عنده ال eyeball طبيعية صحيح أو
+
+1013
+01:02:14,790 --> 01:02:17,610
+كما تفضل الصورة هي طبيعية لكن فيه عنده ال upper
+
+1014
+01:02:17,610 --> 01:02:21,950
+eyelid في الناحيتين إيش فيه عنده؟ و كأنه أصبح فيه
+
+1015
+01:02:21,950 --> 01:02:25,030
+عنده torsus لكن هو حق ترامبر مش torsus هو الجزء
+
+1016
+01:02:25,030 --> 01:02:28,390
+العلوي من ال superior eyelid هو الجزء العلوي من ال
+
+1017
+01:02:28,390 --> 01:02:31,190
+superior scale of the superior eyelid جزء العلوي
+
+1018
+01:02:31,190 --> 01:02:33,130
+من ال superior scale of the superior eyelid فيه
+
+1019
+01:02:33,130 --> 01:02:36,220
+عنده إستدالةهذه الحالة احنا نسميها طبعا تابعة ال
+
+1020
+01:02:36,220 --> 01:02:38,840
+aging process هي مش مرضية تابعة ال aging process
+
+1021
+01:02:38,840 --> 01:02:41,480
+طبعا ممكن أيضا تكون بسبب مرضي لكن بالحالة هذه لأ
+
+1022
+01:02:41,480 --> 01:02:44,580
+هي طبيعية يعني بسبب تقدم السن بتحسس في عنده
+
+1023
+01:02:44,580 --> 01:02:47,300
+تراحولات في ال superior eye بالذات عنده obey's
+
+1024
+01:02:47,300 --> 01:02:50,320
+people يعني بالذات اللي قصدهم ما عندهم السمنة
+
+1025
+01:02:50,320 --> 01:02:54,020
+صحيح؟ او في عندهم وزن فائق فالحالة هذه بتحسس تفي
+
+1026
+01:02:54,020 --> 01:02:58,120
+عند حد يسميها dermatocalysis تماما زي في حالة ال
+
+1027
+01:02:58,120 --> 01:03:02,210
+conjunctivocolisis ماعنى conjunctivocolysis؟نفس
+
+1028
+01:03:02,210 --> 01:03:05,050
+الشيء محدث في الدامة، في الدام هلأ، في الconjectum
+
+1029
+01:03:05,050 --> 01:03:08,050
+نفس الشيء، حالك فيه عيلة تروح و ترجع، حتى تخرج
+
+1030
+01:03:08,050 --> 01:03:13,610
+خارج العيلة، طيب، هذه الحالة بيسميها احنا أيضا
+
+1031
+01:03:13,610 --> 01:03:18,210
+pseudoplepharotosis، هل بيسميها تقسس؟ شو تعرف انها
+
+1032
+01:03:18,210 --> 01:03:19,430
+تقسس يعني بشكل مختصر؟
+
+1033
+01:03:24,050 --> 01:03:27,970
+طيب انا لو حدث في عندي مشكلة في ال amygdala از
+
+1034
+01:03:27,970 --> 01:03:31,170
+ماصل او muscle of amygdala ليه اصلا؟ رح ينزل تنملي
+
+1035
+01:03:31,170 --> 01:03:34,550
+رح ينزل تنملي هذي ارتبط process ولا لا؟ هذي ارتبط
+
+1036
+01:03:34,550 --> 01:03:37,590
+جزء صح؟ لكن full process complete process متى يحدث
+
+1037
+01:03:37,590 --> 01:03:40,370
+عندى؟ لمّا يجرب اللي بيبقى اللي اثر على الصغير
+
+1038
+01:03:40,370 --> 01:03:43,390
+اللي بيبقى اللي بيبقى اللي بيبقى اللي بيبقى اللي
+
+1039
+01:03:43,390 --> 01:03:44,070
+بيبقى اللي بيبقى اللي بيبقى اللي بيبقى اللي بيبقى
+
+1040
+01:03:44,070 --> 01:03:45,790
+اللي بيبقى اللي بيبقى اللي بيبقى اللي بيبقى اللي
+
+1041
+01:03:45,790 --> 01:03:52,820
+بيبقى اللي بيبقى اللاحنا بنتنبأ تقريب ايش و عندهم
+
+1042
+01:03:52,820 --> 01:03:55,840
+مشكلة؟
+
+1043
+01:03:55,840 --> 01:03:59,220
+اكيد؟
+
+1044
+01:03:59,220 --> 01:04:03,000
+ممكن الحدث عنده يكون دمار او damage لل liver or
+
+1045
+01:04:03,000 --> 01:04:06,300
+muscle كلها ككل او يكون في عنده superior division
+
+1046
+01:04:06,300 --> 01:04:11,020
+او دفاع الكرينال في عنده ايش damageو بوضح اللي
+
+1047
+01:04:11,020 --> 01:04:14,500
+اكتر في كتير من الحلقات هذه احنا بشوفها بشكل طبعا
+
+1048
+01:04:14,500 --> 01:04:17,840
+مش يومي لأ بشكل نادر لكن هي موجودة حتى يحدث عنده
+
+1049
+01:04:17,840 --> 01:04:22,960
+بنفس الوقت في عند ال mad racers شو يعني؟ اه عند ال
+
+1050
+01:04:22,960 --> 01:04:25,820
+.. ال pupil عنده متوسع صاح بدون استخدام اي علاجات
+
+1051
+01:04:26,360 --> 01:04:29,060
+الـ pupil أصلا عند ال .. ال .. الـ sphincter مصر
+
+1052
+01:04:29,060 --> 01:04:32,120
+من ورا عندها ال innovation من ال parasympathetic
+
+1053
+01:04:32,120 --> 01:04:35,220
+صح اللي هو أصلا جاي من ال oculomotor nerve فأصبح
+
+1054
+01:04:35,220 --> 01:04:38,100
+في عندي .. حيكون في عندي encidalage في العلوي و
+
+1055
+01:04:38,100 --> 01:04:40,980
+أصبح في عندي dilatation of the pupil هذا كله عائد
+
+1056
+01:04:40,980 --> 01:04:46,700
+علاش اللي هو oculomotor nerve destruction ففي عند
+
+1057
+01:04:46,700 --> 01:04:49,400
+التعريف هذا أيضا أحنا نعرفه known as صدوة إيش
+
+1058
+01:04:49,400 --> 01:04:53,160
+معاها الصدوة؟ زئف غير حقيبت صحيح صدوة
+
+1059
+01:04:53,160 --> 01:04:57,510
+plepharoptosis plepharoptosis مش معناهابالجثن
+
+1060
+01:04:57,510 --> 01:05:00,090
+العين، آية اللى بقى إيه اسمها الـ plephara، صحيح؟
+
+1061
+01:05:00,090 --> 01:05:04,390
+torsus اللى هو صدق، الـ torus أصلا هم ممكن يسموه
+
+1062
+01:05:04,390 --> 01:05:07,550
+plepharotosis بالحالة الطبيعية، لكن هذا صدق
+
+1063
+01:05:07,550 --> 01:05:10,870
+plepharotosis يعني غير حقيقي، تابع على أو يعني
+
+1064
+01:05:10,870 --> 01:05:15,560
+السبب تبعه إنسدالطبقة الجلدية العلوية من اللي هو
+
+1065
+01:05:15,560 --> 01:05:18,540
+الجفن العلوي لكن عند ال lid margin هل في عندنا
+
+1066
+01:05:18,540 --> 01:05:22,420
+صداق طالع عليه هذا تقريبا طالع الصورة هذه هل هي
+
+1067
+01:05:22,420 --> 01:05:25,660
+lid margin تقريبا طبيعي صح ولا لأ لكن هو مايعيق ال
+
+1068
+01:05:25,660 --> 01:05:28,480
+visual function أو بصدق ال visual access اللي هو
+
+1069
+01:05:28,480 --> 01:05:33,860
+إيش ال upper eyelid بسبب increased laxity في عندى
+
+1070
+01:05:33,860 --> 01:05:36,760
+ترحولات أو رخاوة زايدة ل ال skin of the upper
+
+1071
+01:05:36,760 --> 01:05:39,600
+eyelid هناخد المثال رقم أربعة
+
+1072
+01:05:44,390 --> 01:05:48,150
+هناخد مثال رقم 4 من ال agent تقدم العمر طبعا عادى
+
+1073
+01:05:48,150 --> 01:05:51,910
+agent process هى الطبيعى horizontal led laxity may
+
+1074
+01:05:51,910 --> 01:05:57,410
+cause ectropion او انترابيون اش معاك اكترابيون طب
+
+1075
+01:05:57,410 --> 01:06:02,260
+حد لاحظ في كل الناس لأ في فئة معينة من الناسكان في
+
+1076
+01:06:02,260 --> 01:06:05,340
+عندها اسم مسبق ان في حالة ال .. في التهابات في ..
+
+1077
+01:06:05,340 --> 01:06:07,940
+في مرض معين و جفن العين ممكن يحدثلي بشكل طرد لكن
+
+1078
+01:06:07,940 --> 01:06:11,180
+ايضا في بعض الناس بسبب aging process ممكن يحدثليه
+
+1079
+01:06:11,180 --> 01:06:15,580
+يعني فقط السبب الوحيد هو تقدم السن عند شخص معين في
+
+1080
+01:06:15,580 --> 01:06:18,540
+السبعينات او في التامينات ممكن يحدثلي حاجة اسمها
+
+1081
+01:06:18,540 --> 01:06:22,780
+ectropion او entropion طلع عليهاهدي اللي حاول
+
+1082
+01:06:22,780 --> 01:06:26,920
+اعيش، هدي اللي هنا، هين أصبح الجفن بحالة طبيعية
+
+1083
+01:06:26,920 --> 01:06:30,080
+مفروض يلتقى ال margins of the lower eyelid مع ال
+
+1084
+01:06:30,080 --> 01:06:32,720
+margins of the upper eyelid، صحيح؟ حتى اللي ما
+
+1085
+01:06:32,720 --> 01:06:37,240
+عمليتاش تتبقى، صح ولا لا؟ لكن هار فيه يندي انا، مش
+
+1086
+01:06:37,240 --> 01:06:41,020
+هندي، أصبح فيه يندي الجفن السفلي معرض exposed to
+
+1087
+01:06:41,020 --> 01:06:43,900
+the outer environment، معرض يعيش للبيئة الخارجية،
+
+1088
+01:06:43,900 --> 01:06:47,420
+طبعا ممكن يعمل التهابات و بكتير الاخرينفي حالة
+
+1089
+01:06:47,420 --> 01:06:54,260
+أخرى سنجد أن الدموع
+
+1090
+01:06:54,260 --> 01:06:58,620
+يذهب إلى الخارج المفروض بالشكل الطبيعي الاتصاق
+
+1091
+01:06:58,620 --> 01:07:03,640
+الماجن مع كرة العين سيسهل الخروج أو التخلص من هذه
+
+1092
+01:07:03,640 --> 01:07:06,440
+الدموع عبر إيش ال punctum لكن مازالت عند ال
+
+1093
+01:07:06,440 --> 01:07:08,280
+punctum طالع مثل ما نشاهده في الصورة هذه ال
+
+1094
+01:07:08,280 --> 01:07:11,420
+punctum أصلا معرض للخارج بالتالي ال eyelid هذه لن
+
+1095
+01:07:11,420 --> 01:07:14,950
+تدخل داخل ال lacrimal systemفاقفوا إلى الخارج
+
+1096
+01:07:14,950 --> 01:07:18,630
+نلاقي الإنسان دايما في دموع تساقط لكن مافيش عنده
+
+1097
+01:07:18,630 --> 01:07:21,750
+لا حزن ولا كأب ولا في عنده أي التهابات فقط السبب
+
+1098
+01:07:21,750 --> 01:07:25,570
+الوحيد هو إيش اكتروبيان اكتروبيان هو انقلاب أو
+
+1099
+01:07:25,570 --> 01:07:31,330
+حركة الجفن السفلي إلى إيش الخارج عكس انتروبيان
+
+1100
+01:07:31,330 --> 01:07:39,130
+الانتروبيان هو حركة الجفن إلى إيش داخل العين طيب
+
+1101
+01:07:39,130 --> 01:07:43,010
+هناخد في عندك كمان ظاهرتينيعني اللي لازمة الأولى
+
+1102
+01:07:43,010 --> 01:07:46,510
+اللي هي Horner's Syndrome، Horner's Syndrome اللي
+
+1103
+01:07:46,510 --> 01:07:49,330
+متلاعب بالهورنا، هل لها علاقة بالمحصولة بالهورنا؟
+
+1104
+01:07:49,330 --> 01:07:52,410
+لأ ملاقاش، بس صدفة أنه نفس الاسم أو نفس العالم،
+
+1105
+01:07:52,410 --> 01:07:55,790
+لكن يشيء مختلف تماما عن Horner's Syndrome. It's a
+
+1106
+01:07:55,790 --> 01:07:58,550
+clinical triad between العترامياضي، Tuosis and
+
+1107
+01:07:58,550 --> 01:08:00,410
+anhidrosis
+
+1108
+01:08:01,910 --> 01:08:05,090
+مايحدث اننا في المتلازم تحولنا .. قبل ما نتكلم عن
+
+1109
+01:08:05,090 --> 01:08:08,750
+المتلازم تحولنا نعرف ان احنا اتكلمنا على ال upper
+
+1110
+01:08:08,750 --> 01:08:11,870
+eyelid retractors صحيح؟ اللي هو meullars muscle او
+
+1111
+01:08:11,870 --> 01:08:15,170
+muscle of ال meullar في عندنا ال levator صحيح؟
+
+1112
+01:08:15,170 --> 01:08:18,050
+مدان فيه عنده incidal معناته ان لمدة الأمر انه بخص
+
+1113
+01:08:18,050 --> 01:08:21,470
+اما ال levator muscle او .. او meullar syndrome او
+
+1114
+01:08:21,470 --> 01:08:24,930
+meullar muscle او بقصة في دمه صحيح؟ في عند .. في
+
+1115
+01:08:24,930 --> 01:08:27,330
+عندنا incidal في أي عين؟ في اليمين ولا في اليسار؟
+
+1116
+01:08:27,330 --> 01:08:31,830
+في اليمين ده بيحصل في اليمينهذا اليمين اه؟ هذا
+
+1117
+01:08:31,830 --> 01:08:38,210
+اليمين هل ال install كله عندي هنا؟ هذا اليمين، هذا
+
+1118
+01:08:38,210 --> 01:08:40,850
+اليمين طبعا عليها هل انا باعقبهم اليمين؟ هاي
+
+1119
+01:08:40,850 --> 01:08:44,850
+اليمين، خلاص، عصمه نفس الشي طيب، خلّيكم معاه،
+
+1120
+01:08:44,850 --> 01:08:48,150
+الinstall عندك في اليمين، هل هو كامل؟مش كامة
+
+1121
+01:08:48,150 --> 01:08:50,830
+تقريبا في عندي اكتر من اثنين من اللي نازلة صح ولا
+
+1122
+01:08:50,830 --> 01:08:54,350
+لا فهد .. هل في عندي meiosis انا انا عارف في عندي
+
+1123
+01:08:54,350 --> 01:08:57,850
+mediasis لو I ل ال people تقريبا متساوي مع ال
+
+1124
+01:08:57,850 --> 01:09:01,990
+other I صحيح ففي عندي هد متلازمة كليكية اللي هتلت
+
+1125
+01:09:01,990 --> 01:09:05,990
+خصائص الخاصية الأولى في عندي meiosis meiosis إيش
+
+1126
+01:09:05,990 --> 01:09:10,210
+يعني بؤبة في عندي مضايقة صحيح الخاصية التانية
+
+1127
+01:09:10,210 --> 01:09:13,070
+tosis في عندي إنسدار لجفن العين لكن الإنسدار هد
+
+1128
+01:09:13,070 --> 01:09:19,510
+جزء .. جزء مبسطالخاصية التالتة في عند العين او
+
+1129
+01:09:19,510 --> 01:09:23,750
+الجهة المصابة في انهيدروسس اللى هو جفاف البشرة
+
+1130
+01:09:23,750 --> 01:09:30,110
+مافيش عندى ال sweat glands او الغدد العرقية لا
+
+1131
+01:09:30,110 --> 01:09:33,730
+تعمل في نفس الجهة المصابة هذه عبارة عن متلازمة هنا
+
+1132
+01:09:33,730 --> 01:09:37,750
+و السبب الرئيسي وراها طبعا هو عبارة عن sympathetic
+
+1133
+01:09:37,750 --> 01:09:41,780
+pathwayبالتالي في عند ال muscles أساس ال
+
+1134
+01:09:41,780 --> 01:09:44,160
+innervation لها هو عبارة عن sympathetic
+
+1135
+01:09:44,160 --> 01:09:48,040
+innervation إذا لو أصبح في نفس الباثوري حالة تم
+
+1136
+01:09:48,040 --> 01:09:52,520
+تدميره بسبب همرج معين نصيف أو نيو بلازم أو ضربة
+
+1137
+01:09:52,520 --> 01:09:56,280
+معينة طبعا المسئول على هذا ال sympathetic pathway
+
+1138
+01:09:56,280 --> 01:09:59,320
+هي superior cervical sympathetic pathway هناخدها
+
+1139
+01:09:59,320 --> 01:10:01,980
+في مبعد ان شاء الله لو تم إلها التلف بالتالي ال
+
+1140
+01:10:01,980 --> 01:10:05,340
+muscles لها هيحصل ارتخاء ارتخاء ال muscles لها
+
+1141
+01:10:05,340 --> 01:10:06,080
+هيحصل ارتخاء ارتخاء ال muscles لها هيحصل ارتخاء
+
+1142
+01:10:06,080 --> 01:10:06,120
+ارتخاء ال muscles لها هيحصل ارتخاء ارتخاء ال
+
+1143
+01:10:06,120 --> 01:10:07,260
+muscles لها هيحصل ارتخاء ارتخاء ال muscles لها
+
+1144
+01:10:07,260 --> 01:10:08,040
+هيحصل ارتخاء ارتخاء ال muscles لها هيحصل ارتخاء
+
+1145
+01:10:08,040 --> 01:10:10,340
+ارتخاء االلي هو بده يتعود لبدالة ما احنا حكينا
+
+1146
+01:10:10,340 --> 01:10:12,620
+دميوز مصر بدها تشارك بال two millimeters
+
+1147
+01:10:12,620 --> 01:10:15,000
+additional of elevation، ال two millimeters هدولة
+
+1148
+01:10:15,000 --> 01:10:17,700
+هيفقدوه، فبالتالة حاسس ان في عنده flexation او
+
+1149
+01:10:17,700 --> 01:10:21,380
+رخابة فالجفن العلوي بده يشارك فيها عيش، اللي هو ان
+
+1150
+01:10:21,380 --> 01:10:26,310
+سدها الجفن لكن مش أكل جزيفيه أندي أخر شيء أو أخر
+
+1151
+01:10:26,310 --> 01:10:30,810
+مثال هو pleural spasm، pleural تابع للآلة دائما،
+
+1152
+01:10:30,810 --> 01:10:34,770
+spasm مش معناها تشنر، صحيح؟ ال pleural spasm لها
+
+1153
+01:10:34,770 --> 01:10:38,470
+أقسام كثيرة، احنا هناخدها لك بشكل بسيط، هناخد منها
+
+1154
+01:10:38,470 --> 01:10:41,630
+ال benign، عزيزي ما احنا شايفين، benign essential
+
+1155
+01:10:41,630 --> 01:10:44,710
+pleural spasm، يعني هذا ال pleural spasm مش تابع
+
+1156
+01:10:44,710 --> 01:10:49,870
+لأي مرض، هنجد هذا ال pleural spasm في حالة الأطفال
+
+1157
+01:10:50,420 --> 01:10:53,780
+كتير يعني متمدد علينا بعض الأحالي و لإنه الطفل
+
+1158
+01:10:53,780 --> 01:10:56,880
+اللي عندى او الطفلة بتمضي عنا بشكل .. بشكل هادا،
+
+1159
+01:10:56,880 --> 01:11:00,660
+بشكل صريح، صحيح؟ لأ يا بعضى، و حيانا بيكون في بعض
+
+1160
+01:11:00,660 --> 01:11:03,880
+التهابات و حيانا ان حد يسمى ايه دلوقت يعنى غير
+
+1161
+01:11:03,880 --> 01:11:07,230
+معروف السبب، بالعنية دلوقت احنا بسميه primeمع تقدم
+
+1162
+01:11:07,230 --> 01:11:10,850
+السن ممكن الإنسان إيش يتخلص من هذه الحالة، طبعا
+
+1163
+01:11:10,850 --> 01:11:15,150
+إيه موضوع خاص أو آخر حاجة نتكلم عنه؟ الجديد بالذكر
+
+1164
+01:11:15,150 --> 01:11:18,950
+هنا إنه كلما زاد الإنسان عنده stress أو الأطفال،
+
+1165
+01:11:18,950 --> 01:11:22,650
+إحنا نلاحظ عليه هو بشكل ملحوظ أو نبهه إنه ماتعملش
+
+1166
+01:11:22,650 --> 01:11:26,230
+.. ماتعملش أشياء تحاسف عنده أو تتفعل، معاكسة حيث
+
+1167
+01:11:26,230 --> 01:11:29,110
+زاد عنده اللي هو ال .. ال contraction of the
+
+1168
+01:11:29,110 --> 01:11:33,900
+island بشكل إيشأو ب rate ومعدة أكتر لإنه أصلا ال
+
+1169
+01:11:33,900 --> 01:11:36,920
+munus muscle بتماشي لإن ال person تبقى حقا ماشي
+
+1170
+01:11:36,920 --> 01:11:39,940
+sympathetic صحيح؟ اللي هو أصلا مسئول على الخوف و
+
+1171
+01:11:39,940 --> 01:11:42,360
+الدعوة و الاخرين، فلو احنا لما بحنا الإنسان بكثرة
+
+1172
+01:11:42,360 --> 01:11:45,480
+التنبيه هذا و القلق اللي حدث عند الطفل، بالتالي
+
+1173
+01:11:45,480 --> 01:11:48,740
+حالة اللي هو ال .. ال difference balance محزدي
+
+1174
+01:11:48,740 --> 01:11:52,680
+عنده أثناء القلقهذا بالنسبة الأخر مثال اللي احنا
+
+1175
+01:11:52,680 --> 01:11:57,240
+هناخده في ال IELTS، في عندك أي أسئلة، ان شاء الله
+
+1176
+01:11:57,240 --> 01:12:00,420
+هيكم كلنا خلصنا في theology of the IELTS ككل، و
+
+1177
+01:12:00,420 --> 01:12:03,760
+نتابع المحاضرات التانية في باقي المحاضرات، في عندك
+
+1178
+01:12:03,760 --> 01:12:09,700
+أي سؤال؟ فضل كيف يفضل مدرسة الجامعة في العام؟ كيف
+
+1179
+01:12:09,700 --> 01:12:12,080
+يفضل مدرسة الجامعة في العام؟
+
+1180
+01:12:16,080 --> 01:12:18,940
+طيب هو احنا حكينا عن تشفاف العين ماتكلمش عنه كمرض
+
+1181
+01:12:18,940 --> 01:12:22,180
+و لا تكلمنا عنه كعلاج احنا حكينا لبلين كينك ..ماشي
+
+1182
+01:12:22,180 --> 01:12:26,180
+لحاجة لبلين كينك بده يزودلي أو يوزعلي ال tear film
+
+1183
+01:12:26,180 --> 01:12:29,260
+بشكل متساوي على كل أنحاء القرنية و أيضا ال
+
+1184
+01:12:29,260 --> 01:12:35,460
+conjunctiva الشخص اللي عنده ال dry eye اخد أعراضة
+
+1185
+01:12:35,460 --> 01:12:40,460
+حيث شرب الحرقال أو الاحتكاك الخشونة أثناء قفل و
+
+1186
+01:12:40,460 --> 01:12:47,050
+فتح العين يعني بشكل بسيط سؤال أخر؟طيب يعطيكوا
+
+1187
+01:12:47,050 --> 01:12:48,350
+الحكاية شكرا جزيلا
+
diff --git a/PL9fwy3NUQKwZ2K6wMRTZMEoGVTbELxinF/WdvxTuIS2DA_raw.srt b/PL9fwy3NUQKwZ2K6wMRTZMEoGVTbELxinF/WdvxTuIS2DA_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..8f734f5d0546684a47a0c09fdae929945ba977a1
--- /dev/null
+++ b/PL9fwy3NUQKwZ2K6wMRTZMEoGVTbELxinF/WdvxTuIS2DA_raw.srt
@@ -0,0 +1,2892 @@
+1
+00:00:20,550 --> 00:00:24,750
+طيب السلام عليكم ورحمة الله وبركاته، نشارككم اليوم
+
+2
+00:00:24,750 --> 00:00:27,950
+ان شاء الله في محاضرة جديدة على physiology of the
+
+3
+00:00:27,950 --> 00:00:31,330
+retina، العملاء الحيوي اللي بتحدث في شبكية العين
+
+4
+00:00:31,330 --> 00:00:36,710
+وبدأ هميل شبكية العين في رؤية عند الإنسانأعتقد
+
+5
+00:00:36,710 --> 00:00:39,230
+يعني بعد إحنا اتكلمنا عنه بشكل كبير، في أكتر من
+
+6
+00:00:39,230 --> 00:00:42,290
+المحاضرة، في الأجهزة اتكلمنا عنه، في الأجهزة B
+
+7
+00:00:42,290 --> 00:00:45,270
+أيضا اتكلمنا عنه، visual field اتكلمنا عنه بشكل
+
+8
+00:00:45,270 --> 00:00:48,890
+مفصل، صحيح؟ فحناخد مقادرة بسيطة، بتشوفوا إحنا ايضا
+
+9
+00:00:48,890 --> 00:00:54,150
+أخدتوا بشكل أفضل من المناطق المذكورة التشريحية في
+
+10
+00:00:54,150 --> 00:00:57,850
+الكتاب معاكم، فحنمرح عليها يعني بشكل سريع إن شاء
+
+11
+00:00:57,850 --> 00:01:02,680
+الله، تمام؟أول شيء our eyes are marvellous sense
+
+12
+00:01:02,680 --> 00:01:06,800
+organs that allows us to appreciate all beauty of
+
+13
+00:01:06,800 --> 00:01:11,440
+the world we live in مش هنتبق لكل نقطة بالتفصيل
+
+14
+00:01:11,440 --> 00:01:16,800
+لكن المعروف أن الإنسان يعني يحصل على كل
+
+15
+00:01:16,800 --> 00:01:20,600
+معلومات اللي يحصل عليها أثناء حياته تقريبا فوق 95%
+
+16
+00:01:20,600 --> 00:01:24,540
+عن طريق البصر صحيح عن طريق العين وبالتالي أهم جزء
+
+17
+00:01:24,540 --> 00:01:28,650
+حساس ونفسيه في ال marvellous رائعWonderful، أهم
+
+18
+00:01:28,650 --> 00:01:32,410
+حساس عندي و رائع جدا من خلال العمليات الحيوية اللي
+
+19
+00:01:32,410 --> 00:01:35,830
+تحدث فيه اللي هو المنطقة العصبية أو الطبقة العصبية
+
+20
+00:01:35,830 --> 00:01:39,210
+في شبكية العين اللي هي neuroscience الويتنا، صحيح؟
+
+21
+00:01:39,210 --> 00:01:42,570
+و احنا اتكلمنا قبل ذلك أن الويتنا تتجمد من طبقتين
+
+22
+00:01:42,570 --> 00:01:47,050
+pigmented epitheliaو ال neurosincerity اللي هي
+
+23
+00:01:47,050 --> 00:01:50,590
+الطبقة العصبية فأهم طبقة عندى في كورة العين كلها
+
+24
+00:01:50,590 --> 00:01:54,310
+تقريبا هي الطبقة العصبية لإن أي طبقة ممكن تجديدها
+
+25
+00:01:54,310 --> 00:01:58,490
+ممكن تغلب عليها سواء جراحيا أو درايا بلما الطبقة
+
+26
+00:01:58,490 --> 00:02:01,330
+العصبية صعب جدا تجديدها لإن الخلايا العصبية من
+
+27
+00:02:01,330 --> 00:02:05,410
+إحدى صفاتها أو خصائصها أنها لاتت جدا صحيح فبالتالي
+
+28
+00:02:05,410 --> 00:02:09,570
+أيضا يحدث لخلايا العصبية في شركية العين أشبكت لها
+
+29
+00:02:09,570 --> 00:02:14,320
+صعب جدا أنه يرجع كما كانبالذات لو كان فيه قد التلف
+
+30
+00:02:14,320 --> 00:02:17,920
+هذا عبارة عن ثقب كبير او ثقب في مركز الإبصار او
+
+31
+00:02:17,920 --> 00:02:20,540
+ابتلف يعني ابتلف هذا السبب اللي فيه غياب بعض
+
+32
+00:02:20,540 --> 00:02:24,120
+الخلايا وبالتالي صعب جدا انه ماعيش الجسم يحاول
+
+33
+00:02:24,120 --> 00:02:28,440
+يعود عليهم لكن الجسم او الشبكية هتعمل على تعويض
+
+34
+00:02:28,440 --> 00:02:32,400
+المنطقة لتنصب إتها لكن الخلايا هتصبح عنده ماعيش اي
+
+35
+00:02:32,400 --> 00:02:37,660
+وظيفة في السلوكية كما سبق فنتطبق ايضا فيفي
+
+36
+00:02:37,660 --> 00:02:39,780
+محاضرتنا عن اللي هو ال photoreceptors أو
+
+37
+00:02:39,780 --> 00:02:43,020
+المستقبلات الضوئية، بس كلهم احنا اكتر من مرة في
+
+38
+00:02:43,020 --> 00:02:46,380
+المعمل و في المحاضرات الأخرى عن اللي هو ال
+
+39
+00:02:46,380 --> 00:02:49,160
+photoreceptors اللي يتنقسم إلى road و cause و ال
+
+40
+00:02:49,160 --> 00:02:53,740
+cause يتنقسم إلى ثلاثة
+
+41
+00:02:53,740 --> 00:02:57,980
+أنواع أخرى، ال long, mid, short, cause، تابعا
+
+42
+00:02:57,980 --> 00:03:03,720
+لنسبة انتصاص الأمواج أو الطيبن لغاية المرء في هذا
+
+43
+00:03:03,720 --> 00:03:04,220
+ال receptor
+
+44
+00:03:07,210 --> 00:03:10,770
+طب هنتكلم عن موقع اللي هو ال retina احنا عارفين ان
+
+45
+00:03:10,770 --> 00:03:13,450
+ال retina زى ما حكينا تقع في the innermost layer
+
+46
+00:03:13,450 --> 00:03:17,770
+يعني أكتر طبقة .. أبعد طبقة تقريبا في كورة العين و
+
+47
+00:03:17,770 --> 00:03:22,170
+الداخل هي طبقة شبكية صحيح؟ طبقة الشبكية نفسها
+
+48
+00:03:22,170 --> 00:03:25,630
+اتكون من منطقتين او من طبقتين دى ال neuroscience
+
+49
+00:03:25,630 --> 00:03:28,650
+of retina زي the brittle pigmented epithelium بس
+
+50
+00:03:28,650 --> 00:03:31,870
+لنمر على نفسي هذا بسرعة ده يوم ال retina
+
+51
+00:03:38,080 --> 00:03:44,080
+الغلاف الداخلي هو البرعان
+
+52
+00:03:44,080 --> 00:03:46,220
+اللي هو الطبقة العصبية اللي موجودة في كرة العين
+
+53
+00:03:46,220 --> 00:03:50,600
+والمقصود للطبقة العصبية اللي هو شبكية العين it's a
+
+54
+00:03:50,600 --> 00:03:54,270
+thin transparent and purple membraneفي عندى بعض
+
+55
+00:03:54,270 --> 00:03:57,870
+الخصائص شبكية العين تشريحيا طبعا خاصية أولا إنها
+
+56
+00:03:57,870 --> 00:04:00,950
+very thin كذلك يعني كباقي اللي هو موركبات كورة
+
+57
+00:04:00,950 --> 00:04:04,010
+العين لكن الشبكية على حد الخصوص extremely thin
+
+58
+00:04:04,010 --> 00:04:08,250
+يعني رقيقة بشكل كبير جدا عدد المحجم هذا الاسم
+
+59
+00:04:08,250 --> 00:04:10,830
+تقريبا إلى 100 micro يعني تقريبا واحد من عشرة ملي
+
+60
+00:04:10,830 --> 00:04:14,210
+متر والحجم هذا اللي بحط تحته خط لإن هو كل منطقة من
+
+61
+00:04:14,210 --> 00:04:16,250
+منطقة الشبكية في السبيرة في ال timbre في ال
+
+62
+00:04:16,250 --> 00:04:19,130
+enviera كلها تختلف باختلاع في thickness صحيح أو de
+
+63
+00:04:19,130 --> 00:04:24,040
+sclera أو ما شاء اللهفحنلاقي جذبتنا سميكة جدا ما
+
+64
+00:04:24,040 --> 00:04:26,320
+حولها اللي هو ال optic disc اللي هو هنا في ندي
+
+65
+00:04:26,320 --> 00:04:29,920
+أكبر تجمع للألياف العصبية من كل نواحي الشبكية،
+
+66
+00:04:29,920 --> 00:04:33,560
+صحيح؟ بينما الأرق هتكون قريبا من الأورا السبعة و
+
+67
+00:04:33,560 --> 00:04:37,860
+الاخرين هو اقل انطقاء ده في ندي موجود بالفوغيا،
+
+68
+00:04:37,860 --> 00:04:41,680
+صحيح؟ extremely thin طيب، نجح من الأخرى،
+
+69
+00:04:41,680 --> 00:04:46,070
+transparent هل الشبكية فلا شفافة؟الشبكية الشفافة
+
+70
+00:04:46,070 --> 00:04:49,110
+طب وجود ال block visas هنا حتى مع وجود ال block
+
+71
+00:04:49,110 --> 00:04:52,310
+visas الشبكية شفافة لكن اللون هذا اللي احنا بنشوفه
+
+72
+00:04:52,310 --> 00:04:55,030
+اللحنه هو عباره عن الكورول صحيح؟ او من ال little
+
+73
+00:04:55,030 --> 00:04:58,830
+pigmented epithelium هو عباره عن اتجامع كثيف جدا
+
+74
+00:04:58,830 --> 00:05:02,390
+من الحبيبات اللي هو الصبغيات المتواجدة في little
+
+75
+00:05:02,390 --> 00:05:04,990
+pigmented epithelium أو حتى في الكورول زر كيب
+
+76
+00:05:04,990 --> 00:05:08,210
+اللون عنده اللي هو اللي بنحكيه كله معاه طيب purple
+
+77
+00:05:08,210 --> 00:05:12,070
+membrane مقصود في ال purple membrane هو صحيح؟شفاف
+
+78
+00:05:12,070 --> 00:05:16,810
+لكن شفاف ماقل ال ال breath سجينه معنّع نذكر احنا
+
+79
+00:05:16,810 --> 00:05:22,570
+ال اكتر ناس بيستشعروا هذه الخصائص الشبكية غير
+
+80
+00:05:22,570 --> 00:05:24,690
+الجراحين، طبعا الجراح بتعامل مع الشبكية بشكل
+
+81
+00:05:24,690 --> 00:05:28,790
+مباشر، ايضا اللي في المعمل بتعاملين على زراعة
+
+82
+00:05:28,790 --> 00:05:32,490
+الخلايا و التعامل مع الحيوانات، لدراسة أحوال
+
+83
+00:05:32,490 --> 00:05:38,250
+الشبكية من عدة مناطق حلاديإنه يعني لبس كل مرة و
+
+84
+00:05:38,250 --> 00:05:42,350
+احنا بنعمل قاعدين عملية معينة لقرب أجالك الله في
+
+85
+00:05:42,350 --> 00:05:45,690
+المعمل لدراسة الخلايا العصبية في الشباكية فعملنا
+
+86
+00:05:45,690 --> 00:05:48,710
+علاقات ان هو written in the artery مباشرة الشباكية
+
+87
+00:05:48,710 --> 00:05:52,270
+أصبح لونها عيش أبيض طب هى اللون أبيض الحليب لأ هى
+
+88
+00:05:52,270 --> 00:05:55,210
+اكتسبت لون اللى هو ال sclera الطبقة اللى تتاليها
+
+89
+00:05:55,210 --> 00:05:58,210
+لكن الحقيقة اللى عمرها لما نزعلها الشباكية شفافة
+
+90
+00:05:58,210 --> 00:06:03,130
+جدا قريب لونها او مائلة للون الأبيض البسيط لكن
+
+91
+00:06:03,130 --> 00:06:07,510
+بخاصيتها انهاشفافية، يعني لو وضعنا حاجز خلفها، بده
+
+92
+00:06:07,510 --> 00:06:10,790
+يبين لك تبع شفافيتها لا تصل إلى شفافية العدسة أو
+
+93
+00:06:10,790 --> 00:06:13,550
+شفافية اللي هو مقارنينها، لأنه بالنهاية هذه خلايا
+
+94
+00:06:13,550 --> 00:06:16,910
+عصبية متكتبة تحتوي على الكثير من الأنسجة التي لا
+
+95
+00:06:16,910 --> 00:06:22,280
+تحتوي عليها لا العدسة ولا حتى المقارنيةfrom part
+
+96
+00:06:22,280 --> 00:06:24,820
+of the central nervous system and extends from
+
+97
+00:06:24,820 --> 00:06:26,840
+parts of the planar anteriorly to the edges of the
+
+98
+00:06:26,840 --> 00:06:29,680
+optic nerve posteriorly فنعرف أن انتداد الشبكية
+
+99
+00:06:29,680 --> 00:06:34,380
+يبدأ أو يتبع اللي هو ال nerve fiber للـoptic nerve
+
+100
+00:06:34,380 --> 00:06:38,040
+نفسه، صحيح؟ فعندي تقريبا تمتد من الـorisserata، من
+
+101
+00:06:38,040 --> 00:06:41,380
+المنطقة الأمامية باتصالها مع اللي هو pigment
+
+102
+00:06:41,380 --> 00:06:45,130
+epithelium of the ciliary body، صحيح؟نهاية بالـ
+
+103
+00:06:45,130 --> 00:06:48,790
+Optic Disk وهذا يعني هو عبارة عن مخرج خارجي صحيح
+
+104
+00:06:48,790 --> 00:06:51,950
+تترك فيه الألياف العصبية إلى أن تتصل بالجهاز
+
+105
+00:06:51,950 --> 00:06:56,070
+العصبي وإذا انت فاكر حكينا احنا .. حكينا احنا
+
+106
+00:06:56,070 --> 00:06:58,990
+Center Nerve System ان الـ Optic Nerve هو التأبع
+
+107
+00:06:58,990 --> 00:07:02,470
+التصنيف الأساسي لكن هو سمى خطأ الـCranial Nerve
+
+108
+00:07:02,470 --> 00:07:04,910
+لكن حقق الأمر هو يرجع إلى انه الـCentral Nerve
+
+109
+00:07:04,910 --> 00:07:09,230
+دلوقت بعض المكونات المتواجدة فيه فقط متواجدة في
+
+110
+00:07:09,230 --> 00:07:12,190
+اللي هو الجهاز العصب المركزي مش الجهاز العصبي
+
+111
+00:07:12,190 --> 00:07:16,480
+الطرفيلذلك يعتبر الألياف العصبية هذه تابعة أو
+
+112
+00:07:16,480 --> 00:07:20,140
+شبكية تابعة مباشرة إلى الجهاز العصبي المركزي
+
+113
+00:07:20,140 --> 00:07:23,820
+بالنسبة للألقاب المكتوبة معانا، هم شهود طالبين
+
+114
+00:07:23,820 --> 00:07:28,520
+فيها each retina possesses about two million
+
+115
+00:07:28,520 --> 00:07:32,620
+neurons that is responsible for converting the
+
+116
+00:07:32,620 --> 00:07:34,480
+relevant information from the image of the
+
+117
+00:07:34,480 --> 00:07:37,350
+external environment into the neural impulsesthat
+
+118
+00:07:37,350 --> 00:07:40,310
+are transmitted to the brain for decoding and
+
+119
+00:07:40,310 --> 00:07:44,490
+analysis نرجع من الأخرى جداش تقريبا حجم أو عدد
+
+120
+00:07:44,490 --> 00:07:48,610
+الخلايا العصبية الموجودة في أوكتا كنيرف واحدطب
+
+121
+00:07:48,610 --> 00:07:53,830
+عليها تختلف باختلاف تقريبا
+
+122
+00:07:53,830 --> 00:07:56,130
+من تسعمائة ألف إلى مليار و متين ألف بعد دراسات
+
+123
+00:07:56,130 --> 00:07:58,830
+مليار و تلاتمية ألف يعني فيها ايضا اختلافات علاقية
+
+124
+00:07:58,830 --> 00:08:01,970
+اختلافات جسدية حتى بين ال male و بين ال female لكن
+
+125
+00:08:01,970 --> 00:08:05,250
+العمر مبثلش العمر هو متواجد يعني التغيير من نفس
+
+126
+00:08:05,250 --> 00:08:11,300
+الحاجة صحيح وانقلت الوظيفة فالاختلافات هذهيعني هي
+
+127
+00:08:11,300 --> 00:08:14,280
+بتحكس عدد الأليح العصبية و هي بتحكس أيضا عدد هاش
+
+128
+00:08:14,280 --> 00:08:16,940
+الخلايا العصبية، احنا لما نحكي خلايا العصبية في
+
+129
+00:08:16,940 --> 00:08:19,960
+الشبكية، نقصدش منها ال filter receptors وإن كان ال
+
+130
+00:08:19,960 --> 00:08:21,620
+filter receptors تعتبر خلايا عصبية very
+
+131
+00:08:21,620 --> 00:08:25,840
+specialized، يعني خاصة جدا، لو شفت العالم نقصد هاش
+
+132
+00:08:28,850 --> 00:08:31,850
+لو وصلنا لجهر جيجليونسيز هى نوصل لما نحكي الخلايا
+
+133
+00:08:31,850 --> 00:08:35,310
+العصبية نوصل فيها يعني بشكل بديهي يعني عبارة عن
+
+134
+00:08:35,310 --> 00:08:39,550
+جهر جيجليونسيز لذلك ممكن توصل الى 8 مليون خلية طب
+
+135
+00:08:39,550 --> 00:08:44,090
+فى بعض الناس الآخرين لأ ربما يعني على حسب العدد
+
+136
+00:08:44,090 --> 00:08:48,050
+اللى ولد فيها ولا تجدد ولا تتكاتر صحيح هى ثابتة
+
+137
+00:08:48,050 --> 00:08:51,150
+لكن اقصى شيء ممكن نوصل لعدد الأجار العصبية لوحدها
+
+138
+00:08:51,150 --> 00:08:55,710
+مليون و 200 او مليون تلاتمية الف اللى هو ال nerve
+
+139
+00:08:55,710 --> 00:09:00,990
+fibersطيب ما هي الموضوع في هذه الخلية العصبية؟ هنا
+
+140
+00:09:00,990 --> 00:09:05,750
+كلمتان، اللي عبارة عن decoding and analysis، بتعمل
+
+141
+00:09:05,750 --> 00:09:09,870
+على عملية يعني كل منارة بتتحول إلى نبضات عصبية، ثم
+
+142
+00:09:09,870 --> 00:09:13,670
+يتم توصيل نبضات عصبية هذه من الشبكية للعصب العاد،
+
+143
+00:09:13,670 --> 00:09:16,650
+ثم عبر مراحل أخرى حتى يصل إلى منطقة ال visual
+
+144
+00:09:16,650 --> 00:09:20,010
+cortex في الدماغ، صحيح؟واضيفة ال visual cortex في
+
+145
+00:09:20,010 --> 00:09:22,870
+الدماغ هي عبارة عن decoding يعني فاكة الشفرات هذه
+
+146
+00:09:22,870 --> 00:09:26,610
+اللي هي أصلا عبارة عن صورة حولت إلى نبوتات عصبية
+
+147
+00:09:26,610 --> 00:09:29,170
+ويتم استخبارها في الدماغ من ناحية ألوان من ناحية
+
+148
+00:09:29,170 --> 00:09:33,110
+أبعاد ثلاثية من ناحية visual functions ويتم أيضا
+
+149
+00:09:33,110 --> 00:09:37,590
+أيش decoding على سلسولتين بالتالي تحليلها والتحليل
+
+150
+00:09:37,590 --> 00:09:41,230
+المقصود فيها تحليلها من كل الأبعاد تحكي عدد خيار
+
+151
+00:09:41,230 --> 00:09:44,150
+عصبية في روتين ألف قطة سنتين مليون
+
+152
+00:09:46,810 --> 00:09:51,470
+بتم اليوم اه بتم اليوم عفوا طيب لأ موضوع انا جمع
+
+153
+00:09:51,470 --> 00:09:55,490
+جمع كل الخلايا العصبية كلها في انت كم خلايا ..
+
+154
+00:09:55,490 --> 00:09:59,450
+اكمل من الخلايا العصبية اللي هادى عندي؟ يعني ال
+
+155
+00:09:59,450 --> 00:10:09,470
+bipolar يعني ال horizontal شو هنا كمان؟ كلها شو
+
+156
+00:10:09,470 --> 00:10:15,630
+هنا؟ كلها الceptorsهذه المقصود هي خلايا عصبية في
+
+157
+00:10:15,630 --> 00:10:18,470
+الشبكات اللي هي المقصود فقط اللي هو adjacency أما
+
+158
+00:10:18,470 --> 00:10:21,550
+هذه كلها مش ثابتة طبعا صعب جدا تحديدها جدتاش بل
+
+159
+00:10:21,550 --> 00:10:23,970
+أنا لذا اتحدث عن القارة هذه مش متطلبين فيها صعب
+
+160
+00:10:23,970 --> 00:10:27,290
+جدا أن أحددها لإنها لعدد معين وهذه مش ثابتة بالذات
+
+161
+00:10:27,290 --> 00:10:31,670
+ما هي ليها يعني هذه كلها مش ثابتة
+
+162
+00:10:31,670 --> 00:10:36,450
+Consist of two layers ما هي طبقات الشبكية الشبكية
+
+163
+00:10:36,450 --> 00:10:41,690
+تكون بطبقتين أساسيتين طبقة داخليةوهي عبارة عن
+
+164
+00:10:41,690 --> 00:10:45,330
+Neurosensory retina طبقة خارجية عبارة عن
+
+165
+00:10:45,330 --> 00:10:49,290
+Neuroretinal Pigmented Epithelial أو RPE كلهم
+
+166
+00:10:49,290 --> 00:10:52,970
+بالكابتن فالأولى الداخلية اللي هي Neurosensory
+
+167
+00:10:52,970 --> 00:10:56,050
+retina أما الخارجية يعني مش شكلها أقارة العلم
+
+168
+00:10:56,050 --> 00:11:01,150
+صحيح؟ مافيه دلوقت كذا طبقة داخلية اللي هي
+
+169
+00:11:01,150 --> 00:11:05,930
+Neurosensory retinaبنما الخارجية اللى ملاسقة و
+
+170
+00:11:05,930 --> 00:11:10,510
+قريبة من ال sclera هى تسمى خارجية صحى اللى بتنبت
+
+171
+00:11:10,510 --> 00:11:14,770
+مينتل الفيسيليا between two layers there is a
+
+172
+00:11:14,770 --> 00:11:18,070
+potential space called subpertinal space مع بعض
+
+173
+00:11:18,070 --> 00:11:21,290
+اللى بتنبت مينتل الفيسيليا و مع بعض طبقة الناس
+
+174
+00:11:21,290 --> 00:11:25,510
+السورية اللى فيها عندهم مسافة او فجوة صحى هذه
+
+175
+00:11:25,510 --> 00:11:29,490
+المسافة اللى تسمح لبطاراكوم السائلالمسلسلين بتعتبر
+
+176
+00:11:29,490 --> 00:11:32,530
+ضعيفة طبعا، مافيش بينها بيانات كثيرة كثيرة في
+
+177
+00:11:32,530 --> 00:11:35,730
+الepithelia ومبينة طبقة عصبية، مش هبكات شديدة زي
+
+178
+00:11:35,730 --> 00:11:39,630
+تايت جانجيز الموجودة في الepithelia مفضة ال retina
+
+179
+00:11:39,630 --> 00:11:43,930
+او ال zonules او crude zonules، صحيح؟ لأ فهذه هشة،
+
+180
+00:11:43,930 --> 00:11:47,950
+لذلك سهل جدا يحدث عندي انفصال شبكة، صحيح؟ نفس
+
+181
+00:11:47,950 --> 00:11:50,770
+انفصال الشبكة اللي أخدنا احناالـ Ultrasound-B،
+
+182
+00:11:50,770 --> 00:11:53,530
+الفصال الشبكي عليه هو انحلال أو اتصال طبقة
+
+183
+00:11:53,530 --> 00:11:55,610
+الهوارتة اللي بيقول دي Epithelia معاك للـ
+
+184
+00:11:55,610 --> 00:11:58,730
+Neurosocceretina Across which the two layers must
+
+185
+00:11:58,730 --> 00:12:01,670
+adhere، طبعا اتصاقه لايحدث في منطقة اللي هو
+
+186
+00:12:01,670 --> 00:12:05,370
+الsubretinal space منطقة الsubretinal space هو
+
+187
+00:12:05,370 --> 00:12:08,450
+المنطقة اللي بتعمل على اتصاق اللي هو ال two layers
+
+188
+00:12:08,450 --> 00:12:11,760
+of the retinaThe optic nerve is the site of the
+
+189
+00:12:11,760 --> 00:12:15,880
+exit of ganglion cell axons from dying طبعا كل
+
+190
+00:12:15,880 --> 00:12:19,080
+خلية عصبية لها axons صحيح؟ و ال axons الوحيد اللي
+
+191
+00:12:19,080 --> 00:12:24,080
+تترك كرة العين هي axons of ORGCs only فقط ان ال
+
+192
+00:12:24,080 --> 00:12:26,420
+axons of the bipolar cells و the blood vessels هذي
+
+193
+00:12:26,420 --> 00:12:29,600
+عملها داخلها لا تترك كرة العين فهي ليست حاجة فقط
+
+194
+00:12:29,600 --> 00:12:33,600
+هي علامة في العصبية المنبثقة من ال ORGCs هي اللي
+
+195
+00:12:33,600 --> 00:12:38,770
+تترك كرة العين من خلال ال opticدسك حتى تصل الى ال
+
+196
+00:12:38,770 --> 00:12:41,910
+center nervous system بينما باقى الخلايا العصبية
+
+197
+00:12:41,910 --> 00:12:46,870
+الأخرى لأ عملها او التشابك بتبعها فقط يعني محدد
+
+198
+00:12:46,870 --> 00:12:51,210
+داخل اللي هو شبكية العين داخل الطبقة العصبية
+
+199
+00:12:51,210 --> 00:12:58,190
+الشبكية العين فقط طيب
+
+200
+00:12:58,190 --> 00:13:03,380
+ترجع مرة أخرىأعتقد الصورة هذه مش عارف كده واضحة
+
+201
+00:13:03,380 --> 00:13:07,140
+معاكم يعني احنا خدناها وشوفناها اكتر من مرة يبقى
+
+202
+00:13:07,140 --> 00:13:10,360
+صورة لفان ده الصحيح بغض النظر كانت direct او
+
+203
+00:13:10,360 --> 00:13:14,100
+indirect او حتى باستخدام اللي هو الستلام باستخدام
+
+204
+00:13:14,100 --> 00:13:17,690
+اكتر من عدسة اللي رؤيتهازي ما تشوفي فيه اندي ال
+
+205
+00:13:17,690 --> 00:13:20,610
+optic disk هنا، فهذا ال optic disk هي عبارة عن
+
+206
+00:13:20,610 --> 00:13:23,710
+عبتة nerve head، صحيح؟ فيه ان الفاضية، مركز
+
+207
+00:13:23,710 --> 00:13:27,890
+الإبصار، صح ولا؟ ده، قبل اندي باقي اللي هو الألياف
+
+208
+00:13:27,890 --> 00:13:32,310
+العصبية كلها اللي تركت ال RGCs حتى تجتمع و تتمركز
+
+209
+00:13:32,310 --> 00:13:35,270
+في ال optic disk، لأن ال optic disk نوعا ما يختلف
+
+210
+00:13:35,270 --> 00:13:40,550
+عن اللي هو الفمدة، صحيح؟ و السبب رأيت عليه انهأسفل
+
+211
+00:13:40,550 --> 00:13:43,430
+اللون ال disk مافيش عندى اي منطقة اخرى مافيش عندى
+
+212
+00:13:43,430 --> 00:13:46,790
+اللي هو كرويد ولا مكونات اخرى مباشرة بس فقط هي
+
+213
+00:13:46,790 --> 00:13:51,090
+الألياف العصبية صحيح فبالتالي لونه أخف نوعا ما أو
+
+214
+00:13:51,090 --> 00:13:54,610
+أخف بشكل ملاحظ حتى significantly من اللون اللي هو
+
+215
+00:13:54,610 --> 00:14:00,320
+باقي شبكية العين صحيح؟نرجع مرة أخرى when an
+
+216
+00:14:00,320 --> 00:14:02,840
+ophthalmologist uses an ophthalmoscope to look
+
+217
+00:14:02,840 --> 00:14:05,880
+into the eye he sees the front view of the antenna
+
+218
+00:14:05,880 --> 00:14:09,180
+يعني نخلق استخدامنا ال direct و ال direct و ال
+
+219
+00:14:09,180 --> 00:14:14,260
+indirect أو أي جهاز أخر بيمكنني بمشاهدة قاع العين
+
+220
+00:14:14,260 --> 00:14:17,400
+إيش الحتة اللي أنا بدي أشوفها أعتقد يعني إحنا مرنا
+
+221
+00:14:17,400 --> 00:14:19,480
+عليها في المعمل أكتر من المرة و اتكلمنا عن أكتر
+
+222
+00:14:19,480 --> 00:14:23,430
+مخاصية لها، همروا عليها بشكل أيش سريعin the center
+
+223
+00:14:23,430 --> 00:14:25,450
+of the retina is the optic nerve و ال optic nerve
+
+224
+00:14:25,450 --> 00:14:28,190
+متواجد في المركز أو في المتصف اللي هو الشبكيات
+
+225
+00:14:28,190 --> 00:14:31,130
+صحيح طبعا عند اللي هي في العصب تتركها في العين
+
+226
+00:14:31,130 --> 00:14:34,110
+ناحية ال nasal أكتر صحيح لذلك في عند لو احنا
+
+227
+00:14:34,110 --> 00:14:36,790
+قصناها من المتصف بالضبط هلاجة temporary retina
+
+228
+00:14:36,790 --> 00:14:41,410
+أوسع من nasal retina صحيح عشان الاقتراب لك في ان
+
+229
+00:14:41,410 --> 00:14:46,710
+ال optic nerveوالـ non-optimal هو العصب البصري أو
+
+230
+00:14:46,710 --> 00:14:48,810
+الطبقة العصبية كلها الشبكية، الطبقة العصبية
+
+231
+00:14:48,810 --> 00:14:52,350
+الوحيدة التي يمكن رؤيتها عند الإنسان بشكل مباشر من
+
+232
+00:14:52,350 --> 00:14:55,150
+خلال البقبوة، صحيح؟ بينما أي منطقة عصبية أخرى في
+
+233
+00:14:55,150 --> 00:14:58,150
+جسم الإنسان كلها مخبأ أو مغرسة داخل جسم الإنسان،
+
+234
+00:14:58,150 --> 00:15:01,530
+صحيح؟ إلا اللي هو شبكية العلم، هي تعتبر المنطقة
+
+235
+00:15:01,530 --> 00:15:04,730
+العصبية الوحيدة التي يمكن رؤيتها بشكل مباشر من
+
+236
+00:15:04,730 --> 00:15:07,650
+خلال استخدام أدوات يعني بديلة مثل الـDiet أو
+
+237
+00:15:07,650 --> 00:15:12,370
+الـCeramic أو الـCeteloid أو الـDietaryتوافق ال
+
+238
+00:15:12,370 --> 00:15:18,010
+page area majority دي about two ملايby 1.5 mm
+
+239
+00:15:18,010 --> 00:15:20,970
+across يعني حجم ال optic nerve هذا طبعا احنا نقصد
+
+240
+00:15:20,970 --> 00:15:23,130
+مقصد ال optic nerve لو optic nerve head او ال
+
+241
+00:15:23,130 --> 00:15:25,590
+optic desk صحيح؟ ال optic nerve نفسه لا يمكن رؤيته
+
+242
+00:15:25,590 --> 00:15:28,790
+احنا فقط نرا اللي هو المقدمة او رأس ال optic nerve
+
+243
+00:15:28,790 --> 00:15:31,570
+لذلك هيقولنا انتوا اعتبر ال optic nerve مش الحق ال
+
+244
+00:15:31,570 --> 00:15:34,930
+optic nerve head حجمه حاجة ان احنا تختلف صحيح؟
+
+245
+00:15:34,930 --> 00:15:38,990
+حاجة انه شكله oval والسبب وراء ذلك ان ال both ال
+
+246
+00:15:38,990 --> 00:15:41,250
+horizontal و ال vertical diameters are not equal
+
+247
+00:15:41,250 --> 00:15:45,520
+صحيح؟ تنمية مثل اللي هو القرنيةfrom the center of
+
+248
+00:15:45,520 --> 00:15:47,460
+the optic nerve radially they measure blood
+
+249
+00:15:47,460 --> 00:15:52,940
+vessels of the retina PND ما هو الأوعي الدموية مش
+
+250
+00:15:52,940 --> 00:15:56,040
+واضحة صورة كتير الأوعي الدموية PND أربع أوعي دموية
+
+251
+00:15:56,040 --> 00:16:00,880
+اللي هو arteries و PND صحيح؟ PND two arteries و
+
+252
+00:16:00,880 --> 00:16:04,340
+PND two veins أيه عين الشباكية بالشكل العادى؟
+
+253
+00:16:04,340 --> 00:16:09,760
+either right eye و لا left eye؟عادى فدى ال right
+
+254
+00:16:09,760 --> 00:16:13,000
+ان فى عندى أيضا عين أخرى صحيح فدى ال right eye ال
+
+255
+00:16:13,000 --> 00:16:18,600
+right eye اللى اللى بفت منها بشكل هذا ففى عندى two
+
+256
+00:16:18,600 --> 00:16:22,120
+veins و two arteries one superior artery superior
+
+257
+00:16:22,120 --> 00:16:25,260
+vein فدى عندى inferior artery فدى عندى inferior
+
+258
+00:16:25,260 --> 00:16:29,240
+vein انا هشغل احنا ان فى عندى ال optic disc بداخل
+
+259
+00:16:29,240 --> 00:16:33,380
+ال optic disc فى عندى فجوة او excavation صحيح تقعة
+
+260
+00:16:33,380 --> 00:16:38,060
+مبسيطة جدا اسمها cup صحيح هذا موجود تقريباحجام
+
+261
+00:16:38,060 --> 00:16:42,300
+مختلفة حسب الجسم اللي عارف ان احنا بنفحصه ماريش
+
+262
+00:16:42,300 --> 00:16:45,380
+علاقة بس تاكرها ده بشكل عام في أيدي الفاوية مكان
+
+263
+00:16:45,380 --> 00:16:49,700
+موجودها يبقى بقع انتوا تقريبا تقريبا تقريبا تقريبا
+
+264
+00:16:49,700 --> 00:16:53,180
+تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا
+
+265
+00:16:53,180 --> 00:16:55,940
+تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا
+
+266
+00:16:55,940 --> 00:16:55,940
+تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا
+
+267
+00:16:55,940 --> 00:17:01,000
+تقريبا تقريبا تقريبا
+
+268
+00:17:01,000 --> 00:17:05,400
+تقريبا تقريبا تقريبا ت
+
+269
+00:17:06,770 --> 00:17:11,390
+this can be the slightly oval-shaped blood vessels
+
+270
+00:17:11,390 --> 00:17:14,850
+in three British spots of the fovea من هنا تبدأ
+
+271
+00:17:14,850 --> 00:17:18,970
+حصائص اللي هو منطقات الفوبيا او الفوبيا اللي عبارة
+
+272
+00:17:18,970 --> 00:17:22,630
+عن منطقة has no blood vessels او vascular صحيح
+
+273
+00:17:22,630 --> 00:17:27,010
+عادي ما ان هو اللواعي الدموية شكلها oval-shaped
+
+274
+00:17:27,010 --> 00:17:31,370
+تاخد شكل بيضاوي British spot of the fovea which is
+
+275
+00:17:31,370 --> 00:17:34,530
+in the center of the area known as macula lutea هي
+
+276
+00:17:34,530 --> 00:17:38,690
+هذه المنطقة نفسهامتواجدة بالمركز المنطقة الأخرى
+
+277
+00:17:38,690 --> 00:17:42,890
+اللي هي الماكن اللي هي تقريبا عبارة عن دائرة حجمها
+
+278
+00:17:42,890 --> 00:17:47,820
+6 ملي مترالمركز بده يكون بالفوزيولا او بالمنطقة
+
+279
+00:17:47,820 --> 00:17:51,440
+اللي احنا بتحكينا عنها اللي هي عديمة المنطقة اللي
+
+280
+00:17:51,440 --> 00:17:55,040
+هي عديمة اللي هو هي الدموية بالشكل هنا تماما فلو
+
+281
+00:17:55,040 --> 00:17:59,160
+مشينا ستة متر دقيقة كترها ستة متر هلأجي بستة ملي
+
+282
+00:17:59,160 --> 00:18:02,880
+متر عفن هلأجي عبارة عن الماكينالوتية سمية
+
+283
+00:18:02,880 --> 00:18:07,320
+الماكينالوتية ماكينالوتية عبارة عن بسبب وجود نوعين
+
+284
+00:18:07,320 --> 00:18:10,260
+من الصفغيات حتى ندفنهم بعد ان شاء الله بده يكسبلي
+
+285
+00:18:10,260 --> 00:18:15,150
+منطقة دلوقت اللي هو الأسفرأصلا بيحنا اللقه الصفراء
+
+286
+00:18:15,150 --> 00:18:20,330
+صحيح؟ طيب ال كوزفوفيا has no rods small in objects
+
+287
+00:18:20,330 --> 00:18:24,490
+in the dark not between if one locks at them طيب
+
+288
+00:18:24,490 --> 00:18:28,710
+احنا اتكلمنا عن التوزيع اللي هو ال photoreceptor
+
+289
+00:18:28,710 --> 00:18:31,610
+في الشبكة و حكينا ان ال rods متوجه بشكل غزين جدا
+
+290
+00:18:31,610 --> 00:18:35,410
+في ال peripheral بينما الكوز متوجه في ال center هل
+
+291
+00:18:35,410 --> 00:18:38,110
+كل الكوز متوجه في ال center؟ لأ فيه ان ال blue
+
+292
+00:18:38,110 --> 00:18:42,120
+cone هو في الفوضى تقريبا محبوب نهائي مش موجودلكن
+
+293
+00:18:42,120 --> 00:18:45,740
+في بعض المناطق اللي انا اكلها مش هاكلش ضائم، لكن
+
+294
+00:18:45,740 --> 00:18:49,660
+أكثر غزارة هو في منطقة الفوفيولا، بالفرن، بينما ال
+
+295
+00:18:49,660 --> 00:18:53,980
+red و ال green cones متواجدين هم أكثر من طبقة في
+
+296
+00:18:53,980 --> 00:18:56,620
+ال center طيب، هاي بدي منطقة أخر مع هذه الكلام،
+
+297
+00:18:56,620 --> 00:19:00,140
+أنه لما أنا بدي أستخدم الرؤية الليلية، هكون في
+
+298
+00:19:00,140 --> 00:19:03,120
+عندي فقط ال rods، هو الفعال، صحيح؟ لأن ال rods
+
+299
+00:19:03,120 --> 00:19:07,260
+أكتر حساسية من ال conesهو فقط شوية إضاءة بسيطة و
+
+300
+00:19:07,260 --> 00:19:11,280
+ممكن تساعد الرز على الترشيد بينما ال cones لأ بدها
+
+301
+00:19:11,280 --> 00:19:15,320
+إضاءة شديدة جدا حتى يشغل الإنسان أو تتفعل تصبح
+
+302
+00:19:15,320 --> 00:19:19,100
+نشطة للإنسان اللي هو النبضات العصبية في وقت
+
+303
+00:19:19,100 --> 00:19:23,560
+الحلقات التي تحتاجك تكتب في ال topic رؤية ليلية و
+
+304
+00:19:23,560 --> 00:19:27,240
+رؤية النهارية الرؤية النهارية مسؤولة عنها ال cones
+
+305
+00:19:27,240 --> 00:19:30,020
+اللي هي الفوبيولا أما الرؤية الليلية مسؤولة عنها
+
+306
+00:19:30,020 --> 00:19:35,580
+الرز في مثل بسيط جدا هنا طبعا هي حفيرة الماكلةو هي
+
+307
+00:19:35,580 --> 00:19:38,540
+توسيعت اللي هو الركز اللي عبارة عن القوس أو
+
+308
+00:19:38,540 --> 00:19:41,540
+العدمية العلوية أو العدمية السفلية، حكينا الفرق
+
+309
+00:19:41,540 --> 00:19:45,120
+بين الاردر والفين أن الفين بيعتبر wide، صحيح؟ و في
+
+310
+00:19:45,120 --> 00:19:47,500
+عندنا بعض الخصائص، حكينا .. إيش .. إيش كمان؟ في
+
+311
+00:19:47,500 --> 00:19:52,620
+عندنا لون أكتر دكانة، في عندنا أيضا أسمكطب و هاد
+
+312
+00:19:52,620 --> 00:19:55,620
+نفس الشيء هي فيه excavation اللي هو عبارة عن
+
+313
+00:19:55,620 --> 00:19:59,240
+recovery طب وبعد التوزيع احنا أخدناها نجع بس
+
+314
+00:19:59,240 --> 00:20:02,720
+المثال اللي مضروب عندنا في الكتاب ان أخت الليل
+
+315
+00:20:02,720 --> 00:20:06,380
+صحيح لو انا بدأ أطلع أخصاص مهيئة دقيقة في ال indy
+
+316
+00:20:06,380 --> 00:20:10,220
+رقم خافة جداصعب جدا أن أشوف التفاصيل هذه، لماذا؟
+
+317
+00:20:10,220 --> 00:20:13,120
+لأن الأضاءة الخافتة تحسس أن ما شوفنا الـperipheral
+
+318
+00:20:13,120 --> 00:20:16,660
+أكتر من الـcentral، صحيح؟ فلتالك، عندي الجانس
+
+319
+00:20:16,660 --> 00:20:20,440
+العلل الـY، يعني الـdim light، الأضاءة الخافتة،
+
+320
+00:20:20,440 --> 00:20:22,860
+صعب جدا أن انا أعرف تفاصيل ال objects اللي أمامي
+
+321
+00:20:24,410 --> 00:20:27,990
+لأن المفروض التفاصيل هذه من ناحية ألوان أبعاد إلى
+
+322
+00:20:27,990 --> 00:20:31,970
+أخرى لها علاقة بالرؤية النهارية أكتر من اللي هو
+
+323
+00:20:31,970 --> 00:20:34,430
+رؤية ليلية لأنها برؤية ليلية فقط تنشأت ال codes ال
+
+324
+00:20:34,430 --> 00:20:36,730
+rods و ال rods هذه متواجدة في ال peripheral مش
+
+325
+00:20:36,730 --> 00:20:39,270
+بالخاصيتها التركيز و التعرف على خصائص شيء معين
+
+326
+00:20:39,270 --> 00:20:43,690
+بينما في الرؤية النهارية هي ال codes التي تنشأت من
+
+327
+00:20:43,690 --> 00:20:46,790
+خصائصها اللي هو التعرف على بعض خصائص الشيء اللي
+
+328
+00:20:46,790 --> 00:20:50,550
+احنا بنشوفه من كل نواحي من اللون من أبعاد إلى أخرى
+
+329
+00:20:53,740 --> 00:20:58,340
+نأتي لعدد اللي هو ال cones في الفافيا والروز بشكل
+
+330
+00:20:58,340 --> 00:21:01,400
+عام طبعا زى ما حكينا احنا مبقى معانا متفاوتة مش
+
+331
+00:21:01,400 --> 00:21:04,380
+متعارف يعني اننا نقدر نعرف انه عندى ال cones
+
+332
+00:21:04,380 --> 00:21:09,340
+بالذات اللي هو ال green و ال red متكدسة بشكل كبير
+
+333
+00:21:09,340 --> 00:21:12,720
+جدا جدا جدا بالفافيا اللى أخده ماهش الحاجة نقدر
+
+334
+00:21:12,720 --> 00:21:16,220
+نتفلنا تقريبا 25 ألف خلية لكل ميلي متر مربع في
+
+335
+00:21:16,220 --> 00:21:21,560
+منطقة الفافيا بينما في منطقة الماكلة كلها اللي هي
+
+336
+00:21:21,560 --> 00:21:27,320
+تقريبا 110 ألفخلّى تصل إلى 115000 خلايا هذه تتفاوت
+
+337
+00:21:27,320 --> 00:21:29,460
+لكن محتوى اللي بناعرفه بمنطقة الفافيولا اللى هى ال
+
+338
+00:21:29,460 --> 00:21:32,180
+center of the fava بتواجد عنده اللى هو ال cones
+
+339
+00:21:32,180 --> 00:21:38,320
+بشكل مقدس كثير جدا طيب ال ocular او fava area is
+
+340
+00:21:38,320 --> 00:21:40,540
+the main portion of the retina used for color
+
+341
+00:21:40,540 --> 00:21:45,410
+discriminationو بصراحة الفقراء هذي هتاخدوها بال
+
+342
+00:21:45,410 --> 00:21:47,670
+visual perception اللي هو ال color of a shape هو
+
+343
+00:21:47,670 --> 00:21:51,190
+هي خصائصه اهميته الاخره هندرس احنا بالتفصيل هي بس
+
+344
+00:21:51,190 --> 00:21:54,290
+اللي نعرف المنطقة هالي او احنا احساسنا او دراكنا
+
+345
+00:21:54,290 --> 00:21:57,850
+بالألوان يأتي من ال center رتنا بغض ان انا عن
+
+346
+00:21:57,850 --> 00:22:00,370
+تفصيل متواجهة فيه بينما ال peripheral رتنا لأ
+
+347
+00:22:00,370 --> 00:22:03,490
+مانهاش علاقة بالألوان و احنا يا ربنا مثلا بصيت جدا
+
+348
+00:22:03,490 --> 00:22:07,830
+في المعمل اذا تذكرين حكينا ليش ال blue light صحيح
+
+349
+00:22:07,830 --> 00:22:11,250
+بال center ممكن يبين لكن لو اناواضعتها على
+
+350
+00:22:11,250 --> 00:22:14,930
+البريفيرا لانها تبقى قادرة على تمييز الألوان
+
+351
+00:22:21,040 --> 00:22:23,420
+طيب a circular field of approximately 6
+
+352
+00:22:23,420 --> 00:22:25,620
+millimeters around the fovula is considered the
+
+353
+00:22:25,620 --> 00:22:28,760
+central retina لما نحن نعرف ال central retina نقول
+
+354
+00:22:28,760 --> 00:22:32,320
+ال central يعني المركز الشبكية يعني المنطقة
+
+355
+00:22:32,320 --> 00:22:35,080
+المركزية أو المنطقة الطلافية هي أقرارا من ال
+
+356
+00:22:35,080 --> 00:22:38,820
+fovula 6 millimeters هي اللي تعتبر كلها اللي هو ال
+
+357
+00:22:38,820 --> 00:22:42,420
+central retina تقريبا أقصى درجات الماكينة، ماعندي
+
+358
+00:22:42,420 --> 00:22:47,290
+ذلك إيش تعتبر؟باريفرال طبعا في عندي منت بيريفرال و
+
+359
+00:22:47,290 --> 00:22:51,150
+اكترين بيريفرال بانت تتقسم أيضا قسام تبعي هي
+
+360
+00:22:51,150 --> 00:22:56,630
+الماكين اللوتية هي الماكين اللوتية لكن خصصا عرفنا
+
+361
+00:22:56,630 --> 00:22:59,870
+نحكي عنها الماكين اللوتية السيكرافيد هو
+
+362
+00:22:59,870 --> 00:23:02,070
+approximately 6 millimeters around the fovea
+
+363
+00:23:02,070 --> 00:23:06,830
+considered the central retina while beyond this is
+
+364
+00:23:06,830 --> 00:23:11,340
+the peripheralتعتبر bridge in roads صحيح هذه
+
+365
+00:23:11,340 --> 00:23:14,880
+المنطقة الشبكية الترافية stretched from the center
+
+366
+00:23:14,880 --> 00:23:17,700
+of the optic disc تقريبا 21 مم from the center of
+
+367
+00:23:17,700 --> 00:23:20,220
+the optic disc الحكاية اللي اتكلمنا عليها the
+
+368
+00:23:20,220 --> 00:23:25,140
+total width is a circular disc of approximately 42
+
+369
+00:23:25,140 --> 00:23:25,920
+mm
+
+370
+00:23:28,490 --> 00:23:31,830
+فصلنا كل الشبكة يعني كرة العين و وضعناها على
+
+371
+00:23:31,830 --> 00:23:35,010
+المختار الحلقى هي عبارة عن منطقة او طبقة دائرية
+
+372
+00:23:35,010 --> 00:23:39,930
+صحيح تقريبا حجمها اللي هو 42 ملي متر بشكلها طبعا
+
+373
+00:23:39,930 --> 00:23:42,630
+في عند بعض الأطراف اللي احنا مش شايفينها لإنه
+
+374
+00:23:42,630 --> 00:23:45,470
+عندنا ال iris او ال diaphragm او ال iris الموتة
+
+375
+00:23:45,470 --> 00:23:49,280
+عليهاصورة اللي هو من ال indirect في thermoscope،
+
+376
+00:23:49,280 --> 00:23:52,140
+عم باينها مش كل ال written التشريحية الحقيقية
+
+377
+00:23:52,140 --> 00:23:56,780
+صحيح، لكن اذا احنا نستجع بعض المعلومات لما خدنا ال
+
+378
+00:23:56,780 --> 00:23:58,640
+code من ال three mirror lens، حكينا ال DNA من ال
+
+379
+00:23:58,640 --> 00:24:01,480
+three mirror صح؟ في من هالمنطقة اللي هي بتشوف في
+
+380
+00:24:01,480 --> 00:24:04,420
+ال angle، منطقة اللي بتشوف في ال optic disk، اللي
+
+381
+00:24:04,420 --> 00:24:07,110
+هو ال direct ال DNA الابتمجفي المنطقتين اللي
+
+382
+00:24:07,110 --> 00:24:10,330
+بتشوفيها هو ال most peripheral و ال equator و ما
+
+383
+00:24:10,330 --> 00:24:13,450
+هدوله في منطقتين ال most peripheral معروف ال
+
+384
+00:24:13,450 --> 00:24:16,030
+equator و ال extreme peripheral في الصورة هذه يعني
+
+385
+00:24:16,030 --> 00:24:19,410
+مش موجودين فاحنا زي ما حكينا المرة أخرى لو خرجنا
+
+386
+00:24:19,410 --> 00:24:22,950
+ال retina تشريحيا و وضعناها أمامنا في المختبر
+
+387
+00:24:22,950 --> 00:24:25,990
+هنلاقي ان هي عبارة عن منطقة دائرية لأن مجموعة
+
+388
+00:24:25,990 --> 00:24:29,110
+العالم شكلها دائري كله عايش منتظم المنطقة هذه
+
+389
+00:24:29,110 --> 00:24:32,290
+هتكون حجمها تقريبا دائرة قطرها اتنين و أربعين
+
+390
+00:24:32,290 --> 00:24:37,680
+مليمتر أو تتفاوت لحجم نوعا مانعود مرة أخرى، الـ
+
+391
+00:24:37,680 --> 00:24:41,800
+top technology اللي هو يدين انطباع الـ blind spot
+
+392
+00:24:41,800 --> 00:24:45,200
+بالvisual field، اللي فيه عنده في ال optic disc،
+
+393
+00:24:45,200 --> 00:24:48,590
+لأنه جانجله وسدفتش عنده خلايا عصبيةقصدنا من
+
+394
+00:24:48,590 --> 00:24:52,030
+الخلايا العصبية وهي عواجة تحديد ال R-GCs ربما يكون
+
+395
+00:24:52,030 --> 00:24:54,690
+عندك بعض الخلايا العصبية اللي وردتها جاعمة
+
+396
+00:24:54,690 --> 00:24:57,910
+وتشابكية بس تحاول تربط ما بين الأجهزة العصبية فقط
+
+397
+00:24:57,910 --> 00:25:00,750
+مابتعملش على نقل اللي هو الإشارة العصبية
+
+398
+00:25:00,750 --> 00:25:04,210
+الكهربائية إلى الدماغ لذا اللي بتعتبر اللي هو
+
+399
+00:25:04,210 --> 00:25:07,370
+منطقة ال optic disk في ال virtual field عبارة عن
+
+400
+00:25:07,370 --> 00:25:10,110
+blind spot منطقة غير بنية مش هنتكلم عنها دي انا
+
+401
+00:25:10,110 --> 00:25:15,290
+اتكلمنا عنها احنا بما يكفي ان شاء الله طيب شوف ال
+
+402
+00:25:15,290 --> 00:25:20,190
+blend supply to the retinaكيفية التزويد اللى هو
+
+403
+00:25:20,190 --> 00:25:25,910
+الشبكية أو تغذيتها من قبل الوعي الدموية الشبكية من
+
+404
+00:25:25,910 --> 00:25:28,070
+ناحية ها دى يعني بالتقسيم الى blood supply
+
+405
+00:25:28,070 --> 00:25:32,050
+والقسمحنة المقصودها ان تتمامل يوميتنا لكل اللى هو
+
+406
+00:25:32,050 --> 00:25:35,070
+الشبكية السادية كل السادية صحيح متوجهة فيها
+
+407
+00:25:35,070 --> 00:25:37,690
+الشبكية بالشكل هذا تقريبا منتظر ما هيكون تكوينها
+
+408
+00:25:37,690 --> 00:25:43,690
+مقارب جدا للإنسان يتم اللى هو تغذي الشبكية عن طريق
+
+409
+00:25:43,690 --> 00:25:47,490
+اما عن طريق الcentral lateral arteryهذا يعني
+
+410
+00:25:47,490 --> 00:25:52,550
+ببيعمل على تزويد تقريبا one third of the retina
+
+411
+00:25:52,550 --> 00:25:57,690
+اللي هو تقريبا تلت من طبقات الشبكية فيه ايضا
+
+412
+00:25:57,690 --> 00:26:00,410
+decorated black pieces او decorate بشكل مختصر
+
+413
+00:26:00,410 --> 00:26:04,950
+ودزوز تقريبا تلتين من ال black supply من الشبكية
+
+414
+00:26:04,950 --> 00:26:10,230
+هذا التلت هو الداخل صحيح thinner وهذا هو جزء
+
+415
+00:26:10,230 --> 00:26:24,790
+الخارجي من الشبكيةالكورايد تحصل على تقريبا تلتين
+
+416
+00:26:24,790 --> 00:26:32,070
+طبقة شبكية من الخارج من خلال الكورايد بينما التلت
+
+417
+00:26:32,070 --> 00:26:37,190
+الداخلي فقط من خلال الـ central retinal artery and
+
+418
+00:26:37,190 --> 00:26:39,390
+is vital for the maintenance of the outer retina
+
+419
+00:26:39,390 --> 00:26:45,340
+مهم جدا اللي هو المواصلة المقصود فيهاالمقصود في ال
+
+420
+00:26:45,340 --> 00:26:50,440
+mentalist هو ال survival لإنعاشة أو وجود يعني حتى
+
+421
+00:26:50,440 --> 00:26:53,560
+يعمل على تغذية الخلايا العصبية المتواجدة فيها
+
+422
+00:26:53,560 --> 00:26:59,450
+لرسالة نبض عصبية لهو الدمارUndermining twenty to
+
+423
+00:26:59,450 --> 00:27:01,750
+thirty percent اللي هو التلت اللي احنا اتكلمنا عنه
+
+424
+00:27:01,750 --> 00:27:03,890
+flows to the retina through the central retinal
+
+425
+00:27:03,890 --> 00:27:07,370
+artery بيأتي اوى البثقمن اللي هو الشريان المركزي
+
+426
+00:27:07,370 --> 00:27:10,210
+الرئيسي لشبكية العين اللي احنا اسمناها ال central
+
+427
+00:27:10,210 --> 00:27:14,950
+retinal artery اللي هو اذا نعتبر جزء او من البثقمن
+
+428
+00:27:14,950 --> 00:27:19,390
+الأفثالمي كارتريمش ع فكرة أخرى doctor knelford to
+
+429
+00:27:19,390 --> 00:27:22,470
+nourish the inner retinal layers the central
+
+430
+00:27:22,470 --> 00:27:25,550
+retinal artery has four main branches in the human
+
+431
+00:27:25,550 --> 00:27:28,150
+retina و ات كلها نحن على ال four main branches PND
+
+432
+00:27:28,150 --> 00:27:34,390
+two superior PND ايضا و inferior حاجة طبقات رتنا
+
+433
+00:27:34,390 --> 00:27:37,090
+بعشرة احنا مش هناخدها انتوا اكيد ماريتوا عليها
+
+434
+00:27:37,090 --> 00:27:41,570
+بالتشريح صحيح؟ طيب بس ناخدها بشكل سريع PND دنايا
+
+435
+00:27:41,570 --> 00:27:46,980
+fiber layer بأول طبقة داخليةبعد أو أسفل ال
+
+436
+00:27:46,980 --> 00:27:49,800
+internal limiting membrane صحيح؟ في اندي internal
+
+437
+00:27:49,800 --> 00:27:52,080
+و في اندي outer limiting membrane نعمل على إحكام
+
+438
+00:27:52,080 --> 00:27:55,940
+اللي هو الطبقات الشبكية، في أن الطبقة الثانية هي
+
+439
+00:27:55,940 --> 00:28:00,840
+عبارة عن الجاجرينسلزالطبقة الثالثة في عندي عبارة
+
+440
+00:28:00,840 --> 00:28:04,140
+عن ال inner plexiform layer يعني في ان ال bipolar
+
+441
+00:28:04,140 --> 00:28:06,320
+cells و ال horizontal cells متواجدة من خلالها
+
+442
+00:28:06,320 --> 00:28:08,980
+بتعمل على اتشابك ما بين الجائجاليا cells و ما بين
+
+443
+00:28:08,980 --> 00:28:11,800
+ال photoreceptors صحيح؟ طب في عندي ال outer
+
+444
+00:28:11,800 --> 00:28:14,200
+plexiform layer اللي هي عبارة عن اتشابكات ما بين
+
+445
+00:28:14,200 --> 00:28:16,520
+ال photoreceptors و ال synapses و ما بين اللي هو
+
+446
+00:28:16,520 --> 00:28:18,720
+ال bipolar و ال horizontal cells اذا اتسميها
+
+447
+00:28:18,720 --> 00:28:22,060
+plexiform اتشابكيةفى انها photoreceptors اللى
+
+448
+00:28:22,060 --> 00:28:25,400
+تحتوي على ال cones و ال rods فى انها منطقات اللى
+
+449
+00:28:25,400 --> 00:28:28,880
+هو written pigmented epithelium بعدين مابين ال
+
+450
+00:28:28,880 --> 00:28:31,360
+written pigmented epithelium و مابين الكورويد فى
+
+451
+00:28:31,360 --> 00:28:36,780
+اندي بروجز membrane المرة أخرى طب نرجع مرة أخرى
+
+452
+00:28:36,780 --> 00:28:39,920
+نشوف ال light هه انه طبعا أول ما يدفع ال light
+
+453
+00:28:39,920 --> 00:28:42,700
+صحيح انه هيمر عبر الطبقات هذه لكن لابد ان يأتي إلى
+
+454
+00:28:42,700 --> 00:28:46,420
+photoreceptors أول شيء فى نشطها بعدين حتى يعمل على
+
+455
+00:28:46,420 --> 00:28:49,060
+إتمام اللى هو الإشارة العصبية أو nerve impulse من
+
+456
+00:28:49,060 --> 00:28:52,500
+ال photoreceptors إلىالـ Bipolar Cells ثم إلى الـ
+
+457
+00:28:52,500 --> 00:28:56,040
+RGCs ليس يأتي مضافة RGCs ويعملها تحفيزها لا يتم
+
+458
+00:28:56,040 --> 00:29:00,480
+تحفيز الـ RGCs إلا إذا حفزت الـ photoreceptors
+
+459
+00:29:00,480 --> 00:29:03,640
+والدليل على ذلك أنه يحدث انتصال شبكي هيحدث من
+
+460
+00:29:03,640 --> 00:29:06,920
+المنطقة هذه صحيح بالضبط صحيح الـ photoreceptors
+
+461
+00:29:06,920 --> 00:29:10,300
+حتى نسلق عن الهوارزة اللي بنادقنا اليوم بالتالي
+
+462
+00:29:10,300 --> 00:29:13,720
+الشعع صحيح يوصل إلى الـ RGCs لكن لم يتصل إلى الـ
+
+463
+00:29:13,720 --> 00:29:17,420
+photoreceptors لذلك لن يتم أو لن يتم نقل الصورة
+
+464
+00:29:17,420 --> 00:29:18,780
+بشكل واضح
+
+465
+00:29:20,970 --> 00:29:25,190
+هذا نفس الشيء يعني أبقى عبارة عن رسمة كركترية توضح
+
+466
+00:29:25,190 --> 00:29:28,530
+وجود ال RGCs و ال bipolar cells اللي هو هذه ال
+
+467
+00:29:28,530 --> 00:29:31,170
+photoreceptors ال cones اللي هي مدببة من ال rods
+
+468
+00:29:31,170 --> 00:29:35,270
+اللي هي عبارة عن المخاري نرجح مجرد أخر شكل سريع مش
+
+469
+00:29:35,270 --> 00:29:38,070
+هنعيد اللي هو الطبقات الشبكية لكن all vertebrates
+
+470
+00:29:38,070 --> 00:29:42,610
+اللي هو كل الفقاريات are composed of three layers
+
+471
+00:29:42,610 --> 00:29:46,790
+of nerve cell bodies and two layers of synapses كل
+
+472
+00:29:46,790 --> 00:29:51,190
+الفقارياتتحتوي على شبكية تتكون من ثلاث طبقات of
+
+473
+00:29:51,190 --> 00:29:53,710
+nerve cell bodies المقصود nerve cell bodies شو هي؟
+
+474
+00:29:55,990 --> 00:30:00,890
+الـ IGCs والـ Bipolar Cells والفتوريسبترز هى تلات
+
+475
+00:30:00,890 --> 00:30:03,730
+واحدات من الخلايا العصبية عشان الحق تلات واحدات من
+
+476
+00:30:03,730 --> 00:30:07,050
+الخلايا العصبية فيها تباقتين من الـ synapses
+
+477
+00:30:07,050 --> 00:30:09,950
+تباقتين من الـ synapses اللى هى ال inner plexiform
+
+478
+00:30:09,950 --> 00:30:12,210
+layer و ال outer plexiform layer هى بتعمل على
+
+479
+00:30:12,210 --> 00:30:15,530
+تشابكة التواصل ما بين التلات واحدات من الخلايا
+
+480
+00:30:15,530 --> 00:30:18,990
+اللى احنا اتكلمنا عليها بشكل ايش أساسى مايدون ذلك
+
+481
+00:30:18,990 --> 00:30:21,570
+اقل عن التباقات العشرة المتواجدة بالشبكية زى ما
+
+482
+00:30:21,570 --> 00:30:22,210
+اتكلمنا عليها
+
+483
+00:30:25,220 --> 00:30:28,680
+أنا قلت لك تتكلم هنا خصائص written on pigmented
+
+484
+00:30:28,680 --> 00:30:32,420
+epithelium قبل ما نتكلم على أي شيء آخر، حكينا
+
+485
+00:30:32,420 --> 00:30:37,090
+هنطلع معايا مرة أخرىحيث في عند الرتناب الابيثيليام
+
+486
+00:30:37,090 --> 00:30:39,230
+و الرتناب الابيثيليام في عندى حاجة اسمها
+
+487
+00:30:39,230 --> 00:30:42,890
+microvilli او اللحتاب الصغيرة صحيح او الدقيقة اللى
+
+488
+00:30:42,890 --> 00:30:45,830
+تعمل على احتضان ال outer segment طبعا عليها هاد ال
+
+489
+00:30:45,830 --> 00:30:48,830
+outer segment هاد عبارة عن cone هاد ال rod صحيح
+
+490
+00:30:48,830 --> 00:30:52,570
+cone rod حسب تدبقهم في عند ال outer segment في عند
+
+491
+00:30:52,570 --> 00:30:56,270
+ال inner segment صحيح المكان المتواجدة فيه اللى هو
+
+492
+00:30:57,080 --> 00:31:00,040
+ال visual pigments عبارة عن الصبغات البصرية اللى
+
+493
+00:31:00,040 --> 00:31:03,600
+بتساعد على الرؤية هو يعتبر ال outer segments بينما
+
+494
+00:31:03,600 --> 00:31:07,100
+المناطق وجود ال mitochondria و ال .. هتتكلم عليها
+
+495
+00:31:07,100 --> 00:31:09,200
+كمان شوية ان شاء الله هي تعتبر ال inner segments
+
+496
+00:31:09,200 --> 00:31:12,520
+بالنهاية يعمل ال written pigmented epithelium علي
+
+497
+00:31:12,520 --> 00:31:17,880
+احتضان الجزءالخارجي من ال photoreceptors وده فيه
+
+498
+00:31:17,880 --> 00:31:21,440
+عندى احتضان معناه تتكلم انه لا تتم اي عملية
+
+499
+00:31:21,440 --> 00:31:24,640
+اسكنجية حامة فى ال photoreceptors الا ويصحبها اللى
+
+500
+00:31:24,640 --> 00:31:27,200
+هو retina-pigmented epithelium عزى يعنى ان ال
+
+501
+00:31:27,200 --> 00:31:30,560
+retina-pigmented epithelium مهم جدا جدا جدا لعامل
+
+502
+00:31:30,560 --> 00:31:33,100
+ال photoreceptors وحكى ان الدليل وراء ذالب ان عند
+
+503
+00:31:33,100 --> 00:31:35,420
+الفصالة الشبكية اللى هيحدث عندى فى المنطقة هيتم
+
+504
+00:31:35,420 --> 00:31:40,450
+أمنطلع عليهاهي تنسلك أو تنفصل يعني مش هيحدث عند
+
+505
+00:31:40,450 --> 00:31:43,890
+احتضان اخر خلاص، هتنسلق اللي هو الـUltra-segmental
+
+506
+00:31:43,890 --> 00:31:47,890
+receptor صحيح بعيد عن اللي هو Retinopathy بسيطة،
+
+507
+00:31:47,890 --> 00:31:52,890
+بتاني لن تصل لأي أشارات عصبيةده فترة كبيرة او
+
+508
+00:31:52,890 --> 00:31:56,390
+التأثر ده فترة كبيرة لسان حاسب حياته و غير قادر
+
+509
+00:31:56,390 --> 00:31:59,130
+على الرؤية و ده اللي عذلك في عندنا مرض شائع اذا في
+
+510
+00:31:59,130 --> 00:32:03,010
+غزة موجود مرض براسي اسمه العش الليلة صحيح؟ العش
+
+511
+00:32:03,010 --> 00:32:05,870
+الليلة عند الخلع الصبيل كامل مافيش احد اي مشكلة،
+
+512
+00:32:05,870 --> 00:32:08,330
+المشكلة الوحيدة ان فيها اندي اشط، فيه اندي .. اذا
+
+513
+00:32:08,330 --> 00:32:10,650
+انت اللي بيتمدى Epithelium فيه اندي تغليم او تهتك
+
+514
+00:32:10,650 --> 00:32:14,950
+فيهابالتالي أيضا الإنسان غير قادر عبوية لأنه الجزء
+
+515
+00:32:14,950 --> 00:32:18,550
+الوحيد اللي يعمل على تغذية ال outer segment و
+
+516
+00:32:18,550 --> 00:32:21,430
+التدخل في عاملات الحيوية of the photoreceptors هو
+
+517
+00:32:21,430 --> 00:32:24,870
+فقط ال retinopigmented epithelia لذلك يعتبر مهم
+
+518
+00:32:24,870 --> 00:32:28,930
+جدا جدا لإتمام العاملات الحيوية داخل اللي هو ال
+
+519
+00:32:28,930 --> 00:32:33,530
+photoreceptors طيب ما هي خصائص ال retinopigmented
+
+520
+00:32:33,530 --> 00:32:38,060
+epithelia؟ في عدة خصائصIt's formed only of one
+
+521
+00:32:38,060 --> 00:32:40,820
+layer، مافيش عندك أكتر من تكادس من طبقات، هو عبارة
+
+522
+00:32:40,820 --> 00:32:44,420
+عن إيش طبقة واحدة و نرجح مرة أخرى، هذا السبب يعني
+
+523
+00:32:44,420 --> 00:32:47,820
+ورا ضعف الاتصال أو التواصل أو ال adherence،
+
+524
+00:32:47,820 --> 00:32:51,120
+التماسك ما بينه، اللي هو طبقات الشركية، ما بين ال
+
+525
+00:32:51,120 --> 00:32:53,580
+retina و الbethelium و ما بين الneurosensory
+
+526
+00:32:53,580 --> 00:32:56,640
+retina، يعني سهل جدا يحدث عندك انفصال، لأن طريقتها
+
+527
+00:32:56,640 --> 00:33:01,510
+التماسك والاتصال ضعيفةسيبرينز الـ sensor retina من
+
+528
+00:33:01,510 --> 00:33:04,490
+البروشيز ممبران، هي تعتبر الطبقة الوحيدة اللي
+
+529
+00:33:04,490 --> 00:33:07,850
+بتعمل على فاصل أو الفاصل يعني ما بين ال sensor
+
+530
+00:33:07,850 --> 00:33:11,130
+retina وما بين البروشيز ممبران of the choroid. it
+
+531
+00:33:11,130 --> 00:33:13,850
+extends from the aorta continued with the
+
+532
+00:33:13,850 --> 00:33:15,970
+pigmented epithelium of the ciliary body واحنا لما
+
+533
+00:33:15,970 --> 00:33:19,250
+اتكلمنا على ال ciliary body فكنا فيه انه pigmented
+
+534
+00:33:19,250 --> 00:33:21,570
+وفيه انه non-pigmented، ال pigmented بيتصل مع ال
+
+535
+00:33:21,570 --> 00:33:24,390
+pigmented وال non-pigmented بيتصل مع ال
+
+536
+00:33:24,390 --> 00:33:26,790
+neurosensory retina، صح؟ هذه الموضوع اللي أنا
+
+537
+00:33:26,790 --> 00:33:32,130
+حكيتها قبل ذلكطيب هل كل منطقة متوجهة فيها الشبكية
+
+538
+00:33:32,130 --> 00:33:38,730
+متوجهة فيها written word of epithelia؟ طبعا لازم
+
+539
+00:33:38,730 --> 00:33:41,650
+يكون فيه و هي أهم حد الفوابي أساسها كلها موجود
+
+540
+00:33:41,650 --> 00:33:44,490
+فيها مقعد ال .. مقعد ال .. مقعد ال .. مقعد ال ..
+
+541
+00:33:44,490 --> 00:33:45,370
+مقعد ال .. مقعد ال .. مقعد ال .. مقعد ال .. مقعد
+
+542
+00:33:45,370 --> 00:33:45,470
+ال .. مقعد ال .. مقعد ال .. مقعد ال .. مقعد ال ..
+
+543
+00:33:45,470 --> 00:33:46,830
+مقعد ال .. مقعد ال .. مقعد ال .. مقعد ال .. مقعد
+
+544
+00:33:46,830 --> 00:33:49,350
+ال .. مقعد ال .. مقعد ال .. مقعد ال .. مقعد ال ..
+
+545
+00:33:49,350 --> 00:33:49,790
+مقعد ال .. مقعد ال .. مقعد ال .. مقعد ال .. مقعد
+
+546
+00:33:49,790 --> 00:33:55,750
+ال .. مقعد ال .. مقعد ال .. مقعد ال .. مقعد ال ..
+
+547
+00:33:55,750 --> 00:34:00,000
+مقعد ال ..الأبتك ديست بشكل هذا كل الريتم اللي بده
+
+548
+00:34:00,000 --> 00:34:03,860
+يقف عند المنطقة هذه تماما عند الopticies و ال
+
+549
+00:34:03,860 --> 00:34:06,740
+bipolar اللي حالي كلها بده يقف على المنطقة هذه مع
+
+550
+00:34:06,740 --> 00:34:08,780
+ذلك هو بعض الطبقات من ضمنها اللي هو الألياف
+
+551
+00:34:08,780 --> 00:34:11,800
+العصبية اللي هي جزء الأساسي لتكوين ال optic disk
+
+552
+00:34:13,790 --> 00:34:16,110
+طيب دول تقنعوا أن الوضع اللي يسمونه الوضع اللي
+
+553
+00:34:16,110 --> 00:34:16,510
+يسمونه الوضع اللي يسمونه الوضع اللي يسمونه الوضع
+
+554
+00:34:16,510 --> 00:34:18,430
+اللي يسمونه الوضع اللي يسمونه الوضع اللي يسمونه
+
+555
+00:34:18,430 --> 00:34:20,110
+الوضع اللي يسمونه الوضع اللي يسمونه الوضع اللي
+
+556
+00:34:20,110 --> 00:34:20,650
+يسمونه الوضع اللي يسمونه الوضع اللي يسمونه الوضع
+
+557
+00:34:20,650 --> 00:34:20,890
+اللي يسمونه الوضع اللي يسمونه الوضع اللي يسمونه
+
+558
+00:34:20,890 --> 00:34:23,330
+الوضع اللي يسمونه الوضع اللي يسمونه الوضع اللي
+
+559
+00:34:23,330 --> 00:34:26,990
+يسمونه الوضع اللي يسمونه الوضع اللي يسمونه الوضع
+
+560
+00:34:26,990 --> 00:34:30,370
+اللي
+
+561
+00:34:30,370 --> 00:34:38,210
+يسمونه الوض
+
+562
+00:34:39,640 --> 00:34:43,320
+فيه هنا طبعا من ناحية ال SMG المحفوظ انه مايكونش
+
+563
+00:34:43,320 --> 00:34:46,680
+فيه اي ثقورات ما بين خلية و خلية اخرى ما بينها
+
+564
+00:34:46,680 --> 00:34:50,260
+مثلا بيصيب نفسه ما بين الكورويد ثقوره ذلك ان
+
+565
+00:34:50,260 --> 00:34:53,240
+الكورويد مليء بنوعية دموية صحيح بنوعية دموية هذا
+
+566
+00:34:53,240 --> 00:34:56,440
+فيها سائل جدا و فيه ايضا بلازمه كثيرة فلو تدفقت
+
+567
+00:34:56,440 --> 00:34:59,820
+عندك بلازمه الدم او السائل الدمه من بين الخلايا
+
+568
+00:34:59,820 --> 00:35:04,160
+هذه الى الرتنا هيحدث عندك اش اللي هو الفصال شبكي و
+
+569
+00:35:04,160 --> 00:35:07,690
+الفصال شبكي اللي هيحدث على اش نوعهحكينا في ذات
+
+570
+00:35:07,690 --> 00:35:16,050
+أنواع اللي صار الشبكة صحيح؟ روموتاجيراس؟
+
+571
+00:35:16,050 --> 00:35:19,030
+روموتاجيراس اللي هو عبارة عن ثقب كثير في الرتنا،
+
+572
+00:35:19,030 --> 00:35:24,970
+وهذا مش معانا، فيه tractional، اللي هو السحب، وفي
+
+573
+00:35:24,970 --> 00:35:27,950
+end-exudative، اللي هو الترسب اللي احنا هدا
+
+574
+00:35:27,950 --> 00:35:30,910
+بتهيأس، صحيح؟ ويحدث عن دي انتقال السلم أو البلازم
+
+575
+00:35:30,910 --> 00:35:34,930
+الدم من الكرويد نفسه، الكرويد الـfusion اللي انتصل
+
+576
+00:35:34,930 --> 00:35:38,790
+إليه، اللي هوالـ Neurosensorytema عبر الـ retinol
+
+577
+00:35:38,790 --> 00:35:41,050
+-pigmented epithelia، قلت لحاسبها، في عندي .. اللي
+
+578
+00:35:41,050 --> 00:35:43,750
+هو سائل، في عندي انتفاح، هذا الانتفاح هو الفصل
+
+579
+00:35:43,750 --> 00:35:46,390
+اللي هو بين ال retinol-pigmented epithelia و بين
+
+580
+00:35:46,390 --> 00:35:50,090
+Neurosensorytemaالحواوة الطبيعية المفروض انهم تكون
+
+581
+00:35:50,090 --> 00:35:53,230
+الخلايا الريتربوجوذي إبسيليا مع بعض لبعض متواصلة
+
+582
+00:35:53,230 --> 00:35:58,390
+بشكلاش تام وايضا مابين الريتربوجوذي إبسيليا ومابين
+
+583
+00:35:58,390 --> 00:36:01,850
+الكورويد او البروشيز بور براين وايضا في تواصل تام
+
+584
+00:36:01,850 --> 00:36:06,190
+ليسمح بنفاذية السائل من الكورويد الى نيوسنس ريتنا
+
+585
+00:36:06,190 --> 00:36:09,410
+بالتالي هي الحدوث اللي هو Retinal Detachment او
+
+586
+00:36:09,410 --> 00:36:10,910
+Exudative Retinal Detachment
+
+587
+00:36:14,560 --> 00:36:17,540
+طيب حكينا احنا كمان ضال دقال و قليل ان عندي افكار
+
+588
+00:36:17,540 --> 00:36:20,080
+بقدر المثال انها تحتوي على micro glide صحيح؟ هي
+
+589
+00:36:20,080 --> 00:36:24,240
+عبارة عن أحداب رقيقة و كثيرة جدا تعمل على احتضان
+
+590
+00:36:24,240 --> 00:36:27,180
+ال outer segments، تحيط ال outer segments من كل
+
+591
+00:36:27,180 --> 00:36:30,820
+الجهاتبالتالي تشارك في كل العملية الحيوية اللي
+
+592
+00:36:30,820 --> 00:36:34,880
+تشارك بحق اللي هو ال photoreceptor 7 نقطة مهمة ان
+
+593
+00:36:34,880 --> 00:36:39,080
+ال retinabegonibacillium يعمل على تغذية أو ضرور
+
+594
+00:36:39,080 --> 00:36:42,840
+جدا لتغذية ال photoreceptors بغض انه كانت calls او
+
+595
+00:36:42,840 --> 00:36:45,280
+rides بدون ال photoreceptors هذه عفوا بدون ال
+
+596
+00:36:45,280 --> 00:36:49,510
+retinabegonibacillium لابد يحدث عنديوهو أطرفي للـ
+
+597
+00:36:49,510 --> 00:36:51,210
+Retinal Pigmented Epithelium أو للـ
+
+598
+00:36:51,210 --> 00:36:54,250
+photoreceptors، وبالتالي، سيكون الإنسان فيه عنده
+
+599
+00:36:54,250 --> 00:36:57,510
+منطقة عمياء، المنطقة اللي تم فيها خلال في الـ
+
+600
+00:36:57,510 --> 00:36:59,110
+Retinal Pigmented Epithelium
+
+601
+00:37:09,480 --> 00:37:12,720
+الدماغيولة تحتوى على عدد كبير جدا من الصبغيات
+
+602
+00:37:12,720 --> 00:37:16,020
+الدماغيولة تحتوى على عدد كبير جدا من الصبغيات
+
+603
+00:37:16,020 --> 00:37:21,110
+دماغيولة تحتوى على عدد كبير جدا من الصبغياتوالـ
+
+604
+00:37:21,110 --> 00:37:24,210
+little pigmented epithelium حكي أنه يبدلها أكثر
+
+605
+00:37:24,210 --> 00:37:27,610
+أتامة بسبب تقدس اللي هو الـ little pigmented
+
+606
+00:37:27,610 --> 00:37:30,890
+epithelium في المنطقة هذه أو الصبغيات المتوجدة في
+
+607
+00:37:30,890 --> 00:37:32,870
+الـ little pigmented epithelium المتوجدة في
+
+608
+00:37:32,870 --> 00:37:36,310
+المنطقة الماكلة أكثر بكثير من باقي المناطق و
+
+609
+00:37:36,310 --> 00:37:39,290
+الصبغة ذلك حتى إيش يعمل على عدم scattering of
+
+610
+00:37:39,290 --> 00:37:43,170
+light، صحيح؟ بعدين يعمل على حماية الشبكية نفسها،
+
+611
+00:37:43,170 --> 00:37:45,290
+يعمل على انتصاص الـ ultraviolet light أو الأشعة
+
+612
+00:37:45,290 --> 00:37:49,270
+الدارة، مما لاسمح يعني بتدهور أو محدوث أي خلال في
+
+613
+00:37:49,270 --> 00:37:56,120
+الشبكيةعن آخر نقطة الـ junction between the apex
+
+614
+00:37:56,120 --> 00:37:58,520
+of the retinal epithelium cells and the
+
+615
+00:37:58,520 --> 00:37:59,700
+photoreceptors is weak
+
+616
+00:38:04,080 --> 00:38:06,540
+حتى من ناحية الهيستولوجيا هي فعلا الرابط ما بين ال
+
+617
+00:38:06,540 --> 00:38:09,320
+photoreceptors وما بين ال retina بمجموعة بيسيليان
+
+618
+00:38:09,320 --> 00:38:12,840
+تعتبر ضعيفة لإن مافيش عند أي اتصال أخر، مجرد فقط
+
+619
+00:38:12,840 --> 00:38:16,320
+ال microglia تعمل عليها سرعة وانتجة تحيط بال outer
+
+620
+00:38:16,320 --> 00:38:18,480
+circuit و ال photoreceptors من كل الجهة تلاقي فشان
+
+621
+00:38:18,480 --> 00:38:22,060
+دي ارتباط أخرى، مما يسهل عملية اللي هو الانفصال
+
+622
+00:38:22,060 --> 00:38:26,840
+الشبكيبناخد أخر شيء وهو functions of the retina
+
+623
+00:38:26,840 --> 00:38:29,700
+-pigmented epithelia ما هي الوضع التسليميجي
+
+624
+00:38:29,700 --> 00:38:33,560
+للretina-pigmented epithelia وهي فيه غاية الأهمية
+
+625
+00:38:33,560 --> 00:38:37,040
+لكل العيون الحيوانية زي ما حكينا مرة أخرى of the
+
+626
+00:38:37,040 --> 00:38:40,580
+retina أول حاجة بتعمل على management of سلسل
+
+627
+00:38:40,580 --> 00:38:43,320
+الретينا المقصود للسلسل الретينا هو فقط جزء ال
+
+628
+00:38:43,320 --> 00:38:46,300
+photo receptors صحيح؟ الجزء الوحيد اللي تبتغضيته
+
+629
+00:38:46,300 --> 00:38:50,340
+من ال retina-pigmented epithelia هو فقط ال photo
+
+630
+00:38:50,340 --> 00:38:58,030
+receptorsإذا كان دوائي
+
+631
+00:38:58,030 --> 00:39:02,250
+أو كان بطلبة معينة فهيكون فيه عنده الهو أكتروفيك،
+
+632
+00:39:02,250 --> 00:39:05,710
+فيه عنده دمور، و الدمور هذا معناته يعني التلف في
+
+633
+00:39:05,710 --> 00:39:09,270
+الخلايا العصبية أو الفترونسيبترز نفسها، لو حدث فيه
+
+634
+00:39:09,270 --> 00:39:11,870
+عنده تلف في الأرض، فإذا كان دوائي أو كان بطلبة
+
+635
+00:39:11,870 --> 00:39:11,870
+معينة فهيكون فيه دمور، و الدمور هذا معناته يعني
+
+636
+00:39:11,870 --> 00:39:11,870
+التلف في الخلايا العصبية أو الفترونسيبترز نفسها،
+
+637
+00:39:11,870 --> 00:39:11,870
+لو حدث فيه عنده تلف في الأرض، فإذا كان دوائي أو
+
+638
+00:39:11,870 --> 00:39:12,510
+كان بطلبة معينة فهيكون فيه تلف في الأرض، و دوائي
+
+639
+00:39:12,510 --> 00:39:14,290
+أو كان بطلبة معينة لابد يلحقوا التلف الل
+
+640
+00:39:19,460 --> 00:39:22,260
+رقم 2 Integrity of the upper segment of the
+
+641
+00:39:22,260 --> 00:39:26,840
+photoreceptors يحافظ على التنظيم أو كمالية الجزء
+
+642
+00:39:26,840 --> 00:39:31,120
+الخارج من الفوتوريسبترات لأنه يفتح من كل الجهات
+
+643
+00:39:31,120 --> 00:39:34,360
+ويعمل عليها احتضانة صحيح؟ فبالتالي يعمل على تنظيم
+
+644
+00:39:34,360 --> 00:39:39,340
+وحتى تشريحيةFibrocytosis of the big paws of the
+
+645
+00:39:39,340 --> 00:39:44,360
+phytoreceptors هي جزء الخاج منها فقط هو الذي يتجدد
+
+646
+00:39:44,360 --> 00:39:47,820
+بينما ال other segments لا يتجدد طيب كل جزء يتم
+
+647
+00:39:47,820 --> 00:39:51,540
+تشديده في اندق لجد انه يتم اتصاصه مقابل الجسم
+
+648
+00:39:51,540 --> 00:39:54,180
+صحيح؟ فال outer segment نجح مرة أخرى على الصورة
+
+649
+00:39:54,180 --> 00:39:58,420
+هذههذا يمكن أن يكون في الـ outer segment و يمكن أن
+
+650
+00:39:58,420 --> 00:40:00,280
+يكون في ال inner segment صحيح ال inner segment
+
+651
+00:40:00,280 --> 00:40:03,180
+سيمكن تشديده بينما ال outer segment سيسب اللي هو
+
+652
+00:40:03,180 --> 00:40:06,800
+ال photopic و ال scotopic اللي هو رؤية ليلية و
+
+653
+00:40:06,800 --> 00:40:09,860
+رؤية نهارية و النشاط اللي هو الخلايا العصبية اللي
+
+654
+00:40:09,860 --> 00:40:12,180
+هو ال photoreceptor بشكل عام لابدوا الجزء هذا يتم
+
+655
+00:40:12,180 --> 00:40:15,680
+تنشيطه من موقته لآخر طب الجزء المفقود أو الجزء
+
+656
+00:40:15,680 --> 00:40:19,480
+اللي تم تلفه أو تم استغناء عنه يبدوا يتم حضمه في
+
+657
+00:40:19,480 --> 00:40:23,890
+angiocytosis من ال Britain and the segmentedرقم
+
+658
+00:40:23,890 --> 00:40:28,030
+اربعة يعمل على تخزين كميات كبيرة من vitamin A احنا
+
+659
+00:40:28,030 --> 00:40:32,150
+حكينا ان vitamin A مهم جدا جدا جدا في عند المرض
+
+660
+00:40:32,150 --> 00:40:35,270
+ايضا اسمه العاشر ليلة صحيح عاشر ليلة اتكلمنا عنه
+
+661
+00:40:35,270 --> 00:40:39,270
+هذا نقص نقص vitamin A مش علاقة بالمرض الوراثي صحيح
+
+662
+00:40:39,270 --> 00:40:42,690
+فحتى لو اهل الإنسان يعني احنا عارفين ان مشكلة
+
+663
+00:40:42,690 --> 00:40:44,570
+عياره الكبد هو يعمل على تخزين كميات كبيرة من
+
+664
+00:40:44,570 --> 00:40:47,590
+vitamin A صحيح و ايضا ال .. ال .. little bit more
+
+665
+00:40:47,590 --> 00:40:50,490
+than epithelium يعمل على تخزين كميات كبيرة جدا من
+
+666
+00:40:50,490 --> 00:40:55,010
+vitamin Aلو الإنسان توقف عن تناول الأبطحنة، انها
+
+667
+00:40:55,010 --> 00:40:57,370
+تحتفظ على الـVitamin A بشكل مباشر لمدة ان شاء الله
+
+668
+00:40:57,370 --> 00:41:00,630
+تلت أربع شهور، لسه ما زالت اللي هو الـRetinol
+
+669
+00:41:00,630 --> 00:41:04,890
+بيتمد ديبثيليا بتحتفظ بكميات اللي هو كبيرة جدا
+
+670
+00:41:04,890 --> 00:41:07,530
+لاستخدامها لكورتلاحية، طلع لهامية روية، يعني لسه
+
+671
+00:41:07,530 --> 00:41:09,890
+فقط أيضا في الكبد، لأ أيضا في الـRetinol بيتمد
+
+672
+00:41:09,890 --> 00:41:14,810
+ديبثيليا بتحتفظ مسبقا بكميات كبيرة حتى يعني لو حدث
+
+673
+00:41:14,810 --> 00:41:17,230
+لي عندي رقص بالـVitamin A، يكون الإنسان على الأقل
+
+674
+00:41:17,230 --> 00:41:22,240
+قادر أنه إيش يستقبل الصورة اللي أمرقم خمسة
+
+675
+00:41:22,240 --> 00:41:25,700
+absorption of the excessive harmful light like
+
+676
+00:41:25,700 --> 00:41:28,260
+infrared light by melanin granules يعمل على أساس
+
+677
+00:41:28,260 --> 00:41:30,920
+اللي هو الأشعة الدرّا من ضمن الأشعة ال ultraviolet
+
+678
+00:41:30,920 --> 00:41:34,440
+اللي هي ال infrared light بسبب وجود اللي هو ال
+
+679
+00:41:34,440 --> 00:41:37,600
+melanin pigments أو بعد الميلانين أو سبب الميلانين
+
+680
+00:41:37,600 --> 00:41:40,580
+متواجدة في ال retina pigmented epithelium وهذه
+
+681
+00:41:40,580 --> 00:41:44,670
+يعني مهم جدا لعندي في حلقاتاللي هو الالبنزم،
+
+682
+00:41:44,670 --> 00:41:47,310
+عارفينها؟ فيناها بالجامعة اكتر من حالها، اللي هو
+
+683
+00:41:47,310 --> 00:41:51,250
+البحق، صحيح؟ يعني فقدان .. فقدان اللي هو ال
+
+684
+00:41:51,250 --> 00:41:54,750
+pigments اللي في كل جسم الناس على .. هدو بتحمله
+
+685
+00:41:54,750 --> 00:42:01,410
+شمس بشكل كبير، رقم ستةتعمل على transport of
+
+686
+00:42:01,410 --> 00:42:05,230
+nutrients to inside the retina تعمل على نقل بعض
+
+687
+00:42:05,230 --> 00:42:08,710
+المواد المقضية إلى داخل الشبكية طبعا لسه احنا ما
+
+688
+00:42:08,710 --> 00:42:12,150
+نزلنا فيه تلتين صحيح لإن كل المواد اللي دفق مننا
+
+689
+00:42:12,150 --> 00:42:16,030
+الكروين عبر ال retina بجميع دبيسينيا ثم عبر او ثم
+
+690
+00:42:16,030 --> 00:42:19,110
+إلى اللي هو ال neuroscience retina فقط الجزاء
+
+691
+00:42:19,110 --> 00:42:22,530
+الخارجيةDetoxification of drugs that enter the
+
+692
+00:42:22,530 --> 00:42:26,130
+retina تعمل على أنه التخلص من المواد السامة أو
+
+693
+00:42:26,130 --> 00:42:29,150
+لادوية السامة، تحليل السموم هذه ناتجة من الأدوية
+
+694
+00:42:29,150 --> 00:42:33,290
+التي دخلت شبكية العين، طبعا هذه الأدوية ممكن أن أي
+
+695
+00:42:33,290 --> 00:42:35,870
+إنسان ياخد أي عقار حتى كان عن طريق الفرق، اللي
+
+696
+00:42:35,870 --> 00:42:38,810
+لابد أنه يصل عبر مجلة ده، لكي يصل إلى الكورويد،
+
+697
+00:42:38,810 --> 00:42:42,170
+فبالتالي هناك أن ال retinopectomid بيحاول أن تخلص
+
+698
+00:42:42,170 --> 00:42:46,450
+من هذه السموم حتى تعمل علاقة سموم الشبكيةprovide a
+
+699
+00:42:46,450 --> 00:42:48,330
+barrier between the corrod and the sensor retina
+
+700
+00:42:48,330 --> 00:42:53,470
+رقم تسعة ability to transfer water and can pump
+
+701
+00:42:53,470 --> 00:42:56,290
+fluid from the sub retinal space outside the
+
+702
+00:42:56,290 --> 00:43:02,450
+retina بشكل عام تعمل كحاجز ما بين ال corrod و ما
+
+703
+00:43:02,450 --> 00:43:06,150
+بين ال sensor retina تعمل على عدم تكدوس السائل في
+
+704
+00:43:06,150 --> 00:43:09,710
+المنطقة هذه حتى لا تحدث اللي هو retinal detachment
+
+705
+00:43:11,340 --> 00:43:15,480
+أخر slide Unliked Britain is capable of Local
+
+706
+00:43:15,480 --> 00:43:25,080
+Repair Unliked in Europe is capable of Local
+
+707
+00:43:25,080 --> 00:43:36,060
+Repair
+
+708
+00:43:36,130 --> 00:43:39,350
+الـ Neurotransmitter هو الخلايا العصبية داخل
+
+709
+00:43:39,350 --> 00:43:42,490
+الشبكية اللى يمكن أنت جد بطا نفقده خلاص بكون انت
+
+710
+00:43:42,490 --> 00:43:45,010
+هيتم تعويضه بخلايا أخرى لكن الخلايا الأخرى هادى
+
+711
+00:43:45,010 --> 00:43:48,030
+لتعمل نفس عمل اللى هو الخلايا العصبية الأولى انما
+
+712
+00:43:48,030 --> 00:43:49,490
+فقط تسد المكان
+
+713
+00:43:52,850 --> 00:43:55,430
+في الأخر ملاحظة الـ dysfunction of retinopigmented
+
+714
+00:43:55,430 --> 00:43:57,970
+epithelium occurs in a number of retinal diseases
+
+715
+00:43:57,970 --> 00:44:02,430
+like spinal microdegeneration الخلل اللي بحدث عنده
+
+716
+00:44:02,430 --> 00:44:04,830
+في retinopigmented epithelium فيه أكتر من مرض من
+
+717
+00:44:04,830 --> 00:44:07,710
+ضمنها ال retinitis pigmentosa أو العشريلي اللي هو
+
+718
+00:44:07,710 --> 00:44:10,850
+المرض البراسي اللي اتكلمنا عنه بسبب غياب بعض اللي
+
+719
+00:44:10,850 --> 00:44:13,290
+هو retinopigmented epithelium بالتالي هتكون ال
+
+720
+00:44:13,290 --> 00:44:15,690
+retinopigmented epithelium غير قادر على تغيية اللي
+
+721
+00:44:15,690 --> 00:44:19,130
+هو ال outer segment of the photoreceptorsبالتالي
+
+722
+00:44:19,130 --> 00:44:21,510
+اذا انا حقق في قطقه ما قدرته على اللي هو الرؤية
+
+723
+00:44:21,510 --> 00:44:27,670
+احدى بشكل مختصر، في عندكوا اي سؤال، يحكوا لكم فيه
+
diff --git a/PL9fwy3NUQKwZ2K6wMRTZMEoGVTbELxinF/cqrTpVBC-bA.srt b/PL9fwy3NUQKwZ2K6wMRTZMEoGVTbELxinF/cqrTpVBC-bA.srt
new file mode 100644
index 0000000000000000000000000000000000000000..2c213c39f7f70c9535c306818027331271b1aed1
--- /dev/null
+++ b/PL9fwy3NUQKwZ2K6wMRTZMEoGVTbELxinF/cqrTpVBC-bA.srt
@@ -0,0 +1,2550 @@
+1
+00:00:20,770 --> 00:00:24,330
+طيب السلام عليكم ورحمة الله وبركاته سأتكلم اليوم
+
+2
+00:00:24,330 --> 00:00:27,310
+إن شاء الله في the trilogy of the iris بتكلمنا احنا 
+
+3
+00:00:27,310 --> 00:00:30,930
+بتكلمنا عن بعض التفاصيل البسيطة في التشريح بتكلمنا
+
+4
+00:00:30,930 --> 00:00:34,250
+أيضا عن the plexus of the pupil بتكلمنا على ال
+
+5
+00:00:34,250 --> 00:00:36,650
+sympathetic and the parasympathetic pathway for
+
+6
+00:00:36,650 --> 00:00:39,610
+constriction and the dilation of the pupil صحيح؟
+
+7
+00:00:39,610 --> 00:00:41,870
+حكينا فيه أن ال two pathways are most important
+
+8
+00:00:41,870 --> 00:00:45,070
+سواء كان في الاختبارات أو كان حتى في الحياة
+
+9
+00:00:45,070 --> 00:00:49,700
+العملية الreflex الأول هو عبارة عن constriction of
+
+10
+00:00:49,700 --> 00:00:53,120
+the pupil هو المسار نفسه كله اللي اخذناه صحيح؟ ال
+
+11
+00:00:53,120 --> 00:00:56,620
+dilation عبارة عن إيش؟ المسار أيضا اللي أخدنا
+
+12
+00:00:56,620 --> 00:00:59,560
+إحنا بالafferent و بالefferent ماشي الحاجة ففينا
+
+13
+00:00:59,560 --> 00:01:01,100
+two reflexes الأول
+
+14
+00:01:16,160 --> 00:01:23,120
+طبعا طبعا طبعا طبعا طبعا طبعا طبعا طبعا طبعا
+
+15
+00:01:23,120 --> 00:01:24,720
+طبعا
+
+16
+00:01:44,080 --> 00:01:46,400
+الشرح المختصر هو عبارة عن تدبير أعصاب ال
+
+17
+00:01:46,400 --> 00:01:49,520
+sympathetic و ال parasympathetic innervation of
+
+18
+00:01:49,520 --> 00:01:52,860
+the iris muscles بشكل عام اللي هي عبارة عن ال
+
+19
+00:01:52,860 --> 00:01:55,800
+sphincter muscle أو اللي هي ال dilator muscle طيب
+
+20
+00:01:55,800 --> 00:01:58,700
+واتكلمنا بعد ذلك تكلمنا أيضا على causes of
+
+21
+00:01:58,700 --> 00:02:01,600
+relative afferent pupillary defect و قسمنا إحنا ل
+
+22
+00:02:01,600 --> 00:02:04,060
+total pupillary afferent defect صحيح و ل relative
+
+23
+00:02:04,060 --> 00:02:08,960
+pupillary defect و عملنا رسمة و شرحناها و حكينا
+
+24
+00:02:08,960 --> 00:02:12,160
+أنها مهمة جدا من بعض الأسباب هم مشكلة من بعض
+
+25
+00:02:12,160 --> 00:02:16,030
+الأسباب اللي هتؤدي إلى اللي هو فقدان ال reflex بشكل
+
+26
+00:02:16,030 --> 00:02:19,170
+كله أو بشكل جزء، لأن بشكل .. بشكل كله طبعا هو
+
+27
+00:02:19,170 --> 00:02:22,190
+عبارة عن فقدان العين كلها، صحيح؟ أو أن تكون
+
+28
+00:02:22,190 --> 00:02:27,870
+المشكلة عند pre-chiasma، هذا صحيح؟ صح ولا؟ لو
+
+29
+00:02:27,870 --> 00:02:31,870
+كانت عند المشكلة اللي تجي في ال .. ال optic
+
+30
+00:02:31,870 --> 00:02:35,830
+pathway، في ال visual pathway، لو كانت post
+
+31
+00:02:36,860 --> 00:02:39,060
+الكيازما أو post chiasmal مش هيكون .. هيكون ما فيه
+
+32
+00:02:39,060 --> 00:02:42,220
+عنده إيش في ال fellow eye صحيح؟ بينما لو كانت فقط ال
+
+33
+00:02:42,220 --> 00:02:45,620
+pre-chiasmal هيكون عنده in one eye على أحد الخصوص
+
+34
+00:02:45,620 --> 00:02:48,480
+اللي هو هيكون فيه عنده blindness، إذا كانت طبعا ال
+
+35
+00:02:48,480 --> 00:02:51,560
+damage قوي بما فيه الكفاية، من بعد هذه الأمراض
+
+36
+00:02:51,560 --> 00:02:54,220
+عند ال optic neuritis، ال optic neuritis عبارة عن
+
+37
+00:02:55,750 --> 00:02:58,690
+التهاب في العصب صحيح حكينا أنه صنفناه فقط إحنا
+
+38
+00:02:58,690 --> 00:03:02,330
+خدنا ال optic neuritis بشكل مبسط يعمل في ال optic
+
+39
+00:03:02,330 --> 00:03:04,870
+nerve على إصابة قاعد ال optic nerve fibers
+
+40
+00:03:04,870 --> 00:03:08,790
+اللتي لها علاقة في اللي هو ال afferent و ال
+
+41
+00:03:08,790 --> 00:03:11,950
+efferent و مثلا ما بِدُّوْ يحدث ل afferent pupillary or
+
+42
+00:03:11,950 --> 00:03:14,050
+defect لكن طبيعة ال afferent pupillary or defect هي
+
+43
+00:03:14,050 --> 00:03:17,210
+عبارة عن relative و ليس total مش حاجة عبارة عن
+
+44
+00:03:17,210 --> 00:03:21,910
+جزء و ليس كله تاني شيء retinal detachment و حكينا
+
+45
+00:03:21,910 --> 00:03:23,690
+أيضا أن ال retinal detachment مش كل ال retinal
+
+46
+00:03:23,690 --> 00:03:26,370
+detachment على كل أنواعه يعني ربما يكون فيه عندك
+
+47
+00:03:26,370 --> 00:03:30,290
+جزء معين بالشبكية فقط بالشكل هذا هي ده الشبكية فيه
+
+48
+00:03:30,290 --> 00:03:34,510
+عندها retinal detachment حاجة ما بتحملش أي مشكلة يعني
+
+49
+00:03:34,510 --> 00:03:37,450
+حقيقية لما ده باقي عنده الخلايا الموجودة الأربعة
+
+50
+00:03:37,450 --> 00:03:41,270
+طبقات الشبكية كلها متصلة غير مفصلة هتوصل لرسالة
+
+51
+00:03:41,270 --> 00:03:46,390
+بشكل كامل فالغالب هو عبارة عن v-shaped صحيح أو حالة
+
+52
+00:03:46,390 --> 00:03:50,330
+نسميها hypotony يعني عبارة عن انخفاض ضغط العين
+
+53
+00:03:54,070 --> 00:03:57,750
+إنها تجعل الانفصال الشبكي أيضا ممكن سبب ليه اللي
+
+54
+00:03:57,750 --> 00:04:01,890
+هو relative afferent pupillary defect يتحاجى lesion
+
+55
+00:04:01,890 --> 00:04:05,330
+of the visual pathway أي مشكلة في العصب البصري أو
+
+56
+00:04:05,330 --> 00:04:08,490
+في الكيازما أو حتى في ال optic tract في كل المسار
+
+57
+00:04:08,490 --> 00:04:11,070
+هذا البصري ممكن سبب ليه اللي هو afferent pupillary
+
+58
+00:04:11,070 --> 00:04:16,530
+defect آخر حاجة حكينا تعرض الإنسان لبعض اللي هو
+
+59
+00:04:16,530 --> 00:04:20,750
+السموم من ضمنها الكحول والتدخين ممكن أيضا سبب ليه
+
+60
+00:04:20,750 --> 00:04:21,250
+هذه المشكلة
+
+61
+00:04:29,140 --> 00:04:32,860
+كلها من أهم الأسباب صحيح؟ طيب different و by increasing
+
+62
+00:04:32,860 --> 00:04:36,840
+pupil size وهذا يعني الفقرة كلها تقريبا مهمة ما هو
+
+63
+00:04:36,840 --> 00:04:45,170
+تأثيره أو ناتج عن زيادة حجم البؤبؤ أو بؤبؤ العين هنا
+
+64
+00:04:45,170 --> 00:04:48,110
+عددها سبعة، بعد ما نكون عارفين هي يعني إيه،
+
+65
+00:04:48,110 --> 00:04:51,130
+كمُنشِّر، لو أجينا بسؤال مُنشِّر، نكون عارفينها pupil
+
+66
+00:04:51,130 --> 00:04:54,230
+dilation بتوسع البؤبؤ will increase depth of
+
+67
+00:04:54,230 --> 00:04:57,510
+focus and depth of field، حاجة مهمة، أول حاجة
+
+68
+00:04:57,510 --> 00:05:00,490
+depth of focus will increase and depth of field
+
+69
+00:05:00,490 --> 00:05:08,430
+will also increase، السبب هو ذلك، السبب هو ذلك، لو
+
+70
+00:05:08,430 --> 00:05:09,570
+أجي أنا بعلم، نكون عارفينه
+
+71
+00:05:14,140 --> 00:05:18,380
+هذه ال pupil صحيح هذه حوافها هذه ال pupil كله كله
+
+72
+00:05:18,380 --> 00:05:23,040
+الآن الضوء عندما يدخل كرة العين خليكم معي اه مش 
+
+73
+00:05:23,040 --> 00:05:26,120
+هيدخل من الأطراف صحيح هيدخل طبعا أكيد هيكون في جزء
+
+74
+00:05:26,120 --> 00:05:30,120
+من الأطراف داخل لكن غالبية الضوء لأن الأطراف هتعمل
+
+75
+00:05:30,120 --> 00:05:33,800
+علي تحجيم الضوء حتما الضوء صحيح القصد من ال pupil
+
+76
+00:05:33,800 --> 00:05:38,000
+يعمل على مركز أو تمركز صحيح الضوء لحيث ال focusing
+
+77
+00:05:38,000 --> 00:05:41,160
+اللي هو في ال fovea صح ولا لأ صح ولا لأ أو باقي
+
+78
+00:05:41,160 --> 00:05:45,530
+اللي هو المناطق الشبكية فالضوء عندها هيكون في الوسط
+
+79
+00:05:45,530 --> 00:05:49,450
+كثافته أكثر بكثير من إيش؟ من الأطراف الأطراف هيكون
+
+80
+00:05:49,450 --> 00:05:55,450
+شكله قليل هذا السبب الأول عشان كده إن الضوء يخترق
+
+81
+00:05:55,450 --> 00:06:00,010
+مركز البؤبؤ أكثر بكثير من اختراقه المناطق الموجودة
+
+82
+00:06:00,010 --> 00:06:06,510
+على حواف ال pupil عشان كده الحاجة رقم اثنين إن الضوء
+
+83
+00:06:06,510 --> 00:06:10,750
+يعمل على تحفيز ال photoreceptors
+
+84
+00:06:16,230 --> 00:06:21,050
+photoreceptors بشكل إيش؟ actually أو obliquely؟
+
+85
+00:06:21,050 --> 00:06:25,170
+بشكل obliquely but not actually يعني الضوء مش
+
+86
+00:06:25,170 --> 00:06:30,050
+هيصدر مباشرة بالضوء بشكل إيش actually درجة تسليط
+
+87
+00:06:30,050 --> 00:06:33,930
+بشكل هذا لا لكن هيكون فيه انعكاس تعرض والتعرض لهذا
+
+88
+00:06:33,930 --> 00:06:38,300
+من إحدى أسبابه اللي هو الضوء هيبدأ انتشاره أولا من
+
+89
+00:06:38,300 --> 00:06:41,400
+الشبكية لل pigmented epithelium ثم يوزع على ال
+
+90
+00:06:41,400 --> 00:06:43,460
+photoreceptors السبب الثاني بنقوله إننا كنا عارفين
+
+91
+00:06:43,460 --> 00:06:46,120
+لو جاء السؤال إننا كنا عارفين أن ال light entering
+
+92
+00:06:46,120 --> 00:06:48,580
+the eye at the edge of the pupil is less effective
+
+93
+00:06:48,580 --> 00:06:51,380
+than stimulating photoreceptors وهذا أول شيء ثاني
+
+94
+00:06:51,380 --> 00:06:56,980
+حاجة السبب براء ذلك أن ال light هيعمل hits ل ال
+
+95
+00:06:56,980 --> 00:06:59,740
+photoreceptors اللي هيتعيش بليكلي  بطريقة not actually
+
+96
+00:06:59,740 --> 00:07:05,620
+طيب شوف رقم اثنين تأثير أيضا اللي هو increasing ال
+
+97
+00:07:05,620 --> 00:07:09,190
+pupil size Pupil size increases, diffraction of
+
+98
+00:07:09,190 --> 00:07:11,490
+light decrease and spherical and chromatic
+
+99
+00:07:11,490 --> 00:07:14,030
+aberration will increase فإحنا إحنا حكيناها كل ما
+
+100
+00:07:14,030 --> 00:07:17,570
+توسع البؤبؤ بغض النظر إن كان باستخدام الأدوية معينة أو
+
+101
+00:07:17,570 --> 00:07:21,050
+إنسان تعرض لضربة معينة أو مرض معين الآخرين بيحدث
+
+102
+00:07:21,050 --> 00:07:24,070
+عنده blurring of vision فأسباب ال blurring of
+
+103
+00:07:24,070 --> 00:07:29,050
+vision هي spherical and chromatic aberration رقم
+
+104
+00:07:29,050 --> 00:07:34,090
+ثلاثة increase illumination of the retina زي في أي
+
+105
+00:07:34,090 --> 00:07:41,070
+حالة من الحالات تعرفوا المرد قلب الاسم؟ بِحَقّ، بس إحنا
+
+106
+00:07:41,070 --> 00:07:43,830
+حكيناها على سبيل المثال، الضوء بِدُّوْ يتشتت داخل
+
+107
+00:07:43,830 --> 00:07:46,670
+الشبكية، اللي غير موجود، اللي هو ال ret .. ال RP
+
+108
+00:07:46,670 --> 00:07:49,710
+.. ال retinal pigmented epithelium، صحيح؟ بينما في
+
+109
+00:07:49,710 --> 00:07:52,490
+الحالات هذه لا موجود، موجود لكن ما فيه end focusing،
+
+110
+00:07:52,490 --> 00:07:55,830
+إحنا حكينا وظيفة ال pupil أساسية تعمل على تجمع
+
+111
+00:07:55,830 --> 00:07:58,750
+الضوء صحيح، تعكسه على الشبكية، لكن في end في ال
+
+112
+00:07:58,750 --> 00:08:01,820
+pupil اللي هو dilated غير قادر اللي بِدُّوْ يعمل تجميع هذا
+
+113
+00:08:01,820 --> 00:08:04,700
+الشعاع بتاعي هيتشتت داخل اللي هو الشبكية هيبقى
+
+114
+00:08:04,700 --> 00:08:07,920
+تشتت الضوء هذا أيضا وبيعمله decreased visual
+
+115
+00:08:07,920 --> 00:08:12,100
+function مش الحاجة رقم ثلاثة الناتج عنه هيعمل له
+
+116
+00:08:12,100 --> 00:08:15,260
+decreased visual function اللي هو انخفاض الوظائف
+
+117
+00:08:15,260 --> 00:08:20,920
+البصرية رقم أربعة هو إحنا ذكرناها لما أخذنا ال pin
+
+118
+00:08:20,920 --> 00:08:23,520
+torch حكينا dilation of the pupil إيش بيعمل له
+
+119
+00:08:23,520 --> 00:08:29,040
+بيتجه أو يعمل على ضغط كل ال dilator muscle حتى تتجه
+
+120
+00:08:29,040 --> 00:08:29,440
+ناحية
+
+121
+00:08:37,170 --> 00:08:43,430
+وتصبح عند ال angle ضيقة إحنا أخذناها لما حكينا
+
+122
+00:08:43,430 --> 00:08:48,750
+قبل استخدام ال media text كلها لابد من فحص الزاوية
+
+123
+00:08:48,750 --> 00:08:51,870
+حتى لو كان زاوية عندها narrow مش المفروض أن أنا أعمل
+
+124
+00:08:51,870 --> 00:08:54,910
+dilation of the pupil صحيح لأن dilation of the pupil بالبحث
+
+125
+00:08:54,910 --> 00:09:00,430
+ذاته بحد ذاته بيعمل ال block ل اللي هو ال angle
+
+126
+00:09:03,390 --> 00:09:06,550
+رقم خمسة Prevent Posterior Synechia هو هذا اللي
+
+127
+00:09:06,550 --> 00:09:09,510
+إحنا بدنا نصرحه عشان نتفهمه مش معايا ال Synechia
+
+128
+00:09:09,510 --> 00:09:15,630
+ونصرّح الحالة Synechia
+
+129
+00:09:15,630 --> 00:09:19,590
+عبارة عن مرض أو مش مرض يعني عبارة عن sign معين
+
+130
+00:09:19,590 --> 00:09:26,530
+نتيجته سببه عن التصاق ال posterior surface of the
+
+131
+00:09:26,530 --> 00:09:31,210
+iris مع ال anterior surface of the lens
+
+132
+00:09:39,330 --> 00:09:43,150
+خليني أقول معاكم، هناك adhesions من ناحية الخلفية،
+
+133
+00:09:43,150 --> 00:09:46,170
+ماشي الحال، في اندر ال pupil نفسه أو ال posterior
+
+134
+00:09:46,170 --> 00:09:49,490
+surface of the iris، حتى تلتصق ال anterior .. ال
+
+135
+00:09:49,490 --> 00:09:51,690
+posterior مع ال anterior surface of the lens
+
+136
+00:09:51,690 --> 00:09:57,250
+فالالتصاق به الشكل هذا هيعمل ميوّسس، صحيح؟ هذا السبب،
+
+137
+00:09:57,250 --> 00:10:00,110
+لكن أنا لما أخلّي فيه مِدْرِيَاسِس، أستخدم دواء
+
+138
+00:10:00,110 --> 00:10:02,750
+معينة، المرضى اللي فيه عندي هو الالتحام القزحي
+
+139
+00:10:03,010 --> 00:10:06,690
+الأكثر حاجة نخاف منها اللي هي posterior synechia
+
+140
+00:10:06,690 --> 00:10:10,830
+اللي هو الالتصاق، التصاق لأن الالتصاق إذا حدث سعدّ، يفك
+
+141
+00:10:10,830 --> 00:10:14,510
+بيحدث بشكل دائم مش الحرف حتى أنا أمنع حدوث هذا
+
+142
+00:10:14,510 --> 00:10:17,250
+الالتصاق اللي هو هيسبّب لي مشاكل في المستقبل ربما
+
+143
+00:10:17,250 --> 00:10:20,990
+ارتفاع ضغط العين ربما هيسبّب لي cataract  الآخرين بدل
+
+144
+00:10:20,990 --> 00:10:23,310
+ده المريض اللي هو نوع من ال mydriatics حتى يخلّي
+
+145
+00:10:23,310 --> 00:10:26,930
+البؤبؤ شغال متوسّع فالتوسع هذا هو يمنحني فرصة
+
+146
+00:10:26,930 --> 00:10:29,850
+حدوث أو يقلل لي من فرصة حدوث اللي هو ال posterior
+
+147
+00:10:29,850 --> 00:10:33,210
+synechia بالتالي مش هيحدث عندي الالتصاقات ما بين
+
+148
+00:10:33,210 --> 00:10:36,030
+posterior surface of the iris and anterior surface
+
+149
+00:10:36,030 --> 00:10:42,200
+of the lens طيب، في كمان نقطتين مهمتين جدا، وهم ال
+
+150
+00:10:42,200 --> 00:10:48,960
+mydriatics و ال miotics، كيف تحدث؟ كيف تحدث؟ إحنا
+
+151
+00:10:48,960 --> 00:10:53,540
+ذكرنا يعني في المحاضرة السابقة عن اللي هو ال
+
+152
+00:10:53,540 --> 00:10:57,040
+mydriatics، كيفية حصول النشاط، اللي هو ال dilation
+
+153
+00:10:57,040 --> 00:11:00,360
+المصدرة، صحيح؟ أخذناها كلها، ولا لا؟ عبارة عن اللي
+
+154
+00:11:00,360 --> 00:11:02,960
+حصل نفسه، التابع مالاش، ال simplistic أو pre
+
+155
+00:11:02,960 --> 00:11:07,850
+synaptic؟ ال mydriatics هه من ال pre-synaptic صحيح؟
+
+156
+00:11:07,850 --> 00:11:09,210
+بينما بيبقى على ال post-synaptic الناس العالمية
+
+157
+00:11:09,210 --> 00:11:13,390
+يؤسسوا لها ثاني mydriatics قدرها عن dilation of the
+
+158
+00:11:13,390 --> 00:11:16,490
+pupil هذا المصطلح يعني dilation of the pupil هي
+
+159
+00:11:16,490 --> 00:11:20,450
+معك mydriatics لذلك بعض الوقت تسمى mydriatics صحيح؟
+
+160
+00:11:20,450 --> 00:11:23,590
+أو زي ال mydriasis هي الأصل مشتقة من mydriatics من
+
+161
+00:11:23,590 --> 00:11:26,310
+النشاط اللي هو العمل في الفسيولوجيا لتوسيع بؤبؤ
+
+162
+00:11:26,310 --> 00:11:30,290
+العين is produced by contraction of the dilator
+
+163
+00:11:30,290 --> 00:11:34,840
+muscle which is stimulated by noradrenergic
+
+164
+00:11:34,840 --> 00:11:39,900
+sympathetic nerves يريد تحت noradrenergic نحط خط nor
+
+165
+00:11:39,900 --> 00:11:42,940
+adrenergic هي نفس ال sympathetic nerves بس هذي يعني
+
+166
+00:11:42,940 --> 00:11:47,740
+تتبع هي تبع نوعية ال neurotransmitters اللي
+
+167
+00:11:47,740 --> 00:11:50,880
+بتنفرزها من النهايات العصبية في عضلة اللي هو
+
+168
+00:11:50,880 --> 00:11:54,240
+dilator muscle هذي يعني زي ما أخذناها بال
+
+169
+00:11:54,240 --> 00:11:56,380
+sympathetic أو لا sympathetic مش عارف أنت فاكرني
+
+170
+00:11:56,380 --> 00:11:57,340
+هأبقى في السجن ولا لا
+
+171
+00:12:03,900 --> 00:12:09,080
+فيه أن ال synapse صح ولا أقلّ هيخليها عضلية الآخر
+
+172
+00:12:09,080 --> 00:12:14,100
+هيخليها عضلية ال synapse  هيش نسمّيها هي ال pre
+
+173
+00:12:14,100 --> 00:12:18,960
+-synaptic صح معناها هي ال post-synaptic ال post
+
+174
+00:12:18,960 --> 00:12:21,560
+-synaptic هي المنطقة اللي تم تغذيتها وتعصيبها من
+
+175
+00:12:21,560 --> 00:12:24,680
+العصب صحيح المنطقة اللي ما بين ال pre-synaptic و post
+
+176
+00:12:24,680 --> 00:12:30,020
+-synaptic هي حاجة اسمها cleft صحيح
+
+177
+00:12:30,020 --> 00:12:36,710
+صح ولا لا ال cleft فده إيش وظيفته؟ بيسمح لي تفرز كل
+
+178
+00:12:36,710 --> 00:12:39,990
+ال neurotransmitters اللي أنا من نهاية العصبية اللي فيها
+
+179
+00:12:39,990 --> 00:12:44,010
+ال neurotransmitters صح ولا لا؟ صح ولا لا؟ حكينا
+
+180
+00:12:
+
+216
+00:15:18,230 --> 00:15:22,390
+المقصود في الأول أو المذكور أولاً مش الحاجة في ال
+
+217
+00:15:22,390 --> 00:15:25,570
+number أخرى sympathomimetic agents هي عبارة عن
+
+218
+00:15:25,570 --> 00:15:28,530
+عقاقير لا تحاكي عمل ال sympathetic nervous system
+
+219
+00:15:28,530 --> 00:15:31,390
+يعني بشكل مختصر هتعمل مدرسات صحيح
+
+220
+00:15:33,880 --> 00:15:40,760
+و مصطلح آخر parasympatholytics يعني بارسينباثولنتكس
+
+221
+00:15:40,760 --> 00:15:44,560
+يعني parasympatholytics يعني parasympatholytics يعني
+
+222
+00:15:44,560 --> 00:15:45,560
+parasympatholytics يعني parasympatholytics يعني
+
+223
+00:15:45,560 --> 00:15:47,680
+parasympatholytics يعني parasympatholytics يعني
+
+224
+00:15:47,680 --> 00:15:50,520
+parasympatholytics يعني parasympatholytics يعني
+
+225
+00:15:50,520 --> 00:15:56,280
+parasympatholytics يعني parasympatholytics يعني
+
+226
+00:15:56,280 --> 00:15:58,300
+parasympathol
+
+227
+00:16:02,430 --> 00:16:05,690
+تعمل أو تحاكي ال sympathetic nervous system منها
+
+228
+00:16:05,690 --> 00:16:10,550
+ال adrenaline التي
+
+229
+00:16:10,550 --> 00:16:13,650
+هو شائع جداً بالاستخدام و أيضاً في العمليات وهو التي
+
+230
+00:16:13,650 --> 00:16:18,670
+برفع ضغط الدم بسرعة صحيح منها أيضاً الـ epinephrine
+
+231
+00:16:18,670 --> 00:16:21,790
+والكوكايين إلى آخره بعض الأمثلة التي ذكرت معانا
+
+232
+00:16:21,790 --> 00:16:25,810
+بينما الأكثر شيوعاً وعن استخدامها مش ال
+
+233
+00:16:25,810 --> 00:16:29,250
+sympathomimetics هي ال parasympatholytics التي هي
+
+234
+00:16:29,250 --> 00:16:33,670
+أدوية غير مباشرة صحيح تعمله هي العقاقير التي
+
+235
+00:16:33,670 --> 00:16:38,650
+هتستخدم أو بتعمل على عكس آلية عمل ال mechanism of the
+
+236
+00:16:38,650 --> 00:16:40,990
+pupil الباستك نقبض السباني يعني مكانها بده تعمل 
+
+237
+00:16:40,990 --> 00:16:44,310
+تثبيط لعملية ال pupil الباستك بتاريخ وديم تجعله
+
+238
+00:16:44,310 --> 00:16:49,030
+الذي هو المدرسات من هذه العقاقير المشهورة جداً
+
+239
+00:16:49,030 --> 00:16:52,950
+معانا منها الأتروبيل ولما هنعمل سايكل استخدامها
+
+240
+00:16:52,950 --> 00:16:55,870
+هي الـ cyclopentolate طيب في عندك أربع عقاقير طبعا في 
+
+241
+00:16:55,870 --> 00:16:58,510
+عندك كمان سكوبولامين في عندك عدة أدوية لكن هذا
+
+242
+00:16:58,510 --> 00:17:02,900
+يعني أشرحها أول شيء الأتروبيل أو atropine بتعرفين
+
+243
+00:17:02,900 --> 00:17:06,120
+لما إحنا نعمل سايكل لما نريد معين بدنا كل عشر
+
+244
+00:17:06,120 --> 00:17:08,520
+دقيقة تقريباً نقطر مرة أو كل ساعة صحيح لفترة
+
+245
+00:17:08,520 --> 00:17:12,140
+أربعين دقيقة أو خمس وأربعين دقيقة صح ولا لأ فعند ال
+
+246
+00:17:12,140 --> 00:17:15,840
+maximum الفكرة أفضل حاجة له هو بعد أربعين دقيقة
+
+247
+00:17:15,840 --> 00:17:18,060
+لذا إحنا لما نعمل ال سايكل حتى لو كان في عندي
+
+248
+00:17:18,420 --> 00:17:21,400
+مدرسات مش هنقول للمريض الذي بتعب صراحة لأن في بعض
+
+249
+00:17:21,400 --> 00:17:23,300
+المرضى بيستجيب خمس عشرة دقيقة من اللاجئ فيه يعني
+
+250
+00:17:23,300 --> 00:17:26,220
+بتبصر على البابا لأ حتى يحدث عنده التي هو
+
+251
+00:17:26,220 --> 00:17:30,060
+cycloplegia بالمعنى الحقيقي ونستناش أربعين دقيقة
+
+252
+00:17:30,060 --> 00:17:33,960
+فأفضل تأثير له الذي هو بعد أربعين دقيقة طبعاً جداً
+
+253
+00:17:33,960 --> 00:17:37,980
+المدة هذه ممكن حتى يوصل لسبعين أو أكثر مش الحق من 
+
+254
+00:17:37,980 --> 00:17:43,040
+سبعة إلى عشر أيام بينما الـ homatropine طبعاً مصنفة من
+
+255
+00:17:43,040 --> 00:17:47,640
+الأفضل تأثير إلى الأقل تأثير، الـ homatropine تقريباً
+
+256
+00:17:47,640 --> 00:17:50,380
+أغلب الأدوية التي حصلنا عليها قبل خمس دقائق، صحيح؟
+
+257
+00:17:50,380 --> 00:17:53,980
+إذا كان أنا القصد منها التي هو ال سايكل، صح أو
+
+258
+00:17:53,980 --> 00:17:56,640
+لا؟ بينما إذا كان فقط مجرد توسيع للبابا وبدأ
+
+259
+00:17:56,640 --> 00:18:00,180
+أعمل فحص عادي، ممكن حتى fifty minus مجرد نتوسع عند
+
+260
+00:18:00,180 --> 00:18:02,240
+البابا وممكن نعمل five or six examinations، لأن
+
+261
+00:18:02,240 --> 00:18:07,740
+ماليش علاقة بالـ refraction طيب أفضل حاجة بعد 40
+
+262
+00:18:07,740 --> 00:18:10,980
+minutes طبعاً هذا الذي عند ال long lasting لحد ات
+
+263
+00:18:10,980 --> 00:18:15,640
+يوم أو يومين cyclopentolate الذي هو أكثر شيء يعاني
+
+264
+00:18:15,640 --> 00:18:19,160
+حتى في جميع القصص العربية يعني مستخدم بشكل كبير بأن
+
+265
+00:18:19,160 --> 00:18:22,400
+ما في دول أخرى ما بتبدأش تعمل refraction أو للأطفال
+
+266
+00:18:22,400 --> 00:18:26,580
+يعني لفقط باستخدام الـ atropine لأن هو أفضل يعني
+
+267
+00:18:26,580 --> 00:18:30,100
+أفضل علاج ممكن يعمل يحصل على أفضل نتاج حتى الآن
+
+268
+00:18:30,100 --> 00:18:35,820
+cyclopentolate تقريباً 30 minutes يكون enough ومدة
+
+269
+00:18:35,820 --> 00:18:40,420
+من 12 إلى 24 ساعة ثم يتلاشى مرة أخرى خاليكوا معايا
+
+270
+00:18:40,420 --> 00:18:43,020
+بس نضرب مثال بسيط إحنا حكينا هذه الأدوية كلها
+
+271
+00:18:43,020 --> 00:18:45,860
+عبارة عن parasympatholytics و لا parasympathomimetics
+
+272
+00:18:45,860 --> 00:18:48,220
+parasympatholytics parasympatholytics ماشي الحال
+
+273
+00:18:48,220 --> 00:18:51,340
+parasympatholytics ماشي الحال parasympatholytics ماشي
+
+274
+00:18:51,340 --> 00:18:52,840
+الحال parasympatholytics ماشي الحال parasympatholytics
+
+275
+00:18:52,840 --> 00:18:55,540
+ماشي الحال parasympatholytics ماشي الحال
+
+276
+00:18:55,540 --> 00:18:59,840
+parasympatholytics ماشي الحال parasympatholytics ماشي
+
+277
+00:18:59,840 --> 00:19:06,180
+الحال parasympatholytics أو عقاقير تعمل ضد Parasympathetic
+
+278
+00:19:06,180 --> 00:19:10,040
+لفترة معينة بعدين يحدث عنده إيش أن هو مدرسات ومن
+
+279
+00:19:10,040 --> 00:19:14,600
+ثم مرة أخرى لما يحدث عنده أن هو تلاشى للإنزين هذا و
+
+280
+00:19:14,600 --> 00:19:16,980
+بنرجع للمرة الأخرى constriction أو بنرجع لوضعه
+
+281
+00:19:16,980 --> 00:19:21,500
+الطبيعي هذا بالنسبة للعقاقير هذه معانا لنعرف أيه
+
+282
+00:19:21,500 --> 00:19:27,000
+أكثر فعالية وأيه أقل فعالية بعدين نطلع بينهم فيها
+
+283
+00:19:27,000 --> 00:19:30,700
+بعيداً
+
+284
+00:19:30,700 --> 00:19:34,490
+عن استخدام عقاقير في هنا أيضاً أسباب أخرى ممكن تؤدي
+
+285
+00:19:34,490 --> 00:19:38,730
+إلى مدرسات أو تدريبات interpretation of
+
+286
+00:19:38,730 --> 00:19:43,390
+stimulation of the sympathetic nervous system هو
+
+287
+00:19:43,390 --> 00:19:45,890
+طبيعي جداً وإحنا حكينا لما اتكلمنا آخر مرة على 
+
+288
+00:19:45,890 --> 00:19:49,470
+أجهزة الكذب التي يسموها أجهزة الكذب صحيح بيعمل
+
+289
+00:19:49,470 --> 00:19:53,610
+على يحاول يعني يستفز الإنسان أو يشوف هالإنسان
+
+290
+00:19:53,610 --> 00:19:57,260
+يتوتر أو لا طبعاً الإنسان في حالة الـ tension ما يكون
+
+291
+00:19:57,260 --> 00:19:59,400
+تحت تأثير التي هو sympathetic nervous system
+
+292
+00:19:59,400 --> 00:20:01,780
+stimulation صحيح؟ فال sympathetic nervous system
+
+293
+00:20:01,780 --> 00:20:04,060
+stimulation بس هو بدرجة أولى عن الـ mydriasis
+
+294
+00:20:04,060 --> 00:20:07,220
+بالتالي طبيعة الحلقة أن هو حيحكي سؤال دي التي هو 
+
+295
+00:20:07,220 --> 00:20:11,560
+mydriasis يعني لو جتنا بعلل بدنا عارفين نعلل مش
+
+296
+00:20:11,560 --> 00:20:14,600
+الحق لو جتنا الحق هذا قصته yet why بدنا عارفين نذكر
+
+297
+00:20:14,600 --> 00:20:20,690
+السبب why؟ طيب ثاني حاجة paralysis or inhibition of 
+
+298
+00:20:20,690 --> 00:20:25,170
+the parasympathetic nerve إيش يعني أصبح في عندي
+
+299
+00:20:25,170 --> 00:20:28,450
+مشكلة أو من ال parasympathetic وهذه نفس التي أنا
+
+300
+00:20:28,450 --> 00:20:35,230
+حكيتها صح ولا لأ صح ولا لأ فقط عقاقير يعني طيب نفس
+
+301
+00:20:35,230 --> 00:20:40,910
+المثال ادنا مثال يعني رقم ثلاثة Paralysis عبارة عن
+
+302
+00:20:40,910 --> 00:20:45,210
+شلل مؤقت طبعاً أو inhibition أو منْع التي هو لعملية
+
+303
+00:20:45,210 --> 00:20:48,070
+Parasympathetic system أو تثبيط لـ Parasympathetic
+
+304
+00:20:48,070 --> 00:20:51,750
+nervous system غير الأدوية التي حكيناها إحنا عبارة
+
+305
+00:20:51,750 --> 00:20:54,730
+عن parasympatholytics صحيح يعني أدوية أو عقاقير
+
+306
+00:20:54,730 --> 00:20:57,230
+تعمل بشكل مناقض للـ Parasympathetic nervous system
+
+307
+00:20:57,230 --> 00:21:00,930
+صحيح طب لو العضل نفسها ممكن بس العضل عدمها مش
+
+308
+00:21:00,930 --> 00:21:03,570
+علاقة إحنا بنحكي لو استهدفت راعية ونارية أصبح له 
+
+309
+00:21:03,570 --> 00:21:07,390
+damage فأنت عارف إيش رأيي صح ولا حاسس إيش فيه
+
+310
+00:21:07,390 --> 00:21:07,790
+عندك؟
+
+311
+00:21:13,240 --> 00:21:18,440
+لأ إحنا ببني الأسباب التي تؤدي إلى مدرياسس بده إذا
+
+312
+00:21:18,440 --> 00:21:21,620
+كان عنده بَراسَبَاستك بيعمللي ميواسس فمحلته تدمير
+
+313
+00:21:21,620 --> 00:21:25,360
+أيضاً معرفة براسباستك براس واحدة هيعمللياش مدرياسس
+
+314
+00:21:25,360 --> 00:21:29,480
+من ذلك الذي هو third cranial nerve pulsing الذي هو 
+
+315
+00:21:29,480 --> 00:21:34,380
+الالتهاب في العصب الجمجمي الثالث أو حتى الشلل في
+
+316
+00:21:34,380 --> 00:21:36,800
+العصب الجمجمي الثالث نتيجة نزيف أو نتيجة أدوية
+
+317
+00:21:36,800 --> 00:21:41,780
+معينة أو نتيجة الالتهابات آخر حاجة التي هو trauma،
+
+318
+00:21:41,780 --> 00:21:45,480
+trauma بشكل عام ممكن تعمل على تدمير التي هو عضلات
+
+319
+00:21:45,480 --> 00:21:49,080
+الـ iris كلاً من الـ dilator أو الـ sphincter بأنها ينتج
+
+320
+00:21:49,080 --> 00:21:53,940
+عنه التي هو مدرسات أو أيضاً ممكن تعمللي على تدمير
+
+321
+00:21:53,940 --> 00:21:56,740
+الـ pupil و نفسه بإذن الله الـ pupil يبقى sympathetic
+
+322
+00:21:56,740 --> 00:22:00,000
+فتالي التي هيحدث عندي التي هو مدرسات طبعاً هذه الـ
+
+323
+00:22:00,000 --> 00:22:03,000
+trauma بدنا نعلل كيف أصبح كيف ممكن الـ trauma
+
+324
+00:22:03,000 --> 00:22:07,400
+توصللي أو تسببلي مدرسات ممكن نعرفين بالطبع المرأة
+
+325
+00:22:07,400 --> 00:22:11,780
+بتهيألي على كل باسم بيقف باسم باسم صحيح بغض النظر
+
+326
+00:22:11,780 --> 00:22:18,460
+كان العضلة نفسها أو حتى الناقب نفسه طيب مقطع رقم
+
+327
+00:22:18,460 --> 00:22:22,220
+اثنين اتكلم عليها هي مراقبة نعمة المدرسات هي أيضاً
+
+328
+00:22:22,220 --> 00:22:25,420
+الـ miosis كنت بأقول المدرسات والمياصس الحالة
+
+329
+00:22:25,420 --> 00:22:27,980
+الطبيعية هم أثر موجودة أو الحالة الطبيعية يعني
+
+330
+00:22:27,980 --> 00:22:30,740
+بدون استخدام أي عقاقير غيره بدون أمراض موجودة وحكينا
+
+331
+00:22:30,740 --> 00:22:34,720
+في حالة اسمها Iris أو pupillary tremor صح ولا شفنا
+
+332
+00:22:34,720 --> 00:22:35,080
+الـ tremor
+
+333
+00:22:38,570 --> 00:22:42,930
+لأ يعني أمس بالـ visual feed كنا نطلع على شكل
+
+334
+00:22:42,930 --> 00:22:46,690
+البابا إيش كان، شكل دائم، سمر، ببعض المصاد، يعني
+
+335
+00:22:46,690 --> 00:22:49,730
+التي هي الرعشة دي عبارة عن ببعض المصاد، ببعض الشكل
+
+336
+00:22:49,730 --> 00:22:53,170
+الدائم، صحيح؟ فهي هذه الـ miosis والمدرسات، ده كان
+
+337
+00:22:53,170 --> 00:22:58,070
+الأغلب أنه .. على الأغلب أن الصلاحات هذي أقصد فيها
+
+338
+00:22:58,070 --> 00:23:01,390
+مدرسات يعني بشكل دائم، بشكل دائم يعني فترة معينة
+
+339
+00:23:01,390 --> 00:23:04,350
+دل في عنده إيش موسع، والـ miosis يكون عنده فيش ..
+
+340
+00:23:04,350 --> 00:23:07,430
+ففترة في المدرسات والـ miosis الـ trimmer هذا ما كانش
+
+341
+00:23:07,430 --> 00:23:15,250
+معلوم ضعيف جداً يتوقف ماشي الحال هاه
+
+342
+00:23:15,250 --> 00:23:21,670
+كوفيا
+
+343
+00:23:21,670 --> 00:23:27,370
+المدرسة المياثر
+
+344
+00:23:27,370 --> 00:23:32,370
+الحالتين هذو اشمل بديق الماشي الحال لكتر ما في
+
+345
+00:23:32,370 --> 00:23:35,070
+الحالة هذه أو في الحالة هذه لأن القدرة التي كانت في
+
+346
+00:23:35,070 --> 00:23:37,950
+الـ meiosis هيكون ثابت وكفر المدرسات باستخدام
+
+347
+00:23:37,950 --> 00:23:41,050
+العقلي أيضاً هيكون ثابت فال three مرحلة دي التي هي 
+
+348
+00:23:41,050 --> 00:23:44,970
+حركة بعض المساطر التي بقبها هتكون عيشها تقل لدرجة
+
+349
+00:23:44,970 --> 00:23:49,130
+أنها ربما تبقى يعني ثابتة مش الحق لأن بالحالة في
+
+350
+00:23:49,130 --> 00:23:53,990
+الفيسيولوجيا فقط هي تحدث طيب نرجع مرة أخرى ال
+
+351
+00:23:53,990 --> 00:23:56,950
+meiosis هو عبارة عن constriction of the pupil هذا
+
+352
+00:23:56,950 --> 00:24:01,150
+التعريف بنهاخه يعني عبارة عن constriction of the
+
+353
+00:24:01,150 --> 00:24:05,510
+pupil طيب إحنا لو بتكلمنا عن ال mydriatics إيش
+
+354
+00:24:05,510 --> 00:24:09,430
+حاكينا؟ في بعض الأدوية التي بتعمل نفس عمل المدرسات
+
+355
+00:24:09,430 --> 00:24:12,190
+نسمينا إحنا mydriatics صحيح؟ أو mydriatics من ناحية 
+
+356
+00:24:12,190 --> 00:24:15,290
+تجاري يعني هي الأدوية التي بتعمل على توسيع البابا
+
+357
+00:24:15,290 --> 00:24:20,910
+بينما الأدوية التي بتعمل على .. إيش اسمها؟ miotics
+
+358
+00:24:20,910 --> 00:24:27,870
+على عكس miotics miotics
+
+359
+00:24:27,870 --> 00:24:30,270
+that's probably أن هو miotics طبعاً هي مشتقة من
+
+360
+00:24:30,270 --> 00:24:35,060
+كلمات miotics عشان الحق إذا نقيد لـ miotics في عيش
+
+361
+00:24:35,060 --> 00:24:41,100
+بالميوتكس طيب برجع مرة أخرى نتبعه برجع مرة أخرى
+
+362
+00:24:41,100 --> 00:24:44,120
+stimulation of the sphincter papillae from
+
+363
+00:24:44,120 --> 00:24:47,000
+parasympathetic cholinergic fibers causes meiosis
+
+364
+00:24:47,000 --> 00:24:50,460
+or constriction of the sphincter papillae muscle is
+
+365
+00:24:50,460 --> 00:24:55,740
+caused by وفي عدة أسباب التي هي تؤدي إلى التضيق
+
+366
+00:24:55,740 --> 00:25:00,300
+الذي هو الـ lipid بس مرة أخرى نحط خط تحت
+
+367
+00:25:00,300 --> 00:25:01,420
+cholinergic fibers
+
+368
+00:25:06,310 --> 00:25:09,570
+طيب ترجع لنفس الناس التي أسميها لك وأرسمها سواها
+
+369
+00:25:09,570 --> 00:25:13,130
+هذه
+
+370
+00:25:13,130 --> 00:25:17,950
+هي النهاية العصبية عشان الحال وهيندي أنا هذا الـ
+
+371
+00:25:17,950 --> 00:25:25,070
+sphincter مثلاً
+
+372
+00:25:25,070 --> 00:25:28,610
+صحيح؟ طبعاً إحنا بختار ليه واحد من الألياف العضلية
+
+373
+00:25:28,610 --> 00:25:31,930
+هذه فهيندي أنا الـ parasympathetic
+
+374
+00:25:42,710 --> 00:25:47,730
+عصب بتاعك تعصي بقى مثلاً صحيح صح ولا طيب إن هيطلع
+
+375
+00:25:47,730 --> 00:25:49,850
+عصبية التي بتردي ال center muscle الموجودة بال
+
+376
+00:25:49,850 --> 00:25:54,990
+iris بتحطزلها تنشيط صحيح فتنشيطها هذا بتعمل على 
+
+377
+00:25:54,990 --> 00:26:00,850
+إفراز فيه
+
+378
+00:26:00,850 --> 00:26:03,650
+يعني vesicles صحيح بتعمل على إفراز ال vesicles
+
+379
+00:26:03,650 --> 00:26:09,390
+التي موجودة هنا تنتج لإيش neurotransmitters
+
+380
+00:26:09,390 --> 00:26:13,850
+صح ولا مش معناه neurotransmitters التي إحنا حكينا
+
+381
+00:26:13,850 --> 00:26:18,030
+عنها في المدرسات زي مثلاً الـ adrenaline صحيح؟ صح
+
+382
+00:26:18,030 --> 00:26:21,490
+ولا لا؟ بينما في الـ path بسيط الذي هو ال cooling
+
+383
+00:26:21,490 --> 00:26:23,450
+stress الـ cooling stress جاي من الكلمة التي
+
+384
+00:26:23,450 --> 00:26:30,350
+حكيناها تحتها خط هاخد
+
+385
+00:26:30,350 --> 00:26:34,570
+أكرر شوية بدي أعمل على إفراز ال neurotransmitters
+
+386
+00:26:34,570 --> 00:26:38,630
+التي تعمل على انقباض أو تحفيز ال sphincter muscle
+
+387
+00:26:38,630 --> 00:26:39,770
+صحيح؟ من خلال
+
+388
+00:26:47,410 --> 00:26:52,350
+الثالث هيحدث عندي انقباض لـ sphincter muscle وهيحدث عندي 
+
+389
+00:26:52,350 --> 00:26:55,870
+هيحدث عندي miosis هذا هذا بشكل مختصر يعني بشكل
+
+390
+00:26:55,870 --> 00:26:59,510
+عام كمراجعة لما هي بتفصيل هتاخدوها بالـ pharmacology
+
+391
+00:26:59,510 --> 00:27:03,610
+إن شاء الله طيب السبب الأول زي ما اتكلمنا على 
+
+392
+00:27:03,610 --> 00:27:05,930
+المدرسات السبب الأول عبار
+
+431
+00:29:49,730 --> 00:29:54,010
+الأسئلة الذكية مش معانا اللي هو الـ morphine هذه
+
+432
+00:29:54,010 --> 00:29:56,950
+بعض العقول اللي بيستخدموها طبعا المدمنين صحيح تؤدي 
+
+433
+00:29:56,950 --> 00:30:00,950
+إلى الإدمان تستخدم علاجيا أيضا لتصبيت من الألم صحيح
+
+434
+00:30:00,950 --> 00:30:05,010
+بذلك الألم المستعصى طبيعيًا هذا الـ morphine بيعمل
+
+435
+00:30:05,010 --> 00:30:09,690
+على constriction of the pupil وكثير من المرضى أو
+
+436
+00:30:09,690 --> 00:30:15,360
+يعني اللي بيتم ضبطهم التبروتة في عقل النفس الهادي
+
+437
+00:30:15,360 --> 00:30:19,060
+يعني لأن بجلول مفحص كلينيكي ملاقي endomeosis بشكل
+
+438
+00:30:19,060 --> 00:30:21,900
+كبير صعب جدا يعمله ده لدرجة أن حتى بالأدوية يكون
+
+439
+00:30:21,900 --> 00:30:24,700
+صعب جدا يستجيب لأن المرض بيكون بتحتها ده المادة
+
+440
+00:30:24,700 --> 00:30:28,080
+لفترة كبيرة بس طبعا هذا ما يدلش أنه كل واحد عنده
+
+441
+00:30:28,080 --> 00:30:32,360
+construction أن هو بتاعته يفهمه مشكلة هذا طيب
+
+442
+00:30:32,360 --> 00:30:37,150
+آخر حاجة اللي هي الـ trauma تمامًا زي ما اتكلمت الـ
+
+443
+00:30:37,150 --> 00:30:40,350
+trauma أيضا ممكن تسبب لي مياسثس ممكن بنفس الوقت
+
+444
+00:30:40,350 --> 00:30:44,290
+تسبب لي أشد مدرسة طيب كيف ممكن تسبب لي مياسثس للـ
+
+445
+00:30:44,290 --> 00:30:47,350
+trauma؟
+
+446
+00:30:47,350 --> 00:30:50,490
+فقط بتعمل على تدمير جهة الموضوع ده وبالتالي هيظل
+
+447
+00:30:50,490 --> 00:30:55,550
+لأن دي مباشرة مياسثس طيب
+
+448
+00:30:55,550 --> 00:30:59,230
+ناخد بس الفقرة الأخيرة هذه بتعتبر مهمة جدا احنا أخدنا
+
+449
+00:30:59,230 --> 00:31:02,310
+أيضا كمان لما اتكلمنا على الـ upper eyelids
+
+450
+00:31:02,310 --> 00:31:05,390
+retractor زي مرة أخرى خدنا فيه syndrome horner
+
+451
+00:31:05,390 --> 00:31:08,450
+syndrome إيش أسبابه الـ horner syndrome؟ هو بعرفوا
+
+452
+00:31:08,450 --> 00:31:13,730
+إن إيش علماته؟ anhedrosis صحيح myosis والتواءصص
+
+453
+00:31:13,730 --> 00:31:18,450
+والتواءصص السبب هو إيش؟
+
+454
+00:31:18,450 --> 00:31:23,110
+أنه sympathetic لا بس بعثوا يتملوا تدمير صحيح أو 
+
+455
+00:31:23,110 --> 00:31:26,030
+يتملوا damage بالتالي أصبح في عندي عيش بشكل دائم
+
+456
+00:31:26,030 --> 00:31:28,970
+فإنه مش حاجة تطبطب صحيح بس بيظل بشكل دائم عشان
+
+457
+00:31:28,970 --> 00:31:33,440
+عندي myosis طب نشوف الفقرة هذه مع بعض، Bilateral
+
+458
+00:31:33,440 --> 00:31:37,080
+small pupils may be due to irritation of the third
+
+459
+00:31:37,080 --> 00:31:40,720
+nerve by a central nervous system disease or
+
+460
+00:31:40,720 --> 00:31:43,180
+Potassium hemorrhage الـ Potassium hemorrhage أنتو
+
+461
+00:31:43,180 --> 00:31:47,880
+عارفين؟ مش عارف إذا كانت تشرحيها ولا لا، the
+
+462
+00:31:47,880 --> 00:31:50,620
+nucleus of the third and fourth cranial nerve و
+
+463
+00:31:50,620 --> 00:31:54,460
+الموجودين، احنا الآن كل cranial nerve يلو nucleus
+
+464
+00:31:54,460 --> 00:31:58,380
+معينة، صحيح؟ مش هيجي من الهواء يعني موجودة في الـ
+
+465
+00:31:58,380 --> 00:32:01,660
+midbrain عشان الحاجة فالـ midbrain هو نفسه هذا إيه
+
+466
+00:32:01,660 --> 00:32:07,920
+بتقدر تقسيمته ولا لأ اللي بتقسم ولا هو عبارة عن
+
+467
+00:32:07,920 --> 00:32:11,540
+صوت يعني بتقدر نظرة عن تقسيمته بس نكتب هذه المقطة
+
+468
+00:32:11,540 --> 00:32:19,380
+معانا حدوث لذيف في
+
+469
+00:32:19,380 --> 00:32:24,280
+منطقة الـ pawns الـ جسد صح ولا لأ اللي هي الربط ما
+
+470
+00:32:24,280 --> 00:32:29,560
+بين الـ midbrain و مدل القلون جاتا صح ولا لا؟ هيؤثر
+
+471
+00:32:29,560 --> 00:32:35,300
+بشكل سلبي على عمل third cranial nerve اللي هو
+
+472
+00:32:35,300 --> 00:32:39,540
+بالعصب الجمجمي الثالث السبب لذلك أنه نواية العصب
+
+473
+00:32:39,540 --> 00:32:42,620
+الجمجمي الثالث والرابع متواجدة أصلا في الـ bones مش
+
+474
+00:32:42,620 --> 00:32:46,460
+الحاجة فالمقصود في Pontine اللي هي آتية من كلمة الـ
+
+475
+00:32:46,460 --> 00:32:49,160
+bone نفسها مش الحاجة Pontine Hemorrhea النظيف حدث
+
+476
+00:32:49,160 --> 00:32:54,380
+فيه أو نسميه النظيف الجسري طبعا هذا مرض يجعل
+
+477
+00:32:54,380 --> 00:32:57,820
+ارتفاع ضغط الدم الشديد ممكن طبعا يحدث عنده
+
+478
+00:33:00,950 --> 00:33:06,130
+ثاني شيء مورفين poisoning تسمى بعقار اللي هو
+
+479
+00:33:06,130 --> 00:33:08,930
+المورفين هتكلمنا عنه احنا probably due to
+
+480
+00:33:08,930 --> 00:33:13,550
+sympathetic Paralysis واخدنا أيضا كمان مثل على ذلك
+
+481
+00:33:13,550 --> 00:33:16,670
+اللي هو Horner Syndrome عبارة عن Paralysis معناها
+
+482
+00:33:16,670 --> 00:33:19,810
+شلل أحسس أن عندي شلل أو خلل في عملية اللي هو
+
+483
+00:33:19,810 --> 00:33:22,850
+sympathetic nervous system بالتالي طبعا مش في كل
+
+484
+00:33:22,850 --> 00:33:25,150
+sympathetic nervous system لفقط احنا قصدنا هنا
+
+485
+00:33:25,150 --> 00:33:28,290
+اللي هو في superior cervical sympathetic ganglion
+
+486
+00:33:28,290 --> 00:33:30,770
+صحيح احنا حكينا عن جنجل في عنا superior في عنا
+
+487
+00:33:30,770 --> 00:33:34,250
+middle في عنا inferior فقط الـ superior وفي أشخاص
+
+488
+00:33:34,250 --> 00:33:37,990
+كثير يعني في دول برا متعبين يعملوا النوع من المساج
+
+489
+00:33:37,990 --> 00:33:42,570
+الخاطئ للرقبة صحيح فعندك عمل مساج للرقبة بالناحية
+
+490
+00:33:42,570 --> 00:33:46,630
+اليمنى يعني أو اليسرى ناحية العلوية بتغطي بشكل
+
+491
+00:33:46,630 --> 00:33:50,230
+خاطئ اللي هو ممارس هذه المساج وبالتالي مع فترة
+
+492
+00:33:50,230 --> 00:33:52,910
+زمنية كبيرة ممكن الملعقة تدمي الجانجليون هذه وينتج
+
+493
+00:33:52,910 --> 00:33:55,390
+عنه اللي هو horners syndrome
+
+494
+00:34:00,660 --> 00:34:04,260
+طيب آخر حاجة when sympatic function in one side is
+
+495
+00:34:04,260 --> 00:34:07,660
+lost gives the condition of Horner's syndrome طبعا
+
+496
+00:34:07,660 --> 00:34:10,480
+معرفة أنه Horner's syndrome فقط عندي يوم العتر أه
+
+497
+00:34:10,480 --> 00:34:15,360
+مابحنساش بقى العتر طيب هاي مرة أخرى Horner's
+
+498
+00:34:15,360 --> 00:34:17,220
+syndrome إذا بتلاحظ بقى إيه فيها مشكلة الـ right
+
+499
+00:34:17,220 --> 00:34:22,680
+ولا الـ left الـ right صحيح لأن في عندي process ربما
+
+500
+00:34:22,680 --> 00:34:25,850
+الميزة فيها مش هتبين مشكلة كبيرة لكن في عندي ..
+
+501
+00:34:25,850 --> 00:34:30,970
+هنبقى مدرسة صحيح؟ وهذا أكبر من الـ right pupil ففي
+
+502
+00:34:30,970 --> 00:34:33,590
+عندي أول حاجة الـ two sides اللي احنا شايفينها، في
+
+503
+00:34:33,590 --> 00:34:36,510
+عندي الـ toesies وهذا الـ toesies partial toesies فقط
+
+504
+00:34:36,510 --> 00:34:39,890
+لأن أحدث عندي paralysis لـ اللي هو sympathetic
+
+505
+00:34:39,890 --> 00:34:42,770
+fibers اللي بتغضيلي الـ Mullars muscle صحيح؟ or
+
+506
+00:34:42,770 --> 00:34:46,310
+muscle of Mullar صحيح؟ فهذا مجرد انسدال للجثة
+
+507
+00:34:46,310 --> 00:34:51,440
+الجثة عبارة عن two millimeters الإضافية صحيح؟ هذه
+
+508
+00:34:51,440 --> 00:34:54,220
+الرقم واحد، الرقم اثنين في عندي ham dilatation
+
+509
+00:34:54,220 --> 00:34:57,380
+بينما ما في عندي ash اللي هو meiosis وفي إشارة احنا
+
+510
+00:34:57,380 --> 00:35:00,980
+ما نشوفهاش اللي هي anhidrosis أو عبارة عن جفاف نصف
+
+511
+00:35:00,980 --> 00:35:05,840
+اللي هو الوجه it's caused by paralysis of the
+
+512
+00:35:05,840 --> 00:35:09,120
+cervical-selvastic ganglia ونحط تحتها خط، ده هو
+
+513
+00:35:09,120 --> 00:35:12,220
+السبب الرئيسي وراء الحدوث اللي هو horner syndrome
+
+514
+00:35:12,220 --> 00:35:16,380
+فـ horner syndrome في الحالة هذا يعتبر مكتسب صحيح؟
+
+515
+00:35:16,380 --> 00:35:21,580
+يعتبر مكتسب مرة أخرى is caused by paralysis of the
+
+516
+00:35:21,580 --> 00:35:24,440
+cervical sympathetic ganglion due to lesion in the
+
+517
+00:35:24,440 --> 00:35:27,520
+middle brain بسبب وجود مشكلة في الـ brain stem أو
+
+518
+00:35:27,520 --> 00:35:31,160
+في الـ spinal cord أو حتى في أمراض أخرى مش بس فقط
+
+519
+00:35:31,160 --> 00:35:34,180
+في الحالة اللي أنا ذكرتها أن ربما يكون في مساج أو
+
+520
+00:35:34,180 --> 00:35:38,300
+مشاكل الياقة أخرى، لا أي مرض أو نزيف ممكن يسبب لي
+
+521
+00:35:38,300 --> 00:35:40,620
+أو يسبب لي المشكلة دي في شكل مباشر أو غير مباشر
+
+522
+00:35:40,620 --> 00:35:44,320
+ممكن يعمل لي اللي هو hornet syndrome طيب it consist
+
+523
+00:35:44,320 --> 00:35:49,360
+of تكون من مياصص صحيح الـ construction of the pupil
+
+524
+00:35:49,360 --> 00:35:52,340
+بعد في اندة تواصص نفسي ده الـ different طبعا نفسي
+
+525
+00:35:52,340 --> 00:35:55,560
+ده هنحكي partial هو مش total هو بين جثتين partial
+
+526
+00:35:55,560 --> 00:36:02,080
+فقط أنه فالثرمس معناها عادة مش منها هي مش تأخرها
+
+527
+00:36:02,080 --> 00:36:05,180
+يعني عبارة عن مكان اللي عين تدخل إلى الخارج عكس
+
+528
+00:36:05,180 --> 00:36:05,940
+الثرمس
+
+529
+00:36:09,670 --> 00:36:13,110
+آخر حاجة anhidrosis يعني هي الوظائف السلقة أو الـ
+
+530
+00:36:13,110 --> 00:36:15,530
+science .. three science هي أهم حاجة meiosis,
+
+531
+00:36:15,910 --> 00:36:19,690
+toesis and anhidrosis عبارة عن اللي هو الـ smith
+
+532
+00:36:19,690 --> 00:36:24,670
+gland متواجدة اللي عبارة عن الغدد العرقية متواجدة
+
+533
+00:36:24,670 --> 00:36:27,930
+كل الجسم صحيح فالغدد العرقية المتواجدة بالشق اللي
+
+534
+00:36:27,930 --> 00:36:33,320
+تم إصابته بتتمشي لها جفاف الشخص يشعر بجفاف في
+
+535
+00:36:33,320 --> 00:36:36,060
+الواجهة الـ permit of splitting of the Ipsilateral
+
+536
+00:36:36,060 --> 00:36:39,320
+Ipsilateral هي نفس الاتجاه اللي تم فيه يعني مش
+
+537
+00:36:39,320 --> 00:36:41,620
+هاناج .. خلوكوا معايا على الصورة مش هاناج هان فيه
+
+538
+00:36:41,620 --> 00:36:44,220
+انديهورناس سندروم و الانهيدروسس هيكون هان بقى
+
+539
+00:36:44,220 --> 00:36:46,800
+الانهيدروسس و الاتواسس و الـ three sides هيكونوا
+
+540
+00:36:46,800 --> 00:36:51,140
+على نفس الاتجاه طيب
+
+541
+00:36:51,140 --> 00:36:56,720
+هورناس سندروم و الناقط طيلات هذه نقطة مهمة جدا in
+
+542
+00:36:56,720 --> 00:36:59,260
+dim light يعني حتى لو يعني طلعوا الصورة هذا اللي
+
+543
+00:36:59,260 --> 00:37:03,460
+أخده أصلا أخده في غرفة عتمة صحيح in dim light
+
+544
+00:37:03,460 --> 00:37:06,420
+فأصبح فيه عند الـ people طبيعي اللي هو هذا صحيح أنه
+
+545
+00:37:06,420 --> 00:37:08,780
+يكون dilatation لكن الـ right people اللي فيه
+
+546
+00:37:08,780 --> 00:37:13,440
+horner syndrome مش هيتملوا اللي هو dilatation حدّه
+
+547
+00:37:13,440 --> 00:37:15,780
+اللي في حالته اللي هو الـ constructed people while
+
+548
+00:37:15,780 --> 00:37:18,080
+normal people يكونوا dilate in dim light ويحكي أن
+
+549
+00:37:18,080 --> 00:37:22,160
+ليش صحيح for this anisocoria is increased in dim
+
+550
+00:37:22,160 --> 00:37:25,400
+light، أنيسوكوريا هي عبارة عن الفارق ما بين حجم
+
+551
+00:37:25,400 --> 00:37:27,900
+البقب الأيمن والأيسر، وحكي أن احنا الفارق قادر
+
+552
+00:37:27,900 --> 00:37:36,920
+يبدأ من الـ 0.5، صحيح؟ من الـ limiter طيب،
+
+553
+00:37:36,920 --> 00:37:43,340
+في أن بعض أيضا الحالات المرضية غير فيسيولوجية،
+
+554
+00:37:43,340 --> 00:37:47,500
+ممكن تؤدي لإما اللي هو constriction or dilatation
+
+555
+00:37:47,500 --> 00:37:50,820
+of the pubic bone، بعض الحالات اللي ممكن تؤدي
+
+556
+00:37:50,820 --> 00:37:53,100
+لـ constriction of the pubic bone هي نسمة أرجايد
+
+557
+00:37:53,100 --> 00:37:55,960
+بوكارتسون، حاجة أرجايد بوكارتسون تبع اسم العالم
+
+558
+00:37:55,960 --> 00:37:58,860
+اللي موصف هذه الحالة، وهذه الحالة زمان تقريبا
+
+559
+00:37:58,860 --> 00:38:04,250
+يقارب مائة عام، مش شديدة فيها عدة صفات لما نقارن
+
+560
+00:38:04,250 --> 00:38:07,610
+احنا بينها بين agile repulsive pupil لو يسمي هذا
+
+561
+00:38:07,610 --> 00:38:10,790
+الحال يعني هو مش الـ pupil نفسه لأ بس هذا الحال
+
+562
+00:38:10,790 --> 00:38:13,410
+يعني اكتشاف الحال اسم الـ pupil في الـ .. في الـ ..
+
+563
+00:38:13,410 --> 00:38:16,150
+في الـ meiosis في الـ construction وصفه هذا العالم
+
+564
+00:38:16,150 --> 00:38:20,310
+وسميته على اسمه أو عند adults tonic pupil ناخد
+
+565
+00:38:20,310 --> 00:38:23,190
+الأولى agile repulsive pupil usually caused by
+
+566
+00:38:23,190 --> 00:38:27,770
+syphilis دائما يسمى .. السبب الأساسي عليها في وراثه
+
+567
+00:38:27,770 --> 00:38:30,870
+أخرى، لكن السبب الرئيسي له اللي هو مرض syphilis،
+
+568
+00:38:30,870 --> 00:38:32,870
+مرض الـ syphilis عبارة عن sexually transmitted
+
+569
+00:38:32,870 --> 00:38:35,750
+diseases، صحيح؟ عبارة عن بعض الأمراض اللي تنتقلش
+
+570
+00:38:35,750 --> 00:38:39,730
+للنشاط الجسد، sexually transmitted diseases، اللي
+
+571
+00:38:39,730 --> 00:38:42,570
+متعرف عليها STD، هذا مرض أشهر الـ syphilis، مرض
+
+572
+00:38:42,570 --> 00:38:44,870
+الـ syphilis معدٍ جدا، ومرض الـ syphilis أيضا
+
+573
+00:38:44,870 --> 00:38:50,220
+يتواصل معه، syphilis A، syphilis B، الأخرى هذا
+
+574
+00:38:50,220 --> 00:38:53,300
+احنا مش هناخد فيها بس نشوف أنه الشخص اللي ما نشوف
+
+575
+00:38:53,300 --> 00:38:56,080
+عنده a gyropersonal tumor من المحتمل يكون عنده
+
+576
+00:38:56,080 --> 00:38:59,820
+syphilis هذا الأكثر وعلى أغلب طبعا إضافة احتمال
+
+577
+00:38:59,820 --> 00:39:02,440
+يكون في عنده أمراض أخرى من ضمن هذه الأمراض الأخرى
+
+578
+00:39:02,440 --> 00:39:06,280
+الـ diabetic mellitus هذه طبعا يعني هتكون الـ
+
+579
+00:39:06,280 --> 00:39:09,480
+probability أو الاحتمالية نادرة وضعيفة ثاني حاجة
+
+580
+00:39:09,480 --> 00:39:12,200
+الـ encephalitis عبارة عن انتهاء السحاية الـ
+
+581
+00:39:12,200 --> 00:39:16,400
+encephalitis عبارة عن انتهاء السحاية and some
+
+582
+00:39:16,400 --> 00:39:21,610
+cerebral tumors بعد اللي هو أو رم الدماغ نرجع مرة
+
+583
+00:39:21,610 --> 00:39:25,370
+أخرى وهذه ممكن يعني كل الأمراض كلها السبب ليه a
+
+584
+00:39:25,370 --> 00:39:28,090
+gyroperson pupil لكن على حد الخصوص اللي هو الـ
+
+585
+00:39:28,090 --> 00:39:30,710
+syphilis عشان الحاجة طبعا الـ syphilis يعتبر
+
+586
+00:39:30,710 --> 00:39:36,450
+بكثير السبب الأساسي بكتيريا طيب نرجع من خصائص
+
+587
+00:39:36,450 --> 00:39:40,210
+هذا المرض أنه bilateral شو يعني مش هيحدث 71 و 1 لأ
+
+588
+00:39:40,210 --> 00:39:45,670
+كل أغلب الأمراض الـ systemica زي مثلا احنا نحكي
+
+589
+00:39:45,670 --> 00:39:48,890
+المرض ده بتكمل يتأثر على الشبكية ولا يعني .. مش
+
+590
+00:39:48,890 --> 00:39:52,430
+هلاقيه يتأثر على الشبكية اليمين واليسار، لأ،
+
+591
+00:39:52,430 --> 00:39:55,750
+مستحيل، مش منطق، كل الأمراض systemic بتتأثر على
+
+592
+00:39:55,750 --> 00:39:58,950
+both eyes بنفس تقريبا الدرجة، المهم يكون موجودة
+
+593
+00:40:00,110 --> 00:40:02,590
+فأصبح في عندي argyroperson الصفة بتاعته التانية
+
+594
+00:40:02,590 --> 00:40:05,950
+أنه إيش؟ bilateral صحيح it is characterized by
+
+595
+00:40:05,950 --> 00:40:08,630
+meiosis وهذه عبارة عن الـ characteristics أو
+
+596
+00:40:08,630 --> 00:40:11,910
+الخصائص argyroperson في عندي ثلاث خصائص الخاصية
+
+597
+00:40:11,910 --> 00:40:15,550
+الأولى meiosis construction of the pupil of both
+
+598
+00:40:15,550 --> 00:40:19,290
+eyes هذا مهم ثاني حاجة irregularity إيش معنى
+
+599
+00:40:19,290 --> 00:40:23,870
+irregularity؟ عدم انتظام إيش معناها؟ أنه حتى في
+
+600
+00:40:23,870 --> 00:40:25,790
+حالة الـ construction مش حالة دي construction
+
+601
+00:40:25,790 --> 00:40:30,830
+بالشكل هذا في عندي بعض إيش التعرجات يعني غير منتظم،
+
+602
+00:40:30,830 --> 00:40:34,890
+ثاني حاجة inequality، inequality المقصود فيها in
+
+603
+00:40:34,890 --> 00:40:38,920
+Asia Korea بين الـ right و الـ left unconstriction of
+
+604
+00:40:38,920 --> 00:40:43,060
+the pupils to accommodation but not to light أيضا
+
+605
+00:40:43,060 --> 00:40:46,220
+نقطة مهمة جدا وهي أهم نقطة احنا بنحكم عليها أساسًا
+
+606
+00:40:46,220 --> 00:40:49,900
+بتشخيص اللي هو اجاي رو بيرسون أنه ما فيش عندي right
+
+607
+00:40:49,900 --> 00:40:51,920
+reflexes light reflexes في الـ direct ولا الـ
+
+608
+00:40:51,920 --> 00:40:54,980
+indirect كلها absent مش موج
+
+646
+00:43:27,290 --> 00:43:33,230
+reflex هذا مش موجود اللي احنا اسمنا absent knee 
+
+647
+00:43:33,230 --> 00:43:42,660
+jerks هو نفسه الـ  first sight التفاعل اللي يعمل 
+
+648
+00:43:42,660 --> 00:43:45,060
+على الناس للضوء و الانتقال يبدو غير موجود،
+
+649
+00:43:45,060 --> 00:43:46,660
+والتجارب اللي يعمل على الناس للضوء و الانتقال يبدو
+
+650
+00:43:46,660 --> 00:43:48,180
+غير موجود، والتجارب اللي يعمل على الناس للضوء و
+
+651
+00:43:48,180 --> 00:43:49,320
+الانتقال يبدو غير موجود، والتجارب اللي يعمل على
+
+652
+00:43:49,320 --> 00:43:51,280
+الناس للضوء و الانتقال يبدو غير موجود، والتجارب
+
+653
+00:43:51,280 --> 00:43:55,680
+اللي يعمل على الناس للضوء و الانتقال يبدو غير
+
+654
+00:43:55,680 --> 00:44:00,140
+موجود، والتجارب اللي يعمل على الناس للضوء و
+
+655
+00:44:00,140 --> 00:44:05,500
+الانتقال يبدو غير موجود،
+
+656
+00:44:05,500 --> 00:44:10,980
+والتجارب اللي يعمل على الناس للضوء و الانتقال يبد
+
+657
+00:44:13,420 --> 00:44:15,380
+طبعا على النقيد من the Agile Repression الـ Tunic
+
+658
+00:44:15,380 --> 00:44:18,720
+Pupil ممكن نعمله Dialysation بالأتروبيل أو حتى
+
+659
+00:44:18,720 --> 00:44:22,460
+بالهيمواتروبيل أو حتى بالسايكلو بينما the Tunic Pupil
+
+660
+00:44:22,460 --> 00:44:25,500
+is slightly dilated and larger than its fellow in
+
+661
+00:44:25,500 --> 00:44:30,760
+the cornea حيكون the Tunic Pupil نوعا ما أكثر إيش
+
+662
+00:44:30,760 --> 00:44:36,280
+توسعا من الطبيعي طيب هناخد بعض اللي هو ال
+
+663
+00:44:36,280 --> 00:44:40,450
+differential diagnosis of pupil مش هناخدهم كل حين
+
+664
+00:44:40,450 --> 00:44:42,990
+هناخد بعضها فنعلم علي بعضها، pupil dilated,
+
+665
+00:44:43,150 --> 00:44:46,410
+constricted, poorly يعني بعض الحالات اللي هيكون
+
+666
+00:44:46,410 --> 00:44:49,570
+فيها .. طبعا الحالات اللي كليكية هيكون فيها البواب
+
+667
+00:44:49,570 --> 00:44:53,570
+متوسط صعب جدا انه يعش يرجع في حالة ال
+
+668
+00:44:53,570 --> 00:44:57,210
+construction، من هذه الحالة the adestronic pupil،
+
+669
+00:44:57,210 --> 00:45:00,730
+the adestronic pupil صعب يحدث يعش construction،
+
+670
+00:45:00,730 --> 00:45:01,550
+صحيح؟
+
+671
+00:45:04,790 --> 00:45:07,630
+و هيكون في عند ال dilated pupil اكتر من العين
+
+672
+00:45:07,630 --> 00:45:10,190
+الأخرى لأن هذا الحالة unilateral مش bilateral
+
+673
+00:45:10,190 --> 00:45:14,130
+صحيح؟ مالهاش علاقة بمرض السفر ساعات اللي متحدث فيه
+
+674
+00:45:14,130 --> 00:45:19,220
+اللي هو the adult woman رقم تنين the farmacological madres
+
+675
+00:45:19,220 --> 00:45:22,380
+the farmacological madres هي حالات اللي حدث بيها توسع
+
+676
+00:45:22,380 --> 00:45:25,440
+للباب و صعب جدا اللي حدث لها construction الا بعد
+
+677
+00:45:25,440 --> 00:45:29,000
+غياب مفعول الدباب يعني بمعنى خلكن معاها لو احنا
+
+678
+00:45:29,000 --> 00:45:33,220
+مريض معين قطرنا له atropine و بعدها الخطأ تحدثيه و
+
+679
+00:45:33,220 --> 00:45:37,140
+من دلوقت نقطرله احنا مثلا meatex مش هيسبطه لابد ال
+
+680
+00:45:37,140 --> 00:45:42,420
+atropine ياخد مفعول اول شىء هذه واضحة تالت شىء
+
+681
+00:45:42,420 --> 00:45:46,750
+اللي هو the optic nerve atrophyبوب تكنولوجيا أساسا
+
+682
+00:45:46,750 --> 00:45:50,390
+ممكن تستخدم بلاي وهو Relative أو Total Affluent
+
+683
+00:45:50,390 --> 00:45:53,270
+Popular Defect صحيح؟ بالتالي ال construction صعب
+
+684
+00:45:53,270 --> 00:45:57,370
+جدا في هذه الحالة أن البوب يرجع نفس الدقة إلا إذا
+
+685
+00:45:57,370 --> 00:45:59,990
+احنا استخدمنا matrix إذا استخدمنا ال matrix سيكون
+
+686
+00:45:59,990 --> 00:46:02,750
+بشكل دائم أول ما نوقف في ال matrix ستنتهي المفاعل
+
+687
+00:46:02,750 --> 00:46:07,730
+دواها ده سيرجع نفس الشيء بحالة زي المدرسات direct
+
+688
+00:46:07,730 --> 00:46:11,970
+damage to the filter بابلله هذا طبيعيأي تدمير
+
+689
+00:46:11,970 --> 00:46:14,830
+للعدل الصفينكتر ماصل هيحاسس ليه أيضا ايش و هيسبب
+
+690
+00:46:14,830 --> 00:46:19,810
+ليه اللي هو mad masses فانقي الحاجات و بعدين اخد
+
+691
+00:46:19,810 --> 00:46:24,590
+the third nerve pulsing اللي هو تلف او شلل في العصب
+
+692
+00:46:24,590 --> 00:46:26,350
+جمجم الثالث أيضا ممكن يسبب ليه
+
+693
+00:46:29,220 --> 00:46:32,740
+اللي هو Madness is irritation of sympathetic وهي
+
+694
+00:46:32,740 --> 00:46:34,720
+طبيعي و أيضا في ال trauma هذه كل حاجة اللي اتكلمنا
+
+695
+00:46:34,720 --> 00:46:36,980
+عليها صحيح بس في نقطة احنا متكلمش احنا اتكلمنا عن
+
+696
+00:46:36,980 --> 00:46:39,720
+بصيرة Seneca حكي اللي احنا بنستخدم اللي هو
+
+697
+00:46:39,720 --> 00:46:42,380
+dilatation of the pupil حتى نمنع حدوث هذا ال
+
+698
+00:46:42,380 --> 00:46:47,780
+Seneca لكن لو حدثت عندي صعب جدا ال pupil يرجعاش
+
+699
+00:46:47,780 --> 00:46:53,480
+مرة أخرى constricted طيب
+
+700
+00:46:53,480 --> 00:46:57,280
+على نقل من ذلك ناخد ال pupil constricted dilates
+
+701
+00:46:57,280 --> 00:47:01,910
+fully يعنيالغالبية العضماء اللي حلق يكون فيها
+
+702
+00:47:01,910 --> 00:47:04,390
+البيو بير طبعا بالاترال يكون هنا ال construction
+
+703
+00:47:04,390 --> 00:47:08,150
+of the البيو بير صعب جدا أنه يعيش تلاتة مرة أخرى أول
+
+704
+00:47:08,150 --> 00:47:11,610
+حاجة the pharmacological meiosisis يعني احنا قطرنا
+
+705
+00:47:11,610 --> 00:47:14,790
+اللي برا يتبدأ المدرياتكس meiotics صحيح؟ بالخطأ و
+
+706
+00:47:14,790 --> 00:47:17,250
+بعدين اذا كان احنا لأ بدنا نعمل التوسع عن ال
+
+707
+00:47:17,250 --> 00:47:19,910
+bubble أو القطر اللي أنا مسكته بالخطأ صعب جدا
+
+708
+00:47:19,910 --> 00:47:23,190
+يتوسع ال bubble اللي بعد ما ياخدش ال meiotics
+
+709
+00:47:23,190 --> 00:47:28,330
+مفعوله ينتهي المفعولة في مرة أخرى طيب والثانيكيا
+
+710
+00:47:31,060 --> 00:47:35,980
+حدثت عندى التهاب قضحى وحدث عندى اللى هو ال post
+
+711
+00:47:35,980 --> 00:47:40,100
+-diasteic اللى حدكلمنا عليها قبل قليلما هو السبيل
+
+712
+00:47:40,100 --> 00:47:43,640
+ورا انه انا افك صينيكيا هذه، اذا كانت حدثت بشكل
+
+713
+00:47:43,640 --> 00:47:47,660
+constructed صعب جدا جدا جدا جدا ان البابا حتى و
+
+714
+00:47:47,660 --> 00:47:51,060
+نعطينا احنا كمية كبيرة من الاتروبيل، صعب جدا انه
+
+715
+00:47:51,060 --> 00:47:53,980
+يعيش، ينفك، طبعا في بعض الحالات ممكن يكون فك
+
+716
+00:47:53,980 --> 00:47:57,060
+للاتثاقات هذه و يرجع للعين الطبيعية، لكن هذا حالة
+
+717
+00:47:57,060 --> 00:48:00,060
+نادرة، لغالبها العظمة، اذا حد فات صينيكيا، لابد
+
+718
+00:48:00,060 --> 00:48:03,910
+يظل تأثيرها موجودةبالتالي صعب جدا حتى .. حتى لو
+
+719
+00:48:03,910 --> 00:48:07,030
+كان في dim light صعب جدا يرجع اللي هو ال people
+
+720
+00:48:07,030 --> 00:48:10,110
+بحجمه الطبيعى، ال trauma حكينا عنها ال right
+
+721
+00:48:10,110 --> 00:48:14,250
+answer هو الاتهاب القزحى، الاتهاب القزحى هو أساسا
+
+722
+00:48:14,250 --> 00:48:16,410
+اللي بدي أعمله construction ال people، الاتهاب
+
+723
+00:48:16,410 --> 00:48:19,470
+القزحى من أحد أعراضه يعني أو من أحد علاماته أنه
+
+724
+00:48:19,470 --> 00:48:21,330
+هيكون ال people اللي عنده بحالة عايش construction
+
+725
+00:48:22,890 --> 00:48:25,570
+هنا السندروم اتكلمنا عليها irritation of the cytokina
+
+726
+00:48:25,570 --> 00:48:28,550
+نيبو ايضا اتكلمنا عليها واخر حاجة paralysis of the
+
+727
+00:48:28,550 --> 00:48:31,450
+lymphatic nervous system ايضا اتكلمنا عليها في
+
+728
+00:48:31,450 --> 00:48:35,470
+حالة خاصة اللي هي رقم تلاتة bilateral meiosis وهذا
+
+729
+00:48:35,470 --> 00:48:39,150
+ال meiosis عادة صعب جدا ان يرجع مرة اخرى اول حاجة
+
+730
+00:48:39,150 --> 00:48:44,270
+the pontile hemorrhage عبارة عن النظيف الجسري يحدث
+
+731
+00:48:44,270 --> 00:48:49,110
+اثناء ارتفاع ضبط الدم الخبيث
+
+732
+00:48:50,210 --> 00:48:54,330
+يعني ضغط ده بيكون ارتفع بشكل ايش الجسم غير قادر
+
+733
+00:48:54,330 --> 00:48:57,990
+على تحمله the morphine poisoning اللي عبارة عن تسمه
+
+734
+00:48:57,990 --> 00:49:01,770
+بالعقار ال morphine بسبب كسرة استخدام اللي هو ال
+
+735
+00:49:01,770 --> 00:49:06,670
+morphine بسبب كسرة استخدام ال morphine أو هذا
+
+736
+00:49:06,670 --> 00:49:09,750
+العقار من ناحية إدمانية أو حتى من ناحية علاجية
+
+737
+00:49:09,750 --> 00:49:13,390
+يعني بيكون بيحطيها فوق اللي هو الدوز المعينة او
+
+738
+00:49:13,390 --> 00:49:14,270
+المطلوبة للمريض
+
+739
+00:49:19,230 --> 00:49:23,970
+شيخوها او الحرم صحيح فنتكلم انه ال pupil عادةوقت
+
+740
+00:49:23,970 --> 00:49:27,410
+الميلاد الى حدية البرت حدية البلوغ يبدأ باش
+
+741
+00:49:27,410 --> 00:49:33,090
+اللازمة يبدأ يكبر صح ولا بعد البلوغ يبدأ اش small
+
+742
+00:49:33,090 --> 00:49:37,150
+لذلك عندى كل ماتقدم as the aging process بدي يحدث عندى
+
+743
+00:49:37,150 --> 00:49:40,630
+meiosis فكل ماتقدم الإنسان بالعمر بعد سن البلوغ
+
+744
+00:49:40,630 --> 00:49:43,850
+طبعا بدي يحدث عنده ash اللي هو ال meiosis طبعا هذا
+
+745
+00:49:43,850 --> 00:49:46,550
+هيكون صفته انه bilateral interpretation of the
+
+746
+00:49:46,550 --> 00:49:49,710
+side cranial nerve وهذا طبيعى اخر حاجة paralysis
+
+747
+00:49:49,710 --> 00:49:54,690
+of the synpastic nerve هذا اتكلمنا عنه احناطيب حتى
+
+748
+00:49:54,690 --> 00:49:55,730
+الآن في أي سؤال؟
diff --git a/PL9fwy3NUQKwZ2K6wMRTZMEoGVTbELxinF/cqrTpVBC-bA_postprocess.srt b/PL9fwy3NUQKwZ2K6wMRTZMEoGVTbELxinF/cqrTpVBC-bA_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..dce9a339fcccec7ddce55cd25fa829a31d99fdb3
--- /dev/null
+++ b/PL9fwy3NUQKwZ2K6wMRTZMEoGVTbELxinF/cqrTpVBC-bA_postprocess.srt
@@ -0,0 +1,2992 @@
+1
+00:00:20,770 --> 00:00:24,330
+طيب السلام عليكم ورحمة الله وبركاته سأتكلم اليوم
+
+2
+00:00:24,330 --> 00:00:27,310
+ان شاء الله في ال trilogy of the iris بتكلمنا احنا
+
+3
+00:00:27,310 --> 00:00:30,930
+بتكلمنا عن بعض التفاصيل البسيطة في التشريت بتكلمنا
+
+4
+00:00:30,930 --> 00:00:34,250
+ايضا عن the plexus of the pupil بتكلمنا على ال
+
+5
+00:00:34,250 --> 00:00:36,650
+sympathetic and the parasympathetic pathway for
+
+6
+00:00:36,650 --> 00:00:39,610
+construction and the rotation of the pupil صحيح؟
+
+7
+00:00:39,610 --> 00:00:41,870
+حكينا فيه ان ال two pathways are most important
+
+8
+00:00:41,870 --> 00:00:45,070
+سواء كان في الاختبارات أو كان حتى في الحياة
+
+9
+00:00:45,070 --> 00:00:49,700
+العمليةالreflex الأول هو عبارة عن construction of
+
+10
+00:00:49,700 --> 00:00:53,120
+the cube هو المسار نفسه كله يتواخدناه صحيح؟ ال
+
+11
+00:00:53,120 --> 00:00:56,620
+dilatation عبارة عن إيش؟ المسار أيضا اللي أخدنا
+
+12
+00:00:56,620 --> 00:00:59,560
+إحنا بالafferent و بالafferent ماشي الحاجة ففينا
+
+13
+00:00:59,560 --> 00:01:01,100
+two reflexes الأول
+
+14
+00:01:16,160 --> 00:01:23,120
+طبعا طبعا طبعا طبعا طبعا طبعا طبعا طبعا طبعا
+
+15
+00:01:23,120 --> 00:01:24,720
+طبعا
+
+16
+00:01:44,080 --> 00:01:46,400
+الشركة المختصة هي عبارة عن تدبر نساء ال
+
+17
+00:01:46,400 --> 00:01:49,520
+sympathetic و ال parasympathetic innervation of
+
+18
+00:01:49,520 --> 00:01:52,860
+the iris muscles بشكل حالي اللي هي عبارة عن ال
+
+19
+00:01:52,860 --> 00:01:55,800
+sphincter muscle او اللي هي ال dilator muscle طيب
+
+20
+00:01:55,800 --> 00:01:58,700
+و اتكلمنا بعد ذلك اتكلمنا ايضا على causes of
+
+21
+00:01:58,700 --> 00:02:01,600
+relative afferent pupillary defect و قسمنا احنا ل
+
+22
+00:02:01,600 --> 00:02:04,060
+total pupillary afferent defect صحيح و ل relative
+
+23
+00:02:04,060 --> 00:02:08,960
+pupillary defect و عملنا رسمة و شرحناها و حكينا
+
+24
+00:02:08,960 --> 00:02:12,160
+انها مهمة جدا من بعض الأسباب همشكلها من بعض
+
+25
+00:02:12,160 --> 00:02:16,030
+الأسباب اللي هتؤدي إلىاللي هو فقدار ال reflex بشكل
+
+26
+00:02:16,030 --> 00:02:19,170
+كله أو بشكل جزء، لإن بشكل .. بشكل كله طبعا هو
+
+27
+00:02:19,170 --> 00:02:22,190
+عبارة عن فقدار العين كلها، صحيح؟ أو أن تكون
+
+28
+00:02:22,190 --> 00:02:27,870
+المشكلة عنده pre-chiasma، هذا صحيح؟ صح و لا؟ لو
+
+29
+00:02:27,870 --> 00:02:31,870
+كانت عند المشكلة اللي يجي في ال .. ال New York
+
+30
+00:02:31,870 --> 00:02:35,830
+pathway، في ال visual pathway، لو كانت post
+
+31
+00:02:36,860 --> 00:02:39,060
+الكيازمال أو boss kiazmal مش هيكون .. هيكون مافيه
+
+32
+00:02:39,060 --> 00:02:42,220
+عنده إيش في ال boss eye صحيح؟ بينما لو كانت فقط ال
+
+33
+00:02:42,220 --> 00:02:45,620
+pre-kiazmal هيكون عنده in one eye على أحد الخصوص
+
+34
+00:02:45,620 --> 00:02:48,480
+اللي هو هيكون فيه عنده blindness، إذا كانت طبعا ال
+
+35
+00:02:48,480 --> 00:02:51,560
+damage قوي بما فيها الكفاية، من بعد هذه الأمراض
+
+36
+00:02:51,560 --> 00:02:54,220
+عند ال optic neuritis، ال optic neuritis عبارة عن
+
+37
+00:02:55,750 --> 00:02:58,690
+التهار في العصب صحيح حكينا انه تصنفته فقط احنا
+
+38
+00:02:58,690 --> 00:03:02,330
+خدنا ال optic neuritis بشكل مبسط يعمل في ال optic
+
+39
+00:03:02,330 --> 00:03:04,870
+neuritis على إصابة قاعد ال optic nerve fibers
+
+40
+00:03:04,870 --> 00:03:08,790
+اللتي لها علاقة في اللي هو ال afferent و ال
+
+41
+00:03:08,790 --> 00:03:11,950
+efferent و مثلا مابدو يحدث ل afferent people or
+
+42
+00:03:11,950 --> 00:03:14,050
+defect لكن طبيعة ال afferent people or defect هي
+
+43
+00:03:14,050 --> 00:03:17,210
+عبارة عن relative و ليس عيش كله مش حاجة عبارة عن
+
+44
+00:03:17,210 --> 00:03:21,910
+جزء و ليس كله تاني شئ return of attachmentو تحكينا
+
+45
+00:03:21,910 --> 00:03:23,690
+أيضا ان ال retina detachment مش كل ال retina
+
+46
+00:03:23,690 --> 00:03:26,370
+detachment على كل أنواعه يعني ربما يكون فيه عندك
+
+47
+00:03:26,370 --> 00:03:30,290
+جزء معين بالشبكية فقط بالشكل هذا هي ده الشبكية فيه
+
+48
+00:03:30,290 --> 00:03:34,510
+عندها retina detachment حاجة مابحملش اي مشكلة يعني
+
+49
+00:03:34,510 --> 00:03:37,450
+حقيقية لما ده باقى عنده الخلايا الموجودة أربعة
+
+50
+00:03:37,450 --> 00:03:41,270
+طبقات الشبكية كلها متصلة غير مفصلة هتوصل لرسالة
+
+51
+00:03:41,270 --> 00:03:46,390
+بشكل كامل فالغالب هو عبارة عن v-shaft صحيح او حالة
+
+52
+00:03:46,390 --> 00:03:50,330
+نسميها hypotony يعني عبارة عن غيار ضغط العين
+
+53
+00:03:54,070 --> 00:03:57,750
+إنها تجعل الانفصال الشبكي أيضا ممكن سبب ليه اللي
+
+54
+00:03:57,750 --> 00:04:01,890
+هو relative afferent people defect تتحاجى lesion
+
+55
+00:04:01,890 --> 00:04:05,330
+of the visual pathway أي مشكلة في العصب البصري أو
+
+56
+00:04:05,330 --> 00:04:08,490
+في الكيازمة أو حتى في ال optic tract في كل المسار
+
+57
+00:04:08,490 --> 00:04:11,070
+هذا البصري ممكن سبب ليه اللي هو afferent people
+
+58
+00:04:11,070 --> 00:04:16,530
+defect أخر حاجة حكينا تعرض الإنسان لبعض اللي هو
+
+59
+00:04:16,530 --> 00:04:20,750
+السموم من ضمنها الكحول واتباط ممكن أيضا سبب ليها
+
+60
+00:04:20,750 --> 00:04:21,250
+هذه المشكلة
+
+61
+00:04:29,140 --> 00:04:32,860
+كلها من أهالي صحيح؟ طيب different و ب increasing
+
+62
+00:04:32,860 --> 00:04:36,840
+pupil size وهذا يعني الفقرة كلها تقريبا مهمة ما هو
+
+63
+00:04:36,840 --> 00:04:45,170
+تأثير او ناتج عن زيادة حجم البقبو او بقبو العينهنا
+
+64
+00:04:45,170 --> 00:04:48,110
+عدت أسبوع بخمسة، بعد ما نكون عارفين هي يعني ايه،
+
+65
+00:04:48,110 --> 00:04:51,130
+كمنشر، لو أجينا بسؤال منشر، نكون عارفينها pupil
+
+66
+00:04:51,130 --> 00:04:54,230
+dilatation بتوسع البابو will increase depth of
+
+67
+00:04:54,230 --> 00:04:57,510
+focus and depth of field، حاجة تنتهي، أول حاجة
+
+68
+00:04:57,510 --> 00:05:00,490
+depth of focus will increase and depth of field
+
+69
+00:05:00,490 --> 00:05:08,430
+will also increase، السبب هو ذلك، السبب هو ذلك، لو
+
+70
+00:05:08,430 --> 00:05:09,570
+أجي أنا بعلم، نكون عارفينه
+
+71
+00:05:14,140 --> 00:05:18,380
+هذه ال pupil صحيح هذه حوافه هذه ال pupil كله ككله
+
+72
+00:05:18,380 --> 00:05:23,040
+الآن الضوء عندما يدخل كرة العين اخلوا معايا اه مش
+
+73
+00:05:23,040 --> 00:05:26,120
+هيدخل من الأطراف صحيح هيدخل طبعا اكيد هيكون في جزء
+
+74
+00:05:26,120 --> 00:05:30,120
+من الأطراف داخل لكن غالبى تضوء لإن الأطراف هتعمل
+
+75
+00:05:30,120 --> 00:05:33,800
+علي تحجيم الضوء حتما تضوء صحيح القصد من ال pupil
+
+76
+00:05:33,800 --> 00:05:38,000
+يعمل علي مركز او تمركز صحيح الضوء لحيث ال focusing
+
+77
+00:05:38,000 --> 00:05:41,160
+اللى هو في ال phobia صح ولا لأ صح ولا لأ او باقي
+
+78
+00:05:41,160 --> 00:05:45,530
+اللى هو المناطق الشبكيةفالضوء عنده هيكون في الوسط
+
+79
+00:05:45,530 --> 00:05:49,450
+كثافته اكتر بكتير من ايش؟ من الأطراف الأطراف هيكون
+
+80
+00:05:49,450 --> 00:05:55,450
+شكل قليل هذا السبب الأول عشان الحال ان الضوء يخترق
+
+81
+00:05:55,450 --> 00:06:00,010
+مركز البقبو اكثر بكثير من اختراقه المناطق الموجودة
+
+82
+00:06:00,010 --> 00:06:06,510
+على حواف ال pupil عشان الحال رقم تاني ان الضوء
+
+83
+00:06:06,510 --> 00:06:10,750
+يعمل على تحفيز ال photoreceptors
+
+84
+00:06:16,230 --> 00:06:21,050
+photoreceptors بشكل ايش؟ actually ولا obliquely؟
+
+85
+00:06:21,050 --> 00:06:25,170
+بشكل obliquely but not actually يعني الضوء مش
+
+86
+00:06:25,170 --> 00:06:30,050
+هيصدر مباشرة بالضوء بشكل ايش actually درجة تسييم
+
+87
+00:06:30,050 --> 00:06:33,930
+بشكل هذا لأ لكن حيكون فيه اندهاش تعرض والتعرض لهذا
+
+88
+00:06:33,930 --> 00:06:38,300
+من إحدى أسبابه اللي هو الضوء هيبدأ انتصاره أولامن
+
+89
+00:06:38,300 --> 00:06:41,400
+الريتين للبيجمت ديباثيليام ثم يوزع على ال
+
+90
+00:06:41,400 --> 00:06:43,460
+photoreceptors السبب بيناه تقوله اننا كنا عارفين
+
+91
+00:06:43,460 --> 00:06:46,120
+لو جاء العلل اننا كنا عارفين ان ال light entering
+
+92
+00:06:46,120 --> 00:06:48,580
+the eye at the edge of the pupil is less effective
+
+93
+00:06:48,580 --> 00:06:51,380
+than stimulating photoreceptors و هذا أول تاني
+
+94
+00:06:51,380 --> 00:06:56,980
+حاجة السبب براء ذلك ان ال light هيعمل hits ل ال
+
+95
+00:06:56,980 --> 00:06:59,740
+photoreceptors اللي هيتعيش بليكلي بطنه actually
+
+96
+00:06:59,740 --> 00:07:05,620
+طيب شوف رقم 2 تأثير أيضا اللي هو increasing ال
+
+97
+00:07:05,620 --> 00:07:09,190
+pupil sizePupil size increases, diffraction of
+
+98
+00:07:09,190 --> 00:07:11,490
+light decrease and spherical and chromatic
+
+99
+00:07:11,490 --> 00:07:14,030
+abrasion will increase فانا احنا حاكيناها كل ما
+
+100
+00:07:14,030 --> 00:07:17,570
+توسع البوم بغض ان كان باستخدام الأدوية معينة او
+
+101
+00:07:17,570 --> 00:07:21,050
+انسان تعرض لضربة معينة او مرض معين الاخرين بيحدث
+
+102
+00:07:21,050 --> 00:07:24,070
+عنده blurring of vision فاسباب ال blurring of
+
+103
+00:07:24,070 --> 00:07:29,050
+vision هي spherical and chromatic abrasion رقم
+
+104
+00:07:29,050 --> 00:07:34,090
+تلاتة increase illumination of the retina زي في أي
+
+105
+00:07:34,090 --> 00:07:41,070
+حالة من الحلقاتتعرفي المرد قلب الاسم؟ بحق، بس احنا
+
+106
+00:07:41,070 --> 00:07:43,830
+حكيها على سبيل المثال، الضوء بده يتشتت داخل
+
+107
+00:07:43,830 --> 00:07:46,670
+الشبكية، اللي عدم موجود، اللي هو ال ret .. ال RP
+
+108
+00:07:46,670 --> 00:07:49,710
+.. ال retinal pigmented epithelium، صحيح؟ بينما في
+
+109
+00:07:49,710 --> 00:07:52,490
+الحالات هذه لأ موجود، موجود لكن فيش end focusing،
+
+110
+00:07:52,490 --> 00:07:55,830
+احنا حكينا وظيفة ال pupil أساسية تعمل على تجمع
+
+111
+00:07:55,830 --> 00:07:58,750
+الضوء صحيح، تعكسها على الشبكية، لكن في end في ال
+
+112
+00:07:58,750 --> 00:08:01,820
+pupil اللي هو dilatedغير قادر اللي بيبلع تجميل هذا
+
+113
+00:08:01,820 --> 00:08:04,700
+الشعب بتاعي هيتشتت الداخل اللي هو الشبكة هيبقى
+
+114
+00:08:04,700 --> 00:08:07,920
+تشتت الدوء هذا أيضا و بيعمله decreased visual
+
+115
+00:08:07,920 --> 00:08:12,100
+function مش الحاجة رقم تلاتة النتج عنه هيعمله
+
+116
+00:08:12,100 --> 00:08:15,260
+decreased visual function اللي هو انخفاض الوظائف
+
+117
+00:08:15,260 --> 00:08:20,920
+البصرية رقم أربعة هو احنا ذاكرناها لما خدنا ال pin
+
+118
+00:08:20,920 --> 00:08:23,520
+torch حكينا dilatation of the pupil ايش بيعمله
+
+119
+00:08:23,520 --> 00:08:29,040
+بيتجه او يعمل على ضغط لكل ال dilator ماصل حتى تتجه
+
+120
+00:08:29,040 --> 00:08:29,440
+ناحية
+
+121
+00:08:37,170 --> 00:08:43,430
+و تصبح عند ال angle طيقة احنا اخدناها لما حكينا
+
+122
+00:08:43,430 --> 00:08:48,750
+قبل استخدام ال media text كلها لابد من فحص الزاوية
+
+123
+00:08:48,750 --> 00:08:51,870
+حتى لو كان زاوية عند نارو مش المفروض ان انا اعمل
+
+124
+00:08:51,870 --> 00:08:54,910
+dilation of w بل صحيح لان dilation of w بالبحث
+
+125
+00:08:54,910 --> 00:09:00,430
+ذاته بحد نفسه بيعمل ال block لأ اللي هو ال angle
+
+126
+00:09:03,390 --> 00:09:06,550
+رقم خمسة Prevent Posterior Cynicia هو هذا اللي
+
+127
+00:09:06,550 --> 00:09:09,510
+احنا بدنا نصره عشان نتفهمه مش معايا ال Cynicia
+
+128
+00:09:09,510 --> 00:09:15,630
+ونصر الحالة Cynicia
+
+129
+00:09:15,630 --> 00:09:19,590
+عبارة عن مرض أو مش مرض يعني عبارة عن sign معين
+
+130
+00:09:19,590 --> 00:09:26,530
+نتيجته أسببه عن التساق ال posterior surface of the
+
+131
+00:09:26,530 --> 00:09:31,210
+iris مع ال anterior surface of the lens
+
+132
+00:09:39,330 --> 00:09:43,150
+خلّيني أقول معايا، هناك أندرليز من ناحية الخلفية،
+
+133
+00:09:43,150 --> 00:09:46,170
+ماشي الحل، في أندر ال pupil نفسه أو ال posterior
+
+134
+00:09:46,170 --> 00:09:49,490
+surface of the iris، حتى تقمع ال anterior .. ال
+
+135
+00:09:49,490 --> 00:09:51,690
+posterior مع ال anterior surface of the lesion
+
+136
+00:09:51,690 --> 00:09:57,250
+فالتصاق به الشكل هذا هيعمل ميوسس، صحيح؟ هذا السبب،
+
+137
+00:09:57,250 --> 00:10:00,110
+لكن أنا لما أخل فيه أندي مدرياسيز، أستخدم دوقة
+
+138
+00:10:00,110 --> 00:10:02,750
+معينة، المرضى اللي فيه عندي هو الاتحاد القزحي
+
+139
+00:10:03,010 --> 00:10:06,690
+الأكتر حاجة نخاف منها اللي هي posterior syneche
+
+140
+00:10:06,690 --> 00:10:10,830
+اللي هو الحجوز التساقط لأن التساقط إذا حدث سعد يفك
+
+141
+00:10:10,830 --> 00:10:14,510
+بيحدث بشكل دائممش الحرف حتى انا امنع حدوث هذا
+
+142
+00:10:14,510 --> 00:10:17,250
+الاتصاق اللي هو هيسبلي مشاكل في المستقبل ربما
+
+143
+00:10:17,250 --> 00:10:20,990
+ارتفاع دقت العين ربما هيسبلي cataract الاخرين بدل
+
+144
+00:10:20,990 --> 00:10:23,310
+دي المريض اللي هو النوع من ال madriatex حتى يخلي
+
+145
+00:10:23,310 --> 00:10:26,930
+البوبو أشماله متوسع فالتوسع هذا هو يبنعني فرصة
+
+146
+00:10:26,930 --> 00:10:29,850
+حدوث او يقلللي من فرصة حدوث اللي هو ال posterior
+
+147
+00:10:29,850 --> 00:10:33,210
+synechia بالتالي مش هيحدث عندى التساقات ما بين
+
+148
+00:10:33,210 --> 00:10:36,030
+posterior surface of the iris and anterior surface
+
+149
+00:10:36,030 --> 00:10:42,200
+of the lensطيب، في كمان نقطين مهمين جدا، و هم ال
+
+150
+00:10:42,200 --> 00:10:48,960
+matrices و ال biases، كيف تحدث؟ كيف تحدث؟ احنا
+
+151
+00:10:48,960 --> 00:10:53,540
+ذكرنا يعني في المحاضرة السابقة عن اللي هو ال
+
+152
+00:10:53,540 --> 00:10:57,040
+matrices، كيفية حصول النشاط، اللي هو الديالات
+
+153
+00:10:57,040 --> 00:11:00,360
+المصدرة، صحيح؟ خدناها كلها، ولا لأ؟ عبارة عن اللي
+
+154
+00:11:00,360 --> 00:11:02,960
+حصل نفسه، التابع مالاش، ال simplistic ولا برا
+
+155
+00:11:02,960 --> 00:11:07,850
+simplistic؟المدرياتيكس هه من ال simbastic صحيح؟
+
+156
+00:11:07,850 --> 00:11:09,210
+بينما بيبقى على ال simbastic الناس العالمية
+
+157
+00:11:09,210 --> 00:11:13,390
+يؤسسوها تالت مدرياتيكس قدرها عن dilatation of the
+
+158
+00:11:13,390 --> 00:11:16,490
+pupil هذا المصطلح يعني dilatation of the pupil هي
+
+159
+00:11:16,490 --> 00:11:20,450
+معاك مدرياتيكس لذلك بعض الوقت تسمى مدرياتيكس صحيح؟
+
+160
+00:11:20,450 --> 00:11:23,590
+او زي المدرمايد هي الأصل مشتقة من مدرياتيكس من
+
+161
+00:11:23,590 --> 00:11:26,310
+الناتش اللي هو العمل في السيولوجيا لتوسع بأبو
+
+162
+00:11:26,310 --> 00:11:30,290
+العين is produced by contraction of the dilator
+
+163
+00:11:30,290 --> 00:11:34,840
+muscle which is stimulated byno adrenagic
+
+164
+00:11:34,840 --> 00:11:39,900
+sympathetic nerves يريد تحت no adrenagic نحط خط no
+
+165
+00:11:39,900 --> 00:11:42,940
+adrenagic هي نفس ال sympathetic nerves بس هذي يعني
+
+166
+00:11:42,940 --> 00:11:47,740
+تتبع هي تبع نوعية ال neurotransmitters اللي
+
+167
+00:11:47,740 --> 00:11:50,880
+بتنفرزها من النهيات العصبية في عضلة اللي هو
+
+168
+00:11:50,880 --> 00:11:54,240
+dilator muscle هذي يعني زي ما خدحني بال
+
+169
+00:11:54,240 --> 00:11:56,380
+sympathetic و لا sympathetic مش عارف انت فاكريني
+
+170
+00:11:56,380 --> 00:11:57,340
+هبقى في السجن ولا لأ
+
+171
+00:12:03,900 --> 00:12:09,080
+في ان ال silence صح ولا اقل هيخليا عضلية الاخر
+
+172
+00:12:09,080 --> 00:12:14,100
+هيخليا عضلية ال silence هيش نسميها هي ال pre
+
+173
+00:12:14,100 --> 00:12:18,960
+-synaptic صح معناه هي ال post-synaptic ال post
+
+174
+00:12:18,960 --> 00:12:21,560
+-synaptic هي المنطقة اللى تم تغذيةها و تعصيبها من
+
+175
+00:12:21,560 --> 00:12:24,680
+العصب صحيح المنطقة المابينة ال pre-synaptic و post
+
+176
+00:12:24,680 --> 00:12:30,020
+-synaptic هي حاجة اسمها cleft صحيح
+
+177
+00:12:30,020 --> 00:12:36,710
+صح ولا اقلالكلفة فده ايش مظيفته؟ بيسمحلي تفرز كل
+
+178
+00:12:36,710 --> 00:12:39,990
+ال physical اللي هانا من نهاية العصبية اللي فيها
+
+179
+00:12:39,990 --> 00:12:44,010
+ال neurotransmitters صح ولا لأ؟ صح ولا لأ؟ حكينا
+
+180
+00:12:44,010 --> 00:12:47,130
+طبعا أكيد أنتم راسيين ال neurotransmitters يتم
+
+181
+00:12:47,130 --> 00:12:50,990
+اطلاقه عن طريق عملية اللي هي exocytosis صحيح؟ يعني
+
+182
+00:12:50,990 --> 00:12:54,490
+حتى تفقق أحد بعض ال neurotransmitters فانت فرزق ال
+
+183
+00:12:54,490 --> 00:12:56,410
+neurotransmitters من هذه ال neurotransmitters اللي
+
+184
+00:12:56,410 --> 00:12:59,110
+احنا حطنا تحتها خط مش الحق اللي هي النور
+
+185
+00:12:59,110 --> 00:13:03,270
+adrenalgicأو ال adrenaline هذا ايش بيعمللي هيتفقلي
+
+186
+00:13:03,270 --> 00:13:07,470
+مع ال receptors الموجودة هنا صحيح على سطح الخلية
+
+187
+00:13:07,470 --> 00:13:10,090
+الأخرى اللي هي ال dilator muscle بعدين بيعمللي
+
+188
+00:13:10,090 --> 00:13:12,990
+activation لل dilator muscle وبالتالي هيعمللي
+
+189
+00:13:12,990 --> 00:13:18,590
+توصيع للبابا عملية هذي واضحة ولا يعنيها مشكلة عامة
+
+190
+00:13:18,590 --> 00:13:21,050
+احنا مش مطالبين فيها بس من اللي عارف يعني ايش هو
+
+191
+00:13:21,050 --> 00:13:26,710
+هذا عبارة عن ال neurotransmitter يعمل على تحفيز
+
+192
+00:13:27,940 --> 00:13:34,140
+يعمل على تحفيز اللى هو dilator muscle مما ينتج عنه
+
+193
+00:13:34,140 --> 00:13:41,580
+اللى هو عملية ال madracis نفسها طيب من هذه الأسباب
+
+194
+00:13:41,580 --> 00:13:46,520
+إيش بعض الأسباب اللى ممكن سبب ل madracis؟ أول شىء
+
+195
+00:13:46,520 --> 00:13:52,110
+لدوية و هي أكتر شيء يعني أكتر استخدامةو لو حسبنا
+
+196
+00:13:52,110 --> 00:13:56,230
+نسبال تنع السببين الأسباب اللتي تؤدي إلى مدرسة
+
+197
+00:13:56,230 --> 00:13:59,190
+كأدوية أو أسباب اللتي تؤدي إلى مدرسة من ناحية
+
+198
+00:13:59,190 --> 00:14:02,350
+أمراض أو إصابات أو أي شيء هنلاقي الغالب يالأعظم
+
+199
+00:14:02,350 --> 00:14:05,470
+كلها أدوية لإن أغلب الأشخاص اللي مرة فحص طب
+
+200
+00:14:05,470 --> 00:14:10,330
+للعيارة فحص عام كلهم بيدهيش توصية لبابهم طيب وبعض
+
+201
+00:14:10,330 --> 00:14:13,390
+الأدوية هذه فيها دي مصطلحين مش دي المعنى سواء كان
+
+202
+00:14:13,390 --> 00:14:17,970
+في المدرسة او في المياصس المصطلح الأول
+
+203
+00:14:19,880 --> 00:14:27,740
+sympathomimetic مش بعيط mimetic، يعني هي عبارة عن
+
+204
+00:14:27,740 --> 00:14:33,960
+الادوية أو العقاقير التي تحاكي أو بين قوسين تشبه
+
+205
+00:14:33,960 --> 00:14:42,150
+عمل sympathetic nervous systemشو يعني حيصير عند ال
+
+206
+00:14:42,150 --> 00:14:46,130
+madresses ولا .. ده لا تاشي ولا عفر ولا ميوسز،
+
+207
+00:14:46,130 --> 00:14:49,310
+madresses صحيح؟ لإن هو أصلا مسئول بالشكل الأساسي
+
+208
+00:14:49,310 --> 00:14:51,450
+على ال madresses اللي هو ال subcastics صحيح؟ طب
+
+209
+00:14:51,450 --> 00:14:53,950
+احنا نفسنا اللي أخدت معايا طالع عليها memetics
+
+210
+00:14:53,950 --> 00:14:58,710
+معناته العقيل اللي تتحاكي كده كده كده، موجود عند
+
+211
+00:14:58,710 --> 00:15:01,310
+ال sympathomimetics يعني العقيل اللي تتحاكي عملا
+
+212
+00:15:01,310 --> 00:15:04,510
+اللي هو ال sympathic صحيح؟ طب هذه اللي كانت برث ال
+
+213
+00:15:04,510 --> 00:15:08,550
+pathomimetics العقل اللي تتحاكي، ممتاز، فإن على
+
+214
+00:15:08,550 --> 00:15:10,430
+مقيد منها هي ال latex
+
+215
+00:15:14,490 --> 00:15:18,230
+عقيل لا تحاكي يعني انت عمل باتجاه مراقب تماما لجزء
+
+216
+00:15:18,230 --> 00:15:22,390
+المقصود في الأول أو المذكور أولا مش الحاجة في ال
+
+217
+00:15:22,390 --> 00:15:25,570
+number أخرى sympathomimetic agents هي عبارة عن
+
+218
+00:15:25,570 --> 00:15:28,530
+عقيل لا تحاكي عمل ال sympathetic nervous system
+
+219
+00:15:28,530 --> 00:15:31,390
+يعني بشكل مختصر هتعمل لمدرسات صحيح
+
+220
+00:15:33,880 --> 00:15:40,760
+و مصطلح آخر باراسينباثولنتكس يعني بارسينباثولنتكس
+
+221
+00:15:40,760 --> 00:15:44,560
+يعني بارسينباثولنتكس يعني بارسينباثولنتكس يعني
+
+222
+00:15:44,560 --> 00:15:45,560
+بارسينباثولنتكس يعني بارسينباثولنتكس يعني
+
+223
+00:15:45,560 --> 00:15:47,680
+بارسينباثولنتكس يعني بارسينباثولنتكس يعني
+
+224
+00:15:47,680 --> 00:15:50,520
+بارسينباثولنتكس يعني بارسينباثولنتكس يعني
+
+225
+00:15:50,520 --> 00:15:56,280
+بارسينباثولنتكس يعني بارسينباثولنتكس يعني
+
+226
+00:15:56,280 --> 00:15:58,300
+بارسينباثول
+
+227
+00:16:02,430 --> 00:16:05,690
+تعمل أو تحاكي ال sympathetic nervous system منها
+
+228
+00:16:05,690 --> 00:16:10,550
+ال adrenaline اللى
+
+229
+00:16:10,550 --> 00:16:13,650
+هو شائع جدا بالاستخدام و ايضا في العمليات وهو اللى
+
+230
+00:16:13,650 --> 00:16:18,670
+برفع ضغط الدم بسرعة صحيح منها ايضا الابنفرين
+
+231
+00:16:18,670 --> 00:16:21,790
+والكوكاين الى اخره بعض الأمثلة اللى مذكرة معانا
+
+232
+00:16:21,790 --> 00:16:25,810
+بينما الاكثر شيء وعن استخدامها مش ال
+
+233
+00:16:25,810 --> 00:16:29,250
+sympathomimetics هي ال parasympatholetics اللى هى
+
+234
+00:16:29,250 --> 00:16:33,670
+أدرية غير مباشرة صحيح تعملهو هي العققية اللي
+
+235
+00:16:33,670 --> 00:16:38,650
+هتستخدم او بتعمل على عكس عفر ال mechanism of the
+
+236
+00:16:38,650 --> 00:16:40,990
+virus الباستك نقبص السيباني يعني مكانها بده تعمل
+
+237
+00:16:40,990 --> 00:16:44,310
+تفبيت لعملية ال virus الباستك بتاريخ وديم تجعله
+
+238
+00:16:44,310 --> 00:16:49,030
+اللي هو المدرياسيز من هذه العققية المشهورة جدا
+
+239
+00:16:49,030 --> 00:16:52,950
+معانا منها الأتروبيل ولمّا هنعمل سايكلوم استخدامها
+
+240
+00:16:52,950 --> 00:16:55,870
+هي السايكلو بنتولاتي طيب في عندك أربع عقية طبعا في
+
+241
+00:16:55,870 --> 00:16:58,510
+عندك كمان سكوبولامين في عندك عدة أدوية لكن هذا
+
+242
+00:16:58,510 --> 00:17:02,900
+يعني أشرحها أول شيء الأتروبيلو ال atropine بتعرفين
+
+243
+00:17:02,900 --> 00:17:06,120
+لما احنا نعمل cycle لما نريد معين بدنا كل عشر
+
+244
+00:17:06,120 --> 00:17:08,520
+دقيقة تقريبا نقطر مرة او كربا ساعة صحيح لفترة
+
+245
+00:17:08,520 --> 00:17:12,140
+اربعين دقيقة او خمس اربعين دقيقة صح ولا لأ فعند ال
+
+246
+00:17:12,140 --> 00:17:15,840
+maximum الفكرة افضل حاجة له هو بعد اربعين دقيقة
+
+247
+00:17:15,840 --> 00:17:18,060
+لذا احنا لما نعمل ال cycle حتى لو كان في عندي
+
+248
+00:17:18,420 --> 00:17:21,400
+مدرسات مش هنقول للمريض اللي بتعب صراحة لإن في بعض
+
+249
+00:17:21,400 --> 00:17:23,300
+المرضى بيستجيب خمس عشر دقايق من اللاجئ فيه يعني
+
+250
+00:17:23,300 --> 00:17:26,220
+بتبصر على البابا لأ حتى يحدث عنده اللي هو
+
+251
+00:17:26,220 --> 00:17:30,060
+cycloplegia بالمعنى الحقيقي و نستناش أربعين دقيقة
+
+252
+00:17:30,060 --> 00:17:33,960
+فأفضل تأثير له اللي هو بعد أربعين دقيقة طبعا جدش
+
+253
+00:17:33,960 --> 00:17:37,980
+المدة هذه ممكن حتى يوصل لإسبعين أو أكتر مش الحق من
+
+254
+00:17:37,980 --> 00:17:43,040
+سبعة إلى عشر أيامبينما ال hemotropin طبعا مصنفة من
+
+255
+00:17:43,040 --> 00:17:47,640
+الأفضل تأثير إلى الأقل تأثير، ال hemotropin تقريبا
+
+256
+00:17:47,640 --> 00:17:50,380
+أغلب الأدوية اللي حصلنا عليها قبلين دقيقة، صحيح؟
+
+257
+00:17:50,380 --> 00:17:53,980
+إذا كان أنا القصد منها اللي هو ال cyclone، صح أو
+
+258
+00:17:53,980 --> 00:17:56,640
+لا؟ بينما إذا كان فقط مجرم التوسيع للبابا و بدأ
+
+259
+00:17:56,640 --> 00:18:00,180
+أعمل فحص عادي، ممكن حتى fifty minus مجرم نتوسع عند
+
+260
+00:18:00,180 --> 00:18:02,240
+البابا و ممكن نعمل five or six examinations، لإن
+
+261
+00:18:02,240 --> 00:18:07,740
+ماليش علاقة بال refractionطيب أفضل حاجة بعد 40
+
+262
+00:18:07,740 --> 00:18:10,980
+minutes طبعا هذا اللي عند ال long lasting لحد ات
+
+263
+00:18:10,980 --> 00:18:15,640
+يوم او يومين cyclopentolase اللي هو اكثر شي يعانى
+
+264
+00:18:15,640 --> 00:18:19,160
+حتى في جميع القصص العربية يعني مستخدم شكل كبير بإن
+
+265
+00:18:19,160 --> 00:18:22,400
+ما في دول أخرى مابتداش تعمل refraction او للأطفال
+
+266
+00:18:22,400 --> 00:18:26,580
+يعنى لفقط باستخدام ال atropine لأن هو افضل يعني
+
+267
+00:18:26,580 --> 00:18:30,100
+افضل علاج ممكن يعمل يحصل على أفضل نتاج حتى الآن
+
+268
+00:18:30,100 --> 00:18:35,820
+cyclopentolate تقريبا 30 minutes يكون enoughومدة
+
+269
+00:18:35,820 --> 00:18:40,420
+من 12 الى 24 ساعة ثم يتلاشى مرة أخرى خالكوا معايا
+
+270
+00:18:40,420 --> 00:18:43,020
+بس نضرب مثال بسيط احنا حكينا هذه الأدوية كلها
+
+271
+00:18:43,020 --> 00:18:45,860
+عبارة عن باراسينباثولاتكس و لا باراسينباثولامتكس
+
+272
+00:18:45,860 --> 00:18:48,220
+باراسينباثولاتكس باراسينباثولاتكس ماشي الحال
+
+273
+00:18:48,220 --> 00:18:51,340
+باراسينباثولاتكس ماشي الحال باراسينباثولاتكس ماشي
+
+274
+00:18:51,340 --> 00:18:52,840
+الحال باراسينباثولاتكس ماشي الحال باراسينباثولاتكس
+
+275
+00:18:52,840 --> 00:18:55,540
+ماشي الحال باراسينباطولاتكس ماشي الحال
+
+276
+00:18:55,540 --> 00:18:59,840
+باراسينباطولاتكس ماشي الحال باراسينباطولاتكس ماشي
+
+277
+00:18:59,840 --> 00:19:06,180
+الحال باراسينعدوية او عقير تعمل ضد Parasympathetic
+
+278
+00:19:06,180 --> 00:19:10,040
+لفترة معينة بعدين يحدث عنده إيش ان هو مدرياسيس ومن
+
+279
+00:19:10,040 --> 00:19:14,600
+ثم مرة أخرى لما يحدث عنده ان هو تلاش للإنزين هذا و
+
+280
+00:19:14,600 --> 00:19:16,980
+بنرجع للمرة أخرى construction أو بنرجع لوضعه
+
+281
+00:19:16,980 --> 00:19:21,500
+الطبيعي هذا بالنسبة للعقير هذه معانا لنعرف أيه
+
+282
+00:19:21,500 --> 00:19:27,000
+أكثر فعالية و أيه أقل فعالية بعدين نطلع بين فيها
+
+283
+00:19:27,000 --> 00:19:30,700
+بعيدا
+
+284
+00:19:30,700 --> 00:19:34,490
+عن استخدام عدويةفي هنا أيضا أسباب أخرى ممكن تؤدي
+
+285
+00:19:34,490 --> 00:19:38,730
+إلى مدرسات أو تدريبات interpretation of
+
+286
+00:19:38,730 --> 00:19:43,390
+stimulation of the sympathetic nervous system هو
+
+287
+00:19:43,390 --> 00:19:45,890
+طبيعي جدا و احنا حكينا لما اتكلمنا أخر مرة على
+
+288
+00:19:45,890 --> 00:19:49,470
+أجهزة الكذب اللي بيسموها أجهزة الكذب صحيح بيعمل
+
+289
+00:19:49,470 --> 00:19:53,610
+على يحاول يعني يستفز الإنسان او يشوف هالإنسان
+
+290
+00:19:53,610 --> 00:19:57,260
+يتوتر او لا طبعا الإنسان في حالة ال tensionماحيكون
+
+291
+00:19:57,260 --> 00:19:59,400
+تحتاش اللي هو sympathetic nervous system
+
+292
+00:19:59,400 --> 00:20:01,780
+stimulation صحيح؟ فال sympathetic nervous system
+
+293
+00:20:01,780 --> 00:20:04,060
+stimulation بس هو بدرجة أولى عن ال madrassas
+
+294
+00:20:04,060 --> 00:20:07,220
+بالتالة طبيعة الحلقة أنه حيحكي سؤال دي اللي هو
+
+295
+00:20:07,220 --> 00:20:11,560
+madrassas يعني لو جتنا بعلّل بدنا عارف نعلّل مش
+
+296
+00:20:11,560 --> 00:20:14,600
+الحق لو جتنا الحق هذا قصته yet why بدنا عارف نذكر
+
+297
+00:20:14,600 --> 00:20:20,690
+السبق why؟طيب تاني حاجة paralysis or inhibition of
+
+298
+00:20:20,690 --> 00:20:25,170
+the parasympathetic nerve ايش يعني اصبح في عندي
+
+299
+00:20:25,170 --> 00:20:28,450
+مشكلة او من ال parasympathetic و هذه نفس اللي انا
+
+300
+00:20:28,450 --> 00:20:35,230
+حكيتها صح ولا لأ صح ولا لأ فقط يعققير يعني طيب نفس
+
+301
+00:20:35,230 --> 00:20:40,910
+المثال ادنا مثال يعني رقم تلاتةParalysis عبارة عن
+
+302
+00:20:40,910 --> 00:20:45,210
+شلل مؤقت طبعا او inhibition او منح اللي هو لعملية
+
+303
+00:20:45,210 --> 00:20:48,070
+Parasympathetic system او تفبيه ل Parasympathetic
+
+304
+00:20:48,070 --> 00:20:51,750
+nervous system غير الأدوية اللي حكيناها احنا عبارة
+
+305
+00:20:51,750 --> 00:20:54,730
+عن Parasympatholetics صحيح يعني أدوية او عقلية
+
+306
+00:20:54,730 --> 00:20:57,230
+تعمل بشكل مناقض لل Parasympathetic nervous system
+
+307
+00:20:57,230 --> 00:21:00,930
+صحيح طب لو العضل نفسها ممكن بس العضل عدمها مش
+
+308
+00:21:00,930 --> 00:21:03,570
+علاقة احنا بنحكي لو استهدق رانيه و ناريه أصبح له
+
+309
+00:21:03,570 --> 00:21:07,390
+damage فانت عارف ايش رأيزي صح ولا حاسس ايش فيه
+
+310
+00:21:07,390 --> 00:21:07,790
+عندك؟
+
+311
+00:21:13,240 --> 00:21:18,440
+لأ احنا ببنى الاسباب اللي تؤدي الى مدرياسس بده اذا
+
+312
+00:21:18,440 --> 00:21:21,620
+كان عنده براسباستك بيعمللي ميواسس فمحلته تدمير
+
+313
+00:21:21,620 --> 00:21:25,360
+ايضا معرفة براسباستك براس واحدة هيعمللياش مدرياسس
+
+314
+00:21:25,360 --> 00:21:29,480
+من ذلك اللي هو third cranial nerve pulsing اللي هو
+
+315
+00:21:29,480 --> 00:21:34,380
+الانتهاب في العصب الجمجم الثالث او حتى الشلل في
+
+316
+00:21:34,380 --> 00:21:36,800
+العصب الجمجم الثالث نتيجة نزيق او نتيجة أدوية
+
+317
+00:21:36,800 --> 00:21:41,780
+معينة او نتيجة الاتهاباتأخر حاجة اللي هو trauma،
+
+318
+00:21:41,780 --> 00:21:45,480
+trauma بشكل عام ممكن تعمل على تدمير اللي هو عضلات
+
+319
+00:21:45,480 --> 00:21:49,080
+ال iris كلا ال dilator أو ال sphincter بإنها ينتج
+
+320
+00:21:49,080 --> 00:21:53,940
+عنه اللي هو مدرسات أو ايضا ممكن تعمللي على تدمير
+
+321
+00:21:53,940 --> 00:21:56,740
+البقس ويه نفسه بإذن الله البقس يبقى sympathetic
+
+322
+00:21:56,740 --> 00:22:00,000
+فالتالي اللي هيحدث عندي اللي هو مدرسات طبعا هذه ال
+
+323
+00:22:00,000 --> 00:22:03,000
+trauma بدنا نعلّل كيف أصبح كيف ممكن ال trauma
+
+324
+00:22:03,000 --> 00:22:07,400
+توصللي أو تسببلي مدرسات ممكن نعرفينبالطبع المرأة
+
+325
+00:22:07,400 --> 00:22:11,780
+بتهيأسلي على كل باسم بيقف باسم باسم صحيح بغض النظر
+
+326
+00:22:11,780 --> 00:22:18,460
+كان العضلة نفسها أو حتى الناقب نفسه طيب مقطع رقم
+
+327
+00:22:18,460 --> 00:22:22,220
+اتنين اتكلم عليها هي مراقبة نعمة المدرسات هي ايضا
+
+328
+00:22:22,220 --> 00:22:25,420
+المياصس كنت بأقول المدرسات والمياصس الحالة
+
+329
+00:22:25,420 --> 00:22:27,980
+الطبيعية هم أثر موجودة او الحالة الطبيعية يعني
+
+330
+00:22:27,980 --> 00:22:30,740
+بدون استخدام اي عقل غيره بدون أمراض موجودة وحكينا
+
+331
+00:22:30,740 --> 00:22:34,720
+في حالة اسمها Iris او pupillary tremor صح ولا شفعة
+
+332
+00:22:34,720 --> 00:22:35,080
+ال tremor
+
+333
+00:22:38,570 --> 00:22:42,930
+لأ يعني أمس بال visual feed كنا نطلع على شكل
+
+334
+00:22:42,930 --> 00:22:46,690
+البابا إيش كان، شكل دائم، سمر، ببعض المصاد، يعني
+
+335
+00:22:46,690 --> 00:22:49,730
+اللي هي الرعشة دي عبارة عن ببعض المصاد، ببعض الشكل
+
+336
+00:22:49,730 --> 00:22:53,170
+الدائم، صحيح؟ فهي هذه الميواثيس و المدرسات، ده كان
+
+337
+00:22:53,170 --> 00:22:58,070
+الأغلب انه .. على الأغلب ان الصلاحات هذي اقصد فيها
+
+338
+00:22:58,070 --> 00:23:01,390
+مدرسات يعني بشكل دائم، بشكل دائم يعني فترة معينة
+
+339
+00:23:01,390 --> 00:23:04,350
+دل في عنده إيش موسع، و الميواثيس يكون عنده فيش ..
+
+340
+00:23:04,350 --> 00:23:07,430
+ففترة في المدرسات و الميواثيس ال trimmer هذا ماكنش
+
+341
+00:23:07,430 --> 00:23:15,250
+معلومضعيف جدا يتوقف ماشي الحال هاه
+
+342
+00:23:15,250 --> 00:23:21,670
+كوفيا
+
+343
+00:23:21,670 --> 00:23:27,370
+المدرسة المياثر
+
+344
+00:23:27,370 --> 00:23:32,370
+الحالتين هذو اشمل بديق الماشي الحال لكتر ما في
+
+345
+00:23:32,370 --> 00:23:35,070
+الحالة هذه او في الحالة هذهلأن القدرة اللي كانت في
+
+346
+00:23:35,070 --> 00:23:37,950
+ال meiosis هيكون ثابت وكفر المدرسات باستخدام
+
+347
+00:23:37,950 --> 00:23:41,050
+العقلي أيضا هيكون ثابت فال three مرحلة دي اللي هي
+
+348
+00:23:41,050 --> 00:23:44,970
+حركة بعض المساطر اللي بقبها هتكون عيشها تقل لدرجة
+
+349
+00:23:44,970 --> 00:23:49,130
+انها ربما تبقى يعني ثابتة مش الحق لأن بالحالة في
+
+350
+00:23:49,130 --> 00:23:53,990
+السيولوجيا فقط هي تحدث طيب نرجع مرة أخرى ال
+
+351
+00:23:53,990 --> 00:23:56,950
+meiosis هو عبارة عن construction of the pupil هذا
+
+352
+00:23:56,950 --> 00:24:01,150
+التعريف بناخه يعني عبارة عن construction of the
+
+353
+00:24:01,150 --> 00:24:05,510
+pupilطب احنا لو بتكلمنا عن ال mediatics إيش
+
+354
+00:24:05,510 --> 00:24:09,430
+حاكينا؟ في بعض الأدوية اللي بتعمل نفس عمل المدرسة
+
+355
+00:24:09,430 --> 00:24:12,190
+تسمينا احنا mediatics صحيح؟ او mediatics من ناحية
+
+356
+00:24:12,190 --> 00:24:15,290
+تجارية يعني هي الأدوية اللي بتعمل على توسع البابا
+
+357
+00:24:15,290 --> 00:24:20,910
+بينما الأدوية اللي بتعمل على .. إيش اسمها؟ ميوتكس
+
+358
+00:24:20,910 --> 00:24:27,870
+على عكس ميوتكس ميوتكس
+
+359
+00:24:27,870 --> 00:24:30,270
+that's probably ان هو ميوتكس طبعا هي مشتقة من
+
+360
+00:24:30,270 --> 00:24:35,060
+كلمات ميوتكسعشان الحق إذا نقيد لميوتيكس في عيش
+
+361
+00:24:35,060 --> 00:24:41,100
+بالميوتيكس طيب برجع مرة أخرى نتبعه برجع مرة أخرى
+
+362
+00:24:41,100 --> 00:24:44,120
+stimulation of the sphincter papilla from
+
+363
+00:24:44,120 --> 00:24:47,000
+parasympathetic cholinergic fibers causes meiosis
+
+364
+00:24:47,000 --> 00:24:50,460
+or constriction of the sphincter papilla muscle is
+
+365
+00:24:50,460 --> 00:24:55,740
+caused by وفي عدة أسباب اللي هي تؤدي إلى التضيق
+
+366
+00:24:55,740 --> 00:25:00,300
+اللي هو ال lipid بس مرة أخرى نحط خط تحت
+
+367
+00:25:00,300 --> 00:25:01,420
+cholinergic fibers
+
+368
+00:25:06,310 --> 00:25:09,570
+طيب ترجع لنفس الناس اللي أسميها لك و أرسمها سواها
+
+369
+00:25:09,570 --> 00:25:13,130
+هذه
+
+370
+00:25:13,130 --> 00:25:17,950
+هي النهاية العصبية عشان الحال و هيندي أنا هذا الـ
+
+371
+00:25:17,950 --> 00:25:25,070
+sphincter مثلا
+
+372
+00:25:25,070 --> 00:25:28,610
+صحيح؟ طبعا احنا بختار ليه واحد من الألياف العضلية
+
+373
+00:25:28,610 --> 00:25:31,930
+هذه فهيندي أنا الـparasympathetic
+
+374
+00:25:42,710 --> 00:25:47,730
+عصر بتاعك تعسى بقى مثلا صحيح صح و لا طيب إن هيطلع
+
+375
+00:25:47,730 --> 00:25:49,850
+عصرية اللى بتردي ال center muscle الموجودة بال
+
+376
+00:25:49,850 --> 00:25:54,990
+iris بتحطزلها تنشيط صحيح فتنشيطها هدا بتعمل على
+
+377
+00:25:54,990 --> 00:26:00,850
+إفراز فيه
+
+378
+00:26:00,850 --> 00:26:03,650
+يعني vesicles صحيح بتعمل على إفراز ال vesicles
+
+379
+00:26:03,650 --> 00:26:09,390
+اللى موجودة هنا تنتج لإيش neurotransmitters
+
+380
+00:26:09,390 --> 00:26:13,850
+صح و لا مش معناه neurotransmittersاللي احنا حكينا
+
+381
+00:26:13,850 --> 00:26:18,030
+عنها في المدرسات زي مثلا ال adrenaline صحيح؟ صح
+
+382
+00:26:18,030 --> 00:26:21,490
+ولا لا؟ بينما في ال path بسيط اللي هو ال cooling
+
+383
+00:26:21,490 --> 00:26:23,450
+stress ال cooling stress جاي من الكلمة اللي
+
+384
+00:26:23,450 --> 00:26:30,350
+حكيناها تحتها خط هاخد
+
+385
+00:26:30,350 --> 00:26:34,570
+أكرر شوية بدي أعمل على إفراز ال neurotransmitters
+
+386
+00:26:34,570 --> 00:26:38,630
+التي تعمل على انقباض أو تحفيز ال sphincter muscle
+
+387
+00:26:38,630 --> 00:26:39,770
+صحيح؟ من خلال
+
+388
+00:26:47,410 --> 00:26:52,350
+الثالث هيحدث عندى انقباض لـ sphincter muscle و
+
+389
+00:26:52,350 --> 00:26:55,870
+هيحدث عندى meiosis هدى هدى بشكل مختصر يعني بشكل
+
+390
+00:26:55,870 --> 00:26:59,510
+عام كمراجعة لما هى بتفصيل هتاخدوها بالpharmacology
+
+391
+00:26:59,510 --> 00:27:03,610
+ان شاء الله طيب السبب الأول زى ما اتكلمنا على
+
+392
+00:27:03,610 --> 00:27:05,930
+المدرسة السبب الأول عبارة عن ال drugs و ايضا ال
+
+393
+00:27:05,930 --> 00:27:09,950
+meiosis السبب الأول عبارة عن اللى هو drugs من هذه
+
+394
+00:27:09,950 --> 00:27:15,060
+الأدويةباراسينباتو ميمتيكس يعني عقير تحكي عمل
+
+395
+00:27:15,060 --> 00:27:22,900
+الباراسينباتو نفس الشيء بدى اتنشط ليا نضمن
+
+396
+00:27:22,900 --> 00:27:28,380
+ذلك البيلو كاربين يعمل عبارة عن عقاريعمل علي تضييق
+
+397
+00:27:28,380 --> 00:27:31,420
+البابا او يعمل علي construction of the pupil by
+
+398
+00:27:31,420 --> 00:27:36,200
+واسطة activation of the sphincter muscle او
+
+399
+00:27:36,200 --> 00:27:40,180
+استموليشن للسفينكتر مصر بتاعي هيعمل علي تضييق
+
+400
+00:27:40,180 --> 00:27:44,260
+البابا في ايضا عندى أدوية اخرى مش معاناة حببت لكن
+
+401
+00:27:44,260 --> 00:27:46,760
+تعالى تشوفها هنا which causes meiosisis by
+
+402
+00:27:46,760 --> 00:27:51,240
+anticholesterase ايش
+
+403
+00:27:51,240 --> 00:27:56,260
+هو anticholesterase عبارة عن انزيمبدون auntie،
+
+404
+00:27:56,260 --> 00:27:58,880
+auntie معرفة dead، صح ولا لا؟ فانتي معرفة dead، ضد
+
+405
+00:27:58,880 --> 00:28:04,440
+العمل هذا، عبارة عن أنزين يعمل أو يساعد فيه اللي
+
+406
+00:28:04,440 --> 00:28:08,340
+هو madresses of the people، صحيح؟ فلما نحكي ان
+
+407
+00:28:08,340 --> 00:28:11,540
+auntie كل نسترز، يعني هو عبارة عن أنزين، صحيح؟ أو
+
+408
+00:28:11,540 --> 00:28:17,340
+عبارة عن العقار اللي يعمل على اللي هو تضيق البابا،
+
+409
+00:28:17,340 --> 00:28:23,390
+هذه المقطة واضحة، بالذات، مش الحالباضح؟ إذا من ضمن
+
+410
+00:28:23,390 --> 00:28:26,610
+هذا البراسينباثوميموتكس في أدوية كتير عنده هي تعمل
+
+411
+00:28:26,610 --> 00:28:29,410
+على مبدأ أن الانتكولنستيريز عندك بيقدسله
+
+412
+00:28:29,410 --> 00:28:32,770
+stimulation والانتكولنستيريز هذا عبارة عن انزيم
+
+413
+00:28:32,770 --> 00:28:37,110
+صحيح يعمل على اللي هو توسع البقبة صحيح؟ بتفاعل
+
+414
+00:28:37,110 --> 00:28:40,830
+دواء معين هتاخده بال pharmacology فأي عقر هيعمله
+
+415
+00:28:40,830 --> 00:28:44,650
+على تخبيط المادة هذه هو هيعملها على إيش؟ تضيق
+
+416
+00:28:44,650 --> 00:28:52,740
+البقبة حد ما أنا عارفها رقم 2هي simpatholytics هي
+
+417
+00:28:52,740 --> 00:28:57,540
+العقيرة التي تعمل بشكل مضاد لـ Simpastic nervous
+
+418
+00:28:57,540 --> 00:29:01,820
+system بتاعة تعمل عليها توصية تعفن تضييق البواء من
+
+419
+00:29:01,820 --> 00:29:05,880
+ضمن هذه هي Adrenalic blockers Adrenalic من
+
+420
+00:29:05,880 --> 00:29:08,800
+Adrenaline نحط تحت خاطر Adrenalic blockers
+
+421
+00:29:08,800 --> 00:29:13,300
+Adrenaline إيش مظيفته؟ بطل ثلاثية إذا كانت توصية
+
+422
+00:29:13,300 --> 00:29:18,840
+هتقتل عين صح ولا فلما نحكي هنا blockers لسه منها
+
+423
+00:29:18,840 --> 00:29:23,060
+blockersيدي انا receptors يعني صحيح؟ و deflucent
+
+424
+00:29:23,060 --> 00:29:26,880
+هي مادة تعمل على انغلاق هذه ال receptors بغض نظرها
+
+425
+00:29:26,880 --> 00:29:30,100
+ايش فيها ال deflucent ا submit adrenergic blockers
+
+426
+00:29:30,100 --> 00:29:34,640
+خايلة وقت راح تاخدوها بشكل موسع ان شاء الله طيب
+
+427
+00:29:34,640 --> 00:29:38,420
+السبب التاني نفس ما اتكلمنا عن المدرسات اتكلم
+
+428
+00:29:38,420 --> 00:29:42,720
+عالمي أساس أيضا اي حدوث او irritation او تهيج او
+
+429
+00:29:42,720 --> 00:29:46,020
+stimulation للبعض بسبب نفس ال system ايضا ممكن
+
+430
+00:29:46,020 --> 00:29:49,730
+يسبب ليه؟اللي هو تضيق في البواب ومن ضمن هذه
+
+431
+00:29:49,730 --> 00:29:54,010
+الاسئلة الذكية مش معانا اللي هو ال morphine هذه
+
+432
+00:29:54,010 --> 00:29:56,950
+بعض العقل اللي بيستخدموها طبعا المدمنين صحيح تؤدي
+
+433
+00:29:56,950 --> 00:30:00,950
+إلى الدمان تستخدم علاجيا ايضا لتصبيت من الألم صحيح
+
+434
+00:30:00,950 --> 00:30:05,010
+بذلك الألم المستعصى طبيعيا هذا ال morphine بيعمل
+
+435
+00:30:05,010 --> 00:30:09,690
+على construction of the pupil وكثير من المرضى او
+
+436
+00:30:09,690 --> 00:30:15,360
+يعني اللي بيتم ضبطهمالتبروتة في عقل النفس الهادي
+
+437
+00:30:15,360 --> 00:30:19,060
+يعني لإن بجلول مفحص كلينيكي ملاقي endomeosis بشكل
+
+438
+00:30:19,060 --> 00:30:21,900
+كبير صعب جدا يعمله ده لدرجة ان حتى بالأدوية يكون
+
+439
+00:30:21,900 --> 00:30:24,700
+صعب جدا يستجيب لإن المرض بيكون بتحتها ده المادة
+
+440
+00:30:24,700 --> 00:30:28,080
+لفترة كبيرة بس طبعا هذا مابيدلش أنه كل واحد عنده
+
+441
+00:30:28,080 --> 00:30:32,360
+construction أن هو بتاعته فهم يفهماش مشكلة هذا طيب
+
+442
+00:30:32,360 --> 00:30:37,150
+أخر حاجة اللي هي ال traumaتماما زى ما اتكلمت ال
+
+443
+00:30:37,150 --> 00:30:40,350
+trauma ايضا ممكن تسببلي مياثس ممكن بنفس الوقت
+
+444
+00:30:40,350 --> 00:30:44,290
+تسببلياش مدرسة طيب كيف ممكن تسببلي مياثس لل
+
+445
+00:30:44,290 --> 00:30:47,350
+trauma؟
+
+446
+00:30:47,350 --> 00:30:50,490
+فقط بتعمل على تدمير جهة الموضوع ده وبالتالي هيظل
+
+447
+00:30:50,490 --> 00:30:55,550
+لان دي مباشرة مياثس طيب
+
+448
+00:30:55,550 --> 00:30:59,230
+ناخد بس الفقر الأخير هذه بتعتبر مهم جدا احنا أخدنا
+
+449
+00:30:59,230 --> 00:31:02,310
+ايضا كمان لما اتكلمنا علىال upper eyelids
+
+450
+00:31:02,310 --> 00:31:05,390
+retractor زي مرة أخرى خدنا فيه syndrome horner
+
+451
+00:31:05,390 --> 00:31:08,450
+syndrome ايش أسبابه ال horner syndrome؟ هو بعرفوا
+
+452
+00:31:08,450 --> 00:31:13,730
+ان ايش علماته؟ anhedrosis صحيح myosis والتواصس
+
+453
+00:31:13,730 --> 00:31:18,450
+والتواصس السبب هو ايش؟
+
+454
+00:31:18,450 --> 00:31:23,110
+انه sympathetic لا بس بعثوا يتملوا تدمير صحيح او
+
+455
+00:31:23,110 --> 00:31:26,030
+تملوا damage بالتالي أصبح في عندي عيش بشكل دائم
+
+456
+00:31:26,030 --> 00:31:28,970
+فانه مش حاجة تطبطه صحيح بس بيظل بشكل دائم عشان
+
+457
+00:31:28,970 --> 00:31:33,440
+عندي myosisطب نشوف الفقرة هذه مع بعض، Bilateral
+
+458
+00:31:33,440 --> 00:31:37,080
+small pupils may be due to irritation of the third
+
+459
+00:31:37,080 --> 00:31:40,720
+nerve by a central nervous system disease or
+
+460
+00:31:40,720 --> 00:31:43,180
+Potassium hemorrhage ال Potassium hemorrhage أنتوا
+
+461
+00:31:43,180 --> 00:31:47,880
+عارفين؟ مش عارف اذا كانت تشرحيها ولا لا، the
+
+462
+00:31:47,880 --> 00:31:50,620
+nucleus of the third and fourth cranial nerve و
+
+463
+00:31:50,620 --> 00:31:54,460
+الموجودين، احنا الان كل cranial nerve يلو nucleus
+
+464
+00:31:54,460 --> 00:31:58,380
+معينة، صحيح؟ مش هيجي من الهواء يعنيموجودة في ال
+
+465
+00:31:58,380 --> 00:32:01,660
+midbrain عشان الحاجة فال midbrain هو نفسه هذا إيه
+
+466
+00:32:01,660 --> 00:32:07,920
+بتقدر تقسيمته ولا لأ اللي بتقسم ولا هو عبارة عن
+
+467
+00:32:07,920 --> 00:32:11,540
+صوت يعني بتقدر نظره عن تقسيمته بس نكتب هذه المقطة
+
+468
+00:32:11,540 --> 00:32:19,380
+معانا حدوث لذيف في
+
+469
+00:32:19,380 --> 00:32:24,280
+منطقة ال pawns ال جسد صح ولا لأاللي هي الربط ما
+
+470
+00:32:24,280 --> 00:32:29,560
+بين ال midbrain و مدل القلون جاتا صح ولا لا؟هيؤثر
+
+471
+00:32:29,560 --> 00:32:35,300
+بشكل سلبي على عمل third cranial nerve اللي هو
+
+472
+00:32:35,300 --> 00:32:39,540
+بالعصب الجمجمي الثالث السبب لذلك انه نواية العصب
+
+473
+00:32:39,540 --> 00:32:42,620
+الجمجمي الثالث والرابع متواجدة أصلا في ال bones مش
+
+474
+00:32:42,620 --> 00:32:46,460
+الحاجة فالمقصود في Pontine اللي هي آتية من كلمة ال
+
+475
+00:32:46,460 --> 00:32:49,160
+bone نفسها مش الحاجة Pontine Hemorrhea النظيف حدث
+
+476
+00:32:49,160 --> 00:32:54,380
+فيه أو نسميه النظيف الجسري طبعا هذا مرض تجعل
+
+477
+00:32:54,380 --> 00:32:57,820
+ارتفاع ضغط الدم الشديد ممكن طبعا يحدث عنده
+
+478
+00:33:00,950 --> 00:33:06,130
+تاني شئ مورفين poisoning تسمى بعقار اللي هو
+
+479
+00:33:06,130 --> 00:33:08,930
+المورفين هتكلمنا عنه احنا probably due to
+
+480
+00:33:08,930 --> 00:33:13,550
+sympatheticParalysis واخدنا ايضا كمان مثل على ذلك
+
+481
+00:33:13,550 --> 00:33:16,670
+اللي هو Horner Syndrome عبارة عن Paralysis معناها
+
+482
+00:33:16,670 --> 00:33:19,810
+شلل احسس ان عندي شلل او خلل في عملية اللي هو
+
+483
+00:33:19,810 --> 00:33:22,850
+sympathetic nervous system بالتالي طبعا مش في كل
+
+484
+00:33:22,850 --> 00:33:25,150
+sympathetic nervous system لفقط احنا قصدنا هنا
+
+485
+00:33:25,150 --> 00:33:28,290
+اللي هو في superior cervical sympathetic ganglion
+
+486
+00:33:28,290 --> 00:33:30,770
+صحيح احنا حكينا عن جنجل في عنا superior في عنا
+
+487
+00:33:30,770 --> 00:33:34,250
+middle في عنا inferior فقط ال superior وفي اشخاص
+
+488
+00:33:34,250 --> 00:33:37,990
+كتير يعني في دول برا متعبين يعملواالنوع من المساج
+
+489
+00:33:37,990 --> 00:33:42,570
+الخاطئ للرقبة صحيح فعندك عمل مساج للرقبة بالناحية
+
+490
+00:33:42,570 --> 00:33:46,630
+اليمنة يعني أو اليسرة ناحية العلوية بتغطي بشكل
+
+491
+00:33:46,630 --> 00:33:50,230
+خاطئ اللي هو ممارس هذه المساج وبالتالي مع فترة
+
+492
+00:33:50,230 --> 00:33:52,910
+زمنية كبره ممكن الملعقة تدمي الجانجليون هذه وينتج
+
+493
+00:33:52,910 --> 00:33:55,390
+عنه اللي هو horners syndrome
+
+494
+00:34:00,660 --> 00:34:04,260
+طيب أخر حاجة when sympatic function in one side is
+
+495
+00:34:04,260 --> 00:34:07,660
+lost gives the condition of Horner's syndrome طبعا
+
+496
+00:34:07,660 --> 00:34:10,480
+معرفة أنه Horner's syndrome فقط عندي يوم العتر أه
+
+497
+00:34:10,480 --> 00:34:15,360
+مابحنساش بقى العتر طيب هاي مرة أخرى Horner's
+
+498
+00:34:15,360 --> 00:34:17,220
+syndrome إذا بتلاحظ بقى إيه فيها مشكلة ال right
+
+499
+00:34:17,220 --> 00:34:22,680
+ولا ال left ال right صحيح لإن في عندي process ربما
+
+500
+00:34:22,680 --> 00:34:25,850
+الميزة فيها مش هتبين مشكلة كبيرةلكن في عندي ..
+
+501
+00:34:25,850 --> 00:34:30,970
+هنبقى مدرسة صحيح؟ وهذا أكبر من ال right pupil ففي
+
+502
+00:34:30,970 --> 00:34:33,590
+عندي أول حاجة ال two sides اللي احنا شايفينها، في
+
+503
+00:34:33,590 --> 00:34:36,510
+عندي الtoesies و هذا الtoesies partial toesies فقط
+
+504
+00:34:36,510 --> 00:34:39,890
+لإن أحدث عندي paralysis ل .. اللي هو sympathetic
+
+505
+00:34:39,890 --> 00:34:42,770
+fibers اللي بتغضيلي ال Mullars muscle صحيح؟ or
+
+506
+00:34:42,770 --> 00:34:46,310
+muscle of Mullar صحيح؟ فهذا مجرد انسدال للجثة
+
+507
+00:34:46,310 --> 00:34:51,440
+الجثة عبارة عن two millimeters الإضافية صحيح؟هذه
+
+508
+00:34:51,440 --> 00:34:54,220
+الرقم واحد، الرقم اتنين في عندي ham dilatation
+
+509
+00:34:54,220 --> 00:34:57,380
+بينما مافي عندي ash اللي هو meiosis وفي إشارة احنا
+
+510
+00:34:57,380 --> 00:35:00,980
+مانشوفهاش اللي هي anhidrosis أو عبارة عن جفاف نصف
+
+511
+00:35:00,980 --> 00:35:05,840
+اللي هو الوجه it's caused by paralysis of the
+
+512
+00:35:05,840 --> 00:35:09,120
+cervical-selvastic ganglia ونحط تحتها خط، ده هو
+
+513
+00:35:09,120 --> 00:35:12,220
+السبب الرئيسي وراء الحدوث اللي هو horner syndrome
+
+514
+00:35:12,220 --> 00:35:16,380
+فhorner syndrome في الحال هذا يعتبر مكتسب صحيح؟
+
+515
+00:35:16,380 --> 00:35:21,580
+يعتبر مكتسبمرة أخرى is caused by paralysis of the
+
+516
+00:35:21,580 --> 00:35:24,440
+cervical sympathetic ganglion due to lesion in the
+
+517
+00:35:24,440 --> 00:35:27,520
+middle brain بسبب وجود مشكلة في ال brain stem أو
+
+518
+00:35:27,520 --> 00:35:31,160
+في ال spinal cord أو حتى في أمراض أخرى مش بس فقط
+
+519
+00:35:31,160 --> 00:35:34,180
+في الحالة اللي أنا ذكرتها أن ربما يكون في مساج أو
+
+520
+00:35:34,180 --> 00:35:38,300
+مشاكل الياقة أخرى، لا أي مرض أو نزيف ممكن يسببلي
+
+521
+00:35:38,300 --> 00:35:40,620
+أو يسببلي المشكلة دي في شكل مباشر أو غير مباشر
+
+522
+00:35:40,620 --> 00:35:44,320
+ممكن يعمللي اللي هو hornet syndrome طيب it consist
+
+523
+00:35:44,320 --> 00:35:49,360
+ofتكون مناش مياصس صحيح الconstruction of the pupil
+
+524
+00:35:49,360 --> 00:35:52,340
+بعد في انده تواصس نفسي ده ال different طبعا نفسي
+
+525
+00:35:52,340 --> 00:35:55,560
+ده هنحكي partial هو مش total هو بين جثين partial
+
+526
+00:35:55,560 --> 00:36:02,080
+فقط انه فالثرمسش معناها عادة مش منها هي مش تاخرها
+
+527
+00:36:02,080 --> 00:36:05,180
+يعني عبارة عن مكان اللي عين تدخل إلى الخارج عكس
+
+528
+00:36:05,180 --> 00:36:05,940
+الثرمس
+
+529
+00:36:09,670 --> 00:36:13,110
+أخر حاجة anhidrosis يعني هي الوظائف السلقة أو ال
+
+530
+00:36:13,110 --> 00:36:15,530
+science .. three science هي أهم حاجة meiosis,
+
+531
+00:36:15,910 --> 00:36:19,690
+toesis and anhidrosis عبارة عن اللي هو ال smith
+
+532
+00:36:19,690 --> 00:36:24,670
+gland متواجدة اللي عبارة عن الغدد العراقية متواجدة
+
+533
+00:36:24,670 --> 00:36:27,930
+كل الجسم صحيح فالغدد العراقية المتواجدة بالشق اللي
+
+534
+00:36:27,930 --> 00:36:33,320
+تم إصابته بتتمشي لها جفافالشخص يشعر بجفاف في
+
+535
+00:36:33,320 --> 00:36:36,060
+الواجهة ال permit of splitting of the Ipsilateral
+
+536
+00:36:36,060 --> 00:36:39,320
+Ipsilateral هي نفس الاتجاه اللى تم فيه يعني مش
+
+537
+00:36:39,320 --> 00:36:41,620
+هاناج .. خلوكوا معايا على الصورة مش هاناج هان فيه
+
+538
+00:36:41,620 --> 00:36:44,220
+انديهورناس سندروم و الانهيدروسس هيكون هان بق
+
+539
+00:36:44,220 --> 00:36:46,800
+الانهيدروسس و الاتواسس و ال three sides هيكونوا
+
+540
+00:36:46,800 --> 00:36:51,140
+على نفس الاتجاه طيب
+
+541
+00:36:51,140 --> 00:36:56,720
+هورناس سندروم و الناقط طيلات هذه نقطة مهمة جداin
+
+542
+00:36:56,720 --> 00:36:59,260
+dim light يعني حتى لو يعني طلعوا الصورة هذا اللي
+
+543
+00:36:59,260 --> 00:37:03,460
+اخده اصلا اخده في غرفة عتمة صحيح in dim light
+
+544
+00:37:03,460 --> 00:37:06,420
+فأصبح فيه عند ال people طبيعي اللي هو هذا صحيح انه
+
+545
+00:37:06,420 --> 00:37:08,780
+يكون dilatation لكن ال right people اللي فيه
+
+546
+00:37:08,780 --> 00:37:13,440
+horner syndrome مش هيتملوا اللي هو dilatation حده
+
+547
+00:37:13,440 --> 00:37:15,780
+اللي في حالته اللي هو ال constructed people while
+
+548
+00:37:15,780 --> 00:37:18,080
+normal people يكونوا dilate in dim light ويحكي ان
+
+549
+00:37:18,080 --> 00:37:22,160
+ليش صحيحfor this anisocoria is increased in dim
+
+550
+00:37:22,160 --> 00:37:25,400
+light، أنيسوكوريا هي عبارة عن الفارق ما بين حجم
+
+551
+00:37:25,400 --> 00:37:27,900
+البقب الأيمن والأيسر، وحكي ان احنا الفارق قادر
+
+552
+00:37:27,900 --> 00:37:36,920
+يبدأ من ال 0.5، صحيح؟ من ال limiter طيب،
+
+553
+00:37:36,920 --> 00:37:43,340
+في أن بعض أيضا الحالات المرضية غير فيستيولوجية،
+
+554
+00:37:43,340 --> 00:37:47,500
+ممكن تأدي لإمااللي هو constriction or dilatation
+
+555
+00:37:47,500 --> 00:37:50,820
+of the pubic bone، بعض الحالات اللي ممكن تؤدي
+
+556
+00:37:50,820 --> 00:37:53,100
+لconstriction of the pubic bone هي نسمة أرجايد
+
+557
+00:37:53,100 --> 00:37:55,960
+بوكارتسون، حاجة أرجايد بوكارتسون تبع اسم العالم
+
+558
+00:37:55,960 --> 00:37:58,860
+اللي موصف هذه الحالة، وهذه الحالة زمان تقريبا
+
+559
+00:37:58,860 --> 00:38:04,250
+يقارب مائة عام، مش شديدةفيها عدة صفات لما نقارن
+
+560
+00:38:04,250 --> 00:38:07,610
+احنا بينها بين agile repulsive pupil لو يسمي هذا
+
+561
+00:38:07,610 --> 00:38:10,790
+الحال يعني هو مش ال pupil نفسه لأ بس هذا الحال
+
+562
+00:38:10,790 --> 00:38:13,410
+يعني اكتشاف الحال اسم ال pupil في ال .. في ال ..
+
+563
+00:38:13,410 --> 00:38:16,150
+في ال meiosis في ال construction وصفه هذا العالم
+
+564
+00:38:16,150 --> 00:38:20,310
+وسميته على اسمه او عند adults tonic pupil ناخد
+
+565
+00:38:20,310 --> 00:38:23,190
+الأولى agile repulsive pupil usually caused by
+
+566
+00:38:23,190 --> 00:38:27,770
+syphilisدائما يسمى .. السبب الأساسي عليها في ورثة
+
+567
+00:38:27,770 --> 00:38:30,870
+أخرى، لكن السبب الرئيسي له اللي هو مرض syphilis،
+
+568
+00:38:30,870 --> 00:38:32,870
+مرض الـ syphilis عبارة عن sexually transmitted
+
+569
+00:38:32,870 --> 00:38:35,750
+diseases، صحيح؟ عبارة عن بعض الأمراض اللي تنتقلش
+
+570
+00:38:35,750 --> 00:38:39,730
+للنشاط الجسد، sexually transmitted diseases، اللي
+
+571
+00:38:39,730 --> 00:38:42,570
+متعرف عليها STD، هذا مرض أشهر الـ syphilis، مرض
+
+572
+00:38:42,570 --> 00:38:44,870
+الـ syphilis معدو جدا، ومرض الـ syphilis أيضا
+
+573
+00:38:44,870 --> 00:38:50,220
+يتواصل معته، syphilis A، syphilis B، الاخرىهذا
+
+574
+00:38:50,220 --> 00:38:53,300
+احنا مش هناخد فيها بس نشوف انه الشخص اللي ما نشوف
+
+575
+00:38:53,300 --> 00:38:56,080
+عنده a gyropersonal tumor من المحتمل يكون عنده
+
+576
+00:38:56,080 --> 00:38:59,820
+syphilis هذا الأكتر و على أغلب طبعا اضاف احتمال
+
+577
+00:38:59,820 --> 00:39:02,440
+يكون في عنده أمراض أخرى من ضمن هذه الأمراض الأخرى
+
+578
+00:39:02,440 --> 00:39:06,280
+ال diabetic mellitus هذه طبعا يعني هتكون ال
+
+579
+00:39:06,280 --> 00:39:09,480
+probability او الاحتمالية نادرة و ضعيفة تاني حاجة
+
+580
+00:39:09,480 --> 00:39:12,200
+ال encephalitis عبارة عن انتهاء السحاية ال
+
+581
+00:39:12,200 --> 00:39:16,400
+encephalitis عبارة عن انتهاء السحاية and some
+
+582
+00:39:16,400 --> 00:39:21,610
+cerebral tumors بعد اللي هوأو رأم الدماغ نرجع مرة
+
+583
+00:39:21,610 --> 00:39:25,370
+أخرى وهذه ممكن يعني كل الأمراض كلها السبب ليه a
+
+584
+00:39:25,370 --> 00:39:28,090
+gyroperson pupil لكن على حد الخصوص اللي هو ال
+
+585
+00:39:28,090 --> 00:39:30,710
+syphilis عشان الحاجة طبعا ال syphilis يعتبر
+
+586
+00:39:30,710 --> 00:39:36,450
+بكتيريا السبب الأساسي بكتيريا طيب نرجع من خصائص
+
+587
+00:39:36,450 --> 00:39:40,210
+هذا المرض انه bilateral شو يعني مش هيحدث 71 و 1 لأ
+
+588
+00:39:40,210 --> 00:39:45,670
+كل أغلب الأمراض ال systemicaزي مثلا إحنا نحكي
+
+589
+00:39:45,670 --> 00:39:48,890
+المرض ده بتكمل يتأثر على الشبكية و لا يعني .. مش
+
+590
+00:39:48,890 --> 00:39:52,430
+هلاقيه يتأثر على الشبكية اليمين و اليسار، لأ،
+
+591
+00:39:52,430 --> 00:39:55,750
+مستحيل، مش منطق، كل الأمراض systemic بتتأثر على
+
+592
+00:39:55,750 --> 00:39:58,950
+both eyes بنفس تقريبا الدرجة، المهم يكون موجودة
+
+593
+00:40:00,110 --> 00:40:02,590
+فأصبح في عندي argyroperson الصفة بتاعته التانية
+
+594
+00:40:02,590 --> 00:40:05,950
+أنه إيش؟ bilateral صحيح it is characterized by
+
+595
+00:40:05,950 --> 00:40:08,630
+meiosis وهذه عبارة عن ال characteristics أو
+
+596
+00:40:08,630 --> 00:40:11,910
+الخصائص argyroperson في عندي ثلاث خصائص الخاصية
+
+597
+00:40:11,910 --> 00:40:15,550
+الأولى meiosis construction of the pupil of both
+
+598
+00:40:15,550 --> 00:40:19,290
+eyes هذا مهم تاني حاجة irregularity إيش معنى
+
+599
+00:40:19,290 --> 00:40:23,870
+irregularity؟ عدم انتظام إيش معناها؟ إنه حتى في
+
+600
+00:40:23,870 --> 00:40:25,790
+حالة ال construction مش حالة دي construction
+
+601
+00:40:25,790 --> 00:40:30,830
+بالشكل هذا في عندي بعض إيش التعرجاتيعني غير منتظر،
+
+602
+00:40:30,830 --> 00:40:34,890
+تاني حاجة inequality، inequality المقصود فيها in
+
+603
+00:40:34,890 --> 00:40:38,920
+Asia Korea بين ال right و ال leftunconstriction of
+
+604
+00:40:38,920 --> 00:40:43,060
+the pupils to accommodation but not to light ايضا
+
+605
+00:40:43,060 --> 00:40:46,220
+نقطة مهمة جدا وهي اهم نقطة احنا بنحكم عليها أساسا
+
+606
+00:40:46,220 --> 00:40:49,900
+بتشخيص اللي هو اجاي رو بيرسون انه مافيش عندى right
+
+607
+00:40:49,900 --> 00:40:51,920
+reflexes light reflexes في ال direct ولا ال
+
+608
+00:40:51,920 --> 00:40:54,980
+indirect كلها absent مش موجودة عندى فقط في عندى
+
+609
+00:40:54,980 --> 00:40:57,500
+اللي هو ال accommodation reflex هو ال positive اما
+
+610
+00:40:57,500 --> 00:41:00,860
+بعض ال reflexes كلها عاش ناقطة فمش الحاجة فاجاي رو
+
+611
+00:41:00,860 --> 00:41:05,200
+بيرسون اخر حاجة اللي هي light reflexesبستجيبش
+
+612
+00:41:05,200 --> 00:41:07,800
+ناحيتها لكن استجيب ناحية اللي هو ال accommodation
+
+613
+00:41:07,800 --> 00:41:12,340
+reflex هذه النقطة الأساسية اللي بتخلنا نشخص agile
+
+614
+00:41:12,340 --> 00:41:14,820
+person غير هيك حتى وإن كان المريض عنده syphilis
+
+615
+00:41:14,820 --> 00:41:17,600
+حتى وإن كان المريض الحالة الميوسيز عنده بيلاترا
+
+616
+00:41:17,600 --> 00:41:20,700
+لكن في عنده المريض يستجيب ال light ال direct و ال
+
+617
+00:41:20,700 --> 00:41:23,300
+indirect فهذا أكيد مش agile person مش الحق يعني هو
+
+618
+00:41:23,300 --> 00:41:27,240
+الفارق الوحيد أو الفاصل في هذه الحالة هو عبارة عن
+
+619
+00:41:27,240 --> 00:41:31,600
+غياب ال light reflex مع وجود ال accommodation
+
+620
+00:41:31,600 --> 00:41:34,890
+reflex بنفس الوقت مش الحقحالة حالة احنا نسميها
+
+621
+00:41:34,890 --> 00:41:41,650
+ايش? Argyle Roberto طيب
+
+622
+00:41:41,650 --> 00:41:46,210
+اخر حاجة انه ال .. بدلا من هي حادثة يعني من ناحية
+
+623
+00:41:46,210 --> 00:41:50,030
+فسيولوجية انه very difficult to direct بالادوية
+
+624
+00:41:50,030 --> 00:41:54,600
+صعب جدا احنا احنا نعملها توصيةطيب على نقيب من ذلك
+
+625
+00:41:54,600 --> 00:41:57,540
+it is a tonic pupil، خدنا نتابع اسم العالم اللي
+
+626
+00:41:57,540 --> 00:42:01,660
+عمل description أو وصف لهذه الحالة it's not
+
+627
+00:42:01,660 --> 00:42:04,680
+associated with syphilis، إذا فقط هي متعلقة بمرض
+
+628
+00:42:04,680 --> 00:42:08,600
+السفلس، هي a gyro person، مش الحل، بينما ال tonic
+
+629
+00:42:08,600 --> 00:42:13,420
+person ماروش علاقة بمرض السفلس، هاد أول حاجة، a
+
+630
+00:42:13,420 --> 00:42:16,680
+gyro person تعتبر bilateral صحيح، لكن ال tonic
+
+631
+00:42:16,680 --> 00:42:22,350
+pupil فقط مش تعتبر unilateral، هي الواحدةو من صفته
+
+632
+00:42:22,350 --> 00:42:27,090
+ان اوكى in young women and often associated with
+
+633
+00:42:27,090 --> 00:42:34,210
+absent knee jerks absent knee jerks تحتها خط فيه
+
+634
+00:42:34,210 --> 00:42:42,190
+إنه العكس كلنا بنعرفه اسمه patella tendon
+
+635
+00:42:42,190 --> 00:42:45,290
+appendix
+
+636
+00:42:45,290 --> 00:42:51,850
+مش عكس شفته على ال ..ع اليوتيوب و لا لأ صاحبكم
+
+637
+00:42:51,850 --> 00:42:55,490
+مذاكرينه ان اجلس المريض على كرسي او على طاولة و
+
+638
+00:42:55,490 --> 00:42:58,790
+بعدين تقوم ناحية هذه على الرابط هذه يصبح في عنده
+
+639
+00:42:58,790 --> 00:43:02,490
+ارتداد امامي صحيح حتى يشوف يعني هل العصب فعال او
+
+640
+00:43:02,490 --> 00:43:05,930
+لا، ففي عند عادة الأشخاص اللي يكون في عندهم absent
+
+641
+00:43:05,930 --> 00:43:07,370
+مش موجود هذا reflex
+
+642
+00:43:15,850 --> 00:43:18,290
+مش العكس في أشخاص كتير مش موجودة عندهم reflex هذا
+
+643
+00:43:18,290 --> 00:43:21,910
+لكن مش عندهم tone of people لكن جمعة مثلا ميت حالة
+
+644
+00:43:21,910 --> 00:43:24,410
+ميتين حالة من tone of people رشدوا عندهم عندهم
+
+645
+00:43:24,410 --> 00:43:27,290
+غالبية ال tone of people هدولة بيكون في عندهم عيش
+
+646
+00:43:27,290 --> 00:43:33,230
+reflex هذا مش موجود اللي احنا اسمنا absent knee
+
+647
+00:43:33,230 --> 00:43:42,660
+jerks هو نفسه ال god first sightالتفاعل اللي يعمل
+
+648
+00:43:42,660 --> 00:43:45,060
+على الناس للضوء و الانتقال يبدو غير موجود،
+
+649
+00:43:45,060 --> 00:43:46,660
+والتجارب اللي يعمل على الناس للضوء و الانتقال يبدو
+
+650
+00:43:46,660 --> 00:43:48,180
+غير موجود، والتجارب اللي يعمل على الناس للضوء و
+
+651
+00:43:48,180 --> 00:43:49,320
+الانتقال يبدو غير موجود، والتجارب اللي يعمل على
+
+652
+00:43:49,320 --> 00:43:51,280
+الناس للضوء و الانتقال يبدو غير موجود، والتجارب
+
+653
+00:43:51,280 --> 00:43:55,680
+اللي يعمل على الناس للضوء و الانتقال يبدو غير
+
+654
+00:43:55,680 --> 00:44:00,140
+موجود، والتجارب اللي يعمل على الناس للضوء و
+
+655
+00:44:00,140 --> 00:44:05,500
+الانتقال يبدو غير موجود،
+
+656
+00:44:05,500 --> 00:44:10,980
+والتجارب اللي يعمل على الناس للضوء و الانتقال يبد
+
+657
+00:44:13,420 --> 00:44:15,380
+طبعا على النقيد من Agile Repression الـ Tunic
+
+658
+00:44:15,380 --> 00:44:18,720
+Pupil ممكن نعمله Dialysation بالأتروبيل أو حتى
+
+659
+00:44:18,720 --> 00:44:22,460
+بالهيمواتروبيل أو حتى بالسايكلو بينما Tunic Pupil
+
+660
+00:44:22,460 --> 00:44:25,500
+is slightly dilated and larger than its fellow in
+
+661
+00:44:25,500 --> 00:44:30,760
+the cornea حيكون Tunic Pupil نوعا ما أكثر إيش
+
+662
+00:44:30,760 --> 00:44:36,280
+توسعا من الطبيعي طيب هناخد بعض اللي هو ال
+
+663
+00:44:36,280 --> 00:44:40,450
+differential diagnosispupil مش هناخدهم كل حين
+
+664
+00:44:40,450 --> 00:44:42,990
+هناخد بعضها فنعلم علي بعضها، pupil dilated,
+
+665
+00:44:43,150 --> 00:44:46,410
+constricted, poorly يعني بعض الحالات اللي هيكون
+
+666
+00:44:46,410 --> 00:44:49,570
+فيها .. طبعا الحالات اللي كليكية هيكون فيها البواب
+
+667
+00:44:49,570 --> 00:44:53,570
+متوسط صعب جدا انه يعش يرجع في حالة ال
+
+668
+00:44:53,570 --> 00:44:57,210
+construction، من هذه الحالة adestronic، pupil،
+
+669
+00:44:57,210 --> 00:45:00,730
+adestronic ال pupil صعب يحدث يعش construction،
+
+670
+00:45:00,730 --> 00:45:01,550
+صحيح؟
+
+671
+00:45:04,790 --> 00:45:07,630
+و هيكون في عند ال dilated pupil اكتر من العين
+
+672
+00:45:07,630 --> 00:45:10,190
+الأخرى لأن هذا الحالة unilateral مش bilateral
+
+673
+00:45:10,190 --> 00:45:14,130
+صحيح؟ مالهاش علاقة بمرض السفر ساعات اللي متحدث فيه
+
+674
+00:45:14,130 --> 00:45:19,220
+اللي هو adult womanرقم تنين farmacological madres
+
+675
+00:45:19,220 --> 00:45:22,380
+farmacological madres هي حالات اللي حدث بيها توسع
+
+676
+00:45:22,380 --> 00:45:25,440
+للباب و صعب جدا اللي حدث لها construction الا بعد
+
+677
+00:45:25,440 --> 00:45:29,000
+غياب مفعول الدباب يعني بمعنى خلكن معاها لو احنا
+
+678
+00:45:29,000 --> 00:45:33,220
+مريض معين قطرنا له atropine و بعدها الخطأ تحدثيه و
+
+679
+00:45:33,220 --> 00:45:37,140
+من دلوقت نقطرله احنا مثلا meatex مش هيسبطه لابد ال
+
+680
+00:45:37,140 --> 00:45:42,420
+atropine ياخد مفعول اول شىء هذه واضحة تالت شىء
+
+681
+00:45:42,420 --> 00:45:46,750
+اللي هو optic nerve atrophyبوب تكنولوجيا أساسا
+
+682
+00:45:46,750 --> 00:45:50,390
+ممكن تستخدم بلاي وهو Relative أو Total Affluent
+
+683
+00:45:50,390 --> 00:45:53,270
+Popular Defect صحيح؟ بالتالي ال construction صعب
+
+684
+00:45:53,270 --> 00:45:57,370
+جدا في هذه الحالة أن البوب يرجع نفس الدقة إلا إذا
+
+685
+00:45:57,370 --> 00:45:59,990
+احنا استخدمنا matrix إذا استخدمنا ال matrix سيكون
+
+686
+00:45:59,990 --> 00:46:02,750
+بشكل دائم أول ما نوقف في ال matrix ستنتهي المفاعل
+
+687
+00:46:02,750 --> 00:46:07,730
+دواها ده سيرجع نفس الشيء بحالة زي المدرسات direct
+
+688
+00:46:07,730 --> 00:46:11,970
+damage to the filter بابلله هذا طبيعيأي تدمير
+
+689
+00:46:11,970 --> 00:46:14,830
+للعدل الصفينكتر ماصل هيحاسس ليه أيضا ايش و هيسبب
+
+690
+00:46:14,830 --> 00:46:19,810
+ليه اللي هو mad masses فانقي الحاجات و بعدين اخد
+
+691
+00:46:19,810 --> 00:46:24,590
+third nerve pulsing اللي هو تلف او شلل في العصب
+
+692
+00:46:24,590 --> 00:46:26,350
+جمجم الثالث أيضا ممكن يسبب ليه
+
+693
+00:46:29,220 --> 00:46:32,740
+اللي هو Madness is irritation of sympathetic وهي
+
+694
+00:46:32,740 --> 00:46:34,720
+طبيعي و أيضا في ال trauma هذه كل حاجة اللي اتكلمنا
+
+695
+00:46:34,720 --> 00:46:36,980
+عليها صحيح بس في نقطة احنا متكلمش احنا اتكلمنا عن
+
+696
+00:46:36,980 --> 00:46:39,720
+بصيرة Seneca حكي اللي احنا بنستخدم اللي هو
+
+697
+00:46:39,720 --> 00:46:42,380
+dilatation of the pupil حتى نمنع حدوث هذا ال
+
+698
+00:46:42,380 --> 00:46:47,780
+Seneca لكن لو حدثت عندي صعب جدا ال pupil يرجعاش
+
+699
+00:46:47,780 --> 00:46:53,480
+مرة أخرى constricted طيب
+
+700
+00:46:53,480 --> 00:46:57,280
+على نقل من ذلك ناخد ال pupil constricted dilates
+
+701
+00:46:57,280 --> 00:47:01,910
+fully يعنيالغالبية العضماء اللي حلق يكون فيها
+
+702
+00:47:01,910 --> 00:47:04,390
+البيو بير طبعا بالاترال يكون هنا ال construction
+
+703
+00:47:04,390 --> 00:47:08,150
+of البيو بير صعب جدا أنه يعيش تلاتة مرة أخرى أول
+
+704
+00:47:08,150 --> 00:47:11,610
+حاجة pharmacological meiosisis يعني احنا قطرنا
+
+705
+00:47:11,610 --> 00:47:14,790
+اللي برا يتبدأ المدرياتكس meiotics صحيح؟ بالخطأ و
+
+706
+00:47:14,790 --> 00:47:17,250
+بعدين اذا كان احنا لأ بدنا نعمل التوسع عن ال
+
+707
+00:47:17,250 --> 00:47:19,910
+bubble أو القطر اللي أنا مسكته بالخطأ صعب جدا
+
+708
+00:47:19,910 --> 00:47:23,190
+يتوسع ال bubble اللي بعد ما ياخدش ال meiotics
+
+709
+00:47:23,190 --> 00:47:28,330
+مفعوله ينتهي المفعولة في مرة أخرى طيب والثانيكيا
+
+710
+00:47:31,060 --> 00:47:35,980
+حدثت عندى التهاب قضحى وحدث عندى اللى هو ال post
+
+711
+00:47:35,980 --> 00:47:40,100
+-diasteic اللى حدكلمنا عليها قبل قليلما هو السبيل
+
+712
+00:47:40,100 --> 00:47:43,640
+ورا انه انا افك صينيكيا هذه، اذا كانت حدثت بشكل
+
+713
+00:47:43,640 --> 00:47:47,660
+constructed صعب جدا جدا جدا جدا ان البابا حتى و
+
+714
+00:47:47,660 --> 00:47:51,060
+نعطينا احنا كمية كبيرة من الاتروبيل، صعب جدا انه
+
+715
+00:47:51,060 --> 00:47:53,980
+يعيش، ينفك، طبعا في بعض الحالات ممكن يكون فك
+
+716
+00:47:53,980 --> 00:47:57,060
+للاتثاقات هذه و يرجع للعين الطبيعية، لكن هذا حالة
+
+717
+00:47:57,060 --> 00:48:00,060
+نادرة، لغالبها العظمة، اذا حد فات صينيكيا، لابد
+
+718
+00:48:00,060 --> 00:48:03,910
+يظل تأثيرها موجودةبالتالي صعب جدا حتى .. حتى لو
+
+719
+00:48:03,910 --> 00:48:07,030
+كان في dim light صعب جدا يرجع اللي هو ال people
+
+720
+00:48:07,030 --> 00:48:10,110
+بحجمه الطبيعى، ال trauma حكينا عنها ال right
+
+721
+00:48:10,110 --> 00:48:14,250
+answer هو الاتهاب القزحى، الاتهاب القزحى هو أساسا
+
+722
+00:48:14,250 --> 00:48:16,410
+اللي بدي أعمله construction ال people، الاتهاب
+
+723
+00:48:16,410 --> 00:48:19,470
+القزحى من أحد أعراضه يعني أو من أحد علاماته أنه
+
+724
+00:48:19,470 --> 00:48:21,330
+هيكون ال people اللي عنده بحالة عايش construction
+
+725
+00:48:22,890 --> 00:48:25,570
+هنا السندروم اتكلمنا عليها ارتيشن of the cytokina
+
+726
+00:48:25,570 --> 00:48:28,550
+نيبو ايضا اتكلمنا عليها واخر حاجة paralysis of the
+
+727
+00:48:28,550 --> 00:48:31,450
+lymphatic nervous system ايضا اتكلمنا عليها في
+
+728
+00:48:31,450 --> 00:48:35,470
+حالة خاصة اللي هي رقم تلاتة bilateral meiosis وهذا
+
+729
+00:48:35,470 --> 00:48:39,150
+ال meiosis عادة صعب جدا ان يرجع مرة اخرى اول حاجة
+
+730
+00:48:39,150 --> 00:48:44,270
+pontile hemorrhage عبارة عن النظيف الجسري يحدث
+
+731
+00:48:44,270 --> 00:48:49,110
+اثناء ارتفاع ضبط الدم الخبيث
+
+732
+00:48:50,210 --> 00:48:54,330
+يعني ضغط ده بيكون ارتفع بشكل ايش الجسم غير قادر
+
+733
+00:48:54,330 --> 00:48:57,990
+على تحمله morphine poisoning اللي عبارة عن تسمه
+
+734
+00:48:57,990 --> 00:49:01,770
+بالعقار ال morphine بسبب كسرة استخدام اللي هو ال
+
+735
+00:49:01,770 --> 00:49:06,670
+morphine بسبب كسرة استخدام ال morphine أو هذا
+
+736
+00:49:06,670 --> 00:49:09,750
+العقار من ناحية إدمانية أو حتى من ناحية علاجية
+
+737
+00:49:09,750 --> 00:49:13,390
+يعني بيكون بيحطيها فوق اللي هو الدوز المعينة او
+
+738
+00:49:13,390 --> 00:49:14,270
+المطلوبة للمريض
+
+739
+00:49:19,230 --> 00:49:23,970
+شيخوها او الحرم صحيح فنتكلم انه ال pupil عادةوقت
+
+740
+00:49:23,970 --> 00:49:27,410
+الميلاد الى حدية البرت حدية البلوغ يبدأ باش
+
+741
+00:49:27,410 --> 00:49:33,090
+اللازمة يبدأ يكبر صح ولا بعد البلوغ يبدأ اش small
+
+742
+00:49:33,090 --> 00:49:37,150
+لذلك عندى كل ماتقدم as aging process بدي يحدث عندى
+
+743
+00:49:37,150 --> 00:49:40,630
+meiosis فكل ماتقدم الإنسان بالعمر بعد سن البلوغ
+
+744
+00:49:40,630 --> 00:49:43,850
+طبعا بدي يحدث عنده ash اللي هو ال meiosis طبعا هذا
+
+745
+00:49:43,850 --> 00:49:46,550
+هيكون صفته انه bilateral interpretation of the
+
+746
+00:49:46,550 --> 00:49:49,710
+side cranial nerve وهذا طبيعى اخر حاجة paralysis
+
+747
+00:49:49,710 --> 00:49:54,690
+of the synpastic nerve هذا اتكلمنا عنه احناطيب حتى
+
+748
+00:49:54,690 --> 00:49:55,730
+الآن في أي سؤال؟
+
diff --git a/PL9fwy3NUQKwZ2K6wMRTZMEoGVTbELxinF/mNW3KoEXSZc_raw.json b/PL9fwy3NUQKwZ2K6wMRTZMEoGVTbELxinF/mNW3KoEXSZc_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..75c08efb5c51fb2f49a8c5af0d55891311c74dd4
--- /dev/null
+++ b/PL9fwy3NUQKwZ2K6wMRTZMEoGVTbELxinF/mNW3KoEXSZc_raw.json
@@ -0,0 +1 @@
+{"segments": [{"id": 1, "seek": 4720, "start": 21.06, "end": 47.2, "text": "السلام عليكم تفسيرتنا اليوم ان شاء الله موضوعنا اللي هو ال search of the lens نحن ناخد characteristics of the lens ما هي الخصائص العدسات اللي خصها بعدة نقاط المبتد أولى completely transparent يعني بقى انبسس مشفاف جدا bi-convex ال anterior capsule و ال posterior capsule و ال anterior surface و ال posterior surface كلها هم convex مش هده لقم كيب الأخرى convex لكن هي bi-convex lens", "tokens": [6027, 3794, 37440, 25894, 24793, 6055, 36178, 13546, 2655, 8315, 45595, 20498, 16472, 13412, 16606, 21984, 3714, 2407, 11242, 45367, 8315, 13672, 1829, 31439, 2423, 3164, 295, 264, 6765, 8717, 5016, 1863, 8717, 47283, 3215, 10891, 295, 264, 6765, 19446, 39896, 33962, 9381, 16373, 9381, 18863, 3215, 3794, 9307, 13672, 1829, 16490, 9381, 11296, 45030, 41891, 8717, 4587, 41193, 9673, 3555, 2655, 3215, 5551, 12610, 7578, 2584, 12737, 37495, 22653, 4724, 4587, 7578, 16472, 3555, 3794, 3794, 37893, 5172, 31845, 10874, 28259, 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"word": " the", "probability": 0.869140625}, {"start": 1575.76, "end": 1575.96, "word": " cell", "probability": 0.71240234375}, {"start": 1575.96, "end": 1576.4, "word": " divide", "probability": 0.671875}, {"start": 1576.4, "end": 1576.66, "word": " and", "probability": 0.9599609375}, {"start": 1576.66, "end": 1577.12, "word": " differentiate", "probability": 0.80908203125}, {"start": 1577.12, "end": 1577.72, "word": " into", "probability": 0.80810546875}, {"start": 1577.72, "end": 1578.44, "word": " new", "probability": 0.8583984375}, {"start": 1578.44, "end": 1578.74, "word": " lens", "probability": 0.8984375}, {"start": 1578.74, "end": 1579.2, "word": " fibers", "probability": 0.875}], "temperature": 1.0}, {"id": 58, "seek": 161100, "start": 1581.24, "end": 1611.0, "text": "يعني العدسة نفسها أو الطبقة قاعدة تعمل على differentiation of the lens cover حتى تصبح crystal شفاف جدا عادي من عضيات و فاقد حتى لأ اللي هو ال nucleus of the lens of the virus عفوا طيب ميجرى المحتويات الأساسية من 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"probability": 0.9268798828125}, {"start": 1603.16, "end": 1603.42, "word": " كما", "probability": 0.770751953125}, {"start": 1603.42, "end": 1603.72, "word": " حكينا", "probability": 0.961669921875}, {"start": 1603.72, "end": 1603.84, "word": " احنا", "probability": 0.8230794270833334}, {"start": 1603.84, "end": 1603.96, "word": " ال", "probability": 0.66455078125}, {"start": 1603.96, "end": 1604.2, "word": " aqueous", "probability": 0.5397542317708334}, {"start": 1604.2, "end": 1604.5, "word": " humor", "probability": 0.7880859375}, {"start": 1604.5, "end": 1604.98, "word": " اللي", "probability": 0.53851318359375}, {"start": 1604.98, "end": 1605.58, "word": " محتويات", "probability": 0.8499755859375}, {"start": 1605.58, "end": 1605.94, "word": " فيها", "probability": 0.662109375}, {"start": 1605.94, "end": 1606.0, "word": " ال", "probability": 0.82958984375}, {"start": 1606.0, "end": 1606.38, "word": " asterobic", "probability": 0.36962890625}, {"start": 1606.38, "end": 1606.7, "word": " acid", "probability": 0.94580078125}, {"start": 1606.7, "end": 1607.46, "word": " البروتينات", "probability": 0.751611328125}, {"start": 1607.46, "end": 1608.3, "word": " السكر", "probability": 0.772216796875}, {"start": 1608.3, "end": 1608.96, "word": " الاخرين", "probability": 0.68023681640625}, {"start": 1608.96, "end": 1609.84, "word": " صحيح؟", "probability": 0.85400390625}, {"start": 1609.84, "end": 1610.04, "word": " هكذا", "probability": 0.6627197265625}, {"start": 1610.04, "end": 1610.26, "word": " بعض", "probability": 0.75341796875}, {"start": 1610.26, "end": 1610.48, "word": " المواد", "probability": 0.7869466145833334}, {"start": 1610.48, "end": 1610.68, "word": " هذه", "probability": 0.5927734375}, {"start": 1610.68, "end": 1611.0, "word": " مهمة", "probability": 0.912109375}], "temperature": 1.0}, {"id": 59, "seek": 163403, "start": 1611.59, "end": 1634.03, "text": "وفي عندنا ما هو المحتوى الأساسي للعدسة بشكل عام طيب هو المحتوى الأساسي لكل عضو في الجسم الإنسان 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للبروتين مع الكلام إنه عادسة مكدسة بشكل كبير جدا بشكل ما هو جدا أشترى كيميات كبيرة من البروتين هذا وأصلا يعني لو لا البروتين و جينا من ناحية عكسية ده إن البروتين مافيش عنده أي عملية حيوية لو كانت البروتين هدماء مافيش عنده ال index و الrefraction هيختلف اختلاف كبير صحيح مش هيكون في عندي أهمية عملية ال accommodation لإنه بالنهاية ثائل مش صلب مش هيساعدلي على ال flattering", "tokens": [3555, 2655, 9566, 1211, 3615, 2423, 2407, 9566, 1863, 6055, 4587, 16572, 3555, 995, 12174, 16572, 3555, 10874, 28259, 37495, 22653, 5551, 9381, 49628, 2423, 2407, 9566, 1863, 6156, 47432, 48812, 3615, 5172, 3714, 25720, 36764, 24401, 3660, 24976, 26890, 35473, 9957, 20449, 2423, 28820, 10943, 36145, 3224, 6225, 18513, 3794, 3660, 3714, 4117, 3215, 3794, 3660, 4724, 8592, 28820, 9122, 3555, 13546, 10874, 28259, 4724, 8592, 28820, 19446, 31439, 10874, 28259, 5551, 8592, 2655, 2288, 7578, 9122, 32640, 1829, 9307, 9122, 3555, 48923, 9154, 2423, 26890, 35473, 9957, 23758, 36725, 9381, 15040, 37495, 22653, 45164, 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"text": "الماء يعني نسبته أكتر من 66%، على فكرة هو الماء كمان مش متوزع ما بين الخلايا بشكل كبير، حتى على صلابة هذا أو هذا العضو اللي كان أصبح فيه ان ال refractive index of the lens بدي يختلف، لإنه أصبح فيه أندي محتوى الماء له كبير جدا، صحيح؟ و refractive index of the water بدي يختلف عن refractive index of the lens، فهذا عندي عامل آخر، ياريت أملخصهم كلهم مع بعض، في نهاية، هحنحطهم عايشين في ربط واحد، لإن جيبنا سؤال عال، لإن بنرسل الأسباب", "tokens": [6027, 2304, 16606, 37495, 22653, 8717, 35457, 47395, 5551, 4117, 2655, 2288, 9154, 21126, 4, 12399, 15844, 6156, 4117, 25720, 31439, 9673, 16606, 9122, 2304, 7649, 37893, 44650, 2407, 11622, 3615, 19446, 49374, 33962, 15040, 25528, 4724, 8592, 28820, 9122, 3555, 13546, 12399, 11331, 49975, 15844, 20328, 15040, 49401, 23758, 34051, 23758, 18863, 11242, 2407, 13672, 1829, 25961, 5551, 9381, 49628, 8978, 3224, 16472, 2423, 45353, 488, 8186, 295, 264, 6765, 4724, 16254, 7251, 46456, 46538, 12399, 5296, 28814, 1863, 3224, 5551, 9381, 49628, 8978, 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الحياة", "probability": 0.8307291666666666}, {"start": 2597.98, "end": 2598.48, "word": " المرضية", "probability": 0.91455078125}, {"start": 2598.48, "end": 2599.16, "word": " هنلاقي", "probability": 0.83837890625}, {"start": 2599.16, "end": 2599.48, "word": " ايضا", "probability": 0.83441162109375}, {"start": 2599.48, "end": 2599.9, "word": " التلاتة", "probability": 0.8853759765625}, {"start": 2599.9, "end": 2600.6, "word": " المتواجدين", "probability": 0.9712727864583334}, {"start": 2600.6, "end": 2601.38, "word": " لكناش", "probability": 0.7049560546875}, {"start": 2601.38, "end": 2602.2, "word": " بنسبة", "probability": 0.8458658854166666}, {"start": 2602.2, "end": 2602.76, "word": " مختلفة", "probability": 0.9942626953125}, {"start": 2602.76, "end": 2603.0, "word": " هى", "probability": 0.547119140625}, {"start": 2603.0, "end": 2603.4, "word": " المقصود", "probability": 0.8685302734375}, {"start": 2603.4, "end": 2603.74, "word": " فيها", "probability": 0.866455078125}, {"start": 2603.74, "end": 2604.38, "word": " بنسبة", "probability": 0.86083984375}, {"start": 2604.38, "end": 2605.58, "word": " مختلفة", "probability": 0.9942626953125}, {"start": 2605.58, "end": 2606.18, "word": " the", "probability": 0.36328125}, {"start": 2606.18, "end": 2606.46, "word": " amount", "probability": 0.9609375}, {"start": 2606.46, "end": 2606.62, "word": " of", "probability": 0.98388671875}, {"start": 2606.62, "end": 2606.98, "word": " soluble", "probability": 0.97265625}, {"start": 2606.98, "end": 2607.32, "word": " protein", "probability": 0.8388671875}, {"start": 2607.32, "end": 2607.92, "word": " fraction", "probability": 0.85400390625}, {"start": 2607.92, "end": 2609.5, "word": " gradually", "probability": 0.89599609375}, {"start": 2609.5, "end": 2610.5, "word": " diminish", "probability": 0.459716796875}, {"start": 2610.5, "end": 2611.22, "word": " اللي", "probability": 0.707275390625}, {"start": 2611.22, "end": 2611.36, "word": " هو", "probability": 0.98388671875}, {"start": 2611.36, "end": 2611.84, "word": " كمية", "probability": 0.9949544270833334}], "temperature": 1.0}, {"id": 95, "seek": 263625, "start": 2612.27, "end": 2636.25, "text": "البروتينات هي البروتينات اللي تدوب في الماء مع تقدم العمر شيئا فشيئا بشكل تدريجي ستقل with aging and the insoluble proteins fraction continues to increase بالتالي إذا قلتي عندي ال insoluble proteins مع تقدم العمر زادت، صحيح؟ زادت قل هي نسمتها، بالتالي حجزاتي عندي هي insoluble proteins وهذا النقطة مهمة", "tokens": [6027, 26890, 35473, 9957, 9307, 39896, 2423, 26890, 35473, 9957, 9307, 13672, 1829, 6055, 3215, 37746, 8978, 9673, 16606, 20449, 6055, 28543, 2304, 18863, 29973, 13412, 1829, 19986, 995, 6156, 8592, 1829, 19986, 995, 4724, 8592, 28820, 6055, 3215, 16572, 7435, 1829, 8608, 2655, 4587, 1211, 365, 19090, 293, 264, 1028, 39754, 638, 15577, 14135, 6515, 281, 3488, 20666, 2655, 6027, 1829, 11933, 15730, 12174, 1211, 31371, 18871, 16254, 2423, 1028, 39754, 638, 15577, 20449, 6055, 28543, 2304, 18863, 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{"start": 2632.35, "end": 2632.85, "word": " حجزاتي", "probability": 0.6278076171875}, {"start": 2632.85, "end": 2633.19, "word": " عندي", "probability": 0.890625}, {"start": 2633.19, "end": 2633.65, "word": " هي", "probability": 0.765625}, {"start": 2633.65, "end": 2634.31, "word": " insoluble", "probability": 0.9352213541666666}, {"start": 2634.31, "end": 2634.89, "word": " proteins", "probability": 0.9453125}, {"start": 2634.89, "end": 2635.21, "word": " وهذا", "probability": 0.57470703125}, {"start": 2635.21, "end": 2635.75, "word": " النقطة", "probability": 0.8553059895833334}, {"start": 2635.75, "end": 2636.25, "word": " مهمة", "probability": 0.912109375}], "temperature": 1.0}, {"id": 96, "seek": 266569, "start": 2638.69, "end": 2665.69, "text": "اللي هو ماذا يحدث لـ soluble protein و لـ insoluble protein أثناء تقدم الأمر اللي هو ال soluble protein هي .. هي .. قد يتسبح إليه قدما نفسها، هيقل يعني، it reduces تلقائيًا أو درجيًا، بينما عاجها الأخر أكيد هيتسبح فيه عنده اللي هو increase في ال insoluble أيه أهم؟ soluble ولا insoluble؟ ال soluble هو الأهم اللي بيحافظ على ال last step of the lens", "tokens": [6027, 20292, 31439, 3714, 45636, 995, 7251, 24401, 12984, 5296, 39184, 24807, 638, 7944, 4032, 5296, 39184, 1028, 39754, 638, 7944, 5551, 12984, 1863, 16606, 6055, 28543, 2304, 16247, 29973, 13672, 1829, 31439, 2423, 24807, 638, 7944, 39896, 4386, 39896, 4386, 12174, 3215, 7251, 2655, 35457, 5016, 11933, 20292, 3224, 12174, 3215, 15042, 8717, 36178, 11296, 12399, 39896, 4587, 1211, 37495, 22653, 12399, 309, 18081, 6055, 1211, 4587, 16373, 1829, 14111, 995, 34051, 11778, 47341, 1829, 14111, 995, 12399, 49374, 15042, 6225, 26108, 11296, 16247, 34740, 5551, 4117, 25708, 39896, 2655, 35457, 5016, 8978, 3224, 43242, 3224, 13672, 1829, 31439, 3488, 8978, 2423, 1028, 39754, 638, 36632, 3224, 5551, 16095, 22807, 24807, 638, 49429, 1028, 39754, 638, 22807, 2423, 24807, 638, 31439, 16247, 16095, 13672, 1829, 4724, 1829, 5016, 31845, 19913, 15844, 2423, 1036, 1823, 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