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 تركيبة جل متطورة مع بلورات المنثول سريعة الامتصاص مصنوعة من مزيج خاص من 10 مكونات طبيعية فعالة لهم قوة تآزرية تجعلها فريدة من نوعها في توفير راحة فورية ضد الألم من أول استخدام. يستخدم في علاج المرضي اللذين يعانون من: ألم أسفل الظهر. آلام الرقبة والكتف. الم عرق النسا. التهاب المفاصل. الاصابات الرياضية. الشد و التشنج العضلي. VALDERA Roll On يستخدم بسهولة لاستهداف الألم الذي لا يمكن الوصول إليه مع الحفاظ على نظافة يدك

  Paediatrics and geriatrics Station 67 Child immunisation programme 185 That having been said, they are still very common in some other countries, from where they may be reintroduced to unvaccinated children in the UK. Vaccines can and often do have side-effects, but these are usually very mild. They include redness and swelling at the injection site, flu-like symptoms, and a fever. Some vaccines are given together in a single injection so as to minimise the number of injections required and to prevent delayed or missed vaccinations. There is no added benefit to giving them separately. The MMR controversy • Measles can cause pneumonia, fits, encephalitis, sub-acute sclerosing panencephalitis, and death. • Mumps can cause meningitis, encephalitis, deafness, and sterility. • Rubella in pregnancy can cause severe damage to the foetus. • The MMR vaccine is safe and effective, and more than 500 million doses of the vaccine have been given since 1972. • Common side-effects of

  Paediatrics and geriatrics Station 62 Paediatric examination: cardiovascular system 171 Chest examination Auscultate the bases of the lungs and check for sacral oedema. Abdominal examination Palpate the abdomen to exclude ascites and/or an enlarged liver (congestive heart failure). Note that the liver edge can usually be palpated in younger infants. Peripheral pulses Feel the temperature of the feet, palpate the femoral pulses, and check for pedal oedema. After the examination • Cover the child. • Ask the child and parent if they have any questions or concerns. • Thank the child and parent. • Indicate that you would test the urine, examine the retina with an ophthalmoscope and, if appropriate, order some key investigations, e.g. a CXR, ECG, echocardiogram. • Summarise your findings and offer a differential diagnosis. Conditions most likely to come up in a paediatric cardiovascular examination station Ventricular septal defect (VSD) • Pansystolic murmur best heard ov