1. تكرمأ من اهل الخبره الاطلاع والافاده..


2. التقرير الطبي للطفله البالغه من العمر 6 سنوات ...


3. 2. Detrusitol 1 mg p.o. b.i.d.


4. RECOMMENDATIONS:

اخواني واخواتي الافاضل بمنتديات العرب المسافرون تحيه عطره

تكرمأ من اهل الخبره الاطلاع والافاده..

التقرير الطبي للطفله البالغه من العمر 6 سنوات ...

CLINICAL PRESENTATION : The patient is a 5-year-old girl who has been followed in the outpatient clinic with a history of status post repair of the myelomeningocele, cerebral palsy with paraplegia, severe neurogenic bladder with bilateral vesicoureteral reflux and status post creation of vesicostomy. The patient has a history of recurrent urinary tract infection with severe bilateral vesicoureteral reflux during the neonatal period. She underwent creation of a cutaneous vesicostomy. The patient did well from the urology point of view. She was maintained on prophylactic antibiotics and anti-cholinergic.
The patient was last seen in the outpatient cilinic on 16 December 2006. At that time, the patient was doing well and there was no recent urinary tract infection.
INVESTIGATIONS:
Sodium was 139, potassium 5.5,urea 4.6 and creatinine 23.
The vesicostomy site appeared to be normal with clear margins. The patient is wheelchair bound with small body habits and severe contractures.
The last ultrasonnd showed normal kidneys and bladder. There was no evidence of any hydronephrosis. The micturating cystourethrogram through the vesicostomy site revealed bilateral reflux, grade3.
The latest dimercaptosuccinic acid scan showed equal renal function with evidence of bilateral scars probably related to the previous urinary tract infections with a split function of 54% on the right and 46% on the left.
DIAGNOSES:
1. Status post repair of the myelomeningocele.
2. Cerebral palsy with paraplegia.
3. Severe neurogenic bladder with bilateral vesicoureteral reflux.
4. Status post creation of vesicostomy.
TREATMENT:
1. Nitrofurantoin 2.5 cc p.o. h.s.

2. Detrusitol 1 mg p.o. b.i.d.

RECOMMENDATIONS:

Due to the severe disability that the patient has and with stable upper tract and renal function, and apparently no documented urinary tract infection for the past six months, vesicostomy should be continued and to delay any major reconstuctive surgery because of her affected body figure and stature. The reconstructive surgery can be considered later on if the patient grows older. The patient will have followup in the outpatient clinic in six months time with repeat ultrasound of the kidneys and bladder and repeat urine culture and laboratory work ups.
الاستفسارات ؟
ماهي افضل المستشفيات والاطباء الاخصائيون في مثل هالحاله؟
كيف يكون الطقس من شهر ابريل الى شهر اغسطس تقريبأ؟
ماهي افضل وسيله للتنقل داخل اللمانيا؟
هل مطلوب رخصه دوليه للقياده ام الرخصه السعوديه معترف فيها هناك ؟
ماهي اماكن الاكل الخليجي او الاسلامي هناك؟
ماهو موقع السفاره السعوديه والمكتب الصحي هناك؟
هل الافضل اخذ معي كاش والا فيزه ؟
واين اماكن السكن الأمن ويفضل شقق كبيره اكثر من غرفتين ؟
وكيف احصل على مترجم هناك ؟
ومشكورين سلفأ ... مع انني سألت عن بعض التفاصيل الاخوه في الخاص لاكن الحرص المعرفه مطلوبه ولكم مني اجمل وارق تحيه .