Medical report
Name: Eman Ibrahim Wassef date of admission: 1/1/2011 Age : 48 years discharge: still in ICU treating doctors: prof. Hatem Amin Attala Concultant of anaethesiology prof. Magdy akel
prof. Amin malty Consultant of ophthalmology prof. Hossam Elkafrawy Consultant of plastic surgery dr. Ehab naeem Consultant of ENT The patient was admitted to our hospital after the explosion accident on 1-1-2011.Alexandria, Egypt The patient was admitted to the ICU she was shocked and look pale so fluid resuscitation started and blood transfusion started On admission patient was suffering from: DLOC, RT shoulder open fracture, RT breast contused wound, LT eye trauma, multiple areas of burn and abrasions in the skin of face and legs, perforating wound in the abdomen, inhalational burn injury .
After admission the following interventions were done to her: ETT was inserted and she was attached to MV for fear of edema of upper airways then she was weaned when conscious level improved Orthopedic Debridement and removal of necrotic tissue for open fracture of the RT shoulder General surgery Repair of the contused wound of the RT breast Exploration of the abdomen was done and a tear in transverse colon was found and repaired Shrapnel was removed from the colon
Another one was found in the liver the CT scan showed that she it was in segment 5 of liver near the IVC, it couldn’t be removed.
Ophthalmology A CT of LT orbit and US of the LT eye were done showed the following
• Suspected rupture of globe • Traumatic sublaxation of lens • Subconjunctival he • Fracture of the floor of orbit with herniation of inferior rectus muscle • Corneal edema and abrasions • Contused wound in the LT eye lid which was sutured. • Intraocular foreign body
Maxilofascial surgeon reviewed the patient and said she needs surgery 1 gm of solumedrol was given for 3 days and then oral prednisolone was given and many eye drops
Plastic surgey Examined the face and said the small foreign bodies in face can be removed during operation Last investigations Hb : 11.9 WBCS: 6400 platelet :225.000 SGOT: 21 SGPT : 44 urea:27 Creatinine: 0.98 s.albumin :3.3 P.T: 80% INR:1.13 Last medications Rocephin 2gm iv daily Levoxin 0.5 gm iv daily Flagyl 0.5 gm iv q 8hr Acc e times daily Solupred 20 mg 2 tab mourning 1 evening Controloc 40 mg iv daily Corneo eye gel 3 times daily Cyclo plegico E.D 3 times daily Mydracil E.D 3 times daily Vigamax drops q 8 hr Predforte E.D q 1hr Vita c Vita zinc Last condition The patient is fully conscious, well oriented , haemodynamically stable, On partial parental nutrition She is still in ICU Arranging for repairing the floor of LT orbit She may need :.
1- Repairing of the floor of LT. orbit. 2- Myringoplasty bilaterally.
Medical Director Critical care medicine Prof. Dr. Hatem Amin Attala Dr. HanySafwat Thabet
Chapter 15: Lipids - unlike carbohydrates and proteins, lipids are not easily characterized by their structural features - lipids encompass a range of molecular structures and, as a result, an extraordinary range of biochemical functions: - as molecules of dietary fat certain lipids provide a major source of metabolic energy - as components of biological membranes, lipids provide an insol
LETRA DE CÂMBIO E NOTA PROMISSÓRIA - X I - Letra de Câmbio: a) Aspectos gerais e históricos: - Muito pouco se utiliza neste país a letra de câmbio, porque com a criação da duplicata mercantil, largamente utilizada nas operações mercantis, por ser mais operacional, aquele título praticamente caiu em desuso junto aos comerciantes, mesmo porque é proibida a sua emissão, na co
Medical report 
Another one was found in the liver the CT scan showed that she it was in segment 5 of liver near the IVC, it couldn’t be removed.
Ophthalmology 