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this could be increased if phe modelers require more samples.
tan waxaa kor loogu qaadi karaa hadii qaabeeyaasha phe ay u baahdaan sambalo badan.
Last Update: 2020-08-25
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avoid learning methodologies that require face-to-face communication.
in lasiiyo taageero macalimiinta iyo waalidka ah sidii loo isticmaali lahaa agabka dhijitaalka ah: in la sameeyo tobobkar kooban ama macluumaad hordhac bixin oo waalidka iyo macalinka ah sidoo kale, hadii loo baahdo kormeer iyo u fududayn.
Last Update: 2020-08-25
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no sustenance do i require of them, nor do i require that they should feed me.
kamana doonaayo risqi, iyo inay i quudiyaan.
Last Update: 2014-07-03
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approximately 20-30% of patients subsequently require intensive care and mechanical ventilation.
qiyaas ahaan 20-30% ayaa ugu danbeyn u baahan daryeel caadimaad oo dagdaga iyo neef-siin mashiineed
Last Update: 2020-08-25
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administrative controls are changes in work policy or procedures that require action by the worker or employer.
agabka ilaalinta shakhsi ahaaneed (ppe) waxaa loo arkaa inay ka waxtar yar yihiin samaynta iyo dhaqan gelinta xakamaynta, laakiin waxay kahortagi karaan caabuqyada qaar.
Last Update: 2020-08-25
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others will require more inconvenient connections than usual—multiple stops and long waits between flights.
mararka qaar waxay taasi ka dhigan tahay tigidho aad qaali u ah.
Last Update: 2020-08-25
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“allah is the un-wanting.” (perfect, does not require anything.)
waana sayid (deeqtoon).
Last Update: 2014-07-03
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although many questions still require answers, we hope that this review helps in the understanding and eradication of the threatening disease.
inkastoo sua'aalo badan ay wali u baahanyihiin jawaabo, waxaan rajaynaynaa in aragtidan ay caawiso fahanka iyo cidhib tirka xanuunka hanjabaya.
Last Update: 2020-08-25
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blood tests can be used, but these require two blood samples taken two weeks apart and the results have little immediate value.
saynisyahano jayniis ah ayaa gooni u saaray unuga coronavirus oo waxa ay baahiyeen hide sidihiisa si shaybaadhada caalamku ay si iskood ah ugu samayn karaan jawaab celin (pcr) shaybaadh ah oo lagu onaadao caabuqa fayruska.
Last Update: 2020-08-25
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most cases of covid-19 are not severe enough to require mechanical ventilation or alternatives, but a percentage of cases are.
noocyada taageerada neefsiga ee covid-19 waxa uu la xidhiidhaa ku guul daraysiga neefsiga kaas oo si wanaagsan loogu daraasadaynayo dadka ku jira isbitaalka, taas oo cadaymo muujinayaan in tuunbo la is geliyo la iska ilaalin karo oo sanka la iskaga dhaadhiciyo ama laba heer oo hawo mareenka ah.
Last Update: 2020-08-25
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the younger patients, in many practices younger than 14 years, and in nearly all for children younger than 8 years will require pediatric serology surveillance.
bukaanada yaryar, ee habab badan ee ka yar 14 sano, iyo ku dhawaad dhamaan caruurta ka yar 8 sano ayaa u baahan doona ilaalin dheecaan dhiig ee daryeelka ilmaha.
Last Update: 2020-08-25
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comorbidities and complications: patients with covid-19 who require intensive care are more likely to suffer from acute cardiac injury and arrhythmia.
daryeelka degdegga ayaa u badan inay la xanuunsadaan dhaawac wadnaha oo daran iyo wadna garaac aan caadi ahayn.
Last Update: 2020-08-25
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failing this, it is likely that the healthcare systems of other eu/eea countries will face a surge of patients that require intensive care within the coming days or weeks.
fashilitaanka tan, waxay u badantahay in nidaamyada daryeelka caafimaad ee dalalka kale ee eu/eea ay wajihi doonaankor u kac wayn ee bukaanada u baahan daryeel degdegga maalmaha mise todobaadyada soo socda.
Last Update: 2020-08-25
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o my son! keep up prayer and enjoin the good and forbid the evil, and bear patiently that which befalls you; surely these acts require courage;
wiilkayow oog salaadda, oo far waanaagga oo reeb waxa lanaco kuna samir waxa ku gaadha, arrintaasu waxay ka midtahay umuuraha wanaagsane.
Last Update: 2014-07-03
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medium exposure risk jobs include those that require frequent or close contact with people who are not known or suspected with covid-19, but may be infected due to ongoing community transmission or international travel.
kuwaas waxaa kamid ah shaqaalaha ay isasoo gaadheen shacabka guud sida dugsiyada, deegaanada shaqo ee dadku ku badan yihiin, iyo tukaamada dadka badan.
Last Update: 2020-08-25
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based on the experience from italy, countries, hospitals and intensive care units should increase their preparedness for a surge of patients with covid-19 who will require healthcare, and in particular intensive care.
ayadoo la tixraacayo khibrada laga helay talyaaniga , wadanada, isbitaalada iyo qeybaha daryeelka dagdagga ah waa in ay kordhiyaan diyaar garawgooda ah in ay daba galaan bukaanada qaba covid-19 kuwaas oo u baahaan daryeel caafimaad, gaar ahaan daryeelka dagdagga ah.
Last Update: 2020-08-25
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a sacred month for a sacred month, and all sanctities require retribution. so should anyone aggress against you, assail him in the manner he assailed you, and be wary of allah, and know that allah is with the godwary.
bisha xurmaysan (dagaalkeeda) waxaa laga horgayn bisha xurmaysan, waxyaalaha xurmaysanna qisaasbaa ah, ee ciddii idinku xadgudubta ku xadgudba «ku abaal mariya» intuu idinku xadgudbay wax la eg, eebana ka dhawrsada, ogaadana in eebe la jiro kuwa dhawrsada.
Last Update: 2014-07-03
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acknowledgment ................................................................................................................... i table of contents .................................................................................................................. ii chapter one: shock ............................................................................................................. 1 introduction ................................................................................................. 1 classification .............................................................................................. 1 patho physiology of shock ......................................................................... 2 management of shock ................................................................................ 3 complications of shock .............................................................................. 4 chapter two: fluid and electolytes ..................................................................................... 5 introduction ................................................................................................. 5 normal distribution of body fluids .............................................................. 5 disturbances of fluid and electrolytes ........................................................ 7 acid – base balance ................................................................................... 12 review questions ....................................................................................... 15 references .................................................................................................. 16 chapter three: blood transfusion ....................................................................................... 17 indications for blood transfusion ............................................................... 17 compatibility tests ...................................................................................... 17 component therapy ................................................................................... 18 review questions ....................................................................................... 21 references .................................................................................................. 22 chapter four: pre-operative and post-operative care ...................................................... 23 introduction ................................................................................................. 23 general consideration ............................................................................... 23 assessment and minimization of surgical risks ........................................ 24 post-operative care, complications and their treatment ......................... 26 post operative intestinal obstruction ......................................................... 31 hematoma, abscess and seromas ............................................................ 33 review questions ....................................................................................... 34 references .................................................................................................. 35 chapter five: aseptic and antisepic techniques ................................................................ 36 introduction ................................................................................................. 36 choice of antiseptic ................................................................................... 37 review questions ....................................................................................... 41 references .................................................................................................. 42 chapter six: suture materials and suturing ......................................................................... 43 types of suture materials ........................................................................... 43 suturing techniques ................................................................................... 44 iii chapter seven: wounds- wound healing and care ........................................................... 47 introduction ................................................................................................. 47 wound healing ............................................................................................ 47 wound assessment and classification ....................................................... 49 wound management ................................................................................... 50 crush and avulsion wounds ....................................................................... 53 wound complications ................................................................................. 55 review questions ....................................................................................... 57 key to the review questions ..................................................................... 59 references .................................................................................................. 60 chapter eight: surgical infections ........................................................................................ 61 introduction ................................................................................................. 61 classification .............................................................................................. 62 pathogenesis .............................................................................................. 62 specific types of infections ........................................................................ 64 review questions ....................................................................................... 73 key to the review questions ..................................................................... 75 references .................................................................................................. 76 chapter nine: trauma .......................................................................................................... 77 introduction ................................................................................................. 77 treatment priorities ..................................................................................... 78 road traffic accidents ................................................................................ 79 firearm injuries ........................................................................................... 80 burn injuries ......................................................................................... 81 review questions ....................................................................................... 84 references .................................................................................................. 85 head and spinal injuries ............................................................................ 86 head injury .................................................................................................. 86 brain injuries ............................................................................................... 87 spinal cord injuries ..................................................................................... 90 review questions ....................................................................................... 92 references .................................................................................................. 93 chapter ten: orthopedic surgery ........................................................................................ 94 introduction ................................................................................................. 94 infections of bones and joints .................................................................... 94 fractures ..................................................................................................... 97 dislocations ................................................................................................. 102 amputations ................................................................................................ 103 review questions ....................................................................................... 105 references .................................................................................................. 106 chapter eleven: anesthesia................................................................................................. 107 pre-anesthetic patient evaluation and preparation .................................... 107 iv cardiopulmonary resuscitation .................................................................. 111 systemic (general) anesthesia .................................................................. 115 regional anesthesia ................................................................................... 118 review questions ....................................................................................... 124 references .................................................................................................. 125 systemic surgery chapter one: the thyroid gland ......................................................................................... 126 thyroid enlargement: goiter ....................................................................... 126 neoplasms of the thyroid ........................................................................... 130 review questions ....................................................................................... 132 references .................................................................................................. 133 chapter two: the breast ..................................................................................................... 134 introduction ................................................................................................. 134 anatomy ..................................................................................................... 134 breast lumps .............................................................................................. 135 carcinoma of the breast ............................................................................. 137 review questions ....................................................................................... 140 references .................................................................................................. 141 chapter three: the chest ................................................................................................... 142 introduction ................................................................................................. 142 upper airway obstruction ........................................................................... 142 tracheostomy ............................................................................................. 143 chest injuries .............................................................................................. 146 pneumothorax ............................................................................................. 149 hemothorax ................................................................................................. 149 tube thoracostomy (chest tube) .............................................................. 150 empyema and lung abscess ..................................................................... 152 lung abscess .............................................................................................. 154 review questions ....................................................................................... 156 references .................................................................................................. 157 chapter four: gastrointestinal tract .................................................................................... 158 introduction ................................................................................................. 158 upper gastrointestinal bleeding ................................................................. 159 colorectal tumors ....................................................................................... 164 common perianal conditions ..................................................................... 166 anal fissure (fissure in ano) .................................................................... 170 hemorrhoids (piles) .................................................................................... 171 references .................................................................................................. 175 acute abdomen ........................................................................................... 176 intestinal obstruction .................................................................................. 177 sigmoid volvulus ......................................................................................... 179 v appendicitis ................................................................................................. 180 peritonitis .................................................................................................... 183 hepato biliary diseases .............................................................................. 185 hydatid cyst of the liver ............................................................................. 187 diseases of gall bladder and biliary tree .................................................. 189 obstructive jaundice................................................................................... 193 review questions ....................................................................................... 197 abdominal wall hernias ............................................................................. 198 introduction ................................................................................................. 198 risk factors for abdominal wall hernia development ............................... 199 specific types of hernia ............................................................................. 200 review questions ....................................................................................... 204 references .................................................................................................. 205 stomach and duodenum ............................................................................ 206 introduction ................................................................................................. 206 peptic ulcer disease ................................................................................... 206 gastric cancer ............................................................................................ 211 review questions ....................................................................................... 213 dysphagia ............................................................................................. 214 introduction ................................................................................................. 214 dysphagia ................................................................................................... 214 carcinoma of the esophagus...................................................................... 215 review questions ....................................................................................... 218 references .................................................................................................. 219 chapter five: urology .......................................................................................................... 220 introduction ................................................................................................. 220 urinary symptoms and investigations of urinary tract problems .............. 220 acute renal failure (anuria/oliguria) ......................................................... 222 disorder of the kidneys and ureters ........................................................... 223 urinary tract infection ................................................................................. 224 renal tuberculosis ..................................................................................... 226 urinary bladder ........................................................................................... 230 bladder cancer ........................................................................................... 231 benign prostatic hyperplasia ...................................................................... 231 the urethra and penis ................................................................................ 233 urethral stricture ......................................................................................... 234 review questions ....................................................................................... 238 references .................................................................................................. 239 1 chapter one shock learning objectives at the end of this chapter, each student should be able to: • state the clinical definition of shock • list the chief characteristics and causes of all types of shock • describe the clinical symptoms and signs that are indicative of shock • list the immediate treatment measures to prevent complications introduction shock is a life-threatening condition which occurs when the circulatory system fails to deliver oxygen and nutrients to the body tissues and becomes unable to remove waste products from the body. it is a descriptive term based on the symptoms and signs secondary to one or more of a wide range of problems. if not recognized and corrected as early as possible, shock may rapidly progress to an irreversible state with subsequent multi-organ failure and death. definition shock is defined as a pathological state causing inadequate oxygen delivery to the peripheral tissues and resulting in lactic acidosis, cellular hypoxia and disruption of normal metabolic condition. classification shock is generally classified into three major categories: 1. hypovolemic shock 2. cardiogenic shock 3. distributive shock distributive shock is further subdivided into three subgroups: a. septic shock b. neurogenic shock c. anaphylactic shock hypovolemic shock is present when marked reduction in oxygen delivery results from diminished cardiac output secondary to inadequate vascular volume. in general, it results from loss of fluid from circulation, either directly or indirectly. 2 e.g. ▪ hemorrhage loss of plasma due to burns loss of water and electrolytes in diarrhea third space loss (internal fluid shift into inflammatory exudates in the peritoneum, such as in pancreatitis.) cardiogenic shock is present when there is severe reduction in oxygen delivery secondary to impaired cardiac function. usually it is due to myocardial infarction or pericardial tamponade. septic shock (vasogenic shock) develops as a result of the systemic effect of infection. it is the result of a septicemia with endotoxin and exotoxin release by gram-negative and gram-positive bacteria. despite normal or increased cardiac output and oxygen delivery, cellular oxygen consumption is less than normal due to impaired extraction as a result of impaired metabolism. neurogenic shock results primarily from the disruption of the sympathetic nervous system which may be due to pain or loss of sympathetic tone, as in spinal cord injuries. patho physiology of shock shock stimulates a physiologic response. this circulatory response to hypotension is to cons
download mymemory free ingiriisi in somali
Last Update: 2016-01-17
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