-- Table structure for table `follow_ups`
--

CREATE TABLE `follow_ups` (
  `id` int(10) unsigned NOT NULL AUTO_INCREMENT,
  `patient_id` int(10) unsigned NOT NULL,
  `session_id` int(10) unsigned NOT NULL,
  `complaint` text CHARACTER SET utf8,
  `relevant_history` text CHARACTER SET utf8,
  `dd` text CHARACTER SET utf8,
  `feeding` text CHARACTER SET utf8,
  `patientm_eds` text CHARACTER SET utf8,
  `provisional_diagnosis` text CHARACTER SET utf8,
  `normal_age` tinyint(4) DEFAULT NULL,
  `gross_motor` varchar(191) CHARACTER SET utf8 DEFAULT NULL,
  `motor_vision` varchar(191) CHARACTER SET utf8 DEFAULT NULL,
  `speech_hearing` varchar(191) CHARACTER SET utf8 DEFAULT NULL,
  `social` varchar(191) CHARACTER SET utf8 DEFAULT NULL,
  `cognitive` varchar(191) CHARACTER SET utf8 DEFAULT NULL,
  `recommendations` text CHARACTER SET utf8,
  `labs` varchar(191) CHARACTER SET utf8 DEFAULT NULL,
  `radiology` varchar(191) CHARACTER SET utf8 DEFAULT NULL,
  `procedures` varchar(191) CHARACTER SET utf8 DEFAULT NULL,
  `meds` varchar(191) CHARACTER SET utf8 DEFAULT NULL,
  `other_consultation_referral` varchar(191) CHARACTER SET utf8 DEFAULT NULL,
  `notes` text CHARACTER SET utf8,
  `created_by` int(10) unsigned NOT NULL,
  `created_at` timestamp NULL DEFAULT NULL,
  `updated_at` timestamp NULL DEFAULT NULL,
  PRIMARY KEY (`id`),
  KEY `follow_ups_patient_id_foreign` (`patient_id`),
  KEY `follow_ups_session_id_foreign` (`session_id`),
  KEY `follow_ups_created_by_foreign` (`created_by`),
  CONSTRAINT `follow_ups_created_by_foreign` FOREIGN KEY (`created_by`) REFERENCES `users` (`id`),
  CONSTRAINT `follow_ups_patient_id_foreign` FOREIGN KEY (`patient_id`) REFERENCES `patients` (`id`),
  CONSTRAINT `follow_ups_session_id_foreign` FOREIGN KEY (`session_id`) REFERENCES `sessions` (`id`)
) ENGINE=InnoDB AUTO_INCREMENT=82 DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `follow_ups`
--

INSERT INTO `follow_ups` VALUES (1,19,43,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,117,'2020-02-16 09:38:29','2020-02-16 09:38:29'),(2,165,289,NULL,NULL,NULL,NULL,NULL,'Spinal muscular atrophy, TYPE 2  ?',0,NULL,NULL,NULL,NULL,NULL,'Spinal muscular atrophy\r\nSMN GENE WITH COPY NUMBER',NULL,NULL,NULL,NULL,NULL,NULL,225,'2020-11-29 11:38:06','2020-11-29 11:38:06'),(3,189,296,NULL,NULL,NULL,NULL,NULL,'Breath holding attacks',0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,284,'2020-12-03 09:58:00','2020-12-03 09:58:00'),(4,200,303,NULL,NULL,NULL,NULL,NULL,'congenital heart disease fallot tetralogy with situs inversus totalies',0,NULL,NULL,NULL,NULL,NULL,'give indral orally 1 mg per kilogram once',NULL,'repeat echo if pulmonary arteries are not well seen,also to dect , if PDA is present also do abdominal ultra sound to detect other congenital anomalies.','if oxygen saturation above 90 % remove nasal pronge',NULL,'after repeating the echo',NULL,248,'2020-12-06 09:53:06','2020-12-06 09:53:06'),(5,198,301,'left focal convulsion 3 days ago',NULL,NULL,NULL,NULL,'lEFT HEMIPARESIS WITH LEFT FACIAL PALSY',0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'MRI and MRA brain , CBC',NULL,225,'2020-12-06 10:19:44','2020-12-06 10:19:44'),(6,216,323,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,'repeat cortisol am & pm do ACTH am & pm as well as HbA1c','pelviabdominal ultrasound',NULL,NULL,NULL,NULL,225,'2020-12-13 09:26:36','2020-12-13 09:26:36'),(7,263,349,'CYANOSIS since 10 days old\r\nCONSTIPATION','good suckling\r\nnormal weight \r\nrt sided hydroureter hydronephrosis','VACTERL Syndrome\r\nother congenital cyanotic heart disease','artificially fed','propranolol (inderal)\r\n1 mg /kg/day divided every 12 hours orally\r\nLACTULOSE 5 CC/ 8 HOURS\r\nV DROP DROPS 10 DROPS DAILY MORNING','extreme tetralogy of Fallot',1,NULL,NULL,NULL,NULL,NULL,'MONITOR O2 SATURATION METICULOUSLY  EVERY WEEK AND IF DISTRESSED ANY TIME\r\nKEEP SATURATION ABOVE 70% \r\n EXCLUDE OTHER CONGENITAL MALFORMATIONS\r\nSKELETAL SURVEY\r\nMSCT CARDIAC ANGIOGRAPHY OR DIAGNOSTIC CATHETERIZATION (WHAT\'S AVAILABLE )\r\nCBC EVERY MONTH TO CHECK HEMATOCRIT VALUE IF ABOVE 65 %FOR PARTIAL EXCHANGE TRANSFUSION','REGULAR CHECK CBC','repeat echo if pulmonary arteries are not well seen,also to de , if PDA is presentdo abdominal ultra sound to detect other congenital anomalies.',NULL,NULL,NULL,NULL,248,'2020-12-27 10:33:52','2020-12-27 10:33:52'),(8,283,363,'Encephalopathy','Global developmental delay',NULL,NULL,NULL,NULL,0,'Delayed',NULL,NULL,NULL,NULL,'L\'carnitine \r\nBiotine\r\nB12',NULL,NULL,NULL,NULL,'Endocrinology',NULL,248,'2021-01-10 09:58:52','2021-01-10 09:58:52'),(9,346,397,'intractable convulsion',NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,241,'2021-02-14 09:07:00','2021-02-14 09:07:00'),(10,327,397,'Intractable epilepsy',NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,225,'2021-02-14 09:08:01','2021-02-14 09:08:01'),(11,327,397,'Generalized tonic clonic seizure','Post encephalitic',NULL,NULL,NULL,'Postencephalitic,  Drug resistant epilepsy, slow learner',1,'Normal',NULL,NULL,NULL,NULL,'Adjust dose of sycocetam to 60 mg per kg per day divided on 2 doses',NULL,NULL,NULL,NULL,NULL,NULL,225,'2021-02-14 09:58:25','2021-02-14 09:58:25'),(12,452,477,'Fever with convulsion','family history of febrile convulsion',NULL,NULL,'Depakine',NULL,1,NULL,NULL,NULL,NULL,NULL,'Withdraw after EEG',NULL,NULL,NULL,NULL,NULL,NULL,225,'2021-06-13 09:06:21','2021-06-13 09:06:21'),(13,449,477,'Febrile convulsion','family history of febrile convulsion',NULL,NULL,'Depakine\r\nPsychodal','Febrile convulsion\r\nhyperactivity\r\nDelayed speech development',0,'Normal',NULL,'delayed',NULL,NULL,'Behavioral therapy\r\nWithdraw Depakine if normal EEG, or replace with Levetiracetam if abnormal',NULL,NULL,'EEG',NULL,NULL,NULL,225,'2021-06-13 09:13:53','2021-06-13 09:13:53'),(14,492,502,NULL,NULL,NULL,NULL,NULL,'Febrile seizure',1,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'Decrease temperature.\r\nNo antiepileptics',225,'2021-07-25 08:54:36','2021-07-25 08:54:36'),(15,491,502,'Drop attacks once per month',NULL,NULL,NULL,NULL,'Iron deficiency anemia',0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'Treat anemia\r\nDo EEG FOR 2 HOURS\r\nECG',225,'2021-07-25 09:13:23','2021-07-25 09:13:23'),(16,548,535,'abnormal movement',NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'follow up',NULL,225,'2021-08-29 09:20:54','2021-08-29 09:20:54'),(17,658,10482,'Behavior, slow learner',NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'slow learner',NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,225,'2021-10-03 09:55:24','2021-10-03 09:55:24'),(18,657,10482,'screaming\r\naggressive mother\r\nmental illness',NULL,NULL,NULL,NULL,'child abuse',0,NULL,NULL,NULL,NULL,NULL,'Consult social agency and psychiatrist',NULL,NULL,NULL,NULL,'علاج سلوكي',NULL,225,'2021-10-03 10:03:32','2021-10-03 10:03:32'),(19,662,11326,'Global developmental delay.\r\nSpastic left hemiplegic cerebral palsy',NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'Orthopedic consultation','Botox',225,'2021-10-03 10:31:16','2021-10-03 10:31:16'),(20,663,11326,'Neonatal RDS\r\nMICROCEPHALY\r\nPOOR SUCKLING\r\nHypotonia\r\nAmbigous genetalia',NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'MRI brain',NULL,225,'2021-10-03 10:39:04','2021-10-03 10:39:04'),(21,654,10482,'Epilepsy\r\nStatus',NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'MRI','Trileptal 1cc  twice daily',NULL,NULL,225,'2021-10-03 10:50:15','2021-10-03 10:50:15'),(22,699,14226,NULL,NULL,NULL,NULL,NULL,NULL,0,'Delayed',NULL,'delayed',NULL,NULL,NULL,NULL,NULL,NULL,'Depakin 200 mg twice daily','Orthopedic consultation',NULL,225,'2021-10-10 09:00:48','2021-10-10 09:00:48'),(23,696,14225,'Delayed speech\r\nAutism spectrum disorder',NULL,NULL,NULL,NULL,'ASD',0,NULL,NULL,NULL,NULL,NULL,'Behavioral training',NULL,NULL,NULL,NULL,NULL,NULL,225,'2021-10-10 09:12:31','2021-10-10 09:12:31'),(24,610,14223,'Hematuria',NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,225,'2021-10-10 09:22:43','2021-10-10 09:22:43'),(25,698,12617,'Aggressive',NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'Behavioral',NULL,NULL,NULL,225,'2021-10-10 09:36:31','2021-10-10 09:36:31'),(26,672,12617,'Delayed speech development\r\nfacial hemangioma',NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'delayed',NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'Sturge weber syndrome',225,'2021-10-10 09:54:12','2021-10-10 09:54:12'),(27,709,15128,'shortness of breath of 5 days duration and fever','irrelevant','acute viral bronchitis ,suspected COVID 19',NULL,'nebulizer and antipyretics','acute viral bronchitis',1,NULL,NULL,NULL,NULL,NULL,'follow up vital data ,antipyretics, nebulizer for wheezy chest',NULL,NULL,NULL,NULL,NULL,NULL,197,'2021-10-13 10:17:15','2021-10-13 10:17:15'),(28,715,15835,'Pallor',NULL,NULL,NULL,NULL,'Alpha Thalasemia',1,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,197,'2021-10-13 10:36:17','2021-10-13 10:36:17'),(29,715,15835,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,'Vitamin D 1000 unit daily for 8 weeks\r\nDaily folic acid 2.5 mg \r\nFerritin level\r\nTest for the father',NULL,NULL,NULL,NULL,NULL,NULL,197,'2021-10-13 10:39:13','2021-10-13 10:39:13'),(30,746,20523,'Delayed motor development','perinatal history irrelevant\r\nConsanguineous',NULL,NULL,NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'MRI brain','EEG',NULL,'Physiotherapy',NULL,225,'2021-10-24 08:54:01','2021-10-24 08:54:01'),(31,758,20523,'Polysyndactyly',NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'Echo cardiography Plain X-ray long bones MRI brain',NULL,NULL,NULL,NULL,225,'2021-10-24 08:59:16','2021-10-24 08:59:16'),(32,758,20523,'Polysyndactyly',NULL,NULL,NULL,NULL,NULL,0,'Delayed',NULL,NULL,NULL,NULL,'Echo cardiography\r\nPlain X-ray long bones\r\nMRI brain',NULL,'Echo cardiography                                                                      Plain X-ray long bones MRI brain',NULL,NULL,NULL,NULL,225,'2021-10-24 09:01:44','2021-10-24 09:01:44'),(33,759,20523,'Congenital tongue anomalies','Consanguinity\r\nFather has polydactyly',NULL,NULL,NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,225,'2021-10-24 09:05:29','2021-10-24 09:05:29'),(34,740,20524,'Dysmorphic features \r\nRDS III',NULL,NULL,NULL,NULL,'Down syndrome, common AV canal,',0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,225,'2021-10-24 09:20:28','2021-10-24 09:20:28'),(35,757,20525,'Left Bell\'s palsy',NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,'Augmentin\r\nZovirax\r\nSteroids 1.5 mg per kg daily',NULL,NULL,NULL,NULL,NULL,NULL,225,'2021-10-24 09:35:56','2021-10-24 09:35:56'),(36,760,20525,'Disturbed consciousness yesterday\r\nPost ictal','Positive brother with epilepsy',NULL,NULL,NULL,NULL,1,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'EEG',NULL,NULL,NULL,225,'2021-10-24 09:46:48','2021-10-24 09:46:48'),(37,756,20525,'Drop attacks\r\nSyncopal attacks\r\nversus vertigo',NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'vestibular function',NULL,'ENT',NULL,225,'2021-10-24 09:58:24','2021-10-24 09:58:24'),(38,761,20525,'Left congenital hemiparesis',NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,'Physiotherapy',NULL,NULL,NULL,NULL,NULL,NULL,225,'2021-10-24 10:08:52','2021-10-24 10:08:52'),(39,790,23218,'Delayed speech and cognitive',NULL,NULL,NULL,NULL,NULL,0,'Normal',NULL,'delayed',NULL,NULL,NULL,NULL,'MRI brain',NULL,NULL,NULL,NULL,225,'2021-10-31 09:22:06','2021-10-31 09:22:06'),(40,789,23218,'global delay',NULL,NULL,NULL,NULL,NULL,0,'Normal',NULL,'delayed',NULL,NULL,NULL,NULL,NULL,'EEG    mri',NULL,NULL,NULL,225,'2021-10-31 09:30:37','2021-10-31 09:30:37'),(41,837,28461,'Delayed motor development','consanguineous parents',NULL,'Nutritional assessment',NULL,NULL,0,'Can walk supported',NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'nutritional support',NULL,NULL,225,'2021-11-14 09:07:11','2021-11-14 09:07:11'),(42,672,28021,'Delayed speech development',NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,'delayed','agression',NULL,'Behavioral and speech therapy',NULL,NULL,'IQ assessment',NULL,'علاج سلوكي',NULL,225,'2021-11-14 09:43:24','2021-11-14 09:43:24'),(43,873,30676,'bone aches recurrent of 2 years duration',NULL,'Growing pains',NULL,NULL,'Normal CBC , ESR,',0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'Follow up',NULL,225,'2021-11-21 09:53:38','2021-11-21 09:53:38'),(44,875,30675,'Obesity','normal perinatal history',NULL,'eating disorders',NULL,NULL,0,'Normal',NULL,NULL,NULL,NULL,'Diet, and physical activity','repeat cortisol am & pm do ACTH am & pm as well as HbA1c','Bone age',NULL,NULL,'Endocrinology',NULL,225,'2021-11-21 10:17:02','2021-11-21 10:17:02'),(45,922,32744,'Rt focal seizure','He is on Oxclepatal',NULL,NULL,NULL,'Epilepsy',1,NULL,NULL,NULL,NULL,NULL,'MRI brain epilepsy protocol , Thin cuts temporal lobes',NULL,'MRI brain epilepsy protocol , Thin cuts temporal lobes',NULL,'Trileptal 7cc  twice daily',NULL,NULL,225,'2021-12-01 09:32:14','2021-12-01 09:32:14'),(46,935,33493,'Scoliosis thoraco lumbar',NULL,'Destructive lesion in the thoraco lumbar',NULL,NULL,NULL,1,'Normal',NULL,NULL,NULL,NULL,'Orthopedic consultation',NULL,'Chest x-ray',NULL,NULL,'Orthopedic consultation','Active disease or not',225,'2021-12-05 09:03:02','2021-12-05 09:03:02'),(47,936,33493,NULL,NULL,NULL,NULL,NULL,'Arnold Chiaria malformation, scar of lumbar meningomyelocele, neurogenic bladder, loss of sensation in both lower limbs, vomiting',0,'Delayed',NULL,NULL,NULL,NULL,'Catheterization','Renal function','Pelvi-abdominal ultrasound',NULL,NULL,NULL,NULL,225,'2021-12-05 09:17:05','2021-12-05 09:17:05'),(48,957,35403,'MR',NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'MRI brain','EEG',NULL,NULL,NULL,225,'2021-12-12 09:01:56','2021-12-12 09:01:56'),(49,658,35404,'ADHD, SLOW LEARNER',NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,'Psychodal 1/4 cc daily',NULL,NULL,NULL,NULL,NULL,NULL,225,'2021-12-12 09:10:16','2021-12-12 09:10:16'),(50,958,35404,'Excessive crying',NULL,NULL,NULL,NULL,'Global developmental delay',0,'Delayed',NULL,'delayed','agression',NULL,NULL,NULL,'MRI brain',NULL,NULL,'physiotherapy',NULL,225,'2021-12-12 09:17:05','2021-12-12 09:17:05'),(51,959,35404,'Febrile convulsion, generalized status',NULL,NULL,NULL,NULL,'Generalized epilepsy',1,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'MRI brain epilepsy work up',NULL,'Tiratam 1 cc every 12 hours',NULL,NULL,225,'2021-12-12 09:28:34','2021-12-12 09:28:34'),(52,960,35404,'Global delay and congenital pulmonary stenosis',NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'Echo cardiography',NULL,NULL,NULL,NULL,225,'2021-12-12 09:34:17','2021-12-12 09:34:17'),(53,984,36737,'Generalized seizure second attack afebrile','Uncle epileptic',NULL,NULL,NULL,NULL,1,NULL,NULL,NULL,NULL,NULL,'MRI brain',NULL,NULL,NULL,'Levetiracetam (Tiralepcy, or Levepex)',NULL,NULL,225,'2021-12-19 08:47:31','2021-12-19 08:47:31'),(54,1015,38650,'Global developmental delay','first day jaundice, NICU admission\r\nFirst cousin parent',NULL,NULL,NULL,NULL,0,'Delayed',NULL,'delayed','delayed',NULL,NULL,NULL,'CT brain',NULL,NULL,'Genetic counseling','Neurometabolic',225,'2021-12-26 09:43:45','2021-12-26 09:43:45'),(55,850,39236,'Abnormal behavior, aggressive','One of a twin, preterm labor,',NULL,NULL,'Slow learner',NULL,0,'Normal',NULL,'slow learner','agression',NULL,'MRI brain , EEG, IQ ASSESSMENT',NULL,'MRI brain','EEG','Psychodal','BEHAVIORAL THERAPY',NULL,225,'2021-12-26 10:08:07','2021-12-26 10:08:07'),(56,1132,41783,'Generalized seizure, Febrile status',NULL,NULL,NULL,NULL,'Epilepsy generalized',0,NULL,NULL,NULL,NULL,NULL,'Tiratam 1 cc every 12 hr',NULL,'MRI brain epilepsy work up',NULL,NULL,NULL,NULL,225,'2022-01-09 09:01:10','2022-01-09 09:01:10'),(57,1134,41783,'Recurrent acute headache',NULL,NULL,NULL,NULL,NULL,1,NULL,NULL,NULL,NULL,NULL,'Stop artificial food additives',NULL,NULL,'Behavioral',NULL,NULL,NULL,225,'2022-01-09 09:12:13','2022-01-09 09:12:13'),(58,1126,41783,'Global developmental delay','abortions, similar condition (boy)',NULL,'difficult',NULL,NULL,0,'Delayed',NULL,'delayed',NULL,NULL,'Extended metabolic screen\r\nWhole exon sequencing',NULL,NULL,NULL,'Baclofan 10 mg tab','Genetic counseling',NULL,225,'2022-01-09 09:17:23','2022-01-09 09:17:23'),(59,1127,41783,'Global developmental delay',NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'Genetic counseling','Whole exome sequencing',225,'2022-01-09 09:20:37','2022-01-09 09:20:37'),(60,1140,42525,NULL,'recurrent abortions with death of a sib with CP',NULL,NULL,NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,'assessment of s.albumin and PT, PTT\r\nUrine analysis and C&S, prot./cr ratio\r\nTORCH SCREEING and karyotyping\r\nFup of platelet count, blood pressure and URINE OUTPUT',NULL,NULL,NULL,NULL,NULL,NULL,316,'2022-01-10 09:49:22','2022-01-10 09:49:22'),(61,1193,44601,NULL,NULL,NULL,NULL,NULL,'congenital heart disease PFO with hypertension for follow up',0,NULL,NULL,NULL,NULL,NULL,'aldactone 3 mg/kg/day \r\nfor sildenifil intake after echo repeatition \r\nand change of antibiotics',NULL,NULL,NULL,NULL,NULL,NULL,327,'2022-01-17 09:52:26','2022-01-17 09:52:26'),(62,1245,47987,'Recurrent seizure, post head trauma, fever 3 days duration',NULL,NULL,NULL,NULL,'post traumatic seizure',1,'normal',NULL,NULL,'normal',NULL,'Withdraw Epilepsy',NULL,'MRI brain',NULL,'Trileptal half cc  twice daily','nutrition vitamin D',NULL,225,'2022-01-24 12:31:53','2022-01-24 12:31:53'),(63,1256,49460,NULL,NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,'mother of diagnosed galactosemia cases should be informed to start feeding her newborn baby under medical supervision',NULL,NULL,NULL,NULL,NULL,NULL,316,'2022-01-31 09:13:54','2022-01-31 09:13:54'),(64,1289,50636,'Generalized seizures',NULL,NULL,NULL,NULL,NULL,1,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'MRI brain epilepsy protocol',NULL,225,'2022-02-06 08:58:18','2022-02-06 08:58:18'),(65,1288,50636,'Paroxysmal attacks of disturb. polyuria and polydepsia','Father is epileptic',NULL,NULL,NULL,NULL,1,NULL,NULL,NULL,NULL,NULL,NULL,'serum sodium , potasium  and extended metabolic screen, blood osmolality. Blood lactate and pyruvate. Urine osmolality','MRI brain epilepsy work up',NULL,NULL,NULL,NULL,225,'2022-02-06 09:16:44','2022-02-06 09:16:44'),(66,1289,50636,'Generalized seizure','Consanguineous parents.           Brothers had',NULL,NULL,NULL,NULL,1,NULL,NULL,NULL,NULL,NULL,'Extended metabolic screen.',NULL,'MRI brain epilepsy work up',NULL,NULL,'Genetic counseling',NULL,225,'2022-02-06 09:22:07','2022-02-06 09:22:07'),(67,1296,50636,'Choreo athetosis of 1 year duration','Consanguineous parents. Positive family history of abnormal gait','Dopa responsive dystonia or Biotine responsive dystonia',NULL,NULL,'Heredo-familial dystonia',1,NULL,NULL,NULL,NULL,NULL,'Whole exome sequencing',NULL,NULL,NULL,'Biotine forte capsule 2 capsules 3 times daily','Genetic counseling, occupational therapy  and physiotherapy',NULL,225,'2022-02-06 09:41:12','2022-02-06 09:41:12'),(68,1294,51076,'Headache chronic',NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,'Behavioral therapy',NULL,NULL,NULL,NULL,'علاج سلوكي',NULL,225,'2022-02-06 10:16:13','2022-02-06 10:16:13'),(69,1233,51080,NULL,NULL,NULL,NULL,NULL,'neonatal hypoglycemia (spontaneous regression)',0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,327,'2022-02-07 09:31:24','2022-02-07 09:31:24'),(70,1290,54185,'Repeated drop attacks. Diagnosed as epilepsy. Was on antiepileptic','No family history of epilepsy',NULL,NULL,NULL,'Generalized epilepsy',1,NULL,NULL,NULL,NULL,NULL,'Levetiracetam 500 tablet half tablet twice',NULL,'MRI brain epilepsy work up',NULL,NULL,NULL,NULL,225,'2022-02-20 09:14:58','2022-02-20 09:14:58'),(71,1357,54185,'Neonatal respiratory distress','At age of 20 days admitted to NICU','Attacks of apnea','Sucking preserved','55 breath/min','Neonatal apneic attacks',0,NULL,NULL,NULL,NULL,NULL,NULL,'Extended metabolic screen. Neurimax capsule','Transcranial US.   ECHO cardiography',NULL,'L carnitine Neurimax',NULL,NULL,225,'2022-02-20 09:36:58','2022-02-20 09:36:58'),(72,1356,54185,'Delayed motor develop mainly lower limbs',NULL,'Malnutrition',NULL,NULL,'Severe iron deficiency anemia, search for other vitamin deficiencies',0,'Delayed','normal',NULL,NULL,NULL,'Exclude lead toxicity','CPK total','MRI brain, Nerve conduction study',NULL,NULL,NULL,NULL,225,'2022-02-20 09:46:25','2022-02-20 09:46:25'),(73,1289,50636,'Recurrent convulsions',NULL,NULL,NULL,NULL,'Generalized epilepsy',1,NULL,NULL,NULL,NULL,NULL,'MRI brain epilepsy protocol',NULL,'MRI brain epilepsy work up',NULL,'Levetiracetam (Tiralepcy, or Levepex)',NULL,NULL,225,'2022-02-20 09:52:46','2022-02-20 09:52:46'),(74,1355,54185,'Recurrent apnea and RDS','First cousin parents',NULL,NULL,NULL,'Exclude seizure',0,NULL,NULL,NULL,NULL,NULL,NULL,'Extended metabolic screen. Neurimax capsule','Transcranial US.   ECHO cardiography',NULL,'L carnitine Neurimax',NULL,NULL,225,'2022-02-20 09:57:40','2022-02-20 09:57:40'),(75,1357,54185,'Apnea hypoglycemia','Infant of diabetic mother',NULL,'Poor suckling',NULL,'Hypoglycemia',0,NULL,NULL,NULL,NULL,NULL,'Transcranial US. Neurodevelopmental follow up',NULL,'MRI brain',NULL,NULL,NULL,NULL,225,'2022-02-20 10:05:16','2022-02-20 10:05:16'),(76,1029,54187,'Failure of growth',NULL,NULL,NULL,NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,'Endocrinal consultation and nutritional management',NULL,NULL,NULL,NULL,NULL,NULL,225,'2022-02-20 10:22:43','2022-02-20 10:22:43'),(77,1362,54187,'Down syndrome, congenital heart',NULL,NULL,NULL,NULL,'Hypothyrodism on L-troxine',0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'Endocrinology consultation',NULL,225,'2022-02-20 10:31:49','2022-02-20 10:31:49'),(78,1363,54626,'Recurrent drop attacks, Arthralgia , fever and abdominal pain','Perinatal hypoxic ischemic encephalopathy, neonatal convulsion','Mild delay in motor and speech development. Slow learner',NULL,'Jaundice at age of 4 years diagnosed as Hepatitis A','Recurrent urinary tract infection',0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'EEG with hyperventilation                            MRI brain',NULL,NULL,'Physiotherapy',NULL,225,'2022-02-20 11:06:13','2022-02-20 11:06:13'),(79,1337,54627,NULL,NULL,NULL,NULL,NULL,'maple syrup urine disease',0,NULL,NULL,NULL,NULL,NULL,'sepsis screen \r\nABG\r\nnutritional rehabilitation',NULL,NULL,NULL,NULL,NULL,NULL,327,'2022-02-21 09:21:47','2022-02-21 09:21:47'),(80,1695,66949,'Paroxysmal motor event. Breath holding attacks?? Epilepsy','Lapse in consciousness, Twin',NULL,NULL,NULL,'Epilepsy Vs. Breath holding attacks',0,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'MRI brain, EEG',NULL,NULL,NULL,NULL,225,'2022-05-08 09:14:01','2022-05-08 09:14:01'),(81,1697,66949,'Delayed motor development, Dysmorphic features','Twin pregnancy, IVF',NULL,NULL,NULL,NULL,0,NULL,NULL,NULL,NULL,NULL,'Physiotherapy',NULL,NULL,NULL,NULL,'High resolution karyotype',NULL,225,'2022-05-08 09:29:36','2022-05-08 09:29:36');

--
-- Table structure for table `follow_ups_covid19`
--

CREATE TABLE `follow_ups_covid19` (
  `id` int(11) NOT NULL AUTO_INCREMENT,
  `patient_id` int(10) unsigned NOT NULL,
  `session_id` int(10) unsigned NOT NULL,
  `relevant_history` text CHARACTER SET utf8,
  `patientm_eds` text CHARACTER SET utf8,
  `provisional_diagnosis` text CHARACTER SET utf8,
  `exposure_date` int(11) DEFAULT NULL,
  `exposure_history` int(11) DEFAULT NULL,
  `travel_date` int(11) DEFAULT NULL,
  `travel_history` int(11) DEFAULT NULL,
  `positive_sample_date` int(11) DEFAULT NULL,
  `transferal_site` varchar(200) CHARACTER SET utf8 DEFAULT NULL,
  `admission_site` varchar(100) CHARACTER SET utf8 DEFAULT NULL,
  `presenting_symptoms` varchar(100) CHARACTER SET utf8 DEFAULT NULL,
  `comorbidities` varchar(100) CHARACTER SET utf8 DEFAULT NULL,
  `recommendations` text CHARACTER SET utf8,
  `labs` varchar(191) CHARACTER SET utf8 DEFAULT NULL,
  `radiology` varchar(191) CHARACTER SET utf8 DEFAULT NULL,
  `procedures` varchar(191) CHARACTER SET utf8 DEFAULT NULL,
  `meds` varchar(191) CHARACTER SET utf8 DEFAULT NULL,
  `other_consultation_referral` varchar(191) CHARACTER SET utf8 DEFAULT NULL,
  `notes` text CHARACTER SET utf8,
  `created_by` int(10) unsigned NOT NULL,
  `created_at` timestamp NULL DEFAULT NULL,
  `updated_at` timestamp NULL DEFAULT NULL,
  PRIMARY KEY (`id`),
  KEY `follow_ups_patient_id_foreign` (`patient_id`),
  KEY `follow_ups_session_id_foreign` (`session_id`),
  KEY `follow_ups_created_by_foreign` (`created_by`),
  CONSTRAINT `follow_ups_covid_19_created_by_foreign` FOREIGN KEY (`created_by`) REFERENCES `users` (`id`),
  CONSTRAINT `follow_ups_covid_19_patient_id_foreign` FOREIGN KEY (`patient_id`) REFERENCES `patients` (`id`),
  CONSTRAINT `follow_ups_covid_19_session_id_foreign` FOREIGN KEY (`session_id`) REFERENCES `sessions` (`id`)
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `follow_ups_covid19`
--


--
-- Table structure for table `general_follow_ups`
--

CREATE TABLE `general_follow_ups` (
  `id` int(10) unsigned NOT NULL AUTO_INCREMENT,
  `suggested_note` text CHARACTER SET utf8,
  `patient_id` int(10) unsigned NOT NULL,
  `drugs` varchar(191) COLLATE utf8mb4_unicode_ci DEFAULT NULL,
  `body_temperature` float(5,1) DEFAULT NULL,
  `session_id` int(10) unsigned NOT NULL,
  `doctor_id` int(10) unsigned NOT NULL,
  `created_by` int(10) unsigned NOT NULL,
  `created_at` timestamp NULL DEFAULT NULL,
  `updated_at` timestamp NULL DEFAULT NULL,
  PRIMARY KEY (`id`),
  KEY `general_follow_ups_patient_id_foreign` (`patient_id`),
  KEY `general_follow_ups_session_id_foreign` (`session_id`),
  KEY `general_follow_ups_doctor_id_foreign` (`doctor_id`),
  KEY `general_follow_ups_created_by_foreign` (`created_by`),
  CONSTRAINT `general_follow_ups_created_by_foreign` FOREIGN KEY (`created_by`) REFERENCES `users` (`id`),
  CONSTRAINT `general_follow_ups_doctor_id_foreign` FOREIGN KEY (`doctor_id`) REFERENCES `users` (`id`),
  CONSTRAINT `general_follow_ups_patient_id_foreign` FOREIGN KEY (`patient_id`) REFERENCES `patients` (`id`),
  CONSTRAINT `general_follow_ups_session_id_foreign` FOREIGN KEY (`session_id`) REFERENCES `sessions` (`id`)
) ENGINE=InnoDB AUTO_INCREMENT=2848 DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `general_follow_ups`
--

INSERT INTO `general_follow_ups` VALUES (14,'LP Hypertrophic and oral\r\nStop UVB for 1 month then reconsider ReUVB\r\nUrology consultation',42,',  Zinc oxide sunblock, zarotex gel, Acitretin 25mg, Lipanthyl 300mg, Dermovate ointment,',NULL,69,154,154,'2020-02-27 10:26:08','2020-02-27 10:26:08'),(15,'UVA increase to 10 then 15 then 20J\r\nAntiScl70 titre\r\nANA with titre\r\nAnticentromere\r\nStool analysis\r\nRoutine labs\r\nU1 RNP',43,'Respatio 20mg 2x3, dicalderm 1x2, UVA, MTX 20mg/W, Meloxicam 5mg, Cymbatex 1x1,',NULL,69,154,154,'2020-02-27 10:41:24','2020-02-27 10:41:24'),(17,'For Cardiac MRI to confirm the diagnosis.',61,NULL,NULL,91,184,184,'2020-03-10 08:46:40','2020-03-10 08:46:40'),(18,'ascending cystourethrogram\r\nABG\r\nIron therapy\r\nSerum Ca total\r\nPO4\r\nALP\r\nPTH\r\nCT Abdomen',86,'Iron therapy',NULL,127,197,197,'2020-03-11 09:44:35','2020-03-11 09:44:35'),(19,'refer to pediatric urologist at AIN SHAMS university',86,NULL,NULL,127,197,197,'2020-03-11 09:49:41','2020-03-11 09:49:41'),(20,'POST ENCEPHALITIC MOTOR, COGNITIVE, SPEECH DYSFUNCTION\r\n\\deeg-\\mric\r\n\r\ncbc\r\nALT \r\nCREAT\r\nALBUMIN\r\nFUP 1 MONTH LATER',73,'\\levetiracetam 5 cc every 12 hours then 7.5 cc every 12 hours',NULL,128,191,191,'2020-03-11 09:56:53','2020-03-11 09:56:53'),(21,'tuberculin test\r\nCT chest\r\nXray chest\r\nZeihl neelson stain for the sputum sample',92,NULL,NULL,127,197,197,'2020-03-11 10:01:19','2020-03-11 10:01:19'),(22,NULL,63,'water',37.0,183,231,231,'2020-11-16 10:57:43','2020-11-16 10:57:43'),(23,'Metabolic screen\r\nL\'CARNITINE',125,NULL,37.0,196,225,225,'2020-11-22 09:29:59','2020-11-22 09:29:59'),(24,NULL,126,NULL,37.0,196,225,225,'2020-11-22 09:38:48','2020-11-22 09:38:48'),(25,'lipid profile \r\nechocardiography\r\ncoronary angio',127,'nitroglycerimn sr   12 hour',37.0,199,244,244,'2020-11-22 09:42:44','2020-11-22 09:42:44'),(26,'fasting ,postprandial blood suger, hba1c\r\nlipid profile\r\nechocardiography\r\nurine analysis \r\nabdominal sonography\r\nfundus examinations\r\nsputum culture and sensitivity',128,NULL,37.0,199,244,244,'2020-11-22 09:49:10','2020-11-22 09:49:10'),(27,NULL,151,NULL,37.0,237,262,262,'2020-11-25 08:39:32','2020-11-25 08:39:32'),(28,'withdraw oxygen if saturation above 90',200,'Indral',37.0,303,248,248,'2020-12-06 09:43:02','2020-12-06 09:43:02'),(29,'physiotherapy',292,NULL,37.0,371,225,225,'2021-01-17 08:47:02','2021-01-17 08:47:02'),(30,'Serum IgA',292,NULL,37.0,371,225,225,'2021-01-17 08:59:21','2021-01-17 08:59:21'),(31,'genetic study',298,NULL,37.0,371,225,225,'2021-01-17 09:07:49','2021-01-17 09:07:49'),(32,'MRI brain\r\nKaryotype',295,'Psychodal 1mg tablet',37.0,371,225,225,'2021-01-17 09:19:48','2021-01-17 09:19:48'),(33,NULL,293,'Baclofan 10 mg tablets',37.0,371,225,225,'2021-01-17 09:28:22','2021-01-17 09:28:22'),(34,'Breath holding',300,NULL,37.0,371,225,225,'2021-01-17 09:56:29','2021-01-17 09:56:29'),(35,NULL,283,NULL,37.0,370,225,225,'2021-01-17 10:05:14','2021-01-17 10:05:14'),(36,'EMG and NCS after 3 months or evidence of reinnervation',277,NULL,37.0,374,290,290,'2021-01-20 10:36:52','2021-01-20 10:36:52'),(37,'CBC AND Serology for transfusion infection',315,NULL,37.0,378,225,225,'2021-01-24 09:01:39','2021-01-24 09:01:39'),(38,NULL,312,NULL,37.0,377,225,225,'2021-01-24 09:31:51','2021-01-24 09:31:51'),(39,'Stool analysis\r\nUrine analysis and culture\r\nPlain xray abdomen and barium enema',312,NULL,37.0,377,225,225,'2021-01-24 09:35:16','2021-01-24 09:35:16'),(40,'علاج سلوكي',330,NULL,37.0,388,225,225,'2021-02-07 09:13:26','2021-02-07 09:13:26'),(41,'Bone age X-RAY',337,NULL,37.0,388,225,225,'2021-02-07 09:27:13','2021-02-07 09:27:13'),(42,NULL,336,NULL,37.0,389,225,225,'2021-02-07 09:49:10','2021-02-07 09:49:10'),(43,NULL,338,NULL,37.0,390,327,327,'2021-02-08 09:07:44','2021-02-08 09:07:44'),(44,NULL,339,NULL,37.0,390,327,327,'2021-02-08 09:09:26','2021-02-08 09:09:26'),(45,'Baclofan 10 mg tablet ربع قرص مرتين يوميا',346,NULL,37.0,397,225,225,'2021-02-14 09:21:51','2021-02-14 09:21:51'),(46,'Physiotherapy\r\nEchocardiogrphy\r\nTotal CPK for the sisters, brothers , and sisters , \r\nMolecular diagnosis of Duchenne',323,NULL,37.0,397,225,225,'2021-02-14 09:41:21','2021-02-14 09:41:21'),(47,'Baclofan 10 mg tablets',347,NULL,37.0,397,225,225,'2021-02-14 10:25:24','2021-02-14 10:25:24'),(48,'Recent EEG',352,NULL,37.0,401,225,225,'2021-02-21 09:49:53','2021-02-21 09:49:53'),(49,NULL,357,NULL,37.0,406,298,298,'2021-02-24 09:44:51','2021-02-24 09:44:51'),(50,'take neural',357,'Neural',37.0,406,275,275,'2021-02-24 09:59:20','2021-02-24 09:59:20'),(51,'sun protection',358,'plaquonil 200',37.0,406,275,275,'2021-02-24 10:22:58','2021-02-24 10:22:58'),(52,'emollients',359,'elidel',37.0,406,275,275,'2021-02-24 10:42:07','2021-02-24 10:42:07'),(53,'cranial us',360,'follow up',37.0,406,275,275,'2021-02-24 10:53:37','2021-02-24 10:53:37'),(54,'FOLLOWUP',361,'CAUTERY',37.0,406,275,275,'2021-02-24 11:05:15','2021-02-24 11:05:15'),(55,'nothing',20,'antinal',37.0,408,63,63,'2021-02-25 18:34:30','2021-02-25 18:34:30'),(56,'test',18,'panadol',37.0,43,337,337,'2021-02-26 19:34:15','2021-02-26 19:34:15'),(57,'EEG',363,NULL,37.0,409,225,225,'2021-02-28 09:41:38','2021-02-28 09:41:38'),(58,'Physiothery',362,'Baclofan 10 mg tablets',37.0,409,225,225,'2021-02-28 09:55:57','2021-02-28 09:55:57'),(59,'followup echo',365,'antifailure treatment',37.0,410,338,338,'2021-03-01 08:57:41','2021-03-01 08:57:41'),(60,'no need',123,'panadol',37.0,411,230,230,'2021-03-01 18:13:17','2021-03-01 18:13:17'),(61,'surgical myomectomy vs septal aplasion',247,'metoprolol 25mg',37.0,412,301,301,'2021-03-02 09:56:38','2021-03-02 09:56:38'),(62,'if patient continued to have attacks of VT will refered for CRT-ICD',367,'amiodarone 200mg - rampril 1.25 mg- carvidlol 6.25-warfarin 2mg - plavix 75- asprin 75',37.0,412,301,301,'2021-03-02 10:08:13','2021-03-02 10:08:13'),(63,NULL,369,NULL,37.0,414,276,276,'2021-03-03 09:26:37','2021-03-03 09:26:37'),(64,'a',63,'a',37.0,415,230,230,'2021-03-03 12:07:32','2021-03-03 12:07:32'),(65,NULL,370,'Iron supplementation',37.0,417,225,225,'2021-03-07 09:19:55','2021-03-07 09:19:55'),(66,NULL,331,'Baclofan 10 mg tablets',37.0,417,225,225,'2021-03-07 09:31:15','2021-03-07 09:31:15'),(67,'emolient',376,'Anti hist.',37.0,420,275,275,'2021-03-10 09:26:30','2021-03-10 09:26:30'),(68,'lazer therapy',377,'q- Switched ENdiagi Lazer bean',37.0,420,275,275,'2021-03-10 09:35:03','2021-03-10 09:35:03'),(69,NULL,380,'Pravotin schets',37.0,422,225,225,'2021-03-14 09:39:54','2021-03-14 09:39:54'),(70,'PCI FOR STENTS',375,'stop bradycardic treatment',37.0,424,307,307,'2021-03-16 10:26:31','2021-03-16 10:26:31'),(71,'THyroid functions\r\nTrans E E\r\nHOLTER MONITORING FOR 48 HOURS\r\nElectric cardioversions',388,'cordarone for 48 hours',37.0,426,329,329,'2021-03-23 10:31:42','2021-03-23 10:31:42'),(72,'CT CHEST',387,'BB',37.0,426,329,329,'2021-03-23 10:42:39','2021-03-23 10:42:39'),(73,'Cardiac & Ped. FollowUP',389,'PrOPRANOLOL',37.0,427,275,275,'2021-03-24 08:55:52','2021-03-24 08:55:52'),(74,'NA BICARBONATE BATH',390,'EMOLIENTS',37.0,427,275,275,'2021-03-24 09:14:39','2021-03-24 09:14:39'),(75,'Metabolic screen\r\nMRI brain\r\nKaryotype',392,'L carnitine',37.0,428,225,225,'2021-03-28 09:26:18','2021-03-28 09:26:18'),(76,'estimation of blood glucose 3times before meals and gradual titration of dose 2-4 units if not controlled',364,'lantus at bed time and act rapid 3times before meals',37.0,429,267,267,'2021-03-28 09:47:14','2021-03-28 09:47:14'),(77,'FOLLOW UP',394,'according to c &s and MSCT KUB',37.0,430,310,310,'2021-03-29 08:17:09','2021-03-29 08:17:09'),(78,'followup ECG',398,'bisoprolol , cordarone, NOAC',37.0,432,257,257,'2021-03-30 10:32:32','2021-03-30 10:32:32'),(79,'foloo]low up',405,'Occlusive C-st. therapy',37.0,437,275,275,'2021-04-07 09:09:23','2021-04-07 09:09:23'),(80,'Biopsy',406,'k. permenganate !L8ooo',37.0,437,275,275,'2021-04-07 09:17:27','2021-04-07 09:17:27'),(81,'follow up',407,'nitronal iv',37.0,440,350,350,'2021-04-11 09:36:12','2021-04-11 09:36:12'),(82,'follw  up',408,'plasma exchang',37.0,440,350,350,'2021-04-11 09:47:22','2021-04-11 09:47:22'),(83,'pcr',412,NULL,37.0,442,352,352,'2021-04-12 08:37:56','2021-04-12 08:37:56'),(84,'FUP  urine output',413,'nutritional improvement',37.0,442,352,352,'2021-04-12 08:49:25','2021-04-12 08:49:25'),(85,'Myocardial biobsy\r\nHomocystine level\r\nLipoprotien a',415,'Rivaroxiba and folic acid',37.0,444,354,354,'2021-04-13 09:32:30','2021-04-13 09:32:30'),(86,'connective tissue diseseases labs and exclude TB',422,'solupred 20  brufen 600',37.0,451,301,301,'2021-04-20 10:46:57','2021-04-20 10:46:57'),(87,NULL,423,'add cordarone 200mg and torsamide 10mg',37.0,451,301,301,'2021-04-20 10:52:16','2021-04-20 10:52:16'),(88,'to exclude pulmonary embolism and anamiae induced ECG changes',424,'metoprolol 50mg',37.0,451,301,301,'2021-04-20 11:02:20','2021-04-20 11:02:20'),(89,'Surgical removal',416,NULL,37.0,453,275,275,'2021-04-21 09:21:47','2021-04-21 09:21:47'),(90,'Follow up',417,'Anti hist.',37.0,453,275,275,'2021-04-21 09:29:34','2021-04-21 09:29:34'),(91,'Tiratam',400,'tiratam',37.0,456,225,225,'2021-04-25 09:52:29','2021-04-25 09:52:29'),(92,NULL,402,NULL,37.0,456,225,225,'2021-04-25 10:14:20','2021-04-25 10:14:20'),(93,'rehabilitation',403,NULL,37.0,456,225,225,'2021-04-25 10:22:24','2021-04-25 10:22:24'),(94,NULL,410,NULL,37.0,456,225,225,'2021-04-25 10:28:00','2021-04-25 10:28:00'),(95,'Genetic counselling',410,'L\'carnitine',37.0,456,225,225,'2021-04-25 10:30:21','2021-04-25 10:30:21'),(96,NULL,403,'social play',37.0,456,225,225,'2021-04-25 10:47:50','2021-04-25 10:47:50'),(97,NULL,420,NULL,37.0,456,225,225,'2021-04-25 10:50:26','2021-04-25 10:50:26'),(98,'Tiratam',420,'Depakine',37.0,456,225,225,'2021-04-25 10:55:57','2021-04-25 10:55:57'),(99,'MRI BRAIN\r\nEEG',427,'Cerebrolysin',37.0,456,225,225,'2021-04-25 11:01:38','2021-04-25 11:01:38'),(100,'Skin Biopsy',431,'Radio Therapy',37.0,459,275,275,'2021-04-28 09:33:09','2021-04-28 09:33:09'),(101,'Follow up',432,'Anti biotics',37.0,459,275,275,'2021-04-28 09:41:04','2021-04-28 09:41:04'),(102,NULL,433,'optihyfresh',37.0,460,346,346,'2021-04-28 10:46:50','2021-04-28 10:46:50'),(103,NULL,434,'hyfresh',37.0,460,346,346,'2021-04-28 10:58:51','2021-04-28 10:58:51'),(104,'cosult hepatology',435,'ibuprofen .steriods',37.0,462,321,321,'2021-05-11 09:43:10','2021-05-11 09:43:10'),(105,'for multislce coronary angio',437,'antiischemic ttt and follow up',37.0,462,321,321,'2021-05-11 10:00:36','2021-05-11 10:00:36'),(106,'coronary ANGIO',439,NULL,37.0,465,307,307,'2021-05-18 10:07:52','2021-05-18 10:07:52'),(107,'Biopsy',440,'Antihist.',37.0,466,275,275,'2021-05-19 09:30:20','2021-05-19 09:30:20'),(108,NULL,441,'Solupred 20  brufen 600',37.0,466,275,275,'2021-05-19 09:38:56','2021-05-19 09:38:56'),(109,'Treat anemia',442,'Levetiracetam if seizure recurred without fever',37.0,467,225,225,'2021-05-23 09:22:17','2021-05-23 09:22:17'),(110,NULL,446,'unictam,cefotax, diflucan,flazol,zithrons',37.0,469,361,361,'2021-05-31 08:28:36','2021-05-31 08:28:36'),(111,NULL,448,'antibiotics',37.0,472,257,257,'2021-06-01 08:36:39','2021-06-01 08:36:39'),(112,'FOLLOW UP OF S. AMMONIA , ABDOMINAL US ,TRANSCRANIAL US',453,NULL,37.0,478,249,249,'2021-06-14 08:50:59','2021-06-14 08:50:59'),(113,'EXCLUDE ALL CAUSES OF SECONDARY HYPERTENSION',454,'EXFORGE HCT 10 AND CARVID 25 MG TWICE DAILY, CARFALONE 25 MG TWICE DAILY. MODURITIC ONCE DAILY',37.0,479,311,311,'2021-06-15 10:56:20','2021-06-15 10:56:20'),(114,NULL,455,'Acitretin',37.0,480,275,275,'2021-06-16 09:48:17','2021-06-16 09:48:17'),(115,'Split smear',456,'Dapsone',37.0,480,275,275,'2021-06-16 09:56:06','2021-06-16 09:56:06'),(116,NULL,458,'DEPAKINE',37.0,482,347,347,'2021-06-20 09:17:08','2021-06-20 09:17:08'),(117,NULL,460,'Psychodal 1mg tablet',37.0,482,225,225,'2021-06-20 09:18:41','2021-06-20 09:18:41'),(118,NULL,460,NULL,37.0,482,225,225,'2021-06-20 09:19:18','2021-06-20 09:19:18'),(119,NULL,461,NULL,37.0,482,225,225,'2021-06-20 09:24:54','2021-06-20 09:24:54'),(120,NULL,459,NULL,37.0,482,225,225,'2021-06-20 09:39:57','2021-06-20 09:39:57'),(121,NULL,458,NULL,37.0,482,225,225,'2021-06-20 09:52:48','2021-06-20 09:52:48'),(122,'Itraconazole Pulse Therapy',466,NULL,37.0,484,275,275,'2021-06-23 10:00:13','2021-06-23 10:00:13'),(123,'Biopsy',465,NULL,37.0,484,275,275,'2021-06-23 10:20:19','2021-06-23 10:20:19'),(124,'تعدبل السلوكبات',469,NULL,37.0,486,225,225,'2021-06-27 08:45:21','2021-06-27 08:45:21'),(125,'Electromyography',470,NULL,37.0,486,225,225,'2021-06-27 09:00:58','2021-06-27 09:00:58'),(126,'follow up CT',471,'antibiotics.antipyretic.oral feeding',37.0,487,338,338,'2021-06-28 08:33:57','2021-06-28 08:33:57'),(127,'Reassurance',464,NULL,37.0,489,354,354,'2021-06-29 10:28:36','2021-06-29 10:28:36'),(128,'BIOPSY',472,'Bleaching creams',37.0,490,275,275,'2021-06-30 10:13:09','2021-06-30 10:13:09'),(129,'fOLLOW UP',473,'FLUCONasole',37.0,490,275,275,'2021-06-30 10:18:35','2021-06-30 10:18:35'),(130,'Follow UP',474,'CRYO',37.0,490,275,275,'2021-06-30 10:22:29','2021-06-30 10:22:29'),(131,'for MSCT CA after troponin',493,NULL,37.0,498,301,301,'2021-07-13 09:41:05','2021-07-13 09:41:05'),(132,'stop ACEI and replace it with CCB',481,'torsamide 20mg   concor 5mg  amlodipine 5mg',37.0,498,301,301,'2021-07-13 09:49:37','2021-07-13 09:49:37'),(133,NULL,379,'Safinace',37.0,502,225,225,'2021-07-25 09:01:37','2021-07-25 09:01:37'),(134,'withdraw depakine',379,NULL,37.0,502,225,225,'2021-07-25 09:04:58','2021-07-25 09:04:58'),(135,'Mental rehabilitation',507,NULL,37.0,506,225,225,'2021-08-01 09:14:00','2021-08-01 09:14:00'),(136,NULL,366,NULL,37.0,508,391,391,'2021-08-01 16:40:51','2021-08-01 16:40:51'),(137,NULL,517,'CLEXANE Aspocid Plavix',37.0,513,325,325,'2021-08-03 09:10:13','2021-08-03 09:10:13'),(138,'Follow up',518,'elidel',37.0,515,275,275,'2021-08-04 09:48:25','2021-08-04 09:48:25'),(139,'Biopsy',519,'C-St.',37.0,515,275,275,'2021-08-04 09:54:57','2021-08-04 09:54:57'),(140,'Exisional Biopsy',521,'Emollient',37.0,515,275,275,'2021-08-04 10:04:46','2021-08-04 10:04:46'),(141,'vitamin D',63,'panadol',37.0,521,522,522,'2021-08-10 11:07:31','2021-08-10 11:07:31'),(142,NULL,527,NULL,37.0,525,311,311,'2021-08-17 10:56:24','2021-08-17 10:56:24'),(143,NULL,528,NULL,37.0,526,275,275,'2021-08-18 10:01:47','2021-08-18 10:01:47'),(144,NULL,529,NULL,37.0,526,275,275,'2021-08-18 10:20:26','2021-08-18 10:20:26'),(145,NULL,536,NULL,37.0,526,275,275,'2021-08-18 10:29:10','2021-08-18 10:29:10'),(146,NULL,537,NULL,37.0,526,275,275,'2021-08-18 10:35:12','2021-08-18 10:35:12'),(147,NULL,538,'glycerin suppository',37.0,528,225,225,'2021-08-22 09:25:03','2021-08-22 09:25:03'),(148,NULL,540,NULL,37.0,530,350,350,'2021-08-22 09:49:53','2021-08-22 09:49:53'),(149,'EEG',539,'Dekadel',37.0,529,225,225,'2021-08-22 09:50:05','2021-08-22 09:50:05'),(150,'torchs screening for the mother and other twin',532,NULL,37.0,531,313,313,'2021-08-23 09:28:35','2021-08-23 09:28:35'),(151,NULL,541,NULL,37.0,532,329,329,'2021-08-24 10:51:46','2021-08-24 10:51:46'),(152,NULL,546,NULL,37.0,535,225,225,'2021-08-29 09:28:28','2021-08-29 09:28:28'),(153,'reassurance',547,NULL,37.0,535,225,225,'2021-08-29 09:37:15','2021-08-29 09:37:15'),(154,'ryle feeding due to recurrent aspiration \r\ngenetic counselling',550,NULL,37.0,536,331,331,'2021-08-30 09:25:11','2021-08-30 09:25:11'),(155,'Follow up',552,NULL,37.0,538,275,275,'2021-09-01 09:52:46','2021-09-01 09:52:46'),(156,NULL,553,NULL,37.0,538,275,275,'2021-09-01 09:57:24','2021-09-01 09:57:24'),(157,NULL,554,NULL,37.0,538,275,275,'2021-09-01 10:02:18','2021-09-01 10:02:18'),(158,NULL,559,NULL,37.0,540,275,275,'2021-09-08 09:59:43','2021-09-08 09:59:43'),(159,NULL,560,NULL,37.0,540,275,275,'2021-09-08 10:24:16','2021-09-08 10:24:16'),(160,'bone marrow aspirate and biopsy - CMV iGM and EPV IGg and IGm',562,NULL,37.0,542,627,627,'2021-09-12 09:40:08','2021-09-12 09:40:08'),(161,'URINE ANALYSIS',566,'IVIG',37.0,544,300,300,'2021-09-13 09:35:46','2021-09-13 09:35:46'),(162,'TCUS\r\nSTOOL ANALYSIS',565,'GOOD ANTIBIOTIC',37.0,544,300,300,'2021-09-13 09:42:47','2021-09-13 09:42:47'),(163,'Chest specialist referral',574,NULL,37.0,546,354,354,'2021-09-14 09:41:50','2021-09-14 09:41:50'),(164,NULL,580,NULL,37.0,548,398,398,'2021-09-14 11:50:30','2021-09-14 11:50:30'),(165,NULL,616,NULL,37.0,724,671,671,'2021-09-20 09:39:22','2021-09-20 09:39:22'),(166,'اعطاء اتمرا اذا لما تتحسن',625,'solumedrol',37.0,723,674,674,'2021-09-20 10:03:32','2021-09-20 10:03:32'),(167,'remdisivir for 10days in pts on MV',626,'solumedrol haprin cefipime tavanic averozolid',37.0,723,674,674,'2021-09-20 10:07:26','2021-09-20 10:07:26'),(168,'2tr',606,'2tr',37.0,2942,339,339,'2021-09-21 10:25:10','2021-09-21 10:25:10'),(169,NULL,646,NULL,37.0,8426,343,343,'2021-09-28 10:16:48','2021-09-28 10:16:48'),(170,'stool analysis\r\nCBC with blood film\r\nFundus examination',655,NULL,37.0,10482,225,225,'2021-10-03 09:33:06','2021-10-03 09:33:06'),(171,'MRI brain',656,'25 mg twice Levetiracetam',37.0,10482,225,225,'2021-10-03 09:45:31','2021-10-03 09:45:31'),(172,NULL,658,NULL,37.0,10482,225,225,'2021-10-03 09:49:51','2021-10-03 09:49:51'),(173,'Diabetic, liver cirrhosis, HCC, Renal impairment complaining of abdominal pain and constipation \r\nThe patient is for upper endoscopy, Symptomatic treatment for the constipation, proper hydration, \r\nAnd for urine analysis, Serum sodium and potassium level\r\nStop oral hypoglycemics and start low dose of insulin',651,'Controloc , laxitaive , antispasmodic',37.0,11525,280,280,'2021-10-03 09:52:12','2021-10-03 09:52:12'),(174,'gene analysis for parent',666,NULL,37.0,14227,777,777,'2021-10-10 08:58:27','2021-10-10 08:58:27'),(175,NULL,708,'/zyrtec/predesol fort',37.0,15695,366,366,'2021-10-13 10:12:43','2021-10-13 10:12:43'),(176,NULL,710,'Betafos ampoule / Minoxidil forte gel / Borgasone ointment',37.0,15695,366,366,'2021-10-13 10:44:46','2021-10-13 10:44:46'),(177,NULL,692,NULL,37.0,15836,793,793,'2021-10-13 11:24:52','2021-10-13 11:24:52'),(178,NULL,716,NULL,37.0,15983,793,793,'2021-10-13 11:42:27','2021-10-13 11:42:27'),(179,'male patient 61 year old presenting with Disturbed conscious level, fever, Acute kidney injury, discovered to have multilobular hepatic focal lesion ? liver abcess and basal lesions in the right lung, the patient is for CT chest, to know the nature of the focal lesions ?hydatid? and for Aspiration of the focal lesion of the liver for chemistry, cytology, pathology after exclusion of hydatid disease\r\nExclude chronic kidney disease, for total calcium, phosphorus, uric acid \r\ncontinue on IV antibiotics, fluids',722,'Fluids, antibiotics, prophylactic anticoagulants',37.0,16571,280,280,'2021-10-17 10:47:10','2021-10-17 10:47:10'),(180,NULL,717,NULL,37.0,16960,755,755,'2021-10-18 09:25:31','2021-10-18 09:25:31'),(181,'CBC',731,NULL,37.0,17304,816,816,'2021-10-19 09:58:25','2021-10-19 09:58:25'),(182,NULL,366,NULL,37.0,17743,339,339,'2021-10-19 15:35:07','2021-10-19 15:35:07'),(183,'Avoid sun & follow up',742,'Cutivate & moist one creams & Sunscreen',37.0,18470,341,341,'2021-10-20 10:34:24','2021-10-20 10:34:24'),(184,'Skin biopsy',743,NULL,37.0,18470,341,341,'2021-10-20 10:46:36','2021-10-20 10:46:36'),(185,'continue on already started medications',762,'continue on already started medications',37.0,20867,342,342,'2021-10-25 09:30:59','2021-10-25 09:30:59'),(186,NULL,768,NULL,37.0,22146,140,140,'2021-10-27 10:28:46','2021-10-27 10:28:46'),(187,'after 2 weeks follow up for skin biopsy',768,'Terbibafen 250 mg daily plus diflucan 300 mg per week for 3 wks',37.0,22146,140,140,'2021-10-27 10:31:19','2021-10-27 10:31:19'),(188,'after 2 weeks follow up for skin biopsy',768,'Terbibafen 250 mg daily plus diflucan 300 mg per week for 3 wks',37.0,22146,140,140,'2021-10-27 10:32:44','2021-10-27 10:32:44'),(189,'proper history taking and good photography',769,'Emolients',37.0,22146,140,140,'2021-10-27 10:38:15','2021-10-27 10:38:15'),(190,'ESR\r\nECHO TO EXCLUDE ph',816,'Erythropoitin',37.0,25822,864,864,'2021-11-07 09:40:13','2021-11-07 09:40:13'),(191,'diavobet 1x1 carbamide 1x1 vaseline 1x2 kerella 1x1 nizapex shampoo',819,'diavobet , carbamide , vaselinm xamiol gel , polytar and nizapex v-drop',37.0,26335,318,318,'2021-11-08 08:41:15','2021-11-08 08:41:15'),(192,'repeated application of moisturizers under occlusion',807,'zinc oxide',37.0,26989,363,363,'2021-11-10 09:05:47','2021-11-10 09:05:47'),(193,'autoimmune profile & skin biopsy',826,NULL,37.0,27139,363,363,'2021-11-10 09:49:11','2021-11-10 09:49:11'),(194,NULL,827,'prednisolone 40mg',37.0,27139,363,363,'2021-11-10 10:05:41','2021-11-10 10:05:41'),(195,'follow up of routine labs FBS & BP',827,'prednisolone 40mg',37.0,27139,363,363,'2021-11-10 10:08:33','2021-11-10 10:08:33'),(196,'stabilize the patient and treat sepsis then start to withdraw solucortef  to 15 mg/m2/day\r\nadd  Astonin H 0.025\r\nDo Abdominal sonar and Acth level \r\nfolow up adrenal precoursors after withdrawal of solucortef',785,'hydrocortisone and fludrocortisone',37.0,28168,876,876,'2021-11-14 08:54:28','2021-11-14 08:54:28'),(197,'to inrease feeding regulary and wean nasal o2',847,'neblizures and antibiotics',37.0,28168,888,888,'2021-11-16 11:25:14','2021-11-16 11:25:14'),(198,'to do cultures and chnage antibiotics , urgent echo ,to reconsult neonotogist and genteics',854,NULL,37.0,28168,888,888,'2021-11-16 11:27:50','2021-11-16 11:27:50'),(199,NULL,864,'cutivate cream',37.0,29364,755,755,'2021-11-17 10:36:46','2021-11-17 10:36:46'),(200,'hiotacid 300 cap كبسولة قبل الفطار وقبل العشاء \r\nمتابعة قياس الضغط والعرض علي طبيبب الباطنة العامة',863,'tryptazole 10 mg قرص مساء',37.0,29648,872,872,'2021-11-17 10:47:45','2021-11-17 10:47:45'),(201,'مرتين في اليوم',865,'kenalogue in orabase gel- cutivate cream',37.0,29364,755,755,'2021-11-17 10:48:46','2021-11-17 10:48:46'),(202,'skin biopsy',864,NULL,37.0,29364,755,755,'2021-11-17 10:55:42','2021-11-17 10:55:42'),(203,'Diet and physical activity',875,'Diet',37.0,30675,225,225,'2021-11-21 10:17:59','2021-11-21 10:17:59'),(204,NULL,882,'bobai sunblock, clindasol lotion, lit up cream, glycerin soap',37.0,30883,895,895,'2021-11-22 11:08:41','2021-11-22 11:08:41'),(205,'biopsy',883,'symtomatic ttt',37.0,31273,140,140,'2021-11-24 10:07:24','2021-11-24 10:07:24'),(206,'biopsy and good history',884,'symptomatic ttt',37.0,31273,140,140,'2021-11-24 10:13:29','2021-11-24 10:13:29'),(207,NULL,907,'25 mg قرص بعد الغداْ لمدة شهر Dantrelax',37.0,32007,901,901,'2021-11-28 09:26:30','2021-11-28 09:26:30'),(208,'Mobitil 15mg once during lunch\r\nCymbatex 30 mg /Duloxiprine 30 mg once after dinner \r\nMaloox syrup 3spoons during the day \r\nVoltaren gel 3 times daily',907,'25 mg قرص بعد الغداْ لمدة شهر Dantrelax',37.0,32007,901,901,'2021-11-28 09:29:52','2021-11-28 09:29:52'),(209,'For skin biopsy and full drug history. Exclude history of viral infections. Ecclude arthritis, eye problems, history of erythema nodosum, history of chest problems (to exclude sarcoidosis)',908,'Till skin biopsy appears: only emollients and antihistamines if there is itching.',37.0,32498,852,852,'2021-11-29 09:47:36','2021-11-29 09:47:36'),(210,'Bthalassemia major in need of spleenectomy',805,NULL,37.0,32596,316,316,'2021-11-29 09:58:43','2021-11-29 09:58:43'),(211,'TILL BIOPSY RESULT',925,'ANTIHISTAMINICS PLUS EMOLIENTS',37.0,32892,364,364,'2021-12-01 10:37:23','2021-12-01 10:37:23'),(212,'biopsy',927,NULL,37.0,32892,364,364,'2021-12-01 10:45:44','2021-12-01 10:45:44'),(213,NULL,879,'prostride 5 mg tab',37.0,33640,910,910,'2021-12-05 09:22:02','2021-12-05 09:22:02'),(214,'close follow up',947,'ttt of psoriasis',37.0,34376,140,140,'2021-12-08 10:32:30','2021-12-08 10:32:30'),(215,'give treatment and follow up',948,'topical steroids, antihistamines, mini pulse steroids, gap[ten',37.0,34376,140,140,'2021-12-08 10:39:48','2021-12-08 10:39:48'),(216,'follow up better photography and history',953,'topical steroids plus topical tarolimus',37.0,34524,140,140,'2021-12-08 10:51:00','2021-12-08 10:51:00'),(217,'needs better photography and dermoscopy',952,NULL,37.0,34524,140,140,'2021-12-08 10:55:19','2021-12-08 10:55:19'),(218,'give ttt and follow up',950,'topical timolol plus indral 0.5 mg per kg after cardiology consultation plus pulsed dye laser',37.0,34524,140,140,'2021-12-08 10:57:27','2021-12-08 10:57:27'),(219,'history taking and good photograophy',955,NULL,37.0,34524,140,140,'2021-12-08 11:07:39','2021-12-08 11:07:39'),(220,'avoid humidity',956,'pulse steroids , lamisil',37.0,34671,140,140,'2021-12-08 11:30:20','2021-12-08 11:30:20'),(221,NULL,658,'Psychodal SOLUTION',37.0,35404,225,225,'2021-12-12 09:11:18','2021-12-12 09:11:18'),(222,NULL,959,'tiratam 2 cc every 12 hours for 2 years',37.0,35404,225,225,'2021-12-12 09:29:48','2021-12-12 09:29:48'),(223,'reconsult after consultation of the pediatric surgery department',976,NULL,37.0,36732,284,284,'2021-12-16 09:57:09','2021-12-16 09:57:09'),(224,'cow milk protein restriction and gradual re-introduction',977,NULL,37.0,36732,284,284,'2021-12-16 09:59:24','2021-12-16 09:59:24'),(225,NULL,984,'Levetiracetam',37.0,36737,225,225,'2021-12-19 08:51:07','2021-12-19 08:51:07'),(226,'check Pt, PTT\r\nduplex on LL\r\ncheck s. albumin \r\nTORCH SCREENING',987,NULL,37.0,37616,316,316,'2021-12-20 09:44:03','2021-12-20 09:44:03'),(227,'check Pt, PTT duplex on LL check s. albumin TORCH SCREENING',987,NULL,37.0,37616,316,316,'2021-12-20 09:46:15','2021-12-20 09:46:15'),(228,NULL,1003,'gastrazol 1x2',37.0,37620,913,913,'2021-12-21 09:17:11','2021-12-21 09:17:11'),(229,'الابتعاد عن الماكولات الحمضية و التوابل و الشاي و القهوة الاكثار من شرب الماء و الخضار',1004,'clarithromycine 500 mg 1x2 for 5 days then flagyle 500 mg 1x2 foe one week + pantazol 40 mg 1x2 for one month - dysflatyle 1x2 -duphlac 1x3',37.0,37620,913,913,'2021-12-21 10:30:01','2021-12-21 10:30:01'),(230,'stop any cosmetics',1001,'hydrocortisone emollients',37.0,37768,363,363,'2021-12-22 09:54:53','2021-12-22 09:54:53'),(231,'avoid soap and detergents',1002,'emollients',37.0,37768,363,363,'2021-12-22 10:11:13','2021-12-22 10:11:13'),(232,'Treatment of hypersensitivity and allergy and consider behavioral therapy for psychic cough',1011,NULL,37.0,38355,284,284,'2021-12-23 11:18:11','2021-12-23 11:18:11'),(233,'Behavioral therapy, cerebrolysin and antipsychotic',1014,NULL,37.0,38355,284,284,'2021-12-23 11:19:19','2021-12-23 11:19:19'),(234,'Reconsult diabetic clinic and get back to the patient',1013,NULL,37.0,38355,284,284,'2021-12-23 11:20:27','2021-12-23 11:20:27'),(235,'MRI brain , extended metabolic screen',1015,'Senemet 250 mg half tablet',37.0,38650,225,225,'2021-12-26 09:47:14','2021-12-26 09:47:14'),(236,'Whole exome sequencing',1016,'Senemet 250 mg half tablet',37.0,38650,225,225,'2021-12-26 09:54:53','2021-12-26 09:54:53'),(237,'MRI brain',850,'Psychodal solution',37.0,39236,225,225,'2021-12-26 10:10:37','2021-12-26 10:10:37'),(238,'exclude trichitiliomania by psychiatrist, start intralesional steroid injection once every month, taper systemic steroids',982,'psychiatry to exclude trichitillomaniataper systemic steroids, start intralesional steroid injection once every month (dilute 1:8), continue topical minoxidil, refer to',37.0,39586,852,852,'2021-12-27 08:46:45','2021-12-27 08:46:45'),(239,'systemic vibramycin and topical adapelene gel',983,'vibramycin 100 mg twice a day for 3 weeks then once a day for 2 months. Topical adapalene gel: 2 hurs at night only then rinse with water',37.0,39586,852,852,'2021-12-27 08:49:51','2021-12-27 08:49:51'),(240,'systemic vibramycin capsules and topical adapelene gel',1024,'vibramycin 100 mg twice a day for 3 weeks then once a day for 2 months. Topical adapalene gel: 2 hurs at night only then rinse with water',37.0,39586,852,852,'2021-12-27 08:51:10','2021-12-27 08:51:10'),(241,'systemic vibramycin and topical adapalene gel',1025,'vibramycin 100 mg twice a day for 3 weeks then once a day for 2 months. Topical adapalene gel: 2 hurs at night only then rinse with water',37.0,39586,852,852,'2021-12-27 08:56:26','2021-12-27 08:56:26'),(242,'She needs a skin biopsy before starting systemic treatment. DD:  neurodermatitis (eczema), MF, psoriasis',983,'borgasone cream twice a day, vaseline ointment twice a day, allarge tablet twice a day',37.0,39586,852,852,'2021-12-27 08:58:22','2021-12-27 08:58:22'),(243,'systemic vibramycin and topical adapalene gel. If no response after 3 months: consider isotretinoin therapy after performing liver functions and serum lipids before treatment and every month of treatment',1026,'vibramycin 100 mg twice a day for 3 weeks then once a day for 2 months. Topical adapalene gel: 2 hurs at night only then rinse with water',37.0,39586,852,852,'2021-12-27 09:01:02','2021-12-27 09:01:02'),(244,'extended metabolic screen',1021,NULL,37.0,39675,327,327,'2021-12-27 10:13:45','2021-12-27 10:13:45'),(245,NULL,1021,NULL,37.0,39675,327,327,'2021-12-27 10:17:43','2021-12-27 10:17:43'),(246,'serum electrolytes renal and liver function tests growth hormone with clonidine test 17 oh progesterone',1029,NULL,37.0,39822,327,327,'2021-12-27 10:31:11','2021-12-27 10:31:11'),(247,'serum electrolytes renal and liver function tests growth hormone with clonidine test 17 oh progesterone',1029,NULL,37.0,39822,327,327,'2021-12-27 10:33:11','2021-12-27 10:33:11'),(248,'move easy 5 mg tab                                      قرص كل يوم قبل النوم                       \r\narcoxia 90 mg tab                                          قرص كل يوم بعد الفطار\r\nswivica sach     كيس فوار كل يوم بعد الغدا\r\nfrost spray سبراي 3 مرات \r\nd-troll cap                  قرص كل يوم و تبدأ به بعد سحب التحاليل الاتية \r\nserum vit D \r\nserum calcium free and ionized \r\n\r\nمطلوب أشعة عادية علي الفقرات العنقية أخ و جانبي \r\nأشعة عادية علي الكتف الأيم أخ',1035,'arcoxia 90 tab',37.0,39972,941,941,'2021-12-28 08:58:05','2021-12-28 08:58:05'),(249,'anticox II amp\r\nحقنة كل يوم لمدة أسبوع\r\ndantrelax combound tab\r\nقرص قبل النوم\r\nneuroton amp\r\nحقنة كل 3 أيام \r\nمطلوب \r\nx ray lumbosacral spine ap, lat, flexion and extension views\r\nMRI cervical spine',1037,NULL,37.0,39972,941,941,'2021-12-28 09:14:39','2021-12-28 09:14:39'),(250,'ABG\r\nserum electrolytes : Na , K , Ph\r\nCBC\r\npelvi-abdominal US\r\nmonitor BP, HR , UOP',1043,NULL,37.0,40124,945,945,'2021-12-28 12:15:02','2021-12-28 12:15:02'),(251,NULL,1049,'topical and systemic antifungal',37.0,40271,364,364,'2021-12-29 10:45:19','2021-12-29 10:45:19'),(252,'follow up echo, and serum electrolytes',1082,'on lasix and capoten',37.0,41177,227,227,'2022-01-03 07:48:26','2022-01-03 07:48:26'),(253,NULL,1085,'Fastel 180 tab قرص مساء',37.0,41180,712,712,'2022-01-03 09:23:13','2022-01-03 09:23:13'),(254,'panthenol cream دهان ثلاث مرات يوميا\r\nCalcipoheal cort oint دهان مرتين يوميا\r\nSelenium ACE tab قرص بعد الغداء',1085,'Fastel 180 tab قرص مساء',37.0,41180,712,712,'2022-01-03 09:25:46','2022-01-03 09:25:46'),(255,'Mondo cream دهان ثلاث مرات يوميا\r\nGlycerin soap صابونة للاستحمام',1087,'Trecziums oint دهان مساء',37.0,41180,712,712,'2022-01-03 09:36:55','2022-01-03 09:36:55'),(256,'Dermatin cream دهان مرتين يوميا\r\nCorino shampoo يوم بعد يوم ويترك على الجسم 10 دقائق',1086,'Flucoral 150 mg 2 ك بعد الغداء تكرر بعد اسبوعين',37.0,41180,712,712,'2022-01-03 09:43:15','2022-01-03 09:43:15'),(257,'Isoromyderm gel  دهان مساء خمس دقائق ويشطف ويزداد كل يوم خمس دقائق\r\nNatry soap  صابونة للوجه غسول صباحا',1084,'Doxy 100 mg cap ك بعد الغداء يوميا',37.0,41180,712,712,'2022-01-03 09:48:30','2022-01-03 09:48:30'),(258,'Closol spray بخاخة مرتين يوميا\r\nNizapex shampoo يوم بعد يوم ويترك على الشعر 5 دقائق',1088,'Ultragriseofulvin 125 mg 3 اقراص على نصف  كوب عصير  او لبن يوميا لمدة شهر',37.0,41181,731,731,'2022-01-03 10:06:07','2022-01-03 10:06:07'),(259,'DERMATOLOGICAL CONSULTATION\r\nCBC\r\nESR\r\nPSYCHTHERAPY',982,NULL,37.0,41183,816,816,'2022-01-04 08:50:34','2022-01-04 08:50:34'),(260,NULL,982,NULL,37.0,41183,816,816,'2022-01-04 08:51:31','2022-01-04 08:51:31'),(261,'BEHAVIOUR THERAPY\r\nNURSERY',1093,NULL,37.0,41183,816,816,'2022-01-04 08:54:41','2022-01-04 08:54:41'),(262,NULL,1093,'ADHDAND SLEEPING DISORDERS',37.0,41183,816,816,'2022-01-04 08:55:27','2022-01-04 08:55:27'),(263,'Tiratam 1cc every 12 hr',1132,NULL,37.0,41783,225,225,'2022-01-09 09:02:38','2022-01-09 09:02:38'),(264,'Behavioral therapy',1134,NULL,37.0,41783,225,225,'2022-01-09 09:13:38','2022-01-09 09:13:38'),(265,'Modesta hair oil زيت مرتين اسبوعيا\r\nScalogen hair lotionيوم بعد يوم\r\nاN hair black again يوميا',1146,'Pantogar cap ك بعد الغداء يوميا',37.0,42674,731,731,'2022-01-10 08:25:41','2022-01-10 08:25:41'),(266,'دهان خمس دقائق مساء ويشطف ويذداد كل يوم خمس دقائقIsoromyderm gel \r\nNatry soap  صابونه للوجه صباحا',1147,'Vibramycin 100 cap  كل بعد الغداء يوميا',37.0,42674,731,731,'2022-01-10 08:30:14','2022-01-10 08:30:14'),(267,'Calcipoheal oint  دهان مرتين يوميا \r\nMondo cream دهان ثلاث مرات يويما\r\n\r\nTrecziums oint دهان للطفل مرتين يوميا',1144,'Bioforce cream  دهان ثلاث مرات يوميا',37.0,42674,731,731,'2022-01-10 08:39:17','2022-01-10 08:39:17'),(268,NULL,1193,NULL,37.0,44601,327,327,'2022-01-17 09:55:15','2022-01-17 09:55:15'),(269,'kl,o,lop./[;////',593,NULL,37.0,47684,339,339,'2022-01-23 13:30:14','2022-01-23 13:30:14'),(270,NULL,1245,'tiratam',37.0,47987,225,225,'2022-01-24 12:43:07','2022-01-24 12:43:07'),(271,'amylase and lipase today and reconsult.',1244,NULL,37.0,48578,1028,1028,'2022-01-26 09:55:29','2022-01-26 09:55:29'),(272,NULL,1244,NULL,37.0,48578,1028,1028,'2022-01-26 09:56:06','2022-01-26 09:56:06'),(273,NULL,1256,NULL,37.0,49460,316,316,'2022-01-31 09:15:55','2022-01-31 09:15:55'),(274,'apexidone drops 3 drops once at night\r\n\r\nrequest\r\nserum ammonia\r\nlactate\r\nextended metabolic screen by tandem mass spectrometry\r\nurine organic acids\r\nMRI brain',1255,'atomorelax syrup 2.5 ml once daily',37.0,49607,981,981,'2022-01-31 10:33:35','2022-01-31 10:33:35'),(275,'biopsy and histopathological assessment',1266,'biopsy and histopathological assessment',37.0,49900,364,364,'2022-02-02 10:50:19','2022-02-02 10:50:19'),(276,'glycerine soap cotton wear no irritation',1265,'topical steroid antihistaminic emolients',37.0,49900,364,364,'2022-02-02 10:59:13','2022-02-02 10:59:13'),(277,'cotton wear glycerine soap',1097,'topicaln steroids antihistaminics emolients',37.0,49900,364,364,'2022-02-02 11:04:37','2022-02-02 11:04:37'),(278,NULL,1289,'Levetiracetam',37.0,50636,225,225,'2022-02-06 08:59:43','2022-02-06 08:59:43'),(279,'Whole exome sequencing\r\nGenetic counseling, occupational therapy  and physiotherapy',1296,'Biotine capsules 2 three time daily',37.0,50636,225,225,'2022-02-06 09:41:07','2022-02-06 09:41:07'),(280,'Behavioral therapy',1294,'Motinorm and antihistamine and analgesic',37.0,51076,225,225,'2022-02-06 10:17:49','2022-02-06 10:17:49'),(281,'neonatal hypoglycemia (spontaneous regression)',1233,NULL,37.0,51080,327,327,'2022-02-07 09:34:06','2022-02-07 09:34:06'),(282,'solupred 60 mg/day only 2 days every week (thursday and fridy)\r\ndiprosalic ointment cream under cover for hypertrophic lesions every night',1304,'solupred 20 , diprosalic cream, evastine tabs',37.0,51079,881,881,'2022-02-07 09:56:20','2022-02-07 09:56:20'),(283,'after consultation of internal medicine and nephrologist',1234,'gaptin, thiotacid',37.0,51079,881,881,'2022-02-07 09:59:56','2022-02-07 09:59:56'),(284,NULL,1301,'diprosalic cream, polytar shampoo',37.0,51079,881,881,'2022-02-07 10:03:06','2022-02-07 10:03:06'),(285,'borgasone  (at night)\r\nezalline (8 am with sun exposure 30 min)\r\nvitamins (twice daily)\r\n\r\ntry to do narrow band sessions for hands and feet 3 times every week',1305,'borgasone cream, ezalline paint, octatron caps, antox tabs',37.0,51079,881,881,'2022-02-07 10:08:24','2022-02-07 10:08:24'),(286,NULL,1303,'vitix gel or vitiskin (twice daily)',37.0,51079,881,881,'2022-02-07 10:13:16','2022-02-07 10:13:16'),(287,'if spreading lesio, add:  solupred 20 mg 3 tabs after meal (thursday and friday only) as oral pulse to stop activity',1303,'vitix gel twice daily, elidel cream once at night, octatron caps twice daily',37.0,51079,881,881,'2022-02-07 10:15:33','2022-02-07 10:15:33'),(288,NULL,593,'sada',37.0,51378,339,339,'2022-02-07 12:24:26','2022-02-07 12:24:26'),(289,'مراعاة متابعة الدوالي',1319,'venotonics daflon',37.0,51823,363,363,'2022-02-09 10:25:24','2022-02-09 10:25:24'),(290,NULL,1320,NULL,37.0,51823,363,363,'2022-02-09 10:42:10','2022-02-09 10:42:10'),(291,'use emollients regularly',1320,'zinc oxide',37.0,51823,363,363,'2022-02-09 10:44:22','2022-02-09 10:44:22'),(292,NULL,1327,'investigate',37.0,51823,363,363,'2022-02-09 11:04:00','2022-02-09 11:04:00'),(293,'CBC with differential, LFT, KFT, Fasting and postprandial blood sugar, urine and stool analysis',1344,'Ectomethrin 5% and antihitamine and emollients',37.0,53154,1056,1056,'2022-02-16 10:41:14','2022-02-16 10:41:14'),(294,'Skin biopsies from 2 different sites',1345,NULL,37.0,53154,1056,1056,'2022-02-16 10:46:59','2022-02-16 10:46:59'),(295,'Skin biopsy and ANA and antidsDNA assessment',1346,'Topical steroid',37.0,53154,1056,1056,'2022-02-16 10:51:54','2022-02-16 10:51:54'),(296,'MRI brain epilepsy work up',1290,'Levetiracetam 500 tablet half tablet twice',37.0,54185,225,225,'2022-02-20 09:14:55','2022-02-20 09:14:55'),(297,'Continue anticoagulation as epistaxis ceased',1354,NULL,37.0,54180,1077,1077,'2022-02-20 09:17:01','2022-02-20 09:17:01'),(298,NULL,1337,NULL,37.0,54627,327,327,'2022-02-21 09:22:11','2022-02-21 09:22:11'),(299,'cycloplegica Ed 3times daily\r\ncornitears or corner gel 5 times daily',1413,'vigamox Ed 5 times daily',37.0,56841,777,777,'2022-02-27 09:59:42','2022-02-27 09:59:42'),(300,'maintain circulation through fluids and inotropes guided by CVP, cardiac shadow and chest condition\r\nif indicated resort to peritoneal dialysis',1416,NULL,37.0,56990,316,316,'2022-02-28 08:38:06','2022-02-28 08:38:06'),(301,NULL,1416,NULL,37.0,56990,316,316,'2022-02-28 08:39:11','2022-02-28 08:39:11'),(302,'FOLLOW UP us \r\nANTIBIOTIC ADJUSTMENT \r\nBLADDER IRRIGATION \r\nURINE CULTURE',1435,'CONSERVATIVE',37.0,58319,1101,1101,'2022-03-01 11:49:36','2022-03-01 11:49:36'),(303,'stop rubbing treat eyelid eczema',1444,'hydrocortisone emollients',37.0,58466,363,363,'2022-03-02 08:59:05','2022-03-02 08:59:05'),(304,'laser hair removal if possible',1447,'keratolytics',37.0,58466,363,363,'2022-03-02 09:15:45','2022-03-02 09:15:45'),(305,NULL,1448,'co2 laser',37.0,58466,363,363,'2022-03-02 09:24:54','2022-03-02 09:24:54'),(306,'MRI brain epilepsy protocol',1462,'Levetiracetam 3 cc every twelve hours',37.0,59349,225,225,'2022-03-06 08:44:59','2022-03-06 08:44:59'),(307,'MRI EPILEPSY PROTOCOL',1462,'Levetiracetam',37.0,59349,225,225,'2022-03-06 08:45:56','2022-03-06 08:45:56'),(308,'MRI  brain, MRA BRAIN and neck arteries.            Blood lactate and pyruvate',1460,NULL,37.0,59349,225,225,'2022-03-06 08:55:26','2022-03-06 08:55:26'),(309,'stop Pepsi',1461,NULL,37.0,59349,225,225,'2022-03-06 09:03:27','2022-03-06 09:03:27'),(310,'Holter ECG',1469,NULL,37.0,59349,225,225,'2022-03-06 09:21:09','2022-03-06 09:21:09'),(311,'MRI brain                                                                                   CBC, Reticulocytic count, serum ferritin.                               TSH and T3, antithyroid antibodies',1464,'Cerebrolysin 1ml per week',37.0,59350,225,225,'2022-03-06 09:36:27','2022-03-06 09:36:27'),(312,'Neurosurgical consultation',1403,NULL,37.0,59350,225,225,'2022-03-06 09:43:56','2022-03-06 09:43:56'),(313,'Blood lactate and pyruvate                                            Extended metabolic screen',1457,'Neurimax capsules once daily                                                                                            Sycocetam',37.0,59350,225,225,'2022-03-06 09:59:26','2022-03-06 09:59:26'),(314,'Exclude slit ventricle syndrome                                   Neurosurgical consultation',1463,NULL,37.0,59352,225,225,'2022-03-06 10:17:36','2022-03-06 10:17:36'),(315,'IQ assessment        \r\n  MRI BRAIN                   Extended metabolic screen                                           \r\n  Whole exome sequencing',1465,NULL,37.0,59352,225,225,'2022-03-06 10:26:35','2022-03-06 10:26:35'),(316,'follow up cbc and renal function and introduction of enteral feeding or partial tpn if possible.',1473,NULL,37.0,59649,327,327,'2022-03-07 10:14:23','2022-03-07 10:14:23'),(317,NULL,1473,'neonate with viral bronchopneumonia and tubular dysfunction',37.0,59649,327,327,'2022-03-07 10:14:49','2022-03-07 10:14:49'),(318,NULL,1478,'Abilify 5mg tablets',37.0,60096,261,261,'2022-03-08 09:47:12','2022-03-08 09:47:12'),(319,'Atomox apex 25mg كبسوله بعد الغداء الساعه 3 م\r\nAbilify 5mg قرص الساعه 8 مساء \r\nمتابعه بعد اسبوعين',1478,NULL,37.0,60096,261,261,'2022-03-08 10:02:15','2022-03-08 10:02:15'),(320,'Abilify 5mg tablets قرص قبل النوم الساعه 8 م \r\nAtomoxapex 25mg كبسوله كل 12 ساعه الساعه واحده صباحا و مساء\r\nQuitapin 25mg نصف قرص كل 12 ساعه الساعه 6 صباح و مساء',1479,NULL,37.0,60096,261,261,'2022-03-08 10:06:36','2022-03-08 10:06:36'),(321,NULL,1479,NULL,37.0,60096,261,261,'2022-03-08 10:07:32','2022-03-08 10:07:32'),(322,NULL,1506,NULL,37.0,61127,284,284,'2022-03-10 10:29:24','2022-03-10 10:29:24'),(323,'cerebrolysin ampoule and follow up',1508,NULL,37.0,61127,284,284,'2022-03-10 10:32:40','2022-03-10 10:32:40'),(324,NULL,1508,NULL,37.0,61127,284,284,'2022-03-10 10:32:58','2022-03-10 10:32:58'),(325,'Omega three oral and metformin and follow up',1507,NULL,37.0,61127,284,284,'2022-03-10 10:44:05','2022-03-10 10:44:05'),(326,NULL,1507,NULL,37.0,61127,284,284,'2022-03-10 10:44:46','2022-03-10 10:44:46'),(327,'follow up of blood glucose, assay serum insulin and c peptide fasting levels\r\nfollow up with cardiology for HOCM',1512,NULL,37.0,61569,227,227,'2022-03-14 07:34:33','2022-03-14 07:34:33'),(328,NULL,1512,NULL,37.0,61569,227,227,'2022-03-14 07:34:47','2022-03-14 07:34:47'),(329,'Salibet oint دهان مساءا\r\nRevi 25 cream دهان مرتين يوميا',1532,'Fastel 180 tab قرص مساء صباحا',37.0,62746,712,712,'2022-03-16 09:42:32','2022-03-16 09:42:32'),(330,'carbamide oint \r\nfusidin oint\r\nتخلط وتدهن صباحا ومساء',1533,'Dermovate oint',37.0,62746,712,712,'2022-03-16 09:45:32','2022-03-16 09:45:32'),(331,'Clavimox 1 g tab قرص كل 12 ساعة لمدة 10 ايام بعد الحقن\r\nk-PERMANGANT 1/8000 مسة ثلاثة مرات يوميا\r\nFusidin cream دهان بعد المسة ثلاث مرات يوميا',1534,'Cefotax 1 g حقنة عضل كل 12 ساعة لمدة ثلاثة ايام',37.0,62746,712,712,'2022-03-16 09:49:01','2022-03-16 09:49:01'),(332,'Change feeding habits and behavioral therapy',1544,NULL,37.0,62752,225,225,'2022-03-20 09:34:57','2022-03-20 09:34:57'),(333,'Change feeding habits and behavioral therapy',1544,NULL,37.0,62752,225,225,'2022-03-20 09:35:00','2022-03-20 09:35:00'),(334,'cardiothoracic surgery consultation\r\nneurosurgical consultation',1556,'clexane',37.0,62905,1057,1057,'2022-03-21 09:23:34','2022-03-21 09:23:34'),(335,NULL,1556,'follow up - CT brain',37.0,63347,1085,1085,'2022-03-23 08:07:27','2022-03-23 08:07:27'),(336,'ear wash',1572,'remowax E.D',37.0,63497,1009,1009,'2022-03-26 09:56:11','2022-03-26 09:56:11'),(337,NULL,1573,'remowax E.D',37.0,63497,1009,1009,'2022-03-26 09:56:38','2022-03-26 09:56:38'),(338,NULL,606,NULL,37.0,63940,339,339,'2022-03-27 10:13:36','2022-03-27 10:13:36'),(339,'العلاج لمدة شهر',1577,'zincosil cream   صباحا وظهرا قبل التعرض للشمس- tarolimus   oint. دهان مساء -panthenol cream   صباحا ومساء',37.0,63939,712,712,'2022-03-27 10:32:05','2022-03-27 10:32:05'),(340,'العلاج لمدة شهر',1577,'zincosil cream   صباحا وظهرا قبل التعرض للشمس- tarolimus   oint. دهان مساء -panthenol cream   صباحا ومساء',37.0,63939,712,712,'2022-03-27 10:33:20','2022-03-27 10:33:20'),(341,NULL,1578,'panthenol   cream مرتين يوميا لمدة 3 اسابيع - glycerine soap صباحا ومساء- texacort creamمساء لمدة اسبوع',37.0,63939,712,712,'2022-03-27 10:36:21','2022-03-27 10:36:21'),(342,NULL,1580,'zincosil   cream قبل التعرض للشمس او الحرارة -levoctivene tabق مساء قبل النوم',37.0,63939,712,712,'2022-03-27 10:46:29','2022-03-27 10:46:29'),(343,'العلاج لمدة اسبوع',1582,'curicef 500mg sus.3cmكل 12 ساعة - k permengnate 1/8000 paint ماسة 3 مرات يوميا -ficidin cream 3 مرات دهان بعد الماسة',37.0,63939,712,712,'2022-03-27 10:55:16','2022-03-27 10:55:16'),(344,'follow up ammonia and extended metabolic screen and torchinfection',1538,NULL,37.0,64087,327,327,'2022-03-28 09:49:40','2022-03-28 09:49:40'),(345,NULL,1538,NULL,37.0,64087,327,327,'2022-03-28 09:50:03','2022-03-28 09:50:03'),(346,'biopsy to confirm diagnosis\r\nCBC every 6 months',1595,'none',37.0,64241,1161,1161,'2022-03-30 10:19:30','2022-03-30 10:19:30'),(347,'follow up after one month of treatment',1591,'betadrem cream',37.0,64241,1161,1161,'2022-03-30 10:23:19','2022-03-30 10:23:19'),(348,'avoid nail trauma, avoid tight shoes',1594,NULL,37.0,64241,1161,1161,'2022-03-30 10:32:35','2022-03-30 10:32:35'),(349,'skin biopsy',1593,NULL,37.0,64241,1161,1161,'2022-03-30 10:38:53','2022-03-30 10:38:53'),(350,NULL,1603,'Carnitol solution',37.0,64536,225,225,'2022-04-03 09:02:44','2022-04-03 09:02:44'),(351,'Physiotherapy',1603,'Lcarnitine , vitamin D',37.0,64536,225,225,'2022-04-03 09:14:10','2022-04-03 09:14:10'),(352,'MRI brain                                                                                                                            EEG',1602,'Measures to decrease temperature             Levetiracetam                                                           Lev',37.0,64536,225,225,'2022-04-03 09:23:23','2022-04-03 09:23:23'),(353,NULL,1602,'Levetiracetam  if seizure become afebrile',37.0,64536,225,225,'2022-04-03 09:25:01','2022-04-03 09:25:01'),(354,NULL,1601,NULL,37.0,64536,225,225,'2022-04-03 09:41:22','2022-04-03 09:41:22'),(355,'Total CPK                           Blood lactate and pyruvate                                              Whole exome sequencing',1604,NULL,37.0,64536,225,225,'2022-04-03 09:51:21','2022-04-03 09:51:21'),(356,'it is probably a hemangioma versus teratoma or hamartoma needing ULTRASOUND and duplex for diagnosis\r\nhe\'s infant of diabetic mother who needs an Echo and Pelviabdominal US',1619,NULL,37.0,64830,316,316,'2022-04-04 10:11:51','2022-04-04 10:11:51'),(357,'every 3 weeks and follow up',1628,'intralesional 5 flurouracil 1:1 with lidocaine',37.0,64986,140,140,'2022-04-06 08:51:37','2022-04-06 08:51:37'),(358,'skin biopsy is a must to exclude histiocytosis',1629,'refer to psychiatry',37.0,64986,140,140,'2022-04-06 08:58:04','2022-04-06 08:58:04'),(359,'Mitochondrial disease ? Whole exome sequencing',1633,'L carnitine',37.0,65284,225,225,'2022-04-10 08:22:16','2022-04-10 08:22:16'),(360,'Mitochondrial disease ? Whole exome sequencing',1633,NULL,37.0,65284,225,225,'2022-04-10 08:22:46','2022-04-10 08:22:46'),(361,'Mitochondrial disease ? Whole exome sequencing',1604,'L carnitine',37.0,65284,225,225,'2022-04-10 08:24:03','2022-04-10 08:24:03'),(362,'Mitochondrial disease ? Whole exome sequencing',1604,'L carnitine and Co-enzyme Q10',37.0,65284,225,225,'2022-04-10 08:25:11','2022-04-10 08:25:11'),(363,'Psychiatry consultation',1469,NULL,37.0,65285,225,225,'2022-04-10 08:40:20','2022-04-10 08:40:20'),(364,'Whole exome sequencing',1635,NULL,37.0,65285,225,225,'2022-04-10 08:51:53','2022-04-10 08:51:53'),(365,NULL,1638,'Depakin   200 mg tablets  1 tablet every 12 hours',37.0,65284,225,225,'2022-04-10 08:59:47','2022-04-10 08:59:47'),(366,'ECHO cardiography                     Pelvi-abdominal ultrasound',1634,NULL,37.0,65284,225,225,'2022-04-10 09:08:54','2022-04-10 09:08:54'),(367,'Neonatal edema          ECHO cardiography and Pelvi-abdominal ultrasound      Follow up urinary albumin, serum proteins and albumin',1634,NULL,37.0,65284,225,225,'2022-04-10 09:11:37','2022-04-10 09:11:37'),(368,NULL,1649,NULL,37.0,65736,731,731,'2022-04-14 08:46:11','2022-04-14 08:46:11'),(369,'iruxol ointment twice daily for 2 weaks',1649,'fuizone cream twice daily for 2 weaks/',37.0,65736,731,731,'2022-04-14 08:48:49','2022-04-14 08:48:49'),(370,'nizoral shampoo twice weekly for 1 month',1648,'lamifen craem twice daily for 1 month',37.0,65736,731,731,'2022-04-14 08:55:10','2022-04-14 08:55:10'),(371,'Ryle tube\r\nCBC\r\nKIDNEY Fun\r\nliver fun.\r\ndehydrating measures\r\nfollow up vital data\r\ngood hydration and feeding',1647,NULL,37.0,65738,923,923,'2022-04-14 09:26:56','2022-04-14 09:26:56'),(372,NULL,1560,'Solupred 5 mg tablets 2 tablets per day',37.0,65735,284,284,'2022-04-14 10:25:12','2022-04-14 10:25:12'),(373,'physiotherapy, echocardiography, gene study for duchenne muscular dystrophy',1560,'solupred 5 mg tablets 2 tablets per day',37.0,65735,284,284,'2022-04-14 10:26:57','2022-04-14 10:26:57'),(374,'physiotherapy, echocardiography, gene study for duchenne muscular dystrophy',1560,'Solupred 5 mg tablets 2 tablets per day',37.0,65735,284,284,'2022-04-14 10:28:23','2022-04-14 10:28:23'),(375,'cardiothoracic consultation',1658,'vancomycin twice daily',37.0,65889,1177,1177,'2022-04-17 11:08:05','2022-04-17 11:08:05'),(376,'enhance nutritional support by TPN or special formula',1659,NULL,37.0,65890,327,327,'2022-04-18 09:19:31','2022-04-18 09:19:31'),(377,'Lustral50',1662,'Olapex 5mg',37.0,66183,923,923,'2022-04-18 09:59:20','2022-04-18 09:59:20'),(378,'عمل الاتي\r\nECG\r\nelectrolytea\r\nTSH ,Free T3,Free T4 \r\nNeck U/S',1666,'isopten  40 mg tab نصف قرص يوميا',37.0,66187,1151,1151,'2022-04-19 09:19:11','2022-04-19 09:19:11'),(379,'CBC\r\nConner\'s parents rating scale',1665,NULL,37.0,66186,261,261,'2022-04-19 10:27:26','2022-04-19 10:27:26'),(380,'MRi brain\r\nOFC measurment',1508,'Abilify 5mg tablets',37.0,66186,261,261,'2022-04-19 10:39:16','2022-04-19 10:39:16'),(381,'MRI brain \r\nOFC ircumference\r\nCBC',1508,'Efalex syrup 10 مللي بالفم صباحا &  قرص قبل النوم الساعه 11 م  Abilify 5mg tablets',37.0,66186,261,261,'2022-04-19 10:46:39','2022-04-19 10:46:39'),(382,'Drugs for PDA closure and cardiac consultation and follow up',1687,'Follow up',37.0,66948,284,284,'2022-04-28 10:39:57','2022-04-28 10:39:57'),(383,NULL,1687,NULL,37.0,66948,284,284,'2022-04-28 10:41:12','2022-04-28 10:41:12'),(384,'Modification of life style. Sleep and feeding',1696,'Indral 10 mg',37.0,66949,225,225,'2022-05-08 09:04:07','2022-05-08 09:04:07'),(385,'MRI  brain and EEG',1695,NULL,37.0,66949,225,225,'2022-05-08 09:15:49','2022-05-08 09:15:49'),(386,NULL,1708,'aricept 5 mg قرص مساء',37.0,67247,1192,1192,'2022-05-09 09:10:17','2022-05-09 09:10:17'),(387,'Alzmenda drops قطاره على نصف كوب ماء بعد الفطار\r\nolapex 5 mg tab  قرص بعد الغداء\r\nمتابعه وظائف الكلى',1718,'Apixdone 2mg tab قرص مساءا',37.0,67400,923,923,'2022-05-11 09:23:28','2022-05-11 09:23:28'),(388,'levohistam tab.\r\nقرص يوميا قبل النوم \r\ntexacort cream \r\npanthenol cream \r\nيخلط الدهانين معا صباحا ومساءا \r\ntreczimus oint \r\nدهان للبقعة البيضاء مرة واحدة يوميا',1719,NULL,37.0,67409,712,712,'2022-05-11 09:58:42','2022-05-11 09:58:42'),(389,NULL,1721,NULL,37.0,67409,712,712,'2022-05-11 10:02:39','2022-05-11 10:02:39'),(390,'levohistam tab.\r\nقرص قبل النوم يوميا \r\nlamifen cream \r\nfusi cream \r\nيخلط الدهانين صباحا ومساءا لمدة اسبوعين \r\npandermal cream \r\nدهان عصرا يوميا لمدة 4 ايام ويوقف \r\nglycerin transparent soap \r\nصابونة لغسيل اليدين \r\nمع عدم استعمال ايه منظفات الفترة القادمة او ارتداء جوانتي سيليكون مع كل استخدام للمنظفات',1721,NULL,37.0,67409,712,712,'2022-05-11 10:08:24','2022-05-11 10:08:24'),(391,NULL,1724,NULL,37.0,67409,712,712,'2022-05-11 10:13:45','2022-05-11 10:13:45'),(392,'locasten cream \r\nfusi cream \r\nدهانين للقدمين معا صباحا ومساءا \r\npandermal cream \r\npanthenol cream\r\nدهان لليدين معا صباحا ومساءا\r\nclaritine tab.\r\nقرص قبل النوم يوميا',1724,NULL,37.0,67409,712,712,'2022-05-11 10:17:04','2022-05-11 10:17:04'),(393,NULL,1725,'locasten cream',37.0,67409,712,712,'2022-05-11 10:18:20','2022-05-11 10:18:20'),(394,'locasten cream \r\n3 مرات يوميا لمدة اسبوعين \r\nمع عدم الاحتكاك باطفال اخرين لاحتمال نقل العدوي',1725,NULL,37.0,67409,712,712,'2022-05-11 10:19:42','2022-05-11 10:19:42'),(395,'take a biopsy to confirm the diagnosis\r\ndd:fixed drug eruption or lichenoid drug eruption',1714,NULL,37.0,67408,1056,1056,'2022-05-11 10:51:10','2022-05-11 10:51:10'),(396,'Fractional Co2 laser for forehead and cheek and free Co2 laser for skin tags on neck',1715,NULL,37.0,67408,1056,1056,'2022-05-11 10:59:24','2022-05-11 10:59:24'),(397,'MRI brain epilepsy protocol',1752,'Levetiracetam',37.0,67860,225,225,'2022-05-15 09:52:46','2022-05-15 09:52:46'),(398,NULL,1751,NULL,37.0,67860,225,225,'2022-05-15 10:20:49','2022-05-15 10:20:49'),(399,'MRI brain and spinal cord 1.5 Tesla                                    Blood lactate and pyruvate, metabolic screen',1751,'Sinemet 250 mg half tablet  in 10 cc . 1cc twice daily',37.0,67860,225,225,'2022-05-15 10:24:04','2022-05-15 10:24:04'),(400,'Whole exome sequencing',1699,'Cerebrolysin 1ml per week, Spinobac 1mg per 1ml 0.2 ml twice daily. Mental and physical rehabilitation',37.0,67860,225,225,'2022-05-15 10:35:56','2022-05-15 10:35:56'),(401,'Extended metabolic screen',1700,'Cerebrolysin 1ml per week, Spinobac 1mg per 1ml 0.2 ml twice daily. Mental and physical rehabilitation',37.0,67860,225,225,'2022-05-15 10:36:44','2022-05-15 10:36:44'),(402,'Genetic consultaion',1701,'Cerebrolysin 1ml per week, Spinobac 1mg per 1ml 0.2 ml twice daily. Mental and physical rehabilitation',37.0,67860,225,225,'2022-05-15 10:37:39','2022-05-15 10:37:39'),(403,NULL,1508,NULL,37.0,68755,261,261,'2022-05-17 10:44:28','2022-05-17 10:44:28'),(404,NULL,1786,NULL,37.0,68755,261,261,'2022-05-17 12:29:38','2022-05-17 12:29:38'),(405,'extended metabolic screen, ammonia, lactate',1814,'cerebrolysin ampoule, omega three, l carnitine',37.0,69649,284,284,'2022-05-19 10:23:20','2022-05-19 10:23:20'),(406,'extended metabolic screen, lactate, ammonia',1814,'cerebrolysin ampoule, omega three, l carnitine',37.0,69649,284,284,'2022-05-19 10:24:14','2022-05-19 10:24:14'),(407,NULL,606,NULL,37.0,69655,339,339,'2022-05-19 11:53:57','2022-05-19 11:53:57'),(408,'MRI brain epilepsy protocol          CBC, , RBG, Lactate and pyruvate in blood',1830,'Levetiracetam',37.0,69656,225,225,'2022-05-22 08:51:54','2022-05-22 08:51:54'),(409,'Whole exome sequencing     MRI brain',1831,'Levetiracetam',37.0,69656,225,225,'2022-05-22 08:54:31','2022-05-22 08:54:31'),(410,'MRI BRAIN , whole exome sequencing and extended metabolic screen',614,'Cerebrolysin 1ml per week, Spinobac 1mg per 1ml 0.2 ml twice daily. Mental and physical rehabilitation',37.0,69656,225,225,'2022-05-22 09:07:47','2022-05-22 09:07:47'),(411,NULL,1838,NULL,37.0,69656,225,225,'2022-05-22 09:09:48','2022-05-22 09:09:48'),(412,NULL,617,'hjhj',37.0,70248,339,339,'2022-05-22 13:20:54','2022-05-22 13:20:54'),(413,NULL,1850,NULL,37.0,70397,327,327,'2022-05-23 10:11:07','2022-05-23 10:11:07'),(414,NULL,1850,NULL,37.0,70397,327,327,'2022-05-23 10:11:34','2022-05-23 10:11:34'),(415,'stool analysis\r\nH.PYLORI STOOL AG',1609,'nexium 40mg tab /mucosta tab /mucogel syrup',37.0,70402,893,893,'2022-05-23 11:30:22','2022-05-23 11:30:22'),(416,NULL,593,'m,m,m',37.0,70403,339,339,'2022-05-23 14:11:30','2022-05-23 14:11:30'),(417,'ALT/AST/ T.bilirubin \r\nabdominal us follow up after 3mths',1871,'Gastreg 200mg tab 1x3/  disflatyl tab 1x3/ zurcal 40 1x1',37.0,70714,893,893,'2022-05-24 11:59:25','2022-05-24 11:59:25'),(418,NULL,1886,NULL,37.0,70863,1042,1042,'2022-05-25 09:43:53','2022-05-25 09:43:53'),(419,'يحول المريض الب مركز الجوهرة الطبي',1895,NULL,37.0,71014,1261,1261,'2022-05-25 10:00:51','2022-05-25 10:00:51'),(420,NULL,1893,'ciprofar 500 tab every 12 hour',37.0,71013,1260,1260,'2022-05-25 10:11:05','2022-05-25 10:11:05'),(421,'متابعه بعد 10 ايام',1893,'ciprofar 500 tab every 12 hour -paramol 2 tablet 12 hours',37.0,71013,1260,1260,'2022-05-25 10:13:46','2022-05-25 10:13:46'),(422,'biopsy',1868,NULL,37.0,70715,364,364,'2022-05-25 10:33:25','2022-05-25 10:33:25'),(423,NULL,1869,NULL,37.0,70715,364,364,'2022-05-25 10:42:22','2022-05-25 10:42:22'),(424,'transesophageal  echo then cardiothoracic consultation',1896,NULL,37.0,71015,1262,1262,'2022-05-25 11:00:14','2022-05-25 11:00:14'),(425,'coombs\r\nretix\r\nUS\r\ntsb\r\ndsb',1898,NULL,37.0,71018,1267,1267,'2022-05-25 12:19:05','2022-05-25 12:19:05'),(426,'follow up in the rheumatology out patient clinic',1902,'dorfene caps twice daily-milga tab once daily',37.0,71021,1270,1270,'2022-05-26 09:16:10','2022-05-26 09:16:10'),(427,'marked pericardial effusion,left mild pleural effusion with left basal atelectasis,right minimal pleural effusion',1901,NULL,37.0,71019,990,990,'2022-05-26 09:30:52','2022-05-26 09:30:52'),(428,'follow up cardiothoraxic for pericardiocentesis',1901,NULL,37.0,71023,1272,1272,'2022-05-26 09:53:07','2022-05-26 09:53:07'),(429,'refer to al hayat port foad',1903,NULL,37.0,71175,1274,1274,'2022-05-26 10:23:03','2022-05-26 10:23:03'),(430,'control blood pressure\r\nfollow up',1764,'Tiratam 500 mg',37.0,71171,923,923,'2022-05-26 10:36:54','2022-05-26 10:36:54'),(431,NULL,1905,NULL,37.0,71022,1271,1271,'2022-05-26 10:51:51','2022-05-26 10:51:51'),(432,'Thyroid U/S\r\nPelvi-abdominal U/S\r\nFasting blood glucose, HbA1c\r\nNa, K, HCO3\r\nUrine analysis\r\nUrine albumin/creatinine ratio (spot sample)\r\nUric acid\r\nCa, PO4\r\nESR, CRP',1905,'Increase Eltroxin to 150 micro per day',37.0,71022,1271,1271,'2022-05-26 10:54:50','2022-05-26 10:54:50'),(433,NULL,1909,'multirelax 5mg per 24hr',37.0,71474,1282,1282,'2022-05-29 10:18:57','2022-05-29 10:18:57'),(434,'Electrolytes in urine\r\ncorrection of acidosis\r\nlink to nephrology team for planning RRT',1921,NULL,37.0,72207,1285,1285,'2022-05-30 10:07:11','2022-05-30 10:07:11'),(435,'echo\r\nnew cxr to rule out pneumothorax',1923,NULL,37.0,72503,1289,1289,'2022-05-31 08:37:55','2022-05-31 08:37:55'),(436,NULL,1940,'add Garamycin',37.0,72948,1294,1294,'2022-06-01 08:59:01','2022-06-01 08:59:01'),(437,'new CXR\r\nBlood gases\r\nNa and K twice weekly\r\nincrease feeds gradually \r\ntry Infatrini milk instead of usual formulas',1940,'add Garamycin + reduce Lasix to 0.25 mg/kg/12 hr + Capoten increase to 0.5',37.0,72948,1294,1294,'2022-06-01 09:02:09','2022-06-01 09:02:09'),(438,NULL,1940,NULL,37.0,72948,1294,1294,'2022-06-01 09:02:42','2022-06-01 09:02:42'),(439,'stop Atrovent\r\nthree Pulmicort nebulizations \r\nall other nebulization sessions saline 0.9%\r\nonce saline 2.7%',1946,'+days) azithromycin (20 mg/kg/day) vancomycin (up to 14 days) + Garamycin (for 5',37.0,72949,1294,1294,'2022-06-01 09:44:05','2022-06-01 09:44:05'),(440,NULL,1946,NULL,37.0,72949,1294,1294,'2022-06-01 09:44:36','2022-06-01 09:44:36'),(441,'stop Atrovent\r\nthree Pulmicort nebulizations \r\nall other nebulization sessions saline 0.9%\r\nonce saline 2.7%',1947,'vancomycin + garamycin',37.0,72949,1294,1294,'2022-06-01 09:45:51','2022-06-01 09:45:51'),(442,NULL,1947,NULL,37.0,72949,1294,1294,'2022-06-01 09:46:04','2022-06-01 09:46:04'),(443,'تقويه العضله الرباعيه بالعلاج الطبيعي\r\nوتمارين فرد وثني الركبه',1943,'ossofortin 10.000 IU tab',37.0,73100,1064,1064,'2022-06-02 09:18:23','2022-06-02 09:18:23'),(444,'hghhedhfgdhjjdhfshjdsdfjskhdfsjhdgfsndkjfnjdrfk\r\ngfgkjfkjihng',606,'knjvdjnvgkj',37.0,73253,339,339,'2022-06-02 15:50:21','2022-06-02 15:50:21'),(445,'exercise diet control',1818,'ator  20',37.0,73678,714,714,'2022-06-05 09:05:11','2022-06-05 09:05:11'),(446,NULL,1992,NULL,37.0,73775,327,327,'2022-06-06 10:05:03','2022-06-06 10:05:03'),(447,NULL,1992,NULL,37.0,73775,327,327,'2022-06-06 10:05:14','2022-06-06 10:05:14'),(448,'قياس سمع وضغط اذن بعيادة السمعيات\r\ntsh جديد',1996,'amocerebral plus SR tab قرص كل 8ساعات لمدة 5 ايام',37.0,73273,1315,1315,'2022-06-06 12:14:50','2022-06-06 12:14:50'),(449,NULL,1989,NULL,37.0,73947,1042,1042,'2022-06-08 09:46:26','2022-06-08 09:46:26'),(450,'planile 200  ق بعد الافطار والعشاء  و viit D 10000 iu daily\r\nArcoxia 90 mg tab \r\nallzyme tab ق قبل الافطار والعشاء \r\n\r\nANA (IIF ) pattern and titer',1989,NULL,37.0,73947,1042,1042,'2022-06-08 09:53:31','2022-06-08 09:53:31'),(451,'ECHO FOLLOW UP\r\nWEANING O2',2012,NULL,37.0,74094,994,994,'2022-06-08 10:40:47','2022-06-08 10:40:47'),(452,'CT brain\r\nantibiotic ,antistaph\r\nkeep vital data within normal',2013,NULL,37.0,74094,994,994,'2022-06-08 10:52:56','2022-06-08 10:52:56'),(453,'CT brain \r\nMRI MRV brain',2043,'Cidamex 250 mg',37.0,74411,923,923,'2022-06-11 10:09:57','2022-06-11 10:09:57'),(454,'MRI and MRA brain,  Karyotype, ECHO CARDIOGRAPHY, CT bone widow head',2052,'indral',37.0,74403,225,225,'2022-06-12 08:31:47','2022-06-12 08:31:47'),(455,'MRI and MRA brain,  Karyotype, ECHO CARDIOGRAPHY, CT bone widow head',2052,'Indral',37.0,74403,225,225,'2022-06-12 08:31:55','2022-06-12 08:31:55'),(456,'Whole exome sequencing, Extended metabolic screen, MRI brain epilepsy protocol         L\' Carnitine, Vitamine B6 100mg daily, Biotin forte capsule, folinic acid',2049,'L\' Carnitine, Vitamine B6 100mg daily, Biotin forte capsule, folinic acid',36.9,74403,225,225,'2022-06-12 08:42:47','2022-06-12 08:42:47'),(457,'Whole exome sequencing, Extended metabolic screen, MRI brain epilepsy protocol         L\' Carnitine, Vitamine B6 100mg daily, Biotin forte capsule, folinic acid',2049,'Psychodal 1mg tablet',37.0,74403,225,225,'2022-06-12 08:44:46','2022-06-12 08:44:46'),(458,NULL,2048,'Cital when needed',37.0,74403,225,225,'2022-06-12 08:50:15','2022-06-12 08:50:15'),(459,'Whole exome sequencing, Extended metabolic screen, blood  Lactate pyruvate ratio. MRI and MRS brain, Mutlislice CT chest',2051,'L carnitine, vit B complex',37.0,74403,225,225,'2022-06-12 08:57:57','2022-06-12 08:57:57'),(460,'Whole exome sequencing, Extended metabolic screen, blood  Lactate pyruvate ratio. MRI and MRS brain, Mutlislice CT chest',2051,'L carnitine, vit B complex',37.0,74403,225,225,'2022-06-12 08:57:57','2022-06-12 08:57:57'),(461,'Follow up   Vit amin D',2057,NULL,37.0,74403,225,225,'2022-06-12 09:02:08','2022-06-12 09:02:08'),(462,'Follow up motor development',2057,NULL,37.0,74403,225,225,'2022-06-12 09:02:42','2022-06-12 09:02:42'),(463,'MRI brain',2046,NULL,37.0,74403,225,225,'2022-06-12 09:07:17','2022-06-12 09:07:17'),(464,'MRI brain',2046,NULL,37.0,74403,225,225,'2022-06-12 09:07:48','2022-06-12 09:07:48'),(465,'IQ test, EEG, MRI brain, behavioral therapy',2050,NULL,37.0,74403,225,225,'2022-06-12 09:11:34','2022-06-12 09:11:34'),(466,'IQ test, EEG, MRI brain, behavioral therapy',2050,NULL,37.0,74403,225,225,'2022-06-12 09:13:09','2022-06-12 09:13:09'),(467,'MRI brain epilepsy protocol, Whole exome sequencing',2047,NULL,37.0,74403,225,225,'2022-06-12 09:15:48','2022-06-12 09:15:48'),(468,'MRI brain epilepsy protocol, Whole exome sequencing',2047,NULL,37.0,74403,225,225,'2022-06-12 09:15:51','2022-06-12 09:15:51'),(469,'check renal functions every 12 hours and UOP every 6 hours if there are signs of circulatory overload or rapid rate of rise of renal functions, restrict fluids and arrange for dialysis',2064,'fluid challenge and assessment of UOP',37.0,74788,316,316,'2022-06-13 09:31:21','2022-06-13 09:31:21'),(470,NULL,2064,NULL,37.0,74788,316,316,'2022-06-13 09:31:45','2022-06-13 09:31:45'),(471,'TTT: oxygen, bronchodilators,if fever give antibiotic\r\nInvestigations: exclude COVID by PCR or rapid test, repeat CRP, do sputum and blood cultuse if no improvement of the condition within 3 days, follow up CXR',2054,NULL,37.0,75093,1387,1387,'2022-06-13 10:32:34','2022-06-13 10:32:34'),(472,'follow up CT\r\ncarotid Doppler\r\nECHO',2095,'Dual antiplatlet',37.0,75556,923,923,'2022-06-15 17:45:22','2022-06-15 17:45:22'),(473,NULL,2095,'Dual antiplatlet',37.0,75556,923,923,'2022-06-15 17:46:47','2022-06-15 17:46:47'),(474,'physiotherapy\r\nnebulisations\r\nstart BPD regimen',2013,NULL,37.0,76154,946,946,'2022-06-16 09:52:16','2022-06-16 09:52:16'),(475,'urgent endocrine consultation\r\nincrease Eltroxin dose to 70 mg/day',2097,NULL,37.0,76154,946,946,'2022-06-16 09:54:02','2022-06-16 09:54:02'),(476,'Preparation for ERCP sphenctrotomy and stone extraction\r\n\r\nLaboratory    ALK Ph, CBC, LIVER AND KIDENY FUNCTION',2099,NULL,37.0,75859,1200,1200,'2022-06-16 10:29:03','2022-06-16 10:29:03'),(477,'cranial and abdominal US\r\nretics , iron profile\r\ncheck of any source of bleeding',2030,NULL,37.0,76156,946,946,'2022-06-16 10:35:50','2022-06-16 10:35:50'),(478,'double photo therapy and follow up bilirubin, rtx and \r\n  haemoglobin after 6 hours',2111,NULL,37.0,76156,946,946,'2022-06-16 10:38:21','2022-06-16 10:38:21'),(479,'urgent neurological consultations\r\nincrease tiratam doe to 50 mg/kg/day',2112,NULL,37.0,76156,946,946,'2022-06-16 10:40:55','2022-06-16 10:40:55'),(480,'MRI brain , EEG',2122,NULL,37.0,76204,225,225,'2022-06-19 08:25:25','2022-06-19 08:25:25'),(481,'MRI brain EEG',2122,NULL,37.0,76204,225,225,'2022-06-19 08:26:06','2022-06-19 08:26:06'),(482,'MRI brain',2123,NULL,37.0,76204,225,225,'2022-06-19 08:30:36','2022-06-19 08:30:36'),(483,'Physiotherapy balance exercises,  MRI brain',2123,NULL,37.0,76204,225,225,'2022-06-19 08:31:42','2022-06-19 08:31:42'),(484,'EEG, MRI MRA brain',2125,NULL,37.0,76204,225,225,'2022-06-19 08:34:46','2022-06-19 08:34:46'),(485,'EEG, MRI MRA brain, Behavioral therapy',2125,NULL,37.0,76204,225,225,'2022-06-19 08:36:43','2022-06-19 08:36:43'),(486,'Audiogram, MRI brain, EEG, Speech therapy, IQ assessment',2129,NULL,37.0,76204,225,225,'2022-06-19 08:57:05','2022-06-19 08:57:05'),(487,'MRI brain, blood lactate and pyruvate, Whole exome sequencing for global developmental delay',2126,'Levetiracetam , L\'carnitine',37.0,76204,225,225,'2022-06-19 09:06:48','2022-06-19 09:06:48'),(488,'IQ , Speech therapy',2128,NULL,37.0,76204,225,225,'2022-06-19 09:11:42','2022-06-19 09:11:42'),(489,'IQ assessment, speech therapy',2128,NULL,37.0,76204,225,225,'2022-06-19 09:12:58','2022-06-19 09:12:58'),(490,'MRI brain, IQ assessment, Extended metabolic screen, ERG examination',2127,NULL,37.0,76204,225,225,'2022-06-19 09:23:06','2022-06-19 09:23:06'),(491,'MRI brain, EXTENDED METABOLIC screen, ERG, Whole exome sequencing for global developmental delay',2127,NULL,37.0,76204,225,225,'2022-06-19 09:24:20','2022-06-19 09:24:20'),(492,'MRI brain, EEG , Nerve conduction study',2118,NULL,37.0,76204,225,225,'2022-06-19 09:32:19','2022-06-19 09:32:19'),(493,'MRI brain, EEG , Nerve conduction study',2118,NULL,37.0,76204,225,225,'2022-06-19 09:33:15','2022-06-19 09:33:15'),(494,'To do ca/creat and oxalate/creat ratio in urine',2139,'surgical intervention for stone removal',37.0,76663,1418,1418,'2022-06-20 09:20:51','2022-06-20 09:20:51'),(495,'sequential nephron block.albumin,fresh frozen plasma.NIV CPAP.Follow up ECHO DIALY FOR PERICARDIAL EFFUSION',2136,NULL,37.0,76510,1151,1151,'2022-06-20 09:22:07','2022-06-20 09:22:07'),(496,NULL,2143,NULL,37.0,76508,327,327,'2022-06-20 09:42:07','2022-06-20 09:42:07'),(497,'abdominopelvic ultrasound',2141,'zurcal 40 tab قرص قبل الفطار بنص ساعه     Ganaton tab قرص تلات مرات قبل الاكل          EUCARBON tab 2 قرص يطحن علي كوب زبادي مرتين ف اليوم',37.0,76511,893,893,'2022-06-20 10:33:27','2022-06-20 10:33:27'),(498,NULL,2152,'panthenol cream',37.0,76676,820,820,'2022-06-21 09:30:35','2022-06-21 09:30:35'),(499,NULL,2167,'erastapex trio 40/10/25, protofix 40',37.0,76681,1426,1426,'2022-06-21 10:07:52','2022-06-21 10:07:52'),(500,'the following labs \r\n1-TSH.FT4\r\n2-LDL,cholesterol ,TGs\r\n3-HBA1c \r\n4-urine analysis\r\n5-echocardiography  عمل موجات صوتية عالقلب\r\n6- متابعة وظائف الكلي من (creat,K) مع البدء فاستخدام العلاج الموصوف',2170,'Erastapex plus 20/12,5,thiotacid compound 600',37.0,76682,1430,1430,'2022-06-21 11:23:36','2022-06-21 11:23:36'),(501,'TTT of AC joint osteo.\r\ninjection of corticosteroid at RT shoulder \r\nphysiotherapy on RT shoulder 12 session\r\nTTT for C5-6 disc bulge with bilat. brachialgia:\r\n anticox 2      15mg amp.\r\nprkm uqg lvm ,hp]m d,ldh gl]m 6 hdhl\r\nBetolvex B12 amp. \r\nحقنة عضل كل 3 ايام \r\nmerkfast tab\r\nقرص 3 مرات يوميا بعد الاكل\r\nthiotacid 300 mg  cap\r\nكبسولة مرة واحدة بعد الغداء\r\nphysiotherapy on cervical spine 12 session \r\nالعلاج لمدة 21 يوم',1987,NULL,37.0,76667,1423,1423,'2022-06-21 11:54:48','2022-06-21 11:54:48'),(502,NULL,2148,'forxiga 10mg',37.0,76686,1164,1164,'2022-06-22 08:48:40','2022-06-22 08:48:40'),(503,'injection and physiotherapy',2184,NULL,37.0,76689,1085,1085,'2022-06-22 09:30:29','2022-06-22 09:30:29'),(504,'-\r\nDO FASTING c PEPTIDE-\r\nUSE mODY CALCULATOR\r\ntRIAL OF dIAMICRON ACCORDINGLY',2146,'trial of Diamicron 30 mg before breakfast and lunch but after C peptide result',37.0,76694,1435,1435,'2022-06-22 10:57:59','2022-06-22 10:57:59'),(505,NULL,2146,NULL,37.0,76694,1435,1435,'2022-06-22 10:58:29','2022-06-22 10:58:29'),(506,'echo to exclude ductus arteriosus\r\ndo not wean from vent before closing ductus',2172,'amikin to be added if not improving',37.0,76692,1294,1294,'2022-06-22 11:30:55','2022-06-22 11:30:55'),(507,NULL,2172,NULL,37.0,76692,1294,1294,'2022-06-22 11:32:05','2022-06-22 11:32:05'),(508,'thyroid function after 3 days\r\nadd amikin',2097,'eltroxin 50 microgram daily',37.0,76692,1294,1294,'2022-06-22 11:34:23','2022-06-22 11:34:23'),(509,'MRI ... exclude PRESS Syndrom ... follow up BP for 6 weeks',2178,NULL,37.0,76701,984,984,'2022-06-22 11:47:27','2022-06-22 11:47:27'),(510,'close follow up',2190,'steroids',37.0,76703,714,714,'2022-06-23 08:22:16','2022-06-23 08:22:16'),(511,NULL,2198,'Avil amp',37.0,76710,1276,1276,'2022-06-23 09:27:59','2022-06-23 09:27:59'),(512,NULL,2198,'Avil amp - Dexacort vial مرة واحدة فقط',37.0,76710,1276,1276,'2022-06-23 09:30:06','2022-06-23 09:30:06'),(513,'activate Cath lab for PPCI',2221,'ASPRIN,,ATOR ,,ppci',37.0,76716,1016,1016,'2022-06-23 10:32:08','2022-06-23 10:32:08'),(514,NULL,2077,'voltaren gel دهان صباحا و مساء',37.0,76705,916,916,'2022-06-23 11:08:42','2022-06-23 11:08:42'),(515,NULL,2192,'steroid/  immuran',37.0,76714,893,893,'2022-06-23 11:45:37','2022-06-23 11:45:37'),(516,'ANA \r\nC3 and  c4\r\nurine analysis',2194,NULL,37.0,76768,1463,1463,'2022-06-25 09:11:39','2022-06-25 09:11:39'),(517,'رسم عصب لاحد الطرفين العلويين ولاحد الطرفين السفليين وتحليل كالسيوم كلي ومتاين وتحليل غدة درقية',2258,'thiotal600 mg caps كبسولة قبل الغداء بنصف ساعة   /cerebrolysin 5 mg amp',37.0,76939,923,923,'2022-06-26 09:31:18','2022-06-26 09:31:18'),(518,'stool analysis and C&S\r\nPT, PTT\r\ncheck for liocal causes',2294,NULL,37.0,76959,316,316,'2022-06-27 08:59:16','2022-06-27 08:59:16'),(519,NULL,2294,NULL,37.0,76959,316,316,'2022-06-27 08:59:36','2022-06-27 08:59:36'),(520,'urosurgical consultation for pyeloplasty or stent insertion as soon as possible as the AP diameter of renal pelvis is rapidly increasing',2299,NULL,37.0,76958,316,316,'2022-06-27 09:12:10','2022-06-27 09:12:10'),(521,NULL,2299,NULL,37.0,76958,316,316,'2022-06-27 09:12:29','2022-06-27 09:12:29'),(522,NULL,2287,'Atomoxapex 18 mg',37.0,76940,271,271,'2022-06-27 09:32:32','2022-06-27 09:32:32'),(523,'fup after 1 month',2287,'Atomoxapex 18 mg riperidal 1ml/12 hrs vidrop 1ml efalex 5 ml',37.0,76940,271,271,'2022-06-27 09:34:26','2022-06-27 09:34:26'),(524,NULL,2287,NULL,37.0,76940,271,271,'2022-06-27 09:34:43','2022-06-27 09:34:43'),(525,'fup after 1 month',2286,'Atomoxapex25mg  vidrop 1ml cerebroforte 400mg',37.0,76940,271,271,'2022-06-27 09:44:05','2022-06-27 09:44:05'),(526,NULL,2286,NULL,37.0,76940,271,271,'2022-06-27 09:44:34','2022-06-27 09:44:34'),(527,'Cxr , echocardiography  ,follow up urine analysis  , follow up renal functions',2271,'adjustment of dose of antibiotic acccording to culture and sensitivity ,',37.0,76955,986,986,'2022-06-27 09:52:03','2022-06-27 09:52:03'),(528,NULL,2285,'atomoxapex 40mg aripiprex 3m three times daily',37.0,76940,271,271,'2022-06-27 09:53:51','2022-06-27 09:53:51'),(529,NULL,2285,NULL,37.0,76940,271,271,'2022-06-27 09:54:28','2022-06-27 09:54:28'),(530,'MRI brain EEG CBC S.iron',2289,'Efalex 5ml once',37.0,76940,271,271,'2022-06-27 10:12:18','2022-06-27 10:12:18'),(531,NULL,2289,NULL,37.0,76940,271,271,'2022-06-27 10:12:33','2022-06-27 10:12:33'),(532,'pelviabdominal us with bladder dimensions urine analysis',2288,NULL,37.0,76940,271,271,'2022-06-27 10:19:42','2022-06-27 10:19:42'),(533,NULL,2288,NULL,37.0,76940,271,271,'2022-06-27 10:20:10','2022-06-27 10:20:10'),(534,NULL,2290,'soulofresh EDقطره 4مرات باليوم',37.0,76954,777,777,'2022-06-27 10:21:50','2022-06-27 10:21:50'),(535,'CARS',696,NULL,37.0,76940,271,271,'2022-06-27 10:28:18','2022-06-27 10:28:18'),(536,NULL,696,NULL,37.0,76940,271,271,'2022-06-27 10:29:08','2022-06-27 10:29:08'),(537,NULL,1967,'voltareen gel',37.0,76972,1500,1500,'2022-06-27 11:07:27','2022-06-27 11:07:27'),(538,'foolow up ct brain',2306,'vildagluse plus',37.0,76979,714,714,'2022-06-28 08:46:07','2022-06-28 08:46:07'),(539,NULL,2078,'Tritace 2.5 mg tab/24 hours',37.0,76981,1220,1220,'2022-06-28 09:12:29','2022-06-28 09:12:29'),(540,'maximize dialusis- f/u K& Hb',2078,'Tritace 2.5 mg tab/24 hours- carvide 6.25 mg tab/12 hours-',37.0,76981,1220,1220,'2022-06-28 09:15:27','2022-06-28 09:15:27'),(541,NULL,2304,NULL,37.0,76982,923,923,'2022-06-28 09:24:10','2022-06-28 09:24:10'),(542,NULL,2332,'antiplatlet   vit b12 injection',37.0,76985,923,923,'2022-06-28 09:43:49','2022-06-28 09:43:49'),(543,NULL,2333,NULL,37.0,76985,923,923,'2022-06-28 09:44:29','2022-06-28 09:44:29'),(544,'neurology follow up and physiotherapy',2302,'dystonia managment',37.0,76993,1047,1047,'2022-06-28 09:48:16','2022-06-28 09:48:16'),(545,'multidisciplinary team management \r\nphysiotherapy \r\nmetabolic screening \r\nskeletal survey including bilateral hip xray \r\nechocardiography \r\nabdominal US \r\nIF ALL ARE normal go for further genetic diagnosis',2274,NULL,37.0,76993,1047,1047,'2022-06-28 10:07:27','2022-06-28 10:07:27'),(546,'CREAT-NA-K- A/C ratio \r\niron profil -ESR\r\nVIROLOGY',2170,'natrilex sR-EXAMIDE 5 -FOLLOW UP ABP -FERRODOUNAL',37.0,76987,1503,1503,'2022-06-28 10:08:45','2022-06-28 10:08:45'),(547,NULL,2359,'dexamethasone 6 mg im every 6 hrs for 48 hrs',37.0,77012,984,984,'2022-06-29 09:58:04','2022-06-29 09:58:04'),(548,NULL,1793,'doxycyclinis plus topical antibiotic',37.0,77023,364,364,'2022-06-29 10:12:40','2022-06-29 10:12:40'),(549,'consider acitretin 25 mg per day',1795,NULL,37.0,77023,364,364,'2022-06-29 10:18:27','2022-06-29 10:18:27'),(550,'consider acitretin 25 mg per day plus consult ENT',1796,NULL,37.0,77023,364,364,'2022-06-29 10:19:23','2022-06-29 10:19:23'),(551,'i was told that patient is 12 years old with complaints of palpitation and no fever.. by examination patient is tachycardic 120 beat per minute and normal hemoglobin\r\n\r\npatient need to do 24 hours holter ECG and Echocardiography and cardiac enzymes troponin I',2370,NULL,37.0,77026,1520,1520,'2022-06-29 10:39:11','2022-06-29 10:39:11'),(552,'patient is 1.2 year old .. delayed motor and mental development.. MRI brain normal... patient need to do ammonia, lactate, Tandem mass spectroscopy (TMS) and organic acids in urine to diagnose.',2341,NULL,37.0,77026,1520,1520,'2022-06-29 10:41:35','2022-06-29 10:41:35'),(553,NULL,2183,'good hydration and follow up electrolyte &polyurea',37.0,77014,966,966,'2022-06-29 10:43:30','2022-06-29 10:43:30'),(554,'follow up pt labs after 2 weeks from discharge',2434,'disharge pt after control of pt heamodynamics',37.0,77053,956,956,'2022-07-03 08:06:35','2022-07-03 08:06:35'),(555,'EEG',2382,NULL,37.0,77054,923,923,'2022-07-03 09:06:49','2022-07-03 09:06:49'),(556,'REPEAT PROCALCITONIN & CRP',2452,NULL,37.0,77367,1540,1540,'2022-07-03 09:48:02','2022-07-03 09:48:02'),(557,NULL,2400,NULL,37.0,77056,921,921,'2022-07-03 10:11:22','2022-07-03 10:11:22'),(558,'increase feeding ,blood culture',2465,'meropnem supportive .increase feeding',37.0,77375,1548,1548,'2022-07-03 11:43:08','2022-07-03 11:43:08'),(559,'supportive ,treat sepsis ,neuroimaging',2467,'epanutin ,antibiotic',37.0,77375,1548,1548,'2022-07-03 11:44:29','2022-07-03 11:44:29'),(560,'start perfulgan ,supportive ,stop doubutamine',2468,'lasix .perfulgan',37.0,77375,1548,1548,'2022-07-03 11:47:53','2022-07-03 11:47:53'),(561,'عمل تحاليل cbc crp',572,'panadol',37.0,77376,339,339,'2022-07-03 11:51:48','2022-07-03 11:51:48'),(562,NULL,2276,NULL,37.0,77373,1069,1069,'2022-07-03 12:23:50','2022-07-03 12:23:50'),(563,NULL,2069,'tryptazole 10 mg قرص مساء',37.0,77380,923,923,'2022-07-04 08:26:34','2022-07-04 08:26:34'),(564,NULL,2484,'supportive masures',37.0,77379,1127,1127,'2022-07-04 09:53:12','2022-07-04 09:53:12'),(565,NULL,2485,'supportive masures',37.0,77379,1127,1127,'2022-07-04 09:53:35','2022-07-04 09:53:35'),(566,'termination of pregnancy if needed after consultation of cardiology department and after counselling of patient and consent',2473,NULL,37.0,77378,1071,1071,'2022-07-04 10:30:09','2022-07-04 10:30:09'),(567,NULL,2458,'borgasone cream',37.0,77400,1276,1276,'2022-07-04 11:00:47','2022-07-04 11:00:47'),(568,NULL,2458,'borgasone cream K hipanthene plus cream, fastel 180 mg tab',37.0,77400,1276,1276,'2022-07-04 11:02:53','2022-07-04 11:02:53'),(569,'hepatic encephlopathy\r\nesrd on dialysis\r\nttt\r\nclopex 75 mg قرص مساءا\r\ndepovit b12 امبول عضل كل 5 ايام\r\ntebonina forte tab\r\nقرص كل 8 ساعات',2492,NULL,37.0,77429,1154,1154,'2022-07-06 09:00:33','2022-07-06 09:00:33'),(570,'متابعه',2543,'steroids',37.0,77435,1052,1052,'2022-07-06 09:22:25','2022-07-06 09:22:25'),(571,'CT brain with contrast\r\ntotal serum IGS, CDs\r\nserum galactomannan\r\nneurosurgical consultation \r\nfollow up ABR is a must',2558,NULL,37.0,77440,1573,1573,'2022-07-06 09:50:37','2022-07-06 09:50:37'),(572,NULL,2558,NULL,37.0,77440,1573,1573,'2022-07-06 09:51:45','2022-07-06 09:51:45'),(573,'below knee amputation',2547,'gas gangrene for amputation',37.0,77446,928,928,'2022-07-06 10:21:18','2022-07-06 10:21:18'),(574,'jsryjytjsryjryj',593,'rjrtyjyj',37.0,77434,339,339,'2022-07-06 10:25:06','2022-07-06 10:25:06'),(575,'MSCT, Cardiothoracic consultation',2486,', Inotropic support,IV prostaglandins',37.0,77448,1575,1575,'2022-07-06 10:39:43','2022-07-06 10:39:43'),(576,'Skin biopsy for confirmation, topical wound care: topical antibiotics and K permanagantae',2519,'Solupred 0.5 mg/kg with strict control for the diabetes and hypertenstion',37.0,77428,927,927,'2022-07-06 11:02:33','2022-07-06 11:02:33'),(577,'Examine the patient to exclude palpable purpura and if it is palpable then think of vasculitis and investigate accordingly. Urgent investigations for bleeding tendency..CBC with differential, PT, PTT and INR',2520,NULL,37.0,77428,927,927,'2022-07-06 11:12:29','2022-07-06 11:12:29'),(578,'clexan  prophlaxis',2568,NULL,37.0,77432,1070,1070,'2022-07-06 11:37:54','2022-07-06 11:37:54'),(579,'rh imunoglobulins',2532,NULL,37.0,77445,1070,1070,'2022-07-06 11:52:31','2022-07-06 11:52:31'),(580,'تست ست تست',593,NULL,37.0,77434,339,339,'2022-07-06 12:11:01','2022-07-06 12:11:01'),(581,'dsadasaddsa',806,'ewfref',37.0,77450,339,339,'2022-07-06 16:03:15','2022-07-06 16:03:15'),(582,'dsadasaddsa',806,'ewfref',37.0,77450,339,339,'2022-07-06 16:03:15','2022-07-06 16:03:15'),(583,'sadassa',728,'sdada',37.0,77450,339,339,'2022-07-06 16:05:03','2022-07-06 16:05:03'),(584,'wwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwww',728,NULL,37.0,77450,339,339,'2022-07-06 16:11:01','2022-07-06 16:11:01'),(585,NULL,728,'dsdssd',37.0,185,339,339,'2022-07-06 16:11:35','2022-07-06 16:11:35'),(586,NULL,728,'ddsfdjfjd',37.0,183,339,339,'2022-07-06 16:12:05','2022-07-06 16:12:05'),(587,NULL,2581,'Oral anticoagulant',37.0,77459,923,923,'2022-07-07 11:08:05','2022-07-07 11:08:05'),(588,'Oral anticoagulant\r\nAspocid 75 \r\nAtor2mg \r\nEchocardiography',2581,NULL,37.0,77459,923,923,'2022-07-07 11:10:18','2022-07-07 11:10:18'),(589,'Oral anticoagulant\r\nAspocid 75 \r\nAtor2mg \r\nEchocardiography',2581,NULL,37.0,77459,923,923,'2022-07-07 11:10:21','2022-07-07 11:10:21'),(590,'Oral anticoagulant\r\nAspocid 75 \r\nAtor2mg \r\nEchocardiography',2581,NULL,37.0,77459,923,923,'2022-07-07 11:10:22','2022-07-07 11:10:22'),(591,'Oral anticoagulant\r\nAspocid 75 \r\nAtor2mg \r\nEchocardiography',2581,NULL,37.0,77459,923,923,'2022-07-07 11:10:25','2022-07-07 11:10:25'),(592,'Oral anticoagulant\r\nAspocid 75 \r\nAtor2mg \r\nEchocardiography',2581,NULL,37.0,77459,923,923,'2022-07-07 11:10:28','2022-07-07 11:10:28'),(593,'Oral anticoagulant\r\nAspocid 75 \r\nAtor2mg \r\nEchocardiography',2581,NULL,37.0,77459,923,923,'2022-07-07 11:10:30','2022-07-07 11:10:30'),(594,'same managment \r\ncare of bedridden patient \r\nprevention of VAP',2592,NULL,37.0,77465,986,986,'2022-07-07 11:43:20','2022-07-07 11:43:20'),(595,'asdasd',366,'asd',37.0,77467,339,339,'2022-07-07 12:10:24','2022-07-07 12:10:24'),(596,'stool analysis and culture\r\nceliac screen\r\noccult blood in stool\r\nreducing substance in stool',2609,NULL,37.0,77469,870,870,'2022-07-16 09:09:07','2022-07-16 09:09:07'),(597,'MRI brain epilepsy protocol',2616,'Levetiracetam',37.0,77476,225,225,'2022-07-17 08:45:11','2022-07-17 08:45:11'),(598,'MRI brain epilepsy protocol',2616,'Levetiracetam',37.0,77476,225,225,'2022-07-17 08:45:45','2022-07-17 08:45:45'),(599,'ECHO cardiography, MRI brain urine organic acids',2618,'L carnitine and Co-enzyme Q10 vitamin B complex',37.0,77476,225,225,'2022-07-17 08:56:48','2022-07-17 08:56:48'),(600,'Fundus examination, MRI brain',2615,NULL,37.0,77476,225,225,'2022-07-17 09:03:11','2022-07-17 09:03:11'),(601,'Fundus examination, MRI brain',2615,NULL,37.0,77476,225,225,'2022-07-17 09:04:11','2022-07-17 09:04:11'),(602,'EEG',2617,NULL,37.0,77476,225,225,'2022-07-17 09:07:34','2022-07-17 09:07:34'),(603,'EEG',2617,NULL,37.0,77476,225,225,'2022-07-17 09:07:38','2022-07-17 09:07:38'),(604,'EEG 1 hour , MRI brain  epilepsy protocol',2619,NULL,37.0,77476,225,225,'2022-07-17 09:19:59','2022-07-17 09:19:59'),(605,'EEG 1 hour , MRI brain  epilepsy protocol',2619,NULL,37.0,77476,225,225,'2022-07-17 09:20:01','2022-07-17 09:20:01'),(606,'MRI brain, Whole exome sequencing',2255,NULL,37.0,77476,225,225,'2022-07-17 09:23:47','2022-07-17 09:23:47'),(607,'MRI brain , Whole exome sequencing',2255,NULL,37.0,77476,225,225,'2022-07-17 09:23:49','2022-07-17 09:23:49'),(608,'He was diagnosed as epilepsy at the age of  year and she is on Depakin for 1 year. We need to revise the diagnosis.     EEG sleep  and MRI brain',2614,NULL,37.0,77476,225,225,'2022-07-17 09:36:32','2022-07-17 09:36:32'),(609,'EEG for 1 hour and MRI brain',2614,NULL,37.0,77476,225,225,'2022-07-17 09:37:11','2022-07-17 09:37:11'),(610,'She was diagnosed as epilepsy at the age of 2 months. She is on oral depakin since then.   Fisrt stop depakin gradually. A new sleep deprived EEG with hyperventilation. MRI epilepsy protocol.',2648,NULL,37.0,77490,225,225,'2022-07-17 09:55:30','2022-07-17 09:55:30'),(611,'She was diagnosed as epilepsy at the age of 2 months. She is on oral depakin since then.   First stop depakin gradually. A new sleep deprived EEG with hyperventilation. MRI epilepsy protocol.',2648,NULL,37.0,77490,225,225,'2022-07-17 09:56:26','2022-07-17 09:56:26'),(612,'EEG, MRI epilepsy protocol',2649,NULL,37.0,77490,225,225,'2022-07-17 10:00:42','2022-07-17 10:00:42'),(613,'EEG, MRI epilepsy protocol',2649,NULL,37.0,77490,225,225,'2022-07-17 10:00:45','2022-07-17 10:00:45'),(614,'Revise the diagnosis.   ESR, CBC, creatinine, ANA, Nerve conduction study sensory and motor.  Vitamin B12',2650,NULL,37.0,77490,225,225,'2022-07-17 10:07:07','2022-07-17 10:07:07'),(615,'Revise the diagnosis.   ESR, CBC, creatinine, ANA, Nerve conduction study sensory and motor.  Vitamin B12',2650,NULL,37.0,77490,225,225,'2022-07-17 10:07:11','2022-07-17 10:07:11'),(616,'NEURODEVELOPMENTAL FOLLOW UP',2654,NULL,37.0,77490,225,225,'2022-07-17 10:17:39','2022-07-17 10:17:39'),(617,'urine culture and sensitivity\r\nrepeat documented abdominal us to assess differentiation of both kidneys',2628,NULL,37.0,77495,1595,1595,'2022-07-17 10:45:39','2022-07-17 10:45:39'),(618,NULL,2651,NULL,37.0,77482,1578,1578,'2022-07-17 11:01:44','2022-07-17 11:01:44'),(619,'MRI Brain-EEG',2611,'cogintol -resperidal',37.0,77502,1597,1597,'2022-07-17 11:37:15','2022-07-17 11:37:15'),(620,'follow up',2671,'memexa',37.0,77510,912,912,'2022-07-18 08:06:40','2022-07-18 08:06:40'),(621,NULL,2617,NULL,37.0,77503,816,816,'2022-07-18 08:30:33','2022-07-18 08:30:33'),(622,'EEG   SERUM IRON   CBC',2659,NULL,37.0,77503,816,816,'2022-07-18 08:36:16','2022-07-18 08:36:16'),(623,NULL,2659,NULL,37.0,77503,816,816,'2022-07-18 08:36:42','2022-07-18 08:36:42'),(624,NULL,2660,'ENRICH SYP  & VIDROP',37.0,77503,816,816,'2022-07-18 08:44:33','2022-07-18 08:44:33'),(625,NULL,2660,NULL,37.0,77503,816,816,'2022-07-18 08:44:57','2022-07-18 08:44:57'),(626,NULL,2684,'aspocid 75 mg 2 قرص بعد الغدا',37.0,77505,1154,1154,'2022-07-18 09:45:28','2022-07-18 09:45:28'),(627,NULL,2061,'conventin  100 mg tab twice daily',37.0,77529,1602,1602,'2022-07-18 10:30:39','2022-07-18 10:30:39'),(628,NULL,2696,NULL,37.0,77530,1599,1599,'2022-07-18 11:05:37','2022-07-18 11:05:37'),(629,NULL,2355,NULL,37.0,77531,968,968,'2022-07-18 11:26:13','2022-07-18 11:26:13'),(630,'For follow up CT brain\r\nThen discharge on\r\nSomazina 2 cm/12 h\r\nFlozac 20 mg /24\r\nStop anticoagulant and follow up on mechanical prophylaxis\r\nStop antiepleptic\r\nPhysiotherapy\r\nStart swallowing training',2694,NULL,37.0,77530,1599,1599,'2022-07-18 11:52:09','2022-07-18 11:52:09'),(631,'good hydration Control sepsis\r\nStabilization of Haemodymics. weany from MV as early as possible. Single Autiplutlet & statin.',2690,NULL,37.0,77523,1599,1599,'2022-07-18 11:57:53','2022-07-18 11:57:53'),(632,'Double Antiplatet for 3 wech then angle Antiplate\r\nSycodal /½ tab IF agitation occured.',2693,NULL,37.0,77523,1599,1599,'2022-07-18 11:59:04','2022-07-18 11:59:04'),(633,'.CT bran Follow up..\r\n\r\nFundus Examition.\r\n\r\nMRA when possible. good hydration.\r\n\r\nStabilization of handyman\'s',2695,NULL,37.0,77523,1599,1599,'2022-07-18 12:00:25','2022-07-18 12:00:25'),(634,'Hussein Elkhodery: eep in the same anticoagulant Fundus Examinalin\r\n[1:41 pm, 18/07/2022] Hussein Elkhodery: Follow up CT brain 148h when \"Follow up CT ban ofter dehydrating Mensare.\r\n\r\n• sedation caccation assess tachypnen et chest if needed. • consider antiepileptic & tination.',2697,NULL,37.0,77523,1599,1599,'2022-07-18 12:02:06','2022-07-18 12:02:06'),(635,'Follow up MRI\r\nContinue tiratam 500/12\r\nSingle antipalt\r\nActor 40\r\nFlozac 20/24\r\nSomazina 2 cm /12\r\nSwallowing training\r\nPhysiotherapy',2696,NULL,37.0,77530,1599,1599,'2022-07-18 12:11:17','2022-07-18 12:11:17'),(636,NULL,2669,'cerebrolysin 1ml ampoule /cerebroprove syrp/osteocare syrp/vidrops',37.0,77543,1529,1529,'2022-07-19 08:19:43','2022-07-19 08:19:43'),(637,NULL,2704,'Good Hydration guided by CVP and IVC diameter',37.0,77542,1607,1607,'2022-07-19 08:56:41','2022-07-19 08:56:41'),(638,'Ultrasound on kidney\r\nencourage oral fluid \r\nfollow up of UOP\r\nAntibiotic for sepsis\r\nfollow up of ur creat ABG Na K',2704,NULL,37.0,77542,1607,1607,'2022-07-19 09:00:15','2022-07-19 09:00:15'),(639,'FOLLOW UP CT \r\nCARE OF BED RIDDEN PATIENT',2706,'aspocid 75 mg 2 قرص بعد الغدا    \\ ator 20 mg قرص مساءاTEBONINA FORTE قرص كل 12 ساعة\\ FOLLOW UPCT \\\\CARE OF',37.0,77548,1154,1154,'2022-07-19 09:34:08','2022-07-19 09:34:08'),(640,NULL,2699,'Follow up hemodynamics.volume state,ABG,RFT,NA,K,,',37.0,77536,1151,1151,'2022-07-19 11:21:25','2022-07-19 11:21:25'),(641,'PEDIATRIC CARDIOTHORACIC SURGEON CONSULTATION',2686,NULL,37.0,77534,365,365,'2022-07-19 11:29:31','2022-07-19 11:29:31'),(642,'PEDIATRIC CARDIOTHOERACICX SURGERY CONSULTATION',2686,NULL,37.0,77534,365,365,'2022-07-19 11:36:34','2022-07-19 11:36:34'),(643,'FEVER, BP chartEC\r\n\r\nECHO,  ECG, FERITTIN, LDH,TRIGLYCERIDES, , FIBRINOGEN, D DIMER, CT CHEST, CT BRAIN., \r\nIVIG 2 GM/KGB OVER 24 HOURS, ASPRIN 30 MG/KG/DAY DIVIDED, RECONSULT ABOUT ANTICOAGULATION AND ECHO',2609,NULL,37.0,77561,1613,1613,'2022-07-20 08:21:18','2022-07-20 08:21:18'),(644,NULL,2681,NULL,37.0,77570,1615,1615,'2022-07-20 09:35:40','2022-07-20 09:35:40'),(645,'close monitoring of CBC as the patient is old age for fear of methotrexate toxicity\r\nX-ray hand\r\ninsure the patient to continue on folic acid',2682,'hydroquine, arthfree',37.0,77570,1615,1615,'2022-07-20 10:02:33','2022-07-20 10:02:33'),(646,'stop betafos \r\nstart oral steroid withdrawal with close monitoring of the \r\n patient during withdarwal for fear of addisonian crisis\r\nclose monitoring of blood pressure, blood sugar, fever\r\ninvestigations needed: CBC,ESR,AST,ALT,CREATININE,HBSAG,HCVAB,protein in 24 hr urine, TSH\r\nadd methotrexate if the investigations wil be normal by dose 12.5 mg every week plus folic acid as the patient isnot controlled on the current treatment\r\nX ray lumbosacral vertebrae',2681,'hydroquine, arthfree',37.0,77570,1615,1615,'2022-07-20 10:11:26','2022-07-20 10:11:26'),(647,NULL,2742,NULL,37.0,77557,990,990,'2022-07-20 10:13:32','2022-07-20 10:13:32'),(648,'the patient is complaining of redness of both eyes with foreign body sensation and mouth ulcers for dermatological and ophthalmologic consultations \r\nESR,CBC',2714,'hydroquine, arthfree',37.0,77570,1615,1615,'2022-07-20 10:16:13','2022-07-20 10:16:13'),(649,'ask for investigations: CBC, ESR,urine analysis, protein in 24 hr urine',2715,'hydroquine, oral steroid 20 mg, azathioprine 50 mg 1*2',37.0,77570,1615,1615,'2022-07-20 10:19:48','2022-07-20 10:19:48'),(650,NULL,593,'dssdsd',37.0,77572,339,339,'2022-07-20 10:50:46','2022-07-20 10:50:46'),(651,NULL,2734,NULL,37.0,77577,1617,1617,'2022-07-20 11:08:02','2022-07-20 11:08:02'),(652,'to perform investigations  HA1C',2723,NULL,37.0,77574,1622,1622,'2022-07-20 11:37:31','2022-07-20 11:37:31'),(653,'fully conscious and needs endocrine consultation a',2773,NULL,37.0,77588,1628,1628,'2022-07-21 09:14:13','2022-07-21 09:14:13'),(654,'dual antiplatlet \r\nanti hyperlipidemic',2767,NULL,37.0,77582,714,714,'2022-07-21 09:21:43','2022-07-21 09:21:43'),(655,'follow up lab , ECHO',2737,'Antibiotics according to blood cultures , antipyretics',39.0,77589,1627,1627,'2022-07-21 09:30:00','2022-07-21 09:30:00'),(656,'COVID pcr',2760,NULL,37.0,77587,1628,1628,'2022-07-21 09:43:20','2022-07-21 09:43:20'),(657,'COVID pcr',2761,NULL,37.0,77587,1628,1628,'2022-07-21 09:44:15','2022-07-21 09:44:15'),(658,'investigate for arrythmia due to the cardiac arrest in epleptic patient and arrange for holter',2762,NULL,37.0,77587,1628,1628,'2022-07-21 09:46:25','2022-07-21 09:46:25'),(659,'observe pupils and GCS  for any urgent interventionavoid hyperglycemia and hypertention',2763,NULL,37.0,77587,1628,1628,'2022-07-21 09:49:13','2022-07-21 09:49:13'),(660,NULL,2688,NULL,37.0,77583,1026,1026,'2022-07-21 10:12:56','2022-07-21 10:12:56'),(661,NULL,2689,NULL,37.0,77583,1026,1026,'2022-07-21 10:14:10','2022-07-21 10:14:10'),(662,'to  follow  up after 3 days',2774,'symptomatic ttt',37.0,77591,1636,1636,'2022-07-21 10:27:02','2022-07-21 10:27:02'),(663,NULL,2771,NULL,37.0,77584,1026,1026,'2022-07-21 10:28:05','2022-07-21 10:28:05'),(664,NULL,2770,NULL,37.0,77584,1026,1026,'2022-07-21 10:28:48','2022-07-21 10:28:48'),(665,NULL,2584,NULL,37.0,77584,1026,1026,'2022-07-21 10:29:18','2022-07-21 10:29:18'),(666,'physiotherapy, medications and follow up',1814,', , coenzyme Q cerebrolysin ampoule, omega three, l carnitine',37.0,77579,284,284,'2022-07-21 10:29:22','2022-07-21 10:29:22'),(667,'physiotherapy, medications and follow up',1814,'L carnitine cerebrolysin coenzyme Q',37.0,77579,284,284,'2022-07-21 10:30:27','2022-07-21 10:30:27'),(668,'withdrawal of depakene, ecg and echocardiography',2108,'withdrawal of depakene',37.0,77579,284,284,'2022-07-21 10:35:11','2022-07-21 10:35:11'),(669,'ecg and echocardiography withdrawal of depakene',2108,'withdrawal of depakene,',37.0,77579,284,284,'2022-07-21 10:36:03','2022-07-21 10:36:03'),(670,'fractional CO2 Laser',2779,NULL,37.0,77591,1636,1636,'2022-07-21 10:48:04','2022-07-21 10:48:04'),(671,'to follow up on same treatment for 3 weeks',2781,'same ttt',37.0,77596,1633,1633,'2022-07-21 11:21:25','2022-07-21 11:21:25'),(672,'Resolution of DkA\r\nsTART sc INSULIN 0.5iu/kg/day AND TITRATE THE DOSE ACCORDING TO BLOOD GLUCOSE READINGS\r\nfOLLOW UP ACETONE IN URINE TILL BE NIL\r\nsTOP MANNITOL\r\ntO DO hBa1c\r\nFor Diabetes education',2773,NULL,37.0,77597,1638,1638,'2022-07-21 11:41:15','2022-07-21 11:41:15'),(673,'الحجز بالمستشفي وعمل منظار علي المعده',2764,'ganaton 50 mg tab -قرص كل 8 ساعات -spasmodigestin tab قرص كل 8 ساعات - calmag tab قرص كل 8 ساعات - one alpha .5 mg tab قرص مساءا',37.0,77600,1540,1540,'2022-07-24 09:22:42','2022-07-24 09:22:42'),(674,'Monitor vital signs - good hydration - Hg follow up - serum diurnal cortisol',2799,'Therapeutic anti coagulation - Daflon 500 - alphintern',37.0,77606,1647,1647,'2022-07-24 10:21:15','2022-07-24 10:21:15'),(675,'follow up of another attack and follow up of polydypsia',2789,NULL,37.0,77612,1650,1650,'2022-07-24 10:24:54','2022-07-24 10:24:54'),(676,'full sepsis profile and repeat abdominal US and ct abdomen',2790,NULL,37.0,77612,1650,1650,'2022-07-24 10:27:11','2022-07-24 10:27:11'),(677,'warm fluids and symptomatic treatment',2792,NULL,37.0,77611,1650,1650,'2022-07-24 10:32:19','2022-07-24 10:32:19'),(678,NULL,2807,'.cidamex tab twice daily     potassium syruo 5cm 8h       stugeron 25 mg twice daily',37.0,77607,1199,1199,'2022-07-24 10:35:45','2022-07-24 10:35:45'),(679,'LIFE STYLE MODIFICATION',2791,'PANTOPRAZOLE',37.0,77599,893,893,'2022-07-24 11:22:22','2022-07-24 11:22:22'),(680,NULL,727,'ashigasfjfsdjgfs jfhsdgfiujdsih',37.0,77617,339,339,'2022-07-24 13:22:58','2022-07-24 13:22:58'),(681,'urgent brain imaging and checking liver functions and PT, PTT',2826,NULL,37.0,77619,316,316,'2022-07-25 08:49:42','2022-07-25 08:49:42'),(682,'urgent brain imaging and checking liver functions and PT, PTT',2826,NULL,37.0,77619,316,316,'2022-07-25 08:51:15','2022-07-25 08:51:15'),(683,NULL,2769,'hostacortin 5 mg  2قرص صباحا وقرص مساءا',37.0,77630,1602,1602,'2022-07-25 08:59:20','2022-07-25 08:59:20'),(684,NULL,2648,NULL,37.0,77620,271,271,'2022-07-25 09:32:13','2022-07-25 09:32:13'),(685,NULL,2838,NULL,37.0,77620,271,271,'2022-07-25 09:39:15','2022-07-25 09:39:15'),(686,NULL,2837,NULL,37.0,77620,271,271,'2022-07-25 09:45:18','2022-07-25 09:45:18'),(687,NULL,2288,NULL,37.0,77620,271,271,'2022-07-25 09:47:31','2022-07-25 09:47:31'),(688,NULL,2839,NULL,37.0,77620,271,271,'2022-07-25 09:52:27','2022-07-25 09:52:27'),(689,NULL,2821,'calcium vit D',37.0,77626,1660,1660,'2022-07-25 09:57:04','2022-07-25 09:57:04'),(690,NULL,2850,NULL,37.0,77620,271,271,'2022-07-25 10:00:51','2022-07-25 10:00:51'),(691,NULL,2841,NULL,37.0,77620,271,271,'2022-07-25 10:05:29','2022-07-25 10:05:29'),(692,NULL,2836,NULL,37.0,77620,271,271,'2022-07-25 10:08:06','2022-07-25 10:08:06'),(693,NULL,2797,'terbin 125 mg tab',37.0,77635,1276,1276,'2022-07-25 10:20:46','2022-07-25 10:20:46'),(694,NULL,2798,'krella oint',37.0,77635,1276,1276,'2022-07-25 10:24:03','2022-07-25 10:24:03'),(695,NULL,2840,'itacon 100 mg tab 2x1x15',37.0,77638,1276,1276,'2022-07-25 10:34:03','2022-07-25 10:34:03'),(696,NULL,2824,'TCA or fractional CO2',37.0,77639,1276,1276,'2022-07-25 10:41:46','2022-07-25 10:41:46'),(697,NULL,2823,'topical steroid',37.0,77639,1276,1276,'2022-07-25 10:49:12','2022-07-25 10:49:12'),(698,NULL,2828,'apixiban 10mg tab twice for one week then apixiban 5mg tab twice for life',37.0,77644,1164,1164,'2022-07-26 07:56:51','2022-07-26 07:56:51'),(699,NULL,2870,'aspocide 75mg    pk merz infusion  vit b12',37.0,77645,1154,1154,'2022-07-26 08:28:43','2022-07-26 08:28:43'),(700,NULL,2872,NULL,37.0,77645,1154,1154,'2022-07-26 08:29:02','2022-07-26 08:29:02'),(701,'sebaceous hyperplasia for dd',744,'sebaceous hyperplasia for dd',37.0,77667,339,339,'2022-07-26 09:02:54','2022-07-26 09:02:54'),(702,'dermatopathia pigmentosa reticularis',744,'dermatopathia pigmentosa reticularis',37.0,77667,339,339,'2022-07-26 09:06:32','2022-07-26 09:06:32'),(703,'lumbar puncture   MRI brain',2820,NULL,37.0,77662,1154,1154,'2022-07-26 09:17:15','2022-07-26 09:17:15'),(704,'Renal biopsy \r\nIf class 4 : continue cyclophoshamide and corticosteroid\r\nif cresentic GN : add TPE',2862,NULL,37.0,77668,1607,1607,'2022-07-26 09:18:36','2022-07-26 09:18:36'),(705,NULL,2877,NULL,37.0,77648,893,893,'2022-07-26 10:06:46','2022-07-26 10:06:46'),(706,NULL,2892,'itrapex 100 bid for 14 days',37.0,77666,1610,1610,'2022-07-26 10:55:56','2022-07-26 10:55:56'),(707,'brain MRI, MRV, MRA \r\nfull cultures\r\nIgG and IgM for Herps and CMV\r\ntotal metabolic screaning',2875,'zovirax',37.0,77677,1685,1685,'2022-07-26 12:43:06','2022-07-26 12:43:06'),(708,NULL,2951,NULL,37.0,77679,1026,1026,'2022-07-27 08:52:48','2022-07-27 08:52:48'),(709,'follow up calcium ph,uric acid ,pth,renal function in 2 weeks',2954,NULL,37.0,77679,1026,1026,'2022-07-27 09:01:52','2022-07-27 09:01:52'),(710,NULL,2883,NULL,37.0,77689,1615,1615,'2022-07-27 09:10:40','2022-07-27 09:10:40'),(711,NULL,2950,'Antiplatelets',37.0,77692,1399,1399,'2022-07-27 09:21:40','2022-07-27 09:21:40'),(712,NULL,2885,'hydroquine, immuran,steroid',37.0,77689,1615,1615,'2022-07-27 09:35:48','2022-07-27 09:35:48'),(713,NULL,2919,'carvid 25 twice is added plus alkapres 10 once',37.0,77678,1026,1026,'2022-07-27 09:36:38','2022-07-27 09:36:38'),(714,NULL,2887,NULL,37.0,77689,1615,1615,'2022-07-27 09:36:38','2022-07-27 09:36:38'),(715,NULL,2889,NULL,37.0,77689,1615,1615,'2022-07-27 09:37:22','2022-07-27 09:37:22'),(716,NULL,2891,NULL,37.0,77689,1615,1615,'2022-07-27 09:37:47','2022-07-27 09:37:47'),(717,NULL,2947,'anticoglant',37.0,77696,1399,1399,'2022-07-27 09:38:21','2022-07-27 09:38:21'),(718,'CBC,SER,AST,ALT, serum creatinine\r\npelvi-abdominal ultrasound\r\nchest x ray\r\nif the inversigations will be normal and the last activity was from more than one year, start to lower the dose of methotrexate or athfree',2891,'methotrexate, hydroquine, arthfree',37.0,77689,1615,1615,'2022-07-27 09:42:03','2022-07-27 09:42:03'),(719,NULL,2948,'pystinone',37.0,77696,1399,1399,'2022-07-27 09:44:48','2022-07-27 09:44:48'),(720,'CBC,ESR,CRP,URINE ANALYSIS\r\nX ray cervical and lumbo-sacral vertebrea AP and lateral view\r\nstress in the history of the patient on recurrent genitourinary tract infection or gasrtointestinal\r\nophthalmologic consultation to exclude uvietis\r\nMRI on sacroiliac joints',2889,NULL,37.0,77689,1615,1615,'2022-07-27 09:46:47','2022-07-27 09:46:47'),(721,'reassess the patient to be sure of the diagnosis??\r\nrepeat ANA, protein in 24hr urine, CBC,ESR\r\nif the results will be normal, consider withdrawal of the treatment',2887,'hydroquine, immuran,',37.0,77689,1615,1615,'2022-07-27 09:50:28','2022-07-27 09:50:28'),(722,'ESR,CRP,CBC,ANAAST,ALT, serum creatinine\r\ndermatological consultation',2885,'hydroquine, immuran,steroid',37.0,77689,1615,1615,'2022-07-27 09:52:36','2022-07-27 09:52:36'),(723,NULL,2903,'levitrcetam',37.0,77701,1399,1399,'2022-07-27 09:54:16','2022-07-27 09:54:16'),(724,'regular follow up of the patient\r\ncontinue on the same treatment',2883,'hydroquine, immuran,steroid',37.0,77689,1615,1615,'2022-07-27 09:54:27','2022-07-27 09:54:27'),(725,NULL,2959,'steroid',37.0,77700,1399,1399,'2022-07-27 09:58:47','2022-07-27 09:58:47'),(726,NULL,2958,'tonics',37.0,77700,1399,1399,'2022-07-27 10:01:54','2022-07-27 10:01:54'),(727,NULL,2372,'levitractam',37.0,77700,1399,1399,'2022-07-27 10:07:13','2022-07-27 10:07:13'),(728,NULL,2957,'aspirin',37.0,77694,1399,1399,'2022-07-27 10:15:42','2022-07-27 10:15:42'),(729,'CARDIOTHOTACIC SURGERY CONSALTION',1998,NULL,37.0,73942,1352,1352,'2022-07-27 10:46:32','2022-07-27 10:46:32'),(730,'CHEST CONSULTATION\r\nPATIENT MUST PUT ON O2 CONSANTRATOR AND HOME B.BAP',2010,NULL,37.0,73942,1352,1352,'2022-07-27 10:48:47','2022-07-27 10:48:47'),(731,'zinc syrup\r\nnitazode syrup\r\nlacteale forte sachets \r\nhydrosafe sachets\r\nif tolerating oral feeding stop iv fluids \r\nstool analysis and Na, K',2927,NULL,37.0,77711,1702,1702,'2022-07-27 11:35:56','2022-07-27 11:35:56'),(732,'continue IV antibiotics\r\nchest care , nebulization\r\nstart oral feeding if vitally stable  then stop IV fluids\r\nbasic labs : CBC diff, CRP',2928,NULL,37.0,77711,1702,1702,'2022-07-27 11:38:22','2022-07-27 11:38:22'),(733,NULL,2971,NULL,37.0,77717,973,973,'2022-07-28 08:21:23','2022-07-28 08:21:23'),(734,'reassurance and follow up',2983,'no need',37.0,77714,284,284,'2022-07-28 08:23:14','2022-07-28 08:23:14'),(735,'reassurance and follow up',2983,'no need',37.0,77714,284,284,'2022-07-28 08:24:03','2022-07-28 08:24:03'),(736,NULL,2995,'inotropic support as the patient shocked',37.0,77726,1627,1627,'2022-07-28 09:27:10','2022-07-28 09:27:10'),(737,NULL,2977,'diuretics , SGLT2I , ENTERESTO',37.0,77727,1627,1627,'2022-07-28 09:48:53','2022-07-28 09:48:53'),(738,'oral zithromax \r\nonce xylocaine inhalation very small does',2993,NULL,37.0,77734,1628,1628,'2022-07-28 09:54:44','2022-07-28 09:54:44'),(739,'CRP\r\nK level\r\nthe patient is tolerating oral no red flags',2996,NULL,37.0,77734,1628,1628,'2022-07-28 09:56:18','2022-07-28 09:56:18'),(740,'BMA',2998,NULL,37.0,77732,1628,1628,'2022-07-28 10:22:34','2022-07-28 10:22:34'),(741,'HCV ab',2975,'sun protection +avoid predisposing agent +sys anti-oxidant + systemic anti malaria to be added after invest',37.0,77736,1633,1633,'2022-07-28 10:23:42','2022-07-28 10:23:42'),(742,'familial for ceruloplasmin\r\nlactate and ammonia\r\nMRI with contrast',3001,NULL,37.0,77732,1628,1628,'2022-07-28 10:23:57','2022-07-28 10:23:57'),(743,'presence  or absence of pulmonary hypertention\r\nto adjust diuretics and add pulmonary vasodilator\r\nneubilizer on vent',3003,NULL,37.0,77732,1628,1628,'2022-07-28 10:25:45','2022-07-28 10:25:45'),(744,NULL,2965,'exforg hct carvid 25',37.0,77719,966,966,'2022-07-28 10:26:36','2022-07-28 10:26:36'),(745,NULL,2967,'regicore 10 carvid 25',37.0,77719,966,966,'2022-07-28 10:29:51','2022-07-28 10:29:51'),(746,NULL,2994,'octerotide mididrine albumin gastrobiotic',37.0,77720,966,966,'2022-07-28 10:55:43','2022-07-28 10:55:43'),(747,NULL,2771,'methyl prednisilone   renal adjustment of antbiotic doses   redmisfir',37.0,77720,966,966,'2022-07-28 10:57:29','2022-07-28 10:57:29'),(748,'Revision surgery',2979,NULL,37.0,77744,928,928,'2022-07-28 11:59:02','2022-07-28 11:59:02'),(749,'iron profile / increase dose of eprex l blood transfusion',3020,NULL,37.0,77749,1639,1639,'2022-07-31 08:53:09','2022-07-31 08:53:09'),(750,'increase utrafiltration \r\nparacentisis',3021,NULL,37.0,77749,1639,1639,'2022-07-31 08:55:56','2022-07-31 08:55:56'),(751,'shift to CCB',3022,NULL,37.0,77749,1639,1639,'2022-07-31 08:57:21','2022-07-31 08:57:21'),(752,'salt restriction > increase ultrafiltration<ECHO And Pelvi Abdominal U/S',3023,NULL,37.0,77749,1639,1639,'2022-07-31 08:59:49','2022-07-31 08:59:49'),(753,'Follow up BP\r\nEcho\r\nincrease dose of midodrine',3026,NULL,37.0,77749,1639,1639,'2022-07-31 09:02:04','2022-07-31 09:02:04'),(754,NULL,676,'GERD control + weight reduction + Bronchodilator +DM & HTN control + multivitamins',37.0,77759,1721,1721,'2022-07-31 09:15:55','2022-07-31 09:15:55'),(755,'عرض قلب ورسم قلب بالمجهود',3016,'epilat retard',37.0,77748,966,966,'2022-07-31 09:34:29','2022-07-31 09:34:29'),(756,'متابعه ضغط الدم',3017,'exforg 10 160',37.0,77748,966,966,'2022-07-31 09:35:46','2022-07-31 09:35:46'),(757,'follow up monthly NDYAG LASER if available',3045,'.betaval ointement once daily for 2 weeks,zithrocin 500 once daily for 5 days monthly',37.0,77768,1726,1726,'2022-07-31 10:53:15','2022-07-31 10:53:15'),(758,'ketones in urine and critical sample withdrawal \r\nstop steroids\r\nincrease GIR',3010,NULL,37.0,77770,1730,1730,'2022-07-31 11:55:22','2022-07-31 11:55:22'),(759,'follow up random blood sugar before and during HD session',3057,'stopped insulin',37.0,77787,1734,1734,'2022-08-01 08:38:31','2022-08-01 08:38:31'),(760,NULL,3093,NULL,37.0,77771,271,271,'2022-08-01 09:45:21','2022-08-01 09:45:21'),(761,'start zovirax (20mg/kgldose)\r\nkeep the patient on anticonvulsant\r\nmri brain and eeg',3110,NULL,37.0,77797,1743,1743,'2022-08-01 10:22:20','2022-08-01 10:22:20'),(762,NULL,3078,'sunbloock , topical retenoid',37.0,77786,1680,1680,'2022-08-01 10:31:28','2022-08-01 10:31:28'),(763,NULL,3066,'calcium vit D - l thyroxine',37.0,77791,1660,1660,'2022-08-01 10:36:18','2022-08-01 10:36:18'),(764,NULL,3078,',topical steroidemolient ,antihistamine,urea 10',37.0,77786,1680,1680,'2022-08-01 10:36:38','2022-08-01 10:36:38'),(765,'norflex amp أمبول عضل يوميا لمدة تلات ايام\r\nlornoxicam vial امبول عضل يوميا لمدة 3 أيام\r\nmarkfast cap كبسولة بعد الاكل لمدة تلات ايام لمدة أسبوع ثم كبسولة بعد الالكل مرتين\r\nambizem tab قرص قبل الالكل مرتين لمدة 10 أيام\r\ndeluxeprine 30 mg cap كبسولة مساء ويمكن زياتدها الى كبسولتين مساء في حالة عدم التحسن\r\nmilga tab قرص صباحا ومساء \r\nكمادات دافئة على الرقبى صباحا ومساء لمدة نص ساعة ثم دهان \r\nalgasone cream\r\nمتابعة بعد أسبوعين',3075,NULL,37.0,77794,1599,1599,'2022-08-01 10:54:38','2022-08-01 10:54:38'),(766,NULL,3059,'ablative co2 laser or sugical removal',37.0,77804,1678,1678,'2022-08-01 11:00:54','2022-08-01 11:00:54'),(767,NULL,3102,'systemic antibiotic, topical antibiotic, k permangnate',37.0,77804,1678,1678,'2022-08-01 11:03:46','2022-08-01 11:03:46'),(768,'Holter data to be delivered to asses minimum and maximum heart rates',3027,NULL,37.0,77800,1744,1744,'2022-08-01 11:30:12','2022-08-01 11:30:12'),(769,'CT chest, CTPA, abdominal US(to exclude liver and kidney disease), , KFTs, LFTs',3127,NULL,37.0,77809,1390,1390,'2022-08-02 09:05:04','2022-08-02 09:05:04'),(770,'cbc\r\nstool analysis\r\nironstudy\r\nconners rating scale IQ',3126,'effalex syp ENRICH SYP  & VIDROP',37.0,77806,816,816,'2022-08-02 09:11:48','2022-08-02 09:11:48'),(771,'urine analysis\r\npUAS\r\nBEHAVIOR THERAPY',3100,NULL,37.0,77806,816,816,'2022-08-02 09:23:56','2022-08-02 09:23:56'),(772,'urine analysis pUAS BEHAVIOR THERAPY',2841,NULL,37.0,77806,816,816,'2022-08-02 09:31:40','2022-08-02 09:31:40'),(773,NULL,2953,NULL,37.0,77811,990,990,'2022-08-02 10:23:30','2022-08-02 10:23:30'),(774,'shift antibiotic according to culture and sensitivity , x ray abdomen and chest , give plasma transfusion',3082,'shift antibiotic according to culture and sensitivity , x ray abdomen and chest , give plasma transfusion',37.0,77835,1754,1754,'2022-08-02 10:32:47','2022-08-02 10:32:47'),(775,'shift antibiotic according to culture and sensitivity , x ray abdomen and chest , give plasma transfusion',3083,'plasma , antibiotics',37.0,77835,1754,1754,'2022-08-02 10:33:43','2022-08-02 10:33:43'),(776,'start to withdraw tiratam , start to withdraw support, plain x ray on chest, continue on same antibiotics, recent crp , cbc, cranial ultrasound',3084,'plasma',37.0,77835,1754,1754,'2022-08-02 10:41:54','2022-08-02 10:41:54'),(777,'improved respiratory distress, for discharge',3086,'oxygen',37.0,77835,1754,1754,'2022-08-02 10:45:08','2022-08-02 10:45:08'),(778,'plasma , add adrenaline support, a recent crp , cbc , shift antibiotics , cranial ultrasound',3090,'plasma , meropenem , blood transfusion',37.0,77835,1754,1754,'2022-08-02 10:52:50','2022-08-02 10:52:50'),(779,'withdraw noradernaline, plasma /12 hours, shift antibiotics , x ray chest',3094,'plasma, vancomycin , mereponem, konakion',37.0,77821,1754,1754,'2022-08-02 11:09:50','2022-08-02 11:09:50'),(780,'maintain good oral feeding, stop antibiotics, start tonics',3095,'tonics , premature milk',37.0,77821,1754,1754,'2022-08-02 11:15:03','2022-08-02 11:15:03'),(781,'o  antibiotics according to culture\r\nCBC\r\nABD U/S',3159,'medical treatment',38.0,77826,1756,1756,'2022-08-02 11:53:53','2022-08-02 11:53:53'),(782,'follow up',3160,'topical and systemic , antibiotics',37.0,77826,1756,1756,'2022-08-02 12:02:01','2022-08-02 12:02:01'),(783,'ct abdomen\r\ncbc',3161,'follow up',38.0,77826,1756,1756,'2022-08-02 12:10:55','2022-08-02 12:10:55'),(784,'lap append follow up',3162,'shift antibiotic according to culture and sensetivit',38.0,77826,1756,1756,'2022-08-02 12:18:50','2022-08-02 12:18:50'),(785,NULL,3163,'shift antibiotic according to culture and sensitivity',37.0,77826,1756,1756,'2022-08-02 12:26:26','2022-08-02 12:26:26'),(786,'further investigations (CBC,BLOOD GROUPING FOR BABY AND MOTHER,RETIX,Coombs test)',3150,'phototherapy',37.0,77842,1769,1769,'2022-08-03 08:25:16','2022-08-03 08:25:16'),(787,'HD /HAEMODIALYSIS',2450,NULL,37.0,77857,1777,1777,'2022-08-03 09:16:34','2022-08-03 09:16:34'),(788,'operative intervention in form of augmentation plating and grafting',3169,'operative intervention in form of augmentation plating and grafting',37.0,77841,1766,1766,'2022-08-03 09:31:13','2022-08-03 09:31:13'),(789,'CBC\r\nCRP\r\nCranial US\r\nsingle antibiotic Unasyn\r\nIf CRP is positive.. proceed to blood culture and add Garamycin',3192,'Konakion',37.0,77849,1294,1294,'2022-08-03 09:39:41','2022-08-03 09:39:41'),(790,NULL,3217,NULL,37.0,77859,996,996,'2022-08-03 09:40:00','2022-08-03 09:40:00'),(791,NULL,3213,NULL,37.0,77859,996,996,'2022-08-03 09:42:42','2022-08-03 09:42:42'),(792,'gradual withdrawal of phototherapy\r\nrebound level tomorrow',3193,'photo + feeding',37.0,77849,1294,1294,'2022-08-03 09:46:31','2022-08-03 09:46:31'),(793,'gradual decrease photo',3193,NULL,37.0,77849,1294,1294,'2022-08-03 09:47:10','2022-08-03 09:47:10'),(794,'decrease dose of methotrexate to 12.5 mg weekly(.5cm)\r\n steroid withdrawal until stopping it on period of three months\r\nclose monitoring of the patient during withdrawal',3186,'methotrexate, hydroquine, steroid',37.0,77855,1615,1615,'2022-08-03 09:47:35','2022-08-03 09:47:35'),(795,'stop unictam\r\nlabs to ensure normal electrolytes and exclude significant septicemia\r\nlacteol forte',3180,'cefotaxime',37.0,77849,1294,1294,'2022-08-03 09:52:11','2022-08-03 09:52:11'),(796,'stop unictam\r\nlabs to ensure normal electrolytes and exclude significant septicemia\r\nlacteol forte',3180,NULL,37.0,77849,1294,1294,'2022-08-03 09:52:34','2022-08-03 09:52:34'),(797,'the patient presented with activity for minipulse steroid\r\n(epizolone depot 80 mg) for three days then continue on oral steroid 10 mg for two weeks then withdraw\r\ncontinue on the same dose of methotrexate (17.5 mg)  \r\nif the patient developed recurrent activities again , shift to biologic treatment',3187,', steroid, methotrexate, hydroquine, arthfree',37.0,77855,1615,1615,'2022-08-03 09:53:09','2022-08-03 09:53:09'),(798,'advice the patient to stop taking dexamethazone by him self\r\ncontinue on colchicie three time per day\r\nwithdraw steroid to dose 10 mg\r\ndermatology consultation to be sure about the presence of genital ulcer\r\nophthalmologic consultation for uvietis or other ocular manifestations',3189,'colchicine, steroid',37.0,77855,1615,1615,'2022-08-03 09:56:47','2022-08-03 09:56:47'),(799,'stool analysis\r\nconsider helicobacter\r\ntriple therapy\r\nlabs for sepsis and electrolytes',3179,'nexium + flagyl + azithromycin',37.0,77849,1294,1294,'2022-08-03 09:58:41','2022-08-03 09:58:41'),(800,'GOOD ULTRA FILTRATION ,S.ALBUMIN&PLASMA TRANSFUSTION IF PT NEEDED',3157,'EXFORGE HCT',37.0,77847,1751,1751,'2022-08-03 09:58:57','2022-08-03 09:58:57'),(801,'follow up of thyroid functions\r\ngynecological consultation for detection the cause of reecurrent vaginal bleeding\r\nflolow up CBC and protein in 24hr urine\r\nconsider shifting of methotrexate to azathioprine\r\nconsider addition of aspirin 75 mg for anti-phospholopids',3206,'methotrexate, hydroquine, steroid',37.0,77855,1615,1615,'2022-08-03 10:01:29','2022-08-03 10:01:29'),(802,'follow up ca &ph level monthy PTHevery 3 month',3170,'one alpha ,25mg &calcimate tb',37.0,77848,1751,1751,'2022-08-03 10:09:39','2022-08-03 10:09:39'),(803,NULL,3219,'further investigations (dorsolumber MRI - NCV)',37.0,77861,1784,1784,'2022-08-03 10:23:15','2022-08-03 10:23:15'),(804,NULL,3194,'Brain MRI - Brain stimulasnt',37.0,77862,1784,1784,'2022-08-03 10:40:10','2022-08-03 10:40:10'),(805,NULL,3197,'NCV - plasma pharesis',37.0,77862,1784,1784,'2022-08-03 10:44:22','2022-08-03 10:44:22'),(806,'MRI brain',3009,'Anticoagulation (heparin) then shift to oral anticoagulants',37.0,77867,1784,1784,'2022-08-03 10:49:57','2022-08-03 10:49:57'),(807,'to follow up',3117,'onychomadesis mostly post viral',37.0,77865,1701,1701,'2022-08-03 11:02:12','2022-08-03 11:02:12'),(808,'dietetic management',3212,'dietetic management',37.0,77869,1778,1778,'2022-08-03 11:44:24','2022-08-03 11:44:24'),(809,'progress feeding until reach weight 1600 gm',3164,'shift antibiotic according to culture and sensetivit',37.0,77871,1792,1792,'2022-08-04 08:55:53','2022-08-04 08:55:53'),(810,'laparoscopic cholecystectomy',3167,'laparoscopic cholecystectomy',37.0,77872,1791,1791,'2022-08-04 09:27:36','2022-08-04 09:27:36'),(811,'EEG, fundus examination and reconsult',3249,'analgesics, iron supplementation',37.0,77888,284,284,'2022-08-04 09:57:48','2022-08-04 09:57:48'),(812,'EEG, fundus examination and reconsult',3249,'analgesics, iron supplementation',37.0,77888,284,284,'2022-08-04 09:58:21','2022-08-04 09:58:21'),(813,'CBC\r\nESR\r\nVitamin D level Essay',3191,'follow up',37.0,77901,680,680,'2022-08-04 10:09:24','2022-08-04 10:09:24'),(814,'need biobsy from new lesion \r\nlab for anti-malarial \r\nSGOT SGPT\r\nfundus examination\r\ns.urea s creat\r\nCBC\r\nFBS +2h post prandial \r\n>>>\r\nTTT\r\nsystemic AB +fucicort+avoid sun exposure',3264,NULL,37.0,47838,1633,1633,'2022-08-04 10:59:56','2022-08-04 10:59:56'),(815,'check cbc (plt) count\r\ncheck coagulation profile\r\ngasstric wash if clear start tropic feeding',3229,NULL,37.0,77910,1808,1808,'2022-08-04 11:18:53','2022-08-04 11:18:53'),(816,'weaning of mechanical ventilator settings ( deacrease fio2 decrease pip)\r\necho exclude cong heart disease or pulmonary hypertension\r\nstart trophic feeding',3232,NULL,37.0,77910,1808,1808,'2022-08-04 11:22:06','2022-08-04 11:22:06'),(817,'RENAL DUPLEX AND echo',3258,'INCREASED DOSES OF ANTIHYPERTENSION',37.0,77911,1809,1809,'2022-08-06 08:11:48','2022-08-06 08:11:48'),(818,'doing CBC',3259,'incrase dose of hyparin sodium',37.0,77911,1809,1809,'2022-08-06 08:13:20','2022-08-06 08:13:20'),(819,'FOLLOW UP',2930,'ORiF',37.0,77912,1810,1810,'2022-08-06 08:42:50','2022-08-06 08:42:50'),(820,'FOLLOW UP',2929,'ILIOSACRAL SCREW',37.0,77912,1810,1810,'2022-08-06 08:58:22','2022-08-06 08:58:22'),(821,'STOP IV FLUID',3271,'follow up HB',37.0,77913,1811,1811,'2022-08-06 09:18:57','2022-08-06 09:18:57'),(822,'discharge to inward unit',3274,'antibiotics, oxygen, nebulizer',37.0,77913,1811,1811,'2022-08-06 09:25:55','2022-08-06 09:25:55'),(823,'EEG study',3270,'anticonvulsant',37.0,77914,1811,1811,'2022-08-06 09:42:16','2022-08-06 09:42:16'),(824,'discharge on lasix oral',3272,'oxygen, lasix, antibiotics',37.0,77914,1811,1811,'2022-08-06 09:46:36','2022-08-06 09:46:36'),(825,'serum K level, new ECHO follow up',3273,'lasix, capotin, lanoxien, soluprid',37.0,77914,1811,1811,'2022-08-06 09:53:26','2022-08-06 09:53:26'),(826,'add dopamine infusion',3275,'inotopes, antibiotics',37.0,77914,1811,1811,'2022-08-06 10:07:06','2022-08-06 10:07:06'),(827,'BM biopsy',3287,'blood transfusion',37.0,77924,1811,1811,'2022-08-06 10:15:18','2022-08-06 10:15:18'),(828,NULL,3277,'chemical peeling ,photoprotection, fractionalco2',37.0,77927,1330,1330,'2022-08-06 10:32:22','2022-08-06 10:32:22'),(829,NULL,3276,'doppler ,, INR  , antibiotic systemic and topical ,thrombophobe gel,check dose anticoagulant',37.0,77927,1330,1330,'2022-08-06 10:39:23','2022-08-06 10:39:23'),(830,'متابعة بعد اسبوعين',3295,'zaditien tab قرص مرتين يومياو اكل خفيف ملح ومسلوق وشرب ماء كتير',37.0,77926,1330,1330,'2022-08-06 11:03:24','2022-08-06 11:03:24'),(831,'neck ultrasound- vascular surgery consultation for peripheral arterial disease',3298,'cinacalcet 30 mg once daily- alphacalcidol 1 micro twice wkly',37.0,77934,1826,1826,'2022-08-07 08:17:52','2022-08-07 08:17:52'),(832,'stool analysis, CRP, basic lab. CBC, iron studies, INR, thyroid function test, HBA1C, CT abdomen with oral and IV  contrat',3313,'stool analysis, CRP, basic lab. CBC, iron studies, INR, thyroid function test, HBA1C, CT abdomen with oral and IV  contrat',37.0,77938,1827,1827,'2022-08-07 08:59:32','2022-08-07 08:59:32'),(833,'ENDOSCOPIC BAND LIGATION, antibiotics, mucosal protecting agents, PPI',3316,'ENDOSCOPIC BAND LIGATION, antibiotics, mucosal protecting agents, PPI',37.0,77938,1827,1827,'2022-08-07 09:00:54','2022-08-07 09:00:54'),(834,'test, electrolytesMRI brain to excluded neurological insult, start rifaximine , lactulose, Liver Function',3325,'test, electrolytesMRI brain to excluded neurological insult, start rifaximine , lactulose, Liver Function',37.0,77937,1827,1827,'2022-08-07 09:12:58','2022-08-07 09:12:58'),(835,'complete on tiratam .antibiotice meningitic dose and MRI brain is mandatory',3317,'complete on tiratam .antibiotice meningitic dose and MRI brain is mandatory',37.0,77939,1828,1828,'2022-08-07 09:45:35','2022-08-07 09:45:35'),(836,'FOLLOW up ECHO',3319,'FOLLOW up ECHO',37.0,77939,1828,1828,'2022-08-07 09:47:21','2022-08-07 09:47:21'),(837,'adrenaline,dobutamine..',3321,'adrenaline,dobutamine..',37.0,77939,1828,1828,'2022-08-07 09:58:40','2022-08-07 09:58:40'),(838,'nfgn  x xxc',3338,'hydroquine, immuran,steroid',37.0,77944,1830,1830,'2022-08-07 10:07:20','2022-08-07 10:07:20'),(839,'tsl.frret4 \r\nanti- thyroid ab\r\nheist  paticn.both pcren\r\nwag of paticn\r\ndavte birth',3338,'hydroquine, immuran,steroid',37.0,77944,1830,1830,'2022-08-07 10:22:12','2022-08-07 10:22:12'),(840,NULL,3293,NULL,37.0,77961,1597,1597,'2022-08-07 10:33:32','2022-08-07 10:33:32'),(841,NULL,3305,'pulsed dye LASER is recommended on confirmation',37.0,77960,1726,1726,'2022-08-07 11:00:33','2022-08-07 11:00:33'),(842,'Assessment of coronary anatomy by either coronary \r\n                                                          or    angiography \r\n Multislice coronary CT plus assessment of aortic root  , ALSO control of arryhthmia byot amiodarone and follow up of QT interval +  EP consultation for ICD implantation or',3323,'Amiodarone',37.0,77954,1835,1835,'2022-08-07 11:04:14','2022-08-07 11:04:14'),(843,'amlodipine 10 mg  once daily \r\nambulatory BP monitoring\r\nfollow up',3294,'amlodipine',37.0,77953,1835,1835,'2022-08-07 11:08:57','2022-08-07 11:08:57'),(844,NULL,3341,NULL,37.0,77932,1578,1578,'2022-08-07 11:21:31','2022-08-07 11:21:31'),(845,NULL,3343,NULL,37.0,77932,1578,1578,'2022-08-07 11:22:03','2022-08-07 11:22:03'),(846,'for AFP, bilateral breast U/S , interventional radiology consultation for TCNB, start voriconazole till results of culture',3203,'for AFP, bilateral breast U/S , interventional radiology consultation for TCNB, start voriconazole till results of culture',37.0,77983,1845,1845,'2022-08-08 08:15:11','2022-08-08 08:15:11'),(847,'follow up',3379,'follow up after operation',37.0,77978,1842,1842,'2022-08-08 08:58:06','2022-08-08 08:58:06'),(848,'no recommendation termination already done',3382,'dexa and penicilline',37.0,77978,1842,1842,'2022-08-08 09:01:13','2022-08-08 09:01:13'),(849,'IV FLUID.combination antibiotics,packed RBCs transfusion.platelet transfusion ,albumin infusin if serum albumin below 2.5 gm',2893,'IV FLUID.combination antibiotics,packed RBCs transfusion.platelet transfusion ,albumin in',37.0,77987,1847,1847,'2022-08-08 09:25:45','2022-08-08 09:25:45'),(850,NULL,3365,'marcal tab  3times per day',37.0,77972,1073,1073,'2022-08-08 09:26:30','2022-08-08 09:26:30'),(851,'cpap, iv fluid, combined antibiotics\r\nserum bilirubin level',3364,'cpap, iv fluid, combined antibiotics',37.0,77987,1847,1847,'2022-08-08 09:28:18','2022-08-08 09:28:18'),(852,NULL,3368,'EXFORGE HCT',37.0,77972,1073,1073,'2022-08-08 09:28:59','2022-08-08 09:28:59'),(853,'for CRP,SERUM FERRITIN, D.dimer',3366,'oxygen therapy.iv fluid and combination antibiotics',37.0,77987,1847,1847,'2022-08-08 09:30:29','2022-08-08 09:30:29'),(854,'CONSIDER DISCHARGE AFTER INITIATION OF BREAST FEEDING\r\nCONSIDER ECHO',3367,'CONSIDER DISCHARGE AFTER INITIATION OF BREAST FEEDING',37.0,77987,1847,1847,'2022-08-08 09:32:00','2022-08-08 09:32:00'),(855,'PROCEED ORAL FEEDING\r\nCONSIDER DISCHARGE AFTER BREAST FEEDING AND ECHO IN FOLLOW UP',3369,'PROCEED ORAL FEEDING',37.0,77987,1847,1847,'2022-08-08 09:33:38','2022-08-08 09:33:38'),(856,NULL,3168,NULL,37.0,77996,1857,1857,'2022-08-08 09:37:47','2022-08-08 09:37:47'),(857,'PT 31 WEEKS, RDS FREQUENT APNEA .ON VENTILATOR',3346,NULL,37.0,77989,1847,1847,'2022-08-08 09:51:27','2022-08-08 09:51:27'),(858,'follow up \r\nurea ,cretinine,na,k,abg,\r\nurine output',3330,'bicarb amp every 12 hours  anringer every 8 huors kidmen every 12 hours saline every 12 hours',37.0,77973,1073,1073,'2022-08-08 09:55:31','2022-08-08 09:55:31'),(859,NULL,3377,NULL,37.0,77988,1847,1847,'2022-08-08 09:58:40','2022-08-08 09:58:40'),(860,NULL,3396,'avoid non steroidal antiinflammatory drugs, give systemic steroid, antihistaminic',37.0,78001,1680,1680,'2022-08-08 10:18:59','2022-08-08 10:18:59'),(861,NULL,3387,'doxcycyline 100mg twice daily for 4 weeks ,2 weeks rest then NBUVB',37.0,78002,1680,1680,'2022-08-08 10:28:41','2022-08-08 10:28:41'),(862,'DUE TO UNCONTROLLED CONVULSIONS: IV SOMINALETTA, \r\nEPANUTIN,TERATAM\r\nCOSIDER TROPHIC FEEDING AFTER CONTROL OF CONVULSIONS\r\nAND NEUROLOGICAL CONSULTATION TO  GIVE THE ANTICONVULSANT ORALLY',3378,'DUE TO UNCONTROLLED CONVULSIONS: IV SOMINALETTA, EPANUTIN,TERATAM',37.0,77988,1847,1847,'2022-08-08 10:30:48','2022-08-08 10:30:48'),(863,'VENTILATOR,IV FLUID.,NORADRENALIN INFUSION.COMBINED ANTIBIOTICS',3380,'VENTILATOR,IV FLUID.,NORADRENALIN INFUSION.COMBINED ANTIBIOTICS',37.0,77988,1847,1847,'2022-08-08 10:34:13','2022-08-08 10:34:13'),(864,'TONICS ,PROCEED ORAL FEEDING AND CONSIDER DISCHARGE AFTER THAT\r\nFUNDUS EXAMINATION.INITIATE BREAST FEEDING',3381,'TONICS ,PROCEED ORAL FEEDING AND CONSIDER DISCHARGE AFTER THAT',37.0,77988,1847,1847,'2022-08-08 10:37:49','2022-08-08 10:37:49'),(865,'OXYGEN THERAPY ,IN FLUIDS AND COMBINED ANTIBIOTICS',3383,'OXYGEN THERAPY ,IN FLUIDS AND COMBINED ANTIBIOTICS',37.0,77988,1847,1847,'2022-08-08 10:39:29','2022-08-08 10:39:29'),(866,'CARDIOLOGICAL CONSULTtion  to be operated after improvement',3384,'IV FLUID, COMBINED ANTIBIOTICS AND IBUPROFEN',37.0,77988,1847,1847,'2022-08-08 10:45:01','2022-08-08 10:45:01'),(867,NULL,3397,'carbamide cr ,vaseline oint, fucicort cr, antihistaminic tab',37.0,78003,1680,1680,'2022-08-08 10:51:14','2022-08-08 10:51:14'),(868,'laser sessions for pigmentation',2386,NULL,37.0,78005,1136,1136,'2022-08-08 10:59:08','2022-08-08 10:59:08'),(869,NULL,3398,'telfast 180 mg up to 4 folds for 4 to 6 weeks, soothing calmine ,light diet',37.0,78003,1680,1680,'2022-08-08 10:59:27','2022-08-08 10:59:27'),(870,'عمل تحاليل CBC CRP',3404,'PANDOL',37.0,78007,1731,1731,'2022-08-08 20:04:23','2022-08-08 20:04:23'),(871,'no need',3404,'congistal',37.0,78008,1548,1548,'2022-08-08 22:00:00','2022-08-08 22:00:00'),(872,'حسين و قطر',1118,'congistal',37.0,78009,93,93,'2022-08-08 23:17:45','2022-08-08 23:17:45'),(873,NULL,3427,NULL,37.0,78021,1862,1862,'2022-08-09 08:34:27','2022-08-09 08:34:27'),(874,NULL,3422,NULL,37.0,78017,1864,1864,'2022-08-09 08:35:03','2022-08-09 08:35:03'),(875,NULL,3428,NULL,37.0,78021,1862,1862,'2022-08-09 08:35:08','2022-08-09 08:35:08'),(876,NULL,3429,NULL,37.0,78021,1862,1862,'2022-08-09 08:35:55','2022-08-09 08:35:55'),(877,NULL,3430,NULL,37.0,78021,1862,1862,'2022-08-09 08:36:39','2022-08-09 08:36:39'),(878,NULL,3416,NULL,37.0,78020,1862,1862,'2022-08-09 08:48:38','2022-08-09 08:48:38'),(879,'follow up',3424,NULL,37.0,78017,1864,1864,'2022-08-09 09:00:19','2022-08-09 09:00:19'),(880,'follow up',3426,NULL,37.0,78017,1864,1864,'2022-08-09 09:01:36','2022-08-09 09:01:36'),(881,'maintain target saturation from 88-92% - nutrional management (decrease fat & CHO) - breathing exercise -  -  check for thyroid functions - correct hypoalbuminemia - send the patient if needed for sleep study in mansoura',3356,'nasal steroids - inhales triple therapy - bipap for mechanical support -  - - atrovent + beta agonist - antireflux - antibiotic - respiratory stimulants  - prophylactic anticoagulant -',37.0,78024,1721,1721,'2022-08-09 09:26:45','2022-08-09 09:26:45'),(882,'Do Full coagulation profile including PTT then reconsult',3413,NULL,37.0,78029,1877,1877,'2022-08-09 09:43:01','2022-08-09 09:43:01'),(883,'repeated  ESR CRP - Echo - send for endoscope and biopsy , respiratory function tests - to detect need for specific diagnosis &  antifibrotic drugs -',3434,'systemic steroids (dexamethazone) - combined antibiotic  - antireflux -   - azathioprine',37.0,78025,1721,1721,'2022-08-09 09:46:05','2022-08-09 09:46:05'),(884,NULL,3405,'suliprid',37.0,78031,973,973,'2022-08-09 10:06:51','2022-08-09 10:06:51'),(885,'dopler examination of peripheral pulses follow up platlate count',3276,'arxtera 7.5 once dialy',37.0,78023,1867,1867,'2022-08-09 10:41:48','2022-08-09 10:41:48'),(886,'add sandostatin and PPI infusion \r\nadd moxifloxacin 400 once \r\ncare for cellulitis and melena',3391,NULL,37.0,78011,893,893,'2022-08-09 11:25:22','2022-08-09 11:25:22'),(887,NULL,3443,NULL,37.0,78027,893,893,'2022-08-09 11:52:47','2022-08-09 11:52:47'),(888,NULL,3408,'eradication therapy for Hpylori 15 days and follow up',37.0,78012,893,893,'2022-08-09 12:10:50','2022-08-09 12:10:50'),(889,NULL,593,'ghfg',37.0,78040,339,339,'2022-08-09 12:31:52','2022-08-09 12:31:52'),(890,'لحين الانتهاء من الفحوصات',3417,NULL,37.0,78042,1078,1078,'2022-08-10 08:48:34','2022-08-10 08:48:34'),(891,'phenytoin &antibiotics+ followup CT brain',3482,'phenytoin &antibiotics+ followup CT brain',37.0,78051,1888,1888,'2022-08-10 09:15:04','2022-08-10 09:15:04'),(892,NULL,3488,NULL,37.0,78041,1078,1078,'2022-08-10 09:22:08','2022-08-10 09:22:08'),(893,'isolation& followup',3477,'SYMPTOMATIC treatment',37.0,78051,1888,1888,'2022-08-10 09:26:50','2022-08-10 09:26:50'),(894,'continue treatment& followup',3484,'antibiotics& acyclovir',37.0,78051,1888,1888,'2022-08-10 09:28:29','2022-08-10 09:28:29'),(895,'marpalen ream natry soap',3481,NULL,37.0,78063,1052,1052,'2022-08-10 09:35:55','2022-08-10 09:35:55'),(896,'dermovate cream',3480,NULL,37.0,78063,1052,1052,'2022-08-10 09:37:40','2022-08-10 09:37:40'),(897,'doxycost 2oo tab',1048,NULL,37.0,78063,1052,1052,'2022-08-10 09:40:37','2022-08-10 09:40:37'),(898,NULL,3463,'continue antibiotics& nebulization',37.0,78052,1888,1888,'2022-08-10 09:45:30','2022-08-10 09:45:30'),(899,'refer to general surgery\r\nCBC with blood film',3445,NULL,37.0,78065,1615,1615,'2022-08-10 09:46:00','2022-08-10 09:46:00'),(900,'vibramycin caps 100',3471,NULL,37.0,78063,1052,1052,'2022-08-10 09:46:23','2022-08-10 09:46:23'),(901,NULL,3464,'combination & followup chest x ray',37.0,78052,1888,1888,'2022-08-10 09:47:04','2022-08-10 09:47:04'),(902,'for iron, ferritin & total iron binding capacity after improvement',3465,'combination antibiotics',37.0,78052,1888,1888,'2022-08-10 09:48:33','2022-08-10 09:48:33'),(903,'خروج مع متابعه التحاليل وغازات الدم والرضاعه بالفم',3458,NULL,37.0,78058,1894,1894,'2022-08-10 09:52:36','2022-08-10 09:52:36'),(904,'fungican caps 150',3475,NULL,37.0,78063,1052,1052,'2022-08-10 09:52:37','2022-08-10 09:52:37'),(905,'bringo lotion',3472,NULL,37.0,78063,1052,1052,'2022-08-10 09:54:16','2022-08-10 09:54:16'),(906,'mri ( brain) \'\'\'\'mri\'\'\'\'\'mrv',3252,'aspocid 75 mg 2 قرص بعد الغدا    \\ ator 20 mg قرص مساءاTEBONINA FORTE قرص كل 12 ساعة\\ FOLLOW UPCT \\\\CARE OF',37.0,78045,1154,1154,'2022-08-10 09:56:42','2022-08-10 09:56:42'),(907,'bringo lotion',3478,NULL,37.0,78063,1052,1052,'2022-08-10 09:59:16','2022-08-10 09:59:16'),(908,NULL,3352,'clopex 75 mg قرص مساءا',37.0,78045,1154,1154,'2022-08-10 10:01:59','2022-08-10 10:01:59'),(909,'dermovate cream',3476,NULL,37.0,78063,1052,1052,'2022-08-10 10:02:46','2022-08-10 10:02:46'),(910,'followup CT chest& consider aspiration from lung abcess if not improving',3485,'tripple therapy( vancomycin, meronam& metronidazole)',37.0,78053,1888,1888,'2022-08-10 10:03:28','2022-08-10 10:03:28'),(911,'متابعه مع جراحه الاطفال واطفال العصبيه مع الحفاظ علي الوزن ومتابعه الهيمجلوبين للعمليه القادمه',3496,NULL,37.0,78059,1894,1894,'2022-08-10 10:04:46','2022-08-10 10:04:46'),(912,NULL,3353,NULL,37.0,78045,1154,1154,'2022-08-10 10:06:48','2022-08-10 10:06:48'),(913,NULL,3497,NULL,37.0,78067,1901,1901,'2022-08-10 10:12:06','2022-08-10 10:12:06'),(914,'internal medicine consultation\'\'\'\'\'\'\'\'\'\'\'\'\'mri brain',3354,'tebonina forte قرص كل 12 ساعة',37.0,78045,1154,1154,'2022-08-10 10:13:57','2022-08-10 10:13:57'),(915,'to be on local ttt and narrow band',3479,'local ttt + narrow band',37.0,78069,1701,1701,'2022-08-10 10:23:39','2022-08-10 10:23:39'),(916,'biopsy and histopathological consultation',3438,NULL,37.0,78039,364,364,'2022-08-10 10:24:19','2022-08-10 10:24:19'),(917,'biopsy and histopathological exammination',3439,NULL,37.0,78039,364,364,'2022-08-10 10:32:34','2022-08-10 10:32:34'),(918,'+ syst. antifungal (terbinafine 1/2 tab of 125 mg /d/2w + + \r\nsyst.Ab + syst. anti-histamine+topical steroid over papules +betadine shampoo',3440,'as mentioned below',37.0,47838,1701,1701,'2022-08-10 10:36:44','2022-08-10 10:36:44'),(919,'systemic azithromycin 1x1x3days to be repeated same \r\ndays 4w\r\nfucicort twice a day for one week \r\nantihistamine',3500,'as mentioned below',37.0,47839,1701,1701,'2022-08-10 11:07:18','2022-08-10 11:07:18'),(920,'عينة من بطانة الرحم',3435,NULL,37.0,78073,1905,1905,'2022-08-10 11:44:09','2022-08-10 11:44:09'),(921,'inpatient admission\r\naccording maternal and fetal condition \r\nconservative vs termination',3436,NULL,37.0,78073,1905,1905,'2022-08-10 11:46:52','2022-08-10 11:46:52'),(922,'increase oral intake',3459,NULL,37.0,78068,1808,1808,'2022-08-10 12:10:08','2022-08-10 12:10:08'),(923,'put on single phtothearapy\r\nfollow bilirubin \r\ncheck mother and baby blood groups',3460,NULL,37.0,78068,1808,1808,'2022-08-10 12:13:11','2022-08-10 12:13:11'),(924,'new bilirubin with cbc with differential',3451,NULL,37.0,78068,1808,1808,'2022-08-10 12:15:36','2022-08-10 12:15:36'),(925,'cbc with diff \r\ndecrease frequency of neublizers',3454,NULL,37.0,78068,1808,1808,'2022-08-10 12:16:59','2022-08-10 12:16:59'),(926,'blood groups for mother and baby\r\ncbc with diff \r\ncranial us \r\noff photothearaby and repeat bilirubin after 2 days',3461,NULL,37.0,78068,1808,1808,'2022-08-10 12:19:42','2022-08-10 12:19:42'),(927,'cbc with diff \r\ncrp \r\nincrease oral feeding',3462,NULL,37.0,78068,1808,1808,'2022-08-10 12:21:29','2022-08-10 12:21:29'),(928,'no need',606,'panadol',37.0,78074,339,339,'2022-08-10 22:58:46','2022-08-10 22:58:46'),(929,'no need',611,'panadol',37.0,78074,339,339,'2022-08-10 23:28:59','2022-08-10 23:28:59'),(930,'Intensification of ultrafiltration to maintain the patient on his dry body weight',3411,'asthma medications',37.0,78078,1833,1833,'2022-08-11 08:20:22','2022-08-11 08:20:22'),(931,'Virus serology; liver and spleen ultrasonography; serum albumin; 24 hour urinary protein',3540,'diuretics',37.0,78079,1833,1833,'2022-08-11 08:40:22','2022-08-11 08:40:22'),(932,'Renal ultrasound; 24 hour urinary protein; albumin; cholesterol; lupus serology; investigations for anemia',3543,NULL,37.0,78079,1833,1833,'2022-08-11 08:45:01','2022-08-11 08:45:01'),(933,'Blood culture, and follow up whether to change the antibiotics as CRP and TLC are elevated.',3559,NULL,37.0,78106,1915,1915,'2022-08-11 08:48:55','2022-08-11 08:48:55'),(934,'Renal ultrasound\'; 24 hour protein; albumin; cholesterol;calcium; phosphorus\r\nTo diagnose if the patient a case of AKI or not\r\nIs he nephrotic syndrome or not',3542,NULL,37.0,78079,1833,1833,'2022-08-11 08:49:09','2022-08-11 08:49:09'),(935,'Toxicological screening (complete [panel) \r\nElectrophysiological study',3561,NULL,37.0,78107,1913,1913,'2022-08-11 08:56:37','2022-08-11 08:56:37'),(936,NULL,3525,NULL,37.0,78094,1911,1911,'2022-08-11 09:03:17','2022-08-11 09:03:17'),(937,'Need referral for catheter\r\nابو الريش او معهد ناصر',3506,NULL,37.0,78082,1906,1906,'2022-08-11 09:03:22','2022-08-11 09:03:22'),(938,'Follow up with serum creatinine; potassiu; ABG and hemodialysis on need',3515,'IV fluid and antibiotics',37.0,78080,1833,1833,'2022-08-11 09:07:53','2022-08-11 09:07:53'),(939,'vit k and fresh frozen plasma',3513,NULL,37.0,78092,1906,1906,'2022-08-11 09:11:17','2022-08-11 09:11:17'),(940,NULL,3527,NULL,37.0,78094,1911,1911,'2022-08-11 09:13:12','2022-08-11 09:13:12'),(941,'detailed history\r\nneurological examination\r\nmri brain and reconsult\r\nلحين الانتهاء من الفحوصات',3450,NULL,37.0,78076,1154,1154,'2022-08-11 09:14:31','2022-08-11 09:14:31'),(942,'Chest care, AB ttt and adjust according to culture and sensetivity, nutritional consultation, convulsions control',3557,NULL,37.0,78105,1914,1914,'2022-08-11 09:14:31','2022-08-11 09:14:31'),(943,'Clear air and iron supplement',3518,NULL,37.0,78109,1915,1915,'2022-08-11 09:15:01','2022-08-11 09:15:01'),(944,'Clear air and iron supplement',3518,NULL,37.0,78109,1915,1915,'2022-08-11 09:15:01','2022-08-11 09:15:01'),(945,'adequate history taking and perinatal and developmental history and family history\r\nbrain imaging \r\nconvulsions control\r\nneuro consultatin\r\nfull lab assessment about the cause of convulsions\r\nclose follow up and monitoring',3555,NULL,37.0,78105,1914,1914,'2022-08-11 09:16:59','2022-08-11 09:16:59'),(946,'follow up and parentral genetic counsiling',2751,NULL,37.0,78084,1906,1906,'2022-08-11 09:18:26','2022-08-11 09:18:26'),(947,'control of heart faillure \r\nttt of pneumonia if present\r\ncardiology consult about adjusting the antifailure measurment and time and appropriate surgical intervention',3553,NULL,37.0,78105,1914,1914,'2022-08-11 09:19:14','2022-08-11 09:19:14'),(948,'Iron and continue on treatment.',3519,NULL,37.0,78109,1915,1915,'2022-08-11 09:20:04','2022-08-11 09:20:04'),(949,'Iron and continue on treatment.',3519,NULL,37.0,78109,1915,1915,'2022-08-11 09:20:04','2022-08-11 09:20:04'),(950,NULL,3525,NULL,37.0,78094,1911,1911,'2022-08-11 09:23:34','2022-08-11 09:23:34'),(951,NULL,3522,NULL,37.0,78094,1911,1911,'2022-08-11 09:23:58','2022-08-11 09:23:58'),(952,'Physiotherapy and suction with treatment given.',3520,NULL,37.0,78109,1915,1915,'2022-08-11 09:25:15','2022-08-11 09:25:15'),(953,'follow up ct brain',3565,'acyclovir 500 mg /12\'\'\'\'\'\'ceftrixone 1gm /12 shum \'\'\'\'\'\'tiratam500mg /12 shum',37.0,78077,1154,1154,'2022-08-11 09:28:52','2022-08-11 09:28:52'),(954,'Treatment is appropriate.',3521,NULL,37.0,78109,1915,1915,'2022-08-11 09:29:00','2022-08-11 09:29:00'),(955,'For medical treatment, if not improved for stress ECG',1851,'Aspirin, Plavix, nitromack, zurcal, rositor',37.0,78100,1913,1913,'2022-08-11 09:30:13','2022-08-11 09:30:13'),(956,'Medical treatment and regular echo follow up every 6 months',3296,'Isoptin 80',37.0,78100,1913,1913,'2022-08-11 09:31:27','2022-08-11 09:31:27'),(957,'echocardiography\r\nphysiotherapy\r\nand discharge',3566,'aspocid 75 mg 2 قرص بعد الغدا    \\ ator 20 mg قرص مساءاTEBONINA FORTE قرص كل 12 ساعة\\ FOLLOW UPCT \\\\CARE OF',37.0,78077,1154,1154,'2022-08-11 09:32:23','2022-08-11 09:32:23'),(958,'For coronary angiography',3551,'Juspirin 81 (1x1), Cholerose plus 20/10 (1x1) , nitromack 2.5  ( 1 x 2) , tritace 1.25 ( 1x1), nevilob 2.5 (1/2 x 1), itopride, zurcal,',37.0,78100,1913,1913,'2022-08-11 09:34:05','2022-08-11 09:34:05'),(959,'follow up',3552,NULL,37.0,78096,1906,1906,'2022-08-11 09:37:28','2022-08-11 09:37:28'),(960,'Constipation occurred to do abdominal ultrasound and give oral intake.',3524,NULL,37.0,78109,1915,1915,'2022-08-11 09:37:58','2022-08-11 09:37:58'),(961,'Iron supplementation.',3523,NULL,37.0,78109,1915,1915,'2022-08-11 09:38:51','2022-08-11 09:38:51'),(962,'follow up ct',3525,'aspocid 75 mg 2 قرص بعد الغدا    \\ ator 20 mg قرص مساءاTEBONINA FORTE قرص كل 12 ساعة\\ FOLLOW UPCT \\\\CARE OF',37.0,78075,1154,1154,'2022-08-11 09:41:10','2022-08-11 09:41:10'),(963,'follow up ct',3525,'aspocid 75 mg 2 قرص بعد الغدا    \\ ator 20 mg قرص مساءاTEBONINA FORTE قرص كل 12 ساعة\\ FOLLOW UPCT \\\\CARE OF',37.0,78075,1154,1154,'2022-08-11 09:41:13','2022-08-11 09:41:13'),(964,'Good hydration; IV antibiotic (culture-based); Hepatology consultation',3548,NULL,37.0,78081,1833,1833,'2022-08-11 09:44:14','2022-08-11 09:44:14'),(965,'discharge and follow up at out pt clinic',3529,'aspocid 75 mg 2 قرص بعد الغدا    \\ ator 20 mg قرص مساءاTEBONINA FORTE قرص كل 12 ساعة\\ FOLLOW UPCT \\\\CARE OF',37.0,78075,1154,1154,'2022-08-11 09:45:21','2022-08-11 09:45:21'),(966,'tibialis anterior lateral transfer\r\nbasal metatarsal osteotomy\r\ncorrection of metatarsal adductus',2908,NULL,37.0,78093,1907,1907,'2022-08-11 09:50:41','2022-08-11 09:50:41'),(967,'ccho and carotid doppler',3530,'aspocide 75mg    pk merz infusion  vit b12',37.0,78075,1154,1154,'2022-08-11 09:52:56','2022-08-11 09:52:56'),(968,'Control hyperphosphatemia',3554,NULL,37.0,78103,1833,1833,'2022-08-11 09:58:03','2022-08-11 09:58:03'),(969,'For Cardiac MRI to assess viability & plan for invasive coronary angiography',3550,'Diuretics, full anti-ischemic, Full anti-failure',37.0,78099,1913,1913,'2022-08-11 10:06:02','2022-08-11 10:06:02'),(970,'fucicort cream\r\nclamil lot',3533,NULL,37.0,78111,1276,1276,'2022-08-11 10:20:47','2022-08-11 10:20:47'),(971,'استكمال الفحوصات',3572,NULL,37.0,78114,1924,1924,'2022-08-11 10:22:56','2022-08-11 10:22:56'),(972,'fucicort cream\r\nglycrol soap',3563,NULL,37.0,78111,1276,1276,'2022-08-11 10:24:52','2022-08-11 10:24:52'),(973,'fucidin oint\r\nbetadine shampoo',3570,NULL,37.0,78111,1276,1276,'2022-08-11 10:28:48','2022-08-11 10:28:48'),(974,'CT  with contrast abomen and pelvis',3573,NULL,37.0,78114,1924,1924,'2022-08-11 10:30:11','2022-08-11 10:30:11'),(975,'PSG NIV TSH ECHO',3526,NULL,37.0,78118,1722,1722,'2022-08-11 10:31:52','2022-08-11 10:31:52'),(976,'unacin vial\r\nciprofar tab',3568,NULL,37.0,78121,1276,1276,'2022-08-11 10:38:53','2022-08-11 10:38:53'),(977,'to follow on ttt',3499,'symptomatic ttt',37.0,78117,1633,1633,'2022-08-11 10:38:58','2022-08-11 10:38:58'),(978,'to follow on ttt for 2 w',3509,'symptomatic ttt',37.0,78117,1633,1633,'2022-08-11 10:40:03','2022-08-11 10:40:03'),(979,'CT BRAIN NEUROLOGICAL ASSESSMENT',3528,NULL,37.0,78118,1722,1722,'2022-08-11 10:41:08','2022-08-11 10:41:08'),(980,'other auto-immune diseases to be excluded \r\nfollow up on mini pulse steroid\r\n+same local ttt',3537,'as mentioned below',37.0,78117,1633,1633,'2022-08-11 10:42:27','2022-08-11 10:42:27'),(981,'cardiothoracic consultation for mitral valve stenosis and thrombus',3547,'anticoagulant',37.0,78124,1930,1930,'2022-08-11 10:44:02','2022-08-11 10:44:02'),(982,NULL,3549,'chest phyisotherapy',37.0,78124,1930,1930,'2022-08-11 10:44:55','2022-08-11 10:44:55'),(983,'pediatric surgeon',3577,NULL,37.0,78115,1924,1924,'2022-08-11 10:45:19','2022-08-11 10:45:19'),(984,'biopsy',3560,NULL,37.0,78113,1276,1276,'2022-08-11 10:48:45','2022-08-11 10:48:45'),(985,'biopsy',3560,NULL,37.0,78113,1276,1276,'2022-08-11 10:48:51','2022-08-11 10:48:51'),(986,'biopsy',3560,NULL,37.0,78113,1276,1276,'2022-08-11 10:49:01','2022-08-11 10:49:01'),(987,'biopsy',3560,NULL,37.0,78113,1276,1276,'2022-08-11 10:49:13','2022-08-11 10:49:13'),(988,'symptomatic ttt + avoid predisposing factor',3574,'as mentioned below',37.0,78123,1633,1633,'2022-08-11 10:54:02','2022-08-11 10:54:02'),(989,'appendicitis cmplicated with mass or not preoperative is recommended',3578,NULL,37.0,78115,1924,1924,'2022-08-11 10:58:39','2022-08-11 10:58:39'),(990,'for biopsy',3264,NULL,37.0,78122,1276,1276,'2022-08-11 11:04:42','2022-08-11 11:04:42'),(991,'عمل سونار علي الباطن والحوض وعمل تحاليل وظائف كبد وكلي و pt/ptt/inr\r\nونسبة bilirubin و يرجي المتابعة',3541,NULL,37.0,3642,1771,1771,'2022-08-11 12:15:40','2022-08-11 12:15:40'),(992,'sputum culture',3594,NULL,37.0,78128,1932,1932,'2022-08-13 08:12:00','2022-08-13 08:12:00'),(993,'ct brain for confusion',3595,NULL,37.0,78128,1932,1932,'2022-08-13 08:14:49','2022-08-13 08:14:49'),(994,'calculation of input and output',3596,NULL,37.0,78128,1932,1932,'2022-08-13 08:21:10','2022-08-13 08:21:10'),(995,'follow up input and output',3597,NULL,37.0,78128,1932,1932,'2022-08-13 08:25:27','2022-08-13 08:25:27'),(996,NULL,3562,NULL,37.0,78133,1934,1934,'2022-08-13 08:30:02','2022-08-13 08:30:02'),(997,'stool analysis +ESR+SURGERY ONSULTATION',3598,NULL,37.0,78134,1932,1932,'2022-08-13 08:31:15','2022-08-13 08:31:15'),(998,'URINE analysis + Abd US',3599,NULL,37.0,78134,1932,1932,'2022-08-13 08:32:51','2022-08-13 08:32:51'),(999,'urine analysis + Abd us',3604,NULL,37.0,78134,1932,1932,'2022-08-13 08:33:43','2022-08-13 08:33:43'),(1000,NULL,3571,'Clexan 80 mg twice daily',37.0,78130,1893,1893,'2022-08-13 08:34:48','2022-08-13 08:34:48'),(1001,'ESR+ Abd us +virology test',3607,NULL,37.0,78127,1932,1932,'2022-08-13 08:44:48','2022-08-13 08:44:48'),(1002,'xray chest and abd. with gastrographin',3575,NULL,37.0,78133,1934,1934,'2022-08-13 08:45:00','2022-08-13 08:45:00'),(1003,'cvp +calculation of input and output',3610,NULL,37.0,78127,1932,1932,'2022-08-13 08:46:39','2022-08-13 08:46:39'),(1004,'xray chest nd abd. with gastrographin',3569,NULL,37.0,78133,1934,1934,'2022-08-13 08:47:05','2022-08-13 08:47:05'),(1005,'Stress ECG or coronary angiography',3583,'Rivarospire 20 mg once daily, Solekanzoc 100 mg 1/2 tab daily',37.0,78130,1893,1893,'2022-08-13 08:48:10','2022-08-13 08:48:10'),(1006,'EEG',3612,NULL,37.0,78142,1934,1934,'2022-08-13 08:58:16','2022-08-13 08:58:16'),(1007,'The patient was in need for further assessment for his diagnosis. i request investigations and re consult us again',3605,NULL,37.0,78137,1936,1936,'2022-08-13 09:48:14','2022-08-13 09:48:14'),(1008,'LDH ESR coOM\'S TEST RETCS BLOODFILM FERRETIN TIBCIRON',3606,NULL,37.0,78147,1794,1794,'2022-08-13 09:57:13','2022-08-13 09:57:13'),(1009,'refer to Rheumatology',3632,NULL,37.0,78149,1944,1944,'2022-08-13 10:01:35','2022-08-13 10:01:35'),(1010,NULL,3629,'One alpha 0.25 micro cap بعد كل حلسه غسيل ميدئيا لحين ظهور التحاليل',37.0,78138,1938,1938,'2022-08-13 10:12:04','2022-08-13 10:12:04'),(1011,NULL,3611,'fractional co2, scar subcision ,topical retenoid, panthenol',37.0,78151,1330,1330,'2022-08-13 10:15:20','2022-08-13 10:15:20'),(1012,'COVID SWAB  \r\nanti staph',3633,'AVEROZOLID 600 TWICWE',37.0,78155,1944,1944,'2022-08-13 10:22:11','2022-08-13 10:22:11'),(1013,'non invasive ventilation alternating with mask reservoir',3636,NULL,37.0,78155,1944,1944,'2022-08-13 10:23:42','2022-08-13 10:23:42'),(1014,NULL,3580,'Insuline',37.0,78139,1938,1938,'2022-08-13 10:32:47','2022-08-13 10:32:47'),(1015,'متابعه بعد شهر',3627,'azrolid 500 mg قرص يوميا 3 ايام من كل اسبوع لمدة شهر aknemycin lotion  دهان مرتين و synobar soap',37.0,78153,1330,1330,'2022-08-13 10:45:04','2022-08-13 10:45:04'),(1016,NULL,3593,'dialysis, oncology consultation and follow up',37.0,78140,1938,1938,'2022-08-13 10:46:36','2022-08-13 10:46:36'),(1017,NULL,3609,'Urine analysis ACEI SGLPT2 Follow up and dialysis if indicated',37.0,78141,1938,1938,'2022-08-13 11:06:36','2022-08-13 11:06:36'),(1018,'shift back to Marivan according to cardiologist',3571,NULL,37.0,78156,1945,1945,'2022-08-13 12:02:14','2022-08-13 12:02:14'),(1019,'and CBC transvaginal ultrasound',3576,NULL,37.0,78156,1945,1945,'2022-08-13 12:07:42','2022-08-13 12:07:42'),(1020,'no need',611,'tri b',37.0,78157,339,339,'2022-08-13 23:58:19','2022-08-13 23:58:19'),(1021,'for results of histopathology of hemithyroidectomy in 2007 if available, FNAC from thyroid nodule, thyroid scan, TG and anti TG',3241,NULL,37.0,78167,1845,1845,'2022-08-14 08:47:57','2022-08-14 08:47:57'),(1022,'investigation cbc, LDH, ferritin, urea, crea, VBG, crp, Na <K\r\nCT CHEST\r\ncontiue antibiotics',3666,NULL,37.0,78174,1951,1951,'2022-08-14 09:03:25','2022-08-14 09:03:25'),(1023,'CBC e diff ,ESR,urine analysis ,stool analysis \r\ncheck any symptoms of arthritis',3600,NULL,38.0,78183,1956,1956,'2022-08-14 09:07:17','2022-08-14 09:07:17'),(1024,'ENT consultation\r\navoid contact with pets \r\nproper chest examination to exclude lower airway',3601,NULL,37.0,78183,1956,1956,'2022-08-14 09:14:22','2022-08-14 09:14:22'),(1025,'nasal obstruction give nasal baby saline\r\ncardiac examination to exclude cardiac causes',3603,NULL,37.0,78183,1956,1956,'2022-08-14 09:17:29','2022-08-14 09:17:29'),(1026,'cbc, crp urea, crea, pt ,ppt, INR, \r\nfollow up xray chest\r\nfollow up echo',3669,NULL,37.0,78174,1951,1951,'2022-08-14 09:19:56','2022-08-14 09:19:56'),(1027,'cbc, crp, urea , crea, vbg, NA, K, blood culture\r\nupgrade antibiotics\r\nx ray chestplt count for the mother',3672,NULL,37.0,78174,1951,1951,'2022-08-14 09:22:08','2022-08-14 09:22:08'),(1028,'Mechanical ventilation \r\nchange antibiotics according to culture \r\ndo sputum culture \r\nestablish hemodynamics',3696,NULL,37.0,78189,1956,1956,'2022-08-14 09:35:23','2022-08-14 09:35:23'),(1029,'Cervical Lymph node biopsy',3642,NULL,37.0,78186,1959,1959,'2022-08-14 09:39:31','2022-08-14 09:39:31'),(1030,'nerve conduction on facial nerve\r\nfollow up echo',3319,NULL,37.0,78175,1951,1951,'2022-08-14 09:42:16','2022-08-14 09:42:16'),(1031,NULL,725,'dads',37.0,78195,339,339,'2022-08-14 09:54:38','2022-08-14 09:54:38'),(1032,'cbc, crp,urea, crea, NA, K\r\ncontrol blood pressure\r\nincreas fluid\r\nconsultation cardiac surgery and pediatric cardiology',3321,NULL,37.0,78175,1951,1951,'2022-08-14 09:57:19','2022-08-14 09:57:19'),(1033,'cbc, crp,urea, crea, NA, K\r\ncontrol blood pressure\r\nincreas fluid\r\nconsultation cardiac surgery and pediatric cardiology',3321,NULL,37.0,78175,1951,1951,'2022-08-14 09:57:20','2022-08-14 09:57:20'),(1034,'continue ttt with follow up clinical and lab for possibility of DC ttt',3338,'already on l.troxin 50 mic',37.0,78196,1830,1830,'2022-08-14 10:02:02','2022-08-14 10:02:02'),(1035,'غلي الملابس والفوط',3686,'systemic antibiotic ,topical antibiotic cr, k permangnate 1\\8000كمدات لمدة 5 دقايق',37.0,78197,1838,1838,'2022-08-14 10:09:57','2022-08-14 10:09:57'),(1036,'cbc, crp, \r\nx ray chest\r\nremove chest tube if possible\r\nwithdraw anti shock therapy if possible',3689,NULL,37.0,78175,1951,1951,'2022-08-14 10:17:17','2022-08-14 10:17:17'),(1037,'extended metabolic screening\r\nfollow up with metabolic clinic',3684,NULL,37.0,78178,1951,1951,'2022-08-14 10:26:40','2022-08-14 10:26:40'),(1038,NULL,3657,'medodrin,,forced diuresis',37.0,78173,1026,1026,'2022-08-14 10:29:42','2022-08-14 10:29:42'),(1039,'change to oral lasix\r\ncontinue antibiotic\r\ncontinue oral feeding\r\nrefer for cardiac surgery',3685,NULL,37.0,78178,1951,1951,'2022-08-14 10:34:16','2022-08-14 10:34:16'),(1040,'medical treatment and follow up investigations',3605,NULL,37.0,78190,1962,1962,'2022-08-14 10:37:07','2022-08-14 10:37:07'),(1041,'غلي الملابس وكي  الملابس على ظهرها',3694,'terbin250 mg tab قرص واحد يوميا لمدة اسبوعين و  cr lamifen مرتين يوميا',37.0,78198,1726,1726,'2022-08-14 10:39:51','2022-08-14 10:39:51'),(1042,'adding antibiotics according to the culture with close followup to the clilcal condition and lab results.',3619,NULL,37.0,78169,1948,1948,'2022-08-14 10:47:40','2022-08-14 10:47:40'),(1043,NULL,3502,'cinacacit',37.0,78176,1026,1026,'2022-08-14 10:48:55','2022-08-14 10:48:55'),(1044,NULL,3503,'cinacalcit30 twice',37.0,78176,1026,1026,'2022-08-14 10:51:18','2022-08-14 10:51:18'),(1045,'cbc , crp, urea, crea, NA, K\r\nblood culture\r\nVBG, lactate, pyruvate, ammonia\r\nECG, echo\r\nconsider change antibiotics\r\nconsider inotropes',3650,NULL,37.0,78177,1951,1951,'2022-08-14 10:52:59','2022-08-14 10:52:59'),(1046,NULL,3511,'torseritic 100mg once b,,examide 10 mg tab',37.0,78176,1026,1026,'2022-08-14 10:53:49','2022-08-14 10:53:49'),(1047,'blood culture with sepsis screen and follow up.',3621,NULL,37.0,78169,1948,1948,'2022-08-14 10:56:10','2022-08-14 10:56:10'),(1048,NULL,3512,'antibiotic according to culture,,regular dialysis,,correct cause of septecemia',37.0,78176,1026,1026,'2022-08-14 10:57:03','2022-08-14 10:57:03'),(1049,'just follow up with CXR and lab results',3623,NULL,37.0,78169,1948,1948,'2022-08-14 11:00:32','2022-08-14 11:00:32'),(1050,'Shock fluids and follow up ABG',3624,NULL,37.0,78169,1948,1948,'2022-08-14 11:04:26','2022-08-14 11:04:26'),(1051,'follow up medical traetment and prepare for coronary angiography after discharge',3634,NULL,37.0,78199,1962,1962,'2022-08-14 11:08:18','2022-08-14 11:08:18'),(1052,'fOLLOW UP CBC, serum K ,  START TROPHIC ENTERAL FEEDING BY EXPRESSED BREAST MILK',3625,NULL,37.0,78169,1948,1948,'2022-08-14 11:12:07','2022-08-14 11:12:07'),(1053,NULL,3668,'exforge hct10,160,25',37.0,78179,1026,1026,'2022-08-14 11:12:33','2022-08-14 11:12:33'),(1054,'occult blood in stool,,stop iron therapy,,continue on esa therapy',3670,NULL,37.0,78179,1026,1026,'2022-08-14 11:15:12','2022-08-14 11:15:12'),(1055,'Ready for discharge after CBC & CRP',3626,NULL,37.0,78169,1948,1948,'2022-08-14 11:16:11','2022-08-14 11:16:11'),(1056,'serum ammonia, lactate, TMS and reconsult',3620,NULL,37.0,78169,1948,1948,'2022-08-14 11:21:19','2022-08-14 11:21:19'),(1057,'admisssion magnesium sulphate lading and maintenance\r\ncontrol Blood presssure and insert urianry catheter\r\n blood and fresh frozen plasma and paletlets preparaion \r\ntermination of pregnancy after aneasthesia consultation \r\nre admit to ICU\r\ndialy monitoring of  Lab investigation and 4 hourly Vitals and uterine contractility\r\nsulphatemagns\r\nblood pressure',3328,NULL,37.0,78200,1966,1966,'2022-08-14 11:41:43','2022-08-14 11:41:43'),(1058,'hysterectomy',3705,NULL,37.0,78172,1578,1578,'2022-08-14 11:43:43','2022-08-14 11:43:43'),(1059,'repeat thromboplilia profile\r\nandrogen and dheas profile\r\ncombined laproscopy and hystroscopy \r\n\r\ncorrection of male semen analysis preparation for controlled ovarianstimulation and induction of ovulation for short term and preparation of IUI or IVF if male factor presistent',3687,NULL,37.0,78200,1966,1966,'2022-08-14 12:12:13','2022-08-14 12:12:13'),(1060,'perfussion imaging and coronary angiography',3703,NULL,37.0,78215,1971,1971,'2022-08-15 08:24:14','2022-08-15 08:24:14'),(1061,'removal of miniplate and insertion of suzuki frame',3534,NULL,37.0,78209,1907,1907,'2022-08-15 08:43:02','2022-08-15 08:43:02'),(1062,'2.5yrs old , male pt , FT no NICU admission , no hospital admission , presented with global development delay . on exam pt has coarse facial feature , no anthropometric measures , pt is developentally delayed just sit with support , no single word , interact only with mother , bow leg , no +ve finding by systemic exam .\r\nrecommendation : 1. anthropometric measures \r\n2. bone age and skeletal survey \r\n3. slit lamb and fundus exam\r\n3. basic lab include CBC , S ca ph ALP , LFT , S cr , Vit D2 l;evel , TFT \r\n4. metabolic screen ?? MPS \r\nfallow up with our endocrine and genetic OPC',3727,NULL,37.0,78216,1157,1157,'2022-08-15 08:50:12','2022-08-15 08:50:12'),(1063,'mri brain with contrast',3658,'topamax 25     busbar 10',37.0,78203,973,973,'2022-08-15 08:53:04','2022-08-15 08:53:04'),(1064,NULL,3691,NULL,37.0,78202,327,327,'2022-08-15 08:57:27','2022-08-15 08:57:27'),(1065,NULL,3691,NULL,37.0,78202,327,327,'2022-08-15 08:58:02','2022-08-15 08:58:02'),(1066,'conservative management and repeat x ray and sonar after 3 monthes',3659,NULL,37.0,78208,1907,1907,'2022-08-15 08:58:58','2022-08-15 08:58:58'),(1067,NULL,3693,NULL,37.0,78202,327,327,'2022-08-15 09:02:28','2022-08-15 09:02:28'),(1068,'follow up ct brain control blood sugar',3744,'tirtam tabelts begin by 500 twice an d increase 1000 twice if fits not controlled',37.0,78206,973,973,'2022-08-15 09:13:40','2022-08-15 09:13:40'),(1069,'surgical correction',3616,NULL,37.0,78210,1907,1907,'2022-08-15 09:14:28','2022-08-15 09:14:28'),(1070,'cpk emg ncv',3678,NULL,37.0,78206,973,973,'2022-08-15 09:15:17','2022-08-15 09:15:17'),(1071,'plasma pharesis',3671,NULL,37.0,78206,973,973,'2022-08-15 09:16:09','2022-08-15 09:16:09'),(1072,'acase f bilateral hydronephrosis for urologicalonsultation for VCUG to exclude  PUV or ureteric stricure then follow up ofe patient clinically and lab (serum creat nd cbc and electreolytes )for any signs of renal impairment',3723,NULL,37.0,78228,1984,1984,'2022-08-15 09:20:59','2022-08-15 09:20:59'),(1073,'subtalar arthrodesis',3617,NULL,37.0,78210,1907,1907,'2022-08-15 09:24:52','2022-08-15 09:24:52'),(1074,NULL,3734,'supportive masures',37.0,78213,1127,1127,'2022-08-15 09:29:01','2022-08-15 09:29:01'),(1075,'followw up of urea and creatinine  blood gases Na K consultation of internal medicine',3758,'as recommended treatment',37.0,78204,973,973,'2022-08-15 09:29:17','2022-08-15 09:29:17'),(1076,'CONSEVATIVE',3616,NULL,37.0,78210,1907,1907,'2022-08-15 09:29:20','2022-08-15 09:29:20'),(1077,'surgical correction',3647,NULL,37.0,78210,1907,1907,'2022-08-15 09:30:22','2022-08-15 09:30:22'),(1078,NULL,3741,NULL,37.0,78212,1127,1127,'2022-08-15 09:36:01','2022-08-15 09:36:01'),(1079,NULL,3752,'clexane',37.0,78214,1127,1127,'2022-08-15 09:42:50','2022-08-15 09:42:50'),(1080,'متابعه بعد اسبوع',3756,'alphintern tab , antihistaminic ,topical fucicort cr',37.0,78236,1680,1680,'2022-08-15 10:23:47','2022-08-15 10:23:47'),(1081,NULL,3760,'reassurance',37.0,78237,1680,1680,'2022-08-15 10:29:46','2022-08-15 10:29:46'),(1082,'no need for further assessment or recommendation',3728,NULL,37.0,78233,1532,1532,'2022-08-15 10:30:32','2022-08-15 10:30:32'),(1083,'no need for further assessment or recommendation',3731,NULL,37.0,78233,1532,1532,'2022-08-15 10:31:32','2022-08-15 10:31:32'),(1084,NULL,3387,'biopsy',37.0,78237,1680,1680,'2022-08-15 10:34:09','2022-08-15 10:34:09'),(1085,'cotton clothes ,avoid sun ,humidity ,,showering',3761,'fucicort cr , soothing agent, antihistaminic syrp',37.0,78238,1680,1680,'2022-08-15 10:46:34','2022-08-15 10:46:34'),(1086,'CTbrain, Ca profile , KFT, prepare for discharge',3736,NULL,37.0,78240,1986,1986,'2022-08-15 10:51:14','2022-08-15 10:51:14'),(1087,'Lung US or CT chest',3738,NULL,37.0,78240,1986,1986,'2022-08-15 10:52:46','2022-08-15 10:52:46'),(1088,'echo,cardiac enz,exclude myocarditis,increase dose of lasix, ca and mg regular',3739,NULL,37.0,78240,1986,1986,'2022-08-15 10:54:39','2022-08-15 10:54:39'),(1089,'متابعه بعد اسبوعين',3743,'systemic and topical antibiotic, antihistaminic',37.0,78239,1680,1680,'2022-08-15 10:54:48','2022-08-15 10:54:48'),(1090,'start enteral feeding with high caloric formula, echo,genetic follow up',3740,NULL,37.0,78240,1986,1986,'2022-08-15 10:56:08','2022-08-15 10:56:08'),(1091,'follow up CT brain and follow conscious level\r\nstart ryle feeding\r\nfollow liver function\r\nneurosurgical consultation',3753,NULL,37.0,78243,1993,1993,'2022-08-15 10:58:42','2022-08-15 10:58:42'),(1092,NULL,3742,'ablative laser',37.0,78239,1680,1680,'2022-08-15 11:02:23','2022-08-15 11:02:23'),(1093,NULL,3014,NULL,37.0,78211,952,952,'2022-08-15 11:23:15','2022-08-15 11:23:15'),(1094,NULL,3635,NULL,37.0,78211,952,952,'2022-08-15 11:23:50','2022-08-15 11:23:50'),(1095,NULL,3639,NULL,37.0,78211,952,952,'2022-08-15 11:24:56','2022-08-15 11:24:56'),(1096,NULL,3640,NULL,37.0,78211,952,952,'2022-08-15 11:25:24','2022-08-15 11:25:24'),(1097,'ct abdomen with iv contrast',3757,NULL,37.0,78235,1384,1384,'2022-08-15 11:59:57','2022-08-15 11:59:57'),(1098,'upper endoscopy and psncultures',3755,'potasium iv',37.0,78235,1384,1384,'2022-08-15 12:01:18','2022-08-15 12:01:18'),(1099,'Arexitra 7.5 and follow up INR',3632,NULL,37.0,78246,1794,1794,'2022-08-16 07:45:22','2022-08-16 07:45:22'),(1100,'LDH ESR Coom US RC Virology',3630,NULL,37.0,78246,1794,1794,'2022-08-16 07:49:34','2022-08-16 07:49:34'),(1101,'MRI MRCP',3628,NULL,37.0,78246,1794,1794,'2022-08-16 07:55:07','2022-08-16 07:55:07'),(1102,'clexan 40 to be stopped 12hrs befors',3631,NULL,37.0,78246,1794,1794,'2022-08-16 08:01:50','2022-08-16 08:01:50'),(1103,'plasma cryo Vwf PFT',3775,NULL,37.0,78245,1794,1794,'2022-08-16 08:15:26','2022-08-16 08:15:26'),(1104,NULL,3777,NULL,37.0,78259,1862,1862,'2022-08-16 08:44:59','2022-08-16 08:44:59'),(1105,NULL,3778,NULL,37.0,78259,1862,1862,'2022-08-16 08:45:35','2022-08-16 08:45:35'),(1106,'ayloir',3788,NULL,37.0,78268,1732,1732,'2022-08-16 08:54:27','2022-08-16 08:54:27'),(1107,'Musculoskeletal ultrasond of small joints and affected joints\r\nANA (titre and pattern)',3697,NULL,37.0,78251,1995,1995,'2022-08-16 08:54:39','2022-08-16 08:54:39'),(1108,'anomyin',3789,NULL,37.0,78268,1732,1732,'2022-08-16 08:55:44','2022-08-16 08:55:44'),(1109,'bma',3793,NULL,37.0,78262,1732,1732,'2022-08-16 09:06:02','2022-08-16 09:06:02'),(1110,'thiotacid, gaptin, soral, xilonforte',3802,NULL,37.0,78266,1999,1999,'2022-08-16 09:15:24','2022-08-16 09:15:24'),(1111,'sf',3807,NULL,37.0,78264,1732,1732,'2022-08-16 09:18:32','2022-08-16 09:18:32'),(1112,NULL,3771,NULL,37.0,78269,1862,1862,'2022-08-16 09:18:47','2022-08-16 09:18:47'),(1113,NULL,3772,NULL,37.0,78269,1862,1862,'2022-08-16 09:19:19','2022-08-16 09:19:19'),(1114,NULL,3773,NULL,37.0,78269,1862,1862,'2022-08-16 09:19:45','2022-08-16 09:19:45'),(1115,'oxygen',3814,NULL,37.0,78264,1732,1732,'2022-08-16 09:20:49','2022-08-16 09:20:49'),(1116,'follow up',3812,NULL,37.0,78264,1732,1732,'2022-08-16 09:24:07','2022-08-16 09:24:07'),(1117,'follow up',3808,NULL,37.0,78264,1732,1732,'2022-08-16 09:24:55','2022-08-16 09:24:55'),(1118,'ct brain',3810,NULL,37.0,78264,1732,1732,'2022-08-16 09:25:58','2022-08-16 09:25:58'),(1119,'karyotyping if normal-0-> whole exome sequence\r\nkaryotyping of parents\r\nbrain MRI\r\nskeletal surveyrevise ECHO for possible right isomerism\r\nprophylactic antibiotic for a splenia and revise immunization protocol for asplenia\r\ngenetic counseling depends on the result of molecular diagnosis',3748,NULL,37.0,78270,1496,1496,'2022-08-16 09:40:41','2022-08-16 09:40:41'),(1120,NULL,3806,NULL,37.0,78247,1164,1164,'2022-08-16 09:48:38','2022-08-16 09:48:38'),(1121,NULL,3294,'coversyl 10 قرص صباحا',37.0,78253,1164,1164,'2022-08-16 09:58:27','2022-08-16 09:58:27'),(1122,NULL,3803,NULL,37.0,78274,1682,1682,'2022-08-16 10:02:52','2022-08-16 10:02:52'),(1123,'CBC, liver and kidney functions',3811,'Zyrtec tab, allergyl tab , gabtin 300mg cap',37.0,78275,1368,1368,'2022-08-16 10:04:03','2022-08-16 10:04:03'),(1124,NULL,3815,'carbamide cream or urea 20%+ salicylic 5% in lanovasline once at night',37.0,78275,1368,1368,'2022-08-16 10:08:10','2022-08-16 10:08:10'),(1125,'follow up CBC, liver enzymes, serum cholesterol and TG\r\nif no improvement, consider cyclosporine after measuring the blood pressure',3750,'Methotrexate 25 mg weekly + Acitretin 25 mg',37.0,78277,1368,1368,'2022-08-16 10:25:07','2022-08-16 10:25:07'),(1126,'Echocardiography',3776,'Erastapex trio 40/10/25',37.0,78273,2001,2001,'2022-08-16 10:26:17','2022-08-16 10:26:17'),(1127,NULL,3780,NULL,37.0,78248,981,981,'2022-08-16 10:29:21','2022-08-16 10:29:21'),(1128,NULL,3783,NULL,37.0,78248,981,981,'2022-08-16 10:30:17','2022-08-16 10:30:17'),(1129,NULL,3790,NULL,37.0,78248,981,981,'2022-08-16 10:31:03','2022-08-16 10:31:03'),(1130,NULL,3794,NULL,37.0,78248,981,981,'2022-08-16 10:31:31','2022-08-16 10:31:31'),(1131,NULL,3801,NULL,37.0,78248,981,981,'2022-08-16 10:32:11','2022-08-16 10:32:11'),(1132,'fasting blood sugar,c.b.c with differential, lipid profile',3437,'electric cautry',37.0,78030,1610,1610,'2022-08-16 10:50:59','2022-08-16 10:50:59'),(1133,'coronary angiography',3769,'aspirin 81 mg 1x1 , plavix 75 mg 1x1 , rosuvast 20 mg 1x1 , concor 5 mg',37.0,78279,2001,2001,'2022-08-16 11:01:19','2022-08-16 11:01:19'),(1134,NULL,3751,NULL,37.0,78249,893,893,'2022-08-16 11:15:24','2022-08-16 11:15:24'),(1135,NULL,3695,NULL,37.0,78250,893,893,'2022-08-16 11:27:35','2022-08-16 11:27:35'),(1136,NULL,3544,'management of sepsis',37.0,78288,823,823,'2022-08-17 07:44:46','2022-08-17 07:44:46'),(1137,NULL,3868,'medical treatment and prepare for surgery',37.0,78288,823,823,'2022-08-17 07:50:01','2022-08-17 07:50:01'),(1138,NULL,3869,'zyrtec, calcium renagel high flux filter',37.0,78288,823,823,'2022-08-17 07:58:30','2022-08-17 07:58:30'),(1139,NULL,3871,'potassium replacement',37.0,78288,823,823,'2022-08-17 08:05:13','2022-08-17 08:05:13'),(1140,'termination of pregnancy\r\nلحين الانتهاء من الفحوصات',3795,NULL,37.0,78282,1578,1578,'2022-08-17 08:20:56','2022-08-17 08:20:56'),(1141,'لحين الانتهاء من الفحوصات\r\nu/s    -     preeclamspia work up',3797,NULL,37.0,78282,1578,1578,'2022-08-17 08:24:37','2022-08-17 08:24:37'),(1142,'follow up for drain sites and  TLC allow oral fluids after 3 days',3875,NULL,37.0,78290,2009,2009,'2022-08-17 08:27:50','2022-08-17 08:27:50'),(1143,'follow up for postop gastritis versus  CT Finding  of superior mesentric artery syndrome for consultation of a pediatric surgeon',3877,NULL,37.0,78290,2009,2009,'2022-08-17 08:30:46','2022-08-17 08:30:46'),(1144,NULL,3854,NULL,37.0,78294,1818,1818,'2022-08-17 08:46:20','2022-08-17 08:46:20'),(1145,NULL,3840,'continue antibotic course and follow up',37.0,78297,823,823,'2022-08-17 09:04:39','2022-08-17 09:04:39'),(1146,NULL,3835,'antibiobiotics, dialysis according to serum creatinine',37.0,78297,823,823,'2022-08-17 09:12:56','2022-08-17 09:12:56'),(1147,NULL,3835,'antibiobiotics, dialysis according to serum creatinine',37.0,78297,823,823,'2022-08-17 09:12:59','2022-08-17 09:12:59'),(1148,'chromosomal karyotyping \r\ntorch screen',3880,NULL,37.0,78292,1298,1298,'2022-08-17 09:19:40','2022-08-17 09:19:40'),(1149,NULL,3881,'antibiotics 5 ampoules potassium',37.0,78297,823,823,'2022-08-17 09:20:15','2022-08-17 09:20:15'),(1150,'full anticoagulation - fasciotomy - follow up with CBC - broad spectrum IV antibiotics',3848,NULL,37.0,78298,2016,2016,'2022-08-17 09:21:02','2022-08-17 09:21:02'),(1151,NULL,3884,'calcium and vitamin D',37.0,78297,823,823,'2022-08-17 09:25:32','2022-08-17 09:25:32'),(1152,'improve general condition - consult anaesthesia for posibility of  below elbow amputation - and for need for tracheostomy - broad spectrum antibiotics -',3847,NULL,37.0,78298,2016,2016,'2022-08-17 09:28:08','2022-08-17 09:28:08'),(1153,NULL,3837,'continue antibiotic course, follow up urine output and renal function tests',37.0,78297,823,823,'2022-08-17 09:31:35','2022-08-17 09:31:35'),(1154,NULL,3893,NULL,37.0,78284,994,994,'2022-08-17 09:32:52','2022-08-17 09:32:52'),(1155,NULL,3894,NULL,37.0,78284,994,994,'2022-08-17 09:33:17','2022-08-17 09:33:17'),(1156,'follow up echo and follow up renal function',3846,'aspirin 81 mg 1x1 , plavix 75 mg 1x1 , rosuvast 20 mg 1x1 N',37.0,78296,2013,2013,'2022-08-17 10:02:56','2022-08-17 10:02:56'),(1157,'follow up echo renal function',3846,'aspirin 81 mg 1x1 , plavix 75 mg 1x1 , rosuvast 20 mg 1x1 N',37.0,78296,2013,2013,'2022-08-17 10:04:13','2022-08-17 10:04:13'),(1158,NULL,3346,NULL,37.0,78285,994,994,'2022-08-17 10:14:43','2022-08-17 10:14:43'),(1159,NULL,3845,NULL,37.0,78285,994,994,'2022-08-17 10:15:04','2022-08-17 10:15:04'),(1160,'topical C.S /emollients/anti-seborrhic shampoo',3889,'as mentioned below',37.0,78304,1701,1701,'2022-08-17 10:37:18','2022-08-17 10:37:18'),(1161,NULL,3236,NULL,37.0,78286,1109,1109,'2022-08-17 10:39:29','2022-08-17 10:39:29'),(1162,NULL,3279,NULL,37.0,78286,1109,1109,'2022-08-17 10:40:29','2022-08-17 10:40:29'),(1163,NULL,3885,NULL,37.0,78305,1109,1109,'2022-08-17 10:54:52','2022-08-17 10:54:52'),(1164,'canulated screw of med .m and plate',3762,NULL,37.0,78308,2024,2024,'2022-08-17 11:04:44','2022-08-17 11:04:44'),(1165,'Skin biopsy',3898,NULL,37.0,78281,927,927,'2022-08-17 11:13:16','2022-08-17 11:13:16'),(1166,NULL,3899,'Qs-Nd-YAg laser session every month',37.0,78281,927,927,'2022-08-17 11:16:48','2022-08-17 11:16:48'),(1167,'REPEAT asot \\\r\nANA with titre \r\nechocardiography \r\ncrp \r\nknee us \r\nx ray lumbar spine \r\nrheumatoid factor',2364,NULL,37.0,78306,2023,2023,'2022-08-17 11:16:57','2022-08-17 11:16:57'),(1168,'do stool analysis \r\ncbc e diff\' crp \r\nadd iv rocephin \r\noral lacteole forte \r\noral hydrasec\r\noral nanazoxide',3818,NULL,37.0,78306,2023,2023,'2022-08-17 11:20:11','2022-08-17 11:20:11'),(1169,'do stool analysis \r\ncbc e diff\' crp \r\nadd iv rocephin \r\noral lacteole forte \r\noral hydrasec\r\noral nanazoxide',3822,NULL,37.0,78306,2023,2023,'2022-08-17 11:22:12','2022-08-17 11:22:12'),(1170,'the patient has history of new drug intake no mucous membrane affection  the rash most probably drug eruption for investigations and treatment under supervision of internal medicine as the patient is diabetic not controled hba1c 12 more investigatins needed\r\ncbc differential\r\ne.s.r\r\nsgot\r\nsgpt\r\nserum creatinine\r\nBUN',3900,'hydrocortisone vial injection',37.0,78309,2025,2025,'2022-08-17 11:27:59','2022-08-17 11:27:59'),(1171,'Proper wound care (garamycin followed by vaseline gauze then loose gauze), avoiding trauma to the skin as much as possible, vaseline on the affected nails, proper nutrition for the children and vitamin supplementation)',3842,NULL,37.0,78281,927,927,'2022-08-17 11:28:46','2022-08-17 11:28:46'),(1172,'Proper wound care (garamycin followed by vaseline gauze then loose gauze), avoiding trauma to the skin as much as possible, vaseline on the affected nails, proper nutrition for the children and vitamin supplementation)',3843,NULL,37.0,78281,927,927,'2022-08-17 11:29:16','2022-08-17 11:29:16'),(1173,'Proper wound care (garamycin followed by vaseline gauze then loose gauze), avoiding trauma to the skin as much as possible, vaseline on the affected nails, proper nutrition for the children and vitamin supplementation)',3844,NULL,37.0,78281,927,927,'2022-08-17 11:29:51','2022-08-17 11:29:51'),(1174,'avrozolid      .                 perfelgan/6 hrs',3873,NULL,37.0,78312,2030,2030,'2022-08-17 11:43:13','2022-08-17 11:43:13'),(1175,'echo \r\nct chest',3905,NULL,37.0,78312,2030,2030,'2022-08-17 11:44:02','2022-08-17 11:44:02'),(1176,'follow up',3903,'quadriderm cream -moist1 cream-flucoral caps',37.0,78310,2025,2025,'2022-08-17 11:45:08','2022-08-17 11:45:08'),(1177,'follow up',3878,'cutivate cream -minoxidil 5% gel',37.0,78310,2025,2025,'2022-08-17 11:51:15','2022-08-17 11:51:15'),(1178,'follow up',3878,'cutivate cream-minoxidil gel',37.0,78310,2025,2025,'2022-08-17 11:57:10','2022-08-17 11:57:10'),(1179,NULL,3883,'electrocautery',37.0,78310,2025,2025,'2022-08-17 11:57:45','2022-08-17 11:57:45'),(1180,'repeat cbc with MCV and MCH to detect type\r\nadd iron therapy\r\ndo electrolytes and blood gases',3860,NULL,37.0,78311,2027,2027,'2022-08-17 12:04:12','2022-08-17 12:04:12'),(1181,'repeat kidney functions and do electrolytes, discharge if dehydration corrected and established oral feeding',3862,NULL,37.0,78311,2027,2027,'2022-08-17 12:05:55','2022-08-17 12:05:55'),(1182,'discharge patient if no need for oxygen support and do CXR if developped RD , stop IV antibiotics',3864,NULL,37.0,78311,2027,2027,'2022-08-17 12:07:14','2022-08-17 12:07:14'),(1183,'if persistent fever with uncontrolled convulsions even after resuming revotril do CSF analysis and start IV unacyn and zovirax on meningetic doses',3867,NULL,37.0,78311,2027,2027,'2022-08-17 12:08:42','2022-08-17 12:08:42'),(1184,'parathyroidectomy',3890,'cinacalcet 90 mg once daily -parathyroidectomy if no responce',37.0,78322,1926,1926,'2022-08-18 08:17:05','2022-08-18 08:17:05'),(1185,'urgent general surgery consultation and ext. fix of the tibia',3901,NULL,37.0,78319,1907,1907,'2022-08-18 08:20:28','2022-08-18 08:20:28'),(1186,'speech therapy, skills development, follow up',3913,'cerebrolysin ampoule, omega three, l carnitine',37.0,78314,284,284,'2022-08-18 08:27:17','2022-08-18 08:27:17'),(1187,NULL,3891,'adjust dialyzer specification and hemodialysis prescribtion',37.0,78322,1926,1926,'2022-08-18 08:28:28','2022-08-18 08:28:28'),(1188,'continue session of plasmaphaersis',3702,NULL,37.0,78327,2033,2033,'2022-08-18 08:29:43','2022-08-18 08:29:43'),(1189,NULL,3872,'stop antihypertensive medication_add ivabradine',37.0,78323,1926,1926,'2022-08-18 08:33:44','2022-08-18 08:33:44'),(1190,'speech therapy, follow up',3656,'cerebrolysin, omega three',37.0,78332,284,284,'2022-08-18 08:41:34','2022-08-18 08:41:34'),(1191,'adding insulin inrease statin dose',3861,NULL,37.0,78328,2033,2033,'2022-08-18 08:41:40','2022-08-18 08:41:40'),(1192,'ct hest urine analysis',3774,NULL,37.0,78328,2033,2033,'2022-08-18 08:42:38','2022-08-18 08:42:38'),(1193,'full lab',3866,NULL,37.0,78328,2033,2033,'2022-08-18 08:43:51','2022-08-18 08:43:51'),(1194,'increase eltroxin dose and follow up',3921,NULL,37.0,78331,2033,2033,'2022-08-18 09:01:47','2022-08-18 09:01:47'),(1195,'follow up inestigation',3924,NULL,37.0,78331,2033,2033,'2022-08-18 09:02:29','2022-08-18 09:02:29'),(1196,'Urgent operative intervention',3907,NULL,37.0,78336,1451,1451,'2022-08-18 09:08:41','2022-08-18 09:08:41'),(1197,'FOLLOW UP',3908,NULL,37.0,78329,2033,2033,'2022-08-18 09:10:07','2022-08-18 09:10:07'),(1198,'renal biopsy...start imperical steroids if history of NSAID intake exists.',3540,'renal biposy',37.0,78325,1926,1926,'2022-08-18 09:11:32','2022-08-18 09:11:32'),(1199,'mri brain tsh ultra sound',3909,NULL,37.0,78329,2033,2033,'2022-08-18 09:12:53','2022-08-18 09:12:53'),(1200,'echo',3910,NULL,37.0,78329,2033,2033,'2022-08-18 09:13:30','2022-08-18 09:13:30'),(1201,'AMH\r\nIF NORMAL / REPEAT INDUCTION OF OVULATION FOR ANOTHER 2 MONTHS\r\nIF NO RESPONSE / ICSI',3920,NULL,37.0,78333,2034,2034,'2022-08-18 09:17:10','2022-08-18 09:17:10'),(1202,'serum lactate waiting for cultures',3935,NULL,37.0,78335,2033,2033,'2022-08-18 09:20:38','2022-08-18 09:20:38'),(1203,NULL,3940,'tiratam 500 mg',37.0,78318,923,923,'2022-08-18 09:22:54','2022-08-18 09:22:54'),(1204,NULL,3941,'depakin 500',37.0,78318,923,923,'2022-08-18 09:23:29','2022-08-18 09:23:29'),(1205,'check virology and lupus serology, urine analysis and culture, followed by renal biposy',3932,NULL,37.0,78325,1926,1926,'2022-08-18 09:23:30','2022-08-18 09:23:30'),(1206,'antibiotics, keep the current permicath and plan for future synthetic graft if recurrent episodes of catheter related infections.',3934,NULL,37.0,78326,1926,1926,'2022-08-18 09:32:53','2022-08-18 09:32:53'),(1207,'FOLLOW UP',3895,NULL,37.0,78338,1912,1912,'2022-08-18 09:35:04','2022-08-18 09:35:04'),(1208,'BONE MARROW EXAMINATION\r\nUS',3897,NULL,37.0,78338,1912,1912,'2022-08-18 09:36:52','2022-08-18 09:36:52'),(1209,'ANTIVIRAL THERAPY',3816,NULL,37.0,78321,2032,2032,'2022-08-18 09:38:04','2022-08-18 09:38:04'),(1210,NULL,3943,NULL,37.0,78339,1609,1609,'2022-08-18 10:10:10','2022-08-18 10:10:10'),(1211,'follow up for drain & vital signs - disscharge afree drain  & stable al signs',3943,NULL,37.0,78339,1609,1609,'2022-08-18 10:19:19','2022-08-18 10:19:19'),(1212,'recomendation for lap cholecystectomy if no absolute contraindication for laparoscopy',3944,NULL,37.0,78339,1609,1609,'2022-08-18 10:30:38','2022-08-18 10:30:38'),(1213,'topical C.S',3892,'as mentioned below',37.0,78341,1633,1633,'2022-08-18 10:33:10','2022-08-18 10:33:10'),(1214,'متابعة حالة الكوفيد من حيث الحرارة و الاكسجين مع عمل اشعة مقطعية على الصدر و اعادة صورة الدم مع فيلم للتحقق من وجود عدوى بكتيرية فى حال استمرار الحرارة  و عمل تحاليل CRP, Ferritin and LDH\r\n\r\nينصح بعمل  fluid chart , و تركيب CVP \r\nكما ينصح بطلب عرض  قلب',3942,'الاستمرار على العلاج الحالى مع المتابعة',37.0,78337,2040,2040,'2022-08-18 10:47:31','2022-08-18 10:47:31'),(1215,'photo protection\r\nparenteral dexamethasone once a week\r\ntopical fucicort\r\ntopical anti-fungal +nizapex shampoo\r\noral anti-histamine\r\ninvestigations for systemic anti-malaria',3781,'as mentioned below',37.0,78342,1633,1633,'2022-08-18 10:51:04','2022-08-18 10:51:04'),(1216,'adhesions only is not indication for resction unless intestinal injury occured - mesh is not recommended in any repair with GIT opening to avoid complications & infection - apply abdominal binder - wide spectrum antibiotic - late removal of drains',3946,NULL,37.0,78339,1609,1609,'2022-08-18 10:52:45','2022-08-18 10:52:45'),(1217,'stop previous ttt(methotrexate)',3781,'as mentioned below',37.0,78342,1633,1633,'2022-08-18 10:53:54','2022-08-18 10:53:54'),(1218,'virology, ANA , ANCA,Anti smith antibody,alkma, covid PCRrepeat alt ast after 10 days',3613,NULL,37.0,78346,2045,2045,'2022-08-18 10:55:19','2022-08-18 10:55:19'),(1219,'ct brain , three succesive blood culture , new echo to exclude vegetations',3701,NULL,37.0,78345,2045,2045,'2022-08-18 11:10:32','2022-08-18 11:10:32'),(1220,'investigations: thyroid auto-antibodies\r\ngradual withdrawal of systemic steroid\r\nnarrow band \r\nsystemic anti-oxidant',3782,'as mentioned below',37.0,78343,1633,1633,'2022-08-18 11:11:17','2022-08-18 11:11:17'),(1221,'polyvalent pneumococcal vaccine - in cases of minimal amount of free fluid you can conserve on the patient aasking for CT scan & follow up with vital signs , serial  CBC FAST serial US once deteriorati - you explore and don\'t take decision according to rigidity only as it can occurs with any amount of free fluid in the peritoneum due to  irritation & peritonitis',3943,NULL,37.0,78339,1609,1609,'2022-08-18 11:11:44','2022-08-18 11:11:44'),(1222,'for igs and cds to exclude immunodeficiency from repeated chest infection, ct chest with contrast to exclude h shaped bronchoesophageal fistula',3936,NULL,37.0,78345,2045,2045,'2022-08-18 11:12:48','2022-08-18 11:12:48'),(1223,'photo protection (physical sunscreen+ vitamin C )\r\ntopical C.S\r\ntopical calcinurin inhibitors\r\nsystemic antihistamin to avoid koebnerization',3784,'as mentioned below',37.0,78343,1633,1633,'2022-08-18 11:13:47','2022-08-18 11:13:47'),(1224,'biobsy',3949,'as mentioned below',37.0,78344,1633,1633,'2022-08-18 11:26:02','2022-08-18 11:26:02'),(1225,'treatment of 2ry bact infection  then re-evaluation',3948,'as mentioned below',37.0,78344,1633,1633,'2022-08-18 11:35:23','2022-08-18 11:35:23'),(1226,'topical treatment',3950,'as mentioned below',37.0,78344,1633,1633,'2022-08-18 11:36:13','2022-08-18 11:36:13'),(1227,'Continuation on his regimen and follow up of white blood cells and temperature',3978,'We added Meropenem 1 gm every 8 hours to his regimen',37.0,78353,2046,2046,'2022-08-20 07:46:26','2022-08-20 07:46:26'),(1228,'Follow up',3980,'continue on the same medication and follow up',37.0,78353,2046,2046,'2022-08-20 07:55:49','2022-08-20 07:55:49'),(1229,'check serum calcium and phosphorus',3917,'cinacalcet',37.0,78348,1809,1809,'2022-08-20 07:57:49','2022-08-20 07:57:49'),(1230,'follow up RBS fasting and 2h pp',3918,'galvus 50mg once',37.0,78348,1809,1809,'2022-08-20 08:05:47','2022-08-20 08:05:47'),(1231,'Detailed history and examination- Arterial Blood gases base line and Oxygen therapy with follow up according to it- Endocrine and Rheumatology consultation- High resolution CT chest',3929,'solupred 40 mg and continue on her antibiotic',37.0,78356,2046,2046,'2022-08-20 08:10:23','2022-08-20 08:10:23'),(1232,'check calcium and phosphorus level',3919,'marcal tab',37.0,78348,1809,1809,'2022-08-20 08:12:08','2022-08-20 08:12:08'),(1233,'as the general condition and labs improved on the given IV antibiotics, you can discharge in Oral Cephalosporin and follo-up at OPC',3971,NULL,37.0,78365,2048,2048,'2022-08-20 08:24:15','2022-08-20 08:24:15'),(1234,'Add lnezolid and ceftazidim. Neurological consultation',3990,NULL,37.0,78357,2046,2046,'2022-08-20 08:25:52','2022-08-20 08:25:52'),(1235,'NEBS with hypertonic saline and Pulmicort\r\ndischarge and OPC follow-up',3972,NULL,37.0,78365,2048,2048,'2022-08-20 08:26:28','2022-08-20 08:26:28'),(1236,'Nitazode - Hidrasec 10 mg sachets (t.d.s), anti-emetics, discharge when no dehydration and good oral intake',3973,NULL,37.0,78365,2048,2048,'2022-08-20 08:29:59','2022-08-20 08:29:59'),(1237,'NEBS \r\navoid asthma triggers',3975,NULL,37.0,78365,2048,2048,'2022-08-20 08:31:23','2022-08-20 08:31:23'),(1238,'Oral antibiotic ( Cephalosporin) and OPC follow-up',3977,NULL,37.0,78365,2048,2048,'2022-08-20 08:32:41','2022-08-20 08:32:41'),(1239,'NEBS, ORAL ANTIBIOTICS AND opc FOLLOW-UP WHEN NO SUPPLEMENTAL O2 NEEDED',3979,NULL,37.0,78365,2048,2048,'2022-08-20 08:34:15','2022-08-20 08:34:15'),(1240,'follow up with fluid and antibiotics',3992,NULL,37.0,78364,1753,1753,'2022-08-20 08:36:02','2022-08-20 08:36:02'),(1241,'Discharge with OPC follow-up of bilirubin level 48 hr later\r\nencourage breast feeding',3981,NULL,37.0,78365,2048,2048,'2022-08-20 08:36:34','2022-08-20 08:36:34'),(1242,'OPC follow-up of bilirubin level\r\nencourage breast feeding',3982,NULL,37.0,78365,2048,2048,'2022-08-20 08:37:50','2022-08-20 08:37:50'),(1243,'Chest X ray\r\nEchocardiogram\r\nO2 support \r\nryle feeding',3983,NULL,37.0,78365,2048,2048,'2022-08-20 08:39:47','2022-08-20 08:39:47'),(1244,'improving, for promoting oral feeding and discharge',3985,NULL,37.0,78365,2048,2048,'2022-08-20 08:41:22','2022-08-20 08:41:22'),(1245,'follow up chest tube , continue on the same regiemen , cardiothoracic consult',3469,NULL,37.0,78364,1753,1753,'2022-08-20 08:41:32','2022-08-20 08:41:32'),(1246,'follow up',3674,NULL,37.0,78364,1753,1753,'2022-08-20 08:44:05','2022-08-20 08:44:05'),(1247,'Continue on same regimen and follow up',3905,'Continue on same regimen',37.0,78368,2046,2046,'2022-08-20 08:44:40','2022-08-20 08:44:40'),(1248,'follow up cardiac enzyme and ecg',3984,NULL,37.0,78367,1753,1753,'2022-08-20 08:47:21','2022-08-20 08:47:21'),(1249,'follow up',3986,NULL,37.0,78367,1753,1753,'2022-08-20 08:48:52','2022-08-20 08:48:52'),(1250,'follow up',3993,NULL,37.0,78367,1753,1753,'2022-08-20 08:50:57','2022-08-20 08:50:57'),(1251,'follow up ct brain',3994,NULL,37.0,78367,1753,1753,'2022-08-20 08:53:01','2022-08-20 08:53:01'),(1252,'PCr for confirmation of Vovid 19 infection- CTPA after weaning from MV- Neurological consultaion',3987,'Continue on same regimen',37.0,78368,2046,2046,'2022-08-20 08:54:27','2022-08-20 08:54:27'),(1253,'ECHcardiography- Outpatient inhaled LABA-ICS',3989,'Continue inpatient treatment- Recommend inhaled LABA-ICS after discharge',37.0,78368,2046,2046,'2022-08-20 09:01:17','2022-08-20 09:01:17'),(1254,NULL,3636,'Continue on same regimen',37.0,78368,2046,2046,'2022-08-20 09:05:04','2022-08-20 09:05:04'),(1255,'follow up and antibiotics',4000,NULL,37.0,78361,1753,1753,'2022-08-20 09:05:58','2022-08-20 09:05:58'),(1256,'follow up and ABG',4002,NULL,37.0,78361,1753,1753,'2022-08-20 09:09:41','2022-08-20 09:09:41'),(1257,'viral profile CMV ,EBV\r\nAUTOIMMUNE PROFILE\r\nBlood culture ,LDH,ESR,Blood film',3998,NULL,37.0,78350,1769,1769,'2022-08-20 09:11:29','2022-08-20 09:11:29'),(1258,'MDCT with contrast',3988,NULL,37.0,78368,2046,2046,'2022-08-20 09:12:19','2022-08-20 09:12:19'),(1259,'FOLLOW UP',4009,NULL,37.0,78361,1753,1753,'2022-08-20 09:14:27','2022-08-20 09:14:27'),(1260,'FOLLOW UP',4005,NULL,37.0,78361,1753,1753,'2022-08-20 09:19:13','2022-08-20 09:19:13'),(1261,'blood,stool cultures\r\nautoimmune profile\r\nblood film\r\ncovid igG,iGm',4001,NULL,37.0,78350,1769,1769,'2022-08-20 09:21:01','2022-08-20 09:21:01'),(1262,'FOLLOW UP AND CHEST CARE',4015,NULL,37.0,78361,1753,1753,'2022-08-20 09:25:50','2022-08-20 09:25:50'),(1263,'o2\r\nnebulizer\r\nantifailure capoten-spironolactone\r\nABS',4014,NULL,37.0,78351,1769,1769,'2022-08-20 09:29:03','2022-08-20 09:29:03'),(1264,'FOLLOW UP AND ECHO',4019,NULL,37.0,78361,1753,1753,'2022-08-20 09:30:25','2022-08-20 09:30:25'),(1265,'Echocardiography',3974,'Continue on same regimen',37.0,78359,2047,2047,'2022-08-20 09:31:36','2022-08-20 09:31:36'),(1266,'repeat ct brain',3923,'care of comatosed',37.0,78369,2051,2051,'2022-08-20 09:32:48','2022-08-20 09:32:48'),(1267,'SHIFT TO MAXIPIME\r\nO2\r\niv fluids\r\nnebulizers',4016,NULL,37.0,78351,1769,1769,'2022-08-20 09:33:00','2022-08-20 09:33:00'),(1268,'FOLLOW UP',4020,NULL,37.0,78361,1753,1753,'2022-08-20 09:35:22','2022-08-20 09:35:22'),(1269,'CA+\\- PCI',3976,'Continue on same regimen',37.0,78359,2047,2047,'2022-08-20 09:35:53','2022-08-20 09:35:53'),(1270,'FOLLOW UP',4013,NULL,37.0,78375,1753,1753,'2022-08-20 09:44:14','2022-08-20 09:44:14'),(1271,'CA',4025,'Continue on same regimen',37.0,78372,2047,2047,'2022-08-20 09:45:44','2022-08-20 09:45:44'),(1272,'consevative treatment',4022,NULL,37.0,78352,1907,1907,'2022-08-20 09:46:03','2022-08-20 09:46:03'),(1273,'FOLLOW UP AND CHEST , CARDIO CONSULTATION',4012,NULL,37.0,78375,1753,1753,'2022-08-20 09:48:54','2022-08-20 09:48:54'),(1274,'nerve conduction study',4024,NULL,37.0,78352,1907,1907,'2022-08-20 09:50:13','2022-08-20 09:50:13'),(1275,'Glycosylated Hb, check for hypoadrenalism',3539,NULL,37.0,78373,2054,2054,'2022-08-20 09:51:37','2022-08-20 09:51:37'),(1276,'CA',4027,NULL,37.0,78372,2047,2047,'2022-08-20 09:53:00','2022-08-20 09:53:00'),(1277,'Conservative TTT',4023,NULL,37.0,78352,1907,1907,'2022-08-20 09:55:39','2022-08-20 09:55:39'),(1278,'BM ASPIRATION AND BIOPSY',3997,NULL,37.0,78376,1912,1912,'2022-08-20 10:00:35','2022-08-20 10:00:35'),(1279,'BM aspiration\r\nLDH\r\nESR\r\nThyroid profile',3996,NULL,37.0,78376,1912,1912,'2022-08-20 10:01:34','2022-08-20 10:01:34'),(1280,'CA',4021,NULL,37.0,78372,2047,2047,'2022-08-20 10:09:59','2022-08-20 10:09:59'),(1281,'CA',4017,NULL,37.0,78372,2047,2047,'2022-08-20 10:11:45','2022-08-20 10:11:45'),(1282,'MRI lumbosacral spine',3711,NULL,37.0,78355,1907,1907,'2022-08-20 10:22:32','2022-08-20 10:22:32'),(1283,'medical TTT and follow up',3709,NULL,37.0,78355,1907,1907,'2022-08-20 10:29:01','2022-08-20 10:29:01'),(1284,'medical TTT',3655,NULL,37.0,78355,1907,1907,'2022-08-20 10:31:42','2022-08-20 10:31:42'),(1285,'متابعه بعد اسبوعين',3995,'tinox cr l مرتين يوميا fexophenadine syrp معلقه مرتين',37.0,78382,1330,1330,'2022-08-20 10:33:13','2022-08-20 10:33:13'),(1286,NULL,4003,NULL,37.0,78380,2056,2056,'2022-08-20 10:36:08','2022-08-20 10:36:08'),(1287,NULL,3945,'carbamide cr مرتين diprosalic oint مرتين يوميا اسبوعين',37.0,78383,1330,1330,'2022-08-20 10:48:13','2022-08-20 10:48:13'),(1288,NULL,3999,'panthenol cr . betaval cr',37.0,78384,1330,1330,'2022-08-20 10:59:50','2022-08-20 10:59:50'),(1289,NULL,3963,NULL,37.0,78381,2056,2056,'2022-08-20 11:02:39','2022-08-20 11:02:39'),(1290,NULL,3968,NULL,37.0,78381,2056,2056,'2022-08-20 11:04:59','2022-08-20 11:04:59'),(1291,'k permangnate كمدات 3 مرات يوميا',4040,'solupred 20 mg tab قرص ونص يوميا اسبوعينfucicort cr مرتين و oracure gel ,  \\',37.0,78388,1330,1330,'2022-08-20 11:11:16','2022-08-20 11:11:16'),(1292,'for ultrasound of the affected arm to exclude deep abcess formation',3916,NULL,37.0,78385,2057,2057,'2022-08-20 11:15:15','2022-08-20 11:15:15'),(1293,NULL,4037,'electrocautry',37.0,78389,1330,1330,'2022-08-20 11:17:24','2022-08-20 11:17:24'),(1294,NULL,4050,'panthenol cr ,texacort cr ,, intalesional steroid injection for keloid',37.0,78389,1330,1330,'2022-08-20 11:21:50','2022-08-20 11:21:50'),(1295,NULL,3737,NULL,37.0,78400,2062,2062,'2022-08-21 07:46:24','2022-08-21 07:46:24'),(1296,'follow up \r\nEEG',4074,NULL,37.0,78412,2067,2067,'2022-08-21 08:18:00','2022-08-21 08:18:00'),(1297,'EEG   MRI',1981,'tiratam500 twice daily',37.0,78395,973,973,'2022-08-21 08:26:26','2022-08-21 08:26:26'),(1298,'no need',4088,'no',37.0,78410,2065,2065,'2022-08-21 08:30:28','2022-08-21 08:30:28'),(1299,'proceed feeding rapidly',4078,NULL,37.0,78406,1258,1258,'2022-08-21 08:37:38','2022-08-21 08:37:38'),(1300,'COVID swab \\d dimer\r\nPT PC PTT   INR',4080,NULL,37.0,78406,1258,1258,'2022-08-21 08:38:40','2022-08-21 08:38:40'),(1301,'BIND SCORE\r\nfollow up bilirubin levels after 4 hours',4083,NULL,37.0,78406,1258,1258,'2022-08-21 08:39:49','2022-08-21 08:39:49'),(1302,'cardiothoracic consultation',4085,NULL,37.0,78406,1258,1258,'2022-08-21 08:41:37','2022-08-21 08:41:37'),(1303,'echo\r\nmonitor urine output proper hydration adjust antibiotics follow up kidney functions',4086,NULL,37.0,78406,1258,1258,'2022-08-21 08:43:28','2022-08-21 08:43:28'),(1304,'follow up echo proceed in feeding \r\nfollow up na level',4087,NULL,37.0,78406,1258,1258,'2022-08-21 08:44:37','2022-08-21 08:44:37'),(1305,'adequate dialysis dose and use of high flux dialyzers...antihistaminic ....PTH level',4091,NULL,37.0,78425,1926,1926,'2022-08-21 08:47:52','2022-08-21 08:47:52'),(1306,'iron profile\r\nHbA1',4034,NULL,37.0,78415,1843,1843,'2022-08-21 08:52:56','2022-08-21 08:52:56'),(1307,NULL,3991,NULL,37.0,78398,973,973,'2022-08-21 08:58:42','2022-08-21 08:58:42'),(1308,'INVESTIGATIOS',4038,NULL,37.0,78415,1843,1843,'2022-08-21 08:59:37','2022-08-21 08:59:37'),(1309,'K and ABg  testing. if abnormal values exists, start hemodialysis. if normal values, conservative measures and creation of AVF',4107,NULL,37.0,78425,1926,1926,'2022-08-21 08:59:48','2022-08-21 08:59:48'),(1310,'REOSULT RHEUMATOLOGIST',4042,NULL,37.0,78415,1843,1843,'2022-08-21 09:03:39','2022-08-21 09:03:39'),(1311,'متابعة',4092,NULL,37.0,78413,1843,1843,'2022-08-21 09:07:47','2022-08-21 09:07:47'),(1312,'ramipril 10 mg, amlodipine 10mg, loop diuretics, spironolactone',4090,NULL,37.0,78425,1926,1926,'2022-08-21 09:10:16','2022-08-21 09:10:16'),(1313,NULL,4112,NULL,37.0,78424,2070,2070,'2022-08-21 09:15:34','2022-08-21 09:15:34'),(1314,'inhaled B2 agonist and inhaled steroids, ECg  to exclude IHD, high flux dialysis',4077,NULL,37.0,78420,1926,1926,'2022-08-21 09:17:58','2022-08-21 09:17:58'),(1315,NULL,3530,NULL,37.0,78409,973,973,'2022-08-21 09:23:09','2022-08-21 09:23:09'),(1316,'admister more fluids and monitor for UOP guided clinically to avoid volume overload\\upgrade inotropes as needed',3038,NULL,37.0,78429,1519,1519,'2022-08-21 09:23:11','2022-08-21 09:23:11'),(1317,NULL,4082,NULL,37.0,78409,973,973,'2022-08-21 09:23:41','2022-08-21 09:23:41'),(1318,'antiplateley, statin, duplex scan both lower limbs, ankle brachial pressure index, vascular consultation for suspected need for angioplasty',4079,NULL,37.0,78420,1926,1926,'2022-08-21 09:25:25','2022-08-21 09:25:25'),(1319,'cardiothorasic consultation',3208,'Continue on same regimen',37.0,78390,2060,2060,'2022-08-21 09:27:53','2022-08-21 09:27:53'),(1320,NULL,4004,'Continue on same regimen',37.0,78390,2060,2060,'2022-08-21 09:29:20','2022-08-21 09:29:20'),(1321,NULL,3904,NULL,37.0,78432,1947,1947,'2022-08-21 09:30:34','2022-08-21 09:30:34'),(1322,'REHYDRATE THE PATIENT',4101,NULL,37.0,78422,1843,1843,'2022-08-21 09:31:56','2022-08-21 09:31:56'),(1323,'triphasic CT\r\nDiagnostic tapping\r\nurine  analysis \r\nblood culture\r\nCXR\r\nstop antibiotics',4123,NULL,37.0,78408,2064,2064,'2022-08-21 09:32:59','2022-08-21 09:32:59'),(1324,NULL,4067,'ppi',37.0,78408,2064,2064,'2022-08-21 09:34:42','2022-08-21 09:34:42'),(1325,'maximize diuretics fractionated every 6 hours or continous IV infusion if  needed\r\ncheck patient outpatient doses and compliance',3558,NULL,37.0,78429,1519,1519,'2022-08-21 09:35:34','2022-08-21 09:35:34'),(1326,'PPI\r\nUDCA',4068,NULL,37.0,78408,2064,2064,'2022-08-21 09:36:48','2022-08-21 09:36:48'),(1327,NULL,4011,NULL,37.0,78430,973,973,'2022-08-21 09:37:41','2022-08-21 09:37:41'),(1328,'DIAGNOSTIC ENDOSCOPY',4067,NULL,37.0,78408,2064,2064,'2022-08-21 09:38:09','2022-08-21 09:38:09'),(1329,'stabilize hemodynamic state, ascitic fluid tapping,',4122,NULL,37.0,78431,1926,1926,'2022-08-21 09:38:31','2022-08-21 09:38:31'),(1330,'PPI',4127,'PPI',37.0,78408,2064,2064,'2022-08-21 09:39:28','2022-08-21 09:39:28'),(1331,NULL,4010,'Continue on same regimen',37.0,78390,2060,2060,'2022-08-21 09:40:51','2022-08-21 09:40:51'),(1332,'ABDOMEN\r\nSURGICAL CONSULTATIONCT',4070,NULL,37.0,78408,2064,2064,'2022-08-21 09:41:10','2022-08-21 09:41:10'),(1333,'COMPLETE ai MARKERS \r\nCONTINUE STEROID\r\nFOLLOW UP RBS',4069,NULL,37.0,78408,2064,2064,'2022-08-21 09:42:36','2022-08-21 09:42:36'),(1334,NULL,4010,'Continue on same regimen',37.0,78390,2060,2060,'2022-08-21 09:42:42','2022-08-21 09:42:42'),(1335,'antibiotics and hemodialysis',4124,NULL,37.0,78431,1926,1926,'2022-08-21 09:43:25','2022-08-21 09:43:25'),(1336,'COMP;ETE INVESTIAGATIONS',4129,NULL,37.0,78408,2064,2064,'2022-08-21 09:43:42','2022-08-21 09:43:42'),(1337,NULL,4066,NULL,37.0,78405,1947,1947,'2022-08-21 09:51:14','2022-08-21 09:51:14'),(1338,'discharge on moxifloxacin and nephro and cardiology consultation',4118,NULL,37.0,78390,2060,2060,'2022-08-21 09:52:25','2022-08-21 09:52:25'),(1339,'cvp and nephrology consultation',4103,NULL,37.0,78437,2060,2060,'2022-08-21 10:13:52','2022-08-21 10:13:52'),(1340,NULL,4151,'Mg So4',37.0,78399,1578,1578,'2022-08-21 10:21:28','2022-08-21 10:21:28'),(1341,NULL,4060,', eye care,{ under suppervision ICU} ,electrolyte imbalance, emolients,',37.0,78440,1726,1726,'2022-08-21 10:24:01','2022-08-21 10:24:01'),(1342,NULL,4114,'topical treczimus once, sunscreen daily',37.0,78453,1726,1726,'2022-08-21 10:37:51','2022-08-21 10:37:51'),(1343,NULL,4110,'cryotherapy ,',37.0,78453,1726,1726,'2022-08-21 10:40:44','2022-08-21 10:40:44'),(1344,'cbc with platelet count manual\r\nif patient doing well just ecchymotic patch follow up \r\nif presented with mucous membrane bleeding do bone marrow aspiration \r\ntreatment according to lab result',3766,NULL,37.0,78258,1997,1997,'2022-08-21 10:54:08','2022-08-21 10:54:08'),(1345,'متابعه بعد عمل الفحوصات',4081,'emolients until result of investigation {HCV Ag, liver functions ,CBC, random Blood sugar}',37.0,78453,1726,1726,'2022-08-21 10:54:36','2022-08-21 10:54:36'),(1346,'repeat cbc with platelet manual\r\nurine analysis\r\nbone marrow aspiration\r\n liver profile\r\ntreatment according to lab result \r\nreconsult after lab result',3768,NULL,37.0,78258,1997,1997,'2022-08-21 10:59:25','2022-08-21 10:59:25'),(1347,'متابعه بعد اسبوعين  و الصور غير واضحه والمريض غير متواجد للمرة التانيه',3235,'nizoral shampoo twice per week, dermatin cort cr twice per day for 2 weeks',37.0,78441,1726,1726,'2022-08-21 11:06:53','2022-08-21 11:06:53'),(1348,NULL,3652,NULL,37.0,78457,2080,2080,'2022-08-21 11:31:31','2022-08-21 11:31:31'),(1349,'endocrine consultation, keep sandostatin , Ca profile and PTH level',4156,NULL,37.0,78449,1993,1993,'2022-08-21 11:42:09','2022-08-21 11:42:09'),(1350,NULL,4106,'Continue on same regimen',37.0,78456,1129,1129,'2022-08-21 11:42:51','2022-08-21 11:42:51'),(1351,'increase PIP due to PCO2 retension then repeat VBG, do CSF after improvement of thrombocytopenia, ask about blood culyure result, MSCT result',4159,NULL,37.0,78449,1993,1993,'2022-08-21 11:45:45','2022-08-21 11:45:45'),(1352,'vasoconstrictors and revascularization',4113,'vasoconstrictors plus antiischemic then revascularization',37.0,78454,1129,1129,'2022-08-21 11:55:24','2022-08-21 11:55:24'),(1353,'start trophic ryle feeding, do sputum culture, repeat Echo, withdraw dobutrex and repeat sepsis screen after 48 hr.',3698,NULL,37.0,78451,1993,1993,'2022-08-21 12:08:33','2022-08-21 12:08:33'),(1354,'ask about csf culture result, antibiotics meningitic dose, neurosurgical consultation, start ryle feeding',4166,NULL,37.0,78451,1993,1993,'2022-08-21 12:10:41','2022-08-21 12:10:41'),(1355,'withdraw dopaminem start ryle feeding, repeat VBG after increase fluid intake',4167,NULL,37.0,78451,1993,1993,'2022-08-21 12:12:09','2022-08-21 12:12:09'),(1356,'TTT BASED ON CULTURE AND TTT THE CAUSE',4203,NULL,37.0,78467,2084,2084,'2022-08-22 07:39:31','2022-08-22 07:39:31'),(1357,NULL,4215,'diprosalic oint twice daily',37.0,78475,2087,2087,'2022-08-22 07:43:54','2022-08-22 07:43:54'),(1358,'skin protection and job safe gaurd',4157,'dermovate oint  1 tube in vaseline 100gm, betnovate cream add to carbamide cream, telfast 180mg tab if not cardiac or has obstructed jaundice',37.0,78475,2087,2087,'2022-08-22 07:51:59','2022-08-22 07:51:59'),(1359,'biopsy to reach diagnosis',4155,NULL,37.0,78475,2087,2087,'2022-08-22 07:56:34','2022-08-22 07:56:34'),(1360,'ECG....TSH..Ft3..FT4.....Echo',4178,NULL,37.0,78477,1037,1037,'2022-08-22 07:57:56','2022-08-22 07:57:56'),(1361,'Erythropoitin....avoid recuurent blood clots in session',4179,NULL,37.0,78477,1037,1037,'2022-08-22 07:58:59','2022-08-22 07:58:59'),(1362,'vascular consultaion',4180,NULL,37.0,78477,1037,1037,'2022-08-22 08:00:09','2022-08-22 08:00:09'),(1363,'RFT....control of diabetes...fundus exam....vascular consultaion',4181,NULL,37.0,78477,1037,1037,'2022-08-22 08:01:13','2022-08-22 08:01:13'),(1364,NULL,3392,'moist 1 cream 3times daily, carbamide cream twice daily, dove pinl soap',37.0,78475,2087,2087,'2022-08-22 08:03:11','2022-08-22 08:03:11'),(1365,'avoid blood clots....erythropoetin.....vit c...folic acid ....search for cause of blleding as melena',4184,NULL,37.0,78477,1037,1037,'2022-08-22 08:04:17','2022-08-22 08:04:17'),(1366,'erythropotin...folic acid....vit c ....avoid blood clots in session....ask for GIT bleeding',4185,NULL,37.0,78477,1037,1037,'2022-08-22 08:05:21','2022-08-22 08:05:21'),(1367,NULL,4154,'need surgical intervention',37.0,78475,2087,2087,'2022-08-22 08:07:08','2022-08-22 08:07:08'),(1368,'clinical assessment....vital sign...labs..neuro consultation',4187,NULL,37.0,78477,1037,1037,'2022-08-22 08:07:43','2022-08-22 08:07:43'),(1369,'biopsy',4216,NULL,37.0,78475,2087,2087,'2022-08-22 08:10:25','2022-08-22 08:10:25'),(1370,'CT GUIDED BIPSY',4099,NULL,37.0,78467,2084,2084,'2022-08-22 08:16:11','2022-08-22 08:16:11'),(1371,NULL,4073,'krella lotion , daicalderm oint , poly tar shampoo',37.0,78476,2087,2087,'2022-08-22 08:16:51','2022-08-22 08:16:51'),(1372,'ASSESSMENT OF C OLLAGEN AND SYMP TTT',4205,NULL,37.0,78467,2084,2084,'2022-08-22 08:17:11','2022-08-22 08:17:11'),(1373,'combined contraception',702,NULL,37.0,78485,2091,2091,'2022-08-22 08:20:04','2022-08-22 08:20:04'),(1374,NULL,4126,'nizapex shampoo , terbicumasil spray once daily',37.0,78476,2087,2087,'2022-08-22 08:21:22','2022-08-22 08:21:22'),(1375,NULL,4225,'clindasol gel (morning and noon), acneact cream ( at night for 15 min then wash), cyteal lotion (cleanser), doxycost 200mg cap aonce after launch',37.0,78476,2087,2087,'2022-08-22 08:25:30','2022-08-22 08:25:30'),(1376,NULL,4227,'acyclovir 800mg tab 5 times daily for 5 days, hibiotic 1 gm tam twice daily, k permenganate 1/800lotion 3times daily, garamycin in cream',37.0,78476,2087,2087,'2022-08-22 08:33:06','2022-08-22 08:33:06'),(1377,'BRONCHOSOPE',4217,NULL,37.0,78467,2084,2084,'2022-08-22 08:39:40','2022-08-22 08:39:40'),(1378,'add cipro\r\nplasma transfusion\r\nCBC CRP after 48 hours',3625,NULL,37.0,78483,1258,1258,'2022-08-22 08:40:36','2022-08-22 08:40:36'),(1379,'FOLLOW UP ON BIPAP AND GRADUAL WITHDRAWAL WITH USUAL TTT',4220,NULL,37.0,78467,2084,2084,'2022-08-22 08:40:56','2022-08-22 08:40:56'),(1380,'control convulsions\r\nmay increase tiratam to 100 mg per kg per day\r\ncheck electrolytes Na mg ionized calcium blood glucose\r\nmonitor urine output and adjust fluids',3956,NULL,37.0,78483,1258,1258,'2022-08-22 08:42:40','2022-08-22 08:42:40'),(1381,'add noradrenaline low dose 0.05 mic per kg per minute to correct hypotension\r\nmonitoe urine output\r\nadjust ventilator settings based on ABGs',3957,NULL,37.0,78483,1258,1258,'2022-08-22 08:44:21','2022-08-22 08:44:21'),(1382,'decrease PIP then rate based on current blood gases\r\nblood transfusion\r\ncardiothoracic consultation for arterial switch when stabilized',3958,NULL,37.0,78483,1258,1258,'2022-08-22 08:46:14','2022-08-22 08:46:14'),(1383,'echocardiography\r\nincrease ryle feeding by 20 cc per kg per day\r\ndiflucan prophylactic',4104,NULL,37.0,78483,1258,1258,'2022-08-22 08:47:22','2022-08-22 08:47:22'),(1384,NULL,4043,'scaro gel twice daily',37.0,78478,2087,2087,'2022-08-22 08:47:41','2022-08-22 08:47:41'),(1385,'oral feeding \r\ndischarge',4105,NULL,37.0,78483,1258,1258,'2022-08-22 08:48:06','2022-08-22 08:48:06'),(1386,'Do HRCT  for the Rt pulm nodule and may need PET-CT',4212,'symbicort 320 BD + Tiotropium inhaler OD  are main line treatment',37.0,78466,2085,2085,'2022-08-22 09:00:42','2022-08-22 09:00:42'),(1387,'salt restriction\r\nweight loss\r\ncompliance to treatment',4257,'olmesartan amlodipine',37.0,78488,1660,1660,'2022-08-22 09:11:44','2022-08-22 09:11:44'),(1388,'FOLLOW UP AND CARDIAC CONSULTATION',4261,NULL,37.0,78492,1753,1753,'2022-08-22 09:15:27','2022-08-22 09:15:27'),(1389,NULL,4141,NULL,37.0,78498,1127,1127,'2022-08-22 09:15:34','2022-08-22 09:15:34'),(1390,NULL,4143,NULL,37.0,78498,1127,1127,'2022-08-22 09:16:08','2022-08-22 09:16:08'),(1391,'extended metabolic screening\r\npelviabdominal US\r\nechocardiology',4230,NULL,37.0,78461,316,316,'2022-08-22 09:17:13','2022-08-22 09:17:13'),(1392,'Do CBC + ESR + ANA+ antidsDNA+ rheumatoid factor and antiscleroderma 70',4218,'20 mg prednisolone + Omeprazole 20 mg/day + Calcium and Mg supplement',37.0,78466,2085,2085,'2022-08-22 09:22:58','2022-08-22 09:22:58'),(1393,NULL,4230,NULL,37.0,78461,316,316,'2022-08-22 09:25:52','2022-08-22 09:25:52'),(1394,'treat as COPD acute exacerbation\r\ncheck serum potassium as there is metabolic alkalosis\r\ngive copntrolled oxygen therapy by venturi \r\ndo echo cardiography\r\nfollow up the rutine labs and inflammatory markers',4239,'Systemic steroid + nebulized bronchodilators salbutamol and ipratropium + Levofloxacin + Controlled oxygen therapy by Venturi mask',37.0,78501,2085,2085,'2022-08-22 09:54:25','2022-08-22 09:54:25'),(1395,NULL,611,'fulic',37.0,78502,339,339,'2022-08-22 10:05:33','2022-08-22 10:05:33'),(1396,NULL,4111,'vibramycin 100 mg مرتين يوميا adapalene gel مره مساا ساعه ويشطف sebaclar gel صباحا synobar soap',37.0,78505,1678,1678,'2022-08-22 10:24:56','2022-08-22 10:24:56'),(1397,'جوانتي وتجنب المنظفات',4282,'Glycerin soap, panthenol cr مرتين و betaval cr مرتين يوميا لمدة 3 اسابيع analarge tab مره مساء اسبوعين',37.0,78505,1678,1678,'2022-08-22 10:36:53','2022-08-22 10:36:53'),(1398,'cbc culture covid markers',4051,'acyclovir antibiotics',37.0,78479,1225,1225,'2022-08-22 10:38:02','2022-08-22 10:38:02'),(1399,'cbc culture covid markers',4054,'acyclovir antibiotics',37.0,78479,1225,1225,'2022-08-22 10:38:53','2022-08-22 10:38:53'),(1400,'entral feeding as early as you  can ( once intestinal sound hearing) - good decision',4145,NULL,37.0,78507,2100,2100,'2022-08-22 10:39:57','2022-08-22 10:39:57'),(1401,'Total lipid profile, Stress testing, Lifestyle modification',3677,'Aspirin 81mg tab, Ator 20mg tab',37.0,78470,2086,2086,'2022-08-22 10:43:00','2022-08-22 10:43:00'),(1402,NULL,4234,'aspocid 75',37.0,78499,1854,1854,'2022-08-22 10:44:34','2022-08-22 10:44:34'),(1403,'تنشيف كويس و لبس قطن',4259,'Diflucan 150 mg كبسولتين اليوم ويكرر بعد اسبوع 2, lamifen cr مرتين شهر nizapex shampoo  في الاستحمام',37.0,78506,1678,1678,'2022-08-22 10:44:54','2022-08-22 10:44:54'),(1404,'check for combined injury in struggle other than only pullets - advantage of laparoscopic exploration as a less invasive procedure in such cases -',4089,NULL,37.0,78507,2100,2100,'2022-08-22 10:45:52','2022-08-22 10:45:52'),(1405,'do omnipaque study, Echo to exclude vascular ring, and AR formula',4153,NULL,37.0,78504,1993,1993,'2022-08-22 10:48:05','2022-08-22 10:48:05'),(1406,'kidney function test, insert urinary catheter to asses UOP acurately, do urine analysis, pelvi abdominal US,correct metabolic acidosis with HCO3,nephrology consultation, may be dialysis if still hyperkalemic',4160,NULL,37.0,78504,1993,1993,'2022-08-22 10:52:00','2022-08-22 10:52:00'),(1407,'increase feeding gradually',4211,NULL,37.0,78504,1993,1993,'2022-08-22 11:00:16','2022-08-22 11:00:16'),(1408,'Echo, measure BP, add inotropes according to BP, fentanyl sedation, increase PIP',4213,NULL,37.0,78504,1993,1993,'2022-08-22 11:02:05','2022-08-22 11:02:05'),(1409,'upper endoscopy after regain concious',4171,'carvid',37.0,78512,1384,1384,'2022-08-22 11:25:29','2022-08-22 11:25:29'),(1410,'proceed in oral feeding',4271,NULL,37.0,78513,1993,1993,'2022-08-22 11:28:49','2022-08-22 11:28:49'),(1411,'do mother and baby blood groub, retics, coombs for diagnosis',4268,NULL,37.0,78513,1993,1993,'2022-08-22 11:31:05','2022-08-22 11:31:05'),(1412,'proceed in feeding',4272,NULL,37.0,78513,1993,1993,'2022-08-22 11:34:08','2022-08-22 11:34:08'),(1413,'proceed in feeding',4273,NULL,37.0,78513,1993,1993,'2022-08-22 11:35:32','2022-08-22 11:35:32'),(1414,'do mother and baby blood group, Retics, coomb',4277,NULL,37.0,78513,1993,1993,'2022-08-22 11:37:16','2022-08-22 11:37:16'),(1415,'proceed in feeding',4293,NULL,37.0,78513,1993,1993,'2022-08-22 11:38:04','2022-08-22 11:38:04'),(1416,'ct chest echo',4267,'methotrexate',37.0,78512,1384,1384,'2022-08-22 11:39:10','2022-08-22 11:39:10'),(1417,'gaptin cap\r\nmedexaflam amp',4262,NULL,37.0,78528,1999,1999,'2022-08-23 07:53:10','2022-08-23 07:53:10'),(1418,'gaptin',4338,NULL,37.0,78530,1999,1999,'2022-08-23 08:00:19','2022-08-23 08:00:19'),(1419,'Repeat echo in full details, MPI',4253,'impagliflozin, adjust warfarin, other low-dose diuretics if needed',37.0,78522,2107,2107,'2022-08-23 08:01:12','2022-08-23 08:01:12'),(1420,'calpreg d\r\nsoral',4257,NULL,37.0,78530,1999,1999,'2022-08-23 08:05:07','2022-08-23 08:05:07'),(1421,'nothing\r\nreassurance',4337,NULL,37.0,78530,1999,1999,'2022-08-23 08:07:09','2022-08-23 08:07:09'),(1422,'gaptin\r\nmedexaflam amo',4348,NULL,37.0,78530,1999,1999,'2022-08-23 08:14:53','2022-08-23 08:14:53'),(1423,'votaren gel\r\ncalpreg d cap',3991,NULL,37.0,78532,1999,1999,'2022-08-23 08:22:30','2022-08-23 08:22:30'),(1424,'soral cap\r\narticusafe',4342,NULL,37.0,78533,1999,1999,'2022-08-23 08:30:26','2022-08-23 08:30:26'),(1425,NULL,4263,NULL,37.0,78548,1862,1862,'2022-08-23 08:37:01','2022-08-23 08:37:01'),(1426,NULL,4264,NULL,37.0,78548,1862,1862,'2022-08-23 08:37:21','2022-08-23 08:37:21'),(1427,NULL,3216,NULL,37.0,78535,1999,1999,'2022-08-23 08:44:09','2022-08-23 08:44:09'),(1428,NULL,3934,NULL,37.0,78547,1862,1862,'2022-08-23 08:48:07','2022-08-23 08:48:07'),(1429,NULL,4379,NULL,37.0,78547,1862,1862,'2022-08-23 08:48:38','2022-08-23 08:48:38'),(1430,NULL,4249,NULL,37.0,78547,1862,1862,'2022-08-23 08:49:07','2022-08-23 08:49:07'),(1431,'PULSE STEROID',4308,NULL,37.0,78546,1732,1732,'2022-08-23 08:55:04','2022-08-23 08:55:04'),(1432,'INSULIN INFUSION',4309,NULL,37.0,78546,1732,1732,'2022-08-23 08:58:36','2022-08-23 08:58:36'),(1433,'x rays',4383,NULL,37.0,78536,1999,1999,'2022-08-23 09:07:02','2022-08-23 09:07:02'),(1434,NULL,4355,NULL,37.0,78550,1862,1862,'2022-08-23 09:07:07','2022-08-23 09:07:07'),(1435,NULL,4353,NULL,37.0,78550,1862,1862,'2022-08-23 09:08:52','2022-08-23 09:08:52'),(1436,'more investgations',4370,NULL,37.0,78536,1999,1999,'2022-08-23 09:10:55','2022-08-23 09:10:55'),(1437,NULL,4357,NULL,37.0,78550,1862,1862,'2022-08-23 09:11:43','2022-08-23 09:11:43'),(1438,NULL,4360,NULL,37.0,78550,1862,1862,'2022-08-23 09:12:07','2022-08-23 09:12:07'),(1439,NULL,4362,NULL,37.0,78550,1862,1862,'2022-08-23 09:12:23','2022-08-23 09:12:23'),(1440,NULL,4229,NULL,37.0,78550,1862,1862,'2022-08-23 09:12:41','2022-08-23 09:12:41'),(1441,'floax cao\r\ncalpreg dcap',4382,NULL,37.0,78535,1999,1999,'2022-08-23 09:12:58','2022-08-23 09:12:58'),(1442,NULL,4363,NULL,37.0,78550,1862,1862,'2022-08-23 09:12:59','2022-08-23 09:12:59'),(1443,NULL,4368,NULL,37.0,78535,1999,1999,'2022-08-23 09:14:14','2022-08-23 09:14:14'),(1444,'PFTs. ABGs.',4371,'LABA- ICS inhaler and postural drainage',37.0,78526,2046,2046,'2022-08-23 09:20:59','2022-08-23 09:20:59'),(1445,'x rays mri\r\ncalpreg d cap',4373,NULL,37.0,78535,1999,1999,'2022-08-23 09:21:16','2022-08-23 09:21:16'),(1446,'medexafam amp\r\nvoltaren fel',4282,NULL,37.0,78535,1999,1999,'2022-08-23 09:26:26','2022-08-23 09:26:26'),(1447,NULL,4148,NULL,37.0,78558,1862,1862,'2022-08-23 09:31:48','2022-08-23 09:31:48'),(1448,NULL,4147,NULL,37.0,78558,1862,1862,'2022-08-23 09:32:23','2022-08-23 09:32:23'),(1449,'Follow up fever',4161,'Systemic steroid',38.0,78527,2046,2046,'2022-08-23 09:44:26','2022-08-23 09:44:26'),(1450,'Follow up fever',4161,'Systemic steroid',38.0,78527,2046,2046,'2022-08-23 09:46:11','2022-08-23 09:46:11'),(1451,NULL,4391,NULL,37.0,78562,2108,2108,'2022-08-23 09:55:13','2022-08-23 09:55:13'),(1452,NULL,4256,NULL,37.0,78537,2108,2108,'2022-08-23 10:01:06','2022-08-23 10:01:06'),(1453,'PFTs. CXR',4340,'Miflonide inhaler',37.0,78529,2046,2046,'2022-08-23 10:05:51','2022-08-23 10:05:51'),(1454,'washed RBCs after hematologist consultation',4393,NULL,37.0,78561,2108,2108,'2022-08-23 10:08:12','2022-08-23 10:08:12'),(1455,'single dose of quinolones',4394,NULL,37.0,78561,2108,2108,'2022-08-23 10:09:07','2022-08-23 10:09:07'),(1456,'ادخال عقا رال AZATHIOPRINE لوجود تليف بالرئة',3929,NULL,37.0,78560,2119,2119,'2022-08-23 10:10:47','2022-08-23 10:10:47'),(1457,'no need',611,'panadol',37.0,78556,339,339,'2022-08-23 10:14:50','2022-08-23 10:14:50'),(1458,NULL,702,NULL,37.0,78538,2108,2108,'2022-08-23 10:20:00','2022-08-23 10:20:00'),(1459,NULL,4071,NULL,37.0,78538,2108,2108,'2022-08-23 10:20:28','2022-08-23 10:20:28'),(1460,'Follow up',4274,'Transition to Non invasive ventilation. Continue on same regimen with adjustment of tavanic dose',37.0,78531,2046,2046,'2022-08-23 10:23:47','2022-08-23 10:23:47'),(1461,'Neurological and nephrology consultaion. CXR. Sputum culture bacterial and fungal. Repeat PCR for COVID diagnosis. Follow up fever and TLC',4283,'Add levofloxacin to the antibiotic regimen',37.0,78531,2046,2046,'2022-08-23 10:36:52','2022-08-23 10:36:52'),(1462,NULL,4367,'texacort cr مرتين يوميا اسبوعcr zinc oxide قبل الخروج للشمس',37.0,78567,1610,1610,'2022-08-23 10:39:44','2022-08-23 10:39:44'),(1463,NULL,4369,'kerella lotion , fluconazole once',37.0,78567,1610,1610,'2022-08-23 10:42:06','2022-08-23 10:42:06'),(1464,NULL,4372,'lamifen twice daily',37.0,78567,1610,1610,'2022-08-23 10:43:37','2022-08-23 10:43:37'),(1465,NULL,4396,'moist 1 cr carbamide cr مرتين يوميا analaege قرص مساء betaval مرتين يوميا',37.0,78566,1610,1610,'2022-08-23 10:52:18','2022-08-23 10:52:18'),(1466,NULL,4390,'electric cautry',37.0,78566,1610,1610,'2022-08-23 10:53:59','2022-08-23 10:53:59'),(1467,'followup CT',3469,NULL,37.0,78534,1474,1474,'2022-08-23 10:56:42','2022-08-23 10:56:42'),(1468,'investigations required ophthalmology,renal and heart',4344,'topical retinoids removal of lesions by laser and follow up',37.0,78568,1610,1610,'2022-08-23 11:01:28','2022-08-23 11:01:28'),(1469,NULL,4343,'topical and systemic antibiotic for 1 week',37.0,78568,1610,1610,'2022-08-23 11:04:29','2022-08-23 11:04:29'),(1470,'glycerin soap',4347,'emolient as carbamide and phototherapy  cipra pro ` 15 قرص مساء',37.0,78568,1610,1610,'2022-08-23 11:08:39','2022-08-23 11:08:39'),(1471,NULL,4297,NULL,37.0,78572,2129,2129,'2022-08-23 11:18:01','2022-08-23 11:18:01'),(1472,NULL,4266,'fucidin cr مرتين يوميا cephalexin tab مرتين يوميا اسبوعzinc oxide cr',37.0,78571,1610,1610,'2022-08-23 11:22:02','2022-08-23 11:22:02'),(1473,NULL,4416,NULL,37.0,78574,2129,2129,'2022-08-23 11:37:59','2022-08-23 11:37:59'),(1474,'supportie ttt',2371,NULL,37.0,78578,1213,1213,'2022-08-24 08:07:09','2022-08-24 08:07:09'),(1475,'continue ttt',4304,NULL,37.0,78578,1213,1213,'2022-08-24 08:16:19','2022-08-24 08:16:19'),(1476,'pleural fluid aspiration for chemical - bacteriological and cytological evaluation',3353,NULL,37.0,78579,2136,2136,'2022-08-24 08:31:13','2022-08-24 08:31:13'),(1477,NULL,3966,'dASET REGULAR',37.0,78579,2136,2136,'2022-08-24 08:32:47','2022-08-24 08:32:47'),(1478,NULL,4345,'/ Hb/ bilateral renal US/TSH',37.0,78584,1938,1938,'2022-08-24 08:47:10','2022-08-24 08:47:10'),(1479,NULL,4349,'TSH/ CBC/ Abd US/ Ca/ Ph',37.0,78584,1938,1938,'2022-08-24 08:47:50','2022-08-24 08:47:50'),(1480,'do MRI brain and followup i neuro outpatient lini',4449,NULL,37.0,78610,2143,2143,'2022-08-24 08:49:07','2022-08-24 08:49:07'),(1481,'FOLLOW UP PSYCHAITRY CLINIC',4463,NULL,37.0,78610,2143,2143,'2022-08-24 08:54:28','2022-08-24 08:54:28'),(1482,'chest x ray ,CBC diff and CRP',4438,NULL,37.0,78620,2151,2151,'2022-08-24 08:55:18','2022-08-24 08:55:18'),(1483,'CBC diff and CRP',4437,NULL,37.0,78620,2151,2151,'2022-08-24 08:56:12','2022-08-24 08:56:12'),(1484,'FOR UUPER GI ENDO',4465,NULL,37.0,78624,2143,2143,'2022-08-24 09:00:24','2022-08-24 09:00:24'),(1485,NULL,4103,'Urine analysis',37.0,78585,1938,1938,'2022-08-24 09:02:22','2022-08-24 09:02:22'),(1486,'FOLLOWUP CVP AND FLUID BALANCE',4467,NULL,37.0,78624,2143,2143,'2022-08-24 09:04:50','2022-08-24 09:04:50'),(1487,'FULL LAB AND FOLLOWUP CT BRAIN AND CHEST FLUID SAMPLE, Q/ MALIGNANCY',4468,NULL,37.0,78624,2143,2143,'2022-08-24 09:11:09','2022-08-24 09:11:09'),(1488,NULL,3991,NULL,37.0,78604,1154,1154,'2022-08-24 09:16:16','2022-08-24 09:16:16'),(1489,NULL,4142,'Hydration/ urine analysis',37.0,78585,1938,1938,'2022-08-24 09:18:19','2022-08-24 09:18:19'),(1490,NULL,4429,'Hemodialysis/ urine analysis',37.0,78585,1938,1938,'2022-08-24 09:19:24','2022-08-24 09:19:24'),(1491,'FOLLOWUP HEMATOLOGY',4415,NULL,37.0,78616,2143,2143,'2022-08-24 09:20:57','2022-08-24 09:20:57'),(1492,'CVP GUIDED FLUIDS AND FOLLOWUP BY PAUS',4413,NULL,37.0,78616,2143,2143,'2022-08-24 09:23:18','2022-08-24 09:23:18'),(1493,'oct and FFA',4464,NULL,37.0,78625,2152,2152,'2022-08-24 09:24:49','2022-08-24 09:24:49'),(1494,'Surgery',4466,'Surgery',37.0,78625,2152,2152,'2022-08-24 09:25:51','2022-08-24 09:25:51'),(1495,'ANTIBIOTICS CHANGED AND PEDIATRIC CONSULTATION',4414,NULL,37.0,78616,2143,2143,'2022-08-24 09:26:42','2022-08-24 09:26:42'),(1496,'surgery',4469,NULL,37.0,78625,2152,2152,'2022-08-24 09:28:46','2022-08-24 09:28:46'),(1497,'follow up of pregnancy and termination at 37 weeks',3770,NULL,37.0,78633,2153,2153,'2022-08-24 09:28:56','2022-08-24 09:28:56'),(1498,'cross linking',4474,NULL,37.0,78625,2152,2152,'2022-08-24 09:29:32','2022-08-24 09:29:32'),(1499,NULL,4457,'Inderal 40 mg tab قرص كل 12 ساعه.........topamax 25 mg tab  قرص بعد الغداء.......Neuroton amp  عضل كل ثانى يوم...........buspar 10 mg tab   نصف قرص كل 12 ساعه',37.0,78604,1154,1154,'2022-08-24 09:29:56','2022-08-24 09:29:56'),(1500,'surgery',4466,NULL,37.0,78625,2152,2152,'2022-08-24 09:30:03','2022-08-24 09:30:03'),(1501,NULL,4524,'URINE ANALYSIS/ FUNDUS EXAM',37.0,78586,1938,1938,'2022-08-24 09:35:10','2022-08-24 09:35:10'),(1502,'Dimra tab \r\n قرص بعد الغداء\r\nProthiadin 25 tab\r\n قرص بعد العشاء\r\nstugeron  tab 25 mg\r\n قرص كل 12 ساعه\r\n inderal 40 mg tab \r\nنصف قرص كل 12 ساعه',3991,'Dimra tab once after lunch>>>>>>>>>>>>> stugeron tab 25mg  twice daily>>>>',37.0,78604,1154,1154,'2022-08-24 09:35:24','2022-08-24 09:35:24'),(1503,'LAB AND FOLLOWUP RADIO',4440,NULL,37.0,78613,2143,2143,'2022-08-24 09:38:29','2022-08-24 09:38:29'),(1504,'FOLLOWUP CBC AND ENDOSCOPE',4441,NULL,37.0,78613,2143,2143,'2022-08-24 09:40:42','2022-08-24 09:40:42'),(1505,'RBCS TRANSFUSION',4442,NULL,37.0,78613,2143,2143,'2022-08-24 09:42:30','2022-08-24 09:42:30'),(1506,'FOLLOW up general condition and cardiological resolve pf bradycardia',4504,NULL,37.0,78593,2138,2138,'2022-08-24 09:42:38','2022-08-24 09:42:38'),(1507,'orhopedic consultation',4286,NULL,37.0,78614,2145,2145,'2022-08-24 09:46:07','2022-08-24 09:46:07'),(1508,'DOBUTAMINE ECHO \r\nFOLLOW UP RF,BP,CVP',4389,'ACEI,DIURETIC',37.0,78581,2013,2013,'2022-08-24 09:47:15','2022-08-24 09:47:15'),(1509,'Cerebromap 200 caps \r\n ك كل 12 ساعه\r\ncerebrolysin 5 mg amp\r\n  عضل كل تانى يوم\r\nAlphentern tab \r\n قرص كل 8 ساعات قبل الاكل\r\n milga tab advance \r\nقرص كل 12 ساعه',4493,NULL,37.0,78652,1199,1199,'2022-08-24 09:49:04','2022-08-24 09:49:04'),(1510,'MRCP, ALP,GGT',4506,'sleeve operation',37.0,78593,2138,2138,'2022-08-24 09:49:25','2022-08-24 09:49:25'),(1511,'MRCP, ALP,GGT',4506,'sleeve operation',37.0,78593,2138,2138,'2022-08-24 09:49:25','2022-08-24 09:49:25'),(1512,'the doctor should do parial calcelnectomy and aggressive debridement',4288,NULL,37.0,78614,2145,2145,'2022-08-24 09:50:36','2022-08-24 09:50:36'),(1513,'Barium enema and surgical consultation and assess need for rectal biopsy \r\nkeep on same antibiotics if no improvement add polymyxin meronem high dose\r\nafter dischage refer to cystic fibrosis clinic',4298,NULL,37.0,78622,2151,2151,'2022-08-24 09:51:51','2022-08-24 09:51:51'),(1514,NULL,4417,'imbrove general condition',37.0,78653,1857,1857,'2022-08-24 09:53:30','2022-08-24 09:53:30'),(1515,NULL,4397,'CONCOR AMLO',37.0,78581,2013,2013,'2022-08-24 09:53:54','2022-08-24 09:53:54'),(1516,'chest consultaion for decreased saturation',4294,NULL,37.0,78614,2145,2145,'2022-08-24 09:54:26','2022-08-24 09:54:26'),(1517,'FOLLOW UP RF BL PR',4397,'CONCORAMLO CANDELKAN 16PLUS',37.0,78581,2013,2013,'2022-08-24 09:54:54','2022-08-24 09:54:54'),(1518,'CT brain',4518,NULL,37.0,78593,2138,2138,'2022-08-24 09:54:55','2022-08-24 09:54:55'),(1519,'CT brain',4518,NULL,37.0,78593,2138,2138,'2022-08-24 09:54:55','2022-08-24 09:54:55'),(1520,'CT brain',4518,NULL,37.0,78593,2138,2138,'2022-08-24 09:54:55','2022-08-24 09:54:55'),(1521,'CT brain',4518,NULL,37.0,78593,2138,2138,'2022-08-24 09:54:55','2022-08-24 09:54:55'),(1522,'CT brain',4518,NULL,37.0,78593,2138,2138,'2022-08-24 09:54:55','2022-08-24 09:54:55'),(1523,'CT brain',4518,NULL,37.0,78593,2138,2138,'2022-08-24 09:54:55','2022-08-24 09:54:55'),(1524,'CT brain',4518,NULL,37.0,78593,2138,2138,'2022-08-24 09:54:55','2022-08-24 09:54:55'),(1525,'CT brain',4518,NULL,37.0,78593,2138,2138,'2022-08-24 09:54:55','2022-08-24 09:54:55'),(1526,'CT brain',4518,NULL,37.0,78593,2138,2138,'2022-08-24 09:54:55','2022-08-24 09:54:55'),(1527,'Dimra tab\r\n قرص بعد الغداء\r\n Prothiadin 25 tab \r\n rvw fu] hguahx\r\n  stugeron tab 25 mg \r\n قرص كل 12 ساعه\r\n inderal 40 mg tab \r\nنصف قرص كل 12 ساعه',4500,NULL,37.0,78652,1199,1199,'2022-08-24 09:54:55','2022-08-24 09:54:55'),(1528,'lead acetae , penicellin g iv according wight and age and sensetivity elevation of limbs , stop corticosteriods',4419,'lead acetae , penicellin g iv according wight and age and sensetivity',37.0,78653,1857,1857,'2022-08-24 09:56:57','2022-08-24 09:56:57'),(1529,'lead acetae , penicellin g iv according wight and age and sensetivity elevation of limbs , stop corticosteriods',4494,'lead acetae , penicellin g iv according wight and age and sensetivity elevation of limbs , stop corticosteriods',37.0,78653,1857,1857,'2022-08-24 09:57:31','2022-08-24 09:57:31'),(1530,'new chest xray to assess cause of RD either due to infection or heart failure associated with clinical examination\r\nNew sepsis screen >> and assess need of increasing dose of \r\n antifailure measures if no improvement assess need for pulmonary artery banding with cardiothoracic surgery',4526,NULL,37.0,78622,2151,2151,'2022-08-24 09:59:28','2022-08-24 09:59:28'),(1531,'tryptizole 10 tab\r\n قرص بعد العشاء\r\nflexilax tab \r\nقرص بعد الغداء\r\nstugeron tab 25 mg\r\nقرص كل 12 ساعه\r\nDoliprane 1000 mg tab \r\nقرص كل 12 ساعه\r\nيكرر لمد 15 يوم',4511,NULL,37.0,78652,1199,1199,'2022-08-24 10:01:37','2022-08-24 10:01:37'),(1532,'SAME TTT',3525,'LANOXIN CORDARONE',37.0,78582,2013,2013,'2022-08-24 10:01:37','2022-08-24 10:01:37'),(1533,NULL,4508,NULL,37.0,78593,2138,2138,'2022-08-24 10:04:24','2022-08-24 10:04:24'),(1534,NULL,4509,NULL,37.0,78593,2138,2138,'2022-08-24 10:04:53','2022-08-24 10:04:53'),(1535,NULL,4512,NULL,37.0,78593,2138,2138,'2022-08-24 10:05:09','2022-08-24 10:05:09'),(1536,NULL,4513,NULL,37.0,78593,2138,2138,'2022-08-24 10:05:22','2022-08-24 10:05:22'),(1537,NULL,4517,'PROPER ANTIBIOTIC/ HYDRATION',37.0,78586,1938,1938,'2022-08-24 10:05:30','2022-08-24 10:05:30'),(1538,NULL,4515,NULL,37.0,78593,2138,2138,'2022-08-24 10:05:34','2022-08-24 10:05:34'),(1539,NULL,4516,NULL,37.0,78593,2138,2138,'2022-08-24 10:05:45','2022-08-24 10:05:45'),(1540,NULL,4519,'PROPER ANTIBIOTIC/ REMOVAL OF DOUBLE',37.0,78586,1938,1938,'2022-08-24 10:06:06','2022-08-24 10:06:06'),(1541,'ECHO and ECG and cardiology and Chest consultation and CT pulmonary Angiography',4428,NULL,37.0,78647,1041,1041,'2022-08-24 10:12:42','2022-08-24 10:12:42'),(1542,'follow up',3792,NULL,37.0,78644,1615,1615,'2022-08-24 10:20:10','2022-08-24 10:20:10'),(1543,NULL,4443,'Doliprane 1000 mg tab',37.0,78607,1199,1199,'2022-08-24 10:20:42','2022-08-24 10:20:42'),(1544,'skin biopsy and CT Abdomen and pelvis with contrast',4322,NULL,37.0,78654,1041,1041,'2022-08-24 10:20:58','2022-08-24 10:20:58'),(1545,'follow up',3796,NULL,37.0,78644,1615,1615,'2022-08-24 10:21:03','2022-08-24 10:21:03'),(1546,'follow up',3800,NULL,37.0,78644,1615,1615,'2022-08-24 10:22:05','2022-08-24 10:22:05'),(1547,'phototherapy NBUVB',4528,NULL,37.0,78638,803,803,'2022-08-24 10:23:16','2022-08-24 10:23:16'),(1548,'swap culture and sesitivity\r\nceftriaxon 1gm after check for sensitivity for 5days\r\nkpermegnate 1/800 solution every 6 hrs\r\nmupirax oint every 8 hrs\r\nfollow up after lab results',4529,'cefo',37.0,78638,803,803,'2022-08-24 10:29:00','2022-08-24 10:29:00'),(1549,'please for covid IGM&IGG  monospot test stool analysis',4381,NULL,37.0,78590,2140,2140,'2022-08-24 10:31:06','2022-08-24 10:31:06'),(1550,'systemic antibiotic according to patient weight\r\nfusi cream \r\nbetadine shampoo',4530,NULL,37.0,78638,803,803,'2022-08-24 10:33:05','2022-08-24 10:33:05'),(1551,'follow up',4439,NULL,37.0,78651,1615,1615,'2022-08-24 10:33:19','2022-08-24 10:33:19'),(1552,'xithron 500mg tab one tab per day for 5 days\r\nfusi cream\r\npom shower gel',4533,NULL,37.0,78638,803,803,'2022-08-24 10:35:12','2022-08-24 10:35:12'),(1553,'oral retinoid after investigations and using 2 contraceptive methods',4407,'oral isotretinoin',37.0,78670,1701,1701,'2022-08-24 10:36:18','2022-08-24 10:36:18'),(1554,'levohistam tab tab at night\r\nfucicort cream twice daily for one week\r\nvasline petroleum jelly',4536,NULL,37.0,78638,803,803,'2022-08-24 10:37:06','2022-08-24 10:37:06'),(1555,'sweet rash\r\nfor hexacore lotion three times dailly',4539,NULL,37.0,78638,803,803,'2022-08-24 10:38:57','2022-08-24 10:38:57'),(1556,'emollient',4404,'as mentioned below',37.0,78670,1701,1701,'2022-08-24 10:40:12','2022-08-24 10:40:12'),(1557,'nizapex shampoo day after day \r\nlamifen cream twice daily on lesions',4541,NULL,37.0,78638,803,803,'2022-08-24 10:40:43','2022-08-24 10:40:43'),(1558,'topical retinoid',4406,'as mentioned below',37.0,78670,1701,1701,'2022-08-24 10:42:47','2022-08-24 10:42:47'),(1559,'follow up MRI\r\nfollow up CSF another Lab.',4412,NULL,37.0,78606,1199,1199,'2022-08-24 10:47:45','2022-08-24 10:47:45'),(1560,'add aspirin\r\nCBC, protein in 24hr urine',3796,'hydroquine, marevan, epilat',37.0,78644,1615,1615,'2022-08-24 10:47:47','2022-08-24 10:47:47'),(1561,'follow up',1827,'emolient + topical steroid+follow up',37.0,78670,1701,1701,'2022-08-24 10:48:19','2022-08-24 10:48:19'),(1562,'RBS\r\nABG\r\ntranscranial us\r\nscreen for sepsis',4560,NULL,37.0,78678,1682,1682,'2022-08-24 10:49:31','2022-08-24 10:49:31'),(1563,'stop steroid as the patient is in remission\r\nfollow up investigations',3792,'immuran, steroid, pentaza',37.0,78644,1615,1615,'2022-08-24 10:50:23','2022-08-24 10:50:23'),(1564,'CBC, ESR, CRP, RF , anticcp\r\nTSH\r\npelviabdominal ultrasound\r\nXray hand\r\nmusculoskeletal ultrasound',3799,NULL,37.0,78644,1615,1615,'2022-08-24 10:52:51','2022-08-24 10:52:51'),(1565,'coomb\r\nreticks\r\nabdominal us\r\nbrain image',4558,NULL,37.0,78678,1682,1682,'2022-08-24 10:53:03','2022-08-24 10:53:03'),(1566,'investigations: bile salts + bilirubin',4507,'oral anti-histamines(fexofinadine eg: telfast ) + narrow band if available',37.0,78672,1701,1701,'2022-08-24 10:54:14','2022-08-24 10:54:14'),(1567,'the patient isnot controlled on the treatment. so, she needs to be shifted to biologics',3800,'methotrexate, hydroquine, arthfree',37.0,78644,1615,1615,'2022-08-24 10:54:20','2022-08-24 10:54:20'),(1568,NULL,4439,'methotrexate, hydroquine, steroid',37.0,78651,1615,1615,'2022-08-24 10:56:34','2022-08-24 10:56:34'),(1569,NULL,4553,NULL,37.0,78592,2140,2140,'2022-08-24 10:57:30','2022-08-24 10:57:30'),(1570,'improved\r\ncontinue the same TTT',4014,NULL,37.0,78678,1682,1682,'2022-08-24 10:57:40','2022-08-24 10:57:40'),(1571,NULL,4555,NULL,37.0,78592,2140,2140,'2022-08-24 10:57:53','2022-08-24 10:57:53'),(1572,NULL,4535,NULL,37.0,78608,990,990,'2022-08-24 10:59:08','2022-08-24 10:59:08'),(1573,'reduce the methotrexate dose to 12.5 mg\r\nadd calcium and vitamin D\r\nRF\r\nHBsag\r\nHCVab',4439,'methotrexate, hydroquine,',36.8,78651,1615,1615,'2022-08-24 11:00:48','2022-08-24 11:00:48'),(1574,NULL,4548,NULL,37.0,78608,990,990,'2022-08-24 11:02:55','2022-08-24 11:02:55'),(1575,'ANA\r\nRF\r\nAnti-ccp\r\nECHO\r\npelviabdominalultrasound\r\nurine analysis',3966,'hydroquine, avara',37.0,78649,1615,1615,'2022-08-24 11:03:22','2022-08-24 11:03:22'),(1576,'blood film\r\nstool analysis and culture\r\nblood culture\r\nabdominal us\r\nPT\r\nPTT',4562,NULL,37.0,78678,1682,1682,'2022-08-24 11:04:13','2022-08-24 11:04:13'),(1577,'investigations FBS+2-h post-prandial',4497,'systemic fluconazol +topical antifungal',37.0,78676,1701,1701,'2022-08-24 11:09:19','2022-08-24 11:09:19'),(1578,'ILS sessions in hypertrophic areas',4531,'as mentioned below',37.0,78676,1701,1701,'2022-08-24 11:12:55','2022-08-24 11:12:55'),(1579,'Echo\r\nblood culture and vancomycin\r\nPT',4332,NULL,37.0,78673,1682,1682,'2022-08-24 11:14:58','2022-08-24 11:14:58'),(1580,NULL,4453,NULL,37.0,78594,2140,2140,'2022-08-24 11:16:47','2022-08-24 11:16:47'),(1581,NULL,4456,NULL,37.0,78594,2140,2140,'2022-08-24 11:17:10','2022-08-24 11:17:10'),(1582,NULL,4458,NULL,37.0,78594,2140,2140,'2022-08-24 11:17:39','2022-08-24 11:17:39'),(1583,NULL,4460,NULL,37.0,78594,2140,2140,'2022-08-24 11:18:02','2022-08-24 11:18:02'),(1584,NULL,4462,NULL,37.0,78594,2140,2140,'2022-08-24 11:18:28','2022-08-24 11:18:28'),(1585,NULL,4537,NULL,37.0,78594,2140,2140,'2022-08-24 11:19:07','2022-08-24 11:19:07'),(1586,'ventilation\r\nshould receive surfactant\r\ndo PT\r\nionized calcium',4333,NULL,37.0,78673,1682,1682,'2022-08-24 11:20:36','2022-08-24 11:20:36'),(1587,'ventilate\r\ndo PT\r\nionized ca\r\nmonitor BP\r\nmonitor RBS',4334,NULL,37.0,78673,1682,1682,'2022-08-24 11:22:16','2022-08-24 11:22:16'),(1588,NULL,3203,NULL,37.0,78609,990,990,'2022-08-24 11:25:37','2022-08-24 11:25:37'),(1589,'ENDOCRINE AND NEUROMETABOLIC  STOOL ANALYSIS AND IRON AND CELIAC PROFILE',4117,'NUTRITIONAL MANAGEMENT',37.0,78688,2171,2171,'2022-08-24 11:27:44','2022-08-24 11:27:44'),(1590,NULL,4300,NULL,37.0,78609,990,990,'2022-08-24 11:31:47','2022-08-24 11:31:47'),(1591,NULL,4499,NULL,37.0,78597,2140,2140,'2022-08-24 11:36:39','2022-08-24 11:36:39'),(1592,NULL,4501,NULL,37.0,78597,2140,2140,'2022-08-24 11:37:09','2022-08-24 11:37:09'),(1593,NULL,4502,NULL,37.0,78597,2140,2140,'2022-08-24 11:37:43','2022-08-24 11:37:43'),(1594,'progress feeding\r\ndo cbc and serum electrolytes',4336,NULL,37.0,78689,1682,1682,'2022-08-24 11:38:06','2022-08-24 11:38:06'),(1595,NULL,4380,NULL,37.0,78609,990,990,'2022-08-24 11:38:29','2022-08-24 11:38:29'),(1596,'suprapubic catheter as urgent solution for monitoring shocked patient yhen vaginoplasty later after improving general condition',4399,'multirelax 5mg per 24hr',37.0,78659,2159,2159,'2022-08-24 11:40:00','2022-08-24 11:40:00'),(1597,'blood film\r\nblood culture\r\nchange amikin to maxipeme',4335,NULL,37.0,78689,1682,1682,'2022-08-24 11:44:14','2022-08-24 11:44:14'),(1598,'1- Whole neuroaxis MRI (MRI DS/CS/Brai) to exclude other anomalies.\r\n2- Surgery for lipomyelocele and untethering of the cord (at protracted time frame not later than 3months)\r\n3- Monitor neurlogy in the maintime and reconsult urgently if any deterioration.',4566,NULL,37.0,78686,2170,2170,'2022-08-24 12:25:33','2022-08-24 12:25:33'),(1599,'Pelvic floor \\EMG - Sphincters\r\nUrodynamic studies',4566,NULL,37.0,78695,2173,2173,'2022-08-24 13:46:11','2022-08-24 13:46:11'),(1600,NULL,4566,NULL,37.0,78695,2173,2173,'2022-08-24 13:46:24','2022-08-24 13:46:24'),(1601,'جاري تنسيق تحويل المريض لمستشفيات جامعة عين شمس',4430,NULL,37.0,78696,2173,2173,'2022-08-24 14:26:46','2022-08-24 14:26:46'),(1602,NULL,4591,NULL,37.0,78697,2179,2179,'2022-08-25 07:39:29','2022-08-25 07:39:29'),(1603,'biopsy and grommets tube',4599,NULL,37.0,78702,2180,2180,'2022-08-25 07:45:53','2022-08-25 07:45:53'),(1604,NULL,1384,'inderal 40 mg',37.0,78713,923,923,'2022-08-25 07:53:03','2022-08-25 07:53:03'),(1605,'Migracid tab 2 ق عند بداية الصداع',1384,'inderal 40 mg نص ق مرتين',37.0,78713,923,923,'2022-08-25 07:54:55','2022-08-25 07:54:55'),(1606,NULL,4598,NULL,37.0,78704,2179,2179,'2022-08-25 08:06:27','2022-08-25 08:06:27'),(1607,'stop offending drug ....conservative treatment',4615,NULL,37.0,78725,1926,1926,'2022-08-25 08:06:56','2022-08-25 08:06:56'),(1608,NULL,4601,NULL,37.0,78714,923,923,'2022-08-25 08:10:20','2022-08-25 08:10:20'),(1609,'antibiotics, drainage of emphysematous pyelonephritis',4618,NULL,37.0,78725,1926,1926,'2022-08-25 08:13:35','2022-08-25 08:13:35'),(1610,'medial treatment and ct',4624,NULL,37.0,78738,2180,2180,'2022-08-25 08:14:09','2022-08-25 08:14:09'),(1611,NULL,4405,NULL,37.0,78704,2179,2179,'2022-08-25 08:17:02','2022-08-25 08:17:02'),(1612,'local nasal spray',4071,NULL,37.0,78738,2180,2180,'2022-08-25 08:17:22','2022-08-25 08:17:22'),(1613,'تحويل لتخصص اخر جراحة مخ واعصاب',4594,NULL,37.0,78715,923,923,'2022-08-25 08:17:51','2022-08-25 08:17:51'),(1614,NULL,4258,NULL,37.0,78699,2181,2181,'2022-08-25 08:29:44','2022-08-25 08:29:44'),(1615,NULL,4561,NULL,37.0,78706,2179,2179,'2022-08-25 08:30:38','2022-08-25 08:30:38'),(1616,NULL,3998,NULL,37.0,78736,2179,2179,'2022-08-25 08:35:48','2022-08-25 08:35:48'),(1617,'single level ACDF',4594,NULL,37.0,78701,2181,2181,'2022-08-25 08:37:55','2022-08-25 08:37:55'),(1618,'intradialytic infusion of dextrose solution',4557,NULL,37.0,78729,1926,1926,'2022-08-25 08:39:10','2022-08-25 08:39:10'),(1619,NULL,4001,NULL,37.0,78736,2179,2179,'2022-08-25 08:39:13','2022-08-25 08:39:13'),(1620,'intradialytic infusion of dextrose solution',4559,NULL,37.0,78729,1926,1926,'2022-08-25 08:39:55','2022-08-25 08:39:55'),(1621,NULL,4634,NULL,37.0,78736,2179,2179,'2022-08-25 08:42:48','2022-08-25 08:42:48'),(1622,NULL,4405,NULL,37.0,78737,2187,2187,'2022-08-25 08:42:53','2022-08-25 08:42:53'),(1623,'basal bolus regemin',4238,NULL,37.0,78739,954,954,'2022-08-25 08:48:46','2022-08-25 08:48:46'),(1624,'Spirometry',2710,'Steroids',37.0,78741,2192,2192,'2022-08-25 08:51:20','2022-08-25 08:51:20'),(1625,'ct abdomen- fasting insulin',4633,NULL,37.0,78739,954,954,'2022-08-25 08:53:16','2022-08-25 08:53:16'),(1626,'Cervical lymph node biopsy',4581,'Wait for investigatons',37.0,78741,2192,2192,'2022-08-25 08:56:16','2022-08-25 08:56:16'),(1627,'TREAYMENT',4636,NULL,37.0,78739,954,954,'2022-08-25 08:56:31','2022-08-25 08:56:31'),(1628,'ENEMA-HEPAMEREZ',4252,NULL,37.0,78739,954,954,'2022-08-25 09:00:36','2022-08-25 09:00:36'),(1629,'Pleural fluid cytology then bronchoscope',4583,'Wait for diagnosis',37.0,78741,2192,2192,'2022-08-25 09:01:53','2022-08-25 09:01:53'),(1630,'17 oh progesterone\r\nLH\r\nFSH\r\nE2',4035,NULL,37.0,78747,794,794,'2022-08-25 09:03:14','2022-08-25 09:03:14'),(1631,NULL,3933,'dostinex نصف قرص كل اسبوع ومتابعة التحليل',37.0,78747,794,794,'2022-08-25 09:04:21','2022-08-25 09:04:21'),(1632,'tobradex ed & ont for 2 weeks \r\nthen excision if not improved',4420,NULL,37.0,78719,777,777,'2022-08-25 09:12:39','2022-08-25 09:12:39'),(1633,'hematology cosultation\r\nPT, INR\r\nPTT\r\nbleeding time',4651,NULL,37.0,78752,794,794,'2022-08-25 09:12:40','2022-08-25 09:12:40'),(1634,'conservative TTT and investigations',4653,NULL,37.0,78711,1907,1907,'2022-08-25 09:21:46','2022-08-25 09:21:46'),(1635,'renal biopsy',4608,NULL,37.0,78730,1926,1926,'2022-08-25 09:23:03','2022-08-25 09:23:03'),(1636,'abdominopelvic US\r\ns albumin\r\nPT INR\r\nCBC\r\nkidney function\r\nelectrolytes\r\ngastroenterology consultation',4606,NULL,37.0,78749,794,794,'2022-08-25 09:26:51','2022-08-25 09:26:51'),(1637,'For Vitrectomy & Endolaser',4652,NULL,37.0,78720,777,777,'2022-08-25 09:27:59','2022-08-25 09:27:59'),(1638,'ABG\r\nNa, K\r\ncalcium total, ionized\r\nnephrology consultation',4578,NULL,37.0,78749,794,794,'2022-08-25 09:28:49','2022-08-25 09:28:49'),(1639,'CBC\r\ns iron\r\nferritin TIBC\r\nhematology cosultation',4580,NULL,37.0,78749,794,794,'2022-08-25 09:29:37','2022-08-25 09:29:37'),(1640,'adjust position of the permicath and vascular consultation',4675,NULL,37.0,78731,1926,1926,'2022-08-25 09:30:03','2022-08-25 09:30:03'),(1641,'add quinolone to antibiotic regimen and dialysis',4677,NULL,37.0,78731,1926,1926,'2022-08-25 09:34:55','2022-08-25 09:34:55'),(1642,'fixation by gamma nail',4422,NULL,37.0,78707,1907,1907,'2022-08-25 09:35:33','2022-08-25 09:35:33'),(1643,'cortisol am, pm\r\nACTH am\r\nCBC',4514,NULL,37.0,78777,794,794,'2022-08-25 09:37:00','2022-08-25 09:37:00'),(1644,'pediatric hematology consultation',4603,NULL,37.0,78777,794,794,'2022-08-25 09:37:41','2022-08-25 09:37:41'),(1645,'fortum and vancomycin and catheter exchange',4678,NULL,37.0,78731,1926,1926,'2022-08-25 09:39:32','2022-08-25 09:39:32'),(1646,'bone marrow biopsy\r\ncoomb test\r\nLDH\r\nRC',4577,NULL,37.0,78770,1912,1912,'2022-08-25 09:40:50','2022-08-25 09:40:50'),(1647,'cephalosporines and quinolones and maintenance dialysis',4679,NULL,37.0,78731,1926,1926,'2022-08-25 09:43:38','2022-08-25 09:43:38'),(1648,'Abdominal Ultrasound , Corection of hypokalemia, Add Neocate As formula',4648,NULL,37.0,78784,2203,2203,'2022-08-25 09:46:18','2022-08-25 09:46:18'),(1649,'Abdominal Ultrasound , Corection of hypokalemia, Add Neocate As formula',4646,NULL,37.0,78784,2203,2203,'2022-08-25 09:47:29','2022-08-25 09:47:29'),(1650,'MRI Brain - Try to decrease supports & Neurology consultation',4648,NULL,37.0,78784,2203,2203,'2022-08-25 09:49:31','2022-08-25 09:49:31'),(1651,'stop dialysis sessions , adjust electrolytes and follow up',4275,NULL,37.0,78732,1926,1926,'2022-08-25 09:50:18','2022-08-25 09:50:18'),(1652,NULL,4289,NULL,37.0,78732,1926,1926,'2022-08-25 09:54:40','2022-08-25 09:54:40'),(1653,'if no contraindication immediate cholecystectomy is recommended',4673,NULL,37.0,78775,1609,1609,'2022-08-25 09:55:24','2022-08-25 09:55:24'),(1654,'fdssdfsdfsdfds',611,'fdsdfsd',37.0,78751,339,339,'2022-08-25 09:55:33','2022-08-25 09:55:33'),(1655,'If not contraindicated immediate cholecystectomy',4670,NULL,37.0,78775,1609,1609,'2022-08-25 09:57:39','2022-08-25 09:57:39'),(1656,'assessment of the surgery was good',4593,NULL,37.0,78708,1907,1907,'2022-08-25 09:58:27','2022-08-25 09:58:27'),(1657,'ESR\r\nCRP\r\nRF\r\nANA\r\nimmunology consultation',4644,NULL,37.0,78750,794,794,'2022-08-25 09:58:52','2022-08-25 09:58:52'),(1658,'MRI knee followed by surgical TTT',4595,NULL,37.0,78708,1907,1907,'2022-08-25 09:59:25','2022-08-25 09:59:25'),(1659,'If not contraindicated immediate cholecystectomy',4670,NULL,37.0,78775,1609,1609,'2022-08-25 09:59:27','2022-08-25 09:59:27'),(1660,'hematology consultation',4643,NULL,37.0,78750,794,794,'2022-08-25 09:59:27','2022-08-25 09:59:27'),(1661,'stabilize hemodynamic state ...vasopressors.....with-hold dialysis temporarily',4639,NULL,37.0,78732,1926,1926,'2022-08-25 09:59:49','2022-08-25 09:59:49'),(1662,'Continue on Oral anti convulsants & Do MRI + EEG',4065,NULL,37.0,78781,2203,2203,'2022-08-25 10:00:23','2022-08-25 10:00:23'),(1663,'bone marrow aspirate\r\ntherapeuti trial of FA B12',4656,NULL,37.0,78772,1912,1912,'2022-08-25 10:04:51','2022-08-25 10:04:51'),(1664,'medical TTT',4650,NULL,37.0,78710,1907,1907,'2022-08-25 10:10:00','2022-08-25 10:10:00'),(1665,NULL,4694,'surgery',37.0,78800,1276,1276,'2022-08-25 10:10:08','2022-08-25 10:10:08'),(1666,'colhiine 3gm daily',4545,NULL,37.0,78768,1912,1912,'2022-08-25 10:11:57','2022-08-25 10:11:57'),(1667,NULL,4485,'fucicort',37.0,78800,1276,1276,'2022-08-25 10:13:01','2022-08-25 10:13:01'),(1668,'Medical TTT',4685,NULL,37.0,78710,1907,1907,'2022-08-25 10:14:13','2022-08-25 10:14:13'),(1669,'Echo, lab: creat, urea , K, URINE ANALYSIS , ABD U/S, lipid profile  and stress ECG',4495,'SAME TTT UNTIL INVESTIGATION',37.0,78742,1805,1805,'2022-08-25 10:15:12','2022-08-25 10:15:12'),(1670,'COLCHICINE 2GM DAILY\r\nSERUM AMYLOID A',4385,NULL,37.0,78768,1912,1912,'2022-08-25 10:16:32','2022-08-25 10:16:32'),(1671,NULL,3042,'antihistaminics',37.0,78776,1276,1276,'2022-08-25 10:16:34','2022-08-25 10:16:34'),(1672,'ASD Closure & Add Infatrini',4637,NULL,37.0,78782,2203,2203,'2022-08-25 10:17:06','2022-08-25 10:17:06'),(1673,NULL,4162,NULL,37.0,78799,777,777,'2022-08-25 10:22:54','2022-08-25 10:22:54'),(1674,'skin biopsy',4693,'topical steroid',37.0,78776,1276,1276,'2022-08-25 10:23:12','2022-08-25 10:23:12'),(1675,'difflustero ED\r\nacyclovir 400 3times \r\nsystane gel 5 times',4162,NULL,37.0,78799,777,777,'2022-08-25 10:24:19','2022-08-25 10:24:19'),(1676,NULL,4699,'treflucan cap',37.0,78776,1276,1276,'2022-08-25 10:25:43','2022-08-25 10:25:43'),(1677,'emollient + follow up',4687,'as mentioned below',37.0,78788,1633,1633,'2022-08-25 10:33:55','2022-08-25 10:33:55'),(1678,'Gastrostomy & Correction of Dehydration + caloric intake',4613,NULL,37.0,78780,2203,2203,'2022-08-25 10:34:48','2022-08-25 10:34:48'),(1679,'simbrinza\r\nTwinzol\r\ncidamex\r\nmydriatic\r\npredforte \r\nintravitreal injection then prp or cryo\r\ninvestigation : FFA \r\nSystemic work up for uveitis  (general medicine0',4163,NULL,37.0,78799,777,777,'2022-08-25 10:37:52','2022-08-25 10:37:52'),(1680,'syst. anti-viral + symptomatic tttt+ topical CS + Ab',4629,'as mentioned below',37.0,78789,1633,1633,'2022-08-25 10:45:02','2022-08-25 10:45:02'),(1681,'PT PC INR \r\nCBC with Retics \r\nBlood Film \r\nUrine analysis',4411,NULL,37.0,78763,2195,2195,'2022-08-25 10:46:06','2022-08-25 10:46:06'),(1682,'+investigations of other  chronic diseases \r\ntopical CS + \r\noral anti histamine \r\ncontrol of DM',4680,'as mentioned below',37.0,78789,1633,1633,'2022-08-25 10:59:25','2022-08-25 10:59:25'),(1683,'dd: nevus versus localized neurofibromatosis for follow up',4692,'as mentioned below',37.0,78789,1633,1633,'2022-08-25 11:01:05','2022-08-25 11:01:05'),(1684,'cardiology & cardiothoracic consultations about PDA stenting\r\nmonitor for O2 sat.',4700,NULL,37.0,78806,2211,2211,'2022-08-25 11:07:52','2022-08-25 11:07:52'),(1685,'pleural aspirate analysis',3353,NULL,37.0,78761,2195,2195,'2022-08-25 11:07:55','2022-08-25 11:07:55'),(1686,'ask about sensitivity to polymixin',4702,NULL,37.0,78806,2211,2211,'2022-08-25 11:08:59','2022-08-25 11:08:59'),(1687,'for koh scraping',4704,'as mentioned below',37.0,78789,1633,1633,'2022-08-25 11:09:51','2022-08-25 11:09:51'),(1688,'TSH \r\nESR \r\nROUTinelab',3354,NULL,37.0,78761,2195,2195,'2022-08-25 11:10:07','2022-08-25 11:10:07'),(1689,'full sepsis screen , ETA ,urine,CSF culture',4706,NULL,37.0,78806,2211,2211,'2022-08-25 11:10:18','2022-08-25 11:10:18'),(1690,'liver function \r\ncreat \r\nelectrolyte \r\nthyroid function',3964,NULL,37.0,78761,2195,2195,'2022-08-25 11:10:53','2022-08-25 11:10:53'),(1691,'liver function \r\ncreat \r\nelectrolyte \r\nthyroid function',3964,NULL,37.0,78761,2195,2195,'2022-08-25 11:10:53','2022-08-25 11:10:53'),(1692,'keep CPAP\r\necho to exclude pulmonary hypertension',4031,NULL,37.0,78803,2211,2211,'2022-08-25 11:16:47','2022-08-25 11:16:47'),(1693,'new bilirubin , RTX ,comb\'s',4207,NULL,37.0,78803,2211,2211,'2022-08-25 11:18:04','2022-08-25 11:18:04'),(1694,'for syst Ab + topical ttt',4696,'scalp folliculitis',37.0,78791,1633,1633,'2022-08-25 11:20:06','2022-08-25 11:20:06'),(1695,'triphasic ct abdomen and pelvis with contrast\r\nalpha feto protein analysis\r\nupper endoscopy screeening for varices',4401,NULL,37.0,78728,1741,1741,'2022-08-25 11:26:26','2022-08-25 11:26:26'),(1696,'triphasic ct abdomen and pelvis with contrast\r\nalpha feto protein analysis\r\nupper endoscopy screeening for varices',4401,NULL,37.0,78728,1741,1741,'2022-08-25 11:26:30','2022-08-25 11:26:30'),(1697,'triphasic ct abdomen and pelvis with contrast\r\nalpha feto protein analysis\r\nupper endoscopy screeening for varices',4401,NULL,37.0,78728,1741,1741,'2022-08-25 11:26:41','2022-08-25 11:26:41'),(1698,'hav.igm\r\nhbcore igm',4569,NULL,37.0,78724,1741,1741,'2022-08-25 11:32:42','2022-08-25 11:32:42'),(1699,'echo\r\nwean from ventilator\r\nsputum culture\r\nfollow KFT',4341,NULL,37.0,78811,2211,2211,'2022-08-25 11:33:35','2022-08-25 11:33:35'),(1700,'rhythm control\r\nprophylactic anticoagulant',4689,NULL,37.0,78765,2195,2195,'2022-08-25 11:33:46','2022-08-25 11:33:46'),(1701,'managment of COPD',4710,NULL,37.0,78765,2195,2195,'2022-08-25 11:35:02','2022-08-25 11:35:02'),(1702,'Full data echocardiography focusing of aortic valve, pulmonaty hypertension, etc...',4688,NULL,37.0,78813,1911,1911,'2022-08-25 11:39:10','2022-08-25 11:39:10'),(1703,'trial of extubation on oral airway\r\nENT consultaion',4461,NULL,37.0,78805,2211,2211,'2022-08-25 11:45:15','2022-08-25 11:45:15'),(1704,NULL,4621,NULL,37.0,78810,2213,2213,'2022-08-25 11:55:15','2022-08-25 11:55:15'),(1705,NULL,4645,'ARNI, diuresis, SGLTi, MRA',37.0,78814,1911,1911,'2022-08-25 11:55:54','2022-08-25 11:55:54'),(1706,'ARNI, diuresis, BB MRA and SGLTi\r\ncontrol blood sugar target HBA1C 7\r\nFollow up serum Creatinine, Potassium',4645,NULL,37.0,78814,1911,1911,'2022-08-25 11:58:44','2022-08-25 11:58:44'),(1707,'EEG\r\nCSF follow \r\nup',4611,NULL,37.0,78809,2213,2213,'2022-08-25 12:01:51','2022-08-25 12:01:51'),(1708,'confimed if free MRI brain',4604,NULL,37.0,78809,2213,2213,'2022-08-25 12:04:25','2022-08-25 12:04:25'),(1709,'Full lab\r\nLiver fs\r\nRenal\r\nElectrolyte \r\nurea',4602,NULL,37.0,78809,2213,2213,'2022-08-25 12:08:39','2022-08-25 12:08:39'),(1710,'MRI brain\r\nCsf if free mri\r\nfull lab\r\nplastic consult\r\nchange good antibiotic',4596,NULL,37.0,78809,2213,2213,'2022-08-25 12:16:30','2022-08-25 12:16:30'),(1711,'meronim 1gm ial /3 times /d\r\naverozolid 600 mg /twie /d\r\nquantiferon  TB gold \r\nbronhosope',4744,NULL,37.0,78816,2226,2226,'2022-08-27 07:35:39','2022-08-27 07:35:39'),(1712,'bronchosopy\r\nmeronim\r\nmoxiflox 400 drip\r\naverozolid 600 mg \r\nsteroids',3203,NULL,37.0,78816,2226,2226,'2022-08-27 07:53:22','2022-08-27 07:53:22'),(1713,'ICU care, measures of HE, Nutritional support, Follow up CBC, ABG, hemodynamics',4122,NULL,37.0,78815,2227,2227,'2022-08-27 07:58:16','2022-08-27 07:58:16'),(1714,'Ceftriaxone + Amikacin\r\nmonitor Temp. and CRP\r\nDischarge when good general condition withOPC follow-up',4751,NULL,37.0,78827,2048,2048,'2022-08-27 08:03:24','2022-08-27 08:03:24'),(1715,'Chest care , physiotherapy',4752,NULL,37.0,78827,2048,2048,'2022-08-27 08:04:40','2022-08-27 08:04:40'),(1716,NULL,4205,NULL,37.0,78816,2226,2226,'2022-08-27 08:05:41','2022-08-27 08:05:41'),(1717,'OPC followu up, Diuretics, good nutrition, control of blood glucose',4792,NULL,37.0,78815,2227,2227,'2022-08-27 08:05:58','2022-08-27 08:05:58'),(1718,'Mostly Viral illness\r\nas long as good general condition we can discharge the patient with OPC follow-up with good hydration',4753,NULL,37.0,78827,2048,2048,'2022-08-27 08:06:00','2022-08-27 08:06:00'),(1719,'Ceftriaxone amikacin\r\nPCR for COVID-19\r\nNutritional support\r\nfollow Temp. and CRP',4754,NULL,37.0,78827,2048,2048,'2022-08-27 08:07:22','2022-08-27 08:07:22'),(1720,'HB drop must be investigated well\r\nIron profile, Coagulation profile, Cranial and Abdominal US, Stool analysis and Occult-blood in stools\r\n\r\nPRBCs transfusion',4755,NULL,37.0,78827,2048,2048,'2022-08-27 08:09:13','2022-08-27 08:09:13'),(1721,'prophylactic anticoagulation, CT abdomen with contrast, toxicology screen, reconsult again after results of investigations',4827,NULL,37.0,78818,2227,2227,'2022-08-27 08:31:10','2022-08-27 08:31:10'),(1722,'Supportive care\r\nSenior neurologist confirmation ( TWO DOCTORS).',4725,NULL,37.0,78847,2048,2048,'2022-08-27 08:33:37','2022-08-27 08:33:37'),(1723,'follow up and laboratory requested',4452,NULL,37.0,78857,1753,1753,'2022-08-27 08:52:52','2022-08-27 08:52:52'),(1724,'for left total knee replacement',2575,NULL,37.0,78831,2231,2231,'2022-08-27 08:56:17','2022-08-27 08:56:17'),(1725,'treatment and cardiac assessment',4821,NULL,37.0,78857,1753,1753,'2022-08-27 08:57:20','2022-08-27 08:57:20'),(1726,'physical therapy and follow up',4711,NULL,37.0,78831,2231,2231,'2022-08-27 09:02:21','2022-08-27 09:02:21'),(1727,'CHEST X RAY\r\nABD US\r\nURINALYSIS\r\nFOLLOW UP OF SERUM CREatinin\r\nhydration if necessary',4730,NULL,37.0,78819,2228,2228,'2022-08-27 09:03:05','2022-08-27 09:03:05'),(1728,'orthotic devices with physeotherapist',4713,NULL,37.0,78835,2231,2231,'2022-08-27 09:11:55','2022-08-27 09:11:55'),(1729,'biopsy if no improvementfollow up , and consider CT guided',4829,'Continue on same regimen',37.0,78830,2233,2233,'2022-08-27 09:13:03','2022-08-27 09:13:03'),(1730,NULL,3804,'conservative managment.',37.0,78873,1870,1870,'2022-08-27 09:14:03','2022-08-27 09:14:03'),(1731,'diuretics and albumin\r\necho evaluation',4733,NULL,37.0,78819,2228,2228,'2022-08-27 09:18:41','2022-08-27 09:18:41'),(1732,'investigations for collagen diseases',4828,'Continue on same regimen',37.0,78830,2233,2233,'2022-08-27 09:19:58','2022-08-27 09:19:58'),(1733,'opertive ttt',4798,NULL,37.0,78836,2231,2231,'2022-08-27 09:20:20','2022-08-27 09:20:20'),(1734,'operative ttt by Gamma nail',4805,NULL,37.0,78836,2231,2231,'2022-08-27 09:21:00','2022-08-27 09:21:00'),(1735,'conservative ttt and physeotherapy',4433,NULL,37.0,78838,2231,2231,'2022-08-27 09:26:23','2022-08-27 09:26:23'),(1736,'for MRI rt knee',4826,NULL,37.0,78839,2231,2231,'2022-08-27 09:32:22','2022-08-27 09:32:22'),(1737,'FOLLOW UP OF SERUM CR AND UOP\r\nRENAL US\r\nFUNDUS EXANM URINALYSIS\r\nCONSIDER STOPPING ACEIS',4741,NULL,37.0,78874,2228,2228,'2022-08-27 09:35:40','2022-08-27 09:35:40'),(1738,'follow up',4260,NULL,37.0,78860,1753,1753,'2022-08-27 09:39:10','2022-08-27 09:39:10'),(1739,'x ray  spine and physeotherapyu',1394,NULL,37.0,78842,2231,2231,'2022-08-27 09:44:22','2022-08-27 09:44:22'),(1740,'degenerative spine',4842,NULL,37.0,78842,2231,2231,'2022-08-27 09:44:47','2022-08-27 09:44:47'),(1741,'CBC AND CRP \r\nINCREASE FEEDING AND DECREASE I.V FLUIDS',4745,NULL,37.0,78890,2242,2242,'2022-08-27 10:07:34','2022-08-27 10:07:34'),(1742,NULL,4859,'Borgasone cream  دهان مرتين يوميا لمدة اسبوعين ثم مرة يوميا لمدة اسبوعين ثم يوقف',37.0,78888,775,775,'2022-08-27 10:08:10','2022-08-27 10:08:10'),(1743,'nephrology , psychiatric and neurology consultation for assessment',4794,NULL,37.0,78861,1753,1753,'2022-08-27 10:10:12','2022-08-27 10:10:12'),(1744,NULL,4866,'perfectil 5% lotion once at night on the scalp for at least 6 months',37.0,78888,775,775,'2022-08-27 10:10:52','2022-08-27 10:10:52'),(1745,'CBC AND CRP \r\nCHEST X RAY \r\nURINE ANALYSIS',4746,NULL,37.0,78890,2242,2242,'2022-08-27 10:13:56','2022-08-27 10:13:56'),(1746,'CBC, Thyroid function , Anti Thyroid Ab, ANA, , liver and kidney',1652,'minoxidil 2 once 6 puffs daily , borgasone cr , trecimus cr on eye brows',37.0,78892,1679,1679,'2022-08-27 10:13:59','2022-08-27 10:13:59'),(1747,NULL,4811,'elica M cream twice daily for 2 weeks',37.0,78868,775,775,'2022-08-27 10:16:04','2022-08-27 10:16:04'),(1748,NULL,4819,'Dermovate cr , mosedin tab بعد الغداء قرص وanalarge tab قرص مساءmoist 1 cr',37.0,78892,1679,1679,'2022-08-27 10:17:45','2022-08-27 10:17:45'),(1749,NULL,4812,'cryotherapy or electrocautry',37.0,78868,775,775,'2022-08-27 10:18:03','2022-08-27 10:18:03'),(1750,'follow up cultures',4797,NULL,37.0,78861,1753,1753,'2022-08-27 10:19:30','2022-08-27 10:19:30'),(1751,NULL,4817,'systemic and topical antibiotic , nizapex shampoo',37.0,78892,1679,1679,'2022-08-27 10:20:23','2022-08-27 10:20:23'),(1752,'CBC AND CRP \r\nBLOOD CULTURE \r\nCHEST X RAY \r\nURINE ANALYSIS',4747,NULL,37.0,78890,2242,2242,'2022-08-27 10:20:45','2022-08-27 10:20:45'),(1753,NULL,4775,'perfectil 5% lotion once at night on the scalp for at least 6 months',37.0,78893,775,775,'2022-08-27 10:22:27','2022-08-27 10:22:27'),(1754,NULL,4691,'tacrolimus ointment once at night and borgasone cream once daily',37.0,78893,775,775,'2022-08-27 10:23:40','2022-08-27 10:23:40'),(1755,'CBC, Urine and stool analysis',4481,'minoxidil 2% 6puffs once daily ,',37.0,78892,1679,1679,'2022-08-27 10:23:50','2022-08-27 10:23:50'),(1756,'ANALYSIS FOR CORTISOL ACTH',4784,NULL,37.0,78897,2229,2229,'2022-08-27 10:24:13','2022-08-27 10:24:13'),(1757,NULL,4772,'griseofulvin one tab for each 10 kgs daily for 8 weeks',37.0,78893,775,775,'2022-08-27 10:25:33','2022-08-27 10:25:33'),(1758,NULL,4810,'Borgasone cream  دهان مرتين يوميا لمدة اسبوعين ثم مرة يوميا لمدة اسبوعين ثم يوقف',37.0,78893,775,775,'2022-08-27 10:26:27','2022-08-27 10:26:27'),(1759,NULL,4782,'isotretinoin',37.0,78893,775,775,'2022-08-27 10:28:08','2022-08-27 10:28:08'),(1760,NULL,4804,'kligman formula مرة مساء لمدة ساعه للبقع الغامقه و  نهارا sunscreen glycerin soap , panthenol cr',37.0,78892,1679,1679,'2022-08-27 10:28:30','2022-08-27 10:28:30'),(1761,NULL,4774,'tacrolimus ointment once at night and borgasone cream once daily',37.0,78893,775,775,'2022-08-27 10:29:29','2022-08-27 10:29:29'),(1762,'CBC AND CRP \r\nBLOOD CULTURE \r\nTOTAL AND DIRECT BILIRUBIN \r\nMOTHER BLOOD GROUP AND Rh \r\nbaby blood group and rH \r\ngestational age \r\nfull history',4748,NULL,37.0,78890,2242,2242,'2022-08-27 10:33:55','2022-08-27 10:33:55'),(1763,'ABD US  H PYLORI AG IN STOOL',4783,NULL,37.0,78898,2229,2229,'2022-08-27 10:34:54','2022-08-27 10:34:54'),(1764,'H PYLORI  AG IN STOOL ABD US',4867,NULL,37.0,78898,2229,2229,'2022-08-27 10:35:52','2022-08-27 10:35:52'),(1765,NULL,4479,NULL,37.0,78892,1679,1679,'2022-08-27 10:37:01','2022-08-27 10:37:01'),(1766,NULL,4839,NULL,37.0,78849,2232,2232,'2022-08-27 10:37:03','2022-08-27 10:37:03'),(1767,NULL,4835,NULL,37.0,78849,2232,2232,'2022-08-27 10:37:15','2022-08-27 10:37:15'),(1768,NULL,4837,NULL,37.0,78849,2232,2232,'2022-08-27 10:37:35','2022-08-27 10:37:35'),(1769,NULL,4767,'perfectil 5% lotion once at night on the scalp for at least 6 months with',37.0,78871,775,775,'2022-08-27 10:38:11','2022-08-27 10:38:11'),(1770,'CBC AND CRP \r\nBLOOD CULTURE \r\nCHEST X RAY \r\nFULL HISTORY',4749,NULL,37.0,78890,2242,2242,'2022-08-27 10:38:17','2022-08-27 10:38:17'),(1771,'Serial Trop then Angiography',4885,'Continue on same regimen',37.0,78844,2047,2047,'2022-08-27 10:40:33','2022-08-27 10:40:33'),(1772,NULL,4778,NULL,37.0,78871,775,775,'2022-08-27 10:41:02','2022-08-27 10:41:02'),(1773,'iron profile \r\noult blood in stool \r\nserum total pt \r\neletrolytes',4800,NULL,37.0,78877,2240,2240,'2022-08-27 10:42:32','2022-08-27 10:42:32'),(1774,NULL,4802,NULL,37.0,78850,2232,2232,'2022-08-27 10:42:53','2022-08-27 10:42:53'),(1775,'CBC AND CRP \r\nBLOOD CULTURE \r\nFULL HISTORY',4750,NULL,37.0,78890,2242,2242,'2022-08-27 10:43:22','2022-08-27 10:43:22'),(1776,'intensify medical ttt then CA if not improved',4664,'Continue on same regimen+diuretic + nitrate',37.0,78840,2047,2047,'2022-08-27 10:47:52','2022-08-27 10:47:52'),(1777,NULL,4729,NULL,37.0,78855,1892,1892,'2022-08-27 10:59:41','2022-08-27 10:59:41'),(1778,NULL,4726,NULL,37.0,78855,1892,1892,'2022-08-27 11:00:09','2022-08-27 11:00:09'),(1779,NULL,4727,NULL,37.0,78855,1892,1892,'2022-08-27 11:00:34','2022-08-27 11:00:34'),(1780,NULL,4718,NULL,37.0,78855,1892,1892,'2022-08-27 11:00:56','2022-08-27 11:00:56'),(1781,'FOLLOW UP OF PATIENT CONDITION AND COMPLIANCE IF COMPLIANT AND STILL DEVELOPING HEART FAILURE INCREASE DOSE OF LASIX TO 1.5 MG PER KG PER DAY AND CAPOTEN TO 2 MG PER KG PER DAY AND FOLLOW UP PATIENT CONDITION ON NEW DOSES AND BLOOD PRESSURE',3272,NULL,37.0,78881,2242,2242,'2022-08-27 11:02:09','2022-08-27 11:02:09'),(1782,NULL,4722,NULL,37.0,78855,1892,1892,'2022-08-27 11:03:15','2022-08-27 11:03:15'),(1783,NULL,4683,'fractional laser face , hair tranceplantation scalp',37.0,78894,1679,1679,'2022-08-27 11:04:41','2022-08-27 11:04:41'),(1784,NULL,4724,NULL,37.0,78855,1892,1892,'2022-08-27 11:06:35','2022-08-27 11:06:35'),(1785,'FOLLOW UP VITAL DATA AND CONCIOUS LEVEL \r\nINCREASE ANTIBIOTIC DOSAGE TO MENINGETIC DOSES AND FOLLOW UP WITH NEUROSURGERY',4790,NULL,37.0,78881,2242,2242,'2022-08-27 11:06:36','2022-08-27 11:06:36'),(1786,'sunscreen , ginkobiloba cap',4716,'tarolimus oint مرتين borgasone cr مرة لللجسم ماعدا الوجه والاماكن الحساسه 0soulpred20 قرص بعد الافطار خميس وجمعخه',37.0,78894,1679,1679,'2022-08-27 11:09:02','2022-08-27 11:09:02'),(1787,'FOLLOW UP OF THE PATIENT WITH NEUROSURGERY AND CARDIOTHORACIC',4791,NULL,37.0,78881,2242,2242,'2022-08-27 11:09:27','2022-08-27 11:09:27'),(1788,'FOLLOW UP OF ELECTROLYTES AND CBC CRP KIDNEY FUNCTION AND STARING LOOK IF NOT IMPROVED CONSIDER CSF EXAMINATION',4796,NULL,37.0,78881,2242,2242,'2022-08-27 11:15:46','2022-08-27 11:15:46'),(1789,NULL,4597,NULL,37.0,78853,1892,1892,'2022-08-27 11:18:21','2022-08-27 11:18:21'),(1790,NULL,4878,'zinc oxide للوجه يوميا tarolimus oint مرتين للوجه للبقع البيضا فقط ويحفظ في التلاجه',37.0,78900,1679,1679,'2022-08-27 11:21:41','2022-08-27 11:21:41'),(1791,NULL,1141,NULL,37.0,78854,1892,1892,'2022-08-27 11:32:16','2022-08-27 11:32:16'),(1792,'BLOOD CULTURE \r\nPT AND PTT \r\nVBG\r\nCHANGE ANTIBIOTICS TO FORTUM AND VANCOMYCIN\r\nTOMORROW CBC AND KIDNEY FUNCTION \r\nIV FLUID FOR LOSSES',4814,NULL,37.0,78887,2242,2242,'2022-08-27 11:40:47','2022-08-27 11:40:47'),(1793,NULL,4655,NULL,37.0,78856,1892,1892,'2022-08-27 11:42:35','2022-08-27 11:42:35'),(1794,NULL,4658,NULL,37.0,78856,1892,1892,'2022-08-27 11:42:54','2022-08-27 11:42:54'),(1795,'CT CHEST \r\nBLOOD AND SPUTUM CULTURES \r\nTO ADD ACETYL CYSTEIN SACHET EVRY 12 BY RYLE \r\nCONSULT CARDIOTHORACIC ABOUT NEED FOR SURGICAL INTERVENTION FOR LUNG ABSCESS AND INTER COSTAL TUBE POSITION',4815,NULL,37.0,78887,2242,2242,'2022-08-27 11:58:19','2022-08-27 11:58:19'),(1796,'FOLLOW UO GENERAL CONDITION \r\nVITAL DATA AND URINE OUTPOT \r\nCRANIAL U/S \r\nNEW CBC AND CRP \r\nBLOOD CULTURE',4849,NULL,37.0,78883,2242,2242,'2022-08-27 12:20:14','2022-08-27 12:20:14'),(1797,'CBC WITH RETICS \r\nDIRECT AND INDIRECT COOMBS TEST \r\nOFF PHOTO AND FOLLOW UP BILIRUBIN LEVEL AFTER 12-24 HRS OF PHOTO',4734,NULL,37.0,78885,2242,2242,'2022-08-27 12:30:19','2022-08-27 12:30:19'),(1798,'ASK ABOUT CSF \r\nBLOOD CULTURE \r\nANTIREFLUX TREATMENT \r\nCHANGE ANTIBIOTICS TO MERONAM VANCOMYCIN MENINGETIC DOSES',4896,NULL,37.0,78901,2242,2242,'2022-08-27 12:45:39','2022-08-27 12:45:39'),(1799,'MRI BRAIN \r\nPEDIATRIC NEUROLOGY CONSULTATION',4898,NULL,37.0,78901,2242,2242,'2022-08-27 12:53:12','2022-08-27 12:53:12'),(1800,'PFTs- Follow up CT chest',4953,'ICS-LABA inhaler',37.0,78905,2046,2046,'2022-08-28 07:47:26','2022-08-28 07:47:26'),(1801,'Begin all patient radiological and other investigations- Diagnostic aspiration from pleural effusion',3988,'Add metronidazole',38.5,78906,2046,2046,'2022-08-28 07:55:35','2022-08-28 07:55:35'),(1802,'Urine analysis- Abdominal ultrasound nd urological consultation',4413,'Continue on the same regimen',37.0,78906,2046,2046,'2022-08-28 07:59:04','2022-08-28 07:59:04'),(1803,'change ttt with adding ati inflammatory with new inestigation',3929,NULL,37.0,78931,1582,1582,'2022-08-28 08:03:08','2022-08-28 08:03:08'),(1804,'change antibiotics',4889,NULL,37.0,78931,1582,1582,'2022-08-28 08:03:59','2022-08-28 08:03:59'),(1805,'MRI MRV MRA EEG',4907,'acyclovir FOR 14 days',37.0,78939,1025,1025,'2022-08-28 08:04:17','2022-08-28 08:04:17'),(1806,NULL,4856,'tear substitute..vasoconstrictor..antihestaminic',37.0,78933,355,355,'2022-08-28 08:11:34','2022-08-28 08:11:34'),(1807,'needs follow up',1400,NULL,37.0,78941,1947,1947,'2022-08-28 08:14:01','2022-08-28 08:14:01'),(1808,'hemodialysis, optimize anti-hypertensive medications, CT brain nd tacrolimus blood level assessment',4947,NULL,37.0,78934,1926,1926,'2022-08-28 08:15:01','2022-08-28 08:15:01'),(1809,'Controlled Oxygen therapy with follow up ABG- correction of hypokalemia',4984,'Add levofloxacine 750 mg once daily- Conrolled oxygen therapy by venturi mask- Potassium',37.0,78907,2046,2046,'2022-08-28 08:18:39','2022-08-28 08:18:39'),(1810,'conservative treatment',4870,NULL,37.0,78935,1926,1926,'2022-08-28 08:21:47','2022-08-28 08:21:47'),(1811,NULL,4739,'Antihestaminic..Tear substitute',37.0,78927,355,355,'2022-08-28 08:23:32','2022-08-28 08:23:32'),(1812,'needs fixation',4996,NULL,37.0,78945,1947,1947,'2022-08-28 08:24:36','2022-08-28 08:24:36'),(1813,'plain x ray both knees AP view- Lat view\r\nPlain x ray lumbosacral spine AP-Lat\r\nEchocardiography\r\nESR-CRP\r\n anselacox 90 tab\r\n  : treatment',4575,NULL,37.0,78956,2264,2264,'2022-08-28 08:26:42','2022-08-28 08:26:42'),(1814,'bipolar hemi arthroplasty',4943,NULL,37.0,78944,1947,1947,'2022-08-28 08:29:14','2022-08-28 08:29:14'),(1815,'Controlled oxygen therapy with follow up ABGs- Begin the radiologyand follow up',3526,'Controlled Oxygen therapy by venturi mask and continue on the same treatment',37.0,78907,2046,2046,'2022-08-28 08:29:57','2022-08-28 08:29:57'),(1816,'IOP follow up',4740,'antiglucoma..tear substitute..',37.0,78927,355,355,'2022-08-28 08:33:26','2022-08-28 08:33:26'),(1817,NULL,4942,NULL,37.0,78942,1947,1947,'2022-08-28 08:36:00','2022-08-28 08:36:00'),(1818,'follow up',5015,NULL,37.0,78942,1947,1947,'2022-08-28 08:36:27','2022-08-28 08:36:27'),(1819,'Plain x-ray both hands APview\r\nPlain xray both feet AP-Lat view\r\nAntiCCP\r\nNerve conduction study of both median n',4144,NULL,37.0,78954,2264,2264,'2022-08-28 08:37:35','2022-08-28 08:37:35'),(1820,'البعد عن الشمس و التراب قدر المستطاع -عمل مقاس نظارة جديد',4475,'Antihestaminic..vasoconstrictor',37.0,78932,355,355,'2022-08-28 08:39:30','2022-08-28 08:39:30'),(1821,'Follow up BP, RR, RBS, HR',4969,'Examide, nebuilizer, same previous medication',37.0,78952,2265,2265,'2022-08-28 08:41:17','2022-08-28 08:41:17'),(1822,'follow up',4740,NULL,37.0,78947,1947,1947,'2022-08-28 08:44:15','2022-08-28 08:44:15'),(1823,NULL,4532,'steroid eye drop-antibiotic eye drop-combined antibiotic and antiinflamatory eye ointment',37.0,78932,355,355,'2022-08-28 08:44:40','2022-08-28 08:44:40'),(1824,'كمادات ماء دافئ و متابعة بعد اسبوع',4551,'combined antibiotic and antiinflamatory eye dro',37.0,78932,355,355,'2022-08-28 08:48:19','2022-08-28 08:48:19'),(1825,'hestabilize hemodynamic state by vasopressors, fluid balance',4921,NULL,37.0,78936,1926,1926,'2022-08-28 08:52:15','2022-08-28 08:52:15'),(1826,'فحص قاع العين',4830,NULL,37.0,78932,355,355,'2022-08-28 08:53:14','2022-08-28 08:53:14'),(1827,'needs x rays and examination',4305,NULL,37.0,78946,1947,1947,'2022-08-28 08:56:11','2022-08-28 08:56:11'),(1828,'عمل نظارة-فحص قاع العين - شعة مقطعية علي شبكية العين اليمني-عرض قلب',4911,NULL,37.0,78932,355,355,'2022-08-28 08:58:51','2022-08-28 08:58:51'),(1829,'U>A',5003,NULL,37.0,78970,1732,1732,'2022-08-28 08:59:56','2022-08-28 08:59:56'),(1830,'MRI',1814,NULL,37.0,78946,1947,1947,'2022-08-28 09:00:45','2022-08-28 09:00:45'),(1831,'echo',5008,NULL,37.0,78970,1732,1732,'2022-08-28 09:01:23','2022-08-28 09:01:23'),(1832,'sputum ulture',4712,NULL,37.0,78968,1732,1732,'2022-08-28 09:05:41','2022-08-28 09:05:41'),(1833,NULL,4926,NULL,37.0,78949,2262,2262,'2022-08-28 09:05:59','2022-08-28 09:05:59'),(1834,'duplex  ,venous system',4607,NULL,37.0,78950,2262,2262,'2022-08-28 09:13:24','2022-08-28 09:13:24'),(1835,'tsh',4669,NULL,37.0,78977,1732,1732,'2022-08-28 09:13:41','2022-08-28 09:13:41'),(1836,'Repeat sputum examination for acid fast bacilli- PCR for covid diagnosis- May need Bronchoalveolar lavag',4884,NULL,37.0,78903,2046,2046,'2022-08-28 09:14:24','2022-08-28 09:14:24'),(1837,'glyperssi',4971,NULL,37.0,78977,1732,1732,'2022-08-28 09:14:47','2022-08-28 09:14:47'),(1838,'blood transfusion and ESA therapy ,, increase dialysis dose and cardiac assessment',4936,NULL,37.0,78982,1926,1926,'2022-08-28 09:14:55','2022-08-28 09:14:55'),(1839,'open drainage with use of rubber drain - culture and sensitivity from bus',4912,NULL,37.0,78998,1609,1609,'2022-08-28 09:16:55','2022-08-28 09:16:55'),(1840,'follow up s creatinie., s urea, ABG, \r\ndischarge , follow up out patient clinic, nephrology clinic',4987,NULL,37.0,78953,2265,2265,'2022-08-28 09:16:57','2022-08-28 09:16:57'),(1841,'t brain',4980,NULL,37.0,78977,1732,1732,'2022-08-28 09:17:14','2022-08-28 09:17:14'),(1842,'UPPER git, lower GIT endoscopy to detect source of bleeding',4991,NULL,37.0,78953,2265,2265,'2022-08-28 09:18:04','2022-08-28 09:18:04'),(1843,'Follow up ABG, S CREATININE, AND Urology consultation about obstruction',4994,NULL,37.0,78953,2265,2265,'2022-08-28 09:19:49','2022-08-28 09:19:49'),(1844,'TSH',4982,NULL,37.0,78977,1732,1732,'2022-08-28 09:20:08','2022-08-28 09:20:08'),(1845,'follow up with antibiotic - discharge when stable',4954,NULL,37.0,78992,1609,1609,'2022-08-28 09:21:11','2022-08-28 09:21:11'),(1846,'increase dialysis dose and reduce body weight and ultrasound for assessment of liver and spleen',4938,NULL,37.0,78982,1926,1926,'2022-08-28 09:21:48','2022-08-28 09:21:48'),(1847,'dsopamine',4985,NULL,37.0,78977,1732,1732,'2022-08-28 09:22:39','2022-08-28 09:22:39'),(1848,'continue antibiotic - dischargewhen stable - laparoscopic appendectomy when available',4954,NULL,37.0,78992,1609,1609,'2022-08-28 09:23:08','2022-08-28 09:23:08'),(1849,'stop methotrexate\r\ncontinue folic acid 5 mg daily\r\nHRCT chest every 6 month\r\nfor the other case that are suspected Wegners granulomatosis\r\n Ask about rhinitis, sinusitis, hoarsness of voice, hematria, weight loss\r\n\r\nlaryngoscopy for exclusion of vocal cord granuloma and tracheal stenosis , Order urine analysis for proteinuria and haematuria, ESR,CRP,  ANCA P and C',3929,NULL,37.0,78958,2264,2264,'2022-08-28 09:24:03','2022-08-28 09:24:03'),(1850,'reduce dry body weight and optimize dialysis',4937,NULL,37.0,78982,1926,1926,'2022-08-28 09:24:24','2022-08-28 09:24:24'),(1851,'follow up - continue antibiotics - discharge when improve',4955,NULL,37.0,78992,1609,1609,'2022-08-28 09:26:13','2022-08-28 09:26:13'),(1852,'Sputum smear for AFB- PCR for covid 19- follow up fever and TLC',4880,'Add clarithromyci 500mg twice daily',37.0,78903,2046,2046,'2022-08-28 09:26:38','2022-08-28 09:26:38'),(1853,'For upper GIT, LOWER GIT ENDOSCOPY \r\nPATHOLOGICAL  CORRELATION',4838,NULL,37.0,78955,2265,2265,'2022-08-28 09:29:25','2022-08-28 09:29:25'),(1854,'MRCP and reconsult',4955,NULL,37.0,78992,1609,1609,'2022-08-28 09:30:53','2022-08-28 09:30:53'),(1855,'Replace ACEIs by another antihypertensive group- Referral for cardiology department',4868,'Add colchicin',37.0,78903,2046,2046,'2022-08-28 09:35:30','2022-08-28 09:35:30'),(1856,'serum electrolytes - correction of any electrolytes imblance antibiotic - exclude acute abdomen',5041,NULL,37.0,78992,1609,1609,'2022-08-28 09:40:37','2022-08-28 09:40:37'),(1857,'iron therapy',4756,NULL,37.0,78987,2277,2277,'2022-08-28 09:42:09','2022-08-28 09:42:09'),(1858,'discharge',4757,NULL,37.0,78987,2277,2277,'2022-08-28 09:43:10','2022-08-28 09:43:10'),(1859,'discharge',4759,NULL,37.0,78987,2277,2277,'2022-08-28 09:44:46','2022-08-28 09:44:46'),(1860,'البعد عن اي كريمات فيها كورتيزون',4960,NULL,37.0,79002,842,842,'2022-08-28 09:47:40','2022-08-28 09:47:40'),(1861,'Follow up ABGs, fever and TLc- urine analysis- Abdominal US- nephrology and cardiology consultation',4895,'Continue on the same regimen- Controlled oxygen therapy by venturi mask',37.0,78903,2046,2046,'2022-08-28 09:48:07','2022-08-28 09:48:07'),(1862,'creatinine hba1c',5029,'ezapril co tab-diamicron 60',37.0,79005,1540,1540,'2022-08-28 09:48:27','2022-08-28 09:48:27'),(1863,'blood pressure , fundus exam, ca ph alp , neurology consultation , neurosurgery consultation , history pf vomiting duration and associated GIT habits',4940,NULL,37.0,78987,2277,2277,'2022-08-28 09:49:51','2022-08-28 09:49:51'),(1864,'تحليل يوريك اسيد - تحليل Albumin / createnine ratio,',4705,'Vildagluse 50/1000 tab قرص قبل الغدا والعشا',37.0,78917,986,986,'2022-08-28 09:51:40','2022-08-28 09:51:40'),(1865,'antibiotics and zovirax for two weeks,EEG , neurology consulation',4941,NULL,37.0,78987,2277,2277,'2022-08-28 09:52:03','2022-08-28 09:52:03'),(1866,NULL,4705,NULL,37.0,78917,986,986,'2022-08-28 09:54:21','2022-08-28 09:54:21'),(1867,'عمل تحاليل ووظاءف كبد وصوره دم كامله  وبعدا اخذ حقن ميثو تريكسات',4961,NULL,37.0,79002,842,842,'2022-08-28 09:57:47','2022-08-28 09:57:47'),(1868,'mixtard-galvus met-forflozin',5020,NULL,37.0,78940,1540,1540,'2022-08-28 09:59:11','2022-08-28 09:59:11'),(1869,'ppi for 1 month upper endoscopy',5022,NULL,37.0,78940,1540,1540,'2022-08-28 09:59:53','2022-08-28 09:59:53'),(1870,'ask for ft3 ft4 for follow up',4224,'carbimazole 5mg',37.0,78962,2267,2267,'2022-08-28 10:03:41','2022-08-28 10:03:41'),(1871,'continue antibiotic - temporary stop oral feeding - NG tube - operative report - abdominal us  - check intestinal motility - \r\n - check electrolytescheck drain & fluid analysis - postpone drain removal',4924,NULL,37.0,78994,1609,1609,'2022-08-28 10:05:31','2022-08-28 10:05:31'),(1872,'US',4707,'Antopral 40mg tab once daily -   gast reg 200 mg tab twice daily  --- spasmodigestien tab 3 times daily--lacteol forte sach daily',37.0,78917,986,986,'2022-08-28 10:13:04','2022-08-28 10:13:04'),(1873,'confirm by superficial ultrasound - excision of large lipoma or painful or in areas like neck, back  or shoulders',3652,NULL,37.0,78996,1609,1609,'2022-08-28 10:13:19','2022-08-28 10:13:19'),(1874,NULL,4813,NULL,37.0,79020,2284,2284,'2022-08-28 10:14:47','2022-08-28 10:14:47'),(1875,'for neurology',4892,NULL,37.0,79020,2284,2284,'2022-08-28 10:15:44','2022-08-28 10:15:44'),(1876,'Echo- duplex- CTPA- chest consultation',4901,NULL,37.0,78922,986,986,'2022-08-28 10:22:32','2022-08-28 10:22:32'),(1877,'confirmation by duplex US on venous system of LL - rest elastic stocking after improving',5025,'Augmentin 1gm tab 1X2   -  Ambezim tab 1X3 - Throbex cream',37.0,78996,1609,1609,'2022-08-28 10:25:12','2022-08-28 10:25:12'),(1878,NULL,4423,NULL,37.0,79008,2284,2284,'2022-08-28 10:26:43','2022-08-28 10:26:43'),(1879,'Neuroconsultation- stop clexan',4904,NULL,37.0,78922,986,986,'2022-08-28 10:26:44','2022-08-28 10:26:44'),(1880,NULL,4424,NULL,37.0,79008,2284,2284,'2022-08-28 10:27:06','2022-08-28 10:27:06'),(1881,NULL,4425,NULL,37.0,79008,2284,2284,'2022-08-28 10:27:34','2022-08-28 10:27:34'),(1882,'correct metabolic acidosis , monitor vitals and capillary refill time , zovirax',4993,NULL,37.0,79027,2277,2277,'2022-08-28 10:28:02','2022-08-28 10:28:02'),(1883,'zovirax , antibiotics meningitic dose',5067,NULL,37.0,79027,2277,2277,'2022-08-28 10:29:46','2022-08-28 10:29:46'),(1884,'عمل اشعة مقطعية بعد 24 ساعة او ف حالة حدوث اى اضطراب ف درجة الوعى',4922,NULL,37.0,79024,1480,1480,'2022-08-28 10:30:17','2022-08-28 10:30:17'),(1885,'heparin /12h ,',4908,NULL,37.0,78922,986,986,'2022-08-28 10:31:19','2022-08-28 10:31:19'),(1886,NULL,1400,'تم تاجيل الحاله لعدم حضورها',37.0,79016,1726,1726,'2022-08-28 10:32:33','2022-08-28 10:32:33'),(1887,NULL,3606,NULL,37.0,79003,2284,2284,'2022-08-28 10:35:30','2022-08-28 10:35:30'),(1888,'treatment of vaginal bleeding and follow up after treatment',4816,'iron infusion',37.0,79029,2080,2080,'2022-08-28 10:35:59','2022-08-28 10:35:59'),(1889,NULL,4956,'follow up ,reassurance no need for ttt',37.0,79018,1726,1726,'2022-08-28 10:36:07','2022-08-28 10:36:07'),(1890,'Moxiflox 400mg tab',4905,NULL,37.0,78924,986,986,'2022-08-28 10:36:59','2022-08-28 10:36:59'),(1891,'new thyroid us\r\nthyroid profile',1442,NULL,37.0,78966,2267,2267,'2022-08-28 10:37:31','2022-08-28 10:37:31'),(1892,NULL,3564,NULL,37.0,79004,1267,1267,'2022-08-28 10:40:39','2022-08-28 10:40:39'),(1893,NULL,4567,'الصور على الموبايل لم ترفع على ملف المريض تم تاجيل الجلسه',37.0,79017,1726,1726,'2022-08-28 10:53:20','2022-08-28 10:53:20'),(1894,'سحب دواء الهالونيز بالتدريج على مدار يومين مع اعطاء الكيوتابين نص قرص عند اللزوم',4900,NULL,37.0,79036,1480,1480,'2022-08-28 11:04:25','2022-08-28 11:04:25'),(1895,'Treatment of hepatic coma',4918,'SUPPORTIVE TREATMENT',37.0,79031,2080,2080,'2022-08-28 11:05:02','2022-08-28 11:05:02'),(1896,'CT abd and pelvis with contrast\r\nESr\r\nEchocardiography',5026,NULL,37.0,79041,2195,2195,'2022-08-28 11:07:34','2022-08-28 11:07:34'),(1897,'CT abd and pelvis with contrast\r\nESr\r\nEchocardiography',5026,NULL,37.0,79041,2195,2195,'2022-08-28 11:07:34','2022-08-28 11:07:34'),(1898,'لا يوجد',4156,'sandostatin',37.0,78964,1593,1593,'2022-08-28 11:09:41','2022-08-28 11:09:41'),(1899,NULL,4568,'الصور من الموبايل وغير واضحه ولم ترفع على الملف',37.0,79017,1726,1726,'2022-08-28 11:13:41','2022-08-28 11:13:41'),(1900,NULL,5027,'referral',37.0,79033,1726,1726,'2022-08-28 11:24:42','2022-08-28 11:24:42'),(1901,'s albumin\r\n24 hour urinary protein\r\nroutine lab',4888,NULL,37.0,79054,2195,2195,'2022-08-28 11:25:24','2022-08-28 11:25:24'),(1902,'Microcytic hypochromic anemia (HB 7.7) for further investigation & internal medicine (Hematological) consultation \r\nFor serum electrolytes & Thyroid profile',4929,NULL,37.0,78974,2272,2272,'2022-08-28 11:26:32','2022-08-28 11:26:32'),(1903,'nephrology consultation',4963,NULL,37.0,78926,1578,1578,'2022-08-28 11:28:19','2022-08-28 11:28:19'),(1904,'chest care, good feeding\r\nconsider discharge if clinically stable, saturation above 94%, good oral intake',4944,NULL,37.0,79052,2278,2278,'2022-08-28 11:31:05','2022-08-28 11:31:05'),(1905,'chest care, anti reflux measures',4945,NULL,37.0,79052,2278,2278,'2022-08-28 11:33:29','2022-08-28 11:33:29'),(1906,'For ESR, CRP & Multi-slice CT coronary angiography',4928,'Colchicine 0.5 cm ( 1 tab twice) if not contraindicated after gastroenterology consultation)',37.0,78974,2272,2272,'2022-08-28 11:34:14','2022-08-28 11:34:14'),(1907,'follow upp creatinine level and boby weight',3704,'add abixaban',37.0,78910,1129,1129,'2022-08-28 11:34:58','2022-08-28 11:34:58'),(1908,'48h follow up then measuring cervical lenght at 30wks of gestation',5078,NULL,37.0,78928,1578,1578,'2022-08-28 11:35:52','2022-08-28 11:35:52'),(1909,'kidney US follow up',5078,NULL,37.0,78928,1578,1578,'2022-08-28 11:37:14','2022-08-28 11:37:14'),(1910,'follow up 48h then measuring cervical lenght at 30wks of gestation',5079,NULL,37.0,78928,1578,1578,'2022-08-28 11:38:15','2022-08-28 11:38:15'),(1911,'For Liver Function tests, follow up serum creatinine, serum potassium',4927,', SGLT2, Diuretics, (Nebivolol), clopidgrel',37.0,78974,2272,2272,'2022-08-28 11:44:54','2022-08-28 11:44:54'),(1912,'+ FOLLOW UP AFTER 2 WEEKS - Thyroid profile , HBA1C, CBC',5021,'antihypertensive medications( combination) - aspirin- statin',37.0,78974,2272,2272,'2022-08-28 11:55:20','2022-08-28 11:55:20'),(1913,'refere to CCU to control the arrhythmia and follow up the patient',4883,'Loading Cordarone then maintenance dose as prescribed',37.0,79050,1129,1129,'2022-08-28 12:00:54','2022-08-28 12:00:54'),(1914,'follow up',5004,NULL,37.0,79047,1578,1578,'2022-08-28 12:06:15','2022-08-28 12:06:15'),(1915,'follow up',5000,NULL,37.0,79047,1578,1578,'2022-08-28 12:07:19','2022-08-28 12:07:19'),(1916,'SERUM POTASSIUM FOLLOW UP',4389,'ELIQUIS 5 TWICE DAILY',37.0,79056,2272,2272,'2022-08-28 12:07:25','2022-08-28 12:07:25'),(1917,'myomectomy',5018,NULL,37.0,79047,1578,1578,'2022-08-28 12:07:55','2022-08-28 12:07:55'),(1918,'follow up',4998,NULL,37.0,79047,1578,1578,'2022-08-28 12:08:35','2022-08-28 12:08:35'),(1919,'blood film then transfer to our hospital to do bone marrow biopsy after improve thrombocytopenia by plt transfusion',4656,NULL,37.0,79049,986,986,'2022-08-28 12:24:08','2022-08-28 12:24:08'),(1920,'source of infection (UTI?, ....)\r\nfollow up the HF',4923,'rate control by nevilob plus anticoagulation by heparin and warfarin plus other regimin',37.0,79055,1129,1129,'2022-08-28 12:24:13','2022-08-28 12:24:13'),(1921,'planned for BM Biopsy by transfer to our hospital',4845,NULL,37.0,79049,986,986,'2022-08-28 12:27:28','2022-08-28 12:27:28'),(1922,'ask for NSAID\r\nask for vegetable intake\r\nfollow up bleeding and INR closely',5042,'statrt marevan 2 mg when INR is 3.5',37.0,79055,1129,1129,'2022-08-28 12:30:55','2022-08-28 12:30:55'),(1923,'DERMATOLOGICAL &neuropsychiatric consultation \r\nstop chemotherapy until improve general condition & may need csf ex & pan \r\n   ct with contrast or  mri brain',4854,NULL,37.0,79049,986,986,'2022-08-28 12:36:17','2022-08-28 12:36:17'),(1924,'blood culture\r\ncorrection of nemia by packed RBCs\r\ntransthoracic then TEE to evaluate the prostheisis\r\nmarevan 2.5mg per day to adjust INR between 2.5-3.5',5044,'Continue on same regimen',37.0,79055,1129,1129,'2022-08-28 12:59:56','2022-08-28 12:59:56'),(1925,'increase the seloken zoc to keep the HR between 55-60\r\nincrease crestor to 20 and check ALT and AST\r\nensure that LDL is below 55 mg/dl\r\nif still chest pain consult interventionlist',4916,'crestor 20, adancor 20 twice, dual antiplatelet, seloken zoc',37.0,79057,1129,1129,'2022-08-28 13:03:28','2022-08-28 13:03:28'),(1926,'control sepsis \r\nif c bc not improved for BMA',4990,NULL,37.0,79074,2240,2240,'2022-08-29 07:42:01','2022-08-29 07:42:01'),(1927,'refer to our center \r\nمحمد جمال يوسف جامعة الزقازيق',5030,NULL,37.0,79062,2240,2240,'2022-08-29 07:55:32','2022-08-29 07:55:32'),(1928,'revision of diagnosis',5211,NULL,37.0,79065,1818,1818,'2022-08-29 08:20:17','2022-08-29 08:20:17'),(1929,'For spiral NCCT abdomen and pelvis',5095,NULL,37.0,79101,1868,1868,'2022-08-29 08:21:02','2022-08-29 08:21:02'),(1930,'patient for Rt. sided ICT imsertion and follow up chest ct',5048,NULL,37.0,79085,1844,1844,'2022-08-29 08:22:49','2022-08-29 08:22:49'),(1931,NULL,5094,NULL,37.0,79117,2033,2033,'2022-08-29 08:35:20','2022-08-29 08:35:20'),(1932,'8yrs old acase of pancytopenia with DM1 admitted with uncontrolled hyperglycemia , RBS 460 , ABG normal , pt on SC insulin 1.1 IU/KG/day , pt has no regular fallow up for DM and no lab available such as HgA1C , TSH , celiac screen , lipid profile . \r\nadvice : 1. anthropometric measurement 2.. basic lab for electrolyte and liver and kidney function 3. HgA1c and TSH and lipid profile and celiac screen . 4. start IV infusion insulin 0.05IU/Kg/hr and fallow up RBS and discontinue when RBS controlled 5. diet control',5037,NULL,37.0,79092,2304,2304,'2022-08-29 08:42:59','2022-08-29 08:42:59'),(1933,'8yrs old acase of pancytopenia with DM1 admitted with uncontrolled hyperglycemia , RBS 460 , ABG normal , pt on SC insulin 1.1 IU/KG/day , pt has no regular fallow up for DM and no lab available such as HgA1C , TSH , celiac screen , lipid profile . \r\nadvice : 1. anthropometric measurement 2.. basic lab for electrolyte and liver and kidney function 3. HgA1c and TSH and lipid profile and celiac screen . 4. start IV infusion insulin 0.05IU/Kg/hr and fallow up RBS and discontinue when RBS controlled 5. diet control',5037,NULL,37.0,79092,2304,2304,'2022-08-29 08:43:00','2022-08-29 08:43:00'),(1934,'8yrs old acase of pancytopenia with DM1 admitted with uncontrolled hyperglycemia , RBS 460 , ABG normal , pt on SC insulin 1.1 IU/KG/day , pt has no regular fallow up for DM and no lab available such as HgA1C , TSH , celiac screen , lipid profile . \r\nadvice : 1. anthropometric measurement 2.. basic lab for electrolyte and liver and kidney function 3. HgA1c and TSH and lipid profile and celiac screen . 4. start IV infusion insulin 0.05IU/Kg/hr and fallow up RBS and discontinue when RBS controlled 5. diet control',5037,NULL,37.0,79092,2304,2304,'2022-08-29 08:43:00','2022-08-29 08:43:00'),(1935,'8yrs old acase of pancytopenia with DM1 admitted with uncontrolled hyperglycemia , RBS 460 , ABG normal , pt on SC insulin 1.1 IU/KG/day , pt has no regular fallow up for DM and no lab available such as HgA1C , TSH , celiac screen , lipid profile . \r\nadvice : 1. anthropometric measurement 2.. basic lab for electrolyte and liver and kidney function 3. HgA1c and TSH and lipid profile and celiac screen . 4. start IV infusion insulin 0.05IU/Kg/hr and fallow up RBS and discontinue when RBS controlled 5. diet control',5037,NULL,37.0,79092,2304,2304,'2022-08-29 08:43:00','2022-08-29 08:43:00'),(1936,'8yrs old acase of pancytopenia with DM1 admitted with uncontrolled hyperglycemia , RBS 460 , ABG normal , pt on SC insulin 1.1 IU/KG/day , pt has no regular fallow up for DM and no lab available such as HgA1C , TSH , celiac screen , lipid profile . \r\nadvice : 1. anthropometric measurement 2.. basic lab for electrolyte and liver and kidney function 3. HgA1c and TSH and lipid profile and celiac screen . 4. start IV infusion insulin 0.05IU/Kg/hr and fallow up RBS and discontinue when RBS controlled 5. diet control',5037,NULL,37.0,79092,2304,2304,'2022-08-29 08:43:01','2022-08-29 08:43:01'),(1937,'8yrs old acase of pancytopenia with DM1 admitted with uncontrolled hyperglycemia , RBS 460 , ABG normal , pt on SC insulin 1.1 IU/KG/day , pt has no regular fallow up for DM and no lab available such as HgA1C , TSH , celiac screen , lipid profile . \r\nadvice : 1. anthropometric measurement 2.. basic lab for electrolyte and liver and kidney function 3. HgA1c and TSH and lipid profile and celiac screen . 4. start IV infusion insulin 0.05IU/Kg/hr and fallow up RBS and discontinue when RBS controlled 5. diet control',5037,NULL,37.0,79092,2304,2304,'2022-08-29 08:43:01','2022-08-29 08:43:01'),(1938,'9yrs old acase of DM1 admitted with uncontrolled hyperglycemia , RBS 500 , ABG normal , pt on SC insulin 1.2 IU/KG/day , pt has no regular fallow up for DM and no lab available such as HgA1C , TSH , celiac screen , lipid profile . \r\nadvice : 1. anthropometric measurement 2.. basic lab for electrolyte and liver and kidney function 3. HgA1c and TSH and lipid profile and celiac screen . 4. start IV infusion insulin 0.05IU/Kg/hr and fallow up RBS and discontinue when RBS controlled 5. diet control',5226,NULL,37.0,79092,2304,2304,'2022-08-29 08:44:37','2022-08-29 08:44:37'),(1939,'for MRI brain, EEG, neurological follow up',5214,NULL,37.0,79112,2313,2313,'2022-08-29 08:45:20','2022-08-29 08:45:20'),(1940,'urology onsultation',4939,NULL,37.0,79118,2033,2033,'2022-08-29 08:45:22','2022-08-29 08:45:22'),(1941,'discharge on oral augmentin, home nebulizations and antihistaminic.',5229,NULL,37.0,79112,2313,2313,'2022-08-29 08:46:20','2022-08-29 08:46:20'),(1942,NULL,5178,'krella loton       minoxidil forte gel                           zinctron caps',37.0,79081,1125,1125,'2022-08-29 08:47:19','2022-08-29 08:47:19'),(1943,'Calcium, phosporus, ALP, kidney functions, skeletal survey & abdominal US',5264,NULL,37.0,79112,2313,2313,'2022-08-29 08:47:54','2022-08-29 08:47:54'),(1944,'UPPER ENDOSOPY',5268,NULL,37.0,79111,2033,2033,'2022-08-29 08:51:27','2022-08-29 08:51:27'),(1945,'give metformin',4784,'metformin',37.0,79067,2297,2297,'2022-08-29 08:54:34','2022-08-29 08:54:34'),(1946,NULL,5006,NULL,37.0,79110,327,327,'2022-08-29 08:57:13','2022-08-29 08:57:13'),(1947,'mild diuresis, platelets transfusion, inotrops if vitally unstable, follow up CBC, CRP, 2nd line antibiotics',4303,NULL,37.0,79124,2313,2313,'2022-08-29 08:57:24','2022-08-29 08:57:24'),(1948,NULL,5097,'closol spray',37.0,79083,1125,1125,'2022-08-29 08:57:27','2022-08-29 08:57:27'),(1949,NULL,5006,NULL,37.0,79110,327,327,'2022-08-29 08:57:29','2022-08-29 08:57:29'),(1950,NULL,5100,'minoidil         krella   zinctron caps',37.0,79083,1125,1125,'2022-08-29 08:58:37','2022-08-29 08:58:37'),(1951,'urine and blood cultures, urological consultation',5276,NULL,37.0,79068,2297,2297,'2022-08-29 09:08:54','2022-08-29 09:08:54'),(1952,'urine and blood cultures, urological consultation',5276,NULL,37.0,79068,2297,2297,'2022-08-29 09:08:54','2022-08-29 09:08:54'),(1953,'urine and blood cultures, urological consultation',5276,NULL,37.0,79068,2297,2297,'2022-08-29 09:08:54','2022-08-29 09:08:54'),(1954,'urine and blood cultures, urological consultation',5276,NULL,37.0,79068,2297,2297,'2022-08-29 09:08:54','2022-08-29 09:08:54'),(1955,'urine and blood cultures, urological consultation',5276,NULL,37.0,79068,2297,2297,'2022-08-29 09:08:54','2022-08-29 09:08:54'),(1956,'urine and blood cultures, urological consultation',5276,NULL,37.0,79068,2297,2297,'2022-08-29 09:08:54','2022-08-29 09:08:54'),(1957,'urine and blood cultures, urological consultation',5276,NULL,37.0,79068,2297,2297,'2022-08-29 09:08:55','2022-08-29 09:08:55'),(1958,'urine and blood cultures, urological consultation',5276,NULL,37.0,79068,2297,2297,'2022-08-29 09:08:55','2022-08-29 09:08:55'),(1959,'urine and blood cultures, urological consultation',5276,NULL,37.0,79068,2297,2297,'2022-08-29 09:08:55','2022-08-29 09:08:55'),(1960,'urine and blood cultures, urological consultation',5276,NULL,37.0,79068,2297,2297,'2022-08-29 09:08:55','2022-08-29 09:08:55'),(1961,'urine and blood cultures, urological consultation',5276,NULL,37.0,79068,2297,2297,'2022-08-29 09:08:55','2022-08-29 09:08:55'),(1962,'urine and blood cultures, urological consultation',5276,NULL,37.0,79068,2297,2297,'2022-08-29 09:08:55','2022-08-29 09:08:55'),(1963,'urine and blood cultures, urological consultation',5276,NULL,37.0,79068,2297,2297,'2022-08-29 09:08:55','2022-08-29 09:08:55'),(1964,'urine and blood cultures, urological consultation',5276,NULL,37.0,79068,2297,2297,'2022-08-29 09:08:56','2022-08-29 09:08:56'),(1965,NULL,5074,'concor  5   1x1',37.0,79097,2305,2305,'2022-08-29 09:14:15','2022-08-29 09:14:15'),(1966,'Antibiotics, o2 support',5107,NULL,37.0,79134,2319,2319,'2022-08-29 09:22:46','2022-08-29 09:22:46'),(1967,'antibiotics, o2 support',5109,NULL,37.0,79134,2319,2319,'2022-08-29 09:23:23','2022-08-29 09:23:23'),(1968,'antibiotics, o2 support',5109,NULL,37.0,79134,2319,2319,'2022-08-29 09:23:23','2022-08-29 09:23:23'),(1969,'MRCP - control electrolytes disturbance & calcium - may need ERCP - sandostatin',4563,'meronem 1/2 gm every 8 hours',37.0,79135,1609,1609,'2022-08-29 09:24:13','2022-08-29 09:24:13'),(1970,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:35','2022-08-29 09:25:35'),(1971,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:36','2022-08-29 09:25:36'),(1972,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:36','2022-08-29 09:25:36'),(1973,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:36','2022-08-29 09:25:36'),(1974,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:36','2022-08-29 09:25:36'),(1975,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:36','2022-08-29 09:25:36'),(1976,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:37','2022-08-29 09:25:37'),(1977,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:37','2022-08-29 09:25:37'),(1978,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:37','2022-08-29 09:25:37'),(1979,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:37','2022-08-29 09:25:37'),(1980,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:37','2022-08-29 09:25:37'),(1981,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:38','2022-08-29 09:25:38'),(1982,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:38','2022-08-29 09:25:38'),(1983,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:38','2022-08-29 09:25:38'),(1984,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:38','2022-08-29 09:25:38'),(1985,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:38','2022-08-29 09:25:38'),(1986,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:39','2022-08-29 09:25:39'),(1987,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:39','2022-08-29 09:25:39'),(1988,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:39','2022-08-29 09:25:39'),(1989,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:39','2022-08-29 09:25:39'),(1990,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:39','2022-08-29 09:25:39'),(1991,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:40','2022-08-29 09:25:40'),(1992,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:40','2022-08-29 09:25:40'),(1993,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:40','2022-08-29 09:25:40'),(1994,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:40','2022-08-29 09:25:40'),(1995,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:40','2022-08-29 09:25:40'),(1996,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:40','2022-08-29 09:25:40'),(1997,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:41','2022-08-29 09:25:41'),(1998,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:41','2022-08-29 09:25:41'),(1999,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:41','2022-08-29 09:25:41'),(2000,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:42','2022-08-29 09:25:42'),(2001,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:42','2022-08-29 09:25:42'),(2002,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:42','2022-08-29 09:25:42'),(2003,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:42','2022-08-29 09:25:42'),(2004,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:42','2022-08-29 09:25:42'),(2005,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:42','2022-08-29 09:25:42'),(2006,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:43','2022-08-29 09:25:43'),(2007,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:43','2022-08-29 09:25:43'),(2008,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:43','2022-08-29 09:25:43'),(2009,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:44','2022-08-29 09:25:44'),(2010,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:44','2022-08-29 09:25:44'),(2011,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:44','2022-08-29 09:25:44'),(2012,'antibiotics, 52 support,',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:44','2022-08-29 09:25:44'),(2013,'antibiotics, 52 support,',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:44','2022-08-29 09:25:44'),(2014,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:45','2022-08-29 09:25:45'),(2015,'antibiotics, 52 support,',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:45','2022-08-29 09:25:45'),(2016,'antibiotics, 52 support,',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:45','2022-08-29 09:25:45'),(2017,'antibiotics, 52 support,',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:45','2022-08-29 09:25:45'),(2018,'antibiotics, 52 support,',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:45','2022-08-29 09:25:45'),(2019,'antibiotics, 52 support,',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:46','2022-08-29 09:25:46'),(2020,'antibiotics, 52 support,',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:46','2022-08-29 09:25:46'),(2021,'antibiotics, 52 support,',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:46','2022-08-29 09:25:46'),(2022,'antibiotics, 52 support,',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:46','2022-08-29 09:25:46'),(2023,'antibiotics, 52 support,',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:46','2022-08-29 09:25:46'),(2024,'antibiotics, 52 support,',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:47','2022-08-29 09:25:47'),(2025,'antibiotics, 52 support,',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:47','2022-08-29 09:25:47'),(2026,'antibiotics, 52 support,',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:47','2022-08-29 09:25:47'),(2027,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:47','2022-08-29 09:25:47'),(2028,'antibiotics, 52 support,',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:47','2022-08-29 09:25:47'),(2029,'antibiotics, 52 support,',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:48','2022-08-29 09:25:48'),(2030,'antibiotics, 52 support,',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:48','2022-08-29 09:25:48'),(2031,'antibiotics, 52 support,',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:48','2022-08-29 09:25:48'),(2032,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:48','2022-08-29 09:25:48'),(2033,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:49','2022-08-29 09:25:49'),(2034,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:49','2022-08-29 09:25:49'),(2035,'antibiotics, 52 support,',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:49','2022-08-29 09:25:49'),(2036,'antibiotics, 52 support,',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:49','2022-08-29 09:25:49'),(2037,'antibiotics, 52 support, supportive ttt',5110,NULL,37.0,79134,2319,2319,'2022-08-29 09:25:50','2022-08-29 09:25:50'),(2038,'photo',5112,NULL,37.0,79134,2319,2319,'2022-08-29 09:26:36','2022-08-29 09:26:36'),(2039,NULL,5265,'systemic and topical antibiotic   aniseptic',37.0,79084,1125,1125,'2022-08-29 09:27:42','2022-08-29 09:27:42'),(2040,NULL,5269,'systemic and topical antibiotic   aniseptic',37.0,79084,1125,1125,'2022-08-29 09:29:35','2022-08-29 09:29:35'),(2041,'antibiotics, supportive ttt',5230,NULL,37.0,79133,2319,2319,'2022-08-29 09:33:45','2022-08-29 09:33:45'),(2042,'antibiotics, cpap, supportive ttt',5233,NULL,37.0,79133,2319,2319,'2022-08-29 09:34:30','2022-08-29 09:34:30'),(2043,'do ammonia, lactate, pyruvate\r\ndo extende metabolic screen\r\ndo urine organic acids\r\nif any stress occured in the form of infection losses, reducing oral feeding --> instruct the mother to seek medical advice and withdraw ABG, anion gap, RBS, urine ketones, ammonia, lactate and pyruvate and start IVF , STOPfeeding and reconsult again\r\nstart carnitine 100mg/kg/dfay\r\ncoenzyme Qcap once daily\r\nepicozyme 5cm/12h\r\nbiotin forte cap once daily',4686,NULL,37.0,79093,1496,1496,'2022-08-29 09:36:42','2022-08-29 09:36:42'),(2044,NULL,5086,NULL,37.0,79075,966,966,'2022-08-29 09:43:44','2022-08-29 09:43:44'),(2045,'TSH\r\nthyroid ultrasoun',5167,'l thyroxine',37.0,79069,2298,2298,'2022-08-29 09:47:26','2022-08-29 09:47:26'),(2046,NULL,5088,NULL,37.0,79075,966,966,'2022-08-29 09:47:36','2022-08-29 09:47:36'),(2047,'oncological referal',5106,NULL,37.0,79089,2302,2302,'2022-08-29 09:52:35','2022-08-29 09:52:35'),(2048,NULL,5159,NULL,37.0,79090,1126,1126,'2022-08-29 09:53:29','2022-08-29 09:53:29'),(2049,NULL,5190,NULL,37.0,79142,1854,1854,'2022-08-29 09:55:38','2022-08-29 09:55:38'),(2050,'antibiotics, o2 support',5144,NULL,37.0,79136,2319,2319,'2022-08-29 09:57:16','2022-08-29 09:57:16'),(2051,NULL,5152,NULL,37.0,79090,1126,1126,'2022-08-29 09:57:28','2022-08-29 09:57:28'),(2052,NULL,5086,NULL,37.0,78075,966,966,'2022-08-29 09:57:32','2022-08-29 09:57:32'),(2053,'antibiotics, supportive ttt',5141,NULL,37.0,79136,2319,2319,'2022-08-29 09:58:05','2022-08-29 09:58:05'),(2054,'photo, feedeing',5142,NULL,37.0,79136,2319,2319,'2022-08-29 09:58:45','2022-08-29 09:58:45'),(2055,'antibiotics,o2 support, nebulization',5146,NULL,37.0,79136,2319,2319,'2022-08-29 09:59:37','2022-08-29 09:59:37'),(2056,'photo, feeding',5145,NULL,37.0,79136,2319,2319,'2022-08-29 10:00:11','2022-08-29 10:00:11'),(2057,NULL,5157,NULL,37.0,79090,1126,1126,'2022-08-29 10:01:17','2022-08-29 10:01:17'),(2058,NULL,5161,NULL,37.0,79090,1126,1126,'2022-08-29 10:03:57','2022-08-29 10:03:57'),(2059,'open the wound for drainage - culture & sensitivity from bus',5081,'continue tavanic - add alpha clindamycin to cover gram positive & anaerobic infection',37.0,79141,1609,1609,'2022-08-29 10:04:13','2022-08-29 10:04:13'),(2060,NULL,5016,NULL,37.0,79090,1126,1126,'2022-08-29 10:05:02','2022-08-29 10:05:02'),(2061,NULL,5299,NULL,37.0,79147,1854,1854,'2022-08-29 10:07:12','2022-08-29 10:07:12'),(2062,NULL,5304,NULL,37.0,79147,1854,1854,'2022-08-29 10:07:31','2022-08-29 10:07:31'),(2063,'photo, feeding',5185,NULL,37.0,79163,2319,2319,'2022-08-29 10:10:14','2022-08-29 10:10:14'),(2064,NULL,2972,'the patient needs biopsy',37.0,79156,1680,1680,'2022-08-29 10:10:31','2022-08-29 10:10:31'),(2065,'antibiotics, o2',5187,NULL,37.0,79163,2319,2319,'2022-08-29 10:11:05','2022-08-29 10:11:05'),(2066,'complete investigations of sarcoidosis: serum Ca,AcE ,CD4/CD8 in BAL\r\nSputum smear for fungal infection\r\ncollagen profile\r\nbroad spectrum antibiotics',5105,NULL,37.0,79089,2302,2302,'2022-08-29 10:11:16','2022-08-29 10:11:16'),(2067,'antibiotics, feeding,o2',5189,NULL,37.0,79163,2319,2319,'2022-08-29 10:11:33','2022-08-29 10:11:33'),(2068,'photo, feeding',5324,NULL,37.0,79163,2319,2319,'2022-08-29 10:11:58','2022-08-29 10:11:58'),(2069,'core biopsy from hypoehoic breast lesion for histopathological examinatio',5082,NULL,37.0,79153,1041,1041,'2022-08-29 10:13:11','2022-08-29 10:13:11'),(2070,NULL,5039,'topical steroid and topical antihistamine one week and follow',37.0,79156,1680,1680,'2022-08-29 10:14:30','2022-08-29 10:14:30'),(2071,NULL,5001,NULL,37.0,79169,2325,2325,'2022-08-29 10:18:14','2022-08-29 10:18:14'),(2072,'follow up on uop and s creat\r\nfu on cultures',5001,NULL,37.0,79169,2325,2325,'2022-08-29 10:20:00','2022-08-29 10:20:00'),(2073,'antibiotics, o2 support , nebulization',5155,NULL,37.0,79139,2319,2319,'2022-08-29 10:27:03','2022-08-29 10:27:03'),(2074,'photo',5157,NULL,37.0,79139,2319,2319,'2022-08-29 10:27:45','2022-08-29 10:27:45'),(2075,'photo',5156,NULL,37.0,79139,2319,2319,'2022-08-29 10:28:29','2022-08-29 10:28:29'),(2076,NULL,3526,NULL,37.0,79144,1854,1854,'2022-08-29 10:28:39','2022-08-29 10:28:39'),(2077,'antibiotics, o2 ,supportive',5154,NULL,37.0,79139,2319,2319,'2022-08-29 10:29:30','2022-08-29 10:29:30'),(2078,'VASCULAR CONSULTATION',3852,'tryptizole 25',37.0,79077,966,966,'2022-08-29 10:30:57','2022-08-29 10:30:57'),(2079,'no emergency to start chemotherapy as patient on palliative ttt correct general condition till covid ulture negatve and then possibility to reicieve radiotherapy bone',4886,NULL,37.0,79154,1041,1041,'2022-08-29 10:32:23','2022-08-29 10:32:23'),(2080,'glycerin soap',4894,'vaseline lotion dermovate cr analarge tab',37.0,79158,1680,1680,'2022-08-29 10:38:00','2022-08-29 10:38:00'),(2081,'PSYCHATRY CONSULTATION',5076,NULL,37.0,79174,966,966,'2022-08-29 10:44:42','2022-08-29 10:44:42'),(2082,'blood film+- bone marrow aspiration and immuneophenotyping......if negative gop for ore or lymph node excision biopsy....RECOMMENDATION: trasfer to ONOLOGY and Hematology Department to omplee workup and proper management',4099,NULL,37.0,79154,1041,1041,'2022-08-29 10:44:45','2022-08-29 10:44:45'),(2083,'csf analysis icp measure',5339,NULL,37.0,79169,2325,2325,'2022-08-29 10:45:11','2022-08-29 10:45:11'),(2084,'DIETRY CONTROL , SALT FREE',5077,NULL,37.0,79174,966,966,'2022-08-29 10:45:48','2022-08-29 10:45:48'),(2085,NULL,4784,'adapalene gel topical steroid borgazone cr and keratolytic مره مساء',37.0,79159,1680,1680,'2022-08-29 10:46:08','2022-08-29 10:46:08'),(2086,'lymph node biopsy\r\nblood lympoma',5350,NULL,37.0,79176,2325,2325,'2022-08-29 10:51:28','2022-08-29 10:51:28'),(2087,NULL,5125,'SUPPORTIVE TREATMENT',37.0,79172,1747,1747,'2022-08-29 10:55:40','2022-08-29 10:55:40'),(2088,NULL,5049,'neupulizer ,short couse steroid',37.0,79175,1548,1548,'2022-08-29 10:57:20','2022-08-29 10:57:20'),(2089,'ضرورة عرض المريضة علي اخصائي القلب وعمل موجات ايكو لاستبعاد وجود التهاب بالقلب \r\nضرورة عمل موجات صوتية دقيقة للمريضة لمعرفة طبيعة الاكياس المةجةدة بالمبيض \r\nالتوصية بعمل MRI pelvis  للمريضة \r\nالمتابعة الدقيقة للمريضة حيث انها تعتبر حالة غير مستقرة',5044,'triple antibiotics',39.0,79126,2315,2315,'2022-08-29 10:58:03','2022-08-29 10:58:03'),(2090,NULL,5051,'neubulizer .zithromax',37.0,79175,1548,1548,'2022-08-29 10:58:42','2022-08-29 10:58:42'),(2091,'csf analysis',5344,NULL,37.0,79176,2325,2325,'2022-08-29 10:59:40','2022-08-29 10:59:40'),(2092,NULL,5053,'antibiotic ,neubulizer',37.0,79175,1548,1548,'2022-08-29 10:59:50','2022-08-29 10:59:50'),(2093,NULL,5298,NULL,37.0,79161,1680,1680,'2022-08-29 11:00:43','2022-08-29 11:00:43'),(2094,NULL,5055,'iv fluid ,nanazoid,zinc origin',37.0,79175,1548,1548,'2022-08-29 11:01:02','2022-08-29 11:01:02'),(2095,NULL,5058,'neupulizer ,short couse steroid,antibiotics',37.0,79175,1548,1548,'2022-08-29 11:02:06','2022-08-29 11:02:06'),(2096,'lwork up echo',5331,NULL,37.0,79176,2325,2325,'2022-08-29 11:04:04','2022-08-29 11:04:04'),(2097,'avoid sun exposure',5302,'lovir 400 ثلاث مرات يوميا zovirax cream',37.0,79161,1680,1680,'2022-08-29 11:06:00','2022-08-29 11:06:00'),(2098,'PCI',5113,NULL,37.0,79071,2299,2299,'2022-08-29 11:07:44','2022-08-29 11:07:44'),(2099,'enzymes',5116,NULL,37.0,79071,2299,2299,'2022-08-29 11:08:17','2022-08-29 11:08:17'),(2100,'PCI',5117,NULL,37.0,79071,2299,2299,'2022-08-29 11:08:48','2022-08-29 11:08:48'),(2101,'Echocardiography\r\nFollow-up INR & Hb level',5224,'Rivarospire 15mg tab once daily',37.0,79122,2086,2086,'2022-08-29 11:10:23','2022-08-29 11:10:23'),(2102,'gradual withdrawal after improvement follow up after 3 week',5092,'treczimous cr antox tab once daily methabiogen 8mg once two days weekly contorloc  once',37.0,79162,1680,1680,'2022-08-29 11:11:24','2022-08-29 11:11:24'),(2103,'pelivabdominal ultrasound and pancreatic enzymes',5200,'proton pump inhipitors',37.0,79171,1747,1747,'2022-08-29 11:14:30','2022-08-29 11:14:30'),(2104,NULL,5209,'calcium channel blocker',37.0,79171,1747,1747,'2022-08-29 11:16:09','2022-08-29 11:16:09'),(2105,'Echocardiography\r\nIV fluids if CVP less than 20 with hypotension',5279,NULL,37.0,79122,2086,2086,'2022-08-29 11:18:56','2022-08-29 11:18:56'),(2106,'increase the dose of steroids \r\nno need for double antibiotics \r\ncontinue steroid nebulization',5096,NULL,37.0,79185,2307,2307,'2022-08-29 11:27:25','2022-08-29 11:27:25'),(2107,'the patient was already discharged at the session time',5098,NULL,37.0,79185,2307,2307,'2022-08-29 11:28:15','2022-08-29 11:28:15'),(2108,'pelviabdominal ultrasound widal and Brucella test',4773,'antispasmodic with ppi',37.0,79173,1747,1747,'2022-08-29 11:28:37','2022-08-29 11:28:37'),(2109,'STRICT LIFESTYLE MODIFICATION\r\nFollow-up at aoutpatient cardiology clinic',5194,'Intensive anti-ischemic TTT',37.0,79181,2086,2086,'2022-08-29 11:28:41','2022-08-29 11:28:41'),(2110,'for CXR and CBC \r\nstop steroids \r\nuse single agent antibiotic when indicated',5099,NULL,37.0,79185,2307,2307,'2022-08-29 11:30:16','2022-08-29 11:30:16'),(2111,'antibiotic should be used wisely \r\nsteroids should not be added without indications\r\nCXR is recommended',5102,NULL,37.0,79185,2307,2307,'2022-08-29 11:31:43','2022-08-29 11:31:43'),(2112,'no need for antibiotics \r\nadequate hydration',5104,NULL,37.0,79185,2307,2307,'2022-08-29 11:32:52','2022-08-29 11:32:52'),(2113,'AFP SERUM ALBUMIN',5213,'frequent paracentesis with albumin replacment',37.0,79182,1747,1747,'2022-08-29 11:34:31','2022-08-29 11:34:31'),(2114,NULL,5122,'imporved for discharge',37.0,79166,1548,1548,'2022-08-29 11:36:41','2022-08-29 11:36:41'),(2115,'CT CHEST ABDOMINAL ULTRASOUND',5118,'PARACENTESIS WITH ALBUMIN',37.0,79184,1747,1747,'2022-08-29 11:51:09','2022-08-29 11:51:09'),(2116,'Requested::::\r\nProtein C\r\nProtein S\r\nAntithrombin III\r\nFactor V Leiden',5492,'Anticoagulant',37.0,79206,2345,2345,'2022-08-30 07:47:27','2022-08-30 07:47:27'),(2117,'CT abdomen',3107,'imoflora+ vancomycin oral',37.0,79206,2345,2345,'2022-08-30 07:53:01','2022-08-30 07:53:01'),(2118,'MRCP+CT abdomen \r\nALK phosphatase \r\nGGT\r\nRyle insertion',5291,NULL,37.0,79208,2345,2345,'2022-08-30 08:07:57','2022-08-30 08:07:57'),(2119,'MRI LUMBOSACRAL SPINE',4957,NULL,37.0,79239,1810,1810,'2022-08-30 08:16:53','2022-08-30 08:16:53'),(2120,'follow up Ct  brain \r\nCD\r\nECHO',5127,NULL,37.0,79274,2067,2067,'2022-08-30 08:21:51','2022-08-30 08:21:51'),(2121,'CT LUUMBOSACRAL SPINE',5401,NULL,37.0,79240,1810,1810,'2022-08-30 08:24:10','2022-08-30 08:24:10'),(2122,'Triphasic CT abdomen \r\nRefer to Liver Transplant Center',5280,NULL,37.0,79284,2345,2345,'2022-08-30 08:26:01','2022-08-30 08:26:01'),(2123,NULL,5542,NULL,37.0,79282,1862,1862,'2022-08-30 08:31:38','2022-08-30 08:31:38'),(2124,'MRI AND CT SHOULDER',5322,NULL,37.0,79241,1810,1810,'2022-08-30 08:35:19','2022-08-30 08:35:19'),(2125,NULL,5547,NULL,37.0,79282,1862,1862,'2022-08-30 08:35:43','2022-08-30 08:35:43'),(2126,'follow up CL,proper hydration, gradual correction of hyponatremia,anti dementia ttt',5129,NULL,37.0,79274,2067,2067,'2022-08-30 08:38:45','2022-08-30 08:38:45'),(2127,NULL,5543,NULL,37.0,79282,1862,1862,'2022-08-30 08:39:44','2022-08-30 08:39:44'),(2128,'Gene xpert and culture and sensitivity for TB',5328,'Start anti tuberculous regimen. Rifampicinn , Isoniazide, ethambutol and pyrazinamide for  2 months followed by rifampin and isoniazide for 2 months',38.0,79199,2046,2046,'2022-08-30 08:40:36','2022-08-30 08:40:36'),(2129,NULL,5507,NULL,37.0,79215,2346,2346,'2022-08-30 08:41:14','2022-08-30 08:41:14'),(2130,NULL,5548,NULL,37.0,79282,1862,1862,'2022-08-30 08:42:45','2022-08-30 08:42:45'),(2131,'PCR for COVID diagnosis',5206,'Continue on the same regimen',37.0,79199,2046,2046,'2022-08-30 08:45:05','2022-08-30 08:45:05'),(2132,'CT brain',5131,NULL,37.0,79274,2067,2067,'2022-08-30 08:46:08','2022-08-30 08:46:08'),(2133,'ct with contrasr pelviabdominal',5509,NULL,37.0,79215,2346,2346,'2022-08-30 08:46:38','2022-08-30 08:46:38'),(2134,'PCR for covid',5312,'Continue on same regimen',37.0,79199,2046,2046,'2022-08-30 08:47:57','2022-08-30 08:47:57'),(2135,'X RAY AP STANDINING BOTH KNEE',5589,NULL,37.0,79243,1810,1810,'2022-08-30 08:49:20','2022-08-30 08:49:20'),(2136,'PCR for covid',5300,'Continue on same regimen',37.0,79199,2046,2046,'2022-08-30 08:49:48','2022-08-30 08:49:48'),(2137,'repeat tube culture\r\ndo abdominal us\r\nadd tasocin replace sulprazone\r\nrepeat creat everyday',5466,NULL,37.0,79285,1682,1682,'2022-08-30 08:51:00','2022-08-30 08:51:00'),(2138,NULL,5513,NULL,37.0,79215,2346,2346,'2022-08-30 08:51:45','2022-08-30 08:51:45'),(2139,'LN biopsy',5319,NULL,37.0,79199,2046,2046,'2022-08-30 08:54:36','2022-08-30 08:54:36'),(2140,'SUPPORTIVE ttt',5516,NULL,37.0,79215,2346,2346,'2022-08-30 08:54:55','2022-08-30 08:54:55'),(2141,'stool analysis\r\nph and occult blood in stool\r\nadd tazocin',5465,NULL,37.0,79285,1682,1682,'2022-08-30 08:56:52','2022-08-30 08:56:52'),(2142,NULL,5083,NULL,37.0,79279,1862,1862,'2022-08-30 08:58:04','2022-08-30 08:58:04'),(2143,NULL,5084,NULL,37.0,79279,1862,1862,'2022-08-30 08:58:24','2022-08-30 08:58:24'),(2144,'do ionized calcium\r\nstart feeding\r\n4 cm every 3 hours',5463,NULL,37.0,79285,1682,1682,'2022-08-30 08:59:07','2022-08-30 08:59:07'),(2145,NULL,5085,NULL,37.0,79279,1862,1862,'2022-08-30 09:00:49','2022-08-30 09:00:49'),(2146,'discharge and follow up with pediatric nutrition',4785,NULL,37.0,79287,1682,1682,'2022-08-30 09:05:57','2022-08-30 09:05:57'),(2147,NULL,5500,NULL,37.0,79217,2346,2346,'2022-08-30 09:09:22','2022-08-30 09:09:22'),(2148,NULL,5577,NULL,37.0,79277,1862,1862,'2022-08-30 09:09:24','2022-08-30 09:09:24'),(2149,NULL,5581,'NS',37.0,79277,1862,1862,'2022-08-30 09:11:10','2022-08-30 09:11:10'),(2150,NULL,5583,NULL,37.0,79277,1862,1862,'2022-08-30 09:12:25','2022-08-30 09:12:25'),(2151,NULL,5586,NULL,37.0,79277,1862,1862,'2022-08-30 09:16:48','2022-08-30 09:16:48'),(2152,'surgical consultation\r\ndo echo\r\ntransfuse platlets\r\nadd levofloxacin',4787,NULL,37.0,79287,1682,1682,'2022-08-30 09:16:52','2022-08-30 09:16:52'),(2153,'stop meronem\r\nadd dobutrex\r\ndo pt',4788,NULL,37.0,79287,1682,1682,'2022-08-30 09:23:33','2022-08-30 09:23:33'),(2154,'24h urinary protein\r\nupper git endoscope',5498,NULL,37.0,79217,2346,2346,'2022-08-30 09:26:37','2022-08-30 09:26:37'),(2155,'الاستمرار على العلاج الحالي مع المتابعه المستمره',5354,NULL,37.0,79288,1290,1290,'2022-08-30 09:27:03','2022-08-30 09:27:03'),(2156,'continue antibiotics\r\noral tiratam\r\nwithdrawl of epanutin',4789,NULL,37.0,79287,1682,1682,'2022-08-30 09:28:25','2022-08-30 09:28:25'),(2157,'abdominal ultrasound',5589,'omeprasol 20 mg tab-dysflatyle tab',37.0,79265,2353,2353,'2022-08-30 09:28:49','2022-08-30 09:28:49'),(2158,NULL,5515,'garamycin cream',37.0,79309,835,835,'2022-08-30 09:29:51','2022-08-30 09:29:51'),(2159,NULL,5255,NULL,37.0,79280,1862,1862,'2022-08-30 09:30:28','2022-08-30 09:30:28'),(2160,NULL,5090,NULL,37.0,79300,2362,2362,'2022-08-30 09:32:12','2022-08-30 09:32:12'),(2161,NULL,5080,NULL,37.0,79269,1007,1007,'2022-08-30 09:34:42','2022-08-30 09:34:42'),(2162,NULL,5562,'perderm cream and sun block',37.0,79309,835,835,'2022-08-30 09:34:56','2022-08-30 09:34:56'),(2163,'Treatment',4308,NULL,37.0,79300,2362,2362,'2022-08-30 09:35:49','2022-08-30 09:35:49'),(2164,'add dubetrex\r\nstop meronem\r\ndo tube culture\r\nrevise blood culture',4801,NULL,37.0,79287,1682,1682,'2022-08-30 09:35:57','2022-08-30 09:35:57'),(2165,NULL,5364,NULL,37.0,79220,2346,2346,'2022-08-30 09:37:00','2022-08-30 09:37:00'),(2166,'treatment',5089,NULL,37.0,79300,2362,2362,'2022-08-30 09:37:08','2022-08-30 09:37:08'),(2167,NULL,5366,NULL,37.0,79220,2346,2346,'2022-08-30 09:37:27','2022-08-30 09:37:27'),(2168,'observe weight until 1600 gm',4877,NULL,37.0,79287,1682,1682,'2022-08-30 09:37:39','2022-08-30 09:37:39'),(2169,NULL,5368,NULL,37.0,79220,2346,2346,'2022-08-30 09:37:59','2022-08-30 09:37:59'),(2170,'treatment',5069,NULL,37.0,79300,2362,2362,'2022-08-30 09:38:43','2022-08-30 09:38:43'),(2171,NULL,5602,'STEROID AND ASH',37.0,79309,835,835,'2022-08-30 09:38:51','2022-08-30 09:38:51'),(2172,'continue antibiotics and progress feedin',5533,NULL,37.0,79287,1682,1682,'2022-08-30 09:39:06','2022-08-30 09:39:06'),(2173,NULL,5611,'ASSURANCE',37.0,79309,835,835,'2022-08-30 09:46:17','2022-08-30 09:46:17'),(2174,NULL,5619,'ASSURANCE',37.0,79309,835,835,'2022-08-30 09:48:48','2022-08-30 09:48:48'),(2175,'give alveofact vial 108 mg\r\nadd tasocin\r\nstop amikin stop colistin\r\ndo xray and echo',5393,NULL,37.0,79291,1682,1682,'2022-08-30 09:50:05','2022-08-30 09:50:05'),(2176,'MDCT with contrast- Echocardiography',5433,NULL,37.0,79202,2046,2046,'2022-08-30 09:51:20','2022-08-30 09:51:20'),(2177,'follow up total calcium , phosphorus , vitamin d , PTH & Mg',5499,'alfacalcidol & calcium',37.0,79229,1861,1861,'2022-08-30 09:51:24','2022-08-30 09:51:24'),(2178,NULL,5654,'ANTIHISTAMINE',37.0,79307,835,835,'2022-08-30 09:52:06','2022-08-30 09:52:06'),(2179,NULL,1317,'BORGASONE',37.0,79307,835,835,'2022-08-30 09:54:17','2022-08-30 09:54:17'),(2180,'add motilium danset\r\nabdominal us',5502,NULL,37.0,79291,1682,1682,'2022-08-30 09:55:35','2022-08-30 09:55:35'),(2181,NULL,5650,'MUPIRAX',37.0,79307,835,835,'2022-08-30 09:57:28','2022-08-30 09:57:28'),(2182,'BAL with gene expert with culture and sensitivity for TB and fungal culture',5437,'Continue on the same regimen till appearence of investigation results',37.0,79202,2046,2046,'2022-08-30 09:58:33','2022-08-30 09:58:33'),(2183,'stop tigycline\r\nadd tazocin\r\nand regmin of  BPD\r\nprogress feeding\r\nfundus examinatin\r\nmri\r\naudiometry',5506,NULL,37.0,79291,1682,1682,'2022-08-30 10:01:21','2022-08-30 10:01:21'),(2184,'cinacalcit + calcium+ VIt D',5447,NULL,37.0,79298,1802,1802,'2022-08-30 10:04:27','2022-08-30 10:04:27'),(2185,NULL,5652,'FUSIZON',37.0,79310,835,835,'2022-08-30 10:06:08','2022-08-30 10:06:08'),(2186,NULL,4983,NULL,37.0,79249,2349,2349,'2022-08-30 10:06:19','2022-08-30 10:06:19'),(2187,'CT guided or bronchoscopic biopsy',5428,NULL,37.0,79202,2046,2046,'2022-08-30 10:06:45','2022-08-30 10:06:45'),(2188,NULL,5084,'PREDNISOLONE',37.0,79310,835,835,'2022-08-30 10:08:20','2022-08-30 10:08:20'),(2189,'dentist consultation',4647,NULL,37.0,79249,2349,2349,'2022-08-30 10:08:59','2022-08-30 10:08:59'),(2190,'EEG\r\nammonia and lactate\r\nmetabolic screening\r\nupgrade  dose of vanco and meronam\r\nrevise blood and csf culture',5518,NULL,37.0,79291,1682,1682,'2022-08-30 10:09:16','2022-08-30 10:09:16'),(2191,'erythropoitin + folic + Vit B12',5449,NULL,37.0,79298,1802,1802,'2022-08-30 10:10:43','2022-08-30 10:10:43'),(2192,'erythropoitin + folic + Vit B12',5449,NULL,37.0,79298,1802,1802,'2022-08-30 10:10:43','2022-08-30 10:10:43'),(2193,NULL,4894,'solupred 20 mg for 5 days then 10 mg for 5days',37.0,79249,2349,2349,'2022-08-30 10:12:28','2022-08-30 10:12:28'),(2194,'Sputum culture and sensitivity. Chest ultrasound and diagnostic aspiration of pleural effusion if present',5419,'Add clindamycin and metronidazole',37.0,79202,2046,2046,'2022-08-30 10:15:58','2022-08-30 10:15:58'),(2195,'decrease phosphorus +increase Ca INTAKE+ antihistaminic+cevlamer',5453,NULL,37.0,79298,1802,1802,'2022-08-30 10:16:30','2022-08-30 10:16:30'),(2196,NULL,3142,NULL,37.0,79271,2354,2354,'2022-08-30 10:17:02','2022-08-30 10:17:02'),(2197,NULL,5372,NULL,37.0,79249,2349,2349,'2022-08-30 10:17:28','2022-08-30 10:17:28'),(2198,'for RC if low for BMA if high for Coombs tes \r\nAbdominal Us',4951,NULL,37.0,79234,1861,1861,'2022-08-30 10:18:10','2022-08-30 10:18:10'),(2199,'blood culture\r\nblood film\r\nstart feeding gradual\r\nand restrict fluid\r\nfever chart',5541,NULL,37.0,79318,2371,2371,'2022-08-30 10:20:02','2022-08-30 10:20:02'),(2200,NULL,5376,NULL,37.0,79249,2349,2349,'2022-08-30 10:20:23','2022-08-30 10:20:23'),(2201,'NCT then possiblity of bone scan',5438,NULL,37.0,79298,1802,1802,'2022-08-30 10:22:32','2022-08-30 10:22:32'),(2202,NULL,5556,'cryotherapy ,',37.0,79313,1610,1610,'2022-08-30 10:22:46','2022-08-30 10:22:46'),(2203,'Newclave 642 mg\r\nmaxilase \r\nrhinocalm',5378,NULL,37.0,79249,2349,2349,'2022-08-30 10:23:10','2022-08-30 10:23:10'),(2204,'gradual withdrawl of fluid\r\nstart feeding\r\ncontinue nebulization',5544,NULL,37.0,79318,2371,2371,'2022-08-30 10:23:22','2022-08-30 10:23:22'),(2205,NULL,5388,'DOXYCOST',37.0,79331,835,835,'2022-08-30 10:24:45','2022-08-30 10:24:45'),(2206,'+ 100 cc for every rise of body temp.\r\n\r\nfluid balance  : fliud intake=urine output+ 200 cc/ 6hr\r\navoid nephrotoxic drugs, give modified dose of antibiotic according to cr.clearsnce',5307,NULL,37.0,79322,1826,1826,'2022-08-30 10:25:07','2022-08-30 10:25:07'),(2207,'neck us sestimi scan',4952,NULL,37.0,79234,1861,1861,'2022-08-30 10:25:34','2022-08-30 10:25:34'),(2208,'IMMUNOLOGIC PROFILE :\r\nSERUM IMMUNOGLOBULINS AND CD MARKERS \r\nESR AND TUBERCULIN TEST',2237,NULL,37.0,79228,1087,1087,'2022-08-30 10:26:56','2022-08-30 10:26:56'),(2209,NULL,5389,'ANTIHISTAMINE',37.0,79331,835,835,'2022-08-30 10:27:51','2022-08-30 10:27:51'),(2210,'RETICULOCTE COUNT \r\nBLEEDING PROFILE \r\nEXCLUDE RENAL CAUSE BY IMAGING',5545,'VS HEMOLYTIC ANEMIA',37.0,79228,1087,1087,'2022-08-30 10:29:06','2022-08-30 10:29:06'),(2211,'neck us sestimibi scan',4951,NULL,37.0,79234,1861,1861,'2022-08-30 10:30:12','2022-08-30 10:30:12'),(2212,NULL,5551,'nizapex shampoo difflucan tab two cap weekly for one month  lamisil cr twice daily',37.0,79314,1610,1610,'2022-08-30 10:30:44','2022-08-30 10:30:44'),(2213,'anti ishemic measures + with good UF + anti arrthymic druges',5458,NULL,37.0,79298,1802,1802,'2022-08-30 10:30:46','2022-08-30 10:30:46'),(2214,'Referral for CT guided malignany. If impossible refer for bronchoscopic biopsy',2707,NULL,37.0,79202,2046,2046,'2022-08-30 10:33:35','2022-08-30 10:33:35'),(2215,'for iron study, if normal strat erythropiotin + vit. B12+ folic acid',5495,NULL,37.0,79323,1826,1826,'2022-08-30 10:34:03','2022-08-30 10:34:03'),(2216,'CT petrous bone coronal and axial cut 1mm',5327,'dropiflox ED 3 times per day',37.0,79248,2349,2349,'2022-08-30 10:34:18','2022-08-30 10:34:18'),(2217,NULL,5369,'SUPPORTIVE TT',37.0,79332,835,835,'2022-08-30 10:34:31','2022-08-30 10:34:31'),(2218,'betaderm cream',5207,NULL,37.0,79304,2364,2364,'2022-08-30 10:36:29','2022-08-30 10:36:29'),(2219,NULL,5313,'METHOTREXATE',37.0,79332,835,835,'2022-08-30 10:36:49','2022-08-30 10:36:49'),(2220,'continue feeding\r\ncontinue nebulization',5550,NULL,37.0,79318,2371,2371,'2022-08-30 10:38:11','2022-08-30 10:38:11'),(2221,'electrolytes level revision\r\ncontinue treatment',5521,NULL,37.0,79318,2371,2371,'2022-08-30 10:40:03','2022-08-30 10:40:03'),(2222,NULL,5249,'CAUTERY',37.0,79332,835,835,'2022-08-30 10:40:04','2022-08-30 10:40:04'),(2223,'dobutatmine stress Echo',5560,'beta blocker Marivan',37.0,79327,2373,2373,'2022-08-30 10:41:55','2022-08-30 10:41:55'),(2224,NULL,5250,'systemic and topical antibiotics',37.0,79304,2364,2364,'2022-08-30 10:42:16','2022-08-30 10:42:16'),(2225,'gluteal abcess needs surgery',5050,'hibiotic for one week k permanganate 1-8000 thrice daily topical antibiotic for one week',37.0,79315,1610,1610,'2022-08-30 10:42:49','2022-08-30 10:42:49'),(2226,NULL,5384,'TEST LASER',37.0,79332,835,835,'2022-08-30 10:43:02','2022-08-30 10:43:02'),(2227,NULL,5054,NULL,37.0,79315,1610,1610,'2022-08-30 10:43:26','2022-08-30 10:43:26'),(2228,NULL,5554,'marivan',37.0,79327,2373,2373,'2022-08-30 10:44:56','2022-08-30 10:44:56'),(2229,'to be sure of volume status, if auvolimic do dynamic renogram if not obestructed do renal biopsy\r\npossible diagnosis  ATN OR  INTERSTITIAL NEPHRITIS',5655,NULL,37.0,79324,1826,1826,'2022-08-30 10:46:01','2022-08-30 10:46:01'),(2230,NULL,5391,'perderm cream and sun block',37.0,79332,835,835,'2022-08-30 10:46:58','2022-08-30 10:46:58'),(2231,'nail scrapimg,culture and sensitivity',5256,NULL,37.0,79304,2364,2364,'2022-08-30 10:46:59','2022-08-30 10:46:59'),(2232,NULL,5391,'perderm cream and sun block',37.0,79332,835,835,'2022-08-30 10:47:02','2022-08-30 10:47:02'),(2233,NULL,5686,NULL,37.0,79327,2373,2373,'2022-08-30 10:47:38','2022-08-30 10:47:38'),(2234,NULL,5687,NULL,37.0,79327,2373,2373,'2022-08-30 10:50:21','2022-08-30 10:50:21'),(2235,'BE SURE OF NORMAL PHOSPHORUS LEVEL AND EFFECACY OF HEMODIALYSIS AND NO DRYNESS OF SKIN THEN REFER TO DERMATOLOGY',5613,NULL,37.0,79325,1826,1826,'2022-08-30 10:52:01','2022-08-30 10:52:01'),(2236,'HEPARIN INDUCED THROMBOCYTOPENIA FOR HEPARINE FREE DIALYSIS',5616,NULL,37.0,79325,1826,1826,'2022-08-30 10:57:19','2022-08-30 10:57:19'),(2237,NULL,5497,NULL,37.0,79328,2373,2373,'2022-08-30 11:00:41','2022-08-30 11:00:41'),(2238,'IN hemodialysis avoid salt rich food, encourage weight loss, instruct him to decrease fluid intake between dialysis session below 2 kg',5620,NULL,37.0,79325,1826,1826,'2022-08-30 11:01:19','2022-08-30 11:01:19'),(2239,'Biopsy is needed',5659,'carbamide cr diacalderm cr for one month',37.0,79316,1610,1610,'2022-08-30 11:02:03','2022-08-30 11:02:03'),(2240,NULL,5668,NULL,37.0,79329,2371,2371,'2022-08-30 11:02:40','2022-08-30 11:02:40'),(2241,'monitor urine output , ABG , BP , kidney functions , electrolytes, adjust fluid intake \r\ncorrect acidosis',5588,NULL,37.0,79235,1087,1087,'2022-08-30 11:04:54','2022-08-30 11:04:54'),(2242,'DD MF sarcoidosis pitryiasis alba biopsy is needed',5684,'biopsy',37.0,79316,1610,1610,'2022-08-30 11:05:33','2022-08-30 11:05:33'),(2243,'Start petaza again',3926,'pentaza and steroid',37.0,79195,1996,1996,'2022-08-30 11:06:30','2022-08-30 11:06:30'),(2244,'sure of iron storage, folic acid and vit B12 supplement then give erythropiotin',5623,NULL,37.0,79325,1826,1826,'2022-08-30 11:07:08','2022-08-30 11:07:08'),(2245,'anemia to be corrected by erythropiotin be sure of iron storage folic acid and vit B 12 supplement aviod epo resistance by correction of hyperparathyroidism',5626,NULL,37.0,79325,1826,1826,'2022-08-30 11:09:13','2022-08-30 11:09:13'),(2246,'follow up; vital signs, temp, cbc, urine analysis CRP. \r\n respiratory symptoms, GIT symptoms',5347,'antibiotics + antipyretics',38.5,79227,1876,1876,'2022-08-30 11:10:39','2022-08-30 11:10:39'),(2247,', crp wating resuts of cultures for blood film \r\ncytological analysis of pleural fluids \r\nfollow up with crp .cbc.chest x ray \r\ngood coverage with antibiotic \r\nfollow up with fever chart',5604,NULL,37.0,79320,2371,2371,'2022-08-30 11:11:28','2022-08-30 11:11:28'),(2248,NULL,5351,'pus drainage + antibiotics',37.0,79227,1876,1876,'2022-08-30 11:12:03','2022-08-30 11:12:03'),(2249,NULL,5523,'pus drainage + antibiotics',37.0,79227,1876,1876,'2022-08-30 11:13:06','2022-08-30 11:13:06'),(2250,'gradual withdrawal of fluids and progress of feeding \r\ninstruct mother for weaning \r\nnutritional support \r\niron herapy after control of infection',5606,NULL,37.0,79320,2371,2371,'2022-08-30 11:15:16','2022-08-30 11:15:16'),(2251,'follow  up echo',5386,NULL,37.0,79335,2376,2376,'2022-08-30 11:17:07','2022-08-30 11:17:07'),(2252,NULL,5468,NULL,37.0,79250,2232,2232,'2022-08-30 11:19:51','2022-08-30 11:19:51'),(2253,NULL,5470,NULL,37.0,79250,2232,2232,'2022-08-30 11:20:08','2022-08-30 11:20:08'),(2254,NULL,5348,NULL,38.5,79252,2232,2232,'2022-08-30 11:26:30','2022-08-30 11:26:30'),(2255,'for PDA stent vs BT shunt operation regarding the shape of the',4700,NULL,37.0,79338,2376,2376,'2022-08-30 11:29:52','2022-08-30 11:29:52'),(2256,'for improving effecacy of hemodialysis',5247,NULL,37.0,79326,1826,1826,'2022-08-30 11:31:03','2022-08-30 11:31:03'),(2257,'avoid excessive water wear cotton',5717,'emolient as heel forte twice daily betaval cr twice daily one week',37.0,79317,1610,1610,'2022-08-30 11:36:56','2022-08-30 11:36:56'),(2258,'follow up cbc ESR',4887,NULL,37.0,79340,2376,2376,'2022-08-30 11:41:57','2022-08-30 11:41:57'),(2259,'add piperacillin tazobactam\r\nconsider colistin',5400,NULL,37.0,79236,1087,1087,'2022-08-30 11:42:10','2022-08-30 11:42:10'),(2260,'FOR vit. D3 level\r\ncalcuim carbonate supplement 1 hr before or 2 hr after meal\r\nalpha calcedol supplement 2 micro after every HD session',5706,NULL,37.0,79326,1826,1826,'2022-08-30 11:44:20','2022-08-30 11:44:20'),(2261,'for CBC with differential ESR antibiotics surgical consultations and reconsult',5316,NULL,37.0,79337,2376,2376,'2022-08-30 11:47:30','2022-08-30 11:47:30'),(2262,'treat drug addiction , refer to endoscopist for FOGD, avoid and treat  hypotension',5234,NULL,37.0,79326,1826,1826,'2022-08-30 11:52:09','2022-08-30 11:52:09'),(2263,'HEMODIALYSIS, INTENSIFY SESSION FOR BETTER EFFECACY',5241,NULL,37.0,79326,1826,1826,'2022-08-30 11:56:09','2022-08-30 11:56:09'),(2264,'FOR VIT. B complex , thitacid 300mg twice daily\r\ncorrection of hypocalcemia',5274,NULL,37.0,79326,1826,1826,'2022-08-30 12:04:52','2022-08-30 12:04:52'),(2265,'intensify hemodialysis effecacy',5287,NULL,37.0,79326,1826,1826,'2022-08-30 12:06:17','2022-08-30 12:06:17'),(2266,'for iron study, transferrin TIBC, Ferritin \r\nthen give erythropiotin after normalization of iron store + folic acid+ vit. B12',5311,NULL,37.0,79326,1826,1826,'2022-08-30 12:11:06','2022-08-30 12:11:06'),(2267,'IF NO RESPONCE REFER TO UROLOGIST FOR CYSTOSCOPY\r\nLEVOFLOXACIN 500MG AFTER EVERY HD SESSION',5317,NULL,37.0,79326,1826,1826,'2022-08-30 12:18:27','2022-08-30 12:18:27'),(2268,'CONTINUE ANTIISHEMIC MEASURES, AVOID AGGRESSIVE ULTRAFILTRATION DURING HD',5710,NULL,37.0,79326,1826,1826,'2022-08-30 12:20:34','2022-08-30 12:20:34'),(2269,'assess in 1st follow up visit for serum creatinine - abdominal ultrasound - radioisotope scan of renal function(renography)',3754,NULL,37.0,79343,1609,1609,'2022-08-30 13:03:54','2022-08-30 13:03:54'),(2270,'cardioembolic stroke in hypertensive patient, known AF. so it is recommended to be started on anticoagulant for secondary prophylaxis against stroke .the patient has lacunar infarction so it is accepted to start anticoagulant therapy after 3 days.',5688,'start anticoagulant after onset of stroke by 3 days',37.0,79342,2386,2386,'2022-08-30 13:25:07','2022-08-30 13:25:07'),(2271,NULL,5779,'nasal wash \\ multivitamens',37.0,79344,1128,1128,'2022-08-31 07:17:34','2022-08-31 07:17:34'),(2272,'flexible endoscopy stroposcope',5780,NULL,37.0,79344,1128,1128,'2022-08-31 07:24:30','2022-08-31 07:24:30'),(2273,NULL,5788,'Renal biopsy',37.0,79349,1938,1938,'2022-08-31 07:31:31','2022-08-31 07:31:31'),(2274,NULL,5793,'Upper and lower GIT endoscopy',37.0,79349,1938,1938,'2022-08-31 07:32:34','2022-08-31 07:32:34'),(2275,'excision',5781,NULL,37.0,79344,1128,1128,'2022-08-31 07:33:07','2022-08-31 07:33:07'),(2276,'continue ttt',5367,NULL,37.0,79345,1213,1213,'2022-08-31 07:36:37','2022-08-31 07:36:37'),(2277,'continue ttt',5370,NULL,37.0,79345,1213,1213,'2022-08-31 07:37:22','2022-08-31 07:37:22'),(2278,'tratment',5385,NULL,37.0,79345,1213,1213,'2022-08-31 07:37:56','2022-08-31 07:37:56'),(2279,'continue ttt',5539,NULL,37.0,79345,1213,1213,'2022-08-31 07:38:27','2022-08-31 07:38:27'),(2280,'start ttt',5656,NULL,37.0,79345,1213,1213,'2022-08-31 07:39:04','2022-08-31 07:39:04'),(2281,'histopathological  exam',5782,NULL,37.0,79344,1128,1128,'2022-08-31 07:41:31','2022-08-31 07:41:31'),(2282,'stop NOAcs ......previous echo if present .....examine lower limb for possible DVT ...CTPA when stabilizing',5776,'Clexane mg twice daily.....according to ideal body weight  +combination antibiotic covering ESBL',37.0,79348,2391,2391,'2022-08-31 07:44:56','2022-08-31 07:44:56'),(2283,'NEXIUM 40 MG TWICE DAILY BEFORE MEALS BY ONE HPOUR... ADD ITOPRIDE 50 MG tds.... if no improvement after 2 months upper endoscopy must be redone for biopsy from GERD...',5732,NULL,37.0,79358,2138,2138,'2022-08-31 07:46:20','2022-08-31 07:46:20'),(2284,'barium swallow',5783,NULL,37.0,79344,1128,1128,'2022-08-31 07:46:21','2022-08-31 07:46:21'),(2285,NULL,4356,'Vascular surgery/ CBC/ PT/PTT/BT/CT',37.0,79352,1938,1938,'2022-08-31 07:46:35','2022-08-31 07:46:35'),(2286,NULL,4358,'CA/PH/PTH',37.0,79352,1938,1938,'2022-08-31 07:47:06','2022-08-31 07:47:06'),(2287,NULL,4359,'HBA1C/ FOXIGA 10/ METFORMIN',37.0,79352,1938,1938,'2022-08-31 07:47:52','2022-08-31 07:47:52'),(2288,NULL,4361,'ESR/ CBC/ BLOOD FILM/ CA/ PH',37.0,79352,1938,1938,'2022-08-31 07:48:39','2022-08-31 07:48:39'),(2289,'switching to oral clarithro twice daily adjusted according to BWt for 14 days',5695,'Continue on same regimen',37.0,79351,2391,2391,'2022-08-31 07:52:47','2022-08-31 07:52:47'),(2290,'PURE TUNE AUDIOMETRY',5702,'NAVOPROXEN',37.0,79353,1128,1128,'2022-08-31 07:53:32','2022-08-31 07:53:32'),(2291,'UGIE\r\namylase, lipase',5481,'antibiotics, antiemetics, IV fluids, NPO',37.0,79389,889,889,'2022-08-31 07:54:50','2022-08-31 07:54:50'),(2292,'PURE TONE AUDIOGRAM TYMPANOGRAM',5723,NULL,37.0,79353,1128,1128,'2022-08-31 07:54:52','2022-08-31 07:54:52'),(2293,NULL,4741,'ECHO/URINE ANALYSIS/ FREQUENT NEUBILZERS/CT CHEST/BLOOD CUTURE/SPUTUM CULTURES',37.0,79355,1938,1938,'2022-08-31 07:59:46','2022-08-31 07:59:46'),(2294,'LAB INVESTIGATION',5724,'ANTIREFLUX \\ ANTIFUNGAL',37.0,79347,1128,1128,'2022-08-31 08:01:27','2022-08-31 08:01:27'),(2295,'occult blood in stool, abdominal ultrasound, ferritin, iron',5816,'blood transfusion',37.0,79398,889,889,'2022-08-31 08:02:06','2022-08-31 08:02:06'),(2296,'repeat PCR if no improvement ...continue on her LABA  ICS',5469,'oselttamivir plus clarithro',37.0,79351,2391,2391,'2022-08-31 08:02:54','2022-08-31 08:02:54'),(2297,'patient is now fully conscious... follow up serum K if still less than 3 mmol/l add 2 amp k in ringer every 12 h ... when k above 3 stop  k in ringer... upper endoscope must be performed before discharge... doppler on dilated veins in ant abdominal wall... aldactone 100 mg before discharge added with weekly follow up of edema and response to treatment.... inderal 20 mg every 12 h added before discharge if there is no peripheral vascular disease no asthma no bradycardia... follow up every 6 months by abdominal ultrasound and alpha feto protein',5807,NULL,37.0,79359,2138,2138,'2022-08-31 08:05:13','2022-08-31 08:05:13'),(2298,'monoclonal if confirmed 2nd PCR ......PET ct if persistant ct finding after 3wks ....',5471,'claithro  plus favipravir ......repeat PCR.....',37.0,79351,2391,2391,'2022-08-31 08:14:05','2022-08-31 08:14:05'),(2299,'continue the same regiemne and wait culture results',3879,NULL,37.0,79388,2395,2395,'2022-08-31 08:20:03','2022-08-31 08:20:03'),(2300,NULL,5448,'acei/ sglpt2',37.0,79355,1938,1938,'2022-08-31 08:25:49','2022-08-31 08:25:49'),(2301,'packed rbcs and wait culture result and continue same regieme',4255,NULL,37.0,79388,2395,2395,'2022-08-31 08:28:43','2022-08-31 08:28:43'),(2302,'serum miron, ferritin\r\nHB electrophoresis',5804,'blood transfusion',37.0,79394,889,889,'2022-08-31 08:30:16','2022-08-31 08:30:16'),(2303,'paus amylase and lipase     albumin creatinine ratio and urine analysis   cardiac consultation',5561,NULL,37.0,79388,2395,2395,'2022-08-31 08:35:45','2022-08-31 08:35:45'),(2304,'hysterectomy',5114,NULL,37.0,79414,1564,1564,'2022-08-31 08:40:11','2022-08-31 08:40:11'),(2305,'PATIENT DEVELOPEED RECURRENT CYANOTIC SPELL , LOW BASAL SATURATION , TO INCREASE PROPRANOLOL DOSE , NEW CARDIAC CT IS RECOMMENDED FPR PLAN OF SURGERY',5715,NULL,37.0,79413,2405,2405,'2022-08-31 08:41:33','2022-08-31 08:41:33'),(2306,'ascitic tap for biochemical and culture',5478,'antibiotics, albumin infusion',37.0,79393,889,889,'2022-08-31 08:41:47','2022-08-31 08:41:47'),(2307,'Na K ALT urine analysis',5476,NULL,37.0,79414,1564,1564,'2022-08-31 08:41:48','2022-08-31 08:41:48'),(2308,'continue the same regieme',5563,NULL,37.0,79388,2395,2395,'2022-08-31 08:41:57','2022-08-31 08:41:57'),(2309,'continue the same regieme',5566,NULL,37.0,79388,2395,2395,'2022-08-31 08:42:46','2022-08-31 08:42:46'),(2310,'IUD',5119,NULL,37.0,79414,1564,1564,'2022-08-31 08:43:24','2022-08-31 08:43:24'),(2311,', arthralgia mostly unrelated to  cardiac conditionFU ECHO IS recommended to exclude infective endocarditis',5725,NULL,37.0,79413,2405,2405,'2022-08-31 08:44:22','2022-08-31 08:44:22'),(2312,'cardiological consultation plus treating cmorbids',5126,'Continue on same regimen',37.0,79354,2391,2391,'2022-08-31 08:48:03','2022-08-31 08:48:03'),(2313,'urine analysis and culture',5789,'antibiotic, rowatinex',37.0,79397,889,889,'2022-08-31 08:49:01','2022-08-31 08:49:01'),(2314,NULL,5791,'levofloxacin, alkapride, rowatinex',37.0,79397,889,889,'2022-08-31 08:51:38','2022-08-31 08:51:38'),(2315,'topical steroid\r\ntopical minoxidil',5705,NULL,37.0,15836,2408,2408,'2022-08-31 08:52:18','2022-08-31 08:52:18'),(2316,'LMWH   medium intensity -PCR',5131,'protective lung strategy   plus adding systemic steroid plus remdsevier',37.0,79354,2391,2391,'2022-08-31 08:52:23','2022-08-31 08:52:23'),(2317,'topical and systemic steroid',5707,NULL,37.0,15836,2408,2408,'2022-08-31 08:53:22','2022-08-31 08:53:22'),(2318,'increase dose of glucovace, urine culture, virology',5796,'ANTIBIOTIC, THIOTACID,',37.0,79397,889,889,'2022-08-31 08:56:06','2022-08-31 08:56:06'),(2319,'topical steroid and antibiotic\r\nsystemic steroid and antibiotic',5709,NULL,37.0,15836,2408,2408,'2022-08-31 08:58:30','2022-08-31 08:58:30'),(2320,'serum amylase',5520,NULL,37.0,79363,2140,2140,'2022-08-31 08:59:08','2022-08-31 08:59:08'),(2321,'brain MRI',5819,NULL,37.0,79363,2140,2140,'2022-08-31 08:59:38','2022-08-31 08:59:38'),(2322,'another AVF operation',4833,NULL,37.0,79400,2399,2399,'2022-08-31 09:00:41','2022-08-31 09:00:41'),(2323,'albumin creatinine ratio \r\ncontinue same regieme',5032,NULL,37.0,79403,2395,2395,'2022-08-31 09:01:38','2022-08-31 09:01:38'),(2324,'rheumatological consult- delay pleuredesis',620,NULL,37.0,79356,2391,2391,'2022-08-31 09:01:41','2022-08-31 09:01:41'),(2325,'EEG &MRI brain',5806,NULL,37.0,79366,2140,2140,'2022-08-31 09:05:24','2022-08-31 09:05:24'),(2326,'sputum for gene expert ...collagen profile',620,NULL,37.0,79356,2391,2391,'2022-08-31 09:08:14','2022-08-31 09:08:14'),(2327,'repeat rheumatological evaluation...delay pleurodesis',5841,NULL,37.0,79356,2391,2391,'2022-08-31 09:09:01','2022-08-31 09:09:01'),(2328,'Contrast imaging\r\nWaiting for Histo-pathology\r\nConsider nedd for EUS',5826,NULL,37.0,79402,1062,1062,'2022-08-31 09:12:35','2022-08-31 09:12:35'),(2329,'serum calcium&PT &PC RBS MRI&CRP',5854,NULL,37.0,79367,2140,2140,'2022-08-31 09:16:46','2022-08-31 09:16:46'),(2330,'echo\r\niron profile \r\ncardiac consultation',5128,NULL,37.0,79408,2395,2395,'2022-08-31 09:18:26','2022-08-31 09:18:26'),(2331,NULL,5130,NULL,37.0,79408,2395,2395,'2022-08-31 09:19:27','2022-08-31 09:19:27'),(2332,'FOB',5828,NULL,37.0,79356,2391,2391,'2022-08-31 09:21:35','2022-08-31 09:21:35'),(2333,'Fecal occult blood test\r\n? nedd for colonoscopy',5855,NULL,37.0,79402,1062,1062,'2022-08-31 09:21:53','2022-08-31 09:21:53'),(2334,'supportive ttt.. isolation',5363,NULL,37.0,79356,2391,2391,'2022-08-31 09:22:11','2022-08-31 09:22:11'),(2335,'Contrast imaging\r\nBiopsy results',5855,NULL,37.0,79402,1062,1062,'2022-08-31 09:22:43','2022-08-31 09:22:43'),(2336,'supportive ttt ...isolation',5371,NULL,37.0,79356,2391,2391,'2022-08-31 09:23:03','2022-08-31 09:23:03'),(2337,'supportive ttt ..isolation',5375,NULL,37.0,79356,2391,2391,'2022-08-31 09:23:59','2022-08-31 09:23:59'),(2338,'supportive ttt... isolation',5373,NULL,37.0,79356,2391,2391,'2022-08-31 09:24:58','2022-08-31 09:24:58'),(2339,'abdominal pelvic ultrasounnd , urine analysis',5704,NULL,37.0,79443,2414,2414,'2022-08-31 09:25:28','2022-08-31 09:25:28'),(2340,NULL,5399,'CT brain, erastapex',37.0,79395,889,889,'2022-08-31 09:27:05','2022-08-31 09:27:05'),(2341,'echo study\r\nblood film',5721,NULL,37.0,79406,2395,2395,'2022-08-31 09:27:35','2022-08-31 09:27:35'),(2342,NULL,5790,'UGIE',37.0,79395,889,889,'2022-08-31 09:28:02','2022-08-31 09:28:02'),(2343,NULL,5795,'ugie',37.0,79395,889,889,'2022-08-31 09:28:44','2022-08-31 09:28:44'),(2344,NULL,5799,'DISCHARGE',37.0,79395,889,889,'2022-08-31 09:29:21','2022-08-31 09:29:21'),(2345,'echocardiography',5359,NULL,37.0,79443,2414,2414,'2022-08-31 09:29:53','2022-08-31 09:29:53'),(2346,NULL,5802,'UGIE',37.0,79395,889,889,'2022-08-31 09:29:56','2022-08-31 09:29:56'),(2347,'parathyroid hormone',5708,NULL,37.0,79443,2414,2414,'2022-08-31 09:34:11','2022-08-31 09:34:11'),(2348,'blood culture, stool culture \r\ncbc with diff, crp quantitative \r\nnitazode, zinc',5488,NULL,39.5,79431,2277,2277,'2022-08-31 09:34:32','2022-08-31 09:34:32'),(2349,'discharge\r\nfree T3, free T4, TSH thn adjust l-thyroxin accordingly\r\necho',5639,NULL,37.0,79431,2277,2277,'2022-08-31 09:36:48','2022-08-31 09:36:48'),(2350,'wait for pathology',5490,'l-thyroxine for life (start with 1.6 ug x Body wt ) + osteocare tab 1X 2',37.0,79436,1609,1609,'2022-08-31 09:38:05','2022-08-31 09:38:05'),(2351,'anti itiching medications',5712,NULL,37.0,79443,2414,2414,'2022-08-31 09:39:04','2022-08-31 09:39:04'),(2352,'FOLLOW UP CBC AT 36 WEEKS',5862,NULL,37.0,79418,1945,1945,'2022-08-31 09:39:05','2022-08-31 09:39:05'),(2353,'vitals, zofran, epicogel, gastregif no improvement for gastroenterology consultation',5645,NULL,37.0,79431,2277,2277,'2022-08-31 09:39:14','2022-08-31 09:39:14'),(2354,'CBC AND CRP',5867,NULL,37.0,79418,1945,1945,'2022-08-31 09:39:39','2022-08-31 09:39:39'),(2355,'adapalene gel\r\nsynopar soap',5851,NULL,37.0,79455,1153,1153,'2022-08-31 09:39:55','2022-08-31 09:39:55'),(2356,'treatment',5494,'bronchial asthma',37.0,79433,2362,2362,'2022-08-31 09:40:37','2022-08-31 09:40:37'),(2357,'MRI on the right hand\r\northopedic consultation for possibility of tendon release operation',3799,NULL,37.0,79428,1615,1615,'2022-08-31 09:40:52','2022-08-31 09:40:52'),(2358,'hibiotic syrp\r\nfusiderm cr betadine shampoo',5850,NULL,37.0,79455,1153,1153,'2022-08-31 09:40:56','2022-08-31 09:40:56'),(2359,NULL,4320,NULL,37.0,79369,2140,2140,'2022-08-31 09:42:03','2022-08-31 09:42:03'),(2360,'reduce the dose of long acting insulin 2 units',5836,NULL,37.0,79431,2277,2277,'2022-08-31 09:42:21','2022-08-31 09:42:21'),(2361,'tight blood pressure control',5714,NULL,37.0,79443,2414,2414,'2022-08-31 09:44:23','2022-08-31 09:44:23'),(2362,'ABG , eletrolytes , acetone in urine , iv fluids if still hypeerglycemic consult endocrine',5845,NULL,37.0,79431,2277,2277,'2022-08-31 09:44:24','2022-08-31 09:44:24'),(2363,'serum creatinine, serum uric acid\r\npelvi-abdominal ultrasound\r\nX ray lumbosacral\r\nadd feburic 80 mg \r\nphysiotherapy\r\ntest muscle enzymes (CK)\r\ndermatology consultation',5665,'cochicine,concor,ator',37.0,79428,1615,1615,'2022-08-31 09:44:43','2022-08-31 09:44:43'),(2364,'For Phosphorus level, PTH estimation plus addition of erythropiotin',5496,NULL,37.0,79433,2362,2362,'2022-08-31 09:45:09','2022-08-31 09:45:09'),(2365,'duplex u/s on venous system - if repeated cellulitis - long acting penicillin - avoid extra effort of standing',5493,'Maxipime 1gm   vial /12h - ambezim tab 1 X3 - betadine oint (all the day)',37.0,79439,1609,1609,'2022-08-31 09:45:56','2022-08-31 09:45:56'),(2366,'acretin .o25 cr \r\nsynopar cleanser',5740,NULL,37.0,79453,1153,1153,'2022-08-31 09:47:47','2022-08-31 09:47:47'),(2367,'refer to neurology consultant',5716,NULL,37.0,79443,2414,2414,'2022-08-31 09:47:52','2022-08-31 09:47:52'),(2368,'postpone decision of pregnancy as the patient is still active\r\nadvise the patient to wait until she remain in remission for at least six months\r\nif the patient didnot improve on cosentyx after six months, you should shift to another biologics',5671,'cosentyx',37.0,79428,1615,1615,'2022-08-31 09:47:52','2022-08-31 09:47:52'),(2369,'refer to neurology consultant',5716,NULL,37.0,79443,2414,2414,'2022-08-31 09:47:52','2022-08-31 09:47:52'),(2370,'victoza to loss weight',5306,'victoza/ glucophage',37.0,79372,2390,2390,'2022-08-31 09:49:30','2022-08-31 09:49:30'),(2371,'MDCT PA',5776,'Clexan 80 mg twice daily',37.0,79357,2013,2013,'2022-08-31 09:49:43','2022-08-31 09:49:43'),(2372,'shift to cosentyx instead of enbrel\r\nX ray hand to assess the deformity and rehabilitation should be advised to the patient',5675,'enbrel',37.0,79428,1615,1615,'2022-08-31 09:50:32','2022-08-31 09:50:32'),(2373,'debridement oint - follow up ABG & electrolytes - WBC - daily dressing (N.saline -',5291,NULL,37.0,79440,1609,1609,'2022-08-31 09:51:50','2022-08-31 09:51:50'),(2374,'methabiogene 8 mg tab \r\nelidel cr\r\ndicalderm cr \r\nselenium ace tab',5741,NULL,37.0,79453,1153,1153,'2022-08-31 09:53:23','2022-08-31 09:53:23'),(2375,'stabilize the systemic condition of the patient\r\ncontrol diabetes mellitus\r\nrefer to the rehabilitation unit to change the prosthesis',5308,NULL,37.0,79427,1615,1615,'2022-08-31 09:55:03','2022-08-31 09:55:03'),(2376,'prepare for liver transplant',5491,NULL,37.0,79433,2362,2362,'2022-08-31 09:57:38','2022-08-31 09:57:38'),(2377,'ask about hypopituitarism how to suspect and what is the investigation',5794,NULL,37.0,79375,2390,2390,'2022-08-31 09:58:10','2022-08-31 09:58:10'),(2378,'add steroid 7.5 mg for two weeks and withdraw\r\nnonsteeroidal injection for three days\r\nadd hydroquine (hydroxypteoid 200 mg once daily)\r\nthen reassess the patient',5308,'arthfree',37.0,79427,1615,1615,'2022-08-31 09:58:21','2022-08-31 09:58:21'),(2379,'Fluids plus antibiotics',5501,NULL,37.0,79433,2362,2362,'2022-08-31 09:59:28','2022-08-31 09:59:28'),(2380,'nerve conduction studies',5452,NULL,37.0,79445,2414,2414,'2022-08-31 09:59:30','2022-08-31 09:59:30'),(2381,'control diabetes\r\nrefer to rehabilitation unit to change prostehesis',5165,NULL,37.0,79427,1615,1615,'2022-08-31 10:00:30','2022-08-31 10:00:30'),(2382,'admission',5685,'aspirin 81 mg 1x1 , plavix 75 mg 1x1 , rosuvast 20 mg 1x1 N',37.0,79360,2013,2013,'2022-08-31 10:00:33','2022-08-31 10:00:33'),(2383,'examination of rest of rest of body\r\nHCV',5860,NULL,37.0,79421,2408,2408,'2022-08-31 10:01:27','2022-08-31 10:01:27'),(2384,'Follow up with iron study plus addition oferythropiotin',5504,NULL,37.0,79433,2362,2362,'2022-08-31 10:02:19','2022-08-31 10:02:19'),(2385,'topical and systemic steroid',5864,NULL,37.0,79421,2408,2408,'2022-08-31 10:02:45','2022-08-31 10:02:45'),(2386,NULL,5173,NULL,NULL,79377,1766,1766,'2022-08-31 10:04:18','2022-08-31 10:04:18'),(2387,NULL,5718,NULL,37.0,79456,1901,1901,'2022-08-31 10:04:26','2022-08-31 10:04:26'),(2388,'topical steroid and tarolimus',5866,NULL,37.0,79421,2408,2408,'2022-08-31 10:05:12','2022-08-31 10:05:12'),(2389,'shock therapy , iv fluids severe dehydration , inotropes , iv antibiotics , icu admession',5356,NULL,38.0,79430,2277,2277,'2022-08-31 10:05:41','2022-08-31 10:05:41'),(2390,'fractional co2 laser',5829,NULL,37.0,79454,1153,1153,'2022-08-31 10:05:59','2022-08-31 10:05:59'),(2391,'conservative treatment',5679,NULL,37.0,79407,1062,1062,'2022-08-31 10:06:14','2022-08-31 10:06:14'),(2392,'resting ECG then echo and follow up',5632,NULL,37.0,79364,2013,2013,'2022-08-31 10:06:45','2022-08-31 10:06:45'),(2393,'topical antiscabitic',5868,NULL,37.0,79421,2408,2408,'2022-08-31 10:06:49','2022-08-31 10:06:49'),(2394,NULL,5175,NULL,NULL,79377,1766,1766,'2022-08-31 10:08:42','2022-08-31 10:08:42'),(2395,'antihypertensive treatment with dialysis',5768,NULL,37.0,79445,2414,2414,'2022-08-31 10:09:33','2022-08-31 10:09:33'),(2396,'re estimate dry weight of the patient',5442,NULL,37.0,79445,2414,2414,'2022-08-31 10:15:04','2022-08-31 10:15:04'),(2397,'re estimate dry weight of the patient',5442,NULL,37.0,79445,2414,2414,'2022-08-31 10:15:04','2022-08-31 10:15:04'),(2398,'referal to zagazig university outpatient',4625,NULL,37.0,79454,1153,1153,'2022-08-31 10:17:16','2022-08-31 10:17:16'),(2399,'soluprede 20 mg \r\nplaqunil 200mg\r\ndermovate cr',5830,NULL,37.0,79454,1153,1153,'2022-08-31 10:18:26','2022-08-31 10:18:26'),(2400,'methotrexate 50mg amp\r\nzihtrocine \r\nfolic acid',5831,NULL,37.0,79454,1153,1153,'2022-08-31 10:19:30','2022-08-31 10:19:30'),(2401,'keep on same management as long as patient is improving',5748,NULL,37.0,79465,2427,2427,'2022-08-31 10:20:58','2022-08-31 10:20:58'),(2402,'tca 30',5833,NULL,37.0,79454,1153,1153,'2022-08-31 10:22:08','2022-08-31 10:22:08'),(2403,'add levofloxacine to maxipim antibiotics for 3 days empirically\r\nfollow up labs and CXR after 48 hours \r\npending culture results \r\nre-consult with results',5757,NULL,37.0,40203,2427,2427,'2022-08-31 10:25:04','2022-08-31 10:25:04'),(2404,'for icu admission',5123,NULL,37.0,79445,2414,2414,'2022-08-31 10:28:23','2022-08-31 10:28:23'),(2405,'symptomatic ttt + Mycophenolate mofetil',5815,'as mentioned below',37.0,79467,1701,1701,'2022-08-31 10:29:50','2022-08-31 10:29:50'),(2406,'Follow up lab\r\nstart feeding+ half iv maintence fluid',5727,NULL,37.0,79471,1894,1894,'2022-08-31 10:29:57','2022-08-31 10:29:57'),(2407,'start feeding+ gradual withdrawal of oxygen therapy',5729,NULL,37.0,79471,1894,1894,'2022-08-31 10:31:03','2022-08-31 10:31:03'),(2408,'follow up lab for hepatitis + anti GERD if persist upper endoscope is recomended',5739,NULL,37.0,79471,1894,1894,'2022-08-31 10:32:54','2022-08-31 10:32:54'),(2409,'continue antibiotics for blood, stool and urine culture and follow up lab',5808,NULL,37.0,79471,1894,1894,'2022-08-31 10:34:54','2022-08-31 10:34:54'),(2410,'bronchodilator - CT angiography - d-dimer - anticoagulant',5658,'clexane',37.0,79448,1456,1456,'2022-08-31 10:36:07','2022-08-31 10:36:07'),(2411,'withhold insulin and reevaluate random blood sugar',5767,NULL,37.0,79445,2414,2414,'2022-08-31 10:37:27','2022-08-31 10:37:27'),(2412,'physiotherapy and follow up MRI to be reported',5792,NULL,37.0,79379,1766,1766,'2022-08-31 10:43:27','2022-08-31 10:43:27'),(2413,NULL,5633,'lantos 30 + mextard',37.0,79448,1456,1456,'2022-08-31 10:43:51','2022-08-31 10:43:51'),(2414,'antihypertensive within session',5771,NULL,37.0,79445,2414,2414,'2022-08-31 10:44:46','2022-08-31 10:44:46'),(2415,'Biobsy to be re-diagnosed by a dermatopathologist',5872,'as mentioned below',37.0,79468,1701,1701,'2022-08-31 10:44:47','2022-08-31 10:44:47'),(2416,'FOLLOW UP URINE ANALYSIS AND REPEAT CULTURE AND DO ascu if recurrent uti',5689,NULL,37.0,79410,1579,1579,'2022-08-31 10:45:53','2022-08-31 10:45:53'),(2417,'fasting uric acid - MRI both ankles',5786,NULL,37.0,79379,1766,1766,'2022-08-31 10:46:20','2022-08-31 10:46:20'),(2418,'for diagnostic coronary angiography',5456,NULL,37.0,79445,2414,2414,'2022-08-31 10:49:39','2022-08-31 10:49:39'),(2419,NULL,5638,'Anticoagulant - antiplatelets',37.0,79448,1456,1456,'2022-08-31 10:52:59','2022-08-31 10:52:59'),(2420,'URINE ANALYSIS \r\nEXCLUDE LOCAL CAUSES ( UROLOGICAL SURGERY CONSULTATION )\r\nDO ABDOMINAL SONAR \r\nABDOMINAL X RAY ERECT',5806,NULL,37.0,79410,1579,1579,'2022-08-31 10:54:57','2022-08-31 10:54:57'),(2421,'refer the patient to higher center for debidement and sequestrectomy and Ilizarov fixation + bone transport',5642,NULL,37.0,79378,1766,1766,'2022-08-31 10:56:09','2022-08-31 10:56:09'),(2422,'woods lamp\r\ntreczimus /topical CS / systemic ant-oxidant for 1 month then follow up',1866,'as mentioned below',37.0,79470,1701,1701,'2022-08-31 10:56:37','2022-08-31 10:56:37'),(2423,'hair tonics + multivitamins',5358,'as mentioned below',37.0,79470,1701,1701,'2022-08-31 10:59:29','2022-08-31 10:59:29'),(2424,'try weaning today and follow up ABG every 6 hrs andkeep on same management',4239,NULL,37.0,79460,2426,2426,'2022-08-31 11:00:28','2022-08-31 11:00:28'),(2425,'topical CS + topical eledel +antihistamine+emollient',5785,'as mentioned below',37.0,79470,1701,1701,'2022-08-31 11:01:27','2022-08-31 11:01:27'),(2426,'keep on same antibiotics, pt ready to ward transfer and then discharge on tavanic for 10 days',5260,NULL,37.0,79460,2426,2426,'2022-08-31 11:01:48','2022-08-31 11:01:48'),(2427,'oral folic acid\r\ntopical steroid and tarolimus',4931,NULL,37.0,79478,2408,2408,'2022-08-31 11:03:04','2022-08-31 11:03:04'),(2428,'for new culture and sensitivity',5889,NULL,37.0,79380,1766,1766,'2022-08-31 11:04:40','2022-08-31 11:04:40'),(2429,'Anti - ischemic measures - noradrenaline continuation - broad spectrum antibiotics - \r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\nanti ischemic measures - broad spectrum antibiotics - continue noreadrenaline',5846,NULL,37.0,79451,1456,1456,'2022-08-31 11:05:23','2022-08-31 11:05:23'),(2430,'systemic methotrexate\r\nexamination of joints',4933,NULL,37.0,79450,2408,2408,'2022-08-31 11:06:26','2022-08-31 11:06:26'),(2431,'keep on same regemin including averozolid, do d dimer, bil LL duplex, echo and add prophylactic antibiotic',5822,NULL,37.0,79484,2426,2426,'2022-08-31 11:08:17','2022-08-31 11:08:17'),(2432,'intradialytic hypertension for good heamoultraflltration and intradialytic antihypertensive',5446,NULL,37.0,79445,2414,2414,'2022-08-31 11:08:50','2022-08-31 11:08:50'),(2433,'topica steroid\r\nemollient',4934,NULL,37.0,79450,2408,2408,'2022-08-31 11:09:41','2022-08-31 11:09:41'),(2434,'refer to the nearest hospital for orthopedic neurological examination to decide the line of management',5615,NULL,37.0,79381,1766,1766,'2022-08-31 11:10:30','2022-08-31 11:10:30'),(2435,'oral antihistamine\r\nwithdraw of systemic steroid\r\nfurther investigations to determine cause of fever',5585,'as mentioned below',37.0,79472,1701,1701,'2022-08-31 11:11:59','2022-08-31 11:11:59'),(2436,'CT BRAIN \r\nMRI BRAIN \r\nEEG \r\nSERUM CALCIUM AND mg',3780,NULL,37.0,79411,1579,1579,'2022-08-31 11:12:52','2022-08-31 11:12:52'),(2437,'adjustment of marivan dose for af with a cardiologist',5451,NULL,37.0,79445,2414,2414,'2022-08-31 11:13:59','2022-08-31 11:13:59'),(2438,'concor 2,5 once daily',5773,NULL,37.0,79445,2414,2414,'2022-08-31 11:17:39','2022-08-31 11:17:39'),(2439,'for follow up the vitals and dry weight of the patient',5459,NULL,37.0,79445,2414,2414,'2022-08-31 11:19:55','2022-08-31 11:19:55'),(2440,'rheumatological consultation - wt reduction to BMI under 30',5904,NULL,37.0,79384,1766,1766,'2022-08-31 11:21:51','2022-08-31 11:21:51'),(2441,'ORIF by posterior anteglide plating',5907,NULL,37.0,79384,1766,1766,'2022-08-31 11:23:34','2022-08-31 11:23:34'),(2442,'monitor amount of urine over 24 hours \r\nuse prper formula for age and weight \r\nproceed with feeding and try breast feeding later on',4749,NULL,37.0,79411,1579,1579,'2022-08-31 11:24:41','2022-08-31 11:24:41'),(2443,'physiotherapy',5419,NULL,37.0,79488,2431,2431,'2022-08-31 11:25:31','2022-08-31 11:25:31'),(2444,'continue vascular treatment (antiplatelet - stastins) - physiotherapy',5809,NULL,37.0,79491,2431,2431,'2022-08-31 11:35:21','2022-08-31 11:35:21'),(2445,'exclude asthma from history\r\ndo chest x ray \r\nfull history taking\r\nother investigatiions for immunodefciency if included in history',5814,NULL,37.0,79411,1579,1579,'2022-08-31 11:37:46','2022-08-31 11:37:46'),(2446,'continue anticoagulation -',5693,NULL,37.0,79489,2431,2431,'2022-08-31 11:42:31','2022-08-31 11:42:31'),(2447,'give calcium IV then oral\r\nadmit till calcium level adjusted and investigation done and patient stable',5820,NULL,37.0,79411,1579,1579,'2022-08-31 11:52:15','2022-08-31 11:52:15'),(2448,'broncoscopy and BAL, galactomanan, follow CT in 15 days,',4004,NULL,37.0,79483,2426,2426,'2022-08-31 11:56:59','2022-08-31 11:56:59'),(2449,'admit and monitor 24 hours \r\ncheck patient~s fontanelle\r\ndo serum calcium, NA, mg and potassium \r\ncontrol fever \r\nif stable dischage home later on',5823,NULL,37.0,79411,1579,1579,'2022-08-31 11:58:07','2022-08-31 11:58:07'),(2450,'KEEP ON SAME REGIME, MAY NEED HOME BIPAP',5800,NULL,37.0,79483,2426,2426,'2022-08-31 11:58:10','2022-08-31 11:58:10'),(2451,'ADD AVEROZOLIDE, follow up CRP, AND KEEP ON SAME MANAGEMENT',5805,NULL,37.0,79483,2426,2426,'2022-08-31 11:59:20','2022-08-31 11:59:20'),(2452,NULL,5915,NULL,37.0,79495,1008,1008,'2022-08-31 12:15:38','2022-08-31 12:15:38'),(2453,'change abs, add antifailure measures',5914,NULL,37.0,79495,1008,1008,'2022-08-31 12:19:57','2022-08-31 12:19:57'),(2454,NULL,1375,NULL,37.0,79494,1008,1008,'2022-08-31 12:24:17','2022-08-31 12:24:17'),(2455,NULL,5765,NULL,37.0,79494,1008,1008,'2022-08-31 12:28:48','2022-08-31 12:28:48'),(2456,NULL,5764,NULL,37.0,79494,1008,1008,'2022-08-31 12:29:36','2022-08-31 12:29:36'),(2457,NULL,5881,NULL,37.0,79494,1008,1008,'2022-08-31 12:30:06','2022-08-31 12:30:06'),(2458,NULL,5883,NULL,37.0,79494,1008,1008,'2022-08-31 12:32:05','2022-08-31 12:32:05'),(2459,NULL,5892,NULL,37.0,79494,1008,1008,'2022-08-31 12:33:16','2022-08-31 12:33:16'),(2460,NULL,5879,NULL,37.0,79494,1008,1008,'2022-08-31 12:36:18','2022-08-31 12:36:18'),(2461,NULL,5878,NULL,37.0,79494,1008,1008,'2022-08-31 12:38:22','2022-08-31 12:38:22'),(2462,NULL,5877,NULL,37.0,79494,1008,1008,'2022-08-31 12:40:33','2022-08-31 12:40:33'),(2463,NULL,5765,NULL,37.0,79494,1008,1008,'2022-08-31 12:41:18','2022-08-31 12:41:18'),(2464,NULL,5695,NULL,37.0,79496,1008,1008,'2022-08-31 12:49:30','2022-08-31 12:49:30'),(2465,'supportive tretment-ultrasound -LDH-ESR',5848,NULL,37.0,79530,2448,2448,'2022-09-01 07:57:25','2022-09-01 07:57:25'),(2466,'for colonoscope',5949,NULL,37.0,79499,2437,2437,'2022-09-01 07:58:17','2022-09-01 07:58:17'),(2467,'for colonoscope',5949,NULL,37.0,79499,2437,2437,'2022-09-01 07:58:17','2022-09-01 07:58:17'),(2468,'for colonoscope',5949,NULL,37.0,79499,2437,2437,'2022-09-01 07:58:18','2022-09-01 07:58:18'),(2469,'long covid syndrome, pulmonology followup',3978,NULL,37.0,79565,2143,2143,'2022-09-01 08:04:12','2022-09-01 08:04:12'),(2470,'carotid doppler to be done and neuro consultation',4980,NULL,37.0,79565,2143,2143,'2022-09-01 08:06:32','2022-09-01 08:06:32'),(2471,'stool analysis electrolytes',5059,NULL,37.0,79532,2448,2448,'2022-09-01 08:10:01','2022-09-01 08:10:01'),(2472,'EEG',5060,NULL,37.0,79532,2448,2448,'2022-09-01 08:10:46','2022-09-01 08:10:46'),(2473,'DIALYSIS WITH CONTINUOUS HEPARIN INFUSION AND RINSING',5875,NULL,37.0,79531,1926,1926,'2022-09-01 08:11:27','2022-09-01 08:11:27'),(2474,'mets and infection + increase kft',5222,NULL,37.0,79565,2143,2143,'2022-09-01 08:11:32','2022-09-01 08:11:32'),(2475,'chest x ray',5062,NULL,37.0,79532,2448,2448,'2022-09-01 08:12:15','2022-09-01 08:12:15'),(2476,'electrolytes',5884,NULL,37.0,79532,2448,2448,'2022-09-01 08:13:14','2022-09-01 08:13:14'),(2477,'blood culture- change of antibiotics after culture-TPN',4560,NULL,37.0,79559,2444,2444,'2022-09-01 08:13:23','2022-09-01 08:13:23'),(2478,'ampiciilin amikin',5900,NULL,37.0,79532,2448,2448,'2022-09-01 08:13:54','2022-09-01 08:13:54'),(2479,'promote feeding- oral if not possible then ryle with bottle teat to train for suckling- surgical consultation',6005,NULL,37.0,79559,2444,2444,'2022-09-01 08:14:44','2022-09-01 08:14:44'),(2480,'waiting for lab results',6004,NULL,37.0,79565,2143,2143,'2022-09-01 08:14:46','2022-09-01 08:14:46'),(2481,'fluids',5902,NULL,37.0,79532,2448,2448,'2022-09-01 08:14:50','2022-09-01 08:14:50'),(2482,'followup electrolyte and fluid balance',6007,NULL,37.0,79565,2143,2143,'2022-09-01 08:17:17','2022-09-01 08:17:17'),(2483,'WITHDRAWAL OF ANTIHYPERTENSIVE DRUGS AND REDUCE INTER-DIALYTIC WEIGHT GAIN AND FOLLOW UP OF BLOOD PRESSURE IN DIALYSIS FREE DAY',4914,NULL,37.0,79534,1926,1926,'2022-09-01 08:18:21','2022-09-01 08:18:21'),(2484,'of chronic disease, DM + thigh abcess',6010,NULL,37.0,79565,2143,2143,'2022-09-01 08:19:48','2022-09-01 08:19:48'),(2485,'start l troxine therapy for hypothroisism\r\nFU with cardiologist as regard to CHD\r\nkartotyping for the infant for genetic counseling abiut the risk of recurrence',6002,NULL,37.0,79555,1496,1496,'2022-09-01 08:19:57','2022-09-01 08:19:57'),(2486,'INTERNAL JUGULAR PERMICATH , IF FAILED, SYNTHETIC VENOUS GRAFT',5035,NULL,37.0,79534,1926,1926,'2022-09-01 08:23:57','2022-09-01 08:23:57'),(2487,'ANTIHYPERTENSIVE MEDICATION AFTER DIALYSIS',5982,NULL,37.0,79536,1926,1926,'2022-09-01 08:29:35','2022-09-01 08:29:35'),(2488,'neurosurgery',4723,NULL,37.0,79533,2448,2448,'2022-09-01 08:33:29','2022-09-01 08:33:29'),(2489,'REDUCE DRY BODY WEIGHT AND ADEQUATE DIALYSIS DOSE',5983,NULL,37.0,79536,1926,1926,'2022-09-01 08:35:33','2022-09-01 08:35:33'),(2490,'echo',5072,NULL,37.0,79533,2448,2448,'2022-09-01 08:36:32','2022-09-01 08:36:32'),(2491,'FOLLOW UP',5073,NULL,37.0,79533,2448,2448,'2022-09-01 08:38:00','2022-09-01 08:38:00'),(2492,'FOLLOW UP',5945,NULL,37.0,79533,2448,2448,'2022-09-01 08:38:33','2022-09-01 08:38:33'),(2493,'CHANGE GLIMEPRIDE TO INSULIN',5984,NULL,37.0,79536,1926,1926,'2022-09-01 08:40:34','2022-09-01 08:40:34'),(2494,'ABDOMINAL  ULTRASOUND',5946,NULL,37.0,79533,2448,2448,'2022-09-01 08:40:56','2022-09-01 08:40:56'),(2495,'ADJUST DRY BODY WEIGHT AND USE OF DIALYZER WITH LOWER SURFACE AREA',5985,NULL,37.0,79536,1926,1926,'2022-09-01 08:48:17','2022-09-01 08:48:17'),(2496,'physiotherapy and trachestomy',4715,NULL,37.0,79573,2143,2143,'2022-09-01 08:52:13','2022-09-01 08:52:13'),(2497,'for dialysis',6037,NULL,37.0,79573,2143,2143,'2022-09-01 08:54:42','2022-09-01 08:54:42'),(2498,'growth hormone stimulation test by insulin and close follow up of height and signs of puberty',5880,NULL,37.0,79574,2187,2187,'2022-09-01 08:54:50','2022-09-01 08:54:50'),(2499,'Follow up',5377,'Continue on same regimen',37.0,79529,2040,2040,'2022-09-01 08:55:35','2022-09-01 08:55:35'),(2500,'neuro consultation',6003,NULL,37.0,79521,2143,2143,'2022-09-01 08:57:48','2022-09-01 08:57:48'),(2501,'ANTIBIOTICS AND CONTROL BLOOD PRESSURE',6030,NULL,37.0,79539,1926,1926,'2022-09-01 08:57:55','2022-09-01 08:57:55'),(2502,'recent echo, followup electrolytes and fluid balance',6027,NULL,37.0,79521,2143,2143,'2022-09-01 09:00:43','2022-09-01 09:00:43'),(2503,'FLUID BALANCE AND AVOID ACEI,',6032,NULL,37.0,79539,1926,1926,'2022-09-01 09:06:36','2022-09-01 09:06:36'),(2504,NULL,5960,NULL,37.0,79529,2040,2040,'2022-09-01 09:10:31','2022-09-01 09:10:31'),(2505,'FOB, CONSERVATIVE TREATMENT',6029,NULL,37.0,79539,1926,1926,'2022-09-01 09:13:14','2022-09-01 09:13:14'),(2506,'medical treatment and CT PNS',6048,NULL,37.0,79579,2180,2180,'2022-09-01 09:14:53','2022-09-01 09:14:53'),(2507,'CT NECK\r\nBIOPSY',6047,NULL,37.0,79579,2180,2180,'2022-09-01 09:16:36','2022-09-01 09:16:36'),(2508,'ANTI HYPERTEMSIVE MEDICATION AFTER DIALYSIS AND REDICE DRY BODY WEIGHT',5993,NULL,37.0,79541,1926,1926,'2022-09-01 09:18:34','2022-09-01 09:18:34'),(2509,'follow up',5961,'Continue on same regimen',37.0,79529,2040,2040,'2022-09-01 09:19:27','2022-09-01 09:19:27'),(2510,'REDUCE DRY BODY WEIGHT AND ANTIHYPERTENSIVE MEDICATIONS',6008,NULL,37.0,79541,1926,1926,'2022-09-01 09:21:21','2022-09-01 09:21:21'),(2511,'nutritional rehabilitation',5353,NULL,37.0,79575,1711,1711,'2022-09-01 09:22:49','2022-09-01 09:22:49'),(2512,'ascites sampling for SBP - ADJUSTEMENT of fluid intake - stop lasix - upper GIT endoscopy after stabilization',5192,NULL,37.0,79506,2438,2438,'2022-09-01 09:24:52','2022-09-01 09:24:52'),(2513,'Echo\r\nDirect laryngeoscopy\r\nSpirometry',5960,'Continue on same regimen',37.0,79529,2040,2040,'2022-09-01 09:25:12','2022-09-01 09:25:12'),(2514,'acase of bilateral dilatation of pelvicayceal system for prper imaging to identify naturec of this dilatation ,, urological  consultation for possibilityb of VCUG to exclude ureteric stricture or PUV and follow up of patient with serum creat and abg',4681,NULL,37.0,79558,2283,2283,'2022-09-01 09:26:03','2022-09-01 09:26:03'),(2515,'ANTIHISTAMINIC , INCREASE DIALYSIS DOSE',5932,NULL,37.0,79544,1926,1926,'2022-09-01 09:26:20','2022-09-01 09:26:20'),(2516,'complete workup CBC LFT serum cr ESR Hx of drug intake -evaluating of compliant and muscle power',5511,NULL,37.0,79506,2438,2438,'2022-09-01 09:27:16','2022-09-01 09:27:16'),(2517,'treatment',6019,NULL,37.0,79578,2465,2465,'2022-09-01 09:27:37','2022-09-01 09:27:37'),(2518,'INCREASE BLOOD FLOW AND CALCIUM CONTAINING PHOSPHORUS BINDERS',5934,NULL,37.0,79544,1926,1926,'2022-09-01 09:29:14','2022-09-01 09:29:14'),(2519,'NEED X RAY',5942,NULL,37.0,79537,2450,2450,'2022-09-01 09:29:44','2022-09-01 09:29:44'),(2520,NULL,5943,NULL,37.0,79537,2450,2450,'2022-09-01 09:31:31','2022-09-01 09:31:31'),(2521,'REDUCE DRY BODY WEIGHT AND EXTENDED DIALYSIS SESSION',5938,NULL,37.0,79544,1926,1926,'2022-09-01 09:33:28','2022-09-01 09:33:28'),(2522,'treatment and good hydration',6022,'antiplat. and anticogaulant and rate control',37.0,79578,2465,2465,'2022-09-01 09:35:52','2022-09-01 09:35:52'),(2523,'ADEQUATE DIALYSIS',5936,NULL,37.0,79544,1926,1926,'2022-09-01 09:36:18','2022-09-01 09:36:18'),(2524,NULL,5971,NULL,37.0,79535,2450,2450,'2022-09-01 09:36:27','2022-09-01 09:36:27'),(2525,'serum ldh and tuberculin test',5848,NULL,37.0,79576,1711,1711,'2022-09-01 09:37:13','2022-09-01 09:37:13'),(2526,'treatment , good hydration and physiotherapy',6024,'asprin , clopex , ator and brain stimulant',37.0,79578,2465,2465,'2022-09-01 09:39:20','2022-09-01 09:39:20'),(2527,'medical treatment\r\nif fails incision and debridment',6009,NULL,37.0,79582,2180,2180,'2022-09-01 09:39:51','2022-09-01 09:39:51'),(2528,NULL,5972,NULL,37.0,79535,2450,2450,'2022-09-01 09:40:41','2022-09-01 09:40:41'),(2529,'Keep ear dry\r\ncontinous suction\r\nsystemic antibiotic\r\nlocal antibiotic and anti fungal',6011,NULL,37.0,79582,2180,2180,'2022-09-01 09:41:05','2022-09-01 09:41:05'),(2530,'Neurosurgical consultation and continue on same treatment',3930,NULL,37.0,79592,1915,1915,'2022-09-01 09:43:34','2022-09-01 09:43:34'),(2531,'BONE GRAFT',5538,NULL,37.0,79538,2450,2450,'2022-09-01 09:45:28','2022-09-01 09:45:28'),(2532,'the condition is well controlled continue on the same treatment',5999,NULL,37.0,79508,2439,2439,'2022-09-01 09:49:54','2022-09-01 09:49:54'),(2533,'full examination and Ct Brain',5742,NULL,37.0,79585,2465,2465,'2022-09-01 09:52:28','2022-09-01 09:52:28'),(2534,'Full Examination to determine if pt UMNL or LMNL',5743,NULL,37.0,79585,2465,2465,'2022-09-01 09:53:18','2022-09-01 09:53:18'),(2535,'repeated rectal washes and follow up',5941,'repeated rectal washes',37.0,79587,2467,2467,'2022-09-01 09:57:35','2022-09-01 09:57:35'),(2536,'INCREASE BLOOD FLOW RATE AND ESA AND IRON SUPPLEMENT AND SCHOCARDIOGRAPHY',5824,NULL,37.0,79549,1926,1926,'2022-09-01 10:01:34','2022-09-01 10:01:34'),(2537,'septoplasty',5956,NULL,37.0,79583,2180,2180,'2022-09-01 10:03:23','2022-09-01 10:03:23'),(2538,'ECHOCARDIOGRAPHY AND FOLLOW UP SERUM K',5177,'TRITACE 5 ALDOMET 250',37.0,79553,1805,1805,'2022-09-01 10:06:58','2022-09-01 10:06:58'),(2539,'previous antiparkinsoin Treatment \r\ngood hydration \r\nLiver work UP',6062,'PK Merz bottle one time daily',37.0,79580,2465,2465,'2022-09-01 10:07:00','2022-09-01 10:07:00'),(2540,'CT PNS\r\nCT chest',6067,NULL,37.0,79579,2180,2180,'2022-09-01 10:07:40','2022-09-01 10:07:40'),(2541,'ECHOCARDIOGRAPHY',5954,'Continue on same regimen',37.0,79553,1805,1805,'2022-09-01 10:09:11','2022-09-01 10:09:11'),(2542,'ECHOCARDIOGRAPHY',5999,'TRITACE 2.5 STATIN ASPIRIN',37.0,79553,1805,1805,'2022-09-01 10:14:43','2022-09-01 10:14:43'),(2543,'KEEP SAME MANAGEMENT',5382,'Continue on same regimen',37.0,79553,1805,1805,'2022-09-01 10:21:43','2022-09-01 10:21:43'),(2544,NULL,6018,NULL,37.0,79542,2232,2232,'2022-09-01 10:25:58','2022-09-01 10:25:58'),(2545,NULL,6017,NULL,37.0,79542,2232,2232,'2022-09-01 10:27:55','2022-09-01 10:27:55'),(2546,'ULTRAFILTRATION PROFILING AND CARDIAC ASSESSMENT UPTO STRESS TESTING',5911,NULL,37.0,79551,1926,1926,'2022-09-01 10:29:36','2022-09-01 10:29:36'),(2547,'ECHOCARDIOGRAPHY',5948,'IV DIURETICS',37.0,79553,1805,1805,'2022-09-01 10:30:09','2022-09-01 10:30:09'),(2548,NULL,5947,'ACI INHIBITORS OR ARBS BLOCKER',37.0,79524,2445,2445,'2022-09-01 10:33:37','2022-09-01 10:33:37'),(2549,'ANTIPLATELET, STATIN, REDUCE DRY BODY WEIGHT',5912,NULL,37.0,79551,1926,1926,'2022-09-01 10:34:49','2022-09-01 10:34:49'),(2550,NULL,6046,NULL,37.0,79560,1087,1087,'2022-09-01 10:38:52','2022-09-01 10:38:52'),(2551,'REDUCE DRY WEIGHT, ANTIPLATELET, CARDIAC ASSESSMENT',5913,NULL,37.0,79551,1926,1926,'2022-09-01 10:39:19','2022-09-01 10:39:19'),(2552,'increasing insulin dose',6049,NULL,37.0,79560,1087,1087,'2022-09-01 10:43:46','2022-09-01 10:43:46'),(2553,'AVOID ACEI, FLUID BALANCE AND ANTIBIOTICS FOR PNEUMONIA',5177,NULL,37.0,79554,1926,1926,'2022-09-01 10:45:29','2022-09-01 10:45:29'),(2554,'increase zinc dose',6023,NULL,37.0,79561,1087,1087,'2022-09-01 10:51:33','2022-09-01 10:51:33'),(2555,'high tibial osteotomy',4879,NULL,37.0,79584,2466,2466,'2022-09-01 10:53:15','2022-09-01 10:53:15'),(2556,'ASSESSMENT FOR PROTEINURIA, FLUID BALANCE , PTH',4874,NULL,37.0,79554,1926,1926,'2022-09-01 10:55:31','2022-09-01 10:55:31'),(2557,NULL,6021,NULL,37.0,79561,1087,1087,'2022-09-01 10:56:01','2022-09-01 10:56:01'),(2558,'dd : atopic dermatitis/erythrodermic icthyosis bollus type\r\natopic patient for further investigations \r\n\r\ncurrent ttt : antihistamines +topical CS+emollient',6051,'as mentioned below',37.0,79599,1633,1633,'2022-09-01 10:57:34','2022-09-01 10:57:34'),(2559,NULL,6020,NULL,37.0,79561,1087,1087,'2022-09-01 11:00:14','2022-09-01 11:00:14'),(2560,'MRI  LS spine',4881,NULL,37.0,79584,2466,2466,'2022-09-01 11:01:57','2022-09-01 11:01:57'),(2561,'NSAIDs@ physiotherapy',5733,NULL,37.0,79584,2466,2466,'2022-09-01 11:08:23','2022-09-01 11:08:23'),(2562,'NSAIDs@ physiotherapy',5733,NULL,37.0,79584,2466,2466,'2022-09-01 11:08:33','2022-09-01 11:08:33'),(2563,'FLUID BALANCE, BLOOD TRANSFUSION, CORRECTION OF ELECTROLYTE ABNORMALITY, URINE ANALYSIS, FOLLOW UP OF SERUM CREATININE AND IF NO IMPREOVEMENT, PROCEED TO RENAL BIOPSY',5852,NULL,37.0,79556,1926,1926,'2022-09-01 11:08:33','2022-09-01 11:08:33'),(2564,'NSAIDs & physiotherapy',5733,NULL,37.0,79584,2466,2466,'2022-09-01 11:09:44','2022-09-01 11:09:44'),(2565,'MRI BRAIN,TSH',5951,NULL,37.0,79562,1087,1087,'2022-09-01 11:10:44','2022-09-01 11:10:44'),(2566,'Cast and repeat clear X- Ray',5735,NULL,37.0,79584,2466,2466,'2022-09-01 11:12:20','2022-09-01 11:12:20'),(2567,'correction of dehydration and metabolic acidosis\r\nurgent ABG and electrolytes\r\ncheck CRP and CBC if there is evidence of bacterial infection or not to avoid overuse of antibiotics',6036,NULL,37.0,79614,1394,1394,'2022-09-01 11:20:55','2022-09-01 11:20:55'),(2568,'ENT consultation\r\nVitamin D \r\ncheck calcium level\r\navoid aspiration',6042,NULL,37.0,79614,1394,1394,'2022-09-01 11:22:44','2022-09-01 11:22:44'),(2569,NULL,5132,NULL,37.0,79596,1087,1087,'2022-09-01 11:23:07','2022-09-01 11:23:07'),(2570,NULL,5134,NULL,37.0,79596,1087,1087,'2022-09-01 11:23:43','2022-09-01 11:23:43'),(2571,'+follow up+  topical calcinurin inhibitors+ stop koebnerization',6090,'as mentioned below',37.0,79606,1633,1633,'2022-09-01 11:24:22','2022-09-01 11:24:22'),(2572,'Cast for one month',5737,NULL,37.0,79584,2466,2466,'2022-09-01 11:28:22','2022-09-01 11:28:22'),(2573,'Cardio thoracic surgery',4843,NULL,37.0,79584,2466,2466,'2022-09-01 11:30:05','2022-09-01 11:30:05'),(2574,'for investigations',6092,'as mentioned below',37.0,79606,1633,1633,'2022-09-01 11:30:42','2022-09-01 11:30:42'),(2575,'For Surgery( high tibial osteotomy)',4879,NULL,37.0,79584,2466,2466,'2022-09-01 11:31:13','2022-09-01 11:31:13'),(2576,'Dermatology consultation\r\nnutritional consultation\r\nimmunology consultation\r\nCBC with differential count, liver and kidney function tests, urine and stool analysis as intial investigations',6051,NULL,37.0,79612,1394,1394,'2022-09-01 11:41:10','2022-09-01 11:41:10'),(2577,NULL,5959,NULL,37.0,79564,1087,1087,'2022-09-01 11:48:25','2022-09-01 11:48:25'),(2578,NULL,5958,NULL,37.0,79564,1087,1087,'2022-09-01 11:48:47','2022-09-01 11:48:47'),(2579,'Esr crp abd us ct abdomen viral marker s cr.',5775,NULL,37.0,79617,2227,2227,'2022-09-03 07:49:30','2022-09-03 07:49:30'),(2580,'reticlocytic count .ESR CRP  , upper endoscopy \r\n plasma  antibiotic according to urine culture platelet transfusion ,',6136,NULL,37.0,79619,2227,2227,'2022-09-03 08:03:59','2022-09-03 08:03:59'),(2581,'تتحول اليلا مستشفي يوجد بها مناظير جهاز هضمي',6144,NULL,37.0,79640,1887,1887,'2022-09-03 08:04:09','2022-09-03 08:04:09'),(2582,'waiting culutures',6139,NULL,37.0,79640,1887,1887,'2022-09-03 08:06:41','2022-09-03 08:06:41'),(2583,'mrcp-viral markers',4822,NULL,37.0,79640,1887,1887,'2022-09-03 08:08:58','2022-09-03 08:08:58'),(2584,'dopller on L L- HBA1C',4919,NULL,37.0,79635,1887,1887,'2022-09-03 08:13:25','2022-09-03 08:13:25'),(2585,'NEPHROLOGY  CONSULTATION',5176,NULL,37.0,79635,1887,1887,'2022-09-03 08:16:41','2022-09-03 08:16:41'),(2586,'BASAL BOLUS- SPUTUM CULTURE',5574,NULL,37.0,79635,1887,1887,'2022-09-03 08:20:25','2022-09-03 08:20:25'),(2587,'skin biopsy to diagnose the disease',6051,NULL,37.0,79638,1934,1934,'2022-09-03 08:20:31','2022-09-03 08:20:31'),(2588,'GOOD HYDRATION',6109,NULL,37.0,79635,1887,1887,'2022-09-03 08:22:45','2022-09-03 08:22:45'),(2589,'CARDIOLOGY CONSULTATION',6143,NULL,37.0,79636,1887,1887,'2022-09-03 08:27:25','2022-09-03 08:27:25'),(2590,'H.PYLORI AG IN STOOL- PPI-MUCOSTA',6145,NULL,37.0,79636,1887,1887,'2022-09-03 08:29:51','2022-09-03 08:29:51'),(2591,'triphasic CT',5390,'according to last urine culture',37.0,79639,1934,1934,'2022-09-03 08:35:30','2022-09-03 08:35:30'),(2592,'decelerate antibiotics',6153,'Continue on same regimen',37.0,79628,2488,2488,'2022-09-03 08:38:43','2022-09-03 08:38:43'),(2593,'serum creatinine\r\nh pylori stool Ag\r\nPPI\r\nupper endoscope',4773,NULL,37.0,79620,2228,2228,'2022-09-03 08:38:56','2022-09-03 08:38:56'),(2594,'coombs test retix and finally BM aspiration',5909,NULL,37.0,79641,1934,1934,'2022-09-03 08:58:22','2022-09-03 08:58:22'),(2595,'increase pressure support\r\ncorrection of hypokalemia',5989,'Continue on same regimen',37.0,79629,2488,2488,'2022-09-03 09:06:19','2022-09-03 09:06:19'),(2596,'DIAGNOSTIC CYSTOSCOPY +_ OPEN CYSTOLOTHOTOMY',5979,NULL,37.0,79668,1870,1870,'2022-09-03 09:09:00','2022-09-03 09:09:00'),(2597,'FOR LEFT PCNL',5980,NULL,37.0,79668,1870,1870,'2022-09-03 09:12:04','2022-09-03 09:12:04'),(2598,'Continue on same regimen+colchicine 500 mg /12h',5753,'Continue on same regimen+colchicine 500 mg /12h',37.0,79630,2488,2488,'2022-09-03 09:12:35','2022-09-03 09:12:35'),(2599,'good antibiotic coverage\r\nfollow of serum albumin\r\ndiuretics',6150,NULL,37.0,79622,2228,2228,'2022-09-03 09:13:49','2022-09-03 09:13:49'),(2600,'DIAGNOSTIC CYSTOSCOPY +- CONTRAST ENHANCED CT: ABDOMEN AND PELVIS',5981,NULL,37.0,79668,1870,1870,'2022-09-03 09:16:09','2022-09-03 09:16:09'),(2601,'continue antibiotics\r\nobtain blood and sputum culture better by BAL if available\r\ncardiothoracic consultation',5069,NULL,37.0,79643,2490,2490,'2022-09-03 09:16:28','2022-09-03 09:16:28'),(2602,'CT CHEST AND FOLLOW UP',5754,'Continue on same regimen',37.0,79630,2488,2488,'2022-09-03 09:17:27','2022-09-03 09:17:27'),(2603,'Bone marrow aspiration',6136,NULL,37.0,79658,1912,1912,'2022-09-03 09:20:26','2022-09-03 09:20:26'),(2604,'good drainage continue at least 1 week - if repeated with plastic consultation for flap after excision of sweet glands - for the patient stop use of sweet deodrants',5766,'Antibiotic (Augmentin + dalacin c 300 mg \"anti anaerobe\")',37.0,79664,1609,1609,'2022-09-03 09:20:30','2022-09-03 09:20:30'),(2605,NULL,5726,'Continue on same regimen+EVerizine',37.0,79630,2488,2488,'2022-09-03 09:21:06','2022-09-03 09:21:06'),(2606,'continue on same treatment +everizine+ ceprofar',5726,NULL,37.0,79630,2488,2488,'2022-09-03 09:23:28','2022-09-03 09:23:28'),(2607,'Hb electrophoresis',6171,NULL,37.0,79655,1912,1912,'2022-09-03 09:24:44','2022-09-03 09:24:44'),(2608,'CT chest and renal function and hospital admission',5758,'Continue on same regimen+molnopiravir after renal function+iverizine',37.0,79630,2488,2488,'2022-09-03 09:29:14','2022-09-03 09:29:14'),(2609,NULL,6135,'SWAB CULTURE   SKIN BIOBSY',37.0,79650,763,763,'2022-09-03 09:29:41','2022-09-03 09:29:41'),(2610,'PCNL',6071,NULL,37.0,79669,1870,1870,'2022-09-03 09:30:04','2022-09-03 09:30:04'),(2611,'follow up',6091,'Continue on same regimen+clarithromycin',37.0,79630,2488,2488,'2022-09-03 09:32:46','2022-09-03 09:32:46'),(2612,'surgical consultation for possibility of wound sepsis\r\nantibiiotic coverage\r\nblood culture\r\nrepeat abdominal US\r\nCT CHEST\r\nLYMPH NODE EXAMINATION\r\nFOLLOWUP OF CBC & liver function',6095,NULL,37.0,79623,2228,2228,'2022-09-03 09:33:01','2022-09-03 09:33:01'),(2613,'Blood film\r\nLDH\r\nESR\r\nPAUS',4874,NULL,37.0,79656,1912,1912,'2022-09-03 09:34:00','2022-09-03 09:34:00'),(2614,'sodium bicarbonate infusion 25 meq / hour for 4 hours\r\nincrease fluid input \r\nhydrocortisone 1oo mg once \r\nif no improvement of persistent acidosis initiate dialysis\r\nMRI brain with diffusion when transfer is possible\r\ndifferential diagnosis:\r\nstroke\r\ndehydration\r\nsepsis\r\nuremia',5718,NULL,37.0,79643,2490,2490,'2022-09-03 09:34:10','2022-09-03 09:34:10'),(2615,'swab',5608,NULL,37.0,79630,2488,2488,'2022-09-03 09:35:28','2022-09-03 09:35:28'),(2616,'echo',5990,'inhaled steroids as controller',37.0,79663,2496,2496,'2022-09-03 09:37:01','2022-09-03 09:37:01'),(2617,NULL,4157,'Borgasone cream  دهان مرتين يوميا لمدة اسبوعين ثم مرة يوميا لمدة اسبوعين ثم يوقف',37.0,79650,763,763,'2022-09-03 09:38:23','2022-09-03 09:38:23'),(2618,'SWAB AND FOLLOW UP',5215,NULL,37.0,79630,2488,2488,'2022-09-03 09:38:44','2022-09-03 09:38:44'),(2619,'NON CONTRAST CT: ABDOMEN AND PELVIS',5392,NULL,37.0,79670,1870,1870,'2022-09-03 09:39:28','2022-09-03 09:39:28'),(2620,NULL,4157,'Borgasone cream  دهان مرتين يوميا لمدة اسبوعين ثم مرة يوميا لمدة اسبوعين ثم يوقف  + emollient + low dose gaptin after int medicine consultation',37.0,33,763,763,'2022-09-03 09:41:11','2022-09-03 09:41:11'),(2621,NULL,6187,'sildenafil',37.0,79661,2496,2496,'2022-09-03 09:41:36','2022-09-03 09:41:36'),(2622,'PCI',5962,NULL,37.0,79644,2490,2490,'2022-09-03 09:41:48','2022-09-03 09:41:48'),(2623,'Correct electrolytes, anemia, acidosis',5458,NULL,37.0,79644,2490,2490,'2022-09-03 09:45:07','2022-09-03 09:45:07'),(2624,'METASTATIC WORKUP +abdominal thyroid+breast ultrasound and lymph node examination\r\nshow CT CHEST',6141,NULL,37.0,79629,2488,2488,'2022-09-03 09:46:25','2022-09-03 09:46:25'),(2625,'referral for skin biobsy',6154,NULL,37.0,79651,763,763,'2022-09-03 09:49:56','2022-09-03 09:49:56'),(2626,NULL,5965,NULL,37.0,79644,2490,2490,'2022-09-03 09:51:01','2022-09-03 09:51:01'),(2627,'stool analysis and culture',6183,'nitazode',37.0,79662,2496,2496,'2022-09-03 09:51:21','2022-09-03 09:51:21'),(2628,NULL,5430,NULL,37.0,79644,2490,2490,'2022-09-03 09:51:34','2022-09-03 09:51:34'),(2629,'ANTIBIOTCS levofloxacin+ ceftazidine\r\ninternal medicine consultation for low platelet count\r\ncontinue tuberclusis workup',5988,NULL,37.0,79629,2488,2488,'2022-09-03 09:52:07','2022-09-03 09:52:07'),(2630,'OUTPATIENT CYSTOSCOPY+- URODYNAMICS',5734,NULL,37.0,79671,1870,1870,'2022-09-03 09:52:12','2022-09-03 09:52:12'),(2631,'l thyroxin \r\nfollow up after one month\r\non ventilator\r\nchest consultation',5953,NULL,37.0,79624,2229,2229,'2022-09-03 09:52:17','2022-09-03 09:52:17'),(2632,'follow up CBC and bilirubin \r\noff photo 12 hours and follow up bilirubin',6105,NULL,37.0,79679,2242,2242,'2022-09-03 09:55:39','2022-09-03 09:55:39'),(2633,NULL,6156,'betaderm cream + tarolimus +emoillient + follow up',37.0,79651,763,763,'2022-09-03 09:57:47','2022-09-03 09:57:47'),(2634,'Cultures\r\ncoagulation profile\r\nCRP\r\nprocalcitonin',4990,NULL,37.0,79677,1912,1912,'2022-09-03 09:58:01','2022-09-03 09:58:01'),(2635,'iron indices\r\noccult blood in stool',6148,NULL,37.0,79677,1912,1912,'2022-09-03 09:58:39','2022-09-03 09:58:39'),(2636,'follow up',6106,NULL,37.0,79679,2242,2242,'2022-09-03 10:01:34','2022-09-03 10:01:34'),(2637,'Debridement if necrotic tissue - local antibiotic spray - 2nd stage local stimating factors for healing e.g healosol after clean wound - continuation of general care change in patient position',5406,'Broad spectrum antibiotic (gram +ve , -ve , anaerobic)',37.0,79667,1609,1609,'2022-09-03 10:02:31','2022-09-03 10:02:31'),(2638,NULL,6157,'skin biobsy',37.0,79651,763,763,'2022-09-03 10:05:21','2022-09-03 10:05:21'),(2639,NULL,6157,'skin biobsy',37.0,2020,763,763,'2022-09-03 10:06:08','2022-09-03 10:06:08'),(2640,'retix \r\nivig if high retix',5881,NULL,37.0,79681,2496,2496,'2022-09-03 10:09:48','2022-09-03 10:09:48'),(2641,NULL,4567,NULL,37.0,79653,763,763,'2022-09-03 10:10:24','2022-09-03 10:10:24'),(2642,'double photo\r\ntreat infection \r\nproper hydration \r\nretix',6073,NULL,37.0,79681,2496,2496,'2022-09-03 10:10:38','2022-09-03 10:10:38'),(2643,'serial FAST - Abdominal CT if available - serial CBC & ABG electrolytes - immediate exploration if confirmed pneumoperotineum',5445,'broad spectrum antibiotics',37.0,79667,1609,1609,'2022-09-03 10:11:05','2022-09-03 10:11:05'),(2644,'follow up CBC AND CRP\r\n VITAL DATA\r\nWEIGHT ENCREAMENT',6107,NULL,37.0,79679,2242,2242,'2022-09-03 10:14:38','2022-09-03 10:14:38'),(2645,'PCR for COVID \r\n6MWT',6166,NULL,37.0,79684,2502,2502,'2022-09-03 10:16:02','2022-09-03 10:16:02'),(2646,'elective cholecystectomy unless contraindication to general anaestehesis & laparoscopic',5412,'quinolones',37.0,79667,1609,1609,'2022-09-03 10:16:30','2022-09-03 10:16:30'),(2647,'Echocardiography',5929,NULL,37.0,79631,2047,2047,'2022-09-03 10:17:14','2022-09-03 10:17:14'),(2648,NULL,4568,'curam 1gm tab',37.0,79653,763,763,'2022-09-03 10:18:55','2022-09-03 10:18:55'),(2649,'CHEST X RAY \r\nBLOOD CULTURE \r\nABG',6108,NULL,37.0,79679,2242,2242,'2022-09-03 10:20:57','2022-09-03 10:20:57'),(2650,'Follow up',6167,NULL,37.0,79684,2502,2502,'2022-09-03 10:21:03','2022-09-03 10:21:03'),(2651,'check vascularityby ultrasound - & no gangernous loop of intestine - CBC - exclude intestinal obstruction - cold fomentation if normal vascularity - if pain not relieved -or intestinal obstruction or strangulation explore & reduction if normal intestine & resection if gangrenous loop',5426,NULL,37.0,79667,1609,1609,'2022-09-03 10:21:04','2022-09-03 10:21:04'),(2652,NULL,6087,'dactacort cream 1 week then daktrin cream 1 week + flucoral cap  e',37.0,79653,763,763,'2022-09-03 10:21:35','2022-09-03 10:21:35'),(2653,'no need',6209,'panadol',37.0,79683,339,339,'2022-09-03 10:22:50','2022-09-03 10:22:50'),(2654,'Coronary angiography',6066,NULL,37.0,79626,2484,2484,'2022-09-03 10:24:00','2022-09-03 10:24:00'),(2655,NULL,4567,'systemic acyclovir',37.0,79653,763,763,'2022-09-03 10:24:06','2022-09-03 10:24:06'),(2656,NULL,4568,NULL,37.0,79653,763,763,'2022-09-03 10:26:14','2022-09-03 10:26:14'),(2657,'FUP Cardiac enzymes- if Positive or intractable Chest Pain CA+\\-PCI',6208,NULL,37.0,79632,2047,2047,'2022-09-03 10:26:28','2022-09-03 10:26:28'),(2658,'Follow up',3987,NULL,37.0,79684,2502,2502,'2022-09-03 10:29:35','2022-09-03 10:29:35'),(2659,NULL,6155,NULL,37.0,79627,2484,2484,'2022-09-03 10:32:22','2022-09-03 10:32:22'),(2660,NULL,5847,'Borgasone cream  دهان مرتين يوميا لمدة اسبوعين ثم مرة يوميا لمدة اسبوعين ثم يوقف',37.0,79659,763,763,'2022-09-03 10:34:01','2022-09-03 10:34:01'),(2661,'condition not improved - cholecystectomy by expert surgeon in GIT',6111,'broad spectrum antibiotic (3rd generation quinolones)',37.0,79680,1609,1609,'2022-09-03 10:34:30','2022-09-03 10:34:30'),(2662,'BLOOD AND SPUTUM CULTURE \r\nADD VANCOMYCIN',6086,NULL,37.0,79676,2242,2242,'2022-09-03 10:34:32','2022-09-03 10:34:32'),(2663,'follow up and wenning of thr patient',6164,NULL,37.0,79684,2502,2502,'2022-09-03 10:37:52','2022-09-03 10:37:52'),(2664,'betadine shampoo مع الاستحمام',6190,'systemic antibiotic ,topical antibiotic cr, k permangnate 1\\8000كمدات لمدة 5 دقايق',37.0,79686,1330,1330,'2022-09-03 10:39:45','2022-09-03 10:39:45'),(2665,'duplex us on arterial system - as to ulcer 2stage ofdressing & management : 1st : debridement and infection  2nd stage : healing stimulation  - offloadi',6112,NULL,37.0,79680,1609,1609,'2022-09-03 10:41:19','2022-09-03 10:41:19'),(2666,'MOSTLY ACUTE KIDNEY INJURY WAITING FOR SONAR AND URINE ANALYSIS',5777,NULL,37.0,79646,2491,2491,'2022-09-03 10:41:49','2022-09-03 10:41:49'),(2667,'BLOOD AND SPUTUM CULTURE \r\nADD VANCOMYCIN',6088,NULL,37.0,79676,2242,2242,'2022-09-03 10:42:43','2022-09-03 10:42:43'),(2668,'add also vaccum if available + diabetes control',6112,'diabetic foot ulcer',37.0,79680,1609,1609,'2022-09-03 10:43:25','2022-09-03 10:43:25'),(2669,NULL,6161,'acitretin  + azaithromycin + calcipotriol',37.0,79654,763,763,'2022-09-03 10:44:32','2022-09-03 10:44:32'),(2670,'surgical repair',6113,NULL,37.0,79680,1609,1609,'2022-09-03 10:45:58','2022-09-03 10:45:58'),(2671,'betadine shampoo مع الاستحمام',6197,'systemic antibiotic ,topical antibiotic cr, k permangnate 1\\8000كمدات لمدة 5 دقايق',37.0,79686,1330,1330,'2022-09-03 10:49:43','2022-09-03 10:49:43'),(2672,NULL,6055,NULL,37.0,79648,2491,2491,'2022-09-03 10:50:41','2022-09-03 10:50:41'),(2673,NULL,6059,NULL,37.0,79648,2491,2491,'2022-09-03 10:51:06','2022-09-03 10:51:06'),(2674,'treatment of chronic codition increasing intraabdominal pressure - stop hard work - then hernioplasty remove of old mesh',6114,NULL,37.0,79680,1609,1609,'2022-09-03 10:51:49','2022-09-03 10:51:49'),(2675,'ABDOMINAL ERECT X RAY\r\nNEPHROLOGY CONSULTATION',6132,NULL,37.0,79676,2242,2242,'2022-09-03 10:52:03','2022-09-03 10:52:03'),(2676,'CVline , CT pulmonary angiography , anticoagulation',5240,NULL,37.0,79633,2047,2047,'2022-09-03 10:54:07','2022-09-03 10:54:07'),(2677,'consult urology',6115,NULL,37.0,79680,1609,1609,'2022-09-03 10:55:57','2022-09-03 10:55:57'),(2678,'try methotrexate again  if failed try phototherapy  or combine \r\nuse rotatory treatment',6152,NULL,37.0,79660,763,763,'2022-09-03 10:56:36','2022-09-03 10:56:36'),(2679,'ANTICOAGULATION AND RYTHM CONTROL AND ANTISCHAEMIC',5235,NULL,37.0,79633,2047,2047,'2022-09-03 10:59:27','2022-09-03 10:59:27'),(2680,'PERINATAL HISTORY \r\nEXAMINATION\r\nLABS \r\nCULTURES \r\nAPGAR SCORE \r\nCHEST X RAY \r\nABDOMINAL UTRASOUND',6134,NULL,37.0,79676,2242,2242,'2022-09-03 11:01:34','2022-09-03 11:01:34'),(2681,'Echocardiography and reconsult',5237,NULL,37.0,79633,2047,2047,'2022-09-03 11:06:40','2022-09-03 11:06:40'),(2682,NULL,6116,NULL,37.0,79649,2491,2491,'2022-09-03 11:12:45','2022-09-03 11:12:45'),(2683,NULL,6117,NULL,37.0,79649,2491,2491,'2022-09-03 11:13:21','2022-09-03 11:13:21'),(2684,NULL,6118,NULL,37.0,79649,2491,2491,'2022-09-03 11:13:41','2022-09-03 11:13:41'),(2685,'FOLLOW UP GENETIC CONSULTATION \r\nORTHOPEDIC CONSULTATION',6168,NULL,37.0,79687,2242,2242,'2022-09-03 11:27:23','2022-09-03 11:27:23'),(2686,'urine culture\r\ninterventional radiology consultation\r\nantibiotics\r\nantipyretic\r\nfluid resuscitation',6146,NULL,37.0,79688,2491,2491,'2022-09-03 11:29:42','2022-09-03 11:29:42'),(2687,'CARDIOTHORACIC CONSULTATION \r\nPEDIATRIC CARDIOLOGY CONSULTATION',6173,NULL,37.0,79687,2242,2242,'2022-09-03 11:32:28','2022-09-03 11:32:28'),(2688,'FOOLOW UP BILIRUBIN LEVEL FOR PREPARING DISCHARGE',6188,NULL,37.0,79687,2242,2242,'2022-09-03 11:37:50','2022-09-03 11:37:50'),(2689,'medical treatment and lumbosacral belt',5479,NULL,37.0,79702,2513,2513,'2022-09-04 07:22:24','2022-09-04 07:22:24'),(2690,'medical treatment and MRI cervical spines',5480,NULL,37.0,79702,2513,2513,'2022-09-04 07:23:41','2022-09-04 07:23:41'),(2691,'antifungal\r\nTB assessment',6260,NULL,37.0,79689,2226,2226,'2022-09-04 07:29:57','2022-09-04 07:29:57'),(2692,'tiratam  vial \r\ndepakine chrono tab',6094,NULL,37.0,79703,2513,2513,'2022-09-04 07:32:31','2022-09-04 07:32:31'),(2693,'serum electrolytes\r\narterial blood ammonia',6321,NULL,37.0,79701,2512,2512,'2022-09-04 07:51:32','2022-09-04 07:51:32'),(2694,'upper GIT ensoscopy\r\nfresh blood transfusion\r\nplasma transfusion',6324,NULL,37.0,79701,2512,2512,'2022-09-04 07:53:10','2022-09-04 07:53:10'),(2695,'urine culture then antibiotic with follow up of liver enzymes',6322,NULL,37.0,79701,2512,2512,'2022-09-04 07:55:00','2022-09-04 07:55:00'),(2696,'topamax 25mg tab one tablet at night\r\n\\few mig cap \r\nsolpadol 5mg tab. on demand',6133,NULL,37.0,79709,2513,2513,'2022-09-04 08:06:14','2022-09-04 08:06:14'),(2697,'tryptizol 10md one tab at bed time\r\ndolipran 1000mg caplet on demand\r\n EEG IS RECOMMENDED',6138,NULL,37.0,79709,2513,2513,'2022-09-04 08:07:45','2022-09-04 08:07:45'),(2698,'yag laser peripheral iridectomy',5977,'cidamex..full antiglucoma eye drops',37.0,79695,2510,2510,'2022-09-04 08:09:22','2022-09-04 08:09:22'),(2699,'yag laser peripheral iridectomy',5977,'cidamex..full antiglucoma eye drops',37.0,79695,2510,2510,'2022-09-04 08:09:22','2022-09-04 08:09:22'),(2700,NULL,6212,NULL,37.0,79711,2513,2513,'2022-09-04 08:15:13','2022-09-04 08:15:13'),(2701,'albumen -glypressin',6149,NULL,37.0,79723,2512,2512,'2022-09-04 08:16:27','2022-09-04 08:16:27'),(2702,'Treatment of wound infection, P\'RN dialysis, fundus examination, echocardiography',6224,NULL,37.0,79743,2517,2517,'2022-09-04 08:18:10','2022-09-04 08:18:10'),(2703,'follow up ..surgical debridement',5978,'fortified antibiotic..antifungal..antiviral eye drops',37.0,79695,2510,2510,'2022-09-04 08:18:21','2022-09-04 08:18:21'),(2704,'follow up P\'tH decrease ESA dose',5618,NULL,37.0,79742,2517,2517,'2022-09-04 08:30:34','2022-09-04 08:30:34'),(2705,'PRP....Panretinal Photocoagulation',4916,NULL,37.0,79696,2510,2510,'2022-09-04 08:37:23','2022-09-04 08:37:23'),(2706,'try to convince the patient to extend dialysis time and protein supplementation oral or intradialytic',5627,NULL,37.0,79742,2517,2517,'2022-09-04 08:37:53','2022-09-04 08:37:53'),(2707,'D-dimer\r\nransfer to fever hospital',6250,NULL,37.0,79699,2512,2512,'2022-09-04 08:39:19','2022-09-04 08:39:19'),(2708,'follow up PTH and alkaline phosphatasse',5631,NULL,37.0,79742,2517,2517,'2022-09-04 08:40:19','2022-09-04 08:40:19'),(2709,'gradual decrease of body weight and the use of nondialyzable antihypertensive medications',5635,NULL,37.0,79742,2517,2517,'2022-09-04 08:43:17','2022-09-04 08:43:17'),(2710,'discussion of kidney transplantation',5643,NULL,37.0,79742,2517,2517,'2022-09-04 08:45:36','2022-09-04 08:45:36'),(2711,'best supportive care, and hepatology consultation',6363,NULL,37.0,79745,1635,1635,'2022-09-04 08:47:24','2022-09-04 08:47:24'),(2712,'fulfil staging work up, pathology, pain management',6361,NULL,37.0,79745,1635,1635,'2022-09-04 08:48:31','2022-09-04 08:48:31'),(2713,'S CREATININE, S Amylase, S LIPASE, ,,,Ultasound, , CT abdomen, virology',6185,'stopped NSAID',37.0,79717,2265,2265,'2022-09-04 08:49:28','2022-09-04 08:49:28'),(2714,'transfer to an equiped hospital with NICU with neurosurgical care',6294,NULL,37.0,79749,2519,2519,'2022-09-04 08:51:15','2022-09-04 08:51:15'),(2715,',abdominal ultasound  ,Fecal occult blood stool, s creatinine, CBC, Liver function test',6192,'fluid, PPI',37.0,79717,2265,2265,'2022-09-04 08:51:39','2022-09-04 08:51:39'),(2716,'follow up the patient\'s iPTH level. Perform a fistulogram on the AVF to exclude the presence of arterial stenosis as the patient sufferes from blood clot on needle extraction.',6178,NULL,37.0,79741,2530,2530,'2022-09-04 08:57:21','2022-09-04 08:57:21'),(2717,'repeat us neck with tirads and size designation, ct chest with medistinal window, us abdomen and pelvis, dippler of neck vessels',6068,NULL,37.0,79744,1635,1635,'2022-09-04 08:58:10','2022-09-04 08:58:10'),(2718,NULL,6327,NULL,37.0,79718,985,985,'2022-09-04 08:58:34','2022-09-04 08:58:34'),(2719,'follow up',6339,NULL,37.0,79712,1947,1947,'2022-09-04 09:00:56','2022-09-04 09:00:56'),(2720,'follow up',6344,NULL,37.0,79712,1947,1947,'2022-09-04 09:03:10','2022-09-04 09:03:10'),(2721,'follow up TSAT and serum ferritin level together with serum iPTH, and treat accordingly.',6184,NULL,37.0,79741,2530,2530,'2022-09-04 09:03:55','2022-09-04 09:03:55'),(2722,'duplex US to exclude DVT',6172,'Maxipime 1gm vial 1*2 - Local betadine oint. - azim tab 1*3',37.0,79766,1609,1609,'2022-09-04 09:06:10','2022-09-04 09:06:10'),(2723,'follow up',6175,NULL,37.0,79713,1947,1947,'2022-09-04 09:06:35','2022-09-04 09:06:35'),(2724,'duplex US to exclude DVT',6172,'Maxipime 1gm vial 1*2 - Local betadine oint. - azim tab 1*3',37.0,79766,1609,1609,'2022-09-04 09:07:30','2022-09-04 09:07:30'),(2725,NULL,6366,NULL,37.0,79744,1635,1635,'2022-09-04 09:07:50','2022-09-04 09:07:50'),(2726,'The patients had thrombocytopenia since 3 months and she is HCV PCR positive. We recommend performing quantitative HCV PCR and abdominal US to recieve the proper treatment.',6249,NULL,37.0,79741,2530,2530,'2022-09-04 09:10:46','2022-09-04 09:10:46'),(2727,'follow up',5167,NULL,37.0,79715,1947,1947,'2022-09-04 09:12:00','2022-09-04 09:12:00'),(2728,NULL,6097,NULL,37.0,79735,1602,1602,'2022-09-04 09:13:13','2022-09-04 09:13:13'),(2729,NULL,3211,'vit. D THERAPY',37.0,79719,985,985,'2022-09-04 09:14:14','2022-09-04 09:14:14'),(2730,'If the patient has accepted lab and normal ECG and echo, then he can proceed to the surgery. We recommend that the perioperative HD session should be heparin free.',6265,NULL,37.0,79741,2530,2530,'2022-09-04 09:14:31','2022-09-04 09:14:31'),(2731,NULL,6323,'calcium',37.0,79767,2529,2529,'2022-09-04 09:17:33','2022-09-04 09:17:33'),(2732,'follow up Procalcitonin\r\nfollow up CBC',6382,'Continue on same regimen',37.0,79762,2060,2060,'2022-09-04 09:21:55','2022-09-04 09:21:55'),(2733,'follow up liver enzymes',3905,'Continue on same regimen',37.0,79762,2060,2060,'2022-09-04 09:22:39','2022-09-04 09:22:39'),(2734,'We recoomend performing a therapeutic pleuricentesis and taking samples for chemistry, culture and cytology.',6268,NULL,37.0,79741,2530,2530,'2022-09-04 09:23:58','2022-09-04 09:23:58'),(2735,'We recommend performing dopller on the arterial and venous system',6271,NULL,37.0,79741,2530,2530,'2022-09-04 09:24:52','2022-09-04 09:24:52'),(2736,NULL,3905,'Continue on same regimen+withdraw steroid gradually+colchisine',37.0,79762,2060,2060,'2022-09-04 09:24:52','2022-09-04 09:24:52'),(2737,NULL,5995,NULL,37.0,79780,1602,1602,'2022-09-04 09:26:18','2022-09-04 09:26:18'),(2738,'follow up CT chest',3905,NULL,37.0,79762,2060,2060,'2022-09-04 09:26:52','2022-09-04 09:26:52'),(2739,'please:\r\n1- take all measures and plot on centiles\r\n2- do  full iron profile: FE ferretin TIBC\r\n3- there is history of cardiac lesion: do Echo ECG, if normal consider holter after cardio consultation\r\n4- neuro assessement may be type of seizures: do EEG after cardio assessment if normal consult neurologist',5920,NULL,37.0,79778,2534,2534,'2022-09-04 09:27:18','2022-09-04 09:27:18'),(2740,'follow up',5181,NULL,37.0,79714,1947,1947,'2022-09-04 09:27:29','2022-09-04 09:27:29'),(2741,'follow up',5186,NULL,37.0,79714,1947,1947,'2022-09-04 09:27:54','2022-09-04 09:27:54'),(2742,NULL,6236,NULL,37.0,79780,1602,1602,'2022-09-04 09:28:10','2022-09-04 09:28:10'),(2743,'follow up',6160,NULL,37.0,79714,1947,1947,'2022-09-04 09:28:14','2022-09-04 09:28:14'),(2744,NULL,6170,NULL,37.0,79714,1947,1947,'2022-09-04 09:28:48','2022-09-04 09:28:48'),(2745,'follow up',6239,NULL,37.0,79714,1947,1947,'2022-09-04 09:29:22','2022-09-04 09:29:22'),(2746,'FOLLOW UP  MORE LABS',6325,'FOLLOW UP',37.0,79767,2529,2529,'2022-09-04 09:29:47','2022-09-04 09:29:47'),(2747,'follow up',6247,NULL,37.0,79714,1947,1947,'2022-09-04 09:29:55','2022-09-04 09:29:55'),(2748,'follow up',6255,NULL,37.0,79714,1947,1947,'2022-09-04 09:30:23','2022-09-04 09:30:23'),(2749,'follow up',6255,NULL,37.0,79714,1947,1947,'2022-09-04 09:30:23','2022-09-04 09:30:23'),(2750,NULL,6331,NULL,37.0,79718,985,985,'2022-09-04 09:31:55','2022-09-04 09:31:55'),(2751,NULL,6332,NULL,37.0,79718,985,985,'2022-09-04 09:32:28','2022-09-04 09:32:28'),(2752,'follow up',6350,NULL,37.0,79716,1947,1947,'2022-09-04 09:32:40','2022-09-04 09:32:40'),(2753,'we recoomend a proper clinical examination of the petient on narrow interval visits (every 2 weeks) and follow up his serum creatinine. potassium, blood gases and blood pressure and ofcourse daily urine output. And then we decide if the patient needs JHD session accordingly.',6274,NULL,37.0,79741,2530,2530,'2022-09-04 09:32:52','2022-09-04 09:32:52'),(2754,'CPK, ESR, CRP, ANA, MRI on the proximal muscles ( shoulder and pelvic gridle), esophageal motility test',6359,'continue on steroid',37.0,79706,2265,2265,'2022-09-04 09:33:10','2022-09-04 09:33:10'),(2755,NULL,6329,NULL,37.0,79718,985,985,'2022-09-04 09:33:17','2022-09-04 09:33:17'),(2756,'follow up',6165,NULL,37.0,79716,1947,1947,'2022-09-04 09:34:25','2022-09-04 09:34:25'),(2757,',  ICU admission ,Non contrast CT abdomen, urology consultation,',6352,', fluid restriction, stop lasix',37.0,79706,2265,2265,'2022-09-04 09:38:50','2022-09-04 09:38:50'),(2758,'We recoomend gradual reduction of dry body weight guided by the blood pressure. Regarding oral iron, we recommend to stop it and take iron indices ;lab like TSAT and ferritin.',6251,NULL,37.0,79740,2530,2530,'2022-09-04 09:42:37','2022-09-04 09:42:37'),(2759,NULL,6229,NULL,37.0,79720,985,985,'2022-09-04 09:43:09','2022-09-04 09:43:09'),(2760,'diagnostic pleural effusion',6286,NULL,37.0,79784,2060,2060,'2022-09-04 09:43:38','2022-09-04 09:43:38'),(2761,NULL,6231,NULL,37.0,79720,985,985,'2022-09-04 09:43:54','2022-09-04 09:43:54'),(2762,NULL,6230,NULL,37.0,79720,985,985,'2022-09-04 09:44:23','2022-09-04 09:44:23'),(2763,NULL,6233,NULL,37.0,79720,985,985,'2022-09-04 09:44:46','2022-09-04 09:44:46'),(2764,'We recoomend ransferring the patient for kidney transplant preparation from a related living donor.',6254,NULL,37.0,79740,2530,2530,'2022-09-04 09:50:27','2022-09-04 09:50:27'),(2765,'surgically reduced - mesh repair',6283,NULL,37.0,79769,1609,1609,'2022-09-04 09:52:06','2022-09-04 09:52:06'),(2766,'We recoomend transferring the patient for kidney transplant preparation from a related living donor.',6257,NULL,37.0,79740,2530,2530,'2022-09-04 09:53:01','2022-09-04 09:53:01'),(2767,'HEMODIALYSIS',6345,'FOLLOW UP',37.0,79767,2529,2529,'2022-09-04 09:54:24','2022-09-04 09:54:24'),(2768,'We recommend transferring the patient for kidney transplant preparation',6259,NULL,37.0,79740,2530,2530,'2022-09-04 09:54:56','2022-09-04 09:54:56'),(2769,'local examination for piles - check Hemoglobulin - NG tube - coagulants (kapron vit k',6285,NULL,37.0,79769,1609,1609,'2022-09-04 09:56:33','2022-09-04 09:56:33'),(2770,'BMB PET CT',5026,NULL,37.0,79779,1794,1794,'2022-09-04 09:56:59','2022-09-04 09:56:59'),(2771,'1- calculate the caloric intake and need according to his age and weight then decide if he is receiving enough  intake\r\n2- if receiving good intake  then may be there is loss from his cardiac condition\r\n3- do cardio consultation due to ASD',1337,NULL,37.0,79777,2534,2534,'2022-09-04 09:58:42','2022-09-04 09:58:42'),(2772,'ask for fsh, lh, prolactin, 17 oh progesterone, total testosterone, dhea-s',6096,NULL,37.0,79707,2267,2267,'2022-09-04 09:59:44','2022-09-04 09:59:44'),(2773,'We recommend shifting the antihypertensive from alkapress to carvidelol 25 mg twice per day. Also check the patient volume statuts and his body weight before the HD session plus or minus reduction of his dry body weight gradually.',6261,NULL,37.0,79740,2530,2530,'2022-09-04 09:59:44','2022-09-04 09:59:44'),(2774,'Better one side every time',6284,NULL,37.0,79769,1609,1609,'2022-09-04 10:00:54','2022-09-04 10:00:54'),(2775,'1- MRI brain to exclude any organic brain lesions\r\n2- if normal do ophthalmological and ENT consultations\r\nfollow up of his blood pressure',5674,NULL,37.0,79777,2534,2534,'2022-09-04 10:01:24','2022-09-04 10:01:24'),(2776,NULL,6336,NULL,37.0,79722,985,985,'2022-09-04 10:02:40','2022-09-04 10:02:40'),(2777,'1- do CPK, LDH, Ca, Ph ALP, ionized Ca, CBC\r\n2- MRI brain\r\n3- EMG and NCV',6375,NULL,37.0,79777,2534,2534,'2022-09-04 10:03:41','2022-09-04 10:03:41'),(2778,'We recommend performing full chemistry and CBC and blood gases every month, virology every three months, and iPTH evefry three months for all the HD patients.',6263,NULL,37.0,79740,2530,2530,'2022-09-04 10:04:07','2022-09-04 10:04:07'),(2779,'1-  as the weight and height are nornal on centiles as Dr mentioned the Dr should see and ensure of this diarrhea\r\n2-do Fe, ferretin, TIBC, as there is micro hypo anemia in CBC\r\n3-GIT consultation',6377,NULL,37.0,79777,2534,2534,'2022-09-04 10:07:03','2022-09-04 10:07:03'),(2780,NULL,6403,'systemic and topical antibiotic',37.0,79796,1726,1726,'2022-09-04 10:17:51','2022-09-04 10:17:51'),(2781,NULL,6186,'لا توجد صور لم يتم التشخيص',37.0,79796,1726,1726,'2022-09-04 10:23:43','2022-09-04 10:23:43'),(2782,NULL,6301,NULL,37.0,79798,2010,2010,'2022-09-04 10:25:21','2022-09-04 10:25:21'),(2783,'echocardiography and follow up',6288,'NA',37.0,79791,1962,1962,'2022-09-04 10:27:30','2022-09-04 10:27:30'),(2784,'حاله طارئة استسقاء حاد في المخ وتدهور بدرجه وعي المريض تجتاج الي تدخل جراحي لتغيير مجري سائل المخ بصورة عاجلة',6386,NULL,37.0,79754,2522,2522,'2022-09-04 10:27:40','2022-09-04 10:27:40'),(2785,NULL,672,NULL,37.0,79797,2010,2010,'2022-09-04 10:30:02','2022-09-04 10:30:02'),(2786,'PCI',5787,'ADANCOR 10, PROCORLAN 5 TWICE DAILY',37.0,79708,2511,2511,'2022-09-04 10:30:58','2022-09-04 10:30:58'),(2787,'STOP MAREVAN, START CLEXAN THEN STOP CLEXAN 24 HOURS BEFORE PROCEDURE',5797,NULL,37.0,79708,2511,2511,'2022-09-04 10:32:09','2022-09-04 10:32:09'),(2788,'عرض باطنه',6269,'topical antibiotic ,until further investigation',37.0,79792,1726,1726,'2022-09-04 10:32:37','2022-09-04 10:32:37'),(2789,'FOR PCI',5853,NULL,37.0,79708,2511,2511,'2022-09-04 10:32:40','2022-09-04 10:32:40'),(2790,NULL,6302,NULL,37.0,79798,2010,2010,'2022-09-04 10:32:43','2022-09-04 10:32:43'),(2791,NULL,4156,NULL,37.0,79721,985,985,'2022-09-04 10:32:46','2022-09-04 10:32:46'),(2792,NULL,6396,NULL,37.0,79721,985,985,'2022-09-04 10:34:13','2022-09-04 10:34:13'),(2793,'1- do urine analysis, CBC\r\n2- modify antibiotics acc to cultures\r\n3-heamatology consultation if in need of bone marrow aspirate after stabilization of condition  may be red cell aplasia',6413,NULL,37.0,79785,2534,2534,'2022-09-04 10:37:32','2022-09-04 10:37:32'),(2794,'consultation  about asthma management after discharge\r\n for pulmonology \r\nthe Dr mentioned the patient is not distressed at this moment',6418,NULL,37.0,79785,2534,2534,'2022-09-04 10:41:03','2022-09-04 10:41:03'),(2795,NULL,6226,NULL,37.0,79800,2010,2010,'2022-09-04 10:41:08','2022-09-04 10:41:08'),(2796,'1- do ABG electrolytes for monitoring the condition\r\n2- correct hyper natremia gradually with special fluid therapy\r\n3- if K is 3.5 to 2.5 correct by oral syrup: 1mg/ kg/ day and follow up the labs\r\n4- do anion gap if any metabolic acidosis if normal: RTA- GE, if high : cosider inborn errors of metabolism\r\n5- do abd Us if any renal nephropathy or organomegaly',6419,NULL,37.0,79785,2534,2534,'2022-09-04 10:46:03','2022-09-04 10:46:03'),(2797,'investigations for vaginal bleeding - transvaginal US - treatment of Diabetic ketoacidosis (insulin  mixtard + lantos)( -  follow up for albumin - leave free fluid in abdomen to resolve spontaneous',6415,NULL,37.0,79773,1456,1456,'2022-09-04 10:46:30','2022-09-04 10:46:30'),(2798,NULL,6342,'woods light or biopsy  to confirm diagnosis',37.0,79794,1726,1726,'2022-09-04 10:49:48','2022-09-04 10:49:48'),(2799,'FOR CORONARY ANGIOGRAPHY, ANTIPLATELETS',6219,'ANTIPLATELT',37.0,79710,2511,2511,'2022-09-04 10:50:12','2022-09-04 10:50:12'),(2800,'DIGOXIN, REFERAKL TO PULMONARY HTN CLINIC',6270,NULL,37.0,79710,2511,2511,'2022-09-04 10:51:02','2022-09-04 10:51:02'),(2801,'bronchoalveolar lavage - Nebulizer every 2 hours with bronchodilator - +plus lasix plus corticosteroids  - continue therapeutic parentral anticoaulant',6412,'Tavanic+ Tygalcil + therapeutic dose of clexane',37.0,79773,1456,1456,'2022-09-04 10:54:18','2022-09-04 10:54:18'),(2802,'daily follow up of conscious level',5996,'marivan 1mg once daily',37.0,79789,2541,2541,'2022-09-04 10:59:00','2022-09-04 10:59:00'),(2803,NULL,5998,'anti coma measures , lactulose enema idabact 550',37.0,79789,2541,2541,'2022-09-04 11:02:09','2022-09-04 11:02:09'),(2804,'cardiac catheters as rapid as possible',6367,NULL,37.0,79774,1456,1456,'2022-09-04 11:02:39','2022-09-04 11:02:39'),(2805,'cardiac cathetarization as soon as possible',6357,NULL,37.0,79774,1456,1456,'2022-09-04 11:04:47','2022-09-04 11:04:47'),(2806,'virology testing, urine analysis, s.creatnine , s.urea , s.Na , s.K ,ABG 24hrs urinary protien , ECHO, central line , fluid shart , fundus examination',6193,NULL,37.0,79787,2541,2541,'2022-09-04 11:07:25','2022-09-04 11:07:25'),(2807,'sepsis wise controlled start pulse steroid 1gm daily for 3 doses …followed by booster dose IVIG for 3 doses 1  week apart ….physiotherapy chest and balance gait when possible',5751,NULL,37.0,79806,2257,2257,'2022-09-04 11:08:20','2022-09-04 11:08:20'),(2808,'s.amylase , s.lipase , HbA1c, CBC, Na, K , creatinine , urea , ANA , Anti phospholipid AB, CT abdomin and pelvis with contrast',6195,NULL,37.0,79787,2541,2541,'2022-09-04 11:11:16','2022-09-04 11:11:16'),(2809,NULL,6223,NULL,37.0,79757,1948,1948,'2022-09-04 11:12:29','2022-09-04 11:12:29'),(2810,'follow up hydration status\r\nfull exam of the child \r\nrecord weight height and plot on centiles\r\nfull nutritional history\r\ndonot give IV antibiotics for acute tonsilittis\r\ngive cephalosporins oral if indicated',6422,NULL,37.0,79786,2534,2534,'2022-09-04 11:14:07','2022-09-04 11:14:07'),(2811,'ECG , ECHO, 24HRs urinary protein , fundus examination',6319,NULL,37.0,79787,2541,2541,'2022-09-04 11:14:08','2022-09-04 11:14:08'),(2812,NULL,6392,NULL,37.0,79795,1726,1726,'2022-09-04 11:15:13','2022-09-04 11:15:13'),(2813,'follow up hydaration status\r\ncontinue on zinc and oral cephalosporins if indicated',6423,NULL,37.0,79786,2534,2534,'2022-09-04 11:16:13','2022-09-04 11:16:13'),(2814,'anticoma measures, plasma transfusion,folow up conscious level',6390,NULL,37.0,79787,2541,2541,'2022-09-04 11:16:47','2022-09-04 11:16:47'),(2815,'follow hydration status\r\nask if recurrent: do h pylori Ag in stools',6426,NULL,37.0,79786,2534,2534,'2022-09-04 11:18:02','2022-09-04 11:18:02'),(2816,'decrease dose of lantus insulin , follow up blood glucose',6441,NULL,37.0,79788,2541,2541,'2022-09-04 11:18:20','2022-09-04 11:18:20'),(2817,NULL,6234,NULL,37.0,79756,1948,1948,'2022-09-04 11:18:48','2022-09-04 11:18:48'),(2818,'follow up hydration status\r\ncontinue on oral zinc',6427,NULL,37.0,79786,2534,2534,'2022-09-04 11:18:59','2022-09-04 11:18:59'),(2819,NULL,6387,NULL,37.0,79759,1948,1948,'2022-09-04 11:29:59','2022-09-04 11:29:59'),(2820,NULL,6399,NULL,37.0,79759,1948,1948,'2022-09-04 11:30:11','2022-09-04 11:30:11'),(2821,'monitor bl pr , UOP, kidney function and electrolytes\r\nas long as the child is diagnosed as first presentation nephrotic syndrome and on oral steroid on 2mg/kg/day divided every 12 hours after meals for 4-6 weeks and gradual tapering after remission , gastroprotective agent and oral vitamin D prophylactic dose \r\nAlbumin transfusion when indicated only after control of blood pressure',6445,NULL,37.0,79730,1394,1394,'2022-09-04 11:32:21','2022-09-04 11:32:21'),(2822,'sacrofer 2 amp twice weekly\r\nfollow up hemoglobin level during treatment',4046,NULL,37.0,79817,2558,2558,'2022-09-04 11:46:51','2022-09-04 11:46:51'),(2823,'Continue follow up with close monitoring of kidney function (risk of renal impairment and may need renal replacement therapy in the future), urine analysis for hematuria and proteinuria\r\nophthalmology consultation, and ENT consultation for audoigram to detect extra renal manifestation',6338,NULL,37.0,79728,1394,1394,'2022-09-04 11:48:27','2022-09-04 11:48:27'),(2824,'fluid therapy\r\nstart weaning of fluid with semisolid meals\r\nantiemetics, corticosteroids\r\nfollow up acetone in urine , hematocrit\r\nif there is hemoconcentration ,thromboprophylaxis by LMWH e.g; calexane',4048,NULL,37.0,79817,2558,2558,'2022-09-04 11:52:14','2022-09-04 11:52:14'),(2825,'INVESTIGATIONS FOR FOLLOW UP( DOBUTAMINE ECHO OR STRESS ECG IF STRESS ECHO NOT AVAILABLE)',6307,NULL,37.0,79790,1962,1962,'2022-09-04 11:53:30','2022-09-04 11:53:30'),(2826,'correction of anemia sacrofer 2 amp twice weekly\r\nfollow up hemoglobin level during treatment',5064,NULL,37.0,79817,2558,2558,'2022-09-04 11:53:43','2022-09-04 11:53:43'),(2827,'sacrofer 2 amp twice weekly\r\nfollow up hemoglobin during treatment',5825,NULL,37.0,79817,2558,2558,'2022-09-04 11:54:53','2022-09-04 11:54:53'),(2828,'INVESTIGAIONS FOR FOLLOW UP( STRESS ECHO)',6306,NULL,37.0,79790,1962,1962,'2022-09-04 12:01:57','2022-09-04 12:01:57'),(2829,'CORONARY ANGIOGRAPHY',6304,NULL,37.0,79790,1962,1962,'2022-09-04 12:04:08','2022-09-04 12:04:08'),(2830,'متابعة قراءات السكر في الدم والغازات والاملاح',6045,NULL,37.0,79823,2559,2559,'2022-09-04 12:06:02','2022-09-04 12:06:02'),(2831,'STRESS ECHOCARDIOGRAPHY THEN FOLLOW UP',6303,NULL,37.0,79790,1962,1962,'2022-09-04 12:08:22','2022-09-04 12:08:22'),(2832,NULL,6305,'ANTIHYPERTENSIVE TREATMENT AND FOLLOE UP BLOOD PRESSURE',37.0,79790,1962,1962,'2022-09-04 12:14:38','2022-09-04 12:14:38'),(2833,'تحويل علي تخصص جهاز هضمي وكبد',2722,NULL,37.0,79823,2559,2559,'2022-09-04 12:18:18','2022-09-04 12:18:18'),(2834,'متابعه مع تخصص قلب وعمل اشعه ايكو',6057,NULL,37.0,79823,2559,2559,'2022-09-04 12:24:49','2022-09-04 12:24:49'),(2835,'myomectomy versus hysterectomy after patient consent\r\ncorrection of anemia if present\r\navailability of intraoperative blood transfusion',6103,NULL,37.0,79822,2558,2558,'2022-09-04 12:27:20','2022-09-04 12:27:20'),(2836,'corticosteroids (dexamethasone 6mg twice daily for 48 hr or betamethasone 12 \r\nmg /day /48hr)\r\nyou can try amniocentesis if there is available expert in fetal medicine and termination if there is fetal or maternal complication or active labor \r\nfollow up fetal wellbeing with ultra sound and CTG (if not available refer to university hospital )',6100,NULL,37.0,79822,2558,2558,'2022-09-04 12:38:22','2022-09-04 12:38:22'),(2837,'termination of pregnancy after patient consent( better in university hospital)\r\ntemnination of pregnancy by 1/4 tab mesotac / 6 hr \r\nwe are not in hurry for trmination',6101,NULL,37.0,79822,2558,2558,'2022-09-04 12:42:06','2022-09-04 12:42:06'),(2838,'متابعه وظائف الكلي ومتابعه الاملاح كل 6 سعات',6362,NULL,37.0,79823,2559,2559,'2022-09-04 12:44:37','2022-09-04 12:44:37'),(2839,'متابعه صوره الدم',2363,NULL,37.0,79823,2559,2559,'2022-09-04 12:45:16','2022-09-04 12:45:16'),(2840,'termination of pregnancy after patient consent\r\ntermination better in university hospital\r\ntermination of pregnancy by mesotac 1/4 tab/6hr\r\nwe are not in hurry for termination',6102,NULL,37.0,79822,2558,2558,'2022-09-04 12:46:31','2022-09-04 12:46:31'),(2841,'myomectomy versus hysterectomy after patient consent\r\ncorrection of anemia \r\navailabirlity of intraoperative blood transfusion',6104,NULL,37.0,79822,2558,2558,'2022-09-04 12:49:23','2022-09-04 12:49:23'),(2842,'متابعه وظائف الكبد والكلي',6365,NULL,37.0,79823,2559,2559,'2022-09-04 12:54:31','2022-09-04 12:54:31'),(2843,'متابعه وظائف الكبد والكلي',6365,NULL,37.0,79823,2559,2559,'2022-09-04 12:54:32','2022-09-04 12:54:32'),(2844,'متابعه مع تخصص اوعيه دمويه',6368,NULL,37.0,79823,2559,2559,'2022-09-04 12:57:26','2022-09-04 12:57:26'),(2845,'oral glucose tolerance test\r\ncorticosteroids\r\ntermination not before 38 weak except if there is maternal or fetal indication',6101,NULL,37.0,78058,2558,2558,'2022-09-04 12:59:50','2022-09-04 12:59:50'),(2846,'control of blood sugar\r\ncorticosteroid with increase dose of insulin after endocrine consultation\r\nfollow up of fetal wellbeing\r\ntermination after complete of 38 week',6103,NULL,37.0,77729,2558,2558,'2022-09-04 13:08:52','2022-09-04 13:08:52'),(2847,'x ray hip',5590,NULL,37.0,79826,2560,2560,'2022-09-04 13:12:43','2022-09-04 13:12:43');

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