diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/BhUIXmwX_jA.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/BhUIXmwX_jA.srt new file mode 100644 index 0000000000000000000000000000000000000000..3504c4381011fa5997022fde83e8f77027e74aa1 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/BhUIXmwX_jA.srt @@ -0,0 +1,1403 @@ +1 +00:00:21,630 --> 00:00:24,770 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:24,770 --> 00:00:29,290 +وبركاته and a very good morning to all of you + +3 +00:00:29,290 --> 00:00:34,890 +اليوم هنتناول موضوع ال tear film and blinking + +4 +00:00:34,890 --> 00:00:44,250 +بداية لو بدأنا المحاضرة ما هو مفهوم ال tears؟ + +5 +00:00:44,250 --> 00:00:49,350 +tears, it covers the anterior surface of the cornea + +6 +00:00:51,060 --> 00:00:56,200 +طيب ال functions of tears, number one, nourishment + +7 +00:00:56,200 --> 00:01:01,580 +of the cornea, number two, protection it from + +8 +00:01:01,580 --> 00:01:09,140 +infection. okay, normal blinking from fifteen to + +9 +00:01:09,140 --> 00:01:15,540 +twenty blinks. okay, from fifteen to twenty blinks + +10 +00:01:18,740 --> 00:01:24,120 +Have an effect on fitting. بداية ال tear لو كان + +11 +00:01:24,120 --> 00:01:32,600 +عندنا حاجة بنسميها tear film instability + +12 +00:01:32,600 --> 00:01:38,120 +أي + +13 +00:01:38,120 --> 00:01:42,840 +عدم ثبات في ال tear. هذا بيؤثر على أداء العدسة + +14 +00:01:42,840 --> 00:01:43,720 +اللاصقة + +15 +00:01:46,110 --> 00:01:50,770 +أيضا موضوع ال blinking، الترميش احنا في المحاضرة + +16 +00:01:50,770 --> 00:01:56,370 +السابقة اتكلمنا عن ال keratometer readings و ال + +17 +00:01:56,370 --> 00:02:05,530 +visual acuity chart. اذا عندنا كان optimal fit + +18 +00:02:05,530 --> 00:02:13,610 +lens, هيكون before و after ال blinking الصورة clear + +19 +00:02:14,440 --> 00:02:18,600 +لو كانت loose before a blinking, clear after a + +20 +00:02:18,600 --> 00:02:23,180 +blinking, هتكون unclear. لو كانت tight before a + +21 +00:02:23,180 --> 00:02:27,720 +blinking, unclear after a blinking, clear. فالان + +22 +00:02:27,720 --> 00:02:32,340 +بنستنتج من هذا الكلام انه ال .. انه ال blinking + +23 +00:02:32,340 --> 00:02:36,880 +الترميش هو عامل مهم في الوصول الى مين؟ ال optimal + +24 +00:02:36,880 --> 00:02:38,880 +fit lens. okay + +25 +00:02:41,360 --> 00:02:47,680 +Lens movement, حركة العدسة اللى normally من 0.5 to + +26 +00:02:47,680 --> 00:02:54,140 +1 ملي متر, can be affected, يمكن انه تتأثر by + +27 +00:02:54,140 --> 00:02:59,200 +interactions, بواسطة التفاعل between the lens and + +28 +00:02:59,200 --> 00:03:05,210 +upper lid. احنا حكينا ان ال diameter لل soft contact + +29 +00:03:05,210 --> 00:03:09,290 +lens أكبر من ال diameter للكورنية، ففي هناك + +30 +00:03:09,290 --> 00:03:14,190 +interaction ما بين ال upper eyelid و ال lens + +31 +00:03:14,190 --> 00:03:22,250 +لكن هذا التفاعل بينهم من مميزاته انه no hard, no + +32 +00:03:22,250 --> 00:03:26,590 +hard interaction. فالان لو كانت في عنا زيادة في + +33 +00:03:26,590 --> 00:03:31,670 +الحركة هتلاقي الشخص ايش ماله؟ discomfort. بيحكيلك + +34 +00:03:31,670 --> 00:03:35,370 +يعني من ال .. ضمن الشكوى انه يما ييجي على المركز + +35 +00:03:35,370 --> 00:03:39,530 +بيقولك دايما انا بحس الحركة بتخبط .. العدسة بتخبط + +36 +00:03:39,530 --> 00:03:43,890 +وين؟ في ال upper eyelid. وهذا غير محمود بالنسبة + +37 +00:03:43,890 --> 00:03:50,800 +لمين؟ للمريض. فالان حركة العدسة هي تعتبر عامل مهم في + +38 +00:03:50,800 --> 00:03:55,760 +الوصول للـ optimal lens fitting للعدسة الملائمة أو + +39 +00:03:55,760 --> 00:04:01,020 +العدسة المناسبة طبعا + +40 +00:04:01,020 --> 00:04:05,740 +في هناك عوامل بتعتمد عليها، depending on the + +41 +00:04:05,740 --> 00:04:10,560 +lubricative properties of the pre-lens tear film + +42 +00:04:11,330 --> 00:04:15,990 +أول حاجة انه بيعتمد على خواص الترطيب لل tear film + +43 +00:04:15,990 --> 00:04:19,890 +احنا بنعرف ان ال tear film بتكون من تلت طبقات + +44 +00:04:19,890 --> 00:04:25,330 +الطبقة الأولى هي عبارة عن ال outer lipid layer, ال + +45 +00:04:25,330 --> 00:04:30,470 +middle aqueous layer, و ال inner mucus layer. دايما + +46 +00:04:30,470 --> 00:04:35,970 +موضوع ال movement بيعتمد بالاساس على زيادة الترطيب + +47 +00:04:35,970 --> 00:04:42,590 +لمين؟ للعدسة اللاصقة. لذلك هناك بعض أنواع العدسات + +48 +00:04:42,590 --> 00:04:46,830 +اللاصقة خاصة ال extended wear، لازم المريض كل ما + +49 +00:04:46,830 --> 00:04:51,110 +يستيقظ من النوم انه يقطر ايه؟ قطرة. هذه القطرة ايش + +50 +00:04:51,110 --> 00:04:57,450 +بتعمل؟ عملية ترطيب للعدسة و ايضا عملية ترطيب لمين؟ + +51 +00:04:57,450 --> 00:05:04,350 +للكورنية ايضا. the surface equality of both lens + +52 +00:05:04,350 --> 00:05:10,650 +and lid. الان اجانا شخص كان عنده a dry eye disease + +53 +00:05:10,650 --> 00:05:15,650 +هل انا بصرفله عدسة لاسقة؟ لأ لأنه عنده bad + +54 +00:05:15,650 --> 00:05:19,210 +equality of tear film. فمن ضمن ال counter + +55 +00:05:19,210 --> 00:05:25,130 +indication له ان انا اروح اصرف عدسة لاسقة، واضحة + +56 +00:05:25,130 --> 00:05:29,520 +الفكرة؟ and the nature of the blink, طبيعة البلينك + +57 +00:05:29,520 --> 00:05:36,360 +شخص يعني بيرمش بشكل مستمر أو مثلا عنده زيادة في + +58 +00:05:36,360 --> 00:05:40,480 +الترميش, excessive blinking. أكيد هيكون هناك أيش + +59 +00:05:40,480 --> 00:05:49,120 +عنده تأثيرات على ارتداء العدسة اللاصقة. the + +60 +00:05:49,120 --> 00:05:53,900 +post lens tear film appears to influence lens + +61 +00:05:53,900 --> 00:06:00,090 +movement. في المحاضرة السابقة اتكلمنا ان العدسة + +62 +00:06:00,090 --> 00:06:05,690 +اللاصقة بتتميز ب minimal movement compared to hard + +63 +00:06:05,690 --> 00:06:10,310 +contact lens اللي بيساعد في حركة ال post tear lens + +64 +00:06:10,310 --> 00:06:13,950 +هو عبارة عن مين؟ حركة العدسة نفسها. يعني العدسة + +65 +00:06:13,950 --> 00:06:18,850 +بتتحرك فهذا بيساعد في حركة مين؟ ال post tear lens + +66 +00:06:22,370 --> 00:06:27,750 +hypotonic solutions. هناك بعض المحليل زي ال + +67 +00:06:27,750 --> 00:06:33,270 +hypotonic بتعمل على سحب كمية كبيرة من الماء طبعا + +68 +00:06:33,270 --> 00:06:38,590 +هذا المي، الماء من وين بنسحب؟ من الكورنيا. زي فكرة + +69 +00:06:38,590 --> 00:06:42,770 +بالضبط ان شخص عنده dry eye بديه high ولا low water + +70 +00:06:42,770 --> 00:06:46,930 +content؟ low water content. نفس الحاجة المحلول هذا + +71 +00:06:46,930 --> 00:06:51,390 +ما بنفع مع شخص يكون عنده dry eye لأن طبيعة هذا ال + +72 +00:06:51,390 --> 00:06:56,690 +solution بيعمل على امتصاص، absorption، أكبر كمية من + +73 +00:06:56,690 --> 00:07:01,910 +مين من المياه اللي موجودة في الكورنيا، وبالتالي هذا + +74 +00:07:01,910 --> 00:07:07,350 +ايش هيسبب؟ جفاف في العين. وهذا هيأثر اللي هو على + +75 +00:07:07,350 --> 00:07:12,640 +المريض من حيث ال dry eye symptoms. إذا hypotonic + +76 +00:07:12,640 --> 00:07:17,580 +solutions can thin the post lens tear film and + +77 +00:07:17,580 --> 00:07:22,740 +cause lens adherence. هيأثر أول حاجة على حركة + +78 +00:07:22,740 --> 00:07:29,680 +العدسة، وبالتالي هيأثر على حركة tear lens. فهتلاحظ + +79 +00:07:29,680 --> 00:07:34,020 +انه دايما انه في هناك adherence، تماسك ما بين + +80 +00:07:34,020 --> 00:07:38,740 +العدسة و الكورنيا. يعني no sensation at all for the + +81 +00:07:38,740 --> 00:07:48,720 +lens. المريض مش هيشعر في إيش؟ في وجود العدسة lens + +82 +00:07:48,720 --> 00:07:55,900 +settling. أي بمعنى استقرار العدسة، استقرار العدسة + +83 +00:07:56,730 --> 00:08:01,730 +Post-insertion equilibration process، هي عملية + +84 +00:08:01,730 --> 00:08:08,710 +استقرار أو عملية ثبات للعدسة. يعني دايما ان العدسة + +85 +00:08:08,710 --> 00:08:13,370 +لازم يكون في الها concentration. وهذا ال + +86 +00:08:13,370 --> 00:08:19,160 +concentration ايش يكون بين قصين؟ جيد. الان لو في + +87 +00:08:19,160 --> 00:08:22,520 +عندنا Decentration للعدسة، هيكون ال evaluation + +88 +00:08:22,520 --> 00:08:29,540 +عبارة عن non optimal fit lens. صحيح؟ فال lens + +89 +00:08:29,540 --> 00:08:33,280 +settling، post insertion equilibration process + +90 +00:08:33,280 --> 00:08:39,620 +عملية استقرار أو ثبات العدسة. the tear film sequest + +91 +00:08:39,620 --> 00:08:45,660 +out by the initial blinking, by reduction in lens + +92 +00:08:45,660 --> 00:08:51,700 +movement. دايما المريض اول ما برتدي العدسة اللاصقة + +93 +00:08:51,700 --> 00:08:58,000 +هيتكون هناك tear، دمع، بعض هذا ال tear هيتجمع وين؟ + +94 +00:08:58,000 --> 00:09:04,140 +خلف العدسة، والبعض الآخر هيطلع للخارج. طبعا تجميع + +95 +00:09:04,140 --> 00:09:09,160 +ال tears خلف العدسة، هذا هيقلل من ايه؟ من حركة + +96 +00:09:09,160 --> 00:09:15,240 +العدسة. صحيح؟ ايضا يما يخرج في الخارج المريض هيصير + +97 +00:09:15,240 --> 00:09:20,100 +ايه؟ over أو هيصير اللي هو يعني بمعنى حساس، over + +98 +00:09:20,100 --> 00:09:27,900 +sensitivity. يعني الحساسية عنده بالزيد. reflects + +99 +00:09:27,900 --> 00:09:37,920 +tearing. طبعا عندنا ال tear secretion، ال + +100 +00:09:37,920 --> 00:09:38,200 +tear + +101 +00:09:41,410 --> 00:09:54,530 +secretion، إفراز الدمع، can be classified in + +102 +00:09:54,530 --> 00:09:58,190 +two types + +103 +00:09:58,190 --> 00:10:08,190 +في هناك نوعين. النوع الأول، basic tear secretion + +104 +00:10:10,430 --> 00:10:17,770 +والنوع التاني ال reflex tear secretion. بالنسبة ل + +105 +00:10:17,770 --> 00:10:21,390 +ال basic tear secretion اللي مسئول عنه ال + +106 +00:10:21,390 --> 00:10:25,610 +accessory lacrimal glands اللي هي عبارة عن الكراوس + +107 +00:10:25,610 --> 00:10:30,410 +و ال Wolfring glands. بالنسبة ل ال reflex tear + +108 +00:10:30,410 --> 00:10:34,550 +secretion اللي مسئول عنه ال main lacrimal glands + +109 +00:10:35,870 --> 00:10:42,290 +طيب، الآن ارتداء العدسة اللاصقة أيضا بيؤثر على ال + +110 +00:10:42,290 --> 00:10:48,610 +reflex tearing. كيف بيؤثر على ال reflex tearing؟ + +111 +00:10:48,610 --> 00:10:52,990 +reflex tearing on lens insertion may also affect + +112 +00:10:52,990 --> 00:10:56,630 +lens movement. إذا هو بالأساس هيؤثر على حركة + +113 +00:10:56,630 --> 00:11:03,040 +العدسة، leading to a transitory reduction. فهذا هيعمل + +114 +00:11:03,040 --> 00:11:08,820 +اللي هو تقليل حركة العدسة بشكل مؤقت. لذلك دايما + +115 +00:11:08,820 --> 00:11:13,460 +بينصح عند تقييم العدسة اللي لاسقة اللينة، ما نبدأ + +116 +00:11:13,460 --> 00:11:19,180 +عملية التقييم بشكل مباشر، على الأقل لازم نقيم بعد + +117 +00:11:19,180 --> 00:11:24,310 +خمس دقائق. طبعا بعد خمس دقائق هيتجمع ال tear خلف + +118 +00:11:24,310 --> 00:11:28,850 +العدسة، ال tear اللي هو الخارج هيقل، فانا بقدر انه + +119 +00:11:28,850 --> 00:11:31,650 +اتم اللي هو عملية التقييم + +120 +00:11:36,260 --> 00:11:40,780 +Lens Movement، حركة العدسة، زي ما اتفقنا ان حركة + +121 +00:11:40,780 --> 00:11:44,240 +العدسة سواء في ال hard contact lens أو ال soft + +122 +00:11:44,240 --> 00:11:49,460 +contact lens، هي غير كافية لتقييم العدسة هل هي + +123 +00:11:49,460 --> 00:11:52,740 +optimal أو loose أو steep + +124 +00:11:57,120 --> 00:12:02,440 +Immediately, بالتأكيد، on insertion is not usually + +125 +00:12:02,440 --> 00:12:07,580 +representative of normal movement. يعني أنا أول ما + +126 +00:12:07,580 --> 00:12:13,880 +ألبس العدسة للمريض، هذا لا يمثل أو لا يعبر عن حركة + +127 +00:12:13,880 --> 00:12:15,560 +العدسة الأصلية + +128 +00:12:20,050 --> 00:12:24,930 +Evaluating movement، تقييم الحركة، after five + +129 +00:12:24,930 --> 00:12:30,370 +minutes، بعد خمس دقائق، It predicts movement after + +130 +00:12:30,370 --> 00:12:36,170 +eight hours of wear. الان انا عندما هقوم بعملية ال + +131 +00:12:36,170 --> 00:12:43,250 +evaluation بعد خمس دقائق هي بتكتشف حركة العدسة بعد + +132 +00:12:43,250 --> 00:12:49,300 +ثمان ساعات. okay، يعني وكأنه عملتله تقييم بعد ثمان + +133 +00:12:49,300 --> 00:12:55,440 +ساعات. I + +134 +00:12:55,440 --> 00:13:03,100 +closer، اغلاق العين، واضحة الفكرة هذه؟ اذا الان عندنا + +135 +00:13:03,100 --> 00:13:07,760 +تقييم العدسة بعد خمس دقائق وكأنه انا عملت لنور + +136 +00:13:07,760 --> 00:13:12,600 +تقييم للعدسة بعد ثمان ساعات. هتكون ال movement of + +137 +00:13:12,600 --> 00:13:19,630 +the lens the same. Eye closer can also affect lens + +138 +00:13:19,630 --> 00:13:25,510 +movement. أيضا اللي هو بتأثر على حركة العدسة. يعني + +139 +00:13:25,510 --> 00:13:29,870 +انتوا ملاحظين ان كل العناصر أو كل العوامل هي بتأثر + +140 +00:13:29,870 --> 00:13:34,410 +على مين؟ على ال lens movement. طيب ال eye closer + +141 +00:13:34,410 --> 00:13:38,470 +كيف بتأثر على حركة العدسة؟ إنه بيبطل يكون عند + +142 +00:13:38,470 --> 00:13:40,630 +المريض إيه؟ أيّة blinking + +143 +00:13:44,490 --> 00:13:50,410 +eye closure as short as 15 minutes thinning of the + +144 +00:13:50,410 --> 00:13:55,590 +post lens tear film by reduce lens movement to + +145 +00:13:55,590 --> 00:14:01,150 +near zero الآن لو شخص قام بإغلاق عينه خمس عشر + +146 +00:14:01,150 --> 00:14:05,980 +دقيقة نفترض طبعًا الآن هو إيش لابس يا جماعة؟ + +147 +00:14:05,980 --> 00:14:10,360 +conventional daily wear lens يعني عدسة اللبس + +148 +00:14:10,360 --> 00:14:14,980 +اليومي التقليدي هو مش لابس عدسة extended wear أو + +149 +00:14:14,980 --> 00:14:20,220 +daily wear واضحة؟ إذا اغلاق العين لمدة خمس عشر + +150 +00:14:20,220 --> 00:14:25,080 +دقيقة هذه هتعمل thinning لمين؟ لل post lens tear + +151 +00:14:25,080 --> 00:14:31,040 +film نتيجة أن في هناك قلة لحركة العدسة لأن تقريبًا + +152 +00:14:31,040 --> 00:14:32,800 +في هناك stable + +153 +00:14:35,440 --> 00:14:41,300 +movement ثبات لحركة العدسة اللي هي تقريبًا قد إيش + +154 +00:14:41,300 --> 00:14:51,720 +بالساوي zero ما فيش أي حركة لمين للعدسة air + +155 +00:14:51,720 --> 00:14:55,280 +movement حركة اللي هو الهواء + +156 +00:14:57,820 --> 00:15:03,580 +At the anterior surface of the lens by post lens + +157 +00:15:03,580 --> 00:15:07,360 +tear film thinning by reduction in lens movement + +158 +00:15:07,360 --> 00:15:13,640 +الآن العدسة اللاصقة القرنية بتتكون من سطحين سطح + +159 +00:15:13,640 --> 00:15:20,070 +أمامي وسطح خلفي الآن تعرض العدسة للهواء الجوي + +160 +00:15:20,070 --> 00:15:25,490 +هيعمل امتصاص لمن؟ للـ air صحيح؟ يعني وكأنه إنه + +161 +00:15:25,490 --> 00:15:29,930 +هيصير هناك thinning لـ ال post tear limbs وبالتالي + +162 +00:15:29,930 --> 00:15:38,230 +هذا أيضًا هيأثر على مين؟ على حركة العدسة water + +163 +00:15:38,230 --> 00:15:44,630 +flow conductivity تدفق الماء أو تدفق ال tear خلال + +164 +00:15:44,630 --> 00:15:45,370 +العدسة + +165 +00:15:49,080 --> 00:15:54,020 +The flow conductivity عملية التدخق is a function + +166 +00:15:54,020 --> 00:16:00,460 +of the material pore size and lens thickness الآن + +167 +00:16:00,460 --> 00:16:05,520 +في عندنا قانون ال oxygen transmissibility equal dk + +168 +00:16:05,520 --> 00:16:12,140 +over T صحيح؟ الآن كل ما زادت سماكة العدسة هذا هيقلل + +169 +00:16:12,140 --> 00:16:17,760 +من إيش؟ من نفاذية دخول ال oxygen أيضًا هيقلل من + +170 +00:16:17,760 --> 00:16:24,280 +دخول ال tears okay لا ال cornea لذلك دائمًا بننصح + +171 +00:16:24,280 --> 00:16:28,620 +بالعدسات ال daily wear أو ال extended wear أن تكون + +172 +00:16:28,620 --> 00:16:33,860 +very thin عشان تسمح بأكبر كمية من ال tear أن يدخل + +173 +00:16:33,860 --> 00:16:40,240 +وأيضًا من ال oxygen لذلك المواد اللي مصنوعة من ال + +174 +00:16:40,240 --> 00:16:43,240 +high water أو العدسات اللي مصنوعة من ال high water + +175 +00:16:43,240 --> 00:16:47,960 +content هتلاقي كمية التدفق فيها إيه كبير وعالي + +176 +00:16:47,960 --> 00:16:53,020 +مقارنة بال low water content أو ال medium water + +177 +00:16:53,020 --> 00:16:59,940 +content أيضًا كل ما زادت المسامات في داخل العدسة كل + +178 +00:16:59,940 --> 00:17:05,470 +ما كان التدفق لل tear أكثر أكثر كل ما زادت المسامات + +179 +00:17:05,470 --> 00:17:09,330 +يعني الفتحات اللي موجودة في داخل العدسة هيسمح + +180 +00:17:09,330 --> 00:17:15,810 +بدخول كمية أكبر من مين من ال tear high water + +181 +00:17:15,810 --> 00:17:19,290 +content materials طبعًا إحنا عارفين ال high water + +182 +00:17:19,290 --> 00:17:23,550 +content okay ال materials هنضيف لها مادة السيليكون + +183 +00:17:23,550 --> 00:17:28,570 +عشان نعمل زيادة لمين لـ ال wetability المتانة okay + +184 +00:17:53,650 --> 00:18:00,700 +Lens Verification and Inspection Lens verification + +185 +00:18:00,700 --> 00:18:05,640 +أي بمعنى التحقق من العدسة، دائمًا أنا ك + +186 +00:18:05,640 --> 00:18:11,460 +practitioner لازم أعمل تحقق لأداء العدسة، خاصة إذا + +187 +00:18:11,460 --> 00:18:14,940 +كانت conventional daily wear، يعني المريض بعمل + +188 +00:18:14,940 --> 00:18:19,980 +باستمرار follow-up عنده and inspection إنه أعمل + +189 +00:18:19,980 --> 00:18:22,680 +عملية تفتيش لمين للعدسة + +190 +00:18:25,450 --> 00:18:31,030 +Lens Integrity سلامة العدسة checked بتتم تأكيدها + +191 +00:18:31,030 --> 00:18:36,530 +using باستخدام a projection microscope أو الستلم + +192 +00:18:36,530 --> 00:18:41,110 +دائمًا عملية التقييم سواء اللي أخذناها ال corneal + +193 +00:18:41,110 --> 00:18:44,830 +staining أو ال conjunctival staining أيضًا سلامة + +194 +00:18:44,830 --> 00:18:49,370 +العدسة بتتم من خلال ال bio microscope أو الستلم + +195 +00:18:51,600 --> 00:18:55,140 +when the lens is on the eye، إذا ديدي أعمل إيه؟ + +196 +00:18:55,140 --> 00:19:00,060 +insertion للعدسة okay، إذا لازم أنا أعمل insertion + +197 +00:19:00,060 --> 00:19:07,200 +للعدسة check for edge defects، دائمًا ممكن يكون فيه + +198 +00:19:07,200 --> 00:19:12,980 +هناك scratch لحواف العدسة أو ممكن يكون فيه هناك + +199 +00:19:14,010 --> 00:19:18,730 +مثلًا لسعة في أطراف العدسة فدايمًا أنا بدي أتأكد من + +200 +00:19:18,730 --> 00:19:23,910 +هذه النقطة من خلال جهاز الاستلان أيضًا بشوف ال + +201 +00:19:23,910 --> 00:19:28,470 +central مركز العدسة إنه هل هو سليم ولا فيه defects + +202 +00:19:32,290 --> 00:19:37,430 +Variety of Electronic Mechanical Gauges or + +203 +00:19:37,430 --> 00:19:42,490 +Bakymeter Major Soft Lens Thickness طبعًا زي ما + +204 +00:19:42,490 --> 00:19:47,170 +إحنا عارفين أن هناك يوجد مجموعة من ال parameters + +205 +00:19:47,170 --> 00:19:52,290 +اللي خاصة بالعدسة ال soft contact lens بتشمل ال + +206 +00:19:52,290 --> 00:19:56,610 +power ال diameter ال base curve ال water content + +207 +00:19:56,610 --> 00:20:00,970 +ال thickness of the lens عندنا موضوع مثلًا ال + +208 +00:20:00,970 --> 00:20:04,950 +thickness of the lens بتتم تقييمها من خلال جهاز + +209 +00:20:04,950 --> 00:20:10,290 +electronic mechanical gauges أو ال bakymeter يعني + +210 +00:20:10,290 --> 00:20:19,010 +الجهاز هذا خاص بسماكة عدسة ال soft contact lens it + +211 +00:20:19,010 --> 00:20:25,670 +is impractical for the practitioner to verify each + +212 +00:20:25,670 --> 00:20:30,770 +disposable lens but the patient can check each new + +213 +00:20:30,770 --> 00:20:36,490 +lens before inserting it دائمًا العدسات اللي بتلبس + +214 +00:20:36,490 --> 00:20:41,990 +لفترات زمنية قصيرة من المستحيل إنه كل شوية المريض + +215 +00:20:41,990 --> 00:20:45,970 +وينروح على ال practitioner يشوف يعمل verification + +216 +00:20:45,970 --> 00:20:52,020 +للعدسة فأنا ك practitioner لازم إنه أعلم من المريض + +217 +00:20:52,020 --> 00:20:57,140 +إنه كيف يعمل insertion أو removal للعدسة وكيف يعمل + +218 +00:20:57,140 --> 00:21:01,620 +check للعدسة إنه هل هي الأطراف فيها سليمة، هل ال + +219 +00:21:01,620 --> 00:21:05,220 +center فيها سليم، ليش؟ لأن هذه العدسات بتعيش فترة + +220 +00:21:05,220 --> 00:21:08,860 +زمنية قصيرة، إذا كانت daily wear، بلبسها لمدة يوم + +221 +00:21:08,860 --> 00:21:12,960 +واحد، إذا كانت extended wear، بلبسها لمدة أسبوع، + +222 +00:21:12,960 --> 00:21:14,900 +وبعد ذلك بتخلص منها + +223 +00:21:17,600 --> 00:21:22,560 +في أي استفسار أي سؤال واضحة الأمور إن شاء الله okay + +224 +00:21:25,960 --> 00:21:31,400 +الآن بدنا نعمل عملية كل اللي اتكلمنا فيه التقييم + +225 +00:21:31,400 --> 00:21:38,060 +السابق كان من خلال العدسة إنه تقييم للعدسة سواء ال + +226 +00:21:38,060 --> 00:21:42,400 +base curve ال diameter ال power أيضًا تقييم ال + +227 +00:21:42,400 --> 00:21:46,280 +water content ال thickness للعدسة الآن هنتكلم من + +228 +00:21:46,280 --> 00:21:47,360 +ناحية فسيولوجية + +229 +00:21:51,290 --> 00:21:56,110 +It's the term used by Efron and Holden to + +230 +00:21:56,110 --> 00:22:01,550 +designate the role of lens design and fitting in + +231 +00:22:01,550 --> 00:22:06,910 +ocular complications in lens wear في هناك باحثين + +232 +00:22:06,910 --> 00:22:12,350 +في العدسات اللاصقة الأول Efron والثاني Holden + +233 +00:22:12,350 --> 00:22:18,800 +عملوا كتاب ذكروا في هذا الكتاب كل مضاعفات العدسات + +234 +00:22:18,800 --> 00:22:24,780 +اللاصقة سواء كانت اللينة أو الصلبة وأيضًا وضعوا + +235 +00:22:24,780 --> 00:22:30,800 +مجموعة من المعايير أو مجموعة من ال parameters من + +236 +00:22:30,800 --> 00:22:35,500 +خلالها أنا بقدر أعمل تقييم للعدسة اللاصقة + +237 +00:22:39,430 --> 00:22:43,530 +Some ocular complications بعض من هذه المضاعفات + +238 +00:22:43,530 --> 00:22:49,010 +للعين of contact lens were observed at follow-up + +239 +00:22:49,010 --> 00:22:54,270 +visits يعني ممكن أن أنا أكتشفها ك examiner أو ك + +240 +00:22:54,270 --> 00:22:58,170 +practitioner من خلال أن المريض إيش يعمل follow-up + +241 +00:22:58,170 --> 00:23:01,470 +إذا مدام follow-up بدي أفهم أن هذه العدسة إيه + +242 +00:23:01,470 --> 00:23:03,190 +conventional daily wear + +243 +00:23:07,830 --> 00:23:13,510 +At follow-up visits can be viewed as an indication + +244 +00:23:13,510 --> 00:23:19,290 +for changing lens design for a given mood of wear + +245 +00:23:19,290 --> 00:23:25,570 +يعني الآن مثلًا المريض ييجي عندي على المركز وأديته + +246 +00:23:25,570 --> 00:23:29,930 +عدسات conventional daily wear لكن هذا المريض ما + +247 +00:23:29,930 --> 00:23:33,830 +تَأقلم مع هذا النوع من العدسات الآن أنا بدي أعمل + +248 +00:23:33,830 --> 00:23:39,810 +عملية تغيير لنوع العدسة لـ type of a lens ممكن أدي + +249 +00:23:39,810 --> 00:23:44,450 +مثلًا daily wear أو extended wear هذا كله لازم أنا + +250 +00:23:44,450 --> 00:23:48,170 +أكون بعين الاعتبار بالنسبة للمريض يعني بدي أقوله + +251 +00:23:48,170 --> 00:23:52,470 +أن ال rules الخاصة بال conventional daily wear ال + +252 +00:23:52,470 --> 00:23:55,390 +rules الخاصة في ال extended wear عملية ال + +253 +00:23:55,390 --> 00:23:59,310 +insertion ال removal عملية أيضًا اللي هو ال check + +254 +00:23:59,310 --> 00:24:03,370 +للعدسة لازم تكون واضحة بالنسبة لل patient + +255 +00:24:06,420 --> 00:24:12,260 +such ocular changes fall into eight categories of + +256 +00:24:12,260 --> 00:24:18,380 +signs and symptoms، هناك تمام مجموعات هذه خاصة + +257 +00:24:18,380 --> 00:24:24,160 +بالشكوى من قبل المريض أو ال signs اللي بيشوفها مين + +258 +00:24:24,160 --> 00:24:27,920 +أو ال clinical sign اللي بيشوفه ال examiner أو ال + +259 +00:24:27,920 --> 00:24:28,400 +practitioner + +260 +00:24:31,720 --> 00:24:39,400 +Number one Hypoxia and hypercapnia Hypoxia معناها + +261 +00:24:39,400 --> 00:24:44,820 +إيه؟ نقص في الأكسجين للأنتيريور surface of the + +262 +00:24:44,820 --> 00:24:50,500 +cornea Hypercapnia زيادة دخول ثاني أكسجين ثاني + +263 +00:24:50,500 --> 00:24:54,640 +الأكسجين نعم اللي هو الـCO2 لوين؟ للأنتيريور + +264 +00:24:54,640 --> 00:25:00,140 +surface of the cornea زيادة اللي هو increase + +265 +00:25:02,530 --> 00:25:10,310 +الـ هيبوكسية تتخلص من الـCO2 إلى الجزء الأمامي + +266 +00:25:10,310 --> 00:25:16,350 +القلبي + +267 +00:25:16,350 --> 00:25:22,410 +الـ هيبوكسية + +268 +00:25:22,410 --> 00:25:31,630 +تتخلص من الـCO2 إلى الجزء الأمامي القلبي Normally + +269 +00:25:31,630 --> 00:25:35,950 +there is a flow of oxygen into the anterior + +270 +00:25:35,950 --> 00:25:42,010 +corneal surface and an efflux of carbon dioxide + +271 +00:25:42,010 --> 00:25:48,070 +يعني من الطبيعي أن يتم هناك تدفق للأكسجين داخل + +272 +00:25:48,070 --> 00:25:53,590 +السطح الأمامي للقرنية ويصير إيش اللي هو خروج + +273 +00:25:53,590 --> 00:25:58,050 +efflux أي بمعنى خروج لثاني أكسيد الكربون + +274 +00:26:01,730 --> 00:26:07,230 +When the eyelid is closed during sleep، إذا + +275 +00:26:07,230 --> 00:26:13,190 +الإنسان هو نائم، okay، the palpebral vascular + +276 +00:26:13,190 --> 00:26:19,030 +supply becomes the site of gas exchange طبعًا إحنا + +277 +00:26:19,030 --> 00:26:24,690 +بنعرف من خصائص القرنية إنه هي transparent فدايمًا + +278 +00:26:24,690 --> 00:26:30,090 +غذائها بيكون من وين جزء منه كبير من الهواء الجوي + +279 +00:26:30,090 --> 00:26:34,230 +طيب الآن الإنسان أغلق عينه زي في حالة ال extended + +280 +00:26:34,230 --> 00:26:39,950 +wear، lenses كيف بده يعني القرنية كيف ممكن أنه + +281 +00:26:39,950 --> 00:26:45,660 +تتغذى؟ ففي عندنا ال Vascular أو الـ Limbal Vascular + +282 +00:26:45,660 --> 00:26:50,560 +Supply طبعا الـ Limbal Vascular اذا الوظيفة بتاعتها + +283 +00:26:50,560 --> 00:26:55,000 +ايش تعتبر؟ اللي هو الـ nutrition كتخدية فهذه + +284 +00:26:55,000 --> 00:27:00,020 +بالساعد في عملية التخدية لمين؟ للكورنية، اذا الهدف + +285 +00:27:00,020 --> 00:27:06,700 +منها المساعدة في عملية تخدية الكورنية وهي تعتبر + +286 +00:27:06,700 --> 00:27:14,760 +يعني مكان مهم في عملية تبادل مين؟ الأكسجين Okay يعني + +287 +00:27:14,760 --> 00:27:19,540 +ممكن واحد من المرضى يسألكم العدسات الـ extended + +288 +00:27:19,540 --> 00:27:24,300 +wear أو العدسات الـ daily wear كيف أنا بدي انه + +289 +00:27:24,300 --> 00:27:28,480 +اتعامل معها و أنا نايم انه كيف بدي يصير هناك اللي + +290 +00:27:28,480 --> 00:27:34,000 +هو يعني كتنفس للكورنية من خلال اللي هو الـ Limbal vascular + +291 +00:27:34,000 --> 00:27:39,720 +أو الـ Limbal vascular supply hypoxia and + +292 +00:27:39,720 --> 00:27:44,560 +hypercapnia indication for contact lens refitting + +293 +00:27:44,560 --> 00:27:49,700 +أي مريض بيظهر عنده علامة الـ hypoxia أو الـ + +294 +00:27:49,700 --> 00:27:54,100 +hypercapnia لازم أنا أعيد ايه الـ fitting للعدسة + +295 +00:27:54,100 --> 00:27:58,820 +اللاصقة قد تسأل طالبة انه كيف أنا بدي اعرف انه + +296 +00:27:58,820 --> 00:28:04,230 +مريض عنده hypoxia أو hypercapnia من خلال الـ + +297 +00:28:04,230 --> 00:28:08,070 +Corneal Fluorescein Staining الـ Fluorescein Grading + +298 +00:28:08,070 --> 00:28:11,050 +of Corneal Fluorescein Staining اللي أخدناه في + +299 +00:28:11,050 --> 00:28:15,670 +المعمل الأول لذلك هي أهمية مين؟ الـ Corneal + +300 +00:28:15,670 --> 00:28:19,170 +Fluorescein Staining grade 0، no staining of the + +301 +00:28:19,170 --> 00:28:23,390 +corneal epithelia، grade 1، هيكون less than 1 over + +302 +00:28:23,390 --> 00:28:27,550 +3 of the corneal fluorescein staining، و grade 2 و + +303 +00:28:27,550 --> 00:28:28,510 +grade 3 + +304 +00:28:33,440 --> 00:28:39,440 +Reduced Epithelial Aerobic Metabolism الآن ما هي + +305 +00:28:39,440 --> 00:28:45,200 +التغيرات الفيسيولوجية اللي بتحدث لـ Corneal + +306 +00:28:45,200 --> 00:28:49,720 +Epithelium واللي لازم أنا كـ practitioner أن اعمل + +307 +00:28:49,720 --> 00:28:55,060 +عملية observation ملاحظة لها عندما المريض يرتدي + +308 +00:28:55,060 --> 00:28:56,860 +العدسة اللاصقة + +309 +00:29:00,570 --> 00:29:06,250 +Number one reduction in mitotic cell activity احنا + +310 +00:29:06,250 --> 00:29:12,130 +بنعرف ان في هناك نمو أو تكاثر لخلايا الـ corneal + +311 +00:29:12,130 --> 00:29:17,350 +epithelium الشخص لما بيرتدي العدسة اللاصقة اللينة + +312 +00:29:17,350 --> 00:29:22,190 +ممكن انه يقلل من الـ mitotic الانقسام لهذه الخلايا + +313 +00:29:22,190 --> 00:29:28,900 +زي بالضبط لما شخص بيعمل عملية الليزك أول حاجة بنقوله + +314 +00:29:28,900 --> 00:29:33,820 +انه من الـ complications الها هتعمل تقليل في انقسام + +315 +00:29:33,820 --> 00:29:40,440 +ايه الخلايا التفاعلية أي بمعنى الـ corneal + +316 +00:29:40,440 --> 00:29:41,620 +epithelium cells + +317 +00:29:47,430 --> 00:29:52,950 +الروابط ما بين هذه الخلايا اشمالها هتقل أو هتنكسر + +318 +00:29:52,950 --> 00:29:58,670 +يعني ما هيصير ان في هناك good junction ما بين هذه + +319 +00:29:58,670 --> 00:29:59,590 +الروابط + +320 +00:30:02,860 --> 00:30:08,400 +decrease in numbers of طبعا كيف هذي اللي هو هيصير + +321 +00:30:08,400 --> 00:30:14,060 +اللي هو تقليل في عدد الـ hemidesmosomes الان اول شغلة + +322 +00:30:14,060 --> 00:30:18,720 +بتلاقي الشخص اللي بيعمل عملية الليزك بنقوله دائما + +323 +00:30:18,720 --> 00:30:23,100 +غطى عينك صح؟ عشان يصير regeneration لمين؟ للـ + +324 +00:30:23,100 --> 00:30:26,860 +corneal epithelia لكن السبب الرئيسي في عملية + +325 +00:30:26,860 --> 00:30:32,890 +التغطية انه مايصير هناك ايه؟ infection للمريض اذا + +326 +00:30:32,890 --> 00:30:37,610 +أهم شيء اللي هو عملية الخوف من الـ infection فممكن + +327 +00:30:37,610 --> 00:30:41,750 +هذا يقلل من مين؟ من الـ hemidesmosomes اللي هو عملية + +328 +00:30:41,750 --> 00:30:47,270 +الـ infection لكن ارتداء العدسة اللاصقة اشماله بيزود + +329 +00:30:47,270 --> 00:30:48,570 +حدوث الـ infection + +330 +00:30:52,640 --> 00:30:57,140 +Expiration of corneal epithelial cells أيضًا هيزود + +331 +00:30:57,140 --> 00:31:01,520 +من ايش؟ من انقسام الـ corneal epithelia عملية + +332 +00:31:01,520 --> 00:31:06,460 +الانفصال لهذه الخلايا أيضًا بيزيد طبعا يا جماعة + +333 +00:31:06,460 --> 00:31:10,340 +كل هذه الـ science كيف بتم الاكتشاف عنها؟ هذه كلها + +334 +00:31:10,340 --> 00:31:13,780 +نظرية من الـ corneal fluorescein staining + +335 +00:31:17,560 --> 00:31:23,000 +The surface cells خلايا السطح may become ربما تصبح + +336 +00:31:23,000 --> 00:31:27,500 +more fragile هشة and there may be a slight + +337 +00:31:27,500 --> 00:31:31,500 +epithelial thinning وطبقة الـ epithelium ممكن انه + +338 +00:31:31,500 --> 00:31:36,720 +تصير نحيفة، نتيجة اللي هو قد يكون الـ infection + +339 +00:31:36,720 --> 00:31:40,600 +اللي اتعرض لها الـ corneal epithelium في بعض + +340 +00:31:40,600 --> 00:31:47,700 +الأحيان A clinical manifestation، اذا عملية الكشف + +341 +00:31:47,700 --> 00:31:52,800 +عنها للـ hypoxia أو الـ hypercapnia من خلال الـ + +342 +00:31:52,800 --> 00:32:02,520 +fluorescein أو الـ corneal fluorescein staining طبعا + +343 +00:32:02,520 --> 00:32:09,930 +الفيجر هذه بتوضح مجموعة من الـ clinical signs اللي + +344 +00:32:09,930 --> 00:32:16,410 +بتظهر عند المريض وعندها لازم المريض يوقف من + +345 +00:32:16,410 --> 00:32:21,470 +ارتداء العدسة اللاصقة طبعا كلها الـ ocular + +346 +00:32:21,470 --> 00:32:24,830 +manifestation اللي لها أو الـ clinical diagnosis + +347 +00:32:24,830 --> 00:32:28,690 +test اللي خاص فيها بتتم الاكتشاف من خلال الـ + +348 +00:32:28,690 --> 00:32:30,450 +corneal fluorescein scanning + +349 +00:32:34,190 --> 00:32:37,950 +نتوقف ان شاء الله عند الـ signs of reduced + +350 +00:32:37,950 --> 00:32:42,950 +epithelial aerobic metabolism في المحاضرة القادمة + +351 +00:32:42,950 --> 00:32:44,470 +ان شاء الله نكمل diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/BhUIXmwX_jA_postprocess.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/BhUIXmwX_jA_postprocess.srt new file mode 100644 index 0000000000000000000000000000000000000000..2acbfa2079c56ba4fd7613c988241022629e6392 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/BhUIXmwX_jA_postprocess.srt @@ -0,0 +1,1404 @@ +1 +00:00:21,630 --> 00:00:24,770 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:24,770 --> 00:00:29,290 +وبركاته and a very good morning to all of you + +3 +00:00:29,290 --> 00:00:34,890 +اليوم هنتناول موضوع ال tear film and blinking + +4 +00:00:34,890 --> 00:00:44,250 +بداية لو بدأنا المحاضرة ما هو مفهوم ال tears ال + +5 +00:00:44,250 --> 00:00:49,350 +tears it covers the anterior surface of the cornea + +6 +00:00:51,060 --> 00:00:56,200 +طيب ال functions of tears number one nourishment + +7 +00:00:56,200 --> 00:01:01,580 +of the cornea number two protection it from + +8 +00:01:01,580 --> 00:01:09,140 +infection okay normal blinking from fifteen to + +9 +00:01:09,140 --> 00:01:15,540 +twenty blink okay from fifteen to twenty blink + +10 +00:01:18,740 --> 00:01:24,120 +Have an effect on fitting بداية ال tier لو كان + +11 +00:01:24,120 --> 00:01:32,600 +عندنا حاجة بنسميها tier film instability + +12 +00:01:32,600 --> 00:01:38,120 +أي + +13 +00:01:38,120 --> 00:01:42,840 +عدم ثبات في ال tier هذا بيؤثر على أداء العدسة + +14 +00:01:42,840 --> 00:01:43,720 +اللاصقة + +15 +00:01:46,110 --> 00:01:50,770 +أيضا موضوع ال blinking الترميش احنا في المحاضرة + +16 +00:01:50,770 --> 00:01:56,370 +السابقة اتكلمنا عن الكيراتو ميتر مياردز و ال + +17 +00:01:56,370 --> 00:02:05,530 +visual acuity chart اذا عندنا كان optimal fit + +18 +00:02:05,530 --> 00:02:13,610 +lens هيكون before و after ال blinking الصورة clear + +19 +00:02:14,440 --> 00:02:18,600 +لو كانت loose before a blinking ا clear after a + +20 +00:02:18,600 --> 00:02:23,180 +blinking هتكون unclear لو كانت tight before a + +21 +00:02:23,180 --> 00:02:27,720 +blinking ا unclear after a blinking ا clear فالان + +22 +00:02:27,720 --> 00:02:32,340 +بنستنتج من هذا الكلام انه ال .. انه ال blinking + +23 +00:02:32,340 --> 00:02:36,880 +الترميش هو عامل مهم في الوصول الى مين ال optimal + +24 +00:02:36,880 --> 00:02:38,880 +fit lens okay + +25 +00:02:41,360 --> 00:02:47,680 +Lens movement حركة العدسة اللى normally من 0.5 to + +26 +00:02:47,680 --> 00:02:54,140 +1 ملي متر can be affected يمكن انه تتأثر by + +27 +00:02:54,140 --> 00:02:59,200 +interactions بواسطة التفاعل between the lens and + +28 +00:02:59,200 --> 00:03:05,210 +upper lidاحنا حكينا ان ال diameter لل soft contact + +29 +00:03:05,210 --> 00:03:09,290 +lens أكبر من ال diameter للكورنية ففي هناك + +30 +00:03:09,290 --> 00:03:14,190 +interaction ما بين ال upper eyelid و ال upper lens + +31 +00:03:14,190 --> 00:03:22,250 +لكن هذا التفاعل بينهم من مميزاته انه no hardNo + +32 +00:03:22,250 --> 00:03:26,590 +hard interaction فالان لو كانت في عنا زيادة في + +33 +00:03:26,590 --> 00:03:31,670 +الحركة هتلاقي الشخص ايش ماله؟ discomfort بيحكيلك + +34 +00:03:31,670 --> 00:03:35,370 +يعني من ال .. ضمن الشكوى انه يما ييجي على المركز + +35 +00:03:35,370 --> 00:03:39,530 +بيقولك دايما انا بحس الحركة بتخبط .. العدسة بتخبط + +36 +00:03:39,530 --> 00:03:43,890 +وين؟ في ال upper eyelid وهذا غير محمود بالنسبة + +37 +00:03:43,890 --> 00:03:50,800 +لمين؟ للمريضفالان حركة العدسة هي تعتبر عامل مهم في + +38 +00:03:50,800 --> 00:03:55,760 +الوصول للـ optimal lens fitting للعدسة الملائمة أو + +39 +00:03:55,760 --> 00:04:01,020 +العدسة المناسبة طبعا + +40 +00:04:01,020 --> 00:04:05,740 +في هناك عوامل بتعتمد عليها depending on the + +41 +00:04:05,740 --> 00:04:10,560 +lubricative properties of the pre-lens tear film + +42 +00:04:11,330 --> 00:04:15,990 +أول حاجة انه بيعتمد على خواص الترطيب لل tear film + +43 +00:04:15,990 --> 00:04:19,890 +احنا بنعرف ان ال tear film بتكون من تلت طبقات + +44 +00:04:19,890 --> 00:04:25,330 +الطبقة الأولى هي عبارة عن ال outer lipid layer ال + +45 +00:04:25,330 --> 00:04:30,470 +middle aqueous layer و ال inner mucus layer دايما + +46 +00:04:30,470 --> 00:04:35,970 +موضوع ال movement بيعتمد بالاساس على زيادة الترطيب + +47 +00:04:35,970 --> 00:04:42,590 +لمين؟ للعدسة اللاصقةلذلك هناك بعض أنواع العدسات + +48 +00:04:42,590 --> 00:04:46,830 +اللاصقة خاصة ال extended wear لازم المريض كل ما + +49 +00:04:46,830 --> 00:04:51,110 +يستيقظ من النوم انه يقطر ايه؟ قطرة هذه القطرة ايش + +50 +00:04:51,110 --> 00:04:57,450 +بتعمل؟ عملية ترطيب للعدسة و ايضا عملية ترطيب لمين؟ + +51 +00:04:57,450 --> 00:05:04,350 +للكورنية ايضا the surface equality of both lens + +52 +00:05:04,350 --> 00:05:10,650 +and lidالان اجانا شخص كان عنده a dry eye disease + +53 +00:05:10,650 --> 00:05:15,650 +هل انا بصرفله عدسة لاسقة؟ لأ لأنه عنده bad + +54 +00:05:15,650 --> 00:05:19,210 +equality of tear film فمن ضمن ال counter + +55 +00:05:19,210 --> 00:05:25,130 +indication له ان انا اروح اصرف عدسة لاسقة، واضحة + +56 +00:05:25,130 --> 00:05:29,520 +الفكرة؟and the nature of the blink طبيعة البلينك + +57 +00:05:29,520 --> 00:05:36,360 +شخص يعني بيرمش بشكل مستمر أو مثلا عنده زيادة في + +58 +00:05:36,360 --> 00:05:40,480 +الترميش excessive blinking أكيد هيكون هناك أيش + +59 +00:05:40,480 --> 00:05:49,120 +عنده تأثيرات على ارتداء العدسة اللاصقة the + +60 +00:05:49,120 --> 00:05:53,900 +post lens tear film appears to influence lens + +61 +00:05:53,900 --> 00:06:00,090 +movementفي المحاضرة السابقة اتكلمنا ان العدسة + +62 +00:06:00,090 --> 00:06:05,690 +اللاصقة بتتميز ب minimal movement compared to hard + +63 +00:06:05,690 --> 00:06:10,310 +contact lens اللي بيساعد في حركة ال post tear lens + +64 +00:06:10,310 --> 00:06:13,950 +هو عبارة عن مين؟ حركة العدسة نفسها يعني العدسة + +65 +00:06:13,950 --> 00:06:18,850 +بتتحرك فهذا بيساعد في حركة مين؟ ال post tear lens + +66 +00:06:22,370 --> 00:06:27,750 +hybotonic solutions هناك بعض المحليل زي ال + +67 +00:06:27,750 --> 00:06:33,270 +hybotonic بتعمل على سحب كمية كبيرة من الماء طبعا + +68 +00:06:33,270 --> 00:06:38,590 +هذا المي الماء من وين بنسحب؟ من الكورنيا زي فكرة + +69 +00:06:38,590 --> 00:06:42,770 +بالضبط ان شخص عنده dry eye بديه high ولا low water + +70 +00:06:42,770 --> 00:06:46,930 +content؟ low water contentنفس الحاجة المحلول هذا + +71 +00:06:46,930 --> 00:06:51,390 +ما بنفع مع شخص يكون عنده dry eye لأن طبيعة هذا ال + +72 +00:06:51,390 --> 00:06:56,690 +solution بيعمل على امتصاص absorption أكبر كمية من + +73 +00:06:56,690 --> 00:07:01,910 +مين من المياه اللي موجودة في الكورنيا وبالتالي هذا + +74 +00:07:01,910 --> 00:07:07,350 +ايش هيسبب؟ جفاف في العين وهذا هيأثر اللي هو على + +75 +00:07:07,350 --> 00:07:12,640 +المريض من حيث ال dry eye symptomsإذا hypotonic + +76 +00:07:12,640 --> 00:07:17,580 +solutions can thin the post lens tear film and + +77 +00:07:17,580 --> 00:07:22,740 +cause lens adherence هيأثر أول حاجة على حركة + +78 +00:07:22,740 --> 00:07:29,680 +العدسة وبالتالي هيأثر على حركة tear lensفهتلاحظ + +79 +00:07:29,680 --> 00:07:34,020 +انه دايما انه في هناك adherence تماسك ما بين + +80 +00:07:34,020 --> 00:07:38,740 +العدسة و الكورنيا يعني no sensation at all for the + +81 +00:07:38,740 --> 00:07:48,720 +lens المريض مش هيشعر في إيش؟ في وجود العدسة lens + +82 +00:07:48,720 --> 00:07:55,900 +settling أي بمعنى استقرار العدسة استقرار العدسة + +83 +00:07:56,730 --> 00:08:01,730 +Post-insertion equilibration process هي عملية + +84 +00:08:01,730 --> 00:08:08,710 +استقرار أو عملية ثبات للعدسة يعني دايما ان العدسة + +85 +00:08:08,710 --> 00:08:13,370 +لازم يكون في الها concentration وهذا ال + +86 +00:08:13,370 --> 00:08:19,160 +concentration ايش يكون بين قصين؟ جيدالان لو في + +87 +00:08:19,160 --> 00:08:22,520 +عندنا Decentration للعدسة هيكون ال evaluation + +88 +00:08:22,520 --> 00:08:29,540 +عبارة عن non optimal fit lens صحيح؟ فال lens + +89 +00:08:29,540 --> 00:08:33,280 +settling post insertion equilibration process + +90 +00:08:33,280 --> 00:08:39,620 +عملية استقرار أو ثبات العدسة the tear film sequest + +91 +00:08:39,620 --> 00:08:45,660 +out by the initial blinking by reduction in lens + +92 +00:08:45,660 --> 00:08:51,700 +movementدايما المريض اول ما برتدي العدسة اللاصقة + +93 +00:08:51,700 --> 00:08:58,000 +هيتكون هناك tear، دمع، بعض هذا ال tear هيتجمع وين؟ + +94 +00:08:58,000 --> 00:09:04,140 +خلف العدسة، والبعض الآخر هيطلع للخارج طبعا تجميع + +95 +00:09:04,140 --> 00:09:09,160 +ال tears خلف العدسة، هذا هيقلل من ايه؟ من حركة + +96 +00:09:09,160 --> 00:09:15,240 +العدسةصحيح؟ ايضا يما يخرج في الخارج المريض هيصير + +97 +00:09:15,240 --> 00:09:20,100 +ايه؟ over او هيصير اللي هو يعني بمعنى حساس over + +98 +00:09:20,100 --> 00:09:27,900 +sensitivity يعني الحساسية عنده بالزيد reflects + +99 +00:09:27,900 --> 00:09:37,920 +tearing طبعا عندنا ال tear secretion ال + +100 +00:09:37,920 --> 00:09:38,200 +tear + +101 +00:09:41,410 --> 00:09:54,530 +secretion إفراز الدمع can be classified in + +102 +00:09:54,530 --> 00:09:58,190 +two types + +103 +00:09:58,190 --> 00:10:08,190 +في هناك نوعين النوع الأول basic tier secretion + +104 +00:10:10,430 --> 00:10:17,770 +والنوع التاني ال reflex tear secretion بالنسبة ل + +105 +00:10:17,770 --> 00:10:21,390 +ال basic tear secretion اللي مسئول عنه ال + +106 +00:10:21,390 --> 00:10:25,610 +accessory lacrimal glands اللي هي عبارة عن الكراوس + +107 +00:10:25,610 --> 00:10:30,410 +و ال wolfring glands بالنسبة ل ال reflex tear + +108 +00:10:30,410 --> 00:10:34,550 +secretion اللي مسئول عنه ال main lacrimal glands + +109 +00:10:35,870 --> 00:10:42,290 +طيب، الآن ارتداء العدسة اللاصقة أيضا بيؤثر على ال + +110 +00:10:42,290 --> 00:10:48,610 +reflex tearing كيف بيؤثر على ال reflex tearing؟ + +111 +00:10:48,610 --> 00:10:52,990 +reflex tearing on lens insertion may also affect + +112 +00:10:52,990 --> 00:10:56,630 +lens movement، إذا هو بالأساس هيؤثر على حركة + +113 +00:10:56,630 --> 00:11:03,040 +العدسةleading to a transitory reduction فهذا هيعمل + +114 +00:11:03,040 --> 00:11:08,820 +اللي هو تقليل حركة العدسة بشكل مؤقت لذلك دايما + +115 +00:11:08,820 --> 00:11:13,460 +بينصح عند تقييم العدسة اللي لاسقة اللينة ما نبدأ + +116 +00:11:13,460 --> 00:11:19,180 +عملية التقييم بشكل مباشر على الأقل لازم نقيم بعد + +117 +00:11:19,180 --> 00:11:24,310 +خمس دقائقطبعا بعد خمس دقائق هيتجمع ال tier خلف + +118 +00:11:24,310 --> 00:11:28,850 +العدسة ال tier اللي هو الخارج هيقل فانا بقدر انه + +119 +00:11:28,850 --> 00:11:31,650 +اتم اللي هو عملية التقييم + +120 +00:11:36,260 --> 00:11:40,780 +Lens Movement حركة العدسة زي ما اتفقنا ان حركة + +121 +00:11:40,780 --> 00:11:44,240 +العدسة سواء في ال hard contact lens او ال soft + +122 +00:11:44,240 --> 00:11:49,460 +contact lens هي غير كافية لتقييم العدسة هل هي + +123 +00:11:49,460 --> 00:11:52,740 +optimal or loose or steep + +124 +00:11:57,120 --> 00:12:02,440 +Immediately بالتأكيد on insertion is not usually + +125 +00:12:02,440 --> 00:12:07,580 +representative of normal movement يعني أنا أول ما + +126 +00:12:07,580 --> 00:12:13,880 +ألبس العدسة للمريض، هذا لا يمثل أو لا يعبر عن حركة + +127 +00:12:13,880 --> 00:12:15,560 +العدسة الأصلية + +128 +00:12:20,050 --> 00:12:24,930 +Evaluating movement تقييم الحركة after five + +129 +00:12:24,930 --> 00:12:30,370 +minutes بعد خمس دقائق It predicts movement after + +130 +00:12:30,370 --> 00:12:36,170 +eight hours of wear الان انا عندما هقوم بعملية ال + +131 +00:12:36,170 --> 00:12:43,250 +evaluation بعد خمس دقائق هي بتكتشف حركة العدسة بعد + +132 +00:12:43,250 --> 00:12:49,300 +تمام ساعاتOkay يعني و كأنه عملتله تقييم بعد تمان + +133 +00:12:49,300 --> 00:12:55,440 +ساعات I + +134 +00:12:55,440 --> 00:13:03,100 +closer اغلاق العين واضح الفكرة هذه؟ اذا الان عندنا + +135 +00:13:03,100 --> 00:13:07,760 +تقييم العدسة بعد خمس دقائق و كأنه انا عملت لنور + +136 +00:13:07,760 --> 00:13:12,600 +تقييم للعدسة بعد تمان ساعات هتكون ال movement of + +137 +00:13:12,600 --> 00:13:19,630 +the lens the sameEye closer can also affect lens + +138 +00:13:19,630 --> 00:13:25,510 +movement أيضا اللي هو بتأثر على حركة العدسة يعني + +139 +00:13:25,510 --> 00:13:29,870 +انتوا ملاحظين ان كل العناصر او كل العوامل هي بتأثر + +140 +00:13:29,870 --> 00:13:34,410 +على مين؟ على ال lens movement طيب ال eye closer + +141 +00:13:34,410 --> 00:13:38,470 +كيف بتأثر على حركة العدسة؟ انه بيبطل يكون عند + +142 +00:13:38,470 --> 00:13:40,630 +المريض ايه؟ اي تة blinking + +143 +00:13:44,490 --> 00:13:50,410 +eye closer as short as 15 minutes thinning of the + +144 +00:13:50,410 --> 00:13:55,590 +post lens tear film by reduce lens movement to + +145 +00:13:55,590 --> 00:14:01,150 +near zero الان لو شخص قام بإغلاق عينه خمس عشر + +146 +00:14:01,150 --> 00:14:05,980 +دقيقة نفترضطبعا الان هو ايش لابس يا جماعة؟ + +147 +00:14:05,980 --> 00:14:10,360 +conventional daily wear lens يعني عدسة اللبس + +148 +00:14:10,360 --> 00:14:14,980 +اليومي التقليدي هو مش لابس عدسة extended wear او + +149 +00:14:14,980 --> 00:14:20,220 +daily wear واضحة؟ اذا اغلاق العين لمدة خمس عشر + +150 +00:14:20,220 --> 00:14:25,080 +دقيقة هذه هتعمل thinning لمين؟ لل post lens tear + +151 +00:14:25,080 --> 00:14:31,040 +film نتيجة ان في هناك قلة لحركة العدسة لان تقريبا + +152 +00:14:31,040 --> 00:14:32,800 +في هناك stable + +153 +00:14:35,440 --> 00:14:41,300 +Movement ثبات لحركة العدسة اللي هي تقريبا قداش + +154 +00:14:41,300 --> 00:14:51,720 +بالساوي Zero مافيش أي حركة لمين للعدسة Air + +155 +00:14:51,720 --> 00:14:55,280 +Movement حركة اللي هو الهواء + +156 +00:14:57,820 --> 00:15:03,580 +At the anterior surface of the lens by post lens + +157 +00:15:03,580 --> 00:15:07,360 +tear film thinning by reduction in lens movement + +158 +00:15:07,360 --> 00:15:13,640 +الآن العدسة اللاصقة كالقرانية بتتكون من سطحين سطح + +159 +00:15:13,640 --> 00:15:20,070 +أمامي و سطح خلفيالان تعرض العدسة للهواء الجوى + +160 +00:15:20,070 --> 00:15:25,490 +هيعمل امتصاص لمن؟ لال air صحيح؟ يعني و كأنه انه + +161 +00:15:25,490 --> 00:15:29,930 +هيصير هناك thinning ل ال post tear limbs وبالتالي + +162 +00:15:29,930 --> 00:15:38,230 +هذا أيضا هيأثر على مين؟ على حركة العدسة water + +163 +00:15:38,230 --> 00:15:44,630 +flow conductivity تدفق الماء او تدفق ال tear خلال + +164 +00:15:44,630 --> 00:15:45,370 +العدسة + +165 +00:15:49,080 --> 00:15:54,020 +The flow conductivity عملية التدخق is a function + +166 +00:15:54,020 --> 00:16:00,460 +of the material pore size and lens thickness الآن + +167 +00:16:00,460 --> 00:16:05,520 +في عندنا قانون ال oxygen transmissibility equal dk + +168 +00:16:05,520 --> 00:16:12,140 +over T صحيح؟الان كل ما زادت سماكة العدسة هذا هيقلل + +169 +00:16:12,140 --> 00:16:17,760 +من ايش؟ من نفاذية دخول ال oxygen ايضا هيقلل من + +170 +00:16:17,760 --> 00:16:24,280 +دخول ال tears okay لا ال cornea لذلك دايما بننصح + +171 +00:16:24,280 --> 00:16:28,620 +بالعدسات ال daily wear او ال extended wear ان تكون + +172 +00:16:28,620 --> 00:16:33,860 +very thin عشان تسمح باكبر كمية من ال tear ان يدخل + +173 +00:16:33,860 --> 00:16:40,240 +و ايضا من ال oxygenلذلك المواد اللى مصنوعة من ال + +174 +00:16:40,240 --> 00:16:43,240 +high water او العدسات اللى مصنوعة من ال high water + +175 +00:16:43,240 --> 00:16:47,960 +content هتلاقي كمية التدفق فيها ايه كبير وعالى + +176 +00:16:47,960 --> 00:16:53,020 +مقارنة بال low water content او ال medium water + +177 +00:16:53,020 --> 00:16:59,940 +content ايضا كل ما زادت المسامات في داخل العدسة كل + +178 +00:16:59,940 --> 00:17:05,470 +ما كان التدفق للتير اكتر اكتركل ما زادت المسامات + +179 +00:17:05,470 --> 00:17:09,330 +يعني الفتحات اللى موجودة فى داخل العدسة هيسمح + +180 +00:17:09,330 --> 00:17:15,810 +بدخول كمية اكبر من مين من ال tier high water + +181 +00:17:15,810 --> 00:17:19,290 +content materials طبعا احنا عارفين ال high water + +182 +00:17:19,290 --> 00:17:23,550 +content okay ال materials هنضيفنا مادة السيليكون + +183 +00:17:23,550 --> 00:17:28,570 +عشان نعمل زيادة لمين ل ال wetability المتانة okay + +184 +00:17:53,650 --> 00:18:00,700 +Lens Verification and InspectionLens verification + +185 +00:18:00,700 --> 00:18:05,640 +أي بمعنى التحقق من العدسة، دايما انا ك + +186 +00:18:05,640 --> 00:18:11,460 +practitioner لازم اعمل تحقق لأداء العدسة، خاصة اذا + +187 +00:18:11,460 --> 00:18:14,940 +كانت conventional daily wear، يعني المريض بعمل + +188 +00:18:14,940 --> 00:18:19,980 +باستمرار follow-up عنده and inspection انه اعمل + +189 +00:18:19,980 --> 00:18:22,680 +عملية تفتيش لمين للعدسة + +190 +00:18:25,450 --> 00:18:31,030 +Lens Integrity سلامة العدسة checked بتم تأكيدها + +191 +00:18:31,030 --> 00:18:36,530 +using باستخدام a projection microscope أو الستلم + +192 +00:18:36,530 --> 00:18:41,110 +دائما عملية التقييم سواء اللي أخدناها ال corneal + +193 +00:18:41,110 --> 00:18:44,830 +staining أو ال conjunctival staining أيضا سلامة + +194 +00:18:44,830 --> 00:18:49,370 +العدسة بتتم من خلال ال bio microscope أو الستلم + +195 +00:18:51,600 --> 00:18:55,140 +when the lens is on the eye، اذا ديدي اعمل ايه؟ + +196 +00:18:55,140 --> 00:19:00,060 +insertion للعدسة okay، اذا لازم انا اعمل insertion + +197 +00:19:00,060 --> 00:19:07,200 +للعدسة check for edge defects، دايما ممكن يكون فيه + +198 +00:19:07,200 --> 00:19:12,980 +هناك scratch لحواف العدسة او ممكن يكون فيه هناك + +199 +00:19:14,010 --> 00:19:18,730 +مثلا لسعة في أطراف العدسة فدايما انا بدي اتأكد من + +200 +00:19:18,730 --> 00:19:23,910 +هذه النقطة من خلال جهاز الاستلان ايضا بشوف ال + +201 +00:19:23,910 --> 00:19:28,470 +central مركز العدسة انه هل هو سليم ولا فيه defects + +202 +00:19:32,290 --> 00:19:37,430 +Variety of Electronic Mechanical Gauges or + +203 +00:19:37,430 --> 00:19:42,490 +Bakymeter Major Soft Lens Thickness طبعا زي ما + +204 +00:19:42,490 --> 00:19:47,170 +احنا عارفين ان هناك يوجد مجموعة من ال parameters + +205 +00:19:47,170 --> 00:19:52,290 +اللي خاصة بالعدسة ال soft contact lens بتشمل ال + +206 +00:19:52,290 --> 00:19:56,610 +power ال diameter ال base curve ال water content + +207 +00:19:56,610 --> 00:20:00,970 +ال thickness of the lensعنا موضوع مثلا ال + +208 +00:20:00,970 --> 00:20:04,950 +thickness of the lens بتم تقييمها من خلال جهاز + +209 +00:20:04,950 --> 00:20:10,290 +electronic mechanical gauges أو ال bakymeter يعني + +210 +00:20:10,290 --> 00:20:19,010 +الجهاز هذا خاص بسماكة عدسة ال soft contact lens it + +211 +00:20:19,010 --> 00:20:25,670 +is impractical for the practitioner to verifyEach + +212 +00:20:25,670 --> 00:20:30,770 +disposable lens but the patient can check each new + +213 +00:20:30,770 --> 00:20:36,490 +lens before inserting it دايما العدسات اللي بتلبس + +214 +00:20:36,490 --> 00:20:41,990 +لفترات زمانية قصيرة من المستحيل انه كل شوية المريض + +215 +00:20:41,990 --> 00:20:45,970 +وينروح على ال practitioner يشوف يعمل verification + +216 +00:20:45,970 --> 00:20:52,020 +للعدسةفانا ك practitioner لازم انه اعلم من المريض + +217 +00:20:52,020 --> 00:20:57,140 +انه كيف يعمل insertion أو removal للعدسة وكيف يعمل + +218 +00:20:57,140 --> 00:21:01,620 +check للعدسة انه هل هي الأطراف فيها سليمة، هل ال + +219 +00:21:01,620 --> 00:21:05,220 +center فيها سليم، ليش؟ لأن هذه العدسات بتعيش فترة + +220 +00:21:05,220 --> 00:21:08,860 +زمانية قصيرة، اذا كانت daily wear، بلبسها لمدة يوم + +221 +00:21:08,860 --> 00:21:12,960 +واحد، اذا كانت extended wear، بلبسها لمدة اسبوع، + +222 +00:21:12,960 --> 00:21:14,900 +وبعد ذلك بتخلص منها + +223 +00:21:17,600 --> 00:21:22,560 +في اي استفسار اي سؤال واضح الأمور ان شاء الله okay + +224 +00:21:25,960 --> 00:21:31,400 +الان بدنا نعمل عملية كل اللى اتكلمنا فيه التقييم + +225 +00:21:31,400 --> 00:21:38,060 +السابق كان من خلال العدسة انه تقييم للعدسة سواء ال + +226 +00:21:38,060 --> 00:21:42,400 +base curve ال diameter ال power ايضا تقييم ال + +227 +00:21:42,400 --> 00:21:46,280 +water content ال thickness للعدسة الان هنتكلم من + +228 +00:21:46,280 --> 00:21:47,360 +ناحية فيستيولوجية + +229 +00:21:51,290 --> 00:21:56,110 +It's the term used by Efron and Holden to + +230 +00:21:56,110 --> 00:22:01,550 +designate the role of lens design and fitting in + +231 +00:22:01,550 --> 00:22:06,910 +ocular complications in lens wear في هناك باحثين + +232 +00:22:06,910 --> 00:22:12,350 +في العدسات اللاصقة الأول Efron والتاني Holden + +233 +00:22:12,350 --> 00:22:18,800 +عملوا كتابذكروا في هذا الكتاب كل مضاعفات العدسات + +234 +00:22:18,800 --> 00:22:24,780 +اللاصقة سواء كانت اللينة أو الصلبة وأيضا وضعوا + +235 +00:22:24,780 --> 00:22:30,800 +مجموعة من المعايير أو مجموعة من ال parameters من + +236 +00:22:30,800 --> 00:22:35,500 +خلالها انا بقدر اعمل تقييم للعدسة اللاصقة + +237 +00:22:39,430 --> 00:22:43,530 +Some ocular complications بعض من هذه المضاعفات + +238 +00:22:43,530 --> 00:22:49,010 +للعين of contact lens were observed at follow-up + +239 +00:22:49,010 --> 00:22:54,270 +visits يعني ممكن ان انا اكتشفها ك examiner او ك + +240 +00:22:54,270 --> 00:22:58,170 +practitioner من خلال ان المريض ايش يعمل follow-up + +241 +00:22:58,170 --> 00:23:01,470 +اذا مدام follow-up بدي افهم ان هذه العدسة ايه + +242 +00:23:01,470 --> 00:23:03,190 +conventional daily wear + +243 +00:23:07,830 --> 00:23:13,510 +At follow-up visits can be viewed as an indication + +244 +00:23:13,510 --> 00:23:19,290 +for changing lens design for a given mood of wear + +245 +00:23:19,290 --> 00:23:25,570 +يعني الآن مثلا المريض إيجي عندي ع المركز وإديته + +246 +00:23:25,570 --> 00:23:29,930 +عدسات conventional daily wear لكن هذا المريض مات + +247 +00:23:29,930 --> 00:23:33,830 +أقلم مع هذا النوع من العدسات الآن أنا بدي أعمل + +248 +00:23:33,830 --> 00:23:39,810 +عملية تغيير لنوع العدسةلـ type of a lens ممكن ادي + +249 +00:23:39,810 --> 00:23:44,450 +مثلا daily wear او extended wear هذا كله لازم انا + +250 +00:23:44,450 --> 00:23:48,170 +اكون بعين الاعتبار بالنسبة للمريض يعني بدي اقوله + +251 +00:23:48,170 --> 00:23:52,470 +ان ال rules الخاصة بال conventional daily wear ال + +252 +00:23:52,470 --> 00:23:55,390 +rules الخاصة في ال extended wear عملية ال + +253 +00:23:55,390 --> 00:23:59,310 +insertion ال removal عملية ايضا اللي هو ال check + +254 +00:23:59,310 --> 00:24:03,370 +للعدسة لازم تكون واضحة بالنسبة لل patient + +255 +00:24:06,420 --> 00:24:12,260 +such ocular changes fall into eight categories of + +256 +00:24:12,260 --> 00:24:18,380 +signs and symptoms، هناك تمام مجموعات هذه خاصة + +257 +00:24:18,380 --> 00:24:24,160 +بالشكوى من قبل المريض أو ال signs اللي بيشوفها مين + +258 +00:24:24,160 --> 00:24:27,920 +أو ال clinical sign اللي بيشوفه ال examiner أو ال + +259 +00:24:27,920 --> 00:24:28,400 +practitioner + +260 +00:24:31,720 --> 00:24:39,400 +Number one Hypoxia and hypercapnia Hypoxia معناها + +261 +00:24:39,400 --> 00:24:44,820 +ايه؟ نقص في الأكسجين للأنتيريور surface of the + +262 +00:24:44,820 --> 00:24:50,500 +cornea Hypercapnia زيادة دخول ثاني أكسجين ثاني + +263 +00:24:50,500 --> 00:24:54,640 +الأكسجين نعم اللي هو الـCO2 لوين؟ للأنتيريور + +264 +00:24:54,640 --> 00:25:00,140 +surface of the cornea زيادة اللي هو increase + +265 +00:25:02,530 --> 00:25:10,310 +الهيبوكسية تتخلص من الـCO2 إلى الجزء الأمامي + +266 +00:25:10,310 --> 00:25:16,350 +القلبي + +267 +00:25:16,350 --> 00:25:22,410 +الهيبوكسية + +268 +00:25:22,410 --> 00:25:31,630 +تتخلص من الـCO2 إلى الجزء الأمامي القلبيNormally + +269 +00:25:31,630 --> 00:25:35,950 +there is a flow of oxygen into the anterior + +270 +00:25:35,950 --> 00:25:42,010 +corneal surface and an efflux of carbon dioxide + +271 +00:25:42,010 --> 00:25:48,070 +يعني من الطبيعي أن يتم هناك تدفق للأكسجين داخل + +272 +00:25:48,070 --> 00:25:53,590 +السطح الأمامي للقرنية ويصير إيش اللي هو خروج + +273 +00:25:53,590 --> 00:25:58,050 +efflux أي بمعنى خروج لثاني أكسيد الكربون + +274 +00:26:01,730 --> 00:26:07,230 +When the eyelid is closed during sleep، إذا + +275 +00:26:07,230 --> 00:26:13,190 +الإنسان هو نائم، okay، the palpebral vascular + +276 +00:26:13,190 --> 00:26:19,030 +supply becomes the site of gas exchange طبعا احنا + +277 +00:26:19,030 --> 00:26:24,690 +بنعرف من خصائص الكورنيا إنه هي transparentفدايما + +278 +00:26:24,690 --> 00:26:30,090 +غذائها بيكون من وين جزء منه كبير من الهواء الجوي + +279 +00:26:30,090 --> 00:26:34,230 +طيب الآن الإنسان أغلق عينه زي في حالة ال extended + +280 +00:26:34,230 --> 00:26:39,950 +wear، lenses كيف بده يعني الكورنيا كيف ممكن أنه + +281 +00:26:39,950 --> 00:26:45,660 +تتغذى؟ففي عندنا ال Vascular أو البلببرال Vascular + +282 +00:26:45,660 --> 00:26:50,560 +Supply طبعا المدام Vascular اذا الوظيفة بتاعتها + +283 +00:26:50,560 --> 00:26:55,000 +ايش تعتبر؟ اللي هو ال nutrition كتخدية فهذه + +284 +00:26:55,000 --> 00:27:00,020 +بالساعد في عملية التخدية لمين؟ للكورنية، اذا الهدف + +285 +00:27:00,020 --> 00:27:06,700 +منها المساعدة في عملية تخدية الكورنية وهي تعتبر + +286 +00:27:06,700 --> 00:27:14,760 +يعني مكان مهم في عملية تبادل مين؟ التيرOkay يعني + +287 +00:27:14,760 --> 00:27:19,540 +ممكن واحد من المرضى يسألكم العدسات ال extended + +288 +00:27:19,540 --> 00:27:24,300 +wear او العدسات ال daily wear كيف انا بدى انه + +289 +00:27:24,300 --> 00:27:28,480 +اتعامل معها و انا نايم انه كيف بدى يصير هناك اللي + +290 +00:27:28,480 --> 00:27:34,000 +هو يعني كتنفس للكورنية من خلال اللي هو ال vascular + +291 +00:27:34,000 --> 00:27:39,720 +او البلببرال vascular supplyhypoxia and + +292 +00:27:39,720 --> 00:27:44,560 +hypercapnia indication for contact lens refitting + +293 +00:27:44,560 --> 00:27:49,700 +أي مريض بيظهر عنده علامة الـ hypoxia أو الـ + +294 +00:27:49,700 --> 00:27:54,100 +hypercapnia لازم انا اعيد ايه ال fitting للعدسة + +295 +00:27:54,100 --> 00:27:58,820 +اللاصقة قد تسأل طالبة انه كيف انا بدي اعرف انه + +296 +00:27:58,820 --> 00:28:04,230 +مريض عنده hypoxia او hypercapniaمن خلال الـ + +297 +00:28:04,230 --> 00:28:08,070 +Corneal Fluorescein Staining الـ Efron Aggrading + +298 +00:28:08,070 --> 00:28:11,050 +of Corneal Fluorescein Staining اللي أخدناه في + +299 +00:28:11,050 --> 00:28:15,670 +المعمل الأول لذلك هي أهمية مين؟ ال Corneal + +300 +00:28:15,670 --> 00:28:19,170 +Fluorescein Staining grade 0، no staining of the + +301 +00:28:19,170 --> 00:28:23,390 +corneal epithelia، grade 1، هيكون less than 1 over + +302 +00:28:23,390 --> 00:28:27,550 +3 of the corneal fluorescein staining، و grade 2 و + +303 +00:28:27,550 --> 00:28:28,510 +grade 3 + +304 +00:28:33,440 --> 00:28:39,440 +Reduced Epithelial Aerobic Metabolism الآن ما هي + +305 +00:28:39,440 --> 00:28:45,200 +التغيرات الفيسيولوجية اللى بتحدث لـ Corneal + +306 +00:28:45,200 --> 00:28:49,720 +Epithelium و اللى لازم انا ك practitioner ان اعمل + +307 +00:28:49,720 --> 00:28:55,060 +عملية observation ملاحظة لها عندما المريض يرتدي + +308 +00:28:55,060 --> 00:28:56,860 +العدسة اللاصقة + +309 +00:29:00,570 --> 00:29:06,250 +Number one reduction in meiotic cell activity احنا + +310 +00:29:06,250 --> 00:29:12,130 +بنعرف ان في هناك نمو او تكاثر لخلايا ال corneal + +311 +00:29:12,130 --> 00:29:17,350 +epithelium الشخص يما بيرتد العدسة اللاصقة اللينة + +312 +00:29:17,350 --> 00:29:22,190 +ممكن انه يقلل من ال meiotic الانقسام لهذه الخلايا + +313 +00:29:22,190 --> 00:29:28,900 +زي بالضبط يما شخص بعمل عملية الإذا أول حاجة بنقوله + +314 +00:29:28,900 --> 00:29:33,820 +إنه من ال complications إلها هتعمل تقليل في انقسام + +315 +00:29:33,820 --> 00:29:40,440 +إيه الخلايا التفاعلية أي بمعنى ال corneal + +316 +00:29:40,440 --> 00:29:41,620 +epithelium cells + +317 +00:29:47,430 --> 00:29:52,950 +الروابط ما بين هذه الخلايا اشمالها هتقل او هتنكسر + +318 +00:29:52,950 --> 00:29:58,670 +يعني ما هيصير ان في هناك good junction ما بين هذه + +319 +00:29:58,670 --> 00:29:59,590 +الروابط + +320 +00:30:02,860 --> 00:30:08,400 +decrease in numbers of طبعا كيف هذي اللي هو هيصير + +321 +00:30:08,400 --> 00:30:14,060 +اللي هو تقليل في عدد ال hemodemosis الان اول شغلة + +322 +00:30:14,060 --> 00:30:18,720 +بتلاقي الشخص اللي بيعمل عملية اللازك بنقوله دايما + +323 +00:30:18,720 --> 00:30:23,100 +غطى عينك صح؟ عشان يصير regeneration لمن؟ لل + +324 +00:30:23,100 --> 00:30:26,860 +corneal epithelia لكن السبب الرئيسي في عملية + +325 +00:30:26,860 --> 00:30:32,890 +التغطية انه مايصير هناك ايه؟ infection للمريضإذا + +326 +00:30:32,890 --> 00:30:37,610 +أهم شيء اللي هو عملية الخوف من ال infection فممكن + +327 +00:30:37,610 --> 00:30:41,750 +هذا يقلل من مين؟ من ال hemidemesis اللي هو عملية + +328 +00:30:41,750 --> 00:30:47,270 +ال infection لكن ارتداء العدسة اللاصقة اشماله بزود + +329 +00:30:47,270 --> 00:30:48,570 +حدوث ال infection + +330 +00:30:52,640 --> 00:30:57,140 +Expiration of corneal epithelial cells أيضًا هيزود + +331 +00:30:57,140 --> 00:31:01,520 +من إيش؟ من انقسام الـ corneal epithelia عملية + +332 +00:31:01,520 --> 00:31:06,460 +الانفصال لهذه الخلايا أيضًا بالزيد طبعًا يا جماعة + +333 +00:31:06,460 --> 00:31:10,340 +كل هذه ال science كيف بتم الاكتشاف عنها؟ هذه كلها + +334 +00:31:10,340 --> 00:31:13,780 +نظرية من الـ corneal fluorescein staining + +335 +00:31:17,560 --> 00:31:23,000 +The surface cells خلايا السطح may become ربما تصبح + +336 +00:31:23,000 --> 00:31:27,500 +more fragile هشة and there may be a slight + +337 +00:31:27,500 --> 00:31:31,500 +epithelial thinning وطبقة الابيثيليام ممكن انه + +338 +00:31:31,500 --> 00:31:36,720 +تصير نحيفة، نتيجة اللي هو قد يكون ال infection + +339 +00:31:36,720 --> 00:31:40,600 +اللي اتعرض لها ال corneal epithelium في بعض + +340 +00:31:40,600 --> 00:31:47,700 +الأحيانA clinical manifestation، إذا عملية الكشف + +341 +00:31:47,700 --> 00:31:52,800 +عنها للـ hypoxia أو الـ hypercapnia من خلال الـ + +342 +00:31:52,800 --> 00:32:02,520 +florescein أو الـ corneal florescein staining طبعا + +343 +00:32:02,520 --> 00:32:09,930 +الفيجر هذه بتوضحمجموعة من ال clinical signs اللى + +344 +00:32:09,930 --> 00:32:16,410 +بتظهر عند المريض و عندها لازم المريض يوقف من + +345 +00:32:16,410 --> 00:32:21,470 +ارتداء العدسة اللاصقة طبعا كلها ال ocular + +346 +00:32:21,470 --> 00:32:24,830 +manifestation اللى لها او ال clinical diagnosis + +347 +00:32:24,830 --> 00:32:28,690 +test اللى خاص فيها بتتم الاكتشاف من خلال ال + +348 +00:32:28,690 --> 00:32:30,450 +corneal fluorescein scanning + +349 +00:32:34,190 --> 00:32:37,950 +نتوقف ان شاء الله عند ال signs of reduced + +350 +00:32:37,950 --> 00:32:42,950 +epithelial aerobic metabolism في المحاضرة القادمة + +351 +00:32:42,950 --> 00:32:44,470 +ان شاء الله نكمل + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/BhUIXmwX_jA_raw.json b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/BhUIXmwX_jA_raw.json new file mode 100644 index 0000000000000000000000000000000000000000..cedc47b339ee9e9218df8915603d9960479ff184 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/BhUIXmwX_jA_raw.json @@ -0,0 +1 @@ +{"segments": [{"id": 1, "seek": 4935, "start": 21.63, "end": 49.35, "text": "بسم الله الرحمن الرحيم السلام عليكم ورحمة الله وبركاته and a very good morning to all of you اليوم هنتناول موضوع ال tear film and blinking بداية لو بدأنا المحاضرة ما هو مفهوم ال tears ال tears it covers the anterior surface of the cornea", "tokens": [3555, 38251, 21984, 34892, 5016, 27842, 34892, 5016, 32640, 21136, 37440, 25894, 24793, 4032, 2288, 35571, 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الماء من وين بنسحب؟ من الكورنيا زي فكرة بالضبط ان شخص عنده dry eye بديه high ولا low water content؟ low water content", "tokens": [3495, 18870, 11630, 6547, 34105, 4117, 45030, 11242, 9673, 5016, 20292, 1211, 30767, 1829, 2423, 2477, 18870, 11630, 39894, 25957, 1211, 15844, 8608, 5016, 3555, 9122, 2304, 10632, 9122, 3555, 48923, 9154, 9673, 16606, 23032, 3555, 3615, 995, 23758, 9673, 1829, 9673, 16606, 9154, 4032, 9957, 44945, 3794, 5016, 3555, 22807, 9154, 33251, 13063, 22653, 995, 30767, 1829, 6156, 4117, 25720, 20666, 11242, 3555, 9566, 16472, 13412, 9778, 9381, 43242, 3224, 4016, 3313, 4724, 16254, 3224, 1090, 49429, 2295, 1281, 2701, 22807, 2295, 1281, 2701], "avg_logprob": -0.16415334198363993, "compression_ratio": 1.5817307692307692, "no_speech_prob": 0.0, "words": [{"start": 382.37, "end": 383.23, "word": "hybotonic", "probability": 0.5502115885416666}, {"start": 383.23, "end": 384.21, "word": " solutions", "probability": 0.94091796875}, {"start": 384.21, "end": 385.31, "word": 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"temperature": 1.0}, {"id": 24, "seek": 63454, "start": 610.43, "end": 634.55, "text": "والنوع التاني ال reflex tear secretion بالنسبة ل ال basic tear secretion اللي مسئول عنه ال accessory lacrimal glands اللي هي عبارة عن الكراوس و ال wolfring glands بالنسبة ل ال reflex tear secretion اللي مسئول عنه ال main lacrimal glands", "tokens": [2407, 6027, 1863, 45367, 16712, 7649, 1829, 2423, 23802, 12556, 4054, 313, 20666, 1863, 35457, 3660, 5296, 2423, 3875, 12556, 4054, 313, 13672, 1829, 47524, 19986, 12610, 18871, 3224, 2423, 30617, 28027, 5565, 304, 49533, 13672, 1829, 39896, 6225, 3555, 9640, 3660, 18871, 33251, 23557, 41779, 4032, 2423, 19216, 2937, 49533, 20666, 1863, 35457, 3660, 5296, 2423, 23802, 12556, 4054, 313, 13672, 1829, 47524, 19986, 12610, 18871, 3224, 2423, 2135, 28027, 5565, 304, 49533], "avg_logprob": -0.14000000476837157, "compression_ratio": 1.9454545454545455, "no_speech_prob": 0.0, "words": [{"start": 610.43, "end": 610.93, "word": "والنوع", "probability": 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closer اغلاق العين واضح الفكرة هذه؟ اذا الان عندنا تقييم العدسة بعد خمس دقائق و كأنه انا عملت لنور تقييم للعدسة بعد تمان ساعات هتكون ال movement of the lens the same", "tokens": [8297, 37495, 22653, 4032, 9122, 33456, 3224, 6225, 42213, 2655, 43761, 6055, 38436, 32640, 39182, 46811, 7649, 8608, 45761, 9307, 286, 4966, 1975, 17082, 15040, 4587, 18863, 9957, 4032, 46958, 5016, 27188, 4117, 25720, 29538, 22807, 1975, 15730, 2423, 7649, 43242, 8315, 6055, 38436, 32640, 18863, 3215, 3794, 3660, 39182, 16490, 2304, 3794, 11778, 4587, 16373, 4587, 4032, 9122, 33456, 3224, 1975, 8315, 6225, 42213, 2655, 5296, 1863, 13063, 6055, 38436, 32640, 24976, 22488, 3794, 3660, 39182, 46811, 7649, 8608, 45761, 9307, 8032, 2655, 30544, 2423, 3963, 295, 264, 6765, 264, 912], "avg_logprob": -0.13810484447786886, "compression_ratio": 1.697560975609756, "no_speech_prob": 0.0, "words": [{"start": 765.74, "end": 766.16, "word": "Okay", "probability": 0.68408203125}, {"start": 766.16, "end": 767.1, "word": " 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ال removal عملية ايضا اللي هو ال check للعدسة لازم تكون واضحة بالنسبة لل patient", "tokens": [1211, 39184, 2010, 295, 257, 6765, 3714, 43020, 1975, 16254, 50113, 15040, 5212, 3728, 1975, 2407, 10913, 3728, 23758, 28242, 3224, 5296, 31377, 2304, 1975, 8315, 1975, 30544, 45030, 9957, 42963, 34268, 3555, 9640, 20666, 1863, 35457, 3660, 5296, 19528, 16572, 11242, 37495, 22653, 4724, 16254, 1975, 39648, 3224, 16472, 2423, 4474, 33962, 33546, 3660, 20666, 16011, 5212, 3728, 2423, 4474, 33962, 33546, 3660, 8978, 2423, 10913, 3728, 6225, 42213, 10632, 2423, 8969, 313, 2423, 17933, 6225, 42213, 10632, 1975, 1829, 11242, 995, 13672, 1829, 31439, 2423, 1520, 24976, 22488, 3794, 3660, 5296, 31377, 2304, 6055, 30544, 4032, 46958, 5016, 3660, 20666, 1863, 35457, 3660, 24976, 4537], "avg_logprob": -0.15306713418276222, "compression_ratio": 1.7882352941176471, "no_speech_prob": 0.0, "words": [{"start": 1417.57, "end": 1417.89, "word": "لـ", "probability": 0.4228515625}, {"start": 1417.89, "end": 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"probability": 0.994873046875}, {"start": 1963.43, "end": 1963.71, "word": " الله", "probability": 0.9619140625}, {"start": 1963.71, "end": 1964.47, "word": " نكمل", "probability": 0.85986328125}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 1964.5939375, "duration_after_vad": 1824.811249999994} \ No newline at end of file diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/BhUIXmwX_jA_raw.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/BhUIXmwX_jA_raw.srt new file mode 100644 index 0000000000000000000000000000000000000000..2acbfa2079c56ba4fd7613c988241022629e6392 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/BhUIXmwX_jA_raw.srt @@ -0,0 +1,1404 @@ +1 +00:00:21,630 --> 00:00:24,770 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:24,770 --> 00:00:29,290 +وبركاته and a very good morning to all of you + +3 +00:00:29,290 --> 00:00:34,890 +اليوم هنتناول موضوع ال tear film and blinking + +4 +00:00:34,890 --> 00:00:44,250 +بداية لو بدأنا المحاضرة ما هو مفهوم ال tears ال + +5 +00:00:44,250 --> 00:00:49,350 +tears it covers the anterior surface of the cornea + +6 +00:00:51,060 --> 00:00:56,200 +طيب ال functions of tears number one nourishment + +7 +00:00:56,200 --> 00:01:01,580 +of the cornea number two protection it from + +8 +00:01:01,580 --> 00:01:09,140 +infection okay normal blinking from fifteen to + +9 +00:01:09,140 --> 00:01:15,540 +twenty blink okay from fifteen to twenty blink + +10 +00:01:18,740 --> 00:01:24,120 +Have an effect on fitting بداية ال tier لو كان + +11 +00:01:24,120 --> 00:01:32,600 +عندنا حاجة بنسميها tier film instability + +12 +00:01:32,600 --> 00:01:38,120 +أي + +13 +00:01:38,120 --> 00:01:42,840 +عدم ثبات في ال tier هذا بيؤثر على أداء العدسة + +14 +00:01:42,840 --> 00:01:43,720 +اللاصقة + +15 +00:01:46,110 --> 00:01:50,770 +أيضا موضوع ال blinking الترميش احنا في المحاضرة + +16 +00:01:50,770 --> 00:01:56,370 +السابقة اتكلمنا عن الكيراتو ميتر مياردز و ال + +17 +00:01:56,370 --> 00:02:05,530 +visual acuity chart اذا عندنا كان optimal fit + +18 +00:02:05,530 --> 00:02:13,610 +lens هيكون before و after ال blinking الصورة clear + +19 +00:02:14,440 --> 00:02:18,600 +لو كانت loose before a blinking ا clear after a + +20 +00:02:18,600 --> 00:02:23,180 +blinking هتكون unclear لو كانت tight before a + +21 +00:02:23,180 --> 00:02:27,720 +blinking ا unclear after a blinking ا clear فالان + +22 +00:02:27,720 --> 00:02:32,340 +بنستنتج من هذا الكلام انه ال .. انه ال blinking + +23 +00:02:32,340 --> 00:02:36,880 +الترميش هو عامل مهم في الوصول الى مين ال optimal + +24 +00:02:36,880 --> 00:02:38,880 +fit lens okay + +25 +00:02:41,360 --> 00:02:47,680 +Lens movement حركة العدسة اللى normally من 0.5 to + +26 +00:02:47,680 --> 00:02:54,140 +1 ملي متر can be affected يمكن انه تتأثر by + +27 +00:02:54,140 --> 00:02:59,200 +interactions بواسطة التفاعل between the lens and + +28 +00:02:59,200 --> 00:03:05,210 +upper lidاحنا حكينا ان ال diameter لل soft contact + +29 +00:03:05,210 --> 00:03:09,290 +lens أكبر من ال diameter للكورنية ففي هناك + +30 +00:03:09,290 --> 00:03:14,190 +interaction ما بين ال upper eyelid و ال upper lens + +31 +00:03:14,190 --> 00:03:22,250 +لكن هذا التفاعل بينهم من مميزاته انه no hardNo + +32 +00:03:22,250 --> 00:03:26,590 +hard interaction فالان لو كانت في عنا زيادة في + +33 +00:03:26,590 --> 00:03:31,670 +الحركة هتلاقي الشخص ايش ماله؟ discomfort بيحكيلك + +34 +00:03:31,670 --> 00:03:35,370 +يعني من ال .. ضمن الشكوى انه يما ييجي على المركز + +35 +00:03:35,370 --> 00:03:39,530 +بيقولك دايما انا بحس الحركة بتخبط .. العدسة بتخبط + +36 +00:03:39,530 --> 00:03:43,890 +وين؟ في ال upper eyelid وهذا غير محمود بالنسبة + +37 +00:03:43,890 --> 00:03:50,800 +لمين؟ للمريضفالان حركة العدسة هي تعتبر عامل مهم في + +38 +00:03:50,800 --> 00:03:55,760 +الوصول للـ optimal lens fitting للعدسة الملائمة أو + +39 +00:03:55,760 --> 00:04:01,020 +العدسة المناسبة طبعا + +40 +00:04:01,020 --> 00:04:05,740 +في هناك عوامل بتعتمد عليها depending on the + +41 +00:04:05,740 --> 00:04:10,560 +lubricative properties of the pre-lens tear film + +42 +00:04:11,330 --> 00:04:15,990 +أول حاجة انه بيعتمد على خواص الترطيب لل tear film + +43 +00:04:15,990 --> 00:04:19,890 +احنا بنعرف ان ال tear film بتكون من تلت طبقات + +44 +00:04:19,890 --> 00:04:25,330 +الطبقة الأولى هي عبارة عن ال outer lipid layer ال + +45 +00:04:25,330 --> 00:04:30,470 +middle aqueous layer و ال inner mucus layer دايما + +46 +00:04:30,470 --> 00:04:35,970 +موضوع ال movement بيعتمد بالاساس على زيادة الترطيب + +47 +00:04:35,970 --> 00:04:42,590 +لمين؟ للعدسة اللاصقةلذلك هناك بعض أنواع العدسات + +48 +00:04:42,590 --> 00:04:46,830 +اللاصقة خاصة ال extended wear لازم المريض كل ما + +49 +00:04:46,830 --> 00:04:51,110 +يستيقظ من النوم انه يقطر ايه؟ قطرة هذه القطرة ايش + +50 +00:04:51,110 --> 00:04:57,450 +بتعمل؟ عملية ترطيب للعدسة و ايضا عملية ترطيب لمين؟ + +51 +00:04:57,450 --> 00:05:04,350 +للكورنية ايضا the surface equality of both lens + +52 +00:05:04,350 --> 00:05:10,650 +and lidالان اجانا شخص كان عنده a dry eye disease + +53 +00:05:10,650 --> 00:05:15,650 +هل انا بصرفله عدسة لاسقة؟ لأ لأنه عنده bad + +54 +00:05:15,650 --> 00:05:19,210 +equality of tear film فمن ضمن ال counter + +55 +00:05:19,210 --> 00:05:25,130 +indication له ان انا اروح اصرف عدسة لاسقة، واضحة + +56 +00:05:25,130 --> 00:05:29,520 +الفكرة؟and the nature of the blink طبيعة البلينك + +57 +00:05:29,520 --> 00:05:36,360 +شخص يعني بيرمش بشكل مستمر أو مثلا عنده زيادة في + +58 +00:05:36,360 --> 00:05:40,480 +الترميش excessive blinking أكيد هيكون هناك أيش + +59 +00:05:40,480 --> 00:05:49,120 +عنده تأثيرات على ارتداء العدسة اللاصقة the + +60 +00:05:49,120 --> 00:05:53,900 +post lens tear film appears to influence lens + +61 +00:05:53,900 --> 00:06:00,090 +movementفي المحاضرة السابقة اتكلمنا ان العدسة + +62 +00:06:00,090 --> 00:06:05,690 +اللاصقة بتتميز ب minimal movement compared to hard + +63 +00:06:05,690 --> 00:06:10,310 +contact lens اللي بيساعد في حركة ال post tear lens + +64 +00:06:10,310 --> 00:06:13,950 +هو عبارة عن مين؟ حركة العدسة نفسها يعني العدسة + +65 +00:06:13,950 --> 00:06:18,850 +بتتحرك فهذا بيساعد في حركة مين؟ ال post tear lens + +66 +00:06:22,370 --> 00:06:27,750 +hybotonic solutions هناك بعض المحليل زي ال + +67 +00:06:27,750 --> 00:06:33,270 +hybotonic بتعمل على سحب كمية كبيرة من الماء طبعا + +68 +00:06:33,270 --> 00:06:38,590 +هذا المي الماء من وين بنسحب؟ من الكورنيا زي فكرة + +69 +00:06:38,590 --> 00:06:42,770 +بالضبط ان شخص عنده dry eye بديه high ولا low water + +70 +00:06:42,770 --> 00:06:46,930 +content؟ low water contentنفس الحاجة المحلول هذا + +71 +00:06:46,930 --> 00:06:51,390 +ما بنفع مع شخص يكون عنده dry eye لأن طبيعة هذا ال + +72 +00:06:51,390 --> 00:06:56,690 +solution بيعمل على امتصاص absorption أكبر كمية من + +73 +00:06:56,690 --> 00:07:01,910 +مين من المياه اللي موجودة في الكورنيا وبالتالي هذا + +74 +00:07:01,910 --> 00:07:07,350 +ايش هيسبب؟ جفاف في العين وهذا هيأثر اللي هو على + +75 +00:07:07,350 --> 00:07:12,640 +المريض من حيث ال dry eye symptomsإذا hypotonic + +76 +00:07:12,640 --> 00:07:17,580 +solutions can thin the post lens tear film and + +77 +00:07:17,580 --> 00:07:22,740 +cause lens adherence هيأثر أول حاجة على حركة + +78 +00:07:22,740 --> 00:07:29,680 +العدسة وبالتالي هيأثر على حركة tear lensفهتلاحظ + +79 +00:07:29,680 --> 00:07:34,020 +انه دايما انه في هناك adherence تماسك ما بين + +80 +00:07:34,020 --> 00:07:38,740 +العدسة و الكورنيا يعني no sensation at all for the + +81 +00:07:38,740 --> 00:07:48,720 +lens المريض مش هيشعر في إيش؟ في وجود العدسة lens + +82 +00:07:48,720 --> 00:07:55,900 +settling أي بمعنى استقرار العدسة استقرار العدسة + +83 +00:07:56,730 --> 00:08:01,730 +Post-insertion equilibration process هي عملية + +84 +00:08:01,730 --> 00:08:08,710 +استقرار أو عملية ثبات للعدسة يعني دايما ان العدسة + +85 +00:08:08,710 --> 00:08:13,370 +لازم يكون في الها concentration وهذا ال + +86 +00:08:13,370 --> 00:08:19,160 +concentration ايش يكون بين قصين؟ جيدالان لو في + +87 +00:08:19,160 --> 00:08:22,520 +عندنا Decentration للعدسة هيكون ال evaluation + +88 +00:08:22,520 --> 00:08:29,540 +عبارة عن non optimal fit lens صحيح؟ فال lens + +89 +00:08:29,540 --> 00:08:33,280 +settling post insertion equilibration process + +90 +00:08:33,280 --> 00:08:39,620 +عملية استقرار أو ثبات العدسة the tear film sequest + +91 +00:08:39,620 --> 00:08:45,660 +out by the initial blinking by reduction in lens + +92 +00:08:45,660 --> 00:08:51,700 +movementدايما المريض اول ما برتدي العدسة اللاصقة + +93 +00:08:51,700 --> 00:08:58,000 +هيتكون هناك tear، دمع، بعض هذا ال tear هيتجمع وين؟ + +94 +00:08:58,000 --> 00:09:04,140 +خلف العدسة، والبعض الآخر هيطلع للخارج طبعا تجميع + +95 +00:09:04,140 --> 00:09:09,160 +ال tears خلف العدسة، هذا هيقلل من ايه؟ من حركة + +96 +00:09:09,160 --> 00:09:15,240 +العدسةصحيح؟ ايضا يما يخرج في الخارج المريض هيصير + +97 +00:09:15,240 --> 00:09:20,100 +ايه؟ over او هيصير اللي هو يعني بمعنى حساس over + +98 +00:09:20,100 --> 00:09:27,900 +sensitivity يعني الحساسية عنده بالزيد reflects + +99 +00:09:27,900 --> 00:09:37,920 +tearing طبعا عندنا ال tear secretion ال + +100 +00:09:37,920 --> 00:09:38,200 +tear + +101 +00:09:41,410 --> 00:09:54,530 +secretion إفراز الدمع can be classified in + +102 +00:09:54,530 --> 00:09:58,190 +two types + +103 +00:09:58,190 --> 00:10:08,190 +في هناك نوعين النوع الأول basic tier secretion + +104 +00:10:10,430 --> 00:10:17,770 +والنوع التاني ال reflex tear secretion بالنسبة ل + +105 +00:10:17,770 --> 00:10:21,390 +ال basic tear secretion اللي مسئول عنه ال + +106 +00:10:21,390 --> 00:10:25,610 +accessory lacrimal glands اللي هي عبارة عن الكراوس + +107 +00:10:25,610 --> 00:10:30,410 +و ال wolfring glands بالنسبة ل ال reflex tear + +108 +00:10:30,410 --> 00:10:34,550 +secretion اللي مسئول عنه ال main lacrimal glands + +109 +00:10:35,870 --> 00:10:42,290 +طيب، الآن ارتداء العدسة اللاصقة أيضا بيؤثر على ال + +110 +00:10:42,290 --> 00:10:48,610 +reflex tearing كيف بيؤثر على ال reflex tearing؟ + +111 +00:10:48,610 --> 00:10:52,990 +reflex tearing on lens insertion may also affect + +112 +00:10:52,990 --> 00:10:56,630 +lens movement، إذا هو بالأساس هيؤثر على حركة + +113 +00:10:56,630 --> 00:11:03,040 +العدسةleading to a transitory reduction فهذا هيعمل + +114 +00:11:03,040 --> 00:11:08,820 +اللي هو تقليل حركة العدسة بشكل مؤقت لذلك دايما + +115 +00:11:08,820 --> 00:11:13,460 +بينصح عند تقييم العدسة اللي لاسقة اللينة ما نبدأ + +116 +00:11:13,460 --> 00:11:19,180 +عملية التقييم بشكل مباشر على الأقل لازم نقيم بعد + +117 +00:11:19,180 --> 00:11:24,310 +خمس دقائقطبعا بعد خمس دقائق هيتجمع ال tier خلف + +118 +00:11:24,310 --> 00:11:28,850 +العدسة ال tier اللي هو الخارج هيقل فانا بقدر انه + +119 +00:11:28,850 --> 00:11:31,650 +اتم اللي هو عملية التقييم + +120 +00:11:36,260 --> 00:11:40,780 +Lens Movement حركة العدسة زي ما اتفقنا ان حركة + +121 +00:11:40,780 --> 00:11:44,240 +العدسة سواء في ال hard contact lens او ال soft + +122 +00:11:44,240 --> 00:11:49,460 +contact lens هي غير كافية لتقييم العدسة هل هي + +123 +00:11:49,460 --> 00:11:52,740 +optimal or loose or steep + +124 +00:11:57,120 --> 00:12:02,440 +Immediately بالتأكيد on insertion is not usually + +125 +00:12:02,440 --> 00:12:07,580 +representative of normal movement يعني أنا أول ما + +126 +00:12:07,580 --> 00:12:13,880 +ألبس العدسة للمريض، هذا لا يمثل أو لا يعبر عن حركة + +127 +00:12:13,880 --> 00:12:15,560 +العدسة الأصلية + +128 +00:12:20,050 --> 00:12:24,930 +Evaluating movement تقييم الحركة after five + +129 +00:12:24,930 --> 00:12:30,370 +minutes بعد خمس دقائق It predicts movement after + +130 +00:12:30,370 --> 00:12:36,170 +eight hours of wear الان انا عندما هقوم بعملية ال + +131 +00:12:36,170 --> 00:12:43,250 +evaluation بعد خمس دقائق هي بتكتشف حركة العدسة بعد + +132 +00:12:43,250 --> 00:12:49,300 +تمام ساعاتOkay يعني و كأنه عملتله تقييم بعد تمان + +133 +00:12:49,300 --> 00:12:55,440 +ساعات I + +134 +00:12:55,440 --> 00:13:03,100 +closer اغلاق العين واضح الفكرة هذه؟ اذا الان عندنا + +135 +00:13:03,100 --> 00:13:07,760 +تقييم العدسة بعد خمس دقائق و كأنه انا عملت لنور + +136 +00:13:07,760 --> 00:13:12,600 +تقييم للعدسة بعد تمان ساعات هتكون ال movement of + +137 +00:13:12,600 --> 00:13:19,630 +the lens the sameEye closer can also affect lens + +138 +00:13:19,630 --> 00:13:25,510 +movement أيضا اللي هو بتأثر على حركة العدسة يعني + +139 +00:13:25,510 --> 00:13:29,870 +انتوا ملاحظين ان كل العناصر او كل العوامل هي بتأثر + +140 +00:13:29,870 --> 00:13:34,410 +على مين؟ على ال lens movement طيب ال eye closer + +141 +00:13:34,410 --> 00:13:38,470 +كيف بتأثر على حركة العدسة؟ انه بيبطل يكون عند + +142 +00:13:38,470 --> 00:13:40,630 +المريض ايه؟ اي تة blinking + +143 +00:13:44,490 --> 00:13:50,410 +eye closer as short as 15 minutes thinning of the + +144 +00:13:50,410 --> 00:13:55,590 +post lens tear film by reduce lens movement to + +145 +00:13:55,590 --> 00:14:01,150 +near zero الان لو شخص قام بإغلاق عينه خمس عشر + +146 +00:14:01,150 --> 00:14:05,980 +دقيقة نفترضطبعا الان هو ايش لابس يا جماعة؟ + +147 +00:14:05,980 --> 00:14:10,360 +conventional daily wear lens يعني عدسة اللبس + +148 +00:14:10,360 --> 00:14:14,980 +اليومي التقليدي هو مش لابس عدسة extended wear او + +149 +00:14:14,980 --> 00:14:20,220 +daily wear واضحة؟ اذا اغلاق العين لمدة خمس عشر + +150 +00:14:20,220 --> 00:14:25,080 +دقيقة هذه هتعمل thinning لمين؟ لل post lens tear + +151 +00:14:25,080 --> 00:14:31,040 +film نتيجة ان في هناك قلة لحركة العدسة لان تقريبا + +152 +00:14:31,040 --> 00:14:32,800 +في هناك stable + +153 +00:14:35,440 --> 00:14:41,300 +Movement ثبات لحركة العدسة اللي هي تقريبا قداش + +154 +00:14:41,300 --> 00:14:51,720 +بالساوي Zero مافيش أي حركة لمين للعدسة Air + +155 +00:14:51,720 --> 00:14:55,280 +Movement حركة اللي هو الهواء + +156 +00:14:57,820 --> 00:15:03,580 +At the anterior surface of the lens by post lens + +157 +00:15:03,580 --> 00:15:07,360 +tear film thinning by reduction in lens movement + +158 +00:15:07,360 --> 00:15:13,640 +الآن العدسة اللاصقة كالقرانية بتتكون من سطحين سطح + +159 +00:15:13,640 --> 00:15:20,070 +أمامي و سطح خلفيالان تعرض العدسة للهواء الجوى + +160 +00:15:20,070 --> 00:15:25,490 +هيعمل امتصاص لمن؟ لال air صحيح؟ يعني و كأنه انه + +161 +00:15:25,490 --> 00:15:29,930 +هيصير هناك thinning ل ال post tear limbs وبالتالي + +162 +00:15:29,930 --> 00:15:38,230 +هذا أيضا هيأثر على مين؟ على حركة العدسة water + +163 +00:15:38,230 --> 00:15:44,630 +flow conductivity تدفق الماء او تدفق ال tear خلال + +164 +00:15:44,630 --> 00:15:45,370 +العدسة + +165 +00:15:49,080 --> 00:15:54,020 +The flow conductivity عملية التدخق is a function + +166 +00:15:54,020 --> 00:16:00,460 +of the material pore size and lens thickness الآن + +167 +00:16:00,460 --> 00:16:05,520 +في عندنا قانون ال oxygen transmissibility equal dk + +168 +00:16:05,520 --> 00:16:12,140 +over T صحيح؟الان كل ما زادت سماكة العدسة هذا هيقلل + +169 +00:16:12,140 --> 00:16:17,760 +من ايش؟ من نفاذية دخول ال oxygen ايضا هيقلل من + +170 +00:16:17,760 --> 00:16:24,280 +دخول ال tears okay لا ال cornea لذلك دايما بننصح + +171 +00:16:24,280 --> 00:16:28,620 +بالعدسات ال daily wear او ال extended wear ان تكون + +172 +00:16:28,620 --> 00:16:33,860 +very thin عشان تسمح باكبر كمية من ال tear ان يدخل + +173 +00:16:33,860 --> 00:16:40,240 +و ايضا من ال oxygenلذلك المواد اللى مصنوعة من ال + +174 +00:16:40,240 --> 00:16:43,240 +high water او العدسات اللى مصنوعة من ال high water + +175 +00:16:43,240 --> 00:16:47,960 +content هتلاقي كمية التدفق فيها ايه كبير وعالى + +176 +00:16:47,960 --> 00:16:53,020 +مقارنة بال low water content او ال medium water + +177 +00:16:53,020 --> 00:16:59,940 +content ايضا كل ما زادت المسامات في داخل العدسة كل + +178 +00:16:59,940 --> 00:17:05,470 +ما كان التدفق للتير اكتر اكتركل ما زادت المسامات + +179 +00:17:05,470 --> 00:17:09,330 +يعني الفتحات اللى موجودة فى داخل العدسة هيسمح + +180 +00:17:09,330 --> 00:17:15,810 +بدخول كمية اكبر من مين من ال tier high water + +181 +00:17:15,810 --> 00:17:19,290 +content materials طبعا احنا عارفين ال high water + +182 +00:17:19,290 --> 00:17:23,550 +content okay ال materials هنضيفنا مادة السيليكون + +183 +00:17:23,550 --> 00:17:28,570 +عشان نعمل زيادة لمين ل ال wetability المتانة okay + +184 +00:17:53,650 --> 00:18:00,700 +Lens Verification and InspectionLens verification + +185 +00:18:00,700 --> 00:18:05,640 +أي بمعنى التحقق من العدسة، دايما انا ك + +186 +00:18:05,640 --> 00:18:11,460 +practitioner لازم اعمل تحقق لأداء العدسة، خاصة اذا + +187 +00:18:11,460 --> 00:18:14,940 +كانت conventional daily wear، يعني المريض بعمل + +188 +00:18:14,940 --> 00:18:19,980 +باستمرار follow-up عنده and inspection انه اعمل + +189 +00:18:19,980 --> 00:18:22,680 +عملية تفتيش لمين للعدسة + +190 +00:18:25,450 --> 00:18:31,030 +Lens Integrity سلامة العدسة checked بتم تأكيدها + +191 +00:18:31,030 --> 00:18:36,530 +using باستخدام a projection microscope أو الستلم + +192 +00:18:36,530 --> 00:18:41,110 +دائما عملية التقييم سواء اللي أخدناها ال corneal + +193 +00:18:41,110 --> 00:18:44,830 +staining أو ال conjunctival staining أيضا سلامة + +194 +00:18:44,830 --> 00:18:49,370 +العدسة بتتم من خلال ال bio microscope أو الستلم + +195 +00:18:51,600 --> 00:18:55,140 +when the lens is on the eye، اذا ديدي اعمل ايه؟ + +196 +00:18:55,140 --> 00:19:00,060 +insertion للعدسة okay، اذا لازم انا اعمل insertion + +197 +00:19:00,060 --> 00:19:07,200 +للعدسة check for edge defects، دايما ممكن يكون فيه + +198 +00:19:07,200 --> 00:19:12,980 +هناك scratch لحواف العدسة او ممكن يكون فيه هناك + +199 +00:19:14,010 --> 00:19:18,730 +مثلا لسعة في أطراف العدسة فدايما انا بدي اتأكد من + +200 +00:19:18,730 --> 00:19:23,910 +هذه النقطة من خلال جهاز الاستلان ايضا بشوف ال + +201 +00:19:23,910 --> 00:19:28,470 +central مركز العدسة انه هل هو سليم ولا فيه defects + +202 +00:19:32,290 --> 00:19:37,430 +Variety of Electronic Mechanical Gauges or + +203 +00:19:37,430 --> 00:19:42,490 +Bakymeter Major Soft Lens Thickness طبعا زي ما + +204 +00:19:42,490 --> 00:19:47,170 +احنا عارفين ان هناك يوجد مجموعة من ال parameters + +205 +00:19:47,170 --> 00:19:52,290 +اللي خاصة بالعدسة ال soft contact lens بتشمل ال + +206 +00:19:52,290 --> 00:19:56,610 +power ال diameter ال base curve ال water content + +207 +00:19:56,610 --> 00:20:00,970 +ال thickness of the lensعنا موضوع مثلا ال + +208 +00:20:00,970 --> 00:20:04,950 +thickness of the lens بتم تقييمها من خلال جهاز + +209 +00:20:04,950 --> 00:20:10,290 +electronic mechanical gauges أو ال bakymeter يعني + +210 +00:20:10,290 --> 00:20:19,010 +الجهاز هذا خاص بسماكة عدسة ال soft contact lens it + +211 +00:20:19,010 --> 00:20:25,670 +is impractical for the practitioner to verifyEach + +212 +00:20:25,670 --> 00:20:30,770 +disposable lens but the patient can check each new + +213 +00:20:30,770 --> 00:20:36,490 +lens before inserting it دايما العدسات اللي بتلبس + +214 +00:20:36,490 --> 00:20:41,990 +لفترات زمانية قصيرة من المستحيل انه كل شوية المريض + +215 +00:20:41,990 --> 00:20:45,970 +وينروح على ال practitioner يشوف يعمل verification + +216 +00:20:45,970 --> 00:20:52,020 +للعدسةفانا ك practitioner لازم انه اعلم من المريض + +217 +00:20:52,020 --> 00:20:57,140 +انه كيف يعمل insertion أو removal للعدسة وكيف يعمل + +218 +00:20:57,140 --> 00:21:01,620 +check للعدسة انه هل هي الأطراف فيها سليمة، هل ال + +219 +00:21:01,620 --> 00:21:05,220 +center فيها سليم، ليش؟ لأن هذه العدسات بتعيش فترة + +220 +00:21:05,220 --> 00:21:08,860 +زمانية قصيرة، اذا كانت daily wear، بلبسها لمدة يوم + +221 +00:21:08,860 --> 00:21:12,960 +واحد، اذا كانت extended wear، بلبسها لمدة اسبوع، + +222 +00:21:12,960 --> 00:21:14,900 +وبعد ذلك بتخلص منها + +223 +00:21:17,600 --> 00:21:22,560 +في اي استفسار اي سؤال واضح الأمور ان شاء الله okay + +224 +00:21:25,960 --> 00:21:31,400 +الان بدنا نعمل عملية كل اللى اتكلمنا فيه التقييم + +225 +00:21:31,400 --> 00:21:38,060 +السابق كان من خلال العدسة انه تقييم للعدسة سواء ال + +226 +00:21:38,060 --> 00:21:42,400 +base curve ال diameter ال power ايضا تقييم ال + +227 +00:21:42,400 --> 00:21:46,280 +water content ال thickness للعدسة الان هنتكلم من + +228 +00:21:46,280 --> 00:21:47,360 +ناحية فيستيولوجية + +229 +00:21:51,290 --> 00:21:56,110 +It's the term used by Efron and Holden to + +230 +00:21:56,110 --> 00:22:01,550 +designate the role of lens design and fitting in + +231 +00:22:01,550 --> 00:22:06,910 +ocular complications in lens wear في هناك باحثين + +232 +00:22:06,910 --> 00:22:12,350 +في العدسات اللاصقة الأول Efron والتاني Holden + +233 +00:22:12,350 --> 00:22:18,800 +عملوا كتابذكروا في هذا الكتاب كل مضاعفات العدسات + +234 +00:22:18,800 --> 00:22:24,780 +اللاصقة سواء كانت اللينة أو الصلبة وأيضا وضعوا + +235 +00:22:24,780 --> 00:22:30,800 +مجموعة من المعايير أو مجموعة من ال parameters من + +236 +00:22:30,800 --> 00:22:35,500 +خلالها انا بقدر اعمل تقييم للعدسة اللاصقة + +237 +00:22:39,430 --> 00:22:43,530 +Some ocular complications بعض من هذه المضاعفات + +238 +00:22:43,530 --> 00:22:49,010 +للعين of contact lens were observed at follow-up + +239 +00:22:49,010 --> 00:22:54,270 +visits يعني ممكن ان انا اكتشفها ك examiner او ك + +240 +00:22:54,270 --> 00:22:58,170 +practitioner من خلال ان المريض ايش يعمل follow-up + +241 +00:22:58,170 --> 00:23:01,470 +اذا مدام follow-up بدي افهم ان هذه العدسة ايه + +242 +00:23:01,470 --> 00:23:03,190 +conventional daily wear + +243 +00:23:07,830 --> 00:23:13,510 +At follow-up visits can be viewed as an indication + +244 +00:23:13,510 --> 00:23:19,290 +for changing lens design for a given mood of wear + +245 +00:23:19,290 --> 00:23:25,570 +يعني الآن مثلا المريض إيجي عندي ع المركز وإديته + +246 +00:23:25,570 --> 00:23:29,930 +عدسات conventional daily wear لكن هذا المريض مات + +247 +00:23:29,930 --> 00:23:33,830 +أقلم مع هذا النوع من العدسات الآن أنا بدي أعمل + +248 +00:23:33,830 --> 00:23:39,810 +عملية تغيير لنوع العدسةلـ type of a lens ممكن ادي + +249 +00:23:39,810 --> 00:23:44,450 +مثلا daily wear او extended wear هذا كله لازم انا + +250 +00:23:44,450 --> 00:23:48,170 +اكون بعين الاعتبار بالنسبة للمريض يعني بدي اقوله + +251 +00:23:48,170 --> 00:23:52,470 +ان ال rules الخاصة بال conventional daily wear ال + +252 +00:23:52,470 --> 00:23:55,390 +rules الخاصة في ال extended wear عملية ال + +253 +00:23:55,390 --> 00:23:59,310 +insertion ال removal عملية ايضا اللي هو ال check + +254 +00:23:59,310 --> 00:24:03,370 +للعدسة لازم تكون واضحة بالنسبة لل patient + +255 +00:24:06,420 --> 00:24:12,260 +such ocular changes fall into eight categories of + +256 +00:24:12,260 --> 00:24:18,380 +signs and symptoms، هناك تمام مجموعات هذه خاصة + +257 +00:24:18,380 --> 00:24:24,160 +بالشكوى من قبل المريض أو ال signs اللي بيشوفها مين + +258 +00:24:24,160 --> 00:24:27,920 +أو ال clinical sign اللي بيشوفه ال examiner أو ال + +259 +00:24:27,920 --> 00:24:28,400 +practitioner + +260 +00:24:31,720 --> 00:24:39,400 +Number one Hypoxia and hypercapnia Hypoxia معناها + +261 +00:24:39,400 --> 00:24:44,820 +ايه؟ نقص في الأكسجين للأنتيريور surface of the + +262 +00:24:44,820 --> 00:24:50,500 +cornea Hypercapnia زيادة دخول ثاني أكسجين ثاني + +263 +00:24:50,500 --> 00:24:54,640 +الأكسجين نعم اللي هو الـCO2 لوين؟ للأنتيريور + +264 +00:24:54,640 --> 00:25:00,140 +surface of the cornea زيادة اللي هو increase + +265 +00:25:02,530 --> 00:25:10,310 +الهيبوكسية تتخلص من الـCO2 إلى الجزء الأمامي + +266 +00:25:10,310 --> 00:25:16,350 +القلبي + +267 +00:25:16,350 --> 00:25:22,410 +الهيبوكسية + +268 +00:25:22,410 --> 00:25:31,630 +تتخلص من الـCO2 إلى الجزء الأمامي القلبيNormally + +269 +00:25:31,630 --> 00:25:35,950 +there is a flow of oxygen into the anterior + +270 +00:25:35,950 --> 00:25:42,010 +corneal surface and an efflux of carbon dioxide + +271 +00:25:42,010 --> 00:25:48,070 +يعني من الطبيعي أن يتم هناك تدفق للأكسجين داخل + +272 +00:25:48,070 --> 00:25:53,590 +السطح الأمامي للقرنية ويصير إيش اللي هو خروج + +273 +00:25:53,590 --> 00:25:58,050 +efflux أي بمعنى خروج لثاني أكسيد الكربون + +274 +00:26:01,730 --> 00:26:07,230 +When the eyelid is closed during sleep، إذا + +275 +00:26:07,230 --> 00:26:13,190 +الإنسان هو نائم، okay، the palpebral vascular + +276 +00:26:13,190 --> 00:26:19,030 +supply becomes the site of gas exchange طبعا احنا + +277 +00:26:19,030 --> 00:26:24,690 +بنعرف من خصائص الكورنيا إنه هي transparentفدايما + +278 +00:26:24,690 --> 00:26:30,090 +غذائها بيكون من وين جزء منه كبير من الهواء الجوي + +279 +00:26:30,090 --> 00:26:34,230 +طيب الآن الإنسان أغلق عينه زي في حالة ال extended + +280 +00:26:34,230 --> 00:26:39,950 +wear، lenses كيف بده يعني الكورنيا كيف ممكن أنه + +281 +00:26:39,950 --> 00:26:45,660 +تتغذى؟ففي عندنا ال Vascular أو البلببرال Vascular + +282 +00:26:45,660 --> 00:26:50,560 +Supply طبعا المدام Vascular اذا الوظيفة بتاعتها + +283 +00:26:50,560 --> 00:26:55,000 +ايش تعتبر؟ اللي هو ال nutrition كتخدية فهذه + +284 +00:26:55,000 --> 00:27:00,020 +بالساعد في عملية التخدية لمين؟ للكورنية، اذا الهدف + +285 +00:27:00,020 --> 00:27:06,700 +منها المساعدة في عملية تخدية الكورنية وهي تعتبر + +286 +00:27:06,700 --> 00:27:14,760 +يعني مكان مهم في عملية تبادل مين؟ التيرOkay يعني + +287 +00:27:14,760 --> 00:27:19,540 +ممكن واحد من المرضى يسألكم العدسات ال extended + +288 +00:27:19,540 --> 00:27:24,300 +wear او العدسات ال daily wear كيف انا بدى انه + +289 +00:27:24,300 --> 00:27:28,480 +اتعامل معها و انا نايم انه كيف بدى يصير هناك اللي + +290 +00:27:28,480 --> 00:27:34,000 +هو يعني كتنفس للكورنية من خلال اللي هو ال vascular + +291 +00:27:34,000 --> 00:27:39,720 +او البلببرال vascular supplyhypoxia and + +292 +00:27:39,720 --> 00:27:44,560 +hypercapnia indication for contact lens refitting + +293 +00:27:44,560 --> 00:27:49,700 +أي مريض بيظهر عنده علامة الـ hypoxia أو الـ + +294 +00:27:49,700 --> 00:27:54,100 +hypercapnia لازم انا اعيد ايه ال fitting للعدسة + +295 +00:27:54,100 --> 00:27:58,820 +اللاصقة قد تسأل طالبة انه كيف انا بدي اعرف انه + +296 +00:27:58,820 --> 00:28:04,230 +مريض عنده hypoxia او hypercapniaمن خلال الـ + +297 +00:28:04,230 --> 00:28:08,070 +Corneal Fluorescein Staining الـ Efron Aggrading + +298 +00:28:08,070 --> 00:28:11,050 +of Corneal Fluorescein Staining اللي أخدناه في + +299 +00:28:11,050 --> 00:28:15,670 +المعمل الأول لذلك هي أهمية مين؟ ال Corneal + +300 +00:28:15,670 --> 00:28:19,170 +Fluorescein Staining grade 0، no staining of the + +301 +00:28:19,170 --> 00:28:23,390 +corneal epithelia، grade 1، هيكون less than 1 over + +302 +00:28:23,390 --> 00:28:27,550 +3 of the corneal fluorescein staining، و grade 2 و + +303 +00:28:27,550 --> 00:28:28,510 +grade 3 + +304 +00:28:33,440 --> 00:28:39,440 +Reduced Epithelial Aerobic Metabolism الآن ما هي + +305 +00:28:39,440 --> 00:28:45,200 +التغيرات الفيسيولوجية اللى بتحدث لـ Corneal + +306 +00:28:45,200 --> 00:28:49,720 +Epithelium و اللى لازم انا ك practitioner ان اعمل + +307 +00:28:49,720 --> 00:28:55,060 +عملية observation ملاحظة لها عندما المريض يرتدي + +308 +00:28:55,060 --> 00:28:56,860 +العدسة اللاصقة + +309 +00:29:00,570 --> 00:29:06,250 +Number one reduction in meiotic cell activity احنا + +310 +00:29:06,250 --> 00:29:12,130 +بنعرف ان في هناك نمو او تكاثر لخلايا ال corneal + +311 +00:29:12,130 --> 00:29:17,350 +epithelium الشخص يما بيرتد العدسة اللاصقة اللينة + +312 +00:29:17,350 --> 00:29:22,190 +ممكن انه يقلل من ال meiotic الانقسام لهذه الخلايا + +313 +00:29:22,190 --> 00:29:28,900 +زي بالضبط يما شخص بعمل عملية الإذا أول حاجة بنقوله + +314 +00:29:28,900 --> 00:29:33,820 +إنه من ال complications إلها هتعمل تقليل في انقسام + +315 +00:29:33,820 --> 00:29:40,440 +إيه الخلايا التفاعلية أي بمعنى ال corneal + +316 +00:29:40,440 --> 00:29:41,620 +epithelium cells + +317 +00:29:47,430 --> 00:29:52,950 +الروابط ما بين هذه الخلايا اشمالها هتقل او هتنكسر + +318 +00:29:52,950 --> 00:29:58,670 +يعني ما هيصير ان في هناك good junction ما بين هذه + +319 +00:29:58,670 --> 00:29:59,590 +الروابط + +320 +00:30:02,860 --> 00:30:08,400 +decrease in numbers of طبعا كيف هذي اللي هو هيصير + +321 +00:30:08,400 --> 00:30:14,060 +اللي هو تقليل في عدد ال hemodemosis الان اول شغلة + +322 +00:30:14,060 --> 00:30:18,720 +بتلاقي الشخص اللي بيعمل عملية اللازك بنقوله دايما + +323 +00:30:18,720 --> 00:30:23,100 +غطى عينك صح؟ عشان يصير regeneration لمن؟ لل + +324 +00:30:23,100 --> 00:30:26,860 +corneal epithelia لكن السبب الرئيسي في عملية + +325 +00:30:26,860 --> 00:30:32,890 +التغطية انه مايصير هناك ايه؟ infection للمريضإذا + +326 +00:30:32,890 --> 00:30:37,610 +أهم شيء اللي هو عملية الخوف من ال infection فممكن + +327 +00:30:37,610 --> 00:30:41,750 +هذا يقلل من مين؟ من ال hemidemesis اللي هو عملية + +328 +00:30:41,750 --> 00:30:47,270 +ال infection لكن ارتداء العدسة اللاصقة اشماله بزود + +329 +00:30:47,270 --> 00:30:48,570 +حدوث ال infection + +330 +00:30:52,640 --> 00:30:57,140 +Expiration of corneal epithelial cells أيضًا هيزود + +331 +00:30:57,140 --> 00:31:01,520 +من إيش؟ من انقسام الـ corneal epithelia عملية + +332 +00:31:01,520 --> 00:31:06,460 +الانفصال لهذه الخلايا أيضًا بالزيد طبعًا يا جماعة + +333 +00:31:06,460 --> 00:31:10,340 +كل هذه ال science كيف بتم الاكتشاف عنها؟ هذه كلها + +334 +00:31:10,340 --> 00:31:13,780 +نظرية من الـ corneal fluorescein staining + +335 +00:31:17,560 --> 00:31:23,000 +The surface cells خلايا السطح may become ربما تصبح + +336 +00:31:23,000 --> 00:31:27,500 +more fragile هشة and there may be a slight + +337 +00:31:27,500 --> 00:31:31,500 +epithelial thinning وطبقة الابيثيليام ممكن انه + +338 +00:31:31,500 --> 00:31:36,720 +تصير نحيفة، نتيجة اللي هو قد يكون ال infection + +339 +00:31:36,720 --> 00:31:40,600 +اللي اتعرض لها ال corneal epithelium في بعض + +340 +00:31:40,600 --> 00:31:47,700 +الأحيانA clinical manifestation، إذا عملية الكشف + +341 +00:31:47,700 --> 00:31:52,800 +عنها للـ hypoxia أو الـ hypercapnia من خلال الـ + +342 +00:31:52,800 --> 00:32:02,520 +florescein أو الـ corneal florescein staining طبعا + +343 +00:32:02,520 --> 00:32:09,930 +الفيجر هذه بتوضحمجموعة من ال clinical signs اللى + +344 +00:32:09,930 --> 00:32:16,410 +بتظهر عند المريض و عندها لازم المريض يوقف من + +345 +00:32:16,410 --> 00:32:21,470 +ارتداء العدسة اللاصقة طبعا كلها ال ocular + +346 +00:32:21,470 --> 00:32:24,830 +manifestation اللى لها او ال clinical diagnosis + +347 +00:32:24,830 --> 00:32:28,690 +test اللى خاص فيها بتتم الاكتشاف من خلال ال + +348 +00:32:28,690 --> 00:32:30,450 +corneal fluorescein scanning + +349 +00:32:34,190 --> 00:32:37,950 +نتوقف ان شاء الله عند ال signs of reduced + +350 +00:32:37,950 --> 00:32:42,950 +epithelial aerobic metabolism في المحاضرة القادمة + +351 +00:32:42,950 --> 00:32:44,470 +ان شاء الله نكمل + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/Gf3x8Uj-IeE.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/Gf3x8Uj-IeE.srt new file mode 100644 index 0000000000000000000000000000000000000000..46991f233cfdc1cfa147a32156709edcc18ac117 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/Gf3x8Uj-IeE.srt @@ -0,0 +1,1631 @@ +1 +00:00:20,960 --> 00:00:23,880 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:23,880 --> 00:00:30,860 +وبركاته ومرحبا بكم جميعا اليوم هنتكلم في موضوع + +3 +00:00:30,860 --> 00:00:37,210 +superficial vascularization superficial بمعنى سطحي، + +4 +00:00:37,210 --> 00:00:43,090 +vascularization أي بمعنى blood vessels طبعا تتميز + +5 +00:00:43,090 --> 00:00:46,490 +هذه الأوعية الدموية بأن تصير لها عملية dilatation + +6 +00:00:46,490 --> 00:00:52,230 +توسيع أيضا هذه الأوعية الدموية تعتبر fragile هشة + +7 +00:00:52,230 --> 00:00:56,870 +وبالتالي أن ممكن تنكسر بسهولة بعد ذلك + +8 +00:01:00,330 --> 00:01:04,250 +is penetration of blood vessels into the + +9 +00:01:04,250 --> 00:01:09,830 +superficial cornea أي بمعنى اختراق للأوعية الدموية + +10 +00:01:09,830 --> 00:01:15,450 +وين في أطراف القرنية طبعا احنا بنعرف أن ال cornea + +11 +00:01:15,450 --> 00:01:19,410 +تتميز بأنها transparent or completely transparent + +12 +00:01:19,410 --> 00:01:25,190 +فأي أوعية دموية موجودة في داخل ال cornea بتصبح + +13 +00:01:25,190 --> 00:01:31,660 +opacity أو فيها opaque عتامة continuous with the + +14 +00:01:31,660 --> 00:01:36,060 +limbal vessels في المحاضرة الماضية حكينا ال width + +15 +00:01:36,060 --> 00:01:39,400 +of + +16 +00:01:39,400 --> 00:01:48,880 +limbus بساوي 1 ملم طبعا إذا كانت هذه الأوعية + +17 +00:01:48,880 --> 00:01:54,980 +الدموية حجمها 1 ملم أو أقل مش هتأثر، ليش؟ لأن + +18 +00:01:54,980 --> 00:02:00,120 +طبيعة ال limbus هو يعتبر فيه capillaries، في أوعية + +19 +00:02:00,120 --> 00:02:06,460 +دموية أو بنسميها plexus of capillaries فإذا كان + +20 +00:02:06,460 --> 00:02:11,250 +حجمها أقل من 1 ملم مافيش أي تأثير إذا زاد عن + +21 +00:02:11,250 --> 00:02:15,330 +الواحد من الملي بيصبح هناك تأثير على مين؟ القرنية + +22 +00:02:15,330 --> 00:02:19,350 +وبالتالي أن بيصبح اختراق للقرنية + +23 +00:02:21,480 --> 00:02:27,000 +The superior limbus is most susceptible يعني بتميز + +24 +00:02:27,000 --> 00:02:31,280 +اللي هو السطح اللي هو ال superior يعني part أو + +25 +00:02:31,280 --> 00:02:34,620 +الجزء اللي .. اللي .. اللي هو في الأعلى بالنسبة + +26 +00:02:34,620 --> 00:02:39,120 +للlimbus معظمه إيش؟ اللي هو بيكون وعائي يعني فيه + +27 +00:02:39,120 --> 00:02:41,800 +اللي هو blood vessels okay؟ + +28 +00:02:44,660 --> 00:02:50,340 +في two researchers واحد اسمه stark and martin + +29 +00:02:50,340 --> 00:02:55,720 +defined عرفوا ال vascularization as vessels + +30 +00:02:55,720 --> 00:03:01,700 +penetration greater than 1.5 millimeter إذا هدول + +31 +00:03:01,700 --> 00:03:06,560 +two researchers عرفوا ال .. ال vascularization على + +32 +00:03:06,560 --> 00:03:10,720 +أن اختراق للأوعية الدموية و بيكون قيمة هذا + +33 +00:03:10,720 --> 00:03:15,100 +الاختراق أكثر من جداش واحد و نص ملي متر + +34 +00:03:18,800 --> 00:03:23,020 +طبعا هذا النوع من ال Vascularization هو يعتبر + +35 +00:03:23,020 --> 00:03:27,700 +uncommon بالـ Hydrogel Lens Daily Wear أو الـ + +36 +00:03:27,700 --> 00:03:31,300 +Conventional Daily Wear يعني عدسات اللبس اليومي + +37 +00:03:31,300 --> 00:03:36,220 +التقليدي أما لاحظين أنتو كتير من ال complications + +38 +00:03:36,220 --> 00:03:41,660 +لل contact lenses هي غير مصاحبة لمين؟ لعدسات اللبس + +39 +00:03:41,660 --> 00:03:45,840 +اليومي التقليدي، ببساطة لأن عدسات اللبس اليومي + +40 +00:03:45,840 --> 00:03:51,060 +التقليدي بصير لها insertion أو removal every day و + +41 +00:03:51,060 --> 00:03:55,760 +بيختلف مثلا شخص بلبسها عشر ساعات، آخر بلبسها أربع + +42 +00:03:55,760 --> 00:03:59,980 +ساعات، واحد ثاني بلبسها اتناشر ساعة فهذا بيقلل من + +43 +00:03:59,980 --> 00:04:04,040 +إيش؟ من ال complications للعدسات اللاصقة + +44 +00:04:07,940 --> 00:04:14,180 +أكثر شيوعا أو أكثر انتشارا قد تكون ملاحظة لـ + +45 +00:04:14,180 --> 00:04:18,900 +aphakic إذا في العدسات إيه الـ aphakic؟ أفيكيك + +46 +00:04:18,900 --> 00:04:22,460 +لينزز يعني واحد مثلا اللي هو بزرع عدسة في داخل + +47 +00:04:22,460 --> 00:04:26,480 +العين مادام أفيكيك أن العدسة إيش هتكون؟ plus + +48 +00:04:26,480 --> 00:04:30,800 +lenses إذا هيكون ال center فيها إيه؟ Thick compared + +49 +00:04:30,800 --> 00:04:35,380 +to the peripheral فالاشخاص اللي بيلبسوه عدسات plus + +50 +00:04:35,380 --> 00:04:41,220 +lenses هيكونوا معرضين أكثر من الأشخاص اللي بيلبسوه + +51 +00:04:41,220 --> 00:04:45,920 +minus lenses السبب في ذلك أن كمية ال oxygen اللي + +52 +00:04:45,920 --> 00:04:50,160 +هتدخل في ال center هتكون اشمالها قليلة مقارنة + +53 +00:04:50,160 --> 00:04:57,000 +بالأطراف Or Therapeutic Hydrogel Extended Wear أو + +54 +00:04:57,000 --> 00:05:00,540 +في عدسات اللي بيصير لها يعني الأشخاص اللي بيرتديوا + +55 +00:05:00,540 --> 00:05:05,160 +العدسات اللاصقة لعملية ال treatment العلاج يعني + +56 +00:05:05,160 --> 00:05:09,780 +مثلا شخص ارتدى عدسة بعد عملية ال laser أو واحد مثلا + +57 +00:05:09,780 --> 00:05:13,930 +بيصير له عملية اللي هو علاج من ال amblyopia كل هذه + +58 +00:05:13,930 --> 00:05:17,790 +ال .. أو هدول الأشخاص بيكونوا معرضين للإصابة في + +59 +00:05:17,790 --> 00:05:21,850 +مين؟ في ال superficial vascularization أي بمعنى أن + +60 +00:05:21,850 --> 00:05:26,810 +فترة حياة العدسة بتكون قصيرة لكن المريض بلبسها + +61 +00:05:26,810 --> 00:05:28,990 +لمدة زمنية إيه طويلة + +62 +00:05:32,640 --> 00:05:38,180 +Corneal vascularization is of concern because it + +63 +00:05:38,180 --> 00:05:42,280 +makes the cornea more susceptible to inflammation + +64 +00:05:42,280 --> 00:05:47,460 +or hemorrhage دائما صحيح بيكون محدود ولكن خطورته + +65 +00:05:47,460 --> 00:05:50,700 +كبيرة ليش؟ لأن بيعمل على القرنية ممكن + +66 +00:05:50,700 --> 00:05:55,700 +inflammation التهاب دائما أي انفلامش في القرنية + +67 +00:05:55,700 --> 00:06:02,200 +أربطيه مع ال stroma اللي هو بيسمى infiltration + +68 +00:06:05,440 --> 00:06:09,720 +الـ stroma يعني في الغالب أي التهاب يصير للقرنية + +69 +00:06:09,720 --> 00:06:13,920 +السبب الرئيسي له مين؟ الـ stroma أو ال Substantia + +70 +00:06:13,920 --> 00:06:18,320 +Epropria اللي بتمثل أكثر من 90% من ثماكة مين؟ + +71 +00:06:18,320 --> 00:06:23,540 +القرنية طبعا ممكن يكون أيضا hemorrhage نزيف في + +72 +00:06:23,540 --> 00:06:27,800 +داخل مين؟ القرنية يعني بمعنى أنه حيصير هناك opacity + +73 +00:06:27,800 --> 00:06:28,820 +للقرنية + +74 +00:06:33,920 --> 00:06:39,340 +Because vascularization can develop in the absence + +75 +00:06:39,340 --> 00:06:43,380 +of symptoms، إذا أنا بفهم من هذه الفقرة أن ال + +76 +00:06:43,380 --> 00:06:47,040 +superficial vascularization asymptomatic، يعني + +77 +00:06:47,040 --> 00:06:52,420 +بعدم وجود أي أعراض، المريض مش هييجي مثلا يشكي من + +78 +00:06:52,420 --> 00:06:56,440 +burning أو redness أو itching، لأ without any + +79 +00:06:56,440 --> 00:07:01,650 +symptoms Routine follow-up examinations are the only + +80 +00:07:01,650 --> 00:07:06,470 +means of detecting this condition إذا لازم المريض + +81 +00:07:06,470 --> 00:07:11,570 +يعمل follow-up examinations أو regular check كلمة + +82 +00:07:11,570 --> 00:07:15,610 +regular check + +83 +00:07:16,740 --> 00:07:21,040 +يعني فحص اللي هو دوري أو تأكيد على العدسات اللاصقة + +84 +00:07:21,040 --> 00:07:25,980 +بشكل دوري لأن ممكن أن يحدث هناك تغيرات، لذلك + +85 +00:07:25,980 --> 00:07:30,520 +احنا كأخصائيين بصريات ما بنفعل أنا أول ما المريض + +86 +00:07:30,520 --> 00:07:35,160 +بيحتاج عدسة لاصقة أصرف لهياها بشكل مباشر، فيه هناك + +87 +00:07:35,160 --> 00:07:40,870 +حاجة بنسميها instructions اللي هي مجموعة من + +88 +00:07:40,870 --> 00:07:45,130 +الإرشادات بدي أعلم المريض عملية ال insertion بدي + +89 +00:07:45,130 --> 00:07:49,170 +أعلمه عملية ال removal ال complications المضاعفات + +90 +00:07:49,170 --> 00:07:53,750 +كل هذه الأمور لازم تكون واضحة بالنسبة لمين؟ لل patient + +91 +00:07:53,750 --> 00:07:58,830 +يعني أذكر الخميس الماضي إجت حالة يعني تقريبا هي + +92 +00:07:58,830 --> 00:08:03,950 +female subject عمرها أربعين سنة فبتحكي لي أنا بدي + +93 +00:08:03,950 --> 00:08:08,350 +عدة لاصقة بتعيش فترة حياتها تلاتة لاربع سنوات + +94 +00:08:08,350 --> 00:08:14,150 +طبعا أول جواب مني أن مافيش عدسة لاصقة بالفترة + +95 +00:08:14,150 --> 00:08:18,750 +الزمنية هذه فبيقولي مثلا سين أو صاد بيعمل اللي هو + +96 +00:08:18,750 --> 00:08:22,630 +عدسة لاصقة بتعيش تلت سنوات أو أربع سنوات قولت له + +97 +00:08:22,630 --> 00:08:27,530 +ممكن مثلا أنت تقدر تحافظ على عدسة لاصقة لمدة سنتين + +98 +00:08:27,530 --> 00:08:32,610 +أو تلاتة لكن هذا إيش بيعمل؟ complications للشخص + +99 +00:08:32,610 --> 00:08:36,430 +قالت طب أنا ما بشعر فيه ال complications قولت لها + +100 +00:08:36,430 --> 00:08:40,050 +لأن قد يكون asymptomatic بدون اللي هو أي عرض + +101 +00:08:40,050 --> 00:08:44,750 +فيعني بدأت أن أشرح لها موضوع ال insertion ال + +102 +00:08:44,750 --> 00:08:47,990 +removal برضه ال corneal fluorescein staining + +103 +00:08:47,990 --> 00:08:50,550 +عملت لها هي ال conjunctival staining ال + +104 +00:08:50,550 --> 00:08:53,910 +conjunctival redness بدأت المرأة أن تعمل + +105 +00:08:53,910 --> 00:08:57,990 +response يعني لهذه الأمور فاقتنعت العدسة عملت لها + +106 +00:08:57,990 --> 00:09:03,020 +هي عدسة تجريبية عملت يعني بمعنى adaptation للعدسة + +107 +00:09:03,020 --> 00:09:06,680 +فاقتنعت أن هذه الأمور كلها مرتبطة في مين؟ في + +108 +00:09:06,680 --> 00:09:11,220 +العدسات اللاصقة فهي يعني جات لي أن أول مرة صراحة + +109 +00:09:11,220 --> 00:09:15,620 +أشتري عدسة لاصقة و يكون هذا الاهتمام بالشكل هذا + +110 +00:09:15,620 --> 00:09:20,620 +فأنا بنصحكم يعني قد يكون مثلا العالم كله باستخدامش + +111 +00:09:20,620 --> 00:09:23,880 +هذه الأمور لكن أنتو ممكن إن شاء الله تستخدموها + +112 +00:09:23,880 --> 00:09:30,520 +okay؟ و هذا يعود بالإيجاب للشخص يعني بعد ذلك أن هو + +113 +00:09:30,520 --> 00:09:36,700 +بياخد ثقة من الناس في هذه الأمور طيب عندنا ال deep + +114 +00:09:36,700 --> 00:09:41,020 +stromal vascularization إذا مدام deep إذا هو يعتبر + +115 +00:09:41,020 --> 00:09:45,660 +أخطر من مين؟ من ال superficial vascularization + +116 +00:09:45,660 --> 00:09:49,960 +صحيح؟ و دائما كلمة stroma اربط معها كلمة + +117 +00:09:49,960 --> 00:09:50,480 +inflammation + +118 +00:09:54,400 --> 00:10:00,000 +is the rarest of the vascular changes associated + +119 +00:10:00,000 --> 00:10:06,060 +with contact lens wear، إذا هو نادر الحدوث و بيعمل + +120 +00:10:06,060 --> 00:10:10,860 +هناك إيش؟ تغيرات في اللي هو الأوعية الدموية مع + +121 +00:10:10,860 --> 00:10:17,390 +ارتداء من العدسة اللاصقة But it is also potentially + +122 +00:10:17,390 --> 00:10:22,670 +the most serious أيضا افتراضيا أن يعتبر إيه هو + +123 +00:10:22,670 --> 00:10:32,730 +أكثر خطورة من ال superficial vascularization أهم + +124 +00:10:32,730 --> 00:10:37,670 +شيء عندنا ال vision الرؤية can be profoundly + +125 +00:10:37,670 --> 00:10:43,230 +affected in some cases owing to associated opacity + +126 +00:10:44,510 --> 00:10:48,810 +إذا الشخص اللي هيصاب بال deep stromal + +127 +00:10:48,810 --> 00:10:52,650 +vascularization هيلاقي أن فيه هناك اختلاف في + +128 +00:10:52,650 --> 00:10:57,190 +الرؤية أو عدم وضوح في الرؤية، إذا في عندنا إيه؟ + +129 +00:10:57,190 --> 00:11:02,370 +symptomatic effect، هذه واحدة في بعض الحالات و + +130 +00:11:02,370 --> 00:11:07,110 +أيضا هيصاحبها إيش؟ Opacities اللي هي عتمة على + +131 +00:11:07,110 --> 00:11:11,900 +القرنية إذا المريض هيشعر في هذا الأمر ولا لأ؟ إذا + +132 +00:11:11,900 --> 00:11:17,300 +هيكون فيه هناك feeling من مين؟ أو sensation feeling + +133 +00:11:17,300 --> 00:11:22,540 +from the patient okay risk + +134 +00:11:22,540 --> 00:11:27,400 +factors يعني بمعنى اللي هي الأعراض لهذا الأمر ال + +135 +00:11:27,400 --> 00:11:31,830 +deepest trauma ال vascularization Number one a + +136 +00:11:31,830 --> 00:11:37,330 +chronic hypoxia شخص عنده hypoxia بشكل إيه مزمن + +137 +00:11:37,330 --> 00:11:41,430 +دائما عنده hypoxia ومع ذلك بيروح بارتدي عدسة + +138 +00:11:41,430 --> 00:11:45,310 +لاصقة لأن هو مش عارف أن عنده hypoxia يعني ممكن + +139 +00:11:45,310 --> 00:11:48,610 +ببساطة أنا أعرف أن مريض عنده hypoxia من خلال + +140 +00:11:48,610 --> 00:11:52,710 +corneal fluorescein staining يعني هو عنده hypoxia و + +141 +00:11:52,710 --> 00:11:56,230 +بيظلوا إيه؟ Recurrent non-wearing اللي هو العدسة + +142 +00:11:56,230 --> 00:12:01,910 +اللاصقة and stromal edema عنده أيضًا اللي هو edema + +143 +00:12:01,910 --> 00:12:06,630 +وين فيه الـ stroma، إذا هذه الاثنتين يعتبروا من + +144 +00:12:06,630 --> 00:12:11,150 +العوامل الأساسية لحدوث الـ deep stromal + +145 +00:12:11,150 --> 00:12:12,250 +vascularization + +146 +00:12:21,720 --> 00:12:25,780 +العدسات الموجبة بتكون في ال center more thick + +147 +00:12:25,780 --> 00:12:29,400 +compared to the peripheral فكمية ال oxygen اللي + +148 +00:12:29,400 --> 00:12:35,360 +هتدخل في ال center هتكون أقل مقارنة بال peripheral + +149 +00:12:38,310 --> 00:12:42,990 +corneal disease injury or infection وأضيف له كلمة + +150 +00:12:42,990 --> 00:12:46,530 +hemorrhage اللي هو أيضًا بيصير هناك إيه ممكن اللي + +151 +00:12:46,530 --> 00:12:54,090 +هو نزيف في داخل القرنية extended + +152 +00:12:54,090 --> 00:12:59,170 +wear of low dk على the lenses طب ليش هذه ال extended + +153 +00:12:59,170 --> 00:13:03,370 +wear low dk على the lenses مصاحبة ال deep stromal + +154 +00:13:03,370 --> 00:13:05,650 +vascularization؟ why؟ + +155 +00:13:08,870 --> 00:13:11,430 +هو بالضبط يبتدي على عدسة اللاصقة لزيادة القمر ممكن + +156 +00:13:11,430 --> 00:13:16,530 +أعملهم ممتازة، إذا دائمًا العدسات الـ extended wear + +157 +00:13:16,530 --> 00:13:20,410 +according to food and drug administration أن هي + +158 +00:13:20,410 --> 00:13:26,050 +بترتدى لمدة أسبوع، واحد لو أنا استخدمت عدسة لاصقة + +159 +00:13:26,050 --> 00:13:30,810 +extended wear، low decay على the lenses، كمية ال oxygen + +160 +00:13:30,810 --> 00:13:35,350 +اللى هتدخل للقرنية إيش هتكون؟ quite low أو very + +161 +00:13:35,350 --> 00:13:35,870 +low + +162 +00:13:43,600 --> 00:13:48,640 +deep stromal vascularization لذلك إيش الحل إنه + +163 +00:13:48,640 --> 00:13:53,460 +أستبدلها ب extended wear اما middle أو تكون high + +164 +00:13:53,460 --> 00:14:01,700 +water content أيضًا + +165 +00:14:01,700 --> 00:14:07,900 +toxic solution preservatives ممكن واحد بيروح بيشتري + +166 +00:14:07,900 --> 00:14:12,680 +محلول عدسات لاصقة لكن ال expire date بتاعه منتهي + +167 +00:14:13,570 --> 00:14:17,570 +بيقول لك عادي أنا بستخدم محلول منتهي اللي هو إيه + +168 +00:14:17,570 --> 00:14:22,650 +الصلاحية طبعًا أي محلول بيكون منتهي الصلاحية أعرف + +169 +00:14:22,650 --> 00:14:27,610 +أنه فيه له إيه side effects تأثيرات جانبية نتيجة + +170 +00:14:27,610 --> 00:14:32,910 +هو مصنوع من إيه؟ من مواد كيميائية أو مواد حافظة بعد + +171 +00:14:32,910 --> 00:14:37,170 +ذلك هذه هتتحول كلها إلى إيه؟ سموم ومن ثم إنه + +172 +00:14:37,170 --> 00:14:41,830 +بتنتقل للعدسة اللاصقة وبعد ذلك بتنتقل للقرنية + +173 +00:14:47,210 --> 00:14:51,930 +An intracorneal hemorrhage، أي نزيف داخله بيصير + +174 +00:14:51,930 --> 00:14:55,990 +وين؟ داخل القرنية، طبعًا أنتم لاحظين إن ال + +175 +00:14:55,990 --> 00:14:59,550 +complicated كل ما لها بتساعد، يعني ما دام + +176 +00:14:59,550 --> 00:15:03,010 +hemorrhage في داخل القرنية، يعني تقريبًا هيصير ال + +177 +00:15:03,010 --> 00:15:07,870 +opacity overall، يعني أو اللي هو most of the + +178 +00:15:07,870 --> 00:15:10,130 +cornea في معظم القرنية + +179 +00:15:13,120 --> 00:15:18,600 +At the subepithelial level is an uncommon sequence + +180 +00:15:18,600 --> 00:15:22,780 +to superficial corneal vascularization طبعًا هذا + +181 +00:15:22,780 --> 00:15:27,140 +يعني بيكون غير شائع أو نادر الحدوث في إيش مع + +182 +00:15:27,140 --> 00:15:31,920 +العدسات اللاصقة اللينة يعني هذه وين مثلًا بيحدث؟ + +183 +00:15:31,920 --> 00:15:36,020 +شخص بيُلبس conventional daily wear lenses ونفترض إنه + +184 +00:15:36,020 --> 00:15:40,470 +نام فيها شهرالعدسة اللاصقة، يعني كل يوم يلبسها و + +185 +00:15:40,470 --> 00:15:44,290 +ينام فيها، يلبسها و ينام فيها، ممكن هذه يكون اللي + +186 +00:15:44,290 --> 00:15:51,870 +هو عرضة لإلان Intracranial Hemorrhage، okay؟ + +187 +00:15:51,870 --> 00:15:57,250 +It has been most often related to aphicic hydrogel + +188 +00:15:57,250 --> 00:16:02,050 +lenses، إذا أكثر شيوعًا في العدسات وين ال aphicic + +189 +00:16:02,050 --> 00:16:03,370 +hydrogel lenses + +190 +00:16:07,410 --> 00:16:12,390 +An intrastromal opacity يعني بمعنى اللي هو عتامة + +191 +00:16:12,390 --> 00:16:18,450 +في الاسترومة associated with vascularization is + +192 +00:16:18,450 --> 00:16:23,310 +also a rare complication of lens wear طب ليش هن + +193 +00:16:23,310 --> 00:16:26,810 +اللي هو الاسترومة ال opacity بتكون نادرة كثير؟ + +194 +00:16:27,860 --> 00:16:32,380 +ببساطة لأن المريض أول ما بيصير عنده infection في + +195 +00:16:32,380 --> 00:16:37,700 +داخل القرنية مش هيتحمل العدسة اللاصقة، هيصير عنده + +196 +00:16:37,700 --> 00:16:48,020 +حاجة بنسميها hazy vision أو بنسميها blurred vision + +197 +00:16:49,590 --> 00:16:54,510 +بالتالي هو هيرفع العدسة هيعمل removal لها ال soft + +198 +00:16:54,510 --> 00:17:01,310 +contact lenses قبل ما يصل لمرحلة مين الانترا + +199 +00:17:01,310 --> 00:17:09,510 +أسترومال opacity عتامة في داخل وين الاسترومال إذا + +200 +00:17:09,510 --> 00:17:12,990 +هن اللي هو threaten vision أو blurred vision أو + +201 +00:17:12,990 --> 00:17:20,290 +hazy vision إذا كان هذا + +202 +00:17:20,290 --> 00:17:27,790 +مصاحب لإنهاج للقرنية، فالعتامة ستكون + +203 +00:17:27,790 --> 00:17:32,650 +بشكل معمق في داخل وين الاسترومة، but avascular + +204 +00:17:32,650 --> 00:17:38,110 +يعني صح اللي هو فيه عتامة، لكن جزء منها اللي + +205 +00:17:38,110 --> 00:17:41,090 +هو غير وعائي أو transparent + +206 +00:17:44,410 --> 00:17:48,570 +بالنسبة لـ Management قلية العلاج، طبعًا اللي + +207 +00:17:48,570 --> 00:17:54,270 +ذكرناهم بالنسبة لـ deep stromal vascularization أو + +208 +00:17:54,270 --> 00:17:58,910 +موضوع الـ opacity في الـ stroma، هذه نادر الحدوث + +209 +00:17:58,910 --> 00:17:59,950 +بشكل كبير + +210 +00:18:02,650 --> 00:18:07,630 +Management mild-limbal hyperemia requires no + +211 +00:18:07,630 --> 00:18:12,770 +management and is an unavoidable part of hydrogen + +212 +00:18:12,770 --> 00:18:16,750 +lens wear يبقى واحد يكون عنده mild-hyperemia هذا + +213 +00:18:16,750 --> 00:18:21,510 +أمر normal طبيعي، أي شخص هيرتدي عدسات لاصقة قليلة قد + +214 +00:18:21,510 --> 00:18:26,290 +يكون مش مصاحب له أو يكون معاه اللي هو من ال limbal + +215 +00:18:26,290 --> 00:18:31,360 +hyperemia إذا ما بتطلب أي تعلاج أو أي removal لمين + +216 +00:18:31,360 --> 00:18:37,260 +للعدسة أو تغيير نوع العدسة Marked hyperemia أي + +217 +00:18:37,260 --> 00:18:42,080 +بمعنى moderate أو severe أو any vascularization أو + +218 +00:18:42,080 --> 00:18:46,140 +أيّة in you blood vessels بتطلب اللي هو lens + +219 +00:18:46,140 --> 00:18:50,380 +refitting بفهم ما دام lens refitting يعني العدسة اما + +220 +00:18:50,380 --> 00:18:56,960 +tight أو loose يعني هي ليست optimal fit okay to + +221 +00:18:56,960 --> 00:19:01,220 +improve عشان أعمل عملية تحسين ل ال peripheral + +222 +00:19:01,220 --> 00:19:05,820 +corneal oxygenation عملية اللي هو دخول ال oxygen + +223 +00:19:05,820 --> 00:19:08,040 +سواء لل center أو ال peripheral + +224 +00:19:12,210 --> 00:19:17,770 +Patients may be refitted with silicon, hydrogel or + +225 +00:19:17,770 --> 00:19:23,790 +GB lenses بعض الأحيان بنضطر إضافة السيليكون لزيادة + +226 +00:19:23,790 --> 00:19:28,370 +ال wetability أو نستغنى عن العدسة ال soft lenses + +227 +00:19:28,370 --> 00:19:33,610 +يعني مريض عنده دائمًا deposits بشكل كبير فالأفضل له + +228 +00:19:33,610 --> 00:19:37,930 +أدي ال GB lenses أفضل من مين؟ من ال soft contact + +229 +00:19:37,930 --> 00:19:38,610 +lenses + +230 +00:19:43,070 --> 00:19:46,570 +Mainly to reduce wearing time، أيضًا بدي أقلل + +231 +00:19:46,570 --> 00:19:50,630 +ساعات اللبس بالنسبة للعدسات اللاصقة، لكن هذه + +232 +00:19:50,630 --> 00:19:54,470 +بيستثنى منها مين؟ ال marked hyperemia، يعني سواء + +233 +00:19:54,470 --> 00:19:58,970 +ال moderate أو ال severe، إذا صابوا moderate أو + +234 +00:19:58,970 --> 00:20:03,330 +severe hyperemia، لازم أوقف المريض بشكل كامل في + +235 +00:20:03,330 --> 00:20:07,230 +الفترة الأولى عن ارتداء العدسة اللاصقة + +236 +00:20:10,240 --> 00:20:14,200 +أيضًا يفضل extended wear أنه يتوقف عن ارتداء + +237 +00:20:14,200 --> 00:20:17,620 +العدسات ال extended wear لكن أضيف له with low water + +238 +00:20:17,620 --> 00:20:21,540 +content لو كانت اللي هو moderate أو high water + +239 +00:20:21,540 --> 00:20:26,800 +content ممكن إنه يعني يظل يلبس العدسة اللاصقة، إذا + +240 +00:20:26,800 --> 00:20:30,600 +ال hand يتوقف عن ال extended wear with low water + +241 +00:20:30,600 --> 00:20:31,200 +content + +242 +00:20:38,070 --> 00:20:42,850 +deep stromal vascularization is a most serious + +243 +00:20:42,850 --> 00:20:48,030 +complication يعني هتكون أخطر كمضاعفات and + +244 +00:20:48,030 --> 00:20:53,310 +immediate بالتأكيد cessation of lens wear بدي أوقف + +245 +00:20:53,310 --> 00:20:57,890 +عن ارتداء العدسة اللاصقة بشكل كامل، ملاحظين هنا، + +246 +00:20:57,890 --> 00:21:01,470 +يعني سواء conventional daily wear أو daily + +247 +00:21:01,470 --> 00:21:05,010 +disposable lenses أو extended wear، أي نوع من + +248 +00:21:05,010 --> 00:21:10,060 +العدسات اللاصقة Rather than lens refitting is + +249 +00:21:10,060 --> 00:21:14,400 +indicated طيب الآن أنا توقفت عن ارتداء العدسة + +250 +00:21:14,400 --> 00:21:19,000 +اللاصقة لفترة زمنية بعد ذلك رجعت ألبس العدسات + +251 +00:21:19,000 --> 00:21:22,720 +وجيت نفس ال problem رجعت إذا بدي أعمل إيه + +252 +00:21:22,720 --> 00:21:31,200 +refitting للعدسة اللاصقة هنبدأ + +253 +00:21:31,200 --> 00:21:37,340 +في موضوع مهم اليوم وهو ال infection أي بمعنى العدوى + +254 +00:21:37,340 --> 00:21:43,220 +اللي بتتم من العدسات اللاصقة في أي سؤال على موضوع + +255 +00:21:43,220 --> 00:21:47,260 +ال complications ل ال hydrogel soft contact lenses + +256 +00:21:47,260 --> 00:21:52,480 +بالنسبة + +257 +00:21:52,480 --> 00:21:58,600 +لل infection العدوى it is the most serious دائمًا + +258 +00:21:58,600 --> 00:22:02,580 +أنا ك practitioner أو ك optometrist أكثر حاجة بخاف + +259 +00:22:02,580 --> 00:22:06,520 +منها في ال soft contact lenses موضوع ال infection + +260 +00:22:06,520 --> 00:22:11,780 +العدوى ليه؟ لأن ببساطة العدسة conform to the shape + +261 +00:22:11,780 --> 00:22:17,500 +of the cornea إذا it is the most serious أكثر اللي + +262 +00:22:17,500 --> 00:22:23,840 +هو خطورة but also one of the rarest يعني بتكون إيش + +263 +00:22:23,840 --> 00:22:29,500 +نادرة الحدوث Complications of Contact Lens Wear هي + +264 +00:22:29,500 --> 00:22:34,780 +تعتبر من مضاعفات العدسات اللاصقة بشكل عام، لكن + +265 +00:22:34,780 --> 00:22:38,260 +أكثر شيوعًا عنوان في الـ Hydrogel Soft Contact + +266 +00:22:38,260 --> 00:22:45,950 +Lenses مقارنة بالـ RGB Lenses It can occur in all + +267 +00:22:45,950 --> 00:22:51,370 +types of lens wear، إذا هذه الفقرة المقصودة فيها، + +268 +00:22:51,370 --> 00:22:56,870 +عنا ال RGB و ال soft contact lenses، هدول النوعين، + +269 +00:22:56,870 --> 00:23:01,750 +but has been most commonly associated with + +270 +00:23:01,750 --> 00:23:06,690 +cosmetic extended wear، إذا في العدسات التجميلية، + +271 +00:23:06,690 --> 00:23:11,290 +بتكون يعني more dangerous أو more serious، أكثر + +272 +00:23:11,290 --> 00:23:16,030 +اللي هو خطورة طب لو سألنا السؤال ليش؟ إنه دائمًا في + +273 +00:23:16,030 --> 00:23:20,550 +ال cosmetic contact lenses هي أكثر خطورة أو دائمًا + +274 +00:23:20,550 --> 00:23:25,390 +بتكون مصاحبة للعدسات اللي هي التجميلية؟ ليه ممكنش + +275 +00:23:25,390 --> 00:23:28,850 +مُراعي فيها براميتها، بس يعني اللي كاعتها ممكنش + +276 +00:23:28,850 --> 00:23:32,590 +مُراعي فيها، يعني ممكن يصير معايا مريض اللي عنده + +277 +00:23:32,590 --> 00:23:37,610 +للسندرام ومش حاسس فيه؟ ممكنش يلحظ نظام insertion + +278 +00:23:41,700 --> 00:23:48,020 +آه another answer؟ فضل طب + +279 +00:23:48,020 --> 00:23:52,880 +ليش أنا ماذا أنا ماذا أنا ماذا أنا ماذا أنا ماذا + +280 +00:23:52,880 --> 00:23:53,080 +أنا ماذا أنا ماذا أنا ماذا أنا ماذا أنا ماذا أنا + +281 +00:23:53,080 --> 00:23:53,300 +ماذا أنا ماذا أنا ماذا أنا ماذا أنا ماذا أنا ماذا + +282 +00:23:53,300 --> 00:23:53,340 +ماذا أنا ماذا أنا ماذا أنا ماذا أنا ماذا أنا ماذا + +283 +00:23:53,340 --> 00:23:53,420 +أنا ماذا أنا ماذا أنا ماذا أنا ماذا أنا ماذا أنا + +284 +00:23:53,420 --> 00:24:10,700 +أنا ماذا أنا ماذا أنا ماذا أنا ماذا أنا + +285 +00:24:12,010 --> 00:24:17,190 +أول حاجة بالنسبة لـ Cosmetic Contact Lenses المصدر + +286 +00:24:17,190 --> 00:24:21,630 +اللي أنت بتشير إليه فيه هو مصدر غير موثوق صحيح؟ يعني + +287 +00:24:21,630 --> 00:24:26,310 +الشخص اللي أنا ما بشتريه مثلاً من اللي هو محلات + +288 +00:24:26,310 --> 00:24:31,490 +التجميل أو محلات العطور هذا المصدر نفسه هو غير + +289 +00:24:31,490 --> 00:24:35,450 +موثوق فيه لأنه مش إنسان متخصص في إيش؟ في العدسات + +290 +00:24:35,450 --> 00:24:40,320 +اللاصقة. النقطة الثانية أنه موضوع ال expired date + +291 +00:24:40,320 --> 00:24:44,760 +يعني ممكن أنا ألبس عدة لاصقة تكون منتهية التاريخ + +292 +00:24:44,760 --> 00:24:50,100 +يعني مالهاش تاريخ واضح. الفكرة النقطة الثالثة ممكن + +293 +00:24:50,100 --> 00:24:55,000 +أنا مثلاً ألبس عدة لاصقة على أنه هي مثلاً لمدة + +294 +00:24:55,000 --> 00:24:59,360 +أسبوع كـ cosmetic contact lenses وهي تكون لمدة إيه؟ + +295 +00:24:59,360 --> 00:25:06,090 +يوم واحد. دائماً أنه تعتبر العدسات اللاصقة التجميلية + +296 +00:25:06,090 --> 00:25:11,510 +أكثر العدسات اللي بيكون مصاحب لها ال infection + +297 +00:25:11,510 --> 00:25:17,270 +مقارنة بالعدسات الأخرى. فعشان هيك أنا دائماً بحذر + +298 +00:25:17,270 --> 00:25:21,610 +اللي هو الطلاب أو الطالبات دائماً يما تشتري عدسة + +299 +00:25:21,610 --> 00:25:25,530 +لاصقة أو تشتري عدسة لاصقة لازم أن المصدر يكون + +300 +00:25:25,530 --> 00:25:29,730 +موثوق فيه. كيف يعني؟ واحد الـ name of the company اسم + +301 +00:25:29,730 --> 00:25:34,940 +الشركة. اثنين الـ DK على T أو بنسميها الـ H2O في + +302 +00:25:34,940 --> 00:25:38,860 +العدسة. البراميتر من حيث ال power، ال base curve، ال + +303 +00:25:38,860 --> 00:25:43,220 +diameter لازم كله يكون موجود وين؟ على اللي هو ال + +304 +00:25:43,220 --> 00:25:50,540 +case اللي خاصة في العدسة. even + +305 +00:25:50,540 --> 00:25:57,600 +in extended wear 99.9% of contact lens wearers + +306 +00:25:57,600 --> 00:26:07,870 +don't contract corneal infection. 99.9 + +307 +00:26:07,870 --> 00:26:14,090 +% من الأشخاص اللي بيرتدوا العدسات اللاصقة اللينة + +308 +00:26:14,090 --> 00:26:18,290 +بيكونوا حذرين من موضوع ال infection و بيكونوا غير + +309 +00:26:18,290 --> 00:26:22,270 +مُجَذَّبين لحدوث إيش؟ اللي هو ال infection. يعني دائماً + +310 +00:26:22,270 --> 00:26:26,760 +بيخافوا من موضوع إيه؟ ال infection. Okay؟ يعني مثلاً + +311 +00:26:26,760 --> 00:26:31,160 +بيكون موضوع ال poor hygiene عندهم لأ، بيكونوا good + +312 +00:26:31,160 --> 00:26:36,040 +hygiene. بمعنى إن نظافة الشخصية عندهم ملائمة، موضوع + +313 +00:26:36,040 --> 00:26:40,760 +مثلاً الأظافر أيضاً بيكونوا جيدة، موضوع اللي هو good + +314 +00:26:40,760 --> 00:26:44,340 +habits، العادات اللي بيقوموا فيها كلها جيدة، عشان + +315 +00:26:44,340 --> 00:26:46,320 +يتجنبوا إيه؟ حدوث ال infection. + +316 +00:26:50,890 --> 00:26:56,930 +A number of ocular defense mechanisms exist to + +317 +00:26:56,930 --> 00:27:02,370 +help prevent infection. في هناك مجموعة من خطوط + +318 +00:27:02,370 --> 00:27:07,150 +الدفاع موجودة في داخل العين. هذه بتعمل على اللي هو + +319 +00:27:07,150 --> 00:27:13,750 +المساعدة في إيه؟ في منع حدوث ال infection. من خطوط + +320 +00:27:13,750 --> 00:27:16,690 +الدفاع هذه. أول حاجة عندنا ال blinking وال tear + +321 +00:27:16,690 --> 00:27:21,450 +film. طبعاً احنا اللي هو بالنسبة لي ال blinking ال + +322 +00:27:21,450 --> 00:27:26,610 +normal من خمسة عشر لعشرين اللي هو ال blink اللي هو + +323 +00:27:26,610 --> 00:27:32,790 +كل دقيقة. موضوع أيضاً ال tear flow تدفق التير أو ال + +324 +00:27:32,790 --> 00:27:38,170 +tear film. الاثنين هذول إيش يعتبروا؟ خط الدفاع الأول + +325 +00:27:38,170 --> 00:27:46,120 +للعين بعد ما يتم ارتداء من العدسة اللاصقة. طيب التير + +326 +00:27:46,120 --> 00:27:57,660 +فيه كم بروتين فيه؟ اه فيه أكثر من ستين بروتينز، إذا + +327 +00:27:57,660 --> 00:28:02,720 +يوجد فيه أكثر من ستين بروتينز، ال...الستين + +328 +00:28:02,720 --> 00:28:06,680 +بروتينز هذول كل الغرض منهم عملية اللي هو ال + +329 +00:28:06,680 --> 00:28:09,540 +defense، الدفاع، okay؟ + +330 +00:28:13,710 --> 00:28:20,830 +الخطوط الهيوغوكسية تتحكم عبر الكورنيا بشكل بلنك و + +331 +00:28:20,830 --> 00:28:26,640 +هذه تتجه لإتراب البكتيريا. بعد اللي هو موضوع ال + +332 +00:28:26,640 --> 00:28:31,160 +blinking الترميش و ال tear flow أو ال tear film أو + +333 +00:28:31,160 --> 00:28:35,920 +ال tears. في عندنا ال mucus الطبقة المخاطية. الهدف + +334 +00:28:35,920 --> 00:28:41,520 +منها أنه تعمل عملية التقاط لكل البكتيريا و تعمل لها + +335 +00:28:41,520 --> 00:28:50,100 +تكوير أو تدوير للخارج. أي بمعنى كلمة wash out. يعني + +336 +00:28:50,100 --> 00:28:56,670 +بتعمل لها إزالة لوين؟ لخارج العين. طبعاً احنا بنعرف + +337 +00:28:56,670 --> 00:29:01,550 +أنه دائماً ال...ال foreign body في العدسات اللاصقة + +338 +00:29:01,550 --> 00:29:07,190 +اللينة بنحصرها أقل من مين؟ من ال RGB. لكن إذا دخل في + +339 +00:29:07,190 --> 00:29:11,170 +... ما بين العدسة و الكورنيا بكون more serious أو + +340 +00:29:11,170 --> 00:29:12,990 +اللي هو أكثر خطورة + +341 +00:29:17,920 --> 00:29:21,860 +في عندنا موضوع ال desquamation of epithelial cells + +342 +00:29:21,860 --> 00:29:26,040 +طيب خليني أسأل سؤال. ال desquamation of epithelial + +343 +00:29:26,040 --> 00:29:30,980 +cells هل هذه الظاهرة إيجابية بالنسبة للعدسة + +344 +00:29:30,980 --> 00:29:34,860 +بالنسبة للعدسة اللاصقة ولا لأ؟ يعني هل هذه يعني + +345 +00:29:34,860 --> 00:29:38,640 +بيصير في ال normal subjects في الناس الطبيعيين ولا + +346 +00:29:38,640 --> 00:29:42,620 +لأ؟ بمعنى تقشر + +347 +00:29:50,230 --> 00:29:54,490 +الآن الطبقة الأولى لل كورنيا هي عبارة عن مين؟ + +348 +00:29:54,490 --> 00:29:59,010 +الابيثيليان. الابيثيليان طبيعتها إيش تعتبر؟ اللي هو + +349 +00:29:59,010 --> 00:30:04,090 +regeneration متجددة. الآن بمعنى أن كل أربع وعشرين + +350 +00:30:04,090 --> 00:30:09,010 +ساعة بيصير تقشر لهذه الطبقة فاسمها desquamation + +351 +00:30:09,010 --> 00:30:15,700 +of epithelial cells. أي بمعنى تقشر لطبقة مين؟ الآن + +352 +00:30:15,700 --> 00:30:22,960 +أي بكتيريا أو أي infection بيعمل عملية التساقط + +353 +00:30:22,960 --> 00:30:29,560 +مع ال corneal epithelium. يحدث التقشر بنزول للخارج + +354 +00:30:29,560 --> 00:30:35,410 +يعني بيزال مع من؟ مع طبقة ال epithelium. إذا الـ + +355 +00:30:35,410 --> 00:30:39,850 +desquamation of epithelial cells هي تعتبر irregular + +356 +00:30:39,850 --> 00:30:44,710 +occurrence، يعني حدوثها بشكل طبيعي أو بشكل اللي هو + +357 +00:30:44,710 --> 00:30:50,810 +منتظم، which helps هذه هتساعد لـ remove بكتيريا، + +358 +00:30:50,810 --> 00:30:56,750 +إزالة البكتيريا that may have adhered اللي هتلتصق + +359 +00:30:56,750 --> 00:31:00,070 +مع مين؟ مع طبقة ال corneal epithelia. + +360 +00:31:05,450 --> 00:31:11,570 +طبعاً في هناك أي شخص بيلبس عدسة لاصقة هيصير فيه يعني + +361 +00:31:11,570 --> 00:31:15,550 +حرب مستمرة ما بين البكتيريا و ما بين ال + +362 +00:31:15,550 --> 00:31:21,780 +antibacterial reaction. طبعاً أي طرف بينتصر على الطرف + +363 +00:31:21,780 --> 00:31:25,540 +الثاني بيعمل عملية اللي هو يعني بمعنى البكتيريا لو + +364 +00:31:25,540 --> 00:31:31,420 +انتصرت بتعمل إنتشار مباشرة لمين؟ للقرنية. إذا ال + +365 +00:31:31,420 --> 00:31:35,480 +antibacterial هي اللي انتصرت الشخص هيحافظ على + +366 +00:31:35,480 --> 00:31:40,700 +سلامة العين أو سلامة القرنية. إذا tear film + +367 +00:31:40,700 --> 00:31:44,660 +antibacterial factors اللي أخذناهم اللي هو الستين + +368 +00:31:44,660 --> 00:31:50,000 +proteins الهدف منهم كله ال defenses Act toward + +369 +00:31:50,000 --> 00:31:54,760 +lysing bacteria، إذا بتعملوا عملية إيه؟ كمّش أو + +370 +00:31:54,760 --> 00:32:01,850 +اللي هو لزق للبكتيريا. هذه المجالات تشمل لايزوزيم، + +371 +00:32:01,850 --> 00:32:08,130 +لاكتوفيرين، ترانسفيرين، سيريوابلاستين، بيتالايزين + +372 +00:32:08,130 --> 00:32:13,050 +و أميون فاكتورز سلولار. يعني كلهم الهدف منهم عملية + +373 +00:32:13,050 --> 00:32:17,590 +المناعة و الحماية لمين؟ للبكتيريا. طبعاً هم مش + +374 +00:32:17,590 --> 00:32:22,130 +مُطَلَبِين منها اللي هو كحفظ، لكن بعرف إن في في ال + +375 +00:32:22,130 --> 00:32:26,420 +tear film Antibacterial الهدف منه للـ Antibacterial + +376 +00:32:26,420 --> 00:32:33,420 +عملية الـ Defense. The + +377 +00:32:33,420 --> 00:32:38,280 +acquired immune system يعني نظام المناعة المكتسب of + +378 +00:32:38,280 --> 00:32:43,480 +the eye من داخل العين consist of أنه هيتكون من + +379 +00:32:43,480 --> 00:32:52,190 +immunoglobulin Asecretary IgA and the complement + +380 +00:32:52,190 --> 00:32:55,790 +system اللي هو نظام إيش؟ ما له complementary rule + +381 +00:32:55,790 --> 00:33:00,010 +يعني نظام اللي هو تكاملي، متكامل في داخل ال + +382 +00:33:00,010 --> 00:33:05,450 +antibacterial factor اللي هو في داخل ال tear film. + +383 +00:33:09,160 --> 00:33:12,980 +The nature طبيعة ال immune system النظام المناعي + +384 +00:33:12,980 --> 00:33:20,620 +هذا بتكون من macrophages أو neutrophils and natural + +385 +00:33:20,620 --> 00:33:25,540 +killer اللي هو cells يعني بمعنى أنه بتكون كله من + +386 +00:33:25,540 --> 00:33:29,860 +antibacterial factors الهدف منها اللي هو قتل من + +387 +00:33:29,860 --> 00:33:35,580 +البكتيريا و التخلص منها. يعني خلايا اللي هو قاتلة + +388 +00:33:36,630 --> 00:33:40,330 +طبعاً هذه المكونات كلها هي تعتبر من ضمن الـ 60 + +389 +00:33:40,330 --> 00:33:43,010 +proteins اللي موجودين في ال tear film. + +390 +00:33:48,810 --> 00:33:53,150 +طبعاً في عندنا ال ulcer bacterial هذه في داخل + +391 +00:33:53,150 --> 00:33:57,570 +القرنية أو موضوع البلبر زي ما أنتم شايفين يعني + +392 +00:33:57,570 --> 00:34:01,030 +هنا بيكون في ال center هنا بيكون بالـ peripheral في + +393 +00:34:01,030 --> 00:34:05,490 +الأطراف. هنا بيكون فقط في ال upper part okay و + +394 +00:34:05,490 --> 00:34:09,150 +بيكون بشكل اللي هو ال archius و هنا عبارة عن + +395 +00:34:09,150 --> 00:34:12,630 +بكتيريا. أيضاً بيكون في ال upper part + +396 +00:34:18,610 --> 00:34:23,170 +في أيضاً عندنا موضوع ال conjunctival impairment. إذا + +397 +00:34:23,170 --> 00:34:27,650 +هتكون حوالين اللي هو ال conjunctiva. في a wrinkling + +398 +00:34:27,650 --> 00:34:32,150 +soft lens اللي هو يصير هناك تجعد في العدسة. لذلك + +399 +00:34:32,150 --> 00:34:35,530 +دائماً بقول لكم أنه لازم الواحد يعمل التاكو تيست + +400 +00:34:35,530 --> 00:34:39,350 +أهمية التاكو تيست. غير أن العدسة بيصير real أو + +401 +00:34:39,350 --> 00:34:44,150 +inverted بيقدر اللي هو لتكامش مين؟ أنه بتنكمش يعني + +402 +00:34:44,150 --> 00:34:49,960 +العدسة. خاصة إذا كانت ستيب بتكمش القرنية يعني بمعنى + +403 +00:34:49,960 --> 00:34:56,600 +أنه بيصير التقاط لها. أيضاً في عندنا ال dimple بالشكل + +404 +00:34:56,600 --> 00:35:01,180 +هادئ. نقاط ال foreign body في داخل اللي هو ما بين + +405 +00:35:01,180 --> 00:35:06,540 +القرنية و العدسة و ال epithelial edema أي بمعنى + +406 +00:35:06,540 --> 00:35:08,820 +inflammation of the cornea + +407 +00:35:15,300 --> 00:35:18,460 +بدنا نقف إن شاء الله لل bacterial corneal + +408 +00:35:18,460 --> 00:35:22,300 +infection في المحاضرة القادمة إن شاء الله diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/Gf3x8Uj-IeE_raw.json b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/Gf3x8Uj-IeE_raw.json new file mode 100644 index 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lenses، إذا أكتر شيوعا في العدسات وين ال aphicic hydrogel lenses", "tokens": [6027, 22488, 3794, 3660, 13672, 33546, 28671, 12399, 37495, 22653, 28242, 7251, 20498, 7251, 46152, 3794, 11296, 4032, 7251, 8315, 2304, 8978, 11296, 12399, 7251, 46152, 3794, 11296, 4032, 7251, 8315, 2304, 8978, 11296, 12399, 3714, 43020, 29538, 7251, 30544, 13672, 1829, 31439, 6225, 43042, 3660, 5296, 28814, 1211, 7649, 5681, 12080, 4257, 831, 18568, 24362, 71, 609, 12399, 1392, 22807, 467, 575, 668, 881, 2049, 4077, 281, 257, 950, 299, 299, 5796, 6675, 338, 18059, 12399, 11933, 15730, 5551, 4117, 2655, 2288, 13412, 1829, 45367, 995, 8978, 18863, 3215, 3794, 9307, 4032, 9957, 2423, 257, 950, 299, 299, 5796, 6675, 338, 18059], "avg_logprob": -0.23662859860521096, "compression_ratio": 1.5589519650655022, "no_speech_prob": 0.0, "words": [{"start": 937.61, "end": 938.17, "word": "العدسة", "probability": 0.8306884765625}, {"start": 938.17, "end": 939.01, "word": " اللاصقة،", "probability": 0.75244140625}, 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اللاصقة، هيصير عنده حاجة بنسميها hazy vision أو بنسميها blurred vision", "tokens": [3555, 3555, 3794, 41193, 3660, 5296, 33456, 9673, 16572, 11242, 5551, 12610, 19446, 4724, 1829, 9381, 13546, 43242, 3224, 11764, 8978, 11778, 47283, 1211, 33251, 13063, 1863, 10632, 37893, 8032, 36081, 35571, 1211, 18863, 3215, 3794, 3660, 13672, 33546, 28671, 12399, 8032, 1829, 9381, 13546, 43242, 3224, 11331, 26108, 3660, 44945, 38251, 1829, 11296, 324, 1229, 5201, 34051, 44945, 38251, 1829, 11296, 43525, 5201], "avg_logprob": -0.14903846153846154, "compression_ratio": 1.4523809523809523, "no_speech_prob": 0.0, "words": [{"start": 987.86, "end": 988.72, "word": "ببساطة", "probability": 0.94052734375}, {"start": 988.72, "end": 989.08, "word": " لأن", "probability": 0.77197265625}, {"start": 989.08, "end": 989.62, "word": " المريض", "probability": 0.8860677083333334}, {"start": 989.62, "end": 990.04, "word": " أول", "probability": 0.843505859375}, {"start": 990.04, "end": 990.16, "word": " ما", 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"probability": 0.9230143229166666}, {"start": 1125.12, "end": 1125.5, "word": " اللي", "probability": 0.91015625}, {"start": 1125.5, "end": 1125.72, "word": " هو", "probability": 0.98779296875}, {"start": 1125.72, "end": 1126.14, "word": " lens", "probability": 0.85498046875}, {"start": 1126.14, "end": 1126.9, "word": " refitting", "probability": 0.92529296875}, {"start": 1126.9, "end": 1127.58, "word": " بفهم", "probability": 0.9567057291666666}, {"start": 1127.58, "end": 1127.94, "word": " مدام", "probability": 0.6856282552083334}, {"start": 1127.94, "end": 1128.34, "word": " lens", "probability": 0.8271484375}, {"start": 1128.34, "end": 1129.04, "word": " refitting", "probability": 0.931640625}, {"start": 1129.04, "end": 1129.58, "word": " يعني", "probability": 0.96728515625}, {"start": 1129.58, "end": 1130.12, "word": " العدسة", "probability": 0.9962158203125}, {"start": 1130.12, "end": 1130.38, "word": " اما", "probability": 0.667724609375}, {"start": 1130.38, "end": 1130.86, "word": " tight", "probability": 0.888671875}, {"start": 1130.86, "end": 1131.14, "word": " او", "probability": 0.827880859375}, {"start": 1131.14, "end": 1131.48, "word": " loose", "probability": 0.6728515625}, {"start": 1131.48, "end": 1132.68, "word": " يعني", "probability": 0.954345703125}, {"start": 1132.68, "end": 1132.88, "word": " هي", "probability": 0.87548828125}, {"start": 1132.88, "end": 1133.32, "word": " ليست", "probability": 0.9736328125}, {"start": 1133.32, "end": 1133.82, "word": " optimal", "probability": 0.92431640625}, {"start": 1133.82, "end": 1134.28, "word": " fit", "probability": 0.97119140625}, {"start": 1134.28, "end": 1134.78, "word": " okay", "probability": 0.5947265625}], "temperature": 1.0}, {"id": 48, "seek": 114804, "start": 1136.66, "end": 1148.04, "text": "to improve عشان اعمل عملية تحسين ل ال peripheral corneal oxygenation عملية اللي هو دخول ال oxygen سواء لل center او ال peripheral", "tokens": [1353, 3470, 6225, 8592, 7649, 1975, 25957, 1211, 6225, 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"end": 1381.75, "word": " with", "probability": 0.9326171875}, {"start": 1381.75, "end": 1382.53, "word": " cosmetic", "probability": 0.92626953125}, {"start": 1382.53, "end": 1383.51, "word": " extended", "probability": 0.87353515625}, {"start": 1383.51, "end": 1384.67, "word": " wear،", "probability": 0.6900634765625}, {"start": 1384.67, "end": 1384.85, "word": " إذا", "probability": 0.888671875}, {"start": 1384.85, "end": 1385.03, "word": " في", "probability": 0.8369140625}, {"start": 1385.03, "end": 1385.61, "word": " العدسات", "probability": 0.9674072265625}, {"start": 1385.61, "end": 1386.69, "word": " التجميلية،", "probability": 0.8731689453125}, {"start": 1386.69, "end": 1387.51, "word": " بتكون", "probability": 0.9228515625}, {"start": 1387.51, "end": 1388.23, "word": " يعني", "probability": 0.782958984375}, {"start": 1388.23, "end": 1388.61, "word": " more", "probability": 0.9267578125}, {"start": 1388.61, "end": 1389.37, "word": " dangerous", "probability": 0.9208984375}, 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0000000000000000000000000000000000000000..4c9bba25924065077aa266c3ebb9c41778e03a38 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/Gf3x8Uj-IeE_raw.srt @@ -0,0 +1,1640 @@ +1 +00:00:20,960 --> 00:00:23,880 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:23,880 --> 00:00:30,860 +وبركاته ومرحبا لكم جميعا اليوم هنتكلم في موضوع + +3 +00:00:30,860 --> 00:00:37,210 +superfacial vascularizationsuperfacial بمعنى سطحي، + +4 +00:00:37,210 --> 00:00:43,090 +vascularization أي بمعنى blood vessels طبعا بتتميز + +5 +00:00:43,090 --> 00:00:46,490 +هذه القويع الدموية انه بتصير لها عملية dilatation + +6 +00:00:46,490 --> 00:00:52,230 +توسيع ايضا هذه القويع الدموية تعتبر fragile هشة + +7 +00:00:52,230 --> 00:00:56,870 +وبالتالي انه ممكن تنكسر بسهولة بعد ذلك + +8 +00:01:00,330 --> 00:01:04,250 +is ventilation of blood vessels into the + +9 +00:01:04,250 --> 00:01:09,830 +superficial cornea أي بمعنى اختراق للأوعية الدموية + +10 +00:01:09,830 --> 00:01:15,450 +وين في أطراف القرنية طبعا احنا بنعرف ان ال cornea + +11 +00:01:15,450 --> 00:01:19,410 +تتميز انه transparent or completely transparent + +12 +00:01:19,410 --> 00:01:25,190 +فأي أوعية دموية موجودة في داخل ال cornea بتصبح + +13 +00:01:25,190 --> 00:01:31,660 +opacity او فيها opaque عتامةcontinuous with the + +14 +00:01:31,660 --> 00:01:36,060 +limbal vessels في المحاضرة الماضية حكينا ال width + +15 +00:01:36,060 --> 00:01:39,400 +of + +16 +00:01:39,400 --> 00:01:48,880 +limbus بساوي واحد مليطبعا إذا كانت هذه الأوعياء + +17 +00:01:48,880 --> 00:01:54,980 +الدموية حجمها واحد ملي أو أقل مش هتأثر، ليش؟ لأن + +18 +00:01:54,980 --> 00:02:00,120 +طبيعة ال limbus هو يعتبر في capillaries، في أوعياء + +19 +00:02:00,120 --> 00:02:06,460 +دموية أو بنسميها plexus of capillaries فإذا كان + +20 +00:02:06,460 --> 00:02:11,250 +حجمها أقل من واحد ملي مافيش أي تأثيرإذا زاد عن + +21 +00:02:11,250 --> 00:02:15,330 +الواحد من اللي بيصبح هناك تأثير على مين الكورنية + +22 +00:02:15,330 --> 00:02:19,350 +وبالتالي انه بيصبح اختراق للقرانية + +23 +00:02:21,480 --> 00:02:27,000 +The superior limbus is most susceptible يعني بتميز + +24 +00:02:27,000 --> 00:02:31,280 +اللي هو السطح اللي هو ال superior يعني part أو + +25 +00:02:31,280 --> 00:02:34,620 +الجزء اللي .. اللي .. اللي هو في الأعلى بالنسبة + +26 +00:02:34,620 --> 00:02:39,120 +للlimbus معظمه إيش؟ اللي هو بيكون وعائي يعني فيه + +27 +00:02:39,120 --> 00:02:41,800 +اللي هو blood vessels okay؟ + +28 +00:02:44,660 --> 00:02:50,340 +في two researchers واحد اسمه stark and martin + +29 +00:02:50,340 --> 00:02:55,720 +defined عرفه ال vascularization as vessels + +30 +00:02:55,720 --> 00:03:01,700 +penetration greater than 1.5 millimeterاذا هدولة + +31 +00:03:01,700 --> 00:03:06,560 +two researchers عرفوا ال .. ال vascularization على + +32 +00:03:06,560 --> 00:03:10,720 +انه اختراق للأويع الدموية و بيكون قيمة هذا + +33 +00:03:10,720 --> 00:03:15,100 +الاختراق اكتر من جداش واحد و نص ملي متر + +34 +00:03:18,800 --> 00:03:23,020 +طبعا هذا النوع من ال Vascularization هو يعتبر + +35 +00:03:23,020 --> 00:03:27,700 +uncommon بالـ Hydrogel Lens Daily Wear أو الـ + +36 +00:03:27,700 --> 00:03:31,300 +Conventional Daily Wear يعني عدسات اللبس اليومي + +37 +00:03:31,300 --> 00:03:36,220 +التقليدي اما لاحظين انتوا كتير منال complications + +38 +00:03:36,220 --> 00:03:41,660 +لل contact lenses هي غير مصاحبة لمين؟ لعدسات اللبس + +39 +00:03:41,660 --> 00:03:45,840 +اليومي التقليدي، ببساطة لأن عدسات اللبس اليومي + +40 +00:03:45,840 --> 00:03:51,060 +التقليدي بصير لها insertion أو removal every day و + +41 +00:03:51,060 --> 00:03:55,760 +بختلف مثلا شخص بلبسها عشر ساعات، آخر بلبسها أربع + +42 +00:03:55,760 --> 00:03:59,980 +ساعات، واحد تاني بلبسها اتناشر ساعة فهذا بيقلل من + +43 +00:03:59,980 --> 00:04:04,040 +إيش؟ من ال complications للعدسات اللاصقة + +44 +00:04:07,940 --> 00:04:14,180 +أكتر شيوعا او اكتر انتشارا قد تكون ملاحظة لـ + +45 +00:04:14,180 --> 00:04:18,900 +aphecic اذا في العدسات ايه الـ aphecic؟ افيكيك + +46 +00:04:18,900 --> 00:04:22,460 +لينزز يعني واحد مثلا اللي هو بزرع عدسة في داخل + +47 +00:04:22,460 --> 00:04:26,480 +العين مادام افيكيك ان العدسة ايش هتكون؟ plus + +48 +00:04:26,480 --> 00:04:30,800 +lenses اذا هيكون ال center فيها ايه؟Thick compared + +49 +00:04:30,800 --> 00:04:35,380 +to the peripheral فالاشخاص اللي بيلبسوه عدسات plus + +50 +00:04:35,380 --> 00:04:41,220 +lenses هيكونوا معرضين اكتر من الاشخاص اللي بيلبسوه + +51 +00:04:41,220 --> 00:04:45,920 +minus lenses السبب في ذلك ان كمية ال oxygen اللي + +52 +00:04:45,920 --> 00:04:50,160 +هتدخل في ال center هتكون اشمالها جليلة مقارنة + +53 +00:04:50,160 --> 00:04:57,000 +بالاطرافOr Therapeutic Hydrogel Extended Wear أو + +54 +00:04:57,000 --> 00:05:00,540 +في عدسات اللي بيصير لها يعني الأشخاص اللي بيرتديوا + +55 +00:05:00,540 --> 00:05:05,160 +العدسات اللاصقة لعملية ال treatment العلاج يعني + +56 +00:05:05,160 --> 00:05:09,780 +مثلا شخص ارتد عدسة بعد عملية ال laser أو واحد مثلا + +57 +00:05:09,780 --> 00:05:13,930 +بيصيرله عملية اللي هو علاج من ال amblyopiaكل هذه + +58 +00:05:13,930 --> 00:05:17,790 +ال .. او هدول الأشخاص بيكونوا معرضين للاصابة في + +59 +00:05:17,790 --> 00:05:21,850 +مين في ال superficial vascularization أي بمعنى ان + +60 +00:05:21,850 --> 00:05:26,810 +فترة حياة العدسة بتكون قصيرة لكن المريض بلبسها + +61 +00:05:26,810 --> 00:05:28,990 +لمدة زمنية ايه طويلة + +62 +00:05:32,640 --> 00:05:38,180 +Corneal vascularization is of concern because it + +63 +00:05:38,180 --> 00:05:42,280 +makes the cornea more susceptible to inflammation + +64 +00:05:42,280 --> 00:05:47,460 +or hemorrhage دايما صحيح بيكون محدود ولكن خطورته + +65 +00:05:47,460 --> 00:05:50,700 +كبيرة ليش؟ لأنه بيعمل على القرنية ممكن + +66 +00:05:50,700 --> 00:05:55,700 +inflammation التهاب دايما أي انفلامش في القرنية + +67 +00:05:55,700 --> 00:06:02,200 +أربطيه مع الاسترامة اللي هو بيسمى infiltration + +68 +00:06:05,440 --> 00:06:09,720 +الـ stroma يعني في الغالب أي التهاب يصير للقرنية + +69 +00:06:09,720 --> 00:06:13,920 +السبب الرئيسي له مين الـ stroma أو ال Substantia + +70 +00:06:13,920 --> 00:06:18,320 +Epropria اللي بتمثل أكتر من 90% من ثماكة مين + +71 +00:06:18,320 --> 00:06:23,540 +القرنية طبعا ممكن يكون أيضا hemorrhage نزيف في + +72 +00:06:23,540 --> 00:06:27,800 +داخل مين القرنية يعني بمعنى أنه حيصير هناك opacity + +73 +00:06:27,800 --> 00:06:28,820 +للقرنية + +74 +00:06:33,920 --> 00:06:39,340 +Because vascularization can develop in the absence + +75 +00:06:39,340 --> 00:06:43,380 +of symptoms، إذا أنا بفهم من هذه الفقرة إن ال + +76 +00:06:43,380 --> 00:06:47,040 +superfacial vascularization asymptomatic، يعني + +77 +00:06:47,040 --> 00:06:52,420 +بعدم وجود أي أعراض، المريض مش هييجي مثلا يشكي من + +78 +00:06:52,420 --> 00:06:56,440 +burning أو redness أو itching، لأ without any + +79 +00:06:56,440 --> 00:07:01,650 +symptomsRoutine follow-up examination are the only + +80 +00:07:01,650 --> 00:07:06,470 +means of detecting this condition اذا لازم المريض + +81 +00:07:06,470 --> 00:07:11,570 +يعمل follow-up examination او regular check كلمة + +82 +00:07:11,570 --> 00:07:15,610 +regular check + +83 +00:07:16,740 --> 00:07:21,040 +يعني فحص اللي هو دوري أو تأكيد على العدسات اللاصقة + +84 +00:07:21,040 --> 00:07:25,980 +بشكل دوري لإنه ممكن إنه يحدث هناك تغيرات، لذلك + +85 +00:07:25,980 --> 00:07:30,520 +احنا كأخصيين بصريات ما بنفعل انا اول ما المريض + +86 +00:07:30,520 --> 00:07:35,160 +بحتاج عدسة لاصقة أصرف لهياها بشكل مباشر، فيه هناك + +87 +00:07:35,160 --> 00:07:40,870 +حاجة بنسميهاinstructions اللي هي مجموعة من + +88 +00:07:40,870 --> 00:07:45,130 +الإرشادات بدي أعلم المريض عملية ال insertion بدي + +89 +00:07:45,130 --> 00:07:49,170 +أعلمه عملية ال removal ال complications المضاعفات + +90 +00:07:49,170 --> 00:07:53,750 +كل هذه الأمور لازم تكون واضحة بالنسبة لمين للبيشن + +91 +00:07:53,750 --> 00:07:58,830 +يعني أذكر الخميس الماضي إجت حالة يعني تقريبا هي + +92 +00:07:58,830 --> 00:08:03,950 +female subject عمرها أربعين سنةفبتحكيلي انا بدي + +93 +00:08:03,950 --> 00:08:08,350 +عدة سلاسقة بتعيش فترة حياتها تلاتة لاربع سنوات + +94 +00:08:08,350 --> 00:08:14,150 +طبعا اول جواب مني ان مافيش عدة سلاسقة بالفترة + +95 +00:08:14,150 --> 00:08:18,750 +الزمنية هذه فبيقولي مثلا سين او صاد بيعمل اللي هو + +96 +00:08:18,750 --> 00:08:22,630 +عدة سلاسقة بتعيش تلت سنوات او اربع سنوات قولتله + +97 +00:08:22,630 --> 00:08:27,530 +ممكن مثلا انت تقدر تحافظ على عدة سلاسقة لمدة سنتين + +98 +00:08:27,530 --> 00:08:32,610 +او تلاتة لكن هذا ايش بيعمل؟complications ل الشخص + +99 +00:08:32,610 --> 00:08:36,430 +قالت طب انا مابشعر فيه ال complications قلتلها + +100 +00:08:36,430 --> 00:08:40,050 +لأنه قد يكون asymptomatic بدون اللي هو اي تعراض + +101 +00:08:40,050 --> 00:08:44,750 +فيعني بدأت انه اشرحلها موضوع ال insertion ال + +102 +00:08:44,750 --> 00:08:47,990 +removal برضه ال corneal fluorescein staining + +103 +00:08:47,990 --> 00:08:50,550 +اعملتلها هي ال conjunctival staining ال + +104 +00:08:50,550 --> 00:08:53,910 +conjunctival redness بدأت المرأيش انه تعمل + +105 +00:08:53,910 --> 00:08:57,990 +response يعني لهذه الأمور فاقتنعت العدسة عملتلها + +106 +00:08:57,990 --> 00:09:03,020 +هي عدسة تجريبيةعملت يعني بمعنى adaptation ل العدسة + +107 +00:09:03,020 --> 00:09:06,680 +فاقتنعت ان هذه الأمور كلها مرتبطة في مين؟ في + +108 +00:09:06,680 --> 00:09:11,220 +العدسات اللاصقة فهي يعني جاتلي ان أول مرة صراحة + +109 +00:09:11,220 --> 00:09:15,620 +اشتري عدسة لاصقة و يكون هذا الاهتمام بالشكل هذا + +110 +00:09:15,620 --> 00:09:20,620 +فانا بنصحكم يعني قد يكون مثلا العالم كله باستخدامش + +111 +00:09:20,620 --> 00:09:23,880 +هذه الأمور لكن انتوا ممكن ان شاء الله تستخدموها + +112 +00:09:23,880 --> 00:09:30,520 +okay؟و هذا يعود بالإيجاب للشخص يعني بعد ذلك ان هو + +113 +00:09:30,520 --> 00:09:36,700 +بياخد ثقة من الناس في هذه الأمور طيب عندنا ال deep + +114 +00:09:36,700 --> 00:09:41,020 +stromal vascularization اذا مدام ديب اذا هو يعتبر + +115 +00:09:41,020 --> 00:09:45,660 +اخطر من مين من ال superficial vascularization + +116 +00:09:45,660 --> 00:09:49,960 +صحيح؟ و دايما كلمة stroma اربط معها كلمة + +117 +00:09:49,960 --> 00:09:50,480 +inflammation + +118 +00:09:54,400 --> 00:10:00,000 +is the rarest of the vascular changes associated + +119 +00:10:00,000 --> 00:10:06,060 +with contact lens wear، إذا هو نادر الحدوث وبيعمل + +120 +00:10:06,060 --> 00:10:10,860 +هناك إيش؟ تغيرات في اللي هو الأوعية الدموية مع + +121 +00:10:10,860 --> 00:10:17,390 +ارتداء من العدسة اللاصقةBut it is also potentially + +122 +00:10:17,390 --> 00:10:22,670 +the most serious أيضا افتراضيا انه يعتبر ايه هو + +123 +00:10:22,670 --> 00:10:32,730 +اكتر خطورة من ال superficial vascularization اهم + +124 +00:10:32,730 --> 00:10:37,670 +شي عندنا ال vision الرؤية can be profoundly + +125 +00:10:37,670 --> 00:10:43,230 +affected in some cases owing to associated obesity + +126 +00:10:44,510 --> 00:10:48,810 +إذا الشخص اللى هيصاب بال deep stromal + +127 +00:10:48,810 --> 00:10:52,650 +vascularization هيلاجى إنه فيه هناك اختلاف في + +128 +00:10:52,650 --> 00:10:57,190 +الرؤية أو عدم وضوح في الرؤية، إذا في عندنا ايه؟ + +129 +00:10:57,190 --> 00:11:02,370 +symptomatic effect، هذه واحدة في بعض الحالات و + +130 +00:11:02,370 --> 00:11:07,110 +أيضا هيصاحبها ايش؟ Opositiles اللى هى عتموين على + +131 +00:11:07,110 --> 00:11:11,900 +القرنيةإذا المريض هيشعر في هذا الأمر ولا لأ؟ إذا + +132 +00:11:11,900 --> 00:11:17,300 +هيكون فيه هناك feeling من مين أو sensation feeling + +133 +00:11:17,300 --> 00:11:22,540 +from the patient okay risk + +134 +00:11:22,540 --> 00:11:27,400 +factors يعني بمعنى اللي هي الأعراض لهذا الأمر ال + +135 +00:11:27,400 --> 00:11:31,830 +deepest trauma ال vascularizationNumber one a + +136 +00:11:31,830 --> 00:11:37,330 +chronic hypoxia شخص عنده hypoxia بشكل ايه مزمن + +137 +00:11:37,330 --> 00:11:41,430 +دائما عنده hypoxia و مع ذلك بيروح بارتدي عدسة + +138 +00:11:41,430 --> 00:11:45,310 +لاصقة لان هو مش عارف انه عنده hypoxia يعني ممكن + +139 +00:11:45,310 --> 00:11:48,610 +ببساطة انا اعرف ان مريض عنده hypoxia من خلال + +140 +00:11:48,610 --> 00:11:52,710 +كورنيا الفلوروسينستاني يعني هو عنده hypoxia و + +141 +00:11:52,710 --> 00:11:56,230 +بيظلوا ايه؟ Recurrent لا ارتداء اللي هو العدسة + +142 +00:11:56,230 --> 00:12:01,910 +اللاصقةand stromal edema عنده أيضًا اللي هو edema + +143 +00:12:01,910 --> 00:12:06,630 +وين فيه الـ stroma، إذا هذه التنتين يعتبروا من + +144 +00:12:06,630 --> 00:12:11,150 +العوامل الأساسية لحدوث الـ deep stromal + +145 +00:12:11,150 --> 00:12:12,250 +vascularization + +146 +00:12:21,720 --> 00:12:25,780 +العدسات الموجبة بتكون في ال center more thick + +147 +00:12:25,780 --> 00:12:29,400 +compared to the peripheral فكمية ال oxygen اللي + +148 +00:12:29,400 --> 00:12:35,360 +هتدخل في ال center هتكون أقل مقارنة بال peripheral + +149 +00:12:38,310 --> 00:12:42,990 +corneal disease injury or infection وضيفه كلمة + +150 +00:12:42,990 --> 00:12:46,530 +hemorrhage اللي هو أيضا بيصير هناك ايه ممكن اللي + +151 +00:12:46,530 --> 00:12:54,090 +هو نزيف في داخل القرنية extended + +152 +00:12:54,090 --> 00:12:59,170 +wear of low dk على t lenses طب ليش هذه ال extended + +153 +00:12:59,170 --> 00:13:03,370 +wear low dk على t مصاحبة ال deep stromal + +154 +00:13:03,370 --> 00:13:05,650 +vascularization؟ why؟ + +155 +00:13:08,870 --> 00:13:11,430 +هو بالضبط يبتد على عدسة اللاصقة لحيزد القمر ممكن + +156 +00:13:11,430 --> 00:13:16,530 +اعملهممتازة، اذا دايما العدسات الـ extended wear + +157 +00:13:16,530 --> 00:13:20,410 +according to food and drug administration ان هي + +158 +00:13:20,410 --> 00:13:26,050 +بترتدى لمدة اسبوع، واحد لو انا استخدمت عدسة لاصقة + +159 +00:13:26,050 --> 00:13:30,810 +extended wear، low decay على T، كمية ال oxygen + +160 +00:13:30,810 --> 00:13:35,350 +اللى هتدخل للقرنية إيش هتكون؟ quite low أو very + +161 +00:13:35,350 --> 00:13:35,870 +low + +162 +00:13:43,600 --> 00:13:48,640 +deep stromal vascularization لذلك ايش الحل انه + +163 +00:13:48,640 --> 00:13:53,460 +استبدلها ب extended wear اما middle او اتكون high + +164 +00:13:53,460 --> 00:14:01,700 +water content ايضا + +165 +00:14:01,700 --> 00:14:07,900 +toxic solution preservatives ممكن واحد بروح بشتري + +166 +00:14:07,900 --> 00:14:12,680 +محلول عدسات لاصقة لكن ال expire date بتاعه منتهي + +167 +00:14:13,570 --> 00:14:17,570 +بقولك عادي انا بستخدم محليل منتهية اللي هو ايه + +168 +00:14:17,570 --> 00:14:22,650 +الصلاحية طبعا اي محلول بيكون منتهي الصلاحية اعرف + +169 +00:14:22,650 --> 00:14:27,610 +انه فيه له ايه side effects تأثيرات جانبية نتيجة + +170 +00:14:27,610 --> 00:14:32,910 +هو مصنوع من ايه؟ من مواد كيموية او مواد حافظة بعد + +171 +00:14:32,910 --> 00:14:37,170 +ذلك هذه هتتحول كلها الى ايه؟ سموم ومن ثم انه + +172 +00:14:37,170 --> 00:14:41,830 +بتنتقل للعدسة اللاصقة وبعد ذلك بتنتقل لال كورنية + +173 +00:14:47,210 --> 00:14:51,930 +An intracorneal hemorrhage، أي نزيف داخله بيصير + +174 +00:14:51,930 --> 00:14:55,990 +وين؟ داخل الكورنيا، طبعا انتم لاحظين ان ال + +175 +00:14:55,990 --> 00:14:59,550 +complicated كل ما لها بتساعد، يعني مادام + +176 +00:14:59,550 --> 00:15:03,010 +hemorrhage في داخل الكورنيا، يعني تقريبا هيصير ال + +177 +00:15:03,010 --> 00:15:07,870 +opacity overall، يعني او اللي هو most of the + +178 +00:15:07,870 --> 00:15:10,130 +cornea في معظم القرنية + +179 +00:15:13,120 --> 00:15:18,600 +At the subepithelial level is an uncommon sequence + +180 +00:15:18,600 --> 00:15:22,780 +to superficial corneal vascularization طبعا هذا + +181 +00:15:22,780 --> 00:15:27,140 +يعني بيكون غير شائع أو نادر الحدوث في إيش مع + +182 +00:15:27,140 --> 00:15:31,920 +العدسات اللاصقة اللينة يعني هذه وين مثلا بيحدث؟ + +183 +00:15:31,920 --> 00:15:36,020 +شخص بلبس conventional daily wear lenses ونفترض إنه + +184 +00:15:36,020 --> 00:15:40,470 +نام فيها شهرالعدسة اللاصقة، يعني كل يوم يلبسها و + +185 +00:15:40,470 --> 00:15:44,290 +ينام فيها، يلبسها و ينام فيها، ممكن هذه يكون اللي + +186 +00:15:44,290 --> 00:15:51,870 +هو عرضة لإلان Intracranial Hemorrhage، okay؟ + +187 +00:15:51,870 --> 00:15:57,250 +It has been most often related to aphicic hydrogel + +188 +00:15:57,250 --> 00:16:02,050 +lenses، إذا أكتر شيوعا في العدسات وين ال aphicic + +189 +00:16:02,050 --> 00:16:03,370 +hydrogel lenses + +190 +00:16:07,410 --> 00:16:12,390 +An intrastromal obesity يعني بمعنى اللي هو عتامة + +191 +00:16:12,390 --> 00:16:18,450 +في الاسترومة associated with vascularization is + +192 +00:16:18,450 --> 00:16:23,310 +also a rare complication of lens wear طب ليش هان + +193 +00:16:23,310 --> 00:16:26,810 +اللي هو الاسترومة ال obesity بتكون نادرة كتير؟ + +194 +00:16:27,860 --> 00:16:32,380 +ببساطة لأن المريض أول ما بيصير عنده infection في + +195 +00:16:32,380 --> 00:16:37,700 +داخل الكورنية مش هيتحمل العدسة اللاصقة، هيصير عنده + +196 +00:16:37,700 --> 00:16:48,020 +حاجة بنسميها hazy vision أو بنسميها blurred vision + +197 +00:16:49,590 --> 00:16:54,510 +بالتالي هو هيرفع العدسة هيعمل removal لها ال soft + +198 +00:16:54,510 --> 00:17:01,310 +contact lenses قبل ما يصل لمرحلة مين الان انترا + +199 +00:17:01,310 --> 00:17:09,510 +أسترومال opacity عتمة في داخل وين الاسترومال اذا + +200 +00:17:09,510 --> 00:17:12,990 +هان اللي هو ثرييتين فيجين او blurred vision او + +201 +00:17:12,990 --> 00:17:20,290 +hazy visionإذا كان هذا + +202 +00:17:20,290 --> 00:17:27,790 +مصاحب لإنهاج للقرنية، فالعتامة ستكون + +203 +00:17:27,790 --> 00:17:32,650 +بشكل معمق في داخل وين الاسترومة، but avascular + +204 +00:17:32,650 --> 00:17:38,110 +يعني صح اللي هو فيه عتامة، لكن حضرها جزء منها اللي + +205 +00:17:38,110 --> 00:17:41,090 +هو غير وعائي أو transparent + +206 +00:17:44,410 --> 00:17:48,570 +بالنسبة لـ Management قلية العلاج، طبعا اللي + +207 +00:17:48,570 --> 00:17:54,270 +ذكرناهم بالنسبة لـ deep scromal vascularization أو + +208 +00:17:54,270 --> 00:17:58,910 +موضوع الـ opacity في الـ scroma، هذه نادر الحدوث + +209 +00:17:58,910 --> 00:17:59,950 +بشكل كبير + +210 +00:18:02,650 --> 00:18:07,630 +Management mild-limbal hyperemia requires no + +211 +00:18:07,630 --> 00:18:12,770 +management and is an unavoidable part of hydrogen + +212 +00:18:12,770 --> 00:18:16,750 +lens wear يبقى واحد يكون عنده mild-hyperemia هذا + +213 +00:18:16,750 --> 00:18:21,510 +أمر normal طبيعي، أي شخص هيرتدي عدة سلاسة قليلة قد + +214 +00:18:21,510 --> 00:18:26,290 +يكون مش مصاحب له أو يكون معاه اللي هو من ال limbal + +215 +00:18:26,290 --> 00:18:31,360 +hyperemiaإذا ما بتطلب أي تعلاج أو أي removal لمين + +216 +00:18:31,360 --> 00:18:37,260 +للعدسة أو تغيير نوع العدسة ماركت هايبريميا أي + +217 +00:18:37,260 --> 00:18:42,080 +بمعنى moderate أو severe او any vascularization او + +218 +00:18:42,080 --> 00:18:46,140 +أية in you blood vessels بتطلب اللي هو lens + +219 +00:18:46,140 --> 00:18:50,380 +refitting بفهم مدام lens refitting يعني العدسة اما + +220 +00:18:50,380 --> 00:18:56,960 +tight او loose يعني هي ليست optimal fit okayto + +221 +00:18:56,960 --> 00:19:01,220 +improve عشان اعمل عملية تحسين ل ال peripheral + +222 +00:19:01,220 --> 00:19:05,820 +corneal oxygenation عملية اللي هو دخول ال oxygen + +223 +00:19:05,820 --> 00:19:08,040 +سواء لل center او ال peripheral + +224 +00:19:12,210 --> 00:19:17,770 +Patients may be refitted with silicon, hydrogel or + +225 +00:19:17,770 --> 00:19:23,790 +GB lenses بعض الأحيان بنضطر إضافة السيليكون لزيادة + +226 +00:19:23,790 --> 00:19:28,370 +ال wetability أو نستغنى عن العدسة ال soft lenses + +227 +00:19:28,370 --> 00:19:33,610 +يعني مريض عنده دايما deposits بشكل كبير فالأفضل له + +228 +00:19:33,610 --> 00:19:37,930 +أدي ال GB lenses أفضل من مين؟ من ال soft contact + +229 +00:19:37,930 --> 00:19:38,610 +lenses + +230 +00:19:43,070 --> 00:19:46,570 +Mainly to reduce wearing time، أيضًا بدي أقلل + +231 +00:19:46,570 --> 00:19:50,630 +ساعات اللبس بالنسبة للعدسات اللاصقة، لكن هذه + +232 +00:19:50,630 --> 00:19:54,470 +بيستثنى منها مين؟ ال marked hyperemia، يعني سواء + +233 +00:19:54,470 --> 00:19:58,970 +ال moderate أو ال severe، إذا صابوا moderate أو + +234 +00:19:58,970 --> 00:20:03,330 +severe hyperemia، لازم أوقف المريض بشكل كامل في + +235 +00:20:03,330 --> 00:20:07,230 +الفترة الأولى عن ارتداء العدسة اللاصقة + +236 +00:20:10,240 --> 00:20:14,200 +ايضا seals extended wear انه يتوقف عن ارتداء + +237 +00:20:14,200 --> 00:20:17,620 +العدسات ال extended wear لكن ضيفه with low water + +238 +00:20:17,620 --> 00:20:21,540 +content لو كانت اللي هو moderate او high water + +239 +00:20:21,540 --> 00:20:26,800 +content ممكن انه يعني يظل يلبس العدسة اللاصقة، اذا + +240 +00:20:26,800 --> 00:20:30,600 +ال hand يتوقف عن ال extended wear with low water + +241 +00:20:30,600 --> 00:20:31,200 +content + +242 +00:20:38,070 --> 00:20:42,850 +deep stromal vascularization is a most serious + +243 +00:20:42,850 --> 00:20:48,030 +complication يعني هتكون أخطر كمضاعفات and + +244 +00:20:48,030 --> 00:20:53,310 +immediate بالتأكيد cessation of lens wear بدي أوقف + +245 +00:20:53,310 --> 00:20:57,890 +عن ارتداء العدسة اللاصقة بشكل كامل، ملاحظين هنا، + +246 +00:20:57,890 --> 00:21:01,470 +يعني سواء conventional daily wear أو daily + +247 +00:21:01,470 --> 00:21:05,010 +disposable lenses أو extended wear، أي نوع من + +248 +00:21:05,010 --> 00:21:10,060 +العدسات اللاصقةRather than lens refitting is + +249 +00:21:10,060 --> 00:21:14,400 +indicated طيب الآن انا اتوقفت عن ارتداء العدسة + +250 +00:21:14,400 --> 00:21:19,000 +اللاصقة لفترة زمانية بعد ذلك ارجعت لبس العدسات + +251 +00:21:19,000 --> 00:21:22,720 +وجيت نفس ال problem رجعت اذا بدي اعمل ايه + +252 +00:21:22,720 --> 00:21:31,200 +refitting للعدسة اللاصقة هنبدأ + +253 +00:21:31,200 --> 00:21:37,340 +في موضوع مهم اليوم وهو ال infectionأي بمعنى العدوى + +254 +00:21:37,340 --> 00:21:43,220 +اللي بتتم من العدسات اللاصقة في أي سؤال على موضوع + +255 +00:21:43,220 --> 00:21:47,260 +ال complications ل ال hydrogel soft contact lenses + +256 +00:21:47,260 --> 00:21:52,480 +بالنسبة + +257 +00:21:52,480 --> 00:21:58,600 +لل infection العدوىit is the most serious دايما + +258 +00:21:58,600 --> 00:22:02,580 +انا ك practitioner او ك optometrist اكتر حاجة بخاف + +259 +00:22:02,580 --> 00:22:06,520 +منها في ال soft contact lenses موضوع ال infection + +260 +00:22:06,520 --> 00:22:11,780 +العدوى ليه؟ لان ببساطة العدسة conform to the shape + +261 +00:22:11,780 --> 00:22:17,500 +of the cornea اذا it is the most serious اكتر اللي + +262 +00:22:17,500 --> 00:22:23,840 +هو خطورة but also one of the rarest يعني بتكون ايش + +263 +00:22:23,840 --> 00:22:29,500 +نادرة الحدوثComplications of Contact Lens Wear هي + +264 +00:22:29,500 --> 00:22:34,780 +تعتبر من مضاعفات العدسات اللاصقة بشكل عام، لكن + +265 +00:22:34,780 --> 00:22:38,260 +أكتر شيوع عنوان في الـ Hydrogel Soft Contact + +266 +00:22:38,260 --> 00:22:45,950 +Lenses مقارنة بالـ RGB LensesIt can occur in all + +267 +00:22:45,950 --> 00:22:51,370 +types of lens wear، إذا هذه الفقرة المقصودة فيها، + +268 +00:22:51,370 --> 00:22:56,870 +عنا ال RGB و ال soft contact lenses، هدول النوعين، + +269 +00:22:56,870 --> 00:23:01,750 +but has been most commonly associated with + +270 +00:23:01,750 --> 00:23:06,690 +cosmetic extended wear، إذا في العدسات التجميلية، + +271 +00:23:06,690 --> 00:23:11,290 +بتكون يعني more dangerous أو more serious، أكتر + +272 +00:23:11,290 --> 00:23:16,030 +اللي هو خطورةطب لو سألنا السؤال ليش؟ انه دايما في + +273 +00:23:16,030 --> 00:23:20,550 +ال cosmetic contact lenses هي أكتر خطورة أو دايما + +274 +00:23:20,550 --> 00:23:25,390 +بتكون مصاحبة للعدسات اللي هي التجميلية؟ ليه ممكنش + +275 +00:23:25,390 --> 00:23:28,850 +مراعب فيها براميتها، بس يعني اللي كاعتها ممكنش + +276 +00:23:28,850 --> 00:23:32,590 +مراعب فيها، يعني ممكن يصير معايا مريض اللي ادهي + +277 +00:23:32,590 --> 00:23:37,610 +للسندرام ومش حاسس فيه؟ ممكنش يلها نظام insertion + +278 +00:23:41,700 --> 00:23:48,020 +اها another answer؟ فضل طب + +279 +00:23:48,020 --> 00:23:52,880 +ليش انا ماذا انا ماذا انا ماذا انا ماذا انا ماذا + +280 +00:23:52,880 --> 00:23:53,080 +انا ماذا انا ماذا انا ماذا انا ماذا انا ماذا انا + +281 +00:23:53,080 --> 00:23:53,300 +ماذا انا ماذا انا ماذا انا ماذا انا ماذا انا ماذا + +282 +00:23:53,300 --> 00:23:53,300 +انا ماذا انا ماذا انا ماذا انا ماذا انا ماذا انا + +283 +00:23:53,300 --> 00:23:53,340 +ماذا انا ماذا انا ماذا انا ماذا انا ماذا انا ماذا + +284 +00:23:53,340 --> 00:23:53,420 +انا ماذا انا ماذا انا ماذا انا ماذا انا ماذا انا + +285 +00:23:53,420 --> 00:23:53,420 +ماذا انا ماذا انا ماذا انا ماذا انا ماذا انا ماذا + +286 +00:23:53,420 --> 00:24:10,700 +انا ماذا انا ماذا انا ماذا انا ماذا انا + +287 +00:24:12,010 --> 00:24:17,190 +أول حاجة بالنسبة لـ Cosmetic Contact Lenses المصدر + +288 +00:24:17,190 --> 00:24:21,630 +اللى انت بتشيريه فيه هو مصدر غير موثوق صحيح؟ يعني + +289 +00:24:21,630 --> 00:24:26,310 +الشخص اللى أنا مابشريه مثلا من اللي هو محلات + +290 +00:24:26,310 --> 00:24:31,490 +التجميل أو محلات العطور هذا المصدر نفسه هو غير + +291 +00:24:31,490 --> 00:24:35,450 +موثوق فيه لأنه مش انسان متخصص في إيش؟ في العدسات + +292 +00:24:35,450 --> 00:24:40,320 +اللاصقةالنقطة التانية انه موضوع ال expired date + +293 +00:24:40,320 --> 00:24:44,760 +يعني ممكن انا ألبس عدة سلاسقة تكون منتهية التاريخ + +294 +00:24:44,760 --> 00:24:50,100 +يعني مالهاش تاريخ واضح الفكرة النقطة التالتة ممكن + +295 +00:24:50,100 --> 00:24:55,000 +انا مثلا ألبس عدة سلاسقة على انه هي مثلا لمدة + +296 +00:24:55,000 --> 00:24:59,360 +اسبوع ك cosmetic contact lenses وهي تكون لمدة ايه؟ + +297 +00:24:59,360 --> 00:25:06,090 +يوم واحدفدايما انه تعتبر العدسات اللاصقة التجميلية + +298 +00:25:06,090 --> 00:25:11,510 +اكتر العدسات اللي بيكون مصاحب لها ال infection + +299 +00:25:11,510 --> 00:25:17,270 +مقارنة بالعدسات الأخرى فعشان هيك انا دايما بحذر + +300 +00:25:17,270 --> 00:25:21,610 +اللي هو الطلاب او الطالبات دايما يما تشتري عدسة + +301 +00:25:21,610 --> 00:25:25,530 +لاصقة او تشتري عدسة لاصقة لازم ان المصدر يكون + +302 +00:25:25,530 --> 00:25:29,730 +موثوق فيه كيف يعني؟ واحد ال name of company اسم + +303 +00:25:29,730 --> 00:25:34,940 +الشركةأثنين الـDK على T أو بنسميها الـH2O في + +304 +00:25:34,940 --> 00:25:38,860 +العدسة البراميتر من حيث ال power ال base curve ال + +305 +00:25:38,860 --> 00:25:43,220 +diameter لازم كله يكون موجود وين على اللي هو ال + +306 +00:25:43,220 --> 00:25:50,540 +case اللي خاصة في العدسة even + +307 +00:25:50,540 --> 00:25:57,600 +in extended wear 99.9% of contact lens wearers + +308 +00:25:57,600 --> 00:26:07,870 +don'tContract Corneal infection 99.9 + +309 +00:26:07,870 --> 00:26:14,090 +% من الأشخاص اللي بيرتديوا العدسات اللاصقة اللينة + +310 +00:26:14,090 --> 00:26:18,290 +بيكون حاذرين من موضوع ال infection و بيكونوا غير + +311 +00:26:18,290 --> 00:26:22,270 +جذبين لحدوث إيش اللي هو ال infection يعني دايما + +312 +00:26:22,270 --> 00:26:26,760 +بخاف من موضوع إيه ال infectionOkay؟ يعني مثلا + +313 +00:26:26,760 --> 00:26:31,160 +بيكون موضوع ال poor hygiene عندهم لأ، بيكونوا good + +314 +00:26:31,160 --> 00:26:36,040 +hygiene بمعنى إن نظافة الشخصية عندهم ملائمة، موضوع + +315 +00:26:36,040 --> 00:26:40,760 +مثلا الأظافر أيضا بيكونوا جيدة، موضوع اللي هو good + +316 +00:26:40,760 --> 00:26:44,340 +habits، العادات اللي بيقوموا فيها كلها جيدة، عشان + +317 +00:26:44,340 --> 00:26:46,320 +يتجنبوا ايه؟ حدوث ال infection + +318 +00:26:50,890 --> 00:26:56,930 +A number of ocular defense mechanisms exist to + +319 +00:26:56,930 --> 00:27:02,370 +help prevent infection في هناك مجموعة من خطوط + +320 +00:27:02,370 --> 00:27:07,150 +الدفاع موجودة في داخل العين هذه بتعمل على اللي هو + +321 +00:27:07,150 --> 00:27:13,750 +المساعدة في إيه في منع حدوث ال infection من خطوط + +322 +00:27:13,750 --> 00:27:16,690 +الدفاع هذه أول حاجة عندنا ال blinking وال tear + +323 +00:27:16,690 --> 00:27:21,450 +filmطبعا احنا اللى هو بالنسبالى ال blinking ال + +324 +00:27:21,450 --> 00:27:26,610 +normal من خمساشة لعشرين اللى هو ال blink اللى هو + +325 +00:27:26,610 --> 00:27:32,790 +كل دقيقة موضوع ايضا ال tear flow تدفق التير او ال + +326 +00:27:32,790 --> 00:27:38,170 +tear film الاتنين هذول ايش يعتبروا خط الدفاع الاول + +327 +00:27:38,170 --> 00:27:46,120 +للعين بعد ما يتم ارتداء من العدسة اللاصقةطيب التير + +328 +00:27:46,120 --> 00:27:57,660 +اكم بروتين فيه؟ اه فيه اكتر من ستين بروتينز، اذا + +329 +00:27:57,660 --> 00:28:02,720 +يوجد فيه اكتر من ستين بروتينز، ال .. الستين + +330 +00:28:02,720 --> 00:28:06,680 +بروتينز هدول كل الغرض منهم عملية اللي هو ال + +331 +00:28:06,680 --> 00:28:09,540 +defense، الدفاع، okay؟ + +332 +00:28:13,710 --> 00:28:20,830 +الخطوط الهيوغوكسية تتحكم عبر الكورنيا بشكل بلنك و + +333 +00:28:20,830 --> 00:28:26,640 +هذه تتجه لإتراب البكتيريابعد اللي هو موضوع ال + +334 +00:28:26,640 --> 00:28:31,160 +blinking الترميش و ال tear flow او ال tear film او + +335 +00:28:31,160 --> 00:28:35,920 +ال tears فى عندنا ال mucus الطبقة المخاطية الهدف + +336 +00:28:35,920 --> 00:28:41,520 +منها انه تعمل عملية التقاط لكل البكتيريا و تعمللها + +337 +00:28:41,520 --> 00:28:50,100 +تكوير او تدوير للخارج اي بمعنى كلمة wash out يعني + +338 +00:28:50,100 --> 00:28:56,670 +بتعمللها ازالة لوين؟ لخارج العينطبعا احنا بنعرف + +339 +00:28:56,670 --> 00:29:01,550 +انه دايما ال .. ال foreign body في العدسات اللاصقة + +340 +00:29:01,550 --> 00:29:07,190 +اللينة بنحصر اقل من مين من ال RGB لكن اذا دخل في + +341 +00:29:07,190 --> 00:29:11,170 +.. ما بين العدسة و الكورنيا بكون more serious او + +342 +00:29:11,170 --> 00:29:12,990 +اللي هو اكتر خطورة + +343 +00:29:17,920 --> 00:29:21,860 +في عندنا موضوع ال discomation of epithelial cells + +344 +00:29:21,860 --> 00:29:26,040 +طيب خليني أسأل سؤال ال discomation of epithelial + +345 +00:29:26,040 --> 00:29:30,980 +cells هل هذه الظاهرة إيجابية بالنسبة للعدسة + +346 +00:29:30,980 --> 00:29:34,860 +بالنسبة للعدسة اللاصقة ولا لأ؟ يعني هل هذه يعني + +347 +00:29:34,860 --> 00:29:38,640 +بيصير في ال normal subjects في الناس الطبيعيين ولا + +348 +00:29:38,640 --> 00:29:42,620 +لأ؟ بمعنى تقشر + +349 +00:29:50,230 --> 00:29:54,490 +الان الطبقة الأولى لل كورنيا هي عبارة عن مين؟ + +350 +00:29:54,490 --> 00:29:59,010 +الابيثيليان الابيثيليان طبيعتها ايش تعتبر؟ اللي هو + +351 +00:29:59,010 --> 00:30:04,090 +regeneration متجددة الان بمعنى ان كل اربع و عشرين + +352 +00:30:04,090 --> 00:30:09,010 +ساعة بصير تقشر لهذه الطبقة فاسمها discrimination + +353 +00:30:09,010 --> 00:30:15,700 +of epithelial cells اي بمعنى تقشر لطبقة مين؟الان + +354 +00:30:15,700 --> 00:30:22,960 +اي تبكتيريا او اي ت infection بيعمل عملية التساق + +355 +00:30:22,960 --> 00:30:29,560 +مع ال corneal epithelium يحدث التقشر بنزال للخارج + +356 +00:30:29,560 --> 00:30:35,410 +يعني بيزال مع من؟ مع طبقة ال epitheliumإذا الـ + +357 +00:30:35,410 --> 00:30:39,850 +discomation of epithelial cells هي تعتبر irregular + +358 +00:30:39,850 --> 00:30:44,710 +occurrence، يعني حدوثها بشكل طبيعي أو بشكل اللي هو + +359 +00:30:44,710 --> 00:30:50,810 +منتظم، which helps هذه هتساعد ل remove بكتيريا، + +360 +00:30:50,810 --> 00:30:56,750 +إزالة البكتيريا that may have adhered اللي هتلتسق + +361 +00:30:56,750 --> 00:31:00,070 +مع مين؟ مع طبقة ال corneal epithelia + +362 +00:31:05,450 --> 00:31:11,570 +طبعا في هناك أي شخص بلبس عدة ثلاثقة هيصير فيه يعني + +363 +00:31:11,570 --> 00:31:15,550 +حرب مستمرة ما بين ال bacteria و ما بين ال + +364 +00:31:15,550 --> 00:31:21,780 +antibacterial reactionطبعا اي تطرف بنتصر على الطرف + +365 +00:31:21,780 --> 00:31:25,540 +التاني بعمل عملية اللي هو يعني بمعنى البكتيريا لو + +366 +00:31:25,540 --> 00:31:31,420 +انتصرت بتعمل بنترياش مباشرة لمين للقرنية اذا ال + +367 +00:31:31,420 --> 00:31:35,480 +antibacterial هي اللي انتصرت الشخص هيحافظ على + +368 +00:31:35,480 --> 00:31:40,700 +سلامة العين او سلامة القرنية اذا نتير فيلم + +369 +00:31:40,700 --> 00:31:44,660 +antibacterial factors اللي أخدناهم اللي هو الستين + +370 +00:31:44,660 --> 00:31:50,000 +proteins الهدف منهم كله ال defensesAct toward + +371 +00:31:50,000 --> 00:31:54,760 +lysing bacteria، إذا بتعملوا عملية إيه؟ كمش أو + +372 +00:31:54,760 --> 00:32:01,850 +اللي هو لسق للبكتيرياهذه المجالات تشمل لايزوزيم، + +373 +00:32:01,850 --> 00:32:08,130 +لاكتوفيرين، ترانسفيرين، سيريوابلاستين، بيتالايزين + +374 +00:32:08,130 --> 00:32:13,050 +واميون فاكتورز سلولار يعني كلهم الهدف منهم عملية + +375 +00:32:13,050 --> 00:32:17,590 +المناعة و الحماية لمين للبكتيريا طبعا هم مش + +376 +00:32:17,590 --> 00:32:22,130 +مطالبين منها اللي هو كحفظ لكن بعرف ان في في ال + +377 +00:32:22,130 --> 00:32:26,420 +tier filmAntibacterial الهدف منه للـ Antibacterial + +378 +00:32:26,420 --> 00:32:33,420 +عملية الـ Defense The + +379 +00:32:33,420 --> 00:32:38,280 +acquired immune system يعني نظام المناع المكتسب of + +380 +00:32:38,280 --> 00:32:43,480 +the eye من داخل العين consist of انه هيتكون من + +381 +00:32:43,480 --> 00:32:52,190 +immunoglobulin Asecretary IGA and the complement + +382 +00:32:52,190 --> 00:32:55,790 +system اللي هو نظام إيش ما له complementary rule + +383 +00:32:55,790 --> 00:33:00,010 +يعني نظام اللي هو تكاملي متكامل في داخل ال + +384 +00:33:00,010 --> 00:33:05,450 +antibacterial factor اللي هو في داخل ال tear film + +385 +00:33:09,160 --> 00:33:12,980 +The nature طبيعة ال immune system النظام المناعي + +386 +00:33:12,980 --> 00:33:20,620 +هذا بتكون من macroveges او neutrophils and natural + +387 +00:33:20,620 --> 00:33:25,540 +killer اللي هو cells يعني بمعنى انه بتكون كله من + +388 +00:33:25,540 --> 00:33:29,860 +antibacterial factors الهدف منها اللي هو قتل من + +389 +00:33:29,860 --> 00:33:35,580 +البكتيريا و التخلص منها يعني خلايا اللي هو قاتلة + +390 +00:33:36,630 --> 00:33:40,330 +طبعا هذه المكونات كلها هي تعتبر من ضمن ال 60 + +391 +00:33:40,330 --> 00:33:43,010 +proteins اللي موجودين في ال tier film + +392 +00:33:48,810 --> 00:33:53,150 +طبعا في عندنا ال ulcer bacterial هذه في داخل + +393 +00:33:53,150 --> 00:33:57,570 +القورنية او موضوع البلبر زي ما انتوا شايفين يعني + +394 +00:33:57,570 --> 00:34:01,030 +هان بيكون في ال center هان بيكون بال peripheral في + +395 +00:34:01,030 --> 00:34:05,490 +الأطراف هان بيكون فقط في ال upper part okay و + +396 +00:34:05,490 --> 00:34:09,150 +بيكون بشكل اللي هو ال archius و هان عبارة عن + +397 +00:34:09,150 --> 00:34:12,630 +بنكتات أيضا بيكون في ال upper part + +398 +00:34:18,610 --> 00:34:23,170 +في ايضا عندنا موضوع ال conjunctival impairment اذا + +399 +00:34:23,170 --> 00:34:27,650 +هتكون حوالين اللي هو ال conjunctiva في a wrinkling + +400 +00:34:27,650 --> 00:34:32,150 +soft lens اللي هو يصير هناك تجاعد في العدسة لذلك + +401 +00:34:32,150 --> 00:34:35,530 +دايما بقولكم انه لازم الواحد يعمل التاكو تيست + +402 +00:34:35,530 --> 00:34:39,350 +اهمية التاكو تيست غير ان العدسة بيصير real او + +403 +00:34:39,350 --> 00:34:44,150 +inverted بيقدر اللي هو لتكامش مين انه بتنكمش يعني + +404 +00:34:44,150 --> 00:34:49,960 +العدسةخاصة اذا كانت ستيب بتكمش القرانية يعني بمعنى + +405 +00:34:49,960 --> 00:34:56,600 +انه بصير التقاط لها ايضا في عندنا ال dimple بالشكل + +406 +00:34:56,600 --> 00:35:01,180 +هادئ نقاط ال foreign body في داخل اللي هو ما بين + +407 +00:35:01,180 --> 00:35:06,540 +الكورنيا و العدسة و ال epithelial edema اي بمعنى + +408 +00:35:06,540 --> 00:35:08,820 +inflammation of the cornea + +409 +00:35:15,300 --> 00:35:18,460 +بدنا نقف ان شاء الله لل bacterial corneal + +410 +00:35:18,460 --> 00:35:22,300 +infection في المحاضرة القادمة ان شاء الله + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/KtVSKgJh5r4.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/KtVSKgJh5r4.srt new file mode 100644 index 0000000000000000000000000000000000000000..9945ee7758762a954c9f7071b854d2aab9d59178 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/KtVSKgJh5r4.srt @@ -0,0 +1,1939 @@ +1 +00:00:21,020 --> 00:00:23,760 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:23,760 --> 00:00:26,960 +وبركاته and a very good morning to all of you + +3 +00:00:26,960 --> 00:00:31,100 +هنبدأ في موضوع أو نكمل في موضوع الـ software + +4 +00:00:31,100 --> 00:00:36,980 +contact lenses عندنا في اختبار مهم كثير هو عبارة + +5 +00:00:36,980 --> 00:00:48,480 +عن الـ twist test أو بمعنى آخر الـ rotation أو + +6 +00:00:48,480 --> 00:00:49,340 +الـ screw + +7 +00:00:54,950 --> 00:01:01,750 +بمعنى اختبار اللف أو دوران الـ cylinder lens أو + +8 +00:01:01,750 --> 00:01:07,870 +دوران أو لف اللي هو من الفروبتر إذا the screw + +9 +00:01:07,870 --> 00:01:12,750 +test أو الـ rotation test أو الـ twist test is a + +10 +00:01:12,750 --> 00:01:17,210 +useful screening test for softorix يعني الآن بعد + +11 +00:01:17,210 --> 00:01:21,290 +ما أنا بعمل evaluation للمريض من حيث الـ subjective + +12 +00:01:21,290 --> 00:01:22,090 +refraction + +13 +00:01:26,310 --> 00:01:31,010 +أكد أن هذا الـ axis اللي المريض لابسه، هل هو صحيح + +14 +00:01:31,010 --> 00:01:35,770 +ولا لأ؟ هذه نقطة أولى، يعني مثلاً المريض عنده minus + +15 +00:01:35,770 --> 00:01:37,110 +ثلاثة + +16 +00:01:42,320 --> 00:01:46,880 +أول حاجة بدي أشوف أن العجز اللاصقة هل هي على axis + +17 +00:01:46,880 --> 00:01:52,220 +30 فعلاً ولا لأ؟ أن هل هذا صحيح؟ النقطة الثانية أن + +18 +00:01:52,220 --> 00:01:56,700 +بدي أشوف هل المريض عنده sensitivity عالية ولا لأ + +19 +00:01:59,950 --> 00:02:04,030 +it helps in determining patient tolerance يعني هذا + +20 +00:02:04,030 --> 00:02:08,830 +بالساعد في تحديد ما هو تقبل المريض tolerance بمعنى + +21 +00:02:08,830 --> 00:02:14,150 +accepted تقبل المريض for the lens rotation لدوران + +22 +00:02:14,150 --> 00:02:19,330 +العدسة commonly seen with torric lenses وهذا بيكون + +23 +00:02:19,330 --> 00:02:24,950 +أكثر شيوعاً في العدسات الـ soft torric lenses rotate + +24 +00:02:24,950 --> 00:02:29,310 +the best cylinder يعني الآن احنا نفترض على الـ axis + +25 +00:02:29,310 --> 00:02:33,550 +30 روحت أنا عملت rotation تدوير من خلال الفروبتر + +26 +00:02:33,550 --> 00:02:36,950 +أو الـ cylinder lens اللي أنا وضعته في الـ trial + +27 +00:02:36,950 --> 00:02:43,710 +frame إذا rotate the best cylinder in the phoropter + +28 +00:02:43,710 --> 00:02:48,770 +until it blurs it's just noticeable يعني أنا بخلي + +29 +00:02:48,770 --> 00:02:52,990 +المريض يلف في الـ cylinder lens أو أنا بلف في الـ + +30 +00:02:52,990 --> 00:02:57,110 +phoropter لحد ما الصورة إيش تصير غير واضحة، it + +31 +00:02:57,110 --> 00:03:02,240 +blurs اللي هي غير واضحة، إذا مرة ثانية أنا حطيت + +32 +00:03:02,240 --> 00:03:06,820 +اللي هو عدسة لاصقة في عين المريض minus 3 ع minus 1 + +33 +00:03:06,820 --> 00:03:14,100 +.5 X 30 بحط له عدسة مثلاً ربع سيلندر تمام أو مثلاً + +34 +00:03:14,100 --> 00:03:16,900 +Jackson across cylinder عملناها في معمل يوم + +35 +00:03:16,900 --> 00:03:21,600 +الرابع أو بجيب إذا كان عندي phoropter بخلي المريض + +36 +00:03:21,600 --> 00:03:26,460 +يعمل rotation تدوير لحد ما الصورة تصبح غير واضحة + +37 +00:03:26,460 --> 00:03:32,500 +طيب ليش؟ الآن هنعرف You may also ask the patient to + +38 +00:03:32,500 --> 00:03:37,440 +twist the axes down until they notice a decrease + +39 +00:03:37,440 --> 00:03:38,040 +in vision + +40 +00:03:47,120 --> 00:03:51,040 +If a response is elicited in less than five + +41 +00:03:51,040 --> 00:03:55,920 +degrees يعني بمعنى آخر إذا الاستجابة للمريض هذه + +42 +00:03:55,920 --> 00:04:01,260 +وجدت elicited بمعنى وجدت في أقل من خمسة degree + +43 +00:04:01,260 --> 00:04:06,140 +يعني الآن أنا مثلاً المريض لف العدسة نفترض لسبعة + +44 +00:04:06,140 --> 00:04:13,090 +وعشرين كده الفرق؟ ثلاثة degree بالضبط، إذا المريض + +45 +00:04:13,090 --> 00:04:17,110 +شعر أنه عنده السبعه و عشرين فيه اللي هو تأثير + +46 +00:04:17,110 --> 00:04:21,490 +كبير، معنى الكلام أن هذا المريض إيه؟ عنده high + +47 +00:04:21,490 --> 00:04:29,230 +sensitivity طيب مرة ثانية الآن minus 3 ع minus 1.5 + +48 +00:04:29,230 --> 00:04:34,270 +لما المريض عمل rotation لـ trial frame عن 27 + +49 +00:04:34,270 --> 00:04:40,070 +تأثر هو في الأصل قد ايش 30 إذا أقل من 5 degree هذا + +50 +00:04:40,070 --> 00:04:44,970 +بتديني انطباع أن المريض عنده high sensitivity طب + +51 +00:04:44,970 --> 00:04:48,990 +نفترض لو كان الفرق أكثر من خمسة، بيكون هذا طبيعي، + +52 +00:04:48,990 --> 00:04:52,850 +يعني للآن لو احنا بدنا نعمل اللي هو نظارة وطلع + +53 +00:04:52,850 --> 00:04:56,130 +الفرق أكثر من خمسة degree، المريض إيش هيقول لك؟ + +54 +00:04:56,130 --> 00:05:00,210 +الرؤية مش واضحة وهتتغير عنده الرؤية، هيقول لك مثلاً + +55 +00:05:00,210 --> 00:05:09,440 +شايف الأرض إيش غير طبيعية، تمام؟ إذا إذا استجابة + +56 +00:05:09,440 --> 00:05:15,120 +وجدت في أقل من خمسة degree، فهناك مستوى عالي من + +57 +00:05:15,120 --> 00:05:19,240 +حساسية + +58 +00:05:19,240 --> 00:05:23,980 +عالية كثير. طيب في هذه الحالة إيش بدنا نتجه؟ باتجاه + +59 +00:05:23,980 --> 00:05:34,480 +مين؟ الـ GP lens إذا المريض + +60 +00:05:34,480 --> 00:05:39,820 +عندما يكون عنده مرتبط عالي لازم أنا اروح باتجاه + +61 +00:05:39,820 --> 00:05:45,300 +مين الـ RGB contact lens لأن الـ RGB contact lens + +62 +00:05:45,300 --> 00:05:52,800 +ما فيش فيها الـ axis على العدسة فبالتالي ما بسبب + +63 +00:05:52,800 --> 00:05:58,830 +الموضوع الـ rotation طيب لو المريض مصمم أن يلبس + +64 +00:05:58,830 --> 00:06:02,290 +عدسة soft trick contact lenses ومش قادر يعمل + +65 +00:06:02,290 --> 00:06:06,630 +adaptation مع الـ RGB إيش بدنا نعمل؟ if a soft + +66 +00:06:06,630 --> 00:06:11,190 +trick is necessary يعني المريض عنده motivation فقط + +67 +00:06:11,190 --> 00:06:17,570 +لارتداء الـ soft trick except more trials and the + +68 +00:06:17,570 --> 00:06:19,690 +need for a lens design + +69 +00:06:25,610 --> 00:06:30,730 +هذا المريض بدي أعمل له trial أكثر من مرة لحد ما أصل + +70 +00:06:30,730 --> 00:06:35,190 + لأفضل access لهذا المريض يعني لأفضل access لمن؟ + +71 +00:06:35,190 --> 00:06:39,630 +للعدسة اللي هي الـ software نما اثنين بدي استخدم + +72 +00:06:39,630 --> 00:06:44,550 +اللي هو design تصميم للعدسة أن يكون هذا التصميم في + +73 +00:06:44,550 --> 00:06:49,550 +أقل اللي هو rotation وأكثر اللي هو stability واضح + +74 +00:06:49,550 --> 00:06:55,110 +الفكرة؟ إذا الآن لو سألنا سؤال إيش المقصود بالـ twist + +75 +00:06:55,110 --> 00:06:58,930 +test؟ اه يا داليا إيش المقصود في الـ twist test؟ + +76 +00:07:01,400 --> 00:07:05,620 +اللي هو الـ rotation test تمام يعني أنا بدي أخلي + +77 +00:07:05,620 --> 00:07:10,000 +المريض يعمل rotation بالـ cylinder lens أو يلبس + +78 +00:07:10,000 --> 00:07:14,620 +phoropter لحد ما تصبح الرؤية إيه غير واضحة بدي أشوف + +79 +00:07:14,620 --> 00:07:18,100 +قد ايش هذا المريض عنده sensitivity هل هي high ولا + +80 +00:07:18,100 --> 00:07:21,820 +low إذا كانت أقل من خمسة degree معناه الكلام أن + +81 +00:07:21,820 --> 00:07:25,180 +عنده high level of sensitivity إذا كانت أكثر من + +82 +00:07:25,180 --> 00:07:28,700 +خمسة degree بده يكون عنده low level of sensitivity + +83 +00:07:29,410 --> 00:07:33,270 +بالتالي إذا بدي أعرف مين الـ best choice لمين + +84 +00:07:33,270 --> 00:07:38,690 +للمريض طيب + +85 +00:07:38,690 --> 00:07:44,630 +عندنا الآن software lens design يعني تصميم هذا + +86 +00:07:44,630 --> 00:07:46,850 +النوع من العدسات الـ software + +87 +00:07:52,230 --> 00:07:56,470 +They differ from spherical lenses، إذا تصميم + +88 +00:07:56,470 --> 00:08:00,630 +العدسات الـ Soft-Rig هيختلف عن مين؟ عن الـ + +89 +00:08:00,630 --> 00:08:04,830 +Spherical Soft Contact Lenses تمام؟ ليش؟ لأنه + +90 +00:08:04,830 --> 00:08:08,950 +هيكون في لها front و back surface وهتعمل على + +91 +00:08:08,950 --> 00:08:13,310 +تصحيح مين قيمة الـ astigmatism إذا كانت موجودة في الـ + +92 +00:08:13,310 --> 00:08:18,010 +front أو كانت موجودة بالـ back surface إذا they + +93 +00:08:18,010 --> 00:08:20,430 +differ from spherical lenses + +94 +00:08:29,290 --> 00:08:36,100 +إذا أول حاجة هي بتعتمد على قيمة السيلندر يعني قد ايش + +95 +00:08:36,100 --> 00:08:40,440 +قيمة السيلندر بالنسبة لمن يا جماعة للسفير هذه واحد + +96 +00:08:40,440 --> 00:08:45,840 +بعد ما اعتمدت على قيمة السيلندر بده أشوف أن هل هذا + +97 +00:08:45,840 --> 00:08:49,200 +السيلندر في الـ front ولا الـ back surface أي number + +98 +00:08:49,200 --> 00:09:00,000 +اثنين إذا number one determine the + +99 +00:09:00,000 --> 00:09:04,820 +amount of + +100 +00:09:07,970 --> 00:09:14,170 +سيلندر لينز إذا number one بدنا نحدد قيمة اللي هو + +101 +00:09:14,170 --> 00:09:18,430 +السيلندر اللي موجود عند المريض اثنين بدنا نحدد + +102 +00:09:18,430 --> 00:09:21,650 +وجود هذا السيلندر هل هو في الـ front ولا الـ back + +103 +00:09:21,650 --> 00:09:26,950 +surface ثلاثة بدنا نحدد نوع الـ stabilization يعني + +104 +00:09:26,950 --> 00:09:31,350 +هل المريض هذا عنده high level of Sensitivity ولا + +105 +00:09:31,350 --> 00:09:34,990 +low level of sensitivity؟ طبعاً إذا كان عنده high + +106 +00:09:34,990 --> 00:09:39,290 +level of sensitivity معنى الكلام أنه بدي more + +107 +00:09:39,290 --> 00:09:43,810 +stability أكثر ثبات لمن؟ للعدسة وأمنع أي ت + +108 +00:09:43,810 --> 00:09:46,570 +rotation للعدسة اللاصقة + +109 +00:09:50,220 --> 00:09:55,180 +The eyelids close in a temporal to nasal fashion, + +110 +00:09:56,080 --> 00:10:00,820 +producing the so-called zebra effect هان بمعنى + +111 +00:10:00,820 --> 00:10:05,300 +اللي هو طريقة الصحابة يعني الآن احنا لما نلبس + +112 +00:10:05,300 --> 00:10:09,980 +المريض عدسة لاصقة، لاحظوا أن المريض دائماً بيغلق + +113 +00:10:09,980 --> 00:10:14,620 +عينه من الـ temporal to nasal هذه العملية إيش + +114 +00:10:14,620 --> 00:10:18,360 +بالساعد؟ لما يغلق من اللي هو الـ temporal، طبعاً هي + +115 +00:10:18,360 --> 00:10:24,150 +بتكون بشكل لحظي Okay لما بيغلق من الـ temporal للـ + +116 +00:10:24,150 --> 00:10:28,730 +nasal هذه بتعمل على لف شوية العدسة أن بتعمل + +117 +00:10:28,730 --> 00:10:34,010 +rotation لمين؟ للعدسة فهنا أن في هذه الظاهرة + +118 +00:10:34,010 --> 00:10:38,850 +لازم أنا أزود من قيمة مين الـ stability عشان أمنع + +119 +00:10:38,850 --> 00:10:43,670 +اللي هو الـ rotation لمين؟ للعدسة إذا مرة أخرى + +120 +00:10:45,860 --> 00:10:51,180 +بمعنى طريقة السحاب أو تأثير السحاب من خلاله المريض + +121 +00:10:51,180 --> 00:10:55,660 +بيغلق جفنه من الـ temporal تنزل لمنع اللي هو أي + +122 +00:10:55,660 --> 00:10:59,480 +rotation لمن؟ للعدسة كيف؟ بدي أزود الـ stability + +123 +00:10:59,480 --> 00:11:08,560 +يعني بمعنى أن أمنع rotation للعدسة لأ + +124 +00:11:08,560 --> 00:11:13,620 +هو بيزيد بيزيد اللي هو الـ rotation كيف أنا بدي + +125 +00:11:13,620 --> 00:11:18,880 +أمنعه؟ بدي أعمل اللي هو design أن أمنع اللي هو مين + +126 +00:11:18,880 --> 00:11:23,420 +موضوع الـ rotation تمام يا جماعة؟ يعني هذا القمر + +127 +00:11:23,420 --> 00:11:27,760 +بيزيد الـ rotation كيف بدي أمنعه؟ بدي استخدم اللي هو + +128 +00:11:27,760 --> 00:11:32,420 +prism أو بدي أستخدم مثلاً طريقة الـ truncation أو أي + +129 +00:11:32,420 --> 00:11:38,920 +طريقة أن تمنع اللي هو الدوران رسمها يمكن أوضح + +130 +00:11:38,920 --> 00:11:41,640 +هالشيء؟ هي مثلاً العين + +131 +00:11:51,740 --> 00:11:57,920 +الآن أنا بدي أمنع اللي هو دوران العدسة كيف بدي + +132 +00:11:57,920 --> 00:12:02,740 +أعمل؟ بدي أعمل مصدر ثقل للعدسة مصدر الثقل هذا + +133 +00:12:02,740 --> 00:12:06,790 +بيمنع اللي هو دوران العدسة أو في طريقة ثانية مثلاً + +134 +00:12:06,790 --> 00:12:10,590 +الـ truncation يعني هذه الظاهرة أو هذا التأثير + +135 +00:12:10,590 --> 00:12:15,830 +بيزيد من مين؟ من دوران العدسة كيف بمنعه؟ اللي هو + +136 +00:12:15,830 --> 00:12:20,610 +من خلال اللي هو الـ stability يعني design معين أن + +137 +00:12:20,610 --> 00:12:26,510 +يمنع الـ stability، الآن هناخده مع بعض الصفتوريك + +138 +00:12:26,510 --> 00:12:31,850 +الأفضل سيكون لديه تحويل مينيمال وسيحافظ على موقع + +139 +00:12:31,850 --> 00:12:39,570 +مستمر يسمى بالمقاومة الآن أنا لما بدي المريض يلبسه + +140 +00:12:39,570 --> 00:12:45,730 +عدسة لاصقة صفتوريك أهم شيء إيش أمنع؟ rotation العدسة + +141 +00:12:46,880 --> 00:12:51,400 +كيف أنا ببدأ أمنع روتيشن العدسة بدي أوفر design + +142 +00:12:51,400 --> 00:12:56,360 +مثالي لهذا المريض بيعمل على اللي هو ثابت العدسة في + +143 +00:12:56,360 --> 00:13:02,340 +داخل العين طبعًا قد يكون في عندنا أكثر من design مثل + +144 +00:13:02,340 --> 00:13:06,180 +ال prism ballast أو مثلًا ال truncation أو ال ISO + +145 +00:13:06,180 --> 00:13:10,810 +horizontal أكثر من اللي هو طريقة طيب في عملية ال + +146 +00:13:10,810 --> 00:13:14,950 +stability أفضل حاجة أنه لازم العدسة وأن تكون ماخدة + +147 +00:13:14,950 --> 00:13:19,010 +ال concentration تمركز جيد يعني زيادة اللي هو + +148 +00:13:19,010 --> 00:13:23,750 +تمركز العدسة بشكل صحيح هذا هيمنع من ال rotation + +149 +00:13:23,750 --> 00:13:28,070 +للعدسة وهيوفر له اللي هو stability ملائم أو + +150 +00:13:28,070 --> 00:13:30,290 +مناسب للعدسة + +151 +00:13:39,770 --> 00:13:44,570 +Okay سؤال مهم دائمًا أنا أما بمسك عدسة software + +152 +00:13:44,570 --> 00:13:48,370 +contact lens العدسة بيكون يمكن شفتوها معظمكم + +153 +00:13:52,050 --> 00:13:58,170 +أكسس 30 يعني العدسة مصممة هذه أو من الشركة هم + +154 +00:13:58,170 --> 00:14:01,790 +عاملين ال prescription الوصفة لها على أكسس 30 + +155 +00:14:01,790 --> 00:14:06,110 +زي الآن عفوا أنت لما تنظف اللي هو العدسات لإيمان + +156 +00:14:06,110 --> 00:14:10,230 +بتعمله اللي هو cleaning هل بتغير ال access لأ ليش + +157 +00:14:10,230 --> 00:14:14,410 +لأنه ما فيش أي rotation ونفس الحاجة في العدسات اللي + +158 +00:14:14,410 --> 00:14:18,600 +هو ال software بيكون هناك فيه marker طبعًا احنا قلنا + +159 +00:14:18,600 --> 00:14:22,840 +أنه صار لها update جديد ورفعه اللي هو الموضوع من ال + +160 +00:14:22,840 --> 00:14:28,580 +marker فعملية تنظيف العدسة لا يمكن أنه ايش يغير من + +161 +00:14:28,580 --> 00:14:33,180 +قيمة ال access إلا مع الزمن يعني كل اللي هو متقدم + +162 +00:14:33,180 --> 00:14:37,960 +العدسة في عملية التنظيف ممكن أنه يعمل اللي هو + +163 +00:14:37,960 --> 00:14:42,340 +تغيير للي هو ال access اللي خاص بالعدسة أو يزود + +164 +00:14:42,340 --> 00:14:44,960 +من قيمة ال scratch تمام؟ + +165 +00:14:48,420 --> 00:14:54,370 +Predicting بمعنى اكتشاف أو اللي هو تخمين how a + +166 +00:14:54,370 --> 00:14:59,390 +toric lens will rotate on the eye cannot be done + +167 +00:14:59,390 --> 00:15:04,450 +with any reliability يعني هذا الموضوع ما بيعتمد + +168 +00:15:04,450 --> 00:15:08,730 +على ثقة ما بين الفترات وما بين مين ال facial يعني + +169 +00:15:08,730 --> 00:15:12,330 +ايه مثلًا يجي المريض عنده يقول لي والله أنا بلاحظ أن + +170 +00:15:12,330 --> 00:15:15,830 +العدسة بتلف لليمين أو في الشمال احنا بناخد ال + +171 +00:15:15,830 --> 00:15:20,950 +history بنسمع للمريض ولكن هل هذا بنعتبره اللي هو + +172 +00:15:20,950 --> 00:15:25,150 +مصدر ثقة reliability بمعنى اللي هو ثقة لأ لازم أنا + +173 +00:15:25,150 --> 00:15:30,690 +بدي أعمل examination عشان أعرف أن قيمة ال rotation + +174 +00:15:30,690 --> 00:15:34,510 +هادي هل هي باتجاه ال right ولا باتجاه ال left + +175 +00:15:43,360 --> 00:15:46,780 +فاكرين الـ Conventional Daily Wear Lenses؟ عندما + +176 +00:15:46,780 --> 00:15:51,180 +يكون فترة حياتها من 6 إلى 12 شهر، قلنا إنه بتم + +177 +00:15:51,180 --> 00:15:54,580 +صناعتها من خلال الـ Lathe Cutting Method ونفس + +178 +00:15:54,580 --> 00:15:58,480 +الحاجة هنا، إذا كانت العدسة، الـ Softery Contact + +179 +00:15:58,480 --> 00:16:02,720 +Lenses فترة حياتها من 6 إلى 12 شهر، بدنا نستخدم + +180 +00:16:02,720 --> 00:16:08,110 +الـ Same Method طيب إذا كانت disposable lenses for + +181 +00:16:08,110 --> 00:16:11,530 +two weeks أو one month بدنا نستخدم اللي هو ال + +182 +00:16:11,530 --> 00:16:20,390 +molded technology method تمام؟ إذا anterior and + +183 +00:16:20,390 --> 00:16:24,550 +posterior surface are molded on both or either + +184 +00:16:24,550 --> 00:16:28,410 +surfaces يعني للسطح الأمامي ال back و ال front + +185 +00:16:28,410 --> 00:16:29,190 +surface + +186 +00:16:34,350 --> 00:16:40,350 +Okay at one time it was thought that a gravity + +187 +00:16:40,350 --> 00:16:45,650 +caused the toric lens to position into a place on + +188 +00:16:45,650 --> 00:16:52,020 +the eye بنرجع gravity بمعنى مصدر ثقة مصدر ثقل يعني + +189 +00:16:52,020 --> 00:16:57,380 +أي عدسة software contact lenses لازم أن + +190 +00:16:57,380 --> 00:17:03,160 +يكون لها ايه مركز ثقل اللي هو gravity عشان يمنع ال + +191 +00:17:03,160 --> 00:17:07,480 +rotation لمن؟ للعدسة أو سميناها يمكن في الجانب + +192 +00:17:07,480 --> 00:17:11,700 +العملي اللي هو ال marker الساعة ستة ال six اللي هو + +193 +00:17:11,700 --> 00:17:18,260 +position تمام؟ الآن في مراحل لتطوير تصميم العدسة + +194 +00:17:18,260 --> 00:17:20,720 +الصوفتوريك نشوف ايش هي المراحل + +195 +00:17:28,730 --> 00:17:32,810 +طبعًا هذا مبدأ اللي هو الضغط طبعًا water melon ايش + +196 +00:17:32,810 --> 00:17:37,870 +هو اللي هو بذر البطيخ seed بمعنى بذر water melon + +197 +00:17:37,870 --> 00:17:43,550 +اللي هو ايه البطيخ فعندنا اللي هو مبدأ بذر البطيخ أو + +198 +00:17:43,550 --> 00:17:49,630 +بسموه اللي هو مبدأ الضغط تمام كيف المبدأ هذا + +199 +00:17:49,630 --> 00:17:56,510 +explains the force يعني بيستخدم اللي هو utilize + +200 +00:17:56,510 --> 00:18:01,490 +بمعنى استخدام للقوة إذا بستخدم اللي هو القوة in + +201 +00:18:01,490 --> 00:18:06,010 +toric lens designs مش القوة بتاعة الأنظمة العربية + +202 +00:18:06,010 --> 00:18:10,350 +لأ احنا بنقول اللي هو قوة عشان نمنع اللي هو لمن + +203 +00:18:10,350 --> 00:18:16,230 +ال rotation للعدسة تمام؟ إذا بالقوة هو بده يعمل + +204 +00:18:16,230 --> 00:18:21,750 +عملية تثبيت أو stability للعدسة نشوف كيف a toric + +205 +00:18:21,750 --> 00:18:23,170 +lens must have + +206 +00:18:27,890 --> 00:18:34,290 +ببساطة بيخلي ال center مركز العدسة اللي هو في داخل + +207 +00:18:34,290 --> 00:18:39,470 +العدسة من المنتصف بيخليه اللي هو thin ولا thick؟ + +208 +00:18:39,470 --> 00:18:48,480 +طيب والأطراف؟ ليش طيب؟ ببساطة دائمًا الأطراف هي + +209 +00:18:48,480 --> 00:18:53,980 +أكثر حاجة بتعمل ال rotation لمن؟ للمريض، تمام؟ + +210 +00:18:53,980 --> 00:18:59,160 +إذا دائمًا الأطراف هم بيعملوها اللي هو ايه؟ thin و + +211 +00:18:59,160 --> 00:19:03,640 +بيزود اللي هو ال thick wave في المنتصف طبعًا ممكن + +212 +00:19:03,640 --> 00:19:08,300 +طالبة تسألني في لها disadvantages ايش هي أن ال + +213 +00:19:08,300 --> 00:19:12,520 +oxygen transmissibility هتكون ايش قليلة احنا لذلك + +214 +00:19:12,520 --> 00:19:17,980 +أنه في جينا ايه update لهذا الموضوع إذا مرة أخرى + +215 +00:19:17,980 --> 00:19:26,100 +مبدأ البغض أو مبدأ بذور البطيخ okay ببساطة أنه + +216 +00:19:26,100 --> 00:19:31,510 +بيعتمد على القوة استخدام القوة كيف؟ أنه بيوفر مصدر + +217 +00:19:31,510 --> 00:19:37,110 +ثقل أنه بيخلي الأطراف نحيفة وال center بيخليه ثقل + +218 +00:19:37,110 --> 00:19:44,910 +عشان يمنع دوران العدسة واضح؟ + +219 +00:19:44,910 --> 00:19:50,390 +طيب بالنسبة ل ال prism ballast + +220 +00:19:53,480 --> 00:19:58,120 +أيضًا بيسمى هذا النوع اللي هو is the most common + +221 +00:19:58,120 --> 00:20:03,120 +method هو أكثر اللي هو شيوعًا هذا النوع to add a + +222 +00:20:03,120 --> 00:20:06,880 +thick zone to a soft reclines، إذا بيزود منطقة + +223 +00:20:06,880 --> 00:20:13,500 +سميكة عشان يعمل زيادة اللي هو لإيه؟ لا ال stability + +224 +00:20:13,500 --> 00:20:18,500 +للعدسة يعني دائمًا بدك تعرفي أي تصميم احنا بنستخدمه + +225 +00:20:18,500 --> 00:20:22,780 +للعدسة اللاصقة ال soft toric أنه to increase the + +226 +00:20:22,780 --> 00:20:26,680 +stability and comfort for the soft toric contact + +227 +00:20:26,680 --> 00:20:33,540 +lenses لهذا الغرضين okay because + +228 +00:20:33,540 --> 00:20:38,420 +the thickness weight is not needed and would cause + +229 +00:20:38,420 --> 00:20:43,580 +patient awareness فيه قلة عيوب دائمًا أنا يما بلبس + +230 +00:20:43,580 --> 00:20:47,700 +عدسة بيكون من المنتصف فيه لها سماكة معينة والأطراف فيه لها سماكة معينة المريض ايش هيصير عنده + +231 +00:20:47,700 --> 00:20:51,640 +awareness إدراك بهذا الشيء فهيسبب للمريض excessive + +232 +00:20:51,640 --> 00:20:56,160 +awareness + +233 +00:20:56,160 --> 00:20:56,900 +awareness + +234 +00:21:02,960 --> 00:21:07,240 +يعني زيادة الإدراك في مين بالعدسة الصحية أو بوجود + +235 +00:21:07,240 --> 00:21:13,190 +العدسة الصحيحة طيب الآن ال manufacturer المصنعين كيف + +236 +00:21:13,190 --> 00:21:17,790 +اللي هو حاولوا أنه يتجاوزوا هذا ال drawback هذا + +237 +00:21:17,790 --> 00:21:20,850 +العيب أو هذا ال disadvantage أو هذا ال limitation + +238 +00:21:20,850 --> 00:21:27,550 +تمام؟ each manufacturer uses a method to eliminate + +239 +00:21:27,550 --> 00:21:32,230 +the extra unneeded thickness at the inferior edge + +240 +00:21:32,230 --> 00:21:39,020 +which also improves stability قال لكل الزيادة بتاعة + +241 +00:21:39,020 --> 00:21:43,120 +السماكة في الأطراف بدنا نعمل عملية إزالة لها + +242 +00:21:43,120 --> 00:21:48,580 +تمام؟ طبعًا هذه ايش بتعمل؟ بتحسن من عملية اللي هو + +243 +00:21:48,580 --> 00:21:53,840 +ثبات العدسة إذا each manufacturer هدول المصنعين + +244 +00:21:53,840 --> 00:21:58,720 +استخدموا اللي هو طريقة أو method معين to eliminate + +245 +00:21:58,720 --> 00:22:03,820 +لا إزالة the extra unneeded thickness كل اللي هي + +246 +00:22:03,820 --> 00:22:08,080 +السماكة الغير مطلوبة أو الزائدة وين في الـ inferior + +247 +00:22:08,080 --> 00:22:13,080 +edge في أطراف العدسة هذا الشيء بتعمل أنه بتحسن ال + +248 +00:22:13,080 --> 00:22:19,940 +stability لمن؟ للعدسة أيضًا هذا ال method بنسميه له + +249 +00:22:19,940 --> 00:22:24,560 +مسميات أخرى eccentric lenticulation أو بنسميه + +250 +00:22:24,560 --> 00:22:29,020 +comfort chamfer أو slap off إذا فيه له another + +251 +00:22:29,020 --> 00:22:34,020 +اللي هو name لطريقة اللي هو ال prism ballast + +252 +00:22:38,500 --> 00:22:43,590 +comfort chamfer لا هذا name of test Okay ال name of + +253 +00:22:43,590 --> 00:22:47,670 +test يعني مش شرط أنه أنه الكلمة تعبر عن اللي هو + +254 +00:22:47,670 --> 00:22:51,430 +ايه المفهوم يعني دائمًا هو ال manufacturer يما + +255 +00:22:51,430 --> 00:22:56,050 +بيعمل design معين هو بيحاول أنه ايش يروج له صح ولا + +256 +00:22:56,050 --> 00:23:00,270 +لا وأن كان له drawback بعدين دائمًا يا جماعة ال + +257 +00:23:00,270 --> 00:23:04,770 +drawback ما بيجيش أول ما بيصنع العدسة صح ولا لا بعد + +258 +00:23:04,770 --> 00:23:08,510 +ما المستخدمين بيستخدموه بعد ذلك بيبين اللي هو ال + +259 +00:23:08,510 --> 00:23:15,140 +drawback أو المشاكل لهذا ال design Okay All lens + +260 +00:23:15,140 --> 00:23:20,200 +designs have unique ballast zones that determine + +261 +00:23:20,200 --> 00:23:21,200 +the stability + +262 +00:23:46,730 --> 00:23:51,410 +طيب الآن يما شافوا ال drawback هذا راحوا زودوا من + +263 +00:23:51,410 --> 00:23:56,630 +ايش؟ من نحافة اللي هو العدسة في الأطراف تمام؟ يما + +264 +00:23:56,630 --> 00:24:00,790 +زودوا يعني يما شافوا أنه في drawback أنه في اختلاف + +265 +00:24:00,790 --> 00:24:04,090 +ما بين اللي هو ال thickness في المنتصف وال + +266 +00:24:04,090 --> 00:24:08,290 +thickness في الأطراف جالك أنا بزيد في المنتصف لكن + +267 +00:24:08,290 --> 00:24:11,950 +ايش؟ بقلل اللي هو السماكة وين؟ في الأطراف عشان + +268 +00:24:11,950 --> 00:24:18,010 +أريح المريض ايه؟ أكثر إذا this thinner edge around + +269 +00:24:18,010 --> 00:24:21,610 +the entire limbs increases the comfort level for + +270 +00:24:21,610 --> 00:24:24,970 +the patient إذا هذه بتزود الراحة عند المريض + +271 +00:24:28,020 --> 00:24:32,280 +طبعًا وأنتم الدليل على ذلك أن ليش العدسة ال RGB + +272 +00:24:32,280 --> 00:24:37,540 +دائمًا بيكون ال small diameter لها عشان ما يصيرش + +273 +00:24:37,540 --> 00:24:42,020 +اللي هو hard irritation ما بين أطراف العدسة وال + +274 +00:24:42,020 --> 00:24:46,300 +upper وال lower eyelid عشان هيك احنا دائمًا بنخلي + +275 +00:24:46,300 --> 00:24:52,020 +اللي هو small diameter the prism ballast is used for + +276 +00:24:52,020 --> 00:24:55,960 +both front and back surface toric designs إذا + +277 +00:24:55,960 --> 00:24:59,840 +بيستخدم لها ال front وال back surface contact + +278 +00:24:59,840 --> 00:25:04,300 +lens Typically a marker is placed at the inferior + +279 +00:25:04,300 --> 00:25:07,460 +or 6 o'clock position of the toric lens + +280 +00:25:07,460 --> 00:25:10,200 +indicating the base of the prism + +281 +00:25:13,280 --> 00:25:17,340 +في اللي هو منطقة بنسميها اللي هي ال six position + +282 +00:25:17,340 --> 00:25:22,500 +الساعة ستة هذه بيكون فيها مصدر أثقل أو ال Prism + +283 +00:25:22,500 --> 00:25:31,640 +Palace تمام؟ طيب + +284 +00:25:31,640 --> 00:25:37,300 +في عندنا ال Prism Palace advantages طبعا هذا من + +285 +00:25:37,300 --> 00:25:44,150 +وجهة نظر مين؟ ال manufacturer المصنعين لها Number + +286 +00:25:44,150 --> 00:25:48,950 +one أنه بيزود ال stability زيادة ال stability هو + +287 +00:25:48,950 --> 00:25:54,070 +هذا الغرض لإجراء ايش هيك design صح ولا لا اتنين + +288 +00:25:54,070 --> 00:25:57,970 +the cylinder power increases طب ليش هو بيزود قيمة + +289 +00:25:57,970 --> 00:26:04,410 +ال cylinder power ركزوا + +290 +00:26:04,410 --> 00:26:11,890 +كويس إذا the cylinder power increases ليش + +291 +00:26:11,890 --> 00:26:13,290 +هو بيزود القوة + +292 +00:26:20,410 --> 00:26:25,110 +ببساطة الذي هو نتيجة زيادة ال thickness يعني هان + +293 +00:26:25,110 --> 00:26:28,810 +زاد اللي هو من قيمة ال power لأن ببساطة ال + +294 +00:26:28,810 --> 00:26:33,330 +thickness زادت في المنتصف صح ولا لأ فممكن انه يغير + +295 +00:26:33,330 --> 00:26:38,640 +في قوة الـ cylinder ايه قصدك يعني تمام القوة + +296 +00:26:38,640 --> 00:26:43,540 +الكبيرة في الـ cylinder دائما أنا ما بدء ألبس مريض soft + +297 +00:26:43,540 --> 00:26:47,220 +rigid contact lenses وين هتكون ال majority power + +298 +00:26:47,220 --> 00:26:50,980 +إله؟ في الـ cylinder يعني معقولة minus 3 أو minus نص + +299 +00:26:50,980 --> 00:26:54,400 +ألبسه soft rigid لأ ليش؟ أنه قيمة اللي هو الـ cylinder + +300 +00:26:54,400 --> 00:27:02,490 +lens أقل من 25% مقارنة في مين؟ في الـ sphere power طيب + +301 +00:27:02,490 --> 00:27:06,770 +بالنسبة لل disadvantages العيوب إلها vertical + +302 +00:27:06,770 --> 00:27:12,470 +imbalance that may occur if only one eye needs a + +303 +00:27:12,470 --> 00:27:16,470 +torque lens كيف؟ يعني الآن أنا لابس فقط في العين + +304 +00:27:16,470 --> 00:27:21,570 +الـ right عدسة لاصقة و مستخدم اللي هو prism palace + +305 +00:27:21,570 --> 00:27:25,990 +و العين التانية مافيش فيها عدسة فهيكون كل مصدر + +306 +00:27:25,990 --> 00:27:30,230 +الثقة الوين؟ على area معينة أو zone معين فبالتالي + +307 +00:27:30,230 --> 00:27:34,490 +هيعمل vertical imbalance يعني الصورة هتكون غير + +308 +00:27:34,490 --> 00:27:39,930 +متوازنة أو غير ملائمة أو غير مناسبة بالنسبة للمريض + +309 +00:27:41,650 --> 00:27:46,130 +الآن أنا مثلا عندي قيمة الـ refractive error في one + +310 +00:27:46,130 --> 00:27:50,290 +eye و الـ another eye normal تمام؟ الآن كل مصدر + +311 +00:27:50,290 --> 00:27:54,030 +الثقة ال one هيكون في area معينة أو zone معين + +312 +00:27:54,030 --> 00:27:57,930 +فبالتالي هيعمل اختلاف في الرؤية ما بين الـ right و + +313 +00:27:57,930 --> 00:28:01,930 +الـ left eye اه + +314 +00:28:01,930 --> 00:28:06,950 +في one eye تمام؟ مش في بعض الحالات ممكن أدي له يعني + +315 +00:28:06,950 --> 00:28:13,160 +molecular اللي هو تكون soft contact lens طيب عندنا + +316 +00:28:13,160 --> 00:28:16,480 +بالنسبة لـ الـ figure هذا بس بدنا نضيف اللي هو الـ + +317 +00:28:16,480 --> 00:28:21,480 +name له طبعا دائما أنا في حالة العدسة الـ software + +318 +00:28:21,480 --> 00:28:26,760 +الـ contact lenses بنظر للمنطقة هذه تمام المنطقة + +319 +00:28:26,760 --> 00:28:33,620 +هذه بتعبر عن anterior eccentric lenticulation يعني + +320 +00:28:33,620 --> 00:28:38,460 +إنتوا ملاحظين هل هذا هو centric متمركز بشكل جيد؟ لأ + +321 +00:28:38,460 --> 00:28:43,830 +eccentric تمام الجماعة يفهموا وبعدين يكتبوا أنا + +322 +00:28:43,830 --> 00:28:47,750 +بديكم الـ slides تمام؟ إذا في عندنا anterior + +323 +00:28:47,750 --> 00:28:52,650 +eccentric lenticulation يعني الشكل غير منتظم أو + +324 +00:28:52,650 --> 00:28:58,050 +غير متمركز بشكل صحيح هذا إيش هيعمل؟ هيقلل من الـ + +325 +00:28:58,050 --> 00:29:03,910 +mass من كتلة العدسة و الأطراف إيش هيعمل فيها؟ + +326 +00:29:03,910 --> 00:29:08,610 +بالضبط إذا هيزود اللي هو هذا الـ version الأول إذا + +327 +00:29:08,610 --> 00:29:13,590 +هيزود اللي هو من سماكة العدسة في الأطراف هذا عبارة + +328 +00:29:13,590 --> 00:29:17,590 +عن الـ version الأول أو يعني بمعنى اللي هو النوع + +329 +00:29:17,590 --> 00:29:21,650 +الأول من هذا النوع من العدسات زودوا السماكة فيه + +330 +00:29:21,650 --> 00:29:27,450 +اللي هو وين؟ الأطراف طيب + +331 +00:29:27,450 --> 00:29:34,190 +أيضا عندنا النوع نفس النوع اللي هو ملاحظين ان هنا + +332 +00:29:34,190 --> 00:29:39,250 +في عندنا front و back surface هي في اللي هو طالع + +333 +00:29:39,250 --> 00:29:44,570 +على منطقة ال two dash هدول الشحاتين تمام الـ Prism + +334 +00:29:44,570 --> 00:29:48,230 +palest adds thickness to the inferior edge + +335 +00:29:51,400 --> 00:29:55,100 +uniform thickness around the lens بمعنى آخر أنا + +336 +00:29:55,100 --> 00:29:59,220 +عندي منطقة الـ back surface سميكة و الـ front + +337 +00:29:59,220 --> 00:30:03,340 +surface كانت اللي هو thin إيش الحل في ذلك؟ بروح + +338 +00:30:03,340 --> 00:30:06,860 +بزود السماكة في الـ front surface عشان التنتين + +339 +00:30:06,860 --> 00:30:11,740 +يصيروا إيش؟ uniform اللي هو يعني symmetric متماثلين + +340 +00:30:11,740 --> 00:30:17,850 +مرة ثانية في الشكل الثاني أنا في عندي منطقة اللي هي + +341 +00:30:17,850 --> 00:30:22,190 +الـ back surface كانت سميكة والـ front surface كانت + +342 +00:30:22,190 --> 00:30:27,090 +اللي هو thin راح أزود السماكة في الـ front surface + +343 +00:30:27,090 --> 00:30:31,210 +تمام اللي هو في الـ inferior يعني الـ front surface + +344 +00:30:31,210 --> 00:30:35,890 +أقصد فيها المنطقة العلوية عشان يصير كله ايه؟ uniform + +345 +00:30:35,890 --> 00:30:41,850 +أو symmetric متماثلين hand eccentric lenticular zone + +346 +00:30:43,910 --> 00:30:49,350 +على السطح الأمامي، يساعد في إعادة تصميم الـ Edge + +347 +00:30:49,350 --> 00:30:54,070 +نفس الفكرة أنه أنا ليش رحت زودت السماكة في + +348 +00:30:54,070 --> 00:30:57,170 +المنطقة العلوية لأطراف العدسة؟ + +349 +00:31:14,300 --> 00:31:18,980 +ما فيش توازن بينهم فراح أزود الـ thickness من الطرف + +350 +00:31:18,980 --> 00:31:22,600 +اللي هو الـ inferior و الـ superior عشان أنه يمنع الـ + +351 +00:31:22,600 --> 00:31:24,940 +rotation لمن؟ للعدسة + +352 +00:31:30,290 --> 00:31:36,710 +الـ Dynamic Stabilization هذه الطريقة يعني بمعنى + +353 +00:31:36,710 --> 00:31:41,710 +آخر الـ Prism palest يا جماعة روحنا عملنا marker + +354 +00:31:41,710 --> 00:31:47,950 +للعدسة في الساعة ستة الماركر هذا يعني بالطريقة هذه + +355 +00:31:47,950 --> 00:31:52,270 +عمل اللي هو أو منع الـ rotation للعدسة أو خلينا + +356 +00:31:52,270 --> 00:31:56,870 +نقول قلل من الـ rotation للعدسة و زود اللي هو موضوع + +357 +00:31:56,870 --> 00:32:01,250 +الـ stability تمام؟ فيه لها another name زي مثلا + +358 +00:32:01,490 --> 00:32:05,710 +الـ comfort shaper أو في عندنا الـ slab of أو الـ + +359 +00:32:05,710 --> 00:32:09,290 +integration هذه كلها تعتبر another name لمين؟ + +360 +00:32:09,290 --> 00:32:16,110 +لموضوع الـ Prism Palace طبعا هي الطريقة الأولى أنه + +361 +00:32:16,110 --> 00:32:21,050 +زود سماكة في منطقة و المنطقة الثانية إيش اللي هو + +362 +00:32:21,050 --> 00:32:27,570 +خلالها thin طيب الـ dynamic stabilization أو بنسميها + +363 +00:32:27,570 --> 00:32:39,730 +الـ thin zone من اسمه إيش بتتوقعه؟ إذا المناطق + +364 +00:32:39,730 --> 00:32:46,710 +هتكون اللي هو عبارة عن thin كيف؟ طيب؟ + +365 +00:32:58,750 --> 00:33:03,970 +ببساطة بيروح و بيعمل عملية تنحيف لـ الـ superior و + +366 +00:33:03,970 --> 00:33:08,230 +الـ inferior part which enhance هذه بتعمل عملية تحسين + +367 +00:33:08,230 --> 00:33:12,800 +الراحة للمرضى دائما المريض لما بلبس slim limbs + +368 +00:33:12,800 --> 00:33:16,580 +بتلاقي أنه إيش؟ أنه more comfortable أكثر اللي هو + +369 +00:33:16,580 --> 00:33:20,520 +راحة بالنسبة له، ليش؟ لأنه بسهولة بتاخد اللي هو + +370 +00:33:20,520 --> 00:33:24,840 +conform to the shape of the cornea، إذا also + +371 +00:33:24,840 --> 00:33:29,440 +enhances بمعنى اللي هو تحسين، يعني بتعمل improve، + +372 +00:33:29,440 --> 00:33:30,960 +اللي هو تحسين للراحة + +373 +00:33:42,770 --> 00:33:47,490 +9 o'clock positions so that rotation can be + +374 +00:33:47,490 --> 00:33:52,170 +measured في العدسة هذه أو في الطريقة هذه اللي هي + +375 +00:33:52,170 --> 00:33:56,770 +الـ dynamic stabilization بيعمل الـ marker وين؟ + +376 +00:33:56,770 --> 00:34:03,330 +في الـ three و nine o'clock تمام ذكرتكم في موضوع إيش؟ الـ + +377 +00:34:03,330 --> 00:34:06,870 +RGB بتعمل إيش؟ لكن الـ three nine o'clock staining + +378 +00:34:06,870 --> 00:34:10,990 +تمام؟ اللي هي لأنه واحدة من الـ disadvantages هذا + +379 +00:34:10,990 --> 00:34:15,830 +النوع من العدسات لكن هان بعمل الـ marker الـ three و + +380 +00:34:15,830 --> 00:34:19,890 +nine o'clock ولكن المنطقة إيش هتكون؟ thinnest نحيفة + +381 +00:34:23,520 --> 00:34:28,300 +طبعا أي ماركر في داخل العدسة وأنا بقدر أشوفه من + +382 +00:34:28,300 --> 00:34:32,880 +خلال الـ slit lamp هذا بيسهل في عملية تحديد قيمة الـ + +383 +00:34:32,880 --> 00:34:38,200 +angle الزاوية تمام أو بيحدد بصورة أخرى اللي هو + +384 +00:34:38,200 --> 00:34:43,710 +rotation اللي هو الدوران لمين؟ للعدسة لذلك العدسات + +385 +00:34:43,710 --> 00:34:47,950 +الحديثة قلنا الـ stability فيها أعلى ولكن في لها + +386 +00:34:47,950 --> 00:34:51,410 +drawback إيش؟ إن الـ marker مش موجود، يعني بدي أنا + +387 +00:34:51,410 --> 00:34:54,450 +أقيم اللي هو ايه؟ بحد ذاته + +388 +00:35:04,530 --> 00:35:08,450 +في الـ prism palace أو في المثال اللي هو بتاع الـ + +389 +00:35:08,450 --> 00:35:11,850 +water melon الـ principle كنا وين اللي هو الـ marker + +390 +00:35:11,850 --> 00:35:15,770 +نحطه في المنطقة اللي هو الـ thickest لكن هان إيش + +391 +00:35:15,770 --> 00:35:23,710 +عندنا؟ التنتين اللي هو thinnest طيب + +392 +00:35:23,710 --> 00:35:31,330 +الآن الـ figure هذا إيش بيمثل لكم؟ ممتازة أول حاجة + +393 +00:35:31,330 --> 00:35:39,340 +عندنا موضوع الـ three و الـ nine و clock صح ولا لا؟ + +394 +00:35:39,340 --> 00:35:44,220 +طيب عندنا الـ three dash هدول أو اللي هو الـ sign + +395 +00:35:44,220 --> 00:35:49,320 +الإشارة هذه بتمثل إيش؟ + +396 +00:35:49,320 --> 00:35:55,580 +هذه عبارة عن الـ marker تمام؟ + +397 +00:35:55,580 --> 00:36:03,300 +يعني في عندنا three markers وين؟ في داخل العدسة + +398 +00:36:07,290 --> 00:36:13,010 +إن الـ one hour إيش بيساوي؟ تلاتين degrees صح ولا + +399 +00:36:13,010 --> 00:36:20,690 +لأ طيب الآن كل dash هذه بتمثل ten degree كل واحدة + +400 +00:36:20,690 --> 00:36:27,990 +هذه بتمثل ten degree إذا الـ three إيش بيمثلها؟ 30 + +401 +00:36:27,990 --> 00:36:33,750 +degrees يعني عبارة عن ايه؟ one hour تمام؟ إذا ممكن + +402 +00:36:33,750 --> 00:36:37,330 +أجيب لك figure و أقول لك اشرحي عليها إذا عندنا سهل + +403 +00:36:37,330 --> 00:36:41,770 +جدا هذه بتمثل أول حاجة الـ method إيش هو؟ dynamic + +404 +00:36:41,770 --> 00:36:45,770 +stabilization الـ dynamic stabilization في عندنا + +405 +00:36:45,770 --> 00:36:49,190 +three nine o'clock كل اللي هو dash بتمثل ten + +406 +00:36:49,190 --> 00:36:52,410 +degree الـ three بيمثلوا قداش؟ one hour اللي هي + +407 +00:36:52,410 --> 00:36:53,570 +thirty degrees + +408 +00:37:03,700 --> 00:37:07,220 +وكان يعمل update وحطها في thickest area يعني الآن + +409 +00:37:07,220 --> 00:37:12,460 +مرة أخرى يما هو زود ال graffiti لموضوع الـ prism + +410 +00:37:12,460 --> 00:37:16,400 +palace راحوا طلبوا أنه يحط الـ marker في thickest + +411 +00:37:16,400 --> 00:37:21,380 +area لكن هي كلها هذه الهو under review يعني تحت + +412 +00:37:21,380 --> 00:37:25,700 +الدراسة ما زالت يعني يا جماعة يما شاف أنه نعم + +413 +00:37:28,290 --> 00:37:32,590 +اه هذه في الجيل الأول لكن الجيل الثاني يما شاف أنه + +414 +00:37:32,590 --> 00:37:35,690 +التأثير اللي هو مش كبير يما حط على thinnest area + +415 +00:37:35,690 --> 00:37:41,070 +اضطر أنه يحطها على thickest zone يعني بمعنى اللي + +416 +00:37:41,070 --> 00:37:45,410 +هو update للجيل الأول من هذا النوع من العدسات + +417 +00:37:50,950 --> 00:37:56,370 +طيب بالنسبة لـ الـ dynamic stabilization advantages + +418 +00:37:56,370 --> 00:38:01,550 +المميزات اللي خاصة فيها طبعا ليش هي أريح من الـ + +419 +00:38:01,550 --> 00:38:08,850 +prison palace؟ بالضبط لأن الـ dynamic stabilization + +420 +00:38:08,850 --> 00:38:13,290 +المنطقتين هتكون thinnest zone لكن هناك هتكون منطقة + +421 +00:38:13,290 --> 00:38:15,030 +thick ومنطقة thin + +422 +00:38:22,810 --> 00:38:27,150 +الجيل الأول من ال prison palace راح حط اللي هو + +423 +00:38:27,150 --> 00:38:31,870 +منطقة الثقة اللي كلها في ال thin zone area أنتم + +424 +00:38:31,870 --> 00:38:36,350 +ممكنش ماخدين بالكم تمام؟ واحدة واحدة في السن في + +425 +00:38:36,350 --> 00:38:41,590 +المرحلة الأولى حطها في السن zone area لما حطوها في + +426 +00:38:41,590 --> 00:38:46,530 +السن zone area لاحظوا أن في هناك awareness إدراك + +427 +00:38:46,530 --> 00:38:51,970 +كبير من المريض تمام؟ راحوا عملوا عملية تبديل لها + +428 +00:38:51,970 --> 00:38:55,890 +جالك بدل ما نحطها في السن نحطها في ال sick برضه + +429 +00:38:55,890 --> 00:39:01,170 +لاحظوا أن في ايش؟ أن في اللي هو awareness إدراك من + +430 +00:39:01,170 --> 00:39:06,320 +قبل المريض فقال لك أفضل حاجة أن نعمل thin zone area + +431 +00:39:06,320 --> 00:39:10,220 +في اللي هو ال superior و ال inferior اللي هي مثل + +432 +00:39:10,220 --> 00:39:14,340 +من ال dynamic stabilization + +433 +00:39:17,100 --> 00:39:20,120 +يعني المراحل بالشكل هذا يعني الآن هو ال + +434 +00:39:20,120 --> 00:39:24,300 +manufacturer بعمل اللي هو التصميم وبيشوف رد فعل العين + +435 +00:39:24,300 --> 00:39:28,340 +ال patients كيف اللي هو ال awareness بتاعهم فإنها + +436 +00:39:28,340 --> 00:39:32,360 +في المنطقة هذه يعني أنتم لاحظين حتى ال marker area + +437 +00:39:32,360 --> 00:39:36,760 +راح رفعة من ال 6 o'clock وانخلاها في ال 39 ليش؟ + +438 +00:39:36,760 --> 00:39:43,800 +لأن المنطقة هذه أقل تأثير تمام؟ طيب، الآن في الـ + +439 +00:39:43,800 --> 00:39:49,420 +dynamic stabilization، تمام؟ احنا بنعرف أنه زود ال + +440 +00:39:49,420 --> 00:39:52,840 +comfort الراحة، البساطة زادت ال comfort لأن + +441 +00:39:52,840 --> 00:39:58,570 +المنطقتين صارت اللي هو thin zones، تمام؟ Number + +442 +00:39:58,570 --> 00:40:02,970 +two, lack of induced, the prismatic effect دائما + +443 +00:40:02,970 --> 00:40:05,890 +الprismatic effect وين بيكون تأثيره أكثر؟ في ال + +444 +00:40:05,890 --> 00:40:08,930 +vertical ولا ال horizontal؟ في ال vertical عشان هي + +445 +00:40:08,930 --> 00:40:13,670 +قلنا ايش بيعمل vertical imbalance هان صح فيه تأثير + +446 +00:40:13,670 --> 00:40:18,950 +ولكن لو قارناه في ال vertical هيكون ايه؟ أعلى تمام؟ + +447 +00:40:21,170 --> 00:40:25,390 +نشوف الـ Dynamic Stabilization لها الـ + +448 +00:40:25,390 --> 00:40:29,170 +disadvantages اللي هو موضوع الـ with the rule في + +449 +00:40:29,170 --> 00:40:32,570 +ال with the rule حيكون عندنا ايه؟ ال vertical + +450 +00:40:32,570 --> 00:40:36,090 +meridian steeper than ال horizontal meridian يما + +451 +00:40:36,090 --> 00:40:39,970 +اعمل اللي هو ال three nine o'clock بالساعة تلاتة + +452 +00:40:39,970 --> 00:40:46,170 +وتسعة حيكون اللي هو ايه؟ هيعمل اللي هو ده، هيعمل + +453 +00:40:46,170 --> 00:40:49,590 +اللي هو movement للعدسة، الجماعة تخيلوها معاه، + +454 +00:40:49,590 --> 00:40:53,570 +الآن احنا عملنا ال three nine o'clock، تمام؟ + +455 +00:40:53,570 --> 00:40:59,650 +المريض عنده ايه؟ الساعة اتناشر ستة هي ال stable، + +456 +00:40:59,650 --> 00:41:04,230 +فهتلاحظي انه هيصير في العدسة de-centration، إزاحة، + +457 +00:41:04,230 --> 00:41:07,710 +يعني ما هيكون فيه هناك اللي هو التمركز جيد، طبعا + +458 +00:41:07,710 --> 00:41:11,690 +في ال against درون، العكس، هتكون هي ال best + +459 +00:41:11,690 --> 00:41:13,430 +option، تمام؟ + +460 +00:41:16,830 --> 00:41:20,110 +طيب خليني أقف إن شاء الله ل ال ISO thickness + +461 +00:41:20,110 --> 00:41:27,750 +profile في أي سؤال؟ طيب انخص المحاضرة بشكل مبسط + +462 +00:41:27,750 --> 00:41:34,910 +الآن بالنسبة لل design لل software contact lenses + +463 +00:41:34,910 --> 00:41:41,460 +دخلت بعدة مراحل المرحلة الأولى تمثلت بالـ Prism + +464 +00:41:41,460 --> 00:41:47,300 +Palace تمام؟ بتعتمد على زيادة ال thickness في + +465 +00:41:47,300 --> 00:41:52,780 +منطقة مقارنة في المنطقة الأخرى في الجيل الأول من + +466 +00:41:52,780 --> 00:41:57,900 +هذه العدسات وين وضعوا اللي هو السماكة أو وين وضعوا + +467 +00:41:57,900 --> 00:42:01,540 +اللي هو ال prism لأن ايش هي ال marker عبارة عن ال + +468 +00:42:01,540 --> 00:42:05,660 +prism صح ولا لا وضعوه يا جماعة في المرحلة الأولى + +469 +00:42:05,660 --> 00:42:09,400 +في اللي هو .. لأ في أي منطقة اللي هو بال center + +470 +00:42:09,400 --> 00:42:14,040 +تمام فلاحظوا أن ال awareness ده المريض عالي كثير + +471 +00:42:14,040 --> 00:42:19,040 +عملوا اللي هو second generation جيل ثاني من + +472 +00:42:19,040 --> 00:42:25,930 +العدسات بحيث أن يكون منطقة اللي فيها ال marker area + +473 +00:42:25,930 --> 00:42:30,490 +هي المنطقة ال thin برضه لاحظوا أن ال awareness + +474 +00:42:30,490 --> 00:42:35,770 +عالي عند المريض فاكتشفوا أو اللي هو عملوا update + +475 +00:42:35,770 --> 00:42:40,330 +لموضوع ال prism palace بال dynamic stabilization + +476 +00:42:40,330 --> 00:42:45,110 +البساطة ال dynamic stabilization عمل marker في ال + +477 +00:42:45,110 --> 00:42:48,730 +three و ال nine o'clock وكل المنطقة صارت ايش؟ + +478 +00:42:48,730 --> 00:42:53,730 +thin zone تمام؟ هي بدها يعني عملية تخيل لأن هذا + +479 +00:42:53,730 --> 00:42:57,870 +عبارة عن ايه؟ Manufacture اللي هو تصنيع، الآن في + +480 +00:42:57,870 --> 00:43:01,610 +ال three nine o'clock لما عملوها لاحظوا أن ال + +481 +00:43:01,610 --> 00:43:06,130 +stability هيكون أكثر وإدراك المريض أقل بالعدسة، + +482 +00:43:06,130 --> 00:43:10,730 +لكن في لها disadvantages اللي هو في موضوع ايه؟ ال + +483 +00:43:10,730 --> 00:43:14,510 +with the rule of stigmatism أو حتى بال irregular + +484 +00:43:14,510 --> 00:43:20,700 +stigmatism بشكل عام في أي سؤال أي استفسار يعطيكم + +485 +00:43:20,700 --> 00:43:21,140 +العافية diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/KtVSKgJh5r4_postprocess.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/KtVSKgJh5r4_postprocess.srt new file mode 100644 index 0000000000000000000000000000000000000000..6968794d3542a16dcad67e5dd68aa43ef5dc39bf --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/KtVSKgJh5r4_postprocess.srt @@ -0,0 +1,1940 @@ +1 +00:00:21,020 --> 00:00:23,760 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:23,760 --> 00:00:26,960 +وبركاته and a very good morning to all of you + +3 +00:00:26,960 --> 00:00:31,100 +هنبدأ في موضوع أو نكمل في موضوع ال software + +4 +00:00:31,100 --> 00:00:36,980 +contact lenses عندنا في اختبار مهم كتير هو عبارة + +5 +00:00:36,980 --> 00:00:48,480 +عن ال twist test او بمعنى اخر ال rotation او + +6 +00:00:48,480 --> 00:00:49,340 +ال screw + +7 +00:00:54,950 --> 00:01:01,750 +بمعنى اختبار اللف أو دوران الـcylinder lens او + +8 +00:01:01,750 --> 00:01:07,870 +دوران او لف اللي هو من الفروبتور اذا the screw + +9 +00:01:07,870 --> 00:01:12,750 +test او ال rotation test او ال twist test is a + +10 +00:01:12,750 --> 00:01:17,210 +useful screening test for softorix يعني الآن بعد + +11 +00:01:17,210 --> 00:01:21,290 +ما انا بعمل evaluation للمريض من حيث ال subjective + +12 +00:01:21,290 --> 00:01:22,090 +refraction + +13 +00:01:26,310 --> 00:01:31,010 +أكد إن هذا الـ axis اللي المريض لابسه، هل هو صحيح + +14 +00:01:31,010 --> 00:01:35,770 +ولا لأ؟ هذه نقطة أولى، يعني مثلا المريض عنده minus + +15 +00:01:35,770 --> 00:01:37,110 +تلاتة + +16 +00:01:42,320 --> 00:01:46,880 +أول حاجة بدي اشوف ان العجز اللاصقة هل هي على axis + +17 +00:01:46,880 --> 00:01:52,220 +30 فعلا ولا لأ انه هل هذا صحيح النقطة التانية انه + +18 +00:01:52,220 --> 00:01:56,700 +بدي اشوف هل المريض عنده sensitivity عالية ولا لأ + +19 +00:01:59,950 --> 00:02:04,030 +it helps in determining patient tolerance يعني هذا + +20 +00:02:04,030 --> 00:02:08,830 +بالساعد في تحديد ما هو تقبل المريض tolerance بمعنى + +21 +00:02:08,830 --> 00:02:14,150 +accepted تقبل المريض for the lens rotation لدوران + +22 +00:02:14,150 --> 00:02:19,330 +العدسة commonly seen with torric lenses وهذا بيكون + +23 +00:02:19,330 --> 00:02:24,950 +أكتر شيوعا في العدسات ال soft torric lensesrotate + +24 +00:02:24,950 --> 00:02:29,310 +the best cylinder يعني الآن احنا نفترض على ال axis + +25 +00:02:29,310 --> 00:02:33,550 +30 روحت انا عملت rotation تدوير من خلال الفروبتر + +26 +00:02:33,550 --> 00:02:36,950 +او ال cylinder lens اللي انا وضعته في ال trial + +27 +00:02:36,950 --> 00:02:43,710 +frameإذا rotate the best cylinder in the phoropter + +28 +00:02:43,710 --> 00:02:48,770 +until it blare it's just noticeable يعني أنا بخلي + +29 +00:02:48,770 --> 00:02:52,990 +المريض يلف في ال cylinder lens أو أنا بلف في ال + +30 +00:02:52,990 --> 00:02:57,110 +phoropter لحد ما الصورة إيش صير غير واضحة، it + +31 +00:02:57,110 --> 00:03:02,240 +blare اللي هي غير واضحة، إذا مرة تانيةانا حطيت + +32 +00:03:02,240 --> 00:03:06,820 +اللي هو عدسة لاسقة في عين المريض minus 3 ع minus 1 + +33 +00:03:06,820 --> 00:03:14,100 +.5 X 30 بحطله عدسة مثلا ربع سيلندر تمام او مثلا + +34 +00:03:14,100 --> 00:03:16,900 +Jackson across cylinder اعملناها في معمل يوم + +35 +00:03:16,900 --> 00:03:21,600 +الأربعة او بجيب اذا كان عندي فروبتور بخلي المريض + +36 +00:03:21,600 --> 00:03:26,460 +يعمل rotation تدوير لحد ما الصورة تصبح غير واضحة + +37 +00:03:26,460 --> 00:03:32,500 +طيب ليش؟ الآن هنعرفYou may also ask the patient to + +38 +00:03:32,500 --> 00:03:37,440 +twist the axes down until they notice a decrease + +39 +00:03:37,440 --> 00:03:38,040 +in vision + +40 +00:03:47,120 --> 00:03:51,040 +If a response is elicited in less than five + +41 +00:03:51,040 --> 00:03:55,920 +degrees يعني بمعنى آخر إذا الاستجابة للمريض هذه + +42 +00:03:55,920 --> 00:04:01,260 +وجدت elicited بمعنى وجدت في أقل من خمسة degree + +43 +00:04:01,260 --> 00:04:06,140 +يعني الآن أنا مثلا المريض لف العجسة نفترض لسبع + +44 +00:04:06,140 --> 00:04:13,090 +وعشرين كده الفرق؟ تلاتة degreeبالضبط، إذا المريض + +45 +00:04:13,090 --> 00:04:17,110 +شعر إنه عنده السبعة و عشرين فيه اللي هو تأثير + +46 +00:04:17,110 --> 00:04:21,490 +كبير، معنى الكلام إن هذا المريض إيه؟ عنده high + +47 +00:04:21,490 --> 00:04:29,230 +sensitivityطيب مرة تانية الان minus 3 ع minus 1.5 + +48 +00:04:29,230 --> 00:04:34,270 +لما المريض عمل rotation ل ال trial frame عن 27 + +49 +00:04:34,270 --> 00:04:40,070 +اتأثر هو في الاصل جديش 30 اذا اقل من 5 degree هذا + +50 +00:04:40,070 --> 00:04:44,970 +بتديني انطباع ان المريض عنده high sensitivityطب + +51 +00:04:44,970 --> 00:04:48,990 +نفترض لو كان الفرج أكتر من خمسة، بيكون هذا طبيعي، + +52 +00:04:48,990 --> 00:04:52,850 +يعني للآن لو احنا بدنا نعمل اللي هو نضارة و طلع + +53 +00:04:52,850 --> 00:04:56,130 +الفرج أكتر من خمسة degree، المريض إيش هيقولك؟ + +54 +00:04:56,130 --> 00:05:00,210 +الرؤية مش واضحة و هتتغير عنده الرؤية، هيقولك مثلا + +55 +00:05:00,210 --> 00:05:09,440 +شايف الأرض إيش غير طبيعية، تمام؟إذا إذا إستجابة + +56 +00:05:09,440 --> 00:05:15,120 +وُجدت في أقل من خمسة ديجري، فهناك مستوى عالي من + +57 +00:05:15,120 --> 00:05:19,240 +حساسية + +58 +00:05:19,240 --> 00:05:23,980 +عالية كثير.طيب في هذه الحالة إيش بدنا نتجه؟ باتجاه + +59 +00:05:23,980 --> 00:05:34,480 +مين؟ ال جي بي لينزإذا المريض + +60 +00:05:34,480 --> 00:05:39,820 +عندما يكون عنده مرتبط عالي لازم انا اروح باتجاه + +61 +00:05:39,820 --> 00:05:45,300 +مين ال RGB contact lens لأن ال RGB contact lens + +62 +00:05:45,300 --> 00:05:52,800 +مافيش فيها ال axis على العدسة فبالتالي ما بسبب + +63 +00:05:52,800 --> 00:05:58,830 +الموضوع ال rotationطيب لو المريض مصمم انه يلبس + +64 +00:05:58,830 --> 00:06:02,290 +عدسة soft trick contact lenses ومش قادر يعمل + +65 +00:06:02,290 --> 00:06:06,630 +adaptation مع ال RGB ايش بدنا نعمل؟ if a soft + +66 +00:06:06,630 --> 00:06:11,190 +trick is necessary يعني المريض عنده motivation فقط + +67 +00:06:11,190 --> 00:06:17,570 +لارتداء ال soft trick except more trials and the + +68 +00:06:17,570 --> 00:06:19,690 +need for a lens design + +69 +00:06:25,610 --> 00:06:30,730 +هذا المريض بدي أعمله trial أكتر من مرة لحد ما أصل + +70 +00:06:30,730 --> 00:06:35,190 +لأفضل access لهذا المريض يعني لأفضل access لمن؟ + +71 +00:06:35,190 --> 00:06:39,630 +للعدسة اللي هي ال software نما اتنين بدي استخدم + +72 +00:06:39,630 --> 00:06:44,550 +اللي هو design تصميم للعدسة ان يكون هذا التصميم في + +73 +00:06:44,550 --> 00:06:49,550 +أقل اللي هو rotation و أكتر اللي هو stability واضح + +74 +00:06:49,550 --> 00:06:55,110 +الفكرة؟اذا الان لو سألنا سؤال اش المقصود بال twist + +75 +00:06:55,110 --> 00:06:58,930 +test؟ اه يا داليا اش المقصود في ال twist test؟ + +76 +00:07:01,400 --> 00:07:05,620 +اللي هو ال rotation test تمام يعني انا بدى اخلى + +77 +00:07:05,620 --> 00:07:10,000 +المريض يعمل rotation بال cylinder lens او فيلبس + +78 +00:07:10,000 --> 00:07:14,620 +فوربتر لحد ما تصبح الرؤية ايه غير واضحة بدى اشوف + +79 +00:07:14,620 --> 00:07:18,100 +قداش هذا المريض عنده sensitivity هل هي high ولا + +80 +00:07:18,100 --> 00:07:21,820 +low اذا كانت اقل من خمسة degree معناه الكلام انه + +81 +00:07:21,820 --> 00:07:25,180 +عنده high level of sensitivity اذا كانت اكتر من + +82 +00:07:25,180 --> 00:07:28,700 +خمسة degree بده يكون عنده low level of sensitivity + +83 +00:07:29,410 --> 00:07:33,270 +بالتالي اذا بدي اعرف مين ال best choice لمين + +84 +00:07:33,270 --> 00:07:38,690 +للمريض طيب + +85 +00:07:38,690 --> 00:07:44,630 +عندنا الان software lens design يعني تصميم هذا + +86 +00:07:44,630 --> 00:07:46,850 +النوع من العدسات ال software + +87 +00:07:52,230 --> 00:07:56,470 +They differ from spherical lenses، إذا تصميم + +88 +00:07:56,470 --> 00:08:00,630 +العدسات الـ Soft-Rig هيختلف عن مين؟ عن الـ + +89 +00:08:00,630 --> 00:08:04,830 +Spherical Soft Contact Lenses تمام؟ ليش؟ لأنه + +90 +00:08:04,830 --> 00:08:08,950 +هيكون في إلها front و back surface و هتعمل على + +91 +00:08:08,950 --> 00:08:13,310 +تصحيح مين قيمة الastigmatism إذا كانت موجودة في ال + +92 +00:08:13,310 --> 00:08:18,010 +front أو كانت موجودة بال back surface إذا they + +93 +00:08:18,010 --> 00:08:20,430 +differ from spherical lenses + +94 +00:08:29,290 --> 00:08:36,100 +إذا أول حاجة هي بتعتمد على قيمة السيلندريعني قداش + +95 +00:08:36,100 --> 00:08:40,440 +قيمة السلندر بالنسبة لمن يا جماعة للاسفير هذه واحد + +96 +00:08:40,440 --> 00:08:45,840 +بعد ما اعتمدت على قيمة السلندر بده اشوف ان هل هذا + +97 +00:08:45,840 --> 00:08:49,200 +السلندر في ال front ولا ال back surface اي number + +98 +00:08:49,200 --> 00:09:00,000 +two اذا number one determine the + +99 +00:09:00,000 --> 00:09:04,820 +amount of + +100 +00:09:07,970 --> 00:09:14,170 +سيلندر لينز إذا number one بدنا نحدد قيمة اللي هو + +101 +00:09:14,170 --> 00:09:18,430 +السيلندر اللي موجود عند المريض اتنين بدنا نحدد + +102 +00:09:18,430 --> 00:09:21,650 +وجود هذا السيلندر هل هو في ال front ولا ال back + +103 +00:09:21,650 --> 00:09:26,950 +surface تلاتة بدنا نحدد نوع ال stabilization يعني + +104 +00:09:26,950 --> 00:09:31,350 +هل المريض هذا عنده high level ofSensitivity ولا + +105 +00:09:31,350 --> 00:09:34,990 +low level of sensitivity؟ طبعا إذا كان عنده high + +106 +00:09:34,990 --> 00:09:39,290 +level of sensitivity معنى الكلام أنه بدي more + +107 +00:09:39,290 --> 00:09:43,810 +stability أكتر تبات لمن؟ للعدسة و أمنع أي ت + +108 +00:09:43,810 --> 00:09:46,570 +rotation للعدسة اللاصقة + +109 +00:09:50,220 --> 00:09:55,180 +The eyelids close in a temporal to nasal fashion, + +110 +00:09:56,080 --> 00:10:00,820 +producing the so-called zebra effect هان بمعنى + +111 +00:10:00,820 --> 00:10:05,300 +اللي هو طريقة الصحابة يعني الآن إحنا يما نلبس + +112 +00:10:05,300 --> 00:10:09,980 +المريض عدسة لاسقة، لاحظوا إن المريض دايما بيغلق + +113 +00:10:09,980 --> 00:10:14,620 +عينه من ال temporal to nasal هذه العملية إيش + +114 +00:10:14,620 --> 00:10:18,360 +بالساعد؟ يما يغلق من اللي هو ال temporal، طبعا هي + +115 +00:10:18,360 --> 00:10:24,150 +بتكون بشكل لحظيOkay يما بيغلق من ال temporal لال + +116 +00:10:24,150 --> 00:10:28,730 +nasal هذه بتعمل على لف شوية العدسة انه بتعمل + +117 +00:10:28,730 --> 00:10:34,010 +rotation لمين ل العدسة فهان انه في هذه الظاهرة + +118 +00:10:34,010 --> 00:10:38,850 +لازم انا ازود من قيمة مين ال stability عشان امنع + +119 +00:10:38,850 --> 00:10:43,670 +اللي هو ال rotation لمين ل العدسة اذا مرة اخرى + +120 +00:10:45,860 --> 00:10:51,180 +بمعنى طريقة السحاب او تأثير السحاب من خلاله المريض + +121 +00:10:51,180 --> 00:10:55,660 +بيغلق جفنه من ال temporal تنزل لمنع اللي هو اي + +122 +00:10:55,660 --> 00:10:59,480 +rotation لمن؟ للعدسة كيف؟ بدي ازود ال stability + +123 +00:10:59,480 --> 00:11:08,560 +يعني بمعنى انه امنع rotation للعدسة لأ + +124 +00:11:08,560 --> 00:11:13,620 +هو بيزود بيزود اللي هو ال rotationكيف انا بدي + +125 +00:11:13,620 --> 00:11:18,880 +امنعه؟ بدي اعمل الهو design انه امنع الهو مين + +126 +00:11:18,880 --> 00:11:23,420 +موضوع ال rotation تمام يا جماعة؟ يعني هذا القمر + +127 +00:11:23,420 --> 00:11:27,760 +بيزود ال rotation كيف بدي امنعه؟ بدي استخدم ال هو + +128 +00:11:27,760 --> 00:11:32,420 +prism او بدي استخدم مثلا طريقة ال truncation او اي + +129 +00:11:32,420 --> 00:11:38,920 +طريقة انه تمنع ال هو الدوران رسمها يمكن اوضح + +130 +00:11:38,920 --> 00:11:41,640 +هلجيت؟ هى مثلا العين + +131 +00:11:51,740 --> 00:11:57,920 +الان انا بدي امنع اللى هو دوران العدسة كيف بدي + +132 +00:11:57,920 --> 00:12:02,740 +اعمل؟ بدي اعمل مصدر ثقل للعدسة مصدر الثقل هذا + +133 +00:12:02,740 --> 00:12:06,790 +بيمنع اللى هو دوران العدسةأو في طريقة تانية مثلا + +134 +00:12:06,790 --> 00:12:10,590 +الـ truncation يعني هذه الظاهرة أو هذا التأثير + +135 +00:12:10,590 --> 00:12:15,830 +بيزود من مين؟ من دوران العدسة كيف بيمنعه؟ اللي هو + +136 +00:12:15,830 --> 00:12:20,610 +من خلال اللي هو ال stability يعني design معين أنه + +137 +00:12:20,610 --> 00:12:26,510 +يمنع ال stability، الآن هناخده مع بعضالصفتوريك + +138 +00:12:26,510 --> 00:12:31,850 +الأفضل سيكون لديه تحويل مينيمال و سيحافظ على موقع + +139 +00:12:31,850 --> 00:12:39,570 +مستمر يسمى بالمقاومة الآن أنا لما بده المريض ألبسه + +140 +00:12:39,570 --> 00:12:45,730 +عدسة لاصقة صفتوريك أهم شيء إيش أمنع؟ روتيشن العدسة + +141 +00:12:46,880 --> 00:12:51,400 +كيف انا ببدأ امنع روتيشن العدسة بدي اوفر design + +142 +00:12:51,400 --> 00:12:56,360 +مثالي لهذا المريض بيعمل على اللي هو ثابت العدسة في + +143 +00:12:56,360 --> 00:13:02,340 +داخل العين طبعا قد يكون في عنا اكتر من design مثل + +144 +00:13:02,340 --> 00:13:06,180 +ال prison palace او مثلا ال truncation او ال ISO + +145 +00:13:06,180 --> 00:13:10,810 +horizontal اكتر من اللي هو طريقةطيب في عملية ال + +146 +00:13:10,810 --> 00:13:14,950 +stability أفضل حاجة أنه لازم العدسة وان تكون ماخدة + +147 +00:13:14,950 --> 00:13:19,010 +ال concentration تمركز جيد يعني زيادة اللي هو + +148 +00:13:19,010 --> 00:13:23,750 +تمركز العدسة بشكل صحيح هذا هيمنع من ال rotation + +149 +00:13:23,750 --> 00:13:28,070 +للعدسة و هيوفر ليه اللي هو stability ملائم أو + +150 +00:13:28,070 --> 00:13:30,290 +مناسب للعدسة + +151 +00:13:39,770 --> 00:13:44,570 +Okay سؤال مهم دايما انا اما بمسك عدسة software + +152 +00:13:44,570 --> 00:13:48,370 +contact lens العدسة بيكون يمكن شفتوها معظمكم + +153 +00:13:52,050 --> 00:13:58,170 +أكسس تلاتين يعني العدسة مصممة هذه أو من الشركة هم + +154 +00:13:58,170 --> 00:14:01,790 +عاملين ال prescription الوصوى لها على اكسس تلاتين + +155 +00:14:01,790 --> 00:14:06,110 +زي الآن عفوا انت لما تنظفي اللي هو العدسات لإيمان + +156 +00:14:06,110 --> 00:14:10,230 +تعمليه اللي هو cleaning هل بتغير ال access لأ ليش + +157 +00:14:10,230 --> 00:14:14,410 +لأنه مافيش اي rotation ونفس الحاجة في العدسات اللي + +158 +00:14:14,410 --> 00:14:18,600 +هو ال software بيكون هناك فيه markerطبعا احنا قلنا + +159 +00:14:18,600 --> 00:14:22,840 +انه صار لها update جديد ورفعه اللي هو موضوع من ال + +160 +00:14:22,840 --> 00:14:28,580 +marker فعملية تنظيف العدسة لا يمكن انه ايش يغير من + +161 +00:14:28,580 --> 00:14:33,180 +قيمة ال access الا مع الزمن يعني كل اللي هو متقدم + +162 +00:14:33,180 --> 00:14:37,960 +العدسة في عملية التنظيف ممكن انه يعمل اللي هو + +163 +00:14:37,960 --> 00:14:42,340 +تغيير لاللي هو ال access اللي خاص بالعدسة او يزود + +164 +00:14:42,340 --> 00:14:44,960 +من قيمة ال scratch تمام؟ + +165 +00:14:48,420 --> 00:14:54,370 +Predicting بمعنى اكتشافأو اللي هو تخمين how a + +166 +00:14:54,370 --> 00:14:59,390 +toric lens will rotate on the eye cannot be done + +167 +00:14:59,390 --> 00:15:04,450 +with any reliability يعني هذا الموضوع ما بيعتمد + +168 +00:15:04,450 --> 00:15:08,730 +على ثقة ما بين الفتر و ما بين مين ال facial يعني + +169 +00:15:08,730 --> 00:15:12,330 +إيش مثلا ييجي المريض عنده يقولي والله أنا بلاحظ أن + +170 +00:15:12,330 --> 00:15:15,830 +العدسة بتلف لليمين أو في الشمال احنا بناخد ال + +171 +00:15:15,830 --> 00:15:20,950 +history بنسمع للمريض ولكن هل هذابنعتبره اللي هو + +172 +00:15:20,950 --> 00:15:25,150 +مصدر ثقة reliability بمعنى اللي هو ثقة لأ لازم انا + +173 +00:15:25,150 --> 00:15:30,690 +بدي اعمل examination عشان اعرف ان قيمة ال rotation + +174 +00:15:30,690 --> 00:15:34,510 +هادي هل هي باتجاه ال right ولا باتجاه ال left + +175 +00:15:43,360 --> 00:15:46,780 +فاكرين الـ Conventional Daily Wear Lenses؟ عندما + +176 +00:15:46,780 --> 00:15:51,180 +يكون فترة حياتها من 6 إلى 12 شهر، قلنا إنه بتم + +177 +00:15:51,180 --> 00:15:54,580 +صناعتها من خلال الـ Lathe Cutting Method ونفس + +178 +00:15:54,580 --> 00:15:58,480 +الحاجة هنا، إذا كانت العدسة، الـ Softery Contact + +179 +00:15:58,480 --> 00:16:02,720 +Lenses فترة حياتها من 6 إلى 12 شهر، بدنا نستخدم + +180 +00:16:02,720 --> 00:16:08,110 +الـ Same Methodطيب إذا كانت disposable lenses for + +181 +00:16:08,110 --> 00:16:11,530 +two weeks أو one month بدنا نستخدم اللي هو ال + +182 +00:16:11,530 --> 00:16:20,390 +molded technology method تمام؟ إذا anterior and + +183 +00:16:20,390 --> 00:16:24,550 +posterior surface are molded on both or either + +184 +00:16:24,550 --> 00:16:28,410 +surfaces يعني للسطح الأمامي ال back و ال front + +185 +00:16:28,410 --> 00:16:29,190 +surface + +186 +00:16:34,350 --> 00:16:40,350 +Okay at one time it was thought that a graffiti + +187 +00:16:40,350 --> 00:16:45,650 +caused the toric lens to position into a place on + +188 +00:16:45,650 --> 00:16:52,020 +the eyeبنرجع اجرافتي بمعنى مصدر ثقة مصدر ثقل يعني + +189 +00:16:52,020 --> 00:16:57,380 +اي عدسة لا ثقة software contact lenses لازم ان + +190 +00:16:57,380 --> 00:17:03,160 +يكون لها ايه مركز ثقل اللي هو اجرافتي عشان يمنع ال + +191 +00:17:03,160 --> 00:17:07,480 +rotation لمن؟ للعدسة او سمنها يمكن في الجانب + +192 +00:17:07,480 --> 00:17:11,700 +العملي اللي هو ال marker الساعة ستة ال six اللي هو + +193 +00:17:11,700 --> 00:17:18,260 +position تمام؟الان في مراحل لتطوير تصميم العدسة + +194 +00:17:18,260 --> 00:17:20,720 +الصوفتوريك انشوف ايش هي المراحل + +195 +00:17:28,730 --> 00:17:32,810 +طبعا هذا مبدأ اللي هو الضغط طبعا water melon إيش + +196 +00:17:32,810 --> 00:17:37,870 +هو اللي هو بذر البطيخ seed بمعنى بذر water melon + +197 +00:17:37,870 --> 00:17:43,550 +اللي هو إيه البطيخ فعنا اللي هو مبدأ بذر البطيخ أو + +198 +00:17:43,550 --> 00:17:49,630 +بسموه اللي هو مبدأ الضغط تمام كيف المبدأ هذا + +199 +00:17:49,630 --> 00:17:56,510 +explains the force يعنيبستخدم اللي هو utilize + +200 +00:17:56,510 --> 00:18:01,490 +بمعنى استخدام للقوة اذا بستخدم اللي هو القوة in + +201 +00:18:01,490 --> 00:18:06,010 +turk lens designs مش القوة بتاعة الأنظمة العربية + +202 +00:18:06,010 --> 00:18:10,350 +لأ احنا بنقول اللي هو قوة عشان نمنع اللي هو لمين + +203 +00:18:10,350 --> 00:18:16,230 +ال rotation للعدسة تمام؟ اذا بالقوة هو بده يعمل + +204 +00:18:16,230 --> 00:18:21,750 +عملية تثبيت أو stability للعدسة نشوف كيف a turk + +205 +00:18:21,750 --> 00:18:23,170 +lens must have + +206 +00:18:27,890 --> 00:18:34,290 +ببساطة بيخلي ال center مركز العدسة اللي هو في داخل + +207 +00:18:34,290 --> 00:18:39,470 +العدسة من المنتصف بيخليه اللي هو thin ولا thick؟ + +208 +00:18:39,470 --> 00:18:48,480 +طيب و الأطراف؟ ليش طيب؟ببساطة دايما الأطراف هي + +209 +00:18:48,480 --> 00:18:53,980 +أكتر حاجة بتعمل ال rotation لمين؟ للمريض، تمام؟ + +210 +00:18:53,980 --> 00:18:59,160 +اذا دايما الأطراف هم بيعملوها اللي هو ايه؟ thin و + +211 +00:18:59,160 --> 00:19:03,640 +بيزود اللي هو ال thick wave في المنتصفطبعا ممكن + +212 +00:19:03,640 --> 00:19:08,300 +طالبة تسألني في لها disadvantages ايش هي ان ال + +213 +00:19:08,300 --> 00:19:12,520 +oxygen transmissibility هتكون ايش جليلة احنا لذلك + +214 +00:19:12,520 --> 00:19:17,980 +انه في جينا ايه update لهذا الموضوع اذا مرة اخرى + +215 +00:19:17,980 --> 00:19:26,100 +مبدأ البغض او مبدأ بذور البطيخ okay ببساطة انه + +216 +00:19:26,100 --> 00:19:31,510 +بيعتمد على القوةاستخدام القوة كيف؟ انه بيوفر مصدر + +217 +00:19:31,510 --> 00:19:37,110 +ثقل انه بيخلي الأطراف نحيفة و ال center بيخليه ثقل + +218 +00:19:37,110 --> 00:19:44,910 +عشان يمنع دوران العدسة واضح؟ + +219 +00:19:44,910 --> 00:19:50,390 +طيب بالنسبة ل ال prism palest + +220 +00:19:53,480 --> 00:19:58,120 +أيضا بيسمى هذا النوع اللي هو is the most common + +221 +00:19:58,120 --> 00:20:03,120 +method هو أكتر اللي هو شيوعان هذا النوع to add a + +222 +00:20:03,120 --> 00:20:06,880 +thick zone to a soft reclines، إذا بيزود منطقة + +223 +00:20:06,880 --> 00:20:13,500 +سميكة عشان يعمل زيادة اللي هو لإيه؟لا ال stability + +224 +00:20:13,500 --> 00:20:18,500 +للعدسة يعني دائما بدك تعرفي اي تصميم احنا بنستخدمه + +225 +00:20:18,500 --> 00:20:22,780 +للعدسة اللاصقة ال soft trick انه to increase the + +226 +00:20:22,780 --> 00:20:26,680 +stability and comfort for the soft trick contact + +227 +00:20:26,680 --> 00:20:33,540 +lenses لهذا الغرضين okay because + +228 +00:20:33,540 --> 00:20:38,420 +the thickness weight is notneeded and would cause + +229 +00:20:38,420 --> 00:20:43,580 +patient awareness فيه قلوعيب دايما انا يما بلبس + +230 +00:20:43,580 --> 00:20:47,700 +عبسة بيكون من المنتصف فيه لها سماكة معينة و + +231 +00:20:47,700 --> 00:20:51,640 +الأطراف فيه لها سماكة معينة المريض إيش هيصير عنده + +232 +00:20:51,640 --> 00:20:56,160 +awareness إدراك بهذا الاشي فهيسبب للمريض excessive + +233 +00:20:56,160 --> 00:20:56,900 +awareness + +234 +00:21:02,960 --> 00:21:07,240 +يعني زيادة الإدراك في مين بالعدل الصحي أو بوجود + +235 +00:21:07,240 --> 00:21:13,190 +العدل الصحيطيب الآن ال manufacturer المصنعين كيف + +236 +00:21:13,190 --> 00:21:17,790 +اللي هو حاولوا انه يتجاوزوا هذا ال drawback هذا + +237 +00:21:17,790 --> 00:21:20,850 +العيب او هذا ال disadvantage او هذا ال limitation + +238 +00:21:20,850 --> 00:21:27,550 +تمام؟ each manufacturer uses a method to eliminate + +239 +00:21:27,550 --> 00:21:32,230 +the extra unneeded thickness at the inferior edge + +240 +00:21:32,230 --> 00:21:39,020 +which also improves stability قال لكل الزيادةبتاعة + +241 +00:21:39,020 --> 00:21:43,120 +السماكة في الأطراف بدنا نعمل عملية إزالة إليها + +242 +00:21:43,120 --> 00:21:48,580 +تمام؟ طبعا هذه إيش بتعمل؟ بتحسن من عملية اللي هو + +243 +00:21:48,580 --> 00:21:53,840 +ثبات العدسة إذا each manufacturer هدول المصنعين + +244 +00:21:53,840 --> 00:21:58,720 +استخدموا اللي هو طريقة أو method معين to eliminate + +245 +00:21:58,720 --> 00:22:03,820 +لا إزالة the extra unneeded thickness كل اللي هي + +246 +00:22:03,820 --> 00:22:08,080 +السماكة الغير مطلوبة أو الزايدةوين في الـ inferior + +247 +00:22:08,080 --> 00:22:13,080 +edge في أطراف العدسة هذه الشيء بتعمل انه بتحسن ال + +248 +00:22:13,080 --> 00:22:19,940 +stability لمن؟ للعدسة ايضا هذا ال method بنسميه له + +249 +00:22:19,940 --> 00:22:24,560 +مسميات اخرى eccentric lenticulation او بنسميه + +250 +00:22:24,560 --> 00:22:29,020 +comfort chamfer او slap off اذا فيه له another + +251 +00:22:29,020 --> 00:22:34,020 +اللي هو name لطريقة اللي هو ال prism ballast + +252 +00:22:38,500 --> 00:22:43,590 +comfort chamfer لأ هذا name of testOkay ال name of + +253 +00:22:43,590 --> 00:22:47,670 +test يعني مش شرط انه انه الكلمة تعدر عن اللي هو + +254 +00:22:47,670 --> 00:22:51,430 +ايه المفهوم يعني دايما هو ال manufacturer يما + +255 +00:22:51,430 --> 00:22:56,050 +بيعمل design معين هو بيحاول انه ايش اروجله صح ولا + +256 +00:22:56,050 --> 00:23:00,270 +لا وان كان له drawback بعدين دايما يا جماعة ال + +257 +00:23:00,270 --> 00:23:04,770 +drawback مابيجيش اول ما بيصنع العدسة صح ولا لا بعد + +258 +00:23:04,770 --> 00:23:08,510 +ما المستخدمين بيستخدموه بعد ذلك بيبين اللي هو ال + +259 +00:23:08,510 --> 00:23:15,140 +drawback او المشاكل لهذا ال designOkay All lens + +260 +00:23:15,140 --> 00:23:20,200 +designs have unique palest zones that determine + +261 +00:23:20,200 --> 00:23:21,200 +the stability + +262 +00:23:46,730 --> 00:23:51,410 +طيب الآن يما شافوا ال drawback هذا راحوا زودوا من + +263 +00:23:51,410 --> 00:23:56,630 +إيش؟ من نحافة اللي هو العدسة في الأطرافتمام؟ يما + +264 +00:23:56,630 --> 00:24:00,790 +زودوا يعني يما شافوا انه في drawback انه في اختلاف + +265 +00:24:00,790 --> 00:24:04,090 +ما بين اللي هو ال thickness في المنتصف و ال + +266 +00:24:04,090 --> 00:24:08,290 +thickness في الأطراف جالك انا بضح في المنتصف لكن + +267 +00:24:08,290 --> 00:24:11,950 +ايش؟ بقلل اللي هو السماكة وين؟ في الأطراف عشان + +268 +00:24:11,950 --> 00:24:18,010 +اريح المريض ايه؟ اكتر اذا this thinner edge around + +269 +00:24:18,010 --> 00:24:21,610 +the entire limbs increases the comfort level for + +270 +00:24:21,610 --> 00:24:24,970 +the patient اذا هذه بتزود الراحة عند المريض + +271 +00:24:28,020 --> 00:24:32,280 +طبعا وانتوا الدليل ع ذلك ان ليش العدسة ال RGB + +272 +00:24:32,280 --> 00:24:37,540 +دايما بيكون ال small diameter لها عشان مايصيرش + +273 +00:24:37,540 --> 00:24:42,020 +اللي هو hard irritation ما بين أطراف العدسة و ال + +274 +00:24:42,020 --> 00:24:46,300 +upper و ال lower eyelid عشان هيك احنا دايما بنخلي + +275 +00:24:46,300 --> 00:24:52,020 +اللي هو small diameterالبريزم palest is used for + +276 +00:24:52,020 --> 00:24:55,960 +both front and back surface torque designs إذا + +277 +00:24:55,960 --> 00:24:59,840 +بيستخدم لها ال front و ال back surface contact + +278 +00:24:59,840 --> 00:25:04,300 +lens Typically a marker is placed at the inferior + +279 +00:25:04,300 --> 00:25:07,460 +or 6 o'clock position of the torque lens + +280 +00:25:07,460 --> 00:25:10,200 +indicating the base of the prism + +281 +00:25:13,280 --> 00:25:17,340 +في اللي هو منطقة بنسميها اللي هي ال six position + +282 +00:25:17,340 --> 00:25:22,500 +الساعة ستة هذه بيكون فيها مصدر اثقل او ال Prism + +283 +00:25:22,500 --> 00:25:31,640 +Palace تمام؟ طيب + +284 +00:25:31,640 --> 00:25:37,300 +في عندنا ال Prism Palace advantages طبعا هذا من + +285 +00:25:37,300 --> 00:25:44,150 +وجهة نظر مين؟ ال manufacturer المصنعين لهاNumber + +286 +00:25:44,150 --> 00:25:48,950 +one انه بيزود ال stability زيادة ال stability هو + +287 +00:25:48,950 --> 00:25:54,070 +هذا الغرض لإجراء ايش هيك design صح ولا لا اتنين + +288 +00:25:54,070 --> 00:25:57,970 +the cylinder power increases طب ليش هو بيزود قيمة + +289 +00:25:57,970 --> 00:26:04,410 +ال cylinder power ركزوا + +290 +00:26:04,410 --> 00:26:11,890 +كويس اذا the cylinder power increases ليش + +291 +00:26:11,890 --> 00:26:13,290 +هو بيزود القوة + +292 +00:26:20,410 --> 00:26:25,110 +بساطة الذي هو نتيجة زيادة ال thickness يعني هان + +293 +00:26:25,110 --> 00:26:28,810 +زاد اللي هو من قيمة ال power لأن البساطة ال + +294 +00:26:28,810 --> 00:26:33,330 +thickness زادت في المنتصف صح ولا لأ فممكن انه يغير + +295 +00:26:33,330 --> 00:26:38,640 +في قوة mean السيلندر ايه قصدك يعني تمامالقوة + +296 +00:26:38,640 --> 00:26:43,540 +الكبيرة في السليندر دائما انا مابدأ لبس مريض soft + +297 +00:26:43,540 --> 00:26:47,220 +rec contact lenses وين هتكون ال majority power + +298 +00:26:47,220 --> 00:26:50,980 +إله؟ في السليندر يعني معقولة minus 3 او minus نص + +299 +00:26:50,980 --> 00:26:54,400 +ألبسه soft rec لأ ليش انه قيمة اللي هو السليندر + +300 +00:26:54,400 --> 00:27:02,490 +lens أقل من 25% مقارنة في مين في الاسفير powerطيب + +301 +00:27:02,490 --> 00:27:06,770 +بالنسبة لل disadvantages العيوب إلها vertical + +302 +00:27:06,770 --> 00:27:12,470 +imbalance that may occur if only one eye needs a + +303 +00:27:12,470 --> 00:27:16,470 +torque lens كيف؟ يعني الآن أنا لابس فقط في العين + +304 +00:27:16,470 --> 00:27:21,570 +ال right عدسة لاصقة و مستخدم اللي هو prism palace + +305 +00:27:21,570 --> 00:27:25,990 +و العين التانية مافيش فيها عدسةفهيكون كل مصدر + +306 +00:27:25,990 --> 00:27:30,230 +الثقة الوين على area معينة أو عزون معين فبالتالي + +307 +00:27:30,230 --> 00:27:34,490 +هيعمل vertical imbalance يعني الصورة هتكون غير + +308 +00:27:34,490 --> 00:27:39,930 +متوازنة أو غير ملائمة أو غير مناسبة بالنسبة للمريض + +309 +00:27:41,650 --> 00:27:46,130 +الان انا مثلا عندي قيمة ال refractive error في one + +310 +00:27:46,130 --> 00:27:50,290 +eye و ال another eye normal تمام؟ الان كل مصدر + +311 +00:27:50,290 --> 00:27:54,030 +الثقة ال one هيكون في area معينة او zone معين + +312 +00:27:54,030 --> 00:27:57,930 +فبالتالي هيعمل اختلاف في الرؤية ما بين ال right و + +313 +00:27:57,930 --> 00:28:01,930 +ال left eye اه + +314 +00:28:01,930 --> 00:28:06,950 +في one eye تمام؟ مش في بعض الحلات ممكن ادي له يعني + +315 +00:28:06,950 --> 00:28:13,160 +molecular اللي هو تكون soft contact lensطيب عندنا + +316 +00:28:13,160 --> 00:28:16,480 +بالنسبة ل ال figure هذا بس بدنا نضيف اللي هو ال + +317 +00:28:16,480 --> 00:28:21,480 +name له طبعا دايما انا في حالة العدسة ال software + +318 +00:28:21,480 --> 00:28:26,760 +ال contact lenses بنظر للمنطقة هذه تمام المنطقة + +319 +00:28:26,760 --> 00:28:33,620 +هذه بتعبر عن anterior eccentric lenticulation يعني + +320 +00:28:33,620 --> 00:28:38,460 +انتوا ملاحظين هل هذا هو centric متمركز بشكل جيد لأ + +321 +00:28:38,460 --> 00:28:43,830 +eccentric تمام الجماعة افهموا وبعدين اكتبواأنا + +322 +00:28:43,830 --> 00:28:47,750 +بديكم ال slides تمام؟ إذا في عندنا anterior + +323 +00:28:47,750 --> 00:28:52,650 +eccentric lenticulation يعني الشكل غير منتظم أو + +324 +00:28:52,650 --> 00:28:58,050 +غير متمركز بشكل صحيح هذا إيش هيعمل؟ هيقلل من ال + +325 +00:28:58,050 --> 00:29:03,910 +mass من كتلة العدسة و الأطراف إيش هيعمل فيها؟ + +326 +00:29:03,910 --> 00:29:08,610 +بالضبط إذا هيزود اللي هو هذا ال version الأول إذا + +327 +00:29:08,610 --> 00:29:13,590 +هيزود اللي هو من سماكة العدسة في الأطرافهذا عبارة + +328 +00:29:13,590 --> 00:29:17,590 +عن ال version الأول أو يعني بمعنى اللي هو النوع + +329 +00:29:17,590 --> 00:29:21,650 +الأول من هذا النوع من العدسات زودوا السماكة فيه + +330 +00:29:21,650 --> 00:29:27,450 +اللي هو وين الأطراف طيب + +331 +00:29:27,450 --> 00:29:34,190 +أيضا عندنا النوع نفس النوع اللي هواملاحظين ان هنا + +332 +00:29:34,190 --> 00:29:39,250 +في عندنا front و back surface هي في اللي هو طالع + +333 +00:29:39,250 --> 00:29:44,570 +على منطقة ال two dash هدولة الشحاتين تمام ال Prism + +334 +00:29:44,570 --> 00:29:48,230 +palest adds thickness to the inferior edge + +335 +00:29:51,400 --> 00:29:55,100 +uniform thickness around the lens بمعنى أخر أنا + +336 +00:29:55,100 --> 00:29:59,220 +عندي منطقة ال back surface سميكة و ال front + +337 +00:29:59,220 --> 00:30:03,340 +surface كانت اللي هو thin إيش الحل في ذلك؟ بروح + +338 +00:30:03,340 --> 00:30:06,860 +بزود السماكة في ال front surface عشان التنتين + +339 +00:30:06,860 --> 00:30:11,740 +يصيروا إيش؟ uniform اللي هو يعني symmetric متمثلين + +340 +00:30:11,740 --> 00:30:17,850 +مرة تانيةفي الشكل التاني انا في عندي منطقة اللي هي + +341 +00:30:17,850 --> 00:30:22,190 +ال back surface كانت سميكة وال front surface كانت + +342 +00:30:22,190 --> 00:30:27,090 +اللي هو thin راح زود السماكة في ال front surface + +343 +00:30:27,090 --> 00:30:31,210 +تمام اللي هو في ال inferior يعني ال front surface + +344 +00:30:31,210 --> 00:30:35,890 +اقصد فيها المنطقة العلوية عشان يصير كلهيته uniform + +345 +00:30:35,890 --> 00:30:41,850 +او symmetric متمافن hand eccentric lenticular zone + +346 +00:30:43,910 --> 00:30:49,350 +على السطح الأمامي، يساعد في إعادة صميمة الـ Edge + +347 +00:30:49,350 --> 00:30:54,070 +نفس الفكرة أنه أنا ليش روحت زودت السماكة في + +348 +00:30:54,070 --> 00:30:57,170 +المنطقة العلوية لأطراف العدسة؟ + +349 +00:31:14,300 --> 00:31:18,980 +مافيش توازن بينهم فراح زود ال thickness من الطرف + +350 +00:31:18,980 --> 00:31:22,600 +اللى هو ال inferior و ال superior عشان انه يمنع ال + +351 +00:31:22,600 --> 00:31:24,940 +rotation لمن؟ للعدسة + +352 +00:31:30,290 --> 00:31:36,710 +الـ Dynamic Stabilization هذا الطريقة يعني بمعنى + +353 +00:31:36,710 --> 00:31:41,710 +آخر ال Prism palest ياجماعة روحنا اعملنا marker + +354 +00:31:41,710 --> 00:31:47,950 +للعدسة في الساعة ستةالمركر هذا يعني بالطريقة هذه + +355 +00:31:47,950 --> 00:31:52,270 +عمل اللي هو او منع ال rotation للعدسة او خلينا + +356 +00:31:52,270 --> 00:31:56,870 +نقول قلل من ال rotation للعدسة وزود اللي هو موضوع + +357 +00:31:56,870 --> 00:32:01,250 +ال stability تمام؟ فيه لها another name زي مثلا + +358 +00:32:01,490 --> 00:32:05,710 +الكمفورت شافر او في عندنا ال slab of او ال + +359 +00:32:05,710 --> 00:32:09,290 +integration هذه كلها تعتبر another name لمين + +360 +00:32:09,290 --> 00:32:16,110 +لموضوع ال Prism Palace طبعا هي الطريقة الاولى انه + +361 +00:32:16,110 --> 00:32:21,050 +زود سماكة في منطقة و المنطقة التانية ايش اللي هو + +362 +00:32:21,050 --> 00:32:27,570 +خلاها thin طيب ال dynamic stabilization او بنسميها + +363 +00:32:27,570 --> 00:32:39,730 +ال thin zoneمن اسمه ايش بتتوقعيه؟ اذا المناطق + +364 +00:32:39,730 --> 00:32:46,710 +هتكون اللي هو عبارة عن thin كيف طيب؟ + +365 +00:32:58,750 --> 00:33:03,970 +بساطة بيروح و بعمل عملية تنحيف ل السوبريور و + +366 +00:33:03,970 --> 00:33:08,230 +الانفريور part which enhance هذه بتعمل عملية تحسين + +367 +00:33:08,230 --> 00:33:12,800 +الراحة للمرضىدايمًا المريض لما بلبس slim limbs + +368 +00:33:12,800 --> 00:33:16,580 +بتلاقي انه ايش؟ انه more comfortable اكتر اللي هو + +369 +00:33:16,580 --> 00:33:20,520 +راحة بالنسباله، ليش؟ لأنه بسهولة بتاخد اللي هو + +370 +00:33:20,520 --> 00:33:24,840 +conform to the shape of the cornea، اذا also + +371 +00:33:24,840 --> 00:33:29,440 +enhances بمعنى اللي هو تحسن، يعني بتعمل improve، + +372 +00:33:29,440 --> 00:33:30,960 +اللي هو تحسين للراحة + +373 +00:33:42,770 --> 00:33:47,490 +9 o'clock positions so that rotation can be + +374 +00:33:47,490 --> 00:33:52,170 +measured في العدسة هذه او في الطريقة هذه اللي هي + +375 +00:33:52,170 --> 00:33:56,770 +ال dynamic stabilization بيعمل ال marker وين؟ + +376 +00:33:56,770 --> 00:34:03,330 +بالتلاتة وتسعة o'clock تمام ذكرتكم في موضوع ايش؟ال + +377 +00:34:03,330 --> 00:34:06,870 +RGB بتعمل ايش؟ لكن ال three nine o'clock staining + +378 +00:34:06,870 --> 00:34:10,990 +تمام؟ اللي هي لأنه واحدة من ال disadvantages هذا + +379 +00:34:10,990 --> 00:34:15,830 +النوع من العدسات لكن هان بعمل ال marker ال three و + +380 +00:34:15,830 --> 00:34:19,890 +nine o'clock ولكن المنطقة ايش هتكون؟ thinest نحيفة + +381 +00:34:23,520 --> 00:34:28,300 +قبعا اي ماركر في داخل العدسة وانا بقدر اشوفه من + +382 +00:34:28,300 --> 00:34:32,880 +خلال الـ set lamp هذا بيسهل في عملية تحديد قيمة ال + +383 +00:34:32,880 --> 00:34:38,200 +angle الزاوية تمام او بيحدد بصورة اخرى اللي هو + +384 +00:34:38,200 --> 00:34:43,710 +rotation اللي هو الدوران لمين للعدسةلذلك العدسات + +385 +00:34:43,710 --> 00:34:47,950 +الحديثة قلنا ال stability فيها أعلى ولكن في الها + +386 +00:34:47,950 --> 00:34:51,410 +drawback إيش؟ إن ال marker مش موجود، يعني بدي أنا + +387 +00:34:51,410 --> 00:34:54,450 +أقيمه اللي هو إيه بحد ذاتي + +388 +00:35:04,530 --> 00:35:08,450 +في ال prison palace أو في المثال اللى هو بتاع ال + +389 +00:35:08,450 --> 00:35:11,850 +water melon ال principle كنا وين اللى هو ال marker + +390 +00:35:11,850 --> 00:35:15,770 +نحطه في المنطقة اللى هو ال thickest لكن هان إيش + +391 +00:35:15,770 --> 00:35:23,710 +عندنا التنتين اللى هو thinest طيب + +392 +00:35:23,710 --> 00:35:31,330 +الآن ال figure هذا إيش بيمثل لكم؟ ممتازة أول حاجة + +393 +00:35:31,330 --> 00:35:39,340 +عندنا موضوع ال threeو ال nine و clock صح ولا لا؟ + +394 +00:35:39,340 --> 00:35:44,220 +طيب عندنا ال three dash هدولة أو اللي هو ال sign + +395 +00:35:44,220 --> 00:35:49,320 +الإشارة هذه بمثل إيش؟ + +396 +00:35:49,320 --> 00:35:55,580 +هذه عبارة عن ال marker تمام؟ + +397 +00:35:55,580 --> 00:36:03,300 +يعني في عندنا three markers وين؟ في داخل العدسة + +398 +00:36:07,290 --> 00:36:13,010 +إن ال one hour ايش بالساوية تلاتين degrees صح ولا + +399 +00:36:13,010 --> 00:36:20,690 +لأ طيب الآن كل dash هذه بتمثل ten degree كل واحدة + +400 +00:36:20,690 --> 00:36:27,990 +هذه بتمثل ten degree إذا التلاتة أيش بيمثلها؟30 + +401 +00:36:27,990 --> 00:36:33,750 +ديجريز يعني عبارة عن ايه؟ one hour تمام؟ اذا ممكن + +402 +00:36:33,750 --> 00:36:37,330 +اجيبلك figure و اقولك اشرحي عليها اذا عندنا سهل + +403 +00:36:37,330 --> 00:36:41,770 +جدا هذه بتمثل اول حاجة ال method ايش هو؟ dynamic + +404 +00:36:41,770 --> 00:36:45,770 +stabilization ال dynamic stabilization في عندنا + +405 +00:36:45,770 --> 00:36:49,190 +three nine o'clock كل اللي هو dash بتمثل ten + +406 +00:36:49,190 --> 00:36:52,410 +degree التلاتة بيمثلوا قداش one hour اللي هي + +407 +00:36:52,410 --> 00:36:53,570 +thirty degrees + +408 +00:37:03,700 --> 00:37:07,220 +وكان يعمل update وحطها في thickest area يعني الآن + +409 +00:37:07,220 --> 00:37:12,460 +مرة أخرى يما هو زود ال graffiti لموضوع ال prison + +410 +00:37:12,460 --> 00:37:16,400 +palace راحوا اطلبوا انه يحط ال marker في thickest + +411 +00:37:16,400 --> 00:37:21,380 +area لكن هي كلها هذه الهو under review يعني تحت + +412 +00:37:21,380 --> 00:37:25,700 +الدراسة ما زالت يعني يا جماعة يما شاف انه نعم + +413 +00:37:28,290 --> 00:37:32,590 +أه هذه في الجيل الأول لكن الجيل التاني يما شاف انه + +414 +00:37:32,590 --> 00:37:35,690 +التأثير اللى هو مش كبير يما حط على thinest area + +415 +00:37:35,690 --> 00:37:41,070 +اضطر انه يحطها على thickest zone يعني بمعنى اللى + +416 +00:37:41,070 --> 00:37:45,410 +هو update للجيل الأول من هذا النوع من العدسات + +417 +00:37:50,950 --> 00:37:56,370 +طيب بالنسبة ل ال dynamic stabilization advantages + +418 +00:37:56,370 --> 00:38:01,550 +المميزات اللي خاصة فيها طبعا ليش هي أريح من ال + +419 +00:38:01,550 --> 00:38:08,850 +prison palace؟ بالضبط لأن ال dynamic stabilization + +420 +00:38:08,850 --> 00:38:13,290 +المنطقتين هتكون thinest zone لكن هناك هتكون منطقة + +421 +00:38:13,290 --> 00:38:15,030 +thick ومنطقة thin + +422 +00:38:22,810 --> 00:38:27,150 +الجيل الأول من ال prison palace راح حط اللي هو + +423 +00:38:27,150 --> 00:38:31,870 +منطقة الثقة اللي كلها في ال thin zone area انتم + +424 +00:38:31,870 --> 00:38:36,350 +ممكنش ماخدين بالكم تمام؟ واحدة واحدةفي السن في + +425 +00:38:36,350 --> 00:38:41,590 +المرحلة الأولى حطها في السن zone area لما حطوها في + +426 +00:38:41,590 --> 00:38:46,530 +السن zone area لاحظوا ان في هناك awareness ادراك + +427 +00:38:46,530 --> 00:38:51,970 +كبير من المريض تمام؟ راحوا عملوا عملية تبديل لها + +428 +00:38:51,970 --> 00:38:55,890 +جالك بدل ما نحطها في السن نحطها في ال sick برضه + +429 +00:38:55,890 --> 00:39:01,170 +لاحظوا ان في ايش؟ ان في اللي هو awareness ادراك من + +430 +00:39:01,170 --> 00:39:06,320 +قبل المريضفقال لك افضل حاجة ان نعمل thin zone area + +431 +00:39:06,320 --> 00:39:10,220 +في اللي هو ال superior و ال inferior اللي هي مثلة + +432 +00:39:10,220 --> 00:39:14,340 +من ال dynamic stabilization + +433 +00:39:17,100 --> 00:39:20,120 +يعني المراحل بالشكل هذا يعني الان هو ال + +434 +00:39:20,120 --> 00:39:24,300 +manufacturer بعمل اللي هو التصميم و بشوف ردف علمين + +435 +00:39:24,300 --> 00:39:28,340 +ال patience كيف اللي هو ال awareness بتاعهم فإنها + +436 +00:39:28,340 --> 00:39:32,360 +في المنطقة هذه يعني انتم لاحظين حتى ال marker area + +437 +00:39:32,360 --> 00:39:36,760 +راح رفعة من ال 6 o'clock وانخلاها في ال 39 ليش؟ + +438 +00:39:36,760 --> 00:39:43,800 +لأن المنطقة هذه أقل تأثير تمام؟طيب، الآن في الـ + +439 +00:39:43,800 --> 00:39:49,420 +dynamic stabilization، تمام؟ احنا بنعرف انه زود ال + +440 +00:39:49,420 --> 00:39:52,840 +comfort الراحة، البساطة زادت ال comfort لان + +441 +00:39:52,840 --> 00:39:58,570 +المنطقتين صارت اللي هو thin zones، تمام؟Number + +442 +00:39:58,570 --> 00:40:02,970 +two, lack of induced, the prismatic effect دايما + +443 +00:40:02,970 --> 00:40:05,890 +الprismatic effect وين بيكون تأثيره أكتر؟ في ال + +444 +00:40:05,890 --> 00:40:08,930 +vertical ولا ال horizontal؟ في ال vertical عشان هي + +445 +00:40:08,930 --> 00:40:13,670 +قلنا إيش بيعمل vertical imbalance هان صح فيه تأثير + +446 +00:40:13,670 --> 00:40:18,950 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طبعا + +458 +00:41:07,710 --> 00:41:11,690 +في ال against درون، العكس، هتكون هي ال best + +459 +00:41:11,690 --> 00:41:13,430 +option، تمام؟ + +460 +00:41:16,830 --> 00:41:20,110 +طيب خليني اقف ان شاء الله ل ال ISO thickness + +461 +00:41:20,110 --> 00:41:27,750 +profile في اي سؤال؟ طيب انخص المحاضرة بشكل مبسط + +462 +00:41:27,750 --> 00:41:34,910 +الان بالنسبة لل design لل software contact lenses + +463 +00:41:34,910 --> 00:41:41,460 +دخلت بعدة مراحلالمرحلة الأولى اتمثلت بالـ Prism + +464 +00:41:41,460 --> 00:41:47,300 +Palace تمام؟ بتعتمد على زيادة ال thickness في + +465 +00:41:47,300 --> 00:41:52,780 +منطقة مقارنة في المنطقة الأخرىفي الجيل الأول من + +466 +00:41:52,780 --> 00:41:57,900 +هذه العدسات وين مضعوا اللي هو السماكة او وين مضعوا + +467 +00:41:57,900 --> 00:42:01,540 +اللي هو ال prism لان ايش هي ال marker عبارة عن ال + +468 +00:42:01,540 --> 00:42:05,660 +prism صح ولا لا وضعوه يا جماعة في المرحلة الأولى + +469 +00:42:05,660 --> 00:42:09,400 +في اللي هو .. لأ في أي منطقة اللي 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00:43:06,130 +stability هيكون اكتر وادراك المريض اقل بالعدسة، + +482 +00:43:06,130 --> 00:43:10,730 +لكن في إلها disadvantages اللي هو في موضوع ايه؟ ال + +483 +00:43:10,730 --> 00:43:14,510 +with the rule of stigmatism او حتى بال irregular + +484 +00:43:14,510 --> 00:43:20,700 +stigmatism بشكل عامفي اي سؤال اي استفسار يعطيكم + +485 +00:43:20,700 --> 00:43:21,140 +العافية + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/KtVSKgJh5r4_raw.json b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/KtVSKgJh5r4_raw.json new file mode 100644 index 0000000000000000000000000000000000000000..daa5c675fa85e9ac311dc325b8c5d90829c4759a --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/KtVSKgJh5r4_raw.json @@ -0,0 +1 @@ +{"segments": [{"id": 1, "seek": 4934, "start": 21.02, "end": 49.34, "text": "بسم الله الرحمن الرحيم السلام عليكم ورحمة الله وبركاته and a very good morning to all of you هنبدأ في موضوع أو نكمل في موضوع ال software contact lenses عندنا في اختبار مهم كتير هو عبارة عن ال twist test او بمعنى اخر ال 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1.0}, {"id": 5, "seek": 14259, "start": 119.95, "end": 142.59, "text": "it helps in determining patient tolerance يعني هذا بالساعد في تحديد ما هو تقبل المريض tolerance بمعنى accepted تقبل المريض for the lens rotation لدوران العدسة commonly seen with torric lenses وهذا بيكون أكتر شيوعا في العدسات ال soft torric lenses", "tokens": [270, 3665, 294, 23751, 4537, 23368, 37495, 22653, 23758, 20666, 3794, 995, 22488, 8978, 6055, 5016, 16254, 3215, 19446, 31439, 6055, 4587, 36150, 9673, 16572, 11242, 23368, 4724, 2304, 3615, 1863, 7578, 9035, 6055, 4587, 36150, 9673, 16572, 11242, 337, 264, 6765, 12447, 5296, 3215, 13063, 7649, 18863, 3215, 3794, 3660, 12719, 1612, 365, 3930, 1341, 18059, 37037, 15730, 4724, 1829, 30544, 5551, 4117, 2655, 2288, 13412, 1829, 45367, 995, 8978, 18863, 3215, 3794, 9307, 2423, 2787, 3930, 1341, 18059], "avg_logprob": -0.2029320928785536, "compression_ratio": 1.5529953917050692, "no_speech_prob": 0.0, "words": [{"start": 119.95, "end": 120.21, "word": "it", "probability": 0.26806640625}, {"start": 120.21, "end": 120.75, "word": " helps", "probability": 0.83642578125}, {"start": 120.75, "end": 121.13, "word": " in", "probability": 0.95458984375}, {"start": 121.13, "end": 121.85, "word": " determining", "probability": 0.9287109375}, {"start": 121.85, "end": 122.65, "word": " patient", "probability": 0.91259765625}, {"start": 122.65, "end": 123.39, "word": " tolerance", "probability": 0.83642578125}, {"start": 123.39, "end": 123.81, "word": " يعني", "probability": 0.5975341796875}, {"start": 123.81, "end": 124.03, "word": " هذا", "probability": 0.30322265625}, {"start": 124.03, "end": 124.67, "word": " بالساعد", "probability": 0.8504638671875}, {"start": 124.67, "end": 124.83, "word": " في", "probability": 0.82763671875}, {"start": 124.83, "end": 125.45, "word": " تحديد", "probability": 0.9730224609375}, {"start": 125.45, "end": 125.65, "word": " ما", "probability": 0.378662109375}, {"start": 125.65, "end": 126.05, "word": " هو", "probability": 0.6650390625}, {"start": 126.05, "end": 126.99, "word": " تقبل", "probability": 0.7913411458333334}, {"start": 126.99, "end": 127.43, "word": " المريض", "probability": 0.9851888020833334}, {"start": 127.43, "end": 128.13, "word": " tolerance", "probability": 0.357666015625}, {"start": 128.13, "end": 128.83, "word": " بمعنى", "probability": 0.942578125}, {"start": 128.83, "end": 129.43, "word": " accepted", "probability": 0.92431640625}, {"start": 129.43, "end": 130.33, "word": " تقبل", "probability": 0.9085286458333334}, {"start": 130.33, "end": 131.03, "word": " المريض", "probability": 0.99365234375}, {"start": 131.03, "end": 131.85, "word": " for", "probability": 0.86083984375}, {"start": 131.85, "end": 132.07, "word": " the", "probability": 0.84033203125}, {"start": 132.07, "end": 132.45, "word": " lens", "probability": 0.92724609375}, {"start": 132.45, "end": 133.27, "word": " rotation", "probability": 0.97216796875}, {"start": 133.27, "end": 134.15, "word": " لدوران", "probability": 0.9539794921875}, {"start": 134.15, "end": 134.75, "word": " العدسة", "probability": 0.97119140625}, {"start": 134.75, "end": 136.05, "word": " commonly", "probability": 0.73974609375}, {"start": 136.05, "end": 137.07, "word": " seen", "probability": 0.92529296875}, {"start": 137.07, "end": 137.61, "word": " with", "probability": 0.92919921875}, {"start": 137.61, "end": 137.99, "word": " torric", "probability": 0.3802490234375}, {"start": 137.99, "end": 138.51, "word": " lenses", "probability": 0.896484375}, {"start": 138.51, "end": 138.95, "word": " وهذا", "probability": 0.904541015625}, {"start": 138.95, "end": 139.33, "word": " بيكون", "probability": 0.7714029947916666}, {"start": 139.33, "end": 139.75, "word": " أكتر", "probability": 0.9140625}, {"start": 139.75, "end": 140.25, "word": " شيوعا", "probability": 0.94287109375}, {"start": 140.25, "end": 140.35, "word": " في", "probability": 0.85107421875}, {"start": 140.35, "end": 141.03, "word": " العدسات", "probability": 0.9925537109375}, {"start": 141.03, "end": 141.33, "word": " ال", "probability": 0.63916015625}, {"start": 141.33, "end": 141.57, "word": " soft", "probability": 0.8662109375}, {"start": 141.57, "end": 141.97, "word": " torric", "probability": 0.65087890625}, {"start": 141.97, "end": 142.59, "word": " lenses", "probability": 0.89111328125}], "temperature": 1.0}, {"id": 6, "seek": 15733, "start": 144.23, "end": 157.33, "text": "rotate the best cylinder يعني الآن احنا نفترض على ال axis 30 روحت انا عملت rotation تدوير من خلال الفروبتر او ال cylinder lens اللي انا وضعته في ال trial frame", "tokens": [10536, 473, 264, 1151, 17884, 37495, 22653, 6024, 48506, 1975, 5016, 8315, 8717, 5172, 2655, 43042, 15844, 2423, 10298, 2217, 12602, 2407, 33753, 1975, 8315, 6225, 42213, 2655, 12447, 6055, 3215, 2407, 13546, 9154, 16490, 1211, 6027, 27188, 32887, 3555, 2655, 2288, 1975, 2407, 2423, 17884, 6765, 13672, 1829, 1975, 8315, 4032, 11242, 34268, 3224, 8978, 2423, 7308, 3920], "avg_logprob": -0.22565103843808174, "compression_ratio": 1.3668639053254439, "no_speech_prob": 0.0, "words": [{"start": 144.23, "end": 144.95, "word": "rotate", "probability": 0.656005859375}, {"start": 144.95, "end": 145.33, "word": " the", "probability": 0.8701171875}, {"start": 145.33, "end": 145.67, "word": " best", "probability": 0.8505859375}, {"start": 145.67, "end": 146.35, "word": " cylinder", "probability": 0.7666015625}, {"start": 146.35, "end": 146.99, "word": " يعني", "probability": 0.6878662109375}, {"start": 146.99, "end": 147.29, "word": " الآن", "probability": 0.619140625}, {"start": 147.29, "end": 148.11, "word": " احنا", "probability": 0.8824869791666666}, {"start": 148.11, "end": 148.69, "word": " نفترض", "probability": 0.9835205078125}, {"start": 148.69, "end": 148.89, "word": " على", "probability": 0.88427734375}, {"start": 148.89, "end": 149.01, "word": " ال", "probability": 0.81689453125}, {"start": 149.01, "end": 149.31, "word": " axis", "probability": 0.406005859375}, {"start": 149.31, "end": 149.89, "word": " 30", "probability": 0.67822265625}, {"start": 149.89, "end": 150.43, "word": " روحت", "probability": 0.7262369791666666}, {"start": 150.43, "end": 150.59, "word": " انا", "probability": 0.856201171875}, {"start": 150.59, "end": 150.97, "word": " عملت", "probability": 0.9471028645833334}, {"start": 150.97, "end": 151.55, "word": " rotation", "probability": 0.6337890625}, {"start": 151.55, "end": 152.31, "word": " تدوير", "probability": 0.943359375}, {"start": 152.31, "end": 152.53, "word": " من", "probability": 0.99609375}, {"start": 152.53, "end": 152.87, "word": " خلال", "probability": 0.9873046875}, {"start": 152.87, "end": 153.55, "word": " الفروبتر", "probability": 0.71953125}, {"start": 153.55, "end": 154.13, "word": " او", "probability": 0.877197265625}, {"start": 154.13, "end": 154.25, "word": " ال", "probability": 0.759765625}, {"start": 154.25, "end": 154.61, "word": " cylinder", "probability": 0.75830078125}, {"start": 154.61, "end": 155.03, "word": " lens", "probability": 0.71484375}, {"start": 155.03, "end": 155.37, "word": " اللي", "probability": 0.857666015625}, {"start": 155.37, "end": 155.53, "word": " انا", "probability": 0.7822265625}, {"start": 155.53, "end": 156.05, "word": " وضعته", "probability": 0.9254150390625}, {"start": 156.05, "end": 156.27, "word": " في", "probability": 0.58544921875}, {"start": 156.27, "end": 156.61, "word": " ال", "probability": 0.87255859375}, {"start": 156.61, "end": 156.95, "word": " trial", "probability": 0.76953125}, {"start": 156.95, "end": 157.33, "word": " frame", "probability": 0.9140625}], "temperature": 1.0}, {"id": 7, "seek": 18071, "start": 158.93, "end": 180.71, "text": "إذا rotate the best cylinder in the phoropter until it blare it's just noticeable يعني أنا بخلي المريض يلف في ال cylinder lens أو أنا بلف في ال phoropter لحد ما الصورة إيش صير غير واضحة، it blare اللي هي غير واضحة، إذا مرة تانية", "tokens": [28814, 15730, 13121, 264, 1151, 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"text": "كيف انا بدي امنعه؟ بدي اعمل الهو design انه امنع الهو مين موضوع ال rotation تمام يا جماعة؟ يعني هذا القمر بيزود ال rotation كيف بدي امنعه؟ بدي استخدم ال هو prism او بدي استخدم مثلا طريقة ال truncation او اي طريقة انه تمنع ال هو الدوران رسمها يمكن اوضح هلجيت؟ هى مثلا العين", "tokens": [4117, 33911, 1975, 8315, 4724, 16254, 1975, 27842, 3615, 3224, 22807, 4724, 16254, 1975, 25957, 1211, 2423, 3224, 2407, 1715, 16472, 3224, 1975, 27842, 3615, 2423, 3224, 2407, 3714, 9957, 3714, 2407, 11242, 45367, 2423, 12447, 46811, 10943, 35186, 10874, 15042, 27884, 22807, 37495, 22653, 23758, 25062, 29973, 4724, 1829, 11622, 23328, 2423, 12447, 9122, 33911, 4724, 16254, 1975, 27842, 3615, 3224, 22807, 4724, 16254, 44713, 9778, 40448, 2423, 31439, 582, 1434, 1975, 2407, 4724, 16254, 44713, 9778, 40448, 50113, 15040, 23032, 16572, 28671, 2423, 504, 409, 46252, 1975, 2407, 1975, 1829, 23032, 16572, 28671, 16472, 3224, 46811, 1863, 3615, 2423, 31439, 32748, 13063, 7649, 12602, 38251, 11296, 7251, 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"end": 690.28, "word": " استخدم", "probability": 0.9138997395833334}, {"start": 690.28, "end": 690.62, "word": " مثلا", "probability": 0.8720703125}, {"start": 690.62, "end": 691.14, "word": " طريقة", "probability": 0.9905598958333334}, {"start": 691.14, "end": 691.3, "word": " ال", "probability": 0.76318359375}, {"start": 691.3, "end": 691.92, "word": " truncation", "probability": 0.8229166666666666}, {"start": 691.92, "end": 692.22, "word": " او", "probability": 0.922607421875}, {"start": 692.22, "end": 692.42, "word": " اي", "probability": 0.888427734375}, {"start": 692.42, "end": 692.96, "word": " طريقة", "probability": 0.99169921875}, {"start": 692.96, "end": 693.64, "word": " انه", "probability": 0.916015625}, {"start": 693.64, "end": 694.14, "word": " تمنع", "probability": 0.89111328125}, {"start": 694.14, "end": 694.38, "word": " ال", "probability": 0.72705078125}, {"start": 694.38, "end": 694.56, "word": " هو", "probability": 0.93115234375}, {"start": 694.56, "end": 695.18, "word": " الدوران", "probability": 0.9773763020833334}, {"start": 695.18, "end": 698.18, "word": " رسمها", "probability": 0.7511393229166666}, {"start": 698.18, "end": 698.48, "word": " يمكن", "probability": 0.958740234375}, {"start": 698.48, "end": 698.92, "word": " اوضح", "probability": 0.962158203125}, {"start": 698.92, "end": 699.8, "word": " هلجيت؟", "probability": 0.8380859375}, {"start": 699.8, "end": 700.2, "word": " هى", "probability": 0.54443359375}, {"start": 700.2, "end": 700.62, "word": " مثلا", "probability": 0.99169921875}, {"start": 700.62, "end": 701.64, "word": " العين", "probability": 0.9677734375}], "temperature": 1.0}, {"id": 30, "seek": 72460, "start": 711.74, "end": 724.6, "text": "الان انا بدي امنع اللى هو دوران العدسة كيف بدي اعمل؟ بدي اعمل مصدر ثقل للعدسة مصدر الثقل هذا بيمنع اللى هو دوران العدسة", "tokens": [6027, 7649, 1975, 8315, 4724, 16254, 1975, 27842, 3615, 13672, 7578, 31439, 11778, 13063, 7649, 18863, 3215, 3794, 3660, 9122, 33911, 4724, 16254, 1975, 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" العدسة", "probability": 0.96826171875}, {"start": 716.18, "end": 717.7, "word": " كيف", "probability": 0.59130859375}, {"start": 717.7, "end": 717.92, "word": " بدي", "probability": 0.8310546875}, {"start": 717.92, "end": 718.44, "word": " اعمل؟", "probability": 0.81982421875}, {"start": 718.44, "end": 718.82, "word": " بدي", "probability": 0.82568359375}, {"start": 718.82, "end": 719.14, "word": " اعمل", "probability": 0.9845377604166666}, {"start": 719.14, "end": 719.56, "word": " مصدر", "probability": 0.9954833984375}, {"start": 719.56, "end": 720.0, "word": " ثقل", "probability": 0.9842122395833334}, {"start": 720.0, "end": 720.9, "word": " للعدسة", "probability": 0.95947265625}, {"start": 720.9, "end": 722.06, "word": " مصدر", "probability": 0.883544921875}, {"start": 722.06, "end": 722.5, "word": " الثقل", "probability": 0.9676513671875}, {"start": 722.5, "end": 722.74, "word": " هذا", "probability": 0.60888671875}, {"start": 722.74, "end": 723.22, "word": " بيمنع", 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the most common method هو أكتر اللي هو شيوعان هذا النوع to add a thick zone to a soft reclines، إذا بيزود منطقة سميكة عشان يعمل زيادة اللي هو لإيه؟", "tokens": [10721, 1829, 11242, 995, 4724, 1829, 38251, 7578, 23758, 28239, 45367, 13672, 1829, 31439, 307, 264, 881, 2689, 3170, 31439, 5551, 4117, 2655, 2288, 13672, 1829, 31439, 44049, 45367, 7649, 23758, 28239, 45367, 281, 909, 257, 5060, 6668, 281, 257, 2787, 850, 11045, 12399, 11933, 15730, 4724, 1829, 11622, 23328, 9154, 9566, 28671, 8608, 2304, 1829, 4117, 3660, 6225, 8592, 7649, 7251, 25957, 1211, 30767, 1829, 18513, 3660, 13672, 1829, 31439, 5296, 28814, 1829, 3224, 22807], "avg_logprob": -0.2049512963790398, "compression_ratio": 1.5224719101123596, "no_speech_prob": 0.0, "words": [{"start": 1193.48, "end": 1194.06, "word": "أيضا", "probability": 0.81231689453125}, {"start": 1194.06, "end": 1195.0, "word": " بيسمى", "probability": 0.8663330078125}, {"start": 1195.0, "end": 1195.36, "word": " هذا", "probability": 0.8544921875}, 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"temperature": 1.0}, {"id": 59, "seek": 136112, "start": 1358.5, "end": 1361.12, "text": "comfort chamfer لأ هذا name of test", "tokens": [27289, 8268, 612, 5296, 10721, 23758, 1315, 295, 1500], "avg_logprob": -0.21074218153953553, "compression_ratio": 0.8163265306122449, "no_speech_prob": 0.0, "words": [{"start": 1358.5, "end": 1358.86, "word": "comfort", "probability": 0.5556640625}, {"start": 1358.86, "end": 1359.56, "word": " chamfer", "probability": 0.720458984375}, {"start": 1359.56, "end": 1359.86, "word": " لأ", "probability": 0.876708984375}, {"start": 1359.86, "end": 1360.16, "word": " هذا", "probability": 0.873046875}, {"start": 1360.16, "end": 1360.46, "word": " name", "probability": 0.8173828125}, {"start": 1360.46, "end": 1360.7, "word": " of", "probability": 0.95263671875}, {"start": 1360.7, "end": 1361.12, "word": " test", "probability": 0.955078125}], "temperature": 1.0}, {"id": 60, "seek": 139153, "start": 1362.33, "end": 1391.53, "text": "Okay ال name of test يعني مش 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drawback", "probability": 0.947021484375}, {"start": 1380.95, "end": 1381.73, "word": " مابيجيش", "probability": 0.8496907552083334}, {"start": 1381.73, "end": 1382.03, "word": " اول", "probability": 0.91455078125}, {"start": 1382.03, "end": 1382.17, "word": " ما", "probability": 0.74169921875}, {"start": 1382.17, "end": 1383.09, "word": " بيصنع", "probability": 0.83994140625}, {"start": 1383.09, "end": 1383.57, "word": " العدسة", "probability": 0.9556884765625}, {"start": 1383.57, "end": 1383.81, "word": " صح", "probability": 0.98388671875}, {"start": 1383.81, "end": 1383.99, "word": " ولا", "probability": 0.9775390625}, {"start": 1383.99, "end": 1384.23, "word": " لا", "probability": 0.86865234375}, {"start": 1384.23, "end": 1384.77, "word": " بعد", "probability": 0.935546875}, {"start": 1384.77, "end": 1384.91, "word": " ما", "probability": 0.9365234375}, {"start": 1384.91, "end": 1385.73, "word": " المستخدمين", "probability": 0.98896484375}, {"start": 1385.73, "end": 1386.85, 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"word": " design", "probability": 0.9794921875}], "temperature": 1.0}, {"id": 61, "seek": 140120, "start": 1393.16, "end": 1401.2, "text": "Okay All lens designs have unique palest zones that determine the stability", "tokens": [8297, 1057, 6765, 11347, 362, 3845, 3984, 377, 16025, 300, 6997, 264, 11826], "avg_logprob": -0.5775669813156128, "compression_ratio": 1.0135135135135136, "no_speech_prob": 0.0, "words": [{"start": 1393.16, "end": 1393.52, "word": "Okay", "probability": 0.13818359375}, {"start": 1393.52, "end": 1394.5, "word": " All", "probability": 0.416015625}, {"start": 1394.5, "end": 1395.14, "word": " lens", "probability": 0.76904296875}, {"start": 1395.14, "end": 1396.06, "word": " designs", "probability": 0.849609375}, {"start": 1396.06, "end": 1396.7, "word": " have", "probability": 0.94775390625}, {"start": 1396.7, "end": 1397.2, "word": " unique", "probability": 0.818359375}, {"start": 1397.2, "end": 1398.2, "word": " palest", "probability": 0.402587890625}, {"start": 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0000000000000000000000000000000000000000..6968794d3542a16dcad67e5dd68aa43ef5dc39bf --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/KtVSKgJh5r4_raw.srt @@ -0,0 +1,1940 @@ +1 +00:00:21,020 --> 00:00:23,760 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:23,760 --> 00:00:26,960 +وبركاته and a very good morning to all of you + +3 +00:00:26,960 --> 00:00:31,100 +هنبدأ في موضوع أو نكمل في موضوع ال software + +4 +00:00:31,100 --> 00:00:36,980 +contact lenses عندنا في اختبار مهم كتير هو عبارة + +5 +00:00:36,980 --> 00:00:48,480 +عن ال twist test او بمعنى اخر ال rotation او + +6 +00:00:48,480 --> 00:00:49,340 +ال screw + +7 +00:00:54,950 --> 00:01:01,750 +بمعنى اختبار اللف أو دوران الـcylinder lens او + +8 +00:01:01,750 --> 00:01:07,870 +دوران او لف اللي هو من الفروبتور اذا the screw + +9 +00:01:07,870 --> 00:01:12,750 +test او ال rotation test او ال twist test is a + +10 +00:01:12,750 --> 00:01:17,210 +useful screening test for softorix يعني الآن بعد + +11 +00:01:17,210 --> 00:01:21,290 +ما انا بعمل evaluation للمريض من حيث ال subjective + +12 +00:01:21,290 --> 00:01:22,090 +refraction + +13 +00:01:26,310 --> 00:01:31,010 +أكد إن هذا الـ axis اللي المريض لابسه، هل هو صحيح + +14 +00:01:31,010 --> 00:01:35,770 +ولا لأ؟ هذه نقطة أولى، يعني مثلا المريض عنده minus + +15 +00:01:35,770 --> 00:01:37,110 +تلاتة + +16 +00:01:42,320 --> 00:01:46,880 +أول حاجة بدي اشوف ان العجز اللاصقة هل هي على axis + +17 +00:01:46,880 --> 00:01:52,220 +30 فعلا ولا لأ انه هل هذا صحيح النقطة التانية انه + +18 +00:01:52,220 --> 00:01:56,700 +بدي اشوف هل المريض عنده sensitivity عالية ولا لأ + +19 +00:01:59,950 --> 00:02:04,030 +it helps in determining patient tolerance يعني هذا + +20 +00:02:04,030 --> 00:02:08,830 +بالساعد في تحديد ما هو تقبل المريض tolerance بمعنى + +21 +00:02:08,830 --> 00:02:14,150 +accepted تقبل المريض for the lens rotation لدوران + +22 +00:02:14,150 --> 00:02:19,330 +العدسة commonly seen with torric lenses وهذا بيكون + +23 +00:02:19,330 --> 00:02:24,950 +أكتر شيوعا في العدسات ال soft torric lensesrotate + +24 +00:02:24,950 --> 00:02:29,310 +the best cylinder يعني الآن احنا نفترض على ال axis + +25 +00:02:29,310 --> 00:02:33,550 +30 روحت انا عملت rotation تدوير من خلال الفروبتر + +26 +00:02:33,550 --> 00:02:36,950 +او ال cylinder lens اللي انا وضعته في ال trial + +27 +00:02:36,950 --> 00:02:43,710 +frameإذا rotate the best cylinder in the phoropter + +28 +00:02:43,710 --> 00:02:48,770 +until it blare it's just noticeable يعني أنا بخلي + +29 +00:02:48,770 --> 00:02:52,990 +المريض يلف في ال cylinder lens أو أنا بلف في ال + +30 +00:02:52,990 --> 00:02:57,110 +phoropter لحد ما الصورة إيش صير غير واضحة، it + +31 +00:02:57,110 --> 00:03:02,240 +blare اللي هي غير واضحة، إذا مرة تانيةانا حطيت + +32 +00:03:02,240 --> 00:03:06,820 +اللي هو عدسة لاسقة في عين المريض minus 3 ع minus 1 + +33 +00:03:06,820 --> 00:03:14,100 +.5 X 30 بحطله عدسة مثلا ربع سيلندر تمام او مثلا + +34 +00:03:14,100 --> 00:03:16,900 +Jackson across cylinder اعملناها في معمل يوم + +35 +00:03:16,900 --> 00:03:21,600 +الأربعة او بجيب اذا كان عندي فروبتور بخلي المريض + +36 +00:03:21,600 --> 00:03:26,460 +يعمل rotation تدوير لحد ما الصورة تصبح غير واضحة + +37 +00:03:26,460 --> 00:03:32,500 +طيب ليش؟ الآن هنعرفYou may also ask the patient to + +38 +00:03:32,500 --> 00:03:37,440 +twist the axes down until they notice a decrease + +39 +00:03:37,440 --> 00:03:38,040 +in vision + +40 +00:03:47,120 --> 00:03:51,040 +If a response is elicited in less than five + +41 +00:03:51,040 --> 00:03:55,920 +degrees يعني بمعنى آخر إذا الاستجابة للمريض هذه + +42 +00:03:55,920 --> 00:04:01,260 +وجدت elicited بمعنى وجدت في أقل من خمسة degree + +43 +00:04:01,260 --> 00:04:06,140 +يعني الآن أنا مثلا المريض لف العجسة نفترض لسبع + +44 +00:04:06,140 --> 00:04:13,090 +وعشرين كده الفرق؟ تلاتة degreeبالضبط، إذا المريض + +45 +00:04:13,090 --> 00:04:17,110 +شعر إنه عنده السبعة و عشرين فيه اللي هو تأثير + +46 +00:04:17,110 --> 00:04:21,490 +كبير، معنى الكلام إن هذا المريض إيه؟ عنده high + +47 +00:04:21,490 --> 00:04:29,230 +sensitivityطيب مرة تانية الان minus 3 ع minus 1.5 + +48 +00:04:29,230 --> 00:04:34,270 +لما المريض عمل rotation ل ال trial frame عن 27 + +49 +00:04:34,270 --> 00:04:40,070 +اتأثر هو في الاصل جديش 30 اذا اقل من 5 degree هذا + +50 +00:04:40,070 --> 00:04:44,970 +بتديني انطباع ان المريض عنده high sensitivityطب + +51 +00:04:44,970 --> 00:04:48,990 +نفترض لو كان الفرج أكتر من خمسة، بيكون هذا طبيعي، + +52 +00:04:48,990 --> 00:04:52,850 +يعني للآن لو احنا بدنا نعمل اللي هو نضارة و طلع + +53 +00:04:52,850 --> 00:04:56,130 +الفرج أكتر من خمسة degree، المريض إيش هيقولك؟ + +54 +00:04:56,130 --> 00:05:00,210 +الرؤية مش واضحة و هتتغير عنده الرؤية، هيقولك مثلا + +55 +00:05:00,210 --> 00:05:09,440 +شايف الأرض إيش غير طبيعية، تمام؟إذا إذا إستجابة + +56 +00:05:09,440 --> 00:05:15,120 +وُجدت في أقل من خمسة ديجري، فهناك مستوى عالي من + +57 +00:05:15,120 --> 00:05:19,240 +حساسية + +58 +00:05:19,240 --> 00:05:23,980 +عالية كثير.طيب في هذه الحالة إيش بدنا نتجه؟ باتجاه + +59 +00:05:23,980 --> 00:05:34,480 +مين؟ ال جي بي لينزإذا المريض + +60 +00:05:34,480 --> 00:05:39,820 +عندما يكون عنده مرتبط عالي لازم انا اروح باتجاه + +61 +00:05:39,820 --> 00:05:45,300 +مين ال RGB contact lens لأن ال RGB contact lens + +62 +00:05:45,300 --> 00:05:52,800 +مافيش فيها ال axis على العدسة فبالتالي ما بسبب + +63 +00:05:52,800 --> 00:05:58,830 +الموضوع ال rotationطيب لو المريض مصمم انه يلبس + +64 +00:05:58,830 --> 00:06:02,290 +عدسة soft trick contact lenses ومش قادر يعمل + +65 +00:06:02,290 --> 00:06:06,630 +adaptation مع ال RGB ايش بدنا نعمل؟ if a soft + +66 +00:06:06,630 --> 00:06:11,190 +trick is necessary يعني المريض عنده motivation فقط + +67 +00:06:11,190 --> 00:06:17,570 +لارتداء ال soft trick except more trials and the + +68 +00:06:17,570 --> 00:06:19,690 +need for a lens design + +69 +00:06:25,610 --> 00:06:30,730 +هذا المريض بدي أعمله trial أكتر من مرة لحد ما أصل + +70 +00:06:30,730 --> 00:06:35,190 +لأفضل access لهذا المريض يعني لأفضل access لمن؟ + +71 +00:06:35,190 --> 00:06:39,630 +للعدسة اللي هي ال software نما اتنين بدي استخدم + +72 +00:06:39,630 --> 00:06:44,550 +اللي هو design تصميم للعدسة ان يكون هذا التصميم في + +73 +00:06:44,550 --> 00:06:49,550 +أقل اللي هو rotation و أكتر اللي هو stability واضح + +74 +00:06:49,550 --> 00:06:55,110 +الفكرة؟اذا الان لو سألنا سؤال اش المقصود بال twist + +75 +00:06:55,110 --> 00:06:58,930 +test؟ اه يا داليا اش المقصود في ال twist test؟ + +76 +00:07:01,400 --> 00:07:05,620 +اللي هو ال rotation test تمام يعني انا بدى اخلى + +77 +00:07:05,620 --> 00:07:10,000 +المريض يعمل rotation بال cylinder lens او فيلبس + +78 +00:07:10,000 --> 00:07:14,620 +فوربتر لحد ما تصبح الرؤية ايه غير واضحة بدى اشوف + +79 +00:07:14,620 --> 00:07:18,100 +قداش هذا المريض عنده sensitivity هل هي high ولا + +80 +00:07:18,100 --> 00:07:21,820 +low اذا كانت اقل من خمسة degree معناه الكلام انه + +81 +00:07:21,820 --> 00:07:25,180 +عنده high level of sensitivity اذا كانت اكتر من + +82 +00:07:25,180 --> 00:07:28,700 +خمسة degree بده يكون عنده low level of sensitivity + +83 +00:07:29,410 --> 00:07:33,270 +بالتالي اذا بدي اعرف مين ال best choice لمين + +84 +00:07:33,270 --> 00:07:38,690 +للمريض طيب + +85 +00:07:38,690 --> 00:07:44,630 +عندنا الان software lens design يعني تصميم هذا + +86 +00:07:44,630 --> 00:07:46,850 +النوع من العدسات ال software + +87 +00:07:52,230 --> 00:07:56,470 +They differ from spherical lenses، إذا تصميم + +88 +00:07:56,470 --> 00:08:00,630 +العدسات الـ Soft-Rig هيختلف عن مين؟ عن الـ + +89 +00:08:00,630 --> 00:08:04,830 +Spherical Soft Contact Lenses تمام؟ ليش؟ لأنه + +90 +00:08:04,830 --> 00:08:08,950 +هيكون في إلها front و back surface و هتعمل على + +91 +00:08:08,950 --> 00:08:13,310 +تصحيح مين قيمة الastigmatism إذا كانت موجودة في ال + +92 +00:08:13,310 --> 00:08:18,010 +front أو كانت موجودة بال back surface إذا they + +93 +00:08:18,010 --> 00:08:20,430 +differ from spherical lenses + +94 +00:08:29,290 --> 00:08:36,100 +إذا أول حاجة هي بتعتمد على قيمة السيلندريعني قداش + +95 +00:08:36,100 --> 00:08:40,440 +قيمة السلندر بالنسبة لمن يا جماعة للاسفير هذه واحد + +96 +00:08:40,440 --> 00:08:45,840 +بعد ما اعتمدت على قيمة السلندر بده اشوف ان هل هذا + +97 +00:08:45,840 --> 00:08:49,200 +السلندر في ال front ولا ال back surface اي number + +98 +00:08:49,200 --> 00:09:00,000 +two اذا number one determine the + +99 +00:09:00,000 --> 00:09:04,820 +amount of + +100 +00:09:07,970 --> 00:09:14,170 +سيلندر لينز إذا number one بدنا نحدد قيمة اللي هو + +101 +00:09:14,170 --> 00:09:18,430 +السيلندر اللي موجود عند المريض اتنين بدنا نحدد + +102 +00:09:18,430 --> 00:09:21,650 +وجود هذا السيلندر هل هو في ال front ولا ال back + +103 +00:09:21,650 --> 00:09:26,950 +surface تلاتة بدنا نحدد نوع ال stabilization يعني + +104 +00:09:26,950 --> 00:09:31,350 +هل المريض هذا عنده high level ofSensitivity ولا + +105 +00:09:31,350 --> 00:09:34,990 +low level of sensitivity؟ طبعا إذا كان عنده high + +106 +00:09:34,990 --> 00:09:39,290 +level of sensitivity معنى الكلام أنه بدي more + +107 +00:09:39,290 --> 00:09:43,810 +stability أكتر تبات لمن؟ للعدسة و أمنع أي ت + +108 +00:09:43,810 --> 00:09:46,570 +rotation للعدسة اللاصقة + +109 +00:09:50,220 --> 00:09:55,180 +The eyelids close in a temporal to nasal fashion, + +110 +00:09:56,080 --> 00:10:00,820 +producing the so-called zebra effect هان بمعنى + +111 +00:10:00,820 --> 00:10:05,300 +اللي هو طريقة الصحابة يعني الآن إحنا يما نلبس + +112 +00:10:05,300 --> 00:10:09,980 +المريض عدسة لاسقة، لاحظوا إن المريض دايما بيغلق + +113 +00:10:09,980 --> 00:10:14,620 +عينه من ال temporal to nasal هذه العملية إيش + +114 +00:10:14,620 --> 00:10:18,360 +بالساعد؟ يما يغلق من اللي هو ال temporal، طبعا هي + +115 +00:10:18,360 --> 00:10:24,150 +بتكون بشكل لحظيOkay يما بيغلق من ال temporal لال + +116 +00:10:24,150 --> 00:10:28,730 +nasal هذه بتعمل على لف شوية العدسة انه بتعمل + +117 +00:10:28,730 --> 00:10:34,010 +rotation لمين ل العدسة فهان انه في هذه الظاهرة + +118 +00:10:34,010 --> 00:10:38,850 +لازم انا ازود من قيمة مين ال stability عشان امنع + +119 +00:10:38,850 --> 00:10:43,670 +اللي هو ال rotation لمين ل العدسة اذا مرة اخرى + +120 +00:10:45,860 --> 00:10:51,180 +بمعنى طريقة السحاب او تأثير السحاب من خلاله المريض + +121 +00:10:51,180 --> 00:10:55,660 +بيغلق جفنه من ال temporal تنزل لمنع اللي هو اي + +122 +00:10:55,660 --> 00:10:59,480 +rotation لمن؟ للعدسة كيف؟ بدي ازود ال stability + +123 +00:10:59,480 --> 00:11:08,560 +يعني بمعنى انه امنع rotation للعدسة لأ + +124 +00:11:08,560 --> 00:11:13,620 +هو بيزود بيزود اللي هو ال rotationكيف انا بدي + +125 +00:11:13,620 --> 00:11:18,880 +امنعه؟ بدي اعمل الهو design انه امنع الهو مين + +126 +00:11:18,880 --> 00:11:23,420 +موضوع ال rotation تمام يا جماعة؟ يعني هذا القمر + +127 +00:11:23,420 --> 00:11:27,760 +بيزود ال rotation كيف بدي امنعه؟ بدي استخدم ال هو + +128 +00:11:27,760 --> 00:11:32,420 +prism او بدي استخدم مثلا طريقة ال truncation او اي + +129 +00:11:32,420 --> 00:11:38,920 +طريقة انه تمنع ال هو الدوران رسمها يمكن اوضح + +130 +00:11:38,920 --> 00:11:41,640 +هلجيت؟ هى مثلا العين + +131 +00:11:51,740 --> 00:11:57,920 +الان انا بدي امنع اللى هو دوران العدسة كيف بدي + +132 +00:11:57,920 --> 00:12:02,740 +اعمل؟ بدي اعمل مصدر ثقل للعدسة مصدر الثقل هذا + +133 +00:12:02,740 --> 00:12:06,790 +بيمنع اللى هو دوران العدسةأو في طريقة تانية مثلا + +134 +00:12:06,790 --> 00:12:10,590 +الـ truncation يعني هذه الظاهرة أو هذا التأثير + +135 +00:12:10,590 --> 00:12:15,830 +بيزود من مين؟ من دوران العدسة كيف بيمنعه؟ اللي هو + +136 +00:12:15,830 --> 00:12:20,610 +من خلال اللي هو ال stability يعني design معين أنه + +137 +00:12:20,610 --> 00:12:26,510 +يمنع ال stability، الآن هناخده مع بعضالصفتوريك + +138 +00:12:26,510 --> 00:12:31,850 +الأفضل سيكون لديه تحويل مينيمال و سيحافظ على موقع + +139 +00:12:31,850 --> 00:12:39,570 +مستمر يسمى بالمقاومة الآن أنا لما بده المريض ألبسه + +140 +00:12:39,570 --> 00:12:45,730 +عدسة لاصقة صفتوريك أهم شيء إيش أمنع؟ روتيشن العدسة + +141 +00:12:46,880 --> 00:12:51,400 +كيف انا ببدأ امنع روتيشن العدسة بدي اوفر design + +142 +00:12:51,400 --> 00:12:56,360 +مثالي لهذا المريض بيعمل على اللي هو ثابت العدسة في + +143 +00:12:56,360 --> 00:13:02,340 +داخل العين طبعا قد يكون في عنا اكتر من design مثل + +144 +00:13:02,340 --> 00:13:06,180 +ال prison palace او مثلا ال truncation او ال ISO + +145 +00:13:06,180 --> 00:13:10,810 +horizontal اكتر من اللي هو طريقةطيب في عملية ال + +146 +00:13:10,810 --> 00:13:14,950 +stability أفضل حاجة أنه لازم العدسة وان تكون ماخدة + +147 +00:13:14,950 --> 00:13:19,010 +ال concentration تمركز جيد يعني زيادة اللي هو + +148 +00:13:19,010 --> 00:13:23,750 +تمركز العدسة بشكل صحيح هذا هيمنع من ال rotation + +149 +00:13:23,750 --> 00:13:28,070 +للعدسة و هيوفر ليه اللي هو stability ملائم أو + +150 +00:13:28,070 --> 00:13:30,290 +مناسب للعدسة + +151 +00:13:39,770 --> 00:13:44,570 +Okay سؤال مهم دايما انا اما بمسك عدسة software + +152 +00:13:44,570 --> 00:13:48,370 +contact lens العدسة بيكون يمكن شفتوها معظمكم + +153 +00:13:52,050 --> 00:13:58,170 +أكسس تلاتين يعني العدسة مصممة هذه أو من الشركة هم + +154 +00:13:58,170 --> 00:14:01,790 +عاملين ال prescription الوصوى لها على اكسس تلاتين + +155 +00:14:01,790 --> 00:14:06,110 +زي الآن عفوا انت لما تنظفي اللي هو العدسات لإيمان + +156 +00:14:06,110 --> 00:14:10,230 +تعمليه اللي هو cleaning هل بتغير ال access لأ ليش + +157 +00:14:10,230 --> 00:14:14,410 +لأنه مافيش اي rotation ونفس الحاجة في العدسات اللي + +158 +00:14:14,410 --> 00:14:18,600 +هو ال software بيكون هناك فيه markerطبعا احنا قلنا + +159 +00:14:18,600 --> 00:14:22,840 +انه صار لها update جديد ورفعه اللي هو موضوع من ال + +160 +00:14:22,840 --> 00:14:28,580 +marker فعملية تنظيف العدسة لا يمكن انه ايش يغير من + +161 +00:14:28,580 --> 00:14:33,180 +قيمة ال access الا مع الزمن يعني كل اللي هو متقدم + +162 +00:14:33,180 --> 00:14:37,960 +العدسة في عملية التنظيف ممكن انه يعمل اللي هو + +163 +00:14:37,960 --> 00:14:42,340 +تغيير لاللي هو ال access اللي خاص بالعدسة او يزود + +164 +00:14:42,340 --> 00:14:44,960 +من قيمة ال scratch تمام؟ + +165 +00:14:48,420 --> 00:14:54,370 +Predicting بمعنى اكتشافأو اللي هو تخمين how a + +166 +00:14:54,370 --> 00:14:59,390 +toric lens will rotate on the eye cannot be done + +167 +00:14:59,390 --> 00:15:04,450 +with any reliability يعني هذا الموضوع ما بيعتمد + +168 +00:15:04,450 --> 00:15:08,730 +على ثقة ما بين الفتر و ما بين مين ال facial يعني + +169 +00:15:08,730 --> 00:15:12,330 +إيش مثلا ييجي المريض عنده يقولي والله أنا بلاحظ أن + +170 +00:15:12,330 --> 00:15:15,830 +العدسة بتلف لليمين أو في الشمال احنا بناخد ال + +171 +00:15:15,830 --> 00:15:20,950 +history بنسمع للمريض ولكن هل هذابنعتبره اللي هو + +172 +00:15:20,950 --> 00:15:25,150 +مصدر ثقة reliability بمعنى اللي هو ثقة لأ لازم انا + +173 +00:15:25,150 --> 00:15:30,690 +بدي اعمل examination عشان اعرف ان قيمة ال rotation + +174 +00:15:30,690 --> 00:15:34,510 +هادي هل هي باتجاه ال right ولا باتجاه ال left + +175 +00:15:43,360 --> 00:15:46,780 +فاكرين الـ Conventional Daily Wear Lenses؟ عندما + +176 +00:15:46,780 --> 00:15:51,180 +يكون فترة حياتها من 6 إلى 12 شهر، قلنا إنه بتم + +177 +00:15:51,180 --> 00:15:54,580 +صناعتها من خلال الـ Lathe Cutting Method ونفس + +178 +00:15:54,580 --> 00:15:58,480 +الحاجة هنا، إذا كانت العدسة، الـ Softery Contact + +179 +00:15:58,480 --> 00:16:02,720 +Lenses فترة حياتها من 6 إلى 12 شهر، بدنا نستخدم + +180 +00:16:02,720 --> 00:16:08,110 +الـ Same Methodطيب إذا كانت disposable lenses for + +181 +00:16:08,110 --> 00:16:11,530 +two weeks أو one month بدنا نستخدم اللي هو ال + +182 +00:16:11,530 --> 00:16:20,390 +molded technology method تمام؟ إذا anterior and + +183 +00:16:20,390 --> 00:16:24,550 +posterior surface are molded on both or either + +184 +00:16:24,550 --> 00:16:28,410 +surfaces يعني للسطح الأمامي ال back و ال front + +185 +00:16:28,410 --> 00:16:29,190 +surface + +186 +00:16:34,350 --> 00:16:40,350 +Okay at one time it was thought that a graffiti + +187 +00:16:40,350 --> 00:16:45,650 +caused the toric lens to position into a place on + +188 +00:16:45,650 --> 00:16:52,020 +the eyeبنرجع اجرافتي بمعنى مصدر ثقة مصدر ثقل يعني + +189 +00:16:52,020 --> 00:16:57,380 +اي عدسة لا ثقة software contact lenses لازم ان + +190 +00:16:57,380 --> 00:17:03,160 +يكون لها ايه مركز ثقل اللي هو اجرافتي عشان يمنع ال + +191 +00:17:03,160 --> 00:17:07,480 +rotation لمن؟ للعدسة او سمنها يمكن في الجانب + +192 +00:17:07,480 --> 00:17:11,700 +العملي اللي هو ال marker الساعة ستة ال six اللي هو + +193 +00:17:11,700 --> 00:17:18,260 +position تمام؟الان في مراحل لتطوير تصميم العدسة + +194 +00:17:18,260 --> 00:17:20,720 +الصوفتوريك انشوف ايش هي المراحل + +195 +00:17:28,730 --> 00:17:32,810 +طبعا هذا مبدأ اللي هو الضغط طبعا water melon إيش + +196 +00:17:32,810 --> 00:17:37,870 +هو اللي هو بذر البطيخ seed بمعنى بذر water melon + +197 +00:17:37,870 --> 00:17:43,550 +اللي هو إيه البطيخ فعنا اللي هو مبدأ بذر البطيخ أو + +198 +00:17:43,550 --> 00:17:49,630 +بسموه اللي هو مبدأ الضغط تمام كيف المبدأ هذا + +199 +00:17:49,630 --> 00:17:56,510 +explains the force يعنيبستخدم اللي هو utilize + +200 +00:17:56,510 --> 00:18:01,490 +بمعنى استخدام للقوة اذا بستخدم اللي هو القوة in + +201 +00:18:01,490 --> 00:18:06,010 +turk lens designs مش القوة بتاعة الأنظمة العربية + +202 +00:18:06,010 --> 00:18:10,350 +لأ احنا بنقول اللي هو قوة عشان نمنع اللي هو لمين + +203 +00:18:10,350 --> 00:18:16,230 +ال rotation للعدسة تمام؟ اذا بالقوة هو بده يعمل + +204 +00:18:16,230 --> 00:18:21,750 +عملية تثبيت أو stability للعدسة نشوف كيف a turk + +205 +00:18:21,750 --> 00:18:23,170 +lens must have + +206 +00:18:27,890 --> 00:18:34,290 +ببساطة بيخلي ال center مركز العدسة اللي هو في داخل + +207 +00:18:34,290 --> 00:18:39,470 +العدسة من المنتصف بيخليه اللي هو thin ولا thick؟ + +208 +00:18:39,470 --> 00:18:48,480 +طيب و الأطراف؟ ليش طيب؟ببساطة دايما الأطراف هي + +209 +00:18:48,480 --> 00:18:53,980 +أكتر حاجة بتعمل ال rotation لمين؟ للمريض، تمام؟ + +210 +00:18:53,980 --> 00:18:59,160 +اذا دايما الأطراف هم بيعملوها اللي هو ايه؟ thin و + +211 +00:18:59,160 --> 00:19:03,640 +بيزود اللي هو ال thick wave في المنتصفطبعا ممكن + +212 +00:19:03,640 --> 00:19:08,300 +طالبة تسألني في لها disadvantages ايش هي ان ال + +213 +00:19:08,300 --> 00:19:12,520 +oxygen transmissibility هتكون ايش جليلة احنا لذلك + +214 +00:19:12,520 --> 00:19:17,980 +انه في جينا ايه update لهذا الموضوع اذا مرة اخرى + +215 +00:19:17,980 --> 00:19:26,100 +مبدأ البغض او مبدأ بذور البطيخ okay ببساطة انه + +216 +00:19:26,100 --> 00:19:31,510 +بيعتمد على القوةاستخدام القوة كيف؟ انه بيوفر مصدر + +217 +00:19:31,510 --> 00:19:37,110 +ثقل انه بيخلي الأطراف نحيفة و ال center بيخليه ثقل + +218 +00:19:37,110 --> 00:19:44,910 +عشان يمنع دوران العدسة واضح؟ + +219 +00:19:44,910 --> 00:19:50,390 +طيب بالنسبة ل ال prism palest + +220 +00:19:53,480 --> 00:19:58,120 +أيضا بيسمى هذا النوع اللي هو is the most common + +221 +00:19:58,120 --> 00:20:03,120 +method هو أكتر اللي هو شيوعان هذا النوع to add a + +222 +00:20:03,120 --> 00:20:06,880 +thick zone to a soft reclines، إذا بيزود منطقة + +223 +00:20:06,880 --> 00:20:13,500 +سميكة عشان يعمل زيادة اللي هو لإيه؟لا ال stability + +224 +00:20:13,500 --> 00:20:18,500 +للعدسة يعني دائما بدك تعرفي اي تصميم احنا بنستخدمه + +225 +00:20:18,500 --> 00:20:22,780 +للعدسة اللاصقة ال soft trick انه to increase the + +226 +00:20:22,780 --> 00:20:26,680 +stability and comfort for the soft trick contact + +227 +00:20:26,680 --> 00:20:33,540 +lenses لهذا الغرضين okay because + +228 +00:20:33,540 --> 00:20:38,420 +the thickness weight is notneeded and would cause + +229 +00:20:38,420 --> 00:20:43,580 +patient awareness فيه قلوعيب دايما انا يما بلبس + +230 +00:20:43,580 --> 00:20:47,700 +عبسة بيكون من المنتصف فيه لها سماكة معينة و + +231 +00:20:47,700 --> 00:20:51,640 +الأطراف فيه لها سماكة معينة المريض إيش هيصير عنده + +232 +00:20:51,640 --> 00:20:56,160 +awareness إدراك بهذا الاشي فهيسبب للمريض excessive + +233 +00:20:56,160 --> 00:20:56,900 +awareness + +234 +00:21:02,960 --> 00:21:07,240 +يعني زيادة الإدراك في مين بالعدل الصحي أو بوجود + +235 +00:21:07,240 --> 00:21:13,190 +العدل الصحيطيب الآن ال manufacturer المصنعين كيف + +236 +00:21:13,190 --> 00:21:17,790 +اللي هو حاولوا انه يتجاوزوا هذا ال drawback هذا + +237 +00:21:17,790 --> 00:21:20,850 +العيب او هذا ال disadvantage او هذا ال limitation + +238 +00:21:20,850 --> 00:21:27,550 +تمام؟ each manufacturer uses a method to eliminate + +239 +00:21:27,550 --> 00:21:32,230 +the extra unneeded thickness at the inferior edge + +240 +00:21:32,230 --> 00:21:39,020 +which also improves stability قال لكل الزيادةبتاعة + +241 +00:21:39,020 --> 00:21:43,120 +السماكة في الأطراف بدنا نعمل عملية إزالة إليها + +242 +00:21:43,120 --> 00:21:48,580 +تمام؟ طبعا هذه إيش بتعمل؟ بتحسن من عملية اللي هو + +243 +00:21:48,580 --> 00:21:53,840 +ثبات العدسة إذا each manufacturer هدول المصنعين + +244 +00:21:53,840 --> 00:21:58,720 +استخدموا اللي هو طريقة أو method معين to eliminate + +245 +00:21:58,720 --> 00:22:03,820 +لا إزالة the extra unneeded thickness كل اللي هي + +246 +00:22:03,820 --> 00:22:08,080 +السماكة الغير مطلوبة أو الزايدةوين في الـ inferior + +247 +00:22:08,080 --> 00:22:13,080 +edge في أطراف العدسة هذه الشيء بتعمل انه بتحسن ال + +248 +00:22:13,080 --> 00:22:19,940 +stability لمن؟ للعدسة ايضا هذا ال method بنسميه له + +249 +00:22:19,940 --> 00:22:24,560 +مسميات اخرى eccentric lenticulation او بنسميه + +250 +00:22:24,560 --> 00:22:29,020 +comfort chamfer او slap off اذا فيه له another + +251 +00:22:29,020 --> 00:22:34,020 +اللي هو name لطريقة اللي هو ال prism ballast + +252 +00:22:38,500 --> 00:22:43,590 +comfort chamfer لأ هذا name of testOkay ال name of + +253 +00:22:43,590 --> 00:22:47,670 +test يعني مش شرط انه انه الكلمة تعدر عن اللي هو + +254 +00:22:47,670 --> 00:22:51,430 +ايه المفهوم يعني دايما هو ال manufacturer يما + +255 +00:22:51,430 --> 00:22:56,050 +بيعمل design معين هو بيحاول انه ايش اروجله صح ولا + +256 +00:22:56,050 --> 00:23:00,270 +لا وان كان له drawback بعدين دايما يا جماعة ال + +257 +00:23:00,270 --> 00:23:04,770 +drawback مابيجيش اول ما بيصنع العدسة صح ولا لا بعد + +258 +00:23:04,770 --> 00:23:08,510 +ما المستخدمين بيستخدموه بعد ذلك بيبين اللي هو ال + +259 +00:23:08,510 --> 00:23:15,140 +drawback او المشاكل لهذا ال designOkay All lens + +260 +00:23:15,140 --> 00:23:20,200 +designs have unique palest zones that determine + +261 +00:23:20,200 --> 00:23:21,200 +the stability + +262 +00:23:46,730 --> 00:23:51,410 +طيب الآن يما شافوا ال drawback هذا راحوا زودوا من + +263 +00:23:51,410 --> 00:23:56,630 +إيش؟ من نحافة اللي هو العدسة في الأطرافتمام؟ يما + +264 +00:23:56,630 --> 00:24:00,790 +زودوا يعني يما شافوا انه في drawback انه في اختلاف + +265 +00:24:00,790 --> 00:24:04,090 +ما بين اللي هو ال thickness في المنتصف و ال + +266 +00:24:04,090 --> 00:24:08,290 +thickness في الأطراف جالك انا بضح في المنتصف لكن + +267 +00:24:08,290 --> 00:24:11,950 +ايش؟ بقلل اللي هو السماكة وين؟ في الأطراف عشان + +268 +00:24:11,950 --> 00:24:18,010 +اريح المريض ايه؟ اكتر اذا this thinner edge around + +269 +00:24:18,010 --> 00:24:21,610 +the entire limbs increases the comfort level for + +270 +00:24:21,610 --> 00:24:24,970 +the patient اذا هذه بتزود الراحة عند المريض + +271 +00:24:28,020 --> 00:24:32,280 +طبعا وانتوا الدليل ع ذلك ان ليش العدسة ال RGB + +272 +00:24:32,280 --> 00:24:37,540 +دايما بيكون ال small diameter لها عشان مايصيرش + +273 +00:24:37,540 --> 00:24:42,020 +اللي هو hard irritation ما بين أطراف العدسة و ال + +274 +00:24:42,020 --> 00:24:46,300 +upper و ال lower eyelid عشان هيك احنا دايما بنخلي + +275 +00:24:46,300 --> 00:24:52,020 +اللي هو small diameterالبريزم palest is used for + +276 +00:24:52,020 --> 00:24:55,960 +both front and back surface torque designs إذا + +277 +00:24:55,960 --> 00:24:59,840 +بيستخدم لها ال front و ال back surface contact + +278 +00:24:59,840 --> 00:25:04,300 +lens Typically a marker is placed at the inferior + +279 +00:25:04,300 --> 00:25:07,460 +or 6 o'clock position of the torque lens + +280 +00:25:07,460 --> 00:25:10,200 +indicating the base of the prism + +281 +00:25:13,280 --> 00:25:17,340 +في اللي هو منطقة بنسميها اللي هي ال six position + +282 +00:25:17,340 --> 00:25:22,500 +الساعة ستة هذه بيكون فيها مصدر اثقل او ال Prism + +283 +00:25:22,500 --> 00:25:31,640 +Palace تمام؟ طيب + +284 +00:25:31,640 --> 00:25:37,300 +في عندنا ال Prism Palace advantages طبعا هذا من + +285 +00:25:37,300 --> 00:25:44,150 +وجهة نظر مين؟ ال manufacturer المصنعين لهاNumber + +286 +00:25:44,150 --> 00:25:48,950 +one انه بيزود ال stability زيادة ال stability هو + +287 +00:25:48,950 --> 00:25:54,070 +هذا الغرض لإجراء ايش هيك design صح ولا لا اتنين + +288 +00:25:54,070 --> 00:25:57,970 +the cylinder power increases طب ليش هو بيزود قيمة + +289 +00:25:57,970 --> 00:26:04,410 +ال cylinder power ركزوا + +290 +00:26:04,410 --> 00:26:11,890 +كويس اذا the cylinder power increases ليش + +291 +00:26:11,890 --> 00:26:13,290 +هو بيزود القوة + +292 +00:26:20,410 --> 00:26:25,110 +بساطة الذي هو نتيجة زيادة ال thickness يعني هان + +293 +00:26:25,110 --> 00:26:28,810 +زاد اللي هو من قيمة ال power لأن البساطة ال + +294 +00:26:28,810 --> 00:26:33,330 +thickness زادت في المنتصف صح ولا لأ فممكن انه يغير + +295 +00:26:33,330 --> 00:26:38,640 +في قوة mean السيلندر ايه قصدك يعني تمامالقوة + +296 +00:26:38,640 --> 00:26:43,540 +الكبيرة في السليندر دائما انا مابدأ لبس مريض soft + +297 +00:26:43,540 --> 00:26:47,220 +rec contact lenses وين هتكون ال majority power + +298 +00:26:47,220 --> 00:26:50,980 +إله؟ في السليندر يعني معقولة minus 3 او minus نص + +299 +00:26:50,980 --> 00:26:54,400 +ألبسه soft rec لأ ليش انه قيمة اللي هو السليندر + +300 +00:26:54,400 --> 00:27:02,490 +lens أقل من 25% مقارنة في مين في الاسفير powerطيب + +301 +00:27:02,490 --> 00:27:06,770 +بالنسبة لل disadvantages العيوب إلها vertical + +302 +00:27:06,770 --> 00:27:12,470 +imbalance that may occur if only one eye needs a + +303 +00:27:12,470 --> 00:27:16,470 +torque lens كيف؟ يعني الآن أنا لابس فقط في العين + +304 +00:27:16,470 --> 00:27:21,570 +ال right عدسة لاصقة و مستخدم اللي هو prism palace + +305 +00:27:21,570 --> 00:27:25,990 +و العين التانية مافيش فيها عدسةفهيكون كل مصدر + +306 +00:27:25,990 --> 00:27:30,230 +الثقة الوين على area معينة أو عزون معين فبالتالي + +307 +00:27:30,230 --> 00:27:34,490 +هيعمل vertical imbalance يعني الصورة هتكون غير + +308 +00:27:34,490 --> 00:27:39,930 +متوازنة أو غير ملائمة أو غير مناسبة بالنسبة للمريض + +309 +00:27:41,650 --> 00:27:46,130 +الان انا مثلا عندي قيمة ال refractive error في one + +310 +00:27:46,130 --> 00:27:50,290 +eye و ال another eye normal تمام؟ الان كل مصدر + +311 +00:27:50,290 --> 00:27:54,030 +الثقة ال one هيكون في area معينة او zone معين + +312 +00:27:54,030 --> 00:27:57,930 +فبالتالي هيعمل اختلاف في الرؤية ما بين ال right و + +313 +00:27:57,930 --> 00:28:01,930 +ال left eye اه + +314 +00:28:01,930 --> 00:28:06,950 +في one eye تمام؟ مش في بعض الحلات ممكن ادي له يعني + +315 +00:28:06,950 --> 00:28:13,160 +molecular اللي هو تكون soft contact lensطيب عندنا + +316 +00:28:13,160 --> 00:28:16,480 +بالنسبة ل ال figure هذا بس بدنا نضيف اللي هو ال + +317 +00:28:16,480 --> 00:28:21,480 +name له طبعا دايما انا في حالة العدسة ال software + +318 +00:28:21,480 --> 00:28:26,760 +ال contact lenses بنظر للمنطقة هذه تمام المنطقة + +319 +00:28:26,760 --> 00:28:33,620 +هذه بتعبر عن anterior eccentric lenticulation يعني + +320 +00:28:33,620 --> 00:28:38,460 +انتوا ملاحظين هل هذا هو centric متمركز بشكل جيد لأ + +321 +00:28:38,460 --> 00:28:43,830 +eccentric تمام الجماعة افهموا وبعدين اكتبواأنا + +322 +00:28:43,830 --> 00:28:47,750 +بديكم ال slides تمام؟ إذا في عندنا anterior + +323 +00:28:47,750 --> 00:28:52,650 +eccentric lenticulation يعني الشكل غير منتظم أو + +324 +00:28:52,650 --> 00:28:58,050 +غير متمركز بشكل صحيح هذا إيش هيعمل؟ هيقلل من ال + +325 +00:28:58,050 --> 00:29:03,910 +mass من كتلة العدسة و الأطراف إيش هيعمل فيها؟ + +326 +00:29:03,910 --> 00:29:08,610 +بالضبط إذا هيزود اللي هو هذا ال version الأول إذا + +327 +00:29:08,610 --> 00:29:13,590 +هيزود اللي هو من سماكة العدسة في الأطرافهذا عبارة + +328 +00:29:13,590 --> 00:29:17,590 +عن ال version الأول أو يعني بمعنى اللي هو النوع + +329 +00:29:17,590 --> 00:29:21,650 +الأول من هذا النوع من العدسات زودوا السماكة فيه + +330 +00:29:21,650 --> 00:29:27,450 +اللي هو وين الأطراف طيب + +331 +00:29:27,450 --> 00:29:34,190 +أيضا عندنا النوع نفس النوع اللي هواملاحظين ان هنا + +332 +00:29:34,190 --> 00:29:39,250 +في عندنا front و back surface هي في اللي هو طالع + +333 +00:29:39,250 --> 00:29:44,570 +على منطقة ال two dash هدولة الشحاتين تمام ال Prism + +334 +00:29:44,570 --> 00:29:48,230 +palest adds thickness to the inferior edge + +335 +00:29:51,400 --> 00:29:55,100 +uniform thickness around the lens بمعنى أخر أنا + +336 +00:29:55,100 --> 00:29:59,220 +عندي منطقة ال back surface سميكة و ال front + +337 +00:29:59,220 --> 00:30:03,340 +surface كانت اللي هو thin إيش الحل في ذلك؟ بروح + +338 +00:30:03,340 --> 00:30:06,860 +بزود السماكة في ال front surface عشان التنتين + +339 +00:30:06,860 --> 00:30:11,740 +يصيروا إيش؟ uniform اللي هو يعني symmetric متمثلين + +340 +00:30:11,740 --> 00:30:17,850 +مرة تانيةفي الشكل التاني انا في عندي منطقة اللي هي + +341 +00:30:17,850 --> 00:30:22,190 +ال back surface كانت سميكة وال front surface كانت + +342 +00:30:22,190 --> 00:30:27,090 +اللي هو thin راح زود السماكة في ال front surface + +343 +00:30:27,090 --> 00:30:31,210 +تمام اللي هو في ال inferior يعني ال front surface + +344 +00:30:31,210 --> 00:30:35,890 +اقصد فيها المنطقة العلوية عشان يصير كلهيته uniform + +345 +00:30:35,890 --> 00:30:41,850 +او symmetric متمافن hand eccentric lenticular zone + +346 +00:30:43,910 --> 00:30:49,350 +على السطح الأمامي، يساعد في إعادة صميمة الـ Edge + +347 +00:30:49,350 --> 00:30:54,070 +نفس الفكرة أنه أنا ليش روحت زودت السماكة في + +348 +00:30:54,070 --> 00:30:57,170 +المنطقة العلوية لأطراف العدسة؟ + +349 +00:31:14,300 --> 00:31:18,980 +مافيش توازن بينهم فراح زود ال thickness من الطرف + +350 +00:31:18,980 --> 00:31:22,600 +اللى هو ال inferior و ال superior عشان انه يمنع ال + +351 +00:31:22,600 --> 00:31:24,940 +rotation لمن؟ للعدسة + +352 +00:31:30,290 --> 00:31:36,710 +الـ Dynamic Stabilization هذا الطريقة يعني بمعنى + +353 +00:31:36,710 --> 00:31:41,710 +آخر ال Prism palest ياجماعة روحنا اعملنا marker + +354 +00:31:41,710 --> 00:31:47,950 +للعدسة في الساعة ستةالمركر هذا يعني بالطريقة هذه + +355 +00:31:47,950 --> 00:31:52,270 +عمل اللي هو او منع ال rotation للعدسة او خلينا + +356 +00:31:52,270 --> 00:31:56,870 +نقول قلل من ال rotation للعدسة وزود اللي هو موضوع + +357 +00:31:56,870 --> 00:32:01,250 +ال stability تمام؟ فيه لها another name زي مثلا + +358 +00:32:01,490 --> 00:32:05,710 +الكمفورت شافر او في عندنا ال slab of او ال + +359 +00:32:05,710 --> 00:32:09,290 +integration هذه كلها تعتبر another name لمين + +360 +00:32:09,290 --> 00:32:16,110 +لموضوع ال Prism Palace طبعا هي الطريقة الاولى انه + +361 +00:32:16,110 --> 00:32:21,050 +زود سماكة في منطقة و المنطقة التانية ايش اللي هو + +362 +00:32:21,050 --> 00:32:27,570 +خلاها thin طيب ال dynamic stabilization او بنسميها + +363 +00:32:27,570 --> 00:32:39,730 +ال thin zoneمن اسمه ايش بتتوقعيه؟ اذا المناطق + +364 +00:32:39,730 --> 00:32:46,710 +هتكون اللي هو عبارة عن thin كيف طيب؟ + +365 +00:32:58,750 --> 00:33:03,970 +بساطة بيروح و بعمل عملية تنحيف ل السوبريور و + +366 +00:33:03,970 --> 00:33:08,230 +الانفريور part which enhance هذه بتعمل عملية تحسين + +367 +00:33:08,230 --> 00:33:12,800 +الراحة للمرضىدايمًا المريض لما بلبس slim limbs + +368 +00:33:12,800 --> 00:33:16,580 +بتلاقي انه ايش؟ انه more comfortable اكتر اللي هو + +369 +00:33:16,580 --> 00:33:20,520 +راحة بالنسباله، ليش؟ لأنه بسهولة بتاخد اللي هو + +370 +00:33:20,520 --> 00:33:24,840 +conform to the shape of the cornea، اذا also + +371 +00:33:24,840 --> 00:33:29,440 +enhances بمعنى اللي هو تحسن، يعني بتعمل improve، + +372 +00:33:29,440 --> 00:33:30,960 +اللي هو تحسين للراحة + +373 +00:33:42,770 --> 00:33:47,490 +9 o'clock positions so that rotation can be + +374 +00:33:47,490 --> 00:33:52,170 +measured في العدسة هذه او في الطريقة هذه اللي هي + +375 +00:33:52,170 --> 00:33:56,770 +ال dynamic stabilization بيعمل ال marker وين؟ + +376 +00:33:56,770 --> 00:34:03,330 +بالتلاتة وتسعة o'clock تمام ذكرتكم في موضوع ايش؟ال + +377 +00:34:03,330 --> 00:34:06,870 +RGB بتعمل ايش؟ لكن ال three nine o'clock staining + +378 +00:34:06,870 --> 00:34:10,990 +تمام؟ اللي هي لأنه واحدة من ال disadvantages هذا + +379 +00:34:10,990 --> 00:34:15,830 +النوع من العدسات لكن هان بعمل ال marker ال three و + +380 +00:34:15,830 --> 00:34:19,890 +nine o'clock ولكن المنطقة ايش هتكون؟ thinest نحيفة + +381 +00:34:23,520 --> 00:34:28,300 +قبعا اي ماركر في داخل العدسة وانا بقدر اشوفه من + +382 +00:34:28,300 --> 00:34:32,880 +خلال الـ set lamp هذا بيسهل في عملية تحديد قيمة ال + +383 +00:34:32,880 --> 00:34:38,200 +angle الزاوية تمام او بيحدد بصورة اخرى اللي هو + +384 +00:34:38,200 --> 00:34:43,710 +rotation اللي هو الدوران لمين للعدسةلذلك العدسات + +385 +00:34:43,710 --> 00:34:47,950 +الحديثة قلنا ال stability فيها أعلى ولكن في الها + +386 +00:34:47,950 --> 00:34:51,410 +drawback إيش؟ إن ال marker مش موجود، يعني بدي أنا + +387 +00:34:51,410 --> 00:34:54,450 +أقيمه اللي هو إيه بحد ذاتي + +388 +00:35:04,530 --> 00:35:08,450 +في ال prison palace أو في المثال اللى هو بتاع ال + +389 +00:35:08,450 --> 00:35:11,850 +water melon ال principle كنا وين اللى هو ال marker + +390 +00:35:11,850 --> 00:35:15,770 +نحطه في المنطقة اللى هو ال thickest لكن هان إيش + +391 +00:35:15,770 --> 00:35:23,710 +عندنا التنتين اللى هو thinest طيب + +392 +00:35:23,710 --> 00:35:31,330 +الآن ال figure هذا إيش بيمثل لكم؟ ممتازة أول حاجة + +393 +00:35:31,330 --> 00:35:39,340 +عندنا موضوع ال threeو ال nine و clock صح ولا لا؟ + +394 +00:35:39,340 --> 00:35:44,220 +طيب عندنا ال three dash هدولة أو اللي هو ال sign + +395 +00:35:44,220 --> 00:35:49,320 +الإشارة هذه بمثل إيش؟ + +396 +00:35:49,320 --> 00:35:55,580 +هذه عبارة عن ال marker تمام؟ + +397 +00:35:55,580 --> 00:36:03,300 +يعني في عندنا three markers وين؟ في داخل العدسة + +398 +00:36:07,290 --> 00:36:13,010 +إن ال one hour ايش بالساوية تلاتين degrees صح ولا + +399 +00:36:13,010 --> 00:36:20,690 +لأ طيب الآن كل dash هذه بتمثل ten degree كل واحدة + +400 +00:36:20,690 --> 00:36:27,990 +هذه بتمثل ten degree إذا التلاتة أيش بيمثلها؟30 + +401 +00:36:27,990 --> 00:36:33,750 +ديجريز يعني عبارة عن ايه؟ one hour تمام؟ اذا ممكن + +402 +00:36:33,750 --> 00:36:37,330 +اجيبلك figure و اقولك اشرحي عليها اذا عندنا سهل + +403 +00:36:37,330 --> 00:36:41,770 +جدا هذه بتمثل اول حاجة ال method ايش هو؟ dynamic + +404 +00:36:41,770 --> 00:36:45,770 +stabilization ال dynamic stabilization في عندنا + +405 +00:36:45,770 --> 00:36:49,190 +three nine o'clock كل اللي هو dash بتمثل ten + +406 +00:36:49,190 --> 00:36:52,410 +degree التلاتة بيمثلوا قداش one hour اللي هي + +407 +00:36:52,410 --> 00:36:53,570 +thirty degrees + +408 +00:37:03,700 --> 00:37:07,220 +وكان يعمل update وحطها في thickest area يعني الآن + +409 +00:37:07,220 --> 00:37:12,460 +مرة أخرى يما هو زود ال graffiti لموضوع ال prison + +410 +00:37:12,460 --> 00:37:16,400 +palace راحوا اطلبوا انه يحط ال marker في thickest + +411 +00:37:16,400 --> 00:37:21,380 +area لكن هي كلها هذه الهو under review يعني تحت + +412 +00:37:21,380 --> 00:37:25,700 +الدراسة ما زالت يعني يا جماعة يما شاف انه نعم + +413 +00:37:28,290 --> 00:37:32,590 +أه هذه في الجيل الأول لكن الجيل التاني يما شاف انه + +414 +00:37:32,590 --> 00:37:35,690 +التأثير اللى هو مش كبير يما حط على thinest area + +415 +00:37:35,690 --> 00:37:41,070 +اضطر انه يحطها على thickest zone يعني بمعنى اللى + +416 +00:37:41,070 --> 00:37:45,410 +هو update للجيل الأول من هذا النوع من العدسات + +417 +00:37:50,950 --> 00:37:56,370 +طيب بالنسبة ل ال dynamic stabilization advantages + +418 +00:37:56,370 --> 00:38:01,550 +المميزات اللي خاصة فيها طبعا ليش هي أريح من ال + +419 +00:38:01,550 --> 00:38:08,850 +prison palace؟ بالضبط لأن ال dynamic stabilization + +420 +00:38:08,850 --> 00:38:13,290 +المنطقتين هتكون thinest zone لكن هناك هتكون منطقة + +421 +00:38:13,290 --> 00:38:15,030 +thick ومنطقة thin + +422 +00:38:22,810 --> 00:38:27,150 +الجيل الأول من ال prison palace راح حط اللي هو + +423 +00:38:27,150 --> 00:38:31,870 +منطقة الثقة اللي كلها في ال thin zone area انتم + +424 +00:38:31,870 --> 00:38:36,350 +ممكنش ماخدين بالكم تمام؟ واحدة واحدةفي السن في + +425 +00:38:36,350 --> 00:38:41,590 +المرحلة الأولى حطها في السن zone area لما حطوها في + +426 +00:38:41,590 --> 00:38:46,530 +السن zone area لاحظوا ان في هناك awareness ادراك + +427 +00:38:46,530 --> 00:38:51,970 +كبير من المريض تمام؟ راحوا عملوا عملية تبديل لها + +428 +00:38:51,970 --> 00:38:55,890 +جالك بدل ما نحطها في السن نحطها في ال sick برضه + +429 +00:38:55,890 --> 00:39:01,170 +لاحظوا ان في ايش؟ ان في اللي هو awareness ادراك من + +430 +00:39:01,170 --> 00:39:06,320 +قبل المريضفقال لك افضل حاجة ان نعمل thin zone area + +431 +00:39:06,320 --> 00:39:10,220 +في اللي هو ال superior و ال inferior اللي هي مثلة + +432 +00:39:10,220 --> 00:39:14,340 +من ال dynamic stabilization + +433 +00:39:17,100 --> 00:39:20,120 +يعني المراحل بالشكل هذا يعني الان هو ال + +434 +00:39:20,120 --> 00:39:24,300 +manufacturer بعمل اللي هو التصميم و بشوف ردف علمين + +435 +00:39:24,300 --> 00:39:28,340 +ال patience كيف اللي هو ال awareness بتاعهم فإنها + +436 +00:39:28,340 --> 00:39:32,360 +في المنطقة هذه يعني انتم لاحظين حتى ال marker area + +437 +00:39:32,360 --> 00:39:36,760 +راح رفعة من ال 6 o'clock وانخلاها في ال 39 ليش؟ + +438 +00:39:36,760 --> 00:39:43,800 +لأن المنطقة هذه أقل تأثير تمام؟طيب، الآن في الـ + +439 +00:39:43,800 --> 00:39:49,420 +dynamic stabilization، تمام؟ احنا بنعرف انه زود ال + +440 +00:39:49,420 --> 00:39:52,840 +comfort الراحة، البساطة زادت ال comfort لان + +441 +00:39:52,840 --> 00:39:58,570 +المنطقتين صارت اللي هو thin zones، تمام؟Number + +442 +00:39:58,570 --> 00:40:02,970 +two, lack of induced, the prismatic effect دايما + +443 +00:40:02,970 --> 00:40:05,890 +الprismatic effect وين بيكون تأثيره أكتر؟ في ال + +444 +00:40:05,890 --> 00:40:08,930 +vertical ولا ال horizontal؟ في ال vertical عشان هي + +445 +00:40:08,930 --> 00:40:13,670 +قلنا إيش بيعمل vertical imbalance هان صح فيه تأثير + +446 +00:40:13,670 --> 00:40:18,950 +ولكن لو قرناه في ال vertical هيكون إيه؟ أعلى تمام؟ + +447 +00:40:21,170 --> 00:40:25,390 +نشوف الـ Dynamic Stabilization لها الـ + +448 +00:40:25,390 --> 00:40:29,170 +disadvantages اللي هو موضوع الـ with the rule في + +449 +00:40:29,170 --> 00:40:32,570 +ال with the rule حيكون عندنا ايه؟ ال vertical + +450 +00:40:32,570 --> 00:40:36,090 +meridian steeper than ال horizontal meridian يما + +451 +00:40:36,090 --> 00:40:39,970 +اعمل اللي هو ال three nine o'clock بالساعة تلاتة + +452 +00:40:39,970 --> 00:40:46,170 +وتسعة حيكون اللي هو ايه؟ هيعمل اللي هولأ، هيعمل + +453 +00:40:46,170 --> 00:40:49,590 +اللي هو movement للعدسة، الجماعة تخيلوها معاه، + +454 +00:40:49,590 --> 00:40:53,570 +الآن احنا عملنا ال three nine o'clock، تمام؟ + +455 +00:40:53,570 --> 00:40:59,650 +المريض عنده إيه؟ الساعة اتناشر ستة هي ال stable، + +456 +00:40:59,650 --> 00:41:04,230 +فهتلاحظي انه هيصير في العدسة de-centration، إزاحة، + +457 +00:41:04,230 --> 00:41:07,710 +يعني ما هيكون فيه هناك اللي هو التمركز جيد، طبعا + +458 +00:41:07,710 --> 00:41:11,690 +في ال against درون، العكس، هتكون هي ال best + +459 +00:41:11,690 --> 00:41:13,430 +option، تمام؟ + +460 +00:41:16,830 --> 00:41:20,110 +طيب خليني اقف ان شاء الله ل ال ISO thickness + +461 +00:41:20,110 --> 00:41:27,750 +profile في اي سؤال؟ طيب انخص المحاضرة بشكل مبسط + +462 +00:41:27,750 --> 00:41:34,910 +الان بالنسبة لل design لل software contact lenses + +463 +00:41:34,910 --> 00:41:41,460 +دخلت بعدة مراحلالمرحلة الأولى اتمثلت بالـ Prism + +464 +00:41:41,460 --> 00:41:47,300 +Palace تمام؟ بتعتمد على زيادة ال thickness في + +465 +00:41:47,300 --> 00:41:52,780 +منطقة مقارنة في المنطقة الأخرىفي الجيل الأول من + +466 +00:41:52,780 --> 00:41:57,900 +هذه العدسات وين مضعوا اللي هو السماكة او وين مضعوا + +467 +00:41:57,900 --> 00:42:01,540 +اللي هو ال prism لان ايش هي ال marker عبارة عن ال + +468 +00:42:01,540 --> 00:42:05,660 +prism صح ولا لا وضعوه يا جماعة في المرحلة الأولى + +469 +00:42:05,660 --> 00:42:09,400 +في اللي هو .. لأ في أي منطقة اللي هو بال center + +470 +00:42:09,400 --> 00:42:14,040 +تمام فلاحظوا ان ال awareness ده المريض عالي كتير + +471 +00:42:14,040 --> 00:42:19,040 +عملوا اللي هو second generation جيل تاني من + +472 +00:42:19,040 --> 00:42:25,930 +العدساتبحيث ان يكون منطقة اللي فيها ال marker area + +473 +00:42:25,930 --> 00:42:30,490 +هي المنطقة ال thin برضه لاحظوا ان ال awareness + +474 +00:42:30,490 --> 00:42:35,770 +عالي عند المريض فاكتشفوا او اللي هو عملوا update + +475 +00:42:35,770 --> 00:42:40,330 +لموضوع ال prism palace بال dynamic stabilization + +476 +00:42:40,330 --> 00:42:45,110 +البساطة ال dynamic stabilization عمل marker في ال + +477 +00:42:45,110 --> 00:42:48,730 +three و ال nine o'clock و كل المنطقة صارت ايش؟ + +478 +00:42:48,730 --> 00:42:53,730 +thin zoneتمام؟ هي بدها يعني عملية تخيل لأن هذا + +479 +00:42:53,730 --> 00:42:57,870 +عبارة عن ايه؟ Manufacture اللي هو تصنيع، الآن في + +480 +00:42:57,870 --> 00:43:01,610 +ال three nine o'clock لما عملوها لاحظوا ان ال + +481 +00:43:01,610 --> 00:43:06,130 +stability هيكون اكتر وادراك المريض اقل بالعدسة، + +482 +00:43:06,130 --> 00:43:10,730 +لكن في إلها disadvantages اللي هو في موضوع ايه؟ ال + +483 +00:43:10,730 --> 00:43:14,510 +with the rule of stigmatism او حتى بال irregular + +484 +00:43:14,510 --> 00:43:20,700 +stigmatism بشكل عامفي اي سؤال اي استفسار يعطيكم + +485 +00:43:20,700 --> 00:43:21,140 +العافية + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/LtC_WUO6f-o_postprocess.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/LtC_WUO6f-o_postprocess.srt new file mode 100644 index 0000000000000000000000000000000000000000..da0649e63f4f4c0a7f67a375b99010484c9f730e --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/LtC_WUO6f-o_postprocess.srt @@ -0,0 +1,1552 @@ +1 +00:00:21,080 --> 00:00:23,800 +بسم الله الرحمن الرحيم، السلام عليكم ورحمة الله + +2 +00:00:23,800 --> 00:00:29,660 +وبركاته ومرحباً لكم جميعًا. هنتناول اليوم موضوع + +3 +00:00:29,660 --> 00:00:39,960 +علامات تقليل الهيبوكسيا + +4 +00:00:39,960 --> 00:00:45,550 +والهيبركابنيا.في المحاضرة السابقة عرفنا الـ + +5 +00:00:45,550 --> 00:00:50,270 +hypoxia نقص في الأكسجين الداخل للـ anterior + +6 +00:00:50,270 --> 00:00:56,010 +surface of the cornea الـ hypercapnia زيادة في + +7 +00:00:56,010 --> 00:00:59,910 +ثاني أكسيد الكربون اللي داخل للـ anterior surface + +8 +00:00:59,910 --> 00:01:05,670 +of the cornea من هذه العلمات طبعا هي متعلقة كلها + +9 +00:01:05,670 --> 00:01:11,540 +في الـ corneal epitheliumsuperfacial panictate + +10 +00:01:11,540 --> 00:01:16,460 +keratitis superfacial سطحي panictate نقطة + +11 +00:01:16,460 --> 00:01:19,980 +keratitis inflammation of the cornea + +12 +00:01:22,870 --> 00:01:27,270 +طبعا بيكون لما بنعمل corneal efflorosin staining + +13 +00:01:27,270 --> 00:01:31,570 +عند إجراء ال corneal efflorosin staining بنلاحظ أن + +14 +00:01:31,570 --> 00:01:37,050 +سطح القرنية بيظهر بالشكل هذا و كأنه نقاط على ال + +15 +00:01:37,050 --> 00:01:41,500 +corneal epitheliumفي المعمل أخدنا ال cornial + +16 +00:01:41,500 --> 00:01:46,620 +staining وقسمناها إلى grade 0 و 1 و 2 و 3 وعرفنا + +17 +00:01:46,620 --> 00:01:51,540 +ان grade 0 no staining of the cornea grade 1 mild + +18 +00:01:51,540 --> 00:01:54,660 +staining of the corneal epithelium grade 2 + +19 +00:01:54,660 --> 00:01:57,940 +moderate staining of the corneal epithelium و + +20 +00:01:57,940 --> 00:02:03,660 +grade 3 severe staining of the corneal epitheliumA + +21 +00:02:03,660 --> 00:02:08,340 +premature sheeting of small groups of surface + +22 +00:02:08,340 --> 00:02:15,300 +cells الطبقة أو الـ corneal epithelium عند ارتداء + +23 +00:02:15,300 --> 00:02:19,500 +العدسة اللاصقة هتتقشر، اذا هيصير لها نوع من + +24 +00:02:19,500 --> 00:02:25,160 +التقشر، بالتالي ان هي حيصير فيها ضعف، نتيجة ايش + +25 +00:02:25,160 --> 00:02:32,200 +هذا التقشر؟ ضعف الروابط ما بين الخلاياأكتر حاجة + +26 +00:02:32,200 --> 00:02:36,680 +بنخاف منها في هذا النوع هو موضوع ال infection، + +27 +00:02:36,680 --> 00:02:40,720 +العدوى، ليه؟ لأن طبقة ال corneal epithelium هي + +28 +00:02:40,720 --> 00:02:45,620 +تعتبر regeneration، يعني حتى لو اتقشرت بعد 24 ساعة + +29 +00:02:45,620 --> 00:02:50,880 +بصير عملية ايه؟ تجدد إلها، ولكن الخوف من ال + +30 +00:02:50,880 --> 00:02:54,100 +superficial panictate keratitis هو موضوع ال + +31 +00:02:54,100 --> 00:02:54,520 +infection + +32 +00:02:57,860 --> 00:03:02,140 +بعد ذلك إيش هيسبب؟ إذا أول حاجة هيعمل تقشر للـ + +33 +00:03:02,140 --> 00:03:05,760 +corneal epithelium number two disruption of the + +34 +00:03:05,760 --> 00:03:11,640 +ocular surface mucous layer أي بمعنى عرقلة أو قطع + +35 +00:03:11,640 --> 00:03:16,940 +لمين؟ للطبقة المخاطية اللى موجودة وين؟ فى سطح + +36 +00:03:16,940 --> 00:03:17,480 +العين + +37 +00:03:20,470 --> 00:03:25,530 +بتتميز ال superficial panictate keratitis بإنها + +38 +00:03:25,530 --> 00:03:31,060 +asymptomatic، إيش معناها؟يعني لا يوجد هناك أعراض، + +39 +00:03:31,060 --> 00:03:35,840 +يعني المريض لا يشعر بأي ألم، لا يوجد ألم بيشعر فيه + +40 +00:03:35,840 --> 00:03:39,280 +مين المريض، يعني مش هييجي على المركز يقول لي مثلا + +41 +00:03:39,280 --> 00:03:42,500 +في عندي watering أو في عندي redness أو في عندي + +42 +00:03:42,500 --> 00:03:46,740 +itching، لأ without pain، أنا كيف بدأ اكتشفها؟ من + +43 +00:03:46,740 --> 00:03:50,040 +ال clinical sign of a dry eye العبارة عن ال + +44 +00:03:50,040 --> 00:03:55,100 +corneal florescein staininga symptomatic because + +45 +00:03:55,100 --> 00:04:00,080 +the injury threshold of the cornea is less than + +46 +00:04:00,080 --> 00:04:05,160 +the touch threshold دايما كلمة threshold معناها + +47 +00:04:05,160 --> 00:04:11,260 +استطالة أو إثارة، دايما يما بيكون الاستطالة أو + +48 +00:04:11,260 --> 00:04:16,100 +الإثارة في الأطراف بيكون أقل أثرا من يما تكون في + +49 +00:04:16,100 --> 00:04:20,920 +ال center، فلذلك المريض ما بيشعر بأي وجود لألم + +50 +00:04:33,860 --> 00:04:39,820 +ملاحظين في الشكل ان وجود ال staining وين على ال + +51 +00:04:39,820 --> 00:04:45,740 +upper part ايضا لل corneal ابيثيليام Staining in a + +52 +00:04:45,740 --> 00:04:47,660 +horizontal linear pattern + +53 +00:04:51,550 --> 00:04:55,630 +close to the superior limbus هيكون قريب من مين من + +54 +00:04:55,630 --> 00:04:59,110 +ال limbus لأنه احنا بنعرف ان ال diameter للعدسة + +55 +00:04:59,110 --> 00:05:03,890 +اللاصقة ال soft contact lenses هتصل تقريبا لل para + +56 +00:05:03,890 --> 00:05:11,330 +limbal okay the sign is more likely in patients + +57 +00:05:11,330 --> 00:05:16,290 +with tight or low positioning upper limbs دايما + +58 +00:05:16,290 --> 00:05:19,950 +هذه بتكون مصاحبة لمين لإنسان عنده tight + +59 +00:05:23,140 --> 00:05:31,440 +لل upper eyelid هذه النقطة الأولى النقطة التانية + +60 +00:05:31,440 --> 00:05:42,420 +ان هذا الشخص ايش بيكون عنده partially toses بمعنى + +61 +00:05:42,420 --> 00:05:46,900 +ان ما بيصير هناك اي تتنفس لهذه المنطقة يعني ما + +62 +00:05:46,900 --> 00:05:52,340 +بيدخل ال oxygen بكمية كافية وكأنه في هناك close + +63 +00:05:53,950 --> 00:06:01,010 +Eyes اغلاق لمين للعينتين Reduced + +64 +00:06:01,010 --> 00:06:05,750 +oxygen availability to the superior region of the + +65 +00:06:05,750 --> 00:06:10,630 +cornea اذا هيحدث هناك نقص لدخول ال oxygen في هذه + +66 +00:06:10,630 --> 00:06:17,690 +المنطقة Even in daily contact lens wear طبعا hand + +67 +00:06:17,690 --> 00:06:21,650 +daily أي بمعنى conventional daily wear يعني عدسات + +68 +00:06:21,650 --> 00:06:26,920 +اللبس اليومي التقليديThe superior cornea is an + +69 +00:06:26,920 --> 00:06:31,940 +extended wear is covered by the upper lid ايش + +70 +00:06:31,940 --> 00:06:37,800 +المقصود فيها؟ ان المريض هو بلبس عدسات اللبس اليومي + +71 +00:06:37,800 --> 00:06:41,780 +التقليدي طبعا احنا بنعرف عدسات اللبس اليومي + +72 +00:06:41,780 --> 00:06:48,410 +التقليدي maximum هتصل لقداش اتناشر hours صحيح؟الان + +73 +00:06:48,410 --> 00:06:53,990 +هذا المريض نتيجة ان في عنده partially dropping او + +74 +00:06:53,990 --> 00:06:59,030 +في عنده tight لل eyelid و كأنه لابس عدسات extended + +75 +00:06:59,030 --> 00:07:03,130 +wear طبعا احنا عارفين عدسات ال extended wear + +76 +00:07:03,130 --> 00:07:07,650 +المريض بلبسها لمدة اسبوع واحد و بينام فيها لازم ان + +77 +00:07:07,650 --> 00:07:11,210 +يكون فيها ال DK على T very high compared to mean + +78 +00:07:12,180 --> 00:07:16,460 +conventional daily wear فهذا المريض نتيجة ال + +79 +00:07:16,460 --> 00:07:20,720 +partially dropping لل upper eyelid او ال tight لل + +80 +00:07:20,720 --> 00:07:24,920 +upper eyelid هيكون لابس عدسات اللبس اليوم التقليدي + +81 +00:07:24,920 --> 00:07:29,980 +لكن و كأنه هي بتمثل ايه extended wear lenses + +82 +00:07:29,980 --> 00:07:35,600 +فبيحدث عنده مين ال superior arcuate panectate + +83 +00:07:35,600 --> 00:07:42,240 +staining طيب ايه ما اختار؟Superfacial panictate + +84 +00:07:42,240 --> 00:07:47,780 +keratitis ولا ال superior arcuate staining؟ طبعا + +85 +00:07:47,780 --> 00:07:52,180 +الأخطر اللي هي ال superior لأنه نوعا ما المريض + +86 +00:07:52,180 --> 00:07:58,340 +بيشعر بوجود ألم، okay؟ و بيكون هناك في عنده يعني + +87 +00:07:58,340 --> 00:08:02,320 +أعراض مصاحبة لمين لل clinical science بس طالما + +88 +00:08:02,320 --> 00:08:05,940 +بيشعر بألم مش هتكون فخر يعني هيروح للطبيب مباشر؟ + +89 +00:08:05,940 --> 00:08:12,980 +أكيدلأ ايضا ال super facial panictate keratitis هي + +90 +00:08:12,980 --> 00:08:18,780 +مش هتكون deep يعني هتكون سطحية فممكن علاجها يعني + +91 +00:08:18,780 --> 00:08:21,640 +بمعنى انه هيكون عنده mild corneal fluorescein + +92 +00:08:21,640 --> 00:08:28,700 +staining مش هتصل للمدرة او السيفير لان كل هذا + +93 +00:08:28,700 --> 00:08:32,500 +هيكون متعلق في مين؟ في ال corneal epithelium مش + +94 +00:08:32,500 --> 00:08:37,820 +هيكون في الاسترومة او ال endotheliumبالنسبة لـ + +95 +00:08:37,820 --> 00:08:43,000 +Epithelial Aberration أبراشن بمعنى كشط لمن؟ لطبقة + +96 +00:08:43,000 --> 00:08:47,560 +الـ corneal epithelium الآن لو احنا وضعنا إفلروسين + +97 +00:08:47,560 --> 00:08:52,140 +هيكون بالشكل هذا عبارة عن confluent أي بمعنى منطقة + +98 +00:08:52,140 --> 00:08:57,280 +متجمعة، هتتجمع كلها في المنطقة هذه صبغة الإفلروسين + +99 +00:08:57,280 --> 00:09:00,740 +Severe + +100 +00:09:00,740 --> 00:09:04,420 +central efflurosin staining resulting + +101 +00:09:10,500 --> 00:09:16,160 +إذا في هذه الحالة المريض يجب أن لا يلبس العدسة + +102 +00:09:16,160 --> 00:09:20,180 +لازم ان انا اوقفه عن ارتداء العدسة في الـ + +103 +00:09:20,180 --> 00:09:21,360 +epithelial aberration + +104 +00:09:25,750 --> 00:09:31,030 +become adherent to an epithelium already weakened + +105 +00:09:31,030 --> 00:09:36,510 +by hypoxia إذا مدام العدسة بتعمل adherence to the + +106 +00:09:36,510 --> 00:09:41,850 +eye معنى الكلام إن العدسة tight lens إذا هان if + +107 +00:09:41,850 --> 00:09:46,110 +the lens has become adherent to an epithelium إذا + +108 +00:09:46,110 --> 00:09:52,540 +العدسة tight lens إنه no sensation at allAlready + +109 +00:09:52,540 --> 00:09:58,040 +weakened by hypoxia هيتم إلها ضعف بنقص ال oxygen + +110 +00:09:58,040 --> 00:10:04,820 +أو دخول ال oxygen لهذه المنطقةالابراشن الكشط هذا + +111 +00:10:04,820 --> 00:10:10,180 +will have sharply demarcated هيعمل شكل مخطط زي ما + +112 +00:10:10,180 --> 00:10:14,080 +احنا شايفينه في الفلورسين each and maybe several + +113 +00:10:14,080 --> 00:10:18,540 +millimeters in diameter و هيكون قطر اشماله كبير + +114 +00:10:18,540 --> 00:10:23,800 +مقارنة بال superfacial panectate keratitis او في + +115 +00:10:23,800 --> 00:10:30,180 +ال superior staining these + +116 +00:10:30,180 --> 00:10:35,360 +are acute conditionsدايماً هذه إيش بتكون acute + +117 +00:10:35,360 --> 00:10:41,480 +حادة significant discomfort or pain المريض هيشعر + +118 +00:10:41,480 --> 00:10:46,080 +بعدم راحة و ألم شديد طبعا متى هذا الألم الشديد + +119 +00:10:46,080 --> 00:10:51,020 +بيظهر؟ بالضبط لما ال practitioner بيعمل عملية + +120 +00:10:51,020 --> 00:10:53,180 +removal لل soft contact lens + +121 +00:10:56,500 --> 00:11:00,940 +The lesion is not usually infected by stromal + +122 +00:11:00,940 --> 00:11:05,980 +infiltration is not present هان في هذه الحالة مش + +123 +00:11:05,980 --> 00:11:11,880 +هيصاب المريض بأي انفكشن لأن الأمر هذا مش هيكون + +124 +00:11:11,880 --> 00:11:17,800 +علاقة في الاسترومة يعني لا يؤذي الاسترومة و دايما + +125 +00:11:17,800 --> 00:11:21,720 +الانفكشن بيكون مصاحب لمن؟ للاسترومال + +126 +00:11:24,090 --> 00:11:29,070 +إذا بتميز هذا النوع صحيح بشدة ألم وعدم راحة للمريض + +127 +00:11:29,070 --> 00:11:35,550 +وإن العدسة بتكون tight مع الابيثيليا وبسبب hypoxia + +128 +00:11:35,550 --> 00:11:41,750 +لكن rarely من النادر أن يحدث infection للمريض + +129 +00:11:45,900 --> 00:11:51,620 +نومبر فور مايكرو زيست و vacuous مايكرو زيست ايش + +130 +00:11:51,620 --> 00:11:58,760 +معناها هو يصلها و vacuous بمعنى فراغات طبعا بيكون + +131 +00:11:58,760 --> 00:12:05,060 +بالشكل هذا النقاط البيض و منطقتها يعني بيكون ال + +132 +00:12:05,060 --> 00:12:13,130 +area في ال superior part في الغالبtranslucent zest + +133 +00:12:13,130 --> 00:12:17,730 +أي بمعنى اللي هو أكياس بتكون شبه شفافة in the + +134 +00:12:17,730 --> 00:12:23,790 +epithelium 0.01 to 0.1 millimeter in diameter إذا + +135 +00:12:23,790 --> 00:12:28,790 +قطرها إيش ملاحظينه؟ إنه very small وهذا بتديني + +136 +00:12:28,790 --> 00:12:33,950 +indicator مؤشر إنه لا يمكن رؤيتها بالعين المجردة + +137 +00:12:33,950 --> 00:12:41,740 +إذا بتحتاج إيه؟ micro scope في هناك طريقةمن خلال + +138 +00:12:41,740 --> 00:12:46,400 +الـ retro illumination يمكن ان اشوف هذه الأكياز + +139 +00:12:46,400 --> 00:12:52,500 +ولكن بتحتاج لخبرة كبيرة من ال examiner طيب انا ك + +140 +00:12:52,500 --> 00:12:56,580 +beginner مبتدئ كيف اعرف ان هذا المريض عنده micro + +141 +00:12:56,580 --> 00:13:01,160 +zest او اكتشف هذا الأمر؟ البساطة اني بعمل ال + +142 +00:13:01,160 --> 00:13:06,120 +corneal fluorescein staining ممكن انه يديني انطباع + +143 +00:13:06,120 --> 00:13:09,820 +او مؤشر اذا المريض كان عنده micro zest + +144 +00:13:13,110 --> 00:13:24,990 +الميكروزيكس صغير وقليل من الواكولاس بشكل + +145 +00:13:28,460 --> 00:13:33,120 +destination is uncertain التنتين غير محددة ال + +146 +00:13:33,120 --> 00:13:38,160 +function لهم يعني لحد الآن ال micro zest و ال + +147 +00:13:38,160 --> 00:13:43,240 +vacuous التنتين without function بدون أي وظيفة + +148 +00:13:45,730 --> 00:13:50,090 +It takes 6 to 8 weeks of extended wear with + +149 +00:13:50,090 --> 00:13:55,990 +hydrogel lenses before micro-zest appear دايما + +150 +00:13:55,990 --> 00:14:01,810 +بتاخد مدة من 6 ل 8 أسابيع لظهور من ال micro-zest + +151 +00:14:01,810 --> 00:14:07,090 +او ال vaculus طب هان سؤال انه هل هي بتتعلق في ال + +152 +00:14:07,090 --> 00:14:11,090 +daily wear اقصد اللي هو ال daily disposable lenses + +153 +00:14:11,090 --> 00:14:14,250 +ولا ال extended wear ولا ال conventional daily + +154 +00:14:14,250 --> 00:14:18,550 +wearالها علاقة في ال extended wear و ال + +155 +00:14:18,550 --> 00:14:22,230 +conventional daily wear ليه؟ لأنه بمعنى هي + +156 +00:14:22,230 --> 00:14:25,370 +chronic، ما بتيجي بشكل ايه مفاجئ + +157 +00:14:30,010 --> 00:14:35,410 +One clue يعني واحدة من الأفكار to the presence + +158 +00:14:35,410 --> 00:14:41,630 +لظهور of microcyst or vacuous may be scattered by + +159 +00:14:41,630 --> 00:14:45,150 +nectarine fluorocene staining زي ما اتفقنا ان + +160 +00:14:45,150 --> 00:14:50,170 +واحدة من الحلول او واحدة من المؤشرات ان هذا المريض + +161 +00:14:50,170 --> 00:14:55,250 +عنده microcyst او vacuous من خلال ايه ان استخدم + +162 +00:14:55,250 --> 00:14:56,470 +الكورنيا لفلوروسين + +163 +00:14:59,640 --> 00:15:05,760 +يعني وجودها أو عدم وجودها طبعا الأربعة هدول لا + +164 +00:15:05,760 --> 00:15:11,100 +يعتبروا مخيفات بشكل كبير لأن موقعهم كله وين في ال + +165 +00:15:11,100 --> 00:15:16,180 +corneal epithelia management + +166 +00:15:16,180 --> 00:15:20,620 +أي بمعنى العلاج أو آلية العلاج أو الطريقة + +167 +00:15:20,620 --> 00:15:26,460 +significant epithelial staining المقصود فيها إما + +168 +00:15:26,460 --> 00:15:34,390 +moderate أو severe24 hour discontinuation of lens + +169 +00:15:34,390 --> 00:15:38,770 +wear إذا الشخص كان عنده severe أو moderate + +170 +00:15:38,770 --> 00:15:43,650 +staining وظهر عنده الحالات هدول الأربعة بعمل عملية + +171 +00:15:43,650 --> 00:15:49,150 +توقيف لارتداء العدسة لمدة 24 ساعة هان إيش بنقصد ال + +172 +00:15:49,150 --> 00:15:53,210 +conventional daily wear طبعا إذا كانت extended + +173 +00:15:53,210 --> 00:15:58,430 +wear أو daily disposable lenses بنوقفها بشكل إيه؟ + +174 +00:15:58,430 --> 00:16:04,190 +كاملمرة تانية، الآن إذا كان المريض عنده moderate + +175 +00:16:04,190 --> 00:16:07,930 +أو severe staining وكان بلبس conventional daily + +176 +00:16:07,930 --> 00:16:16,090 +wear بوقف ارتداء العدسة لمدة كده؟ 24 ساعة طبعا إذا + +177 +00:16:16,090 --> 00:16:19,630 +ظهرت عندي الأربع حالات هدول ال superfacial + +178 +00:16:19,630 --> 00:16:23,230 +panictate keratitis أو ال superior arcuate + +179 +00:16:23,230 --> 00:16:27,130 +panictate staining أو epithelial aberration أو ال + +180 +00:16:27,130 --> 00:16:34,370 +micro zestإذا ما ظهروا خلاص ان المريض بيستمر في + +181 +00:16:34,370 --> 00:16:39,810 +ارتداء العدسة طيب بعض الأحيان انت بتعمل الفحص ولكن + +182 +00:16:39,810 --> 00:16:44,250 +انه بيصير ايه اللي هو absent غياب إلها يعني بمعنى + +183 +00:16:44,250 --> 00:16:48,330 +الآن انا اتوقفت اربع وعشرين ساعة عن ارتداء العدسة + +184 +00:16:48,330 --> 00:16:51,650 +روحت اعملت corneal florescence stain مرة تانية + +185 +00:16:51,650 --> 00:16:56,350 +مظهرش البانكتيت كيروتايتس ايش بدي اعمل في هذه + +186 +00:16:56,350 --> 00:17:01,480 +الحالة؟ برجع ألبس العدسةولكن إذا كان هذا المريض + +187 +00:17:01,480 --> 00:17:07,440 +بلبس extended wear أو daily disposable lenses، بده + +188 +00:17:07,440 --> 00:17:11,640 +يتوقف بشكل كامل، في حالة مين؟ الـ significant + +189 +00:17:11,640 --> 00:17:18,340 +staining، اللي هي ال moderate أو السيفير، mild + +190 +00:17:18,340 --> 00:17:25,220 +staining يعني grade one، reducing wearing time، + +191 +00:17:25,220 --> 00:17:30,340 +بدنا نقلل من ساعات ارتداء العدسةfor example to + +192 +00:17:30,340 --> 00:17:35,720 +less than ten hours beer day or ceasing extended + +193 +00:17:35,720 --> 00:17:36,040 +wear + +194 +00:17:41,320 --> 00:17:45,460 +بنقوله فقط لبس العدسة اربع ساعات او ساعتين او + +195 +00:17:45,460 --> 00:17:50,880 +تلاتة يعني المهم انه اوقف من عدد يعني اوقف اللي هو + +196 +00:17:50,880 --> 00:17:54,700 +عدد الساعات ارتدائي العدسة طب لو كانت extended + +197 +00:17:54,700 --> 00:17:59,880 +wear او daily disposable lenses بوقفها بشكل كامل + +198 +00:17:59,880 --> 00:18:04,080 +حتى في ال mild حتى في ال mild staining ليه؟ لان ال + +199 +00:18:04,080 --> 00:18:07,440 +mild staining لو لبس العدسة لمدة اسبوع حصير + +200 +00:18:07,440 --> 00:18:08,400 +moderate او severe + +201 +00:18:12,570 --> 00:18:16,250 +if the staining is chronic يعني هذا كان ال + +202 +00:18:16,250 --> 00:18:20,050 +staining مظمن عند الشخص من قبل حتى ما يرتدي عدسة + +203 +00:18:20,050 --> 00:18:25,170 +لاسقة even if it's light or mild حتى لو كان بسيط + +204 +00:18:25,170 --> 00:18:30,770 +modification أي بمعنى تعديل of lens parameters انا + +205 +00:18:30,770 --> 00:18:35,650 +بدي اعمل عملية تعديل لمين لل parameters اللي خاصة + +206 +00:18:35,650 --> 00:18:42,370 +في العدسة to increase dk على t is advisableطب هذا + +207 +00:18:42,370 --> 00:18:55,410 +الكلام ممكن يكون خطأ صح؟ مين بتفق معايا؟ ممتازة + +208 +00:18:55,410 --> 00:19:01,090 +بالضبط، يعني الآن مثلا شخص كان عنده dry eye في بعض + +209 +00:19:01,090 --> 00:19:05,150 +الأحيان قد يكون مصاحب له ايه؟ ال corneal + +210 +00:19:05,150 --> 00:19:10,430 +fluorescein staining فروحت انا زودت ال DK على Tإيش + +211 +00:19:10,430 --> 00:19:15,770 +صار؟ زود الجفاف يعني ال dry eye symptoms صار أكتر + +212 +00:19:15,770 --> 00:19:20,270 +ظهور لهذا الشخص فانا إيش عملت في هذه الحالة؟ أسأت + +213 +00:19:20,270 --> 00:19:25,130 +اللي هو أكتر ل ال patient واضحة الفكرة؟ فدايما ال + +214 +00:19:25,130 --> 00:19:30,130 +parameters مش المقصود فيها اللي هو أنه فقط أزود ال + +215 +00:19:30,130 --> 00:19:34,930 +DK على T لأ لازم أنا أراعي كل الظروف يعني ممكن أنا + +216 +00:19:34,930 --> 00:19:40,660 +أغير ال thickness دون تغيير مين؟ ال DK على Tكيف + +217 +00:19:40,660 --> 00:19:44,680 +طيب؟ ممكن مثلا هو بلبس low water content بخليه + +218 +00:19:44,680 --> 00:19:48,000 +medium water content ولكن بقلل ال mean ال + +219 +00:19:48,000 --> 00:19:53,520 +thickness فدايما يعني اختيار ال option مهم كتير في + +220 +00:19:53,520 --> 00:19:54,720 +جميع الظروف + +221 +00:19:59,590 --> 00:20:04,630 +Superior arcuate panectate staining may require an + +222 +00:20:04,630 --> 00:20:09,850 +improvement to peripheral lens، DK على T وهذا أمر + +223 +00:20:09,850 --> 00:20:16,190 +طبيعي لأن هو عنده tight upper eyelid أو في عنده .. + +224 +00:20:16,190 --> 00:20:21,830 +في عنده partially toses ففي هذه الحالة أنا إيش بدي + +225 +00:20:21,830 --> 00:20:27,440 +أعمل؟ أزود الـDK على T من الأطرافعشان إيش يعمل + +226 +00:20:27,440 --> 00:20:33,200 +زيادة لدخول ال oxygen وين؟ في الأطراف whereas + +227 +00:20:33,200 --> 00:20:38,240 +بينما central staining may indicate the need to + +228 +00:20:38,240 --> 00:20:43,360 +improve central corneal oxygenation لكن لو كان + +229 +00:20:43,360 --> 00:20:46,620 +عنده الحالة الأولى ال superficial panictate + +230 +00:20:46,620 --> 00:20:50,700 +keratitis لجينا إن كل ال staining وين موجود؟ في ال + +231 +00:20:50,700 --> 00:20:54,340 +center فانا بدى أزود ال DK على T وين؟ في ال center + +232 +00:20:59,450 --> 00:21:04,870 +Unlike ocular changes with other causes, ocular + +233 +00:21:04,870 --> 00:21:10,250 +changes related to hypoxia and hypercapnia tend to + +234 +00:21:10,250 --> 00:21:14,410 +affect only the cornea, and there are a few + +235 +00:21:14,410 --> 00:21:20,570 +associated symptoms دايما الأعراض اللي بتسببها + +236 +00:21:20,570 --> 00:21:25,210 +الhypercapnia أو الhypoxia بتكون متعلقة في + +237 +00:21:25,210 --> 00:21:30,250 +الكورنيافي بعض الأحيان بتكون مصاحبة للأجزاء اللى + +238 +00:21:30,250 --> 00:21:35,630 +حوالين مين الكورنيا زى مثلا ايش يا رغد؟ زى مثلا + +239 +00:21:35,630 --> 00:21:41,230 +عندنا ال eyelid انه يصير عنده eyelid disorders او + +240 +00:21:41,230 --> 00:21:45,090 +مثلا يصير عنده conjunctival staining فهذه هيكون + +241 +00:21:45,090 --> 00:21:51,370 +مصاحبة لمين؟ للكورنيا disorders و بالتالي المريض + +242 +00:21:51,370 --> 00:21:55,110 +هيصير عنده شكوى اكتر في هذا الأمر + +243 +00:21:59,300 --> 00:22:05,500 +Stromal Edema طبعاً بداية الاسترومة او ال + +244 +00:22:05,500 --> 00:22:10,300 +Substantia Epropria هي بتمثل تسعين في المية تقريبا + +245 +00:22:10,300 --> 00:22:17,470 +من سماكة مين القرنيةarises within hours of the + +246 +00:22:17,470 --> 00:22:23,070 +onset of hypoxia، الآن الـ hypoxia لم تكتفي فقط في + +247 +00:22:23,070 --> 00:22:27,610 +التأثير على الـ corneal epithelium، بينما امتد + +248 +00:22:27,610 --> 00:22:33,470 +الأمر لوين؟ للاسترامة، دايماً لما تسمع ان في هناك + +249 +00:22:33,470 --> 00:22:38,150 +defect موجود في الاسترامة، في الغالب هيكون مصاحب + +250 +00:22:38,150 --> 00:22:42,690 +له infection زي الاسترامة ال infiltration + +251 +00:22:46,690 --> 00:22:50,470 +The degree being related to the severity of the + +252 +00:22:50,470 --> 00:22:56,310 +hypoxia وهذا بالأساس بيعتمد على حدة الهيبوكسية كل + +253 +00:22:56,310 --> 00:23:01,710 +ما زادت الهيبوكسية كل ما كان هناك عرضة أكتر لحدوث + +254 +00:23:01,710 --> 00:23:06,830 +من الهيبوكسية + +255 +00:23:06,830 --> 00:23:09,830 +الهيبوكسية related increase + +256 +00:23:11,810 --> 00:23:16,590 +In anaerobic metabolism دايماً إلها علاقة في زيادة + +257 +00:23:16,590 --> 00:23:22,190 +مين؟ عملية الهدم، عندنا ال aerobic metabolism + +258 +00:23:22,190 --> 00:23:27,350 +عملية البناء، ال anaerobic metabolism عملية الهدم + +259 +00:23:28,670 --> 00:23:34,070 +via the Emden-Meyerhof biochemical pathway of the + +260 +00:23:34,070 --> 00:23:40,170 +epithelial cells طبعا عملية الهدم هي مصاحبة لهؤلاء + +261 +00:23:40,170 --> 00:23:46,370 +العالمين Emden and Meyerhof اللي عملوا تجاربطبعا + +262 +00:23:46,370 --> 00:23:50,490 +كانت هذه التجارب من خلال أخد عينة من ال tiers + +263 +00:23:50,490 --> 00:23:54,630 +وتحليل ال protein اللي موجود في ال tier و بعد ذلك + +264 +00:23:54,630 --> 00:24:00,110 +تحليل ما هو مصاحب لل defect اللي حدث في ال corneal + +265 +00:24:00,110 --> 00:24:05,510 +epithelium و ال stroma accumulation انه صار في + +266 +00:24:05,510 --> 00:24:10,590 +هناك تراكم of lactate للأملاح وين هذا التراكم حدث؟ + +267 +00:24:10,590 --> 00:24:16,770 +in the stromaان انفلوه طبعا صار هناك تدفق of water + +268 +00:24:16,770 --> 00:24:22,290 +into the stroma وحدث اديمة يعني بمعنى انه ايش حدث + +269 +00:24:22,290 --> 00:24:28,390 +حاجة حاجة بنسميها ال swelling of + +270 +00:24:28,390 --> 00:24:37,530 +the stroma اذا حدث انتفاخ لمين للاسترومة + +271 +00:24:41,440 --> 00:24:48,370 +corneal thickness زيادة السماكةطبعا زيادة السماكة + +272 +00:24:48,370 --> 00:24:54,770 +ليس من السهل عملية تقييمها كليكيا طبعا احنا بنعرف + +273 +00:24:54,770 --> 00:25:00,030 +ان قياس سماكة القرانية ممكن ان يتم من خلال جهاز ال + +274 +00:25:00,030 --> 00:25:05,750 +باكميتر ولكن الآن زيادة سماكة الكورنية نتيجة + +275 +00:25:05,750 --> 00:25:10,190 +ارتداء العدسة اللاصقة مش من السهل تقييمها ليه؟ لأن + +276 +00:25:10,190 --> 00:25:16,570 +ممكن مثلا في الصباح يكون السماكة 500بعد الظهر يكون + +277 +00:25:16,570 --> 00:25:22,790 +مثلا أجل، مثلا أربعمية و خمسين، بعد ذلك في الليل + +278 +00:25:22,790 --> 00:25:27,650 +ممكن كمان اتقل اكتر، ففي ملاحظين انه variation من + +279 +00:25:27,650 --> 00:25:32,830 +حيث مين ال values أو ال numbersكل فترة زمنية + +280 +00:25:32,830 --> 00:25:38,470 +هتختلف عن الفترة الزمنية التانية وهذه هي دايما ال + +281 +00:25:38,470 --> 00:25:42,250 +complications اللي مصاحبة لمين لل soft contact + +282 +00:25:42,250 --> 00:25:47,490 +lens اللي من الصعب ان المريض يكتشفها يعني مين مننا + +283 +00:25:47,490 --> 00:25:51,450 +الان لو بلبس soft contact lens يعمل تلت مرات قياس + +284 +00:25:51,450 --> 00:25:54,450 +ل ال corneal thickness؟ هيكون قمر مجهد + +285 +00:25:56,890 --> 00:26:01,330 +إذا is not simple ليس من السهل أو من البسيط to + +286 +00:26:01,330 --> 00:26:06,410 +measure clinically قياسها بالعيادة أو في ال center + +287 +00:26:06,410 --> 00:26:12,610 +The edema response دايما استجابة ال edema begins + +288 +00:26:12,610 --> 00:26:17,610 +تبدأ within half an hour of lens insertion بعد + +289 +00:26:17,610 --> 00:26:22,540 +النص الساعة الأولى من ارتداء العدسةand generally + +290 +00:26:22,540 --> 00:26:27,900 +bakes within three hours وبتكون القمة لها بعد قديش + +291 +00:26:27,900 --> 00:26:32,560 +تلت ساعات in + +292 +00:26:32,560 --> 00:26:38,400 +daily wear lenses typically ranges from one point + +293 +00:26:38,400 --> 00:26:43,100 +five percent to five percent طبعا هان المقصود فيها + +294 +00:26:43,100 --> 00:26:46,720 +ال conventional daily wear عدسات اللبس اليومي + +295 +00:26:46,720 --> 00:26:52,410 +التقليديإذا كانت النسبة هذه ما بين واحد و نص لخمسة + +296 +00:26:52,410 --> 00:26:58,150 +بيكون normal ولكن بدي أسأل سؤال إن هذه النسبة طوال + +297 +00:26:58,150 --> 00:27:04,030 +اليوم ولا في فترة زمانية معينة؟ طول اليوم طول + +298 +00:27:04,030 --> 00:27:07,930 +اليوم هتختلف وبتاعة بس لازم تكون ضمن ال range هذا + +299 +00:27:07,930 --> 00:27:14,230 +يعني حتى لساعات زي ما كان الشغل انا بقول بما أن هي + +300 +00:27:14,230 --> 00:27:20,070 +لبس يعني مرة واحدة و خلاصفإنه لأ عادي، اتضمن في + +301 +00:27:20,070 --> 00:27:25,770 +ريش معين، لأ مش كل اليوم، لإنه لما بيسأل صباحا + +302 +00:27:25,770 --> 00:27:28,570 +أحيانا إنهم بتكون عنده أعلى من النسبة هذه، هو + +303 +00:27:28,570 --> 00:27:31,050 +طبيعي ال thickness بيكون أكتر، يعني ال school has + +304 +00:27:31,050 --> 00:27:39,750 +to .. another answer النسبة هذه بتكون طبيعية إذا + +305 +00:27:39,750 --> 00:27:44,920 +كانت طوال اليوملأن انتوا شايفين مافي fixed number + +306 +00:27:44,920 --> 00:27:50,440 +في ايه اللي هو range يعني من واحد و نص لخمسة يعني + +307 +00:27:50,440 --> 00:27:55,260 +ممكن اول ما يصحى من النوم تكون خمسة بعد ذلك بتقل + +308 +00:27:55,260 --> 00:27:58,900 +كل ما الانسان راح على العمل او على الدراسة بتقل + +309 +00:27:58,900 --> 00:28:02,380 +هذه النسبة ولكن هذه النسبة في ال conventional + +310 +00:28:02,380 --> 00:28:07,260 +daily wear اذا زادت عن خمسة خلال اليوم هان بيكون + +311 +00:28:07,260 --> 00:28:09,400 +في ايه امر اللي هو pathology + +312 +00:28:12,530 --> 00:28:16,130 +طبعا في حالة عدسات الـ extended wear اللي بتم + +313 +00:28:16,130 --> 00:28:20,170 +ارتدائها لمدة أسبوع كامل و بينام فيها النسبة هذه + +314 +00:28:20,170 --> 00:28:27,670 +أيضا هتزيد هتكون تقريبا من 10% ل 12% و أيضا إذا + +315 +00:28:27,670 --> 00:28:33,330 +أنا كانت النسبة هذه من 10% ل 12% بيكون الأمر طبيعي + +316 +00:28:33,330 --> 00:28:38,550 +إذا زادت عن ذلك بيكون في هناك يعني داعي للتدخل من + +317 +00:28:38,550 --> 00:28:41,730 +قبل ال practitioner أو ال optometrist + +318 +00:28:45,100 --> 00:28:51,120 +مقارنة الثقيلة الهيبوتونية يمكن تأثيرها أيضًا من + +319 +00:28:51,120 --> 00:28:57,500 +نوع من الهيبوتونية أو من نوع من الهيبوتونية أو من + +320 +00:28:57,500 --> 00:28:59,180 +نوع من الهيبوتونية أو من نوع من الهيبوتونية أو من + +321 +00:29:02,530 --> 00:29:07,310 +دايمًا فيه هناك عاملين أساسيين بأثره على مين؟ على + +322 +00:29:07,310 --> 00:29:12,650 +سماكة القرانية العامل الأول هو تأثير ال reflex + +323 +00:29:12,650 --> 00:29:16,770 +hypotonic tearing طبعًا احنا عارفين ال basic tear + +324 +00:29:16,770 --> 00:29:21,970 +secretion من أنواعه ال reflex tearing صحيح؟ معناة + +325 +00:29:21,970 --> 00:29:27,360 +hypotonic ايش معناها؟انه بيكون هناك ضغط اسموزي + +326 +00:29:27,360 --> 00:29:32,720 +يعني دايما ال concentration التركيز ل ال stroma + +327 +00:29:32,720 --> 00:29:38,580 +هيكون مختلف عن مين الأجزاء الأخرى في القرنية كيف + +328 +00:29:38,580 --> 00:29:47,340 +يعني؟ نفترض مثلا عندنا ال stroma كان فيها ال + +329 +00:29:47,340 --> 00:29:53,200 +concentration عشرة + +330 +00:29:53,200 --> 00:30:00,550 +في الميةالابيثيليام والأزاء التانية من الكورنيا + +331 +00:30:00,550 --> 00:30:07,310 +كانت تلاتة في المية او اربعة في المية يعني اقل هذا + +332 +00:30:07,310 --> 00:30:12,030 +بيعمل ايه؟ tearing hypotonic يعني بيكون التمركز او + +333 +00:30:12,030 --> 00:30:17,010 +التركيز في الاسترومة اعلى من باقي الأجزاء فبيعمل + +334 +00:30:17,010 --> 00:30:22,890 +حاجة بنسميها reflex hypotonic tearing واضحة؟ + +335 +00:30:24,290 --> 00:30:29,150 +or by a physical thinning of the stroma الـ long + +336 +00:30:29,150 --> 00:30:35,950 +term wear الآن بعض الناس بيكون مخصص إله إنه يلبس + +337 +00:30:35,950 --> 00:30:41,450 +العدسة اللاصقة لمدة عشر ساعات بروح بلبسها خمس عشر + +338 +00:30:41,450 --> 00:30:47,030 +ساعات إذا صار عنده إيش long term wear هذا إيش كله + +339 +00:30:47,030 --> 00:30:51,690 +هيعمل thinning للاسترومة، هيقلل من سماكة مين + +340 +00:30:51,690 --> 00:30:53,770 +الاسترومة مع الوقت + +341 +00:30:58,120 --> 00:31:03,300 +Also there is marked individual variability in the + +342 +00:31:03,300 --> 00:31:08,740 +degree of corneal swelling response بعض الأحيان + +343 +00:31:08,740 --> 00:31:14,460 +بيكون هذا الكلام غير معمّم على كل الناس، كيف يعني؟ + +344 +00:31:14,860 --> 00:31:20,140 +الان مثلا نور ارتدت عدسة conventional daily wear + +345 +00:31:20,140 --> 00:31:24,600 +ال parameters معين من حيث ال base curve ال power + +346 +00:31:24,600 --> 00:31:29,880 +ال diameter ال water content ال thicknessكل هذا + +347 +00:31:29,880 --> 00:31:35,080 +مشابه لمين لعدسة ارتدتها خديجة في نفس ايش ال + +348 +00:31:35,080 --> 00:31:39,940 +parameters الآن قد يكون عندها الـ stroma القديمة + +349 +00:31:39,940 --> 00:31:45,660 +مختلفة عن مين عن اللي هو خديجة فكل شخص بيكون مختلف + +350 +00:31:45,660 --> 00:31:51,140 +عن الآخر في استجابته لمين للتأثيرات الخارجية اللي + +351 +00:31:51,140 --> 00:31:56,200 +بتطرق من خلال العدسة اللاصقةلذلك احنا قلنا there + +352 +00:31:56,200 --> 00:32:00,220 +is marked individual يعني هيكون هذا الأمر ثردي + +353 +00:32:00,220 --> 00:32:06,360 +variability اختلاف في درجة ايه انتفاخ او الاستجابة + +354 +00:32:06,360 --> 00:32:12,820 +لانتفاخ من ال cornea corneal + +355 +00:32:12,820 --> 00:32:17,580 +distortion طبعا ال corneal distortion دايما بتكون + +356 +00:32:17,580 --> 00:32:23,330 +مصاحبة لمين؟لل RGB ال R RGB او ال hard contact + +357 +00:32:23,330 --> 00:32:27,910 +lenses من ال advantages لل soft contact lens انه + +358 +00:32:27,910 --> 00:32:32,990 +بيكون غير شائع او very rarely نتيجة انه اشحت ال + +359 +00:32:32,990 --> 00:32:37,010 +soft contact lens دايما بيسبب minimal central + +360 +00:32:37,010 --> 00:32:38,630 +corneal distortion + +361 +00:32:41,500 --> 00:32:46,780 +أسبابها number one a result of poor gb lens + +362 +00:32:46,780 --> 00:32:52,020 +fitting كانت العدسة مثلا tight أو كانت العدسة flat + +363 +00:32:52,020 --> 00:32:57,400 +ممكن يسبب عند المريض corneal distortion or wear of + +364 +00:32:57,400 --> 00:33:02,900 +low dk على t أو دايما بلبس عدسات فيها dk على t + +365 +00:33:02,900 --> 00:33:08,460 +very low إيش معناها؟ يعني حياتها مدة حياتها طويلة + +366 +00:33:08,460 --> 00:33:09,180 +العدسة + +367 +00:33:19,520 --> 00:33:25,300 +أو بلبس عدسات لاصقة فقط مصنوعة من مادة الـ + +368 +00:33:25,300 --> 00:33:28,600 +polymethyl methacrylateاللي هي تعتبر الجيل الأول + +369 +00:33:28,600 --> 00:33:32,460 +من العدسات طبعا و أكيد هذا هيسبب إيش Cornial + +370 +00:33:32,460 --> 00:33:36,760 +distortion لذلك ال researchers الباحثين عملوا على + +371 +00:33:36,760 --> 00:33:40,740 +إضافة مين مادة ال silicon عشان تزود من ال + +372 +00:33:40,740 --> 00:33:44,920 +wetability المتانة في الجيل التاني من هذا النوع من + +373 +00:33:44,920 --> 00:33:50,920 +العدساتis an uncommon complication of hydrogel + +374 +00:33:50,920 --> 00:33:56,220 +lens wear طبعا هي غير ما هتكون شائعة مع عدسات ايه + +375 +00:33:56,220 --> 00:33:59,040 +ال conventional daily wear soft contact lenses + +376 +00:33:59,040 --> 00:34:03,740 +السبب في ذلك minimal central corneal distortion + +377 +00:34:07,210 --> 00:34:13,250 +Such distortion is known as spectacle blare or + +378 +00:34:13,250 --> 00:34:18,450 +corneal warpage and is manifested as a change in + +379 +00:34:18,450 --> 00:34:22,890 +the spectacle refraction and central corneal + +380 +00:34:22,890 --> 00:34:28,250 +curvature هذا ال corneal distortion خطورته انه + +381 +00:34:28,250 --> 00:34:32,590 +بيعمل حاجة بنسميها ال spectacle blare شو معناها؟ + +382 +00:34:33,530 --> 00:34:37,450 +إنه هيكون فيه اختلاف للرؤية ما بين ارتداء العدسة + +383 +00:34:37,450 --> 00:34:42,310 +اللاصقة والنضارة وطبعا هذا بيأد لإيش للكورنيا + +384 +00:34:42,310 --> 00:34:46,190 +القديمة لأنه دايما الكورنيا القديمة في العدسات ال + +385 +00:34:46,190 --> 00:34:51,630 +hard contact lens أكتر من ال soft contact lenses و + +386 +00:34:51,630 --> 00:34:55,830 +أيضا بيعمل على تغيير في إيش؟ في تحدب القرانية ال + +387 +00:34:55,830 --> 00:35:01,650 +kernel curvature powerنتوقف ان شاء الله للاستراما + +388 +00:35:01,650 --> 00:35:05,790 +ال استرايه في المحاضرة القادمة بنكمل ان شاء الله + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/LtC_WUO6f-o_raw.json b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/LtC_WUO6f-o_raw.json new file mode 100644 index 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" المخاطية", "probability": 0.97705078125}, {"start": 194.94, "end": 195.34, "word": " اللى", "probability": 0.748046875}, {"start": 195.34, "end": 195.84, "word": " موجودة", "probability": 0.9893798828125}, {"start": 195.84, "end": 196.32, "word": " وين؟", "probability": 0.8575846354166666}, {"start": 196.32, "end": 196.52, "word": " فى", "probability": 0.75146484375}, {"start": 196.52, "end": 196.94, "word": " سطح", "probability": 0.9723307291666666}, {"start": 196.94, "end": 197.48, "word": " العين", "probability": 0.987548828125}], "temperature": 1.0}, {"id": 9, "seek": 20811, "start": 200.47, "end": 208.11, "text": "بتتميز ال superficial panictate keratitis بإنها asymptomatic، إيش معناها؟", "tokens": [3555, 2655, 39237, 1829, 11622, 2423, 34622, 2462, 985, 473, 19377, 267, 16074, 4724, 28814, 1863, 11296, 35114, 13143, 12399, 11933, 1829, 8592, 20449, 8315, 11296, 22807], "avg_logprob": -0.22460938032184327, "compression_ratio": 0.9897959183673469, "no_speech_prob": 0.0, "words": [{"start": 200.47, "end": 201.45, "word": "بتتميز", "probability": 0.958203125}, {"start": 201.45, "end": 201.81, "word": " ال", "probability": 0.81494140625}, {"start": 201.81, "end": 202.61, "word": " superficial", "probability": 0.26171875}, {"start": 202.61, "end": 203.85, "word": " panictate", "probability": 0.6831868489583334}, {"start": 203.85, "end": 204.71, "word": " keratitis", "probability": 0.9627278645833334}, {"start": 204.71, "end": 205.53, "word": " بإنها", "probability": 0.835205078125}, {"start": 205.53, "end": 207.01, "word": " asymptomatic،", "probability": 0.8014322916666666}, {"start": 207.01, "end": 207.21, "word": " إيش", "probability": 0.7945149739583334}, {"start": 207.21, "end": 208.11, "word": " معناها؟", "probability": 0.9815673828125}], "temperature": 1.0}, {"id": 10, "seek": 23220, "start": 208.88, "end": 232.2, "text": "يعني لا يوجد هناك أعراض، يعني المريض لا يشعر بأي ألم، لا يوجد ألم بيشعر فيه مين المريض، يعني مش هييجي على المركز يقول لي مثلا في عندي watering أو في عندي redness أو في عندي itching، لأ without pain، أنا كيف بدأ اكتشفها؟ من ال clinical sign of a dry eye العبارة عن ال corneal florescein staining", "tokens": [40228, 22653, 20193, 7251, 29245, 3215, 34105, 4117, 5551, 3615, 2288, 46958, 12399, 37495, 22653, 9673, 16572, 11242, 20193, 7251, 8592, 3615, 2288, 4724, 10721, 1829, 5551, 19528, 12399, 20193, 7251, 29245, 3215, 5551, 19528, 4724, 1829, 8592, 3615, 2288, 8978, 3224, 3714, 9957, 9673, 16572, 11242, 12399, 37495, 22653, 37893, 39896, 1829, 7435, 1829, 15844, 9673, 31747, 11622, 7251, 39648, 32239, 50113, 15040, 8978, 18871, 16254, 33028, 34051, 8978, 18871, 16254, 2182, 1287, 34051, 8978, 18871, 16254, 309, 17354, 12399, 5296, 10721, 1553, 1822, 12399, 41850, 9122, 33911, 47525, 10721, 1975, 4117, 2655, 8592, 5172, 11296, 22807, 9154, 2423, 9115, 1465, 295, 257, 4016, 3313, 18863, 3555, 9640, 3660, 18871, 2423, 1181, 716, 304, 932, 2706, 384, 259, 342, 3686], "avg_logprob": -0.14920594677573346, 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إثارة، دايما يما بيكون الاستطالة أو الإثارة في الأطراف بيكون أقل أثرا من يما تكون في ال center، فلذلك المريض ما بيشعر بأي وجود لألم", "tokens": [64, 7266, 13143, 570, 264, 10454, 14678, 295, 264, 1181, 22160, 307, 1570, 813, 264, 2557, 14678, 11778, 47302, 15042, 9122, 19528, 3660, 14678, 20449, 8315, 11296, 44713, 9566, 6027, 3660, 34051, 11933, 12984, 9640, 3660, 12399, 11778, 47302, 15042, 7251, 15042, 4724, 1829, 30544, 42963, 14851, 9566, 6027, 3660, 34051, 33688, 12984, 9640, 3660, 8978, 16247, 9566, 23557, 5172, 4724, 1829, 30544, 5551, 4587, 1211, 5551, 49115, 995, 9154, 7251, 15042, 6055, 30544, 8978, 2423, 3056, 12399, 6156, 1211, 8848, 23275, 9673, 16572, 11242, 19446, 4724, 1829, 8592, 3615, 2288, 4724, 10721, 1829, 49610, 23328, 5296, 10721, 19528], "avg_logprob": -0.17781249761581422, "compression_ratio": 1.7035398230088497, "no_speech_prob": 0.0, "words": [{"start": 233.46, "end": 233.7, "word": "a", "probability": 0.10906982421875}, {"start": 233.7, "end": 234.38, 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{"start": 310.15, "end": 310.75, "word": " in", "probability": 0.95556640625}, {"start": 310.75, "end": 311.33, "word": " patients", "probability": 0.845703125}, {"start": 311.33, "end": 311.85, "word": " with", "probability": 0.9306640625}, {"start": 311.85, "end": 312.51, "word": " tight", "probability": 0.8701171875}, {"start": 312.51, "end": 312.91, "word": " or", "probability": 0.923828125}, {"start": 312.91, "end": 313.27, "word": " low", "probability": 0.96337890625}, {"start": 313.27, "end": 314.13, "word": " positioning", "probability": 0.8271484375}, {"start": 314.13, "end": 314.67, "word": " upper", "probability": 0.7470703125}, {"start": 314.67, "end": 315.13, "word": " limbs", "probability": 0.332763671875}, {"start": 315.13, "end": 316.29, "word": " دايما", "probability": 0.8741861979166666}, {"start": 316.29, "end": 316.61, "word": " هذه", "probability": 0.58642578125}, {"start": 316.61, "end": 317.01, "word": " بتكون", "probability": 0.92333984375}, {"start": 317.01, "end": 317.59, "word": " مصاحبة", "probability": 0.896728515625}, {"start": 317.59, "end": 317.99, "word": " لمين", "probability": 0.7277018229166666}, {"start": 317.99, "end": 318.77, "word": " لإنسان", "probability": 0.87861328125}, {"start": 318.77, "end": 319.29, "word": " عنده", "probability": 0.988037109375}, {"start": 319.29, "end": 319.95, "word": " tight", "probability": 0.85791015625}], "temperature": 1.0}, {"id": 14, "seek": 35234, "start": 323.14, "end": 352.34, "text": "لل upper eyelid هذه النقطة الأولى النقطة التانية ان هذا الشخص ايش بيكون عنده partially toses بمعنى ان ما بيصير هناك اي تتنفس لهذه المنطقة يعني ما بيدخل ال oxygen بكمية كافية وكأنه في هناك close", "tokens": [1211, 1211, 6597, 39386, 29538, 28239, 47432, 3660, 16247, 12610, 7578, 28239, 47432, 3660, 16712, 7649, 10632, 16472, 23758, 25124, 9778, 9381, 1975, 1829, 8592, 4724, 1829, 30544, 43242, 3224, 18886, 281, 6196, 4724, 2304, 3615, 1863, 7578, 16472, 19446, 4724, 1829, 9381, 13546, 34105, 4117, 1975, 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331.44, "end": 331.72, "word": " ان", "probability": 0.697265625}, {"start": 331.72, "end": 332.04, "word": " هذا", "probability": 0.88330078125}, {"start": 332.04, "end": 332.5, "word": " الشخص", "probability": 0.9934895833333334}, {"start": 332.5, "end": 332.74, "word": " ايش", "probability": 0.8279622395833334}, {"start": 332.74, "end": 333.08, "word": " بيكون", "probability": 0.8614908854166666}, {"start": 333.08, "end": 333.68, "word": " عنده", "probability": 0.99072265625}, {"start": 333.68, "end": 334.66, "word": " partially", "probability": 0.849609375}, {"start": 334.66, "end": 337.6, "word": " toses", "probability": 0.15875244140625}, {"start": 337.6, "end": 342.42, "word": " بمعنى", "probability": 0.97314453125}, {"start": 342.42, "end": 342.6, "word": " ان", "probability": 0.87890625}, {"start": 342.6, "end": 342.76, "word": " ما", "probability": 0.84912109375}, {"start": 342.76, "end": 343.16, "word": " بيصير", "probability": 0.93017578125}, {"start": 343.16, "end": 343.58, "word": " هناك", "probability": 0.970947265625}, {"start": 343.58, "end": 343.78, "word": " اي", "probability": 0.84765625}, {"start": 343.78, "end": 344.46, "word": " تتنفس", "probability": 0.9593505859375}, {"start": 344.46, "end": 344.9, "word": " لهذه", "probability": 0.91162109375}, {"start": 344.9, "end": 345.5, "word": " المنطقة", "probability": 0.989990234375}, {"start": 345.5, "end": 346.68, "word": " يعني", "probability": 0.930908203125}, {"start": 346.68, "end": 346.9, "word": " ما", "probability": 0.91845703125}, {"start": 346.9, "end": 347.72, "word": " بيدخل", "probability": 0.868408203125}, {"start": 347.72, "end": 347.96, "word": " ال", "probability": 0.86083984375}, {"start": 347.96, "end": 348.42, "word": " oxygen", "probability": 0.8193359375}, {"start": 348.42, "end": 349.4, "word": " بكمية", "probability": 0.9698893229166666}, {"start": 349.4, "end": 350.1, "word": " كافية", "probability": 0.99658203125}, {"start": 350.1, "end": 350.98, "word": " وكأنه", "probability": 0.8096923828125}, {"start": 350.98, "end": 351.1, "word": " في", "probability": 0.828125}, {"start": 351.1, "end": 351.7, "word": " هناك", "probability": 0.95556640625}, {"start": 351.7, "end": 352.34, "word": " close", "probability": 0.287841796875}], "temperature": 1.0}, {"id": 15, "seek": 38353, "start": 353.95, "end": 383.53, "text": "Eyes اغلاق لمين للعينتين Reduced oxygen availability to the superior region of the cornea اذا هيحدث هناك نقص لدخول ال oxygen في هذه المنطقة Even in daily contact lens wear طبعا hand daily أي بمعنى conventional daily wear يعني عدسات اللبس اليومي التقليدي", "tokens": [36, 2346, 1975, 17082, 15040, 4587, 32767, 9957, 24976, 3615, 9957, 2655, 9957, 4477, 41209, 9169, 17945, 281, 264, 13028, 4458, 295, 264, 1181, 22160, 1975, 15730, 39896, 24401, 12984, 34105, 4117, 8717, 4587, 9381, 5296, 3215, 9778, 12610, 2423, 9169, 8978, 29538, 9673, 1863, 9566, 28671, 2754, 294, 5212, 3385, 6765, 3728, 23032, 3555, 3615, 995, 1011, 5212, 36632, 4724, 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طبعا احنا بنعرف عدسات اللبس اليومي التقليدي maximum هتصل لقداش اتناشر hours صحيح؟", "tokens": [2278, 13028, 1181, 22160, 307, 364, 10913, 3728, 307, 5343, 538, 264, 6597, 10252, 1975, 1829, 8592, 9673, 4587, 9381, 23328, 8978, 11296, 22807, 16472, 9673, 16572, 11242, 31439, 4724, 46152, 3794, 6225, 3215, 3794, 9307, 13672, 3555, 3794, 45595, 20498, 1829, 16712, 4587, 20292, 16254, 23032, 3555, 3615, 995, 1975, 5016, 8315, 44945, 3615, 28480, 6225, 3215, 3794, 9307, 13672, 3555, 3794, 45595, 20498, 1829, 16712, 4587, 20292, 16254, 6674, 8032, 2655, 36520, 5296, 28543, 33599, 1975, 2655, 1863, 33599, 2288, 2496, 20328, 5016, 1829, 5016, 22807], "avg_logprob": -0.14448736356885244, "compression_ratio": 1.615, "no_speech_prob": 0.0, "words": [{"start": 384.58, "end": 384.84, "word": "The", "probability": 0.26953125}, {"start": 384.84, "end": 385.36, "word": " superior", "probability": 0.97314453125}, {"start": 385.36, "end": 386.12, "word": " cornea", "probability": 0.94189453125}, 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"word": " فيها؟", "probability": 0.9034830729166666}, {"start": 393.86, "end": 394.76, "word": " ان", "probability": 0.68359375}, {"start": 394.76, "end": 395.24, "word": " المريض", "probability": 0.9524739583333334}, {"start": 395.24, "end": 395.44, "word": " هو", "probability": 0.85400390625}, {"start": 395.44, "end": 396.1, "word": " بلبس", "probability": 0.8068033854166666}, {"start": 396.1, "end": 396.78, "word": " عدسات", "probability": 0.976318359375}, {"start": 396.78, "end": 397.16, "word": " اللبس", "probability": 0.98876953125}, {"start": 397.16, "end": 397.8, "word": " اليومي", "probability": 0.9344075520833334}, {"start": 397.8, "end": 398.6, "word": " التقليدي", "probability": 0.9241943359375}, {"start": 398.6, "end": 399.2, "word": " طبعا", "probability": 0.8795166015625}, {"start": 399.2, "end": 399.48, "word": " احنا", "probability": 0.9724934895833334}, {"start": 399.48, "end": 400.02, "word": " بنعرف", "probability": 0.9368489583333334}, {"start": 400.02, "end": 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extended wear طبعا احنا عارفين عدسات ال extended wear المريض بلبسها لمدة اسبوع واحد و بينام فيها لازم ان يكون فيها ال DK على T very high compared to mean", "tokens": [6027, 7649, 23758, 9673, 16572, 11242, 8717, 31371, 7435, 3660, 16472, 8978, 43242, 3224, 18886, 13601, 1975, 2407, 8978, 43242, 3224, 4524, 24976, 39386, 4032, 9122, 33456, 3224, 5296, 16758, 3794, 6225, 3215, 3794, 9307, 10913, 3728, 23032, 3555, 3615, 995, 1975, 5016, 8315, 6225, 9640, 5172, 9957, 6225, 3215, 3794, 9307, 2423, 10913, 3728, 9673, 16572, 11242, 4724, 46152, 3794, 11296, 32767, 41891, 24525, 3555, 45367, 36764, 24401, 4032, 4724, 1829, 8315, 2304, 8978, 11296, 5296, 31377, 2304, 16472, 7251, 30544, 8978, 11296, 2423, 31934, 15844, 314, 588, 1090, 5347, 281, 914], "avg_logprob": -0.1423703500248016, "compression_ratio": 1.5822784810126582, "no_speech_prob": 0.0, "words": [{"start": 407.95, "end": 408.41, "word": "الان", "probability": 0.854736328125}, {"start": 408.41, "end": 408.73, "word": " هذا", 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0.8245849609375}, {"start": 558.34, "end": 558.52, "word": " عن", "probability": 0.9462890625}, {"start": 558.52, "end": 559.2, "word": " ارتداء", "probability": 0.9610595703125}, {"start": 559.2, "end": 559.88, "word": " العدسة", "probability": 0.9942626953125}, {"start": 559.88, "end": 560.08, "word": " في", "probability": 0.8466796875}, {"start": 560.08, "end": 560.18, "word": " الـ", "probability": 0.53778076171875}, {"start": 560.18, "end": 560.72, "word": " epithelial", "probability": 0.81964111328125}, {"start": 560.72, "end": 561.36, "word": " aberration", "probability": 0.943359375}], "temperature": 1.0}, {"id": 23, "seek": 59087, "start": 565.75, "end": 590.87, "text": "become adherent to an epithelium already weakened by hypoxia إذا مدام العدسة بتعمل adherence to the eye معنى الكلام إن العدسة tight lens إذا هان if the lens has become adherent to an epithelium إذا العدسة tight lens إنه no sensation at all", "tokens": [650, 1102, 30106, 317, 281, 364, 2388, 355, 338, 2197, 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احنا شايفينه في الفلورسين each and maybe several millimeters in diameter و هيكون قطر اشماله كبير مقارنة بال superfacial panectate keratitis او في ال superior staining these are acute conditions", "tokens": [6027, 995, 26890, 33599, 1863, 33251, 8592, 9566, 23758, 486, 362, 42893, 1371, 40088, 770, 39896, 25957, 1211, 13412, 28820, 3714, 9778, 9566, 9566, 30767, 1829, 19446, 1975, 5016, 8315, 13412, 995, 33911, 9957, 3224, 8978, 27188, 1211, 13063, 3794, 9957, 1184, 293, 1310, 2940, 24388, 294, 14196, 4032, 39896, 30544, 12174, 9566, 2288, 1975, 8592, 2304, 6027, 3224, 9122, 3555, 13546, 3714, 4587, 9640, 1863, 3660, 20666, 1687, 69, 25980, 2462, 557, 473, 19377, 267, 16074, 1975, 2407, 8978, 2423, 13028, 342, 3686, 613, 366, 24390, 4487], "avg_logprob": -0.2686095559195186, "compression_ratio": 1.4344262295081966, "no_speech_prob": 0.0, "words": [{"start": 602.74, "end": 603.62, "word": "الابراشن", "probability": 0.589794921875}, {"start": 603.62, "end": 604.4, "word": " الكشط", 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760.98, "end": 789.82, "text": "من خلال الـ retro illumination يمكن ان اشوف هذه الأكياز ولكن بتحتاج لخبرة كبيرة من ال examiner طيب انا ك beginner مبتدئ كيف اعرف ان هذا المريض عنده micro zest او اكتشف هذا الأمر؟ البساطة اني بعمل ال corneal fluorescein staining ممكن انه يديني انطباع او مؤشر اذا المريض كان عنده micro zest", "tokens": [27842, 16490, 1211, 6027, 2423, 39184, 18820, 30579, 2486, 7251, 43020, 16472, 1975, 8592, 38688, 29538, 16247, 4117, 1829, 31377, 35525, 19452, 39894, 33753, 26108, 5296, 9778, 3555, 25720, 9122, 3555, 48923, 9154, 2423, 1139, 4564, 23032, 1829, 3555, 1975, 8315, 9122, 22080, 3714, 3555, 2655, 3215, 19986, 9122, 33911, 1975, 3615, 28480, 16472, 23758, 9673, 16572, 11242, 43242, 3224, 4532, 37889, 1975, 2407, 1975, 4117, 2655, 8592, 5172, 23758, 16247, 29973, 22807, 29739, 3794, 41193, 3660, 16472, 1829, 4724, 25957, 1211, 2423, 1181, 716, 304, 32471, 384, 259, 16441, 278, 3714, 43020, 16472, 3224, 7251, 3215, 9957, 1829, 16472, 9566, 3555, 45761, 1975, 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{"start": 843.75, "end": 844.49, "word": " سؤال", "probability": 0.8961588541666666}, {"start": 844.49, "end": 845.03, "word": " انه", "probability": 0.702392578125}, {"start": 845.03, "end": 845.23, "word": " هل", "probability": 0.98193359375}, {"start": 845.23, "end": 845.37, "word": " هي", "probability": 0.78515625}, {"start": 845.37, "end": 846.23, "word": " بتتعلق", "probability": 0.9730224609375}, {"start": 846.23, "end": 846.73, "word": " في", "probability": 0.927734375}, {"start": 846.73, "end": 847.09, "word": " ال", "probability": 0.9501953125}, {"start": 847.09, "end": 847.35, "word": " daily", "probability": 0.98583984375}, {"start": 847.35, "end": 847.75, "word": " wear", "probability": 0.94482421875}, {"start": 847.75, "end": 849.11, "word": " اقصد", "probability": 0.9410400390625}, {"start": 849.11, "end": 849.31, "word": " اللي", "probability": 0.905029296875}, {"start": 849.31, "end": 849.49, "word": " هو", "probability": 0.96875}, {"start": 849.49, "end": 849.57, "word": " ال", "probability": 0.43701171875}, {"start": 849.57, "end": 849.81, "word": " daily", "probability": 0.97607421875}, {"start": 849.81, "end": 850.41, "word": " disposable", "probability": 0.97607421875}, {"start": 850.41, "end": 851.09, "word": " lenses", "probability": 0.8359375}, {"start": 851.09, "end": 851.77, "word": " ولا", "probability": 0.841796875}, {"start": 851.77, "end": 851.89, "word": " ال", "probability": 0.841796875}, {"start": 851.89, "end": 852.29, "word": " extended", "probability": 0.89208984375}, {"start": 852.29, "end": 852.71, "word": " wear", "probability": 0.95361328125}, {"start": 852.71, "end": 853.11, "word": " ولا", "probability": 0.95068359375}, {"start": 853.11, "end": 853.27, "word": " ال", "probability": 0.98779296875}, {"start": 853.27, "end": 853.77, "word": " conventional", "probability": 0.7939453125}, {"start": 853.77, "end": 854.25, "word": " daily", "probability": 0.9619140625}, {"start": 854.25, "end": 854.59, "word": " wear", "probability": 0.95458984375}], "temperature": 1.0}, {"id": 35, "seek": 86537, "start": 855.97, "end": 865.37, "text": "الها علاقة في ال extended wear و ال conventional daily wear ليه؟ لأنه بمعنى هي chronic، ما بتيجي بشكل ايه مفاجئ", "tokens": [6027, 11296, 11203, 995, 28671, 8978, 2423, 10913, 3728, 4032, 2423, 16011, 5212, 3728, 32239, 3224, 22807, 5296, 33456, 3224, 4724, 2304, 3615, 1863, 7578, 39896, 14493, 12399, 19446, 4724, 31371, 7435, 1829, 4724, 8592, 28820, 1975, 1829, 3224, 3714, 5172, 26108, 19986], "avg_logprob": -0.2009943120858886, "compression_ratio": 1.1911764705882353, "no_speech_prob": 0.0, "words": [{"start": 855.97, "end": 856.33, "word": "الها", "probability": 0.681884765625}, {"start": 856.33, "end": 856.79, "word": " علاقة", "probability": 0.98681640625}, {"start": 856.79, "end": 856.93, "word": " في", "probability": 0.77001953125}, {"start": 856.93, "end": 856.99, "word": " ال", "probability": 0.8681640625}, {"start": 856.99, "end": 857.45, "word": " 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{"start": 888.15, "end": 889.17, "word": " المؤشرات", "probability": 0.9732666015625}, {"start": 889.17, "end": 889.39, "word": " ان", "probability": 0.9013671875}, {"start": 889.39, "end": 889.71, "word": " هذا", "probability": 0.92578125}, {"start": 889.71, "end": 890.17, "word": " المريض", "probability": 0.9899088541666666}, {"start": 890.17, "end": 890.79, "word": " عنده", "probability": 0.9853515625}, {"start": 890.79, "end": 892.07, "word": " microcyst", "probability": 0.9397786458333334}, {"start": 892.07, "end": 892.37, "word": " او", "probability": 0.89794921875}, {"start": 892.37, "end": 893.21, "word": " vacuous", "probability": 0.925048828125}, {"start": 893.21, "end": 893.73, "word": " من", "probability": 0.97900390625}, {"start": 893.73, "end": 894.17, "word": " خلال", "probability": 0.9951171875}, {"start": 894.17, "end": 894.47, "word": " ايه", "probability": 0.9361979166666666}, {"start": 894.47, "end": 894.69, "word": " ان", "probability": 0.6640625}, {"start": 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حالة مين؟ الـ significant staining، اللي هي ال moderate أو السيفير، mild staining يعني grade one، reducing wearing time، بدنا نقلل من ساعات ارتداء العدسة", "tokens": [12610, 19452, 11933, 15730, 25961, 23758, 9673, 16572, 11242, 4724, 46152, 3794, 10913, 3728, 34051, 5212, 41578, 18059, 12399, 47525, 3224, 7251, 2655, 30543, 5172, 4724, 8592, 28820, 9122, 10943, 1211, 12399, 8978, 11331, 6027, 3660, 3714, 9957, 22807, 2423, 39184, 4776, 342, 3686, 12399, 13672, 1829, 39896, 2423, 18174, 34051, 21136, 1829, 5172, 13546, 12399, 15154, 342, 3686, 37495, 22653, 7204, 472, 12399, 12245, 4769, 565, 12399, 47525, 8315, 8717, 4587, 1211, 1211, 9154, 8608, 45761, 9307, 1975, 43500, 3215, 16606, 18863, 3215, 3794, 3660], "avg_logprob": -0.21336206759529552, "compression_ratio": 1.4412955465587045, "no_speech_prob": 0.0, "words": [{"start": 1019.54, "end": 1020.1, "word": "ولكن", "probability": 0.97802734375}, {"start": 1020.1, "end": 1020.36, "word": " إذا", "probability": 0.83349609375}, 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moderate", "probability": 0.8720703125}, {"start": 1034.04, "end": 1034.4, "word": " أو", "probability": 0.90625}, {"start": 1034.4, "end": 1035.28, "word": " السيفير،", "probability": 0.60029296875}, {"start": 1035.28, "end": 1038.34, "word": " mild", "probability": 0.529296875}, {"start": 1038.34, "end": 1039.1, "word": " staining", "probability": 0.854736328125}, {"start": 1039.1, "end": 1040.6, "word": " يعني", "probability": 0.6673583984375}, {"start": 1040.6, "end": 1041.02, "word": " grade", "probability": 0.9326171875}, {"start": 1041.02, "end": 1042.4, "word": " one،", "probability": 0.63037109375}, {"start": 1042.4, "end": 1043.4, "word": " reducing", "probability": 0.90576171875}, {"start": 1043.4, "end": 1044.24, "word": " wearing", "probability": 0.92236328125}, {"start": 1044.24, "end": 1045.22, "word": " time،", "probability": 0.86474609375}, {"start": 1045.22, "end": 1045.44, "word": " بدنا", "probability": 0.9228515625}, {"start": 1045.44, "end": 1046.06, "word": " نقلل", "probability": 0.982666015625}, {"start": 1046.06, "end": 1046.4, "word": " من", "probability": 0.99267578125}, {"start": 1046.4, "end": 1046.94, "word": " ساعات", "probability": 0.9892578125}, {"start": 1046.94, "end": 1047.52, "word": " ارتداء", "probability": 0.962890625}, {"start": 1047.52, "end": 1048.18, "word": " العدسة", "probability": 0.98095703125}], "temperature": 1.0}, {"id": 42, "seek": 105604, "start": 1048.88, "end": 1056.04, "text": "for example to less than ten hours beer day or ceasing extended wear", "tokens": [2994, 1365, 281, 1570, 813, 2064, 2496, 8795, 786, 420, 1769, 3349, 10913, 3728], "avg_logprob": -0.248828125, "compression_ratio": 1.0461538461538462, "no_speech_prob": 0.0, "words": [{"start": 1048.88, "end": 1049.2, "word": "for", "probability": 0.330078125}, {"start": 1049.2, "end": 1050.0, "word": " example", "probability": 0.97119140625}, {"start": 1050.0, "end": 1050.34, "word": " to", "probability": 0.6513671875}, {"start": 1050.34, "end": 1050.6, "word": " less", "probability": 0.96337890625}, {"start": 1050.6, "end": 1050.96, "word": " than", "probability": 0.9345703125}, {"start": 1050.96, "end": 1051.3, "word": " ten", "probability": 0.60107421875}, {"start": 1051.3, "end": 1051.88, "word": " hours", "probability": 0.9296875}, {"start": 1051.88, "end": 1052.48, "word": " beer", "probability": 0.85205078125}, {"start": 1052.48, "end": 1053.18, "word": " day", "probability": 0.9287109375}, {"start": 1053.18, "end": 1054.22, "word": " or", "probability": 0.8046875}, {"start": 1054.22, "end": 1054.84, "word": " ceasing", "probability": 0.951416015625}, {"start": 1054.84, "end": 1055.72, "word": " extended", "probability": 0.8818359375}, {"start": 1055.72, "end": 1056.04, "word": " wear", "probability": 0.58056640625}], "temperature": 1.0}, {"id": 43, "seek": 108840, "start": 1061.32, "end": 1088.4, "text": "بنقوله فقط لبس العدسة اربع ساعات او ساعتين او تلاتة يعني المهم انه اوقف من عدد يعني اوقف اللي هو عدد الساعات 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يعني بيكون التمركز او التركيز في الاسترومة اعلى من باقي الأجزاء فبيعمل حاجة بنسميها reflex hypotonic tearing واضحة؟", "tokens": [6027, 16758, 1829, 12984, 1829, 20292, 10943, 16070, 10721, 11622, 16606, 16712, 7649, 10632, 9154, 33251, 13063, 22653, 995, 25961, 2655, 6055, 1211, 9307, 3660, 8978, 9673, 10632, 1975, 2407, 1975, 25513, 27884, 8978, 9673, 10632, 37495, 22653, 1975, 4587, 1211, 23758, 4724, 1829, 25957, 1211, 1975, 1829, 3224, 22807, 29401, 7420, 310, 11630, 37495, 22653, 4724, 1829, 30544, 16712, 29973, 4117, 11622, 1975, 2407, 16712, 31747, 1829, 11622, 8978, 42963, 14851, 2288, 20498, 3660, 1975, 3615, 23942, 9154, 4724, 995, 38436, 16247, 7435, 11622, 16606, 6156, 21292, 25957, 1211, 11331, 26108, 3660, 44945, 38251, 1829, 11296, 23802, 7420, 310, 11630, 29401, 4032, 46958, 5016, 3660, 22807], "avg_logprob": -0.16536458885228192, "compression_ratio": 1.7954545454545454, "no_speech_prob": 0.0, "words": [{"start": 1796.01, "end": 1797.21, "word": "الابيثيليام", 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1874.86, "end": 1875.32, "word": "الان", "probability": 0.803955078125}, {"start": 1875.32, "end": 1875.82, "word": " مثلا", "probability": 0.9482421875}, {"start": 1875.82, "end": 1876.66, "word": " نور", "probability": 0.843017578125}, {"start": 1876.66, "end": 1877.4, "word": " ارتدت", "probability": 0.98388671875}, {"start": 1877.4, "end": 1878.04, "word": " عدسة", "probability": 0.982666015625}, {"start": 1878.04, "end": 1878.96, "word": " conventional", "probability": 0.51318359375}, {"start": 1878.96, "end": 1879.8, "word": " daily", "probability": 0.90966796875}, {"start": 1879.8, "end": 1880.14, "word": " wear", "probability": 0.9775390625}, {"start": 1880.14, "end": 1881.0, "word": " ال", "probability": 0.630859375}, {"start": 1881.0, "end": 1881.46, "word": " parameters", "probability": 0.6455078125}, {"start": 1881.46, "end": 1882.26, "word": " معين", "probability": 0.96484375}, {"start": 1882.26, "end": 1882.62, "word": " من", "probability": 0.92236328125}, {"start": 1882.62, "end": 1883.06, "word": " حيث", "probability": 0.98291015625}, {"start": 1883.06, "end": 1883.28, "word": " ال", "probability": 0.99072265625}, {"start": 1883.28, "end": 1883.52, "word": " base", "probability": 0.763671875}, {"start": 1883.52, "end": 1883.96, "word": " curve", "probability": 0.9658203125}, {"start": 1883.96, "end": 1884.26, "word": " ال", "probability": 0.37744140625}, {"start": 1884.26, "end": 1884.6, "word": " power", "probability": 0.84814453125}, {"start": 1884.6, "end": 1885.4, "word": " ال", "probability": 0.80322265625}, {"start": 1885.4, "end": 1885.92, "word": " diameter", "probability": 0.95849609375}, {"start": 1885.92, "end": 1886.64, "word": " ال", "probability": 0.97705078125}, {"start": 1886.64, "end": 1886.92, "word": " water", "probability": 0.96923828125}, {"start": 1886.92, "end": 1887.6, "word": " content", "probability": 0.98486328125}, {"start": 1887.6, "end": 1887.98, "word": " ال", "probability": 0.6943359375}, {"start": 1887.98, "end": 1888.38, "word": " thickness", "probability": 0.9619140625}], "temperature": 1.0}, {"id": 76, "seek": 191370, "start": 1889.12, "end": 1913.7, "text": "كل هذا مشابه لمين لعدسة ارتدتها خديجة في نفس ايش ال parameters الآن قد يكون عندها الـ stroma القديمة مختلفة عن مين عن اللي هو خديجة فكل شخص بيكون مختلف عن الآخر في استجابته لمين للتأثيرات الخارجية اللي بتطرق من خلال العدسة اللاصقة", "tokens": [28820, 23758, 37893, 16758, 3224, 32767, 9957, 5296, 22488, 3794, 3660, 1975, 43500, 3215, 2655, 11296, 16490, 16254, 7435, 3660, 8978, 8717, 36178, 1975, 1829, 8592, 2423, 9834, 6024, 48506, 12174, 3215, 7251, 30544, 43242, 11296, 2423, 39184, 1056, 6440, 25062, 16254, 46007, 3714, 46456, 46538, 3660, 18871, 3714, 9957, 18871, 13672, 1829, 31439, 16490, 16254, 7435, 3660, 6156, 28820, 13412, 9778, 9381, 4724, 1829, 30544, 3714, 46456, 46538, 18871, 6024, 95, 34740, 8978, 44713, 7435, 16758, 47395, 32767, 9957, 24976, 2655, 10721, 12984, 13546, 9307, 33962, 9640, 7435, 10632, 13672, 1829, 39894, 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"word": " مين", "probability": 0.940673828125}, {"start": 1901.34, "end": 1901.92, "word": " عن", "probability": 0.7451171875}, {"start": 1901.92, "end": 1902.24, "word": " اللي", "probability": 0.930908203125}, {"start": 1902.24, "end": 1902.58, "word": " هو", "probability": 0.9755859375}, {"start": 1902.58, "end": 1903.62, "word": " خديجة", "probability": 0.96923828125}, {"start": 1903.62, "end": 1904.38, "word": " فكل", "probability": 0.9560546875}, {"start": 1904.38, "end": 1904.76, "word": " شخص", "probability": 0.9982096354166666}, {"start": 1904.76, "end": 1905.14, "word": " بيكون", "probability": 0.9454752604166666}, {"start": 1905.14, "end": 1905.66, "word": " مختلف", "probability": 0.9947916666666666}, {"start": 1905.66, "end": 1905.88, "word": " عن", "probability": 0.98046875}, {"start": 1905.88, "end": 1906.44, "word": " الآخر", "probability": 0.94775390625}, {"start": 1906.44, "end": 1907.0, "word": " في", "probability": 0.92041015625}, {"start": 1907.0, "end": 1907.66, "word": " استجابته", "probability": 0.92529296875}, {"start": 1907.66, "end": 1908.12, "word": " لمين", "probability": 0.873779296875}, {"start": 1908.12, "end": 1909.8, "word": " للتأثيرات", "probability": 0.9600423177083334}, {"start": 1909.8, "end": 1910.82, "word": " الخارجية", "probability": 0.997314453125}, {"start": 1910.82, "end": 1911.14, "word": " اللي", "probability": 0.888916015625}, {"start": 1911.14, "end": 1911.6, "word": " بتطرق", "probability": 0.8917236328125}, {"start": 1911.6, "end": 1911.76, "word": " من", "probability": 0.99755859375}, {"start": 1911.76, "end": 1912.24, "word": " خلال", "probability": 0.9923502604166666}, {"start": 1912.24, "end": 1913.0, "word": " العدسة", "probability": 0.97802734375}, {"start": 1913.0, "end": 1913.7, "word": " اللاصقة", "probability": 0.9241536458333334}], "temperature": 1.0}, {"id": 77, "seek": 193890, "start": 1914.4, "end": 1938.9, "text": "لذلك احنا قلنا there is marked individual يعني هيكون هذا الأمر ثردي variability اختلاف في درجة ايه انتفاخ او الاستجابة لانتفاخ من ال cornea corneal distortion طبعا ال corneal distortion دايما بتكون مصاحبة لمين؟", "tokens": [1211, 8848, 23275, 1975, 5016, 8315, 12174, 1211, 8315, 456, 307, 12658, 2609, 37495, 22653, 39896, 30544, 23758, 16247, 29973, 38637, 2288, 16254, 35709, 1975, 46456, 15040, 5172, 8978, 11778, 47341, 3660, 1975, 1829, 3224, 16472, 2655, 5172, 47283, 1975, 2407, 42963, 14851, 7435, 16758, 3660, 5296, 7649, 2655, 5172, 47283, 9154, 2423, 1181, 22160, 1181, 716, 304, 28426, 23032, 3555, 3615, 995, 2423, 1181, 716, 304, 28426, 11778, 47302, 15042, 39894, 30544, 3714, 9381, 39319, 49401, 32767, 9957, 22807], "avg_logprob": -0.18952546296296297, "compression_ratio": 1.4976076555023923, "no_speech_prob": 0.0, "words": [{"start": 1914.4, "end": 1914.96, "word": "لذلك", "probability": 0.9122721354166666}, {"start": 1914.96, "end": 1915.22, "word": " احنا", "probability": 0.8759765625}, {"start": 1915.22, "end": 1915.62, "word": " قلنا", "probability": 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"probability": 0.9248046875}, {"start": 1923.0, "end": 1923.44, "word": " درجة", "probability": 0.9918619791666666}, {"start": 1923.44, "end": 1923.76, "word": " ايه", "probability": 0.8243815104166666}, {"start": 1923.76, "end": 1924.54, "word": " انتفاخ", "probability": 0.8846435546875}, {"start": 1924.54, "end": 1924.88, "word": " او", "probability": 0.7225341796875}, {"start": 1924.88, "end": 1926.36, "word": " الاستجابة", "probability": 0.92080078125}, {"start": 1926.36, "end": 1927.46, "word": " لانتفاخ", "probability": 0.88486328125}, {"start": 1927.46, "end": 1927.74, "word": " من", "probability": 0.9189453125}, {"start": 1927.74, "end": 1928.2, "word": " ال", "probability": 0.5595703125}, {"start": 1928.2, "end": 1928.68, "word": " cornea", "probability": 0.3675537109375}, {"start": 1928.68, "end": 1932.82, "word": " corneal", "probability": 0.8522135416666666}, {"start": 1932.82, "end": 1933.74, "word": " distortion", "probability": 0.9580078125}, {"start": 1933.74, "end": 1935.58, "word": " طبعا", "probability": 0.954345703125}, {"start": 1935.58, "end": 1935.72, "word": " ال", "probability": 0.8974609375}, {"start": 1935.72, "end": 1936.18, "word": " corneal", "probability": 0.8258463541666666}, {"start": 1936.18, "end": 1936.78, "word": " distortion", "probability": 0.9462890625}, {"start": 1936.78, "end": 1937.2, "word": " دايما", "probability": 0.91064453125}, {"start": 1937.2, "end": 1937.58, "word": " بتكون", "probability": 0.91796875}, {"start": 1937.58, "end": 1938.18, "word": " مصاحبة", "probability": 0.8814697265625}, {"start": 1938.18, "end": 1938.9, "word": " لمين؟", "probability": 0.8170572916666666}], "temperature": 1.0}, {"id": 78, "seek": 195863, "start": 1939.39, "end": 1958.63, "text": "لل RGB ال R RGB او ال hard contact lenses من ال advantages لل soft contact lens انه بيكون غير شائع او very rarely نتيجة انه اشحت ال soft contact lens دايما بيسبب minimal central corneal distortion", "tokens": [1211, 1211, 31231, 2423, 497, 31231, 1975, 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0.91552734375}, {"start": 1942.63, "end": 1942.85, "word": " hard", "probability": 0.462646484375}, {"start": 1942.85, "end": 1943.33, "word": " contact", "probability": 0.90380859375}, {"start": 1943.33, "end": 1943.83, "word": " lenses", "probability": 0.8134765625}, {"start": 1943.83, "end": 1944.81, "word": " من", "probability": 0.9423828125}, {"start": 1944.81, "end": 1944.97, "word": " ال", "probability": 0.95849609375}, {"start": 1944.97, "end": 1945.65, "word": " advantages", "probability": 0.953125}, {"start": 1945.65, "end": 1946.17, "word": " لل", "probability": 0.65234375}, {"start": 1946.17, "end": 1946.55, "word": " soft", "probability": 0.89892578125}, {"start": 1946.55, "end": 1947.01, "word": " contact", "probability": 0.93359375}, {"start": 1947.01, "end": 1947.45, "word": " lens", "probability": 0.671875}, {"start": 1947.45, "end": 1947.91, "word": " انه", "probability": 0.942138671875}, {"start": 1947.91, "end": 1948.41, "word": " بيكون", "probability": 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b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/LtC_WUO6f-o_raw.srt new file mode 100644 index 0000000000000000000000000000000000000000..9f179e28acc17b1d58fbb24c2365e53a26ba58a9 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/LtC_WUO6f-o_raw.srt @@ -0,0 +1,1560 @@ +1 +00:00:21,080 --> 00:00:23,800 +بسم الله الرحمن الرحيم، السلام عليكم ورحمة الله + +2 +00:00:23,800 --> 00:00:29,660 +وبركاته ومرحباً لكم جميعًا. هنتناول اليوم موضوع + +3 +00:00:29,660 --> 00:00:39,960 +علامات تقليل الهيبوكسيا + +4 +00:00:39,960 --> 00:00:45,550 +والهيبركابنيا.في المحاضرة السابقة عرفنا الـ + +5 +00:00:45,550 --> 00:00:50,270 +hypoxia نقص في الأكسجين الداخل للـ anterior + +6 +00:00:50,270 --> 00:00:56,010 +surface of the cornea الـ hypercapnia زيادة في + +7 +00:00:56,010 --> 00:00:59,910 +ثاني أكسيد الكربون اللي داخل للـ anterior surface + +8 +00:00:59,910 --> 00:01:05,670 +of the cornea من هذه العلمات طبعا هي متعلقة كلها + +9 +00:01:05,670 --> 00:01:11,540 +في الـ corneal epitheliumsuperfacial panictate + +10 +00:01:11,540 --> 00:01:16,460 +keratitis superfacial سطحي panictate نقطة + +11 +00:01:16,460 --> 00:01:19,980 +keratitis inflammation of the cornea + +12 +00:01:22,870 --> 00:01:27,270 +طبعا بيكون لما بنعمل corneal efflorosin staining + +13 +00:01:27,270 --> 00:01:31,570 +عند إجراء ال corneal efflorosin staining بنلاحظ أن + +14 +00:01:31,570 --> 00:01:37,050 +سطح القرنية بيظهر بالشكل هذا و كأنه نقاط على ال + +15 +00:01:37,050 --> 00:01:41,500 +corneal epitheliumفي المعمل أخدنا ال cornial + +16 +00:01:41,500 --> 00:01:46,620 +staining وقسمناها إلى grade 0 و 1 و 2 و 3 وعرفنا + +17 +00:01:46,620 --> 00:01:51,540 +ان grade 0 no staining of the cornea grade 1 mild + +18 +00:01:51,540 --> 00:01:54,660 +staining of the corneal epithelium grade 2 + +19 +00:01:54,660 --> 00:01:57,940 +moderate staining of the corneal epithelium و + +20 +00:01:57,940 --> 00:02:03,660 +grade 3 severe staining of the corneal epitheliumA + +21 +00:02:03,660 --> 00:02:08,340 +premature sheeting of small groups of surface + +22 +00:02:08,340 --> 00:02:15,300 +cells الطبقة أو الـ corneal epithelium عند ارتداء + +23 +00:02:15,300 --> 00:02:19,500 +العدسة اللاصقة هتتقشر، اذا هيصير لها نوع من + +24 +00:02:19,500 --> 00:02:25,160 +التقشر، بالتالي ان هي حيصير فيها ضعف، نتيجة ايش + +25 +00:02:25,160 --> 00:02:32,200 +هذا التقشر؟ ضعف الروابط ما بين الخلاياأكتر حاجة + +26 +00:02:32,200 --> 00:02:36,680 +بنخاف منها في هذا النوع هو موضوع ال infection، + +27 +00:02:36,680 --> 00:02:40,720 +العدوى، ليه؟ لأن طبقة ال corneal epithelium هي + +28 +00:02:40,720 --> 00:02:45,620 +تعتبر regeneration، يعني حتى لو اتقشرت بعد 24 ساعة + +29 +00:02:45,620 --> 00:02:50,880 +بصير عملية ايه؟ تجدد إلها، ولكن الخوف من ال + +30 +00:02:50,880 --> 00:02:54,100 +superficial panictate keratitis هو موضوع ال + +31 +00:02:54,100 --> 00:02:54,520 +infection + +32 +00:02:57,860 --> 00:03:02,140 +بعد ذلك إيش هيسبب؟ إذا أول حاجة هيعمل تقشر للـ + +33 +00:03:02,140 --> 00:03:05,760 +corneal epithelium number two disruption of the + +34 +00:03:05,760 --> 00:03:11,640 +ocular surface mucous layer أي بمعنى عرقلة أو قطع + +35 +00:03:11,640 --> 00:03:16,940 +لمين؟ للطبقة المخاطية اللى موجودة وين؟ فى سطح + +36 +00:03:16,940 --> 00:03:17,480 +العين + +37 +00:03:20,470 --> 00:03:25,530 +بتتميز ال superficial panictate keratitis بإنها + +38 +00:03:25,530 --> 00:03:31,060 +asymptomatic، إيش معناها؟يعني لا يوجد هناك أعراض، + +39 +00:03:31,060 --> 00:03:35,840 +يعني المريض لا يشعر بأي ألم، لا يوجد ألم بيشعر فيه + +40 +00:03:35,840 --> 00:03:39,280 +مين المريض، يعني مش هييجي على المركز يقول لي مثلا + +41 +00:03:39,280 --> 00:03:42,500 +في عندي watering أو في عندي redness أو في عندي + +42 +00:03:42,500 --> 00:03:46,740 +itching، لأ without pain، أنا كيف بدأ اكتشفها؟ من + +43 +00:03:46,740 --> 00:03:50,040 +ال clinical sign of a dry eye العبارة عن ال + +44 +00:03:50,040 --> 00:03:55,100 +corneal florescein staininga symptomatic because + +45 +00:03:55,100 --> 00:04:00,080 +the injury threshold of the cornea is less than + +46 +00:04:00,080 --> 00:04:05,160 +the touch threshold دايما كلمة threshold معناها + +47 +00:04:05,160 --> 00:04:11,260 +استطالة أو إثارة، دايما يما بيكون الاستطالة أو + +48 +00:04:11,260 --> 00:04:16,100 +الإثارة في الأطراف بيكون أقل أثرا من يما تكون في + +49 +00:04:16,100 --> 00:04:20,920 +ال center، فلذلك المريض ما بيشعر بأي وجود لألم + +50 +00:04:33,860 --> 00:04:39,820 +ملاحظين في الشكل ان وجود ال staining وين على ال + +51 +00:04:39,820 --> 00:04:45,740 +upper part ايضا لل corneal ابيثيليام Staining in a + +52 +00:04:45,740 --> 00:04:47,660 +horizontal linear pattern + +53 +00:04:51,550 --> 00:04:55,630 +close to the superior limbus هيكون قريب من مين من + +54 +00:04:55,630 --> 00:04:59,110 +ال limbus لأنه احنا بنعرف ان ال diameter للعدسة + +55 +00:04:59,110 --> 00:05:03,890 +اللاصقة ال soft contact lenses هتصل تقريبا لل para + +56 +00:05:03,890 --> 00:05:11,330 +limbal okay the sign is more likely in patients + +57 +00:05:11,330 --> 00:05:16,290 +with tight or low positioning upper limbs دايما + +58 +00:05:16,290 --> 00:05:19,950 +هذه بتكون مصاحبة لمين لإنسان عنده tight + +59 +00:05:23,140 --> 00:05:31,440 +لل upper eyelid هذه النقطة الأولى النقطة التانية + +60 +00:05:31,440 --> 00:05:42,420 +ان هذا الشخص ايش بيكون عنده partially toses بمعنى + +61 +00:05:42,420 --> 00:05:46,900 +ان ما بيصير هناك اي تتنفس لهذه المنطقة يعني ما + +62 +00:05:46,900 --> 00:05:52,340 +بيدخل ال oxygen بكمية كافية وكأنه في هناك close + +63 +00:05:53,950 --> 00:06:01,010 +Eyes اغلاق لمين للعينتين Reduced + +64 +00:06:01,010 --> 00:06:05,750 +oxygen availability to the superior region of the + +65 +00:06:05,750 --> 00:06:10,630 +cornea اذا هيحدث هناك نقص لدخول ال oxygen في هذه + +66 +00:06:10,630 --> 00:06:17,690 +المنطقة Even in daily contact lens wear طبعا hand + +67 +00:06:17,690 --> 00:06:21,650 +daily أي بمعنى conventional daily wear يعني عدسات + +68 +00:06:21,650 --> 00:06:26,920 +اللبس اليومي التقليديThe superior cornea is an + +69 +00:06:26,920 --> 00:06:31,940 +extended wear is covered by the upper lid ايش + +70 +00:06:31,940 --> 00:06:37,800 +المقصود فيها؟ ان المريض هو بلبس عدسات اللبس اليومي + +71 +00:06:37,800 --> 00:06:41,780 +التقليدي طبعا احنا بنعرف عدسات اللبس اليومي + +72 +00:06:41,780 --> 00:06:48,410 +التقليدي maximum هتصل لقداش اتناشر hours صحيح؟الان + +73 +00:06:48,410 --> 00:06:53,990 +هذا المريض نتيجة ان في عنده partially dropping او + +74 +00:06:53,990 --> 00:06:59,030 +في عنده tight لل eyelid و كأنه لابس عدسات extended + +75 +00:06:59,030 --> 00:07:03,130 +wear طبعا احنا عارفين عدسات ال extended wear + +76 +00:07:03,130 --> 00:07:07,650 +المريض بلبسها لمدة اسبوع واحد و بينام فيها لازم ان + +77 +00:07:07,650 --> 00:07:11,210 +يكون فيها ال DK على T very high compared to mean + +78 +00:07:12,180 --> 00:07:16,460 +conventional daily wear فهذا المريض نتيجة ال + +79 +00:07:16,460 --> 00:07:20,720 +partially dropping لل upper eyelid او ال tight لل + +80 +00:07:20,720 --> 00:07:24,920 +upper eyelid هيكون لابس عدسات اللبس اليوم التقليدي + +81 +00:07:24,920 --> 00:07:29,980 +لكن و كأنه هي بتمثل ايه extended wear lenses + +82 +00:07:29,980 --> 00:07:35,600 +فبيحدث عنده مين ال superior arcuate panectate + +83 +00:07:35,600 --> 00:07:42,240 +staining طيب ايه ما اختار؟Superfacial panictate + +84 +00:07:42,240 --> 00:07:47,780 +keratitis ولا ال superior arcuate staining؟ طبعا + +85 +00:07:47,780 --> 00:07:52,180 +الأخطر اللي هي ال superior لأنه نوعا ما المريض + +86 +00:07:52,180 --> 00:07:58,340 +بيشعر بوجود ألم، okay؟ و بيكون هناك في عنده يعني + +87 +00:07:58,340 --> 00:08:02,320 +أعراض مصاحبة لمين لل clinical science بس طالما + +88 +00:08:02,320 --> 00:08:05,940 +بيشعر بألم مش هتكون فخر يعني هيروح للطبيب مباشر؟ + +89 +00:08:05,940 --> 00:08:12,980 +أكيدلأ ايضا ال super facial panictate keratitis هي + +90 +00:08:12,980 --> 00:08:18,780 +مش هتكون deep يعني هتكون سطحية فممكن علاجها يعني + +91 +00:08:18,780 --> 00:08:21,640 +بمعنى انه هيكون عنده mild corneal fluorescein + +92 +00:08:21,640 --> 00:08:28,700 +staining مش هتصل للمدرة او السيفير لان كل هذا + +93 +00:08:28,700 --> 00:08:32,500 +هيكون متعلق في مين؟ في ال corneal epithelium مش + +94 +00:08:32,500 --> 00:08:37,820 +هيكون في الاسترومة او ال endotheliumبالنسبة لـ + +95 +00:08:37,820 --> 00:08:43,000 +Epithelial Aberration أبراشن بمعنى كشط لمن؟ لطبقة + +96 +00:08:43,000 --> 00:08:47,560 +الـ corneal epithelium الآن لو احنا وضعنا إفلروسين + +97 +00:08:47,560 --> 00:08:52,140 +هيكون بالشكل هذا عبارة عن confluent أي بمعنى منطقة + +98 +00:08:52,140 --> 00:08:57,280 +متجمعة، هتتجمع كلها في المنطقة هذه صبغة الإفلروسين + +99 +00:08:57,280 --> 00:09:00,740 +Severe + +100 +00:09:00,740 --> 00:09:04,420 +central efflurosin staining resulting + +101 +00:09:10,500 --> 00:09:16,160 +إذا في هذه الحالة المريض يجب أن لا يلبس العدسة + +102 +00:09:16,160 --> 00:09:20,180 +لازم ان انا اوقفه عن ارتداء العدسة في الـ + +103 +00:09:20,180 --> 00:09:21,360 +epithelial aberration + +104 +00:09:25,750 --> 00:09:31,030 +become adherent to an epithelium already weakened + +105 +00:09:31,030 --> 00:09:36,510 +by hypoxia إذا مدام العدسة بتعمل adherence to the + +106 +00:09:36,510 --> 00:09:41,850 +eye معنى الكلام إن العدسة tight lens إذا هان if + +107 +00:09:41,850 --> 00:09:46,110 +the lens has become adherent to an epithelium إذا + +108 +00:09:46,110 --> 00:09:52,540 +العدسة tight lens إنه no sensation at allAlready + +109 +00:09:52,540 --> 00:09:58,040 +weakened by hypoxia هيتم إلها ضعف بنقص ال oxygen + +110 +00:09:58,040 --> 00:10:04,820 +أو دخول ال oxygen لهذه المنطقةالابراشن الكشط هذا + +111 +00:10:04,820 --> 00:10:10,180 +will have sharply demarcated هيعمل شكل مخطط زي ما + +112 +00:10:10,180 --> 00:10:14,080 +احنا شايفينه في الفلورسين each and maybe several + +113 +00:10:14,080 --> 00:10:18,540 +millimeters in diameter و هيكون قطر اشماله كبير + +114 +00:10:18,540 --> 00:10:23,800 +مقارنة بال superfacial panectate keratitis او في + +115 +00:10:23,800 --> 00:10:30,180 +ال superior staining these + +116 +00:10:30,180 --> 00:10:35,360 +are acute conditionsدايماً هذه إيش بتكون acute + +117 +00:10:35,360 --> 00:10:41,480 +حادة significant discomfort or pain المريض هيشعر + +118 +00:10:41,480 --> 00:10:46,080 +بعدم راحة و ألم شديد طبعا متى هذا الألم الشديد + +119 +00:10:46,080 --> 00:10:51,020 +بيظهر؟ بالضبط لما ال practitioner بيعمل عملية + +120 +00:10:51,020 --> 00:10:53,180 +removal لل soft contact lens + +121 +00:10:56,500 --> 00:11:00,940 +The lesion is not usually infected by stromal + +122 +00:11:00,940 --> 00:11:05,980 +infiltration is not present هان في هذه الحالة مش + +123 +00:11:05,980 --> 00:11:11,880 +هيصاب المريض بأي انفكشن لأن الأمر هذا مش هيكون + +124 +00:11:11,880 --> 00:11:17,800 +علاقة في الاسترومة يعني لا يؤذي الاسترومة و دايما + +125 +00:11:17,800 --> 00:11:21,720 +الانفكشن بيكون مصاحب لمن؟ للاسترومال + +126 +00:11:24,090 --> 00:11:29,070 +إذا بتميز هذا النوع صحيح بشدة ألم وعدم راحة للمريض + +127 +00:11:29,070 --> 00:11:35,550 +وإن العدسة بتكون tight مع الابيثيليا وبسبب hypoxia + +128 +00:11:35,550 --> 00:11:41,750 +لكن rarely من النادر أن يحدث infection للمريض + +129 +00:11:45,900 --> 00:11:51,620 +نومبر فور مايكرو زيست و vacuous مايكرو زيست ايش + +130 +00:11:51,620 --> 00:11:58,760 +معناها هو يصلها و vacuous بمعنى فراغات طبعا بيكون + +131 +00:11:58,760 --> 00:12:05,060 +بالشكل هذا النقاط البيض و منطقتها يعني بيكون ال + +132 +00:12:05,060 --> 00:12:13,130 +area في ال superior part في الغالبtranslucent zest + +133 +00:12:13,130 --> 00:12:17,730 +أي بمعنى اللي هو أكياس بتكون شبه شفافة in the + +134 +00:12:17,730 --> 00:12:23,790 +epithelium 0.01 to 0.1 millimeter in diameter إذا + +135 +00:12:23,790 --> 00:12:28,790 +قطرها إيش ملاحظينه؟ إنه very small وهذا بتديني + +136 +00:12:28,790 --> 00:12:33,950 +indicator مؤشر إنه لا يمكن رؤيتها بالعين المجردة + +137 +00:12:33,950 --> 00:12:41,740 +إذا بتحتاج إيه؟ micro scope في هناك طريقةمن خلال + +138 +00:12:41,740 --> 00:12:46,400 +الـ retro illumination يمكن ان اشوف هذه الأكياز + +139 +00:12:46,400 --> 00:12:52,500 +ولكن بتحتاج لخبرة كبيرة من ال examiner طيب انا ك + +140 +00:12:52,500 --> 00:12:56,580 +beginner مبتدئ كيف اعرف ان هذا المريض عنده micro + +141 +00:12:56,580 --> 00:13:01,160 +zest او اكتشف هذا الأمر؟ البساطة اني بعمل ال + +142 +00:13:01,160 --> 00:13:06,120 +corneal fluorescein staining ممكن انه يديني انطباع + +143 +00:13:06,120 --> 00:13:09,820 +او مؤشر اذا المريض كان عنده micro zest + +144 +00:13:13,110 --> 00:13:24,990 +الميكروزيكس صغير وقليل من الواكولاس بشكل + +145 +00:13:24,990 --> 00:13:24,990 +عام + +146 +00:13:28,460 --> 00:13:33,120 +destination is uncertain التنتين غير محددة ال + +147 +00:13:33,120 --> 00:13:38,160 +function لهم يعني لحد الآن ال micro zest و ال + +148 +00:13:38,160 --> 00:13:43,240 +vacuous التنتين without function بدون أي وظيفة + +149 +00:13:45,730 --> 00:13:50,090 +It takes 6 to 8 weeks of extended wear with + +150 +00:13:50,090 --> 00:13:55,990 +hydrogel lenses before micro-zest appear دايما + +151 +00:13:55,990 --> 00:14:01,810 +بتاخد مدة من 6 ل 8 أسابيع لظهور من ال micro-zest + +152 +00:14:01,810 --> 00:14:07,090 +او ال vaculus طب هان سؤال انه هل هي بتتعلق في ال + +153 +00:14:07,090 --> 00:14:11,090 +daily wear اقصد اللي هو ال daily disposable lenses + +154 +00:14:11,090 --> 00:14:14,250 +ولا ال extended wear ولا ال conventional daily + +155 +00:14:14,250 --> 00:14:18,550 +wearالها علاقة في ال extended wear و ال + +156 +00:14:18,550 --> 00:14:22,230 +conventional daily wear ليه؟ لأنه بمعنى هي + +157 +00:14:22,230 --> 00:14:25,370 +chronic، ما بتيجي بشكل ايه مفاجئ + +158 +00:14:30,010 --> 00:14:35,410 +One clue يعني واحدة من الأفكار to the presence + +159 +00:14:35,410 --> 00:14:41,630 +لظهور of microcyst or vacuous may be scattered by + +160 +00:14:41,630 --> 00:14:45,150 +nectarine fluorocene staining زي ما اتفقنا ان + +161 +00:14:45,150 --> 00:14:50,170 +واحدة من الحلول او واحدة من المؤشرات ان هذا المريض + +162 +00:14:50,170 --> 00:14:55,250 +عنده microcyst او vacuous من خلال ايه ان استخدم + +163 +00:14:55,250 --> 00:14:56,470 +الكورنيا لفلوروسين + +164 +00:14:59,640 --> 00:15:05,760 +يعني وجودها أو عدم وجودها طبعا الأربعة هدول لا + +165 +00:15:05,760 --> 00:15:11,100 +يعتبروا مخيفات بشكل كبير لأن موقعهم كله وين في ال + +166 +00:15:11,100 --> 00:15:16,180 +corneal epithelia management + +167 +00:15:16,180 --> 00:15:20,620 +أي بمعنى العلاج أو آلية العلاج أو الطريقة + +168 +00:15:20,620 --> 00:15:26,460 +significant epithelial staining المقصود فيها إما + +169 +00:15:26,460 --> 00:15:34,390 +moderate أو severe24 hour discontinuation of lens + +170 +00:15:34,390 --> 00:15:38,770 +wear إذا الشخص كان عنده severe أو moderate + +171 +00:15:38,770 --> 00:15:43,650 +staining وظهر عنده الحالات هدول الأربعة بعمل عملية + +172 +00:15:43,650 --> 00:15:49,150 +توقيف لارتداء العدسة لمدة 24 ساعة هان إيش بنقصد ال + +173 +00:15:49,150 --> 00:15:53,210 +conventional daily wear طبعا إذا كانت extended + +174 +00:15:53,210 --> 00:15:58,430 +wear أو daily disposable lenses بنوقفها بشكل إيه؟ + +175 +00:15:58,430 --> 00:16:04,190 +كاملمرة تانية، الآن إذا كان المريض عنده moderate + +176 +00:16:04,190 --> 00:16:07,930 +أو severe staining وكان بلبس conventional daily + +177 +00:16:07,930 --> 00:16:16,090 +wear بوقف ارتداء العدسة لمدة كده؟ 24 ساعة طبعا إذا + +178 +00:16:16,090 --> 00:16:19,630 +ظهرت عندي الأربع حالات هدول ال superfacial + +179 +00:16:19,630 --> 00:16:23,230 +panictate keratitis أو ال superior arcuate + +180 +00:16:23,230 --> 00:16:27,130 +panictate staining أو epithelial aberration أو ال + +181 +00:16:27,130 --> 00:16:34,370 +micro zestإذا ما ظهروا خلاص ان المريض بيستمر في + +182 +00:16:34,370 --> 00:16:39,810 +ارتداء العدسة طيب بعض الأحيان انت بتعمل الفحص ولكن + +183 +00:16:39,810 --> 00:16:44,250 +انه بيصير ايه اللي هو absent غياب إلها يعني بمعنى + +184 +00:16:44,250 --> 00:16:48,330 +الآن انا اتوقفت اربع وعشرين ساعة عن ارتداء العدسة + +185 +00:16:48,330 --> 00:16:51,650 +روحت اعملت corneal florescence stain مرة تانية + +186 +00:16:51,650 --> 00:16:56,350 +مظهرش البانكتيت كيروتايتس ايش بدي اعمل في هذه + +187 +00:16:56,350 --> 00:17:01,480 +الحالة؟ برجع ألبس العدسةولكن إذا كان هذا المريض + +188 +00:17:01,480 --> 00:17:07,440 +بلبس extended wear أو daily disposable lenses، بده + +189 +00:17:07,440 --> 00:17:11,640 +يتوقف بشكل كامل، في حالة مين؟ الـ significant + +190 +00:17:11,640 --> 00:17:18,340 +staining، اللي هي ال moderate أو السيفير، mild + +191 +00:17:18,340 --> 00:17:25,220 +staining يعني grade one، reducing wearing time، + +192 +00:17:25,220 --> 00:17:30,340 +بدنا نقلل من ساعات ارتداء العدسةfor example to + +193 +00:17:30,340 --> 00:17:35,720 +less than ten hours beer day or ceasing extended + +194 +00:17:35,720 --> 00:17:36,040 +wear + +195 +00:17:41,320 --> 00:17:45,460 +بنقوله فقط لبس العدسة اربع ساعات او ساعتين او + +196 +00:17:45,460 --> 00:17:50,880 +تلاتة يعني المهم انه اوقف من عدد يعني اوقف اللي هو + +197 +00:17:50,880 --> 00:17:54,700 +عدد الساعات ارتدائي العدسة طب لو كانت extended + +198 +00:17:54,700 --> 00:17:59,880 +wear او daily disposable lenses بوقفها بشكل كامل + +199 +00:17:59,880 --> 00:18:04,080 +حتى في ال mild حتى في ال mild staining ليه؟ لان ال + +200 +00:18:04,080 --> 00:18:07,440 +mild staining لو لبس العدسة لمدة اسبوع حصير + +201 +00:18:07,440 --> 00:18:08,400 +moderate او severe + +202 +00:18:12,570 --> 00:18:16,250 +if the staining is chronic يعني هذا كان ال + +203 +00:18:16,250 --> 00:18:20,050 +staining مظمن عند الشخص من قبل حتى ما يرتدي عدسة + +204 +00:18:20,050 --> 00:18:25,170 +لاسقة even if it's light or mild حتى لو كان بسيط + +205 +00:18:25,170 --> 00:18:30,770 +modification أي بمعنى تعديل of lens parameters انا + +206 +00:18:30,770 --> 00:18:35,650 +بدي اعمل عملية تعديل لمين لل parameters اللي خاصة + +207 +00:18:35,650 --> 00:18:42,370 +في العدسة to increase dk على t is advisableطب هذا + +208 +00:18:42,370 --> 00:18:55,410 +الكلام ممكن يكون خطأ صح؟ مين بتفق معايا؟ ممتازة + +209 +00:18:55,410 --> 00:19:01,090 +بالضبط، يعني الآن مثلا شخص كان عنده dry eye في بعض + +210 +00:19:01,090 --> 00:19:05,150 +الأحيان قد يكون مصاحب له ايه؟ ال corneal + +211 +00:19:05,150 --> 00:19:10,430 +fluorescein staining فروحت انا زودت ال DK على Tإيش + +212 +00:19:10,430 --> 00:19:15,770 +صار؟ زود الجفاف يعني ال dry eye symptoms صار أكتر + +213 +00:19:15,770 --> 00:19:20,270 +ظهور لهذا الشخص فانا إيش عملت في هذه الحالة؟ أسأت + +214 +00:19:20,270 --> 00:19:25,130 +اللي هو أكتر ل ال patient واضحة الفكرة؟ فدايما ال + +215 +00:19:25,130 --> 00:19:30,130 +parameters مش المقصود فيها اللي هو أنه فقط أزود ال + +216 +00:19:30,130 --> 00:19:34,930 +DK على T لأ لازم أنا أراعي كل الظروف يعني ممكن أنا + +217 +00:19:34,930 --> 00:19:40,660 +أغير ال thickness دون تغيير مين؟ ال DK على Tكيف + +218 +00:19:40,660 --> 00:19:44,680 +طيب؟ ممكن مثلا هو بلبس low water content بخليه + +219 +00:19:44,680 --> 00:19:48,000 +medium water content ولكن بقلل ال mean ال + +220 +00:19:48,000 --> 00:19:53,520 +thickness فدايما يعني اختيار ال option مهم كتير في + +221 +00:19:53,520 --> 00:19:54,720 +جميع الظروف + +222 +00:19:59,590 --> 00:20:04,630 +Superior arcuate panectate staining may require an + +223 +00:20:04,630 --> 00:20:09,850 +improvement to peripheral lens، DK على T وهذا أمر + +224 +00:20:09,850 --> 00:20:16,190 +طبيعي لأن هو عنده tight upper eyelid أو في عنده .. + +225 +00:20:16,190 --> 00:20:21,830 +في عنده partially toses ففي هذه الحالة أنا إيش بدي + +226 +00:20:21,830 --> 00:20:27,440 +أعمل؟ أزود الـDK على T من الأطرافعشان إيش يعمل + +227 +00:20:27,440 --> 00:20:33,200 +زيادة لدخول ال oxygen وين؟ في الأطراف whereas + +228 +00:20:33,200 --> 00:20:38,240 +بينما central staining may indicate the need to + +229 +00:20:38,240 --> 00:20:43,360 +improve central corneal oxygenation لكن لو كان + +230 +00:20:43,360 --> 00:20:46,620 +عنده الحالة الأولى ال superficial panictate + +231 +00:20:46,620 --> 00:20:50,700 +keratitis لجينا إن كل ال staining وين موجود؟ في ال + +232 +00:20:50,700 --> 00:20:54,340 +center فانا بدى أزود ال DK على T وين؟ في ال center + +233 +00:20:59,450 --> 00:21:04,870 +Unlike ocular changes with other causes, ocular + +234 +00:21:04,870 --> 00:21:10,250 +changes related to hypoxia and hypercapnia tend to + +235 +00:21:10,250 --> 00:21:14,410 +affect only the cornea, and there are a few + +236 +00:21:14,410 --> 00:21:20,570 +associated symptoms دايما الأعراض اللي بتسببها + +237 +00:21:20,570 --> 00:21:25,210 +الhypercapnia أو الhypoxia بتكون متعلقة في + +238 +00:21:25,210 --> 00:21:30,250 +الكورنيافي بعض الأحيان بتكون مصاحبة للأجزاء اللى + +239 +00:21:30,250 --> 00:21:35,630 +حوالين مين الكورنيا زى مثلا ايش يا رغد؟ زى مثلا + +240 +00:21:35,630 --> 00:21:41,230 +عندنا ال eyelid انه يصير عنده eyelid disorders او + +241 +00:21:41,230 --> 00:21:45,090 +مثلا يصير عنده conjunctival staining فهذه هيكون + +242 +00:21:45,090 --> 00:21:51,370 +مصاحبة لمين؟ للكورنيا disorders و بالتالي المريض + +243 +00:21:51,370 --> 00:21:55,110 +هيصير عنده شكوى اكتر في هذا الأمر + +244 +00:21:59,300 --> 00:22:05,500 +Stromal Edema طبعاً بداية الاسترومة او ال + +245 +00:22:05,500 --> 00:22:10,300 +Substantia Epropria هي بتمثل تسعين في المية تقريبا + +246 +00:22:10,300 --> 00:22:17,470 +من سماكة مين القرنيةarises within hours of the + +247 +00:22:17,470 --> 00:22:23,070 +onset of hypoxia، الآن الـ hypoxia لم تكتفي فقط في + +248 +00:22:23,070 --> 00:22:27,610 +التأثير على الـ corneal epithelium، بينما امتد + +249 +00:22:27,610 --> 00:22:33,470 +الأمر لوين؟ للاسترامة، دايماً لما تسمع ان في هناك + +250 +00:22:33,470 --> 00:22:38,150 +defect موجود في الاسترامة، في الغالب هيكون مصاحب + +251 +00:22:38,150 --> 00:22:42,690 +له infection زي الاسترامة ال infiltration + +252 +00:22:46,690 --> 00:22:50,470 +The degree being related to the severity of the + +253 +00:22:50,470 --> 00:22:56,310 +hypoxia وهذا بالأساس بيعتمد على حدة الهيبوكسية كل + +254 +00:22:56,310 --> 00:23:01,710 +ما زادت الهيبوكسية كل ما كان هناك عرضة أكتر لحدوث + +255 +00:23:01,710 --> 00:23:06,830 +من الهيبوكسية + +256 +00:23:06,830 --> 00:23:09,830 +الهيبوكسية related increase + +257 +00:23:11,810 --> 00:23:16,590 +In anaerobic metabolism دايماً إلها علاقة في زيادة + +258 +00:23:16,590 --> 00:23:22,190 +مين؟ عملية الهدم، عندنا ال aerobic metabolism + +259 +00:23:22,190 --> 00:23:27,350 +عملية البناء، ال anaerobic metabolism عملية الهدم + +260 +00:23:28,670 --> 00:23:34,070 +via the Emden-Meyerhof biochemical pathway of the + +261 +00:23:34,070 --> 00:23:40,170 +epithelial cells طبعا عملية الهدم هي مصاحبة لهؤلاء + +262 +00:23:40,170 --> 00:23:46,370 +العالمين Emden and Meyerhof اللي عملوا تجاربطبعا + +263 +00:23:46,370 --> 00:23:50,490 +كانت هذه التجارب من خلال أخد عينة من ال tiers + +264 +00:23:50,490 --> 00:23:54,630 +وتحليل ال protein اللي موجود في ال tier و بعد ذلك + +265 +00:23:54,630 --> 00:24:00,110 +تحليل ما هو مصاحب لل defect اللي حدث في ال corneal + +266 +00:24:00,110 --> 00:24:05,510 +epithelium و ال stroma accumulation انه صار في + +267 +00:24:05,510 --> 00:24:10,590 +هناك تراكم of lactate للأملاح وين هذا التراكم حدث؟ + +268 +00:24:10,590 --> 00:24:16,770 +in the stromaان انفلوه طبعا صار هناك تدفق of water + +269 +00:24:16,770 --> 00:24:22,290 +into the stroma وحدث اديمة يعني بمعنى انه ايش حدث + +270 +00:24:22,290 --> 00:24:28,390 +حاجة حاجة بنسميها ال swelling of + +271 +00:24:28,390 --> 00:24:37,530 +the stroma اذا حدث انتفاخ لمين للاسترومة + +272 +00:24:41,440 --> 00:24:48,370 +corneal thickness زيادة السماكةطبعا زيادة السماكة + +273 +00:24:48,370 --> 00:24:54,770 +ليس من السهل عملية تقييمها كليكيا طبعا احنا بنعرف + +274 +00:24:54,770 --> 00:25:00,030 +ان قياس سماكة القرانية ممكن ان يتم من خلال جهاز ال + +275 +00:25:00,030 --> 00:25:05,750 +باكميتر ولكن الآن زيادة سماكة الكورنية نتيجة + +276 +00:25:05,750 --> 00:25:10,190 +ارتداء العدسة اللاصقة مش من السهل تقييمها ليه؟ لأن + +277 +00:25:10,190 --> 00:25:16,570 +ممكن مثلا في الصباح يكون السماكة 500بعد الظهر يكون + +278 +00:25:16,570 --> 00:25:22,790 +مثلا أجل، مثلا أربعمية و خمسين، بعد ذلك في الليل + +279 +00:25:22,790 --> 00:25:27,650 +ممكن كمان اتقل اكتر، ففي ملاحظين انه variation من + +280 +00:25:27,650 --> 00:25:32,830 +حيث مين ال values أو ال numbersكل فترة زمنية + +281 +00:25:32,830 --> 00:25:38,470 +هتختلف عن الفترة الزمنية التانية وهذه هي دايما ال + +282 +00:25:38,470 --> 00:25:42,250 +complications اللي مصاحبة لمين لل soft contact + +283 +00:25:42,250 --> 00:25:47,490 +lens اللي من الصعب ان المريض يكتشفها يعني مين مننا + +284 +00:25:47,490 --> 00:25:51,450 +الان لو بلبس soft contact lens يعمل تلت مرات قياس + +285 +00:25:51,450 --> 00:25:54,450 +ل ال corneal thickness؟ هيكون قمر مجهد + +286 +00:25:56,890 --> 00:26:01,330 +إذا is not simple ليس من السهل أو من البسيط to + +287 +00:26:01,330 --> 00:26:06,410 +measure clinically قياسها بالعيادة أو في ال center + +288 +00:26:06,410 --> 00:26:12,610 +The edema response دايما استجابة ال edema begins + +289 +00:26:12,610 --> 00:26:17,610 +تبدأ within half an hour of lens insertion بعد + +290 +00:26:17,610 --> 00:26:22,540 +النص الساعة الأولى من ارتداء العدسةand generally + +291 +00:26:22,540 --> 00:26:27,900 +bakes within three hours وبتكون القمة لها بعد قديش + +292 +00:26:27,900 --> 00:26:32,560 +تلت ساعات in + +293 +00:26:32,560 --> 00:26:38,400 +daily wear lenses typically ranges from one point + +294 +00:26:38,400 --> 00:26:43,100 +five percent to five percent طبعا هان المقصود فيها + +295 +00:26:43,100 --> 00:26:46,720 +ال conventional daily wear عدسات اللبس اليومي + +296 +00:26:46,720 --> 00:26:52,410 +التقليديإذا كانت النسبة هذه ما بين واحد و نص لخمسة + +297 +00:26:52,410 --> 00:26:58,150 +بيكون normal ولكن بدي أسأل سؤال إن هذه النسبة طوال + +298 +00:26:58,150 --> 00:27:04,030 +اليوم ولا في فترة زمانية معينة؟ طول اليوم طول + +299 +00:27:04,030 --> 00:27:07,930 +اليوم هتختلف وبتاعة بس لازم تكون ضمن ال range هذا + +300 +00:27:07,930 --> 00:27:14,230 +يعني حتى لساعات زي ما كان الشغل انا بقول بما أن هي + +301 +00:27:14,230 --> 00:27:20,070 +لبس يعني مرة واحدة و خلاصفإنه لأ عادي، اتضمن في + +302 +00:27:20,070 --> 00:27:25,770 +ريش معين، لأ مش كل اليوم، لإنه لما بيسأل صباحا + +303 +00:27:25,770 --> 00:27:28,570 +أحيانا إنهم بتكون عنده أعلى من النسبة هذه، هو + +304 +00:27:28,570 --> 00:27:31,050 +طبيعي ال thickness بيكون أكتر، يعني ال school has + +305 +00:27:31,050 --> 00:27:39,750 +to .. another answer النسبة هذه بتكون طبيعية إذا + +306 +00:27:39,750 --> 00:27:44,920 +كانت طوال اليوملأن انتوا شايفين مافي fixed number + +307 +00:27:44,920 --> 00:27:50,440 +في ايه اللي هو range يعني من واحد و نص لخمسة يعني + +308 +00:27:50,440 --> 00:27:55,260 +ممكن اول ما يصحى من النوم تكون خمسة بعد ذلك بتقل + +309 +00:27:55,260 --> 00:27:58,900 +كل ما الانسان راح على العمل او على الدراسة بتقل + +310 +00:27:58,900 --> 00:28:02,380 +هذه النسبة ولكن هذه النسبة في ال conventional + +311 +00:28:02,380 --> 00:28:07,260 +daily wear اذا زادت عن خمسة خلال اليوم هان بيكون + +312 +00:28:07,260 --> 00:28:09,400 +في ايه امر اللي هو pathology + +313 +00:28:12,530 --> 00:28:16,130 +طبعا في حالة عدسات الـ extended wear اللي بتم + +314 +00:28:16,130 --> 00:28:20,170 +ارتدائها لمدة أسبوع كامل و بينام فيها النسبة هذه + +315 +00:28:20,170 --> 00:28:27,670 +أيضا هتزيد هتكون تقريبا من 10% ل 12% و أيضا إذا + +316 +00:28:27,670 --> 00:28:33,330 +أنا كانت النسبة هذه من 10% ل 12% بيكون الأمر طبيعي + +317 +00:28:33,330 --> 00:28:38,550 +إذا زادت عن ذلك بيكون في هناك يعني داعي للتدخل من + +318 +00:28:38,550 --> 00:28:41,730 +قبل ال practitioner أو ال optometrist + +319 +00:28:45,100 --> 00:28:51,120 +مقارنة الثقيلة الهيبوتونية يمكن تأثيرها أيضًا من + +320 +00:28:51,120 --> 00:28:57,500 +نوع من الهيبوتونية أو من نوع من الهيبوتونية أو من + +321 +00:28:57,500 --> 00:28:59,180 +نوع من الهيبوتونية أو من نوع من الهيبوتونية أو من + +322 +00:28:59,180 --> 00:28:59,180 +نوع من ال + +323 +00:29:02,530 --> 00:29:07,310 +دايمًا فيه هناك عاملين أساسيين بأثره على مين؟ على + +324 +00:29:07,310 --> 00:29:12,650 +سماكة القرانية العامل الأول هو تأثير ال reflex + +325 +00:29:12,650 --> 00:29:16,770 +hypotonic tearing طبعًا احنا عارفين ال basic tear + +326 +00:29:16,770 --> 00:29:21,970 +secretion من أنواعه ال reflex tearing صحيح؟ معناة + +327 +00:29:21,970 --> 00:29:27,360 +hypotonic ايش معناها؟انه بيكون هناك ضغط اسموزي + +328 +00:29:27,360 --> 00:29:32,720 +يعني دايما ال concentration التركيز ل ال stroma + +329 +00:29:32,720 --> 00:29:38,580 +هيكون مختلف عن مين الأجزاء الأخرى في القرنية كيف + +330 +00:29:38,580 --> 00:29:47,340 +يعني؟ نفترض مثلا عندنا ال stroma كان فيها ال + +331 +00:29:47,340 --> 00:29:53,200 +concentration عشرة + +332 +00:29:53,200 --> 00:30:00,550 +في الميةالابيثيليام والأزاء التانية من الكورنيا + +333 +00:30:00,550 --> 00:30:07,310 +كانت تلاتة في المية او اربعة في المية يعني اقل هذا + +334 +00:30:07,310 --> 00:30:12,030 +بيعمل ايه؟ tearing hypotonic يعني بيكون التمركز او + +335 +00:30:12,030 --> 00:30:17,010 +التركيز في الاسترومة اعلى من باقي الأجزاء فبيعمل + +336 +00:30:17,010 --> 00:30:22,890 +حاجة بنسميها reflex hypotonic tearing واضحة؟ + +337 +00:30:24,290 --> 00:30:29,150 +or by a physical thinning of the stroma الـ long + +338 +00:30:29,150 --> 00:30:35,950 +term wear الآن بعض الناس بيكون مخصص إله إنه يلبس + +339 +00:30:35,950 --> 00:30:41,450 +العدسة اللاصقة لمدة عشر ساعات بروح بلبسها خمس عشر + +340 +00:30:41,450 --> 00:30:47,030 +ساعات إذا صار عنده إيش long term wear هذا إيش كله + +341 +00:30:47,030 --> 00:30:51,690 +هيعمل thinning للاسترومة، هيقلل من سماكة مين + +342 +00:30:51,690 --> 00:30:53,770 +الاسترومة مع الوقت + +343 +00:30:58,120 --> 00:31:03,300 +Also there is marked individual variability in the + +344 +00:31:03,300 --> 00:31:08,740 +degree of corneal swelling response بعض الأحيان + +345 +00:31:08,740 --> 00:31:14,460 +بيكون هذا الكلام غير معمّم على كل الناس، كيف يعني؟ + +346 +00:31:14,860 --> 00:31:20,140 +الان مثلا نور ارتدت عدسة conventional daily wear + +347 +00:31:20,140 --> 00:31:24,600 +ال parameters معين من حيث ال base curve ال power + +348 +00:31:24,600 --> 00:31:29,880 +ال diameter ال water content ال thicknessكل هذا + +349 +00:31:29,880 --> 00:31:35,080 +مشابه لمين لعدسة ارتدتها خديجة في نفس ايش ال + +350 +00:31:35,080 --> 00:31:39,940 +parameters الآن قد يكون عندها الـ stroma القديمة + +351 +00:31:39,940 --> 00:31:45,660 +مختلفة عن مين عن اللي هو خديجة فكل شخص بيكون مختلف + +352 +00:31:45,660 --> 00:31:51,140 +عن الآخر في استجابته لمين للتأثيرات الخارجية اللي + +353 +00:31:51,140 --> 00:31:56,200 +بتطرق من خلال العدسة اللاصقةلذلك احنا قلنا there + +354 +00:31:56,200 --> 00:32:00,220 +is marked individual يعني هيكون هذا الأمر ثردي + +355 +00:32:00,220 --> 00:32:06,360 +variability اختلاف في درجة ايه انتفاخ او الاستجابة + +356 +00:32:06,360 --> 00:32:12,820 +لانتفاخ من ال cornea corneal + +357 +00:32:12,820 --> 00:32:17,580 +distortion طبعا ال corneal distortion دايما بتكون + +358 +00:32:17,580 --> 00:32:23,330 +مصاحبة لمين؟لل RGB ال R RGB او ال hard contact + +359 +00:32:23,330 --> 00:32:27,910 +lenses من ال advantages لل soft contact lens انه + +360 +00:32:27,910 --> 00:32:32,990 +بيكون غير شائع او very rarely نتيجة انه اشحت ال + +361 +00:32:32,990 --> 00:32:37,010 +soft contact lens دايما بيسبب minimal central + +362 +00:32:37,010 --> 00:32:38,630 +corneal distortion + +363 +00:32:41,500 --> 00:32:46,780 +أسبابها number one a result of poor gb lens + +364 +00:32:46,780 --> 00:32:52,020 +fitting كانت العدسة مثلا tight أو كانت العدسة flat + +365 +00:32:52,020 --> 00:32:57,400 +ممكن يسبب عند المريض corneal distortion or wear of + +366 +00:32:57,400 --> 00:33:02,900 +low dk على t أو دايما بلبس عدسات فيها dk على t + +367 +00:33:02,900 --> 00:33:08,460 +very low إيش معناها؟ يعني حياتها مدة حياتها طويلة + +368 +00:33:08,460 --> 00:33:09,180 +العدسة + +369 +00:33:19,520 --> 00:33:25,300 +أو بلبس عدسات لاصقة فقط مصنوعة من مادة الـ + +370 +00:33:25,300 --> 00:33:28,600 +polymethyl methacrylateاللي هي تعتبر الجيل الأول + +371 +00:33:28,600 --> 00:33:32,460 +من العدسات طبعا و أكيد هذا هيسبب إيش Cornial + +372 +00:33:32,460 --> 00:33:36,760 +distortion لذلك ال researchers الباحثين عملوا على + +373 +00:33:36,760 --> 00:33:40,740 +إضافة مين مادة ال silicon عشان تزود من ال + +374 +00:33:40,740 --> 00:33:44,920 +wetability المتانة في الجيل التاني من هذا النوع من + +375 +00:33:44,920 --> 00:33:50,920 +العدساتis an uncommon complication of hydrogel + +376 +00:33:50,920 --> 00:33:56,220 +lens wear طبعا هي غير ما هتكون شائعة مع عدسات ايه + +377 +00:33:56,220 --> 00:33:59,040 +ال conventional daily wear soft contact lenses + +378 +00:33:59,040 --> 00:34:03,740 +السبب في ذلك minimal central corneal distortion + +379 +00:34:07,210 --> 00:34:13,250 +Such distortion is known as spectacle blare or + +380 +00:34:13,250 --> 00:34:18,450 +corneal warpage and is manifested as a change in + +381 +00:34:18,450 --> 00:34:22,890 +the spectacle refraction and central corneal + +382 +00:34:22,890 --> 00:34:28,250 +curvature هذا ال corneal distortion خطورته انه + +383 +00:34:28,250 --> 00:34:32,590 +بيعمل حاجة بنسميها ال spectacle blare شو معناها؟ + +384 +00:34:33,530 --> 00:34:37,450 +إنه هيكون فيه اختلاف للرؤية ما بين ارتداء العدسة + +385 +00:34:37,450 --> 00:34:42,310 +اللاصقة والنضارة وطبعا هذا بيأد لإيش للكورنيا + +386 +00:34:42,310 --> 00:34:46,190 +القديمة لأنه دايما الكورنيا القديمة في العدسات ال + +387 +00:34:46,190 --> 00:34:51,630 +hard contact lens أكتر من ال soft contact lenses و + +388 +00:34:51,630 --> 00:34:55,830 +أيضا بيعمل على تغيير في إيش؟ في تحدب القرانية ال + +389 +00:34:55,830 --> 00:35:01,650 +kernel curvature powerنتوقف ان شاء الله للاستراما + +390 +00:35:01,650 --> 00:35:05,790 +ال استرايه في المحاضرة القادمة بنكمل ان شاء الله + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/OUPPZyn-4Io.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/OUPPZyn-4Io.srt new file mode 100644 index 0000000000000000000000000000000000000000..a9932a72898220cacd0cc2cfaeeb16c58f448598 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/OUPPZyn-4Io.srt @@ -0,0 +1,1335 @@ +1 +00:00:20,890 --> 00:00:24,130 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:24,130 --> 00:00:30,220 +وبركاته and a very good morning to all of you الآن + +3 +00:00:30,220 --> 00:00:34,560 +نحن كأخصائيي بصريات الهدف هو ليس ال treatment + +4 +00:00:34,560 --> 00:00:40,320 +العلاج إذا حدث corneal infection ولكن الهدف الذي + +5 +00:00:40,320 --> 00:00:44,500 +هو تقليل من ال corneal infection بمعنى آخر أنه + +6 +00:00:44,500 --> 00:00:49,680 +يجب أن يتوفر لكل شخص يعمل في مركز بصريات ال + +7 +00:00:49,680 --> 00:00:53,430 +pin torch، الهدف من ال pin torch هو عملية ال + +8 +00:00:53,430 --> 00:00:58,670 +evaluation أي بمعنى آخر عملية التقييم لأي عَوَبة + +9 +00:00:58,670 --> 00:01:03,690 +قد تحدث أين؟ في القرنية، ببساطة أجيب اللي + +10 +00:01:03,690 --> 00:01:07,390 +هو ال pin torch وأقوم بعمل evaluation لكل اللي هو + +11 +00:01:07,390 --> 00:01:13,290 +سطح القرنية، أي عَوَبة فطبعًا أنا أظن أو أشك في + +12 +00:01:13,290 --> 00:01:16,570 +وجود ما هو؟ corneal infection maybe correct + +13 +00:01:16,570 --> 00:01:22,390 +maybe incorrect، فأول خطوة أقوم بإزالة العدسة هذه + +14 +00:01:22,390 --> 00:01:27,950 +واحدة. نقطة ثانية أُعطي للمريض جنتاميسين كل ساعتين + +15 +00:01:27,950 --> 00:01:32,450 +الذي يستخدمه حتى متى؟ حتى أن + +16 +00:01:32,450 --> 00:01:36,690 +يذهب المريض إلى ophthalmologist وبعد ذلك يتم + +17 +00:01:36,690 --> 00:01:42,830 +التعامل معه من قبل من؟ طبيب العيون. طيب الآن + +18 +00:01:42,830 --> 00:01:47,090 +كيف أستطيع أن أقلل من حدوث ال corneal + +19 +00:01:47,090 --> 00:01:47,630 +infection؟ + +20 +00:01:50,450 --> 00:01:55,530 +لنزفة التقنية يمكن استخدامها لتقديم رغبات الانفكاش + +21 +00:02:00,450 --> 00:02:06,310 +إذا أول حاجة بالنسبة للـ optimal fitting للعدسة + +22 +00:02:06,310 --> 00:02:10,950 +يجب أن تكون بشكل صحيح أو بشكل جيد، هذا كله يُقلل من + +23 +00:02:10,950 --> 00:02:14,770 +ماذا؟ من خطورة حدوث ال infection، يعني إذا كانت + +24 +00:02:14,770 --> 00:02:19,950 +العدسة flat أو steep هذا ممكن أن يُسبب للمريض ماذا؟ + +25 +00:02:19,950 --> 00:02:25,190 +corneal infection، فأول حاجة لازم أضمن اللي هو + +26 +00:02:25,190 --> 00:02:27,430 +حدوث ال optimal fit lens + +27 +00:02:30,020 --> 00:02:35,100 +Number two, ensure adequate movement and post lens + +28 +00:02:35,100 --> 00:02:40,920 +tear flow. أضمن أيضًا اللي هو حركة ملائمة أو مناسبة + +29 +00:02:40,920 --> 00:02:45,980 +للعدسة، واتفقنا على أن الحركة الملائمة أو المناسبة + +30 +00:02:45,980 --> 00:02:51,960 +من نصف إلى 1 مليمتر، أيضًا عندنا ال post lens tear + +31 +00:02:51,960 --> 00:02:55,640 +film، كما نعرف أن هناك limitation + +32 +00:02:55,640 --> 00:03:00,600 +للعدسة الـ soft contact lenses، موضوع ال post lens + +33 +00:03:00,600 --> 00:03:04,350 +أو ال tear exchange اللي هو تبادل ال tear، الآن + +34 +00:03:04,350 --> 00:03:08,250 +حركة العدسة هي التي تساعد في موضوع ماذا؟ ال post + +35 +00:03:08,250 --> 00:03:12,310 +lens tear flow اللي هو تدفق التير، إذًا من الذي + +36 +00:03:12,310 --> 00:03:17,250 +يساعد في عملية تدفق التير؟ هو عبارة عن ال + +37 +00:03:17,250 --> 00:03:22,530 +lens movement، حركة العدسة، this + +38 +00:03:22,530 --> 00:03:28,030 +helps a clear bacteria Maintain a normal rate of + +39 +00:03:28,030 --> 00:03:32,590 +epithelial desquamation. الآن حدوث عملية اللي هو + +40 +00:03:32,590 --> 00:03:37,470 +تقشر الظهارية أو إعادة تجديد الخلايا، هذه تحدث + +41 +00:03:37,470 --> 00:03:43,430 +بشكل طبيعي مع من؟ مع الأشخاص الذين لا يرتدون العدسات اللاصقة + +42 +00:03:43,430 --> 00:03:48,790 +non contact lens users، إذًا هذه تحدث بشكل دوري كما نعرف + +43 +00:03:48,790 --> 00:03:53,330 +أنها عملية تجديد للقرنية الظهارية + +44 +00:03:53,330 --> 00:03:59,360 +كل 24 ساعة. الآن هذه الـ desquammation، أنا كأخصائي + +45 +00:03:59,360 --> 00:04:04,700 +بصريات يجب أن أحافظ عليها أثناء ارتداء المريض للعدسات + +46 +00:04:04,700 --> 00:04:10,200 +اللاصقة soft contact lenses، أيضًا يجب أن أحافظ على + +47 +00:04:10,200 --> 00:04:14,640 +الـ replenish أي بمعنى تجديد لمن؟ لطبقة الميوسين + +48 +00:04:14,640 --> 00:04:18,400 +layer، طبعًا من المسؤول عن إفراز طبقة المخاط + +49 +00:04:18,400 --> 00:04:24,520 +الـ goblet cells and circulate tear film + +50 +00:04:24,520 --> 00:04:28,300 +antibacterial factors and nutritions for the + +51 +00:04:28,300 --> 00:04:32,680 +epithelium. اتفقنا أن الشخص حين يرتدي عدسة لاصقة + +52 +00:04:32,680 --> 00:04:37,260 +هناك دائمًا صراع بين + +53 +00:04:37,260 --> 00:04:43,300 +العدسة والبكتيريا، بين الـ antibacterial + +54 +00:04:43,300 --> 00:04:47,620 +factors والبكتيريا. طبعًا الـ antibacterial factors + +55 +00:04:47,620 --> 00:04:51,280 +تمثل في ماذا؟ في البروتينات الموجودة في ال + +56 +00:04:51,280 --> 00:04:56,200 +tears. طبعًا أي طرف ينتصر على الطرف الآخر، يعني بمعنى + +57 +00:04:56,200 --> 00:05:00,280 +إذا البكتيريا انتصرت ستحدث اختراق لمن؟ للقرنية + +58 +00:05:00,280 --> 00:05:05,180 +وبالتالي ستُسبب عَوَبة ومن ثم corneal infection. إذا الـ antibacterial factors انتصرت + +59 +00:05:05,180 --> 00:05:10,450 +ستوفر رؤية واضحة وستحافظ على سلامة العدسة و + +60 +00:05:10,450 --> 00:05:16,090 +أيضًا سلامة القرنية. + +61 +00:05:16,090 --> 00:05:17,710 +أيضًا سلامة القرنية. + +62 +00:05:21,250 --> 00:05:26,450 +تأكد من التعامل مع التعزيز القرني من خلال عصيرية + +63 +00:05:26,450 --> 00:05:32,130 +مع تدخل تقليد عام أو تدخل تقليد عالي أو تدخل + +64 +00:05:32,130 --> 00:05:33,270 +تقليد عالي أو تدخل تقليد عالي أو تدخل + +65 +00:05:33,270 --> 00:05:33,710 +تقليد عالي أو تدخل تقليد عالي أو تدخل + +66 +00:05:33,710 --> 00:05:36,530 +تقليد عالي أو تدخل تقليد عالي أو تدخل + +67 +00:05:36,530 --> 00:05:37,370 +تقليد عالي أو تدخل تقليد عالي أو تدخل + +68 +00:05:37,370 --> 00:05:38,930 +تقليد عالي أو تدخل تقليد عالي أو تدخل + +69 +00:05:38,930 --> 00:05:47,010 +تقليد عالي أو تدخل تقليد عالي أو + +70 +00:05:47,010 --> 00:05:51,890 +تدخلان. عندنا موضوع الـ DK على T كلما زاد + +71 +00:05:51,890 --> 00:05:56,810 +كلما كان دخول الـ oxygen أكثر، لكن هنا + +72 +00:05:56,810 --> 00:06:01,310 +هناك مشكلة وهي أن كلما زاد دخول ال oxygen للقرنية، ماذا؟ + +73 +00:06:01,310 --> 00:06:08,530 +الـ problem الذي قد يحدث؟ الآن كلما زادت كمية ال + +74 +00:06:08,530 --> 00:06:10,630 +oxygen على القرنية + +75 +00:06:13,370 --> 00:06:16,990 +عادةً تصبح too thin وبالتالي تؤثر على القرنية + +76 +00:06:18,840 --> 00:06:23,560 +أكثر من ناحية أعراض هو موضوع الـ dry eye. إذا كلما + +77 +00:06:23,560 --> 00:06:29,320 +زاد الـ water content أو كلما زاد الـ DK على T أو + +78 +00:06:29,320 --> 00:06:33,760 +كلما كانت العدسة too thin نفس المعنى، حينها يكون + +79 +00:06:33,760 --> 00:06:39,820 +الشخص عرضة لمن؟ لـ dry eye symptoms. بمعنى آخر الآن + +80 +00:06:39,820 --> 00:06:44,360 +ما هي العدسات التي تسبب أعراض جفاف العين؟ + +81 +00:06:45,470 --> 00:06:48,450 +الـ high water content أو الـ moderate الـ DK + +82 +00:06:48,450 --> 00:06:53,750 +على T، لكن الـ low water content قد يصعب + +83 +00:06:53,750 --> 00:06:58,410 +مقارنتها مع من؟ مع الـ moderate أو الـ high + +84 +00:06:58,410 --> 00:07:02,710 +water content. فالآن زيادة دخول الـ oxygen + +85 +00:07:02,710 --> 00:07:07,390 +ستضمن ماذا؟ أن سيكون هناك تأثير على من؟ على + +86 +00:07:07,390 --> 00:07:11,810 +الظهارية، وسيحدث هناك عملية الالتصاق + +87 +00:07:11,810 --> 00:07:18,610 +والبناء aerobic metabolism، وهذا يزيد قابلية + +88 +00:07:18,610 --> 00:07:24,830 +الالتصاق للبكتيريا في الظهارية القرنية وهذه + +89 +00:07:24,830 --> 00:07:30,050 +العملية تعتبر عملية طبيعية، بمعنى أن هدفي من + +90 +00:07:30,050 --> 00:07:33,550 +القرنية الظهارية في ارتداء العدسة + +91 +00:07:33,550 --> 00:07:36,770 +اللاصقة هو حدوث الترابط + +92 +00:07:36,770 --> 00:07:40,710 +أو الالتصاق بين البكتيريا والظهارية القرنية + +93 +00:07:40,710 --> 00:07:45,650 +حتى يتم التخلص من البكتيريا حتى يتم التخلص + +94 +00:07:45,650 --> 00:07:51,720 +من البكتيريا خارج العين. إذًا ببساطة زيادة الـ DK على + +95 +00:07:51,720 --> 00:07:56,760 +T ستؤدي إلى زيادة في دخول الأكسجين، بعد ذلك ستؤدي إلى + +96 +00:07:56,760 --> 00:08:00,800 +الالتصاق بين البكتيريا وبين القرنية + +97 +00:08:00,800 --> 00:08:05,100 +الظهارية، وستؤدي إلى طرد من؟ للبكتيريا خارج + +98 +00:08:05,100 --> 00:08:10,440 +القرنية. Minimize + +99 +00:08:10,440 --> 00:08:15,620 +exposure of the eye to microbial contamination by + +100 +00:08:15,620 --> 00:08:21,940 +patient education on hygiene. نعرف عند صرف + +101 +00:08:21,940 --> 00:08:27,380 +العدسة اللاصقة اللينة، أولًا يجب أن يكون لدى المريض + +102 +00:08:27,380 --> 00:08:33,560 +أمر هام وهو موضوع التحفيز، هذه + +103 +00:08:33,560 --> 00:08:38,720 +أولًا التحفيز، يجب أن يكون لدى المريض + +104 +00:08:38,720 --> 00:08:44,640 +النقطة الثانية، ألاحظ حالة المريض إذا + +105 +00:08:44,640 --> 00:08:49,200 +كان لديه good أم poor hygiene، إذا رأيت poor + +106 +00:08:49,200 --> 00:08:54,100 +hygiene من الأفضل ألا يتم صرف العدسة + +107 +00:08:54,100 --> 00:08:59,200 +اللاصقة، وإذا كان لديه good hygiene يمكنني البدء + +108 +00:08:59,200 --> 00:09:03,340 +بالنظر في صرف العدسة مع العوامل الأخرى. + +109 +00:09:03,340 --> 00:09:09,490 +هنا لدينا نقطة هامة وهي موضوع ال + +110 +00:09:09,490 --> 00:09:13,650 +bacterial contamination، التلوث البكتيري، أعلم المريض أنه + +111 +00:09:13,650 --> 00:09:17,550 +في الغالب المرضى الذين + +112 +00:09:17,550 --> 00:09:22,490 +يرتدون العدسات اللاصقة اللينة يحتاجون إلى + +113 +00:09:22,490 --> 00:09:24,710 +ماذا؟ ارشادات، instructions + +114 +00:09:30,780 --> 00:09:35,340 +وهذه الـ instructions يجب أن تُعطى من قبل + +115 +00:09:35,340 --> 00:09:38,860 +practitioner أو من قبل supervisor أو من قبل + +116 +00:09:38,860 --> 00:09:43,840 +optometrist أو eye doctor. طيب، ما هي + +117 +00:09:43,840 --> 00:09:48,620 +هذه الارشادات؟ أمنع المريض من استخدام الـ homemade + +118 +00:09:48,620 --> 00:09:55,320 +saline، أي محلول مُصنع محليًا. يجب على المريض + +119 +00:09:55,320 --> 00:10:01,530 +ألا يستخدمه. أي محلول لا نعرف contents له، مكونات، من + +120 +00:10:01,530 --> 00:10:05,210 +حيث لا نعرف نسبة الـ water، لا نعرف نسبة مثلاً + +121 +00:10:05,210 --> 00:10:08,530 +الـ disinfection، لا نعرف نسبة الـ + +122 +00:10:08,530 --> 00:10:13,330 +cleaning، هذا أطلبه من المريض ألا يستخدمه. أي + +123 +00:10:13,330 --> 00:10:18,650 +solution ليس له اسم شركة. أيضًا ألا + +124 +00:10:18,650 --> 00:10:19,490 +يستخدمه. + +125 +00:10:44,200 --> 00:10:48,140 +أيضًا عندنا مياه الصنبور. بعض المرضى بعد انتهاء + +126 +00:10:48,140 --> 00:10:53,240 +المحلول، لا يستطيع الذهاب + +127 +00:10:53,240 --> 00:10:58,440 +لشراء محلول جديد، فيقوم بتنظيف العدسات في مياه الصنبور، خاصة + +128 +00:10:58,440 --> 00:11:02,100 +الـ hard contact lenses. فبالتالي هذا يُسبب ماذا؟ + +129 +00:11:02,100 --> 00:11:06,520 +bacterial contamination. طبعًا الـ soft أقل تأثيرًا + +130 +00:11:06,520 --> 00:11:12,410 +لأنها لا تتحمل الماء، تصبح هشة. And + +131 +00:11:12,410 --> 00:11:16,610 +attention to compliance with lens care systems + +132 +00:11:16,610 --> 00:11:22,010 +أيضًا يجب أن يكون لدى المريض اهتمام بـ + +133 +00:11:22,010 --> 00:11:26,730 +أنظمة الرعاية والعناية بالعدسات كما أخذنا نحن + +134 +00:11:26,730 --> 00:11:31,110 +مثلاً في المعمل كيفية تنظيف العدسات اللاصقة اللينة + +135 +00:11:31,110 --> 00:11:34,770 +في أوقات مختلفة، أربعة، يجب علي أن أعلم المريض بهذه + +136 +00:11:34,770 --> 00:11:39,160 +الأمور، بمعنى أن العدسة لا تُنظف مرة واحدة، إذا كان هناك + +137 +00:11:39,160 --> 00:11:43,560 +فرق بين الأوقات، يجب على المريض عمل عملية + +138 +00:11:43,560 --> 00:11:47,940 +cleaning للعدسة اللاصقة، أيضًا يجب ألا يظن + +139 +00:11:47,940 --> 00:11:51,280 +المريض أن يحفظ المحلول في الحاوية + +140 +00:11:51,280 --> 00:11:56,780 +الحاوية، يجب التخلص من المحلول الموجود في + +141 +00:11:56,780 --> 00:11:59,660 +الحاوية بشكل دوري + +142 +00:12:02,720 --> 00:12:06,340 +هذه كلها لها علاقة في الـ bacterial + +143 +00:12:06,340 --> 00:12:10,940 +contamination أو الـ bacteria immunologic reaction + +144 +00:12:10,940 --> 00:12:16,140 +الآن الأخطر من ذلك موضوع الـ acanthamoeba other + +145 +00:12:16,140 --> 00:12:21,580 +risk factor for acanthamoeba infection are the + +146 +00:12:21,580 --> 00:12:25,680 +contamination of lenses or solutions through + +147 +00:12:25,680 --> 00:12:31,320 +contact with swimming pools, hot tubs and + +148 +00:12:31,320 --> 00:12:35,620 +freshwater ponds احنا قلنا أن العدسات اللاصقة + +149 +00:12:35,620 --> 00:12:41,720 +اللينة ممكن استخدامها في كل الـ activities باستثناء + +150 +00:12:41,720 --> 00:12:45,760 +من الـ swimming pool والسبب في ذلك أنه قد تكون + +151 +00:12:45,760 --> 00:12:52,520 +معرضة لـ الـ acanthamoeba corneal infection أحواض + +152 +00:12:52,520 --> 00:12:57,980 +اللي هو الصباحة أو عندنا مثلاً المياه الساخنة هذه + +153 +00:12:57,980 --> 00:13:02,920 +كلها بتعرض العدسة اللاصقة لحدوث ايه؟ الـ + +154 +00:13:02,920 --> 00:13:10,120 +acanthamoeba infection + +155 +00:13:10,120 --> 00:13:15,440 +clean the lens case daily and replace it regularly + +156 +00:13:16,400 --> 00:13:22,400 +الآن أول ما بتم صرف العدسة اللاصقة مثلاً لرقد لازم + +157 +00:13:22,400 --> 00:13:27,820 +أتعرف على نوع الـ occupation اللي هي بتقوم فيها إذا + +158 +00:13:27,820 --> 00:13:32,600 +كان مثلاً officer أو كان مثلاً teacher أو مدرس جامعة + +159 +00:13:32,600 --> 00:13:37,440 +الأخرى هذا الشخص ممكن أديه حاوية واحدة هذا أنا + +160 +00:13:37,440 --> 00:13:40,460 +بتكلم على الـ conventional daily wear اللي بتم + +161 +00:13:40,460 --> 00:13:45,770 +ارتداها من ست شهور لسنة Okay لكن لو هذا الشخص مثلاً + +162 +00:13:45,770 --> 00:13:51,290 +بيقوم بأعمال زي البناء أو مثلاً حداد بمعنى يعني قد + +163 +00:13:51,290 --> 00:13:56,710 +يكون عنده poor hygiene لازم أوفر له حاوتين إذا + +164 +00:13:56,710 --> 00:14:01,230 +خلال الست شهور أو خلال السنة أو الثمان شهور لازم + +165 +00:14:01,230 --> 00:14:04,810 +أنه يتم توفير اللي هو two cases لهذا الشخص + +166 +00:14:04,810 --> 00:14:10,550 +ويستبدلهم خلال الفترة المعينة لارتداء العدسة + +167 +00:14:10,550 --> 00:14:15,030 +اللاصقة، و أيضاً مربة ثانية بنكارولر موضوع اللي هو + +168 +00:14:15,030 --> 00:14:20,030 +تنظيف الكاس كل يوم والتخلص من المحلول القديم مهم + +169 +00:14:20,030 --> 00:14:22,430 +جداً في المحافظة على العدسة + +170 +00:14:28,960 --> 00:14:32,960 +العدسات اللي متوفرة عندنا في الـ المعمل الـ daily + +171 +00:14:32,960 --> 00:14:37,860 +disposable lenses don't appear to alter the risk + +172 +00:14:37,860 --> 00:14:43,200 +of infection when allowance is made for factors + +173 +00:14:43,200 --> 00:14:47,020 +such as compliance with the cleaning and + +174 +00:14:47,020 --> 00:14:51,740 +disinfection systems يعني هذا النوع من العدسات ما + +175 +00:14:51,740 --> 00:14:57,380 +بيحتاج لا تنظيف ولا رعاية ولا عناية ولا تخزين طيب + +176 +00:14:57,380 --> 00:15:02,740 +من وين ممكن تيجي الـ bacterial contamination أو من + +177 +00:15:02,740 --> 00:15:06,000 +وين ممكن تيجي الـ acanthamoeba infection في هذا + +178 +00:15:06,000 --> 00:15:12,560 +النوع؟ Do you have answer؟ + +179 +00:15:13,730 --> 00:15:17,630 +لا، ما احنا قلنا المريض اتعلم أنه مافيش فيه أية + +180 +00:15:17,630 --> 00:15:20,730 +cleaning system، no cleaning system or no care + +181 +00:15:20,730 --> 00:15:24,450 +system نعم + +182 +00:15:28,710 --> 00:15:33,650 +Okay أو الـ bad habits لهو المريض أو مثلاً أنا أصرف + +183 +00:15:33,650 --> 00:15:37,930 +عدسة يومية لهذا الشخص وأروح يستخدمها مثلاً في الـ + +184 +00:15:37,930 --> 00:15:41,590 +freshwater pools أو يروح يستخدمها في الـ swimming + +185 +00:15:41,590 --> 00:15:45,970 +pool كل هذه ممكن أن تأدي لمين؟ إذا كان ثميبيا + +186 +00:15:45,970 --> 00:15:46,630 +infection + +187 +00:15:50,870 --> 00:15:58,530 +التواصل الناري عادي لتقليل تأثير الاتفاق اللاجئ + +188 +00:16:00,570 --> 00:16:05,950 +يعني الاستبدال بشكل منظم للعدسة وهنا نتكلم عن الـ + +189 +00:16:05,950 --> 00:16:10,750 +conventional daily wear هذا مهم في تقليل نسبة مين؟ + +190 +00:16:10,750 --> 00:16:14,890 +نسبة حدوث الـ inflammatory reaction طبعاً هناك + +191 +00:16:14,890 --> 00:16:18,430 +اختلاف إحصائي ما بين الـ incidence و الـ prevalence + +192 +00:16:18,430 --> 00:16:23,150 +الـ incidence هي كل الحالات الـ new يعني الآن أنا + +193 +00:16:23,150 --> 00:16:27,290 +بدي أشوف نسبة اللي هو الناس اللي بيرتديوا العدسة + +194 +00:16:27,290 --> 00:16:32,940 +اللاصقة في قطاع غزة Okay هذا بنسميه incidence يعني + +195 +00:16:32,940 --> 00:16:37,180 +number أو appropriation لكل الـ new patients اللي + +196 +00:16:37,180 --> 00:16:41,580 +أنا بأخذهم لكن الـ prevalence بيشمل الـ old و الـ new + +197 +00:16:41,580 --> 00:16:47,040 +patient فاهمين عليّ كيف؟ يعني الآن مثلاً في أشخاص + +198 +00:16:47,040 --> 00:16:53,040 +بيرتديوا عدسات لاصقة من الـ 2010 وأنا عملت دراستي في + +199 +00:16:53,040 --> 00:16:58,720 +الـ 2018 صحيح؟ لو أنا بدي آخذ الأشخاص اللي من + +200 +00:16:58,720 --> 00:17:07,580 +الـ 2010 والـ 18 هذه بنسميها prevalence ليش؟ + +201 +00:17:07,580 --> 00:17:14,140 +لأن هنا عندنا old وهنا عندنا ايه؟ الـ new طيب لو + +202 +00:17:14,140 --> 00:17:20,080 +الدراسة تم إجراءها في 2018 و أخذت فقط العينة للأشخاص + +203 +00:17:20,080 --> 00:17:24,120 +اللي بيرتديوا العدسات اللاصقة في 2018، إذا كلهم + +204 +00:17:24,120 --> 00:17:28,580 +الـ new patients، إذا هذه بنسميها incidence أو + +205 +00:17:28,580 --> 00:17:33,600 +preparation أو frequency أو percentage، كل هذه نفس + +206 +00:17:33,600 --> 00:17:40,940 +المسمى نرجع لموضوعنا الاستبدال المنظم للعدسة + +207 +00:17:40,940 --> 00:17:46,580 +اللاصقة أو الكاس الحاوية أو المحلول هذا كله بيقلل + +208 +00:17:46,580 --> 00:17:50,760 +من حدوث ايه؟ الـ inflammation أو من نسبة اللي هو + +209 +00:17:50,760 --> 00:17:52,700 +حدوث الـ corneal infection + +210 +00:17:57,590 --> 00:18:02,290 +اقوموا بـ Minimize Extended Wear، لأن التأثيرات + +211 +00:18:02,290 --> 00:18:08,750 +والإنفلامات ليست معروفة في الـ daily wear الآن لو + +212 +00:18:08,750 --> 00:18:13,290 +احنا قررنا ما بين عدسات الـ extended wear و الـ + +213 +00:18:13,290 --> 00:18:17,870 +daily wear هن الـ daily disposable lenses أول حاجة + +214 +00:18:17,870 --> 00:18:22,570 +مين أكثر عرضة؟ يعني مين بيعمل اللي هو corneal + +215 +00:18:22,570 --> 00:18:26,810 +infection أكثر؟ الـ daily disposable lenses ولا الـ + +216 +00:18:26,810 --> 00:18:31,450 +extended wear؟ الـ extended wear ببساطة لأنه بتعيش + +217 +00:18:31,450 --> 00:18:37,230 +فترة زمنية أطول، و أيضاً بتم ارتداها بشكل أطول، لكن + +218 +00:18:37,230 --> 00:18:40,350 +الآن لو قررنا ما بين الـ extended wear و الـ + +219 +00:18:40,350 --> 00:18:44,550 +conventional daily wear، إذا أكيد الـ conventional + +220 +00:18:44,550 --> 00:18:48,930 +daily wear هي هتسبب ايش؟ corneal infection أكثر، + +221 +00:18:48,930 --> 00:18:52,910 +فعندنا هنا Minimize extended wear، إذا دائماً الـ + +222 +00:18:52,910 --> 00:18:57,290 +corneal infection حدوثه هيكون أقل في العدسات من الـ + +223 +00:18:57,290 --> 00:18:58,070 +extended wear + +224 +00:19:05,080 --> 00:19:10,320 +بس هنضيفه daily disposable lenses في العدسات اللي + +225 +00:19:10,320 --> 00:19:14,080 +هو ايه؟ الـ daily disposable lenses لأن لو اتكلمنا + +226 +00:19:14,080 --> 00:19:17,280 +عن الـ daily wear هيكون most common + +227 +00:19:25,760 --> 00:19:29,780 +واضح الفكرة؟ يعني كل ما امتد فترة حياة العدسة أكثر + +228 +00:19:29,780 --> 00:19:33,960 +كل ما كانت معرضة لـ bacterial infection أو الـ + +229 +00:19:33,960 --> 00:19:39,940 +bacterial contamination أكثر طيب الآن نفترض أنه + +230 +00:19:39,940 --> 00:19:44,620 +أنا صرفت العدسة اللاصقة للمريض بعد ما عملت عملية + +231 +00:19:44,620 --> 00:19:48,980 +evaluation لـ power و الـ diameter و الـ base curve + +232 +00:19:48,980 --> 00:19:53,600 +وعملت الـ push up test وشوفنا أن العدسة هذه ملائمة + +233 +00:19:53,600 --> 00:19:58,520 +للمريض، أجى المريض بعد يوم أو يومين قال لي أنا بشوف + +234 +00:19:58,520 --> 00:20:02,980 +his vision أو reduce vision أو blurred vision عدم + +235 +00:20:02,980 --> 00:20:08,180 +وضوح بالعدسة اللاصقة اللي تم إعطاها للمريض أنا + +236 +00:20:08,180 --> 00:20:10,900 +كأخصائي بصريات ايش بتوقع؟ + +237 +00:20:17,070 --> 00:20:21,630 +ممكن اللي هو عمل عملية اللي هو incorrect يعني من + +238 +00:20:21,630 --> 00:20:26,530 +ناحية الـ right left و الـ left right أو ممكن عمل + +239 +00:20:26,530 --> 00:20:30,910 +عملية inverted قلب للعدسة عشان هيك قلنا أول ما + +240 +00:20:30,910 --> 00:20:35,350 +بنطلع العدسة من الكيس الخطوة الأولى بعد ما بعمل + +241 +00:20:35,350 --> 00:20:38,950 +عملية cleaning بعمل الـ tackle test للتأكيد أنه هل + +242 +00:20:38,950 --> 00:20:45,660 +العدسة inverted ولا real إذا عندنا الـ causes + +243 +00:20:45,660 --> 00:20:51,740 +الأسباب Tight أو Loose Lens إذا العدسة لو كانت Flat + +244 +00:20:51,740 --> 00:20:56,900 +أو كانت Steep ممكن هذا بيؤدي لمين؟ لهو الـ Hayes + +245 +00:20:56,900 --> 00:21:00,200 +region، ببساطة كيف الـ steep بتعمل الـ Hayes + +246 +00:21:00,200 --> 00:21:04,300 +region؟ لأنه no sensation at all و بتكون عاملة + +247 +00:21:04,300 --> 00:21:08,800 +حاجة بنسميها أن بتكون suction، suction بمعنى + +248 +00:21:08,800 --> 00:21:14,760 +مصممة يعني بتكون اللي هو لازقة وين؟ أو مثبتة على أو + +249 +00:21:14,760 --> 00:21:19,400 +ضاغطة على القرنية فبالتالي قد تسبب اللي هو ايه؟ الـ + +250 +00:21:19,400 --> 00:21:23,940 +blurred vision أو haze vision أيضاً عندنا الـ loose + +251 +00:21:23,940 --> 00:21:29,200 +lens يعني بتكون العدسة flat بالضبط أن هيكون الـ + +252 +00:21:29,200 --> 00:21:33,400 +diameter بتاعتها أول حاجة أبعادها صغير وبالتالي أن + +253 +00:21:33,400 --> 00:21:37,340 +هتكون excessive movement حركة اللي هو كبيرة + +254 +00:21:37,620 --> 00:21:41,940 +فبالتالي قد تسبب Blurred Vision أو Haze Vision + +255 +00:21:41,940 --> 00:21:48,100 +Inverted Lens العدسة مقلوبة، و بتم التعرف عليها من + +256 +00:21:48,100 --> 00:21:54,280 +قبل الـ tackle test check the power because right eye + +257 +00:21:54,280 --> 00:21:57,940 +may be instead of left eye طبعاً هذه الخربة طوال + +258 +00:21:57,940 --> 00:22:03,040 +الوقت تصبح عند شخص بيكون عنده الـ variation في الـ + +259 +00:22:03,040 --> 00:22:06,040 +refractive error يعني نفترض مثلاً الـ right كانت + +260 +00:22:06,040 --> 00:22:10,360 +minus 3 و الـ left كانت عنده minus 8 فبتكون واضحة + +261 +00:22:10,360 --> 00:22:14,080 +عنده أن هو عمل عملية طلب للعدسة + +262 +00:22:17,700 --> 00:22:23,180 +أيضاً deposits on the lens and it is clarity الآن + +263 +00:22:23,180 --> 00:22:28,420 +تراكم الترسبات على سطح العدسة في بعض الدراسات + +264 +00:22:28,420 --> 00:22:33,980 +بتأكد أنه بيزيد من حركة العدسة وبالتالي أنه بتقرب + +265 +00:22:33,980 --> 00:22:38,240 +العدسة أن تكون flat فبسبب اللي هو الـ blurred أو + +266 +00:22:38,240 --> 00:22:42,810 +الـ variable vision أيضاً كل ما زادت الترسبات على + +267 +00:22:42,810 --> 00:22:47,090 +العدسة اللي transparent الوضوح بتاعتها أبعادها + +268 +00:22:47,090 --> 00:22:55,330 +بتقل وبالتالي بيصير الرؤية غير واضحة + +269 +00:22:55,330 --> 00:22:59,490 +drying of the lens because of air conditions or + +270 +00:22:59,490 --> 00:23:04,610 +atmosphere احنا بنعرف أن الـ air condition أو لما + +271 +00:23:04,610 --> 00:23:09,430 +يكون في عندنا اللي هو الـ tropical region هذا بيؤدي + +272 +00:23:09,430 --> 00:23:14,430 +إلى زيادة حدوث مين؟ جفاف العين فما بالك إنسان قاعد + +273 +00:23:14,430 --> 00:23:20,050 +في غرفة مكيفة، و لابس عدسة لاصقة فهذا هيصير اللي هو + +274 +00:23:20,050 --> 00:23:26,950 +ايه؟ مضاعف حدوث جفاف العين إذا مرة أخرى من الـ main + +275 +00:23:26,950 --> 00:23:31,130 +causes للـ dry eye عندنا الـ air condition أو الـ + +276 +00:23:31,130 --> 00:23:36,430 +tropical region طيب نفترض مثلاً عندنا بلد فيها اللي + +277 +00:23:36,430 --> 00:23:39,370 +هو الـ tropical region يعني الـ tropical region اللي + +278 +00:23:39,370 --> 00:23:45,070 +هو استوائي، و ببساطة ثلاثي فـ هيكون هذا الشخص عنده + +279 +00:23:45,070 --> 00:23:48,930 +حدوث لـ dry eye مضاعف مقارنة في دول ايه؟ أخرى + +280 +00:23:53,460 --> 00:23:57,300 +طيب، عندنا الـ Red Eye احمرار العين الـ in contact + +281 +00:23:57,300 --> 00:24:02,200 +lens wearer للأشخاص اللي بيرتدوا يوميا العدسات + +282 +00:24:02,200 --> 00:24:06,700 +اللاصقة، وهذا بقصد اللي هو اللينة the causes + +283 +00:24:06,700 --> 00:24:12,260 +الأسباب، number one incomplete blinking إن المريض + +284 +00:24:12,260 --> 00:24:16,900 +ما بيقوم بترميش كامل أو بترميش اللي هو بنسمي + +285 +00:24:16,900 --> 00:24:22,850 +adequate أو sufficient، okay؟ طبعا عندنا ال educate + +286 +00:24:22,850 --> 00:24:28,090 +normal blinking من خمس عشرة لعشرين مرة في الدقيقة، + +287 +00:24:28,090 --> 00:24:32,850 +من خمس عشرة لعشرين مرة في الدقيقة، هذا يعتبر ال + +288 +00:24:32,850 --> 00:24:35,390 +normal blinking للأشخاص + +289 +00:24:37,200 --> 00:24:41,080 +و لازم أن هذا الشخص يحافظ على ال normal blinking + +290 +00:24:41,080 --> 00:24:45,920 +أثناء ارتداء العدسة اللاصقة يمكن فيكم اللي بيلبس + +291 +00:24:45,920 --> 00:24:49,840 +عدسة لاصقة دائما عندما ترتدي العدسة اللاصقة سواء + +292 +00:24:49,840 --> 00:24:53,660 +ال hard أو ال soft contact lenses بتحاول أنك تقلل + +293 +00:24:53,660 --> 00:24:57,860 +ال blinking لأنه بيكون فيها ثقل على القرنية فدايما + +294 +00:24:57,860 --> 00:25:02,410 +الشخص بتلاقي عنده reduce لل blinking فأنا هان + +295 +00:25:02,410 --> 00:25:07,450 +كأخصائي بصريات بأوصي المريض على المحافظة على ال + +296 +00:25:07,450 --> 00:25:13,150 +normal blinking أيضا + +297 +00:25:13,150 --> 00:25:19,360 +عندنا lens deposits change in fit تراكم الترسبات + +298 +00:25:19,360 --> 00:25:24,880 +على العدسة ممكن أنه يعمل تغيير في ال curvature تحدب + +299 +00:25:24,880 --> 00:25:30,800 +بالعدسة أو ممكن يغير من ال parameters للعدسة أو + +300 +00:25:30,800 --> 00:25:35,800 +ممكن يغير أيضا من ال base curve أو ال diameter أو + +301 +00:25:35,800 --> 00:25:40,640 +يعمل مثلا scratch في أطراف العدسة كل هذا هيأثر على + +302 +00:25:40,640 --> 00:25:44,880 +مين قد يسبب اللي هو red eye للمريض + +303 +00:25:48,300 --> 00:25:53,880 +Infection due to bacteria or virus في المحاضرة السابقة + +304 +00:25:53,880 --> 00:25:57,340 +أو اللي قبلها قلنا ال most common bacteria هي + +305 +00:25:57,340 --> 00:26:01,940 +عبارة عن ال Staphylococcus هذه قد تسبب ايه؟ اللي + +306 +00:26:01,940 --> 00:26:07,200 +هو corneal infection للمريض وبالتالي هتعمل له red + +307 +00:26:07,200 --> 00:26:12,880 +eye وايضا اللي هو احمرار يعني هسبب اللي هو red eye + +308 +00:26:12,880 --> 00:26:18,430 +بالإضافة قد تسبب dry eye عند المريض طب ايه هو أخطر؟ + +309 +00:26:18,430 --> 00:26:22,630 +البكتيريا ولا الفيروس؟ الفيروس، ليش؟ لأنه هو يعتبر + +310 +00:26:22,630 --> 00:26:27,050 +اللي هو small size، والأخطر منهم اثنين الفنجاي + +311 +00:26:30,130 --> 00:26:33,790 +Allergy to solutions بعض المحاليل اللي احنا + +312 +00:26:33,790 --> 00:26:39,830 +بنسميها hypotonic solutions هذه المحاليل بتعمل + +313 +00:26:39,830 --> 00:26:45,070 +لسع للعدسة سواء من الطرف أو من وين من اللي هو + +314 +00:26:45,070 --> 00:26:51,550 +ال center فاحنا بنسميها incompatible solutions + +315 +00:26:57,400 --> 00:27:01,580 +يعني محاليل غير ملائمة أو غير مناسبة للعدسة قد + +316 +00:27:01,580 --> 00:27:09,360 +تسبب اللسع للعدسة Infective + +317 +00:27:09,360 --> 00:27:13,240 +Blepharitis طبعا Blepharitis inflammation of the + +318 +00:27:13,240 --> 00:27:16,440 +eyelid and may cause redness and thickness of the + +319 +00:27:16,440 --> 00:27:21,340 +eyelid ممكن أن العدسة اللاصقة تعمل Blepharitis + +320 +00:27:23,690 --> 00:27:27,730 +lens thickness too thick or thin دائما قلنا + +321 +00:27:27,730 --> 00:27:33,090 +العدسات لما تكون too thin هتكون عرضة لحدوث ال dry + +322 +00:27:33,090 --> 00:27:37,790 +eye كل ما زاد ال thick ممكن أنه يسبب hypoxia أو + +323 +00:27:37,790 --> 00:27:42,930 +hypercapnia foreign + +324 +00:27:42,930 --> 00:27:48,780 +body decentrationأيضا قلنا أن العدسات اللاصقة لينا + +325 +00:27:48,780 --> 00:27:53,340 +من الصعب أن يدخل ال foreign body ايه بينها وبين ال + +326 +00:27:53,340 --> 00:27:58,460 +cornea لكن أن دخل هيكون ايش أكثر اللي هو فاعلية أو + +327 +00:27:58,460 --> 00:28:03,160 +أكثر اللي هو تأثير مقارنة في مين في ال hard أو ال + +328 +00:28:03,160 --> 00:28:04,760 +rigid contact lenses + +329 +00:28:08,360 --> 00:28:12,300 +dry eye اللي هو عبارة عن a multifactorial disorder + +330 +00:28:12,300 --> 00:28:17,740 +وممكن أنه يسبب discomfort ممكن أنه يسبب أيضا اللي + +331 +00:28:17,740 --> 00:28:23,540 +هو tear film instability و أيضا أنه ممكن يسبب اللي + +332 +00:28:23,540 --> 00:28:29,020 +هو تغير في الرؤية عند الشخص طيب إن شاء الله بنجح + +333 +00:28:29,020 --> 00:28:33,420 +في لا الامبير reading in soft contact lens wearer + +334 +00:28:33,420 --> 00:28:35,520 +في أي سؤال أي استفسار؟ diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/OUPPZyn-4Io_raw.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/OUPPZyn-4Io_raw.srt new file mode 100644 index 0000000000000000000000000000000000000000..8385cc4fec03549713d775fe5a882d8ec0d62dda --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/OUPPZyn-4Io_raw.srt @@ -0,0 +1,1336 @@ +1 +00:00:20,890 --> 00:00:24,130 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:24,130 --> 00:00:30,220 +وبركاته and a very good morning to all of youالان + +3 +00:00:30,220 --> 00:00:34,560 +احنا كاخصيين بصريات الهدف هو ليس ال treatment + +4 +00:00:34,560 --> 00:00:40,320 +العلاج اذا حدث corneal infection ولكن الهدف اللي + +5 +00:00:40,320 --> 00:00:44,500 +هو تقليل من ال corneal infection بمعنى اخر انه + +6 +00:00:44,500 --> 00:00:49,680 +لازم كل شخص بيشتغل فيه مركز بصريات يتوفر عنده ال + +7 +00:00:49,680 --> 00:00:53,430 +pin torchالهدف من ال pin torch هو عملية ال + +8 +00:00:53,430 --> 00:00:58,670 +evaluation أي بمعنى آخر عملية التقييم لأي أوبستة + +9 +00:00:58,670 --> 00:01:03,690 +قد يحدث وين في اللي هو الكورنيا، ببساطة بجيب اللي + +10 +00:01:03,690 --> 00:01:07,390 +هو ال pin torch و بعمل evaluation لكل اللي هو + +11 +00:01:07,390 --> 00:01:13,290 +السطح القرنية، أي أوبستة فطبعا انا بظن او بشك اللي + +12 +00:01:13,290 --> 00:01:16,570 +هو وجود ايه كورنيا ال infection maybe correct + +13 +00:01:16,570 --> 00:01:22,390 +maybe incorrectفأول خطوة بعمل removal للعدسة هذه + +14 +00:01:22,390 --> 00:01:27,950 +واحدة نقطة تانية بدي للمريض جنتاميسين كل ساعتين + +15 +00:01:27,950 --> 00:01:32,450 +اللي هو يستخدمه لحد ما انا ايش يعني لحد ما ان + +16 +00:01:32,450 --> 00:01:36,690 +المريض يروح لل ophthalmologist و بعد ذلك انه يتم + +17 +00:01:36,690 --> 00:01:42,830 +التعامل معاه من قبل اللي هو طبيب العيون طيب الان + +18 +00:01:42,830 --> 00:01:47,090 +كيف انا بدي اقلل من اللي هو حدوث ال corneal + +19 +00:01:47,090 --> 00:01:47,630 +infection + +20 +00:01:50,450 --> 00:01:55,530 +لنزفة التقنية يمكن استخدامها لتقديم رغبات الانفكاش + +21 +00:02:00,450 --> 00:02:06,310 +إذا أول حاجة بالنسبة للـ optimal fitting للعدسة + +22 +00:02:06,310 --> 00:02:10,950 +يما تكون بشكل صحيح أو بشكل جيد هذا كله بيقلل من + +23 +00:02:10,950 --> 00:02:14,770 +إيش؟ من خطورة حدوث ال infection يعني إذا كانت + +24 +00:02:14,770 --> 00:02:19,950 +العدسة flat أو steep هذا ممكن أنه يسبب للمريض إيش؟ + +25 +00:02:19,950 --> 00:02:25,190 +corneal infection فأول حاجة لازم أنه أضمن اللي هو + +26 +00:02:25,190 --> 00:02:27,430 +حدوث ال optimal fit lens + +27 +00:02:30,020 --> 00:02:35,100 +Number two, ensure adequate movement and post lens + +28 +00:02:35,100 --> 00:02:40,920 +tear flow أضمن أيضًا اللي هو حركة ملائمة أو مناسبة + +29 +00:02:40,920 --> 00:02:45,980 +للعدسة واتفقنا على إن الحركة الملائمة أو المناسبة + +30 +00:02:45,980 --> 00:02:51,960 +من نص إلى واحد مليمترأيضا عندنا ال post lens tear + +31 +00:02:51,960 --> 00:02:55,640 +film زي ما احنا عارفين ان في هناك limitation + +32 +00:02:55,640 --> 00:03:00,600 +للعدسة ال soft contact lenses موضوع ال post lens + +33 +00:03:00,600 --> 00:03:04,350 +او ال tear exchange اللي هو تبادل ال tearفالان + +34 +00:03:04,350 --> 00:03:08,250 +حركة العدسة هي اللي بيساعد في موضوع ايه؟ ال post + +35 +00:03:08,250 --> 00:03:12,310 +lens tear flow اللي هو تدفق التير، اذا مين اللي + +36 +00:03:12,310 --> 00:03:17,250 +بيساعد في عملية اللي هو تدفق التير؟ هو عبارة عن ال + +37 +00:03:17,250 --> 00:03:22,530 +lens movement، حركة العدسة، this + +38 +00:03:22,530 --> 00:03:28,030 +helps a clear bacteriaMaintain a normal rate of + +39 +00:03:28,030 --> 00:03:32,590 +epithelial desquamation الآن حدوث عملية اللي هو + +40 +00:03:32,590 --> 00:03:37,470 +تقشر الابيثيليام أو إعادة تجديد الميوسين هذه بتحدث + +41 +00:03:37,470 --> 00:03:43,430 +بشكل طبيعي مع مين؟ مع الأشخاص ال non contact lens + +42 +00:03:43,430 --> 00:03:48,790 +users إذن هذه بتحدث بشكل دوري زي ما احنا عارفين + +43 +00:03:48,790 --> 00:03:53,330 +انه بيصير عملية regeneration لل corneal epithelium + +44 +00:03:53,330 --> 00:03:59,360 +كل 24 ساعةالان هذه ال discommation انا كخصائي + +45 +00:03:59,360 --> 00:04:04,700 +بصريات بدي احافظ عليها اثناء ما المريض ايه بيرتدي + +46 +00:04:04,700 --> 00:04:10,200 +العدسة ال soft contact lenses ايضا بدي احافظ على + +47 +00:04:10,200 --> 00:04:14,640 +ال replenish اي بمعنى اللي هو تجديد لمين؟ للميو سي + +48 +00:04:14,640 --> 00:04:18,400 +layer طبعا مين المسئول عن افراز ال mucus layer + +49 +00:04:18,400 --> 00:04:24,520 +اللي هي ال goblet cellsand circulate tear film + +50 +00:04:24,520 --> 00:04:28,300 +antibacterial factors and nutritions for the + +51 +00:04:28,300 --> 00:04:32,680 +epithelium اتفقنا ان الشخص يما برتدي عدسة لاسقة + +52 +00:04:32,680 --> 00:04:37,260 +لينا فيه هناك دايما اللي هو نزاع مستمر ما بين + +53 +00:04:37,260 --> 00:04:43,300 +العدسة و ما بين البكتيريامابين ال antibacterial + +54 +00:04:43,300 --> 00:04:47,620 +factors و البكتيريا طبعا ال antibacterial factors + +55 +00:04:47,620 --> 00:04:51,280 +بتتمثل فى مين؟ فى البروتينات اللى موجودة فى ال + +56 +00:04:51,280 --> 00:04:56,200 +tears طبعا أي طرف بنتصر على الطرف الآخر يعنى بمعنى + +57 +00:04:56,200 --> 00:05:00,280 +إذا البكتيريا انتصرت هتعمل اختراق لمين؟ لأ اللى هو + +58 +00:05:00,280 --> 00:05:05,180 +الكورنيا وبالتالي هتسبب obesity ومن ثم الكورنيا ال + +59 +00:05:05,180 --> 00:05:10,450 +infection إذا ال antibacterial factors انتصرتيتوفر + +60 +00:05:10,450 --> 00:05:16,090 +اللي هي رؤية واضحة و هتحافظ على سلامة مين العدسة و + +61 +00:05:16,090 --> 00:05:17,710 +أيضا سلامة القرانية + +62 +00:05:21,250 --> 00:05:26,450 +تأكد من التعامل بالتعزيز الكورنيوية من خلال عصيرية + +63 +00:05:26,450 --> 00:05:32,130 +مع تدخل تقليد عام أو تدخل تقليد عام عالي أو تدخل + +64 +00:05:32,130 --> 00:05:33,270 +تقليد عام عالي أو تدخل تقليد عام عالي أو تدخل + +65 +00:05:33,270 --> 00:05:33,710 +تقليد عام عالي أو تدخل تقليد عام عالي أو تدخل + +66 +00:05:33,710 --> 00:05:36,530 +تقليد عام عالي أو تدخل تقليد عام عالي أو تدخل + +67 +00:05:36,530 --> 00:05:37,370 +تقليد عام عالي أو تدخل تقليد عام عالي أو تدخل + +68 +00:05:37,370 --> 00:05:38,930 +تقليد عام عالي أو تدخل تقليد عام عالي أو تدخل + +69 +00:05:38,930 --> 00:05:47,010 +تقليد عام عالي أو تدخل تقليد عام عالي أو + +70 +00:05:47,010 --> 00:05:51,890 +تدالان عندنا اللى هو موضوع الـ DK على T كل ما زاد + +71 +00:05:51,890 --> 00:05:56,810 +كل ما اللى هو ايه كان دخول ال oxygen اكتر لكن هنا + +72 +00:05:56,810 --> 00:06:01,310 +في مشكلة انه كل ما زاد دخول ال oxygen للقرانية ايش + +73 +00:06:01,310 --> 00:06:08,530 +ال problem اللى ممكن تحدث؟ الان كل ما زاد كمية ال + +74 +00:06:08,530 --> 00:06:10,630 +oxygen على القرانية + +75 +00:06:13,370 --> 00:06:16,990 +العادة سبتصير too thin بس بأثيرها على الكوارنية + +76 +00:06:18,840 --> 00:06:23,560 +أكتر اللي هو symptom هو موضوع ال dry eye إذا كل ما + +77 +00:06:23,560 --> 00:06:29,320 +زاد ال water content أو كل ما زاد ال DK على T أو + +78 +00:06:29,320 --> 00:06:33,760 +كل ما كانت العدسة too thin نفس المعنى هان بيكون + +79 +00:06:33,760 --> 00:06:39,820 +الشخص معرض لمين لل dry eye symptoms بمعنى آخر الآن + +80 +00:06:39,820 --> 00:06:44,360 +إيش العدسات اللي بتعمل اللي هو dry eye symptoms؟ + +81 +00:06:45,470 --> 00:06:48,450 +الـ high water content او ال moderate اللي هو DK + +82 +00:06:48,450 --> 00:06:53,750 +على T لكن ال low water content قد لكن من الصعب + +83 +00:06:53,750 --> 00:06:58,410 +مقارنة في مين؟ في ال moderate او اللي هي ال high + +84 +00:06:58,410 --> 00:07:02,710 +water content فالان اللي هو زيادة دخول ال oxygen + +85 +00:07:02,710 --> 00:07:07,390 +هذا هيضمن ايه؟ انه هيصير هناك تأثر لمين؟ لا + +86 +00:07:07,390 --> 00:07:11,810 +الابيثيليام و هيحدث هناك اللي هو عملية القيض + +87 +00:07:11,810 --> 00:07:18,610 +والبناء ال aerobic metabolismوهذا يزوّد قابلية + +88 +00:07:18,610 --> 00:07:24,830 +التساق اي بكتيريا في الكورنيا الابيثيلية وهذه + +89 +00:07:24,830 --> 00:07:30,050 +العملية تعتبر عمليةnormal يعني بمعنى انه انا الغرض + +90 +00:07:30,050 --> 00:07:33,550 +من اللي هو ال corneal epithelium في ارتداء العدسة + +91 +00:07:33,550 --> 00:07:36,770 +اللاصقة انه يصير هناك ال discrimination اللي هو + +92 +00:07:36,770 --> 00:07:40,710 +الاتصاق ما بين البكتيريا و ال corneal epithelium + +93 +00:07:40,710 --> 00:07:45,650 +حتى يتم التخلص من مين؟ من ال core حتى يتم التخلص + +94 +00:07:45,650 --> 00:07:51,720 +من البكتيريا خارج العينإذن ببساطة زيادة الـDK على + +95 +00:07:51,720 --> 00:07:56,760 +T هيعمل زيادة في دخول الأكسجين، بعد ذلك هيعمل اللي + +96 +00:07:56,760 --> 00:08:00,800 +هو التصاق ما بين البكتيريا و ما بين الكورنيا + +97 +00:08:00,800 --> 00:08:05,100 +الابيثيليام و هيعمل wash out لمن؟ للبكتيريا خارج + +98 +00:08:05,100 --> 00:08:10,440 +الكورنيا Minimize + +99 +00:08:10,440 --> 00:08:15,620 +exposure of the eye to microbial contamination by + +100 +00:08:15,620 --> 00:08:21,940 +patient education on hygieneعارفين عند ما يتم صرف + +101 +00:08:21,940 --> 00:08:27,380 +العدسة اللاصقة اللينة اول حاجة عند المريض لازم + +102 +00:08:27,380 --> 00:08:33,560 +يتوفر امر مهم اللي هو موضوع ايه ال motivation هذه + +103 +00:08:33,560 --> 00:08:38,720 +اول حاجة ال motivation الحافظ لازم يتوفر عن مين + +104 +00:08:38,720 --> 00:08:44,640 +عند المريض النقطة التانية انا بنظر بحال المريض اذا + +105 +00:08:44,640 --> 00:08:49,200 +كان هو good ولا poor hygieneإذا والله أنا شفت poor + +106 +00:08:49,200 --> 00:08:54,100 +hygiene من الأفضل ان ايه مايتمش صرف للعدسة + +107 +00:08:54,100 --> 00:08:59,200 +اللاصقة، إذا كان عنده good hygiene ممكن أنه أبدأ + +108 +00:08:59,200 --> 00:09:03,340 +بالتفكير اللي هو مع العوامل الأخرى في صرف العدسة + +109 +00:09:03,340 --> 00:09:09,490 +اللاصقةفهان عنا يعني نقطة مهمة انه في موضوع ال + +110 +00:09:09,490 --> 00:09:13,650 +bacterial contamination التلوث البكتيري انه انا + +111 +00:09:13,650 --> 00:09:17,550 +اعلم المريض لانه يعني في الغالب انه المرضى يما + +112 +00:09:17,550 --> 00:09:22,490 +بيجوا يرتديوا العدسات اللاصقة اللينة بيحتاجوا الى + +113 +00:09:22,490 --> 00:09:24,710 +ايه؟ ارشادات اللي هو ال instructions + +114 +00:09:30,780 --> 00:09:35,340 +و ال instructions هذه لازم انه تم من خلال ال + +115 +00:09:35,340 --> 00:09:38,860 +practitioner او من خلال ال supervisor او من خلال + +116 +00:09:38,860 --> 00:09:43,840 +ال optometrist او ال eye doctor طيب الان انا ايش + +117 +00:09:43,840 --> 00:09:48,620 +الارشادات هذه؟ بمنع المريض من استخدام ال homemade + +118 +00:09:48,620 --> 00:09:55,320 +saline اي تمحلول بتم صناعته محليا لازم ان المريض + +119 +00:09:55,320 --> 00:10:01,530 +ما يستخدمهأي تمحلول مافيش له contents، مكونات، من + +120 +00:10:01,530 --> 00:10:05,210 +حيث اللي هو جديش نسبة ال water، جديش نسبة مثلا في + +121 +00:10:05,210 --> 00:10:08,530 +ال disinfection، جديش مثلا اللي هو نسبة ال + +122 +00:10:08,530 --> 00:10:13,330 +cleaning، هذا أنا بطلب من المريض إنه ما يستخدمهأي + +123 +00:10:13,330 --> 00:10:18,650 +solution مافيش إله اسم اللي هو ال company أيضا انه + +124 +00:10:18,650 --> 00:10:19,490 +مابستخدمه + +125 +00:10:44,200 --> 00:10:48,140 +ايضا عندنا ال tab water بعض المرضى بعد ما يخلص من + +126 +00:10:48,140 --> 00:10:53,240 +عندهم المحلول بيكون اللي هو عنده عجز انه مثلا يروح + +127 +00:10:53,240 --> 00:10:58,440 +يشتري محلول جديد بنظف العدسوين في مية الحنفية خاصة + +128 +00:10:58,440 --> 00:11:02,100 +ال hard contact lenses فبالتالي هذا بيعمل ايه؟ + +129 +00:11:02,100 --> 00:11:06,520 +bacterial contamination طبعا ال soft اقل اللي هو + +130 +00:11:06,520 --> 00:11:12,410 +اثر لانه مابتتحمل ايش الميه بيصير اللي هي هشةand + +131 +00:11:12,410 --> 00:11:16,610 +attention to compliance with lens care systems + +132 +00:11:16,610 --> 00:11:22,010 +أيضًا المريض لازم أن يكون عنده انتباه لكل اللي هو + +133 +00:11:22,010 --> 00:11:26,730 +أنظمة الرعاية والعناية في العدسة زي ما أخدنا احنا + +134 +00:11:26,730 --> 00:11:31,110 +مثلًا في المعمل كيفية تنظيف العدسات اللاصقة اللينة + +135 +00:11:31,110 --> 00:11:34,770 +في أوقات أربع مختلفة لازم أنا أعلم المريض هذه + +136 +00:11:34,770 --> 00:11:39,160 +الأمور بمعنى أن العدسة لا تنظف مرة واحدةإذا كان في + +137 +00:11:39,160 --> 00:11:43,560 +هناك فرق ما بين الوقت لازم ان المريض يعمل عملية + +138 +00:11:43,560 --> 00:11:47,940 +cleaning للعدسة اللاصقة، ايضا لازم انه مايظنش + +139 +00:11:47,940 --> 00:11:51,280 +محافظ على المحلول وين في داخل اللي هو ال case + +140 +00:11:51,280 --> 00:11:56,780 +الحاوية، لازم اتخلص ايضا من المحلول اللي موجود في + +141 +00:11:56,780 --> 00:11:59,660 +الحاوية بشكل دوري + +142 +00:12:02,720 --> 00:12:06,340 +هذه كلهيتها لها علاقة في ال bacterial + +143 +00:12:06,340 --> 00:12:10,940 +contamination أو ال bacteria immunologic reaction + +144 +00:12:10,940 --> 00:12:16,140 +الآن الأخطر من ذلك موضوع ال acanthamibia other + +145 +00:12:16,140 --> 00:12:21,580 +risk factor for acanthamibia infection are the + +146 +00:12:21,580 --> 00:12:25,680 +contamination of lenses or solutions through + +147 +00:12:25,680 --> 00:12:31,320 +contactwith swimming pools, hot tubs and + +148 +00:12:31,320 --> 00:12:35,620 +freshwater ponds احنا قلنا ان العدسات اللاصقة + +149 +00:12:35,620 --> 00:12:41,720 +اللينة ممكن استخدامها في كل ال activities باستثناء + +150 +00:12:41,720 --> 00:12:45,760 +من ال swimming pool والسبب في ذلك انه قد تكون + +151 +00:12:45,760 --> 00:12:52,520 +معرضة ل ال acanthamibia corneal infectionأحواض + +152 +00:12:52,520 --> 00:12:57,980 +اللي هو الصباحة أو عندنا مثلا المياه الساخنة هذه + +153 +00:12:57,980 --> 00:13:02,920 +كلها بتعرض العدسة اللاصقة لحدوث ايه ال + +154 +00:13:02,920 --> 00:13:10,120 +acanthamibia infection ا + +155 +00:13:10,120 --> 00:13:15,440 +clean the lens case daily and replace it regularly + +156 +00:13:16,400 --> 00:13:22,400 +الان اول ما بتم صرف العدسة اللاصقة مثلا لرقد لازم + +157 +00:13:22,400 --> 00:13:27,820 +اتعرف على نوع ال occupation اللي هي بتقوم فيها اذا + +158 +00:13:27,820 --> 00:13:32,600 +كان مثلا officer او كان مثلا teacher او مدرس جامعة + +159 +00:13:32,600 --> 00:13:37,440 +الاخره هذا الشخص ممكن اديه حاوية واحدة هذا انا + +160 +00:13:37,440 --> 00:13:40,460 +بتكلم على ال conventional daily wear اللي بتم + +161 +00:13:40,460 --> 00:13:45,770 +ارتداها من ست شهور لسنةOkay لكن لو هذا الشخص مثلا + +162 +00:13:45,770 --> 00:13:51,290 +بيقوم بأعمال زي البناء او مثلا حداد بمعنى يعني قد + +163 +00:13:51,290 --> 00:13:56,710 +يكون عنده poor hygiene لازم اوفر له حاوتين اذا + +164 +00:13:56,710 --> 00:14:01,230 +خلال السي شهور او خلال السنة او التمن شهور لازم + +165 +00:14:01,230 --> 00:14:04,810 +انه يتم توفير اللي هو two cases لهذا الشخص + +166 +00:14:04,810 --> 00:14:10,550 +ويستبدلهم خلال الفترة المعينة لارتداء العدسة + +167 +00:14:10,550 --> 00:14:15,030 +اللاصقةو ايضا مربة تانية بن كارولر موضوع اللي هو + +168 +00:14:15,030 --> 00:14:20,030 +تنظيف الكاس كل يوم والتخلص من المحلول القديم مهم + +169 +00:14:20,030 --> 00:14:22,430 +جدا في المحافظة على العدسة + +170 +00:14:28,960 --> 00:14:32,960 +العدسات اللي متوفرة عندنا في المعمل ال daily + +171 +00:14:32,960 --> 00:14:37,860 +disposable lenses don't appear to alter the risk + +172 +00:14:37,860 --> 00:14:43,200 +of infection when allowance is made for factors + +173 +00:14:43,200 --> 00:14:47,020 +such as compliance with the cleaning and + +174 +00:14:47,020 --> 00:14:51,740 +disinfection systemsيعني هذا النوع من العدسات ما + +175 +00:14:51,740 --> 00:14:57,380 +بحتاج لا تنظيف ولا رعاية ولا عناية ولا تخزين طيب + +176 +00:14:57,380 --> 00:15:02,740 +من وين ممكن تيجي ال bacterial contamination او من + +177 +00:15:02,740 --> 00:15:06,000 +وين ممكن تيجي ال acanthamibia infection في هذا + +178 +00:15:06,000 --> 00:15:12,560 +النوع؟ do you have answer؟ + +179 +00:15:13,730 --> 00:15:17,630 +لأ، ما احنا قولنا المريض اتعلم انه مافيش فيه أية a + +180 +00:15:17,630 --> 00:15:20,730 +cleaning system، no cleaning system or no care + +181 +00:15:20,730 --> 00:15:24,450 +system نعم + +182 +00:15:28,710 --> 00:15:33,650 +Okay او ال bad habits لهو المريض او مثلا انا اصرف + +183 +00:15:33,650 --> 00:15:37,930 +عجزة يومية لهذا الشخص واروح يستخدمها مثلا في ال + +184 +00:15:37,930 --> 00:15:41,590 +freshwater pools او يروح يستخدمها في ال swimming + +185 +00:15:41,590 --> 00:15:45,970 +pool كل هذه ممكن انه تأدي لمين اذا كان ثميبيا + +186 +00:15:45,970 --> 00:15:46,630 +infection + +187 +00:15:50,870 --> 00:15:58,530 +التواصل الناري عادى لتقليل تأثير الاتفاق اللاجئ + +188 +00:16:00,570 --> 00:16:05,950 +يعني الاستبدال بشكل منظم للعدسة وهنا نتكلم عن الـ + +189 +00:16:05,950 --> 00:16:10,750 +conventional daily wear هذا مهم في تقليل نسبة مين؟ + +190 +00:16:10,750 --> 00:16:14,890 +نسبة حدوث ال inflammatory reaction طبعا هناك + +191 +00:16:14,890 --> 00:16:18,430 +اختلاف احصائي ما بين ال incidence و ال prevalence + +192 +00:16:18,430 --> 00:16:23,150 +ال incidence هي كل الحالات ال new يعني الآن انا + +193 +00:16:23,150 --> 00:16:27,290 +بدي اشوف نسبة اللي هو الناس اللي بيرتديوا العدسة + +194 +00:16:27,290 --> 00:16:32,940 +اللاصقة في قطاع غزةOkay هذا بنسميه incidence يعني + +195 +00:16:32,940 --> 00:16:37,180 +number او appropriation لكل ال new patients اللي + +196 +00:16:37,180 --> 00:16:41,580 +انا باخدهم لكن ال prevalence بيشمل ال old و ال new + +197 +00:16:41,580 --> 00:16:47,040 +patient فاهمين عليكي كيف؟ يعني الآن مثلا في أشخاص + +198 +00:16:47,040 --> 00:16:53,040 +بيرتديوا عدسات لاصقة من ال 2010وانا عملت دراستي في + +199 +00:16:53,040 --> 00:16:58,720 +ال 2000 و 18 صحيح؟ لو انا بدي اخد الأشخاص اللي من + +200 +00:16:58,720 --> 00:17:07,580 +ال 2010 و ال 18 هذه بنسميها prevalence ليش؟ + +201 +00:17:07,580 --> 00:17:14,140 +لأن هنا عندنا old و هنا عندنا ايه؟ ال newطيب لو + +202 +00:17:14,140 --> 00:17:20,080 +الدراسة تم إجراءها في 2018 وخدت فقط العينة للأشخاص + +203 +00:17:20,080 --> 00:17:24,120 +اللي بيرتديوا العدسات اللاصقة في 2018، إذا كلهم + +204 +00:17:24,120 --> 00:17:28,580 +الـ new patients، إذا هذه بنسميها incidence أو + +205 +00:17:28,580 --> 00:17:33,600 +preparation أو frequency أو percentage، كل هذه نفس + +206 +00:17:33,600 --> 00:17:40,940 +المسمةنرجع لموضوعنا الاستبدال المنظم للعدسة + +207 +00:17:40,940 --> 00:17:46,580 +اللاصقة او الكاس الحاوية او المحلول هذا كله بيقلل + +208 +00:17:46,580 --> 00:17:50,760 +من حدوث ايه ال inflammation او من نسبة اللي هو + +209 +00:17:50,760 --> 00:17:52,700 +حدوث ال corneal infection + +210 +00:17:57,590 --> 00:18:02,290 +اقوموا بـ Minimize Extended Wear، لأن التأثيرات + +211 +00:18:02,290 --> 00:18:08,750 +والإنفلامات ليست معروفة في الـ daily wearالان لو + +212 +00:18:08,750 --> 00:18:13,290 +احنا قررنا ما بين عدسات الـ extended wear و ال + +213 +00:18:13,290 --> 00:18:17,870 +daily wear هان ال daily disposable lenses اول حاجة + +214 +00:18:17,870 --> 00:18:22,570 +مين اكتر عرضة؟ يعني مين بيعمل اللي هو corneal + +215 +00:18:22,570 --> 00:18:26,810 +infection اكتر؟ ال daily disposable lenses ولا ال + +216 +00:18:26,810 --> 00:18:31,450 +extended wear؟ ال extended wear ببساطة لانه بتعيش + +217 +00:18:31,450 --> 00:18:37,230 +فترة زمانية اطول و ايضا بتم ارتداهابشكل أطول، لكن + +218 +00:18:37,230 --> 00:18:40,350 +الان لو قررنا ما بين ال extended wear و ال + +219 +00:18:40,350 --> 00:18:44,550 +conventional daily wear، اذا اكيد ال conventional + +220 +00:18:44,550 --> 00:18:48,930 +daily wear هي هسبب ايش؟ corneal infection اكتر، + +221 +00:18:48,930 --> 00:18:52,910 +فعنا هان minimize extended wear، اذا دايما ال + +222 +00:18:52,910 --> 00:18:57,290 +corneal infection حدوثه هيكون اقل في العدسات من ال + +223 +00:18:57,290 --> 00:18:58,070 +extended wear + +224 +00:19:05,080 --> 00:19:10,320 +بس هنضيفه daily disposable lenses في العدسات اللي + +225 +00:19:10,320 --> 00:19:14,080 +هو ايه ال daily disposable lenses لان لو اتكلمنا + +226 +00:19:14,080 --> 00:19:17,280 +عن ال daily wear هيكون most common + +227 +00:19:25,760 --> 00:19:29,780 +واضح الفكرة يعني كل ما امتد فترة حياة العدسة اكتر + +228 +00:19:29,780 --> 00:19:33,960 +كل ما كانت معرضة لل bacterial infection او ال + +229 +00:19:33,960 --> 00:19:39,940 +bacterial contamination اكتر طيب الان نفترض انه + +230 +00:19:39,940 --> 00:19:44,620 +انا صرفت العدسة اللاصقة للمريض بعد ما عملت عملية + +231 +00:19:44,620 --> 00:19:48,980 +evaluation لل power و ال diameter و ال base care + +232 +00:19:48,980 --> 00:19:53,600 +وعملت ال push up test وشوفنا ان العدسة هذه ملائمة + +233 +00:19:53,600 --> 00:19:58,520 +للمريضأجى المريض بعد يوم او يومين قال لي انا بشوف + +234 +00:19:58,520 --> 00:20:02,980 +his vision او reduce vision او blurred vision عدم + +235 +00:20:02,980 --> 00:20:08,180 +وضوح بالعدسة اللاسقة اللى تم اعطاها للمريض انا + +236 +00:20:08,180 --> 00:20:10,900 +كاخصائى بصريات اش بتوقع؟ + +237 +00:20:17,070 --> 00:20:21,630 +ممكن اللي هو عمل عملية اللي هو incorrect يعني من + +238 +00:20:21,630 --> 00:20:26,530 +ناحية ال right left و ال left right أو ممكن عمل + +239 +00:20:26,530 --> 00:20:30,910 +عملية inverted قلب للعدسة عشان هيك قلنا أول ما + +240 +00:20:30,910 --> 00:20:35,350 +بنطلع العدسة من الكيس الخطوة الأولى بعد ما بعمل + +241 +00:20:35,350 --> 00:20:38,950 +عملية cleaning بعمل ال tackle test للتأكيد انه هل + +242 +00:20:38,950 --> 00:20:45,660 +العدسة inverted ولا realإذا عندنا ال causes + +243 +00:20:45,660 --> 00:20:51,740 +الأسباب Tight أو Lose Lens إذا العدسة لو كانت Flat + +244 +00:20:51,740 --> 00:20:56,900 +أو كانت Steep ممكن هذا بيؤدي لمين؟ لهو ال Hayes + +245 +00:20:56,900 --> 00:21:00,200 +region، ببساطة كيف الاستيبي بتعمل الهو Hayes + +246 +00:21:00,200 --> 00:21:04,300 +region؟ لأنه no sensation at all و بتكون عاملة + +247 +00:21:04,300 --> 00:21:08,800 +حاجة بنسميها انه بتكون suction، suction بمعنى + +248 +00:21:08,800 --> 00:21:14,760 +مصممةيعني بتكون اللي هو لازجا وين او امثبت على او + +249 +00:21:14,760 --> 00:21:19,400 +ضاغط على القرانية فبالتالي قد تسبب اللي هو ايه ال + +250 +00:21:19,400 --> 00:21:23,940 +blurred vision او haze vision ايضا عندنا ال loose + +251 +00:21:23,940 --> 00:21:29,200 +lens يعني بتكون العدسة flat بالضبط انه هيكون ال + +252 +00:21:29,200 --> 00:21:33,400 +diameter بتاعة اول حاجة اشماله صغير وبالتالي انه + +253 +00:21:33,400 --> 00:21:37,340 +هتكون excessive movement حركة اللي هو كبيرة + +254 +00:21:37,620 --> 00:21:41,940 +فبالتالي قد تسبب Blurred Vision أو Haze Vision + +255 +00:21:41,940 --> 00:21:48,100 +Inverted Lens العدسة مقلوبة وبتم التعرف عليها من + +256 +00:21:48,100 --> 00:21:54,280 +قبل التاكو تستcheck the power because right eye + +257 +00:21:54,280 --> 00:21:57,940 +may be instead of left eye طبعا هذه الخربة طوال + +258 +00:21:57,940 --> 00:22:03,040 +الوقت تصبح عند شخص بيكون عنده الهو variation في ال + +259 +00:22:03,040 --> 00:22:06,040 +refractive error يعني نفترض مثلا ال right كانت + +260 +00:22:06,040 --> 00:22:10,360 +minus 3 و ال left كانت عنده minus 8 فبتكون واضحة + +261 +00:22:10,360 --> 00:22:14,080 +عنده ان هو عمل عملية طلب للعدسة + +262 +00:22:17,700 --> 00:22:23,180 +أيضًا deposits on the lens and it is clarity الآن + +263 +00:22:23,180 --> 00:22:28,420 +تراكم الترثبات على سطح العدسة في بعض الدراسات + +264 +00:22:28,420 --> 00:22:33,980 +بتأكد أنه بزيد من حركة العدسة وبالتالي أنه بتقرب + +265 +00:22:33,980 --> 00:22:38,240 +العدسة أنه تكون flat فبسبب اللي هو ال blurred أو + +266 +00:22:38,240 --> 00:22:42,810 +ال variable visionأيضا كل ما زادت الترثبات على + +267 +00:22:42,810 --> 00:22:47,090 +العدسة اللى transparent الوضوح بتاعتها اشمالها + +268 +00:22:47,090 --> 00:22:55,330 +بتقل وبالتالي بيصير الرؤية غير واضحة a + +269 +00:22:55,330 --> 00:22:59,490 +drying of the lens because of air conditions or + +270 +00:22:59,490 --> 00:23:04,610 +atmosphereاحنا بنعرف انه ال air condition او يما + +271 +00:23:04,610 --> 00:23:09,430 +يكون في عندنا اللي هو ال tropical region هذا بيؤدى + +272 +00:23:09,430 --> 00:23:14,430 +الى زيادة حدوث مين؟ جفاف العين فما بالك انسان جاعد + +273 +00:23:14,430 --> 00:23:20,050 +فى غرفة مكيفة ولابس عدسة لاسقة فهذا هيصير اللي هو + +274 +00:23:20,050 --> 00:23:26,950 +ايه مضاعف حدوث جفاف العينإذا مرة أخرى من ال main + +275 +00:23:26,950 --> 00:23:31,130 +causes لل dry eye عندنا ال air condition أو ال + +276 +00:23:31,130 --> 00:23:36,430 +tropical region طيب نفترض مثلا عندنا بلد فيها اللي + +277 +00:23:36,430 --> 00:23:39,370 +هو ال tropical region يعني ال tropical region اللي + +278 +00:23:39,370 --> 00:23:45,070 +هو استوائي و بالبساطة ثلاثقة فهيكون هذا الشخص عنده + +279 +00:23:45,070 --> 00:23:48,930 +حدوث ل dry eye مضاعف مقارنة في دول ايه؟ اخرى + +280 +00:23:53,460 --> 00:23:57,300 +طيب، عندنا الـ Red Eye إحمرار العين الـ in contact + +281 +00:23:57,300 --> 00:24:02,200 +lens wearer للأشخاص اللي برتد يومين العدسات + +282 +00:24:02,200 --> 00:24:06,700 +اللاصقة، وهذا بقصد اللي هو اللينة الـ causes + +283 +00:24:06,700 --> 00:24:12,260 +الأسباب، number one incomplete blinking إن المريض + +284 +00:24:12,260 --> 00:24:16,900 +ما بيقوم بترميش كامل أو بترميش اللي هو بنسمي + +285 +00:24:16,900 --> 00:24:22,850 +educate ملائم أو sufficient، okay؟طبعا عندنا ال + +286 +00:24:22,850 --> 00:24:28,090 +normal blinking من خمسائش لعشرين مرة في الدقيقة، + +287 +00:24:28,090 --> 00:24:32,850 +من خمسائش لعشرين مرة في الدقيقة، هذا يعتبر ال + +288 +00:24:32,850 --> 00:24:35,390 +normal blinking للأشخاص + +289 +00:24:37,200 --> 00:24:41,080 +و لازم ان هذا الشخص يحافظ على ال normal blinking + +290 +00:24:41,080 --> 00:24:45,920 +اثناء ارتداء من العدسة اللاصقة يمكن فيكم اللي بلبس + +291 +00:24:45,920 --> 00:24:49,840 +عدسة لاصقة دايما عندما ترتدي العدسة اللاصقة سواء + +292 +00:24:49,840 --> 00:24:53,660 +ال hard او ال soft contact lenses بتحاول انك تقلل + +293 +00:24:53,660 --> 00:24:57,860 +ال blinking لانه بيكون فيها ثقل ع القرنية فدايما + +294 +00:24:57,860 --> 00:25:02,410 +الشخص بتلاقي عنده reduce لمن لال blinkingفانا هان + +295 +00:25:02,410 --> 00:25:07,450 +كاخصائي بصريات بوصي المريض على المحافظة على ال + +296 +00:25:07,450 --> 00:25:13,150 +normal blinking ايضا + +297 +00:25:13,150 --> 00:25:19,360 +عندنا lens deposits change in fitتراكم الترثبات + +298 +00:25:19,360 --> 00:25:24,880 +على العدسة ممكن انه يعمل تغيير في ال curvature تحد + +299 +00:25:24,880 --> 00:25:30,800 +بالعدسة او ممكن يغير من ال parameters للعدسة او + +300 +00:25:30,800 --> 00:25:35,800 +ممكن يغير ايضا من ال base curve او ال diameter او + +301 +00:25:35,800 --> 00:25:40,640 +يعمل مثلا scratch في اطراف العدسة كل هذا هيأثر على + +302 +00:25:40,640 --> 00:25:44,880 +مين قد يسبب اللي هو red eye للمريض + +303 +00:25:48,300 --> 00:25:53,880 +Infection to bacteria or virus في المحاضرة السابقة + +304 +00:25:53,880 --> 00:25:57,340 +أو اللي قبلها قلنا ال most common bacteria هي + +305 +00:25:57,340 --> 00:26:01,940 +عبارة عن ال Staphylococcus هذه قد تسبب ايه؟ اللي + +306 +00:26:01,940 --> 00:26:07,200 +هو corneal infection للمريض وبالتالي هتعمل له red + +307 +00:26:07,200 --> 00:26:12,880 +eye وايضا اللي هو احمرار يعني هسبب اللي هو red eye + +308 +00:26:12,880 --> 00:26:18,430 +بالاضافة قد تسبب dry eye عند المريضطب أيه هو أخطر؟ + +309 +00:26:18,430 --> 00:26:22,630 +البكتيريا ولا الفيروس؟ الفيروس، ليش؟ لأنه هو يعتبر + +310 +00:26:22,630 --> 00:26:27,050 +اللي هو small size، و الأخطر منهم اتنين الفنجاي + +311 +00:26:30,130 --> 00:26:33,790 +Allergy to solutions بعض المحاليل اللي احنا + +312 +00:26:33,790 --> 00:26:39,830 +بنسميها hypotonic solutions هذه المحاليل بتعمل + +313 +00:26:39,830 --> 00:26:45,070 +لسعلاء العدسة سواء من الطرف او من وين من اللي هو + +314 +00:26:45,070 --> 00:26:51,550 +ال center فاحنا بنسميها incompatible solutions + +315 +00:26:57,400 --> 00:27:01,580 +يعني محاليل غير ملائمة أو غير مناسبة للعدسة قد + +316 +00:27:01,580 --> 00:27:09,360 +تسبب اللاسع للعدسة Infective + +317 +00:27:09,360 --> 00:27:13,240 +Epilephritis طبعا Epilephritis inflammation of the + +318 +00:27:13,240 --> 00:27:16,440 +eyelid and may cause redness and thickness of the + +319 +00:27:16,440 --> 00:27:21,340 +eyelid ممكن ان العدسة اللاصقة تعمل Epilephritis + +320 +00:27:23,690 --> 00:27:27,730 +lens thickness too thick or thin دايما قلنا + +321 +00:27:27,730 --> 00:27:33,090 +العدسات يما تكون too thin هتكون عرضة لحدوث ال dry + +322 +00:27:33,090 --> 00:27:37,790 +eye كل ما زاد ال thick ممكن أنه يسبب hypoxia او + +323 +00:27:37,790 --> 00:27:42,930 +hypercapnia foreign + +324 +00:27:42,930 --> 00:27:48,780 +body decentrationأيضا قلنا ان العدسات اللاصقة لينا + +325 +00:27:48,780 --> 00:27:53,340 +من الصعب ان يدخل ال foreign body ايه بينها وبين ال + +326 +00:27:53,340 --> 00:27:58,460 +cornea لكن ان دخل هيكون ايش اكتر اللي هو فاعلية او + +327 +00:27:58,460 --> 00:28:03,160 +اكتر اللي هو تأثير مقارنة في مين في ال hard او ال + +328 +00:28:03,160 --> 00:28:04,760 +rigid contact lenses + +329 +00:28:08,360 --> 00:28:12,300 +dry eye اللي هو عبارة عن a multifactorial disorder + +330 +00:28:12,300 --> 00:28:17,740 +وممكن انه يسبب discomfort ممكن انه يسبب ايضا اللي + +331 +00:28:17,740 --> 00:28:23,540 +هو tear film instability و ايضا انه ممكن يسبب اللي + +332 +00:28:23,540 --> 00:28:29,020 +هو تغير في الرؤية عند الشخص طيب ان شاء الله بنجح + +333 +00:28:29,020 --> 00:28:33,420 +في لا الامبير reading in soft contact lens wearer + +334 +00:28:33,420 --> 00:28:35,520 +في اي سؤال اي استفسار؟ + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/QZITliCZen8.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/QZITliCZen8.srt new file mode 100644 index 0000000000000000000000000000000000000000..ebc287938a3e9b44e9b6fae8e26309747fb9dbbb --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/QZITliCZen8.srt @@ -0,0 +1,1275 @@ +1 +00:00:20,920 --> 00:00:23,820 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:23,820 --> 00:00:28,960 +وبركاته ومرحبا بكم جميعا إن شاء الله في المحاضرة + +3 +00:00:28,960 --> 00:00:33,780 +هذه هنكمل في موضوع ال design لـ ال software contact + +4 +00:00:33,780 --> 00:00:39,160 +lenses في عندنا موضوع ال ISO thickness profile ال + +5 +00:00:39,160 --> 00:00:42,020 +profile بمعنى shape or pattern تمام؟ + +6 +00:00:50,010 --> 00:00:58,370 +هو عبارة عن تصميم للعين، يتميز هذا التصميم بأن هو + +7 +00:00:58,370 --> 00:01:05,790 +biomedics أي بمعنى الطب الحيوي، هو بيكون موافق في + +8 +00:01:05,790 --> 00:01:11,630 +اللي هو تصميمه للطب الحيوي اللي خاص في مين؟ في اللي + +9 +00:01:11,630 --> 00:01:16,250 +هو العدسات ال contact lenses يا جماعة، أي تشغلة في + +10 +00:01:16,250 --> 00:01:19,930 +موضوع ال treatment أو في موضوع ال management أو في + +11 +00:01:19,930 --> 00:01:23,990 +موضوع ال manufacturer لابد أن في هناك حاجة بنسميها + +12 +00:01:23,990 --> 00:01:25,250 +إيه؟ guidelines + +13 +00:01:30,090 --> 00:01:33,710 +الـ guidelines أنا من خلالها أنا إيش؟ بعمل اللي هو + +14 +00:01:33,710 --> 00:01:39,350 +تصميم العدسة الملائم، أو يعني ما ألاقي أي مصمم أنه + +15 +00:01:39,350 --> 00:01:45,050 +يعمل تصميم غير ملائم أو غير مناسب، فلازم أن هو يكون + +16 +00:01:45,050 --> 00:01:51,030 +هذا التصميم موافق لمين؟ للطب الحيوي أو موافق لـ اللي + +17 +00:01:51,030 --> 00:01:56,460 +هو قابلية الإنسان لتقبل هذا التصميم، Copper Vision + +18 +00:01:56,460 --> 00:02:00,300 +هي نوع الـ Manufacturer أو نوع ال company اللي + +19 +00:02:00,300 --> 00:02:05,080 +عملت تصنيع لهذه العدسة، زي مثلا ال Bausch & Lomb أو + +20 +00:02:05,080 --> 00:02:10,080 +مثلا مثال آخر اللي هي ال Copper Vision أو في عندنا + +21 +00:02:10,080 --> 00:02:14,600 +2020 visual acuity، هذه كلها أسماء شركات + +22 +00:02:18,020 --> 00:02:22,200 +Turk lens across sections were studied with a + +23 +00:02:22,200 --> 00:02:26,760 +profilometer، طبعا في أنواع من الدراسات بتعرفوا + +24 +00:02:26,760 --> 00:02:29,600 +اسمها across sectional study، صحيح؟ + +25 +00:02:35,870 --> 00:02:40,690 +طبعا ال cross-sectional study بيقوم الباحث أو ال + +26 +00:02:40,690 --> 00:02:46,530 +manufacturer المصنع بالـ هو أخذ عينة من الأشخاص و + +27 +00:02:46,530 --> 00:02:50,450 +بيستخدم معهم هذا النوع من العدسات، بيشوف أنه هل في + +28 +00:02:50,450 --> 00:02:55,170 +benefit لهذه العدسة، هل مثلا في هناك indication، + +29 +00:02:55,170 --> 00:02:59,230 +contraindication، هل في advantages، disadvantages، + +30 +00:02:59,230 --> 00:03:03,090 +هل في drawbacks، عيوب لهذه التصميم، كل هذه من خلال + +31 +00:03:03,090 --> 00:03:06,680 +مين؟ هذا النوع من الدراسات، طيب شو معنى ال + +32 +00:03:06,680 --> 00:03:12,140 +profilometer؟ أنتم ملاحظين الآن كله بنتكلم شغل + +33 +00:03:12,140 --> 00:03:16,780 +إيش المصنع أو شغل ال manufacturer، ال profilometer + +34 +00:03:16,780 --> 00:03:23,260 +هو عبارة عن جهاز من خلاله ال manufacturer بيحدد + +35 +00:03:23,260 --> 00:03:28,060 +قد إيش ال roughness للسطح، يعني قد إيش خشونة إيش السطح + +36 +00:03:28,060 --> 00:03:34,340 +إذا it is an instrument + +37 +00:03:38,550 --> 00:03:55,050 +to measure the value or quantity of + +38 +00:03:55,050 --> 00:03:59,270 +the roughness + +39 +00:04:02,490 --> 00:04:05,690 +يعني بمعنى آخر أنه بيقول لك ها هي قيمة ال roughness + +40 +00:04:05,690 --> 00:04:10,990 +يعني خشونة السطح لـ العدسة 1% مثلا، نص في + +41 +00:04:10,990 --> 00:04:15,250 +الـ 1% أو 0.25% إذا بيعبر لي أنه + +42 +00:04:15,250 --> 00:04:19,410 +قد إيش قيمة إيه ال roughness، كـ ال value أو كـ + +43 +00:04:19,410 --> 00:04:23,150 +quantitative إذا + +44 +00:04:23,150 --> 00:04:28,970 +هذه بنسميها profilometer، The conclusions الخاتمة + +45 +00:04:28,970 --> 00:04:34,250 +were that thinner designs had better comfort. + +46 +00:04:35,710 --> 00:04:39,710 +Thicker designs offered better orientation، يعني + +47 +00:04:39,710 --> 00:04:44,870 +الخاتمة أو الاستنتاج من التصاميم المختلفة لهذا + +48 +00:04:44,870 --> 00:04:49,590 +النوع من العدسات السفتوريك، أنه أنا كل ما قللت + +49 +00:04:49,590 --> 00:04:55,620 +السماكة بكون مريحة لمن؟ للمريض، ال thick اللي هي + +50 +00:04:55,620 --> 00:05:01,160 +السماكة المقصود هنا فيها ال palest تمام؟ أو + +51 +00:05:01,160 --> 00:05:07,560 +المقصود فيها اللي هو ال thick zone، ال thick zone + +52 +00:05:07,560 --> 00:05:11,900 +بيحدد لأكثر ال orientation، يعني هو قادر على تحديد + +53 +00:05:11,900 --> 00:05:16,990 +ال direction لمين؟ لل axis بشكل أكبر، لذلك أنت بتلاحظ + +54 +00:05:16,990 --> 00:05:20,910 +أنه دائما منطقة الثقل وين موجودة؟ موافقة لـ + +55 +00:05:20,910 --> 00:05:24,770 +ال access تمام؟ إذا الآن لو أنا سألتك إيش ال + +56 +00:05:24,770 --> 00:05:29,330 +conclusion لـ ال different design؟ ببساطة أن ال thin + +57 +00:05:29,330 --> 00:05:32,930 +zone بتديني better comfort أو good comfort، ال + +58 +00:05:32,930 --> 00:05:36,610 +thick zone بتديني better أو good orientation أو + +59 +00:05:36,610 --> 00:05:37,650 +good direction + +60 +00:05:40,450 --> 00:05:44,990 +There were notable junctions on all current tricks + +61 +00:05:44,990 --> 00:05:49,630 +يعني هذه متوافقة مع معظم اللي هو التصاميم الحالية، + +62 +00:05:49,630 --> 00:05:55,110 +current بمعنى present الحالية، and stability may be + +63 +00:05:55,110 --> 00:05:59,910 +related to palest distribution effects، قيمة ال + +64 +00:05:59,910 --> 00:06:05,570 +stability للعدسة بتحدد من خلال إيه؟ تأثيرات توزيع + +65 +00:06:05,570 --> 00:06:11,880 +اللي هو الثقل، يعني هل مثلا، هل مثلا على التلاتة + +66 +00:06:11,880 --> 00:06:17,200 +والتسعة؟ هل توزيعه على كل المناطق بشكل متساوي؟ هل + +67 +00:06:17,200 --> 00:06:21,080 +في area معينة أو في zone معين؟ فهذا بيحدد ليه اللي + +68 +00:06:21,080 --> 00:06:25,160 +هو قيمة ال stability، واحنا قلنا أن تصميم ال + +69 +00:06:25,160 --> 00:06:28,740 +software contact lenses ببساطة صار لها عملية + +70 +00:06:28,740 --> 00:06:35,130 +update لحد ما وصلنا لـ ال beta design، أنه كل ما أنا + +71 +00:06:35,130 --> 00:06:39,270 +قللت اللي هو السماكة بتديني better comfort أو good + +72 +00:06:39,270 --> 00:06:43,190 +comfort وكل ما أنا زودت السماكة بتديني good + +73 +00:06:43,190 --> 00:06:49,850 +orientation أو good direction، an + +74 +00:06:49,850 --> 00:06:55,730 +uneven anterior surface، أي بمعنى سطح غير مستوي أو + +75 +00:06:55,730 --> 00:07:02,570 +سطح uneven غير متماثل، irregular يعني متعرج، إذا an + +76 +00:07:02,570 --> 00:07:07,270 +uneven and tailored surface with notable junctions + +77 +00:07:07,270 --> 00:07:12,610 +offers areas for the superior eyelid to catch as + +78 +00:07:12,610 --> 00:07:18,850 +it moves over the lens، في هناك تصميم بالشكل هذا + +79 +00:07:18,850 --> 00:07:25,240 +أنه عمل على دفع العدسة للأمام بحيث أن ال upper + +80 +00:07:25,240 --> 00:07:30,640 +eyelid يعمل catch للعدسة، وبعد ذلك يعمل عملية دفع + +81 +00:07:30,640 --> 00:07:38,540 +للعدسة مرة أخرى، الآن في أحد التصاميم عمل منطقة + +82 +00:07:38,540 --> 00:07:43,240 +الثقل أو palest zone area في المنطقة العلوية + +83 +00:07:43,240 --> 00:07:49,390 +للعدسة، فهذا إيش هيعمل؟ على catch اللي هو تماثل ما + +84 +00:07:49,390 --> 00:07:53,490 +بين ال upper eyelid وال upper part للعدسة، فال + +85 +00:07:53,490 --> 00:07:57,870 +upper eyelid هيمسك العدسة ويدفعها وين؟ يرجعها اللي + +86 +00:07:57,870 --> 00:08:02,370 +هو مكانها، يعني عشان أنه يزود ال stability، إذا the + +87 +00:08:02,370 --> 00:08:06,530 +eyelid catches on the uneven junctions، لكن إيش + +88 +00:08:06,530 --> 00:08:11,510 +المشكلة فيه؟ أن هذا السطح ده العدسة متعرج أو غير + +89 +00:08:11,510 --> 00:08:15,030 +منتظم أو غير متماثل أو غير مستوي + +90 +00:08:21,640 --> 00:08:26,300 +تفاقنا؟ أي بمعنى منطقة ثقل أو gravity zones and + +91 +00:08:26,300 --> 00:08:30,580 +contributes to instability، ليش طيب؟ تصير عملية عدم + +92 +00:08:30,580 --> 00:08:34,240 +اللي هو ثابت للعدسة، يعني contribute يعني بمعنى إيش؟ + +93 +00:08:34,240 --> 00:08:39,320 +بيساهم، إذا بيساهم بعدم ثابت للعدسة، البساطة يا + +94 +00:08:39,320 --> 00:08:45,040 +جماعة أن منطقة ال upper area هي اللي حصى بثقل، فال + +95 +00:08:45,040 --> 00:08:49,300 +upper eyelid هيعمل catch للعدسة ويتفحها، فهيقلل من + +96 +00:08:49,300 --> 00:08:53,880 +كمية ال stability للعدسة، لكن هذه أحد ال design + +97 +00:08:53,880 --> 00:08:59,680 +لمين؟ للـ soft red contact lenses، + +98 +00:08:59,680 --> 00:09:02,340 +إذن كلمة contribute بمعنى يساهم + +99 +00:09:08,960 --> 00:09:14,320 +إذن an uneven anterior surface with notable + +100 +00:09:14,320 --> 00:09:18,920 +junctions offers areas for the superior eyelid to + +101 +00:09:18,920 --> 00:09:24,400 +catch as it moves over the lens، بيوفوها شغلة مهمة + +102 +00:09:24,400 --> 00:09:28,660 +أن هو عمل على زيادة ال diameter، هو زود ال diameter + +103 +00:09:28,660 --> 00:09:35,780 +لمين؟ للعدسة، عشان يقدر ال upper eyelid يغطي جزء + +104 +00:09:35,780 --> 00:09:40,910 +كبير من اللي هو العدسة، أو حتى من ناحية نظرية دائما + +105 +00:09:40,910 --> 00:09:45,330 +ولكن عمليا هذه لا تصيب، من ناحية ال theory دائما + +106 +00:09:45,330 --> 00:09:48,550 +يقول في العدسات ال software ال contact lenses + +107 +00:09:48,550 --> 00:09:52,370 +يختار diameter over the horizontal visible iris، + +108 +00:09:52,370 --> 00:09:58,100 +diameter من 3 لـ 4 ملليمتر، لكن هذا عمليا صعب + +109 +00:09:58,100 --> 00:10:01,500 +يعني خاصة إحنا عندنا إيه؟ white bulbaral fissure، + +110 +00:10:01,500 --> 00:10:06,600 +بتكلم، يعني بمعنى آخر أنه لو كان شخص عنده 12 + +111 +00:10:06,600 --> 00:10:11,180 +فنضيف تلابة هي 15، مستحيل أنا أجي عدسة بهذا اللي + +112 +00:10:11,180 --> 00:10:14,650 +هو ال diameter، لكن هذه وإن بتظبط زي مثلا ال + +113 +00:10:14,650 --> 00:10:18,650 +Japanese أو الناس ال chinese اللي عندهم small + +114 +00:10:18,650 --> 00:10:21,830 +eyeball، كل ما أنا ازود ال diameter بنلاقي يعني + +115 +00:10:21,830 --> 00:10:26,830 +عندهم ال normal أو ال range لـ ال horizontal أو ال + +116 +00:10:26,830 --> 00:10:32,070 +corneal diameter تقريبا ما بين 11 لـ 10.5 ملليمتر، + +117 +00:10:32,070 --> 00:10:35,570 +فلو إحنا ضفنا 3 يعني هيكون في ال range بتاعنا + +118 +00:10:35,570 --> 00:10:43,060 +14، 14.5 ملليمتر، تمام؟ إذا كان مصطح ومستوى التوريك + +119 +00:10:43,060 --> 00:10:54,040 +لو كان مصطح ومستوى توريك، لو كان مستوى توريك، لو + +120 +00:10:54,040 --> 00:10:58,700 +كان مستوى توريك، لو كان مستوى توريك، لو كان مستوى + +121 +00:10:58,700 --> 00:11:00,820 +توريك، لو كان مستوى توريك، لو كان مستوى توريك، لو كان + +122 +00:11:00,820 --> 00:11:05,180 +مستوى توريك، لو كان مستوى توريك، لو كان مستوى توريك + +123 +00:11:05,180 --> 00:11:07,900 +لو كان مستوى توريك، لو كان مستوى توري + +124 +00:11:17,000 --> 00:11:26,480 +بالإضافة أنه يكون متزامن بشكل عادي، إذا + +125 +00:11:26,480 --> 00:11:27,980 +التوريك لينز + +126 +00:11:33,220 --> 00:11:41,820 +عندما تكون التوريك لينز مستقيمة ومناسبة ومناسبة + +127 +00:11:41,820 --> 00:11:45,040 +ومناسبة ومناسبة ومناسبة ومناسبة ومناسبة ومناسبة ومناسبة + +128 +00:11:45,040 --> 00:11:45,940 +ومناسبة ومناسبة ومناسبة ومناسبة ومناسبة ومناسبة ومناسبة + +129 +00:11:45,940 --> 00:11:46,820 +ومناسبة ومناسبة ومناسبة ومناسبة ومناسبة ومناسبة ومناسبة + +130 +00:11:46,820 --> 00:11:46,880 +ومناسبة ومناسبة ومناسبة ومناسبة ومناسبة ومناسبة ومناسبة + +131 +00:11:46,880 --> 00:11:47,560 +ومناسبة ومناسبة ومناسبة ومناسبة ومناسبة ومناسبة ومناسبة + +132 +00:11:47,560 --> 00:11:53,160 +ومناسبة ومناسبة ومناسبة ومناسبة ومناسبة ومناسبة ومناسبة + +133 +00:11:53,160 --> 00:11:55,340 +ومناسبة + +134 +00:12:04,450 --> 00:12:08,670 +لسطح الأمامي للعدسة، ال upper eyelid هيعمل catch + +135 +00:12:08,670 --> 00:12:13,650 +للعدسة ويعمل عملية دفع للعدسة، ببساطة هيك، تمام؟ + +136 +00:12:13,650 --> 00:12:19,110 +عنده ال ISO-Horizontal Profile، has the same + +137 +00:12:19,110 --> 00:12:22,290 +thickness along the horizontal meridian of the + +138 +00:12:22,290 --> 00:12:28,920 +lens، لو فتحت الفيجر هذا هتلاحظ أن هنا 165 + +139 +00:12:28,920 --> 00:12:35,380 +وهنا 165، إذا the + +140 +00:12:35,380 --> 00:12:40,900 +same إيه؟ meridian، إذا قدامي نفس ال thick وين؟ على + +141 +00:12:40,900 --> 00:12:45,780 +ال horizontal meridian تمام؟ طيب الاحظين أنا عندي + +142 +00:12:45,780 --> 00:12:48,680 +في حاجة إيش بنسميها فاكرين في ال progressive + +143 +00:12:48,680 --> 00:12:54,640 +lenses حاجة بنسميها ال corridor ال corridor كيف؟ + +144 +00:12:54,640 --> 00:12:58,020 +أنه تدريج صح ولا لأ؟ one hundred five .. one + +145 +00:12:58,020 --> 00:13:01,640 +hundred fifty, one hundred sixty five, two hundred + +146 +00:13:01,640 --> 00:13:05,800 +thirty, three hundred twenty بمعنى أنه أنا عندي + +147 +00:13:05,800 --> 00:13:07,640 +التدريج hand thin + +148 +00:13:11,080 --> 00:13:16,780 +و هنا إيش بيصير؟ ثيك يعني كل ما طلعنا لل upper + +149 +00:13:16,780 --> 00:13:22,660 +بيقل اللي هو السماكة كل ما نزلنا إيش بيزيد السماكة + +150 +00:13:22,660 --> 00:13:30,000 +طبعًا ال horizontal أو ال ISO horizontal profile أو + +151 +00:13:30,000 --> 00:13:33,840 +ال ISO horizontal shape اعتمد أن ال horizontal + +152 +00:13:33,840 --> 00:13:37,140 +meridian يكون نفس ال thick أو نفس السماكة + +153 +00:13:42,080 --> 00:13:46,060 +إذن has the same thickness along the horizontal + +154 +00:13:46,060 --> 00:13:51,500 +meridians of the limbs. The thickness profile was + +155 +00:13:51,500 --> 00:13:57,000 +designed to smooth over the junctions and offer a + +156 +00:13:57,000 --> 00:14:01,420 +more even surface for the eyelid to move over + +157 +00:14:01,420 --> 00:14:05,600 +الفرق ما بينهم إيش؟ هنا الصفحة إيش قالت ليه؟ even + +158 +00:14:05,600 --> 00:14:10,360 +يعني بمعنى regular و symmetric و أيضًا اللي هو + +159 +00:14:10,360 --> 00:14:16,370 +uniform تمام؟ لكن في الحالة الأولى كان إيش؟ uneven + +160 +00:14:16,370 --> 00:14:20,210 +غير متماثل فصار catch ما بينه و ما بين ال upper + +161 +00:14:20,210 --> 00:14:26,430 +island لكن هنا كلهيته فقط عملية تدريج واضح الفكرة؟ + +162 +00:14:26,430 --> 00:14:30,410 +يعني بمعنى آخر أنه هنا في الحالة الثانية الـ Iso + +163 +00:14:30,410 --> 00:14:37,070 +-Horizontal Profile مش هيحدث أي تماسك أو أي تكاتش + +164 +00:14:37,070 --> 00:14:41,890 +ما بين العدسة أو ال other part للعدسة و ال other + +165 +00:14:41,890 --> 00:14:42,330 +eyelid + +166 +00:14:56,110 --> 00:15:01,470 +لو لعبته في ال horizontal أو ال ISO horizontal + +167 +00:15:01,470 --> 00:15:08,070 +profile أنه كان ال .. ال .. التوزيع الثقل متساوي + +168 +00:15:08,070 --> 00:15:12,050 +وين؟ في كل أجزاء العدسة صح ولا لأ؟ يعني شفنا مية و + +169 +00:15:12,050 --> 00:15:15,530 +خمسين، مية و ستة و خمسين، متين و تلاتين يعني + +170 +00:15:15,530 --> 00:15:20,690 +بتديني حق أنه إيه؟ the prism ballast is wide بمعنى + +171 +00:15:20,690 --> 00:15:25,620 +أنه متنوع أو مختلف صح ولا لأ؟ بالإضافة أن هو + +172 +00:15:25,620 --> 00:15:29,480 +continuous مستمر يعني مش في منطقة معينة و المنطقة + +173 +00:15:29,480 --> 00:15:35,340 +الثانية مافيش فيها prison palace and the same نفسه + +174 +00:15:35,340 --> 00:15:40,530 +okay regardless بغض النظر عن مين ال lens power يعني + +175 +00:15:40,530 --> 00:15:45,170 +جديش قوة العدسة هل هي minus 3 أو minus 4 أو minus + +176 +00:15:45,170 --> 00:15:51,370 +5 طبعًا هذا التصميم هو يعتبر أحدث تصميم للعدسات ال + +177 +00:15:51,370 --> 00:15:54,910 +software ال contact lenses اللي هو عبارة عن ال ISO + +178 +00:15:54,910 --> 00:15:59,630 +horizontal profile أو ال ISO horizontal shape أو + +179 +00:15:59,630 --> 00:16:03,450 +ال ISO horizontal pattern تمام؟ + +180 +00:16:09,280 --> 00:16:16,560 +التصميم هذا edge design is optimized أي بمعنى بيدي + +181 +00:16:16,560 --> 00:16:21,780 +اللي هو راحة أكثر لكن فيه قلوب عيب معين إذا is + +182 +00:16:21,780 --> 00:16:25,420 +optimized من ناحية الراحة أكثر for comfort for + +183 +00:16:25,420 --> 00:16:32,600 +comfort with less than 220 micron per millimeter + +184 +00:16:32,600 --> 00:16:39,650 +RAM RAM بمعنى ارتفاع لأعلى to edge taper and a less + +185 +00:16:39,650 --> 00:16:45,150 +than 14 degree junction angle البساطة أنه ال edge + +186 +00:16:45,150 --> 00:16:48,230 +design اعتمد على زيادة ال diameter + +187 +00:17:07,520 --> 00:17:12,780 +ببساطة أن هو مماثل لمين؟ لل ISO horizontal profile + +188 +00:17:12,780 --> 00:17:17,860 +ولكن هنا إيش عمل؟ زيادة ال diameter بشكل كبير عشان + +189 +00:17:17,860 --> 00:17:22,180 +هيك دا ومن شوية بقولكم أن بعض ال practitioner + +190 +00:17:22,180 --> 00:17:26,600 +بيفضلوا في زيادة ال diameter ثلاثة لأربعة ملي متر + +191 +00:17:26,600 --> 00:17:31,710 +over the horizontal visible iris diameter فهو زود + +192 +00:17:31,710 --> 00:17:37,190 +الديامتر وعمل على توزيع ال Prism ballast بطريقة أن + +193 +00:17:37,190 --> 00:17:41,950 +تكون تقريبًا متساوية في كل الأجزاء ولكن زيادة + +194 +00:17:41,950 --> 00:17:46,030 +الديامتر عمل عملية ramp اللي هو ارتفاع يعني رفعه + +195 +00:17:46,030 --> 00:17:50,850 +شوية لأعلى تمام؟ طيب هذا بيدي راحة لمين؟ لل + +196 +00:17:50,850 --> 00:17:55,230 +patient ليش طيب؟ البساطة لأنه ما بيعمل direct + +197 +00:17:55,230 --> 00:17:59,450 +اللي هو catch ما بين العدسة و ال other eyelid + +198 +00:18:04,030 --> 00:18:08,450 +Other design features عمل إيه؟ راحوا combined يعني + +199 +00:18:08,450 --> 00:18:12,950 +عملوا اتحاد ما بين ال Prism ballast و ال dynamic + +200 +00:18:12,950 --> 00:18:16,450 +stabilization فاكرين المحاضرة الماضية في ال + +201 +00:18:16,450 --> 00:18:19,710 +dynamic stabilization إيش حكينا أنه بيعمل three + +202 +00:18:19,710 --> 00:18:25,600 +nine و clock تلاقي dash من هنا و dash من هنا to + +203 +00:18:25,600 --> 00:18:29,480 +enhance the stabilization enhance بمعنى improve + +204 +00:18:29,480 --> 00:18:34,460 +عشان يحسن ثبات العدسة طبعًا من خلال إيش؟ زيادة ال + +205 +00:18:34,460 --> 00:18:39,800 +diameter ومن خلال ال edge designs اللي هو ارتفاعها + +206 +00:18:39,800 --> 00:18:46,760 +بقيمة تقريبًا 14 micron Toric lenses are generally + +207 +00:18:46,760 --> 00:18:51,200 +larger in diameter than spherical lenses. ببساطة هي + +208 +00:18:51,200 --> 00:18:55,080 +بشكل عام قطرها أكبر من قطر من العدسات الاسفيركال + +209 +00:18:55,080 --> 00:18:59,920 +why؟ + +210 +00:18:59,920 --> 00:19:03,760 +ليش إن قطرها أكبر؟ لو جالكم سؤال اللي هو + +211 +00:19:03,760 --> 00:19:09,640 +why؟ بالضبط to improve or to enhance the stability + +212 +00:19:09,640 --> 00:19:13,460 +and comfort for the patient or for the subject + +213 +00:19:16,850 --> 00:19:22,010 +Many of the custom high-cylinder lens designs + +214 +00:19:22,010 --> 00:19:28,210 +incorporate a 15mm diameter to aid stabilization + +215 +00:19:28,210 --> 00:19:32,510 +العديد من الفتر أو الـ manufacturer المصنعين + +216 +00:19:32,510 --> 00:19:38,150 +للعدسات كل ما زادت قيمة الـ cylinder lens سواء + +217 +00:19:38,150 --> 00:19:45,000 +power تمام القيمة أو ك value بيفضل إيش أنه يزود ال + +218 +00:19:45,000 --> 00:19:48,100 +diameter أو بيخلي ال diameter ال standard كده إيش + +219 +00:19:48,100 --> 00:19:54,540 +15 ملي متر لزيادة موضوع ال stability طبعًا دائمًا + +220 +00:19:54,540 --> 00:19:58,560 +بدك تفكر تفكير أنه كل ما زاد ال cylinder power + +221 +00:19:58,560 --> 00:20:04,100 +المريض حتفرج معه ال one أو ال two degrees فلازم + +222 +00:20:04,100 --> 00:20:07,800 +أنه يكون ال stability بدرجة كبيرة وإلا أي + +223 +00:20:07,800 --> 00:20:11,980 +rotation حيعمل إيه؟ اختلاف للرؤية عند الشخص + +224 +00:20:14,830 --> 00:20:21,510 +تجارب مصممة مختلفة تجارب تجارب مختلفة تجارب تجارب + +225 +00:20:21,510 --> 00:20:28,530 +تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب + +226 +00:20:28,530 --> 00:20:29,570 +تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب + +227 +00:20:29,570 --> 00:20:29,650 +تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب + +228 +00:20:29,650 --> 00:20:29,710 +تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب + +229 +00:20:29,710 --> 00:20:38,690 +تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب + +230 +00:20:38,860 --> 00:20:42,920 +طبعًا إذا أنت حبيت تزودي ال diameter أو تقللي هذا + +231 +00:20:42,920 --> 00:20:46,740 +حيكون على حساب مين؟ ال patient فلذلك احنا بنعمل + +232 +00:20:46,740 --> 00:20:50,980 +حاجة بنسميها ال cost to benefit كما ذكرنا سابقًا + +233 +00:20:50,980 --> 00:20:56,040 +لكن أنا بنصح إذا كان المريض عنده فوق الخمس درجات + +234 +00:20:56,040 --> 00:21:01,000 +سلندر لازم أنه يكون ال diameter typical وإلا + +235 +00:21:01,000 --> 00:21:06,080 +حيكون في يعني حيصير غلبة للمريض بشكل كبير ومش + +236 +00:21:06,080 --> 00:21:07,260 +حيرتاح للعدسة + +237 +00:21:11,510 --> 00:21:17,690 +هذا بالنسبة لزيادة ال diameter للعدسة مع وضع + +238 +00:21:17,690 --> 00:21:22,750 +البرزم ballast على اللي هو أطراف أو على جميع اللي + +239 +00:21:22,750 --> 00:21:27,450 +هو محاور العدسة عشان تعمل اللي هو عملية stability + +240 +00:21:27,450 --> 00:21:35,690 +و تكون comfort بالنسبة لمين؟ للمريض طيب ال key اللي + +241 +00:21:35,690 --> 00:21:42,190 +هو مفتاح النجاح to successful fitting of toric + +242 +00:21:42,190 --> 00:21:46,650 +contact lenses is an accurate refraction دائمًا + +243 +00:21:46,650 --> 00:21:53,430 +بنذكركم أن أي عدسة لاصقة بدك تنجح في عملية ال + +244 +00:21:53,430 --> 00:21:57,640 +fitting لازم أنا اعمل refraction بشكل accurate يعني + +245 +00:21:57,640 --> 00:22:02,240 +أي refinement من استجماتيك فان Jackson cross + +246 +00:22:02,240 --> 00:22:05,360 +-cylinder for power four-cylinder diachrome test + +247 +00:22:05,360 --> 00:22:10,600 +لابد استخدامها لمين؟ للمريض عشان نصل للـ good + +248 +00:22:10,600 --> 00:22:15,140 +fitting for contact lens طبعًا هذا الكلام أكيد + +249 +00:22:15,140 --> 00:22:18,960 +بنطبقه على باقي العدسات بشكل عام لكن في ال software + +250 +00:22:18,960 --> 00:22:24,530 +أكثر اللي هو حرص عند إطلاق عدسة توريك لينز عند + +251 +00:22:24,530 --> 00:22:29,490 +إطلاق عدسة توريك لينز يجب أن يكون الوضع مرتبط + +252 +00:22:29,490 --> 00:22:33,270 +بالقرنية يجب أن يكون مرتبط بالقرنية يجب أن + +253 +00:22:33,270 --> 00:22:34,030 +يكون مرتبط بالقرنية يجب أن يكون مرتبط بالقرنية + +254 +00:22:34,030 --> 00:22:39,890 +يجب + +255 +00:22:39,890 --> 00:22:42,670 +أن يكون مرتبط بالقرنية يجب أن يكون مرتبط + +256 +00:22:42,670 --> 00:22:44,150 +بالقرنية يجب أن يكون مرتبط بالقرنية يجب أن + +257 +00:22:44,150 --> 00:22:44,250 +يكون مرتبط بالقرنية يجب أن يكون مرتبط بالقرنية + +258 +00:22:44,250 --> 00:22:45,790 +يجب أن يكون مرتبط بالقرنية يجب أن يكون مرتبط + +259 +00:22:45,790 --> 00:22:50,530 +بالقرنية يجب أن يكون مرتبط بالقرنية يجب أن + +260 +00:22:50,530 --> 00:22:55,790 +يكون Convert if necessary to minus cylinder form + +261 +00:22:55,790 --> 00:23:01,510 +افرض أنا مثلًا يجيني شخص من البلاد اللي بيستخدموا + +262 +00:23:01,510 --> 00:23:04,890 +فيها plus cylinder power أول حاجة بدنا نعمل إيه؟ + +263 +00:23:04,890 --> 00:23:07,510 +Transposition نحولها ل minus power + +264 +00:23:11,390 --> 00:23:16,590 +Centration movement بالنسبة للـ lag on up gaze and + +265 +00:23:16,590 --> 00:23:20,810 +version للعدسة should be evaluated لازم أنه يتم + +266 +00:23:20,810 --> 00:23:26,880 +التقييمها أو تحديدها in a manner أي بمعنى تقنيك + +267 +00:23:26,880 --> 00:23:32,080 +similar to that for fitting soft spherical lenses + +268 +00:23:32,080 --> 00:23:37,640 +وهذا مماثل لمين؟ للعدسات الـ spherical soft contact + +269 +00:23:37,640 --> 00:23:42,700 +lenses طيب، الآن بتسأل سؤال، تتوقع بالنسبة للـ + +270 +00:23:42,700 --> 00:23:46,820 +fitting الـ soft contact lenses جديش أنت بدك + +271 +00:23:46,820 --> 00:23:53,170 +تاخدي كم جلسة للمريض؟ يعني الآن اجى مريض و احنا + +272 +00:23:53,170 --> 00:23:58,310 +اقترحنا أنه أفضل خيار له ال toric soft contact lenses + +273 +00:23:58,310 --> 00:24:03,750 +كم جلسة أنه هيكون أو هناخد ليعطي العدسة النهائية + +274 +00:24:03,750 --> 00:24:04,730 +لهذا ال patient + +275 +00:24:28,060 --> 00:24:32,220 +another answer طبعًا + +276 +00:24:32,220 --> 00:24:36,420 +أول حاجة الجلسة الأولى بدي اعمل عملية adaptation + +277 +00:24:36,420 --> 00:24:40,440 +للعدسة بدي اشوف أنه هل المريض عنده motivation + +278 +00:24:40,440 --> 00:24:46,280 +لارتداء عدسة لاصقة soft toric ولا لأ؟ تمام؟ هذه + +279 +00:24:46,280 --> 00:24:51,750 +القضية الأولى طيب ال motivation غير كافي في عدسات + +280 +00:24:51,750 --> 00:24:55,790 +مين؟ ال toric soft contact lenses، البساطة لأنه بيكون + +281 +00:24:55,790 --> 00:24:59,650 +فيه هناك access للعدسة، يعني ممكن مثلا ييجي مريض + +282 +00:24:59,650 --> 00:25:03,230 +يقولك لأ أنا متعود ألبس عدسات لاصقة، هو متعود على + +283 +00:25:03,230 --> 00:25:07,750 +مين؟ على الـ spherical soft contact lens ولكن هو ما + +284 +00:25:07,750 --> 00:25:11,810 +اتعود خاصة هذه أنا بتكلم على الـ high power سواء + +285 +00:25:11,810 --> 00:25:17,370 +سفير أو سيلندر لكن هو لم يتعود على ارتداء العدسات + +286 +00:25:17,370 --> 00:25:22,110 +الـ soft direct contact lenses الموضوع الثاني وهذا + +287 +00:25:22,110 --> 00:25:25,930 +هو المهم دائما أنا لما بدي أعمل fitting للـ + +288 +00:25:25,930 --> 00:25:30,090 +software إلى contact lenses فاكرين في الـ RGB ممكن + +289 +00:25:30,090 --> 00:25:34,090 +أنا أدي عدسة عشوائية صح ولا لا بناء على مين؟ على الـ + +290 +00:25:34,090 --> 00:25:37,130 +base curve يعني بمعنى آخر ممكن الـ power ما يكون + +291 +00:25:37,130 --> 00:25:42,260 +الصحيح لكن الـ base curve صحيح اللي هو كبسكسفير لكن في + +292 +00:25:42,260 --> 00:25:46,100 +الـ software ايش ما بنفعش الكلام هذا لازم العدسة اللي + +293 +00:25:46,100 --> 00:25:50,440 +هي الـ fairest lens اللي أنا أديها للمريض مقاربة + +294 +00:25:50,440 --> 00:25:55,060 +لقيمة الاسفير ومقاربة لقيمة السيلندر والأهم من + +295 +00:25:55,060 --> 00:25:59,810 +التنتين هدول مقاربة لقيمة مين؟ الـ axels يعني بمعنى + +296 +00:25:59,810 --> 00:26:04,630 +آخر المريض عنده access تسعين ما اروحش أدقق قداش + +297 +00:26:04,630 --> 00:26:08,210 +access مية وثلاثين أو مية وأربعين ليه؟ لأنه + +298 +00:26:08,210 --> 00:26:12,370 +هيلاحظ أنه رؤية مغبشة أو مش واضحة بالمريض عنده + +299 +00:26:12,370 --> 00:26:16,390 +هيقولك لأ أنا هذه العدسة بتلاقمنيش أو غير مناسبة + +300 +00:26:16,390 --> 00:26:20,570 +هو ممكن عامل adaptation للعدسة لكن وين المشكلة؟ في + +301 +00:26:20,570 --> 00:26:27,650 +موضوع الـ access فتقريبا كـ range لو أنت بدك تعمل + +302 +00:26:27,650 --> 00:26:31,350 +good fitting للعدسة من ثلاثة لأربعة مع التسليم + +303 +00:26:31,350 --> 00:26:36,290 +العدسة يعني بمعنى آخر لما أنا بدي الـ instructions + +304 +00:26:36,290 --> 00:26:38,810 +الإرشادات لهذا المريض + +305 +00:26:45,710 --> 00:26:49,770 +consideration should be given to the location of + +306 +00:26:49,770 --> 00:26:54,050 +the refractive cylinder دائما بدي أحدد قيمة الـ + +307 +00:26:54,050 --> 00:26:58,250 +residual astigmatism الـ corneal cylinder والـ + +308 +00:26:58,250 --> 00:27:02,790 +manifest refraction لهذا المريض Okay أيضا بعد ذلك + +309 +00:27:02,790 --> 00:27:06,090 +بدي أحدد هل هذا الـ cylinder من الكورنيا ولا + +310 +00:27:06,090 --> 00:27:10,790 +lenticular حقيقة الآن يعني شغالين مع الدكتور عمر + +311 +00:27:10,790 --> 00:27:14,490 +في موضوع اللي هو عند مين الـ most common كـ + +312 +00:27:14,490 --> 00:27:18,630 +prevalent في قطاع غزة إنه هل هو الـ lenticular ولا + +313 +00:27:18,630 --> 00:27:21,950 +القرنية الـ cylinder طبعا العينة إن شاء الله هي + +314 +00:27:21,950 --> 00:27:26,850 +هتكون ثلاثمية حالة لحد الآن خلصنا تقريبا خمسة + +315 +00:27:26,850 --> 00:27:31,270 +وأربعين حالة تتفاجئوا إن احنا عندنا في قطاع غزة + +316 +00:27:31,270 --> 00:27:35,810 +الأكثر شيوعا لحد الآن الـ lenticular بنتوقف إن شاء + +317 +00:27:35,810 --> 00:27:39,750 +الله لـ الـ fitting for software contact lenses في + +318 +00:27:39,750 --> 00:27:43,610 +المحاضرة القادمة إن شاء الله بنكمل في هذا الموضوع + +319 +00:27:43,610 --> 00:27:46,790 +في أي سؤال؟ يعطيكم العافية diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/QZITliCZen8_postprocess.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/QZITliCZen8_postprocess.srt new file mode 100644 index 0000000000000000000000000000000000000000..42794cdb862afec884325581f16ef82b71a19485 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/QZITliCZen8_postprocess.srt @@ -0,0 +1,1276 @@ +1 +00:00:20,920 --> 00:00:23,820 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:23,820 --> 00:00:28,960 +وبركاته ومرحبا لكم جميعا ان شاء الله في المحاضرة + +3 +00:00:28,960 --> 00:00:33,780 +هذه هنكمل في موضوع ال design ل ال software contact + +4 +00:00:33,780 --> 00:00:39,160 +lenses في عندنا موضوع ال ISO thickness profile ال + +5 +00:00:39,160 --> 00:00:42,020 +profile بمعنى shape or pattern تمام؟ + +6 +00:00:50,010 --> 00:00:58,370 +هو عبارة عن تصميم للعينبتميز هذا التصميم بان هو + +7 +00:00:58,370 --> 00:01:05,790 +biomedics أي بمعنى الطب الحيوي هو بيكون موافق في + +8 +00:01:05,790 --> 00:01:11,630 +اللي هو تصميمه للطب الحيوي اللي خاص في مين في اللي + +9 +00:01:11,630 --> 00:01:16,250 +هو العدسات ال contact lenses يا جماعة أي تشغلة في + +10 +00:01:16,250 --> 00:01:19,930 +موضوع ال treatment او في موضوع ال management او في + +11 +00:01:19,930 --> 00:01:23,990 +موضوع ال manufacturer لابد ان في هناك حاجة بنسميها + +12 +00:01:23,990 --> 00:01:25,250 +ايه guidelines + +13 +00:01:30,090 --> 00:01:33,710 +الـ guidelines انا من خلالها انا ايش؟ بعمل اللي هو + +14 +00:01:33,710 --> 00:01:39,350 +تصميم العدسة الملائم او يعني مالف اي تمصمم انه + +15 +00:01:39,350 --> 00:01:45,050 +يعمل تصميم غير ملائم او غير مناسب فلازم ان هو يكون + +16 +00:01:45,050 --> 00:01:51,030 +هذا التصميم موافق لمين للطب الحيوي او موافق لاللي + +17 +00:01:51,030 --> 00:01:56,460 +هو قابلية الانسان لتقبل هذا التصميمCopper Vision + +18 +00:01:56,460 --> 00:02:00,300 +هى النوع الـ Manufacturer أو نوع ال company اللى + +19 +00:02:00,300 --> 00:02:05,080 +عملت تصنيع لهذه العدسة زى مثلا ال بوش اند لوم او + +20 +00:02:05,080 --> 00:02:10,080 +مثلا مثال اخر اللى هى ال copper vision او في عندنا + +21 +00:02:10,080 --> 00:02:14,600 +2020 visual acuity هدى كلها اسماء شركات + +22 +00:02:18,020 --> 00:02:22,200 +Turk lens across sections were studied with a + +23 +00:02:22,200 --> 00:02:26,760 +profilometer طبعا في أنواع من الدراسات بتعرفوا + +24 +00:02:26,760 --> 00:02:29,600 +اسمها across sectional study صحيح؟ + +25 +00:02:35,870 --> 00:02:40,690 +طبعا ال cross-sectional study بيقوم الباحث أو ال + +26 +00:02:40,690 --> 00:02:46,530 +manufacturer المصنع بالهو أخد عينة من الأشخاص و + +27 +00:02:46,530 --> 00:02:50,450 +بيستخدم معهم هذا النوع من العدسات بيشوف انه هل في + +28 +00:02:50,450 --> 00:02:55,170 +benefit لهذه العدسة، هل مثلا في هناك indication، + +29 +00:02:55,170 --> 00:02:59,230 +contraindication، هل في advantages، disadvantages، + +30 +00:02:59,230 --> 00:03:03,090 +هل في drawbacks، عيوب لهذه التصميم، كل هذه من خلال + +31 +00:03:03,090 --> 00:03:06,680 +مين؟ هذا النوع من الدراساتطيب شو معنى ال + +32 +00:03:06,680 --> 00:03:12,140 +profilometer؟ انتوا ملاحظين الان كله بنتكلم شغل + +33 +00:03:12,140 --> 00:03:16,780 +ايش المصنع او شغل ال manufacturer ال profilometer + +34 +00:03:16,780 --> 00:03:23,260 +هو عبارة عن جهاز من خلاله ال manufacturer بحدد + +35 +00:03:23,260 --> 00:03:28,060 +جديش ال roughness للسطح يعني جديش خشونة ايش السطح + +36 +00:03:28,060 --> 00:03:34,340 +اذا it is an instrument + +37 +00:03:38,550 --> 00:03:55,050 +to measure the value or quantity of + +38 +00:03:55,050 --> 00:03:59,270 +the roughness + +39 +00:04:02,490 --> 00:04:05,690 +يعني بمعنى اخر انه بيقول لك هان قيمة ال roughness + +40 +00:04:05,690 --> 00:04:10,990 +يعني خشونة السطح ل العدسة واحد في المية مثلا نص في + +41 +00:04:10,990 --> 00:04:15,250 +المية او point two five percent اذا بيعبرلي انه + +42 +00:04:15,250 --> 00:04:19,410 +جديش قيمة ايه ال roughness كالهو value او ك + +43 +00:04:19,410 --> 00:04:23,150 +quantitative اذا + +44 +00:04:23,150 --> 00:04:28,970 +هذه بنسميها profilometerThe conclusions الخاتمة + +45 +00:04:28,970 --> 00:04:34,250 +were that thinner designs had better comfort. + +46 +00:04:35,710 --> 00:04:39,710 +Thicker designs offered better orientation يعني + +47 +00:04:39,710 --> 00:04:44,870 +الخاتمة أو الاستنتاج من التصاميم المختلفة لهذا + +48 +00:04:44,870 --> 00:04:49,590 +النوع من العدسات السفتوريك انه انا كل ما قللت + +49 +00:04:49,590 --> 00:04:55,620 +السماكة بكون مريحة لمن؟ للمريضو ال thick اللي هي + +50 +00:04:55,620 --> 00:05:01,160 +السماكة المقصود هنا فيها ال palest تمام؟ او + +51 +00:05:01,160 --> 00:05:07,560 +المقصود فيها اللي هو ال thick zone ال thick zone + +52 +00:05:07,560 --> 00:05:11,900 +بحدد لأكتر ال orientation يعني هو قادر على تحديد + +53 +00:05:11,900 --> 00:05:16,990 +ال direction لمين لل axisبشكل اكبر لذلك انت بتلاحظ + +54 +00:05:16,990 --> 00:05:20,910 +انه دايما منطقة الثقة اللي وين موجودة موافقة لل + +55 +00:05:20,910 --> 00:05:24,770 +access تمام؟ اذا الان لو انا سألتك ايش ال + +56 +00:05:24,770 --> 00:05:29,330 +conclusion ل ال different design بساطة ان ال thin + +57 +00:05:29,330 --> 00:05:32,930 +zone بتديني better comfort او good comfort ال + +58 +00:05:32,930 --> 00:05:36,610 +thick zone بتديني better او good orientation او + +59 +00:05:36,610 --> 00:05:37,650 +good direction + +60 +00:05:40,450 --> 00:05:44,990 +There were notable junctions on all current tricks + +61 +00:05:44,990 --> 00:05:49,630 +يعني هذه متوافقة مع معظم اللي هو التصاميم الحالية + +62 +00:05:49,630 --> 00:05:55,110 +current بمعنى present الحالية and stability may be + +63 +00:05:55,110 --> 00:05:59,910 +related to palest distribution effects قيمة ال + +64 +00:05:59,910 --> 00:06:05,570 +stability للعدسة بتحدد من خلال ايه تأثيرات توزيع + +65 +00:06:05,570 --> 00:06:11,880 +اللي هو الثقل يعني هل مثلاهل مثلا على التلاتة + +66 +00:06:11,880 --> 00:06:17,200 +والتسعة؟ هل توزيعه على كل المناطق بشكل متساوي؟ هل + +67 +00:06:17,200 --> 00:06:21,080 +في area معينة او في zone معين فهذا بيحدد ليه اللي + +68 +00:06:21,080 --> 00:06:25,160 +هو قيمة ال stability واحنا قلنا ان تصميم ال + +69 +00:06:25,160 --> 00:06:28,740 +software contact lenses ببساطة صار لها عملية + +70 +00:06:28,740 --> 00:06:35,130 +update لحد ما وصلنا ل ال betadesign انه كل ما انا + +71 +00:06:35,130 --> 00:06:39,270 +قللت اللي هو السماكة بتديني better comfort او good + +72 +00:06:39,270 --> 00:06:43,190 +comfort وكل ما انا زودت السماكة بتديني good + +73 +00:06:43,190 --> 00:06:49,850 +orientation او good direction an + +74 +00:06:49,850 --> 00:06:55,730 +uneven anterior surface اي بمعنى سطح غير مستوي او + +75 +00:06:55,730 --> 00:07:02,570 +سطح uneven غير متماثل irregular يعني متعرجإذا an + +76 +00:07:02,570 --> 00:07:07,270 +uneven and tailored surface with notable junctions + +77 +00:07:07,270 --> 00:07:12,610 +offers areas for the superior eyelid to catch as + +78 +00:07:12,610 --> 00:07:18,850 +it moves over the lens في هناك تصميم بالشكل هذا + +79 +00:07:18,850 --> 00:07:25,240 +إنه عمل على دفع العدسة للأمامبحيث ان ال upper + +80 +00:07:25,240 --> 00:07:30,640 +eyelid يعمل catch للعدسة وبعد ذلك يعمل عملية دفع + +81 +00:07:30,640 --> 00:07:38,540 +للعدسة مرة اخرى الان في احد التصاميم عمل منطقة + +82 +00:07:38,540 --> 00:07:43,240 +الثقل او palest zone area في المنطقة العلوية + +83 +00:07:43,240 --> 00:07:49,390 +للعدسةفهذا ايش هيعمل؟ على catch اللي هو تماثل ما + +84 +00:07:49,390 --> 00:07:53,490 +بين ال upper eyelid وال upper part للعدسة فال + +85 +00:07:53,490 --> 00:07:57,870 +upper eyelid هيمسك العدسة ويدفعها وين رجعها اللي + +86 +00:07:57,870 --> 00:08:02,370 +هو مكانها يعني عشان انه يزود ال stability اذا the + +87 +00:08:02,370 --> 00:08:06,530 +eyelid catches on the uneven junctions لكن ايش + +88 +00:08:06,530 --> 00:08:11,510 +المشكلة فيه؟ ان هذا السطح ده العدسة متعرج او غير + +89 +00:08:11,510 --> 00:08:15,030 +منتظم او غير متماثلأو غير مستوي + +90 +00:08:21,640 --> 00:08:26,300 +تفاقنا أي بمعنى منطقة ثقل او gravity zones and + +91 +00:08:26,300 --> 00:08:30,580 +contributes to instability ليش طيب تصير عملية عدم + +92 +00:08:30,580 --> 00:08:34,240 +اللي هو ثابت للعدسة يعني contribute يعني بمعنى إيش + +93 +00:08:34,240 --> 00:08:39,320 +بيساهم إذا بيساهم بعدم ثابت للعدسة، البساطة يا + +94 +00:08:39,320 --> 00:08:45,040 +جماعة أن منطقة ال upper area هي اللي حصي بثقةفال + +95 +00:08:45,040 --> 00:08:49,300 +upper eyelid هيعمل catch للعدسة ويتفحها، فهيقلل من + +96 +00:08:49,300 --> 00:08:53,880 +كمية ال stability للعدسة، لكن هذه أحد ال design + +97 +00:08:53,880 --> 00:08:59,680 +لمين؟ لل soft red contact lenses، + +98 +00:08:59,680 --> 00:09:02,340 +إذن كلمة contribute بمعنى يساهم + +99 +00:09:08,960 --> 00:09:14,320 +إذن an uneven anterior surface with notable + +100 +00:09:14,320 --> 00:09:18,920 +junctions offers areas for the superior eyelid to + +101 +00:09:18,920 --> 00:09:24,400 +catch as it moves over the lens بيفوها شغلة مهمة + +102 +00:09:24,400 --> 00:09:28,660 +ان هو عمل على زيادة ال diameter هو زود ال diameter + +103 +00:09:28,660 --> 00:09:35,780 +لمين؟ للعدسة عشان يقدر ال upper eyelid يغطي جزء + +104 +00:09:35,780 --> 00:09:40,910 +كبير من اللي هو العدسةأو حتى من ناحية كليكية دائما + +105 +00:09:40,910 --> 00:09:45,330 +ولكن عمليا هذه لا تصبت من ناحية ال theory دائما + +106 +00:09:45,330 --> 00:09:48,550 +يقول في العدسات ال software ال contact lenses + +107 +00:09:48,550 --> 00:09:52,370 +اختار ديامتر over the horizontal visible iris + +108 +00:09:52,370 --> 00:09:58,100 +ديامتر من تلاتة لاربعة مليمترلكن هذا عمليا صعب + +109 +00:09:58,100 --> 00:10:01,500 +يعني خاصة احنا عندنا ايه white bulbaral fissure + +110 +00:10:01,500 --> 00:10:06,600 +بتكلم يعني بمعنى اخر انه لو كان شخص عنده اتناش + +111 +00:10:06,600 --> 00:10:11,180 +فنضيف تلابة هي خمساش مستحيل اناجي عدسة بهذا اللي + +112 +00:10:11,180 --> 00:10:14,650 +هو ال diameterلكن هذه وان بتظبط زي مثلا ال + +113 +00:10:14,650 --> 00:10:18,650 +Japanese او الناس ال chinese اللي عندهم small + +114 +00:10:18,650 --> 00:10:21,830 +eyeball كل ما انا ازود ال diameter بنلاقي يعني + +115 +00:10:21,830 --> 00:10:26,830 +عندهم ال normal او ال range ل ال horizontal او ال + +116 +00:10:26,830 --> 00:10:32,070 +cornial diameter تقريبا ما بين 11 ل 10.5 ملي متر + +117 +00:10:32,070 --> 00:10:35,570 +فلو احنا ضفنا تلاتة يعني هيكون في ال range بتاعنا + +118 +00:10:35,570 --> 00:10:43,060 +14 14.5 ملي مترتمام؟ اذا كان مصطح و مستوى التوريك + +119 +00:10:43,060 --> 00:10:54,040 +لو كان مصطح و مستوى توريك لو كان مستوى توريك لو + +120 +00:10:54,040 --> 00:10:58,700 +كان مستوى توريك لو كان مستوى توريك لو كان مستوى + +121 +00:10:58,700 --> 00:11:00,820 +توريك لو كان مستوى توريك لو كان مستوى توريك لو كان + +122 +00:11:00,820 --> 00:11:05,180 +مستوى توريك لو كان مستوى توريك لو كان مستوى توريك + +123 +00:11:05,180 --> 00:11:07,900 +لو كان مستوى توريك لو كان مستوى توري + +124 +00:11:17,000 --> 00:11:26,480 +بالاضافة انه يكون متظامن بشكل عادى اذا + +125 +00:11:26,480 --> 00:11:27,980 +التوريك لينز + +126 +00:11:33,220 --> 00:11:41,820 +عندما تكون التوريك لينز مستقل ومناسب ومناسب + +127 +00:11:41,820 --> 00:11:45,040 +ومناسب ومناسب ومناسب ومناسب ومناسب ومناسب ومناسب + +128 +00:11:45,040 --> 00:11:45,940 +ومناسب ومناسب ومناسب ومناسب ومناسب ومناسب ومناسب + +129 +00:11:45,940 --> 00:11:46,820 +ومناسب ومناسب ومناسب ومناسب ومناسب ومناسب ومناسب + +130 +00:11:46,820 --> 00:11:46,880 +ومناسب ومناسب ومناسب ومناسب ومناسب ومناسب ومناسب + +131 +00:11:46,880 --> 00:11:47,560 +ومناسب ومناسب ومناسب ومناسب ومناسب ومناسب ومناسب + +132 +00:11:47,560 --> 00:11:53,160 +ومناسب ومناسب ومناسب ومناسب ومناسب ومناسب ومناسب + +133 +00:11:53,160 --> 00:11:55,340 +ومناسب + +134 +00:12:04,450 --> 00:12:08,670 +للسطح الأمامي للعدسة ال upper eyelid هيعمل catch + +135 +00:12:08,670 --> 00:12:13,650 +للعدسة ويعمل عملية دفع للعدسة، ببساطة هيك، تمام؟ + +136 +00:12:13,650 --> 00:12:19,110 +عنده ال ISO-Horizontal Profile، has the same + +137 +00:12:19,110 --> 00:12:22,290 +thickness along the horizontal meridian of the + +138 +00:12:22,290 --> 00:12:28,920 +lensلو فتحت الفيجر هذا هتلاحظ ان هنا one hundred + +139 +00:12:28,920 --> 00:12:35,380 +sixty five وهنا one hundred sixty five اذا the + +140 +00:12:35,380 --> 00:12:40,900 +same ايه؟ meridian اذا قداني نفس ال thick وين على + +141 +00:12:40,900 --> 00:12:45,780 +ال horizontal meridianتمام؟ طيب الاحظين انا عندى + +142 +00:12:45,780 --> 00:12:48,680 +في حاجة ايش بنسميها فاكرين في ال progressive + +143 +00:12:48,680 --> 00:12:54,640 +lenses حاجة بنسميها ال corridor ال corridor كيف؟ + +144 +00:12:54,640 --> 00:12:58,020 +انه تدريج صح ولا لأ؟ one hundred five .. one + +145 +00:12:58,020 --> 00:13:01,640 +hundred fifty, one hundred sixty five, two hundred + +146 +00:13:01,640 --> 00:13:05,800 +thirty, three hundred twenty بمعنى انه انا عندى + +147 +00:13:05,800 --> 00:13:07,640 +التدريج hand thin + +148 +00:13:11,080 --> 00:13:16,780 +و هان ايش بيصير؟ ثيك يعني كل ما اطلعنا لل upper + +149 +00:13:16,780 --> 00:13:22,660 +بيقل اللي هو السماكة كل ما نزلنا ايش بيزيد السماكة + +150 +00:13:22,660 --> 00:13:30,000 +طبعا ال horizontal او ال ISO horizontal profile او + +151 +00:13:30,000 --> 00:13:33,840 +ال ISO horizontal shape اعتمد ان ال horizontal + +152 +00:13:33,840 --> 00:13:37,140 +meridian يكون نفس ال thick او نفس السماكة + +153 +00:13:42,080 --> 00:13:46,060 +إذن has the same thickness along the horizontal + +154 +00:13:46,060 --> 00:13:51,500 +meridians of the limbs. The thickness profile was + +155 +00:13:51,500 --> 00:13:57,000 +designed to smooth over the junctions and offer a + +156 +00:13:57,000 --> 00:14:01,420 +more even surface for the eyelid to move over + +157 +00:14:01,420 --> 00:14:05,600 +الفرق ما بينهم إيش؟ هان الصفح إيش قال ليه؟ even + +158 +00:14:05,600 --> 00:14:10,360 +يعني بمعنى regular و symmetric و أيضا اللي هو + +159 +00:14:10,360 --> 00:14:16,370 +uniformتمام؟ لكن في الحالة الأولى كان إيش؟ uneven + +160 +00:14:16,370 --> 00:14:20,210 +غير متماثل فصار catch ما بينه و ما بين ال upper + +161 +00:14:20,210 --> 00:14:26,430 +island لكن هان كلهيته فقط عملية تدريجواضح الفكرة؟ + +162 +00:14:26,430 --> 00:14:30,410 +يعني بمعنى آخر إنه هان في الحالة التانية الـ Iso + +163 +00:14:30,410 --> 00:14:37,070 +-Horizontal Eprofile مش هيحدث أي تماسك أو أي تكاتش + +164 +00:14:37,070 --> 00:14:41,890 +ما بين العدسة أو ال other part للعدسة و ال other + +165 +00:14:41,890 --> 00:14:42,330 +eyelid + +166 +00:14:56,110 --> 00:15:01,470 +لو لعبته في ال horizontal او ال ISO horizontal + +167 +00:15:01,470 --> 00:15:08,070 +profile انه كان ال .. ال .. التوزيع الثقل متساوي + +168 +00:15:08,070 --> 00:15:12,050 +وين؟ في كل أزاء العدسة صح ولا لأ؟ يعني شفنا مية و + +169 +00:15:12,050 --> 00:15:15,530 +خمسين، مية و ستة و خمسين، متين و تلاتين يعني + +170 +00:15:15,530 --> 00:15:20,690 +بتديني احق انه ايه؟ the prism palest is wide بمعنى + +171 +00:15:20,690 --> 00:15:25,620 +انه متنوع او مختلف صح ولا لأ؟بالاضافة ان هو + +172 +00:15:25,620 --> 00:15:29,480 +continuous مستمر يعني مش في منطقة معينة و المنطقة + +173 +00:15:29,480 --> 00:15:35,340 +التانية مافيش فيها prison palace and the same نفسه + +174 +00:15:35,340 --> 00:15:40,530 +okay regardless بغض النظر عن مين ال lens powerيعني + +175 +00:15:40,530 --> 00:15:45,170 +جديش قوة العدسة هل هي minus 3 أو minus 4 أو minus + +176 +00:15:45,170 --> 00:15:51,370 +5 طبعا هذا التصميم هو يعتبر أحدث تصميم للعدسات ال + +177 +00:15:51,370 --> 00:15:54,910 +software ال contact lenses اللي هو عبارة عن ال ISO + +178 +00:15:54,910 --> 00:15:59,630 +horizontal profile أو ال ISO horizontal shape أو + +179 +00:15:59,630 --> 00:16:03,450 +ال ISO horizontal pattern تمام؟ + +180 +00:16:09,280 --> 00:16:16,560 +التصميم هذا edge design is optimized أي بمعنى بيدي + +181 +00:16:16,560 --> 00:16:21,780 +اللي هو راحة اكتر لكن فيه قلوب عيب معين اذا is + +182 +00:16:21,780 --> 00:16:25,420 +optimized من ناحية الراحة اكتر for comfort for + +183 +00:16:25,420 --> 00:16:32,600 +comfort with less than 220 micron per millimeter + +184 +00:16:32,600 --> 00:16:39,650 +RAM RAM بمعنى ارتفاع لأعلىto edge taper and a less + +185 +00:16:39,650 --> 00:16:45,150 +than 14 degree junction angle البساطة انه ال edge + +186 +00:16:45,150 --> 00:16:48,230 +design اعتمد على زيادة ال diameter + +187 +00:17:07,520 --> 00:17:12,780 +ببساطة ان هو مماثل لمين لل ISO horizontal profile + +188 +00:17:12,780 --> 00:17:17,860 +ولكن هان اشعمل زيادة ال diameter بشكل كبير عشان + +189 +00:17:17,860 --> 00:17:22,180 +هيك دا و من شوية بقولكم ان بعض ال practitioner + +190 +00:17:22,180 --> 00:17:26,600 +بيفضبل في زيادة ال diameter تلاتة لاربعة مليمتر + +191 +00:17:26,600 --> 00:17:31,710 +over the horizontal visible iris diameterفهو زود + +192 +00:17:31,710 --> 00:17:37,190 +الديامتر وعمل على توزيع ال Prism Palace بطريقة ان + +193 +00:17:37,190 --> 00:17:41,950 +تكون تقريبا متساوية في كل الأجزاء ولكن زيادة + +194 +00:17:41,950 --> 00:17:46,030 +الديامتر عمل عملية ramp اللي هو ارتفاع يعني رفعه + +195 +00:17:46,030 --> 00:17:50,850 +شوية لأعلى تمام؟ طيب هذا بيدي راحة لمين؟ لل + +196 +00:17:50,850 --> 00:17:55,230 +patient ليش طيب؟ البساطة لأن هو ما بيعمل direct + +197 +00:17:55,230 --> 00:17:59,450 +اللي هو catch ما بين العدسة و ال other eyelid + +198 +00:18:04,030 --> 00:18:08,450 +Other design fishes عمل ايه؟ راحوا combined يعني + +199 +00:18:08,450 --> 00:18:12,950 +عملوا اتحاد ما بين ال Prism ballast و ال dynamic + +200 +00:18:12,950 --> 00:18:16,450 +stabilization فاكرين المحاضرة الماضية في ال + +201 +00:18:16,450 --> 00:18:19,710 +dynamic stabilization ايش حكينا انه بعمل three + +202 +00:18:19,710 --> 00:18:25,600 +nine و clock تلاقي dash من هنا و dash من هناto + +203 +00:18:25,600 --> 00:18:29,480 +enhance the stabilization enhance بمعنى improve + +204 +00:18:29,480 --> 00:18:34,460 +عشان يحسن ثبات العدسة طبعا من خلال ايش زيادة ال + +205 +00:18:34,460 --> 00:18:39,800 +diameter ومن خلال ال edge designs اللي هو ارتفاعها + +206 +00:18:39,800 --> 00:18:46,760 +بقيمة تقريبا 14 micronTurkic lenses are generally + +207 +00:18:46,760 --> 00:18:51,200 +larger in diameter than spherical lenses.ببساطة هي + +208 +00:18:51,200 --> 00:18:55,080 +بشكل عام قطرها أكبر من قطر من العدسات الاسفريكال + +209 +00:18:55,080 --> 00:18:59,920 +why؟ + +210 +00:18:59,920 --> 00:19:03,760 +ليش إن قطرها أكبر؟ لو جالكم سؤال اللي هو + +211 +00:19:03,760 --> 00:19:09,640 +why؟بالضبط to improve or to enhance the stability + +212 +00:19:09,640 --> 00:19:13,460 +and comfort for the patient or for the subject + +213 +00:19:16,850 --> 00:19:22,010 +Many of the custom high-cylinder lens designs + +214 +00:19:22,010 --> 00:19:28,210 +incorporate a 15mm diameter to aid stabilization + +215 +00:19:28,210 --> 00:19:32,510 +العديد من الفتر أو الـ manufacturer المصنعين + +216 +00:19:32,510 --> 00:19:38,150 +للعدسات كل ما زادت قيمة الـ cylinder lens سواء + +217 +00:19:38,150 --> 00:19:45,000 +power تمامالقيمة او ك value بيفضل ايش انه يزود ال + +218 +00:19:45,000 --> 00:19:48,100 +diameter او بيخل ال diameter ال standard كده ايش + +219 +00:19:48,100 --> 00:19:54,540 +15 ملي متر لزيادة موضوع ال stability طبعا دايما + +220 +00:19:54,540 --> 00:19:58,560 +بدك تفكر تفكير انه كل ما زاد ال cylinder power + +221 +00:19:58,560 --> 00:20:04,100 +المريض هتفرج معه ال one او ال two degrees فلازم + +222 +00:20:04,100 --> 00:20:07,800 +انه يكون ال stability بدرجة كبيرةوإلا أي ت + +223 +00:20:07,800 --> 00:20:11,980 +rotation هيعمل ايه اختلاف للرؤية عند الشخص + +224 +00:20:14,830 --> 00:20:21,510 +تجارب مصممة مختلفة تجارب تجارب مختلفة تجارب تجارب + +225 +00:20:21,510 --> 00:20:28,530 +تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب + +226 +00:20:28,530 --> 00:20:29,570 +تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب + +227 +00:20:29,570 --> 00:20:29,650 +تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب + +228 +00:20:29,650 --> 00:20:29,710 +تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب + +229 +00:20:29,710 --> 00:20:38,690 +تجارب تجارب تجارب تجارب تجارب تجارب تجارب تجارب + +230 +00:20:38,860 --> 00:20:42,920 +طبعا اذا انت حبيت تزودي ال diameter او تقللي هذا + +231 +00:20:42,920 --> 00:20:46,740 +حيكون على حساب mean ال patient فلذلك احنا بنعمل + +232 +00:20:46,740 --> 00:20:50,980 +حاجة بنسميها ال cost to benefit كما ذكرنا سابقا + +233 +00:20:50,980 --> 00:20:56,040 +لكن انا بنصح اذا كان المريض عنده فوق الخمس درجات + +234 +00:20:56,040 --> 00:21:01,000 +سلمدر لازم انه يكون ال diameter typical و الا + +235 +00:21:01,000 --> 00:21:06,080 +حيكون في يعني حيصير غلبة للمريض بشكل كبير و مش + +236 +00:21:06,080 --> 00:21:07,260 +هيرتاح للعدسة + +237 +00:21:11,510 --> 00:21:17,690 +هذا بالنسبة لزيادة ال diameter للعدسة مع وضع + +238 +00:21:17,690 --> 00:21:22,750 +البريزم palest على اللي هو أطراف أو على جميع اللي + +239 +00:21:22,750 --> 00:21:27,450 +هو محاور العدسة عشان تعمل اللي هو عملية stability + +240 +00:21:27,450 --> 00:21:35,690 +و تكون comfort بالنسبة لمين للمريض طيب ال key اللي + +241 +00:21:35,690 --> 00:21:42,190 +هو مفتاح النجاحto successful fitting of softeric + +242 +00:21:42,190 --> 00:21:46,650 +contact lenses is an accurate refraction دايما + +243 +00:21:46,650 --> 00:21:53,430 +بنذكركم ان اي عدسة لاصقة بدك تنجح في عملية ال + +244 +00:21:53,430 --> 00:21:57,640 +fitting لازم انا اعمل refraction بشكل accurateيعني + +245 +00:21:57,640 --> 00:22:02,240 +أي تـrefinement من استجماتيك فان Jackson cross + +246 +00:22:02,240 --> 00:22:05,360 +-cylinder for power four-cylinder diachrome test + +247 +00:22:05,360 --> 00:22:10,600 +لابد استخدامها لمين؟ للمريض عشان نصل للـ good + +248 +00:22:10,600 --> 00:22:15,140 +fitting for contact lens طبعا هذا الكلام أكيد + +249 +00:22:15,140 --> 00:22:18,960 +بنطبق على باقي العدسات بشكل عام لكن في ال software + +250 +00:22:18,960 --> 00:22:24,530 +أكتر اللي هو حرصاعند إطلاق عدسة توريك لينز عند + +251 +00:22:24,530 --> 00:22:29,490 +إطلاق عدسة توريك لينز يجب أن يكون الوضع مرتبط + +252 +00:22:29,490 --> 00:22:33,270 +بالكورنيال يجب أن يكون مرتبط بالكورنيال يجب أن + +253 +00:22:33,270 --> 00:22:34,030 +يكون مرتبط بالكورنيال يجب أن يكون مرتبط بالكورنيال + +254 +00:22:34,030 --> 00:22:39,890 +يجب + +255 +00:22:39,890 --> 00:22:42,670 +أن يكون مرتبط بالكورنيال يجب أن يكون مرتبط + +256 +00:22:42,670 --> 00:22:44,150 +بالكورنيال يجب أن يكون مرتبط بالكورنيال يجب أن + +257 +00:22:44,150 --> 00:22:44,250 +يكون مرتبط بالكورنيال يجب أن يكون مرتبط بالكورنيال + +258 +00:22:44,250 --> 00:22:45,790 +يجب أن يكون مرتبط بالكورنيال يجب أن يكون مرتبط + +259 +00:22:45,790 --> 00:22:50,530 +بالكورنيال يجب أن يكون مرتبط بالكورنيال يجب أن + +260 +00:22:50,530 --> 00:22:55,790 +يكون مConvert if necessary to minus cylinder form + +261 +00:22:55,790 --> 00:23:01,510 +افرض انا مثلا يجاني شخص من البلاد اللي بيستخدموا + +262 +00:23:01,510 --> 00:23:04,890 +فيها plus cylinder power اول حاجة بدنا نعمل ايه + +263 +00:23:04,890 --> 00:23:07,510 +Transposition نحولها ل minus power + +264 +00:23:11,390 --> 00:23:16,590 +Centration movement بالنسبة للـ lag on up gaze and + +265 +00:23:16,590 --> 00:23:20,810 +version للعدسة should be evaluated لازم انه يتم + +266 +00:23:20,810 --> 00:23:26,880 +التقييمها او تحديدهاin a manner أي بمعنى تقنيك + +267 +00:23:26,880 --> 00:23:32,080 +similar to that for fitting soft spherical lenses + +268 +00:23:32,080 --> 00:23:37,640 +وهذا مماثل لمن؟ للعدسات الـ spherical soft contact + +269 +00:23:37,640 --> 00:23:42,700 +lenses طيب، الآن بتسأل سؤال، تتوقع بالنسبة للـ + +270 +00:23:42,700 --> 00:23:46,820 +fitting الـ soft contact lenses جدّيش أنت بدك + +271 +00:23:46,820 --> 00:23:53,170 +تاخدي أكم جلسة للمريض؟يعني الآن اجى مريض و احنا + +272 +00:23:53,170 --> 00:23:58,310 +اقترحنا انه افضل خيار له ال softer contact lenses + +273 +00:23:58,310 --> 00:24:03,750 +كام جلسة انه هيكون او هناخد ليعطاء العدسة النهائية + +274 +00:24:03,750 --> 00:24:04,730 +لهذا ال patient + +275 +00:24:28,060 --> 00:24:32,220 +another answer طبعا + +276 +00:24:32,220 --> 00:24:36,420 +اول حاجة الجلسة الاولى بدي اعمل عملية adaptation + +277 +00:24:36,420 --> 00:24:40,440 +للعدسة بدي اشوف انه هل المريض عنده motivation + +278 +00:24:40,440 --> 00:24:46,280 +لارتداء عدسة لاصقة soft trick ولا لأ تمام؟ هذه + +279 +00:24:46,280 --> 00:24:51,750 +القضية الاولىطيب ال motivation غير كافي في عدسات + +280 +00:24:51,750 --> 00:24:55,790 +مين ال software contact lenses، البساطة لأنه بيكون + +281 +00:24:55,790 --> 00:24:59,650 +فيه هناك access للعدسة، يعني ممكن مثلا ييجي مريض + +282 +00:24:59,650 --> 00:25:03,230 +يقولك لأ أنا متعود ألبس عدسات لاصقة، هو متعود ع + +283 +00:25:03,230 --> 00:25:07,750 +مين؟على الـ spherical soft contact lens ولكن هو ما + +284 +00:25:07,750 --> 00:25:11,810 +اتعود خاصة هذه انا بتكلم على ال high power سواء + +285 +00:25:11,810 --> 00:25:17,370 +سفير او سيلندر لكن هو لم يتعود على ارتداء العدسات + +286 +00:25:17,370 --> 00:25:22,110 +ال soft direct contact lensesالموضوع التاني وهذا + +287 +00:25:22,110 --> 00:25:25,930 +هو المهم دائما انا يما بدى اعمل fitting لل + +288 +00:25:25,930 --> 00:25:30,090 +software الى contact lenses فاكرين فى ال RGB ممكن + +289 +00:25:30,090 --> 00:25:34,090 +انا ادي عدسة عشوائية صح ولا لا بناء على مين على ال + +290 +00:25:34,090 --> 00:25:37,130 +base curve يعني بمعنى اخر ممكن ال power مايكون + +291 +00:25:37,130 --> 00:25:42,260 +الصح لكن ال base curve صحيح اللى هو كبسكسفيرلكن في + +292 +00:25:42,260 --> 00:25:46,100 +ال software ايش بنفعش الكلام هذا لازم العدسة اللي + +293 +00:25:46,100 --> 00:25:50,440 +هي ال fairest lens اللي انا اديها للمريض مقاربة + +294 +00:25:50,440 --> 00:25:55,060 +لقيمة الاسفير و مقاربة لقيمة السيلندر و الأهم من + +295 +00:25:55,060 --> 00:25:59,810 +التنتين هدول مقاربة لقيمة مين ال axelsيعني بمعنى + +296 +00:25:59,810 --> 00:26:04,630 +اخر المريض عنده access تسعين ماروحش تدقيق قداش + +297 +00:26:04,630 --> 00:26:08,210 +access مية و تلاتين او مية و أربعين ليه؟ لأنه + +298 +00:26:08,210 --> 00:26:12,370 +هيلاحظ انه رؤية مغبشة او مش واضحة بالمرضى عنده + +299 +00:26:12,370 --> 00:26:16,390 +هيقولك لأ انا هذه العدسة بتلاقمنيش او غير مناسبة + +300 +00:26:16,390 --> 00:26:20,570 +هو ممكن عامل adaptation للعدسة لكن وين المشكلة؟ في + +301 +00:26:20,570 --> 00:26:27,650 +موضوع ال access فتقريبا ك rangeلو انت بدك تعمل + +302 +00:26:27,650 --> 00:26:31,350 +good fitting للعدسة من تلاتة لاربع مع التسليم + +303 +00:26:31,350 --> 00:26:36,290 +العدسة يعني بمعنى اخر يما انا بدي ال instructions + +304 +00:26:36,290 --> 00:26:38,810 +الإرشادات لهذا المريض + +305 +00:26:45,710 --> 00:26:49,770 +consideration should be given to the location of + +306 +00:26:49,770 --> 00:26:54,050 +the refractive cylinder دايما بدي احدد قيمة ال + +307 +00:26:54,050 --> 00:26:58,250 +residual astigmatism ال corneal cylinder و ال + +308 +00:26:58,250 --> 00:27:02,790 +manifest refraction لهذا المريضOkay ايضا بعد ذلك + +309 +00:27:02,790 --> 00:27:06,090 +بدي احدد هل هذا ال cylinder من الكورنيا ولا + +310 +00:27:06,090 --> 00:27:10,790 +lenticular حقيقة الآن يعني شغالين مع الدكتور عمر + +311 +00:27:10,790 --> 00:27:14,490 +في موضوع اللي هو عند مين ال most common ك + +312 +00:27:14,490 --> 00:27:18,630 +prevalent في قطاع غزة انه هل هو ال lenticular ولا + +313 +00:27:18,630 --> 00:27:21,950 +الكورنيا ال cylinderطبعا العينة ان شاء الله هي + +314 +00:27:21,950 --> 00:27:26,850 +هتكون تلاتمية حالة لحد الآن خلصنا تقريبا خمسة + +315 +00:27:26,850 --> 00:27:31,270 +واربعين حالة تتفاجأوا ان احنا عندنا في قطاع غزة + +316 +00:27:31,270 --> 00:27:35,810 +الأكتر شيوعا لحد الآن ال lenticular بنتوقف ان شاء + +317 +00:27:35,810 --> 00:27:39,750 +الله ل ال fitting for software contact lenses في + +318 +00:27:39,750 --> 00:27:43,610 +المحاضرة القادمة ان شاء الله بنكمل في هذا الموضوع + +319 +00:27:43,610 --> 00:27:46,790 +في اي سؤال؟ يعطيكم العافية + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/QZITliCZen8_raw.json b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/QZITliCZen8_raw.json new file mode 100644 index 0000000000000000000000000000000000000000..16e568ec637d384df8c9c3b6f79987b4778f1176 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/QZITliCZen8_raw.json @@ -0,0 +1 @@ +{"segments": [{"id": 1, "seek": 4202, "start": 20.92, "end": 42.02, "text": "بسم الله الرحمن الرحيم السلام عليكم ورحمة الله وبركاته ومرحبا لكم جميعا ان شاء الله في المحاضرة هذه هنكمل في موضوع ال design ل ال software contact lenses في عندنا موضوع ال ISO thickness profile ال profile بمعنى shape or pattern تمام؟", "tokens": [3555, 38251, 21984, 34892, 5016, 27842, 34892, 5016, 32640, 21136, 37440, 25894, 24793, 4032, 2288, 35571, 3660, 21984, 4032, 26890, 4117, 9307, 3224, 4032, 29973, 5016, 3555, 995, 5296, 24793, 10874, 2304, 40228, 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Thicker designs offered better orientation يعني الخاتمة أو الاستنتاج من التصاميم المختلفة لهذا النوع من العدسات السفتوريك انه انا كل ما قللت السماكة بكون مريحة لمن؟ للمريض", "tokens": [2278, 22865, 33962, 9307, 46007, 645, 300, 21905, 11347, 632, 1101, 3400, 13, 334, 33804, 11347, 8059, 1101, 14764, 37495, 22653, 33962, 9307, 46007, 34051, 42963, 14851, 29399, 26108, 9154, 16712, 9381, 10943, 32640, 9673, 46456, 46538, 3660, 46740, 15730, 28239, 45367, 9154, 18863, 3215, 3794, 9307, 21136, 5172, 2655, 13063, 1829, 4117, 16472, 3224, 1975, 8315, 28242, 19446, 12174, 1211, 1211, 2655, 21136, 15042, 4117, 3660, 4724, 30544, 3714, 16572, 5016, 3660, 5296, 27842, 22807, 5296, 19528, 16572, 11242], "avg_logprob": -0.1506558612540916, "compression_ratio": 1.5777777777777777, "no_speech_prob": 0.0, "words": [{"start": 266.35, "end": 266.73, "word": "The", "probability": 0.43505859375}, {"start": 266.73, "end": 267.87, "word": " conclusions", "probability": 0.70361328125}, {"start": 267.87, "end": 268.97, "word": " الخاتمة", "probability": 0.9736328125}, {"start": 268.97, "end": 270.19, "word": " were", "probability": 0.56005859375}, {"start": 270.19, "end": 270.73, "word": " that", "probability": 0.9453125}, {"start": 270.73, "end": 271.39, "word": " thinner", "probability": 0.84814453125}, {"start": 271.39, "end": 272.45, "word": " designs", "probability": 0.908203125}, {"start": 272.45, "end": 273.01, "word": " had", "probability": 0.939453125}, {"start": 273.01, "end": 273.39, "word": " better", "probability": 0.8857421875}, {"start": 273.39, "end": 274.25, "word": " comfort.", "probability": 0.9443359375}, {"start": 275.71, "end": 276.11, "word": " Thicker", "probability": 0.7939453125}, {"start": 276.11, "end": 276.85, "word": " designs", "probability": 0.9130859375}, {"start": 276.85, "end": 277.55, "word": " offered", "probability": 0.810546875}, {"start": 277.55, "end": 278.17, "word": " better", "probability": 0.8857421875}, {"start": 278.17, "end": 278.95, "word": " orientation", "probability": 0.92919921875}, {"start": 278.95, "end": 279.71, "word": " يعني", "probability": 0.67626953125}, {"start": 279.71, "end": 280.39, "word": " الخاتمة", "probability": 0.9856770833333334}, {"start": 280.39, "end": 280.97, "word": " أو", "probability": 0.8134765625}, {"start": 280.97, "end": 282.13, "word": " الاستنتاج", "probability": 0.9449462890625}, {"start": 282.13, "end": 282.51, "word": " من", "probability": 0.99169921875}, {"start": 282.51, "end": 283.19, "word": " التصاميم", "probability": 0.9443359375}, {"start": 283.19, "end": 284.35, "word": " المختلفة", "probability": 0.99658203125}, {"start": 284.35, "end": 284.87, "word": " لهذا", "probability": 0.93994140625}, {"start": 284.87, "end": 285.31, "word": " النوع", "probability": 0.9912109375}, {"start": 285.31, "end": 286.07, "word": " من", "probability": 0.98291015625}, {"start": 286.07, "end": 286.89, "word": " العدسات", "probability": 0.9691162109375}, {"start": 286.89, "end": 287.73, "word": " السفتوريك", "probability": 0.7123006184895834}, {"start": 287.73, "end": 288.31, "word": " انه", "probability": 0.528564453125}, {"start": 288.31, "end": 288.55, "word": " انا", "probability": 0.865478515625}, {"start": 288.55, "end": 288.77, "word": " كل", "probability": 0.98779296875}, {"start": 288.77, "end": 288.95, "word": " ما", "probability": 0.81591796875}, {"start": 288.95, "end": 289.59, "word": " قللت", "probability": 0.96826171875}, {"start": 289.59, "end": 290.47, "word": " السماكة", "probability": 0.9383544921875}, {"start": 290.47, "end": 291.19, "word": " بكون", "probability": 0.91455078125}, {"start": 291.19, "end": 291.87, "word": " مريحة", "probability": 0.9757080078125}, {"start": 291.87, "end": 292.31, "word": " لمن؟", "probability": 0.7706705729166666}, {"start": 292.31, "end": 293.17, "word": " للمريض", "probability": 0.9703369140625}], "temperature": 1.0}, {"id": 12, "seek": 31364, "start": 294.1, "end": 313.64, "text": "و ال thick اللي هي السماكة المقصود هنا فيها ال palest تمام؟ او المقصود فيها اللي هو ال thick zone ال thick zone بحدد لأكتر ال orientation يعني هو قادر على تحديد ال direction لمين لل axis", "tokens": [2407, 2423, 5060, 13672, 1829, 39896, 21136, 15042, 4117, 3660, 9673, 4587, 9381, 23328, 34105, 8978, 11296, 2423, 3984, 377, 46811, 10943, 22807, 1975, 2407, 9673, 4587, 9381, 23328, 8978, 11296, 13672, 1829, 31439, 2423, 5060, 6668, 2423, 5060, 6668, 4724, 24401, 3215, 5296, 10721, 4117, 2655, 2288, 2423, 14764, 37495, 22653, 31439, 12174, 18513, 2288, 15844, 6055, 5016, 16254, 3215, 2423, 3513, 32767, 9957, 24976, 10298], "avg_logprob": -0.168772977502907, "compression_ratio": 1.654970760233918, "no_speech_prob": 0.0, "words": [{"start": 294.1, "end": 294.52, "word": "و", "probability": 0.96044921875}, {"start": 294.52, "end": 294.86, "word": " ال", "probability": 0.469482421875}, {"start": 294.86, "end": 295.12, "word": " thick", "probability": 0.5283203125}, {"start": 295.12, "end": 295.42, "word": " اللي", 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0.93505859375}, {"start": 302.68, "end": 302.92, "word": " هو", "probability": 0.9794921875}, {"start": 302.92, "end": 303.1, "word": " ال", "probability": 0.83935546875}, {"start": 303.1, "end": 303.38, "word": " thick", "probability": 0.853515625}, {"start": 303.38, "end": 305.44, "word": " zone", "probability": 0.76171875}, {"start": 305.44, "end": 307.0, "word": " ال", "probability": 0.5234375}, {"start": 307.0, "end": 307.22, "word": " thick", "probability": 0.94189453125}, {"start": 307.22, "end": 307.56, "word": " zone", "probability": 0.95263671875}, {"start": 307.56, "end": 308.28, "word": " بحدد", "probability": 0.93310546875}, {"start": 308.28, "end": 308.86, "word": " لأكتر", "probability": 0.90634765625}, {"start": 308.86, "end": 309.1, "word": " ال", "probability": 0.97607421875}, {"start": 309.1, "end": 309.76, "word": " orientation", "probability": 0.9248046875}, {"start": 309.76, "end": 310.44, "word": " يعني", "probability": 0.822509765625}, {"start": 310.44, "end": 310.68, "word": " هو", "probability": 0.98046875}, {"start": 310.68, "end": 311.2, "word": " قادر", "probability": 0.9943033854166666}, {"start": 311.2, "end": 311.4, "word": " على", "probability": 0.91357421875}, {"start": 311.4, "end": 311.9, "word": " تحديد", "probability": 0.9627685546875}, {"start": 311.9, "end": 312.02, "word": " ال", "probability": 0.98681640625}, {"start": 312.02, "end": 312.46, "word": " direction", "probability": 0.96044921875}, {"start": 312.46, "end": 312.94, "word": " لمين", "probability": 0.822265625}, {"start": 312.94, "end": 313.22, "word": " لل", "probability": 0.67626953125}, {"start": 313.22, "end": 313.64, "word": " axis", "probability": 0.5126953125}], "temperature": 1.0}, {"id": 13, "seek": 33765, "start": 314.53, "end": 337.65, "text": "بشكل اكبر لذلك انت بتلاحظ انه دايما منطقة الثقة اللي وين موجودة موافقة لل access تمام؟ اذا الان لو انا سألتك ايش ال conclusion ل ال different design بساطة ان ال thin zone بتديني better comfort او good comfort ال thick zone بتديني better او good orientation او good direction", "tokens": [3555, 8592, 28820, 1975, 4117, 26890, 5296, 8848, 23275, 16472, 2655, 39894, 15040, 5016, 19913, 16472, 3224, 11778, 47302, 15042, 9154, 9566, 28671, 6024, 104, 28671, 13672, 1829, 4032, 9957, 3714, 29245, 23328, 3660, 3714, 14407, 5172, 28671, 24976, 2105, 46811, 10943, 22807, 1975, 15730, 2423, 7649, 45164, 1975, 8315, 8608, 10721, 1211, 2655, 4117, 1975, 1829, 8592, 2423, 10063, 5296, 2423, 819, 1715, 4724, 3794, 41193, 3660, 16472, 2423, 5862, 6668, 39894, 3215, 9957, 1829, 1101, 3400, 1975, 2407, 665, 3400, 2423, 5060, 6668, 39894, 3215, 9957, 1829, 1101, 1975, 2407, 665, 14764, 1975, 2407, 665, 3513], "avg_logprob": -0.17945076419849587, "compression_ratio": 1.672340425531915, "no_speech_prob": 5.960464477539063e-08, "words": [{"start": 314.53, "end": 314.95, "word": "بشكل", "probability": 0.9345703125}, {"start": 314.95, "end": 315.39, "word": " اكبر", "probability": 0.7901204427083334}, {"start": 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"There were notable junctions on all current tricks يعني هذه متوافقة مع معظم اللي هو التصاميم الحالية current بمعنى present الحالية and stability may be related to palest distribution effects قيمة ال stability للعدسة بتحدد من خلال ايه تأثيرات توزيع اللي هو الثقل يعني هل مثلا", "tokens": [51, 511, 68, 645, 22556, 8156, 3916, 322, 439, 2190, 11733, 37495, 22653, 29538, 44650, 14407, 5172, 28671, 20449, 20449, 19913, 2304, 13672, 1829, 31439, 16712, 9381, 10943, 32640, 21542, 6027, 10632, 2190, 4724, 2304, 3615, 1863, 7578, 1974, 21542, 6027, 10632, 293, 11826, 815, 312, 4077, 281, 3984, 377, 7316, 5065, 12174, 32640, 3660, 2423, 11826, 24976, 22488, 3794, 3660, 39894, 24401, 3215, 9154, 16490, 1211, 6027, 1975, 1829, 3224, 6055, 10721, 12984, 13546, 9307, 33427, 11622, 40228, 13672, 1829, 31439, 6024, 104, 4587, 1211, 37495, 22653, 8032, 1211, 50113, 15040], "avg_logprob": -0.20715725934633644, "compression_ratio": 1.5755102040816327, "no_speech_prob": 0.0, "words": [{"start": 340.45, 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"word": " معظم", "probability": 0.9729817708333334}, {"start": 348.11, "end": 348.31, "word": " اللي", "probability": 0.6800537109375}, {"start": 348.31, "end": 348.49, "word": " هو", "probability": 0.953125}, {"start": 348.49, "end": 349.07, "word": " التصاميم", "probability": 0.9371337890625}, {"start": 349.07, "end": 349.63, "word": " الحالية", "probability": 0.9796549479166666}, {"start": 349.63, "end": 350.23, "word": " current", "probability": 0.67236328125}, {"start": 350.23, "end": 350.89, "word": " بمعنى", "probability": 0.971484375}, {"start": 350.89, "end": 351.49, "word": " present", "probability": 0.7265625}, {"start": 351.49, "end": 352.51, "word": " الحالية", "probability": 0.97509765625}, {"start": 352.51, "end": 353.63, "word": " and", "probability": 0.59765625}, {"start": 353.63, "end": 354.31, "word": " stability", "probability": 0.74462890625}, {"start": 354.31, "end": 354.99, "word": " may", "probability": 0.65234375}, {"start": 354.99, "end": 355.11, "word": " 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"probability": 0.927734375}, {"start": 807.38, "end": 807.74, "word": " ISO", "probability": 0.389892578125}, {"start": 807.74, "end": 808.74, "word": " horizontal", "probability": 0.623046875}, {"start": 808.74, "end": 809.62, "word": " profile", "probability": 0.77294921875}, {"start": 809.62, "end": 810.0, "word": " او", "probability": 0.9873046875}, {"start": 810.0, "end": 810.16, "word": " ال", "probability": 0.908203125}, {"start": 810.16, "end": 810.52, "word": " ISO", "probability": 0.93603515625}, {"start": 810.52, "end": 811.14, "word": " horizontal", "probability": 0.76806640625}, {"start": 811.14, "end": 811.68, "word": " shape", "probability": 0.93212890625}, {"start": 811.68, "end": 812.56, "word": " اعتمد", "probability": 0.9620361328125}, {"start": 812.56, "end": 812.82, "word": " ان", "probability": 0.9453125}, {"start": 812.82, "end": 813.3, "word": " ال", "probability": 0.6357421875}, {"start": 813.3, "end": 813.84, "word": " horizontal", "probability": 0.421142578125}, {"start": 813.84, "end": 814.46, "word": " meridian", "probability": 0.92236328125}, {"start": 814.46, "end": 814.98, "word": " يكون", "probability": 0.97802734375}, {"start": 814.98, "end": 815.3, "word": " نفس", "probability": 0.87841796875}, {"start": 815.3, "end": 815.48, "word": " ال", "probability": 0.87451171875}, {"start": 815.48, "end": 815.74, "word": " thick", "probability": 0.63720703125}, {"start": 815.74, "end": 816.26, "word": " او", "probability": 0.92919921875}, {"start": 816.26, "end": 816.48, "word": " نفس", "probability": 0.9755859375}, {"start": 816.48, "end": 817.14, "word": " السماكة", "probability": 0.9835205078125}], "temperature": 1.0}, {"id": 34, "seek": 85074, "start": 822.08, "end": 850.74, "text": "إذن has the same thickness along the horizontal meridians of the limbs. The thickness profile was designed to smooth over the junctions and offer a more even surface for the eyelid to move over الفرق ما بينهم إيش؟ هان الصفح إيش قال ليه؟ even يعني بمعنى regular و symmetric و أيضا اللي هو uniform", "tokens": [28814, 8848, 1863, 575, 264, 912, 14855, 2051, 264, 12750, 3551, 327, 2567, 295, 264, 29315, 13, 440, 14855, 7964, 390, 4761, 281, 5508, 670, 264, 8156, 3916, 293, 2626, 257, 544, 754, 3753, 337, 264, 39386, 281, 1286, 670, 27188, 2288, 4587, 19446, 49374, 16095, 11933, 1829, 8592, 22807, 8032, 7649, 31767, 5172, 5016, 11933, 1829, 8592, 50239, 32239, 3224, 22807, 754, 37495, 22653, 4724, 2304, 3615, 1863, 7578, 3890, 4032, 32330, 4032, 36632, 11242, 995, 13672, 1829, 31439, 9452], "avg_logprob": -0.18969130370675064, "compression_ratio": 1.4291497975708503, "no_speech_prob": 0.0, "words": [{"start": 822.08, "end": 822.5, "word": "إذن", "probability": 0.44439697265625}, {"start": 822.5, "end": 823.22, "word": " has", "probability": 0.51220703125}, {"start": 823.22, "end": 823.64, "word": " the", "probability": 0.93603515625}, {"start": 823.64, "end": 824.06, "word": " same", "probability": 0.91796875}, {"start": 824.06, "end": 824.86, "word": " thickness", "probability": 0.943359375}, {"start": 824.86, "end": 825.3, "word": " along", "probability": 0.9482421875}, {"start": 825.3, "end": 825.56, "word": " the", "probability": 0.92138671875}, {"start": 825.56, "end": 826.06, "word": " horizontal", "probability": 0.7568359375}, {"start": 826.06, "end": 827.22, "word": " meridians", "probability": 0.9337565104166666}, {"start": 827.22, "end": 827.54, "word": " of", "probability": 0.98046875}, {"start": 827.54, "end": 827.7, "word": " the", "probability": 0.880859375}, {"start": 827.7, "end": 828.0, "word": " limbs.", "probability": 0.96533203125}, {"start": 828.74, "end": 829.32, "word": " The", "probability": 0.4951171875}, {"start": 829.32, "end": 829.82, "word": " thickness", "probability": 0.94384765625}, {"start": 829.82, "end": 830.56, "word": " profile", "probability": 0.4619140625}, {"start": 830.56, "end": 831.5, "word": " was", "probability": 0.96484375}, {"start": 831.5, "end": 832.5, "word": " designed", "probability": 0.86181640625}, {"start": 832.5, "end": 832.96, "word": " to", "probability": 0.97412109375}, {"start": 832.96, "end": 833.58, "word": " smooth", "probability": 0.888671875}, {"start": 833.58, "end": 834.66, "word": " over", "probability": 0.91796875}, {"start": 834.66, "end": 835.16, "word": " the", "probability": 0.9208984375}, {"start": 835.16, "end": 835.86, "word": " junctions", "probability": 0.9169921875}, {"start": 835.86, "end": 836.32, "word": " and", "probability": 0.89306640625}, {"start": 836.32, "end": 836.72, "word": " offer", "probability": 0.9150390625}, {"start": 836.72, "end": 837.0, "word": " a", "probability": 0.97998046875}, {"start": 837.0, "end": 837.28, "word": " more", "probability": 0.9423828125}, {"start": 837.28, "end": 838.02, "word": " even", 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{"start": 843.96, "end": 844.36, "word": " الصفح", "probability": 0.7257486979166666}, {"start": 844.36, "end": 844.6, "word": " إيش", "probability": 0.9371744791666666}, {"start": 844.6, "end": 844.8, "word": " قال", "probability": 0.92724609375}, {"start": 844.8, "end": 845.2, "word": " ليه؟", "probability": 0.9158528645833334}, {"start": 845.2, "end": 845.6, "word": " even", "probability": 0.67041015625}, {"start": 845.6, "end": 846.04, "word": " يعني", "probability": 0.81396484375}, {"start": 846.04, "end": 846.62, "word": " بمعنى", "probability": 0.98525390625}, {"start": 846.62, "end": 847.4, "word": " regular", "probability": 0.955078125}, {"start": 847.4, "end": 847.88, "word": " و", "probability": 0.87646484375}, {"start": 847.88, "end": 848.34, "word": " symmetric", "probability": 0.705078125}, {"start": 848.34, "end": 849.08, "word": " و", "probability": 0.81689453125}, {"start": 849.08, "end": 849.94, "word": " أيضا", "probability": 0.9130859375}, {"start": 849.94, "end": 850.14, "word": " اللي", "probability": 0.884033203125}, {"start": 850.14, "end": 850.36, "word": " هو", "probability": 0.99365234375}, {"start": 850.36, "end": 850.74, "word": " uniform", "probability": 0.96484375}], "temperature": 1.0}, {"id": 35, "seek": 86399, "start": 851.97, "end": 863.99, "text": "تمام؟ لكن في الحالة الأولى كان إيش؟ uneven غير متماثل فصار catch ما بينه و ما بين ال upper island لكن هان كلهيته فقط عملية تدريج", "tokens": [39237, 10943, 22807, 44381, 8978, 21542, 6027, 3660, 16247, 12610, 7578, 25961, 11933, 1829, 8592, 22807, 34022, 32771, 13546, 44650, 2304, 5718, 104, 1211, 6156, 9381, 9640, 3745, 19446, 49374, 3224, 4032, 19446, 49374, 2423, 6597, 6077, 44381, 8032, 7649, 28242, 3224, 36081, 3224, 6156, 47432, 6225, 42213, 10632, 6055, 3215, 16572, 7435], "avg_logprob": -0.17997685681890557, "compression_ratio": 1.3660130718954249, "no_speech_prob": 1.7881393432617188e-07, "words": [{"start": 851.97, "end": 852.87, "word": "تمام؟", "probability": 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{"start": 859.23, "end": 859.51, "word": " بينه", "probability": 0.98583984375}, {"start": 859.51, "end": 859.61, "word": " و", "probability": 0.671875}, {"start": 859.61, "end": 859.65, "word": " ما", "probability": 0.86865234375}, {"start": 859.65, "end": 859.85, "word": " بين", "probability": 0.99365234375}, {"start": 859.85, "end": 859.97, "word": " ال", "probability": 0.9267578125}, {"start": 859.97, "end": 860.21, "word": " upper", "probability": 0.8076171875}, {"start": 860.21, "end": 860.65, "word": " island", "probability": 0.5185546875}, {"start": 860.65, "end": 861.21, "word": " لكن", "probability": 0.69775390625}, {"start": 861.21, "end": 861.53, "word": " هان", "probability": 0.628173828125}, {"start": 861.53, "end": 862.31, "word": " كلهيته", "probability": 0.7208251953125}, {"start": 862.31, "end": 862.87, "word": " فقط", "probability": 0.989501953125}, {"start": 862.87, "end": 863.37, "word": " عملية", "probability": 0.9680989583333334}, {"start": 863.37, "end": 863.99, "word": " تدريج", "probability": 0.9942626953125}], "temperature": 1.0}, {"id": 36, "seek": 88233, "start": 865.31, "end": 882.33, "text": "واضح الفكرة؟ يعني بمعنى آخر إنه هان في الحالة التانية الـ Iso-Horizontal Eprofile مش هيحدث أي تماسك أو أي تكاتش ما بين العدسة أو ال other part للعدسة و ال other eyelid", "tokens": [2407, 46958, 5016, 27188, 4117, 25720, 22807, 37495, 22653, 4724, 2304, 3615, 1863, 7578, 19753, 34740, 36145, 3224, 8032, 7649, 8978, 21542, 6027, 3660, 16712, 7649, 10632, 2423, 39184, 286, 539, 12, 39, 284, 590, 896, 304, 9970, 340, 69, 794, 37893, 39896, 24401, 12984, 36632, 6055, 15042, 3794, 4117, 34051, 36632, 6055, 4117, 9307, 8592, 19446, 49374, 18863, 3215, 3794, 3660, 34051, 2423, 661, 644, 24976, 22488, 3794, 3660, 4032, 2423, 661, 39386], "avg_logprob": -0.23312500715255738, "compression_ratio": 1.458100558659218, "no_speech_prob": 5.960464477539063e-08, "words": [{"start": 865.31, "end": 865.65, "word": "واضح", "probability": 0.9832356770833334}, {"start": 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"end": 872.45, "word": " Eprofile", "probability": 0.572052001953125}, {"start": 872.45, "end": 873.15, "word": " مش", "probability": 0.65185546875}, {"start": 873.15, "end": 873.87, "word": " هيحدث", "probability": 0.9539388020833334}, {"start": 873.87, "end": 874.19, "word": " أي", "probability": 0.7470703125}, {"start": 874.19, "end": 875.65, "word": " تماسك", "probability": 0.9073486328125}, {"start": 875.65, "end": 875.97, "word": " أو", "probability": 0.93505859375}, {"start": 875.97, "end": 876.23, "word": " أي", "probability": 0.7958984375}, {"start": 876.23, "end": 877.07, "word": " تكاتش", "probability": 0.72454833984375}, {"start": 877.07, "end": 877.55, "word": " ما", "probability": 0.9384765625}, {"start": 877.55, "end": 877.97, "word": " بين", "probability": 0.99560546875}, {"start": 877.97, "end": 879.45, "word": " العدسة", "probability": 0.9698486328125}, {"start": 879.45, "end": 879.73, "word": " أو", "probability": 0.9462890625}, {"start": 879.73, "end": 879.89, "word": " ال", "probability": 0.96533203125}, {"start": 879.89, "end": 880.11, "word": " other", "probability": 0.392578125}, {"start": 880.11, "end": 880.51, "word": " part", "probability": 0.943359375}, {"start": 880.51, "end": 881.33, "word": " للعدسة", "probability": 0.95068359375}, {"start": 881.33, "end": 881.51, "word": " و", "probability": 0.467529296875}, {"start": 881.51, "end": 881.61, "word": " ال", "probability": 0.94970703125}, {"start": 881.61, "end": 881.89, "word": " other", "probability": 0.9072265625}, {"start": 881.89, "end": 882.33, "word": " eyelid", "probability": 0.873046875}], "temperature": 1.0}, {"id": 37, "seek": 92371, "start": 896.11, "end": 923.71, "text": "لو لعبته في ال horizontal او ال ISO horizontal profile انه كان ال .. ال .. التوزيع الثقل متساوي وين؟ في كل أزاء العدسة صح ولا لأ؟ يعني شفنا مية و خمسين، مية و ستة و خمسين، متين و تلاتين يعني بتديني احق انه ايه؟ the prism palest is wide بمعنى انه متنوع او مختلف صح ولا لأ؟", "tokens": [1211, 2407, 5296, 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احنا عندنا في قطاع غزة الأكتر شيوعا لحد الآن ال lenticular بنتوقف ان شاء الله ل ال fitting for software contact lenses في المحاضرة القادمة ان شاء الله بنكمل في هذا الموضوع في اي سؤال؟ يعطيكم العافية", "tokens": [9566, 3555, 3615, 995, 18863, 9957, 3660, 16472, 13412, 16606, 21984, 39896, 8032, 2655, 30544, 6055, 1211, 9307, 2304, 10632, 11331, 6027, 3660, 5296, 24401, 6024, 48506, 16490, 1211, 9381, 8315, 6055, 4587, 16572, 3555, 995, 16490, 2304, 3794, 3660, 4032, 9640, 3555, 3615, 9957, 11331, 6027, 3660, 6055, 2655, 5172, 26108, 10721, 14407, 16472, 1975, 5016, 8315, 43242, 8315, 8978, 12174, 9566, 45761, 32771, 11622, 3660, 16247, 4117, 2655, 2288, 13412, 1829, 45367, 995, 5296, 24401, 6024, 48506, 2423, 23556, 14646, 44945, 2655, 30543, 5172, 16472, 13412, 16606, 21984, 5296, 2423, 15669, 337, 4722, 3385, 18059, 8978, 9673, 5016, 46958, 25720, 25062, 18513, 46007, 16472, 13412, 16606, 21984, 44945, 24793, 1211, 8978, 23758, 9673, 2407, 11242, 45367, 8978, 1975, 1829, 8608, 33604, 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a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/YZZ_de8tRBA_postprocess.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/YZZ_de8tRBA_postprocess.srt new file mode 100644 index 0000000000000000000000000000000000000000..cd9facdfd290852c6d40a32432752e54a800755e --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/YZZ_de8tRBA_postprocess.srt @@ -0,0 +1,1948 @@ +1 +00:00:20,960 --> 00:00:23,580 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:23,580 --> 00:00:29,340 +وبركاته ومرحبا لكم جميعا في المحاضرة السابقة + +3 +00:00:29,340 --> 00:00:32,880 +اتناولنا موضوع ال بيجي باق contact lens system + +4 +00:00:32,880 --> 00:00:38,360 +وقلنا هي عبارة عن نظام بتكون من عدستين العدسة + +5 +00:00:38,360 --> 00:00:42,380 +الأولى هي عبارة عن RGB اللي هي بتكون في ال center + +6 +00:00:42,380 --> 00:00:47,360 +في المنتصف ال diameter لهذه العدسة بيكون من 8.5 ل + +7 +00:00:47,360 --> 00:00:52,740 +9.5 ميلي متر وقد يكون مختلفحسب اللي هو ال patient + +8 +00:00:52,740 --> 00:00:57,400 +وحسب ال fitting اللي بتم إجراءه للمريض الهدف من + +9 +00:00:57,400 --> 00:01:01,440 +ذلك اللي هو توفير ال stability و ال concentration + +10 +00:01:01,440 --> 00:01:07,460 +ل ال patient بشكل صحيح او ل العدسة ايضا توفير رؤية + +11 +00:01:07,460 --> 00:01:12,460 +مفيدة للمريض بينما ال soft contact lens بتكون في + +12 +00:01:12,460 --> 00:01:16,180 +الأطراف و ال diameter لها تكون تقريبا 14.5 ميلي + +13 +00:01:16,180 --> 00:01:21,350 +متر و ممكن اللي هو بيختلف حسبالـ Bulbiparal Fisher + +14 +00:01:21,350 --> 00:01:24,730 +بالنسبة للمريض أو الـ Horizontal أو ال Cornial + +15 +00:01:24,730 --> 00:01:27,850 +Diameter أو بنسميه الـ Horizontal Visible Iris + +16 +00:01:27,850 --> 00:01:31,690 +Diameter الهدف من الـ Soft Contact Lens اللي هو + +17 +00:01:31,690 --> 00:01:36,090 +توفير من الـ comfortable الراحة بالنسبة للمريض + +18 +00:01:38,820 --> 00:01:44,280 +الـ Indications دواعي الاستخدام للعدسات ال بيجي + +19 +00:01:44,280 --> 00:01:48,640 +باك contact lens system number one post-operative + +20 +00:01:48,640 --> 00:01:54,960 +corneal keratoplasty يعني أي مريض بيقبل على عملية + +21 +00:01:54,960 --> 00:02:00,120 +ال corneal transplantation زراعة قرانية او ال + +22 +00:02:00,120 --> 00:02:05,890 +corneal keratoplasty ممكن معه انه نحتاج ايه؟نحتاج + +23 +00:02:05,890 --> 00:02:10,290 +اللي هو عدسة اللي بيجي بها contact lens طبعا الهدف + +24 +00:02:10,290 --> 00:02:14,970 +من ذلك زي ما احنا اتفقنا ان ال optics لال RGB انه + +25 +00:02:14,970 --> 00:02:19,750 +بتعمل new surface لمين؟ للكورنيةأيضا في حالات + +26 +00:02:19,750 --> 00:02:24,830 +الأفاكيا ال absence of the crystalline lens في + +27 +00:02:24,830 --> 00:02:28,310 +حالات الكراتوكونس ال non inflammatory pathology + +28 +00:02:28,310 --> 00:02:31,350 +that can cause ectasia or protrusion for + +29 +00:02:31,350 --> 00:02:36,470 +substantia propria or for stroma أيضا في حالات ال + +30 +00:02:36,470 --> 00:02:40,890 +traumatic induced irregular astigmatism دايما أي + +31 +00:02:40,890 --> 00:02:45,730 +مريض عنده irregularity في ال surface لال كورنية + +32 +00:02:46,440 --> 00:02:51,000 +بحاول إنه أستخدم معه ال RGB contact lens أو اللي + +33 +00:02:51,000 --> 00:02:55,420 +هو فيه طرق علاج أخرى زي مثلا ال rings أو اللي + +34 +00:02:55,420 --> 00:02:59,420 +بنسميها ال intact rings أو اللي هي ال cross + +35 +00:02:59,420 --> 00:03:05,380 +linking تمام المشاكل لهذا النظام ال problems with + +36 +00:03:05,380 --> 00:03:10,000 +the system inability to center the rigid lens طب + +37 +00:03:10,000 --> 00:03:10,920 +إيش السبب؟ + +38 +00:03:13,170 --> 00:03:18,670 +إذا عدم القدرة على تمركز العدسة ال RGB دايما ليش + +39 +00:03:18,670 --> 00:03:27,430 +بيكون صعوبة في عملية التمركز ال RGB؟ فضلا طيب + +40 +00:03:27,430 --> 00:03:31,290 +سبب آخر من ضمن الأسباب اللي هو بتكون ال small + +41 +00:03:31,290 --> 00:03:41,170 +diameter كلام صليم عفوا لأ + +42 +00:03:41,280 --> 00:03:45,620 +هي فقط لل center صح ولا لأ؟ يعني هي ال diameter + +43 +00:03:45,620 --> 00:03:49,680 +بتاعها ما هيصل للأطراف لأن الأطراف هتكون عبارة عن + +44 +00:03:49,680 --> 00:03:54,120 +soft contact lens السبب الآخر يا جماعة هي ما يكون + +45 +00:03:54,120 --> 00:03:59,160 +عنده مثلا hand أربع و أربعين و نفترض hand اتنين و + +46 +00:03:59,160 --> 00:04:03,600 +أربعين لأ في عندنا hand ايش with the rule of + +47 +00:04:03,600 --> 00:04:10,760 +stigmatism او أربع و أربعينوهن اتنين واربعين زي + +48 +00:04:10,760 --> 00:04:15,020 +مثلا ال against the rule of stigmatism اذا ال with + +49 +00:04:15,020 --> 00:04:17,840 +the rule او ال against the rule of stigmatism + +50 +00:04:17,840 --> 00:04:24,130 +بيعمل ايه؟ دي center اذاحة باتجاه مين؟باتجاه + +51 +00:04:24,130 --> 00:04:28,930 +المنطقة اللي بتكون flat، الأكتر flat فهان العدسة + +52 +00:04:28,930 --> 00:04:33,350 +هيكون فيه هناك صعوبة لمين للتمركز فيها، لذلك الآن + +53 +00:04:33,350 --> 00:04:37,390 +لو اجالك شخص عنده with a rule of stigmatism أو + +54 +00:04:37,390 --> 00:04:40,830 +against a rule of stigmatism، مين الأفضل أديه RGB + +55 +00:04:40,830 --> 00:04:44,920 +ولا software contact lens؟الـ software الـ contact + +56 +00:04:44,920 --> 00:04:50,040 +lens لأن ال RGB بتعمل إيه؟ Decentration إزاحة سواء + +57 +00:04:50,040 --> 00:04:54,340 +إما بتكون temporarily أو نازلة أو up أو down تمام + +58 +00:04:54,340 --> 00:04:58,440 +فهي نفس الفكرة إنه في حالة ال بيجي باك contact + +59 +00:04:58,440 --> 00:05:02,680 +lens من مشاكلها إنه بيكون هناك صعوبة في عملية + +60 +00:05:02,680 --> 00:05:08,880 +تمركز من العدسة ال RGBnumber two inability to + +61 +00:05:08,880 --> 00:05:14,180 +handle the combination of the lenses واحدة فيهم + +62 +00:05:14,180 --> 00:05:18,700 +hard والتانية soft فالمريض بيشعر انه ايه في هناك + +63 +00:05:18,700 --> 00:05:24,090 +صعوبة في عملية اللي هو ايهلبس العدسة او في عملية + +64 +00:05:24,090 --> 00:05:28,550 +مثلا التنظيف او في عملية التخزين للعدسة يعني ممكن + +65 +00:05:28,550 --> 00:05:33,310 +زي ما انت تمسك عدسة hard و at the same time تمسك + +66 +00:05:33,310 --> 00:05:38,370 +عدسة soft فهناك شعور ان واحدة نعمة و واحدة hard + +67 +00:05:38,370 --> 00:05:44,510 +صلبةNumber three confusion over rigid and soft + +68 +00:05:44,510 --> 00:05:49,930 +cleaning and soaking solutions دايما محليل التنظيف + +69 +00:05:49,930 --> 00:05:54,830 +ومحليل التخزين بالنسبة للعدسات الصلبة او العدسات + +70 +00:05:54,830 --> 00:05:59,670 +النعمة هي تعتبر مختلفة صح ولا لا فممكن مثلا المريض + +71 +00:05:59,670 --> 00:06:06,250 +خربط يستخدممحلول ال RGB لل soft والعكس صحيح وهنا + +72 +00:06:06,250 --> 00:06:09,050 +دايما في ال contact lens اي كتاب في ال contact + +73 +00:06:09,050 --> 00:06:18,370 +lens بتقرأيه في حاجة اسمها ال benefit to cost ايش + +74 +00:06:18,370 --> 00:06:22,330 +معناها ال benefit to cost؟ اي كتاب في ال contact + +75 +00:06:22,330 --> 00:06:26,130 +lenses بكتبلك هذه الجملة او هذه الكلمتين benefit + +76 +00:06:26,130 --> 00:06:31,510 +to costالان احنا بنعرف ان في حاجة اسمها ال ideal + +77 +00:06:31,510 --> 00:06:35,830 +optical case for contact lens يعني ايش هو ال best + +78 +00:06:35,830 --> 00:06:41,230 +option لرقد او ايش ال best option لنورمثال مثلا + +79 +00:06:41,230 --> 00:06:45,730 +مريض بصل ال visual acuity عنده 6 ع 12 تمام؟ + +80 +00:06:45,730 --> 00:06:48,930 +philosophical soft contact lens تسأله لا إيش + +81 +00:06:48,930 --> 00:06:52,410 +الغرض؟ بقولك والله أنا بس بلبس العدسة اللي لها ثقة + +82 +00:06:52,410 --> 00:06:57,610 +ل ceremony أو ل مثلا party معين أو مثلا يمروا على + +83 +00:06:57,610 --> 00:07:02,230 +الجامعة إذا الغرض إيش ماله؟ محدود طيب في ال + +84 +00:07:02,230 --> 00:07:06,630 +software ال contact lens ال 6 ع 12 ممكن تصل 6 ع 9 + +85 +00:07:06,630 --> 00:07:13,100 +plus أو 6 ع 6 تمام؟إذا في هذه الحالة استخدامها + +86 +00:07:13,100 --> 00:07:17,340 +محدود دي الـ spherical soft contact lens ولا دي ال + +87 +00:07:17,340 --> 00:07:23,340 +soft contact lens؟ إيش رأيكم؟ ليش طيب؟ أديته ال + +88 +00:07:23,340 --> 00:07:29,270 +spherical soft contact lens، why؟بالضبط موضوع انه + +89 +00:07:29,270 --> 00:07:33,530 +انا والله استخدامها محدود العدسة اربع ساعات تعرفوا + +90 +00:07:33,530 --> 00:07:36,690 +انتوا الآن يعني بدنا نجيبها اللي هو كسعر ال + +91 +00:07:36,690 --> 00:07:40,450 +spherical soft contact lens اذا كانت ثانوية سعر + +92 +00:07:40,450 --> 00:07:43,690 +اللي هو ال two pair حوالي اللي هو مية و خمسين شكل + +93 +00:07:43,690 --> 00:07:47,270 +بينما ال soft trick ال two pair حوالي اللي هو + +94 +00:07:47,270 --> 00:07:51,900 +ستمائة شكللما تحكي للمريض انه فيه اختلاف سطر او + +95 +00:07:51,900 --> 00:07:56,780 +سطرين بسعر برقم هذا حيكون ايش فيه حاجة بنسميها ال + +96 +00:07:56,780 --> 00:08:00,340 +benefit to cost و لو كانت على حساب مين ال quality + +97 +00:08:00,340 --> 00:08:04,220 +of vision تمام؟ هذه الحالة اشتغلناها هي عبارة عن + +98 +00:08:04,220 --> 00:08:08,140 +piggyback contact lens حالة keratoconus طبعا كانت + +99 +00:08:08,140 --> 00:08:12,310 +اللي هو ال centerطبعا هذه قبل حوالي سنتين اول ما + +100 +00:08:12,310 --> 00:08:18,070 +رجعنا على البلد كان اللي هو ال center هو عبارة عن + +101 +00:08:18,070 --> 00:08:23,150 +RGB contact lens و ال peripheral كانت ايه؟ اللي + +102 +00:08:23,150 --> 00:08:26,410 +عبارة عن soft contact lens طبعا مشكلة العدسة هذه + +103 +00:08:26,410 --> 00:08:29,630 +لحد الآن بعمل follow up مع المريض انه عنده دايما + +104 +00:08:29,630 --> 00:08:33,970 +irritation كبير لاحظين ال conjunctival redness عند + +105 +00:08:33,970 --> 00:08:39,090 +المريض بشكل اللي هو كبيرفكان أمامي هو عنده ال + +106 +00:08:39,090 --> 00:08:43,150 +regular surface للكورنية عنده حوالي steep كورنية + +107 +00:08:43,150 --> 00:08:48,790 +اربع و خمسين ديوبتر واضحةعنده اللي هو with a rule + +108 +00:08:48,790 --> 00:08:53,630 +of stigmatism عاملة العدسة ال RGB دي center وانا + +109 +00:08:53,630 --> 00:08:58,110 +متفهم هذا الموضوع لكن هان يعني زي بنرجع لمثال ال + +110 +00:08:58,110 --> 00:09:01,770 +benefit to cost انه موضوع لو انا بدى استخدم معه ال + +111 +00:09:01,770 --> 00:09:05,750 +software ال contact lens هيكون ايش مش قادرة انه + +112 +00:09:05,750 --> 00:09:10,580 +تغطي اللي هو ال cornial cylinder بشكل كاملفانا + +113 +00:09:10,580 --> 00:09:14,780 +اضطريت ان ودي RGB عشان اعمل a new surface للكورنية + +114 +00:09:14,780 --> 00:09:18,900 +و الأطراف ان تكون عبارة عن مين ال soft العادية + +115 +00:09:18,900 --> 00:09:23,340 +عشان اخفف اللي هو ال irritation التهيوج بدا اسمع + +116 +00:09:23,340 --> 00:09:29,560 +منكم هل يعني انتوا accepted لهذا الموضوع ولا كيف؟ + +117 +00:09:30,760 --> 00:09:34,960 +الان متفاهمين الحالة، الحالة عندها اربعة و خمسين + +118 +00:09:34,960 --> 00:09:39,140 +ديوبتر على محور يعني في عندها steep cornea و + +119 +00:09:39,140 --> 00:09:42,340 +الذرول أستيجماتيزم انا اديتها بيجي بقى contact + +120 +00:09:42,340 --> 00:09:46,280 +lens معناه الكلام ان ال center الأطراف soft و بال + +121 +00:09:46,280 --> 00:09:52,060 +center كانت اللي هو ال RGB فإيش رأيكم في الموضوع؟ + +122 +00:09:58,520 --> 00:10:01,900 +الكلام مائة في المائة صحيح وهذه انا ايش عملت في + +123 +00:10:01,900 --> 00:10:06,640 +الحالة هذه؟ روحت قللت من ال edge lift جللت منه + +124 +00:10:06,640 --> 00:10:10,960 +شوية فصار اللي هو ال decentralization اتعودالكلام + +125 +00:10:10,960 --> 00:10:14,340 +يعني رائع مية في المية الان ال with the rule of + +126 +00:10:14,340 --> 00:10:17,340 +stigmatism ال decentralization هيكون كيف؟ up و + +127 +00:10:17,340 --> 00:10:21,200 +down اقل من مين؟ من ال against the rule ال against + +128 +00:10:21,200 --> 00:10:24,440 +the rule بتلاحظ ان كل العدسة بتميل اما نازلي او + +129 +00:10:24,440 --> 00:10:28,600 +temporarily تمام فهنا في هذه الحالة بتقلل من اطراف + +130 +00:10:28,600 --> 00:10:32,400 +العدسة ال RGB يعني بتقلل ال diameter بيصير عندك + +131 +00:10:32,400 --> 00:10:36,440 +اللي هو الأمر بيقلل لكن مش مية في المية من ناحية + +132 +00:10:36,440 --> 00:10:39,780 +ال decentralization تمام؟ + +133 +00:10:42,350 --> 00:10:45,590 +عنا ال orthocarotology، مين بتعرف ال + +134 +00:10:45,590 --> 00:10:50,530 +orthocarotology؟ العدسات هذه؟ بالضبط، هي بنسميها + +135 +00:10:50,530 --> 00:10:55,690 +ال dreams lenses فعنا ال dreams lenses اللي هي + +136 +00:10:55,690 --> 00:10:59,250 +عبارة عن عدسات الأحلام و ال another name اليوم + +137 +00:10:59,250 --> 00:11:05,990 +بيسموها ortho .. ممتازة .. k lenses + +138 +00:11:07,240 --> 00:11:12,600 +من اسمها هذا النوع من العدسات بتعمل reshape او + +139 +00:11:12,600 --> 00:11:18,920 +remolded اي بمعنى اعادة تشكيل القرنية، اذا بتعمل + +140 +00:11:18,920 --> 00:11:25,380 +reshape او + +141 +00:11:25,380 --> 00:11:28,740 +remolded + +142 +00:11:28,740 --> 00:11:34,090 +لمين؟ للانتريور surface of the corneaطيب، مدام هي + +143 +00:11:34,090 --> 00:11:39,410 +بتعمل إعادة تشكيل لسطح القرنية، بتتوقع هي بتستخدم + +144 +00:11:39,410 --> 00:11:43,730 +مع الميوب ولا ال hypermetrope؟ مع الميوب، ليش؟ + +145 +00:11:43,730 --> 00:11:49,130 +لأنه ببساطة انه .. لكن هذا الأمر يعني الآن احنا مع + +146 +00:11:49,130 --> 00:11:53,270 +طالبات اللي هو في بحث التخرج، هنثبت العكس اعتقد، + +147 +00:11:53,270 --> 00:11:58,090 +الميوب هوانه في الدراسات السابقة بنعرف ان الشخص + +148 +00:11:58,090 --> 00:12:02,250 +لما يكون ميوب بيكون عنده steep cornea كلام سليم + +149 +00:12:02,250 --> 00:12:06,850 +لكن هذا الأمر يعني الآن هي .. في دراسة بيقولك لأ + +150 +00:12:06,850 --> 00:12:09,570 +انه there is no significant مافيش significant + +151 +00:12:09,570 --> 00:12:14,270 +association ما بينهم نرجع لموضوع لمرة تانية يعني + +152 +00:12:14,270 --> 00:12:18,370 +انا بدي اصل لكم لمعلومة انه دايما مش كل معلومة في + +153 +00:12:18,370 --> 00:12:21,110 +الكتاب هي مية في المية دقيقة يمكن تكون عندنا + +154 +00:12:21,110 --> 00:12:25,620 +مختلفةفاحنا يا جماعة ال Orthocarotology او لـ + +155 +00:12:25,620 --> 00:12:29,280 +Dreams Lenses الهدف منها إعادة تشكيل القرنية + +156 +00:12:29,280 --> 00:12:34,200 +للأشخاص اللي بيكونوا ايه؟ ميوب، okay؟ ليش ميوب؟ + +157 +00:12:34,200 --> 00:12:37,740 +لأنه بيكون عنده steep cornea يعني قيمة الديوبتريك + +158 +00:12:37,740 --> 00:12:41,740 +باور بيفترض انه اعلى من ال normal range يعني اعلى + +159 +00:12:41,740 --> 00:12:45,580 +من اتنين واربعين او تلاتة واربعين لو افترض معها هي + +160 +00:12:45,580 --> 00:12:51,500 +ال normal rangeإذن Orthokeratology or + +161 +00:12:51,500 --> 00:12:56,120 +Orthokeratosis has been advanced a system for + +162 +00:12:56,120 --> 00:13:00,960 +sight without glasses يعني هي بتوفرلك رؤية sight + +163 +00:13:00,960 --> 00:13:06,440 +يعني بمعنى vision بدون استخدام لمين؟ للنضارة، ما + +164 +00:13:06,440 --> 00:13:09,980 +بحتاج إن المريض يلبس نضارة أو عدسة لاصقة + +165 +00:13:14,250 --> 00:13:18,650 +The premise أو بمعنى the principle، المبدأ، إيش + +166 +00:13:18,650 --> 00:13:24,930 +مبدأ هذه العدسة؟ The premise behind the system is + +167 +00:13:24,930 --> 00:13:29,590 +that progressive flattening of the cornea، إذا + +168 +00:13:29,590 --> 00:13:35,690 +بتعمل عملية تسطيح لسطح القرنيةThrough the use of a + +169 +00:13:35,690 --> 00:13:39,770 +series of flatter-fitting lenses will eliminate + +170 +00:13:39,770 --> 00:13:45,050 +myopia.إذن بتعمل تسطيح لسطح القرنية من خلال + +171 +00:13:45,050 --> 00:13:50,370 +استخدام مجموعة من العدسات واضحة؟ وهذه إيش بتعمل + +172 +00:13:50,370 --> 00:13:52,150 +بالزيل الميوبيا + +173 +00:13:57,250 --> 00:14:01,270 +The degree of flattening درجة اللي هو التصطيح هذه + +174 +00:14:01,270 --> 00:14:06,660 +must be uniformاحنا بنعرف ان الميوب هو يعتبر ايه + +175 +00:14:06,660 --> 00:14:11,060 +دي focus او يعتبر low order aberration يعني في + +176 +00:14:11,060 --> 00:14:15,620 +عنده سفير كورنية صحيح يعني بمعنى اخر ان كل ال + +177 +00:14:15,620 --> 00:14:19,960 +power متساوي في كل المحاور فالان انا ما بدى استخدم + +178 +00:14:19,960 --> 00:14:24,580 +هذا النوع من العدسات لازم انه تعمل تسطيح لايه لكل + +179 +00:14:24,580 --> 00:14:30,240 +سطح القرنية اذا uniform بمعنى regular بشكل منتظم + +180 +00:14:31,490 --> 00:14:35,950 +إذا التصطيح هذا must be uniform in all meridians + +181 +00:14:35,950 --> 00:14:41,490 +but this is not always the case and many cases + +182 +00:14:41,490 --> 00:14:46,610 +resulting in atoric cornea طيب الآن الزيادة في + +183 +00:14:46,610 --> 00:14:50,010 +استخدام هذا النوع من العدسات ممكن يديني نتيجة + +184 +00:14:50,010 --> 00:14:54,410 +عكسية زي الآن مريض عنده إيزوترابيا بعد العملية صار + +185 +00:14:54,410 --> 00:15:00,290 +إيش؟ إكزوترابيا راح الجراح إيش عمل؟عمل اللي هو + +186 +00:15:00,290 --> 00:15:04,350 +كأنه universally يعني جلب اللي هو حالة المريض فهان + +187 +00:15:04,350 --> 00:15:08,450 +الكترة من استخدام هذا النوع من العدسات ممكن يؤدي + +188 +00:15:08,450 --> 00:15:14,030 +إلى شيء عكسي اللي هو يعمل ترك كورنية عند المريض + +189 +00:15:14,030 --> 00:15:15,070 +واضحة؟ + +190 +00:15:19,280 --> 00:15:23,560 +طيب ال method هذا وين بيستخدم؟ الآن مثلا إنسان + +191 +00:15:23,560 --> 00:15:28,940 +pilot طيار هل بتتوقع إن هذا الشخص بيقدر يلبس عدا + +192 +00:15:28,940 --> 00:15:33,160 +سلاسقة أو يلبس نضارة؟ ممنوع طيب عنده refractive + +193 +00:15:33,160 --> 00:15:37,320 +error إذا ممكن إحنا نستخدم معه إيش ال + +194 +00:15:37,320 --> 00:15:42,280 +orthochiratology إنسان مثلا football player لاعب + +195 +00:15:42,280 --> 00:15:46,710 +كرة قدمطبعا ممكن يلبس soft contact lens لكن مش + +196 +00:15:46,710 --> 00:15:50,650 +حابب أثناء المباراة يلبس العدسة ممكن اللي هو + +197 +00:15:50,650 --> 00:15:55,170 +نستخدم معه ال orthokeratology أو مثلا في ال fire + +198 +00:15:55,170 --> 00:16:00,610 +fighters رجال الأطفاء أو ال policeman and ال + +199 +00:16:00,610 --> 00:16:04,690 +swimmers كل هدول الأشخاص ممكن أنه نستخدم معهم هذا + +200 +00:16:04,690 --> 00:16:09,630 +النوع من العدساتwho require good vision but cannot + +201 +00:16:09,630 --> 00:16:14,510 +wear contact lens يعني هتعمل على تحسين حالة المريض + +202 +00:16:14,510 --> 00:16:19,170 +لكن مش هيظلوا لابس العدسة بالضبط يعني بلبسها في + +203 +00:16:19,170 --> 00:16:23,910 +الليل و بنام فيها بس okay بعد ذلك هتعمله ايش + +204 +00:16:23,910 --> 00:16:26,830 +improvement ل ال visual acuity + +205 +00:16:30,460 --> 00:16:34,100 +طبعا هذا ال method شبهوه كأنه عبارة عن ايه؟ + +206 +00:16:34,100 --> 00:16:39,660 +surgical procedure يعني كأنه عملية للكورنية عشان + +207 +00:16:39,660 --> 00:16:44,420 +تصلح من الامترابيا او الميابيا يعني ممكن تكتب بين + +208 +00:16:44,420 --> 00:16:49,640 +جثين عشان تعمل flattening لل surface of the cornea + +209 +00:16:49,640 --> 00:16:53,780 +اذا الان لو سألتك السؤال ايش ال main objective ل + +210 +00:16:53,780 --> 00:16:58,480 +ال orthokeratology lenses of the cornea؟ + +211 +00:17:01,800 --> 00:17:07,860 +أورثو كيراتولوجيا فيتينج سيطس هم مستعملين و مصنعين + +212 +00:17:07,860 --> 00:17:14,500 +قبل قليل من ال RGB لنزل تقريبا 370 لنزل بعض من ال + +213 +00:17:14,500 --> 00:17:18,160 +update لهذا النوع من العدسات طبعا هي مش موجودة + +214 +00:17:18,160 --> 00:17:24,620 +عندناانه صاروا يستخدموا RGB طبعا هي طبيعة العدسة + +215 +00:17:24,620 --> 00:17:28,480 +semisqueral design وهي soft contact lens الآن + +216 +00:17:28,480 --> 00:17:33,040 +البعض صار يستخدم RGB ولكن لها مشاكل انتوا عارفينها + +217 +00:17:33,040 --> 00:17:36,180 +اللي هي عبارة عن ال disadvantage الزمين لل RGB + +218 +00:17:36,180 --> 00:17:40,460 +contact lenses طبعا بيكون انا هشوفكم إياها ان شاء + +219 +00:17:40,460 --> 00:17:43,920 +الله في المعمل لكن المشكلة انه احنا مابنستخدم هذا + +220 +00:17:43,920 --> 00:17:47,280 +النوع من العدسات الا في الأبحاث لان المريض لازم + +221 +00:17:47,280 --> 00:17:51,920 +ينام فيهايعني لو استخدمناها في المعمل انه هيكون + +222 +00:17:51,920 --> 00:17:56,340 +useless بدون فائدة okay فبتيجي هي حوالي انه + +223 +00:17:56,340 --> 00:18:00,400 +تلاتمية و سبعين عدسة انه pair اللي هو كزوج من + +224 +00:18:00,400 --> 00:18:01,260 +العدسات + +225 +00:18:04,350 --> 00:18:09,950 +the lenses are reassessed every six weeks اذا كل + +226 +00:18:09,950 --> 00:18:14,370 +ستة سابق انا بدي اعمل اعادة تقييم او اعادة اللي هو + +227 +00:18:14,370 --> 00:18:20,230 +ايه investigation تحقق من هذا النوع من العدسات طيب + +228 +00:18:20,230 --> 00:18:24,250 +فكركم وين هذي ممكن انا يعني ايش ال indication لها + +229 +00:18:24,250 --> 00:18:28,890 +يعني متى انا بقدر استخدم هذا النوع لأي شخص ممكن + +230 +00:18:28,890 --> 00:18:36,200 +استخدمهالأ انا افترض مثلا انسان مدرس جامعي او + +231 +00:18:36,200 --> 00:18:40,320 +نفترض مثلا officer او مهندس ممكن استخدم معاه هذا + +232 +00:18:40,320 --> 00:18:46,310 +النوع من العدسات ولا لا؟لأ بس يعني انه بعد فترة + +233 +00:18:46,310 --> 00:18:50,090 +مابتش يستخدم عجزات لإنه بعد فترة هبقى بطل أستخدمها + +234 +00:18:50,090 --> 00:18:53,950 +لإنها عملت reshaping للكورنيا و اتصلح يعني لا بد + +235 +00:18:53,950 --> 00:18:58,570 +يعمل ليزج ولا بد يستخدم كلام سليم الان مثلا مريض + +236 +00:18:58,570 --> 00:19:03,810 +عمل فحوصات ليزج عمل كورنيا توبوغرافي عمل cct لجأ + +237 +00:19:03,810 --> 00:19:07,870 +انه ال central corneal thickness أقل من المقلوب هل + +238 +00:19:07,870 --> 00:19:13,110 +بنفع يعمله الدكتور ليزج سيرجيري؟ لأبالضبط فبنعمل + +239 +00:19:13,110 --> 00:19:18,470 +reshaping لمين؟ للكورنيا من خلال استخدام ايه؟ ال + +240 +00:19:18,470 --> 00:19:22,250 +orthokeratology لكن يا جماعة بدكم تحطوا في بالكم + +241 +00:19:22,250 --> 00:19:27,890 +ان في هناك دراسات اثبتت ان ال orthokeratology ايضا + +242 +00:19:27,890 --> 00:19:31,730 +فيها disadvantages انه بتعمل reduce لل central + +243 +00:19:31,730 --> 00:19:37,730 +corneal thickness تمام؟ انه بتقلل من اللي هو ايه؟ + +244 +00:19:37,730 --> 00:19:44,260 +ال cctطبعا هي بشكل عام ال .. ال contact lenses + +245 +00:19:44,260 --> 00:19:50,320 +بتقلل من ال CCT حتى .. لكن .. اه هذه بكمية اكبر .. + +246 +00:19:50,320 --> 00:19:53,520 +نعم تمام + +247 +00:19:53,520 --> 00:19:58,080 +اللي هي central corneal thickness + +248 +00:20:14,760 --> 00:20:20,980 +A patient may need five or six pairs of lenses the + +249 +00:20:20,980 --> 00:20:27,060 +first year فعلا هي تعتبر surgical procedure المريض + +250 +00:20:27,060 --> 00:20:32,360 +في السنة الأولى بيحتاج حوالي من خمسة لست أزواج من + +251 +00:20:32,360 --> 00:20:36,940 +العدسات لكن يا جماعة هذا ليس يعني شئ ثابت ممكن + +252 +00:20:36,940 --> 00:20:42,180 +يتغيريعني أنا بذكر في بيشان تلت أزواج كان اللي هو + +253 +00:20:42,180 --> 00:20:46,900 +عاملة flattening لل surface of the corn يعني تمام؟ + +254 +00:20:46,900 --> 00:20:49,280 +يعني دايما انتوا عارفين ال theory مختلف عن ال + +255 +00:20:49,280 --> 00:20:52,840 +practice لكن هان هو دايما بذكر اللي هو ال ideal + +256 +00:20:52,840 --> 00:20:57,720 +method الطريقة المثالية three or four the second + +257 +00:20:57,720 --> 00:21:03,200 +yearOkay or three more the third year يعني تقريبا + +258 +00:21:03,200 --> 00:21:08,800 +بعض الأشخاص العلاج بتاعهم من سنتين لتلاتة بيعمل a + +259 +00:21:08,800 --> 00:21:15,010 +flattening لمين؟ لل surface of the corneaAs a + +260 +00:21:15,010 --> 00:21:18,890 +general, five to seven pairs of lenses are + +261 +00:21:18,890 --> 00:21:22,170 +required to achieve a flattening effect يعني ممكن + +262 +00:21:22,170 --> 00:21:26,550 +أن المريض بيحتاج من خمسة إلى سبع أزواج عشان تعمل + +263 +00:21:26,550 --> 00:21:30,110 +reshaping أو remolded للsurface of the cornea + +264 +00:21:30,110 --> 00:21:34,330 +وبالتالي بتعمله flattening للsurface of the cornea + +265 +00:21:36,570 --> 00:21:40,570 +طيب ال procedure is most applicable يعني أكتر + +266 +00:21:40,570 --> 00:21:45,590 +استعمالا أو استخداما to myopic people minus three + +267 +00:21:45,590 --> 00:21:50,750 +diopter or less لكن للأمانة أنا قرأت دراسة 2017 + +268 +00:21:50,750 --> 00:21:56,390 +ذكروا فيها to minus six diopter فهذه صلحوها أنه + +269 +00:21:56,390 --> 00:22:00,790 +minus six diopter or lessطيب، الآن أنا بقولك، + +270 +00:22:00,790 --> 00:22:05,090 +minus 3 او اقل، ايش بتتوقع هذا النوع؟ هيكون mild + +271 +00:22:05,090 --> 00:22:09,230 +myopia او low myopia من minus 6 او اقل، اذا + +272 +00:22:09,230 --> 00:22:13,870 +moderate myopia، تمام؟ يعني هي قادرة على تصحيح ال + +273 +00:22:13,870 --> 00:22:15,670 +mild and moderate myopia + +274 +00:22:22,020 --> 00:22:27,280 +A proper fit يعني بمعنى انه يكون الفت ملائم او + +275 +00:22:27,280 --> 00:22:32,660 +مناسب او صحيح بالنسبة للمريض is one in which the + +276 +00:22:32,660 --> 00:22:37,140 +lens has a tangent touch ايش معناه ال tangent؟ + +277 +00:22:37,140 --> 00:22:42,260 +لازم انه تكون العدسة ملامس ويكون عبارة عن curve + +278 +00:22:42,260 --> 00:22:46,680 +لان احنا قلنا ان القرنية كده بتكون steep cornea + +279 +00:22:46,680 --> 00:22:51,060 +فلازم انه يعمل وكأنه اللي هو curve الوجه عليه + +280 +00:23:01,130 --> 00:23:04,570 +للسطح اللي هو بيكون flattest meridian + +281 +00:23:07,750 --> 00:23:12,510 +طبعا هي العدسة احنا عارفين انه بالنسبة لالميوب انه + +282 +00:23:12,510 --> 00:23:16,290 +ال incident light rays are brought to focus in + +283 +00:23:16,290 --> 00:23:20,110 +front of the retina بنستخدم اللي هو العدسة عشان + +284 +00:23:20,110 --> 00:23:24,690 +تعمل reshaping او remolding لانتريو surface of the + +285 +00:23:24,690 --> 00:23:29,330 +cornea فالهدف الأساسي انه تعمل flattening للانتريو + +286 +00:23:29,330 --> 00:23:32,950 +surface of the cornea و تعمل اللي هو تجميع الأشعة + +287 +00:23:32,950 --> 00:23:34,810 +كلها on the retina + +288 +00:23:39,300 --> 00:23:45,240 +الشكل هذا مين تقدر تعملي explanation له خدوا دقيقة + +289 +00:23:45,240 --> 00:23:49,960 +و بدي واحدة تعملي explanation ل ال three figures + +290 +00:23:49,960 --> 00:23:57,400 +الشكل الأول هو قرنية المريض كانت ان هو مياب بعد + +291 +00:23:57,400 --> 00:24:01,940 +هيك جيبناله عدسة بس طبعا تاخد الشكل القرنية بتاخد + +292 +00:24:01,940 --> 00:24:06,960 +شكل بحيث لما انا اشيل العدسة تكون عاملة re-shaping + +293 +00:24:06,960 --> 00:24:11,540 +ومصالحة ال ..ال refraction اللى عندها فكانت من + +294 +00:24:11,540 --> 00:24:15,140 +النص اللى هضغط عليها لإنه بتكون عنده thick trauma + +295 +00:24:15,140 --> 00:24:19,300 +فإنه بتكون مياب فإنه هتضغط عشان تتقلل من ال cct + +296 +00:24:19,300 --> 00:24:23,880 +هذا .. هذا كان شكل اتنين و هو نايم كانت ضغطة لما + +297 +00:24:23,880 --> 00:24:28,080 +انشعله الصبح هتظهر نفس شكل العدسة اللى هو مسلح + +298 +00:24:28,080 --> 00:24:33,640 +يعني ال curve نعمو في الشكل الآخر اللي هو عملت ايش + +299 +00:24:33,640 --> 00:24:37,340 +remolded او reshape لمن؟ للانتريو ال surface of + +300 +00:24:37,340 --> 00:24:44,160 +the cone و اضحى اعتقد كلير بيم soft contact lenses + +301 +00:24:44,160 --> 00:24:45,640 +for astigmatism + +302 +00:25:03,660 --> 00:25:07,140 +Motivation should be considered in screening + +303 +00:25:07,140 --> 00:25:11,760 +patients for any contact lens زي ما اتفقنا ان + +304 +00:25:11,760 --> 00:25:17,200 +الحافظ هو يعتبر number one للمريض اللي بينوي + +305 +00:25:17,200 --> 00:25:21,580 +ارتداء العدسة اللاسقة سواء كانت spherical soft + +306 +00:25:21,580 --> 00:25:27,170 +contact lens كانت مثلاSoft-rec contact lens حتى ال + +307 +00:25:27,170 --> 00:25:30,490 +RGB إذا ما كان المريض عنده motivation من الداخل + +308 +00:25:30,490 --> 00:25:35,830 +حافظ من الداخل مش هيقدر على ارتداء العدسة اللاصقة + +309 +00:25:35,830 --> 00:25:39,970 +أو بمعنى آخر يعني هان ال motivation ليش مهم؟ عشان + +310 +00:25:39,970 --> 00:25:43,550 +المريض بالاخر يقدر يعمل adaptation تكييف مع العدسة + +311 +00:25:43,550 --> 00:25:48,150 +تمام؟ لأنه إذا المريض مش مقتنع في العدسة مش هيقدر + +312 +00:25:48,150 --> 00:25:55,350 +يعمل adaptation إليها بالضبطهناك معلومات مختصرة + +313 +00:25:55,350 --> 00:26:01,530 +لتنافس المريض بصيغة توريك لينزطبعا فاكرين كل ال + +314 +00:26:01,530 --> 00:26:06,830 +indications او ال advantages اللي خاصة بال soft + +315 +00:26:06,830 --> 00:26:11,050 +contact lens او ال spherical soft contact lens هي + +316 +00:26:11,050 --> 00:26:14,410 +نفسها من ال advantages لل soft tourique contact + +317 +00:26:14,410 --> 00:26:18,350 +lenses لكن الاختلاف بينهم في موضوع من ال residual + +318 +00:26:18,350 --> 00:26:22,230 +astigmatism او في موضوع ال tourique cornea طبعا + +319 +00:26:22,230 --> 00:26:26,850 +احنا هتيجي معنا انه المميزات ل ال soft tourique + +320 +00:26:26,850 --> 00:26:36,370 +contact lensesمئة من المريضين كانت 45% كانت صحيحة + +321 +00:26:36,370 --> 00:26:48,910 +أوريجرياتر 4.75 مئة + +322 +00:26:48,910 --> 00:26:49,230 +مئة مئة مئة مئة مئة مئة مئة مئتا مئتا مئتا مئتا + +323 +00:26:49,230 --> 00:26:50,010 +مئتا مئتا مئتا مئتا مئتا مئتا مئتا مئتا مئتا مئتا + +324 +00:26:50,010 --> 00:26:50,290 +مئتا مئتا مئتا مئتا مئتا مئتا مئتا مئتا مئتا مئتا + +325 +00:26:50,290 --> 00:26:54,540 +مئتا مئتا مئتا مئتا مئتا مئتا مئتا مئتا مئتع الـ + +326 +00:26:54,540 --> 00:26:59,600 +minus نص أكسز مية و تمانين تمام؟ الآن بدنا نتفق ع + +327 +00:26:59,600 --> 00:27:04,300 +شغل مهم ان قيمة ال astigmatism في المثال الأول هي + +328 +00:27:04,300 --> 00:27:07,980 +مساوية لقيمة ال astigmatism في المثال التاني ولكن + +329 +00:27:07,980 --> 00:27:12,820 +شتتان بين التنين صح؟ في القيمة الأولى، قداش قيمة + +330 +00:27:12,820 --> 00:27:18,740 +ال astigmatism بالنسبة للاسفير تعتبر .. المثال + +331 +00:27:18,740 --> 00:27:25,440 +الأولإذا قيمة ال astigmatism بالنسبة للسفير في + +332 +00:27:25,440 --> 00:27:31,220 +المثال الأول تعتبر insignificant يعني غير مهمة أو + +333 +00:27:31,220 --> 00:27:34,980 +ممكن أنا أعملها إيش ignore أو ممكن عفوا يما أعمل + +334 +00:27:34,980 --> 00:27:38,300 +subjective refraction المريض إيش ماله مايحتاجه + +335 +00:27:38,300 --> 00:27:43,000 +طبعا طالب ال astigmatism أجمع لغة السفير مابحطوش + +336 +00:27:43,000 --> 00:27:48,180 +بعد جوبة السفير ببدأ أشوف إذا هوتمام وهذه عبارة عن + +337 +00:27:48,180 --> 00:27:51,200 +قاعدة مين ال rule of four اللي هتيجي معنا ان شاء + +338 +00:27:51,200 --> 00:27:56,400 +الله لقدام فالان الفكرة العامة انه انا بدي اعمل + +339 +00:27:56,400 --> 00:28:01,500 +مقارنة ما بين قيمة الاسفير و قيمة السيلندرفي + +340 +00:28:01,500 --> 00:28:04,980 +الحالة الأولى قيمة السلندر بالنسبة للاسفير + +341 +00:28:04,980 --> 00:28:09,140 +insignificant فالمريض ممكن ما يحتاج ايه السلندر + +342 +00:28:09,140 --> 00:28:14,980 +هذه المثال التاني قيمة السلندر مشابهة لمين لقيمة + +343 +00:28:14,980 --> 00:28:18,700 +الاسفير ف hand قد تكون ايش انه hand significant + +344 +00:28:18,700 --> 00:28:22,640 +تمام الفكرة؟ يعني قد تكون اللي هو المريض بده يحتاج + +345 +00:28:22,640 --> 00:28:25,580 +و بالتأكيد انه هيحتاج القيمة هذه + +346 +00:28:29,300 --> 00:28:33,900 +Patients with 0.75 of refractive astigmatism + +347 +00:28:33,900 --> 00:28:39,080 +should be considered candidates for softeric + +348 +00:28:39,080 --> 00:28:43,280 +lenses مين بتقدر تعمل الهو explanation لهذه الجملة + +349 +00:28:43,280 --> 00:28:48,460 +يعني مرشح اللي هو participants اللي هو كمتسابق + +350 +00:28:48,460 --> 00:28:51,660 +يعني انا بقول مثلا candidate one متسابق الأول + +351 +00:28:51,660 --> 00:28:55,280 +candidate two متسابق التاني التالت يعني بمعنى + +352 +00:28:55,280 --> 00:28:57,280 +subjects okay + +353 +00:29:11,170 --> 00:29:17,750 +بس هان ايش بده يكون؟ بالضبط حسب ال benefit to cost + +354 +00:29:17,750 --> 00:29:23,170 +لكن هان هو الكتاب بتكلم بطريقة ايش؟ ال ideal + +355 +00:29:23,170 --> 00:29:28,060 +بالطريقة ال ideal optical methodلكن زي ما احنا + +356 +00:29:28,060 --> 00:29:31,880 +بنعرف بالنسبة انه دايما ال benefit to cost هذه + +357 +00:29:31,880 --> 00:29:37,900 +القاعدة اللى بنشتغل عليها softoric + +358 +00:29:37,900 --> 00:29:41,860 +lenses make the tear lens compensation + +359 +00:29:41,860 --> 00:29:46,520 +considerations of gb lenses and in many cases + +360 +00:29:46,520 --> 00:29:51,560 +maybe easier to prescribeلو فاكرين في ال soft + +361 +00:29:51,560 --> 00:29:56,080 +contact lens حكينا ال post tear lens يعتبر very + +362 +00:29:56,080 --> 00:29:59,980 +limit صحيح؟ في حالة ال soft contact lens و نفس + +363 +00:29:59,980 --> 00:30:03,560 +الحاجة وين؟ في ال software ال contact lens ال post + +364 +00:30:03,560 --> 00:30:07,240 +tear lens يعتبر very limit لأنه ببساطة هي بتاخد + +365 +00:30:07,240 --> 00:30:12,880 +شكل القرنية تمام؟ لكن في ال GB lenses تعتبر ال + +366 +00:30:12,880 --> 00:30:16,780 +post tear lens اشمالها significant يعني ذات قيمة + +367 +00:30:24,610 --> 00:30:29,910 +Soft rec lenses are most successful with regular + +368 +00:30:29,910 --> 00:30:37,230 +astigmatism why خديجة ايش السبب ان ليش ال soft rec + +369 +00:30:37,230 --> 00:30:42,230 +contact lenses هي اكتر نجاحا في حالات ال regular + +370 +00:30:42,230 --> 00:30:43,510 +astigmatism + +371 +00:30:51,910 --> 00:30:55,810 +ممتازة البساطة لان ال software ال contact lens + +372 +00:30:55,810 --> 00:31:01,550 +هتاخد شكل مين القرنية طيب نفترض شكل القرنية كان + +373 +00:31:01,550 --> 00:31:08,630 +irregular مش هتعدله اذا هذا بدخل في مين؟ في ال + +374 +00:31:08,630 --> 00:31:13,510 +optics لل RGB ال optics لل RGB ايش هتعمل؟ ال new + +375 +00:31:13,510 --> 00:31:17,790 +surface للكورنية فهتعمل عملية ايش؟ يعني اللي هو + +376 +00:31:17,790 --> 00:31:23,510 +تعديلبالضبط من ناحية اللى هو ك optics لل RGB + +377 +00:31:23,510 --> 00:31:27,090 +Contact Lens انه هتاخد New Surface للكورنية وبعد + +378 +00:31:27,090 --> 00:31:31,310 +ذلك من خلال التير هتعمل اللى هو شكل يكون منتظم + +379 +00:31:31,310 --> 00:31:36,770 +للقرانية تمام؟ اذا الان لو سألتك السؤال why soft + +380 +00:31:36,770 --> 00:31:41,030 +rec lenses are most successful with regular + +381 +00:31:41,030 --> 00:31:44,970 +astigmatism عارفين اللى هو السبب لأنها بتاخد شكل + +382 +00:31:44,970 --> 00:31:52,150 +القرانية لكن هي بتصلح مين؟الريزيدي والاستيجماتيزم + +383 +00:31:52,150 --> 00:31:57,330 +with software cleanse availability ranging from + +384 +00:31:57,330 --> 00:32:02,170 +plus twenty to minus twenty diopter of sphere + +385 +00:32:02,170 --> 00:32:06,270 +power يعني بمعنى ال range بتاعها هيكون من plus + +386 +00:32:06,270 --> 00:32:09,050 +عشرين ل minus عشرين ديوبتر + +387 +00:32:11,920 --> 00:32:15,840 +and up to ten diopters of cylinder power in one + +388 +00:32:15,840 --> 00:32:22,100 +degree axis steps يعني كل degree لها قيمة هناخد ان + +389 +00:32:22,100 --> 00:32:25,920 +شاء الله في المعمل يما يصير هناك انه عندنا كل اللي + +390 +00:32:25,920 --> 00:32:30,040 +هو واحد degree عبارة عن thirty cycle هاد ان شاء + +391 +00:32:30,040 --> 00:32:33,220 +الله هنتكلم فيها من خلال المعمل ان كيف نشوف ال + +392 +00:32:33,220 --> 00:32:39,340 +rotation العدسة من خلال الستلةThere is no limit to + +393 +00:32:39,340 --> 00:32:44,740 +the potential astigmatic patients who can be fit + +394 +00:32:44,740 --> 00:32:49,520 +with softeric lens وهذه النقطة مهمة.الان ممكن انا + +395 +00:32:49,520 --> 00:32:54,640 +ادى للمريض RGB contact lens لكن انا اتوقع انه في + +396 +00:32:54,640 --> 00:32:58,600 +عنده potential.ايش معناه potential astigmatism؟ + +397 +00:32:58,760 --> 00:33:03,100 +يعني astigmatism افتراضي وهو عبارة عن مين ال + +398 +00:33:03,100 --> 00:33:07,180 +residual astigmatism لكن انا لما بدي للمريض ال + +399 +00:33:07,180 --> 00:33:10,760 +software contact lens مش هتوقع انه يبقى عنده ايش + +400 +00:33:10,760 --> 00:33:14,460 +ال potential او ال residual astigmatism اذا هان + +401 +00:33:14,460 --> 00:33:18,620 +كلمة potential المقصود فيها residual astigmatism + +402 +00:33:18,620 --> 00:33:24,280 +الان احنا اتفقنا ان ال best option لل software + +403 +00:33:24,280 --> 00:33:28,860 +contact lenses هي بتصلح مين؟الـ residual + +404 +00:33:28,860 --> 00:33:33,560 +astigmatism another name للـ residual astigmatism + +405 +00:33:33,560 --> 00:33:38,980 +هو عبارة عن ال potential astigmatism تمام ال RGB + +406 +00:33:38,980 --> 00:33:44,000 +هل قادر على تصحيحه؟ لأ إذا أنا بتوقع أنه لما + +407 +00:33:44,000 --> 00:33:48,900 +المريض يلبس RGB لو كان عنده significant residual + +408 +00:33:48,900 --> 00:33:52,860 +astigmatism اضال في عنده ايش؟ Astigmatism افتراضي + +409 +00:33:52,860 --> 00:33:56,490 +و هذا وين بيبين على فكرة في ال detailsيعني المريض + +410 +00:33:56,490 --> 00:34:01,090 +بده details بيبين معاه الأمر هذا طيب نفترض هذا + +411 +00:34:01,090 --> 00:34:05,930 +الشخص عنده significant residual astigmatism اذا + +412 +00:34:05,930 --> 00:34:09,910 +وولد ال software contact lenses بتوقع انه ايش + +413 +00:34:09,910 --> 00:34:12,430 +هيخفي تمام او هيصلحه + +414 +00:34:16,320 --> 00:34:21,600 +Generally, refractive astigmatism of 0.75 or more + +415 +00:34:21,600 --> 00:34:26,580 +may be an indication for soft recontact lenses + +416 +00:34:26,580 --> 00:34:29,560 +يعني بشكل عام المريض لما يكون عنده قيمة + +417 +00:34:29,560 --> 00:34:35,560 +الastigmatism 0.75 or more هذا بيكون مرشح لاستخدام + +418 +00:34:35,560 --> 00:34:41,860 +من ال soft recontact lenses لكن هذا بشكل عامالها + +419 +00:34:41,860 --> 00:34:44,700 +يعني لها ما لها و عليها ما عليها + +420 +00:35:25,110 --> 00:35:31,110 +إذا كانت قيمة السليندر باور أقل من 25% أو أقل من + +421 +00:35:31,110 --> 00:35:36,850 +ربع إذا حيكون إيه؟ الاسفير هو الحل الأمثل للمريض + +422 +00:35:39,330 --> 00:35:43,250 +Commonly practitioners or fitters يعني الأشخاص + +423 +00:35:43,250 --> 00:35:47,490 +اللي بيعملوا عملية ال .. ال fitting للعدسة اللاصقة + +424 +00:35:47,490 --> 00:35:54,510 +consider that بيعتبروا 0.75 is the lower limit + +425 +00:35:54,510 --> 00:36:00,370 +يعني أقل قيمة أو أقل حد أو أقل range and would + +426 +00:36:00,370 --> 00:36:04,470 +prescribe a soft trick in all but the highest + +427 +00:36:04,470 --> 00:36:09,770 +spherical prescriptionإذا أقل حد عندهم كقيمة انه + +428 +00:36:09,770 --> 00:36:16,710 +تعتبر significant هي الـ 0.75 طيب + +429 +00:36:16,710 --> 00:36:21,650 +عندنا هنا notebook ملاحظة مهمة بناء على قاعدة rule + +430 +00:36:21,650 --> 00:36:28,150 +of four with cylinder power greater than 25% of + +431 +00:36:28,150 --> 00:36:32,970 +the sphere power a soft trick is indicatedإذا + +432 +00:36:32,970 --> 00:36:37,370 +المريض كان عنده قيمة السلندر بالنسبة للاسفير أكتر + +433 +00:36:37,370 --> 00:36:42,470 +من 25% او أكتر من ربع هان بديني انطباع ايش؟ يا + +434 +00:36:42,470 --> 00:36:46,110 +جماعة هان يما بنقصد أكتر من ربع يما بنعمل مقارنة + +435 +00:36:46,110 --> 00:36:51,530 +بين الاسفير والسلندر تمام؟ إذا هان الحل الأمثل قد + +436 +00:36:51,530 --> 00:36:56,780 +يكون من ال software contact lensesطيب إذا كانت + +437 +00:36:56,780 --> 00:37:00,100 +قيمة الـ cylinder power أقل من 25% إذا الـ + +438 +00:37:00,100 --> 00:37:03,800 +spherical soft contact lens قد تكون هي الحل الأمثل + +439 +00:37:07,950 --> 00:37:12,590 +Soft-rick lenses share some similar indications + +440 +00:37:12,590 --> 00:37:16,970 +for prescribing with soft-rick contact lenses إذا + +441 +00:37:16,970 --> 00:37:21,690 +في هناك مجموعة من ال indication هي اللي بتكون + +442 +00:37:21,690 --> 00:37:27,310 +مميزة لمين؟ ل ال soft-rick contact lenses ياسمين + +443 +00:37:27,310 --> 00:37:31,330 +إيش بتتوقع إيه؟ ال indication لل soft-rick contact + +444 +00:37:31,330 --> 00:37:31,850 +lenses + +445 +00:37:38,970 --> 00:37:44,310 +إذا اول قضية زي ما اتفضلت موضوع ال potential + +446 +00:37:44,310 --> 00:37:48,210 +astigmatism او ال residual astigmatism إذا هي + +447 +00:37:48,210 --> 00:37:52,630 +العدسة الوحيدة لو استثننا ال RGB turret قادرة على + +448 +00:37:52,630 --> 00:37:56,970 +تصحيح ال potential أو ال residual astigmatism + +449 +00:37:56,970 --> 00:38:00,750 +تمام؟طبعا انتوا عارفين في another name لـ residual + +450 +00:38:00,750 --> 00:38:04,290 +astigmatism هي عبارة عن ال internal اللي هو + +451 +00:38:04,290 --> 00:38:07,670 +cylinder تمام؟ يعني the same meaning يعني في ال + +452 +00:38:07,670 --> 00:38:10,910 +American academy لو واحدة قرأت في الكتاب هتلاحظ + +453 +00:38:10,910 --> 00:38:12,990 +انه بيكتبوا internal cylinder + +454 +00:38:17,880 --> 00:38:23,100 +Patience who wear lenses occasionally يعني في بعض + +455 +00:38:23,100 --> 00:38:28,480 +الأشخاص بلبسه العلسات اللاصقة أحيانا مش دايما okay + +456 +00:38:28,480 --> 00:38:33,220 +يعني فقط بلبسها يوم بروح على وظيفته بروح بستخدم + +457 +00:38:33,220 --> 00:38:41,420 +النضارة تمام؟ wear a monocular lens بليه contact + +458 +00:38:41,420 --> 00:38:47,530 +sporesShow sensitivity to GB lenses واحد مثلا لعيب + +459 +00:38:47,530 --> 00:38:52,390 +كرة قدم او volleyball او basketball بقدر ادي مثلا + +460 +00:38:52,390 --> 00:38:58,450 +ال GB lenses اول حاجة انه ممكن تسقط بسهولة لانه + +461 +00:38:58,450 --> 00:39:02,910 +small diameter شغلتانية ال sensitivity ممكن تكون + +462 +00:39:02,910 --> 00:39:07,050 +عالية ان هو مش متقبلها ال adaptation اللي هو مش + +463 +00:39:07,050 --> 00:39:11,950 +سريع بالنسبة له تمام؟or work in dusty environments + +464 +00:39:11,950 --> 00:39:18,030 +طب هل ليش لما واحد بيشتغل مثلا في بيئة جاثة بستخدم + +465 +00:39:18,030 --> 00:39:21,810 +معه ال soft trick contact lenses؟ طيب السؤال كان + +466 +00:39:21,810 --> 00:39:26,390 +تالي انه في حالة ما يكون عندنا dusty environments + +467 +00:39:26,390 --> 00:39:31,200 +يعني بيئة مغبرة زي بلاد مثل السعوديةاللي عاش في + +468 +00:39:31,200 --> 00:39:36,760 +السعودية الجو عندهم دايما صحراوي تمام فهان الأفضل + +469 +00:39:36,760 --> 00:39:40,980 +لو كان عنده regular surface زي الكورنيا مديهو ال + +470 +00:39:40,980 --> 00:39:45,620 +جي بي اديه صفتري البساطة لو انتوا فاكرين ان الصفة + +471 +00:39:45,620 --> 00:39:50,720 +العادية الأجسام الغريبة يما بتنحصر بينها بتكون ايش + +472 +00:39:50,720 --> 00:39:55,920 +اقل من ال جي بي لينزز ولكن اذا انحصرت بينهم بتكون + +473 +00:39:55,920 --> 00:40:00,500 +ايش اكتر اللي هو complication ونفس الفكرة وين؟في + +474 +00:40:00,500 --> 00:40:04,000 +الـ soft trick إذن السبب في ذلك لأنها بتحصر + +475 +00:40:04,000 --> 00:40:10,680 +الأجسام الغريبة بنسبة أقل من ال GB lenses are + +476 +00:40:10,680 --> 00:40:15,160 +often better candidates for soft lens than for GB + +477 +00:40:15,160 --> 00:40:21,080 +lenses إذن + +478 +00:40:21,080 --> 00:40:24,940 +مرة أخرى الحالات اللي بنستخدم فيها ال soft trick + +479 +00:40:24,940 --> 00:40:30,890 +contact lenses الحالة الأولىيما الشخص بيستخدم + +480 +00:40:30,890 --> 00:40:35,010 +العدسة اللاصقة أحيانا أو في فترة زمانية قصيرة + +481 +00:40:35,010 --> 00:40:40,070 +occasionally ممكن مثلا يستخدم molecular lenses + +482 +00:40:40,070 --> 00:40:45,350 +عدسة واحدة عشان يقلل من ال sensitivity ممكن مثلا + +483 +00:40:45,350 --> 00:40:50,350 +في بيئة مغبلرة أيضا اللي هو ممكن مثلا في بعض + +484 +00:40:50,350 --> 00:40:54,630 +الرياضات أو بعض الألعاب أنه بده يضطر لاستخدام مين + +485 +00:40:55,160 --> 00:40:58,620 +ال software ال contact lenses أفضل من مين من ال + +486 +00:40:58,620 --> 00:41:03,180 +RGB contact lenses ان شاء الله بنتوقف للنقطة هذه + +487 +00:41:03,180 --> 00:41:05,160 +في المحاضرة القادمة بنكمل + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/YZZ_de8tRBA_raw.json b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/YZZ_de8tRBA_raw.json new file mode 100644 index 0000000000000000000000000000000000000000..42308748b0b00d8510b9c99e1a2d0a2966397480 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/YZZ_de8tRBA_raw.json @@ -0,0 +1 @@ +{"segments": [{"id": 1, "seek": 5044, "start": 20.96, "end": 50.44, "text": "بسم الله الرحمن الرحيم السلام عليكم ورحمة الله وبركاته ومرحبا لكم جميعا في المحاضرة السابقة اتناولنا موضوع ال بيجي باق contact lens system وقلنا هي عبارة عن نظام بتكون من عدستين العدسة الأولى هي عبارة عن RGB اللي هي بتكون في ال center في المنتصف ال diameter لهذه العدسة بيكون من 8.5 ل 9.5 ميلي متر وقد يكون مختلف", "tokens": [3555, 38251, 21984, 34892, 5016, 27842, 34892, 5016, 32640, 21136, 37440, 25894, 24793, 4032, 2288, 35571, 3660, 21984, 4032, 26890, 4117, 9307, 3224, 4032, 29973, 5016, 3555, 995, 5296, 24793, 10874, 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أنا قرأت دراسة 2017 ذكروا فيها to minus six diopter فهذه صلحوها أنه minus six diopter or less", "tokens": [9566, 1829, 3555, 2423, 10747, 307, 881, 21142, 37495, 22653, 5551, 4117, 2655, 2288, 44713, 25957, 6027, 995, 34051, 44713, 9778, 3215, 10943, 995, 281, 452, 40216, 561, 3175, 1045, 1026, 404, 391, 420, 1570, 44381, 24976, 10721, 2304, 7649, 3660, 41850, 12174, 2288, 10721, 2655, 11778, 23557, 3794, 3660, 6591, 29910, 37983, 14407, 8978, 11296, 281, 3175, 2309, 1026, 404, 391, 6156, 3224, 24192, 20328, 1211, 5016, 2407, 11296, 14739, 3224, 3175, 2309, 1026, 404, 391, 420, 1570], "avg_logprob": -0.14414062388241292, "compression_ratio": 1.4455445544554455, "no_speech_prob": 0.0, "words": [{"start": 1296.57, "end": 1296.95, "word": "طيب", "probability": 0.84521484375}, {"start": 1296.95, "end": 1297.33, "word": " ال", "probability": 0.90576171875}, {"start": 1297.33, "end": 1297.85, "word": " procedure", "probability": 0.890625}, {"start": 1297.85, "end": 1298.49, "word": " is", 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{"id": 58, "seek": 133567, "start": 1319.01, "end": 1335.67, "text": "طيب، الآن أنا بقولك، minus 3 او اقل، ايش بتتوقع هذا النوع؟ هيكون mild myopia او low myopia من minus 6 او اقل، اذا moderate myopia، تمام؟ يعني هي قادرة على تصحيح ال mild and moderate myopia", "tokens": [9566, 1829, 3555, 12399, 6024, 48506, 41850, 4724, 39648, 4117, 12399, 3175, 805, 1975, 2407, 1975, 4587, 1211, 12399, 1975, 1829, 8592, 39894, 2655, 30543, 3615, 23758, 28239, 45367, 22807, 39896, 30544, 15154, 452, 22376, 1975, 2407, 2295, 452, 22376, 9154, 3175, 1386, 1975, 2407, 1975, 4587, 1211, 12399, 1975, 15730, 18174, 452, 22376, 12399, 46811, 10943, 22807, 37495, 22653, 39896, 12174, 18513, 25720, 15844, 6055, 9381, 5016, 1829, 5016, 2423, 15154, 293, 18174, 452, 22376], "avg_logprob": -0.15919237322621532, "compression_ratio": 1.5222222222222221, "no_speech_prob": 0.0, "words": [{"start": 1319.01, "end": 1319.53, "word": "طيب،", "probability": 0.840576171875}, {"start": 1319.53, "end": 1319.77, "word": " 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lenses make the tear lens compensation considerations of gb lenses and in many cases maybe easier to prescribe", "tokens": [1211, 19452, 30767, 1829, 19446, 1975, 5016, 8315, 44945, 3615, 28480, 20666, 1863, 35457, 3660, 16472, 3224, 11778, 47302, 15042, 2423, 5121, 281, 2063, 29538, 25062, 995, 22488, 3660, 13672, 7578, 44945, 8592, 2655, 17082, 1211, 25894, 11296, 2787, 16345, 18059, 652, 264, 12556, 6765, 19644, 24070, 295, 290, 65, 18059, 293, 294, 867, 3331, 1310, 3571, 281, 49292], "avg_logprob": -0.24804687450329463, "compression_ratio": 1.4171122994652405, "no_speech_prob": 0.0, "words": [{"start": 1766.86, "end": 1767.32, "word": "لكن", "probability": 0.798583984375}, {"start": 1767.32, "end": 1767.82, "word": " زي", "probability": 0.83935546875}, {"start": 1767.82, "end": 1767.94, "word": " ما", "probability": 0.94580078125}, {"start": 1767.94, "end": 1768.06, "word": " احنا", "probability": 0.77587890625}, {"start": 1768.06, "end": 1768.58, "word": " بنعرف", "probability": 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soft rec contact lenses هي اكتر نجاحا في حالات ال regular astigmatism", "tokens": [6455, 844, 850, 18059, 366, 881, 4406, 365, 3890, 5357, 46496, 1434, 983, 16490, 16254, 7435, 3660, 1975, 1829, 8592, 21136, 3555, 3555, 16472, 32239, 8592, 2423, 2787, 850, 3385, 18059, 39896, 1975, 4117, 2655, 2288, 8717, 7435, 39319, 995, 8978, 11331, 6027, 9307, 2423, 3890, 5357, 46496, 1434], "avg_logprob": -0.3349999862909317, "compression_ratio": 1.36986301369863, "no_speech_prob": 0.0, "words": [{"start": 1824.61, "end": 1825.15, "word": "Soft", "probability": 0.532318115234375}, {"start": 1825.15, "end": 1825.43, "word": " rec", "probability": 0.0472412109375}, {"start": 1825.43, "end": 1826.03, "word": " lenses", "probability": 0.771484375}, {"start": 1826.03, "end": 1826.63, "word": " are", "probability": 0.93701171875}, {"start": 1826.63, "end": 1827.17, "word": " most", "probability": 0.853515625}, {"start": 1827.17, "end": 1828.09, "word": " successful", "probability": 0.7412109375}, 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هتاخد شكل مين القرنية طيب نفترض شكل القرنية كان irregular مش هتعدله اذا هذا بدخل في مين؟ في ال optics لل RGB ال optics لل RGB ايش هتعمل؟ ال new surface للكورنية فهتعمل عملية ايش؟ يعني اللي هو تعديل", "tokens": [2304, 2304, 2655, 31377, 3660, 29739, 3794, 41193, 3660, 5296, 7649, 2423, 4722, 2423, 3385, 6765, 8032, 2655, 47283, 3215, 13412, 28820, 3714, 9957, 25062, 2288, 1863, 10632, 23032, 1829, 3555, 8717, 5172, 2655, 43042, 13412, 28820, 25062, 2288, 1863, 10632, 25961, 29349, 37893, 8032, 2655, 22488, 43761, 1975, 15730, 23758, 47525, 9778, 1211, 8978, 3714, 9957, 22807, 8978, 2423, 42599, 24976, 31231, 2423, 42599, 24976, 31231, 1975, 1829, 8592, 8032, 2655, 25957, 1211, 22807, 2423, 777, 3753, 5296, 23275, 13063, 1863, 10632, 6156, 3224, 2655, 25957, 1211, 6225, 42213, 10632, 1975, 1829, 8592, 22807, 37495, 22653, 13672, 1829, 31439, 37279, 16254, 1211], "avg_logprob": -0.1745793249171514, "compression_ratio": 1.746606334841629, "no_speech_prob": 0.0, "words": [{"start": 1851.91, 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"بالضبط من ناحية اللى هو ك optics لل RGB Contact Lens انه هتاخد New Surface للكورنية وبعد ذلك من خلال التير هتعمل اللى هو شكل يكون منتظم للقرانية تمام؟ اذا الان لو سألتك السؤال why soft rec lenses are most successful with regular astigmatism عارفين اللى هو السبب لأنها بتاخد شكل القرانية لكن هي بتصلح مين؟", "tokens": [3555, 6027, 11242, 3555, 9566, 9154, 8717, 39319, 10632, 13672, 7578, 31439, 9122, 42599, 24976, 31231, 30683, 441, 694, 16472, 3224, 8032, 2655, 47283, 3215, 1873, 36052, 5296, 23275, 13063, 1863, 10632, 46599, 22488, 29910, 23275, 9154, 16490, 1211, 6027, 16712, 13546, 8032, 2655, 25957, 1211, 13672, 7578, 31439, 13412, 28820, 7251, 30544, 9154, 2655, 19913, 2304, 24976, 4587, 2288, 7649, 10632, 46811, 10943, 22807, 1975, 15730, 2423, 7649, 45164, 8608, 10721, 1211, 2655, 4117, 21136, 33604, 6027, 983, 2787, 850, 18059, 366, 881, 4406, 365, 3890, 5357, 46496, 1434, 6225, 9640, 5172, 9957, 13672, 7578, 31439, 21136, 3555, 3555, 5296, 33456, 11296, 39894, 47283, 3215, 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1903.03, "word": " اللى", "probability": 0.95849609375}, {"start": 1903.03, "end": 1903.21, "word": " هو", "probability": 0.97900390625}, {"start": 1903.21, "end": 1903.63, "word": " السبب", "probability": 0.990234375}, {"start": 1903.63, "end": 1904.23, "word": " لأنها", "probability": 0.5078938802083334}, {"start": 1904.23, "end": 1904.67, "word": " بتاخد", "probability": 0.93408203125}, {"start": 1904.67, "end": 1904.97, "word": " شكل", "probability": 0.7431640625}, {"start": 1904.97, "end": 1905.51, "word": " القرانية", "probability": 0.986083984375}, {"start": 1905.51, "end": 1907.63, "word": " لكن", "probability": 0.2724609375}, {"start": 1907.63, "end": 1907.97, "word": " هي", "probability": 0.5078125}, {"start": 1907.97, "end": 1908.61, "word": " بتصلح", "probability": 0.79638671875}, {"start": 1908.61, "end": 1909.05, "word": " مين؟", "probability": 0.9344075520833334}], "temperature": 1.0}, {"id": 81, "seek": 192905, "start": 1910.25, "end": 1929.05, "text": "الريزيدي والاستيجماتيزم with software cleanse availability ranging from plus twenty to minus twenty diopter of sphere power يعني بمعنى ال range بتاعها هيكون من plus عشرين ل minus عشرين ديوبتر", "tokens": [6027, 16572, 11622, 1829, 16254, 16070, 995, 14851, 1829, 7435, 2304, 9307, 1829, 11622, 2304, 365, 4722, 36085, 17945, 25532, 490, 1804, 7699, 281, 3175, 7699, 1026, 404, 391, 295, 16687, 1347, 37495, 22653, 4724, 2304, 3615, 1863, 7578, 2423, 3613, 39894, 45761, 11296, 39896, 30544, 9154, 1804, 6225, 46309, 9957, 5296, 3175, 6225, 46309, 9957, 11778, 1829, 37746, 2655, 2288], "avg_logprob": -0.3326613042623766, "compression_ratio": 1.4033149171270718, "no_speech_prob": 0.0, "words": [{"start": 1910.25, "end": 1910.91, "word": "الريزيدي", "probability": 0.5490966796875}, {"start": 1910.91, "end": 1912.15, "word": " والاستيجماتيزم", "probability": 0.6839599609375}, {"start": 1912.15, "end": 1913.39, "word": " with", "probability": 0.302978515625}, {"start": 1913.39, "end": 1914.05, "word": " 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0.498046875}], "temperature": 1.0}, {"id": 83, "seek": 197860, "start": 1957.92, "end": 1978.6, "text": "There is no limit to the potential astigmatic patients who can be fit with softeric lens وهذه النقطة مهمة.الان ممكن انا ادى للمريض RGB contact lens لكن انا اتوقع انه في عنده potential.ايش معناه potential astigmatism؟", "tokens": [51, 511, 68, 307, 572, 4948, 281, 264, 3995, 5357, 46496, 299, 4209, 567, 393, 312, 3318, 365, 37259, 391, 299, 6765, 37037, 24192, 28239, 47432, 3660, 3714, 16095, 3660, 13, 6027, 7649, 3714, 43020, 1975, 8315, 1975, 3215, 7578, 5296, 19528, 16572, 11242, 31231, 3385, 6765, 44381, 1975, 8315, 1975, 2655, 30543, 3615, 16472, 3224, 8978, 43242, 3224, 3995, 13, 47302, 8592, 20449, 8315, 3224, 3995, 5357, 46496, 1434, 22807], "avg_logprob": -0.3088107634749677, "compression_ratio": 1.4307692307692308, "no_speech_prob": 0.0, "words": [{"start": 1957.92, "end": 1958.26, "word": "There", "probability": 0.5575764973958334}, {"start": 1958.26, "end": 1958.38, 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"end": 1978.6, "word": " astigmatism؟", "probability": 0.9283447265625}], "temperature": 1.0}, {"id": 84, "seek": 200680, "start": 1978.76, "end": 2006.8, "text": "يعني astigmatism افتراضي وهو عبارة عن مين ال residual astigmatism لكن انا لما بدي للمريض ال software contact lens مش هتوقع انه يبقى عنده ايش ال potential او ال residual astigmatism اذا هان كلمة potential المقصود فيها residual astigmatism الان احنا اتفقنا ان ال best option لل software contact lenses هي بتصلح مين؟", "tokens": [40228, 22653, 5357, 46496, 1434, 1975, 5172, 2655, 2288, 46958, 1829, 37037, 2407, 6225, 3555, 9640, 3660, 18871, 3714, 9957, 2423, 27980, 5357, 46496, 1434, 44381, 1975, 8315, 5296, 15042, 4724, 16254, 5296, 19528, 16572, 11242, 2423, 4722, 3385, 6765, 37893, 8032, 2655, 30543, 3615, 16472, 3224, 7251, 3555, 4587, 7578, 43242, 3224, 1975, 1829, 8592, 2423, 3995, 1975, 2407, 2423, 27980, 5357, 46496, 1434, 1975, 15730, 8032, 7649, 9122, 19528, 3660, 3995, 9673, 4587, 9381, 23328, 8978, 11296, 27980, 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" هتوقع", "probability": 0.976806640625}, {"start": 1989.6, "end": 1989.84, "word": " انه", "probability": 0.7841796875}, {"start": 1989.84, "end": 1990.16, "word": " يبقى", "probability": 0.981201171875}, {"start": 1990.16, "end": 1990.5, "word": " عنده", "probability": 0.992431640625}, {"start": 1990.5, "end": 1990.76, "word": " ايش", "probability": 0.751708984375}, {"start": 1990.76, "end": 1991.02, "word": " ال", "probability": 0.95068359375}, {"start": 1991.02, "end": 1991.5, "word": " potential", "probability": 0.91748046875}, {"start": 1991.5, "end": 1991.92, "word": " او", "probability": 0.886474609375}, {"start": 1991.92, "end": 1992.06, "word": " ال", "probability": 0.935546875}, {"start": 1992.06, "end": 1992.5, "word": " residual", "probability": 0.98486328125}, {"start": 1992.5, "end": 1993.46, "word": " astigmatism", "probability": 0.9365234375}, {"start": 1993.46, "end": 1994.22, "word": " اذا", "probability": 0.80078125}, {"start": 1994.22, "end": 1994.46, "word": " 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"temperature": 1.0}, {"id": 89, "seek": 213685, "start": 2125.11, "end": 2136.85, "text": "إذا كانت قيمة السليندر باور أقل من 25% أو أقل من ربع إذا حيكون إيه؟ الاسفير هو الحل الأمثل للمريض", "tokens": [28814, 15730, 25961, 2655, 12174, 32640, 3660, 21136, 1211, 9957, 3215, 2288, 4724, 995, 13063, 5551, 4587, 1211, 9154, 3552, 4, 34051, 5551, 4587, 1211, 9154, 12602, 3555, 3615, 11933, 15730, 11331, 1829, 30544, 11933, 1829, 3224, 22807, 2423, 32277, 5172, 13546, 31439, 21542, 1211, 16247, 2304, 12984, 1211, 5296, 19528, 16572, 11242], "avg_logprob": -0.22439235862758425, "compression_ratio": 1.3983739837398375, "no_speech_prob": 0.0, "words": [{"start": 2125.11, "end": 2126.31, "word": "إذا", "probability": 0.7222900390625}, {"start": 2126.31, "end": 2127.03, "word": " كانت", "probability": 0.779052734375}, {"start": 2127.03, "end": 2127.69, "word": " قيمة", "probability": 0.9920247395833334}, {"start": 2127.69, "end": 2128.29, "word": " السليندر", "probability": 0.637255859375}, 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"end": 2164.47, "word": " highest", "probability": 0.93994140625}, {"start": 2164.47, "end": 2165.27, "word": " spherical", "probability": 0.93408203125}, {"start": 2165.27, "end": 2166.39, "word": " prescription", "probability": 0.93896484375}], "temperature": 1.0}, {"id": 91, "seek": 219181, "start": 2167.29, "end": 2191.81, "text": "إذا أقل حد عندهم كقيمة انه تعتبر significant هي الـ 0.75 طيب عندنا هنا notebook ملاحظة مهمة بناء على قاعدة rule of four with cylinder power greater than 25% of the sphere power a soft trick is indicated", "tokens": [28814, 15730, 5551, 4587, 1211, 11331, 3215, 43242, 16095, 9122, 4587, 32640, 3660, 16472, 3224, 6055, 34268, 26890, 4776, 39896, 2423, 39184, 1958, 13, 11901, 23032, 1829, 3555, 43242, 8315, 34105, 21060, 3714, 15040, 5016, 19913, 3660, 3714, 16095, 3660, 44945, 16606, 15844, 12174, 995, 22488, 3660, 4978, 295, 1451, 365, 17884, 1347, 5044, 813, 3552, 4, 295, 264, 16687, 1347, 257, 2787, 4282, 307, 16176], "avg_logprob": -0.2441697707816736, 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with soft-rick contact lenses إذا في هناك مجموعة من ال indication هي اللي بتكون مميزة لمين؟ ل ال soft-rick contact lenses ياسمين إيش بتتوقع إيه؟ ال indication لل soft-rick contact lenses", "tokens": [6455, 844, 12, 9323, 18059, 2073, 512, 2531, 44450, 337, 1183, 39541, 365, 2787, 12, 9323, 3385, 18059, 11933, 15730, 8978, 34105, 4117, 3714, 7435, 2304, 2407, 27884, 9154, 2423, 18877, 39896, 13672, 1829, 39894, 30544, 3714, 2304, 1829, 11622, 3660, 32767, 9957, 22807, 5296, 2423, 2787, 12, 9323, 3385, 18059, 7251, 32277, 2304, 9957, 11933, 1829, 8592, 39894, 2655, 30543, 3615, 11933, 1829, 3224, 22807, 2423, 18877, 24976, 2787, 12, 9323, 3385, 18059], "avg_logprob": -0.2779166682561239, "compression_ratio": 1.6719576719576719, "no_speech_prob": 0.0, "words": [{"start": 2227.95, "end": 2228.45, "word": "Soft", "probability": 0.5821533203125}, {"start": 2228.45, "end": 2228.63, "word": "-rick", "probability": 0.127838134765625}, {"start": 2228.63, "end": 2229.01, "word": " lenses", 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candidates for soft lens than for GB lenses إذن مرة أخرى الحالات اللي بنستخدم فيها ال soft trick contact lenses الحالة الأولى", "tokens": [41185, 2423, 39184, 2787, 4282, 11933, 8848, 1863, 21136, 3555, 3555, 8978, 29910, 23275, 5296, 33456, 11296, 39894, 5016, 9381, 2288, 16247, 7435, 3794, 10943, 6024, 118, 16572, 49401, 44945, 35457, 3660, 5551, 4587, 1211, 9154, 2423, 26809, 18059, 366, 2049, 1101, 11255, 337, 2787, 6765, 813, 337, 26809, 18059, 11933, 8848, 1863, 3714, 25720, 5551, 34740, 7578, 21542, 6027, 9307, 13672, 1829, 44945, 14851, 9778, 40448, 8978, 11296, 2423, 2787, 4282, 3385, 18059, 21542, 6027, 3660, 16247, 12610, 7578], "avg_logprob": -0.1789158950617284, "compression_ratio": 1.5913461538461537, "no_speech_prob": 0.0, "words": [{"start": 2400.3, "end": 2400.5, "word": "في", "probability": 0.65380859375}, {"start": 2400.5, "end": 2400.7, "word": " الـ", "probability": 0.6629638671875}, {"start": 2400.7, "end": 2400.84, "word": " soft", "probability": 0.36962890625}, 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مغبلرة", "probability": 0.8524169921875}, {"start": 2446.55, "end": 2448.09, "word": " أيضا", "probability": 0.85595703125}, {"start": 2448.09, "end": 2448.31, "word": " اللي", "probability": 0.942138671875}, {"start": 2448.31, "end": 2448.65, "word": " هو", "probability": 0.97998046875}, {"start": 2448.65, "end": 2449.21, "word": " ممكن", "probability": 0.97119140625}, {"start": 2449.21, "end": 2449.67, "word": " مثلا", "probability": 0.967529296875}, {"start": 2449.67, "end": 2450.07, "word": " في", "probability": 0.982421875}, {"start": 2450.07, "end": 2450.35, "word": " بعض", "probability": 0.9931640625}, {"start": 2450.35, "end": 2451.65, "word": " الرياضات", "probability": 0.8118896484375}, {"start": 2451.65, "end": 2451.83, "word": " أو", "probability": 0.796875}, {"start": 2451.83, "end": 2452.11, "word": " بعض", "probability": 0.98681640625}, {"start": 2452.11, "end": 2452.67, "word": " الألعاب", "probability": 0.993896484375}, {"start": 2452.67, "end": 2452.99, "word": " أنه", "probability": 0.6959228515625}, {"start": 2452.99, "end": 2453.23, "word": " بده", "probability": 0.495361328125}, {"start": 2453.23, "end": 2453.59, "word": " يضطر", "probability": 0.924560546875}, {"start": 2453.59, "end": 2454.31, "word": " لاستخدام", "probability": 0.92978515625}, {"start": 2454.31, "end": 2454.63, "word": " مين", "probability": 0.891357421875}], "temperature": 1.0}, {"id": 103, "seek": 246516, "start": 2455.16, "end": 2465.16, "text": "ال software ال contact lenses أفضل من مين من ال RGB contact lenses ان شاء الله بنتوقف للنقطة هذه في المحاضرة القادمة بنكمل", "tokens": [6027, 4722, 2423, 3385, 18059, 5551, 5172, 11242, 1211, 9154, 3714, 9957, 9154, 2423, 31231, 3385, 18059, 16472, 13412, 16606, 21984, 44945, 2655, 30543, 5172, 24976, 1863, 47432, 3660, 29538, 8978, 9673, 5016, 46958, 25720, 25062, 18513, 46007, 44945, 24793, 1211], "avg_logprob": -0.19456845592884792, "compression_ratio": 1.330935251798561, "no_speech_prob": 5.960464477539063e-08, "words": [{"start": 2455.16, "end": 2455.44, "word": "ال", "probability": 0.7724609375}, {"start": 2455.44, "end": 2455.8, "word": " software", "probability": 0.3291015625}, {"start": 2455.8, "end": 2456.02, "word": " ال", "probability": 0.55419921875}, {"start": 2456.02, "end": 2456.32, "word": " contact", "probability": 0.69580078125}, {"start": 2456.32, "end": 2456.9, "word": " lenses", "probability": 0.87060546875}, {"start": 2456.9, "end": 2457.38, "word": " أفضل", "probability": 0.877197265625}, {"start": 2457.38, "end": 2457.54, "word": " من", "probability": 0.98388671875}, {"start": 2457.54, "end": 2457.88, "word": " مين", "probability": 0.94287109375}, {"start": 2457.88, "end": 2458.34, "word": " من", "probability": 0.90673828125}, {"start": 2458.34, "end": 2458.62, "word": " ال", "probability": 0.96728515625}, {"start": 2458.62, "end": 2459.06, "word": " RGB", "probability": 0.89111328125}, {"start": 2459.06, "end": 2460.14, "word": " contact", "probability": 0.78466796875}, {"start": 2460.14, "end": 2460.74, "word": " lenses", "probability": 0.8486328125}, {"start": 2460.74, "end": 2461.3, "word": " ان", "probability": 0.6298828125}, {"start": 2461.3, "end": 2461.48, "word": " شاء", "probability": 0.942626953125}, {"start": 2461.48, "end": 2461.48, "word": " الله", "probability": 0.9599609375}, {"start": 2461.48, "end": 2462.12, "word": " بنتوقف", "probability": 0.80657958984375}, {"start": 2462.12, "end": 2462.86, "word": " للنقطة", "probability": 0.8538818359375}, {"start": 2462.86, "end": 2463.18, "word": " هذه", "probability": 0.751953125}, {"start": 2463.18, "end": 2463.5, "word": " في", "probability": 0.69921875}, {"start": 2463.5, "end": 2464.1, "word": " المحاضرة", "probability": 0.9810791015625}, {"start": 2464.1, "end": 2464.72, "word": " القادمة", "probability": 0.9933268229166666}, {"start": 2464.72, "end": 2465.16, "word": " بنكمل", "probability": 0.9280598958333334}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 2465.843125, "duration_after_vad": 2289.2187499999936} \ No newline at end of file diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/YZZ_de8tRBA_raw.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/YZZ_de8tRBA_raw.srt new file mode 100644 index 0000000000000000000000000000000000000000..68da4c7064a01313c63fdb7041d697f97354469a --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/YZZ_de8tRBA_raw.srt @@ -0,0 +1,1952 @@ +1 +00:00:20,960 --> 00:00:23,580 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:23,580 --> 00:00:29,340 +وبركاته ومرحبا لكم جميعا في المحاضرة السابقة + +3 +00:00:29,340 --> 00:00:32,880 +اتناولنا موضوع ال بيجي باق contact lens system + +4 +00:00:32,880 --> 00:00:38,360 +وقلنا هي عبارة عن نظام بتكون من عدستين العدسة + +5 +00:00:38,360 --> 00:00:42,380 +الأولى هي عبارة عن RGB اللي هي بتكون في ال center + +6 +00:00:42,380 --> 00:00:47,360 +في المنتصف ال diameter لهذه العدسة بيكون من 8.5 ل + +7 +00:00:47,360 --> 00:00:52,740 +9.5 ميلي متر وقد يكون مختلفحسب اللي هو ال patient + +8 +00:00:52,740 --> 00:00:57,400 +وحسب ال fitting اللي بتم إجراءه للمريض الهدف من + +9 +00:00:57,400 --> 00:01:01,440 +ذلك اللي هو توفير ال stability و ال concentration + +10 +00:01:01,440 --> 00:01:07,460 +ل ال patient بشكل صحيح او ل العدسة ايضا توفير رؤية + +11 +00:01:07,460 --> 00:01:12,460 +مفيدة للمريض بينما ال soft contact lens بتكون في + +12 +00:01:12,460 --> 00:01:16,180 +الأطراف و ال diameter لها تكون تقريبا 14.5 ميلي + +13 +00:01:16,180 --> 00:01:21,350 +متر و ممكن اللي هو بيختلف حسبالـ Bulbiparal Fisher + +14 +00:01:21,350 --> 00:01:24,730 +بالنسبة للمريض أو الـ Horizontal أو ال Cornial + +15 +00:01:24,730 --> 00:01:27,850 +Diameter أو بنسميه الـ Horizontal Visible Iris + +16 +00:01:27,850 --> 00:01:31,690 +Diameter الهدف من الـ Soft Contact Lens اللي هو + +17 +00:01:31,690 --> 00:01:36,090 +توفير من الـ comfortable الراحة بالنسبة للمريض + +18 +00:01:38,820 --> 00:01:44,280 +الـ Indications دواعي الاستخدام للعدسات ال بيجي + +19 +00:01:44,280 --> 00:01:48,640 +باك contact lens system number one post-operative + +20 +00:01:48,640 --> 00:01:54,960 +corneal keratoplasty يعني أي مريض بيقبل على عملية + +21 +00:01:54,960 --> 00:02:00,120 +ال corneal transplantation زراعة قرانية او ال + +22 +00:02:00,120 --> 00:02:05,890 +corneal keratoplasty ممكن معه انه نحتاج ايه؟نحتاج + +23 +00:02:05,890 --> 00:02:10,290 +اللي هو عدسة اللي بيجي بها contact lens طبعا الهدف + +24 +00:02:10,290 --> 00:02:14,970 +من ذلك زي ما احنا اتفقنا ان ال optics لال RGB انه + +25 +00:02:14,970 --> 00:02:19,750 +بتعمل new surface لمين؟ للكورنيةأيضا في حالات + +26 +00:02:19,750 --> 00:02:24,830 +الأفاكيا ال absence of the crystalline lens في + +27 +00:02:24,830 --> 00:02:28,310 +حالات الكراتوكونس ال non inflammatory pathology + +28 +00:02:28,310 --> 00:02:31,350 +that can cause ectasia or protrusion for + +29 +00:02:31,350 --> 00:02:36,470 +substantia propria or for stroma أيضا في حالات ال + +30 +00:02:36,470 --> 00:02:40,890 +traumatic induced irregular astigmatism دايما أي + +31 +00:02:40,890 --> 00:02:45,730 +مريض عنده irregularity في ال surface لال كورنية + +32 +00:02:46,440 --> 00:02:51,000 +بحاول إنه أستخدم معه ال RGB contact lens أو اللي + +33 +00:02:51,000 --> 00:02:55,420 +هو فيه طرق علاج أخرى زي مثلا ال rings أو اللي + +34 +00:02:55,420 --> 00:02:59,420 +بنسميها ال intact rings أو اللي هي ال cross + +35 +00:02:59,420 --> 00:03:05,380 +linking تمام المشاكل لهذا النظام ال problems with + +36 +00:03:05,380 --> 00:03:10,000 +the system inability to center the rigid lens طب + +37 +00:03:10,000 --> 00:03:10,920 +إيش السبب؟ + +38 +00:03:13,170 --> 00:03:18,670 +إذا عدم القدرة على تمركز العدسة ال RGB دايما ليش + +39 +00:03:18,670 --> 00:03:27,430 +بيكون صعوبة في عملية التمركز ال RGB؟ فضلا طيب + +40 +00:03:27,430 --> 00:03:31,290 +سبب آخر من ضمن الأسباب اللي هو بتكون ال small + +41 +00:03:31,290 --> 00:03:41,170 +diameter كلام صليم عفوا لأ + +42 +00:03:41,280 --> 00:03:45,620 +هي فقط لل center صح ولا لأ؟ يعني هي ال diameter + +43 +00:03:45,620 --> 00:03:49,680 +بتاعها ما هيصل للأطراف لأن الأطراف هتكون عبارة عن + +44 +00:03:49,680 --> 00:03:54,120 +soft contact lens السبب الآخر يا جماعة هي ما يكون + +45 +00:03:54,120 --> 00:03:59,160 +عنده مثلا hand أربع و أربعين و نفترض hand اتنين و + +46 +00:03:59,160 --> 00:04:03,600 +أربعين لأ في عندنا hand ايش with the rule of + +47 +00:04:03,600 --> 00:04:10,760 +stigmatism او أربع و أربعينوهن اتنين واربعين زي + +48 +00:04:10,760 --> 00:04:15,020 +مثلا ال against the rule of stigmatism اذا ال with + +49 +00:04:15,020 --> 00:04:17,840 +the rule او ال against the rule of stigmatism + +50 +00:04:17,840 --> 00:04:24,130 +بيعمل ايه؟ دي center اذاحة باتجاه مين؟باتجاه + +51 +00:04:24,130 --> 00:04:28,930 +المنطقة اللي بتكون flat، الأكتر flat فهان العدسة + +52 +00:04:28,930 --> 00:04:33,350 +هيكون فيه هناك صعوبة لمين للتمركز فيها، لذلك الآن + +53 +00:04:33,350 --> 00:04:37,390 +لو اجالك شخص عنده with a rule of stigmatism أو + +54 +00:04:37,390 --> 00:04:40,830 +against a rule of stigmatism، مين الأفضل أديه RGB + +55 +00:04:40,830 --> 00:04:44,920 +ولا software contact lens؟الـ software الـ contact + +56 +00:04:44,920 --> 00:04:50,040 +lens لأن ال RGB بتعمل إيه؟ Decentration إزاحة سواء + +57 +00:04:50,040 --> 00:04:54,340 +إما بتكون temporarily أو نازلة أو up أو down تمام + +58 +00:04:54,340 --> 00:04:58,440 +فهي نفس الفكرة إنه في حالة ال بيجي باك contact + +59 +00:04:58,440 --> 00:05:02,680 +lens من مشاكلها إنه بيكون هناك صعوبة في عملية + +60 +00:05:02,680 --> 00:05:08,880 +تمركز من العدسة ال RGBnumber two inability to + +61 +00:05:08,880 --> 00:05:14,180 +handle the combination of the lenses واحدة فيهم + +62 +00:05:14,180 --> 00:05:18,700 +hard والتانية soft فالمريض بيشعر انه ايه في هناك + +63 +00:05:18,700 --> 00:05:24,090 +صعوبة في عملية اللي هو ايهلبس العدسة او في عملية + +64 +00:05:24,090 --> 00:05:28,550 +مثلا التنظيف او في عملية التخزين للعدسة يعني ممكن + +65 +00:05:28,550 --> 00:05:33,310 +زي ما انت تمسك عدسة hard و at the same time تمسك + +66 +00:05:33,310 --> 00:05:38,370 +عدسة soft فهناك شعور ان واحدة نعمة و واحدة hard + +67 +00:05:38,370 --> 00:05:44,510 +صلبةNumber three confusion over rigid and soft + +68 +00:05:44,510 --> 00:05:49,930 +cleaning and soaking solutions دايما محليل التنظيف + +69 +00:05:49,930 --> 00:05:54,830 +ومحليل التخزين بالنسبة للعدسات الصلبة او العدسات + +70 +00:05:54,830 --> 00:05:59,670 +النعمة هي تعتبر مختلفة صح ولا لا فممكن مثلا المريض + +71 +00:05:59,670 --> 00:06:06,250 +خربط يستخدممحلول ال RGB لل soft والعكس صحيح وهنا + +72 +00:06:06,250 --> 00:06:09,050 +دايما في ال contact lens اي كتاب في ال contact + +73 +00:06:09,050 --> 00:06:18,370 +lens بتقرأيه في حاجة اسمها ال benefit to cost ايش + +74 +00:06:18,370 --> 00:06:22,330 +معناها ال benefit to cost؟ اي كتاب في ال contact + +75 +00:06:22,330 --> 00:06:26,130 +lenses بكتبلك هذه الجملة او هذه الكلمتين benefit + +76 +00:06:26,130 --> 00:06:31,510 +to costالان احنا بنعرف ان في حاجة اسمها ال ideal + +77 +00:06:31,510 --> 00:06:35,830 +optical case for contact lens يعني ايش هو ال best + +78 +00:06:35,830 --> 00:06:41,230 +option لرقد او ايش ال best option لنورمثال مثلا + +79 +00:06:41,230 --> 00:06:45,730 +مريض بصل ال visual acuity عنده 6 ع 12 تمام؟ + +80 +00:06:45,730 --> 00:06:48,930 +philosophical soft contact lens تسأله لا إيش + +81 +00:06:48,930 --> 00:06:52,410 +الغرض؟ بقولك والله أنا بس بلبس العدسة اللي لها ثقة + +82 +00:06:52,410 --> 00:06:57,610 +ل ceremony أو ل مثلا party معين أو مثلا يمروا على + +83 +00:06:57,610 --> 00:07:02,230 +الجامعة إذا الغرض إيش ماله؟ محدود طيب في ال + +84 +00:07:02,230 --> 00:07:06,630 +software ال contact lens ال 6 ع 12 ممكن تصل 6 ع 9 + +85 +00:07:06,630 --> 00:07:13,100 +plus أو 6 ع 6 تمام؟إذا في هذه الحالة استخدامها + +86 +00:07:13,100 --> 00:07:17,340 +محدود دي الـ spherical soft contact lens ولا دي ال + +87 +00:07:17,340 --> 00:07:23,340 +soft contact lens؟ إيش رأيكم؟ ليش طيب؟ أديته ال + +88 +00:07:23,340 --> 00:07:29,270 +spherical soft contact lens، why؟بالضبط موضوع انه + +89 +00:07:29,270 --> 00:07:33,530 +انا والله استخدامها محدود العدسة اربع ساعات تعرفوا + +90 +00:07:33,530 --> 00:07:36,690 +انتوا الآن يعني بدنا نجيبها اللي هو كسعر ال + +91 +00:07:36,690 --> 00:07:40,450 +spherical soft contact lens اذا كانت ثانوية سعر + +92 +00:07:40,450 --> 00:07:43,690 +اللي هو ال two pair حوالي اللي هو مية و خمسين شكل + +93 +00:07:43,690 --> 00:07:47,270 +بينما ال soft trick ال two pair حوالي اللي هو + +94 +00:07:47,270 --> 00:07:51,900 +ستمائة شكللما تحكي للمريض انه فيه اختلاف سطر او + +95 +00:07:51,900 --> 00:07:56,780 +سطرين بسعر برقم هذا حيكون ايش فيه حاجة بنسميها ال + +96 +00:07:56,780 --> 00:08:00,340 +benefit to cost و لو كانت على حساب مين ال quality + +97 +00:08:00,340 --> 00:08:04,220 +of vision تمام؟ هذه الحالة اشتغلناها هي عبارة عن + +98 +00:08:04,220 --> 00:08:08,140 +piggyback contact lens حالة keratoconus طبعا كانت + +99 +00:08:08,140 --> 00:08:12,310 +اللي هو ال centerطبعا هذه قبل حوالي سنتين اول ما + +100 +00:08:12,310 --> 00:08:18,070 +رجعنا على البلد كان اللي هو ال center هو عبارة عن + +101 +00:08:18,070 --> 00:08:23,150 +RGB contact lens و ال peripheral كانت ايه؟ اللي + +102 +00:08:23,150 --> 00:08:26,410 +عبارة عن soft contact lens طبعا مشكلة العدسة هذه + +103 +00:08:26,410 --> 00:08:29,630 +لحد الآن بعمل follow up مع المريض انه عنده دايما + +104 +00:08:29,630 --> 00:08:33,970 +irritation كبير لاحظين ال conjunctival redness عند + +105 +00:08:33,970 --> 00:08:39,090 +المريض بشكل اللي هو كبيرفكان أمامي هو عنده ال + +106 +00:08:39,090 --> 00:08:43,150 +regular surface للكورنية عنده حوالي steep كورنية + +107 +00:08:43,150 --> 00:08:48,790 +اربع و خمسين ديوبتر واضحةعنده اللي هو with a rule + +108 +00:08:48,790 --> 00:08:53,630 +of stigmatism عاملة العدسة ال RGB دي center وانا + +109 +00:08:53,630 --> 00:08:58,110 +متفهم هذا الموضوع لكن هان يعني زي بنرجع لمثال ال + +110 +00:08:58,110 --> 00:09:01,770 +benefit to cost انه موضوع لو انا بدى استخدم معه ال + +111 +00:09:01,770 --> 00:09:05,750 +software ال contact lens هيكون ايش مش قادرة انه + +112 +00:09:05,750 --> 00:09:10,580 +تغطي اللي هو ال cornial cylinder بشكل كاملفانا + +113 +00:09:10,580 --> 00:09:14,780 +اضطريت ان ودي RGB عشان اعمل a new surface للكورنية + +114 +00:09:14,780 --> 00:09:18,900 +و الأطراف ان تكون عبارة عن مين ال soft العادية + +115 +00:09:18,900 --> 00:09:23,340 +عشان اخفف اللي هو ال irritation التهيوج بدا اسمع + +116 +00:09:23,340 --> 00:09:29,560 +منكم هل يعني انتوا accepted لهذا الموضوع ولا كيف؟ + +117 +00:09:30,760 --> 00:09:34,960 +الان متفاهمين الحالة، الحالة عندها اربعة و خمسين + +118 +00:09:34,960 --> 00:09:39,140 +ديوبتر على محور يعني في عندها steep cornea و + +119 +00:09:39,140 --> 00:09:42,340 +الذرول أستيجماتيزم انا اديتها بيجي بقى contact + +120 +00:09:42,340 --> 00:09:46,280 +lens معناه الكلام ان ال center الأطراف soft و بال + +121 +00:09:46,280 --> 00:09:52,060 +center كانت اللي هو ال RGB فإيش رأيكم في الموضوع؟ + +122 +00:09:58,520 --> 00:10:01,900 +الكلام مائة في المائة صحيح وهذه انا ايش عملت في + +123 +00:10:01,900 --> 00:10:06,640 +الحالة هذه؟ روحت قللت من ال edge lift جللت منه + +124 +00:10:06,640 --> 00:10:10,960 +شوية فصار اللي هو ال decentralization اتعودالكلام + +125 +00:10:10,960 --> 00:10:14,340 +يعني رائع مية في المية الان ال with the rule of + +126 +00:10:14,340 --> 00:10:17,340 +stigmatism ال decentralization هيكون كيف؟ up و + +127 +00:10:17,340 --> 00:10:21,200 +down اقل من مين؟ من ال against the rule ال against + +128 +00:10:21,200 --> 00:10:24,440 +the rule بتلاحظ ان كل العدسة بتميل اما نازلي او + +129 +00:10:24,440 --> 00:10:28,600 +temporarily تمام فهنا في هذه الحالة بتقلل من اطراف + +130 +00:10:28,600 --> 00:10:32,400 +العدسة ال RGB يعني بتقلل ال diameter بيصير عندك + +131 +00:10:32,400 --> 00:10:36,440 +اللي هو الأمر بيقلل لكن مش مية في المية من ناحية + +132 +00:10:36,440 --> 00:10:39,780 +ال decentralization تمام؟ + +133 +00:10:42,350 --> 00:10:45,590 +عنا ال orthocarotology، مين بتعرف ال + +134 +00:10:45,590 --> 00:10:50,530 +orthocarotology؟ العدسات هذه؟ بالضبط، هي بنسميها + +135 +00:10:50,530 --> 00:10:55,690 +ال dreams lenses فعنا ال dreams lenses اللي هي + +136 +00:10:55,690 --> 00:10:59,250 +عبارة عن عدسات الأحلام و ال another name اليوم + +137 +00:10:59,250 --> 00:11:05,990 +بيسموها ortho .. ممتازة .. k lenses + +138 +00:11:07,240 --> 00:11:12,600 +من اسمها هذا النوع من العدسات بتعمل reshape او + +139 +00:11:12,600 --> 00:11:18,920 +remolded اي بمعنى اعادة تشكيل القرنية، اذا بتعمل + +140 +00:11:18,920 --> 00:11:25,380 +reshape او + +141 +00:11:25,380 --> 00:11:28,740 +remolded + +142 +00:11:28,740 --> 00:11:34,090 +لمين؟ للانتريور surface of the corneaطيب، مدام هي + +143 +00:11:34,090 --> 00:11:39,410 +بتعمل إعادة تشكيل لسطح القرنية، بتتوقع هي بتستخدم + +144 +00:11:39,410 --> 00:11:43,730 +مع الميوب ولا ال hypermetrope؟ مع الميوب، ليش؟ + +145 +00:11:43,730 --> 00:11:49,130 +لأنه ببساطة انه .. لكن هذا الأمر يعني الآن احنا مع + +146 +00:11:49,130 --> 00:11:53,270 +طالبات اللي هو في بحث التخرج، هنثبت العكس اعتقد، + +147 +00:11:53,270 --> 00:11:58,090 +الميوب هوانه في الدراسات السابقة بنعرف ان الشخص + +148 +00:11:58,090 --> 00:12:02,250 +لما يكون ميوب بيكون عنده steep cornea كلام سليم + +149 +00:12:02,250 --> 00:12:06,850 +لكن هذا الأمر يعني الآن هي .. في دراسة بيقولك لأ + +150 +00:12:06,850 --> 00:12:09,570 +انه there is no significant مافيش significant + +151 +00:12:09,570 --> 00:12:14,270 +association ما بينهم نرجع لموضوع لمرة تانية يعني + +152 +00:12:14,270 --> 00:12:18,370 +انا بدي اصل لكم لمعلومة انه دايما مش كل معلومة في + +153 +00:12:18,370 --> 00:12:21,110 +الكتاب هي مية في المية دقيقة يمكن تكون عندنا + +154 +00:12:21,110 --> 00:12:25,620 +مختلفةفاحنا يا جماعة ال Orthocarotology او لـ + +155 +00:12:25,620 --> 00:12:29,280 +Dreams Lenses الهدف منها إعادة تشكيل القرنية + +156 +00:12:29,280 --> 00:12:34,200 +للأشخاص اللي بيكونوا ايه؟ ميوب، okay؟ ليش ميوب؟ + +157 +00:12:34,200 --> 00:12:37,740 +لأنه بيكون عنده steep cornea يعني قيمة الديوبتريك + +158 +00:12:37,740 --> 00:12:41,740 +باور بيفترض انه اعلى من ال normal range يعني اعلى + +159 +00:12:41,740 --> 00:12:45,580 +من اتنين واربعين او تلاتة واربعين لو افترض معها هي + +160 +00:12:45,580 --> 00:12:51,500 +ال normal rangeإذن Orthokeratology or + +161 +00:12:51,500 --> 00:12:56,120 +Orthokeratosis has been advanced a system for + +162 +00:12:56,120 --> 00:13:00,960 +sight without glasses يعني هي بتوفرلك رؤية sight + +163 +00:13:00,960 --> 00:13:06,440 +يعني بمعنى vision بدون استخدام لمين؟ للنضارة، ما + +164 +00:13:06,440 --> 00:13:09,980 +بحتاج إن المريض يلبس نضارة أو عدسة لاصقة + +165 +00:13:14,250 --> 00:13:18,650 +The premise أو بمعنى the principle، المبدأ، إيش + +166 +00:13:18,650 --> 00:13:24,930 +مبدأ هذه العدسة؟ The premise behind the system is + +167 +00:13:24,930 --> 00:13:29,590 +that progressive flattening of the cornea، إذا + +168 +00:13:29,590 --> 00:13:35,690 +بتعمل عملية تسطيح لسطح القرنيةThrough the use of a + +169 +00:13:35,690 --> 00:13:39,770 +series of flatter-fitting lenses will eliminate + +170 +00:13:39,770 --> 00:13:45,050 +myopia.إذن بتعمل تسطيح لسطح القرنية من خلال + +171 +00:13:45,050 --> 00:13:50,370 +استخدام مجموعة من العدسات واضحة؟ وهذه إيش بتعمل + +172 +00:13:50,370 --> 00:13:52,150 +بالزيل الميوبيا + +173 +00:13:57,250 --> 00:14:01,270 +The degree of flattening درجة اللي هو التصطيح هذه + +174 +00:14:01,270 --> 00:14:06,660 +must be uniformاحنا بنعرف ان الميوب هو يعتبر ايه + +175 +00:14:06,660 --> 00:14:11,060 +دي focus او يعتبر low order aberration يعني في + +176 +00:14:11,060 --> 00:14:15,620 +عنده سفير كورنية صحيح يعني بمعنى اخر ان كل ال + +177 +00:14:15,620 --> 00:14:19,960 +power متساوي في كل المحاور فالان انا ما بدى استخدم + +178 +00:14:19,960 --> 00:14:24,580 +هذا النوع من العدسات لازم انه تعمل تسطيح لايه لكل + +179 +00:14:24,580 --> 00:14:30,240 +سطح القرنية اذا uniform بمعنى regular بشكل منتظم + +180 +00:14:31,490 --> 00:14:35,950 +إذا التصطيح هذا must be uniform in all meridians + +181 +00:14:35,950 --> 00:14:41,490 +but this is not always the case and many cases + +182 +00:14:41,490 --> 00:14:46,610 +resulting in atoric cornea طيب الآن الزيادة في + +183 +00:14:46,610 --> 00:14:50,010 +استخدام هذا النوع من العدسات ممكن يديني نتيجة + +184 +00:14:50,010 --> 00:14:54,410 +عكسية زي الآن مريض عنده إيزوترابيا بعد العملية صار + +185 +00:14:54,410 --> 00:15:00,290 +إيش؟ إكزوترابيا راح الجراح إيش عمل؟عمل اللي هو + +186 +00:15:00,290 --> 00:15:04,350 +كأنه universally يعني جلب اللي هو حالة المريض فهان + +187 +00:15:04,350 --> 00:15:08,450 +الكترة من استخدام هذا النوع من العدسات ممكن يؤدي + +188 +00:15:08,450 --> 00:15:14,030 +إلى شيء عكسي اللي هو يعمل ترك كورنية عند المريض + +189 +00:15:14,030 --> 00:15:15,070 +واضحة؟ + +190 +00:15:19,280 --> 00:15:23,560 +طيب ال method هذا وين بيستخدم؟ الآن مثلا إنسان + +191 +00:15:23,560 --> 00:15:28,940 +pilot طيار هل بتتوقع إن هذا الشخص بيقدر يلبس عدا + +192 +00:15:28,940 --> 00:15:33,160 +سلاسقة أو يلبس نضارة؟ ممنوع طيب عنده refractive + +193 +00:15:33,160 --> 00:15:37,320 +error إذا ممكن إحنا نستخدم معه إيش ال + +194 +00:15:37,320 --> 00:15:42,280 +orthochiratology إنسان مثلا football player لاعب + +195 +00:15:42,280 --> 00:15:46,710 +كرة قدمطبعا ممكن يلبس soft contact lens لكن مش + +196 +00:15:46,710 --> 00:15:50,650 +حابب أثناء المباراة يلبس العدسة ممكن اللي هو + +197 +00:15:50,650 --> 00:15:55,170 +نستخدم معه ال orthokeratology أو مثلا في ال fire + +198 +00:15:55,170 --> 00:16:00,610 +fighters رجال الأطفاء أو ال policeman and ال + +199 +00:16:00,610 --> 00:16:04,690 +swimmers كل هدول الأشخاص ممكن أنه نستخدم معهم هذا + +200 +00:16:04,690 --> 00:16:09,630 +النوع من العدساتwho require good vision but cannot + +201 +00:16:09,630 --> 00:16:14,510 +wear contact lens يعني هتعمل على تحسين حالة المريض + +202 +00:16:14,510 --> 00:16:19,170 +لكن مش هيظلوا لابس العدسة بالضبط يعني بلبسها في + +203 +00:16:19,170 --> 00:16:23,910 +الليل و بنام فيها بس okay بعد ذلك هتعمله ايش + +204 +00:16:23,910 --> 00:16:26,830 +improvement ل ال visual acuity + +205 +00:16:30,460 --> 00:16:34,100 +طبعا هذا ال method شبهوه كأنه عبارة عن ايه؟ + +206 +00:16:34,100 --> 00:16:39,660 +surgical procedure يعني كأنه عملية للكورنية عشان + +207 +00:16:39,660 --> 00:16:44,420 +تصلح من الامترابيا او الميابيا يعني ممكن تكتب بين + +208 +00:16:44,420 --> 00:16:49,640 +جثين عشان تعمل flattening لل surface of the cornea + +209 +00:16:49,640 --> 00:16:53,780 +اذا الان لو سألتك السؤال ايش ال main objective ل + +210 +00:16:53,780 --> 00:16:58,480 +ال orthokeratology lenses of the cornea؟ + +211 +00:17:01,800 --> 00:17:07,860 +أورثو كيراتولوجيا فيتينج سيطس هم مستعملين و مصنعين + +212 +00:17:07,860 --> 00:17:14,500 +قبل قليل من ال RGB لنزل تقريبا 370 لنزل بعض من ال + +213 +00:17:14,500 --> 00:17:18,160 +update لهذا النوع من العدسات طبعا هي مش موجودة + +214 +00:17:18,160 --> 00:17:24,620 +عندناانه صاروا يستخدموا RGB طبعا هي طبيعة العدسة + +215 +00:17:24,620 --> 00:17:28,480 +semisqueral design وهي soft contact lens الآن + +216 +00:17:28,480 --> 00:17:33,040 +البعض صار يستخدم RGB ولكن لها مشاكل انتوا عارفينها + +217 +00:17:33,040 --> 00:17:36,180 +اللي هي عبارة عن ال disadvantage الزمين لل RGB + +218 +00:17:36,180 --> 00:17:40,460 +contact lenses طبعا بيكون انا هشوفكم إياها ان شاء + +219 +00:17:40,460 --> 00:17:43,920 +الله في المعمل لكن المشكلة انه احنا مابنستخدم هذا + +220 +00:17:43,920 --> 00:17:47,280 +النوع من العدسات الا في الأبحاث لان المريض لازم + +221 +00:17:47,280 --> 00:17:51,920 +ينام فيهايعني لو استخدمناها في المعمل انه هيكون + +222 +00:17:51,920 --> 00:17:56,340 +useless بدون فائدة okay فبتيجي هي حوالي انه + +223 +00:17:56,340 --> 00:18:00,400 +تلاتمية و سبعين عدسة انه pair اللي هو كزوج من + +224 +00:18:00,400 --> 00:18:01,260 +العدسات + +225 +00:18:04,350 --> 00:18:09,950 +the lenses are reassessed every six weeks اذا كل + +226 +00:18:09,950 --> 00:18:14,370 +ستة سابق انا بدي اعمل اعادة تقييم او اعادة اللي هو + +227 +00:18:14,370 --> 00:18:20,230 +ايه investigation تحقق من هذا النوع من العدسات طيب + +228 +00:18:20,230 --> 00:18:24,250 +فكركم وين هذي ممكن انا يعني ايش ال indication لها + +229 +00:18:24,250 --> 00:18:28,890 +يعني متى انا بقدر استخدم هذا النوع لأي شخص ممكن + +230 +00:18:28,890 --> 00:18:36,200 +استخدمهالأ انا افترض مثلا انسان مدرس جامعي او + +231 +00:18:36,200 --> 00:18:40,320 +نفترض مثلا officer او مهندس ممكن استخدم معاه هذا + +232 +00:18:40,320 --> 00:18:46,310 +النوع من العدسات ولا لا؟لأ بس يعني انه بعد فترة + +233 +00:18:46,310 --> 00:18:50,090 +مابتش يستخدم عجزات لإنه بعد فترة هبقى بطل أستخدمها + +234 +00:18:50,090 --> 00:18:53,950 +لإنها عملت reshaping للكورنيا و اتصلح يعني لا بد + +235 +00:18:53,950 --> 00:18:58,570 +يعمل ليزج ولا بد يستخدم كلام سليم الان مثلا مريض + +236 +00:18:58,570 --> 00:19:03,810 +عمل فحوصات ليزج عمل كورنيا توبوغرافي عمل cct لجأ + +237 +00:19:03,810 --> 00:19:07,870 +انه ال central corneal thickness أقل من المقلوب هل + +238 +00:19:07,870 --> 00:19:13,110 +بنفع يعمله الدكتور ليزج سيرجيري؟ لأبالضبط فبنعمل + +239 +00:19:13,110 --> 00:19:18,470 +reshaping لمين؟ للكورنيا من خلال استخدام ايه؟ ال + +240 +00:19:18,470 --> 00:19:22,250 +orthokeratology لكن يا جماعة بدكم تحطوا في بالكم + +241 +00:19:22,250 --> 00:19:27,890 +ان في هناك دراسات اثبتت ان ال orthokeratology ايضا + +242 +00:19:27,890 --> 00:19:31,730 +فيها disadvantages انه بتعمل reduce لل central + +243 +00:19:31,730 --> 00:19:37,730 +corneal thickness تمام؟ انه بتقلل من اللي هو ايه؟ + +244 +00:19:37,730 --> 00:19:44,260 +ال cctطبعا هي بشكل عام ال .. ال contact lenses + +245 +00:19:44,260 --> 00:19:50,320 +بتقلل من ال CCT حتى .. لكن .. اه هذه بكمية اكبر .. + +246 +00:19:50,320 --> 00:19:53,520 +نعم تمام + +247 +00:19:53,520 --> 00:19:58,080 +اللي هي central corneal thickness + +248 +00:20:14,760 --> 00:20:20,980 +A patient may need five or six pairs of lenses the + +249 +00:20:20,980 --> 00:20:27,060 +first year فعلا هي تعتبر surgical procedure المريض + +250 +00:20:27,060 --> 00:20:32,360 +في السنة الأولى بيحتاج حوالي من خمسة لست أزواج من + +251 +00:20:32,360 --> 00:20:36,940 +العدسات لكن يا جماعة هذا ليس يعني شئ ثابت ممكن + +252 +00:20:36,940 --> 00:20:42,180 +يتغيريعني أنا بذكر في بيشان تلت أزواج كان اللي هو + +253 +00:20:42,180 --> 00:20:46,900 +عاملة flattening لل surface of the corn يعني تمام؟ + +254 +00:20:46,900 --> 00:20:49,280 +يعني دايما انتوا عارفين ال theory مختلف عن ال + +255 +00:20:49,280 --> 00:20:52,840 +practice لكن هان هو دايما بذكر اللي هو ال ideal + +256 +00:20:52,840 --> 00:20:57,720 +method الطريقة المثالية three or four the second + +257 +00:20:57,720 --> 00:21:03,200 +yearOkay or three more the third year يعني تقريبا + +258 +00:21:03,200 --> 00:21:08,800 +بعض الأشخاص العلاج بتاعهم من سنتين لتلاتة بيعمل a + +259 +00:21:08,800 --> 00:21:15,010 +flattening لمين؟ لل surface of the corneaAs a + +260 +00:21:15,010 --> 00:21:18,890 +general, five to seven pairs of lenses are + +261 +00:21:18,890 --> 00:21:22,170 +required to achieve a flattening effect يعني ممكن + +262 +00:21:22,170 --> 00:21:26,550 +أن المريض بيحتاج من خمسة إلى سبع أزواج عشان تعمل + +263 +00:21:26,550 --> 00:21:30,110 +reshaping أو remolded للsurface of the cornea + +264 +00:21:30,110 --> 00:21:34,330 +وبالتالي بتعمله flattening للsurface of the cornea + +265 +00:21:36,570 --> 00:21:40,570 +طيب ال procedure is most applicable يعني أكتر + +266 +00:21:40,570 --> 00:21:45,590 +استعمالا أو استخداما to myopic people minus three + +267 +00:21:45,590 --> 00:21:50,750 +diopter or less لكن للأمانة أنا قرأت دراسة 2017 + +268 +00:21:50,750 --> 00:21:56,390 +ذكروا فيها to minus six diopter فهذه صلحوها أنه + +269 +00:21:56,390 --> 00:22:00,790 +minus six diopter or lessطيب، الآن أنا بقولك، + +270 +00:22:00,790 --> 00:22:05,090 +minus 3 او اقل، ايش بتتوقع هذا النوع؟ هيكون mild + +271 +00:22:05,090 --> 00:22:09,230 +myopia او low myopia من minus 6 او اقل، اذا + +272 +00:22:09,230 --> 00:22:13,870 +moderate myopia، تمام؟ يعني هي قادرة على تصحيح ال + +273 +00:22:13,870 --> 00:22:15,670 +mild and moderate myopia + +274 +00:22:22,020 --> 00:22:27,280 +A proper fit يعني بمعنى انه يكون الفت ملائم او + +275 +00:22:27,280 --> 00:22:32,660 +مناسب او صحيح بالنسبة للمريض is one in which the + +276 +00:22:32,660 --> 00:22:37,140 +lens has a tangent touch ايش معناه ال tangent؟ + +277 +00:22:37,140 --> 00:22:42,260 +لازم انه تكون العدسة ملامس ويكون عبارة عن curve + +278 +00:22:42,260 --> 00:22:46,680 +لان احنا قلنا ان القرنية كده بتكون steep cornea + +279 +00:22:46,680 --> 00:22:51,060 +فلازم انه يعمل وكأنه اللي هو curve الوجه عليه + +280 +00:23:01,130 --> 00:23:04,570 +للسطح اللي هو بيكون flattest meridian + +281 +00:23:07,750 --> 00:23:12,510 +طبعا هي العدسة احنا عارفين انه بالنسبة لالميوب انه + +282 +00:23:12,510 --> 00:23:16,290 +ال incident light rays are brought to focus in + +283 +00:23:16,290 --> 00:23:20,110 +front of the retina بنستخدم اللي هو العدسة عشان + +284 +00:23:20,110 --> 00:23:24,690 +تعمل reshaping او remolding لانتريو surface of the + +285 +00:23:24,690 --> 00:23:29,330 +cornea فالهدف الأساسي انه تعمل flattening للانتريو + +286 +00:23:29,330 --> 00:23:32,950 +surface of the cornea و تعمل اللي هو تجميع الأشعة + +287 +00:23:32,950 --> 00:23:34,810 +كلها on the retina + +288 +00:23:39,300 --> 00:23:45,240 +الشكل هذا مين تقدر تعملي explanation له خدوا دقيقة + +289 +00:23:45,240 --> 00:23:49,960 +و بدي واحدة تعملي explanation ل ال three figures + +290 +00:23:49,960 --> 00:23:57,400 +الشكل الأول هو قرنية المريض كانت ان هو مياب بعد + +291 +00:23:57,400 --> 00:24:01,940 +هيك جيبناله عدسة بس طبعا تاخد الشكل القرنية بتاخد + +292 +00:24:01,940 --> 00:24:06,960 +شكل بحيث لما انا اشيل العدسة تكون عاملة re-shaping + +293 +00:24:06,960 --> 00:24:11,540 +ومصالحة ال ..ال refraction اللى عندها فكانت من + +294 +00:24:11,540 --> 00:24:15,140 +النص اللى هضغط عليها لإنه بتكون عنده thick trauma + +295 +00:24:15,140 --> 00:24:19,300 +فإنه بتكون مياب فإنه هتضغط عشان تتقلل من ال cct + +296 +00:24:19,300 --> 00:24:23,880 +هذا .. هذا كان شكل اتنين و هو نايم كانت ضغطة لما + +297 +00:24:23,880 --> 00:24:28,080 +انشعله الصبح هتظهر نفس شكل العدسة اللى هو مسلح + +298 +00:24:28,080 --> 00:24:33,640 +يعني ال curve نعمو في الشكل الآخر اللي هو عملت ايش + +299 +00:24:33,640 --> 00:24:37,340 +remolded او reshape لمن؟ للانتريو ال surface of + +300 +00:24:37,340 --> 00:24:44,160 +the cone و اضحى اعتقد كلير بيم soft contact lenses + +301 +00:24:44,160 --> 00:24:45,640 +for astigmatism + +302 +00:25:03,660 --> 00:25:07,140 +Motivation should be considered in screening + +303 +00:25:07,140 --> 00:25:11,760 +patients for any contact lens زي ما اتفقنا ان + +304 +00:25:11,760 --> 00:25:17,200 +الحافظ هو يعتبر number one للمريض اللي بينوي + +305 +00:25:17,200 --> 00:25:21,580 +ارتداء العدسة اللاسقة سواء كانت spherical soft + +306 +00:25:21,580 --> 00:25:27,170 +contact lens كانت مثلاSoft-rec contact lens حتى ال + +307 +00:25:27,170 --> 00:25:30,490 +RGB إذا ما كان المريض عنده motivation من الداخل + +308 +00:25:30,490 --> 00:25:35,830 +حافظ من الداخل مش هيقدر على ارتداء العدسة اللاصقة + +309 +00:25:35,830 --> 00:25:39,970 +أو بمعنى آخر يعني هان ال motivation ليش مهم؟ عشان + +310 +00:25:39,970 --> 00:25:43,550 +المريض بالاخر يقدر يعمل adaptation تكييف مع العدسة + +311 +00:25:43,550 --> 00:25:48,150 +تمام؟ لأنه إذا المريض مش مقتنع في العدسة مش هيقدر + +312 +00:25:48,150 --> 00:25:55,350 +يعمل adaptation إليها بالضبطهناك معلومات مختصرة + +313 +00:25:55,350 --> 00:26:01,530 +لتنافس المريض بصيغة توريك لينزطبعا فاكرين كل ال + +314 +00:26:01,530 --> 00:26:06,830 +indications او ال advantages اللي خاصة بال soft + +315 +00:26:06,830 --> 00:26:11,050 +contact lens او ال spherical soft contact lens هي + +316 +00:26:11,050 --> 00:26:14,410 +نفسها من ال advantages لل soft tourique contact + +317 +00:26:14,410 --> 00:26:18,350 +lenses لكن الاختلاف بينهم في موضوع من ال residual + +318 +00:26:18,350 --> 00:26:22,230 +astigmatism او في موضوع ال tourique cornea طبعا + +319 +00:26:22,230 --> 00:26:26,850 +احنا هتيجي معنا انه المميزات ل ال soft tourique + +320 +00:26:26,850 --> 00:26:36,370 +contact lensesمئة من المريضين كانت 45% كانت صحيحة + +321 +00:26:36,370 --> 00:26:48,910 +أوريجرياتر 4.75 مئة + +322 +00:26:48,910 --> 00:26:49,230 +مئة مئة مئة مئة مئة مئة مئة مئتا مئتا مئتا مئتا + +323 +00:26:49,230 --> 00:26:50,010 +مئتا مئتا مئتا مئتا مئتا مئتا مئتا مئتا مئتا مئتا + +324 +00:26:50,010 --> 00:26:50,290 +مئتا مئتا مئتا مئتا مئتا مئتا مئتا مئتا مئتا مئتا + +325 +00:26:50,290 --> 00:26:50,290 +مئتا مئتا مئتا مئتا مئتا مئتا مئتا مئتا مئتا مئتا + +326 +00:26:50,290 --> 00:26:54,540 +مئتا مئتا مئتا مئتا مئتا مئتا مئتا مئتا مئتع الـ + +327 +00:26:54,540 --> 00:26:59,600 +minus نص أكسز مية و تمانين تمام؟ الآن بدنا نتفق ع + +328 +00:26:59,600 --> 00:27:04,300 +شغل مهم ان قيمة ال astigmatism في المثال الأول هي + +329 +00:27:04,300 --> 00:27:07,980 +مساوية لقيمة ال astigmatism في المثال التاني ولكن + +330 +00:27:07,980 --> 00:27:12,820 +شتتان بين التنين صح؟ في القيمة الأولى، قداش قيمة + +331 +00:27:12,820 --> 00:27:18,740 +ال astigmatism بالنسبة للاسفير تعتبر .. المثال + +332 +00:27:18,740 --> 00:27:25,440 +الأولإذا قيمة ال astigmatism بالنسبة للسفير في + +333 +00:27:25,440 --> 00:27:31,220 +المثال الأول تعتبر insignificant يعني غير مهمة أو + +334 +00:27:31,220 --> 00:27:34,980 +ممكن أنا أعملها إيش ignore أو ممكن عفوا يما أعمل + +335 +00:27:34,980 --> 00:27:38,300 +subjective refraction المريض إيش ماله مايحتاجه + +336 +00:27:38,300 --> 00:27:43,000 +طبعا طالب ال astigmatism أجمع لغة السفير مابحطوش + +337 +00:27:43,000 --> 00:27:48,180 +بعد جوبة السفير ببدأ أشوف إذا هوتمام وهذه عبارة عن + +338 +00:27:48,180 --> 00:27:51,200 +قاعدة مين ال rule of four اللي هتيجي معنا ان شاء + +339 +00:27:51,200 --> 00:27:56,400 +الله لقدام فالان الفكرة العامة انه انا بدي اعمل + +340 +00:27:56,400 --> 00:28:01,500 +مقارنة ما بين قيمة الاسفير و قيمة السيلندرفي + +341 +00:28:01,500 --> 00:28:04,980 +الحالة الأولى قيمة السلندر بالنسبة للاسفير + +342 +00:28:04,980 --> 00:28:09,140 +insignificant فالمريض ممكن ما يحتاج ايه السلندر + +343 +00:28:09,140 --> 00:28:14,980 +هذه المثال التاني قيمة السلندر مشابهة لمين لقيمة + +344 +00:28:14,980 --> 00:28:18,700 +الاسفير ف hand قد تكون ايش انه hand significant + +345 +00:28:18,700 --> 00:28:22,640 +تمام الفكرة؟ يعني قد تكون اللي هو المريض بده يحتاج + +346 +00:28:22,640 --> 00:28:25,580 +و بالتأكيد انه هيحتاج القيمة هذه + +347 +00:28:29,300 --> 00:28:33,900 +Patients with 0.75 of refractive astigmatism + +348 +00:28:33,900 --> 00:28:39,080 +should be considered candidates for softeric + +349 +00:28:39,080 --> 00:28:43,280 +lenses مين بتقدر تعمل الهو explanation لهذه الجملة + +350 +00:28:43,280 --> 00:28:48,460 +يعني مرشح اللي هو participants اللي هو كمتسابق + +351 +00:28:48,460 --> 00:28:51,660 +يعني انا بقول مثلا candidate one متسابق الأول + +352 +00:28:51,660 --> 00:28:55,280 +candidate two متسابق التاني التالت يعني بمعنى + +353 +00:28:55,280 --> 00:28:57,280 +subjects okay + +354 +00:29:11,170 --> 00:29:17,750 +بس هان ايش بده يكون؟ بالضبط حسب ال benefit to cost + +355 +00:29:17,750 --> 00:29:23,170 +لكن هان هو الكتاب بتكلم بطريقة ايش؟ ال ideal + +356 +00:29:23,170 --> 00:29:28,060 +بالطريقة ال ideal optical methodلكن زي ما احنا + +357 +00:29:28,060 --> 00:29:31,880 +بنعرف بالنسبة انه دايما ال benefit to cost هذه + +358 +00:29:31,880 --> 00:29:37,900 +القاعدة اللى بنشتغل عليها softoric + +359 +00:29:37,900 --> 00:29:41,860 +lenses make the tear lens compensation + +360 +00:29:41,860 --> 00:29:46,520 +considerations of gb lenses and in many cases + +361 +00:29:46,520 --> 00:29:51,560 +maybe easier to prescribeلو فاكرين في ال soft + +362 +00:29:51,560 --> 00:29:56,080 +contact lens حكينا ال post tear lens يعتبر very + +363 +00:29:56,080 --> 00:29:59,980 +limit صحيح؟ في حالة ال soft contact lens و نفس + +364 +00:29:59,980 --> 00:30:03,560 +الحاجة وين؟ في ال software ال contact lens ال post + +365 +00:30:03,560 --> 00:30:07,240 +tear lens يعتبر very limit لأنه ببساطة هي بتاخد + +366 +00:30:07,240 --> 00:30:12,880 +شكل القرنية تمام؟ لكن في ال GB lenses تعتبر ال + +367 +00:30:12,880 --> 00:30:16,780 +post tear lens اشمالها significant يعني ذات قيمة + +368 +00:30:24,610 --> 00:30:29,910 +Soft rec lenses are most successful with regular + +369 +00:30:29,910 --> 00:30:37,230 +astigmatism why خديجة ايش السبب ان ليش ال soft rec + +370 +00:30:37,230 --> 00:30:42,230 +contact lenses هي اكتر نجاحا في حالات ال regular + +371 +00:30:42,230 --> 00:30:43,510 +astigmatism + +372 +00:30:51,910 --> 00:30:55,810 +ممتازة البساطة لان ال software ال contact lens + +373 +00:30:55,810 --> 00:31:01,550 +هتاخد شكل مين القرنية طيب نفترض شكل القرنية كان + +374 +00:31:01,550 --> 00:31:08,630 +irregular مش هتعدله اذا هذا بدخل في مين؟ في ال + +375 +00:31:08,630 --> 00:31:13,510 +optics لل RGB ال optics لل RGB ايش هتعمل؟ ال new + +376 +00:31:13,510 --> 00:31:17,790 +surface للكورنية فهتعمل عملية ايش؟ يعني اللي هو + +377 +00:31:17,790 --> 00:31:23,510 +تعديلبالضبط من ناحية اللى هو ك optics لل RGB + +378 +00:31:23,510 --> 00:31:27,090 +Contact Lens انه هتاخد New Surface للكورنية وبعد + +379 +00:31:27,090 --> 00:31:31,310 +ذلك من خلال التير هتعمل اللى هو شكل يكون منتظم + +380 +00:31:31,310 --> 00:31:36,770 +للقرانية تمام؟ اذا الان لو سألتك السؤال why soft + +381 +00:31:36,770 --> 00:31:41,030 +rec lenses are most successful with regular + +382 +00:31:41,030 --> 00:31:44,970 +astigmatism عارفين اللى هو السبب لأنها بتاخد شكل + +383 +00:31:44,970 --> 00:31:52,150 +القرانية لكن هي بتصلح مين؟الريزيدي والاستيجماتيزم + +384 +00:31:52,150 --> 00:31:57,330 +with software cleanse availability ranging from + +385 +00:31:57,330 --> 00:32:02,170 +plus twenty to minus twenty diopter of sphere + +386 +00:32:02,170 --> 00:32:06,270 +power يعني بمعنى ال range بتاعها هيكون من plus + +387 +00:32:06,270 --> 00:32:09,050 +عشرين ل minus عشرين ديوبتر + +388 +00:32:11,920 --> 00:32:15,840 +and up to ten diopters of cylinder power in one + +389 +00:32:15,840 --> 00:32:22,100 +degree axis steps يعني كل degree لها قيمة هناخد ان + +390 +00:32:22,100 --> 00:32:25,920 +شاء الله في المعمل يما يصير هناك انه عندنا كل اللي + +391 +00:32:25,920 --> 00:32:30,040 +هو واحد degree عبارة عن thirty cycle هاد ان شاء + +392 +00:32:30,040 --> 00:32:33,220 +الله هنتكلم فيها من خلال المعمل ان كيف نشوف ال + +393 +00:32:33,220 --> 00:32:39,340 +rotation العدسة من خلال الستلةThere is no limit to + +394 +00:32:39,340 --> 00:32:44,740 +the potential astigmatic patients who can be fit + +395 +00:32:44,740 --> 00:32:49,520 +with softeric lens وهذه النقطة مهمة.الان ممكن انا + +396 +00:32:49,520 --> 00:32:54,640 +ادى للمريض RGB contact lens لكن انا اتوقع انه في + +397 +00:32:54,640 --> 00:32:58,600 +عنده potential.ايش معناه potential astigmatism؟ + +398 +00:32:58,760 --> 00:33:03,100 +يعني astigmatism افتراضي وهو عبارة عن مين ال + +399 +00:33:03,100 --> 00:33:07,180 +residual astigmatism لكن انا لما بدي للمريض ال + +400 +00:33:07,180 --> 00:33:10,760 +software contact lens مش هتوقع انه يبقى عنده ايش + +401 +00:33:10,760 --> 00:33:14,460 +ال potential او ال residual astigmatism اذا هان + +402 +00:33:14,460 --> 00:33:18,620 +كلمة potential المقصود فيها residual astigmatism + +403 +00:33:18,620 --> 00:33:24,280 +الان احنا اتفقنا ان ال best option لل software + +404 +00:33:24,280 --> 00:33:28,860 +contact lenses هي بتصلح مين؟الـ residual + +405 +00:33:28,860 --> 00:33:33,560 +astigmatism another name للـ residual astigmatism + +406 +00:33:33,560 --> 00:33:38,980 +هو عبارة عن ال potential astigmatism تمام ال RGB + +407 +00:33:38,980 --> 00:33:44,000 +هل قادر على تصحيحه؟ لأ إذا أنا بتوقع أنه لما + +408 +00:33:44,000 --> 00:33:48,900 +المريض يلبس RGB لو كان عنده significant residual + +409 +00:33:48,900 --> 00:33:52,860 +astigmatism اضال في عنده ايش؟ Astigmatism افتراضي + +410 +00:33:52,860 --> 00:33:56,490 +و هذا وين بيبين على فكرة في ال detailsيعني المريض + +411 +00:33:56,490 --> 00:34:01,090 +بده details بيبين معاه الأمر هذا طيب نفترض هذا + +412 +00:34:01,090 --> 00:34:05,930 +الشخص عنده significant residual astigmatism اذا + +413 +00:34:05,930 --> 00:34:09,910 +وولد ال software contact lenses بتوقع انه ايش + +414 +00:34:09,910 --> 00:34:12,430 +هيخفي تمام او هيصلحه + +415 +00:34:16,320 --> 00:34:21,600 +Generally, refractive astigmatism of 0.75 or more + +416 +00:34:21,600 --> 00:34:26,580 +may be an indication for soft recontact lenses + +417 +00:34:26,580 --> 00:34:29,560 +يعني بشكل عام المريض لما يكون عنده قيمة + +418 +00:34:29,560 --> 00:34:35,560 +الastigmatism 0.75 or more هذا بيكون مرشح لاستخدام + +419 +00:34:35,560 --> 00:34:41,860 +من ال soft recontact lenses لكن هذا بشكل عامالها + +420 +00:34:41,860 --> 00:34:44,700 +يعني لها ما لها و عليها ما عليها + +421 +00:35:25,110 --> 00:35:31,110 +إذا كانت قيمة السليندر باور أقل من 25% أو أقل من + +422 +00:35:31,110 --> 00:35:36,850 +ربع إذا حيكون إيه؟ الاسفير هو الحل الأمثل للمريض + +423 +00:35:39,330 --> 00:35:43,250 +Commonly practitioners or fitters يعني الأشخاص + +424 +00:35:43,250 --> 00:35:47,490 +اللي بيعملوا عملية ال .. ال fitting للعدسة اللاصقة + +425 +00:35:47,490 --> 00:35:54,510 +consider that بيعتبروا 0.75 is the lower limit + +426 +00:35:54,510 --> 00:36:00,370 +يعني أقل قيمة أو أقل حد أو أقل range and would + +427 +00:36:00,370 --> 00:36:04,470 +prescribe a soft trick in all but the highest + +428 +00:36:04,470 --> 00:36:09,770 +spherical prescriptionإذا أقل حد عندهم كقيمة انه + +429 +00:36:09,770 --> 00:36:16,710 +تعتبر significant هي الـ 0.75 طيب + +430 +00:36:16,710 --> 00:36:21,650 +عندنا هنا notebook ملاحظة مهمة بناء على قاعدة rule + +431 +00:36:21,650 --> 00:36:28,150 +of four with cylinder power greater than 25% of + +432 +00:36:28,150 --> 00:36:32,970 +the sphere power a soft trick is indicatedإذا + +433 +00:36:32,970 --> 00:36:37,370 +المريض كان عنده قيمة السلندر بالنسبة للاسفير أكتر + +434 +00:36:37,370 --> 00:36:42,470 +من 25% او أكتر من ربع هان بديني انطباع ايش؟ يا + +435 +00:36:42,470 --> 00:36:46,110 +جماعة هان يما بنقصد أكتر من ربع يما بنعمل مقارنة + +436 +00:36:46,110 --> 00:36:51,530 +بين الاسفير والسلندر تمام؟ إذا هان الحل الأمثل قد + +437 +00:36:51,530 --> 00:36:56,780 +يكون من ال software contact lensesطيب إذا كانت + +438 +00:36:56,780 --> 00:37:00,100 +قيمة الـ cylinder power أقل من 25% إذا الـ + +439 +00:37:00,100 --> 00:37:03,800 +spherical soft contact lens قد تكون هي الحل الأمثل + +440 +00:37:07,950 --> 00:37:12,590 +Soft-rick lenses share some similar indications + +441 +00:37:12,590 --> 00:37:16,970 +for prescribing with soft-rick contact lenses إذا + +442 +00:37:16,970 --> 00:37:21,690 +في هناك مجموعة من ال indication هي اللي بتكون + +443 +00:37:21,690 --> 00:37:27,310 +مميزة لمين؟ ل ال soft-rick contact lenses ياسمين + +444 +00:37:27,310 --> 00:37:31,330 +إيش بتتوقع إيه؟ ال indication لل soft-rick contact + +445 +00:37:31,330 --> 00:37:31,850 +lenses + +446 +00:37:38,970 --> 00:37:44,310 +إذا اول قضية زي ما اتفضلت موضوع ال potential + +447 +00:37:44,310 --> 00:37:48,210 +astigmatism او ال residual astigmatism إذا هي + +448 +00:37:48,210 --> 00:37:52,630 +العدسة الوحيدة لو استثننا ال RGB turret قادرة على + +449 +00:37:52,630 --> 00:37:56,970 +تصحيح ال potential أو ال residual astigmatism + +450 +00:37:56,970 --> 00:38:00,750 +تمام؟طبعا انتوا عارفين في another name لـ residual + +451 +00:38:00,750 --> 00:38:04,290 +astigmatism هي عبارة عن ال internal اللي هو + +452 +00:38:04,290 --> 00:38:07,670 +cylinder تمام؟ يعني the same meaning يعني في ال + +453 +00:38:07,670 --> 00:38:10,910 +American academy لو واحدة قرأت في الكتاب هتلاحظ + +454 +00:38:10,910 --> 00:38:12,990 +انه بيكتبوا internal cylinder + +455 +00:38:17,880 --> 00:38:23,100 +Patience who wear lenses occasionally يعني في بعض + +456 +00:38:23,100 --> 00:38:28,480 +الأشخاص بلبسه العلسات اللاصقة أحيانا مش دايما okay + +457 +00:38:28,480 --> 00:38:33,220 +يعني فقط بلبسها يوم بروح على وظيفته بروح بستخدم + +458 +00:38:33,220 --> 00:38:41,420 +النضارة تمام؟ wear a monocular lens بليه contact + +459 +00:38:41,420 --> 00:38:47,530 +sporesShow sensitivity to GB lenses واحد مثلا لعيب + +460 +00:38:47,530 --> 00:38:52,390 +كرة قدم او volleyball او basketball بقدر ادي مثلا + +461 +00:38:52,390 --> 00:38:58,450 +ال GB lenses اول حاجة انه ممكن تسقط بسهولة لانه + +462 +00:38:58,450 --> 00:39:02,910 +small diameter شغلتانية ال sensitivity ممكن تكون + +463 +00:39:02,910 --> 00:39:07,050 +عالية ان هو مش متقبلها ال adaptation اللي هو مش + +464 +00:39:07,050 --> 00:39:11,950 +سريع بالنسبة له تمام؟or work in dusty environments + +465 +00:39:11,950 --> 00:39:18,030 +طب هل ليش لما واحد بيشتغل مثلا في بيئة جاثة بستخدم + +466 +00:39:18,030 --> 00:39:21,810 +معه ال soft trick contact lenses؟ طيب السؤال كان + +467 +00:39:21,810 --> 00:39:26,390 +تالي انه في حالة ما يكون عندنا dusty environments + +468 +00:39:26,390 --> 00:39:31,200 +يعني بيئة مغبرة زي بلاد مثل السعوديةاللي عاش في + +469 +00:39:31,200 --> 00:39:36,760 +السعودية الجو عندهم دايما صحراوي تمام فهان الأفضل + +470 +00:39:36,760 --> 00:39:40,980 +لو كان عنده regular surface زي الكورنيا مديهو ال + +471 +00:39:40,980 --> 00:39:45,620 +جي بي اديه صفتري البساطة لو انتوا فاكرين ان الصفة + +472 +00:39:45,620 --> 00:39:50,720 +العادية الأجسام الغريبة يما بتنحصر بينها بتكون ايش + +473 +00:39:50,720 --> 00:39:55,920 +اقل من ال جي بي لينزز ولكن اذا انحصرت بينهم بتكون + +474 +00:39:55,920 --> 00:40:00,500 +ايش اكتر اللي هو complication ونفس الفكرة وين؟في + +475 +00:40:00,500 --> 00:40:04,000 +الـ soft trick إذن السبب في ذلك لأنها بتحصر + +476 +00:40:04,000 --> 00:40:10,680 +الأجسام الغريبة بنسبة أقل من ال GB lenses are + +477 +00:40:10,680 --> 00:40:15,160 +often better candidates for soft lens than for GB + +478 +00:40:15,160 --> 00:40:21,080 +lenses إذن + +479 +00:40:21,080 --> 00:40:24,940 +مرة أخرى الحالات اللي بنستخدم فيها ال soft trick + +480 +00:40:24,940 --> 00:40:30,890 +contact lenses الحالة الأولىيما الشخص بيستخدم + +481 +00:40:30,890 --> 00:40:35,010 +العدسة اللاصقة أحيانا أو في فترة زمانية قصيرة + +482 +00:40:35,010 --> 00:40:40,070 +occasionally ممكن مثلا يستخدم molecular lenses + +483 +00:40:40,070 --> 00:40:45,350 +عدسة واحدة عشان يقلل من ال sensitivity ممكن مثلا + +484 +00:40:45,350 --> 00:40:50,350 +في بيئة مغبلرة أيضا اللي هو ممكن مثلا في بعض + +485 +00:40:50,350 --> 00:40:54,630 +الرياضات أو بعض الألعاب أنه بده يضطر لاستخدام مين + +486 +00:40:55,160 --> 00:40:58,620 +ال software ال contact lenses أفضل من مين من ال + +487 +00:40:58,620 --> 00:41:03,180 +RGB contact lenses ان شاء الله بنتوقف للنقطة هذه + +488 +00:41:03,180 --> 00:41:05,160 +في المحاضرة القادمة بنكمل + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/Yp4C5cHZjcg.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/Yp4C5cHZjcg.srt new file mode 100644 index 0000000000000000000000000000000000000000..f9f1ead8f4a8a0e65bab6bde53ffa7a1510bd4be --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/Yp4C5cHZjcg.srt @@ -0,0 +1,1555 @@ +1 +00:00:21,060 --> 00:00:23,700 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:23,700 --> 00:00:27,080 +وبركاته and a very good morning to all of you + +3 +00:00:27,080 --> 00:00:34,040 +بداية لو بدأنا المحاضرة بسؤال الـ GP lenses وين هي + +4 +00:00:34,040 --> 00:00:40,580 +بتكون يعني أفضل خيار للمريض العدسات الـ RGB أو الـ + +5 +00:00:40,580 --> 00:00:45,260 +GP lenses متى بتكون هي أفضل خيار؟ لما يكون الـ + +6 +00:00:45,260 --> 00:00:51,190 +cornea neocentral أو الـ regularity تمام، إذا في حالة + +7 +00:00:51,190 --> 00:00:56,510 +ما يكون عندنا الـ regular surface of the cornea أو + +8 +00:00:56,510 --> 00:01:00,510 +يكون عندنا قيمة الـ corneal cylinder يعني كل قيمة + +9 +00:01:00,510 --> 00:01:04,590 +الـ astigmatism اللي جاي من الـ cornea بتكون هي أفضل + +10 +00:01:04,590 --> 00:01:11,980 +خيار لمين؟ للمريض GB lenses can cause a patient + +11 +00:01:11,980 --> 00:01:17,300 +to show an uncorrected residual astigmatism إذا + +12 +00:01:17,300 --> 00:01:22,820 +العدسات الـ GB lenses هي بتكون غير قادرة على تصحيح + +13 +00:01:22,820 --> 00:01:26,460 +مين؟ الـ residual astigmatism أو الـ internal + +14 +00:01:26,460 --> 00:01:33,340 +cylinder طبعًا احنا احنا عارفين أن الـ residual أو + +15 +00:01:33,340 --> 00:01:37,520 +الـ internal cylinder من وين جاي؟ this results هذا + +16 +00:01:37,520 --> 00:01:42,070 +القيمة من العلاقة ما بين الكورنيا والـ refractive + +17 +00:01:42,070 --> 00:01:47,390 +astigmatism، هذه واضحة A residual difference may + +18 +00:01:47,390 --> 00:01:51,730 +be corrected with a GB on the eye owing to + +19 +00:01:51,730 --> 00:01:54,890 +lenticular or internal astigmatism + +20 +00:01:58,070 --> 00:02:02,910 +إذا العدسات الـ GP lenses بتصلح الـ residual + +21 +00:02:02,910 --> 00:02:06,950 +astigmatism ولكن فقط لما يكون من الـ lenticular + +22 +00:02:06,950 --> 00:02:11,810 +ببساطة لما يكون قيمته insignificant يعني أقل من 0 + +23 +00:02:11,810 --> 00:02:17,390 +.75 ممكن ليش؟ لأن هان لما يكون عندنا قيمة الـ + +24 +00:02:17,390 --> 00:02:24,110 +residual astigmatism أقل من 0.75 هان تعتبر هذه + +25 +00:02:24,110 --> 00:02:25,310 +القيمة insignificant + +26 +00:02:28,610 --> 00:02:34,150 +تمام؟ فالـ new surface للقرنية من خلال الـ GB + +27 +00:02:34,150 --> 00:02:38,450 +lenses هي ممكن أن تعمل mask أو cover لقيمة + +28 +00:02:38,450 --> 00:02:41,810 +الـ astigmatism ولكن بدنا نعرف أن هون قيمة الـ + +29 +00:02:41,810 --> 00:02:43,970 +residual و الـ astigmatism insignificant + +30 +00:02:47,200 --> 00:02:52,920 +وإذا كانت قيمة الـ Residual astigmatism مفروضة، + +31 +00:02:52,920 --> 00:02:59,100 +فالطبيعي سيكون أفضل مناسب للعين السفتوريكية يعني + +32 +00:02:59,100 --> 00:03:03,660 +الآن لو كانت قيمة الـ Residual astigmatism أكثر من + +33 +00:03:03,660 --> 00:03:09,320 +0.75، إذن هان تعتبر مهمة، صح ولا لا؟ إذا مين أفضل + +34 +00:03:09,320 --> 00:03:14,140 +خيار للمريض؟ السفتوريكية contact lenses هي العدسة + +35 +00:03:14,140 --> 00:03:18,660 +اللي قادرة على تصحيح الـ residual astigmatism أو الـ + +36 +00:03:18,660 --> 00:03:20,060 +internal cylinder + +37 +00:03:31,000 --> 00:03:35,480 +astigmatic against the rule corneas، إيش معناه + +38 +00:03:35,480 --> 00:03:39,140 +against the rule؟ أنه هيكون الـ horizontal meridian + +39 +00:03:39,140 --> 00:03:46,380 +أكبر من الـ vertical meridian خيار الأفضل لهذا الـ + +40 +00:03:46,380 --> 00:03:48,760 +patient هو عبارة عن الـ soft-toric contact lenses + +41 +00:03:48,760 --> 00:03:54,220 +في حال ما يكون المريض عنده against the rule الخيار + +42 +00:03:54,220 --> 00:03:57,500 +الأفضل لهذا الـ patient هو عبارة عن الـ soft-toric + +43 +00:03:57,500 --> 00:04:01,840 +contact lenses ببساطة العدسة الـ soft-toric فيها + +44 +00:04:01,840 --> 00:04:07,120 +عملية rotation تدوير لأن بيكون فيها marker وممكن + +45 +00:04:07,120 --> 00:04:12,270 +أنا بقدر أعمل عملية rotation فهي قادرة على ضبط + +46 +00:04:12,270 --> 00:04:16,230 +إيقاع اللي هو الـ against the rule of astigmatism + +47 +00:04:16,230 --> 00:04:19,390 +احنا عارفين الـ against the rule of astigmatism لما + +48 +00:04:19,390 --> 00:04:24,270 +بنستخدم معه العدسات الـ RGB بتعمل decentralization + +49 +00:04:24,270 --> 00:04:30,570 +إزاحة سواء nasal أو temporal لكن الـ soft toric + +50 +00:04:30,570 --> 00:04:35,070 +contact lenses بتجنبني اللي هو إيه؟ قضية الـ + +51 +00:04:35,070 --> 00:04:39,470 +decentration الإزاحة سواء nasally أو temporally + +52 +00:04:39,470 --> 00:04:44,970 +they often except أي بمعنى شو بتوضح significant + +53 +00:04:44,970 --> 00:04:49,230 +residual astigmatism إذا بكون عندنا قيمة الـ + +54 +00:04:49,230 --> 00:04:52,570 +residual astigmatism في هذه الحالة في الـ against + +55 +00:04:52,570 --> 00:04:56,130 +the rule of astigmatism واضحة أو significant ذات + +56 +00:04:56,130 --> 00:05:03,790 +قيمة العدسات الـ GP lenses لديها تأثير تقريبًا أو + +57 +00:05:03,790 --> 00:05:08,030 +نزيلًا بسبب القرنية. + +58 +00:05:25,260 --> 00:05:30,300 +في الـ Against the rule نفترض أنها مثلًا 54 هنا + +59 +00:05:30,300 --> 00:05:38,760 +ستكون 45 إذن سيكون الـ horizontal meridian steeper + +60 +00:05:38,760 --> 00:05:42,500 +than الـ vertical meridian فهتلاحظ لو أنا استخدمت + +61 +00:05:42,500 --> 00:05:46,580 +عدسة الـ GP lenses هتعمل اللي هو دي سنتراشن سواء + +62 +00:05:46,580 --> 00:05:51,480 +نازليًا أو تمبرارلي لكن الـ soft toric عشان فيها عملية + +63 +00:05:51,480 --> 00:05:54,080 +الـ rotation هتتجنب هذا الموضوع + +64 +00:05:59,370 --> 00:06:00,950 +أيضًا في الـ استيجماتيزم + +65 +00:06:06,640 --> 00:06:10,540 +نفس قضية يعني الـ against the rule لكن الـ with the + +66 +00:06:10,540 --> 00:06:13,900 +rule هيكون الـ vertical meridian steeper than الـ + +67 +00:06:13,900 --> 00:06:17,600 +horizontal meridian لو استخدمنا الـ GB هتعمل اللي + +68 +00:06:17,600 --> 00:06:21,500 +هو decentration up و down لكن الـ soft toric هتلاقيها + +69 +00:06:21,500 --> 00:06:25,220 +إيش أنه conform to the shape of the cornea وبتاخد + +70 +00:06:25,220 --> 00:06:28,440 +اللي هو قيمة المحور أو قيمة الـ axels اللي أنا + +71 +00:06:28,440 --> 00:06:29,240 +بديها + +72 +00:06:33,050 --> 00:06:41,330 +Patients who have not been able to adapt to the + +73 +00:06:41,330 --> 00:06:46,670 +comfort of GB lenses يعني الآن مريض لاحظنا أن أفضل + +74 +00:06:46,670 --> 00:06:51,110 +خيار له الـ GB lenses لبسناه العدسة مش قادر يعمل + +75 +00:06:51,110 --> 00:06:55,090 +adaptation مع العدسة تمام؟ + +76 +00:06:59,060 --> 00:07:02,320 +على الـ 3 9 o'clock staining يعني الـ clinical sign + +77 +00:07:02,320 --> 00:07:08,080 +عنده أنه فيه staining على اللي هو الـ 3 والـ 9 or + +78 +00:07:08,080 --> 00:07:13,480 +who have poor positioning GB lenses maybe well + +79 +00:07:13,480 --> 00:07:17,780 +motivated to use soft toric lenses طب أنا بسأل + +80 +00:07:17,780 --> 00:07:22,340 +السؤال ليش في حالة الـ 3 9 o'clock بدنا نستبدل + +81 +00:07:22,340 --> 00:07:26,000 +العدسة الـ RGB بالـ soft toric contact lenses؟ + +82 +00:07:38,150 --> 00:07:42,210 +عشان ما .. يعني ما .. ما تعملش الـ setup بال .. + +83 +00:07:42,210 --> 00:07:45,730 +بالعين ولا ما تستخدمش قرنية بيدينه؟ اه اه ممكن + +84 +00:07:45,730 --> 00:07:50,030 +أنا بتكون ضعيفة لغاية الـ .. الـ soft لغاية الـ .. + +85 +00:07:50,030 --> 00:07:54,310 +طيب ليش بنسبلها في الـ soft toric؟ soft أنا .. فضل + +86 +00:07:54,310 --> 00:07:54,670 +إيه؟ + +87 +00:07:59,500 --> 00:08:04,560 +الآن أنا لما أستخدم الـ GP lenses وبتعمل الـ + +88 +00:08:04,560 --> 00:08:07,920 +three nine o'clock لو أنا رفعت العدسة وحطيت + +89 +00:08:07,920 --> 00:08:11,380 +فلوروسين هتلاحظ أنه هيصير الـ staining وين؟ في + +90 +00:08:11,380 --> 00:08:16,420 +المنطقة الـ three و الـ nine o'clock في حالة الـ soft + +91 +00:08:16,420 --> 00:08:20,240 +toric contact lenses العدسة conform to the shape of the + +92 +00:08:20,240 --> 00:08:24,380 +cornea والعدسة اللي هو طبيعتها إيه؟ هتكون soft + +93 +00:08:24,380 --> 00:08:29,860 +لينة فما هتسببلي اللي هو موضوع الـ staining يعني هي + +94 +00:08:29,860 --> 00:08:32,680 +هتصلح اللي هو الـ with the rule أو الـ against the + +95 +00:08:32,680 --> 00:08:37,620 +rule مع أنه هتجنب المريض حدوث إيه؟ three أو nine o + +96 +00:08:37,620 --> 00:08:41,080 +'clock يعني الآن السؤال أنه هل الـ three أو الـ nine + +97 +00:08:41,080 --> 00:08:43,980 +o'clock هو يعتبر common في حالات الـ soft toric + +98 +00:08:43,980 --> 00:08:47,980 +contact lenses؟ لا تمام؟ لكن وين بتكون اللي هي + +99 +00:08:47,980 --> 00:08:51,560 +most common في الـ RGB contact lenses؟ + +100 +00:08:54,950 --> 00:08:59,750 +Some patients are better managed with GP lenses، + +101 +00:08:59,750 --> 00:09:04,930 +إذا بعض المرضى بفضل أنه managedها بمعنى اللي هو + +102 +00:09:04,930 --> 00:09:09,130 +treatment كعلاج، أنه يتعالجوا بعدسات الـ GP lenses + +103 +00:09:10,240 --> 00:09:14,540 +Patients with certain occupations يعني في عندهم + +104 +00:09:14,540 --> 00:09:19,440 +مضاعفات اللي هو معينة أو محددة عنده مثلًا مشاكل اللي + +105 +00:09:19,440 --> 00:09:24,320 +هو فيه القرنية Handling issues عنده صعوبة في عملية + +106 +00:09:24,320 --> 00:09:27,820 +مسك العدسة مقدرش أنه يمسك اللي هو الـ soft الـ + +107 +00:09:27,820 --> 00:09:33,620 +contact lens بسهولة And visual demands may require + +108 +00:09:33,620 --> 00:09:38,160 +the use of GP lenses إيش المقصود هنا في الـ visual + +109 +00:09:38,160 --> 00:09:45,640 +demands؟ كيف يعني؟ حسب + +110 +00:09:45,640 --> 00:09:50,920 +طبيعة التعامل، وإذا كان بيعمل في مكتب أو خارج البيت + +111 +00:09:50,920 --> 00:09:54,460 +أو خارج العمل، يعني حسب أشخاص يعني لو كان مثلًا إن + +112 +00:09:54,460 --> 00:09:58,700 +في موقع عمل إنه مفتوح فهو بحتاج الـ RGB أكثر من الـ + +113 +00:09:58,700 --> 00:10:01,900 +soft أو يعني العكس لأ أنا بقصد hand في الـ visual + +114 +00:10:01,900 --> 00:10:05,580 +demands أنه حسب طلبات البصرية يعني، فيه بيكون + +115 +00:10:05,580 --> 00:10:09,420 +به للـ near به للـ به يعني تصحيح أكثر، فيه به + +116 +00:10:09,420 --> 00:10:15,200 +يعني به كلامك صحيح، بس أنا بسط أكثر أنه هل هو + +117 +00:10:15,200 --> 00:10:18,740 +بيستخدمها كـ monocular ولا binocular؟ هل مثلًا + +118 +00:10:18,740 --> 00:10:22,340 +النوعين فيه عنده لنير والتاني للـ distance ولا لا؟ + +119 +00:10:22,340 --> 00:10:26,100 +هل الاثنين دائمًا بيستخدمهم لنير؟ هل الاثنين طبيعي + +120 +00:10:26,100 --> 00:10:29,180 +اتعملوا دائمًا للـ distance؟ هذا المقصود فيه اللي هو + +121 +00:10:29,180 --> 00:10:34,140 +كـ visual demands in general، بشكل عام يعني استخدام + +122 +00:10:34,140 --> 00:10:38,600 +الرؤية بالنسبة للمريض واحد مثلًا driver إذا دائمًا + +123 +00:10:38,600 --> 00:10:42,920 +طبيعة عمله وين؟ هيكون للأمام للـ distance واحد مثلًا + +124 +00:10:42,920 --> 00:10:47,000 +officer أو teacher دائمًا طبيعة عمله وين؟ للـ near + +125 +00:10:47,000 --> 00:10:53,680 +فاستخدامه لللي هو الـ vision okay may require the use + +126 +00:10:53,680 --> 00:10:57,480 +of GP lenses طب ليش هنا بدنا نستخدم الـ GP lenses + +127 +00:10:57,480 --> 00:11:03,580 +أكثر؟ ببساطة لأنه دائمًا الـ soft toric contact lenses الـ + +128 +00:11:03,580 --> 00:11:07,840 +sensitivity فيها very high عالية كثير بمعنى آخر و + +129 +00:11:07,840 --> 00:11:12,800 +الآن هأمر معناه لو قدام المريض لو عنده مثلًا اختلاف + +130 +00:11:12,800 --> 00:11:16,820 +خمسة degree في الـ soft toric contact lenses هيشعر فيها + +131 +00:11:16,820 --> 00:11:21,700 +يعني لازم أن يكون في حالات الـ soft toric contact + +132 +00:11:21,700 --> 00:11:26,480 +lenses typical اللي هو بالنسبة لمين؟ للـ axis أي + +133 +00:11:26,480 --> 00:11:33,040 +تروتيش للعدسة هيأثر على مين؟ على رؤية المريض تمام؟ + +134 +00:11:33,040 --> 00:11:39,220 +in addition بالإضافة unacceptable visual acuity + +135 +00:11:39,220 --> 00:11:44,900 +with soft lenses may occur because of corneal + +136 +00:11:44,900 --> 00:11:49,640 +irregularities or optical or rotational problems + +137 +00:11:49,640 --> 00:11:56,480 +GB lenses may provide more acceptable acuity الآن + +138 +00:11:56,480 --> 00:12:00,880 +لو كان عنده patient و بنفع نستخدم معه الـ soft + +139 +00:12:00,880 --> 00:12:06,560 +toric و بنفع نستخدم معه الـ RGB بتتوقع الآن كرؤية + +140 +00:12:06,560 --> 00:12:12,660 +مين أوضح؟ الـ RGB وهذه بناء على دراسة تم إجراءها + +141 +00:12:12,660 --> 00:12:18,880 +استخدموا فيها الـ color vision + +142 +00:12:22,140 --> 00:12:27,260 +و أيضاً الـ functional acuity contrast sensitivity + +143 +00:12:27,260 --> 00:12:32,980 +test تمام و استخدموا أيضاً فيها الـ visual acuity + +144 +00:12:32,980 --> 00:12:39,520 +test فلاحظوا أن العدسات الـ RGB من حيث الرؤية أو من + +145 +00:12:39,520 --> 00:12:44,920 +حيث الوضوح بتكون أكثر مقارنة في مين في الـ software + +146 +00:12:44,920 --> 00:12:50,320 +contact lenses ولكن من حيث أرباحها الـ software + +147 +00:12:50,320 --> 00:12:56,420 +أريح تمام؟ إذا من حيث الـ vision مين أفضل؟ الـ RGB + +148 +00:12:56,420 --> 00:13:00,120 +ببساطة لأنه بتعمل الـ new surface لمين؟ للقرنية و + +149 +00:13:00,120 --> 00:13:04,200 +بتعدل أي الـ regular surface للقرنية + +150 +00:13:07,610 --> 00:13:12,710 +هذه عبارة عن الدراسة one study okay أو previous + +151 +00:13:12,710 --> 00:13:18,290 +study دراسة سابقة using multiple objective tests + +152 +00:13:18,290 --> 00:13:21,770 +استخدموا مجموعة من التستات الـ color vision test + +153 +00:13:21,770 --> 00:13:26,310 +functional acuity contrast sensitivity أيضاً الـ + +154 +00:13:26,310 --> 00:13:30,530 +visual acuity test demonstrated وضحوا أن الـ visual + +155 +00:13:30,530 --> 00:13:31,970 +acuity with + +156 +00:13:37,170 --> 00:13:41,570 +to be equivalent or less يعني إما متساوي أو أقل + +157 +00:13:41,570 --> 00:13:47,490 +while objective tests were equivalent the patients + +158 +00:13:47,490 --> 00:13:50,190 +subjectively احنا بنعتمد دائماً ع مين؟ ع الـ + +159 +00:13:50,190 --> 00:13:55,170 +subjective reported better vision with gb lenses + +160 +00:13:55,170 --> 00:13:59,930 +إذا المريض أشار في الـ subjective مين أفضل كرؤية؟ + +161 +00:13:59,930 --> 00:14:06,130 +الـ gb lenses ولكن مجموعة من المستخدمين أفضلوا الـ + +162 +00:14:06,130 --> 00:14:10,730 +Soft-Rig بسبب سهولة الانزلاق والتعامل إذا أفضلوا + +163 +00:14:10,730 --> 00:14:14,350 +الـ Soft-Rig من حيث اللي هو الـ insertion و الـ + +164 +00:14:14,350 --> 00:14:18,970 +removal و الراحة التي تقدمها هذا النوع من العدسات + +165 +00:14:18,970 --> 00:14:22,230 +طيب + +166 +00:14:22,230 --> 00:14:27,330 +الآن عندنا why GB lenses better than Soft-Rig + +167 +00:14:27,330 --> 00:14:28,030 +lenses + +168 +00:14:32,150 --> 00:14:38,970 +الرقم الأول لا يوجد اتجاهات مناسبة بين توريسيتي + +169 +00:14:38,970 --> 00:14:40,610 +القرنية والانكسارية الانكسارية الانكسارية + +170 +00:14:40,610 --> 00:14:41,670 +الانكسارية الانكسارية الانكسارية الانكسارية + +171 +00:14:41,670 --> 00:14:45,290 +الانكسارية الانكسارية الانكسارية الانكسارية + +172 +00:14:45,290 --> 00:14:46,310 +الانكسارية الانكسارية الانكسارية الانكسارية + +173 +00:14:46,310 --> 00:14:47,910 +الانكسارية الانكسارية الانكسارية الانكسارية + +174 +00:14:47,910 --> 00:14:50,470 +الانكسارية الانكسارية الانكسارية الانكسارية + +175 +00:14:50,470 --> 00:14:53,970 +الانكسارية الانكسارية الانكسارية الانكسارية + +176 +00:14:53,970 --> 00:14:59,910 +الانكسارية الحالة الأولى non coincident axis يعني non + +177 +00:14:59,910 --> 00:15:04,230 +equivalent عدم تساوي ما بين المحور الآن عندنا الـ + +178 +00:15:04,230 --> 00:15:16,250 +corneal torsity نفترض + +179 +00:15:16,250 --> 00:15:18,370 +الآن عندنا وصفة + +180 +00:15:37,400 --> 00:15:41,600 +الآن عندنا non coincident axis يعني عدم اللي هو + +181 +00:15:41,600 --> 00:15:45,940 +التساوي من حيث إيش المحور ما بين الـ corneal + +182 +00:15:45,940 --> 00:15:49,660 +toricity أو الـ corneal cylinder تمام and the + +183 +00:15:49,660 --> 00:15:54,280 +refractive astigmatism ما بينهم مختلفين من حيث إيش + +184 +00:15:54,280 --> 00:15:59,300 +المحور maybe any indication for a spherical gb + +185 +00:15:59,300 --> 00:16:03,920 +lenses هذا بتديني إشارة إنه أنا أستخدم مين أو أكون + +186 +00:16:03,920 --> 00:16:09,560 +باتجاه الـ gb lenses إذا كان هناك اختلاف ما بين الـ + +187 +00:16:09,560 --> 00:16:12,540 +المحور الـ cornial cylinder و الـ axis الـ refractive + +188 +00:16:12,540 --> 00:16:16,720 +astigmatism، الأفضل أن يكون اتجاهي باتجاه مين؟ الـ + +189 +00:16:16,720 --> 00:16:18,380 +RGB، لكن ليس دائماً + +190 +00:16:21,630 --> 00:16:28,570 +لماذا؟ طيب العدسات الـ softoric دائماً تكون + +191 +00:16:28,570 --> 00:16:33,370 +فيها استقامة مع المصادر القناعية مع المصادر + +192 +00:16:33,370 --> 00:16:34,910 +القناعية مع المصادر القناعية مع المصادر القناعية + +193 +00:16:34,910 --> 00:16:36,350 +مع المصادر القناعية مع المصادر القناعية مع المصادر + +194 +00:16:36,350 --> 00:16:37,390 +القناعية مع المصادر القناعية مع المصادر القناعية + +195 +00:16:37,390 --> 00:16:37,810 +مع المصادر القناعية مع المصادر القناعية مع المصادر + +196 +00:16:37,810 --> 00:16:38,610 +القناعية مع المصادر القناعية مع المصادر القناعية + +197 +00:16:38,610 --> 00:16:39,190 +مع المصادر القناعية مع المصادر القناعية مع المصادر + +198 +00:16:39,190 --> 00:16:40,610 +القناعية مع المصادر القناعية مع المصادر القناعية + +199 +00:16:40,610 --> 00:16:47,530 +مع المصادر القناعية مع المصادر القناعية مع المصادر + +200 +00:16:47,530 --> 00:16:54,220 +القناخمسة وأربعين متراً ومئة وثمانين سيكون الـ corneal + +201 +00:16:54,220 --> 00:16:58,680 +cylinder عبارة عن ماينص واحد اكسس الفلاتس اللي هو + +202 +00:16:58,680 --> 00:17:03,840 +تسعين تمام الآن الـ corneal الـ software الـ + +203 +00:17:03,840 --> 00:17:09,080 +contact lenses دائماً بيكون اتجاهها باتجاه مين؟ الـ + +204 +00:17:09,080 --> 00:17:12,680 +Corneal curvature الجماعة في نقطة مهمة أنا دائماً + +205 +00:17:12,680 --> 00:17:17,260 +بحكي على Corneal curvature أو Corneal power أو + +206 +00:17:17,260 --> 00:17:20,580 +Corneal curvature meridian دائماً بنستخدم كلمة + +207 +00:17:20,580 --> 00:17:25,020 +meridian لكن نحن كـ contact lenses الأقرب العدسة + +208 +00:17:25,020 --> 00:17:28,920 +بيكون فيها meridian لاء إيش بيكون اكسس عليها صح ولا + +209 +00:17:28,920 --> 00:17:33,060 +لاء؟ يعني الآن تعاملاتنا كلها تاك اكسس ولكن + +210 +00:17:33,060 --> 00:17:36,900 +الأجهزة التي تطلع لك مريديا معناها عبارة عن ايه + +211 +00:17:36,900 --> 00:17:41,720 +Cornial curvature يعني اتـ Cornial plane فهنا نرجع + +212 +00:17:41,720 --> 00:17:45,240 +لموضوعنا طبيعة العدسات الـ software الـ contact + +213 +00:17:45,240 --> 00:17:51,580 +lenses okay مثلًا أن سام عندها اكسس ثلاثين بتحط + +214 +00:17:51,580 --> 00:17:56,620 +العدسة على الـ axis h ثلاثين يعني الآن أنا الذي أطلب + +215 +00:17:56,620 --> 00:18:00,640 +من الـ manufacturer أن لازم يكون الـ axis مساوي + +216 +00:18:00,640 --> 00:18:03,880 +لمين للـ axis بتاع الـ subjective refraction إلا لو + +217 +00:18:03,880 --> 00:18:08,300 +صار عملية rotation زي ما أخذنا وين في اللي هو لبعض + +218 +00:18:08,300 --> 00:18:12,740 +الشرط صح ولا لا أن لازم يكون الـ axis مساوي للـ + +219 +00:18:12,740 --> 00:18:15,780 +axis الـ subjective refraction الذي أنا ارتحت عليه + +220 +00:18:15,780 --> 00:18:26,650 +كمريضLens rotation دوران العدسة يمكن أن يكون + +221 +00:18:26,650 --> 00:18:33,030 +غير مهم أو غير ما هو مكتشف يعني الآن لو أنا مثلًا + +222 +00:18:33,030 --> 00:18:37,890 +ما عنديش slit lamp examination ورحت اتقدمت لرغبة بناء + +223 +00:18:37,890 --> 00:18:41,530 +على subjective refraction ممكن العدسة عاملة + +224 +00:18:41,530 --> 00:18:44,770 +rotation و أنا لست دارس صح ولا لا فهيك إيش عملت + +225 +00:18:44,770 --> 00:18:50,820 +غيرت بقيمة الـ axis إذا كان غير مكشوف and cause + +226 +00:18:50,820 --> 00:18:54,140 +fitting problems، هذا سيسبب للمريض أن الرؤية ليست + +227 +00:18:54,140 --> 00:18:57,140 +واضحة، سيقول لك والله أنا في العدسات التي أخذتها + +228 +00:18:57,140 --> 00:19:01,300 +منها، هؤلاء ليست واضحة، أنا أشعر الدنيا a planet + +229 +00:19:01,300 --> 00:19:07,140 +vision في عندي Potential rotational problems يعني + +230 +00:19:07,140 --> 00:19:11,160 +مشاكل اللي هو الدوران الافتراضية potential بمعنى + +231 +00:19:11,160 --> 00:19:16,100 +افتراضي are avoided هذه كلها ستتجنبيها وين؟ يما + +232 +00:19:16,100 --> 00:19:21,240 +تستخدمي الـ GB lenses طب لماذا؟ لأن الـ GB lenses ليس + +233 +00:19:21,240 --> 00:19:25,160 +فيها rotation وبالإضافة إلى ذلك أن بيكون موضوع الـ + +234 +00:19:25,160 --> 00:19:29,060 +tear lens الـ tear lens ما بين العدسة والقرنية + +235 +00:19:29,060 --> 00:19:33,320 +سيكون قادر على إيش أن mask أو cover أن يغطي مين + +236 +00:19:33,320 --> 00:19:37,640 +كل قيمة اللي هو الـ cylinder الموجودة عند الـ + +237 +00:19:37,640 --> 00:19:39,800 +patient تمام إن شاء الله؟ + +238 +00:19:46,090 --> 00:19:54,630 +الحالة الثانية عندما تتحرك السليندر أكثر من قوة + +239 +00:19:54,630 --> 00:19:59,770 +الاسفير وقوة الاسفير قريبة من بلانو يعني مثل + +240 +00:19:59,770 --> 00:20:03,690 +المثال هذا عندنا قيمة بلانو ع ماينص واحد ونصف و + +241 +00:20:03,690 --> 00:20:09,690 +نفترض أن هذه القيمة جاية من قرنية حكينا فيها أن الـ + +242 +00:20:09,690 --> 00:20:13,390 +GB lenses أفضل من من الـ soft direct contact + +243 +00:20:13,390 --> 00:20:14,030 +lenses + +244 +00:20:20,830 --> 00:20:27,470 +ماذا تتوقع؟ لأنه كما اتفقنا أنه في حالة الـ soft + +245 +00:20:27,470 --> 00:20:31,590 +ring contact lenses الـ sensitivity ستكون عالية + +246 +00:20:31,590 --> 00:20:36,110 +يعني عندنا بلانو ع ماينص واحد ونصف إذا كل قيمة الـ + +247 +00:20:36,110 --> 00:20:39,270 +refractive error عند المريض هو عبارة عن ايه؟ + +248 +00:20:39,270 --> 00:20:44,780 +cylinder فاي دوران للعدسة سيؤثر على رؤية المريض + +249 +00:20:44,780 --> 00:20:49,480 +بالإضافة نقطة ثانية أن دائماً الـ software الـ + +250 +00:20:49,480 --> 00:20:53,300 +contact lenses مالهاش تأثير على الـ internal + +251 +00:20:53,300 --> 00:20:58,620 +cylinder كتأثير أن بيكون يعني على طول أن بيصير + +252 +00:20:58,620 --> 00:21:02,400 +عند المريض اللي هو very sensitive أن بيكون حساس + +253 +00:21:02,400 --> 00:21:08,950 +بشكل اللي هو كبير بالتالي، في حالة تغيير تحويل صغير + +254 +00:21:08,950 --> 00:21:15,970 +من الـ-1.50 إلى 180 برنامج Viplano، + +255 +00:21:19,070 --> 00:21:24,870 +بسيطة على العدسة أو أي دوران للعدسة إيش سيحدث لبعض + +256 +00:21:24,870 --> 00:21:29,010 +المرضى because the astigmatic correction is the + +257 +00:21:29,010 --> 00:21:32,410 +entire refractive error كل قيمة الـ refractive + +258 +00:21:32,410 --> 00:21:36,390 +error عند المريض جاية من وين؟ من السليندر إياه + +259 +00:21:36,390 --> 00:21:41,530 +نوع ماينص واحد ونصف إذا من هو الأفضل للمريض + +260 +00:21:41,530 --> 00:21:43,050 +الـ RGB + +261 +00:21:46,790 --> 00:21:52,010 +ثالثاً، عندما يكون corneal cylinder أو corneal + +262 +00:21:52,010 --> 00:21:58,270 +toricity أكثر من refractive astigmatism، يمكن أن + +263 +00:21:58,270 --> 00:22:01,490 +يكون موضوع GB lens أيضاً موضوع GB lens + +264 +00:22:11,820 --> 00:22:16,120 +الـ GB lens سيغطي الوضع الاستغماطي ولكن سيُحدث + +265 +00:22:16,120 --> 00:22:19,280 +insignificant residual astigmatism insignificant + +266 +00:22:19,280 --> 00:22:22,480 +residual astigmatism insignificant residual + +267 +00:22:22,480 --> 00:22:25,900 +astigmatism insignificant residual astigmatism + +268 +00:22:25,900 --> 00:22:27,720 +insignificant residual astigmatism insignificant + +269 +00:22:27,720 --> 00:22:31,840 +residual astigmatism insignificant residual + +270 +00:22:31,840 --> 00:22:35,060 +astigmatism insignificant residual استي + +271 +00:22:41,640 --> 00:22:46,020 +Patient selection should be based on the same + +272 +00:22:46,020 --> 00:22:51,820 +criteria as used for the soft spherical lens + +273 +00:22:55,180 --> 00:23:00,680 +الـ indications أو كل الـ advantages الخاصة في الـ + +274 +00:23:00,680 --> 00:23:04,240 +spherical soft contact lens هي نفسها مين الـ + +275 +00:23:04,240 --> 00:23:08,620 +indications أو الـ advantages الخاصة في مين؟ في + +276 +00:23:08,620 --> 00:23:11,540 +الـ soft direct contact lenses أيضاً الـ + +277 +00:23:11,540 --> 00:23:15,340 +disadvantages تحت الـ soft أو الـ spherical soft + +278 +00:23:15,340 --> 00:23:19,020 +contact lens هي نفسها الـ disadvantages لمين للـ + +279 +00:23:19,020 --> 00:23:23,960 +soft direct بالإضافة لموضوع مين؟ الـ rotation صحيح؟ + +280 +00:23:25,890 --> 00:23:30,110 +Patients who are good candidates يعني المرضى الذين + +281 +00:23:30,110 --> 00:23:35,490 +بيكونوا مرشحين بشكل جيد لعدسات الـ soft contact + +282 +00:23:35,490 --> 00:23:40,110 +lenses أو هنا اللي هو الـ spherical soft lenses + +283 +00:23:41,890 --> 00:23:46,150 +Based on lifestyle إذا بتعتمد على طبيعة الحياة + +284 +00:23:46,150 --> 00:23:50,950 +اللي هو عايشها تمام، أيضًا على الـ compliance مدى + +285 +00:23:50,950 --> 00:23:54,370 +الالتزام في عملية الـ cleaning في عملية الـ + +286 +00:23:54,370 --> 00:24:00,750 +insertion والـ removal في عملية الـ disinfection والـ + +287 +00:24:00,750 --> 00:24:04,630 +motivation المحفز اللي هي تعتبر number one لارتداء + +288 +00:24:04,630 --> 00:24:10,010 +أي عدسة لاصقة، And corneal health سلامة القرنية + +289 +00:24:10,010 --> 00:24:13,730 +واحد عنده irregular surface للقرنية ممنوع أنه + +290 +00:24:13,730 --> 00:24:17,730 +يُعطى إيش؟ spherical soft contact lens أو soft + +291 +00:24:17,730 --> 00:24:22,810 +direct contact lenses are likely good candidates + +292 +00:24:22,810 --> 00:24:27,060 +for soft direct contact lenses بينما الـ patients + +293 +00:24:27,060 --> 00:24:31,040 +اللي بيكونوا corneal أو lenticular astigmatism أو + +294 +00:24:31,040 --> 00:24:35,340 +combination أو residual astigmatism هذول ممكن أن + +295 +00:24:35,340 --> 00:24:40,200 +يكونوا يعني أشخاص مرشحين بشكل جيد لارتداء العدسات + +296 +00:24:40,200 --> 00:24:42,280 +الـ software contact lenses + +297 +00:24:51,820 --> 00:24:56,700 +الـ Astigmatism يمكن أن يتم إصلاحه بـ GB أو Soft + +298 +00:24:56,700 --> 00:25:00,400 +-Rig Contact Lenses إذا كانت الـ Astigmatism + +299 +00:25:00,400 --> 00:25:03,760 +ال انكسارية والـ Astigmatism القرني مختلفة بكافة + +300 +00:25:03,760 --> 00:25:08,880 +أكثر من 0.75، فالـ Astigmatism المتبقي يمكن أن يكون + +301 +00:25:08,880 --> 00:25:14,890 +مرتبط بجهاز GB هذه الشخصيات قد تكون مستخدمات جيدة + +302 +00:25:14,890 --> 00:25:18,610 +لـ soft-toric lenses هذه شرحنا المثال إذا كانت + +303 +00:25:18,610 --> 00:25:22,470 +قيمة الـ residual astigmatism أكثر من 75، إذا هو + +304 +00:25:22,470 --> 00:25:27,490 +يُعتبر significant في حالة ما أنا أستخدم الـ GB + +305 +00:25:27,490 --> 00:25:32,910 +lenses هيظل مش هيصلح من الـ residual astigmatism + +306 +00:25:32,910 --> 00:25:35,970 +لكن لما أستخدم الـ soft-toric هيكون قادر على + +307 +00:25:35,970 --> 00:25:36,530 +تصحيحه + +308 +00:25:43,160 --> 00:25:46,440 +صحيح، Residual astigmatism اللي هو كـ significant + +309 +00:25:46,440 --> 00:25:52,120 +طيب عندنا الـ tear film equality and quantity، إيش + +310 +00:25:52,120 --> 00:25:55,020 +الفرق بين الاثنين؟ طيب إيش الفرق ما بين الـ tear + +311 +00:25:55,020 --> 00:25:56,900 +film equality و quantity؟ + +312 +00:26:01,270 --> 00:26:06,430 +الـ tear film quality دائمًا أنه بيعمل عملية تقييم للـ + +313 +00:26:06,430 --> 00:26:11,990 +tear film دون إعطاء number كيف يعني؟ أنه بيعتمد على + +314 +00:26:11,990 --> 00:26:16,810 +الـ quality جودة الـ tear يعني هل المريض عنده normal + +315 +00:26:16,810 --> 00:26:21,610 +tear film ولا عنده abnormal tear film تمام؟ يعني + +316 +00:26:21,610 --> 00:26:26,010 +بمعنى آخر بيعمل اللي هو عملية tear film evaluation + +317 +00:26:26,010 --> 00:26:30,150 +تقييم للـ tear فقط، بيقول إن في المريض عنده good + +318 +00:26:30,150 --> 00:26:33,730 +equality of tear film أو عنده bad equality of tear + +319 +00:26:33,730 --> 00:26:39,420 +film هذا بالنسبة لمين؟ الـ Quantity بيقول للمريض + +320 +00:26:39,420 --> 00:26:43,840 +عنده TB UT بالساوي عشرة، بيقول لي مثلًا الـ TB UT + +321 +00:26:43,840 --> 00:26:47,440 +أكثر من عشرة، بيقول لي مثلًا في الـ Schirmer's test اللي + +322 +00:26:47,440 --> 00:26:53,480 +عنده خمسة عشر ملليمتر، هذا بيعتبر إيه؟ رقمي أو الـ + +323 +00:26:53,480 --> 00:26:58,840 +quantity، إذا need to be assessed لازم أنه يقيم أي + +324 +00:26:58,840 --> 00:27:03,520 +تمريض بيقبل على ارتداء العدسة اللاصقة لابد أنه + +325 +00:27:03,520 --> 00:27:08,920 +يعمل له clinical sign for dry eye تمام؟ deficiencies + +326 +00:27:08,920 --> 00:27:12,200 +هذا المقصود فيها الـ aqueous tear secretion + +327 +00:27:28,430 --> 00:27:34,030 +Deficiencies aqueous tear secretion may prevent a + +328 +00:27:34,030 --> 00:27:38,390 +successful fit يعني واحد عنده dry eye سواء كان + +329 +00:27:38,390 --> 00:27:43,590 +عنده bad quality للـ tear film أو عنده reduce أو + +330 +00:27:43,590 --> 00:27:48,390 +decrease بالـ number للـ TBUT أو الـ Schirmer's test هذا لو + +331 +00:27:48,390 --> 00:27:53,210 +أنا عملت له عدسات لاصقة هيكون عنده بالضبط اللي هو + +332 +00:27:53,210 --> 00:27:59,430 +عدم التكيف مع العدسة اللاصقة Certain lens materials + +333 +00:27:59,430 --> 00:28:03,130 +بعض المواد زي ما قلنا إن الـ high water content + +334 +00:28:03,130 --> 00:28:07,110 +بتعمل dry eye أكثر مقارنة في الـ moderate أو الـ + +335 +00:28:07,110 --> 00:28:10,410 +low water content أيضًا بعض الـ design اللي احنا + +336 +00:28:10,410 --> 00:28:13,850 +خدنا إن شاء الله في اللي هو الـ software الـ contact + +337 +00:28:13,850 --> 00:28:16,950 +lenses زي موضوع الـ truncation عشان تعمل اللي هو + +338 +00:28:16,950 --> 00:28:21,190 +comfortable راحة وتعمل اللي هو stability ثبات + +339 +00:28:21,190 --> 00:28:28,160 +للعدسة برضه في بعضهم أنه بسبب جفاف للعين may aid in + +340 +00:28:28,160 --> 00:28:33,580 +the successful fitting of these patients أيضًا هذه + +341 +00:28:33,580 --> 00:28:37,840 +إما بساعد في عملية الـ fitting أو بالعكس أنه + +342 +00:28:37,840 --> 00:28:42,600 +بتعمل جفاف للعين وبالتالي المريض بيكون غير مهيأ + +343 +00:28:42,600 --> 00:28:49,380 +لارتداء العدسة اللاصقة، طيب شخص عنده lid tension + +344 +00:28:49,380 --> 00:28:55,180 +تتوقع أن يكون الـ soft toric خيار جيد له ولا سيء؟ + +345 +00:29:00,690 --> 00:29:05,730 +شخص عنده lid tension تتوقع أنه يكون عنده خيار الـ + +346 +00:29:05,730 --> 00:29:13,910 +soft toric جيد ولا سيء؟ طبعًا + +347 +00:29:13,910 --> 00:29:17,270 +في حالات الـ lid tension خيار الـ soft toric contact + +348 +00:29:17,270 --> 00:29:22,770 +lenses هيكون سيء بسبب أنه ممكن يعمل اللي هو force + +349 +00:29:22,770 --> 00:29:27,110 +يعني زيادة في عملية rotation للعدسة وبالتالي بيغير + +350 +00:29:27,110 --> 00:29:31,840 +من الـ access للمريض، إذا الـ Lid tension should be + +351 +00:29:31,840 --> 00:29:35,420 +considered in fitting patients with softer contact + +352 +00:29:35,420 --> 00:29:38,700 +lenses لازم أخذها بعين الاعتبار لما أعمل fitting + +353 +00:29:38,700 --> 00:29:43,080 +لمين؟ للـ softer contact lenses patients with tighter + +354 +00:29:43,080 --> 00:29:48,220 +lids أو بمعنى اللي هو lid tension عنده، مي فورس أي + +355 +00:29:48,220 --> 00:29:52,660 +بمعنى مي power هيزود اللي هو من القوة، more limbs + +356 +00:29:52,660 --> 00:29:58,090 +rotation يعني هيزود من قوة دوران العدسة تمام؟ Upon + +357 +00:29:58,090 --> 00:30:02,190 +a blinking تحت اللي هو عملية الرمش، وهذه إيش + +358 +00:30:02,190 --> 00:30:06,130 +بتعمل؟ This additional rotation could lead to + +359 +00:30:06,130 --> 00:30:10,030 +instability of the lens fit. هذه حسب اللي هو عدم + +360 +00:30:10,030 --> 00:30:13,670 +استقامة لمين؟ أو عدم ثبات للعدسة + +361 +00:30:17,570 --> 00:30:22,310 +أيضًا individual patient sensitivity to axes if + +362 +00:30:22,310 --> 00:30:26,010 +fluctuations should be considered الآن مريض + +363 +00:30:26,010 --> 00:30:30,930 +عملت له subjective refraction لجيته مثلًا minus + +364 +00:30:30,930 --> 00:30:36,870 +واحد على minus ثلاثة axes مائة وثمانين، روحت مجرد + +365 +00:30:36,870 --> 00:30:40,210 +إن العجزة كانت مائة وخمسة وسبعين، يعني قد إيش الفرق + +366 +00:30:40,210 --> 00:30:44,520 +خمسة degree، لجيته إن المريض عنده blurred vision يعني + +367 +00:30:44,520 --> 00:30:48,280 +إيش عنده؟ sensitivity عالي بالنسبة لتغيير الـ axis + +368 +00:30:48,280 --> 00:30:53,120 +فهذه الأشخاص ماينفعش معاهم الـ software contact + +369 +00:30:53,120 --> 00:31:00,860 +lenses طيب monocular patients maybe need more + +370 +00:31:00,860 --> 00:31:08,420 +sensitive to axis shift كيف هذه؟ في الأشخاص اللي + +371 +00:31:08,420 --> 00:31:10,560 +بيكون عندهم monocular patients + +372 +00:31:13,120 --> 00:31:18,960 +يعني أكثر حساسية في إزاحة الـ axis، كيف هذه النقطة؟ + +373 +00:31:18,960 --> 00:31:22,100 +ببساطة إذا كان بيكون واحد عنده monocular هيستخدمها + +374 +00:31:22,100 --> 00:31:26,600 +لإيش؟ للقريب، والثاني هتكون إيش؟ للـ distance + +375 +00:31:26,600 --> 00:31:31,820 +فبالتالي أي تغيير في الـ axis هيعمل عند المريض إيه؟ + +376 +00:31:31,820 --> 00:31:36,600 +زيادة في اللي هو يعني اختلاف في الـ axis وبالتالي + +377 +00:31:36,600 --> 00:31:40,100 +أنه هيغير من الرؤية، وهذا هيسبب للمريض + +378 +00:31:40,100 --> 00:31:44,620 +deterioration للـ vision وبالتالي هو هيكون العدسة + +379 +00:31:44,620 --> 00:31:48,340 +غير ملائمة له، جماعة بالنسبة للمونوكيلار يعني + +380 +00:31:48,340 --> 00:31:51,640 +المريض بيستخدم واحدة للنير وواحدة للـ distance، الآن + +381 +00:31:51,640 --> 00:31:55,520 +اللي بيستخدمها للـ distance بتعمل العدسة rotation + +382 +00:31:55,520 --> 00:32:00,480 +يعني بمعنى أنه هيكون أكثر حساسية في موضوع الـ axis + +383 +00:32:04,410 --> 00:32:09,270 +axes shift may be better tolerated in the non + +384 +00:32:09,270 --> 00:32:17,350 +-dominant eye كيف هذه تفسيرها؟ بس + +385 +00:32:17,350 --> 00:32:22,570 +في الـ non-dominant eye بالضبط، يعني التأثير هيكون + +386 +00:32:22,570 --> 00:32:26,470 +أقل لأنه أنا غير اللي هي يعني العين الغير سائدة + +387 +00:32:26,470 --> 00:32:33,120 +بالنسبة لمين؟ للـ patient طيب نقف إن شاء الله لموضوع + +388 +00:32:33,120 --> 00:32:37,500 +الـ twist test إن شاء الله في المحاضرة الجاية بنكمل + +389 +00:32:37,500 --> 00:32:38,040 +بإذن الله diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/Yp4C5cHZjcg_postprocess.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/Yp4C5cHZjcg_postprocess.srt new file mode 100644 index 0000000000000000000000000000000000000000..139419818fe8dd0f602bb20fefd276b3d7346452 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/Yp4C5cHZjcg_postprocess.srt @@ -0,0 +1,1556 @@ +1 +00:00:21,060 --> 00:00:23,700 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:23,700 --> 00:00:27,080 +وبركاته and a very good morning to all of you + +3 +00:00:27,080 --> 00:00:34,040 +بداية لو بدأنا المحاضرة بسؤال ال gp lenses وين هي + +4 +00:00:34,040 --> 00:00:40,580 +بتكون يعني افضل خيار للمريض العدسات ال RGB او ال + +5 +00:00:40,580 --> 00:00:45,260 +gp lenses متى بتكون هي افضل خيار؟ لما يكون ال + +6 +00:00:45,260 --> 00:00:51,190 +decor neocentral او ال regularityتمام، إذا في حالة + +7 +00:00:51,190 --> 00:00:56,510 +ما يكون عندنا ال regular surface of the cornea أو + +8 +00:00:56,510 --> 00:01:00,510 +يكون عندنا قيمة ال corneal cylinder يعني كل قيمة + +9 +00:01:00,510 --> 00:01:04,590 +ال astigmatism اللي جاي من ال cornea بتكون هي أفضل + +10 +00:01:04,590 --> 00:01:11,980 +خيار لمين؟ لل patientGB lenses can cause a patient + +11 +00:01:11,980 --> 00:01:17,300 +to show an uncorrected residual astigmatism اذا + +12 +00:01:17,300 --> 00:01:22,820 +العدسات ال GB lenses هي بتكون غير قادرة على تصحيح + +13 +00:01:22,820 --> 00:01:26,460 +مين ال residual astigmatism او ال internal + +14 +00:01:26,460 --> 00:01:33,340 +cylinder طبعا احنا احنا عارفين ان ال residual او + +15 +00:01:33,340 --> 00:01:37,520 +ال internal cylinder من وين جاي this results هذا + +16 +00:01:37,520 --> 00:01:42,070 +القيمةمن العلاقة ما بين الكورنيا والـ refractive + +17 +00:01:42,070 --> 00:01:47,390 +astigmatism، هذه واضحة A residual difference may + +18 +00:01:47,390 --> 00:01:51,730 +be corrected with a GB on the eye owing to + +19 +00:01:51,730 --> 00:01:54,890 +lenticular or internal astigmatism + +20 +00:01:58,070 --> 00:02:02,910 +إذا العدسات ال جي بي لينزز بتصلح ال residual + +21 +00:02:02,910 --> 00:02:06,950 +astigmatism ولكن فقط يما يكون من ال lenticular + +22 +00:02:06,950 --> 00:02:11,810 +ببساطة يما يكون قيمته insignificant يعني أقل من 0 + +23 +00:02:11,810 --> 00:02:17,390 +.75 ممكن ليش؟ لأنه هان يما يكون عندنا قيمة ال + +24 +00:02:17,390 --> 00:02:24,110 +residual astigmatism أقل من 0.75 هان تعتبر هذه + +25 +00:02:24,110 --> 00:02:25,310 +القيمة insignificant + +26 +00:02:28,610 --> 00:02:34,150 +تمام؟ فالـ new surface لقى الكورنيا من خلال الـ GB + +27 +00:02:34,150 --> 00:02:38,450 +لينزز هي ممكن ان تعمل mask او cover لقيمة + +28 +00:02:38,450 --> 00:02:41,810 +الastigmatism ولكن بدنا نعرف ان هوان قيمة ال + +29 +00:02:41,810 --> 00:02:43,970 +Residue و الastigmatism insignificant + +30 +00:02:47,200 --> 00:02:52,920 +وإذا كانت قيمة الـ Residual أسطيغماتيزم مفروضة، + +31 +00:02:52,920 --> 00:02:59,100 +فالطبيعي سيكون أفضل مناسب للعين السفتوريكية يعني + +32 +00:02:59,100 --> 00:03:03,660 +الآن لو كانت قيمة الـ Residual أسطيغماتيزم أكتر من + +33 +00:03:03,660 --> 00:03:09,320 +0.75، إذن هان تعتبر مهمة، صح ولا لا؟ إذا مين أفضل + +34 +00:03:09,320 --> 00:03:14,140 +خيار للمريض؟الصفتوري ال contact lenses هي العدسة + +35 +00:03:14,140 --> 00:03:18,660 +اللى قادرة على تصحيح ال residual أستigmatism أو ال + +36 +00:03:18,660 --> 00:03:20,060 +internal cylinder + +37 +00:03:31,000 --> 00:03:35,480 +astigmatic against the rule corneas، إيش معناه + +38 +00:03:35,480 --> 00:03:39,140 +against the rule؟ إنه هيكون ال horizontal meridian + +39 +00:03:39,140 --> 00:03:46,380 +أكبر من ال vertical meridianخيار الأفضل لهذا ال + +40 +00:03:46,380 --> 00:03:48,760 +patient هو عبارة عن ال soft-track contact lenses + +41 +00:03:48,760 --> 00:03:54,220 +في حال ما يكون المريض عنده against the rule الخيار + +42 +00:03:54,220 --> 00:03:57,500 +الأفضل لهذا ال patient هو عبارة عن ال soft-track + +43 +00:03:57,500 --> 00:04:01,840 +contact lenses البساطة العدسة ال soft-track فيها + +44 +00:04:01,840 --> 00:04:07,120 +عملية rotation تدوير لأنه بيكون فيها marker و ممكن + +45 +00:04:07,120 --> 00:04:12,270 +انا بقدر اعمل عملية rotationفهي قادرة على ضبط + +46 +00:04:12,270 --> 00:04:16,230 +إيقاع اللي هو ال against the rule of stigmatism + +47 +00:04:16,230 --> 00:04:19,390 +احنا عارفين ال against the rule of stigmatism يما + +48 +00:04:19,390 --> 00:04:24,270 +بنستخدم معه العدسات ال RGB بتعمل decentralization + +49 +00:04:24,270 --> 00:04:30,570 +إزاحة سواء nasal أو temporal لكن ال software + +50 +00:04:30,570 --> 00:04:35,070 +contact lensesبتجنبنى اللى هو ايه قضية ال + +51 +00:04:35,070 --> 00:04:39,470 +decentration الإزاحة سواء nasally أو temporally + +52 +00:04:39,470 --> 00:04:44,970 +they often except أي بمعنى شو بتوضح significant + +53 +00:04:44,970 --> 00:04:49,230 +residual astigmatism إذا بكون عندنا قيمة ال + +54 +00:04:49,230 --> 00:04:52,570 +residual astigmatism في هذه الحالة في ال against + +55 +00:04:52,570 --> 00:04:56,130 +the rule of astigmatism واضحة أو significant ذات + +56 +00:04:56,130 --> 00:05:03,790 +قيمةالعدسات ال جي بي لينزاز لديها تأثير تقريبا او + +57 +00:05:03,790 --> 00:05:08,030 +نزاليا بسبب كورنيا. + +58 +00:05:25,260 --> 00:05:30,300 +في الـ Against the rule نفترض أنها مثلا 54 هنا + +59 +00:05:30,300 --> 00:05:38,760 +ستكون 45 إذا سيكون ال horizontal meridian steeper + +60 +00:05:38,760 --> 00:05:42,500 +than ال vertical meridian فهتلاحظ لو أنا استخدمت + +61 +00:05:42,500 --> 00:05:46,580 +عدسة ال جي بي لينزز هتعمل الهو دي سنتراشن سواء + +62 +00:05:46,580 --> 00:05:51,480 +نازلي أو تمبرارلي لكن ال software عشان فيها عملية + +63 +00:05:51,480 --> 00:05:54,080 +ال rotation هتتجنب هذا الموضوع + +64 +00:05:59,370 --> 00:06:00,950 +أيضًا في الأستيمات + +65 +00:06:06,640 --> 00:06:10,540 +نفس قضية mean ال against the rule لكن ال with the + +66 +00:06:10,540 --> 00:06:13,900 +rule هيكون ال vertical meridian steeper than ال + +67 +00:06:13,900 --> 00:06:17,600 +horizontal meridian لو استخدمنا ال gb هتعمل اللي + +68 +00:06:17,600 --> 00:06:21,500 +هو decentration up و down لكن ال softric هتلاقيها + +69 +00:06:21,500 --> 00:06:25,220 +ايش انه conform to the shape of the conya و بتاخد + +70 +00:06:25,220 --> 00:06:28,440 +اللي هو قيمة المحور او قيمة ال axels اللي انا + +71 +00:06:28,440 --> 00:06:29,240 +بديها + +72 +00:06:33,050 --> 00:06:41,330 +Patients who have not been able to adapt to the + +73 +00:06:41,330 --> 00:06:46,670 +comfort of GB lenses يعني الآن مريض لاحظنا أن أفضل + +74 +00:06:46,670 --> 00:06:51,110 +خيار له ال GB lenses لبسناه العدسة مش قادر يعمل + +75 +00:06:51,110 --> 00:06:55,090 +adaptation مع العدسة تمام؟ + +76 +00:06:59,060 --> 00:07:02,320 +على الـ 3 9 o'clock staining يعني ال clinical sign + +77 +00:07:02,320 --> 00:07:08,080 +عنده انه فيه staining على اللي هو ال 3 و ال 9 or + +78 +00:07:08,080 --> 00:07:13,480 +who have poor positioning gb lenses maybe well + +79 +00:07:13,480 --> 00:07:17,780 +motivated to use soft torque lenses طب انا بتسأل + +80 +00:07:17,780 --> 00:07:22,340 +السؤال ليش في حالة ال 3 9 o'clock بدنا نستبدل + +81 +00:07:22,340 --> 00:07:26,000 +العبثة ال RGB بال soft torque contact lenses؟ + +82 +00:07:38,150 --> 00:07:42,210 +عشان ما .. يعني ما .. ما تعملش ال setup بال .. + +83 +00:07:42,210 --> 00:07:45,730 +بالعين ولا ما تستخدمش كورنيا بيدينه؟ اه اه ممكن + +84 +00:07:45,730 --> 00:07:50,030 +انا بتكون ضعيفة لغاية ال .. ال soft لغاية ال .. + +85 +00:07:50,030 --> 00:07:54,310 +طيب ليش بنسبلها في ال soft trick؟ soft انا .. فضل + +86 +00:07:54,310 --> 00:07:54,670 +ايه؟ + +87 +00:07:59,500 --> 00:08:04,560 +الان انا يما بستخدم ال جي بي لينزز و بتعمل ال + +88 +00:08:04,560 --> 00:08:07,920 +three nine o'clock لو انا رفعت العدسة و حطيت + +89 +00:08:07,920 --> 00:08:11,380 +فلوروسين هتلاحظ انه هيصير ال staining وين؟ في + +90 +00:08:11,380 --> 00:08:16,420 +المنطقة ال three و ال nine o'clock في حالة ال soft + +91 +00:08:16,420 --> 00:08:20,240 +recontact لينزز العدسة conform to the shape of the + +92 +00:08:20,240 --> 00:08:24,380 +cornea و العدسة اللي هو طبيعتها ايه هتكون soft + +93 +00:08:24,380 --> 00:08:29,860 +لينة فما هتسببلي اللي هو موضوع ال stainingيعني هي + +94 +00:08:29,860 --> 00:08:32,680 +هتصلح اللي هو ال with the rule او ال against the + +95 +00:08:32,680 --> 00:08:37,620 +rule مع انه هتجنب المريض حدوث اية three أو nine o + +96 +00:08:37,620 --> 00:08:41,080 +'clock يعني الآن السؤال انه هل ال three أو ال nine + +97 +00:08:41,080 --> 00:08:43,980 +o'clock هو يعتبر common في حالات ال software + +98 +00:08:43,980 --> 00:08:47,980 +contact lenses؟ لأ تمام؟ لكن وين بتكون اللي هي + +99 +00:08:47,980 --> 00:08:51,560 +most common في ال RGB contact lenses؟ + +100 +00:08:54,950 --> 00:08:59,750 +Some patients are better managed with GB lenses، + +101 +00:08:59,750 --> 00:09:04,930 +إذا بعض المرضى بفضله انه managedها بمعنى اللي هو + +102 +00:09:04,930 --> 00:09:09,130 +treatment كعلاج، انه يتعالجوا بعدسات ال GB lenses + +103 +00:09:10,240 --> 00:09:14,540 +Patience with certain occupations يعني في عندهم + +104 +00:09:14,540 --> 00:09:19,440 +مضائف اللي هو معينة او محددة عنده مثلا مشاكل اللي + +105 +00:09:19,440 --> 00:09:24,320 +هو فيه القرنية Handling issues عنده صعوبة في عملية + +106 +00:09:24,320 --> 00:09:27,820 +مسك العدسة مقدرش انه يمسك اللي هو ال software ال + +107 +00:09:27,820 --> 00:09:33,620 +contact lens بسهولة And visual demands may require + +108 +00:09:33,620 --> 00:09:38,160 +the use of gp lenses ايش المقصود هنا في ال visual + +109 +00:09:38,160 --> 00:09:45,640 +demands؟كيف يعني؟ حسب + +110 +00:09:45,640 --> 00:09:50,920 +طبيعي التعمل، وإذا كان بيعمل في مكتب أو خارج البيت + +111 +00:09:50,920 --> 00:09:54,460 +أو خارج العمل، يعني حسب أشخاص يعني لو كان مثلا إن + +112 +00:09:54,460 --> 00:09:58,700 +في موقع عمل إنه مفتوح فهو بحتاج ال RGB أكتر من ال + +113 +00:09:58,700 --> 00:10:01,900 +soft أو يعني العكس لأ أنا بقصد hand في ال visual + +114 +00:10:01,900 --> 00:10:05,580 +demands ان هو حسب طلبات البصرية يعني، فيه بيكون + +115 +00:10:05,580 --> 00:10:09,420 +بته القريب بته اللي بته يعني تصديح أكتر، فيه بته + +116 +00:10:09,420 --> 00:10:15,200 +يعني بتهشكلامك صحيح، بس أنا بسط أكتر أنه هل هو + +117 +00:10:15,200 --> 00:10:18,740 +بيستخدمها ك monocular ولا binocular؟ هل مثلا + +118 +00:10:18,740 --> 00:10:22,340 +النوعين فيه عنده لنير والتاني لل distance ولا لا؟ + +119 +00:10:22,340 --> 00:10:26,100 +هل التنتين دايما بيستخدمهم لنير؟ هل التنتين طبيعي + +120 +00:10:26,100 --> 00:10:29,180 +اتعملوا دايما لل distance؟ هال المقصود فيه اللي هو + +121 +00:10:29,180 --> 00:10:34,140 +ك visual demands in general، بشكل عاميعني استخدام + +122 +00:10:34,140 --> 00:10:38,600 +الرؤية بالنسبة للمريض واحد مثلا driver إذا دايما + +123 +00:10:38,600 --> 00:10:42,920 +طبيعة عمله وين هيكون للأمام لل distance واحد مثلا + +124 +00:10:42,920 --> 00:10:47,000 +officer او teacher دايما طبيعة عمله وين لل near + +125 +00:10:47,000 --> 00:10:53,680 +فاستخدامه لالهو ال vision okay may require the use + +126 +00:10:53,680 --> 00:10:57,480 +of gp lenses طب ليش هنا بدنا نستخدم ال gp lenses + +127 +00:10:57,480 --> 00:11:03,580 +أكتر؟ببساطة لأنه دايما ال soft recontact lenses ال + +128 +00:11:03,580 --> 00:11:07,840 +sensitivity فيها very high عالية كتير بمعنى آخر و + +129 +00:11:07,840 --> 00:11:12,800 +الآن هتمر معناه لو قدام المريض لو عنده مثلا اختلاف + +130 +00:11:12,800 --> 00:11:16,820 +خمسة degree في ال soft recontact lenses هيشعر فيها + +131 +00:11:16,820 --> 00:11:21,700 +يعني لازم ان يكون في حالات ال soft recontact + +132 +00:11:21,700 --> 00:11:26,480 +lenses typical اللي هو بالنسبة لمين لل axisأي + +133 +00:11:26,480 --> 00:11:33,040 +تروتيش للعدسة هيأثر على مين؟ على رؤية المريض تمام؟ + +134 +00:11:33,040 --> 00:11:39,220 +in addition بالإضافة unacceptable visual acuity + +135 +00:11:39,220 --> 00:11:44,900 +with soft lenses may occur because of corneal + +136 +00:11:44,900 --> 00:11:49,640 +irregularities or optical or rotational problems + +137 +00:11:49,640 --> 00:11:56,480 +GB lenses may provide more acceptable acuityالان + +138 +00:11:56,480 --> 00:12:00,880 +لو كان عنده patient و بنفع استخدم معه ال soft + +139 +00:12:00,880 --> 00:12:06,560 +trick و بنفع استخدم معه ال RGB بتتوقع الان كرؤية + +140 +00:12:06,560 --> 00:12:12,660 +مين أوضح ال RGB و هذه بناء على دراسة تم إجراءها + +141 +00:12:12,660 --> 00:12:18,880 +استخدموا فيها ال color vision + +142 +00:12:22,140 --> 00:12:27,260 +و ايضا ال functional acuity contrast sensitivity + +143 +00:12:27,260 --> 00:12:32,980 +test تمام و استخدموا ايضا فيها ال visual acuity + +144 +00:12:32,980 --> 00:12:39,520 +test فلاحظوا ان العدسات ال RGB من حيث الرؤية او من + +145 +00:12:39,520 --> 00:12:44,920 +حيث الوضوح بتكون اكتر مقارنة في مين في ال software + +146 +00:12:44,920 --> 00:12:50,320 +contact lenses ولكن من حيث ارباحها ال software + +147 +00:12:50,320 --> 00:12:56,420 +اريحتمام؟ إذا من حيث ال vision مين أفضل؟ ال RGB + +148 +00:12:56,420 --> 00:13:00,120 +ببساطة لأنه بتعمل ال new surface لمين؟ للكورنية و + +149 +00:13:00,120 --> 00:13:04,200 +بتعدل أية ال regular surface ل الكورنية + +150 +00:13:07,610 --> 00:13:12,710 +هذه عبارة عن الدراسة one study okay او previous + +151 +00:13:12,710 --> 00:13:18,290 +study دراسة سابقة using multiple objective tests + +152 +00:13:18,290 --> 00:13:21,770 +استخدموا مجموعة من التستات ال color vision test + +153 +00:13:21,770 --> 00:13:26,310 +functional acuity contrast sensitivity ايضا ال + +154 +00:13:26,310 --> 00:13:30,530 +visual acuity test demonstrated وضحوا ان ال visual + +155 +00:13:30,530 --> 00:13:31,970 +acuity with + +156 +00:13:37,170 --> 00:13:41,570 +to be equivalent or less يعني اما متساوي او اقل + +157 +00:13:41,570 --> 00:13:47,490 +while objective tests were equivalent the patients + +158 +00:13:47,490 --> 00:13:50,190 +subjectively احنا بنعتمد دايما ع مين؟ ع ال + +159 +00:13:50,190 --> 00:13:55,170 +subjective reported better vision with gb lenses + +160 +00:13:55,170 --> 00:13:59,930 +اذا المريض أشار في ال subjective مين افضل كرؤية؟ + +161 +00:13:59,930 --> 00:14:06,130 +ال gb lensesولكن مجموعة من المستخدمين افضلوا الـ + +162 +00:14:06,130 --> 00:14:10,730 +Soft-Rig بسبب أسهل الانتصاف والتعامل إذا الفضلوا + +163 +00:14:10,730 --> 00:14:14,350 +ال Soft-Rig من حيث اللي هو ال insertion و ال + +164 +00:14:14,350 --> 00:14:18,970 +removal و الراحة اللي بتقدمها هذا النوع من العدسات + +165 +00:14:18,970 --> 00:14:22,230 +طيب + +166 +00:14:22,230 --> 00:14:27,330 +الآن عندنا why GB lenses better than Soft-Rig + +167 +00:14:27,330 --> 00:14:28,030 +lenses + +168 +00:14:32,150 --> 00:14:38,970 +الرقم أولى لا يوجد اتجارات مناسبة بين توريسيتي + +169 +00:14:38,970 --> 00:14:40,610 +الكورنيال والريفراكتيف الريفراكتيف الريفراكتيف + +170 +00:14:40,610 --> 00:14:41,670 +الريفراكتف الريفراكتف الريفراكتف الريفراكتف + +171 +00:14:41,670 --> 00:14:45,290 +الريفراكتف الريفراكتف الريفراكتف الريفراكتف + +172 +00:14:45,290 --> 00:14:46,310 +الريفراكتف الريفراكتف الريفراكتف الريفراكتف + +173 +00:14:46,310 --> 00:14:47,910 +الريفراكتف الريفراكتف الريفراكتف الريفراكتف + +174 +00:14:47,910 --> 00:14:50,470 +الريفراكتف الريفراكتف الريفراكتف الريفراكتف + +175 +00:14:50,470 --> 00:14:53,970 +الريفراكتف الريفراكتف الريفراكتف الريفراكتف + +176 +00:14:53,970 --> 00:14:59,910 +الريفراالحالة الأولى non coincident axis يعني non + +177 +00:14:59,910 --> 00:15:04,230 +equivalent عدم تساوي ما بين ال axis الآن عندنا ال + +178 +00:15:04,230 --> 00:15:16,250 +corneal torsity نفترض + +179 +00:15:16,250 --> 00:15:18,370 +الآن عندنا وصفة + +180 +00:15:37,400 --> 00:15:41,600 +الان عنا non coincident axis يعني عدم اللي هو + +181 +00:15:41,600 --> 00:15:45,940 +التساوي من حيث إيش ال axis ما بين ال corneal + +182 +00:15:45,940 --> 00:15:49,660 +toricity أو ال corneal cylinder تمام and the + +183 +00:15:49,660 --> 00:15:54,280 +refractive astigmatism ما بينهم مختلفين من حيث إيش + +184 +00:15:54,280 --> 00:15:59,300 +ال axis maybe any indication for a spherical gb + +185 +00:15:59,300 --> 00:16:03,920 +lenses هذا بتديني إشارة إنه أنا أستخدم مين أو أكون + +186 +00:16:03,920 --> 00:16:09,560 +باتجاه ال gb lensesإذا كان هناك اختلاف ما بين ال + +187 +00:16:09,560 --> 00:16:12,540 +axis ال cornial cylinder و ال axis ال refractive + +188 +00:16:12,540 --> 00:16:16,720 +astigmatism، الأفضل انه يكون اتجاهي باتجاه مين؟ ال + +189 +00:16:16,720 --> 00:16:18,380 +RGB، لكن مش دايما + +190 +00:16:21,630 --> 00:16:28,570 +ليش؟ طيب الادسات الصفتوريك دايما تكون + +191 +00:16:28,570 --> 00:16:33,370 +فيها استقامة مع المصادر القناعية مع المصادر + +192 +00:16:33,370 --> 00:16:34,910 +القناعية مع المصادر القناعية مع المصادر القناعية + +193 +00:16:34,910 --> 00:16:36,350 +مع المصادر القناعية مع المصادر القناعية مع المصادر + +194 +00:16:36,350 --> 00:16:37,390 +القناعية مع المصادر القناعية مع المصادر القناعية + +195 +00:16:37,390 --> 00:16:37,810 +مع المصادر القناعية مع المصادر القناعية مع المصادر + +196 +00:16:37,810 --> 00:16:38,610 +القناعية مع المصادر القناعية مع المصادر القناعية + +197 +00:16:38,610 --> 00:16:39,190 +مع المصادر القناعية مع المصادر القناعية مع المصادر + +198 +00:16:39,190 --> 00:16:40,610 +القناعية مع المصادر القناعية مع المصادر القناعية + +199 +00:16:40,610 --> 00:16:47,530 +مع المصادر القناعية مع المصادر القناعية مع المصادر + +200 +00:16:47,530 --> 00:16:54,220 +القناخمسة واربعين ات مية و تمانين هيكون ال cornial + +201 +00:16:54,220 --> 00:16:58,680 +cylinder عبارة عن ماينوس واحد اكسس الفلاتس اللى هو + +202 +00:16:58,680 --> 00:17:03,840 +تسعين تمام الان ال cornial ال ال software ال + +203 +00:17:03,840 --> 00:17:09,080 +contact lenses دايما بيكون اتجاهها باتجاه مين؟الـ + +204 +00:17:09,080 --> 00:17:12,680 +Corneal curvature الجماعة في نقطة مهمة انا لان يما + +205 +00:17:12,680 --> 00:17:17,260 +بحكي على Corneal curvature او Corneal power او + +206 +00:17:17,260 --> 00:17:20,580 +Corneal curvature meridian دايما بنستخدم كلمة + +207 +00:17:20,580 --> 00:17:25,020 +meridian لكن احنا ك contact lenses الاقرب العدسة + +208 +00:17:25,020 --> 00:17:28,920 +بيكون فيها meridian لأ اش بيكون اكسس عليها صح ولا + +209 +00:17:28,920 --> 00:17:33,060 +لا؟يعني الآن احنا تعاملاتنا كلها تاك اكسس ولكن + +210 +00:17:33,060 --> 00:17:36,900 +الأجهزة اللي بتطلعلك مريديا معناه عبارة عن ايه + +211 +00:17:36,900 --> 00:17:41,720 +Cornial curvature يعني ات Cornial plane فهنا نرجع + +212 +00:17:41,720 --> 00:17:45,240 +لموضوعنا طبيعة العدسات ال software ال contact + +213 +00:17:45,240 --> 00:17:51,580 +lenses okay مثلا أن سام عندها اكسس تلاتين بتحط + +214 +00:17:51,580 --> 00:17:56,620 +العدسةعلى ال axis h تلاتين يعني الآن انا اللي بطلب + +215 +00:17:56,620 --> 00:18:00,640 +من ال manufacturer انه لازم يكون ال axis مساوي + +216 +00:18:00,640 --> 00:18:03,880 +لمين لل axis بتاع ال subjective refraction الا لو + +217 +00:18:03,880 --> 00:18:08,300 +صار عملية rotation زي ما خدنا وين في اللي هو لبعض + +218 +00:18:08,300 --> 00:18:12,740 +الشعط صح ولا لأ انه لازم يكون ال axis مساوي لل + +219 +00:18:12,740 --> 00:18:15,780 +axis ال subjective refraction اللي انا ارتحت عليه + +220 +00:18:15,780 --> 00:18:26,650 +ك patientLens rotation دوران العدسة يمكن أن يكون + +221 +00:18:26,650 --> 00:18:33,030 +غير مهم أو غير ما هو مكتشف يعني الآن لو أنا مثلا + +222 +00:18:33,030 --> 00:18:37,890 +ماعنديش set lamp examination و راح اتقدت لرغب بناء + +223 +00:18:37,890 --> 00:18:41,530 +على subjective refraction ممكن العدسة عاملة + +224 +00:18:41,530 --> 00:18:44,770 +rotation و انا مش دارس صح ولا لأ فهيك ايش عملت + +225 +00:18:44,770 --> 00:18:50,820 +غيرت بقيمة ال axisفإذا كان غير مكشوف and cause + +226 +00:18:50,820 --> 00:18:54,140 +fitting problems، هذا هيسبب للمريض إن الرؤية مش + +227 +00:18:54,140 --> 00:18:57,140 +واضحة، هيقولك والله أنا في العدسات اللي أخدتهم + +228 +00:18:57,140 --> 00:19:01,300 +منها، هدول مش واضحين، أنا شاعر الدنيا، a planet + +229 +00:19:01,300 --> 00:19:07,140 +vision في عندىPotential rotational problems يعني + +230 +00:19:07,140 --> 00:19:11,160 +مشاكل اللي هو الدوران الافتراضية potential بمعنى + +231 +00:19:11,160 --> 00:19:16,100 +افتراضي are avoided هذه كلها هتتجنبيها وين؟ يما + +232 +00:19:16,100 --> 00:19:21,240 +تستخدمي ال جي بي لينزز طب ليش؟لأن الـ GB lenses فش + +233 +00:19:21,240 --> 00:19:25,160 +فيها rotation وبالاضافة إلى ذلك انه بيكون موضوع ال + +234 +00:19:25,160 --> 00:19:29,060 +tear lens ال tear lens ما بين العدسة و الكورنية + +235 +00:19:29,060 --> 00:19:33,320 +هيكون قادر على ايش انه mask او cover انه يغطي مين + +236 +00:19:33,320 --> 00:19:37,640 +كل قيمة اللي هو ال cylinder اللي موجودة عند ال + +237 +00:19:37,640 --> 00:19:39,800 +patient تمام ان شاء الله؟ + +238 +00:19:46,090 --> 00:19:54,630 +الحالة التانية عندما تحركات السليندر أكثر من قوة + +239 +00:19:54,630 --> 00:19:59,770 +الاسفير و قوة الاسفير قريب من بلانو يعني مثل + +240 +00:19:59,770 --> 00:20:03,690 +المثال هذا عندنا قيمة بلانو ع ماينوس واحد و نصف و + +241 +00:20:03,690 --> 00:20:09,690 +نفترض ان هذا القيمة جاية من كونيا حكينا فيها ان ال + +242 +00:20:09,690 --> 00:20:13,390 +جي بي لينزز افضل من من ال soft direct contact + +243 +00:20:13,390 --> 00:20:14,030 +lenses + +244 +00:20:20,830 --> 00:20:27,470 +ماذا تتوقع؟ لأنه كما اتفقنا انه في حالة ال soft + +245 +00:20:27,470 --> 00:20:31,590 +ring contact lenses ال sensitivity هتكون عالية + +246 +00:20:31,590 --> 00:20:36,110 +يعني عندنا plano ع minus واحد و نص اذا كل قيمة ال + +247 +00:20:36,110 --> 00:20:39,270 +refractive error عند المريض هو عبارة عن ايه؟ + +248 +00:20:39,270 --> 00:20:44,780 +cylinderفأي تروتيشن للعدسة هيأثر على رؤية المريض + +249 +00:20:44,780 --> 00:20:49,480 +بالإضافة نقطة تانية انه دايما ال software ال + +250 +00:20:49,480 --> 00:20:53,300 +contact lenses مالهاش تأثير على ال internal + +251 +00:20:53,300 --> 00:20:58,620 +cylinder كتأثير انه بيكون يعني على طول انه بيصير + +252 +00:20:58,620 --> 00:21:02,400 +عند المريض اللي هو very sensitive انه بيكون حساس + +253 +00:21:02,400 --> 00:21:08,950 +بشكل اللي هو كبيربالتالي، في حالة تغيير تحويل صغير + +254 +00:21:08,950 --> 00:21:15,970 +من الـ-1.50 إلى 180 برنامج Viplano، + +255 +00:21:19,070 --> 00:21:24,870 +بسيطة على العدسة او اي دوران للعدسة ايش هيعمل لبعض + +256 +00:21:24,870 --> 00:21:29,010 +المرضى because the astigmatic correction is the + +257 +00:21:29,010 --> 00:21:32,410 +entire refractive error كل قيمة ال refractive + +258 +00:21:32,410 --> 00:21:36,390 +error عند المريض جاية من وين؟ من السليندر إبلاه + +259 +00:21:36,390 --> 00:21:41,530 +نوع ماينس واحد و نص إذا هان مين الأفضل لل patient + +260 +00:21:41,530 --> 00:21:43,050 +ال RGB + +261 +00:21:46,790 --> 00:21:52,010 +ثالثًا، عندما يكون كورنيال سلندر أو كورنيال + +262 +00:21:52,010 --> 00:21:58,270 +توريسيتي أكتر من رفراكتيف أستيغماتيزم، يمكن أن + +263 +00:21:58,270 --> 00:22:01,490 +يكون موضوع جيبي لينز أيضًا موضوع جيبي لينز + +264 +00:22:11,820 --> 00:22:16,120 +الجي بي لينز سيغطي الوضع الاستيغماطيسي ولكن هان + +265 +00:22:16,120 --> 00:22:19,280 +انسيقنيفيكانت ريزيديوال استيغماطيسي انسيقنيفيكانت + +266 +00:22:19,280 --> 00:22:22,480 +ريزيديوال استيغماطيسي انسيقنيفيكانت ريزيديوال + +267 +00:22:22,480 --> 00:22:25,900 +استيغماطيسي انسيقنيفيكانت ريزيديوال استيغماطيسي + +268 +00:22:25,900 --> 00:22:27,720 +انسيقنيفيكانت ريزيديوال استيغماطيسي انسيقنيفيكانت + +269 +00:22:27,720 --> 00:22:31,840 +ريزيديوال استيغماطيسي انسيقنيفيكانت ريزيديوال + +270 +00:22:31,840 --> 00:22:35,060 +استيغماطيسي انسيقنيفيكانت ريزيديوال استي + +271 +00:22:41,640 --> 00:22:46,020 +Patient selection should be based on the same + +272 +00:22:46,020 --> 00:22:51,820 +criteria as used for the soft spherical lens + +273 +00:22:55,180 --> 00:23:00,680 +ال indications أو كل ال advantages اللي خاصة في ال + +274 +00:23:00,680 --> 00:23:04,240 +spherical soft contact lens هي نفس مين ال + +275 +00:23:04,240 --> 00:23:08,620 +indications أو ال advantages اللي خاصة في مين؟ في + +276 +00:23:08,620 --> 00:23:11,540 +ال soft direct contact lenses أيضا ال + +277 +00:23:11,540 --> 00:23:15,340 +disadvantages تحت ال soft أو ال spherical soft + +278 +00:23:15,340 --> 00:23:19,020 +contact lens هي نفسها ال disadvantages لمين لل + +279 +00:23:19,020 --> 00:23:23,960 +soft direct اضافة لموضوع مين؟ ال rotation صحيح؟ + +280 +00:23:25,890 --> 00:23:30,110 +Patients who are good candidates يعني المرضى اللي + +281 +00:23:30,110 --> 00:23:35,490 +بيكونوا مرشحين بشكل جيد لعدسات ال soft contact + +282 +00:23:35,490 --> 00:23:40,110 +lenses او هنا اللي هو ال spherical soft lenses + +283 +00:23:41,890 --> 00:23:46,150 +Based on lifestyle اذا بتعتمد على طبيعة الحياة + +284 +00:23:46,150 --> 00:23:50,950 +اللى هو عايشها تمام ايضا على ال compliance مدى + +285 +00:23:50,950 --> 00:23:54,370 +الالتزام فى عملية ال cleaning فى عملية ال + +286 +00:23:54,370 --> 00:24:00,750 +insertion ال removal فى عملية ال disinfection ال + +287 +00:24:00,750 --> 00:24:04,630 +motivation الحافظ اللى هى تعتبر number one لارتداء + +288 +00:24:04,630 --> 00:24:10,010 +اى تعادسة لاصقةAnd corneal health سلامة الكورنيا + +289 +00:24:10,010 --> 00:24:13,730 +واحد عنده irregular surface للكورنيا ممنوع انه + +290 +00:24:13,730 --> 00:24:17,730 +يديه ايش؟ spherical soft contact lens او soft + +291 +00:24:17,730 --> 00:24:22,810 +direct contact lenses are likely good candidates + +292 +00:24:22,810 --> 00:24:27,060 +for soft direct contact lensesبينما ال patients + +293 +00:24:27,060 --> 00:24:31,040 +اللي بيكونوا corneal او lenticular astigmatism او + +294 +00:24:31,040 --> 00:24:35,340 +combination او residual astigmatism هدول ممكن ان + +295 +00:24:35,340 --> 00:24:40,200 +يكونوا يعني اشخاص مرشحين بشكل جيد لارتداء العدسات + +296 +00:24:40,200 --> 00:24:42,280 +ال software contact lenses + +297 +00:24:51,820 --> 00:24:56,700 +الـ Astigmatism يمكن أن يتم إصلاحه بـ GB أو Soft + +298 +00:24:56,700 --> 00:25:00,400 +-Rig Contact Lenses إذا كانت الـ Astigmatism + +299 +00:25:00,400 --> 00:25:03,760 +الرفرقية و ال Astigmatism الكورنيل مختلفة بكافة + +300 +00:25:03,760 --> 00:25:08,880 +أكثر من 0.75، فال Astigmatism المتبقى يمكن أن يكون + +301 +00:25:08,880 --> 00:25:14,890 +مرتبط بجهزة GBهذه الشخصيات قد تكون مستخدمات جيدة + +302 +00:25:14,890 --> 00:25:18,610 +لـ soft-track lenses هذه شرحنا المثال إذا كانت + +303 +00:25:18,610 --> 00:25:22,470 +قيمة الـ residual astigmatism أكتر من 75 إذا هو + +304 +00:25:22,470 --> 00:25:27,490 +يعتبر significant في حالة ما أنا أستخدم الـ GB + +305 +00:25:27,490 --> 00:25:32,910 +lenses هيظل مش هيصلح من ال residual astigmatism + +306 +00:25:32,910 --> 00:25:35,970 +لكن لما أستخدم الـ soft-track هيكون قادر على + +307 +00:25:35,970 --> 00:25:36,530 +تصحيحه + +308 +00:25:43,160 --> 00:25:46,440 +صحيح Residual astigmatism اللي هو ك significant + +309 +00:25:46,440 --> 00:25:52,120 +طيب عندنا ال tier film equality and quantity، إيش + +310 +00:25:52,120 --> 00:25:55,020 +الفرق بين التين تين؟ طيب إيش الفرق ما بين ال tier + +311 +00:25:55,020 --> 00:25:56,900 +film equality و quantity؟ + +312 +00:26:01,270 --> 00:26:06,430 +ال tier film quality دايما انه بعمل عملية تقييم لل + +313 +00:26:06,430 --> 00:26:11,990 +tier film دون اعطاء number كيف يعني؟ انه بعتمد على + +314 +00:26:11,990 --> 00:26:16,810 +ال quality جودة ال tier يعني هل المريض عنده normal + +315 +00:26:16,810 --> 00:26:21,610 +tier film ولا عنده abnormal tier filmتمام؟ يعني + +316 +00:26:21,610 --> 00:26:26,010 +بمعنى آخر بعمل اللي هو عملية tier film evaluation + +317 +00:26:26,010 --> 00:26:30,150 +تقييم لل tier فقط بيقول إن في المريض عنده good + +318 +00:26:30,150 --> 00:26:33,730 +equality of tier film أو عنده bad equality of tier + +319 +00:26:33,730 --> 00:26:39,420 +film هذا بالنسبة لمين؟الـ Quantity بيقول للمريض + +320 +00:26:39,420 --> 00:26:43,840 +عنده TB UT بالساوي عشرة بيقول لي مثلا ال TB UT + +321 +00:26:43,840 --> 00:26:47,440 +أكتر من عشرة بيقول لي مثلا في الشير مارتسك اللي + +322 +00:26:47,440 --> 00:26:53,480 +عنده خمس عاشر ملي متر هذا بيعتبر ايه؟ رقمي او ال + +323 +00:26:53,480 --> 00:26:58,840 +quantity اذا need to be assessed لازم انه يقيم اي + +324 +00:26:58,840 --> 00:27:03,520 +تمريض بيقبل على ارتداء العدسة اللاصقة لابد انه + +325 +00:27:03,520 --> 00:27:08,920 +يعمله clinical sign for dry eye تمام؟deficiencies + +326 +00:27:08,920 --> 00:27:12,200 +هذا المقصود فيها ال aqueous tear secretion + +327 +00:27:28,430 --> 00:27:34,030 +Deficiencies aqueous tear secretion may prevent a + +328 +00:27:34,030 --> 00:27:38,390 +successful fit يعني واحد عنده dry eye سواء كان + +329 +00:27:38,390 --> 00:27:43,590 +عنده bad quality لل tear film أو عنده reduce او + +330 +00:27:43,590 --> 00:27:48,390 +decrease بال number لل TBOT او الشيرماردسك هذا لو + +331 +00:27:48,390 --> 00:27:53,210 +انا عملتله عدسات لاصقة هيكون عنده بالضبط اللي هو + +332 +00:27:53,210 --> 00:27:59,430 +عدم تكييف مع العدسة اللاصقةCertain lens materials + +333 +00:27:59,430 --> 00:28:03,130 +بعض المواد زي ما قلنا ان ال high water content + +334 +00:28:03,130 --> 00:28:07,110 +بتعمل dry eye ash اكتر مقارنة في ال moderate او ال + +335 +00:28:07,110 --> 00:28:10,410 +low water content ايضا بعض ال design اللي احنا + +336 +00:28:10,410 --> 00:28:13,850 +خدهم ان شاء الله في اللي هو ال software ال contact + +337 +00:28:13,850 --> 00:28:16,950 +lenses زي موضوع ال truncation عشان تعمل اللي هو + +338 +00:28:16,950 --> 00:28:21,190 +comfortable راحة و تعمل اللي هو stability ثبات + +339 +00:28:21,190 --> 00:28:28,160 +للعدسة برضه في بعضهم انه بسبب جفاف للعينmay aid in + +340 +00:28:28,160 --> 00:28:33,580 +the successful fitting of these patients ايضا هذه + +341 +00:28:33,580 --> 00:28:37,840 +اما بالساعد في عملية ال fitting او بالعكس انه + +342 +00:28:37,840 --> 00:28:42,600 +بتعمل جفاف للعين وبالتالي المريض بيكون غير مهيأ + +343 +00:28:42,600 --> 00:28:49,380 +لارتداء العدسة اللاصقة طيب شخص عنده lead tension + +344 +00:28:49,380 --> 00:28:55,180 +تتوقع ان يكون ال soft trick خيار جيد له ولا سيئ؟ + +345 +00:29:00,690 --> 00:29:05,730 +شخص عنده led tension تتوقع انه يكون عنده خيار ال + +346 +00:29:05,730 --> 00:29:13,910 +soft trick جيد ولا سيء طبعا + +347 +00:29:13,910 --> 00:29:17,270 +في حالات ال led tension خيار ال soft trick contact + +348 +00:29:17,270 --> 00:29:22,770 +lenses هيكون سيء بسبب انه ممكن يعمل اللي هو force + +349 +00:29:22,770 --> 00:29:27,110 +يعني زيادة في عملية rotation للعدسة وبالتالي بيغير + +350 +00:29:27,110 --> 00:29:31,840 +من ال access للمريضإذا الـ Lid tension should be + +351 +00:29:31,840 --> 00:29:35,420 +considered in fitting patients with softer contact + +352 +00:29:35,420 --> 00:29:38,700 +lenses لازم أخدها بعين الاعتبار لما أعمل fitting + +353 +00:29:38,700 --> 00:29:43,080 +لمن؟ لل softer contact lenses بيشونس with tighter + +354 +00:29:43,080 --> 00:29:48,220 +lids او بمعنى اللي هو Lid tension عنده مي فورس أي + +355 +00:29:48,220 --> 00:29:52,660 +بمعنى مي power هيزود اللي هو من القوة more limbs + +356 +00:29:52,660 --> 00:29:58,090 +rotation يعني هيزود من قوة دوران العدسة تمام؟Upon + +357 +00:29:58,090 --> 00:30:02,190 +a blinking تحت اللي هو عملية الترميش وهذه إيش + +358 +00:30:02,190 --> 00:30:06,130 +بتعمل؟ This additional rotation could lead to + +359 +00:30:06,130 --> 00:30:10,030 +instability of the lens fit. هذه حسبب اللي هو بعدم + +360 +00:30:10,030 --> 00:30:13,670 +استقامة لمين أو عدم ثبات للعدسة + +361 +00:30:17,570 --> 00:30:22,310 +ايضا individual patient sensitivity to axes if + +362 +00:30:22,310 --> 00:30:26,010 +fluctuations should be considered الان مريض + +363 +00:30:26,010 --> 00:30:30,930 +اعملتله subjective refraction لجيته مثلا minus + +364 +00:30:30,930 --> 00:30:36,870 +واحد على minus تلاتة axes مية و تمانين روحت مجرد + +365 +00:30:36,870 --> 00:30:40,210 +ان العجزة كانت مية و خمسة و سبعين يعني قداش الفرق + +366 +00:30:40,210 --> 00:30:44,520 +خمسة degree لجيت ان المريض عنده blurred visionيعني + +367 +00:30:44,520 --> 00:30:48,280 +ايش عنده sensitivity عالي بالنسبة لتغيير ال axis + +368 +00:30:48,280 --> 00:30:53,120 +فهذه الأشخاص مايفهاش معاهم ال software contact + +369 +00:30:53,120 --> 00:31:00,860 +lenses طيب molecular patients maybe need more + +370 +00:31:00,860 --> 00:31:08,420 +sensitive to axis shift كيف هذه؟ في الأشخاص اللي + +371 +00:31:08,420 --> 00:31:10,560 +بيكون عندهم molecular patients + +372 +00:31:13,120 --> 00:31:18,960 +يعني أكتر حساسية في إزاحة ال axis كيف هذه النقطة؟ + +373 +00:31:18,960 --> 00:31:22,100 +ببساطة إذا كان يكون واحد عنده molecular هيستخدمها + +374 +00:31:22,100 --> 00:31:26,600 +لإيش؟ للقريب والتاني هتكون إيش؟ لل distance + +375 +00:31:26,600 --> 00:31:31,820 +فبالتالي أي تغيير في ال axis هيعمل عند المريض إيه؟ + +376 +00:31:31,820 --> 00:31:36,600 +زيادة في اللي هو يعني اختلاف في ال axisوبالتالي + +377 +00:31:36,600 --> 00:31:40,100 +انه هيغير من الرؤية وهذا هيسبب للمريض + +378 +00:31:40,100 --> 00:31:44,620 +deterioration لل vision وبالتالي هو هيكون العدسة + +379 +00:31:44,620 --> 00:31:48,340 +غير ملائبة له جماعة بالنسبة للمونوكيلار يعني + +380 +00:31:48,340 --> 00:31:51,640 +المريض بيستخدم واحدة للنير وواحدة لل distance الآن + +381 +00:31:51,640 --> 00:31:55,520 +اللي بيستخدمها لل distance بتعمل العدسة rotation + +382 +00:31:55,520 --> 00:32:00,480 +يعني بمعنى انه هيكون اكتر حساسية في موضوع ال axis + +383 +00:32:04,410 --> 00:32:09,270 +axes shift may be better tolerated in the non + +384 +00:32:09,270 --> 00:32:17,350 +-dominant eye كيف هذه تفسيرها؟ بس + +385 +00:32:17,350 --> 00:32:22,570 +في ال non-dominant eye بالضبط يعني التأثير هيكون + +386 +00:32:22,570 --> 00:32:26,470 +أقل لأنه أنا غير اللي هي يعني العيانة الغير سائدة + +387 +00:32:26,470 --> 00:32:33,120 +بالنسبة لمين لل patientطيب نقف ان شاء الله لموضوع + +388 +00:32:33,120 --> 00:32:37,500 +ال twist test ان شاء الله في المحاضرة الجاية بنكمل + +389 +00:32:37,500 --> 00:32:38,040 +بإذن الله + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/Z5IJhIdypwo_postprocess.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/Z5IJhIdypwo_postprocess.srt new file mode 100644 index 0000000000000000000000000000000000000000..051ef05d69fa29a357c51d9b62d2315584b4bf72 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/Z5IJhIdypwo_postprocess.srt @@ -0,0 +1,1100 @@ +1 +00:00:21,480 --> 00:00:24,260 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:24,260 --> 00:00:27,620 +وبركاته and a very good morning to all of you + +3 +00:00:27,620 --> 00:00:32,980 +هنبدأ اليوم في موضوع corneal exhalation syndrome + +4 +00:00:32,980 --> 00:00:36,080 +أي بمعنى انهاج لالقرانية + +5 +00:00:38,020 --> 00:00:43,340 +طبعا الشكل exohation syndrome بيكون شكل القرنية + +6 +00:00:43,340 --> 00:00:48,940 +عند إجراء مثلا ال corneal fluorescein staining أو + +7 +00:00:48,940 --> 00:00:53,760 +إجراء ال corneal topography بالشكل هذا قريب ل ال + +8 +00:00:53,760 --> 00:00:58,500 +.. ال symmetric bow tie أو ال regular astigmatism + +9 +00:01:00,510 --> 00:01:05,290 +condition associated with the presence of marked + +10 +00:01:05,290 --> 00:01:10,210 +endothelial polymegathism، إذا حالة بتكون مصاحبة + +11 +00:01:10,210 --> 00:01:15,570 +للتغير في حجم من؟ ال endothelium cells، يعني إما + +12 +00:01:15,570 --> 00:01:19,530 +بالزيادة أو بنقصان عدد ال endothelium cells + +13 +00:01:22,800 --> 00:01:27,920 +Patients with high refractive errors and extended + +14 +00:01:27,920 --> 00:01:34,680 +wear who have worn lenses for 10 years بعض الأشخاص + +15 +00:01:34,680 --> 00:01:38,460 +اللي بيكون عندهم high refractive error سواء كان + +16 +00:01:38,460 --> 00:01:42,160 +high minus power أو high plus power أو برتدي + +17 +00:01:42,160 --> 00:01:47,020 +العدسات اللاصقة لفترة زمانية طويلة بيكون مهيأ انه + +18 +00:01:47,020 --> 00:01:52,610 +يصاب في ايه؟ في ال corneal exhauation syndromeطبعا + +19 +00:01:52,610 --> 00:01:57,590 +ال high refractive + +20 +00:01:57,590 --> 00:02:06,230 +error خاصة وين في ال high plus والسبب في ذلك انه + +21 +00:02:06,230 --> 00:02:11,430 +بيكون more thickness + +22 +00:02:11,430 --> 00:02:17,750 +where in the center + +23 +00:02:19,540 --> 00:02:24,280 +Okay زي مثلا ال mono vision lenses + +24 +00:02:26,810 --> 00:02:31,550 +طيب أو بعض المرضى اللي بيرتد العدسة اللاصقة لمدة + +25 +00:02:31,550 --> 00:02:36,010 +عشر ساعات متواصلة ولكن هان المقصود بالعشر ساعات + +26 +00:02:36,010 --> 00:02:39,970 +يعني بمعنى ان هو ما بيعمل removal للعدسة بعض + +27 +00:02:39,970 --> 00:02:44,430 +الأشخاص مثلا بيعمل wake up الساعة مثلا سبعة، بلبس + +28 +00:02:44,430 --> 00:02:48,150 +العدسة اللاصقة الساعة تمانية، بروح الجامعة، بروح + +29 +00:02:48,150 --> 00:02:52,730 +مثلا واحدة، بعد ذلك بيعمل removal للعدسةبلبسها + +30 +00:02:52,730 --> 00:02:57,550 +مثلا الساعة ستة لاربع ساعات، يعني لساعة عشرة، يعني + +31 +00:02:57,550 --> 00:03:01,210 +بمعنى ان ال total عشر ساعات ولكن هو ايش بيعمل؟ + +32 +00:03:01,210 --> 00:03:05,450 +removal للعدسة، هنا بختلف عن ايه؟ المثال اللي احنا + +33 +00:03:05,450 --> 00:03:09,810 +بنذكره، هنا ال ten hours بتكون اللي هو بشكل كامل، + +34 +00:03:09,810 --> 00:03:16,100 +يعني طوال اليومother signs علامات أخرى are + +35 +00:03:16,100 --> 00:03:20,840 +intolerance to lens wear and blurred دايما المريض + +36 +00:03:20,840 --> 00:03:24,440 +بعد ما برتد العدسة اللاصقة في الفترة الزمنية هذه + +37 +00:03:24,440 --> 00:03:29,020 +الطويلة بشكي أنه في هناك fluctuating أو في هناك + +38 +00:03:29,020 --> 00:03:32,980 +variation لل vision يعني ممكن مثلا الصبح العدسة + +39 +00:03:32,980 --> 00:03:37,140 +بتكون واضحة في الليل بتكون مغبشة يعني في اختلاف في + +40 +00:03:37,140 --> 00:03:43,060 +الرؤيةdue to fluctuations in refractive error بسبب + +41 +00:03:43,060 --> 00:03:48,800 +اللي هو اختلاف في القوة الانكسارية للعين بعض + +42 +00:03:48,800 --> 00:03:53,680 +الأحيان ممكن بيصير عنده flare أو Blair و هذا ممكن + +43 +00:03:53,680 --> 00:03:55,880 +يؤدي إلى ايه ال blurred vision + +44 +00:04:01,000 --> 00:04:06,620 +corneal hypoesthesia أي بمعنى حساسية من القرنية، + +45 +00:04:06,620 --> 00:04:11,040 +بدأ أشوف اللي هو مدى الـ corneal sensitivity، هل + +46 +00:04:11,040 --> 00:04:14,860 +هي عالية ولا قليلة بالنسبة للكورنية + +47 +00:04:17,480 --> 00:04:21,160 +It's not easy to measure a quantitatively in the + +48 +00:04:21,160 --> 00:04:26,480 +clinical situation دايما مافيش أي جهاز بقيس اللي + +49 +00:04:26,480 --> 00:04:31,800 +هو حساسية ايه حساسية القرانية ك value كقيمة يعني + +50 +00:04:31,800 --> 00:04:36,180 +ما بيقول مثلا قيمة الحساسية لهذه القرانية تلاتة او + +51 +00:04:36,180 --> 00:04:41,300 +اربع او خمسة او ستة هو بياخدها ك qualitative ان هل + +52 +00:04:41,300 --> 00:04:42,440 +هي good ولا bad + +53 +00:04:46,700 --> 00:04:52,300 +One technique is based on using a fine nylon، fine + +54 +00:04:52,300 --> 00:04:56,360 +يعني بمعنى دقيق، nylon threaded of adjustable + +55 +00:04:56,360 --> 00:05:00,300 +length and stimulating a peripheral corneal + +56 +00:05:00,300 --> 00:05:05,040 +location قبل ما أنا بقوم بإجراء اللي هو ارتداء + +57 +00:05:05,040 --> 00:05:09,960 +العدسة اللاصقة، بعمله ال مريض test بسيط سواء كان + +58 +00:05:09,960 --> 00:05:13,800 +اللي هو فيه fine، threaded، nylon، أي بمعنى بيكون + +59 +00:05:13,800 --> 00:05:18,350 +رفيق أو رقيق كتيروبشوف حساسية القرانية وين؟ + +60 +00:05:18,350 --> 00:05:21,910 +بالأطراف، انه هل في اللي هو هناك sensitivity ولا + +61 +00:05:21,910 --> 00:05:25,650 +لا؟ طبعا بعض الأشخاص بيكون عندهم ال sensitivity + +62 +00:05:25,650 --> 00:05:29,250 +very high، إذن هذا يعتبر من ضمن ال contra + +63 +00:05:29,250 --> 00:05:32,590 +indications لمن؟ لل contact lenses، سواء ال soft + +64 +00:05:32,590 --> 00:05:36,550 +أو ال hard، okay؟ بعضهم بيكون low، أيضا هذا يعتبر + +65 +00:05:36,550 --> 00:05:38,950 +contra indications، okay؟ + +66 +00:05:42,160 --> 00:05:47,660 +Low decay over tea hydrogel or RGB lenses are most + +67 +00:05:47,660 --> 00:05:49,700 +commonly implicated + +68 +00:05:57,260 --> 00:06:02,500 +دايما اربط ال low .. ال low dk على d في موضوع ايش؟ + +69 +00:06:02,500 --> 00:06:06,740 +ال hypoxia وبعد ذلك انه بيسبب ال corneal edema، + +70 +00:06:06,740 --> 00:06:10,100 +دايما الشخص لما بيصير عنده corneal edema او + +71 +00:06:10,100 --> 00:06:13,740 +hypoxia بيصير عنده ايه؟ reduce لل corneal + +72 +00:06:13,740 --> 00:06:19,720 +sensitivity okay؟ بالنسبة لل RGB lensesالشخص اللى + +73 +00:06:19,720 --> 00:06:23,720 +برتد العدسة اللاصقة الصلبة احنا بنعرف انها مصنوعة + +74 +00:06:23,720 --> 00:06:28,580 +من مادة ال MMA بوليميثايل ميثي اكريليت بتتميز هذه + +75 +00:06:28,580 --> 00:06:33,640 +المادة انه بتعمل hard interaction مع الكورنيا + +76 +00:06:33,640 --> 00:06:39,220 +فبتقلل من ايه؟ من حساسية القرانية واضحة الفكرة؟ + +77 +00:06:39,800 --> 00:06:45,620 +إذاً why كورنيا الهايبو طبعاً هيبو أستيزيا is + +78 +00:06:45,620 --> 00:06:50,440 +common with RGB contact lenses السبب إنه هي مصنوعة + +79 +00:06:50,440 --> 00:06:54,740 +من مادة الـ polymethyl methacrylate وتعتبر هذه + +80 +00:06:54,740 --> 00:06:59,620 +المادة hard وبالتالي إنه بتعمل ايه؟ اللي هو تصادم + +81 +00:06:59,620 --> 00:07:04,640 +hard يعني اللي هو irritation hard irritation مع + +82 +00:07:04,640 --> 00:07:08,580 +مين؟ مع الكورنيا وبالتالي بتأدي إلى قلة مين؟ + +83 +00:07:08,810 --> 00:07:15,590 +الحساسية للقرانية affected + +84 +00:07:15,590 --> 00:07:20,710 +patients are naturally asymptomatic دايما المريض + +85 +00:07:20,710 --> 00:07:26,010 +ما بيشعر ان هو في عنده قلة او زيادة في اللي هو + +86 +00:07:26,010 --> 00:07:29,830 +حساسية القرانية يعني بدون اعراض او بدون شكوى من + +87 +00:07:29,830 --> 00:07:36,020 +مين من المريضSo corneal hypoesthesia is an + +88 +00:07:36,020 --> 00:07:40,960 +uncommon indication for lens refitting.معنى الكلام + +89 +00:07:40,960 --> 00:07:44,440 +ان المريض عندما يكون عنده قلة في حساسية القرنية + +90 +00:07:44,440 --> 00:07:51,320 +يجعل المركز يريد refitting او ريجولار تشك للعدسة + +91 +00:07:51,320 --> 00:07:57,880 +مش هيكون متعرف على هذا الأمر طب + +92 +00:07:57,880 --> 00:08:01,660 +الآن ال corneal hypoesthesia كيف انا ممكن اعرفها؟ + +93 +00:08:02,450 --> 00:08:06,750 +إن المريض عنده إما من خلال الجهاز زي ما اتفقنا أو + +94 +00:08:06,750 --> 00:08:10,490 +من خلال .. يمكن طبقناها في المعمل إنه دايما قبل ما + +95 +00:08:10,490 --> 00:08:14,570 +ألبسه العدسة أعمل ب .. اللي هو ال tissue أو بالقطن + +96 +00:08:14,570 --> 00:08:20,070 +من اللي هو أطراف القرانيةالان بالنسبة لـ + +97 +00:08:20,070 --> 00:08:24,710 +Management قلية العلاج لمين؟ لـ Corneal Exhasion + +98 +00:08:24,710 --> 00:08:28,410 +أو الـ Stoma القديمة أو الـ Stomal Stray بمعنى + +99 +00:08:28,410 --> 00:08:32,550 +اللي هو جميع العلمات اللي بتظهر بعد ارتداء العدسة + +100 +00:08:32,550 --> 00:08:38,830 +اللاصقة عندنا الـ Polymegathism و Corneal Exhasion + +101 +00:08:38,830 --> 00:08:43,750 +Syndrome و Corneal Hypoesthesia ده سؤال سؤال مين + +102 +00:08:43,750 --> 00:08:46,830 +اختارهم؟ + +103 +00:08:46,830 --> 00:08:48,350 +فضلك + +104 +00:08:50,240 --> 00:08:58,860 +ليش طيب؟ another answer + +105 +00:09:00,890 --> 00:09:05,550 +مين يعتبر ال more dangerous؟ او عنده لازم المريض + +106 +00:09:05,550 --> 00:09:09,450 +يتوقف عن ارتداء العدسة اللاصقة؟ كلامك صحيح هو ال + +107 +00:09:09,450 --> 00:09:13,670 +corneal exohation syndrome احنا قلنا ان ال corneal + +108 +00:09:13,670 --> 00:09:17,570 +exohation syndrome بيكون مصاحب لمين؟ لل + +109 +00:09:17,570 --> 00:09:22,450 +polymegathism يعني هناك بيحدث تغير في حجم الخلايا + +110 +00:09:22,450 --> 00:09:26,200 +بتاعة ال endotheliumالـ corneal hypoesthesia + +111 +00:09:26,200 --> 00:09:30,520 +المريض أصلا مش هييجي على ال .. ال clinic أو على + +112 +00:09:30,520 --> 00:09:35,920 +المشفى أنه يشكي لأنه هو يعتبر asymptomaticهان + +113 +00:09:35,920 --> 00:09:39,260 +أيضًا الـ Corneal Exhaustion Syndrome بعمل حاجة + +114 +00:09:39,260 --> 00:09:43,240 +بسميها Scattering للفلورسين يعني الآن لو أنا + +115 +00:09:43,240 --> 00:09:46,500 +عملتله مثلًا Corneal Fluorosin Staining، هتلاقي + +116 +00:09:46,500 --> 00:09:51,360 +على كل القرنية فيه إيه؟ Fluorosin Staining، بختلف + +117 +00:09:51,360 --> 00:09:55,600 +عن Superfacial Panictate Keratitis أو Superior + +118 +00:09:55,600 --> 00:09:58,960 +Arcuate Staining اللي شفناها النقاط بتكون في جزء + +119 +00:09:58,960 --> 00:10:04,260 +محدد إما بالـ Center أو بالأطراففعنا أختارهم هو + +120 +00:10:04,260 --> 00:10:09,020 +يعتبر الـ Corneal Exhaustion Syndrome is an + +121 +00:10:09,020 --> 00:10:13,840 +indication of the need to refit with a lens of + +122 +00:10:13,840 --> 00:10:18,360 +moderate to high Dk على T دايما أنا بستبدل ال + +123 +00:10:18,360 --> 00:10:22,780 +material بتاعة العدسة ب moderate Dk على T بتقدر من + +124 +00:10:22,780 --> 00:10:28,740 +55 ل 58% الآن معظم العدسات الموجودة في السوق + +125 +00:10:28,740 --> 00:10:34,490 +بتلاقوا ال H2Oمن خمسة و خمسين لتمانية و خمسين في + +126 +00:10:34,490 --> 00:10:42,350 +المية وهذا يعتبر moderate DK + +127 +00:10:42,350 --> 00:10:47,850 +على T عشان احافظ على عمر العدسة و في نفس الوجد انه + +128 +00:10:47,850 --> 00:10:57,830 +ايه انه احافظ على عدم الكورنية القديمة اي + +129 +00:10:57,830 --> 00:10:59,270 +سؤال في الموضوع هذا + +130 +00:11:03,170 --> 00:11:07,730 +أيضًا بده يعمل SEAS أي بمعنى اللي هو التوقف عن ال + +131 +00:11:07,730 --> 00:11:11,770 +extended wear ان المريض مايرتدي العدسة ال extended + +132 +00:11:11,770 --> 00:11:15,750 +wear ليش؟ ببساطة لأنه بيكون فيها ال DK على T very + +133 +00:11:15,750 --> 00:11:20,570 +high فبالتالي هتعمل corneal edema هتعمل hypoxia + +134 +00:11:20,570 --> 00:11:23,970 +وممكن تعمل ال corneal exhalation syndrome + +135 +00:11:28,940 --> 00:11:33,480 +طيب في عندنا موضوع ال hyperemia and + +136 +00:11:33,480 --> 00:11:38,540 +vascularization ايش الفرق ما بين ال hyperemia و ال + +137 +00:11:38,540 --> 00:11:42,440 +vascularization؟ + +138 +00:11:42,440 --> 00:11:47,640 +ال hyperemia دايما ان الاوعية الدموية اللى موجودة + +139 +00:11:47,640 --> 00:11:52,520 +بصير فيها عملية ايش احتقان وبالتالي بصير هناك + +140 +00:11:52,520 --> 00:11:55,580 +dilatation لل blood vessels يعني نفس الاوعية + +141 +00:11:55,580 --> 00:11:59,580 +الدموية اللى موجودة عند الشخصفاكرين اما اشتغلنا + +142 +00:11:59,580 --> 00:12:02,380 +على ال conjunctival redness وشوفنا القوية الدموية + +143 +00:12:02,380 --> 00:12:05,900 +في ال peripheral و ال nasal و ال up و ال down هذه + +144 +00:12:05,900 --> 00:12:09,460 +نفسها بيصير عملية احتقال يعني بتصل ل moderate او + +145 +00:12:09,460 --> 00:12:15,120 +severe لكن هل هي انضاف لها a new blood vessels؟ لأ + +146 +00:12:15,120 --> 00:12:20,180 +فقط انه صار لها عملية conjunction وبعد ذلك اللي هو + +147 +00:12:20,180 --> 00:12:25,860 +صار عملية dilatationبالنسبة لل Vascularization انه + +148 +00:12:25,860 --> 00:12:30,620 +new blood vessels اوعية دموية جديدة بتتميز انه هذه + +149 +00:12:30,620 --> 00:12:35,540 +الاوعية الدموية هشة فصارلها يعني بمعنى اللي هو + +150 +00:12:35,540 --> 00:12:40,660 +عملية تراكم او تكوين بسبب ارتداء العدسات اللاصقة + +151 +00:12:40,660 --> 00:12:47,260 +وممكن انه في عملية ال Vascularization انه تنكسر + +152 +00:12:47,260 --> 00:12:49,300 +بسهولة واضح الفكرة + +153 +00:12:51,880 --> 00:12:55,860 +فعندنا هان the normal limbus احنا عارفين ان ال + +154 +00:12:55,860 --> 00:13:00,000 +diameter بتاع ال soft contact lens larger than the + +155 +00:13:00,000 --> 00:13:04,780 +cornea بيصل لوين ل ال para limbal يعني بمعنى انه + +156 +00:13:04,780 --> 00:13:08,420 +semi-scleral design تقريبا ال diameter بتراوح ما + +157 +00:13:08,420 --> 00:13:14,220 +بين تلتاش و نص لخمساش مليمترفبغطي كل اللي هو مين + +158 +00:13:14,220 --> 00:13:19,580 +ال limbus طبعا ال limbus تعتبر منطقة translational + +159 +00:13:19,580 --> 00:13:24,940 +اللي هو zone بمعنى منطقة شبه شفافة بتربط ما بين + +160 +00:13:24,940 --> 00:13:30,680 +مين ال cornea و اللي هو ال sclera يعني هذه المنطقة + +161 +00:13:30,680 --> 00:13:35,360 +بتتميز أنه فيها بعض من ال blood vessels صح ولا لأ؟ + +162 +00:13:35,360 --> 00:13:38,560 +مش زي مثلا ال cornea أنه هي transparent أو + +163 +00:13:38,560 --> 00:13:44,400 +completely transparentفعنا the normal limbus a + +164 +00:13:44,400 --> 00:13:50,520 +vascular transition zone يعني بمعنى أنه شبه شفافة + +165 +00:13:50,520 --> 00:13:58,700 +المنطقة هذه وبتكون وعائيةcontaining blood vessels + +166 +00:13:58,700 --> 00:14:04,820 +هتحتوي على أوعى دموية whereas the cornea itself is + +167 +00:14:04,820 --> 00:14:09,520 +vascular بينما القرنية هتكون غير وعائية أو هتكون + +168 +00:14:09,520 --> 00:14:15,400 +completely transparent it is approximately one + +169 +00:14:15,400 --> 00:14:20,040 +millimeter in width عرض ال limbus تقريبا بيقدر + +170 +00:14:20,040 --> 00:14:21,740 +واحد ملي متر + +171 +00:14:24,860 --> 00:14:28,700 +wider in the vertical meridian particularly + +172 +00:14:28,700 --> 00:14:34,060 +superiorly دايما المنطقة اللي بتكون اللي هي أعرب + +173 +00:14:34,060 --> 00:14:38,960 +وين في ال superior و بتكون شكلها اللي هو vertical + +174 +00:14:38,960 --> 00:14:45,100 +طيب + +175 +00:14:45,100 --> 00:14:50,600 +الآن إيش خطورة ال hyperemia؟ ال hyperemia إيش + +176 +00:14:50,600 --> 00:14:56,650 +خطورتها؟احنا عارفين ان ال diameter بتاع العدسة + +177 +00:14:56,650 --> 00:15:01,270 +اللاصقة هيكون Paralimbal صحيح فالان كل الأوعي + +178 +00:15:01,270 --> 00:15:06,890 +الدموية في الطبيعي هتعملها irritation تهيج طيب اذا + +179 +00:15:06,890 --> 00:15:10,430 +وصلنا لمرحلة ال moderate او ال severe لهذا التهيج + +180 +00:15:10,430 --> 00:15:14,610 +ممكن بعد ذلك انه هيعمل ليه complication للمريض + +181 +00:15:14,610 --> 00:15:18,550 +وبالتالي انه لازم انا اوقف عن ارتداء العدسة + +182 +00:15:18,550 --> 00:15:25,770 +اللاصقة طيب هلالـ Hyperemia تعتبر شائعة في الـ RGB + +183 +00:15:25,770 --> 00:15:33,170 +Contact Lenses، ليش طيب؟ بالضبط، إذا هي ليست شائعة + +184 +00:15:33,170 --> 00:15:36,970 +وين في الـ RGB Contact Lenses، ببساطة لأن الـ + +185 +00:15:36,970 --> 00:15:40,610 +Diameter بتاعها مش هيصل لمين للـ Paralimbal Area + +186 +00:15:40,610 --> 00:15:44,310 +وبالتالي مش هتعمل Irritation لمين للـ Blood + +187 +00:15:44,310 --> 00:15:52,180 +vessels ومش هيتبعها اللي هو إيهالسؤال هو لماذا + +188 +00:15:52,180 --> 00:15:56,580 +الهيباريميا ليست متوفرة أو غير معروفة مع الوصفات + +189 +00:15:56,580 --> 00:16:02,740 +الرقمية بسبب صغر الديامتر مقارنة في الوصفات + +190 +00:16:02,740 --> 00:16:06,860 +الهيباريميا لمبل + +191 +00:16:06,860 --> 00:16:13,710 +هيباريميا is a dilatationof existing limbal + +192 +00:16:13,710 --> 00:16:18,890 +capillaries limbal hyperemia is a dilatation of + +193 +00:16:18,890 --> 00:16:23,090 +existing limbal capillaries عبارة عن توسيع + +194 +00:16:23,090 --> 00:16:29,250 +للشعيرات الدموية في منطقة البارا limbal طيب الآن + +195 +00:16:29,250 --> 00:16:33,310 +ال limbal hyperemia أكتر شيوعا في ال minus ولا ال + +196 +00:16:33,310 --> 00:16:37,950 +plus power lenses؟ ليش طيب في ال plus؟ + +197 +00:16:45,260 --> 00:16:50,020 +هي بتكون اكتر شيوعا في مين؟ في ال minus lenses لان + +198 +00:16:50,020 --> 00:16:53,860 +ال minus ال thickness بيكون ايه؟ اكتر من ال center + +199 +00:16:53,860 --> 00:16:57,340 +يعني في ال peripheral بيكون اكتر من مين من ال + +200 +00:16:57,340 --> 00:17:02,550 +centerفالان why hyperemia is more common with + +201 +00:17:02,550 --> 00:17:06,390 +minus lenses ببساطة لأن السماكة في الأطراف بتكون + +202 +00:17:06,390 --> 00:17:10,490 +أكتر من ال center فبالتالي انه بتعمل كورنية + +203 +00:17:10,490 --> 00:17:15,190 +القديمة وبعد ذلك انه بتعمل ايه؟ reduce the oxygen + +204 +00:17:15,190 --> 00:17:19,510 +enter to the cornea وممكن انه تعمل ايه؟ Hypoxia + +205 +00:17:19,510 --> 00:17:26,130 +واضحة؟is a common icronic bilateral complication + +206 +00:17:26,130 --> 00:17:30,530 +of hydrogel contact lens wear وهنضيف كلمة + +207 +00:17:30,530 --> 00:17:34,710 +conventional contact lens wear يعني هي شائعة مع + +208 +00:17:34,710 --> 00:17:39,950 +ارتداء العدسات اللبس اليومي التقليدي بشكل ايه؟ + +209 +00:17:44,680 --> 00:17:49,520 +Patients are usually asymptomatic، دايما المريض لا + +210 +00:17:49,520 --> 00:17:57,020 +يعاني من أي وجود لألم أو أي تأعراض Causes + +211 +00:17:57,020 --> 00:18:01,420 +أسبابها، والدليل على ذلك أن بعض الطالبات شفنا + +212 +00:18:01,420 --> 00:18:04,380 +عندهم moderate في ال conjunctival redness، + +213 +00:18:04,380 --> 00:18:07,420 +moderate لمين؟ لال blood vessels من ناحية ال + +214 +00:18:07,420 --> 00:18:11,980 +irritation وهي غير شعرة في أي علامة من هذه + +215 +00:18:11,980 --> 00:18:18,870 +العلاماتالسبب هو الهيدروجيل + +216 +00:18:18,870 --> 00:18:19,110 +السليماني السليماني السليماني السليماني السليماني + +217 +00:18:19,110 --> 00:18:21,470 +السليماني السليماني السليماني السليماني السليماني + +218 +00:18:21,470 --> 00:18:24,890 +السليماني السليماني السليماني السليماني السليماني + +219 +00:18:24,890 --> 00:18:28,210 +السليماني السليماني السليماني السليماني السليماني + +220 +00:18:28,210 --> 00:18:28,790 +السليماني السليماني السليماني السليماني السليماني + +221 +00:18:28,790 --> 00:18:28,990 +السليماني السليماني السليماني السليماني السليماني + +222 +00:18:28,990 --> 00:18:31,090 +السليماني السليماني السليماني السليماني السليماني + +223 +00:18:31,090 --> 00:18:32,970 +السليماني السليماني السليمان + +224 +00:18:37,340 --> 00:18:41,600 +Mid water hydrogen lenses with a thick periphery + +225 +00:18:41,600 --> 00:18:46,280 +دايما بنختار mid water content من خمسة و خمسين ل + +226 +00:18:46,280 --> 00:18:50,800 +تمانية و خمسين في المية مع العدسات اللي بتكون ايه + +227 +00:18:50,800 --> 00:18:54,940 +ال more thick وين في الأطراف يعني ال minus lenses + +228 +00:18:54,940 --> 00:19:00,920 +مقارنة بالcenter long + +229 +00:19:00,920 --> 00:19:06,540 +wearing times or overnight wearبعض المرضى بيجوا + +230 +00:19:06,540 --> 00:19:10,900 +على المركز او على المستشفى بقولك انا بلبس العدسة + +231 +00:19:10,900 --> 00:19:14,960 +اللاصقة دون ما اشعر بأي تتعب و دون ما اشعر بأي + +232 +00:19:14,960 --> 00:19:18,840 +تغيير في النظر لكن ايش هذي ممكن تعمل؟ Limbal + +233 +00:19:18,840 --> 00:19:23,280 +hyperemia ساعات اللبس الطويلة الأكتر من اتناشر + +234 +00:19:23,280 --> 00:19:27,980 +ساعة ممكن تؤدي لذلك لكن بشكل مستمر يعني continuous + +235 +00:19:27,980 --> 00:19:32,680 +wearing for soft contact lensأو overnight wear + +236 +00:19:32,680 --> 00:19:36,200 +هاذي ايش هتعمل كورنية القديمة؟ طبعا إذا كانت + +237 +00:19:36,200 --> 00:19:41,820 +القيمة من عشرة لعشرين في المية طوال اليوم هذي + +238 +00:19:41,820 --> 00:19:45,980 +تعتبر خطيرة لكن لو أول ما بصحى المريض من النوم + +239 +00:19:45,980 --> 00:19:50,560 +بيكون الأمر طبيعي زي ما اتفقنا في الكورنية القديمة + +240 +00:19:54,680 --> 00:19:59,600 +A tight or immobile hydrogel lens يعني كانت العدسة + +241 +00:19:59,600 --> 00:20:05,720 +tight وما أخد كل شكل القرنية بمعنى ان فيها large + +242 +00:20:05,720 --> 00:20:10,640 +diameter مافيش اي حركة للعدسة هذا ممكن يعمل limbal + +243 +00:20:10,640 --> 00:20:15,300 +hyperemia طيب في الحالة هذه ال a tight or immobile + +244 +00:20:15,300 --> 00:20:20,410 +hydrogel lens ايش الحل؟أما بجيب small diameter + +245 +00:20:20,410 --> 00:20:25,950 +أصغر من اللي عندى أو بجيب اللي هو ايه، flat base + +246 +00:20:25,950 --> 00:20:31,710 +layer، يعني واحدة من الحالين Limbal hyperemia, + +247 +00:20:32,270 --> 00:20:36,670 +fluorescein staining and the presence of microzest + +248 +00:20:36,670 --> 00:20:40,770 +have been found to be the best biomicroscopic + +249 +00:20:40,770 --> 00:20:45,490 +indicators of corneal hypoxia in hydrogel extended + +250 +00:20:45,490 --> 00:20:50,380 +wheelلو جبتلك سؤال كيف بدك تعملي مقارنة ما بين ال + +251 +00:20:50,380 --> 00:20:55,000 +micro zest و ال corneal او ال super facial + +252 +00:20:55,000 --> 00:20:59,700 +panictate keratitis و ال superior arcuate staining + +253 +00:20:59,700 --> 00:21:03,920 +التلاتة هدول طبعا اول واحدة ال superior arcuate لو + +254 +00:21:03,920 --> 00:21:07,480 +يعملنا ال florescein هنلاقيه فقط وين في ال upper + +255 +00:21:07,480 --> 00:21:12,260 +partبالضبط الـ superfacial panictate keratitis في + +256 +00:21:12,260 --> 00:21:16,700 +الغالب هيكون في ال center لكن بالنسبة لالميكروزيست + +257 +00:21:16,700 --> 00:21:21,140 +okay الفقاعات هيكون اللي هو scattering منتشر في كل + +258 +00:21:21,140 --> 00:21:22,620 +سطح القرنية + +259 +00:21:27,140 --> 00:21:31,880 +طبعا ال limbal hyperemia بالشكل هذا ملاحظين انه + +260 +00:21:31,880 --> 00:21:36,380 +فيه هناك irritation ل ال blood vessels و أيضا اللي + +261 +00:21:36,380 --> 00:21:40,720 +هو فيه هناك dilatation ل ال blood vessels و هذا + +262 +00:21:40,720 --> 00:21:45,220 +شفناه في العمل بشكل اللي هو كبير لاحظنا ان بعض من + +263 +00:21:45,220 --> 00:21:48,660 +ال blood vessels لونه مختلف عن مين ال blood + +264 +00:21:48,660 --> 00:21:52,680 +vessels الآخرين تلاقي اللي هو dark بشكل اللي هو + +265 +00:21:52,680 --> 00:21:53,980 +red كبير + +266 +00:21:56,570 --> 00:22:00,750 +طب المريض لو كان عنده mild أو كان عنده مثلا a + +267 +00:22:00,750 --> 00:22:05,330 +trace، لمبة الhyperemia، هل بنوقفه عن ارتداء + +268 +00:22:05,330 --> 00:22:10,410 +العدسة؟ لأ، يعني this is normalوفي بعض الحالات + +269 +00:22:10,410 --> 00:22:14,530 +يعني مثلا زي الناس اللي بيكون يعني smokers مدخنين + +270 +00:22:14,530 --> 00:22:19,050 +هدول الأشخاص دايما إيش بيكون عندهم irritation أو + +271 +00:22:19,050 --> 00:22:23,210 +في عندهم limbal hyperemia فمختلف في عملية التقييم + +272 +00:22:23,210 --> 00:22:27,670 +عن مين عن ال normal أو ال normal human subjects في + +273 +00:22:27,670 --> 00:22:30,790 +عملية ال evaluation بتوقف ان شاء الله ل super + +274 +00:22:30,790 --> 00:22:35,070 +facial vascularization و المحاضرة القادمة ان شاء + +275 +00:22:35,070 --> 00:22:35,610 +الله بنكمل + diff --git 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"probability": 0.970703125}], "temperature": 1.0}, {"id": 19, "seek": 45135, "start": 428.81, "end": 451.35, "text": "الحساسية للقرانية affected patients are naturally asymptomatic دايما المريض ما بيشعر ان هو في عنده قلة او زيادة في اللي هو حساسية القرانية يعني بدون اعراض او بدون شكوى من مين من المريض", "tokens": [6027, 5016, 3794, 32277, 10632, 24976, 4587, 2288, 7649, 10632, 8028, 4209, 366, 8195, 35114, 13143, 11778, 47302, 15042, 9673, 16572, 11242, 19446, 4724, 1829, 8592, 3615, 2288, 16472, 31439, 8978, 43242, 3224, 12174, 37977, 1975, 2407, 30767, 1829, 18513, 3660, 8978, 13672, 1829, 31439, 11331, 3794, 32277, 10632, 25062, 2288, 7649, 10632, 37495, 22653, 47525, 11536, 1975, 3615, 2288, 46958, 1975, 2407, 47525, 11536, 13412, 4117, 2407, 7578, 9154, 3714, 9957, 9154, 9673, 16572, 11242], "avg_logprob": -0.13991477582361792, "compression_ratio": 1.5913978494623655, "no_speech_prob": 1.7881393432617188e-07, "words": [{"start": 428.81, "end": 430.11, "word": "الحساسية", 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الحل؟", "probability": 0.9187825520833334}], "temperature": 1.0}, {"id": 51, "seek": 124577, "start": 1218.15, "end": 1245.77, "text": "أما بجيب small diameter أصغر من اللي عندى أو بجيب اللي هو ايه، flat base layer، يعني واحدة من الحالين Limbal hyperemia, fluorescein staining and the presence of microzest have been found to be the best biomicroscopic indicators of corneal hypoxia in hydrogel extended wheel", "tokens": [10721, 15042, 4724, 7435, 1829, 3555, 1359, 14196, 5551, 9381, 17082, 2288, 9154, 13672, 1829, 43242, 7578, 34051, 4724, 7435, 1829, 3555, 13672, 1829, 31439, 1975, 1829, 3224, 12399, 4962, 3096, 4583, 12399, 37495, 22653, 36764, 24401, 3660, 9154, 21542, 6027, 9957, 16406, 2645, 9848, 14058, 11, 32471, 384, 259, 342, 3686, 293, 264, 6814, 295, 4532, 89, 377, 362, 668, 1352, 281, 312, 264, 1151, 27450, 299, 38006, 299, 22176, 295, 1181, 716, 304, 2477, 42871, 654, 294, 5796, 6675, 338, 10913, 5589], "avg_logprob": -0.24999998878030216, "compression_ratio": 1.4, 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corneal او ال super facial panictate keratitis و ال superior arcuate staining التلاتة هدول طبعا اول واحدة ال superior arcuate لو يعملنا ال florescein هنلاقيه فقط وين في ال upper part", "tokens": [1211, 2407, 10874, 3555, 2655, 23275, 8608, 33604, 6027, 9122, 33911, 47525, 4117, 6055, 25957, 20292, 3714, 4587, 9640, 1863, 3660, 19446, 49374, 2423, 4532, 37889, 4032, 2423, 1181, 716, 304, 1975, 2407, 2423, 1687, 15642, 2462, 985, 473, 19377, 267, 16074, 4032, 2423, 13028, 10346, 10107, 16441, 278, 16712, 1211, 9307, 3660, 8032, 3215, 12610, 23032, 3555, 3615, 995, 1975, 12610, 36764, 24401, 3660, 2423, 13028, 10346, 10107, 45164, 7251, 25957, 1211, 8315, 2423, 932, 2706, 384, 259, 8032, 1863, 15040, 38436, 3224, 6156, 47432, 4032, 9957, 8978, 2423, 6597, 644], "avg_logprob": -0.21253360215053763, "compression_ratio": 1.5596330275229358, "no_speech_prob": 0.0, "words": [{"start": 1246.44, "end": 1246.68, "word": "لو", "probability": 0.85693359375}, {"start": 1246.68, "end": 1247.08, 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ال", "probability": 0.80419921875}, {"start": 1252.64, "end": 1253.4, "word": " corneal", "probability": 0.8595377604166666}, {"start": 1253.4, "end": 1254.02, "word": " او", "probability": 0.812744140625}, {"start": 1254.02, "end": 1254.26, "word": " ال", "probability": 0.76123046875}, {"start": 1254.26, "end": 1254.42, "word": " super", "probability": 0.459228515625}, {"start": 1254.42, "end": 1255.0, "word": " facial", "probability": 0.59716796875}, {"start": 1255.0, "end": 1255.66, "word": " panictate", "probability": 0.5217692057291666}, {"start": 1255.66, "end": 1256.48, "word": " keratitis", "probability": 0.97412109375}, {"start": 1256.48, "end": 1257.2, "word": " و", "probability": 0.94482421875}, {"start": 1257.2, "end": 1257.6, "word": " ال", "probability": 0.75439453125}, {"start": 1257.6, "end": 1258.1, "word": " superior", "probability": 0.98779296875}, {"start": 1258.1, "end": 1258.9, "word": " arcuate", "probability": 0.771240234375}, {"start": 1258.9, "end": 1259.7, 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1265.62, "word": " florescein", "probability": 0.5360107421875}, {"start": 1265.62, "end": 1266.36, "word": " هنلاقيه", "probability": 0.8234375}, {"start": 1266.36, "end": 1266.7, "word": " فقط", "probability": 0.96826171875}, {"start": 1266.7, "end": 1266.98, "word": " وين", "probability": 0.8759765625}, {"start": 1266.98, "end": 1267.14, "word": " في", "probability": 0.64404296875}, {"start": 1267.14, "end": 1267.26, "word": " ال", "probability": 0.93896484375}, {"start": 1267.26, "end": 1267.48, "word": " upper", "probability": 0.89306640625}, {"start": 1267.48, "end": 1267.94, "word": " part", "probability": 0.95263671875}], "temperature": 1.0}, {"id": 53, "seek": 128261, "start": 1268.76, "end": 1282.62, "text": "بالضبط الـ superfacial panictate keratitis في الغالب هيكون في ال center لكن بالنسبة لالميكروزيست okay الفقاعات هيكون اللي هو scattering منتشر في كل سطح القرنية", "tokens": [3555, 6027, 11242, 3555, 9566, 2423, 39184, 1687, 69, 25980, 2462, 985, 473, 19377, 267, 16074, 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القادمة", "probability": 0.994140625}, {"start": 1354.65, "end": 1354.93, "word": " ان", "probability": 0.900390625}, {"start": 1354.93, "end": 1355.07, "word": " شاء", "probability": 0.99560546875}, {"start": 1355.07, "end": 1355.13, "word": " الله", "probability": 0.96533203125}, {"start": 1355.13, "end": 1355.61, "word": " بنكمل", "probability": 0.9666341145833334}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 1355.92925, "duration_after_vad": 1245.0768749999986} \ No newline at end of file diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/Z5IJhIdypwo_raw.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/Z5IJhIdypwo_raw.srt new file mode 100644 index 0000000000000000000000000000000000000000..5a8aaf27b4d47b4fb47fb6065ecec9dba36e8991 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/Z5IJhIdypwo_raw.srt @@ -0,0 +1,1104 @@ +1 +00:00:21,480 --> 00:00:24,260 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:24,260 --> 00:00:27,620 +وبركاته and a very good morning to all of you + +3 +00:00:27,620 --> 00:00:32,980 +هنبدأ اليوم في موضوع corneal exhalation syndrome + +4 +00:00:32,980 --> 00:00:36,080 +أي بمعنى انهاج لالقرانية + +5 +00:00:38,020 --> 00:00:43,340 +طبعا الشكل exohation syndrome بيكون شكل القرنية + +6 +00:00:43,340 --> 00:00:48,940 +عند إجراء مثلا ال corneal fluorescein staining أو + +7 +00:00:48,940 --> 00:00:53,760 +إجراء ال corneal topography بالشكل هذا قريب ل ال + +8 +00:00:53,760 --> 00:00:58,500 +.. ال symmetric bow tie أو ال regular astigmatism + +9 +00:01:00,510 --> 00:01:05,290 +condition associated with the presence of marked + +10 +00:01:05,290 --> 00:01:10,210 +endothelial polymegathism، إذا حالة بتكون مصاحبة + +11 +00:01:10,210 --> 00:01:15,570 +للتغير في حجم من؟ ال endothelium cells، يعني إما + +12 +00:01:15,570 --> 00:01:19,530 +بالزيادة أو بنقصان عدد ال endothelium cells + +13 +00:01:22,800 --> 00:01:27,920 +Patients with high refractive errors and extended + +14 +00:01:27,920 --> 00:01:34,680 +wear who have worn lenses for 10 years بعض الأشخاص + +15 +00:01:34,680 --> 00:01:38,460 +اللي بيكون عندهم high refractive error سواء كان + +16 +00:01:38,460 --> 00:01:42,160 +high minus power أو high plus power أو برتدي + +17 +00:01:42,160 --> 00:01:47,020 +العدسات اللاصقة لفترة زمانية طويلة بيكون مهيأ انه + +18 +00:01:47,020 --> 00:01:52,610 +يصاب في ايه؟ في ال corneal exhauation syndromeطبعا + +19 +00:01:52,610 --> 00:01:57,590 +ال high refractive + +20 +00:01:57,590 --> 00:02:06,230 +error خاصة وين في ال high plus والسبب في ذلك انه + +21 +00:02:06,230 --> 00:02:11,430 +بيكون more thickness + +22 +00:02:11,430 --> 00:02:17,750 +where in the center + +23 +00:02:19,540 --> 00:02:24,280 +Okay زي مثلا ال mono vision lenses + +24 +00:02:26,810 --> 00:02:31,550 +طيب أو بعض المرضى اللي بيرتد العدسة اللاصقة لمدة + +25 +00:02:31,550 --> 00:02:36,010 +عشر ساعات متواصلة ولكن هان المقصود بالعشر ساعات + +26 +00:02:36,010 --> 00:02:39,970 +يعني بمعنى ان هو ما بيعمل removal للعدسة بعض + +27 +00:02:39,970 --> 00:02:44,430 +الأشخاص مثلا بيعمل wake up الساعة مثلا سبعة، بلبس + +28 +00:02:44,430 --> 00:02:48,150 +العدسة اللاصقة الساعة تمانية، بروح الجامعة، بروح + +29 +00:02:48,150 --> 00:02:52,730 +مثلا واحدة، بعد ذلك بيعمل removal للعدسةبلبسها + +30 +00:02:52,730 --> 00:02:57,550 +مثلا الساعة ستة لاربع ساعات، يعني لساعة عشرة، يعني + +31 +00:02:57,550 --> 00:03:01,210 +بمعنى ان ال total عشر ساعات ولكن هو ايش بيعمل؟ + +32 +00:03:01,210 --> 00:03:05,450 +removal للعدسة، هنا بختلف عن ايه؟ المثال اللي احنا + +33 +00:03:05,450 --> 00:03:09,810 +بنذكره، هنا ال ten hours بتكون اللي هو بشكل كامل، + +34 +00:03:09,810 --> 00:03:16,100 +يعني طوال اليومother signs علامات أخرى are + +35 +00:03:16,100 --> 00:03:20,840 +intolerance to lens wear and blurred دايما المريض + +36 +00:03:20,840 --> 00:03:24,440 +بعد ما برتد العدسة اللاصقة في الفترة الزمنية هذه + +37 +00:03:24,440 --> 00:03:29,020 +الطويلة بشكي أنه في هناك fluctuating أو في هناك + +38 +00:03:29,020 --> 00:03:32,980 +variation لل vision يعني ممكن مثلا الصبح العدسة + +39 +00:03:32,980 --> 00:03:37,140 +بتكون واضحة في الليل بتكون مغبشة يعني في اختلاف في + +40 +00:03:37,140 --> 00:03:43,060 +الرؤيةdue to fluctuations in refractive error بسبب + +41 +00:03:43,060 --> 00:03:48,800 +اللي هو اختلاف في القوة الانكسارية للعين بعض + +42 +00:03:48,800 --> 00:03:53,680 +الأحيان ممكن بيصير عنده flare أو Blair و هذا ممكن + +43 +00:03:53,680 --> 00:03:55,880 +يؤدي إلى ايه ال blurred vision + +44 +00:04:01,000 --> 00:04:06,620 +corneal hypoesthesia أي بمعنى حساسية من القرنية، + +45 +00:04:06,620 --> 00:04:11,040 +بدأ أشوف اللي هو مدى الـ corneal sensitivity، هل + +46 +00:04:11,040 --> 00:04:14,860 +هي عالية ولا قليلة بالنسبة للكورنية + +47 +00:04:17,480 --> 00:04:21,160 +It's not easy to measure a quantitatively in the + +48 +00:04:21,160 --> 00:04:26,480 +clinical situation دايما مافيش أي جهاز بقيس اللي + +49 +00:04:26,480 --> 00:04:31,800 +هو حساسية ايه حساسية القرانية ك value كقيمة يعني + +50 +00:04:31,800 --> 00:04:36,180 +ما بيقول مثلا قيمة الحساسية لهذه القرانية تلاتة او + +51 +00:04:36,180 --> 00:04:41,300 +اربع او خمسة او ستة هو بياخدها ك qualitative ان هل + +52 +00:04:41,300 --> 00:04:42,440 +هي good ولا bad + +53 +00:04:46,700 --> 00:04:52,300 +One technique is based on using a fine nylon، fine + +54 +00:04:52,300 --> 00:04:56,360 +يعني بمعنى دقيق، nylon threaded of adjustable + +55 +00:04:56,360 --> 00:05:00,300 +length and stimulating a peripheral corneal + +56 +00:05:00,300 --> 00:05:05,040 +location قبل ما أنا بقوم بإجراء اللي هو ارتداء + +57 +00:05:05,040 --> 00:05:09,960 +العدسة اللاصقة، بعمله ال مريض test بسيط سواء كان + +58 +00:05:09,960 --> 00:05:13,800 +اللي هو فيه fine، threaded، nylon، أي بمعنى بيكون + +59 +00:05:13,800 --> 00:05:18,350 +رفيق أو رقيق كتيروبشوف حساسية القرانية وين؟ + +60 +00:05:18,350 --> 00:05:21,910 +بالأطراف، انه هل في اللي هو هناك sensitivity ولا + +61 +00:05:21,910 --> 00:05:25,650 +لا؟ طبعا بعض الأشخاص بيكون عندهم ال sensitivity + +62 +00:05:25,650 --> 00:05:29,250 +very high، إذن هذا يعتبر من ضمن ال contra + +63 +00:05:29,250 --> 00:05:32,590 +indications لمن؟ لل contact lenses، سواء ال soft + +64 +00:05:32,590 --> 00:05:36,550 +أو ال hard، okay؟ بعضهم بيكون low، أيضا هذا يعتبر + +65 +00:05:36,550 --> 00:05:38,950 +contra indications، okay؟ + +66 +00:05:42,160 --> 00:05:47,660 +Low decay over tea hydrogel or RGB lenses are most + +67 +00:05:47,660 --> 00:05:49,700 +commonly implicated + +68 +00:05:57,260 --> 00:06:02,500 +دايما اربط ال low .. ال low dk على d في موضوع ايش؟ + +69 +00:06:02,500 --> 00:06:06,740 +ال hypoxia وبعد ذلك انه بيسبب ال corneal edema، + +70 +00:06:06,740 --> 00:06:10,100 +دايما الشخص لما بيصير عنده corneal edema او + +71 +00:06:10,100 --> 00:06:13,740 +hypoxia بيصير عنده ايه؟ reduce لل corneal + +72 +00:06:13,740 --> 00:06:19,720 +sensitivity okay؟ بالنسبة لل RGB lensesالشخص اللى + +73 +00:06:19,720 --> 00:06:23,720 +برتد العدسة اللاصقة الصلبة احنا بنعرف انها مصنوعة + +74 +00:06:23,720 --> 00:06:28,580 +من مادة ال MMA بوليميثايل ميثي اكريليت بتتميز هذه + +75 +00:06:28,580 --> 00:06:33,640 +المادة انه بتعمل hard interaction مع الكورنيا + +76 +00:06:33,640 --> 00:06:39,220 +فبتقلل من ايه؟ من حساسية القرانية واضحة الفكرة؟ + +77 +00:06:39,800 --> 00:06:45,620 +إذاً why كورنيا الهايبو طبعاً هيبو أستيزيا is + +78 +00:06:45,620 --> 00:06:50,440 +common with RGB contact lenses السبب إنه هي مصنوعة + +79 +00:06:50,440 --> 00:06:54,740 +من مادة الـ polymethyl methacrylate وتعتبر هذه + +80 +00:06:54,740 --> 00:06:59,620 +المادة hard وبالتالي إنه بتعمل ايه؟ اللي هو تصادم + +81 +00:06:59,620 --> 00:07:04,640 +hard يعني اللي هو irritation hard irritation مع + +82 +00:07:04,640 --> 00:07:08,580 +مين؟ مع الكورنيا وبالتالي بتأدي إلى قلة مين؟ + +83 +00:07:08,810 --> 00:07:15,590 +الحساسية للقرانية affected + +84 +00:07:15,590 --> 00:07:20,710 +patients are naturally asymptomatic دايما المريض + +85 +00:07:20,710 --> 00:07:26,010 +ما بيشعر ان هو في عنده قلة او زيادة في اللي هو + +86 +00:07:26,010 --> 00:07:29,830 +حساسية القرانية يعني بدون اعراض او بدون شكوى من + +87 +00:07:29,830 --> 00:07:36,020 +مين من المريضSo corneal hypoesthesia is an + +88 +00:07:36,020 --> 00:07:40,960 +uncommon indication for lens refitting.معنى الكلام + +89 +00:07:40,960 --> 00:07:44,440 +ان المريض عندما يكون عنده قلة في حساسية القرنية + +90 +00:07:44,440 --> 00:07:51,320 +يجعل المركز يريد refitting او ريجولار تشك للعدسة + +91 +00:07:51,320 --> 00:07:57,880 +مش هيكون متعرف على هذا الأمر طب + +92 +00:07:57,880 --> 00:08:01,660 +الآن ال corneal hypoesthesia كيف انا ممكن اعرفها؟ + +93 +00:08:02,450 --> 00:08:06,750 +إن المريض عنده إما من خلال الجهاز زي ما اتفقنا أو + +94 +00:08:06,750 --> 00:08:10,490 +من خلال .. يمكن طبقناها في المعمل إنه دايما قبل ما + +95 +00:08:10,490 --> 00:08:14,570 +ألبسه العدسة أعمل ب .. اللي هو ال tissue أو بالقطن + +96 +00:08:14,570 --> 00:08:20,070 +من اللي هو أطراف القرانيةالان بالنسبة لـ + +97 +00:08:20,070 --> 00:08:24,710 +Management قلية العلاج لمين؟ لـ Corneal Exhasion + +98 +00:08:24,710 --> 00:08:28,410 +أو الـ Stoma القديمة أو الـ Stomal Stray بمعنى + +99 +00:08:28,410 --> 00:08:32,550 +اللي هو جميع العلمات اللي بتظهر بعد ارتداء العدسة + +100 +00:08:32,550 --> 00:08:38,830 +اللاصقة عندنا الـ Polymegathism و Corneal Exhasion + +101 +00:08:38,830 --> 00:08:43,750 +Syndrome و Corneal Hypoesthesia ده سؤال سؤال مين + +102 +00:08:43,750 --> 00:08:46,830 +اختارهم؟ + +103 +00:08:46,830 --> 00:08:48,350 +فضلك + +104 +00:08:50,240 --> 00:08:58,860 +ليش طيب؟ another answer + +105 +00:09:00,890 --> 00:09:05,550 +مين يعتبر ال more dangerous؟ او عنده لازم المريض + +106 +00:09:05,550 --> 00:09:09,450 +يتوقف عن ارتداء العدسة اللاصقة؟ كلامك صحيح هو ال + +107 +00:09:09,450 --> 00:09:13,670 +corneal exohation syndrome احنا قلنا ان ال corneal + +108 +00:09:13,670 --> 00:09:17,570 +exohation syndrome بيكون مصاحب لمين؟ لل + +109 +00:09:17,570 --> 00:09:22,450 +polymegathism يعني هناك بيحدث تغير في حجم الخلايا + +110 +00:09:22,450 --> 00:09:26,200 +بتاعة ال endotheliumالـ corneal hypoesthesia + +111 +00:09:26,200 --> 00:09:30,520 +المريض أصلا مش هييجي على ال .. ال clinic أو على + +112 +00:09:30,520 --> 00:09:35,920 +المشفى أنه يشكي لأنه هو يعتبر asymptomaticهان + +113 +00:09:35,920 --> 00:09:39,260 +أيضًا الـ Corneal Exhaustion Syndrome بعمل حاجة + +114 +00:09:39,260 --> 00:09:43,240 +بسميها Scattering للفلورسين يعني الآن لو أنا + +115 +00:09:43,240 --> 00:09:46,500 +عملتله مثلًا Corneal Fluorosin Staining، هتلاقي + +116 +00:09:46,500 --> 00:09:51,360 +على كل القرنية فيه إيه؟ Fluorosin Staining، بختلف + +117 +00:09:51,360 --> 00:09:55,600 +عن Superfacial Panictate Keratitis أو Superior + +118 +00:09:55,600 --> 00:09:58,960 +Arcuate Staining اللي شفناها النقاط بتكون في جزء + +119 +00:09:58,960 --> 00:10:04,260 +محدد إما بالـ Center أو بالأطراففعنا أختارهم هو + +120 +00:10:04,260 --> 00:10:09,020 +يعتبر الـ Corneal Exhaustion Syndrome is an + +121 +00:10:09,020 --> 00:10:13,840 +indication of the need to refit with a lens of + +122 +00:10:13,840 --> 00:10:18,360 +moderate to high Dk على T دايما أنا بستبدل ال + +123 +00:10:18,360 --> 00:10:22,780 +material بتاعة العدسة ب moderate Dk على T بتقدر من + +124 +00:10:22,780 --> 00:10:28,740 +55 ل 58% الآن معظم العدسات الموجودة في السوق + +125 +00:10:28,740 --> 00:10:34,490 +بتلاقوا ال H2Oمن خمسة و خمسين لتمانية و خمسين في + +126 +00:10:34,490 --> 00:10:42,350 +المية وهذا يعتبر moderate DK + +127 +00:10:42,350 --> 00:10:47,850 +على T عشان احافظ على عمر العدسة و في نفس الوجد انه + +128 +00:10:47,850 --> 00:10:57,830 +ايه انه احافظ على عدم الكورنية القديمة اي + +129 +00:10:57,830 --> 00:10:59,270 +سؤال في الموضوع هذا + +130 +00:11:03,170 --> 00:11:07,730 +أيضًا بده يعمل SEAS أي بمعنى اللي هو التوقف عن ال + +131 +00:11:07,730 --> 00:11:11,770 +extended wear ان المريض مايرتدي العدسة ال extended + +132 +00:11:11,770 --> 00:11:15,750 +wear ليش؟ ببساطة لأنه بيكون فيها ال DK على T very + +133 +00:11:15,750 --> 00:11:20,570 +high فبالتالي هتعمل corneal edema هتعمل hypoxia + +134 +00:11:20,570 --> 00:11:23,970 +وممكن تعمل ال corneal exhalation syndrome + +135 +00:11:28,940 --> 00:11:33,480 +طيب في عندنا موضوع ال hyperemia and + +136 +00:11:33,480 --> 00:11:38,540 +vascularization ايش الفرق ما بين ال hyperemia و ال + +137 +00:11:38,540 --> 00:11:42,440 +vascularization؟ + +138 +00:11:42,440 --> 00:11:47,640 +ال hyperemia دايما ان الاوعية الدموية اللى موجودة + +139 +00:11:47,640 --> 00:11:52,520 +بصير فيها عملية ايش احتقان وبالتالي بصير هناك + +140 +00:11:52,520 --> 00:11:55,580 +dilatation لل blood vessels يعني نفس الاوعية + +141 +00:11:55,580 --> 00:11:59,580 +الدموية اللى موجودة عند الشخصفاكرين اما اشتغلنا + +142 +00:11:59,580 --> 00:12:02,380 +على ال conjunctival redness وشوفنا القوية الدموية + +143 +00:12:02,380 --> 00:12:05,900 +في ال peripheral و ال nasal و ال up و ال down هذه + +144 +00:12:05,900 --> 00:12:09,460 +نفسها بيصير عملية احتقال يعني بتصل ل moderate او + +145 +00:12:09,460 --> 00:12:15,120 +severe لكن هل هي انضاف لها a new blood vessels؟ لأ + +146 +00:12:15,120 --> 00:12:20,180 +فقط انه صار لها عملية conjunction وبعد ذلك اللي هو + +147 +00:12:20,180 --> 00:12:25,860 +صار عملية dilatationبالنسبة لل Vascularization انه + +148 +00:12:25,860 --> 00:12:30,620 +new blood vessels اوعية دموية جديدة بتتميز انه هذه + +149 +00:12:30,620 --> 00:12:35,540 +الاوعية الدموية هشة فصارلها يعني بمعنى اللي هو + +150 +00:12:35,540 --> 00:12:40,660 +عملية تراكم او تكوين بسبب ارتداء العدسات اللاصقة + +151 +00:12:40,660 --> 00:12:47,260 +وممكن انه في عملية ال Vascularization انه تنكسر + +152 +00:12:47,260 --> 00:12:49,300 +بسهولة واضح الفكرة + +153 +00:12:51,880 --> 00:12:55,860 +فعندنا هان the normal limbus احنا عارفين ان ال + +154 +00:12:55,860 --> 00:13:00,000 +diameter بتاع ال soft contact lens larger than the + +155 +00:13:00,000 --> 00:13:04,780 +cornea بيصل لوين ل ال para limbal يعني بمعنى انه + +156 +00:13:04,780 --> 00:13:08,420 +semi-scleral design تقريبا ال diameter بتراوح ما + +157 +00:13:08,420 --> 00:13:14,220 +بين تلتاش و نص لخمساش مليمترفبغطي كل اللي هو مين + +158 +00:13:14,220 --> 00:13:19,580 +ال limbus طبعا ال limbus تعتبر منطقة translational + +159 +00:13:19,580 --> 00:13:24,940 +اللي هو zone بمعنى منطقة شبه شفافة بتربط ما بين + +160 +00:13:24,940 --> 00:13:30,680 +مين ال cornea و اللي هو ال sclera يعني هذه المنطقة + +161 +00:13:30,680 --> 00:13:35,360 +بتتميز أنه فيها بعض من ال blood vessels صح ولا لأ؟ + +162 +00:13:35,360 --> 00:13:38,560 +مش زي مثلا ال cornea أنه هي transparent أو + +163 +00:13:38,560 --> 00:13:44,400 +completely transparentفعنا the normal limbus a + +164 +00:13:44,400 --> 00:13:50,520 +vascular transition zone يعني بمعنى أنه شبه شفافة + +165 +00:13:50,520 --> 00:13:58,700 +المنطقة هذه وبتكون وعائيةcontaining blood vessels + +166 +00:13:58,700 --> 00:14:04,820 +هتحتوي على أوعى دموية whereas the cornea itself is + +167 +00:14:04,820 --> 00:14:09,520 +vascular بينما القرنية هتكون غير وعائية أو هتكون + +168 +00:14:09,520 --> 00:14:15,400 +completely transparent it is approximately one + +169 +00:14:15,400 --> 00:14:20,040 +millimeter in width عرض ال limbus تقريبا بيقدر + +170 +00:14:20,040 --> 00:14:21,740 +واحد ملي متر + +171 +00:14:24,860 --> 00:14:28,700 +wider in the vertical meridian particularly + +172 +00:14:28,700 --> 00:14:34,060 +superiorly دايما المنطقة اللي بتكون اللي هي أعرب + +173 +00:14:34,060 --> 00:14:38,960 +وين في ال superior و بتكون شكلها اللي هو vertical + +174 +00:14:38,960 --> 00:14:45,100 +طيب + +175 +00:14:45,100 --> 00:14:50,600 +الآن إيش خطورة ال hyperemia؟ ال hyperemia إيش + +176 +00:14:50,600 --> 00:14:56,650 +خطورتها؟احنا عارفين ان ال diameter بتاع العدسة + +177 +00:14:56,650 --> 00:15:01,270 +اللاصقة هيكون Paralimbal صحيح فالان كل الأوعي + +178 +00:15:01,270 --> 00:15:06,890 +الدموية في الطبيعي هتعملها irritation تهيج طيب اذا + +179 +00:15:06,890 --> 00:15:10,430 +وصلنا لمرحلة ال moderate او ال severe لهذا التهيج + +180 +00:15:10,430 --> 00:15:14,610 +ممكن بعد ذلك انه هيعمل ليه complication للمريض + +181 +00:15:14,610 --> 00:15:18,550 +وبالتالي انه لازم انا اوقف عن ارتداء العدسة + +182 +00:15:18,550 --> 00:15:25,770 +اللاصقة طيب هلالـ Hyperemia تعتبر شائعة في الـ RGB + +183 +00:15:25,770 --> 00:15:33,170 +Contact Lenses، ليش طيب؟ بالضبط، إذا هي ليست شائعة + +184 +00:15:33,170 --> 00:15:36,970 +وين في الـ RGB Contact Lenses، ببساطة لأن الـ + +185 +00:15:36,970 --> 00:15:40,610 +Diameter بتاعها مش هيصل لمين للـ Paralimbal Area + +186 +00:15:40,610 --> 00:15:44,310 +وبالتالي مش هتعمل Irritation لمين للـ Blood + +187 +00:15:44,310 --> 00:15:52,180 +vessels ومش هيتبعها اللي هو إيهالسؤال هو لماذا + +188 +00:15:52,180 --> 00:15:56,580 +الهيباريميا ليست متوفرة أو غير معروفة مع الوصفات + +189 +00:15:56,580 --> 00:16:02,740 +الرقمية بسبب صغر الديامتر مقارنة في الوصفات + +190 +00:16:02,740 --> 00:16:06,860 +الهيباريميا لمبل + +191 +00:16:06,860 --> 00:16:13,710 +هيباريميا is a dilatationof existing limbal + +192 +00:16:13,710 --> 00:16:18,890 +capillaries limbal hyperemia is a dilatation of + +193 +00:16:18,890 --> 00:16:23,090 +existing limbal capillaries عبارة عن توسيع + +194 +00:16:23,090 --> 00:16:29,250 +للشعيرات الدموية في منطقة البارا limbal طيب الآن + +195 +00:16:29,250 --> 00:16:33,310 +ال limbal hyperemia أكتر شيوعا في ال minus ولا ال + +196 +00:16:33,310 --> 00:16:37,950 +plus power lenses؟ ليش طيب في ال plus؟ + +197 +00:16:45,260 --> 00:16:50,020 +هي بتكون اكتر شيوعا في مين؟ في ال minus lenses لان + +198 +00:16:50,020 --> 00:16:53,860 +ال minus ال thickness بيكون ايه؟ اكتر من ال center + +199 +00:16:53,860 --> 00:16:57,340 +يعني في ال peripheral بيكون اكتر من مين من ال + +200 +00:16:57,340 --> 00:17:02,550 +centerفالان why hyperemia is more common with + +201 +00:17:02,550 --> 00:17:06,390 +minus lenses ببساطة لأن السماكة في الأطراف بتكون + +202 +00:17:06,390 --> 00:17:10,490 +أكتر من ال center فبالتالي انه بتعمل كورنية + +203 +00:17:10,490 --> 00:17:15,190 +القديمة وبعد ذلك انه بتعمل ايه؟ reduce the oxygen + +204 +00:17:15,190 --> 00:17:19,510 +enter to the cornea وممكن انه تعمل ايه؟ Hypoxia + +205 +00:17:19,510 --> 00:17:26,130 +واضحة؟is a common icronic bilateral complication + +206 +00:17:26,130 --> 00:17:30,530 +of hydrogel contact lens wear وهنضيف كلمة + +207 +00:17:30,530 --> 00:17:34,710 +conventional contact lens wear يعني هي شائعة مع + +208 +00:17:34,710 --> 00:17:39,950 +ارتداء العدسات اللبس اليومي التقليدي بشكل ايه؟ + +209 +00:17:44,680 --> 00:17:49,520 +Patients are usually asymptomatic، دايما المريض لا + +210 +00:17:49,520 --> 00:17:57,020 +يعاني من أي وجود لألم أو أي تأعراض Causes + +211 +00:17:57,020 --> 00:18:01,420 +أسبابها، والدليل على ذلك أن بعض الطالبات شفنا + +212 +00:18:01,420 --> 00:18:04,380 +عندهم moderate في ال conjunctival redness، + +213 +00:18:04,380 --> 00:18:07,420 +moderate لمين؟ لال blood vessels من ناحية ال + +214 +00:18:07,420 --> 00:18:11,980 +irritation وهي غير شعرة في أي علامة من هذه + +215 +00:18:11,980 --> 00:18:18,870 +العلاماتالسبب هو الهيدروجيل + +216 +00:18:18,870 --> 00:18:18,870 +السليماني السليماني السليماني السليماني السليماني + +217 +00:18:18,870 --> 00:18:19,110 +السليماني السليماني السليماني السليماني السليماني + +218 +00:18:19,110 --> 00:18:21,470 +السليماني السليماني السليماني السليماني السليماني + +219 +00:18:21,470 --> 00:18:24,890 +السليماني السليماني السليماني السليماني السليماني + +220 +00:18:24,890 --> 00:18:28,210 +السليماني السليماني السليماني السليماني السليماني + +221 +00:18:28,210 --> 00:18:28,790 +السليماني السليماني السليماني السليماني السليماني + +222 +00:18:28,790 --> 00:18:28,990 +السليماني السليماني السليماني السليماني السليماني + +223 +00:18:28,990 --> 00:18:31,090 +السليماني السليماني السليماني السليماني السليماني + +224 +00:18:31,090 --> 00:18:32,970 +السليماني السليماني السليمان + +225 +00:18:37,340 --> 00:18:41,600 +Mid water hydrogen lenses with a thick periphery + +226 +00:18:41,600 --> 00:18:46,280 +دايما بنختار mid water content من خمسة و خمسين ل + +227 +00:18:46,280 --> 00:18:50,800 +تمانية و خمسين في المية مع العدسات اللي بتكون ايه + +228 +00:18:50,800 --> 00:18:54,940 +ال more thick وين في الأطراف يعني ال minus lenses + +229 +00:18:54,940 --> 00:19:00,920 +مقارنة بالcenter long + +230 +00:19:00,920 --> 00:19:06,540 +wearing times or overnight wearبعض المرضى بيجوا + +231 +00:19:06,540 --> 00:19:10,900 +على المركز او على المستشفى بقولك انا بلبس العدسة + +232 +00:19:10,900 --> 00:19:14,960 +اللاصقة دون ما اشعر بأي تتعب و دون ما اشعر بأي + +233 +00:19:14,960 --> 00:19:18,840 +تغيير في النظر لكن ايش هذي ممكن تعمل؟ Limbal + +234 +00:19:18,840 --> 00:19:23,280 +hyperemia ساعات اللبس الطويلة الأكتر من اتناشر + +235 +00:19:23,280 --> 00:19:27,980 +ساعة ممكن تؤدي لذلك لكن بشكل مستمر يعني continuous + +236 +00:19:27,980 --> 00:19:32,680 +wearing for soft contact lensأو overnight wear + +237 +00:19:32,680 --> 00:19:36,200 +هاذي ايش هتعمل كورنية القديمة؟ طبعا إذا كانت + +238 +00:19:36,200 --> 00:19:41,820 +القيمة من عشرة لعشرين في المية طوال اليوم هذي + +239 +00:19:41,820 --> 00:19:45,980 +تعتبر خطيرة لكن لو أول ما بصحى المريض من النوم + +240 +00:19:45,980 --> 00:19:50,560 +بيكون الأمر طبيعي زي ما اتفقنا في الكورنية القديمة + +241 +00:19:54,680 --> 00:19:59,600 +A tight or immobile hydrogel lens يعني كانت العدسة + +242 +00:19:59,600 --> 00:20:05,720 +tight وما أخد كل شكل القرنية بمعنى ان فيها large + +243 +00:20:05,720 --> 00:20:10,640 +diameter مافيش اي حركة للعدسة هذا ممكن يعمل limbal + +244 +00:20:10,640 --> 00:20:15,300 +hyperemia طيب في الحالة هذه ال a tight or immobile + +245 +00:20:15,300 --> 00:20:20,410 +hydrogel lens ايش الحل؟أما بجيب small diameter + +246 +00:20:20,410 --> 00:20:25,950 +أصغر من اللي عندى أو بجيب اللي هو ايه، flat base + +247 +00:20:25,950 --> 00:20:31,710 +layer، يعني واحدة من الحالين Limbal hyperemia, + +248 +00:20:32,270 --> 00:20:36,670 +fluorescein staining and the presence of microzest + +249 +00:20:36,670 --> 00:20:40,770 +have been found to be the best biomicroscopic + +250 +00:20:40,770 --> 00:20:45,490 +indicators of corneal hypoxia in hydrogel extended + +251 +00:20:45,490 --> 00:20:50,380 +wheelلو جبتلك سؤال كيف بدك تعملي مقارنة ما بين ال + +252 +00:20:50,380 --> 00:20:55,000 +micro zest و ال corneal او ال super facial + +253 +00:20:55,000 --> 00:20:59,700 +panictate keratitis و ال superior arcuate staining + +254 +00:20:59,700 --> 00:21:03,920 +التلاتة هدول طبعا اول واحدة ال superior arcuate لو + +255 +00:21:03,920 --> 00:21:07,480 +يعملنا ال florescein هنلاقيه فقط وين في ال upper + +256 +00:21:07,480 --> 00:21:12,260 +partبالضبط الـ superfacial panictate keratitis في + +257 +00:21:12,260 --> 00:21:16,700 +الغالب هيكون في ال center لكن بالنسبة لالميكروزيست + +258 +00:21:16,700 --> 00:21:21,140 +okay الفقاعات هيكون اللي هو scattering منتشر في كل + +259 +00:21:21,140 --> 00:21:22,620 +سطح القرنية + +260 +00:21:27,140 --> 00:21:31,880 +طبعا ال limbal hyperemia بالشكل هذا ملاحظين انه + +261 +00:21:31,880 --> 00:21:36,380 +فيه هناك irritation ل ال blood vessels و أيضا اللي + +262 +00:21:36,380 --> 00:21:40,720 +هو فيه هناك dilatation ل ال blood vessels و هذا + +263 +00:21:40,720 --> 00:21:45,220 +شفناه في العمل بشكل اللي هو كبير لاحظنا ان بعض من + +264 +00:21:45,220 --> 00:21:48,660 +ال blood vessels لونه مختلف عن مين ال blood + +265 +00:21:48,660 --> 00:21:52,680 +vessels الآخرين تلاقي اللي هو dark بشكل اللي هو + +266 +00:21:52,680 --> 00:21:53,980 +red كبير + +267 +00:21:56,570 --> 00:22:00,750 +طب المريض لو كان عنده mild أو كان عنده مثلا a + +268 +00:22:00,750 --> 00:22:05,330 +trace، لمبة الhyperemia، هل بنوقفه عن ارتداء + +269 +00:22:05,330 --> 00:22:10,410 +العدسة؟ لأ، يعني this is normalوفي بعض الحالات + +270 +00:22:10,410 --> 00:22:14,530 +يعني مثلا زي الناس اللي بيكون يعني smokers مدخنين + +271 +00:22:14,530 --> 00:22:19,050 +هدول الأشخاص دايما إيش بيكون عندهم irritation أو + +272 +00:22:19,050 --> 00:22:23,210 +في عندهم limbal hyperemia فمختلف في عملية التقييم + +273 +00:22:23,210 --> 00:22:27,670 +عن مين عن ال normal أو ال normal human subjects في + +274 +00:22:27,670 --> 00:22:30,790 +عملية ال evaluation بتوقف ان شاء الله ل super + +275 +00:22:30,790 --> 00:22:35,070 +facial vascularization و المحاضرة القادمة ان شاء + +276 +00:22:35,070 --> 00:22:35,610 +الله بنكمل + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/bwhB5ZI4dt4_postprocess.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/bwhB5ZI4dt4_postprocess.srt new file mode 100644 index 0000000000000000000000000000000000000000..6b95d7c35b9d23483dc94db0c05ecda2cd4b99c3 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/bwhB5ZI4dt4_postprocess.srt @@ -0,0 +1,1400 @@ +1 +00:00:20,750 --> 00:00:23,950 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:23,950 --> 00:00:27,310 +وبركاته and a very good morning to all of you + +3 +00:00:27,310 --> 00:00:32,550 +هنكمل في موضوع ال soft contact lens evaluation and + +4 +00:00:32,550 --> 00:00:37,850 +fitting فى عندنا التقييم الأخير ال keratometer + +5 +00:00:37,850 --> 00:00:46,070 +measures طبعا فى هذا النوع فى عندنا ال keratometer + +6 +00:00:46,070 --> 00:00:48,850 +measures + +7 +00:00:52,130 --> 00:00:58,230 +أو الـ visual acuity chart و + +8 +00:00:58,230 --> 00:01:07,950 +ال retina scope reflex بداية + +9 +00:01:07,950 --> 00:01:15,130 +إذا كان الشخص العدسة اللي لبسها optimal fit before + +10 +00:01:15,130 --> 00:01:20,920 +و after blink هنشوف ال red reflex واطحبالـ retina + +11 +00:01:20,920 --> 00:01:25,120 +scope أو الـ chart اللي خاصة في الـ visual acuity + +12 +00:01:25,120 --> 00:01:30,390 +هتكون واضحةأو ال مياردز اللي خاصة في جهاز ال bush + +13 +00:01:30,390 --> 00:01:34,670 +and lum طبعا الجهاز هذا معطل حاليا عندنا في القسم + +14 +00:01:34,670 --> 00:01:40,270 +لكن جهاز ال bush and lum هو بيعمل نفس وظيفة الجوال + +15 +00:01:40,270 --> 00:01:44,630 +كيراتوميتر لكن الفرق بين الاتنين ان ال bush and + +16 +00:01:44,630 --> 00:01:49,150 +lum بياخد الصورة للمحورين او القراءات ال + +17 +00:01:49,150 --> 00:01:53,410 +measurement ل ال two readings at the same time لل + +18 +00:01:53,410 --> 00:01:57,870 +vertical و ال horizontalطبعا في محور بيمثل ال + +19 +00:01:57,870 --> 00:02:02,510 +vertical و المحور التاني بيمثل ال horizontal او + +20 +00:02:02,510 --> 00:02:08,250 +بمعنى اخر محور هيكون along ninety degree و المحور + +21 +00:02:08,250 --> 00:02:13,750 +التاني هيكون along one hundred eighty degree طيب + +22 +00:02:13,750 --> 00:02:18,290 +الان لو كان انسان عنده steep العدسة اللي لابسها + +23 +00:02:18,290 --> 00:02:24,510 +كانت steepحلاحظ قبل الترميش الرؤية فيها غير واضحة + +24 +00:02:24,510 --> 00:02:27,690 +يعني الآن لو انا اديته على ال vision الرؤية غير + +25 +00:02:27,690 --> 00:02:32,730 +واضحة قبل الترميش بعد الترميش هتصبح واضحة طبعا هذه + +26 +00:02:32,730 --> 00:02:37,750 +هتكون للحظات يعني بشكل ثوري واضح الفكرة طب لو كانت + +27 +00:02:37,750 --> 00:02:41,700 +العدسة flatإذا اللي فلات احنا عارفين انه هيكون + +28 +00:02:41,700 --> 00:02:46,380 +فيها excessive movement قبل ما يرمش الرؤية واضحة + +29 +00:02:46,380 --> 00:02:50,760 +بعد ما يرمش بيصير اللي هو a blurred vision او + +30 +00:02:50,760 --> 00:02:56,420 +unclear vision إذا كيراتوميتر ميارز can be + +31 +00:02:56,420 --> 00:03:00,960 +examined يمكن إجراء الفحص on the anterior lens + +32 +00:03:00,960 --> 00:03:06,120 +surfaceto detect any lens distortion on the eye + +33 +00:03:06,120 --> 00:03:10,040 +طبعا بعد ما المريض يرتدي العدسة او يعمل insertion + +34 +00:03:10,040 --> 00:03:15,040 +للعدسة بشوف ال evaluation التقييم من خلال جهاز + +35 +00:03:15,040 --> 00:03:17,480 +البوش اندلوم كيراتوميتر + +36 +00:03:19,900 --> 00:03:23,460 +Any ميار irregularity would be considered + +37 +00:03:23,460 --> 00:03:28,140 +abnormal، إذا أي حاجة بيكون فيها عدم انتظام + +38 +00:03:28,140 --> 00:03:32,160 +بالصورة بالشكل هادي، يعني بمعنى انه distortion في + +39 +00:03:32,160 --> 00:03:36,580 +الميارات، معنى الكلام ان العدسة هي مش optimal fit + +40 +00:03:37,380 --> 00:03:42,460 +اما flat او steep بناء على الخطوات اللى تم ذكرها + +41 +00:03:42,460 --> 00:03:48,460 +اذا كانت flat هتكون قبل الترميش واضحة بعد الترميش + +42 +00:03:48,460 --> 00:03:53,140 +غير واضحة اذا كانت steep قبل الترميش هتكون غير + +43 +00:03:53,140 --> 00:03:59,500 +واضحة بعد الترميش هتصبح واضحة اذا هنا عندنا steep + +44 +00:03:59,500 --> 00:04:03,800 +vision clear after a blank لو استخدمنا ال visual + +45 +00:04:03,800 --> 00:04:12,200 +acuity chartالميارز clear after a blink طبعا هذه + +46 +00:04:12,200 --> 00:04:17,800 +هتكون للحظات يعني بشكل فوري لثواني معدودة احنا + +47 +00:04:17,800 --> 00:04:24,620 +هنلاحظها ك examiners ironing effect انه هيصير هناك + +48 +00:04:24,620 --> 00:04:28,840 +تأثير ملاحظين هنا الصورة ال circle كاملة لكن في + +49 +00:04:28,840 --> 00:04:33,700 +الشكل هذا انه هتكون unclear والصورة ايش هيصير فيها + +50 +00:04:33,700 --> 00:04:36,440 +distortion انه غير واضحة + +51 +00:04:38,760 --> 00:04:43,400 +بالنسبة للفلات هتكون ال vision blurred after بلينك + +52 +00:04:43,400 --> 00:04:52,080 +والميارد ديستورتد بعد بلينك ايضا هيكون هناك عنا + +53 +00:04:52,080 --> 00:04:56,920 +excessive movement زيادة في الحركة وهذا بتديني + +54 +00:04:56,920 --> 00:05:01,740 +انطباع ان العدسة هي flat lens او loose lens + +55 +00:05:05,120 --> 00:05:09,620 +Selection of a lens for fitting requires the + +56 +00:05:09,620 --> 00:05:16,000 +choice of parameters الآن حتى يتم اختيار ملائم او + +57 +00:05:16,000 --> 00:05:22,000 +اختيار مناسب للعدسة لازم ان يتوفر في العدسة مجموعة + +58 +00:05:22,000 --> 00:05:28,470 +من ال parameters او مجموعة من المحدداتالمحدد الاول + +59 +00:05:28,470 --> 00:05:34,130 +هو عبارة عن ال back optic zone radius او بنسميه ال + +60 +00:05:34,130 --> 00:05:42,710 +base curve طيب ماهو مفهوم ال base curve ال + +61 +00:05:42,710 --> 00:05:50,110 +base curve تفضلي يا نور ايش تعريفه؟ اه اه okay + +62 +00:05:50,110 --> 00:05:53,250 +تفضلي يا انسام هو عبارة عن ال + +63 +00:05:58,210 --> 00:06:05,750 +Okay طيب another answer ما هو مفهوم ال base curve؟ + +64 +00:06:05,750 --> 00:06:12,590 +ال base curve كتعريف له هو عبارة عنالبوستيريور لل + +65 +00:06:12,590 --> 00:06:18,270 +center curvature of the lens وبيكون adjacent to + +66 +00:06:18,270 --> 00:06:23,190 +the cornea او هو عبارة عن البوستيريور center + +67 +00:06:23,190 --> 00:06:27,610 +curvature of the lens وبيكون عامل adjacent to the + +68 +00:06:27,610 --> 00:06:34,950 +cornea ملتسق مع مين؟ مع القرنية الان بالنسبة لل + +69 +00:06:34,950 --> 00:06:37,850 +back optic zone radius + +70 +00:06:39,330 --> 00:06:47,750 +غالبا انا بختار base curve من 0.6 mm ل 0.8 mm + +71 +00:06:47,750 --> 00:06:51,410 +flatter than the average corneal curvature + +72 +00:06:51,410 --> 00:06:57,090 +measured with keratometry نشوف هذا الكلام بمثال + +73 +00:06:57,090 --> 00:07:03,390 +نفترض + +74 +00:07:03,390 --> 00:07:07,250 +عندنا ال K1 40 + +75 +00:07:09,150 --> 00:07:19,710 +ديوبتر وال K2 واحد واربعين ديوبتر ال R1 تمانية + +76 +00:07:19,710 --> 00:07:30,050 +واربعة ال R2 تمانية واتنين okay الآن بدنا ناخد ال + +77 +00:07:30,050 --> 00:07:37,060 +K averageهيكون اربعين و نص اذا ال R average كده + +78 +00:07:37,060 --> 00:07:41,800 +هيكون تمانية و تلاتة According to American Academy + +79 +00:07:41,800 --> 00:07:47,800 +بيحكيلك انه لازم انا اعمل اضافة من ستة من عشرة + +80 +00:07:47,800 --> 00:07:53,940 +لتمانية من عشرة لقيمة ال base curve average واضحة؟ + +81 +00:07:54,510 --> 00:07:59,210 +إذا في حالة ال soft contact lens بدي أضيف من 6 من + +82 +00:07:59,210 --> 00:08:05,730 +10 ل 8 من 10 على ال R average هذه كإضافة طيب إيش + +83 +00:08:05,730 --> 00:08:10,270 +ال function أو ال task؟ ليش إحنا بنضيف هذا الرقم؟ + +84 +00:08:10,270 --> 00:08:14,050 +إحنا بنعرف إن ال diameter ل ال soft contact lens + +85 +00:08:14,050 --> 00:08:19,190 +أكبر من ال diameter لمين؟ للكورنية طيب لو أنا بدي + +86 +00:08:19,190 --> 00:08:23,870 +أقلل ال diameterأيش بدي أعمل من الحلول؟ بدي أزود + +87 +00:08:23,870 --> 00:08:27,950 +ال base care لذلك انا بختار base care ان يكون + +88 +00:08:27,950 --> 00:08:34,170 +قيمته اعلى من ال R average من 6 من 10 ل 8 من 10 + +89 +00:08:34,170 --> 00:08:39,990 +اذا الهدف من ذلك ان اقلل من ال diameter يعني في + +90 +00:08:39,990 --> 00:08:46,310 +بعض الأحيان احنا بنطلب diameter 13.5 طب غير متوفر + +91 +00:08:46,310 --> 00:08:50,570 +في الشركة 13.5 بنروح نلعب في مين؟ في ال base care + +92 +00:08:51,070 --> 00:08:58,670 +لأن الاتنين في بينهم relationship if + +93 +00:08:58,670 --> 00:09:03,630 +a lens back optic zone radius is too flat for the + +94 +00:09:03,630 --> 00:09:09,150 +cornea lens centration may be poor إذا كان عندنا + +95 +00:09:09,150 --> 00:09:13,530 +ال base curve هنا flat إذا معنى الكلام أن العدسة + +96 +00:09:13,530 --> 00:09:18,900 +إيش هتكونبالضبط فيها poor centration يعني العدسة + +97 +00:09:18,900 --> 00:09:26,300 +مش ماخدة تمركز مناسب أو جيد if the + +98 +00:09:26,300 --> 00:09:31,300 +lens back optic zone radius is too steep the lens + +99 +00:09:31,300 --> 00:09:37,340 +may not conform properly to the eye during wear لو + +100 +00:09:37,340 --> 00:09:42,340 +كانت العدسة steep إيش هتعمل؟ no sensation at all + +101 +00:09:43,100 --> 00:09:47,900 +المريض مش هيشعر نهائي بالعدسة صحيح؟ فالان العدسة + +102 +00:09:47,900 --> 00:09:53,500 +ما هيكونش إلها يعني المكان بتاعها مش هيكون مناسب + +103 +00:09:53,500 --> 00:09:57,620 +وين في داخل العين يعني ما بتاخد appropriately fit + +104 +00:09:57,620 --> 00:10:02,660 +of the lens inside the eye يعني هتتمركز بشكل غير + +105 +00:10:02,660 --> 00:10:07,960 +ملائم أو غير مناسب في داخل العينواضح الفكرة و لذلك + +106 +00:10:07,960 --> 00:10:11,260 +انا ايش بدى اعمل بدى اغير اما بال base curve في + +107 +00:10:11,260 --> 00:10:18,020 +هذه الحالة او في ال diameter Aspheric + +108 +00:10:18,020 --> 00:10:23,180 +back curves are used in some soft lenses هذا النوع + +109 +00:10:23,180 --> 00:10:27,460 +ال aspheric back curves انه انا اما بدى اغير + +110 +00:10:27,460 --> 00:10:32,300 +بسماكة المركز او بدى اغير بسماكة main ال + +111 +00:10:32,300 --> 00:10:36,730 +peripheralوالهدف من ذلك في التغيير انه بدي اعمل + +112 +00:10:36,730 --> 00:10:41,330 +العدسة optimal fit طبعا بيكون هذا موجود ال + +113 +00:10:41,330 --> 00:10:45,870 +aspheric back curves بال trial case منه بيكون more + +114 +00:10:45,870 --> 00:10:50,610 +plus ومنه بيكون more minus حسب الحاجة اللى بحتاجها + +115 +00:10:50,610 --> 00:10:51,850 +مين ال examiner + +116 +00:10:55,590 --> 00:11:00,850 +available in flat أو available in steep طبعا و كل + +117 +00:11:00,850 --> 00:11:05,290 +هدمين بيستخدمها ال manufacturer المصنعين بيخلوها + +118 +00:11:05,290 --> 00:11:06,910 +في ال trial case + +119 +00:11:09,240 --> 00:11:13,100 +The lens curvature is slightly flatter + +120 +00:11:13,100 --> 00:11:17,540 +peripherally than centrally to more closely match + +121 +00:11:17,540 --> 00:11:21,640 +the average corneal shape يعني هو بيحاول انه يغير + +122 +00:11:21,640 --> 00:11:26,320 +بتمركز العدسة سواء من ال center او ال peripheral + +123 +00:11:26,320 --> 00:11:31,780 +للوصول الى افضل fitting للعدسة اما باستخدام flat + +124 +00:11:31,780 --> 00:11:33,580 +او steep a base curve + +125 +00:11:36,330 --> 00:11:40,630 +For such lenses, the manufacturer usually has + +126 +00:11:40,630 --> 00:11:45,190 +recommendations as to which lens curvature to + +127 +00:11:45,190 --> 00:11:49,370 +trial fit in the first instance بعض الشركات اللي + +128 +00:11:49,370 --> 00:11:53,050 +بنتعامل معها بيحكيلك إنه دايما في ال contact lens + +129 +00:11:53,050 --> 00:12:00,210 +خديه إفلات وستيبممكن ببعض الأحيان انه يكون ال + +130 +00:12:00,210 --> 00:12:04,890 +prescription اللي انت وصفتيه للمريض 100% تماما و + +131 +00:12:04,890 --> 00:12:09,530 +بناء على دراسات سابقة و بناء على table معين لكن مع + +132 +00:12:09,530 --> 00:12:13,890 +ذلك مايكونش مناسب للمريض طيب انا ك examiner كيف + +133 +00:12:13,890 --> 00:12:18,310 +بدي اتخلص من هذا الأمر؟ بستخدم اما EFLAT او steep + +134 +00:12:18,310 --> 00:12:21,770 +pace curve للوصول لل optimal fit + +135 +00:12:26,090 --> 00:12:30,070 +بالنسبة للـ total diameter الـ diameter للعدسة هو + +136 +00:12:30,070 --> 00:12:36,030 +عبارة عن ايه ال width من الطرف للطرف الآخر للعدسة + +137 +00:12:36,030 --> 00:12:41,910 +يعني من ال edge to the edge طبعا ال ال soft + +138 +00:12:41,910 --> 00:12:46,990 +contact lens بتتميز بأنه بيكون لها large diameter + +139 +00:12:46,990 --> 00:12:51,010 +compared to the corner أخدنا ال average diameter + +140 +00:12:52,270 --> 00:12:57,630 +تقريبا من تلتاش و نص لخمساش و في بعض الكتب من اربع + +141 +00:12:57,630 --> 00:13:04,350 +تاش لخمساش ملي متر اذا هي تعتبر larger than the + +142 +00:13:04,350 --> 00:13:08,910 +cornea total + +143 +00:13:08,910 --> 00:13:15,630 +diameter usually selected as about هان بدنا نغير + +144 +00:13:15,630 --> 00:13:19,770 +الرقم او point five to two millimeter ك average + +145 +00:13:20,670 --> 00:13:25,090 +يعني الان نفترض مثلا ريم كان عندها ال horizontal + +146 +00:13:25,090 --> 00:13:33,950 +visible iris diameter اتناش ملي متر في عندي range + +147 +00:13:33,950 --> 00:13:41,710 +من اتناش و نصلحد الاربعتاشر ملي متر ممكن ان انا + +148 +00:13:41,710 --> 00:13:47,250 +ايه اختاره طبعا كل هذا مابجيش بطريقة عشوائية انا + +149 +00:13:47,250 --> 00:13:51,750 +بعد ما بختار ال diameter لازم اعمل evaluation من + +150 +00:13:51,750 --> 00:14:00,920 +خلال الUsually selected as about 0.5 to 2 mm + +151 +00:14:00,920 --> 00:14:05,880 +greater than the patient's horizontal visible iris + +152 +00:14:05,880 --> 00:14:10,280 +diameter اذا عنا بده يكون ال diameter اللي بده + +153 +00:14:10,280 --> 00:14:14,140 +اختاره للعدسة اكبر من ال horizontal visible iris + +154 +00:14:14,140 --> 00:14:19,420 +diameter بقيمة من نص الى اتنين ملي مترلأن بعض + +155 +00:14:19,420 --> 00:14:23,200 +الأحيان بكون عند ال visible iris diameter اتناش + +156 +00:14:23,200 --> 00:14:28,520 +لازم اربعتاش طيب غير متوفر في السوق ايش اعمل؟ بجيب + +157 +00:14:28,520 --> 00:14:32,220 +مثلا اتناش و نص او تلتاش او بجيب مثلا تلتاش و نص + +158 +00:14:32,220 --> 00:14:36,740 +يعني بحاول ان اغير في مين في ال number طبعا احنا + +159 +00:14:36,740 --> 00:14:40,420 +العدسات اللاصقة اللينة اللي متوفرة عندنا في قطاع + +160 +00:14:40,420 --> 00:14:45,740 +غزة فيه هناك fixed valueلموضوع ال diameter + +161 +00:14:45,740 --> 00:14:51,300 +بتلاقيها من 14 ل 14.5 مليمتر واعتقد هي ملائمة + +162 +00:14:51,300 --> 00:14:55,400 +لمعظمنا لان المعظم عندنا ال horizontal visible + +163 +00:14:55,400 --> 00:14:58,340 +iris diameter من 12 ل 12.75 + +164 +00:15:02,370 --> 00:15:08,110 +a lens that is too large يمّا يكون العدسة قطرها + +165 +00:15:08,110 --> 00:15:13,570 +كبير خالص، هذه إيش هتميل؟ to show low amounts of + +166 +00:15:13,570 --> 00:15:18,410 +movement يعني الحركة تحت العدسة هتقل، هتكون أقل من + +167 +00:15:18,410 --> 00:15:24,070 +نص مليمتر وبالتالي إنه هتعمل إيه؟ تأثير على تبادل + +168 +00:15:24,070 --> 00:15:28,610 +التير، يعني ممكن إنه يسبب في هذه الحالة corneal + +169 +00:15:28,610 --> 00:15:33,500 +edemaيعني بعض الأشخاص بيجيوا عندك على ال clinic او + +170 +00:15:33,500 --> 00:15:36,740 +على ال center بيقولك انا بدي عدسة يكون ال diameter + +171 +00:15:36,740 --> 00:15:42,480 +بتاعها كبير لكن انت بدك تشرحيله انه ايش هي مضاعفات + +172 +00:15:42,480 --> 00:15:46,920 +او تأثير ال large diameter انه ممكن هي السبب + +173 +00:15:46,920 --> 00:15:51,200 +corneal edema ليه؟ لأنه هيقل من حركتها وبالتالي + +174 +00:15:51,200 --> 00:15:57,000 +هيقل من ال tear exchange للعدسة لو كانت العدسة + +175 +00:15:57,000 --> 00:16:02,350 +smallهتكون more excessively يعني بمعنى إن حركتها + +176 +00:16:02,350 --> 00:16:07,790 +سريعة show poor concentration التمركز تاعها هيكون + +177 +00:16:07,790 --> 00:16:12,470 +ضعيف أو غير ملائم and be less comfortable to wear + +178 +00:16:12,470 --> 00:16:17,050 +إنه هتكون غير ملائمة أو غير مريحة بالنسبة لمين لل + +179 +00:16:17,050 --> 00:16:17,630 +patient + +180 +00:16:23,240 --> 00:16:28,400 +اذا اخدنا ال base curve ال total diameter النقطة + +181 +00:16:28,400 --> 00:16:32,440 +التالتة والمهمة هي ال oxygen transmissibility + +182 +00:16:32,440 --> 00:16:38,040 +نفاذية ال oxygen طبعا ال oxygen transmissibility + +183 +00:16:38,040 --> 00:16:45,340 +القانون ديكي على Tdirectly appropriational علاقة + +184 +00:16:45,340 --> 00:16:49,200 +تردية to the oxygen permeability of the lens + +185 +00:16:49,200 --> 00:16:54,180 +material إذا تتناسب تناسبا ترديا مع نفاذية + +186 +00:16:54,180 --> 00:17:01,060 +الأكسجين أو دخول الأكسجين inversely related علاقة + +187 +00:17:01,060 --> 00:17:05,320 +عكسية to the lens average thickness إذا بتتناسب + +188 +00:17:05,320 --> 00:17:08,240 +تناسب عكسي مع سماكة العدسة + +189 +00:17:10,590 --> 00:17:15,110 +Under open eye conditions or conventional daily + +190 +00:17:15,110 --> 00:17:19,030 +wear يعني + +191 +00:17:19,030 --> 00:17:23,410 +عدسات اللبس اليومي التقليدي بمعنى ان المريض بلبسها + +192 +00:17:23,410 --> 00:17:27,710 +اربع ساعات خمس ساعات قد تصل الى اتناشر ساعة وبعد + +193 +00:17:27,710 --> 00:17:33,790 +ذلك ايه؟ برفع العدسة هذه النوع من العدسات بديكون + +194 +00:17:33,790 --> 00:17:39,100 +فيها ال decay على T moderate صحيح؟Are usually + +195 +00:17:39,100 --> 00:17:44,300 +suitable غالبا هيكون ملائم او مناسب بالنسبة للمريض + +196 +00:17:44,300 --> 00:17:47,780 +طيب الان لو سألنا سؤال ل سيهام لو عملنا في هذه + +197 +00:17:47,780 --> 00:17:51,900 +الحالة من العدسات عملنا high water content ايش + +198 +00:17:51,900 --> 00:17:57,760 +هيصير؟ بتضبط ان فترة حياة العدسة هتقل و هتصير اللي + +199 +00:17:57,760 --> 00:18:04,160 +هي more fragile هتصير هشة و بالتالي انه مش هتعيش + +200 +00:18:04,160 --> 00:18:11,300 +فترة زمانية طويلةUnder a closed eye conditions زي + +201 +00:18:11,300 --> 00:18:15,320 +مثلا ال Extended wear lenses العدسات اللي بتتم + +202 +00:18:15,320 --> 00:18:20,280 +ارتدائها لمدة أسبوع واحد وبعد ذلك بتخلص منها الشخص + +203 +00:18:20,280 --> 00:18:24,380 +هذه لازم يكون فيها ال DK على T very high عشان ما + +204 +00:18:24,380 --> 00:18:30,440 +يسبب ال corneal اديمة Back + +205 +00:18:30,440 --> 00:18:35,440 +vertex power بالتأكيد بتعتمد على مين القوة الصحيحة + +206 +00:18:35,440 --> 00:18:41,940 +للعدسةبمعنى لو مريض بلبس minus تلاتة بده D minus + +207 +00:18:41,940 --> 00:18:46,420 +تلاتة لو بلبس minus خمسة بده دخله على قانون F ال + +208 +00:18:46,420 --> 00:18:50,500 +contact lens بساوي F الاسفير لل lens على واحد ناقص + +209 +00:18:50,500 --> 00:18:57,480 +D في F الاسفير لل lensa fixed lens thickness, a + +210 +00:18:57,480 --> 00:19:01,900 +profile, a profile and average thickness اذا هو + +211 +00:19:01,900 --> 00:19:07,380 +بتأثر في سماكة العدسة okay طبعا كل ما كان الشخص + +212 +00:19:07,380 --> 00:19:12,780 +high emetropia هيكون عنده high thickness حزيد + +213 +00:19:12,780 --> 00:19:18,300 +صحيح؟ لذلك ان بعض .. كيف يعني؟ + +214 +00:19:24,070 --> 00:19:29,250 +لأ هان ال sphere يعني مثلا minus تلاتة يعني مثلا + +215 +00:19:29,250 --> 00:19:33,170 +لو واحد عنده minus عفوا تمانية هان ايش تعتبر؟ ده + +216 +00:19:33,170 --> 00:19:37,290 +يبتر ال sphere اه نوصف اللي هو ايه soft contact + +217 +00:19:37,290 --> 00:19:41,590 +lens او spherical soft contact lens لكن يمكن انت + +218 +00:19:41,590 --> 00:19:45,030 +بتقصدي لو كان هاي سلندر okay + +219 +00:19:48,290 --> 00:19:53,830 +consequently or so لذلك many lens attributes are + +220 +00:19:53,830 --> 00:19:58,250 +affected, including decay over T, fitting and + +221 +00:19:58,250 --> 00:20:02,150 +handling في تلت شغلات مهمة في العدسات اللاصقة + +222 +00:20:02,150 --> 00:20:07,890 +اللينة، الآن انا لو زودت ال decay على T، ال + +223 +00:20:07,890 --> 00:20:12,410 +thickness العدسة اشمالها بقل، بالتالي في هناك + +224 +00:20:12,410 --> 00:20:16,890 +صعوبة انه امسك من العدسة، يعني العدسة بتصير too + +225 +00:20:16,890 --> 00:20:23,500 +thinطيب قللت ال DK على T، ال thickness هيزيد، مسك + +226 +00:20:23,500 --> 00:20:28,340 +العدسة هيصير سهل، okay؟ يعني دايما في عملية ال + +227 +00:20:28,340 --> 00:20:31,960 +evaluation لل soft contact lens، حُط التلاش شغلات + +228 +00:20:31,960 --> 00:20:35,580 +هدول، DK على T، thickness and ال handling + +229 +00:20:39,530 --> 00:20:43,790 +contact lens power differs significantly from + +230 +00:20:43,790 --> 00:20:48,550 +spectacle lens power for powers greater than 4 + +231 +00:20:48,550 --> 00:20:52,490 +diopter إذا كانت أكتر من أربع ديوبتر نستخدم + +232 +00:20:52,490 --> 00:20:57,630 +القانون الخاص بالعدسات اللاصقة the required + +233 +00:20:57,630 --> 00:21:01,050 +contact lens power is needed to be calculated + +234 +00:21:12,980 --> 00:21:19,900 +Lens thickness سماكة العدسة The + +235 +00:21:19,900 --> 00:21:25,700 +majority of current lenses are made as thin as + +236 +00:21:25,700 --> 00:21:31,880 +practical to maximize oxygen transmissibilityدايما + +237 +00:21:31,880 --> 00:21:37,640 +ال practitioners بفضله ان يطلبوا عدسات لاصقة يكون + +238 +00:21:37,640 --> 00:21:42,180 +فيها ال DK على T very high وبالتالي هتكون العدسة + +239 +00:21:42,180 --> 00:21:47,620 +ايش؟ thin طيب + +240 +00:21:47,620 --> 00:21:52,420 +الآن ايش ال disadvantages؟ العيوب يما تكون العدسة + +241 +00:21:52,420 --> 00:21:57,940 +too thin نحيفة؟ بالضبط اول حاجة ان هناك صعوبة في + +242 +00:21:57,940 --> 00:22:04,530 +عملية مسك العدسةdifficult for the patient to + +243 +00:22:04,530 --> 00:22:08,810 +handle them، دايما هتلاقي العدسة انه ممكن تسقط من + +244 +00:22:08,810 --> 00:22:13,910 +ايد مين المريض، بالضبط، اذا have a shorter life + +245 +00:22:13,910 --> 00:22:18,090 +فبالتالي انه هتكون ايه؟ fragile، انه هش العدسة + +246 +00:22:19,080 --> 00:22:23,800 +thinner post lens tear film has less movement with + +247 +00:22:23,800 --> 00:22:28,660 +blinks في المحاضرة السابقة أخدنا أنه دايما حركة + +248 +00:22:28,660 --> 00:22:33,040 +العدسة هي بالساعد في حركة مين ال tear طب هي قلت + +249 +00:22:33,040 --> 00:22:36,960 +الحركة تاعت مين العدسة فبالتالي أن حركة ال tear + +250 +00:22:36,960 --> 00:22:38,020 +film هيقل + +251 +00:22:41,150 --> 00:22:46,070 +إذا كان عدسة أكثر من نقاط فالنتيجة يمكن أن تكون + +252 +00:22:46,070 --> 00:22:50,490 +ديسيكاشن او staining of the cornea دايما العدسة + +253 +00:22:50,490 --> 00:22:54,310 +لما تكون تانية هتعمل adherence to the cornea + +254 +00:22:54,310 --> 00:22:59,370 +فبالتالي انه هتعمل حاجة بنسميه no sensation at all + +255 +00:22:59,370 --> 00:23:04,830 +فهيطبعوا ايه ال staining في ال cornea بمعنى + +256 +00:23:04,830 --> 00:23:10,200 +ديسيكاشن اللي هي نقاط يعني كأنه dry spotيعني + +257 +00:23:10,200 --> 00:23:15,560 +المريض هيشعر انه عنده dry spot كا symptoms كاعراض + +258 +00:23:15,560 --> 00:23:20,760 +ال dry eye symptoms + +259 +00:23:20,760 --> 00:23:28,200 +as a guide ركزوا في المعلومة هذه as a guide low + +260 +00:23:28,200 --> 00:23:33,280 +water content lenses may have a center thickness + +261 +00:23:33,280 --> 00:23:42,270 +as low as 0.04 to 0.06 millimeterبينما ال .. ال .. + +262 +00:23:42,270 --> 00:23:48,010 +ال mid water content لنزل ال thickness فيها 0.07 + +263 +00:23:48,010 --> 00:23:56,170 +to 0.09 ال high water content هيكون من 0.1 to 0.14 + +264 +00:23:56,170 --> 00:24:01,690 +الملاحظة هنا في ال guide ان ال high water content + +265 +00:24:01,690 --> 00:24:05,950 +بشوف السماكة فيها اعلى من مين من ال low water + +266 +00:24:05,950 --> 00:24:08,050 +content طب شو السبب؟ + +267 +00:24:13,900 --> 00:24:17,520 +كلامك صحيح، بس ايش تفسير هام؟ يعني في ال guide هذا + +268 +00:24:17,520 --> 00:24:22,600 +انه بنلاحظ ان العدسة يما كانت low water content + +269 +00:24:22,600 --> 00:24:26,500 +السماكة في ال center عشان تاخد شكل قرنية و تكون + +270 +00:24:26,500 --> 00:24:31,360 +تاردة؟ لأ طيب، الآن العدسة دايما بتتكون من two + +271 +00:24:31,360 --> 00:24:36,590 +partsمن ال center وال peripheral صح ولا لا؟ الان + +272 +00:24:36,590 --> 00:24:41,510 +انا لو قللت سماكة العدسة من ناحية ال center العدسة + +273 +00:24:41,510 --> 00:24:46,050 +مش هقدر اسيطر عليها بمعنى هتعمل adherence بشكل ايه + +274 +00:24:46,050 --> 00:24:50,630 +مباشر مع الكورنيا حتى لو وصلت انا لل optimal fit + +275 +00:24:51,560 --> 00:24:55,100 +فدايما في العدسات اللى بتكون high water content + +276 +00:24:55,100 --> 00:24:58,880 +بحاول انه ازود ال thickness وين؟ في منطقة ال + +277 +00:24:58,880 --> 00:25:03,180 +center عشان احافظ على العدسة خوفا من انه تعمل + +278 +00:25:03,180 --> 00:25:08,720 +التساق مع مين؟ مع الكورنيا وهذا ال guide مهم دايما + +279 +00:25:08,720 --> 00:25:12,540 +في العدسات اللاصقة يما تكون high water content + +280 +00:25:12,540 --> 00:25:17,280 +حاول انه تنتبه على ال center thickness جداش قيمته؟ + +281 +00:25:18,410 --> 00:25:23,650 +إذا والله كانت قيمته أقل من ال low water content + +282 +00:25:23,650 --> 00:25:28,770 +هان مشكلة مش هيصير تماثق ما بين مركز العدسة و ال + +283 +00:25:28,770 --> 00:25:34,610 +cornea choosing + +284 +00:25:34,610 --> 00:25:38,990 +soft lenses for patients الآن اختيار العدسات + +285 +00:25:38,990 --> 00:25:41,050 +اللينة للمرضى + +286 +00:25:43,440 --> 00:25:48,880 +هناك بعض المسائل يجب تحديدها من قبل ال examiners + +287 +00:25:48,880 --> 00:25:54,580 +حتى انه يتم اختيار العدسة اللاصقة اللينة بشكل + +288 +00:25:54,580 --> 00:25:59,800 +مناسب اذا some of the key issues اذا مجموعة من + +289 +00:25:59,800 --> 00:26:04,540 +المفاتيح او المسائل that need اللي بتحتاج to be + +290 +00:26:04,540 --> 00:26:10,160 +considered الى اعتبار RWhat refractive correction + +291 +00:26:10,160 --> 00:26:14,240 +is required؟ كده قيمة refractive error عند المريض؟ + +292 +00:26:14,240 --> 00:26:18,900 +إذا كان أقل من أربعة، بديه الوصفة بشكل مباشر، أكتر + +293 +00:26:18,900 --> 00:26:22,880 +من أربعة، بدخله على قانون التحويل، هذه النقطة + +294 +00:26:22,880 --> 00:26:28,240 +الأولىNumber two is a steep or flat fitting + +295 +00:26:28,240 --> 00:26:33,160 +required إذا كانت العدسة flat أو steep بدي أحاول + +296 +00:26:33,160 --> 00:26:37,600 +أغير إما بال base curve أو ال diameter لحد ما أصل + +297 +00:26:37,600 --> 00:26:43,940 +إلى مين ال optimal fit للعدسة A + +298 +00:26:43,940 --> 00:26:49,260 +corneal curvature يما يكون تحد بالقرنيةاستيبر دان + +299 +00:26:49,260 --> 00:26:58,480 +44 ديوبتر 7.67 راديوس of curvature usually needs a + +300 +00:26:58,480 --> 00:27:00,000 +steep fitting lens + +301 +00:27:16,160 --> 00:27:21,720 +ممتازة طيب another answer اذا + +302 +00:27:21,720 --> 00:27:25,780 +الان في حالة ما يكون عندى ال key reading steep + +303 +00:27:25,780 --> 00:27:30,460 +يعني اكتر من اربع و اربعين ديوبتر دايما بنحاول انه + +304 +00:27:30,460 --> 00:27:36,000 +نختار base curve ايش ماله قيمته steep واضح حتى + +305 +00:27:36,000 --> 00:27:41,550 +نحافظ على شكل ايش العدسةيعني لأن العدسة conform to + +306 +00:27:41,550 --> 00:27:45,930 +the shape of the cornea لو اخترت انا base curve + +307 +00:27:45,930 --> 00:27:49,930 +عالي ايش هيصير في اللي انه هيكون هناك اللي هو flat + +308 +00:27:49,930 --> 00:27:54,770 +lens او excessive movement بالضبط انه هيصير في لها + +309 +00:27:54,770 --> 00:27:58,710 +حركة و المريض مش هيقدر ايش يسيطر عليها و ممكن انه + +310 +00:27:58,710 --> 00:28:03,990 +تسقط من العين واضح الفكرة؟ اذا دايما بختار corneal + +311 +00:28:03,990 --> 00:28:08,090 +curvature انه يكون steep 44ديوبتر or more + +312 +00:28:10,700 --> 00:28:14,960 +selection of lens type modality بدي أختار نوع + +313 +00:28:14,960 --> 00:28:19,320 +العدسة المناسب هل العدسة أنا مثلا بدي conventional + +314 +00:28:19,320 --> 00:28:24,180 +daily wear هل extended wear هل المريض ممكن يتلاقم + +315 +00:28:24,180 --> 00:28:26,980 +مع ال extended wear ولا لأ هل هتكون ال + +316 +00:28:26,980 --> 00:28:31,180 +conventional daily wear له مناسبة وأهم شيء موضوع + +317 +00:28:31,180 --> 00:28:35,420 +ال task أو + +318 +00:28:35,420 --> 00:28:41,180 +ال functions اللي بيقوم فيها من المريضOkay، هذه + +319 +00:28:41,180 --> 00:28:45,140 +مهمة كتير دايما، وهذه بنختصرها في موضوع ال + +320 +00:28:45,140 --> 00:28:49,200 +occupation، الوظيفة، دايما ال occupation هي تعتبر + +321 +00:28:49,200 --> 00:28:53,860 +عامل مهم في عملية إعطاء العدسة اللاصقة أو صرفة + +322 +00:28:53,860 --> 00:28:57,560 +بالنسبة للمريض، سواء كان ال soft contact lens أو + +323 +00:28:57,560 --> 00:29:04,460 +hard contact lensIs their dry eye or a patient + +324 +00:29:04,460 --> 00:29:09,920 +history suggestive of a tear film abnormality or + +325 +00:29:09,920 --> 00:29:14,320 +anomaly؟ دايما انا بده اشوف هل المريض عنده dry eye + +326 +00:29:14,320 --> 00:29:17,960 +symptoms؟ اذا عنده dry eye symptoms وعملنا a + +327 +00:29:17,960 --> 00:29:21,760 +clinical diagnosis of a dry eye زي ال TPUT او + +328 +00:29:21,760 --> 00:29:26,100 +الشيرمارتس او ال corneal fluorescein staining انا + +329 +00:29:26,100 --> 00:29:31,280 +ايش بده امنع المريض من اعطاء العدسة اللاصقةلأن هى + +330 +00:29:31,280 --> 00:29:36,380 +تعتبر من ضمن ال Contra Indication ايضا بدي اطمن ع + +331 +00:29:36,380 --> 00:29:41,280 +موضوع ال tier film انه بدي اشوف هل normal ال tier + +332 +00:29:41,280 --> 00:29:46,740 +film التلت طبقات سواء ال water او ال mucus او ال + +333 +00:29:46,740 --> 00:29:50,720 +middle layer او ال limit layer كلهيتهم سليمات ولا + +334 +00:29:50,720 --> 00:29:54,820 +لا اذا في هناك اي ت defect في ال tier film ايضا + +335 +00:29:54,820 --> 00:30:00,570 +لازم انه نتوقف من اعطاء العدسة اللاصقةللمريض، ان + +336 +00:30:00,570 --> 00:30:06,010 +شاء الله بنقف للنقطة هذه و المحاضرة الجاية بنكمل، + +337 +00:30:06,010 --> 00:30:07,610 +في أي سؤال؟ فضليك + +338 +00:30:12,710 --> 00:30:17,310 +Okay الان بالنسبة في عندنا تلت أنواع من العدسات + +339 +00:30:17,310 --> 00:30:21,350 +العدسة اما بتكون high water content او mid water + +340 +00:30:21,350 --> 00:30:26,050 +content او بتكون low water content اذا كانت العدسة + +341 +00:30:26,050 --> 00:30:30,510 +low water content دايما السماكة في ال center بحاول + +342 +00:30:30,510 --> 00:30:36,190 +ان اقللها لان هي العدسة بشكل عام متماسكة صح ولا لا + +343 +00:30:36,190 --> 00:30:40,790 +لان كمية الميه اللى موجودة فيها تعتبر مناسبة ان + +344 +00:30:40,790 --> 00:30:45,940 +تعيش فترة زمانية طويلةلكن لو كانت المشكلة في ال + +345 +00:30:45,940 --> 00:30:49,740 +high water content بحاول سماكة العدسة في ال center + +346 +00:30:49,740 --> 00:30:54,280 +ازودها لان طبيعة العدسة ايش مالها؟ fragile هشة + +347 +00:30:54,280 --> 00:30:58,540 +يعني لو كل هيتها كانت في نفس السماكة بتلاقي انه + +348 +00:30:58,540 --> 00:31:03,200 +هتعمل adherence to the cornea وبالتالي المريض no + +349 +00:31:03,200 --> 00:31:08,820 +sensation at all مش هيشعر اللي هو في العدسة تعطيكم + +350 +00:31:08,820 --> 00:31:09,480 +العافية وشكرا + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/bwhB5ZI4dt4_raw.json b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/bwhB5ZI4dt4_raw.json new file mode 100644 index 0000000000000000000000000000000000000000..e22bf78522298b29721e7e119820b19702eeb76b --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/bwhB5ZI4dt4_raw.json @@ -0,0 +1 @@ +{"segments": [{"id": 1, "seek": 4885, "start": 20.75, "end": 48.85, "text": "بسم الله الرحمن الرحيم السلام عليكم ورحمة الله وبركاته and a very good morning to all of you هنكمل في موضوع ال soft contact lens evaluation and fitting فى عندنا التقييم الأخير ال keratometer measures طبعا فى هذا النوع فى عندنا ال keratometer measures", "tokens": [3555, 38251, 21984, 34892, 5016, 27842, 34892, 5016, 32640, 21136, 37440, 25894, 24793, 4032, 2288, 35571, 3660, 21984, 4032, 26890, 4117, 9307, 3224, 293, 257, 588, 665, 2446, 281, 439, 295, 291, 8032, 1863, 24793, 1211, 8978, 3714, 2407, 11242, 45367, 2423, 2787, 3385, 6765, 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الرؤية غير واضحة قبل الترميش بعد الترميش هتصبح واضحة طبعا هذه هتكون للحظات يعني بشكل ثوري واضح الفكرة طب لو كانت العدسة flat", "tokens": [5016, 15040, 5016, 19913, 12174, 36150, 16712, 2288, 2304, 1829, 8592, 34892, 33604, 10632, 8978, 11296, 32771, 13546, 4032, 46958, 5016, 3660, 37495, 22653, 6024, 48506, 45164, 1975, 8315, 1975, 16254, 47395, 15844, 2423, 5201, 34892, 33604, 10632, 32771, 13546, 4032, 46958, 5016, 3660, 12174, 36150, 16712, 2288, 2304, 1829, 8592, 39182, 16712, 2288, 2304, 1829, 8592, 8032, 2655, 9381, 49628, 4032, 46958, 5016, 3660, 23032, 3555, 3615, 995, 29538, 8032, 2655, 30544, 5296, 1211, 5016, 19913, 9307, 37495, 22653, 4724, 8592, 28820, 38637, 13063, 1829, 4032, 46958, 5016, 27188, 4117, 25720, 23032, 3555, 45164, 25961, 2655, 18863, 3215, 3794, 3660, 4962], "avg_logprob": -0.1250758445957332, "compression_ratio": 1.8882978723404256, "no_speech_prob": 0.0, "words": [{"start": 140.25, "end": 140.97, "word": "حلاحظ", "probability": 0.78240966796875}, 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flat", "probability": 0.61767578125}], "temperature": 1.0}, {"id": 7, "seek": 18160, "start": 159.52, "end": 181.6, "text": "إذا اللي فلات احنا عارفين انه هيكون فيها excessive movement قبل ما يرمش الرؤية واضحة بعد ما يرمش بيصير اللي هو a blurred vision او unclear vision إذا كيراتوميتر ميارز can be examined يمكن إجراء الفحص on the anterior lens surface", "tokens": [28814, 15730, 13672, 1829, 6156, 1211, 9307, 1975, 5016, 8315, 6225, 9640, 5172, 9957, 16472, 3224, 39896, 30544, 8978, 11296, 22704, 3963, 12174, 36150, 19446, 7251, 2288, 2304, 8592, 34892, 33604, 10632, 4032, 46958, 5016, 3660, 39182, 19446, 7251, 2288, 2304, 8592, 4724, 1829, 9381, 13546, 13672, 1829, 31439, 257, 43525, 5201, 1975, 2407, 517, 43679, 5201, 11933, 15730, 9122, 13546, 9307, 20498, 36081, 2288, 3714, 1829, 9640, 11622, 393, 312, 30972, 7251, 43020, 11933, 7435, 2288, 16606, 27188, 5016, 9381, 322, 264, 22272, 6765, 3753], "avg_logprob": -0.23455459907137113, "compression_ratio": 1.5022421524663676, 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211.78, "word": " distortion", "probability": 0.90771484375}, {"start": 211.78, "end": 212.16, "word": " في", "probability": 0.970703125}, {"start": 212.16, "end": 213.0, "word": " الميارات،", "probability": 0.82783203125}, {"start": 213.0, "end": 213.26, "word": " معنى", "probability": 0.9059244791666666}, {"start": 213.26, "end": 213.74, "word": " الكلام", "probability": 0.9376627604166666}, {"start": 213.74, "end": 214.02, "word": " ان", "probability": 0.495361328125}, {"start": 214.02, "end": 214.74, "word": " العدسة", "probability": 0.9788818359375}, {"start": 214.74, "end": 215.14, "word": " هي", "probability": 0.7021484375}, {"start": 215.14, "end": 215.42, "word": " مش", "probability": 0.99365234375}, {"start": 215.42, "end": 215.96, "word": " optimal", "probability": 0.91015625}, {"start": 215.96, "end": 216.58, "word": " fit", "probability": 0.916015625}], "temperature": 1.0}, {"id": 10, "seek": 24542, "start": 217.38, "end": 245.42, "text": "اما flat او steep بناء على الخطوات اللى تم ذكرها اذا كانت flat هتكون قبل الترميش واضحة بعد الترميش غير واضحة اذا كانت steep قبل الترميش هتكون غير واضحة بعد الترميش هتصبح واضحة اذا هنا عندنا steep vision clear after a blank لو استخدمنا ال visual acuity chart", "tokens": [10943, 995, 4962, 1975, 2407, 16841, 44945, 16606, 15844, 33962, 9566, 2407, 9307, 13672, 7578, 46811, 29910, 37983, 11296, 1975, 15730, 25961, 2655, 4962, 8032, 2655, 30544, 12174, 36150, 16712, 2288, 2304, 1829, 8592, 4032, 46958, 5016, 3660, 39182, 16712, 2288, 2304, 1829, 8592, 32771, 13546, 4032, 46958, 5016, 3660, 1975, 15730, 25961, 2655, 16841, 12174, 36150, 16712, 2288, 2304, 1829, 8592, 8032, 2655, 30544, 32771, 13546, 4032, 46958, 5016, 3660, 39182, 16712, 2288, 2304, 1829, 8592, 8032, 2655, 9381, 49628, 4032, 46958, 5016, 3660, 1975, 15730, 34105, 43242, 8315, 16841, 5201, 1850, 934, 257, 8247, 45164, 44713, 9778, 40448, 8315, 2423, 5056, 696, 21757, 6927], "avg_logprob": -0.12886974577591798, "compression_ratio": 1.919431279620853, 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{"start": 238.86, "end": 239.5, "word": " steep", "probability": 0.80224609375}, {"start": 239.5, "end": 240.16, "word": " vision", "probability": 0.810546875}, {"start": 240.16, "end": 240.8, "word": " clear", "probability": 0.70849609375}, {"start": 240.8, "end": 241.52, "word": " after", "probability": 0.88623046875}, {"start": 241.52, "end": 241.9, "word": " a", "probability": 0.3623046875}, {"start": 241.9, "end": 242.22, "word": " blank", "probability": 0.51806640625}, {"start": 242.22, "end": 242.56, "word": " لو", "probability": 0.96533203125}, {"start": 242.56, "end": 243.3, "word": " استخدمنا", "probability": 0.9534912109375}, {"start": 243.3, "end": 243.52, "word": " ال", "probability": 0.892578125}, {"start": 243.52, "end": 243.8, "word": " visual", "probability": 0.9501953125}, {"start": 243.8, "end": 244.56, "word": " acuity", "probability": 0.7188720703125}, {"start": 244.56, "end": 245.42, "word": " chart", "probability": 0.9130859375}], "temperature": 1.0}, {"id": 11, "seek": 27644, "start": 247.08, "end": 276.44, "text": "الميارز clear after a blink طبعا هذه هتكون للحظات يعني بشكل فوري لثواني معدودة احنا هنلاحظها ك examiners ironing effect انه هيصير هناك تأثير ملاحظين هنا الصورة ال circle كاملة لكن في الشكل هذا انه هتكون unclear والصورة ايش هيصير فيها distortion انه غير واضحة", "tokens": [6027, 2304, 1829, 9640, 11622, 1850, 934, 257, 24667, 23032, 3555, 3615, 995, 29538, 8032, 2655, 30544, 5296, 1211, 5016, 19913, 9307, 37495, 22653, 4724, 8592, 28820, 6156, 13063, 1829, 5296, 12984, 2407, 7649, 1829, 20449, 3215, 23328, 3660, 1975, 5016, 8315, 8032, 1863, 15040, 5016, 19913, 11296, 9122, 1139, 259, 433, 6497, 278, 1802, 16472, 3224, 39896, 9381, 13546, 34105, 4117, 6055, 10721, 12984, 13546, 3714, 15040, 5016, 19913, 9957, 34105, 31767, 13063, 3660, 2423, 6329, 9122, 10943, 37977, 44381, 8978, 25124, 28820, 23758, 16472, 3224, 8032, 2655, 30544, 25636, 16070, 9381, 13063, 3660, 1975, 1829, 8592, 39896, 9381, 13546, 8978, 11296, 28426, 16472, 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"probability": 0.97119140625}, {"start": 264.62, "end": 265.12, "word": " تأثير", "probability": 0.996337890625}, {"start": 265.12, "end": 265.76, "word": " ملاحظين", "probability": 0.832568359375}, {"start": 265.76, "end": 265.98, "word": " هنا", "probability": 0.75634765625}, {"start": 265.98, "end": 266.62, "word": " الصورة", "probability": 0.9827473958333334}, {"start": 266.62, "end": 267.08, "word": " ال", "probability": 0.890625}, {"start": 267.08, "end": 267.46, "word": " circle", "probability": 0.779296875}, {"start": 267.46, "end": 268.02, "word": " كاملة", "probability": 0.9765625}, {"start": 268.02, "end": 268.6, "word": " لكن", "probability": 0.87548828125}, {"start": 268.6, "end": 268.84, "word": " في", "probability": 0.9326171875}, {"start": 268.84, "end": 269.48, "word": " الشكل", "probability": 0.9609375}, {"start": 269.48, "end": 269.92, "word": " هذا", "probability": 0.92724609375}, {"start": 269.92, "end": 270.68, "word": " انه", "probability": 0.908203125}, {"start": 270.68, "end": 271.4, "word": " هتكون", "probability": 0.9794921875}, {"start": 271.4, "end": 271.82, "word": " unclear", "probability": 0.51953125}, {"start": 271.82, "end": 272.68, "word": " والصورة", "probability": 0.8924560546875}, {"start": 272.68, "end": 272.84, "word": " ايش", "probability": 0.776123046875}, {"start": 272.84, "end": 273.26, "word": " هيصير", "probability": 0.9108072916666666}, {"start": 273.26, "end": 273.7, "word": " فيها", "probability": 0.990234375}, {"start": 273.7, "end": 274.48, "word": " distortion", "probability": 0.68408203125}, {"start": 274.48, "end": 275.38, "word": " انه", "probability": 0.92626953125}, {"start": 275.38, "end": 275.7, "word": " غير", "probability": 0.995361328125}, {"start": 275.7, "end": 276.44, "word": " واضحة", "probability": 0.9833984375}], "temperature": 1.0}, {"id": 12, "seek": 30174, "start": 278.76, "end": 301.74, "text": "بالنسبة للفلات هتكون ال vision blurred after بلينك والميارد ديستورتد بعد بلينك ايضا هيكون هناك عنا excessive movement زيادة في الحركة وهذا بتديني انطباع ان العدسة هي flat lens او loose lens", "tokens": [3555, 6027, 1863, 35457, 3660, 24976, 5172, 1211, 9307, 8032, 2655, 30544, 2423, 5201, 43525, 934, 4724, 1211, 9957, 4117, 16070, 2304, 1829, 9640, 3215, 11778, 1829, 14851, 13063, 2655, 3215, 39182, 4724, 1211, 9957, 4117, 1975, 1829, 11242, 995, 8032, 1829, 30544, 34105, 4117, 6225, 8315, 22704, 3963, 30767, 1829, 18513, 3660, 8978, 21542, 31747, 3660, 37037, 15730, 39894, 3215, 9957, 1829, 16472, 9566, 3555, 45761, 16472, 18863, 3215, 3794, 3660, 39896, 4962, 6765, 1975, 2407, 9612, 6765], "avg_logprob": -0.3330078236758709, "compression_ratio": 1.49746192893401, "no_speech_prob": 0.0, "words": [{"start": 278.76, "end": 279.28, "word": "بالنسبة", "probability": 0.972265625}, {"start": 279.28, "end": 279.84, "word": " للفلات", "probability": 0.6211700439453125}, {"start": 279.84, "end": 280.28, "word": " هتكون", "probability": 0.7501627604166666}, {"start": 280.28, "end": 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ال back optic zone radius او بنسميه ال base curve طيب ماهو مفهوم ال base curve ال base curve تفضلي يا نور ايش تعريفه؟ اه اه okay تفضلي يا انسام هو عبارة عن ال", "tokens": [45340, 24401, 3215, 42963, 12610, 31439, 6225, 3555, 9640, 3660, 18871, 2423, 646, 48269, 6668, 15845, 1975, 2407, 44945, 38251, 1829, 3224, 2423, 3096, 7605, 23032, 1829, 3555, 19446, 3224, 2407, 3714, 5172, 3224, 20498, 2423, 3096, 7605, 2423, 3096, 7605, 6055, 5172, 11242, 20292, 35186, 8717, 13063, 1975, 1829, 8592, 37279, 16572, 5172, 3224, 22807, 1975, 3224, 1975, 3224, 1392, 6055, 5172, 11242, 20292, 35186, 16472, 3794, 10943, 31439, 6225, 3555, 9640, 3660, 18871, 2423], "avg_logprob": -0.24086849952672984, "compression_ratio": 1.6951219512195121, "no_speech_prob": 0.0, "words": [{"start": 327.17, "end": 327.89, "word": "المحدد", "probability": 0.9736328125}, {"start": 327.89, "end": 328.47, "word": " الاول", "probability": 0.646728515625}, {"start": 328.47, "end": 328.91, "word": " هو", "probability": 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"end": 370.35, "text": "Okay طيب another answer ما هو مفهوم ال base curve؟ ال base curve كتعريف له هو عبارة عن", "tokens": [8297, 23032, 1829, 3555, 1071, 1867, 19446, 31439, 3714, 5172, 3224, 20498, 2423, 3096, 7605, 22807, 2423, 3096, 7605, 9122, 2655, 3615, 16572, 5172, 46740, 31439, 6225, 3555, 9640, 3660, 18871], "avg_logprob": -0.1436767615377903, "compression_ratio": 1.1764705882352942, "no_speech_prob": 0.0, "words": [{"start": 358.21, "end": 359.19, "word": "Okay", "probability": 0.5029296875}, {"start": 359.19, "end": 360.17, "word": " طيب", "probability": 0.92138671875}, {"start": 360.17, "end": 360.99, "word": " another", "probability": 0.57275390625}, {"start": 360.99, "end": 361.55, "word": " answer", "probability": 0.98681640625}, {"start": 361.55, "end": 363.17, "word": " ما", "probability": 0.80322265625}, {"start": 363.17, "end": 363.39, "word": " هو", "probability": 0.77197265625}, {"start": 363.39, "end": 363.87, "word": " مفهوم", "probability": 0.98291015625}, 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curvature of the lens وبيكون adjacent to the cornea او هو عبارة عن البوستيريور center curvature of the lens وبيكون عامل adjacent to the cornea ملتسق مع مين؟ مع القرنية الان بالنسبة لل back optic zone radius", "tokens": [6027, 3555, 2407, 14851, 13546, 1829, 13063, 24976, 3056, 37638, 295, 264, 6765, 4032, 21292, 30544, 24441, 281, 264, 1181, 22160, 1975, 2407, 31439, 6225, 3555, 9640, 3660, 18871, 29739, 2407, 14851, 13546, 1829, 13063, 3056, 37638, 295, 264, 6765, 4032, 21292, 30544, 6225, 10943, 1211, 24441, 281, 264, 1181, 22160, 3714, 1211, 2655, 3794, 4587, 20449, 3714, 9957, 22807, 20449, 25062, 2288, 1863, 10632, 2423, 7649, 20666, 1863, 35457, 3660, 24976, 646, 48269, 6668, 15845], "avg_logprob": -0.20687905611929955, "compression_ratio": 1.7430167597765363, "no_speech_prob": 0.0, "words": [{"start": 371.11, "end": 372.21, "word": "البوستيريور", "probability": 0.6525530133928571}, {"start": 372.21, "end": 372.59, "word": " لل", "probability": 0.6943359375}, {"start": 372.59, 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"word": " بختار", "probability": 0.85009765625}, {"start": 401.09, "end": 402.37, "word": " base", "probability": 0.12176513671875}, {"start": 402.37, "end": 402.89, "word": " curve", "probability": 0.90283203125}, {"start": 402.89, "end": 403.57, "word": " من", "probability": 0.978515625}, {"start": 403.57, "end": 403.89, "word": " 0", "probability": 0.6416015625}, {"start": 403.89, "end": 404.67, "word": ".6", "probability": 0.986083984375}, {"start": 404.67, "end": 405.55, "word": " mm", "probability": 0.228515625}, {"start": 405.55, "end": 405.97, "word": " ل", "probability": 0.90869140625}, {"start": 405.97, "end": 406.27, "word": " 0", "probability": 0.83544921875}, {"start": 406.27, "end": 406.95, "word": ".8", "probability": 0.994384765625}, {"start": 406.95, "end": 407.75, "word": " mm", "probability": 0.876953125}, {"start": 407.75, "end": 408.45, "word": " flatter", "probability": 0.39892578125}, {"start": 408.45, "end": 409.19, "word": " than", "probability": 0.89453125}, 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"probability": 0.6943359375}, {"start": 551.65, "end": 552.25, "word": " إذا", "probability": 0.80859375}, {"start": 552.25, "end": 552.55, "word": " معنى", "probability": 0.708251953125}, {"start": 552.55, "end": 552.91, "word": " الكلام", "probability": 0.92236328125}, {"start": 552.91, "end": 553.09, "word": " أن", "probability": 0.525390625}, {"start": 553.09, "end": 553.53, "word": " العدسة", "probability": 0.928955078125}, {"start": 553.53, "end": 553.67, "word": " إيش", "probability": 0.7978515625}, {"start": 553.67, "end": 554.17, "word": " هتكون", "probability": 0.8946940104166666}], "temperature": 1.0}, {"id": 23, "seek": 58234, "start": 555.3, "end": 582.34, "text": "بالضبط فيها poor centration يعني العدسة مش ماخدة تمركز مناسب أو جيد if the lens back optic zone radius is too steep the lens may not conform properly to the eye during wear لو كانت العدسة steep إيش هتعمل؟ no sensation at all", "tokens": [3555, 6027, 11242, 3555, 9566, 8978, 11296, 4716, 1489, 2405, 37495, 22653, 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"end": 575.5, "word": " during", "probability": 0.91064453125}, {"start": 575.5, "end": 576.62, "word": " wear", "probability": 0.9375}, {"start": 576.62, "end": 577.34, "word": " لو", "probability": 0.93017578125}, {"start": 577.34, "end": 577.76, "word": " كانت", "probability": 0.9755859375}, {"start": 577.76, "end": 578.44, "word": " العدسة", "probability": 0.9951171875}, {"start": 578.44, "end": 579.0, "word": " steep", "probability": 0.65234375}, {"start": 579.0, "end": 579.74, "word": " إيش", "probability": 0.7317708333333334}, {"start": 579.74, "end": 580.74, "word": " هتعمل؟", "probability": 0.94970703125}, {"start": 580.74, "end": 580.94, "word": " no", "probability": 0.7138671875}, {"start": 580.94, "end": 581.62, "word": " sensation", "probability": 0.9267578125}, {"start": 581.62, "end": 582.06, "word": " at", "probability": 0.98681640625}, {"start": 582.06, "end": 582.34, "word": " all", "probability": 0.95556640625}], "temperature": 1.0}, {"id": 24, "seek": 60548, 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"word": " يعني", "probability": 0.6966552734375}, {"start": 590.02, "end": 591.92, "word": " المكان", "probability": 0.869873046875}, {"start": 591.92, "end": 592.34, "word": " بتاعها", "probability": 0.8123372395833334}, {"start": 592.34, "end": 592.52, "word": " مش", "probability": 0.9697265625}, {"start": 592.52, "end": 592.96, "word": " هيكون", "probability": 0.960693359375}, {"start": 592.96, "end": 593.5, "word": " مناسب", "probability": 0.9137369791666666}, {"start": 593.5, "end": 593.84, "word": " وين", "probability": 0.853271484375}, {"start": 593.84, "end": 594.08, "word": " في", "probability": 0.68505859375}, {"start": 594.08, "end": 594.46, "word": " داخل", "probability": 0.9768880208333334}, {"start": 594.46, "end": 594.8, "word": " العين", "probability": 0.983642578125}, {"start": 594.8, "end": 595.32, "word": " يعني", "probability": 0.78564453125}, {"start": 595.32, "end": 595.7, "word": " ما", "probability": 0.85888671875}, {"start": 595.7, "end": 596.34, "word": " بتاخد", "probability": 0.96923828125}, {"start": 596.34, "end": 597.04, "word": " appropriately", "probability": 0.6162109375}, {"start": 597.04, "end": 597.62, "word": " fit", "probability": 0.947265625}, {"start": 597.62, "end": 598.5, "word": " of", "probability": 0.9658203125}, {"start": 598.5, "end": 598.66, "word": " the", "probability": 0.93115234375}, {"start": 598.66, "end": 598.96, "word": " lens", "probability": 0.9482421875}, {"start": 598.96, "end": 599.4, "word": " inside", "probability": 0.6865234375}, {"start": 599.4, "end": 599.7, "word": " the", "probability": 0.9375}, {"start": 599.7, "end": 599.94, "word": " eye", "probability": 0.919921875}, {"start": 599.94, "end": 600.88, "word": " يعني", "probability": 0.926513671875}, {"start": 600.88, "end": 601.72, "word": " هتتمركز", "probability": 0.9415690104166666}, {"start": 601.72, "end": 602.3, "word": " بشكل", "probability": 0.9918619791666666}, {"start": 602.3, "end": 602.66, "word": " غير", "probability": 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8315, 1975, 1829, 8592, 47525, 7578, 1975, 25957, 1211, 47525, 7578, 1975, 17082, 13546, 1975, 15042, 20666, 3096, 7605, 8978, 29538, 21542, 6027, 3660, 1975, 2407, 8978, 2423, 14196, 1018, 79, 23920, 646, 19490, 366, 1143, 294, 512, 2787, 18059, 23758, 28239, 45367, 2423, 382, 79, 23920, 646, 19490, 16472, 3224, 1975, 8315, 1975, 15042, 47525, 7578, 1975, 17082, 13546, 4724, 38251, 995, 4117, 3660, 9673, 31747, 11622, 1975, 2407, 47525, 7578, 1975, 17082, 13546, 4724, 38251, 995, 4117, 3660, 2135, 2423, 40235], "avg_logprob": -0.19374999717662209, "compression_ratio": 1.7718446601941749, "no_speech_prob": 0.0, "words": [{"start": 606.08, "end": 606.34, "word": "واضح", "probability": 0.9845377604166666}, {"start": 606.34, "end": 606.82, "word": " الفكرة", "probability": 0.8938802083333334}, {"start": 606.82, "end": 607.54, "word": " و", "probability": 0.301025390625}, {"start": 607.54, "end": 607.96, "word": " لذلك", "probability": 0.830078125}, {"start": 607.96, "end": 608.16, "word": 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621.34, "end": 621.98, "word": " lenses", "probability": 0.90234375}, {"start": 621.98, "end": 622.8, "word": " هذا", "probability": 0.771484375}, {"start": 622.8, "end": 623.18, "word": " النوع", "probability": 0.987060546875}, {"start": 623.18, "end": 623.34, "word": " ال", "probability": 0.93994140625}, {"start": 623.34, "end": 623.8, "word": " aspheric", "probability": 0.72265625}, {"start": 623.8, "end": 624.24, "word": " back", "probability": 0.63134765625}, {"start": 624.24, "end": 625.24, "word": " curves", "probability": 0.87255859375}, {"start": 625.24, "end": 626.2, "word": " انه", "probability": 0.7034912109375}, {"start": 626.2, "end": 626.38, "word": " انا", "probability": 0.877685546875}, {"start": 626.38, "end": 626.66, "word": " اما", "probability": 0.95947265625}, {"start": 626.66, "end": 627.02, "word": " بدى", "probability": 0.830078125}, {"start": 627.02, "end": 627.46, "word": " اغير", "probability": 0.9690755208333334}, {"start": 627.46, "end": 629.16, "word": " بسماكة", "probability": 0.727587890625}, {"start": 629.16, "end": 629.84, "word": " المركز", "probability": 0.9718424479166666}, {"start": 629.84, "end": 630.26, "word": " او", "probability": 0.937255859375}, {"start": 630.26, "end": 630.58, "word": " بدى", "probability": 0.846435546875}, {"start": 630.58, "end": 630.96, "word": " اغير", "probability": 0.9772135416666666}, {"start": 630.96, "end": 631.66, "word": " بسماكة", "probability": 0.9736328125}, {"start": 631.66, "end": 631.94, "word": " main", "probability": 0.296630859375}, {"start": 631.94, "end": 632.3, "word": " ال", "probability": 0.9580078125}, {"start": 632.3, "end": 632.66, "word": " peripheral", "probability": 0.87548828125}], "temperature": 1.0}, {"id": 26, "seek": 65185, "start": 633.27, "end": 651.85, "text": "والهدف من ذلك في التغيير انه بدي اعمل العدسة optimal fit طبعا بيكون هذا موجود ال aspheric back curves بال trial case منه بيكون more plus ومنه بيكون more minus حسب الحاجة اللى بحتاجها مين ال examiner", 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{"start": 797.65, "end": 797.89, "word": " two", "probability": 0.93017578125}, {"start": 797.89, "end": 798.47, "word": " millimeter", "probability": 0.4423828125}, {"start": 798.47, "end": 799.37, "word": " ك", "probability": 0.89990234375}, {"start": 799.37, "end": 799.77, "word": " average", "probability": 0.47314453125}], "temperature": 1.0}, {"id": 33, "seek": 81541, "start": 800.67, "end": 815.41, "text": "يعني الان نفترض مثلا ريم كان عندها ال horizontal visible iris diameter اتناش ملي متر في عندي range من اتناش و نص", "tokens": [40228, 22653, 2423, 7649, 8717, 5172, 2655, 43042, 50113, 15040, 12602, 32640, 25961, 43242, 11296, 2423, 12750, 8974, 3418, 271, 14196, 1975, 2655, 1863, 33599, 3714, 20292, 44650, 2288, 8978, 18871, 16254, 3613, 9154, 1975, 2655, 1863, 33599, 4032, 8717, 9381], "avg_logprob": -0.30933778626578196, "compression_ratio": 1.2518518518518518, "no_speech_prob": 0.0, "words": [{"start": 800.67, "end": 800.97, "word": "يعني", "probability": 0.79541015625}, {"start": 800.97, "end": 801.29, "word": " الان", "probability": 0.57720947265625}, {"start": 801.29, "end": 801.77, "word": " نفترض", "probability": 0.9737548828125}, {"start": 801.77, "end": 802.23, "word": " مثلا", "probability": 0.927490234375}, {"start": 802.23, "end": 803.23, "word": " ريم", "probability": 0.6331787109375}, {"start": 803.23, "end": 803.53, "word": " كان", "probability": 0.98193359375}, {"start": 803.53, "end": 804.11, "word": " عندها", "probability": 0.993408203125}, {"start": 804.11, "end": 804.43, "word": " ال", "probability": 0.89990234375}, {"start": 804.43, "end": 805.09, "word": " horizontal", "probability": 0.323974609375}, {"start": 805.09, "end": 807.07, "word": " visible", "probability": 0.54345703125}, {"start": 807.07, "end": 807.75, "word": " iris", "probability": 0.934326171875}, {"start": 807.75, "end": 808.51, "word": " diameter", "probability": 0.425537109375}, {"start": 808.51, "end": 810.71, "word": " اتناش", "probability": 0.55535888671875}, 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0.546875}, {"start": 847.62, "end": 847.96, "word": " عنا", "probability": 0.6727294921875}, {"start": 847.96, "end": 848.28, "word": " بده", "probability": 0.6484375}, {"start": 848.28, "end": 848.66, "word": " يكون", "probability": 0.993896484375}, {"start": 848.66, "end": 849.24, "word": " ال", "probability": 0.97216796875}, {"start": 849.24, "end": 849.7, "word": " diameter", "probability": 0.60009765625}, {"start": 849.7, "end": 850.0, "word": " اللي", "probability": 0.82861328125}, {"start": 850.0, "end": 850.28, "word": " بده", "probability": 0.86376953125}, {"start": 850.28, "end": 850.82, "word": " اختاره", "probability": 0.9578857421875}, {"start": 850.82, "end": 851.54, "word": " للعدسة", "probability": 0.9312744140625}, {"start": 851.54, "end": 852.26, "word": " اكبر", "probability": 0.91357421875}, {"start": 852.26, "end": 852.46, "word": " من", "probability": 0.99609375}, {"start": 852.46, "end": 852.58, "word": " ال", "probability": 0.63720703125}, {"start": 852.58, "end": 853.04, "word": " horizontal", "probability": 0.60693359375}, {"start": 853.04, "end": 853.66, "word": " visible", "probability": 0.771484375}, {"start": 853.66, "end": 854.14, "word": " iris", "probability": 0.9541015625}, {"start": 854.14, "end": 854.68, "word": " diameter", "probability": 0.9130859375}, {"start": 854.68, "end": 855.8, "word": " بقيمة", "probability": 0.921630859375}, {"start": 855.8, "end": 856.06, "word": " من", "probability": 0.99267578125}, {"start": 856.06, "end": 856.42, "word": " نص", "probability": 0.969970703125}, {"start": 856.42, "end": 856.8, "word": " الى", "probability": 0.6796875}, {"start": 856.8, "end": 857.16, "word": " اتنين", "probability": 0.8433837890625}, {"start": 857.16, "end": 857.66, "word": " ملي", "probability": 0.796630859375}, {"start": 857.66, "end": 858.08, "word": " متر", "probability": 0.6136474609375}], "temperature": 1.0}, {"id": 36, "seek": 88342, "start": 858.92, "end": 883.42, "text": "لأن بعض الأحيان بكون عند ال visible iris diameter اتناش لازم اربعتاش طيب غير متوفر في السوق ايش اعمل؟ بجيب مثلا اتناش و نص او تلتاش او بجيب مثلا تلتاش و نص يعني بحاول ان اغير في مين في ال number طبعا احنا العدسات اللاصقة اللينة اللي متوفرة عندنا في قطاع غزة فيه هناك fixed value", "tokens": [1211, 33456, 45030, 11242, 16247, 5016, 1829, 7649, 4724, 30544, 43242, 2423, 8974, 3418, 271, 14196, 1975, 2655, 1863, 33599, 5296, 31377, 2304, 1975, 25513, 34268, 33599, 23032, 1829, 3555, 32771, 13546, 44650, 38688, 2288, 8978, 21136, 30543, 1975, 1829, 8592, 1975, 25957, 1211, 22807, 4724, 7435, 1829, 3555, 50113, 15040, 1975, 2655, 1863, 33599, 4032, 8717, 9381, 1975, 2407, 6055, 1211, 2655, 33599, 1975, 2407, 4724, 7435, 1829, 3555, 50113, 15040, 6055, 1211, 2655, 33599, 4032, 8717, 9381, 37495, 22653, 4724, 5016, 995, 12610, 16472, 1975, 17082, 13546, 8978, 3714, 9957, 8978, 2423, 1230, 23032, 3555, 3615, 995, 1975, 5016, 8315, 18863, 3215, 3794, 9307, 13672, 33546, 28671, 13672, 9957, 3660, 13672, 1829, 44650, 38688, 25720, 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{"start": 873.32, "end": 873.54, "word": " ان", "probability": 0.7412109375}, {"start": 873.54, "end": 874.04, "word": " اغير", "probability": 0.9620768229166666}, {"start": 874.04, "end": 874.26, "word": " في", "probability": 0.69873046875}, {"start": 874.26, "end": 874.48, "word": " مين", "probability": 0.87646484375}, {"start": 874.48, "end": 874.88, "word": " في", "probability": 0.6875}, {"start": 874.88, "end": 874.98, "word": " ال", "probability": 0.9375}, {"start": 874.98, "end": 875.32, "word": " number", "probability": 0.97802734375}, {"start": 875.32, "end": 876.46, "word": " طبعا", "probability": 0.983154296875}, {"start": 876.46, "end": 876.74, "word": " احنا", "probability": 0.9833984375}, {"start": 876.74, "end": 877.34, "word": " العدسات", "probability": 0.9815673828125}, {"start": 877.34, "end": 877.9, "word": " اللاصقة", "probability": 0.89697265625}, {"start": 877.9, "end": 878.58, "word": " اللينة", "probability": 0.8240559895833334}, {"start": 878.58, "end": 879.04, 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diameter من 12 ل 12.75", "tokens": [1211, 2304, 2407, 11242, 45367, 2423, 14196, 39894, 15040, 38436, 11296, 9154, 3499, 5296, 3499, 13, 20, 3714, 20292, 2304, 2655, 2288, 36764, 34268, 28543, 39896, 3714, 1211, 16373, 46007, 32767, 3615, 19913, 2304, 8315, 5296, 7649, 9673, 3615, 19913, 2304, 43242, 8315, 2423, 12750, 8974, 3418, 271, 14196, 9154, 2272, 5296, 2272, 13, 11901], "avg_logprob": -0.21861049479671887, "compression_ratio": 1.3246753246753247, "no_speech_prob": 5.960464477539063e-08, "words": [{"start": 883.64, "end": 884.98, "word": "لموضوع", "probability": 0.751806640625}, {"start": 884.98, "end": 885.26, "word": " ال", "probability": 0.9775390625}, {"start": 885.26, "end": 885.74, "word": " diameter", "probability": 0.40869140625}, {"start": 885.74, "end": 886.6, "word": " بتلاقيها", "probability": 0.886474609375}, {"start": 886.6, "end": 886.76, "word": " من", "probability": 0.98828125}, {"start": 886.76, "end": 887.22, "word": " 14", "probability": 0.329345703125}, 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"duration_after_vad": 1753.779374999996} \ No newline at end of file diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/bwhB5ZI4dt4_raw.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/bwhB5ZI4dt4_raw.srt new file mode 100644 index 0000000000000000000000000000000000000000..6b95d7c35b9d23483dc94db0c05ecda2cd4b99c3 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/bwhB5ZI4dt4_raw.srt @@ -0,0 +1,1400 @@ +1 +00:00:20,750 --> 00:00:23,950 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:23,950 --> 00:00:27,310 +وبركاته and a very good morning to all of you + +3 +00:00:27,310 --> 00:00:32,550 +هنكمل في موضوع ال soft contact lens evaluation and + +4 +00:00:32,550 --> 00:00:37,850 +fitting فى عندنا التقييم الأخير ال keratometer + +5 +00:00:37,850 --> 00:00:46,070 +measures طبعا فى هذا النوع فى عندنا ال keratometer + +6 +00:00:46,070 --> 00:00:48,850 +measures + +7 +00:00:52,130 --> 00:00:58,230 +أو الـ visual acuity chart و + +8 +00:00:58,230 --> 00:01:07,950 +ال retina scope reflex بداية + +9 +00:01:07,950 --> 00:01:15,130 +إذا كان الشخص العدسة اللي لبسها optimal fit before + +10 +00:01:15,130 --> 00:01:20,920 +و after blink هنشوف ال red reflex واطحبالـ retina + +11 +00:01:20,920 --> 00:01:25,120 +scope أو الـ chart اللي خاصة في الـ visual acuity + +12 +00:01:25,120 --> 00:01:30,390 +هتكون واضحةأو ال مياردز اللي خاصة في جهاز ال bush + +13 +00:01:30,390 --> 00:01:34,670 +and lum طبعا الجهاز هذا معطل حاليا عندنا في القسم + +14 +00:01:34,670 --> 00:01:40,270 +لكن جهاز ال bush and lum هو بيعمل نفس وظيفة الجوال + +15 +00:01:40,270 --> 00:01:44,630 +كيراتوميتر لكن الفرق بين الاتنين ان ال bush and + +16 +00:01:44,630 --> 00:01:49,150 +lum بياخد الصورة للمحورين او القراءات ال + +17 +00:01:49,150 --> 00:01:53,410 +measurement ل ال two readings at the same time لل + +18 +00:01:53,410 --> 00:01:57,870 +vertical و ال horizontalطبعا في محور بيمثل ال + +19 +00:01:57,870 --> 00:02:02,510 +vertical و المحور التاني بيمثل ال horizontal او + +20 +00:02:02,510 --> 00:02:08,250 +بمعنى اخر محور هيكون along ninety degree و المحور + +21 +00:02:08,250 --> 00:02:13,750 +التاني هيكون along one hundred eighty degree طيب + +22 +00:02:13,750 --> 00:02:18,290 +الان لو كان انسان عنده steep العدسة اللي لابسها + +23 +00:02:18,290 --> 00:02:24,510 +كانت steepحلاحظ قبل الترميش الرؤية فيها غير واضحة + +24 +00:02:24,510 --> 00:02:27,690 +يعني الآن لو انا اديته على ال vision الرؤية غير + +25 +00:02:27,690 --> 00:02:32,730 +واضحة قبل الترميش بعد الترميش هتصبح واضحة طبعا هذه + +26 +00:02:32,730 --> 00:02:37,750 +هتكون للحظات يعني بشكل ثوري واضح الفكرة طب لو كانت + +27 +00:02:37,750 --> 00:02:41,700 +العدسة flatإذا اللي فلات احنا عارفين انه هيكون + +28 +00:02:41,700 --> 00:02:46,380 +فيها excessive movement قبل ما يرمش الرؤية واضحة + +29 +00:02:46,380 --> 00:02:50,760 +بعد ما يرمش بيصير اللي هو a blurred vision او + +30 +00:02:50,760 --> 00:02:56,420 +unclear vision إذا كيراتوميتر ميارز can be + +31 +00:02:56,420 --> 00:03:00,960 +examined يمكن إجراء الفحص on the anterior lens + +32 +00:03:00,960 --> 00:03:06,120 +surfaceto detect any lens distortion on the eye + +33 +00:03:06,120 --> 00:03:10,040 +طبعا بعد ما المريض يرتدي العدسة او يعمل insertion + +34 +00:03:10,040 --> 00:03:15,040 +للعدسة بشوف ال evaluation التقييم من خلال جهاز + +35 +00:03:15,040 --> 00:03:17,480 +البوش اندلوم كيراتوميتر + +36 +00:03:19,900 --> 00:03:23,460 +Any ميار irregularity would be considered + +37 +00:03:23,460 --> 00:03:28,140 +abnormal، إذا أي حاجة بيكون فيها عدم انتظام + +38 +00:03:28,140 --> 00:03:32,160 +بالصورة بالشكل هادي، يعني بمعنى انه distortion في + +39 +00:03:32,160 --> 00:03:36,580 +الميارات، معنى الكلام ان العدسة هي مش optimal fit + +40 +00:03:37,380 --> 00:03:42,460 +اما flat او steep بناء على الخطوات اللى تم ذكرها + +41 +00:03:42,460 --> 00:03:48,460 +اذا كانت flat هتكون قبل الترميش واضحة بعد الترميش + +42 +00:03:48,460 --> 00:03:53,140 +غير واضحة اذا كانت steep قبل الترميش هتكون غير + +43 +00:03:53,140 --> 00:03:59,500 +واضحة بعد الترميش هتصبح واضحة اذا هنا عندنا steep + +44 +00:03:59,500 --> 00:04:03,800 +vision clear after a blank لو استخدمنا ال visual + +45 +00:04:03,800 --> 00:04:12,200 +acuity chartالميارز clear after a blink طبعا هذه + +46 +00:04:12,200 --> 00:04:17,800 +هتكون للحظات يعني بشكل فوري لثواني معدودة احنا + +47 +00:04:17,800 --> 00:04:24,620 +هنلاحظها ك examiners ironing effect انه هيصير هناك + +48 +00:04:24,620 --> 00:04:28,840 +تأثير ملاحظين هنا الصورة ال circle كاملة لكن في + +49 +00:04:28,840 --> 00:04:33,700 +الشكل هذا انه هتكون unclear والصورة ايش هيصير فيها + +50 +00:04:33,700 --> 00:04:36,440 +distortion انه غير واضحة + +51 +00:04:38,760 --> 00:04:43,400 +بالنسبة للفلات هتكون ال vision blurred after بلينك + +52 +00:04:43,400 --> 00:04:52,080 +والميارد ديستورتد بعد بلينك ايضا هيكون هناك عنا + +53 +00:04:52,080 --> 00:04:56,920 +excessive movement زيادة في الحركة وهذا بتديني + +54 +00:04:56,920 --> 00:05:01,740 +انطباع ان العدسة هي flat lens او loose lens + +55 +00:05:05,120 --> 00:05:09,620 +Selection of a lens for fitting requires the + +56 +00:05:09,620 --> 00:05:16,000 +choice of parameters الآن حتى يتم اختيار ملائم او + +57 +00:05:16,000 --> 00:05:22,000 +اختيار مناسب للعدسة لازم ان يتوفر في العدسة مجموعة + +58 +00:05:22,000 --> 00:05:28,470 +من ال parameters او مجموعة من المحدداتالمحدد الاول + +59 +00:05:28,470 --> 00:05:34,130 +هو عبارة عن ال back optic zone radius او بنسميه ال + +60 +00:05:34,130 --> 00:05:42,710 +base curve طيب ماهو مفهوم ال base curve ال + +61 +00:05:42,710 --> 00:05:50,110 +base curve تفضلي يا نور ايش تعريفه؟ اه اه okay + +62 +00:05:50,110 --> 00:05:53,250 +تفضلي يا انسام هو عبارة عن ال + +63 +00:05:58,210 --> 00:06:05,750 +Okay طيب another answer ما هو مفهوم ال base curve؟ + +64 +00:06:05,750 --> 00:06:12,590 +ال base curve كتعريف له هو عبارة عنالبوستيريور لل + +65 +00:06:12,590 --> 00:06:18,270 +center curvature of the lens وبيكون adjacent to + +66 +00:06:18,270 --> 00:06:23,190 +the cornea او هو عبارة عن البوستيريور center + +67 +00:06:23,190 --> 00:06:27,610 +curvature of the lens وبيكون عامل adjacent to the + +68 +00:06:27,610 --> 00:06:34,950 +cornea ملتسق مع مين؟ مع القرنية الان بالنسبة لل + +69 +00:06:34,950 --> 00:06:37,850 +back optic zone radius + +70 +00:06:39,330 --> 00:06:47,750 +غالبا انا بختار base curve من 0.6 mm ل 0.8 mm + +71 +00:06:47,750 --> 00:06:51,410 +flatter than the average corneal curvature + +72 +00:06:51,410 --> 00:06:57,090 +measured with keratometry نشوف هذا الكلام بمثال + +73 +00:06:57,090 --> 00:07:03,390 +نفترض + +74 +00:07:03,390 --> 00:07:07,250 +عندنا ال K1 40 + +75 +00:07:09,150 --> 00:07:19,710 +ديوبتر وال K2 واحد واربعين ديوبتر ال R1 تمانية + +76 +00:07:19,710 --> 00:07:30,050 +واربعة ال R2 تمانية واتنين okay الآن بدنا ناخد ال + +77 +00:07:30,050 --> 00:07:37,060 +K averageهيكون اربعين و نص اذا ال R average كده + +78 +00:07:37,060 --> 00:07:41,800 +هيكون تمانية و تلاتة According to American Academy + +79 +00:07:41,800 --> 00:07:47,800 +بيحكيلك انه لازم انا اعمل اضافة من ستة من عشرة + +80 +00:07:47,800 --> 00:07:53,940 +لتمانية من عشرة لقيمة ال base curve average واضحة؟ + +81 +00:07:54,510 --> 00:07:59,210 +إذا في حالة ال soft contact lens بدي أضيف من 6 من + +82 +00:07:59,210 --> 00:08:05,730 +10 ل 8 من 10 على ال R average هذه كإضافة طيب إيش + +83 +00:08:05,730 --> 00:08:10,270 +ال function أو ال task؟ ليش إحنا بنضيف هذا الرقم؟ + +84 +00:08:10,270 --> 00:08:14,050 +إحنا بنعرف إن ال diameter ل ال soft contact lens + +85 +00:08:14,050 --> 00:08:19,190 +أكبر من ال diameter لمين؟ للكورنية طيب لو أنا بدي + +86 +00:08:19,190 --> 00:08:23,870 +أقلل ال diameterأيش بدي أعمل من الحلول؟ بدي أزود + +87 +00:08:23,870 --> 00:08:27,950 +ال base care لذلك انا بختار base care ان يكون + +88 +00:08:27,950 --> 00:08:34,170 +قيمته اعلى من ال R average من 6 من 10 ل 8 من 10 + +89 +00:08:34,170 --> 00:08:39,990 +اذا الهدف من ذلك ان اقلل من ال diameter يعني في + +90 +00:08:39,990 --> 00:08:46,310 +بعض الأحيان احنا بنطلب diameter 13.5 طب غير متوفر + +91 +00:08:46,310 --> 00:08:50,570 +في الشركة 13.5 بنروح نلعب في مين؟ في ال base care + +92 +00:08:51,070 --> 00:08:58,670 +لأن الاتنين في بينهم relationship if + +93 +00:08:58,670 --> 00:09:03,630 +a lens back optic zone radius is too flat for the + +94 +00:09:03,630 --> 00:09:09,150 +cornea lens centration may be poor إذا كان عندنا + +95 +00:09:09,150 --> 00:09:13,530 +ال base curve هنا flat إذا معنى الكلام أن العدسة + +96 +00:09:13,530 --> 00:09:18,900 +إيش هتكونبالضبط فيها poor centration يعني العدسة + +97 +00:09:18,900 --> 00:09:26,300 +مش ماخدة تمركز مناسب أو جيد if the + +98 +00:09:26,300 --> 00:09:31,300 +lens back optic zone radius is too steep the lens + +99 +00:09:31,300 --> 00:09:37,340 +may not conform properly to the eye during wear لو + +100 +00:09:37,340 --> 00:09:42,340 +كانت العدسة steep إيش هتعمل؟ no sensation at all + +101 +00:09:43,100 --> 00:09:47,900 +المريض مش هيشعر نهائي بالعدسة صحيح؟ فالان العدسة + +102 +00:09:47,900 --> 00:09:53,500 +ما هيكونش إلها يعني المكان بتاعها مش هيكون مناسب + +103 +00:09:53,500 --> 00:09:57,620 +وين في داخل العين يعني ما بتاخد appropriately fit + +104 +00:09:57,620 --> 00:10:02,660 +of the lens inside the eye يعني هتتمركز بشكل غير + +105 +00:10:02,660 --> 00:10:07,960 +ملائم أو غير مناسب في داخل العينواضح الفكرة و لذلك + +106 +00:10:07,960 --> 00:10:11,260 +انا ايش بدى اعمل بدى اغير اما بال base curve في + +107 +00:10:11,260 --> 00:10:18,020 +هذه الحالة او في ال diameter Aspheric + +108 +00:10:18,020 --> 00:10:23,180 +back curves are used in some soft lenses هذا النوع + +109 +00:10:23,180 --> 00:10:27,460 +ال aspheric back curves انه انا اما بدى اغير + +110 +00:10:27,460 --> 00:10:32,300 +بسماكة المركز او بدى اغير بسماكة main ال + +111 +00:10:32,300 --> 00:10:36,730 +peripheralوالهدف من ذلك في التغيير انه بدي اعمل + +112 +00:10:36,730 --> 00:10:41,330 +العدسة optimal fit طبعا بيكون هذا موجود ال + +113 +00:10:41,330 --> 00:10:45,870 +aspheric back curves بال trial case منه بيكون more + +114 +00:10:45,870 --> 00:10:50,610 +plus ومنه بيكون more minus حسب الحاجة اللى بحتاجها + +115 +00:10:50,610 --> 00:10:51,850 +مين ال examiner + +116 +00:10:55,590 --> 00:11:00,850 +available in flat أو available in steep طبعا و كل + +117 +00:11:00,850 --> 00:11:05,290 +هدمين بيستخدمها ال manufacturer المصنعين بيخلوها + +118 +00:11:05,290 --> 00:11:06,910 +في ال trial case + +119 +00:11:09,240 --> 00:11:13,100 +The lens curvature is slightly flatter + +120 +00:11:13,100 --> 00:11:17,540 +peripherally than centrally to more closely match + +121 +00:11:17,540 --> 00:11:21,640 +the average corneal shape يعني هو بيحاول انه يغير + +122 +00:11:21,640 --> 00:11:26,320 +بتمركز العدسة سواء من ال center او ال peripheral + +123 +00:11:26,320 --> 00:11:31,780 +للوصول الى افضل fitting للعدسة اما باستخدام flat + +124 +00:11:31,780 --> 00:11:33,580 +او steep a base curve + +125 +00:11:36,330 --> 00:11:40,630 +For such lenses, the manufacturer usually has + +126 +00:11:40,630 --> 00:11:45,190 +recommendations as to which lens curvature to + +127 +00:11:45,190 --> 00:11:49,370 +trial fit in the first instance بعض الشركات اللي + +128 +00:11:49,370 --> 00:11:53,050 +بنتعامل معها بيحكيلك إنه دايما في ال contact lens + +129 +00:11:53,050 --> 00:12:00,210 +خديه إفلات وستيبممكن ببعض الأحيان انه يكون ال + +130 +00:12:00,210 --> 00:12:04,890 +prescription اللي انت وصفتيه للمريض 100% تماما و + +131 +00:12:04,890 --> 00:12:09,530 +بناء على دراسات سابقة و بناء على table معين لكن مع + +132 +00:12:09,530 --> 00:12:13,890 +ذلك مايكونش مناسب للمريض طيب انا ك examiner كيف + +133 +00:12:13,890 --> 00:12:18,310 +بدي اتخلص من هذا الأمر؟ بستخدم اما EFLAT او steep + +134 +00:12:18,310 --> 00:12:21,770 +pace curve للوصول لل optimal fit + +135 +00:12:26,090 --> 00:12:30,070 +بالنسبة للـ total diameter الـ diameter للعدسة هو + +136 +00:12:30,070 --> 00:12:36,030 +عبارة عن ايه ال width من الطرف للطرف الآخر للعدسة + +137 +00:12:36,030 --> 00:12:41,910 +يعني من ال edge to the edge طبعا ال ال soft + +138 +00:12:41,910 --> 00:12:46,990 +contact lens بتتميز بأنه بيكون لها large diameter + +139 +00:12:46,990 --> 00:12:51,010 +compared to the corner أخدنا ال average diameter + +140 +00:12:52,270 --> 00:12:57,630 +تقريبا من تلتاش و نص لخمساش و في بعض الكتب من اربع + +141 +00:12:57,630 --> 00:13:04,350 +تاش لخمساش ملي متر اذا هي تعتبر larger than the + +142 +00:13:04,350 --> 00:13:08,910 +cornea total + +143 +00:13:08,910 --> 00:13:15,630 +diameter usually selected as about هان بدنا نغير + +144 +00:13:15,630 --> 00:13:19,770 +الرقم او point five to two millimeter ك average + +145 +00:13:20,670 --> 00:13:25,090 +يعني الان نفترض مثلا ريم كان عندها ال horizontal + +146 +00:13:25,090 --> 00:13:33,950 +visible iris diameter اتناش ملي متر في عندي range + +147 +00:13:33,950 --> 00:13:41,710 +من اتناش و نصلحد الاربعتاشر ملي متر ممكن ان انا + +148 +00:13:41,710 --> 00:13:47,250 +ايه اختاره طبعا كل هذا مابجيش بطريقة عشوائية انا + +149 +00:13:47,250 --> 00:13:51,750 +بعد ما بختار ال diameter لازم اعمل evaluation من + +150 +00:13:51,750 --> 00:14:00,920 +خلال الUsually selected as about 0.5 to 2 mm + +151 +00:14:00,920 --> 00:14:05,880 +greater than the patient's horizontal visible iris + +152 +00:14:05,880 --> 00:14:10,280 +diameter اذا عنا بده يكون ال diameter اللي بده + +153 +00:14:10,280 --> 00:14:14,140 +اختاره للعدسة اكبر من ال horizontal visible iris + +154 +00:14:14,140 --> 00:14:19,420 +diameter بقيمة من نص الى اتنين ملي مترلأن بعض + +155 +00:14:19,420 --> 00:14:23,200 +الأحيان بكون عند ال visible iris diameter اتناش + +156 +00:14:23,200 --> 00:14:28,520 +لازم اربعتاش طيب غير متوفر في السوق ايش اعمل؟ بجيب + +157 +00:14:28,520 --> 00:14:32,220 +مثلا اتناش و نص او تلتاش او بجيب مثلا تلتاش و نص + +158 +00:14:32,220 --> 00:14:36,740 +يعني بحاول ان اغير في مين في ال number طبعا احنا + +159 +00:14:36,740 --> 00:14:40,420 +العدسات اللاصقة اللينة اللي متوفرة عندنا في قطاع + +160 +00:14:40,420 --> 00:14:45,740 +غزة فيه هناك fixed valueلموضوع ال diameter + +161 +00:14:45,740 --> 00:14:51,300 +بتلاقيها من 14 ل 14.5 مليمتر واعتقد هي ملائمة + +162 +00:14:51,300 --> 00:14:55,400 +لمعظمنا لان المعظم عندنا ال horizontal visible + +163 +00:14:55,400 --> 00:14:58,340 +iris diameter من 12 ل 12.75 + +164 +00:15:02,370 --> 00:15:08,110 +a lens that is too large يمّا يكون العدسة قطرها + +165 +00:15:08,110 --> 00:15:13,570 +كبير خالص، هذه إيش هتميل؟ to show low amounts of + +166 +00:15:13,570 --> 00:15:18,410 +movement يعني الحركة تحت العدسة هتقل، هتكون أقل من + +167 +00:15:18,410 --> 00:15:24,070 +نص مليمتر وبالتالي إنه هتعمل إيه؟ تأثير على تبادل + +168 +00:15:24,070 --> 00:15:28,610 +التير، يعني ممكن إنه يسبب في هذه الحالة corneal + +169 +00:15:28,610 --> 00:15:33,500 +edemaيعني بعض الأشخاص بيجيوا عندك على ال clinic او + +170 +00:15:33,500 --> 00:15:36,740 +على ال center بيقولك انا بدي عدسة يكون ال diameter + +171 +00:15:36,740 --> 00:15:42,480 +بتاعها كبير لكن انت بدك تشرحيله انه ايش هي مضاعفات + +172 +00:15:42,480 --> 00:15:46,920 +او تأثير ال large diameter انه ممكن هي السبب + +173 +00:15:46,920 --> 00:15:51,200 +corneal edema ليه؟ لأنه هيقل من حركتها وبالتالي + +174 +00:15:51,200 --> 00:15:57,000 +هيقل من ال tear exchange للعدسة لو كانت العدسة + +175 +00:15:57,000 --> 00:16:02,350 +smallهتكون more excessively يعني بمعنى إن حركتها + +176 +00:16:02,350 --> 00:16:07,790 +سريعة show poor concentration التمركز تاعها هيكون + +177 +00:16:07,790 --> 00:16:12,470 +ضعيف أو غير ملائم and be less comfortable to wear + +178 +00:16:12,470 --> 00:16:17,050 +إنه هتكون غير ملائمة أو غير مريحة بالنسبة لمين لل + +179 +00:16:17,050 --> 00:16:17,630 +patient + +180 +00:16:23,240 --> 00:16:28,400 +اذا اخدنا ال base curve ال total diameter النقطة + +181 +00:16:28,400 --> 00:16:32,440 +التالتة والمهمة هي ال oxygen transmissibility + +182 +00:16:32,440 --> 00:16:38,040 +نفاذية ال oxygen طبعا ال oxygen transmissibility + +183 +00:16:38,040 --> 00:16:45,340 +القانون ديكي على Tdirectly appropriational علاقة + +184 +00:16:45,340 --> 00:16:49,200 +تردية to the oxygen permeability of the lens + +185 +00:16:49,200 --> 00:16:54,180 +material إذا تتناسب تناسبا ترديا مع نفاذية + +186 +00:16:54,180 --> 00:17:01,060 +الأكسجين أو دخول الأكسجين inversely related علاقة + +187 +00:17:01,060 --> 00:17:05,320 +عكسية to the lens average thickness إذا بتتناسب + +188 +00:17:05,320 --> 00:17:08,240 +تناسب عكسي مع سماكة العدسة + +189 +00:17:10,590 --> 00:17:15,110 +Under open eye conditions or conventional daily + +190 +00:17:15,110 --> 00:17:19,030 +wear يعني + +191 +00:17:19,030 --> 00:17:23,410 +عدسات اللبس اليومي التقليدي بمعنى ان المريض بلبسها + +192 +00:17:23,410 --> 00:17:27,710 +اربع ساعات خمس ساعات قد تصل الى اتناشر ساعة وبعد + +193 +00:17:27,710 --> 00:17:33,790 +ذلك ايه؟ برفع العدسة هذه النوع من العدسات بديكون + +194 +00:17:33,790 --> 00:17:39,100 +فيها ال decay على T moderate صحيح؟Are usually + +195 +00:17:39,100 --> 00:17:44,300 +suitable غالبا هيكون ملائم او مناسب بالنسبة للمريض + +196 +00:17:44,300 --> 00:17:47,780 +طيب الان لو سألنا سؤال ل سيهام لو عملنا في هذه + +197 +00:17:47,780 --> 00:17:51,900 +الحالة من العدسات عملنا high water content ايش + +198 +00:17:51,900 --> 00:17:57,760 +هيصير؟ بتضبط ان فترة حياة العدسة هتقل و هتصير اللي + +199 +00:17:57,760 --> 00:18:04,160 +هي more fragile هتصير هشة و بالتالي انه مش هتعيش + +200 +00:18:04,160 --> 00:18:11,300 +فترة زمانية طويلةUnder a closed eye conditions زي + +201 +00:18:11,300 --> 00:18:15,320 +مثلا ال Extended wear lenses العدسات اللي بتتم + +202 +00:18:15,320 --> 00:18:20,280 +ارتدائها لمدة أسبوع واحد وبعد ذلك بتخلص منها الشخص + +203 +00:18:20,280 --> 00:18:24,380 +هذه لازم يكون فيها ال DK على T very high عشان ما + +204 +00:18:24,380 --> 00:18:30,440 +يسبب ال corneal اديمة Back + +205 +00:18:30,440 --> 00:18:35,440 +vertex power بالتأكيد بتعتمد على مين القوة الصحيحة + +206 +00:18:35,440 --> 00:18:41,940 +للعدسةبمعنى لو مريض بلبس minus تلاتة بده D minus + +207 +00:18:41,940 --> 00:18:46,420 +تلاتة لو بلبس minus خمسة بده دخله على قانون F ال + +208 +00:18:46,420 --> 00:18:50,500 +contact lens بساوي F الاسفير لل lens على واحد ناقص + +209 +00:18:50,500 --> 00:18:57,480 +D في F الاسفير لل lensa fixed lens thickness, a + +210 +00:18:57,480 --> 00:19:01,900 +profile, a profile and average thickness اذا هو + +211 +00:19:01,900 --> 00:19:07,380 +بتأثر في سماكة العدسة okay طبعا كل ما كان الشخص + +212 +00:19:07,380 --> 00:19:12,780 +high emetropia هيكون عنده high thickness حزيد + +213 +00:19:12,780 --> 00:19:18,300 +صحيح؟ لذلك ان بعض .. كيف يعني؟ + +214 +00:19:24,070 --> 00:19:29,250 +لأ هان ال sphere يعني مثلا minus تلاتة يعني مثلا + +215 +00:19:29,250 --> 00:19:33,170 +لو واحد عنده minus عفوا تمانية هان ايش تعتبر؟ ده + +216 +00:19:33,170 --> 00:19:37,290 +يبتر ال sphere اه نوصف اللي هو ايه soft contact + +217 +00:19:37,290 --> 00:19:41,590 +lens او spherical soft contact lens لكن يمكن انت + +218 +00:19:41,590 --> 00:19:45,030 +بتقصدي لو كان هاي سلندر okay + +219 +00:19:48,290 --> 00:19:53,830 +consequently or so لذلك many lens attributes are + +220 +00:19:53,830 --> 00:19:58,250 +affected, including decay over T, fitting and + +221 +00:19:58,250 --> 00:20:02,150 +handling في تلت شغلات مهمة في العدسات اللاصقة + +222 +00:20:02,150 --> 00:20:07,890 +اللينة، الآن انا لو زودت ال decay على T، ال + +223 +00:20:07,890 --> 00:20:12,410 +thickness العدسة اشمالها بقل، بالتالي في هناك + +224 +00:20:12,410 --> 00:20:16,890 +صعوبة انه امسك من العدسة، يعني العدسة بتصير too + +225 +00:20:16,890 --> 00:20:23,500 +thinطيب قللت ال DK على T، ال thickness هيزيد، مسك + +226 +00:20:23,500 --> 00:20:28,340 +العدسة هيصير سهل، okay؟ يعني دايما في عملية ال + +227 +00:20:28,340 --> 00:20:31,960 +evaluation لل soft contact lens، حُط التلاش شغلات + +228 +00:20:31,960 --> 00:20:35,580 +هدول، DK على T، thickness and ال handling + +229 +00:20:39,530 --> 00:20:43,790 +contact lens power differs significantly from + +230 +00:20:43,790 --> 00:20:48,550 +spectacle lens power for powers greater than 4 + +231 +00:20:48,550 --> 00:20:52,490 +diopter إذا كانت أكتر من أربع ديوبتر نستخدم + +232 +00:20:52,490 --> 00:20:57,630 +القانون الخاص بالعدسات اللاصقة the required + +233 +00:20:57,630 --> 00:21:01,050 +contact lens power is needed to be calculated + +234 +00:21:12,980 --> 00:21:19,900 +Lens thickness سماكة العدسة The + +235 +00:21:19,900 --> 00:21:25,700 +majority of current lenses are made as thin as + +236 +00:21:25,700 --> 00:21:31,880 +practical to maximize oxygen transmissibilityدايما + +237 +00:21:31,880 --> 00:21:37,640 +ال practitioners بفضله ان يطلبوا عدسات لاصقة يكون + +238 +00:21:37,640 --> 00:21:42,180 +فيها ال DK على T very high وبالتالي هتكون العدسة + +239 +00:21:42,180 --> 00:21:47,620 +ايش؟ thin طيب + +240 +00:21:47,620 --> 00:21:52,420 +الآن ايش ال disadvantages؟ العيوب يما تكون العدسة + +241 +00:21:52,420 --> 00:21:57,940 +too thin نحيفة؟ بالضبط اول حاجة ان هناك صعوبة في + +242 +00:21:57,940 --> 00:22:04,530 +عملية مسك العدسةdifficult for the patient to + +243 +00:22:04,530 --> 00:22:08,810 +handle them، دايما هتلاقي العدسة انه ممكن تسقط من + +244 +00:22:08,810 --> 00:22:13,910 +ايد مين المريض، بالضبط، اذا have a shorter life + +245 +00:22:13,910 --> 00:22:18,090 +فبالتالي انه هتكون ايه؟ fragile، انه هش العدسة + +246 +00:22:19,080 --> 00:22:23,800 +thinner post lens tear film has less movement with + +247 +00:22:23,800 --> 00:22:28,660 +blinks في المحاضرة السابقة أخدنا أنه دايما حركة + +248 +00:22:28,660 --> 00:22:33,040 +العدسة هي بالساعد في حركة مين ال tear طب هي قلت + +249 +00:22:33,040 --> 00:22:36,960 +الحركة تاعت مين العدسة فبالتالي أن حركة ال tear + +250 +00:22:36,960 --> 00:22:38,020 +film هيقل + +251 +00:22:41,150 --> 00:22:46,070 +إذا كان عدسة أكثر من نقاط فالنتيجة يمكن أن تكون + +252 +00:22:46,070 --> 00:22:50,490 +ديسيكاشن او staining of the cornea دايما العدسة + +253 +00:22:50,490 --> 00:22:54,310 +لما تكون تانية هتعمل adherence to the cornea + +254 +00:22:54,310 --> 00:22:59,370 +فبالتالي انه هتعمل حاجة بنسميه no sensation at all + +255 +00:22:59,370 --> 00:23:04,830 +فهيطبعوا ايه ال staining في ال cornea بمعنى + +256 +00:23:04,830 --> 00:23:10,200 +ديسيكاشن اللي هي نقاط يعني كأنه dry spotيعني + +257 +00:23:10,200 --> 00:23:15,560 +المريض هيشعر انه عنده dry spot كا symptoms كاعراض + +258 +00:23:15,560 --> 00:23:20,760 +ال dry eye symptoms + +259 +00:23:20,760 --> 00:23:28,200 +as a guide ركزوا في المعلومة هذه as a guide low + +260 +00:23:28,200 --> 00:23:33,280 +water content lenses may have a center thickness + +261 +00:23:33,280 --> 00:23:42,270 +as low as 0.04 to 0.06 millimeterبينما ال .. ال .. + +262 +00:23:42,270 --> 00:23:48,010 +ال mid water content لنزل ال thickness فيها 0.07 + +263 +00:23:48,010 --> 00:23:56,170 +to 0.09 ال high water content هيكون من 0.1 to 0.14 + +264 +00:23:56,170 --> 00:24:01,690 +الملاحظة هنا في ال guide ان ال high water content + +265 +00:24:01,690 --> 00:24:05,950 +بشوف السماكة فيها اعلى من مين من ال low water + +266 +00:24:05,950 --> 00:24:08,050 +content طب شو السبب؟ + +267 +00:24:13,900 --> 00:24:17,520 +كلامك صحيح، بس ايش تفسير هام؟ يعني في ال guide هذا + +268 +00:24:17,520 --> 00:24:22,600 +انه بنلاحظ ان العدسة يما كانت low water content + +269 +00:24:22,600 --> 00:24:26,500 +السماكة في ال center عشان تاخد شكل قرنية و تكون + +270 +00:24:26,500 --> 00:24:31,360 +تاردة؟ لأ طيب، الآن العدسة دايما بتتكون من two + +271 +00:24:31,360 --> 00:24:36,590 +partsمن ال center وال peripheral صح ولا لا؟ الان + +272 +00:24:36,590 --> 00:24:41,510 +انا لو قللت سماكة العدسة من ناحية ال center العدسة + +273 +00:24:41,510 --> 00:24:46,050 +مش هقدر اسيطر عليها بمعنى هتعمل adherence بشكل ايه + +274 +00:24:46,050 --> 00:24:50,630 +مباشر مع الكورنيا حتى لو وصلت انا لل optimal fit + +275 +00:24:51,560 --> 00:24:55,100 +فدايما في العدسات اللى بتكون high water content + +276 +00:24:55,100 --> 00:24:58,880 +بحاول انه ازود ال thickness وين؟ في منطقة ال + +277 +00:24:58,880 --> 00:25:03,180 +center عشان احافظ على العدسة خوفا من انه تعمل + +278 +00:25:03,180 --> 00:25:08,720 +التساق مع مين؟ مع الكورنيا وهذا ال guide مهم دايما + +279 +00:25:08,720 --> 00:25:12,540 +في العدسات اللاصقة يما تكون high water content + +280 +00:25:12,540 --> 00:25:17,280 +حاول انه تنتبه على ال center thickness جداش قيمته؟ + +281 +00:25:18,410 --> 00:25:23,650 +إذا والله كانت قيمته أقل من ال low water content + +282 +00:25:23,650 --> 00:25:28,770 +هان مشكلة مش هيصير تماثق ما بين مركز العدسة و ال + +283 +00:25:28,770 --> 00:25:34,610 +cornea choosing + +284 +00:25:34,610 --> 00:25:38,990 +soft lenses for patients الآن اختيار العدسات + +285 +00:25:38,990 --> 00:25:41,050 +اللينة للمرضى + +286 +00:25:43,440 --> 00:25:48,880 +هناك بعض المسائل يجب تحديدها من قبل ال examiners + +287 +00:25:48,880 --> 00:25:54,580 +حتى انه يتم اختيار العدسة اللاصقة اللينة بشكل + +288 +00:25:54,580 --> 00:25:59,800 +مناسب اذا some of the key issues اذا مجموعة من + +289 +00:25:59,800 --> 00:26:04,540 +المفاتيح او المسائل that need اللي بتحتاج to be + +290 +00:26:04,540 --> 00:26:10,160 +considered الى اعتبار RWhat refractive correction + +291 +00:26:10,160 --> 00:26:14,240 +is required؟ كده قيمة refractive error عند المريض؟ + +292 +00:26:14,240 --> 00:26:18,900 +إذا كان أقل من أربعة، بديه الوصفة بشكل مباشر، أكتر + +293 +00:26:18,900 --> 00:26:22,880 +من أربعة، بدخله على قانون التحويل، هذه النقطة + +294 +00:26:22,880 --> 00:26:28,240 +الأولىNumber two is a steep or flat fitting + +295 +00:26:28,240 --> 00:26:33,160 +required إذا كانت العدسة flat أو steep بدي أحاول + +296 +00:26:33,160 --> 00:26:37,600 +أغير إما بال base curve أو ال diameter لحد ما أصل + +297 +00:26:37,600 --> 00:26:43,940 +إلى مين ال optimal fit للعدسة A + +298 +00:26:43,940 --> 00:26:49,260 +corneal curvature يما يكون تحد بالقرنيةاستيبر دان + +299 +00:26:49,260 --> 00:26:58,480 +44 ديوبتر 7.67 راديوس of curvature usually needs a + +300 +00:26:58,480 --> 00:27:00,000 +steep fitting lens + +301 +00:27:16,160 --> 00:27:21,720 +ممتازة طيب another answer اذا + +302 +00:27:21,720 --> 00:27:25,780 +الان في حالة ما يكون عندى ال key reading steep + +303 +00:27:25,780 --> 00:27:30,460 +يعني اكتر من اربع و اربعين ديوبتر دايما بنحاول انه + +304 +00:27:30,460 --> 00:27:36,000 +نختار base curve ايش ماله قيمته steep واضح حتى + +305 +00:27:36,000 --> 00:27:41,550 +نحافظ على شكل ايش العدسةيعني لأن العدسة conform to + +306 +00:27:41,550 --> 00:27:45,930 +the shape of the cornea لو اخترت انا base curve + +307 +00:27:45,930 --> 00:27:49,930 +عالي ايش هيصير في اللي انه هيكون هناك اللي هو flat + +308 +00:27:49,930 --> 00:27:54,770 +lens او excessive movement بالضبط انه هيصير في لها + +309 +00:27:54,770 --> 00:27:58,710 +حركة و المريض مش هيقدر ايش يسيطر عليها و ممكن انه + +310 +00:27:58,710 --> 00:28:03,990 +تسقط من العين واضح الفكرة؟ اذا دايما بختار corneal + +311 +00:28:03,990 --> 00:28:08,090 +curvature انه يكون steep 44ديوبتر or more + +312 +00:28:10,700 --> 00:28:14,960 +selection of lens type modality بدي أختار نوع + +313 +00:28:14,960 --> 00:28:19,320 +العدسة المناسب هل العدسة أنا مثلا بدي conventional + +314 +00:28:19,320 --> 00:28:24,180 +daily wear هل extended wear هل المريض ممكن يتلاقم + +315 +00:28:24,180 --> 00:28:26,980 +مع ال extended wear ولا لأ هل هتكون ال + +316 +00:28:26,980 --> 00:28:31,180 +conventional daily wear له مناسبة وأهم شيء موضوع + +317 +00:28:31,180 --> 00:28:35,420 +ال task أو + +318 +00:28:35,420 --> 00:28:41,180 +ال functions اللي بيقوم فيها من المريضOkay، هذه + +319 +00:28:41,180 --> 00:28:45,140 +مهمة كتير دايما، وهذه بنختصرها في موضوع ال + +320 +00:28:45,140 --> 00:28:49,200 +occupation، الوظيفة، دايما ال occupation هي تعتبر + +321 +00:28:49,200 --> 00:28:53,860 +عامل مهم في عملية إعطاء العدسة اللاصقة أو صرفة + +322 +00:28:53,860 --> 00:28:57,560 +بالنسبة للمريض، سواء كان ال soft contact lens أو + +323 +00:28:57,560 --> 00:29:04,460 +hard contact lensIs their dry eye or a patient + +324 +00:29:04,460 --> 00:29:09,920 +history suggestive of a tear film abnormality or + +325 +00:29:09,920 --> 00:29:14,320 +anomaly؟ دايما انا بده اشوف هل المريض عنده dry eye + +326 +00:29:14,320 --> 00:29:17,960 +symptoms؟ اذا عنده dry eye symptoms وعملنا a + +327 +00:29:17,960 --> 00:29:21,760 +clinical diagnosis of a dry eye زي ال TPUT او + +328 +00:29:21,760 --> 00:29:26,100 +الشيرمارتس او ال corneal fluorescein staining انا + +329 +00:29:26,100 --> 00:29:31,280 +ايش بده امنع المريض من اعطاء العدسة اللاصقةلأن هى + +330 +00:29:31,280 --> 00:29:36,380 +تعتبر من ضمن ال Contra Indication ايضا بدي اطمن ع + +331 +00:29:36,380 --> 00:29:41,280 +موضوع ال tier film انه بدي اشوف هل normal ال tier + +332 +00:29:41,280 --> 00:29:46,740 +film التلت طبقات سواء ال water او ال mucus او ال + +333 +00:29:46,740 --> 00:29:50,720 +middle layer او ال limit layer كلهيتهم سليمات ولا + +334 +00:29:50,720 --> 00:29:54,820 +لا اذا في هناك اي ت defect في ال tier film ايضا + +335 +00:29:54,820 --> 00:30:00,570 +لازم انه نتوقف من اعطاء العدسة اللاصقةللمريض، ان + +336 +00:30:00,570 --> 00:30:06,010 +شاء الله بنقف للنقطة هذه و المحاضرة الجاية بنكمل، + +337 +00:30:06,010 --> 00:30:07,610 +في أي سؤال؟ فضليك + +338 +00:30:12,710 --> 00:30:17,310 +Okay الان بالنسبة في عندنا تلت أنواع من العدسات + +339 +00:30:17,310 --> 00:30:21,350 +العدسة اما بتكون high water content او mid water + +340 +00:30:21,350 --> 00:30:26,050 +content او بتكون low water content اذا كانت العدسة + +341 +00:30:26,050 --> 00:30:30,510 +low water content دايما السماكة في ال center بحاول + +342 +00:30:30,510 --> 00:30:36,190 +ان اقللها لان هي العدسة بشكل عام متماسكة صح ولا لا + +343 +00:30:36,190 --> 00:30:40,790 +لان كمية الميه اللى موجودة فيها تعتبر مناسبة ان + +344 +00:30:40,790 --> 00:30:45,940 +تعيش فترة زمانية طويلةلكن لو كانت المشكلة في ال + +345 +00:30:45,940 --> 00:30:49,740 +high water content بحاول سماكة العدسة في ال center + +346 +00:30:49,740 --> 00:30:54,280 +ازودها لان طبيعة العدسة ايش مالها؟ fragile هشة + +347 +00:30:54,280 --> 00:30:58,540 +يعني لو كل هيتها كانت في نفس السماكة بتلاقي انه + +348 +00:30:58,540 --> 00:31:03,200 +هتعمل adherence to the cornea وبالتالي المريض no + +349 +00:31:03,200 --> 00:31:08,820 +sensation at all مش هيشعر اللي هو في العدسة تعطيكم + +350 +00:31:08,820 --> 00:31:09,480 +العافية وشكرا + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/dyrPqQNoh6k_postprocess.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/dyrPqQNoh6k_postprocess.srt new file mode 100644 index 0000000000000000000000000000000000000000..e64be165dafb4e917e814a2a4afd3491a7cf0c52 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/dyrPqQNoh6k_postprocess.srt @@ -0,0 +1,1680 @@ +1 +00:00:21,020 --> 00:00:25,340 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:25,340 --> 00:00:29,760 +وبركاته and a very good morning to all of you في + +3 +00:00:29,760 --> 00:00:34,540 +المحاضرة السابقة اتناولنا تعريف العدسات اللاصقة + +4 +00:00:34,540 --> 00:00:39,800 +اللينة وبعد ذلك ال advantages و ال limitations + +5 +00:00:39,800 --> 00:00:47,200 +للعدسات اللاصقة اللينةاليوم هنبدأ بال soft lens + +6 +00:00:47,200 --> 00:00:53,360 +modalities أي بمعنى أنماط أو أشكال أو أنواع العدسة + +7 +00:00:53,360 --> 00:00:59,920 +اللاصقة اللينة النوع الأول conventional daily wear + +8 +00:00:59,920 --> 00:01:07,980 +عدسات اللبس اليومي التقليدي هي عبارة عن عدسات فترة + +9 +00:01:07,980 --> 00:01:15,250 +حياة العدسة بتكون من ستة إلى اتناشر شهراذا بدي + +10 +00:01:15,250 --> 00:01:20,090 +افهم شغلة مهمة كتير مدام فترة حياتها من ستة الى + +11 +00:01:20,090 --> 00:01:26,130 +اتناشر شهر اذا العدسة هذه نوعا ما هي ما هتكون هشة + +12 +00:01:26,130 --> 00:01:34,010 +ايضا بدي اعرف ان سعرها هيكون عالي الثمن نقطة اخرى + +13 +00:01:34,010 --> 00:01:40,540 +ان هذه العدسة هيكون فيها ال DK على Tmedium لأ مش + +14 +00:01:40,540 --> 00:01:44,640 +هيكون اللي هو high اما هيكون low او هيكون medium + +15 +00:01:44,640 --> 00:01:49,340 +لان لو كان high او very high بالتالي انه هتكون هشة + +16 +00:01:49,340 --> 00:01:54,610 +و هتكون thinning و مش هتعيش فترة زمنية طويلةإذاً + +17 +00:01:54,610 --> 00:01:59,550 +six to twelve months هذه عبارة عن فترة حياة العدسة + +18 +00:01:59,550 --> 00:02:05,030 +a lens that is worn العدسة بتظل ملبوسة في العين + +19 +00:02:05,030 --> 00:02:10,170 +until change is necessary due to deteriorating + +20 +00:02:10,170 --> 00:02:16,390 +lens performance or lens loss or lens damage وضيفه + +21 +00:02:16,390 --> 00:02:21,610 +كمان decreased visionإذا العدسة بتظل ملبوسة في + +22 +00:02:21,610 --> 00:02:27,290 +العين لحد ما إنه يصير هناك تدهور بأداء العدسة أو + +23 +00:02:27,290 --> 00:02:31,710 +فقدان للعدسة أو خدش في العدسة أو إنه يحدث هناك + +24 +00:02:31,710 --> 00:02:37,550 +دمار للعدسة أو إنه يقل النظر وين في العدسة اللاصقة + +25 +00:02:40,110 --> 00:02:43,930 +Planned or frequent replacement systems use + +26 +00:02:43,930 --> 00:02:48,610 +conventional daily wear lenses with a prescribed + +27 +00:02:48,610 --> 00:02:56,710 +replacement interval إذا فترة الاستبدال محددة بهذا + +28 +00:02:56,710 --> 00:03:03,540 +النوع من العدساتوهذه نقطة مهمة، لو مثلا مريض بده + +29 +00:03:03,540 --> 00:03:08,800 +يغير عدسة كل أسبوعين أو كل مثلا أربع أسابيع، هذا + +30 +00:03:08,800 --> 00:03:12,780 +النوع من العدسات غير مناسب، ليه؟ لأن فترة + +31 +00:03:12,780 --> 00:03:19,700 +الاستبدال فيها محددة، من 6 إلى 12 شهر Common + +32 +00:03:19,700 --> 00:03:25,650 +Replacement Intervalفي هناك أنواع لهذا النوع من + +33 +00:03:25,650 --> 00:03:29,850 +العدسات ويمكن تسمع فيها في السوق اما بتكون annual + +34 +00:03:29,850 --> 00:03:35,590 +سنوية او بتكون semi-annual نصف سنة او بتكون + +35 +00:03:35,590 --> 00:03:41,510 +quarterly ربع سنة يعني تلت شهور بمعنى اخر ان مدة + +36 +00:03:41,510 --> 00:03:46,030 +حياة العدسة له علاقة في مين؟ في ال cost في السعر + +37 +00:03:46,030 --> 00:03:50,330 +ان كل ما زاد فترة حياة العدسة كل ما كان سعرها ايه + +38 +00:03:50,330 --> 00:03:56,760 +اغلىconventional care and maintenance systems are + +39 +00:03:56,760 --> 00:04:02,340 +used إذا أنظمة الرعاية والمحافظة والنظافة للعدسة + +40 +00:04:02,340 --> 00:04:07,880 +اللاسقة اللينة هان تعتبر أساسية في هذا النوع من + +41 +00:04:07,880 --> 00:04:14,480 +العدسات advantages + +42 +00:04:14,480 --> 00:04:21,600 +ما هي مميزات ال conventional daily wearNumber one + +43 +00:04:21,600 --> 00:04:27,280 +custom عادة fitted in a wide range of spheric, + +44 +00:04:27,600 --> 00:04:33,380 +toric and multifocal designs يعني لو أردنا صناعة + +45 +00:04:33,380 --> 00:04:39,760 +عدسة أن تكون special lens + +46 +00:04:41,340 --> 00:04:45,660 +بمعنى انه الـ base curve معين، ال parameter معينة، + +47 +00:04:45,660 --> 00:04:49,860 +ال diameter معين، انه بتستخدم للنير و لل distance + +48 +00:04:49,860 --> 00:04:53,820 +و ال intermediate، هذا النوع من العدسات يعتبر + +49 +00:04:53,820 --> 00:05:00,450 +مناسبIn materials of low, medium or high water + +50 +00:05:00,450 --> 00:05:05,290 +content لكن في هنا ملاحظة مهمة ان كل ما زاد ال + +51 +00:05:05,290 --> 00:05:10,410 +water content للعدسة كل ما أصبحت هشة ففترة حياتها + +52 +00:05:10,410 --> 00:05:16,070 +ايه بتقل يعني ممكن مثلا مريض بده يرتدي عدسة لاصقة + +53 +00:05:16,070 --> 00:05:20,350 +انه تكون multifocal او progressive lens لفترة + +54 +00:05:20,350 --> 00:05:25,600 +زمانية قصيرةال cost مش مهم عنده فممكن انا اوفرله + +55 +00:05:25,600 --> 00:05:30,640 +عدسة conventional daily wear بس ال cost ايش هيكون + +56 +00:05:30,640 --> 00:05:36,000 +very high number two + +57 +00:05:36,000 --> 00:05:39,600 +the widest variety of parameters is available + +58 +00:05:39,600 --> 00:05:44,660 +هيكون هناك مجموعة متنوعة واسعة من المحددات لهذا + +59 +00:05:44,660 --> 00:05:48,560 +النوع من العدسات من حيث ال base curve ال diameter + +60 +00:05:48,560 --> 00:05:49,340 +ال power + +61 +00:05:53,340 --> 00:05:57,460 +conventional daily wear lenses may be the only + +62 +00:05:57,460 --> 00:06:03,000 +option for patients who require complex expensive + +63 +00:06:03,000 --> 00:06:08,880 +lenses بعض الأشخاص بحب إنه يلبس عدسة من نوع ال + +64 +00:06:08,880 --> 00:06:15,230 +progressive lensفبعمله كل ال evaluation لل soft + +65 +00:06:15,230 --> 00:06:18,550 +contact lens بشوف ال indication ال contra + +66 +00:06:18,550 --> 00:06:23,850 +indication تقبله للعدسة لكن بدي اخد بعين الاعتبار + +67 +00:06:23,850 --> 00:06:29,550 +انه قد يكون السعر غالي للعدسة المريض بيحكيلك انه + +68 +00:06:29,550 --> 00:06:33,650 +لو حتى السعر غالي انا ممكن ايه ادفع سعر العدسة + +69 +00:06:33,650 --> 00:06:38,970 +بشكل طبيعيأيضا موضوع التنظيف انه لازم انه يعمل + +70 +00:06:38,970 --> 00:06:43,850 +عملية تنظيف daily wear كل يوم مش كتير فارقة معه + +71 +00:06:43,850 --> 00:06:48,490 +انه ممكن انه ينظف العدسة بشكل يومي ممكن انه يستخدم + +72 +00:06:48,490 --> 00:06:52,910 +أنظمة المحافظة عليها الرعاية كل هذه ال systems + +73 +00:06:52,910 --> 00:06:57,410 +لازم انه يكون معروف عن مين عند المريض او ال + +74 +00:06:57,410 --> 00:07:03,750 +patient ال disadvantages العيوب لهذا النوع من + +75 +00:07:03,750 --> 00:07:09,320 +العدساتNumber one require complex care systems + +76 +00:07:09,320 --> 00:07:15,900 +that include protein remover tablets اذا بتطلب من + +77 +00:07:15,900 --> 00:07:22,080 +المريض انه يستخدم محاليل تنظيف ومحاليل عناية + +78 +00:07:22,080 --> 00:07:27,580 +ومحافظة عليها بشكل كبير ليه؟ لأن فترة حياة العدسة + +79 +00:07:27,580 --> 00:07:33,940 +طويلة فهيتراكم عليها العديد من البروتيناتفكيف انا + +80 +00:07:33,940 --> 00:07:38,060 +ممكن ان اتخلص من هذه الترثبات و هذه البروتينات من + +81 +00:07:38,060 --> 00:07:45,180 +خلال استخدام البروتين تابلس higher + +82 +00:07:45,180 --> 00:07:50,340 +overall rate of adverse reactions than disposable + +83 +00:07:50,340 --> 00:07:56,890 +lensesلو سألي السؤال مين العدسات اللى بتكون فيها + +84 +00:07:56,890 --> 00:08:01,710 +العدو أكتر؟ هذا النوع من العدسات ال conventional + +85 +00:08:01,710 --> 00:08:06,230 +daily wear ولا ال disposable lenses اللى بتكون + +86 +00:08:06,230 --> 00:08:11,720 +فترة حياتها قصيرة؟الـ Conventional Daily Wear ليه؟ + +87 +00:08:11,720 --> 00:08:16,200 +لأنه بتعيش فترة زمانية طويلة فبتعمل inflammatory + +88 +00:08:16,200 --> 00:08:21,340 +complications بشكل أكبر مقارنة في مين في العدسات + +89 +00:08:21,340 --> 00:08:25,560 +الـ disposable lenses اللي بيكون فترة حياتها قصيرة + +90 +00:08:25,560 --> 00:08:29,200 +في بعض العدسات بيكون من two weeks ل one month + +91 +00:08:29,200 --> 00:08:33,700 +Leath + +92 +00:08:33,700 --> 00:08:39,460 +cutting وهذا عبارة عن قالب القطعالان ممكن طالب + +93 +00:08:39,460 --> 00:08:43,980 +تسألني سؤال ليش الـ conventional daily wear يعتبر + +94 +00:08:43,980 --> 00:08:49,040 +سعرها غالي؟ لأنها بتستخدم قالب بنسميه الـ lathe + +95 +00:08:49,040 --> 00:08:54,140 +cutting هذا القالب بيستخدم للعدسات اللي بتكون + +96 +00:08:54,140 --> 00:08:59,930 +غالية الثمنوبتكون يعني صناعتها بشكل معقد يعني الآن + +97 +00:08:59,930 --> 00:09:03,310 +لو احنا قررنا ما بين عدسة progressive lens او + +98 +00:09:03,310 --> 00:09:08,450 +multifocal lens مع عدسة عادية هتلاحظ ان السعر بتاع + +99 +00:09:08,450 --> 00:09:13,090 +ال progressive غالي وايضا القالب اللي بيستخدم + +100 +00:09:13,090 --> 00:09:17,610 +لصناعة هذا النوع من العدسات هيكون معقد اكتر صح ولا + +101 +00:09:17,610 --> 00:09:23,680 +لا فهذا كله بيتحكم في مين؟ في ال costThe most + +102 +00:09:23,680 --> 00:09:28,740 +labor intensive حيكون عمل شديد وين في اللي هو ال + +103 +00:09:28,740 --> 00:09:33,300 +labor او في المعمل and hence هلاحظ the most + +104 +00:09:33,300 --> 00:09:37,580 +expensive انه ال peer lens الذوج من العدسات هيكون + +105 +00:09:37,580 --> 00:09:42,620 +غالي مقارنة بالعدسات الأخرى of the available + +106 +00:09:42,620 --> 00:09:47,880 +methods مقارنة بالعدسات ال disposable lenses او ال + +107 +00:09:47,880 --> 00:09:53,350 +extended wear lensesإذا لو سألنا سؤال ليش العدسات + +108 +00:09:53,350 --> 00:10:00,830 +الـ conventional daily wear غالية الثمن؟ فضل إيه؟ + +109 +00:10:00,830 --> 00:10:06,710 +عشان ال .. ال led cutting عبارة عن قلب و هو + +110 +00:10:06,710 --> 00:10:10,110 +باستخدام العدسة تغالية الثمن فهي تكون conventional + +111 +00:10:10,110 --> 00:10:15,110 +بالضبط و هذا بيكون القلب إشماله معقد من حيث + +112 +00:10:15,110 --> 00:10:16,950 +الصناعة okay؟ + +113 +00:10:20,100 --> 00:10:24,880 +High DK Materials الان ايش العدسات اللي بيكون High + +114 +00:10:24,880 --> 00:10:29,820 +DK Materials انواع العدسات اللي بيكون فيها DK + +115 +00:10:29,820 --> 00:10:37,700 +Materials High فضل يا سحر اها اذا هي تعتبر ايه + +116 +00:10:37,700 --> 00:10:41,680 +very high water content صح عشان ما تعمل cornia + +117 +00:10:41,680 --> 00:10:48,160 +القديمة والنوع التاني تفضليبالضبط إذا في عنا نوعين + +118 +00:10:48,160 --> 00:10:52,520 +أساسيين بيكون فيهم الـ DK على T material very high + +119 +00:10:52,520 --> 00:10:57,260 +النوع الأول ال very high water content النوع + +120 +00:10:57,260 --> 00:11:02,820 +التاني ال silicon hydro gel soft contact lens هدول + +121 +00:11:02,820 --> 00:11:06,060 +غير متاحين وين؟ في ال conventional daily wear + +122 +00:11:06,060 --> 00:11:11,520 +السبب في ذلك لو أنا عملت high DK material لعدسة ال + +123 +00:11:11,520 --> 00:11:16,800 +conventional daily wear هصير إيش؟ هشةو هصير فترة + +124 +00:11:16,800 --> 00:11:24,120 +حياتها قصيرة و هتخلص منها بشكل سريع لكن العدسات + +125 +00:11:24,120 --> 00:11:28,220 +اللى بتتم التخلص منها بشكل سريع خلال اسبوع او خلال + +126 +00:11:28,220 --> 00:11:32,760 +يوم ممكن ان تكون العدسة هذه very thinning ممكن ان + +127 +00:11:32,760 --> 00:11:36,340 +يكون فيها ال water content very high هذا امر اشي + +128 +00:11:36,340 --> 00:11:41,900 +اعتبر طبيعى بالنسبة لهذا النوع من العدساتإذاً، + +129 +00:11:41,900 --> 00:11:46,280 +لماذا المواد الـ High-Decay ليسوا مفيدين للعدسة + +130 +00:11:46,280 --> 00:11:51,700 +الواتر؟ لأن كل ما زاد ال water content للعدسة، كل + +131 +00:11:51,700 --> 00:11:55,040 +ما أصبعت هي very thin، وبالتالي فترة حياتها إيش + +132 +00:11:55,040 --> 00:12:01,440 +بتصبح قصيرة؟ Okay، وبنتخلص منها بشكل سريع + +133 +00:12:05,400 --> 00:12:09,920 +Two approaches to selecting a replacement interval + +134 +00:12:09,920 --> 00:12:16,540 +هناك طريقتان لعملية الاستبدال للعدسات اللاصقة + +135 +00:12:16,540 --> 00:12:24,210 +الطريقة الأولى بتعتمد على المريض نفسهبواسطة ان + +136 +00:12:24,210 --> 00:12:29,870 +اعمل انا observation ملاحظة او monitoring للمريض + +137 +00:12:29,870 --> 00:12:34,750 +الان انا لما بدي اصرف العدسة اللاصقة لازم اعمل + +138 +00:12:34,750 --> 00:12:40,430 +follow-up متابعة للمريض كل فترة زمنية محددة بمعنى + +139 +00:12:40,430 --> 00:12:44,370 +انه مثلا كل شهرين لو conventional daily weed كل + +140 +00:12:44,370 --> 00:12:49,650 +شهرين ان المريض بدي يعمل متابعة من خلال ال + +141 +00:12:49,650 --> 00:12:54,670 +practitioner او من خلال ال optometristفهذا النوع + +142 +00:12:54,670 --> 00:12:59,110 +patient dependent replacement interval، إذا هذا + +143 +00:12:59,110 --> 00:13:03,830 +النوع من العدسات هيعتمد على المريض نفسه Monitoring + +144 +00:13:03,830 --> 00:13:08,490 +أو observing إنه ملاحظة ال patient المريض in the + +145 +00:13:08,490 --> 00:13:12,670 +first few weeks في الأسابيع الأولى أو في الأشهر + +146 +00:13:12,670 --> 00:13:17,850 +الأولى of lens wear من إتداء العدسة بعض الأشخاص + +147 +00:13:17,850 --> 00:13:23,940 +بتلاقي أن تراكم ال deposit بشكل كبيرعندهم مقارنة + +148 +00:13:23,940 --> 00:13:30,900 +بشخص آخر فهذا كله بيعمل ايه؟ تأثير على العدسة + +149 +00:13:30,900 --> 00:13:36,620 +اللاصقة و بيقلل من فترة حياة العدسة اللاصقةThe + +150 +00:13:36,620 --> 00:13:41,500 +replacement frequency فترة الاستبدال of soft + +151 +00:13:41,500 --> 00:13:46,260 +lenses للعدسات اللينة is often determined غالبا + +152 +00:13:46,260 --> 00:13:51,780 +بيحدد by the ratio of cost to benefit يعني حسب ان + +153 +00:13:51,780 --> 00:13:56,020 +انا بدي اعمل استفتاء للمريض كيف استفتاء للمريض؟ ان + +154 +00:13:56,020 --> 00:14:01,100 +ال cost و ال benefitبداية ال cost يعتبر غالي ال + +155 +00:14:01,100 --> 00:14:05,120 +conventional daily wear فهل المريض مستعد انه يغير + +156 +00:14:05,120 --> 00:14:10,200 +بعد أسابيع قليلة العدسة اللاصقة او هل هو مستعد على + +157 +00:14:10,200 --> 00:14:13,860 +تغيير العدسة اللاصقة بعد أشهر بعد شهرين تلاتة + +158 +00:14:13,860 --> 00:14:19,060 +فلازم انا اعمل discussion مع المريض ايضا ال + +159 +00:14:19,060 --> 00:14:22,900 +benefit هل هتكون كبيرة لو هو غير العدسة ولا لا؟ هل + +160 +00:14:22,900 --> 00:14:28,140 +هتحسن من الرؤية؟هل مثلا بعد شهرين او تلاتة هيصير + +161 +00:14:28,140 --> 00:14:31,860 +تدهور كبير في أداء العدسة ولا ممكن انا اتغاضى عن + +162 +00:14:31,860 --> 00:14:36,140 +النقطة هذه؟ كل هذه الأمور يجب ان تكون واضحة + +163 +00:14:36,140 --> 00:14:42,620 +بالنسبة للـ practitioner number + +164 +00:14:42,620 --> 00:14:47,580 +two fixed replacement interval depends on lens + +165 +00:14:47,580 --> 00:14:52,500 +material اذا ايضا بتعتمد على نوع ال material + +166 +00:14:52,500 --> 00:14:58,690 +للعدسةالان لو انا استخدمت ال CR 39 تعتبر رخيصة + +167 +00:14:58,690 --> 00:15:03,230 +الثمن فممكن انا كل شهرين كل أسبوعين اعمل تغيير + +168 +00:15:03,230 --> 00:15:07,310 +للعدسة يعني this is normal okay for a practitioner + +169 +00:15:07,310 --> 00:15:11,470 +and patient لكن لو انا استخدمت material غالية + +170 +00:15:11,470 --> 00:15:16,950 +الثمن هتكون مكلفة لمين؟لل patient و غير ذلك انت اي + +171 +00:15:16,950 --> 00:15:21,610 +عدسة بدك تعمليلها وصف لازم انه يتم صناعتها من خلال + +172 +00:15:21,610 --> 00:15:26,670 +main المصنع اي بمعنى انه بدها فترة زمنية اطول لحد + +173 +00:15:26,670 --> 00:15:29,070 +ما تصل ل ال patient + +174 +00:15:33,290 --> 00:15:39,250 +هذه notebook ملاحظة مهمة if the new lens feels + +175 +00:15:39,250 --> 00:15:43,610 +much better than the one it replaced it was + +176 +00:15:43,610 --> 00:15:49,070 +supplied too late نفترض الآن مريض لبس عدسة لمدة + +177 +00:15:49,070 --> 00:15:55,460 +الشهرينبعد الشهرين اعملنا استبدال للعدسة، إذا لاحظ + +178 +00:15:55,460 --> 00:16:00,000 +المريض هناك فيه فرق ما بين الرؤية في العدسة الأولى + +179 +00:16:00,000 --> 00:16:04,300 +و العدسة التانية و الفرق هذا كبير في الرؤية، يعني + +180 +00:16:04,300 --> 00:16:09,000 +في هناك رؤية أفضل في العدسة التانية، معنى الكلام + +181 +00:16:09,000 --> 00:16:12,620 +أن ال practitioner أو ال optometrist أو ال + +182 +00:16:12,620 --> 00:16:17,730 +physician الطبيب اتأخر في عملية استبدال العدسةيعني + +183 +00:16:17,730 --> 00:16:22,450 +أخدنا فترة زمانية طويلة لعملية إيه الاستبدال وهذا + +184 +00:16:22,450 --> 00:16:28,590 +يعتبر من الأخطاء الشائعة في انه كيف انا بدي أصرف + +185 +00:16:28,590 --> 00:16:32,970 +العدسة اللاصقة لازم ان يكون الفرق ما بين العدسة + +186 +00:16:32,970 --> 00:16:37,690 +الأولى والعدسة التانية فرق بسيط في الرؤية مايشعرش + +187 +00:16:37,690 --> 00:16:43,610 +هناك جاب فجوة كبيرة في الرؤية من حيث العدستين واضح + +188 +00:16:43,610 --> 00:16:44,270 +الفكرة؟ + +189 +00:16:47,870 --> 00:16:52,530 +النوع التاني من العدسات هي عبارة عن الـ Hydrogel + +190 +00:16:52,530 --> 00:16:57,930 +disposable lenses هذا النوع من العدسات أول ما تم + +191 +00:16:57,930 --> 00:17:01,390 +صناعته في سنة الف وتسعمائة و تمانين + +192 +00:17:04,360 --> 00:17:09,100 +بتتميز بأنها ليست غالية الثمن لو عملنا مقارنة ما + +193 +00:17:09,100 --> 00:17:14,280 +بينها وبين ال daily wear إذا هي inexpensive ليست + +194 +00:17:14,280 --> 00:17:18,280 +غالية الثمن disposable limbs that could be + +195 +00:17:18,280 --> 00:17:23,440 +replaced weekly ممكن إنه يتم تغييرها كل مثلا أسبوع + +196 +00:17:23,440 --> 00:17:27,680 +أو أسبوعين لأنه رخيصة بالنسبة للمريض to buy weekly + +197 +00:17:27,680 --> 00:17:32,630 +would be a beneficial modality for many patientsزي + +198 +00:17:32,630 --> 00:17:37,010 +ما ذكرنا في السابق أن بعض الأشخاص بيكون عنده تراكم + +199 +00:17:37,010 --> 00:17:41,870 +الترثبات أو ال deposits بشكل كبير فلازم أنا كل + +200 +00:17:41,870 --> 00:17:45,290 +فترة زمانية أعمل استبدال، إذا ال conventional + +201 +00:17:45,290 --> 00:17:50,190 +daily wear هي لا تعتبر مناسبة أو ملائمة لهذا النوع + +202 +00:17:50,190 --> 00:17:55,120 +من الأشخاصطيب إيش البديل؟ الـ Hydrogel disposable + +203 +00:17:55,120 --> 00:18:00,600 +lenses بديه هذا النوع من العدسات يعني هو قادر على + +204 +00:18:00,600 --> 00:18:05,380 +تغيير العدسة كل مثلا أسبوع أو أسبوعين أو تلاتة لأن + +205 +00:18:05,380 --> 00:18:10,180 +التكلفة بتاعة العدسة بتكون بسيطة مدام هي Hydrogel + +206 +00:18:10,180 --> 00:18:14,380 +إذاً Hydrophilic material أيضا إيش تعتبر very high + +207 +00:18:14,380 --> 00:18:15,980 +water content؟ + +208 +00:18:21,040 --> 00:18:25,020 +Disposable lenses reduce the amount of lens + +209 +00:18:25,020 --> 00:18:30,760 +maintenance required بالنسبة للمحافظة لهذا النوع + +210 +00:18:30,760 --> 00:18:36,660 +من العدسات ليس بدرجة كبيرة مقارنة في مين في ال + +211 +00:18:36,660 --> 00:18:39,860 +conventional daily wear زي ما اتفقنا ان ال + +212 +00:18:39,860 --> 00:18:44,020 +conventional daily wear أنظمة المحافظة والعناية + +213 +00:18:44,020 --> 00:18:50,100 +عليها لازم ان تكون بدرجة كبيرةعشان تقدر ان تعيش + +214 +00:18:50,100 --> 00:18:54,660 +فترة زمانية أطول مع الشخص هذا النوع من العدسات لأ + +215 +00:18:54,660 --> 00:19:00,180 +أنظمة المحافظة عليها ممكن مثلا تكون بسيطة او غير + +216 +00:19:00,180 --> 00:19:04,660 +مهمة كتير لان خلال أسبوع او أسبوعين المريض هيتخلص + +217 +00:19:04,660 --> 00:19:11,080 +منهاthereby reducing the cost هذا هيقلل من ايه؟ من + +218 +00:19:11,080 --> 00:19:16,520 +السعر للعدسة and compliance والالتزام فيها burden + +219 +00:19:16,520 --> 00:19:21,600 +on the patient يعني هذا هيقلل من سعر العدسة + +220 +00:19:21,600 --> 00:19:27,440 +والتزام او المطاوعة او موافقة المريض مع ايه؟ مع كل + +221 +00:19:27,440 --> 00:19:31,220 +هذه الأنظمة اللي خاصة بالرعاية و العناية + +222 +00:19:34,770 --> 00:19:38,890 +A wide variety of disposable lenses are now + +223 +00:19:38,890 --> 00:19:43,530 +available في هناك مجموعة واسعة من هذا النوع من + +224 +00:19:43,530 --> 00:19:47,770 +العدسات متوفرة في السوق زي ما بتعرفوا في هناك ال + +225 +00:19:47,770 --> 00:19:51,270 +extended wear في هناك ال daily wear في أكتر من نوع + +226 +00:19:51,270 --> 00:19:58,130 +موجود من هذا النوع من العدساتعنا النوع الأول two + +227 +00:19:58,130 --> 00:20:03,530 +week monthly disposable hydrogel lenses يعني هذه + +228 +00:20:03,530 --> 00:20:08,790 +العدسة بتعيش فترة زمانية أسبوعين أو شهر وبعد ذلك + +229 +00:20:08,790 --> 00:20:15,550 +بتتم إيه التخلص منها okay molding + +230 +00:20:15,550 --> 00:20:20,610 +technology إذا هذا عبارة عن القالب اللي بيستخدم + +231 +00:20:20,610 --> 00:20:24,940 +لصناعة هذا النوع من العدساتفي الـ conventional + +232 +00:20:24,940 --> 00:20:28,660 +daily wear استخدمنا الـ lathe cutting اللي هو + +233 +00:20:28,660 --> 00:20:34,180 +يعتبر قالب معقد و غير بسيط في الاستخدام و اللي + +234 +00:20:34,180 --> 00:20:39,200 +بيجعل العدسة سعرها غالي السمن لكن هذا النوع تستخدم + +235 +00:20:39,200 --> 00:20:44,990 +تقنية القالب ال molding technologyفكان low cost + +236 +00:20:44,990 --> 00:20:51,450 +اقل ثمن او السعر بتاعه اقل permit disposing of + +237 +00:20:51,450 --> 00:20:57,110 +lenses rather than a protein cleaning them شركات + +238 +00:20:57,110 --> 00:21:02,270 +اللي بتصنع العدسات اللاصقة نفس الشركات اللي بتصنع + +239 +00:21:02,270 --> 00:21:09,070 +ال mobileإنه إيش بتعمل؟ limitation في الجوال عشان + +240 +00:21:09,070 --> 00:21:13,870 +بعد ذلك يصير هناك update للجوال ويتم تغييره خلال + +241 +00:21:13,870 --> 00:21:18,530 +فترة زمانية قصيرة نفس الحاجة هنا بيستخدموا هذا + +242 +00:21:18,530 --> 00:21:23,290 +القالب ال molding technology لسببينبقلل السعر + +243 +00:21:23,290 --> 00:21:30,870 +والسبب التاني هذا النوع من القوالب بيعمل على تجميع + +244 +00:21:30,870 --> 00:21:36,810 +اكتر من عشر بروتينات على سطح ايش العدسةيعني العدسة + +245 +00:21:36,810 --> 00:21:40,790 +الـ anterior surface للـ lens بيتجمع هناك أكتر من + +246 +00:21:40,790 --> 00:21:45,030 +عشر أنواع من البروتينات، بالتالي هيحدث هناك + +247 +00:21:45,030 --> 00:21:51,850 +deposits للعدسة وبالتالي يجب أن نتخلص من العدسة + +248 +00:21:51,850 --> 00:21:57,240 +خلال فترة زمنية قصيرةOkay فهو يما بيحكيلك ان فترة + +249 +00:21:57,240 --> 00:22:02,760 +حياة العدسة مجرد اسبوعين او شهر لازم بعد ذلك ممكن + +250 +00:22:02,760 --> 00:22:06,420 +ان تعيش معاك العدسة اكتر من ذلك و ممكن مايصير هناك + +251 +00:22:06,420 --> 00:22:10,280 +تداهور للرؤية لكن هذا كله بيعمل ايه؟ complications + +252 +00:22:10,280 --> 00:22:13,860 +للمريض و بيعمل هناك ادرار له + +253 +00:22:18,080 --> 00:22:22,620 +Innovative Multiple Packaging of Lenses هذا النوع + +254 +00:22:22,620 --> 00:22:29,060 +من العدسات بتكون مغلفة بشكل إبداعيهي ما بتيجي زوج + +255 +00:22:29,060 --> 00:22:33,420 +من العدسات، بتيجي اكتر من تنتين، يعني ممكن تكون + +256 +00:22:33,420 --> 00:22:37,480 +مثلا اربع ازواج، خمس ازواج، يعني بمعنى ان المريض + +257 +00:22:37,480 --> 00:22:41,200 +ايش بيكون عنده في البيت؟ ال spare lenses، يعني + +258 +00:22:41,200 --> 00:22:45,680 +عدسات احتياط، يعني ما بيحتاج كل فترة زمانية قصيرة + +259 +00:22:45,680 --> 00:22:49,820 +يرجع لمين؟ لل practitioner أو يرجع لل optometrist، + +260 +00:22:49,820 --> 00:22:55,530 +لأ عنده في عدسات ال spareإذا innovative multiple + +261 +00:22:55,530 --> 00:22:59,790 +packaging of lenses هناك طريقة بتكون فيها نوع من + +262 +00:22:59,790 --> 00:23:04,570 +الإبداع في عملية التغليف للعدسات which allows هذه + +263 +00:23:04,570 --> 00:23:08,570 +هتسمح convenient replacement أن تكون طريقة + +264 +00:23:08,570 --> 00:23:13,110 +الاستبدال سهلة ومريحة بالنسبة لمن؟ للمريض أيضا ال + +265 +00:23:13,110 --> 00:23:18,350 +schedules الجدول للبس أو ارتداء العدسات هيكون سهل + +266 +00:23:18,350 --> 00:23:23,530 +بالنسبة للمريضSince the patient not in need + +267 +00:23:23,530 --> 00:23:27,110 +returned to the practitioner for every new pair of + +268 +00:23:27,110 --> 00:23:30,410 +lenses مش هيحتاج من المريض انه يرجع ل ال + +269 +00:23:30,410 --> 00:23:36,710 +practitioner كل ما يستبدل زوج من العدسات الميزة + +270 +00:23:36,710 --> 00:23:43,270 +اللى بتتميز عن ميزة ال two week monthly عن عدسات + +271 +00:23:43,270 --> 00:23:46,590 +ال conventional daily wear ان هناك يوجد عدسات + +272 +00:23:46,590 --> 00:23:53,490 +احتياط عند المريض ال spare lensesالنوع التاني + +273 +00:23:53,490 --> 00:23:59,850 +daily disposable lenses من اسمها Badam Daily يومي، + +274 +00:23:59,850 --> 00:24:05,690 +يعني المريض بتخلص منها في نهاية اليوم، يعني يوم + +275 +00:24:05,690 --> 00:24:08,610 +واحد فقط ايه برتديها أو بلبسها + +276 +00:24:11,110 --> 00:24:15,670 +Lenses don't need to be cleaned or disinfected + +277 +00:24:15,670 --> 00:24:20,910 +each night ما بتطلب من المريض عملية التعقيم وعملية + +278 +00:24:20,910 --> 00:24:27,330 +التنظيف للعدسة مجرد انه ما يلبسها يوم واحد بعد ذلك + +279 +00:24:27,330 --> 00:24:32,010 +بتخلص منها طيب + +280 +00:24:32,010 --> 00:24:36,710 +هذا النوع من العدسات هيكون ال DK على T high ولا + +281 +00:24:36,710 --> 00:24:44,070 +low؟ very highحيكون very high فبال thickness ايش + +282 +00:24:44,070 --> 00:24:48,730 +هتكون؟ بالضبط انه هتكون thinning of the lens لان + +283 +00:24:48,730 --> 00:24:53,110 +العلاقة ما بين ال oxygen transmissibility و + +284 +00:24:53,110 --> 00:24:56,730 +thickness of the lens علاقة ايش؟ inversely + +285 +00:24:56,730 --> 00:25:02,160 +appropriation علاقة عكسيةThere is no care system + +286 +00:25:02,160 --> 00:25:09,200 +مفيش في اي انظمة محافظة او عناية للعدسة and a lens + +287 +00:25:09,200 --> 00:25:15,920 +storage case is no longer required طيب ليش في هذا + +288 +00:25:15,920 --> 00:25:21,100 +النوع من العدسات حتى بيحكيلك ان ال storage case مش + +289 +00:25:21,100 --> 00:25:23,460 +مطلوبة او مش متوفرة؟ + +290 +00:25:25,720 --> 00:25:30,220 +طيب أنا بدي أديكي مثال، الآن أنا عندي عدسة daily + +291 +00:25:30,220 --> 00:25:35,960 +wear، البست لمدة الساعة فقط، لو أنا بدي أرجحها في + +292 +00:25:35,960 --> 00:25:45,280 +الكيس، ممكن ولا لا؟ ايش رأيكم؟ فضلي + +293 +00:25:46,830 --> 00:25:52,010 +واضح السؤال؟ الان انا عندى عدسة daily wear lens + +294 +00:25:52,010 --> 00:25:57,950 +فترة حياتها twenty four hours انا البستها لمدة + +295 +00:25:57,950 --> 00:26:03,070 +ساعة و بدى اتخلص منها، هل لو انا مثلا فكرت بعد + +296 +00:26:03,070 --> 00:26:08,570 +ساعتين ارجع ألبسها ممكن ولا لا؟ + +297 +00:26:08,570 --> 00:26:16,050 +ايش رأيكم؟دايما أسئلة ال practitioner في ال + +298 +00:26:16,050 --> 00:26:19,690 +contact lens بالشكل هذا يعني انتم لاحظين يمكن في + +299 +00:26:19,690 --> 00:26:24,210 +هناك سهولة في المادة من حيث الأنواع لكن وين دايما + +300 +00:26:24,210 --> 00:26:28,310 +المطب زي هيك شغلة بيجي المريض daily wear lenses + +301 +00:26:28,310 --> 00:26:34,110 +بده يلبس طيب أنا بلبسها فقط لمدة تلت ساعات ايش + +302 +00:26:34,110 --> 00:26:38,760 +رأيك ألبس تلت ساعات بعد ذلك ألبسها ولا لأ؟طبعا + +303 +00:26:38,760 --> 00:26:43,860 +الإجابة لأ مش ممكن ألبسها، ليش؟ لأن ببساطة المريض + +304 +00:26:43,860 --> 00:26:49,620 +لو رجع العدسة على الكيس، هتصبح العدسة و كأنه drop، + +305 +00:26:49,620 --> 00:26:54,700 +قطرةواضحة؟ يا ما ييجي يلبسها مرة تانية و كأنه drop + +306 +00:26:54,700 --> 00:26:59,380 +فبتلبس العدسة فقط مدة اربع و عشرين ساعة وبتم + +307 +00:26:59,380 --> 00:27:04,980 +التخلص منها سواء لبسها نص ساعة لبسها عشر دقائق خمس + +308 +00:27:04,980 --> 00:27:10,560 +دقائق بعد ذلك يجب التخلص من هذا النوع من العدسات + +309 +00:27:10,560 --> 00:27:15,940 +لأن لو حاول أنه يلبسها مرة تانية هتصبح العدسة و + +310 +00:27:15,940 --> 00:27:18,980 +كأنه drop قطرة في العين + +311 +00:27:24,160 --> 00:27:27,940 +و كأنه قطرة يعني كيف الآن تأثير القطرة اللي هان + +312 +00:27:27,940 --> 00:27:32,620 +يما انا مثلا احطلك ميدراميد او لوكالين كيف هتشعره؟ + +313 +00:27:32,620 --> 00:27:36,420 +بشعور انه و كأنه foreign body هيكون فيه هناك حرجان + +314 +00:27:36,420 --> 00:27:40,600 +burning في ال eye صح ولا لأ؟ فهذا الشعور اللي + +315 +00:27:40,600 --> 00:27:45,690 +هيشعر فيه المريضAccording to Food and Drug + +316 +00:27:45,690 --> 00:27:50,770 +Administration، هذه المنظمة الصحية والدواء عرفوا + +317 +00:27:50,770 --> 00:27:56,110 +الـ disposable in terms of contact lenses as using + +318 +00:27:56,110 --> 00:28:03,060 +once مربى واحدة فقطWhich may mean one week of + +319 +00:28:03,060 --> 00:28:07,600 +extended wear. إذا الـ extended wear لمدة أسبوع، + +320 +00:28:07,600 --> 00:28:13,240 +بلبسها المريض، بنام فيها بشكل طبيعي طبعا ال .. هذا + +321 +00:28:13,240 --> 00:28:16,860 +النوع من العدسات أيضا الـ DK على T يجب أن تكون + +322 +00:28:16,860 --> 00:28:20,440 +very high لأنه لو ماكنتش عالية ممكن أنه تعمل + +323 +00:28:20,440 --> 00:28:24,760 +للمريض a corneal edema مباشرةOr one day of daily + +324 +00:28:24,760 --> 00:28:28,180 +wear أو العدسات ال daily disposable lenses اللي + +325 +00:28:28,180 --> 00:28:33,240 +بتلبس مدة twenty four hours لازم لو لبسها مدة عشر + +326 +00:28:33,240 --> 00:28:37,540 +دقائق ربع ساعة ساعة نص ساعة لازم انه يتخلص منها + +327 +00:28:37,540 --> 00:28:43,020 +بعد ذلك وهذه الأسئلة كتير دايما انه مع ال examiner + +328 +00:28:43,020 --> 00:28:46,780 +او مع ال practitioner بتمر عليه من خلال المريض + +329 +00:28:48,740 --> 00:28:53,100 +Daily disposable lenses appear to reduce or + +330 +00:28:53,100 --> 00:28:58,540 +eliminate many of the problems that may occur with + +331 +00:28:58,540 --> 00:29:04,260 +conventional soft lenses هناك عديد من المشاكل اللي + +332 +00:29:04,260 --> 00:29:08,080 +عملت إلها إيش تحديد أو قللتها أو عملت إلها + +333 +00:29:08,080 --> 00:29:13,320 +eliminate إزالة من هذا النوع من العدسات مقارنة بال + +334 +00:29:13,320 --> 00:29:18,120 +conventional daily wearAs well as providing + +335 +00:29:18,120 --> 00:29:23,060 +maximum convenience for the patient وهذه ستعمل + +336 +00:29:23,060 --> 00:29:28,880 +سهولة وارتياح بالنسبة لمن؟ للمريض أصعب شيء للشخص + +337 +00:29:28,880 --> 00:29:32,820 +اللي بيرتدي ال soft contact lens هو موضوع ال care + +338 +00:29:32,820 --> 00:29:37,400 +system ال cleaning system وموضوع ال maintenance + +339 +00:29:37,400 --> 00:29:42,480 +أدوة التلاش شغلات أصعب شيءفدائما اللى بيفكر انه + +340 +00:29:42,480 --> 00:29:47,700 +يلبس العدسة لفترة زمانية قصيرة لازم انه نتجه + +341 +00:29:47,700 --> 00:29:53,420 +باتجاه ال daily او ال extended wear lenses لان كل + +342 +00:29:53,420 --> 00:29:57,640 +هذه يعني هذه النوع من العدسات no care system, no + +343 +00:29:57,640 --> 00:30:02,160 +cleaning, no maintenance system كله هيتجنبه او + +344 +00:30:02,160 --> 00:30:04,820 +هيعمله اذانة تقريبا او تقليل + +345 +00:30:08,310 --> 00:30:13,390 +طيب هذا النوع من العدسات بتميز ب major advantages + +346 +00:30:13,390 --> 00:30:17,790 +بمميزات رئيسية فوق ال conventional و planet + +347 +00:30:17,790 --> 00:30:23,210 +replacement lenses يعني في هناك له مميزات بتفوق ال + +348 +00:30:23,210 --> 00:30:27,930 +conventional daily wear الميزة + +349 +00:30:27,930 --> 00:30:32,470 +الأولى في theoregic advantages ايش المقصود فيها في + +350 +00:30:32,470 --> 00:30:33,870 +theoregic advantages؟ + +351 +00:30:37,530 --> 00:30:42,150 +بمعنى انه بتعمل reduce ل ال deposits او ال + +352 +00:30:42,150 --> 00:30:46,330 +inflammatory complications بمعنى الكلام انه بتكون + +353 +00:30:46,330 --> 00:30:51,270 +ال DK لل T عالية فبتكون العدسة ال thinning بتاعها + +354 +00:30:51,270 --> 00:30:56,510 +قليل فما بتعمل كورنيا الاديمة لمن؟ للشخص هذا معناه + +355 +00:30:56,510 --> 00:31:01,090 +انه physiologic advantages يعني كمية ال oxygen + +356 +00:31:01,090 --> 00:31:06,610 +اللى بتدخل لها الكورنيا بتكون كبيرةفما بتعمل حاجة + +357 +00:31:06,610 --> 00:31:12,950 +بنسميها ال hypoxia و هذا هيقلل من مين؟ من ال + +358 +00:31:12,950 --> 00:31:17,410 +deposits او ال inflammatory complication لذلك احنا + +359 +00:31:17,410 --> 00:31:21,770 +حكينا في هذا النوع من العدسات هيكون ال adverse + +360 +00:31:21,770 --> 00:31:27,310 +interaction اقل انتقال العدوى اقل مقارنة في مين؟ + +361 +00:31:27,310 --> 00:31:31,430 +في ال conventional daily wear اللي بتلبس من ستة + +362 +00:31:31,430 --> 00:31:37,140 +الى اتناشر شهرcan be made thinner الهدف انه تكون + +363 +00:31:37,140 --> 00:31:40,940 +thinner موضوع ال ديكي على تة higher oxygen and + +364 +00:31:40,940 --> 00:31:44,120 +comfort هتكون مريحة للمريض + +365 +00:31:45,950 --> 00:31:50,350 +compliance هتكون موافقة او مطاوعة لل patient من + +366 +00:31:50,350 --> 00:31:55,370 +حيث أنظمة الرعاية والعناية يعني ما بتحتاج تنظيف + +367 +00:31:55,370 --> 00:31:59,950 +بشكل دوري او بشكل يومي بالنسبة للمريض خاصة العدسات + +368 +00:31:59,950 --> 00:32:03,170 +اللي بتلبسها مدة أسبوعين او شهر يعني ممكن خلال + +369 +00:32:03,170 --> 00:32:07,690 +مثلا دقيقة انه يعمل عملية rinsing ويرتدي العدسة + +370 +00:32:07,690 --> 00:32:09,130 +بشكل مريح + +371 +00:32:12,320 --> 00:32:16,740 +No enzymatic protein remover فترة حياة العدسة + +372 +00:32:16,740 --> 00:32:21,760 +قصيرة فمش هتطلب من المريض أن يستخدم أنزيمات معينة + +373 +00:32:21,760 --> 00:32:28,250 +لإزالة الـ deposit من سطح العدسةNo cleaning or + +374 +00:32:28,250 --> 00:32:32,790 +disinfecting solutions or lens storage case is + +375 +00:32:32,790 --> 00:32:37,050 +required for daily disposable lenses كل أنظمة + +376 +00:32:37,050 --> 00:32:41,150 +التنظيف والعناية والرعاية والتخزين لهذا النوع من + +377 +00:32:41,150 --> 00:32:46,610 +العدسات يعني غير موجودة أو هتكون reduce أو + +378 +00:32:46,610 --> 00:32:51,230 +eliminate يعني هتكون محددةأيضا هذا النوع من + +379 +00:32:51,230 --> 00:32:54,770 +العدسات إضافة إلى ذلك موضوع ال convenience انه + +380 +00:32:54,770 --> 00:33:03,890 +مريحة وفي عندنا نقطة مهمة ال handling tint + +381 +00:33:03,890 --> 00:33:08,690 +في هذا النوع من العدسات انه ممكن انا اعمل عملية + +382 +00:33:08,690 --> 00:33:13,090 +التلوين مقارنة بال conventional daily wear خاصة + +383 +00:33:13,090 --> 00:33:17,690 +اذا كانت complex معقدة بيكون هناك صعوبة في عملية + +384 +00:33:17,690 --> 00:33:19,070 +تلوين العدسة + +385 +00:33:23,030 --> 00:33:29,750 +في هناك بعض العيوب أو المحددات الافتراضية لهذا + +386 +00:33:29,750 --> 00:33:35,130 +النوع من العدسات quantity + +387 +00:33:35,130 --> 00:33:39,910 +of manufacturing is affected large number is + +388 +00:33:39,910 --> 00:33:46,020 +needed fewer parametersهي .. انه هيكون هناك عدد + +389 +00:33:46,020 --> 00:33:52,200 +كبير من العدسات هتصنع في فترة زمانية قصيرة، يعني + +390 +00:33:52,200 --> 00:33:56,460 +ممكن الفين عدسة، تلتلاف عدسة في فترة زمانية ايش + +391 +00:33:56,460 --> 00:34:01,380 +بسيطة بتصنع at the same time طيب بعض الأشخاص اللي + +392 +00:34:01,380 --> 00:34:05,980 +بيكون عندهمover sensitive او بيكون عندهم allergy + +393 +00:34:05,980 --> 00:34:10,580 +ممكن مش هيتوافقوا مع هذا النوع من العدسات يعني + +394 +00:34:10,580 --> 00:34:15,020 +بدهم مثلا high water content بدهم مثلا العدسة تكون + +395 +00:34:15,020 --> 00:34:19,480 +اكتر thinning دخول ال oxygen ممكن يكون اكتر موضوع + +396 +00:34:19,480 --> 00:34:24,690 +ال comfort الراحة لازم تكون اكترفالاشخاص اللي + +397 +00:34:24,690 --> 00:34:29,210 +بيكون عندهم contra indication من العدسات اللاصقة + +398 +00:34:29,210 --> 00:34:33,290 +او بيكون عندهم over sensitive حساسية اكتر مش + +399 +00:34:33,290 --> 00:34:38,570 +هتتوافق معهم هذا النوع من العدسات لان كل العدسات + +400 +00:34:38,570 --> 00:34:43,450 +بتصنع at the same time ببرامتر معينة بوقت معين + +401 +00:34:47,060 --> 00:34:52,000 +Lens Parameter Repeatability وهذه مهمة كتير، الآن + +402 +00:34:52,000 --> 00:34:57,080 +احنا قلنا هذا النوع من العدسات بتيجي مغلفة، صحيح؟ + +403 +00:34:57,080 --> 00:35:02,600 +وبيكون تغليفها بشكل إيه؟ إبداعي، لكن ممكن في هدول + +404 +00:35:02,600 --> 00:35:07,000 +العدسات يكون مجموعة منهم في تكرار، يعني ال base + +405 +00:35:07,000 --> 00:35:10,700 +curve بتلاقيه مكرر أو ال power بتلاقيه مكرر + +406 +00:35:11,430 --> 00:35:15,890 +فبالتالي هذا كله خسارة لمين؟ لل practitioner او لل + +407 +00:35:15,890 --> 00:35:20,650 +examiner يعني مثلا انا بدي عشرة plus اتنين عشرة + +408 +00:35:20,650 --> 00:35:24,490 +مثلا plus تلاتة اللاحق العشرين واحدة كانت plus + +409 +00:35:24,490 --> 00:35:29,450 +تلاتة okay فبالتالي هذه ومش ممكن انا اعمل عملية + +410 +00:35:29,450 --> 00:35:35,490 +ايه استبدال لهذا النوع من العدسات ايضا no warranty + +411 +00:35:35,490 --> 00:35:40,100 +on individualموضوع الضمانة ما بيكون هناك ضمانة + +412 +00:35:40,100 --> 00:35:45,900 +يعني الآن انا يما بدي العدسات للمريض okay مش احنا + +413 +00:35:45,900 --> 00:35:49,540 +حكينا انه في ال spare lenses افرض مثلا هدول ال + +414 +00:35:49,540 --> 00:35:53,540 +spare كانوا فيهم نوع من ال damage او كانوا خربنات + +415 +00:35:53,540 --> 00:35:57,500 +او كانوا مثلا فيه scratch خلاص هدول بيعتبروا على + +416 +00:35:57,500 --> 00:36:01,080 +ال patient مش على ال practitioner او على ال + +417 +00:36:01,080 --> 00:36:02,640 +examiner okay؟ + +418 +00:36:06,580 --> 00:36:11,500 +Silicon Hydrogel Extended Wear Disposable Lenses + +419 +00:36:11,500 --> 00:36:16,440 +بنكتفي ان شاء الله لحد النقطة هذه في المحاضرة + +420 +00:36:16,440 --> 00:36:21,080 +القادمة بنكمل أنواع العدسات اللاصقة اللينة + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/dyrPqQNoh6k_raw.json b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/dyrPqQNoh6k_raw.json new file mode 100644 index 0000000000000000000000000000000000000000..1c0bd9ab08ac3220f78656c73b8d199098f7e698 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/dyrPqQNoh6k_raw.json @@ -0,0 +1 @@ +{"segments": [{"id": 1, "seek": 4328, "start": 21.02, "end": 43.28, "text": "بسم الله الرحمن الرحيم السلام عليكم ورحمة الله وبركاته and a very good morning to all of you في المحاضرة السابقة اتناولنا تعريف العدسات اللاصقة اللينة وبعد ذلك ال advantages و ال limitations للعدسات اللاصقة اللينة", "tokens": [3555, 38251, 21984, 34892, 5016, 27842, 34892, 5016, 32640, 21136, 37440, 25894, 24793, 4032, 2288, 35571, 3660, 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اللاصقة الطريقة الأولى بتعتمد على المريض نفسه", "tokens": [33594, 11587, 281, 18182, 257, 14419, 15035, 34105, 4117, 23032, 16572, 38149, 7649, 5296, 25957, 1211, 10632, 42963, 14851, 44510, 6027, 24976, 22488, 3794, 9307, 13672, 33546, 28671, 41950, 16572, 28671, 16247, 12610, 7578, 39894, 34268, 2304, 3215, 15844, 9673, 16572, 11242, 8717, 36178, 3224], "avg_logprob": -0.15268342164547546, "compression_ratio": 1.3290322580645162, "no_speech_prob": 0.0, "words": [{"start": 725.4, "end": 725.74, "word": "Two", "probability": 0.130859375}, {"start": 725.74, "end": 726.38, "word": " approaches", "probability": 0.68359375}, {"start": 726.38, "end": 727.04, "word": " to", "probability": 0.9580078125}, {"start": 727.04, "end": 727.8, "word": " selecting", "probability": 0.921875}, {"start": 727.8, "end": 728.24, "word": " a", "probability": 0.9482421875}, {"start": 728.24, "end": 728.74, "word": " replacement", "probability": 0.8974609375}, {"start": 728.74, "end": 729.92, "word": " 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"text": "الان لو انا استخدمت ال CR 39 تعتبر رخيصة الثمن فممكن انا كل شهرين كل أسبوعين اعمل تغيير للعدسة يعني this is normal okay for a practitioner and patient لكن لو انا استخدمت material غالية الثمن هتكون مكلفة لمين؟", "tokens": [6027, 7649, 45164, 1975, 8315, 44713, 9778, 40448, 2655, 2423, 14123, 15238, 6055, 34268, 26890, 12602, 9778, 1829, 9381, 3660, 6024, 104, 27842, 6156, 2304, 43020, 1975, 8315, 28242, 13412, 3224, 2288, 9957, 28242, 5551, 35457, 45367, 9957, 1975, 25957, 1211, 6055, 17082, 1829, 13546, 24976, 22488, 3794, 3660, 37495, 22653, 341, 307, 2710, 1392, 337, 257, 32125, 293, 4537, 44381, 45164, 1975, 8315, 44713, 9778, 40448, 2655, 2527, 32771, 6027, 10632, 6024, 104, 27842, 8032, 2655, 30544, 3714, 28820, 5172, 3660, 32767, 9957, 22807], "avg_logprob": -0.13253996625196102, "compression_ratio": 1.5, "no_speech_prob": 0.0, "words": [{"start": 894.29, "end": 894.71, "word": "الان", "probability": 0.8251953125}, {"start": 894.71, "end": 894.87, "word": " لو", 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a", "probability": 0.9423828125}, {"start": 1049.04, "end": 1049.46, "word": " beneficial", "probability": 0.5908203125}, {"start": 1049.46, "end": 1050.22, "word": " modality", "probability": 0.9609375}, {"start": 1050.22, "end": 1050.66, "word": " for", "probability": 0.96826171875}, {"start": 1050.66, "end": 1051.08, "word": " many", "probability": 0.89208984375}, {"start": 1051.08, "end": 1051.6, "word": " patients", "probability": 0.86572265625}], "temperature": 1.0}, {"id": 44, "seek": 107139, "start": 1052.31, "end": 1071.39, "text": "زي ما ذكرنا في السابق أن بعض الأشخاص بيكون عنده تراكم الترثبات أو ال deposits بشكل كبير فلازم أنا كل فترة زمانية أعمل استبدال، إذا ال conventional daily wear هي لا تعتبر مناسبة أو ملائمة لهذا النوع من الأشخاص", "tokens": [11622, 1829, 19446, 29910, 37983, 8315, 8978, 21136, 16758, 4587, 14739, 45030, 11242, 16247, 8592, 9778, 33546, 4724, 1829, 30544, 43242, 3224, 6055, 23557, 24793, 16712, 2288, 12984, 3555, 9307, 34051, 2423, 30958, 4724, 8592, 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تلاتة لأن التكلفة بتاعة العدسة بتكون بسيطة مدام هي Hydrogel إذاً Hydrophilic material أيضا إيش تعتبر very high water content؟", "tokens": [9566, 1829, 3555, 11933, 1829, 8592, 29739, 16254, 1211, 22807, 2423, 39184, 24231, 6675, 338, 41578, 18059, 4724, 16254, 3224, 23758, 28239, 45367, 9154, 18863, 3215, 3794, 9307, 37495, 22653, 31439, 12174, 18513, 2288, 15844, 6055, 17082, 1829, 13546, 18863, 3215, 3794, 3660, 28242, 50113, 15040, 5551, 35457, 45367, 34051, 5551, 35457, 45367, 9957, 34051, 6055, 1211, 9307, 3660, 5296, 33456, 16712, 28820, 5172, 3660, 39894, 995, 27884, 18863, 3215, 3794, 3660, 39894, 30544, 4724, 3794, 1829, 9566, 3660, 3714, 3215, 10943, 39896, 24231, 6675, 338, 11933, 15730, 14111, 24231, 11741, 388, 299, 2527, 36632, 11242, 995, 11933, 1829, 8592, 6055, 34268, 26890, 588, 1090, 1281, 2701, 22807], "avg_logprob": -0.1668577965246428, "compression_ratio": 1.5731225296442688, "no_speech_prob": 0.0, "words": [{"start": 1071.88, "end": 1072.14, "word": "طيب", 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1487.07, "end": 1487.51, "word": " thinning", "probability": 0.851806640625}, {"start": 1487.51, "end": 1487.71, "word": " of", "probability": 0.98291015625}, {"start": 1487.71, "end": 1487.89, "word": " the", "probability": 0.90185546875}, {"start": 1487.89, "end": 1488.15, "word": " lens", "probability": 0.94580078125}, {"start": 1488.15, "end": 1488.73, "word": " لان", "probability": 0.79833984375}, {"start": 1488.73, "end": 1489.23, "word": " العلاقة", "probability": 0.8631184895833334}, {"start": 1489.23, "end": 1489.41, "word": " ما", "probability": 0.94189453125}, {"start": 1489.41, "end": 1489.73, "word": " بين", "probability": 0.98876953125}, {"start": 1489.73, "end": 1490.33, "word": " ال", "probability": 0.91357421875}, {"start": 1490.33, "end": 1490.93, "word": " oxygen", "probability": 0.93505859375}, {"start": 1490.93, "end": 1492.57, "word": " transmissibility", "probability": 0.7766927083333334}, {"start": 1492.57, "end": 1493.11, "word": " و", "probability": 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انظمة محافظة او عناية للعدسة and a lens storage case is no longer required طيب ليش في هذا النوع من العدسات حتى بيحكيلك ان ال storage case مش مطلوبة او مش متوفرة؟", "tokens": [51, 511, 68, 307, 572, 1127, 1185, 3714, 41185, 8592, 8978, 1975, 1829, 16472, 19913, 46007, 3714, 5016, 31845, 19913, 3660, 1975, 2407, 6225, 8315, 10632, 24976, 22488, 3794, 3660, 293, 257, 6765, 6725, 1389, 307, 572, 2854, 4739, 23032, 1829, 3555, 32239, 8592, 8978, 23758, 28239, 45367, 9154, 18863, 3215, 3794, 9307, 11331, 49975, 4724, 1829, 5016, 4117, 1829, 23275, 16472, 2423, 6725, 1389, 37893, 3714, 9566, 1211, 37746, 3660, 1975, 2407, 37893, 44650, 38688, 25720, 22807], "avg_logprob": -0.18651107632661168, "compression_ratio": 1.4895833333333333, "no_speech_prob": 0.0, "words": [{"start": 1500.68, "end": 1501.0, "word": "There", "probability": 0.588623046875}, {"start": 1501.0, "end": 1501.16, "word": " is", "probability": 0.83984375}, {"start": 1501.16, "end": 1501.36, "word": " no", "probability": 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ببساطة المريض لو رجع العدسة على الكيس، هتصبح العدسة و كأنه drop، قطرة", "tokens": [9566, 3555, 3615, 995, 33688, 7435, 16758, 3660, 5296, 10721, 37893, 3714, 43020, 5551, 46152, 3794, 11296, 12399, 32239, 8592, 22807, 5296, 33456, 4724, 3555, 3794, 41193, 3660, 9673, 16572, 11242, 45164, 12602, 7435, 3615, 18863, 3215, 3794, 3660, 15844, 33251, 1829, 3794, 12399, 8032, 2655, 9381, 49628, 18863, 3215, 3794, 3660, 4032, 9122, 33456, 3224, 3270, 12399, 12174, 9566, 25720], "avg_logprob": -0.11517136928535276, "compression_ratio": 1.462686567164179, "no_speech_prob": 0.0, "words": [{"start": 1598.4, "end": 1598.76, "word": "طبعا", "probability": 0.9503173828125}, {"start": 1598.76, "end": 1599.28, "word": " الإجابة", "probability": 0.9029541015625}, {"start": 1599.28, "end": 1599.56, "word": " لأ", "probability": 0.878662109375}, {"start": 1599.56, "end": 1600.12, "word": " مش", "probability": 0.7275390625}, {"start": 1600.12, "end": 1600.46, "word": " ممكن", "probability": 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"word": " اللينة", "probability": 0.7879231770833334}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 2181.4915, "duration_after_vad": 2052.3406249999925} \ No newline at end of file diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/dyrPqQNoh6k_raw.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/dyrPqQNoh6k_raw.srt new file mode 100644 index 0000000000000000000000000000000000000000..e64be165dafb4e917e814a2a4afd3491a7cf0c52 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/dyrPqQNoh6k_raw.srt @@ -0,0 +1,1680 @@ +1 +00:00:21,020 --> 00:00:25,340 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:25,340 --> 00:00:29,760 +وبركاته and a very good morning to all of you في + +3 +00:00:29,760 --> 00:00:34,540 +المحاضرة السابقة اتناولنا تعريف العدسات اللاصقة + +4 +00:00:34,540 --> 00:00:39,800 +اللينة وبعد ذلك ال advantages و ال limitations + +5 +00:00:39,800 --> 00:00:47,200 +للعدسات اللاصقة اللينةاليوم هنبدأ بال soft lens + +6 +00:00:47,200 --> 00:00:53,360 +modalities أي بمعنى أنماط أو أشكال أو أنواع العدسة + +7 +00:00:53,360 --> 00:00:59,920 +اللاصقة اللينة النوع الأول conventional daily wear + +8 +00:00:59,920 --> 00:01:07,980 +عدسات اللبس اليومي التقليدي هي عبارة عن عدسات فترة + +9 +00:01:07,980 --> 00:01:15,250 +حياة العدسة بتكون من ستة إلى اتناشر شهراذا بدي + +10 +00:01:15,250 --> 00:01:20,090 +افهم شغلة مهمة كتير مدام فترة حياتها من ستة الى + +11 +00:01:20,090 --> 00:01:26,130 +اتناشر شهر اذا العدسة هذه نوعا ما هي ما هتكون هشة + +12 +00:01:26,130 --> 00:01:34,010 +ايضا بدي اعرف ان سعرها هيكون عالي الثمن نقطة اخرى + +13 +00:01:34,010 --> 00:01:40,540 +ان هذه العدسة هيكون فيها ال DK على Tmedium لأ مش + +14 +00:01:40,540 --> 00:01:44,640 +هيكون اللي هو high اما هيكون low او هيكون medium + +15 +00:01:44,640 --> 00:01:49,340 +لان لو كان high او very high بالتالي انه هتكون هشة + +16 +00:01:49,340 --> 00:01:54,610 +و هتكون thinning و مش هتعيش فترة زمنية طويلةإذاً + +17 +00:01:54,610 --> 00:01:59,550 +six to twelve months هذه عبارة عن فترة حياة العدسة + +18 +00:01:59,550 --> 00:02:05,030 +a lens that is worn العدسة بتظل ملبوسة في العين + +19 +00:02:05,030 --> 00:02:10,170 +until change is necessary due to deteriorating + +20 +00:02:10,170 --> 00:02:16,390 +lens performance or lens loss or lens damage وضيفه + +21 +00:02:16,390 --> 00:02:21,610 +كمان decreased visionإذا العدسة بتظل ملبوسة في + +22 +00:02:21,610 --> 00:02:27,290 +العين لحد ما إنه يصير هناك تدهور بأداء العدسة أو + +23 +00:02:27,290 --> 00:02:31,710 +فقدان للعدسة أو خدش في العدسة أو إنه يحدث هناك + +24 +00:02:31,710 --> 00:02:37,550 +دمار للعدسة أو إنه يقل النظر وين في العدسة اللاصقة + +25 +00:02:40,110 --> 00:02:43,930 +Planned or frequent replacement systems use + +26 +00:02:43,930 --> 00:02:48,610 +conventional daily wear lenses with a prescribed + +27 +00:02:48,610 --> 00:02:56,710 +replacement interval إذا فترة الاستبدال محددة بهذا + +28 +00:02:56,710 --> 00:03:03,540 +النوع من العدساتوهذه نقطة مهمة، لو مثلا مريض بده + +29 +00:03:03,540 --> 00:03:08,800 +يغير عدسة كل أسبوعين أو كل مثلا أربع أسابيع، هذا + +30 +00:03:08,800 --> 00:03:12,780 +النوع من العدسات غير مناسب، ليه؟ لأن فترة + +31 +00:03:12,780 --> 00:03:19,700 +الاستبدال فيها محددة، من 6 إلى 12 شهر Common + +32 +00:03:19,700 --> 00:03:25,650 +Replacement Intervalفي هناك أنواع لهذا النوع من + +33 +00:03:25,650 --> 00:03:29,850 +العدسات ويمكن تسمع فيها في السوق اما بتكون annual + +34 +00:03:29,850 --> 00:03:35,590 +سنوية او بتكون semi-annual نصف سنة او بتكون + +35 +00:03:35,590 --> 00:03:41,510 +quarterly ربع سنة يعني تلت شهور بمعنى اخر ان مدة + +36 +00:03:41,510 --> 00:03:46,030 +حياة العدسة له علاقة في مين؟ في ال cost في السعر + +37 +00:03:46,030 --> 00:03:50,330 +ان كل ما زاد فترة حياة العدسة كل ما كان سعرها ايه + +38 +00:03:50,330 --> 00:03:56,760 +اغلىconventional care and maintenance systems are + +39 +00:03:56,760 --> 00:04:02,340 +used إذا أنظمة الرعاية والمحافظة والنظافة للعدسة + +40 +00:04:02,340 --> 00:04:07,880 +اللاسقة اللينة هان تعتبر أساسية في هذا النوع من + +41 +00:04:07,880 --> 00:04:14,480 +العدسات advantages + +42 +00:04:14,480 --> 00:04:21,600 +ما هي مميزات ال conventional daily wearNumber one + +43 +00:04:21,600 --> 00:04:27,280 +custom عادة fitted in a wide range of spheric, + +44 +00:04:27,600 --> 00:04:33,380 +toric and multifocal designs يعني لو أردنا صناعة + +45 +00:04:33,380 --> 00:04:39,760 +عدسة أن تكون special lens + +46 +00:04:41,340 --> 00:04:45,660 +بمعنى انه الـ base curve معين، ال parameter معينة، + +47 +00:04:45,660 --> 00:04:49,860 +ال diameter معين، انه بتستخدم للنير و لل distance + +48 +00:04:49,860 --> 00:04:53,820 +و ال intermediate، هذا النوع من العدسات يعتبر + +49 +00:04:53,820 --> 00:05:00,450 +مناسبIn materials of low, medium or high water + +50 +00:05:00,450 --> 00:05:05,290 +content لكن في هنا ملاحظة مهمة ان كل ما زاد ال + +51 +00:05:05,290 --> 00:05:10,410 +water content للعدسة كل ما أصبحت هشة ففترة حياتها + +52 +00:05:10,410 --> 00:05:16,070 +ايه بتقل يعني ممكن مثلا مريض بده يرتدي عدسة لاصقة + +53 +00:05:16,070 --> 00:05:20,350 +انه تكون multifocal او progressive lens لفترة + +54 +00:05:20,350 --> 00:05:25,600 +زمانية قصيرةال cost مش مهم عنده فممكن انا اوفرله + +55 +00:05:25,600 --> 00:05:30,640 +عدسة conventional daily wear بس ال cost ايش هيكون + +56 +00:05:30,640 --> 00:05:36,000 +very high number two + +57 +00:05:36,000 --> 00:05:39,600 +the widest variety of parameters is available + +58 +00:05:39,600 --> 00:05:44,660 +هيكون هناك مجموعة متنوعة واسعة من المحددات لهذا + +59 +00:05:44,660 --> 00:05:48,560 +النوع من العدسات من حيث ال base curve ال diameter + +60 +00:05:48,560 --> 00:05:49,340 +ال power + +61 +00:05:53,340 --> 00:05:57,460 +conventional daily wear lenses may be the only + +62 +00:05:57,460 --> 00:06:03,000 +option for patients who require complex expensive + +63 +00:06:03,000 --> 00:06:08,880 +lenses بعض الأشخاص بحب إنه يلبس عدسة من نوع ال + +64 +00:06:08,880 --> 00:06:15,230 +progressive lensفبعمله كل ال evaluation لل soft + +65 +00:06:15,230 --> 00:06:18,550 +contact lens بشوف ال indication ال contra + +66 +00:06:18,550 --> 00:06:23,850 +indication تقبله للعدسة لكن بدي اخد بعين الاعتبار + +67 +00:06:23,850 --> 00:06:29,550 +انه قد يكون السعر غالي للعدسة المريض بيحكيلك انه + +68 +00:06:29,550 --> 00:06:33,650 +لو حتى السعر غالي انا ممكن ايه ادفع سعر العدسة + +69 +00:06:33,650 --> 00:06:38,970 +بشكل طبيعيأيضا موضوع التنظيف انه لازم انه يعمل + +70 +00:06:38,970 --> 00:06:43,850 +عملية تنظيف daily wear كل يوم مش كتير فارقة معه + +71 +00:06:43,850 --> 00:06:48,490 +انه ممكن انه ينظف العدسة بشكل يومي ممكن انه يستخدم + +72 +00:06:48,490 --> 00:06:52,910 +أنظمة المحافظة عليها الرعاية كل هذه ال systems + +73 +00:06:52,910 --> 00:06:57,410 +لازم انه يكون معروف عن مين عند المريض او ال + +74 +00:06:57,410 --> 00:07:03,750 +patient ال disadvantages العيوب لهذا النوع من + +75 +00:07:03,750 --> 00:07:09,320 +العدساتNumber one require complex care systems + +76 +00:07:09,320 --> 00:07:15,900 +that include protein remover tablets اذا بتطلب من + +77 +00:07:15,900 --> 00:07:22,080 +المريض انه يستخدم محاليل تنظيف ومحاليل عناية + +78 +00:07:22,080 --> 00:07:27,580 +ومحافظة عليها بشكل كبير ليه؟ لأن فترة حياة العدسة + +79 +00:07:27,580 --> 00:07:33,940 +طويلة فهيتراكم عليها العديد من البروتيناتفكيف انا + +80 +00:07:33,940 --> 00:07:38,060 +ممكن ان اتخلص من هذه الترثبات و هذه البروتينات من + +81 +00:07:38,060 --> 00:07:45,180 +خلال استخدام البروتين تابلس higher + +82 +00:07:45,180 --> 00:07:50,340 +overall rate of adverse reactions than disposable + +83 +00:07:50,340 --> 00:07:56,890 +lensesلو سألي السؤال مين العدسات اللى بتكون فيها + +84 +00:07:56,890 --> 00:08:01,710 +العدو أكتر؟ هذا النوع من العدسات ال conventional + +85 +00:08:01,710 --> 00:08:06,230 +daily wear ولا ال disposable lenses اللى بتكون + +86 +00:08:06,230 --> 00:08:11,720 +فترة حياتها قصيرة؟الـ Conventional Daily Wear ليه؟ + +87 +00:08:11,720 --> 00:08:16,200 +لأنه بتعيش فترة زمانية طويلة فبتعمل inflammatory + +88 +00:08:16,200 --> 00:08:21,340 +complications بشكل أكبر مقارنة في مين في العدسات + +89 +00:08:21,340 --> 00:08:25,560 +الـ disposable lenses اللي بيكون فترة حياتها قصيرة + +90 +00:08:25,560 --> 00:08:29,200 +في بعض العدسات بيكون من two weeks ل one month + +91 +00:08:29,200 --> 00:08:33,700 +Leath + +92 +00:08:33,700 --> 00:08:39,460 +cutting وهذا عبارة عن قالب القطعالان ممكن طالب + +93 +00:08:39,460 --> 00:08:43,980 +تسألني سؤال ليش الـ conventional daily wear يعتبر + +94 +00:08:43,980 --> 00:08:49,040 +سعرها غالي؟ لأنها بتستخدم قالب بنسميه الـ lathe + +95 +00:08:49,040 --> 00:08:54,140 +cutting هذا القالب بيستخدم للعدسات اللي بتكون + +96 +00:08:54,140 --> 00:08:59,930 +غالية الثمنوبتكون يعني صناعتها بشكل معقد يعني الآن + +97 +00:08:59,930 --> 00:09:03,310 +لو احنا قررنا ما بين عدسة progressive lens او + +98 +00:09:03,310 --> 00:09:08,450 +multifocal lens مع عدسة عادية هتلاحظ ان السعر بتاع + +99 +00:09:08,450 --> 00:09:13,090 +ال progressive غالي وايضا القالب اللي بيستخدم + +100 +00:09:13,090 --> 00:09:17,610 +لصناعة هذا النوع من العدسات هيكون معقد اكتر صح ولا + +101 +00:09:17,610 --> 00:09:23,680 +لا فهذا كله بيتحكم في مين؟ في ال costThe most + +102 +00:09:23,680 --> 00:09:28,740 +labor intensive حيكون عمل شديد وين في اللي هو ال + +103 +00:09:28,740 --> 00:09:33,300 +labor او في المعمل and hence هلاحظ the most + +104 +00:09:33,300 --> 00:09:37,580 +expensive انه ال peer lens الذوج من العدسات هيكون + +105 +00:09:37,580 --> 00:09:42,620 +غالي مقارنة بالعدسات الأخرى of the available + +106 +00:09:42,620 --> 00:09:47,880 +methods مقارنة بالعدسات ال disposable lenses او ال + +107 +00:09:47,880 --> 00:09:53,350 +extended wear lensesإذا لو سألنا سؤال ليش العدسات + +108 +00:09:53,350 --> 00:10:00,830 +الـ conventional daily wear غالية الثمن؟ فضل إيه؟ + +109 +00:10:00,830 --> 00:10:06,710 +عشان ال .. ال led cutting عبارة عن قلب و هو + +110 +00:10:06,710 --> 00:10:10,110 +باستخدام العدسة تغالية الثمن فهي تكون conventional + +111 +00:10:10,110 --> 00:10:15,110 +بالضبط و هذا بيكون القلب إشماله معقد من حيث + +112 +00:10:15,110 --> 00:10:16,950 +الصناعة okay؟ + +113 +00:10:20,100 --> 00:10:24,880 +High DK Materials الان ايش العدسات اللي بيكون High + +114 +00:10:24,880 --> 00:10:29,820 +DK Materials انواع العدسات اللي بيكون فيها DK + +115 +00:10:29,820 --> 00:10:37,700 +Materials High فضل يا سحر اها اذا هي تعتبر ايه + +116 +00:10:37,700 --> 00:10:41,680 +very high water content صح عشان ما تعمل cornia + +117 +00:10:41,680 --> 00:10:48,160 +القديمة والنوع التاني تفضليبالضبط إذا في عنا نوعين + +118 +00:10:48,160 --> 00:10:52,520 +أساسيين بيكون فيهم الـ DK على T material very high + +119 +00:10:52,520 --> 00:10:57,260 +النوع الأول ال very high water content النوع + +120 +00:10:57,260 --> 00:11:02,820 +التاني ال silicon hydro gel soft contact lens هدول + +121 +00:11:02,820 --> 00:11:06,060 +غير متاحين وين؟ في ال conventional daily wear + +122 +00:11:06,060 --> 00:11:11,520 +السبب في ذلك لو أنا عملت high DK material لعدسة ال + +123 +00:11:11,520 --> 00:11:16,800 +conventional daily wear هصير إيش؟ هشةو هصير فترة + +124 +00:11:16,800 --> 00:11:24,120 +حياتها قصيرة و هتخلص منها بشكل سريع لكن العدسات + +125 +00:11:24,120 --> 00:11:28,220 +اللى بتتم التخلص منها بشكل سريع خلال اسبوع او خلال + +126 +00:11:28,220 --> 00:11:32,760 +يوم ممكن ان تكون العدسة هذه very thinning ممكن ان + +127 +00:11:32,760 --> 00:11:36,340 +يكون فيها ال water content very high هذا امر اشي + +128 +00:11:36,340 --> 00:11:41,900 +اعتبر طبيعى بالنسبة لهذا النوع من العدساتإذاً، + +129 +00:11:41,900 --> 00:11:46,280 +لماذا المواد الـ High-Decay ليسوا مفيدين للعدسة + +130 +00:11:46,280 --> 00:11:51,700 +الواتر؟ لأن كل ما زاد ال water content للعدسة، كل + +131 +00:11:51,700 --> 00:11:55,040 +ما أصبعت هي very thin، وبالتالي فترة حياتها إيش + +132 +00:11:55,040 --> 00:12:01,440 +بتصبح قصيرة؟ Okay، وبنتخلص منها بشكل سريع + +133 +00:12:05,400 --> 00:12:09,920 +Two approaches to selecting a replacement interval + +134 +00:12:09,920 --> 00:12:16,540 +هناك طريقتان لعملية الاستبدال للعدسات اللاصقة + +135 +00:12:16,540 --> 00:12:24,210 +الطريقة الأولى بتعتمد على المريض نفسهبواسطة ان + +136 +00:12:24,210 --> 00:12:29,870 +اعمل انا observation ملاحظة او monitoring للمريض + +137 +00:12:29,870 --> 00:12:34,750 +الان انا لما بدي اصرف العدسة اللاصقة لازم اعمل + +138 +00:12:34,750 --> 00:12:40,430 +follow-up متابعة للمريض كل فترة زمنية محددة بمعنى + +139 +00:12:40,430 --> 00:12:44,370 +انه مثلا كل شهرين لو conventional daily weed كل + +140 +00:12:44,370 --> 00:12:49,650 +شهرين ان المريض بدي يعمل متابعة من خلال ال + +141 +00:12:49,650 --> 00:12:54,670 +practitioner او من خلال ال optometristفهذا النوع + +142 +00:12:54,670 --> 00:12:59,110 +patient dependent replacement interval، إذا هذا + +143 +00:12:59,110 --> 00:13:03,830 +النوع من العدسات هيعتمد على المريض نفسه Monitoring + +144 +00:13:03,830 --> 00:13:08,490 +أو observing إنه ملاحظة ال patient المريض in the + +145 +00:13:08,490 --> 00:13:12,670 +first few weeks في الأسابيع الأولى أو في الأشهر + +146 +00:13:12,670 --> 00:13:17,850 +الأولى of lens wear من إتداء العدسة بعض الأشخاص + +147 +00:13:17,850 --> 00:13:23,940 +بتلاقي أن تراكم ال deposit بشكل كبيرعندهم مقارنة + +148 +00:13:23,940 --> 00:13:30,900 +بشخص آخر فهذا كله بيعمل ايه؟ تأثير على العدسة + +149 +00:13:30,900 --> 00:13:36,620 +اللاصقة و بيقلل من فترة حياة العدسة اللاصقةThe + +150 +00:13:36,620 --> 00:13:41,500 +replacement frequency فترة الاستبدال of soft + +151 +00:13:41,500 --> 00:13:46,260 +lenses للعدسات اللينة is often determined غالبا + +152 +00:13:46,260 --> 00:13:51,780 +بيحدد by the ratio of cost to benefit يعني حسب ان + +153 +00:13:51,780 --> 00:13:56,020 +انا بدي اعمل استفتاء للمريض كيف استفتاء للمريض؟ ان + +154 +00:13:56,020 --> 00:14:01,100 +ال cost و ال benefitبداية ال cost يعتبر غالي ال + +155 +00:14:01,100 --> 00:14:05,120 +conventional daily wear فهل المريض مستعد انه يغير + +156 +00:14:05,120 --> 00:14:10,200 +بعد أسابيع قليلة العدسة اللاصقة او هل هو مستعد على + +157 +00:14:10,200 --> 00:14:13,860 +تغيير العدسة اللاصقة بعد أشهر بعد شهرين تلاتة + +158 +00:14:13,860 --> 00:14:19,060 +فلازم انا اعمل discussion مع المريض ايضا ال + +159 +00:14:19,060 --> 00:14:22,900 +benefit هل هتكون كبيرة لو هو غير العدسة ولا لا؟ هل + +160 +00:14:22,900 --> 00:14:28,140 +هتحسن من الرؤية؟هل مثلا بعد شهرين او تلاتة هيصير + +161 +00:14:28,140 --> 00:14:31,860 +تدهور كبير في أداء العدسة ولا ممكن انا اتغاضى عن + +162 +00:14:31,860 --> 00:14:36,140 +النقطة هذه؟ كل هذه الأمور يجب ان تكون واضحة + +163 +00:14:36,140 --> 00:14:42,620 +بالنسبة للـ practitioner number + +164 +00:14:42,620 --> 00:14:47,580 +two fixed replacement interval depends on lens + +165 +00:14:47,580 --> 00:14:52,500 +material اذا ايضا بتعتمد على نوع ال material + +166 +00:14:52,500 --> 00:14:58,690 +للعدسةالان لو انا استخدمت ال CR 39 تعتبر رخيصة + +167 +00:14:58,690 --> 00:15:03,230 +الثمن فممكن انا كل شهرين كل أسبوعين اعمل تغيير + +168 +00:15:03,230 --> 00:15:07,310 +للعدسة يعني this is normal okay for a practitioner + +169 +00:15:07,310 --> 00:15:11,470 +and patient لكن لو انا استخدمت material غالية + +170 +00:15:11,470 --> 00:15:16,950 +الثمن هتكون مكلفة لمين؟لل patient و غير ذلك انت اي + +171 +00:15:16,950 --> 00:15:21,610 +عدسة بدك تعمليلها وصف لازم انه يتم صناعتها من خلال + +172 +00:15:21,610 --> 00:15:26,670 +main المصنع اي بمعنى انه بدها فترة زمنية اطول لحد + +173 +00:15:26,670 --> 00:15:29,070 +ما تصل ل ال patient + +174 +00:15:33,290 --> 00:15:39,250 +هذه notebook ملاحظة مهمة if the new lens feels + +175 +00:15:39,250 --> 00:15:43,610 +much better than the one it replaced it was + +176 +00:15:43,610 --> 00:15:49,070 +supplied too late نفترض الآن مريض لبس عدسة لمدة + +177 +00:15:49,070 --> 00:15:55,460 +الشهرينبعد الشهرين اعملنا استبدال للعدسة، إذا لاحظ + +178 +00:15:55,460 --> 00:16:00,000 +المريض هناك فيه فرق ما بين الرؤية في العدسة الأولى + +179 +00:16:00,000 --> 00:16:04,300 +و العدسة التانية و الفرق هذا كبير في الرؤية، يعني + +180 +00:16:04,300 --> 00:16:09,000 +في هناك رؤية أفضل في العدسة التانية، معنى الكلام + +181 +00:16:09,000 --> 00:16:12,620 +أن ال practitioner أو ال optometrist أو ال + +182 +00:16:12,620 --> 00:16:17,730 +physician الطبيب اتأخر في عملية استبدال العدسةيعني + +183 +00:16:17,730 --> 00:16:22,450 +أخدنا فترة زمانية طويلة لعملية إيه الاستبدال وهذا + +184 +00:16:22,450 --> 00:16:28,590 +يعتبر من الأخطاء الشائعة في انه كيف انا بدي أصرف + +185 +00:16:28,590 --> 00:16:32,970 +العدسة اللاصقة لازم ان يكون الفرق ما بين العدسة + +186 +00:16:32,970 --> 00:16:37,690 +الأولى والعدسة التانية فرق بسيط في الرؤية مايشعرش + +187 +00:16:37,690 --> 00:16:43,610 +هناك جاب فجوة كبيرة في الرؤية من حيث العدستين واضح + +188 +00:16:43,610 --> 00:16:44,270 +الفكرة؟ + +189 +00:16:47,870 --> 00:16:52,530 +النوع التاني من العدسات هي عبارة عن الـ Hydrogel + +190 +00:16:52,530 --> 00:16:57,930 +disposable lenses هذا النوع من العدسات أول ما تم + +191 +00:16:57,930 --> 00:17:01,390 +صناعته في سنة الف وتسعمائة و تمانين + +192 +00:17:04,360 --> 00:17:09,100 +بتتميز بأنها ليست غالية الثمن لو عملنا مقارنة ما + +193 +00:17:09,100 --> 00:17:14,280 +بينها وبين ال daily wear إذا هي inexpensive ليست + +194 +00:17:14,280 --> 00:17:18,280 +غالية الثمن disposable limbs that could be + +195 +00:17:18,280 --> 00:17:23,440 +replaced weekly ممكن إنه يتم تغييرها كل مثلا أسبوع + +196 +00:17:23,440 --> 00:17:27,680 +أو أسبوعين لأنه رخيصة بالنسبة للمريض to buy weekly + +197 +00:17:27,680 --> 00:17:32,630 +would be a beneficial modality for many patientsزي + +198 +00:17:32,630 --> 00:17:37,010 +ما ذكرنا في السابق أن بعض الأشخاص بيكون عنده تراكم + +199 +00:17:37,010 --> 00:17:41,870 +الترثبات أو ال deposits بشكل كبير فلازم أنا كل + +200 +00:17:41,870 --> 00:17:45,290 +فترة زمانية أعمل استبدال، إذا ال conventional + +201 +00:17:45,290 --> 00:17:50,190 +daily wear هي لا تعتبر مناسبة أو ملائمة لهذا النوع + +202 +00:17:50,190 --> 00:17:55,120 +من الأشخاصطيب إيش البديل؟ الـ Hydrogel disposable + +203 +00:17:55,120 --> 00:18:00,600 +lenses بديه هذا النوع من العدسات يعني هو قادر على + +204 +00:18:00,600 --> 00:18:05,380 +تغيير العدسة كل مثلا أسبوع أو أسبوعين أو تلاتة لأن + +205 +00:18:05,380 --> 00:18:10,180 +التكلفة بتاعة العدسة بتكون بسيطة مدام هي Hydrogel + +206 +00:18:10,180 --> 00:18:14,380 +إذاً Hydrophilic material أيضا إيش تعتبر very high + +207 +00:18:14,380 --> 00:18:15,980 +water content؟ + +208 +00:18:21,040 --> 00:18:25,020 +Disposable lenses reduce the amount of lens + +209 +00:18:25,020 --> 00:18:30,760 +maintenance required بالنسبة للمحافظة لهذا النوع + +210 +00:18:30,760 --> 00:18:36,660 +من العدسات ليس بدرجة كبيرة مقارنة في مين في ال + +211 +00:18:36,660 --> 00:18:39,860 +conventional daily wear زي ما اتفقنا ان ال + +212 +00:18:39,860 --> 00:18:44,020 +conventional daily wear أنظمة المحافظة والعناية + +213 +00:18:44,020 --> 00:18:50,100 +عليها لازم ان تكون بدرجة كبيرةعشان تقدر ان تعيش + +214 +00:18:50,100 --> 00:18:54,660 +فترة زمانية أطول مع الشخص هذا النوع من العدسات لأ + +215 +00:18:54,660 --> 00:19:00,180 +أنظمة المحافظة عليها ممكن مثلا تكون بسيطة او غير + +216 +00:19:00,180 --> 00:19:04,660 +مهمة كتير لان خلال أسبوع او أسبوعين المريض هيتخلص + +217 +00:19:04,660 --> 00:19:11,080 +منهاthereby reducing the cost هذا هيقلل من ايه؟ من + +218 +00:19:11,080 --> 00:19:16,520 +السعر للعدسة and compliance والالتزام فيها burden + +219 +00:19:16,520 --> 00:19:21,600 +on the patient يعني هذا هيقلل من سعر العدسة + +220 +00:19:21,600 --> 00:19:27,440 +والتزام او المطاوعة او موافقة المريض مع ايه؟ مع كل + +221 +00:19:27,440 --> 00:19:31,220 +هذه الأنظمة اللي خاصة بالرعاية و العناية + +222 +00:19:34,770 --> 00:19:38,890 +A wide variety of disposable lenses are now + +223 +00:19:38,890 --> 00:19:43,530 +available في هناك مجموعة واسعة من هذا النوع من + +224 +00:19:43,530 --> 00:19:47,770 +العدسات متوفرة في السوق زي ما بتعرفوا في هناك ال + +225 +00:19:47,770 --> 00:19:51,270 +extended wear في هناك ال daily wear في أكتر من نوع + +226 +00:19:51,270 --> 00:19:58,130 +موجود من هذا النوع من العدساتعنا النوع الأول two + +227 +00:19:58,130 --> 00:20:03,530 +week monthly disposable hydrogel lenses يعني هذه + +228 +00:20:03,530 --> 00:20:08,790 +العدسة بتعيش فترة زمانية أسبوعين أو شهر وبعد ذلك + +229 +00:20:08,790 --> 00:20:15,550 +بتتم إيه التخلص منها okay molding + +230 +00:20:15,550 --> 00:20:20,610 +technology إذا هذا عبارة عن القالب اللي بيستخدم + +231 +00:20:20,610 --> 00:20:24,940 +لصناعة هذا النوع من العدساتفي الـ conventional + +232 +00:20:24,940 --> 00:20:28,660 +daily wear استخدمنا الـ lathe cutting اللي هو + +233 +00:20:28,660 --> 00:20:34,180 +يعتبر قالب معقد و غير بسيط في الاستخدام و اللي + +234 +00:20:34,180 --> 00:20:39,200 +بيجعل العدسة سعرها غالي السمن لكن هذا النوع تستخدم + +235 +00:20:39,200 --> 00:20:44,990 +تقنية القالب ال molding technologyفكان low cost + +236 +00:20:44,990 --> 00:20:51,450 +اقل ثمن او السعر بتاعه اقل permit disposing of + +237 +00:20:51,450 --> 00:20:57,110 +lenses rather than a protein cleaning them شركات + +238 +00:20:57,110 --> 00:21:02,270 +اللي بتصنع العدسات اللاصقة نفس الشركات اللي بتصنع + +239 +00:21:02,270 --> 00:21:09,070 +ال mobileإنه إيش بتعمل؟ limitation في الجوال عشان + +240 +00:21:09,070 --> 00:21:13,870 +بعد ذلك يصير هناك update للجوال ويتم تغييره خلال + +241 +00:21:13,870 --> 00:21:18,530 +فترة زمانية قصيرة نفس الحاجة هنا بيستخدموا هذا + +242 +00:21:18,530 --> 00:21:23,290 +القالب ال molding technology لسببينبقلل السعر + +243 +00:21:23,290 --> 00:21:30,870 +والسبب التاني هذا النوع من القوالب بيعمل على تجميع + +244 +00:21:30,870 --> 00:21:36,810 +اكتر من عشر بروتينات على سطح ايش العدسةيعني العدسة + +245 +00:21:36,810 --> 00:21:40,790 +الـ anterior surface للـ lens بيتجمع هناك أكتر من + +246 +00:21:40,790 --> 00:21:45,030 +عشر أنواع من البروتينات، بالتالي هيحدث هناك + +247 +00:21:45,030 --> 00:21:51,850 +deposits للعدسة وبالتالي يجب أن نتخلص من العدسة + +248 +00:21:51,850 --> 00:21:57,240 +خلال فترة زمنية قصيرةOkay فهو يما بيحكيلك ان فترة + +249 +00:21:57,240 --> 00:22:02,760 +حياة العدسة مجرد اسبوعين او شهر لازم بعد ذلك ممكن + +250 +00:22:02,760 --> 00:22:06,420 +ان تعيش معاك العدسة اكتر من ذلك و ممكن مايصير هناك + +251 +00:22:06,420 --> 00:22:10,280 +تداهور للرؤية لكن هذا كله بيعمل ايه؟ complications + +252 +00:22:10,280 --> 00:22:13,860 +للمريض و بيعمل هناك ادرار له + +253 +00:22:18,080 --> 00:22:22,620 +Innovative Multiple Packaging of Lenses هذا النوع + +254 +00:22:22,620 --> 00:22:29,060 +من العدسات بتكون مغلفة بشكل إبداعيهي ما بتيجي زوج + +255 +00:22:29,060 --> 00:22:33,420 +من العدسات، بتيجي اكتر من تنتين، يعني ممكن تكون + +256 +00:22:33,420 --> 00:22:37,480 +مثلا اربع ازواج، خمس ازواج، يعني بمعنى ان المريض + +257 +00:22:37,480 --> 00:22:41,200 +ايش بيكون عنده في البيت؟ ال spare lenses، يعني + +258 +00:22:41,200 --> 00:22:45,680 +عدسات احتياط، يعني ما بيحتاج كل فترة زمانية قصيرة + +259 +00:22:45,680 --> 00:22:49,820 +يرجع لمين؟ لل practitioner أو يرجع لل optometrist، + +260 +00:22:49,820 --> 00:22:55,530 +لأ عنده في عدسات ال spareإذا innovative multiple + +261 +00:22:55,530 --> 00:22:59,790 +packaging of lenses هناك طريقة بتكون فيها نوع من + +262 +00:22:59,790 --> 00:23:04,570 +الإبداع في عملية التغليف للعدسات which allows هذه + +263 +00:23:04,570 --> 00:23:08,570 +هتسمح convenient replacement أن تكون طريقة + +264 +00:23:08,570 --> 00:23:13,110 +الاستبدال سهلة ومريحة بالنسبة لمن؟ للمريض أيضا ال + +265 +00:23:13,110 --> 00:23:18,350 +schedules الجدول للبس أو ارتداء العدسات هيكون سهل + +266 +00:23:18,350 --> 00:23:23,530 +بالنسبة للمريضSince the patient not in need + +267 +00:23:23,530 --> 00:23:27,110 +returned to the practitioner for every new pair of + +268 +00:23:27,110 --> 00:23:30,410 +lenses مش هيحتاج من المريض انه يرجع ل ال + +269 +00:23:30,410 --> 00:23:36,710 +practitioner كل ما يستبدل زوج من العدسات الميزة + +270 +00:23:36,710 --> 00:23:43,270 +اللى بتتميز عن ميزة ال two week monthly عن عدسات + +271 +00:23:43,270 --> 00:23:46,590 +ال conventional daily wear ان هناك يوجد عدسات + +272 +00:23:46,590 --> 00:23:53,490 +احتياط عند المريض ال spare lensesالنوع التاني + +273 +00:23:53,490 --> 00:23:59,850 +daily disposable lenses من اسمها Badam Daily يومي، + +274 +00:23:59,850 --> 00:24:05,690 +يعني المريض بتخلص منها في نهاية اليوم، يعني يوم + +275 +00:24:05,690 --> 00:24:08,610 +واحد فقط ايه برتديها أو بلبسها + +276 +00:24:11,110 --> 00:24:15,670 +Lenses don't need to be cleaned or disinfected + +277 +00:24:15,670 --> 00:24:20,910 +each night ما بتطلب من المريض عملية التعقيم وعملية + +278 +00:24:20,910 --> 00:24:27,330 +التنظيف للعدسة مجرد انه ما يلبسها يوم واحد بعد ذلك + +279 +00:24:27,330 --> 00:24:32,010 +بتخلص منها طيب + +280 +00:24:32,010 --> 00:24:36,710 +هذا النوع من العدسات هيكون ال DK على T high ولا + +281 +00:24:36,710 --> 00:24:44,070 +low؟ very highحيكون very high فبال thickness ايش + +282 +00:24:44,070 --> 00:24:48,730 +هتكون؟ بالضبط انه هتكون thinning of the lens لان + +283 +00:24:48,730 --> 00:24:53,110 +العلاقة ما بين ال oxygen transmissibility و + +284 +00:24:53,110 --> 00:24:56,730 +thickness of the lens علاقة ايش؟ inversely + +285 +00:24:56,730 --> 00:25:02,160 +appropriation علاقة عكسيةThere is no care system + +286 +00:25:02,160 --> 00:25:09,200 +مفيش في اي انظمة محافظة او عناية للعدسة and a lens + +287 +00:25:09,200 --> 00:25:15,920 +storage case is no longer required طيب ليش في هذا + +288 +00:25:15,920 --> 00:25:21,100 +النوع من العدسات حتى بيحكيلك ان ال storage case مش + +289 +00:25:21,100 --> 00:25:23,460 +مطلوبة او مش متوفرة؟ + +290 +00:25:25,720 --> 00:25:30,220 +طيب أنا بدي أديكي مثال، الآن أنا عندي عدسة daily + +291 +00:25:30,220 --> 00:25:35,960 +wear، البست لمدة الساعة فقط، لو أنا بدي أرجحها في + +292 +00:25:35,960 --> 00:25:45,280 +الكيس، ممكن ولا لا؟ ايش رأيكم؟ فضلي + +293 +00:25:46,830 --> 00:25:52,010 +واضح السؤال؟ الان انا عندى عدسة daily wear lens + +294 +00:25:52,010 --> 00:25:57,950 +فترة حياتها twenty four hours انا البستها لمدة + +295 +00:25:57,950 --> 00:26:03,070 +ساعة و بدى اتخلص منها، هل لو انا مثلا فكرت بعد + +296 +00:26:03,070 --> 00:26:08,570 +ساعتين ارجع ألبسها ممكن ولا لا؟ + +297 +00:26:08,570 --> 00:26:16,050 +ايش رأيكم؟دايما أسئلة ال practitioner في ال + +298 +00:26:16,050 --> 00:26:19,690 +contact lens بالشكل هذا يعني انتم لاحظين يمكن في + +299 +00:26:19,690 --> 00:26:24,210 +هناك سهولة في المادة من حيث الأنواع لكن وين دايما + +300 +00:26:24,210 --> 00:26:28,310 +المطب زي هيك شغلة بيجي المريض daily wear lenses + +301 +00:26:28,310 --> 00:26:34,110 +بده يلبس طيب أنا بلبسها فقط لمدة تلت ساعات ايش + +302 +00:26:34,110 --> 00:26:38,760 +رأيك ألبس تلت ساعات بعد ذلك ألبسها ولا لأ؟طبعا + +303 +00:26:38,760 --> 00:26:43,860 +الإجابة لأ مش ممكن ألبسها، ليش؟ لأن ببساطة المريض + +304 +00:26:43,860 --> 00:26:49,620 +لو رجع العدسة على الكيس، هتصبح العدسة و كأنه drop، + +305 +00:26:49,620 --> 00:26:54,700 +قطرةواضحة؟ يا ما ييجي يلبسها مرة تانية و كأنه drop + +306 +00:26:54,700 --> 00:26:59,380 +فبتلبس العدسة فقط مدة اربع و عشرين ساعة وبتم + +307 +00:26:59,380 --> 00:27:04,980 +التخلص منها سواء لبسها نص ساعة لبسها عشر دقائق خمس + +308 +00:27:04,980 --> 00:27:10,560 +دقائق بعد ذلك يجب التخلص من هذا النوع من العدسات + +309 +00:27:10,560 --> 00:27:15,940 +لأن لو حاول أنه يلبسها مرة تانية هتصبح العدسة و + +310 +00:27:15,940 --> 00:27:18,980 +كأنه drop قطرة في العين + +311 +00:27:24,160 --> 00:27:27,940 +و كأنه قطرة يعني كيف الآن تأثير القطرة اللي هان + +312 +00:27:27,940 --> 00:27:32,620 +يما انا مثلا احطلك ميدراميد او لوكالين كيف هتشعره؟ + +313 +00:27:32,620 --> 00:27:36,420 +بشعور انه و كأنه foreign body هيكون فيه هناك حرجان + +314 +00:27:36,420 --> 00:27:40,600 +burning في ال eye صح ولا لأ؟ فهذا الشعور اللي + +315 +00:27:40,600 --> 00:27:45,690 +هيشعر فيه المريضAccording to Food and Drug + +316 +00:27:45,690 --> 00:27:50,770 +Administration، هذه المنظمة الصحية والدواء عرفوا + +317 +00:27:50,770 --> 00:27:56,110 +الـ disposable in terms of contact lenses as using + +318 +00:27:56,110 --> 00:28:03,060 +once مربى واحدة فقطWhich may mean one week of + +319 +00:28:03,060 --> 00:28:07,600 +extended wear. إذا الـ extended wear لمدة أسبوع، + +320 +00:28:07,600 --> 00:28:13,240 +بلبسها المريض، بنام فيها بشكل طبيعي طبعا ال .. هذا + +321 +00:28:13,240 --> 00:28:16,860 +النوع من العدسات أيضا الـ DK على T يجب أن تكون + +322 +00:28:16,860 --> 00:28:20,440 +very high لأنه لو ماكنتش عالية ممكن أنه تعمل + +323 +00:28:20,440 --> 00:28:24,760 +للمريض a corneal edema مباشرةOr one day of daily + +324 +00:28:24,760 --> 00:28:28,180 +wear أو العدسات ال daily disposable lenses اللي + +325 +00:28:28,180 --> 00:28:33,240 +بتلبس مدة twenty four hours لازم لو لبسها مدة عشر + +326 +00:28:33,240 --> 00:28:37,540 +دقائق ربع ساعة ساعة نص ساعة لازم انه يتخلص منها + +327 +00:28:37,540 --> 00:28:43,020 +بعد ذلك وهذه الأسئلة كتير دايما انه مع ال examiner + +328 +00:28:43,020 --> 00:28:46,780 +او مع ال practitioner بتمر عليه من خلال المريض + +329 +00:28:48,740 --> 00:28:53,100 +Daily disposable lenses appear to reduce or + +330 +00:28:53,100 --> 00:28:58,540 +eliminate many of the problems that may occur with + +331 +00:28:58,540 --> 00:29:04,260 +conventional soft lenses هناك عديد من المشاكل اللي + +332 +00:29:04,260 --> 00:29:08,080 +عملت إلها إيش تحديد أو قللتها أو عملت إلها + +333 +00:29:08,080 --> 00:29:13,320 +eliminate إزالة من هذا النوع من العدسات مقارنة بال + +334 +00:29:13,320 --> 00:29:18,120 +conventional daily wearAs well as providing + +335 +00:29:18,120 --> 00:29:23,060 +maximum convenience for the patient وهذه ستعمل + +336 +00:29:23,060 --> 00:29:28,880 +سهولة وارتياح بالنسبة لمن؟ للمريض أصعب شيء للشخص + +337 +00:29:28,880 --> 00:29:32,820 +اللي بيرتدي ال soft contact lens هو موضوع ال care + +338 +00:29:32,820 --> 00:29:37,400 +system ال cleaning system وموضوع ال maintenance + +339 +00:29:37,400 --> 00:29:42,480 +أدوة التلاش شغلات أصعب شيءفدائما اللى بيفكر انه + +340 +00:29:42,480 --> 00:29:47,700 +يلبس العدسة لفترة زمانية قصيرة لازم انه نتجه + +341 +00:29:47,700 --> 00:29:53,420 +باتجاه ال daily او ال extended wear lenses لان كل + +342 +00:29:53,420 --> 00:29:57,640 +هذه يعني هذه النوع من العدسات no care system, no + +343 +00:29:57,640 --> 00:30:02,160 +cleaning, no maintenance system كله هيتجنبه او + +344 +00:30:02,160 --> 00:30:04,820 +هيعمله اذانة تقريبا او تقليل + +345 +00:30:08,310 --> 00:30:13,390 +طيب هذا النوع من العدسات بتميز ب major advantages + +346 +00:30:13,390 --> 00:30:17,790 +بمميزات رئيسية فوق ال conventional و planet + +347 +00:30:17,790 --> 00:30:23,210 +replacement lenses يعني في هناك له مميزات بتفوق ال + +348 +00:30:23,210 --> 00:30:27,930 +conventional daily wear الميزة + +349 +00:30:27,930 --> 00:30:32,470 +الأولى في theoregic advantages ايش المقصود فيها في + +350 +00:30:32,470 --> 00:30:33,870 +theoregic advantages؟ + +351 +00:30:37,530 --> 00:30:42,150 +بمعنى انه بتعمل reduce ل ال deposits او ال + +352 +00:30:42,150 --> 00:30:46,330 +inflammatory complications بمعنى الكلام انه بتكون + +353 +00:30:46,330 --> 00:30:51,270 +ال DK لل T عالية فبتكون العدسة ال thinning بتاعها + +354 +00:30:51,270 --> 00:30:56,510 +قليل فما بتعمل كورنيا الاديمة لمن؟ للشخص هذا معناه + +355 +00:30:56,510 --> 00:31:01,090 +انه physiologic advantages يعني كمية ال oxygen + +356 +00:31:01,090 --> 00:31:06,610 +اللى بتدخل لها الكورنيا بتكون كبيرةفما بتعمل حاجة + +357 +00:31:06,610 --> 00:31:12,950 +بنسميها ال hypoxia و هذا هيقلل من مين؟ من ال + +358 +00:31:12,950 --> 00:31:17,410 +deposits او ال inflammatory complication لذلك احنا + +359 +00:31:17,410 --> 00:31:21,770 +حكينا في هذا النوع من العدسات هيكون ال adverse + +360 +00:31:21,770 --> 00:31:27,310 +interaction اقل انتقال العدوى اقل مقارنة في مين؟ + +361 +00:31:27,310 --> 00:31:31,430 +في ال conventional daily wear اللي بتلبس من ستة + +362 +00:31:31,430 --> 00:31:37,140 +الى اتناشر شهرcan be made thinner الهدف انه تكون + +363 +00:31:37,140 --> 00:31:40,940 +thinner موضوع ال ديكي على تة higher oxygen and + +364 +00:31:40,940 --> 00:31:44,120 +comfort هتكون مريحة للمريض + +365 +00:31:45,950 --> 00:31:50,350 +compliance هتكون موافقة او مطاوعة لل patient من + +366 +00:31:50,350 --> 00:31:55,370 +حيث أنظمة الرعاية والعناية يعني ما بتحتاج تنظيف + +367 +00:31:55,370 --> 00:31:59,950 +بشكل دوري او بشكل يومي بالنسبة للمريض خاصة العدسات + +368 +00:31:59,950 --> 00:32:03,170 +اللي بتلبسها مدة أسبوعين او شهر يعني ممكن خلال + +369 +00:32:03,170 --> 00:32:07,690 +مثلا دقيقة انه يعمل عملية rinsing ويرتدي العدسة + +370 +00:32:07,690 --> 00:32:09,130 +بشكل مريح + +371 +00:32:12,320 --> 00:32:16,740 +No enzymatic protein remover فترة حياة العدسة + +372 +00:32:16,740 --> 00:32:21,760 +قصيرة فمش هتطلب من المريض أن يستخدم أنزيمات معينة + +373 +00:32:21,760 --> 00:32:28,250 +لإزالة الـ deposit من سطح العدسةNo cleaning or + +374 +00:32:28,250 --> 00:32:32,790 +disinfecting solutions or lens storage case is + +375 +00:32:32,790 --> 00:32:37,050 +required for daily disposable lenses كل أنظمة + +376 +00:32:37,050 --> 00:32:41,150 +التنظيف والعناية والرعاية والتخزين لهذا النوع من + +377 +00:32:41,150 --> 00:32:46,610 +العدسات يعني غير موجودة أو هتكون reduce أو + +378 +00:32:46,610 --> 00:32:51,230 +eliminate يعني هتكون محددةأيضا هذا النوع من + +379 +00:32:51,230 --> 00:32:54,770 +العدسات إضافة إلى ذلك موضوع ال convenience انه + +380 +00:32:54,770 --> 00:33:03,890 +مريحة وفي عندنا نقطة مهمة ال handling tint + +381 +00:33:03,890 --> 00:33:08,690 +في هذا النوع من العدسات انه ممكن انا اعمل عملية + +382 +00:33:08,690 --> 00:33:13,090 +التلوين مقارنة بال conventional daily wear خاصة + +383 +00:33:13,090 --> 00:33:17,690 +اذا كانت complex معقدة بيكون هناك صعوبة في عملية + +384 +00:33:17,690 --> 00:33:19,070 +تلوين العدسة + +385 +00:33:23,030 --> 00:33:29,750 +في هناك بعض العيوب أو المحددات الافتراضية لهذا + +386 +00:33:29,750 --> 00:33:35,130 +النوع من العدسات quantity + +387 +00:33:35,130 --> 00:33:39,910 +of manufacturing is affected large number is + +388 +00:33:39,910 --> 00:33:46,020 +needed fewer parametersهي .. انه هيكون هناك عدد + +389 +00:33:46,020 --> 00:33:52,200 +كبير من العدسات هتصنع في فترة زمانية قصيرة، يعني + +390 +00:33:52,200 --> 00:33:56,460 +ممكن الفين عدسة، تلتلاف عدسة في فترة زمانية ايش + +391 +00:33:56,460 --> 00:34:01,380 +بسيطة بتصنع at the same time طيب بعض الأشخاص اللي + +392 +00:34:01,380 --> 00:34:05,980 +بيكون عندهمover sensitive او بيكون عندهم allergy + +393 +00:34:05,980 --> 00:34:10,580 +ممكن مش هيتوافقوا مع هذا النوع من العدسات يعني + +394 +00:34:10,580 --> 00:34:15,020 +بدهم مثلا high water content بدهم مثلا العدسة تكون + +395 +00:34:15,020 --> 00:34:19,480 +اكتر thinning دخول ال oxygen ممكن يكون اكتر موضوع + +396 +00:34:19,480 --> 00:34:24,690 +ال comfort الراحة لازم تكون اكترفالاشخاص اللي + +397 +00:34:24,690 --> 00:34:29,210 +بيكون عندهم contra indication من العدسات اللاصقة + +398 +00:34:29,210 --> 00:34:33,290 +او بيكون عندهم over sensitive حساسية اكتر مش + +399 +00:34:33,290 --> 00:34:38,570 +هتتوافق معهم هذا النوع من العدسات لان كل العدسات + +400 +00:34:38,570 --> 00:34:43,450 +بتصنع at the same time ببرامتر معينة بوقت معين + +401 +00:34:47,060 --> 00:34:52,000 +Lens Parameter Repeatability وهذه مهمة كتير، الآن + +402 +00:34:52,000 --> 00:34:57,080 +احنا قلنا هذا النوع من العدسات بتيجي مغلفة، صحيح؟ + +403 +00:34:57,080 --> 00:35:02,600 +وبيكون تغليفها بشكل إيه؟ إبداعي، لكن ممكن في هدول + +404 +00:35:02,600 --> 00:35:07,000 +العدسات يكون مجموعة منهم في تكرار، يعني ال base + +405 +00:35:07,000 --> 00:35:10,700 +curve بتلاقيه مكرر أو ال power بتلاقيه مكرر + +406 +00:35:11,430 --> 00:35:15,890 +فبالتالي هذا كله خسارة لمين؟ لل practitioner او لل + +407 +00:35:15,890 --> 00:35:20,650 +examiner يعني مثلا انا بدي عشرة plus اتنين عشرة + +408 +00:35:20,650 --> 00:35:24,490 +مثلا plus تلاتة اللاحق العشرين واحدة كانت plus + +409 +00:35:24,490 --> 00:35:29,450 +تلاتة okay فبالتالي هذه ومش ممكن انا اعمل عملية + +410 +00:35:29,450 --> 00:35:35,490 +ايه استبدال لهذا النوع من العدسات ايضا no warranty + +411 +00:35:35,490 --> 00:35:40,100 +on individualموضوع الضمانة ما بيكون هناك ضمانة + +412 +00:35:40,100 --> 00:35:45,900 +يعني الآن انا يما بدي العدسات للمريض okay مش احنا + +413 +00:35:45,900 --> 00:35:49,540 +حكينا انه في ال spare lenses افرض مثلا هدول ال + +414 +00:35:49,540 --> 00:35:53,540 +spare كانوا فيهم نوع من ال damage او كانوا خربنات + +415 +00:35:53,540 --> 00:35:57,500 +او كانوا مثلا فيه scratch خلاص هدول بيعتبروا على + +416 +00:35:57,500 --> 00:36:01,080 +ال patient مش على ال practitioner او على ال + +417 +00:36:01,080 --> 00:36:02,640 +examiner okay؟ + +418 +00:36:06,580 --> 00:36:11,500 +Silicon Hydrogel Extended Wear Disposable Lenses + +419 +00:36:11,500 --> 00:36:16,440 +بنكتفي ان شاء الله لحد النقطة هذه في المحاضرة + +420 +00:36:16,440 --> 00:36:21,080 +القادمة بنكمل أنواع العدسات اللاصقة اللينة + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/ejLWw1g5ydc.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/ejLWw1g5ydc.srt new file mode 100644 index 0000000000000000000000000000000000000000..e83b61c1deffbf79bc6432ffa42f7b9a582b14ff --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/ejLWw1g5ydc.srt @@ -0,0 +1,1779 @@ +1 +00:00:21,210 --> 00:00:24,010 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:24,010 --> 00:00:27,050 +وبركاته and a very good morning to all of you + +3 +00:00:27,050 --> 00:00:30,930 +بداية كل عام و تبخير مع بداية الفصل الدراسي الثاني + +4 +00:00:30,930 --> 00:00:34,610 +بنتمنى إن شاء الله أن يكون فصل مليء بالنجاح و + +5 +00:00:34,610 --> 00:00:38,790 +التفوق إن شاء الله طبعا هنبدأ في مادة the soft + +6 +00:00:38,790 --> 00:00:43,890 +contact lens بداية ما هو تعريف العدسات اللاصقة + +7 +00:00:43,890 --> 00:00:49,600 +اللينة A soft lens may be defined as a contact lens + +8 +00:00:49,600 --> 00:00:54,120 +made from a hydrophilic material هي عبارة عن عدسة + +9 +00:00:54,120 --> 00:00:58,860 +مصنوعة من مادة محبة للماء، قطر العدسة بيكون + +10 +00:00:58,860 --> 00:01:03,320 +أكبر من قطر القرنية، لذلك بنسميها semisqueral + +11 +00:01:03,320 --> 00:01:07,220 +design. The + +12 +00:01:07,220 --> 00:01:14,060 +hydrophilic material بمعنى water content. إذا very + +13 +00:01:14,060 --> 00:01:19,080 +high water content أو محبة للماء. طبعا التركيبة + +14 +00:01:19,080 --> 00:01:24,540 +الكيميائية المستخدمة في صناعة العدسات اللاصقة + +15 +00:01:24,540 --> 00:01:29,040 +اللينة هي عبارة عن Hydroxyethyl Methacrylate + +16 +00:01:36,230 --> 00:01:41,330 +المادة المحبة للماء بتزود من مرونة أو ليونة العدسة + +17 +00:01:41,330 --> 00:01:46,090 +allowing it to conform to the shape of + +18 +00:01:46,090 --> 00:01:52,150 +the eye ومرونتها أو ليونتها هتسمح للعدسة أن تأخذ + +19 +00:01:52,150 --> 00:01:53,370 +شكل العين + +20 +00:01:55,960 --> 00:02:00,160 +Because soft lenses بسبب أن العدسات اللينة readily + +21 +00:02:00,160 --> 00:02:04,380 +conform بسهولة بتاخد شكل العين readily بمعنى + +22 +00:02:04,380 --> 00:02:08,520 +بسهولة conform to the shape of the eye بتاخد شكل + +23 +00:02:08,520 --> 00:02:12,380 +العين. They tend to be easy to fit and to be + +24 +00:02:12,380 --> 00:02:17,000 +relatively comfortable لذلك عملية لذلك هي تعتبر + +25 +00:02:17,000 --> 00:02:23,140 +مريحة نسبيا وعملية ال fitting لها تعتبر سهلة نسبيا + +26 +00:02:23,140 --> 00:02:25,620 +مقارنة بالـ hard contact + +27 +00:02:29,180 --> 00:02:34,620 +The hydrophilic material also maintains lens + +28 +00:02:34,620 --> 00:02:39,080 +movement أيضا المادة المحبة للماء هتحافظ على حركة + +29 +00:02:39,080 --> 00:02:43,580 +العدسة اتفقنا أن حركة العدسة الـ hard contact lens + +30 +00:02:43,580 --> 00:02:48,040 +من واحد إلى اثنين ملليمتر بينما الـ soft contact + +31 +00:02:48,040 --> 00:02:54,260 +lens من نصف إلى واحد ملليمتر. إذا المادة المحبة + +32 +00:02:54,260 --> 00:02:59,200 +للماء أيضا هتحافظ على حركة العدسة because the + +33 +00:02:59,200 --> 00:03:03,560 +pores أي بمعنى المسامات أو الجزيئات in the + +34 +00:03:03,560 --> 00:03:08,440 +material في المادة هذه يعني المسامات الموجودة ما + +35 +00:03:08,440 --> 00:03:16,040 +بين العدسة allow tear flow هتسمح بتدفق الدموع من + +36 +00:03:16,040 --> 00:03:21,500 +خلال العدسة through the lens itself avoiding any + +37 +00:03:21,500 --> 00:03:26,380 +suction onto the eye وإن العدسة هتكون ليست مصممة، + +38 +00:03:26,380 --> 00:03:29,700 +إيش معناتها؟ إنه ليست جافة، يعني الآن الـ soft + +39 +00:03:29,700 --> 00:03:33,480 +contact lens، أي مريض بيرتديها مش هتكون جافة + +40 +00:03:33,480 --> 00:03:37,900 +العدسة، هتكون إيش معناتها؟ رطبة، صح ولا لا؟ مقارنة + +41 +00:03:37,900 --> 00:03:44,100 +بالـ hard contact lens. طيب هن السؤال جداش المسامات + +42 +00:03:44,100 --> 00:03:49,760 +اللى موجودة بين العدسة اللاصقة اللينة؟ بتقدر + +43 +00:03:49,760 --> 00:03:56,820 +بثلاثة nanometer يعني ثلاثة في عشرة أس minus تسعة + +44 +00:03:56,820 --> 00:04:02,100 +من الملليمتر صح ولا لأ؟ الآن السؤال why bacteria or + +45 +00:04:02,100 --> 00:04:06,400 +fungi cannot penetrate intact soft contact lens؟ + +46 +00:04:06,400 --> 00:04:13,700 +لماذا البكتيريا أو الفطريات لا تستطيع اختراق العدسة + +47 +00:04:13,700 --> 00:04:20,720 +اللينة السليمة؟ تفضلي ممتازة + +48 +00:04:21,410 --> 00:04:27,170 +طيب، الآن بناء على دراسات سابقة اتضح أن الـ average + +49 +00:04:27,170 --> 00:04:32,230 +diameter للفطريات أو البكتيريا بيقدر بـ 230 + +50 +00:04:32,230 --> 00:04:33,730 +نانومتر + +51 +00:04:35,330 --> 00:04:40,850 +Okay فهي تعتبر أكبر من مين من المسامات أو جزيئات + +52 +00:04:40,850 --> 00:04:46,070 +العدسة اللاصقة اللينة لذلك هي لا تستطيع أن تخترق + +53 +00:04:46,070 --> 00:04:50,590 +من الـ soft contact lens أو الـ intact soft contact + +54 +00:04:50,590 --> 00:04:56,750 +lens العدسة اللاصقة اللينة السليمة. بنفس الوجه why + +55 +00:04:56,750 --> 00:05:02,190 +bacteria or fungi can penetrate damaged soft + +56 +00:05:02,190 --> 00:05:07,290 +contact lens. يعني العدسة اللي خربانة من السهل أن + +57 +00:05:07,290 --> 00:05:12,830 +تخترقها، بالضبط لأن مسامات العدسة اللاصقة اللي هي + +58 +00:05:12,830 --> 00:05:17,090 +تعتبر damaged هتكون أكبر من ثلاثة نانومتر، صحيح؟ + +59 +00:05:17,090 --> 00:05:21,490 +وبالتالي من السهل أن إيه تخترق اللي هو البكتيريا + +60 +00:05:21,490 --> 00:05:26,470 +أو الفطريات تخترق من العدسة اللاصقة اللي هي تعتبر + +61 +00:05:26,470 --> 00:05:26,810 +damaged + +62 +00:05:29,750 --> 00:05:34,290 +Most soft lenses are made with hydrogel materials، + +63 +00:05:34,290 --> 00:05:39,590 +إذا الجيل الأول من العدسات اللاصقة اللينة فقط صنع + +64 +00:05:39,590 --> 00:05:43,730 +من مادة الـ hydrogel materials أو الـ hydrophilic + +65 +00:05:43,730 --> 00:05:48,270 +material، إذا فقط من مادة إيش؟ الماء، هذا الجيل + +66 +00:05:48,270 --> 00:05:54,630 +الأول. لكن الجيل الحديث أو الجيل الثاني اللي عمل + +67 +00:05:54,630 --> 00:06:01,290 +تحديث له of soft lenses للعدسات اللينة تم إضافة + +68 +00:06:01,290 --> 00:06:06,190 +مادة السيليكون فصارت اللي هو silicone hydro gel + +69 +00:06:06,190 --> 00:06:10,790 +soft contact lens. طيب السؤال ليش تم إضافة مادة + +70 +00:06:10,790 --> 00:06:15,350 +السيليكون؟ + +71 +00:06:15,350 --> 00:06:18,590 +okay another answer + +72 +00:06:22,200 --> 00:06:26,680 +بالضبط، إذا عشان بزود أول حاجة الـ flexibility + +73 +00:06:26,680 --> 00:06:32,240 +مرونة العدسة اللي يونا إلها وشغلة مهمة كثير الـ + +74 +00:06:32,240 --> 00:06:40,470 +durability المتانة لمين؟ للعدسة. إذا زود من متانة + +75 +00:06:40,470 --> 00:06:44,950 +العدسة لذلك احنا ضفنا أو العلماء أو researchers + +76 +00:06:44,950 --> 00:06:49,590 +الباحثين ضافوا مادة السيليكون لمادة الهيدروجيل + +77 +00:06:49,590 --> 00:06:57,610 +فصار السيليكون هيدروجيل soft contact lens. و هذه يعني + +78 +00:06:57,610 --> 00:07:01,790 +is rapidly gaining popularity، يعني اللي هو شافت + +79 +00:07:01,790 --> 00:07:06,210 +إقبال بشكل اللي هو سريع من قبل مين الناس، يعني + +80 +00:07:06,210 --> 00:07:10,930 +اتقبلوا الأمر، ليش؟ لأن المرونة زادت بالنسبة لمين؟ + +81 +00:07:10,930 --> 00:07:15,630 +للعدسة، والمتانة إلها إيه؟ بالزيادة، طبعا دائما + +82 +00:07:15,630 --> 00:07:20,250 +بتكون تربطوا عامل المتانة بفترة حياة العدسة، إنه + +83 +00:07:20,250 --> 00:07:24,030 +كل ما زاد متانة العدسة، فترة حياته إيش مالها بالزيادة + +84 +00:07:27,680 --> 00:07:31,540 +The large diameter القطر الكبير طبعا الـ standard + +85 +00:07:31,540 --> 00:07:37,360 +diameter حكينا من 14 إلى 15 ملليمتر أو من 13.5 إلى + +86 +00:07:37,360 --> 00:07:42,340 +15 ملليمتر بناء على الدراسة اللي تم أخذ منها + +87 +00:07:42,340 --> 00:07:48,750 +المعلومة. الـ large diameter هو يعتبر مهم. Okay طيب أو + +88 +00:07:48,750 --> 00:07:53,650 +ضروري للمحافظة على إيه؟ ensure lens centration + +89 +00:07:53,650 --> 00:07:59,510 +يعني تمركز مناسب للعدسة on the cornea على القرنية + +90 +00:07:59,510 --> 00:08:03,770 +أيضا الـ stability الثبات و الـ retention in the eye + +91 +00:08:03,770 --> 00:08:07,290 +الاحتفاظ أو المحافظة عليها في داخل العين + +92 +00:08:11,150 --> 00:08:16,550 +Soft lenses are the most popular contact lens wear + +93 +00:08:16,550 --> 00:08:22,390 +modality accounting for some 88% of lens wearers + +94 +00:08:22,390 --> 00:08:27,210 +الأشخاص اللي بيرتديوا العدسات اللاصقة على مستوى + +95 +00:08:27,210 --> 00:08:33,590 +العالم 88% من هؤلاء الأشخاص بيرتديوا أنواع الـ soft + +96 +00:08:33,590 --> 00:08:38,580 +contact lens المختلفة. قدرت هناك دراسة في الولايات + +97 +00:08:38,580 --> 00:08:43,240 +المتحدة الأمريكية أن في أكثر من سبعين companies + +98 +00:08:43,240 --> 00:08:49,820 +شركة لصناعة العدسات اللاصقة بتصنع أكثر من 185 نوع + +99 +00:08:49,820 --> 00:08:55,960 +من الـ soft contact lenses. طيب + +100 +00:08:55,960 --> 00:09:01,440 +الآن هنبدأ في الـ advantages ما هي مميزات العدسات + +101 +00:09:01,440 --> 00:09:03,140 +اللاصقة اللينة + +102 +00:09:06,070 --> 00:09:10,750 +Number one soft lenses are immediately comfortable + +103 +00:09:10,750 --> 00:09:17,290 +إذا بتتميز العدسات اللاصقة اللينة براحة مباشرة + +104 +00:09:17,290 --> 00:09:22,630 +بسبب أول حاجة الـ water content very high. Number two + +105 +00:09:22,630 --> 00:09:25,930 +الـ flexibility of the lens أو الـ flexibility لـ + +106 +00:09:25,930 --> 00:09:31,290 +العدسة المرونة. أيضا السبب الثالث أن ما فيش hard + +107 +00:09:31,290 --> 00:09:36,370 +interaction ما بين الـ eyelid margin و الـ lens edge + +108 +00:09:36,370 --> 00:09:42,350 +أطراف العدسة. لذلك العدسات اللاصقة اللينة بتتميز + +109 +00:09:42,350 --> 00:09:49,410 +براحة مباشرة أو بتتميز بأنها مريحة. adaptation time + +110 +00:09:49,410 --> 00:09:53,170 +is short owing وممكن تكتب بين قوسين rapid + +111 +00:09:53,170 --> 00:09:59,930 +adaptation يعني سريعة التكييف. okay why soft lenses + +112 +00:09:59,930 --> 00:10:06,510 +are short adaptation؟ ليش التكييف فيها سريع بيكون؟ + +113 +00:10:06,510 --> 00:10:12,650 +فضلّي إنه to conform to the shape of the eye + +114 +00:10:12,650 --> 00:10:13,510 +another one + +115 +00:10:18,520 --> 00:10:22,460 +طبعا هي تعتبر إيه؟ Minimal movement compared to + +116 +00:10:22,460 --> 00:10:26,240 +hard contact lens زي ما اتفقنا من نصف إلى واحد ملليمتر + +117 +00:10:26,240 --> 00:10:30,220 +متر لذلك أن هي بيكون فيها tear exchange إيش مالها + +118 +00:10:30,220 --> 00:10:34,540 +محدود صح ولا لأ؟ وموضوع الـ interaction أو الـ + +119 +00:10:34,540 --> 00:10:39,340 +irritation التهيج للعين بيكون أقل مقارنة بمين؟ + +120 +00:10:39,340 --> 00:10:43,860 +في الـ hard contact lenses. هذا السبب أن ليش الـ + +121 +00:10:43,860 --> 00:10:47,520 +adaptation بيكون اللي هو أسرع مقارنة بالـ hard + +122 +00:10:47,520 --> 00:10:51,320 +lenses. soft + +123 +00:10:51,320 --> 00:10:56,360 +lenses العدسات اللينة are suitable for long or + +124 +00:10:56,360 --> 00:11:00,740 +short wearing times and variable wearing schedules + +125 +00:11:00,740 --> 00:11:06,740 +الآن شخص بده يرتدي العدسة اللاصقة ليوم واحد في + +126 +00:11:06,740 --> 00:11:12,870 +السنة فقط عنده مثلا convocation حفل تخرج. okay بعد + +127 +00:11:12,870 --> 00:11:17,150 +نهاية الدراسة بده يرتدي العدسة اللاصقة بهذا اليوم + +128 +00:11:17,150 --> 00:11:22,640 +أنسب خيار إله بيكون مين الـ soft contact lens. أو + +129 +00:11:22,640 --> 00:11:27,120 +إنسان مثلا بده يستبدل العدسات كل فترة نتيجة اللي + +130 +00:11:27,120 --> 00:11:31,680 +هو تراكم من الـ deposits على العدسات. أنسب خيار + +131 +00:11:31,680 --> 00:11:37,080 +بيكون من الـ soft contact lenses. شخص مثلا فترة عمله + +132 +00:11:37,080 --> 00:11:41,640 +اثنتا عشرة ساعة بيقدرش يعني خلال اثنتا عشرة ساعة يكون فيه + +133 +00:11:41,640 --> 00:11:45,820 +هناك rest. أفضل خيار له اللي هو الـ soft contact + +134 +00:11:45,820 --> 00:11:49,780 +lenses. إذا هي استخدمت في الـ short أو الـ long + +135 +00:11:49,780 --> 00:11:52,000 +wearing في الطرفين هذول + +136 +00:11:55,840 --> 00:11:59,380 +These lenses هذي العدسات are relatively + +137 +00:11:59,380 --> 00:12:04,420 +inexpensive يعني نسبيا هي تعتبر ليست غالية الثمن + +138 +00:12:04,420 --> 00:12:09,780 +which makes them suitable for frequent replacement + +139 +00:12:09,780 --> 00:12:17,540 +systems. الطبيب أو أخصائي البصريات طلب من المريض كل + +140 +00:12:17,540 --> 00:12:21,860 +أسبوعين أنه يغير العدسة اللاصقة، بده يشوف مدى ال + +141 +00:12:21,860 --> 00:12:26,160 +التهاب ل الكورنيا، طبعا لو قلنا له البس hard + +142 +00:12:26,160 --> 00:12:30,490 +contact lens عالية الثمن كل أسبوعين يغير العدسة أو + +143 +00:12:30,490 --> 00:12:34,570 +كل شهرين أو كل مثلا شهر بيكون الأمر ايه مكلف + +144 +00:12:34,570 --> 00:12:38,630 +بالنسبة للمريض فأفضل حاجة ايش نستخدم ال soft + +145 +00:12:38,630 --> 00:12:44,450 +contact lens لعملية الاستبدال للعدسات اللاصقة بشكل + +146 +00:12:44,450 --> 00:12:45,210 +مستمر + +147 +00:12:48,420 --> 00:12:53,240 +Lenses can often be dispensed from an inventory + +148 +00:12:53,240 --> 00:12:58,180 +الآن شخص بِرتدي عدسة لاصقة قوتها plus واحد و نصف + +149 +00:12:58,180 --> 00:13:01,960 +ديوبتر، السفير إذا مباشرة أنا بجيبها من ال + +150 +00:13:01,960 --> 00:13:06,920 +inventory المستودع أو المخزن وبصرفها لمين؟ للمريض + +151 +00:13:06,920 --> 00:13:10,580 +دون النظر في مين؟ في ال parameters الثانية زي ال + +152 +00:13:10,580 --> 00:13:14,840 +base curve و ال diameter اللي هي تعتبر ايه؟ عوامل + +153 +00:13:14,840 --> 00:13:17,420 +مهمة في ال hard contact lenses + +154 +00:13:21,360 --> 00:13:25,980 +اللون العيوني، المظهر يمكن تغييره بصيغة لينزة لطيفة + +155 +00:13:26,780 --> 00:13:32,500 +معظم الممثلين، ال actors أو الرياضيين بيستخدموا مين؟ + +156 +00:13:32,500 --> 00:13:37,360 +ال soft contact lens لتغيير ال iris color وطبعا + +157 +00:13:37,360 --> 00:13:42,520 +بيكون بألوان مختلفة ليه؟ ببساطة لأن قطر العدسة + +158 +00:13:42,520 --> 00:13:47,300 +بيكون كبير، بالتالي هي بتغطي ايش؟ كل ال iris و + +159 +00:13:47,300 --> 00:13:51,300 +ممكن أنه تغير من لون ال iris، طيب ليش ال hard + +160 +00:13:51,300 --> 00:13:55,040 +contact lens؟ مش ممكن أنا استخدمها في اللي هو + +161 +00:13:55,040 --> 00:14:00,260 +تغيير لون ال iris بالضبط لأنه بيكون ال diameter + +162 +00:14:00,260 --> 00:14:03,980 +إلها أقل من مين؟ من ال soft contact lens، بالتالي + +163 +00:14:03,980 --> 00:14:08,560 +هي لا تستطيع إنه تغطي كل ال iris، أيضًا في بعض + +164 +00:14:08,560 --> 00:14:12,920 +الأشخاص بيحبوا مثلًا اللي هو عملية التلوين لل .. + +165 +00:14:12,920 --> 00:14:16,880 +ال .. ال iris بمعنى أنه بيكون عنده refractive + +166 +00:14:16,880 --> 00:14:21,700 +error فمرة مثلًا بلبس اللي هو نفترض a green okay + +167 +00:14:21,700 --> 00:14:25,880 +contact lens، تاني يوم مثلًا بلبس black، بلبس + +168 +00:14:25,880 --> 00:14:29,480 +brown، يعني هو عنده refractive error ومع ذلك + +169 +00:14:29,480 --> 00:14:34,150 +بيغير مين؟ ال iris color واضحة الفكرة لكن هذه من + +170 +00:14:34,150 --> 00:14:38,490 +الصعب أنه تموين في اللي هو ال hard contact lenses + +171 +00:14:38,490 --> 00:14:42,610 +soft + +172 +00:14:42,610 --> 00:14:47,650 +lenses cause minimal central corneal distortion so + +173 +00:14:47,650 --> 00:14:53,430 +a spectacular glare is rare بتتميز العدسات اللاصقة + +174 +00:14:53,430 --> 00:14:58,690 +اللينة بأنها بتسبب ال cornea القديمة لكن القرنية + +175 +00:14:58,690 --> 00:15:04,390 +الاديمية بتنتشر على كل سطح القرنية، لذلك هي ما بتغير + +176 +00:15:04,390 --> 00:15:09,110 +من مين؟ من ال radius of curvature ل القرنية، + +177 +00:15:09,110 --> 00:15:13,850 +بالتالي أن ال spectacular layer هو بيكون أقل في ال + +178 +00:15:13,850 --> 00:15:17,890 +soft contact lens مقارنة في مين؟ في ال hard contact + +179 +00:15:17,890 --> 00:15:22,570 +lenses The + +180 +00:15:22,570 --> 00:15:27,460 +large optic zone makes for minimal flare Okay + +181 +00:15:27,460 --> 00:15:33,440 +السؤال هنا why flare is uncommon with soft lenses؟ + +182 +00:15:33,440 --> 00:15:38,560 +ال flare بمعنى ايه؟ الوهج، ليش بيكون غير شائع في + +183 +00:15:38,560 --> 00:15:45,700 +ال soft contact lens؟ فضلك اه + +184 +00:15:45,700 --> 00:15:50,320 +بس + +185 +00:15:50,320 --> 00:15:53,840 +في نقطة مهمة أيضًا أنه لإن يما يكون ال diameter + +186 +00:15:53,840 --> 00:15:58,340 +للعدسة كبير okay، الـ optic zone ايش ماله؟ هيكون + +187 +00:15:58,340 --> 00:16:02,480 +كبير فهي هتغطي من ال pupil حتى في ال dim + +188 +00:16:02,480 --> 00:16:06,420 +illumination صح ولا لأ؟ يعني الآن ال pupil يما + +189 +00:16:06,420 --> 00:16:10,360 +يكون هناك dim illumination هل هو هيكون في نفس + +190 +00:16:10,360 --> 00:16:14,100 +الوقت زي ال light؟ لأ، في ال light illumination + +191 +00:16:14,100 --> 00:16:18,120 +هيكون ايه؟ في هناك اللي هو constraint مقارنة في + +192 +00:16:18,120 --> 00:16:20,920 +اللي هو ال dim illumination اللي هيكون فيها ال + +193 +00:16:20,920 --> 00:16:23,700 +pupil dilated okay؟ + +194 +00:16:25,450 --> 00:16:29,590 +There is less foreign body a trapping than with GB + +195 +00:16:29,590 --> 00:16:35,610 +lenses الأجسام الغريبة a trapping بمعنى حصر بتنحصر + +196 +00:16:35,610 --> 00:16:40,830 +أقل ما بين الكورنيا و ال soft contact lens مقارنة + +197 +00:16:40,830 --> 00:16:46,110 +بال hard contact lens، يعني هناك صعوبة لدخول + +198 +00:16:46,110 --> 00:16:49,930 +الأجسام الغريبة ما بين ال soft contact lens و + +199 +00:16:49,930 --> 00:16:56,970 +القرنية Okay، طيب الآن مين أصعب لو دخل ال foreign + +200 +00:16:56,970 --> 00:17:01,310 +body مابين ال soft contact lens و الكورنيا ولا + +201 +00:17:01,310 --> 00:17:09,170 +مابين ال hard contact lens و الكورنيا؟ لأ طيب why؟ + +202 +00:17:16,340 --> 00:17:21,380 +بالضبط، إذا زي ما هو من الصعب أنه يدخل لكن إذا هناك + +203 +00:17:21,380 --> 00:17:25,300 +انحصار الجسم الغريب ما بين ال soft contact lens و + +204 +00:17:25,300 --> 00:17:29,480 +ال anterior surface للكورنيا من الصعب خروجه و + +205 +00:17:29,480 --> 00:17:34,260 +هيعمل complications مضاعفات أكثر من مين؟ من ال hard + +206 +00:17:34,260 --> 00:17:39,560 +contact lenses، يعني في نفس الوقت أنه هيسبب اللي هو + +207 +00:17:39,560 --> 00:17:43,680 +more complications compared to the hard contact + +208 +00:17:43,680 --> 00:17:44,360 +lenses + +209 +00:17:47,700 --> 00:17:51,400 +لنزات حلوة، جيدة لعمل أفضل أفضل أفضل أفضل أفضل أفضل + +210 +00:17:51,400 --> 00:17:55,140 +أفضل أفضل أفضل أفضل أفضل أفضل + +211 +00:17:55,640 --> 00:18:00,840 +العدسات اللاصقة اللينة هي مناسبة للرياضيين، يعني + +212 +00:18:00,840 --> 00:18:04,820 +للاعبين كرة القدم، لاعبين ال basket ball، ال + +213 +00:18:04,820 --> 00:18:08,840 +tennis، السبب الأول لأن it follows to the eye + +214 +00:18:08,840 --> 00:18:13,200 +movement بتتبع حركة مين؟ العين، ال visual field ايش + +215 +00:18:13,200 --> 00:18:17,660 +بيكون فيها؟ واسع من الصعب اللي هو سقوط العدسة + +216 +00:18:17,660 --> 00:18:22,780 +اللاصقة اللينة، طيب هناك في حالتين ممكن إنه تسقط + +217 +00:18:22,780 --> 00:18:25,080 +فيها العدسات اللاصقة اللينة + +218 +00:18:34,290 --> 00:18:41,870 +ممتازة، إذا أول حاجة ال trauma كلام سليم إذا لو صار + +219 +00:18:41,870 --> 00:18:46,950 +هناك trauma من السهل اللي هو سقوط العدسة اللاصقة + +220 +00:18:46,950 --> 00:18:54,510 +اللينة و .. تفضلي أو اللي هو ال pinch أي بمعنى أي + +221 +00:18:54,510 --> 00:19:00,910 +لدغة بتحدث لمين؟ للعين، إذا عندنا في هناك اللي هو + +222 +00:19:00,910 --> 00:19:06,430 +two causes سببين لسقوط العدسة اللاصقة اللينة شخص + +223 +00:19:06,430 --> 00:19:10,450 +اتعرض لضربة قوية، والشغل التاني اللي هي ال pinch + +224 +00:19:10,450 --> 00:19:11,130 +اللدغة + +225 +00:19:13,890 --> 00:19:18,110 +لدغة .. لدغة حشرة مثلًا .. لدغة مثلًا نحلة الاخر .. + +226 +00:19:18,110 --> 00:19:21,890 +أنه لما يتعرض المريض للدغة معينة ممكن إنه تسقط + +227 +00:19:21,890 --> 00:19:26,490 +العدسة أو ممكن أنه يصير لها damage لل soft contact + +228 +00:19:26,490 --> 00:19:34,040 +lens، أيضًا أن هي بتستخدم مع الرياضيين سواء كان ال + +229 +00:19:34,040 --> 00:19:37,560 +football players أو ال basketball players لأن هي + +230 +00:19:37,560 --> 00:19:41,620 +بتتميز ب minimal movement compared to hard contact + +231 +00:19:41,620 --> 00:19:46,020 +lenses، بالتالي هي هتسبب ايه؟ Cornial distortion + +232 +00:19:46,020 --> 00:19:50,520 +لكن ال spectacular player هيكون أقل، okay؟ هذه + +233 +00:19:50,520 --> 00:19:55,140 +الأسباب أن ليش هي تعتبر خيار مناسب بالنسبة لمين؟ + +234 +00:19:55,140 --> 00:19:57,100 +للرياضيين + +235 +00:19:58,330 --> 00:20:02,150 +نقطة هذه مهمة، they are a good option when a + +236 +00:20:02,150 --> 00:20:06,170 +spheric refractive error is associated with a + +237 +00:20:06,170 --> 00:20:12,730 +toric cornea، بداية عندنا ال astigmatism إما بيكون + +238 +00:20:12,730 --> 00:20:16,950 +refractive astigmatism بيكون ممكن corneal cylinder + +239 +00:20:16,950 --> 00:20:21,470 +وممكن internal أو residual astigmatism، صحيح هدول + +240 +00:20:21,470 --> 00:20:25,070 +الثلاثة أنواع، طيب الآن نفترض مثلًا + +241 +00:20:44,240 --> 00:20:50,500 +أنه كان عندنا ال internal cylinder plus اتنين أو + +242 +00:20:50,500 --> 00:20:54,480 +minus اتنين، طبعًا لو بنشتغل في ال minus أو plus + +243 +00:20:54,480 --> 00:20:59,460 +cylinder وكان هنا عندنا plano، هذه بالنسبة لل + +244 +00:20:59,460 --> 00:21:05,960 +internal cylinder واضحة؟ + +245 +00:21:05,960 --> 00:21:14,340 +وعندنا كان ال corneal astigmatism هنا plus اتنين أو + +246 +00:21:14,340 --> 00:21:19,880 +ماينوس اتنين وهنا كان بلانه، قداش هتكون قيمة ال + +247 +00:21:19,880 --> 00:21:24,900 +refractive astigmatism في الحالة هذه اللي هو Zero + +248 +00:21:24,900 --> 00:21:29,220 +قيمة ال refractive astigmatism Zero لأن ال + +249 +00:21:29,220 --> 00:21:33,440 +internal cylinder اشمله متعامد مع مين؟ مع ال + +250 +00:21:33,440 --> 00:21:38,660 +corneal cylinder فمدان متعامد إذا هيكون عندنا فقط + +251 +00:21:38,660 --> 00:21:42,680 +اللي هو ال sphere of refraction + +252 +00:21:45,870 --> 00:21:51,010 +إذا في حالة الـ sphere refraction يكون عندنا قيمة + +253 +00:21:51,010 --> 00:21:56,150 +السيلندر Zero، الخيار المناسب للمريض هنا هيكون مين؟ + +254 +00:21:56,150 --> 00:22:00,490 +ال soft contact lens، يعني بتلاحظ أن المريض عنده لو + +255 +00:22:00,490 --> 00:22:06,440 +امسكنا ورقة ال print out مثلًا plus 3، هذه الـ + +256 +00:22:06,440 --> 00:22:10,040 +Objective Refraction، حسنًا، هذه بالصحيحة، لكن + +257 +00:22:10,040 --> 00:22:13,000 +ارجع إلى اللي هو الـ Corneal Cylinder، هتلاقيه + +258 +00:22:13,000 --> 00:22:16,080 +Minus One، روحي على الـ Internal Cylinder، هتلاقيه + +259 +00:22:16,080 --> 00:22:19,520 +Minus One، لكن التنين هذول متعمدين على بعض، يعني + +260 +00:22:19,520 --> 00:22:25,740 +واحد Axis 90، الآخر Axis 180، إذا عندنا الـSphere + +261 +00:22:25,740 --> 00:22:29,500 +Refraction جداش فقط اللي هو الـPower أو فقط + +262 +00:22:29,500 --> 00:22:34,180 +الـValue، أي بمعنى عندنا قيمة الـStigmatism هتكون + +263 +00:22:34,180 --> 00:22:40,160 +Zero Okay، ففي هذه الحالة الخيار الأفضل للمريض هيكون + +264 +00:22:40,160 --> 00:22:45,060 +مين؟ ال soft contact lens، ال cone هيش هيكون شكلها + +265 +00:22:45,060 --> 00:22:53,280 +توريك وانتوا عارفين ايش معناه توريك، صحيح يعني + +266 +00:22:53,280 --> 00:22:57,860 +بمعنى اللي هو ال sphero cylinder صحيح، طيب الآن + +267 +00:22:57,860 --> 00:23:03,320 +بالنسبة لل limitations العيوب أو القيود للعدسات + +268 +00:23:03,320 --> 00:23:05,060 +اللاصقة اللينة + +269 +00:23:07,980 --> 00:23:12,260 +number one they have a relatively short life، إذا + +270 +00:23:12,260 --> 00:23:17,960 +فترة حياة العدسة هتكون قصيرة، مقارنة في مين؟ في ال + +271 +00:23:17,960 --> 00:23:22,900 +hard contact lenses لكن فيها معلومة مهمة كثير أن + +272 +00:23:22,900 --> 00:23:27,540 +في classification تصنيف للعدسات اللاصقة اللينة + +273 +00:23:27,540 --> 00:23:33,440 +ممكن تكون annual سنوية، ممكن تكون semi annual أي + +274 +00:23:33,440 --> 00:23:38,340 +بمعنى نصف سنة، وممكن تكون quarterly ربع سنة أو تلت + +275 +00:23:38,340 --> 00:23:44,370 +شهور طبعًا فترة حياة العدسة السنوية هتكون أطول من + +276 +00:23:44,370 --> 00:23:49,530 +الـ quarterly أطول من مين؟ من ال semi-annual فالآن + +277 +00:23:49,530 --> 00:23:55,130 +العدسات اللاصقة اللينة بتتميز أن فترة حياتها قصيرة + +278 +00:23:55,130 --> 00:23:59,670 +مقارنة في ال hard contact lens Since they are + +279 +00:23:59,670 --> 00:24:05,590 +fragile أي بمعنى هشة and subject بتكون معرضة لإيش؟ + +280 +00:24:05,590 --> 00:24:10,570 +معرضة؟ ل rapid accumulation اللي هو تراكم سريع لل + +281 +00:24:10,570 --> 00:24:17,470 +surface اللي هو deposits أي بمعنى الترسبات بتتراكم + +282 +00:24:17,470 --> 00:24:21,330 +على العدسة بشكل سريع مقارنة بمن؟ في الـ hard + +283 +00:24:21,330 --> 00:24:22,650 +contact lenses + +284 +00:24:26,370 --> 00:24:31,150 +Number two ongoing lens care يعني بمعنى الاستمرار + +285 +00:24:31,150 --> 00:24:36,310 +بعناية العدسة أو رعاية العدسة takes a significant + +286 +00:24:36,310 --> 00:24:41,210 +amount of time هتطلب وقت من من؟ من الـ patient + +287 +00:24:41,210 --> 00:24:49,210 +المريض على الأقل خمس دقائق كل يوم عملية تنظيف طبعا + +288 +00:24:49,210 --> 00:24:52,430 +مقارنة بالـ hard contact lens هتكون المدة ايه + +289 +00:24:52,430 --> 00:24:56,210 +طويلة لأنه في الـ hard contact lens الفترة الزمنية + +290 +00:24:56,210 --> 00:25:00,770 +هتكون أقل حتى من ناحية الآن لو المريض عمل + +291 +00:25:00,770 --> 00:25:04,930 +insertion للـ soft contact lens في البدايات مش بعد + +292 +00:25:04,930 --> 00:25:08,590 +ما يتعود عليها هتلاحظوا في الأول هيصير عنده نوع من + +293 +00:25:08,590 --> 00:25:13,030 +الـ blurred vision الغباش لفترة زمنية طويلة وبعد + +294 +00:25:13,030 --> 00:25:15,810 +ذلك أنه هيصير يتعود عليها + +295 +00:25:19,090 --> 00:25:23,650 +Lens cleaning and disinfection are essential، إذا + +296 +00:25:23,650 --> 00:25:28,730 +تنظيف العدسة وتعقيمها يعتبر أمر أساسي في ارتداء + +297 +00:25:28,730 --> 00:25:33,490 +العدسات اللاصقة اللينة، إذا عملية التعقيم والتنظيف + +298 +00:25:33,490 --> 00:25:38,930 +مهم جدا بالنسبة لمن؟ للمريض اللي بيرتدي العدسات + +299 +00:25:38,930 --> 00:25:46,200 +اللاصقة اللينة The result نتيجة of non-compliance + +300 +00:25:46,200 --> 00:25:51,260 +يعني نتيجة عدم الالتزام with care systems بأنظمة + +301 +00:25:51,260 --> 00:25:56,410 +العناية أو الرعاية may be devastating إيش هذا + +302 +00:25:56,410 --> 00:26:01,710 +يعتبر؟ يعني أمر مدمر للعدسة، إنه الآن أنا ما ألتزم + +303 +00:26:01,710 --> 00:26:06,590 +بأنظمة الرعاية والعناية والتنظيف للعدسة، يعتبر + +304 +00:26:06,590 --> 00:26:12,030 +هذا أمر مدمر لمن؟ للعدسة، يعني بينهي حياة العدسة + +305 +00:26:12,030 --> 00:26:14,130 +في فترة زمنية قصيرة + +306 +00:26:18,130 --> 00:26:22,570 +They may be ineducate for correcting low or + +307 +00:26:22,570 --> 00:26:28,890 +residual astigmatism. هي لا تعتبر مناسبة لتصحيح الـ + +308 +00:26:28,890 --> 00:26:32,330 +low أو الـ residual astigmatism. هذه العدسات + +309 +00:26:32,330 --> 00:26:38,570 +اللاصقة اللينة. Why؟ ليش هي غير مناسبة لتصحيح الـ + +310 +00:26:38,570 --> 00:26:42,310 +low أو الـ residual astigmatism؟ فضلي. لأنها تلغي + +311 +00:26:42,310 --> 00:26:46,830 +... أول حاجة تلغي هي تلغي صفحة القرنية و تلغي صفحة + +312 +00:26:46,830 --> 00:26:47,210 +الديكا + +313 +00:26:54,650 --> 00:26:58,350 +ممتازة، إذا تعلمنا في الـ hard contact lens الـ + +314 +00:26:58,350 --> 00:27:02,770 +optics للـ hard contact lens أن هي بتعمل ايه؟ a new + +315 +00:27:02,770 --> 00:27:06,230 +surface للقرنية، لكن في الـ soft contact lens + +316 +00:27:06,230 --> 00:27:09,750 +conform to the shape of the cornea، هذا السبب أن + +317 +00:27:09,750 --> 00:27:14,730 +ليش هي ما بتكون ملائمة أو مناسبة لتصحيح الـ low أو + +318 +00:27:14,730 --> 00:27:16,550 +الـ residue والـ astigmatism + +319 +00:27:19,640 --> 00:27:24,540 +It is difficult to verify soft lens parameters إذا + +320 +00:27:24,540 --> 00:27:29,840 +من الصعب أنا أتحقق أو أتأكد من خواص أو من الـ + +321 +00:27:29,840 --> 00:27:34,540 +parameters الخاصة بالعدسات اللاصقة اللينة يعني + +322 +00:27:34,540 --> 00:27:38,870 +بمعنى الآن احنا الـ power في الـ hard contact lens + +323 +00:27:38,870 --> 00:27:42,630 +ممكن أقيسه من خلال جهاز الـ lensmeter لكن الـ soft + +324 +00:27:42,630 --> 00:27:47,370 +contact lens صعب أقيس موضوع اللي هو التأكد من الـ + +325 +00:27:47,370 --> 00:27:51,410 +base curve مستحيل أستخدم الـ contact gauge لتأكيد + +326 +00:27:51,410 --> 00:27:55,860 +الـ base curve في الـ soft contact lens لكن العدسات + +327 +00:27:55,860 --> 00:28:00,300 +اللاصقة الصلبة ممكن أتأكد من الـ base care من خلال + +328 +00:28:00,300 --> 00:28:04,800 +استخدام جهاز الـ contact gauge إذا عملية التأكيد للـ + +329 +00:28:04,800 --> 00:28:09,440 +parameters أو التحقيق تعتبر صعبة أين في العدسات + +330 +00:28:09,440 --> 00:28:16,120 +اللاصقة اللينة Hydrogel + +331 +00:28:16,120 --> 00:28:20,340 +soft lenses offer only limited oxygen + +332 +00:28:20,340 --> 00:28:26,190 +transmissibility الآن في أنواع من العدسات اللاصقة + +333 +00:28:26,190 --> 00:28:30,270 +اللينة زي مثلا الـ extended wear إيش معنى الـ + +334 +00:28:30,270 --> 00:28:37,750 +extended wear؟ تفضلي اه + +335 +00:28:37,750 --> 00:28:39,990 +اه + +336 +00:28:41,330 --> 00:28:45,810 +According to Food and Drug Administration على + +337 +00:28:45,810 --> 00:28:50,610 +منظمة اللي هو الصحة والدواء عرفوا العدسات اللاصقة + +338 +00:28:50,610 --> 00:28:54,990 +الـ extended wear أن المريض بيلبسها لمدة أسبوع و + +339 +00:28:54,990 --> 00:29:00,450 +بينام فيها okay الآن في هذه العدسات لازم أن يكون الـ + +340 +00:29:00,450 --> 00:29:05,770 +DK على T أشماله very high okay وإلا إيش هتعمل + +341 +00:29:05,770 --> 00:29:10,170 +القرنية القديمة بالنسبة للمريض إذا لازم أن يكون الـ + +342 +00:29:10,170 --> 00:29:17,960 +DK على T very high in + +343 +00:29:17,960 --> 00:29:23,720 +extended wear + +344 +00:29:23,720 --> 00:29:29,620 +lenses إذا في هذه النوع من العدسات اللاصقة لازم أن + +345 +00:29:29,620 --> 00:29:34,480 +يكون الـ decay على T very high طبعا هذا بنسميه الـ + +346 +00:29:34,480 --> 00:29:38,440 +oxygen transmissibility إذا نفاذ الـ oxygen very + +347 +00:29:38,440 --> 00:29:42,760 +high في هذه الحالة مدام نفاذ الـ oxygen very high، + +348 +00:29:42,760 --> 00:29:47,420 +إذا العدسة إيش هتكون؟ fragile، هشة كثير، يعني فترة + +349 +00:29:47,420 --> 00:29:51,680 +حياتها إيش؟ هتكون جدا قصيرة، يعني قد تكمل الأسبوع + +350 +00:29:51,680 --> 00:29:56,540 +أو لا مع المريض، وهذا هو يعتبر ايه؟ واحدة من عيوب + +351 +00:29:56,540 --> 00:30:01,120 +العدسات اللاصقة اللينة، أن هي بتعمل offer only + +352 +00:30:01,120 --> 00:30:05,720 +limited of oxygen transmissibility يعني صح هي بتزود + +353 +00:30:05,720 --> 00:30:11,220 +الـ oxygen transmissibility بشكل كبير للعدسة، ولكن + +354 +00:30:11,220 --> 00:30:17,950 +أن هي بتنهي على حياة العدسة بشكل مبكر Okay لكن لو + +355 +00:30:17,950 --> 00:30:23,490 +أجينا مثلا العدسات الـ conventional contact lens + +356 +00:30:23,490 --> 00:30:26,910 +اللي هي عدسات اللبس اليومي أو التقليدي، هذه + +357 +00:30:26,910 --> 00:30:31,310 +العدسات هنلاحظها أن فترة حياتها بتجود مثلا من ستة + +358 +00:30:31,310 --> 00:30:35,130 +إلى اثنا عشر شهر، فبالتالي إيش هيكون الـ DK؟ من + +359 +00:30:35,130 --> 00:30:38,650 +أعلى؟ هي ولا الـ extended wear؟ الـ extended wear + +360 +00:30:38,650 --> 00:30:43,030 +هيكون فيها الـ DK على T very high، صحيح؟ مقارنة في + +361 +00:30:43,030 --> 00:30:45,750 +الـ conventional contact lens wear + +362 +00:30:49,210 --> 00:30:55,010 +بالتالي، يمكن أن يكون لديهم مشاكل بشكل مستمر أو + +363 +00:30:55,010 --> 00:31:00,570 +عندما يقوموا بإصلاح أميبروبيا أو استيغماطية الآن أنا + +364 +00:31:00,570 --> 00:31:04,330 +إما أستخدم العدسات الـ soft contact lens في الـ high + +365 +00:31:04,330 --> 00:31:08,650 +ametropia أو في الـ high astigmatism من الصعب أني + +366 +00:31:08,650 --> 00:31:13,050 +أستخدم من؟ الـ soft contact lens إضافة للسبب أن هي + +367 +00:31:13,050 --> 00:31:16,830 +conform to the shape of the cornea أن هذه العدسة + +368 +00:31:16,830 --> 00:31:20,850 +تعتبر الـ oxygen transmissibility أو الـ decay على + +369 +00:31:20,850 --> 00:31:26,530 +THH تعتبر very high فبالتالي هي غير مناسبة لتصحيح + +370 +00:31:26,530 --> 00:31:34,340 +الـ high ametropia أو الـ astigmatism Compare with GB + +371 +00:31:34,340 --> 00:31:39,340 +lenses, soft lenses have limited post lens tear + +372 +00:31:39,340 --> 00:31:43,680 +exchange، إذا التبادل التير في العدسات اللاصقة + +373 +00:31:43,680 --> 00:31:48,860 +اللينة هيكون محدود مقارنة بمن؟ في الـ GB lenses، + +374 +00:31:48,860 --> 00:31:54,920 +why؟ بسبب الـ Minimal Movement للـ Soft Contact + +375 +00:31:54,920 --> 00:31:59,500 +Lens اللي بتقدر من نص إلى واحد مليمتر مقارنة في + +376 +00:31:59,500 --> 00:32:02,700 +الـ Hard Contact Lens اللي الحركة فيها من واحد إلى + +377 +00:32:02,700 --> 00:32:08,290 +اثنين مليمتر إذا مرة أخرى تبادل الـ tear في العدسات + +378 +00:32:08,290 --> 00:32:14,050 +اللاصقة اللينة يعتبر أقل من العدسات اللاصقة الصلبة + +379 +00:32:14,050 --> 00:32:18,170 +السبب في ذلك قلة الحركة اللي هي بتقدر من نص إلى + +380 +00:32:18,170 --> 00:32:21,910 +واحد مقارنة بالـ hard contact lens اللي بتقدر من + +381 +00:32:21,910 --> 00:32:23,850 +واحد إلى اثنين مليمتر + +382 +00:32:27,950 --> 00:32:33,130 +hydrophilic materials المواد المحبة للماء tend to + +383 +00:32:33,130 --> 00:32:38,830 +dehydrate هتعمل تبخر on eye dehydrate بمعنى تبخر + +384 +00:32:38,830 --> 00:32:45,770 +أي بمعنى أنه بيسبب dry eye جفاف للعين which may + +385 +00:32:45,770 --> 00:32:50,230 +cause symptoms يعني بيسبب اللي هو أعراض جفاف العين + +386 +00:32:50,230 --> 00:32:55,170 +لو سألنا السؤال ما هو مفهوم الـ dry eye جفاف العين + +387 +00:32:55,170 --> 00:32:56,130 +ايش تعريفه؟ + +388 +00:33:12,380 --> 00:33:19,140 +تفضلي اه هذه كـ causes صحيح؟ okay another answer + +389 +00:33:21,950 --> 00:33:26,430 +طيب dry eye جفاف العين هو يعتبر a multifactorial + +390 +00:33:26,430 --> 00:33:31,710 +pathology يعني مرض متعدد الأسباب that can cause + +391 +00:33:31,710 --> 00:33:38,730 +بيسبب هذا المرض ocular discomfort يعني عدم راحة + +392 +00:33:38,730 --> 00:33:43,350 +لمين؟ للعين و أيضا بيعمل decrease للـ visual + +393 +00:33:43,350 --> 00:33:47,790 +acuity و بيعمل tear instability عدم ثبات لمن؟ + +394 +00:33:47,790 --> 00:33:50,610 +لل tear اتبعكم التعريف + +395 +00:33:58,010 --> 00:34:03,550 +طبعا هذا التعريف according to اه بيعمل decrease الـ + +396 +00:34:03,550 --> 00:34:08,590 +visual acuity نعم صحيح لذلك الأشخاص اللي بيكون + +397 +00:34:08,590 --> 00:34:13,090 +عندهم جفاف في العين بيقولك أنا discomfort عدم راحة + +398 +00:34:13,090 --> 00:34:17,050 +عندي و أيضا عندي اللي هو بشعر أن الـ visual acuity + +399 +00:34:17,050 --> 00:34:21,550 +ما بشوفش الأشياء اللي بعيدة بيكون هذه لها علاقة في + +400 +00:34:21,550 --> 00:34:24,190 +الـ ocular symptoms ما لهاش علاقة في الـ visual + +401 +00:34:24,190 --> 00:34:37,940 +symptoms إذا N dry أو اختصارها DA according to + +402 +00:34:37,940 --> 00:34:46,240 +dry eye workshop 2007 طبعا هذه اختصار dry eye + +403 +00:34:46,240 --> 00:34:50,620 +workshop هذا عبارة عن workshop تم إجراؤه في + +404 +00:34:50,620 --> 00:34:55,260 +أستراليا في سنة ألفي وسبعة عرفوا الـ dry eye أن + +405 +00:34:55,260 --> 00:34:56,120 +إذا عملت + +406 +00:35:02,410 --> 00:35:10,490 +factorial pathology مرض متعدد الأسباب أو disease + +407 +00:35:10,490 --> 00:35:26,010 +أو disorder that can cause ocular discomfort + +408 +00:35:30,280 --> 00:35:37,700 +Tear film instability + +409 +00:35:37,700 --> 00:35:44,340 +and + +410 +00:35:44,340 --> 00:35:48,320 +reduce + +411 +00:35:48,320 --> 00:36:01,950 +or decrease of visual acuity هذا بالنسبة له مفهوم + +412 +00:36:01,950 --> 00:36:06,470 +الـ dry eye جفاف العين according to dry eye + +413 +00:36:06,470 --> 00:36:14,530 +workshop 2007 طيب الآن ارتداء العدسات اللاصقة + +414 +00:36:14,530 --> 00:36:21,030 +المحبة للماء بسبب جفاف العين وهذا مفهوم جفاف العين + +415 +00:36:22,950 --> 00:36:27,730 +و أيضا بيسبب الـ dry eye symptoms اللي هي أعراض + +416 +00:36:27,730 --> 00:36:32,750 +جفاف العين، زي مثلا واحد بيصير عنده redness، + +417 +00:36:32,750 --> 00:36:35,790 +blurred vision، بيصير مثلا عنده photophobia، + +418 +00:36:35,790 --> 00:36:40,410 +itching، أيضا بيصير عنده red eye، كل هذه الأعراض + +419 +00:36:40,530 --> 00:36:45,230 +مصاحبة لمن؟ لا للـ dry eye اللي هي بيكون لها علاقة + +420 +00:36:45,230 --> 00:36:49,750 +فقط بالـ ocular symptoms يعني متعلقة بتشريح العين + +421 +00:36:49,750 --> 00:36:55,690 +حسب ال symptoms لـ eye strain طيب الآن السؤال + +422 +00:36:55,690 --> 00:37:02,230 +شخص عنده جفاف للعين هل أنا بدي عدسة high water + +423 +00:37:02,230 --> 00:37:07,790 +content ولا low water content؟ why؟ بدي low water + +424 +00:37:07,790 --> 00:37:09,550 +content okay why؟ + +425 +00:37:11,970 --> 00:37:18,670 +ممتازة كلام سليم الآن الأشخاص اللي عندهم dry eye + +426 +00:37:18,670 --> 00:37:23,750 +جفاف في العين أنا بدي عدسات low water content لأن + +427 +00:37:23,750 --> 00:37:28,310 +الـ high water content هتعمل حاجة بنسميها shift + +428 +00:37:28,310 --> 00:37:31,670 +osmotic + +429 +00:37:33,690 --> 00:37:38,630 +يعني بمعنى اللي هو تبخر أو تبادل لمين؟ للـ tear من ال + +430 +00:37:38,630 --> 00:37:44,110 +tear film للعدسة فهتلاحظ أن العدسة هتشفط كل ال + +431 +00:37:44,110 --> 00:37:49,090 +tear film وبالتالي هيصير هناك ايش؟ dehydration تبخر + +432 +00:37:49,090 --> 00:37:53,890 +لمين؟ للـ tear و أيضا أن المريض هيعاني من جفاف + +433 +00:37:53,890 --> 00:37:58,530 +للعين هيصير عنده dry eye symptoms اللي ذكرناها + +434 +00:37:58,530 --> 00:37:59,470 +سابقا + +435 +00:38:04,760 --> 00:38:09,300 +In extended wear أيضًا في العدسات اللي بتتم + +436 +00:38:09,300 --> 00:38:14,600 +ارتدائها لمدة أسبوع واحد وبعد ذلك بتتم التخلص منها + +437 +00:38:14,600 --> 00:38:19,600 +soft lenses may cause inflammatory complications + +438 +00:38:19,600 --> 00:38:24,410 +أيضًا هذا هيسبب ايش؟ مضاعفات للـ inflammation + +439 +00:38:24,410 --> 00:38:28,130 +الالتهابات زي مثلًا الـ Babillary conjunctivitis + +440 +00:38:28,130 --> 00:38:32,250 +ممكن يسبب dry eye ممكن يسبب keratitis كل هذه + +441 +00:38:32,250 --> 00:38:37,410 +الشغلات هتكون مصاحبة لارتداء العدسات اللاصقة + +442 +00:38:37,410 --> 00:38:44,030 +اللينة إذا الآن بنكتفي اليوم إن شاء الله بمقدمة عن + +443 +00:38:44,030 --> 00:38:50,410 +العدسات اللاصقة اللينة و بمميزات و أيضا عيوب أو + +444 +00:38:50,410 --> 00:38:55,630 +قيود العدسات اللاصقة اللينة في أي سؤال؟ أعطيكم + +445 +00:38:55,630 --> 00:38:56,290 +العافية شكرا diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/ejLWw1g5ydc_postprocess.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/ejLWw1g5ydc_postprocess.srt new file mode 100644 index 0000000000000000000000000000000000000000..c6f252e3f9574956900157b7e1ff2252c02abaef --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/ejLWw1g5ydc_postprocess.srt @@ -0,0 +1,1780 @@ +1 +00:00:21,210 --> 00:00:24,010 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:24,010 --> 00:00:27,050 +وبركاته and a very good morning to all of you + +3 +00:00:27,050 --> 00:00:30,930 +بداية كل عام و تبخير مع بداية الفصل الدراسي التاني + +4 +00:00:30,930 --> 00:00:34,610 +بنتمنى ان شاء الله ان يكون فصل مليء بالنجاح و + +5 +00:00:34,610 --> 00:00:38,790 +التفوق ان شاء الله طبعا هنبدأ في مادة ال soft + +6 +00:00:38,790 --> 00:00:43,890 +contact lens بداية ما هو تعريف العدسات اللاصقة + +7 +00:00:43,890 --> 00:00:49,600 +اللينةA soft lens may be defined as a contact lens + +8 +00:00:49,600 --> 00:00:54,120 +made from a hydrophilic material هي عبارة عن عدسة + +9 +00:00:54,120 --> 00:00:58,860 +مصنوعة من مادة محبة لئ الماء، قطر العدسة بيكون + +10 +00:00:58,860 --> 00:01:03,320 +أكبر من قطر القرنية، لذلك بنسميها semisqueral + +11 +00:01:03,320 --> 00:01:07,220 +design The + +12 +00:01:07,220 --> 00:01:14,060 +hydrophilic material بمعنى water contentاذا very + +13 +00:01:14,060 --> 00:01:19,080 +high water content او محبة للماء طبعا التركيبة + +14 +00:01:19,080 --> 00:01:24,540 +الكيميائية المستخدمة في صناعة العدسات اللاسقة + +15 +00:01:24,540 --> 00:01:29,040 +اللينة هي عبارة عن Hydroxyethyl Methacrylate + +16 +00:01:36,230 --> 00:01:41,330 +المادة المحبة للماء بتزود من مرونة او ليونة العدسة + +17 +00:01:41,330 --> 00:01:46,090 +allowing انه هتسمح it to conform to the shape of + +18 +00:01:46,090 --> 00:01:52,150 +the eye ومرونتها او ليونتها هتسمح لعدسة انه تاخد + +19 +00:01:52,150 --> 00:01:53,370 +شكل العين + +20 +00:01:55,960 --> 00:02:00,160 +Because soft lenses بسبب ان العدسات اللينة readily + +21 +00:02:00,160 --> 00:02:04,380 +conform بسهولة بتاخد شكل العين readily بمعنى + +22 +00:02:04,380 --> 00:02:08,520 +بسهولة conform to the shape of the eye بتاخد شكل + +23 +00:02:08,520 --> 00:02:12,380 +العين They tend to be easy to fit and to be + +24 +00:02:12,380 --> 00:02:17,000 +relatively comfortable لذلك عملية لذلك هي تعتبر + +25 +00:02:17,000 --> 00:02:23,140 +مريحة نسبيا وعملية ال fitting لها تعتبر سهلة نسبيا + +26 +00:02:23,140 --> 00:02:25,620 +مقارنة في ال hard contact + +27 +00:02:29,180 --> 00:02:34,620 +The hydrophilic material also maintains lens + +28 +00:02:34,620 --> 00:02:39,080 +movement أيضا المادة المحبة للماء هتحافظ على حركة + +29 +00:02:39,080 --> 00:02:43,580 +العدسة اتفقنا ان حركة العدسة ال hard contact lens + +30 +00:02:43,580 --> 00:02:48,040 +من واحد الى اتنين ملي متر بينما ال soft contact + +31 +00:02:48,040 --> 00:02:54,260 +lens من نصف الى واحد ملي مترإذا المادة المحبة + +32 +00:02:54,260 --> 00:02:59,200 +للماء أيضا هتحافظ على حركة العدسة because the + +33 +00:02:59,200 --> 00:03:03,560 +pores أي بمعنى المسامات أو الجزيئات in the + +34 +00:03:03,560 --> 00:03:08,440 +material في المادة هذه يعني المسامات الموجودة ما + +35 +00:03:08,440 --> 00:03:16,040 +بين العدسةallow tear flow هتسمح بتدفق التير من + +36 +00:03:16,040 --> 00:03:21,500 +خلال العدسة through the lens itself avoiding any + +37 +00:03:21,500 --> 00:03:26,380 +suction onto the eye وإن العدسة هتكون ليست مصممة، + +38 +00:03:26,380 --> 00:03:29,700 +إيش معناتها؟ إنه ليست جافة، يعني الآن ال soft + +39 +00:03:29,700 --> 00:03:33,480 +contact lens، أي مريض بيرتديها مش هتكون جافة + +40 +00:03:33,480 --> 00:03:37,900 +العدسة، هتكون إيش معناها؟ رطبة، صح ولا لا؟ مقارنة + +41 +00:03:37,900 --> 00:03:44,100 +بال hard contact lensطيب هان السؤال جديش المسامات + +42 +00:03:44,100 --> 00:03:49,760 +اللى موجودة بين العدسة اللاسقة اللينة؟ بتقدر + +43 +00:03:49,760 --> 00:03:56,820 +بتلاتة nanometer يعني تلاتة في عشرة أس minus تسعة + +44 +00:03:56,820 --> 00:04:02,100 +من المليمتر صح ولا لأ؟الان السؤال why bacteria or + +45 +00:04:02,100 --> 00:04:06,400 +fungi cannot penetrate intact soft contact lens؟ + +46 +00:04:06,400 --> 00:04:13,700 +لماذا البكتيريا او الفنجاي لا تستطيع اختراق العدسة + +47 +00:04:13,700 --> 00:04:20,720 +اللينة السليمة؟تفضلي ممتازة + +48 +00:04:21,410 --> 00:04:27,170 +طيب، الآن بناء على دراسات سابقة اتضح ان ال average + +49 +00:04:27,170 --> 00:04:32,230 +diameter ل الفنجاي او البكتيريا بيقدر ب 230 + +50 +00:04:32,230 --> 00:04:33,730 +نانومتر + +51 +00:04:35,330 --> 00:04:40,850 +Okay فهي تعتبر اكبر من مين من المسامات او جزيئات + +52 +00:04:40,850 --> 00:04:46,070 +العدسة اللاسقة اللينة لذلك هي لا تستطيع ان تخترق + +53 +00:04:46,070 --> 00:04:50,590 +من ال soft contact lens او ال intact soft contact + +54 +00:04:50,590 --> 00:04:56,750 +lens العدسة اللاسقة اللينة السليمة بنفس الوجه why + +55 +00:04:56,750 --> 00:05:02,190 +bacteria or fungi can penetrate damaged soft + +56 +00:05:02,190 --> 00:05:07,290 +contact lensيعني العدسة اللى خربانة من السهل انه + +57 +00:05:07,290 --> 00:05:12,830 +تخترقها، بالضبط لأن مسامات العدسة اللاصقة اللى هى + +58 +00:05:12,830 --> 00:05:17,090 +تعتبر damage هتكون اكبر من تلاتة نانومتر، صحيح؟ + +59 +00:05:17,090 --> 00:05:21,490 +وبالتالي من السهل انه ايه تخترق اللى هو البكتيريا + +60 +00:05:21,490 --> 00:05:26,470 +او ال fungi تخترق من العدسة اللاصقة اللى هى تعتبر + +61 +00:05:26,470 --> 00:05:26,810 +damage + +62 +00:05:29,750 --> 00:05:34,290 +Most soft lenses are made with hydrogel materials، + +63 +00:05:34,290 --> 00:05:39,590 +إذا الجيل الأول من العدسات اللاصقة اللينة فقط صنع + +64 +00:05:39,590 --> 00:05:43,730 +من مادة ال hydrogel materials أو ال hydrophilic + +65 +00:05:43,730 --> 00:05:48,270 +material، إذا فقط من مادة إيش؟ الماء، هذا الجيل + +66 +00:05:48,270 --> 00:05:54,630 +الأوللكن الجيل الحديث او الجيل التاني اللى عمل + +67 +00:05:54,630 --> 00:06:01,290 +تحديث له of soft lenses للعدسات اللينة تم اضافة + +68 +00:06:01,290 --> 00:06:06,190 +مادة السيليكون فصارت اللى هو silicone hydro gel + +69 +00:06:06,190 --> 00:06:10,790 +soft contact lens طيب السؤال ليش تم اضافة مادة + +70 +00:06:10,790 --> 00:06:15,350 +السيليكون؟ + +71 +00:06:15,350 --> 00:06:18,590 +okay another answer + +72 +00:06:22,200 --> 00:06:26,680 +بالضبط، اذا عشان بزود اول حاجة ال flexibility + +73 +00:06:26,680 --> 00:06:32,240 +مرونة العدسة اللى يونا إلها وشغلة مهمة كتير ال + +74 +00:06:32,240 --> 00:06:40,470 +durability المتانة لمين؟ للعدسةاذا زود من متانة + +75 +00:06:40,470 --> 00:06:44,950 +العدسة لذلك احنا ضفنا او العلماء او researchers + +76 +00:06:44,950 --> 00:06:49,590 +الباحثين ضافوا مادة السيليكون لمادة الهيدروجيل + +77 +00:06:49,590 --> 00:06:57,610 +فصار السيليكون هيدرجيل soft contact lensو هذه يعني + +78 +00:06:57,610 --> 00:07:01,790 +is rapidly gaining popularity، يعني اللي هو شافت + +79 +00:07:01,790 --> 00:07:06,210 +إقبال بشكل اللي هو سريع من قبل مين الناس، يعني + +80 +00:07:06,210 --> 00:07:10,930 +اتقبلوا الأمر، ليش؟ لأن المرونة زادت بالنسبة لمين؟ + +81 +00:07:10,930 --> 00:07:15,630 +لالعدسة، والمتانة إلها إيه؟ بالزيد، طبعا دايما + +82 +00:07:15,630 --> 00:07:20,250 +بتكون تربطوا عامل المتانة بفترة حياة العدسة، إنه + +83 +00:07:20,250 --> 00:07:24,030 +كل ما زاد متانة العدسة، فترة حياته إشمالها بالزيد + +84 +00:07:27,680 --> 00:07:31,540 +The large diameter القطر الكبير طبعا ال standard + +85 +00:07:31,540 --> 00:07:37,360 +diameter حكينا من 14 إلى 15 ملي متر أو من 13.5 إلى + +86 +00:07:37,360 --> 00:07:42,340 +15 ملي متر بناء على الدراسة اللي تم أخذ منها + +87 +00:07:42,340 --> 00:07:48,750 +المعلومة ال large diameter هو يعتبر مهمOkay طيب او + +88 +00:07:48,750 --> 00:07:53,650 +ضروري للمحافظة على ايه؟ educate lens centration + +89 +00:07:53,650 --> 00:07:59,510 +يعني تمركز مناسب للعدسة on the cornea على القرنية + +90 +00:07:59,510 --> 00:08:03,770 +ايضا ال stability الثبات و ال retention in the eye + +91 +00:08:03,770 --> 00:08:07,290 +الاحتفاظ او المحافظة عليها في داخل العين + +92 +00:08:11,150 --> 00:08:16,550 +Soft lenses are the most popular contact lens wear + +93 +00:08:16,550 --> 00:08:22,390 +modality accounting for some 88% of lens wearers + +94 +00:08:22,390 --> 00:08:27,210 +الأشخاص اللي بيرتديوا العدسات اللاصقة ع مستوى + +95 +00:08:27,210 --> 00:08:33,590 +العالم 88% من هؤلاء الأشخاص بيرتديوا أنواع ال soft + +96 +00:08:33,590 --> 00:08:38,580 +contact lens المختلفةقدرت هناك دراسة في الولايات + +97 +00:08:38,580 --> 00:08:43,240 +المتحدة الأمريكية ان في اكتر من سبعين companies + +98 +00:08:43,240 --> 00:08:49,820 +شركة لصناعة العدسات اللاصقة بتصنع اكتر من 185 نوع + +99 +00:08:49,820 --> 00:08:55,960 +من ال soft contact lenses طيب + +100 +00:08:55,960 --> 00:09:01,440 +الان هنبدأ في ال advantages ما هي مميزات العدسات + +101 +00:09:01,440 --> 00:09:03,140 +اللاصقة اللينة + +102 +00:09:06,070 --> 00:09:10,750 +Number one soft lenses are immediately comfortable + +103 +00:09:10,750 --> 00:09:17,290 +اذا بتتميز العدسات اللاصقة اللينة براحة مباشرة + +104 +00:09:17,290 --> 00:09:22,630 +بسبب اول حاجة ال water content very highNumber two + +105 +00:09:22,630 --> 00:09:25,930 +ال flexibility of the lens او ال flexibility ل + +106 +00:09:25,930 --> 00:09:31,290 +العدسة المرونة ايضا السبب التالد ان مافيش hard + +107 +00:09:31,290 --> 00:09:36,370 +interaction ما بين ال eyelid margin و ال lens edge + +108 +00:09:36,370 --> 00:09:42,350 +اطراف العدسة لذلك العدسات اللاصقة اللينة بتتميز + +109 +00:09:42,350 --> 00:09:49,410 +براحة مباشرة او بتتميز بانها مريحةadaptation time + +110 +00:09:49,410 --> 00:09:53,170 +is short owing وممكن تكتب بين قصين rapid + +111 +00:09:53,170 --> 00:09:59,930 +adaptation يعني سريعة التكييف okay why soft lenses + +112 +00:09:59,930 --> 00:10:06,510 +are short adaptation؟ ليش التكييف فيها سريع بيكون؟ + +113 +00:10:06,510 --> 00:10:12,650 +فضلي انه to conform to the shape of the eye + +114 +00:10:12,650 --> 00:10:13,510 +another one + +115 +00:10:18,520 --> 00:10:22,460 +طبعا هي تعتبر ايه؟ Minimal movement compared to + +116 +00:10:22,460 --> 00:10:26,240 +hard contact lens زي ما اتفقنا من نص الى واحد ملي + +117 +00:10:26,240 --> 00:10:30,220 +متر لذلك ان هي بيكون فيها tear exchange اشماله + +118 +00:10:30,220 --> 00:10:34,540 +محدود صح ولا لأ؟ وموضوع ال interaction او ال + +119 +00:10:34,540 --> 00:10:39,340 +irritation التهيج للعين بيكون اقل مقارنة في مين؟ + +120 +00:10:39,340 --> 00:10:43,860 +في ال hard contact lensesهذا السبب ان ليش ال + +121 +00:10:43,860 --> 00:10:47,520 +adaptation بيكون اللي هو أسرع مقارنة في ال hard + +122 +00:10:47,520 --> 00:10:51,320 +lenses soft + +123 +00:10:51,320 --> 00:10:56,360 +lenses العدسات اللينة are suitable for long or + +124 +00:10:56,360 --> 00:11:00,740 +short wearing times and variable wearing schedules + +125 +00:11:00,740 --> 00:11:06,740 +الآن شخص بده يرتدي العدسة اللاصقة ليوم واحد في + +126 +00:11:06,740 --> 00:11:12,870 +السنةفقط عنده مثلا convocation حفل تخرج okay بعد + +127 +00:11:12,870 --> 00:11:17,150 +نهاية الدراسة بده يرتدي العدسة اللاصقة بهذا اليوم + +128 +00:11:17,150 --> 00:11:22,640 +أنسب خيار إله بيكون مين ال soft contact lensأو + +129 +00:11:22,640 --> 00:11:27,120 +إنسان مثلا بده يستبدل العدسات كل فترة نتيجة اللي + +130 +00:11:27,120 --> 00:11:31,680 +هو تراكم من ال deposits على العدسات أنسب خيار + +131 +00:11:31,680 --> 00:11:37,080 +بيكون من ال soft contact lenses شخص مثلا فترة عمله + +132 +00:11:37,080 --> 00:11:41,640 +اتناشر ساعة بيقدرش يعني خلال اتناشر ساعة يكون فيه + +133 +00:11:41,640 --> 00:11:45,820 +هناك rest أفضل خيار له اللي هو ال soft contact + +134 +00:11:45,820 --> 00:11:49,780 +lenses إذا هي استخدمت في ال short أو ال long + +135 +00:11:49,780 --> 00:11:52,000 +wearing في الطرفين هدول + +136 +00:11:55,840 --> 00:11:59,380 +These lenses هذي العدسات are relatively + +137 +00:11:59,380 --> 00:12:04,420 +inexpensive يعني نسبيا هي تعتبر ليست غالية الثمن + +138 +00:12:04,420 --> 00:12:09,780 +which makes them suitable for planet replacement + +139 +00:12:09,780 --> 00:12:17,540 +systemsالطبيب او اخصاء البصريات طلب من المريض كل + +140 +00:12:17,540 --> 00:12:21,860 +أسبوعين انه يغير العدسة اللاصقة، بده يشوف مدى ال + +141 +00:12:21,860 --> 00:12:26,160 +irritation ل الكورنية، طبعا لو قلنا له البس hard + +142 +00:12:26,160 --> 00:12:30,490 +contact lensعالية الثمن كل أسبوعين يغير العدسة أو + +143 +00:12:30,490 --> 00:12:34,570 +كل شهرين أو كل مثلا شهر بيكون الأمر ايه مكلف + +144 +00:12:34,570 --> 00:12:38,630 +بالنسبة للمريض فأفضل حاجة ايش نستخدم ال soft + +145 +00:12:38,630 --> 00:12:44,450 +contact lens لعملية الاستبدال للعدسات اللاصقة بشكل + +146 +00:12:44,450 --> 00:12:45,210 +مستمر + +147 +00:12:48,420 --> 00:12:53,240 +Lenses can often be dispensed from an inventory + +148 +00:12:53,240 --> 00:12:58,180 +الان شخص برتدي عدسة لاسقة قوتها plus واحد و نص + +149 +00:12:58,180 --> 00:13:01,960 +ديوبتر السفير اذا مباشرة انا بجيبها من ال + +150 +00:13:01,960 --> 00:13:06,920 +inventory المستودع او المخزن وبصرفها لمين للمريض + +151 +00:13:06,920 --> 00:13:10,580 +دون النظر في مين في ال parameters التانية زي ال + +152 +00:13:10,580 --> 00:13:14,840 +base curve و ال diameter اللي هي تعتبر ايه عوامل + +153 +00:13:14,840 --> 00:13:17,420 +مهمة في ال hard contact lenses + +154 +00:13:21,360 --> 00:13:25,980 +اللون العيوني المظهر يمكن تغييره بصيغة لينزة لطيفة + +155 +00:13:26,780 --> 00:13:32,500 +معظم الممثلين ال actors او الرياضيين بيستخدموا مين + +156 +00:13:32,500 --> 00:13:37,360 +ال soft contact lens لتغيير ال iris color و طبعا + +157 +00:13:37,360 --> 00:13:42,520 +بيكون بألوان مختلفة ليه؟ ببساطة لأن قطر العدسة + +158 +00:13:42,520 --> 00:13:47,300 +بيكون كبير، بالتالي هي بتغطي ايش؟ كل ال iris و + +159 +00:13:47,300 --> 00:13:51,300 +ممكن انه تغير من لون ال iris طيب ليش ال hard + +160 +00:13:51,300 --> 00:13:55,040 +contact lens؟ مش ممكن انا استخدمها في اللي هو + +161 +00:13:55,040 --> 00:14:00,260 +تغيير لون ال irisبالضبط لأنه بيكون ال diameter + +162 +00:14:00,260 --> 00:14:03,980 +إلها أقل من مين من ال soft contact lens، بالتالي + +163 +00:14:03,980 --> 00:14:08,560 +هي لا تستطيع إنه تغطي كل ال irisأيضًا في بعض + +164 +00:14:08,560 --> 00:14:12,920 +الأشخاص بيحبوا مثلًا اللي هو عملية التلوين لل .. + +165 +00:14:12,920 --> 00:14:16,880 +ال .. ال iris بمعنى أنه بيكون عنده refractive + +166 +00:14:16,880 --> 00:14:21,700 +error فمرة مثلًا بلبس اللي هو نفترض a green okay + +167 +00:14:21,700 --> 00:14:25,880 +contact lens، تاني يوم مثلًا بلبس black، بلبس + +168 +00:14:25,880 --> 00:14:29,480 +brown، يعني هو عنده refractive error و مع ذلك + +169 +00:14:29,480 --> 00:14:34,150 +بيغير مين؟ ال iris colorواضحة الفكرة لكن هذه من + +170 +00:14:34,150 --> 00:14:38,490 +الصعب انه تموين في اللي هو ال hard contact lenses + +171 +00:14:38,490 --> 00:14:42,610 +soft + +172 +00:14:42,610 --> 00:14:47,650 +lenses cause minimal central corneal distortion so + +173 +00:14:47,650 --> 00:14:53,430 +a spectacular glare is rare بتتميز العدسات اللاصقة + +174 +00:14:53,430 --> 00:14:58,690 +اللينة بانها بتسبب ال cornea القديمةلكن القرنية + +175 +00:14:58,690 --> 00:15:04,390 +الإديمة بنتشر على كل سطح القرنية، لذلك هي ما بتغير + +176 +00:15:04,390 --> 00:15:09,110 +من مين من ال radius of curvature ل القرنية، + +177 +00:15:09,110 --> 00:15:13,850 +بالتالي أن ال spectacular layer هو بيكون أقل في ال + +178 +00:15:13,850 --> 00:15:17,890 +soft contact lens مقارنة في مين في ال hard contact + +179 +00:15:17,890 --> 00:15:22,570 +lenses The + +180 +00:15:22,570 --> 00:15:27,460 +large optic zone makes for minimal flareOkay + +181 +00:15:27,460 --> 00:15:33,440 +السؤال هان why flare is uncommon with soft lenses؟ + +182 +00:15:33,440 --> 00:15:38,560 +ال flare بمعنى ايه؟ الوهج، ليش بيكون غير شائع في + +183 +00:15:38,560 --> 00:15:45,700 +ال soft contact lens؟ فضلك اه + +184 +00:15:45,700 --> 00:15:50,320 +بس + +185 +00:15:50,320 --> 00:15:53,840 +في نقطة مهمة ايضا انه لان يما يكون ال diameter + +186 +00:15:53,840 --> 00:15:58,340 +للعدسة كبير okayالـ optic zone ايش ماله؟ هيكون + +187 +00:15:58,340 --> 00:16:02,480 +كبير فهي هتغطي من ال pupil حتى في ال dim + +188 +00:16:02,480 --> 00:16:06,420 +illumination صح ولا لأ؟ يعني الآن ال pupil يما + +189 +00:16:06,420 --> 00:16:10,360 +يكون هناك dim illumination هل هو هيكون في نفس + +190 +00:16:10,360 --> 00:16:14,100 +الوقت زي ال light؟ لأ في ال light illumination + +191 +00:16:14,100 --> 00:16:18,120 +هيكون ايه؟ في هناك اللي هو constraint مقارنة في + +192 +00:16:18,120 --> 00:16:20,920 +اللي هو ال dim illumination اللي هيكون فيها ال + +193 +00:16:20,920 --> 00:16:23,700 +pupil dilated okay؟ + +194 +00:16:25,450 --> 00:16:29,590 +There is less foreign body a trapping than with GB + +195 +00:16:29,590 --> 00:16:35,610 +lenses الأجسام الغريبة a trapping بمعنى حصر بتنحصر + +196 +00:16:35,610 --> 00:16:40,830 +أقل ما بين الكورنيا و ال soft contact lens مقارنة + +197 +00:16:40,830 --> 00:16:46,110 +بال hard contact lens يعني هناك صعوبة لدخول + +198 +00:16:46,110 --> 00:16:49,930 +الأجسام الغريبة ما بين ال soft contact lens و + +199 +00:16:49,930 --> 00:16:56,970 +الكورنياOkay طيب الان مين أصعب لو دخل ال foreign + +200 +00:16:56,970 --> 00:17:01,310 +body مابين ال soft contact lens و الكورنية ولا + +201 +00:17:01,310 --> 00:17:09,170 +مابين ال hard contact lens و الكورنية؟ لأ طيب why؟ + +202 +00:17:16,340 --> 00:17:21,380 +بالضبط اذا زي ما هو من الصعب انه يدخل لكن اذا هناك + +203 +00:17:21,380 --> 00:17:25,300 +انحصار الجسم الغريب ما بين ال soft contact lens و + +204 +00:17:25,300 --> 00:17:29,480 +ال anterior surface للكورنيا من الصعب خروجه و + +205 +00:17:29,480 --> 00:17:34,260 +هيعمل complications مضاعفات اكتر من مين من ال hard + +206 +00:17:34,260 --> 00:17:39,560 +contact lenses يعني في نفس الوقت انه هيسبب اللي هو + +207 +00:17:39,560 --> 00:17:43,680 +more complications compared to the hard contact + +208 +00:17:43,680 --> 00:17:44,360 +lenses + +209 +00:17:47,700 --> 00:17:51,400 +لنزات حلوة جيدة لعمل أفضل أفضل أفضل أفضل أفضل أفضل + +210 +00:17:51,400 --> 00:17:55,140 +أفضل أفضل أفضل أفضل أفضل أفضل + +211 +00:17:55,640 --> 00:18:00,840 +العدسات اللاصقة اللينة هي مناسبة للرياضيين يعني + +212 +00:18:00,840 --> 00:18:04,820 +للاعبين كرة القدم، لاعبين ال basket ball، ال + +213 +00:18:04,820 --> 00:18:08,840 +tennis السبب الأول لأن it follows to the eye + +214 +00:18:08,840 --> 00:18:13,200 +movement بتتبع حركة مين؟ العين ال visual field إيش + +215 +00:18:13,200 --> 00:18:17,660 +بيكون فيها؟ واسع من الصعب اللي هو سقوط العدسة + +216 +00:18:17,660 --> 00:18:22,780 +اللاصقة اللينة طيب هناك في حالتين ممكن إنه تسقط + +217 +00:18:22,780 --> 00:18:25,080 +فيها العدسات اللاصقة اللينة + +218 +00:18:34,290 --> 00:18:41,870 +ممتازة اذا اول حاجة ال trauma كلام سليم اذا لو صار + +219 +00:18:41,870 --> 00:18:46,950 +هناك trauma من السهل اللي هو سقوط العدسة اللاصقة + +220 +00:18:46,950 --> 00:18:54,510 +اللينةو .. تفضلي او اللي هو ال pinch أي بمعنى أي + +221 +00:18:54,510 --> 00:19:00,910 +لدغة بتحدث لمين للعين، اذا عندنا في هناك اللي هو + +222 +00:19:00,910 --> 00:19:06,430 +two causes سببين لسقوط العدسة اللاسقة اللينة شخص + +223 +00:19:06,430 --> 00:19:10,450 +اتعرض لضربة قوية والشغل التاني اللي هي ال pinch + +224 +00:19:10,450 --> 00:19:11,130 +اللدغة + +225 +00:19:13,890 --> 00:19:18,110 +لدغة .. لدغة حشرة مثلا .. لدغة مثلا نحلة الاخر .. + +226 +00:19:18,110 --> 00:19:21,890 +انه لما يتعرض المريض للدغة معينة ممكن انه تسقط + +227 +00:19:21,890 --> 00:19:26,490 +العدسة أو ممكن انه يصير لها damage لل soft contact + +228 +00:19:26,490 --> 00:19:34,040 +lensايضا ان هي بتستخدم مع الرياضيين سواء كان ال + +229 +00:19:34,040 --> 00:19:37,560 +football players او ال basketball players لان هي + +230 +00:19:37,560 --> 00:19:41,620 +بتتميز ب minimal movement compared to hard contact + +231 +00:19:41,620 --> 00:19:46,020 +lenses، بالتالي هي هسبب ايه؟ Cornial distortion + +232 +00:19:46,020 --> 00:19:50,520 +لكن ال spectacular player هيكون اقل، okay؟ هذه + +233 +00:19:50,520 --> 00:19:55,140 +الأسباب ان ليش هي تعتبر خيار مناسب بالنسبة لمين + +234 +00:19:55,140 --> 00:19:57,100 +للرياضيين + +235 +00:19:58,330 --> 00:20:02,150 +نقطة هذه مهمة they are a good option when a + +236 +00:20:02,150 --> 00:20:06,170 +spheric refractive error is associated with a + +237 +00:20:06,170 --> 00:20:12,730 +toric cornea بداية عندنا ال astigmatism إما بيكون + +238 +00:20:12,730 --> 00:20:16,950 +refractive astigmatism بيكون ممكن corneal cylinder + +239 +00:20:16,950 --> 00:20:21,470 +وممكن internal أو residual astigmatism صحيح هدول + +240 +00:20:21,470 --> 00:20:25,070 +التلت أنواع طيب الآن نفترض مثلا + +241 +00:20:44,240 --> 00:20:50,500 +انه كان عندنا ال internal cylinder plus اتنين او + +242 +00:20:50,500 --> 00:20:54,480 +minus اتنين طبعا لو بنشتغل في ال minus او plus + +243 +00:20:54,480 --> 00:20:59,460 +cylinder وكان هنا عندنا plano هذه بالنسبة لل + +244 +00:20:59,460 --> 00:21:05,960 +internal cylinder واضحة؟ + +245 +00:21:05,960 --> 00:21:14,340 +وعندنا كان ال corneal astigmatism هان plus اتنينأو + +246 +00:21:14,340 --> 00:21:19,880 +ماينوس اتنين وهان كان بلانه قداش هتكون قيمة ال + +247 +00:21:19,880 --> 00:21:24,900 +refractive astigmatism في الحالة هذه اللي هو Zero + +248 +00:21:24,900 --> 00:21:29,220 +قيمة ال refractive astigmatism Zero لان ال + +249 +00:21:29,220 --> 00:21:33,440 +internal cylinder اشمله متعامد مع مين؟ مع ال + +250 +00:21:33,440 --> 00:21:38,660 +corneal cylinder فمدان متعامد اذا هيكون عندنا فقط + +251 +00:21:38,660 --> 00:21:42,680 +اللي هو ال sphere of refraction + +252 +00:21:45,870 --> 00:21:51,010 +إذا في حالة الـ sphere refraction يكون عندنا قيمة + +253 +00:21:51,010 --> 00:21:56,150 +السيلندر Zero الخيار المناسب للمريض هان هيكون مين + +254 +00:21:56,150 --> 00:22:00,490 +ال soft contact lens يعني بتلاحظ ان المريض عنده لو + +255 +00:22:00,490 --> 00:22:06,440 +امسكنا ورقة ال print out مثلا plus 3هذه الـ + +256 +00:22:06,440 --> 00:22:10,040 +Objective Refraction، حسنًا، هذه بالصحيحة، لكن + +257 +00:22:10,040 --> 00:22:13,000 +ارجع إلى اللي هو الـ Corneal Cylinder، هتلاقيه + +258 +00:22:13,000 --> 00:22:16,080 +Minus One، روحي على الـ Internal Cylinder، هتلاقيه + +259 +00:22:16,080 --> 00:22:19,520 +Minus One، لكن التنين هذول متعمدين على بعض، يعني + +260 +00:22:19,520 --> 00:22:25,740 +واحد Axis 90، الآخر Axis 180، إذا عندنا الـSphere + +261 +00:22:25,740 --> 00:22:29,500 +Refraction جداش فقط اللي هو الـPower أو فقط + +262 +00:22:29,500 --> 00:22:34,180 +الـValue، أي بمعنى عندنا قيمة الـStigmatism هتكون + +263 +00:22:34,180 --> 00:22:40,160 +ZeroOkay ففي هذه الحالة الخيار الأفضل للمريض هيكون + +264 +00:22:40,160 --> 00:22:45,060 +مين ال soft contact lens ال cone هيش هيكون شكلها + +265 +00:22:45,060 --> 00:22:53,280 +توريك وانتوا عارفين ايش معناه توريك صحيح يعني + +266 +00:22:53,280 --> 00:22:57,860 +بمعنى اللي هو ال sphero cylinder صحيح طيب الآن + +267 +00:22:57,860 --> 00:23:03,320 +بالنسبة لل limitations العيوب او القيود للعدسات + +268 +00:23:03,320 --> 00:23:05,060 +اللاصقة اللينة + +269 +00:23:07,980 --> 00:23:12,260 +number one they have a relatively short life، إذا + +270 +00:23:12,260 --> 00:23:17,960 +فترة حياة العدسة هتكون قصيرة، مقارنة في مين؟في ال + +271 +00:23:17,960 --> 00:23:22,900 +hard contact lenses لكن فيها معلومة مهمة كتير ان + +272 +00:23:22,900 --> 00:23:27,540 +في classification تصنيف للعدسات اللاصقة اللينة + +273 +00:23:27,540 --> 00:23:33,440 +ممكن تكون annual سنوية ممكن تكون semi annual اي + +274 +00:23:33,440 --> 00:23:38,340 +بمعنى نصف سنة و ممكن تكون quarterly ربع سنة او تلت + +275 +00:23:38,340 --> 00:23:44,370 +شهورطبعا فترة حياة العدسة السنوية هتكون أطول من + +276 +00:23:44,370 --> 00:23:49,530 +الـ quarterly أطول من مين من ال semi-annual فالان + +277 +00:23:49,530 --> 00:23:55,130 +العدسات اللاصقة اللينة بتتميز ان فترة حياتها قصيرة + +278 +00:23:55,130 --> 00:23:59,670 +مقارنة في ال hard contact lensSince they are + +279 +00:23:59,670 --> 00:24:05,590 +fragile أي بمعنى هشة and subject بتكون معرضة لإيش + +280 +00:24:05,590 --> 00:24:10,570 +معرضة؟ ل rapid accumulation اللي هو تراكم سريع لل + +281 +00:24:10,570 --> 00:24:17,470 +surface اللي هو deposits أي بمعنى الترثبات بتتراكم + +282 +00:24:17,470 --> 00:24:21,330 +على العدسة بشكل سريع مقارنة في مين؟ في ال hard + +283 +00:24:21,330 --> 00:24:22,650 +contact lenses + +284 +00:24:26,370 --> 00:24:31,150 +Number two ongoing lens care يعني بمعنى الاستمرار + +285 +00:24:31,150 --> 00:24:36,310 +بعناية العدسة أو رعاية العدسة takes a significant + +286 +00:24:36,310 --> 00:24:41,210 +amount of time هتطلب وقت من مين؟ من ال patient + +287 +00:24:41,210 --> 00:24:49,210 +المريض على الأقل خمس دقائق كل يوم عملية تنظيفطبعا + +288 +00:24:49,210 --> 00:24:52,430 +مقارنة في ال hard contact lens هتكون المدة ايه + +289 +00:24:52,430 --> 00:24:56,210 +طويلة لأنه في ال hard contact lens الفترة الزمنية + +290 +00:24:56,210 --> 00:25:00,770 +هتكون اقل حتى من ناحية الآن لو المريض عمل + +291 +00:25:00,770 --> 00:25:04,930 +insertion لل soft contact lens في البدايات مش بعد + +292 +00:25:04,930 --> 00:25:08,590 +ما يتعود عليها هتلاحظوا في الأول هيصير عنده نوع من + +293 +00:25:08,590 --> 00:25:13,030 +ال blurred vision الغباش لفترة زمنية طويلة وبعد + +294 +00:25:13,030 --> 00:25:15,810 +ذلك انه هيصير يتعود عليها + +295 +00:25:19,090 --> 00:25:23,650 +Lens cleaning and disinfection are essential، إذا + +296 +00:25:23,650 --> 00:25:28,730 +تنظيف العدسة وتعقيمها يعتبر أمر أساسي في ارتداء + +297 +00:25:28,730 --> 00:25:33,490 +العدسات اللاصقة اللينة، إذا عملية التعقيم والتنظيف + +298 +00:25:33,490 --> 00:25:38,930 +مهم جدا بالنسبة لمين لمريض اللي بيرتدي العدسات + +299 +00:25:38,930 --> 00:25:46,200 +اللاصقة اللينةThe result نتيجة of non-compliance + +300 +00:25:46,200 --> 00:25:51,260 +يعني نتيجة عدم الالتزام with care systems بأنظمة + +301 +00:25:51,260 --> 00:25:56,410 +العناية أو الرعاية may be devastatingإيش هذا + +302 +00:25:56,410 --> 00:26:01,710 +يعتبر؟ يعني أمر مدمر للعدسة، إنه الآن أنا ما بلتزم + +303 +00:26:01,710 --> 00:26:06,590 +بأنظمة الرعاية والعناية والتنظيف للعدسة، بيعتبر + +304 +00:26:06,590 --> 00:26:12,030 +هذا أمر مدمر لمين؟ للعدسة، يعني بينهي حياة العدسة + +305 +00:26:12,030 --> 00:26:14,130 +في فترة زمنية قصيرة + +306 +00:26:18,130 --> 00:26:22,570 +They may be ineducate for correcting law or + +307 +00:26:22,570 --> 00:26:28,890 +residual astigmatism. هي لا تعتبر مناسبة لتصحيح ال + +308 +00:26:28,890 --> 00:26:32,330 +law او ال residual astigmatism. هذه العدسات + +309 +00:26:32,330 --> 00:26:38,570 +اللاصقة اللينة. Why؟ ليش هي غير مناسبة لتصحيح ال + +310 +00:26:38,570 --> 00:26:42,310 +law او ال residual astigmatism؟ فضلي. لإنها تلغي + +311 +00:26:42,310 --> 00:26:46,830 +.. اول حاجة تلغي هي تلغي صفحة القرانية و تلغي صفحة + +312 +00:26:46,830 --> 00:26:47,210 +الديكا + +313 +00:26:54,650 --> 00:26:58,350 +ممتازة، اذا اتعلمنا في ال hard contact lens ال + +314 +00:26:58,350 --> 00:27:02,770 +optics لل hard contact lens ان هي بتعمل ايه؟ a new + +315 +00:27:02,770 --> 00:27:06,230 +surface للكورنية، لكن في ال soft contact lens + +316 +00:27:06,230 --> 00:27:09,750 +conform to the shape of the cornea، هذا السبب ان + +317 +00:27:09,750 --> 00:27:14,730 +ليش هي مابتكون ملائمة او مناسبة لتصحيح ال low أو + +318 +00:27:14,730 --> 00:27:16,550 +ال residue وال astigmatism + +319 +00:27:19,640 --> 00:27:24,540 +It is difficult to verify soft lens parameters اذا + +320 +00:27:24,540 --> 00:27:29,840 +من الصعب انا اتحقق او اتأكد من خواص او من ال + +321 +00:27:29,840 --> 00:27:34,540 +parameters الخاصة بالعدسات اللاصقة اللينة يعني + +322 +00:27:34,540 --> 00:27:38,870 +بمعنى الان احنا ال powerفي الـ hard contact lens + +323 +00:27:38,870 --> 00:27:42,630 +ممكن أقيصه من خلال جهاز الـ lensmeter لكن ال soft + +324 +00:27:42,630 --> 00:27:47,370 +contact lens صعب أقيص موضوع اللي هو التأكد من ال + +325 +00:27:47,370 --> 00:27:51,410 +base curve مستحيل أستخدم ال contact gauge لتأكيد + +326 +00:27:51,410 --> 00:27:55,860 +ال base curve في ال soft contact lensلكن العدسات + +327 +00:27:55,860 --> 00:28:00,300 +اللاصقة الصلبة ممكن أتأكد من ال base care من خلال + +328 +00:28:00,300 --> 00:28:04,800 +استخدام جهاز ال contact gauge إذا عملية التأكيد لل + +329 +00:28:04,800 --> 00:28:09,440 +parameters أو التحقيق تعتبر صعبة وين في العدسات + +330 +00:28:09,440 --> 00:28:16,120 +اللاصقة اللينة Hydrogel + +331 +00:28:16,120 --> 00:28:20,340 +soft lenses offer only limited oxygen + +332 +00:28:20,340 --> 00:28:26,190 +transmissibilityالان في أنواع من العدسات اللاصقة + +333 +00:28:26,190 --> 00:28:30,270 +اللينة زي مثلا ال extended wear ايش معناة ال + +334 +00:28:30,270 --> 00:28:37,750 +extended wear؟ تفضلي اه + +335 +00:28:37,750 --> 00:28:39,990 +اه + +336 +00:28:41,330 --> 00:28:45,810 +According to Food and Drug Administration على + +337 +00:28:45,810 --> 00:28:50,610 +منظمة اللي هو الصحة والدواء عرفوا العدسات اللاصقة + +338 +00:28:50,610 --> 00:28:54,990 +ال extended wear ان المريض بلبسها لمدة أسبوع و + +339 +00:28:54,990 --> 00:29:00,450 +بنام فيها okay الان في هذه العدسات لازم ان يكون ال + +340 +00:29:00,450 --> 00:29:05,770 +DK على T أشماله very high okay وإلا إيش هتعمل + +341 +00:29:05,770 --> 00:29:10,170 +كورنيا القديمة بالنسبة للمريض إذا لازم ان يكون ال + +342 +00:29:10,170 --> 00:29:17,960 +DKعلى T very high in + +343 +00:29:17,960 --> 00:29:23,720 +extended wear + +344 +00:29:23,720 --> 00:29:29,620 +lenses اذا في هذه النوع من العدسات اللاصقة لازم ان + +345 +00:29:29,620 --> 00:29:34,480 +يكون ال decay على T very high طبعا هذا بنسميه ال + +346 +00:29:34,480 --> 00:29:38,440 +oxygen transmissibility اذا نفاذ ال oxygen very + +347 +00:29:38,440 --> 00:29:42,760 +highفي هذه الحالة مدام نفاذ ال oxygen very high، + +348 +00:29:42,760 --> 00:29:47,420 +إذا العدسة إيش هتكون؟ fragile، هشة كتير، يعني فترة + +349 +00:29:47,420 --> 00:29:51,680 +حياتها إيش؟ هتكون جدا قصيرة، يعني قد تكمل الأسبوع + +350 +00:29:51,680 --> 00:29:56,540 +أو لا مع المريض، وهذا هو يعتبر إيه؟ واحدة من عيوب + +351 +00:29:56,540 --> 00:30:01,120 +العدسات اللاصقة اللينة، إن هي بتعمل offer only + +352 +00:30:01,120 --> 00:30:05,720 +limited of oxygen transmissibilityيعني صح هي بتزود + +353 +00:30:05,720 --> 00:30:11,220 +ال oxygen transmissibility بشكل كبير للعدسة، ولكن + +354 +00:30:11,220 --> 00:30:17,950 +ات هي بتنهيق على حياة العدسة بشكل مبكرOkay لكن لو + +355 +00:30:17,950 --> 00:30:23,490 +اجينا مثلا العدسات ال conventional contact lens + +356 +00:30:23,490 --> 00:30:26,910 +اللي هي عدسات اللبس اليومي او التقليدي، هذه + +357 +00:30:26,910 --> 00:30:31,310 +العدسات هنلاحظها ان فترة حياتها بتجود مثلا من ستة + +358 +00:30:31,310 --> 00:30:35,130 +الى اتناشر شهر، فبالتالي ايش هيكون ال DK؟ مين + +359 +00:30:35,130 --> 00:30:38,650 +اعلى؟ هي ولا ال extended wear؟ ال extended wear + +360 +00:30:38,650 --> 00:30:43,030 +هيكون فيها ال DK على T very high، صحيح؟ مقارنة في + +361 +00:30:43,030 --> 00:30:45,750 +ال conventional contact lens wear + +362 +00:30:49,210 --> 00:30:55,010 +بالتالي، يمكن أن يكون لديهم مشاكل بشكل مستمر أو + +363 +00:30:55,010 --> 00:31:00,570 +عندما يقوموا بإصلاح أمترابيا أو أستيغماطيةالان انا + +364 +00:31:00,570 --> 00:31:04,330 +يما بستخدم العدسات ال soft contact lens في ال high + +365 +00:31:04,330 --> 00:31:08,650 +ametropia او في ال high astigmatism من الصعب اني + +366 +00:31:08,650 --> 00:31:13,050 +استخدم مين؟ ال soft contact lens اضافة للسبب ان هي + +367 +00:31:13,050 --> 00:31:16,830 +conform to the shape of the cornea ان هذه العدسة + +368 +00:31:16,830 --> 00:31:20,850 +تعتبر ال oxygen transmissibility او ال decay على + +369 +00:31:20,850 --> 00:31:26,530 +THH تعتبر very high فبالتالي هي غير مناسبة لتصحيح + +370 +00:31:26,530 --> 00:31:34,340 +ال high ametropia او ال astigmatismCompare with GB + +371 +00:31:34,340 --> 00:31:39,340 +lenses, soft lenses have limited post lens tear + +372 +00:31:39,340 --> 00:31:43,680 +exchange، اذا التبادل التير في العدسات اللاصقة + +373 +00:31:43,680 --> 00:31:48,860 +اللينة هيكون محدود مقارنة في مين في ال GB lenses، + +374 +00:31:48,860 --> 00:31:54,920 +why؟بسبب الـ Minimal Movement للـ Soft Contact + +375 +00:31:54,920 --> 00:31:59,500 +Lens اللي بتقدر من نص إلى واحد مليمتر مقارنة في + +376 +00:31:59,500 --> 00:32:02,700 +الـ Hard Contact Lens اللي الحركة فيها من واحد إلى + +377 +00:32:02,700 --> 00:32:08,290 +اتنين مليمترإذا مرة أخرى تبادل الـ tear في العدسات + +378 +00:32:08,290 --> 00:32:14,050 +اللاصقة اللينة يعتبر أقل من العدسات اللاصقة الصلبة + +379 +00:32:14,050 --> 00:32:18,170 +السبب في ذلك قلة الحركة اللي هي بتقدر من نص إلى + +380 +00:32:18,170 --> 00:32:21,910 +واحد مقارنة في ال hard contact lens اللي بتقدر من + +381 +00:32:21,910 --> 00:32:23,850 +واحد إلى اتنين مليمتر + +382 +00:32:27,950 --> 00:32:33,130 +hydrophilic materials المواد المحبة للماء tend to + +383 +00:32:33,130 --> 00:32:38,830 +dehydrate هتعمل تبخر on eye dehydrate بمعنى تبخر + +384 +00:32:38,830 --> 00:32:45,770 +أي بمعنى انه بيسبب dry eye جفاف للعين which may + +385 +00:32:45,770 --> 00:32:50,230 +cause symptoms يعني بيسبب اللي هو أعراض جفاف العين + +386 +00:32:50,230 --> 00:32:55,170 +لو سألنا السؤال ما هو مفهوم ال dry eye جفاف العين + +387 +00:32:55,170 --> 00:32:56,130 +ايش تعريفه؟ + +388 +00:33:12,380 --> 00:33:19,140 +تفضلي اه هذي ك causes صحيح؟ okay another answer + +389 +00:33:21,950 --> 00:33:26,430 +طيب dry eye جفاف العين هو يعتبر a multifactorial + +390 +00:33:26,430 --> 00:33:31,710 +pathology يعني مرض متعدد الأسباب that can cause + +391 +00:33:31,710 --> 00:33:38,730 +بيسبب هذا المرض ocular discomfort يعني عدم راحة + +392 +00:33:38,730 --> 00:33:43,350 +لمين ل العين و أيضا بيعمل decrease لل visual + +393 +00:33:43,350 --> 00:33:47,790 +acuity و بيعمل tear instability عدم ثبات لمين + +394 +00:33:47,790 --> 00:33:50,610 +للتير اتبعكم التعريف + +395 +00:33:58,010 --> 00:34:03,550 +طبعا هذا التعريف according to اه بيعمل decrease ال + +396 +00:34:03,550 --> 00:34:08,590 +visual acuity نعم صحيح لذلك الأشخاص اللي بيكون + +397 +00:34:08,590 --> 00:34:13,090 +عندهم جفاف في العين بيقولك انا discomfort عدم راحة + +398 +00:34:13,090 --> 00:34:17,050 +عندى و ايضا عندى اللي هو بشعر ان ال visual acuity + +399 +00:34:17,050 --> 00:34:21,550 +مابشوفش الشغلات اللي بعيدة بيكون هذه لها علاقة في + +400 +00:34:21,550 --> 00:34:24,190 +ال ocular symptoms مالهاش علاقة في ال visual + +401 +00:34:24,190 --> 00:34:37,940 +symptoms اذا ن dryأو اختصارها DA according to + +402 +00:34:37,940 --> 00:34:46,240 +dry eye workshop 2007 طبعا هذه اختصار dry eye + +403 +00:34:46,240 --> 00:34:50,620 +workshop هذا عبارة عن workshop تم إجراءه في + +404 +00:34:50,620 --> 00:34:55,260 +استراليا في سنة الفين وسبعة عرفوا ل dry eye انه + +405 +00:34:55,260 --> 00:34:56,120 +اذا عملت + +406 +00:35:02,410 --> 00:35:10,490 +factorial pathology مرض متعدد الأسباب أو disease + +407 +00:35:10,490 --> 00:35:26,010 +أو disorder that can cause ocular discomfort + +408 +00:35:30,280 --> 00:35:37,700 +Tier film instability + +409 +00:35:37,700 --> 00:35:44,340 +and + +410 +00:35:44,340 --> 00:35:48,320 +reduce + +411 +00:35:48,320 --> 00:36:01,950 +or decrease of visual acuityهذا بالنسبة له مفهوم + +412 +00:36:01,950 --> 00:36:06,470 +ال dry eye جفاف العين according to dry eye + +413 +00:36:06,470 --> 00:36:14,530 +workshop 2007 طيب الآن ارتداء العدسات اللاصقة + +414 +00:36:14,530 --> 00:36:21,030 +المحبة للماء بسبب جفاف العين وهذا مفهوم جفاف العين + +415 +00:36:22,950 --> 00:36:27,730 +و أيضا بيسبب ال dry eye symptoms اللي هي أعراض + +416 +00:36:27,730 --> 00:36:32,750 +جفاف العين، زي مثلا واحد بيصير عنده redness، + +417 +00:36:32,750 --> 00:36:35,790 +blurred vision، بيصير مثلا عنده photophobia، + +418 +00:36:35,790 --> 00:36:40,410 +itching، أيضا بيصير عنده red eye، كل هذه الأعراض + +419 +00:36:40,530 --> 00:36:45,230 +مصاحبة لمين؟ لأ ل dry eye اللي هي بيكون لها علاقة + +420 +00:36:45,230 --> 00:36:49,750 +فقط بال ocular symptoms يعني متعلقة بتشريح العين + +421 +00:36:49,750 --> 00:36:55,690 +حسب ال symptoms ل ال eye strain طيب الآن السؤال + +422 +00:36:55,690 --> 00:37:02,230 +شخص عنده جفاف للعين هل أنا بدي عدسة high water + +423 +00:37:02,230 --> 00:37:07,790 +content ولا low water content؟ why؟ بدي low water + +424 +00:37:07,790 --> 00:37:09,550 +content okay why؟ + +425 +00:37:11,970 --> 00:37:18,670 +ممتازة كلام سليم الان الأشخاص اللي عندهم dry eye + +426 +00:37:18,670 --> 00:37:23,750 +جفاف في العين انا بديه عدسات low water content لان + +427 +00:37:23,750 --> 00:37:28,310 +ال high water content هتعمل حاجة بنسميها shift + +428 +00:37:28,310 --> 00:37:31,670 +osmatic + +429 +00:37:33,690 --> 00:37:38,630 +يعني بمعنى اللي هو تبخر او تبادل لمين لل تير من ال + +430 +00:37:38,630 --> 00:37:44,110 +tear film للعدسة فهتلاحظ ان العدسة هتشفط كل ال + +431 +00:37:44,110 --> 00:37:49,090 +tear film وبالتالي هيصير هناك ايش؟ dehydrate تبخر + +432 +00:37:49,090 --> 00:37:53,890 +لمين لا التير و ايضا ان المريض هيعاني من جفاف + +433 +00:37:53,890 --> 00:37:58,530 +للعين هيصير عنده dry eye symptoms اللي ذكرناها + +434 +00:37:58,530 --> 00:37:59,470 +سابقا + +435 +00:38:04,760 --> 00:38:09,300 +In extended wear أيضًا في العدسات اللي بتتم + +436 +00:38:09,300 --> 00:38:14,600 +ارتدائها لمدة أسبوع واحد وبعد ذلك بتتم التخلص منها + +437 +00:38:14,600 --> 00:38:19,600 +soft lenses may cause inflammatory complications + +438 +00:38:19,600 --> 00:38:24,410 +أيضًا هذا هيسبب إيش مضاعفاتللـ inflammation + +439 +00:38:24,410 --> 00:38:28,130 +الالتهابات زي مثلا ال Babillary conjunctivitis + +440 +00:38:28,130 --> 00:38:32,250 +ممكن يسبب dry eye ممكن يسبب keratitis كل هذه + +441 +00:38:32,250 --> 00:38:37,410 +الشغلات هتكون مصاحبة لارتداء العدسات اللاصقة + +442 +00:38:37,410 --> 00:38:44,030 +اللينةإذا الآن بنكتفي اليوم ان شاء الله بمقدمة عن + +443 +00:38:44,030 --> 00:38:50,410 +العدسات اللاصقة اللينة و بمميزات و أيضا عيوب أو + +444 +00:38:50,410 --> 00:38:55,630 +قيود العدسات اللاصقة اللينة في أي سؤال؟ أعطيكم + +445 +00:38:55,630 --> 00:38:56,290 +العافية شكرا + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/ejLWw1g5ydc_raw.json b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/ejLWw1g5ydc_raw.json new file mode 100644 index 0000000000000000000000000000000000000000..565116c2990f8f4a41237b99a0bc28264a68c16e --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/ejLWw1g5ydc_raw.json @@ -0,0 +1 @@ +{"segments": [{"id": 1, "seek": 4477, "start": 21.21, "end": 44.77, "text": "بسم الله الرحمن الرحيم السلام عليكم ورحمة الله وبركاته and a very good morning to all of you بداية كل عام و تبخير مع بداية الفصل الدراسي التاني بنتمنى ان شاء الله ان يكون فصل مليء بالنجاح و التفوق ان شاء الله طبعا هنبدأ في مادة ال soft contact lens بداية ما هو تعريف العدسات اللاصقة 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صناعة العدسات اللاسقة اللينة هي عبارة عن Hydroxyethyl Methacrylate", "tokens": [45636, 995, 588, 1090, 1281, 2701, 1975, 2407, 3714, 5016, 49401, 5296, 19528, 16606, 23032, 3555, 3615, 995, 16712, 31747, 1829, 49401, 33251, 32640, 1829, 16373, 10632, 9673, 14851, 9778, 40448, 3660, 8978, 20328, 8315, 27884, 18863, 3215, 3794, 9307, 13672, 32277, 28671, 13672, 9957, 3660, 39896, 6225, 3555, 9640, 3660, 18871, 24231, 340, 12876, 3293, 5088, 48602, 326, 627, 17593], "avg_logprob": -0.14667338084790013, "compression_ratio": 1.3352941176470587, "no_speech_prob": 0.0, "words": [{"start": 73.12, "end": 73.6, "word": "اذا", "probability": 0.4410400390625}, {"start": 73.6, "end": 74.06, "word": " very", "probability": 0.77587890625}, {"start": 74.06, "end": 74.46, "word": " high", "probability": 0.91455078125}, {"start": 74.46, "end": 75.02, "word": " water", "probability": 0.9404296875}, {"start": 75.02, "end": 75.68, "word": " content", "probability": 0.974609375}, {"start": 75.68, "end": 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inexpensive يعني نسبيا هي تعتبر ليست غالية الثمن which makes them suitable for planet replacement systems", "tokens": [28858, 18059, 8032, 8848, 1829, 18863, 3215, 3794, 9307, 366, 7226, 28382, 37495, 22653, 8717, 35457, 25528, 39896, 6055, 34268, 26890, 32239, 14851, 32771, 6027, 10632, 6024, 104, 27842, 597, 1669, 552, 12873, 337, 5054, 14419, 3652], "avg_logprob": -0.2329358587923803, "compression_ratio": 1.2091503267973855, "no_speech_prob": 0.0, "words": [{"start": 715.84, "end": 716.3, "word": "These", "probability": 0.0445556640625}, {"start": 716.3, "end": 717.0, "word": " lenses", "probability": 0.92529296875}, {"start": 717.0, "end": 717.5, "word": " هذي", "probability": 0.6778971354166666}, {"start": 717.5, "end": 718.26, "word": " العدسات", "probability": 0.978515625}, {"start": 718.26, "end": 718.82, "word": " are", "probability": 0.5654296875}, {"start": 718.82, "end": 719.38, "word": " relatively", "probability": 0.84814453125}, {"start": 719.38, "end": 720.44, "word": " 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error", "probability": 0.95947265625}, {"start": 868.58, "end": 869.0, "word": " و", "probability": 0.8974609375}, {"start": 869.0, "end": 869.16, "word": " مع", "probability": 0.67529296875}, {"start": 869.16, "end": 869.48, "word": " ذلك", "probability": 0.99658203125}, {"start": 869.48, "end": 869.96, "word": " بيغير", "probability": 0.947998046875}, {"start": 869.96, "end": 870.44, "word": " مين؟", "probability": 0.84130859375}, {"start": 870.44, "end": 870.62, "word": " ال", "probability": 0.9873046875}, {"start": 870.62, "end": 871.18, "word": " iris", "probability": 0.93359375}, {"start": 871.18, "end": 871.66, "word": " color", "probability": 0.92236328125}], "temperature": 1.0}, {"id": 38, "seek": 89691, "start": 872.23, "end": 896.91, "text": "واضحة الفكرة لكن هذه من الصعب انه تموين في اللي هو ال hard contact lenses soft lenses cause minimal central corneal distortion so a spectacular glare is rare بتتميز العدسات اللاصقة اللينة بانها بتسبب ال cornea القديمة", "tokens": [2407, 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"word": " is", "probability": 0.95703125}, {"start": 930.22, "end": 930.78, "word": " uncommon", "probability": 0.91796875}, {"start": 930.78, "end": 931.46, "word": " with", "probability": 0.92578125}, {"start": 931.46, "end": 932.0, "word": " soft", "probability": 0.92529296875}, {"start": 932.0, "end": 933.44, "word": " lenses؟", "probability": 0.6265869140625}, {"start": 933.44, "end": 934.02, "word": " ال", "probability": 0.52099609375}, {"start": 934.02, "end": 934.3, "word": " flare", "probability": 0.61572265625}, {"start": 934.3, "end": 934.8, "word": " بمعنى", "probability": 0.9775390625}, {"start": 934.8, "end": 935.16, "word": " ايه؟", "probability": 0.7894287109375}, {"start": 935.16, "end": 936.4, "word": " الوهج،", "probability": 0.822607421875}, {"start": 936.4, "end": 936.82, "word": " ليش", "probability": 0.8798828125}, {"start": 936.82, "end": 937.16, "word": " بيكون", "probability": 0.94775390625}, {"start": 937.16, "end": 937.48, "word": " غير", "probability": 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يما يكون هناك dim illumination هل هو هيكون في نفس الوقت زي ال light؟ لأ في ال light illumination هيكون ايه؟ في هناك اللي هو constraint مقارنة في اللي هو ال dim illumination اللي هيكون فيها ال pupil dilated okay؟", "tokens": [6027, 39184, 48269, 6668, 1975, 1829, 8592, 3714, 6027, 3224, 22807, 39896, 30544, 9122, 3555, 13546, 6156, 3224, 1829, 8032, 2655, 17082, 9566, 1829, 9154, 2423, 44533, 11331, 49975, 8978, 2423, 5013, 30579, 2486, 20328, 5016, 49429, 5296, 10721, 22807, 37495, 22653, 6024, 48506, 2423, 44533, 7251, 15042, 7251, 30544, 34105, 4117, 5013, 30579, 2486, 8032, 1211, 31439, 39896, 30544, 8978, 8717, 36178, 2423, 30543, 2655, 30767, 1829, 2423, 1442, 22807, 5296, 10721, 8978, 2423, 1442, 30579, 2486, 39896, 30544, 1975, 1829, 3224, 22807, 8978, 34105, 4117, 13672, 1829, 31439, 25534, 3714, 4587, 9640, 1863, 3660, 8978, 13672, 1829, 31439, 2423, 5013, 30579, 2486, 13672, 1829, 39896, 30544, 8978, 11296, 2423, 44533, 11504, 770, 1392, 22807], "avg_logprob": 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pupil", "probability": 0.98681640625}, {"start": 965.9, "end": 966.42, "word": " يما", "probability": 0.4471435546875}, {"start": 966.42, "end": 966.76, "word": " يكون", "probability": 0.993896484375}, {"start": 966.76, "end": 967.28, "word": " هناك", "probability": 0.96923828125}, {"start": 967.28, "end": 967.82, "word": " dim", "probability": 0.94677734375}, {"start": 967.82, "end": 968.66, "word": " illumination", "probability": 0.984130859375}, {"start": 968.66, "end": 969.24, "word": " هل", "probability": 0.93359375}, {"start": 969.24, "end": 969.44, "word": " هو", "probability": 0.98291015625}, {"start": 969.44, "end": 969.92, "word": " هيكون", "probability": 0.91748046875}, {"start": 969.92, "end": 970.1, "word": " في", "probability": 0.986328125}, {"start": 970.1, "end": 970.36, "word": " نفس", "probability": 0.998291015625}, {"start": 970.36, "end": 970.88, "word": " الوقت", "probability": 0.99072265625}, {"start": 970.88, "end": 971.22, "word": " زي", "probability": 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"probability": 0.97216796875}, {"start": 980.92, "end": 981.28, "word": " pupil", "probability": 0.99365234375}, {"start": 981.28, "end": 982.06, "word": " dilated", "probability": 0.772216796875}, {"start": 982.06, "end": 983.7, "word": " okay؟", "probability": 0.755126953125}], "temperature": 1.0}, {"id": 42, "seek": 101079, "start": 985.45, "end": 1010.79, "text": "There is less foreign body a trapping than with GB lenses الأجسام الغريبة a trapping بمعنى حصر بتنحصر أقل ما بين الكورنيا و ال soft contact lens مقارنة بال hard contact lens يعني هناك صعوبة لدخول الأجسام الغريبة ما بين ال soft contact lens و الكورنيا", "tokens": [51, 511, 68, 307, 1570, 5329, 1772, 257, 944, 3759, 813, 365, 26809, 18059, 16247, 7435, 3794, 10943, 6024, 118, 16572, 49401, 257, 944, 3759, 4724, 2304, 3615, 1863, 7578, 11331, 9381, 2288, 39894, 1863, 5016, 9381, 2288, 5551, 4587, 1211, 19446, 49374, 33251, 13063, 22653, 995, 4032, 2423, 2787, 3385, 6765, 3714, 4587, 9640, 1863, 3660, 20666, 1152, 3385, 6765, 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" with", "probability": 0.91552734375}, {"start": 989.27, "end": 989.59, "word": " GB", "probability": 0.65234375}, {"start": 989.59, "end": 990.23, "word": " lenses", "probability": 0.90185546875}, {"start": 990.23, "end": 991.79, "word": " الأجسام", "probability": 0.8997802734375}, {"start": 991.79, "end": 992.41, "word": " الغريبة", "probability": 0.977783203125}, {"start": 992.41, "end": 992.91, "word": " a", "probability": 0.65771484375}, {"start": 992.91, "end": 993.33, "word": " trapping", "probability": 0.9755859375}, {"start": 993.33, "end": 993.85, "word": " بمعنى", "probability": 0.97138671875}, {"start": 993.85, "end": 994.33, "word": " حصر", "probability": 0.99267578125}, {"start": 994.33, "end": 995.61, "word": " بتنحصر", "probability": 0.81689453125}, {"start": 995.61, "end": 996.23, "word": " أقل", "probability": 0.94384765625}, {"start": 996.23, "end": 997.07, "word": " ما", "probability": 0.951171875}, {"start": 997.07, "end": 997.33, "word": " بين", "probability": 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are", "probability": 0.9560546875}, {"start": 1200.37, "end": 1200.57, "word": " a", "probability": 0.9560546875}, {"start": 1200.57, "end": 1200.75, "word": " good", "probability": 0.93505859375}, {"start": 1200.75, "end": 1201.29, "word": " option", "probability": 0.9306640625}, {"start": 1201.29, "end": 1201.77, "word": " when", "probability": 0.9296875}, {"start": 1201.77, "end": 1202.15, "word": " a", "probability": 0.70166015625}, {"start": 1202.15, "end": 1202.53, "word": " spheric", "probability": 0.634521484375}, {"start": 1202.53, "end": 1203.49, "word": " refractive", "probability": 0.9482421875}, {"start": 1203.49, "end": 1203.81, "word": " error", "probability": 0.88330078125}, {"start": 1203.81, "end": 1204.53, "word": " is", "probability": 0.94580078125}, {"start": 1204.53, "end": 1205.35, "word": " associated", "probability": 0.919921875}, {"start": 1205.35, "end": 1205.97, "word": " with", "probability": 0.923828125}, {"start": 1205.97, "end": 1206.17, "word": " a", 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"end": 1215.89, "word": " ممكن", "probability": 0.846923828125}, {"start": 1215.89, "end": 1216.49, "word": " corneal", "probability": 0.8408203125}, {"start": 1216.49, "end": 1216.95, "word": " cylinder", "probability": 0.59326171875}, {"start": 1216.95, "end": 1217.65, "word": " وممكن", "probability": 0.7779947916666666}, {"start": 1217.65, "end": 1218.31, "word": " internal", "probability": 0.79736328125}, {"start": 1218.31, "end": 1218.77, "word": " أو", "probability": 0.69580078125}, {"start": 1218.77, "end": 1219.39, "word": " residual", "probability": 0.96142578125}, {"start": 1219.39, "end": 1220.51, "word": " astigmatism", "probability": 0.9412434895833334}, {"start": 1220.51, "end": 1221.07, "word": " صحيح", "probability": 0.9466552734375}, {"start": 1221.07, "end": 1221.47, "word": " هدول", "probability": 0.723388671875}, {"start": 1221.47, "end": 1221.93, "word": " التلت", "probability": 0.8741861979166666}, {"start": 1221.93, "end": 1222.43, "word": " أنواع", 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1268.9, "word": " corneal", "probability": 0.8636067708333334}, {"start": 1268.9, "end": 1269.9, "word": " astigmatism", "probability": 0.9523111979166666}, {"start": 1269.9, "end": 1270.7, "word": " هان", "probability": 0.47235107421875}, {"start": 1270.7, "end": 1271.3, "word": " plus", "probability": 0.8974609375}, {"start": 1271.3, "end": 1272.88, "word": " اتنين", "probability": 0.982666015625}], "temperature": 1.0}, {"id": 53, "seek": 130268, "start": 1274.04, "end": 1302.68, "text": "أو ماينوس اتنين وهان كان بلانه قداش هتكون قيمة ال refractive astigmatism في الحالة هذه اللي هو Zero قيمة ال refractive astigmatism Zero لان ال internal cylinder اشمله متعامد مع مين؟ مع ال corneal cylinder فمدان متعامد اذا هيكون عندنا فقط اللي هو ال sphere of refraction", "tokens": [10721, 2407, 19446, 9957, 41779, 1975, 2655, 1863, 9957, 37037, 7649, 25961, 4724, 1211, 7649, 3224, 12174, 3215, 33599, 8032, 2655, 30544, 12174, 32640, 3660, 2423, 45353, 488, 5357, 46496, 1434, 8978, 21542, 6027, 3660, 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عدم الالتزام with care systems بأنظمة العناية أو الرعاية may be devastating", "tokens": [2278, 1874, 8717, 31371, 7435, 3660, 295, 2107, 12, 43856, 6276, 37495, 22653, 8717, 31371, 7435, 3660, 6225, 40448, 2423, 6027, 2655, 11622, 10943, 365, 1127, 3652, 4724, 33456, 19913, 46007, 18863, 8315, 10632, 34051, 34892, 3615, 995, 10632, 815, 312, 21280], "avg_logprob": -0.15915698090264963, "compression_ratio": 1.2173913043478262, "no_speech_prob": 0.0, "words": [{"start": 1542.68, "end": 1542.92, "word": "The", "probability": 0.1510009765625}, {"start": 1542.92, "end": 1543.4, "word": " result", "probability": 0.95458984375}, {"start": 1543.4, "end": 1544.2, "word": " نتيجة", "probability": 0.9720458984375}, {"start": 1544.2, "end": 1544.52, "word": " of", "probability": 0.90185546875}, {"start": 1544.52, "end": 1545.04, "word": " non", "probability": 0.9755859375}, {"start": 1545.04, "end": 1546.2, "word": "-compliance", "probability": 0.7962239583333334}, {"start": 1546.2, "end": 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astigmatism. هذه العدسات اللاصقة اللينة. Why؟ ليش هي غير مناسبة لتصحيح ال law او ال residual astigmatism؟ فضلي. لإنها تلغي .. اول حاجة تلغي هي تلغي صفحة القرانية و تلغي صفحة الديكا", "tokens": [8829, 815, 312, 294, 32604, 473, 337, 47032, 2101, 420, 27980, 5357, 46496, 1434, 13, 39896, 20193, 6055, 34268, 26890, 3714, 8315, 35457, 3660, 5296, 2655, 9381, 5016, 1829, 5016, 2423, 2101, 1975, 2407, 2423, 27980, 5357, 46496, 1434, 13, 29538, 18863, 3215, 3794, 9307, 13672, 33546, 28671, 13672, 9957, 3660, 13, 1545, 22807, 32239, 8592, 39896, 32771, 13546, 3714, 8315, 35457, 3660, 5296, 2655, 9381, 5016, 1829, 5016, 2423, 2101, 1975, 2407, 2423, 27980, 5357, 46496, 1434, 22807, 6156, 11242, 20292, 13, 5296, 28814, 1863, 11296, 6055, 1211, 17082, 1829, 4386, 1975, 12610, 11331, 26108, 3660, 6055, 1211, 17082, 1829, 39896, 6055, 1211, 17082, 1829, 20328, 5172, 5016, 3660, 25062, 2288, 7649, 10632, 4032, 6055, 1211, 17082, 1829, 20328, 5172, 5016, 3660, 2423, 16254, 4117, 995], "avg_logprob": -0.2902831977698952, "compression_ratio": 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parameters اذا من الصعب انا اتحقق او اتأكد من خواص او من ال parameters الخاصة بالعدسات اللاصقة اللينة يعني بمعنى الان احنا ال power", "tokens": [3522, 307, 2252, 281, 16888, 2787, 6765, 9834, 1975, 15730, 9154, 31767, 3615, 3555, 1975, 8315, 1975, 2655, 5016, 4587, 4587, 1975, 2407, 1975, 2655, 10721, 4117, 3215, 9154, 16490, 2407, 33546, 1975, 2407, 9154, 2423, 9834, 33962, 33546, 3660, 20666, 22488, 3794, 9307, 13672, 33546, 28671, 13672, 9957, 3660, 37495, 22653, 4724, 2304, 3615, 1863, 7578, 2423, 7649, 1975, 5016, 8315, 2423, 1347], "avg_logprob": -0.1450721153846154, "compression_ratio": 1.4880952380952381, "no_speech_prob": 0.0, "words": [{"start": 1639.64, "end": 1639.9, "word": "It", "probability": 0.62109375}, {"start": 1639.9, "end": 1640.08, "word": " is", "probability": 0.8837890625}, {"start": 1640.08, "end": 1640.6, "word": " difficult", "probability": 0.9130859375}, {"start": 1640.6, "end": 1640.96, "word": " to", "probability": 0.986328125}, {"start": 1640.96, "end": 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ايش معناة ال extended wear؟ تفضلي اه اه", "tokens": [6027, 7649, 8978, 14739, 14407, 3615, 9154, 18863, 3215, 3794, 9307, 13672, 33546, 28671, 13672, 9957, 3660, 30767, 1829, 50113, 15040, 2423, 10913, 3728, 1975, 1829, 8592, 20449, 8315, 3660, 2423, 10913, 3728, 22807, 6055, 5172, 11242, 20292, 1975, 3224, 1975, 3224], "avg_logprob": -0.26835030040075614, "compression_ratio": 1.3865546218487395, "no_speech_prob": 0.0, "words": [{"start": 1703.33, "end": 1703.71, "word": "الان", "probability": 0.785888671875}, {"start": 1703.71, "end": 1703.95, "word": " في", "probability": 0.84130859375}, {"start": 1703.95, "end": 1704.65, "word": " أنواع", "probability": 0.84521484375}, {"start": 1704.65, "end": 1704.87, "word": " من", "probability": 0.9404296875}, {"start": 1704.87, "end": 1705.45, "word": " العدسات", "probability": 0.9776611328125}, {"start": 1705.45, "end": 1706.19, "word": " اللاصقة", "probability": 0.89697265625}, {"start": 1706.19, "end": 1707.01, "word": " اللينة", 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"temperature": 1.0}, {"id": 73, "seek": 177876, "start": 1751.88, "end": 1778.76, "text": "على T very high in extended wear lenses اذا في هذه النوع من العدسات اللاصقة لازم ان يكون ال decay على T very high طبعا هذا بنسميه ال oxygen transmissibility اذا نفاذ ال oxygen very high", "tokens": [3615, 23942, 314, 588, 1090, 294, 10913, 3728, 18059, 1975, 15730, 8978, 29538, 28239, 45367, 9154, 18863, 3215, 3794, 9307, 13672, 33546, 28671, 5296, 31377, 2304, 16472, 7251, 30544, 2423, 21039, 15844, 314, 588, 1090, 23032, 3555, 3615, 995, 23758, 44945, 38251, 1829, 3224, 2423, 9169, 7715, 891, 2841, 1975, 15730, 8717, 5172, 45636, 2423, 9169, 588, 1090], "avg_logprob": -0.18935381305419793, "compression_ratio": 1.4970760233918128, "no_speech_prob": 0.0, "words": [{"start": 1751.88, "end": 1752.28, "word": "على", "probability": 0.661376953125}, {"start": 1752.28, "end": 1752.56, "word": " T", "probability": 0.51806640625}, {"start": 1752.56, "end": 1753.4, "word": " very", "probability": 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1859.89, "end": 1889.83, "text": "الان انا يما بستخدم العدسات ال soft contact lens في ال high ametropia او في ال high astigmatism من الصعب اني استخدم مين؟ ال soft contact lens اضافة للسبب ان هي conform to the shape of the cornea ان هذه العدسة تعتبر ال oxygen transmissibility او ال decay على THH تعتبر very high فبالتالي هي غير مناسبة لتصحيح ال high ametropia او ال astigmatism", "tokens": [6027, 7649, 1975, 8315, 7251, 15042, 4724, 14851, 9778, 40448, 18863, 3215, 3794, 9307, 2423, 2787, 3385, 6765, 8978, 2423, 1090, 669, 302, 1513, 654, 1975, 2407, 8978, 2423, 1090, 5357, 46496, 1434, 9154, 31767, 3615, 3555, 16472, 1829, 44713, 9778, 40448, 3714, 9957, 22807, 2423, 2787, 3385, 6765, 1975, 11242, 31845, 3660, 24976, 35457, 3555, 16472, 39896, 18975, 281, 264, 3909, 295, 264, 1181, 22160, 16472, 29538, 18863, 3215, 3794, 3660, 6055, 34268, 26890, 2423, 9169, 7715, 891, 2841, 1975, 2407, 2423, 21039, 15844, 3578, 39, 6055, 34268, 26890, 588, 1090, 6156, 3555, 6027, 2655, 6027, 1829, 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lens", "probability": 0.91943359375}, {"start": 1863.47, "end": 1863.95, "word": " في", "probability": 0.6279296875}, {"start": 1863.95, "end": 1864.07, "word": " ال", "probability": 0.82763671875}, {"start": 1864.07, "end": 1864.33, "word": " high", "probability": 0.83251953125}, {"start": 1864.33, "end": 1865.19, "word": " ametropia", "probability": 0.7867431640625}, {"start": 1865.19, "end": 1865.95, "word": " او", "probability": 0.886474609375}, {"start": 1865.95, "end": 1866.31, "word": " في", "probability": 0.8828125}, {"start": 1866.31, "end": 1866.45, "word": " ال", "probability": 0.9228515625}, {"start": 1866.45, "end": 1866.67, "word": " high", "probability": 0.93701171875}, {"start": 1866.67, "end": 1867.53, "word": " astigmatism", "probability": 0.9446614583333334}, {"start": 1867.53, "end": 1867.99, "word": " من", "probability": 0.8408203125}, {"start": 1867.99, "end": 1868.39, "word": " الصعب", "probability": 0.9931640625}, {"start": 1868.39, "end": 1868.65, "word": " 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"word": " limited", "probability": 0.9404296875}, {"start": 1897.56, "end": 1898.24, "word": " post", "probability": 0.6962890625}, {"start": 1898.24, "end": 1898.96, "word": " lens", "probability": 0.61328125}, {"start": 1898.96, "end": 1899.34, "word": " tear", "probability": 0.468505859375}, {"start": 1899.34, "end": 1900.4, "word": " exchange،", "probability": 0.65966796875}, {"start": 1900.4, "end": 1900.66, "word": " اذا", "probability": 0.653564453125}, {"start": 1900.66, "end": 1901.4, "word": " التبادل", "probability": 0.9058837890625}, {"start": 1901.4, "end": 1902.0, "word": " التير", "probability": 0.712890625}, {"start": 1902.0, "end": 1902.36, "word": " في", "probability": 0.92626953125}, {"start": 1902.36, "end": 1902.98, "word": " العدسات", "probability": 0.9815673828125}, {"start": 1902.98, "end": 1903.68, "word": " اللاصقة", "probability": 0.9231770833333334}, {"start": 1903.68, "end": 1904.46, "word": " اللينة", "probability": 0.82958984375}, {"start": 1904.46, "end": 1905.28, "word": " هيكون", "probability": 0.713134765625}, {"start": 1905.28, "end": 1905.86, "word": " محدود", "probability": 0.98779296875}, {"start": 1905.86, "end": 1906.54, "word": " مقارنة", "probability": 0.952734375}, {"start": 1906.54, "end": 1906.78, "word": " في", "probability": 0.90478515625}, {"start": 1906.78, "end": 1907.08, "word": " مين", "probability": 0.83154296875}, {"start": 1907.08, "end": 1907.7, "word": " في", "probability": 0.796875}, {"start": 1907.7, "end": 1907.92, "word": " ال", "probability": 0.91845703125}, {"start": 1907.92, "end": 1908.18, "word": " GB", "probability": 0.58203125}, {"start": 1908.18, "end": 1908.86, "word": " lenses،", "probability": 0.61279296875}, {"start": 1908.86, "end": 1909.48, "word": " why؟", "probability": 0.896240234375}], "temperature": 1.0}, {"id": 80, "seek": 192388, "start": 1911.72, "end": 1923.88, "text": "بسبب الـ Minimal Movement للـ Soft Contact Lens اللي بتقدر من نص إلى واحد مليمتر مقارنة في الـ Hard Contact Lens اللي الحركة فيها من واحد إلى اتنين مليمتر", "tokens": [3555, 35457, 3555, 2423, 39184, 2829, 10650, 26523, 24976, 39184, 16985, 30683, 441, 694, 13672, 1829, 39894, 28543, 2288, 9154, 8717, 9381, 30731, 36764, 24401, 3714, 20292, 2304, 2655, 2288, 3714, 4587, 9640, 1863, 3660, 8978, 2423, 39184, 11817, 30683, 441, 694, 13672, 1829, 21542, 31747, 3660, 8978, 11296, 9154, 36764, 24401, 30731, 1975, 2655, 1863, 9957, 3714, 20292, 2304, 2655, 2288], "avg_logprob": -0.128596235835363, "compression_ratio": 1.5064102564102564, "no_speech_prob": 0.0, "words": [{"start": 1911.72, "end": 1912.34, "word": "بسبب", "probability": 0.9913736979166666}, {"start": 1912.34, "end": 1912.64, "word": " الـ", "probability": 0.89990234375}, {"start": 1912.64, "end": 1913.04, "word": " Minimal", "probability": 0.8427734375}, {"start": 1913.04, "end": 1913.86, "word": " Movement", "probability": 0.7607421875}, {"start": 1913.86, "end": 1914.28, "word": " للـ", "probability": 0.8408203125}, {"start": 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1.0}, {"id": 81, "seek": 194385, "start": 1924.51, "end": 1943.85, "text": "إذا مرة أخرى تبادل الـ tear في العدسات اللاصقة اللينة يعتبر أقل من العدسات اللاصقة الصلبة السبب في ذلك قلة الحركة اللي هي بتقدر من نص إلى واحد مقارنة في ال hard contact lens اللي بتقدر من واحد إلى اتنين مليمتر", "tokens": [28814, 15730, 3714, 25720, 5551, 34740, 7578, 6055, 3555, 18513, 1211, 2423, 39184, 12556, 8978, 18863, 3215, 3794, 9307, 13672, 33546, 28671, 13672, 9957, 3660, 7251, 34268, 26890, 5551, 4587, 1211, 9154, 18863, 3215, 3794, 9307, 13672, 33546, 28671, 31767, 46152, 3660, 21136, 3555, 3555, 8978, 29910, 23275, 12174, 37977, 21542, 31747, 3660, 13672, 1829, 39896, 39894, 28543, 2288, 9154, 8717, 9381, 30731, 36764, 24401, 3714, 4587, 9640, 1863, 3660, 8978, 2423, 1152, 3385, 6765, 13672, 1829, 39894, 28543, 2288, 9154, 36764, 24401, 30731, 1975, 2655, 1863, 9957, 3714, 20292, 2304, 2655, 2288], "avg_logprob": -0.11602393609095127, "compression_ratio": 1.841025641025641, "no_speech_prob": 0.0, 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{"start": 1967.37, "end": 1968.05, "word": " بيسبب", "probability": 0.9403076171875}, {"start": 1968.05, "end": 1968.25, "word": " اللي", "probability": 0.731689453125}, {"start": 1968.25, "end": 1968.67, "word": " هو", "probability": 0.9794921875}, {"start": 1968.67, "end": 1969.31, "word": " أعراض", "probability": 0.88916015625}, {"start": 1969.31, "end": 1969.83, "word": " جفاف", "probability": 0.9866536458333334}, {"start": 1969.83, "end": 1970.23, "word": " العين", "probability": 0.9912109375}, {"start": 1970.23, "end": 1971.11, "word": " لو", "probability": 0.9755859375}, {"start": 1971.11, "end": 1971.45, "word": " سألنا", "probability": 0.8641357421875}, {"start": 1971.45, "end": 1971.79, "word": " السؤال", "probability": 0.87548828125}, {"start": 1971.79, "end": 1971.97, "word": " ما", "probability": 0.89013671875}, {"start": 1971.97, "end": 1972.17, "word": " هو", "probability": 0.7685546875}, {"start": 1972.17, "end": 1972.69, "word": " مفهوم", "probability": 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"words": [{"start": 1992.38, "end": 1993.46, "word": "تفضلي", "probability": 0.737152099609375}, {"start": 1993.46, "end": 1994.54, "word": " اه", "probability": 0.61962890625}, {"start": 1994.54, "end": 1996.0, "word": " هذي", "probability": 0.6547037760416666}, {"start": 1996.0, "end": 1996.14, "word": " ك", "probability": 0.828125}, {"start": 1996.14, "end": 1996.6, "word": " causes", "probability": 0.7236328125}, {"start": 1996.6, "end": 1997.9, "word": " صحيح؟", "probability": 0.9111328125}, {"start": 1997.9, "end": 1998.24, "word": " okay", "probability": 0.58984375}, {"start": 1998.24, "end": 1998.6, "word": " another", "probability": 0.9345703125}, {"start": 1998.6, "end": 1999.14, "word": " answer", "probability": 0.982421875}], "temperature": 1.0}, {"id": 84, "seek": 203061, "start": 2001.95, "end": 2030.61, "text": "طيب dry eye جفاف العين هو يعتبر a multifactorial pathology يعني مرض متعدد الأسباب that can cause بيسبب هذا المرض ocular discomfort يعني عدم راحة لمين ل العين و 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"end": 2057.05, "word": " acuity", "probability": 0.9609375}, {"start": 2057.05, "end": 2058.09, "word": " مابشوفش", "probability": 0.91689453125}, {"start": 2058.09, "end": 2058.93, "word": " الشغلات", "probability": 0.981689453125}, {"start": 2058.93, "end": 2059.15, "word": " اللي", "probability": 0.6611328125}, {"start": 2059.15, "end": 2059.69, "word": " بعيدة", "probability": 0.95068359375}, {"start": 2059.69, "end": 2060.33, "word": " بيكون", "probability": 0.8225911458333334}, {"start": 2060.33, "end": 2060.65, "word": " هذه", "probability": 0.498046875}, {"start": 2060.65, "end": 2060.91, "word": " لها", "probability": 0.61279296875}, {"start": 2060.91, "end": 2061.37, "word": " علاقة", "probability": 0.98583984375}, {"start": 2061.37, "end": 2061.55, "word": " في", "probability": 0.94921875}, {"start": 2061.55, "end": 2061.65, "word": " ال", "probability": 0.91650390625}, {"start": 2061.65, "end": 2062.07, "word": " ocular", "probability": 0.767822265625}, {"start": 2062.07, "end": 2062.69, "word": " symptoms", "probability": 0.89501953125}, {"start": 2062.69, "end": 2063.21, "word": " مالهاش", "probability": 0.8804931640625}, {"start": 2063.21, "end": 2063.63, "word": " علاقة", "probability": 0.9876302083333334}, {"start": 2063.63, "end": 2063.79, "word": " في", "probability": 0.95458984375}, {"start": 2063.79, "end": 2063.89, "word": " ال", "probability": 0.93896484375}, {"start": 2063.89, "end": 2064.19, "word": " visual", "probability": 0.9912109375}, {"start": 2064.19, "end": 2065.15, "word": " symptoms", "probability": 0.90576171875}, {"start": 2065.15, "end": 2066.25, "word": " اذا", "probability": 0.85498046875}, {"start": 2066.25, "end": 2066.39, "word": " ن", "probability": 0.9326171875}, {"start": 2066.39, "end": 2066.59, "word": " dry", "probability": 0.178955078125}], "temperature": 1.0}, {"id": 86, "seek": 209612, "start": 2068.28, "end": 2096.12, "text": "أو اختصارها DA according to dry eye workshop 2007 طبعا هذه اختصار dry eye workshop هذا عبارة عن workshop تم إجراءه في استراليا في سنة الفين وسبعة عرفوا ل dry eye انه اذا عملت", "tokens": [10721, 2407, 1975, 46456, 9381, 9640, 11296, 9578, 4650, 281, 4016, 3313, 13541, 12656, 23032, 3555, 3615, 995, 29538, 1975, 46456, 9381, 9640, 4016, 3313, 13541, 23758, 6225, 3555, 9640, 3660, 18871, 13541, 46811, 11933, 7435, 2288, 16606, 3224, 8978, 44713, 2288, 6027, 25528, 8978, 8608, 1863, 3660, 27188, 9957, 4032, 35457, 27884, 6225, 28480, 14407, 5296, 4016, 3313, 16472, 3224, 1975, 15730, 6225, 42213, 2655], "avg_logprob": -0.26562500355848623, "compression_ratio": 1.4797687861271676, "no_speech_prob": 5.960464477539063e-08, "words": [{"start": 2068.28, "end": 2068.88, "word": "أو", "probability": 0.4980621337890625}, {"start": 2068.88, "end": 2069.56, "word": " اختصارها", "probability": 0.928515625}, {"start": 2069.56, "end": 2069.98, "word": " DA", "probability": 0.55126953125}, {"start": 2069.98, "end": 2071.46, "word": " according", "probability": 0.52783203125}, {"start": 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2094.04, "end": 2094.1, "word": " ل", "probability": 0.345703125}, {"start": 2094.1, "end": 2094.36, "word": " dry", "probability": 0.89208984375}, {"start": 2094.36, "end": 2094.74, "word": " eye", "probability": 0.9443359375}, {"start": 2094.74, "end": 2095.26, "word": " انه", "probability": 0.668212890625}, {"start": 2095.26, "end": 2095.52, "word": " اذا", "probability": 0.7802734375}, {"start": 2095.52, "end": 2096.12, "word": " عملت", "probability": 0.7027994791666666}], "temperature": 1.0}, {"id": 87, "seek": 212601, "start": 2102.41, "end": 2126.01, "text": "factorial pathology مرض متعدد الأسباب أو disease أو disorder that can cause ocular discomfort", "tokens": [69, 578, 5181, 3100, 1793, 3714, 43042, 44650, 22488, 3215, 16247, 35457, 16758, 34051, 4752, 34051, 13399, 300, 393, 3082, 10409, 1040, 28552], "avg_logprob": -0.17513020584980646, "compression_ratio": 1.087378640776699, "no_speech_prob": 0.0, "words": [{"start": 2102.41, "end": 2103.81, "word": "factorial", "probability": 0.5579427083333334}, {"start": 2103.81, "end": 2105.21, "word": " pathology", "probability": 0.953125}, {"start": 2105.21, "end": 2106.79, "word": " مرض", "probability": 0.951904296875}, {"start": 2106.79, "end": 2107.49, "word": " متعدد", "probability": 0.9910481770833334}, {"start": 2107.49, "end": 2108.39, "word": " الأسباب", "probability": 0.994140625}, {"start": 2108.39, "end": 2109.99, "word": " أو", "probability": 0.89013671875}, {"start": 2109.99, "end": 2110.49, "word": " disease", "probability": 0.469970703125}, {"start": 2110.49, "end": 2110.83, "word": " أو", "probability": 0.814453125}, {"start": 2110.83, "end": 2111.45, "word": " disorder", "probability": 0.873046875}, {"start": 2111.45, "end": 2112.57, "word": " that", "probability": 0.90625}, {"start": 2112.57, "end": 2115.05, "word": " can", "probability": 0.96142578125}, {"start": 2115.05, "end": 2117.73, "word": " cause", "probability": 0.908203125}, {"start": 2117.73, "end": 2119.81, "word": " ocular", "probability": 0.890380859375}, {"start": 2119.81, "end": 2126.01, "word": " discomfort", "probability": 0.9609375}], "temperature": 1.0}, {"id": 88, "seek": 215810, "start": 2130.28, "end": 2158.1, "text": "Tier film instability and reduce or decrease of visual acuity", "tokens": [51, 811, 2007, 34379, 293, 5407, 420, 11514, 295, 5056, 696, 21757], "avg_logprob": -0.2938701923076923, "compression_ratio": 0.953125, "no_speech_prob": 0.0, "words": [{"start": 2130.28, "end": 2130.66, "word": "Tier", "probability": 0.582763671875}, {"start": 2130.66, "end": 2131.12, "word": " film", "probability": 0.347900390625}, {"start": 2131.12, "end": 2137.7, "word": " instability", "probability": 0.6904296875}, {"start": 2137.7, "end": 2144.34, "word": " and", "probability": 0.91748046875}, {"start": 2144.34, "end": 2148.32, "word": " reduce", "probability": 0.73974609375}, {"start": 2148.32, "end": 2150.3, "word": " or", "probability": 0.91015625}, {"start": 2150.3, "end": 2153.12, "word": " decrease", "probability": 0.92529296875}, {"start": 2153.12, "end": 2155.42, "word": " of", "probability": 0.92578125}, {"start": 2155.42, "end": 2157.54, "word": " visual", "probability": 0.96875}, {"start": 2157.54, "end": 2158.1, "word": " acuity", "probability": 0.869873046875}], "temperature": 1.0}, {"id": 89, "seek": 218103, "start": 2160.29, "end": 2181.03, "text": "هذا بالنسبة له مفهوم ال dry eye جفاف العين according to dry eye workshop 2007 طيب الآن ارتداء العدسات اللاصقة المحبة للماء بسبب جفاف العين وهذا مفهوم جفاف العين", "tokens": [3224, 15730, 20666, 1863, 35457, 3660, 46740, 3714, 5172, 3224, 20498, 2423, 4016, 3313, 10874, 5172, 31845, 18863, 9957, 4650, 281, 4016, 3313, 13541, 12656, 23032, 1829, 3555, 6024, 48506, 1975, 43500, 3215, 16606, 18863, 3215, 3794, 9307, 13672, 33546, 28671, 9673, 5016, 49401, 5296, 19528, 16606, 4724, 35457, 3555, 10874, 5172, 31845, 18863, 9957, 37037, 15730, 3714, 5172, 3224, 20498, 10874, 5172, 31845, 18863, 9957], "avg_logprob": 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بسبب", "probability": 0.8269856770833334}, {"start": 2177.77, "end": 2178.35, "word": " جفاف", "probability": 0.99560546875}, {"start": 2178.35, "end": 2178.79, "word": " العين", "probability": 0.990478515625}, {"start": 2178.79, "end": 2179.67, "word": " وهذا", "probability": 0.81640625}, {"start": 2179.67, "end": 2180.13, "word": " مفهوم", "probability": 0.9755859375}, {"start": 2180.13, "end": 2180.67, "word": " جفاف", "probability": 0.9912109375}, {"start": 2180.67, "end": 2181.03, "word": " العين", "probability": 0.995361328125}], "temperature": 1.0}, {"id": 90, "seek": 220041, "start": 2182.95, "end": 2200.41, "text": "و أيضا بيسبب ال dry eye symptoms اللي هي أعراض جفاف العين، زي مثلا واحد بيصير عنده redness، blurred vision، بيصير مثلا عنده photophobia، itching، أيضا بيصير عنده red eye، كل هذه الأعراض", "tokens": [2407, 36632, 11242, 995, 4724, 1829, 35457, 3555, 2423, 4016, 3313, 8332, 13672, 1829, 39896, 5551, 3615, 2288, 46958, 10874, 5172, 31845, 18863, 9957, 12399, 30767, 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0.89453125}, {"start": 2186.29, "end": 2186.69, "word": " اللي", "probability": 0.757080078125}, {"start": 2186.69, "end": 2187.03, "word": " هي", "probability": 0.89453125}, {"start": 2187.03, "end": 2187.73, "word": " أعراض", "probability": 0.9454345703125}, {"start": 2187.73, "end": 2188.37, "word": " جفاف", "probability": 0.99072265625}, {"start": 2188.37, "end": 2188.95, "word": " العين،", "probability": 0.7473958333333334}, {"start": 2188.95, "end": 2189.13, "word": " زي", "probability": 0.908935546875}, {"start": 2189.13, "end": 2189.53, "word": " مثلا", "probability": 0.9892578125}, {"start": 2189.53, "end": 2190.31, "word": " واحد", "probability": 0.948974609375}, {"start": 2190.31, "end": 2190.69, "word": " بيصير", "probability": 0.9609375}, {"start": 2190.69, "end": 2191.21, "word": " عنده", "probability": 0.992919921875}, {"start": 2191.21, "end": 2192.75, "word": " redness،", "probability": 0.8365885416666666}, {"start": 2192.75, "end": 2192.99, "word": " blurred", 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في مادة ال soft + +6 +00:00:38,790 --> 00:00:43,890 +contact lens بداية ما هو تعريف العدسات اللاصقة + +7 +00:00:43,890 --> 00:00:49,600 +اللينةA soft lens may be defined as a contact lens + +8 +00:00:49,600 --> 00:00:54,120 +made from a hydrophilic material هي عبارة عن عدسة + +9 +00:00:54,120 --> 00:00:58,860 +مصنوعة من مادة محبة لئ الماء، قطر العدسة بيكون + +10 +00:00:58,860 --> 00:01:03,320 +أكبر من قطر القرنية، لذلك بنسميها semisqueral + +11 +00:01:03,320 --> 00:01:07,220 +design The + +12 +00:01:07,220 --> 00:01:14,060 +hydrophilic material بمعنى water contentاذا very + +13 +00:01:14,060 --> 00:01:19,080 +high water content او محبة للماء طبعا التركيبة + +14 +00:01:19,080 --> 00:01:24,540 +الكيميائية المستخدمة في صناعة العدسات اللاسقة + +15 +00:01:24,540 --> 00:01:29,040 +اللينة هي عبارة عن Hydroxyethyl Methacrylate + +16 +00:01:36,230 --> 00:01:41,330 +المادة المحبة للماء بتزود من مرونة او ليونة العدسة + +17 +00:01:41,330 --> 00:01:46,090 +allowing انه هتسمح it to conform to the shape of + +18 +00:01:46,090 --> 00:01:52,150 +the eye ومرونتها او ليونتها هتسمح لعدسة انه تاخد + +19 +00:01:52,150 --> 00:01:53,370 +شكل العين + +20 +00:01:55,960 --> 00:02:00,160 +Because soft lenses بسبب ان العدسات اللينة readily + +21 +00:02:00,160 --> 00:02:04,380 +conform بسهولة بتاخد شكل العين readily بمعنى + +22 +00:02:04,380 --> 00:02:08,520 +بسهولة conform to the shape of the eye بتاخد شكل + +23 +00:02:08,520 --> 00:02:12,380 +العين They tend to be easy to fit and to be + +24 +00:02:12,380 --> 00:02:17,000 +relatively comfortable لذلك عملية لذلك هي تعتبر + +25 +00:02:17,000 --> 00:02:23,140 +مريحة نسبيا وعملية ال fitting لها تعتبر سهلة نسبيا + +26 +00:02:23,140 --> 00:02:25,620 +مقارنة في ال hard contact + +27 +00:02:29,180 --> 00:02:34,620 +The hydrophilic material also maintains lens + +28 +00:02:34,620 --> 00:02:39,080 +movement أيضا المادة المحبة للماء هتحافظ على حركة + +29 +00:02:39,080 --> 00:02:43,580 +العدسة اتفقنا ان حركة العدسة ال hard contact lens + +30 +00:02:43,580 --> 00:02:48,040 +من واحد الى اتنين ملي متر بينما ال soft contact + +31 +00:02:48,040 --> 00:02:54,260 +lens من نصف الى واحد ملي مترإذا المادة المحبة + +32 +00:02:54,260 --> 00:02:59,200 +للماء أيضا هتحافظ على حركة العدسة because the + +33 +00:02:59,200 --> 00:03:03,560 +pores أي بمعنى المسامات أو الجزيئات in the + +34 +00:03:03,560 --> 00:03:08,440 +material في المادة هذه يعني المسامات الموجودة ما + +35 +00:03:08,440 --> 00:03:16,040 +بين العدسةallow tear flow هتسمح بتدفق التير من + +36 +00:03:16,040 --> 00:03:21,500 +خلال العدسة through the lens itself avoiding any + +37 +00:03:21,500 --> 00:03:26,380 +suction onto the eye وإن العدسة هتكون ليست مصممة، + +38 +00:03:26,380 --> 00:03:29,700 +إيش معناتها؟ إنه ليست جافة، يعني الآن ال soft + +39 +00:03:29,700 --> 00:03:33,480 +contact lens، أي مريض بيرتديها مش هتكون جافة + +40 +00:03:33,480 --> 00:03:37,900 +العدسة، هتكون إيش معناها؟ رطبة، صح ولا لا؟ مقارنة + +41 +00:03:37,900 --> 00:03:44,100 +بال hard contact lensطيب هان السؤال جديش المسامات + +42 +00:03:44,100 --> 00:03:49,760 +اللى موجودة بين العدسة اللاسقة اللينة؟ بتقدر + +43 +00:03:49,760 --> 00:03:56,820 +بتلاتة nanometer يعني تلاتة في عشرة أس minus تسعة + +44 +00:03:56,820 --> 00:04:02,100 +من المليمتر صح ولا لأ؟الان السؤال why bacteria or + +45 +00:04:02,100 --> 00:04:06,400 +fungi cannot penetrate intact soft contact lens؟ + +46 +00:04:06,400 --> 00:04:13,700 +لماذا البكتيريا او الفنجاي لا تستطيع اختراق العدسة + +47 +00:04:13,700 --> 00:04:20,720 +اللينة السليمة؟تفضلي ممتازة + +48 +00:04:21,410 --> 00:04:27,170 +طيب، الآن بناء على دراسات سابقة اتضح ان ال average + +49 +00:04:27,170 --> 00:04:32,230 +diameter ل الفنجاي او البكتيريا بيقدر ب 230 + +50 +00:04:32,230 --> 00:04:33,730 +نانومتر + +51 +00:04:35,330 --> 00:04:40,850 +Okay فهي تعتبر اكبر من مين من المسامات او جزيئات + +52 +00:04:40,850 --> 00:04:46,070 +العدسة اللاسقة اللينة لذلك هي لا تستطيع ان تخترق + +53 +00:04:46,070 --> 00:04:50,590 +من ال soft contact lens او ال intact soft contact + +54 +00:04:50,590 --> 00:04:56,750 +lens العدسة اللاسقة اللينة السليمة بنفس الوجه why + +55 +00:04:56,750 --> 00:05:02,190 +bacteria or fungi can penetrate damaged soft + +56 +00:05:02,190 --> 00:05:07,290 +contact lensيعني العدسة اللى خربانة من السهل انه + +57 +00:05:07,290 --> 00:05:12,830 +تخترقها، بالضبط لأن مسامات العدسة اللاصقة اللى هى + +58 +00:05:12,830 --> 00:05:17,090 +تعتبر damage هتكون اكبر من تلاتة نانومتر، صحيح؟ + +59 +00:05:17,090 --> 00:05:21,490 +وبالتالي من السهل انه ايه تخترق اللى هو البكتيريا + +60 +00:05:21,490 --> 00:05:26,470 +او ال fungi تخترق من العدسة اللاصقة اللى هى تعتبر + +61 +00:05:26,470 --> 00:05:26,810 +damage + +62 +00:05:29,750 --> 00:05:34,290 +Most soft lenses are made with hydrogel materials، + +63 +00:05:34,290 --> 00:05:39,590 +إذا الجيل الأول من العدسات اللاصقة اللينة فقط صنع + +64 +00:05:39,590 --> 00:05:43,730 +من مادة ال hydrogel materials أو ال hydrophilic + +65 +00:05:43,730 --> 00:05:48,270 +material، إذا فقط من مادة إيش؟ الماء، هذا الجيل + +66 +00:05:48,270 --> 00:05:54,630 +الأوللكن الجيل الحديث او الجيل التاني اللى عمل + +67 +00:05:54,630 --> 00:06:01,290 +تحديث له of soft lenses للعدسات اللينة تم اضافة + +68 +00:06:01,290 --> 00:06:06,190 +مادة السيليكون فصارت اللى هو silicone hydro gel + +69 +00:06:06,190 --> 00:06:10,790 +soft contact lens طيب السؤال ليش تم اضافة مادة + +70 +00:06:10,790 --> 00:06:15,350 +السيليكون؟ + +71 +00:06:15,350 --> 00:06:18,590 +okay another answer + +72 +00:06:22,200 --> 00:06:26,680 +بالضبط، اذا عشان بزود اول حاجة ال flexibility + +73 +00:06:26,680 --> 00:06:32,240 +مرونة العدسة اللى يونا إلها وشغلة مهمة كتير ال + +74 +00:06:32,240 --> 00:06:40,470 +durability المتانة لمين؟ للعدسةاذا زود من متانة + +75 +00:06:40,470 --> 00:06:44,950 +العدسة لذلك احنا ضفنا او العلماء او researchers + +76 +00:06:44,950 --> 00:06:49,590 +الباحثين ضافوا مادة السيليكون لمادة الهيدروجيل + +77 +00:06:49,590 --> 00:06:57,610 +فصار السيليكون هيدرجيل soft contact lensو هذه يعني + +78 +00:06:57,610 --> 00:07:01,790 +is rapidly gaining popularity، يعني اللي هو شافت + +79 +00:07:01,790 --> 00:07:06,210 +إقبال بشكل اللي هو سريع من قبل مين الناس، يعني + +80 +00:07:06,210 --> 00:07:10,930 +اتقبلوا الأمر، ليش؟ لأن المرونة زادت بالنسبة لمين؟ + +81 +00:07:10,930 --> 00:07:15,630 +لالعدسة، والمتانة إلها إيه؟ بالزيد، طبعا دايما + +82 +00:07:15,630 --> 00:07:20,250 +بتكون تربطوا عامل المتانة بفترة حياة العدسة، إنه + +83 +00:07:20,250 --> 00:07:24,030 +كل ما زاد متانة العدسة، فترة حياته إشمالها بالزيد + +84 +00:07:27,680 --> 00:07:31,540 +The large diameter القطر الكبير طبعا ال standard + +85 +00:07:31,540 --> 00:07:37,360 +diameter حكينا من 14 إلى 15 ملي متر أو من 13.5 إلى + +86 +00:07:37,360 --> 00:07:42,340 +15 ملي متر بناء على الدراسة اللي تم أخذ منها + +87 +00:07:42,340 --> 00:07:48,750 +المعلومة ال large diameter هو يعتبر مهمOkay طيب او + +88 +00:07:48,750 --> 00:07:53,650 +ضروري للمحافظة على ايه؟ educate lens centration + +89 +00:07:53,650 --> 00:07:59,510 +يعني تمركز مناسب للعدسة on the cornea على القرنية + +90 +00:07:59,510 --> 00:08:03,770 +ايضا ال stability الثبات و ال retention in the eye + +91 +00:08:03,770 --> 00:08:07,290 +الاحتفاظ او المحافظة عليها في داخل العين + +92 +00:08:11,150 --> 00:08:16,550 +Soft lenses are the most popular contact lens wear + +93 +00:08:16,550 --> 00:08:22,390 +modality accounting for some 88% of lens wearers + +94 +00:08:22,390 --> 00:08:27,210 +الأشخاص اللي بيرتديوا العدسات اللاصقة ع مستوى + +95 +00:08:27,210 --> 00:08:33,590 +العالم 88% من هؤلاء الأشخاص بيرتديوا أنواع ال soft + +96 +00:08:33,590 --> 00:08:38,580 +contact lens المختلفةقدرت هناك دراسة في الولايات + +97 +00:08:38,580 --> 00:08:43,240 +المتحدة الأمريكية ان في اكتر من سبعين companies + +98 +00:08:43,240 --> 00:08:49,820 +شركة لصناعة العدسات اللاصقة بتصنع اكتر من 185 نوع + +99 +00:08:49,820 --> 00:08:55,960 +من ال soft contact lenses طيب + +100 +00:08:55,960 --> 00:09:01,440 +الان هنبدأ في ال advantages ما هي مميزات العدسات + +101 +00:09:01,440 --> 00:09:03,140 +اللاصقة اللينة + +102 +00:09:06,070 --> 00:09:10,750 +Number one soft lenses are immediately comfortable + +103 +00:09:10,750 --> 00:09:17,290 +اذا بتتميز العدسات اللاصقة اللينة براحة مباشرة + +104 +00:09:17,290 --> 00:09:22,630 +بسبب اول حاجة ال water content very highNumber two + +105 +00:09:22,630 --> 00:09:25,930 +ال flexibility of the lens او ال flexibility ل + +106 +00:09:25,930 --> 00:09:31,290 +العدسة المرونة ايضا السبب التالد ان مافيش hard + +107 +00:09:31,290 --> 00:09:36,370 +interaction ما بين ال eyelid margin و ال lens edge + +108 +00:09:36,370 --> 00:09:42,350 +اطراف العدسة لذلك العدسات اللاصقة اللينة بتتميز + +109 +00:09:42,350 --> 00:09:49,410 +براحة مباشرة او بتتميز بانها مريحةadaptation time + +110 +00:09:49,410 --> 00:09:53,170 +is short owing وممكن تكتب بين قصين rapid + +111 +00:09:53,170 --> 00:09:59,930 +adaptation يعني سريعة التكييف okay why soft lenses + +112 +00:09:59,930 --> 00:10:06,510 +are short adaptation؟ ليش التكييف فيها سريع بيكون؟ + +113 +00:10:06,510 --> 00:10:12,650 +فضلي انه to conform to the shape of the eye + +114 +00:10:12,650 --> 00:10:13,510 +another one + +115 +00:10:18,520 --> 00:10:22,460 +طبعا هي تعتبر ايه؟ Minimal movement compared to + +116 +00:10:22,460 --> 00:10:26,240 +hard contact lens زي ما اتفقنا من نص الى واحد ملي + +117 +00:10:26,240 --> 00:10:30,220 +متر لذلك ان هي بيكون فيها tear exchange اشماله + +118 +00:10:30,220 --> 00:10:34,540 +محدود صح ولا لأ؟ وموضوع ال interaction او ال + +119 +00:10:34,540 --> 00:10:39,340 +irritation التهيج للعين بيكون اقل مقارنة في مين؟ + +120 +00:10:39,340 --> 00:10:43,860 +في ال hard contact lensesهذا السبب ان ليش ال + +121 +00:10:43,860 --> 00:10:47,520 +adaptation بيكون اللي هو أسرع مقارنة في ال hard + +122 +00:10:47,520 --> 00:10:51,320 +lenses soft + +123 +00:10:51,320 --> 00:10:56,360 +lenses العدسات اللينة are suitable for long or + +124 +00:10:56,360 --> 00:11:00,740 +short wearing times and variable wearing schedules + +125 +00:11:00,740 --> 00:11:06,740 +الآن شخص بده يرتدي العدسة اللاصقة ليوم واحد في + +126 +00:11:06,740 --> 00:11:12,870 +السنةفقط عنده مثلا convocation حفل تخرج okay بعد + +127 +00:11:12,870 --> 00:11:17,150 +نهاية الدراسة بده يرتدي العدسة اللاصقة بهذا اليوم + +128 +00:11:17,150 --> 00:11:22,640 +أنسب خيار إله بيكون مين ال soft contact lensأو + +129 +00:11:22,640 --> 00:11:27,120 +إنسان مثلا بده يستبدل العدسات كل فترة نتيجة اللي + +130 +00:11:27,120 --> 00:11:31,680 +هو تراكم من ال deposits على العدسات أنسب خيار + +131 +00:11:31,680 --> 00:11:37,080 +بيكون من ال soft contact lenses شخص مثلا فترة عمله + +132 +00:11:37,080 --> 00:11:41,640 +اتناشر ساعة بيقدرش يعني خلال اتناشر ساعة يكون فيه + +133 +00:11:41,640 --> 00:11:45,820 +هناك rest أفضل خيار له اللي هو ال soft contact + +134 +00:11:45,820 --> 00:11:49,780 +lenses إذا هي استخدمت في ال short أو ال long + +135 +00:11:49,780 --> 00:11:52,000 +wearing في الطرفين هدول + +136 +00:11:55,840 --> 00:11:59,380 +These lenses هذي العدسات are relatively + +137 +00:11:59,380 --> 00:12:04,420 +inexpensive يعني نسبيا هي تعتبر ليست غالية الثمن + +138 +00:12:04,420 --> 00:12:09,780 +which makes them suitable for planet replacement + +139 +00:12:09,780 --> 00:12:17,540 +systemsالطبيب او اخصاء البصريات طلب من المريض كل + +140 +00:12:17,540 --> 00:12:21,860 +أسبوعين انه يغير العدسة اللاصقة، بده يشوف مدى ال + +141 +00:12:21,860 --> 00:12:26,160 +irritation ل الكورنية، طبعا لو قلنا له البس hard + +142 +00:12:26,160 --> 00:12:30,490 +contact lensعالية الثمن كل أسبوعين يغير العدسة أو + +143 +00:12:30,490 --> 00:12:34,570 +كل شهرين أو كل مثلا شهر بيكون الأمر ايه مكلف + +144 +00:12:34,570 --> 00:12:38,630 +بالنسبة للمريض فأفضل حاجة ايش نستخدم ال soft + +145 +00:12:38,630 --> 00:12:44,450 +contact lens لعملية الاستبدال للعدسات اللاصقة بشكل + +146 +00:12:44,450 --> 00:12:45,210 +مستمر + +147 +00:12:48,420 --> 00:12:53,240 +Lenses can often be dispensed from an inventory + +148 +00:12:53,240 --> 00:12:58,180 +الان شخص برتدي عدسة لاسقة قوتها plus واحد و نص + +149 +00:12:58,180 --> 00:13:01,960 +ديوبتر السفير اذا مباشرة انا بجيبها من ال + +150 +00:13:01,960 --> 00:13:06,920 +inventory المستودع او المخزن وبصرفها لمين للمريض + +151 +00:13:06,920 --> 00:13:10,580 +دون النظر في مين في ال parameters التانية زي ال + +152 +00:13:10,580 --> 00:13:14,840 +base curve و ال diameter اللي هي تعتبر ايه عوامل + +153 +00:13:14,840 --> 00:13:17,420 +مهمة في ال hard contact lenses + +154 +00:13:21,360 --> 00:13:25,980 +اللون العيوني المظهر يمكن تغييره بصيغة لينزة لطيفة + +155 +00:13:26,780 --> 00:13:32,500 +معظم الممثلين ال actors او الرياضيين بيستخدموا مين + +156 +00:13:32,500 --> 00:13:37,360 +ال soft contact lens لتغيير ال iris color و طبعا + +157 +00:13:37,360 --> 00:13:42,520 +بيكون بألوان مختلفة ليه؟ ببساطة لأن قطر العدسة + +158 +00:13:42,520 --> 00:13:47,300 +بيكون كبير، بالتالي هي بتغطي ايش؟ كل ال iris و + +159 +00:13:47,300 --> 00:13:51,300 +ممكن انه تغير من لون ال iris طيب ليش ال hard + +160 +00:13:51,300 --> 00:13:55,040 +contact lens؟ مش ممكن انا استخدمها في اللي هو + +161 +00:13:55,040 --> 00:14:00,260 +تغيير لون ال irisبالضبط لأنه بيكون ال diameter + +162 +00:14:00,260 --> 00:14:03,980 +إلها أقل من مين من ال soft contact lens، بالتالي + +163 +00:14:03,980 --> 00:14:08,560 +هي لا تستطيع إنه تغطي كل ال irisأيضًا في بعض + +164 +00:14:08,560 --> 00:14:12,920 +الأشخاص بيحبوا مثلًا اللي هو عملية التلوين لل .. + +165 +00:14:12,920 --> 00:14:16,880 +ال .. ال iris بمعنى أنه بيكون عنده refractive + +166 +00:14:16,880 --> 00:14:21,700 +error فمرة مثلًا بلبس اللي هو نفترض a green okay + +167 +00:14:21,700 --> 00:14:25,880 +contact lens، تاني يوم مثلًا بلبس black، بلبس + +168 +00:14:25,880 --> 00:14:29,480 +brown، يعني هو عنده refractive error و مع ذلك + +169 +00:14:29,480 --> 00:14:34,150 +بيغير مين؟ ال iris colorواضحة الفكرة لكن هذه من + +170 +00:14:34,150 --> 00:14:38,490 +الصعب انه تموين في اللي هو ال hard contact lenses + +171 +00:14:38,490 --> 00:14:42,610 +soft + +172 +00:14:42,610 --> 00:14:47,650 +lenses cause minimal central corneal distortion so + +173 +00:14:47,650 --> 00:14:53,430 +a spectacular glare is rare بتتميز العدسات اللاصقة + +174 +00:14:53,430 --> 00:14:58,690 +اللينة بانها بتسبب ال cornea القديمةلكن القرنية + +175 +00:14:58,690 --> 00:15:04,390 +الإديمة بنتشر على كل سطح القرنية، لذلك هي ما بتغير + +176 +00:15:04,390 --> 00:15:09,110 +من مين من ال radius of curvature ل القرنية، + +177 +00:15:09,110 --> 00:15:13,850 +بالتالي أن ال spectacular layer هو بيكون أقل في ال + +178 +00:15:13,850 --> 00:15:17,890 +soft contact lens مقارنة في مين في ال hard contact + +179 +00:15:17,890 --> 00:15:22,570 +lenses The + +180 +00:15:22,570 --> 00:15:27,460 +large optic zone makes for minimal flareOkay + +181 +00:15:27,460 --> 00:15:33,440 +السؤال هان why flare is uncommon with soft lenses؟ + +182 +00:15:33,440 --> 00:15:38,560 +ال flare بمعنى ايه؟ الوهج، ليش بيكون غير شائع في + +183 +00:15:38,560 --> 00:15:45,700 +ال soft contact lens؟ فضلك اه + +184 +00:15:45,700 --> 00:15:50,320 +بس + +185 +00:15:50,320 --> 00:15:53,840 +في نقطة مهمة ايضا انه لان يما يكون ال diameter + +186 +00:15:53,840 --> 00:15:58,340 +للعدسة كبير okayالـ optic zone ايش ماله؟ هيكون + +187 +00:15:58,340 --> 00:16:02,480 +كبير فهي هتغطي من ال pupil حتى في ال dim + +188 +00:16:02,480 --> 00:16:06,420 +illumination صح ولا لأ؟ يعني الآن ال pupil يما + +189 +00:16:06,420 --> 00:16:10,360 +يكون هناك dim illumination هل هو هيكون في نفس + +190 +00:16:10,360 --> 00:16:14,100 +الوقت زي ال light؟ لأ في ال light illumination + +191 +00:16:14,100 --> 00:16:18,120 +هيكون ايه؟ في هناك اللي هو constraint مقارنة في + +192 +00:16:18,120 --> 00:16:20,920 +اللي هو ال dim illumination اللي هيكون فيها ال + +193 +00:16:20,920 --> 00:16:23,700 +pupil dilated okay؟ + +194 +00:16:25,450 --> 00:16:29,590 +There is less foreign body a trapping than with GB + +195 +00:16:29,590 --> 00:16:35,610 +lenses الأجسام الغريبة a trapping بمعنى حصر بتنحصر + +196 +00:16:35,610 --> 00:16:40,830 +أقل ما بين الكورنيا و ال soft contact lens مقارنة + +197 +00:16:40,830 --> 00:16:46,110 +بال hard contact lens يعني هناك صعوبة لدخول + +198 +00:16:46,110 --> 00:16:49,930 +الأجسام الغريبة ما بين ال soft contact lens و + +199 +00:16:49,930 --> 00:16:56,970 +الكورنياOkay طيب الان مين أصعب لو دخل ال foreign + +200 +00:16:56,970 --> 00:17:01,310 +body مابين ال soft contact lens و الكورنية ولا + +201 +00:17:01,310 --> 00:17:09,170 +مابين ال hard contact lens و الكورنية؟ لأ طيب why؟ + +202 +00:17:16,340 --> 00:17:21,380 +بالضبط اذا زي ما هو من الصعب انه يدخل لكن اذا هناك + +203 +00:17:21,380 --> 00:17:25,300 +انحصار الجسم الغريب ما بين ال soft contact lens و + +204 +00:17:25,300 --> 00:17:29,480 +ال anterior surface للكورنيا من الصعب خروجه و + +205 +00:17:29,480 --> 00:17:34,260 +هيعمل complications مضاعفات اكتر من مين من ال hard + +206 +00:17:34,260 --> 00:17:39,560 +contact lenses يعني في نفس الوقت انه هيسبب اللي هو + +207 +00:17:39,560 --> 00:17:43,680 +more complications compared to the hard contact + +208 +00:17:43,680 --> 00:17:44,360 +lenses + +209 +00:17:47,700 --> 00:17:51,400 +لنزات حلوة جيدة لعمل أفضل أفضل أفضل أفضل أفضل أفضل + +210 +00:17:51,400 --> 00:17:55,140 +أفضل أفضل أفضل أفضل أفضل أفضل + +211 +00:17:55,640 --> 00:18:00,840 +العدسات اللاصقة اللينة هي مناسبة للرياضيين يعني + +212 +00:18:00,840 --> 00:18:04,820 +للاعبين كرة القدم، لاعبين ال basket ball، ال + +213 +00:18:04,820 --> 00:18:08,840 +tennis السبب الأول لأن it follows to the eye + +214 +00:18:08,840 --> 00:18:13,200 +movement بتتبع حركة مين؟ العين ال visual field إيش + +215 +00:18:13,200 --> 00:18:17,660 +بيكون فيها؟ واسع من الصعب اللي هو سقوط العدسة + +216 +00:18:17,660 --> 00:18:22,780 +اللاصقة اللينة طيب هناك في حالتين ممكن إنه تسقط + +217 +00:18:22,780 --> 00:18:25,080 +فيها العدسات اللاصقة اللينة + +218 +00:18:34,290 --> 00:18:41,870 +ممتازة اذا اول حاجة ال trauma كلام سليم اذا لو صار + +219 +00:18:41,870 --> 00:18:46,950 +هناك trauma من السهل اللي هو سقوط العدسة اللاصقة + +220 +00:18:46,950 --> 00:18:54,510 +اللينةو .. تفضلي او اللي هو ال pinch أي بمعنى أي + +221 +00:18:54,510 --> 00:19:00,910 +لدغة بتحدث لمين للعين، اذا عندنا في هناك اللي هو + +222 +00:19:00,910 --> 00:19:06,430 +two causes سببين لسقوط العدسة اللاسقة اللينة شخص + +223 +00:19:06,430 --> 00:19:10,450 +اتعرض لضربة قوية والشغل التاني اللي هي ال pinch + +224 +00:19:10,450 --> 00:19:11,130 +اللدغة + +225 +00:19:13,890 --> 00:19:18,110 +لدغة .. لدغة حشرة مثلا .. لدغة مثلا نحلة الاخر .. + +226 +00:19:18,110 --> 00:19:21,890 +انه لما يتعرض المريض للدغة معينة ممكن انه تسقط + +227 +00:19:21,890 --> 00:19:26,490 +العدسة أو ممكن انه يصير لها damage لل soft contact + +228 +00:19:26,490 --> 00:19:34,040 +lensايضا ان هي بتستخدم مع الرياضيين سواء كان ال + +229 +00:19:34,040 --> 00:19:37,560 +football players او ال basketball players لان هي + +230 +00:19:37,560 --> 00:19:41,620 +بتتميز ب minimal movement compared to hard contact + +231 +00:19:41,620 --> 00:19:46,020 +lenses، بالتالي هي هسبب ايه؟ Cornial distortion + +232 +00:19:46,020 --> 00:19:50,520 +لكن ال spectacular player هيكون اقل، okay؟ هذه + +233 +00:19:50,520 --> 00:19:55,140 +الأسباب ان ليش هي تعتبر خيار مناسب بالنسبة لمين + +234 +00:19:55,140 --> 00:19:57,100 +للرياضيين + +235 +00:19:58,330 --> 00:20:02,150 +نقطة هذه مهمة they are a good option when a + +236 +00:20:02,150 --> 00:20:06,170 +spheric refractive error is associated with a + +237 +00:20:06,170 --> 00:20:12,730 +toric cornea بداية عندنا ال astigmatism إما بيكون + +238 +00:20:12,730 --> 00:20:16,950 +refractive astigmatism بيكون ممكن corneal cylinder + +239 +00:20:16,950 --> 00:20:21,470 +وممكن internal أو residual astigmatism صحيح هدول + +240 +00:20:21,470 --> 00:20:25,070 +التلت أنواع طيب الآن نفترض مثلا + +241 +00:20:44,240 --> 00:20:50,500 +انه كان عندنا ال internal cylinder plus اتنين او + +242 +00:20:50,500 --> 00:20:54,480 +minus اتنين طبعا لو بنشتغل في ال minus او plus + +243 +00:20:54,480 --> 00:20:59,460 +cylinder وكان هنا عندنا plano هذه بالنسبة لل + +244 +00:20:59,460 --> 00:21:05,960 +internal cylinder واضحة؟ + +245 +00:21:05,960 --> 00:21:14,340 +وعندنا كان ال corneal astigmatism هان plus اتنينأو + +246 +00:21:14,340 --> 00:21:19,880 +ماينوس اتنين وهان كان بلانه قداش هتكون قيمة ال + +247 +00:21:19,880 --> 00:21:24,900 +refractive astigmatism في الحالة هذه اللي هو Zero + +248 +00:21:24,900 --> 00:21:29,220 +قيمة ال refractive astigmatism Zero لان ال + +249 +00:21:29,220 --> 00:21:33,440 +internal cylinder اشمله متعامد مع مين؟ مع ال + +250 +00:21:33,440 --> 00:21:38,660 +corneal cylinder فمدان متعامد اذا هيكون عندنا فقط + +251 +00:21:38,660 --> 00:21:42,680 +اللي هو ال sphere of refraction + +252 +00:21:45,870 --> 00:21:51,010 +إذا في حالة الـ sphere refraction يكون عندنا قيمة + +253 +00:21:51,010 --> 00:21:56,150 +السيلندر Zero الخيار المناسب للمريض هان هيكون مين + +254 +00:21:56,150 --> 00:22:00,490 +ال soft contact lens يعني بتلاحظ ان المريض عنده لو + +255 +00:22:00,490 --> 00:22:06,440 +امسكنا ورقة ال print out مثلا plus 3هذه الـ + +256 +00:22:06,440 --> 00:22:10,040 +Objective Refraction، حسنًا، هذه بالصحيحة، لكن + +257 +00:22:10,040 --> 00:22:13,000 +ارجع إلى اللي هو الـ Corneal Cylinder، هتلاقيه + +258 +00:22:13,000 --> 00:22:16,080 +Minus One، روحي على الـ Internal Cylinder، هتلاقيه + +259 +00:22:16,080 --> 00:22:19,520 +Minus One، لكن التنين هذول متعمدين على بعض، يعني + +260 +00:22:19,520 --> 00:22:25,740 +واحد Axis 90، الآخر Axis 180، إذا عندنا الـSphere + +261 +00:22:25,740 --> 00:22:29,500 +Refraction جداش فقط اللي هو الـPower أو فقط + +262 +00:22:29,500 --> 00:22:34,180 +الـValue، أي بمعنى عندنا قيمة الـStigmatism هتكون + +263 +00:22:34,180 --> 00:22:40,160 +ZeroOkay ففي هذه الحالة الخيار الأفضل للمريض هيكون + +264 +00:22:40,160 --> 00:22:45,060 +مين ال soft contact lens ال cone هيش هيكون شكلها + +265 +00:22:45,060 --> 00:22:53,280 +توريك وانتوا عارفين ايش معناه توريك صحيح يعني + +266 +00:22:53,280 --> 00:22:57,860 +بمعنى اللي هو ال sphero cylinder صحيح طيب الآن + +267 +00:22:57,860 --> 00:23:03,320 +بالنسبة لل limitations العيوب او القيود للعدسات + +268 +00:23:03,320 --> 00:23:05,060 +اللاصقة اللينة + +269 +00:23:07,980 --> 00:23:12,260 +number one they have a relatively short life، إذا + +270 +00:23:12,260 --> 00:23:17,960 +فترة حياة العدسة هتكون قصيرة، مقارنة في مين؟في ال + +271 +00:23:17,960 --> 00:23:22,900 +hard contact lenses لكن فيها معلومة مهمة كتير ان + +272 +00:23:22,900 --> 00:23:27,540 +في classification تصنيف للعدسات اللاصقة اللينة + +273 +00:23:27,540 --> 00:23:33,440 +ممكن تكون annual سنوية ممكن تكون semi annual اي + +274 +00:23:33,440 --> 00:23:38,340 +بمعنى نصف سنة و ممكن تكون quarterly ربع سنة او تلت + +275 +00:23:38,340 --> 00:23:44,370 +شهورطبعا فترة حياة العدسة السنوية هتكون أطول من + +276 +00:23:44,370 --> 00:23:49,530 +الـ quarterly أطول من مين من ال semi-annual فالان + +277 +00:23:49,530 --> 00:23:55,130 +العدسات اللاصقة اللينة بتتميز ان فترة حياتها قصيرة + +278 +00:23:55,130 --> 00:23:59,670 +مقارنة في ال hard contact lensSince they are + +279 +00:23:59,670 --> 00:24:05,590 +fragile أي بمعنى هشة and subject بتكون معرضة لإيش + +280 +00:24:05,590 --> 00:24:10,570 +معرضة؟ ل rapid accumulation اللي هو تراكم سريع لل + +281 +00:24:10,570 --> 00:24:17,470 +surface اللي هو deposits أي بمعنى الترثبات بتتراكم + +282 +00:24:17,470 --> 00:24:21,330 +على العدسة بشكل سريع مقارنة في مين؟ في ال hard + +283 +00:24:21,330 --> 00:24:22,650 +contact lenses + +284 +00:24:26,370 --> 00:24:31,150 +Number two ongoing lens care يعني بمعنى الاستمرار + +285 +00:24:31,150 --> 00:24:36,310 +بعناية العدسة أو رعاية العدسة takes a significant + +286 +00:24:36,310 --> 00:24:41,210 +amount of time هتطلب وقت من مين؟ من ال patient + +287 +00:24:41,210 --> 00:24:49,210 +المريض على الأقل خمس دقائق كل يوم عملية تنظيفطبعا + +288 +00:24:49,210 --> 00:24:52,430 +مقارنة في ال hard contact lens هتكون المدة ايه + +289 +00:24:52,430 --> 00:24:56,210 +طويلة لأنه في ال hard contact lens الفترة الزمنية + +290 +00:24:56,210 --> 00:25:00,770 +هتكون اقل حتى من ناحية الآن لو المريض عمل + +291 +00:25:00,770 --> 00:25:04,930 +insertion لل soft contact lens في البدايات مش بعد + +292 +00:25:04,930 --> 00:25:08,590 +ما يتعود عليها هتلاحظوا في الأول هيصير عنده نوع من + +293 +00:25:08,590 --> 00:25:13,030 +ال blurred vision الغباش لفترة زمنية طويلة وبعد + +294 +00:25:13,030 --> 00:25:15,810 +ذلك انه هيصير يتعود عليها + +295 +00:25:19,090 --> 00:25:23,650 +Lens cleaning and disinfection are essential، إذا + +296 +00:25:23,650 --> 00:25:28,730 +تنظيف العدسة وتعقيمها يعتبر أمر أساسي في ارتداء + +297 +00:25:28,730 --> 00:25:33,490 +العدسات اللاصقة اللينة، إذا عملية التعقيم والتنظيف + +298 +00:25:33,490 --> 00:25:38,930 +مهم جدا بالنسبة لمين لمريض اللي بيرتدي العدسات + +299 +00:25:38,930 --> 00:25:46,200 +اللاصقة اللينةThe result نتيجة of non-compliance + +300 +00:25:46,200 --> 00:25:51,260 +يعني نتيجة عدم الالتزام with care systems بأنظمة + +301 +00:25:51,260 --> 00:25:56,410 +العناية أو الرعاية may be devastatingإيش هذا + +302 +00:25:56,410 --> 00:26:01,710 +يعتبر؟ يعني أمر مدمر للعدسة، إنه الآن أنا ما بلتزم + +303 +00:26:01,710 --> 00:26:06,590 +بأنظمة الرعاية والعناية والتنظيف للعدسة، بيعتبر + +304 +00:26:06,590 --> 00:26:12,030 +هذا أمر مدمر لمين؟ للعدسة، يعني بينهي حياة العدسة + +305 +00:26:12,030 --> 00:26:14,130 +في فترة زمنية قصيرة + +306 +00:26:18,130 --> 00:26:22,570 +They may be ineducate for correcting law or + +307 +00:26:22,570 --> 00:26:28,890 +residual astigmatism. هي لا تعتبر مناسبة لتصحيح ال + +308 +00:26:28,890 --> 00:26:32,330 +law او ال residual astigmatism. هذه العدسات + +309 +00:26:32,330 --> 00:26:38,570 +اللاصقة اللينة. Why؟ ليش هي غير مناسبة لتصحيح ال + +310 +00:26:38,570 --> 00:26:42,310 +law او ال residual astigmatism؟ فضلي. لإنها تلغي + +311 +00:26:42,310 --> 00:26:46,830 +.. اول حاجة تلغي هي تلغي صفحة القرانية و تلغي صفحة + +312 +00:26:46,830 --> 00:26:47,210 +الديكا + +313 +00:26:54,650 --> 00:26:58,350 +ممتازة، اذا اتعلمنا في ال hard contact lens ال + +314 +00:26:58,350 --> 00:27:02,770 +optics لل hard contact lens ان هي بتعمل ايه؟ a new + +315 +00:27:02,770 --> 00:27:06,230 +surface للكورنية، لكن في ال soft contact lens + +316 +00:27:06,230 --> 00:27:09,750 +conform to the shape of the cornea، هذا السبب ان + +317 +00:27:09,750 --> 00:27:14,730 +ليش هي مابتكون ملائمة او مناسبة لتصحيح ال low أو + +318 +00:27:14,730 --> 00:27:16,550 +ال residue وال astigmatism + +319 +00:27:19,640 --> 00:27:24,540 +It is difficult to verify soft lens parameters اذا + +320 +00:27:24,540 --> 00:27:29,840 +من الصعب انا اتحقق او اتأكد من خواص او من ال + +321 +00:27:29,840 --> 00:27:34,540 +parameters الخاصة بالعدسات اللاصقة اللينة يعني + +322 +00:27:34,540 --> 00:27:38,870 +بمعنى الان احنا ال powerفي الـ hard contact lens + +323 +00:27:38,870 --> 00:27:42,630 +ممكن أقيصه من خلال جهاز الـ lensmeter لكن ال soft + +324 +00:27:42,630 --> 00:27:47,370 +contact lens صعب أقيص موضوع اللي هو التأكد من ال + +325 +00:27:47,370 --> 00:27:51,410 +base curve مستحيل أستخدم ال contact gauge لتأكيد + +326 +00:27:51,410 --> 00:27:55,860 +ال base curve في ال soft contact lensلكن العدسات + +327 +00:27:55,860 --> 00:28:00,300 +اللاصقة الصلبة ممكن أتأكد من ال base care من خلال + +328 +00:28:00,300 --> 00:28:04,800 +استخدام جهاز ال contact gauge إذا عملية التأكيد لل + +329 +00:28:04,800 --> 00:28:09,440 +parameters أو التحقيق تعتبر صعبة وين في العدسات + +330 +00:28:09,440 --> 00:28:16,120 +اللاصقة اللينة Hydrogel + +331 +00:28:16,120 --> 00:28:20,340 +soft lenses offer only limited oxygen + +332 +00:28:20,340 --> 00:28:26,190 +transmissibilityالان في أنواع من العدسات اللاصقة + +333 +00:28:26,190 --> 00:28:30,270 +اللينة زي مثلا ال extended wear ايش معناة ال + +334 +00:28:30,270 --> 00:28:37,750 +extended wear؟ تفضلي اه + +335 +00:28:37,750 --> 00:28:39,990 +اه + +336 +00:28:41,330 --> 00:28:45,810 +According to Food and Drug Administration على + +337 +00:28:45,810 --> 00:28:50,610 +منظمة اللي هو الصحة والدواء عرفوا العدسات اللاصقة + +338 +00:28:50,610 --> 00:28:54,990 +ال extended wear ان المريض بلبسها لمدة أسبوع و + +339 +00:28:54,990 --> 00:29:00,450 +بنام فيها okay الان في هذه العدسات لازم ان يكون ال + +340 +00:29:00,450 --> 00:29:05,770 +DK على T أشماله very high okay وإلا إيش هتعمل + +341 +00:29:05,770 --> 00:29:10,170 +كورنيا القديمة بالنسبة للمريض إذا لازم ان يكون ال + +342 +00:29:10,170 --> 00:29:17,960 +DKعلى T very high in + +343 +00:29:17,960 --> 00:29:23,720 +extended wear + +344 +00:29:23,720 --> 00:29:29,620 +lenses اذا في هذه النوع من العدسات اللاصقة لازم ان + +345 +00:29:29,620 --> 00:29:34,480 +يكون ال decay على T very high طبعا هذا بنسميه ال + +346 +00:29:34,480 --> 00:29:38,440 +oxygen transmissibility اذا نفاذ ال oxygen very + +347 +00:29:38,440 --> 00:29:42,760 +highفي هذه الحالة مدام نفاذ ال oxygen very high، + +348 +00:29:42,760 --> 00:29:47,420 +إذا العدسة إيش هتكون؟ fragile، هشة كتير، يعني فترة + +349 +00:29:47,420 --> 00:29:51,680 +حياتها إيش؟ هتكون جدا قصيرة، يعني قد تكمل الأسبوع + +350 +00:29:51,680 --> 00:29:56,540 +أو لا مع المريض، وهذا هو يعتبر إيه؟ واحدة من عيوب + +351 +00:29:56,540 --> 00:30:01,120 +العدسات اللاصقة اللينة، إن هي بتعمل offer only + +352 +00:30:01,120 --> 00:30:05,720 +limited of oxygen transmissibilityيعني صح هي بتزود + +353 +00:30:05,720 --> 00:30:11,220 +ال oxygen transmissibility بشكل كبير للعدسة، ولكن + +354 +00:30:11,220 --> 00:30:17,950 +ات هي بتنهيق على حياة العدسة بشكل مبكرOkay لكن لو + +355 +00:30:17,950 --> 00:30:23,490 +اجينا مثلا العدسات ال conventional contact lens + +356 +00:30:23,490 --> 00:30:26,910 +اللي هي عدسات اللبس اليومي او التقليدي، هذه + +357 +00:30:26,910 --> 00:30:31,310 +العدسات هنلاحظها ان فترة حياتها بتجود مثلا من ستة + +358 +00:30:31,310 --> 00:30:35,130 +الى اتناشر شهر، فبالتالي ايش هيكون ال DK؟ مين + +359 +00:30:35,130 --> 00:30:38,650 +اعلى؟ هي ولا ال extended wear؟ ال extended wear + +360 +00:30:38,650 --> 00:30:43,030 +هيكون فيها ال DK على T very high، صحيح؟ مقارنة في + +361 +00:30:43,030 --> 00:30:45,750 +ال conventional contact lens wear + +362 +00:30:49,210 --> 00:30:55,010 +بالتالي، يمكن أن يكون لديهم مشاكل بشكل مستمر أو + +363 +00:30:55,010 --> 00:31:00,570 +عندما يقوموا بإصلاح أمترابيا أو أستيغماطيةالان انا + +364 +00:31:00,570 --> 00:31:04,330 +يما بستخدم العدسات ال soft contact lens في ال high + +365 +00:31:04,330 --> 00:31:08,650 +ametropia او في ال high astigmatism من الصعب اني + +366 +00:31:08,650 --> 00:31:13,050 +استخدم مين؟ ال soft contact lens اضافة للسبب ان هي + +367 +00:31:13,050 --> 00:31:16,830 +conform to the shape of the cornea ان هذه العدسة + +368 +00:31:16,830 --> 00:31:20,850 +تعتبر ال oxygen transmissibility او ال decay على + +369 +00:31:20,850 --> 00:31:26,530 +THH تعتبر very high فبالتالي هي غير مناسبة لتصحيح + +370 +00:31:26,530 --> 00:31:34,340 +ال high ametropia او ال astigmatismCompare with GB + +371 +00:31:34,340 --> 00:31:39,340 +lenses, soft lenses have limited post lens tear + +372 +00:31:39,340 --> 00:31:43,680 +exchange، اذا التبادل التير في العدسات اللاصقة + +373 +00:31:43,680 --> 00:31:48,860 +اللينة هيكون محدود مقارنة في مين في ال GB lenses، + +374 +00:31:48,860 --> 00:31:54,920 +why؟بسبب الـ Minimal Movement للـ Soft Contact + +375 +00:31:54,920 --> 00:31:59,500 +Lens اللي بتقدر من نص إلى واحد مليمتر مقارنة في + +376 +00:31:59,500 --> 00:32:02,700 +الـ Hard Contact Lens اللي الحركة فيها من واحد إلى + +377 +00:32:02,700 --> 00:32:08,290 +اتنين مليمترإذا مرة أخرى تبادل الـ tear في العدسات + +378 +00:32:08,290 --> 00:32:14,050 +اللاصقة اللينة يعتبر أقل من العدسات اللاصقة الصلبة + +379 +00:32:14,050 --> 00:32:18,170 +السبب في ذلك قلة الحركة اللي هي بتقدر من نص إلى + +380 +00:32:18,170 --> 00:32:21,910 +واحد مقارنة في ال hard contact lens اللي بتقدر من + +381 +00:32:21,910 --> 00:32:23,850 +واحد إلى اتنين مليمتر + +382 +00:32:27,950 --> 00:32:33,130 +hydrophilic materials المواد المحبة للماء tend to + +383 +00:32:33,130 --> 00:32:38,830 +dehydrate هتعمل تبخر on eye dehydrate بمعنى تبخر + +384 +00:32:38,830 --> 00:32:45,770 +أي بمعنى انه بيسبب dry eye جفاف للعين which may + +385 +00:32:45,770 --> 00:32:50,230 +cause symptoms يعني بيسبب اللي هو أعراض جفاف العين + +386 +00:32:50,230 --> 00:32:55,170 +لو سألنا السؤال ما هو مفهوم ال dry eye جفاف العين + +387 +00:32:55,170 --> 00:32:56,130 +ايش تعريفه؟ + +388 +00:33:12,380 --> 00:33:19,140 +تفضلي اه هذي ك causes صحيح؟ okay another answer + +389 +00:33:21,950 --> 00:33:26,430 +طيب dry eye جفاف العين هو يعتبر a multifactorial + +390 +00:33:26,430 --> 00:33:31,710 +pathology يعني مرض متعدد الأسباب that can cause + +391 +00:33:31,710 --> 00:33:38,730 +بيسبب هذا المرض ocular discomfort يعني عدم راحة + +392 +00:33:38,730 --> 00:33:43,350 +لمين ل العين و أيضا بيعمل decrease لل visual + +393 +00:33:43,350 --> 00:33:47,790 +acuity و بيعمل tear instability عدم ثبات لمين + +394 +00:33:47,790 --> 00:33:50,610 +للتير اتبعكم التعريف + +395 +00:33:58,010 --> 00:34:03,550 +طبعا هذا التعريف according to اه بيعمل decrease ال + +396 +00:34:03,550 --> 00:34:08,590 +visual acuity نعم صحيح لذلك الأشخاص اللي بيكون + +397 +00:34:08,590 --> 00:34:13,090 +عندهم جفاف في العين بيقولك انا discomfort عدم راحة + +398 +00:34:13,090 --> 00:34:17,050 +عندى و ايضا عندى اللي هو بشعر ان ال visual acuity + +399 +00:34:17,050 --> 00:34:21,550 +مابشوفش الشغلات اللي بعيدة بيكون هذه لها علاقة في + +400 +00:34:21,550 --> 00:34:24,190 +ال ocular symptoms مالهاش علاقة في ال visual + +401 +00:34:24,190 --> 00:34:37,940 +symptoms اذا ن dryأو اختصارها DA according to + +402 +00:34:37,940 --> 00:34:46,240 +dry eye workshop 2007 طبعا هذه اختصار dry eye + +403 +00:34:46,240 --> 00:34:50,620 +workshop هذا عبارة عن workshop تم إجراءه في + +404 +00:34:50,620 --> 00:34:55,260 +استراليا في سنة الفين وسبعة عرفوا ل dry eye انه + +405 +00:34:55,260 --> 00:34:56,120 +اذا عملت + +406 +00:35:02,410 --> 00:35:10,490 +factorial pathology مرض متعدد الأسباب أو disease + +407 +00:35:10,490 --> 00:35:26,010 +أو disorder that can cause ocular discomfort + +408 +00:35:30,280 --> 00:35:37,700 +Tier film instability + +409 +00:35:37,700 --> 00:35:44,340 +and + +410 +00:35:44,340 --> 00:35:48,320 +reduce + +411 +00:35:48,320 --> 00:36:01,950 +or decrease of visual acuityهذا بالنسبة له مفهوم + +412 +00:36:01,950 --> 00:36:06,470 +ال dry eye جفاف العين according to dry eye + +413 +00:36:06,470 --> 00:36:14,530 +workshop 2007 طيب الآن ارتداء العدسات اللاصقة + +414 +00:36:14,530 --> 00:36:21,030 +المحبة للماء بسبب جفاف العين وهذا مفهوم جفاف العين + +415 +00:36:22,950 --> 00:36:27,730 +و أيضا بيسبب ال dry eye symptoms اللي هي أعراض + +416 +00:36:27,730 --> 00:36:32,750 +جفاف العين، زي مثلا واحد بيصير عنده redness، + +417 +00:36:32,750 --> 00:36:35,790 +blurred vision، بيصير مثلا عنده photophobia، + +418 +00:36:35,790 --> 00:36:40,410 +itching، أيضا بيصير عنده red eye، كل هذه الأعراض + +419 +00:36:40,530 --> 00:36:45,230 +مصاحبة لمين؟ لأ ل dry eye اللي هي بيكون لها علاقة + +420 +00:36:45,230 --> 00:36:49,750 +فقط بال ocular symptoms يعني متعلقة بتشريح العين + +421 +00:36:49,750 --> 00:36:55,690 +حسب ال symptoms ل ال eye strain طيب الآن السؤال + +422 +00:36:55,690 --> 00:37:02,230 +شخص عنده جفاف للعين هل أنا بدي عدسة high water + +423 +00:37:02,230 --> 00:37:07,790 +content ولا low water content؟ why؟ بدي low water + +424 +00:37:07,790 --> 00:37:09,550 +content okay why؟ + +425 +00:37:11,970 --> 00:37:18,670 +ممتازة كلام سليم الان الأشخاص اللي عندهم dry eye + +426 +00:37:18,670 --> 00:37:23,750 +جفاف في العين انا بديه عدسات low water content لان + +427 +00:37:23,750 --> 00:37:28,310 +ال high water content هتعمل حاجة بنسميها shift + +428 +00:37:28,310 --> 00:37:31,670 +osmatic + +429 +00:37:33,690 --> 00:37:38,630 +يعني بمعنى اللي هو تبخر او تبادل لمين لل تير من ال + +430 +00:37:38,630 --> 00:37:44,110 +tear film للعدسة فهتلاحظ ان العدسة هتشفط كل ال + +431 +00:37:44,110 --> 00:37:49,090 +tear film وبالتالي هيصير هناك ايش؟ dehydrate تبخر + +432 +00:37:49,090 --> 00:37:53,890 +لمين لا التير و ايضا ان المريض هيعاني من جفاف + +433 +00:37:53,890 --> 00:37:58,530 +للعين هيصير عنده dry eye symptoms اللي ذكرناها + +434 +00:37:58,530 --> 00:37:59,470 +سابقا + +435 +00:38:04,760 --> 00:38:09,300 +In extended wear أيضًا في العدسات اللي بتتم + +436 +00:38:09,300 --> 00:38:14,600 +ارتدائها لمدة أسبوع واحد وبعد ذلك بتتم التخلص منها + +437 +00:38:14,600 --> 00:38:19,600 +soft lenses may cause inflammatory complications + +438 +00:38:19,600 --> 00:38:24,410 +أيضًا هذا هيسبب إيش مضاعفاتللـ inflammation + +439 +00:38:24,410 --> 00:38:28,130 +الالتهابات زي مثلا ال Babillary conjunctivitis + +440 +00:38:28,130 --> 00:38:32,250 +ممكن يسبب dry eye ممكن يسبب keratitis كل هذه + +441 +00:38:32,250 --> 00:38:37,410 +الشغلات هتكون مصاحبة لارتداء العدسات اللاصقة + +442 +00:38:37,410 --> 00:38:44,030 +اللينةإذا الآن بنكتفي اليوم ان شاء الله بمقدمة عن + +443 +00:38:44,030 --> 00:38:50,410 +العدسات اللاصقة اللينة و بمميزات و أيضا عيوب أو + +444 +00:38:50,410 --> 00:38:55,630 +قيود العدسات اللاصقة اللينة في أي سؤال؟ أعطيكم + +445 +00:38:55,630 --> 00:38:56,290 +العافية شكرا + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/etEdmxN1t6Q.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/etEdmxN1t6Q.srt new file mode 100644 index 0000000000000000000000000000000000000000..acca17de3171676d72ca2290cf14e0b953a24882 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/etEdmxN1t6Q.srt @@ -0,0 +1,1591 @@ +1 +00:00:24,380 --> 00:00:30,540 +أهلا و مرحبا بكم جميعًا سنكمل اليوم في موضوع + +2 +00:00:30,540 --> 00:00:36,020 +المشاكل و حلولها للعدسات الـ soft red contact + +3 +00:00:36,020 --> 00:00:42,500 +lenses في النقطة رقم 3 If a blurred vision is with + +4 +00:00:42,500 --> 00:00:46,680 +both eyes, you may consider if the lenses were + +5 +00:00:46,680 --> 00:00:51,880 +applied on the correct eye and then perform an + +6 +00:00:51,880 --> 00:00:57,220 +spherical cylindrical oval refraction الآن نفترض أن + +7 +00:00:57,220 --> 00:01:01,860 +كان في عندي عين الـ right eye normal و الـ another + +8 +00:01:01,860 --> 00:01:07,040 +eye كانت abnormal تمامًا؟ و استخدمنا عدسة diagnostic + +9 +00:01:07,040 --> 00:01:12,080 +lens للـ both eyes الآن أما أنا بستخدم للـ both eyes + +10 +00:01:12,080 --> 00:01:16,620 +الرؤية هتصير في العينتين إيه الـ blurred vision طيب + +11 +00:01:16,620 --> 00:01:19,840 +نفترض أنا مش عارف مين هي الـ normal و مين هي الـ + +12 +00:01:19,840 --> 00:01:23,460 +abnormal eye البساطة اللي بعمل spherical + +13 +00:01:23,460 --> 00:01:27,460 +cylindrical over refraction يعني بمعنى آخر بعمل + +14 +00:01:27,460 --> 00:01:33,090 +auto over للعدسة إذا و الله طلعت عندي قيمة سواء بالـ + +15 +00:01:33,090 --> 00:01:37,810 +plus أو بالـ minus بعرف إن هذه العين هي تعتبر + +16 +00:01:37,810 --> 00:01:41,950 +السليمة الـ another eye إذا طلعت اللي هو القيمة + +17 +00:01:41,950 --> 00:01:46,110 +اللي لها plano أو insignificant power من حيث + +18 +00:01:46,110 --> 00:01:49,750 +الاسفير أو السيلندر بعرف إن هذه العين اللي فيها + +19 +00:01:49,750 --> 00:01:56,830 +إيه المشكلة تمام؟ check vertex convergence from the + +20 +00:01:56,830 --> 00:02:01,730 +spectacle refraction to the corneal plane طيب + +21 +00:02:01,730 --> 00:02:08,330 +نفترض الآن أنا المريض طلع عند الوصفة minus 6 على + +22 +00:02:08,330 --> 00:02:14,190 +minus 1 x مثلاً 30 الخطوة الأولى إيش بدي أعمل؟ + +23 +00:02:23,510 --> 00:02:29,990 +بمعنى أعمل عملية تحويل لمن؟ للـ power الخاصة + +24 +00:02:29,990 --> 00:02:34,630 +بقيمة النضارة أو الخاصة بالـ subjective refraction + +25 +00:02:34,630 --> 00:02:41,250 +in addition to rotation the next most common + +26 +00:02:41,250 --> 00:02:47,470 +errors are base curve fitting قلنا أول drawback + +27 +00:02:47,470 --> 00:02:52,170 +لعدسات الـ software الـ contact lenses هو موضوع الـ + +28 +00:02:52,170 --> 00:02:57,770 +rotation تمام النقطة الثانية الـ base curve هي تعتبر + +29 +00:02:57,770 --> 00:03:03,210 +الـ second most أو الـ next step تمام أو الـ error + +30 +00:03:03,210 --> 00:03:07,950 +اللي هو الخطأ الثاني إيش؟ للـ drawback للعدسات اللي + +31 +00:03:07,950 --> 00:03:12,050 +هي الـ soft direct contact lenses إذا مرة ثانية in + +32 +00:03:12,050 --> 00:03:16,610 +addition to rotation the next أو الـ second most + +33 +00:03:16,610 --> 00:03:20,650 +most common errors are base curve fitting + +34 +00:03:20,650 --> 00:03:26,120 +relationship and lens power إذا عندنا المشكلة + +35 +00:03:26,120 --> 00:03:30,700 +الثانية في عدسات الـ soft rec contact lenses هي + +36 +00:03:30,700 --> 00:03:35,900 +عبارة عن مين؟ الـ base curve بيبلغنا وصلنا للسؤال هل + +37 +00:03:35,900 --> 00:03:40,580 +يمكن تقييم أو حساب قيمة الـ base curve للعدسات الـ + +38 +00:03:40,580 --> 00:03:45,380 +soft rec contact lenses ولا لأ؟ كيف؟ طيب اللي أنا + +39 +00:03:45,380 --> 00:03:49,580 +مديتك عدسة soft rec contact lenses قلت لك احسبيه + +40 +00:03:49,580 --> 00:03:52,400 +لقداش أو قيس الـ base curve لها ممكن؟ + +41 +00:03:55,290 --> 00:04:03,530 +طبعًا الـ base curve للـ soft trick من الصعب اللي هو + +42 +00:04:03,530 --> 00:04:09,670 +عملية قياسه تمام لكن أنا ممكن كيف أتعرف من خلال الـ + +43 +00:04:09,670 --> 00:04:15,270 +lens power الـ lens power كيف أنا بقيسه من خلال + +44 +00:04:15,270 --> 00:04:23,070 +اللي هو مثلاً الـ lensometer طبعًا إذا مرة أخرى في + +45 +00:04:23,070 --> 00:04:27,730 +العدسات الـ software contact lenses من الصعب التعرف + +46 +00:04:27,730 --> 00:04:33,490 +على الـ base curve للعدسة لكن أنا ممكن أتعرف على الـ + +47 +00:04:33,490 --> 00:04:37,770 +power parameter من خلال استخدام جهاز الـ lensmeter + +48 +00:04:37,770 --> 00:04:38,770 +أو الفوسيمتر + +49 +00:04:41,420 --> 00:04:45,360 +إذا المشكلة الثانية هي موضوع الـ base curve يما + +50 +00:04:45,360 --> 00:04:49,060 +يكون خاطئ الثالثة عندنا مشكلة الـ power يما يكون + +51 +00:04:49,060 --> 00:04:54,420 +فيها defect أو تكون غير صحيحة The rotation and base + +52 +00:04:54,420 --> 00:04:58,080 +curve can be confirmed with the spherical + +53 +00:04:58,080 --> 00:05:02,280 +cylindrical over refraction ممكن أنا بعمل عملية + +54 +00:05:02,280 --> 00:05:07,040 +confirmed أي بمعنى تأكيد لقيمة الـ rotation و الـ + +55 +00:05:07,040 --> 00:05:10,540 +base curve من خلال الـ spherical cylindrical over + +56 +00:05:10,540 --> 00:05:15,460 +refraction كيف؟ طيب؟ الآن أنا يما بدي آجي بأجيب أي + +57 +00:05:15,460 --> 00:05:21,200 +تشخص بأخذ له الـ K1 و الـ K2 و بأخذ R1 و R2 فمن خلالها + +58 +00:05:21,200 --> 00:05:25,400 +أنا بعرف مين الـ base curve للشخص لكن للعدسة من + +59 +00:05:25,400 --> 00:05:32,840 +الصعب التعرف عليها تمام؟ if a good endpoint acuity + +60 +00:05:32,840 --> 00:05:38,320 +is not found consider the base curve lens design + +61 +00:05:38,320 --> 00:05:43,830 +or lens optics الآن احنا عملنا diagnostic method + +62 +00:05:43,830 --> 00:05:48,290 +أو الـ trial method و لاحظنا إن ما وصلنا لأفضل + +63 +00:05:48,290 --> 00:05:52,290 +visual acuity عند مين؟ عند المريض في هذه الحالة + +64 +00:05:52,290 --> 00:05:57,400 +ممكن أن يكون عنده خلل في الـ base curve للعدسة اثنين + +65 +00:05:57,400 --> 00:06:02,760 +في الـ lens design تصميم العدسة أو ممكن أن يكون إيه؟ + +66 +00:06:02,760 --> 00:06:09,460 +بالخواص البصرية لمين؟ للعدسة يعني بمعنى آخر أنا + +67 +00:06:09,460 --> 00:06:14,310 +مثلاً استخدمت الـ prism palest و المريض كان عنده عدم + +68 +00:06:14,310 --> 00:06:17,570 +القدرة على التحمل على اللي هو الـ thickness في + +69 +00:06:17,570 --> 00:06:21,830 +المنطقة الساعة ستة فهنا مش هيقدر يتعود على مين؟ + +70 +00:06:21,830 --> 00:06:25,270 +على العدسة فهنا بده يكون مشكلة في مين؟ في الـ lens + +71 +00:06:25,270 --> 00:06:29,890 +optics أو مثلاً واحد أديتُه dynamic stabilization و + +72 +00:06:29,890 --> 00:06:33,970 +عنده سعر في الساعة ثلاثة أو تسعة مشكلة أيضًا مش + +73 +00:06:33,970 --> 00:06:37,170 +هيَقدر إنه يتحمل العدسة تمام؟ + +74 +00:06:40,460 --> 00:06:45,480 +يعني في بعض الأحيان ممكن أنا أفكر في عملية اللي هو + +75 +00:06:45,480 --> 00:06:50,360 +تغيير من الـ lens design حتى أدي رؤية إنه تكون + +76 +00:06:50,360 --> 00:06:55,280 +مناسبة أو ملائمة للمريض وبالإضافة إنه أوصل لأفضل + +77 +00:06:55,280 --> 00:07:00,780 +اللي هو راحة لمين؟ للـ patient طيب stable blurred + +78 +00:07:00,780 --> 00:07:05,120 +vision إذا مدام stable إذا إيش هيكون؟ بشكل دائم + +79 +00:07:05,120 --> 00:07:10,920 +تمام؟ يعني غبش في الرؤية بشكل دائم When the patient + +80 +00:07:10,920 --> 00:07:15,700 +returns after wearing the lens for a short time + +81 +00:07:15,700 --> 00:07:23,360 +طيب، الآن المريض أول ما بيرتدي العدسة اللاصقة لفترة + +82 +00:07:23,360 --> 00:07:30,560 +زمنية قصيرة، بيصير عنده إيش؟ غبش بشكل دائم، واضحة؟ + +83 +00:07:30,560 --> 00:07:35,260 +إذا عند ارتداء العدسة اللاصقة لفترة زمنية قصيرة، + +84 +00:07:35,260 --> 00:07:41,900 +المريض بيصبح عنده غبش بشكل دائم طيب في هذه الحالة + +85 +00:07:41,900 --> 00:07:46,380 +إيش بدي أعمل؟ number one بدي أعمل review مراجعة للـ + +86 +00:07:46,380 --> 00:07:50,280 +base curve لقيمة اللي هو الـ base curve أو الـ back + +87 +00:07:50,280 --> 00:07:56,880 +optic zone radius soft lenses may tighten with + +88 +00:07:56,880 --> 00:08:02,700 +wear and what appeared to be good fit may now be + +89 +00:08:02,700 --> 00:08:06,380 +tight causing irregular power effects or a + +90 +00:08:06,380 --> 00:08:11,000 +creeping of the rotation الآن يما بتكون بعد ما أنا + +91 +00:08:11,000 --> 00:08:15,680 +براجع الـ base curve للعدسة و بدي أشوفه هل هو صحيح + +92 +00:08:15,680 --> 00:08:20,800 +أو خطأ ممكن في بعض الأحيان إن العدسة تكون tied + +93 +00:08:20,800 --> 00:08:25,440 +تمام؟ يعني بمعنى إنه as he runs to the shape of + +94 +00:08:25,440 --> 00:08:29,780 +the cornea يعني أول ما بتحطيها على العين بتعمل + +95 +00:08:29,780 --> 00:08:34,380 +اللي هو suction اللي هو بتكون مصممة وين؟ على السطح + +96 +00:08:34,380 --> 00:08:41,280 +القرنية للعين طيب، الآن أنا بدي أوصل لإيش؟ لأفضل + +97 +00:08:41,280 --> 00:08:44,840 +اللي هو نتيجة أو أفضل power أو أفضل base curve + +98 +00:08:44,840 --> 00:08:50,320 +تمام؟ هذه الـ step إيش بيعمل؟ ممكن إنه بيغير في + +99 +00:08:50,320 --> 00:08:54,260 +اللي هو القوة الملائمة للعدسة، يعني بمعنى آخر + +100 +00:08:54,260 --> 00:08:59,040 +المريض بده مثلاً base curve سبعة و ستة أنا رحت + +101 +00:08:59,040 --> 00:09:03,120 +مثلاً أديتُه base curve نفترض على سبيل المثال سبعة و + +102 +00:09:03,120 --> 00:09:07,150 +تسعة طيب الآن التغيير في الـ base curve مش بيعمل على + +103 +00:09:07,150 --> 00:09:10,550 +تغيير الـ power صح ولا لا؟ فإنما بتغير الـ power + +104 +00:09:10,550 --> 00:09:14,750 +بيؤثر على قيمة العدسة الملائمة لمين؟ للمريض + +105 +00:09:14,750 --> 00:09:19,630 +وبالتالي إما يتغير الـ power للعدسة أكيد هيعمل غبش + +106 +00:09:19,630 --> 00:09:24,610 +للرؤية تمام؟ يعني الآن لو سألتك سؤال إيش هي أسباب + +107 +00:09:24,610 --> 00:09:30,140 +اللي هو الـ blurred vision؟ عدم اللي هو رؤية بوضوح + +108 +00:09:30,140 --> 00:09:34,380 +منها إن القوة غير ملائمة أو غير مناسبة للمريض صح + +109 +00:09:34,380 --> 00:09:39,060 +ولا لا؟ أو مثلاً inverted اللي هو إن العلْسة مقلوبة + +110 +00:09:39,060 --> 00:09:45,080 +صح ولا لا؟ ممكن تعمل اللي هو blurred vision طيب الآن + +111 +00:09:45,080 --> 00:09:49,460 +كلمة a creeping of the rotation إن العدسة بتدور + +112 +00:09:49,460 --> 00:09:54,260 +يعني بمعنى إنه ما بتستقر في مكانها و ما بتقدر تصل + +113 +00:09:54,260 --> 00:09:58,940 +لمرحلة أو لمنطقة اللي هو الاستقرار يعني العدسة + +114 +00:09:58,940 --> 00:10:03,360 +بتبقى إنه تعمل عملية rotation دون القدرة على + +115 +00:10:03,360 --> 00:10:07,260 +الاستقرار طبعًا دائمًا أنا بدي أفكر مدام في هناك + +116 +00:10:07,260 --> 00:10:11,940 +rotation للعدسة إذا في مساوي لها إيش؟ اللي هو + +117 +00:10:11,940 --> 00:10:17,660 +stable blurred vision طبعًا إذا دائمًا إعادة تحويل + +118 +00:10:17,660 --> 00:10:23,220 +دوران العدسة وعدم استقرارها بساوية مستقبلية و + +119 +00:10:23,220 --> 00:10:28,500 +مظهرة مظهرة طيب + +120 +00:10:28,500 --> 00:10:32,320 +بعض الأحيان بيكون مظهر مظهر مظهر مظهر مظهر مظهر + +121 +00:10:32,320 --> 00:10:34,500 +مظهر مظهر مظهر مظهر مظهر مظهر مظهر مظهر مظهر + +122 +00:10:34,500 --> 00:10:36,440 +مظهر مظهر مظهر مظهر مظهر مظهر مظهر مظهر مظهر + +123 +00:10:36,440 --> 00:10:36,700 +مظهر مظهر مظهر مظهر مظهر مظهر مظهر مظهر مظهر + +124 +00:10:36,700 --> 00:10:42,360 +مظهر مظهر مظهر مظهر م + +125 +00:10:47,290 --> 00:10:51,550 +بالضبط يعني بدي أجيب اللي هو عملية إيش؟ إنه أعكس + +126 +00:10:51,550 --> 00:10:56,270 +اللي هو العدسة تمام فإيش بعمل؟ طيب لما أنا بعمل اللي + +127 +00:10:56,270 --> 00:11:01,170 +هو عكس العدسة بالضبط إنه بعمل stable blurred + +128 +00:11:01,170 --> 00:11:06,430 +vision لمين؟ للمريض تمام مرة أخرى يا جماعة الآن + +129 +00:11:06,430 --> 00:11:10,910 +أما يكون أنا عندي unilateral blurred vision إيش بدي + +130 +00:11:10,910 --> 00:11:16,170 +أجيب؟ بدي أعمل عملية قلب للعدسة Okay فهيعمل اللي هو + +131 +00:11:16,170 --> 00:11:20,630 +stable blurred vision من خلالها أنا بعرف إن مين + +132 +00:11:20,630 --> 00:11:23,890 +اللي هو العين اللي فيها good و مين فيها الـ bad + +133 +00:11:23,890 --> 00:11:24,350 +vision + +134 +00:11:29,360 --> 00:11:33,460 +Verify the rotation of the lens إذا أنا بدي أعمل + +135 +00:11:33,460 --> 00:11:38,340 +عملية تأكيد لمين؟ لدوران العدسة inconsistent + +136 +00:11:38,340 --> 00:11:43,600 +rotation يما يكون اللي هو بمعنى إنه الـ rotation + +137 +00:11:43,600 --> 00:11:50,440 +غير متعامد أو غير متناقص غير اللي هو متنازم تمام + +138 +00:11:51,550 --> 00:11:57,410 +إذا هنا عندنا inconsistent اللي هو rotation أي + +139 +00:11:57,410 --> 00:12:04,130 +بمعنى إن الدوران غير متناظم okay indicates either + +140 +00:12:04,130 --> 00:12:09,510 +a loose-fitting relationship or inappropriate lens + +141 +00:12:09,510 --> 00:12:16,850 +عندما تكون قيمة الـ rotation غير متناسبة أو + +142 +00:12:16,850 --> 00:12:21,170 +غير ملائمة، يمكن أن العدسة تكون بطيئة، فمع أن + +143 +00:12:21,170 --> 00:12:26,150 +العدسة بطيئة، يعني بمعنى أنها تحتوي على عدسة محدبة + +144 +00:12:26,150 --> 00:12:30,610 +عالية، أي مش ماخدة شكل القرنية أو ممكن أن تكون الـ + +145 +00:12:30,610 --> 00:12:35,660 +small diameter صح ولا لا؟ فهنا معنى الكلام بيحكي + +146 +00:12:35,660 --> 00:12:40,520 +لي أن ال lens design اللي خاص في العدسة غير ملائم + +147 +00:12:40,520 --> 00:12:45,720 +لهذا المريض لابد من تغيره، أو try another base curve + +148 +00:12:45,720 --> 00:12:49,520 +or lens design في هذه الحالة أنا بدي استخدم اللي + +149 +00:12:49,520 --> 00:12:53,360 +هو base curve آخر، أنه يكون steep base curve تمام + +150 +00:12:53,360 --> 00:12:56,340 +أو بدي أغير كل تصميم العدسة + +151 +00:13:00,920 --> 00:13:07,140 +Okay, check lens for deposits or wetability الآن الـ + +152 +00:13:07,140 --> 00:13:10,480 +deposits اللي هي عبارة عن الترسبات اللي بتكون على + +153 +00:13:10,480 --> 00:13:14,440 +سطح العدسة بدي أشوف أنه هل في هناك ترسبات على + +154 +00:13:14,440 --> 00:13:19,020 +العدسة ولا لأ، أيضا بدي أمسك اللي هو مرونة وليونة + +155 +00:13:19,020 --> 00:13:23,160 +العدسة، الـ wetability تمام؟ بدي أشوفها جديش اللي هو + +156 +00:13:23,160 --> 00:13:29,500 +كمّ مرونة للعدسة موجودة، poor tear quality may prevent + +157 +00:13:36,730 --> 00:13:41,970 +الآن أنا شخص عنده dry eye تمام؟ ما ينفعش أنا أروح + +158 +00:13:41,970 --> 00:13:46,230 +أدي ايش؟ high water content أو moderate water + +159 +00:13:46,230 --> 00:13:51,830 +content تمام؟ لأنه في هذه الحالة ايش هيعمل؟ هيسبب + +160 +00:13:51,830 --> 00:13:55,830 +اللي هو dry eye symptoms تمام؟ وهيعمل على + +161 +00:13:55,830 --> 00:14:02,680 +dehydrate اللي هو تبخير كل سطح من القرنية، أيضا عندنا + +162 +00:14:02,680 --> 00:14:08,080 +بيمنع اللي هو حركة ملائمة للعدسة، دائما العين لما + +163 +00:14:08,080 --> 00:14:14,060 +بيصير فيها نوع من الجفاف تمام، هذا بيؤدي إلى إعاقة + +164 +00:14:14,060 --> 00:14:19,420 +حركة العدسة داخل العين، يعني بمعنى آخر أنه ممكن + +165 +00:14:19,420 --> 00:14:24,880 +العدسة احنا نطلع إليها إنه هي steep، وهي إنه تكون + +166 +00:14:24,880 --> 00:14:29,150 +ايش؟ العدسة normal، لكن مين اللي سبب هذا؟ اللي هو الـ + +167 +00:14:29,150 --> 00:14:34,650 +dry eye أو تبخير اللي هو سطح العدسة، أيضا هذا بيؤثر + +168 +00:14:34,650 --> 00:14:39,710 +على مين؟ على الـ rotation للعدسة دوران العدسة، لذلك + +169 +00:14:39,710 --> 00:14:43,450 +دائما قلنا يا جماعة أن العدسة الـ software contact + +170 +00:14:43,450 --> 00:14:48,570 +lenses إذا أنا بدي أستخدم اللي هو ideal evaluation + +171 +00:14:48,570 --> 00:14:54,780 +لازم أنه يكون بعد جديش؟ أسبوع من استخدام العدسة، إذا + +172 +00:14:54,780 --> 00:14:59,200 +بعد الأسبوع أنه بديه عدسة تجريبية يستخدمها بشكل اللي + +173 +00:14:59,200 --> 00:15:04,000 +هو يومي لحد ما أصل لأفضل اللي هو عدسة ملائمة + +174 +00:15:04,000 --> 00:15:11,640 +للمريض، If this is the case consider a lens with a + +175 +00:15:11,640 --> 00:15:15,870 +different material, base curve or thickness، إذا + +176 +00:15:15,870 --> 00:15:19,890 +اتفقنا على موضوع الـ lens material بدي أغيره إذا + +177 +00:15:19,890 --> 00:15:23,590 +والله المريض عنده dry eye بدي أستخدم معه low water + +178 +00:15:23,590 --> 00:15:28,770 +content، اثنين عندنا موضوع الـ base curve بدي أستخدم + +179 +00:15:28,770 --> 00:15:33,230 +ممكن flat base curve حسب يعني ما بتطبيق اللي هو + +180 +00:15:33,230 --> 00:15:37,330 +الحالة، ممكن مثلا الـ thickness أنه أقلله بدل ما + +181 +00:15:37,330 --> 00:15:40,770 +أجيب اللي هو الـ prism tals أستخدم اللي هو الـ + +182 +00:15:40,770 --> 00:15:42,190 +dynamic stabilization + +183 +00:15:47,160 --> 00:15:52,500 +Unstable blurred vision is usually an indicator + +184 +00:15:52,500 --> 00:15:58,100 +that the base curve or back optic zone radius is + +185 +00:15:58,100 --> 00:16:03,340 +not correct، دائما احنا كـ fitter أو كـ practitioner + +186 +00:16:03,340 --> 00:16:08,510 +بنظن أن المشكلة وين دائما؟ في الـ power دائما بنظن + +187 +00:16:08,510 --> 00:16:12,110 +احنا المشكلة وين؟ في الـ power في البداية لكن بعد + +188 +00:16:12,110 --> 00:16:17,090 +ذلك بتصل لمرحلة أنك بتعمل spherical cylindrical + +189 +00:16:17,090 --> 00:16:22,030 +over refraction وبتلاحظ أن قيمتها zero وهو لابس + +190 +00:16:22,030 --> 00:16:26,090 +المريض العدسة على طول، أنا بدي أروح وين؟ أن هذا بدل + +191 +00:16:26,090 --> 00:16:29,390 +على أنه ممكن يكون الـ base curve هو اللي فيه + +192 +00:16:29,390 --> 00:16:34,790 +المشكلة، دائما بتكون تعرفوا أن من خواص العدسة الـ + +193 +00:16:34,790 --> 00:16:38,790 +software contact lenses أن بتكون number one steep + +194 +00:16:38,790 --> 00:16:42,770 +مقارنة في الـ spherical soft contact lens واثنين + +195 +00:16:42,770 --> 00:16:50,230 +بتكون thin تمام؟ إذا عندنا من خواص العدسة الـ + +196 +00:16:50,230 --> 00:16:56,170 +software contact lenses مقارنة بالـ + +197 +00:16:56,170 --> 00:16:58,890 +spherical soft contact lens بتكون more + +198 +00:17:04,280 --> 00:17:12,920 +thin بالإضافة أنها more steam، اثنين هدول الخاصيتين + +199 +00:17:12,920 --> 00:17:16,980 +هدول خاصين في مين؟ في الـ software contact lenses + +200 +00:17:16,980 --> 00:17:23,160 +فدائما أي تغبش خاصة بعد ما أعمل الـ over refraction + +201 +00:17:23,160 --> 00:17:27,120 +ممكن أن أشك أن عنده الـ base curve غير صحيح + +202 +00:17:27,120 --> 00:17:28,600 +للعدسة تمام؟ + +203 +00:17:32,340 --> 00:17:38,700 +a loose fitting أي بمعنى flat lens may cause post + +204 +00:17:38,700 --> 00:17:45,660 +-blink blurring due to the lack of stability الآن + +205 +00:17:45,660 --> 00:17:51,900 +شخص عنده flat lens إذا في عندنا على طول ايش؟ + +206 +00:17:51,900 --> 00:17:55,100 +excessive movement، الشغل الثاني في عندنا small + +207 +00:17:55,100 --> 00:18:01,000 +diameter، الشغل الأهم أنه عنده الـ post tear + +208 +00:18:02,510 --> 00:18:10,050 +Lens بيكون ايش معله؟ thin تمام؟ فهذه ايش بتعمل + +209 +00:18:10,050 --> 00:18:17,610 +unstability للعدسة inside the patient eye، careful + +210 +00:18:17,610 --> 00:18:24,050 +evaluation التقييم بعناية is required of the lens + +211 +00:18:24,050 --> 00:18:29,640 +position، إذا لازم أنا أشوف موقع العدسة وين؟ أنه هل + +212 +00:18:29,640 --> 00:18:33,540 +هي جاية مثلا على الساعة السادسة ولا لأ؟ أو جاية على + +213 +00:18:33,540 --> 00:18:38,220 +الخمسة أو عاملة rotation للـ right أو للـ left and + +214 +00:18:38,220 --> 00:18:42,540 +ability to maintain position، لازم أن احافظ على + +215 +00:18:42,540 --> 00:18:48,160 +ايش؟ احافظ على حركة العدسة داخل العين بمعنى آخر أن + +216 +00:18:48,160 --> 00:18:53,520 +لازم أعمل rotation و stability للعدسة inside of + +217 +00:18:53,520 --> 00:18:59,180 +the patient eye، As the eye moves from side to side + +218 +00:18:59,180 --> 00:19:03,240 +دائما في موضوع الـ movement ما أعتمد فقط على الـ + +219 +00:19:03,240 --> 00:19:07,580 +vertical movement وإن كانت هي الأصل، أيضا في عنده + +220 +00:19:07,580 --> 00:19:11,880 +حاجة الـ horizontal movement يعني from side to side + +221 +00:19:11,880 --> 00:19:17,180 +أو nasal to temporal، okay، and post bling واحنا + +222 +00:19:17,180 --> 00:19:21,280 +اتفقنا أن الـ post tear lens بيكون اللي هو thin في + +223 +00:19:21,280 --> 00:19:24,060 +حالة ما تكون العدسة flat أو loose + +224 +00:19:28,660 --> 00:19:33,640 +A creeping of rotation أي بمعنى أن عدم استقرار + +225 +00:19:33,640 --> 00:19:37,700 +العدسة في مكانها، يعني بمعنى آخر أن في هناك + +226 +00:19:37,700 --> 00:19:43,920 +relocate أن العدسة مش جاعدة في مكانها الملائم أو + +227 +00:19:43,920 --> 00:19:47,600 +slow، طبعا ليش دائما بيصير اللي هو الـ creeping of + +228 +00:19:47,600 --> 00:19:51,520 +rotation، دائما هذه الحالة بيصير عندما تكون العدسة + +229 +00:19:51,520 --> 00:19:57,040 +steep، فاحنا كـ practitioner بنظن أن هي العدسة + +230 +00:19:57,040 --> 00:20:02,650 +ملائمة، لأن ما بنشوفش حركة كبيرة، تمام؟ إذا a + +231 +00:20:02,650 --> 00:20:07,550 +creeping of rotation or slow to relocate to + +232 +00:20:07,550 --> 00:20:12,010 +original position is an indication of a steep fit، + +233 +00:20:12,010 --> 00:20:15,770 +إذا دائما الـ creeping of rotation هذا بتديني + +234 +00:20:15,770 --> 00:20:19,450 +انطباع أن العدسة قد تكون اللي هو ايه؟ + +235 +00:20:26,360 --> 00:20:29,000 +يعني الآن لو وصلنا برا، ايش معنى؟ a creeping of + +236 +00:20:29,000 --> 00:20:35,480 +rotation بمعنى + +237 +00:20:35,480 --> 00:20:41,760 +أن دوران العدسة وعدم استقرارها في مكانها، If + +238 +00:20:41,760 --> 00:20:49,030 +vision clears momentarily with the blink، This may + +239 +00:20:49,030 --> 00:20:55,130 +indicate a steep fit، الآن المريض أول ما بلبس + +240 +00:20:55,130 --> 00:20:59,330 +العدسة لو حطيناها على الـ visual acuity smelling + +241 +00:20:59,330 --> 00:21:03,850 +chart أو الـ keratometer miyard أو مثلا الـ + +242 +00:21:03,850 --> 00:21:08,130 +retinascope reflex الوهلة الأولى ايش هيكون؟ مش + +243 +00:21:08,130 --> 00:21:12,790 +واضحة، بعد الترميش ايش هيصير؟ واضح تمام، هنا المقصود + +244 +00:21:12,790 --> 00:21:16,330 +فيها زي بالضبط مين؟ الـ spherical soft contact + +245 +00:21:16,330 --> 00:21:21,990 +lenses، طيب إذا كان العكس، يعني بمعنى آخر أن قبل + +246 +00:21:21,990 --> 00:21:26,030 +الترميش واضح وبعد الترميش غير واضح، طبعا للحظات يا + +247 +00:21:26,030 --> 00:21:29,890 +جماعة، شايفين كلمة momentary أي بمعنى للحظات أو + +248 +00:21:29,890 --> 00:21:39,710 +ثواني تمام؟ بيكون العدسة هي flat lens، أيضا + +249 +00:21:39,710 --> 00:21:45,620 +بدنا نستخدم الـ push up test، أنه بدي أعمل عملية ضغط + +250 +00:21:45,620 --> 00:21:50,040 +من الـ lower eyelid على العدسة، إذا والله العدسة + +251 +00:21:50,040 --> 00:21:54,840 +رجعت بعد أقل من واحد ثانية هذا بديني انطباع أن + +252 +00:21:54,840 --> 00:21:59,280 +العدسة ايه؟ ملائمة، إذا تأخرت في ذلك بديني أما + +253 +00:21:59,280 --> 00:22:04,420 +العدسة flat أو steep، أيضا موضوع ايش؟ عندنا الـ lag + +254 +00:22:04,420 --> 00:22:08,360 +on up gaze، في عندنا excessive movement، في عندنا الـ + +255 +00:22:08,360 --> 00:22:13,500 +normal من ثلاثة من عشرة لسبعة من عشرة مليمتر، Okay + +256 +00:22:17,360 --> 00:22:21,760 +أيضا written scopie should show a crisp clear + +257 +00:22:21,760 --> 00:22:27,080 +reflex if the base curve is correct، الآن before و + +258 +00:22:27,080 --> 00:22:31,120 +after بلينج، a crisp بمعنى clear واضح، يعني يكون + +259 +00:22:31,120 --> 00:22:35,040 +اللي هو bright لامع الـ red reflex إذا والله كان + +260 +00:22:35,040 --> 00:22:39,520 +قبل وبعد الترميش الـ red reflex واضح، إذا هذا + +261 +00:22:39,520 --> 00:22:43,660 +بتديني انطباع أن العدسة a proper fit أو a good fit + +262 +00:22:43,780 --> 00:22:48,160 +إذا كان قبل الترميش غير واضح وبعد الترميش صار + +263 +00:22:48,160 --> 00:22:52,700 +واضح، بتكون الـ steep والعكس صحيح في حالة الـ flat + +264 +00:22:52,700 --> 00:22:59,720 +written scopy can also help rule out over or under + +265 +00:23:04,760 --> 00:23:10,520 +في بعض الأحيان بيكون غير متوفر جهاز مين؟ الـ slit lamp + +266 +00:23:10,520 --> 00:23:16,040 +تمام، فبضع اللي هو الـ reflex بتاع الـ written score + +267 +00:23:16,040 --> 00:23:22,200 +موازي للساعة 6 وبشوف قد ايش قيمة اللي هو الـ rotation + +268 +00:23:22,200 --> 00:23:26,760 +سواء كانت للـ right أو للـ left، نفس الفكرة بالضبط للـ slit + +269 +00:23:26,760 --> 00:23:27,780 +lamp examination + +270 +00:23:31,540 --> 00:23:35,200 +طبعا بدنا نعمل اللي هو عملية تأكيد أو عملية تقييم + +271 +00:23:35,200 --> 00:23:39,880 +للـ rotation و ال stability وعرفنا ايش الفرق يا + +272 +00:23:39,880 --> 00:23:41,700 +رجال ما بين الـ rotation و ال stability + +273 +00:23:53,230 --> 00:23:56,550 +الـ rotation اللي هو حركة العدسة في الـ primary + +274 +00:23:56,550 --> 00:24:01,270 +position بينما عندنا الـ stability حركة العدسة بعد + +275 +00:24:01,270 --> 00:24:06,890 +اللي هو complete blinking، A different design may be + +276 +00:24:06,890 --> 00:24:10,870 +necessary يعني ممكن اختلاف التصميم ما بين الـ + +277 +00:24:10,870 --> 00:24:14,630 +dynamic stabilization أو الـ prism palace أو الـ ISO + +278 +00:24:14,630 --> 00:24:19,510 +profile thickness كل هذا بيكون ضروري له من حيث + +279 +00:24:19,510 --> 00:24:23,590 +اللي هو معرفة جديش قيمة اللي هو ال stability أو + +280 +00:24:23,590 --> 00:24:30,220 +جديش قيمة الـ rotation للعدسة، mostoric brands بمعنى + +281 +00:24:30,220 --> 00:24:38,980 +المصنعين للعدسات اللاصقة حاليًا even within the same + +282 +00:24:38,980 --> 00:24:43,020 +manufacturer will have different stability + +283 +00:24:43,020 --> 00:24:49,880 +features for each patient الآن أصبح الهم الشاغل + +284 +00:24:49,880 --> 00:24:56,240 +للمانوفاكتشرر أنه كيف يوفر different اللي هو designs + +285 +00:24:56,240 --> 00:24:58,260 +تمام لمختلف + +286 +00:25:00,350 --> 00:25:05,110 +هو أن تكون ثابتة و base curve ثابت بحيث أن الشخص + +287 +00:25:05,110 --> 00:25:09,910 +هذا غير ملائم له the six o'clock على طول يستخدم ال + +288 +00:25:09,910 --> 00:25:13,570 +three nine o'clock غير مناسب مثلًا ال three nine + +289 +00:25:13,570 --> 00:25:16,910 +اللي هي ال dynamic stabilization يستخدم ال ISO + +290 +00:25:16,910 --> 00:25:21,730 +thickness profile وهكذا تمام؟ يعني بمعنى آخر اللي + +291 +00:25:21,730 --> 00:25:26,710 +هو توفير عدسات بنفس ال power ونفس ال base curve و + +292 +00:25:26,710 --> 00:25:36,960 +تكون خواصها مختلفة أي ال lens design مختلف consider + +293 +00:25:36,960 --> 00:25:41,960 +power change in refraction or lens power effects + +294 +00:25:41,960 --> 00:25:47,900 +caused by flexure الآن أي تتغير في قوة العدسة أو + +295 +00:25:47,900 --> 00:25:51,900 +في ال base curve هذا بتديني انطباع أنه قد يكون هناك + +296 +00:25:51,900 --> 00:25:56,400 +تغير في نشأة العدسة أي بين جثتين ال lens design + +297 +00:25:56,400 --> 00:25:57,880 +تمام؟ + +298 +00:26:02,490 --> 00:26:07,270 +Okay. Affection أي بمعنى تغيير اللي هو في نشأة + +299 +00:26:07,270 --> 00:26:14,050 +العدسة of a soft toric lens can lead to unwanted + +300 +00:26:14,050 --> 00:26:19,630 +astigmatism. الآن أنا إذا استخدمت أنواع مختلفة أو + +301 +00:26:19,630 --> 00:26:25,550 +تصميمًا مختلفة من العدسات الـsoft toric ممكن تكون هي + +302 +00:26:25,550 --> 00:26:30,240 +غير قادرة على اكتشاف من الastigmatism لذلك فاكرين + +303 +00:26:30,240 --> 00:26:34,540 +كلام إيش قلت لكم؟ الـ corneal topography هو القادر + +304 +00:26:34,540 --> 00:26:38,460 +على اكتشاف اللي هو جداش الـ significant + +305 +00:26:38,460 --> 00:26:43,280 +astigmatism اللي موجود عند المريض An over + +306 +00:26:43,280 --> 00:26:47,460 +topography will show significant uncorrected + +307 +00:26:47,460 --> 00:26:52,720 +astigmatism. إذا الصحيح أي evaluation للعدسات ال + +308 +00:26:52,720 --> 00:26:56,700 +soft contact lenses لابد أن أستخدم بعد ما ألبس + +309 +00:26:56,700 --> 00:27:01,020 +المريض العدسة اللي هي over topography لأن هي قادرة + +310 +00:27:01,020 --> 00:27:05,660 +على اكتشاف أي كمية من ال astigmatism اللي بتكون + +311 +00:27:05,660 --> 00:27:11,480 +significant consider a flatter limbs, a thicker + +312 +00:27:11,480 --> 00:27:16,720 +design or different cylinder location طبعًا هان + +313 +00:27:16,720 --> 00:27:21,460 +المقصود بال different cylinder location أن يكون + +314 +00:27:21,460 --> 00:27:24,620 +قيمة السيلندر في ال back surface + +315 +00:27:29,720 --> 00:27:32,680 +مش إحنا اتفقنا أنه إما بيكون في ال front أو ال + +316 +00:27:32,680 --> 00:27:36,220 +back لكن في الغالب العدسات اللي موجودة عندنا كلها + +317 +00:27:36,220 --> 00:27:40,440 +في ال front لكن في بعض الحالات ممكن أنه يحتاج أنه + +318 +00:27:40,440 --> 00:27:47,100 +يكون وين الـ toric surface في ال back تمام؟ + +319 +00:27:47,100 --> 00:27:51,400 +Compromised + +320 +00:27:51,400 --> 00:27:57,590 +physiology is a concern as with spherical lenses كل + +321 +00:27:57,590 --> 00:28:02,530 +التأثيرات الفيسيولوجية اللي خاصة في العدسات الـ + +322 +00:28:02,530 --> 00:28:06,430 +spherical soft contact lens هي نفسها موجودة وين في + +323 +00:28:06,430 --> 00:28:10,130 +ال soft toric contact lenses أهمها مين؟ أن + +324 +00:28:10,130 --> 00:28:14,130 +العدسات ال spherical أو ال soft toric contact + +325 +00:28:14,130 --> 00:28:19,430 +lenses بتقلل من مين؟ من ال BH صح ولا لأ؟ إذا + +326 +00:28:19,430 --> 00:28:23,090 +أوليتها أن ال spherical + +327 +00:28:27,680 --> 00:28:37,560 +Soft Contact Lens أو الـ Soft Toric Contact + +328 +00:28:37,560 --> 00:28:42,960 +Lens بتعمل عملية Reduce لمين لل PH هذه تعتبر + +329 +00:28:42,960 --> 00:28:47,620 +من اللي هو التغيرات الفيسيولوجية اللي خاصة في مين + +330 +00:28:47,620 --> 00:28:55,740 +في الكورنيا تمام؟ complications include superior + +331 +00:28:55,740 --> 00:28:56,660 +limbal + +332 +00:29:00,860 --> 00:29:06,200 +الآن الملاحظ من خلال المعمل أن ال diameter بتاع ال + +333 +00:29:06,200 --> 00:29:10,060 +soft toric ال contact lenses أكبر من مين؟ من ال + +334 +00:29:10,060 --> 00:29:13,360 +spherical soft contact lens دائمًا لما بيكون ال + +335 +00:29:13,360 --> 00:29:17,260 +diameter أكبر إذا ممكن هيسبب لي إيش؟ superior + +336 +00:29:17,260 --> 00:29:21,160 +limbal keratoconjunctivitis أي بمعنى inflammation + +337 +00:29:21,160 --> 00:29:26,360 +للّقرنية و ال conjunctiva وين ال zone أو ال area + +338 +00:29:26,360 --> 00:29:31,730 +بتكون؟ في ال superior part تمام؟ والسبب أن large + +339 +00:29:31,730 --> 00:29:36,310 +lenses أو ال diameter اللي هي large diameter + +340 +00:29:36,310 --> 00:29:37,150 +lenses + +341 +00:29:43,530 --> 00:29:49,170 +و Conjunctival Indentation Tight Lenses الآن يما + +342 +00:29:49,170 --> 00:29:54,530 +بتكون العدسة قلنا ال movement للعدسة ال soft toric + +343 +00:29:54,530 --> 00:29:58,670 +contact lenses غالبًا هي أقل من ال spherical soft + +344 +00:29:58,670 --> 00:30:03,070 +contact lenses فهذه الشيء بتعمل suction للّقرنية + +345 +00:30:03,070 --> 00:30:08,390 +فبالتالي أنه ممكن قلنا من خواص العدسة ال + +346 +00:30:08,390 --> 00:30:12,730 +soft toric أنه بتكون quite أو very thin بالإضافة أن + +347 +00:30:12,730 --> 00:30:18,820 +steep فعندما تكون هي thin بتعمل إيه؟ أن suction + +348 +00:30:18,820 --> 00:30:25,240 +للّقرنية تمام؟ أو بتكون tight على الّقرنية soft + +349 +00:30:25,240 --> 00:30:28,880 +toric lenses have been reported to have a higher + +350 +00:30:28,880 --> 00:30:33,160 +incidence of edema or vessel enshrinement due to + +351 +00:30:33,160 --> 00:30:37,500 +the thickness of some lens designs دائمًا هذا النوع + +352 +00:30:37,500 --> 00:30:42,100 +من العدسات أنه بيزود من قيمة اللي هو نسبة حدوث + +353 +00:30:42,100 --> 00:30:46,940 +incidence أي بمعنى نسبة حدوث من الّقرنية القديمة + +354 +00:30:46,940 --> 00:30:54,560 +أيضًا بيعمل instrument أي بمعنى إنهاك للّقرنية + +355 +00:30:54,560 --> 00:30:59,780 +نتيجة اللي هو إيه اختلاف في سماكة اللي هو تصميم + +356 +00:30:59,780 --> 00:31:06,240 +هذا النوع من العدسات تمام؟ يعني بالسبب أن السماكة + +357 +00:31:06,240 --> 00:31:10,120 +بتكون مختلفة ما بين ال superior part و ال inferior + +358 +00:31:10,120 --> 00:31:15,020 +part فهذا هيسبب لإيش؟ أول حاجة أن superior + +359 +00:31:15,020 --> 00:31:20,280 +keratoconjunctivitis، اتنين هيسبب قرنية قديمة، + +360 +00:31:20,280 --> 00:31:23,900 +تلاتة هيسبب اللي هو ال instrument أو إنهاك لمين + +361 +00:31:23,900 --> 00:31:25,340 +للّقرنية + +362 +00:31:27,110 --> 00:31:32,190 +corneal inferior superior panectate keratitis لأنه + +363 +00:31:32,190 --> 00:31:36,250 +قلنا إنه ممكن في ال upper part أو ال lower part صح + +364 +00:31:36,250 --> 00:31:41,670 +لأنه في عندنا large diameter lens has also been + +365 +00:31:41,670 --> 00:31:46,370 +reported with the prism ballast lenses إذا أكثر + +366 +00:31:46,370 --> 00:31:51,730 +حاجة مصاحبة مع ال prism ballast إيش هو ال corneal + +367 +00:31:51,730 --> 00:31:56,550 +inferior superficial panectate keratitis ليش طيب؟ + +368 +00:31:59,430 --> 00:32:03,990 +ممتازة لأن ال graphite وين بيكون على الساعة ستة صح + +369 +00:32:03,990 --> 00:32:07,250 +ولا لأ؟ إذا هو بيكون في ال inferior part أو في ال + +370 +00:32:07,250 --> 00:32:14,010 +inferior zone فشكله بيكون هنا على الساعة ستة مين + +371 +00:32:14,010 --> 00:32:16,450 +اللي هو ال graphite تمام؟ + +372 +00:32:19,370 --> 00:32:24,590 +Consider silicon hydrogel torques a thinner design + +373 +00:32:24,590 --> 00:32:29,530 +or a thinner lens design or the possibility of a + +374 +00:32:29,530 --> 00:32:35,790 +GP lens إذا هان بدنا نستخدم اللي هو إيه ال silicon + +375 +00:32:35,790 --> 00:32:41,950 +فبليش هان بنستخدم ال silicon هادي واحد واتنين + +376 +00:32:41,950 --> 00:32:42,410 +كمان + +377 +00:32:46,680 --> 00:32:50,920 +بنزود اللي هو الوتابلاتي صحيح وفترة حياة العجزة + +378 +00:32:50,920 --> 00:32:57,980 +إيش مالها؟ بنزيد صح ولا لأ thinner lens design إذا + +379 +00:32:57,980 --> 00:33:02,160 +قللنا طبعًا هان لما أنا بدي أجيب thinner lens design + +380 +00:33:02,160 --> 00:33:06,660 +لابد اللي هو من تغيير إيش ال base curve يعني + +381 +00:33:06,660 --> 00:33:11,760 +بدي أجيب dynamic stabilization تمام؟ أو possibility + +382 +00:33:11,760 --> 00:33:16,640 +of a GP lens طب افرضه أنه ضال اللي هو الّقرنية + +383 +00:33:16,640 --> 00:33:21,380 +القديمة أو الـ panectate keratitis عند هذا البريده إذا + +384 +00:33:21,380 --> 00:33:25,920 +على طول بدي أغير اللي هو الخيار له لازم أجيب عدسة + +385 +00:33:25,920 --> 00:33:27,440 +اللي هو GP lenses + +386 +00:33:30,620 --> 00:33:34,340 +الآن لو إحنا غيرنا في ال features أو ال + +387 +00:33:34,340 --> 00:33:38,960 +characteristics لهذا النوع من العدسات ولاحظنا أن + +388 +00:33:38,960 --> 00:33:43,580 +المريض ما استجاب له بمعنى آخر أن أنا رحت بدل ما + +389 +00:33:43,580 --> 00:33:46,540 +استخدمت ال prism ballast جبت ده ال dynamic + +390 +00:33:46,540 --> 00:33:50,160 +stabilization لكن المريض ضال بعاني من الّقرنية + +391 +00:33:50,160 --> 00:33:54,080 +القديمة، ضال بعاني من الانشرامنت، ضال بعاني مثلًا + +392 +00:33:54,080 --> 00:33:57,600 +من موضوع اللي هو ال superficial panectoid + +393 +00:33:57,600 --> 00:34:00,980 +keratitis سواء كان في ال inferior part أو اللي هو + +394 +00:34:00,980 --> 00:34:03,780 +ال superior part في هذه الحالة إيش بدي أعمل؟ + +395 +00:34:04,270 --> 00:34:08,750 +التغيير اللي هو نوع العدسة هو الخيار إيه المناسب + +396 +00:34:08,750 --> 00:34:14,830 +طبعًا إن شاء الله هيك بنكون انتهينا من مادة العدسات + +397 +00:34:14,830 --> 00:34:20,010 +اللاصقة بتمنى إن شاء الله لكم التوفيق والنجاح إن + +398 +00:34:20,010 --> 00:34:22,610 +شاء الله في الامتحان النهائي diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/etEdmxN1t6Q_postprocess.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/etEdmxN1t6Q_postprocess.srt new file mode 100644 index 0000000000000000000000000000000000000000..2fa5821d42f5ad7dca773db23dff5e2e44652c60 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/etEdmxN1t6Q_postprocess.srt @@ -0,0 +1,1592 @@ +1 +00:00:24,380 --> 00:00:30,540 +أهلا و مرحبا لكم جميعًا سنكمل اليوم في موضوع + +2 +00:00:30,540 --> 00:00:36,020 +المشاكل و حلولها للعدسات ال soft red contact + +3 +00:00:36,020 --> 00:00:42,500 +lensesفي النقطة رقم 3 If a blurred vision is with + +4 +00:00:42,500 --> 00:00:46,680 +both eyes, you may consider if the lenses were + +5 +00:00:46,680 --> 00:00:51,880 +applied on the correct eye and then perform an + +6 +00:00:51,880 --> 00:00:57,220 +spherical cylindrical oval refractionالان نفترض ان + +7 +00:00:57,220 --> 00:01:01,860 +كان في عندي عين ال right eye normal و ال another + +8 +00:01:01,860 --> 00:01:07,040 +eye كانت abnormal تمام؟ و استخدمنا عدسة diagnostic + +9 +00:01:07,040 --> 00:01:12,080 +lens لل both eyesالان اما انا بستخدم لل both eyes + +10 +00:01:12,080 --> 00:01:16,620 +الرؤية هصير في العينتين ايه ال blurred vision طيب + +11 +00:01:16,620 --> 00:01:19,840 +نفترض انا مش عارف مين هي ال normal ومين هي ال + +12 +00:01:19,840 --> 00:01:23,460 +abnormal eye البساطة اللي بعمل spherical + +13 +00:01:23,460 --> 00:01:27,460 +cylindrical over refraction يعني بمعنى اخر بعمل + +14 +00:01:27,460 --> 00:01:33,090 +autoover للعبسة إذا و الله طلعت عندي قيمة سواء بال + +15 +00:01:33,090 --> 00:01:37,810 +plus أو بال minus بعرف إن هذه العين هي تعتبر + +16 +00:01:37,810 --> 00:01:41,950 +السليمة ال another eye إذا طلعت اللي هو القيمة + +17 +00:01:41,950 --> 00:01:46,110 +اللي لها plano أو insignificant power من حيث + +18 +00:01:46,110 --> 00:01:49,750 +الاسفير أو السيلندر بعرف إن هذه العين اللي فيها + +19 +00:01:49,750 --> 00:01:56,830 +أيه المشكلة تمام؟check vertex convergence from the + +20 +00:01:56,830 --> 00:02:01,730 +spectacle refraction to the corneal plane طيب + +21 +00:02:01,730 --> 00:02:08,330 +نفترض الآن أنا المريض طلع عند الوصفة minus 6 ع + +22 +00:02:08,330 --> 00:02:14,190 +minus 1 x مثلا 30 الخطوة الأولى إيش بدى أعمل؟ + +23 +00:02:23,510 --> 00:02:29,990 +بمعنى اعمل عملية تحويل لمن لالهو ال power الخاصة + +24 +00:02:29,990 --> 00:02:34,630 +بقيمة النضارة او الخاصة بال subjective refraction + +25 +00:02:34,630 --> 00:02:41,250 +in addition to rotation the next most common + +26 +00:02:41,250 --> 00:02:47,470 +errors are base gear fittingقلنا اول drawback + +27 +00:02:47,470 --> 00:02:52,170 +لعدسات ال software ال contact lenses هو موضوع ال + +28 +00:02:52,170 --> 00:02:57,770 +rotation تمام النقطة التانية ال base curveهى تعتبر + +29 +00:02:57,770 --> 00:03:03,210 +ال second most او ال next step تمام او ال error + +30 +00:03:03,210 --> 00:03:07,950 +اللى هو الخطأ التانى ايش لل drawback للعدسات اللى + +31 +00:03:07,950 --> 00:03:12,050 +هى ال soft direct contact lenses اذا مرة تانية in + +32 +00:03:12,050 --> 00:03:16,610 +addition to rotation the next او ال second most + +33 +00:03:16,610 --> 00:03:20,650 +most common errors are best care fitting + +34 +00:03:20,650 --> 00:03:26,120 +relationship and lens powerإذا عندنا المشكلة + +35 +00:03:26,120 --> 00:03:30,700 +التانية في عدسات ال soft rec contact lenses هي + +36 +00:03:30,700 --> 00:03:35,900 +عبارة عن مين ال base curve بيبلغال وصلنا السؤال هل + +37 +00:03:35,900 --> 00:03:40,580 +يمكن تقييم أو حساب قيمة ال base curve للعدسات ال + +38 +00:03:40,580 --> 00:03:45,380 +soft rec contact lenses ولا لأ كيف طيب اللي انا + +39 +00:03:45,380 --> 00:03:49,580 +مديتك عدسة soft rec contact lenses قلتلك احسبيه + +40 +00:03:49,580 --> 00:03:52,400 +لقداش أو قسيل ال base curve لها ممكن؟ + +41 +00:03:55,290 --> 00:04:03,530 +طبعا ال base curve لل soft trick من الصعب اللى هو + +42 +00:04:03,530 --> 00:04:09,670 +عملية قياسه تمام لكن انا ممكن كيف اتعرف من خلال ال + +43 +00:04:09,670 --> 00:04:15,270 +lens power ال lens power كيف انا بقيسه من خلال + +44 +00:04:15,270 --> 00:04:23,070 +اللى هو مثلا ال lensometerطبعا إذا مرة أخرى في + +45 +00:04:23,070 --> 00:04:27,730 +العدسات ال software contact lenses من الصعب التعرف + +46 +00:04:27,730 --> 00:04:33,490 +على ال base curve للعدسة لكن أنا ممكن أتعرف على ال + +47 +00:04:33,490 --> 00:04:37,770 +power parameter من خلال استخدام جهاز ال lensmeter + +48 +00:04:37,770 --> 00:04:38,770 +أو الفوسيمتر + +49 +00:04:41,420 --> 00:04:45,360 +إذا المشكلة التانية هي موضوع ال base curve يما + +50 +00:04:45,360 --> 00:04:49,060 +يكون خاطق التالتة عندنا مشكلة ال power يما يكون + +51 +00:04:49,060 --> 00:04:54,420 +فيها defect أو تكون غير صحيحةThe rotation and base + +52 +00:04:54,420 --> 00:04:58,080 +curve can be confirmed with the spherical + +53 +00:04:58,080 --> 00:05:02,280 +cylindrical over refraction ممكن انا بعمل عملية + +54 +00:05:02,280 --> 00:05:07,040 +confirmed اي بمعنى تأكيد لقيمة ال rotation و ال + +55 +00:05:07,040 --> 00:05:10,540 +base curve من خلال ال spherical cylindrical over + +56 +00:05:10,540 --> 00:05:15,460 +refraction كيف طيب؟الان انا يما بدي اجي بجيب اي + +57 +00:05:15,460 --> 00:05:21,200 +تشخص باخد له ال K1 و K2 و باخد R1 و R2فمن خلالها + +58 +00:05:21,200 --> 00:05:25,400 +انا بعرف مين ال base curve للشخص لكن للعدسة من + +59 +00:05:25,400 --> 00:05:32,840 +الصعب التعرف عليها تمام؟ if a good endpoint acuity + +60 +00:05:32,840 --> 00:05:38,320 +is not found consider the base curve lens design + +61 +00:05:38,320 --> 00:05:43,830 +or lens opticsالان احنا اعملنا diagnostic method + +62 +00:05:43,830 --> 00:05:48,290 +او ال trial method و لاحظنا ان ماوصلنا لافضل + +63 +00:05:48,290 --> 00:05:52,290 +visual acuity عند مين عند المريض في هذه الحالة + +64 +00:05:52,290 --> 00:05:57,400 +ممكن ان يكون عنده خلل في ال base curve للعدسةاتنين + +65 +00:05:57,400 --> 00:06:02,760 +في ال lens design تصميم العدسة أو ممكن ان يكون ايه + +66 +00:06:02,760 --> 00:06:09,460 +بالخواص البصرية لمين للعدسة يعني بمعنى اخر انا + +67 +00:06:09,460 --> 00:06:14,310 +مثلا استخدمت ال prism palestو المريض كان عنده عدم + +68 +00:06:14,310 --> 00:06:17,570 +القدرة على التحمل على اللي هو ال thickness في + +69 +00:06:17,570 --> 00:06:21,830 +المنطقة الساعة ستة فهان مش هيقدر يتعود على مين؟ + +70 +00:06:21,830 --> 00:06:25,270 +على العدسة فهان بده يكون مشكلة في مين؟ في ال lens + +71 +00:06:25,270 --> 00:06:29,890 +optics او مثلا واحد اديته dynamic stabilization و + +72 +00:06:29,890 --> 00:06:33,970 +عنده سعر في الساعة تلاتة أو تسعة مشكلة ايضا مش + +73 +00:06:33,970 --> 00:06:37,170 +هيقدر انه يتحمل العدسة تمام؟ + +74 +00:06:40,460 --> 00:06:45,480 +يعني في بعض الأحيان ممكن انا افكر في عملية اللي هو + +75 +00:06:45,480 --> 00:06:50,360 +تغير من ال lens design حتى ادي رؤية انه تكون + +76 +00:06:50,360 --> 00:06:55,280 +مناسبة او ملائمة للمريض و بالاضافة انه اصل لأفضل + +77 +00:06:55,280 --> 00:07:00,780 +اللي هو راحة لمين لل patient طيب stable blurred + +78 +00:07:00,780 --> 00:07:05,120 +vision اذا مدام stable اذا ايش هيكون؟ بشكل دائم + +79 +00:07:05,120 --> 00:07:10,920 +تمام؟ يعني ربش في الرؤية بشكل دائمWhen the patient + +80 +00:07:10,920 --> 00:07:15,700 +returns after wearing the lens for a short time + +81 +00:07:15,700 --> 00:07:23,360 +طيب، الآن المريض أول ما برتدي العدسة اللاصقة لفترة + +82 +00:07:23,360 --> 00:07:30,560 +زمنية قصيرة، بصير عنده إيش؟ غبش بشكل دائم، واضحة؟ + +83 +00:07:30,560 --> 00:07:35,260 +إذا عند ارتداء العدسة اللاصقة لفترة زمنية قصيرة، + +84 +00:07:35,260 --> 00:07:41,900 +المريض بيصبح عنده غبش بشكل دائمطيب في هذه الحالة + +85 +00:07:41,900 --> 00:07:46,380 +إيش بدى أعمل number one بدى أعمل review مراجعة لل + +86 +00:07:46,380 --> 00:07:50,280 +base curve لقيمة اللي هو ال base curve أو ال back + +87 +00:07:50,280 --> 00:07:56,880 +optic zone radius soft lenses may tighten with + +88 +00:07:56,880 --> 00:08:02,700 +wear and what appeared to be good fit may now be + +89 +00:08:02,700 --> 00:08:06,380 +tight causing irregular power effects or a + +90 +00:08:06,380 --> 00:08:11,000 +creeping of the rotationالان يما بتكون بعد ما انا + +91 +00:08:11,000 --> 00:08:15,680 +براجع ال base curve للعدسة و بده اشوفه هل هو صحيح + +92 +00:08:15,680 --> 00:08:20,800 +او خطأ ممكن في بعض الأحيان ان العدسة تكون tied + +93 +00:08:20,800 --> 00:08:25,440 +تمام؟ يعني بمعنى انه as he runs to the shape of + +94 +00:08:25,440 --> 00:08:29,780 +the cornea يعني اول ما بتحطيها على العين بتعمل + +95 +00:08:29,780 --> 00:08:34,380 +اللي هو suction اللي هو بتكون مصممة وين على السطح + +96 +00:08:34,380 --> 00:08:41,280 +القرانية للعينطيب، الآن أنا بدي أصل لإيش؟ لأفضل + +97 +00:08:41,280 --> 00:08:44,840 +اللي هو نتيجة أو أفضل power أو أفضل base curve + +98 +00:08:44,840 --> 00:08:50,320 +تمام؟ هذي ال step إيش بيعمل؟ ممكن إنه بيغير في + +99 +00:08:50,320 --> 00:08:54,260 +اللي هو القوة الملائمة للعدسة، يعني بمعنى آخر + +100 +00:08:54,260 --> 00:08:59,040 +المريض بده مثلا base curve سبعة و ستة أنا روحت + +101 +00:08:59,040 --> 00:09:03,120 +مثلا اديته base curve نفترض على سبيل المثال سبعة و + +102 +00:09:03,120 --> 00:09:07,150 +تسعةطيب الآن التغيير في ال base curve مش بيعمل على + +103 +00:09:07,150 --> 00:09:10,550 +تغيير ال power صح ولا لا؟ فإنما بتغير ال power + +104 +00:09:10,550 --> 00:09:14,750 +بيؤثر على قيمة العدسة الملائمة لمين لالمريض + +105 +00:09:14,750 --> 00:09:19,630 +وبالتالي إما يتغير ال power للعدسة أكيد هيعمل غبش + +106 +00:09:19,630 --> 00:09:24,610 +للرؤية تمام؟ يعني الآن لو سألتك سؤال إيش هي أسباب + +107 +00:09:24,610 --> 00:09:30,140 +اللي هو ال blurred vision؟عدم اللي هو رؤية بوضوح + +108 +00:09:30,140 --> 00:09:34,380 +منها ان القوة غير ملائمة او غير مناسبة للمريض صح + +109 +00:09:34,380 --> 00:09:39,060 +ولا لا او مثلا inverted اللي هو ان العلسة مقلوبة + +110 +00:09:39,060 --> 00:09:45,080 +صح ولا لا ممكن تعمل اللي هو blurred visionطيب الان + +111 +00:09:45,080 --> 00:09:49,460 +كلمة a creeping of the rotation ان العدسة بتدور + +112 +00:09:49,460 --> 00:09:54,260 +يعني بمعنى انه ما بتستقر في مكانها وما بتقدر تصل + +113 +00:09:54,260 --> 00:09:58,940 +لمرحلة او لمنطقة اللي هو الاستقرار يعني العدسة + +114 +00:09:58,940 --> 00:10:03,360 +بتبقى انه تعمل عملية rotation دون القدرة على + +115 +00:10:03,360 --> 00:10:07,260 +الاستقرار طبعا دايما انا بدى افكر مدام في هناك + +116 +00:10:07,260 --> 00:10:11,940 +rotation للعدسة اذا في مساوي لها ايش؟ اللي هو + +117 +00:10:11,940 --> 00:10:17,660 +stable blurred visionطبعا إذا دائما إعادة تحويل + +118 +00:10:17,660 --> 00:10:23,220 +دوران العدسة وعدم استقرارها بساوية مستقبلية و + +119 +00:10:23,220 --> 00:10:28,500 +مظهرة مظهرة طيب + +120 +00:10:28,500 --> 00:10:32,320 +بعض الأحيان بيكون مظهر مظهر مظهر مظهر مظهر مظهر + +121 +00:10:32,320 --> 00:10:34,500 +مظهر مظهر مظهر مظهر مظهر مظهر مظهر مظهر مظهر مظهر + +122 +00:10:34,500 --> 00:10:36,440 +مظهر مظهر مظهر مظهر مظهر مظهر مظهر مظهر مظهر مظهر + +123 +00:10:36,440 --> 00:10:36,700 +مظهر مظهر مظهر مظهر مظهر مظهر مظهر مظهر مظهر مظهر + +124 +00:10:36,700 --> 00:10:42,360 +مظهر مظهر مظهر مظهر م + +125 +00:10:47,290 --> 00:10:51,550 +بالضبط يعني بدى اجيب اللى هو عملية ايش انه اعكس + +126 +00:10:51,550 --> 00:10:56,270 +اللى هو العدسة تمام فاش بعمل طيب لما انا بعمل اللى + +127 +00:10:56,270 --> 00:11:01,170 +هو عكس العدسة بالضبط انه بعمل stable blurred + +128 +00:11:01,170 --> 00:11:06,430 +vision لمين؟ للمريض تمام مرة أخرى يا جماعة الآن + +129 +00:11:06,430 --> 00:11:10,910 +اما يكون انا عندى unilateral blurred vision اش بدى + +130 +00:11:10,910 --> 00:11:16,170 +اجيب؟ بدى اعمل عملية قلب للعدسةOkay فهيعمل اللي هو + +131 +00:11:16,170 --> 00:11:20,630 +stable blabbed vision من خلالها انا بعرف ان مين + +132 +00:11:20,630 --> 00:11:23,890 +اللي هو العين اللي فيها good ومين فيها ال bad + +133 +00:11:23,890 --> 00:11:24,350 +vision + +134 +00:11:29,360 --> 00:11:33,460 +Verify the rotation of the lens اذا انا بدي اعمل + +135 +00:11:33,460 --> 00:11:38,340 +عملية تأكيد لمين لدوران العدسة inconsistent + +136 +00:11:38,340 --> 00:11:43,600 +rotation يما يكون اللي هو بمعنى انه ال rotation + +137 +00:11:43,600 --> 00:11:50,440 +غير متعامد او غير متناقص غير اللي هو متنازم تمام + +138 +00:11:51,550 --> 00:11:57,410 +إذا هان عندنا inconsistent اللي هو rotation أي + +139 +00:11:57,410 --> 00:12:04,130 +بمعنى إن الدوران غير متناظم okay indicates either + +140 +00:12:04,130 --> 00:12:09,510 +a loose-fitting relationship or inappropriate lens + +141 +00:12:09,510 --> 00:12:16,850 +designعندما تكون قيمة الـ rotation غير متناقمة أو + +142 +00:12:16,850 --> 00:12:21,170 +غير ملائمة، يمكن أن العدسة تكون بطيئة، فمع أن + +143 +00:12:21,170 --> 00:12:26,150 +العدسة بطيئة، يعني بمعنى أنها تحتوي على عدسة محركة + +144 +00:12:26,150 --> 00:12:30,610 +عالية، أي مش ماخدة شكل القرنية أو ممكن أن تكون الـ + +145 +00:12:30,610 --> 00:12:35,660 +small diameter صح ولا لا؟فهان ان معنى الكلام بيحكي + +146 +00:12:35,660 --> 00:12:40,520 +لي ان ال lens design اللي خاص في العدسة غير ملائم + +147 +00:12:40,520 --> 00:12:45,720 +لهذا المريض لابد من تغيره ا try another base curve + +148 +00:12:45,720 --> 00:12:49,520 +or lens design في هذه الحالة انا بدي استخدم اللي + +149 +00:12:49,520 --> 00:12:53,360 +هو base curve اخر انه يكون steep base curve تمام + +150 +00:12:53,360 --> 00:12:56,340 +او بدي اغير كل تصميم ايش العدسة + +151 +00:13:00,920 --> 00:13:07,140 +Okay check lens for deposits or wetability الان ال + +152 +00:13:07,140 --> 00:13:10,480 +deposits اللي هي عبارة عن الترثبات اللي بتكون على + +153 +00:13:10,480 --> 00:13:14,440 +سطح العدسة بدي اشوف انه هل في هناك ترثبات على + +154 +00:13:14,440 --> 00:13:19,020 +العدسة ولا لأ ايضا بدي امسك اللي هو مرونة و ليونة + +155 +00:13:19,020 --> 00:13:23,160 +العدسة ال wetability تمام؟ بدي اشوفها جديش اللي هو + +156 +00:13:23,160 --> 00:13:29,500 +كمرونة للعدسة موجودة poor tear quality may prevent + +157 +00:13:36,730 --> 00:13:41,970 +الان انا شخص عنده dry eye تمام؟ مانفعش انا اروح + +158 +00:13:41,970 --> 00:13:46,230 +ادي ايش؟ high water content او moderate water + +159 +00:13:46,230 --> 00:13:51,830 +content تمام؟ لانه في هذه الحالة ايش هيعمل؟ هيسبب + +160 +00:13:51,830 --> 00:13:55,830 +اللي هو dry eye symptoms تمام؟ و هيعمل على + +161 +00:13:55,830 --> 00:14:02,680 +dehydrate اللي هو تبخر كل سطح من القرنيةأيضا عندنا + +162 +00:14:02,680 --> 00:14:08,080 +بيمنع اللي هو حركة ملائمة للعدسة، دايما العين لما + +163 +00:14:08,080 --> 00:14:14,060 +بيصير فيها نوع من الجفاف تمام، هذا بيؤدي إلى إعاقة + +164 +00:14:14,060 --> 00:14:19,420 +حركة العدسة داخل العين، يعني بمعنى أخر أنه ممكن + +165 +00:14:19,420 --> 00:14:24,880 +العدسة إحنا نطلع إليها إنه هي steep، و هي إنه تكون + +166 +00:14:24,880 --> 00:14:29,150 +إيش العدسة normalلكن مين اللي سبب هذا اللي هو ال + +167 +00:14:29,150 --> 00:14:34,650 +dry eye او تبخر اللي هو سطح العدسة ايضا هذا بيؤثر + +168 +00:14:34,650 --> 00:14:39,710 +على مين على ال rotation للعدسة دوران العدسة لذلك + +169 +00:14:39,710 --> 00:14:43,450 +دايما قلنا يا جماعة ان العدسة ال software contact + +170 +00:14:43,450 --> 00:14:48,570 +lenses اذا انا بدي استخدم اللي هو ideal evaluation + +171 +00:14:48,570 --> 00:14:54,780 +لازم انه يكون بعد جديش اسبوع من استخدام العدسةإذا + +172 +00:14:54,780 --> 00:14:59,200 +بعد السبوع أنه بديه عدسة تجربية يستخدمها بشكل اللي + +173 +00:14:59,200 --> 00:15:04,000 +هو يومي لحد ما أصل لأفضل اللي هو عدسة ملائمة + +174 +00:15:04,000 --> 00:15:11,640 +للمريض If this is the case consider a lens with a + +175 +00:15:11,640 --> 00:15:15,870 +different material, base curve or thicknessإذا + +176 +00:15:15,870 --> 00:15:19,890 +اتفقنا على موضوع ال lens material بدي أغيره إذا + +177 +00:15:19,890 --> 00:15:23,590 +والله المريض عنده dry eye بدي أستخدم معه low water + +178 +00:15:23,590 --> 00:15:28,770 +content اتنين عندنا موضوع ال base curve بدي أستخدم + +179 +00:15:28,770 --> 00:15:33,230 +ممكن flat base curve حسب يعني ما بتتطبيق اللي هو + +180 +00:15:33,230 --> 00:15:37,330 +الحالة ممكن مثلا ال thickness أنه أقلله بدل ما + +181 +00:15:37,330 --> 00:15:40,770 +أجيب اللي هو ال prism تالس أستخدم اللي هو ال + +182 +00:15:40,770 --> 00:15:42,190 +dynamic stabilization + +183 +00:15:47,160 --> 00:15:52,500 +Unstable blurred vision is usually an indicator + +184 +00:15:52,500 --> 00:15:58,100 +that the base curve or back optic zone radius is + +185 +00:15:58,100 --> 00:16:03,340 +not correct دايما احنا ك fitter او ك practitioner + +186 +00:16:03,340 --> 00:16:08,510 +بنظن ان المشكلة وين دايما؟ في البوارةدائما بنظن + +187 +00:16:08,510 --> 00:16:12,110 +احنا المشكلة وين في ال power في البداية لكن بعد + +188 +00:16:12,110 --> 00:16:17,090 +ذلك بتصلى لمرحلة انه بتعمل spherical cylindrical + +189 +00:16:17,090 --> 00:16:22,030 +over refraction و بتلاحظ انه قيمة zero و هو لابس + +190 +00:16:22,030 --> 00:16:26,090 +المريض العدسى على طول انا بده اروح وين ان هذا بدل + +191 +00:16:26,090 --> 00:16:29,390 +على انه ممكن يكون ال base curve هو اللي فيه + +192 +00:16:29,390 --> 00:16:34,790 +المشكلةدايما بتكون تعرفوا انه من خواص العدسة ال + +193 +00:16:34,790 --> 00:16:38,790 +software contact lenses انه بتكون number one steep + +194 +00:16:38,790 --> 00:16:42,770 +مقارنة في ال spherical soft contact lens و اتنين + +195 +00:16:42,770 --> 00:16:50,230 +بتكون thin تمام؟ اذا عندنا من خواص العدسة ال + +196 +00:16:50,230 --> 00:16:56,170 +software contact lenses مقارنة بال + +197 +00:16:56,170 --> 00:16:58,890 +spherical soft contact lens بتكون more + +198 +00:17:04,280 --> 00:17:12,920 +thin بالاضافة انه more steam اتنين هدول الخاصيتين + +199 +00:17:12,920 --> 00:17:16,980 +هدول خاصين في مين في ال software contact lenses + +200 +00:17:16,980 --> 00:17:23,160 +فدايما اي تغبش خاصة بعد ما اعمل ال over refraction + +201 +00:17:23,160 --> 00:17:27,120 +ممكن انه اشك انه عنده ال base curve غير صحيح + +202 +00:17:27,120 --> 00:17:28,600 +للعدسة تمام؟ + +203 +00:17:32,340 --> 00:17:38,700 +a loose fitting أي بمعنى flat lens may cause post + +204 +00:17:38,700 --> 00:17:45,660 +-blink blurring due to the lack of stability الآن + +205 +00:17:45,660 --> 00:17:51,900 +شخص عنده flat lens إذا في عندنا على طول إيش؟ + +206 +00:17:51,900 --> 00:17:55,100 +excessive movement الشغل التاني في عندنا small + +207 +00:17:55,100 --> 00:18:01,000 +diameter الشغل الأهم أنه عنده ال post tear + +208 +00:18:02,510 --> 00:18:10,050 +Lens بيكون إيش معله؟ Thin تمام؟ فهذه إيش بتعمل + +209 +00:18:10,050 --> 00:18:17,610 +unstability للعدسة inside the patient eye careful + +210 +00:18:17,610 --> 00:18:24,050 +evaluation التقيين بعناية is required of the lens + +211 +00:18:24,050 --> 00:18:29,640 +positionاذا لازم انا اشوف موقع العدسة وين انه هل + +212 +00:18:29,640 --> 00:18:33,540 +هي جاية مثلا على الساعة الستة ولا لأ او جاية على + +213 +00:18:33,540 --> 00:18:38,220 +الخمسة او عاملة rotation لل right او ال left and + +214 +00:18:38,220 --> 00:18:42,540 +ability to maintain position لازم انه احافظ على + +215 +00:18:42,540 --> 00:18:48,160 +ايش احافظ على حركة العدسة داخل العين بمعنى اخر انه + +216 +00:18:48,160 --> 00:18:53,520 +لازم اعمل rotation و stability للعدسة inside of + +217 +00:18:53,520 --> 00:18:59,180 +the patient eyeAs the eye moves from side to side + +218 +00:18:59,180 --> 00:19:03,240 +دايما في موضوع ال movement ماباعتمد فقط على ال + +219 +00:19:03,240 --> 00:19:07,580 +vertical movement وإن كانت هي الأصل أيضا في عنه + +220 +00:19:07,580 --> 00:19:11,880 +حاجة ال horizontal movement يعني from side to side + +221 +00:19:11,880 --> 00:19:17,180 +أو nasal to temporal okay and post bling وإحنا + +222 +00:19:17,180 --> 00:19:21,280 +اتفقنا إن ال post tear lens بيكون اللي هو thin في + +223 +00:19:21,280 --> 00:19:24,060 +حالة ما تكون العدسة flat أو loose + +224 +00:19:28,660 --> 00:19:33,640 +A creeping of rotation اي بمعنى انه عدم استقرار + +225 +00:19:33,640 --> 00:19:37,700 +العدسة في مكانها يعني بمعنى اخر انه في هناك + +226 +00:19:37,700 --> 00:19:43,920 +relocate ان العدسة مش جاعدة في مكانها الملائمة او + +227 +00:19:43,920 --> 00:19:47,600 +slow طبعا ليش دايما بيصير اللي هو ال creeping of + +228 +00:19:47,600 --> 00:19:51,520 +rotation دايما هذه الحالة بيصير عندما تكون العدسة + +229 +00:19:51,520 --> 00:19:57,040 +steam فاحنا ك practitioner بنظن ان هي العدسة + +230 +00:19:57,040 --> 00:20:02,650 +ملائمةلأنه مابنشوفش حركة كبيرة، تمام؟ اذا a + +231 +00:20:02,650 --> 00:20:07,550 +creeping of rotation or slow to relocate to + +232 +00:20:07,550 --> 00:20:12,010 +original position is an indication of a steep fit، + +233 +00:20:12,010 --> 00:20:15,770 +اذا دايما ال creeping of rotation هذا بتديني + +234 +00:20:15,770 --> 00:20:19,450 +انطباع ان العدفة قد تكون اللي هو ايه؟ + +235 +00:20:26,360 --> 00:20:29,000 +يعني الآن لو وصلنا برا، إيش معنى؟ a creeping of + +236 +00:20:29,000 --> 00:20:35,480 +rotation بمعنى + +237 +00:20:35,480 --> 00:20:41,760 +أنه دوران العدسة وعدم استقرارها في مكانها. If + +238 +00:20:41,760 --> 00:20:49,030 +vision eclares momentarily with the blinkThis may + +239 +00:20:49,030 --> 00:20:55,130 +indicate a steep fit.الان المريض اول ما بلبس + +240 +00:20:55,130 --> 00:20:59,330 +العدسة لو حطناها على ال visual acuity smelling + +241 +00:20:59,330 --> 00:21:03,850 +chart او ال keratometer ميارد او مثلا ال + +242 +00:21:03,850 --> 00:21:08,130 +retinascope reflex الوهلة الاولى ايش هيكون مش + +243 +00:21:08,130 --> 00:21:12,790 +واضحة بعد الترميش ايش هيصير واضح تمام هان المقصود + +244 +00:21:12,790 --> 00:21:16,330 +فيها زي بالضبط مين ال spherical soft contact + +245 +00:21:16,330 --> 00:21:21,990 +lensesطيب اذا كان العكس يعني بمعنى اخر انه قبل + +246 +00:21:21,990 --> 00:21:26,030 +الترميش واضح وبعد الترميش غير واضح طبعا للحظات يا + +247 +00:21:26,030 --> 00:21:29,890 +جماعة شايفين كلمة momentary اي بمعنى للحظات او + +248 +00:21:29,890 --> 00:21:39,710 +ثواني تمام؟ بيكون العدسة هي flat lens ايضا + +249 +00:21:39,710 --> 00:21:45,620 +بدنا نستخدم ال push up testانه بدي اعمل عملية ضغط + +250 +00:21:45,620 --> 00:21:50,040 +من ال lower eyelid على العدسة اذا والله العدسة + +251 +00:21:50,040 --> 00:21:54,840 +رجعت بعد اقل من واحد ثانية هذا بديني انطباع ان + +252 +00:21:54,840 --> 00:21:59,280 +العدسة ايه ملائمة اذا اتأخرت في ذلك بديني اما + +253 +00:21:59,280 --> 00:22:04,420 +العدسة flat او steep ايضا موضوع ايش؟ عندنا ال lag + +254 +00:22:04,420 --> 00:22:08,360 +on up gaze في عندنا excessive movement في عندنا ال + +255 +00:22:08,360 --> 00:22:13,500 +normal من تلاتة من عشراء لسبعة من عشراء مليمترOkay + +256 +00:22:17,360 --> 00:22:21,760 +أيضا written scopie should show a crisp clear + +257 +00:22:21,760 --> 00:22:27,080 +reflex if the base curve is correct الان before و + +258 +00:22:27,080 --> 00:22:31,120 +after بلينج a crisp بمعنى clear واضح يعني يكون + +259 +00:22:31,120 --> 00:22:35,040 +اللي هو bright لامع ال red reflex إذا والله كان + +260 +00:22:35,040 --> 00:22:39,520 +قبل و بعد الترميش ال red reflex واضح إذا هذا + +261 +00:22:39,520 --> 00:22:43,660 +بتديني انطباع أن العدسة a proper fit أو a good fit + +262 +00:22:43,780 --> 00:22:48,160 +إذا كان قبل الترميش غير واضح و بعد الترميش صار + +263 +00:22:48,160 --> 00:22:52,700 +واضح، بتكون الـ steep و العكس صحيح في حالة ال flat + +264 +00:22:52,700 --> 00:22:59,720 +written scopy can also help rule out over or under + +265 +00:23:04,760 --> 00:23:10,520 +في بعض الأحيان بيكون غير متوفر جهاز مين للست لام + +266 +00:23:10,520 --> 00:23:16,040 +تمام فبضع اللي هو ال reflex بتاع ال written score + +267 +00:23:16,040 --> 00:23:22,200 +موازي للساعة 6 وبشوف قداش قيمة اللي هو ال rotation + +268 +00:23:22,200 --> 00:23:26,760 +سواء كانت لل right أو لل left نفس فكرة بالضبط للست + +269 +00:23:26,760 --> 00:23:27,780 +لام examination + +270 +00:23:31,540 --> 00:23:35,200 +طبعاً بدنا نعمل اللي هو عملية تأكيد أو عملية تقييم + +271 +00:23:35,200 --> 00:23:39,880 +للـ rotation و ال stability و عرفنا إيش الفرق يا + +272 +00:23:39,880 --> 00:23:41,700 +راج ما بين ال rotation و ال stability + +273 +00:23:53,230 --> 00:23:56,550 +الـ rotation اللي هو حركة العدسة في ال primary + +274 +00:23:56,550 --> 00:24:01,270 +position بينما عندنا ال stability حركة العدسة بعد + +275 +00:24:01,270 --> 00:24:06,890 +اللي هو complete blinkingA different design may be + +276 +00:24:06,890 --> 00:24:10,870 +necessary يعني ممكن اختلاف التصميم ما بين ال + +277 +00:24:10,870 --> 00:24:14,630 +dynamic stabilization او ال prism palace او ال ISO + +278 +00:24:14,630 --> 00:24:19,510 +profile thickness كل هذا بيكون ضروري له من حيث + +279 +00:24:19,510 --> 00:24:23,590 +اللي هو معرفة جديش قيمة اللي هو ال stability او + +280 +00:24:23,590 --> 00:24:30,220 +جديش قيمة ال rotation للعدسةmostoric brands بمعنى + +281 +00:24:30,220 --> 00:24:38,980 +المصنعين للعدسات اللاصقة حالياeven within the same + +282 +00:24:38,980 --> 00:24:43,020 +manufacturer will have different stability + +283 +00:24:43,020 --> 00:24:49,880 +features for each patient الان أصبح الهم الشاغل + +284 +00:24:49,880 --> 00:24:56,240 +للمانيفكشير انه كيف يوفر different اللي هو designs + +285 +00:24:56,240 --> 00:24:58,260 +تمام لمختلف + +286 +00:25:00,350 --> 00:25:05,110 +هو انه تكون ثابتة و base curve ثابت بحيث ان الشخص + +287 +00:25:05,110 --> 00:25:09,910 +هذا غير ملائم له ال six o'clock على طول يستخدم ال + +288 +00:25:09,910 --> 00:25:13,570 +three nine o'clock غير مناسب مثلا ال three nine + +289 +00:25:13,570 --> 00:25:16,910 +اللي هي ال dynamic stabilization يستخدم ال ISO + +290 +00:25:16,910 --> 00:25:21,730 +thickness profile و هكذا تمام؟ يعني بمعنى اخر اللي + +291 +00:25:21,730 --> 00:25:26,710 +هو توفير عدسات بنفس ال power و نفس ال base curve و + +292 +00:25:26,710 --> 00:25:36,960 +تكون خواصة مختلفةأي ال lens design مختلف consider + +293 +00:25:36,960 --> 00:25:41,960 +power change in refraction or lens power effects + +294 +00:25:41,960 --> 00:25:47,900 +caused by flexure الآن أي تتغير في قوة العدسة أو + +295 +00:25:47,900 --> 00:25:51,900 +في ال base gear هذا بتديني انطباع أنه قد يكون هناك + +296 +00:25:51,900 --> 00:25:56,400 +تغير في نشأة العدسة أي بين جثين ال lens design + +297 +00:25:56,400 --> 00:25:57,880 +تمام؟ + +298 +00:26:02,490 --> 00:26:07,270 +Okay. Affliction أي بمعنى تغيير اللي هو في نشأة + +299 +00:26:07,270 --> 00:26:14,050 +العدسة of a sophtoric lens can lead to unwanted + +300 +00:26:14,050 --> 00:26:19,630 +astigmatism.الآن أنا إذا استخدم أنواع مختلفة أو + +301 +00:26:19,630 --> 00:26:25,550 +تصميم مختلفة من العدسات الـsophtoric ممكن تكون هي + +302 +00:26:25,550 --> 00:26:30,240 +غير قادرة على اكتشاف من الastigmatismلذلك فاكرين + +303 +00:26:30,240 --> 00:26:34,540 +كلام ايش قلتلكم؟ الـ corneal topography هو القادر + +304 +00:26:34,540 --> 00:26:38,460 +على اكتشاف اللي هو جداش الـ significant + +305 +00:26:38,460 --> 00:26:43,280 +astigmatism اللي موجود عند المريضAn over + +306 +00:26:43,280 --> 00:26:47,460 +topography will show significant uncorrected + +307 +00:26:47,460 --> 00:26:52,720 +astigmatism.إذا الصحيح أي evaluation للعدسات ال + +308 +00:26:52,720 --> 00:26:56,700 +software contact lenses لابد أن أستخدم بعد ما ألبس + +309 +00:26:56,700 --> 00:27:01,020 +المريض العدسة اللي هي over topography لأن هي قادرة + +310 +00:27:01,020 --> 00:27:05,660 +على اكتشاف أي كمية من ال astigmatism اللي بتكون + +311 +00:27:05,660 --> 00:27:11,480 +significantconsider a flatter limbs, a thicker + +312 +00:27:11,480 --> 00:27:16,720 +design or different cylinder location طبعا هان + +313 +00:27:16,720 --> 00:27:21,460 +المقصود بال different cylinder location ان يكون + +314 +00:27:21,460 --> 00:27:24,620 +قيمة السلمدر في ال back surface + +315 +00:27:29,720 --> 00:27:32,680 +مش احنا اتفقنا انه اما بيكون فى ال front او ال + +316 +00:27:32,680 --> 00:27:36,220 +back لكن فى الغالب العدسات اللى موجودة عندنا كلها + +317 +00:27:36,220 --> 00:27:40,440 +فى ال front لكن فى بعض الحالات ممكن انه يحتاج انه + +318 +00:27:40,440 --> 00:27:47,100 +يكون وين ال ال tourique surface فى ال back تمام؟ + +319 +00:27:47,100 --> 00:27:51,400 +Compromised + +320 +00:27:51,400 --> 00:27:57,590 +physiology is a concern as with spherical lensesكل + +321 +00:27:57,590 --> 00:28:02,530 +التأثيرات الفيسيولوجية اللي خاصة في العدسات الـ + +322 +00:28:02,530 --> 00:28:06,430 +spherical soft contact lens هي نفسها موجودة وين في + +323 +00:28:06,430 --> 00:28:10,130 +ال soft direct contact lenses أهمها مين؟ ان + +324 +00:28:10,130 --> 00:28:14,130 +العدسات ال spherical او ال soft direct contact + +325 +00:28:14,130 --> 00:28:19,430 +lenses بتقلل من مين؟ من ال BH صح ولا لأ؟ اذا + +326 +00:28:19,430 --> 00:28:23,090 +اوليتها ان ال spherical + +327 +00:28:27,680 --> 00:28:37,560 +Soft Contact Lens أو الـ Soft Rec Contact + +328 +00:28:37,560 --> 00:28:42,960 +Lens بتعمل عملية Reduce لمين لل بي اتش هذه تعتبر + +329 +00:28:42,960 --> 00:28:47,620 +من اللي هو التغيرات الفيسيولوجية اللي خاصة في مين + +330 +00:28:47,620 --> 00:28:55,740 +في الكورنيا تمام؟ complications include superior + +331 +00:28:55,740 --> 00:28:56,660 +limbal + +332 +00:29:00,860 --> 00:29:06,200 +الان الملاحظ من خلال المعمل ان ال diameter بتاع ال + +333 +00:29:06,200 --> 00:29:10,060 +software ال contact lenses اكبر من مين؟ من ال + +334 +00:29:10,060 --> 00:29:13,360 +spherical soft contact lens دايما لما بيكون ال + +335 +00:29:13,360 --> 00:29:17,260 +diameter اكبر اذا ممكن هيسببلي ايش؟ superior + +336 +00:29:17,260 --> 00:29:21,160 +limbal keratoconjunctivitis اي بمعنى inflammation + +337 +00:29:21,160 --> 00:29:26,360 +للكورنية و ال conjunctiva وين ال zone او ال area + +338 +00:29:26,360 --> 00:29:31,730 +بتكون؟ في ال superior part تمام؟والسبب انه large + +339 +00:29:31,730 --> 00:29:36,310 +lenses او ال diameter اللي هي large diameter + +340 +00:29:36,310 --> 00:29:37,150 +lenses + +341 +00:29:43,530 --> 00:29:49,170 +و Conjunctival Indentation Tight Lenses الان يما + +342 +00:29:49,170 --> 00:29:54,530 +بتكون العدسة قولنا ال movement للعدسة ال soft rec + +343 +00:29:54,530 --> 00:29:58,670 +contact lenses غالبا هي اقل من ال spherical soft + +344 +00:29:58,670 --> 00:30:03,070 +contact lenses فهذه الشي بتعمل suction لالهو + +345 +00:30:03,070 --> 00:30:08,390 +الكورنية فبالتالي انه ممكن قولنا من خواص العدسة ال + +346 +00:30:08,390 --> 00:30:12,730 +soft rec انه بتكون quite او very thin بالاضافة انه + +347 +00:30:12,730 --> 00:30:18,820 +steepفعندما تكون هى thin بتعمل ايه؟ انه suction + +348 +00:30:18,820 --> 00:30:25,240 +للكورنية تمام؟ او بتكون tight على الكورنية soft + +349 +00:30:25,240 --> 00:30:28,880 +reclinses have been reported to have a higher + +350 +00:30:28,880 --> 00:30:33,160 +incidence of edema or vessel enshrinement due to + +351 +00:30:33,160 --> 00:30:37,500 +the thickness of some lens designsدايما هذا النوع + +352 +00:30:37,500 --> 00:30:42,100 +من العدسات انه بيزود من قيمة اللي هو نسبة حدوث + +353 +00:30:42,100 --> 00:30:46,940 +incidence اي بمعنى نسبة حدوث من الكورنية القديمة + +354 +00:30:46,940 --> 00:30:54,560 +ايضا بيعمل instrument اي بمعنى انهاج للكورنية + +355 +00:30:54,560 --> 00:30:59,780 +نتيجة اللي هو ايه اختلاف في سماكة اللي هو تصميم + +356 +00:30:59,780 --> 00:31:06,240 +هذا النوع من العدساتتمام؟ يعني بالسبب انه السماكة + +357 +00:31:06,240 --> 00:31:10,120 +بتكون مختلفة ما بين ال superior part و ال inferior + +358 +00:31:10,120 --> 00:31:15,020 +part فهذا هيسبب لإيش؟ اول حاجة انه superior + +359 +00:31:15,020 --> 00:31:20,280 +keratoconjunctivitis، اتنين هيسبب كورنية القديمة، + +360 +00:31:20,280 --> 00:31:23,900 +تلاتة هيسبب اللي هو ال instrument او انهاك لمين + +361 +00:31:23,900 --> 00:31:25,340 +للكورنية + +362 +00:31:27,110 --> 00:31:32,190 +corneal inferior superior panectate keratitis لأنه + +363 +00:31:32,190 --> 00:31:36,250 +قلنا إنه ممكن في ال upper part أو ال lower part صح + +364 +00:31:36,250 --> 00:31:41,670 +لأنه في عندنا large diameter lens has also been + +365 +00:31:41,670 --> 00:31:46,370 +reported with the prism palace lenses إذا أكتر + +366 +00:31:46,370 --> 00:31:51,730 +حاجة مصاحبة مع ال prism palace إيش هو ال corneal + +367 +00:31:51,730 --> 00:31:56,550 +inferior superficial panectate keratitis ليش طيب؟ + +368 +00:31:59,430 --> 00:32:03,990 +ممتازة لأن ال graphite وين بيكون على الساعة ستة صح + +369 +00:32:03,990 --> 00:32:07,250 +ولا لأ؟ إذا هو بيكون في ال inferior part أو في ال + +370 +00:32:07,250 --> 00:32:14,010 +inferior zone فشكلتها بيكون هنا على الساعة ستة مين + +371 +00:32:14,010 --> 00:32:16,450 +اللي هو ال graphite تمام؟ + +372 +00:32:19,370 --> 00:32:24,590 +Consider silicon hydrogel turques a thinner design + +373 +00:32:24,590 --> 00:32:29,530 +or a thinner lens design or the possibility of a + +374 +00:32:29,530 --> 00:32:35,790 +GB lens اذا هان بدنا نستخدم اللي هو ايه ال silicon + +375 +00:32:35,790 --> 00:32:41,950 +فبليش هان بنستخدم ال silicon هادي واحد و اتنين + +376 +00:32:41,950 --> 00:32:42,410 +كمان + +377 +00:32:46,680 --> 00:32:50,920 +بنزود اللي هو الوتابلاتي صحيح وفترة حياة العجزة + +378 +00:32:50,920 --> 00:32:57,980 +ايش مالها؟ بنزيد صح ولا لا اثنر لينز ديزاين اذا + +379 +00:32:57,980 --> 00:33:02,160 +انقللنا طبعا هان لما انا بده اجيب اثنر لينز ديزاين + +380 +00:33:02,160 --> 00:33:06,660 +لابد اللي هو من تغيير ايش ال بريزين باليست يعني + +381 +00:33:06,660 --> 00:33:11,760 +بده اجيب dynamic stabilizationتمام؟ او possibility + +382 +00:33:11,760 --> 00:33:16,640 +of a gb lens طب افرضه انه ضال اللي هو الكوارديا + +383 +00:33:16,640 --> 00:33:21,380 +القديمة او البانكتيت كيراتايتس عند هذا البريد اذا + +384 +00:33:21,380 --> 00:33:25,920 +على طول بدي اغير اللي هو الخيار له لازم اجيب عدسة + +385 +00:33:25,920 --> 00:33:27,440 +اللي هو gb lenses + +386 +00:33:30,620 --> 00:33:34,340 +الان لو احنا غيرنا في ال features او ال + +387 +00:33:34,340 --> 00:33:38,960 +characteristics لهذا النوع من العدسات و لاحظنا ان + +388 +00:33:38,960 --> 00:33:43,580 +المريض ما استجابله بمعنى اخر انه انا روحت بدل ما + +389 +00:33:43,580 --> 00:33:46,540 +استخدمت ال prison palace جيب ده ال dynamic + +390 +00:33:46,540 --> 00:33:50,160 +stabilizationلكن المريض ضال بعاني من القرنية + +391 +00:33:50,160 --> 00:33:54,080 +القديمة، ضال بعاني من الانشرامنت، ضال بعاني مثلا + +392 +00:33:54,080 --> 00:33:57,600 +من موضوع اللي هو ال superfacial panectoid + +393 +00:33:57,600 --> 00:34:00,980 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"probability": 0.775634765625}, {"start": 229.58, "end": 230.04, "word": " لقداش", "probability": 0.666259765625}, {"start": 230.04, "end": 230.26, "word": " أو", "probability": 0.595703125}, {"start": 230.26, "end": 230.62, "word": " قسيل", "probability": 0.8597005208333334}, {"start": 230.62, "end": 230.78, "word": " ال", "probability": 0.97802734375}, {"start": 230.78, "end": 231.02, "word": " base", "probability": 0.89404296875}, {"start": 231.02, "end": 231.32, "word": " curve", "probability": 0.96533203125}, {"start": 231.32, "end": 231.66, "word": " لها", "probability": 0.6795654296875}, {"start": 231.66, "end": 232.4, "word": " ممكن؟", "probability": 0.9073893229166666}], "temperature": 1.0}, {"id": 11, "seek": 25727, "start": 235.29, "end": 257.27, "text": "طبعا ال base curve لل soft trick من الصعب اللى هو عملية قياسه تمام لكن انا ممكن كيف اتعرف من خلال ال lens power ال lens power كيف انا بقيسه من خلال اللى هو مثلا ال lensometer", "tokens": [9566, 3555, 3615, 995, 2423, 3096, 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"end": 278.01, "word": " أو", "probability": 0.7587890625}, {"start": 278.01, "end": 278.77, "word": " الفوسيمتر", "probability": 0.745947265625}], "temperature": 1.0}, {"id": 13, "seek": 29136, "start": 281.42, "end": 291.36, "text": "إذا المشكلة التانية هي موضوع ال base curve يما يكون خاطق التالتة عندنا مشكلة ال power يما يكون فيها defect أو تكون غير صحيحة", "tokens": [28814, 15730, 9673, 8592, 28820, 3660, 16712, 7649, 10632, 39896, 3714, 2407, 11242, 45367, 2423, 3096, 7605, 7251, 15042, 7251, 30544, 16490, 41193, 4587, 16712, 6027, 2655, 3660, 43242, 8315, 37893, 28820, 3660, 2423, 1347, 7251, 15042, 7251, 30544, 8978, 11296, 16445, 34051, 6055, 30544, 32771, 13546, 20328, 5016, 1829, 5016, 3660], "avg_logprob": -0.1223466969885916, "compression_ratio": 1.474820143884892, "no_speech_prob": 0.0, "words": [{"start": 281.42, "end": 281.68, "word": "إذا", "probability": 0.6689453125}, {"start": 281.68, "end": 282.32, "word": " المشكلة", "probability": 0.9898681640625}, {"start": 282.32, "end": 282.86, "word": " التانية", "probability": 0.9637044270833334}, {"start": 282.86, "end": 283.26, "word": " هي", "probability": 0.9404296875}, {"start": 283.26, "end": 283.88, "word": " موضوع", "probability": 0.9603271484375}, {"start": 283.88, "end": 284.24, "word": " ال", "probability": 0.95068359375}, {"start": 284.24, "end": 284.48, "word": " base", "probability": 0.27880859375}, {"start": 284.48, "end": 284.92, "word": " curve", "probability": 0.95849609375}, {"start": 284.92, "end": 285.36, "word": " يما", "probability": 0.5811767578125}, {"start": 285.36, "end": 285.7, "word": " يكون", "probability": 0.993408203125}, {"start": 285.7, "end": 286.18, "word": " خاطق", "probability": 0.8971354166666666}, {"start": 286.18, "end": 287.04, "word": " التالتة", "probability": 0.9027099609375}, {"start": 287.04, "end": 287.32, "word": " عندنا", "probability": 0.7724609375}, {"start": 287.32, "end": 287.84, "word": " مشكلة", "probability": 0.9856770833333334}, {"start": 287.84, "end": 288.04, "word": " ال", "probability": 0.919921875}, {"start": 288.04, "end": 288.38, "word": " power", "probability": 0.919921875}, {"start": 288.38, "end": 288.76, "word": " يما", "probability": 0.886474609375}, {"start": 288.76, "end": 289.06, "word": " يكون", "probability": 0.9873046875}, {"start": 289.06, "end": 289.42, "word": " فيها", "probability": 0.986572265625}, {"start": 289.42, "end": 289.84, "word": " defect", "probability": 0.96337890625}, {"start": 289.84, "end": 290.18, "word": " أو", "probability": 0.6689453125}, {"start": 290.18, "end": 290.5, "word": " تكون", "probability": 0.966552734375}, {"start": 290.5, "end": 290.76, "word": " غير", "probability": 0.994873046875}, {"start": 290.76, "end": 291.36, "word": " صحيحة", "probability": 0.99375}], "temperature": 1.0}, {"id": 14, "seek": 32004, "start": 292.78, "end": 320.04, "text": "The rotation and base curve can be confirmed with the spherical cylindrical over refraction ممكن انا بعمل عملية confirmed اي بمعنى تأكيد لقيمة ال rotation و ال base curve من خلال ال spherical cylindrical over refraction كيف طيب؟الان انا يما بدي اجي بجيب اي تشخص باخد له ال K1 و K2 و باخد R1 و R2", "tokens": [2278, 12447, 293, 3096, 7605, 393, 312, 11341, 365, 264, 37300, 28044, 15888, 670, 1895, 26766, 3714, 43020, 1975, 8315, 4724, 25957, 1211, 6225, 42213, 10632, 11341, 1975, 1829, 4724, 2304, 3615, 1863, 7578, 6055, 10721, 4117, 25708, 5296, 4587, 32640, 3660, 2423, 12447, 4032, 2423, 3096, 7605, 9154, 16490, 1211, 6027, 2423, 37300, 28044, 15888, 670, 1895, 26766, 9122, 33911, 23032, 1829, 3555, 22807, 6027, 7649, 1975, 8315, 7251, 15042, 4724, 16254, 1975, 7435, 1829, 4724, 7435, 1829, 3555, 1975, 1829, 6055, 8592, 9778, 9381, 4724, 47283, 3215, 46740, 2423, 591, 16, 4032, 591, 17, 4032, 4724, 47283, 3215, 497, 16, 4032, 497, 17], "avg_logprob": -0.17791863530874252, "compression_ratio": 1.706140350877193, "no_speech_prob": 0.0, "words": [{"start": 292.78, "end": 293.0, "word": "The", "probability": 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{"start": 299.3, "end": 299.96, "word": " refraction", "probability": 0.6741943359375}, {"start": 299.96, "end": 300.98, "word": " ممكن", "probability": 0.81787109375}, {"start": 300.98, "end": 301.26, "word": " انا", "probability": 0.742919921875}, {"start": 301.26, "end": 301.66, "word": " بعمل", "probability": 0.9231770833333334}, {"start": 301.66, "end": 302.28, "word": " عملية", "probability": 0.9892578125}, {"start": 302.28, "end": 302.94, "word": " confirmed", "probability": 0.841796875}, {"start": 302.94, "end": 303.28, "word": " اي", "probability": 0.59063720703125}, {"start": 303.28, "end": 303.74, "word": " بمعنى", "probability": 0.98359375}, {"start": 303.74, "end": 304.36, "word": " تأكيد", "probability": 0.9927978515625}, {"start": 304.36, "end": 305.22, "word": " لقيمة", "probability": 0.956787109375}, {"start": 305.22, "end": 305.42, "word": " ال", "probability": 0.97607421875}, {"start": 305.42, "end": 305.92, "word": " rotation", "probability": 0.9208984375}, 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313.1, "word": " طيب؟الان", "probability": 0.7849527994791666}, {"start": 313.1, "end": 313.52, "word": " انا", "probability": 0.95751953125}, {"start": 313.52, "end": 313.76, "word": " يما", "probability": 0.5557861328125}, {"start": 313.76, "end": 314.1, "word": " بدي", "probability": 0.7861328125}, {"start": 314.1, "end": 314.58, "word": " اجي", "probability": 0.8131510416666666}, {"start": 314.58, "end": 315.24, "word": " بجيب", "probability": 0.972412109375}, {"start": 315.24, "end": 315.46, "word": " اي", "probability": 0.859619140625}, {"start": 315.46, "end": 316.16, "word": " تشخص", "probability": 0.976806640625}, {"start": 316.16, "end": 316.74, "word": " باخد", "probability": 0.9295247395833334}, {"start": 316.74, "end": 316.86, "word": " له", "probability": 0.52783203125}, {"start": 316.86, "end": 317.0, "word": " ال", "probability": 0.81298828125}, {"start": 317.0, "end": 317.48, "word": " K1", "probability": 0.7294921875}, {"start": 317.48, "end": 317.76, "word": " و", "probability": 0.97607421875}, {"start": 317.76, "end": 318.22, "word": " K2", "probability": 0.874755859375}, {"start": 318.22, "end": 318.62, "word": " و", "probability": 0.845703125}, {"start": 318.62, "end": 319.02, "word": " باخد", "probability": 0.921875}, {"start": 319.02, "end": 319.5, "word": " R1", "probability": 0.90869140625}, {"start": 319.5, "end": 319.6, "word": " و", "probability": 0.9921875}, {"start": 319.6, "end": 320.04, "word": " R2", "probability": 0.838623046875}], "temperature": 1.0}, {"id": 15, "seek": 33978, "start": 320.4, "end": 339.78, "text": "فمن خلالها انا بعرف مين ال base curve للشخص لكن للعدسة من الصعب التعرف عليها تمام؟ if a good endpoint acuity is not found consider the base curve lens design or lens optics", "tokens": [5172, 27842, 16490, 1211, 6027, 11296, 1975, 8315, 45030, 28480, 3714, 9957, 2423, 3096, 7605, 24976, 8592, 9778, 9381, 44381, 24976, 22488, 3794, 3660, 9154, 31767, 3615, 3555, 16712, 3615, 28480, 25894, 11296, 46811, 10943, 22807, 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"probability": 0.7490234375}, {"start": 324.2, "end": 325.04, "word": " للعدسة", "probability": 0.914794921875}, {"start": 325.04, "end": 325.4, "word": " من", "probability": 0.95703125}, {"start": 325.4, "end": 325.8, "word": " الصعب", "probability": 0.994140625}, {"start": 325.8, "end": 326.24, "word": " التعرف", "probability": 0.9716796875}, {"start": 326.24, "end": 326.7, "word": " عليها", "probability": 0.982666015625}, {"start": 326.7, "end": 328.68, "word": " تمام؟", "probability": 0.6329752604166666}, {"start": 328.68, "end": 330.68, "word": " if", "probability": 0.45361328125}, {"start": 330.68, "end": 330.88, "word": " a", "probability": 0.9873046875}, {"start": 330.88, "end": 331.14, "word": " good", "probability": 0.94384765625}, {"start": 331.14, "end": 331.84, "word": " endpoint", "probability": 0.43212890625}, {"start": 331.84, "end": 332.84, "word": " acuity", "probability": 0.871337890625}, {"start": 332.84, "end": 333.7, "word": " is", "probability": 0.95263671875}, {"start": 333.7, "end": 334.04, "word": " not", "probability": 0.96630859375}, {"start": 334.04, "end": 334.62, "word": " found", "probability": 0.91552734375}, {"start": 334.62, "end": 335.4, "word": " consider", "probability": 0.71533203125}, {"start": 335.4, "end": 335.9, "word": " the", "probability": 0.9345703125}, {"start": 335.9, "end": 336.28, "word": " base", "probability": 0.8466796875}, {"start": 336.28, "end": 336.76, "word": " curve", "probability": 0.9560546875}, {"start": 336.76, "end": 337.52, "word": " lens", "probability": 0.93603515625}, {"start": 337.52, "end": 338.32, "word": " design", "probability": 0.96533203125}, {"start": 338.32, "end": 338.76, "word": " or", "probability": 0.919921875}, {"start": 338.76, "end": 339.14, "word": " lens", "probability": 0.921875}, {"start": 339.14, "end": 339.78, "word": " optics", "probability": 0.9609375}], "temperature": 1.0}, {"id": 16, "seek": 35619, "start": 340.79, "end": 356.19, "text": "الان احنا اعملنا diagnostic method او ال trial method و لاحظنا ان ماوصلنا لافضل visual acuity عند مين عند المريض في هذه الحالة ممكن ان يكون عنده خلل في ال base curve للعدسة", "tokens": [6027, 7649, 1975, 5016, 8315, 1975, 25957, 1211, 8315, 6801, 4568, 19634, 3170, 1975, 2407, 2423, 7308, 3170, 4032, 20193, 5016, 19913, 8315, 16472, 19446, 2407, 36520, 8315, 5296, 31845, 11242, 1211, 5056, 696, 21757, 43242, 3714, 9957, 43242, 9673, 16572, 11242, 8978, 29538, 21542, 6027, 3660, 3714, 43020, 16472, 7251, 30544, 43242, 3224, 16490, 1211, 1211, 8978, 2423, 3096, 7605, 24976, 22488, 3794, 3660], "avg_logprob": -0.2043087137016383, "compression_ratio": 1.5, "no_speech_prob": 0.0, "words": [{"start": 340.79, "end": 341.15, "word": "الان", "probability": 0.87158203125}, {"start": 341.15, "end": 341.55, "word": " احنا", "probability": 0.947265625}, {"start": 341.55, "end": 342.29, "word": " اعملنا", "probability": 0.8863525390625}, {"start": 342.29, "end": 343.35, "word": " diagnostic", "probability": 0.6749267578125}, {"start": 343.35, "end": 343.83, "word": " method", "probability": 0.9755859375}, {"start": 343.83, "end": 344.19, "word": " او", "probability": 0.91259765625}, {"start": 344.19, "end": 344.29, "word": " ال", "probability": 0.8623046875}, {"start": 344.29, "end": 344.55, "word": " trial", "probability": 0.85400390625}, {"start": 344.55, "end": 345.09, "word": " method", "probability": 0.986328125}, {"start": 345.09, "end": 345.75, "word": " و", "probability": 0.4833984375}, {"start": 345.75, "end": 346.33, "word": " لاحظنا", "probability": 0.9384765625}, {"start": 346.33, "end": 346.61, "word": " ان", "probability": 0.94189453125}, {"start": 346.61, "end": 347.49, "word": " ماوصلنا", "probability": 0.784912109375}, {"start": 347.49, "end": 348.29, "word": " لافضل", "probability": 0.878662109375}, {"start": 348.29, "end": 348.65, "word": " visual", "probability": 0.9541015625}, {"start": 348.65, "end": 349.29, "word": " acuity", "probability": 0.8623046875}, {"start": 349.29, "end": 349.53, "word": " عند", "probability": 0.9755859375}, {"start": 349.53, "end": 349.79, "word": " مين", "probability": 0.740234375}, {"start": 349.79, "end": 350.31, "word": " عند", "probability": 0.83203125}, {"start": 350.31, "end": 350.81, "word": " المريض", "probability": 0.9441731770833334}, {"start": 350.81, "end": 351.41, "word": " في", "probability": 0.41357421875}, {"start": 351.41, "end": 351.69, "word": " هذه", "probability": 0.61962890625}, {"start": 351.69, "end": 352.29, "word": " الحالة", "probability": 0.9739583333333334}, {"start": 352.29, "end": 352.73, "word": " ممكن", "probability": 0.977294921875}, {"start": 352.73, "end": 352.97, "word": " ان", "probability": 0.8974609375}, {"start": 352.97, "end": 353.35, "word": " يكون", "probability": 0.93701171875}, {"start": 353.35, "end": 353.73, "word": " عنده", "probability": 0.5843505859375}, {"start": 353.73, "end": 354.15, "word": " خلل", "probability": 0.9586588541666666}, {"start": 354.15, "end": 354.47, "word": " في", "probability": 0.767578125}, {"start": 354.47, "end": 354.59, "word": " ال", "probability": 0.96875}, {"start": 354.59, "end": 354.85, "word": " base", "probability": 0.481689453125}, {"start": 354.85, "end": 355.33, "word": " curve", "probability": 0.970703125}, {"start": 355.33, "end": 356.19, "word": " للعدسة", "probability": 0.814697265625}], "temperature": 1.0}, {"id": 17, "seek": 37208, "start": 356.82, "end": 372.08, "text": "اتنين في ال lens design تصميم العدسة أو ممكن ان يكون ايه بالخواص البصرية لمين للعدسة يعني بمعنى اخر انا مثلا استخدمت ال prism palest", "tokens": [9307, 1863, 9957, 8978, 2423, 6765, 1715, 6055, 9381, 2304, 32640, 18863, 3215, 3794, 3660, 34051, 3714, 43020, 16472, 7251, 30544, 1975, 1829, 3224, 20666, 9778, 2407, 33546, 29739, 9381, 2288, 10632, 32767, 9957, 24976, 22488, 3794, 3660, 37495, 22653, 4724, 2304, 3615, 1863, 7578, 1975, 34740, 1975, 8315, 50113, 15040, 44713, 9778, 40448, 2655, 2423, 16163, 76, 3984, 377], "avg_logprob": -0.2023565622626758, 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"probability": 0.252197265625}, {"start": 723.31, "end": 724.13, "word": " either", "probability": 0.91650390625}, {"start": 724.13, "end": 724.79, "word": " a", "probability": 0.98388671875}, {"start": 724.79, "end": 725.19, "word": " loose", "probability": 0.77880859375}, {"start": 725.19, "end": 725.77, "word": "-fitting", "probability": 0.7345377604166666}, {"start": 725.77, "end": 726.89, "word": " relationship", "probability": 0.9150390625}, {"start": 726.89, "end": 727.87, "word": " or", "probability": 0.91357421875}, {"start": 727.87, "end": 728.71, "word": " inappropriate", "probability": 0.54638671875}, {"start": 728.71, "end": 729.51, "word": " lens", "probability": 0.93896484375}, {"start": 729.51, "end": 730.05, "word": " design", "probability": 0.97607421875}], "temperature": 1.0}, {"id": 32, "seek": 75279, "start": 731.19, "end": 752.79, "text": "عندما تكون قيمة الـ rotation غير متناقمة أو غير ملائمة، يمكن أن العدسة تكون بطيئة، فمع أن العدسة بطيئة، يعني بمعنى أنها تحتوي على عدسة محركة عالية، أي مش ماخدة شكل القرنية أو ممكن أن تكون الـ small diameter صح ولا لا؟", "tokens": [3615, 41260, 15042, 6055, 30544, 12174, 32640, 3660, 2423, 39184, 12447, 32771, 13546, 44650, 8315, 4587, 46007, 34051, 32771, 13546, 3714, 1211, 16373, 46007, 12399, 7251, 43020, 14739, 18863, 3215, 3794, 3660, 6055, 30544, 4724, 9566, 1829, 19986, 3660, 12399, 6156, 2304, 3615, 14739, 18863, 3215, 3794, 3660, 4724, 9566, 1829, 19986, 3660, 12399, 37495, 22653, 4724, 2304, 3615, 1863, 7578, 14739, 11296, 6055, 33753, 45865, 15844, 6225, 3215, 3794, 3660, 3714, 5016, 31747, 3660, 6225, 6027, 10632, 12399, 36632, 37893, 3714, 47283, 41891, 13412, 28820, 25062, 2288, 1863, 10632, 34051, 3714, 43020, 14739, 6055, 30544, 2423, 39184, 1359, 14196, 20328, 5016, 49429, 20193, 22807], "avg_logprob": -0.4805424500186488, "compression_ratio": 1.7547169811320755, "no_speech_prob": 5.960464477539063e-08, "words": [{"start": 731.19, "end": 731.49, "word": "عندما", "probability": 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{"start": 745.61, "end": 746.15, "word": " محركة", "probability": 0.459381103515625}, {"start": 746.15, "end": 746.49, "word": " عالية،", "probability": 0.503936767578125}, {"start": 746.49, "end": 746.69, "word": " أي", "probability": 0.1566162109375}, {"start": 746.69, "end": 746.87, "word": " مش", "probability": 0.1690673828125}, {"start": 746.87, "end": 747.27, "word": " ماخدة", "probability": 0.927734375}, {"start": 747.27, "end": 747.65, "word": " شكل", "probability": 0.9189453125}, {"start": 747.65, "end": 748.95, "word": " القرنية", "probability": 0.849365234375}, {"start": 748.95, "end": 749.59, "word": " أو", "probability": 0.54296875}, {"start": 749.59, "end": 749.95, "word": " ممكن", "probability": 0.759033203125}, {"start": 749.95, "end": 750.11, "word": " أن", "probability": 0.6220703125}, {"start": 750.11, "end": 750.49, "word": " تكون", "probability": 0.7235107421875}, {"start": 750.49, "end": 750.61, "word": " الـ", "probability": 0.3040771484375}, {"start": 750.61, "end": 750.93, "word": " small", "probability": 0.469970703125}, {"start": 750.93, "end": 751.47, "word": " diameter", "probability": 0.939453125}, {"start": 751.47, "end": 751.91, "word": " صح", "probability": 0.78955078125}, {"start": 751.91, "end": 752.09, "word": " ولا", "probability": 0.7919921875}, {"start": 752.09, "end": 752.79, "word": " لا؟", "probability": 0.779296875}], "temperature": 1.0}, {"id": 33, "seek": 77634, "start": 753.32, "end": 776.34, "text": "فهان ان معنى الكلام بيحكي لي ان ال lens design اللي خاص في العدسة غير ملائم لهذا المريض لابد من تغيره ا try another base curve or lens design في هذه الحالة انا بدي استخدم اللي هو base curve اخر انه يكون steep base curve تمام او بدي اغير كل تصميم ايش العدسة", "tokens": [5172, 3224, 7649, 16472, 20449, 1863, 7578, 2423, 28820, 10943, 4724, 1829, 5016, 4117, 1829, 32239, 16472, 2423, 6765, 1715, 13672, 1829, 16490, 33546, 8978, 18863, 3215, 3794, 3660, 32771, 13546, 3714, 1211, 16373, 2304, 46740, 15730, 9673, 16572, 11242, 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"end": 887.17, "word": " ideal", "probability": 0.66455078125}, {"start": 887.17, "end": 888.57, "word": " evaluation", "probability": 0.95751953125}, {"start": 888.57, "end": 889.57, "word": " لازم", "probability": 0.9801432291666666}, {"start": 889.57, "end": 889.91, "word": " انه", "probability": 0.66552734375}, {"start": 889.91, "end": 890.23, "word": " يكون", "probability": 0.98876953125}, {"start": 890.23, "end": 890.55, "word": " بعد", "probability": 0.96728515625}, {"start": 890.55, "end": 891.15, "word": " جديش", "probability": 0.7159016927083334}, {"start": 891.15, "end": 892.03, "word": " اسبوع", "probability": 0.84375}, {"start": 892.03, "end": 892.37, "word": " من", "probability": 0.9921875}, {"start": 892.37, "end": 893.07, "word": " استخدام", "probability": 0.979248046875}, {"start": 893.07, "end": 893.63, "word": " العدسة", "probability": 0.995361328125}], "temperature": 1.0}, {"id": 38, "seek": 91468, "start": 894.44, "end": 914.68, "text": "إذا بعد السبوع أنه بديه 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"end": 1084.03, "word": " بيكون", "probability": 0.83935546875}, {"start": 1084.03, "end": 1084.27, "word": " إيش", "probability": 0.7338053385416666}, {"start": 1084.27, "end": 1085.23, "word": " معله؟", "probability": 0.643798828125}, {"start": 1085.23, "end": 1085.51, "word": " Thin", "probability": 0.6396484375}, {"start": 1085.51, "end": 1088.51, "word": " تمام؟", "probability": 0.6059977213541666}, {"start": 1088.51, "end": 1089.21, "word": " فهذه", "probability": 0.7900390625}, {"start": 1089.21, "end": 1089.43, "word": " إيش", "probability": 0.8605143229166666}, {"start": 1089.43, "end": 1090.05, "word": " بتعمل", "probability": 0.9635416666666666}, {"start": 1090.05, "end": 1091.21, "word": " unstability", "probability": 0.6497802734375}, {"start": 1091.21, "end": 1092.67, "word": " للعدسة", "probability": 0.9075927734375}, {"start": 1092.67, "end": 1093.47, "word": " inside", "probability": 0.5146484375}, {"start": 1093.47, "end": 1094.03, "word": " the", "probability": 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If vision eclares momentarily with the blink", "tokens": [40228, 22653, 6024, 48506, 45164, 4032, 36520, 8315, 4724, 23557, 12399, 11933, 1829, 8592, 20449, 1863, 7578, 22807, 257, 47753, 295, 12447, 4724, 2304, 3615, 1863, 7578, 14739, 3224, 11778, 13063, 7649, 18863, 3215, 3794, 3660, 4032, 22488, 2304, 44713, 4587, 2288, 9640, 11296, 8978, 3714, 41361, 11296, 13, 759, 5201, 11437, 19415, 1623, 3289, 365, 264, 24667], "avg_logprob": -0.3344809271521487, "compression_ratio": 1.2329545454545454, "no_speech_prob": 0.0, "words": [{"start": 1226.36, "end": 1226.62, "word": "يعني", "probability": 0.6148681640625}, {"start": 1226.62, "end": 1226.86, "word": " الآن", "probability": 0.6058349609375}, {"start": 1226.86, "end": 1227.0, "word": " لو", "probability": 0.97119140625}, {"start": 1227.0, "end": 1227.3, "word": " وصلنا", "probability": 0.8963216145833334}, {"start": 1227.3, "end": 1227.68, "word": " برا،", "probability": 0.765625}, {"start": 1227.68, "end": 1227.8, "word": " إيش", 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العدسة a proper fit أو a good fit", "tokens": [10721, 1829, 11242, 995, 3720, 795, 404, 414, 820, 855, 257, 22952, 1850, 23802, 498, 264, 3096, 7605, 307, 3006, 2423, 7649, 949, 4032, 934, 4724, 1211, 9957, 7435, 257, 22952, 4724, 2304, 3615, 1863, 7578, 1850, 4032, 46958, 5016, 37495, 22653, 7251, 30544, 13672, 1829, 31439, 4730, 5296, 10943, 3615, 2423, 2182, 23802, 11933, 15730, 16070, 43761, 25961, 12174, 36150, 4032, 39182, 16712, 2288, 2304, 1829, 8592, 2423, 2182, 23802, 4032, 46958, 5016, 11933, 15730, 23758, 39894, 3215, 9957, 1829, 16472, 9566, 3555, 45761, 14739, 18863, 3215, 3794, 3660, 257, 2296, 3318, 34051, 257, 665, 3318], "avg_logprob": -0.2514349556699091, "compression_ratio": 1.5708502024291497, "no_speech_prob": 0.0, "words": [{"start": 1337.36, "end": 1337.9, "word": "أيضا", "probability": 0.890380859375}, {"start": 1337.9, "end": 1338.28, "word": " written", "probability": 0.1812744140625}, {"start": 1338.28, "end": 1338.94, "word": " scopie", "probability": 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"probability": 0.55322265625}, {"start": 1372.7, "end": 1374.74, "word": " written", "probability": 0.220947265625}, {"start": 1374.74, "end": 1375.28, "word": " scopy", "probability": 0.4398193359375}, {"start": 1375.28, "end": 1375.84, "word": " can", "probability": 0.92626953125}, {"start": 1375.84, "end": 1376.56, "word": " also", "probability": 0.82666015625}, {"start": 1376.56, "end": 1377.32, "word": " help", "probability": 0.90966796875}, {"start": 1377.32, "end": 1378.04, "word": " rule", "probability": 0.9033203125}, {"start": 1378.04, "end": 1378.62, "word": " out", "probability": 0.908203125}, {"start": 1378.62, "end": 1379.24, "word": " over", "probability": 0.8955078125}, {"start": 1379.24, "end": 1379.58, "word": " or", "probability": 0.94677734375}, {"start": 1379.58, "end": 1379.72, "word": " under", "probability": 0.91796875}], "temperature": 1.0}, {"id": 57, "seek": 140778, "start": 1384.76, "end": 1407.78, "text": "في بعض الأحيان بيكون غير متوفر جهاز مين للست لام تمام فبضع اللي هو ال reflex بتاع ال written score موازي للساعة 6 وبشوف قداش قيمة اللي هو ال rotation سواء كانت لل right أو لل left نفس فكرة بالضبط للست لام examination", "tokens": [41185, 45030, 11242, 16247, 5016, 1829, 7649, 4724, 1829, 30544, 32771, 13546, 44650, 38688, 2288, 10874, 3224, 31377, 3714, 9957, 24976, 14851, 5296, 10943, 46811, 10943, 6156, 3555, 11242, 3615, 13672, 1829, 31439, 2423, 23802, 39894, 45761, 2423, 3720, 6175, 3714, 2407, 31377, 1829, 24976, 3794, 995, 27884, 1386, 46599, 8592, 38688, 12174, 3215, 33599, 12174, 32640, 3660, 13672, 1829, 31439, 2423, 12447, 8608, 2407, 16606, 25961, 2655, 24976, 558, 34051, 24976, 1411, 8717, 36178, 6156, 4117, 25720, 20666, 11242, 3555, 9566, 24976, 14851, 5296, 10943, 23874], "avg_logprob": -0.22265625711191783, "compression_ratio": 1.602803738317757, "no_speech_prob": 5.960464477539063e-08, "words": [{"start": 1384.76, "end": 1385.68, "word": "في", "probability": 0.04248046875}, {"start": 1385.68, "end": 1385.96, "word": " بعض", "probability": 0.969482421875}, {"start": 1385.96, "end": 1386.5, "word": " الأحيان", "probability": 0.9736328125}, {"start": 1386.5, "end": 1387.12, "word": " بيكون", "probability": 0.6569010416666666}, {"start": 1387.12, "end": 1387.4, "word": " غير", "probability": 0.987060546875}, {"start": 1387.4, "end": 1388.08, "word": " متوفر", "probability": 0.9822591145833334}, {"start": 1388.08, "end": 1388.52, "word": " جهاز", "probability": 0.9900716145833334}, {"start": 1388.52, "end": 1389.42, "word": " مين", "probability": 0.667724609375}, {"start": 1389.42, "end": 1390.2, "word": " للست", "probability": 0.5308837890625}, {"start": 1390.2, "end": 1390.52, "word": " لام", "probability": 0.645751953125}, {"start": 1390.52, "end": 1391.52, "word": " تمام", "probability": 0.84375}, {"start": 1391.52, "end": 1392.92, "word": " فبضع", "probability": 0.8719482421875}, {"start": 1392.92, "end": 1393.22, "word": " اللي", "probability": 0.915283203125}, {"start": 1393.22, "end": 1393.54, "word": " هو", "probability": 0.990234375}, {"start": 1393.54, "end": 1393.86, "word": " ال", "probability": 0.83544921875}, {"start": 1393.86, "end": 1394.32, "word": " reflex", "probability": 0.334228515625}, {"start": 1394.32, "end": 1395.06, "word": " بتاع", "probability": 0.779052734375}, {"start": 1395.06, "end": 1395.2, "word": " ال", "probability": 0.86083984375}, {"start": 1395.2, "end": 1395.42, "word": " written", "probability": 0.87890625}, {"start": 1395.42, "end": 1396.04, "word": " score", "probability": 0.8955078125}, {"start": 1396.04, "end": 1396.82, "word": " موازي", "probability": 0.8343505859375}, {"start": 1396.82, "end": 1397.36, "word": " للساعة", "probability": 0.81134033203125}, {"start": 1397.36, "end": 1398.12, "word": " 6", "probability": 0.404296875}, {"start": 1398.12, "end": 1399.1, "word": " وبشوف", "probability": 0.8473307291666666}, {"start": 1399.1, "end": 1399.56, "word": " قداش", "probability": 0.67919921875}, {"start": 1399.56, "end": 1400.1, "word": " قيمة", "probability": 0.99365234375}, {"start": 1400.1, "end": 1400.3, "word": " اللي", "probability": 0.927490234375}, {"start": 1400.3, "end": 1400.64, "word": " هو", "probability": 0.9443359375}, {"start": 1400.64, "end": 1400.88, "word": " ال", "probability": 0.70166015625}, {"start": 1400.88, "end": 1402.2, "word": " rotation", "probability": 0.912109375}, {"start": 1402.2, "end": 1402.76, "word": " سواء", "probability": 0.96875}, {"start": 1402.76, "end": 1403.14, "word": " كانت", "probability": 0.983642578125}, {"start": 1403.14, "end": 1403.3, "word": " لل", "probability": 0.8837890625}, {"start": 1403.3, "end": 1403.68, "word": " right", "probability": 0.619140625}, {"start": 1403.68, "end": 1404.08, "word": " أو", "probability": 0.65283203125}, {"start": 1404.08, "end": 1404.46, "word": " لل", "probability": 0.947265625}, {"start": 1404.46, "end": 1404.76, "word": " left", "probability": 0.94482421875}, {"start": 1404.76, "end": 1405.22, "word": " نفس", "probability": 0.978515625}, {"start": 1405.22, "end": 1405.7, "word": " فكرة", "probability": 0.96923828125}, {"start": 1405.7, "end": 1406.22, "word": " بالضبط", "probability": 0.9490966796875}, {"start": 1406.22, "end": 1406.76, "word": " للست", "probability": 0.950927734375}, {"start": 1406.76, "end": 1407.04, "word": " لام", "probability": 0.876220703125}, {"start": 1407.04, "end": 1407.78, "word": " examination", "probability": 0.67138671875}], "temperature": 1.0}, {"id": 58, "seek": 142170, "start": 1411.54, "end": 1421.7, "text": "طبعاً بدنا نعمل اللي هو عملية تأكيد أو عملية تقييم للـ rotation و ال stability و عرفنا إيش الفرق يا راج ما بين ال rotation و ال stability", "tokens": [9566, 3555, 3615, 995, 14111, 47525, 8315, 8717, 25957, 1211, 13672, 1829, 31439, 6225, 42213, 10632, 6055, 10721, 4117, 25708, 34051, 6225, 42213, 10632, 6055, 38436, 32640, 24976, 39184, 12447, 4032, 2423, 11826, 4032, 6225, 28480, 8315, 11933, 1829, 8592, 27188, 2288, 4587, 35186, 12602, 26108, 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{"start": 1420.22, "end": 1420.42, "word": " بين", "probability": 0.99267578125}, {"start": 1420.42, "end": 1420.54, "word": " ال", "probability": 0.974609375}, {"start": 1420.54, "end": 1420.9, "word": " rotation", "probability": 0.98193359375}, {"start": 1420.9, "end": 1421.1, "word": " و", "probability": 0.92822265625}, {"start": 1421.1, "end": 1421.18, "word": " ال", "probability": 0.9326171875}, {"start": 1421.18, "end": 1421.7, "word": " stability", "probability": 0.83056640625}], "temperature": 1.0}, {"id": 59, "seek": 144297, "start": 1433.23, "end": 1442.97, "text": "الـ rotation اللي هو حركة العدسة في ال primary position بينما عندنا ال stability حركة العدسة بعد اللي هو complete blinking", "tokens": [6027, 39184, 12447, 13672, 1829, 31439, 11331, 31747, 3660, 18863, 3215, 3794, 3660, 8978, 2423, 6194, 2535, 49374, 15042, 43242, 8315, 2423, 11826, 11331, 31747, 3660, 18863, 3215, 3794, 3660, 39182, 13672, 1829, 31439, 3566, 45879], "avg_logprob": -0.20967061294091716, 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{"start": 1438.01, "end": 1438.55, "word": " عندنا", "probability": 0.7197265625}, {"start": 1438.55, "end": 1438.73, "word": " ال", "probability": 0.95751953125}, {"start": 1438.73, "end": 1439.35, "word": " stability", "probability": 0.8154296875}, {"start": 1439.35, "end": 1440.25, "word": " حركة", "probability": 0.9788411458333334}, {"start": 1440.25, "end": 1440.93, "word": " العدسة", "probability": 0.9951171875}, {"start": 1440.93, "end": 1441.27, "word": " بعد", "probability": 0.97412109375}, {"start": 1441.27, "end": 1441.53, "word": " اللي", "probability": 0.921875}, {"start": 1441.53, "end": 1441.75, "word": " هو", "probability": 0.98095703125}, {"start": 1441.75, "end": 1442.31, "word": " complete", "probability": 0.8681640625}, {"start": 1442.31, "end": 1442.97, "word": " blinking", "probability": 0.2064208984375}], "temperature": 1.0}, {"id": 60, "seek": 146557, "start": 1444.65, "end": 1465.57, "text": "A different design may be necessary يعني ممكن اختلاف التصميم ما بين ال dynamic stabilization او ال prism palace او ال ISO profile thickness كل هذا بيكون ضروري له من حيث اللي هو معرفة جديش قيمة اللي هو ال stability او جديش قيمة ال rotation للعدسة", "tokens": [32, 819, 1715, 815, 312, 4818, 37495, 22653, 3714, 43020, 1975, 46456, 15040, 5172, 16712, 9381, 2304, 32640, 19446, 49374, 2423, 8546, 35476, 1975, 2407, 2423, 582, 1434, 15207, 1975, 2407, 2423, 25042, 7964, 14855, 28242, 23758, 4724, 1829, 30544, 48812, 2288, 13063, 1829, 46740, 9154, 11331, 1829, 12984, 13672, 1829, 31439, 20449, 28480, 3660, 10874, 16254, 8592, 12174, 32640, 3660, 13672, 1829, 31439, 2423, 11826, 1975, 2407, 10874, 16254, 8592, 12174, 32640, 3660, 2423, 12447, 24976, 22488, 3794, 3660], "avg_logprob": -0.18287037625724886, "compression_ratio": 1.4935622317596566, "no_speech_prob": 0.0, "words": [{"start": 1444.65, "end": 1444.85, "word": "A", "probability": 0.1173095703125}, {"start": 1444.85, "end": 1445.43, "word": " different", "probability": 0.8447265625}, {"start": 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{"start": 1457.13, "end": 1457.91, "word": " بيكون", "probability": 0.7932942708333334}, {"start": 1457.91, "end": 1458.39, "word": " ضروري", "probability": 0.9427490234375}, {"start": 1458.39, "end": 1458.63, "word": " له", "probability": 0.59814453125}, {"start": 1458.63, "end": 1459.05, "word": " من", "probability": 0.84423828125}, {"start": 1459.05, "end": 1459.51, "word": " حيث", "probability": 0.9923502604166666}, {"start": 1459.51, "end": 1459.71, "word": " اللي", "probability": 0.665283203125}, {"start": 1459.71, "end": 1459.93, "word": " هو", "probability": 0.96728515625}, {"start": 1459.93, "end": 1460.97, "word": " معرفة", "probability": 0.9440104166666666}, {"start": 1460.97, "end": 1461.59, "word": " جديش", "probability": 0.85498046875}, {"start": 1461.59, "end": 1462.11, "word": " قيمة", "probability": 0.9954427083333334}, {"start": 1462.11, "end": 1462.33, "word": " اللي", "probability": 0.901123046875}, {"start": 1462.33, "end": 1462.53, "word": " هو", "probability": 0.96240234375}, {"start": 1462.53, "end": 1462.63, "word": " ال", "probability": 0.68603515625}, {"start": 1462.63, "end": 1463.19, "word": " stability", "probability": 0.853515625}, {"start": 1463.19, "end": 1463.59, "word": " او", "probability": 0.882080078125}, {"start": 1463.59, "end": 1464.01, "word": " جديش", "probability": 0.9602864583333334}, {"start": 1464.01, "end": 1464.41, "word": " قيمة", "probability": 0.99072265625}, {"start": 1464.41, "end": 1464.51, "word": " ال", "probability": 0.98388671875}, {"start": 1464.51, "end": 1464.89, "word": " rotation", "probability": 0.99072265625}, {"start": 1464.89, "end": 1465.57, "word": " للعدسة", "probability": 0.884765625}], "temperature": 1.0}, {"id": 61, "seek": 147490, "start": 1466.94, "end": 1474.9, "text": "mostoric brands بمعنى المصنعين للعدسات اللاصقة حاليا", "tokens": [1761, 16345, 11324, 4724, 2304, 3615, 1863, 7578, 9673, 9381, 1863, 3615, 9957, 24976, 3615, 3215, 3794, 9307, 13672, 33546, 28671, 11331, 6027, 25528], "avg_logprob": -0.3493749904632568, "compression_ratio": 1.0120481927710843, "no_speech_prob": 0.0, "words": [{"start": 1466.94, "end": 1467.82, "word": "mostoric", "probability": 0.34222412109375}, {"start": 1467.82, "end": 1468.66, "word": " brands", "probability": 0.75439453125}, {"start": 1468.66, "end": 1470.22, "word": " بمعنى", "probability": 0.823193359375}, {"start": 1470.22, "end": 1472.58, "word": " المصنعين", "probability": 0.80048828125}, {"start": 1472.58, "end": 1473.72, "word": " للعدسات", "probability": 0.72255859375}, {"start": 1473.72, "end": 1474.32, "word": " اللاصقة", "probability": 0.91162109375}, {"start": 1474.32, "end": 1474.9, "word": " حاليا", "probability": 0.8684895833333334}], "temperature": 1.0}, {"id": 62, "seek": 149826, "start": 1477.2, "end": 1498.26, "text": "even within the same manufacturer will have different stability features for each patient الان أصبح الهم الشاغل للمانيفكشير انه كيف يوفر different اللي هو designs تمام لمختلف", "tokens": 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"probability": 0.9697265625}, {"start": 1481.02, "end": 1481.94, "word": " different", "probability": 0.9091796875}, {"start": 1481.94, "end": 1483.02, "word": " stability", "probability": 0.701171875}, {"start": 1483.02, "end": 1484.24, "word": " features", "probability": 0.6220703125}, {"start": 1484.24, "end": 1484.82, "word": " for", "probability": 0.97265625}, {"start": 1484.82, "end": 1485.22, "word": " each", "probability": 0.95654296875}, {"start": 1485.22, "end": 1485.74, "word": " patient", "probability": 0.91552734375}, {"start": 1485.74, "end": 1486.98, "word": " الان", "probability": 0.57281494140625}, {"start": 1486.98, "end": 1487.64, "word": " أصبح", "probability": 0.8971354166666666}, {"start": 1487.64, "end": 1488.96, "word": " الهم", "probability": 0.9453125}, {"start": 1488.96, "end": 1489.88, "word": " الشاغل", "probability": 0.89453125}, {"start": 1489.88, "end": 1491.42, "word": " للمانيفكشير", "probability": 0.611572265625}, {"start": 1491.42, "end": 1492.44, "word": " انه", "probability": 0.73876953125}, {"start": 1492.44, "end": 1492.8, "word": " كيف", "probability": 0.980224609375}, {"start": 1492.8, "end": 1493.68, "word": " يوفر", "probability": 0.9894205729166666}, {"start": 1493.68, "end": 1494.88, "word": " different", "probability": 0.82421875}, {"start": 1494.88, "end": 1495.2, "word": " اللي", "probability": 0.763916015625}, {"start": 1495.2, "end": 1495.46, "word": " هو", "probability": 0.98876953125}, {"start": 1495.46, "end": 1496.24, "word": " designs", "probability": 0.8525390625}, {"start": 1496.24, "end": 1496.98, "word": " تمام", "probability": 0.988525390625}, {"start": 1496.98, "end": 1498.26, "word": " لمختلف", "probability": 0.9152018229166666}], "temperature": 1.0}, {"id": 63, "seek": 152837, "start": 1500.35, "end": 1528.37, "text": "هو انه تكون ثابتة و base curve ثابت بحيث ان الشخص هذا غير ملائم له ال six o'clock على طول يستخدم ال three nine o'clock غير مناسب مثلا ال three nine اللي هي ال dynamic stabilization 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00:00:51,880 +applied on the correct eye and then perform an + +6 +00:00:51,880 --> 00:00:57,220 +spherical cylindrical oval refractionالان نفترض ان + +7 +00:00:57,220 --> 00:01:01,860 +كان في عندي عين ال right eye normal و ال another + +8 +00:01:01,860 --> 00:01:07,040 +eye كانت abnormal تمام؟ و استخدمنا عدسة diagnostic + +9 +00:01:07,040 --> 00:01:12,080 +lens لل both eyesالان اما انا بستخدم لل both eyes + +10 +00:01:12,080 --> 00:01:16,620 +الرؤية هصير في العينتين ايه ال blurred vision طيب + +11 +00:01:16,620 --> 00:01:19,840 +نفترض انا مش عارف مين هي ال normal ومين هي ال + +12 +00:01:19,840 --> 00:01:23,460 +abnormal eye البساطة اللي بعمل spherical + +13 +00:01:23,460 --> 00:01:27,460 +cylindrical over refraction يعني بمعنى اخر بعمل + +14 +00:01:27,460 --> 00:01:33,090 +autoover للعبسة إذا و الله طلعت عندي قيمة سواء بال + +15 +00:01:33,090 --> 00:01:37,810 +plus أو بال minus بعرف إن هذه العين هي تعتبر + +16 +00:01:37,810 --> 00:01:41,950 +السليمة ال another eye إذا طلعت اللي هو القيمة + +17 +00:01:41,950 --> 00:01:46,110 +اللي لها plano أو insignificant power من حيث + +18 +00:01:46,110 --> 00:01:49,750 +الاسفير أو السيلندر بعرف إن هذه العين اللي فيها + +19 +00:01:49,750 --> 00:01:56,830 +أيه المشكلة تمام؟check vertex convergence from the + +20 +00:01:56,830 --> 00:02:01,730 +spectacle refraction to the corneal plane طيب + +21 +00:02:01,730 --> 00:02:08,330 +نفترض الآن أنا المريض طلع عند الوصفة minus 6 ع + +22 +00:02:08,330 --> 00:02:14,190 +minus 1 x مثلا 30 الخطوة الأولى إيش بدى أعمل؟ + +23 +00:02:23,510 --> 00:02:29,990 +بمعنى اعمل عملية تحويل لمن لالهو ال power الخاصة + +24 +00:02:29,990 --> 00:02:34,630 +بقيمة النضارة او الخاصة بال subjective refraction + +25 +00:02:34,630 --> 00:02:41,250 +in addition to rotation the next most common + +26 +00:02:41,250 --> 00:02:47,470 +errors are base gear fittingقلنا اول drawback + +27 +00:02:47,470 --> 00:02:52,170 +لعدسات ال software ال contact lenses هو موضوع ال + +28 +00:02:52,170 --> 00:02:57,770 +rotation تمام النقطة التانية ال base curveهى تعتبر + +29 +00:02:57,770 --> 00:03:03,210 +ال second most او ال next step تمام او ال error + +30 +00:03:03,210 --> 00:03:07,950 +اللى هو الخطأ التانى ايش لل drawback للعدسات اللى + +31 +00:03:07,950 --> 00:03:12,050 +هى ال soft direct contact lenses اذا مرة تانية in + +32 +00:03:12,050 --> 00:03:16,610 +addition to rotation the next او ال second most + +33 +00:03:16,610 --> 00:03:20,650 +most common errors are best care fitting + +34 +00:03:20,650 --> 00:03:26,120 +relationship and lens powerإذا عندنا المشكلة + +35 +00:03:26,120 --> 00:03:30,700 +التانية في عدسات ال soft rec contact lenses هي + +36 +00:03:30,700 --> 00:03:35,900 +عبارة عن مين ال base curve بيبلغال وصلنا السؤال هل + +37 +00:03:35,900 --> 00:03:40,580 +يمكن تقييم أو حساب قيمة ال base curve للعدسات ال + +38 +00:03:40,580 --> 00:03:45,380 +soft rec contact lenses ولا لأ كيف طيب اللي انا + +39 +00:03:45,380 --> 00:03:49,580 +مديتك عدسة soft rec contact lenses قلتلك احسبيه + +40 +00:03:49,580 --> 00:03:52,400 +لقداش أو قسيل ال base curve لها ممكن؟ + +41 +00:03:55,290 --> 00:04:03,530 +طبعا ال base curve لل soft trick من الصعب اللى هو + +42 +00:04:03,530 --> 00:04:09,670 +عملية قياسه تمام لكن انا ممكن كيف اتعرف من خلال ال + +43 +00:04:09,670 --> 00:04:15,270 +lens power ال lens power كيف انا بقيسه من خلال + +44 +00:04:15,270 --> 00:04:23,070 +اللى هو مثلا ال lensometerطبعا إذا مرة أخرى في + +45 +00:04:23,070 --> 00:04:27,730 +العدسات ال software contact lenses من الصعب التعرف + +46 +00:04:27,730 --> 00:04:33,490 +على ال base curve للعدسة لكن أنا ممكن أتعرف على ال + +47 +00:04:33,490 --> 00:04:37,770 +power parameter من خلال استخدام جهاز ال lensmeter + +48 +00:04:37,770 --> 00:04:38,770 +أو الفوسيمتر + +49 +00:04:41,420 --> 00:04:45,360 +إذا المشكلة التانية هي موضوع ال base curve يما + +50 +00:04:45,360 --> 00:04:49,060 +يكون خاطق التالتة عندنا مشكلة ال power يما يكون + +51 +00:04:49,060 --> 00:04:54,420 +فيها defect أو تكون غير صحيحةThe rotation and base + +52 +00:04:54,420 --> 00:04:58,080 +curve can be confirmed with the spherical + +53 +00:04:58,080 --> 00:05:02,280 +cylindrical over refraction ممكن انا بعمل عملية + +54 +00:05:02,280 --> 00:05:07,040 +confirmed اي بمعنى تأكيد لقيمة ال rotation و ال + +55 +00:05:07,040 --> 00:05:10,540 +base curve من خلال ال spherical cylindrical over + +56 +00:05:10,540 --> 00:05:15,460 +refraction كيف طيب؟الان انا يما بدي اجي بجيب اي + +57 +00:05:15,460 --> 00:05:21,200 +تشخص باخد له ال K1 و K2 و باخد R1 و R2فمن خلالها + +58 +00:05:21,200 --> 00:05:25,400 +انا بعرف مين ال base curve للشخص لكن للعدسة من + +59 +00:05:25,400 --> 00:05:32,840 +الصعب التعرف عليها تمام؟ if a good endpoint acuity + +60 +00:05:32,840 --> 00:05:38,320 +is not found consider the base curve lens design + +61 +00:05:38,320 --> 00:05:43,830 +or lens opticsالان احنا اعملنا diagnostic method + +62 +00:05:43,830 --> 00:05:48,290 +او ال trial method و لاحظنا ان ماوصلنا لافضل + +63 +00:05:48,290 --> 00:05:52,290 +visual acuity عند مين عند المريض في هذه الحالة + +64 +00:05:52,290 --> 00:05:57,400 +ممكن ان يكون عنده خلل في ال base curve للعدسةاتنين + +65 +00:05:57,400 --> 00:06:02,760 +في ال lens design تصميم العدسة أو ممكن ان يكون ايه + +66 +00:06:02,760 --> 00:06:09,460 +بالخواص البصرية لمين للعدسة يعني بمعنى اخر انا + +67 +00:06:09,460 --> 00:06:14,310 +مثلا استخدمت ال prism palestو المريض كان عنده عدم + +68 +00:06:14,310 --> 00:06:17,570 +القدرة على التحمل على اللي هو ال thickness في + +69 +00:06:17,570 --> 00:06:21,830 +المنطقة الساعة ستة فهان مش هيقدر يتعود على مين؟ + +70 +00:06:21,830 --> 00:06:25,270 +على العدسة فهان بده يكون مشكلة في مين؟ في ال lens + +71 +00:06:25,270 --> 00:06:29,890 +optics او مثلا واحد اديته dynamic stabilization و + +72 +00:06:29,890 --> 00:06:33,970 +عنده سعر في الساعة تلاتة أو تسعة مشكلة ايضا مش + +73 +00:06:33,970 --> 00:06:37,170 +هيقدر انه يتحمل العدسة تمام؟ + +74 +00:06:40,460 --> 00:06:45,480 +يعني في بعض الأحيان ممكن انا افكر في عملية اللي هو + +75 +00:06:45,480 --> 00:06:50,360 +تغير من ال lens design حتى ادي رؤية انه تكون + +76 +00:06:50,360 --> 00:06:55,280 +مناسبة او ملائمة للمريض و بالاضافة انه اصل لأفضل + +77 +00:06:55,280 --> 00:07:00,780 +اللي هو راحة لمين لل patient طيب stable blurred + +78 +00:07:00,780 --> 00:07:05,120 +vision اذا مدام stable اذا ايش هيكون؟ بشكل دائم + +79 +00:07:05,120 --> 00:07:10,920 +تمام؟ يعني ربش في الرؤية بشكل دائمWhen the patient + +80 +00:07:10,920 --> 00:07:15,700 +returns after wearing the lens for a short time + +81 +00:07:15,700 --> 00:07:23,360 +طيب، الآن المريض أول ما برتدي العدسة اللاصقة لفترة + +82 +00:07:23,360 --> 00:07:30,560 +زمنية قصيرة، بصير عنده إيش؟ غبش بشكل دائم، واضحة؟ + +83 +00:07:30,560 --> 00:07:35,260 +إذا عند ارتداء العدسة اللاصقة لفترة زمنية قصيرة، + +84 +00:07:35,260 --> 00:07:41,900 +المريض بيصبح عنده غبش بشكل دائمطيب في هذه الحالة + +85 +00:07:41,900 --> 00:07:46,380 +إيش بدى أعمل number one بدى أعمل review مراجعة لل + +86 +00:07:46,380 --> 00:07:50,280 +base curve لقيمة اللي هو ال base curve أو ال back + +87 +00:07:50,280 --> 00:07:56,880 +optic zone radius soft lenses may tighten with + +88 +00:07:56,880 --> 00:08:02,700 +wear and what appeared to be good fit may now be + +89 +00:08:02,700 --> 00:08:06,380 +tight causing irregular power effects or a + +90 +00:08:06,380 --> 00:08:11,000 +creeping of the rotationالان يما بتكون بعد ما انا + +91 +00:08:11,000 --> 00:08:15,680 +براجع ال base curve للعدسة و بده اشوفه هل هو صحيح + +92 +00:08:15,680 --> 00:08:20,800 +او خطأ ممكن في بعض الأحيان ان العدسة تكون tied + +93 +00:08:20,800 --> 00:08:25,440 +تمام؟ يعني بمعنى انه as he runs to the shape of + +94 +00:08:25,440 --> 00:08:29,780 +the cornea يعني اول ما بتحطيها على العين بتعمل + +95 +00:08:29,780 --> 00:08:34,380 +اللي هو suction اللي هو بتكون مصممة وين على السطح + +96 +00:08:34,380 --> 00:08:41,280 +القرانية للعينطيب، الآن أنا بدي أصل لإيش؟ لأفضل + +97 +00:08:41,280 --> 00:08:44,840 +اللي هو نتيجة أو أفضل power أو أفضل base curve + +98 +00:08:44,840 --> 00:08:50,320 +تمام؟ هذي ال step إيش بيعمل؟ ممكن إنه بيغير في + +99 +00:08:50,320 --> 00:08:54,260 +اللي هو القوة الملائمة للعدسة، يعني بمعنى آخر + +100 +00:08:54,260 --> 00:08:59,040 +المريض بده مثلا base curve سبعة و ستة أنا روحت + +101 +00:08:59,040 --> 00:09:03,120 +مثلا اديته base curve نفترض على سبيل المثال سبعة و + +102 +00:09:03,120 --> 00:09:07,150 +تسعةطيب الآن التغيير في ال base curve مش بيعمل على + +103 +00:09:07,150 --> 00:09:10,550 +تغيير ال power صح ولا لا؟ فإنما بتغير ال power + +104 +00:09:10,550 --> 00:09:14,750 +بيؤثر على قيمة العدسة الملائمة لمين لالمريض + +105 +00:09:14,750 --> 00:09:19,630 +وبالتالي إما يتغير ال power للعدسة أكيد هيعمل غبش + +106 +00:09:19,630 --> 00:09:24,610 +للرؤية تمام؟ يعني الآن لو سألتك سؤال إيش هي أسباب + +107 +00:09:24,610 --> 00:09:30,140 +اللي هو ال blurred vision؟عدم اللي هو رؤية بوضوح + +108 +00:09:30,140 --> 00:09:34,380 +منها ان القوة غير ملائمة او غير مناسبة للمريض صح + +109 +00:09:34,380 --> 00:09:39,060 +ولا لا او مثلا inverted اللي هو ان العلسة مقلوبة + +110 +00:09:39,060 --> 00:09:45,080 +صح ولا لا ممكن تعمل اللي هو blurred visionطيب الان + +111 +00:09:45,080 --> 00:09:49,460 +كلمة a creeping of the rotation ان العدسة بتدور + +112 +00:09:49,460 --> 00:09:54,260 +يعني بمعنى انه ما بتستقر في مكانها وما بتقدر تصل + +113 +00:09:54,260 --> 00:09:58,940 +لمرحلة او لمنطقة اللي هو الاستقرار يعني العدسة + +114 +00:09:58,940 --> 00:10:03,360 +بتبقى انه تعمل عملية rotation دون القدرة على + +115 +00:10:03,360 --> 00:10:07,260 +الاستقرار طبعا دايما انا بدى افكر مدام في هناك + +116 +00:10:07,260 --> 00:10:11,940 +rotation للعدسة اذا في مساوي لها ايش؟ اللي هو + +117 +00:10:11,940 --> 00:10:17,660 +stable blurred visionطبعا إذا دائما إعادة تحويل + +118 +00:10:17,660 --> 00:10:23,220 +دوران العدسة وعدم استقرارها بساوية مستقبلية و + +119 +00:10:23,220 --> 00:10:28,500 +مظهرة مظهرة طيب + +120 +00:10:28,500 --> 00:10:32,320 +بعض الأحيان بيكون مظهر مظهر مظهر مظهر مظهر مظهر + +121 +00:10:32,320 --> 00:10:34,500 +مظهر مظهر مظهر مظهر مظهر مظهر مظهر مظهر مظهر مظهر + +122 +00:10:34,500 --> 00:10:36,440 +مظهر مظهر مظهر مظهر مظهر مظهر مظهر مظهر مظهر مظهر + +123 +00:10:36,440 --> 00:10:36,700 +مظهر مظهر مظهر مظهر مظهر مظهر مظهر مظهر مظهر مظهر + +124 +00:10:36,700 --> 00:10:42,360 +مظهر مظهر مظهر مظهر م + +125 +00:10:47,290 --> 00:10:51,550 +بالضبط يعني بدى اجيب اللى هو عملية ايش انه اعكس + +126 +00:10:51,550 --> 00:10:56,270 +اللى هو العدسة تمام فاش بعمل طيب لما انا بعمل اللى + +127 +00:10:56,270 --> 00:11:01,170 +هو عكس العدسة بالضبط انه بعمل stable blurred + +128 +00:11:01,170 --> 00:11:06,430 +vision لمين؟ للمريض تمام مرة أخرى يا جماعة الآن + +129 +00:11:06,430 --> 00:11:10,910 +اما يكون انا عندى unilateral blurred vision اش بدى + +130 +00:11:10,910 --> 00:11:16,170 +اجيب؟ بدى اعمل عملية قلب للعدسةOkay فهيعمل اللي هو + +131 +00:11:16,170 --> 00:11:20,630 +stable blabbed vision من خلالها انا بعرف ان مين + +132 +00:11:20,630 --> 00:11:23,890 +اللي هو العين اللي فيها good ومين فيها ال bad + +133 +00:11:23,890 --> 00:11:24,350 +vision + +134 +00:11:29,360 --> 00:11:33,460 +Verify the rotation of the lens اذا انا بدي اعمل + +135 +00:11:33,460 --> 00:11:38,340 +عملية تأكيد لمين لدوران العدسة inconsistent + +136 +00:11:38,340 --> 00:11:43,600 +rotation يما يكون اللي هو بمعنى انه ال rotation + +137 +00:11:43,600 --> 00:11:50,440 +غير متعامد او غير متناقص غير اللي هو متنازم تمام + +138 +00:11:51,550 --> 00:11:57,410 +إذا هان عندنا inconsistent اللي هو rotation أي + +139 +00:11:57,410 --> 00:12:04,130 +بمعنى إن الدوران غير متناظم okay indicates either + +140 +00:12:04,130 --> 00:12:09,510 +a loose-fitting relationship or inappropriate lens + +141 +00:12:09,510 --> 00:12:16,850 +designعندما تكون قيمة الـ rotation غير متناقمة أو + +142 +00:12:16,850 --> 00:12:21,170 +غير ملائمة، يمكن أن العدسة تكون بطيئة، فمع أن + +143 +00:12:21,170 --> 00:12:26,150 +العدسة بطيئة، يعني بمعنى أنها تحتوي على عدسة محركة + +144 +00:12:26,150 --> 00:12:30,610 +عالية، أي مش ماخدة شكل القرنية أو ممكن أن تكون الـ + +145 +00:12:30,610 --> 00:12:35,660 +small diameter صح ولا لا؟فهان ان معنى الكلام بيحكي + +146 +00:12:35,660 --> 00:12:40,520 +لي ان ال lens design اللي خاص في العدسة غير ملائم + +147 +00:12:40,520 --> 00:12:45,720 +لهذا المريض لابد من تغيره ا try another base curve + +148 +00:12:45,720 --> 00:12:49,520 +or lens design في هذه الحالة انا بدي استخدم اللي + +149 +00:12:49,520 --> 00:12:53,360 +هو base curve اخر انه يكون steep base curve تمام + +150 +00:12:53,360 --> 00:12:56,340 +او بدي اغير كل تصميم ايش العدسة + +151 +00:13:00,920 --> 00:13:07,140 +Okay check lens for deposits or wetability الان ال + +152 +00:13:07,140 --> 00:13:10,480 +deposits اللي هي عبارة عن الترثبات اللي بتكون على + +153 +00:13:10,480 --> 00:13:14,440 +سطح العدسة بدي اشوف انه هل في هناك ترثبات على + +154 +00:13:14,440 --> 00:13:19,020 +العدسة ولا لأ ايضا بدي امسك اللي هو مرونة و ليونة + +155 +00:13:19,020 --> 00:13:23,160 +العدسة ال wetability تمام؟ بدي اشوفها جديش اللي هو + +156 +00:13:23,160 --> 00:13:29,500 +كمرونة للعدسة موجودة poor tear quality may prevent + +157 +00:13:36,730 --> 00:13:41,970 +الان انا شخص عنده dry eye تمام؟ مانفعش انا اروح + +158 +00:13:41,970 --> 00:13:46,230 +ادي ايش؟ high water content او moderate water + +159 +00:13:46,230 --> 00:13:51,830 +content تمام؟ لانه في هذه الحالة ايش هيعمل؟ هيسبب + +160 +00:13:51,830 --> 00:13:55,830 +اللي هو dry eye symptoms تمام؟ و هيعمل على + +161 +00:13:55,830 --> 00:14:02,680 +dehydrate اللي هو تبخر كل سطح من القرنيةأيضا عندنا + +162 +00:14:02,680 --> 00:14:08,080 +بيمنع اللي هو حركة ملائمة للعدسة، دايما العين لما + +163 +00:14:08,080 --> 00:14:14,060 +بيصير فيها نوع من الجفاف تمام، هذا بيؤدي إلى إعاقة + +164 +00:14:14,060 --> 00:14:19,420 +حركة العدسة داخل العين، يعني بمعنى أخر أنه ممكن + +165 +00:14:19,420 --> 00:14:24,880 +العدسة إحنا نطلع إليها إنه هي steep، و هي إنه تكون + +166 +00:14:24,880 --> 00:14:29,150 +إيش العدسة normalلكن مين اللي سبب هذا اللي هو ال + +167 +00:14:29,150 --> 00:14:34,650 +dry eye او تبخر اللي هو سطح العدسة ايضا هذا بيؤثر + +168 +00:14:34,650 --> 00:14:39,710 +على مين على ال rotation للعدسة دوران العدسة لذلك + +169 +00:14:39,710 --> 00:14:43,450 +دايما قلنا يا جماعة ان العدسة ال software contact + +170 +00:14:43,450 --> 00:14:48,570 +lenses اذا انا بدي استخدم اللي هو ideal evaluation + +171 +00:14:48,570 --> 00:14:54,780 +لازم انه يكون بعد جديش اسبوع من استخدام العدسةإذا + +172 +00:14:54,780 --> 00:14:59,200 +بعد السبوع أنه بديه عدسة تجربية يستخدمها بشكل اللي + +173 +00:14:59,200 --> 00:15:04,000 +هو يومي لحد ما أصل لأفضل اللي هو عدسة ملائمة + +174 +00:15:04,000 --> 00:15:11,640 +للمريض If this is the case consider a lens with a + +175 +00:15:11,640 --> 00:15:15,870 +different material, base curve or thicknessإذا + +176 +00:15:15,870 --> 00:15:19,890 +اتفقنا على موضوع ال lens material بدي أغيره إذا + +177 +00:15:19,890 --> 00:15:23,590 +والله المريض عنده dry eye بدي أستخدم معه low water + +178 +00:15:23,590 --> 00:15:28,770 +content اتنين عندنا موضوع ال base curve بدي أستخدم + +179 +00:15:28,770 --> 00:15:33,230 +ممكن flat base curve حسب يعني ما بتتطبيق اللي هو + +180 +00:15:33,230 --> 00:15:37,330 +الحالة ممكن مثلا ال thickness أنه أقلله بدل ما + +181 +00:15:37,330 --> 00:15:40,770 +أجيب اللي هو ال prism تالس أستخدم اللي هو ال + +182 +00:15:40,770 --> 00:15:42,190 +dynamic stabilization + +183 +00:15:47,160 --> 00:15:52,500 +Unstable blurred vision is usually an indicator + +184 +00:15:52,500 --> 00:15:58,100 +that the base curve or back optic zone radius is + +185 +00:15:58,100 --> 00:16:03,340 +not correct دايما احنا ك fitter او ك practitioner + +186 +00:16:03,340 --> 00:16:08,510 +بنظن ان المشكلة وين دايما؟ في البوارةدائما بنظن + +187 +00:16:08,510 --> 00:16:12,110 +احنا المشكلة وين في ال power في البداية لكن بعد + +188 +00:16:12,110 --> 00:16:17,090 +ذلك بتصلى لمرحلة انه بتعمل spherical cylindrical + +189 +00:16:17,090 --> 00:16:22,030 +over refraction و بتلاحظ انه قيمة zero و هو لابس + +190 +00:16:22,030 --> 00:16:26,090 +المريض العدسى على طول انا بده اروح وين ان هذا بدل + +191 +00:16:26,090 --> 00:16:29,390 +على انه ممكن يكون ال base curve هو اللي فيه + +192 +00:16:29,390 --> 00:16:34,790 +المشكلةدايما بتكون تعرفوا انه من خواص العدسة ال + +193 +00:16:34,790 --> 00:16:38,790 +software contact lenses انه بتكون number one steep + +194 +00:16:38,790 --> 00:16:42,770 +مقارنة في ال spherical soft contact lens و اتنين + +195 +00:16:42,770 --> 00:16:50,230 +بتكون thin تمام؟ اذا عندنا من خواص العدسة ال + +196 +00:16:50,230 --> 00:16:56,170 +software contact lenses مقارنة بال + +197 +00:16:56,170 --> 00:16:58,890 +spherical soft contact lens بتكون more + +198 +00:17:04,280 --> 00:17:12,920 +thin بالاضافة انه more steam اتنين هدول الخاصيتين + +199 +00:17:12,920 --> 00:17:16,980 +هدول خاصين في مين في ال software contact lenses + +200 +00:17:16,980 --> 00:17:23,160 +فدايما اي تغبش خاصة بعد ما اعمل ال over refraction + +201 +00:17:23,160 --> 00:17:27,120 +ممكن انه اشك انه عنده ال base curve غير صحيح + +202 +00:17:27,120 --> 00:17:28,600 +للعدسة تمام؟ + +203 +00:17:32,340 --> 00:17:38,700 +a loose fitting أي بمعنى flat lens may cause post + +204 +00:17:38,700 --> 00:17:45,660 +-blink blurring due to the lack of stability الآن + +205 +00:17:45,660 --> 00:17:51,900 +شخص عنده flat lens إذا في عندنا على طول إيش؟ + +206 +00:17:51,900 --> 00:17:55,100 +excessive movement الشغل التاني في عندنا small + +207 +00:17:55,100 --> 00:18:01,000 +diameter الشغل الأهم أنه عنده ال post tear + +208 +00:18:02,510 --> 00:18:10,050 +Lens بيكون إيش معله؟ Thin تمام؟ فهذه إيش بتعمل + +209 +00:18:10,050 --> 00:18:17,610 +unstability للعدسة inside the patient eye careful + +210 +00:18:17,610 --> 00:18:24,050 +evaluation التقيين بعناية is required of the lens + +211 +00:18:24,050 --> 00:18:29,640 +positionاذا لازم انا اشوف موقع العدسة وين انه هل + +212 +00:18:29,640 --> 00:18:33,540 +هي جاية مثلا على الساعة الستة ولا لأ او جاية على + +213 +00:18:33,540 --> 00:18:38,220 +الخمسة او عاملة rotation لل right او ال left and + +214 +00:18:38,220 --> 00:18:42,540 +ability to maintain position لازم انه احافظ على + +215 +00:18:42,540 --> 00:18:48,160 +ايش احافظ على حركة العدسة داخل العين بمعنى اخر انه + +216 +00:18:48,160 --> 00:18:53,520 +لازم اعمل rotation و stability للعدسة inside of + +217 +00:18:53,520 --> 00:18:59,180 +the patient eyeAs the eye moves from side to side + +218 +00:18:59,180 --> 00:19:03,240 +دايما في موضوع ال movement ماباعتمد فقط على ال + +219 +00:19:03,240 --> 00:19:07,580 +vertical movement وإن كانت هي الأصل أيضا في عنه + +220 +00:19:07,580 --> 00:19:11,880 +حاجة ال horizontal movement يعني from side to side + +221 +00:19:11,880 --> 00:19:17,180 +أو nasal to temporal okay and post bling وإحنا + +222 +00:19:17,180 --> 00:19:21,280 +اتفقنا إن ال post tear lens بيكون اللي هو thin في + +223 +00:19:21,280 --> 00:19:24,060 +حالة ما تكون العدسة flat أو loose + +224 +00:19:28,660 --> 00:19:33,640 +A creeping of rotation اي بمعنى انه عدم استقرار + +225 +00:19:33,640 --> 00:19:37,700 +العدسة في مكانها يعني بمعنى اخر انه في هناك + +226 +00:19:37,700 --> 00:19:43,920 +relocate ان العدسة مش جاعدة في مكانها الملائمة او + +227 +00:19:43,920 --> 00:19:47,600 +slow طبعا ليش دايما بيصير اللي هو ال creeping of + +228 +00:19:47,600 --> 00:19:51,520 +rotation دايما هذه الحالة بيصير عندما تكون العدسة + +229 +00:19:51,520 --> 00:19:57,040 +steam فاحنا ك practitioner بنظن ان هي العدسة + +230 +00:19:57,040 --> 00:20:02,650 +ملائمةلأنه مابنشوفش حركة كبيرة، تمام؟ اذا a + +231 +00:20:02,650 --> 00:20:07,550 +creeping of rotation or slow to relocate to + +232 +00:20:07,550 --> 00:20:12,010 +original position is an indication of a steep fit، + +233 +00:20:12,010 --> 00:20:15,770 +اذا دايما ال creeping of rotation هذا بتديني + +234 +00:20:15,770 --> 00:20:19,450 +انطباع ان العدفة قد تكون اللي هو ايه؟ + +235 +00:20:26,360 --> 00:20:29,000 +يعني الآن لو وصلنا برا، إيش معنى؟ a creeping of + +236 +00:20:29,000 --> 00:20:35,480 +rotation بمعنى + +237 +00:20:35,480 --> 00:20:41,760 +أنه دوران العدسة وعدم استقرارها في مكانها. If + +238 +00:20:41,760 --> 00:20:49,030 +vision eclares momentarily with the blinkThis may + +239 +00:20:49,030 --> 00:20:55,130 +indicate a steep fit.الان المريض اول ما بلبس + +240 +00:20:55,130 --> 00:20:59,330 +العدسة لو حطناها على ال visual acuity smelling + +241 +00:20:59,330 --> 00:21:03,850 +chart او ال keratometer ميارد او مثلا ال + +242 +00:21:03,850 --> 00:21:08,130 +retinascope reflex الوهلة الاولى ايش هيكون مش + +243 +00:21:08,130 --> 00:21:12,790 +واضحة بعد الترميش ايش هيصير واضح تمام هان المقصود + +244 +00:21:12,790 --> 00:21:16,330 +فيها زي بالضبط مين ال spherical soft contact + +245 +00:21:16,330 --> 00:21:21,990 +lensesطيب اذا كان العكس يعني بمعنى اخر انه قبل + +246 +00:21:21,990 --> 00:21:26,030 +الترميش واضح وبعد الترميش غير واضح طبعا للحظات يا + +247 +00:21:26,030 --> 00:21:29,890 +جماعة شايفين كلمة momentary اي بمعنى للحظات او + +248 +00:21:29,890 --> 00:21:39,710 +ثواني تمام؟ بيكون العدسة هي flat lens ايضا + +249 +00:21:39,710 --> 00:21:45,620 +بدنا نستخدم ال push up testانه بدي اعمل عملية ضغط + +250 +00:21:45,620 --> 00:21:50,040 +من ال lower eyelid على العدسة اذا والله العدسة + +251 +00:21:50,040 --> 00:21:54,840 +رجعت بعد اقل من واحد ثانية هذا بديني انطباع ان + +252 +00:21:54,840 --> 00:21:59,280 +العدسة ايه ملائمة اذا اتأخرت في ذلك بديني اما + +253 +00:21:59,280 --> 00:22:04,420 +العدسة flat او steep ايضا موضوع ايش؟ عندنا ال lag + +254 +00:22:04,420 --> 00:22:08,360 +on up gaze في عندنا excessive movement في عندنا ال + +255 +00:22:08,360 --> 00:22:13,500 +normal من تلاتة من عشراء لسبعة من عشراء مليمترOkay + +256 +00:22:17,360 --> 00:22:21,760 +أيضا written scopie should show a crisp clear + +257 +00:22:21,760 --> 00:22:27,080 +reflex if the base curve is correct الان before و + +258 +00:22:27,080 --> 00:22:31,120 +after بلينج a crisp بمعنى clear واضح يعني يكون + +259 +00:22:31,120 --> 00:22:35,040 +اللي هو bright لامع ال red reflex إذا والله كان + +260 +00:22:35,040 --> 00:22:39,520 +قبل و بعد الترميش ال red reflex واضح إذا هذا + +261 +00:22:39,520 --> 00:22:43,660 +بتديني انطباع أن العدسة a proper fit أو a good fit + +262 +00:22:43,780 --> 00:22:48,160 +إذا كان قبل الترميش غير واضح و بعد الترميش صار + +263 +00:22:48,160 --> 00:22:52,700 +واضح، بتكون الـ steep و العكس صحيح في حالة ال flat + +264 +00:22:52,700 --> 00:22:59,720 +written scopy can also help rule out over or under + +265 +00:23:04,760 --> 00:23:10,520 +في بعض الأحيان بيكون غير متوفر جهاز مين للست لام + +266 +00:23:10,520 --> 00:23:16,040 +تمام فبضع اللي هو ال reflex بتاع ال written score + +267 +00:23:16,040 --> 00:23:22,200 +موازي للساعة 6 وبشوف قداش قيمة اللي هو ال rotation + +268 +00:23:22,200 --> 00:23:26,760 +سواء كانت لل right أو لل left نفس فكرة بالضبط للست + +269 +00:23:26,760 --> 00:23:27,780 +لام examination + +270 +00:23:31,540 --> 00:23:35,200 +طبعاً بدنا نعمل اللي هو عملية تأكيد أو عملية تقييم + +271 +00:23:35,200 --> 00:23:39,880 +للـ rotation و ال stability و عرفنا إيش الفرق يا + +272 +00:23:39,880 --> 00:23:41,700 +راج ما بين ال rotation و ال stability + +273 +00:23:53,230 --> 00:23:56,550 +الـ rotation اللي هو حركة العدسة في ال primary + +274 +00:23:56,550 --> 00:24:01,270 +position بينما عندنا ال stability حركة العدسة بعد + +275 +00:24:01,270 --> 00:24:06,890 +اللي هو complete blinkingA different design may be + +276 +00:24:06,890 --> 00:24:10,870 +necessary يعني ممكن اختلاف التصميم ما بين ال + +277 +00:24:10,870 --> 00:24:14,630 +dynamic stabilization او ال prism palace او ال ISO + +278 +00:24:14,630 --> 00:24:19,510 +profile thickness كل هذا بيكون ضروري له من حيث + +279 +00:24:19,510 --> 00:24:23,590 +اللي هو معرفة جديش قيمة اللي هو ال stability او + +280 +00:24:23,590 --> 00:24:30,220 +جديش قيمة ال rotation للعدسةmostoric brands بمعنى + +281 +00:24:30,220 --> 00:24:38,980 +المصنعين للعدسات اللاصقة حالياeven within the same + +282 +00:24:38,980 --> 00:24:43,020 +manufacturer will have different stability + +283 +00:24:43,020 --> 00:24:49,880 +features for each patient الان أصبح الهم الشاغل + +284 +00:24:49,880 --> 00:24:56,240 +للمانيفكشير انه كيف يوفر different اللي هو designs + +285 +00:24:56,240 --> 00:24:58,260 +تمام لمختلف + +286 +00:25:00,350 --> 00:25:05,110 +هو انه تكون ثابتة و base curve ثابت بحيث ان الشخص + +287 +00:25:05,110 --> 00:25:09,910 +هذا غير ملائم له ال six o'clock على طول يستخدم ال + +288 +00:25:09,910 --> 00:25:13,570 +three nine o'clock غير مناسب مثلا ال three nine + +289 +00:25:13,570 --> 00:25:16,910 +اللي هي ال dynamic stabilization يستخدم ال ISO + +290 +00:25:16,910 --> 00:25:21,730 +thickness profile و هكذا تمام؟ يعني بمعنى اخر اللي + +291 +00:25:21,730 --> 00:25:26,710 +هو توفير عدسات بنفس ال power و نفس ال base curve و + +292 +00:25:26,710 --> 00:25:36,960 +تكون خواصة مختلفةأي ال lens design مختلف consider + +293 +00:25:36,960 --> 00:25:41,960 +power change in refraction or lens power effects + +294 +00:25:41,960 --> 00:25:47,900 +caused by flexure الآن أي تتغير في قوة العدسة أو + +295 +00:25:47,900 --> 00:25:51,900 +في ال base gear هذا بتديني انطباع أنه قد يكون هناك + +296 +00:25:51,900 --> 00:25:56,400 +تغير في نشأة العدسة أي بين جثين ال lens design + +297 +00:25:56,400 --> 00:25:57,880 +تمام؟ + +298 +00:26:02,490 --> 00:26:07,270 +Okay. Affliction أي بمعنى تغيير اللي هو في نشأة + +299 +00:26:07,270 --> 00:26:14,050 +العدسة of a sophtoric lens can lead to unwanted + +300 +00:26:14,050 --> 00:26:19,630 +astigmatism.الآن أنا إذا استخدم أنواع مختلفة أو + +301 +00:26:19,630 --> 00:26:25,550 +تصميم مختلفة من العدسات الـsophtoric ممكن تكون هي + +302 +00:26:25,550 --> 00:26:30,240 +غير قادرة على اكتشاف من الastigmatismلذلك فاكرين + +303 +00:26:30,240 --> 00:26:34,540 +كلام ايش قلتلكم؟ الـ corneal topography هو القادر + +304 +00:26:34,540 --> 00:26:38,460 +على اكتشاف اللي هو جداش الـ significant + +305 +00:26:38,460 --> 00:26:43,280 +astigmatism اللي موجود عند المريضAn over + +306 +00:26:43,280 --> 00:26:47,460 +topography will show significant uncorrected + +307 +00:26:47,460 --> 00:26:52,720 +astigmatism.إذا الصحيح أي evaluation للعدسات ال + +308 +00:26:52,720 --> 00:26:56,700 +software contact lenses لابد أن أستخدم بعد ما ألبس + +309 +00:26:56,700 --> 00:27:01,020 +المريض العدسة اللي هي over topography لأن هي قادرة + +310 +00:27:01,020 --> 00:27:05,660 +على اكتشاف أي كمية من ال astigmatism اللي بتكون + +311 +00:27:05,660 --> 00:27:11,480 +significantconsider a flatter limbs, a thicker + +312 +00:27:11,480 --> 00:27:16,720 +design or different cylinder location طبعا هان + +313 +00:27:16,720 --> 00:27:21,460 +المقصود بال different cylinder location ان يكون + +314 +00:27:21,460 --> 00:27:24,620 +قيمة السلمدر في ال back surface + +315 +00:27:29,720 --> 00:27:32,680 +مش احنا اتفقنا انه اما بيكون فى ال front او ال + +316 +00:27:32,680 --> 00:27:36,220 +back لكن فى الغالب العدسات اللى موجودة عندنا كلها + +317 +00:27:36,220 --> 00:27:40,440 +فى ال front لكن فى بعض الحالات ممكن انه يحتاج انه + +318 +00:27:40,440 --> 00:27:47,100 +يكون وين ال ال tourique surface فى ال back تمام؟ + +319 +00:27:47,100 --> 00:27:51,400 +Compromised + +320 +00:27:51,400 --> 00:27:57,590 +physiology is a concern as with spherical lensesكل + +321 +00:27:57,590 --> 00:28:02,530 +التأثيرات الفيسيولوجية اللي خاصة في العدسات الـ + +322 +00:28:02,530 --> 00:28:06,430 +spherical soft contact lens هي نفسها موجودة وين في + +323 +00:28:06,430 --> 00:28:10,130 +ال soft direct contact lenses أهمها مين؟ ان + +324 +00:28:10,130 --> 00:28:14,130 +العدسات ال spherical او ال soft direct contact + +325 +00:28:14,130 --> 00:28:19,430 +lenses بتقلل من مين؟ من ال BH صح ولا لأ؟ اذا + +326 +00:28:19,430 --> 00:28:23,090 +اوليتها ان ال spherical + +327 +00:28:27,680 --> 00:28:37,560 +Soft Contact Lens أو الـ Soft Rec Contact + +328 +00:28:37,560 --> 00:28:42,960 +Lens بتعمل عملية Reduce لمين لل بي اتش هذه تعتبر + +329 +00:28:42,960 --> 00:28:47,620 +من اللي هو التغيرات الفيسيولوجية اللي خاصة في مين + +330 +00:28:47,620 --> 00:28:55,740 +في الكورنيا تمام؟ complications include superior + +331 +00:28:55,740 --> 00:28:56,660 +limbal + +332 +00:29:00,860 --> 00:29:06,200 +الان الملاحظ من خلال المعمل ان ال diameter بتاع ال + +333 +00:29:06,200 --> 00:29:10,060 +software ال contact lenses اكبر من مين؟ من ال + +334 +00:29:10,060 --> 00:29:13,360 +spherical soft contact lens دايما لما بيكون ال + +335 +00:29:13,360 --> 00:29:17,260 +diameter اكبر اذا ممكن هيسببلي ايش؟ superior + +336 +00:29:17,260 --> 00:29:21,160 +limbal keratoconjunctivitis اي بمعنى inflammation + +337 +00:29:21,160 --> 00:29:26,360 +للكورنية و ال conjunctiva وين ال zone او ال area + +338 +00:29:26,360 --> 00:29:31,730 +بتكون؟ في ال superior part تمام؟والسبب انه large + +339 +00:29:31,730 --> 00:29:36,310 +lenses او ال diameter اللي هي large diameter + +340 +00:29:36,310 --> 00:29:37,150 +lenses + +341 +00:29:43,530 --> 00:29:49,170 +و Conjunctival Indentation Tight Lenses الان يما + +342 +00:29:49,170 --> 00:29:54,530 +بتكون العدسة قولنا ال movement للعدسة ال soft rec + +343 +00:29:54,530 --> 00:29:58,670 +contact lenses غالبا هي اقل من ال spherical soft + +344 +00:29:58,670 --> 00:30:03,070 +contact lenses فهذه الشي بتعمل suction لالهو + +345 +00:30:03,070 --> 00:30:08,390 +الكورنية فبالتالي انه ممكن قولنا من خواص العدسة ال + +346 +00:30:08,390 --> 00:30:12,730 +soft rec انه بتكون quite او very thin بالاضافة انه + +347 +00:30:12,730 --> 00:30:18,820 +steepفعندما تكون هى thin بتعمل ايه؟ انه suction + +348 +00:30:18,820 --> 00:30:25,240 +للكورنية تمام؟ او بتكون tight على الكورنية soft + +349 +00:30:25,240 --> 00:30:28,880 +reclinses have been reported to have a higher + +350 +00:30:28,880 --> 00:30:33,160 +incidence of edema or vessel enshrinement due to + +351 +00:30:33,160 --> 00:30:37,500 +the thickness of some lens designsدايما هذا النوع + +352 +00:30:37,500 --> 00:30:42,100 +من العدسات انه بيزود من قيمة اللي هو نسبة حدوث + +353 +00:30:42,100 --> 00:30:46,940 +incidence اي بمعنى نسبة حدوث من الكورنية القديمة + +354 +00:30:46,940 --> 00:30:54,560 +ايضا بيعمل instrument اي بمعنى انهاج للكورنية + +355 +00:30:54,560 --> 00:30:59,780 +نتيجة اللي هو ايه اختلاف في سماكة اللي هو تصميم + +356 +00:30:59,780 --> 00:31:06,240 +هذا النوع من العدساتتمام؟ يعني بالسبب انه السماكة + +357 +00:31:06,240 --> 00:31:10,120 +بتكون مختلفة ما بين ال superior part و ال inferior + +358 +00:31:10,120 --> 00:31:15,020 +part فهذا هيسبب لإيش؟ اول حاجة انه superior + +359 +00:31:15,020 --> 00:31:20,280 +keratoconjunctivitis، اتنين هيسبب كورنية القديمة، + +360 +00:31:20,280 --> 00:31:23,900 +تلاتة هيسبب اللي هو ال instrument او انهاك لمين + +361 +00:31:23,900 --> 00:31:25,340 +للكورنية + +362 +00:31:27,110 --> 00:31:32,190 +corneal inferior superior panectate keratitis لأنه + +363 +00:31:32,190 --> 00:31:36,250 +قلنا إنه ممكن في ال upper part أو ال lower part صح + +364 +00:31:36,250 --> 00:31:41,670 +لأنه في عندنا large diameter lens has also been + +365 +00:31:41,670 --> 00:31:46,370 +reported with the prism palace lenses إذا أكتر + +366 +00:31:46,370 --> 00:31:51,730 +حاجة مصاحبة مع ال prism palace إيش هو ال corneal + +367 +00:31:51,730 --> 00:31:56,550 +inferior superficial panectate keratitis ليش طيب؟ + +368 +00:31:59,430 --> 00:32:03,990 +ممتازة لأن ال graphite وين بيكون على الساعة ستة صح + +369 +00:32:03,990 --> 00:32:07,250 +ولا لأ؟ إذا هو بيكون في ال inferior part أو في ال + +370 +00:32:07,250 --> 00:32:14,010 +inferior zone فشكلتها بيكون هنا على الساعة ستة مين + +371 +00:32:14,010 --> 00:32:16,450 +اللي هو ال graphite تمام؟ + +372 +00:32:19,370 --> 00:32:24,590 +Consider silicon hydrogel turques a thinner design + +373 +00:32:24,590 --> 00:32:29,530 +or a thinner lens design or the possibility of a + +374 +00:32:29,530 --> 00:32:35,790 +GB lens اذا هان بدنا نستخدم اللي هو ايه ال silicon + +375 +00:32:35,790 --> 00:32:41,950 +فبليش هان بنستخدم ال silicon هادي واحد و اتنين + +376 +00:32:41,950 --> 00:32:42,410 +كمان + +377 +00:32:46,680 --> 00:32:50,920 +بنزود اللي هو الوتابلاتي صحيح وفترة حياة العجزة + +378 +00:32:50,920 --> 00:32:57,980 +ايش مالها؟ بنزيد صح ولا لا اثنر لينز ديزاين اذا + +379 +00:32:57,980 --> 00:33:02,160 +انقللنا طبعا هان لما انا بده اجيب اثنر لينز ديزاين + +380 +00:33:02,160 --> 00:33:06,660 +لابد اللي هو من تغيير ايش ال بريزين باليست يعني + +381 +00:33:06,660 --> 00:33:11,760 +بده اجيب dynamic stabilizationتمام؟ او possibility + +382 +00:33:11,760 --> 00:33:16,640 +of a gb lens طب افرضه انه ضال اللي هو الكوارديا + +383 +00:33:16,640 --> 00:33:21,380 +القديمة او البانكتيت كيراتايتس عند هذا البريد اذا + +384 +00:33:21,380 --> 00:33:25,920 +على طول بدي اغير اللي هو الخيار له لازم اجيب عدسة + +385 +00:33:25,920 --> 00:33:27,440 +اللي هو gb lenses + +386 +00:33:30,620 --> 00:33:34,340 +الان لو احنا غيرنا في ال features او ال + +387 +00:33:34,340 --> 00:33:38,960 +characteristics لهذا النوع من العدسات و لاحظنا ان + +388 +00:33:38,960 --> 00:33:43,580 +المريض ما استجابله بمعنى اخر انه انا روحت بدل ما + +389 +00:33:43,580 --> 00:33:46,540 +استخدمت ال prison palace جيب ده ال dynamic + +390 +00:33:46,540 --> 00:33:50,160 +stabilizationلكن المريض ضال بعاني من القرنية + +391 +00:33:50,160 --> 00:33:54,080 +القديمة، ضال بعاني من الانشرامنت، ضال بعاني مثلا + +392 +00:33:54,080 --> 00:33:57,600 +من موضوع اللي هو ال superfacial panectoid + +393 +00:33:57,600 --> 00:34:00,980 +keratitis سواء كان في ال inferior part او اللي هو + +394 +00:34:00,980 --> 00:34:03,780 +ال superior part في هذه الحالة ايش بدي اعمل؟ + +395 +00:34:04,270 --> 00:34:08,750 +التغيير اللى هو نوع العدسة هو الخيار ايه المناسب + +396 +00:34:08,750 --> 00:34:14,830 +طبعا ان شاء الله هيك بنكون انتهينا من مادة العدسات + +397 +00:34:14,830 --> 00:34:20,010 +اللاصقة بتمنى ان شاء الله لكم التوفير والنجاح ان + +398 +00:34:20,010 --> 00:34:22,610 +شاء الله في الامتحان النهائي + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/hT9kkkEBwtI.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/hT9kkkEBwtI.srt new file mode 100644 index 0000000000000000000000000000000000000000..77ca836e555e7c1f2c0e3250b3e915464f79c01f --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/hT9kkkEBwtI.srt @@ -0,0 +1,1054 @@ +1 +00:00:21,630 --> 00:00:27,370 +السلام عليكم ورحمة الله وبركاته ومرحبا بكم جميعا + +2 +00:00:27,370 --> 00:00:31,730 +طبعا هنكمل إن شاء الله في الـ software contact + +3 +00:00:31,730 --> 00:00:36,890 +اليوم هنبدأ في موضوع الـ prism ballast أو lenses + +4 +00:00:36,890 --> 00:00:41,370 +اللي هو مصدر الثقل للعدسة الـ software contact lenses + +5 +00:00:41,370 --> 00:00:46,550 +لتجنب اللي هو الـ rotation أو تجنب الـ stability للعدسة + +6 +00:00:46,550 --> 00:00:48,650 + +7 +00:00:51,100 --> 00:00:56,660 +طبعا في الجيل الأول من العدسات عملوا الـ marking + +8 +00:00:56,660 --> 00:01:02,360 +زي ما اتفقنا على الساعة ستة وكلوب وقلنا إن الـ + +9 +00:01:02,360 --> 00:01:07,340 +software contact lens هي عبارة عن صورة أو مجسم + +10 +00:01:07,340 --> 00:01:12,560 +ساعة بتكون كصورة over the surface of the cornea + +11 +00:01:12,560 --> 00:01:19,300 +فيها الساعة ستة تلاتة تسعة اتناش تمام؟ Lenses with + +12 +00:01:19,300 --> 00:01:24,900 +a prism ballast have markings that are intended to + +13 +00:01:24,900 --> 00:01:28,940 +settle at or near six o'clock in the vertical + +14 +00:01:28,940 --> 00:01:33,480 +meridian يعني المفترض أن يكون الـ marker هذا على + +15 +00:01:33,480 --> 00:01:38,100 +settle أي بمعنى اللي هو مقعد أو اللي هو مستقر أو + +16 +00:01:38,100 --> 00:01:44,450 +جالس على الساعة اللي هو كام؟ ستة تمام؟ No prism + +17 +00:01:44,450 --> 00:01:48,710 +lenses وهذه وإحنا خدناها في اللي هو الـ dynamic + +18 +00:01:48,710 --> 00:01:52,530 +stabilization يعني بين جثين أكتب الـ dynamic + +19 +00:01:52,530 --> 00:01:57,910 +stabilization No prism lenses are marked at the + +20 +00:01:57,910 --> 00:02:01,970 +three and nine o'clock positions in the horizontal + +21 +00:02:01,970 --> 00:02:08,080 +meridians إذا معناه إما بنستخدم أو إما تم استخدام + +22 +00:02:08,080 --> 00:02:11,740 +الجيل التاني من العدسات تم استخدام الـ three nine o + +23 +00:02:11,740 --> 00:02:14,920 +'clock اللي هي عبارة عن الـ dynamic stabilization + +24 +00:02:14,920 --> 00:02:20,380 +يعني على الساعة تلاتة والساعة تسعة if the laser + +25 +00:02:20,380 --> 00:02:25,260 +mark on a typical a prism ballasted torric lens + +26 +00:02:29,110 --> 00:02:33,390 +إذا كان الـ marker على الساعة ستة هذا بتديني انطباع + +27 +00:02:33,390 --> 00:02:39,150 +إن العدسة مافيش فيها أي Rotation وهذا المطلوب، + +28 +00:02:39,150 --> 00:02:45,730 +تمام؟ يعني عندنا اللي هو good lens أو عندنا properly + +29 +00:02:45,730 --> 00:02:50,270 +fit يعني الآن إما بسألك الساعة ستة، إما يكون + +30 +00:02:50,270 --> 00:02:54,990 +الـ marker على الساعة ستة، إيش هذا بتديكي انطباع؟ إنه + +31 +00:02:54,990 --> 00:02:58,330 +في عندنا good, fit أو appropriately اللي هو fit + +32 +00:02:58,330 --> 00:03:03,990 +لمن؟ للـ software contact lenses if the laser mark + +33 +00:03:03,990 --> 00:03:08,690 +sits at either five or seven o'clock لو كان في + +34 +00:03:08,690 --> 00:03:11,730 +عندنا rotation على الساعة خمسة أو rotation على + +35 +00:03:11,730 --> 00:03:16,510 +الساعة سبعة طبعا معنى الكلام إنه عبارة عن one hour + +36 +00:03:16,510 --> 00:03:21,490 +واتفقنا إنه كل ساعة هي عبارة عن تلاتين degrees إما + +37 +00:03:21,490 --> 00:03:26,440 +بتكون clockwise Counter clockwise يعني إما باتجاه + +38 +00:03:26,440 --> 00:03:32,280 +الـ left أو باتجاه الـ right Dividing + +39 +00:03:32,280 --> 00:03:37,180 +the hour into three parts produce ten degree + +40 +00:03:37,180 --> 00:03:41,780 +increments كل ساعة أنا بقدر إنه أعمل عملية تقسيم + +41 +00:03:41,780 --> 00:03:45,620 +لها لعشرة degree عشرة degree عشرة degree + +42 +00:03:45,620 --> 00:03:49,840 +Increments يعني بمعنى زيادة إنه بتعمل اللي هو + +43 +00:03:49,840 --> 00:03:51,380 +زيادة تمام؟ + +44 +00:03:53,700 --> 00:03:59,360 +الشعار التالي الـ slit lamp + +45 +00:03:59,360 --> 00:04:03,600 +يمكن أن يكون مرتبط بالمركة التوريقية على اللينز، + +46 +00:04:03,600 --> 00:04:08,980 +إذا لازم أنا أحطه باستقامة مع مين؟ مع الـ marker + +47 +00:04:08,980 --> 00:04:12,920 +الخاص بالعدسة الـ soft toric contact lenses + +48 +00:04:17,190 --> 00:04:22,270 +Slit lamps often have markings or a label can be + +49 +00:04:22,270 --> 00:04:26,590 +added to indicate the degree of beam rotation هذا + +50 +00:04:26,590 --> 00:04:30,290 +الضوء الـ slit أو الـ beam light أنا بعتبره عبارة عن + +51 +00:04:30,290 --> 00:04:33,830 +إيه؟ marker لكن الـ marker هذا خاص في مين؟ في الـ + +52 +00:04:33,830 --> 00:04:38,930 +slit lamp لازم إنه أحاول أن يكون parallel لـ الـ + +53 +00:04:38,930 --> 00:04:41,870 +marker الموجود على العدسة الـ software contact + +54 +00:04:41,870 --> 00:04:46,730 +lenses label بمعنى إيش؟ mark تمام؟ أيضا اللي هي + +55 +00:04:46,730 --> 00:04:51,330 +علامة أو إشارة هن + +56 +00:04:51,330 --> 00:04:56,370 +في شغل مهمة experience اللي هي الخبرة، دائما الـ + +57 +00:04:56,370 --> 00:05:01,170 +experience خبرة مين؟ الـ examiner And repeated + +58 +00:05:01,170 --> 00:05:05,310 +observation وتكرار عملية الفحص دائما الـ rotation + +59 +00:05:05,310 --> 00:05:09,550 +ما تحكميش عليه من الوهلة الأولى لازم مرة ومرتين و + +60 +00:05:09,550 --> 00:05:13,990 +تلاتة لحد ما تشوف استقرار العدسة بعد ذلك اللي هو + +61 +00:05:13,990 --> 00:05:20,750 +جديش قيمة الـ rotation اللي خاصة بالعدسة Experience + +62 +00:05:20,750 --> 00:05:24,370 +and repeated observation will allow the + +63 +00:05:24,370 --> 00:05:29,090 +practitioner to accurately estimate or guess + +64 +00:05:29,090 --> 00:05:32,410 +estimate the rotation of each lens + +65 +00:05:35,370 --> 00:05:41,450 +أو الـ practitioner بالإضافة لتكرار عملية الفحص أو + +66 +00:05:41,450 --> 00:05:45,650 +عملية الـ fitting هذا كله بيساعدني في تحديد جديش + +67 +00:05:45,650 --> 00:05:50,630 +قيمة الـ rotation للعدسة وأيضا اللي هو تقدير guess + +68 +00:05:50,630 --> 00:05:55,450 +estimate أي بمعنى تقدير الدوران اللي خاص بالعدسة + +69 +00:05:56,180 --> 00:05:59,600 +شايفين دائما بكتب كلمة guess estimate لأن مافيش + +70 +00:05:59,600 --> 00:06:03,400 +حاجة بتديكي اللي هو fixed value أو fixed number + +71 +00:06:03,400 --> 00:06:10,940 +كله عبارة عن تقدير للدوران الشكل + +72 +00:06:10,940 --> 00:06:16,760 +هذا جدا مهم تمام طبعا هذا عبارة عن figure + +73 +00:06:19,690 --> 00:06:24,430 +الدراسة عبارة عن part chart بنسميه دائما لما يكون + +74 +00:06:24,430 --> 00:06:32,150 +الشكل هذا اسمه part chart الآن أنا لو قلت لك اعملي + +75 +00:06:32,150 --> 00:06:37,750 +explanation شرح للـ part chart اللي خاص في الدراسة + +76 +00:06:37,750 --> 00:06:43,900 +اللي تم إجراءها عندنا astigmatism diopter in toric + +77 +00:06:43,900 --> 00:06:48,340 +soft contact lens يعني هن قيمة الـ astigmatism + +78 +00:06:48,340 --> 00:06:54,020 +اللي موجود على العدسة تمام؟ هذا بمثل مين؟ الـ + +79 +00:06:54,020 --> 00:06:58,800 +horizontal line بينما أو الـ horizontal meridian + +80 +00:06:58,800 --> 00:07:02,700 +عندنا الـ vertical meridian أو الـ vertical line + +81 +00:07:02,700 --> 00:07:08,120 +بمثل اللي هو الـ induce astigmatism يعني ممتازة + +82 +00:07:08,120 --> 00:07:13,000 +اللي هو قيمة الـ astigmatism المستحدث طيب الآن لو + +83 +00:07:13,000 --> 00:07:19,280 +أخدنا نظرة على الفيجر طبعا طلعت الفيجر مين تقدر + +84 +00:07:19,280 --> 00:07:21,860 +تعمل له explanation لها؟ + +85 +00:07:23,810 --> 00:07:27,130 +وكنا نزلنا كمية الـ astigmatism في الموجودة عند + +86 +00:07:27,130 --> 00:07:31,170 +المريض وكان الـ rotation كتير كنا أحدثنا له + +87 +00:07:31,170 --> 00:07:36,970 +astigmatism أكبر طيب ممتازة فتقدر تقدر جديش من + +88 +00:07:36,970 --> 00:07:40,870 +خلال اللي هو النتائج اللي موجودة عندك كنا نزلنا نص + +89 +00:07:40,870 --> 00:07:45,690 +astigmatism مستعدة للناس بما كانوا مستعدات متوزنة + +90 +00:07:45,690 --> 00:07:52,230 +إحنا هنناقش إيش رأيك؟ طيب + +91 +00:07:52,900 --> 00:07:58,800 +ها تفضلي تمام + +92 +00:07:58,800 --> 00:08:10,540 +okay كلام سليم another + +93 +00:08:10,540 --> 00:08:17,330 +one طيب الآن الـ figure يعني بيمثل لي كم degree قال + +94 +00:08:17,330 --> 00:08:21,670 +على الفيجر هذا تلاتين degree، هي عبارة عن تلاتين + +95 +00:08:21,670 --> 00:08:27,070 +degree، تمام؟ number two، fifteen degree، هي عبارة + +96 +00:08:27,070 --> 00:08:31,190 +عن fifteen degree، صحيح؟ وnumber three، هذه عبارة + +97 +00:08:31,190 --> 00:08:35,930 +عن إيه؟ الـ maps، دائما أي bar chart أو أي table + +98 +00:08:35,930 --> 00:08:40,590 +أو figure لابد أن يكون فيها إيه؟ map، الـ map بتوضح + +99 +00:08:40,590 --> 00:08:46,290 +لمين؟ للقارئ اللي هو كيفية تحليل إيه الدراسة عشرة + +100 +00:08:46,290 --> 00:08:51,310 +degree اللي هي بتمثل small triangle طيب، الآن لو + +101 +00:08:51,310 --> 00:08:55,830 +إيجينا مثلا عند اللي هو من الـ 30 degree الأكبر + +102 +00:08:55,830 --> 00:09:01,490 +ملاحظين اللي هو النص أو خلينا عشان تكون أكثر + +103 +00:09:01,490 --> 00:09:07,190 +وضوحا، عندنا مثلا التلاتة، كم مثلث؟ تلاتة، إيش + +104 +00:09:07,190 --> 00:09:12,590 +معناه الكلام؟ يعني عندما يكون الشخص عنده تلاتة + +105 +00:09:12,590 --> 00:09:13,150 +cylinder + +106 +00:09:16,220 --> 00:09:21,560 +تلاتة cylinder في داخل العدسة هيستحدث وعملت rotation + +107 +00:09:21,560 --> 00:09:27,380 +تلاتين degree هيستحدث قداش اللي هو تلاتة diopter لو + +108 +00:09:27,380 --> 00:09:31,960 +إيجينا مثلا للاربعة قداش استحدث astigmatism أربعة + +109 +00:09:31,960 --> 00:09:36,000 +هذه وين يا جماعة؟ لما العدسة عملت rotation تلاتين + +110 +00:09:36,000 --> 00:09:38,400 +degree واضحة الفكرة؟ + +111 +00:09:41,670 --> 00:09:46,650 +الـ خمس عشر يعني + +112 +00:09:46,650 --> 00:09:53,050 +مثلا عند اتنين جديش استحدثت واحد يعني جديش النص + +113 +00:09:53,050 --> 00:09:58,210 +إذا قيمة الـ astigmatism المستحدث إما يكون الـ + +114 +00:09:58,210 --> 00:10:02,010 +rotation قيمته خمس عشر degree عندنا نص اللي هو مين + +115 +00:10:02,010 --> 00:10:06,230 +القيمة الحقيقية يعني أنتوا لازم يكون فيه نوع من الـ + +116 +00:10:06,230 --> 00:10:09,450 +imagination التخيل يعني الآن لما شخص يكون عنده + +117 +00:10:09,450 --> 00:10:14,630 +أربعة diopter أو تلاتة diopter cylinder وعملت العدسة + +118 +00:10:14,630 --> 00:10:18,870 +دوران بقيمة تلاتين degree عمل لي تلاتة diopter زيهم + +119 +00:10:18,870 --> 00:10:23,750 +تخيلوا جديش القيمة يعني كبيرة طيب عند الخمسة عشرة + +120 +00:10:23,750 --> 00:10:28,810 +اتنين عملت واحد التلاتة عملت اللي هو تقريبا واحد و + +121 +00:10:28,810 --> 00:10:34,360 +نص بمعنى جديش النص بينما عند العشرة degree مثلا + +122 +00:10:34,360 --> 00:10:40,000 +عندنا الواحد ونص أو مش وواضح كتير مثلا الواحد عملت + +123 +00:10:40,000 --> 00:10:44,380 +اللي هو تقريبا ستة من عشرة أي بمعنى اللي هو التلت + +124 +00:10:46,670 --> 00:10:51,410 +بعدين اختصر مرة أخرى إما يكون شخص عنده تلاتة + +125 +00:10:51,410 --> 00:10:55,710 +diopter أو أربعة diopter والعدسة عملت rotation + +126 +00:10:55,710 --> 00:11:00,310 +بقيمة تلاتين degree الـ induce astigmatism هيكون + +127 +00:11:00,310 --> 00:11:07,220 +جديش the same power نفس القيمة طيب الـ خمس عشر نص + +128 +00:11:07,220 --> 00:11:12,460 +القيمة الواحد أو عفوا العشرة degree مثل اللي هو + +129 +00:11:12,460 --> 00:11:18,140 +تلت القيمة لـ الـ software contact lens إذا أعتقد + +130 +00:11:18,140 --> 00:11:22,960 +الـ figure هذا لو كان سؤال في الامتحان بالطريقة هذه + +131 +00:11:22,960 --> 00:11:25,080 +إيش بدك تعملي له explanation + +132 +00:11:31,690 --> 00:11:36,190 +في عندنا equilibrium time أي بمعنى وقت اللي هو + +133 +00:11:36,190 --> 00:11:40,690 +توازن العدسة دائما العدسة الـ soft trick في + +134 +00:11:40,690 --> 00:11:44,990 +المحاضرة الماضية ميزنا بين مصطلحين أساسيين اللي هو + +135 +00:11:44,990 --> 00:11:52,010 +موضوع الـ rotation وموضوع الـ stability إذن الوقت + +136 +00:11:52,010 --> 00:11:57,770 +توازن العدسة أو وقت اللي هو معادلة العدسة is + +137 +00:11:57,770 --> 00:12:02,750 +necessary هو يعتبر ضروري أو critical أساسي as + +138 +00:12:02,750 --> 00:12:07,990 +lenses will continue to settle over time طب ليش هو + +139 +00:12:07,990 --> 00:12:12,510 +أساسي وليه يعتبر مهم؟ لأن العدسة هتاخد اللي هو + +140 +00:12:12,510 --> 00:12:17,150 +فترة زمنية طويلة على إيش تقعد على القرنية أو + +141 +00:12:17,150 --> 00:12:21,930 +conform to the shape of the cornea, indicating that + +142 +00:12:21,930 --> 00:12:27,050 +a week of wear is indeed to better evaluate the + +143 +00:12:27,050 --> 00:12:30,170 +fit دائما عندما يكون الإنسان professional + +144 +00:12:32,870 --> 00:12:38,380 +بشتغل عمل إيديال مية في المية، الآن أنا ما وصلتش + +145 +00:12:38,380 --> 00:12:42,720 +للمرحلة النهائية من عملية ال fitting، تمام؟ يعني + +146 +00:12:42,720 --> 00:12:47,620 +نفترض اللي هو عملت جلسة أولى و ثانية، بدي أشوف + +147 +00:12:47,620 --> 00:12:53,540 +اللي هو قيمة ال rotation كتقدير لها عند scene أو + +148 +00:12:53,540 --> 00:12:57,260 +صاد أو عين، قبل ما بدي ال final اللي هو + +149 +00:12:57,260 --> 00:13:02,240 +prescription، بدي عدسة أسبوعية لمدة أسبوع، يلبسها + +150 +00:13:02,240 --> 00:13:06,900 +تمام؟ ك software contact lens و أشوف بناء على هذه + +151 +00:13:06,900 --> 00:13:11,320 +كده إنه حيصير عنده rotation يما يلبسها، طبعا ممكن + +152 +00:13:11,320 --> 00:13:14,220 +يطلب تقول له هذا مكلف بالنسبة لمين؟ لل + +153 +00:13:14,220 --> 00:13:18,080 +practitioner و ممكن بعض الأحيان يكون مكلف أو مزعج + +154 +00:13:18,080 --> 00:13:22,880 +لمين؟ لل patient لكن هذا الأسلوب الصحيح بدل ما أهدي + +155 +00:13:22,880 --> 00:13:29,080 +عدسة قيمتها اللي هو ال ... أو التكلفة 800 شكل أو + +156 +00:13:29,080 --> 00:13:34,000 +700 شكل ك final prescription، بدي عدسة أن تكون زي + +157 +00:13:34,000 --> 00:13:38,260 +عندنا في المعمل في ال trial set يعني بصل سعرها + +158 +00:13:38,260 --> 00:13:44,200 +تقريبا 50 أو 60 شكل لمدة أسبوع واحد، يلبسها و بيشوف + +159 +00:13:44,200 --> 00:13:50,870 +قيمة ال rotation اللي خاص بالعدسة، تمام؟ ليش؟ لأنه + +160 +00:13:50,870 --> 00:13:54,630 +دائما العدسة ال soft trick ما بتظهر قيمة ال + +161 +00:13:54,630 --> 00:13:58,550 +rotation فيها من أول يوم، و هذا الكلام الآن هناخده + +162 +00:13:58,550 --> 00:14:04,830 +for this reason لهذا السبب many practitioners will + +163 +00:14:04,830 --> 00:14:06,810 +allow the patient to wear + +164 +00:14:10,300 --> 00:14:14,620 +هيسمحوا العديد من اللي هو ال practitioner الأشخاص + +165 +00:14:14,620 --> 00:14:18,400 +اللي نوين يلبسوا العدسات أنه يرتدي مجموعة من + +166 +00:14:18,400 --> 00:14:23,170 +العدسات، يعني بمعنى trial and error يجرب فيهم، If + +167 +00:14:23,170 --> 00:14:26,970 +the fit and visual acuity are acceptable، يأخذ + +168 +00:14:26,970 --> 00:14:31,310 +العدسة لمدة أسبوع و أحكي لي أن العدسة كانت fit لما + +169 +00:14:31,310 --> 00:14:34,770 +أنا شفت على ال slit lamp examination لاحظت أنه في + +170 +00:14:34,770 --> 00:14:39,190 +well-centered للعدسة، و أيضا لاحظت أنه ما في أي + +171 +00:14:39,190 --> 00:14:43,410 +rotation أو rotation بسيط للعدسة، و الأهم أنه لاحظت + +172 +00:14:43,410 --> 00:14:46,870 +أنه في عنده ال visual acuity acceptable اللي هو + +173 +00:14:46,870 --> 00:14:53,940 +مقبول، تمام، before fine tuning يعني قبل الوصفة + +174 +00:14:53,940 --> 00:14:58,480 +النهائية، قبل توفير الوصفة النهائية للمريض + +175 +00:15:01,390 --> 00:15:06,270 +With the newer lenses rotation commonly doesn't + +176 +00:15:06,270 --> 00:15:10,550 +change from day one زي ما اتفقنا إن قيمة ال + +177 +00:15:10,550 --> 00:15:14,970 +rotation لا تظهر عند الشخص خلال يوم واحد، لذلك إن + +178 +00:15:14,970 --> 00:15:20,390 +عملنا على توفير عدسة يلبسها اللي هو المريض لمدة + +179 +00:15:20,390 --> 00:15:24,150 +أسبوع لملاحظة إنه هل ال visual acuity acceptable + +180 +00:15:24,150 --> 00:15:30,390 +هذه number one، و تقدير قيمة ال rotation اللي خاصة + +181 +00:15:30,390 --> 00:15:31,050 +بالعدسة + +182 +00:15:34,620 --> 00:15:38,940 +في عندنا notebook ملاحظة مهمة كتير، if the visual + +183 +00:15:38,940 --> 00:15:43,920 +acuity is good، يعني بمعنى acceptable مقبول كان + +184 +00:15:43,920 --> 00:15:48,920 +ملائم و مناسب بالنسبة للمريض، and the patient is + +185 +00:15:48,920 --> 00:15:53,340 +satisfied، أي بمعنى راضي عن العدسة و موافق عليها + +186 +00:15:53,340 --> 00:15:58,160 +و منصاع لها تمام، even though there is some rotation + +187 +00:15:58,160 --> 00:16:02,400 +of the lens، ممكن يكون one or two degrees في دوران + +188 +00:16:02,400 --> 00:16:07,320 +للعدسة، هذا أمر طبيعي، Compensation may not be + +189 +00:16:07,320 --> 00:16:11,540 +necessary، إذا إن عملية التعويض و عملية اللي هو + +190 +00:16:11,540 --> 00:16:16,980 +أن أجيب عدسة بنفس القيمة أو بنفس ال axis مش مطلوبة + +191 +00:16:16,980 --> 00:16:21,140 +ليش؟ ببساطة لأنه عنده visual acuity acceptable + +192 +00:16:21,140 --> 00:16:24,820 +و أيضا إن قيمة هذه ال rotation ال one أو ال two + +193 +00:16:24,820 --> 00:16:28,500 +degrees مش مؤثرة على المريض، تمام؟ + +194 +00:16:34,730 --> 00:16:40,290 +Compensation for lens rotation إن عملية التعويض + +195 +00:16:40,290 --> 00:16:42,430 +لدوران العدسة + +196 +00:16:46,520 --> 00:16:53,040 +is not critical or necessary، ضرورية to determine the + +197 +00:16:53,040 --> 00:16:59,340 +cylinder lens axis or the final cylinder axis for + +198 +00:16:59,340 --> 00:17:03,940 +a lens. إذن هي مهمة في تحديد قداش قيمة ال axis اللي + +199 +00:17:03,940 --> 00:17:06,800 +خاص بالسلمندر للمريض + +200 +00:17:14,400 --> 00:17:20,160 +و ممكن اللي هو كلمة laser أسهل after a trial lens + +201 +00:17:20,160 --> 00:17:20,720 +has been used + +202 +00:17:25,780 --> 00:17:31,960 +و أعمل عملية اللي هو تقييم لقيمة اللي هو دوران أو + +203 +00:17:31,960 --> 00:17:36,420 +قيمة توازن العدسة، دائما يا جماعة يما تسمع كلمة + +204 +00:17:36,420 --> 00:17:49,400 +equilibrate بمعنى stability بتعادل + +205 +00:17:49,400 --> 00:17:50,700 +كلمة stability + +206 +00:17:56,060 --> 00:18:02,680 +The rotation is measured أنا هقيم اللي هو قداش + +207 +00:18:02,680 --> 00:18:07,080 +قيمة ال rotation من خلال مين؟ الاصطلاح evaluation + +208 +00:18:07,080 --> 00:18:13,200 +أو الاصطلاح examination if the base or reference + +209 +00:18:13,200 --> 00:18:17,500 +point of the lens rotates ten degrees to the + +210 +00:18:17,500 --> 00:18:21,740 +observers left، لو كانت عاملة rotation باتجاه مين؟ + +211 +00:18:21,740 --> 00:18:26,850 +الشمال، The amount of rotation is added to the + +212 +00:18:26,850 --> 00:18:30,710 +refractive cylinder axis left at for the final + +213 +00:18:30,710 --> 00:18:34,870 +lens، و أخذنا أعتقد مثال عليها إن لو كان عند ال axis + +214 +00:18:34,870 --> 00:18:40,970 +هان 170، و في عندنا rotation باتجاه الشمال بقيمة 10 + +215 +00:18:40,970 --> 00:18:47,170 +degree، لقول 170 زائد 10 بساوي 180 قيمة من ال axis + +216 +00:18:47,170 --> 00:18:54,080 +الجديد، طيب بالنسبة للـ rotation باتجاه ال right + +217 +00:18:54,080 --> 00:18:59,540 +بدنا نعمل إيه؟ Subtract اللي هو نقص يعني بمعنى آخر + +218 +00:18:59,540 --> 00:19:03,860 +لو أنا كان عندي اللي هو قيمة ال rotation عشرين + +219 +00:19:03,860 --> 00:19:08,240 +degree باتجاه ال right، إذا بدي أقول تسعين ناقص + +220 +00:19:08,240 --> 00:19:11,980 +عشرين بساوي سبعين degree، ما بدي أخش كتير في هذا + +221 +00:19:11,980 --> 00:19:13,960 +الموضوع، لأن أعتقد إنه واضح + +222 +00:19:17,840 --> 00:19:22,280 +عنا ال guess estimation اللي هو تقدير الدوران هو + +223 +00:19:22,280 --> 00:19:27,700 +يعتبر simplest بسيط and properly اللي هو ملائم the + +224 +00:19:27,700 --> 00:19:33,760 +most common method of measuring rotation، يعني منهج + +225 +00:19:33,760 --> 00:19:39,240 +بسيط و ملائم و مناسب لعملية تقييم إيش اللي هو + +226 +00:19:39,240 --> 00:19:45,330 +دوران العدسة، The clock dial is visualized by the + +227 +00:19:45,330 --> 00:19:48,650 +practitioner with each hour زي ما اتفقنا إما + +228 +00:19:48,650 --> 00:19:53,610 +بستخدم hour ساعة يد أو بحط الastigmatic fan في + +229 +00:19:53,610 --> 00:19:59,450 +عملية التقييم with each hour، ال space between + +230 +00:19:59,450 --> 00:20:04,370 +adjacent numbers such as 5 and 6 equaling 30 + +231 +00:20:04,370 --> 00:20:08,650 +degrees، طبعا إما بكون باتجاه اللي هو ال clockwise + +232 +00:20:08,650 --> 00:20:13,970 +أو ال counter clockwise، و أيضا بعمل عملية تقسيم + +233 +00:20:13,970 --> 00:20:20,170 +الساعة ل 30 degree، okay، in addition to being simple + +234 +00:20:20,170 --> 00:20:24,210 +and easy to perform، guess estimation can be + +235 +00:20:24,210 --> 00:20:28,730 +accurate، طب كيف الآن أنا ممكن أوصل ل اللي هو + +236 +00:20:28,730 --> 00:20:33,370 +التقدير الملائم أو المناسب لقيمة ال rotation؟ + +237 +00:20:33,370 --> 00:20:37,330 +ببساطة أنا قيمت مثلا قيمة ال rotation للعدسة + +238 +00:20:37,330 --> 00:20:44,250 +نفترض 10 degree، يعني اعتمد العشرة degree، لأ بدي أعمل + +239 +00:20:44,250 --> 00:20:48,250 +over refraction، و بعد ذلك إيش بدنا نعمله؟ اللي هو + +240 +00:20:48,250 --> 00:20:51,690 +subjective refraction للمريض من خلال اللي هو + +241 +00:20:51,690 --> 00:20:55,310 +استخدام ال jackson across cylinder، بقدر اللي هو أحدد + +242 +00:20:55,310 --> 00:21:01,510 +قداش قيمة ال axis الملائم لهذا المريض، نشوف الدراسة + +243 +00:21:01,510 --> 00:21:06,870 +هذه مهمة كتير، one study found that mean rotational + +244 +00:21:06,870 --> 00:21:12,150 +estimates were within two degrees of actual values + +245 +00:21:12,150 --> 00:21:15,930 +with no significant differences between the time + +246 +00:21:17,570 --> 00:21:22,410 +يعني واحد مثلا بس هان راجعها كويس الدراسة هان، small + +247 +00:21:22,410 --> 00:21:28,710 +refractive error، تمام؟ لاحظ إنه فيه دوران بقيمة + +248 +00:21:28,710 --> 00:21:33,350 +two degrees للعدسة، فما لاحظش أي ت أيه significant + +249 +00:21:33,350 --> 00:21:38,250 +difference، يعني بمعنى آخر لم يلاحظ أي تغيير في + +250 +00:21:38,250 --> 00:21:42,890 +قيمة اللي هو ال visual acuity، يعني ببساطة يا جماعة + +251 +00:21:42,890 --> 00:21:48,590 +جاب مجموعة من المرضى، تمام؟ و نفترض هدول المرضى ال + +252 +00:21:48,590 --> 00:21:52,490 +access اللي خاص فيهم مية و ثمانية و سبعين، راح + +253 +00:21:52,490 --> 00:21:57,690 +قدهم access قداش؟ مية و ثمانين، تمام؟ عمل لهم visual + +254 +00:21:57,690 --> 00:22:01,530 +acuity على ال Snellen chart ده، لاحظ مش أي تتغير + +255 +00:22:01,530 --> 00:22:05,270 +في ال visual acuity، يعني نفترض إن كل هيتهم كان ال + +256 +00:22:05,270 --> 00:22:10,270 +visual acuity 6 على 7 و نص، فلاحظ إن هو 6 على 7 و + +257 +00:22:10,270 --> 00:22:11,950 +نص دون أي تغير + +258 +00:22:14,980 --> 00:22:18,980 +هنا لدينا قيمة الـ rotation إما باتجاه الـ right + +259 +00:22:18,980 --> 00:22:23,640 +أو الـ left، إما بكون الـ add أو الـ subtract و + +260 +00:22:23,640 --> 00:22:27,920 +بتعتمد على قيمة الـ rotation هل هي one award أو + +261 +00:22:27,920 --> 00:22:32,360 +two awards، هل هي بال degree الأخرى، طيب إن شاء الله + +262 +00:22:32,360 --> 00:22:36,620 +بنتوقف للنقطة هذه، و إن شاء الله في المحاضرة + +263 +00:22:36,620 --> 00:22:40,280 +القادمة بنكمل، نعتذر من الخلل الفني، و يعطيكم + +264 +00:22:40,280 --> 00:22:41,060 +العافية إن شاء الله diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/hT9kkkEBwtI_postprocess.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/hT9kkkEBwtI_postprocess.srt new file mode 100644 index 0000000000000000000000000000000000000000..0ce8b046be2a5b1f193e50869bdf82b238b3d7f2 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/hT9kkkEBwtI_postprocess.srt @@ -0,0 +1,1056 @@ +1 +00:00:21,630 --> 00:00:27,370 +السلام عليكم ورحمة الله وبركاته ومرحبا لكم جميعا + +2 +00:00:27,370 --> 00:00:31,730 +طبعا هنكمل ان شاء الله في ال software contact + +3 +00:00:31,730 --> 00:00:36,890 +lenses اليوم هنبدأ في موضوع ال prism ballast او + +4 +00:00:36,890 --> 00:00:41,370 +اللي هو مصدر الثقل للعدسة ال software contact + +5 +00:00:41,370 --> 00:00:46,550 +lenses لتجنب اللي هو ال rotation او تجنب ال + +6 +00:00:46,550 --> 00:00:48,650 +stability للعدسة + +7 +00:00:51,100 --> 00:00:56,660 +طبعا في الجيل الأول من العدسات عملوا الهو marking + +8 +00:00:56,660 --> 00:01:02,360 +زي ما اتفقنا على الساعة ستة و كلوب و قلنا ان ال + +9 +00:01:02,360 --> 00:01:07,340 +software contact lens هي عبارة عن صورة او مجسم + +10 +00:01:07,340 --> 00:01:12,560 +ساعة بتكون كصورة over the surface of the cornea + +11 +00:01:12,560 --> 00:01:19,300 +فيها الساعة ستة تلاتة تسعة اتناش تمام؟Lenses with + +12 +00:01:19,300 --> 00:01:24,900 +a prism palest have markings that are intended to + +13 +00:01:24,900 --> 00:01:28,940 +settle at or near six o'clock in the vertical + +14 +00:01:28,940 --> 00:01:33,480 +meridian يعني المفترض أن يكون ال marker هذا على + +15 +00:01:33,480 --> 00:01:38,100 +settle أي بمعنى اللي هو مقعد أو اللي هو مستقر أو + +16 +00:01:38,100 --> 00:01:44,450 +جالس على الساعة اللي هو كام؟ ستة تمام؟No prison + +17 +00:01:44,450 --> 00:01:48,710 +lenses وهذه وانا خدناها في اللي هو ال dynamic + +18 +00:01:48,710 --> 00:01:52,530 +stabilization يعني بين جثين اكتب ال dynamic + +19 +00:01:52,530 --> 00:01:57,910 +stabilization No prison lenses are marked at the + +20 +00:01:57,910 --> 00:02:01,970 +three and nine o'clock positions in the horizontal + +21 +00:02:01,970 --> 00:02:08,080 +meridiansاذا معناه يما بنستخدم او يما تم استخدام + +22 +00:02:08,080 --> 00:02:11,740 +الجيل التاني من العدسات تم استخدام ال three nine o + +23 +00:02:11,740 --> 00:02:14,920 +'clock اللي هي عبارة عن ال dynamic stabilization + +24 +00:02:14,920 --> 00:02:20,380 +يعني على الساعة تلاتة والساعة تسعة if the laser + +25 +00:02:20,380 --> 00:02:25,260 +mark on a typical a prism ballasted torric lens + +26 +00:02:29,110 --> 00:02:33,390 +إذا كان الماركر على الساعة ستة هذا بتديني انطباع + +27 +00:02:33,390 --> 00:02:39,150 +إن العدسة مافيش فيها أي Rotation وهذا المطلوب، + +28 +00:02:39,150 --> 00:02:45,730 +تمام؟ يعني عنا اللي هو good lens أو عنا properly + +29 +00:02:45,730 --> 00:02:50,270 +fit يعني الآن يما بسألك الساعة ستة، يما يكون + +30 +00:02:50,270 --> 00:02:54,990 +الماركر على الساعة ستة، إيش هذا بتديكي انطباع؟إنه + +31 +00:02:54,990 --> 00:02:58,330 +في عندنا good, fit أو appropriately اللي هو fit + +32 +00:02:58,330 --> 00:03:03,990 +لمن؟ للـ software contact lenses if the laser mark + +33 +00:03:03,990 --> 00:03:08,690 +sits at either five or seven o'clock لو كان في + +34 +00:03:08,690 --> 00:03:11,730 +عندنا rotation على الساعة خمسة أو rotation على + +35 +00:03:11,730 --> 00:03:16,510 +الساعة سبعة طبعا معنى الكلام إنه عبارة عن one hour + +36 +00:03:16,510 --> 00:03:21,490 +واتفقنا إنه كل ساعة هي عبارة عن تلاتين degrees إما + +37 +00:03:21,490 --> 00:03:26,440 +بتكون clockwiseCounter clockwise يعني اما باتجاه + +38 +00:03:26,440 --> 00:03:32,280 +ال left او باتجاه ال right Dividing + +39 +00:03:32,280 --> 00:03:37,180 +the hour into three parts produce ten degree + +40 +00:03:37,180 --> 00:03:41,780 +increments كل ساعة انا بقدر انه اعمل عملية تقسيم + +41 +00:03:41,780 --> 00:03:45,620 +لها لعشرة degree عشرة degree عشرة degree + +42 +00:03:45,620 --> 00:03:49,840 +Increments يعني بمعنى زيادة انه بتعمل اللي هو + +43 +00:03:49,840 --> 00:03:51,380 +زيادة تمام؟ + +44 +00:03:53,700 --> 00:03:59,360 +الشعار التالي السطلام من السطلام + +45 +00:03:59,360 --> 00:04:03,600 +يمكن أن يكون مرتبط بالمركة التوريقية على اللينز، + +46 +00:04:03,600 --> 00:04:08,980 +إذا لازم انا أحطه باستقامة مع مين؟ مع الماركر + +47 +00:04:08,980 --> 00:04:12,920 +الخاص بالعدسة ال soft toric contact lenses + +48 +00:04:17,190 --> 00:04:22,270 +Slit lamps often have markings or a label can be + +49 +00:04:22,270 --> 00:04:26,590 +added to indicate the degree of beam rotation هذا + +50 +00:04:26,590 --> 00:04:30,290 +الضوء ال slit او ال beam light انا بعتبره عبارة عن + +51 +00:04:30,290 --> 00:04:33,830 +ايه؟ marker لكن ال marker هذا خاص في مين؟ في ال + +52 +00:04:33,830 --> 00:04:38,930 +slit lamp لازم انه احاول ان يكون parallel ل ال + +53 +00:04:38,930 --> 00:04:41,870 +marker الموجود على العدسة ال software contact + +54 +00:04:41,870 --> 00:04:46,730 +lenses label بمعنى ايش؟ markتمام؟ أيضًا اللي هي + +55 +00:04:46,730 --> 00:04:51,330 +علامة أو إشارة هان + +56 +00:04:51,330 --> 00:04:56,370 +في شغل مهمة experience اللي هي الخبرة، دايما ال + +57 +00:04:56,370 --> 00:05:01,170 +experience خبرة مين؟ ال examinerAnd repeated + +58 +00:05:01,170 --> 00:05:05,310 +observation وتكرار عملية الفحص دايما ال rotation + +59 +00:05:05,310 --> 00:05:09,550 +ما تحكميش عليه من الوهلة الأولى لازم مرة و مرتين و + +60 +00:05:09,550 --> 00:05:13,990 +تلاتة لحد ما تشوف استقرار العدسة بعد ذلك اللي هو + +61 +00:05:13,990 --> 00:05:20,750 +جديش قيمة ال rotation اللي خاصة بالعدسةExperience + +62 +00:05:20,750 --> 00:05:24,370 +and repeated observation will allow the + +63 +00:05:24,370 --> 00:05:29,090 +practitioner to accurately estimate or guess + +64 +00:05:29,090 --> 00:05:32,410 +estimate the rotation of each lens + +65 +00:05:35,370 --> 00:05:41,450 +أو الـ practitioner بالإضافة لتكرار عملية الفحص أو + +66 +00:05:41,450 --> 00:05:45,650 +عملية ال fitting هذا كله بيساعدني في تحديد جداش + +67 +00:05:45,650 --> 00:05:50,630 +قيمة ال rotation للعدسة وأيضا اللي هو تقدير guess + +68 +00:05:50,630 --> 00:05:55,450 +estimate أي بمعنى تقدير الدوران اللي خاص بالعدسة + +69 +00:05:56,180 --> 00:05:59,600 +شايفين دايما بكتب كلمة guess estimate لان مافيش + +70 +00:05:59,600 --> 00:06:03,400 +حاجة بتديكي اللي هو fixed value او fixed number + +71 +00:06:03,400 --> 00:06:10,940 +كله عبارة عن تقدير للدوران الشكل + +72 +00:06:10,940 --> 00:06:16,760 +هذا جدا مهم تمام طبعا هذا عبارة عن figure + +73 +00:06:19,690 --> 00:06:24,430 +الدراسة عبارة عن part chart بنسميه دايما لما يكون + +74 +00:06:24,430 --> 00:06:32,150 +الشكل هذا اسمه part chart الان انا لو قلتلك اعملي + +75 +00:06:32,150 --> 00:06:37,750 +explanation شرح لل part chart اللي خاص في الدراسة + +76 +00:06:37,750 --> 00:06:43,900 +اللي تم إجراءهاعنا astigmatism diopter in turic + +77 +00:06:43,900 --> 00:06:48,340 +soft contact lens يعني هان قيمة ال astigmatism + +78 +00:06:48,340 --> 00:06:54,020 +اللي موجود على العدسة تمام؟ هذا بمثل مين؟ ال + +79 +00:06:54,020 --> 00:06:58,800 +horizontal lineبينما او ال horizontal meridian + +80 +00:06:58,800 --> 00:07:02,700 +عندنا ال vertical meridian او ال vertical line + +81 +00:07:02,700 --> 00:07:08,120 +بمثل اللي هو ال induce astigmatism يعني ممتازة + +82 +00:07:08,120 --> 00:07:13,000 +اللي هو قيمة ال astigmatism المستحدث طيب الان لو + +83 +00:07:13,000 --> 00:07:19,280 +أخدنا نظرة على الفيجر طبعا طلعت الفيجر مين تقدر + +84 +00:07:19,280 --> 00:07:21,860 +تعملي explanation لها؟ + +85 +00:07:23,810 --> 00:07:27,130 +و كنا نزلت كمية ال astigmatism في الموجودة عند + +86 +00:07:27,130 --> 00:07:31,170 +المريض و كان ال rotation كتير كنا أحدث ليه + +87 +00:07:31,170 --> 00:07:36,970 +astigmatism أكبر طيب ممتازة فتقدر تقدر جديش من + +88 +00:07:36,970 --> 00:07:40,870 +خلال اللي هو النتائج اللي موجودة عندك كنا نزلت نص + +89 +00:07:40,870 --> 00:07:45,690 +astigmatism مستعدة لناس بما كانوا مستعدات متوزنة + +90 +00:07:45,690 --> 00:07:52,230 +احنا هبنتناقش ايش رأيك؟ طيب + +91 +00:07:52,900 --> 00:07:58,800 +ها تفضلي تمام + +92 +00:07:58,800 --> 00:08:10,540 +okay كلام سليم another + +93 +00:08:10,540 --> 00:08:17,330 +one طيب الآن ال figure يعني بيمثل لي أكم degreeقال + +94 +00:08:17,330 --> 00:08:21,670 +على الفيجر هذا تلاتين ديجري، هي عبارة عن تلاتين + +95 +00:08:21,670 --> 00:08:27,070 +ديجري، تمام؟ number two، fifteen degree، هي عبارة + +96 +00:08:27,070 --> 00:08:31,190 +عن fifteen ديجري، صحيح؟ و number three، هذه عبارة + +97 +00:08:31,190 --> 00:08:35,930 +عن ايه؟ ال maps، دايما اية bar chart او اية table + +98 +00:08:35,930 --> 00:08:40,590 +او فيجر لابد ان يكون فيها ايه؟ map، ال map بتوضح + +99 +00:08:40,590 --> 00:08:46,290 +لمين؟ للقارئ اللي هو كيفية تحليل ايه الدراسةعشرة + +100 +00:08:46,290 --> 00:08:51,310 +degree اللي هي بتمثل small triangle طيب، الآن لو + +101 +00:08:51,310 --> 00:08:55,830 +إيجينا مثلا عند اللي هو من ال 30 degree الأكبر + +102 +00:08:55,830 --> 00:09:01,490 +ملاحظين اللي هو النص أو خلينا عشان تكون أكتر + +103 +00:09:01,490 --> 00:09:07,190 +وضوحا، عندنا مثلا التلاتة، كم مثلات؟ تلاتة، إيش + +104 +00:09:07,190 --> 00:09:12,590 +معناه الكلام؟ يعني عندما يكون الشخص عنده تلاتة + +105 +00:09:12,590 --> 00:09:13,150 +cylinder + +106 +00:09:16,220 --> 00:09:21,560 +تلاتة سيلندر في داخل العدسة هيستحدث وعملت روتيشن + +107 +00:09:21,560 --> 00:09:27,380 +تلاتين ديجرين هيستحدث قداش اللي هو تلاتة ديوبتر لو + +108 +00:09:27,380 --> 00:09:31,960 +اجينا مثلا للاربعة قداش استحدث أستيجماتيزم اربعة + +109 +00:09:31,960 --> 00:09:36,000 +هذه وين يا جماعة؟ لما العدسة عملت روتيشن تلاتين + +110 +00:09:36,000 --> 00:09:38,400 +ديجرين واضحة الفكرة؟ + +111 +00:09:41,670 --> 00:09:46,650 +الخمس عشر يعني + +112 +00:09:46,650 --> 00:09:53,050 +مثلا عند اتنين جداش استحدثات واحد يعني جداش النص + +113 +00:09:53,050 --> 00:09:58,210 +إذا قيمة الـastigmatism المستحدث يما يكون ال + +114 +00:09:58,210 --> 00:10:02,010 +rotation قيمته خمس عشر degree عندنا نص اللي هو مين + +115 +00:10:02,010 --> 00:10:06,230 +القيمة الحقيقيةيعني انتوا لازم يكون فيه نوع من ال + +116 +00:10:06,230 --> 00:10:09,450 +imagination التخيل يعني الآن لما شخص يكون عنده + +117 +00:10:09,450 --> 00:10:14,630 +اربعة ديوبتر او تلاتة ديوبتر سيلندر وعملت العدسة + +118 +00:10:14,630 --> 00:10:18,870 +دوران بقيمة تلاتين ديجري عمللي تلاتة ديوبتر زيهم + +119 +00:10:18,870 --> 00:10:23,750 +تخيلوا قداش القيمة يعني كبيرة طيب عند الخمساش + +120 +00:10:23,750 --> 00:10:28,810 +اتنين عملت واحد التلاتة عملت اللي هو تقريبا واحد و + +121 +00:10:28,810 --> 00:10:34,360 +نص بمعنى قداش النصبينما عند العشرة degree مثلا + +122 +00:10:34,360 --> 00:10:40,000 +عندنا الواحد و نص أو مش وابح كتير مثلا الواحد عملت + +123 +00:10:40,000 --> 00:10:44,380 +اللي هو تقريبا ستة من عشرة أي بمعنى اللي هو التلت + +124 +00:10:46,670 --> 00:10:51,410 +بعدين اختصر مرة اخرى يما يكون شخص عنده تلاتة + +125 +00:10:51,410 --> 00:10:55,710 +ديوبتر او اربعة ديوبتر و العدسة عملت rotation + +126 +00:10:55,710 --> 00:11:00,310 +بقيمة تلاتين degree ال induce astigmatism هيكون + +127 +00:11:00,310 --> 00:11:07,220 +جداش the same power نفس القيمةطيب الخمس عشر نص + +128 +00:11:07,220 --> 00:11:12,460 +القيمة الواحد او عفوا العشرة degree مثل اللي هو + +129 +00:11:12,460 --> 00:11:18,140 +تلت القيمة ل ال software contact lens اذا اعتقد + +130 +00:11:18,140 --> 00:11:22,960 +الفيجر هذا لو كان سؤال في الامتحان بالطريقة هذه + +131 +00:11:22,960 --> 00:11:25,080 +ايش بدك تعمليله explanation + +132 +00:11:31,690 --> 00:11:36,190 +في عندنا equilibrium time أي بمعنى وقت اللي هو + +133 +00:11:36,190 --> 00:11:40,690 +توازن العدسة دايما العدسة ال soft trick في + +134 +00:11:40,690 --> 00:11:44,990 +المحاضرة الماضية ميزنا بين مصطلحين أساسيين اللي هو + +135 +00:11:44,990 --> 00:11:52,010 +موضوع ال rotation وموضوع ال stabilityإذن الوقت + +136 +00:11:52,010 --> 00:11:57,770 +التوازن العدسة أو وقت اللي هو معادلة العدسة is + +137 +00:11:57,770 --> 00:12:02,750 +necessary هو يعتبر ضروري أو critical أساسي as + +138 +00:12:02,750 --> 00:12:07,990 +lenses will continueto settle over time طب ليش هو + +139 +00:12:07,990 --> 00:12:12,510 +أساسي و ليش يعتبر مهم؟ لأن العجزة هتاخد اللي هو + +140 +00:12:12,510 --> 00:12:17,150 +فترة زمانية طويلة على إيش تقعد على القرنية أو + +141 +00:12:17,150 --> 00:12:21,930 +conform to the shape of the cornea Indicating that + +142 +00:12:21,930 --> 00:12:27,050 +a week of wear is indeed to better evaluate the + +143 +00:12:27,050 --> 00:12:30,170 +fit دايما عندما يكون إنسان professional + +144 +00:12:32,870 --> 00:12:38,380 +بشتغل عمل ايديال مية في الميةالان انا ماوصلتش + +145 +00:12:38,380 --> 00:12:42,720 +للمرحلة النهائية من عملية ال fitting، تمام؟ يعني + +146 +00:12:42,720 --> 00:12:47,620 +نفترض اللي هو اعملت جلسة أولى و تانية، بدي اشوف + +147 +00:12:47,620 --> 00:12:53,540 +اللي هو قيمة ال rotation كتقدير لها عند scene أو + +148 +00:12:53,540 --> 00:12:57,260 +صاد أو عين، قبل ما بدي ال final اللي هو + +149 +00:12:57,260 --> 00:13:02,240 +prescription، بدي عجسة أسبوعية لمدة أسبوع، يلبسها + +150 +00:13:02,240 --> 00:13:06,900 +تمام؟ ك software contact lensو اشوف بناء على هذه + +151 +00:13:06,900 --> 00:13:11,320 +كده انه حيصير عنده rotation يما يلبسها طبعا ممكن + +152 +00:13:11,320 --> 00:13:14,220 +طالب تقول ليه هذا مكلف بالنسبة لمين لل + +153 +00:13:14,220 --> 00:13:18,080 +practitioner و ممكن بعض الأحيان يكون مكلف او مزعج + +154 +00:13:18,080 --> 00:13:22,880 +لمين لل patient لكن هذا الاسلوب الصحيح بدل ما هدي + +155 +00:13:22,880 --> 00:13:29,080 +عدسة قيمتها اللي هو ال .. اووالتكلفة 800 شكل او + +156 +00:13:29,080 --> 00:13:34,000 +700 شكل ك final prescription بدي عدسة ان تكون زي + +157 +00:13:34,000 --> 00:13:38,260 +عندنا في المعمل في ال trial set يعني بصل سعرها + +158 +00:13:38,260 --> 00:13:44,200 +تقريبا 50 او 60 شكل لمدة أسبوع واحد بلبسها وبيشوف + +159 +00:13:44,200 --> 00:13:50,870 +قيمة ال rotation اللي خاص بالعدسة تمام؟ليش؟ لأنه + +160 +00:13:50,870 --> 00:13:54,630 +دايما العدسة ال soft trick ما بتظهر قيمة ال + +161 +00:13:54,630 --> 00:13:58,550 +rotation فيها من أول يوم وهذا الكلام الآن هناخده + +162 +00:13:58,550 --> 00:14:04,830 +for this reason لهذا السبب many practitioners will + +163 +00:14:04,830 --> 00:14:06,810 +allow the patient to wear + +164 +00:14:10,300 --> 00:14:14,620 +هيسمحوا العديد من اللي هو ال practitioner الأشخاص + +165 +00:14:14,620 --> 00:14:18,400 +اللي نوين يلبسوا العدسات انه يرتدي مجموعة من + +166 +00:14:18,400 --> 00:14:23,170 +العدسات يعني بمعنى trial and error يجارف فيهمIf + +167 +00:14:23,170 --> 00:14:26,970 +the fit and visual acuity are acceptable أخد + +168 +00:14:26,970 --> 00:14:31,310 +العدسة لمدة أسبوع و أحكى لي أن العدسة كانت fit لما + +169 +00:14:31,310 --> 00:14:34,770 +أنا شفت على ال sitlam examination لاحظت أنه في + +170 +00:14:34,770 --> 00:14:39,190 +well-centered للعدسة و أيضا لاحظت أنه مافي أي ت + +171 +00:14:39,190 --> 00:14:43,410 +rotation أو rotation بسيط للعدسة و الأهم أنه لاحظت + +172 +00:14:43,410 --> 00:14:46,870 +أنه في عنده ال visual acuity acceptable اللي هو + +173 +00:14:46,870 --> 00:14:53,940 +مقبول تمامbefore fine tuning يعني قبل الوصفة + +174 +00:14:53,940 --> 00:14:58,480 +النهائية قبل توفير الوصفة النهائية للمريض + +175 +00:15:01,390 --> 00:15:06,270 +With the newer lenses rotation commonly doesn't + +176 +00:15:06,270 --> 00:15:10,550 +change from day one زي ما اتفقنا ان قيمة ال + +177 +00:15:10,550 --> 00:15:14,970 +rotation لا تظهر عند الشخص خلال يوم واحد لذلك ان + +178 +00:15:14,970 --> 00:15:20,390 +اعملنا على توفير عدسة يلبسها اللي هو المريض لمدة + +179 +00:15:20,390 --> 00:15:24,150 +اسبوع لملاحظة انه هل ال visual acuity acceptable + +180 +00:15:24,150 --> 00:15:30,390 +هذي number one وتقدير قيمة ال rotation اللي خاصة + +181 +00:15:30,390 --> 00:15:31,050 +بالعدسة + +182 +00:15:34,620 --> 00:15:38,940 +في عندنا notebook ملاحظة مهمة كتير if the visual + +183 +00:15:38,940 --> 00:15:43,920 +acuity is good يعني بمعنى acceptable مقبول كان + +184 +00:15:43,920 --> 00:15:48,920 +ملائم ومناسب بالنسبة للمريض and the patient is + +185 +00:15:48,920 --> 00:15:53,340 +satisfied أي بمعنى راضي عن العدسة وموافق عليها + +186 +00:15:53,340 --> 00:15:58,160 +ومنصاع لها تمام even though there is some rotation + +187 +00:15:58,160 --> 00:16:02,400 +of the lens ممكن يكون one or two degrees في دوران + +188 +00:16:02,400 --> 00:16:07,320 +للعدسة هذا أمر طبيعيCompensation may not be + +189 +00:16:07,320 --> 00:16:11,540 +necessary إذا انهان عملية التعويض وعملية اللي هو + +190 +00:16:11,540 --> 00:16:16,980 +أن أجيب عدسة بنفس القيمة أو بنفس ال axis مش مطلوبة + +191 +00:16:16,980 --> 00:16:21,140 +ليش؟ ببساطة لأنه عنده visual acuity acceptable + +192 +00:16:21,140 --> 00:16:24,820 +وأيضا أن قيمة هذه ال rotation ال one أو ال two + +193 +00:16:24,820 --> 00:16:28,500 +degrees مش مأثرة على المريض تمام؟ + +194 +00:16:34,730 --> 00:16:40,290 +Compensation for lens rotation ان عملية التعويض + +195 +00:16:40,290 --> 00:16:42,430 +لدوران العدسة + +196 +00:16:46,520 --> 00:16:53,040 +or critical or necessary ضرورية to determine the + +197 +00:16:53,040 --> 00:16:59,340 +cylinder lens axis or the final cylinder axis for + +198 +00:16:59,340 --> 00:17:03,940 +a lens.إذن هي مهمة في تحديد قداش قيمة ال axis اللي + +199 +00:17:03,940 --> 00:17:06,800 +خاص بالسلمدر للمريض + +200 +00:17:14,400 --> 00:17:20,160 +و ممكن اللي هو كلمة laser أسهل after a trial lens + +201 +00:17:20,160 --> 00:17:20,720 +has been used + +202 +00:17:25,780 --> 00:17:31,960 +و اعمل عملية اللي هو تقييم لقيمة اللي هو دوران او + +203 +00:17:31,960 --> 00:17:36,420 +قيمة توازن العدسة دايما يا جماعة يما تسمع كلمة + +204 +00:17:36,420 --> 00:17:49,400 +equilibrate بمعنى stability بتعادل + +205 +00:17:49,400 --> 00:17:50,700 +كلمة stability + +206 +00:17:56,060 --> 00:18:02,680 +The rotation is measured انا هقيم اللى هو جداش + +207 +00:18:02,680 --> 00:18:07,080 +قيمة ال rotation من خلال مين الاصطلاح evaluation + +208 +00:18:07,080 --> 00:18:13,200 +او الاصطلاح examination if the base or reference + +209 +00:18:13,200 --> 00:18:17,500 +point of the lens rotates ten degrees to the + +210 +00:18:17,500 --> 00:18:21,740 +observers left لو كانت عاملة rotation باتجاه مين؟ + +211 +00:18:21,740 --> 00:18:26,850 +الشمالThe amount of rotation is added to the + +212 +00:18:26,850 --> 00:18:30,710 +refractive cylinder axis left at for the final + +213 +00:18:30,710 --> 00:18:34,870 +lens وخدنا اعتقد مثال عليها ان لو كان عند ال axis + +214 +00:18:34,870 --> 00:18:40,970 +هان 170 وفي عندنا rotation باتجاه الشمال بقيمة 10 + +215 +00:18:40,970 --> 00:18:47,170 +degree لقول 170 زائد 10 بساوة 180 قيمة من ال axis + +216 +00:18:47,170 --> 00:18:54,080 +الجديدطيب بالنسبة للـ rotation باتجاه ال right + +217 +00:18:54,080 --> 00:18:59,540 +بدنا نعمل ايه؟ Subtract اللي هو قرح يعني بمعنى اخر + +218 +00:18:59,540 --> 00:19:03,860 +لو انا كان عندى اللي هو قيمة ال rotation عشرين + +219 +00:19:03,860 --> 00:19:08,240 +ديجري باتجاه ال right اذا بدي اقول تسعين ناقص + +220 +00:19:08,240 --> 00:19:11,980 +عشرين بساوي سبعين ديجري مابديش اخوض كتير في هذا + +221 +00:19:11,980 --> 00:19:13,960 +الموضوع لان اعتقد انه واضح + +222 +00:19:17,840 --> 00:19:22,280 +عنا ال guess estimation اللي هو تقدير الدوران هو + +223 +00:19:22,280 --> 00:19:27,700 +يعتبر simplest بسيط and properly اللي هو ملائم the + +224 +00:19:27,700 --> 00:19:33,760 +most common method of measuring rotation يعني منهج + +225 +00:19:33,760 --> 00:19:39,240 +بسيط و ملائم و مناسب لعملية تقييم إيش اللي هو + +226 +00:19:39,240 --> 00:19:45,330 +دوران العدسةThe clock dial is visualized by the + +227 +00:19:45,330 --> 00:19:48,650 +practitioner with each hour زي ما اتفقنا اما + +228 +00:19:48,650 --> 00:19:53,610 +بستخدم hour ساعة يد او بحط الastigmatic fan في + +229 +00:19:53,610 --> 00:19:59,450 +عملية التقييم with each hour ال space between + +230 +00:19:59,450 --> 00:20:04,370 +adjacent numbers such as 5 and 6 equaling 30 + +231 +00:20:04,370 --> 00:20:08,650 +degrees طبعا اما بكون باتجاه اللي هو ال clockwise + +232 +00:20:08,650 --> 00:20:13,970 +او ال counter clockwiseو ايضا بعمل عملية تقسيم + +233 +00:20:13,970 --> 00:20:20,170 +الساعة ل 30 ديجري okay in addition to being simple + +234 +00:20:20,170 --> 00:20:24,210 +and easy to perform guess estimation can be + +235 +00:20:24,210 --> 00:20:28,730 +accurate طب كيف الان انا ممكن اصل لا اللي هو + +236 +00:20:28,730 --> 00:20:33,370 +التقدير الملائم او المناسب لقيمة ال rotation؟ + +237 +00:20:33,370 --> 00:20:37,330 +البساطة انا قيمت مثلا قيمة ال rotation للعدسة + +238 +00:20:37,330 --> 00:20:44,250 +نفترض 10 ديجرييعني اعتمد العشرة degree لأ بدي اعمل + +239 +00:20:44,250 --> 00:20:48,250 +over refraction وبعد ذلك ايش بدنا نعمله اللي هو + +240 +00:20:48,250 --> 00:20:51,690 +subjective refraction للمريض من خلال اللي هو + +241 +00:20:51,690 --> 00:20:55,310 +استخدام الجاكسون across cylinder بقدر اللي هو احدد + +242 +00:20:55,310 --> 00:21:01,510 +قداش قيمة ال axis الملائم لهذا المريضنشوف الدراسة + +243 +00:21:01,510 --> 00:21:06,870 +هذه مهمة كتير one study found that mean rotational + +244 +00:21:06,870 --> 00:21:12,150 +estimates were within two degrees of actual values + +245 +00:21:12,150 --> 00:21:15,930 +with no significant differences between the time + +246 +00:21:17,570 --> 00:21:22,410 +يعني واحد مثلا بس هان راجزه كويس الدراسة هان small + +247 +00:21:22,410 --> 00:21:28,710 +refractive error تمام؟ لاحظ أنه فيه دوران بقيمة + +248 +00:21:28,710 --> 00:21:33,350 +two degrees للعدسة فمالاحظش أي ت أيه significant + +249 +00:21:33,350 --> 00:21:38,250 +difference يعني بمعنى آخر لم يلاحظ أي تغيير في + +250 +00:21:38,250 --> 00:21:42,890 +قيمة اللي هو ال visual acuityيعني بساطة يا جماعة + +251 +00:21:42,890 --> 00:21:48,590 +جاب مجموعة من المرضى، تمام؟ ونفترض هدول المرضى ال + +252 +00:21:48,590 --> 00:21:52,490 +access اللي خاص فيهم مية و تمانية و سبعين، راح + +253 +00:21:52,490 --> 00:21:57,690 +قدهم access قداش مية و تمانين، تمام؟عملهم visual + +254 +00:21:57,690 --> 00:22:01,530 +acuity على ال smelling chart ده لاحظ مش اي تتغير + +255 +00:22:01,530 --> 00:22:05,270 +في ال visual acuity يعني نفترض ان كل هيتهم كان ال + +256 +00:22:05,270 --> 00:22:10,270 +visual acuity 6 على 7 و نص فلاحظ ان هو 6 على 7 و + +257 +00:22:10,270 --> 00:22:11,950 +نص دون اي تغير + +258 +00:22:14,980 --> 00:22:18,980 +هنا لدينا قيمة الـ rotation إما باتجاه الـ right + +259 +00:22:18,980 --> 00:22:23,640 +أو الـ left إما بكون الـ add أو الـ subtract و + +260 +00:22:23,640 --> 00:22:27,920 +بتعتمد على قيمة الـ rotation هل هي one award او + +261 +00:22:27,920 --> 00:22:32,360 +two awards هل هي بال degree الاخرى طيب ان شاء الله + +262 +00:22:32,360 --> 00:22:36,620 +بنتوقف للنقطة هذه و ان شاء الله في المحاضرة + +263 +00:22:36,620 --> 00:22:40,280 +القادمة بنكمل نعتذر من الخلل الفني و يعطيكم + +264 +00:22:40,280 --> 00:22:41,060 +العافية ان شاء الله + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/hT9kkkEBwtI_raw.json b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/hT9kkkEBwtI_raw.json new file mode 100644 index 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398.01, "end": 398.35, "word": " تم", "probability": 0.9892578125}, {"start": 398.35, "end": 399.07, "word": " إجراءها", "probability": 0.858984375}], "temperature": 1.0}, {"id": 17, "seek": 41542, "start": 400.12, "end": 415.42, "text": "عنا astigmatism diopter in turic soft contact lens يعني هان قيمة ال astigmatism اللي موجود على العدسة تمام؟ هذا بمثل مين؟ ال horizontal line", "tokens": [3615, 8315, 5357, 46496, 1434, 1026, 404, 391, 294, 3243, 299, 2787, 3385, 6765, 37495, 22653, 8032, 7649, 12174, 32640, 3660, 2423, 5357, 46496, 1434, 13672, 1829, 3714, 29245, 23328, 15844, 18863, 3215, 3794, 3660, 46811, 10943, 22807, 23758, 4724, 2304, 12984, 1211, 3714, 9957, 22807, 2423, 12750, 1622], "avg_logprob": -0.28484375655651095, "compression_ratio": 1.28, "no_speech_prob": 0.0, "words": [{"start": 400.12, "end": 400.64, "word": "عنا", "probability": 0.57861328125}, {"start": 400.64, "end": 402.08, "word": " astigmatism", "probability": 0.6909993489583334}, {"start": 402.08, "end": 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"word": " موجود", "probability": 0.9812825520833334}, {"start": 409.04, "end": 409.2, "word": " على", "probability": 0.70751953125}, {"start": 409.2, "end": 409.96, "word": " العدسة", "probability": 0.9122314453125}, {"start": 409.96, "end": 411.3, "word": " تمام؟", "probability": 0.7215983072916666}, {"start": 411.3, "end": 412.84, "word": " هذا", "probability": 0.79443359375}, {"start": 412.84, "end": 413.36, "word": " بمثل", "probability": 0.86181640625}, {"start": 413.36, "end": 413.88, "word": " مين؟", "probability": 0.9161783854166666}, {"start": 413.88, "end": 414.02, "word": " ال", "probability": 0.958984375}, {"start": 414.02, "end": 414.58, "word": " horizontal", "probability": 0.75634765625}, {"start": 414.58, "end": 415.42, "word": " line", "probability": 0.97265625}], "temperature": 1.0}, {"id": 18, "seek": 44186, "start": 416.36, "end": 441.86, "text": "بينما او ال horizontal meridian عندنا ال vertical meridian او ال vertical line بمثل اللي هو ال induce astigmatism يعني ممتازة اللي هو قيمة ال astigmatism المستحدث طيب الان لو أخدنا نظرة على الفيجر طبعا طلعت الفيجر مين تقدر تعملي explanation لها؟", "tokens": [3555, 9957, 15042, 1975, 2407, 2423, 12750, 3551, 34681, 43242, 8315, 2423, 9429, 3551, 34681, 1975, 2407, 2423, 9429, 1622, 4724, 2304, 12984, 1211, 13672, 1829, 31439, 2423, 41263, 5357, 46496, 1434, 37495, 22653, 3714, 2304, 2655, 31377, 3660, 13672, 1829, 31439, 12174, 32640, 3660, 2423, 5357, 46496, 1434, 9673, 14851, 24401, 12984, 23032, 1829, 3555, 2423, 7649, 45164, 5551, 9778, 3215, 8315, 8717, 19913, 25720, 15844, 27188, 1829, 7435, 2288, 23032, 3555, 3615, 995, 23032, 1211, 34268, 27188, 1829, 7435, 2288, 3714, 9957, 6055, 28543, 2288, 6055, 25957, 20292, 10835, 5296, 11296, 22807], "avg_logprob": -0.20115131484834772, "compression_ratio": 1.6545454545454545, "no_speech_prob": 0.0, "words": [{"start": 416.36, "end": 416.94, "word": "بينما", "probability": 0.82568359375}, {"start": 416.94, "end": 417.2, "word": " او", "probability": 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0.9680989583333334}, {"start": 716.17, "end": 717.25, "word": " العدسة", "probability": 0.945556640625}, {"start": 717.25, "end": 717.77, "word": " is", "probability": 0.231689453125}, {"start": 717.77, "end": 718.33, "word": " necessary", "probability": 0.97119140625}, {"start": 718.33, "end": 718.87, "word": " هو", "probability": 0.8720703125}, {"start": 718.87, "end": 719.37, "word": " يعتبر", "probability": 0.9441731770833334}, {"start": 719.37, "end": 719.97, "word": " ضروري", "probability": 0.95263671875}, {"start": 719.97, "end": 720.31, "word": " أو", "probability": 0.81298828125}, {"start": 720.31, "end": 720.99, "word": " critical", "probability": 0.64501953125}, {"start": 720.99, "end": 721.87, "word": " أساسي", "probability": 0.86181640625}, {"start": 721.87, "end": 722.75, "word": " as", "probability": 0.360595703125}, {"start": 722.75, "end": 723.41, "word": " lenses", "probability": 0.85888671875}, {"start": 723.41, "end": 724.17, "word": " will", "probability": 0.90625}, {"start": 724.17, "end": 725.07, "word": " continue", "probability": 0.94384765625}], "temperature": 1.0}, {"id": 31, "seek": 75017, "start": 725.45, "end": 750.17, "text": "to settle over time طب ليش هو أساسي و ليش يعتبر مهم؟ لأن العجزة هتاخد اللي هو فترة زمانية طويلة على إيش تقعد على القرنية أو conform to the shape of the cornea Indicating that a week of wear is indeed to better evaluate the fit دايما عندما يكون إنسان professional", "tokens": [1353, 11852, 670, 565, 23032, 3555, 32239, 8592, 31439, 5551, 3794, 32277, 1829, 4032, 32239, 8592, 7251, 34268, 26890, 3714, 16095, 22807, 5296, 33456, 18863, 7435, 11622, 3660, 8032, 2655, 47283, 3215, 13672, 1829, 31439, 6156, 2655, 25720, 30767, 2304, 7649, 10632, 23032, 2407, 26895, 3660, 15844, 11933, 1829, 8592, 6055, 4587, 22488, 15844, 25062, 2288, 1863, 10632, 34051, 18975, 281, 264, 3909, 295, 264, 1181, 22160, 2333, 30541, 300, 257, 1243, 295, 3728, 307, 6451, 281, 1101, 13059, 264, 3318, 11778, 47302, 15042, 43242, 15042, 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يعتبر", "probability": 0.9759114583333334}, {"start": 729.53, "end": 730.19, "word": " مهم؟", "probability": 0.85107421875}, {"start": 730.19, "end": 730.37, "word": " لأن", "probability": 0.858154296875}, {"start": 730.37, "end": 730.99, "word": " العجزة", "probability": 0.8197021484375}, {"start": 730.99, "end": 731.91, "word": " هتاخد", "probability": 0.8748779296875}, {"start": 731.91, "end": 732.13, "word": " اللي", "probability": 0.778076171875}, {"start": 732.13, "end": 732.51, "word": " هو", "probability": 0.9462890625}, {"start": 732.51, "end": 733.05, "word": " فترة", "probability": 0.9874674479166666}, {"start": 733.05, "end": 733.57, "word": " زمانية", "probability": 0.8590087890625}, {"start": 733.57, "end": 734.23, "word": " طويلة", "probability": 0.9644775390625}, {"start": 734.23, "end": 734.87, "word": " على", "probability": 0.69580078125}, {"start": 734.87, "end": 735.45, "word": " إيش", "probability": 0.853515625}, {"start": 735.45, "end": 736.01, "word": " تقعد", "probability": 0.7786458333333334}, {"start": 736.01, "end": 736.19, "word": " على", "probability": 0.91064453125}, {"start": 736.19, "end": 736.85, "word": " القرنية", "probability": 0.8704833984375}, {"start": 736.85, "end": 737.15, "word": " أو", "probability": 0.5986328125}, {"start": 737.15, "end": 737.51, "word": " conform", "probability": 0.89404296875}, {"start": 737.51, "end": 737.95, "word": " to", "probability": 0.7666015625}, {"start": 737.95, "end": 738.17, "word": " the", "probability": 0.8779296875}, {"start": 738.17, "end": 738.45, "word": " shape", "probability": 0.92822265625}, {"start": 738.45, "end": 738.71, "word": " of", "probability": 0.98193359375}, {"start": 738.71, "end": 738.87, "word": " the", "probability": 0.8984375}, {"start": 738.87, "end": 739.33, "word": " cornea", "probability": 0.674560546875}, {"start": 739.33, "end": 741.41, "word": " Indicating", "probability": 0.77880859375}, {"start": 741.41, "end": 741.93, "word": " that", "probability": 0.94140625}, {"start": 741.93, "end": 742.31, "word": " a", "probability": 0.9326171875}, {"start": 742.31, "end": 742.69, "word": " week", "probability": 0.95703125}, {"start": 742.69, "end": 743.43, "word": " of", "probability": 0.970703125}, {"start": 743.43, "end": 744.13, "word": " wear", "probability": 0.8837890625}, {"start": 744.13, "end": 744.95, "word": " is", "probability": 0.95703125}, {"start": 744.95, "end": 745.45, "word": " indeed", "probability": 0.513671875}, {"start": 745.45, "end": 745.77, "word": " to", "probability": 0.92236328125}, {"start": 745.77, "end": 746.19, "word": " better", "probability": 0.953125}, {"start": 746.19, "end": 746.81, "word": " evaluate", "probability": 0.94287109375}, {"start": 746.81, "end": 747.05, "word": " the", "probability": 0.9248046875}, {"start": 747.05, "end": 747.35, "word": " fit", "probability": 0.9404296875}, {"start": 747.35, "end": 748.47, "word": " دايما", "probability": 0.7713216145833334}, {"start": 748.47, "end": 748.81, "word": " عندما", "probability": 0.565185546875}, {"start": 748.81, "end": 749.13, "word": " يكون", "probability": 0.9931640625}, {"start": 749.13, "end": 749.65, "word": " إنسان", "probability": 0.89453125}, {"start": 749.65, "end": 750.17, "word": " professional", "probability": 0.78662109375}], "temperature": 1.0}, {"id": 32, "seek": 75603, "start": 752.87, "end": 756.03, "text": "بشتغل عمل ايديال مية في المية", "tokens": [3555, 8592, 2655, 17082, 1211, 6225, 42213, 1975, 1829, 16254, 6027, 3714, 10632, 8978, 9673, 10632], "avg_logprob": -0.5661764705882353, "compression_ratio": 1.0392156862745099, "no_speech_prob": 1.1920928955078125e-07, "words": [{"start": 752.87, "end": 753.71, "word": "بشتغل", "probability": 0.5381591796875}, {"start": 753.71, "end": 754.09, "word": " عمل", "probability": 0.6875}, {"start": 754.09, "end": 755.19, "word": " ايديال", "probability": 0.68536376953125}, {"start": 755.19, "end": 755.45, "word": " مية", "probability": 0.5782470703125}, {"start": 755.45, "end": 755.57, "word": " في", "probability": 0.8505859375}, {"start": 755.57, "end": 756.03, "word": " المية", "probability": 0.952392578125}], "temperature": 1.0}, {"id": 33, "seek": 78460, "start": 756.96, "end": 784.6, "text": "الان انا ماوصلتش للمرحلة النهائية من عملية ال fitting، تمام؟ يعني نفترض اللي هو اعملت جلسة أولى و تانية، بدي اشوف اللي هو قيمة ال rotation كتقدير لها عند scene أو صاد أو عين، قبل ما بدي ال final اللي هو prescription، بدي عجسة أسبوعية لمدة أسبوع، يلبسها تمام؟ ك software contact lens", "tokens": [6027, 7649, 1975, 8315, 19446, 2407, 36520, 2655, 8592, 5296, 19528, 2288, 5016, 37977, 28239, 3224, 16373, 10632, 9154, 6225, 42213, 10632, 2423, 15669, 12399, 46811, 10943, 22807, 37495, 22653, 8717, 5172, 2655, 43042, 13672, 1829, 31439, 1975, 25957, 1211, 2655, 10874, 1211, 3794, 3660, 5551, 12610, 7578, 4032, 6055, 7649, 10632, 12399, 4724, 16254, 1975, 8592, 38688, 13672, 1829, 31439, 12174, 32640, 3660, 2423, 12447, 9122, 2655, 28543, 13546, 5296, 11296, 43242, 4145, 34051, 20328, 18513, 34051, 6225, 9957, 12399, 12174, 36150, 19446, 4724, 16254, 2423, 2572, 13672, 1829, 31439, 22456, 12399, 4724, 16254, 6225, 7435, 3794, 3660, 5551, 35457, 45367, 10632, 32767, 41891, 5551, 35457, 45367, 12399, 7251, 46152, 3794, 11296, 46811, 10943, 22807, 9122, 4722, 3385, 6765], "avg_logprob": -0.1956353305785124, "compression_ratio": 1.7404580152671756, "no_speech_prob": 0.0, "words": [{"start": 756.96, "end": 757.4, "word": "الان", "probability": 0.899658203125}, {"start": 757.4, "end": 757.64, "word": " انا", "probability": 0.6729736328125}, {"start": 757.64, "end": 758.38, "word": " ماوصلتش", "probability": 0.90966796875}, {"start": 758.38, "end": 759.26, "word": " للمرحلة", "probability": 0.9166015625}, {"start": 759.26, "end": 759.8, "word": " النهائية", "probability": 0.990234375}, {"start": 759.8, "end": 759.98, "word": " من", "probability": 0.95556640625}, {"start": 759.98, "end": 760.46, "word": " عملية", "probability": 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{"start": 773.54, "end": 773.9, "word": " صاد", "probability": 0.699462890625}, {"start": 773.9, "end": 774.14, "word": " أو", "probability": 0.6494140625}, {"start": 774.14, "end": 775.0, "word": " عين،", "probability": 0.6850179036458334}, {"start": 775.0, "end": 775.32, "word": " قبل", "probability": 0.816650390625}, {"start": 775.32, "end": 775.48, "word": " ما", "probability": 0.236572265625}, {"start": 775.48, "end": 775.84, "word": " بدي", "probability": 0.91064453125}, {"start": 775.84, "end": 776.16, "word": " ال", "probability": 0.78515625}, {"start": 776.16, "end": 776.7, "word": " final", "probability": 0.95263671875}, {"start": 776.7, "end": 777.04, "word": " اللي", "probability": 0.983642578125}, {"start": 777.04, "end": 777.26, "word": " هو", "probability": 0.98974609375}, {"start": 777.26, "end": 778.5, "word": " prescription،", "probability": 0.75634765625}, {"start": 778.5, "end": 778.78, "word": " بدي", "probability": 0.975341796875}, {"start": 778.78, "end": 779.48, "word": " عجسة", "probability": 0.7921142578125}, {"start": 779.48, "end": 780.4, "word": " أسبوعية", "probability": 0.86181640625}, {"start": 780.4, "end": 780.98, "word": " لمدة", "probability": 0.852294921875}, {"start": 780.98, "end": 781.58, "word": " أسبوع،", "probability": 0.8511962890625}, {"start": 781.58, "end": 782.24, "word": " يلبسها", "probability": 0.98681640625}, {"start": 782.24, "end": 783.12, "word": " تمام؟", "probability": 0.6792805989583334}, {"start": 783.12, "end": 783.26, "word": " ك", "probability": 0.9873046875}, {"start": 783.26, "end": 783.64, "word": " software", "probability": 0.2724609375}, {"start": 783.64, "end": 784.14, "word": " contact", "probability": 0.86865234375}, {"start": 784.14, "end": 784.6, "word": " lens", "probability": 0.935546875}], "temperature": 1.0}, {"id": 34, "seek": 80662, "start": 785.16, "end": 806.62, "text": "و اشوف بناء على هذه كده انه حيصير عنده rotation يما يلبسها طبعا ممكن طالب تقول ليه هذا مكلف بالنسبة لمين لل practitioner و ممكن بعض الأحيان يكون مكلف او مزعج لمين لل patient لكن هذا الاسلوب الصحيح بدل ما هدي عدسة قيمتها اللي هو ال .. او", "tokens": [2407, 1975, 8592, 38688, 44945, 16606, 15844, 29538, 9122, 3215, 3224, 16472, 3224, 11331, 1829, 9381, 13546, 43242, 3224, 12447, 7251, 15042, 7251, 46152, 3794, 11296, 23032, 3555, 3615, 995, 3714, 43020, 23032, 6027, 3555, 6055, 39648, 32239, 3224, 23758, 3714, 28820, 5172, 20666, 1863, 35457, 3660, 32767, 9957, 24976, 32125, 4032, 3714, 43020, 45030, 11242, 16247, 5016, 1829, 7649, 7251, 30544, 3714, 28820, 5172, 1975, 2407, 3714, 11622, 3615, 7435, 32767, 9957, 24976, 4537, 44381, 23758, 2423, 32277, 1211, 37746, 31767, 5016, 1829, 5016, 47525, 1211, 19446, 8032, 16254, 6225, 3215, 3794, 3660, 12174, 32640, 2655, 11296, 13672, 1829, 31439, 2423, 4386, 1975, 2407], "avg_logprob": -0.22906839917853195, "compression_ratio": 1.706896551724138, "no_speech_prob": 1.1920928955078125e-07, "words": [{"start": 785.16, "end": 785.38, "word": "و", 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المعمل في ال trial set يعني بصل سعرها تقريبا 50 او 60 شكل لمدة أسبوع واحد بلبسها وبيشوف قيمة ال rotation اللي خاص بالعدسة تمام؟", "tokens": [2407, 6027, 2655, 28820, 5172, 3660, 13083, 13412, 4117, 1211, 1975, 2407, 15204, 13412, 28820, 9122, 2572, 22456, 4724, 16254, 6225, 3215, 3794, 3660, 16472, 6055, 30544, 30767, 1829, 43242, 8315, 8978, 9673, 25957, 1211, 8978, 2423, 7308, 992, 37495, 22653, 4724, 36520, 8608, 3615, 2288, 11296, 6055, 4587, 16572, 3555, 995, 2625, 1975, 2407, 4060, 13412, 28820, 32767, 41891, 5551, 35457, 45367, 36764, 24401, 4724, 46152, 3794, 11296, 4032, 21292, 8592, 38688, 12174, 32640, 3660, 2423, 12447, 13672, 1829, 16490, 33546, 20666, 22488, 3794, 3660, 46811, 10943, 22807], "avg_logprob": -0.2706597129503886, "compression_ratio": 1.5352112676056338, "no_speech_prob": 1.7881393432617188e-07, "words": [{"start": 806.64, "end": 807.42, "word": "والتكلفة", "probability": 0.6928304036458334}, {"start": 807.42, "end": 808.24, "word": " 800", "probability": 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3615, 45865, 11242, 4032, 25957, 1211, 10632, 13672, 1829, 31439, 14739, 5551, 7435, 1829, 3555, 6225, 3215, 3794, 3660, 44945, 36178, 25062, 32640, 3660, 34051, 44945, 36178, 2423, 10298, 37893, 3714, 9566, 1211, 37746, 3660, 32239, 8592, 22807, 4724, 3555, 3794, 41193, 3660, 5296, 33456, 3224, 43242, 3224, 5056, 696, 21757, 15513, 36725, 1829, 11242, 995, 14739, 12174, 32640, 3660, 29538, 2423, 12447, 2423, 472, 34051, 2423, 732, 5310, 37893, 3714, 10721, 12984, 25720, 15844, 9673, 16572, 11242, 46811, 10943, 22807], "avg_logprob": -0.19913902681092827, "compression_ratio": 1.5573770491803278, "no_speech_prob": 5.960464477539063e-08, "words": [{"start": 965.54, "end": 966.44, "word": "Compensation", "probability": 0.6378580729166666}, {"start": 966.44, "end": 967.0, "word": " may", "probability": 0.81689453125}, {"start": 967.0, "end": 967.18, "word": " not", "probability": 0.96142578125}, {"start": 967.18, "end": 967.32, "word": " be", "probability": 0.8701171875}, {"start": 967.32, "end": 967.84, "word": " necessary", "probability": 0.935546875}, {"start": 967.84, "end": 968.28, "word": " إذا", "probability": 0.51141357421875}, {"start": 968.28, "end": 968.62, "word": " انهان", "probability": 0.6785481770833334}, {"start": 968.62, "end": 969.1, "word": " عملية", "probability": 0.9275716145833334}, {"start": 969.1, "end": 969.88, "word": " التعويض", "probability": 0.94140625}, {"start": 969.88, "end": 970.92, "word": " وعملية", "probability": 0.8880615234375}, {"start": 970.92, "end": 971.16, "word": " اللي", "probability": 0.638671875}, {"start": 971.16, "end": 971.54, "word": " هو", "probability": 0.974609375}, {"start": 971.54, "end": 971.82, "word": " أن", "probability": 0.5517578125}, {"start": 971.82, "end": 972.34, "word": " أجيب", "probability": 0.8753662109375}, {"start": 972.34, "end": 972.92, "word": " عدسة", "probability": 0.9627685546875}, {"start": 972.92, "end": 973.8, "word": " بنفس", "probability": 0.991455078125}, {"start": 973.8, "end": 974.52, "word": " القيمة", "probability": 0.9827473958333334}, {"start": 974.52, "end": 974.8, "word": " أو", "probability": 0.87158203125}, {"start": 974.8, "end": 975.2, "word": " بنفس", "probability": 0.98388671875}, {"start": 975.2, "end": 975.36, "word": " ال", "probability": 0.94189453125}, {"start": 975.36, "end": 975.72, "word": " axis", "probability": 0.57177734375}, {"start": 975.72, "end": 976.22, "word": " مش", "probability": 0.87939453125}, {"start": 976.22, "end": 976.98, "word": " مطلوبة", "probability": 0.950390625}, {"start": 976.98, "end": 977.68, "word": " ليش؟", "probability": 0.765625}, {"start": 977.68, "end": 978.16, "word": " ببساطة", "probability": 0.875341796875}, {"start": 978.16, "end": 978.48, "word": " لأنه", "probability": 0.8152669270833334}, {"start": 978.48, "end": 979.0, "word": " عنده", "probability": 0.98486328125}, {"start": 979.0, "end": 979.68, "word": " visual", "probability": 0.8876953125}, {"start": 979.68, "end": 980.34, "word": " acuity", "probability": 0.825439453125}, {"start": 980.34, "end": 981.14, "word": " acceptable", "probability": 0.82763671875}, {"start": 981.14, "end": 982.32, "word": " وأيضا", "probability": 0.8421630859375}, {"start": 982.32, "end": 982.6, "word": " أن", "probability": 0.454345703125}, {"start": 982.6, "end": 983.08, "word": " قيمة", "probability": 0.9532877604166666}, {"start": 983.08, "end": 983.28, "word": " هذه", "probability": 0.81298828125}, {"start": 983.28, "end": 983.38, "word": " ال", "probability": 0.92626953125}, {"start": 983.38, "end": 983.82, "word": " rotation", "probability": 0.92529296875}, {"start": 983.82, "end": 984.14, "word": " ال", "probability": 0.93505859375}, {"start": 984.14, "end": 984.34, "word": " one", "probability": 0.798828125}, {"start": 984.34, "end": 984.56, "word": " أو", "probability": 0.91064453125}, {"start": 984.56, "end": 984.68, "word": " ال", "probability": 0.92822265625}, {"start": 984.68, "end": 984.82, "word": " two", "probability": 0.93505859375}, {"start": 984.82, "end": 985.32, "word": " degrees", "probability": 0.935546875}, {"start": 985.32, "end": 985.88, "word": " مش", "probability": 0.9658203125}, {"start": 985.88, "end": 986.32, "word": " مأثرة", "probability": 0.8218994140625}, {"start": 986.32, "end": 986.62, "word": " على", "probability": 0.77685546875}, {"start": 986.62, "end": 987.52, "word": " المريض", "probability": 0.9845377604166666}, {"start": 987.52, "end": 988.5, "word": " تمام؟", "probability": 0.8447265625}], "temperature": 1.0}, {"id": 43, "seek": 100243, "start": 994.73, "end": 1002.43, "text": "Compensation for lens rotation ان عملية التعويض لدوران العدسة", "tokens": [34, 8586, 35292, 337, 6765, 12447, 16472, 6225, 42213, 10632, 16712, 3615, 45865, 11242, 5296, 3215, 13063, 7649, 18863, 3215, 3794, 3660], "avg_logprob": -0.3306725543478261, "compression_ratio": 1.0875, "no_speech_prob": 1.1920928955078125e-06, "words": [{"start": 994.73, "end": 995.59, "word": "Compensation", "probability": 0.6399332682291666}, {"start": 995.59, "end": 996.03, "word": " for", "probability": 0.8125}, {"start": 996.03, "end": 996.49, "word": " lens", "probability": 0.810546875}, {"start": 996.49, "end": 997.27, "word": " rotation", "probability": 0.9482421875}, {"start": 997.27, "end": 997.79, "word": " ان", "probability": 0.119873046875}, {"start": 997.79, "end": 998.51, "word": " عملية", "probability": 0.8699544270833334}, {"start": 998.51, "end": 1000.29, "word": " التعويض", "probability": 0.7962646484375}, {"start": 1000.29, "end": 1001.59, "word": " لدوران", "probability": 0.90869140625}, {"start": 1001.59, "end": 1002.43, "word": " العدسة", "probability": 0.944580078125}], "temperature": 1.0}, {"id": 44, "seek": 102680, "start": 1006.52, "end": 1026.8, "text": "or critical or necessary ضرورية to determine the cylinder lens axis or the final cylinder axis for a lens.إذن هي مهمة في تحديد قداش قيمة ال axis اللي خاص بالسلمدر للمريض", "tokens": [284, 4924, 420, 4818, 48812, 2288, 13063, 10632, 281, 6997, 264, 17884, 6765, 10298, 420, 264, 2572, 17884, 10298, 337, 257, 6765, 13, 28814, 8848, 1863, 39896, 3714, 16095, 3660, 8978, 6055, 5016, 16254, 3215, 12174, 3215, 33599, 12174, 32640, 3660, 2423, 10298, 13672, 1829, 16490, 33546, 20666, 3794, 19528, 3215, 2288, 5296, 19528, 16572, 11242], "avg_logprob": -0.24712172307466207, "compression_ratio": 1.3454545454545455, "no_speech_prob": 5.960464477539063e-08, "words": [{"start": 1006.52, "end": 1006.76, "word": "or", "probability": 0.155029296875}, {"start": 1006.76, "end": 1007.3, "word": " critical", "probability": 0.8271484375}, {"start": 1007.3, "end": 1008.34, "word": " or", "probability": 0.89111328125}, {"start": 1008.34, "end": 1009.1, "word": " necessary", "probability": 0.958984375}, {"start": 1009.1, "end": 1010.38, "word": " ضرورية", "probability": 0.9013671875}, {"start": 1010.38, "end": 1011.5, "word": " to", "probability": 0.771484375}, {"start": 1011.5, "end": 1012.36, "word": " determine", "probability": 0.951171875}, {"start": 1012.36, "end": 1013.04, "word": " the", "probability": 0.90966796875}, {"start": 1013.04, "end": 1013.76, "word": " cylinder", "probability": 0.7861328125}, {"start": 1013.76, "end": 1014.7, "word": " lens", "probability": 0.783203125}, {"start": 1014.7, "end": 1015.56, "word": " axis", "probability": 0.8759765625}, {"start": 1015.56, "end": 1016.9, "word": " or", "probability": 0.9326171875}, {"start": 1016.9, "end": 1017.06, "word": " the", "probability": 0.90625}, {"start": 1017.06, "end": 1017.58, "word": " final", "probability": 0.95458984375}, {"start": 1017.58, "end": 1018.2, "word": " cylinder", "probability": 0.623046875}, {"start": 1018.2, "end": 1018.88, "word": " axis", "probability": 0.966796875}, {"start": 1018.88, "end": 1019.34, "word": " for", "probability": 0.9091796875}, {"start": 1019.34, "end": 1019.54, "word": " a", "probability": 0.96435546875}, {"start": 1019.54, "end": 1019.82, "word": " lens", "probability": 0.94384765625}, {"start": 1019.82, "end": 1020.24, "word": ".إذن", "probability": 0.529052734375}, {"start": 1020.24, "end": 1020.42, "word": " هي", "probability": 0.80224609375}, {"start": 1020.42, "end": 1021.08, "word": " مهمة", "probability": 0.9918619791666666}, {"start": 1021.08, "end": 1021.48, "word": " في", "probability": 0.79736328125}, {"start": 1021.48, "end": 1022.0, "word": " تحديد", "probability": 0.9664306640625}, {"start": 1022.0, "end": 1022.38, "word": " قداش", "probability": 0.5546875}, {"start": 1022.38, "end": 1022.84, "word": " قيمة", "probability": 0.9977213541666666}, {"start": 1022.84, "end": 1022.96, "word": " ال", "probability": 0.9619140625}, {"start": 1022.96, "end": 1023.5, "word": " axis", "probability": 0.52734375}, {"start": 1023.5, "end": 1023.94, "word": " اللي", "probability": 0.80712890625}, {"start": 1023.94, "end": 1024.36, "word": " خاص", "probability": 0.9833984375}, {"start": 1024.36, "end": 1025.68, "word": " بالسلمدر", "probability": 0.694677734375}, {"start": 1025.68, "end": 1026.8, "word": " للمريض", "probability": 0.965576171875}], "temperature": 1.0}, {"id": 45, "seek": 104072, "start": 1034.4, "end": 1040.72, "text": "و ممكن اللي هو كلمة laser أسهل after a trial lens has been used", "tokens": [2407, 3714, 43020, 13672, 1829, 31439, 9122, 19528, 3660, 12530, 5551, 3794, 3224, 1211, 934, 257, 7308, 6765, 575, 668, 1143], "avg_logprob": -0.5390624918720939, "compression_ratio": 1.0123456790123457, "no_speech_prob": 1.1920928955078125e-07, "words": [{"start": 1034.4, "end": 1035.24, "word": "و", "probability": 0.40673828125}, {"start": 1035.24, "end": 1036.08, "word": " ممكن", "probability": 0.4355926513671875}, {"start": 1036.08, "end": 1036.36, "word": " اللي", "probability": 0.6031494140625}, {"start": 1036.36, "end": 1036.52, "word": " هو", "probability": 0.97607421875}, {"start": 1036.52, "end": 1036.96, "word": " كلمة", "probability": 0.96435546875}, {"start": 1036.96, "end": 1037.38, "word": " laser", "probability": 0.67333984375}, {"start": 1037.38, "end": 1038.2, "word": " أسهل", "probability": 0.8870849609375}, {"start": 1038.2, "end": 1039.02, "word": " after", "probability": 0.26025390625}, {"start": 1039.02, "end": 1039.28, "word": " a", "probability": 0.9453125}, {"start": 1039.28, "end": 1039.64, "word": " trial", "probability": 0.603515625}, {"start": 1039.64, "end": 1040.16, "word": " lens", "probability": 0.93017578125}, {"start": 1040.16, "end": 1040.6, "word": " has", "probability": 0.81640625}, {"start": 1040.6, "end": 1040.72, "word": " been", "probability": 0.45263671875}, {"start": 1040.72, "end": 1040.72, "word": " used", "probability": 0.255126953125}], "temperature": 1.0}, {"id": 46, "seek": 107070, "start": 1045.78, "end": 1070.7, "text": "و اعمل عملية اللي هو تقييم لقيمة اللي هو دوران او قيمة توازن العدسة دايما يا جماعة يما تسمع كلمة equilibrate بمعنى stability بتعادل كلمة stability", "tokens": [2407, 1975, 25957, 1211, 6225, 42213, 10632, 13672, 1829, 31439, 6055, 38436, 32640, 5296, 4587, 32640, 3660, 13672, 1829, 31439, 11778, 13063, 7649, 1975, 2407, 12174, 32640, 3660, 33427, 31377, 1863, 18863, 3215, 3794, 3660, 11778, 47302, 15042, 35186, 10874, 15042, 27884, 7251, 15042, 6055, 38251, 3615, 9122, 19528, 3660, 14204, 4404, 4724, 2304, 3615, 1863, 7578, 11826, 39894, 3615, 18513, 1211, 9122, 19528, 3660, 11826], "avg_logprob": -0.22527985608399803, "compression_ratio": 1.6081081081081081, "no_speech_prob": 2.384185791015625e-07, "words": [{"start": 1045.7800000000002, "end": 1046.8600000000001, "word": "و", "probability": 0.1776123046875}, {"start": 1046.8600000000001, "end": 1047.94, "word": " اعمل", "probability": 0.5931803385416666}, {"start": 1047.94, "end": 1048.44, "word": " عملية", "probability": 0.9806315104166666}, {"start": 1048.44, "end": 1048.66, "word": " اللي", "probability": 0.44580078125}, {"start": 1048.66, "end": 1048.84, "word": " هو", "probability": 0.8154296875}, {"start": 1048.84, "end": 1049.48, "word": " تقييم", "probability": 0.931640625}, {"start": 1049.48, "end": 1050.54, "word": " لقيمة", "probability": 0.817626953125}, {"start": 1050.54, "end": 1050.72, "word": " اللي", "probability": 0.843505859375}, {"start": 1050.72, "end": 1050.92, "word": " هو", "probability": 0.96875}, {"start": 1050.92, "end": 1051.52, "word": " دوران", "probability": 0.9606119791666666}, {"start": 1051.52, "end": 1051.96, "word": " او", "probability": 0.776611328125}, {"start": 1051.96, "end": 1052.36, "word": " قيمة", "probability": 0.8614908854166666}, {"start": 1052.36, "end": 1052.98, "word": " توازن", "probability": 0.9562174479166666}, {"start": 1052.98, "end": 1053.64, "word": " العدسة", "probability": 0.9542236328125}, {"start": 1053.64, "end": 1054.52, "word": " دايما", "probability": 0.79638671875}, {"start": 1054.52, "end": 1054.64, "word": " يا", "probability": 0.94140625}, {"start": 1054.64, "end": 1055.14, "word": " جماعة", "probability": 0.9920247395833334}, {"start": 1055.14, "end": 1055.46, "word": " يما", "probability": 0.5093994140625}, {"start": 1055.46, "end": 1055.96, "word": " تسمع", "probability": 0.99560546875}, {"start": 1055.96, "end": 1056.42, "word": " كلمة", "probability": 0.98291015625}, {"start": 1056.42, "end": 1057.36, "word": " equilibrate", "probability": 0.6676025390625}, {"start": 1057.36, "end": 1057.86, "word": " بمعنى", "probability": 0.981640625}, {"start": 1057.86, "end": 1058.44, "word": " stability", "probability": 0.7783203125}, {"start": 1058.44, "end": 1069.4, "word": " بتعادل", "probability": 0.73779296875}, {"start": 1069.4, "end": 1070.0, "word": " كلمة", "probability": 0.9847005208333334}, {"start": 1070.0, "end": 1070.7, "word": " stability", "probability": 0.71337890625}], "temperature": 1.0}, {"id": 47, "seek": 110232, "start": 1076.06, "end": 1102.32, "text": "The rotation is measured انا هقيم اللى هو جداش قيمة ال rotation من خلال مين الاصطلاح evaluation او الاصطلاح examination if the base or reference point of the lens rotates ten degrees to the observers left لو كانت عاملة rotation باتجاه مين؟ الشمال", "tokens": [2278, 12447, 307, 12690, 1975, 8315, 8032, 38436, 2304, 13672, 7578, 31439, 10874, 3215, 33599, 12174, 32640, 3660, 2423, 12447, 9154, 16490, 1211, 6027, 3714, 9957, 2423, 33546, 9566, 15040, 5016, 13344, 1975, 2407, 2423, 33546, 9566, 15040, 5016, 23874, 498, 264, 3096, 420, 6408, 935, 295, 264, 6765, 42133, 2064, 5310, 281, 264, 48090, 1411, 45164, 25961, 2655, 6225, 10943, 37977, 12447, 4724, 9307, 7435, 40294, 3714, 9957, 22807, 25124, 2304, 6027], "avg_logprob": -0.3093327662429294, "compression_ratio": 1.5603864734299517, "no_speech_prob": 0.0, "words": [{"start": 1076.06, "end": 1077.22, "word": "The", "probability": 0.060638427734375}, {"start": 1077.22, "end": 1078.06, "word": " rotation", "probability": 0.884765625}, {"start": 1078.06, "end": 1079.86, "word": " is", "probability": 0.93994140625}, {"start": 1079.86, "end": 1080.32, "word": " measured", "probability": 0.85400390625}, {"start": 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ملائم", "probability": 0.82525634765625}, {"start": 1175.78, "end": 1176.18, "word": " و", "probability": 0.99560546875}, {"start": 1176.18, "end": 1176.78, "word": " مناسب", "probability": 0.8333333333333334}, {"start": 1176.78, "end": 1177.84, "word": " لعملية", "probability": 0.9622802734375}, {"start": 1177.84, "end": 1178.4, "word": " تقييم", "probability": 0.9405924479166666}, {"start": 1178.4, "end": 1178.78, "word": " إيش", "probability": 0.6675618489583334}, {"start": 1178.78, "end": 1179.04, "word": " اللي", "probability": 0.83203125}, {"start": 1179.04, "end": 1179.24, "word": " هو", "probability": 0.974609375}, {"start": 1179.24, "end": 1179.84, "word": " دوران", "probability": 0.9596354166666666}, {"start": 1179.84, "end": 1180.54, "word": " العدسة", "probability": 0.9703369140625}], "temperature": 1.0}, {"id": 51, "seek": 121055, "start": 1181.77, "end": 1210.55, "text": "The clock dial is visualized by the practitioner with each hour زي ما اتفقنا اما بستخدم hour ساعة يد او بحط الastigmatic fan في عملية التقييم with each hour ال space between adjacent numbers such as 5 and 6 equaling 30 degrees طبعا اما بكون باتجاه اللي هو ال clockwise او ال counter clockwise", "tokens": [2278, 7830, 5502, 307, 5056, 1602, 538, 264, 32125, 365, 1184, 1773, 30767, 1829, 19446, 1975, 2655, 5172, 4587, 8315, 1975, 15042, 4724, 14851, 9778, 40448, 1773, 8608, 995, 27884, 7251, 3215, 1975, 2407, 4724, 5016, 9566, 2423, 525, 20181, 2399, 3429, 8978, 6225, 42213, 10632, 16712, 38436, 32640, 365, 1184, 1773, 2423, 1901, 1296, 24441, 3547, 1270, 382, 1025, 293, 1386, 2681, 278, 2217, 5310, 23032, 3555, 3615, 995, 1975, 15042, 4724, 30544, 4724, 9307, 7435, 40294, 13672, 1829, 31439, 2423, 35790, 1975, 2407, 2423, 5682, 35790], "avg_logprob": -0.23577949973974335, "compression_ratio": 1.458498023715415, "no_speech_prob": 5.960464477539063e-08, "words": [{"start": 1181.77, "end": 1182.03, "word": "The", "probability": 0.09320068359375}, {"start": 1182.03, "end": 1182.39, "word": " clock", "probability": 0.73193359375}, {"start": 1182.39, "end": 1183.13, "word": " dial", "probability": 0.9228515625}, {"start": 1183.13, "end": 1183.91, "word": " is", "probability": 0.9404296875}, {"start": 1183.91, "end": 1184.83, "word": " visualized", "probability": 0.937255859375}, {"start": 1184.83, "end": 1185.13, "word": " by", "probability": 0.97900390625}, {"start": 1185.13, "end": 1185.33, "word": " the", "probability": 0.921875}, {"start": 1185.33, "end": 1185.89, "word": " practitioner", "probability": 0.77197265625}, {"start": 1185.89, "end": 1186.39, "word": " with", "probability": 0.9306640625}, {"start": 1186.39, "end": 1186.75, "word": " each", "probability": 0.9599609375}, {"start": 1186.75, "end": 1187.07, "word": " hour", "probability": 0.95166015625}, {"start": 1187.07, "end": 1187.55, "word": " زي", "probability": 0.6141357421875}, {"start": 1187.55, "end": 1187.65, "word": " ما", "probability": 0.94775390625}, {"start": 1187.65, "end": 1188.25, "word": " 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1202.51, "word": " and", "probability": 0.88720703125}, {"start": 1202.51, "end": 1202.87, "word": " 6", "probability": 0.98974609375}, {"start": 1202.87, "end": 1203.65, "word": " equaling", "probability": 0.7998046875}, {"start": 1203.65, "end": 1204.37, "word": " 30", "probability": 0.91357421875}, {"start": 1204.37, "end": 1204.89, "word": " degrees", "probability": 0.81982421875}, {"start": 1204.89, "end": 1205.61, "word": " طبعا", "probability": 0.9564208984375}, {"start": 1205.61, "end": 1206.05, "word": " اما", "probability": 0.934326171875}, {"start": 1206.05, "end": 1206.49, "word": " بكون", "probability": 0.767333984375}, {"start": 1206.49, "end": 1207.73, "word": " باتجاه", "probability": 0.8778076171875}, {"start": 1207.73, "end": 1207.95, "word": " اللي", "probability": 0.57177734375}, {"start": 1207.95, "end": 1208.15, "word": " هو", "probability": 0.931640625}, {"start": 1208.15, "end": 1208.25, "word": " ال", "probability": 0.5361328125}, {"start": 1208.25, "end": 1208.65, "word": " clockwise", "probability": 0.4189453125}, {"start": 1208.65, "end": 1209.23, "word": " او", "probability": 0.903076171875}, {"start": 1209.23, "end": 1209.37, "word": " ال", "probability": 0.77783203125}, {"start": 1209.37, "end": 1209.79, "word": " counter", "probability": 0.97900390625}, {"start": 1209.79, "end": 1210.55, "word": " clockwise", "probability": 0.7109375}], "temperature": 1.0}, {"id": 52, "seek": 123863, "start": 1211.91, "end": 1238.63, "text": "و ايضا بعمل عملية تقسيم الساعة ل 30 ديجري okay in addition to being simple and easy to perform guess estimation can be accurate طب كيف الان انا ممكن اصل لا اللي هو التقدير الملائم او المناسب لقيمة ال rotation؟ البساطة انا قيمت مثلا قيمة ال rotation للعدسة نفترض 10 ديجري", "tokens": [2407, 1975, 1829, 11242, 995, 4724, 25957, 1211, 6225, 42213, 10632, 6055, 4587, 3794, 32640, 21136, 995, 27884, 5296, 2217, 11778, 1829, 7435, 16572, 1392, 294, 4500, 281, 885, 2199, 293, 1858, 281, 2042, 2041, 35701, 393, 312, 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"probability": 0.858642578125}, {"start": 1227.81, "end": 1228.11, "word": " لا", "probability": 0.313232421875}, {"start": 1228.11, "end": 1228.33, "word": " اللي", "probability": 0.80615234375}, {"start": 1228.33, "end": 1228.73, "word": " هو", "probability": 0.99072265625}, {"start": 1228.73, "end": 1229.83, "word": " التقدير", "probability": 0.9521484375}, {"start": 1229.83, "end": 1230.53, "word": " الملائم", "probability": 0.9632568359375}, {"start": 1230.53, "end": 1230.89, "word": " او", "probability": 0.942138671875}, {"start": 1230.89, "end": 1231.43, "word": " المناسب", "probability": 0.9920247395833334}, {"start": 1231.43, "end": 1231.99, "word": " لقيمة", "probability": 0.9681396484375}, {"start": 1231.99, "end": 1232.13, "word": " ال", "probability": 0.97802734375}, {"start": 1232.13, "end": 1233.37, "word": " rotation؟", "probability": 0.58892822265625}, {"start": 1233.37, "end": 1233.97, "word": " البساطة", "probability": 0.9149169921875}, {"start": 1233.97, "end": 1234.25, "word": " انا", "probability": 0.947021484375}, {"start": 1234.25, "end": 1234.75, "word": " قيمت", "probability": 0.9817708333333334}, {"start": 1234.75, "end": 1235.21, "word": " مثلا", "probability": 0.979736328125}, {"start": 1235.21, "end": 1236.05, "word": " قيمة", "probability": 0.9952799479166666}, {"start": 1236.05, "end": 1236.17, "word": " ال", "probability": 0.98583984375}, {"start": 1236.17, "end": 1236.53, "word": " rotation", "probability": 0.98681640625}, {"start": 1236.53, "end": 1237.33, "word": " للعدسة", "probability": 0.93212890625}, {"start": 1237.33, "end": 1237.87, "word": " نفترض", "probability": 0.985107421875}, {"start": 1237.87, "end": 1238.15, "word": " 10", "probability": 0.4873046875}, {"start": 1238.15, "end": 1238.63, "word": " ديجري", "probability": 0.841796875}], "temperature": 1.0}, {"id": 53, "seek": 125915, "start": 1240.47, "end": 1259.15, "text": "يعني اعتمد العشرة degree لأ بدي اعمل over refraction وبعد ذلك ايش بدنا نعمله اللي هو subjective refraction للمريض من خلال اللي هو استخدام الجاكسون across cylinder بقدر اللي هو احدد قداش قيمة ال axis الملائم لهذا المريض", "tokens": [40228, 22653, 1975, 34268, 2304, 3215, 18863, 8592, 25720, 4314, 5296, 10721, 4724, 16254, 1975, 25957, 1211, 670, 1895, 26766, 46599, 22488, 29910, 23275, 1975, 1829, 8592, 47525, 8315, 8717, 25957, 43761, 13672, 1829, 31439, 25972, 1895, 26766, 5296, 19528, 16572, 11242, 9154, 16490, 1211, 6027, 13672, 1829, 31439, 44713, 9778, 3215, 10943, 25724, 995, 4117, 3794, 11536, 2108, 17884, 4724, 28543, 2288, 13672, 1829, 31439, 1975, 24401, 3215, 12174, 3215, 33599, 12174, 32640, 3660, 2423, 10298, 9673, 1211, 16373, 2304, 46740, 15730, 9673, 16572, 11242], "avg_logprob": -0.21533763956749577, "compression_ratio": 1.6009389671361502, "no_speech_prob": 5.960464477539063e-08, "words": [{"start": 1240.47, "end": 1241.43, "word": "يعني", "probability": 0.516143798828125}, {"start": 1241.43, "end": 1241.97, "word": " اعتمد", "probability": 0.9119873046875}, {"start": 1241.97, "end": 1242.43, "word": " العشرة", "probability": 0.8268229166666666}, {"start": 1242.43, "end": 1242.79, "word": " degree", "probability": 0.448486328125}, {"start": 1242.79, "end": 1243.43, "word": " لأ", "probability": 0.732666015625}, {"start": 1243.43, "end": 1243.89, "word": " بدي", "probability": 0.774658203125}, {"start": 1243.89, "end": 1244.25, "word": " اعمل", "probability": 0.96533203125}, {"start": 1244.25, "end": 1244.53, "word": " over", "probability": 0.5556640625}, {"start": 1244.53, "end": 1245.23, "word": " refraction", "probability": 0.79931640625}, {"start": 1245.23, "end": 1245.79, "word": " وبعد", "probability": 0.7216796875}, {"start": 1245.79, "end": 1246.07, "word": " ذلك", "probability": 0.991455078125}, {"start": 1246.07, "end": 1246.25, "word": " ايش", "probability": 0.8723958333333334}, {"start": 1246.25, "end": 1246.49, "word": " بدنا", "probability": 0.90234375}, {"start": 1246.49, "end": 1247.45, "word": " نعمله", "probability": 0.8902994791666666}, {"start": 1247.45, "end": 1248.05, "word": " اللي", "probability": 0.495849609375}, {"start": 1248.05, "end": 1248.25, "word": " هو", "probability": 0.984375}, {"start": 1248.25, "end": 1248.73, "word": " subjective", "probability": 0.90234375}, {"start": 1248.73, "end": 1249.69, "word": " refraction", "probability": 0.897705078125}, {"start": 1249.69, "end": 1250.33, "word": " للمريض", "probability": 0.9605712890625}, {"start": 1250.33, "end": 1250.83, "word": " من", "probability": 0.974609375}, {"start": 1250.83, "end": 1251.31, "word": " خلال", "probability": 0.9951171875}, {"start": 1251.31, "end": 1251.51, "word": " اللي", "probability": 0.79150390625}, {"start": 1251.51, "end": 1251.69, "word": " هو", "probability": 0.98095703125}, {"start": 1251.69, "end": 1252.25, "word": " استخدام", "probability": 0.9730224609375}, {"start": 1252.25, "end": 1252.93, "word": " الجاكسون", "probability": 0.7715087890625}, {"start": 1252.93, "end": 1253.39, 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وبركاته ومرحبا لكم جميعا + +2 +00:00:27,370 --> 00:00:31,730 +طبعا هنكمل ان شاء الله في ال software contact + +3 +00:00:31,730 --> 00:00:36,890 +lenses اليوم هنبدأ في موضوع ال prism ballast او + +4 +00:00:36,890 --> 00:00:41,370 +اللي هو مصدر الثقل للعدسة ال software contact + +5 +00:00:41,370 --> 00:00:46,550 +lenses لتجنب اللي هو ال rotation او تجنب ال + +6 +00:00:46,550 --> 00:00:48,650 +stability للعدسة + +7 +00:00:51,100 --> 00:00:56,660 +طبعا في الجيل الأول من العدسات عملوا الهو marking + +8 +00:00:56,660 --> 00:01:02,360 +زي ما اتفقنا على الساعة ستة و كلوب و قلنا ان ال + +9 +00:01:02,360 --> 00:01:07,340 +software contact lens هي عبارة عن صورة او مجسم + +10 +00:01:07,340 --> 00:01:12,560 +ساعة بتكون كصورة over the surface of the cornea + +11 +00:01:12,560 --> 00:01:19,300 +فيها الساعة ستة تلاتة تسعة اتناش تمام؟Lenses with + +12 +00:01:19,300 --> 00:01:24,900 +a prism palest have markings that are intended to + +13 +00:01:24,900 --> 00:01:28,940 +settle at or near six o'clock in the vertical + +14 +00:01:28,940 --> 00:01:33,480 +meridian يعني المفترض أن يكون ال marker هذا على + +15 +00:01:33,480 --> 00:01:38,100 +settle أي بمعنى اللي هو مقعد أو اللي هو مستقر أو + +16 +00:01:38,100 --> 00:01:44,450 +جالس على الساعة اللي هو كام؟ ستة تمام؟No prison + +17 +00:01:44,450 --> 00:01:48,710 +lenses وهذه وانا خدناها في اللي هو ال dynamic + +18 +00:01:48,710 --> 00:01:52,530 +stabilization يعني بين جثين اكتب ال dynamic + +19 +00:01:52,530 --> 00:01:57,910 +stabilization No prison lenses are marked at the + +20 +00:01:57,910 --> 00:02:01,970 +three and nine o'clock positions in the horizontal + +21 +00:02:01,970 --> 00:02:08,080 +meridiansاذا معناه يما بنستخدم او يما تم استخدام + +22 +00:02:08,080 --> 00:02:11,740 +الجيل التاني من العدسات تم استخدام ال three nine o + +23 +00:02:11,740 --> 00:02:14,920 +'clock اللي هي عبارة عن ال dynamic stabilization + +24 +00:02:14,920 --> 00:02:20,380 +يعني على الساعة تلاتة والساعة تسعة if the laser + +25 +00:02:20,380 --> 00:02:25,260 +mark on a typical a prism ballasted torric lens + +26 +00:02:29,110 --> 00:02:33,390 +إذا كان الماركر على الساعة ستة هذا بتديني انطباع + +27 +00:02:33,390 --> 00:02:39,150 +إن العدسة مافيش فيها أي Rotation وهذا المطلوب، + +28 +00:02:39,150 --> 00:02:45,730 +تمام؟ يعني عنا اللي هو good lens أو عنا properly + +29 +00:02:45,730 --> 00:02:50,270 +fit يعني الآن يما بسألك الساعة ستة، يما يكون + +30 +00:02:50,270 --> 00:02:54,990 +الماركر على الساعة ستة، إيش هذا بتديكي انطباع؟إنه + +31 +00:02:54,990 --> 00:02:58,330 +في عندنا good, fit أو appropriately اللي هو fit + +32 +00:02:58,330 --> 00:03:03,990 +لمن؟ للـ software contact lenses if the laser mark + +33 +00:03:03,990 --> 00:03:08,690 +sits at either five or seven o'clock لو كان في + +34 +00:03:08,690 --> 00:03:11,730 +عندنا rotation على الساعة خمسة أو rotation على + +35 +00:03:11,730 --> 00:03:16,510 +الساعة سبعة طبعا معنى الكلام إنه عبارة عن one hour + +36 +00:03:16,510 --> 00:03:21,490 +واتفقنا إنه كل ساعة هي عبارة عن تلاتين degrees إما + +37 +00:03:21,490 --> 00:03:26,440 +بتكون clockwiseCounter clockwise يعني اما باتجاه + +38 +00:03:26,440 --> 00:03:32,280 +ال left او باتجاه ال right Dividing + +39 +00:03:32,280 --> 00:03:37,180 +the hour into three parts produce ten degree + +40 +00:03:37,180 --> 00:03:41,780 +increments كل ساعة انا بقدر انه اعمل عملية تقسيم + +41 +00:03:41,780 --> 00:03:45,620 +لها لعشرة degree عشرة degree عشرة degree + +42 +00:03:45,620 --> 00:03:49,840 +Increments يعني بمعنى زيادة انه بتعمل اللي هو + +43 +00:03:49,840 --> 00:03:51,380 +زيادة تمام؟ + +44 +00:03:53,700 --> 00:03:59,360 +الشعار التالي السطلام من السطلام + +45 +00:03:59,360 --> 00:04:03,600 +يمكن أن يكون مرتبط بالمركة التوريقية على اللينز، + +46 +00:04:03,600 --> 00:04:08,980 +إذا لازم انا أحطه باستقامة مع مين؟ مع الماركر + +47 +00:04:08,980 --> 00:04:12,920 +الخاص بالعدسة ال soft toric contact lenses + +48 +00:04:17,190 --> 00:04:22,270 +Slit lamps often have markings or a label can be + +49 +00:04:22,270 --> 00:04:26,590 +added to indicate the degree of beam rotation هذا + +50 +00:04:26,590 --> 00:04:30,290 +الضوء ال slit او ال beam light انا بعتبره عبارة عن + +51 +00:04:30,290 --> 00:04:33,830 +ايه؟ marker لكن ال marker هذا خاص في مين؟ في ال + +52 +00:04:33,830 --> 00:04:38,930 +slit lamp لازم انه احاول ان يكون parallel ل ال + +53 +00:04:38,930 --> 00:04:41,870 +marker الموجود على العدسة ال software contact + +54 +00:04:41,870 --> 00:04:46,730 +lenses label بمعنى ايش؟ markتمام؟ أيضًا اللي هي + +55 +00:04:46,730 --> 00:04:51,330 +علامة أو إشارة هان + +56 +00:04:51,330 --> 00:04:56,370 +في شغل مهمة experience اللي هي الخبرة، دايما ال + +57 +00:04:56,370 --> 00:05:01,170 +experience خبرة مين؟ ال examinerAnd repeated + +58 +00:05:01,170 --> 00:05:05,310 +observation وتكرار عملية الفحص دايما ال rotation + +59 +00:05:05,310 --> 00:05:09,550 +ما تحكميش عليه من الوهلة الأولى لازم مرة و مرتين و + +60 +00:05:09,550 --> 00:05:13,990 +تلاتة لحد ما تشوف استقرار العدسة بعد ذلك اللي هو + +61 +00:05:13,990 --> 00:05:20,750 +جديش قيمة ال rotation اللي خاصة بالعدسةExperience + +62 +00:05:20,750 --> 00:05:24,370 +and repeated observation will allow the + +63 +00:05:24,370 --> 00:05:29,090 +practitioner to accurately estimate or guess + +64 +00:05:29,090 --> 00:05:32,410 +estimate the rotation of each lens + +65 +00:05:35,370 --> 00:05:41,450 +أو الـ practitioner بالإضافة لتكرار عملية الفحص أو + +66 +00:05:41,450 --> 00:05:45,650 +عملية ال fitting هذا كله بيساعدني في تحديد جداش + +67 +00:05:45,650 --> 00:05:50,630 +قيمة ال rotation للعدسة وأيضا اللي هو تقدير guess + +68 +00:05:50,630 --> 00:05:55,450 +estimate أي بمعنى تقدير الدوران اللي خاص بالعدسة + +69 +00:05:56,180 --> 00:05:59,600 +شايفين دايما بكتب كلمة guess estimate لان مافيش + +70 +00:05:59,600 --> 00:06:03,400 +حاجة بتديكي اللي هو fixed value او fixed number + +71 +00:06:03,400 --> 00:06:10,940 +كله عبارة عن تقدير للدوران الشكل + +72 +00:06:10,940 --> 00:06:16,760 +هذا جدا مهم تمام طبعا هذا عبارة عن figure + +73 +00:06:19,690 --> 00:06:24,430 +الدراسة عبارة عن part chart بنسميه دايما لما يكون + +74 +00:06:24,430 --> 00:06:32,150 +الشكل هذا اسمه part chart الان انا لو قلتلك اعملي + +75 +00:06:32,150 --> 00:06:37,750 +explanation شرح لل part chart اللي خاص في الدراسة + +76 +00:06:37,750 --> 00:06:43,900 +اللي تم إجراءهاعنا astigmatism diopter in turic + +77 +00:06:43,900 --> 00:06:48,340 +soft contact lens يعني هان قيمة ال astigmatism + +78 +00:06:48,340 --> 00:06:54,020 +اللي موجود على العدسة تمام؟ هذا بمثل مين؟ ال + +79 +00:06:54,020 --> 00:06:58,800 +horizontal lineبينما او ال horizontal meridian + +80 +00:06:58,800 --> 00:07:02,700 +عندنا ال vertical meridian او ال vertical line + +81 +00:07:02,700 --> 00:07:08,120 +بمثل اللي هو ال induce astigmatism يعني ممتازة + +82 +00:07:08,120 --> 00:07:13,000 +اللي هو قيمة ال astigmatism المستحدث طيب الان لو + +83 +00:07:13,000 --> 00:07:19,280 +أخدنا نظرة على الفيجر طبعا طلعت الفيجر مين تقدر + +84 +00:07:19,280 --> 00:07:21,860 +تعملي explanation لها؟ + +85 +00:07:23,810 --> 00:07:27,130 +و كنا نزلت كمية ال astigmatism في الموجودة عند + +86 +00:07:27,130 --> 00:07:31,170 +المريض و كان ال rotation كتير كنا أحدث ليه + +87 +00:07:31,170 --> 00:07:36,970 +astigmatism أكبر طيب ممتازة فتقدر تقدر جديش من + +88 +00:07:36,970 --> 00:07:40,870 +خلال اللي هو النتائج اللي موجودة عندك كنا نزلت نص + +89 +00:07:40,870 --> 00:07:45,690 +astigmatism مستعدة لناس بما كانوا مستعدات متوزنة + +90 +00:07:45,690 --> 00:07:52,230 +احنا هبنتناقش ايش رأيك؟ طيب + +91 +00:07:52,900 --> 00:07:58,800 +ها تفضلي تمام + +92 +00:07:58,800 --> 00:08:10,540 +okay كلام سليم another + +93 +00:08:10,540 --> 00:08:17,330 +one طيب الآن ال figure يعني بيمثل لي أكم degreeقال + +94 +00:08:17,330 --> 00:08:21,670 +على الفيجر هذا تلاتين ديجري، هي عبارة عن تلاتين + +95 +00:08:21,670 --> 00:08:27,070 +ديجري، تمام؟ number two، fifteen degree، هي عبارة + +96 +00:08:27,070 --> 00:08:31,190 +عن fifteen ديجري، صحيح؟ و number three، هذه عبارة + +97 +00:08:31,190 --> 00:08:35,930 +عن ايه؟ ال maps، دايما اية bar chart او اية table + +98 +00:08:35,930 --> 00:08:40,590 +او فيجر لابد ان يكون فيها ايه؟ map، ال map بتوضح + +99 +00:08:40,590 --> 00:08:46,290 +لمين؟ للقارئ اللي هو كيفية تحليل ايه الدراسةعشرة + +100 +00:08:46,290 --> 00:08:51,310 +degree اللي هي بتمثل small triangle طيب، الآن لو + +101 +00:08:51,310 --> 00:08:55,830 +إيجينا مثلا عند اللي هو من ال 30 degree الأكبر + +102 +00:08:55,830 --> 00:09:01,490 +ملاحظين اللي هو النص أو خلينا عشان تكون أكتر + +103 +00:09:01,490 --> 00:09:07,190 +وضوحا، عندنا مثلا التلاتة، كم مثلات؟ تلاتة، إيش + +104 +00:09:07,190 --> 00:09:12,590 +معناه الكلام؟ يعني عندما يكون الشخص عنده تلاتة + +105 +00:09:12,590 --> 00:09:13,150 +cylinder + +106 +00:09:16,220 --> 00:09:21,560 +تلاتة سيلندر في داخل العدسة هيستحدث وعملت روتيشن + +107 +00:09:21,560 --> 00:09:27,380 +تلاتين ديجرين هيستحدث قداش اللي هو تلاتة ديوبتر لو + +108 +00:09:27,380 --> 00:09:31,960 +اجينا مثلا للاربعة قداش استحدث أستيجماتيزم اربعة + +109 +00:09:31,960 --> 00:09:36,000 +هذه وين يا جماعة؟ لما العدسة عملت روتيشن تلاتين + +110 +00:09:36,000 --> 00:09:38,400 +ديجرين واضحة الفكرة؟ + +111 +00:09:41,670 --> 00:09:46,650 +الخمس عشر يعني + +112 +00:09:46,650 --> 00:09:53,050 +مثلا عند اتنين جداش استحدثات واحد يعني جداش النص + +113 +00:09:53,050 --> 00:09:58,210 +إذا قيمة الـastigmatism المستحدث يما يكون ال + +114 +00:09:58,210 --> 00:10:02,010 +rotation قيمته خمس عشر degree عندنا نص اللي هو مين + +115 +00:10:02,010 --> 00:10:06,230 +القيمة الحقيقيةيعني انتوا لازم يكون فيه نوع من ال + +116 +00:10:06,230 --> 00:10:09,450 +imagination التخيل يعني الآن لما شخص يكون عنده + +117 +00:10:09,450 --> 00:10:14,630 +اربعة ديوبتر او تلاتة ديوبتر سيلندر وعملت العدسة + +118 +00:10:14,630 --> 00:10:18,870 +دوران بقيمة تلاتين ديجري عمللي تلاتة ديوبتر زيهم + +119 +00:10:18,870 --> 00:10:23,750 +تخيلوا قداش القيمة يعني كبيرة طيب عند الخمساش + +120 +00:10:23,750 --> 00:10:28,810 +اتنين عملت واحد التلاتة عملت اللي هو تقريبا واحد و + +121 +00:10:28,810 --> 00:10:34,360 +نص بمعنى قداش النصبينما عند العشرة degree مثلا + +122 +00:10:34,360 --> 00:10:40,000 +عندنا الواحد و نص أو مش وابح كتير مثلا الواحد عملت + +123 +00:10:40,000 --> 00:10:44,380 +اللي هو تقريبا ستة من عشرة أي بمعنى اللي هو التلت + +124 +00:10:46,670 --> 00:10:51,410 +بعدين اختصر مرة اخرى يما يكون شخص عنده تلاتة + +125 +00:10:51,410 --> 00:10:55,710 +ديوبتر او اربعة ديوبتر و العدسة عملت rotation + +126 +00:10:55,710 --> 00:11:00,310 +بقيمة تلاتين degree ال induce astigmatism هيكون + +127 +00:11:00,310 --> 00:11:07,220 +جداش the same power نفس القيمةطيب الخمس عشر نص + +128 +00:11:07,220 --> 00:11:12,460 +القيمة الواحد او عفوا العشرة degree مثل اللي هو + +129 +00:11:12,460 --> 00:11:18,140 +تلت القيمة ل ال software contact lens اذا اعتقد + +130 +00:11:18,140 --> 00:11:22,960 +الفيجر هذا لو كان سؤال في الامتحان بالطريقة هذه + +131 +00:11:22,960 --> 00:11:25,080 +ايش بدك تعمليله explanation + +132 +00:11:31,690 --> 00:11:36,190 +في عندنا equilibrium time أي بمعنى وقت اللي هو + +133 +00:11:36,190 --> 00:11:40,690 +توازن العدسة دايما العدسة ال soft trick في + +134 +00:11:40,690 --> 00:11:44,990 +المحاضرة الماضية ميزنا بين مصطلحين أساسيين اللي هو + +135 +00:11:44,990 --> 00:11:52,010 +موضوع ال rotation وموضوع ال stabilityإذن الوقت + +136 +00:11:52,010 --> 00:11:57,770 +التوازن العدسة أو وقت اللي هو معادلة العدسة is + +137 +00:11:57,770 --> 00:12:02,750 +necessary هو يعتبر ضروري أو critical أساسي as + +138 +00:12:02,750 --> 00:12:07,990 +lenses will continueto settle over time طب ليش هو + +139 +00:12:07,990 --> 00:12:12,510 +أساسي و ليش يعتبر مهم؟ لأن العجزة هتاخد اللي هو + +140 +00:12:12,510 --> 00:12:17,150 +فترة زمانية طويلة على إيش تقعد على القرنية أو + +141 +00:12:17,150 --> 00:12:21,930 +conform to the shape of the cornea Indicating that + +142 +00:12:21,930 --> 00:12:27,050 +a week of wear is indeed to better evaluate the + +143 +00:12:27,050 --> 00:12:30,170 +fit دايما عندما يكون إنسان professional + +144 +00:12:32,870 --> 00:12:38,380 +بشتغل عمل ايديال مية في الميةالان انا ماوصلتش + +145 +00:12:38,380 --> 00:12:42,720 +للمرحلة النهائية من عملية ال fitting، تمام؟ يعني + +146 +00:12:42,720 --> 00:12:47,620 +نفترض اللي هو اعملت جلسة أولى و تانية، بدي اشوف + +147 +00:12:47,620 --> 00:12:53,540 +اللي هو قيمة ال rotation كتقدير لها عند scene أو + +148 +00:12:53,540 --> 00:12:57,260 +صاد أو عين، قبل ما بدي ال final اللي هو + +149 +00:12:57,260 --> 00:13:02,240 +prescription، بدي عجسة أسبوعية لمدة أسبوع، يلبسها + +150 +00:13:02,240 --> 00:13:06,900 +تمام؟ ك software contact lensو اشوف بناء على هذه + +151 +00:13:06,900 --> 00:13:11,320 +كده انه حيصير عنده rotation يما يلبسها طبعا ممكن + +152 +00:13:11,320 --> 00:13:14,220 +طالب تقول ليه هذا مكلف بالنسبة لمين لل + +153 +00:13:14,220 --> 00:13:18,080 +practitioner و ممكن بعض الأحيان يكون مكلف او مزعج + +154 +00:13:18,080 --> 00:13:22,880 +لمين لل patient لكن هذا الاسلوب الصحيح بدل ما هدي + +155 +00:13:22,880 --> 00:13:29,080 +عدسة قيمتها اللي هو ال .. اووالتكلفة 800 شكل او + +156 +00:13:29,080 --> 00:13:34,000 +700 شكل ك final prescription بدي عدسة ان تكون زي + +157 +00:13:34,000 --> 00:13:38,260 +عندنا في المعمل في ال trial set يعني بصل سعرها + +158 +00:13:38,260 --> 00:13:44,200 +تقريبا 50 او 60 شكل لمدة أسبوع واحد بلبسها وبيشوف + +159 +00:13:44,200 --> 00:13:50,870 +قيمة ال rotation اللي خاص بالعدسة تمام؟ليش؟ لأنه + +160 +00:13:50,870 --> 00:13:54,630 +دايما العدسة ال soft trick ما بتظهر قيمة ال + +161 +00:13:54,630 --> 00:13:58,550 +rotation فيها من أول يوم وهذا الكلام الآن هناخده + +162 +00:13:58,550 --> 00:14:04,830 +for this reason لهذا السبب many practitioners will + +163 +00:14:04,830 --> 00:14:06,810 +allow the patient to wear + +164 +00:14:10,300 --> 00:14:14,620 +هيسمحوا العديد من اللي هو ال practitioner الأشخاص + +165 +00:14:14,620 --> 00:14:18,400 +اللي نوين يلبسوا العدسات انه يرتدي مجموعة من + +166 +00:14:18,400 --> 00:14:23,170 +العدسات يعني بمعنى trial and error يجارف فيهمIf + +167 +00:14:23,170 --> 00:14:26,970 +the fit and visual acuity are acceptable أخد + +168 +00:14:26,970 --> 00:14:31,310 +العدسة لمدة أسبوع و أحكى لي أن العدسة كانت fit لما + +169 +00:14:31,310 --> 00:14:34,770 +أنا شفت على ال sitlam examination لاحظت أنه في + +170 +00:14:34,770 --> 00:14:39,190 +well-centered للعدسة و أيضا لاحظت أنه مافي أي ت + +171 +00:14:39,190 --> 00:14:43,410 +rotation أو rotation بسيط للعدسة و الأهم أنه لاحظت + +172 +00:14:43,410 --> 00:14:46,870 +أنه في عنده ال visual acuity acceptable اللي هو + +173 +00:14:46,870 --> 00:14:53,940 +مقبول تمامbefore fine tuning يعني قبل الوصفة + +174 +00:14:53,940 --> 00:14:58,480 +النهائية قبل توفير الوصفة النهائية للمريض + +175 +00:15:01,390 --> 00:15:06,270 +With the newer lenses rotation commonly doesn't + +176 +00:15:06,270 --> 00:15:10,550 +change from day one زي ما اتفقنا ان قيمة ال + +177 +00:15:10,550 --> 00:15:14,970 +rotation لا تظهر عند الشخص خلال يوم واحد لذلك ان + +178 +00:15:14,970 --> 00:15:20,390 +اعملنا على توفير عدسة يلبسها اللي هو المريض لمدة + +179 +00:15:20,390 --> 00:15:24,150 +اسبوع لملاحظة انه هل ال visual acuity acceptable + +180 +00:15:24,150 --> 00:15:30,390 +هذي number one وتقدير قيمة ال rotation اللي خاصة + +181 +00:15:30,390 --> 00:15:31,050 +بالعدسة + +182 +00:15:34,620 --> 00:15:38,940 +في عندنا notebook ملاحظة مهمة كتير if the visual + +183 +00:15:38,940 --> 00:15:43,920 +acuity is good يعني بمعنى acceptable مقبول كان + +184 +00:15:43,920 --> 00:15:48,920 +ملائم ومناسب بالنسبة للمريض and the patient is + +185 +00:15:48,920 --> 00:15:53,340 +satisfied أي بمعنى راضي عن العدسة وموافق عليها + +186 +00:15:53,340 --> 00:15:58,160 +ومنصاع لها تمام even though there is some rotation + +187 +00:15:58,160 --> 00:16:02,400 +of the lens ممكن يكون one or two degrees في دوران + +188 +00:16:02,400 --> 00:16:07,320 +للعدسة هذا أمر طبيعيCompensation may not be + +189 +00:16:07,320 --> 00:16:11,540 +necessary إذا انهان عملية التعويض وعملية اللي هو + +190 +00:16:11,540 --> 00:16:16,980 +أن أجيب عدسة بنفس القيمة أو بنفس ال axis مش مطلوبة + +191 +00:16:16,980 --> 00:16:21,140 +ليش؟ ببساطة لأنه عنده visual acuity acceptable + +192 +00:16:21,140 --> 00:16:24,820 +وأيضا أن قيمة هذه ال rotation ال one أو ال two + +193 +00:16:24,820 --> 00:16:28,500 +degrees مش مأثرة على المريض تمام؟ + +194 +00:16:34,730 --> 00:16:40,290 +Compensation for lens rotation ان عملية التعويض + +195 +00:16:40,290 --> 00:16:42,430 +لدوران العدسة + +196 +00:16:46,520 --> 00:16:53,040 +or critical or necessary ضرورية to determine the + +197 +00:16:53,040 --> 00:16:59,340 +cylinder lens axis or the final cylinder axis for + +198 +00:16:59,340 --> 00:17:03,940 +a lens.إذن هي مهمة في تحديد قداش قيمة ال axis اللي + +199 +00:17:03,940 --> 00:17:06,800 +خاص بالسلمدر للمريض + +200 +00:17:14,400 --> 00:17:20,160 +و ممكن اللي هو كلمة laser أسهل after a trial lens + +201 +00:17:20,160 --> 00:17:20,720 +has been used + +202 +00:17:25,780 --> 00:17:31,960 +و اعمل عملية اللي هو تقييم لقيمة اللي هو دوران او + +203 +00:17:31,960 --> 00:17:36,420 +قيمة توازن العدسة دايما يا جماعة يما تسمع كلمة + +204 +00:17:36,420 --> 00:17:49,400 +equilibrate بمعنى stability بتعادل + +205 +00:17:49,400 --> 00:17:50,700 +كلمة stability + +206 +00:17:56,060 --> 00:18:02,680 +The rotation is measured انا هقيم اللى هو جداش + +207 +00:18:02,680 --> 00:18:07,080 +قيمة ال rotation من خلال مين الاصطلاح evaluation + +208 +00:18:07,080 --> 00:18:13,200 +او الاصطلاح examination if the base or reference + +209 +00:18:13,200 --> 00:18:17,500 +point of the lens rotates ten degrees to the + +210 +00:18:17,500 --> 00:18:21,740 +observers left لو كانت عاملة rotation باتجاه مين؟ + +211 +00:18:21,740 --> 00:18:26,850 +الشمالThe amount of rotation is added to the + +212 +00:18:26,850 --> 00:18:30,710 +refractive cylinder axis left at for the final + +213 +00:18:30,710 --> 00:18:34,870 +lens وخدنا اعتقد مثال عليها ان لو كان عند ال axis + +214 +00:18:34,870 --> 00:18:40,970 +هان 170 وفي عندنا rotation باتجاه الشمال بقيمة 10 + +215 +00:18:40,970 --> 00:18:47,170 +degree لقول 170 زائد 10 بساوة 180 قيمة من ال axis + +216 +00:18:47,170 --> 00:18:54,080 +الجديدطيب بالنسبة للـ rotation باتجاه ال right + +217 +00:18:54,080 --> 00:18:59,540 +بدنا نعمل ايه؟ Subtract اللي هو قرح يعني بمعنى اخر + +218 +00:18:59,540 --> 00:19:03,860 +لو انا كان عندى اللي هو قيمة ال rotation عشرين + +219 +00:19:03,860 --> 00:19:08,240 +ديجري باتجاه ال right اذا بدي اقول تسعين ناقص + +220 +00:19:08,240 --> 00:19:11,980 +عشرين بساوي سبعين ديجري مابديش اخوض كتير في هذا + +221 +00:19:11,980 --> 00:19:13,960 +الموضوع لان اعتقد انه واضح + +222 +00:19:17,840 --> 00:19:22,280 +عنا ال guess estimation اللي هو تقدير الدوران هو + +223 +00:19:22,280 --> 00:19:27,700 +يعتبر simplest بسيط and properly اللي هو ملائم the + +224 +00:19:27,700 --> 00:19:33,760 +most common method of measuring rotation يعني منهج + +225 +00:19:33,760 --> 00:19:39,240 +بسيط و ملائم و مناسب لعملية تقييم إيش اللي هو + +226 +00:19:39,240 --> 00:19:45,330 +دوران العدسةThe clock dial is visualized by the + +227 +00:19:45,330 --> 00:19:48,650 +practitioner with each hour زي ما اتفقنا اما + +228 +00:19:48,650 --> 00:19:53,610 +بستخدم hour ساعة يد او بحط الastigmatic fan في + +229 +00:19:53,610 --> 00:19:59,450 +عملية التقييم with each hour ال space between + +230 +00:19:59,450 --> 00:20:04,370 +adjacent numbers such as 5 and 6 equaling 30 + +231 +00:20:04,370 --> 00:20:08,650 +degrees طبعا اما بكون باتجاه اللي هو ال clockwise + +232 +00:20:08,650 --> 00:20:13,970 +او ال counter clockwiseو ايضا بعمل عملية تقسيم + +233 +00:20:13,970 --> 00:20:20,170 +الساعة ل 30 ديجري okay in addition to being simple + +234 +00:20:20,170 --> 00:20:24,210 +and easy to perform guess estimation can be + +235 +00:20:24,210 --> 00:20:28,730 +accurate طب كيف الان انا ممكن اصل لا اللي هو + +236 +00:20:28,730 --> 00:20:33,370 +التقدير الملائم او المناسب لقيمة ال rotation؟ + +237 +00:20:33,370 --> 00:20:37,330 +البساطة انا قيمت مثلا قيمة ال rotation للعدسة + +238 +00:20:37,330 --> 00:20:44,250 +نفترض 10 ديجرييعني اعتمد العشرة degree لأ بدي اعمل + +239 +00:20:44,250 --> 00:20:48,250 +over refraction وبعد ذلك ايش بدنا نعمله اللي هو + +240 +00:20:48,250 --> 00:20:51,690 +subjective refraction للمريض من خلال اللي هو + +241 +00:20:51,690 --> 00:20:55,310 +استخدام الجاكسون across cylinder بقدر اللي هو احدد + +242 +00:20:55,310 --> 00:21:01,510 +قداش قيمة ال axis الملائم لهذا المريضنشوف الدراسة + +243 +00:21:01,510 --> 00:21:06,870 +هذه مهمة كتير one study found that mean rotational + +244 +00:21:06,870 --> 00:21:12,150 +estimates were within two degrees of actual values + +245 +00:21:12,150 --> 00:21:15,930 +with no significant differences between the time + +246 +00:21:17,570 --> 00:21:22,410 +يعني واحد مثلا بس هان راجزه كويس الدراسة هان small + +247 +00:21:22,410 --> 00:21:28,710 +refractive error تمام؟ لاحظ أنه فيه دوران بقيمة + +248 +00:21:28,710 --> 00:21:33,350 +two degrees للعدسة فمالاحظش أي ت أيه significant + +249 +00:21:33,350 --> 00:21:38,250 +difference يعني بمعنى آخر لم يلاحظ أي تغيير في + +250 +00:21:38,250 --> 00:21:42,890 +قيمة اللي هو ال visual acuityيعني بساطة يا جماعة + +251 +00:21:42,890 --> 00:21:48,590 +جاب مجموعة من المرضى، تمام؟ ونفترض هدول المرضى ال + +252 +00:21:48,590 --> 00:21:52,490 +access اللي خاص فيهم مية و تمانية و سبعين، راح + +253 +00:21:52,490 --> 00:21:57,690 +قدهم access قداش مية و تمانين، تمام؟عملهم visual + +254 +00:21:57,690 --> 00:22:01,530 +acuity على ال smelling chart ده لاحظ مش اي تتغير + +255 +00:22:01,530 --> 00:22:05,270 +في ال visual acuity يعني نفترض ان كل هيتهم كان ال + +256 +00:22:05,270 --> 00:22:10,270 +visual acuity 6 على 7 و نص فلاحظ ان هو 6 على 7 و + +257 +00:22:10,270 --> 00:22:11,950 +نص دون اي تغير + +258 +00:22:14,980 --> 00:22:18,980 +هنا لدينا قيمة الـ rotation إما باتجاه الـ right + +259 +00:22:18,980 --> 00:22:23,640 +أو الـ left إما بكون الـ add أو الـ subtract و + +260 +00:22:23,640 --> 00:22:27,920 +بتعتمد على قيمة الـ rotation هل هي one award او + +261 +00:22:27,920 --> 00:22:32,360 +two awards هل هي بال degree الاخرى طيب ان شاء الله + +262 +00:22:32,360 --> 00:22:36,620 +بنتوقف للنقطة هذه و ان شاء الله في المحاضرة + +263 +00:22:36,620 --> 00:22:40,280 +القادمة بنكمل نعتذر من الخلل الفني و يعطيكم + +264 +00:22:40,280 --> 00:22:41,060 +العافية ان شاء الله + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/hYllUQaUrEo.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/hYllUQaUrEo.srt new file mode 100644 index 0000000000000000000000000000000000000000..4c74b7b8c6b8f806698733b71f9e225cdb59b9f7 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/hYllUQaUrEo.srt @@ -0,0 +1,1643 @@ +1 +00:00:20,920 --> 00:00:23,860 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:23,860 --> 00:00:29,360 +وبركاته هنبدأ اليوم في موضوع impaired reading in + +3 +00:00:29,360 --> 00:00:33,760 +soft contact lens wearer impaired بمعنى تعطيل أو + +4 +00:00:33,760 --> 00:00:38,820 +reduce reading أو بمعنى deterioration تدهور + +5 +00:00:47,870 --> 00:00:51,970 +تدهور القراءة في الأشخاص اللي بيرتديوا العدسات + +6 +00:00:51,970 --> 00:00:58,550 +اللاصقة اللينة بداية أي مريض بيرتدي عدسة لاصقة + +7 +00:00:58,550 --> 00:01:04,610 +لينة بشكل مستمر أو في فترة زمنية طويلة بيصير عنده + +8 +00:01:04,610 --> 00:01:10,330 +نوع من إيه؟ من الإجهاد بعد ما بيصير عنده الإجهاد + +9 +00:01:10,330 --> 00:01:14,910 +هذا بتلاقي إنه زي ما أنت بتعملي attention في ال + +10 +00:01:14,910 --> 00:01:18,030 +mobile أو attention في ال laptop بيقل موضوع ال + +11 +00:01:18,030 --> 00:01:21,250 +blinking اللي هو الترميش إحنا عارفين إنه ال normal + +12 +00:01:21,250 --> 00:01:25,610 +blinking من خمسة عشر إلى عشرين مرة في اللي هو الدقيقة + +13 +00:01:25,610 --> 00:01:33,400 +وبالتالي هذا إيش بيسبب؟ بيسبب إنه عدم اللي هو موضوع + +14 +00:01:33,400 --> 00:01:36,880 +الـ lubrication اللي هو ترطيب لمين؟ للعدسة يعني + +15 +00:01:36,880 --> 00:01:42,680 +بيقلل من ترطيب العدسة فبتصبح العدسة جافة وبالتالي + +16 +00:01:42,680 --> 00:01:47,840 +هذا قد يؤدي إلى تأثير على اللي هو ال comfort راحة + +17 +00:01:47,840 --> 00:01:54,080 +المريض وأيضًا على ال vision بالنسبة للمريض إذا ال + +18 +00:01:54,080 --> 00:01:55,580 +causes الأسباب + +19 +00:01:58,880 --> 00:02:06,340 +القراءة لفترات زمنية طويلة بيسبب إجهاد للمريض and + +20 +00:02:06,340 --> 00:02:09,620 +lack of blinking ونقص في عملية الترميش + +21 +00:02:12,500 --> 00:02:17,700 +leads to هذا بيقود إلى excessive drying زيادة + +22 +00:02:17,700 --> 00:02:23,360 +الجفاف للسطح اللي هو الأمامي اللي خاص بالعدسة لذلك + +23 +00:02:23,360 --> 00:02:27,500 +إحنا بننصح المريض عند ارتداء العدسة اللاصقة اللينة + +24 +00:02:27,500 --> 00:02:33,610 +إنه كل مثلاً خمسة وأربعين دقيقة يطلع بعيد الهدف من + +25 +00:02:33,610 --> 00:02:38,070 +ذلك إنه أعمل relax لل accommodation بالإضافة إنه + +26 +00:02:38,070 --> 00:02:42,990 +أعمل اللي هو عملية blinking وترطيب للعدسة اللاصقة + +27 +00:02:42,990 --> 00:02:50,030 +Decentration + +28 +00:02:50,030 --> 00:02:55,670 +of soft contact lenses أي بمعنى عدم تمركز أو إزاحة + +29 +00:02:55,670 --> 00:03:01,570 +العدسة اللاصقة اللينة الآن مباشرة لما تسمع كلمة الـ + +30 +00:03:01,570 --> 00:03:06,630 +Decentration إيش بيراود لفكرك؟ إن العدسة قد تكون + +31 +00:03:06,630 --> 00:03:15,870 +Flat أي بمعنى إن فيها small diameter + +32 +00:03:15,870 --> 00:03:23,170 +أو بيكون فيها flat base curve الآن هنعرف إيش ال + +33 +00:03:23,170 --> 00:03:29,430 +causes الأسباب لإزاحة العدسة اللاصقة اللينة الـ + +34 +00:03:29,430 --> 00:03:34,930 +causes number one tight eyelids أي شخص بيكون عنده + +35 +00:03:34,930 --> 00:03:39,830 +ال eyelid وهنا بنقصد ال upper eyelid فيه اللي هو + +36 +00:03:39,830 --> 00:03:46,150 +التايت زي مثلاً ال Japanese، ال Chinese، Malaysian، + +37 +00:03:46,150 --> 00:03:50,130 +Singaporean، هدول كلهم الأشخاص في عندهم إيه؟ tight + +38 +00:03:50,130 --> 00:03:57,140 +eyelids فبتلاحظي إنهم دايمًا إنه بيحتاج إلى عدسة بيكون + +39 +00:03:57,140 --> 00:04:01,580 +فيها ال base curve small ولا large؟ large diameter + +40 +00:04:01,580 --> 00:04:06,440 +أو خلينا نقول quite large diameter compared to + +41 +00:04:06,440 --> 00:04:11,990 +another race مقارنة بأعراق أو بأجناس آخرين فهذا + +42 +00:04:11,990 --> 00:04:15,450 +بيؤدي إلى إزاحة العدسة، يعني لو أنا لبست عدسة + +43 +00:04:15,450 --> 00:04:19,590 +لاصقة زي اللي عندنا في المعمل، Diameter 14.2 أو 14 + +44 +00:04:19,590 --> 00:04:23,470 +.5 أو 14 Millimeter، هتلاحظي إن فيه هيصير هناك + +45 +00:04:23,470 --> 00:04:28,750 +Decentration لمين؟ للعدسة Number two، large + +46 +00:04:28,750 --> 00:04:33,890 +corneas، لما تكون ال cornea large، إيش بدها تكون؟ + +47 +00:04:33,890 --> 00:04:39,370 +Flat ولا steep؟ flat cornea صحيح؟ فلذلك أنا بحتاج + +48 +00:04:39,370 --> 00:04:43,910 +إلى diameter إيش لازم إنه يكون؟ large diameter حتى + +49 +00:04:43,910 --> 00:04:49,810 +إنه يكون ال movement للعدسة ملائمة أو مناسبة + +50 +00:04:49,810 --> 00:04:53,070 +against + +51 +00:04:53,070 --> 00:04:56,290 +the rule of stigmatism إيش معناه against the rule + +52 +00:04:56,290 --> 00:05:00,190 +of stigmatism؟ شو معناه against the rule؟ فضلي + +53 +00:05:04,740 --> 00:05:08,240 +طيب الآن لو أنا مثلاً جبت لك صورة corneal topography + +54 +00:05:08,240 --> 00:05:11,740 +إحنا هذا ك definition عارفينه إنه بيكون ال + +55 +00:05:11,740 --> 00:05:14,900 +horizontal meridian steeper than ال vertical + +56 +00:05:14,900 --> 00:05:18,240 +meridian لو أنا جبت صورة ال corneal topography + +57 +00:05:18,240 --> 00:05:23,260 +هتلاقي إن ال botai في ال horizontal meridian واضحين + +58 +00:05:23,260 --> 00:05:26,840 +أكثر من مين؟ من ال vertical meridian يعني بالشكل + +59 +00:05:26,840 --> 00:05:33,980 +هذا هيكون شكل ال corneal topography botai هذه + +60 +00:05:33,980 --> 00:05:38,160 +معناها against the rule of stigmatism ال against + +61 +00:05:38,160 --> 00:05:42,120 +the rule of stigmatism بتعمل إزاحة للعدسة اللاصقة + +62 +00:05:42,120 --> 00:05:47,570 +اللينة لسببين السبب الأول إن هي بتكون unstability + +63 +00:05:47,570 --> 00:05:53,430 +غير ثابتة والسبب الثاني إنه بيكون فيها مدام قيمة + +64 +00:05:53,430 --> 00:05:56,850 +السيلندر طبعًا أنا بتكلم هنا ممكن عن أيضًا ال + +65 +00:05:56,850 --> 00:05:59,810 +software ال contact lenses بيكون فيها ال + +66 +00:05:59,810 --> 00:06:02,490 +horizontal meridian أعلى من ال steeper meridian + +67 +00:06:02,490 --> 00:06:06,230 +فبتعمل اللي هو إزاحة للعدسة أو بنسميها + +68 +00:06:06,230 --> 00:06:07,150 +displacement + +69 +00:06:12,940 --> 00:06:17,100 +لمين؟ للعدسة اللاصقة فالآن عندما تعمل عملية + +70 +00:06:17,100 --> 00:06:20,740 +evaluation تقييم بتلاقي إن العدسة عاملة + +71 +00:06:20,740 --> 00:06:25,660 +displacement أما medial أو lateral بسبب اللي هو + +72 +00:06:25,660 --> 00:06:29,720 +against the rule of stigmatism طيب في ال with the + +73 +00:06:29,720 --> 00:06:32,660 +rule of stigmatism ليش ما بيصير ال decentralization؟ + +74 +00:06:35,230 --> 00:06:40,750 +ببساطة لأنه بيصير عملية suction للعدسة من اللي هو + +75 +00:06:40,750 --> 00:06:44,290 +إيه؟ ال vertical meridian يعني ال vertical meridian + +76 +00:06:44,290 --> 00:06:48,370 +بيكون فيه القوة أعلى أو steeper فالتحدث بيكون فيه + +77 +00:06:48,370 --> 00:06:52,010 +إيش أكثر فبالتالي إن العدسة اللي بيصير فيه لها + +78 +00:06:52,010 --> 00:06:56,330 +suction أكثر فهي بالعكس بيصير العدسة قريبة وكأنه + +79 +00:06:56,330 --> 00:07:01,510 +إيش هي steep واضح الفكرة يعني بتنمسك من المنتصف + +80 +00:07:01,510 --> 00:07:03,830 +أكثر من وين؟ من الأطراف + +81 +00:07:08,220 --> 00:07:12,440 +الـ Symmetric Corneal Topography في موضوع الـ + +82 +00:07:12,440 --> 00:07:16,620 +Corneal Topography أخذنا هناك أكثر من عشر أشكال + +83 +00:07:16,620 --> 00:07:20,060 +للـ High Order Aberration زي الـ Oval و الـ Round + +84 +00:07:20,060 --> 00:07:23,460 +و الـ Asymmetric Potai و Asymmetric Potai وقلنا + +85 +00:07:23,460 --> 00:07:26,580 +فيه الـ Asymmetric Potai إما بيكون inferior أو + +86 +00:07:26,580 --> 00:07:31,980 +superior وأيضًا بيكون ممكن إنه skewed with radial + +87 +00:07:31,980 --> 00:07:38,160 +axis فهذه كلها قد تسبب اللي هو إزاحة لمين؟ للعدسة + +88 +00:07:42,050 --> 00:07:45,670 +الآن عندنا موضوع ال symptoms and signs of loose + +89 +00:07:45,670 --> 00:07:51,830 +lens أعراض وعلامات إن العدسة لما تكون flat أو + +90 +00:07:51,830 --> 00:07:56,450 +تكون loose number + +91 +00:07:56,450 --> 00:08:01,150 +one variable vision أو vision fluctuation + +92 +00:08:01,150 --> 00:08:02,950 +fluctuation بمعنى إيه؟ + +93 +00:08:07,100 --> 00:08:12,260 +اللي هو تذبذب الرؤية أو ال vision variable اختلاف + +94 +00:08:12,260 --> 00:08:18,820 +الرؤية طبعًا هذا بيكون بشكل اللي هو إيه؟ مش دائم + +95 +00:08:18,820 --> 00:08:24,540 +يعني فورًا للحظات وبيكون خاصة بيظهر في الأسطر + +96 +00:08:24,540 --> 00:08:31,500 +الأخيرة يعني بمعنى من 6 على 12 إلى 6 على 6 يعني في + +97 +00:08:31,500 --> 00:08:37,090 +ال two ل three lines الأخيرة بيصير هناك تذبذب بعملية + +98 +00:08:37,090 --> 00:08:44,350 +الرؤية ما بين before و after blinking number + +99 +00:08:44,350 --> 00:08:50,360 +two excess awareness of the lens العدسة لما تكون + +100 +00:08:50,360 --> 00:08:55,620 +flat بتكون حركتها كثيرة فالمريض بيشعر إن العدسة + +101 +00:08:55,620 --> 00:08:59,880 +عبارة عن foreign body أو بالضبط بتكون وكأنه رمل + +102 +00:08:59,880 --> 00:09:04,060 +في داخل عينه، هيك المريض تعبيره لما تكون العدسة + +103 +00:09:04,060 --> 00:09:06,600 +flat، إنه رمل في داخل العين + +104 +00:09:09,400 --> 00:09:15,360 +3- Poor Centering دائمًا تمركز العدسة بيكون ضعيف + +105 +00:09:15,360 --> 00:09:18,880 +لأن فيه أما بتكون ماخدة Decentration Up Down + +106 +00:09:18,880 --> 00:09:23,280 +Lateral Medial طيب + +107 +00:09:23,280 --> 00:09:26,780 +الآن لما يكون عندنا Decentration للعدسة أو Poor + +108 +00:09:26,780 --> 00:09:31,580 +Centering والعدسة Flat إيش بدي أعمل؟ أما بجيب + +109 +00:09:31,580 --> 00:09:35,760 +Large Diameter أو بجيب Steep Base Curve واضح + +110 +00:09:35,760 --> 00:09:41,640 +الفكرة؟ أيضًا excess movement الحركة بتكون من 2 إلى + +111 +00:09:41,640 --> 00:09:45,960 +4 تقريبًا لما يكون العدسة إيش اللي هو excess + +112 +00:09:45,960 --> 00:09:50,340 +movement أو flat أو loose طبعًا إحنا بنعرف ال + +113 +00:09:50,340 --> 00:09:56,400 +normal قد إيش؟ من نص إلى واحد وهنا + +114 +00:09:56,400 --> 00:10:01,580 +مرة ثانية بكرر إن الحركة هي غير كافية لعملية تقييم + +115 +00:10:01,580 --> 00:10:07,740 +العدسة هل هي flat ولا optimal أو stable Lens + +116 +00:10:07,740 --> 00:10:11,960 +falling out of the eye إحنا بنعرف إن العدسة + +117 +00:10:11,960 --> 00:10:17,180 +اللاصقة اللينة بتعمل follow to the eye movement و + +118 +00:10:17,180 --> 00:10:21,000 +بتتميز إن ال diameter بتاعها أكبر من الكورنية + +119 +00:10:21,000 --> 00:10:25,560 +فسقوطها بيكون أصعب من مين؟ من سقوط العدسة ال hard + +120 +00:10:25,560 --> 00:10:28,440 +contact lenses لكن لما يكون ال diameter بتاعها + +121 +00:10:28,440 --> 00:10:33,020 +صغير بسهولة إنه ممكن إيه يصير لها اللي هو سقوط + +122 +00:10:33,020 --> 00:10:36,260 +وهذا بنسميه ال dismatch + +123 +00:10:39,530 --> 00:10:45,910 +أو falling لمين؟ للعدسة أيضًا + +124 +00:10:45,910 --> 00:10:49,870 +عندنا bubble هيكون فيه هناك فقاعات تحت ال lens + +125 +00:10:49,870 --> 00:10:54,150 +edge بينما في العدسة ال steep وين هيكون ال bubble؟ + +126 +00:10:54,150 --> 00:10:59,050 +اللي هو ال center كيرتو ميتري + +127 +00:10:59,050 --> 00:11:02,270 +مياردز الآن before blinking هتكون clear ولا + +128 +00:11:02,270 --> 00:11:10,460 +unclear؟ وعد في ال keratometry mires before blinking + +129 +00:11:10,460 --> 00:11:16,360 +clear after blinking هتكون إيه؟ اللي هو after + +130 +00:11:16,360 --> 00:11:22,500 +blinking هتكون unclear طبعًا هذه بيتم رؤيته أما من + +131 +00:11:22,500 --> 00:11:27,220 +خلال جهاز keratometer المياردز الخاص فيه أو من + +132 +00:11:27,220 --> 00:11:28,640 +خلال ال bush and lum + +133 +00:11:32,030 --> 00:11:36,090 +written scope, read reflex نفس الفكرة، الآن لو أنا + +134 +00:11:36,090 --> 00:11:40,130 +المريض قبل الترميش لو لاحظت ال reflex بتاعة ال + +135 +00:11:40,130 --> 00:11:43,370 +written scope قبل الترميش هيكون إيش ماله؟ واضح + +136 +00:11:43,370 --> 00:11:48,470 +وبعد الترميش هيكون unclear نفس فكرة الكيرتو ميتر + +137 +00:11:48,470 --> 00:11:51,990 +مياردز إن شاء الله هذا هيتم تطبيقه بعد الامتحان + +138 +00:11:51,990 --> 00:11:54,770 +النصفي، موضوع ال written scope و read reflex في + +139 +00:11:54,770 --> 00:11:55,210 +المعملة + +140 +00:11:59,150 --> 00:12:04,930 +symptoms and signs of tight lens أيضًا عندنا ال + +141 +00:12:04,930 --> 00:12:09,230 +causes الأسباب اللي لها فيه fluctuation of vision + +142 +00:12:09,230 --> 00:12:14,890 +وبنكرر نفس الفكرة بيكون في آخر سطرين أو ثلاثة من 6 + +143 +00:12:14,890 --> 00:12:20,790 +على 12 ل 6 على 6 وبعض الدراسات بتقول من 6 ل 15 ل 6 على + +144 +00:12:20,790 --> 00:12:21,550 +7 ونص + +145 +00:12:25,320 --> 00:12:28,700 +initially comfortable but increasingly + +146 +00:12:28,700 --> 00:12:34,240 +uncomfortable as the day progresses العدسة اللاصقة + +147 +00:12:34,240 --> 00:12:38,840 +اللينة لما تكون tight في البداية بتكون comfortable + +148 +00:12:38,840 --> 00:12:39,880 +ليش طيب؟ + +149 +00:12:42,280 --> 00:12:46,080 +بالضبط أنه ممتازة بتعمل ايش adherence to the + +150 +00:12:46,080 --> 00:12:50,340 +cornea بمعنى أنه no sensation at all مباشرة أول ما + +151 +00:12:50,340 --> 00:12:54,800 +المريض بحط على عينه مافي شعور بالعدسة واضحة الفكرة + +152 +00:12:54,800 --> 00:13:00,270 +فبتكون العدسة comfortable مريحة بعد شوية بعد ساعات + +153 +00:13:00,270 --> 00:13:04,190 +بلاحظ أن المريض يعني الآن لو أنت رفعت العدسة + +154 +00:13:04,190 --> 00:13:08,650 +اللاصقة ورحت مثلًا حطيت صبغة فلوريسين هتلاحظي و + +155 +00:13:08,650 --> 00:13:13,030 +كأنه ring حوالين وين الكورنية لأنه بتكون suction + +156 +00:13:13,030 --> 00:13:19,910 +مصممة العدسة absent or minimal movement after a + +157 +00:13:19,910 --> 00:13:25,360 +blink الحركة فيها بتكون أقل من نص مليمتر Okay + +158 +00:13:25,360 --> 00:13:30,340 +فبالتالي بتكون هي تعتبر ايه steep يعني أو بتديني + +159 +00:13:30,340 --> 00:13:37,880 +انطباع أنه قد تكون العدسة steep lens كيراتومتري + +160 +00:13:37,880 --> 00:13:43,300 +ميّارز الآن before blinking ايش بتكون؟ clear زي + +161 +00:13:43,300 --> 00:13:46,620 +اللي هو initially comfortable وبعد الترميش ايش + +162 +00:13:46,620 --> 00:13:47,400 +بتصبح؟ + +163 +00:13:50,970 --> 00:13:54,450 +إذا احنا اتفقنا أنه before a blinking بتكون + +164 +00:13:54,450 --> 00:14:00,470 +unclear و after a blinking بتكون clear أنا + +165 +00:14:00,470 --> 00:14:04,730 +بنتظر منكم إجابة written scope read reflex إذا قبل + +166 +00:14:04,730 --> 00:14:08,970 +الترميش هي بتكون unclear وبعد الترميش بتكون clear + +167 +00:14:08,970 --> 00:14:14,930 +طيب الآن لو كان عندي عدسة steep ايش بدي علاجها أما + +168 +00:14:14,930 --> 00:14:18,150 +بجيب small diameter أو بجيب اللي هو ايه + +169 +00:14:29,290 --> 00:14:33,490 +موضوع ال complications of deposits أي بمعنى + +170 +00:14:33,490 --> 00:14:40,280 +مضاعفات الترسبات طبعًا الترسبات بتعتمد على ثلاث شغلات + +171 +00:14:40,280 --> 00:14:44,880 +اللي خاصة في العدسات اللاصقة اللينة أول حاجة + +172 +00:14:44,880 --> 00:14:50,020 +بتعتمد على ال material of the lens يعني بمعنى أنه + +173 +00:14:50,020 --> 00:14:54,240 +هل هي high water content moderate water content + +174 +00:14:54,240 --> 00:14:59,860 +low water content هذه واحدة إذا كانت high water + +175 +00:14:59,860 --> 00:15:06,340 +content هل بيكون ال deposit أعلى ولا أقل؟ أعلى + +176 +00:15:06,340 --> 00:15:11,440 +وممتازة منطقيًا كل ما كان high water content أو + +177 +00:15:11,440 --> 00:15:14,920 +moderate water content بيكون كمية ال deposit أعلى + +178 +00:15:14,920 --> 00:15:20,900 +النقطة الثانية موضوع ال wear الارتداء للعدسة الآن + +179 +00:15:20,900 --> 00:15:25,760 +الشخص كل ما زاد من ارتداء العدسة اللاصقة اللينة + +180 +00:15:25,760 --> 00:15:30,300 +هيكون معرض أكثر لايش لحدوث اللي هو ال deposits + +181 +00:15:31,400 --> 00:15:36,900 +والنقطة الثالثة وهي الأهم موضوع حياة العدسة الآن + +182 +00:15:36,900 --> 00:15:42,780 +مثلًا إيمان عندها عدسة quarterly for three months + +183 +00:15:42,780 --> 00:15:48,040 +راحت لبستها semi-annual لمدة ست شهور هذه العدسة + +184 +00:15:48,040 --> 00:15:53,260 +بتكون معرضة أكثر لحدوث مين ال deposits واضحة وقد + +185 +00:15:53,260 --> 00:15:56,780 +تكون أن هي مش شاعرة في هذا التغير أو في ال + +186 +00:15:56,780 --> 00:15:58,040 +variable vision + +187 +00:16:01,540 --> 00:16:05,860 +إذا الـ number one decrease in vision حيقل الرؤية + +188 +00:16:05,860 --> 00:16:10,060 +في العدسة اللاصقة اللينة طبعًا احنا بنعرف أن العدسة + +189 +00:16:10,060 --> 00:16:14,340 +بتكون transparent من ال properties الصفات أو ال + +190 +00:16:14,340 --> 00:16:18,000 +characteristics لها يما بصير تراكم ل deposit + +191 +00:16:18,000 --> 00:16:24,540 +بصير unclear أو opaque number two red and + +192 +00:16:24,540 --> 00:16:31,200 +irritable eye طيب هنا ال red eye من وين جاي؟ احنا + +193 +00:16:31,200 --> 00:16:36,520 +بنعرف أن العدسة لو زاد فيها اللي هو التراكمات أو + +194 +00:16:36,520 --> 00:16:41,240 +الـ deposits هتعمل ايش؟ dry eye symptoms ومن ضمن + +195 +00:16:41,240 --> 00:16:45,060 +ال symptoms لـ dry eye هي عبارة عن ال red eye، + +196 +00:16:45,060 --> 00:16:48,820 +okay؟ إذا هنا ال red eye جاية من ضمن ال symptoms + +197 +00:16:48,820 --> 00:16:54,460 +لمين؟ لال dry eye أيضًا حيصير هناك ايش irritation + +198 +00:16:54,460 --> 00:16:58,860 +تهيّج في العين يعني المريض هيصبح uncomfortable غير + +199 +00:16:58,860 --> 00:17:01,580 +مرتاح مع العدسة اللاصقة + +200 +00:17:05,000 --> 00:17:09,160 +An increase in the mass of the lens أي زيادة في + +201 +00:17:09,160 --> 00:17:13,900 +كتلة العدسة ال mass which may affect the fit of + +202 +00:17:13,900 --> 00:17:19,220 +the lens. ببساطة كل ما زادت كتلة العدسة هيقل الحركة + +203 +00:17:19,220 --> 00:17:24,140 +فممكن أنه أنا كاخصائي أظن أن العدسة ايش هي steep + +204 +00:17:29,120 --> 00:17:34,120 +Changes in the parameters of the lens الآن تراكم + +205 +00:17:34,120 --> 00:17:39,440 +الـ Deposit أيضًا هيغير من الـ curvature للعدسة أو + +206 +00:17:39,440 --> 00:17:44,380 +هيغير من الـ diameter للعدسة أو هتلاحظ مثلًا حيصير + +207 +00:17:44,380 --> 00:17:50,060 +في هناك تغيرات في أطراف العدسة which may cause the + +208 +00:17:50,060 --> 00:17:55,380 +lens to tighten إذا هذا ممكن أنه يجعل العدسة + +209 +00:17:55,380 --> 00:17:55,940 +escape + +210 +00:18:00,420 --> 00:18:04,500 +decrease in the oxygen transmission of the lens + +211 +00:18:04,500 --> 00:18:09,660 +تراكم هذه الـ deposit هيعيق من ايش؟ من كمية + +212 +00:18:09,660 --> 00:18:14,000 +الأكسجين اللي هتدخل على الكورنية أو الـ anterior + +213 +00:18:14,000 --> 00:18:19,100 +surface الكورنية وهذا هيقود إلى ايش؟ الhypoxia و + +214 +00:18:19,100 --> 00:18:25,020 +الhypercapnia طبعًا الhypoxia والhypercapnia هتعمل + +215 +00:18:25,020 --> 00:18:29,760 +حاجة مهمة بنسميها ال miutosis لمين؟ + +216 +00:18:37,850 --> 00:18:47,030 +ميوتوسيس زائد migration migration بمعنى necrosis of + +217 +00:18:47,030 --> 00:18:51,990 +epithelial + +218 +00:18:51,990 --> 00:18:55,170 +cell + +219 +00:18:55,170 --> 00:18:57,110 +activity + +220 +00:19:00,850 --> 00:19:03,590 +بالتالي هذا بيقود للهايبوكسيا بالإضافة + +221 +00:19:03,590 --> 00:19:12,450 +للهايبيربكاميا Increase + +222 +00:19:12,450 --> 00:19:16,590 +in the protein antigen factor on the lens which + +223 +00:19:16,590 --> 00:19:22,590 +may cause الآن احنا اتفقنا أن في هناك دائمًا صراع + +224 +00:19:22,590 --> 00:19:27,550 +مستمر ما بين البكتيريا وال antibacterial factor + +225 +00:19:28,610 --> 00:19:34,230 +واضحة؟ طبعًا أي انتصار لطرف إذا مثلًا البكتيريا + +226 +00:19:34,230 --> 00:19:38,610 +انتصرت بتعمل مباشرة اختراق لمين؟ للكورنيا وممكن + +227 +00:19:38,610 --> 00:19:42,830 +هذا بيؤدي إلى الـ corneal infection إذا الـ + +228 +00:19:42,830 --> 00:19:48,510 +Antibacterial factor انتصر، هيعمل حاجة بنسميها + +229 +00:19:48,510 --> 00:19:52,670 +protein يعني بمعنى أن الترسبات كلها هتها وين + +230 +00:19:52,670 --> 00:19:58,090 +هتتراكم على سطح العدسة فهتعمل اللي هو deposits in + +231 +00:19:58,090 --> 00:20:01,470 +the front surface of the lens وبالتالي هتعمل + +232 +00:20:01,470 --> 00:20:05,750 +variable لمين؟ لل vision طبعًا هذه هتكون ايش؟ مع + +233 +00:20:05,750 --> 00:20:10,110 +مرور فترة حياة العدسة، أن كل ما طالت فترة حياة + +234 +00:20:10,110 --> 00:20:14,820 +العدسة هذا ايش هيسبب أن ال giant papillary + +235 +00:20:14,820 --> 00:20:20,270 +conjunctivitis التهاب ال conjunctiva وهذه + +236 +00:20:20,270 --> 00:20:23,650 +ستكون في ال upper eyelid وأعتقد أنه أخذنا في + +237 +00:20:23,650 --> 00:20:27,690 +المعمل كيف أنه بنعمل averted لل upper eyelid + +238 +00:20:27,690 --> 00:20:32,730 +وبنشوف هل هي mild, moderate, severe أو اللي هو + +239 +00:20:32,730 --> 00:20:37,190 +ما بيكونش يعني normal a grade zero طبعًا الشخص لما + +240 +00:20:37,190 --> 00:20:41,230 +بيكون عنده significant بتكون أما moderate أو + +241 +00:20:41,230 --> 00:20:44,110 +severe الشكل هذا الصورة + +242 +00:20:49,010 --> 00:20:54,030 +طبعًا ال giant papillary conjunctivitis هي تعتبر ال + +243 +00:20:54,030 --> 00:20:59,090 +most common cause مع ارتداء العدسات اللاصقة + +244 +00:20:59,090 --> 00:21:00,070 +اللينة + +245 +00:21:02,300 --> 00:21:05,840 +أيضًا عندنا Corneal and conjunctival inflammatory + +246 +00:21:05,840 --> 00:21:10,020 +response أي inflammation في ال Cornea أو ال + +247 +00:21:10,020 --> 00:21:14,720 +conjunctiva بيعمل ايه؟ اللي هو ال protein antigen + +248 +00:21:14,720 --> 00:21:19,080 +وبالتالي بيؤثر على الرؤية للعدسة اللاصقة + +249 +00:21:23,410 --> 00:21:29,170 +طيب، الآن الـ soft lenses العدسات اللاصقة اللينة + +250 +00:21:29,170 --> 00:21:33,710 +وإضافة أيضًا الـ soft trick contact lenses بدها + +251 +00:21:33,710 --> 00:21:39,550 +تكون ideal لمين؟ يعني مثالية لأي الأشخاص + +252 +00:21:42,880 --> 00:21:49,200 +number one individuals الأفراد أو الأشخاص who have + +253 +00:21:49,200 --> 00:21:53,800 +given up wearing rigid lenses because of the + +254 +00:21:53,800 --> 00:21:58,580 +irritation. إذا هو مش قادر يعمل ايه؟ adaptation مع + +255 +00:21:58,580 --> 00:22:03,650 +العدسة اللاصقة ايه؟ لكن في لها ضوابط أو في لها + +256 +00:22:03,650 --> 00:22:07,530 +criteria يعني الآن واحد مثلًا بيكون عنده corneal + +257 +00:22:07,530 --> 00:22:11,730 +cylinder هل بنفعّدي ال soft contact lenses أو اللي + +258 +00:22:11,730 --> 00:22:18,070 +هو الـ ال software ال contact lenses؟ ايش رأيكم؟ + +259 +00:22:18,070 --> 00:22:25,510 +الآن مثلًا مريض له ال best option كان RGB رحت أنا + +260 +00:22:25,510 --> 00:22:29,050 +مثلًا اديته soft contact lenses أو soft trick + +261 +00:22:29,050 --> 00:22:33,770 +contact lenses هل هذا الإجراء صحيح ولا خطأ؟ ايش + +262 +00:22:33,770 --> 00:22:37,050 +رأيكم؟ + +263 +00:22:37,050 --> 00:22:41,740 +تفضلي صحيح لو كان إنه ممكن نعمله ردّارة إنه للسليندر + +264 +00:22:41,740 --> 00:22:44,120 +إنه مع العدسة الصوف أما لو كان عنده زي ال + +265 +00:22:44,120 --> 00:22:47,740 +keratoconus أنه كان ضروري إنه يلبس العدسة فلازم + +266 +00:22:47,740 --> 00:22:51,980 +يعني أن أولًا لازم يعمل عملية معينة عملية إنه + +267 +00:22:51,980 --> 00:22:54,960 +علشان ال keratoconus ما يزدش لأن مش راح نقدر نوقفه + +268 +00:22:54,960 --> 00:23:01,110 +بال RGB وال soft راح يزيد بالتالي طيب أنا الإجابة + +269 +00:23:01,110 --> 00:23:05,090 +الأولى تعطيك صحيحة أن الآن واحد عنده مثلًا corneal + +270 +00:23:05,090 --> 00:23:09,330 +cylinder بروح بلبسه soft contact lenses بعمله over + +271 +00:23:09,330 --> 00:23:14,230 +فجيهًا glasses أو over refraction يعني بلبس عدسة + +272 +00:23:14,230 --> 00:23:18,910 +لاصقة مع نظارة لكن أنا بدي أنبّه مين ال patient لأن + +273 +00:23:18,910 --> 00:23:22,910 +مش كل الناس يعني بكون متقبل هذا الأمر هو في الآخر + +274 +00:23:22,910 --> 00:23:27,670 +بديلبس عدسة لاصقة عشان يرتاح من مين؟ من النظارة طيب + +275 +00:23:27,670 --> 00:23:32,610 +في حالة ال keratoconus لأ خاصة لما تكون early + +276 +00:23:32,610 --> 00:23:36,230 +stage keratoconus الحل الأول هو عبارة عن ال + +277 +00:23:36,230 --> 00:23:41,690 +glasses، الحل الأول هو عبارة عن ال glasses بعد ذلك + +278 +00:23:41,690 --> 00:23:45,810 +بيجي ال RGB من ثم ال cross linking من ثم ال index + +279 +00:23:45,810 --> 00:23:49,390 +وآخر حاجة مين؟ اللي هي ال final stage ال + +280 +00:23:49,390 --> 00:23:50,890 +keratoconus + +281 +00:23:53,260 --> 00:23:57,920 +أول حل في عملية قراءة كوناس هو عبارة عن الـ + +282 +00:23:57,920 --> 00:23:58,320 +glasses + +283 +00:24:01,480 --> 00:24:07,240 +أو الصعوبات في إبقاء ريجيد ديلي ويرينج مستقبل أنه + +284 +00:24:07,240 --> 00:24:11,420 +مش قادر يعمل program معين لارتداء العدسة اللاصقة + +285 +00:24:11,420 --> 00:24:15,580 +الصلبة يعني بنقوله مثلا أول يوم ارتديها فقط ساعتين + +286 +00:24:15,580 --> 00:24:19,800 +ومش قادر يتحملها يعني discomfort في الساعتين فهنا + +287 +00:24:19,800 --> 00:24:24,160 +بدنا لازم نتوقف نوقف المريض عن ارتداء العدسة + +288 +00:24:24,160 --> 00:24:26,180 +اللاصقة الصلبة + +289 +00:24:28,820 --> 00:24:33,260 +Number two intermittent wearers الأشخاص اللي + +290 +00:24:33,260 --> 00:24:37,460 +بيرتديوا العدسات اللاصقة بشكل مؤقت زي مثلا + +291 +00:24:37,460 --> 00:24:42,960 +football players زي مثلا عندنا ال speakers زي ال + +292 +00:24:42,960 --> 00:24:47,800 +actors كل هدول الأشخاص أي طالب مثلا فيكم عندها + +293 +00:24:47,800 --> 00:24:52,320 +نفترض اللي هو convocation احتفال تخرج لفترة زمانية + +294 +00:24:52,320 --> 00:24:59,350 +قصيرة بدها ترتدي مين؟ العدسة اللاصقة اللينة ونفس + +295 +00:24:59,350 --> 00:25:03,390 +الحاجة ما أخذ إبعين الاعتبار موضوع مين؟ ال cylinder + +296 +00:25:03,390 --> 00:25:09,550 +Such as a public speakers or actors who want to + +297 +00:25:09,550 --> 00:25:12,810 +wear their lenses only occasionally occasionally + +298 +00:25:12,810 --> 00:25:14,050 +بمعنى أحيانا + +299 +00:25:18,190 --> 00:25:25,550 +Industrial workers wear the fear of losing a lens + +300 +00:25:25,550 --> 00:25:30,450 +at work can be very disrupting soft lenses rarely + +301 +00:25:30,450 --> 00:25:36,900 +fall out طبعا هذه النقطة هي تعتبر من ضمن إيش؟الـ + +302 +00:25:36,900 --> 00:25:41,240 +contra indication لـ ال contact lenses لكن بعض + +303 +00:25:41,240 --> 00:25:46,680 +الأشخاص مثلا بيشتغل في ال industrial works أو مثلا + +304 +00:25:46,680 --> 00:25:52,020 +في ال chemicals lab بصر على أنه يلبس عدسة لاصقة + +305 +00:25:52,020 --> 00:25:57,020 +فبيكون عند الحل الوحيد إما soft contact lenses أو + +306 +00:25:57,020 --> 00:26:00,780 +soft toric contact lenses واضحة الفكرة؟ هذا إذا + +307 +00:26:00,780 --> 00:26:05,620 +المريض أثرالان مش أنت ما بيجي المريض، أول حاجة بدك + +308 +00:26:05,620 --> 00:26:09,840 +تعرف في موضوع ال motivation، الحافظ النقطة الثانية + +309 +00:26:09,840 --> 00:26:14,200 +موضوع ال occupation، الوظيفة طيب، الآن بيشتغل هو + +310 +00:26:14,200 --> 00:26:19,680 +في مواد كيميائية هل تعتبر من ال indication ولا ال + +311 +00:26:19,680 --> 00:26:22,700 +contra indication للعدسة اللاصقة؟ Contra + +312 +00:26:22,700 --> 00:26:26,420 +indication لكن إذا المريض أصر على أنه بده يرتدي + +313 +00:26:26,420 --> 00:26:31,440 +عدسة لاصقة لينة أو بده يرتدي عدسة لاصقة، بدي + +314 +00:26:31,440 --> 00:26:36,150 +الخيار الأفضل له مين؟ ال soft contact lenses ليش؟ + +315 +00:26:36,150 --> 00:26:40,150 +لأنه احنا عرفنا ان ال poor structure إلها أقل من + +316 +00:26:40,150 --> 00:26:44,050 +مين من ال hard contact lenses فبالتالي ممكن انه ما + +317 +00:26:44,050 --> 00:26:48,530 +تعمل عملية امتصاص لمين؟ للكيميكال أو تعمل لكن + +318 +00:26:48,530 --> 00:26:54,110 +بدرجة أقل من ال hard contact lenses okay النقطة + +319 +00:26:54,110 --> 00:26:58,270 +الثانية أنه صعوبة وقوة للعدسة لأنه ما أخذ كل شكل + +320 +00:26:58,270 --> 00:27:02,770 +القرنية ال + +321 +00:27:02,770 --> 00:27:08,520 +fake patients وهذه خاصة وين؟ في الأطفال إذا + +322 +00:27:08,520 --> 00:27:12,840 +especially in the children طفل مثلا انولد + +323 +00:27:12,840 --> 00:27:16,860 +congenital cataract لازم يعمله عملية ال cataract + +324 +00:27:16,860 --> 00:27:21,020 +as soon as possible صحيح الآن احنا ما زرعناش عدسة + +325 +00:27:21,020 --> 00:27:24,180 +في ال anterior او ال posterior chamber بيكون عندنا + +326 +00:27:24,180 --> 00:27:28,140 +الحل الوحيد هو عبارة عن مين؟ ال contact lenses اللي + +327 +00:27:28,140 --> 00:27:29,260 +هي عبارة عن ال soft + +328 +00:27:35,230 --> 00:27:40,290 +Impatient with the prolonged routine in the + +329 +00:27:40,290 --> 00:27:44,070 +following the rigid lens wearing schedule بعض + +330 +00:27:44,070 --> 00:27:47,850 +الأشخاص الكبار سواء ال males أو ال females ما + +331 +00:27:47,850 --> 00:27:54,780 +عندهمش قدرة على تحمل وقت طويل لعملية إيه؟ المشي فيه + +332 +00:27:54,780 --> 00:27:58,920 +اللي هو program معين للعدسات اللاصقة الصلبة فبيكون + +333 +00:27:58,920 --> 00:28:03,620 +الحل الوحيد امامي إما ال soft contact lenses أو ال + +334 +00:28:03,620 --> 00:28:11,500 +soft toric contact lenses طيب الآن لكن في الأشخاص + +335 +00:28:11,500 --> 00:28:15,420 +الكبار في السن في نقطة مهمة أن ال sensitivity هنا + +336 +00:28:15,420 --> 00:28:19,340 +بتكون عالية ولا low؟ إذا دايما ال cornea ال + +337 +00:28:19,340 --> 00:28:23,480 +sensitivity عنده قليلة فبتلاحظ أن هو بعمل + +338 +00:28:23,480 --> 00:28:28,440 +adaptation لل RGB أسرع من مين؟ من ال young اللي هو + +339 +00:28:28,440 --> 00:28:34,700 +الشباب طيب لو أنا طلبت منكم اللي هو حالات أخرى + +340 +00:28:34,700 --> 00:28:38,860 +بيكون فيها ال soft contact lens أو ال software + +341 +00:28:38,860 --> 00:28:43,020 +contact lenses هي ال ideal المثالية زي إيش مثلا؟ + +342 +00:28:48,570 --> 00:28:53,950 +أخدنا مثلا أن هي تعتبر good option في حالة مين؟ ال + +343 +00:28:53,950 --> 00:28:58,450 +spherical refractive error مع التوريكورنية صح ولا + +344 +00:28:58,450 --> 00:29:02,870 +لا؟ الحالة الثانية يما يكون ما عندي أن فقط عندي ال + +345 +00:29:02,870 --> 00:29:05,850 +spherical refractive error هي تعتبر ال best option + +346 +00:29:05,850 --> 00:29:12,010 +واضح؟ في حالة مثلا موضوع ال ال activities الرياضات + +347 +00:29:12,010 --> 00:29:15,190 +بشكل مختلف هي تعتبر الحل الأفضل + +348 +00:29:18,510 --> 00:29:26,230 +بتقرر مع ال RGB؟ اه إيش يعني؟ يعني دخول + +349 +00:29:26,230 --> 00:29:30,510 +ال foreign body والحصاوة يعني أقل من دخولها اه بس + +350 +00:29:30,510 --> 00:29:33,950 +هذه عفوا تعتبر من ضمن ال advantages لها لكن أنا + +351 +00:29:33,950 --> 00:29:38,010 +بقول when أن هي حالات بتكون ideal مثالية يعني جزء + +352 +00:29:38,010 --> 00:29:41,630 +أن أشخاص بتعرضوا ل foreign body بشكل مستمر قد تكون + +353 +00:29:41,630 --> 00:29:45,510 +أن ال soft contact lenses هي الخيار الأفضل + +354 +00:29:49,490 --> 00:29:54,130 +عندنا الآن ال bandage contact lenses ال bandage + +355 +00:29:54,130 --> 00:29:59,050 +contact lenses الغرض منها دايما هي عبارة عن ال + +356 +00:29:59,050 --> 00:30:05,370 +treatment أو ال therapeutic العلاج في عندنا نوعين من + +357 +00:30:05,370 --> 00:30:11,130 +هذه العدسات النوع الأول therapeutic use of bandage + +358 +00:30:11,130 --> 00:30:19,850 +lenses يعني استخدام علاجي لهذا النوع من العدسات زي + +359 +00:30:19,850 --> 00:30:25,050 +number one عندنا ال flexibility المرونة أو اليونة + +360 +00:30:25,050 --> 00:30:28,690 +يعني بمعنى ال properties الخواص أو ال + +361 +00:30:28,690 --> 00:30:32,850 +characteristics لها واحد flexibility طب من وين + +362 +00:30:32,850 --> 00:30:40,570 +جاية ال flexibility لهذا النوع من العدسات؟ بالضبط + +363 +00:30:40,570 --> 00:30:44,890 +أن في أول حاجة استخدام مادة ال silicon اللي احنا + +364 +00:30:44,890 --> 00:30:48,730 +قلنا عبارة عن second generation صحيح؟ تفضلي + +365 +00:30:54,040 --> 00:30:57,400 +أنه فيه اللي هي كمية ال water content مع ال + +366 +00:30:57,400 --> 00:31:01,000 +silicon اتنين مع بعض هذه بتديها إيش؟ flexibility + +367 +00:31:01,000 --> 00:31:08,020 +بالإضافة لل durability بالضبط + +368 +00:31:08,020 --> 00:31:15,320 +موضوع المتانة أيضا هذا النوع من العدسات بتتميز + +369 +00:31:15,320 --> 00:31:21,250 +أنها too thin إذا مدام هي too thin إذا بتديني أول + +370 +00:31:21,250 --> 00:31:25,690 +حاجة flexibility يعني بمعنى زي ال daily disposable + +371 +00:31:25,690 --> 00:31:30,110 +lenses قد إيش اللي هو فيها flexibility مرونة عالية + +372 +00:31:30,110 --> 00:31:35,210 +كتير فبتلاقي أن ال oxygen ال transmissibility very + +373 +00:31:35,210 --> 00:31:41,770 +high طيب الشوق الحياة فيها short ولا long life؟ + +374 +00:31:41,770 --> 00:31:51,970 +short life بالضبط، number ثلاثة مريحة من السهل أن + +375 +00:31:51,970 --> 00:31:59,030 +المريض يستعمل العدسة الجيل الأول من هذا النوع من + +376 +00:31:59,030 --> 00:32:06,110 +العدسات كان فيها إبلانو refractive error لكن الجيل + +377 +00:32:06,110 --> 00:32:09,070 +الثاني تم إضافة مادة الكولاجين + +378 +00:32:11,950 --> 00:32:16,930 +فصارت كولاجين bandage contact lenses ووضعوا فيها + +379 +00:32:16,930 --> 00:32:20,990 +مثلا ماينوس واحد أو ماينوس اثنين يعني عملت عملية + +380 +00:32:20,990 --> 00:32:23,870 +تصحيح لمين؟ لل refractive errors + +381 +00:32:27,410 --> 00:32:32,090 +أيضا هذا النوع من العدسات it may apply as drug + +382 +00:32:32,090 --> 00:32:37,550 +delivery devices بعض أنواع هذه العدسات بتم حقن + +383 +00:32:37,550 --> 00:32:42,450 +فيها أنواع معينة من ال drug وبالتالي ال anterior + +384 +00:32:42,450 --> 00:32:47,890 +surface للكورنية بتم امتصاصها يعني هذه بتتموين خلال + +385 +00:32:47,890 --> 00:32:51,790 +العملية أن بلبس المريض بانديش contact lenses + +386 +00:32:51,790 --> 00:32:56,150 +بتديه نوع معين من ال drop أو نوع معين من ال + +387 +00:32:56,150 --> 00:33:01,410 +treatment عشان أن تمتصه من ال anterior surface of + +388 +00:33:01,410 --> 00:33:09,090 +the cornea طبعا + +389 +00:33:09,090 --> 00:33:10,950 +هي small refractive error + +390 +00:33:14,830 --> 00:33:18,230 +طبعا ال bandage contact lenses أكثر استخدامات + +391 +00:33:18,230 --> 00:33:22,270 +الهامة في ال refractive surgeries أو مثلا في عملية + +392 +00:33:22,270 --> 00:33:26,410 +الليزك أي عملية بلاحظ فيها الدكتور أن ممكن يصير + +393 +00:33:26,410 --> 00:33:30,090 +فيه inflammation أو infection للمريض بيحاول أن + +394 +00:33:30,090 --> 00:33:35,010 +يلبسوا إيش؟ الـ bandage contact lenses بالضبط + +395 +00:33:35,010 --> 00:33:38,210 +أن مافيش regeneration لمين؟ للابيثيليا + +396 +00:33:41,300 --> 00:33:45,300 +The corneal uses of therapeutic lenses أيضًا + +397 +00:33:45,300 --> 00:33:50,500 +الاستخدامات الأخرى لهذا النوع من العدسات number + +398 +00:33:50,500 --> 00:33:54,980 +one promote healing بتعمل عملية تسريع في اللي هو + +399 +00:33:54,980 --> 00:34:00,120 +العلاج أو الشفاء للمريض provide comfort بتزود له + +400 +00:34:00,120 --> 00:34:03,980 +الراحة لأن زي ما اتفقنا فيها high DK على T وهي + +401 +00:34:03,980 --> 00:34:10,120 +بتتميز أن flexibility protect the eye بتحمي العين + +402 +00:34:10,120 --> 00:34:13,940 +من ال infection أو ال inflammatory okay improve + +403 +00:34:13,940 --> 00:34:18,740 +the corneal draft يعني كيف أن الآن لو واحد عنده + +404 +00:34:18,740 --> 00:34:25,410 +مريض post draft بتعمل عملية تحسين لهذا المريض يعني + +405 +00:34:25,410 --> 00:34:29,510 +بمعنى آخر أن عنده irregularity لل surface of the + +406 +00:34:29,510 --> 00:34:33,850 +cornea فبنستخدم هذا النوع من العدسات قبل عملية + +407 +00:34:33,850 --> 00:34:37,710 +مثلا ال intact الحلقات أو عملية مثلا ال cross + +408 +00:34:37,710 --> 00:34:44,970 +linking عشان عملية التثبيت خليني + +409 +00:34:44,970 --> 00:34:48,590 +أجف إن شاء الله لـ ال indications for therapeutic + +410 +00:34:48,590 --> 00:34:54,540 +lenses في أي سؤال أي استفسار؟ واضح إن شاء الله + +411 +00:34:54,540 --> 00:34:56,640 +الأمور أعطيكم العافية diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/hYllUQaUrEo_postprocess.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/hYllUQaUrEo_postprocess.srt new file mode 100644 index 0000000000000000000000000000000000000000..3bd962873ac74e35a4d48589a67bc8ef2559c62c --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/hYllUQaUrEo_postprocess.srt @@ -0,0 +1,1644 @@ +1 +00:00:20,920 --> 00:00:23,860 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:23,860 --> 00:00:29,360 +وبركاته هنبدأ اليوم في موضوع impair reading in + +3 +00:00:29,360 --> 00:00:33,760 +soft contact lens wearer impair بمعنى تعطيل أو + +4 +00:00:33,760 --> 00:00:38,820 +reduce reading أو بمعنى deterioration تدهور + +5 +00:00:47,870 --> 00:00:51,970 +تدهور القراءة في الأشخاص اللي بيرتديوا العدسات + +6 +00:00:51,970 --> 00:00:58,550 +اللاصقة اللينة بداية أي مريض بيرتدي عدسة لاصقة + +7 +00:00:58,550 --> 00:01:04,610 +لينة بشكل مستمر أو في فترة زمنية طويلة بصير عنده + +8 +00:01:04,610 --> 00:01:10,330 +نوع من إيه؟ من الإجهادبعد ما بيصير عنده الإجهاد + +9 +00:01:10,330 --> 00:01:14,910 +هذا بتلاقي انه زي ما انت بتعملي attention في ال + +10 +00:01:14,910 --> 00:01:18,030 +mobile او attention في ال laptop بقل موضوع ال + +11 +00:01:18,030 --> 00:01:21,250 +blinking اللي هو الترميش احنا عارفين انه ال normal + +12 +00:01:21,250 --> 00:01:25,610 +blinking من خمساش لعشرين مرة في اللي هو الدقيقة + +13 +00:01:25,610 --> 00:01:33,400 +وبالتالي هذا ايش بيسبب؟بسبب انه عدم اللي هو موضوع + +14 +00:01:33,400 --> 00:01:36,880 +الـ lubrication اللي هو ترطيب لمين للعدسة يعني + +15 +00:01:36,880 --> 00:01:42,680 +بيقلل من ترطيب العدسة فبتصبح العدسة جافة وبالتالي + +16 +00:01:42,680 --> 00:01:47,840 +هذا قد يؤدي إلى تأثير على اللي هو ال comfort راحة + +17 +00:01:47,840 --> 00:01:54,080 +المريض وايضا على ال vision بالنسبة للمريض اذا ال + +18 +00:01:54,080 --> 00:01:55,580 +causes الأسباب + +19 +00:01:58,880 --> 00:02:06,340 +القراءة لفترات زمنية طويلة حسبب إجهاد للمريض and + +20 +00:02:06,340 --> 00:02:09,620 +lack of blinking ونقص في عملية الترميش + +21 +00:02:12,500 --> 00:02:17,700 +leads to هذا بيقود إلى excessive drying زيادة + +22 +00:02:17,700 --> 00:02:23,360 +الجفاف للسطح اللي هو الأمامي اللي خاص بالعدسة لذلك + +23 +00:02:23,360 --> 00:02:27,500 +احنا بننصح المريض عند ارتداء العدسة اللاصقة اللينة + +24 +00:02:27,500 --> 00:02:33,610 +انه كل مثلا خمسة واربعين دقيقة يطلع بعيدالهدف من + +25 +00:02:33,610 --> 00:02:38,070 +ذلك أنه أعمل relax لل accommodation بالإضافة أنه + +26 +00:02:38,070 --> 00:02:42,990 +أعمل اللي هو عملية blinking وترطيب للعدسة اللاصقة + +27 +00:02:42,990 --> 00:02:50,030 +Decentration + +28 +00:02:50,030 --> 00:02:55,670 +of soft contact lenses أي بمعنى عدم تمركز أو إزاحة + +29 +00:02:55,670 --> 00:03:01,570 +العدسة اللاصقة اللينةالان مباشرة يما تسمع كلمة الـ + +30 +00:03:01,570 --> 00:03:06,630 +Decentration ايش بيراود لفكرك؟ ان العدسة قد تكون + +31 +00:03:06,630 --> 00:03:15,870 +Flat اي بمعنى ان فيها small diameter + +32 +00:03:15,870 --> 00:03:23,170 +او بيكون فيها flat base curve الان هنعرف ايش ال + +33 +00:03:23,170 --> 00:03:29,430 +causes الأسباب لإزاحة العدسة اللاصقة اللينةالـ + +34 +00:03:29,430 --> 00:03:34,930 +causes number one تايت eyelids أي شخص بيكون عنده + +35 +00:03:34,930 --> 00:03:39,830 +ال eyelid وهنا بنقصد ال upper eyelid فيه اللي هو + +36 +00:03:39,830 --> 00:03:46,150 +التايت زي مثلا ال Japanese، ال Chinese، Malaysian، + +37 +00:03:46,150 --> 00:03:50,130 +Singaporean، هدول كلهم الأشخاص في عندهم ايه؟ تايت + +38 +00:03:50,130 --> 00:03:57,140 +eyelids فبتلاحظي انهدايما انه بحتاج الى عدسة بيكون + +39 +00:03:57,140 --> 00:04:01,580 +فيها ال base curve small ولا large؟ large ديامتر + +40 +00:04:01,580 --> 00:04:06,440 +او خلينا نقول quite large ديامتر compared to + +41 +00:04:06,440 --> 00:04:11,990 +another race مقارنة بأعراق او باجناس آخرينفهذا + +42 +00:04:11,990 --> 00:04:15,450 +بيؤدي إلى إزاحة العدسة، يعني لو أنا لبست عدسة + +43 +00:04:15,450 --> 00:04:19,590 +لاصقة زي اللي عندنا في المعمل، Diameter 14.2 أو 14 + +44 +00:04:19,590 --> 00:04:23,470 +.5 أو 14 Millimeter، هتلاحظ إن فيه هيصير هناك + +45 +00:04:23,470 --> 00:04:28,750 +Decentration لمن؟ للعدسة Number two، large + +46 +00:04:28,750 --> 00:04:33,890 +corneas، لما تكون ال cornea large، إيش بدها تكون؟ + +47 +00:04:33,890 --> 00:04:39,370 +Flat ولا steep؟flat cornea صحيح؟ فلذلك انا بحتاج + +48 +00:04:39,370 --> 00:04:43,910 +الى diameter ايش لازم انه يكون large diameter حتى + +49 +00:04:43,910 --> 00:04:49,810 +انه يكون ال movement ل العدسة ملائمة او مناسبة + +50 +00:04:49,810 --> 00:04:53,070 +against + +51 +00:04:53,070 --> 00:04:56,290 +the rule of stigmatism ايش معناه against the rule + +52 +00:04:56,290 --> 00:05:00,190 +of stigmatism؟ شو معناه against the rule؟ فضلي + +53 +00:05:04,740 --> 00:05:08,240 +طيب الان لو انا مثلا جبتلك صورة corneal topography + +54 +00:05:08,240 --> 00:05:11,740 +احنا هذا ك definition عارفينه انه بيكون ال + +55 +00:05:11,740 --> 00:05:14,900 +horizontal meridian steeper than ال vertical + +56 +00:05:14,900 --> 00:05:18,240 +meridian لو انا جبت صورة ال corneal topography + +57 +00:05:18,240 --> 00:05:23,260 +هتلاقي ان البوتاي في ال horizontal meridian واضحين + +58 +00:05:23,260 --> 00:05:26,840 +اكتر من مين من ال vertical meridian يعني بالشكل + +59 +00:05:26,840 --> 00:05:33,980 +هذا هيكون شكل ال corneal topographyBotai هذي + +60 +00:05:33,980 --> 00:05:38,160 +معناها against the rule of stigmatism ال against + +61 +00:05:38,160 --> 00:05:42,120 +the rule of stigmatism بتعمل إزاحة للعدسة اللاصقة + +62 +00:05:42,120 --> 00:05:47,570 +اللينة لسببينالسبب الأول ان هي بتكون unstability + +63 +00:05:47,570 --> 00:05:53,430 +غير ثابتة والسبب التاني انه بيكون فيها مدام قيمة + +64 +00:05:53,430 --> 00:05:56,850 +السيلندر طبعا انا بتكلم هان ممكن عن ايضا ال + +65 +00:05:56,850 --> 00:05:59,810 +software ال contact lenses بيكون فيها ال + +66 +00:05:59,810 --> 00:06:02,490 +horizontal meridian اعلى من ال steeper meridian + +67 +00:06:02,490 --> 00:06:06,230 +فبتعمل اللي هو ازاحة للعدسة او بنسميها + +68 +00:06:06,230 --> 00:06:07,150 +displacement + +69 +00:06:12,940 --> 00:06:17,100 +لمن؟ للعدسة اللاصقة فالان عندما تعمل عملية + +70 +00:06:17,100 --> 00:06:20,740 +evaluation تقييم بتلاقي ان العدسة عاملة + +71 +00:06:20,740 --> 00:06:25,660 +displacement اما medial او lateral بسبب اللي هو + +72 +00:06:25,660 --> 00:06:29,720 +against the rule of stigmatism طيب في ال with the + +73 +00:06:29,720 --> 00:06:32,660 +rule of stigmatism ليش مابصير ال decentralization؟ + +74 +00:06:35,230 --> 00:06:40,750 +ببساطة لأنه بيصير عملية suction للعدسة من اللي هو + +75 +00:06:40,750 --> 00:06:44,290 +ايه ال vertical meridian يعني ال vertical meridian + +76 +00:06:44,290 --> 00:06:48,370 +بيكون فيه القوة اعلى او steeper فالتحدث بيكون فيه + +77 +00:06:48,370 --> 00:06:52,010 +ايش اكتر فبالتالي ان العدسة اللي بيصير فيه لها + +78 +00:06:52,010 --> 00:06:56,330 +suction اكتر فهي بالعكس بيصير العدسة قريبة و كأنه + +79 +00:06:56,330 --> 00:07:01,510 +ايش هي steep واضح الفكرة يعني بتنمسك من المنتصف + +80 +00:07:01,510 --> 00:07:03,830 +اكتر من وين من الأطراف + +81 +00:07:08,220 --> 00:07:12,440 +الـ Symmetric Corneal Topographyفي موضوع الـ + +82 +00:07:12,440 --> 00:07:16,620 +Corneal Topography أخدنا هناك أكتر من عشر أشكال + +83 +00:07:16,620 --> 00:07:20,060 +للـ High Order Aberration زي الـ Oval و الـ Round + +84 +00:07:20,060 --> 00:07:23,460 +و الـ Asymmetric Potai و Asymmetric Potai وقلنا + +85 +00:07:23,460 --> 00:07:26,580 +فيه الـ Asymmetric Potai إما بيكون inferior أو + +86 +00:07:26,580 --> 00:07:31,980 +superior و أيضا بيكون ممكن أنه skewed with radial + +87 +00:07:31,980 --> 00:07:38,160 +axis فهذه كلها قد تسبب اللي هو إزاحة لمين للعدسة + +88 +00:07:42,050 --> 00:07:45,670 +الان عندنا موضوع ال symptoms and signs of loose + +89 +00:07:45,670 --> 00:07:51,830 +lens اعراض و علامات ان العدسة يما تكون flat او + +90 +00:07:51,830 --> 00:07:56,450 +تكون loose number + +91 +00:07:56,450 --> 00:08:01,150 +one variable vision او vision effectuation + +92 +00:08:01,150 --> 00:08:02,950 +effectuation بمعنى ايه + +93 +00:08:07,100 --> 00:08:12,260 +اللي هو تذبذب الرؤية او ال vision variable اختلاف + +94 +00:08:12,260 --> 00:08:18,820 +الرؤية طبعا هذا بيكون بشكل اللي هو ايه مش دائم + +95 +00:08:18,820 --> 00:08:24,540 +يعني فورا للحظات و بيكون خاصة بيظهر في الأسقر + +96 +00:08:24,540 --> 00:08:31,500 +الأخيرة يعني بمعنى من 6 على 12 ل 6 على 6 يعني في + +97 +00:08:31,500 --> 00:08:37,090 +ال two ل three lines الأخيرةبصير هناك تذبذب بعملية + +98 +00:08:37,090 --> 00:08:44,350 +الرؤية ما بين before و after blinking number + +99 +00:08:44,350 --> 00:08:50,360 +two excess awareness of the lensالعدسة يما بتكون + +100 +00:08:50,360 --> 00:08:55,620 +flat بتكون حركتها كتيرة فالمريض بيشهر ان العدسة + +101 +00:08:55,620 --> 00:08:59,880 +عبارة عن foreign body او بالضبط بتكون و كأنه رمل + +102 +00:08:59,880 --> 00:09:04,060 +في داخل عينه، هيك المريض تعبيره يما تكون العدسة + +103 +00:09:04,060 --> 00:09:06,600 +flat، انه رمل في داخل العين + +104 +00:09:09,400 --> 00:09:15,360 +3- Poor Centering دايما تمركز العدسة بيكون ضعيف + +105 +00:09:15,360 --> 00:09:18,880 +لأن فيه اما بتكون ماخدة Decentration Up Down + +106 +00:09:18,880 --> 00:09:23,280 +Lateral Medial طيب + +107 +00:09:23,280 --> 00:09:26,780 +الآن يما يكون عندنا Decentration للعدسة أو Poor + +108 +00:09:26,780 --> 00:09:31,580 +Centering و العدسة Flat ايش بدي اعمل؟ اما بجيب + +109 +00:09:31,580 --> 00:09:35,760 +Large Diameter او بجيب Steep Base Care واضح + +110 +00:09:35,760 --> 00:09:41,640 +الفكرة؟أيضًا excess movement الحركة بتكون من 2 إلى + +111 +00:09:41,640 --> 00:09:45,960 +4 تقريبًا يما يكون العدسة إيش اللي هو excess + +112 +00:09:45,960 --> 00:09:50,340 +movement أو flat أو loose طبعًا إحنا بنعرف ال + +113 +00:09:50,340 --> 00:09:56,400 +normal جديش من نص إلى واحد وهان + +114 +00:09:56,400 --> 00:10:01,580 +مرة تانية بكرر إن الحركة هي غير كافية لعملية تقييم + +115 +00:10:01,580 --> 00:10:07,740 +العدسة هل هي flat ولا optimal أو stableLens + +116 +00:10:07,740 --> 00:10:11,960 +falling out of the eye احنا بنعرف ان العدسة + +117 +00:10:11,960 --> 00:10:17,180 +اللاصقة اللينة بتعمل follow to the eye movement و + +118 +00:10:17,180 --> 00:10:21,000 +بتتميز ان ال diameter بتاعها اكبر من الكورنية + +119 +00:10:21,000 --> 00:10:25,560 +فسقوطها بيكون اصعب من مين من سقوط العدسة ال hard + +120 +00:10:25,560 --> 00:10:28,440 +contact lenses لكن اما يكون ال diameter بتاعها + +121 +00:10:28,440 --> 00:10:33,020 +صغير بسهولة انه ممكن ايه يصير لها اللي هو سقوط + +122 +00:10:33,020 --> 00:10:36,260 +وهذا بنسميه ال dismatch + +123 +00:10:39,530 --> 00:10:45,910 +أو falling لمن؟ للعدسة ايضا + +124 +00:10:45,910 --> 00:10:49,870 +عندنا bubble هيكون فيه هناك فقاعات تحت ال lens + +125 +00:10:49,870 --> 00:10:54,150 +edge بينما في العدسة ال steep وين هيكون ال bubble؟ + +126 +00:10:54,150 --> 00:10:59,050 +اللي هو ال center كيراتومتري + +127 +00:10:59,050 --> 00:11:02,270 +مياردز الان before blinking هتكون clear ولا + +128 +00:11:02,270 --> 00:11:10,460 +unclear؟ وعد في الكيراتومتري مياردزbefore blinking + +129 +00:11:10,460 --> 00:11:16,360 +clear after blinking هتكون ايه؟ اللي هو after + +130 +00:11:16,360 --> 00:11:22,500 +blinking هتكون unclear طبعا هذه بيتم رؤيته اما من + +131 +00:11:22,500 --> 00:11:27,220 +خلال الجوال كيراتوميتر ال مايرز الخاص فيه او من + +132 +00:11:27,220 --> 00:11:28,640 +خلال ال bush and lum + +133 +00:11:32,030 --> 00:11:36,090 +Written scope, read reflex نفس الفكرة، الان لو انا + +134 +00:11:36,090 --> 00:11:40,130 +المريض قبل الترميش لو لاحظت ال reflex بتاعة ال + +135 +00:11:40,130 --> 00:11:43,370 +written scope قبل الترميش هيكون ايش ماله؟ واضح + +136 +00:11:43,370 --> 00:11:48,470 +وبعد الترميش هيكون unclear نفس فكرة الكيراتوميتر + +137 +00:11:48,470 --> 00:11:51,990 +ميارز ان شاء الله هذا هيتم تطبيقه بعد الامتحان + +138 +00:11:51,990 --> 00:11:54,770 +النصفي، موضوع ال written scope و read reflex في + +139 +00:11:54,770 --> 00:11:55,210 +المعملة + +140 +00:11:59,150 --> 00:12:04,930 +symptoms and signs of tight lens ايضا عندنا ال + +141 +00:12:04,930 --> 00:12:09,230 +causes الأسباب اللي لها فيه effluctuation vision + +142 +00:12:09,230 --> 00:12:14,890 +وبنكرر نفس الفكرة بيكون في آخر سطرين أو تلاتة من 6 + +143 +00:12:14,890 --> 00:12:20,790 +ع 12 ل 6 على 6 وبعض الدراسات بتقول من 6 ع 15 ل 6 ع + +144 +00:12:20,790 --> 00:12:21,550 +7 و نص + +145 +00:12:25,320 --> 00:12:28,700 +initially comfortable but increasingly + +146 +00:12:28,700 --> 00:12:34,240 +uncomfortable as the day progresses العدسة اللاصقة + +147 +00:12:34,240 --> 00:12:38,840 +اللينة لما تكون tight في البداية بتكون comfortable + +148 +00:12:38,840 --> 00:12:39,880 +ليش طيب؟ + +149 +00:12:42,280 --> 00:12:46,080 +بالضبط انه ممتازة بتعمل ايش adherence to the + +150 +00:12:46,080 --> 00:12:50,340 +cornea بمعنى انه no sensation at all مباشرة اول ما + +151 +00:12:50,340 --> 00:12:54,800 +المريض بحط على عينه مافي شعور بالعدسة واضحة الفكرة + +152 +00:12:54,800 --> 00:13:00,270 +فبتكون العدسة comfortable مريحةبعد شوية بعد ساعات + +153 +00:13:00,270 --> 00:13:04,190 +بلاحظ ان المريض يعني الان لو انت رفعت العدسة + +154 +00:13:04,190 --> 00:13:08,650 +اللاصقة و روحت مثلا حطيت صبغة فلوريسين هتلاحظي و + +155 +00:13:08,650 --> 00:13:13,030 +كأنه ring حوالين وين الكورنية لانه بتكون suction + +156 +00:13:13,030 --> 00:13:19,910 +مصممة العدسة absent or minimal movement after a + +157 +00:13:19,910 --> 00:13:25,360 +blink الحركة فيها بتكون اقل من نص مليمترOkay + +158 +00:13:25,360 --> 00:13:30,340 +فبالتالي بتكون هي تعتبر ايه steep يعني او بتديني + +159 +00:13:30,340 --> 00:13:37,880 +انطباع انه قد تكون العدسة steep lens كيراتومتري + +160 +00:13:37,880 --> 00:13:43,300 +ميارز الان before blinking ايش بتكون؟ clear زي + +161 +00:13:43,300 --> 00:13:46,620 +اللي هو initially comfortable وبعد الترميش ايش + +162 +00:13:46,620 --> 00:13:47,400 +بتصبح؟ + +163 +00:13:50,970 --> 00:13:54,450 +إذا احنا اتفقنا انه before a blinking بتكون + +164 +00:13:54,450 --> 00:14:00,470 +unclear و after a blinking بتكون الهو clear انا + +165 +00:14:00,470 --> 00:14:04,730 +بنتظر منكم إجابة written scope read reflex إذا قبل + +166 +00:14:04,730 --> 00:14:08,970 +الترميش هي بتكون unclear وبعد الترميش بتكون clear + +167 +00:14:08,970 --> 00:14:14,930 +طيب الان لو كان عندى عدسة steep ايش بدى علاجها اما + +168 +00:14:14,930 --> 00:14:18,150 +بجيب small diameter او بجيب اللي هو ايه + +169 +00:14:29,290 --> 00:14:33,490 +موضوع ال complications of deposits أي بمعنى + +170 +00:14:33,490 --> 00:14:40,280 +مضاعفات الترثباتطبعا الترثبات بتعتمد على تلت شغلات + +171 +00:14:40,280 --> 00:14:44,880 +اللي خاصة في العدسات اللاصقة اللينة اول حاجة + +172 +00:14:44,880 --> 00:14:50,020 +بتعتمد على ال material of the lens يعني بمعنى انه + +173 +00:14:50,020 --> 00:14:54,240 +هل هي high water content moderate water content + +174 +00:14:54,240 --> 00:14:59,860 +low water content هذه واحدة اذا كانت high water + +175 +00:14:59,860 --> 00:15:06,340 +content ميت بيكون ال deposit اعلى ولا اقلأعلى + +176 +00:15:06,340 --> 00:15:11,440 +وامتازة منطقيا كل ما كان high water content او + +177 +00:15:11,440 --> 00:15:14,920 +moderate water content بكون كمية ال deposit اعلى + +178 +00:15:14,920 --> 00:15:20,900 +النقطة التانية موضوع ال wear الارتداء للعدسة الان + +179 +00:15:20,900 --> 00:15:25,760 +الشخص كل ما زاد من ارتداء العدسة اللاصقة اللينة + +180 +00:15:25,760 --> 00:15:30,300 +هيكون معرض اكتر لايش لحدوث اللي هو ال deposits + +181 +00:15:31,400 --> 00:15:36,900 +والنقطة التالتة و هي الأهم موضوع حياة العدسة الآن + +182 +00:15:36,900 --> 00:15:42,780 +مثلا إيمان عندها عدسة quarterly for three months + +183 +00:15:42,780 --> 00:15:48,040 +راحت لبستها semi-annual لمدة ست شهور هذه العدسة + +184 +00:15:48,040 --> 00:15:53,260 +بتكون معرضة أكتر لحدوث مين ال deposits واضحة و قد + +185 +00:15:53,260 --> 00:15:56,780 +تكون ان هي مش شاعرة في هذا التغير أو في ال + +186 +00:15:56,780 --> 00:15:58,040 +variable vision + +187 +00:16:01,540 --> 00:16:05,860 +إذا الـ number one decrease in vision حيقل الرؤية + +188 +00:16:05,860 --> 00:16:10,060 +في العدسة اللاصقة اللينة طبعا احنا بنعرف ان العدسة + +189 +00:16:10,060 --> 00:16:14,340 +بتكون transparent من ال properties الصفات او ال + +190 +00:16:14,340 --> 00:16:18,000 +characteristics لها يما بصير تراكم لات deposit + +191 +00:16:18,000 --> 00:16:24,540 +بصير unclear او opaque number two red and + +192 +00:16:24,540 --> 00:16:31,200 +irritable eye طيب هان ال red eye من وين جاي؟احنا + +193 +00:16:31,200 --> 00:16:36,520 +بنعرف انه العدسة لو زاد فيها اللي هو التراكمات او + +194 +00:16:36,520 --> 00:16:41,240 +الـ deposits هتعمل ايش؟ dry eye symptoms و من ضمن + +195 +00:16:41,240 --> 00:16:45,060 +ال symptoms لـ dry eye هي عبارة عن ال red eye، + +196 +00:16:45,060 --> 00:16:48,820 +okay؟ اذا هان ال red eye جاية من ضمن ال symptoms + +197 +00:16:48,820 --> 00:16:54,460 +لمين؟ لال dry eyeأيضا حيصير هناك ايش irritation + +198 +00:16:54,460 --> 00:16:58,860 +تهيوج في العين يعني المريض هيصبح uncomfortable غير + +199 +00:16:58,860 --> 00:17:01,580 +مرتاح مع العدسة اللاصقة + +200 +00:17:05,000 --> 00:17:09,160 +An increase in the mass of the lens أي زيادة في + +201 +00:17:09,160 --> 00:17:13,900 +كتلة العدسة ال mass which may affect the fit of + +202 +00:17:13,900 --> 00:17:19,220 +the lens.ببساطة كل ما زادت كتلة العدسة هيقل الحركة + +203 +00:17:19,220 --> 00:17:24,140 +فممكن انه انا كاخصائي اظن ان العدسة إيش هي steep + +204 +00:17:29,120 --> 00:17:34,120 +Changes in the parameters of the lens الآن تراكم + +205 +00:17:34,120 --> 00:17:39,440 +الـ Deposit أيضًا هيغير من الـ curvature للعدسة أو + +206 +00:17:39,440 --> 00:17:44,380 +هيغير من الـ diameter للعدسة أو هتلاحظ مثلًا هيصير + +207 +00:17:44,380 --> 00:17:50,060 +في هناك تغيرات في أطراف العدسة which may cause the + +208 +00:17:50,060 --> 00:17:55,380 +lens to tighten إذا هذا ممكن أنه يجعل العدسة + +209 +00:17:55,380 --> 00:17:55,940 +escape + +210 +00:18:00,420 --> 00:18:04,500 +decrease in the oxygen transmission of the lens + +211 +00:18:04,500 --> 00:18:09,660 +تراكم هذه الـ deposit هيعيق من أيش؟ من كمية + +212 +00:18:09,660 --> 00:18:14,000 +الأكسجين اللي هتدخل على الكورنية أو الـ anterior + +213 +00:18:14,000 --> 00:18:19,100 +surface الكورنية وهذا هيقود إلى أيش؟ الhypoxia و + +214 +00:18:19,100 --> 00:18:25,020 +الhypercapnia طبعا الhypoxia و الhypercapnia هتعمل + +215 +00:18:25,020 --> 00:18:29,760 +حاجة مهمة بنسميها الميوتك لمين؟ + +216 +00:18:37,850 --> 00:18:47,030 +ميوتك زائد ميجريشن ميجريشن بمعنى نكروزز of + +217 +00:18:47,030 --> 00:18:51,990 +epithelial + +218 +00:18:51,990 --> 00:18:55,170 +cell + +219 +00:18:55,170 --> 00:18:57,110 +activity + +220 +00:19:00,850 --> 00:19:03,590 +بالتالي هذا بيقود للهايبوكسيا بالاضافة + +221 +00:19:03,590 --> 00:19:12,450 +للهايباربكاميا Increase + +222 +00:19:12,450 --> 00:19:16,590 +in the protein antigen factor on the lens which + +223 +00:19:16,590 --> 00:19:22,590 +may cause الآن احنا اتفقنا ان في هناك دايما صراع + +224 +00:19:22,590 --> 00:19:27,550 +مستمر ما بين البكتيريا و ال antibacterial factor + +225 +00:19:28,610 --> 00:19:34,230 +واضحة؟ طبعا اي انتصار لطرف اذا مثلا البكتيريا + +226 +00:19:34,230 --> 00:19:38,610 +انتصرت بتعمل مباشرة اختراق لمين؟ للكورنيا وممكن + +227 +00:19:38,610 --> 00:19:42,830 +هذا بيؤدي الى الـ corneal infectionاذا الـ + +228 +00:19:42,830 --> 00:19:48,510 +Antibacterial factor انتصر، هيعمل حاجة بنسميها + +229 +00:19:48,510 --> 00:19:52,670 +protein يعني بمعنى ان الترثبات كلها هيتها وين + +230 +00:19:52,670 --> 00:19:58,090 +هتتراكم على سطح العدسة فهتعمل اللي هو deposits in + +231 +00:19:58,090 --> 00:20:01,470 +the front surface of the lens وبالتالي هتعمل + +232 +00:20:01,470 --> 00:20:05,750 +variable لمين لل vision طبعا هذه هتكون ايش؟ مع + +233 +00:20:05,750 --> 00:20:10,110 +مرور فترة حياة العدسة، انه كل ما طالت فترة حياة + +234 +00:20:10,110 --> 00:20:14,820 +العدسةهذا ايش هيسبب ان ال giant papillary + +235 +00:20:14,820 --> 00:20:20,270 +conjunctivitis انفلامش اللاهالكون جان تايفا وهذه + +236 +00:20:20,270 --> 00:20:23,650 +ستكون في ال upper eyelid واعتقد انه اخدنا في + +237 +00:20:23,650 --> 00:20:27,690 +المعمل كيف انه بنعمل averted لل upper eyelid + +238 +00:20:27,690 --> 00:20:32,730 +وبنشوف هل هي mild, moderate, severe او اللي هو + +239 +00:20:32,730 --> 00:20:37,190 +مابيكونش يعني normal a grade zero طبعا الشخص لما + +240 +00:20:37,190 --> 00:20:41,230 +بيكون عنده significant بتكون اما moderate او + +241 +00:20:41,230 --> 00:20:44,110 +severe الشكل هذا الصورة + +242 +00:20:49,010 --> 00:20:54,030 +طبعا ال giant papillary conjunctivitis هي تعتبر ال + +243 +00:20:54,030 --> 00:20:59,090 +most common cause مع ارتدائش العدسات اللاصقة + +244 +00:20:59,090 --> 00:21:00,070 +اللينة + +245 +00:21:02,300 --> 00:21:05,840 +أيضاً عندنا Corneal and conjunctival inflammatory + +246 +00:21:05,840 --> 00:21:10,020 +response أي تانفلاميشن في ال Cornea أو ال + +247 +00:21:10,020 --> 00:21:14,720 +conjunctiva بيعمل ايه؟ اللي هو ال protein انتيجين + +248 +00:21:14,720 --> 00:21:19,080 +وبالتالي بيؤثر على الرؤية للعدسة اللاصقة + +249 +00:21:23,410 --> 00:21:29,170 +طيب، الآن الـ soft lenses العدسات اللاصقة اللينة + +250 +00:21:29,170 --> 00:21:33,710 +وضيفه أيضًا الـ soft trick contact lenses بدها + +251 +00:21:33,710 --> 00:21:39,550 +تكون ideal لمين؟ يعني مثالية لأي الأشخاص + +252 +00:21:42,880 --> 00:21:49,200 +number one individuals الأفراد أو الأشخاص who have + +253 +00:21:49,200 --> 00:21:53,800 +given up wearing rigid lenses because of the + +254 +00:21:53,800 --> 00:21:58,580 +irritation. إذا هو مش قادر يعمل ايه؟ adaptation مع + +255 +00:21:58,580 --> 00:22:03,650 +العدسة اللاصقة ايه؟لكن في لها ضوابط او في لها + +256 +00:22:03,650 --> 00:22:07,530 +criteria يعني الان واحد مثلا بيكون عنده corneal + +257 +00:22:07,530 --> 00:22:11,730 +cylinder هل بنفعدي ال soft contact lenses او اللي + +258 +00:22:11,730 --> 00:22:18,070 +هو ال ال software ال contact lenses؟ ايش رايكم؟ + +259 +00:22:18,070 --> 00:22:25,510 +الان مثلا مريض له ال best option كان RGBروحت انا + +260 +00:22:25,510 --> 00:22:29,050 +مثلا اديته soft contact lenses او soft trick + +261 +00:22:29,050 --> 00:22:33,770 +contact lenses هل هذا الإجراء صحيح ولا خطأ؟ ايش + +262 +00:22:33,770 --> 00:22:37,050 +رأيكم؟ + +263 +00:22:37,050 --> 00:22:41,740 +تفضليصحيح لو كان إنه ممكن نعمله ردارة إنه للسليندر + +264 +00:22:41,740 --> 00:22:44,120 +إنه مع العدسة الصوف أما لو كان عنده زي ال + +265 +00:22:44,120 --> 00:22:47,740 +keratoconus إنه كان ضروري إنه يلبس العدى فلازم + +266 +00:22:47,740 --> 00:22:51,980 +يعني أن أولها لازم يعمل عملية معينة عملية إنه + +267 +00:22:51,980 --> 00:22:54,960 +علشان ال keratoconus مايزدش لإن مش راح نقدر نوقفه + +268 +00:22:54,960 --> 00:23:01,110 +بال RGB و ال soft راح يزيد بالتاليطيب انا الإجابة + +269 +00:23:01,110 --> 00:23:05,090 +الأولى تعطيك صحيحة انه الان واحد عنده مثلا cornial + +270 +00:23:05,090 --> 00:23:09,330 +cylinder بروح بلبسه soft contact lenses بعمله over + +271 +00:23:09,330 --> 00:23:14,230 +فجيها glasses او over refraction يعني بلبس عدسة + +272 +00:23:14,230 --> 00:23:18,910 +لاصقة مع نضارة لكن انا بدى نبه مين ال patient لان + +273 +00:23:18,910 --> 00:23:22,910 +مش كل الناس يعني بكون متقبل هذا الأمر هو في الآخر + +274 +00:23:22,910 --> 00:23:27,670 +بديلبس عدسة لاصقة عشان يرتاح من مين من النضارةطيب + +275 +00:23:27,670 --> 00:23:32,610 +في حالة ال keratoconus لأ خاصة يما تكون early + +276 +00:23:32,610 --> 00:23:36,230 +stage keratoconus الحل الأول هو عبارة عن ال + +277 +00:23:36,230 --> 00:23:41,690 +glasses، الحل الأول هو عبارة عن ال glasses بعد ذلك + +278 +00:23:41,690 --> 00:23:45,810 +بيجي ال RGB من ثم ال cross linking من ثم ال index + +279 +00:23:45,810 --> 00:23:49,390 +و آخر حاجة مين؟ اللي هي ال final stage ال + +280 +00:23:49,390 --> 00:23:50,890 +keratoiblastic + +281 +00:23:53,260 --> 00:23:57,920 +أول حل في عملية كراءة كوناس هو عبارة عن الـ + +282 +00:23:57,920 --> 00:23:58,320 +glasses + +283 +00:24:01,480 --> 00:24:07,240 +أو الصعوبات في إبقاء ريجد ديالي ويرينج مستقبل انه + +284 +00:24:07,240 --> 00:24:11,420 +مش قادر يعمل program معين لارتداء العدسة اللاصقة + +285 +00:24:11,420 --> 00:24:15,580 +الصلبة يعني بنقوله مثلا اول يوم ارتديها فقط ساعتين + +286 +00:24:15,580 --> 00:24:19,800 +ومش قادر يتحملها يعني discomfort في الساعتين فهنا + +287 +00:24:19,800 --> 00:24:24,160 +بدنا لازم نتوقف نوقف المريض عن ارتداء العدسة + +288 +00:24:24,160 --> 00:24:26,180 +اللاصقة الصلبة + +289 +00:24:28,820 --> 00:24:33,260 +Number two intermittent wearers الأشخاص اللي + +290 +00:24:33,260 --> 00:24:37,460 +بيرتديوا العدسات اللاصقة بشكل مؤقت زي مثلا + +291 +00:24:37,460 --> 00:24:42,960 +football players زي مثلا عندنا ال speakers زي ال + +292 +00:24:42,960 --> 00:24:47,800 +actors كل هدول الأشخاص أي طالب مثلا فيكم عندها + +293 +00:24:47,800 --> 00:24:52,320 +نفترض اللي هو convocation احتفال تخرج لفترة زمانية + +294 +00:24:52,320 --> 00:24:59,350 +قصيرة بدها ترتدي مين؟ العدسة اللاصقة اللينةو نفس + +295 +00:24:59,350 --> 00:25:03,390 +الحاجة ما أخد إبعين الاعتبار موضوع مين ال cylinder + +296 +00:25:03,390 --> 00:25:09,550 +Such as a public speakers or actors who want to + +297 +00:25:09,550 --> 00:25:12,810 +wear their lenses only occasionally occasionally + +298 +00:25:12,810 --> 00:25:14,050 +بمعنى أحيانا + +299 +00:25:18,190 --> 00:25:25,550 +Industrial workers wear the fear of losing a lens + +300 +00:25:25,550 --> 00:25:30,450 +at work can be very disrupting soft lenses rarely + +301 +00:25:30,450 --> 00:25:36,900 +fall out طبعا هذه النقطة هي تعتبر من ضمن إيش؟الـ + +302 +00:25:36,900 --> 00:25:41,240 +contra indication لـ ال contact lenses لكن بعض + +303 +00:25:41,240 --> 00:25:46,680 +الأشخاص مثلا بيشتغل في ال industrial works أو مثلا + +304 +00:25:46,680 --> 00:25:52,020 +في ال chemicals lab بصر على أنه يلبس عدسة لاصقة + +305 +00:25:52,020 --> 00:25:57,020 +فبيكون عند الحل الوحيد إما soft contact lenses أو + +306 +00:25:57,020 --> 00:26:00,780 +soft track contact lenses واضحة الفكرة؟ هذا إذا + +307 +00:26:00,780 --> 00:26:05,620 +المريض أثرالان مش انت ما بيجي المريض، اول حاجة بدك + +308 +00:26:05,620 --> 00:26:09,840 +تعرف في موضوع ال motivation، الحافظ النقطة التانية + +309 +00:26:09,840 --> 00:26:14,200 +موضوع ال occupation، الوظيفة طيب، الان بيشتغل هو + +310 +00:26:14,200 --> 00:26:19,680 +في مواد كيمويةهل تعتبر من ال indication ولا ال + +311 +00:26:19,680 --> 00:26:22,700 +contra indication للعدسة اللاصقة؟ Contra + +312 +00:26:22,700 --> 00:26:26,420 +indication لكن إذا المريض أثر على أنه بده يرتدي + +313 +00:26:26,420 --> 00:26:31,440 +عدسة لاصقة لينة أو بده يرتدي عدسة لاصقة، بدي + +314 +00:26:31,440 --> 00:26:36,150 +الخيار الأفضل له مين؟ ال soft contact lensesليش؟ + +315 +00:26:36,150 --> 00:26:40,150 +لأنه احنا عرفنا ان ال poor structure إلها أقل من + +316 +00:26:40,150 --> 00:26:44,050 +مين من ال hard contact lenses فبالتالي ممكن انه ما + +317 +00:26:44,050 --> 00:26:48,530 +تعمل عملية امتصاص لمين؟ للكيميكال أو ابتعمل لكن + +318 +00:26:48,530 --> 00:26:54,110 +بدرجة أقل من ال hard contact lenses okay النقطة + +319 +00:26:54,110 --> 00:26:58,270 +التانية انه صعوبة وقوحة للعدسة لأنه مااخد كل شكل + +320 +00:26:58,270 --> 00:27:02,770 +القرنية ال + +321 +00:27:02,770 --> 00:27:08,520 +fake patients وهذه خاصة وين؟في الأطفال اذا + +322 +00:27:08,520 --> 00:27:12,840 +especially in the children طفل مثلا انولد + +323 +00:27:12,840 --> 00:27:16,860 +congenital cataract لازم يعمله عملية ال cataract + +324 +00:27:16,860 --> 00:27:21,020 +as soon as possible صحيح الان احنا ما زرعناش عدسة + +325 +00:27:21,020 --> 00:27:24,180 +في ال anterior او ال posterior chamber بيكون عندنا + +326 +00:27:24,180 --> 00:27:28,140 +الحل الوحيد هو عبارة عن مين ال contact lenses اللي + +327 +00:27:28,140 --> 00:27:29,260 +هي عبارة عن ال soft + +328 +00:27:35,230 --> 00:27:40,290 +Impatient with the prolonged routine in the + +329 +00:27:40,290 --> 00:27:44,070 +following the rigid lens wearing schedule بعض + +330 +00:27:44,070 --> 00:27:47,850 +الأشخاص الكبار سواء ال males أو ال females ما + +331 +00:27:47,850 --> 00:27:54,780 +عندهمش قدرة على تحمل وقت طويل لعملية إيه؟المشي فيه + +332 +00:27:54,780 --> 00:27:58,920 +اللي هو program معين للعدسات اللاصقة الصلبة فبيكون + +333 +00:27:58,920 --> 00:28:03,620 +الحل الوحيد امامي اما ال soft contact lenses او ال + +334 +00:28:03,620 --> 00:28:11,500 +soft direct contact lenses طيب الان لكن في الأشخاص + +335 +00:28:11,500 --> 00:28:15,420 +الكبار في السن في نقطة مهمة ان ال sensitivity هان + +336 +00:28:15,420 --> 00:28:19,340 +بتكون عالية ولا lowإذا دايما ال cornea ال + +337 +00:28:19,340 --> 00:28:23,480 +sensitivity عنده قليلة فبتلاحظ ان هو بعمل + +338 +00:28:23,480 --> 00:28:28,440 +adaptation لل RGB أسرع من مين من ال young اللي هو + +339 +00:28:28,440 --> 00:28:34,700 +الشباب طيب لو انا طلبت منكم اللي هو حالات أخرى + +340 +00:28:34,700 --> 00:28:38,860 +بيكون فيها ال soft contact lens أو ال software + +341 +00:28:38,860 --> 00:28:43,020 +contact lenses هي ال ideal المثالية زي ايش مثلا؟ + +342 +00:28:48,570 --> 00:28:53,950 +أخدنا مثلا انه هي تعتبر good option في حالة مين ال + +343 +00:28:53,950 --> 00:28:58,450 +spherical refractive error مع التوريكورنية صح ولا + +344 +00:28:58,450 --> 00:29:02,870 +لا الحالة التانية يما يكون ما عندي انه فقط عندي ال + +345 +00:29:02,870 --> 00:29:05,850 +spherical refractive error هي تعتبر ال best option + +346 +00:29:05,850 --> 00:29:12,010 +واضح في حالة مثلا موضوع ال ال activities الرياضات + +347 +00:29:12,010 --> 00:29:15,190 +بشكل مختلف هي تعتبر الحل الأفضل + +348 +00:29:18,510 --> 00:29:26,230 +بتقرر مع ال RGB؟ اه ايش يعني؟ يعني دخول + +349 +00:29:26,230 --> 00:29:30,510 +ال foreign body و الحصاوة يعني اقل من دخولها اه بس + +350 +00:29:30,510 --> 00:29:33,950 +هذه عفوا تعتبر من ضمن ال advantages لها لكن انا + +351 +00:29:33,950 --> 00:29:38,010 +بقول when ان هي حالات بتكون ideal مثالية يعني جزء + +352 +00:29:38,010 --> 00:29:41,630 +ان اشخاص بتعرضوا ل foreign body بشكل مستمر قد تكون + +353 +00:29:41,630 --> 00:29:45,510 +ان ال soft contact lenses هي الخيار الأفضل + +354 +00:29:49,490 --> 00:29:54,130 +عنا الآن ال bandage contact lenses ال bandage + +355 +00:29:54,130 --> 00:29:59,050 +contact lenses الغرض منها دايما هي عبارة عن ال + +356 +00:29:59,050 --> 00:30:05,370 +treatment او ال therapeutic العلاج في عنا نوعين من + +357 +00:30:05,370 --> 00:30:11,130 +هذه العدسات النوع الاول therapeutic use of bandage + +358 +00:30:11,130 --> 00:30:19,850 +lenses يعني استخدام علاجي لهذا النوع من العدساتزي + +359 +00:30:19,850 --> 00:30:25,050 +number one عندنا ال flexibility المرونة او اليونة + +360 +00:30:25,050 --> 00:30:28,690 +يعني بمعنى ال properties الخواص او ال + +361 +00:30:28,690 --> 00:30:32,850 +characteristics لها واحد flexibility طب من وين + +362 +00:30:32,850 --> 00:30:40,570 +جاية ال flexibility لهذا النوع من العدسات؟ بالضبط + +363 +00:30:40,570 --> 00:30:44,890 +ان في اول حاجة استخدام مادة ال silicon اللي احنا + +364 +00:30:44,890 --> 00:30:48,730 +قلنا عبارة عن second generation صحيح؟ تفضلي + +365 +00:30:54,040 --> 00:30:57,400 +إنه فيه اللي هي كمية ال water content مع ال + +366 +00:30:57,400 --> 00:31:01,000 +silicon اتنين مع بعض هذه بتديها إيش flexibility + +367 +00:31:01,000 --> 00:31:08,020 +بالإضافة لل durability بالضبط + +368 +00:31:08,020 --> 00:31:15,320 +موضوع المتانة أيضا هذا النوع من العدسات بتتميز + +369 +00:31:15,320 --> 00:31:21,250 +إنها too thinإذا مدام هي too thin إذا بتديني أول + +370 +00:31:21,250 --> 00:31:25,690 +حاجة flexibility يعني بمعنى زي ال daily disposable + +371 +00:31:25,690 --> 00:31:30,110 +lenses جديش اللي هو فيها flexibility مرونة عالية + +372 +00:31:30,110 --> 00:31:35,210 +كتير فبتلاقي إن ال oxygen ال transmissibility very + +373 +00:31:35,210 --> 00:31:41,770 +high طيب الشوق الحياة فيها short ولا long life؟ + +374 +00:31:41,770 --> 00:31:51,970 +short life بالضبطنومبر ثلاثة مريحة من السهل ان + +375 +00:31:51,970 --> 00:31:59,030 +المريض يستعمل العدسة الجيل الأول من هذا النوع من + +376 +00:31:59,030 --> 00:32:06,110 +العدسات كان فيها إبلانو refractive error لكن الجيل + +377 +00:32:06,110 --> 00:32:09,070 +التاني تم إضافة مادة الكلاجين + +378 +00:32:11,950 --> 00:32:16,930 +فصارت كلاجين bandage contact lenses ووضعوا فيها + +379 +00:32:16,930 --> 00:32:20,990 +مثلا ماينوس واحد او ماينوس اتنين يعني عملت عملية + +380 +00:32:20,990 --> 00:32:23,870 +تصحيح لمين لل refractive errors + +381 +00:32:27,410 --> 00:32:32,090 +أيضا هذا النوع من العدسات it may apply as drug + +382 +00:32:32,090 --> 00:32:37,550 +delivery devices بعض أنواع هذه العدسات بتم حقن + +383 +00:32:37,550 --> 00:32:42,450 +فيها أنواع معينة من ال drug وبالتالي ال anterior + +384 +00:32:42,450 --> 00:32:47,890 +surface للكورنية بتم امتصاصهايعني هذه بتتموين خلال + +385 +00:32:47,890 --> 00:32:51,790 +العملية انه بلبس المريض بانديش contact lenses + +386 +00:32:51,790 --> 00:32:56,150 +بتديه نوع معين من ال drop او نوع معين من ال + +387 +00:32:56,150 --> 00:33:01,410 +treatment عشان انه تمتصه من ال anterior surface of + +388 +00:33:01,410 --> 00:33:09,090 +the cornea طبعا + +389 +00:33:09,090 --> 00:33:10,950 +هي small refractive error + +390 +00:33:14,830 --> 00:33:18,230 +طبعا ال bandage contact lenses اكتر استخدامات + +391 +00:33:18,230 --> 00:33:22,270 +الهوين في ال refractive surgeries او مثلا في عملية + +392 +00:33:22,270 --> 00:33:26,410 +الليزي اي عملية بلاحظ فيها الدكتور انه ممكن يصير + +393 +00:33:26,410 --> 00:33:30,090 +فيه inflammation او infection للمريض بيحاول انه + +394 +00:33:30,090 --> 00:33:35,010 +يلبسوا ايش ال .. ال bandage contact lenses بالضبط + +395 +00:33:35,010 --> 00:33:38,210 +انه مافي regeneration لمين؟ للابيثيليا + +396 +00:33:41,300 --> 00:33:45,300 +The corneal uses of therapeutic lenses أيضًا + +397 +00:33:45,300 --> 00:33:50,500 +الاستخدامات الأخرى لهذا النوع من العدسات number + +398 +00:33:50,500 --> 00:33:54,980 +one promote healing بتعمل عملية تسريع في اللي هو + +399 +00:33:54,980 --> 00:34:00,120 +العلاج أو الشفاء للمريض provide comfort بتزود له + +400 +00:34:00,120 --> 00:34:03,980 +الراحة لأنه زي ما اتفقنا فيها high DK على T وهي + +401 +00:34:03,980 --> 00:34:10,120 +بتتميز انه flexibilityprotect the eye بتحمي العين + +402 +00:34:10,120 --> 00:34:13,940 +من ال infection أو ال inflammatory okay improve + +403 +00:34:13,940 --> 00:34:18,740 +the corneal draft يعني كيف أنه الآن لو واحد عنده + +404 +00:34:18,740 --> 00:34:25,410 +مريض post draft بتعمل عملية تحسين لهذا المريضيعني + +405 +00:34:25,410 --> 00:34:29,510 +بمعنى اخر انه عنده irregularity لل surface of the + +406 +00:34:29,510 --> 00:34:33,850 +cornea فبنستخدم هذا النوع من العدسات قبل عملية + +407 +00:34:33,850 --> 00:34:37,710 +مثلا ال intact الحلقات او عملية مثلا ال cross + +408 +00:34:37,710 --> 00:34:44,970 +linking عشان عملية التثبيت خليني + +409 +00:34:44,970 --> 00:34:48,590 +جف ان شاء الله ل ال indications for therapeutic + +410 +00:34:48,590 --> 00:34:54,540 +lenses في اي سؤال اي استفسار؟واضح ان شاء الله + +411 +00:34:54,540 --> 00:34:56,640 +الأمور اعطيكم العافية + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/hYllUQaUrEo_raw.json b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/hYllUQaUrEo_raw.json new file mode 100644 index 0000000000000000000000000000000000000000..cb72ee92373f3cfe500215ed29c565a7cdd12bfc --- /dev/null +++ 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طيب؟", "tokens": [259, 270, 2270, 4619, 457, 12980, 10532, 382, 264, 786, 41929, 18863, 3215, 3794, 3660, 13672, 33546, 28671, 13672, 9957, 3660, 5296, 15042, 6055, 30544, 4524, 8978, 29739, 28259, 10632, 39894, 30544, 4619, 32239, 8592, 23032, 1829, 3555, 22807], "avg_logprob": -0.27539062947034837, "compression_ratio": 1.3517241379310345, "no_speech_prob": 0.0, "words": [{"start": 745.32, "end": 746.06, "word": "initially", "probability": 0.6456705729166666}, {"start": 746.06, "end": 747.08, "word": " comfortable", "probability": 0.7841796875}, {"start": 747.08, "end": 747.86, "word": " but", "probability": 0.5693359375}, {"start": 747.86, "end": 748.7, "word": " increasingly", "probability": 0.61474609375}, {"start": 748.7, "end": 749.74, "word": " uncomfortable", "probability": 0.88818359375}, {"start": 749.74, "end": 750.88, "word": " as", "probability": 0.95263671875}, {"start": 750.88, "end": 751.22, "word": " the", "probability": 0.8916015625}, {"start": 751.22, "end": 751.48, 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"end": 801.61, "word": " الحركة", "probability": 0.974609375}, {"start": 801.61, "end": 801.89, "word": " فيها", "probability": 0.98828125}, {"start": 801.89, "end": 802.31, "word": " بتكون", "probability": 0.9580078125}, {"start": 802.31, "end": 802.83, "word": " اقل", "probability": 0.8795572916666666}, {"start": 802.83, "end": 803.13, "word": " من", "probability": 0.9951171875}, {"start": 803.13, "end": 803.39, "word": " نص", "probability": 0.971435546875}, {"start": 803.39, "end": 804.15, "word": " مليمتر", "probability": 0.77607421875}], "temperature": 1.0}, {"id": 34, "seek": 82740, "start": 804.94, "end": 827.4, "text": "Okay فبالتالي بتكون هي تعتبر ايه steep يعني او بتديني انطباع انه قد تكون العدسة steep lens كيراتومتري ميارز الان before blinking ايش بتكون؟ clear زي اللي هو initially comfortable وبعد الترميش ايش بتصبح؟", "tokens": [8297, 6156, 3555, 6027, 2655, 6027, 1829, 39894, 30544, 39896, 6055, 34268, 26890, 1975, 1829, 3224, 16841, 37495, 22653, 1975, 2407, 39894, 3215, 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{"start": 1234.03, "end": 1234.53, "word": " normal", "probability": 0.8427734375}, {"start": 1234.53, "end": 1234.77, "word": " a", "probability": 0.352783203125}, {"start": 1234.77, "end": 1235.03, "word": " grade", "probability": 0.96435546875}, {"start": 1235.03, "end": 1235.47, "word": " zero", "probability": 0.7373046875}, {"start": 1235.47, "end": 1236.47, "word": " طبعا", "probability": 0.9554443359375}, {"start": 1236.47, "end": 1236.95, "word": " الشخص", "probability": 0.9951171875}, {"start": 1236.95, "end": 1237.19, "word": " لما", "probability": 0.830810546875}, {"start": 1237.19, "end": 1237.51, "word": " بيكون", "probability": 0.8046875}, {"start": 1237.51, "end": 1238.01, "word": " عنده", "probability": 0.996337890625}, {"start": 1238.01, "end": 1239.09, "word": " significant", "probability": 0.6533203125}, {"start": 1239.09, "end": 1240.07, "word": " بتكون", "probability": 0.6572265625}, {"start": 1240.07, "end": 1240.39, "word": " اما", "probability": 0.85693359375}, {"start": 1240.39, "end": 1240.85, "word": " moderate", "probability": 0.97216796875}, {"start": 1240.85, "end": 1241.23, "word": " او", "probability": 0.968505859375}, {"start": 1241.23, "end": 1241.83, "word": " severe", "probability": 0.8740234375}, {"start": 1241.83, "end": 1242.47, "word": " الشكل", "probability": 0.7449951171875}, {"start": 1242.47, "end": 1242.87, "word": " هذا", "probability": 0.6826171875}, {"start": 1242.87, "end": 1244.11, "word": " الصورة", "probability": 0.9708658854166666}], "temperature": 1.0}, {"id": 52, "seek": 126007, "start": 1249.01, "end": 1260.07, "text": "طبعا ال giant papillary conjunctivitis هي تعتبر ال most common cause مع ارتدائش العدسات اللاصقة اللينة", "tokens": [9566, 3555, 3615, 995, 2423, 7410, 5806, 46367, 18244, 349, 592, 16074, 39896, 6055, 34268, 26890, 2423, 881, 2689, 3082, 20449, 1975, 43500, 3215, 16373, 8592, 18863, 3215, 3794, 9307, 13672, 33546, 28671, 13672, 9957, 3660], "avg_logprob": -0.21959459781646729, "compression_ratio": 1.168, "no_speech_prob": 0.0, "words": [{"start": 1249.01, "end": 1250.33, "word": "طبعا", "probability": 0.7527389526367188}, {"start": 1250.33, "end": 1250.55, "word": " ال", "probability": 0.6611328125}, {"start": 1250.55, "end": 1250.85, "word": " giant", "probability": 0.30615234375}, {"start": 1250.85, "end": 1251.43, "word": " papillary", "probability": 0.926025390625}, {"start": 1251.43, "end": 1252.67, "word": " conjunctivitis", "probability": 0.9569091796875}, {"start": 1252.67, "end": 1253.01, "word": " هي", "probability": 0.890625}, {"start": 1253.01, "end": 1253.69, "word": " تعتبر", "probability": 0.90087890625}, {"start": 1253.69, "end": 1254.03, "word": " ال", "probability": 0.74609375}, {"start": 1254.03, "end": 1254.39, "word": " most", "probability": 0.463134765625}, {"start": 1254.39, "end": 1254.89, "word": " common", "probability": 0.9736328125}, {"start": 1254.89, "end": 1255.53, "word": " cause", "probability": 0.85595703125}, {"start": 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{"start": 1311.44, "end": 1312.0, "word": " lenses", "probability": 0.908203125}, {"start": 1312.0, "end": 1312.96, "word": " because", "probability": 0.818359375}, {"start": 1312.96, "end": 1313.54, "word": " of", "probability": 0.9873046875}, {"start": 1313.54, "end": 1313.8, "word": " the", "probability": 0.52783203125}, {"start": 1313.8, "end": 1314.56, "word": " irritation.", "probability": 0.96435546875}, {"start": 1315.46, "end": 1315.66, "word": " إذا", "probability": 0.5848388671875}, {"start": 1315.66, "end": 1315.88, "word": " هو", "probability": 0.80029296875}, {"start": 1315.88, "end": 1316.1, "word": " مش", "probability": 0.98779296875}, {"start": 1316.1, "end": 1316.42, "word": " قادر", "probability": 0.9493815104166666}, {"start": 1316.42, "end": 1316.82, "word": " يعمل", "probability": 0.9781901041666666}, {"start": 1316.82, "end": 1317.32, "word": " ايه؟", "probability": 0.771240234375}, {"start": 1317.32, "end": 1317.9, "word": " adaptation", "probability": 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"text": "أو الصعوبات في إبقاء ريجد ديالي ويرينج مستقبل انه مش قادر يعمل program معين لارتداء العدسة اللاصقة الصلبة يعني بنقوله مثلا اول يوم ارتديها فقط ساعتين ومش قادر يتحملها يعني discomfort في الساعتين فهنا بدنا لازم نتوقف نوقف المريض عن ارتداء العدسة اللاصقة الصلبة", "tokens": [10721, 2407, 31767, 3615, 37746, 9307, 8978, 11933, 3555, 4587, 16606, 12602, 1829, 7435, 3215, 11778, 1829, 6027, 1829, 4032, 13546, 9957, 7435, 3714, 14851, 4587, 36150, 16472, 3224, 37893, 12174, 18513, 2288, 7251, 25957, 1211, 1461, 20449, 9957, 5296, 9640, 2655, 3215, 16606, 18863, 3215, 3794, 3660, 13672, 33546, 28671, 31767, 46152, 3660, 37495, 22653, 44945, 39648, 3224, 50113, 15040, 1975, 12610, 7251, 20498, 1975, 43500, 16254, 11296, 6156, 47432, 8608, 995, 34268, 9957, 4032, 2304, 8592, 12174, 18513, 2288, 7251, 2655, 35571, 1211, 11296, 37495, 22653, 28552, 8978, 21136, 995, 34268, 9957, 6156, 3224, 8315, 47525, 8315, 5296, 31377, 2304, 8717, 2655, 30543, 5172, 8717, 30543, 5172, 9673, 16572, 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"temperature": 1.0}, {"id": 63, "seek": 149704, "start": 1468.82, "end": 1497.04, "text": "Number two intermittent wearers الأشخاص اللي بيرتديوا العدسات اللاصقة بشكل مؤقت زي مثلا football players زي مثلا عندنا ال speakers زي ال actors كل هدول الأشخاص أي طالب مثلا فيكم عندها نفترض اللي هو convocation احتفال تخرج لفترة زمانية قصيرة بدها ترتدي مين؟ العدسة اللاصقة اللينة", "tokens": [45, 4182, 732, 44084, 3728, 433, 16247, 8592, 9778, 33546, 13672, 1829, 4724, 13546, 2655, 16254, 14407, 18863, 3215, 3794, 9307, 13672, 33546, 28671, 4724, 8592, 28820, 3714, 33604, 38149, 30767, 1829, 50113, 15040, 7346, 4150, 30767, 1829, 50113, 15040, 43242, 8315, 2423, 9518, 30767, 1829, 2423, 10037, 28242, 8032, 3215, 12610, 16247, 8592, 9778, 33546, 36632, 23032, 6027, 3555, 50113, 15040, 8978, 24793, 43242, 11296, 8717, 5172, 2655, 43042, 13672, 1829, 31439, 3754, 27943, 1975, 33753, 5172, 6027, 6055, 34740, 7435, 5296, 5172, 2655, 25720, 30767, 2304, 7649, 10632, 12174, 9381, 48923, 47525, 11296, 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هنبدأ اليوم في موضوع impair reading in + +3 +00:00:29,360 --> 00:00:33,760 +soft contact lens wearer impair بمعنى تعطيل أو + +4 +00:00:33,760 --> 00:00:38,820 +reduce reading أو بمعنى deterioration تدهور + +5 +00:00:47,870 --> 00:00:51,970 +تدهور القراءة في الأشخاص اللي بيرتديوا العدسات + +6 +00:00:51,970 --> 00:00:58,550 +اللاصقة اللينة بداية أي مريض بيرتدي عدسة لاصقة + +7 +00:00:58,550 --> 00:01:04,610 +لينة بشكل مستمر أو في فترة زمنية طويلة بصير عنده + +8 +00:01:04,610 --> 00:01:10,330 +نوع من إيه؟ من الإجهادبعد ما بيصير عنده الإجهاد + +9 +00:01:10,330 --> 00:01:14,910 +هذا بتلاقي انه زي ما انت بتعملي attention في ال + +10 +00:01:14,910 --> 00:01:18,030 +mobile او attention في ال laptop بقل موضوع ال + +11 +00:01:18,030 --> 00:01:21,250 +blinking اللي هو الترميش احنا عارفين انه ال normal + +12 +00:01:21,250 --> 00:01:25,610 +blinking من خمساش لعشرين مرة في اللي هو الدقيقة + +13 +00:01:25,610 --> 00:01:33,400 +وبالتالي هذا ايش بيسبب؟بسبب انه عدم اللي هو موضوع + +14 +00:01:33,400 --> 00:01:36,880 +الـ lubrication اللي هو ترطيب لمين للعدسة يعني + +15 +00:01:36,880 --> 00:01:42,680 +بيقلل من ترطيب العدسة فبتصبح العدسة جافة وبالتالي + +16 +00:01:42,680 --> 00:01:47,840 +هذا قد يؤدي إلى تأثير على اللي هو ال comfort راحة + +17 +00:01:47,840 --> 00:01:54,080 +المريض وايضا على ال vision بالنسبة للمريض اذا ال + +18 +00:01:54,080 --> 00:01:55,580 +causes الأسباب + +19 +00:01:58,880 --> 00:02:06,340 +القراءة لفترات زمنية طويلة حسبب إجهاد للمريض and + +20 +00:02:06,340 --> 00:02:09,620 +lack of blinking ونقص في عملية الترميش + +21 +00:02:12,500 --> 00:02:17,700 +leads to هذا بيقود إلى excessive drying زيادة + +22 +00:02:17,700 --> 00:02:23,360 +الجفاف للسطح اللي هو الأمامي اللي خاص بالعدسة لذلك + +23 +00:02:23,360 --> 00:02:27,500 +احنا بننصح المريض عند ارتداء العدسة اللاصقة اللينة + +24 +00:02:27,500 --> 00:02:33,610 +انه كل مثلا خمسة واربعين دقيقة يطلع بعيدالهدف من + +25 +00:02:33,610 --> 00:02:38,070 +ذلك أنه أعمل relax لل accommodation بالإضافة أنه + +26 +00:02:38,070 --> 00:02:42,990 +أعمل اللي هو عملية blinking وترطيب للعدسة اللاصقة + +27 +00:02:42,990 --> 00:02:50,030 +Decentration + +28 +00:02:50,030 --> 00:02:55,670 +of soft contact lenses أي بمعنى عدم تمركز أو إزاحة + +29 +00:02:55,670 --> 00:03:01,570 +العدسة اللاصقة اللينةالان مباشرة يما تسمع كلمة الـ + +30 +00:03:01,570 --> 00:03:06,630 +Decentration ايش بيراود لفكرك؟ ان العدسة قد تكون + +31 +00:03:06,630 --> 00:03:15,870 +Flat اي بمعنى ان فيها small diameter + +32 +00:03:15,870 --> 00:03:23,170 +او بيكون فيها flat base curve الان هنعرف ايش ال + +33 +00:03:23,170 --> 00:03:29,430 +causes الأسباب لإزاحة العدسة اللاصقة اللينةالـ + +34 +00:03:29,430 --> 00:03:34,930 +causes number one تايت eyelids أي شخص بيكون عنده + +35 +00:03:34,930 --> 00:03:39,830 +ال eyelid وهنا بنقصد ال upper eyelid فيه اللي هو + +36 +00:03:39,830 --> 00:03:46,150 +التايت زي مثلا ال Japanese، ال Chinese، Malaysian، + +37 +00:03:46,150 --> 00:03:50,130 +Singaporean، هدول كلهم الأشخاص في عندهم ايه؟ تايت + +38 +00:03:50,130 --> 00:03:57,140 +eyelids فبتلاحظي انهدايما انه بحتاج الى عدسة بيكون + +39 +00:03:57,140 --> 00:04:01,580 +فيها ال base curve small ولا large؟ large ديامتر + +40 +00:04:01,580 --> 00:04:06,440 +او خلينا نقول quite large ديامتر compared to + +41 +00:04:06,440 --> 00:04:11,990 +another race مقارنة بأعراق او باجناس آخرينفهذا + +42 +00:04:11,990 --> 00:04:15,450 +بيؤدي إلى إزاحة العدسة، يعني لو أنا لبست عدسة + +43 +00:04:15,450 --> 00:04:19,590 +لاصقة زي اللي عندنا في المعمل، Diameter 14.2 أو 14 + +44 +00:04:19,590 --> 00:04:23,470 +.5 أو 14 Millimeter، هتلاحظ إن فيه هيصير هناك + +45 +00:04:23,470 --> 00:04:28,750 +Decentration لمن؟ للعدسة Number two، large + +46 +00:04:28,750 --> 00:04:33,890 +corneas، لما تكون ال cornea large، إيش بدها تكون؟ + +47 +00:04:33,890 --> 00:04:39,370 +Flat ولا steep؟flat cornea صحيح؟ فلذلك انا بحتاج + +48 +00:04:39,370 --> 00:04:43,910 +الى diameter ايش لازم انه يكون large diameter حتى + +49 +00:04:43,910 --> 00:04:49,810 +انه يكون ال movement ل العدسة ملائمة او مناسبة + +50 +00:04:49,810 --> 00:04:53,070 +against + +51 +00:04:53,070 --> 00:04:56,290 +the rule of stigmatism ايش معناه against the rule + +52 +00:04:56,290 --> 00:05:00,190 +of stigmatism؟ شو معناه against the rule؟ فضلي + +53 +00:05:04,740 --> 00:05:08,240 +طيب الان لو انا مثلا جبتلك صورة corneal topography + +54 +00:05:08,240 --> 00:05:11,740 +احنا هذا ك definition عارفينه انه بيكون ال + +55 +00:05:11,740 --> 00:05:14,900 +horizontal meridian steeper than ال vertical + +56 +00:05:14,900 --> 00:05:18,240 +meridian لو انا جبت صورة ال corneal topography + +57 +00:05:18,240 --> 00:05:23,260 +هتلاقي ان البوتاي في ال horizontal meridian واضحين + +58 +00:05:23,260 --> 00:05:26,840 +اكتر من مين من ال vertical meridian يعني بالشكل + +59 +00:05:26,840 --> 00:05:33,980 +هذا هيكون شكل ال corneal topographyBotai هذي + +60 +00:05:33,980 --> 00:05:38,160 +معناها against the rule of stigmatism ال against + +61 +00:05:38,160 --> 00:05:42,120 +the rule of stigmatism بتعمل إزاحة للعدسة اللاصقة + +62 +00:05:42,120 --> 00:05:47,570 +اللينة لسببينالسبب الأول ان هي بتكون unstability + +63 +00:05:47,570 --> 00:05:53,430 +غير ثابتة والسبب التاني انه بيكون فيها مدام قيمة + +64 +00:05:53,430 --> 00:05:56,850 +السيلندر طبعا انا بتكلم هان ممكن عن ايضا ال + +65 +00:05:56,850 --> 00:05:59,810 +software ال contact lenses بيكون فيها ال + +66 +00:05:59,810 --> 00:06:02,490 +horizontal meridian اعلى من ال steeper meridian + +67 +00:06:02,490 --> 00:06:06,230 +فبتعمل اللي هو ازاحة للعدسة او بنسميها + +68 +00:06:06,230 --> 00:06:07,150 +displacement + +69 +00:06:12,940 --> 00:06:17,100 +لمن؟ للعدسة اللاصقة فالان عندما تعمل عملية + +70 +00:06:17,100 --> 00:06:20,740 +evaluation تقييم بتلاقي ان العدسة عاملة + +71 +00:06:20,740 --> 00:06:25,660 +displacement اما medial او lateral بسبب اللي هو + +72 +00:06:25,660 --> 00:06:29,720 +against the rule of stigmatism طيب في ال with the + +73 +00:06:29,720 --> 00:06:32,660 +rule of stigmatism ليش مابصير ال decentralization؟ + +74 +00:06:35,230 --> 00:06:40,750 +ببساطة لأنه بيصير عملية suction للعدسة من اللي هو + +75 +00:06:40,750 --> 00:06:44,290 +ايه ال vertical meridian يعني ال vertical meridian + +76 +00:06:44,290 --> 00:06:48,370 +بيكون فيه القوة اعلى او steeper فالتحدث بيكون فيه + +77 +00:06:48,370 --> 00:06:52,010 +ايش اكتر فبالتالي ان العدسة اللي بيصير فيه لها + +78 +00:06:52,010 --> 00:06:56,330 +suction اكتر فهي بالعكس بيصير العدسة قريبة و كأنه + +79 +00:06:56,330 --> 00:07:01,510 +ايش هي steep واضح الفكرة يعني بتنمسك من المنتصف + +80 +00:07:01,510 --> 00:07:03,830 +اكتر من وين من الأطراف + +81 +00:07:08,220 --> 00:07:12,440 +الـ Symmetric Corneal Topographyفي موضوع الـ + +82 +00:07:12,440 --> 00:07:16,620 +Corneal Topography أخدنا هناك أكتر من عشر أشكال + +83 +00:07:16,620 --> 00:07:20,060 +للـ High Order Aberration زي الـ Oval و الـ Round + +84 +00:07:20,060 --> 00:07:23,460 +و الـ Asymmetric Potai و Asymmetric Potai وقلنا + +85 +00:07:23,460 --> 00:07:26,580 +فيه الـ Asymmetric Potai إما بيكون inferior أو + +86 +00:07:26,580 --> 00:07:31,980 +superior و أيضا بيكون ممكن أنه skewed with radial + +87 +00:07:31,980 --> 00:07:38,160 +axis فهذه كلها قد تسبب اللي هو إزاحة لمين للعدسة + +88 +00:07:42,050 --> 00:07:45,670 +الان عندنا موضوع ال symptoms and signs of loose + +89 +00:07:45,670 --> 00:07:51,830 +lens اعراض و علامات ان العدسة يما تكون flat او + +90 +00:07:51,830 --> 00:07:56,450 +تكون loose number + +91 +00:07:56,450 --> 00:08:01,150 +one variable vision او vision effectuation + +92 +00:08:01,150 --> 00:08:02,950 +effectuation بمعنى ايه + +93 +00:08:07,100 --> 00:08:12,260 +اللي هو تذبذب الرؤية او ال vision variable اختلاف + +94 +00:08:12,260 --> 00:08:18,820 +الرؤية طبعا هذا بيكون بشكل اللي هو ايه مش دائم + +95 +00:08:18,820 --> 00:08:24,540 +يعني فورا للحظات و بيكون خاصة بيظهر في الأسقر + +96 +00:08:24,540 --> 00:08:31,500 +الأخيرة يعني بمعنى من 6 على 12 ل 6 على 6 يعني في + +97 +00:08:31,500 --> 00:08:37,090 +ال two ل three lines الأخيرةبصير هناك تذبذب بعملية + +98 +00:08:37,090 --> 00:08:44,350 +الرؤية ما بين before و after blinking number + +99 +00:08:44,350 --> 00:08:50,360 +two excess awareness of the lensالعدسة يما بتكون + +100 +00:08:50,360 --> 00:08:55,620 +flat بتكون حركتها كتيرة فالمريض بيشهر ان العدسة + +101 +00:08:55,620 --> 00:08:59,880 +عبارة عن foreign body او بالضبط بتكون و كأنه رمل + +102 +00:08:59,880 --> 00:09:04,060 +في داخل عينه، هيك المريض تعبيره يما تكون العدسة + +103 +00:09:04,060 --> 00:09:06,600 +flat، انه رمل في داخل العين + +104 +00:09:09,400 --> 00:09:15,360 +3- Poor Centering دايما تمركز العدسة بيكون ضعيف + +105 +00:09:15,360 --> 00:09:18,880 +لأن فيه اما بتكون ماخدة Decentration Up Down + +106 +00:09:18,880 --> 00:09:23,280 +Lateral Medial طيب + +107 +00:09:23,280 --> 00:09:26,780 +الآن يما يكون عندنا Decentration للعدسة أو Poor + +108 +00:09:26,780 --> 00:09:31,580 +Centering و العدسة Flat ايش بدي اعمل؟ اما بجيب + +109 +00:09:31,580 --> 00:09:35,760 +Large Diameter او بجيب Steep Base Care واضح + +110 +00:09:35,760 --> 00:09:41,640 +الفكرة؟أيضًا excess movement الحركة بتكون من 2 إلى + +111 +00:09:41,640 --> 00:09:45,960 +4 تقريبًا يما يكون العدسة إيش اللي هو excess + +112 +00:09:45,960 --> 00:09:50,340 +movement أو flat أو loose طبعًا إحنا بنعرف ال + +113 +00:09:50,340 --> 00:09:56,400 +normal جديش من نص إلى واحد وهان + +114 +00:09:56,400 --> 00:10:01,580 +مرة تانية بكرر إن الحركة هي غير كافية لعملية تقييم + +115 +00:10:01,580 --> 00:10:07,740 +العدسة هل هي flat ولا optimal أو stableLens + +116 +00:10:07,740 --> 00:10:11,960 +falling out of the eye احنا بنعرف ان العدسة + +117 +00:10:11,960 --> 00:10:17,180 +اللاصقة اللينة بتعمل follow to the eye movement و + +118 +00:10:17,180 --> 00:10:21,000 +بتتميز ان ال diameter بتاعها اكبر من الكورنية + +119 +00:10:21,000 --> 00:10:25,560 +فسقوطها بيكون اصعب من مين من سقوط العدسة ال hard + +120 +00:10:25,560 --> 00:10:28,440 +contact lenses لكن اما يكون ال diameter بتاعها + +121 +00:10:28,440 --> 00:10:33,020 +صغير بسهولة انه ممكن ايه يصير لها اللي هو سقوط + +122 +00:10:33,020 --> 00:10:36,260 +وهذا بنسميه ال dismatch + +123 +00:10:39,530 --> 00:10:45,910 +أو falling لمن؟ للعدسة ايضا + +124 +00:10:45,910 --> 00:10:49,870 +عندنا bubble هيكون فيه هناك فقاعات تحت ال lens + +125 +00:10:49,870 --> 00:10:54,150 +edge بينما في العدسة ال steep وين هيكون ال bubble؟ + +126 +00:10:54,150 --> 00:10:59,050 +اللي هو ال center كيراتومتري + +127 +00:10:59,050 --> 00:11:02,270 +مياردز الان before blinking هتكون clear ولا + +128 +00:11:02,270 --> 00:11:10,460 +unclear؟ وعد في الكيراتومتري مياردزbefore blinking + +129 +00:11:10,460 --> 00:11:16,360 +clear after blinking هتكون ايه؟ اللي هو after + +130 +00:11:16,360 --> 00:11:22,500 +blinking هتكون unclear طبعا هذه بيتم رؤيته اما من + +131 +00:11:22,500 --> 00:11:27,220 +خلال الجوال كيراتوميتر ال مايرز الخاص فيه او من + +132 +00:11:27,220 --> 00:11:28,640 +خلال ال bush and lum + +133 +00:11:32,030 --> 00:11:36,090 +Written scope, read reflex نفس الفكرة، الان لو انا + +134 +00:11:36,090 --> 00:11:40,130 +المريض قبل الترميش لو لاحظت ال reflex بتاعة ال + +135 +00:11:40,130 --> 00:11:43,370 +written scope قبل الترميش هيكون ايش ماله؟ واضح + +136 +00:11:43,370 --> 00:11:48,470 +وبعد الترميش هيكون unclear نفس فكرة الكيراتوميتر + +137 +00:11:48,470 --> 00:11:51,990 +ميارز ان شاء الله هذا هيتم تطبيقه بعد الامتحان + +138 +00:11:51,990 --> 00:11:54,770 +النصفي، موضوع ال written scope و read reflex في + +139 +00:11:54,770 --> 00:11:55,210 +المعملة + +140 +00:11:59,150 --> 00:12:04,930 +symptoms and signs of tight lens ايضا عندنا ال + +141 +00:12:04,930 --> 00:12:09,230 +causes الأسباب اللي لها فيه effluctuation vision + +142 +00:12:09,230 --> 00:12:14,890 +وبنكرر نفس الفكرة بيكون في آخر سطرين أو تلاتة من 6 + +143 +00:12:14,890 --> 00:12:20,790 +ع 12 ل 6 على 6 وبعض الدراسات بتقول من 6 ع 15 ل 6 ع + +144 +00:12:20,790 --> 00:12:21,550 +7 و نص + +145 +00:12:25,320 --> 00:12:28,700 +initially comfortable but increasingly + +146 +00:12:28,700 --> 00:12:34,240 +uncomfortable as the day progresses العدسة اللاصقة + +147 +00:12:34,240 --> 00:12:38,840 +اللينة لما تكون tight في البداية بتكون comfortable + +148 +00:12:38,840 --> 00:12:39,880 +ليش طيب؟ + +149 +00:12:42,280 --> 00:12:46,080 +بالضبط انه ممتازة بتعمل ايش adherence to the + +150 +00:12:46,080 --> 00:12:50,340 +cornea بمعنى انه no sensation at all مباشرة اول ما + +151 +00:12:50,340 --> 00:12:54,800 +المريض بحط على عينه مافي شعور بالعدسة واضحة الفكرة + +152 +00:12:54,800 --> 00:13:00,270 +فبتكون العدسة comfortable مريحةبعد شوية بعد ساعات + +153 +00:13:00,270 --> 00:13:04,190 +بلاحظ ان المريض يعني الان لو انت رفعت العدسة + +154 +00:13:04,190 --> 00:13:08,650 +اللاصقة و روحت مثلا حطيت صبغة فلوريسين هتلاحظي و + +155 +00:13:08,650 --> 00:13:13,030 +كأنه ring حوالين وين الكورنية لانه بتكون suction + +156 +00:13:13,030 --> 00:13:19,910 +مصممة العدسة absent or minimal movement after a + +157 +00:13:19,910 --> 00:13:25,360 +blink الحركة فيها بتكون اقل من نص مليمترOkay + +158 +00:13:25,360 --> 00:13:30,340 +فبالتالي بتكون هي تعتبر ايه steep يعني او بتديني + +159 +00:13:30,340 --> 00:13:37,880 +انطباع انه قد تكون العدسة steep lens كيراتومتري + +160 +00:13:37,880 --> 00:13:43,300 +ميارز الان before blinking ايش بتكون؟ clear زي + +161 +00:13:43,300 --> 00:13:46,620 +اللي هو initially comfortable وبعد الترميش ايش + +162 +00:13:46,620 --> 00:13:47,400 +بتصبح؟ + +163 +00:13:50,970 --> 00:13:54,450 +إذا احنا اتفقنا انه before a blinking بتكون + +164 +00:13:54,450 --> 00:14:00,470 +unclear و after a blinking بتكون الهو clear انا + +165 +00:14:00,470 --> 00:14:04,730 +بنتظر منكم إجابة written scope read reflex إذا قبل + +166 +00:14:04,730 --> 00:14:08,970 +الترميش هي بتكون unclear وبعد الترميش بتكون clear + +167 +00:14:08,970 --> 00:14:14,930 +طيب الان لو كان عندى عدسة steep ايش بدى علاجها اما + +168 +00:14:14,930 --> 00:14:18,150 +بجيب small diameter او بجيب اللي هو ايه + +169 +00:14:29,290 --> 00:14:33,490 +موضوع ال complications of deposits أي بمعنى + +170 +00:14:33,490 --> 00:14:40,280 +مضاعفات الترثباتطبعا الترثبات بتعتمد على تلت شغلات + +171 +00:14:40,280 --> 00:14:44,880 +اللي خاصة في العدسات اللاصقة اللينة اول حاجة + +172 +00:14:44,880 --> 00:14:50,020 +بتعتمد على ال material of the lens يعني بمعنى انه + +173 +00:14:50,020 --> 00:14:54,240 +هل هي high water content moderate water content + +174 +00:14:54,240 --> 00:14:59,860 +low water content هذه واحدة اذا كانت high water + +175 +00:14:59,860 --> 00:15:06,340 +content ميت بيكون ال deposit اعلى ولا اقلأعلى + +176 +00:15:06,340 --> 00:15:11,440 +وامتازة منطقيا كل ما كان high water content او + +177 +00:15:11,440 --> 00:15:14,920 +moderate water content بكون كمية ال deposit اعلى + +178 +00:15:14,920 --> 00:15:20,900 +النقطة التانية موضوع ال wear الارتداء للعدسة الان + +179 +00:15:20,900 --> 00:15:25,760 +الشخص كل ما زاد من ارتداء العدسة اللاصقة اللينة + +180 +00:15:25,760 --> 00:15:30,300 +هيكون معرض اكتر لايش لحدوث اللي هو ال deposits + +181 +00:15:31,400 --> 00:15:36,900 +والنقطة التالتة و هي الأهم موضوع حياة العدسة الآن + +182 +00:15:36,900 --> 00:15:42,780 +مثلا إيمان عندها عدسة quarterly for three months + +183 +00:15:42,780 --> 00:15:48,040 +راحت لبستها semi-annual لمدة ست شهور هذه العدسة + +184 +00:15:48,040 --> 00:15:53,260 +بتكون معرضة أكتر لحدوث مين ال deposits واضحة و قد + +185 +00:15:53,260 --> 00:15:56,780 +تكون ان هي مش شاعرة في هذا التغير أو في ال + +186 +00:15:56,780 --> 00:15:58,040 +variable vision + +187 +00:16:01,540 --> 00:16:05,860 +إذا الـ number one decrease in vision حيقل الرؤية + +188 +00:16:05,860 --> 00:16:10,060 +في العدسة اللاصقة اللينة طبعا احنا بنعرف ان العدسة + +189 +00:16:10,060 --> 00:16:14,340 +بتكون transparent من ال properties الصفات او ال + +190 +00:16:14,340 --> 00:16:18,000 +characteristics لها يما بصير تراكم لات deposit + +191 +00:16:18,000 --> 00:16:24,540 +بصير unclear او opaque number two red and + +192 +00:16:24,540 --> 00:16:31,200 +irritable eye طيب هان ال red eye من وين جاي؟احنا + +193 +00:16:31,200 --> 00:16:36,520 +بنعرف انه العدسة لو زاد فيها اللي هو التراكمات او + +194 +00:16:36,520 --> 00:16:41,240 +الـ deposits هتعمل ايش؟ dry eye symptoms و من ضمن + +195 +00:16:41,240 --> 00:16:45,060 +ال symptoms لـ dry eye هي عبارة عن ال red eye، + +196 +00:16:45,060 --> 00:16:48,820 +okay؟ اذا هان ال red eye جاية من ضمن ال symptoms + +197 +00:16:48,820 --> 00:16:54,460 +لمين؟ لال dry eyeأيضا حيصير هناك ايش irritation + +198 +00:16:54,460 --> 00:16:58,860 +تهيوج في العين يعني المريض هيصبح uncomfortable غير + +199 +00:16:58,860 --> 00:17:01,580 +مرتاح مع العدسة اللاصقة + +200 +00:17:05,000 --> 00:17:09,160 +An increase in the mass of the lens أي زيادة في + +201 +00:17:09,160 --> 00:17:13,900 +كتلة العدسة ال mass which may affect the fit of + +202 +00:17:13,900 --> 00:17:19,220 +the lens.ببساطة كل ما زادت كتلة العدسة هيقل الحركة + +203 +00:17:19,220 --> 00:17:24,140 +فممكن انه انا كاخصائي اظن ان العدسة إيش هي steep + +204 +00:17:29,120 --> 00:17:34,120 +Changes in the parameters of the lens الآن تراكم + +205 +00:17:34,120 --> 00:17:39,440 +الـ Deposit أيضًا هيغير من الـ curvature للعدسة أو + +206 +00:17:39,440 --> 00:17:44,380 +هيغير من الـ diameter للعدسة أو هتلاحظ مثلًا هيصير + +207 +00:17:44,380 --> 00:17:50,060 +في هناك تغيرات في أطراف العدسة which may cause the + +208 +00:17:50,060 --> 00:17:55,380 +lens to tighten إذا هذا ممكن أنه يجعل العدسة + +209 +00:17:55,380 --> 00:17:55,940 +escape + +210 +00:18:00,420 --> 00:18:04,500 +decrease in the oxygen transmission of the lens + +211 +00:18:04,500 --> 00:18:09,660 +تراكم هذه الـ deposit هيعيق من أيش؟ من كمية + +212 +00:18:09,660 --> 00:18:14,000 +الأكسجين اللي هتدخل على الكورنية أو الـ anterior + +213 +00:18:14,000 --> 00:18:19,100 +surface الكورنية وهذا هيقود إلى أيش؟ الhypoxia و + +214 +00:18:19,100 --> 00:18:25,020 +الhypercapnia طبعا الhypoxia و الhypercapnia هتعمل + +215 +00:18:25,020 --> 00:18:29,760 +حاجة مهمة بنسميها الميوتك لمين؟ + +216 +00:18:37,850 --> 00:18:47,030 +ميوتك زائد ميجريشن ميجريشن بمعنى نكروزز of + +217 +00:18:47,030 --> 00:18:51,990 +epithelial + +218 +00:18:51,990 --> 00:18:55,170 +cell + +219 +00:18:55,170 --> 00:18:57,110 +activity + +220 +00:19:00,850 --> 00:19:03,590 +بالتالي هذا بيقود للهايبوكسيا بالاضافة + +221 +00:19:03,590 --> 00:19:12,450 +للهايباربكاميا Increase + +222 +00:19:12,450 --> 00:19:16,590 +in the protein antigen factor on the lens which + +223 +00:19:16,590 --> 00:19:22,590 +may cause الآن احنا اتفقنا ان في هناك دايما صراع + +224 +00:19:22,590 --> 00:19:27,550 +مستمر ما بين البكتيريا و ال antibacterial factor + +225 +00:19:28,610 --> 00:19:34,230 +واضحة؟ طبعا اي انتصار لطرف اذا مثلا البكتيريا + +226 +00:19:34,230 --> 00:19:38,610 +انتصرت بتعمل مباشرة اختراق لمين؟ للكورنيا وممكن + +227 +00:19:38,610 --> 00:19:42,830 +هذا بيؤدي الى الـ corneal infectionاذا الـ + +228 +00:19:42,830 --> 00:19:48,510 +Antibacterial factor انتصر، هيعمل حاجة بنسميها + +229 +00:19:48,510 --> 00:19:52,670 +protein يعني بمعنى ان الترثبات كلها هيتها وين + +230 +00:19:52,670 --> 00:19:58,090 +هتتراكم على سطح العدسة فهتعمل اللي هو deposits in + +231 +00:19:58,090 --> 00:20:01,470 +the front surface of the lens وبالتالي هتعمل + +232 +00:20:01,470 --> 00:20:05,750 +variable لمين لل vision طبعا هذه هتكون ايش؟ مع + +233 +00:20:05,750 --> 00:20:10,110 +مرور فترة حياة العدسة، انه كل ما طالت فترة حياة + +234 +00:20:10,110 --> 00:20:14,820 +العدسةهذا ايش هيسبب ان ال giant papillary + +235 +00:20:14,820 --> 00:20:20,270 +conjunctivitis انفلامش اللاهالكون جان تايفا وهذه + +236 +00:20:20,270 --> 00:20:23,650 +ستكون في ال upper eyelid واعتقد انه اخدنا في + +237 +00:20:23,650 --> 00:20:27,690 +المعمل كيف انه بنعمل averted لل upper eyelid + +238 +00:20:27,690 --> 00:20:32,730 +وبنشوف هل هي mild, moderate, severe او اللي هو + +239 +00:20:32,730 --> 00:20:37,190 +مابيكونش يعني normal a grade zero طبعا الشخص لما + +240 +00:20:37,190 --> 00:20:41,230 +بيكون عنده significant بتكون اما moderate او + +241 +00:20:41,230 --> 00:20:44,110 +severe الشكل هذا الصورة + +242 +00:20:49,010 --> 00:20:54,030 +طبعا ال giant papillary conjunctivitis هي تعتبر ال + +243 +00:20:54,030 --> 00:20:59,090 +most common cause مع ارتدائش العدسات اللاصقة + +244 +00:20:59,090 --> 00:21:00,070 +اللينة + +245 +00:21:02,300 --> 00:21:05,840 +أيضاً عندنا Corneal and conjunctival inflammatory + +246 +00:21:05,840 --> 00:21:10,020 +response أي تانفلاميشن في ال Cornea أو ال + +247 +00:21:10,020 --> 00:21:14,720 +conjunctiva بيعمل ايه؟ اللي هو ال protein انتيجين + +248 +00:21:14,720 --> 00:21:19,080 +وبالتالي بيؤثر على الرؤية للعدسة اللاصقة + +249 +00:21:23,410 --> 00:21:29,170 +طيب، الآن الـ soft lenses العدسات اللاصقة اللينة + +250 +00:21:29,170 --> 00:21:33,710 +وضيفه أيضًا الـ soft trick contact lenses بدها + +251 +00:21:33,710 --> 00:21:39,550 +تكون ideal لمين؟ يعني مثالية لأي الأشخاص + +252 +00:21:42,880 --> 00:21:49,200 +number one individuals الأفراد أو الأشخاص who have + +253 +00:21:49,200 --> 00:21:53,800 +given up wearing rigid lenses because of the + +254 +00:21:53,800 --> 00:21:58,580 +irritation. إذا هو مش قادر يعمل ايه؟ adaptation مع + +255 +00:21:58,580 --> 00:22:03,650 +العدسة اللاصقة ايه؟لكن في لها ضوابط او في لها + +256 +00:22:03,650 --> 00:22:07,530 +criteria يعني الان واحد مثلا بيكون عنده corneal + +257 +00:22:07,530 --> 00:22:11,730 +cylinder هل بنفعدي ال soft contact lenses او اللي + +258 +00:22:11,730 --> 00:22:18,070 +هو ال ال software ال contact lenses؟ ايش رايكم؟ + +259 +00:22:18,070 --> 00:22:25,510 +الان مثلا مريض له ال best option كان RGBروحت انا + +260 +00:22:25,510 --> 00:22:29,050 +مثلا اديته soft contact lenses او soft trick + +261 +00:22:29,050 --> 00:22:33,770 +contact lenses هل هذا الإجراء صحيح ولا خطأ؟ ايش + +262 +00:22:33,770 --> 00:22:37,050 +رأيكم؟ + +263 +00:22:37,050 --> 00:22:41,740 +تفضليصحيح لو كان إنه ممكن نعمله ردارة إنه للسليندر + +264 +00:22:41,740 --> 00:22:44,120 +إنه مع العدسة الصوف أما لو كان عنده زي ال + +265 +00:22:44,120 --> 00:22:47,740 +keratoconus إنه كان ضروري إنه يلبس العدى فلازم + +266 +00:22:47,740 --> 00:22:51,980 +يعني أن أولها لازم يعمل عملية معينة عملية إنه + +267 +00:22:51,980 --> 00:22:54,960 +علشان ال keratoconus مايزدش لإن مش راح نقدر نوقفه + +268 +00:22:54,960 --> 00:23:01,110 +بال RGB و ال soft راح يزيد بالتاليطيب انا الإجابة + +269 +00:23:01,110 --> 00:23:05,090 +الأولى تعطيك صحيحة انه الان واحد عنده مثلا cornial + +270 +00:23:05,090 --> 00:23:09,330 +cylinder بروح بلبسه soft contact lenses بعمله over + +271 +00:23:09,330 --> 00:23:14,230 +فجيها glasses او over refraction يعني بلبس عدسة + +272 +00:23:14,230 --> 00:23:18,910 +لاصقة مع نضارة لكن انا بدى نبه مين ال patient لان + +273 +00:23:18,910 --> 00:23:22,910 +مش كل الناس يعني بكون متقبل هذا الأمر هو في الآخر + +274 +00:23:22,910 --> 00:23:27,670 +بديلبس عدسة لاصقة عشان يرتاح من مين من النضارةطيب + +275 +00:23:27,670 --> 00:23:32,610 +في حالة ال keratoconus لأ خاصة يما تكون early + +276 +00:23:32,610 --> 00:23:36,230 +stage keratoconus الحل الأول هو عبارة عن ال + +277 +00:23:36,230 --> 00:23:41,690 +glasses، الحل الأول هو عبارة عن ال glasses بعد ذلك + +278 +00:23:41,690 --> 00:23:45,810 +بيجي ال RGB من ثم ال cross linking من ثم ال index + +279 +00:23:45,810 --> 00:23:49,390 +و آخر حاجة مين؟ اللي هي ال final stage ال + +280 +00:23:49,390 --> 00:23:50,890 +keratoiblastic + +281 +00:23:53,260 --> 00:23:57,920 +أول حل في عملية كراءة كوناس هو عبارة عن الـ + +282 +00:23:57,920 --> 00:23:58,320 +glasses + +283 +00:24:01,480 --> 00:24:07,240 +أو الصعوبات في إبقاء ريجد ديالي ويرينج مستقبل انه + +284 +00:24:07,240 --> 00:24:11,420 +مش قادر يعمل program معين لارتداء العدسة اللاصقة + +285 +00:24:11,420 --> 00:24:15,580 +الصلبة يعني بنقوله مثلا اول يوم ارتديها فقط ساعتين + +286 +00:24:15,580 --> 00:24:19,800 +ومش قادر يتحملها يعني discomfort في الساعتين فهنا + +287 +00:24:19,800 --> 00:24:24,160 +بدنا لازم نتوقف نوقف المريض عن ارتداء العدسة + +288 +00:24:24,160 --> 00:24:26,180 +اللاصقة الصلبة + +289 +00:24:28,820 --> 00:24:33,260 +Number two intermittent wearers الأشخاص اللي + +290 +00:24:33,260 --> 00:24:37,460 +بيرتديوا العدسات اللاصقة بشكل مؤقت زي مثلا + +291 +00:24:37,460 --> 00:24:42,960 +football players زي مثلا عندنا ال speakers زي ال + +292 +00:24:42,960 --> 00:24:47,800 +actors كل هدول الأشخاص أي طالب مثلا فيكم عندها + +293 +00:24:47,800 --> 00:24:52,320 +نفترض اللي هو convocation احتفال تخرج لفترة زمانية + +294 +00:24:52,320 --> 00:24:59,350 +قصيرة بدها ترتدي مين؟ العدسة اللاصقة اللينةو نفس + +295 +00:24:59,350 --> 00:25:03,390 +الحاجة ما أخد إبعين الاعتبار موضوع مين ال cylinder + +296 +00:25:03,390 --> 00:25:09,550 +Such as a public speakers or actors who want to + +297 +00:25:09,550 --> 00:25:12,810 +wear their lenses only occasionally occasionally + +298 +00:25:12,810 --> 00:25:14,050 +بمعنى أحيانا + +299 +00:25:18,190 --> 00:25:25,550 +Industrial workers wear the fear of losing a lens + +300 +00:25:25,550 --> 00:25:30,450 +at work can be very disrupting soft lenses rarely + +301 +00:25:30,450 --> 00:25:36,900 +fall out طبعا هذه النقطة هي تعتبر من ضمن إيش؟الـ + +302 +00:25:36,900 --> 00:25:41,240 +contra indication لـ ال contact lenses لكن بعض + +303 +00:25:41,240 --> 00:25:46,680 +الأشخاص مثلا بيشتغل في ال industrial works أو مثلا + +304 +00:25:46,680 --> 00:25:52,020 +في ال chemicals lab بصر على أنه يلبس عدسة لاصقة + +305 +00:25:52,020 --> 00:25:57,020 +فبيكون عند الحل الوحيد إما soft contact lenses أو + +306 +00:25:57,020 --> 00:26:00,780 +soft track contact lenses واضحة الفكرة؟ هذا إذا + +307 +00:26:00,780 --> 00:26:05,620 +المريض أثرالان مش انت ما بيجي المريض، اول حاجة بدك + +308 +00:26:05,620 --> 00:26:09,840 +تعرف في موضوع ال motivation، الحافظ النقطة التانية + +309 +00:26:09,840 --> 00:26:14,200 +موضوع ال occupation، الوظيفة طيب، الان بيشتغل هو + +310 +00:26:14,200 --> 00:26:19,680 +في مواد كيمويةهل تعتبر من ال indication ولا ال + +311 +00:26:19,680 --> 00:26:22,700 +contra indication للعدسة اللاصقة؟ Contra + +312 +00:26:22,700 --> 00:26:26,420 +indication لكن إذا المريض أثر على أنه بده يرتدي + +313 +00:26:26,420 --> 00:26:31,440 +عدسة لاصقة لينة أو بده يرتدي عدسة لاصقة، بدي + +314 +00:26:31,440 --> 00:26:36,150 +الخيار الأفضل له مين؟ ال soft contact lensesليش؟ + +315 +00:26:36,150 --> 00:26:40,150 +لأنه احنا عرفنا ان ال poor structure إلها أقل من + +316 +00:26:40,150 --> 00:26:44,050 +مين من ال hard contact lenses فبالتالي ممكن انه ما + +317 +00:26:44,050 --> 00:26:48,530 +تعمل عملية امتصاص لمين؟ للكيميكال أو ابتعمل لكن + +318 +00:26:48,530 --> 00:26:54,110 +بدرجة أقل من ال hard contact lenses okay النقطة + +319 +00:26:54,110 --> 00:26:58,270 +التانية انه صعوبة وقوحة للعدسة لأنه مااخد كل شكل + +320 +00:26:58,270 --> 00:27:02,770 +القرنية ال + +321 +00:27:02,770 --> 00:27:08,520 +fake patients وهذه خاصة وين؟في الأطفال اذا + +322 +00:27:08,520 --> 00:27:12,840 +especially in the children طفل مثلا انولد + +323 +00:27:12,840 --> 00:27:16,860 +congenital cataract لازم يعمله عملية ال cataract + +324 +00:27:16,860 --> 00:27:21,020 +as soon as possible صحيح الان احنا ما زرعناش عدسة + +325 +00:27:21,020 --> 00:27:24,180 +في ال anterior او ال posterior chamber بيكون عندنا + +326 +00:27:24,180 --> 00:27:28,140 +الحل الوحيد هو عبارة عن مين ال contact lenses اللي + +327 +00:27:28,140 --> 00:27:29,260 +هي عبارة عن ال soft + +328 +00:27:35,230 --> 00:27:40,290 +Impatient with the prolonged routine in the + +329 +00:27:40,290 --> 00:27:44,070 +following the rigid lens wearing schedule بعض + +330 +00:27:44,070 --> 00:27:47,850 +الأشخاص الكبار سواء ال males أو ال females ما + +331 +00:27:47,850 --> 00:27:54,780 +عندهمش قدرة على تحمل وقت طويل لعملية إيه؟المشي فيه + +332 +00:27:54,780 --> 00:27:58,920 +اللي هو program معين للعدسات اللاصقة الصلبة فبيكون + +333 +00:27:58,920 --> 00:28:03,620 +الحل الوحيد امامي اما ال soft contact lenses او ال + +334 +00:28:03,620 --> 00:28:11,500 +soft direct contact lenses طيب الان لكن في الأشخاص + +335 +00:28:11,500 --> 00:28:15,420 +الكبار في السن في نقطة مهمة ان ال sensitivity هان + +336 +00:28:15,420 --> 00:28:19,340 +بتكون عالية ولا lowإذا دايما ال cornea ال + +337 +00:28:19,340 --> 00:28:23,480 +sensitivity عنده قليلة فبتلاحظ ان هو بعمل + +338 +00:28:23,480 --> 00:28:28,440 +adaptation لل RGB أسرع من مين من ال young اللي هو + +339 +00:28:28,440 --> 00:28:34,700 +الشباب طيب لو انا طلبت منكم اللي هو حالات أخرى + +340 +00:28:34,700 --> 00:28:38,860 +بيكون فيها ال soft contact lens أو ال software + +341 +00:28:38,860 --> 00:28:43,020 +contact lenses هي ال ideal المثالية زي ايش مثلا؟ + +342 +00:28:48,570 --> 00:28:53,950 +أخدنا مثلا انه هي تعتبر good option في حالة مين ال + +343 +00:28:53,950 --> 00:28:58,450 +spherical refractive error مع التوريكورنية صح ولا + +344 +00:28:58,450 --> 00:29:02,870 +لا الحالة التانية يما يكون ما عندي انه فقط عندي ال + +345 +00:29:02,870 --> 00:29:05,850 +spherical refractive error هي تعتبر ال best option + +346 +00:29:05,850 --> 00:29:12,010 +واضح في حالة مثلا موضوع ال ال activities الرياضات + +347 +00:29:12,010 --> 00:29:15,190 +بشكل مختلف هي تعتبر الحل الأفضل + +348 +00:29:18,510 --> 00:29:26,230 +بتقرر مع ال RGB؟ اه ايش يعني؟ يعني دخول + +349 +00:29:26,230 --> 00:29:30,510 +ال foreign body و الحصاوة يعني اقل من دخولها اه بس + +350 +00:29:30,510 --> 00:29:33,950 +هذه عفوا تعتبر من ضمن ال advantages لها لكن انا + +351 +00:29:33,950 --> 00:29:38,010 +بقول when ان هي حالات بتكون ideal مثالية يعني جزء + +352 +00:29:38,010 --> 00:29:41,630 +ان اشخاص بتعرضوا ل foreign body بشكل مستمر قد تكون + +353 +00:29:41,630 --> 00:29:45,510 +ان ال soft contact lenses هي الخيار الأفضل + +354 +00:29:49,490 --> 00:29:54,130 +عنا الآن ال bandage contact lenses ال bandage + +355 +00:29:54,130 --> 00:29:59,050 +contact lenses الغرض منها دايما هي عبارة عن ال + +356 +00:29:59,050 --> 00:30:05,370 +treatment او ال therapeutic العلاج في عنا نوعين من + +357 +00:30:05,370 --> 00:30:11,130 +هذه العدسات النوع الاول therapeutic use of bandage + +358 +00:30:11,130 --> 00:30:19,850 +lenses يعني استخدام علاجي لهذا النوع من العدساتزي + +359 +00:30:19,850 --> 00:30:25,050 +number one عندنا ال flexibility المرونة او اليونة + +360 +00:30:25,050 --> 00:30:28,690 +يعني بمعنى ال properties الخواص او ال + +361 +00:30:28,690 --> 00:30:32,850 +characteristics لها واحد flexibility طب من وين + +362 +00:30:32,850 --> 00:30:40,570 +جاية ال flexibility لهذا النوع من العدسات؟ بالضبط + +363 +00:30:40,570 --> 00:30:44,890 +ان في اول حاجة استخدام مادة ال silicon اللي احنا + +364 +00:30:44,890 --> 00:30:48,730 +قلنا عبارة عن second generation صحيح؟ تفضلي + +365 +00:30:54,040 --> 00:30:57,400 +إنه فيه اللي هي كمية ال water content مع ال + +366 +00:30:57,400 --> 00:31:01,000 +silicon اتنين مع بعض هذه بتديها إيش flexibility + +367 +00:31:01,000 --> 00:31:08,020 +بالإضافة لل durability بالضبط + +368 +00:31:08,020 --> 00:31:15,320 +موضوع المتانة أيضا هذا النوع من العدسات بتتميز + +369 +00:31:15,320 --> 00:31:21,250 +إنها too thinإذا مدام هي too thin إذا بتديني أول + +370 +00:31:21,250 --> 00:31:25,690 +حاجة flexibility يعني بمعنى زي ال daily disposable + +371 +00:31:25,690 --> 00:31:30,110 +lenses جديش اللي هو فيها flexibility مرونة عالية + +372 +00:31:30,110 --> 00:31:35,210 +كتير فبتلاقي إن ال oxygen ال transmissibility very + +373 +00:31:35,210 --> 00:31:41,770 +high طيب الشوق الحياة فيها short ولا long life؟ + +374 +00:31:41,770 --> 00:31:51,970 +short life بالضبطنومبر ثلاثة مريحة من السهل ان + +375 +00:31:51,970 --> 00:31:59,030 +المريض يستعمل العدسة الجيل الأول من هذا النوع من + +376 +00:31:59,030 --> 00:32:06,110 +العدسات كان فيها إبلانو refractive error لكن الجيل + +377 +00:32:06,110 --> 00:32:09,070 +التاني تم إضافة مادة الكلاجين + +378 +00:32:11,950 --> 00:32:16,930 +فصارت كلاجين bandage contact lenses ووضعوا فيها + +379 +00:32:16,930 --> 00:32:20,990 +مثلا ماينوس واحد او ماينوس اتنين يعني عملت عملية + +380 +00:32:20,990 --> 00:32:23,870 +تصحيح لمين لل refractive errors + +381 +00:32:27,410 --> 00:32:32,090 +أيضا هذا النوع من العدسات it may apply as drug + +382 +00:32:32,090 --> 00:32:37,550 +delivery devices بعض أنواع هذه العدسات بتم حقن + +383 +00:32:37,550 --> 00:32:42,450 +فيها أنواع معينة من ال drug وبالتالي ال anterior + +384 +00:32:42,450 --> 00:32:47,890 +surface للكورنية بتم امتصاصهايعني هذه بتتموين خلال + +385 +00:32:47,890 --> 00:32:51,790 +العملية انه بلبس المريض بانديش contact lenses + +386 +00:32:51,790 --> 00:32:56,150 +بتديه نوع معين من ال drop او نوع معين من ال + +387 +00:32:56,150 --> 00:33:01,410 +treatment عشان انه تمتصه من ال anterior surface of + +388 +00:33:01,410 --> 00:33:09,090 +the cornea طبعا + +389 +00:33:09,090 --> 00:33:10,950 +هي small refractive error + +390 +00:33:14,830 --> 00:33:18,230 +طبعا ال bandage contact lenses اكتر استخدامات + +391 +00:33:18,230 --> 00:33:22,270 +الهوين في ال refractive surgeries او مثلا في عملية + +392 +00:33:22,270 --> 00:33:26,410 +الليزي اي عملية بلاحظ فيها الدكتور انه ممكن يصير + +393 +00:33:26,410 --> 00:33:30,090 +فيه inflammation او infection للمريض بيحاول انه + +394 +00:33:30,090 --> 00:33:35,010 +يلبسوا ايش ال .. ال bandage contact lenses بالضبط + +395 +00:33:35,010 --> 00:33:38,210 +انه مافي regeneration لمين؟ للابيثيليا + +396 +00:33:41,300 --> 00:33:45,300 +The corneal uses of therapeutic lenses أيضًا + +397 +00:33:45,300 --> 00:33:50,500 +الاستخدامات الأخرى لهذا النوع من العدسات number + +398 +00:33:50,500 --> 00:33:54,980 +one promote healing بتعمل عملية تسريع في اللي هو + +399 +00:33:54,980 --> 00:34:00,120 +العلاج أو الشفاء للمريض provide comfort بتزود له + +400 +00:34:00,120 --> 00:34:03,980 +الراحة لأنه زي ما اتفقنا فيها high DK على T وهي + +401 +00:34:03,980 --> 00:34:10,120 +بتتميز انه flexibilityprotect the eye بتحمي العين + +402 +00:34:10,120 --> 00:34:13,940 +من ال infection أو ال inflammatory okay improve + +403 +00:34:13,940 --> 00:34:18,740 +the corneal draft يعني كيف أنه الآن لو واحد عنده + +404 +00:34:18,740 --> 00:34:25,410 +مريض post draft بتعمل عملية تحسين لهذا المريضيعني + +405 +00:34:25,410 --> 00:34:29,510 +بمعنى اخر انه عنده irregularity لل surface of the + +406 +00:34:29,510 --> 00:34:33,850 +cornea فبنستخدم هذا النوع من العدسات قبل عملية + +407 +00:34:33,850 --> 00:34:37,710 +مثلا ال intact الحلقات او عملية مثلا ال cross + +408 +00:34:37,710 --> 00:34:44,970 +linking عشان عملية التثبيت خليني + +409 +00:34:44,970 --> 00:34:48,590 +جف ان شاء الله ل ال indications for therapeutic + +410 +00:34:48,590 --> 00:34:54,540 +lenses في اي سؤال اي استفسار؟واضح ان شاء الله + +411 +00:34:54,540 --> 00:34:56,640 +الأمور اعطيكم العافية + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/jfd3UxR95_E.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/jfd3UxR95_E.srt new file mode 100644 index 0000000000000000000000000000000000000000..82032ab5bba67029b1c69d1bc6ef0f3ba6beed7c --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/jfd3UxR95_E.srt @@ -0,0 +1,1691 @@ +1 +00:00:21,110 --> 00:00:23,830 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:23,830 --> 00:00:29,590 +وبركاته ومرحباً لكم جميعًا سنكمل إن شاء الله في + +3 +00:00:29,590 --> 00:00:34,790 +موضوع الـ soft contact lenses modalities أنواع أو + +4 +00:00:34,790 --> 00:00:40,790 +أنماط أو أشكال العدسات اللاصقة اللينة سنبدأ اليوم + +5 +00:00:40,790 --> 00:00:46,410 +في موضوع silicon hydrogel extended wear disposable + +6 +00:00:46,410 --> 00:00:52,880 +lenses بداية تم إضافة مادة السيليكون لزيادة + +7 +00:00:52,880 --> 00:00:59,620 +الوتابيلاتي المتانة للعدسة Hydrogel بمعنى water + +8 +00:00:59,620 --> 00:01:04,680 +water loving or hydrophilic مادة محبة للماء + +9 +00:01:04,680 --> 00:01:11,020 +Extended wear بتم ارتدائها لمدة أسبوع واحد وبعد + +10 +00:01:11,020 --> 00:01:17,100 +ذلك بتم التخلص منها طبعًا في هذا النوع من العدسات + +11 +00:01:17,710 --> 00:01:24,350 +بتم استخدام high Dk على T حتى أن تكون العدسة + +12 +00:01:24,350 --> 00:01:29,850 +thinning نحيفة و بتسمح لأكبر كمية من ال oxygen أن + +13 +00:01:29,850 --> 00:01:36,270 +تدخل القرنية مدام هي disposable lens إذا العدسة + +14 +00:01:36,270 --> 00:01:41,310 +بلبسها المريض لفترة زمنية قصيرة وبعد ذلك بتتم + +15 +00:01:41,310 --> 00:01:42,690 +التخلص منها + +16 +00:01:45,470 --> 00:01:50,930 +أول ما تم التفكير في هذا الجيل من العدسات كان في + +17 +00:01:50,930 --> 00:01:56,430 +سنة 1999 كان + +18 +00:01:56,430 --> 00:02:03,670 +المقصود بشكل أساسي هو موضوع ال extended wear وتم + +19 +00:02:03,670 --> 00:02:08,040 +تعريف ال extended wear فيما سبق Silicon is + +20 +00:02:08,040 --> 00:02:14,140 +hydrophobic إذا مادة السيليكون هي كارهة للماء لكن + +21 +00:02:14,140 --> 00:02:19,020 +إيش عملت مادة السيليكون surface modified يعني عملت + +22 +00:02:19,020 --> 00:02:27,900 +تعديل للسطح by a plasma batch process بلازما باتش + +23 +00:02:27,900 --> 00:02:34,170 +بروسس هي عملية دفع البلازما من خلال هذه العملية أن + +24 +00:02:34,170 --> 00:02:39,790 +بتتم تجميع ال tears كله على سطح العدسة وبيمنع دخول + +25 +00:02:39,790 --> 00:02:45,770 +ال tears للداخل مرة أخرى، إذا بيكون هناك فيه + +26 +00:02:45,770 --> 00:02:51,530 +جزيئات في العدسة أو مسامات معينة في هذه العملية + +27 +00:02:51,530 --> 00:02:57,450 +هيمنع من دخول أي ال tears للداخل وكل ال tears + +28 +00:02:57,450 --> 00:03:02,610 +بتجمع وين على سطح العدسة طبعًا ببساطة عشان يحافظ + +29 +00:03:02,610 --> 00:03:07,940 +على مرونة العدسة Okay؟ لأن احنا عارفين أن مادة + +30 +00:03:07,940 --> 00:03:13,180 +السيليكون بتزود من ال wetability المتانة فهي لو .. + +31 +00:03:13,180 --> 00:03:18,460 +وهي hydrophobic صح؟ هذه العملية ما ننسى اسم العدسة + +32 +00:03:18,460 --> 00:03:23,440 +أن هي تعتبر إيه؟ Hydrogel Okay؟ يعني بمعنى أن محب + +33 +00:03:23,440 --> 00:03:29,160 +للماء فهذه العملية ببساطة بتعمل تعديل لسطح العدسة و + +34 +00:03:29,160 --> 00:03:33,560 +كل ال tears هيتجمع على سطح العدسة و بتمنع من دخوله + +35 +00:03:33,560 --> 00:03:40,330 +للداخل يعني بمعنى أن بتحافظ على مرونة العدسة طبعًا + +36 +00:03:40,330 --> 00:03:46,610 +هذه العملية ال plasma batch process زودت من سعر + +37 +00:03:46,610 --> 00:03:52,190 +العدسة بشكل بسيط يعني slightly high cost أو + +38 +00:03:52,190 --> 00:03:58,480 +slightly higher كان سعر العدسة مرتفع نسبياً clean + +39 +00:03:58,480 --> 00:04:03,260 +and disinfect the lenses only occasionally or not + +40 +00:04:03,260 --> 00:04:08,540 +at all احنا بنعرف أن فترة حياة العدسة قصيرة فأنظمة + +41 +00:04:08,540 --> 00:04:13,460 +التنظيف و التعقيم لهذا النوع من العدسات هتكون + +42 +00:04:13,460 --> 00:04:18,460 +occasionally أحيانًا أو اللي هو نادرًا rarely أو + +43 +00:04:18,460 --> 00:04:25,000 +ما هتكونش مطلقًا okay minimizing the cost of lens + +44 +00:04:25,000 --> 00:04:29,740 +maintenance نرجع مرة ثانية، مدام فترة حياة العدسة + +45 +00:04:29,740 --> 00:04:35,120 +قصيرة، إذا أنظمة المحافظة عليها إيش هتكون؟ تقل أو + +46 +00:04:35,120 --> 00:04:40,280 +في بعض الأحيان، لا تحتاج إلى أنظمة محافظة على هذا + +47 +00:04:40,280 --> 00:04:42,100 +النوع من العدسات + +48 +00:04:45,080 --> 00:04:50,580 +الآن المريض هيلبسها لمدة أسبوع واحد وبعد ذلك بتخلص + +49 +00:04:50,580 --> 00:04:55,860 +منها فبيطلب من المريض أن كل صباح يعمل ال + +50 +00:04:55,860 --> 00:05:00,460 +lubricating eyedrop يعني قطرة قطرة okay هذا بتعمل + +51 +00:05:00,460 --> 00:05:06,970 +عملية ترطيب للعدسة وقت إيش؟ By the patient on + +52 +00:05:06,970 --> 00:05:11,430 +waking each morning يعني لما يستيقظ من أنهم لازم + +53 +00:05:11,430 --> 00:05:16,390 +أن يعمل هذه العملية أن تقطير قطرة الهدف منها + +54 +00:05:16,390 --> 00:05:22,030 +اللي هو ترطيب العدسة و سطح القرنية حتى ما يصير عند + +55 +00:05:22,030 --> 00:05:23,910 +المريض corneal edema + +56 +00:05:28,810 --> 00:05:33,930 +الجيل الثاني من هذا النوع من العدسات كان الهدف + +57 +00:05:33,930 --> 00:05:38,510 +منها أو المقصود بشكل أساسي أن تكون daily wear + +58 +00:05:38,510 --> 00:05:44,410 +يعني يتم .. يتم ارتداء العدسة لمدة يوم واحد فقط + +59 +00:05:48,130 --> 00:05:52,530 +أول ما تم التفكير في هذا الجيل من العدسات في عام + +60 +00:05:52,530 --> 00:05:57,210 +الألف .. في عام ألفي وأربعة يعني هي تعتبر update + +61 +00:05:57,210 --> 00:06:02,550 +لمين؟ للـ extended wear أو اللي هي بمعنى أنه جيل + +62 +00:06:02,550 --> 00:06:08,910 +آخر second generation للجيل الأول these lenses + +63 +00:06:08,910 --> 00:06:14,270 +هذا النوع من العدسات have a lower silicon content + +64 +00:06:15,200 --> 00:06:20,560 +احنا ما هنحتاج لل silicon بدرجة كبيرة لأن أنا مش + +65 +00:06:20,560 --> 00:06:24,940 +محتاج wetability عالي في هذا النوع لأن المريض + +66 +00:06:24,940 --> 00:06:30,080 +هيلبسها يوم واحد ويتخلص منها صحيح؟ and + +67 +00:06:30,080 --> 00:06:34,700 +correspondingly higher water content إذا مدام هو + +68 +00:06:34,700 --> 00:06:40,340 +هيقلل من كمية ال silicon هيعدل زيادة في مين؟ في ال + +69 +00:06:40,340 --> 00:06:45,170 +water content إذا الـ DK على T إيش تعتبر very high + +70 +00:06:45,170 --> 00:06:50,450 +في هذا النوع من العدسات Reduce the need for + +71 +00:06:50,450 --> 00:06:55,810 +surface modification وهذا هيقلل من الحاجة لعملية + +72 +00:06:55,810 --> 00:07:01,630 +تعديل سطح العدسة يعني ما بتحتاج ل plasma batch + +73 +00:07:01,630 --> 00:07:07,170 +process Reduce manufacturing cost أيضًا هيقلل من + +74 +00:07:07,170 --> 00:07:13,520 +سعر العدسة لأنه مدة يوم واحد وبعد ذلك هيتم التخلص + +75 +00:07:13,520 --> 00:07:19,620 +منها Their oxygen transmissibility، نفاذية + +76 +00:07:19,620 --> 00:07:24,060 +الأكسجين أو دخول الأكسجين is still مازال much + +77 +00:07:24,060 --> 00:07:28,160 +higher، أعلى من مين؟ من ال traditional hydrogen + +78 +00:07:28,160 --> 00:07:31,200 +lenses، هذا المقصود فيها ال conventional daily + +79 +00:07:31,200 --> 00:07:37,880 +wear، عدسات اللبس اليومي التقليدي without the + +80 +00:07:37,880 --> 00:07:43,740 +tendency to dehydration يعني دون التوجه باتجاه من + +81 +00:07:43,740 --> 00:07:48,360 +التبخر ال dehydration اللي مصاحب مع ال high water + +82 +00:07:48,360 --> 00:07:50,000 +content materials + +83 +00:08:07,470 --> 00:08:11,270 +فنفس الحاجة هذا النوع من العدسات صحيح أن فيها + +84 +00:08:11,270 --> 00:08:16,330 +الـ DK على T high وهي تعتبر very high water content + +85 +00:08:16,330 --> 00:08:20,770 +و أيضًا تعتبر العدسة thinning لكن ما بتصل لمرحلة + +86 +00:08:20,770 --> 00:08:25,870 +أي التبخر لسطح القرنية يعني ما بتعمل dehydration + +87 +00:08:25,870 --> 00:08:28,090 +للـ corneal surface + +88 +00:08:33,840 --> 00:08:37,960 +بطلوب من كل طالبة الآن احنا خدنا ال soft contact + +89 +00:08:37,960 --> 00:08:42,020 +lens modalities بشكل عام ال conventional daily + +90 +00:08:42,020 --> 00:08:46,320 +wear وبعد ذلك أخذنا ال daily wear extended wear + +91 +00:08:46,320 --> 00:08:53,000 +تعمل كـ table كل أنواع العدسات و تضع في كل نوع من + +92 +00:08:53,000 --> 00:08:57,230 +العدسات موضوع ال cleaning موضوع ال disinfecting + +93 +00:08:57,230 --> 00:09:01,490 +موضوع ال maintenance بحيث أن تعملي تستطيع تعملي + +94 +00:09:01,490 --> 00:09:07,030 +comparison ما بين كل نوع و الآخر مثلًا التكنولوجيا + +95 +00:09:07,030 --> 00:09:10,570 +المستخدم hand lathe cutting hand molding + +96 +00:09:10,570 --> 00:09:15,210 +technology حسب كل نوع من العدسات بالنسبة ل ال cost + +97 +00:09:15,210 --> 00:09:19,550 +hand high hand low الآخر زي ما تم اللي هو مناقشته + +98 +00:09:19,550 --> 00:09:27,540 +فيما سبق فضل Okay الآن عندنا soft lens fitting and + +99 +00:09:27,540 --> 00:09:34,500 +evaluation الآن أنا كـ practitioner بدي أعرف هل + +100 +00:09:34,500 --> 00:09:38,800 +العدسة optimal fit ولا لأ يعني هل ال fitting فيها + +101 +00:09:38,800 --> 00:09:43,700 +مثالي أم لا كيف أنا بدي أعرف أن هل ال fitting في + +102 +00:09:43,700 --> 00:09:49,180 +العدسة اللاصقة مثالي أو لا وتحديدًا ال soft contact + +103 +00:09:49,180 --> 00:09:57,970 +lens number one optimal lens fit optimal lens fit + +104 +00:09:57,970 --> 00:10:01,730 +يعني بده أشوف أن هل ال fitting في العدسة مثالي أم + +105 +00:10:01,730 --> 00:10:08,110 +لا في عندنا شغلتين مهمات في العدسات اللاصقة الأمر + +106 +00:10:08,110 --> 00:10:12,930 +الأول ال comfort الراحة الأمر الثاني ال vision + +107 +00:10:12,930 --> 00:10:18,550 +الرؤية مين أهم في ال soft contact lens ال comfort + +108 +00:10:18,550 --> 00:10:24,290 +ولا ال vision ال comfort أهم بنوع ما ال comfort أهم + +109 +00:10:24,290 --> 00:10:29,290 +يعني دائمًا أنا كـ practitioner أو كـ examiner بميل ل + +110 +00:10:29,290 --> 00:10:33,850 +ال comfort أكثر من مين من ال vision يعني بمعنى أن + +111 +00:10:33,850 --> 00:10:39,330 +مريض أخذ عدسة لا ثقة ووصل النظر عنده ستة اتسعة و + +112 +00:10:39,330 --> 00:10:44,390 +مرتاح مية في المية رغم أن في عدسة أخرى وصل فيها + +113 +00:10:44,390 --> 00:10:48,890 +ستة على ستة لكن discomfort what is the benefit إيش + +114 +00:10:48,890 --> 00:10:54,300 +الفايدة؟ Okay فدائمًا ال comfort أهم من ال vision في + +115 +00:10:54,300 --> 00:10:58,880 +العدسات اللاصقة Can + +116 +00:10:58,880 --> 00:11:03,420 +be evaluated in terms of a number of parameters + +117 +00:11:03,420 --> 00:11:08,520 +إذا لما أنا بدي أشوف ال fitting مثالي أو لا للعدسة + +118 +00:11:08,520 --> 00:11:15,790 +بتتم تحديده بمجموعة من المحددات إذا هناك مجموعة من + +119 +00:11:15,790 --> 00:11:21,170 +المحددات بتم وضعها يعني مجموعة من ال criteria + +120 +00:11:21,170 --> 00:11:25,550 +مجموعة + +121 +00:11:25,550 --> 00:11:31,490 +من المعايير بتم وضعها من قبل ال practitioners عشان + +122 +00:11:31,490 --> 00:11:36,970 +يشوف هل ال fitting مناسب أم لا comfort + +123 +00:11:36,970 --> 00:11:40,530 +and vision are most important to the patient + +124 +00:11:42,930 --> 00:11:49,110 +السهلة لعينة صافية اعتبرت أفضل بشكل صغير أو لا + +125 +00:11:49,110 --> 00:11:55,840 +يعرف أن العينة تكون موجودة إذا المريض بيكون مرتاح + +126 +00:11:55,840 --> 00:11:59,980 +في العدسة اللاصقة في حالة أنه ما يكون هناك أي + +127 +00:11:59,980 --> 00:12:06,580 +تأدراك يعني لا يشعر بإدراك بوجود العدسة إذا ما + +128 +00:12:06,580 --> 00:12:10,120 +بيشعر + +129 +00:12:10,120 --> 00:12:16,200 +بأي تأدراك لوجود العدسة طبعًا في هناك مصطلحين ال + +130 +00:12:16,200 --> 00:12:22,050 +awareness و ال sensation طبعًا مختلفين عن بعض الـ + +131 +00:12:22,050 --> 00:12:26,870 +sensation أنا مجرد ما أحط العدسة بتعمل adherence + +132 +00:12:26,870 --> 00:12:33,070 +الالتصاق الكبير ما بين سطح العدسة و القرنية إذا أنا + +133 +00:12:33,070 --> 00:12:38,130 +حاولت أن أرفع العدسة هيعمل epithelium defect أو + +134 +00:12:38,130 --> 00:12:42,590 +epithelium erosion وبالتالي هحتاج فترة زمنية + +135 +00:12:42,590 --> 00:12:49,210 +لإعادة تجديد من ال epithelium إذا + +136 +00:12:49,210 --> 00:12:55,160 +الآن أنا يما بدي أدي المريض عدسة لاصقة لازم تكون + +137 +00:12:55,160 --> 00:13:01,100 +مريحة بحيث أن هو ما يشعر .. لا يشعر المريض بادراك + +138 +00:13:01,100 --> 00:13:05,920 +العدسة يعني بمعنى كيف يما تتحرك العدسة ما يشعرش أن + +139 +00:13:05,920 --> 00:13:09,980 +والله العدسة رايحة up أو down أو مثلًا right أو + +140 +00:13:09,980 --> 00:13:13,800 +left يعني بمعنى ال excessive movement ما يشعرش فيها + +141 +00:13:15,760 --> 00:13:20,940 +Excessive awareness زيادة الإدراك في العدسة المريض **للمريض** + +142 +00:13:20,940 --> 00:13:25,100 +إيش هيشعر وكأنه العدسة عبارة عن foreign body يعني + +143 +00:13:25,100 --> 00:13:30,840 +بالضبط وكأنه رمل في عينه يما بيزيد الإدراك بالعدسة + +144 +00:13:30,840 --> 00:13:34,880 +المريض بيشعر أن العدسة وكأنه رمل في عينه تحديدا ال + +145 +00:13:34,880 --> 00:13:40,360 +soft contact lens Excessive lens movement or poor + +146 +00:13:40,360 --> 00:13:46,500 +concentrationأيضا حركة العدسة هتزعج المريض كل شوية + +147 +00:13:46,500 --> 00:13:51,740 +مثلا عمل up gaze بتروح العدسة تتحرك أعلى down gaze + +148 +00:13:51,740 --> 00:13:56,940 +للأسفل right left بتتحرك بحيث أن المريض هيصبح ايش + +149 +00:13:56,940 --> 00:14:01,560 +discomfort يعني ما عندهوش راحة أو poor + +150 +00:14:01,560 --> 00:14:05,740 +concentration أو وضع العدسة مش هيكون في مكانه طبعا + +151 +00:14:05,740 --> 00:14:09,400 +احنا عارفين أن ال soft contact lens conform to the + +152 +00:14:09,400 --> 00:14:14,120 +shape of the cornea الآن يما تحكي للمريض اعمل ايه؟ + +153 +00:14:14,120 --> 00:14:19,360 +اعمل up gaze بتلاقي أن العدسة بتنزل لتحت أو مثلا + +154 +00:14:19,360 --> 00:14:23,500 +أما يعمل down gaze العدسة بتطلع لفوق واضح ال + +155 +00:14:23,500 --> 00:14:27,720 +excessive movement بالنسبة لل examiner يعني بمعنى + +156 +00:14:27,720 --> 00:14:31,420 +أن الحركة بتكون أكثر من واحد ملي متر + +157 +00:14:34,750 --> 00:14:39,410 +No sensation at all عدم الشعور بوجود العدسة بيعمل + +158 +00:14:39,410 --> 00:14:43,290 +lens adherence اللي هو التساق ما بين سطح العدسة + +159 +00:14:43,290 --> 00:14:44,110 +والقرنية + +160 +00:14:47,180 --> 00:14:53,040 +Lens defects لازم هذه من الوصاية اللي لازم وصيها + +161 +00:14:53,040 --> 00:14:58,680 +ال examiner للمريض أن كل يوم لازم تفحص العدسة و + +162 +00:14:58,680 --> 00:15:03,880 +خاصة أطراف العدسة okay لأنه ممكن يكون فيه هناك في + +163 +00:15:03,880 --> 00:15:08,300 +ال edge فيه اللي هو scratch خدش وبالتالي المريض + +164 +00:15:08,300 --> 00:15:12,160 +لما يلبس العدسة بيشعر و كأنه foreign body في داخل + +165 +00:15:12,160 --> 00:15:17,920 +العين فلازم يعمل evaluation لمدة دقيقة okay للعدسة + +166 +00:15:17,920 --> 00:15:23,560 +everyday Incompatible + +167 +00:15:23,560 --> 00:15:29,420 +care solutions may be reported as staining on lens + +168 +00:15:29,420 --> 00:15:37,220 +insertion الآن لو المريض بيستخدم محلول غير موافق + +169 +00:15:37,220 --> 00:15:41,800 +لنوع العدسة يعني في هناك محلول غير موافقة لنوع + +170 +00:15:41,800 --> 00:15:46,520 +العدسة كيف مثلا أنا بلبس عدسة conventional daily + +171 +00:15:46,520 --> 00:15:50,380 +wear بروح استخدم محلول ال hard contact lens أو + +172 +00:15:50,380 --> 00:15:54,020 +بروح استخدم محلول مثلا ال extended wear أو ال + +173 +00:15:54,020 --> 00:15:57,900 +daily wear بالتالي هذا هيعمل ايه scratches بمعنى + +174 +00:15:57,900 --> 00:16:04,180 +خدش للعدسة وهيسبب اللي هو خدش لأطراف العدسة وبعد + +175 +00:16:04,180 --> 00:16:09,420 +ذلك هيعمل شعور بال foreign body للمريض إذا + +176 +00:16:09,420 --> 00:16:13,940 +المحاليل الغير موافقة للعدسة بتعمل على تخريب + +177 +00:16:13,940 --> 00:16:21,900 +العدسة و بتعمل خدش لسطح العدسة number + +178 +00:16:21,900 --> 00:16:27,620 +two stable vision ثبات الرؤية أنتم عارفين كل شخص + +179 +00:16:27,620 --> 00:16:33,620 +بيعمل blinking ترميش صحيح لازم الرؤية في ال soft + +180 +00:16:33,620 --> 00:16:37,980 +contact lens before و after blinking تكون equal + +181 +00:16:37,980 --> 00:16:44,640 +متساوية فال stable vision relates to the correct + +182 +00:16:44,640 --> 00:16:49,300 +lens vertex power يعني بتعتمد على القوة الصحيحة + +183 +00:16:49,300 --> 00:16:54,500 +للعدسة مثلا لو نور بتلبس minus 2 لازم أديها minus + +184 +00:16:54,500 --> 00:16:59,360 +2، ما نفعش أديها minus 2.25 أو minus 2.5، هيعمل + +185 +00:16:59,360 --> 00:17:03,540 +ايه؟ تغيير في الرؤية وبالتالي أنّه ممكن يعمل + +186 +00:17:03,540 --> 00:17:08,060 +decrease أو reduce لل visual acuity عند ال + +187 +00:17:08,060 --> 00:17:13,120 +patient، إذا أول حاجة ثبات الرؤية بتعتمد على القوة + +188 +00:17:13,120 --> 00:17:15,900 +الصحيحة للعدسة اللي بتم صرفها + +189 +00:17:18,640 --> 00:17:24,780 +Good Limb Centration التمركز الجيد للعدسة والحركة + +190 +00:17:24,780 --> 00:17:31,740 +دايما أخذنا في one أن الحركة هي غير كافية لتقييم + +191 +00:17:31,740 --> 00:17:36,990 +العدسة اللاصقة ال hard في بعض الأحيان ممكن الحركة + +192 +00:17:36,990 --> 00:17:41,890 +بتخدع مين؟ ال examiner أنّه هي مثلا ال steep بتكون + +193 +00:17:41,890 --> 00:17:45,670 +flat أو العكس، optimal fit هي بتكون مثلا flat + +194 +00:17:45,670 --> 00:17:50,910 +فدايما ال movement is not enough to evaluate if + +195 +00:17:50,910 --> 00:17:55,660 +the lens is optimal or not فأول حاجة بدي أشوف أنّه + +196 +00:17:55,660 --> 00:18:00,860 +هل هي good concentration تمركزها جيد؟ أطرافها هل + +197 +00:18:00,860 --> 00:18:05,480 +هم equally؟ uniformly؟ هذه الأمور لازم تكون واضحة + +198 +00:18:05,480 --> 00:18:10,480 +بالنسبة للفاحص موضوع ال movement عندنا ال optimal + +199 +00:18:10,480 --> 00:18:15,740 +movement من 0.5 ل 1 ملي متر لكن هذه غير كافية + +200 +00:18:15,740 --> 00:18:19,620 +لتقييم العدسة اللاصقة اللينة + +201 +00:18:22,300 --> 00:18:28,060 +Good prelims tear film stability greater than + +202 +00:18:28,060 --> 00:18:32,940 +normal inter blink interval الآن كداش ال normally + +203 +00:18:32,940 --> 00:18:41,800 +blinking للأشخاص في ال one minute خمس + +204 +00:18:41,800 --> 00:18:43,780 +عشر؟ مين حكى خمس عشر؟ ال range + +205 +00:18:48,900 --> 00:18:53,100 +طبعا according to manual soft contact lens ال + +206 +00:18:53,100 --> 00:19:01,200 +normal blinking من 15 ل 20 per minute من خمسة عشر ل + +207 +00:19:01,200 --> 00:19:07,100 +عشرين الآن لازم أن يكون هنا good brilliance يعني + +208 +00:19:07,100 --> 00:19:13,710 +ثبات العدسة يكون مهم بالنسبة لمين؟ لا ال examiner + +209 +00:19:13,710 --> 00:19:19,190 +لأنّه الآن لو أنا ما فيش عندي ثبات للعدسة هتلاحظ أن + +210 +00:19:19,190 --> 00:19:22,930 +في المريض دايما عنده blinking فكل ما هو عمل + +211 +00:19:22,930 --> 00:19:27,610 +blinking الحركة تزداد وبالتالي بتعمل + +212 +00:19:27,610 --> 00:19:32,150 +unstable vision و بتعمل blurred vision لل patient + +213 +00:19:32,790 --> 00:19:37,370 +إذا tear film stability إذا ثبات ال + +214 +00:19:37,370 --> 00:19:42,350 +tear film مهم كثير greater than normal inter blink + +215 +00:19:42,350 --> 00:19:48,110 +interval يعني لازم أن يكون الثبات أكثر من الـ blinking بحيث أنّه + +216 +00:19:48,110 --> 00:19:52,880 +دايما العدسة تكون ثابتة أو + +217 +00:19:52,880 --> 00:19:57,740 +ماخدة good concentration للعدسة لمركزها جيد لو كل + +218 +00:19:57,740 --> 00:20:02,560 +المريض مثلا حرك عينه العدسة أنّه تكون follow لمين + +219 +00:20:02,560 --> 00:20:08,120 +للعين lens + +220 +00:20:08,120 --> 00:20:15,780 +movement حركة العدسة الترميش أي بمعنى تعزز post + +221 +00:20:15,780 --> 00:20:21,400 +lens tear film exchange and mixing الآن حركة + +222 +00:20:21,400 --> 00:20:27,820 +العدسة بتعزز من حركة مين؟ ال tear film طبعا احنا + +223 +00:20:27,820 --> 00:20:33,040 +دايما حكينا أن ال soft contact lens بيكون فيها + +224 +00:20:33,040 --> 00:20:38,640 +limitation من ناحية مين؟ من موضوع ال tear exchange + +225 +00:20:38,640 --> 00:20:44,990 +تبادل ال tear صحيح؟ فال lens movement بتعزز من حركة + +226 +00:20:44,990 --> 00:20:50,570 +مين؟ ال tear film movement + +227 +00:20:50,570 --> 00:20:55,110 +is quantified إذا الحركة بتتم تحديدها أو تحدد + +228 +00:20:55,110 --> 00:21:00,050 +بواسطة as the vertical change دايما بطلب من المريض + +229 +00:21:00,050 --> 00:21:05,470 +على الستلام أن يحرك العدسة vertical يعني يطلع up و + +230 +00:21:05,470 --> 00:21:11,530 +down up و down okay as the vertical change ال lens + +231 +00:21:11,530 --> 00:21:16,770 +position بدي أعرف موضع العدسة هل بتغير ولا لأ + +232 +00:21:16,770 --> 00:21:21,630 +before and after a normal blink يعني قبل وبعد ايه + +233 +00:21:21,630 --> 00:21:27,030 +الترميش أنتم عارفين المعادلة، إذا كانت العدسة + +234 +00:21:27,030 --> 00:21:32,290 +tight، هيكون حركتها أقل من قداش؟ من نص، يعني + +235 +00:21:32,290 --> 00:21:36,470 +تقريبا واحد من عشرة ملي متر، هذه بتكون ايه عاملة؟ + +236 +00:21:36,470 --> 00:21:41,150 +adherence، يعني no sensation at all، إذا كانت + +237 +00:21:41,150 --> 00:21:45,490 +حركتها أكثر من واحد، هيكون في هناك excessive + +238 +00:21:45,490 --> 00:21:51,130 +movement طبعا ال normal movement أو ال ideal + +239 +00:21:51,130 --> 00:21:56,390 +movement للعدسة اللاصقة ال soft هي 3 من 10 ملي متر + +240 +00:21:56,390 --> 00:22:00,350 +لكن من الصعب دايما نصل لهذا الرقم فاحنا دايما + +241 +00:22:00,350 --> 00:22:07,510 +بنقول ال range من 0.5 ل 1 ملي متر إذا lens + +242 +00:22:07,510 --> 00:22:12,010 +movement of less than 0.1 ملي متر can be + +243 +00:22:12,010 --> 00:22:16,460 +considered in educate إذا كانت حركتها أقل من واحد + +244 +00:22:16,460 --> 00:22:20,040 +من عشرة، بتكون غير كافية أو غير مناسبة أو غير + +245 +00:22:20,040 --> 00:22:24,700 +ملائمة، بمعنى أنّه بتعمل tight أو بتكون steep أو + +246 +00:22:24,700 --> 00:22:28,660 +بتعمل adherence ما بين ال surface للعدسة و + +247 +00:22:28,660 --> 00:22:29,360 +القرنية + +248 +00:22:32,140 --> 00:22:36,420 +movement of more than one millimeter is excessive، + +249 +00:22:36,420 --> 00:22:40,500 +إذا كانت حركتها أكثر من واحد، هتلاحظوا أنّه في هناك + +250 +00:22:40,500 --> 00:22:45,440 +excessive awareness، إدراك شديد في العدسة، المريض + +251 +00:22:45,440 --> 00:22:48,040 +هيشعر و كأنه هي عبارة عن foreign body + +252 +00:22:51,670 --> 00:22:55,490 +left lenses أو ال conventional daily wear lenses + +253 +00:22:55,490 --> 00:23:02,290 +عدسات اللبس اليومي التقليدي okay that fit بتم وضع + +254 +00:23:02,290 --> 00:23:06,170 +اللي هو ال ideal fit لها أو ال fit well يعني + +255 +00:23:06,170 --> 00:23:11,110 +الأفضل يعني ال fitting الجيد أو المناسب لها show + +256 +00:23:11,110 --> 00:23:16,930 +about 0.3 millimeter of movement أن يكون حركتها + +257 +00:23:16,930 --> 00:23:21,710 +ثلاثة من عشرة من المليميتر لكن هذه دايما تعتبر + +258 +00:23:21,710 --> 00:23:25,330 +theory من الصعب ال practice أصل للرقم هذا + +259 +00:23:28,710 --> 00:23:34,050 +It is easy من السهل to overestimate lens movement + +260 +00:23:34,050 --> 00:23:58,630 +when viewing with a slit lamp + +261 +00:23:58,790 --> 00:24:06,110 +over sensitive بمعنى زيادة في حركة العدسة أو زيادة + +262 +00:24:06,110 --> 00:24:12,550 +الإحساس بحركة العدسة A handy guide هذه من المفيد لل + +263 +00:24:12,550 --> 00:24:17,090 +examiner أن هذه a handy guide is to remember أنّه + +264 +00:24:17,090 --> 00:24:23,050 +تذكر ذات a 14 millimetre lens العدسات اللي بيكون + +265 +00:24:23,050 --> 00:24:27,990 +قطرها 14 millimetre على قرنية بيكون ال horizontal + +266 +00:24:27,990 --> 00:24:35,440 +visible iris diameter لها 12 ملي هيكون فيها حركة + +267 +00:24:35,440 --> 00:24:41,380 +واحد ملي متر، ايش هتعمل؟ هتعمل يعني هيكون فيه + +268 +00:24:41,380 --> 00:24:46,240 +excessive movement و هتتجاوز حتى من ال limbus هتعمل + +269 +00:24:46,240 --> 00:24:52,240 +ال traverses للّي هو ال limbus إذا مرة أخرى، لما + +270 +00:24:52,240 --> 00:24:57,540 +مريض بيكون عنده قطر ال diameter للعدسة أربعة عشر + +271 +00:24:57,540 --> 00:25:01,360 +وهو عنده ال horizontal visible iris diameter + +272 +00:25:01,360 --> 00:25:06,540 +اثنا عشر ملي الآن يما بيحرك العدسة up و down أو + +273 +00:25:06,540 --> 00:25:10,960 +vertical change بتلاقي أن حركة العدسة واحد ملي + +274 +00:25:10,960 --> 00:25:15,100 +واحد ملي يعني excessive movement زيادة الإدراك في + +275 +00:25:15,100 --> 00:25:20,140 +العدسة وبالتالي هذا ايش بيعمل؟ أن العدسة هتتعدى + +276 +00:25:20,140 --> 00:25:24,780 +وين؟ اللي مبصها طبعا هي هتكون غير مناسبة أو غير + +277 +00:25:24,780 --> 00:25:30,870 +ملائمة للمريض لذلك الآن بعض الطالبات يمكن في بداية + +278 +00:25:30,870 --> 00:25:34,830 +الفصل بيسألوني أنّه احنا عندنا في قطاع غزة standard + +279 +00:25:34,830 --> 00:25:41,330 +diameter من 14 ل 14.5 هي الخلاف احنا معظمنا ال + +280 +00:25:41,330 --> 00:25:45,570 +horizontal visible iris diameter ما بين 11.5 و 12 + +281 +00:25:45,570 --> 00:25:50,210 +المعظم عندنا في فترة غزة طيب الآن لو أنا لبست عدسة + +282 +00:25:50,210 --> 00:25:55,490 +12 ميلي متر الحركة هتكون جداش؟ واحد ميلي متر إذا + +283 +00:25:55,490 --> 00:26:00,150 +المريض هيكون في عنده زيادة في الإدراك في العدسة + +284 +00:26:00,150 --> 00:26:06,370 +وبالتالي هذا يعتبر wrong decision يعني قرار خاطئ + +285 +00:26:06,370 --> 00:26:07,350 +لصرف العدسة + +286 +00:26:10,640 --> 00:26:16,670 +بوش أب تيست هذا عبارة عن اختبار من خلاله أنا بقدر + +287 +00:26:16,670 --> 00:26:22,770 +أحدد indicator of lens mobility إذا قابلية الحركة + +288 +00:26:22,770 --> 00:26:27,690 +للعدسة كيف؟ أن ال examiner بيدغط على ال lower + +289 +00:26:27,690 --> 00:26:32,490 +eyelid margin بالنسبة للمريض فبالتالي أنه هيتحرك + +290 +00:26:32,490 --> 00:26:37,270 +أطراف العدسة فهتشوف أن هل حركة العدسة excessive + +291 +00:26:37,270 --> 00:26:41,490 +movement ولا steep أو tight movement + +292 +00:26:43,980 --> 00:26:49,120 +تستخدم لصفته لو رجت نعم تنتين indicator of lens + +293 +00:26:49,120 --> 00:26:54,700 +mobility إذا بتحدد مين قابلية الحركة للعدسة that + +294 +00:26:54,700 --> 00:26:58,660 +is independent of the patient's eyelid blink + +295 +00:26:58,660 --> 00:27:04,660 +dynamics يعني بتتم اللي هو أو بتعتمد اعتماد اللي + +296 +00:27:04,660 --> 00:27:08,800 +هو مباشر على مين على ال eyelid margin اللي خاص + +297 +00:27:08,800 --> 00:27:09,860 +بالمريض + +298 +00:27:12,280 --> 00:27:18,900 +التجارب الفاحس بوشز هيعمل دفع للعدسة superiorly + +299 +00:27:18,900 --> 00:27:23,380 +by manipulating the patient's inferior eyelid + +300 +00:27:23,380 --> 00:27:28,840 +margin من أطراف العدسة هتتحرك العدسة وين لفوق إذا + +301 +00:27:28,840 --> 00:27:32,860 +كان طبيعي optimal lens fit هيكون حركتها من نص إلى + +302 +00:27:32,860 --> 00:27:37,500 +واحد وهذه هيكون ايش good movement لكن إذا أكثر من + +303 +00:27:37,500 --> 00:27:42,080 +هيك هتلاحظ الحركة أكثر من واحد إذا أقل من هيك أقل + +304 +00:27:42,080 --> 00:27:46,820 +من النص لواحد هتلاحظ أن في هناك tight للعدسة + +305 +00:27:48,430 --> 00:27:54,370 +لينز يمكن أن يتحرك بسهولة باستخدام الـ push-up + +306 +00:27:54,370 --> 00:27:59,610 +test يعني المريض أو أفوان ال examiner هيشعر بحركة + +307 +00:27:59,610 --> 00:28:06,350 +العدسة مجرد ما يعمل الاختبار ال push-up test طبعاً + +308 +00:28:06,350 --> 00:28:10,510 +الاختبار هذا هيتم عمله إن شاء الله في المعمل من + +309 +00:28:10,510 --> 00:28:13,610 +خلال اللي هو ال test هذا ال push-up test لما نعمل + +310 +00:28:13,610 --> 00:28:19,590 +evaluation للـ soft contact lens Centration of a + +311 +00:28:19,590 --> 00:28:24,610 +soft lens بدنا نشوف تمركز العدسة أنه هل التمركز + +312 +00:28:24,610 --> 00:28:27,950 +للعدسة اللاصقة ملائم مناسب أو لا + +313 +00:28:31,360 --> 00:28:36,920 +is assessed or evaluated بيقيم as optimal إن هو + +314 +00:28:36,920 --> 00:28:42,520 +مثالي if the lens edge إذا كانت أطراف العدسة shows + +315 +00:28:42,520 --> 00:28:48,600 +بتوضح uniform إن في هناك تماثل أو اللي هو تلائم أو + +316 +00:28:48,600 --> 00:28:53,840 +symmetric إنه تكون متماثلة أو متلائمة overlap لكل + +317 +00:28:53,840 --> 00:28:58,670 +اللي هو سطح القرنية unto the sclera in all + +318 +00:28:58,670 --> 00:29:03,050 +meridians، طبعاً احنا عارفين أن هي بتعدي من الكورنية + +319 +00:29:03,050 --> 00:29:06,830 +و بتكون على حواف الليمبس تقريباً + +320 +00:29:10,240 --> 00:29:14,380 +طيب إذا كان في هناك العدسة Decentration يعني + +321 +00:29:14,380 --> 00:29:19,120 +تمركزها غير ملائم واختلفت أنت وأصدقائك أن هذه + +322 +00:29:19,120 --> 00:29:24,220 +العدسة Decentered ببساطة بنحرك العدسة باستخدام ال + +323 +00:29:24,220 --> 00:29:29,860 +push up test إذا رجعت بعد أقل من واحد ثانية معناه + +324 +00:29:29,860 --> 00:29:33,280 +الكلام أن هي فيها good concentration إذا ما رجعت + +325 +00:29:33,280 --> 00:29:38,240 +إذا هي Decentration مرة ثانية if the lens is + +326 +00:29:38,240 --> 00:29:43,120 +decentered يعني ماكانش فيه تمركز ملائم أو مناسب + +327 +00:29:43,120 --> 00:29:48,100 +للعدسة such as with the push-up test باستخدام هذا + +328 +00:29:48,100 --> 00:29:53,300 +الاختبار it should regain optimal centration in + +329 +00:29:53,300 --> 00:29:58,220 +lens in less than one second العدسة هترجع لمكانها + +330 +00:29:58,220 --> 00:30:02,560 +الأصلي اللي هو ال optimal fit بعد أقل من كده واحد + +331 +00:30:02,560 --> 00:30:03,220 +ثانية + +332 +00:30:07,830 --> 00:30:13,170 +Lag on upgades and virgin movement الآن لوصلنا + +333 +00:30:13,170 --> 00:30:17,210 +لسؤال ما هو المقصود بال virgin ما هو تعريف ال + +334 +00:30:17,210 --> 00:30:21,970 +virgin أنه + +335 +00:30:21,970 --> 00:30:27,350 +تفضلي okay + +336 +00:30:27,350 --> 00:30:33,190 +or binocular movementeither are conjugate يعني + +337 +00:30:33,190 --> 00:30:37,070 +الاثنين بيكونوا ايش مع بعض اللي هو بتحركه، إذا + +338 +00:30:37,070 --> 00:30:41,110 +جاءنا مثلاً ال right abduction، ال left هتكون + +339 +00:30:41,110 --> 00:30:46,500 +abduction، والعكس صحيح Lag on up gaze بطلب أنا من + +340 +00:30:46,500 --> 00:30:51,700 +المريض أن يطلع إلى الأعلى أو الأسفل أما بيكون up + +341 +00:30:51,700 --> 00:30:57,060 +gaze أو down gaze طبعاً الهدف بدي أشوف هل تمركز + +342 +00:30:57,060 --> 00:31:02,260 +العدسة جيد أو لا؟ هل العدسة ماخدة uniform و + +343 +00:31:02,260 --> 00:31:04,960 +symmetric on the sclera أو لا؟ + +344 +00:31:07,820 --> 00:31:13,440 +is readily بسهولة evaluated بيقيم by observing + +345 +00:31:13,440 --> 00:31:18,460 +بواسطة ملاحظة the change التغير ال concentration + +346 +00:31:18,460 --> 00:31:25,260 +إذا أنا بدي ألاحظ التغير في تمركز العدسة okay in I + +347 +00:31:25,260 --> 00:31:29,520 +position other than primary gaze إذا المريض مش + +348 +00:31:29,520 --> 00:31:33,580 +هيُطلع وين في ال primary position إما up gaze أو + +349 +00:31:33,580 --> 00:31:34,240 +down gaze + +350 +00:31:39,080 --> 00:31:44,540 +عادة عدسة عدسة عدسة عدسة عدسة عدسة عدسة عدسة عدسة + +351 +00:31:44,540 --> 00:31:51,180 +عدسة عدسة + +352 +00:31:51,180 --> 00:32:02,100 +عدسة عدسة عدسة + +353 +00:32:02,100 --> 00:32:08,840 +عدسة فهي هتعدي من الكورنية و هتكون على أطراف من ال + +354 +00:32:08,840 --> 00:32:14,840 +limbus فال lag تقريباً فيها هيكون من 0.3 ل 0.7 هذه + +355 +00:32:14,840 --> 00:32:19,560 +في حالة من ال normal لكن ال RGB لو استخدمته + +356 +00:32:19,560 --> 00:32:26,120 +الطريقة هذه كانت مش ظاهرة ال 0.3 ل 0.7 لأن ال + +357 +00:32:26,120 --> 00:32:27,840 +diameter بتاعها أصغر + +358 +00:32:31,560 --> 00:32:35,800 +Excessive lag زيادة ال lag is associated with poor + +359 +00:32:35,800 --> 00:32:39,040 +concentration بالشكل هذا + +360 +00:32:44,380 --> 00:32:50,040 +يما بيزيد اللي هو ال lag هان، يعني بمعنى أنه بيغطي + +361 +00:32:50,040 --> 00:32:54,180 +القرنية و بتعدي ال limbus بمعنى أن ديامتر العدسة + +362 +00:32:54,180 --> 00:32:59,060 +أكبر فبالتالي هتكون أكثر من سبعة من عشرة، ايش + +363 +00:32:59,060 --> 00:33:03,580 +هتعمل؟ poor concentration، عدم تمركز اللي هو جيد + +364 +00:33:03,580 --> 00:33:08,880 +للعدسة يا ما يكون zero lag مش واضح بالمرة، يا ما + +365 +00:33:08,880 --> 00:33:12,240 +يقول لنا المريض اتطلع up gaze أو down gaze، معنى + +366 +00:33:12,240 --> 00:33:16,280 +الكلام أنه ايش عنده العدسة اللي هي ال tie وفيها + +367 +00:33:16,280 --> 00:33:20,440 +اللي هو adherence ما بين ال surface of the lens و + +368 +00:33:20,440 --> 00:33:26,230 +ال cornia ببساطة ال lag أنا بطلب من المريض أنه + +369 +00:33:26,230 --> 00:33:29,510 +دايماً ما يطلع في ال primary position أما في ال up + +370 +00:33:29,510 --> 00:33:33,170 +gaze أو ال down gaze و ممكن في بعض الأحيان بطلب + +371 +00:33:33,170 --> 00:33:37,250 +right and left يعني abduction و abduction okay و + +372 +00:33:37,250 --> 00:33:41,910 +بشوف أنا جداش أطراف العدسة ماخدة إذا كانت النسبة + +373 +00:33:41,910 --> 00:33:45,750 +من تلاتة من عشرة لسبعة من عشرة بنقول هذا normal + +374 +00:33:45,750 --> 00:33:51,180 +طبعاً ليه؟ لأن ال diameter للعدسة بيكون كبير أكبر من + +375 +00:33:51,180 --> 00:33:55,580 +القرنية طيب إذا كانت نسبة ال light zero معناه + +376 +00:33:55,580 --> 00:33:59,960 +الكلام أنه مافيش أي ت ايه بالضبط أن العدسة بتكون + +377 +00:33:59,960 --> 00:34:04,960 +tight يعني adherence to the surface of the cornea + +378 +00:34:04,960 --> 00:34:09,360 +إذا كان أكثر من هذا الرقم معناه الكلام أن العدسة + +379 +00:34:09,360 --> 00:34:13,160 +excessive movement وبالتالي هي قد تكون flat + +380 +00:34:16,710 --> 00:34:21,530 +Tier Exchange تبادل ال tier and the post lens tier + +381 +00:34:21,530 --> 00:34:26,430 +film ما ننسى المعلومة أن من ال limitation للعرصات + +382 +00:34:26,430 --> 00:34:31,190 +اللاصقة اللينة أن في هناك limitation لل tier + +383 +00:34:31,190 --> 00:34:32,030 +exchange + +384 +00:34:34,810 --> 00:34:40,430 +Evaluated بيقيم clinically using observation أنه + +385 +00:34:40,430 --> 00:34:44,530 +أنا بدي ألاحظ في ال Specular illumination طب هل + +386 +00:34:44,530 --> 00:34:46,870 +ممكن أنا أستخدم ال direct illumination في هذا + +387 +00:34:46,870 --> 00:34:50,250 +النوع؟ ليش استخدمنا ال Specular illumination؟ + +388 +00:34:51,130 --> 00:34:56,230 +ببساطة لأن في هناك angle هيكون فيه angle ما بين + +389 +00:34:56,230 --> 00:35:01,550 +اللي هو ال tube أو ال biomicroscope و الجهاز اللي + +390 +00:35:01,550 --> 00:35:05,530 +أنا بدي استخدمه أو ال mires هيكون angle من خمسة و + +391 +00:35:05,530 --> 00:35:09,890 +أربعين لستين degree فدايماً هنا ما بنستخدم ال + +392 +00:35:09,890 --> 00:35:13,170 +direct illumination بنستخدم ال specular + +393 +00:35:13,170 --> 00:35:14,050 +illumination + +394 +00:35:17,470 --> 00:35:22,150 +high magnification تكبير كبير بيكون تقريباً تلاتين + +395 +00:35:22,150 --> 00:35:28,690 +لستين exacts a wide angle of observation more than + +396 +00:35:28,690 --> 00:35:32,650 +sixty degrees أو بنقول دايماً من خمسة وأربعين لستين + +397 +00:35:32,650 --> 00:35:37,750 +degree and a narrow slit أنه هيكون ال slit بيهم أو + +398 +00:35:37,750 --> 00:35:40,030 +point one millimeter are needed + +399 +00:35:42,600 --> 00:35:47,480 +An optimal fit lens or an optimal lens fit + +400 +00:35:47,480 --> 00:35:53,660 +requires an aqueous post lens، tear film لازم أن + +401 +00:35:53,660 --> 00:35:58,640 +يكون فيه هناك ايه تحريك للعدسة عشان تعمل هناك + +402 +00:35:58,640 --> 00:36:04,940 +تحريك لمين؟ لل tear exchange which is observed هذا + +403 +00:36:04,940 --> 00:36:08,680 +هيكون ملاحظ أن هو عبارة عن amorphous ايش يعني + +404 +00:36:08,680 --> 00:36:12,560 +amorphous يعني no pattern ما فيش هناك أي تشكل له + +405 +00:36:12,560 --> 00:36:17,660 +يعني صح بتلاحظ أن في حركة لكن without pattern بدون + +406 +00:36:17,660 --> 00:36:22,520 +شكل أو no pattern أو بنسميها amorphous in a + +407 +00:36:22,520 --> 00:36:25,960 +specular reflection أو a specular illumination + +408 +00:36:31,000 --> 00:36:35,160 +post lens tear film appearances are taken to + +409 +00:36:35,160 --> 00:36:40,100 +indicate reduced tear exchange بتلاحظ أنه لو كان + +410 +00:36:40,100 --> 00:36:43,980 +هناك فيه pattern معناه الكلام أن في هناك + +411 +00:36:43,980 --> 00:36:49,880 +adherence للعدسة في التساق للعدسة فهيكون ظاهر أن + +412 +00:36:49,880 --> 00:36:54,420 +في pattern شكل أو له color معين يكون أقرب لللون + +413 +00:36:54,420 --> 00:36:55,260 +الرمادي + +414 +00:36:57,610 --> 00:37:02,130 +وهذا بتديني indication أن في هناك reduce لل tier + +415 +00:37:02,130 --> 00:37:06,170 +exchange معنى الكلام يما يكون في هذا الموضوع ايش + +416 +00:37:06,170 --> 00:37:10,490 +بدي أعمل؟ بدي أرفع العدسة اللاصقة و أعمل tier film + +417 +00:37:10,490 --> 00:37:14,490 +evaluation من ناحية ال TPUT ال corneal fluorescent + +418 +00:37:14,490 --> 00:37:19,990 +staining keratometer + +419 +00:37:19,990 --> 00:37:20,770 +measures + +420 +00:37:24,950 --> 00:37:31,650 +أنه بدنا نعمل تقييم للكيراتو ميتر في المحاضرة أن + +421 +00:37:31,650 --> 00:37:35,870 +شاء الله يعني بتوقف لهذه النقطة للكراتوميتر مياردز + +422 +00:37:35,870 --> 00:37:40,730 +وفي المحاضرة القادمة بنكمل إن شاء الله موضوع + +423 +00:37:40,730 --> 00:37:44,810 +الكيراتوميتر مياردز يعطيكم العافية diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/jfd3UxR95_E_postprocess.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/jfd3UxR95_E_postprocess.srt new file mode 100644 index 0000000000000000000000000000000000000000..8c9443efd821b4c3ea876ce93d310d82e47e1a96 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/jfd3UxR95_E_postprocess.srt @@ -0,0 +1,1692 @@ +1 +00:00:21,110 --> 00:00:23,830 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:23,830 --> 00:00:29,590 +وبركاته ومرحباً لكم جميعًا سنكمل إن شاء الله في + +3 +00:00:29,590 --> 00:00:34,790 +موضوع الـ soft contact lenses modalities أنواع أو + +4 +00:00:34,790 --> 00:00:40,790 +أنماط أو أشكال العدسات اللاصقة اللينة سنبدأ اليوم + +5 +00:00:40,790 --> 00:00:46,410 +في موضوع silicon hydrogel extended wear disposable + +6 +00:00:46,410 --> 00:00:52,880 +lensesبداية تم إضافة مادة السيليكون لزيادة + +7 +00:00:52,880 --> 00:00:59,620 +الوتابيلاتي المتانة للعدسة Hydrogel بمعنى water + +8 +00:00:59,620 --> 00:01:04,680 +water loving or hydrophilic مادة محبة للماء + +9 +00:01:04,680 --> 00:01:11,020 +Extended wear بتم ارتدائها لمدة اسبوع واحد وبعد + +10 +00:01:11,020 --> 00:01:17,100 +ذلك بتم التخلص منها طبعا في هذا النوع من العدسات + +11 +00:01:17,710 --> 00:01:24,350 +بتم استخدام high decay على T حتى انه تكون العدسة + +12 +00:01:24,350 --> 00:01:29,850 +thinning نحيفة و بتسمح لأكبر كمية من ال oxygen انه + +13 +00:01:29,850 --> 00:01:36,270 +تدخل القرنية مدام هي disposable lens اذا العدسة + +14 +00:01:36,270 --> 00:01:41,310 +بلبسها المريض لفترة زمنية قصيرة وبعد ذلك بتتم + +15 +00:01:41,310 --> 00:01:42,690 +التخلص منها + +16 +00:01:45,470 --> 00:01:50,930 +أول ما تم التفكير في هذا الجيل من العدسات كان في + +17 +00:01:50,930 --> 00:01:56,430 +سنة 1999 كان + +18 +00:01:56,430 --> 00:02:03,670 +المقصود بشكل أساسي هو موضوع ال extended wear و تم + +19 +00:02:03,670 --> 00:02:08,040 +تعريف ال extended wear فيما سبقSilicon is + +20 +00:02:08,040 --> 00:02:14,140 +hydrophobic إذا مادة السيليكون هي كارهة للماء لكن + +21 +00:02:14,140 --> 00:02:19,020 +إيش عملت مادة السيليكون surface modified يعني عملت + +22 +00:02:19,020 --> 00:02:27,900 +تعديل للصبح by a plasma batch process بلازمة باتش + +23 +00:02:27,900 --> 00:02:34,170 +بروسس هي عملية دفع البلازمةمن خلال هذه العملية انه + +24 +00:02:34,170 --> 00:02:39,790 +بتتم تجميع ال tears كله على سطح العدسة وبيمنع دخول + +25 +00:02:39,790 --> 00:02:45,770 +ال tears للداخل مرة أخرى، اذا بيكون هناك فيه + +26 +00:02:45,770 --> 00:02:51,530 +جزيئاتفي العدسة او مسامات معينة في هذه العملية + +27 +00:02:51,530 --> 00:02:57,450 +هيمنع من دخول ايه ال tears للداخل وكل ال tears + +28 +00:02:57,450 --> 00:03:02,610 +بتجمع وين على سطح العدسة طبعا ببساطة عشان يحافظ + +29 +00:03:02,610 --> 00:03:07,940 +على مرونة العدسةOkay؟ لأن احنا عارفين ان مادة + +30 +00:03:07,940 --> 00:03:13,180 +السيليكون بتزود من ال wetability المتانة فهي لو .. + +31 +00:03:13,180 --> 00:03:18,460 +وهي hydrophobic صح؟ هذه العملية ما ننسى اسم العدسة + +32 +00:03:18,460 --> 00:03:23,440 +ان هي تعتبر ايه؟ HydrogelOkay؟ يعني بمعنى انه محب + +33 +00:03:23,440 --> 00:03:29,160 +للماء فهذه العملية بساطة بتعمل تعديل لسطح العدسة و + +34 +00:03:29,160 --> 00:03:33,560 +كل ال tears هيتجمع على سطح العدسة و بتمنع من دخوله + +35 +00:03:33,560 --> 00:03:40,330 +للداخل يعني بمعنى انه بتحافظ على مرونة العدسةطبعا + +36 +00:03:40,330 --> 00:03:46,610 +هذه العملية ال plasma batch process زودت من سعر + +37 +00:03:46,610 --> 00:03:52,190 +العدسة بشكل بسيط يعني slightly high cost أو + +38 +00:03:52,190 --> 00:03:58,480 +slightly higher كان سعر العدسة مرتفع نسبياclean + +39 +00:03:58,480 --> 00:04:03,260 +and disinfect the lenses only occasionally or not + +40 +00:04:03,260 --> 00:04:08,540 +at all احنا بنعرف ان فترة حياة العدسة قصيرة فأنظمة + +41 +00:04:08,540 --> 00:04:13,460 +التنظيف و التعقيم لهذا النوع من العدسات هتكون + +42 +00:04:13,460 --> 00:04:18,460 +occasionally احيانا او اللي هو نادرا rarely او + +43 +00:04:18,460 --> 00:04:25,000 +ماهتكونش مطلقا okay minimizing the cost of lens + +44 +00:04:25,000 --> 00:04:29,740 +maintenanceنرجع مرة تانية، مدام فترة حياة العدسة + +45 +00:04:29,740 --> 00:04:35,120 +قصيرة، إذا أنظمة المحافظة عليها إيش هتكون؟ تقل أو + +46 +00:04:35,120 --> 00:04:40,280 +في بعض الأحيان، لا تحتاج إلى أنظمة محافظة على هذا + +47 +00:04:40,280 --> 00:04:42,100 +النوع من العدسات + +48 +00:04:45,080 --> 00:04:50,580 +الان المريض هيلبسها لمدة اسبوع واحد وبعد ذلك بتخلص + +49 +00:04:50,580 --> 00:04:55,860 +منها فبيطلب من المريض انه كل صباح يعمل ال + +50 +00:04:55,860 --> 00:05:00,460 +lubricating eyedrop يعني قطر قطرة okay هذا بتعمل + +51 +00:05:00,460 --> 00:05:06,970 +عملية ترطيب للعدسة وقت ايش؟By the patient on + +52 +00:05:06,970 --> 00:05:11,430 +waking each morning يعني لما يستيقظ من انهم لازم + +53 +00:05:11,430 --> 00:05:16,390 +انه يعمل هذه العملية انه تقطير قطرة الهدف منها + +54 +00:05:16,390 --> 00:05:22,030 +اللي هو ترطيب العدسة و سطح القرانية حتى مايصير عند + +55 +00:05:22,030 --> 00:05:23,910 +المريض corneal edema + +56 +00:05:28,810 --> 00:05:33,930 +الجيل التاني من هذا النوع من العدسات كان الهدف + +57 +00:05:33,930 --> 00:05:38,510 +منها او المقصود بشكل أساسي انه تكون daily wear + +58 +00:05:38,510 --> 00:05:44,410 +يعني يتم .. يتم ارتداء العدسة لمدة يوم واحد فقط + +59 +00:05:48,130 --> 00:05:52,530 +أول ما تم التفكير في هذا الجيل من العدسات في عام + +60 +00:05:52,530 --> 00:05:57,210 +الف .. في عام الفين وأربعة يعني هي تعتبر update + +61 +00:05:57,210 --> 00:06:02,550 +لمين؟ ل ال extended wear أو اللي هي بمعنى أنه جيل + +62 +00:06:02,550 --> 00:06:08,910 +آخر second generation ل الجيل الأول these lenses + +63 +00:06:08,910 --> 00:06:14,270 +هذا النوع من العدسات have a lower silicon content + +64 +00:06:15,200 --> 00:06:20,560 +احنا ما هنحتاج لل silicon بدرجة كبيرة لان انا مش + +65 +00:06:20,560 --> 00:06:24,940 +محتاج wetability عالي في هذا النوع لان المريض + +66 +00:06:24,940 --> 00:06:30,080 +هيلبسها يوم واحد ويتخلص منها صحيح؟ and + +67 +00:06:30,080 --> 00:06:34,700 +correspondly higher water content اذا مدام هو + +68 +00:06:34,700 --> 00:06:40,340 +هيقلل من كمية ال silicon هيعدل زيادة في مين؟ في ال + +69 +00:06:40,340 --> 00:06:45,170 +water contentإذا الـDK على T إيش تعتبر very high + +70 +00:06:45,170 --> 00:06:50,450 +في هذا النوع من العدسات Reduce the need for + +71 +00:06:50,450 --> 00:06:55,810 +surface modification وهذا هيقلل من الحاجة لعملية + +72 +00:06:55,810 --> 00:07:01,630 +تعديل سطح العدسة يعني ما بتحتاج ل plasma batch + +73 +00:07:01,630 --> 00:07:07,170 +process Reduce manufacturing cost أيضا هيقلل من + +74 +00:07:07,170 --> 00:07:13,520 +سعر العدسةلأنه مدة يوم واحد وبعد ذلك هيتم التخلص + +75 +00:07:13,520 --> 00:07:19,620 +منها Their oxygen transmissibility، نفاذية + +76 +00:07:19,620 --> 00:07:24,060 +الأكسجين أو دخول الأكسجين is still مازال much + +77 +00:07:24,060 --> 00:07:28,160 +higher، أعلى من مين؟ من ال traditional hydrogen + +78 +00:07:28,160 --> 00:07:31,200 +lenses، هذا المقصود فيها ال conventional daily + +79 +00:07:31,200 --> 00:07:37,880 +wear، عدسات اللبس اليومي التقليديwithout the + +80 +00:07:37,880 --> 00:07:43,740 +tendency to dehydration يعني دون التوجه باتجاه من + +81 +00:07:43,740 --> 00:07:48,360 +التبخر ال dehydration اللي مصاحب مع ال high water + +82 +00:07:48,360 --> 00:07:50,000 +content materials + +83 +00:08:07,470 --> 00:08:11,270 +فنفس الحاجة هذا النوع من العدسات صحيح ان فيها + +84 +00:08:11,270 --> 00:08:16,330 +الـDK على T high وهي تعتبر very high water content + +85 +00:08:16,330 --> 00:08:20,770 +و ايضا تعتبر العدسة thinning لكن ما بتصل لمرحلة + +86 +00:08:20,770 --> 00:08:25,870 +ايه التبخر لسطح القرنية يعني ما بتعمل dehydration + +87 +00:08:25,870 --> 00:08:28,090 +ل ال corneal surface + +88 +00:08:33,840 --> 00:08:37,960 +بطلوب من كل طالبة الان احنا خدنا ال soft contact + +89 +00:08:37,960 --> 00:08:42,020 +lens modalities بشكل عام ال conventional daily + +90 +00:08:42,020 --> 00:08:46,320 +wear و بعد ذلك اخدنا ال daily wear extended wear + +91 +00:08:46,320 --> 00:08:53,000 +تعمل ك table كل أنواع العدسات و تضع في كل نوع من + +92 +00:08:53,000 --> 00:08:57,230 +العدساتموضوع ال cleaning موضوع ال disinfecting + +93 +00:08:57,230 --> 00:09:01,490 +موضوع ال maintenance بحيث انه تعملي تستطيع تعملي + +94 +00:09:01,490 --> 00:09:07,030 +comparison ما بين كل نوع و الآخر مثلا التكنولوجيا + +95 +00:09:07,030 --> 00:09:10,570 +المستخدم hand lathe cutting hand molding + +96 +00:09:10,570 --> 00:09:15,210 +technology حسب كل نوع من العدسات بالنسبة ل ال cost + +97 +00:09:15,210 --> 00:09:19,550 +hand high hand low الاخر زي ما تم اللي هو مناقشته + +98 +00:09:19,550 --> 00:09:27,540 +فيما سابق فضلOkay الان عندنا soft lens fitting and + +99 +00:09:27,540 --> 00:09:34,500 +evaluation الان انا ك practitioner بدي اعرف هل + +100 +00:09:34,500 --> 00:09:38,800 +العدسة optimal fit ولا لأ يعني هل ال fitting فيها + +101 +00:09:38,800 --> 00:09:43,700 +مثالي ام لا كيف انا بدي اعرف انه هل ال fitting في + +102 +00:09:43,700 --> 00:09:49,180 +العدسة اللاصقة مثالي او لا وتحديدا ال soft contact + +103 +00:09:49,180 --> 00:09:57,970 +lensnumber one optimal lens fit optimal lens fit + +104 +00:09:57,970 --> 00:10:01,730 +يعني بده اشوف انه هل ال fitting في العدسة مثالي ام + +105 +00:10:01,730 --> 00:10:08,110 +لا في عندنا شغلتين مهمات في العدسات اللاصقة الأمر + +106 +00:10:08,110 --> 00:10:12,930 +الأول ال comfort الراحة الأمر التاني ال vision + +107 +00:10:12,930 --> 00:10:18,550 +الرؤية مين أهم في ال soft contact lens ال comfort + +108 +00:10:18,550 --> 00:10:24,290 +ولا ال visionال comfort اهم بنوع ما ال comfort اهم + +109 +00:10:24,290 --> 00:10:29,290 +يعني دايما انا ك practitioner او ك examiner بميل ل + +110 +00:10:29,290 --> 00:10:33,850 +ال comfort اكتر من مين من ال vision يعني بمعنى انه + +111 +00:10:33,850 --> 00:10:39,330 +مريض اخد عدسة لا ثقة و وصل النظر عنده ستة اتسعة و + +112 +00:10:39,330 --> 00:10:44,390 +مرتاح مية في المية رغم انه في عدسة اخرى وصل فيها + +113 +00:10:44,390 --> 00:10:48,890 +ستة ا ستة لكن discomfort what is the benefit ايش + +114 +00:10:48,890 --> 00:10:54,300 +الفايدة؟Okay فدائما ال comfort أهم من ال vision في + +115 +00:10:54,300 --> 00:10:58,880 +العدسات اللاصقة Can + +116 +00:10:58,880 --> 00:11:03,420 +be evaluated in terms of a number of parameters + +117 +00:11:03,420 --> 00:11:08,520 +اذا لما انا بدي اشوف ال fitting مثالي او لا للعدسة + +118 +00:11:08,520 --> 00:11:15,790 +بتتم تحديده بمجموعة من المحدداتإذا هناك مجموعة من + +119 +00:11:15,790 --> 00:11:21,170 +المحددات بتم وضعها يعني مجموعة من ال criteria + +120 +00:11:21,170 --> 00:11:25,550 +مجموعة + +121 +00:11:25,550 --> 00:11:31,490 +من المعايير بتم وضعها من قبل ال practitioners عشان + +122 +00:11:31,490 --> 00:11:36,970 +يشوف هل ال fitting مناسب ام لا comfort + +123 +00:11:36,970 --> 00:11:40,530 +and vision are most important to the patient + +124 +00:11:42,930 --> 00:11:49,110 +السهيلة لعينة صافية تعتبرت أفضل بشكل صغير أو لا + +125 +00:11:49,110 --> 00:11:55,840 +يعرف أن العينة تكون موجودةإذا المريض بيكون مرتاح + +126 +00:11:55,840 --> 00:11:59,980 +في العدسة اللاصقة في حالة إنه ما يكون هناك أي + +127 +00:11:59,980 --> 00:12:06,580 +تأدراك يعني لا يشعر بإدراك بوجود العدسة إذا ما + +128 +00:12:06,580 --> 00:12:10,120 +بيشعر + +129 +00:12:10,120 --> 00:12:16,200 +بأي تأدراك لوجود العدسة طبعا في هناك مصطلحين ال + +130 +00:12:16,200 --> 00:12:22,050 +awareness و ال sensation طبعا مختلفين عن بعضالـ + +131 +00:12:22,050 --> 00:12:26,870 +sensation انا مجرد ما احط العدسة بتعمل adherence + +132 +00:12:26,870 --> 00:12:33,070 +التصاق كبير ما بين سطح العدسة و القرنية اذا انا + +133 +00:12:33,070 --> 00:12:38,130 +حاولت ان ارفع العدسة هيعمل epithelium defect او + +134 +00:12:38,130 --> 00:12:42,590 +epithelium erosion وبالتالي هحتاج فترة زمنية + +135 +00:12:42,590 --> 00:12:49,210 +لاعادة تجديد من ال epithelium اذا + +136 +00:12:49,210 --> 00:12:55,160 +الان انا يما بدي اديالمريض عدسة لاسقة لازم تكون + +137 +00:12:55,160 --> 00:13:01,100 +مريحة بحيث انه هو ما يشعر .. لا يشعر المريض بادراك + +138 +00:13:01,100 --> 00:13:05,920 +العدسة يعني بمعنى كيف يما تتحرك العدسة مايشعرش ان + +139 +00:13:05,920 --> 00:13:09,980 +والله العدسة رايحة up او down او مثلا right او + +140 +00:13:09,980 --> 00:13:13,800 +left يعني بمعنى ال excessive movement مايشعرش فيها + +141 +00:13:15,760 --> 00:13:20,940 +Excessive awareness زيادة الإدراك في العدسة المريض + +142 +00:13:20,940 --> 00:13:25,100 +إيش هيشعر وكأنه العدسة عبارة عن foreign body يعني + +143 +00:13:25,100 --> 00:13:30,840 +بالضبط وكأنه رمل في عينه يما بيزيد الإدراك بالعدسة + +144 +00:13:30,840 --> 00:13:34,880 +المريض بيشعر أن العدسة وكأنه رمل في عينه تحديدا ال + +145 +00:13:34,880 --> 00:13:40,360 +soft contact lens Excessive lens movement or poor + +146 +00:13:40,360 --> 00:13:46,500 +concentrationأيضا حركة العدسة هتزعج المريض كل شوية + +147 +00:13:46,500 --> 00:13:51,740 +مثلا عمل up gaze بتروح العدسة تتحرك أعلى down gaze + +148 +00:13:51,740 --> 00:13:56,940 +للأسفل right left بتتحرك بحيث ان المريض هيصبح ايش + +149 +00:13:56,940 --> 00:14:01,560 +discomfort يعني ماعندهوش راحة او poor + +150 +00:14:01,560 --> 00:14:05,740 +concentration او وضع العدسة مش هيكون في مكانه طبعا + +151 +00:14:05,740 --> 00:14:09,400 +احنا عارفين ان ال soft contact lens conform to the + +152 +00:14:09,400 --> 00:14:14,120 +shape of the corneaالان يما تحكي للمريض اعمل ايه؟ + +153 +00:14:14,120 --> 00:14:19,360 +اعمل up gaze بتلاقي ان العدسة بتنزل لتحت أو مثلا + +154 +00:14:19,360 --> 00:14:23,500 +اما يعمل down gaze العدسة بتطلع لفوق واضح ال + +155 +00:14:23,500 --> 00:14:27,720 +excessive movement بالنسبة لل examiner يعني بمعنى + +156 +00:14:27,720 --> 00:14:31,420 +ان الحركة بتكون اكتر من واحد ملي متر + +157 +00:14:34,750 --> 00:14:39,410 +No sensation at all عدم الشعور بوجود العدسة بيعمل + +158 +00:14:39,410 --> 00:14:43,290 +lens adherence اللي هو التساق ما بين سطح العدسة + +159 +00:14:43,290 --> 00:14:44,110 +والقرانية + +160 +00:14:47,180 --> 00:14:53,040 +Lens defects لازم هذه من الوصاية اللي لازم وصيها + +161 +00:14:53,040 --> 00:14:58,680 +ال examiner للمريض انه كل يوم لازم تفحص العدسة و + +162 +00:14:58,680 --> 00:15:03,880 +خاصة أطراف العدسة okay لأنه ممكن يكون فيه هناك في + +163 +00:15:03,880 --> 00:15:08,300 +ال edge فيه اللي هو scratch خدش وبالتالي المريض + +164 +00:15:08,300 --> 00:15:12,160 +لما يلبس العدسة بيشعر و كأنه foreign body في داخل + +165 +00:15:12,160 --> 00:15:17,920 +العين فلازم يعمل evaluationلمدة دقيقة okay لالعدسة + +166 +00:15:17,920 --> 00:15:23,560 +everyday Incompatible + +167 +00:15:23,560 --> 00:15:29,420 +care solutions may be reported as staining on lens + +168 +00:15:29,420 --> 00:15:37,220 +insertionالان لو المريض بيستخدم محلول غير موافق + +169 +00:15:37,220 --> 00:15:41,800 +لنوع العدسة يعني في هناك محليل غير موافقة لنوع + +170 +00:15:41,800 --> 00:15:46,520 +العدسة كيف مثلا انا بلبس عدسة conventional daily + +171 +00:15:46,520 --> 00:15:50,380 +wear بروح استخدم محلول ال hard contact lens او + +172 +00:15:50,380 --> 00:15:54,020 +بروح استخدم محلول مثلا ال extended wear او ال + +173 +00:15:54,020 --> 00:15:57,900 +daily wear بالتالي هذا هيعمل ايه skinning بمعنى + +174 +00:15:57,900 --> 00:16:04,180 +لسع للعدسةو هيسبب اللي هو خدش لأطراف العدسة وبعد + +175 +00:16:04,180 --> 00:16:09,420 +ذلك هيعمل شعور بال foreign body للمريض إذا + +176 +00:16:09,420 --> 00:16:13,940 +المحاليل الغير موافقة للعدسة بتعمل على تخريب + +177 +00:16:13,940 --> 00:16:21,900 +العدسة و بتعمل لسع للسطح العدسة number + +178 +00:16:21,900 --> 00:16:27,620 +two stable vision ثبات الرؤيةانتوا عارفين كل شخص + +179 +00:16:27,620 --> 00:16:33,620 +بيعمل blinking ترميش صحيح لازم الرؤية في ال soft + +180 +00:16:33,620 --> 00:16:37,980 +contact lens before و after blinking تكون equal + +181 +00:16:37,980 --> 00:16:44,640 +متساوية ف ال stable vision relates to the correct + +182 +00:16:44,640 --> 00:16:49,300 +lens vertex power يعني بتعتمد على القوة الصحيحة + +183 +00:16:49,300 --> 00:16:54,500 +للعدسةمثلا لو نور بتلبس minus 2 لازم اديها minus + +184 +00:16:54,500 --> 00:16:59,360 +2، مانفعش اديها minus 2.25 أو minus 2.5، هيعمل + +185 +00:16:59,360 --> 00:17:03,540 +ايه؟ تغيير في الرؤية، وبالتالي انه ممكن يعمل + +186 +00:17:03,540 --> 00:17:08,060 +decrease او reduce لل visual acuity عند ال + +187 +00:17:08,060 --> 00:17:13,120 +patient، اذا اول حاجة ثبات الرؤية بتعتمد على القوة + +188 +00:17:13,120 --> 00:17:15,900 +الصحيحة للعدسة اللي بتم صرفها + +189 +00:17:18,640 --> 00:17:24,780 +Good Limb Centration التمركز الجيد للعدسة والحركة + +190 +00:17:24,780 --> 00:17:31,740 +دايما اخدنا في one ان الحركة هي غير كافية لتقييم + +191 +00:17:31,740 --> 00:17:36,990 +العدسة اللاصقة ال hardفي بعض الأحيان ممكن الحركة + +192 +00:17:36,990 --> 00:17:41,890 +بتخدع مين ال examiner انه هي مثلا ال steep بتكون + +193 +00:17:41,890 --> 00:17:45,670 +flat او العكس، optimal fit هي بتكون مثلا flat + +194 +00:17:45,670 --> 00:17:50,910 +فدايما ال movement is not enough to evaluate if + +195 +00:17:50,910 --> 00:17:55,660 +the lens is optimal or notفأول حاجة بدي أشوف انه + +196 +00:17:55,660 --> 00:18:00,860 +هل هي good concentration تمركزها جيد؟ أطرافها هل + +197 +00:18:00,860 --> 00:18:05,480 +هم equally؟ uniformly؟ هذه الأمور لازم تكون واضحة + +198 +00:18:05,480 --> 00:18:10,480 +بالنسبة للفاحص موضوع ال movement عندنا ال optimal + +199 +00:18:10,480 --> 00:18:15,740 +movement من 0.5 ل 1 ملي متر لكن هذه غير كافية + +200 +00:18:15,740 --> 00:18:19,620 +لتقييم العدسة اللاصقة اللينة + +201 +00:18:22,300 --> 00:18:28,060 +Good prelims tear film stability greater than + +202 +00:18:28,060 --> 00:18:32,940 +normal inter blink interval الان كداش ال normally + +203 +00:18:32,940 --> 00:18:41,800 +blinking للأشخاص في ال one minute خمس + +204 +00:18:41,800 --> 00:18:43,780 +عاش؟ مين حكى خمس عاش؟ ال range + +205 +00:18:48,900 --> 00:18:53,100 +طبعا according to manual soft contact lens ال + +206 +00:18:53,100 --> 00:19:01,200 +normal blinking من 15 ل 20 per minute من خمساش ل + +207 +00:19:01,200 --> 00:19:07,100 +عشرين الان لازم ان يكون هنا good brillance يعني + +208 +00:19:07,100 --> 00:19:13,710 +ثبات العدسة يكون مهم بالنسبة لمين؟لا ال examiner + +209 +00:19:13,710 --> 00:19:19,190 +لأنه الآن لو انا مافيش عندي ثبات للعدسة هتلاحظ ان + +210 +00:19:19,190 --> 00:19:22,930 +في المريض دايما عنده blinking فكل ما هو عمل + +211 +00:19:22,930 --> 00:19:27,610 +blinking الحركة اشمالها بالزيد وبالتالي بتعمل + +212 +00:19:27,610 --> 00:19:32,150 +unstable vision و بتعمل blurred vision لل patient + +213 +00:19:32,790 --> 00:19:37,370 +إذا جد بري لينز tier film stability إذا ثبات ال + +214 +00:19:37,370 --> 00:19:42,350 +tier film مهم كتير greater than normal inter blink + +215 +00:19:42,350 --> 00:19:48,110 +interval يعني لازم أن يكون الثبات أكتر من 100 من + +216 +00:19:48,110 --> 00:19:52,880 +ال blinkingبحيث انه دايما العدسة تكون ثابتة او + +217 +00:19:52,880 --> 00:19:57,740 +ماخدة good concentration للعدسة لمركزها جيد لو كل + +218 +00:19:57,740 --> 00:20:02,560 +المريض مثلا حرك عينه العدسة انه تكون follow لمين + +219 +00:20:02,560 --> 00:20:08,120 +للعين lens + +220 +00:20:08,120 --> 00:20:15,780 +movement حركة العدسةالتبرموس أي بمعنى تعزز post + +221 +00:20:15,780 --> 00:20:21,400 +lens tear film exchange and mixing الآن حركة + +222 +00:20:21,400 --> 00:20:27,820 +العدسة بتعزز من حركة مين؟ ال tear film طبعا احنا + +223 +00:20:27,820 --> 00:20:33,040 +دايما حكينا ان ال soft contact lens بيكون فيها + +224 +00:20:33,040 --> 00:20:38,640 +limitation من ناحية مين؟ من موضوع ال tear exchange + +225 +00:20:38,640 --> 00:20:44,990 +تبادل ال tear صحيح؟فال lens movement بتعزز من حركة + +226 +00:20:44,990 --> 00:20:50,570 +مين؟ ال tear film movement + +227 +00:20:50,570 --> 00:20:55,110 +is quantified إذا الحركة بتتم تحديدها أو تحدد + +228 +00:20:55,110 --> 00:21:00,050 +بواسطة as the vertical change دايما بطلب من المريض + +229 +00:21:00,050 --> 00:21:05,470 +على الستلام أن يحرك العدسة vertical يعني يطلع up و + +230 +00:21:05,470 --> 00:21:11,530 +down up و down okay as the vertical changeال lens + +231 +00:21:11,530 --> 00:21:16,770 +position بدي اعرف موضع العدسة هل بتغير ولا لأ + +232 +00:21:16,770 --> 00:21:21,630 +before and after a normal blink يعني قبل وبعد ايه + +233 +00:21:21,630 --> 00:21:27,030 +الترميشوانتوا عارفين المعادلة، إذا كانت العدسة + +234 +00:21:27,030 --> 00:21:32,290 +tight، هيكون حركتها أقل من قداش؟ من نص، يعني + +235 +00:21:32,290 --> 00:21:36,470 +تقريبا واحد من عشرة ملي ميتر، هذه بتكون ايه عاملة؟ + +236 +00:21:36,470 --> 00:21:41,150 +adherence، يعني no sensation at all، إذا كانت + +237 +00:21:41,150 --> 00:21:45,490 +حركتها أكتر من واحد، هيكون في هناك excessive + +238 +00:21:45,490 --> 00:21:51,130 +movementطبعا ال normal movement او ال ideal + +239 +00:21:51,130 --> 00:21:56,390 +movement للعدسة اللاصقة ال soft هي 3 من 10 ملي متر + +240 +00:21:56,390 --> 00:22:00,350 +لكن من الصعب دايما نصل لهذا الرقم فاحنا دايما + +241 +00:22:00,350 --> 00:22:07,510 +بنقول ال range من 0.5 ل 1 ملي متر اذا lens + +242 +00:22:07,510 --> 00:22:12,010 +movement of less than 0.1 ملي متر can be + +243 +00:22:12,010 --> 00:22:16,460 +considered in educateإذا كانت حركتها أقل من واحد + +244 +00:22:16,460 --> 00:22:20,040 +من عشرة، بتكون غير كافية أو غير مناسبة أو غير + +245 +00:22:20,040 --> 00:22:24,700 +ملائمة، بمعنى إنه بتعمل tight أو بتكون steep أو + +246 +00:22:24,700 --> 00:22:28,660 +بتعمل adherence ما بين ال surface للعدسة و + +247 +00:22:28,660 --> 00:22:29,360 +الكورنية + +248 +00:22:32,140 --> 00:22:36,420 +movement of more than one millimeter is excessive، + +249 +00:22:36,420 --> 00:22:40,500 +إذا كانت حركتها أكتر من واحد، هتلاحظوا أنه في هناك + +250 +00:22:40,500 --> 00:22:45,440 +excessive awareness، إدراك شديد في العدسة، المريض + +251 +00:22:45,440 --> 00:22:48,040 +هيشعر و كأنه هي عبارة عن foreign body + +252 +00:22:51,670 --> 00:22:55,490 +left lenses او ال conventional daily wear lenses + +253 +00:22:55,490 --> 00:23:02,290 +عدسات اللبس اليومي التقليدي okay that fit بتم وضع + +254 +00:23:02,290 --> 00:23:06,170 +اللي هو ال ideal fit لها او ال fit well يعني + +255 +00:23:06,170 --> 00:23:11,110 +الأفضل يعني ال fitting الجيد او المناسب لها show + +256 +00:23:11,110 --> 00:23:16,930 +about 0.3 millimeter of movementإن يكون حركتها + +257 +00:23:16,930 --> 00:23:21,710 +تلاتة من عشرة من المليميتر لكن هذه دايما تعتبر + +258 +00:23:21,710 --> 00:23:25,330 +theory من الصعب ال practice أصل للرقم هذا + +259 +00:23:28,710 --> 00:23:34,050 +It is easy من السهل to overestimate lens movement + +260 +00:23:34,050 --> 00:23:58,630 +when viewing with a sit lamp + +261 +00:23:58,790 --> 00:24:06,110 +over sensitive بمعنى زيادة في حركة العدسة أو زيادة + +262 +00:24:06,110 --> 00:24:12,550 +الإحساس بحركة العدسةA handy guide هذي من المفيد لل + +263 +00:24:12,550 --> 00:24:17,090 +examiner إن هذي a handy guide is to remember انه + +264 +00:24:17,090 --> 00:24:23,050 +تذكر ذات a 14 millimetre lens العدسات اللي بيكون + +265 +00:24:23,050 --> 00:24:27,990 +قطرها 14 millimetre على قرانية بيكون ال horizontal + +266 +00:24:27,990 --> 00:24:35,440 +visible iris diameter إلها 12 مليهيكون فيها حركة + +267 +00:24:35,440 --> 00:24:41,380 +واحد مليمتر، ايش هتعمل؟ هتعمل يعني هيكون فيه + +268 +00:24:41,380 --> 00:24:46,240 +excessive movement و هتجتاز حتى من ال limbus هتعمل + +269 +00:24:46,240 --> 00:24:52,240 +ال traverses لاللي هو ال limbus إذا مرة أخرى، لما + +270 +00:24:52,240 --> 00:24:57,540 +مريض بيكون عنده قطر ال diameter للعدسة اربعة عشر + +271 +00:24:57,540 --> 00:25:01,360 +وهو عنده ال horizontal visible iris diameter + +272 +00:25:01,360 --> 00:25:06,540 +اتناشر مليالان يما بيحرك العدسة up و down او + +273 +00:25:06,540 --> 00:25:10,960 +vertical change بتلاقي ان حركة العدسة واحد ملي + +274 +00:25:10,960 --> 00:25:15,100 +واحد ملي يعني excessive movement زيادة الإدراج في + +275 +00:25:15,100 --> 00:25:20,140 +العدسة وبالتالي هذا ايش بيعمل؟ ان العدسة هتتعدى + +276 +00:25:20,140 --> 00:25:24,780 +وين اللي مبصها، طبعا هي هتكون غير مناسبة او غير + +277 +00:25:24,780 --> 00:25:30,870 +ملائمة للمريضلذلك الآن بعض الطالبات يمكن في بداية + +278 +00:25:30,870 --> 00:25:34,830 +الفصل بيسألوني انه احنا عندنا في قطاع غزة standard + +279 +00:25:34,830 --> 00:25:41,330 +diameter من 14 ل 14.5هي الخلاف احنا معظمنا ال + +280 +00:25:41,330 --> 00:25:45,570 +horizontal visible iris diameter ما بين 11.5 و 12 + +281 +00:25:45,570 --> 00:25:50,210 +المعظم عندنا في فترة غزة طيب الان لو انا لبست عدسة + +282 +00:25:50,210 --> 00:25:55,490 +12 ميلي متر الحركة هتكون جداش؟ واحد ميلي متر اذا + +283 +00:25:55,490 --> 00:26:00,150 +المريض هيكون في عنده زيادة في الإدراك في العدسة + +284 +00:26:00,150 --> 00:26:06,370 +وبالتالي هذا يعتبر wrong decision يعني قرار خاطئ + +285 +00:26:06,370 --> 00:26:07,350 +لصرف العدسة + +286 +00:26:10,640 --> 00:26:16,670 +بوش أب تيست هذا عبارة عن اختبارمن خلاله انا بقدر + +287 +00:26:16,670 --> 00:26:22,770 +احدد indicator of lens mobility اذا قابلية الحركة + +288 +00:26:22,770 --> 00:26:27,690 +للعدسة كيف؟ ان ال examiner بيدغط على ال lower + +289 +00:26:27,690 --> 00:26:32,490 +eyelid margin بالنسبة للمريض فبالتالي انه هيتحرك + +290 +00:26:32,490 --> 00:26:37,270 +أطراف العدسة فهتشوف ان هل حركة العدسة excessive + +291 +00:26:37,270 --> 00:26:41,490 +movement ولا steep أو tight movement + +292 +00:26:43,980 --> 00:26:49,120 +تستخدم لصفته لو رجت نعم تنتين indicator of lens + +293 +00:26:49,120 --> 00:26:54,700 +mobility إذا بتحدد مين قابلية الحركة للعدسة that + +294 +00:26:54,700 --> 00:26:58,660 +is independent of the patient's eyelid blink + +295 +00:26:58,660 --> 00:27:04,660 +dynamics يعني بتتم اللي هو او بتعتمد اعتماد اللي + +296 +00:27:04,660 --> 00:27:08,800 +هو مباشر على مين على ال eyelid margin اللي خاص + +297 +00:27:08,800 --> 00:27:09,860 +بالمريد + +298 +00:27:12,280 --> 00:27:18,900 +التجارب الفاحس بوشز هيعمل دفع لالعدسة superiorly + +299 +00:27:18,900 --> 00:27:23,380 +by manipulating the patient's inferior eyelid + +300 +00:27:23,380 --> 00:27:28,840 +marginمن أطراف العدسة هتتحرك العدسة وين لفوق إذا + +301 +00:27:28,840 --> 00:27:32,860 +كان طبيعي optimal lens fit هيكون حركتها من نص الى + +302 +00:27:32,860 --> 00:27:37,500 +واحد وهذه هيكون ايش good movement لكن إذا أكتر من + +303 +00:27:37,500 --> 00:27:42,080 +هيك هتلاحظ الحركة أكتر من واحد إذا أقل من هيك أقل + +304 +00:27:42,080 --> 00:27:46,820 +من النص لواحد هتلاحظ ان في هناك tight للعدسة + +305 +00:27:48,430 --> 00:27:54,370 +لينز يمكن أن يتحرك بسهولة باستخدام الـ push-up + +306 +00:27:54,370 --> 00:27:59,610 +test يعني المريض أو أفوان ال examiner هيشعر بحركة + +307 +00:27:59,610 --> 00:28:06,350 +العدسة مجرد ما يعمل الاختبار ال push-up test طبعا + +308 +00:28:06,350 --> 00:28:10,510 +الاختبار هذا هيتم عمله ان شاء الله في المعمل من + +309 +00:28:10,510 --> 00:28:13,610 +خلال اللي هو ال test هذا ال push-up test لما نعمل + +310 +00:28:13,610 --> 00:28:19,590 +evaluation لل soft contact lensCentration of a + +311 +00:28:19,590 --> 00:28:24,610 +soft lens بدنا نشوف تمركز العدسة انه هل التمركز + +312 +00:28:24,610 --> 00:28:27,950 +للعدسة اللاصقة ملائم مناسب او لا + +313 +00:28:31,360 --> 00:28:36,920 +is assessed or evaluated بيقيم as optimal إن هو + +314 +00:28:36,920 --> 00:28:42,520 +مثالي if the lens edge إذا كانت أطراف العدسة shows + +315 +00:28:42,520 --> 00:28:48,600 +بتوضح uniform إن في هناك تماثل أو اللي هو تلائم أو + +316 +00:28:48,600 --> 00:28:53,840 +symmetric إنه تكون متماثلة أو متلائمة overlap لكل + +317 +00:28:53,840 --> 00:28:58,670 +اللي هو سطح القرنيةunto the sclera in all + +318 +00:28:58,670 --> 00:29:03,050 +meridians، طبعا احنا عارفين ان هي بتعد من الكورنية + +319 +00:29:03,050 --> 00:29:06,830 +و بتكون على حواف الليمبس تقريبا + +320 +00:29:10,240 --> 00:29:14,380 +طيب إذا كان في هناك العدسة Decentration يعني + +321 +00:29:14,380 --> 00:29:19,120 +تمركزها غير ملائم واختلفت أنت و أصدقائك أن هذه + +322 +00:29:19,120 --> 00:29:24,220 +العدسة Decentered ببساطة بنحرك العدسة باستخدام ال + +323 +00:29:24,220 --> 00:29:29,860 +push up test إذا رجعت بعد أقل من واحد ثانية معناه + +324 +00:29:29,860 --> 00:29:33,280 +الكلام أن هي فيها good concentration إذا ما رجعت + +325 +00:29:33,280 --> 00:29:38,240 +إذا هي Decentration مرة تانية if the lens is + +326 +00:29:38,240 --> 00:29:43,120 +decenteredيعني ماكانش فيه تمركز ملائم أو مناسب + +327 +00:29:43,120 --> 00:29:48,100 +للعدسة such as with the push-up test باستخدام هذا + +328 +00:29:48,100 --> 00:29:53,300 +الاختبار it should regain optimal centration in + +329 +00:29:53,300 --> 00:29:58,220 +lens in less than one second العدسة هترجع لمكانها + +330 +00:29:58,220 --> 00:30:02,560 +الأصلي اللي هو ال optimal fit بعد أقل من كده واحد + +331 +00:30:02,560 --> 00:30:03,220 +ثانية + +332 +00:30:07,830 --> 00:30:13,170 +Lag on upgades and virgin movement الان لوصلنا + +333 +00:30:13,170 --> 00:30:17,210 +لسؤال ما هو المقصود بال virgin ما هو تعريف ال + +334 +00:30:17,210 --> 00:30:21,970 +virgin انه + +335 +00:30:21,970 --> 00:30:27,350 +تفضلي okay + +336 +00:30:27,350 --> 00:30:33,190 +or binocular movementeither are conjugate يعني + +337 +00:30:33,190 --> 00:30:37,070 +التنتين بيكونوا ايش مع بعض اللي هو بتحركه، اذا + +338 +00:30:37,070 --> 00:30:41,110 +جونا مثلا ال right abduction، ال left هتكون + +339 +00:30:41,110 --> 00:30:46,500 +abduction، والعكس صحيحLag on up gaze بطلب انا من + +340 +00:30:46,500 --> 00:30:51,700 +المريض ان يطلع الى الاعلى او الاسفل اما بيكون up + +341 +00:30:51,700 --> 00:30:57,060 +gaze او down gaze طبعا الهدف بدي اشوف هل تمركز + +342 +00:30:57,060 --> 00:31:02,260 +العدسة جيد ولا لأ؟ هل العدسة ماخدة uniform و + +343 +00:31:02,260 --> 00:31:04,960 +symmetric on the sclera ولا لأ؟ + +344 +00:31:07,820 --> 00:31:13,440 +is readily بسهولة evaluated بيقيم by observing + +345 +00:31:13,440 --> 00:31:18,460 +بواسطة ملاحظة the change التغير ال concentration + +346 +00:31:18,460 --> 00:31:25,260 +إذا أنا بدي ألاحظ التغير في تمركز العدسة okay in I + +347 +00:31:25,260 --> 00:31:29,520 +position other than primary gaze إذا المريض مش + +348 +00:31:29,520 --> 00:31:33,580 +هيطلع وين في ال primary position إما up gaze أو + +349 +00:31:33,580 --> 00:31:34,240 +down gaze + +350 +00:31:39,080 --> 00:31:44,540 +عادة عدسة عدسة عدسة عدسة عدسة عدسة عدسة عدسة عدسة + +351 +00:31:44,540 --> 00:31:51,180 +عدسة عدسة + +352 +00:31:51,180 --> 00:32:02,100 +عدسة عدسة عدسة + +353 +00:32:02,100 --> 00:32:08,840 +عدسةفهي هتعدي من الكورنية و هتكون على أطراف من ال + +354 +00:32:08,840 --> 00:32:14,840 +limbus فال lag تقريبا فيها هيكون من 0.3 ل 0.7 هذه + +355 +00:32:14,840 --> 00:32:19,560 +في حالة من ال normal لكن ال RGB لو استخدمته + +356 +00:32:19,560 --> 00:32:26,120 +الطريقة هذه كانت مش ظاهرة ال 0.3 ل 0.7 لأن ال + +357 +00:32:26,120 --> 00:32:27,840 +diameter بتاعها أصغر + +358 +00:32:31,560 --> 00:32:35,800 +Excessive lag زيادة ال lag is associated with poor + +359 +00:32:35,800 --> 00:32:39,040 +concentration بالشكل هذا + +360 +00:32:44,380 --> 00:32:50,040 +يما بيزيد اللي هو ال lag هان، يعني بمعنى انه بيغطي + +361 +00:32:50,040 --> 00:32:54,180 +الكورنية و بتعدى ال limbus بمعنى ان ديامتر العدسة + +362 +00:32:54,180 --> 00:32:59,060 +اكبر فبالتالي هتكون اكتر من سبعة من عشرة، ايش + +363 +00:32:59,060 --> 00:33:03,580 +هتعمل؟ poor concentration، عدم تمركز اللي هو جيد + +364 +00:33:03,580 --> 00:33:08,880 +للعدسةيا ما يكون zero lag مش واضح بالمرة، يا ما + +365 +00:33:08,880 --> 00:33:12,240 +يقولنا المريض اتطلع up gaze او down gaze، معنى + +366 +00:33:12,240 --> 00:33:16,280 +الكلام انه ايش عنده العدسة اللي هي ال tie وفيها + +367 +00:33:16,280 --> 00:33:20,440 +اللي هو adherence ما بين ال surface of the lens و + +368 +00:33:20,440 --> 00:33:26,230 +ال corniaببساطة ال lag انا بطلب من المريض انه + +369 +00:33:26,230 --> 00:33:29,510 +دايما ما يطلع في ال primary position اما في ال up + +370 +00:33:29,510 --> 00:33:33,170 +gaze او ال down gaze و ممكن في بعض الأحيان بطلب + +371 +00:33:33,170 --> 00:33:37,250 +right and left يعني abduction و abduction okay و + +372 +00:33:37,250 --> 00:33:41,910 +بشوف انا جديش اطراف العدسة ماخدة اذا كانت النسبة + +373 +00:33:41,910 --> 00:33:45,750 +من تلاتة من عشرة لسبعة من عشرة بنقول هذا normal + +374 +00:33:45,750 --> 00:33:51,180 +طبعا ليه؟ لأن ال diameter للعدسة بيكون كبيرأكبر من + +375 +00:33:51,180 --> 00:33:55,580 +الكورنيا طيب إذا كانت نسبة ال light zero معناه + +376 +00:33:55,580 --> 00:33:59,960 +الكلام انه مافي اي ت ايه بالضبط ان العدسة بتكون + +377 +00:33:59,960 --> 00:34:04,960 +tight يعني adherence to the surface of the cornea + +378 +00:34:04,960 --> 00:34:09,360 +إذا كان اكتر من هذا الرقم معناه الكلام ان العدسة + +379 +00:34:09,360 --> 00:34:13,160 +excessive movement وبالتالي هي قد تكون flat + +380 +00:34:16,710 --> 00:34:21,530 +Tier Exchange تبادل ال tier and the post lens tier + +381 +00:34:21,530 --> 00:34:26,430 +film ما ننسى المعلومة انه من ال limitation للعرصات + +382 +00:34:26,430 --> 00:34:31,190 +اللاصقة اللينة ان في هناك limitation لل tier + +383 +00:34:31,190 --> 00:34:32,030 +exchange + +384 +00:34:34,810 --> 00:34:40,430 +Evaluated بيقيم clinically using observation أنه + +385 +00:34:40,430 --> 00:34:44,530 +أنا بدي ألاحظ في ال Specular illumination طب هل + +386 +00:34:44,530 --> 00:34:46,870 +ممكن أنا أستخدم ال direct illumination في هذا + +387 +00:34:46,870 --> 00:34:50,250 +النوع؟ ليش استخدمنا ال Specular illumination؟ + +388 +00:34:51,130 --> 00:34:56,230 +ببساطة لأن في هناك angle هيكون فيه angle ما بين + +389 +00:34:56,230 --> 00:35:01,550 +اللي هو ال tube او ال biomicroscope و الجهاز اللي + +390 +00:35:01,550 --> 00:35:05,530 +انا بدي استخدمه او ال mires هيكون angle من خمسة و + +391 +00:35:05,530 --> 00:35:09,890 +أربعين لستين degree فدايما هنا ما بنستخدم ال + +392 +00:35:09,890 --> 00:35:13,170 +direct illumination بنستخدم ال specular + +393 +00:35:13,170 --> 00:35:14,050 +illumination + +394 +00:35:17,470 --> 00:35:22,150 +high magnification تكبير كبير بيكون تقريبا تلاتين + +395 +00:35:22,150 --> 00:35:28,690 +لستين اكتس a wide angle of observation more than + +396 +00:35:28,690 --> 00:35:32,650 +sixty degrees او بنقول دايما من خمسة واربين لستين + +397 +00:35:32,650 --> 00:35:37,750 +ديجري and a narrow slit انه هيكون ال slit بيهم او + +398 +00:35:37,750 --> 00:35:40,030 +point one millimeter are needed + +399 +00:35:42,600 --> 00:35:47,480 +An optimal fit lens or an optimal lens fit + +400 +00:35:47,480 --> 00:35:53,660 +requires an aqueous post lens، tear film لازم ان + +401 +00:35:53,660 --> 00:35:58,640 +يكون فيه هناك ايه تحريك للعدسة عشان تعمل هناك + +402 +00:35:58,640 --> 00:36:04,940 +تحريك لمين؟ لل tear exchangewhich is observed هذا + +403 +00:36:04,940 --> 00:36:08,680 +هيكون ملاحظ ان هو عبارة عن amorphous ايش يعني + +404 +00:36:08,680 --> 00:36:12,560 +amorphous يعني no pattern مافيش هناك اي تشكل له + +405 +00:36:12,560 --> 00:36:17,660 +يعني صح بتلاحظ ان في حركة لكن without pattern بدون + +406 +00:36:17,660 --> 00:36:22,520 +شكل او no pattern او بنسميها amorphous in a + +407 +00:36:22,520 --> 00:36:25,960 +specular reflection او a specular illumination + +408 +00:36:31,000 --> 00:36:35,160 +post lens tear film appearances are taken to + +409 +00:36:35,160 --> 00:36:40,100 +indicate reduced tear exchange بتلاحظ انه لو كان + +410 +00:36:40,100 --> 00:36:43,980 +هناك فيه pattern معناه الكلام انه في هناك + +411 +00:36:43,980 --> 00:36:49,880 +adherence للعدسة في التساق للعدسة فهيكون ظاهر انه + +412 +00:36:49,880 --> 00:36:54,420 +في pattern شكل او له color معين يكون اقرب لللون + +413 +00:36:54,420 --> 00:36:55,260 +الرمادي + +414 +00:36:57,610 --> 00:37:02,130 +وهذا بتديني indication انه في هناك reduce لل tier + +415 +00:37:02,130 --> 00:37:06,170 +exchange معنى الكلام يما يكون في هذا الموضوع ايش + +416 +00:37:06,170 --> 00:37:10,490 +بدي اعمل؟ بدي ارفع العدسة اللاصقة و اعمل tier film + +417 +00:37:10,490 --> 00:37:14,490 +evaluation من ناحية ال TPUT ال corneal fluorescent + +418 +00:37:14,490 --> 00:37:19,990 +staining keratometer + +419 +00:37:19,990 --> 00:37:20,770 +measures + +420 +00:37:24,950 --> 00:37:31,650 +إنه بدنا نعمل تقييم ل الكيراتو ميتر في المحاضرة ان + +421 +00:37:31,650 --> 00:37:35,870 +شاء الله يعني بتوقف لهذه النقطة لكراتو ميتر مياردز + +422 +00:37:35,870 --> 00:37:40,730 +وفي المحاضرة القادمة بنكمل ان شاء الله موضوع + +423 +00:37:40,730 --> 00:37:44,810 +الكيراتو ميتر مياردز يعطيكم العافية + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/jfd3UxR95_E_raw.json b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/jfd3UxR95_E_raw.json new file mode 100644 index 0000000000000000000000000000000000000000..07e1001e9288918c564881ce2181301da0776190 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/jfd3UxR95_E_raw.json @@ -0,0 +1 @@ +{"segments": [{"id": 1, "seek": 4739, "start": 21.11, "end": 47.39, "text": "بسم الله الرحمن الرحيم السلام عليكم ورحمة الله وبركاته ومرحباً لكم جميعًا سنكمل إن شاء الله في موضوع الـ soft contact lenses modalities أنواع أو أنماط أو أشكال العدسات 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tears للداخل وكل ال tears بتجمع وين على سطح العدسة طبعا ببساطة عشان يحافظ على مرونة العدسة", "tokens": [41185, 18863, 3215, 3794, 3660, 1975, 2407, 47524, 10943, 9307, 20449, 9957, 3660, 8978, 29538, 18863, 42213, 10632, 39896, 27842, 3615, 9154, 11778, 9778, 12610, 1975, 1829, 3224, 2423, 10462, 24976, 3215, 47283, 1211, 4032, 28820, 2423, 10462, 39894, 7435, 2304, 3615, 4032, 9957, 15844, 8608, 9566, 5016, 18863, 3215, 3794, 3660, 23032, 3555, 3615, 995, 4724, 3555, 3794, 41193, 3660, 6225, 8592, 7649, 7251, 5016, 31845, 19913, 15844, 3714, 2288, 11536, 3660, 18863, 3215, 3794, 3660], "avg_logprob": -0.1094751598743292, "compression_ratio": 1.6666666666666667, "no_speech_prob": 5.960464477539063e-08, "words": [{"start": 167.45, "end": 167.63, "word": "في", "probability": 0.7099609375}, {"start": 167.63, "end": 168.25, "word": " العدسة", "probability": 0.9813232421875}, {"start": 168.25, "end": 168.61, "word": " او", "probability": 0.7724609375}, {"start": 168.61, "end": 169.19, "word": " مسامات", "probability": 0.94873046875}, {"start": 169.19, "end": 169.85, "word": " معينة", "probability": 0.97900390625}, {"start": 169.85, "end": 170.53, "word": " في", "probability": 0.77490234375}, {"start": 170.53, "end": 170.81, "word": " هذه", "probability": 0.9638671875}, {"start": 170.81, "end": 171.53, "word": " العملية", "probability": 0.9822591145833334}, {"start": 171.53, "end": 172.87, "word": " هيمنع", "probability": 0.8543294270833334}, {"start": 172.87, "end": 173.13, "word": " من", "probability": 0.96923828125}, {"start": 173.13, "end": 173.63, "word": " دخول", "probability": 0.98388671875}, {"start": 173.63, "end": 174.31, "word": " ايه", "probability": 0.742431640625}, {"start": 174.31, "end": 174.59, "word": " ال", "probability": 0.7705078125}, {"start": 174.59, "end": 175.05, "word": " tears", "probability": 0.8095703125}, {"start": 175.05, "end": 176.33, "word": " للداخل", "probability": 0.8724365234375}, {"start": 176.33, "end": 177.01, "word": " وكل", "probability": 0.751220703125}, {"start": 177.01, "end": 177.17, "word": " ال", "probability": 0.97607421875}, {"start": 177.17, "end": 177.45, "word": " tears", "probability": 0.99072265625}, {"start": 177.45, "end": 178.27, "word": " بتجمع", "probability": 0.8887939453125}, {"start": 178.27, "end": 178.55, "word": " وين", "probability": 0.855224609375}, {"start": 178.55, "end": 178.89, "word": " على", "probability": 0.5224609375}, {"start": 178.89, "end": 179.21, "word": " سطح", "probability": 0.9812825520833334}, {"start": 179.21, "end": 179.77, "word": " العدسة", "probability": 0.995849609375}, {"start": 179.77, "end": 180.53, "word": " طبعا", "probability": 0.9542236328125}, {"start": 180.53, "end": 181.37, "word": " ببساطة", "probability": 0.868359375}, {"start": 181.37, "end": 182.03, "word": " عشان", "probability": 0.97265625}, {"start": 182.03, "end": 182.61, "word": " يحافظ", "probability": 0.9947509765625}, {"start": 182.61, "end": 182.97, "word": " على", "probability": 0.84716796875}, {"start": 182.97, "end": 183.79, "word": " مرونة", "probability": 0.9775390625}, {"start": 183.79, "end": 184.53, "word": " العدسة", "probability": 0.995849609375}], "temperature": 1.0}, {"id": 8, "seek": 20074, "start": 185.54, "end": 200.74, "text": "Okay؟ لأن احنا عارفين ان مادة السيليكون بتزود من ال wetability المتانة فهي لو .. وهي hydrophobic صح؟ هذه العملية ما ننسى اسم العدسة ان هي تعتبر ايه؟ Hydrogel", "tokens": [8297, 22807, 5296, 33456, 1975, 5016, 8315, 6225, 9640, 5172, 9957, 16472, 3714, 18513, 3660, 21136, 1829, 20292, 30544, 39894, 11622, 23328, 9154, 2423, 6630, 2310, 9673, 2655, 7649, 3660, 6156, 3224, 1829, 45164, 4386, 37037, 1829, 5796, 11741, 22234, 20328, 5016, 22807, 29538, 18863, 42213, 10632, 19446, 8717, 1863, 3794, 7578, 24525, 2304, 18863, 3215, 3794, 3660, 16472, 39896, 6055, 34268, 26890, 1975, 1829, 3224, 22807, 24231, 6675, 338], "avg_logprob": -0.17968749916049795, "compression_ratio": 1.3715846994535519, "no_speech_prob": 0.0, "words": [{"start": 185.54, "end": 186.42, "word": "Okay؟", "probability": 0.7392578125}, {"start": 186.42, "end": 186.6, "word": " لأن", "probability": 0.812255859375}, {"start": 186.6, "end": 186.78, "word": " احنا", "probability": 0.7500813802083334}, {"start": 186.78, "end": 187.22, "word": " عارفين", "probability": 0.9918212890625}, {"start": 187.22, "end": 187.46, "word": " ان", "probability": 0.6748046875}, {"start": 187.46, "end": 187.94, "word": " مادة", "probability": 0.9567057291666666}, {"start": 187.94, "end": 188.54, "word": " السيليكون", "probability": 0.768310546875}, {"start": 188.54, "end": 189.52, "word": " بتزود", "probability": 0.85205078125}, {"start": 189.52, "end": 189.88, "word": " من", "probability": 0.99267578125}, {"start": 189.88, "end": 190.22, "word": " ال", "probability": 0.9697265625}, {"start": 190.22, "end": 190.84, "word": " wetability", "probability": 0.53192138671875}, {"start": 190.84, "end": 191.74, "word": " المتانة", "probability": 0.951416015625}, {"start": 191.74, "end": 192.54, "word": " فهي", "probability": 0.87255859375}, {"start": 192.54, "end": 192.74, "word": " لو", "probability": 0.96630859375}, {"start": 192.74, "end": 193.18, "word": " ..", "probability": 0.63232421875}, {"start": 193.18, "end": 193.46, "word": " وهي", "probability": 0.7301025390625}, {"start": 193.46, "end": 194.32, "word": " hydrophobic", "probability": 0.7892252604166666}, {"start": 194.32, "end": 195.24, "word": " صح؟", "probability": 0.9134114583333334}, {"start": 195.24, "end": 195.54, "word": " هذه", "probability": 0.7646484375}, {"start": 195.54, "end": 196.26, "word": " العملية", "probability": 0.9777018229166666}, {"start": 196.26, "end": 197.28, "word": " ما", "probability": 0.88818359375}, {"start": 197.28, "end": 197.68, "word": " ننسى", "probability": 0.9580078125}, {"start": 197.68, "end": 197.92, "word": " اسم", "probability": 0.914794921875}, {"start": 197.92, "end": 198.46, "word": " العدسة", "probability": 0.9776611328125}, {"start": 198.46, "end": 198.64, "word": " ان", "probability": 0.7841796875}, {"start": 198.64, "end": 198.86, "word": " هي", "probability": 0.64697265625}, {"start": 198.86, "end": 199.4, "word": " تعتبر", "probability": 0.9724934895833334}, {"start": 199.4, "end": 199.9, "word": " ايه؟", "probability": 0.8953857421875}, {"start": 199.9, "end": 200.74, "word": " Hydrogel", "probability": 0.7893880208333334}], "temperature": 1.0}, {"id": 9, "seek": 21822, "start": 201.52, "end": 218.22, "text": "Okay؟ يعني بمعنى انه محب للماء فهذه العملية بساطة بتعمل تعديل لسطح العدسة و كل ال tears هيتجمع على سطح العدسة و بتمنع من دخوله للداخل يعني بمعنى انه بتحافظ على مرونة العدسة", "tokens": [8297, 22807, 37495, 22653, 4724, 2304, 3615, 1863, 7578, 16472, 3224, 3714, 5016, 3555, 5296, 19528, 16606, 6156, 3224, 24192, 18863, 42213, 10632, 4724, 3794, 41193, 3660, 39894, 25957, 1211, 6055, 3615, 16254, 1211, 5296, 3794, 9566, 5016, 18863, 3215, 3794, 3660, 4032, 28242, 2423, 10462, 8032, 36081, 7435, 2304, 3615, 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"word": " العملية", "probability": 0.9599609375}, {"start": 205.16, "end": 205.86, "word": " بساطة", "probability": 0.858154296875}, {"start": 205.86, "end": 206.8, "word": " بتعمل", "probability": 0.9072265625}, {"start": 206.8, "end": 207.42, "word": " تعديل", "probability": 0.8275146484375}, {"start": 207.42, "end": 208.02, "word": " لسطح", "probability": 0.9808349609375}, {"start": 208.02, "end": 208.62, "word": " العدسة", "probability": 0.98193359375}, {"start": 208.62, "end": 209.16, "word": " و", "probability": 0.9482421875}, {"start": 209.16, "end": 209.46, "word": " كل", "probability": 0.493408203125}, {"start": 209.46, "end": 209.62, "word": " ال", "probability": 0.943359375}, {"start": 209.62, "end": 209.94, "word": " tears", "probability": 0.87060546875}, {"start": 209.94, "end": 210.74, "word": " هيتجمع", "probability": 0.88662109375}, {"start": 210.74, "end": 210.9, "word": " على", "probability": 0.85888671875}, {"start": 210.9, "end": 211.26, "word": " سطح", "probability": 0.9876302083333334}, {"start": 211.26, "end": 211.92, "word": " العدسة", "probability": 0.9962158203125}, {"start": 211.92, "end": 212.24, "word": " و", "probability": 0.7890625}, {"start": 212.24, "end": 212.74, "word": " بتمنع", "probability": 0.9026692708333334}, {"start": 212.74, "end": 212.9, "word": " من", "probability": 0.9814453125}, {"start": 212.9, "end": 213.56, "word": " دخوله", "probability": 0.994140625}, {"start": 213.56, "end": 214.38, "word": " للداخل", "probability": 0.971923828125}, {"start": 214.38, "end": 214.84, "word": " يعني", "probability": 0.7490234375}, {"start": 214.84, "end": 215.36, "word": " بمعنى", "probability": 0.98955078125}, {"start": 215.36, "end": 215.62, "word": " انه", "probability": 0.885498046875}, {"start": 215.62, "end": 216.22, "word": " بتحافظ", "probability": 0.9808349609375}, {"start": 216.22, "end": 216.56, "word": " على", "probability": 0.89990234375}, {"start": 216.56, "end": 217.5, "word": " مرونة", "probability": 0.9813232421875}, {"start": 217.5, "end": 218.22, "word": " العدسة", "probability": 0.9959716796875}], "temperature": 1.0}, {"id": 10, "seek": 23647, "start": 219.91, "end": 236.47, "text": "طبعا هذه العملية ال plasma batch process زودت من سعر العدسة بشكل بسيط يعني slightly high cost أو slightly higher كان سعر العدسة مرتفع نسبيا", "tokens": [9566, 3555, 3615, 995, 29538, 18863, 42213, 10632, 2423, 22564, 15245, 1399, 30767, 23328, 2655, 9154, 8608, 3615, 2288, 18863, 3215, 3794, 3660, 4724, 8592, 28820, 4724, 3794, 1829, 9566, 37495, 22653, 4748, 1090, 2063, 34051, 4748, 2946, 25961, 8608, 3615, 2288, 18863, 3215, 3794, 3660, 3714, 43500, 5172, 3615, 8717, 35457, 25528], "avg_logprob": -0.07320601755270252, "compression_ratio": 1.4109589041095891, "no_speech_prob": 0.0, "words": [{"start": 219.91, "end": 220.33, "word": "طبعا", "probability": 0.98828125}, {"start": 220.33, "end": 220.93, "word": " هذه", "probability": 0.76708984375}, {"start": 220.93, "end": 221.95, "word": " العملية", "probability": 0.9803059895833334}, {"start": 221.95, "end": 222.49, "word": " ال", "probability": 0.69970703125}, {"start": 222.49, "end": 223.13, "word": " plasma", "probability": 0.6796875}, {"start": 223.13, "end": 223.91, "word": " batch", "probability": 0.9189453125}, {"start": 223.91, "end": 224.63, "word": " process", "probability": 0.98095703125}, {"start": 224.63, "end": 225.83, "word": " زودت", "probability": 0.9632161458333334}, {"start": 225.83, "end": 226.23, "word": " من", "probability": 0.9892578125}, {"start": 226.23, "end": 226.61, "word": " سعر", "probability": 0.99462890625}, {"start": 226.61, "end": 227.25, "word": " العدسة", "probability": 0.985107421875}, {"start": 227.25, "end": 227.87, "word": " بشكل", "probability": 0.98974609375}, {"start": 227.87, "end": 228.41, "word": " بسيط", "probability": 0.996337890625}, {"start": 228.41, "end": 228.91, "word": " يعني", "probability": 0.739990234375}, {"start": 228.91, "end": 229.57, "word": " slightly", "probability": 0.8505859375}, {"start": 229.57, "end": 230.47, "word": " high", "probability": 0.92578125}, {"start": 230.47, "end": 231.19, "word": " cost", "probability": 0.8955078125}, {"start": 231.19, "end": 232.19, "word": " أو", "probability": 0.54736328125}, {"start": 232.19, "end": 232.73, "word": " slightly", "probability": 0.916015625}, {"start": 232.73, "end": 233.39, "word": " higher", "probability": 0.884765625}, {"start": 233.39, "end": 233.83, "word": " كان", "probability": 0.798828125}, {"start": 233.83, "end": 234.21, "word": " سعر", "probability": 0.9949544270833334}, {"start": 234.21, "end": 234.87, "word": " العدسة", "probability": 0.9969482421875}, {"start": 234.87, "end": 235.75, "word": " مرتفع", "probability": 0.9951171875}, {"start": 235.75, "end": 236.47, "word": " نسبيا", "probability": 0.8857421875}], "temperature": 1.0}, {"id": 11, "seek": 26604, "start": 237.8, "end": 266.04, "text": "clean and disinfect the lenses only occasionally or not at all احنا بنعرف ان فترة حياة العدسة قصيرة فأنظمة التنظيف و التعقيم لهذا النوع من العدسات هتكون occasionally احيانا او اللي هو نادرا rarely او ماهتكونش مطلقا okay minimizing the cost of lens maintenance", "tokens": [2160, 282, 293, 33334, 264, 18059, 787, 16895, 420, 406, 412, 439, 1975, 5016, 8315, 44945, 3615, 28480, 16472, 6156, 2655, 25720, 11331, 25528, 3660, 18863, 3215, 3794, 3660, 12174, 9381, 48923, 6156, 33456, 19913, 46007, 16712, 1863, 19913, 33911, 4032, 16712, 3615, 4587, 32640, 46740, 15730, 28239, 45367, 9154, 18863, 3215, 3794, 9307, 8032, 2655, 30544, 16895, 1975, 5016, 1829, 7649, 995, 1975, 2407, 13672, 1829, 31439, 8717, 18513, 23557, 13752, 1975, 2407, 19446, 3224, 2655, 30544, 8592, 3714, 9566, 1211, 4587, 995, 1392, 46608, 264, 2063, 295, 6765, 11258], "avg_logprob": -0.14444633719065916, "compression_ratio": 1.5617021276595744, "no_speech_prob": 0.0, "words": [{"start": 237.8, "end": 238.48, "word": "clean", "probability": 0.69580078125}, {"start": 238.48, "end": 238.92, "word": " and", 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عشرين", "probability": 0.8919270833333334}, {"start": 1141.92, "end": 1143.26, "word": " الان", "probability": 0.6544189453125}, {"start": 1143.26, "end": 1143.7, "word": " لازم", "probability": 0.97265625}, {"start": 1143.7, "end": 1143.9, "word": " ان", "probability": 0.73046875}, {"start": 1143.9, "end": 1144.26, "word": " يكون", "probability": 0.98095703125}, {"start": 1144.26, "end": 1144.58, "word": " هنا", "probability": 0.59423828125}, {"start": 1144.58, "end": 1145.26, "word": " good", "probability": 0.80615234375}, {"start": 1145.26, "end": 1146.3, "word": " brillance", "probability": 0.751220703125}, {"start": 1146.3, "end": 1147.1, "word": " يعني", "probability": 0.909423828125}, {"start": 1147.1, "end": 1147.58, "word": " ثبات", "probability": 0.8860677083333334}, {"start": 1147.58, "end": 1148.64, "word": " العدسة", "probability": 0.9732666015625}, {"start": 1148.64, "end": 1149.72, "word": " يكون", "probability": 0.7017822265625}, {"start": 1149.72, "end": 1150.16, "word": " مهم", "probability": 0.990234375}, {"start": 1150.16, "end": 1151.06, "word": " بالنسبة", "probability": 0.9368896484375}, {"start": 1151.06, "end": 1151.6, "word": " لمين؟", "probability": 0.767333984375}], "temperature": 1.0}, {"id": 48, "seek": 117215, "start": 1152.51, "end": 1172.15, "text": "لا ال examiner لأنه الآن لو انا مافيش عندي ثبات للعدسة هتلاحظ ان في المريض دايما عنده blinking فكل ما هو عمل blinking الحركة اشمالها بالزيد وبالتالي بتعمل unstable vision و بتعمل blurred vision لل patient", "tokens": [15040, 2423, 1139, 4564, 5296, 33456, 3224, 6024, 48506, 45164, 1975, 8315, 19446, 41185, 8592, 18871, 16254, 38637, 3555, 9307, 24976, 22488, 3794, 3660, 8032, 2655, 15040, 5016, 19913, 16472, 8978, 9673, 16572, 11242, 11778, 47302, 15042, 43242, 3224, 45879, 6156, 28820, 19446, 31439, 6225, 42213, 45879, 21542, 31747, 3660, 1975, 8592, 2304, 6027, 11296, 20666, 11622, 25708, 46599, 6027, 2655, 6027, 1829, 39894, 25957, 1211, 23742, 5201, 4032, 39894, 25957, 1211, 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1156.61, "end": 1158.37, "word": " للعدسة", "probability": 0.8056640625}, {"start": 1158.37, "end": 1158.99, "word": " هتلاحظ", "probability": 0.9119140625}, {"start": 1158.99, "end": 1159.19, "word": " ان", "probability": 0.66357421875}, {"start": 1159.19, "end": 1159.45, "word": " في", "probability": 0.537109375}, {"start": 1159.45, "end": 1160.35, "word": " المريض", "probability": 0.9591471354166666}, {"start": 1160.35, "end": 1160.69, "word": " دايما", "probability": 0.9295247395833334}, {"start": 1160.69, "end": 1161.07, "word": " عنده", "probability": 0.984130859375}, {"start": 1161.07, "end": 1161.45, "word": " blinking", "probability": 0.9580078125}, {"start": 1161.45, "end": 1162.31, "word": " فكل", "probability": 0.949462890625}, {"start": 1162.31, "end": 1162.43, "word": " ما", "probability": 0.93603515625}, {"start": 1162.43, "end": 1162.63, "word": " هو", "probability": 0.896484375}, {"start": 1162.63, "end": 1162.93, "word": " عمل", "probability": 0.939697265625}, {"start": 1162.93, "end": 1163.47, "word": " blinking", "probability": 0.76953125}, {"start": 1163.47, "end": 1164.35, "word": " الحركة", "probability": 0.953125}, {"start": 1164.35, "end": 1165.07, "word": " اشمالها", "probability": 0.8548828125}, {"start": 1165.07, "end": 1166.21, "word": " بالزيد", "probability": 0.733642578125}, {"start": 1166.21, "end": 1166.99, "word": " وبالتالي", "probability": 0.9275390625}, {"start": 1166.99, "end": 1167.61, "word": " بتعمل", "probability": 0.9757486979166666}, {"start": 1167.61, "end": 1168.45, "word": " unstable", "probability": 0.76025390625}, {"start": 1168.45, "end": 1169.49, "word": " vision", "probability": 0.9384765625}, {"start": 1169.49, "end": 1169.97, "word": " و", "probability": 0.73583984375}, {"start": 1169.97, "end": 1170.45, "word": " بتعمل", "probability": 0.8505859375}, {"start": 1170.45, "end": 1170.81, "word": " blurred", "probability": 0.78369140625}, {"start": 1170.81, "end": 1171.21, "word": " vision", "probability": 0.94970703125}, {"start": 1171.21, "end": 1171.59, "word": " لل", "probability": 0.59326171875}, {"start": 1171.59, "end": 1172.15, "word": " patient", "probability": 0.900390625}], "temperature": 1.0}, {"id": 49, "seek": 118875, "start": 1172.79, "end": 1188.75, "text": "إذا جد بري لينز tier film stability إذا ثبات ال tier film مهم كتير greater than normal inter blink interval يعني لازم أن يكون الثبات أكتر من 100 من ال blinking", "tokens": [28814, 15730, 10874, 3215, 4724, 16572, 5296, 9957, 11622, 12362, 2007, 11826, 11933, 15730, 38637, 3555, 9307, 2423, 12362, 2007, 3714, 16095, 9122, 2655, 13546, 5044, 813, 2710, 728, 24667, 15035, 37495, 22653, 5296, 31377, 2304, 14739, 7251, 30544, 6024, 104, 3555, 9307, 5551, 4117, 2655, 2288, 9154, 2319, 9154, 2423, 45879], "avg_logprob": -0.3063089757595422, "compression_ratio": 1.3821656050955413, "no_speech_prob": 0.0, "words": [{"start": 1172.79, "end": 1173.13, "word": "إذا", "probability": 0.6263427734375}, {"start": 1173.13, "end": 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"end": 1178.85, "word": " كتير", "probability": 0.9383138020833334}, {"start": 1178.85, "end": 1179.95, "word": " greater", "probability": 0.154052734375}, {"start": 1179.95, "end": 1180.67, "word": " than", "probability": 0.9580078125}, {"start": 1180.67, "end": 1181.47, "word": " normal", "probability": 0.806640625}, {"start": 1181.47, "end": 1181.97, "word": " inter", "probability": 0.83935546875}, {"start": 1181.97, "end": 1182.35, "word": " blink", "probability": 0.607421875}, {"start": 1182.35, "end": 1183.19, "word": " interval", "probability": 0.9599609375}, {"start": 1183.19, "end": 1184.17, "word": " يعني", "probability": 0.871337890625}, {"start": 1184.17, "end": 1184.63, "word": " لازم", "probability": 0.9840494791666666}, {"start": 1184.63, "end": 1184.83, "word": " أن", "probability": 0.48974609375}, {"start": 1184.83, "end": 1185.35, "word": " يكون", "probability": 0.914794921875}, {"start": 1185.35, "end": 1186.43, "word": " الثبات", "probability": 0.9735107421875}, {"start": 1186.43, "end": 1187.07, "word": " أكتر", "probability": 0.9637451171875}, {"start": 1187.07, "end": 1187.27, "word": " من", "probability": 0.98828125}, {"start": 1187.27, "end": 1187.53, "word": " 100", "probability": 0.6767578125}, {"start": 1187.53, "end": 1188.11, "word": " من", "probability": 0.94580078125}, {"start": 1188.11, "end": 1188.37, "word": " ال", "probability": 0.83740234375}, {"start": 1188.37, "end": 1188.75, "word": " blinking", "probability": 0.96337890625}], "temperature": 1.0}, {"id": 50, "seek": 121033, "start": 1189.96, "end": 1210.34, "text": "بحيث انه دايما العدسة تكون ثابتة او ماخدة good concentration للعدسة لمركزها جيد لو كل المريض مثلا حرك عينه العدسة انه تكون follow لمين للعين lens movement حركة العدسة", "tokens": [49628, 1829, 12984, 16472, 3224, 11778, 47302, 15042, 18863, 3215, 3794, 3660, 6055, 30544, 38637, 16758, 2655, 3660, 1975, 2407, 3714, 47283, 41891, 665, 9856, 24976, 22488, 3794, 3660, 5296, 29973, 4117, 11622, 11296, 10874, 25708, 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0.92724609375}, {"start": 1193.38, "end": 1194.04, "word": " good", "probability": 0.48681640625}, {"start": 1194.04, "end": 1194.88, "word": " concentration", "probability": 0.482421875}, {"start": 1194.88, "end": 1195.8, "word": " للعدسة", "probability": 0.9075927734375}, {"start": 1195.8, "end": 1196.56, "word": " لمركزها", "probability": 0.826318359375}, {"start": 1196.56, "end": 1196.92, "word": " جيد", "probability": 0.986572265625}, {"start": 1196.92, "end": 1197.48, "word": " لو", "probability": 0.568359375}, {"start": 1197.48, "end": 1197.74, "word": " كل", "probability": 0.66259765625}, {"start": 1197.74, "end": 1198.62, "word": " المريض", "probability": 0.8668619791666666}, {"start": 1198.62, "end": 1199.5, "word": " مثلا", "probability": 0.95849609375}, {"start": 1199.5, "end": 1200.14, "word": " حرك", "probability": 0.9423828125}, {"start": 1200.14, "end": 1200.64, "word": " عينه", "probability": 0.98779296875}, {"start": 1200.64, "end": 1201.36, "word": " العدسة", "probability": 0.9571533203125}, {"start": 1201.36, "end": 1201.6, "word": " انه", "probability": 0.875244140625}, {"start": 1201.6, "end": 1201.88, "word": " تكون", "probability": 0.987548828125}, {"start": 1201.88, "end": 1202.14, "word": " follow", "probability": 0.80615234375}, {"start": 1202.14, "end": 1202.56, "word": " لمين", "probability": 0.6959228515625}, {"start": 1202.56, "end": 1203.3, "word": " للعين", "probability": 0.9783528645833334}, {"start": 1203.3, "end": 1208.12, "word": " lens", "probability": 0.5595703125}, {"start": 1208.12, "end": 1208.64, "word": " movement", "probability": 0.9365234375}, {"start": 1208.64, "end": 1209.52, "word": " حركة", "probability": 0.9602864583333334}, {"start": 1209.52, "end": 1210.34, "word": " العدسة", "probability": 0.9952392578125}], "temperature": 1.0}, {"id": 51, "seek": 124088, "start": 1211.72, "end": 1240.88, "text": "التبرموس أي بمعنى تعزز post lens tear film exchange and mixing الآن حركة العدسة بتعزز من حركة مين؟ ال tear film طبعا احنا دايما حكينا ان ال soft contact lens بيكون فيها limitation من ناحية مين؟ من موضوع ال tear exchange تبادل ال tear صحيح؟", "tokens": [6027, 2655, 26890, 2304, 41779, 36632, 4724, 2304, 3615, 1863, 7578, 37279, 11622, 11622, 2183, 6765, 12556, 2007, 7742, 293, 11983, 6024, 48506, 11331, 31747, 3660, 18863, 3215, 3794, 3660, 39894, 3615, 11622, 11622, 9154, 11331, 31747, 3660, 3714, 9957, 22807, 2423, 12556, 2007, 23032, 3555, 3615, 995, 1975, 5016, 8315, 11778, 47302, 15042, 11331, 4117, 1829, 8315, 16472, 2423, 2787, 3385, 6765, 4724, 1829, 30544, 8978, 11296, 27432, 9154, 8717, 39319, 10632, 3714, 9957, 22807, 9154, 3714, 2407, 11242, 45367, 2423, 12556, 7742, 6055, 3555, 18513, 1211, 2423, 12556, 20328, 5016, 1829, 5016, 22807], "avg_logprob": -0.11482747388072312, "compression_ratio": 1.6221198156682028, "no_speech_prob": 0.0, "words": [{"start": 1211.72, "end": 1212.74, "word": "التبرموس", "probability": 0.702099609375}, {"start": 1212.74, "end": 1213.2, "word": " أي", 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1349.36, "text": "إذا كانت حركتها أقل من واحد من عشرة، بتكون غير كافية أو غير مناسبة أو غير ملائمة، بمعنى إنه بتعمل tight أو بتكون steep أو بتعمل adherence ما بين ال surface للعدسة و الكورنية", "tokens": [28814, 15730, 25961, 2655, 11331, 31747, 2655, 11296, 5551, 4587, 1211, 9154, 36764, 24401, 9154, 6225, 8592, 25720, 12399, 39894, 30544, 32771, 13546, 9122, 31845, 10632, 34051, 32771, 13546, 3714, 8315, 35457, 3660, 34051, 32771, 13546, 3714, 1211, 16373, 46007, 12399, 4724, 2304, 3615, 1863, 7578, 36145, 3224, 39894, 25957, 1211, 4524, 34051, 39894, 30544, 16841, 34051, 39894, 25957, 1211, 30106, 655, 19446, 49374, 2423, 3753, 24976, 22488, 3794, 3660, 4032, 33251, 13063, 1863, 10632], "avg_logprob": -0.13301809759516464, "compression_ratio": 1.6033519553072626, "no_speech_prob": 0.0, "words": [{"start": 1334.46, "end": 1334.76, "word": "إذا", "probability": 0.852783203125}, {"start": 1334.76, "end": 1335.12, "word": " كانت", "probability": 0.976806640625}, {"start": 1335.12, 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" عبارة", "probability": 0.99658203125}, {"start": 1366.96, "end": 1367.14, "word": " عن", "probability": 0.99853515625}, {"start": 1367.14, "end": 1367.42, "word": " foreign", "probability": 0.90771484375}, {"start": 1367.42, "end": 1368.04, "word": " body", "probability": 0.8876953125}], "temperature": 1.0}, {"id": 58, "seek": 139515, "start": 1371.67, "end": 1395.15, "text": "left lenses او ال conventional daily wear lenses عدسات اللبس اليومي التقليدي okay that fit بتم وضع اللي هو ال ideal fit لها او ال fit well يعني الأفضل يعني ال fitting الجيد او المناسب لها show about 0.3 millimeter of movement", "tokens": [41761, 18059, 1975, 2407, 2423, 16011, 5212, 3728, 18059, 6225, 3215, 3794, 9307, 13672, 3555, 3794, 45595, 20498, 1829, 16712, 4587, 20292, 16254, 1392, 300, 3318, 39894, 2304, 4032, 11242, 3615, 13672, 1829, 31439, 2423, 7157, 3318, 5296, 11296, 1975, 2407, 2423, 3318, 731, 37495, 22653, 16247, 5172, 11242, 1211, 37495, 22653, 2423, 15669, 25724, 25708, 1975, 2407, 9673, 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هذا الاختبار it should regain optimal centration in lens in less than one second العدسة هترجع لمكانها الأصلي اللي هو ال optimal fit بعد أقل من كده واحد ثانية", "tokens": [40228, 22653, 19446, 41361, 8592, 8978, 3224, 46811, 31747, 11622, 3714, 1211, 16373, 2304, 34051, 3714, 8315, 35457, 24976, 22488, 3794, 3660, 1270, 382, 365, 264, 2944, 12, 1010, 1500, 4724, 995, 14851, 9778, 3215, 10943, 23758, 2423, 47283, 2655, 3555, 9640, 309, 820, 35336, 16252, 1489, 2405, 294, 6765, 294, 1570, 813, 472, 1150, 18863, 3215, 3794, 3660, 8032, 2655, 47341, 3615, 32767, 41361, 11296, 16247, 9381, 20292, 13672, 1829, 31439, 2423, 16252, 3318, 39182, 5551, 4587, 1211, 9154, 9122, 3215, 3224, 36764, 24401, 38637, 7649, 10632], "avg_logprob": -0.145716289455971, "compression_ratio": 1.4703389830508475, "no_speech_prob": 0.0, "words": [{"start": 1780.26, "end": 1780.54, "word": "يعني", "probability": 0.8564453125}, {"start": 1780.54, "end": 1780.98, "word": " ماكانش", "probability": 0.7918294270833334}, 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الاعلى", "probability": 0.8587239583333334}, {"start": 1848.88, "end": 1849.38, "word": " او", "probability": 0.97314453125}, {"start": 1849.38, "end": 1850.3, "word": " الاسفل", "probability": 0.8848876953125}, {"start": 1850.3, "end": 1850.92, "word": " اما", "probability": 0.866455078125}, {"start": 1850.92, "end": 1851.36, "word": " بيكون", "probability": 0.8419596354166666}, {"start": 1851.36, "end": 1851.7, "word": " up", "probability": 0.88427734375}, {"start": 1851.7, "end": 1852.02, "word": " gaze", "probability": 0.900390625}, {"start": 1852.02, "end": 1852.42, "word": " او", "probability": 0.87646484375}, {"start": 1852.42, "end": 1852.8, "word": " down", "probability": 0.8564453125}, {"start": 1852.8, "end": 1853.46, "word": " gaze", "probability": 0.90771484375}, {"start": 1853.46, "end": 1854.52, "word": " طبعا", "probability": 0.9674072265625}, {"start": 1854.52, "end": 1855.04, "word": " الهدف", "probability": 0.98974609375}, {"start": 1855.04, "end": 1855.44, "word": " 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"end": 2160.74, "word": " tear", "probability": 0.74755859375}, {"start": 2160.74, "end": 2161.38, "word": " exchange", "probability": 0.95849609375}], "temperature": 1.0}, {"id": 94, "seek": 218596, "start": 2162.6, "end": 2185.96, "text": "which is observed هذا هيكون ملاحظ ان هو عبارة عن amorphous ايش يعني amorphous يعني no pattern مافيش هناك اي تشكل له يعني صح بتلاحظ ان في حركة لكن without pattern بدون شكل او no pattern او بنسميها amorphous in a specular reflection او a specular illumination", "tokens": [13690, 307, 13095, 23758, 39896, 30544, 3714, 15040, 5016, 19913, 16472, 31439, 6225, 3555, 9640, 3660, 18871, 15543, 950, 563, 1975, 1829, 8592, 37495, 22653, 15543, 950, 563, 37495, 22653, 572, 5102, 19446, 41185, 8592, 34105, 4117, 1975, 1829, 6055, 8592, 28820, 46740, 37495, 22653, 20328, 5016, 39894, 15040, 5016, 19913, 16472, 8978, 11331, 31747, 3660, 44381, 1553, 5102, 47525, 11536, 13412, 28820, 1975, 2407, 572, 5102, 1975, 2407, 44945, 38251, 1829, 11296, 15543, 950, 563, 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0.75537109375}, {"start": 2172.56, "end": 2173.38, "word": " يعني", "probability": 0.876220703125}, {"start": 2173.38, "end": 2173.66, "word": " صح", "probability": 0.9873046875}, {"start": 2173.66, "end": 2174.18, "word": " بتلاحظ", "probability": 0.9503173828125}, {"start": 2174.18, "end": 2174.36, "word": " ان", "probability": 0.85498046875}, {"start": 2174.36, "end": 2174.56, "word": " في", "probability": 0.53515625}, {"start": 2174.56, "end": 2175.18, "word": " حركة", "probability": 0.9835611979166666}, {"start": 2175.18, "end": 2175.72, "word": " لكن", "probability": 0.91748046875}, {"start": 2175.72, "end": 2175.98, "word": " without", "probability": 0.66796875}, {"start": 2175.98, "end": 2177.06, "word": " pattern", "probability": 0.8203125}, {"start": 2177.06, "end": 2177.66, "word": " بدون", "probability": 0.95361328125}, {"start": 2177.66, "end": 2178.06, "word": " شكل", "probability": 0.987548828125}, {"start": 2178.06, "end": 2178.36, "word": " او", "probability": 0.7919921875}, {"start": 2178.36, "end": 2178.54, "word": " no", "probability": 0.6259765625}, {"start": 2178.54, "end": 2179.02, "word": " pattern", "probability": 0.87841796875}, {"start": 2179.02, "end": 2179.62, "word": " او", "probability": 0.86279296875}, {"start": 2179.62, "end": 2180.4, "word": " بنسميها", "probability": 0.967041015625}, {"start": 2180.4, "end": 2181.48, "word": " amorphous", "probability": 0.9217122395833334}, {"start": 2181.48, "end": 2182.36, "word": " in", "probability": 0.84326171875}, {"start": 2182.36, "end": 2182.52, "word": " a", "probability": 0.64013671875}, {"start": 2182.52, "end": 2183.04, "word": " specular", "probability": 0.89599609375}, {"start": 2183.04, "end": 2183.84, "word": " reflection", "probability": 0.9013671875}, {"start": 2183.84, "end": 2184.2, "word": " او", "probability": 0.934814453125}, {"start": 2184.2, "end": 2184.34, "word": " a", "probability": 0.2208251953125}, {"start": 2184.34, "end": 2184.88, "word": " specular", "probability": 0.92138671875}, {"start": 2184.88, "end": 2185.96, "word": " illumination", "probability": 0.9580078125}], "temperature": 1.0}, {"id": 95, "seek": 221526, "start": 2191.0, "end": 2215.26, "text": "post lens tear film appearances are taken to indicate reduced tear exchange بتلاحظ انه لو كان هناك فيه pattern معناه الكلام انه في هناك adherence للعدسة في التساق للعدسة فهيكون ظاهر انه في pattern شكل او له color معين يكون اقرب لللون الرمادي", "tokens": [23744, 6765, 12556, 2007, 29174, 366, 2726, 281, 13330, 9212, 12556, 7742, 39894, 15040, 5016, 19913, 16472, 3224, 45164, 25961, 34105, 4117, 8978, 3224, 5102, 20449, 8315, 3224, 2423, 28820, 10943, 16472, 3224, 8978, 34105, 4117, 30106, 655, 24976, 22488, 3794, 3660, 8978, 16712, 3794, 995, 4587, 24976, 22488, 3794, 3660, 6156, 3224, 1829, 30544, 1357, 116, 40294, 2288, 16472, 3224, 8978, 5102, 13412, 28820, 1975, 2407, 46740, 2017, 20449, 9957, 7251, 30544, 1975, 4587, 25513, 24976, 1211, 11536, 34892, 15042, 16254], "avg_logprob": -0.1803463902100023, "compression_ratio": 1.6186046511627907, "no_speech_prob": 0.0, "words": [{"start": 2191.0, "end": 2191.42, "word": "post", "probability": 0.40185546875}, {"start": 2191.42, "end": 2191.92, "word": " lens", "probability": 0.82373046875}, {"start": 2191.92, "end": 2192.32, "word": " tear", "probability": 0.7314453125}, {"start": 2192.32, "end": 2192.76, "word": " film", "probability": 0.87744140625}, {"start": 2192.76, "end": 2193.78, "word": " appearances", "probability": 0.822265625}, {"start": 2193.78, "end": 2194.42, "word": " are", "probability": 0.95263671875}, {"start": 2194.42, "end": 2194.82, "word": " taken", "probability": 0.81689453125}, {"start": 2194.82, "end": 2195.16, "word": " to", "probability": 0.97998046875}, {"start": 2195.16, "end": 2195.9, "word": " indicate", "probability": 0.873046875}, {"start": 2195.9, "end": 2196.92, "word": " reduced", "probability": 0.7998046875}, {"start": 2196.92, "end": 2197.2, "word": " tear", "probability": 0.96044921875}, {"start": 2197.2, "end": 2197.8, "word": " exchange", "probability": 0.81689453125}, {"start": 2197.8, "end": 2198.96, "word": " بتلاحظ", "probability": 0.867919921875}, {"start": 2198.96, "end": 2199.58, "word": " انه", "probability": 0.5938720703125}, {"start": 2199.58, "end": 2199.78, "word": " لو", "probability": 0.9892578125}, {"start": 2199.78, "end": 2200.1, "word": " كان", "probability": 0.9912109375}, {"start": 2200.1, "end": 2200.64, "word": " هناك", "probability": 0.97412109375}, {"start": 2200.64, "end": 2201.52, "word": " فيه", "probability": 0.770751953125}, {"start": 2201.52, "end": 2201.92, "word": " pattern", "probability": 0.892578125}, {"start": 2201.92, "end": 2202.72, "word": " معناه", "probability": 0.8229166666666666}, {"start": 2202.72, "end": 2203.08, "word": " الكلام", "probability": 0.8533528645833334}, {"start": 2203.08, "end": 2203.42, "word": " انه", "probability": 0.7265625}, {"start": 2203.42, "end": 2203.54, "word": " في", "probability": 0.9072265625}, {"start": 2203.54, "end": 2203.98, "word": " هناك", "probability": 0.81982421875}, {"start": 2203.98, "end": 2204.76, "word": " adherence", "probability": 0.733642578125}, {"start": 2204.76, "end": 2205.56, "word": " للعدسة", "probability": 0.92529296875}, {"start": 2205.56, "end": 2205.94, "word": " في", "probability": 0.60888671875}, {"start": 2205.94, "end": 2206.64, "word": " التساق", "probability": 0.806640625}, {"start": 2206.64, "end": 2207.42, "word": " للعدسة", "probability": 0.9803466796875}, {"start": 2207.42, "end": 2208.2, "word": " فهيكون", "probability": 0.919189453125}, {"start": 2208.2, "end": 2209.5, "word": " ظاهر", "probability": 0.9398193359375}, {"start": 2209.5, "end": 2209.88, "word": " انه", "probability": 0.864990234375}, {"start": 2209.88, "end": 2210.02, "word": " في", "probability": 0.9560546875}, {"start": 2210.02, "end": 2210.46, "word": " pattern", "probability": 0.818359375}, {"start": 2210.46, "end": 2211.06, "word": " شكل", "probability": 0.988037109375}, {"start": 2211.06, "end": 2211.42, "word": " او", "probability": 0.818359375}, {"start": 2211.42, "end": 2211.74, "word": " له", "probability": 0.250732421875}, {"start": 2211.74, "end": 2212.14, "word": " color", "probability": 0.4677734375}, {"start": 2212.14, "end": 2212.82, "word": " معين", "probability": 0.940185546875}, {"start": 2212.82, "end": 2213.48, "word": " يكون", "probability": 0.88232421875}, {"start": 2213.48, "end": 2213.9, "word": " اقرب", "probability": 0.93115234375}, {"start": 2213.9, "end": 2214.42, "word": " لللون", "probability": 0.8470052083333334}, {"start": 2214.42, "end": 2215.26, "word": " الرمادي", "probability": 0.9373372395833334}], "temperature": 1.0}, {"id": 96, "seek": 224077, "start": 2217.61, "end": 2240.77, "text": "وهذا بتديني indication انه في هناك reduce لل tier exchange معنى الكلام يما يكون في هذا الموضوع ايش بدي اعمل؟ بدي ارفع العدسة اللاصقة و اعمل tier film evaluation من ناحية ال TPUT ال corneal fluorescent staining keratometer measures", "tokens": [2407, 3224, 15730, 39894, 3215, 9957, 1829, 18877, 16472, 3224, 8978, 34105, 4117, 5407, 24976, 12362, 7742, 20449, 1863, 7578, 2423, 28820, 10943, 7251, 15042, 7251, 30544, 8978, 23758, 9673, 2407, 11242, 45367, 1975, 1829, 8592, 4724, 16254, 1975, 25957, 1211, 22807, 4724, 16254, 1975, 28480, 3615, 18863, 3215, 3794, 3660, 13672, 33546, 28671, 4032, 1975, 25957, 1211, 12362, 2007, 13344, 9154, 8717, 39319, 10632, 2423, 314, 8115, 51, 2423, 1181, 716, 304, 5029, 2706, 2207, 16441, 278, 19377, 267, 13606, 385, 20044], "avg_logprob": -0.2931547537446022, "compression_ratio": 1.4469026548672566, "no_speech_prob": 0.0, "words": [{"start": 2217.61, "end": 2218.05, "word": "وهذا", "probability": 0.7239583333333334}, {"start": 2218.05, "end": 2218.67, "word": " بتديني", "probability": 0.731353759765625}, {"start": 2218.67, "end": 2219.49, "word": " indication", "probability": 0.7255859375}, {"start": 2219.49, "end": 2220.01, "word": " انه", "probability": 0.4388427734375}, {"start": 2220.01, "end": 2220.13, "word": " في", "probability": 0.822265625}, {"start": 2220.13, "end": 2220.65, "word": " هناك", "probability": 0.9423828125}, {"start": 2220.65, "end": 2221.67, "word": " reduce", "probability": 0.61083984375}, {"start": 2221.67, "end": 2221.93, "word": " لل", "probability": 0.2783203125}, {"start": 2221.93, "end": 2222.13, "word": " tier", "probability": 0.521484375}, {"start": 2222.13, "end": 2222.67, "word": " exchange", "probability": 0.94091796875}, {"start": 2222.67, "end": 2223.45, "word": " معنى", "probability": 0.8562825520833334}, {"start": 2223.45, "end": 2224.01, "word": " الكلام", "probability": 0.94091796875}, {"start": 2224.01, "end": 2224.53, "word": " يما", "probability": 0.4864501953125}, {"start": 2224.53, "end": 2224.89, "word": " يكون", "probability": 0.990478515625}, {"start": 2224.89, "end": 2225.07, "word": " في", "probability": 0.96044921875}, {"start": 2225.07, "end": 2225.33, "word": " هذا", "probability": 0.96728515625}, {"start": 2225.33, "end": 2225.91, "word": " الموضوع", "probability": 0.984619140625}, {"start": 2225.91, "end": 2226.17, "word": " ايش", "probability": 0.7232259114583334}, {"start": 2226.17, "end": 2226.41, "word": " بدي", "probability": 0.781005859375}, {"start": 2226.41, "end": 2227.11, "word": " اعمل؟", "probability": 0.862060546875}, {"start": 2227.11, "end": 2227.39, "word": " بدي", "probability": 0.887451171875}, {"start": 2227.39, "end": 2227.79, "word": " ارفع", "probability": 0.9625651041666666}, {"start": 2227.79, "end": 2228.31, "word": " العدسة", "probability": 0.9609375}, {"start": 2228.31, "end": 2228.93, "word": " اللاصقة", "probability": 0.8548177083333334}, {"start": 2228.93, "end": 2229.39, "word": " و", "probability": 0.7998046875}, {"start": 2229.39, "end": 2229.75, "word": " اعمل", "probability": 0.9524739583333334}, {"start": 2229.75, "end": 2230.05, "word": " tier", "probability": 0.74951171875}, {"start": 2230.05, "end": 2230.49, "word": " film", "probability": 0.9501953125}, {"start": 2230.49, "end": 2231.29, "word": " evaluation", "probability": 0.9716796875}, {"start": 2231.29, "end": 2231.93, "word": " من", "probability": 0.95458984375}, {"start": 2231.93, "end": 2232.31, "word": " ناحية", "probability": 0.9873046875}, {"start": 2232.31, "end": 2232.49, "word": " ال", "probability": 0.9072265625}, {"start": 2232.49, "end": 2233.15, "word": " TPUT", "probability": 0.6399739583333334}, {"start": 2233.15, "end": 2233.39, "word": " ال", "probability": 0.35791015625}, {"start": 2233.39, "end": 2233.87, "word": " corneal", "probability": 0.7171223958333334}, {"start": 2233.87, "end": 2234.49, "word": " fluorescent", "probability": 0.3949788411458333}, {"start": 2234.49, "end": 2236.47, "word": " staining", "probability": 0.7080078125}, {"start": 2236.47, "end": 2239.99, "word": " keratometer", "probability": 0.75244140625}, {"start": 2239.99, "end": 2240.77, "word": " measures", "probability": 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a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/jfd3UxR95_E_raw.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/jfd3UxR95_E_raw.srt new file mode 100644 index 0000000000000000000000000000000000000000..8c9443efd821b4c3ea876ce93d310d82e47e1a96 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/jfd3UxR95_E_raw.srt @@ -0,0 +1,1692 @@ +1 +00:00:21,110 --> 00:00:23,830 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:23,830 --> 00:00:29,590 +وبركاته ومرحباً لكم جميعًا سنكمل إن شاء الله في + +3 +00:00:29,590 --> 00:00:34,790 +موضوع الـ soft contact lenses modalities أنواع أو + +4 +00:00:34,790 --> 00:00:40,790 +أنماط أو أشكال العدسات اللاصقة اللينة سنبدأ اليوم + +5 +00:00:40,790 --> 00:00:46,410 +في موضوع silicon hydrogel extended wear disposable + +6 +00:00:46,410 --> 00:00:52,880 +lensesبداية تم إضافة مادة السيليكون لزيادة + +7 +00:00:52,880 --> 00:00:59,620 +الوتابيلاتي المتانة للعدسة Hydrogel بمعنى water + +8 +00:00:59,620 --> 00:01:04,680 +water loving or hydrophilic مادة محبة للماء + +9 +00:01:04,680 --> 00:01:11,020 +Extended wear بتم ارتدائها لمدة اسبوع واحد وبعد + +10 +00:01:11,020 --> 00:01:17,100 +ذلك بتم التخلص منها طبعا في هذا النوع من العدسات + +11 +00:01:17,710 --> 00:01:24,350 +بتم استخدام high decay على T حتى انه تكون العدسة + +12 +00:01:24,350 --> 00:01:29,850 +thinning نحيفة و بتسمح لأكبر كمية من ال oxygen انه + +13 +00:01:29,850 --> 00:01:36,270 +تدخل القرنية مدام هي disposable lens اذا العدسة + +14 +00:01:36,270 --> 00:01:41,310 +بلبسها المريض لفترة زمنية قصيرة وبعد ذلك بتتم + +15 +00:01:41,310 --> 00:01:42,690 +التخلص منها + +16 +00:01:45,470 --> 00:01:50,930 +أول ما تم التفكير في هذا الجيل من العدسات كان في + +17 +00:01:50,930 --> 00:01:56,430 +سنة 1999 كان + +18 +00:01:56,430 --> 00:02:03,670 +المقصود بشكل أساسي هو موضوع ال extended wear و تم + +19 +00:02:03,670 --> 00:02:08,040 +تعريف ال extended wear فيما سبقSilicon is + +20 +00:02:08,040 --> 00:02:14,140 +hydrophobic إذا مادة السيليكون هي كارهة للماء لكن + +21 +00:02:14,140 --> 00:02:19,020 +إيش عملت مادة السيليكون surface modified يعني عملت + +22 +00:02:19,020 --> 00:02:27,900 +تعديل للصبح by a plasma batch process بلازمة باتش + +23 +00:02:27,900 --> 00:02:34,170 +بروسس هي عملية دفع البلازمةمن خلال هذه العملية انه + +24 +00:02:34,170 --> 00:02:39,790 +بتتم تجميع ال tears كله على سطح العدسة وبيمنع دخول + +25 +00:02:39,790 --> 00:02:45,770 +ال tears للداخل مرة أخرى، اذا بيكون هناك فيه + +26 +00:02:45,770 --> 00:02:51,530 +جزيئاتفي العدسة او مسامات معينة في هذه العملية + +27 +00:02:51,530 --> 00:02:57,450 +هيمنع من دخول ايه ال tears للداخل وكل ال tears + +28 +00:02:57,450 --> 00:03:02,610 +بتجمع وين على سطح العدسة طبعا ببساطة عشان يحافظ + +29 +00:03:02,610 --> 00:03:07,940 +على مرونة العدسةOkay؟ لأن احنا عارفين ان مادة + +30 +00:03:07,940 --> 00:03:13,180 +السيليكون بتزود من ال wetability المتانة فهي لو .. + +31 +00:03:13,180 --> 00:03:18,460 +وهي hydrophobic صح؟ هذه العملية ما ننسى اسم العدسة + +32 +00:03:18,460 --> 00:03:23,440 +ان هي تعتبر ايه؟ HydrogelOkay؟ يعني بمعنى انه محب + +33 +00:03:23,440 --> 00:03:29,160 +للماء فهذه العملية بساطة بتعمل تعديل لسطح العدسة و + +34 +00:03:29,160 --> 00:03:33,560 +كل ال tears هيتجمع على سطح العدسة و بتمنع من دخوله + +35 +00:03:33,560 --> 00:03:40,330 +للداخل يعني بمعنى انه بتحافظ على مرونة العدسةطبعا + +36 +00:03:40,330 --> 00:03:46,610 +هذه العملية ال plasma batch process زودت من سعر + +37 +00:03:46,610 --> 00:03:52,190 +العدسة بشكل بسيط يعني slightly high cost أو + +38 +00:03:52,190 --> 00:03:58,480 +slightly higher كان سعر العدسة مرتفع نسبياclean + +39 +00:03:58,480 --> 00:04:03,260 +and disinfect the lenses only occasionally or not + +40 +00:04:03,260 --> 00:04:08,540 +at all احنا بنعرف ان فترة حياة العدسة قصيرة فأنظمة + +41 +00:04:08,540 --> 00:04:13,460 +التنظيف و التعقيم لهذا النوع من العدسات هتكون + +42 +00:04:13,460 --> 00:04:18,460 +occasionally احيانا او اللي هو نادرا rarely او + +43 +00:04:18,460 --> 00:04:25,000 +ماهتكونش مطلقا okay minimizing the cost of lens + +44 +00:04:25,000 --> 00:04:29,740 +maintenanceنرجع مرة تانية، مدام فترة حياة العدسة + +45 +00:04:29,740 --> 00:04:35,120 +قصيرة، إذا أنظمة المحافظة عليها إيش هتكون؟ تقل أو + +46 +00:04:35,120 --> 00:04:40,280 +في بعض الأحيان، لا تحتاج إلى أنظمة محافظة على هذا + +47 +00:04:40,280 --> 00:04:42,100 +النوع من العدسات + +48 +00:04:45,080 --> 00:04:50,580 +الان المريض هيلبسها لمدة اسبوع واحد وبعد ذلك بتخلص + +49 +00:04:50,580 --> 00:04:55,860 +منها فبيطلب من المريض انه كل صباح يعمل ال + +50 +00:04:55,860 --> 00:05:00,460 +lubricating eyedrop يعني قطر قطرة okay هذا بتعمل + +51 +00:05:00,460 --> 00:05:06,970 +عملية ترطيب للعدسة وقت ايش؟By the patient on + +52 +00:05:06,970 --> 00:05:11,430 +waking each morning يعني لما يستيقظ من انهم لازم + +53 +00:05:11,430 --> 00:05:16,390 +انه يعمل هذه العملية انه تقطير قطرة الهدف منها + +54 +00:05:16,390 --> 00:05:22,030 +اللي هو ترطيب العدسة و سطح القرانية حتى مايصير عند + +55 +00:05:22,030 --> 00:05:23,910 +المريض corneal edema + +56 +00:05:28,810 --> 00:05:33,930 +الجيل التاني من هذا النوع من العدسات كان الهدف + +57 +00:05:33,930 --> 00:05:38,510 +منها او المقصود بشكل أساسي انه تكون daily wear + +58 +00:05:38,510 --> 00:05:44,410 +يعني يتم .. يتم ارتداء العدسة لمدة يوم واحد فقط + +59 +00:05:48,130 --> 00:05:52,530 +أول ما تم التفكير في هذا الجيل من العدسات في عام + +60 +00:05:52,530 --> 00:05:57,210 +الف .. في عام الفين وأربعة يعني هي تعتبر update + +61 +00:05:57,210 --> 00:06:02,550 +لمين؟ ل ال extended wear أو اللي هي بمعنى أنه جيل + +62 +00:06:02,550 --> 00:06:08,910 +آخر second generation ل الجيل الأول these lenses + +63 +00:06:08,910 --> 00:06:14,270 +هذا النوع من العدسات have a lower silicon content + +64 +00:06:15,200 --> 00:06:20,560 +احنا ما هنحتاج لل silicon بدرجة كبيرة لان انا مش + +65 +00:06:20,560 --> 00:06:24,940 +محتاج wetability عالي في هذا النوع لان المريض + +66 +00:06:24,940 --> 00:06:30,080 +هيلبسها يوم واحد ويتخلص منها صحيح؟ and + +67 +00:06:30,080 --> 00:06:34,700 +correspondly higher water content اذا مدام هو + +68 +00:06:34,700 --> 00:06:40,340 +هيقلل من كمية ال silicon هيعدل زيادة في مين؟ في ال + +69 +00:06:40,340 --> 00:06:45,170 +water contentإذا الـDK على T إيش تعتبر very high + +70 +00:06:45,170 --> 00:06:50,450 +في هذا النوع من العدسات Reduce the need for + +71 +00:06:50,450 --> 00:06:55,810 +surface modification وهذا هيقلل من الحاجة لعملية + +72 +00:06:55,810 --> 00:07:01,630 +تعديل سطح العدسة يعني ما بتحتاج ل plasma batch + +73 +00:07:01,630 --> 00:07:07,170 +process Reduce manufacturing cost أيضا هيقلل من + +74 +00:07:07,170 --> 00:07:13,520 +سعر العدسةلأنه مدة يوم واحد وبعد ذلك هيتم التخلص + +75 +00:07:13,520 --> 00:07:19,620 +منها Their oxygen transmissibility، نفاذية + +76 +00:07:19,620 --> 00:07:24,060 +الأكسجين أو دخول الأكسجين is still مازال much + +77 +00:07:24,060 --> 00:07:28,160 +higher، أعلى من مين؟ من ال traditional hydrogen + +78 +00:07:28,160 --> 00:07:31,200 +lenses، هذا المقصود فيها ال conventional daily + +79 +00:07:31,200 --> 00:07:37,880 +wear، عدسات اللبس اليومي التقليديwithout the + +80 +00:07:37,880 --> 00:07:43,740 +tendency to dehydration يعني دون التوجه باتجاه من + +81 +00:07:43,740 --> 00:07:48,360 +التبخر ال dehydration اللي مصاحب مع ال high water + +82 +00:07:48,360 --> 00:07:50,000 +content materials + +83 +00:08:07,470 --> 00:08:11,270 +فنفس الحاجة هذا النوع من العدسات صحيح ان فيها + +84 +00:08:11,270 --> 00:08:16,330 +الـDK على T high وهي تعتبر very high water content + +85 +00:08:16,330 --> 00:08:20,770 +و ايضا تعتبر العدسة thinning لكن ما بتصل لمرحلة + +86 +00:08:20,770 --> 00:08:25,870 +ايه التبخر لسطح القرنية يعني ما بتعمل dehydration + +87 +00:08:25,870 --> 00:08:28,090 +ل ال corneal surface + +88 +00:08:33,840 --> 00:08:37,960 +بطلوب من كل طالبة الان احنا خدنا ال soft contact + +89 +00:08:37,960 --> 00:08:42,020 +lens modalities بشكل عام ال conventional daily + +90 +00:08:42,020 --> 00:08:46,320 +wear و بعد ذلك اخدنا ال daily wear extended wear + +91 +00:08:46,320 --> 00:08:53,000 +تعمل ك table كل أنواع العدسات و تضع في كل نوع من + +92 +00:08:53,000 --> 00:08:57,230 +العدساتموضوع ال cleaning موضوع ال disinfecting + +93 +00:08:57,230 --> 00:09:01,490 +موضوع ال maintenance بحيث انه تعملي تستطيع تعملي + +94 +00:09:01,490 --> 00:09:07,030 +comparison ما بين كل نوع و الآخر مثلا التكنولوجيا + +95 +00:09:07,030 --> 00:09:10,570 +المستخدم hand lathe cutting hand molding + +96 +00:09:10,570 --> 00:09:15,210 +technology حسب كل نوع من العدسات بالنسبة ل ال cost + +97 +00:09:15,210 --> 00:09:19,550 +hand high hand low الاخر زي ما تم اللي هو مناقشته + +98 +00:09:19,550 --> 00:09:27,540 +فيما سابق فضلOkay الان عندنا soft lens fitting and + +99 +00:09:27,540 --> 00:09:34,500 +evaluation الان انا ك practitioner بدي اعرف هل + +100 +00:09:34,500 --> 00:09:38,800 +العدسة optimal fit ولا لأ يعني هل ال fitting فيها + +101 +00:09:38,800 --> 00:09:43,700 +مثالي ام لا كيف انا بدي اعرف انه هل ال fitting في + +102 +00:09:43,700 --> 00:09:49,180 +العدسة اللاصقة مثالي او لا وتحديدا ال soft contact + +103 +00:09:49,180 --> 00:09:57,970 +lensnumber one optimal lens fit optimal lens fit + +104 +00:09:57,970 --> 00:10:01,730 +يعني بده اشوف انه هل ال fitting في العدسة مثالي ام + +105 +00:10:01,730 --> 00:10:08,110 +لا في عندنا شغلتين مهمات في العدسات اللاصقة الأمر + +106 +00:10:08,110 --> 00:10:12,930 +الأول ال comfort الراحة الأمر التاني ال vision + +107 +00:10:12,930 --> 00:10:18,550 +الرؤية مين أهم في ال soft contact lens ال comfort + +108 +00:10:18,550 --> 00:10:24,290 +ولا ال visionال comfort اهم بنوع ما ال comfort اهم + +109 +00:10:24,290 --> 00:10:29,290 +يعني دايما انا ك practitioner او ك examiner بميل ل + +110 +00:10:29,290 --> 00:10:33,850 +ال comfort اكتر من مين من ال vision يعني بمعنى انه + +111 +00:10:33,850 --> 00:10:39,330 +مريض اخد عدسة لا ثقة و وصل النظر عنده ستة اتسعة و + +112 +00:10:39,330 --> 00:10:44,390 +مرتاح مية في المية رغم انه في عدسة اخرى وصل فيها + +113 +00:10:44,390 --> 00:10:48,890 +ستة ا ستة لكن discomfort what is the benefit ايش + +114 +00:10:48,890 --> 00:10:54,300 +الفايدة؟Okay فدائما ال comfort أهم من ال vision في + +115 +00:10:54,300 --> 00:10:58,880 +العدسات اللاصقة Can + +116 +00:10:58,880 --> 00:11:03,420 +be evaluated in terms of a number of parameters + +117 +00:11:03,420 --> 00:11:08,520 +اذا لما انا بدي اشوف ال fitting مثالي او لا للعدسة + +118 +00:11:08,520 --> 00:11:15,790 +بتتم تحديده بمجموعة من المحدداتإذا هناك مجموعة من + +119 +00:11:15,790 --> 00:11:21,170 +المحددات بتم وضعها يعني مجموعة من ال criteria + +120 +00:11:21,170 --> 00:11:25,550 +مجموعة + +121 +00:11:25,550 --> 00:11:31,490 +من المعايير بتم وضعها من قبل ال practitioners عشان + +122 +00:11:31,490 --> 00:11:36,970 +يشوف هل ال fitting مناسب ام لا comfort + +123 +00:11:36,970 --> 00:11:40,530 +and vision are most important to the patient + +124 +00:11:42,930 --> 00:11:49,110 +السهيلة لعينة صافية تعتبرت أفضل بشكل صغير أو لا + +125 +00:11:49,110 --> 00:11:55,840 +يعرف أن العينة تكون موجودةإذا المريض بيكون مرتاح + +126 +00:11:55,840 --> 00:11:59,980 +في العدسة اللاصقة في حالة إنه ما يكون هناك أي + +127 +00:11:59,980 --> 00:12:06,580 +تأدراك يعني لا يشعر بإدراك بوجود العدسة إذا ما + +128 +00:12:06,580 --> 00:12:10,120 +بيشعر + +129 +00:12:10,120 --> 00:12:16,200 +بأي تأدراك لوجود العدسة طبعا في هناك مصطلحين ال + +130 +00:12:16,200 --> 00:12:22,050 +awareness و ال sensation طبعا مختلفين عن بعضالـ + +131 +00:12:22,050 --> 00:12:26,870 +sensation انا مجرد ما احط العدسة بتعمل adherence + +132 +00:12:26,870 --> 00:12:33,070 +التصاق كبير ما بين سطح العدسة و القرنية اذا انا + +133 +00:12:33,070 --> 00:12:38,130 +حاولت ان ارفع العدسة هيعمل epithelium defect او + +134 +00:12:38,130 --> 00:12:42,590 +epithelium erosion وبالتالي هحتاج فترة زمنية + +135 +00:12:42,590 --> 00:12:49,210 +لاعادة تجديد من ال epithelium اذا + +136 +00:12:49,210 --> 00:12:55,160 +الان انا يما بدي اديالمريض عدسة لاسقة لازم تكون + +137 +00:12:55,160 --> 00:13:01,100 +مريحة بحيث انه هو ما يشعر .. لا يشعر المريض بادراك + +138 +00:13:01,100 --> 00:13:05,920 +العدسة يعني بمعنى كيف يما تتحرك العدسة مايشعرش ان + +139 +00:13:05,920 --> 00:13:09,980 +والله العدسة رايحة up او down او مثلا right او + +140 +00:13:09,980 --> 00:13:13,800 +left يعني بمعنى ال excessive movement مايشعرش فيها + +141 +00:13:15,760 --> 00:13:20,940 +Excessive awareness زيادة الإدراك في العدسة المريض + +142 +00:13:20,940 --> 00:13:25,100 +إيش هيشعر وكأنه العدسة عبارة عن foreign body يعني + +143 +00:13:25,100 --> 00:13:30,840 +بالضبط وكأنه رمل في عينه يما بيزيد الإدراك بالعدسة + +144 +00:13:30,840 --> 00:13:34,880 +المريض بيشعر أن العدسة وكأنه رمل في عينه تحديدا ال + +145 +00:13:34,880 --> 00:13:40,360 +soft contact lens Excessive lens movement or poor + +146 +00:13:40,360 --> 00:13:46,500 +concentrationأيضا حركة العدسة هتزعج المريض كل شوية + +147 +00:13:46,500 --> 00:13:51,740 +مثلا عمل up gaze بتروح العدسة تتحرك أعلى down gaze + +148 +00:13:51,740 --> 00:13:56,940 +للأسفل right left بتتحرك بحيث ان المريض هيصبح ايش + +149 +00:13:56,940 --> 00:14:01,560 +discomfort يعني ماعندهوش راحة او poor + +150 +00:14:01,560 --> 00:14:05,740 +concentration او وضع العدسة مش هيكون في مكانه طبعا + +151 +00:14:05,740 --> 00:14:09,400 +احنا عارفين ان ال soft contact lens conform to the + +152 +00:14:09,400 --> 00:14:14,120 +shape of the corneaالان يما تحكي للمريض اعمل ايه؟ + +153 +00:14:14,120 --> 00:14:19,360 +اعمل up gaze بتلاقي ان العدسة بتنزل لتحت أو مثلا + +154 +00:14:19,360 --> 00:14:23,500 +اما يعمل down gaze العدسة بتطلع لفوق واضح ال + +155 +00:14:23,500 --> 00:14:27,720 +excessive movement بالنسبة لل examiner يعني بمعنى + +156 +00:14:27,720 --> 00:14:31,420 +ان الحركة بتكون اكتر من واحد ملي متر + +157 +00:14:34,750 --> 00:14:39,410 +No sensation at all عدم الشعور بوجود العدسة بيعمل + +158 +00:14:39,410 --> 00:14:43,290 +lens adherence اللي هو التساق ما بين سطح العدسة + +159 +00:14:43,290 --> 00:14:44,110 +والقرانية + +160 +00:14:47,180 --> 00:14:53,040 +Lens defects لازم هذه من الوصاية اللي لازم وصيها + +161 +00:14:53,040 --> 00:14:58,680 +ال examiner للمريض انه كل يوم لازم تفحص العدسة و + +162 +00:14:58,680 --> 00:15:03,880 +خاصة أطراف العدسة okay لأنه ممكن يكون فيه هناك في + +163 +00:15:03,880 --> 00:15:08,300 +ال edge فيه اللي هو scratch خدش وبالتالي المريض + +164 +00:15:08,300 --> 00:15:12,160 +لما يلبس العدسة بيشعر و كأنه foreign body في داخل + +165 +00:15:12,160 --> 00:15:17,920 +العين فلازم يعمل evaluationلمدة دقيقة okay لالعدسة + +166 +00:15:17,920 --> 00:15:23,560 +everyday Incompatible + +167 +00:15:23,560 --> 00:15:29,420 +care solutions may be reported as staining on lens + +168 +00:15:29,420 --> 00:15:37,220 +insertionالان لو المريض بيستخدم محلول غير موافق + +169 +00:15:37,220 --> 00:15:41,800 +لنوع العدسة يعني في هناك محليل غير موافقة لنوع + +170 +00:15:41,800 --> 00:15:46,520 +العدسة كيف مثلا انا بلبس عدسة conventional daily + +171 +00:15:46,520 --> 00:15:50,380 +wear بروح استخدم محلول ال hard contact lens او + +172 +00:15:50,380 --> 00:15:54,020 +بروح استخدم محلول مثلا ال extended wear او ال + +173 +00:15:54,020 --> 00:15:57,900 +daily wear بالتالي هذا هيعمل ايه skinning بمعنى + +174 +00:15:57,900 --> 00:16:04,180 +لسع للعدسةو هيسبب اللي هو خدش لأطراف العدسة وبعد + +175 +00:16:04,180 --> 00:16:09,420 +ذلك هيعمل شعور بال foreign body للمريض إذا + +176 +00:16:09,420 --> 00:16:13,940 +المحاليل الغير موافقة للعدسة بتعمل على تخريب + +177 +00:16:13,940 --> 00:16:21,900 +العدسة و بتعمل لسع للسطح العدسة number + +178 +00:16:21,900 --> 00:16:27,620 +two stable vision ثبات الرؤيةانتوا عارفين كل شخص + +179 +00:16:27,620 --> 00:16:33,620 +بيعمل blinking ترميش صحيح لازم الرؤية في ال soft + +180 +00:16:33,620 --> 00:16:37,980 +contact lens before و after blinking تكون equal + +181 +00:16:37,980 --> 00:16:44,640 +متساوية ف ال stable vision relates to the correct + +182 +00:16:44,640 --> 00:16:49,300 +lens vertex power يعني بتعتمد على القوة الصحيحة + +183 +00:16:49,300 --> 00:16:54,500 +للعدسةمثلا لو نور بتلبس minus 2 لازم اديها minus + +184 +00:16:54,500 --> 00:16:59,360 +2، مانفعش اديها minus 2.25 أو minus 2.5، هيعمل + +185 +00:16:59,360 --> 00:17:03,540 +ايه؟ تغيير في الرؤية، وبالتالي انه ممكن يعمل + +186 +00:17:03,540 --> 00:17:08,060 +decrease او reduce لل visual acuity عند ال + +187 +00:17:08,060 --> 00:17:13,120 +patient، اذا اول حاجة ثبات الرؤية بتعتمد على القوة + +188 +00:17:13,120 --> 00:17:15,900 +الصحيحة للعدسة اللي بتم صرفها + +189 +00:17:18,640 --> 00:17:24,780 +Good Limb Centration التمركز الجيد للعدسة والحركة + +190 +00:17:24,780 --> 00:17:31,740 +دايما اخدنا في one ان الحركة هي غير كافية لتقييم + +191 +00:17:31,740 --> 00:17:36,990 +العدسة اللاصقة ال hardفي بعض الأحيان ممكن الحركة + +192 +00:17:36,990 --> 00:17:41,890 +بتخدع مين ال examiner انه هي مثلا ال steep بتكون + +193 +00:17:41,890 --> 00:17:45,670 +flat او العكس، optimal fit هي بتكون مثلا flat + +194 +00:17:45,670 --> 00:17:50,910 +فدايما ال movement is not enough to evaluate if + +195 +00:17:50,910 --> 00:17:55,660 +the lens is optimal or notفأول حاجة بدي أشوف انه + +196 +00:17:55,660 --> 00:18:00,860 +هل هي good concentration تمركزها جيد؟ أطرافها هل + +197 +00:18:00,860 --> 00:18:05,480 +هم equally؟ uniformly؟ هذه الأمور لازم تكون واضحة + +198 +00:18:05,480 --> 00:18:10,480 +بالنسبة للفاحص موضوع ال movement عندنا ال optimal + +199 +00:18:10,480 --> 00:18:15,740 +movement من 0.5 ل 1 ملي متر لكن هذه غير كافية + +200 +00:18:15,740 --> 00:18:19,620 +لتقييم العدسة اللاصقة اللينة + +201 +00:18:22,300 --> 00:18:28,060 +Good prelims tear film stability greater than + +202 +00:18:28,060 --> 00:18:32,940 +normal inter blink interval الان كداش ال normally + +203 +00:18:32,940 --> 00:18:41,800 +blinking للأشخاص في ال one minute خمس + +204 +00:18:41,800 --> 00:18:43,780 +عاش؟ مين حكى خمس عاش؟ ال range + +205 +00:18:48,900 --> 00:18:53,100 +طبعا according to manual soft contact lens ال + +206 +00:18:53,100 --> 00:19:01,200 +normal blinking من 15 ل 20 per minute من خمساش ل + +207 +00:19:01,200 --> 00:19:07,100 +عشرين الان لازم ان يكون هنا good brillance يعني + +208 +00:19:07,100 --> 00:19:13,710 +ثبات العدسة يكون مهم بالنسبة لمين؟لا ال examiner + +209 +00:19:13,710 --> 00:19:19,190 +لأنه الآن لو انا مافيش عندي ثبات للعدسة هتلاحظ ان + +210 +00:19:19,190 --> 00:19:22,930 +في المريض دايما عنده blinking فكل ما هو عمل + +211 +00:19:22,930 --> 00:19:27,610 +blinking الحركة اشمالها بالزيد وبالتالي بتعمل + +212 +00:19:27,610 --> 00:19:32,150 +unstable vision و بتعمل blurred vision لل patient + +213 +00:19:32,790 --> 00:19:37,370 +إذا جد بري لينز tier film stability إذا ثبات ال + +214 +00:19:37,370 --> 00:19:42,350 +tier film مهم كتير greater than normal inter blink + +215 +00:19:42,350 --> 00:19:48,110 +interval يعني لازم أن يكون الثبات أكتر من 100 من + +216 +00:19:48,110 --> 00:19:52,880 +ال blinkingبحيث انه دايما العدسة تكون ثابتة او + +217 +00:19:52,880 --> 00:19:57,740 +ماخدة good concentration للعدسة لمركزها جيد لو كل + +218 +00:19:57,740 --> 00:20:02,560 +المريض مثلا حرك عينه العدسة انه تكون follow لمين + +219 +00:20:02,560 --> 00:20:08,120 +للعين lens + +220 +00:20:08,120 --> 00:20:15,780 +movement حركة العدسةالتبرموس أي بمعنى تعزز post + +221 +00:20:15,780 --> 00:20:21,400 +lens tear film exchange and mixing الآن حركة + +222 +00:20:21,400 --> 00:20:27,820 +العدسة بتعزز من حركة مين؟ ال tear film طبعا احنا + +223 +00:20:27,820 --> 00:20:33,040 +دايما حكينا ان ال soft contact lens بيكون فيها + +224 +00:20:33,040 --> 00:20:38,640 +limitation من ناحية مين؟ من موضوع ال tear exchange + +225 +00:20:38,640 --> 00:20:44,990 +تبادل ال tear صحيح؟فال lens movement بتعزز من حركة + +226 +00:20:44,990 --> 00:20:50,570 +مين؟ ال tear film movement + +227 +00:20:50,570 --> 00:20:55,110 +is quantified إذا الحركة بتتم تحديدها أو تحدد + +228 +00:20:55,110 --> 00:21:00,050 +بواسطة as the vertical change دايما بطلب من المريض + +229 +00:21:00,050 --> 00:21:05,470 +على الستلام أن يحرك العدسة vertical يعني يطلع up و + +230 +00:21:05,470 --> 00:21:11,530 +down up و down okay as the vertical changeال lens + +231 +00:21:11,530 --> 00:21:16,770 +position بدي اعرف موضع العدسة هل بتغير ولا لأ + +232 +00:21:16,770 --> 00:21:21,630 +before and after a normal blink يعني قبل وبعد ايه + +233 +00:21:21,630 --> 00:21:27,030 +الترميشوانتوا عارفين المعادلة، إذا كانت العدسة + +234 +00:21:27,030 --> 00:21:32,290 +tight، هيكون حركتها أقل من قداش؟ من نص، يعني + +235 +00:21:32,290 --> 00:21:36,470 +تقريبا واحد من عشرة ملي ميتر، هذه بتكون ايه عاملة؟ + +236 +00:21:36,470 --> 00:21:41,150 +adherence، يعني no sensation at all، إذا كانت + +237 +00:21:41,150 --> 00:21:45,490 +حركتها أكتر من واحد، هيكون في هناك excessive + +238 +00:21:45,490 --> 00:21:51,130 +movementطبعا ال normal movement او ال ideal + +239 +00:21:51,130 --> 00:21:56,390 +movement للعدسة اللاصقة ال soft هي 3 من 10 ملي متر + +240 +00:21:56,390 --> 00:22:00,350 +لكن من الصعب دايما نصل لهذا الرقم فاحنا دايما + +241 +00:22:00,350 --> 00:22:07,510 +بنقول ال range من 0.5 ل 1 ملي متر اذا lens + +242 +00:22:07,510 --> 00:22:12,010 +movement of less than 0.1 ملي متر can be + +243 +00:22:12,010 --> 00:22:16,460 +considered in educateإذا كانت حركتها أقل من واحد + +244 +00:22:16,460 --> 00:22:20,040 +من عشرة، بتكون غير كافية أو غير مناسبة أو غير + +245 +00:22:20,040 --> 00:22:24,700 +ملائمة، بمعنى إنه بتعمل tight أو بتكون steep أو + +246 +00:22:24,700 --> 00:22:28,660 +بتعمل adherence ما بين ال surface للعدسة و + +247 +00:22:28,660 --> 00:22:29,360 +الكورنية + +248 +00:22:32,140 --> 00:22:36,420 +movement of more than one millimeter is excessive، + +249 +00:22:36,420 --> 00:22:40,500 +إذا كانت حركتها أكتر من واحد، هتلاحظوا أنه في هناك + +250 +00:22:40,500 --> 00:22:45,440 +excessive awareness، إدراك شديد في العدسة، المريض + +251 +00:22:45,440 --> 00:22:48,040 +هيشعر و كأنه هي عبارة عن foreign body + +252 +00:22:51,670 --> 00:22:55,490 +left lenses او ال conventional daily wear lenses + +253 +00:22:55,490 --> 00:23:02,290 +عدسات اللبس اليومي التقليدي okay that fit بتم وضع + +254 +00:23:02,290 --> 00:23:06,170 +اللي هو ال ideal fit لها او ال fit well يعني + +255 +00:23:06,170 --> 00:23:11,110 +الأفضل يعني ال fitting الجيد او المناسب لها show + +256 +00:23:11,110 --> 00:23:16,930 +about 0.3 millimeter of movementإن يكون حركتها + +257 +00:23:16,930 --> 00:23:21,710 +تلاتة من عشرة من المليميتر لكن هذه دايما تعتبر + +258 +00:23:21,710 --> 00:23:25,330 +theory من الصعب ال practice أصل للرقم هذا + +259 +00:23:28,710 --> 00:23:34,050 +It is easy من السهل to overestimate lens movement + +260 +00:23:34,050 --> 00:23:58,630 +when viewing with a sit lamp + +261 +00:23:58,790 --> 00:24:06,110 +over sensitive بمعنى زيادة في حركة العدسة أو زيادة + +262 +00:24:06,110 --> 00:24:12,550 +الإحساس بحركة العدسةA handy guide هذي من المفيد لل + +263 +00:24:12,550 --> 00:24:17,090 +examiner إن هذي a handy guide is to remember انه + +264 +00:24:17,090 --> 00:24:23,050 +تذكر ذات a 14 millimetre lens العدسات اللي بيكون + +265 +00:24:23,050 --> 00:24:27,990 +قطرها 14 millimetre على قرانية بيكون ال horizontal + +266 +00:24:27,990 --> 00:24:35,440 +visible iris diameter إلها 12 مليهيكون فيها حركة + +267 +00:24:35,440 --> 00:24:41,380 +واحد مليمتر، ايش هتعمل؟ هتعمل يعني هيكون فيه + +268 +00:24:41,380 --> 00:24:46,240 +excessive movement و هتجتاز حتى من ال limbus هتعمل + +269 +00:24:46,240 --> 00:24:52,240 +ال traverses لاللي هو ال limbus إذا مرة أخرى، لما + +270 +00:24:52,240 --> 00:24:57,540 +مريض بيكون عنده قطر ال diameter للعدسة اربعة عشر + +271 +00:24:57,540 --> 00:25:01,360 +وهو عنده ال horizontal visible iris diameter + +272 +00:25:01,360 --> 00:25:06,540 +اتناشر مليالان يما بيحرك العدسة up و down او + +273 +00:25:06,540 --> 00:25:10,960 +vertical change بتلاقي ان حركة العدسة واحد ملي + +274 +00:25:10,960 --> 00:25:15,100 +واحد ملي يعني excessive movement زيادة الإدراج في + +275 +00:25:15,100 --> 00:25:20,140 +العدسة وبالتالي هذا ايش بيعمل؟ ان العدسة هتتعدى + +276 +00:25:20,140 --> 00:25:24,780 +وين اللي مبصها، طبعا هي هتكون غير مناسبة او غير + +277 +00:25:24,780 --> 00:25:30,870 +ملائمة للمريضلذلك الآن بعض الطالبات يمكن في بداية + +278 +00:25:30,870 --> 00:25:34,830 +الفصل بيسألوني انه احنا عندنا في قطاع غزة standard + +279 +00:25:34,830 --> 00:25:41,330 +diameter من 14 ل 14.5هي الخلاف احنا معظمنا ال + +280 +00:25:41,330 --> 00:25:45,570 +horizontal visible iris diameter ما بين 11.5 و 12 + +281 +00:25:45,570 --> 00:25:50,210 +المعظم عندنا في فترة غزة طيب الان لو انا لبست عدسة + +282 +00:25:50,210 --> 00:25:55,490 +12 ميلي متر الحركة هتكون جداش؟ واحد ميلي متر اذا + +283 +00:25:55,490 --> 00:26:00,150 +المريض هيكون في عنده زيادة في الإدراك في العدسة + +284 +00:26:00,150 --> 00:26:06,370 +وبالتالي هذا يعتبر wrong decision يعني قرار خاطئ + +285 +00:26:06,370 --> 00:26:07,350 +لصرف العدسة + +286 +00:26:10,640 --> 00:26:16,670 +بوش أب تيست هذا عبارة عن اختبارمن خلاله انا بقدر + +287 +00:26:16,670 --> 00:26:22,770 +احدد indicator of lens mobility اذا قابلية الحركة + +288 +00:26:22,770 --> 00:26:27,690 +للعدسة كيف؟ ان ال examiner بيدغط على ال lower + +289 +00:26:27,690 --> 00:26:32,490 +eyelid margin بالنسبة للمريض فبالتالي انه هيتحرك + +290 +00:26:32,490 --> 00:26:37,270 +أطراف العدسة فهتشوف ان هل حركة العدسة excessive + +291 +00:26:37,270 --> 00:26:41,490 +movement ولا steep أو tight movement + +292 +00:26:43,980 --> 00:26:49,120 +تستخدم لصفته لو رجت نعم تنتين indicator of lens + +293 +00:26:49,120 --> 00:26:54,700 +mobility إذا بتحدد مين قابلية الحركة للعدسة that + +294 +00:26:54,700 --> 00:26:58,660 +is independent of the patient's eyelid blink + +295 +00:26:58,660 --> 00:27:04,660 +dynamics يعني بتتم اللي هو او بتعتمد اعتماد اللي + +296 +00:27:04,660 --> 00:27:08,800 +هو مباشر على مين على ال eyelid margin اللي خاص + +297 +00:27:08,800 --> 00:27:09,860 +بالمريد + +298 +00:27:12,280 --> 00:27:18,900 +التجارب الفاحس بوشز هيعمل دفع لالعدسة superiorly + +299 +00:27:18,900 --> 00:27:23,380 +by manipulating the patient's inferior eyelid + +300 +00:27:23,380 --> 00:27:28,840 +marginمن أطراف العدسة هتتحرك العدسة وين لفوق إذا + +301 +00:27:28,840 --> 00:27:32,860 +كان طبيعي optimal lens fit هيكون حركتها من نص الى + +302 +00:27:32,860 --> 00:27:37,500 +واحد وهذه هيكون ايش good movement لكن إذا أكتر من + +303 +00:27:37,500 --> 00:27:42,080 +هيك هتلاحظ الحركة أكتر من واحد إذا أقل من هيك أقل + +304 +00:27:42,080 --> 00:27:46,820 +من النص لواحد هتلاحظ ان في هناك tight للعدسة + +305 +00:27:48,430 --> 00:27:54,370 +لينز يمكن أن يتحرك بسهولة باستخدام الـ push-up + +306 +00:27:54,370 --> 00:27:59,610 +test يعني المريض أو أفوان ال examiner هيشعر بحركة + +307 +00:27:59,610 --> 00:28:06,350 +العدسة مجرد ما يعمل الاختبار ال push-up test طبعا + +308 +00:28:06,350 --> 00:28:10,510 +الاختبار هذا هيتم عمله ان شاء الله في المعمل من + +309 +00:28:10,510 --> 00:28:13,610 +خلال اللي هو ال test هذا ال push-up test لما نعمل + +310 +00:28:13,610 --> 00:28:19,590 +evaluation لل soft contact lensCentration of a + +311 +00:28:19,590 --> 00:28:24,610 +soft lens بدنا نشوف تمركز العدسة انه هل التمركز + +312 +00:28:24,610 --> 00:28:27,950 +للعدسة اللاصقة ملائم مناسب او لا + +313 +00:28:31,360 --> 00:28:36,920 +is assessed or evaluated بيقيم as optimal إن هو + +314 +00:28:36,920 --> 00:28:42,520 +مثالي if the lens edge إذا كانت أطراف العدسة shows + +315 +00:28:42,520 --> 00:28:48,600 +بتوضح uniform إن في هناك تماثل أو اللي هو تلائم أو + +316 +00:28:48,600 --> 00:28:53,840 +symmetric إنه تكون متماثلة أو متلائمة overlap لكل + +317 +00:28:53,840 --> 00:28:58,670 +اللي هو سطح القرنيةunto the sclera in all + +318 +00:28:58,670 --> 00:29:03,050 +meridians، طبعا احنا عارفين ان هي بتعد من الكورنية + +319 +00:29:03,050 --> 00:29:06,830 +و بتكون على حواف الليمبس تقريبا + +320 +00:29:10,240 --> 00:29:14,380 +طيب إذا كان في هناك العدسة Decentration يعني + +321 +00:29:14,380 --> 00:29:19,120 +تمركزها غير ملائم واختلفت أنت و أصدقائك أن هذه + +322 +00:29:19,120 --> 00:29:24,220 +العدسة Decentered ببساطة بنحرك العدسة باستخدام ال + +323 +00:29:24,220 --> 00:29:29,860 +push up test إذا رجعت بعد أقل من واحد ثانية معناه + +324 +00:29:29,860 --> 00:29:33,280 +الكلام أن هي فيها good concentration إذا ما رجعت + +325 +00:29:33,280 --> 00:29:38,240 +إذا هي Decentration مرة تانية if the lens is + +326 +00:29:38,240 --> 00:29:43,120 +decenteredيعني ماكانش فيه تمركز ملائم أو مناسب + +327 +00:29:43,120 --> 00:29:48,100 +للعدسة such as with the push-up test باستخدام هذا + +328 +00:29:48,100 --> 00:29:53,300 +الاختبار it should regain optimal centration in + +329 +00:29:53,300 --> 00:29:58,220 +lens in less than one second العدسة هترجع لمكانها + +330 +00:29:58,220 --> 00:30:02,560 +الأصلي اللي هو ال optimal fit بعد أقل من كده واحد + +331 +00:30:02,560 --> 00:30:03,220 +ثانية + +332 +00:30:07,830 --> 00:30:13,170 +Lag on upgades and virgin movement الان لوصلنا + +333 +00:30:13,170 --> 00:30:17,210 +لسؤال ما هو المقصود بال virgin ما هو تعريف ال + +334 +00:30:17,210 --> 00:30:21,970 +virgin انه + +335 +00:30:21,970 --> 00:30:27,350 +تفضلي okay + +336 +00:30:27,350 --> 00:30:33,190 +or binocular movementeither are conjugate يعني + +337 +00:30:33,190 --> 00:30:37,070 +التنتين بيكونوا ايش مع بعض اللي هو بتحركه، اذا + +338 +00:30:37,070 --> 00:30:41,110 +جونا مثلا ال right abduction، ال left هتكون + +339 +00:30:41,110 --> 00:30:46,500 +abduction، والعكس صحيحLag on up gaze بطلب انا من + +340 +00:30:46,500 --> 00:30:51,700 +المريض ان يطلع الى الاعلى او الاسفل اما بيكون up + +341 +00:30:51,700 --> 00:30:57,060 +gaze او down gaze طبعا الهدف بدي اشوف هل تمركز + +342 +00:30:57,060 --> 00:31:02,260 +العدسة جيد ولا لأ؟ هل العدسة ماخدة uniform و + +343 +00:31:02,260 --> 00:31:04,960 +symmetric on the sclera ولا لأ؟ + +344 +00:31:07,820 --> 00:31:13,440 +is readily بسهولة evaluated بيقيم by observing + +345 +00:31:13,440 --> 00:31:18,460 +بواسطة ملاحظة the change التغير ال concentration + +346 +00:31:18,460 --> 00:31:25,260 +إذا أنا بدي ألاحظ التغير في تمركز العدسة okay in I + +347 +00:31:25,260 --> 00:31:29,520 +position other than primary gaze إذا المريض مش + +348 +00:31:29,520 --> 00:31:33,580 +هيطلع وين في ال primary position إما up gaze أو + +349 +00:31:33,580 --> 00:31:34,240 +down gaze + +350 +00:31:39,080 --> 00:31:44,540 +عادة عدسة عدسة عدسة عدسة عدسة عدسة عدسة عدسة عدسة + +351 +00:31:44,540 --> 00:31:51,180 +عدسة عدسة + +352 +00:31:51,180 --> 00:32:02,100 +عدسة عدسة عدسة + +353 +00:32:02,100 --> 00:32:08,840 +عدسةفهي هتعدي من الكورنية و هتكون على أطراف من ال + +354 +00:32:08,840 --> 00:32:14,840 +limbus فال lag تقريبا فيها هيكون من 0.3 ل 0.7 هذه + +355 +00:32:14,840 --> 00:32:19,560 +في حالة من ال normal لكن ال RGB لو استخدمته + +356 +00:32:19,560 --> 00:32:26,120 +الطريقة هذه كانت مش ظاهرة ال 0.3 ل 0.7 لأن ال + +357 +00:32:26,120 --> 00:32:27,840 +diameter بتاعها أصغر + +358 +00:32:31,560 --> 00:32:35,800 +Excessive lag زيادة ال lag is associated with poor + +359 +00:32:35,800 --> 00:32:39,040 +concentration بالشكل هذا + +360 +00:32:44,380 --> 00:32:50,040 +يما بيزيد اللي هو ال lag هان، يعني بمعنى انه بيغطي + +361 +00:32:50,040 --> 00:32:54,180 +الكورنية و بتعدى ال limbus بمعنى ان ديامتر العدسة + +362 +00:32:54,180 --> 00:32:59,060 +اكبر فبالتالي هتكون اكتر من سبعة من عشرة، ايش + +363 +00:32:59,060 --> 00:33:03,580 +هتعمل؟ poor concentration، عدم تمركز اللي هو جيد + +364 +00:33:03,580 --> 00:33:08,880 +للعدسةيا ما يكون zero lag مش واضح بالمرة، يا ما + +365 +00:33:08,880 --> 00:33:12,240 +يقولنا المريض اتطلع up gaze او down gaze، معنى + +366 +00:33:12,240 --> 00:33:16,280 +الكلام انه ايش عنده العدسة اللي هي ال tie وفيها + +367 +00:33:16,280 --> 00:33:20,440 +اللي هو adherence ما بين ال surface of the lens و + +368 +00:33:20,440 --> 00:33:26,230 +ال corniaببساطة ال lag انا بطلب من المريض انه + +369 +00:33:26,230 --> 00:33:29,510 +دايما ما يطلع في ال primary position اما في ال up + +370 +00:33:29,510 --> 00:33:33,170 +gaze او ال down gaze و ممكن في بعض الأحيان بطلب + +371 +00:33:33,170 --> 00:33:37,250 +right and left يعني abduction و abduction okay و + +372 +00:33:37,250 --> 00:33:41,910 +بشوف انا جديش اطراف العدسة ماخدة اذا كانت النسبة + +373 +00:33:41,910 --> 00:33:45,750 +من تلاتة من عشرة لسبعة من عشرة بنقول هذا normal + +374 +00:33:45,750 --> 00:33:51,180 +طبعا ليه؟ لأن ال diameter للعدسة بيكون كبيرأكبر من + +375 +00:33:51,180 --> 00:33:55,580 +الكورنيا طيب إذا كانت نسبة ال light zero معناه + +376 +00:33:55,580 --> 00:33:59,960 +الكلام انه مافي اي ت ايه بالضبط ان العدسة بتكون + +377 +00:33:59,960 --> 00:34:04,960 +tight يعني adherence to the surface of the cornea + +378 +00:34:04,960 --> 00:34:09,360 +إذا كان اكتر من هذا الرقم معناه الكلام ان العدسة + +379 +00:34:09,360 --> 00:34:13,160 +excessive movement وبالتالي هي قد تكون flat + +380 +00:34:16,710 --> 00:34:21,530 +Tier Exchange تبادل ال tier and the post lens tier + +381 +00:34:21,530 --> 00:34:26,430 +film ما ننسى المعلومة انه من ال limitation للعرصات + +382 +00:34:26,430 --> 00:34:31,190 +اللاصقة اللينة ان في هناك limitation لل tier + +383 +00:34:31,190 --> 00:34:32,030 +exchange + +384 +00:34:34,810 --> 00:34:40,430 +Evaluated بيقيم clinically using observation أنه + +385 +00:34:40,430 --> 00:34:44,530 +أنا بدي ألاحظ في ال Specular illumination طب هل + +386 +00:34:44,530 --> 00:34:46,870 +ممكن أنا أستخدم ال direct illumination في هذا + +387 +00:34:46,870 --> 00:34:50,250 +النوع؟ ليش استخدمنا ال Specular illumination؟ + +388 +00:34:51,130 --> 00:34:56,230 +ببساطة لأن في هناك angle هيكون فيه angle ما بين + +389 +00:34:56,230 --> 00:35:01,550 +اللي هو ال tube او ال biomicroscope و الجهاز اللي + +390 +00:35:01,550 --> 00:35:05,530 +انا بدي استخدمه او ال mires هيكون angle من خمسة و + +391 +00:35:05,530 --> 00:35:09,890 +أربعين لستين degree فدايما هنا ما بنستخدم ال + +392 +00:35:09,890 --> 00:35:13,170 +direct illumination بنستخدم ال specular + +393 +00:35:13,170 --> 00:35:14,050 +illumination + +394 +00:35:17,470 --> 00:35:22,150 +high magnification تكبير كبير بيكون تقريبا تلاتين + +395 +00:35:22,150 --> 00:35:28,690 +لستين اكتس a wide angle of observation more than + +396 +00:35:28,690 --> 00:35:32,650 +sixty degrees او بنقول دايما من خمسة واربين لستين + +397 +00:35:32,650 --> 00:35:37,750 +ديجري and a narrow slit انه هيكون ال slit بيهم او + +398 +00:35:37,750 --> 00:35:40,030 +point one millimeter are needed + +399 +00:35:42,600 --> 00:35:47,480 +An optimal fit lens or an optimal lens fit + +400 +00:35:47,480 --> 00:35:53,660 +requires an aqueous post lens، tear film لازم ان + +401 +00:35:53,660 --> 00:35:58,640 +يكون فيه هناك ايه تحريك للعدسة عشان تعمل هناك + +402 +00:35:58,640 --> 00:36:04,940 +تحريك لمين؟ لل tear exchangewhich is observed هذا + +403 +00:36:04,940 --> 00:36:08,680 +هيكون ملاحظ ان هو عبارة عن amorphous ايش يعني + +404 +00:36:08,680 --> 00:36:12,560 +amorphous يعني no pattern مافيش هناك اي تشكل له + +405 +00:36:12,560 --> 00:36:17,660 +يعني صح بتلاحظ ان في حركة لكن without pattern بدون + +406 +00:36:17,660 --> 00:36:22,520 +شكل او no pattern او بنسميها amorphous in a + +407 +00:36:22,520 --> 00:36:25,960 +specular reflection او a specular illumination + +408 +00:36:31,000 --> 00:36:35,160 +post lens tear film appearances are taken to + +409 +00:36:35,160 --> 00:36:40,100 +indicate reduced tear exchange بتلاحظ انه لو كان + +410 +00:36:40,100 --> 00:36:43,980 +هناك فيه pattern معناه الكلام انه في هناك + +411 +00:36:43,980 --> 00:36:49,880 +adherence للعدسة في التساق للعدسة فهيكون ظاهر انه + +412 +00:36:49,880 --> 00:36:54,420 +في pattern شكل او له color معين يكون اقرب لللون + +413 +00:36:54,420 --> 00:36:55,260 +الرمادي + +414 +00:36:57,610 --> 00:37:02,130 +وهذا بتديني indication انه في هناك reduce لل tier + +415 +00:37:02,130 --> 00:37:06,170 +exchange معنى الكلام يما يكون في هذا الموضوع ايش + +416 +00:37:06,170 --> 00:37:10,490 +بدي اعمل؟ بدي ارفع العدسة اللاصقة و اعمل tier film + +417 +00:37:10,490 --> 00:37:14,490 +evaluation من ناحية ال TPUT ال corneal fluorescent + +418 +00:37:14,490 --> 00:37:19,990 +staining keratometer + +419 +00:37:19,990 --> 00:37:20,770 +measures + +420 +00:37:24,950 --> 00:37:31,650 +إنه بدنا نعمل تقييم ل الكيراتو ميتر في المحاضرة ان + +421 +00:37:31,650 --> 00:37:35,870 +شاء الله يعني بتوقف لهذه النقطة لكراتو ميتر مياردز + +422 +00:37:35,870 --> 00:37:40,730 +وفي المحاضرة القادمة بنكمل ان شاء الله موضوع + +423 +00:37:40,730 --> 00:37:44,810 +الكيراتو ميتر مياردز يعطيكم العافية + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/nbr1GB4Nc8U.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/nbr1GB4Nc8U.srt new file mode 100644 index 0000000000000000000000000000000000000000..ca19928eb6763fb07faee0a39ffe8ced701d1dec --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/nbr1GB4Nc8U.srt @@ -0,0 +1,1439 @@ +1 +00:00:21,630 --> 00:00:24,490 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:24,490 --> 00:00:28,250 +وبركاته and a very good morning to all of you + +3 +00:00:28,250 --> 00:00:35,230 +هنكمل في المحاضرة موضوع ال signs of hypercapnia + +4 +00:00:35,230 --> 00:00:40,130 +and hypoxia موضوع الstromal scrape + +5 +00:00:42,660 --> 00:00:47,180 +طبعا الاسترومة الاسترية هي عبارة عن عصا بيضاء + +6 +00:00:47,180 --> 00:00:54,480 +اللون بتكون في ال posterior surface للاسترومة طبعا + +7 +00:00:54,480 --> 00:00:59,760 +في الشكل اللي واضح أمامنا find بمعنى دقيق white + +8 +00:00:59,760 --> 00:01:06,180 +vertical lines خطوط بيضاء رفيعة مستقيمة in the + +9 +00:01:06,180 --> 00:01:11,060 +posterior stroma of the cornea في الجزء الخلفي من + +10 +00:01:11,060 --> 00:01:19,520 +الاسترومة إذا كانت + +11 +00:01:19,520 --> 00:01:24,320 +قيمة الإديمة في الاسترومة خمسة في المية فما فوق + +12 +00:01:24,320 --> 00:01:29,980 +طبعا أو ستة في المية فما فوق في جماعة عندنا + +13 +00:01:29,980 --> 00:01:34,380 +الاسترومة أو + +14 +00:01:34,380 --> 00:01:40,120 +ال substantia propria + +15 +00:01:42,550 --> 00:01:51,030 +ك another name طبعا هي بتمثل ninety percent + +16 +00:01:51,030 --> 00:01:55,890 +of corneal thickness + +17 +00:01:59,910 --> 00:02:05,470 +زيادة دخول الماء في الاسترومة بيعمل على اختلاف في + +18 +00:02:05,470 --> 00:02:09,230 +ال concentration التركيز بمعنى أنه بيزيد ال + +19 +00:02:09,230 --> 00:02:14,310 +concentration للاسترومة مقارنة بالأجزاء الأخرى + +20 +00:02:14,310 --> 00:02:20,130 +فهذا بيؤدي إلى الإديمة طبعا إذا كانت قيمة الإديمة + +21 +00:02:20,130 --> 00:02:25,370 +6% فما فوق okay بيعمل حاجة بيسميها الstromal + +22 +00:02:25,370 --> 00:02:26,030 +strain + +23 +00:02:29,070 --> 00:02:34,250 +thus or so, stray are present with most current + +24 +00:02:34,250 --> 00:02:39,790 +generation daily wear, hydrogel lenses for myopia + +25 +00:02:39,790 --> 00:02:45,670 +دايما هذه الـstray هي غير شائعة أو غير حاضرة أو + +26 +00:02:45,670 --> 00:02:51,210 +غير موجودة في حالات المرضى اللي بيرتديوا العدسات + +27 +00:02:51,210 --> 00:02:58,340 +اللاصقة السالبة الـ minus lenses ليش طيب؟ يعني ليش + +28 +00:02:58,340 --> 00:03:02,820 +هذه الـ stray؟ + +29 +00:03:02,820 --> 00:03:06,620 +بالضبط، + +30 +00:03:06,620 --> 00:03:10,720 +دايما العدسات الـ minus lenses بتتميز بأن الـ + +31 +00:03:10,720 --> 00:03:14,720 +center فيها thinner than ال peripheral، يعني + +32 +00:03:14,720 --> 00:03:17,980 +من ال center بتكون thin وال peripheral ايش بتكون + +33 +00:03:17,980 --> 00:03:24,960 +thick فبكون هناك دخول للأكسجين بشكل سليم أو بشكل + +34 +00:03:24,960 --> 00:03:29,460 +اللي هو صحيح أو بكميات كبيرة فهذا ما بيعمل ايه؟ + +35 +00:03:29,460 --> 00:03:33,560 +Corneal edema وبالتالي ما بيؤدي إلى الstromal + +36 +00:03:33,560 --> 00:03:39,740 +strain okay فدائما عند زيادة الأكسجين ال + +37 +00:03:39,740 --> 00:03:44,940 +transmissibility بيعمل على زيادة مين؟ ال Dk على T + +38 +00:03:45,840 --> 00:03:49,540 +وبالتالي هذا لا يؤدي إلى القرنية الإديمة + +39 +00:03:53,460 --> 00:03:58,420 +Stray remained a useful diagnostic indicator طبعا + +40 +00:03:58,420 --> 00:04:04,700 +هي بتعتبر مؤشر تشخيصي للأشخاص اللي بيكون عندهم + +41 +00:04:04,700 --> 00:04:10,520 +إديمة لكن بيرتديوا عدسات ايه plus lenses أو plus + +42 +00:04:10,520 --> 00:04:15,120 +powered hydrogel lenses يعني دايما الأشخاص اللي + +43 +00:04:15,120 --> 00:04:19,960 +بيرتديوا عدسات موجبة بيتبعها ايه corneal إديمة + +44 +00:04:19,960 --> 00:04:24,850 +وبعد ذلك بيسبب stromal stray إذا كانت قيمة القديمة + +45 +00:04:24,850 --> 00:04:30,590 +أكثر من 6% طيب ليه السبب ليش أنه ذكرنا ال plus + +46 +00:04:30,590 --> 00:04:35,070 +lenses ببساطة لأن ال plus lenses بيكون ال thicker + +47 +00:04:35,070 --> 00:04:39,970 +في ال center بالتالي كمية ال oxygen اللي هتدخل + +48 +00:04:39,970 --> 00:04:44,630 +ايه؟ يعني هتكون قليلة فهذا ممكن انه يكون مهيئ + +49 +00:04:44,630 --> 00:04:49,710 +لحدوث ايه؟ القرنية القديمة وبعد ذلك بتبعها ال + +50 +00:04:49,710 --> 00:04:55,860 +stromal strain such as those prescribed for + +51 +00:04:55,860 --> 00:05:01,760 +monovision، طب ليش ذكرنا monovision؟ بالضبط لأنه + +52 +00:05:01,760 --> 00:05:05,760 +بتكون الوصفة plus lenses لأنها بتستخدم فقط لمين؟ + +53 +00:05:05,760 --> 00:05:11,200 +لالقراءة القريبة، يعني فقط لل near أو لل + +54 +00:05:11,200 --> 00:05:16,260 +reading، يعني هي مخصصة أنها فقط تكون ك plus lenses + +55 +00:05:21,200 --> 00:05:25,960 +Extended wear lenses أيضا الأشخاص اللي بيرتديوا + +56 +00:05:25,960 --> 00:05:30,740 +العدسات اللاصقة لمدة أسبوع واحد طبعا في حالة ال + +57 +00:05:30,740 --> 00:05:36,690 +extended wear هتكون ال DK على T quite high طيب لو + +58 +00:05:36,690 --> 00:05:41,430 +كانت low أو medium هذا هيكون diagnostic أو + +59 +00:05:41,430 --> 00:05:45,670 +indicator diagnostic يعني مؤشر اللي هو تشخيصي + +60 +00:05:45,670 --> 00:05:50,690 +لحدوث من القرنية القديمة وبعد ذلك بيعمل stromal + +61 +00:05:50,690 --> 00:05:55,630 +strain يعني دائما أيضا هي بالزيد في حالات المرضى + +62 +00:05:55,630 --> 00:05:59,210 +اللي بيرتديوا ايه ال extended wear lenses + +63 +00:06:03,910 --> 00:06:10,620 +Stromal Falls هي عبارة عن ثنايا بتكون بالشكل هذا، + +64 +00:06:10,620 --> 00:06:16,420 +ظهورها كأنه اللي هو dark line خطوط سوداء، okay؟ + +65 +00:06:16,420 --> 00:06:20,260 +يعني ثنايا سوداء طبقة الاندوثيليام يا جماعة + +66 +00:06:20,260 --> 00:06:25,300 +بتتميز بأنها طبقة ملساء، ايش معناه طبقة ملساء؟ يعني + +67 +00:06:25,300 --> 00:06:30,060 +لو استخدمنا ال specular reflection، أي بمعنى الضوء + +68 +00:06:30,060 --> 00:06:35,700 +الساطع المنعكس، هيعمل انعكاس للصورة بنسبة مائة في + +69 +00:06:35,700 --> 00:06:40,930 +المائة تقريبا، okay؟ لو في أي ثنايا هتعمل + +70 +00:06:40,930 --> 00:06:49,110 +انعكاس بالشكل هذا وكأنه dark lines okay appear + +71 +00:06:49,110 --> 00:06:54,750 +as dark lines إذا هي هتظهر على أنها هي خطوط معتمة + +72 +00:06:54,750 --> 00:07:00,470 +أو سوداء in the endothelial specular reflection + +73 +00:07:00,470 --> 00:07:04,370 +في حالة استخدام الضوء الساطع لرؤية من ال + +74 +00:07:04,370 --> 00:07:11,040 +endothelium they appear when stromal edema exceeds + +75 +00:07:11,040 --> 00:07:15,980 +10% يعني هتظهر إذا كانت قيمة ال edema عشرة في + +76 +00:07:15,980 --> 00:07:20,880 +المية فما فوق، إذا أيهم أختار ال stromal stray + +77 +00:07:20,880 --> 00:07:26,400 +ولا ال stromal false؟ لأن قيمة ال edema بالزيد عن + +78 +00:07:26,400 --> 00:07:27,640 +عشرة في المية + +79 +00:07:31,860 --> 00:07:37,880 +rarely occur with daily wear of GB or Hydrogel + +80 +00:07:37,880 --> 00:07:42,820 +contact lenses هي نادرة الحدوث في عدسات اللبس + +81 +00:07:42,820 --> 00:07:49,500 +اليومي ال soft contact lens أو ال RGB ليش + +82 +00:07:49,500 --> 00:07:54,140 +ال stromal falls بتكون نادرة الحدوث؟ في الـ + +83 +00:07:54,140 --> 00:07:57,920 +conventional daily wear اللي بتتم ارتدائها مثلا + +84 +00:07:57,920 --> 00:08:02,540 +عشر ساعات أو اتناشر ساعة أو في ال GB lenses + +85 +00:08:06,050 --> 00:08:09,690 +لأن الآن العدسات اللاصقة الـ hydrogel conventional + +86 +00:08:09,690 --> 00:08:14,610 +daily wear يوما بتتم عملية ال removal لها، حيصير + +87 +00:08:14,610 --> 00:08:21,890 +هناك إزالة للإديمة وبالتالي أو تلاشي لقيمة الإديمة + +88 +00:08:21,890 --> 00:08:27,090 +وهذا ما بتؤدي إلى حدوث من الstromal falls ولكن + +89 +00:08:27,090 --> 00:08:31,410 +عندنا في حالة يصير هناك stromal falls معنى الكلام + +90 +00:08:31,410 --> 00:08:36,030 +أنه عنده قيمة الإديمة ثابتة overnight يعني في كل + +91 +00:08:36,030 --> 00:08:40,710 +الوقت قيمتها قد ايه عشرة في المية أو أكثر فهذا بيدي + +92 +00:08:40,710 --> 00:08:45,690 +ذريعة لحدوث مين ال stromal falls طبعا هي وين بتكون + +93 +00:08:45,690 --> 00:08:50,890 +أكثر حاجة شائعة؟ في حالتين ال poor fitting لل GB + +94 +00:08:50,890 --> 00:08:55,470 +lenses والحالة الثانية عندما يكون عندي low DK + +95 +00:08:55,470 --> 00:09:02,110 +على T إذا عندنا في ال poor fitting + +96 +00:09:02,110 --> 00:09:05,770 +لل + +97 +00:09:05,770 --> 00:09:12,190 +GB والحالة الثانية في ال low dk على t في هذه + +98 +00:09:12,190 --> 00:09:17,190 +الحالتين بتكون عندنا ال stromal false common بدون + +99 +00:09:17,190 --> 00:09:21,570 +ذلك في حالات الـ conventional daily wear أو العدسة + +100 +00:09:21,570 --> 00:09:25,850 +اللي بتكون GB optimal fit ما بتحدث حدوث الـ + +101 +00:09:25,850 --> 00:09:30,510 +stromal falls with + +102 +00:09:30,510 --> 00:09:35,090 +extended wear of hydrogen lenses posterior falls + +103 +00:09:35,090 --> 00:09:39,730 +can be apparent on eye opening لكن هنا في الها شرط + +104 +00:09:40,700 --> 00:09:45,360 +يومًا عندنا بيكون قيمة الإديمة مثلا أول ما المريض + +105 +00:09:45,360 --> 00:09:49,460 +بيصحى الصبح بتكون عشرة في المية، في آخر النهار عشرة + +106 +00:09:49,460 --> 00:09:53,420 +في المية، في منتصف اليوم عشرة في المية، ممكن أنه + +107 +00:09:53,420 --> 00:09:58,860 +يحدث عند المريض ايه؟ stromal falls طيب المريض الآن + +108 +00:09:58,860 --> 00:10:02,600 +استيقظ من النوم وكانت قيمة الإديمة عنده عشرة في + +109 +00:10:02,600 --> 00:10:06,640 +المية أو تسعة في المية، هل ممكن أنه يحدث عنده + +110 +00:10:06,640 --> 00:10:11,670 +stromal falls؟ قد إذا ربما يحدث وربما ما يحدث لأن + +111 +00:10:11,670 --> 00:10:15,230 +أنتم عارفين أن الإنسان أول ما بيستيقظ من النوم + +112 +00:10:15,230 --> 00:10:19,570 +بيكون عنده ال edema ايه؟ عالية مقارنة في منتصف + +113 +00:10:19,570 --> 00:10:21,410 +اليوم أو آخر اليوم + +114 +00:10:24,760 --> 00:10:29,560 +Management بالنسبة لقالية العلاج للstromal + +115 +00:10:29,560 --> 00:10:35,980 +stray أو الstromal falls أو الstromal edema if + +116 +00:10:35,980 --> 00:10:40,220 +stromal edema is noted at follow-up examination + +117 +00:10:40,220 --> 00:10:45,860 +الآن المريض ارتدى العدسة اللاصقة نفترض لمدة شهر + +118 +00:10:45,860 --> 00:10:50,500 +بعد الشهر بطلب منه أن يعمل follow-up أنا بقصد ايه + +119 +00:10:50,500 --> 00:10:56,050 +ال conventional daily wear lenses increasing lens + +120 +00:10:56,050 --> 00:11:03,350 +Dk على T to at least 15% for daily wear and at + +121 +00:11:03,350 --> 00:11:09,090 +least 34% for extended wear is recommended إذا + +122 +00:11:09,090 --> 00:11:13,750 +سببت عنده أي زيادة في الاسترومة القديمة الحل + +123 +00:11:13,750 --> 00:11:18,210 +الوحيد أنه أعمل زيادة في DK على T طبعا بعض ال + +124 +00:11:18,210 --> 00:11:23,210 +researchers قيم هذه الزيادة حكالك في حالات ال + +125 +00:11:23,210 --> 00:11:26,170 +daily wear أو ال conventional daily wear على ساعة + +126 +00:11:26,170 --> 00:11:32,030 +اللبس اليومي التقليدي بتكون قيمتها 15% لكن في ال + +127 +00:11:32,030 --> 00:11:38,990 +extended wear هتكون قد ايه 34% طيب بدأ أسأل سؤال أنه + +128 +00:11:38,990 --> 00:11:43,250 +دائما ال extended wear لازم أن يكون فيها high + +129 +00:11:43,250 --> 00:11:44,130 +Dk على T + +130 +00:11:47,250 --> 00:11:52,130 +الـ extended wear lenses لازم أنه دائما يكون لها + +131 +00:11:52,130 --> 00:11:58,970 +قيمة ال Dk على T very high why؟ حالة ال extended + +132 +00:11:58,970 --> 00:11:59,890 +wear lenses + +133 +00:12:08,460 --> 00:12:11,440 +لازم تكون عالية بس في نفس الوقت بت… رح يقل ال + +134 +00:12:11,440 --> 00:12:13,800 +thickness فقلت اللي لازم ياخد قطرة أنه يعني كلها + +135 +00:12:13,800 --> 00:12:16,100 +بس هي لازم تكون عالية علشان يصير في عنده more gear + +136 +00:12:16,100 --> 00:12:22,900 +extension okay another answer إذا + +137 +00:12:22,900 --> 00:12:27,140 +احنا متفقين أن عدسات ال extended wear lenses لازم + +138 +00:12:27,140 --> 00:12:31,760 +أن يكون ال DK على T very high لسبب واحد أنه لو + +139 +00:12:31,760 --> 00:12:36,680 +أنا مثلا خليتها medium أو low حيصير مباشرة cornea + +140 +00:12:36,680 --> 00:12:41,470 +القديمة هيتبعها الـ stromal edema بعد ذلك مثلا + +141 +00:12:41,470 --> 00:12:47,750 +stromal stray و stromal falls إذا لازم أنه دائماً + +142 +00:12:47,750 --> 00:12:52,110 +ال decay على T يكون very high عشان أضمن أكبر كمية + +143 +00:12:52,110 --> 00:12:54,870 +من الأكسجين تدخل لمن؟ للقرنية + +144 +00:12:59,780 --> 00:13:03,400 +طبعاً هنا احنا متفقين في النقطة الأولى هذه ك range + +145 +00:13:03,400 --> 00:13:06,360 +اللي هي الخمسة في المئة أو الأربعة و ثلاثين في + +146 +00:13:06,360 --> 00:13:11,420 +المئة يعني ممكن تتغير من patient لآخر يعني هذه ليست + +147 +00:13:11,420 --> 00:13:15,720 +guidelines هذه عبارة عن ال protocol الفرق ما بين + +148 +00:13:15,720 --> 00:13:18,920 +ال protocol و ال guidelines ال protocol في ال + +149 +00:13:18,920 --> 00:13:22,200 +management يعني في العلاج دائماً ممكن أنه يتغير + +150 +00:13:22,200 --> 00:13:27,200 +يعني ممكن مثلاً آية بتأخذ عشرة في المئة مثلاً أنس + +151 +00:13:27,200 --> 00:13:31,860 +خمسة في المئة الصين مثلاً ثلاثة عشر في المئة فقد تتغير + +152 +00:13:31,860 --> 00:13:36,220 +من شخص لآخر حسب ال sensitivity اللي موجود عنده + +153 +00:13:42,050 --> 00:13:45,730 +في حالة العدسات الموجبة اللي بيكون الـ thick vein + +154 +00:13:45,730 --> 00:13:51,260 +في ال center This may require هذا هيتطلب a change + +155 +00:13:51,260 --> 00:13:56,840 +تغير to high water content material or a GB lens + +156 +00:13:56,840 --> 00:14:03,160 +design إذا بتطلب من ال manufacturer أنه يزيد في + +157 +00:14:03,160 --> 00:14:07,260 +مين في ال water content أو يغير ال material لذلك + +158 +00:14:07,260 --> 00:14:11,720 +احنا لاحظنا الجيل الأول من العدسات أنه كان فقط + +159 +00:14:11,720 --> 00:14:15,660 +بيستخدموا مثلاً ال poly methyl methacrylate لل GB + +160 +00:14:15,660 --> 00:14:20,280 +lenses بعد ذلك زودوا مادة ايه؟ السيليكون عشان + +161 +00:14:20,280 --> 00:14:28,020 +يعملوا زيادة ل ال wetability if + +162 +00:14:28,020 --> 00:14:34,410 +a change to lens fitting is not desired يعني نفترض + +163 +00:14:34,410 --> 00:14:38,850 +أنا أعمل التغيير في ال fitting للعدسة ولكن كان غير + +164 +00:14:38,850 --> 00:14:43,570 +مرغوب بالنسبة لمن؟ للمريض يعني بعض المرضى ما + +165 +00:14:43,570 --> 00:14:47,490 +بيرغبوا في ارتداء ال extended wear lenses أو ما + +166 +00:14:47,490 --> 00:14:52,570 +بيرغبوا في ارتداء ال daily disposable lenses okay؟ + +167 +00:14:52,570 --> 00:14:56,430 +the other strategies ممكن هناك يعني طريقة أو + +168 +00:14:56,430 --> 00:15:01,650 +method مختلفة تتبعها غير اللي هو ايه؟ طريقة زيادة + +169 +00:15:01,650 --> 00:15:08,450 +ال DK على T Also be useful such as مثلاً reducing + +170 +00:15:08,450 --> 00:15:13,250 +wearing hours per day، إذا ممكن أقل من ساعات + +171 +00:15:13,250 --> 00:15:17,190 +ارتداء العدسة، يعني بدل ما المريض بيلبسها خمس + +172 +00:15:17,190 --> 00:15:19,810 +ساعات، يلبسها مثلاً ثلاث ساعات + +173 +00:15:23,700 --> 00:15:29,540 +ولا لمدة محددة؟ لمدة معينة دائماً يما أقل العدد + +174 +00:15:29,540 --> 00:15:34,260 +الساعات ارتداء العدسة للمريض بدي يكون يعني في هناك + +175 +00:15:34,260 --> 00:15:39,000 +period time وقت محدد قد يكون أسبوعين ثلاثة وبعد + +176 +00:15:39,000 --> 00:15:44,780 +ذلك هيلبس ايش بشكل اللي هو maximum wearing or + +177 +00:15:44,780 --> 00:15:49,120 +inserting lenses later after eye opening in the + +178 +00:15:49,120 --> 00:15:53,430 +morning احنا عارفين أنه الأديما بتزيد أول ما المريض + +179 +00:15:53,430 --> 00:15:58,890 +wake up يستيقظ من النوم، بقوله مثلاً أول ساعتين من + +180 +00:15:58,890 --> 00:16:04,510 +استيقاظك ما تلبسش العدسة، البسها مثلاً بعد ساعتين، + +181 +00:16:04,510 --> 00:16:09,570 +هتقلل القرنية الأديما okay وبالتالي ممكن أن هذا ما + +182 +00:16:09,570 --> 00:16:14,310 +يُدلي complications عند المريض واضح الفكرة؟ يعني إما + +183 +00:16:14,310 --> 00:16:18,970 +بنقلل عدد الساعات أو المريض يرتدي العدسة بعد اللي + +184 +00:16:18,970 --> 00:16:28,110 +هو ساعتين من استيقاظه بالنسبة + +185 +00:16:28,110 --> 00:16:35,130 +للهيسترومال أسيدوز أي بمعنى زيادة الحمضية في + +186 +00:16:35,130 --> 00:16:36,150 +الهيسترومال + +187 +00:16:45,900 --> 00:16:53,020 +بداية قيمة ال PH يما تكون بالساوي seven معناها + +188 +00:16:53,020 --> 00:16:59,940 +أنه ايه؟ متعادل طيب ال PH أقل من seven بيكون + +189 +00:16:59,940 --> 00:17:06,160 +حامضي أكثر من سبعة بيكون قاعدي okay هذه بدناش + +190 +00:17:06,160 --> 00:17:11,340 +ننساها الناس الملاحظات الastromal acidosis أي + +191 +00:17:11,340 --> 00:17:14,740 +بمعنى زيادة الحامضية في الastroma + +192 +00:17:18,540 --> 00:17:26,220 +can arise from hypercapnia as well as hypoxia، إذا + +193 +00:17:26,220 --> 00:17:31,600 +اتفقنا إن هي تعتبر signs علامات لإن أروبيك + +194 +00:17:31,600 --> 00:17:37,570 +متابوليزم أو signs للـ hypercapnia و الـ hypoxia + +195 +00:17:37,570 --> 00:17:43,190 +بمعنى أنه هيقل دخول ال oxygen للقرنية وفي نفس + +196 +00:17:43,190 --> 00:17:48,150 +الوقت هيقل من .. هيعمل زيادة لدخول مين؟ اللي هو + +197 +00:17:48,150 --> 00:17:49,950 +ثاني أكسيد الكربون + +198 +00:17:53,920 --> 00:17:57,880 +Reciprocal Acidosis أي بمعنى الكيفية اللي بتحدث من + +199 +00:17:57,880 --> 00:18:01,740 +خلالها تستطيع + +200 +00:18:01,740 --> 00:18:04,980 +أن تحدث عندما يحدث جزء من جزء من الجزء من الجزء من + +201 +00:18:04,980 --> 00:18:06,420 +الجزء من الجزء من الجزء من الجزء من الجزء من الجزء + +202 +00:18:06,420 --> 00:18:08,120 +من الجزء من الجزء من الجزء من الجزء من الجزء من + +203 +00:18:08,120 --> 00:18:10,480 +من الجزء من الجزء من الجزء من الجزء من الجزء من + +204 +00:18:10,480 --> 00:18:10,860 +من الجزء من الجزء من الجزء من الجزء من الجزء من + +205 +00:18:10,860 --> 00:18:12,260 +الجزء من الجزء من الجزء من الجزء من الجزء من الجزء + +206 +00:18:12,260 --> 00:18:12,900 +من الجزء من الجزء من الجزء من الجزء من الجزء من + +207 +00:18:12,900 --> 00:18:19,140 +من الجزء من الجزء من الجزء من الجإنه هتسمح لثاني + +208 +00:18:19,140 --> 00:18:23,320 +أكسيد الكربون يدخل الأسترومة ولكن في نفس الوقت + +209 +00:18:23,320 --> 00:18:27,760 +هتمنع من ايه؟ من دخول الأكسجين إلى اللي هو + +210 +00:18:27,760 --> 00:18:32,960 +الأسترومة، هي ب .. ب .. يعني بمختصر أو ب summary + +211 +00:18:32,960 --> 00:18:36,680 +اللي هو الموضوع أو الكيفية اللي بتحدث من خلال + +212 +00:18:39,810 --> 00:18:45,150 +الآن زيادة ثاني أكسيد الكربون داخل ال استرومة و + +213 +00:18:45,150 --> 00:18:49,410 +نقصان الأكسجين بيؤدي إلى نقصان في مين؟ في ال BH + +214 +00:18:49,410 --> 00:18:55,510 +فبالتالي أن ال BH بيصير حامضي استرومال أسيدوز أي + +215 +00:18:55,510 --> 00:19:00,970 +بمعنى زيادة الحامضية في ال استرومة بداية إذا كانت + +216 +00:19:00,970 --> 00:19:06,110 +قيمة ال BH equal 7 بيكون متعادل BH less than 7 + +217 +00:19:06,110 --> 00:19:11,290 +بيكون حامضي أكثر من 7 بيكون قاعدي السبب في زيادة + +218 +00:19:11,290 --> 00:19:15,990 +الحمضية في الاسترومة أنه موضوع يعني ايه؟ علاقة في + +219 +00:19:15,990 --> 00:19:20,330 +ال hypercapnia و الhypoxia بلا ال reciprocal + +220 +00:19:20,330 --> 00:19:27,270 +acidosis أي بمعنى كيفية الحدوث can or can't يعني + +221 +00:19:27,270 --> 00:19:32,390 +ممكن أن تحدث when a gas impermeable يعني كمية + +222 +00:19:32,390 --> 00:19:37,010 +الغاز اللي بدخل أقل يعني العدسة بمعنى أن بتمنع + +223 +00:19:37,010 --> 00:19:41,110 +دخول ال ايه؟ ال oxygen ل ال posterior surface of + +224 +00:19:41,110 --> 00:19:47,370 +the stroma، it prevents carbon dioxide efflux و + +225 +00:19:47,370 --> 00:19:51,270 +أيضاً في نفس الوقت بتمنع من خروج ثاني أكسيد الكربون + +226 +00:19:51,270 --> 00:19:54,910 +from the corneal stroma وهذا ما يسمى + +227 +00:19:54,910 --> 00:19:56,510 +بالhypercapnia + +228 +00:19:58,070 --> 00:20:02,550 +Metabolic Acidosis can occur if there is a + +229 +00:20:02,550 --> 00:20:06,490 +decrease in the pH of the stroma due to + +230 +00:20:06,490 --> 00:20:12,110 +accumulation of stromal lactate كمية الأملح اللي + +231 +00:20:12,110 --> 00:20:16,750 +فيه ال stroma هتزيد، lactate بمعنى أملح، يعني بمعنى + +232 +00:20:16,750 --> 00:20:23,130 +أن كميتها هتصير مقارنة في الأجزاء الأخرى تقريباً حسب + +233 +00:20:23,130 --> 00:20:29,530 +الدراسات السابقة من خمسة إلى سبعة في المئةفهيحدث هناك + +234 +00:20:29,530 --> 00:20:33,650 +زيادة في ايه؟ في الأملاح اللي موجودة في داخل ال + +235 +00:20:33,650 --> 00:20:41,050 +استرومة ومع زيادة ال hypercapnia و ال hypoxia + +236 +00:20:41,050 --> 00:20:46,650 +هيعمل نقصان في مين؟ في ال pH فهيؤدي إلى حمضية ال + +237 +00:20:46,650 --> 00:20:47,270 +استرومة + +238 +00:20:52,020 --> 00:20:56,840 +Under open eye conditions يعني في الحالات الطبيعية + +239 +00:20:56,840 --> 00:21:04,680 +okay a human stromal pH rises about 2% بس هنضيفه O + +240 +00:21:04,680 --> 00:21:11,900 +to 2% هن range يعني في الطبيعي بتكون قيمة ال pH قد + +241 +00:21:11,900 --> 00:21:18,620 +تكون 7% وقد تكون 9% يعني أقرب لمين؟ هي للقاعدية أو + +242 +00:21:18,620 --> 00:21:23,100 +متعادلة في الأشخاص الطبيعيين يعني زينا الآن احنا + +243 +00:21:23,100 --> 00:21:28,220 +مفتحين صح؟ عندنا قيمة الـ pH هتكون سبعة في المئة + +244 +00:21:28,220 --> 00:21:32,380 +قد تكون أو زيادة اثنين في المئة يعني تسعة في المئة + +245 +00:21:32,380 --> 00:21:37,160 +ثمانية في المئة بمعنى أن احنا أقرب لمين؟ للقاعدية + +246 +00:21:37,160 --> 00:21:44,300 +أو متعادل واضح الفكرة؟ and it may decrease as much + +247 +00:21:44,300 --> 00:21:50,140 +as five percent Adhering wear of an oxygen + +248 +00:21:50,140 --> 00:21:55,440 +impermeable contact lens هذه النسبة ممكن أن تقل + +249 +00:21:55,440 --> 00:22:00,540 +جداً 5% يعني تصير مثلاً 6 أو 7 أو 5 حامضي + +250 +00:22:00,540 --> 00:22:05,080 +عندما يرتدي عدسة ما بتعمل نفاذية لمين؟ لا للأكسجين + +251 +00:22:05,080 --> 00:22:09,640 +يعني بمعنى أن كمية ال oxygen اللي بتدخل لا + +252 +00:22:09,640 --> 00:22:14,120 +القرنية عبر العدسات اللاصقة بتكون غير كافية + +253 +00:22:18,880 --> 00:22:23,180 +this condition is a relatively uncommon indication + +254 +00:22:23,180 --> 00:22:29,320 +for lens refitting دائماً إذا حدثت هذه المشكلة أو + +255 +00:22:29,320 --> 00:22:33,780 +هذا ال defect ما بيكون إشارة لإعادة ال fitting + +256 +00:22:33,780 --> 00:22:39,080 +للعدسة اللاصقة okay stromal acidosis this + +257 +00:22:39,080 --> 00:22:43,160 +condition is a relatively uncommon indication for + +258 +00:22:43,160 --> 00:22:49,290 +lens refitting هذه الحالة ما بتكون شائعة في حالة + +259 +00:22:49,290 --> 00:22:53,710 +العدسات اللي بتكون loose أو steep يعني بمعنى الآن + +260 +00:22:53,710 --> 00:22:58,550 +لو احنا عرفنا واحد عنده stromal acidosis ما نعملش + +261 +00:22:58,550 --> 00:23:02,970 +إعادة fitting للعدسة اللاصقة، ايش السبب؟ ببساطة + +262 +00:23:02,970 --> 00:23:08,940 +لأن عمركم سمعتوا في هناك جهاز بفحص ال BH للمريض + +263 +00:23:08,940 --> 00:23:14,080 +مافيش شيء، إذا لحد الآن ال researchers ما وصلوا + +264 +00:23:14,080 --> 00:23:19,460 +لجهاز بيعمل على قياس قيمة ال BH ك value كله احنا + +265 +00:23:19,460 --> 00:23:23,540 +دائماً هذه ال BH سواء كانت سبعة أو أكثر من سبعة أو + +266 +00:23:23,540 --> 00:23:29,070 +أقل من سبعة هي عبارة عن ال range زي ما حكينا ما فيش + +267 +00:23:29,070 --> 00:23:33,870 +هناك اللي هو جهاز بيعمل على قياس ايه؟ اللي هو ال بي + +268 +00:23:33,870 --> 00:23:38,310 +اتش بشكل اللي هو صحيح أو ك value محددة، لأ هذا + +269 +00:23:38,310 --> 00:23:42,470 +الكلام عملي يتم اللي هو تطبيقه، لكن عبارة عن + +270 +00:23:42,470 --> 00:23:45,690 +qualitative، في حاجة دائماً اسمها qualitative و + +271 +00:23:45,690 --> 00:23:49,430 +quantitative الـ quantitative بتديني fixed value + +272 +00:23:49,430 --> 00:23:53,490 +قيمة محددة مثلاً قيمة الـ refractive error عنصرين + +273 +00:23:53,490 --> 00:23:58,490 +minus 3 أو minus 1 لكن هذا بتديني مثلاً مؤشر أن + +274 +00:23:58,490 --> 00:24:03,970 +المريض هذا عنده زيادة في ايش؟ الحمضية للاسترومة قد + +275 +00:24:03,970 --> 00:24:08,070 +يعمل اللي هو مؤثرات ثانية زي مثلاً استرومة القديمة + +276 +00:24:08,070 --> 00:24:12,570 +استرومة ال stray أو استرومة ال false واضح الفكرة؟ + +277 +00:24:14,300 --> 00:24:17,240 +طيب، عندنا الـ endothelial edema + +278 +00:24:21,930 --> 00:24:27,410 +appears as cerium scribe defects in the + +279 +00:24:27,410 --> 00:24:32,130 +endothelial specular reflection يعني هي عبارة عن + +280 +00:24:32,130 --> 00:24:38,530 +عيوب بتكون محددة، يمكن رؤية هذه العيوب المحددة من + +281 +00:24:38,530 --> 00:24:43,950 +خلال استخدام إيه؟ ال specular reflection أي الضوء + +282 +00:24:43,950 --> 00:24:50,860 +الصاطع، هيكون ردة الفعل من خلال اللي هو المشاهد + +283 +00:24:50,860 --> 00:24:54,660 +هتكون بالشكل هادئ النقط اللي هو السوداء اللي احنا + +284 +00:24:54,660 --> 00:24:58,900 +شايفينها أمامنا طبعًا ال endothelia القديمة في + +285 +00:24:58,900 --> 00:25:02,840 +الغالب هي هتكون وين؟ هتحدث في ال endothelial cells + +286 +00:25:02,840 --> 00:25:05,380 +في خلايا ال endothelium + +287 +00:25:07,680 --> 00:25:12,900 +في إلها another name زي مثلًا blips أي بمعنى انتفاخ + +288 +00:25:12,900 --> 00:25:18,600 +أو swelling أيضًا تسمى events and pseudo guttata زي + +289 +00:25:18,600 --> 00:25:23,100 +ما هي موجودة بالشكل هذا إنه بتعمل swelling أو حاجة + +290 +00:25:23,100 --> 00:25:30,520 +بنسميها bulging انتفاخ أو swelling + +291 +00:25:35,930 --> 00:25:41,790 +Application of a contact lens to the unadapted eye + +292 +00:25:41,790 --> 00:25:46,610 +can cause a sudden onset but a transient + +293 +00:25:46,610 --> 00:25:48,750 +endothelial edema response + +294 +00:25:53,190 --> 00:25:57,490 +إنه ممكن بعض المرضى بيسألوا طيب أنا بلبس عدسة لاصقة + +295 +00:25:57,490 --> 00:26:01,830 +لكن عيني غير متأقلمة مع العدسة يعني دايمًا بيصير + +296 +00:26:01,830 --> 00:26:05,530 +عندي مثلًا زيادة في ال sensitivity، دايمًا بيصير + +297 +00:26:05,530 --> 00:26:09,290 +عندي زيادة في الدموع، بيصير عندنا مثلًا burning، + +298 +00:26:09,290 --> 00:26:13,070 +redness، كل هذه الأمور مصاحبة لارتداء العدسة + +299 +00:26:13,070 --> 00:26:19,100 +اللاصقة، هذا بيؤدي إلى إيه؟ الاندوثيليا القديمة، + +300 +00:26:19,100 --> 00:26:25,140 +يعني أي شخص بيلبس عدسة لاصقة وهو غير متكيف أو غير + +301 +00:26:25,140 --> 00:26:29,380 +متلائم مع العدسة اللاصقة، ممكن إنه يؤدي إلى حدوث + +302 +00:26:29,380 --> 00:26:33,560 +إيه؟ الاندوثيليا القديمة، طبعًا نحمد الله إن هو لا + +303 +00:26:33,560 --> 00:26:40,080 +بيكون دايمًا إيه، sudden مفاجئ ولكن بشكل مؤقت، ما بيظلهش + +304 +00:26:40,080 --> 00:26:43,660 +يعني transient أي بمعنى مؤقت ما بيظله اللي هو + +305 +00:26:43,660 --> 00:26:51,460 +permanent بشكل دائم، it occurs يحدث within ten + +306 +00:26:51,460 --> 00:26:56,000 +minutes of lens insertion يعني بيحدث خلال إيه + +307 +00:26:56,000 --> 00:27:02,290 +العشر دقائق الأولى من ارتداء العدسة اللاصقة، بقص + +308 +00:27:02,290 --> 00:27:07,650 +القمة بتاعته بعد حوالي قداش؟ نص ساعة، half an hour + +309 +00:27:07,650 --> 00:27:12,630 +and may last for several hours وبتأخر يعني لعدة + +310 +00:27:12,630 --> 00:27:19,590 +اللي هو ساعات ال endothelial edema، إذا عندنا ببدأ + +311 +00:27:19,590 --> 00:27:25,050 +بعد عشر دقائق، القمة بتكون نص ساعة، بظله لللي هو + +312 +00:27:25,050 --> 00:27:30,570 +يعني بتأخر لعدة ساعات، The initial blip إن هذا + +313 +00:27:30,570 --> 00:27:35,410 +الانتفاخ أو الـ pseudo guttata response to contact + +314 +00:27:35,410 --> 00:27:41,470 +lens wear doesn't result in cell loss، دايمًا ما + +315 +00:27:41,470 --> 00:27:46,670 +بيؤدي إلى خراب أو دمار لمين؟ لخلايا الاندوثيليام، + +316 +00:27:46,670 --> 00:27:53,070 +لكن إيش بيعمل؟ إديمة، إذا هو لا يؤدي إلى cell loss + +317 +00:27:53,070 --> 00:27:58,380 +أو cell damage، لكن بيؤدي إلى cell إديمة، And a + +318 +00:27:58,380 --> 00:28:02,600 +change in lens fitting is not required أيضًا غير + +319 +00:28:02,600 --> 00:28:07,120 +مطلوب من ال examiner إنه يعمل إعادة fitting للعدسة + +320 +00:28:07,120 --> 00:28:11,280 +من جديد، هو ببساطة ليش؟ لأنه دايمًا ال endothelia + +321 +00:28:11,280 --> 00:28:15,720 +القديمة بيحدث لما المريض بيكون غير متأقلم أو غير + +322 +00:28:15,720 --> 00:28:20,840 +متكيف مع العدسة اللاصقة اللي تم تحديدها له، بمعنى + +323 +00:28:20,840 --> 00:28:23,140 +أنه لازم أنا أغير من نوع العدسة + +324 +00:28:27,890 --> 00:28:33,050 +Endothelial polymegathism أي بمعنى تغيير في حجم + +325 +00:28:33,050 --> 00:28:37,330 +الخلايا اللي خاصة في مين؟ في ال endothelium يعني + +326 +00:28:37,330 --> 00:28:41,750 +بمعنى إنه في هناك change في ال size أو في ال + +327 +00:28:41,750 --> 00:28:48,570 +variety of cell size في حجم الخلايا، طبعًا قد ايش + +328 +00:28:48,570 --> 00:28:56,430 +عندنا ال normal حجم الخلايا ال endothelium، الحجم + +329 +00:28:56,430 --> 00:29:04,080 +ال size، حجم الخلايا تقريبًا من تلاتمية لأربعمية + +330 +00:29:04,080 --> 00:29:11,340 +مايكرون، طب عددهم قد ايش؟ العدد يعني تقريبًا ال + +331 +00:29:11,340 --> 00:29:17,970 +average ستلاف وخمسماية خلية، إذا عندنا Endothelial + +332 +00:29:17,970 --> 00:29:23,890 +polymegathism is a greater than normal variation + +333 +00:29:23,890 --> 00:29:29,270 +of cell size in the corneal endothelial mosaic + +334 +00:29:29,270 --> 00:29:33,010 +observed with the biomicroscope or the clinical + +335 +00:29:33,010 --> 00:29:38,280 +specular microscope، إذا هو زيادة في حجم الخلايا + +336 +00:29:38,280 --> 00:29:42,040 +الاندوثيليام، طبعًا عندنا ال normal range لها من + +337 +00:29:42,040 --> 00:29:46,680 +تلاتمية إلى أربعمية، بصير يعني العدد أو الحجم عفواً + +338 +00:29:46,680 --> 00:29:50,820 +يعني ال diameter اللي خاص في الخلايا هذه بيصبح من + +339 +00:29:50,820 --> 00:29:56,680 +ستمية لسبعمية مليمتر، هذا ممكن اللي هو فحصه من خلال + +340 +00:29:56,680 --> 00:30:01,560 +الـ biomicroscope أو الـ specular أو في عندنا ال + +341 +00:30:01,560 --> 00:30:06,140 +microscope يعني بمعنى إنه بناخد شريحة عينة وبنعمل + +342 +00:30:06,140 --> 00:30:09,880 +اللي هو قياس ل ال diameter of the cells + +343 +00:30:13,130 --> 00:30:18,630 +في هناك grade أي بمعنى بتديني fixed value، قيمة هذا + +344 +00:30:18,630 --> 00:30:22,970 +ال grade أو ال score، it is graded by the + +345 +00:30:22,970 --> 00:30:27,650 +coefficient of variation of cell area له رمز + +346 +00:30:27,650 --> 00:30:33,930 +abbreviation CV، هذا بمعنى قد ايش حجم الخلايا، الحجم + +347 +00:30:33,930 --> 00:30:38,990 +الخاص في الخلايا هو بتدينيه ك number أو ك value + +348 +00:30:50,840 --> 00:30:55,220 +وهذا أيضًا ال range يعني تقريبًا من خمسة وعشرين + +349 +00:30:55,220 --> 00:30:58,780 +لتلاتين في المية، okay، هذا في حالة ال normal + +350 +00:30:58,780 --> 00:31:03,440 +الطبيعي دايمًا بيكون قيمته من خمسة وعشرين لتلاتين + +351 +00:31:03,440 --> 00:31:10,980 +في المية، ولكنها قد تكون مرتفعة حوالي 46% في مريض + +352 +00:31:10,980 --> 00:31:18,620 +يمتلك عمره 20 سنة من اكسجين ومشروع ديالي وير أو + +353 +00:31:18,620 --> 00:31:24,800 +خمس سنوات من مجلد هيدروجيلي، يعني هذه القيمة ممكن إنه + +354 +00:31:24,800 --> 00:31:28,740 +تزيد لمريض مثلًا لابس عدسة لاصقة من عشرين سنة + +355 +00:31:28,740 --> 00:31:32,860 +conventional daily wear أو واحد من خمس سنوات بلبس + +356 +00:31:32,860 --> 00:31:36,600 +عدسات extended wear، إذا القيمة إيش مالها؟ هتزيد + +357 +00:31:36,600 --> 00:31:43,660 +عنده، هيكون تقريبًا ال normal بالنسبة له 46% مقارنة + +358 +00:31:43,660 --> 00:31:46,220 +في مين؟ في الأشخاص اللي طبيعيين + +359 +00:31:50,180 --> 00:31:53,720 +طيب إن شاء الله نقفلها ال corneal excision + +360 +00:31:53,720 --> 00:31:57,140 +syndrome، في أي سؤال؟ أي استفسار؟ diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/nbr1GB4Nc8U_postprocess.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/nbr1GB4Nc8U_postprocess.srt new file mode 100644 index 0000000000000000000000000000000000000000..6b1bacfdfdb4d5e57a82565fa1b6b74e8bba79b9 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/nbr1GB4Nc8U_postprocess.srt @@ -0,0 +1,1440 @@ +1 +00:00:21,630 --> 00:00:24,490 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:24,490 --> 00:00:28,250 +وبركاته and a very good morning to all of you + +3 +00:00:28,250 --> 00:00:35,230 +هنكمل في المحاضرة موضوع ال signs of hypercapnia + +4 +00:00:35,230 --> 00:00:40,130 +and hypoxia موضوع الastromal scrape + +5 +00:00:42,660 --> 00:00:47,180 +طبعا الاسترومة ال استريه هي عبارة عن عصا بيضاء + +6 +00:00:47,180 --> 00:00:54,480 +اللون بتكون في ال posterior surface للاسترومةطبعا + +7 +00:00:54,480 --> 00:00:59,760 +في الشكل اللي واضح أمامنا find بمعنى دقيق white + +8 +00:00:59,760 --> 00:01:06,180 +vertical lines خطوط بيضاء رفيعة مستقيمة in the + +9 +00:01:06,180 --> 00:01:11,060 +posterior stroma of the cornea في الجزء الخلفي من + +10 +00:01:11,060 --> 00:01:19,520 +الاسترومةإذا كانت + +11 +00:01:19,520 --> 00:01:24,320 +قيمة الإديمة في الاسترومة خمسة في المية فما فوق + +12 +00:01:24,320 --> 00:01:29,980 +طبعا او ستة في المية فما فوق في جماعة عندنا + +13 +00:01:29,980 --> 00:01:34,380 +الاسترومة أو + +14 +00:01:34,380 --> 00:01:40,120 +ال substantia propria + +15 +00:01:42,550 --> 00:01:51,030 +ك another name طبعا هي بتمثل ninety percent + +16 +00:01:51,030 --> 00:01:55,890 +of corneal thickness + +17 +00:01:59,910 --> 00:02:05,470 +زيادة دخول الماء في الاسترومة بيعمل على اختلاف في + +18 +00:02:05,470 --> 00:02:09,230 +ال concentration التركيز بمعنى انه بيزيد ال + +19 +00:02:09,230 --> 00:02:14,310 +concentration ل الاسترومة مقارنة في الأجزاء الأخرى + +20 +00:02:14,310 --> 00:02:20,130 +فهذا بيؤدي إلى الإديمة طبعا إذا كانت قيمة الإديمة + +21 +00:02:20,130 --> 00:02:25,370 +6% فما فوق okay بيعمل حاجة بيسميها الastromal + +22 +00:02:25,370 --> 00:02:26,030 +strain + +23 +00:02:29,070 --> 00:02:34,250 +thus or so, stray are present with most current + +24 +00:02:34,250 --> 00:02:39,790 +generation daily wear, hydrogel lenses for myopia + +25 +00:02:39,790 --> 00:02:45,670 +دايما هذه الـstray هي غير شائعة أو غير حاضرة أو + +26 +00:02:45,670 --> 00:02:51,210 +غير موجودة في حالات المرضى اللي بيرتديوا العدسات + +27 +00:02:51,210 --> 00:02:58,340 +اللاصقة السالبة الـ minus lenses ليش طيب؟يعني ليش + +28 +00:02:58,340 --> 00:03:02,820 +هذه الـ stray؟ + +29 +00:03:02,820 --> 00:03:06,620 +بالضبط، + +30 +00:03:06,620 --> 00:03:10,720 +دايما العدسات الـ minus lenses بتتميز ان الـ + +31 +00:03:10,720 --> 00:03:14,720 +center فيها thinner than ايه ال peripheral، يعني + +32 +00:03:14,720 --> 00:03:17,980 +من ال center بتكون thin و ال peripheral ايش بتكون + +33 +00:03:17,980 --> 00:03:24,960 +thickفبكون هناك دخول للأكسجين بشكل سليم أو بشكل + +34 +00:03:24,960 --> 00:03:29,460 +اللي هو صحيح أو بكميات كبيرة فهذا ما بيعمل ايه؟ + +35 +00:03:29,460 --> 00:03:33,560 +Cornial edema وبالتالي ما بيؤدي إلى الastromal + +36 +00:03:33,560 --> 00:03:39,740 +strain okay فدائما عند زيادة الأكسجين ال + +37 +00:03:39,740 --> 00:03:44,940 +transmissibility بيعمل على زيادة مين؟ ال Dk على T + +38 +00:03:45,840 --> 00:03:49,540 +وبالتالي هذا لا يؤدي إلى القرنية الإديمة + +39 +00:03:53,460 --> 00:03:58,420 +Stray remained a useful diagnostic indicator طبعا + +40 +00:03:58,420 --> 00:04:04,700 +هي بتعتبر مؤشر تشخيصي للأشخاص اللي بيكون عندهم + +41 +00:04:04,700 --> 00:04:10,520 +إديمة لكن بيرتديوا عدسات إيه plus lenses أو plus + +42 +00:04:10,520 --> 00:04:15,120 +powered hydrogel lenses يعني دايما الأشخاص اللي + +43 +00:04:15,120 --> 00:04:19,960 +بيرتديوا عدسات موجبة بيتبعها إيه corneal إديمة + +44 +00:04:19,960 --> 00:04:24,850 +وبعد ذلك بيسبب stromal strayاذا كانت قيمة القديمة + +45 +00:04:24,850 --> 00:04:30,590 +اكتر من 6% طيب هان السبب ليش انه ذكرنا ال plus + +46 +00:04:30,590 --> 00:04:35,070 +lenses ببساطة لان ال plus lenses بيكون ال ثيكوين + +47 +00:04:35,070 --> 00:04:39,970 +في ال center بالتالي كمية ال oxygen اللي هتدخل + +48 +00:04:39,970 --> 00:04:44,630 +ايه؟ يعني هتكون قليلة فهذا ممكن انه يكون مهيئ + +49 +00:04:44,630 --> 00:04:49,710 +لحدوث ايه؟ القرنية القديمة وبعد ذلك بتبعها ال + +50 +00:04:49,710 --> 00:04:55,860 +stromal streamsuch as those prescribed for + +51 +00:04:55,860 --> 00:05:01,760 +monovision، طب ليش هنذكرنا monovision؟ بالضبط لأنه + +52 +00:05:01,760 --> 00:05:05,760 +بتكون الوصفة plus lenses لأنه بتستخدم فقط لمين؟ + +53 +00:05:05,760 --> 00:05:11,200 +لاله ال near reading، يعني فقط لالنير أو لال + +54 +00:05:11,200 --> 00:05:16,260 +reading، يعني هي مخصصة أنه فقط تكون ك plus lenses + +55 +00:05:21,200 --> 00:05:25,960 +Extended wear lenses أيضا الأشخاص اللي بيرتديوا + +56 +00:05:25,960 --> 00:05:30,740 +العدسات اللاصقة لمدة أسبوع واحد طبعا في حالة ال + +57 +00:05:30,740 --> 00:05:36,690 +extended wear هتكون ال DK على T quite highطيب لو + +58 +00:05:36,690 --> 00:05:41,430 +كانت low او medium هذا هيكون diagnostic او + +59 +00:05:41,430 --> 00:05:45,670 +indicator diagnostic يعني مؤشر اللي هو تشخيصي + +60 +00:05:45,670 --> 00:05:50,690 +لحدوث من الكورنية القديمة وبعد ذلك بيعمل stromal + +61 +00:05:50,690 --> 00:05:55,630 +strain يعني دايما ايضا هي بالزيد في حالات المرضى + +62 +00:05:55,630 --> 00:05:59,210 +اللي بيرتديوا ايه ال extended wear lenses + +63 +00:06:03,910 --> 00:06:10,620 +Stromal Falls هي عبارة عن ثانياتبكون بالشكل هذا، + +64 +00:06:10,620 --> 00:06:16,420 +ظهورها كإنه اللي هو dark line خطوط سوداء، okay؟ + +65 +00:06:16,420 --> 00:06:20,260 +يعني ثانيات سوداء طبقة الاندوثيليام يا جماعة + +66 +00:06:20,260 --> 00:06:25,300 +بتتميز بإنه طبقة ملساق، إيش معناه طبقة ملساق؟ يعني + +67 +00:06:25,300 --> 00:06:30,060 +لو استخدمنا ال specular reflection، أي بمعنى الضوء + +68 +00:06:30,060 --> 00:06:35,700 +الساطع المنعكس، هيعمل انعكاس للصورة بنسبة مائة في + +69 +00:06:35,700 --> 00:06:40,930 +المائة تقريبا، okay؟لو في اي تفالس ثانيات هتعمل + +70 +00:06:40,930 --> 00:06:49,110 +انعكاس بالشكل هذا و كأنه dark lines okay appear + +71 +00:06:49,110 --> 00:06:54,750 +as dark lines اذا هي هتظهر على انه هي خطوط معتمة + +72 +00:06:54,750 --> 00:07:00,470 +او سوداء in in the endothelial specular reflection + +73 +00:07:00,470 --> 00:07:04,370 +في حالة استخدام الضوء الساطع لرؤية من ال + +74 +00:07:04,370 --> 00:07:11,040 +endotheliumthey appear when stromal edema exceeds + +75 +00:07:11,040 --> 00:07:15,980 +10% يعني هتظهر إذا كانت قيمة ال edema عشرة في + +76 +00:07:15,980 --> 00:07:20,880 +المية فما فوق، إذا أيهما أختار ال stromal stray + +77 +00:07:20,880 --> 00:07:26,400 +ولا ال stromal false؟ لأن قيمة ال edema بالزيد عن + +78 +00:07:26,400 --> 00:07:27,640 +عشرة في المية + +79 +00:07:31,860 --> 00:07:37,880 +rarely occur with daily wear of GB or Hydrogel + +80 +00:07:37,880 --> 00:07:42,820 +contact lenses هي نادرة الحدوث في عدسات اللبس + +81 +00:07:42,820 --> 00:07:49,500 +اليومي ال soft contact lens أو ال RGB ليش + +82 +00:07:49,500 --> 00:07:54,140 +ال stromal falls بتكون نادرة الحدوث؟في الـ + +83 +00:07:54,140 --> 00:07:57,920 +conventional daily wear اللي بتتم ارتدائها مثلا + +84 +00:07:57,920 --> 00:08:02,540 +عشر ساعات او اتناشر ساعة او في ال جي بي لينزز + +85 +00:08:06,050 --> 00:08:09,690 +لأن الآن العدسات اللاصقة الهيد ال conventional + +86 +00:08:09,690 --> 00:08:14,610 +daily wear يما بتم عملية ال removal إلها، حيصير + +87 +00:08:14,610 --> 00:08:21,890 +هناك إزالة لإديمة وبالتالي أو تلاشي لقيمة الإديمة + +88 +00:08:21,890 --> 00:08:27,090 +وهذا ما بتأدي إلى حدوث من الastromal fallsولكن + +89 +00:08:27,090 --> 00:08:31,410 +عندنا في حالة يصير هناك stromal falls معنى الكلام + +90 +00:08:31,410 --> 00:08:36,030 +أنه عنده قيمة الإديمة ثابتة overnight يعني في كل + +91 +00:08:36,030 --> 00:08:40,710 +الوقت قيمتها جديش عشرة في المية أو أكتر فهذا بيدّي + +92 +00:08:40,710 --> 00:08:45,690 +ذريعة لحدوث مين ال stromal falls طبعا هي وين بتكون + +93 +00:08:45,690 --> 00:08:50,890 +أكتر حاجة شائعة؟ في حالتين ال poor fitting لل جي + +94 +00:08:50,890 --> 00:08:55,470 +بي لينزز والحالة التانية عندما يكون عندي low DK + +95 +00:08:55,470 --> 00:09:02,110 +على Tإذا عندنا في ال poor fitting + +96 +00:09:02,110 --> 00:09:05,770 +لل + +97 +00:09:05,770 --> 00:09:12,190 +gb والحالة التانية في ال low dk على t في هذه + +98 +00:09:12,190 --> 00:09:17,190 +الحالتين بتكون عندنا ال stromal false commonبدون + +99 +00:09:17,190 --> 00:09:21,570 +ذلك في حالات الـ conventional daily wear أو العدسة + +100 +00:09:21,570 --> 00:09:25,850 +اللى بتكون جي بي optimal fit ما بتحدث حدوث الـ + +101 +00:09:25,850 --> 00:09:30,510 +stromal falls with + +102 +00:09:30,510 --> 00:09:35,090 +extended wear of hydrogen lenses posterior falls + +103 +00:09:35,090 --> 00:09:39,730 +can be apparent on eye opening لكن هنا في الها شرط + +104 +00:09:40,700 --> 00:09:45,360 +يما عندنا بيكون قيمة الإديمة مثلا اول ما المريض + +105 +00:09:45,360 --> 00:09:49,460 +بصحى الصبح بتكون عشرة في المية، في آخر النهار عشرة + +106 +00:09:49,460 --> 00:09:53,420 +في المية، في منتصف اليوم عشرة في المية، ممكن انه + +107 +00:09:53,420 --> 00:09:58,860 +يحدث عند المريض ايه؟ stromal falls طيب المريض الآن + +108 +00:09:58,860 --> 00:10:02,600 +استيقظ من النوم وكانت قيمة الإديمة عنده عشرة في + +109 +00:10:02,600 --> 00:10:06,640 +المية او تسعة في المية، هل ممكن انه يحدث عنده + +110 +00:10:06,640 --> 00:10:11,670 +stromal falls؟ قداذا ربما يحدث و ربما ما يحدث لان + +111 +00:10:11,670 --> 00:10:15,230 +انتوا عارفين ان الانسان اول ما بيستيقظ من النوم + +112 +00:10:15,230 --> 00:10:19,570 +بيكون عنده ال edema ايه؟ عالية مقارنة في منتصف + +113 +00:10:19,570 --> 00:10:21,410 +اليوم او اخر اليوم + +114 +00:10:24,760 --> 00:10:29,560 +Management بالنسبة لقالية العلاج ل الastromal + +115 +00:10:29,560 --> 00:10:35,980 +stray أو الastromal falls أو الastromal edema if + +116 +00:10:35,980 --> 00:10:40,220 +astromal edema is noted at follow-up examination + +117 +00:10:40,220 --> 00:10:45,860 +الآن المريض ارتد العدسة اللاصقة نفترض لمدة الشهر + +118 +00:10:45,860 --> 00:10:50,500 +بعد الشهر بطلب منه ان يعمل follow-up انا بقصد ايه + +119 +00:10:50,500 --> 00:10:56,050 +ال conventional daily wear lensesincreasing lens + +120 +00:10:56,050 --> 00:11:03,350 +dk على t to at least 15% for daily wear and at + +121 +00:11:03,350 --> 00:11:09,090 +least 34% for extended wear is recommended إذا + +122 +00:11:09,090 --> 00:11:13,750 +سببت عنده أي زيادة في الاسترامة القديمة الحل + +123 +00:11:13,750 --> 00:11:18,210 +الوحيد أنه أعمل زيادة في dk على tطبعا بعض ال + +124 +00:11:18,210 --> 00:11:23,210 +researchers قيم هذه الزيادة حكالك في حالات ال + +125 +00:11:23,210 --> 00:11:26,170 +daily wear او ال conventional daily wear على ساعة + +126 +00:11:26,170 --> 00:11:32,030 +اللبس اليومي التقليدي بتكون قيمتها 15% لكن في ال + +127 +00:11:32,030 --> 00:11:38,990 +extended wear هتكون جداش 34% طيب بدأ اسأل سؤال انه + +128 +00:11:38,990 --> 00:11:43,250 +دايما ال extended wear لازم ان يكون فيها high + +129 +00:11:43,250 --> 00:11:44,130 +decay على T + +130 +00:11:47,250 --> 00:11:52,130 +الـ extended wear lenses لازم انه دايما يكون لها + +131 +00:11:52,130 --> 00:11:58,970 +قيمة الديكي على T very high why؟ حالة ال extended + +132 +00:11:58,970 --> 00:11:59,890 +wear lenses + +133 +00:12:08,460 --> 00:12:11,440 +لازم تكون عالية بس في نفس الوقت بت .. رح يقل ال + +134 +00:12:11,440 --> 00:12:13,800 +thickness فقلت اللي لازم ياخد قطرة انه يعني كلها + +135 +00:12:13,800 --> 00:12:16,100 +بس هي لازم تكون عالية علشان يصير في عنده more gear + +136 +00:12:16,100 --> 00:12:22,900 +extension okay another answer اذا + +137 +00:12:22,900 --> 00:12:27,140 +احنا متفقين ان عدسات ال extended wear lenses لازم + +138 +00:12:27,140 --> 00:12:31,760 +انه يكون ال DK على T very high لسبب واحد انه لو + +139 +00:12:31,760 --> 00:12:36,680 +انا مثلا خليتها medium او low حيصير مباشرة cornea + +140 +00:12:36,680 --> 00:12:41,470 +القديمةهيتبعها الـ stromal edema بعد ذلك مثلا + +141 +00:12:41,470 --> 00:12:47,750 +stromal stray و stromal falls اذا لازم انه دايما + +142 +00:12:47,750 --> 00:12:52,110 +ال decay على T يكون very high عشان اضمن اكبر كمية + +143 +00:12:52,110 --> 00:12:54,870 +من ال oxygen تدخل لمن؟ للكورنية + +144 +00:12:59,780 --> 00:13:03,400 +طبعا هان احنا متفقين في النقطة الأولى هادي ك range + +145 +00:13:03,400 --> 00:13:06,360 +اللي هي الخمساش في المية او الاربعة و تلاتين في + +146 +00:13:06,360 --> 00:13:11,420 +المية يعني ممكن تتغير من patient لاخريعني هذه ليست + +147 +00:13:11,420 --> 00:13:15,720 +guidelines هذه عبارة عن ال protocol الفرق ما بين + +148 +00:13:15,720 --> 00:13:18,920 +ال protocol و ال guidelines ال protocol في ال + +149 +00:13:18,920 --> 00:13:22,200 +management يعني في العلاج دايما ممكن انه يتغير + +150 +00:13:22,200 --> 00:13:27,200 +يعني ممكن مثلا آية بتاخد عشرة في المية مثلا اناس + +151 +00:13:27,200 --> 00:13:31,860 +خمساش في المية صين مثلا تلتاش في المية فقد تتغير + +152 +00:13:31,860 --> 00:13:36,220 +من شخص لآخر حسب ال sensitivity اللي موجود عنده + +153 +00:13:42,050 --> 00:13:45,730 +في حالة العدسات الموجبة اللي بيكون الـ thick vein + +154 +00:13:45,730 --> 00:13:51,260 +في ال centerThis may require هذا هيتطلب a change + +155 +00:13:51,260 --> 00:13:56,840 +تغير to high water content material or a GB lens + +156 +00:13:56,840 --> 00:14:03,160 +design اذا بتطلب من ال manufacturer انه يزود في + +157 +00:14:03,160 --> 00:14:07,260 +مين في ال water content او يغير ال material لذلك + +158 +00:14:07,260 --> 00:14:11,720 +احنا لاحظنا الجيل الاول من العدسات انه كان فقط + +159 +00:14:11,720 --> 00:14:15,660 +بيستخدموا مثلا ال poly methyl methacrylate لل GB + +160 +00:14:15,660 --> 00:14:20,280 +lensesبعد ذلك زودوا مادة ايه؟ السيليكون عشان + +161 +00:14:20,280 --> 00:14:28,020 +يعملوا زيادة ل ال wetability if + +162 +00:14:28,020 --> 00:14:34,410 +a change to lens fitting is not desiredيعني نفترض + +163 +00:14:34,410 --> 00:14:38,850 +انا اعمل التغيير في ال fitting للعدسة ولكن كان غير + +164 +00:14:38,850 --> 00:14:43,570 +مرغوب بالنسبة لمن؟ لل patient يعني بعض المرضى ما + +165 +00:14:43,570 --> 00:14:47,490 +بيرغبوا في ارتداء ال extended wear lenses او ما + +166 +00:14:47,490 --> 00:14:52,570 +بيرغبوا في ارتداء ال daily disposable lenses okay؟ + +167 +00:14:52,570 --> 00:14:56,430 +the other strategies ممكن هناك يعني طريقة او + +168 +00:14:56,430 --> 00:15:01,650 +method مختلفة تتبعها غير اللي هو ايه طريقة زيادة + +169 +00:15:01,650 --> 00:15:08,450 +ال DK على TAlso be useful such as مثلا reducing + +170 +00:15:08,450 --> 00:15:13,250 +wearing hours per day، إذا ممكن أقل من ساعات + +171 +00:15:13,250 --> 00:15:17,190 +ارتداء العدسة، يعني بدل ما المريض بيلبسها خمس + +172 +00:15:17,190 --> 00:15:19,810 +ساعات، يلبسها مثلا تلت ساعات + +173 +00:15:23,700 --> 00:15:29,540 +ولا لمدة محددة؟ لمدة معينة دايما يما أقل العدد + +174 +00:15:29,540 --> 00:15:34,260 +الساعات ارتداء العدسة للمريض بدي يكون يعني في هناك + +175 +00:15:34,260 --> 00:15:39,000 +period time وقت محدد قد يكون أسبوعين تلاتة وبعد + +176 +00:15:39,000 --> 00:15:44,780 +ذلك هيلبس إيش بشكل اللي هو maximum wearing or + +177 +00:15:44,780 --> 00:15:49,120 +inserting lenses later after eye opening in the + +178 +00:15:49,120 --> 00:15:53,430 +morningاحنا عارفين انه الاديمة بتزيد اول ما المريض + +179 +00:15:53,430 --> 00:15:58,890 +wake up يستيقظ من النوم، بقوله مثلا اول ساعتين من + +180 +00:15:58,890 --> 00:16:04,510 +استيقاظك ما تلبسش العدسة، البسها مثلا بعد ساعتين، + +181 +00:16:04,510 --> 00:16:09,570 +هتقلل كورنيا الاديمة okay وبالتالي ممكن انه هذا ما + +182 +00:16:09,570 --> 00:16:14,310 +يدلى complications عند المريضواضح الفكرة؟ يعني إما + +183 +00:16:14,310 --> 00:16:18,970 +بنقلل عدد الساعات أو المريض بيرتدي العدسة بعد اللي + +184 +00:16:18,970 --> 00:16:28,110 +هو ساعتين من استيقاظه بالنسبة + +185 +00:16:28,110 --> 00:16:35,130 +ل الهيسترومال أسيدوز أي بمعنى زيادة الحمضية في + +186 +00:16:35,130 --> 00:16:36,150 +الهيسترومال + +187 +00:16:45,900 --> 00:16:53,020 +بداية قيمة ال بي اتش يما تكون بالساوي seven معناها + +188 +00:16:53,020 --> 00:16:59,940 +انه ايه متعادل طيب ال بي اتش اقل من seven بيكون + +189 +00:16:59,940 --> 00:17:06,160 +حامضي اكتر من سبعة بيكون قاعدي okay هذه بدناش + +190 +00:17:06,160 --> 00:17:11,340 +ننساها الناس الملاحظات الastromal acidosis أي + +191 +00:17:11,340 --> 00:17:14,740 +بمعنى زيادة الحامضية في الastroma + +192 +00:17:18,540 --> 00:17:26,220 +كان arise from hypercapnia as well as hypoxia، إذا + +193 +00:17:26,220 --> 00:17:31,600 +اتفقنا إن هي تعتبر signs علامات لإن أروبيك + +194 +00:17:31,600 --> 00:17:37,570 +متابوليزمأو signs للـ hypercapnia و الـ hypoxia + +195 +00:17:37,570 --> 00:17:43,190 +بمعنى انه هيقل دخول ال oxygen للكورنية و في نفس + +196 +00:17:43,190 --> 00:17:48,150 +الوقت هيقل من .. هيعمل زيادة لدخول مين؟ اللي هو + +197 +00:17:48,150 --> 00:17:49,950 +ثاني أكسيد الكربون + +198 +00:17:53,920 --> 00:17:57,880 +Reciprocal Acidosis أي بمعنى الكيفية اللى بتحدث من + +199 +00:17:57,880 --> 00:18:01,740 +خلالها تستطيع + +200 +00:18:01,740 --> 00:18:04,980 +ان تحدث عندما يحدث جزء من جزء من الجزء من الجزء من + +201 +00:18:04,980 --> 00:18:06,420 +الجزء من الجزء من الجزء من الجزء من الجزء من الجزء + +202 +00:18:06,420 --> 00:18:08,120 +من الجزء من الجزء من الجزء من الجزء من الجزء من + +203 +00:18:08,120 --> 00:18:10,480 +الجزء من الجزء من الجزء من الجزء من الجزء من الجزء + +204 +00:18:10,480 --> 00:18:10,860 +من الجزء من الجزء من الجزء من الجزء من الجزء من + +205 +00:18:10,860 --> 00:18:12,260 +الجزء من الجزء من الجزء من الجزء من الجزء من الجزء + +206 +00:18:12,260 --> 00:18:12,900 +من الجزء من الجزء من الجزء من الجزء من الجزء من + +207 +00:18:12,900 --> 00:18:19,140 +من الجزء من الجزء من الجزء من الجإنه هتسمح لثاني + +208 +00:18:19,140 --> 00:18:23,320 +أكسيد الكربون يدخل الأسترومة ولكن في نفس الوقت + +209 +00:18:23,320 --> 00:18:27,760 +هتمنع من أيه؟ من دخول الأكسجين إلى اللي هو + +210 +00:18:27,760 --> 00:18:32,960 +الأسترومة، هي ب .. ب .. يعني بمختصر أو ب summary + +211 +00:18:32,960 --> 00:18:36,680 +اللي هو الموضوع أو الكيفية اللي بتحدث من خلال + +212 +00:18:39,810 --> 00:18:45,150 +الان زيادة ثاني أكسيد الكربون داخل ال استرومة و + +213 +00:18:45,150 --> 00:18:49,410 +نقصان الأكسجين بيؤدي إلى نقصان في مين؟ في ال BH + +214 +00:18:49,410 --> 00:18:55,510 +فبالتالي ان ال BH بيصير حامضي استرومال أسيدوزز أي + +215 +00:18:55,510 --> 00:19:00,970 +بمعنى زيادة الحامضية في ال استرومة بداية إذا كانت + +216 +00:19:00,970 --> 00:19:06,110 +قيمة ال BH equal 7 بيكون متعادل BH less than 7 + +217 +00:19:06,110 --> 00:19:11,290 +بيكون حامضي أكتر من 7 بيكون قاعديالسبب في زيادة + +218 +00:19:11,290 --> 00:19:15,990 +الحمضية في الاسترومة انه موضوع يعني إيه علاقة في + +219 +00:19:15,990 --> 00:19:20,330 +ال hypercapnia و الhypoxia بلا ال reciprocal + +220 +00:19:20,330 --> 00:19:27,270 +acidosis أي بمعنى كيفية الحدوث can or can't يعني + +221 +00:19:27,270 --> 00:19:32,390 +ممكن انه تحدث when a gas impermeable يعني كمية + +222 +00:19:32,390 --> 00:19:37,010 +الغاز اللي بدخل أقليعني العدسة بمعنى انه بتمنع + +223 +00:19:37,010 --> 00:19:41,110 +دخول ال ايه؟ ال oxygen ل ال posterior surface of + +224 +00:19:41,110 --> 00:19:47,370 +the stroma، it prevents carbon dioxide efflux و + +225 +00:19:47,370 --> 00:19:51,270 +أيضا في نفس الوقت بتمنع من خروج ثاني أكسيد الكربون + +226 +00:19:51,270 --> 00:19:54,910 +from the corneal stroma وهذا ما يسمى + +227 +00:19:54,910 --> 00:19:56,510 +بالhypercapnia + +228 +00:19:58,070 --> 00:20:02,550 +Metabolic Acidosis can occur if there is a + +229 +00:20:02,550 --> 00:20:06,490 +decrease in the pH of the stroma due to + +230 +00:20:06,490 --> 00:20:12,110 +accumulation of stromal lactate كمية الأملح اللي + +231 +00:20:12,110 --> 00:20:16,750 +فيه ال stroma هزيد، lactate بمعنى أملح، يعني بمعنى + +232 +00:20:16,750 --> 00:20:23,130 +أن كميتها هصير مقارنة في الأجزاء الأخرى تقريبا حسب + +233 +00:20:23,130 --> 00:20:29,530 +الدراسات السابقة من خمسة إلى سبعة فلميةفهيحدث هناك + +234 +00:20:29,530 --> 00:20:33,650 +زيادة في ايه؟ في الأملاح اللي موجودة في داخل ال + +235 +00:20:33,650 --> 00:20:41,050 +استرومة ومع زيادة ال hypercapnia و ال hypoxia + +236 +00:20:41,050 --> 00:20:46,650 +هيعمل نقصان في مين؟ في ال pH فهيقد إلى حمضية ال + +237 +00:20:46,650 --> 00:20:47,270 +استرومة + +238 +00:20:52,020 --> 00:20:56,840 +Under open eye conditions يعني في الحالات الطبيعية + +239 +00:20:56,840 --> 00:21:04,680 +okay a human stromal pH rises about 2% بس هنضيفه O + +240 +00:21:04,680 --> 00:21:11,900 +to 2% هن range يعني في الطبيعي بتكون قيمة ال pH قد + +241 +00:21:11,900 --> 00:21:18,620 +تكون 7% و قد تكون 9% يعني أقرب لمين هي للقاعدية أو + +242 +00:21:18,620 --> 00:21:23,100 +متعادلةفي الأشخاص الطبيعيين يعني زينا الآن احنا + +243 +00:21:23,100 --> 00:21:28,220 +مفتحين صح؟ عندنا قيمة الـ pH هتكون سبعة في المية + +244 +00:21:28,220 --> 00:21:32,380 +قد تكون او زيادة اتنين في المية يعني تسعة في المية + +245 +00:21:32,380 --> 00:21:37,160 +تمانية في المية بمعنى ان احنا اقرب لمين للقاعدية + +246 +00:21:37,160 --> 00:21:44,300 +او متعادل واضح الفكرة؟ and it may decrease as much + +247 +00:21:44,300 --> 00:21:50,140 +as five percentAdhering wear of an oxygen + +248 +00:21:50,140 --> 00:21:55,440 +impermeable contact lens هذه النسبة ممكن ان تقل + +249 +00:21:55,440 --> 00:22:00,540 +جداش 5% يعني تصير مثلا سين او ساد او عين حامضي + +250 +00:22:00,540 --> 00:22:05,080 +عندما يرتدي عدسة ما بتعمل نفاذية لمين؟ لا ال + +251 +00:22:05,080 --> 00:22:09,640 +oxygen يعني بمعنى ان كمية ال oxygen اللي بتدخل لا + +252 +00:22:09,640 --> 00:22:14,120 +الكورنية عبر العدسات اللاصقة بتكون غير كافية + +253 +00:22:18,880 --> 00:22:23,180 +this condition is a relatively uncommon indication + +254 +00:22:23,180 --> 00:22:29,320 +for lens refitting دايما إذا حدثت هذه المشكلة أو + +255 +00:22:29,320 --> 00:22:33,780 +هذا ال defect ما بيكون إشارة لإعادة ال fitting + +256 +00:22:33,780 --> 00:22:39,080 +للعدسة اللاصقة okay stromal acidosis this + +257 +00:22:39,080 --> 00:22:43,160 +condition is a relatively uncommon indication for + +258 +00:22:43,160 --> 00:22:49,290 +lens refittingهذه الحالة ما بتكون شائعة في حالة + +259 +00:22:49,290 --> 00:22:53,710 +العدسات اللي بتكون loose أو steep يعني بمعنى الآن + +260 +00:22:53,710 --> 00:22:58,550 +لو احنا عرفنا واحد عنده stromal acidosis مابنعملش + +261 +00:22:58,550 --> 00:23:02,970 +إعادة fitting للعدسة اللاصقة، إيش السبب؟ ببساطة + +262 +00:23:02,970 --> 00:23:08,940 +لأن عمركم سمعتوا في هناك جهاز بفحص ال BHلل patient + +263 +00:23:08,940 --> 00:23:14,080 +مافيش شيء، اذا لحد الآن ال researchers ماوصلوا + +264 +00:23:14,080 --> 00:23:19,460 +لجهاز بيعمل على قياس قيمة ال BH ك value كله احنا + +265 +00:23:19,460 --> 00:23:23,540 +دايما هذه ال BH سواء كانت سبعة او اكتر من سبعة او + +266 +00:23:23,540 --> 00:23:29,070 +اقل من سبعة هي عبارة عن ال range زي ما حكينامافيش + +267 +00:23:29,070 --> 00:23:33,870 +هناك اللي هو جهاز بيعمل على قياس ايه اللي هو ال بي + +268 +00:23:33,870 --> 00:23:38,310 +اتش بشكل اللي هو صحيح أو ك value محددة، لأ هذا + +269 +00:23:38,310 --> 00:23:42,470 +الكلام عملي يتم اللي هو تطبيقه، لكن عبارة عن + +270 +00:23:42,470 --> 00:23:45,690 +qualitative، في حاجة دايما اسمها qualitative و + +271 +00:23:45,690 --> 00:23:49,430 +quantitativeالـ quantitative بتديني fixed value + +272 +00:23:49,430 --> 00:23:53,490 +قيمة محددة مثلا قيمة الـ refractive error عنصين + +273 +00:23:53,490 --> 00:23:58,490 +minus 3 او minus 1 لكن هذا بتديني مثلا مؤشر ان + +274 +00:23:58,490 --> 00:24:03,970 +المريض هذا عنده زيادة في إيش الحمضية للاسترومة قد + +275 +00:24:03,970 --> 00:24:08,070 +يعمل اللي هو مؤثرات تانية زي مثلا استرومة القديمة + +276 +00:24:08,070 --> 00:24:12,570 +استرومة ال stray أو استرومة ال false واضح الفكرة؟ + +277 +00:24:14,300 --> 00:24:17,240 +طيب، عندنا الـ endothelial edema + +278 +00:24:21,930 --> 00:24:27,410 +appears as cerium scribe defects in the + +279 +00:24:27,410 --> 00:24:32,130 +endothelial specular reflection يعني هي عبارة عن + +280 +00:24:32,130 --> 00:24:38,530 +عيوب بتكون محددة، يمكن رؤية هذه العيوب المحددة من + +281 +00:24:38,530 --> 00:24:43,950 +خلال استخدام ايه؟ ال specular reflection أي الضوء + +282 +00:24:43,950 --> 00:24:50,860 +الصاطعفهيكون ردة الفعل من خلال اللي هو المشاهد + +283 +00:24:50,860 --> 00:24:54,660 +هتكون بالشكل هادئ النقط اللي هو السوداء اللي احنا + +284 +00:24:54,660 --> 00:24:58,900 +شايفينها أمامنا طبعا ال endothelia القديمة في + +285 +00:24:58,900 --> 00:25:02,840 +الغالب هي هتكون وين؟ هتحدث في ال endothelial cells + +286 +00:25:02,840 --> 00:25:05,380 +في خلايا ال endothelium + +287 +00:25:07,680 --> 00:25:12,900 +في إلها another name زي مثلا blips أي بمعنى انتفاخ + +288 +00:25:12,900 --> 00:25:18,600 +أو swelling أيضا تسمى events and pseudo gotata زي + +289 +00:25:18,600 --> 00:25:23,100 +ما هي موجودة بالشكل هذا إنه بتعمل swelling أو حاجة + +290 +00:25:23,100 --> 00:25:30,520 +بنسميها bulging انتفاخ أو swelling + +291 +00:25:35,930 --> 00:25:41,790 +Application of a contact lens to the unadapted eye + +292 +00:25:41,790 --> 00:25:46,610 +can cause a sudden onset but a transient + +293 +00:25:46,610 --> 00:25:48,750 +endothelial edema response + +294 +00:25:53,190 --> 00:25:57,490 +إنه ممكن بعض المرضى بيسأله طيب أنا بلبس عدسة لاصقة + +295 +00:25:57,490 --> 00:26:01,830 +لكن عيني غير متأقلمة مع العدسة يعني دايما بيصير + +296 +00:26:01,830 --> 00:26:05,530 +عندي مثلا زيادة في ال sensitivity، دايما بيصير + +297 +00:26:05,530 --> 00:26:09,290 +عندي زيادة في الدموع، بيصير عندنا مثلا burning، + +298 +00:26:09,290 --> 00:26:13,070 +redness، كل هذه الأمور مصاحبة لا ارتداء إلى العدسة + +299 +00:26:13,070 --> 00:26:19,100 +اللاصقةهذا بيؤدي الى ايه؟ الاندوثيليا القديمة، + +300 +00:26:19,100 --> 00:26:25,140 +يعني اي شخص بيلبس عدسة لاصقة و هو غير متكيف او غير + +301 +00:26:25,140 --> 00:26:29,380 +متلائم مع العدسة اللاصقة، ممكن انه يؤدي الى حدوث + +302 +00:26:29,380 --> 00:26:33,560 +ايه؟ الاندوثيليا القديمةطبعا نحمد الله ان هو لا + +303 +00:26:33,560 --> 00:26:40,080 +بيكون دايما ايه صدن مفاجئ ولكن بشكل مؤقت ما بيظلهش + +304 +00:26:40,080 --> 00:26:43,660 +يعني transient اي بمعنى مؤقت ما بيظله اللي هو + +305 +00:26:43,660 --> 00:26:51,460 +permanent بشكل دائم it occurs بيحدث within ten + +306 +00:26:51,460 --> 00:26:56,000 +minutes of lens insertion يعني بيحدث خلال ايه + +307 +00:26:56,000 --> 00:27:02,290 +العشر دقائق الأولى من ارتداء العدسة اللاصقةبقص + +308 +00:27:02,290 --> 00:27:07,650 +القمة بتاعته بعد حوالي قداش نص ساعة half an hour + +309 +00:27:07,650 --> 00:27:12,630 +and may last for several hours وبتأخر يعني لعدة + +310 +00:27:12,630 --> 00:27:19,590 +اللي هو ساعات ال endothelial edema اذا عندنا ببدأ + +311 +00:27:19,590 --> 00:27:25,050 +بعد عشر دقائق القمة بتكون نص ساعة بظله لاللي هو + +312 +00:27:25,050 --> 00:27:30,570 +يعني بتأخر لعدة ساعاتThe initial blip إن هذا + +313 +00:27:30,570 --> 00:27:35,410 +الانتفاخ أو الـ pseudo-gotata response to contact + +314 +00:27:35,410 --> 00:27:41,470 +lens wear doesn't result in cell loss، دايما ما + +315 +00:27:41,470 --> 00:27:46,670 +بيؤدي إلى خراب أو دمار لمين لخلايا الاندوثيليام، + +316 +00:27:46,670 --> 00:27:53,070 +لكن إيش بيعمل؟ إديمة، إذا هو لا يؤدي إلى cell loss + +317 +00:27:53,070 --> 00:27:58,380 +أو cell damage، لكن بيؤدي إلى cell إديمةAnd a + +318 +00:27:58,380 --> 00:28:02,600 +change in lens fitting is not required أيضا غير + +319 +00:28:02,600 --> 00:28:07,120 +مطلوب من ال examiner أنه يعمل إعادة fitting للعدسة + +320 +00:28:07,120 --> 00:28:11,280 +من جديد هو ببساطة ليش؟ لأنه دايما ال endothelia + +321 +00:28:11,280 --> 00:28:15,720 +القديمة بيحدث لما المريض بيكون غير متأقلم أو غير + +322 +00:28:15,720 --> 00:28:20,840 +متكيف مع العدسة اللاصقة اللي تم تحديدها له بمعنى + +323 +00:28:20,840 --> 00:28:23,140 +أنه لازم أنا أغير من نوع العدسة + +324 +00:28:27,890 --> 00:28:33,050 +Indothelial polymegathism أي بمعنى تغيير في حجم + +325 +00:28:33,050 --> 00:28:37,330 +الخلايا اللي خاصة في مين في الIndothelium يعني + +326 +00:28:37,330 --> 00:28:41,750 +بمعنى انه في هناك change في ال size او في ال + +327 +00:28:41,750 --> 00:28:48,570 +variety of cell size في حجم الخلايا طبعا قديش + +328 +00:28:48,570 --> 00:28:56,430 +عندنا ال normal حجم الخلايا الIndothelium الحجم + +329 +00:28:56,430 --> 00:29:04,080 +ال sizeحجم الخلايا تقريبا من تلاتمية لاربعمية + +330 +00:29:04,080 --> 00:29:11,340 +مايكرونز، طب عددهم جداش؟ العدد يعني تقريبا ال + +331 +00:29:11,340 --> 00:29:17,970 +average ستلاف و خمسمية خليةإذا عندنا Endothelial + +332 +00:29:17,970 --> 00:29:23,890 +polymegathism is a greater than normal variation + +333 +00:29:23,890 --> 00:29:29,270 +of cell size in the corneal endothelial mosaic + +334 +00:29:29,270 --> 00:29:33,010 +observed with the biomicroscope or the clinical + +335 +00:29:33,010 --> 00:29:38,280 +specular microscopeإذا هو زيادة في حجم الخلايا + +336 +00:29:38,280 --> 00:29:42,040 +الاندوثيليام طبعا عندنا ال normal range لها من + +337 +00:29:42,040 --> 00:29:46,680 +تلاتمية إلى أربعمية بصير يعني العدد أو الحجم عفوا + +338 +00:29:46,680 --> 00:29:50,820 +يعني ال diameter اللي خاص في الخلايا هذه بيصبح من + +339 +00:29:50,820 --> 00:29:56,680 +ستمية لسبعمية مليمترهذا ممكن اللي هو فحصه من خلال + +340 +00:29:56,680 --> 00:30:01,560 +الـ biomicroscope أو الاستلام أو في عندنا ال + +341 +00:30:01,560 --> 00:30:06,140 +microscope يعني ببعنى أنه بناخد شريحة عينة و بنعمل + +342 +00:30:06,140 --> 00:30:09,880 +اللي هو قياس ل ال diameter of the cells + +343 +00:30:13,130 --> 00:30:18,630 +في هناك grade أي بمعنى بتديني fixed value قيمة هذا + +344 +00:30:18,630 --> 00:30:22,970 +ال grade او ال score it is graded by the + +345 +00:30:22,970 --> 00:30:27,650 +coefficient of variation of cell area له رمز + +346 +00:30:27,650 --> 00:30:33,930 +abbreviation CV هذا بمعنى قداش حجم الخلايا الحجم + +347 +00:30:33,930 --> 00:30:38,990 +الخاص في الخلايا هو بتدينيه ك number او ك value + +348 +00:30:50,840 --> 00:30:55,220 +وهذا أيضا ال range يعني تقريبا من خمسة و عشرين + +349 +00:30:55,220 --> 00:30:58,780 +لتلاتين في المية okay هذا في حالة ال normal + +350 +00:30:58,780 --> 00:31:03,440 +الطبيعي دايما بيكون قيمته من خمسة و عشرين لتلاتين + +351 +00:31:03,440 --> 00:31:10,980 +في الميةولكنها قد تكون مرتفعة حوالي 46% في مريض + +352 +00:31:10,980 --> 00:31:18,620 +يمتلك عمره 20 سنة من اكسجين ومشروع ديالي وير أو + +353 +00:31:18,620 --> 00:31:24,800 +خمس سنة من مجلد هيدروجيليعني هذه القيمة ممكن انه + +354 +00:31:24,800 --> 00:31:28,740 +ازيد لمريض مثلا لابس عدسة لاسقة من عشرين سنة + +355 +00:31:28,740 --> 00:31:32,860 +conventional daily wear أو واحد من خمس سنوات بلبس + +356 +00:31:32,860 --> 00:31:36,600 +عدسات extended wear، اذا القيمة ايش مالها؟ هزيد + +357 +00:31:36,600 --> 00:31:43,660 +عنده، هيكون تقريبا ال normal بالنسبة له 46% مقارنة + +358 +00:31:43,660 --> 00:31:46,220 +في مين؟ في الأشخاص اللي طبيعيين + +359 +00:31:50,180 --> 00:31:53,720 +طيب ان شاء الله نقفلها ال corneal excision + +360 +00:31:53,720 --> 00:31:57,140 +syndrome في اي سؤال اي استفسار؟ + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/nbr1GB4Nc8U_raw.json b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/nbr1GB4Nc8U_raw.json new file mode 100644 index 0000000000000000000000000000000000000000..c27543a1be24ba9c6d18a9af3f6dafa213c3054d --- /dev/null +++ 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"end": 62.22, "word": " خطوط", "probability": 0.967529296875}, {"start": 62.22, "end": 63.02, "word": " بيضاء", "probability": 0.968994140625}, {"start": 63.02, "end": 64.18, "word": " رفيعة", "probability": 0.8564453125}, {"start": 64.18, "end": 65.46, "word": " مستقيمة", "probability": 0.95654296875}, {"start": 65.46, "end": 66.02, "word": " in", "probability": 0.89453125}, {"start": 66.02, "end": 66.18, "word": " the", "probability": 0.90869140625}, {"start": 66.18, "end": 66.72, "word": " posterior", "probability": 0.81591796875}, {"start": 66.72, "end": 67.72, "word": " stroma", "probability": 0.859375}, {"start": 67.72, "end": 68.1, "word": " of", "probability": 0.978515625}, {"start": 68.1, "end": 68.32, "word": " the", "probability": 0.90869140625}, {"start": 68.32, "end": 68.8, "word": " cornea", "probability": 0.937744140625}, {"start": 68.8, "end": 69.46, "word": " في", "probability": 0.79443359375}, {"start": 69.46, "end": 69.86, "word": " الجزء", "probability": 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5.960464477539063e-08, "words": [{"start": 72.76, "end": 73.18, "word": "إذا", "probability": 0.6361083984375}, {"start": 73.18, "end": 79.52, "word": " كانت", "probability": 0.669921875}, {"start": 79.52, "end": 80.22, "word": " قيمة", "probability": 0.9957682291666666}, {"start": 80.22, "end": 80.9, "word": " الإديمة", "probability": 0.7857666015625}, {"start": 80.9, "end": 81.1, "word": " في", "probability": 0.75634765625}, {"start": 81.1, "end": 81.86, "word": " الاسترومة", "probability": 0.794580078125}, {"start": 81.86, "end": 82.82, "word": " خمسة", "probability": 0.8990478515625}, {"start": 82.82, "end": 82.92, "word": " في", "probability": 0.8017578125}, {"start": 82.92, "end": 83.4, "word": " المية", "probability": 0.809326171875}, {"start": 83.4, "end": 83.94, "word": " فما", "probability": 0.840087890625}, {"start": 83.94, "end": 84.32, "word": " فوق", "probability": 0.97802734375}, {"start": 84.32, "end": 85.4, "word": " طبعا", "probability": 0.85113525390625}, {"start": 85.4, "end": 86.12, "word": " او", "probability": 0.81005859375}, {"start": 86.12, "end": 86.58, "word": " ستة", "probability": 0.9560546875}, {"start": 86.58, "end": 86.7, "word": " في", "probability": 0.953125}, {"start": 86.7, "end": 87.0, "word": " المية", "probability": 0.9619140625}, {"start": 87.0, "end": 87.34, "word": " فما", "probability": 0.9677734375}, {"start": 87.34, "end": 87.74, "word": " فوق", "probability": 0.97900390625}, {"start": 87.74, "end": 88.52, "word": " في", "probability": 0.71435546875}, {"start": 88.52, "end": 89.14, "word": " جماعة", "probability": 0.7906087239583334}, {"start": 89.14, "end": 89.98, "word": " عندنا", "probability": 0.71923828125}, {"start": 89.98, "end": 91.32, "word": " الاسترومة", "probability": 0.8358642578125}, {"start": 91.32, "end": 94.38, "word": " أو", "probability": 0.64111328125}, {"start": 94.38, "end": 94.52, "word": " ال", "probability": 0.79248046875}, {"start": 94.52, "end": 97.1, "word": " substantia", "probability": 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107.31, "word": " ninety", "probability": 0.491943359375}, {"start": 107.31, "end": 111.03, "word": " percent", "probability": 0.97998046875}, {"start": 111.03, "end": 111.63, "word": " of", "probability": 0.95654296875}, {"start": 111.63, "end": 113.87, "word": " corneal", "probability": 0.8875325520833334}, {"start": 113.87, "end": 115.89, "word": " thickness", "probability": 0.9345703125}], "temperature": 1.0}, {"id": 6, "seek": 14603, "start": 119.91, "end": 146.03, "text": "زيادة دخول الماء في الاسترومة بيعمل على اختلاف في ال concentration التركيز بمعنى انه بيزيد ال concentration ل الاسترومة مقارنة في الأجزاء الأخرى فهذا بيؤدي إلى الإديمة طبعا إذا كانت قيمة الإديمة 6% فما فوق okay بيعمل حاجة بيسميها الastromal strain", "tokens": [11622, 1829, 18513, 3660, 11778, 9778, 12610, 9673, 16606, 8978, 42963, 14851, 2288, 20498, 3660, 4724, 1829, 25957, 1211, 15844, 1975, 46456, 15040, 5172, 8978, 2423, 9856, 16712, 31747, 1829, 11622, 4724, 2304, 3615, 1863, 7578, 16472, 3224, 4724, 1829, 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146.03, "word": " strain", "probability": 0.84521484375}], "temperature": 1.0}, {"id": 7, "seek": 17611, "start": 149.07, "end": 176.11, "text": "thus or so, stray are present with most current generation daily wear, hydrogel lenses for myopia دايما هذه الـstray هي غير شائعة أو غير حاضرة أو غير موجودة في حالات المرضى اللي بيرتديوا العدسات اللاصقة السالبة الـ minus lenses ليش طيب؟", "tokens": [392, 301, 420, 370, 11, 36219, 366, 1974, 365, 881, 2190, 5125, 5212, 3728, 11, 5796, 6675, 338, 18059, 337, 452, 22376, 11778, 47302, 15042, 29538, 2423, 39184, 372, 3458, 39896, 32771, 13546, 13412, 16373, 27884, 34051, 32771, 13546, 11331, 46958, 25720, 34051, 32771, 13546, 3714, 29245, 23328, 3660, 8978, 11331, 6027, 9307, 9673, 43042, 7578, 13672, 1829, 4724, 13546, 2655, 16254, 14407, 18863, 3215, 3794, 9307, 13672, 33546, 28671, 21136, 6027, 49401, 2423, 39184, 3175, 18059, 32239, 8592, 23032, 1829, 3555, 22807], "avg_logprob": -0.21670386408056533, "compression_ratio": 1.4458874458874458, 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164.81, "end": 165.37, "word": " حاضرة", "probability": 0.9563802083333334}, {"start": 165.37, "end": 165.67, "word": " أو", "probability": 0.81591796875}, {"start": 165.67, "end": 165.95, "word": " غير", "probability": 0.994384765625}, {"start": 165.95, "end": 166.69, "word": " موجودة", "probability": 0.991943359375}, {"start": 166.69, "end": 167.11, "word": " في", "probability": 0.97119140625}, {"start": 167.11, "end": 168.01, "word": " حالات", "probability": 0.9591471354166666}, {"start": 168.01, "end": 169.37, "word": " المرضى", "probability": 0.9892578125}, {"start": 169.37, "end": 169.63, "word": " اللي", "probability": 0.8837890625}, {"start": 169.63, "end": 170.49, "word": " بيرتديوا", "probability": 0.71083984375}, {"start": 170.49, "end": 171.21, "word": " العدسات", "probability": 0.807373046875}, {"start": 171.21, "end": 171.99, "word": " اللاصقة", "probability": 0.8922526041666666}, {"start": 171.99, "end": 172.97, "word": " السالبة", "probability": 0.9554036458333334}, 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{"start": 285.21, "end": 286.03, "word": " ايه؟", "probability": 0.9022216796875}, {"start": 286.03, "end": 286.61, "word": " القرنية", "probability": 0.660888671875}, {"start": 286.61, "end": 287.17, "word": " القديمة", "probability": 0.91845703125}, {"start": 287.17, "end": 287.81, "word": " وبعد", "probability": 0.78759765625}, {"start": 287.81, "end": 288.15, "word": " ذلك", "probability": 0.996826171875}, {"start": 288.15, "end": 288.97, "word": " بتبعها", "probability": 0.822265625}, {"start": 288.97, "end": 289.71, "word": " ال", "probability": 0.89404296875}, {"start": 289.71, "end": 290.87, "word": " stromal", "probability": 0.5135091145833334}, {"start": 290.87, "end": 291.49, "word": " stream", "probability": 0.418212890625}], "temperature": 1.0}, {"id": 13, "seek": 31626, "start": 292.54, "end": 316.26, "text": "such as those prescribed for monovision، طب ليش هنذكرنا monovision؟ بالضبط لأنه بتكون الوصفة plus lenses لأنه بتستخدم فقط لمين؟ لاله ال near reading، يعني فقط لالنير أو لال reading، يعني هي مخصصة أنه فقط تكون ك plus lenses", "tokens": [39974, 382, 729, 29099, 337, 1108, 5179, 1991, 12399, 23032, 3555, 32239, 8592, 8032, 1863, 8848, 37983, 8315, 1108, 5179, 1991, 22807, 20666, 11242, 3555, 9566, 5296, 33456, 3224, 39894, 30544, 2423, 2407, 9381, 5172, 3660, 1804, 18059, 5296, 33456, 3224, 39894, 14851, 9778, 40448, 6156, 47432, 32767, 9957, 22807, 5296, 6027, 3224, 2423, 2651, 3760, 12399, 37495, 22653, 6156, 47432, 5296, 6027, 22653, 2288, 34051, 5296, 6027, 3760, 12399, 37495, 22653, 39896, 3714, 9778, 9381, 9381, 3660, 14739, 3224, 6156, 47432, 6055, 30544, 9122, 1804, 18059], "avg_logprob": -0.20933949320831083, "compression_ratio": 1.5960591133004927, "no_speech_prob": 0.0, "words": [{"start": 292.54, "end": 292.94, "word": "such", "probability": 0.55712890625}, {"start": 292.94, "end": 293.44, "word": " as", "probability": 0.984375}, {"start": 293.44, "end": 294.1, "word": " those", "probability": 0.79150390625}, {"start": 294.1, "end": 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"end": 303.68, "word": " lenses", "probability": 0.97265625}, {"start": 303.68, "end": 304.08, "word": " لأنه", "probability": 0.763671875}, {"start": 304.08, "end": 304.64, "word": " بتستخدم", "probability": 0.97900390625}, {"start": 304.64, "end": 305.0, "word": " فقط", "probability": 0.97802734375}, {"start": 305.0, "end": 305.76, "word": " لمين؟", "probability": 0.7765299479166666}, {"start": 305.76, "end": 306.28, "word": " لاله", "probability": 0.6611328125}, {"start": 306.28, "end": 306.86, "word": " ال", "probability": 0.54248046875}, {"start": 306.86, "end": 307.22, "word": " near", "probability": 0.465087890625}, {"start": 307.22, "end": 308.22, "word": " reading،", "probability": 0.786865234375}, {"start": 308.22, "end": 308.82, "word": " يعني", "probability": 0.85546875}, {"start": 308.82, "end": 309.24, "word": " فقط", "probability": 0.98681640625}, {"start": 309.24, "end": 310.0, "word": " لالنير", "probability": 0.6787109375}, {"start": 310.0, "end": 310.3, "word": " 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"text": "Extended wear lenses أيضا الأشخاص اللي بيرتديوا العدسات اللاصقة لمدة أسبوع واحد طبعا في حالة ال extended wear هتكون ال DK على T quite high", "tokens": [36, 734, 3502, 3728, 18059, 36632, 11242, 995, 16247, 8592, 9778, 33546, 13672, 1829, 4724, 13546, 2655, 16254, 14407, 18863, 3215, 3794, 9307, 13672, 33546, 28671, 32767, 41891, 5551, 35457, 45367, 36764, 24401, 23032, 3555, 3615, 995, 8978, 11331, 6027, 3660, 2423, 10913, 3728, 8032, 2655, 30544, 2423, 31934, 15844, 314, 1596, 1090], "avg_logprob": -0.17476852569315168, "compression_ratio": 1.3375796178343948, "no_speech_prob": 0.0, "words": [{"start": 321.2, "end": 321.92, "word": "Extended", "probability": 0.8006184895833334}, {"start": 321.92, "end": 322.26, "word": " wear", "probability": 0.50244140625}, {"start": 322.26, "end": 322.98, "word": " lenses", "probability": 0.90087890625}, {"start": 322.98, "end": 324.12, "word": " أيضا", "probability": 0.6932779947916666}, {"start": 324.12, "end": 324.98, "word": " الأشخاص", "probability": 0.9459228515625}, {"start": 324.98, "end": 325.38, "word": " اللي", "probability": 0.79345703125}, {"start": 325.38, "end": 325.96, "word": " بيرتديوا", "probability": 0.93642578125}, {"start": 325.96, "end": 326.56, "word": " العدسات", "probability": 0.9783935546875}, {"start": 326.56, "end": 327.26, "word": " اللاصقة", "probability": 0.939453125}, {"start": 327.26, "end": 328.0, "word": " لمدة", "probability": 0.96337890625}, {"start": 328.0, "end": 328.58, "word": " أسبوع", "probability": 0.86767578125}, {"start": 328.58, "end": 329.18, "word": " واحد", "probability": 0.966552734375}, {"start": 329.18, "end": 330.08, "word": " طبعا", "probability": 0.89111328125}, {"start": 330.08, "end": 330.24, "word": " في", "probability": 0.87939453125}, {"start": 330.24, "end": 330.64, "word": " حالة", "probability": 0.9969075520833334}, {"start": 330.64, "end": 330.74, "word": " ال", "probability": 0.83544921875}, {"start": 330.74, "end": 331.16, "word": " extended", 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دايما", "probability": 0.8538411458333334}, {"start": 352.55, "end": 352.97, "word": " ايضا", "probability": 0.882080078125}, {"start": 352.97, "end": 353.19, "word": " هي", "probability": 0.8134765625}, {"start": 353.19, "end": 353.81, "word": " بالزيد", "probability": 0.7191569010416666}, {"start": 353.81, "end": 354.25, "word": " في", "probability": 0.890625}, {"start": 354.25, "end": 354.85, "word": " حالات", "probability": 0.96630859375}, {"start": 354.85, "end": 355.63, "word": " المرضى", "probability": 0.9876302083333334}, {"start": 355.63, "end": 355.83, "word": " اللي", "probability": 0.9677734375}, {"start": 355.83, "end": 356.51, "word": " بيرتديوا", "probability": 0.93125}, {"start": 356.51, "end": 357.13, "word": " ايه", "probability": 0.8082682291666666}, {"start": 357.13, "end": 357.29, "word": " ال", "probability": 0.88525390625}, {"start": 357.29, "end": 358.17, "word": " extended", "probability": 0.70849609375}, {"start": 358.17, "end": 358.59, "word": " wear", 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"end": 397.6, "text": "بكون بالشكل هذا، ظهورها كإنه اللي هو dark line خطوط سوداء، okay؟ يعني ثانيات سوداء طبقة الاندوثيليام يا جماعة بتتميز بإنه طبقة ملساق، إيش معناه طبقة ملساق؟ يعني لو استخدمنا ال specular reflection، أي بمعنى الضوء الساطع المنعكس، هيعمل انعكاس للصورة بنسبة مائة في المائة تقريبا، okay؟", "tokens": [3555, 30544, 20666, 8592, 28820, 23758, 12399, 1357, 116, 3224, 13063, 11296, 9122, 28814, 1863, 3224, 13672, 1829, 31439, 2877, 1622, 16490, 9566, 2407, 9566, 8608, 23328, 16606, 12399, 1392, 22807, 37495, 22653, 38637, 7649, 1829, 9307, 8608, 23328, 16606, 23032, 3555, 28671, 2423, 7649, 3215, 2407, 12984, 1829, 20292, 10943, 35186, 10874, 15042, 27884, 39894, 39237, 1829, 11622, 4724, 28814, 1863, 3224, 23032, 3555, 28671, 3714, 1211, 3794, 995, 4587, 12399, 11933, 1829, 8592, 20449, 8315, 3224, 23032, 3555, 28671, 3714, 1211, 3794, 995, 4587, 22807, 37495, 22653, 45164, 44713, 9778, 40448, 8315, 2423, 1608, 1040, 12914, 12399, 36632, 4724, 2304, 3615, 1863, 7578, 6024, 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الastromal falls أو الastromal edema if astromal edema is noted at follow-up examination الآن المريض ارتد العدسة اللاصقة نفترض لمدة الشهر بعد الشهر بطلب منه ان يعمل follow-up انا بقصد ايه ال conventional daily wear lenses", "tokens": [6652, 11129, 20666, 1863, 35457, 3660, 5296, 4587, 6027, 10632, 18863, 1211, 26108, 5296, 2423, 525, 4397, 304, 36219, 34051, 2423, 525, 4397, 304, 8804, 34051, 2423, 525, 4397, 304, 1257, 5619, 498, 5357, 4397, 304, 1257, 5619, 307, 12964, 412, 1524, 12, 1010, 23874, 6024, 48506, 9673, 16572, 11242, 1975, 43500, 3215, 18863, 3215, 3794, 3660, 13672, 33546, 28671, 8717, 5172, 2655, 43042, 32767, 41891, 25124, 3224, 2288, 39182, 25124, 3224, 2288, 4724, 9566, 46152, 9154, 3224, 16472, 7251, 25957, 1211, 1524, 12, 1010, 1975, 8315, 4724, 4587, 9381, 3215, 1975, 1829, 3224, 2423, 16011, 5212, 3728, 18059], "avg_logprob": -0.19593750491738318, "compression_ratio": 1.6379310344827587, "no_speech_prob": 0.0, "words": [{"start": 624.76, "end": 625.54, "word": 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أنا", "probability": 0.5263671875}, {"start": 1701.66, "end": 1702.12, "word": " أغير", "probability": 0.9490559895833334}, {"start": 1702.12, "end": 1702.3, "word": " من", "probability": 0.9921875}, {"start": 1702.3, "end": 1702.54, "word": " نوع", "probability": 0.99462890625}, {"start": 1702.54, "end": 1703.14, "word": " العدسة", "probability": 0.9952392578125}], "temperature": 1.0}, {"id": 73, "seek": 173701, "start": 1707.89, "end": 1737.01, "text": "Indothelial polymegathism أي بمعنى تغيير في حجم الخلايا اللي خاصة في مين في الIndothelium يعني بمعنى انه في هناك change في ال size او في ال variety of cell size في حجم الخلايا طبعا قديش عندنا ال normal حجم الخلايا الIndothelium الحجم ال size", "tokens": [21790, 900, 338, 831, 6754, 42800, 998, 1434, 36632, 4724, 2304, 3615, 1863, 7578, 6055, 17082, 1829, 13546, 8978, 11331, 7435, 2304, 33962, 15040, 25528, 13672, 1829, 16490, 33546, 3660, 8978, 3714, 9957, 8978, 2423, 21790, 900, 338, 2197, 37495, 22653, 4724, 2304, 3615, 1863, 7578, 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" حجم", "probability": 0.9918619791666666}, {"start": 1713.05, "end": 1714.05, "word": " الخلايا", "probability": 0.9425455729166666}, {"start": 1714.05, "end": 1714.53, "word": " اللي", "probability": 0.65185546875}, {"start": 1714.53, "end": 1715.01, "word": " خاصة", "probability": 0.97314453125}, {"start": 1715.01, "end": 1715.13, "word": " في", "probability": 0.87841796875}, {"start": 1715.13, "end": 1715.35, "word": " مين", "probability": 0.6357421875}, {"start": 1715.35, "end": 1715.75, "word": " في", "probability": 0.71923828125}, {"start": 1715.75, "end": 1716.59, "word": " الIndothelium", "probability": 0.68896484375}, {"start": 1716.59, "end": 1717.33, "word": " يعني", "probability": 0.7216796875}, {"start": 1717.33, "end": 1717.93, "word": " بمعنى", "probability": 0.990234375}, {"start": 1717.93, "end": 1718.31, "word": " انه", "probability": 0.45947265625}, {"start": 1718.31, "end": 1718.41, "word": " في", "probability": 0.93212890625}, {"start": 1718.41, "end": 1719.05, "word": " هناك", "probability": 0.954833984375}, {"start": 1719.05, "end": 1719.97, "word": " change", "probability": 0.49560546875}, {"start": 1719.97, "end": 1720.29, "word": " في", "probability": 0.9814453125}, {"start": 1720.29, "end": 1720.45, "word": " ال", "probability": 0.9228515625}, {"start": 1720.45, "end": 1720.93, "word": " size", "probability": 0.560546875}, {"start": 1720.93, "end": 1721.41, "word": " او", "probability": 0.80419921875}, {"start": 1721.41, "end": 1721.61, "word": " في", "probability": 0.9736328125}, {"start": 1721.61, "end": 1721.75, "word": " ال", "probability": 0.73095703125}, {"start": 1721.75, "end": 1722.25, "word": " variety", "probability": 0.7216796875}, {"start": 1722.25, "end": 1722.77, "word": " of", "probability": 0.970703125}, {"start": 1722.77, "end": 1723.21, "word": " cell", "probability": 0.9150390625}, {"start": 1723.21, "end": 1723.85, "word": " size", "probability": 0.7470703125}, {"start": 1723.85, "end": 1724.11, "word": " في", "probability": 0.56103515625}, {"start": 1724.11, "end": 1724.53, "word": " حجم", "probability": 0.99267578125}, {"start": 1724.53, "end": 1725.61, "word": " الخلايا", "probability": 0.9674479166666666}, {"start": 1725.61, "end": 1728.17, "word": " طبعا", "probability": 0.9798583984375}, {"start": 1728.17, "end": 1728.57, "word": " قديش", "probability": 0.600830078125}, {"start": 1728.57, "end": 1728.97, "word": " عندنا", "probability": 0.865478515625}, {"start": 1728.97, "end": 1729.23, "word": " ال", "probability": 0.71435546875}, {"start": 1729.23, "end": 1729.63, "word": " normal", "probability": 0.7158203125}, {"start": 1729.63, "end": 1730.17, "word": " حجم", "probability": 0.9915364583333334}, {"start": 1730.17, "end": 1730.75, "word": " الخلايا", "probability": 0.9685872395833334}, {"start": 1730.75, "end": 1731.79, "word": " الIndothelium", "probability": 0.86298828125}, {"start": 1731.79, "end": 1736.43, "word": " الحجم", "probability": 0.9161783854166666}, {"start": 1736.43, "end": 1736.65, "word": " ال", "probability": 0.90234375}, {"start": 1736.65, "end": 1737.01, "word": " size", "probability": 0.77490234375}], "temperature": 1.0}, {"id": 74, "seek": 175432, "start": 1739.22, "end": 1754.32, "text": "حجم الخلايا تقريبا من تلاتمية لاربعمية مايكرونز، طب عددهم جداش؟ العدد يعني تقريبا ال average ستلاف و خمسمية خلية", "tokens": [5016, 7435, 2304, 33962, 15040, 25528, 6055, 4587, 16572, 3555, 995, 9154, 6055, 1211, 9307, 2304, 10632, 5296, 9640, 3555, 25957, 10632, 19446, 1829, 37983, 11536, 11622, 12399, 23032, 3555, 6225, 3215, 3215, 16095, 10874, 3215, 33599, 22807, 18863, 3215, 3215, 37495, 22653, 6055, 4587, 16572, 3555, 995, 2423, 4274, 8608, 2655, 15040, 5172, 4032, 16490, 2304, 38251, 10632, 16490, 1211, 10632], "avg_logprob": -0.20014881661960057, "compression_ratio": 1.463235294117647, "no_speech_prob": 0.0, "words": [{"start": 1739.22, "end": 1739.6, "word": "حجم", "probability": 0.9314778645833334}, {"start": 1739.6, "end": 1740.04, "word": " الخلايا", "probability": 0.9510091145833334}, {"start": 1740.04, "end": 1740.72, "word": " تقريبا", "probability": 0.9869140625}, {"start": 1740.72, "end": 1741.16, "word": " من", "probability": 0.92529296875}, {"start": 1741.16, "end": 1742.14, "word": " تلاتمية", "probability": 0.83779296875}, {"start": 1742.14, "end": 1744.08, "word": " لاربعمية", "probability": 0.91650390625}, {"start": 1744.08, "end": 1745.9, "word": " مايكرونز،", "probability": 0.7257893880208334}, {"start": 1745.9, "end": 1746.54, "word": " طب", "probability": 0.800537109375}, {"start": 1746.54, "end": 1746.94, "word": " عددهم", "probability": 0.947021484375}, {"start": 1746.94, "end": 1749.62, "word": " جداش؟", "probability": 0.71099853515625}, {"start": 1749.62, "end": 1750.14, "word": " العدد", "probability": 0.8523763020833334}, {"start": 1750.14, "end": 1750.66, "word": " يعني", "probability": 0.799560546875}, {"start": 1750.66, "end": 1751.24, "word": " تقريبا", "probability": 0.9916015625}, {"start": 1751.24, "end": 1751.34, "word": " ال", "probability": 0.861328125}, {"start": 1751.34, "end": 1751.78, "word": " average", "probability": 0.53662109375}, {"start": 1751.78, "end": 1752.64, "word": " ستلاف", "probability": 0.711700439453125}, {"start": 1752.64, "end": 1752.8, "word": " و", "probability": 0.99560546875}, {"start": 1752.8, "end": 1753.4, "word": " خمسمية", "probability": 0.8299560546875}, {"start": 1753.4, "end": 1754.32, "word": " خلية", "probability": 0.8380533854166666}], "temperature": 1.0}, {"id": 75, "seek": 177497, "start": 1756.11, "end": 1774.97, "text": "إذا عندنا Endothelial polymegathism is a greater than normal variation of cell size in the corneal endothelial mosaic observed with the biomicroscope or the clinical specular microscope", "tokens": [28814, 15730, 43242, 8315, 6967, 900, 338, 831, 6754, 42800, 998, 1434, 307, 257, 5044, 813, 2710, 12990, 295, 2815, 2744, 294, 264, 1181, 716, 304, 917, 900, 338, 831, 13659, 64, 299, 13095, 365, 264, 27450, 299, 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0.91357421875}, {"start": 1763.89, "end": 1764.35, "word": " of", "probability": 0.96875}, {"start": 1764.35, "end": 1764.85, "word": " cell", "probability": 0.91259765625}, {"start": 1764.85, "end": 1765.53, "word": " size", "probability": 0.81884765625}, {"start": 1765.53, "end": 1766.37, "word": " in", "probability": 0.95654296875}, {"start": 1766.37, "end": 1766.59, "word": " the", "probability": 0.9052734375}, {"start": 1766.59, "end": 1767.17, "word": " corneal", "probability": 0.953125}, {"start": 1767.17, "end": 1768.17, "word": " endothelial", "probability": 0.9359130859375}, {"start": 1768.17, "end": 1769.27, "word": " mosaic", "probability": 0.6576334635416666}, {"start": 1769.27, "end": 1770.21, "word": " observed", "probability": 0.77783203125}, {"start": 1770.21, "end": 1770.61, "word": " with", "probability": 0.92333984375}, {"start": 1770.61, "end": 1770.79, "word": " the", "probability": 0.79931640625}, {"start": 1770.79, "end": 1771.95, "word": " biomicroscope", "probability": 0.900634765625}, {"start": 1771.95, "end": 1772.27, "word": " or", "probability": 0.92529296875}, {"start": 1772.27, "end": 1772.45, "word": " the", "probability": 0.783203125}, {"start": 1772.45, "end": 1773.01, "word": " clinical", "probability": 0.89013671875}, {"start": 1773.01, "end": 1773.99, "word": " specular", "probability": 0.76611328125}, {"start": 1773.99, "end": 1774.97, "word": " microscope", "probability": 0.8955078125}], "temperature": 1.0}, {"id": 76, "seek": 179322, "start": 1775.2, "end": 1793.22, "text": "إذا هو زيادة في حجم الخلايا الاندوثيليام طبعا عندنا ال normal range لها من تلاتمية إلى أربعمية بصير يعني العدد أو الحجم عفوا يعني ال diameter اللي خاص في الخلايا هذه بيصبح من ستمية لسبعمية مليمتر", "tokens": [28814, 15730, 31439, 30767, 1829, 18513, 3660, 8978, 11331, 7435, 2304, 33962, 15040, 25528, 2423, 7649, 3215, 2407, 12984, 1829, 20292, 10943, 23032, 3555, 3615, 995, 43242, 8315, 2423, 2710, 3613, 5296, 11296, 9154, 6055, 1211, 9307, 2304, 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الاندوثيليام", "probability": 0.7543487548828125}, {"start": 1779.76, "end": 1780.38, "word": " طبعا", "probability": 0.84796142578125}, {"start": 1780.38, "end": 1780.7, "word": " عندنا", "probability": 0.85400390625}, {"start": 1780.7, "end": 1780.8, "word": " ال", "probability": 0.8583984375}, {"start": 1780.8, "end": 1781.1, "word": " normal", "probability": 0.494140625}, {"start": 1781.1, "end": 1781.52, "word": " range", "probability": 0.94873046875}, {"start": 1781.52, "end": 1781.86, "word": " لها", "probability": 0.5648193359375}, {"start": 1781.86, "end": 1782.04, "word": " من", "probability": 0.9794921875}, {"start": 1782.04, "end": 1782.58, "word": " تلاتمية", "probability": 0.79306640625}, {"start": 1782.58, "end": 1782.84, "word": " إلى", "probability": 0.6416015625}, {"start": 1782.84, "end": 1783.5, "word": " أربعمية", "probability": 0.8463134765625}, {"start": 1783.5, "end": 1784.38, "word": " بصير", "probability": 0.8199869791666666}, {"start": 1784.38, "end": 1784.72, "word": " يعني", "probability": 0.959716796875}, {"start": 1784.72, "end": 1785.34, "word": " العدد", "probability": 0.9757486979166666}, {"start": 1785.34, "end": 1785.78, "word": " أو", "probability": 0.61083984375}, {"start": 1785.78, "end": 1786.26, "word": " الحجم", "probability": 0.9884440104166666}, {"start": 1786.26, "end": 1786.68, "word": " عفوا", "probability": 0.9138997395833334}, {"start": 1786.68, "end": 1787.1, "word": " يعني", "probability": 0.962646484375}, {"start": 1787.1, "end": 1787.22, "word": " ال", "probability": 0.978515625}, {"start": 1787.22, "end": 1787.7, "word": " diameter", "probability": 0.87548828125}, {"start": 1787.7, "end": 1788.1, "word": " اللي", "probability": 0.946044921875}, {"start": 1788.1, "end": 1788.4, "word": " خاص", "probability": 0.989501953125}, {"start": 1788.4, "end": 1788.5, "word": " في", "probability": 0.92529296875}, {"start": 1788.5, "end": 1788.96, "word": " الخلايا", "probability": 0.9791666666666666}, {"start": 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a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/nbr1GB4Nc8U_raw.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/nbr1GB4Nc8U_raw.srt new file mode 100644 index 0000000000000000000000000000000000000000..dfae3918d80ce2f6930b5fdb5216e78425777bca --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/nbr1GB4Nc8U_raw.srt @@ -0,0 +1,1444 @@ +1 +00:00:21,630 --> 00:00:24,490 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:24,490 --> 00:00:28,250 +وبركاته and a very good morning to all of you + +3 +00:00:28,250 --> 00:00:35,230 +هنكمل في المحاضرة موضوع ال signs of hypercapnia + +4 +00:00:35,230 --> 00:00:40,130 +and hypoxia موضوع الastromal scrape + +5 +00:00:42,660 --> 00:00:47,180 +طبعا الاسترومة ال استريه هي عبارة عن عصا بيضاء + +6 +00:00:47,180 --> 00:00:54,480 +اللون بتكون في ال posterior surface للاسترومةطبعا + +7 +00:00:54,480 --> 00:00:59,760 +في الشكل اللي واضح أمامنا find بمعنى دقيق white + +8 +00:00:59,760 --> 00:01:06,180 +vertical lines خطوط بيضاء رفيعة مستقيمة in the + +9 +00:01:06,180 --> 00:01:11,060 +posterior stroma of the cornea في الجزء الخلفي من + +10 +00:01:11,060 --> 00:01:19,520 +الاسترومةإذا كانت + +11 +00:01:19,520 --> 00:01:24,320 +قيمة الإديمة في الاسترومة خمسة في المية فما فوق + +12 +00:01:24,320 --> 00:01:29,980 +طبعا او ستة في المية فما فوق في جماعة عندنا + +13 +00:01:29,980 --> 00:01:34,380 +الاسترومة أو + +14 +00:01:34,380 --> 00:01:40,120 +ال substantia propria + +15 +00:01:42,550 --> 00:01:51,030 +ك another name طبعا هي بتمثل ninety percent + +16 +00:01:51,030 --> 00:01:55,890 +of corneal thickness + +17 +00:01:59,910 --> 00:02:05,470 +زيادة دخول الماء في الاسترومة بيعمل على اختلاف في + +18 +00:02:05,470 --> 00:02:09,230 +ال concentration التركيز بمعنى انه بيزيد ال + +19 +00:02:09,230 --> 00:02:14,310 +concentration ل الاسترومة مقارنة في الأجزاء الأخرى + +20 +00:02:14,310 --> 00:02:20,130 +فهذا بيؤدي إلى الإديمة طبعا إذا كانت قيمة الإديمة + +21 +00:02:20,130 --> 00:02:25,370 +6% فما فوق okay بيعمل حاجة بيسميها الastromal + +22 +00:02:25,370 --> 00:02:26,030 +strain + +23 +00:02:29,070 --> 00:02:34,250 +thus or so, stray are present with most current + +24 +00:02:34,250 --> 00:02:39,790 +generation daily wear, hydrogel lenses for myopia + +25 +00:02:39,790 --> 00:02:45,670 +دايما هذه الـstray هي غير شائعة أو غير حاضرة أو + +26 +00:02:45,670 --> 00:02:51,210 +غير موجودة في حالات المرضى اللي بيرتديوا العدسات + +27 +00:02:51,210 --> 00:02:58,340 +اللاصقة السالبة الـ minus lenses ليش طيب؟يعني ليش + +28 +00:02:58,340 --> 00:03:02,820 +هذه الـ stray؟ + +29 +00:03:02,820 --> 00:03:06,620 +بالضبط، + +30 +00:03:06,620 --> 00:03:10,720 +دايما العدسات الـ minus lenses بتتميز ان الـ + +31 +00:03:10,720 --> 00:03:14,720 +center فيها thinner than ايه ال peripheral، يعني + +32 +00:03:14,720 --> 00:03:17,980 +من ال center بتكون thin و ال peripheral ايش بتكون + +33 +00:03:17,980 --> 00:03:24,960 +thickفبكون هناك دخول للأكسجين بشكل سليم أو بشكل + +34 +00:03:24,960 --> 00:03:29,460 +اللي هو صحيح أو بكميات كبيرة فهذا ما بيعمل ايه؟ + +35 +00:03:29,460 --> 00:03:33,560 +Cornial edema وبالتالي ما بيؤدي إلى الastromal + +36 +00:03:33,560 --> 00:03:39,740 +strain okay فدائما عند زيادة الأكسجين ال + +37 +00:03:39,740 --> 00:03:44,940 +transmissibility بيعمل على زيادة مين؟ ال Dk على T + +38 +00:03:45,840 --> 00:03:49,540 +وبالتالي هذا لا يؤدي إلى القرنية الإديمة + +39 +00:03:53,460 --> 00:03:58,420 +Stray remained a useful diagnostic indicator طبعا + +40 +00:03:58,420 --> 00:04:04,700 +هي بتعتبر مؤشر تشخيصي للأشخاص اللي بيكون عندهم + +41 +00:04:04,700 --> 00:04:10,520 +إديمة لكن بيرتديوا عدسات إيه plus lenses أو plus + +42 +00:04:10,520 --> 00:04:15,120 +powered hydrogel lenses يعني دايما الأشخاص اللي + +43 +00:04:15,120 --> 00:04:19,960 +بيرتديوا عدسات موجبة بيتبعها إيه corneal إديمة + +44 +00:04:19,960 --> 00:04:24,850 +وبعد ذلك بيسبب stromal strayاذا كانت قيمة القديمة + +45 +00:04:24,850 --> 00:04:30,590 +اكتر من 6% طيب هان السبب ليش انه ذكرنا ال plus + +46 +00:04:30,590 --> 00:04:35,070 +lenses ببساطة لان ال plus lenses بيكون ال ثيكوين + +47 +00:04:35,070 --> 00:04:39,970 +في ال center بالتالي كمية ال oxygen اللي هتدخل + +48 +00:04:39,970 --> 00:04:44,630 +ايه؟ يعني هتكون قليلة فهذا ممكن انه يكون مهيئ + +49 +00:04:44,630 --> 00:04:49,710 +لحدوث ايه؟ القرنية القديمة وبعد ذلك بتبعها ال + +50 +00:04:49,710 --> 00:04:55,860 +stromal streamsuch as those prescribed for + +51 +00:04:55,860 --> 00:05:01,760 +monovision، طب ليش هنذكرنا monovision؟ بالضبط لأنه + +52 +00:05:01,760 --> 00:05:05,760 +بتكون الوصفة plus lenses لأنه بتستخدم فقط لمين؟ + +53 +00:05:05,760 --> 00:05:11,200 +لاله ال near reading، يعني فقط لالنير أو لال + +54 +00:05:11,200 --> 00:05:16,260 +reading، يعني هي مخصصة أنه فقط تكون ك plus lenses + +55 +00:05:21,200 --> 00:05:25,960 +Extended wear lenses أيضا الأشخاص اللي بيرتديوا + +56 +00:05:25,960 --> 00:05:30,740 +العدسات اللاصقة لمدة أسبوع واحد طبعا في حالة ال + +57 +00:05:30,740 --> 00:05:36,690 +extended wear هتكون ال DK على T quite highطيب لو + +58 +00:05:36,690 --> 00:05:41,430 +كانت low او medium هذا هيكون diagnostic او + +59 +00:05:41,430 --> 00:05:45,670 +indicator diagnostic يعني مؤشر اللي هو تشخيصي + +60 +00:05:45,670 --> 00:05:50,690 +لحدوث من الكورنية القديمة وبعد ذلك بيعمل stromal + +61 +00:05:50,690 --> 00:05:55,630 +strain يعني دايما ايضا هي بالزيد في حالات المرضى + +62 +00:05:55,630 --> 00:05:59,210 +اللي بيرتديوا ايه ال extended wear lenses + +63 +00:06:03,910 --> 00:06:10,620 +Stromal Falls هي عبارة عن ثانياتبكون بالشكل هذا، + +64 +00:06:10,620 --> 00:06:16,420 +ظهورها كإنه اللي هو dark line خطوط سوداء، okay؟ + +65 +00:06:16,420 --> 00:06:20,260 +يعني ثانيات سوداء طبقة الاندوثيليام يا جماعة + +66 +00:06:20,260 --> 00:06:25,300 +بتتميز بإنه طبقة ملساق، إيش معناه طبقة ملساق؟ يعني + +67 +00:06:25,300 --> 00:06:30,060 +لو استخدمنا ال specular reflection، أي بمعنى الضوء + +68 +00:06:30,060 --> 00:06:35,700 +الساطع المنعكس، هيعمل انعكاس للصورة بنسبة مائة في + +69 +00:06:35,700 --> 00:06:40,930 +المائة تقريبا، okay؟لو في اي تفالس ثانيات هتعمل + +70 +00:06:40,930 --> 00:06:49,110 +انعكاس بالشكل هذا و كأنه dark lines okay appear + +71 +00:06:49,110 --> 00:06:54,750 +as dark lines اذا هي هتظهر على انه هي خطوط معتمة + +72 +00:06:54,750 --> 00:07:00,470 +او سوداء in in the endothelial specular reflection + +73 +00:07:00,470 --> 00:07:04,370 +في حالة استخدام الضوء الساطع لرؤية من ال + +74 +00:07:04,370 --> 00:07:11,040 +endotheliumthey appear when stromal edema exceeds + +75 +00:07:11,040 --> 00:07:15,980 +10% يعني هتظهر إذا كانت قيمة ال edema عشرة في + +76 +00:07:15,980 --> 00:07:20,880 +المية فما فوق، إذا أيهما أختار ال stromal stray + +77 +00:07:20,880 --> 00:07:26,400 +ولا ال stromal false؟ لأن قيمة ال edema بالزيد عن + +78 +00:07:26,400 --> 00:07:27,640 +عشرة في المية + +79 +00:07:31,860 --> 00:07:37,880 +rarely occur with daily wear of GB or Hydrogel + +80 +00:07:37,880 --> 00:07:42,820 +contact lenses هي نادرة الحدوث في عدسات اللبس + +81 +00:07:42,820 --> 00:07:49,500 +اليومي ال soft contact lens أو ال RGB ليش + +82 +00:07:49,500 --> 00:07:54,140 +ال stromal falls بتكون نادرة الحدوث؟في الـ + +83 +00:07:54,140 --> 00:07:57,920 +conventional daily wear اللي بتتم ارتدائها مثلا + +84 +00:07:57,920 --> 00:08:02,540 +عشر ساعات او اتناشر ساعة او في ال جي بي لينزز + +85 +00:08:06,050 --> 00:08:09,690 +لأن الآن العدسات اللاصقة الهيد ال conventional + +86 +00:08:09,690 --> 00:08:14,610 +daily wear يما بتم عملية ال removal إلها، حيصير + +87 +00:08:14,610 --> 00:08:21,890 +هناك إزالة لإديمة وبالتالي أو تلاشي لقيمة الإديمة + +88 +00:08:21,890 --> 00:08:27,090 +وهذا ما بتأدي إلى حدوث من الastromal fallsولكن + +89 +00:08:27,090 --> 00:08:31,410 +عندنا في حالة يصير هناك stromal falls معنى الكلام + +90 +00:08:31,410 --> 00:08:36,030 +أنه عنده قيمة الإديمة ثابتة overnight يعني في كل + +91 +00:08:36,030 --> 00:08:40,710 +الوقت قيمتها جديش عشرة في المية أو أكتر فهذا بيدّي + +92 +00:08:40,710 --> 00:08:45,690 +ذريعة لحدوث مين ال stromal falls طبعا هي وين بتكون + +93 +00:08:45,690 --> 00:08:50,890 +أكتر حاجة شائعة؟ في حالتين ال poor fitting لل جي + +94 +00:08:50,890 --> 00:08:55,470 +بي لينزز والحالة التانية عندما يكون عندي low DK + +95 +00:08:55,470 --> 00:09:02,110 +على Tإذا عندنا في ال poor fitting + +96 +00:09:02,110 --> 00:09:05,770 +لل + +97 +00:09:05,770 --> 00:09:12,190 +gb والحالة التانية في ال low dk على t في هذه + +98 +00:09:12,190 --> 00:09:17,190 +الحالتين بتكون عندنا ال stromal false commonبدون + +99 +00:09:17,190 --> 00:09:21,570 +ذلك في حالات الـ conventional daily wear أو العدسة + +100 +00:09:21,570 --> 00:09:25,850 +اللى بتكون جي بي optimal fit ما بتحدث حدوث الـ + +101 +00:09:25,850 --> 00:09:30,510 +stromal falls with + +102 +00:09:30,510 --> 00:09:35,090 +extended wear of hydrogen lenses posterior falls + +103 +00:09:35,090 --> 00:09:39,730 +can be apparent on eye opening لكن هنا في الها شرط + +104 +00:09:40,700 --> 00:09:45,360 +يما عندنا بيكون قيمة الإديمة مثلا اول ما المريض + +105 +00:09:45,360 --> 00:09:49,460 +بصحى الصبح بتكون عشرة في المية، في آخر النهار عشرة + +106 +00:09:49,460 --> 00:09:53,420 +في المية، في منتصف اليوم عشرة في المية، ممكن انه + +107 +00:09:53,420 --> 00:09:58,860 +يحدث عند المريض ايه؟ stromal falls طيب المريض الآن + +108 +00:09:58,860 --> 00:10:02,600 +استيقظ من النوم وكانت قيمة الإديمة عنده عشرة في + +109 +00:10:02,600 --> 00:10:06,640 +المية او تسعة في المية، هل ممكن انه يحدث عنده + +110 +00:10:06,640 --> 00:10:11,670 +stromal falls؟ قداذا ربما يحدث و ربما ما يحدث لان + +111 +00:10:11,670 --> 00:10:15,230 +انتوا عارفين ان الانسان اول ما بيستيقظ من النوم + +112 +00:10:15,230 --> 00:10:19,570 +بيكون عنده ال edema ايه؟ عالية مقارنة في منتصف + +113 +00:10:19,570 --> 00:10:21,410 +اليوم او اخر اليوم + +114 +00:10:24,760 --> 00:10:29,560 +Management بالنسبة لقالية العلاج ل الastromal + +115 +00:10:29,560 --> 00:10:35,980 +stray أو الastromal falls أو الastromal edema if + +116 +00:10:35,980 --> 00:10:40,220 +astromal edema is noted at follow-up examination + +117 +00:10:40,220 --> 00:10:45,860 +الآن المريض ارتد العدسة اللاصقة نفترض لمدة الشهر + +118 +00:10:45,860 --> 00:10:50,500 +بعد الشهر بطلب منه ان يعمل follow-up انا بقصد ايه + +119 +00:10:50,500 --> 00:10:56,050 +ال conventional daily wear lensesincreasing lens + +120 +00:10:56,050 --> 00:11:03,350 +dk على t to at least 15% for daily wear and at + +121 +00:11:03,350 --> 00:11:09,090 +least 34% for extended wear is recommended إذا + +122 +00:11:09,090 --> 00:11:13,750 +سببت عنده أي زيادة في الاسترامة القديمة الحل + +123 +00:11:13,750 --> 00:11:18,210 +الوحيد أنه أعمل زيادة في dk على tطبعا بعض ال + +124 +00:11:18,210 --> 00:11:23,210 +researchers قيم هذه الزيادة حكالك في حالات ال + +125 +00:11:23,210 --> 00:11:26,170 +daily wear او ال conventional daily wear على ساعة + +126 +00:11:26,170 --> 00:11:32,030 +اللبس اليومي التقليدي بتكون قيمتها 15% لكن في ال + +127 +00:11:32,030 --> 00:11:38,990 +extended wear هتكون جداش 34% طيب بدأ اسأل سؤال انه + +128 +00:11:38,990 --> 00:11:43,250 +دايما ال extended wear لازم ان يكون فيها high + +129 +00:11:43,250 --> 00:11:44,130 +decay على T + +130 +00:11:47,250 --> 00:11:52,130 +الـ extended wear lenses لازم انه دايما يكون لها + +131 +00:11:52,130 --> 00:11:58,970 +قيمة الديكي على T very high why؟ حالة ال extended + +132 +00:11:58,970 --> 00:11:59,890 +wear lenses + +133 +00:12:08,460 --> 00:12:11,440 +لازم تكون عالية بس في نفس الوقت بت .. رح يقل ال + +134 +00:12:11,440 --> 00:12:13,800 +thickness فقلت اللي لازم ياخد قطرة انه يعني كلها + +135 +00:12:13,800 --> 00:12:16,100 +بس هي لازم تكون عالية علشان يصير في عنده more gear + +136 +00:12:16,100 --> 00:12:22,900 +extension okay another answer اذا + +137 +00:12:22,900 --> 00:12:27,140 +احنا متفقين ان عدسات ال extended wear lenses لازم + +138 +00:12:27,140 --> 00:12:31,760 +انه يكون ال DK على T very high لسبب واحد انه لو + +139 +00:12:31,760 --> 00:12:36,680 +انا مثلا خليتها medium او low حيصير مباشرة cornea + +140 +00:12:36,680 --> 00:12:41,470 +القديمةهيتبعها الـ stromal edema بعد ذلك مثلا + +141 +00:12:41,470 --> 00:12:47,750 +stromal stray و stromal falls اذا لازم انه دايما + +142 +00:12:47,750 --> 00:12:52,110 +ال decay على T يكون very high عشان اضمن اكبر كمية + +143 +00:12:52,110 --> 00:12:54,870 +من ال oxygen تدخل لمن؟ للكورنية + +144 +00:12:59,780 --> 00:13:03,400 +طبعا هان احنا متفقين في النقطة الأولى هادي ك range + +145 +00:13:03,400 --> 00:13:06,360 +اللي هي الخمساش في المية او الاربعة و تلاتين في + +146 +00:13:06,360 --> 00:13:11,420 +المية يعني ممكن تتغير من patient لاخريعني هذه ليست + +147 +00:13:11,420 --> 00:13:15,720 +guidelines هذه عبارة عن ال protocol الفرق ما بين + +148 +00:13:15,720 --> 00:13:18,920 +ال protocol و ال guidelines ال protocol في ال + +149 +00:13:18,920 --> 00:13:22,200 +management يعني في العلاج دايما ممكن انه يتغير + +150 +00:13:22,200 --> 00:13:27,200 +يعني ممكن مثلا آية بتاخد عشرة في المية مثلا اناس + +151 +00:13:27,200 --> 00:13:31,860 +خمساش في المية صين مثلا تلتاش في المية فقد تتغير + +152 +00:13:31,860 --> 00:13:36,220 +من شخص لآخر حسب ال sensitivity اللي موجود عنده + +153 +00:13:42,050 --> 00:13:45,730 +في حالة العدسات الموجبة اللي بيكون الـ thick vein + +154 +00:13:45,730 --> 00:13:51,260 +في ال centerThis may require هذا هيتطلب a change + +155 +00:13:51,260 --> 00:13:56,840 +تغير to high water content material or a GB lens + +156 +00:13:56,840 --> 00:14:03,160 +design اذا بتطلب من ال manufacturer انه يزود في + +157 +00:14:03,160 --> 00:14:07,260 +مين في ال water content او يغير ال material لذلك + +158 +00:14:07,260 --> 00:14:11,720 +احنا لاحظنا الجيل الاول من العدسات انه كان فقط + +159 +00:14:11,720 --> 00:14:15,660 +بيستخدموا مثلا ال poly methyl methacrylate لل GB + +160 +00:14:15,660 --> 00:14:20,280 +lensesبعد ذلك زودوا مادة ايه؟ السيليكون عشان + +161 +00:14:20,280 --> 00:14:28,020 +يعملوا زيادة ل ال wetability if + +162 +00:14:28,020 --> 00:14:34,410 +a change to lens fitting is not desiredيعني نفترض + +163 +00:14:34,410 --> 00:14:38,850 +انا اعمل التغيير في ال fitting للعدسة ولكن كان غير + +164 +00:14:38,850 --> 00:14:43,570 +مرغوب بالنسبة لمن؟ لل patient يعني بعض المرضى ما + +165 +00:14:43,570 --> 00:14:47,490 +بيرغبوا في ارتداء ال extended wear lenses او ما + +166 +00:14:47,490 --> 00:14:52,570 +بيرغبوا في ارتداء ال daily disposable lenses okay؟ + +167 +00:14:52,570 --> 00:14:56,430 +the other strategies ممكن هناك يعني طريقة او + +168 +00:14:56,430 --> 00:15:01,650 +method مختلفة تتبعها غير اللي هو ايه طريقة زيادة + +169 +00:15:01,650 --> 00:15:08,450 +ال DK على TAlso be useful such as مثلا reducing + +170 +00:15:08,450 --> 00:15:13,250 +wearing hours per day، إذا ممكن أقل من ساعات + +171 +00:15:13,250 --> 00:15:17,190 +ارتداء العدسة، يعني بدل ما المريض بيلبسها خمس + +172 +00:15:17,190 --> 00:15:19,810 +ساعات، يلبسها مثلا تلت ساعات + +173 +00:15:23,700 --> 00:15:29,540 +ولا لمدة محددة؟ لمدة معينة دايما يما أقل العدد + +174 +00:15:29,540 --> 00:15:34,260 +الساعات ارتداء العدسة للمريض بدي يكون يعني في هناك + +175 +00:15:34,260 --> 00:15:39,000 +period time وقت محدد قد يكون أسبوعين تلاتة وبعد + +176 +00:15:39,000 --> 00:15:44,780 +ذلك هيلبس إيش بشكل اللي هو maximum wearing or + +177 +00:15:44,780 --> 00:15:49,120 +inserting lenses later after eye opening in the + +178 +00:15:49,120 --> 00:15:53,430 +morningاحنا عارفين انه الاديمة بتزيد اول ما المريض + +179 +00:15:53,430 --> 00:15:58,890 +wake up يستيقظ من النوم، بقوله مثلا اول ساعتين من + +180 +00:15:58,890 --> 00:16:04,510 +استيقاظك ما تلبسش العدسة، البسها مثلا بعد ساعتين، + +181 +00:16:04,510 --> 00:16:09,570 +هتقلل كورنيا الاديمة okay وبالتالي ممكن انه هذا ما + +182 +00:16:09,570 --> 00:16:14,310 +يدلى complications عند المريضواضح الفكرة؟ يعني إما + +183 +00:16:14,310 --> 00:16:18,970 +بنقلل عدد الساعات أو المريض بيرتدي العدسة بعد اللي + +184 +00:16:18,970 --> 00:16:28,110 +هو ساعتين من استيقاظه بالنسبة + +185 +00:16:28,110 --> 00:16:35,130 +ل الهيسترومال أسيدوز أي بمعنى زيادة الحمضية في + +186 +00:16:35,130 --> 00:16:36,150 +الهيسترومال + +187 +00:16:45,900 --> 00:16:53,020 +بداية قيمة ال بي اتش يما تكون بالساوي seven معناها + +188 +00:16:53,020 --> 00:16:59,940 +انه ايه متعادل طيب ال بي اتش اقل من seven بيكون + +189 +00:16:59,940 --> 00:17:06,160 +حامضي اكتر من سبعة بيكون قاعدي okay هذه بدناش + +190 +00:17:06,160 --> 00:17:11,340 +ننساها الناس الملاحظات الastromal acidosis أي + +191 +00:17:11,340 --> 00:17:14,740 +بمعنى زيادة الحامضية في الastroma + +192 +00:17:18,540 --> 00:17:26,220 +كان arise from hypercapnia as well as hypoxia، إذا + +193 +00:17:26,220 --> 00:17:31,600 +اتفقنا إن هي تعتبر signs علامات لإن أروبيك + +194 +00:17:31,600 --> 00:17:37,570 +متابوليزمأو signs للـ hypercapnia و الـ hypoxia + +195 +00:17:37,570 --> 00:17:43,190 +بمعنى انه هيقل دخول ال oxygen للكورنية و في نفس + +196 +00:17:43,190 --> 00:17:48,150 +الوقت هيقل من .. هيعمل زيادة لدخول مين؟ اللي هو + +197 +00:17:48,150 --> 00:17:49,950 +ثاني أكسيد الكربون + +198 +00:17:53,920 --> 00:17:57,880 +Reciprocal Acidosis أي بمعنى الكيفية اللى بتحدث من + +199 +00:17:57,880 --> 00:18:01,740 +خلالها تستطيع + +200 +00:18:01,740 --> 00:18:04,980 +ان تحدث عندما يحدث جزء من جزء من الجزء من الجزء من + +201 +00:18:04,980 --> 00:18:06,420 +الجزء من الجزء من الجزء من الجزء من الجزء من الجزء + +202 +00:18:06,420 --> 00:18:08,120 +من الجزء من الجزء من الجزء من الجزء من الجزء من + +203 +00:18:08,120 --> 00:18:10,480 +الجزء من الجزء من الجزء من الجزء من الجزء من الجزء + +204 +00:18:10,480 --> 00:18:10,860 +من الجزء من الجزء من الجزء من الجزء من الجزء من + +205 +00:18:10,860 --> 00:18:12,260 +الجزء من الجزء من الجزء من الجزء من الجزء من الجزء + +206 +00:18:12,260 --> 00:18:12,900 +من الجزء من الجزء من الجزء من الجزء من الجزء من + +207 +00:18:12,900 --> 00:18:12,900 +الجزء من الجزء من الجزء من الجزء من الجزء من الجزء + +208 +00:18:12,900 --> 00:18:19,140 +من الجزء من الجزء من الجزء من الجإنه هتسمح لثاني + +209 +00:18:19,140 --> 00:18:23,320 +أكسيد الكربون يدخل الأسترومة ولكن في نفس الوقت + +210 +00:18:23,320 --> 00:18:27,760 +هتمنع من أيه؟ من دخول الأكسجين إلى اللي هو + +211 +00:18:27,760 --> 00:18:32,960 +الأسترومة، هي ب .. ب .. يعني بمختصر أو ب summary + +212 +00:18:32,960 --> 00:18:36,680 +اللي هو الموضوع أو الكيفية اللي بتحدث من خلال + +213 +00:18:39,810 --> 00:18:45,150 +الان زيادة ثاني أكسيد الكربون داخل ال استرومة و + +214 +00:18:45,150 --> 00:18:49,410 +نقصان الأكسجين بيؤدي إلى نقصان في مين؟ في ال BH + +215 +00:18:49,410 --> 00:18:55,510 +فبالتالي ان ال BH بيصير حامضي استرومال أسيدوزز أي + +216 +00:18:55,510 --> 00:19:00,970 +بمعنى زيادة الحامضية في ال استرومة بداية إذا كانت + +217 +00:19:00,970 --> 00:19:06,110 +قيمة ال BH equal 7 بيكون متعادل BH less than 7 + +218 +00:19:06,110 --> 00:19:11,290 +بيكون حامضي أكتر من 7 بيكون قاعديالسبب في زيادة + +219 +00:19:11,290 --> 00:19:15,990 +الحمضية في الاسترومة انه موضوع يعني إيه علاقة في + +220 +00:19:15,990 --> 00:19:20,330 +ال hypercapnia و الhypoxia بلا ال reciprocal + +221 +00:19:20,330 --> 00:19:27,270 +acidosis أي بمعنى كيفية الحدوث can or can't يعني + +222 +00:19:27,270 --> 00:19:32,390 +ممكن انه تحدث when a gas impermeable يعني كمية + +223 +00:19:32,390 --> 00:19:37,010 +الغاز اللي بدخل أقليعني العدسة بمعنى انه بتمنع + +224 +00:19:37,010 --> 00:19:41,110 +دخول ال ايه؟ ال oxygen ل ال posterior surface of + +225 +00:19:41,110 --> 00:19:47,370 +the stroma، it prevents carbon dioxide efflux و + +226 +00:19:47,370 --> 00:19:51,270 +أيضا في نفس الوقت بتمنع من خروج ثاني أكسيد الكربون + +227 +00:19:51,270 --> 00:19:54,910 +from the corneal stroma وهذا ما يسمى + +228 +00:19:54,910 --> 00:19:56,510 +بالhypercapnia + +229 +00:19:58,070 --> 00:20:02,550 +Metabolic Acidosis can occur if there is a + +230 +00:20:02,550 --> 00:20:06,490 +decrease in the pH of the stroma due to + +231 +00:20:06,490 --> 00:20:12,110 +accumulation of stromal lactate كمية الأملح اللي + +232 +00:20:12,110 --> 00:20:16,750 +فيه ال stroma هزيد، lactate بمعنى أملح، يعني بمعنى + +233 +00:20:16,750 --> 00:20:23,130 +أن كميتها هصير مقارنة في الأجزاء الأخرى تقريبا حسب + +234 +00:20:23,130 --> 00:20:29,530 +الدراسات السابقة من خمسة إلى سبعة فلميةفهيحدث هناك + +235 +00:20:29,530 --> 00:20:33,650 +زيادة في ايه؟ في الأملاح اللي موجودة في داخل ال + +236 +00:20:33,650 --> 00:20:41,050 +استرومة ومع زيادة ال hypercapnia و ال hypoxia + +237 +00:20:41,050 --> 00:20:46,650 +هيعمل نقصان في مين؟ في ال pH فهيقد إلى حمضية ال + +238 +00:20:46,650 --> 00:20:47,270 +استرومة + +239 +00:20:52,020 --> 00:20:56,840 +Under open eye conditions يعني في الحالات الطبيعية + +240 +00:20:56,840 --> 00:21:04,680 +okay a human stromal pH rises about 2% بس هنضيفه O + +241 +00:21:04,680 --> 00:21:11,900 +to 2% هن range يعني في الطبيعي بتكون قيمة ال pH قد + +242 +00:21:11,900 --> 00:21:18,620 +تكون 7% و قد تكون 9% يعني أقرب لمين هي للقاعدية أو + +243 +00:21:18,620 --> 00:21:23,100 +متعادلةفي الأشخاص الطبيعيين يعني زينا الآن احنا + +244 +00:21:23,100 --> 00:21:28,220 +مفتحين صح؟ عندنا قيمة الـ pH هتكون سبعة في المية + +245 +00:21:28,220 --> 00:21:32,380 +قد تكون او زيادة اتنين في المية يعني تسعة في المية + +246 +00:21:32,380 --> 00:21:37,160 +تمانية في المية بمعنى ان احنا اقرب لمين للقاعدية + +247 +00:21:37,160 --> 00:21:44,300 +او متعادل واضح الفكرة؟ and it may decrease as much + +248 +00:21:44,300 --> 00:21:50,140 +as five percentAdhering wear of an oxygen + +249 +00:21:50,140 --> 00:21:55,440 +impermeable contact lens هذه النسبة ممكن ان تقل + +250 +00:21:55,440 --> 00:22:00,540 +جداش 5% يعني تصير مثلا سين او ساد او عين حامضي + +251 +00:22:00,540 --> 00:22:05,080 +عندما يرتدي عدسة ما بتعمل نفاذية لمين؟ لا ال + +252 +00:22:05,080 --> 00:22:09,640 +oxygen يعني بمعنى ان كمية ال oxygen اللي بتدخل لا + +253 +00:22:09,640 --> 00:22:14,120 +الكورنية عبر العدسات اللاصقة بتكون غير كافية + +254 +00:22:18,880 --> 00:22:23,180 +this condition is a relatively uncommon indication + +255 +00:22:23,180 --> 00:22:29,320 +for lens refitting دايما إذا حدثت هذه المشكلة أو + +256 +00:22:29,320 --> 00:22:33,780 +هذا ال defect ما بيكون إشارة لإعادة ال fitting + +257 +00:22:33,780 --> 00:22:39,080 +للعدسة اللاصقة okay stromal acidosis this + +258 +00:22:39,080 --> 00:22:43,160 +condition is a relatively uncommon indication for + +259 +00:22:43,160 --> 00:22:49,290 +lens refittingهذه الحالة ما بتكون شائعة في حالة + +260 +00:22:49,290 --> 00:22:53,710 +العدسات اللي بتكون loose أو steep يعني بمعنى الآن + +261 +00:22:53,710 --> 00:22:58,550 +لو احنا عرفنا واحد عنده stromal acidosis مابنعملش + +262 +00:22:58,550 --> 00:23:02,970 +إعادة fitting للعدسة اللاصقة، إيش السبب؟ ببساطة + +263 +00:23:02,970 --> 00:23:08,940 +لأن عمركم سمعتوا في هناك جهاز بفحص ال BHلل patient + +264 +00:23:08,940 --> 00:23:14,080 +مافيش شيء، اذا لحد الآن ال researchers ماوصلوا + +265 +00:23:14,080 --> 00:23:19,460 +لجهاز بيعمل على قياس قيمة ال BH ك value كله احنا + +266 +00:23:19,460 --> 00:23:23,540 +دايما هذه ال BH سواء كانت سبعة او اكتر من سبعة او + +267 +00:23:23,540 --> 00:23:29,070 +اقل من سبعة هي عبارة عن ال range زي ما حكينامافيش + +268 +00:23:29,070 --> 00:23:33,870 +هناك اللي هو جهاز بيعمل على قياس ايه اللي هو ال بي + +269 +00:23:33,870 --> 00:23:38,310 +اتش بشكل اللي هو صحيح أو ك value محددة، لأ هذا + +270 +00:23:38,310 --> 00:23:42,470 +الكلام عملي يتم اللي هو تطبيقه، لكن عبارة عن + +271 +00:23:42,470 --> 00:23:45,690 +qualitative، في حاجة دايما اسمها qualitative و + +272 +00:23:45,690 --> 00:23:49,430 +quantitativeالـ quantitative بتديني fixed value + +273 +00:23:49,430 --> 00:23:53,490 +قيمة محددة مثلا قيمة الـ refractive error عنصين + +274 +00:23:53,490 --> 00:23:58,490 +minus 3 او minus 1 لكن هذا بتديني مثلا مؤشر ان + +275 +00:23:58,490 --> 00:24:03,970 +المريض هذا عنده زيادة في إيش الحمضية للاسترومة قد + +276 +00:24:03,970 --> 00:24:08,070 +يعمل اللي هو مؤثرات تانية زي مثلا استرومة القديمة + +277 +00:24:08,070 --> 00:24:12,570 +استرومة ال stray أو استرومة ال false واضح الفكرة؟ + +278 +00:24:14,300 --> 00:24:17,240 +طيب، عندنا الـ endothelial edema + +279 +00:24:21,930 --> 00:24:27,410 +appears as cerium scribe defects in the + +280 +00:24:27,410 --> 00:24:32,130 +endothelial specular reflection يعني هي عبارة عن + +281 +00:24:32,130 --> 00:24:38,530 +عيوب بتكون محددة، يمكن رؤية هذه العيوب المحددة من + +282 +00:24:38,530 --> 00:24:43,950 +خلال استخدام ايه؟ ال specular reflection أي الضوء + +283 +00:24:43,950 --> 00:24:50,860 +الصاطعفهيكون ردة الفعل من خلال اللي هو المشاهد + +284 +00:24:50,860 --> 00:24:54,660 +هتكون بالشكل هادئ النقط اللي هو السوداء اللي احنا + +285 +00:24:54,660 --> 00:24:58,900 +شايفينها أمامنا طبعا ال endothelia القديمة في + +286 +00:24:58,900 --> 00:25:02,840 +الغالب هي هتكون وين؟ هتحدث في ال endothelial cells + +287 +00:25:02,840 --> 00:25:05,380 +في خلايا ال endothelium + +288 +00:25:07,680 --> 00:25:12,900 +في إلها another name زي مثلا blips أي بمعنى انتفاخ + +289 +00:25:12,900 --> 00:25:18,600 +أو swelling أيضا تسمى events and pseudo gotata زي + +290 +00:25:18,600 --> 00:25:23,100 +ما هي موجودة بالشكل هذا إنه بتعمل swelling أو حاجة + +291 +00:25:23,100 --> 00:25:30,520 +بنسميها bulging انتفاخ أو swelling + +292 +00:25:35,930 --> 00:25:41,790 +Application of a contact lens to the unadapted eye + +293 +00:25:41,790 --> 00:25:46,610 +can cause a sudden onset but a transient + +294 +00:25:46,610 --> 00:25:48,750 +endothelial edema response + +295 +00:25:53,190 --> 00:25:57,490 +إنه ممكن بعض المرضى بيسأله طيب أنا بلبس عدسة لاصقة + +296 +00:25:57,490 --> 00:26:01,830 +لكن عيني غير متأقلمة مع العدسة يعني دايما بيصير + +297 +00:26:01,830 --> 00:26:05,530 +عندي مثلا زيادة في ال sensitivity، دايما بيصير + +298 +00:26:05,530 --> 00:26:09,290 +عندي زيادة في الدموع، بيصير عندنا مثلا burning، + +299 +00:26:09,290 --> 00:26:13,070 +redness، كل هذه الأمور مصاحبة لا ارتداء إلى العدسة + +300 +00:26:13,070 --> 00:26:19,100 +اللاصقةهذا بيؤدي الى ايه؟ الاندوثيليا القديمة، + +301 +00:26:19,100 --> 00:26:25,140 +يعني اي شخص بيلبس عدسة لاصقة و هو غير متكيف او غير + +302 +00:26:25,140 --> 00:26:29,380 +متلائم مع العدسة اللاصقة، ممكن انه يؤدي الى حدوث + +303 +00:26:29,380 --> 00:26:33,560 +ايه؟ الاندوثيليا القديمةطبعا نحمد الله ان هو لا + +304 +00:26:33,560 --> 00:26:40,080 +بيكون دايما ايه صدن مفاجئ ولكن بشكل مؤقت ما بيظلهش + +305 +00:26:40,080 --> 00:26:43,660 +يعني transient اي بمعنى مؤقت ما بيظله اللي هو + +306 +00:26:43,660 --> 00:26:51,460 +permanent بشكل دائم it occurs بيحدث within ten + +307 +00:26:51,460 --> 00:26:56,000 +minutes of lens insertion يعني بيحدث خلال ايه + +308 +00:26:56,000 --> 00:27:02,290 +العشر دقائق الأولى من ارتداء العدسة اللاصقةبقص + +309 +00:27:02,290 --> 00:27:07,650 +القمة بتاعته بعد حوالي قداش نص ساعة half an hour + +310 +00:27:07,650 --> 00:27:12,630 +and may last for several hours وبتأخر يعني لعدة + +311 +00:27:12,630 --> 00:27:19,590 +اللي هو ساعات ال endothelial edema اذا عندنا ببدأ + +312 +00:27:19,590 --> 00:27:25,050 +بعد عشر دقائق القمة بتكون نص ساعة بظله لاللي هو + +313 +00:27:25,050 --> 00:27:30,570 +يعني بتأخر لعدة ساعاتThe initial blip إن هذا + +314 +00:27:30,570 --> 00:27:35,410 +الانتفاخ أو الـ pseudo-gotata response to contact + +315 +00:27:35,410 --> 00:27:41,470 +lens wear doesn't result in cell loss، دايما ما + +316 +00:27:41,470 --> 00:27:46,670 +بيؤدي إلى خراب أو دمار لمين لخلايا الاندوثيليام، + +317 +00:27:46,670 --> 00:27:53,070 +لكن إيش بيعمل؟ إديمة، إذا هو لا يؤدي إلى cell loss + +318 +00:27:53,070 --> 00:27:58,380 +أو cell damage، لكن بيؤدي إلى cell إديمةAnd a + +319 +00:27:58,380 --> 00:28:02,600 +change in lens fitting is not required أيضا غير + +320 +00:28:02,600 --> 00:28:07,120 +مطلوب من ال examiner أنه يعمل إعادة fitting للعدسة + +321 +00:28:07,120 --> 00:28:11,280 +من جديد هو ببساطة ليش؟ لأنه دايما ال endothelia + +322 +00:28:11,280 --> 00:28:15,720 +القديمة بيحدث لما المريض بيكون غير متأقلم أو غير + +323 +00:28:15,720 --> 00:28:20,840 +متكيف مع العدسة اللاصقة اللي تم تحديدها له بمعنى + +324 +00:28:20,840 --> 00:28:23,140 +أنه لازم أنا أغير من نوع العدسة + +325 +00:28:27,890 --> 00:28:33,050 +Indothelial polymegathism أي بمعنى تغيير في حجم + +326 +00:28:33,050 --> 00:28:37,330 +الخلايا اللي خاصة في مين في الIndothelium يعني + +327 +00:28:37,330 --> 00:28:41,750 +بمعنى انه في هناك change في ال size او في ال + +328 +00:28:41,750 --> 00:28:48,570 +variety of cell size في حجم الخلايا طبعا قديش + +329 +00:28:48,570 --> 00:28:56,430 +عندنا ال normal حجم الخلايا الIndothelium الحجم + +330 +00:28:56,430 --> 00:29:04,080 +ال sizeحجم الخلايا تقريبا من تلاتمية لاربعمية + +331 +00:29:04,080 --> 00:29:11,340 +مايكرونز، طب عددهم جداش؟ العدد يعني تقريبا ال + +332 +00:29:11,340 --> 00:29:17,970 +average ستلاف و خمسمية خليةإذا عندنا Endothelial + +333 +00:29:17,970 --> 00:29:23,890 +polymegathism is a greater than normal variation + +334 +00:29:23,890 --> 00:29:29,270 +of cell size in the corneal endothelial mosaic + +335 +00:29:29,270 --> 00:29:33,010 +observed with the biomicroscope or the clinical + +336 +00:29:33,010 --> 00:29:38,280 +specular microscopeإذا هو زيادة في حجم الخلايا + +337 +00:29:38,280 --> 00:29:42,040 +الاندوثيليام طبعا عندنا ال normal range لها من + +338 +00:29:42,040 --> 00:29:46,680 +تلاتمية إلى أربعمية بصير يعني العدد أو الحجم عفوا + +339 +00:29:46,680 --> 00:29:50,820 +يعني ال diameter اللي خاص في الخلايا هذه بيصبح من + +340 +00:29:50,820 --> 00:29:56,680 +ستمية لسبعمية مليمترهذا ممكن اللي هو فحصه من خلال + +341 +00:29:56,680 --> 00:30:01,560 +الـ biomicroscope أو الاستلام أو في عندنا ال + +342 +00:30:01,560 --> 00:30:06,140 +microscope يعني ببعنى أنه بناخد شريحة عينة و بنعمل + +343 +00:30:06,140 --> 00:30:09,880 +اللي هو قياس ل ال diameter of the cells + +344 +00:30:13,130 --> 00:30:18,630 +في هناك grade أي بمعنى بتديني fixed value قيمة هذا + +345 +00:30:18,630 --> 00:30:22,970 +ال grade او ال score it is graded by the + +346 +00:30:22,970 --> 00:30:27,650 +coefficient of variation of cell area له رمز + +347 +00:30:27,650 --> 00:30:33,930 +abbreviation CV هذا بمعنى قداش حجم الخلايا الحجم + +348 +00:30:33,930 --> 00:30:38,990 +الخاص في الخلايا هو بتدينيه ك number او ك value + +349 +00:30:50,840 --> 00:30:55,220 +وهذا أيضا ال range يعني تقريبا من خمسة و عشرين + +350 +00:30:55,220 --> 00:30:58,780 +لتلاتين في المية okay هذا في حالة ال normal + +351 +00:30:58,780 --> 00:31:03,440 +الطبيعي دايما بيكون قيمته من خمسة و عشرين لتلاتين + +352 +00:31:03,440 --> 00:31:10,980 +في الميةولكنها قد تكون مرتفعة حوالي 46% في مريض + +353 +00:31:10,980 --> 00:31:18,620 +يمتلك عمره 20 سنة من اكسجين ومشروع ديالي وير أو + +354 +00:31:18,620 --> 00:31:24,800 +خمس سنة من مجلد هيدروجيليعني هذه القيمة ممكن انه + +355 +00:31:24,800 --> 00:31:28,740 +ازيد لمريض مثلا لابس عدسة لاسقة من عشرين سنة + +356 +00:31:28,740 --> 00:31:32,860 +conventional daily wear أو واحد من خمس سنوات بلبس + +357 +00:31:32,860 --> 00:31:36,600 +عدسات extended wear، اذا القيمة ايش مالها؟ هزيد + +358 +00:31:36,600 --> 00:31:43,660 +عنده، هيكون تقريبا ال normal بالنسبة له 46% مقارنة + +359 +00:31:43,660 --> 00:31:46,220 +في مين؟ في الأشخاص اللي طبيعيين + +360 +00:31:50,180 --> 00:31:53,720 +طيب ان شاء الله نقفلها ال corneal excision + +361 +00:31:53,720 --> 00:31:57,140 +syndrome في اي سؤال اي استفسار؟ + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/s7myczgRoRM.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/s7myczgRoRM.srt new file mode 100644 index 0000000000000000000000000000000000000000..cccbbd10b122ab285ccbc701e21da9d01a02acd8 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/s7myczgRoRM.srt @@ -0,0 +1,1567 @@ +1 +00:00:29,650 --> 00:00:31,690 +وصلنا للـ trial + +2 +00:01:08,380 --> 00:01:15,020 +أهي بمعنى أنه العدسات متوفرة عندي في داخل المركز + +3 +00:01:15,020 --> 00:01:20,730 +أو متوفرة عندنا في داخل المعمل الـ trial or + +4 +00:01:20,730 --> 00:01:26,430 +diagnostic lenses are often used in fitting + +5 +00:01:26,430 --> 00:01:34,590 +software lenses تمام، إذا الطريقة اللي بتعتمد على + +6 +00:01:34,590 --> 00:01:41,230 +التجريب okay غالبا بتستخدم في عملية الـ fitting + +7 +00:01:41,230 --> 00:01:48,450 +لهذا النوع من العدسات The practitioner أو الفتر + +8 +00:01:48,450 --> 00:01:54,690 +تمام can select a trial lens based on keratometry. + +9 +00:01:55,350 --> 00:02:03,070 +إذا المريض بيعتمد على موضوع الـ base curve أو موضوع + +10 +00:02:03,070 --> 00:02:07,950 +الـ radius أو الـ key reading في اللي هو اختيار إيه؟ + +11 +00:02:07,950 --> 00:02:13,750 +في اختيار اللي هو العدسة الملائمة أو العدسة + +12 +00:02:13,750 --> 00:02:20,300 +المناسبة أو بنسميها الـ back optic zone radius back + +13 +00:02:20,300 --> 00:02:24,780 +optic zone radius طبعا وهذه الطريقة هي بتكون + +14 +00:02:24,780 --> 00:02:29,280 +مشابهة لطريقة من الـ spherical soft contact lenses + +15 +00:02:29,280 --> 00:02:33,840 +بمعنى آخر أنه بنضيف تقريبا من اثنين من عشرة ل + +16 +00:02:33,840 --> 00:02:46,800 +ثمانية من عشرة millimeter over the flattest key + +17 +00:02:46,800 --> 00:02:47,160 +reading + +18 +00:02:52,160 --> 00:02:55,980 +طبعا زي ما ذكرنا أنه كل ما زاد الـ base curve في + +19 +00:02:55,980 --> 00:03:00,520 +العدسات الـ software contact lenses هذا بيكون أفضل + +20 +00:03:00,520 --> 00:03:05,260 +عشان موضوع الـ stability و الـ rotation بالنسبة + +21 +00:03:05,260 --> 00:03:12,970 +للعدسات ويسمح لشخص بيختار ديامتر من 3 ملليمتر إلى + +22 +00:03:12,970 --> 00:03:19,510 +4 ملليمتر أكثر من الـ visible cornea طبعا بعض الفتر + +23 +00:03:19,510 --> 00:03:24,850 +بفضل اختيار ديامتر فوق الـ visible iris diameter من + +24 +00:03:24,850 --> 00:03:29,850 +3 إلى 4 ولكن إحنا في المعمل طبقنا اللي هو نظرية من + +25 +00:03:29,850 --> 00:03:35,550 +0.5 to 2 ملي متر والنتيجة اللي هو صحيحة حسب إيش + +26 +00:03:35,550 --> 00:03:38,770 +المعطيات اللي عندي أو حسب اللي هو الـ trial case + +27 +00:03:38,770 --> 00:03:44,110 +اللي موجود عندي في داخل المعمل Lens rotation and + +28 +00:03:44,110 --> 00:03:49,710 +stability are critical to a successful fit إذن + +29 +00:03:49,710 --> 00:03:54,910 +دوران العدسة وثباتها طبعا هناك اختلاف في المصطلحين + +30 +00:03:54,910 --> 00:03:58,310 +ما بين الـ lens rotation و الـ lens stability هنأتي + +31 +00:03:58,310 --> 00:04:01,730 +إليه كمان شوية هذا يعتبر critical إيش معناه + +32 +00:04:01,730 --> 00:04:05,350 +critical؟ أي بمعنى necessary اللي هو ضروري في + +33 +00:04:05,350 --> 00:04:08,350 +عملية نجاح الـ fitting للعدسة + +34 +00:04:11,740 --> 00:04:18,740 +عند التفكير في الوصفات العصبية أولا + +35 +00:04:18,740 --> 00:04:24,840 +أختار عصب تجارب مع أجهزة تقريبا تقريبا تقريبا + +36 +00:04:24,840 --> 00:04:29,080 +تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا + +37 +00:04:29,080 --> 00:04:29,640 +تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا + +38 +00:04:29,640 --> 00:04:29,700 +تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا + +39 +00:04:29,700 --> 00:04:37,840 +تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا تقريب + +40 +00:04:38,400 --> 00:04:43,880 +الخطوة الأولى أنه يتم اختيار access قريب من مين من + +41 +00:04:43,880 --> 00:04:49,480 +الوصفة يعني ثلاثين إذا كان عند الـ access في العدسة + +42 +00:04:49,480 --> 00:04:53,580 +الـ diagnostic أو الـ trial خمسة وثلاثين أو أربعين + +43 +00:04:53,580 --> 00:04:59,520 +أختارها إذا الخطوة الأولى أنه يتم اختيار العدسة + +44 +00:04:59,520 --> 00:05:03,680 +اللي هي الـ trial التجربية قريبة من مين من قيمة الـ + +45 +00:05:03,680 --> 00:05:09,340 +access اللي عند الـ patient أو اللي بيعاني منه + +46 +00:05:09,340 --> 00:05:15,640 +المريض الخطوة الثانية أنه بختار الـ power بتاع الـ + +47 +00:05:15,640 --> 00:05:20,360 +cylinder أيضا يكون قريب من إيه؟ من قيمة اللي هو الـ + +48 +00:05:20,360 --> 00:05:24,780 +cylinder power اللي خاص بالمريض الخطوة الثالثة + +49 +00:05:24,780 --> 00:05:29,180 +اللي هو موضوع الـ sphere طبعا الـ sphere دائما بنفضل + +50 +00:05:29,180 --> 00:05:33,420 +اختياره أن يكون أكثر أو أقل بقيمة اثنين ديوبتر + +51 +00:05:34,780 --> 00:05:37,600 +first select الخيار الأول + +52 +00:05:46,610 --> 00:05:51,830 +دائما يا جماعة هان بدي آخذ بعين الاعتبار أنه كل ما + +53 +00:05:51,830 --> 00:05:56,070 +زاد قيمة الـ refractive error من ناحية السيلندر كل ما + +54 +00:05:56,070 --> 00:05:59,590 +كان تأثير الـ one أو الـ two degrees إيش يعتبر + +55 +00:05:59,590 --> 00:06:04,990 +عالي يعني بمعنى أن المريض عنده high sensitivity + +56 +00:06:04,990 --> 00:06:10,000 +حساسية عالية لعملية الـ rotation للعدسة وكل ما كان + +57 +00:06:10,000 --> 00:06:14,040 +عنده refractive erogalel لو مثلا عشرة ديجري أو + +58 +00:06:14,040 --> 00:06:18,180 +خمسة عشر ديجري ما حتكون مؤثرة كثير بالنسبة لهذا + +59 +00:06:18,180 --> 00:06:26,020 +المريض next select يعني الخطوة اللي هي الأخرى أو + +60 +00:06:26,020 --> 00:06:29,760 +الاختيار الثاني the cylinder power قوة إيه الـ + +61 +00:06:29,760 --> 00:06:34,860 +cylinder lens if a given a choice لو هو أداني إيه + +62 +00:06:34,860 --> 00:06:40,810 +خيار To under correct the vertex cylinder power + +63 +00:06:40,810 --> 00:06:45,250 +دائما في قيمة السيلندر بأخذ under correction ما بأخذش + +64 +00:06:45,250 --> 00:06:49,190 +over correction وكأنه أنا بأعمل إيه الـ trial عادي + +65 +00:06:49,190 --> 00:06:52,490 +اللي هو للمضارة يعني مثلا لو المريض عنده minus + +66 +00:06:52,490 --> 00:06:56,370 +واحد وخمسة وسبعين بأخذ minus واحد وربع أو minus + +67 +00:06:56,370 --> 00:07:02,020 +واحد اللي هو أقل under correction third select أو + +68 +00:07:02,020 --> 00:07:06,280 +third step the spherical power closest within two + +69 +00:07:06,280 --> 00:07:10,580 +diopters to the refractive power طبعا هنا المقصود + +70 +00:07:10,580 --> 00:07:15,740 +فيها اثنين ديوبتر أما زيادة أو اللي هو نقصان ليش + +71 +00:07:15,740 --> 00:07:20,180 +أنه في الآخر أنا إيش هعمل over refraction تمام؟ + +72 +00:07:24,540 --> 00:07:27,740 +السبب في ذلك أنه غير متوفر عندي في الـ trial set + +73 +00:07:27,740 --> 00:07:32,260 +يعني أنا لو عندي مثلا minus ثلاثة minus واحد ونصف + +74 +00:07:32,260 --> 00:07:36,380 +access ثلاثين بديلوها هي بتكون العدسة الملائمة لكن + +75 +00:07:36,380 --> 00:07:40,280 +هاي إحنا اشتغلنا في العمل هل حاطي أما عملتي للـ + +76 +00:07:40,280 --> 00:07:43,740 +patient رغم أنه عندنا small refractive error البعض + +77 +00:07:43,740 --> 00:07:48,340 +لجيتيها موجودة الوصفة لأن هذه بدها تكلفة عالية أن + +78 +00:07:48,340 --> 00:07:52,860 +كل بور لازم تجيها وين موجودة في داخل الـ trial set + +79 +00:07:54,830 --> 00:07:59,410 +Lenses should be allowed to equilibrate أي بمعنى + +80 +00:07:59,410 --> 00:08:04,150 +توازن on the eye for ten to twenty minutes before + +81 +00:08:04,150 --> 00:08:09,610 +evaluation يعني ثبات العدسة في داخل العين بعد ما + +82 +00:08:09,610 --> 00:08:13,390 +أنا أعمل لها insertion بيستغرق تقريبا من عشرة + +83 +00:08:13,390 --> 00:08:20,010 +إلى عشرين إيه؟ اللي هو دقيقة ولكن إحنا زي ما اللي هو + +84 +00:08:20,010 --> 00:08:23,610 +عملنا اللي هو بعد خمس دقائق يعني هذه عبارة عن + +85 +00:08:23,610 --> 00:08:36,110 +دراسات ومختلفة إذا فقط + +86 +00:08:36,110 --> 00:08:40,130 +بعد خمس دقائق ليش؟ أنه إحنا دائما بنحاول أنه نعمل + +87 +00:08:40,130 --> 00:08:44,210 +saving للـ time سواء للمريض أو لو كنا في داخل + +88 +00:08:44,210 --> 00:08:44,850 +المعمل + +89 +00:08:49,280 --> 00:08:55,460 +Manufacturers offer a wide range of parameters in + +90 +00:08:55,460 --> 00:09:02,360 +trick trial sets دائما بدك تعرف أن المصنع أو الناس + +91 +00:09:02,360 --> 00:09:07,220 +اللي بيقوموا بصناعة هذا النوع من العدسات دائما + +92 +00:09:07,220 --> 00:09:11,720 +عندهم اللي هو تفكير مستمر في كيفية راحة المريض + +93 +00:09:11,720 --> 00:09:17,360 +فدائما بعمل اللي هو عملية new method يعني طريقة + +94 +00:09:17,360 --> 00:09:18,000 +إيه؟ + +95 +00:09:23,060 --> 00:09:28,020 +عشان يعمل راحة للمريض ويُوفر أكبر قدر ممكن من مين + +96 +00:09:28,020 --> 00:09:38,180 +من العدسات دائما + +97 +00:09:38,180 --> 00:09:44,580 +الـ manufacturers أو الفترز هم بيحاولوا أن يبتكروا + +98 +00:09:44,580 --> 00:09:49,150 +طرق جديدة في كيفية اللي هو حصر كل الـ refractive + +99 +00:09:49,150 --> 00:09:54,210 +error للأشخاص في اللي هو إيه الـ trial set واحدة + +100 +00:09:54,210 --> 00:09:59,810 +تمام أيضا عندنا الـ parameters في داخل الـ software + +101 +00:09:59,810 --> 00:10:04,590 +الـ contact lenses بتكون كثيرة بتتكون من number one + +102 +00:10:04,590 --> 00:10:09,870 +diameter number two base curve number three power + +103 +00:10:09,870 --> 00:10:14,730 +الـ power إيش بيشمل الـ sphere والسلندر + +104 +00:10:16,860 --> 00:10:21,580 +وبالإضافة له اللي هو الـ axis فدايما بيحاول أنه + +105 +00:10:21,580 --> 00:10:26,100 +يحصر الـ refractive errors لجميع الأشخاص في داخل + +106 +00:10:26,100 --> 00:10:32,280 +هذه الـ trial set which makes هذه هتعمل على صناعة + +107 +00:10:32,280 --> 00:10:37,320 +it easy to fit أنه بيسهل في عملية اللي هو إيه الـ + +108 +00:10:37,320 --> 00:10:43,500 +fitting للـ patient to fit most astigmatic patients + +109 +00:10:43,500 --> 00:10:48,340 +معظم المرضى اللي بيعانوا من refractive astigmatism + +110 +00:10:48,340 --> 00:10:54,780 +أو residual astigmatism the average trial sets has + +111 +00:10:54,780 --> 00:11:00,580 +many blister packs so that reusable lenses are no + +112 +00:11:00,580 --> 00:11:04,800 +longer necessary زي ما لاحظنا الـ trial set في داخل + +113 +00:11:04,800 --> 00:11:12,530 +الجامعة الها مجموعة منفصلة اللي هو blister bags + +114 +00:11:12,530 --> 00:11:17,730 +بقص بمعنى حزم أو بمعنى اللي هو طبقات وبتكون كأنها + +115 +00:11:17,730 --> 00:11:21,130 +عبارة عن blister الطبقة الأولى، الثانية، الثالثة + +116 +00:11:21,130 --> 00:11:25,930 +أو الرابعة هذا إيش بيسهل في عملية إعادة استخدام + +117 +00:11:25,930 --> 00:11:31,530 +العدسة لكن مش لفترة زمنية طويلة يعني بمعنى آخر، + +118 +00:11:31,530 --> 00:11:36,690 +عندنا مريض الـ refractive error له المثال السابق + +119 +00:11:36,690 --> 00:11:41,290 +ناقص ثلاثة أو ناقص واحد ونصف access ثلاثين طب + +120 +00:11:41,290 --> 00:11:44,890 +هذا الشخص بده ثلاث جلسات أو أربع جلسات مش معقول + +121 +00:11:44,890 --> 00:11:48,890 +أنه كل جلسة بده أديها عدسة جديدة تجريبية فأنا ممكن + +122 +00:11:48,890 --> 00:11:54,490 +أحافظ على هذه العدسة لفترة زمنية ولكن إشملها لا + +123 +00:11:54,490 --> 00:11:55,790 +تكون طويلة + +124 +00:12:01,270 --> 00:12:05,310 +Empirical fitting اللي هي الطريقة إيه اللي بتعتمد + +125 +00:12:05,310 --> 00:12:11,970 +بالدرجة الأولى على مهارة أو خبرة مين الـ + +126 +00:12:11,970 --> 00:12:17,590 +practitioner طبعا في الطريقة هذه في عاملين مهمين + +127 +00:12:17,590 --> 00:12:27,090 +العامل الأول الـ practitioner والعامل + +128 +00:12:27,090 --> 00:12:33,800 +الثاني اللي هو الـ fitter أو الـ Manufacturer دائما + +129 +00:12:33,800 --> 00:12:39,080 +يا جماعة يما يكون أنا عندي patient وعنده + +130 +00:12:39,080 --> 00:12:42,780 +refractive error very high بتكلم عن الـ cylinder + +131 +00:12:42,780 --> 00:12:47,980 +دائما أنا بعتمد هان على الـ empirical method يعني + +132 +00:12:47,980 --> 00:12:52,920 +بعتمد على خبرته الشخصية وأيضا على الـ + +133 +00:12:52,920 --> 00:12:58,760 +recommendation أو التوصيات اللي بقدمها إلى مين اللي + +134 +00:12:58,760 --> 00:13:03,100 +بقدمها إليه اللي هو الفتر أو الـ manufacturer ليش؟ + +135 +00:13:03,100 --> 00:13:09,080 +طيب دائما لما المريض يكون عنده نفترض ناقص خمسة + +136 +00:13:09,080 --> 00:13:14,860 +أو ستة أو سبعة cylinder من الصعب ألاجه هذه القيمة + +137 +00:13:14,860 --> 00:13:19,660 +وين؟ موجودة في داخل الـ trial set طيب ممكن طالبة + +138 +00:13:19,660 --> 00:13:22,600 +ثانية تحكي لي ممكن طيب نجرب معها ناقص اثنين و + +139 +00:13:22,600 --> 00:13:27,190 +نعمل لها إيش؟ over refraction كلام مية في المية جميل + +140 +00:13:27,190 --> 00:13:32,170 +نظريا، ولكن عمليا لو patient عندها ناقص سبعة أو + +141 +00:13:32,170 --> 00:13:36,350 +minus خمسة ودناها minus اتنين هتقولك مش شايفة، لو + +142 +00:13:36,350 --> 00:13:40,190 +لبسناها العدسة هتقولك لأ مش مرتاح أنا حتى ولو + +143 +00:13:40,190 --> 00:13:44,190 +عملنا ايه over refraction ليش طيب؟ لأنه هتكون high + +144 +00:13:44,190 --> 00:13:47,910 +sensitivity عندها الحساسية عالية كتير يعني حتى لو + +145 +00:13:47,910 --> 00:13:51,110 +استخدمنا ال Jackson cross cylinder و عملنا عملية + +146 +00:13:51,110 --> 00:13:55,630 +rotation هيبقى ال one degree مؤثر بالنسبة له + +147 +00:13:55,630 --> 00:13:59,870 +فدائما ايش بتشكي انه لأ a blurred vision مش مرتاحة + +148 +00:13:59,870 --> 00:14:04,590 +فدائما زي ما اتفقنا الـ Empirical fitting أو الـ + +149 +00:14:04,590 --> 00:14:08,070 +Empirical method بحب أنا استخدمها مع الأشخاص اللي + +150 +00:14:08,070 --> 00:14:12,110 +عندهم high refractive cylinder أو high refractive + +151 +00:14:12,110 --> 00:14:16,610 +error السبب أنه ما فيش في داخل ال trial set عدسة + +152 +00:14:16,610 --> 00:14:22,460 +ملائمة أو مناسبة لمين أو كافية لهذا المريض الشغلة + +153 +00:14:22,460 --> 00:14:26,260 +التانية أنه أنا لما بقدم ال diameter و ال base + +154 +00:14:26,260 --> 00:14:29,960 +curve و ال refractive error للمصنع ممكن هو يديني + +155 +00:14:29,960 --> 00:14:34,080 +recommendation أو يديني حلول جديدة أنا ايش متجاية + +156 +00:14:34,080 --> 00:14:38,560 +في بالي أو method اللي هو جديد في كيفية اللي هو + +157 +00:14:38,560 --> 00:14:42,820 +ايه إعطاء العدسة الملائمة أو المناسبة يعني بمعنى + +158 +00:14:42,820 --> 00:14:48,040 +أنه بسمع اقتراحات جديدة أو بمعنى آخر اللي هو توصيات + +159 +00:14:48,040 --> 00:14:54,520 +جديدة من قبل المصنع لهذا النوع من العدسات تمام؟ + +160 +00:14:54,520 --> 00:14:59,160 +إذا الـ Empirical fitting can also be used to + +161 +00:14:59,160 --> 00:15:05,130 +successfully fit soft toric lens مع هذه الطريقة، + +162 +00:15:05,130 --> 00:15:11,010 +يمكن للدراسة أن تقدم المعلومات إلى مصمم المصنع أو + +163 +00:15:11,010 --> 00:15:18,970 +المصنع + +164 +00:15:18,970 --> 00:15:25,190 +أو تستخدم تجارب كلينك أو تعتمد على خبرتك الشخصية + +165 +00:15:25,190 --> 00:15:29,090 +يعني to our knowledge معلوماتي أو to our best + +166 +00:15:29,090 --> 00:15:35,010 +knowledge to determine عشان أحدد مين ال base curve + +167 +00:15:35,010 --> 00:15:39,730 +and the prescription اللي هو الوصفة based on + +168 +00:15:39,730 --> 00:15:44,550 +spectacle refraction and keratometer readings بناء + +169 +00:15:44,550 --> 00:15:48,250 +على قراءات ال keratometer readings وأيضا اللي هو وصفة مين + +170 +00:15:48,250 --> 00:15:49,110 +المريض + +171 +00:15:53,670 --> 00:15:58,350 +Various studies هناك مجموعة من الدراسات طبعا هذه + +172 +00:15:58,350 --> 00:16:01,510 +الدراسات كلها كانت cross-sectional study + +173 +00:16:01,510 --> 00:16:08,650 +Demonstrated أي بمعنى Shown وضحت أو بينت a high + +174 +00:16:08,650 --> 00:16:13,830 +success نجاح عالي أو نجاح كبير أو معدلهو نجاح كبير + +175 +00:16:13,830 --> 00:16:18,330 +مع استخدام هذا ال method تقريبا قد إيش من واحد وستة + +176 +00:16:18,330 --> 00:16:23,170 +لواحد وثمانية اللي هو بيحتاجها كيف يعني؟ الآن أنا + +177 +00:16:23,170 --> 00:16:27,330 +كل شخصين بعملهم اللي هو fitting empirical fitting + +178 +00:16:27,330 --> 00:16:31,750 +بنجح منهم يعني واحد وستة يعني ممكن خلينا نقول + +179 +00:16:31,750 --> 00:16:37,170 +اللي هو تقريبا نسبة الفشل اللي هو seventy to اللي + +180 +00:16:37,170 --> 00:16:41,450 +هو خيارتي بالشكل هذا اللي هو نسبة النجاح ونسبة + +181 +00:16:41,450 --> 00:16:47,670 +الفشل needed for successful fitting of high + +182 +00:16:47,670 --> 00:16:51,590 +cylinder over three diopter powers وهذه تكون أكثر + +183 +00:16:51,590 --> 00:16:56,330 +فعالية أو أكثر نجاحا مع الأشخاص اللي بيكون عندهم + +184 +00:16:56,330 --> 00:16:59,830 +قيمة السيلندر أكثر من تلاتة ديوبتر + +185 +00:17:04,670 --> 00:17:09,230 +There is evidence أن هذا ال evidence إيش معناه؟ + +186 +00:17:09,230 --> 00:17:12,950 +اللي هو المساعد أو اللي هو an evidence بمعنى اللي + +187 +00:17:12,950 --> 00:17:17,410 +هو ك famous، اللي هو جهاز مشهور ممكن يساعدنا في + +188 +00:17:17,410 --> 00:17:21,330 +عملية ال fitting هو عبارة عن ال corneal topography + +189 +00:17:21,330 --> 00:17:25,150 +طيب، إبراكم ال corneal topography كيف بيساعد في + +190 +00:17:25,150 --> 00:17:30,310 +عملية ال fitting؟ في خيار عليه اللي ممكن لو عندنا + +191 +00:17:30,310 --> 00:17:33,070 +موجود نوع العدسة اللي بيعمل موجود نفسه في الجهاز + +192 +00:17:33,070 --> 00:17:36,430 +أنه ممكن نحط .. نحط برق الجهاز نفسه من غير ما نحط + +193 +00:17:36,430 --> 00:17:40,070 +العدسة في عين المريض تمام وبيطلعنا كيف القيامة و + +194 +00:17:40,070 --> 00:17:43,950 +كيف ممكن .. إيش نعمله تطلع تقنين صح عليه ولا .. + +195 +00:17:43,950 --> 00:17:49,750 +طيب another answer تمام كلامك سليم لكن في أيضا + +196 +00:17:49,750 --> 00:17:55,030 +اللي هو another answer هو في اتصال اللي كنا + +197 +00:17:55,030 --> 00:17:59,910 +مستخدمه نحكي هو بيعمل محكة زي اللي هو في موضوع ال + +198 +00:17:59,910 --> 00:18:03,230 +law أو ال high order aberration لكن الفكرة هنا في + +199 +00:18:03,230 --> 00:18:07,530 +ال corneal topography أول حاجة أنه بيحدد لي ال + +200 +00:18:07,530 --> 00:18:12,330 +type of astigmatism يعني بيحكي لي مثلا المريض عنده + +201 +00:18:12,330 --> 00:18:15,770 +with the rule of astigmatism المريض عنده against the + +202 +00:18:15,770 --> 00:18:19,810 +rule of astigmatism المريض عنده oblique cylinder طيب + +203 +00:18:19,810 --> 00:18:23,630 +الآن يما أنا بعرف المريض عنده against the rule of + +204 +00:18:23,630 --> 00:18:27,620 +astigmatism إذا مين أفضل خيار له؟ الـ software + +205 +00:18:27,620 --> 00:18:31,860 +contact lenses ليش؟ لأن ال RGB كنا بتعمل اللي هو + +206 +00:18:31,860 --> 00:18:37,240 +Decentration nasal و temporal فمن هنا أنا بانطلق + +207 +00:18:37,240 --> 00:18:41,560 +أن هنا أفضل خيار لهذا ال patient هو عبارة عن ال + +208 +00:18:41,560 --> 00:18:45,700 +software contact lenses شغل ثاني أن الكورنيا + +209 +00:18:45,700 --> 00:18:49,620 +التمоغرافي بيحدد لي كل ال zone أو ال area اللي + +210 +00:18:49,620 --> 00:18:54,660 +بيكون فيها steep وبيكون فيها flat power صح ولا + +211 +00:18:54,660 --> 00:18:55,140 +لا؟ + +212 +00:18:58,250 --> 00:19:05,010 +و ال R maximum و ال R minimum تمام؟ وأيضا بالدينة + +213 +00:19:05,010 --> 00:19:09,010 +اللي هو لو أنا كنت مثلا شخص عنده against the rule + +214 +00:19:09,010 --> 00:19:14,070 +وماشي باتجاه ال RGB هيقول لي هذا الاكتشاف أو هذا + +215 +00:19:14,070 --> 00:19:17,690 +التنبؤ أو هذا التخمين اللي خاص فيك إيش ماله؟ + +216 +00:19:17,690 --> 00:19:23,930 +failure اللي هو خاطئ أو غير صحيح أو فاشل تمام؟ إذا + +217 +00:19:23,930 --> 00:19:25,770 +can help to predict + +218 +00:19:30,470 --> 00:19:35,610 +And patient to prepare for more lens changes أيضا + +219 +00:19:35,610 --> 00:19:39,330 +يا جماعة نقطة مهمة ثانية قلنا في هناك أربع صور + +220 +00:19:39,330 --> 00:19:43,970 +بتديها مين هذا الجهاز من ضمنها اللي هو elevation + +221 +00:19:43,970 --> 00:19:48,210 +map وشوفنا في ال elevation map بتديني إيش قيمة + +222 +00:19:48,210 --> 00:19:52,550 +اللي هو ال best sphere اللي من خلالها أنا ببدأ ال + +223 +00:19:52,550 --> 00:19:56,710 +first point أو ال initial point ل اللي هو ال base + +224 +00:19:56,710 --> 00:20:03,110 +curve high peripheral corneal toricity may predict + +225 +00:20:03,110 --> 00:20:08,290 +first lens failure هذه الجملة مهمة كتير وحابب + +226 +00:20:08,290 --> 00:20:13,210 +المطالبة أعمل explanation لها high peripheral + +227 +00:20:13,210 --> 00:20:18,670 +corneal toricity may predict first lens failure + +228 +00:20:18,670 --> 00:20:27,330 +okay من عندها إجابة طيب نيجي مع بعض one by one الآن + +229 +00:20:27,330 --> 00:20:35,550 +بداية ثانية يا جماعة ال corneal toricity + +230 +00:20:35,550 --> 00:20:40,290 +إيش + +231 +00:20:40,290 --> 00:20:44,110 +هتعمل induce + +232 +00:20:44,110 --> 00:20:48,350 +astigmatism + +233 +00:20:48,350 --> 00:20:53,570 +إيش معنى induce astigmatism يعني قيمة ال + +234 +00:20:53,570 --> 00:21:01,100 +astigmatism المستحدثة يعني بمعنى آخر لو حدث هناك أي + +235 +00:21:01,100 --> 00:21:06,760 +ت rotation أو unstability، عدم ثبات للعدسة ال + +236 +00:21:06,760 --> 00:21:13,650 +software هيعمل إيه؟ induce a stigmatism الـ corneal + +237 +00:21:13,650 --> 00:21:19,750 +toricity usually do induce astigmatism أي بمعنى + +238 +00:21:19,750 --> 00:21:24,430 +قيمة ال astigmatism المستحدثة، ممكن هذه القيمة + +239 +00:21:24,430 --> 00:21:28,870 +بتنتج نتيجة ال rotation أو ال unstability لمين + +240 +00:21:28,870 --> 00:21:34,220 +للعدسات السوفتوريك طيب، الآن أنا روحت عملت corneal + +241 +00:21:34,220 --> 00:21:39,500 +topography لجيت أن قيمة ال peripheral zone أو ال + +242 +00:21:39,500 --> 00:21:44,600 +peripheral area فيها اللي هو corneal toricity و + +243 +00:21:44,600 --> 00:21:48,360 +لجناها اللي هو high power يعني over اللي هو ال + +244 +00:21:48,360 --> 00:21:52,120 +range value يعني قيمتها أن steep cornea + +245 +00:21:56,470 --> 00:22:00,810 +إذا لاحظنا إن المنطقة كل البريفيرال هان اللي هي + +246 +00:22:00,810 --> 00:22:07,910 +فيها steep cornea هان وأنا مثلا أديت للمريض base + +247 +00:22:07,910 --> 00:22:12,230 +care دائما احنا أو بتعرفوا أن الأجهزة بتعتمد على + +248 +00:22:12,230 --> 00:22:17,190 +منطقة مين ال center zone لكن هنا عندي وين ال steep + +249 +00:22:17,190 --> 00:22:20,670 +area أو عفوا ال steep corneal power كانت في ال + +250 +00:22:20,670 --> 00:22:24,570 +peripheral فهنا بتديني indication أن أنت عندك إيه + +251 +00:22:24,570 --> 00:22:29,030 +مشكلة في عملية ال fitting لاختيار العدسة أو بمعنى + +252 +00:22:29,030 --> 00:22:33,470 +آخر اختيار هذه العدسة غير ملائم أو غير مناسب لهذا + +253 +00:22:33,470 --> 00:22:37,530 +المريض مين اللي قادر على اكتشاف ذلك؟ اللي هو ال + +254 +00:22:37,530 --> 00:22:41,490 +corneal topography. ليش؟ لأن البساطة ال corneal + +255 +00:22:41,490 --> 00:22:44,870 +topography قادر أنه ياخد اللي موجود عندنا في + +256 +00:22:44,870 --> 00:22:52,110 +المعمل أكثر من ثمان تلاف discrete points + +257 +00:22:53,760 --> 00:22:58,680 +وقلنا بعض الأجهزة زي البنت كام بيصل لأكثر من 32 + +258 +00:22:58,680 --> 00:23:05,420 +ألف وفيه 64 ألف وفي بعض الأجهزة اليوم 132 ألف اللي + +259 +00:23:05,420 --> 00:23:09,260 +هو discrete points تمام؟ + +260 +00:23:12,370 --> 00:23:17,830 +The advantage of using empirical fitting include + +261 +00:23:17,830 --> 00:23:22,690 +fitting high powers sphere or high cylinder reduce + +262 +00:23:22,690 --> 00:23:27,870 +chair time يعني هو أيضا بيقلل من إيش؟ من الوقت يعني + +263 +00:23:27,870 --> 00:23:31,810 +بدل ما أنا مثلا أقعد أربع جلسات أو تلات جلسات مع + +264 +00:23:31,810 --> 00:23:37,550 +المريض ممكن جلستين فبيقلل من قيمة من استهلاك الوقت + +265 +00:23:37,550 --> 00:23:44,810 +ما بين الفترة قمين وال patient And reduced need for + +266 +00:23:44,810 --> 00:23:50,670 +inventory of trial lenses أيضا بيوفر من عدد + +267 +00:23:50,670 --> 00:23:55,590 +العدسات اللي موجودة في المستودع أو المخزن يعني بدل + +268 +00:23:55,590 --> 00:24:00,010 +ما يكون عندي مثلا ألف عدسة بيكون عندي مثلا مئتين أو + +269 +00:24:00,010 --> 00:24:05,310 +ثلاثمية عدسة إذا فيقلل من عدد العدسات المتوفرة في + +270 +00:24:05,310 --> 00:24:09,450 +داخل المستودع أو في داخل ال inventory المخزن + +271 +00:24:16,670 --> 00:24:22,390 +طيب الآن في عندنا مصطلحين مهمين المصطلح الأول هو + +272 +00:24:22,390 --> 00:24:27,970 +عبارة عن ال lens rotation والمصطلح الثاني هو عبارة + +273 +00:24:27,970 --> 00:24:40,410 +عن ال lens stability إذا عندنا lens rotation و + +274 +00:24:40,410 --> 00:24:42,130 +lens stability + +275 +00:24:47,090 --> 00:24:50,530 +ما هو الفرق ما بين ال lens rotation و ال lens + +276 +00:24:50,530 --> 00:24:58,250 +stability؟ ال lens rotation هو دوران أو حركة + +277 +00:24:58,250 --> 00:25:02,050 +العدسة عندما المريض يكون في ال primary position + +278 +00:25:03,320 --> 00:25:08,980 +يعني بمعنى أنه without a blinking تمام؟ okay you + +279 +00:25:08,980 --> 00:25:12,760 +have two important terms or two important + +280 +00:25:12,760 --> 00:25:18,690 +definitions lens rotation and lens stability Lens + +281 +00:25:18,690 --> 00:25:24,670 +rotation هو عبارة عن حركة أو دوران العدسة عندما + +282 +00:25:24,670 --> 00:25:28,530 +يكون ال patient في ال primary position يعني بدون + +283 +00:25:28,530 --> 00:25:34,390 +أي blinking أو بدون أي وقت يعني أول ما أنت بتضع + +284 +00:25:34,390 --> 00:25:38,850 +العدسة ال insertion من خلال ال slit lamp بتشوف اللي + +285 +00:25:38,850 --> 00:25:43,420 +هو جداش قيمة ال rotation للعدسة تمام؟ إذا ال lens + +286 +00:25:43,420 --> 00:25:48,940 +rotation is not the same as lens stability, okay. + +287 +00:25:48,940 --> 00:25:52,740 +You have two different important terms or + +288 +00:25:52,740 --> 00:25:57,020 +definitions. Number one, lens rotation هو حركة أو + +289 +00:25:57,020 --> 00:26:01,840 +دوران العدسة بدون أي blinking في ال primary position + +290 +00:26:01,840 --> 00:26:07,720 +بدون أي blinking بينما ال lens stability اللي + +291 +00:26:07,720 --> 00:26:11,900 +هو دوران أو حركة العدسة أثناء ما المريض بعمل + +292 +00:26:11,900 --> 00:26:16,560 +complete blinking أو أثناء اللي هو بعد فترة زمنية + +293 +00:26:16,560 --> 00:26:20,800 +معينة سواء اللي هو نفترض بعد الساعة أو بعد + +294 +00:26:20,800 --> 00:26:24,440 +الساعتين أو ممكن بعد الأسبوع، الآن هناخد كيف هذا + +295 +00:26:24,440 --> 00:26:28,990 +هيتم. Lens rotation is not the same as lens + +296 +00:26:28,990 --> 00:26:33,670 +stability. Rotation is the position of the lens in + +297 +00:26:33,670 --> 00:26:38,710 +a primary gaze. Stability refers، أي بمعنى يشير، to + +298 +00:26:38,710 --> 00:26:42,210 +the movement، حركة، of the lens axis أو ال marking + +299 +00:26:42,210 --> 00:26:45,930 +اللي هي الساعة اللي أخدناها الستة أو الساعة سبعة + +300 +00:26:45,930 --> 00:26:51,730 +صح؟ After a complete blink، بعد complete blink، + +301 +00:26:51,730 --> 00:26:58,490 +ترميش كامل، or a change over a، أو بعد فترة زمنية + +302 +00:26:58,490 --> 00:27:05,450 +إيه معينة. The lens axis should return quickly to + +303 +00:27:05,450 --> 00:27:09,750 +the same position following each blink and should + +304 +00:27:09,750 --> 00:27:15,330 +not fluctuate over time. دائمًا يا جماعة بعد ما أنا + +305 +00:27:15,330 --> 00:27:21,230 +بعمل complete blink، ال axis إما بيعود لطبيعته أو + +306 +00:27:21,230 --> 00:27:26,460 +بيعود لقيمة اللي تم تحديده. لذلك دائمًا العدسة ال + +307 +00:27:26,460 --> 00:27:29,420 +software، ال contact lenses، يما يتم عملية ال + +308 +00:27:29,420 --> 00:27:34,140 +evaluation لها لابد من الانتباه لل lens stability + +309 +00:27:34,140 --> 00:27:38,440 +للعدسة، و أيضًا ال fluid اللي بيكون ما بين ال + +310 +00:27:38,440 --> 00:27:41,960 +posterior surface للعدسة و ال anterior surface + +311 +00:27:41,960 --> 00:27:48,840 +لمن؟ للقرنية. Lens rotation should be noted in the + +312 +00:27:48,840 --> 00:27:54,000 +chart for each trial lens. الآن أنا لبست المريض + +313 +00:27:54,000 --> 00:27:58,980 +العدسة عملت rotation، لحظة ما تعمل rotation العدسة + +314 +00:27:58,980 --> 00:28:03,580 +طبعًا after complete blink أو بعد فترة زمنية معينة + +315 +00:28:03,580 --> 00:28:10,560 +المريض هيلاحظ إيش فيه deterioration اللي هو تدهور + +316 +00:28:10,560 --> 00:28:19,980 +في الرؤية تمام أو اختلاف في الرؤية. ابن + +317 +00:28:22,150 --> 00:28:26,750 +Dispensing of a lens, the rotation should be noted + +318 +00:28:26,750 --> 00:28:31,710 +and should be the same as the initial lens. لازم + +319 +00:28:31,710 --> 00:28:36,210 +أنا يما بصرف عن كلمة dispensing اللي هو صرف العدسة + +320 +00:28:36,210 --> 00:28:42,050 +عندما يتم اللي هو صرفها، لازم أنه يكون قيمة ال axis + +321 +00:28:42,050 --> 00:28:48,030 +هو مساوي لقيمة ال axis وين؟ الأصلي أو لقيمة ال + +322 +00:28:48,030 --> 00:28:52,790 +axis اللي تم استخدامه في اللي هو العدسة + +323 +00:28:52,790 --> 00:28:56,230 +التجريبية أو ال diagnostic أو ال trial method. + +324 +00:28:56,230 --> 00:29:02,410 +تمام؟ A test for stability consists of manually + +325 +00:29:02,410 --> 00:29:07,930 +moving the lens axis and observing the time needed + +326 +00:29:07,930 --> 00:29:13,410 +to relocate. يعني الآن أنا دائمًا بدي آخد فترة + +327 +00:29:13,410 --> 00:29:18,420 +زمنية. أنا بتكلم ك practitioner لازم أنه آخد فترة + +328 +00:29:18,420 --> 00:29:23,820 +زمنية معينة، أي بمعنى period time، لحد ما أدى اللي + +329 +00:29:23,820 --> 00:29:27,880 +هو إيه أشوف العدسة وين بدها تستقر أو وين بدها اللي + +330 +00:29:27,880 --> 00:29:32,300 +هو تعمل stability أو ال axis وين بده يكون اللي هو + +331 +00:29:32,300 --> 00:29:38,590 +مستقر. لأنه في بعض الأحيان بتاخد اللي هو history غير + +332 +00:29:38,590 --> 00:29:42,170 +صحيح من مين؟ من المريض، يعني بتكون العدسة حتى إما + +333 +00:29:42,170 --> 00:29:45,970 +أنا بضعها بالـ trial set، بقول لك لأ، الصورة واضحة + +334 +00:29:45,970 --> 00:29:49,250 +مئة في المئة، مع ذلك هي بتكون عاملة إيش؟ اللي هو + +335 +00:29:49,250 --> 00:29:54,930 +rotation، العدسة، أو بمعنى آخر إن المريض بتكونش + +336 +00:29:54,930 --> 00:29:58,850 +الفكرة وصلانه صح أو مش قادر يعبر بشكل صحيح عن + +337 +00:29:58,850 --> 00:30:00,170 +الرؤية. + +338 +00:30:01,910 --> 00:30:07,470 +النتيجة الجيدة ستكون لجهزة تقوم بتعديل التجارب إلى + +339 +00:30:07,470 --> 00:30:12,930 +نفس الموقع خلال 15 دقيقة. عشان هيك ال justification + +340 +00:30:12,930 --> 00:30:17,190 +أو الأسباب أنه ليش أنا بأخر عملية ال fitting لـ 15 + +341 +00:30:17,190 --> 00:30:22,470 +لـ 20 دقيقة، أنه أنا بدي اللي هو إيه أعرف قيمة ال + +342 +00:30:22,470 --> 00:30:25,670 +stability بالضبط أو قيمة اللي هو ال rotation + +343 +00:30:25,670 --> 00:30:31,990 +للعدسة يعني لحد ما تثبت اللي هو العدسة. سلوك + +344 +00:30:31,990 --> 00:30:39,310 +الانتقال بسرعة مرتبط بمجموعة قوية. دائمًا يما يكون + +345 +00:30:39,310 --> 00:30:43,730 +الحركة للعدسة اللي هو بطيئة، هلا بتديني انطباع أن + +346 +00:30:43,730 --> 00:30:49,250 +العدسة إيه شمالها، أنه قد تكون قوية أو قد تكون لنزا + +347 +00:30:49,250 --> 00:30:56,790 +قوية. عندما يتحرك لنزا على العين. + +348 +00:31:00,920 --> 00:31:04,400 +هو كمان اللي بيغلبنا في موضوع ال software contact + +349 +00:31:04,400 --> 00:31:08,500 +lenses evaluation، عندما يكون عندك ال oblique axis + +350 +00:31:08,500 --> 00:31:15,140 +يعني 145 أو 30 أو 45، ليش؟ لأنه بيعمل اللي هو حاجة + +351 +00:31:15,140 --> 00:31:19,040 +بنسميها induce astigmatism، يعني قيمة ال + +352 +00:31:19,040 --> 00:31:24,100 +astigmatism مستحدثة. As long as the rotation is + +353 +00:31:24,100 --> 00:31:29,280 +stable and not more than 30 degrees، جداش حكينا 30 + +354 +00:31:29,280 --> 00:31:34,280 +degrees اللي هي عبارة عن one hour تمام؟ The fit is + +355 +00:31:34,280 --> 00:31:39,640 +acceptable. إذا هيكون مقبول، يعني الآن في بعض + +356 +00:31:39,640 --> 00:31:44,720 +الحالات يما بيكون عندنا قيمة ال rotation أقل من + +357 +00:31:44,720 --> 00:31:50,240 +ثلاثين degree تمام، ممكن أن يكون عندنا العدسة هذه + +358 +00:31:50,240 --> 00:31:54,680 +مقبولة، لكن وين هذه الشرط؟ لازم يكون عندنا low + +359 +00:31:54,680 --> 00:32:00,800 +refractive error أو low sensitivity للمريض. However, + +360 +00:32:01,040 --> 00:32:05,580 +the lens axis needs to be adjusted to compensate + +361 +00:32:05,580 --> 00:32:11,200 +بمعنى تعويض، أنه يعمل عملية تعويض، for the rotation. + +362 +00:32:11,200 --> 00:32:16,700 +If the visual acuity is compromised، لكن هذا إذا + +363 +00:32:16,700 --> 00:32:20,860 +كان عندنا two degrees أو three degrees ومؤثرة على + +364 +00:32:20,860 --> 00:32:24,660 +ال visual acuity، لازم أنا أعمل عملية تعويض عشان + +365 +00:32:24,660 --> 00:32:28,460 +أحسن من مين؟ من ال visual acuity الخاص بالمريض. + +366 +00:32:29,870 --> 00:32:34,650 +Rotation is judged، يعني بمعنى تحكم عليها، يعني أنا + +367 +00:32:34,650 --> 00:32:39,030 +بحكم على اللي هو ال rotation by imaging a clock + +368 +00:32:39,030 --> 00:32:42,710 +face over the cornea، يعني دائمًا أنا بدي اعتبر + +369 +00:32:42,710 --> 00:32:46,650 +العدسة اللي لابسها هي عبارة عن ساعة أو عبارة عن a + +370 +00:32:46,650 --> 00:32:50,070 +stigmatic fan و بدي أشوف اللي هو قيمة ال rotation + +371 +00:32:50,070 --> 00:32:50,590 +لها. + +372 +00:32:57,190 --> 00:33:01,690 +خمس عشرة ثانية أو خمس عشرة دقيقة؟ بتتحكم فيها إنك + +373 +00:33:01,690 --> 00:33:06,070 +تتحكم فيها؟ لأ هي دائمًا fifteen seconds هو بذكر + +374 +00:33:06,070 --> 00:33:11,690 +ولكن أنا بقول كـ evaluation بشكل عام، يعني بمعنى آخر + +375 +00:33:11,690 --> 00:33:17,510 +الآن أنا بلبس المريض بنتظر اللي هو تقريبًا من خمس عشرة + +376 +00:33:17,510 --> 00:33:20,850 +لـ عشرين اللي هو minutes أو بنتظر اللي هو خمسة + +377 +00:33:20,850 --> 00:33:23,350 +minutes لكن هو اللي بقصد فيه في ال complete + +378 +00:33:23,350 --> 00:33:29,290 +blinking أو over a time، تمام؟ لكن هذا كله الشغل + +379 +00:33:29,290 --> 00:33:33,270 +اللي هو theory، يعني في ال practice الأمر بيختلف، + +380 +00:33:33,270 --> 00:33:37,290 +أنت حسب ما أنت إيش كـ observation اللي هو بيشوفه، + +381 +00:33:37,290 --> 00:33:39,910 +يعني إذا أنا شايف مثلًا ال fluid ما بين العدسة و + +382 +00:33:39,910 --> 00:33:43,770 +القرنية، بدي أعمل عملية إيه؟ اللي هو تأخير لهذا + +383 +00:33:43,770 --> 00:33:50,250 +القيمة. يعني بمعنى آخر أن الأرقام هنا مش مكان للحفظ + +384 +00:33:50,250 --> 00:33:54,270 +لأن هذه الأرقام هي اعتمدت على دراسات سابقة وقد + +385 +00:33:54,270 --> 00:34:03,150 +تتغير. طيب، lenses with a prism palest have markings + +386 +00:34:03,150 --> 00:34:08,870 +that are intended، عندما يتم وضع العدسة على القرنية، + +387 +00:34:08,870 --> 00:34:16,440 +أنه لازم نشبه العدسة وكأنها عبارة عن ساعة over the + +388 +00:34:16,440 --> 00:34:23,220 +cornea، وبناء على الساعة هذه اللي over أو ال clock + +389 +00:34:23,220 --> 00:34:27,660 +imaging، أنا بعمل عملية ال evaluation عند المريض. + +390 +00:34:27,660 --> 00:34:32,880 +طبعًا بنكتفي إن شاء الله لهذا القدر. في أي سؤال في + +391 +00:34:32,880 --> 00:34:37,320 +المحاضرة القادمة إن شاء الله بنكمل. طبعًا بنعتذر على + +392 +00:34:37,320 --> 00:34:39,820 +موضوع اللي هو الانقطاع. diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/s7myczgRoRM_raw.json b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/s7myczgRoRM_raw.json new file mode 100644 index 0000000000000000000000000000000000000000..c054f92d8a379304be5b88dad751161bdebb329c --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/s7myczgRoRM_raw.json @@ -0,0 +1 @@ +{"segments": [{"id": 1, "seek": 3169, "start": 29.65, "end": 31.69, "text": "وصلنا لل trial", "tokens": [2407, 36520, 8315, 24976, 7308], "avg_logprob": -0.2486979216337204, "compression_ratio": 0.75, "no_speech_prob": 0.0, "words": [{"start": 29.65, "end": 30.69, "word": "وصلنا", "probability": 0.87841796875}, {"start": 30.69, "end": 31.21, "word": " لل", "probability": 0.465087890625}, {"start": 31.21, "end": 31.69, "word": " trial", "probability": 0.94873046875}], "temperature": 1.0}, {"id": 2, "seek": 7784, "start": 68.38, "end": 77.84, "text": "أهي بمعنى انه العدسات متوفرة عندى في داخل المركز او متوفرة عندنا في داخل المعمل", "tokens": [10721, 3224, 1829, 4724, 2304, 3615, 1863, 7578, 16472, 3224, 18863, 3215, 3794, 9307, 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{"id": 16, "seek": 39540, "start": 369.22, "end": 395.4, "text": "وكل ما كان عنده refractive erogalel لو مثلا عشرة ديجري او خمساشر ديجري ماحتكون مؤثرة كتير بالنسبة لهذا المريض next select يعني الخطوة اللي هي الأخرى او الاختيار التاني the cylinder power قوة ايه ال cylinder lens if a given a choice لو هو اداني ايه خيار", "tokens": [2407, 28820, 19446, 25961, 43242, 3224, 45353, 488, 1189, 664, 304, 338, 45164, 50113, 15040, 6225, 8592, 25720, 11778, 1829, 7435, 16572, 1975, 2407, 16490, 2304, 3794, 33599, 2288, 11778, 1829, 7435, 16572, 19446, 33753, 30544, 3714, 33604, 12984, 25720, 9122, 2655, 13546, 20666, 1863, 35457, 3660, 46740, 15730, 9673, 16572, 11242, 958, 3048, 37495, 22653, 33962, 9566, 2407, 3660, 13672, 1829, 39896, 16247, 34740, 7578, 1975, 2407, 2423, 47283, 31371, 9640, 16712, 7649, 1829, 264, 17884, 1347, 12174, 2407, 3660, 1975, 1829, 3224, 2423, 17884, 6765, 498, 257, 2212, 257, 3922, 45164, 31439, 1975, 3215, 7649, 1829, 1975, 1829, 3224, 16490, 1829, 9640], 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"text": "to fit most astigmatic patients معظم المرضى اللى بيعانوا من refractive astigmatism او residual astigmatism the average trial sets has many plaster packs so that reusable lenses are no longer necessary زى ما لاحظنا ال trial set فى داخل الجامعة الها مجموعة من", "tokens": [1353, 3318, 881, 5357, 46496, 299, 4209, 20449, 19913, 2304, 9673, 43042, 7578, 13672, 7578, 4724, 40228, 7649, 14407, 9154, 45353, 488, 5357, 46496, 1434, 1975, 2407, 27980, 5357, 46496, 1434, 264, 4274, 7308, 6352, 575, 867, 34467, 19403, 370, 300, 41807, 18059, 366, 572, 2854, 4818, 30767, 7578, 19446, 20193, 5016, 19913, 8315, 2423, 7308, 992, 6156, 7578, 11778, 47283, 1211, 25724, 10943, 27884, 2423, 11296, 3714, 7435, 2304, 2407, 27884, 9154], "avg_logprob": -0.22276182714346293, "compression_ratio": 1.4768518518518519, "no_speech_prob": 5.960464477539063e-08, "words": [{"start": 640.96, "end": 641.18, "word": "to", "probability": 0.20849609375}, {"start": 641.18, "end": 641.54, "word": " fit", 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minimum تمام؟ و أيضا بالدينة اللى هو لو أنا كنت مثلا شخص عنده against the rule و ماشي باتجاه ال RGB هيقوللي هذا الاكتشاف او هذا التنبؤ او هذا التخمين اللى خاص فيك ايش ماله؟ failure اللى هو خاطئ او غير صحيح او فاشل تمام؟ اذا can help a predict", "tokens": [2407, 2423, 497, 6674, 4032, 2423, 497, 7285, 46811, 10943, 22807, 4032, 36632, 11242, 995, 20666, 3215, 9957, 3660, 13672, 7578, 31439, 45164, 41850, 9122, 29399, 50113, 15040, 13412, 9778, 9381, 43242, 3224, 1970, 264, 4978, 4032, 3714, 33599, 1829, 4724, 9307, 7435, 40294, 2423, 31231, 8032, 1829, 39648, 20292, 23758, 42963, 4117, 2655, 8592, 31845, 1975, 2407, 23758, 16712, 1863, 3555, 33604, 1975, 2407, 23758, 16712, 9778, 2304, 9957, 13672, 7578, 16490, 33546, 8978, 4117, 1975, 1829, 8592, 3714, 6027, 3224, 22807, 7763, 13672, 7578, 31439, 16490, 41193, 19986, 1975, 2407, 32771, 13546, 20328, 5016, 1829, 5016, 1975, 2407, 6156, 33599, 1211, 46811, 10943, 22807, 1975, 15730, 393, 854, 257, 6069], "avg_logprob": 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1.0}, {"id": 48, "seek": 122519, "start": 1198.85, "end": 1225.19, "text": "high peripheral corneal torsity may predict first lens failure هذه الجملة مهمة كتير و حابب المطالبة تعملي explanation لها high peripheral corneal torsity may predict first lens failure okay من عندها إجابة طيب نيجي مع بعض one by one", "tokens": [21454, 40235, 1181, 716, 304, 3930, 82, 507, 815, 6069, 700, 6765, 7763, 29538, 25724, 2304, 37977, 3714, 16095, 3660, 9122, 2655, 13546, 4032, 11331, 16758, 3555, 9673, 9566, 6027, 49401, 6055, 25957, 20292, 10835, 5296, 11296, 1090, 40235, 1181, 716, 304, 3930, 82, 507, 815, 6069, 700, 6765, 7763, 1392, 9154, 43242, 11296, 11933, 7435, 16758, 3660, 23032, 1829, 3555, 8717, 1829, 7435, 1829, 20449, 45030, 11242, 472, 538, 472], "avg_logprob": -0.18337673217886025, "compression_ratio": 1.6187845303867403, "no_speech_prob": 0.0, "words": [{"start": 1198.85, "end": 1199.21, "word": "high", "probability": 0.53857421875}, {"start": 1199.21, "end": 1199.71, "word": " 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"word": " قادر", "probability": 0.9938151041666666}, {"start": 1363.01, "end": 1363.29, "word": " انه", "probability": 0.578125}, {"start": 1363.29, "end": 1363.73, "word": " ياخد", "probability": 0.9471028645833334}, {"start": 1363.73, "end": 1364.09, "word": " اللي", "probability": 0.873779296875}, {"start": 1364.09, "end": 1364.47, "word": " موجود", "probability": 0.9820963541666666}, {"start": 1364.47, "end": 1364.75, "word": " عندنا", "probability": 0.90869140625}, {"start": 1364.75, "end": 1364.87, "word": " في", "probability": 0.93798828125}, {"start": 1364.87, "end": 1365.35, "word": " المعمل", "probability": 0.9925130208333334}, {"start": 1365.35, "end": 1365.83, "word": " اكتر", "probability": 0.9266357421875}, {"start": 1365.83, "end": 1366.05, "word": " من", "probability": 0.98876953125}, {"start": 1366.05, "end": 1366.85, "word": " تمن", "probability": 0.437744140625}, {"start": 1366.85, "end": 1367.53, "word": " تلاف", "probability": 0.7926432291666666}, {"start": 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lens rotation والمصطلح التاني هو عبارة عن ال lens stability إذا عندنا lens rotation و lens stability", "tokens": [9566, 1829, 3555, 6024, 48506, 8978, 43242, 8315, 3714, 9381, 9566, 1211, 5016, 9957, 3714, 16095, 9957, 9673, 9381, 9566, 1211, 5016, 16247, 12610, 31439, 6225, 3555, 9640, 3660, 18871, 2423, 6765, 12447, 16070, 2304, 9381, 9566, 1211, 5016, 16712, 7649, 1829, 31439, 6225, 3555, 9640, 3660, 18871, 2423, 6765, 11826, 11933, 15730, 43242, 8315, 6765, 12447, 4032, 6765, 11826], "avg_logprob": -0.12237448917060602, "compression_ratio": 1.7681159420289856, "no_speech_prob": 5.960464477539063e-08, "words": [{"start": 1456.67, "end": 1456.99, "word": "طيب", "probability": 0.9226888020833334}, {"start": 1456.99, "end": 1457.67, "word": " الآن", "probability": 0.5701904296875}, {"start": 1457.67, "end": 1457.83, "word": " في", "probability": 0.73193359375}, {"start": 1457.83, "end": 1458.33, "word": " عندنا", "probability": 0.799560546875}, {"start": 1458.33, "end": 1459.15, 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"end": 1615.23, "word": " a", "probability": 0.9580078125}], "temperature": 1.0}, {"id": 66, "seek": 164353, "start": 1616.93, "end": 1643.53, "text": "أو بعد فترة زمانية ايه معينة The limbs axis should return quickly to the same position following each blink and should not fluctuate over time دايما يا جماعة بعد ما انا بعمل complete blink ال axis اما بيعود لطبيته او بيعود لقيمة اللي تم تحديدها", "tokens": [10721, 2407, 39182, 6156, 2655, 25720, 30767, 2304, 7649, 10632, 1975, 1829, 3224, 20449, 9957, 3660, 440, 29315, 10298, 820, 2736, 2661, 281, 264, 912, 2535, 3480, 1184, 24667, 293, 820, 406, 23448, 10107, 670, 565, 11778, 47302, 15042, 35186, 10874, 15042, 27884, 39182, 19446, 1975, 8315, 4724, 25957, 1211, 3566, 24667, 2423, 10298, 1975, 15042, 4724, 40228, 23328, 5296, 9566, 21292, 47395, 1975, 2407, 4724, 40228, 23328, 5296, 4587, 32640, 3660, 13672, 1829, 46811, 6055, 24401, 25708, 11296], "avg_logprob": -0.1931640673428774, "compression_ratio": 1.4434782608695653, "no_speech_prob": 0.0, "words": [{"start": 1616.93, "end": 1617.21, "word": "أو", "probability": 0.8271484375}, {"start": 1617.21, "end": 1617.49, "word": " بعد", "probability": 0.966796875}, {"start": 1617.49, "end": 1617.87, "word": " فترة", "probability": 0.9938151041666666}, {"start": 1617.87, "end": 1618.49, "word": " زمانية", "probability": 0.8564453125}, {"start": 1618.49, "end": 1618.95, "word": " ايه", "probability": 0.6394449869791666}, {"start": 1618.95, "end": 1620.23, "word": " معينة", "probability": 0.96923828125}, {"start": 1620.23, "end": 1621.07, "word": " The", "probability": 0.254638671875}, {"start": 1621.07, "end": 1621.53, "word": " limbs", "probability": 0.5654296875}, {"start": 1621.53, "end": 1622.15, "word": " axis", "probability": 0.658203125}, {"start": 1622.15, "end": 1623.21, "word": " should", "probability": 0.97509765625}, {"start": 1623.21, "end": 1623.95, "word": " return", "probability": 0.91259765625}, {"start": 1623.95, "end": 1624.79, "word": " quickly", "probability": 0.91650390625}, {"start": 1624.79, "end": 1625.45, "word": " to", "probability": 0.9814453125}, {"start": 1625.45, "end": 1625.69, "word": " the", "probability": 0.9287109375}, {"start": 1625.69, "end": 1625.99, "word": " same", "probability": 0.912109375}, {"start": 1625.99, "end": 1626.57, "word": " position", "probability": 0.94091796875}, {"start": 1626.57, "end": 1627.27, "word": " following", "probability": 0.84814453125}, {"start": 1627.27, "end": 1628.29, "word": " each", "probability": 0.9609375}, {"start": 1628.29, "end": 1628.71, "word": " blink", "probability": 0.654296875}, {"start": 1628.71, "end": 1629.47, "word": " and", "probability": 0.83251953125}, {"start": 1629.47, "end": 1629.75, "word": " should", "probability": 0.97119140625}, {"start": 1629.75, "end": 1630.11, "word": " not", "probability": 0.95361328125}, {"start": 1630.11, "end": 1631.01, "word": " fluctuate", "probability": 0.659423828125}, {"start": 1631.01, "end": 1631.37, "word": " over", "probability": 0.8759765625}, {"start": 1631.37, "end": 1631.87, "word": " time", "probability": 0.896484375}, {"start": 1631.87, "end": 1632.83, "word": " دايما", "probability": 0.7939453125}, {"start": 1632.83, "end": 1632.95, "word": " يا", "probability": 0.95654296875}, {"start": 1632.95, "end": 1633.49, "word": " جماعة", "probability": 0.99169921875}, {"start": 1633.49, "end": 1634.17, "word": " بعد", "probability": 0.9365234375}, {"start": 1634.17, "end": 1634.93, "word": " ما", "probability": 0.84619140625}, {"start": 1634.93, "end": 1635.33, "word": " انا", "probability": 0.71435546875}, {"start": 1635.33, "end": 1635.69, "word": " بعمل", "probability": 0.9571940104166666}, {"start": 1635.69, "end": 1636.21, "word": " complete", "probability": 0.87744140625}, {"start": 1636.21, "end": 1636.75, "word": " blink", "probability": 0.978515625}, {"start": 1636.75, "end": 1637.51, "word": " ال", "probability": 0.7900390625}, {"start": 1637.51, "end": 1638.01, "word": " axis", "probability": 0.7080078125}, {"start": 1638.01, "end": 1638.83, "word": " اما", "probability": 0.784423828125}, {"start": 1638.83, "end": 1639.83, "word": " بيعود", "probability": 0.8968098958333334}, {"start": 1639.83, "end": 1640.55, "word": " لطبيته", "probability": 0.9146728515625}, {"start": 1640.55, "end": 1641.23, "word": " او", "probability": 0.837890625}, {"start": 1641.23, "end": 1641.67, "word": " بيعود", "probability": 0.9519856770833334}, {"start": 1641.67, "end": 1642.37, "word": " لقيمة", "probability": 0.8140869140625}, {"start": 1642.37, "end": 1642.67, "word": " اللي", "probability": 0.735595703125}, {"start": 1642.67, "end": 1642.89, "word": " تم", "probability": 0.99365234375}, {"start": 1642.89, "end": 1643.53, "word": " تحديدها", "probability": 0.8155517578125}], "temperature": 1.0}, {"id": 67, "seek": 167282, "start": 1644.2, "end": 1672.82, "text": "لذلك دايمًا العدسة ال software ال contact lenses يما يتم عملية ال evaluation لها لابد من الانتباه لل lens stability للعدسة و أيضًا ال fluid اللي بيكون ما بين ال posterior surface للعدسة و ال anterior surface لمن؟ للكورنية lens rotation should be noted in the chart for each trial lens الآن أنا لبست المريض", "tokens": [1211, 8848, 23275, 11778, 995, 32640, 14111, 995, 18863, 3215, 3794, 3660, 2423, 4722, 2423, 3385, 18059, 7251, 15042, 7251, 39237, 6225, 42213, 10632, 2423, 13344, 5296, 11296, 5296, 16758, 3215, 9154, 2423, 7649, 2655, 3555, 40294, 24976, 6765, 11826, 24976, 22488, 3794, 3660, 4032, 36632, 11242, 14111, 995, 2423, 9113, 13672, 1829, 4724, 1829, 30544, 19446, 49374, 2423, 33529, 3753, 24976, 22488, 3794, 3660, 4032, 2423, 22272, 3753, 5296, 27842, 22807, 5296, 23275, 13063, 1863, 10632, 6765, 12447, 820, 312, 12964, 294, 264, 6927, 337, 1184, 7308, 6765, 6024, 48506, 41850, 5296, 3555, 14851, 9673, 16572, 11242], "avg_logprob": -0.2515782882468869, "compression_ratio": 1.6798418972332017, "no_speech_prob": 0.0, "words": [{"start": 1644.2, "end": 1644.76, "word": "لذلك", "probability": 0.93212890625}, {"start": 1644.76, "end": 1645.42, "word": " دايمًا", "probability": 0.6417236328125}, {"start": 1645.42, "end": 1646.08, "word": " العدسة", "probability": 0.9661865234375}, {"start": 1646.08, "end": 1646.46, "word": " ال", "probability": 0.68359375}, {"start": 1646.46, "end": 1646.8, "word": " software", "probability": 0.1644287109375}, {"start": 1646.8, "end": 1647.06, "word": " ال", "probability": 0.37109375}, {"start": 1647.06, "end": 1647.36, "word": " contact", "probability": 0.89794921875}, {"start": 1647.36, "end": 1647.92, "word": " lenses", "probability": 0.86669921875}, {"start": 1647.92, "end": 1648.44, "word": " يما", "probability": 0.49072265625}, {"start": 1648.44, "end": 1648.72, "word": " يتم", "probability": 0.912109375}, {"start": 1648.72, "end": 1649.22, "word": " عملية", "probability": 0.98486328125}, {"start": 1649.22, "end": 1649.42, "word": " ال", "probability": 0.91943359375}, {"start": 1649.42, "end": 1650.0, "word": " evaluation", "probability": 0.96533203125}, {"start": 1650.0, "end": 1650.64, "word": " لها", "probability": 0.806884765625}, {"start": 1650.64, "end": 1651.42, "word": " لابد", "probability": 0.9098307291666666}, {"start": 1651.42, "end": 1651.6, "word": " من", "probability": 0.99072265625}, {"start": 1651.6, "end": 1652.3, "word": " الانتباه", "probability": 0.95048828125}, {"start": 1652.3, "end": 1653.22, "word": " لل", "probability": 0.63427734375}, {"start": 1653.22, "end": 1653.54, "word": " lens", "probability": 0.54345703125}, {"start": 1653.54, "end": 1654.14, "word": " stability", "probability": 0.77978515625}, {"start": 1654.14, "end": 1654.86, "word": " للعدسة", "probability": 0.9429931640625}, {"start": 1654.86, "end": 1655.32, "word": " و", "probability": 0.65673828125}, {"start": 1655.32, "end": 1655.78, "word": " أيضًا", "probability": 0.918701171875}, {"start": 1655.78, "end": 1656.08, "word": " ال", "probability": 0.62548828125}, {"start": 1656.08, "end": 1656.56, "word": " fluid", "probability": 0.953125}, {"start": 1656.56, "end": 1656.88, "word": " اللي", "probability": 0.85498046875}, {"start": 1656.88, "end": 1657.28, "word": " بيكون", "probability": 0.8544921875}, {"start": 1657.28, "end": 1657.48, "word": " ما", "probability": 0.8076171875}, {"start": 1657.48, "end": 1657.8, "word": " بين", "probability": 0.98095703125}, {"start": 1657.8, "end": 1658.44, "word": " ال", "probability": 0.9345703125}, {"start": 1658.44, "end": 1658.86, "word": " posterior", "probability": 0.9052734375}, {"start": 1658.86, "end": 1659.58, "word": " surface", "probability": 0.91650390625}, {"start": 1659.58, "end": 1660.56, "word": " للعدسة", "probability": 0.79840087890625}, {"start": 1660.56, "end": 1660.88, "word": " و", "probability": 0.587890625}, {"start": 1660.88, "end": 1661.0, "word": " ال", "probability": 0.970703125}, {"start": 1661.0, "end": 1661.38, "word": " anterior", "probability": 0.5712890625}, {"start": 1661.38, "end": 1661.96, "word": " surface", "probability": 0.90869140625}, {"start": 1661.96, "end": 1662.72, "word": " لمن؟", "probability": 0.5930989583333334}, {"start": 1662.72, "end": 1663.94, "word": " للكورنية", "probability": 0.6349609375}, {"start": 1663.94, "end": 1665.92, "word": " lens", "probability": 0.54052734375}, {"start": 1665.92, "end": 1666.8, "word": " rotation", "probability": 0.970703125}, {"start": 1666.8, "end": 1667.5, "word": " should", "probability": 0.95654296875}, {"start": 1667.5, "end": 1667.72, "word": " be", "probability": 0.95166015625}, {"start": 1667.72, "end": 1668.14, "word": " noted", "probability": 0.9267578125}, {"start": 1668.14, "end": 1668.68, "word": " in", "probability": 0.96875}, {"start": 1668.68, "end": 1668.84, "word": " the", "probability": 0.904296875}, {"start": 1668.84, "end": 1669.36, "word": " chart", "probability": 0.92529296875}, {"start": 1669.36, "end": 1669.78, "word": " for", "probability": 0.92529296875}, {"start": 1669.78, "end": 1670.18, "word": " each", "probability": 0.958984375}, {"start": 1670.18, "end": 1670.62, "word": " trial", "probability": 0.95556640625}, {"start": 1670.62, "end": 1671.02, "word": " lens", "probability": 0.92822265625}, {"start": 1671.02, "end": 1671.7, "word": " الآن", "probability": 0.6239013671875}, {"start": 1671.7, "end": 1671.92, "word": " أنا", "probability": 0.75390625}, {"start": 1671.92, "end": 1672.3, "word": " لبست", "probability": 0.85791015625}, {"start": 1672.3, "end": 1672.82, "word": " المريض", "probability": 0.90869140625}], "temperature": 1.0}, {"id": 68, "seek": 169998, "start": 1673.78, "end": 1699.98, "text": "و العدسة عملت rotation لحظة ما تعمل rotation العدسة طبعا after complete blink او بعد فترة زمنية معينة المريض هيلاحظ ايش فيه deterioration اللي هو تدهور في الرؤية تمام او اختلاف في الرؤية ابن", "tokens": [2407, 18863, 3215, 3794, 3660, 6225, 42213, 2655, 12447, 5296, 5016, 19913, 3660, 19446, 6055, 25957, 1211, 12447, 18863, 3215, 3794, 3660, 23032, 3555, 3615, 995, 934, 3566, 24667, 1975, 2407, 39182, 6156, 2655, 25720, 30767, 27842, 10632, 20449, 9957, 3660, 9673, 16572, 11242, 39896, 15040, 5016, 19913, 1975, 1829, 8592, 8978, 3224, 26431, 399, 13672, 1829, 31439, 6055, 3215, 3224, 13063, 8978, 34892, 33604, 10632, 46811, 10943, 1975, 2407, 1975, 46456, 15040, 5172, 8978, 34892, 33604, 10632, 48127, 1863], "avg_logprob": -0.15123457084467382, "compression_ratio": 1.6666666666666667, "no_speech_prob": 5.960464477539063e-08, "words": [{"start": 1673.78, "end": 1674.0, "word": "و", "probability": 0.91357421875}, {"start": 1674.0, "end": 1674.6, "word": " العدسة", "probability": 0.8519287109375}, {"start": 1674.6, "end": 1675.16, "word": " عملت", "probability": 0.9796549479166666}, {"start": 1675.16, "end": 1675.62, "word": " rotation", "probability": 0.7109375}, {"start": 1675.62, "end": 1677.32, "word": " لحظة", "probability": 0.962890625}, {"start": 1677.32, "end": 1677.44, "word": " ما", "probability": 0.63134765625}, {"start": 1677.44, "end": 1677.8, "word": " تعمل", "probability": 0.9864908854166666}, {"start": 1677.8, "end": 1678.26, "word": " rotation", "probability": 0.456787109375}, {"start": 1678.26, "end": 1678.98, "word": " العدسة", "probability": 0.9891357421875}, {"start": 1678.98, "end": 1679.66, "word": " طبعا", "probability": 0.9334716796875}, {"start": 1679.66, "end": 1680.02, "word": " after", "probability": 0.61279296875}, {"start": 1680.02, "end": 1680.66, "word": " complete", "probability": 0.759765625}, {"start": 1680.66, "end": 1681.12, "word": " blink", "probability": 0.44482421875}, {"start": 1681.12, "end": 1681.76, "word": " او", "probability": 0.762451171875}, {"start": 1681.76, "end": 1682.04, "word": " بعد", "probability": 0.974609375}, {"start": 1682.04, "end": 1682.36, "word": " فترة", "probability": 0.9915364583333334}, {"start": 1682.36, "end": 1682.86, "word": " زمنية", "probability": 0.830078125}, {"start": 1682.86, "end": 1683.58, "word": " معينة", "probability": 0.978515625}, {"start": 1683.58, "end": 1684.4, "word": " المريض", "probability": 0.9708658854166666}, {"start": 1684.4, "end": 1685.02, "word": " هيلاحظ", "probability": 0.84881591796875}, {"start": 1685.02, "end": 1685.26, "word": " ايش", "probability": 0.8411458333333334}, {"start": 1685.26, "end": 1685.88, "word": " فيه", "probability": 0.947998046875}, {"start": 1685.88, "end": 1686.8, "word": " deterioration", "probability": 0.684326171875}, {"start": 1686.8, "end": 1689.72, "word": " اللي", "probability": 0.802001953125}, {"start": 1689.72, "end": 1689.92, "word": " هو", "probability": 0.97314453125}, {"start": 1689.92, "end": 1690.56, "word": " تدهور", "probability": 0.91064453125}, {"start": 1690.56, "end": 1690.96, "word": " في", "probability": 0.96240234375}, {"start": 1690.96, "end": 1691.38, "word": " الرؤية", "probability": 0.9716796875}, {"start": 1691.38, "end": 1692.82, "word": " تمام", "probability": 0.911865234375}, {"start": 1692.82, "end": 1693.16, "word": " او", "probability": 0.8115234375}, {"start": 1693.16, "end": 1693.86, "word": " اختلاف", "probability": 0.939697265625}, {"start": 1693.86, "end": 1694.14, "word": " في", "probability": 0.98193359375}, {"start": 1694.14, "end": 1695.2, "word": " الرؤية", "probability": 0.9905598958333334}, {"start": 1695.2, "end": 1699.98, "word": " ابن", "probability": 0.6590576171875}], "temperature": 1.0}, {"id": 69, "seek": 172609, "start": 1702.15, "end": 1726.09, "text": "Dispensing of a lens, the rotation should be noted and should be the same as the initial lens لازم انا يما بصرف عن كلمة dispensing اللي هو صرف العدسة عندما بتم اللي هو صرفها لازم انه يكون قيمة ال axis هو مساوي لقيمة ال axis وين؟ الأصلي", "tokens": [35, 7631, 22481, 295, 257, 6765, 11, 264, 12447, 820, 312, 12964, 293, 820, 312, 264, 912, 382, 264, 5883, 6765, 5296, 31377, 2304, 1975, 8315, 7251, 15042, 4724, 9381, 28480, 18871, 9122, 19528, 3660, 4920, 22481, 13672, 1829, 31439, 20328, 28480, 18863, 3215, 3794, 3660, 43242, 15042, 4724, 39237, 13672, 1829, 31439, 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0.8020833333333334}, {"start": 1879.74, "end": 1880.7, "word": " مستحدثة", "probability": 0.97177734375}], "temperature": 1.0}, {"id": 76, "seek": 190282, "start": 1881.8, "end": 1902.82, "text": "as long as the rotation is stable and not more than 30 degrees جداش حكينا 30 degrees اللي هي عبارة عن one hour تمام؟ the fit is acceptable إذا هيكون مقبول يعني الآن في بعض الحالات يما بيكون عندنا قيمة ال rotation", "tokens": [296, 938, 382, 264, 12447, 307, 8351, 293, 406, 544, 813, 2217, 5310, 10874, 3215, 33599, 11331, 4117, 1829, 8315, 2217, 5310, 13672, 1829, 39896, 6225, 3555, 9640, 3660, 18871, 472, 1773, 46811, 10943, 22807, 264, 3318, 307, 15513, 11933, 15730, 39896, 30544, 3714, 4587, 3555, 12610, 37495, 22653, 6024, 48506, 8978, 45030, 11242, 21542, 6027, 9307, 7251, 15042, 4724, 1829, 30544, 43242, 8315, 12174, 32640, 3660, 2423, 12447], "avg_logprob": -0.21372768453189306, "compression_ratio": 1.4846938775510203, "no_speech_prob": 0.0, "words": [{"start": 1881.8, "end": 1882.16, 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"probability": 0.57275390625}, {"start": 1893.64, "end": 1893.98, "word": " fit", "probability": 0.95263671875}, {"start": 1893.98, "end": 1894.28, "word": " is", "probability": 0.9716796875}, {"start": 1894.28, "end": 1895.0, "word": " acceptable", "probability": 0.87060546875}, {"start": 1895.0, "end": 1895.7, "word": " إذا", "probability": 0.53271484375}, {"start": 1895.7, "end": 1896.32, "word": " هيكون", "probability": 0.86376953125}, {"start": 1896.32, "end": 1897.04, "word": " مقبول", "probability": 0.9847412109375}, {"start": 1897.04, "end": 1898.16, "word": " يعني", "probability": 0.904541015625}, {"start": 1898.16, "end": 1898.64, "word": " الآن", "probability": 0.8525390625}, {"start": 1898.64, "end": 1899.36, "word": " في", "probability": 0.9765625}, {"start": 1899.36, "end": 1899.64, "word": " بعض", "probability": 0.992431640625}, {"start": 1899.64, "end": 1900.34, "word": " الحالات", "probability": 0.9088541666666666}, {"start": 1900.34, "end": 1900.98, "word": " يما", "probability": 0.498779296875}, {"start": 1900.98, "end": 1901.4, "word": " بيكون", "probability": 0.9010416666666666}, {"start": 1901.4, "end": 1901.82, "word": " عندنا", "probability": 0.924072265625}, {"start": 1901.82, "end": 1902.26, "word": " قيمة", "probability": 0.99755859375}, {"start": 1902.26, "end": 1902.38, "word": " ال", "probability": 0.96484375}, {"start": 1902.38, "end": 1902.82, "word": " rotation", "probability": 0.98291015625}], "temperature": 1.0}, {"id": 77, "seek": 191888, "start": 1903.7, "end": 1918.88, "text": "أقل من تلاتين ديجري تمام ممكن أن يكون عندنا العدسة هذه مقبولة، لكن وين هذه الشرط؟ لازم يكون عندنا low refractive error أو low sensitivity للمريض", "tokens": [10721, 4587, 1211, 9154, 6055, 1211, 9307, 9957, 11778, 1829, 7435, 16572, 46811, 10943, 3714, 43020, 14739, 7251, 30544, 43242, 8315, 18863, 3215, 3794, 3660, 29538, 3714, 4587, 3555, 12610, 3660, 12399, 44381, 4032, 9957, 29538, 25124, 2288, 9566, 22807, 5296, 31377, 2304, 7251, 30544, 43242, 8315, 2295, 45353, 488, 6713, 34051, 2295, 19392, 5296, 19528, 16572, 11242], "avg_logprob": -0.12811175544383163, "compression_ratio": 1.4171779141104295, "no_speech_prob": 5.960464477539063e-08, "words": [{"start": 1903.7, "end": 1904.22, "word": "أقل", "probability": 0.8396809895833334}, {"start": 1904.22, "end": 1904.72, "word": " من", "probability": 0.99658203125}, {"start": 1904.72, "end": 1905.36, "word": " تلاتين", "probability": 0.94482421875}, {"start": 1905.36, "end": 1905.98, "word": " ديجري", "probability": 0.7529296875}, {"start": 1905.98, "end": 1906.84, "word": " تمام", "probability": 0.91552734375}, {"start": 1906.84, "end": 1907.8, "word": " ممكن", "probability": 0.908447265625}, {"start": 1907.8, "end": 1908.08, "word": " أن", "probability": 0.44580078125}, {"start": 1908.08, "end": 1908.52, "word": " يكون", "probability": 0.9150390625}, {"start": 1908.52, "end": 1909.18, "word": " عندنا", "probability": 0.93115234375}, {"start": 1909.18, "end": 1909.98, "word": " العدسة", "probability": 0.975830078125}, {"start": 1909.98, "end": 1910.24, "word": " هذه", "probability": 0.80419921875}, {"start": 1910.24, "end": 1911.22, "word": " مقبولة،", "probability": 0.8837483723958334}, {"start": 1911.22, "end": 1911.64, "word": " لكن", "probability": 0.98876953125}, {"start": 1911.64, "end": 1911.88, "word": " وين", "probability": 0.871337890625}, {"start": 1911.88, "end": 1912.16, "word": " هذه", "probability": 0.49169921875}, {"start": 1912.16, "end": 1912.96, "word": " الشرط؟", "probability": 0.9066162109375}, {"start": 1912.96, "end": 1913.28, "word": " لازم", "probability": 0.98681640625}, {"start": 1913.28, "end": 1913.56, "word": " يكون", "probability": 0.9921875}, {"start": 1913.56, "end": 1914.3, "word": " عندنا", "probability": 0.97265625}, {"start": 1914.3, "end": 1914.68, "word": " low", "probability": 0.89208984375}, {"start": 1914.68, "end": 1915.68, "word": " refractive", "probability": 0.953369140625}, {"start": 1915.68, "end": 1915.96, 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1930.7, "word": " the", "probability": 0.912109375}, {"start": 1930.7, "end": 1931.2, "word": " rotation", "probability": 0.97705078125}, {"start": 1931.2, "end": 1931.78, "word": " if", "probability": 0.919921875}, {"start": 1931.78, "end": 1931.98, "word": " the", "probability": 0.90185546875}, {"start": 1931.98, "end": 1932.3, "word": " visual", "probability": 0.9609375}, {"start": 1932.3, "end": 1933.1, "word": " acuity", "probability": 0.873291015625}, {"start": 1933.1, "end": 1933.92, "word": " is", "probability": 0.95849609375}, {"start": 1933.92, "end": 1934.78, "word": " compromised", "probability": 0.7783203125}, {"start": 1934.78, "end": 1935.8, "word": " لكن", "probability": 0.8134765625}, {"start": 1935.8, "end": 1936.28, "word": " هذا", "probability": 0.8837890625}, {"start": 1936.28, "end": 1936.7, "word": " اذا", "probability": 0.6605224609375}, {"start": 1936.7, "end": 1936.98, "word": " كان", "probability": 0.99267578125}, {"start": 1936.98, "end": 1937.48, "word": " عندنا", "probability": 0.906005859375}, {"start": 1937.48, "end": 1938.14, "word": " two", "probability": 0.65869140625}, {"start": 1938.14, "end": 1938.68, "word": " degrees", "probability": 0.94384765625}, {"start": 1938.68, "end": 1939.08, "word": " او", "probability": 0.936767578125}, {"start": 1939.08, "end": 1939.4, "word": " three", "probability": 0.888671875}, {"start": 1939.4, "end": 1939.98, "word": " degrees", "probability": 0.9443359375}, {"start": 1939.98, "end": 1940.68, "word": " ومأثرة", "probability": 0.8189453125}, {"start": 1940.68, "end": 1940.86, "word": " على", "probability": 0.81884765625}, {"start": 1940.86, "end": 1940.96, "word": " ال", "probability": 0.8671875}, {"start": 1940.96, "end": 1941.2, "word": " visual", "probability": 0.931640625}, {"start": 1941.2, "end": 1941.84, "word": " acuity", "probability": 0.9423828125}, {"start": 1941.84, "end": 1942.68, "word": " لازم", "probability": 0.9674479166666666}, {"start": 1942.68, "end": 1942.88, "word": " انا", "probability": 0.909423828125}, {"start": 1942.88, "end": 1943.14, "word": " اعمل", "probability": 0.96728515625}, {"start": 1943.14, "end": 1943.56, "word": " عملية", "probability": 0.9806315104166666}, {"start": 1943.56, "end": 1944.1, "word": " تعويض", "probability": 0.96630859375}, {"start": 1944.1, "end": 1944.66, "word": " عشان", "probability": 0.9842122395833334}, {"start": 1944.66, "end": 1945.24, "word": " احسن", "probability": 0.9052734375}, {"start": 1945.24, "end": 1945.4, "word": " من", "probability": 0.98779296875}, {"start": 1945.4, "end": 1945.68, "word": " مين", "probability": 0.7335205078125}, {"start": 1945.68, "end": 1946.14, "word": " من", "probability": 0.89990234375}, {"start": 1946.14, "end": 1946.26, "word": " ال", "probability": 0.9521484375}, {"start": 1946.26, "end": 1946.56, "word": " visual", "probability": 0.97314453125}, {"start": 1946.56, "end": 1947.08, "word": " acuity", "probability": 0.946044921875}, {"start": 1947.08, "end": 1947.7, "word": " الخاص", "probability": 0.979248046875}, {"start": 1947.7, "end": 1948.46, "word": " بالمريض", "probability": 0.79803466796875}], "temperature": 1.0}, {"id": 79, "seek": 197059, "start": 1949.87, "end": 1970.59, "text": "rotation is judged يعني بمعنى تحكم عليها يعني انا بحكم على اللي هو ال rotation by imaging a clock face over the cornea يعني دايما انا بدي اعتبر العدسة اللي لابسها هي عبارة عن ساعة او عبارة عن a stigmatic fan و بدي اشوف اللي هو قيمة ال rotation لها", "tokens": [10536, 399, 307, 27485, 37495, 22653, 4724, 2304, 3615, 1863, 7578, 6055, 5016, 24793, 25894, 11296, 37495, 22653, 1975, 8315, 4724, 5016, 24793, 15844, 13672, 1829, 31439, 2423, 12447, 538, 25036, 257, 7830, 1851, 670, 264, 1181, 22160, 37495, 22653, 11778, 47302, 15042, 1975, 8315, 4724, 16254, 1975, 34268, 26890, 18863, 3215, 3794, 3660, 13672, 1829, 5296, 16758, 3794, 11296, 39896, 6225, 3555, 9640, 3660, 18871, 8608, 995, 27884, 1975, 2407, 6225, 3555, 9640, 3660, 18871, 257, 342, 20181, 2399, 3429, 4032, 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+وصلنا لل trial + +2 +00:01:08,380 --> 00:01:15,020 +أهي بمعنى انه العدسات متوفرة عندى في داخل المركز + +3 +00:01:15,020 --> 00:01:20,730 +او متوفرة عندنا في داخل المعملالـ trial or + +4 +00:01:20,730 --> 00:01:26,430 +diagnostic lenses are often used in fitting + +5 +00:01:26,430 --> 00:01:34,590 +software lenses تمام، إذا الطريقة اللي بتعتمد على + +6 +00:01:34,590 --> 00:01:41,230 +التجريب okay غالبا بتستخدم في عملية ال fitting + +7 +00:01:41,230 --> 00:01:48,450 +لهذا النوع من العدساتThe practitioner أو الفتر + +8 +00:01:48,450 --> 00:01:54,690 +تمام can select a trial lens based on keratometry. + +9 +00:01:55,350 --> 00:02:03,070 +إذا المريض بيعتمد على موضوع ال base curveأو موضوع + +10 +00:02:03,070 --> 00:02:07,950 +ال radius او ال key reading في اللي هو اختيار ايه؟ + +11 +00:02:07,950 --> 00:02:13,750 +في اختيار اللي هو العدسة الملائمة او العدسة + +12 +00:02:13,750 --> 00:02:20,300 +المناسبة او بنسميها ال back optic zone radiusback + +13 +00:02:20,300 --> 00:02:24,780 +optic zone radius طبعا وهذه الطريقة هي بتكون + +14 +00:02:24,780 --> 00:02:29,280 +مشابهة لطريقة من ال spherical soft contact lenses + +15 +00:02:29,280 --> 00:02:33,840 +بمعنى اخر انه بنضيف تقريبا من اتنين من عشرة ل + +16 +00:02:33,840 --> 00:02:46,800 +تمانية من عشرة millimeter over the flattest key + +17 +00:02:46,800 --> 00:02:47,160 +reading + +18 +00:02:52,160 --> 00:02:55,980 +طبعا زي ما ذكرنا انه كل ما زاد ال base curve في + +19 +00:02:55,980 --> 00:03:00,520 +العدسات ال software contact lenses هذا بيكون افضل + +20 +00:03:00,520 --> 00:03:05,260 +عشان موضوع ال stability و ال rotation بالنسبة + +21 +00:03:05,260 --> 00:03:12,970 +للعدساتو يسمح لشخص بيختيار ديامتر من 3 مليمتر إلى + +22 +00:03:12,970 --> 00:03:19,510 +4 مليمتر أكتر من الـ visible cornea طبعا بعض الفتر + +23 +00:03:19,510 --> 00:03:24,850 +بفضله اختيار ديامترفوق ال visible iris diameter من + +24 +00:03:24,850 --> 00:03:29,850 +3 إلى 4 ولكن احنا في المعمل طبقنا اللي هو نظرية من + +25 +00:03:29,850 --> 00:03:35,550 +0.5 to 2 ملي متر والتنتين اللي هو صحيحة حسب ايش + +26 +00:03:35,550 --> 00:03:38,770 +المعطيات اللي عندى او حسب اللي هو ال trial case + +27 +00:03:38,770 --> 00:03:44,110 +اللي موجود عندى في داخل المعملLens rotation and + +28 +00:03:44,110 --> 00:03:49,710 +stability are critical to a successful fit إذن + +29 +00:03:49,710 --> 00:03:54,910 +دوران العدسة وثباتها طبعا هناك اختلاف في المصطلحين + +30 +00:03:54,910 --> 00:03:58,310 +ما بين ال lens rotation و ال lens stability هنيجي + +31 +00:03:58,310 --> 00:04:01,730 +إليه كمان شوية هذا يعتبر critical إيش معناته + +32 +00:04:01,730 --> 00:04:05,350 +critical؟ أي بمعنى necessary اللي هو ضروري في + +33 +00:04:05,350 --> 00:04:08,350 +عملية نجاح ال fitting للعدسة + +34 +00:04:11,740 --> 00:04:18,740 +عند التفكير في الوصفات العصبية اولا + +35 +00:04:18,740 --> 00:04:24,840 +اختار عصب تجارب مع اجهزة تقريبا تقريبا تقريبا + +36 +00:04:24,840 --> 00:04:29,080 +تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا + +37 +00:04:29,080 --> 00:04:29,640 +تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا + +38 +00:04:29,640 --> 00:04:29,640 +تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا + +39 +00:04:29,640 --> 00:04:29,700 +تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا + +40 +00:04:29,700 --> 00:04:37,840 +تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا تقريب + +41 +00:04:38,400 --> 00:04:43,880 +الخطوة الأولى انه يتم اختيار access قريب من مين من + +42 +00:04:43,880 --> 00:04:49,480 +الوصفة يعني تلاتين اذا كان عند ال access في العدسة + +43 +00:04:49,480 --> 00:04:53,580 +ال diagnostic او ال trial خمسة و تلاتين او اربعين + +44 +00:04:53,580 --> 00:04:59,520 +بختارها اذا الخطوة الأولى انه يتم اختيار العدسة + +45 +00:04:59,520 --> 00:05:03,680 +اللي هي ال trial التجربية قريبة من مين من قيمة ال + +46 +00:05:03,680 --> 00:05:09,340 +accessاللي عند ال patient او اللى بيعانى منه + +47 +00:05:09,340 --> 00:05:15,640 +المريض الخطوة التانية انه بختار ال power بتاع ال + +48 +00:05:15,640 --> 00:05:20,360 +cylinder ايضا يكون قريب من ايه؟ من قيمة اللى هو ال + +49 +00:05:20,360 --> 00:05:24,780 +cylinder power اللى خاص بالمريض الخطوة التالتة + +50 +00:05:24,780 --> 00:05:29,180 +اللى هو موضوع ال sphere طبعا ال sphere دايما بنفضل + +51 +00:05:29,180 --> 00:05:33,420 +اختياره ان يكون اكتر او اقل بقيمة اتنين ديوبتر + +52 +00:05:34,780 --> 00:05:37,600 +فيرسك سيلكت الخيار الأول + +53 +00:05:46,610 --> 00:05:51,830 +دائما يا جماعة هان بدي اخد بعين الاعتبار انه كل ما + +54 +00:05:51,830 --> 00:05:56,070 +زاد قيمة ال refractive error من ناحية السيلندر كل + +55 +00:05:56,070 --> 00:05:59,590 +ما كان تأثير ال one او ال two degrees ايش يعتبر + +56 +00:05:59,590 --> 00:06:04,990 +عالي يعني بمعنى ان المريض عنده high sensitivity + +57 +00:06:04,990 --> 00:06:10,000 +حساسية عالية لعملية ال rotation للعدسةوكل ما كان + +58 +00:06:10,000 --> 00:06:14,040 +عنده refractive erogalel لو مثلا عشرة ديجري او + +59 +00:06:14,040 --> 00:06:18,180 +خمساشر ديجري ماحتكون مؤثرة كتير بالنسبة لهذا + +60 +00:06:18,180 --> 00:06:26,020 +المريض next select يعني الخطوة اللي هي الأخرى او + +61 +00:06:26,020 --> 00:06:29,760 +الاختيار التاني the cylinder power قوة ايه ال + +62 +00:06:29,760 --> 00:06:34,860 +cylinder lens if a given a choice لو هو اداني ايه + +63 +00:06:34,860 --> 00:06:40,810 +خيارTo under correct the vertex cylinder power + +64 +00:06:40,810 --> 00:06:45,250 +دائما في قيمة السيلندر باخد under correction باخدش + +65 +00:06:45,250 --> 00:06:49,190 +over correction وكأنه انا بعمل ايه ال trial عادي + +66 +00:06:49,190 --> 00:06:52,490 +اللي هو للمضارة يعني مثلا لو المريض عنده minus + +67 +00:06:52,490 --> 00:06:56,370 +واحد وخمسة وسبعين باخد minus واحد ربع او minus + +68 +00:06:56,370 --> 00:07:02,020 +واحد اللي هو اقل under correctionthird select او + +69 +00:07:02,020 --> 00:07:06,280 +third step the spherical power closest within two + +70 +00:07:06,280 --> 00:07:10,580 +diopters to the refractive power طبعا هنا المقصود + +71 +00:07:10,580 --> 00:07:15,740 +فيها اتنين ديوبتر اما زيادة او اللي هو نقصان ليش + +72 +00:07:15,740 --> 00:07:20,180 +انه في الآخر انا ايش هعمل over refraction تمام؟ + +73 +00:07:24,540 --> 00:07:27,740 +السبب في ذلك انه غير متوفر عندى في ال trial set + +74 +00:07:27,740 --> 00:07:32,260 +يعني انا لو عندي مثلا minus تلاتة minus واحد و نص + +75 +00:07:32,260 --> 00:07:36,380 +اكسس تلاتين بديلوياها هي بتكون العدسة الملائمة لكن + +76 +00:07:36,380 --> 00:07:40,280 +هاي احنا اشتغلنا في العمل هل حاطي اما عملتي لل ال + +77 +00:07:40,280 --> 00:07:43,740 +patient رغم انه عندنا small refractive error البعض + +78 +00:07:43,740 --> 00:07:48,340 +لجيتيها موجودة الوصفة لأن هذه بدها تكلفة عالية ان + +79 +00:07:48,340 --> 00:07:52,860 +كل بورة لازم تجيها وين موجودة في داخل ال trial set + +80 +00:07:54,830 --> 00:07:59,410 +Lenses should be allowed to equilibrate أي بمعنى + +81 +00:07:59,410 --> 00:08:04,150 +توازن on the eye for ten to twenty minutes before + +82 +00:08:04,150 --> 00:08:09,610 +evaluation يعني ثبات العدسة في داخل العين بعد ما + +83 +00:08:09,610 --> 00:08:13,390 +أنا أعمل إلها insertion بيستغرب تقريبا من عشرة + +84 +00:08:13,390 --> 00:08:20,010 +لعشرين أيهاللي هو دقيقة ولكن احنا زي ما اللي هو + +85 +00:08:20,010 --> 00:08:23,610 +عملنا اللي هو بعد خمس دقائق يعني هذه عبارة عن + +86 +00:08:23,610 --> 00:08:36,110 +دراسات ومختلفة اذا فقط + +87 +00:08:36,110 --> 00:08:40,130 +بعد خمس دقائق ليش؟ انه احنا دايما بنحاول انه نعمل + +88 +00:08:40,130 --> 00:08:44,210 +saving لل time سواء للمريض او لو كنا في داخل + +89 +00:08:44,210 --> 00:08:44,850 +المعمل + +90 +00:08:49,280 --> 00:08:55,460 +Manufacturers offer a wide range of parameters in + +91 +00:08:55,460 --> 00:09:02,360 +trick trial sets دايما بدك تعرف ان المصنع او الناس + +92 +00:09:02,360 --> 00:09:07,220 +اللي بيقوموا بصناعة هذا النوع من العدسات دايما + +93 +00:09:07,220 --> 00:09:11,720 +عندهم اللي هو تفكير مستمر في كيفية راحة المريض + +94 +00:09:11,720 --> 00:09:17,360 +فدايما بعمل اللي هو عملية new method يعني طريقة + +95 +00:09:17,360 --> 00:09:18,000 +ايه؟ + +96 +00:09:23,060 --> 00:09:28,020 +عشان يعمل راحة للمريض ويوفر أكبر قدر ممكن من مين + +97 +00:09:28,020 --> 00:09:38,180 +من العدسات دايما + +98 +00:09:38,180 --> 00:09:44,580 +ال manufacturers او الفترز هم بيحاولوا ان يبتكروا + +99 +00:09:44,580 --> 00:09:49,150 +طرق جديدة في كيفية اللي هو حصركل ال refractive + +100 +00:09:49,150 --> 00:09:54,210 +error للأشخاص في اللى هو ايه ال trial set واحدة + +101 +00:09:54,210 --> 00:09:59,810 +تمام ايضا عندنا ال parameters فى داخل ال software + +102 +00:09:59,810 --> 00:10:04,590 +ال contact lenses بتكون كتيرة بتتكون من number one + +103 +00:10:04,590 --> 00:10:09,870 +diameter number two base curve number three power + +104 +00:10:09,870 --> 00:10:14,730 +ال power ايش بشمل ال أسفير والسلندر + +105 +00:10:16,860 --> 00:10:21,580 +وبالاضافة له اللي هو ال axis فدايما بيحاول انه + +106 +00:10:21,580 --> 00:10:26,100 +يحصر ال refractive errors لجميع الأشخاص في داخل + +107 +00:10:26,100 --> 00:10:32,280 +هذه ال trial set which makes هذه هتعمل على صناعة + +108 +00:10:32,280 --> 00:10:37,320 +it easy to fit انه بيسهل في عملية اللي هو ايه ال + +109 +00:10:37,320 --> 00:10:43,500 +fitting لل patientto fit most astigmatic patients + +110 +00:10:43,500 --> 00:10:48,340 +معظم المرضى اللى بيعانوا من refractive astigmatism + +111 +00:10:48,340 --> 00:10:54,780 +او residual astigmatism the average trial sets has + +112 +00:10:54,780 --> 00:11:00,580 +many plaster packs so that reusable lenses are no + +113 +00:11:00,580 --> 00:11:04,800 +longer necessary زى ما لاحظنا ال trial set فى داخل + +114 +00:11:04,800 --> 00:11:12,530 +الجامعة الها مجموعة منفكلمة اللي هو blister bags + +115 +00:11:12,530 --> 00:11:17,730 +بقص بمعنى حزم أو بمعنى اللي هو طبقات و بتكون كأنها + +116 +00:11:17,730 --> 00:11:21,130 +عبارة عن blister الطبقة الأولى، التانية، التالتة + +117 +00:11:21,130 --> 00:11:25,930 +أو الرابعة هذا إيش بسهل في عملية إعادة استخدام + +118 +00:11:25,930 --> 00:11:31,530 +العدسة لكن مش لفترة زمنية طويلة يعني بمعنى آخر، + +119 +00:11:31,530 --> 00:11:36,690 +عندنا مريض ال refractive error لهالمثال السابق + +120 +00:11:36,690 --> 00:11:41,290 +ماينوس تلاتة او ماينوس واحد و نص اكسس تلاتين طب + +121 +00:11:41,290 --> 00:11:44,890 +هذا الشخص بده تلات جلسات او اربع جلسات مش معقول + +122 +00:11:44,890 --> 00:11:48,890 +انه كل جلسة بده اديها عدسة جديدة تجربية فانا ممكن + +123 +00:11:48,890 --> 00:11:54,490 +احافظ على هذه العدسة لفترة زمنية ولكن اشمالها لا + +124 +00:11:54,490 --> 00:11:55,790 +تكون طويلة + +125 +00:12:01,270 --> 00:12:05,310 +Empirical fitting اللي هي الطريقة إيه اللي بتعتمد + +126 +00:12:05,310 --> 00:12:11,970 +بالدرجة الأولى على مهارة أو خبرة مين ال + +127 +00:12:11,970 --> 00:12:17,590 +practitioner طبعا في الطريقة هذه في عاملين مهمين + +128 +00:12:17,590 --> 00:12:27,090 +العامل الأول ال practitioner والعامل + +129 +00:12:27,090 --> 00:12:33,800 +التاني اللي هو ال fitterأو الـ Manufacturer دايما + +130 +00:12:33,800 --> 00:12:39,080 +يا جماعة يما يكون انا عندى patient وعنده + +131 +00:12:39,080 --> 00:12:42,780 +refractive error very high بتكلم عن ال cylinder + +132 +00:12:42,780 --> 00:12:47,980 +دايما انا بعتمد هان على ال empirical method يعني + +133 +00:12:47,980 --> 00:12:52,920 +بعتمد على خبرته الشخصية و أيضا على ال + +134 +00:12:52,920 --> 00:12:58,760 +recommendation او التوصيات اللى بقدمها الى ميناللي + +135 +00:12:58,760 --> 00:13:03,100 +بقدمها إليه اللي هو الفتر أو ال manufacturer ليش؟ + +136 +00:13:03,100 --> 00:13:09,080 +طيب دايماً لما المريض يكون عنده نفترض minus خمسة + +137 +00:13:09,080 --> 00:13:14,860 +أو ستة أو سبعة cylinder من الصعب ألاجه هذه القيمة + +138 +00:13:14,860 --> 00:13:19,660 +وين؟ موجودة في داخل ال trial ست طيب ممكن طالبة + +139 +00:13:19,660 --> 00:13:22,600 +تانية تحكي لي ممكن طيب نجرب معها minus اتنين و + +140 +00:13:22,600 --> 00:13:27,190 +نعمللها إيش؟over refraction كلام مية في المية جميل + +141 +00:13:27,190 --> 00:13:32,170 +نظريا، ولكن عمليا لو patient عندها minus سبعة أو + +142 +00:13:32,170 --> 00:13:36,350 +minus خمسة ودناها minus اتنين هتقولك مش شايفة، لو + +143 +00:13:36,350 --> 00:13:40,190 +لبسناها العدسة هتقولك لأ مش مرتاح أناحتى و لو + +144 +00:13:40,190 --> 00:13:44,190 +عملنا ايه over refraction ليش طيب؟ لأنه هتكون high + +145 +00:13:44,190 --> 00:13:47,910 +sensitivity عندها الحساسية عالية كتير يعني حتى لو + +146 +00:13:47,910 --> 00:13:51,110 +استخدمنا ال Jackson cross cylinder و عملنا عملية + +147 +00:13:51,110 --> 00:13:55,630 +rotation هيبقى ال one degree مؤثر بالنسبة له + +148 +00:13:55,630 --> 00:13:59,870 +فدائما ايش بتشكي انه لأ a blurred vision مش مرتاحة + +149 +00:13:59,870 --> 00:14:04,590 +فدائما زي ما اتفقناالـ Empirical fitting أو الـ + +150 +00:14:04,590 --> 00:14:08,070 +Empirical method بحب انا استخدمها مع الأشخاص اللي + +151 +00:14:08,070 --> 00:14:12,110 +عندهم high refractive cylinder او high refractive + +152 +00:14:12,110 --> 00:14:16,610 +error السبب انه مافيش في داخل ال trial set عدسة + +153 +00:14:16,610 --> 00:14:22,460 +ملائمة او مناسبة لمين او كافية لهذا المرينالشغلة + +154 +00:14:22,460 --> 00:14:26,260 +التانية انه انا لما بقدم ال diameter و ال base + +155 +00:14:26,260 --> 00:14:29,960 +curve و ال refractive error للمصنع ممكن هو يديني + +156 +00:14:29,960 --> 00:14:34,080 +recommendation او يديني حلول جديدة انا ايش متجاية + +157 +00:14:34,080 --> 00:14:38,560 +في بالي او method اللي هو جديد في كيفية اللي هو + +158 +00:14:38,560 --> 00:14:42,820 +ايه اعطاء العدسة الملائمة او المناسبة يعني بمعنى + +159 +00:14:42,820 --> 00:14:48,040 +انه بسمع اقتراحات جديدة اوبمعنى آخر اللي هو توصيات + +160 +00:14:48,040 --> 00:14:54,520 +جديدة من قبل المصنع لهذا النوع من العدسات تمام؟ + +161 +00:14:54,520 --> 00:14:59,160 +إذا الـ Empirical fitting can also be used to + +162 +00:14:59,160 --> 00:15:05,130 +successfully fit soft trick lensمع هذه الطريقة، + +163 +00:15:05,130 --> 00:15:11,010 +يمكن للدراسة أن تقدم المعلومات إلى مصمم المصنع أو + +164 +00:15:11,010 --> 00:15:18,970 +المصنع + +165 +00:15:18,970 --> 00:15:25,190 +أو تستخدم تجارب كليك أو تعتمد على خبرتك الشخصية + +166 +00:15:25,190 --> 00:15:29,090 +يعني to our knowledge معلوماتي أو to our best + +167 +00:15:29,090 --> 00:15:35,010 +knowledgeto determine عشان أحدد مين ال base curve + +168 +00:15:35,010 --> 00:15:39,730 +and the prescription اللي هو الوصفة based on + +169 +00:15:39,730 --> 00:15:44,550 +spectacle refraction and keratometer readings بناء + +170 +00:15:44,550 --> 00:15:48,250 +على قراءات ال key readings وأيضا اللي هو وصفة مين + +171 +00:15:48,250 --> 00:15:49,110 +المريض + +172 +00:15:53,670 --> 00:15:58,350 +Various studies هناك مجموعة من الدراسات طبعا هذه + +173 +00:15:58,350 --> 00:16:01,510 +الدراسات كلها تكانت cross-sectional study + +174 +00:16:01,510 --> 00:16:08,650 +Demonstrated أي بمعنى شون وضحت او بينت a high + +175 +00:16:08,650 --> 00:16:13,830 +success نجاح عالي او نجاح كبير او معدلهو نجاح كبير + +176 +00:16:13,830 --> 00:16:18,330 +مع استخدام هذا ال method تقريبا قداش من واحد و ستة + +177 +00:16:18,330 --> 00:16:23,170 +لواحد و تمانية اللي هو بيحتاجها كيف يعني؟ الان انا + +178 +00:16:23,170 --> 00:16:27,330 +كل شخصين بعملهم اللي هو fitting empirical fitting + +179 +00:16:27,330 --> 00:16:31,750 +بنجح منهم يعني واحد و ستة يعني ممكن خلينا نقول + +180 +00:16:31,750 --> 00:16:37,170 +اللي هو تقريبا نسبة الفشل اللي هو seventy to اللي + +181 +00:16:37,170 --> 00:16:41,450 +هو خيارتي بالشكل هذا اللي هو نسبة النجاح و نسبة + +182 +00:16:41,450 --> 00:16:47,670 +الفشلneeded for successful fitting of high + +183 +00:16:47,670 --> 00:16:51,590 +cylinder over three diopter powers وهذه تكون اكتر + +184 +00:16:51,590 --> 00:16:56,330 +فعالية او اكتر نجاحا مع الاشخاص اللي بيكون عندهم + +185 +00:16:56,330 --> 00:16:59,830 +قيمة السلمدر اكتر من تلاتة ديوبتر + +186 +00:17:04,670 --> 00:17:09,230 +There is evidence ان هذا ال evidence ايش معناه؟ + +187 +00:17:09,230 --> 00:17:12,950 +اللي هو المساعد او اللي هو an evidence بمعنى اللي + +188 +00:17:12,950 --> 00:17:17,410 +هو ك famous، اللي هو جهاز مشهور ممكن يساعدنا في + +189 +00:17:17,410 --> 00:17:21,330 +عملية ال fitting هو عبارة عن ال corneal topography + +190 +00:17:21,330 --> 00:17:25,150 +طيب، ابراكم ال corneal topography كيف بيساعد في + +191 +00:17:25,150 --> 00:17:30,310 +عملية ال fitting؟في خيار عليه اللي ممكن لو عندنا + +192 +00:17:30,310 --> 00:17:33,070 +موجود نوع العدسة اللي بيعمل موجود نفسه في الجهاز + +193 +00:17:33,070 --> 00:17:36,430 +أنه ممكن نحط .. نحط برق الجهاز نفسه من غير ما نحط + +194 +00:17:36,430 --> 00:17:40,070 +العدسة في عين المريض تمام و بيطلعنا كيف القيامة و + +195 +00:17:40,070 --> 00:17:43,950 +كيف ممكن .. إيش نعمله تطلع تقنين صح عليه ولا .. + +196 +00:17:43,950 --> 00:17:49,750 +طيب another answer تمام كلامك سليم لكن في أيضا + +197 +00:17:49,750 --> 00:17:55,030 +اللي هو another answer هو في اتصال اللي كنا + +198 +00:17:55,030 --> 00:17:59,910 +مستخدمه نحكي هو بيعمل محكة زياللي هو في موضوع ال + +199 +00:17:59,910 --> 00:18:03,230 +law او ال high order aberration لكن الفكرة هنا في + +200 +00:18:03,230 --> 00:18:07,530 +ال corneal topography اول حاجة ان هو بيحددلي ال + +201 +00:18:07,530 --> 00:18:12,330 +type of astigmatism يعني بيحكيلي مثلا صين عنده + +202 +00:18:12,330 --> 00:18:15,770 +with the rule of astigmatism صاد عنده against the + +203 +00:18:15,770 --> 00:18:19,810 +rule of astigmatism عين عنده oblique cylinder طيب + +204 +00:18:19,810 --> 00:18:23,630 +الان يما انا بعرف الصين عنده against the rule of + +205 +00:18:23,630 --> 00:18:27,620 +astigmatism اذا مين افضل خيار له؟الـ software + +206 +00:18:27,620 --> 00:18:31,860 +contact lenses ليش؟ لأن ال RGB كنا بتعمل الهو + +207 +00:18:31,860 --> 00:18:37,240 +Decentration nasal و temporal فمن هنا انا بانطلق + +208 +00:18:37,240 --> 00:18:41,560 +ان هنا افضل خيار لهذا ال patient هو عبارة عن ال + +209 +00:18:41,560 --> 00:18:45,700 +software contact lenses شغل تاني ان الكودنيا + +210 +00:18:45,700 --> 00:18:49,620 +التمографي بحدد لي كل ال zone او ال area اللي + +211 +00:18:49,620 --> 00:18:54,660 +بيكون فيها steep و بيكون فيها flat power صح ولا + +212 +00:18:54,660 --> 00:18:55,140 +لا؟ + +213 +00:18:58,250 --> 00:19:05,010 +و ال R maximum و ال R minimum تمام؟ و أيضا بالدينة + +214 +00:19:05,010 --> 00:19:09,010 +اللى هو لو أنا كنت مثلا شخص عنده against the rule + +215 +00:19:09,010 --> 00:19:14,070 +و ماشي باتجاه ال RGB هيقوللي هذا الاكتشاف او هذا + +216 +00:19:14,070 --> 00:19:17,690 +التنبؤ او هذا التخمين اللى خاص فيك ايش ماله؟ + +217 +00:19:17,690 --> 00:19:23,930 +failure اللى هو خاطئ او غير صحيح او فاشل تمام؟ اذا + +218 +00:19:23,930 --> 00:19:25,770 +can help a predict + +219 +00:19:30,470 --> 00:19:35,610 +And patience to prepare for more lens changes ايضا + +220 +00:19:35,610 --> 00:19:39,330 +يا جماعة نقطة مهمة تانية قلنا في هناك اربع صور + +221 +00:19:39,330 --> 00:19:43,970 +بتديها مين هذا الجهاز من ضمنها اللي هو elevation + +222 +00:19:43,970 --> 00:19:48,210 +map وشوفنا في ال elevation map بتديني ايش قيمة + +223 +00:19:48,210 --> 00:19:52,550 +اللي هو ال best sphere اللي من خلالها انا بدأ ال + +224 +00:19:52,550 --> 00:19:56,710 +first point او ال initial point لاللي هو ال base + +225 +00:19:56,710 --> 00:20:03,110 +curvehigh peripheral corneal torsity may predict + +226 +00:20:03,110 --> 00:20:08,290 +first lens failure هذه الجملة مهمة كتير و حابب + +227 +00:20:08,290 --> 00:20:13,210 +المطالبة تعملي explanation لها high peripheral + +228 +00:20:13,210 --> 00:20:18,670 +corneal torsity may predict first lens failure + +229 +00:20:18,670 --> 00:20:27,330 +okay من عندها إجابة طيب نيجي مع بعض one by oneالان + +230 +00:20:27,330 --> 00:20:35,550 +بداية تانية جماعة ال corneal toricity + +231 +00:20:35,550 --> 00:20:40,290 +ايش + +232 +00:20:40,290 --> 00:20:44,110 +هتعمل induce + +233 +00:20:44,110 --> 00:20:48,350 +astigmatism + +234 +00:20:48,350 --> 00:20:53,570 +ايش معنى induce astigmatism يعني قيمة ال + +235 +00:20:53,570 --> 00:21:01,100 +astigmatism المستحدثةيعني بمعنى آخر لو حدث هناك أي + +236 +00:21:01,100 --> 00:21:06,760 +ت rotation أو unstability، عدم ثبات للعدسة ال + +237 +00:21:06,760 --> 00:21:13,650 +software هيعمل ايه؟ induce a stigmatismالـ corneal + +238 +00:21:13,650 --> 00:21:19,750 +torsity usually do induce astigmatism أي بمعنى + +239 +00:21:19,750 --> 00:21:24,430 +قيمة ال astigmatism المستحدثة، ممكن هذه القيمة + +240 +00:21:24,430 --> 00:21:28,870 +بتنتج نتيجة ال rotation أو ال unstability لمين + +241 +00:21:28,870 --> 00:21:34,220 +للعدسات السفتوريكطيب، الان انا روحت اعملت corneal + +242 +00:21:34,220 --> 00:21:39,500 +topography لجيت ان قيمة ال peripheral zone او ال + +243 +00:21:39,500 --> 00:21:44,600 +peripheral area فيها اللي هو corneal toricity و + +244 +00:21:44,600 --> 00:21:48,360 +لجناها اللي هو high power يعني over اللي هو ال + +245 +00:21:48,360 --> 00:21:52,120 +range value يعني قيمتها انه steep cornea + +246 +00:21:56,470 --> 00:22:00,810 +إذا لاحظنا إن المنطقة كل البريفيرال هان اللي هي + +247 +00:22:00,810 --> 00:22:07,910 +فيها ستيب كورنيا فهان و أنا مثلا أديت للمريض base + +248 +00:22:07,910 --> 00:22:12,230 +care دايما احنا أو بتعرفوا إن الأجهزة بتعتمد على + +249 +00:22:12,230 --> 00:22:17,190 +منطقة مين ال center zoneلكن هنا عندى وين ال steep + +250 +00:22:17,190 --> 00:22:20,670 +area او عفوا ال steep corneal power كانت فى ال + +251 +00:22:20,670 --> 00:22:24,570 +peripheral فهنا بتدينى indication ان انت عندك ايه + +252 +00:22:24,570 --> 00:22:29,030 +مشكلة فى عملية ال fitting لاختيار العدسة او بمعنى + +253 +00:22:29,030 --> 00:22:33,470 +اخر اختيار هذه العدسة غير ملائم او غير مناسب لهذا + +254 +00:22:33,470 --> 00:22:37,530 +المريممين اللي قادر على اكتشاف ذلك؟ اللي هو ال + +255 +00:22:37,530 --> 00:22:41,490 +corneal topography. ليش؟ لأن البساطة ال corneal + +256 +00:22:41,490 --> 00:22:44,870 +topography قادر انه ياخد اللي موجود عندنا في + +257 +00:22:44,870 --> 00:22:52,110 +المعمل اكتر من تمن تلاف discrete points + +258 +00:22:53,760 --> 00:22:58,680 +وقولنا بعض الأجهزة زي البنت كام بيصل لأكتر من 32 + +259 +00:22:58,680 --> 00:23:05,420 +ألف وفيه 64 ألف وفي بعض الأجهزة اليوم 132 ألف اللي + +260 +00:23:05,420 --> 00:23:09,260 +هو discrete points تمام؟ + +261 +00:23:12,370 --> 00:23:17,830 +The advantage of using empirical fitting include + +262 +00:23:17,830 --> 00:23:22,690 +fitting high powers sphere or high cylinder reduce + +263 +00:23:22,690 --> 00:23:27,870 +share time يعني هو أيضا بقلل من أيش؟ من الوقت يعني + +264 +00:23:27,870 --> 00:23:31,810 +بدل ما انا مثلا اقعد اربع جلسات او تلت جلسات مع + +265 +00:23:31,810 --> 00:23:37,550 +المريض ممكن جلستين فبقلل من قيمة من استهلاك الوقت + +266 +00:23:37,550 --> 00:23:44,810 +ما بين الفتر قمين و ال patientAnd reduced need for + +267 +00:23:44,810 --> 00:23:50,670 +inventory of trial lenses أيضا بيوفر من عدد + +268 +00:23:50,670 --> 00:23:55,590 +العدسات اللي موجودة في المستودع او المخزن يعني بدل + +269 +00:23:55,590 --> 00:24:00,010 +ما يكون عندي مثلا الف عدسة بيكون عندي مثلا متين او + +270 +00:24:00,010 --> 00:24:05,310 +تلاتمية عدسة اذا فيقلل من عدد العدسات المتوفرة في + +271 +00:24:05,310 --> 00:24:09,450 +داخل المستودع او في داخل ال inventory المخزن + +272 +00:24:16,670 --> 00:24:22,390 +طيب الآن في عندنا مصطلحين مهمين المصطلح الأول هو + +273 +00:24:22,390 --> 00:24:27,970 +عبارة عن ال lens rotation والمصطلح التاني هو عبارة + +274 +00:24:27,970 --> 00:24:40,410 +عن ال lens stability إذا عندنا lens rotation و + +275 +00:24:40,410 --> 00:24:42,130 +lens stability + +276 +00:24:47,090 --> 00:24:50,530 +ما هو الفرق ما بين ال lens rotation و ال lens + +277 +00:24:50,530 --> 00:24:58,250 +stability؟ ال lens rotation هو دوران أو حركة + +278 +00:24:58,250 --> 00:25:02,050 +العدسة عندما المريض يكون في ال primary position + +279 +00:25:03,320 --> 00:25:08,980 +يعني بمعنى أنه without a blinking تمام؟ okay you + +280 +00:25:08,980 --> 00:25:12,760 +have two important terms or two important + +281 +00:25:12,760 --> 00:25:18,690 +definitions lens rotation and lens stabilityLens + +282 +00:25:18,690 --> 00:25:24,670 +rotation هو عبارة عن حركة او دوران العدسة عندما + +283 +00:25:24,670 --> 00:25:28,530 +يكون ال patient في ال primary position يعني بدون + +284 +00:25:28,530 --> 00:25:34,390 +اي blinking او بدون اي وقت يعني اول ما انت بتضع + +285 +00:25:34,390 --> 00:25:38,850 +العدسة ال insertion من خلال ال set lamp بتشوف اللي + +286 +00:25:38,850 --> 00:25:43,420 +هو جداش قيمة ال rotation للعدسةتمام؟ إذا ال lens + +287 +00:25:43,420 --> 00:25:48,940 +rotation is not the same as lens stability okay + +288 +00:25:48,940 --> 00:25:52,740 +you have two different important terms or + +289 +00:25:52,740 --> 00:25:57,020 +definitions number one lens rotation هو حركة أو + +290 +00:25:57,020 --> 00:26:01,840 +دوران العدسة بدون أي تاء في ال primary position + +291 +00:26:01,840 --> 00:26:07,720 +بدون أي تاء blinking بينما ال lensStability اللي + +292 +00:26:07,720 --> 00:26:11,900 +هو دوران أو حركة العدسة أثناء ما المريض بعمل + +293 +00:26:11,900 --> 00:26:16,560 +complete blinking أو أثناء اللي هو بعد فترة زمنية + +294 +00:26:16,560 --> 00:26:20,800 +معينة سواء اللي هو نفترض بعد الساعة أو بعد + +295 +00:26:20,800 --> 00:26:24,440 +الساعتين أو ممكن بعد السبوع، الآن هناخد كيف هذا + +296 +00:26:24,440 --> 00:26:28,990 +هيتمLens rotation is not the same as lens + +297 +00:26:28,990 --> 00:26:33,670 +stability Rotation is the position of the lens in + +298 +00:26:33,670 --> 00:26:38,710 +a primary gaze Stability refers أي بمعنى يشير to + +299 +00:26:38,710 --> 00:26:42,210 +the movement حركة of the lens axis أو ال marking + +300 +00:26:42,210 --> 00:26:45,930 +اللي هي الساعة اللي أخدناها الستة أو الساعة سبعة + +301 +00:26:45,930 --> 00:26:51,730 +صح؟ After a complete blink بعد complete blink + +302 +00:26:51,730 --> 00:26:58,490 +ترميش كامل or a change over aأو بعد فترة زمانية + +303 +00:26:58,490 --> 00:27:05,450 +ايه معينة The limbs axis should return quickly to + +304 +00:27:05,450 --> 00:27:09,750 +the same position following each blink and should + +305 +00:27:09,750 --> 00:27:15,330 +not fluctuate over time دايما يا جماعة بعد ما انا + +306 +00:27:15,330 --> 00:27:21,230 +بعمل complete blink ال axis اما بيعود لطبيته او + +307 +00:27:21,230 --> 00:27:26,460 +بيعود لقيمة اللي تم تحديدهالذلك دايمًا العدسة ال + +308 +00:27:26,460 --> 00:27:29,420 +software ال contact lenses يما يتم عملية ال + +309 +00:27:29,420 --> 00:27:34,140 +evaluation لها لابد من الانتباه لل lens stability + +310 +00:27:34,140 --> 00:27:38,440 +للعدسة و أيضًا ال fluid اللي بيكون ما بين ال + +311 +00:27:38,440 --> 00:27:41,960 +posterior surface للعدسة و ال anterior surface + +312 +00:27:41,960 --> 00:27:48,840 +لمن؟ للكورنية lens rotation should be noted in the + +313 +00:27:48,840 --> 00:27:54,000 +chart for each trial lens الآن أنا لبست المريضو + +314 +00:27:54,000 --> 00:27:58,980 +العدسة عملت rotation لحظة ما تعمل rotation العدسة + +315 +00:27:58,980 --> 00:28:03,580 +طبعا after complete blink او بعد فترة زمنية معينة + +316 +00:28:03,580 --> 00:28:10,560 +المريض هيلاحظ ايش فيه deterioration اللي هو تدهور + +317 +00:28:10,560 --> 00:28:19,980 +في الرؤية تمام او اختلاف في الرؤية ابن + +318 +00:28:22,150 --> 00:28:26,750 +Dispensing of a lens, the rotation should be noted + +319 +00:28:26,750 --> 00:28:31,710 +and should be the same as the initial lens لازم + +320 +00:28:31,710 --> 00:28:36,210 +انا يما بصرف عن كلمة dispensing اللي هو صرف العدسة + +321 +00:28:36,210 --> 00:28:42,050 +عندما بتم اللي هو صرفها لازم انه يكون قيمة ال axis + +322 +00:28:42,050 --> 00:28:48,030 +هو مساوي لقيمة ال axis وين؟ الأصليأو لقيمة ال + +323 +00:28:48,030 --> 00:28:52,790 +access اللي تم استخدامه في اللي هو العدسة + +324 +00:28:52,790 --> 00:28:56,230 +التجريبية او ال diagnostic او ال trial method + +325 +00:28:56,230 --> 00:29:02,410 +تمام؟ a test for stability consists of manually + +326 +00:29:02,410 --> 00:29:07,930 +moving the lens axis and observing the time need + +327 +00:29:07,930 --> 00:29:13,410 +to relocate يعني الآن انا دايما بدي اخد فترة + +328 +00:29:13,410 --> 00:29:18,420 +زمانيةأنا بتكلم ك practitioner لازم أنه أخد فترة + +329 +00:29:18,420 --> 00:29:23,820 +زمنية معينة أي بمعنى period time لحد ما أدى اللي + +330 +00:29:23,820 --> 00:29:27,880 +هو ايه أشوف العدسة وين بدها تستقر أو وين بدها اللي + +331 +00:29:27,880 --> 00:29:32,300 +هو تعمل stability أو ال axis وين بده يكون اللي هو + +332 +00:29:32,300 --> 00:29:38,590 +مستقرلأنه في بعض الأحيان بتاخد اللي هو history غير + +333 +00:29:38,590 --> 00:29:42,170 +صحيح من مين، من المريض، يعني بتكون العدسة حتى إما + +334 +00:29:42,170 --> 00:29:45,970 +أنا بضع إجبال ال trial set، بقولك لأ الصورة واضحة + +335 +00:29:45,970 --> 00:29:49,250 +مية في المية، مع ذلك هي بتكون عاملة إيش، اللي هو + +336 +00:29:49,250 --> 00:29:54,930 +rotation، العدسة أو بمعنى آخر إن المريض بتكونش + +337 +00:29:54,930 --> 00:29:58,850 +الفكرة وصلانه صح أو مش قادر يعبر بشكل صحيح عن + +338 +00:29:58,850 --> 00:30:00,170 +الرؤية + +339 +00:30:01,910 --> 00:30:07,470 +النتيجة الجيدة ستكون لجهزة تقوم بتعديل التجارب إلى + +340 +00:30:07,470 --> 00:30:12,930 +نفس الموقع خلال 15 دقيقة عشان هيك ال justification + +341 +00:30:12,930 --> 00:30:17,190 +او الأسباب انه ليش انا بأخر عملية ال fitting ل 15 + +342 +00:30:17,190 --> 00:30:22,470 +ل 20 دقيقة انه انا بدي اللي هو ايه اعرف قيمة ال + +343 +00:30:22,470 --> 00:30:25,670 +stability بالضبط او قيمة اللي هو ال rotation + +344 +00:30:25,670 --> 00:30:31,990 +للعدسة يعني لحد ما تثبت اللي هو العدسةسلوك + +345 +00:30:31,990 --> 00:30:39,310 +الانتقال بسرعة مرتبط بمجموعة قوية دائما يما يكون + +346 +00:30:39,310 --> 00:30:43,730 +الحركة للعدسة اللي هو بطيئة هلا بتديني انطباع ان + +347 +00:30:43,730 --> 00:30:49,250 +العدسة إيه شمالها انه قد تكون قوية او قد تكون لنزا + +348 +00:30:49,250 --> 00:30:56,790 +قوية عندما يتحرك لنزا على العين + +349 +00:31:00,920 --> 00:31:04,400 +هو كمان اللي بيغلبنا في موضوع ال software contact + +350 +00:31:04,400 --> 00:31:08,500 +lenses evaluation عندما يكون عندك ال oblique axis + +351 +00:31:08,500 --> 00:31:15,140 +يعني 145 او 30 او 45 ليش؟ لأنه بيعمل اللي هو حاجة + +352 +00:31:15,140 --> 00:31:19,040 +بنسميها induce astigmatism يعني قيمة ال + +353 +00:31:19,040 --> 00:31:24,100 +astigmatism مستحدثةas long as the rotation is + +354 +00:31:24,100 --> 00:31:29,280 +stable and not more than 30 degrees جداش حكينا 30 + +355 +00:31:29,280 --> 00:31:34,280 +degrees اللي هي عبارة عن one hour تمام؟ the fit is + +356 +00:31:34,280 --> 00:31:39,640 +acceptable إذا هيكون مقبول يعني الآن في بعض + +357 +00:31:39,640 --> 00:31:44,720 +الحالات يما بيكون عندنا قيمة ال rotationأقل من + +358 +00:31:44,720 --> 00:31:50,240 +تلاتين ديجري تمام ممكن أن يكون عندنا العدسة هذه + +359 +00:31:50,240 --> 00:31:54,680 +مقبولة، لكن وين هذه الشرط؟ لازم يكون عندنا low + +360 +00:31:54,680 --> 00:32:00,800 +refractive error أو low sensitivity للمريضHowever, + +361 +00:32:01,040 --> 00:32:05,580 +the lens axis needs to be adjusted to compensate + +362 +00:32:05,580 --> 00:32:11,200 +بمعنى تعويض انه يعمل عملية تعويض for the rotation + +363 +00:32:11,200 --> 00:32:16,700 +if the visual acuity is compromised لكن هذا اذا + +364 +00:32:16,700 --> 00:32:20,860 +كان عندنا two degrees او three degrees ومأثرة على + +365 +00:32:20,860 --> 00:32:24,660 +ال visual acuity لازم انا اعمل عملية تعويض عشان + +366 +00:32:24,660 --> 00:32:28,460 +احسن من مين من ال visual acuity الخاص بالمريض + +367 +00:32:29,870 --> 00:32:34,650 +rotation is judged يعني بمعنى تحكم عليها يعني انا + +368 +00:32:34,650 --> 00:32:39,030 +بحكم على اللي هو ال rotation by imaging a clock + +369 +00:32:39,030 --> 00:32:42,710 +face over the cornea يعني دايما انا بدي اعتبر + +370 +00:32:42,710 --> 00:32:46,650 +العدسة اللي لابسها هي عبارة عن ساعة او عبارة عن a + +371 +00:32:46,650 --> 00:32:50,070 +stigmatic fan و بدي اشوف اللي هو قيمة ال rotation + +372 +00:32:50,070 --> 00:32:50,590 +لها + +373 +00:32:57,190 --> 00:33:01,690 +خمساشر ثانية او خمساشر دقيقة؟ بتتحكم فيها انك + +374 +00:33:01,690 --> 00:33:06,070 +تتحكم فيها؟ لأ هي دايما fifteen seconds هو بذكر + +375 +00:33:06,070 --> 00:33:11,690 +ولكن انا بقول ك evaluation بشكل عام يعني بمعنى اخر + +376 +00:33:11,690 --> 00:33:17,510 +الآن انا بلبس المريض بنتظر اللي هو تقريبا من خمساش + +377 +00:33:17,510 --> 00:33:20,850 +لعشرين اللي هو minutes او بنتظر اللي هو خمسة + +378 +00:33:20,850 --> 00:33:23,350 +minutes لكن هو اللي بقصد فيه في ال complete + +379 +00:33:23,350 --> 00:33:29,290 +blinkingأو over a time، تمام؟ لكن هذا كله الشغل + +380 +00:33:29,290 --> 00:33:33,270 +اللي هو theory، يعني في ال practice الأمر بختلف، + +381 +00:33:33,270 --> 00:33:37,290 +انت حسب ما انت إيش ك observation اللي هو بيشوفه، + +382 +00:33:37,290 --> 00:33:39,910 +يعني إذا أنا شايف مثلا ال fluid ما بين العدسة و + +383 +00:33:39,910 --> 00:33:43,770 +الكورنية، بدي أعمل عملية إيه؟ اللي هو تأخير لهذا + +384 +00:33:43,770 --> 00:33:50,250 +القيمةيعني بمعنى أخر أن الأرقام هنا مش مكان للحفظ + +385 +00:33:50,250 --> 00:33:54,270 +لأن هذه الأرقام هي اعتمدت على دراسات سابقة و قد + +386 +00:33:54,270 --> 00:34:03,150 +تتغير طيب lenses with a prism palest have markings + +387 +00:34:03,150 --> 00:34:08,870 +that are intended عندما يتم وضع العدسة على القرنية + +388 +00:34:08,870 --> 00:34:16,440 +أنه لازم نشبه العدسة و كأنها عبارة عن ساعةover the + +389 +00:34:16,440 --> 00:34:23,220 +cornea وبناء على الساعة هذه اللي over او ال clock + +390 +00:34:23,220 --> 00:34:27,660 +imaging انا بعمل عملية ال evaluation عند المريض + +391 +00:34:27,660 --> 00:34:32,880 +طبعا بنكتفي ان شاء الله لهذا القدر في اي سؤال في + +392 +00:34:32,880 --> 00:34:37,320 +المحاضرة القادمة ان شاء الله بنكمل طبعا بنعتذر على + +393 +00:34:37,320 --> 00:34:39,820 +موضوع اللي هو الانقطاع + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/tH3WkzkNA2U_postprocess.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/tH3WkzkNA2U_postprocess.srt new file mode 100644 index 0000000000000000000000000000000000000000..b3ce7b6647ff4fa4e3e9f64a77eef51b67556e39 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/tH3WkzkNA2U_postprocess.srt @@ -0,0 +1,1540 @@ +1 +00:00:21,510 --> 00:00:23,990 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:23,990 --> 00:00:29,390 +وبركاته ومرحبا لكم جميعا في محاضرة اليوم ان شاء + +3 +00:00:29,390 --> 00:00:33,050 +الله هنكمل في موضوع ال software contact lenses + +4 +00:00:33,050 --> 00:00:39,350 +طبعا في البداية لو نفترض عندنا وصفة minus three + +5 +00:00:39,350 --> 00:00:48,180 +over minus point fiftyaxis 90 تمام هذه كانت هي + +6 +00:00:48,180 --> 00:00:53,900 +عبارة عن ال subjective refraction اللي خاصة بالمرض + +7 +00:00:53,900 --> 00:00:59,400 +الخطوة الأولى انا ك examiner لو انا بشتغل في موضوع + +8 +00:00:59,400 --> 00:01:07,040 +ال diagnostic او + +9 +00:01:07,040 --> 00:01:09,740 +ال trial method تمام + +10 +00:01:13,470 --> 00:01:18,710 +يكون قريب من ال access اللي عند المريض تمام؟ يعني + +11 +00:01:18,710 --> 00:01:23,870 +مثلا لو كان عندنا access تمانين هذا بيكون accepted + +12 +00:01:23,870 --> 00:01:28,690 +بالنسبة لي أنا بحكي وين؟ في اللي هو ال trial set + +13 +00:01:28,690 --> 00:01:34,750 +تمام؟الخطوة التانية بختار اللى هو power قريب من + +14 +00:01:34,750 --> 00:01:39,010 +power السليندر اللى خاصة فى مين فى المريض والخطوة + +15 +00:01:39,010 --> 00:01:44,710 +التالتة انه بختار power يكون اللى هو يعني minus or + +16 +00:01:44,710 --> 00:01:49,670 +plus 2 ديوبتر قريب من إيش من قيمة السليندر اللى + +17 +00:01:49,670 --> 00:01:53,670 +خاصة بالمريض لأنه فى الآخر انا إيش هعمل over + +18 +00:01:53,670 --> 00:01:58,950 +refraction تمام خلينا نشوفIf the trial lens axis + +19 +00:01:58,950 --> 00:02:04,050 +is close to the refractive axis يعني إذا كان هان + +20 +00:02:04,050 --> 00:02:07,530 +المقصود في ال trial lens axis العدسة اللي موجودة + +21 +00:02:07,530 --> 00:02:11,890 +في ال trial set طبعا قريبة من ال refractive axis + +22 +00:02:11,890 --> 00:02:14,650 +اللي هي تحت ال subjective refraction أو تحت ال + +23 +00:02:14,650 --> 00:02:17,090 +spectacle العدسة أو النضارة + +24 +00:02:19,820 --> 00:02:23,300 +Compensating اللي هو بعد التعويض for the lens + +25 +00:02:23,300 --> 00:02:26,620 +rotation يعني بعد ما انا بدي اعود قيمة دوران A + +26 +00:02:26,620 --> 00:02:31,880 +العدسة The final lens power can be determined by + +27 +00:02:31,880 --> 00:02:35,820 +over refracting the sphere power اذا انا بدي اعمل + +28 +00:02:35,820 --> 00:02:40,420 +بعد ما احط ال trial lens بدي اعمل للمريض ايه over + +29 +00:02:40,420 --> 00:02:44,920 +refraction واشوف قداش قيمة السفير وقيمة السلندر + +30 +00:02:44,920 --> 00:02:51,320 +واشوف قداش قيمة ال axis الجديدة تمام؟إذن to obtain + +31 +00:02:51,320 --> 00:02:54,420 +the final lens to be ordered طب ليش أنا بدي أعمل + +32 +00:02:54,420 --> 00:02:58,740 +over refraction عشان أطلب العجزة النهائية للمريض؟ + +33 +00:03:00,110 --> 00:03:04,690 +reproducibility of software lenses have improved + +34 +00:03:04,690 --> 00:03:10,350 +greatly in recent years يعني الآن اللي هو صناعة أو + +35 +00:03:10,350 --> 00:03:14,690 +اللي هو إنتاج العدسات ال software في الآونة + +36 +00:03:14,690 --> 00:03:18,310 +الأخيرة صار فيها نوع من التطور يعني صارت اللي هو + +37 +00:03:18,310 --> 00:03:23,150 +متطورة تمام؟ من ناحية مين؟ ال manufacturer اللي هو + +38 +00:03:23,150 --> 00:03:28,290 +المصنع لهاSo there is little concern for errors + +39 +00:03:28,290 --> 00:03:31,790 +حيكون لو انا اشتغلت بطريقة ال diagnostic method + +40 +00:03:31,790 --> 00:03:37,190 +هيكون نسبة الخطأ عند المريض قليلة كتير يعني بمعنى + +41 +00:03:37,190 --> 00:03:41,650 +اخر لو انا اشتغلت للمريض diagnostic method ووصلت + +42 +00:03:41,650 --> 00:03:46,730 +لعدسة ال final power اللي مطلوب لما انا ببعتها + +43 +00:03:46,730 --> 00:03:52,790 +للشركة تمام هيكون نسبة الخطأ للعدسة بسيطة تمام هدف + +44 +00:03:52,790 --> 00:03:58,450 +القاونة الأخيرةSo there is little concern for + +45 +00:03:58,450 --> 00:04:02,110 +errors when using the trial lens method of fitting + +46 +00:04:02,110 --> 00:04:06,350 +من هذه الجملة انا باخد نقطة مهمة ان ال diagnostic + +47 +00:04:06,350 --> 00:04:10,390 +او ال trial method هي تعتبر ايه ادق من ال + +48 +00:04:10,390 --> 00:04:15,030 +empirical method تمام؟ اذا الان لو سالتك مين ادق + +49 +00:04:15,030 --> 00:04:18,130 +ال empirical method ولا ال diagnostic ال trial + +50 +00:04:18,130 --> 00:04:22,410 +method لأ ال diagnostic ال trial method هي الأدق + +51 +00:04:22,410 --> 00:04:24,290 +تمام؟ + +52 +00:04:25,560 --> 00:04:31,080 +إذا لم تتجاوز حركة الورق مع حركة الحرارة، يمكن أن + +53 +00:04:31,080 --> 00:04:32,980 +يكون مجرد عملية عملية عملية عملية عملية عملية + +54 +00:04:32,980 --> 00:04:33,440 +عملية عملية عملية عملية عملية عملية عملية عملية + +55 +00:04:33,440 --> 00:04:35,840 +عملية عملية عملية عملية عملية عملية عملية عملية + +56 +00:04:35,840 --> 00:04:38,720 +عملية عملية عملية عملية عملية عملية عملية عملية + +57 +00:04:38,720 --> 00:04:39,180 +عملية عملية عملية عملية عملية عملية عملية عملية + +58 +00:04:39,180 --> 00:04:39,500 +عملية عملية عملية عملية عملية عملية عملية عملية + +59 +00:04:39,500 --> 00:04:41,740 +عملية عملية عملية عملية عملية عملية عملية عملية + +60 +00:04:41,740 --> 00:04:45,930 +عملية عملواخترت عدسة ملائمة ولاحظت ايضا في blood + +61 +00:04:45,930 --> 00:04:49,890 +vision في هذه الحالة ايش بدي اعمل بدي استخدم + +62 +00:04:49,890 --> 00:04:54,150 +الجاكسون cross cylinder زي ما اتفقنا في المعمل انه + +63 +00:04:54,150 --> 00:04:59,330 +استخدمناه عشان نصلمين لأفضل access ملائم للمريض + +64 +00:05:02,200 --> 00:05:07,580 +Cross-cylinder calculations is an alternate method + +65 +00:05:07,580 --> 00:05:12,680 +to left and right subtract يعني هذه العدسة + +66 +00:05:12,680 --> 00:05:17,300 +الـJackson cross-cylinder هي تعتبر طريقة بديلة أو + +67 +00:05:17,300 --> 00:05:21,600 +تكنيك بديل لاستخدام التكنيك السابق اللي أخدناه + +68 +00:05:21,600 --> 00:05:26,740 +left and right subtract which some believe to be + +69 +00:05:26,740 --> 00:05:30,340 +more precise البعض بيعتبرها أنها دقيقة + +70 +00:05:36,840 --> 00:05:42,020 +once the fit of the lens has been confirmed يعني + +71 +00:05:42,020 --> 00:05:46,980 +واحد من ال researcher أو واحد من الفتر بيعمل عملية + +72 +00:05:46,980 --> 00:05:50,440 +confirmed إيش معناه confirmed؟ أي بمعنى تأكيد أو + +73 +00:05:50,440 --> 00:05:57,500 +تثبيت تمام؟And if visual acuity is compromised + +74 +00:05:57,500 --> 00:06:04,400 +نفترض انه لان انا استخدمت التلاث صور لجاكسون اكروس + +75 +00:06:04,400 --> 00:06:08,360 +سيلندر لاحظت انه ال visual acuity بصيله compromise + +76 +00:06:08,360 --> 00:06:12,800 +ايش منات compromise يعني بمعنى بقل او بنزل تمام؟ + +77 +00:06:13,700 --> 00:06:17,580 +إذا أنا في عندي هن إيش؟ defect صح ولا لأ؟ بمعنى + +78 +00:06:17,580 --> 00:06:22,180 +آخر لو أنا عرضت الصورة الأولى، التانية قال مغبشة، + +79 +00:06:22,180 --> 00:06:25,800 +التالتة مغبشة، إذا الصورة الأولى هي الصح، ليش؟ + +80 +00:06:25,800 --> 00:06:29,260 +لأنه في الصورة التانية والتالتة صار تغبيش عند مين؟ + +81 +00:06:29,260 --> 00:06:32,940 +عند المريض، صحيحة ولا لأ؟ بدي أستخدم مين؟ ال + +82 +00:06:32,940 --> 00:06:36,640 +Jackson cross cylinderAnd if visual acuity is + +83 +00:06:36,640 --> 00:06:42,160 +compromised، لو كان الحدة الإبصار قل، then perform + +84 +00:06:42,160 --> 00:06:45,260 +a sphere-cylinder over-refraction over + +85 +00:06:45,260 --> 00:06:46,700 +equilibrated lenses + +86 +00:07:05,250 --> 00:07:11,770 +في هناك special test تمام maybe needed to attain + +87 +00:07:11,770 --> 00:07:16,790 +the best possible result يعني في هناك اللي هو + +88 +00:07:16,790 --> 00:07:22,450 +testات خاصة بنحتاجها في عملية ال evaluation لل + +89 +00:07:22,450 --> 00:07:25,830 +software اللي كنتك لينزل to attain أي بمعنى to + +90 +00:07:25,830 --> 00:07:32,430 +achieve لتحقيق أفضل اللي هو نتيجة محتملة common + +91 +00:07:32,430 --> 00:07:38,890 +errors causingPoor performance includes incorrect + +92 +00:07:38,890 --> 00:07:44,250 +base curve إذا الآن لو كان في هناك خطأ في العدسة + +93 +00:07:44,250 --> 00:07:48,990 +اللي لبسها المريض أنا ك examiner إيش بتوقع؟ إنه + +94 +00:07:48,990 --> 00:07:52,470 +يكون فيه أول حاجة خطأ في ال base curve بتاع العدسة + +95 +00:07:52,470 --> 00:07:56,470 +الأمر التاني ممكن إنه أتوقع إنه يكون فيه خطأ بال + +96 +00:07:56,470 --> 00:08:01,080 +power بتاع العدسة صح ولا لأ؟انا عمله subjective او + +97 +00:08:01,080 --> 00:08:04,180 +objective refraction بشكل غير صحيح او بشكل غير + +98 +00:08:04,180 --> 00:08:07,140 +دقيق عشان هي قلتلكم دايما اما تعمل subjective + +99 +00:08:07,140 --> 00:08:12,700 +refraction لابد ان يكون ايه؟ accurate دقيق تمام؟ + +100 +00:08:12,700 --> 00:08:17,640 +and unpredictable lens power effects يعني ماقدرنا + +101 +00:08:17,640 --> 00:08:22,180 +انه نستكشف ايه اللي هو او نتنبأ جديش اللي هو تأثير + +102 +00:08:22,180 --> 00:08:27,370 +قوة العدسةبمعنى اخر الان انا مثلا المريض زي المثال + +103 +00:08:27,370 --> 00:08:31,590 +السابق عنده minus 3 لما عملنا over refraction طلع + +104 +00:08:31,590 --> 00:08:37,710 +3.5 اذا في عنده اللي هو lens power اللي هو زائد صح + +105 +00:08:37,710 --> 00:08:41,950 +ولا لا بمعنى اخر ممكن انا ادي عدسة تمام اللي هي ال + +106 +00:08:41,950 --> 00:08:45,610 +final power واروح اعمله over refraction الاقي انه + +107 +00:08:45,610 --> 00:08:50,650 +لسه في عنده ايش اللي هو قيمةفهذا كله اشمله ان هذا + +108 +00:08:50,650 --> 00:08:55,270 +بيدي اللي هو انزعاج للمريض و بيقلل اللي هو الرؤية + +109 +00:08:55,270 --> 00:09:00,490 +اللي خاصة بالمريض اذا الان لو انا سألتك ايش هي + +110 +00:09:00,490 --> 00:09:04,470 +المشاكل ممكن واحد يكون عنده blurred vision في ال + +111 +00:09:04,470 --> 00:09:08,210 +software واحد ان يكون عنده incorrect لل base care + +112 +00:09:08,210 --> 00:09:11,610 +اتنين incorrect لل lens power incorrect لل + +113 +00:09:11,610 --> 00:09:16,230 +refraction ال lens effect unpredictable غير مكتشفة + +114 +00:09:16,230 --> 00:09:21,890 +او غير معروفةThis special test can aid in + +115 +00:09:21,890 --> 00:09:27,450 +achieving the best result quickly. إذن هذه التستات + +116 +00:09:27,450 --> 00:09:31,150 +اللي هيتم مناقشتها الآن كلها هادي بالساعد aid + +117 +00:09:31,150 --> 00:09:35,990 +بمعنى مساعدة في تحقيق اللي هو أفضل نتيجة اللي هو + +118 +00:09:35,990 --> 00:09:38,510 +بشكل سريع لمين للمريض + +119 +00:09:41,780 --> 00:09:46,560 +نمبر وان عندنا ال written scope طبعا احنا بنعرف ان + +120 +00:09:46,560 --> 00:09:49,860 +ال written scope هو عبارة عن objective method + +121 +00:09:49,860 --> 00:09:54,600 +بيستخدم لتحديد ايه ال refractive error للمريض لكن + +122 +00:09:54,600 --> 00:09:58,850 +احنا الآن ايش بدنا نستخدمها؟بدي اشوف to evaluate + +123 +00:09:58,850 --> 00:10:04,770 +the cornea lens fitting relationship as well as to + +124 +00:10:04,770 --> 00:10:08,810 +determine if there any power effects or cross + +125 +00:10:08,810 --> 00:10:13,570 +cylinder effects يعني بدي اشوف انه هل القوة اللي + +126 +00:10:13,570 --> 00:10:18,330 +مش مسلحة عند المريض هل هي تعتبر significant ولا + +127 +00:10:18,330 --> 00:10:21,230 +insignificant طبعا احنا عارفين اذا كانت + +128 +00:10:21,230 --> 00:10:25,730 +insignificant بدنا نتغابى عنها انه غير مهمة يعني + +129 +00:10:25,730 --> 00:10:29,580 +مش مأثرة على النظرتمام؟ لكن إذا كانت significant + +130 +00:10:29,580 --> 00:10:33,540 +لابد من إعادة إيه؟ نعمل refitting للعدسات مرة + +131 +00:10:33,540 --> 00:10:33,940 +تانية + +132 +00:10:38,700 --> 00:10:44,060 +الان نفترض واعد لابسة عدسة optimal fit تمام؟ لازم + +133 +00:10:44,060 --> 00:10:48,100 +انا يما اجي اشوف ال red reflex before و after + +134 +00:10:48,100 --> 00:10:52,280 +blinking و هي لابسة العدسة اللاصقة الحالتين يكونوا + +135 +00:10:52,280 --> 00:10:56,420 +crisp اي بمعنى clear او التنتين يكونوا bright مضيق + +136 +00:10:56,420 --> 00:10:59,700 +ال red reflex يكون واضح تمام؟ + +137 +00:11:02,130 --> 00:11:06,050 +Distortion لو الرد رفليكس هذا ظهر فيه اللي هو تشوش + +138 +00:11:06,050 --> 00:11:09,650 +أو عدم وضوح زي الميارز زي ما شوفناها في الجوال + +139 +00:11:09,650 --> 00:11:15,270 +كراتوميتر Distortion may indicate a steep lens طيب + +140 +00:11:15,270 --> 00:11:18,930 +لو سألنا الآن سيها ممكنش يكون اللي هو steep lens؟ + +141 +00:11:30,930 --> 00:11:35,730 +و احنا طلبنا من وعد نرجع للمثال انه تعمل اللي هو + +142 +00:11:35,730 --> 00:11:39,590 +blinking او complete blinking من خلال ال reflex + +143 +00:11:39,590 --> 00:11:43,190 +بتاع ال retinascope او الكيراتوميتر مايرز بعد + +144 +00:11:43,190 --> 00:11:47,210 +الترميش هيكون ايه شماله؟ اللي هو clear واضح او + +145 +00:11:47,210 --> 00:11:51,450 +crisp اللي هو مضيق تمام؟ طيب قبل الترميش هيكون + +146 +00:11:51,450 --> 00:11:57,030 +unclear لو كانت flat العدسة before blinking هيكون + +147 +00:11:57,030 --> 00:11:57,410 +clear + +148 +00:12:00,410 --> 00:12:05,950 +وفيه distortion okay poor lens optics يعني في هناك + +149 +00:12:05,950 --> 00:12:11,770 +مشكلة من المصنع في العدسة تمام سواء ممكن يكون في + +150 +00:12:11,770 --> 00:12:15,590 +ال base curve أو في ال diameter أو اللي هو يعني في + +151 +00:12:15,590 --> 00:12:19,030 +ال parameters الخاصة بالعدسة أو نفترض مثلا بال + +152 +00:12:19,030 --> 00:12:25,960 +water contentأو ربط الكورنيا غير عادل زي ما اتفقنا + +153 +00:12:25,960 --> 00:12:30,960 +ان الصفتوريك كونتاك لينزلز لبرنسبل تاحه انه موافق + +154 +00:12:30,960 --> 00:12:36,700 +لشكل الكورنيا فلو كان عنده اي تتشقق او اي مثلا + +155 +00:12:36,700 --> 00:12:42,220 +اعوجاج او عدم انتظام في الكورنيابناخد نفس الشكل صح + +156 +00:12:42,220 --> 00:12:48,420 +ولا لا فهذا هيأثر على اللي هو من العدسة الملائمة + +157 +00:12:48,420 --> 00:12:54,920 +او المناسبة للمريض لذلك بدنا نستبدل باللي هو ايه + +158 +00:12:54,920 --> 00:12:59,420 +ال RGB سواء اللي هو spherical RGB او Toric RGB + +159 +00:13:04,430 --> 00:13:09,830 +Autorefraction over the lens can be of benefit as + +160 +00:13:09,830 --> 00:13:14,190 +a starting point in determining an overrefraction + +161 +00:13:14,190 --> 00:13:20,930 +بعض من الأخصائيين أو الأخصائيات أول ما بيضع ال + +162 +00:13:20,930 --> 00:13:26,350 +trial lens اللي هي بتكون close لوصفة النضارة أو ال + +163 +00:13:26,350 --> 00:13:31,630 +subjective refraction بروح بعمل ايه overrefraction + +164 +00:13:32,450 --> 00:13:36,730 +الـ Over Refraction يقدّش قيمة السفير والسلمدر + +165 +00:13:36,730 --> 00:13:41,230 +والأكسز فهذا بيسهّل عليه ايش في ال starting point + +166 +00:13:41,230 --> 00:13:45,770 +زي بالضبط عندما اتفقنا ان في ال RGB الفكرة + +167 +00:13:45,770 --> 00:13:49,310 +الأساسية وين اعرف ال initial point او ال starting + +168 +00:13:49,310 --> 00:13:54,140 +point بتاعة ال base curve وهذا نفس الحاجةو ال over + +169 +00:13:54,140 --> 00:13:58,000 +refraction هو يعتبر guide ليه عشان اعرف اللي هو + +170 +00:13:58,000 --> 00:14:03,780 +جديش البداية اللي ابدأ فيها كعدسة ملائمة او مناسبة + +171 +00:14:03,780 --> 00:14:11,400 +للمريض طيب في عندنا manual rotation يعني بمعنى انه + +172 +00:14:11,400 --> 00:14:17,180 +دوران بشكل يدوي للعدسة وهنا راجزوا معي كويس لان في + +173 +00:14:17,180 --> 00:14:24,210 +اختلاف شوية بسيطManual rotation can only verify if + +174 +00:14:24,210 --> 00:14:30,110 +an axis change will improve vision الان انا قعدت + +175 +00:14:30,110 --> 00:14:34,770 +المريض تمام نفترض عندى في العيادة مش موجود اللى هو + +176 +00:14:34,770 --> 00:14:38,190 +ال Jackson cross cylinder قعدنا المريض امام ال + +177 +00:14:38,190 --> 00:14:43,830 +cylinder chart و العدسة inside the eye اعملنا اللى + +178 +00:14:43,830 --> 00:14:50,170 +هو تحريك للجفن السفليلا المريض فلاحظنا انه العدسة + +179 +00:14:50,170 --> 00:14:54,430 +يما بتروح باتجاه اليمين او باتجاه الشمال في + +180 +00:14:54,430 --> 00:15:01,590 +improvement في تحسن تمام هذا بيديني انطباع ان ال + +181 +00:15:01,590 --> 00:15:06,570 +axis الأصل عند المريض ايه مش صحيح incorrect بدنا + +182 +00:15:06,570 --> 00:15:10,830 +نعمل اللي هو ايه تعديل لل axis اما بالزيادة او + +183 +00:15:10,830 --> 00:15:13,910 +بالنقصان ال axis هذه المقصود فيها ال manual + +184 +00:15:13,910 --> 00:15:21,250 +rotationManual rotation can only verify إذا مالهاش + +185 +00:15:21,250 --> 00:15:24,230 +علاقة في ال rotation يا جماعة أو مالهاش علاقة بال + +186 +00:15:24,230 --> 00:15:31,110 +stability فقط إيش بتأكد اللي هو ال axis إذا can + +187 +00:15:31,110 --> 00:15:35,910 +only verify if an axis change will improve vision + +188 +00:15:35,910 --> 00:15:40,130 +يعني الآن أنا لما بغير اللي هو ال axis هل بتحسن + +189 +00:15:40,130 --> 00:15:46,740 +النظر ولا لا؟Using two lines worse on the Snillen + +190 +00:15:46,740 --> 00:15:51,800 +chart يعني نفترض المريض وصل بالعدسة ال trial او ال + +191 +00:15:51,800 --> 00:15:58,340 +diagnostic lens ستة على تمانتاش تمام حركت العدسة + +192 +00:15:58,340 --> 00:16:04,120 +المريض شاف الستة على اتناش و الستة على تسعة اذا في + +193 +00:16:04,120 --> 00:16:09,800 +عندنا ايش صار improve تمام اذا باخد ال two lines + +194 +00:16:09,800 --> 00:16:15,200 +اللي بعد منالـ line اللي شافهم طيب نفترض انه صار + +195 +00:16:15,200 --> 00:16:19,900 +في عنده worse يعني جل ال visual acuity يعني بدل ما + +196 +00:16:19,900 --> 00:16:24,360 +شاف ال 6 ع 18 يما حركنا العجزة اللي هو شاف ايه + +197 +00:16:24,360 --> 00:16:29,360 +اللي هو 6 على 60 او 6 ع 36 هذا بتديني انطباع ان ال + +198 +00:16:29,360 --> 00:16:32,500 +axis الاول ايش ماله صحيح تمام؟ + +199 +00:16:35,400 --> 00:16:40,640 +إذا using two lines worse on the Snellen chart ask + +200 +00:16:40,640 --> 00:16:45,320 +patient to report better or worse vision as the + +201 +00:16:45,320 --> 00:16:50,200 +lens repositions after you manually rotate the + +202 +00:16:50,200 --> 00:16:53,880 +lens face to the right and the left يعني الآن أنا + +203 +00:16:53,880 --> 00:16:58,800 +بدي أعرض السطرين اللي قبل اللي شافهم يعني نفترض هو + +204 +00:16:58,800 --> 00:17:04,950 +شاف ستة على تسعةبدي اعرض قبله بسطرين وبعده بسطرين + +205 +00:17:04,950 --> 00:17:08,930 +واشوف انه هل بيصير improve ولا worse لل visual + +206 +00:17:08,930 --> 00:17:14,730 +acuity طبعا من خلال ايه؟ تحريك ال lower eyelid + +207 +00:17:14,730 --> 00:17:19,330 +للمريض وبيشوف هل فيه تحسن لل visual acuity ولا لا + +208 +00:17:31,540 --> 00:17:38,380 +لو كان هناك تحسن لحظة زي ما اتفقنا للحظات في تحسن + +209 +00:17:38,380 --> 00:17:43,560 +لكن ايه؟ momentarily أي بمعنى لحظة when you rotate + +210 +00:17:43,560 --> 00:17:45,000 +the lens to the right + +211 +00:17:52,470 --> 00:17:55,830 +يعني بدنا نعمل إضافة لل axis هان احنا قلنا ماناش + +212 +00:17:55,830 --> 00:17:59,550 +علاقة في مين؟ في اللي هو ال rotation أو ال + +213 +00:17:59,550 --> 00:18:02,750 +stability عشان ما تقولليش واحدة انه left add و + +214 +00:18:02,750 --> 00:18:07,270 +right subtract تمام؟ اذا هان انا حركت العدسة + +215 +00:18:07,270 --> 00:18:13,570 +باتجاه اليمين لاحظت انه المريض بتحسن اذا بدي ازود + +216 +00:18:13,570 --> 00:18:18,430 +على ال axis الأصلي بالقيمة اللي اتحسن فيهاتمام؟ + +217 +00:18:18,430 --> 00:18:22,710 +لكن هي بتكون إيش اللي هو قيمة اللي هو about، يعني + +218 +00:18:22,710 --> 00:18:26,070 +مش دقيقة، لذلك الأفضل إنه إيش بستخدم؟ + +219 +00:18:32,470 --> 00:18:38,390 +طيب لو هو اتحسن ال vision باتجاه اللي هو الشمال في + +220 +00:18:38,390 --> 00:18:41,770 +ال left اذا معناه الكلام انه بدي اعمل عملية اللي + +221 +00:18:41,770 --> 00:18:46,250 +هو subtract طريح للي هو قيمة ال axis مرة تانية + +222 +00:18:46,250 --> 00:18:51,490 +بيذكرنا this doesn't verify the amount but only + +223 +00:18:51,490 --> 00:18:55,350 +direction for a new axis هو مابدي نجد اشهر قيمة ال + +224 +00:18:55,350 --> 00:18:59,290 +rotation او ال stability فقطبقول لي أن ال axis + +225 +00:18:59,290 --> 00:19:03,350 +بتاع العدسة غير ملائم أو غير مناسب و بدنا نعمل + +226 +00:19:03,350 --> 00:19:07,710 +اللي هو عملية ايه تغيير لهذا ال axis بالقيمة + +227 +00:19:07,710 --> 00:19:13,470 +الصحيحة Cornial + +228 +00:19:13,470 --> 00:19:20,950 +topography can predict more challenging fitsالجهاز + +229 +00:19:20,950 --> 00:19:26,670 +.. الجهاز ال corneal topography هو يستطيع تنبؤ أو + +230 +00:19:26,670 --> 00:19:31,390 +اللي هو تخمين اللي .. الفت اللي بيكون فيه له + +231 +00:19:31,390 --> 00:19:36,410 +تحديات، كيف يعني؟ نفترض مثلا بيشون عنده في ال + +232 +00:19:36,410 --> 00:19:41,210 +center normal value، لكن في ال peripheral في عنده + +233 +00:19:41,210 --> 00:19:46,200 +steep corneaاذا هان هيكون صعب في عملية ال + +234 +00:19:46,200 --> 00:19:49,760 +evaluation او في عملية ال fitting مين اللي بساعدني + +235 +00:19:49,760 --> 00:19:54,670 +في هذا العمل اللي هو ال corneal topography؟A + +236 +00:19:54,670 --> 00:19:59,130 +higher degree of empirical fitting failures of + +237 +00:19:59,130 --> 00:20:05,370 +care دايما الطريقة التجريبية بتفشل وين؟ لما واحد + +238 +00:20:05,370 --> 00:20:08,950 +يكون عنده high refractive error لأنه عنده high + +239 +00:20:08,950 --> 00:20:13,270 +sensitivity تمام؟ او بيكون في عنده irregular + +240 +00:20:13,270 --> 00:20:17,070 +peripheral corneal toricity يعني منطقة اللي هو + +241 +00:20:17,070 --> 00:20:23,850 +الأطراف فيها ال care reading هي تعتبريعني فيها ال + +242 +00:20:23,850 --> 00:20:28,750 +key reading أعلى ك corneal اللي هو power فها المين + +243 +00:20:28,750 --> 00:20:31,870 +اللي بساعدنا في عملية ال fitting هو عبارة عن ال + +244 +00:20:31,870 --> 00:20:37,690 +corneal topography instrument أيضا + +245 +00:20:37,690 --> 00:20:41,870 +في عندنا dialing and rotation يعني بمعنى اللي هو + +246 +00:20:41,870 --> 00:20:49,060 +التدوير عملية التدوير لل trial frameWhile the lens + +247 +00:20:49,060 --> 00:20:53,560 +is on the eye is helpful in checking rotational + +248 +00:20:53,560 --> 00:20:58,900 +velocity يعني الآن احنا لابد أسمع العدسة للمريض + +249 +00:20:58,900 --> 00:21:04,080 +تمام و بدأ أشوف سرعة الدوران للعدسة ممكن أني + +250 +00:21:04,080 --> 00:21:08,380 +أستخدم ال dial اللي هو الخاص في ال trial frame و + +251 +00:21:08,380 --> 00:21:13,120 +من خلاله بقدر اللي هو أحدد قيمة ال axis يعني قداش + +252 +00:21:13,120 --> 00:21:15,600 +في سرعة الدوران لمن للعدسة + +253 +00:21:19,170 --> 00:21:25,010 +سرعة الدوران is the speed at which a lens returns + +254 +00:21:25,010 --> 00:21:31,370 +to the proper position when mislocatedيعني سرعة + +255 +00:21:31,370 --> 00:21:36,230 +الدوران اللي هي عبارة عن سرعة بتمثل جداش دوران + +256 +00:21:36,230 --> 00:21:40,670 +العدسة عن ال proper fit يعني وضعها الملائم أو + +257 +00:21:40,670 --> 00:21:45,810 +المناسب جداش هي قادرة انه تعمل mislocated يعني انه + +258 +00:21:45,810 --> 00:21:49,610 +تبعد عن ايش مكانها الطبيعي او تعمل اللي هو + +259 +00:21:49,610 --> 00:21:56,750 +displacement ازاحة تمام يا جماعة؟ manually rotate + +260 +00:22:00,420 --> 00:22:05,560 +to return to position إذا هان أنا بشكل يدوي بدي + +261 +00:22:05,560 --> 00:22:10,580 +أعمل تحريك للعدسة و بدي أعمل observe بمعنى ملاحظة + +262 +00:22:10,580 --> 00:22:16,100 +لا اللي هو دوران العدسة عن موضوعها طيب في عندنا ال + +263 +00:22:16,100 --> 00:22:20,080 +dialing or rotation while the lens on the eye is + +264 +00:22:20,080 --> 00:22:24,760 +helpful in checking rotational velocityسرعة تحرك + +265 +00:22:24,760 --> 00:22:29,720 +هي السرعة التي تعود للمصطلح المناسب للمصطلح + +266 +00:22:29,720 --> 00:22:31,560 +المناسب للمصطلح المناسب للمصطلح المناسب للمصطلح + +267 +00:22:31,560 --> 00:22:32,140 +المناسب للمصطلح المناسب للمصطلح المناسب للمصطلح + +268 +00:22:32,140 --> 00:22:35,100 +المناسب للمصطلح المناسب للمصطلح المناسب للمصطلح + +269 +00:22:35,100 --> 00:22:37,460 +المناسب للمصطلح المناسب للمصطلح المناسب للمصطلح + +270 +00:22:37,460 --> 00:22:37,480 +المناسب للمصطلح المناسب للمصطلح المناسب للمصطلح + +271 +00:22:37,480 --> 00:22:42,360 +للمصطلح المunacceptable rotational velocity is 15 + +272 +00:22:42,360 --> 00:22:47,360 +seconds يعني قيمة اللي هو الدوران للعدسة عن موضعها + +273 +00:22:47,360 --> 00:22:52,860 +الطبيعي إذا كان أقل من 15 فهو مقبول طبعا اللي هو + +274 +00:22:52,860 --> 00:22:57,900 +seconds طيب أكتر من 15 بتديني انطباع أنه قد تكون + +275 +00:22:57,900 --> 00:23:03,800 +العدسة unacceptable تمام وفي مشكلة في ال fitting + +276 +00:23:03,800 --> 00:23:04,660 +للعدسة + +277 +00:23:08,170 --> 00:23:14,090 +troubleshooting أي بمعنى مشاكل ممكن انه تكون في + +278 +00:23:14,090 --> 00:23:20,610 +العدسة وكيف بدنا نعمل عملية حل لهذه المشاكل اذا + +279 +00:23:20,610 --> 00:23:27,420 +مشاكل وحلول لل software contact lensesSoft Torque + +280 +00:23:27,420 --> 00:23:36,360 +Lenses أصبح أسهل بسبب تحسين تجارب التورك لينزز كما + +281 +00:23:36,360 --> 00:23:41,420 +اتفقنا أنه في القاونة الأخيرة تم تطوير في العدسات + +282 +00:23:41,420 --> 00:23:44,720 +الـ Soft Torque Contact Lenses خاصة في موضوع ال + +283 +00:23:44,720 --> 00:23:49,770 +designالـ software design بمعنى اخر انه بطلنا + +284 +00:23:49,770 --> 00:23:53,430 +نستخدم اللى هو موضوع ال graffiti او ال prism + +285 +00:23:53,430 --> 00:23:57,550 +palace على الساعة ستة صرنا مثلا نستخدم على الساعة + +286 +00:23:57,550 --> 00:24:02,110 +تلاتة و اللى هو الساعة تسعة بمعنى انه اصبح اللى هو + +287 +00:24:02,110 --> 00:24:07,110 +هناك عملية اللى هو amended اللى هو تغيير او عملية + +288 +00:24:07,110 --> 00:24:11,970 +improvement تحسن في اللى هو موضوع ال design اللى + +289 +00:24:11,970 --> 00:24:17,590 +خاص بالعدسات ال softwaredepending on when the + +290 +00:24:17,590 --> 00:24:21,710 +situation occurs that are several options to + +291 +00:24:21,710 --> 00:24:26,750 +consider هناك عديد من الخيارات وأنا بناء على كل + +292 +00:24:26,750 --> 00:24:31,290 +اللي هو مريض على حده بقدر أحددله إيش ال study + +293 +00:24:31,290 --> 00:24:33,730 +design الملائم له + +294 +00:24:37,030 --> 00:24:42,810 +A stable blurred vision at dispensing may indicate + +295 +00:24:42,810 --> 00:24:47,270 +that the axis is misaligned. There is a power + +296 +00:24:47,270 --> 00:24:51,970 +change or there is power effect changes due to + +297 +00:24:51,970 --> 00:25:00,250 +flexure.الان انا في عندى مريض نفترض بلانه ع minus + +298 +00:25:00,250 --> 00:25:08,660 +اتنينaccess 13 تمام؟ لبسته العدسة عنده غبش دائم + +299 +00:25:08,660 --> 00:25:14,660 +إذا عندنا stable blurred vision يعني هذا المريض + +300 +00:25:14,660 --> 00:25:21,600 +عنده غبش بشكل مستمر أو بشكل دائم أنا الآن بدي أفكر + +301 +00:25:21,600 --> 00:25:27,580 +تفكير إنه إيش أسباب الغبش الدائم هذا عند المريض؟ + +302 +00:25:27,580 --> 00:25:33,030 +ممكن يكونواحد ان ال access غير صحيح يعني الآن انا + +303 +00:25:33,030 --> 00:25:36,930 +بعطت access تلاتين، راحت الشركة عملت access نفترض + +304 +00:25:36,930 --> 00:25:42,370 +مثلا اربعين، تمام؟ اذا صار عند المريض فيه اختلاف + +305 +00:25:42,370 --> 00:25:46,630 +من حيث ال access اتنين، انا طلبت إبلانه على minus + +306 +00:25:46,630 --> 00:25:50,350 +اتنين، راح عمل إبلانه على minus واحد، اختلاف في + +307 +00:25:50,350 --> 00:25:52,590 +قوة العدسة، تمام؟ + +308 +00:25:55,520 --> 00:26:03,300 +due to flexure مين تعرف إيش مانعت flexure؟ أي + +309 +00:26:03,300 --> 00:26:09,120 +بمعنى تغيير بإنشاء العدسة يعني الآن أنا بعتت base + +310 +00:26:09,120 --> 00:26:15,540 +curve سبعة و تلاتة و diameter عشرة و نص و اللي هو + +311 +00:26:15,540 --> 00:26:21,260 +العدسة ال software دايما بتكون steep and thinner + +312 +00:26:21,260 --> 00:26:24,160 +مقارنة في مين؟ + +313 +00:26:28,710 --> 00:26:34,210 +المنشأ او المصنع عمل ما هو مخالف لهذا ال criteria + +314 +00:26:34,210 --> 00:26:39,070 +او مخالف لهذا ال role فهنا بيكون فيه مشكلة في منشأ + +315 +00:26:39,070 --> 00:26:43,650 +ايه؟ العدسة تمام يا جماعة؟ يعني الآن يما بيكون عند + +316 +00:26:43,650 --> 00:26:50,990 +المريضعدم وضوح وهو لابس العدسة بشكل مستمر لو سألتك + +317 +00:26:50,990 --> 00:26:54,530 +إيش أسبابها السبب الأول ممكن يكون مشكلة في ال + +318 +00:26:54,530 --> 00:26:58,430 +access التاني مشكلة في ال power تحت العدسة سواء ال + +319 +00:26:58,430 --> 00:27:01,550 +sphere أو ال cylinder تلاتة أنه في عنده over + +320 +00:27:01,550 --> 00:27:05,480 +refractionاللي هي ال power effect و أربع عنده + +321 +00:27:05,480 --> 00:27:09,180 +مشكلة وين؟ في منشأ العدسة يعني بمعنى أخر عنده + +322 +00:27:09,180 --> 00:27:12,920 +مشكلة بال base care أو مثلا في ال water content أو + +323 +00:27:12,920 --> 00:27:17,000 +في تصميم العدسة ال study design بتاع العدسة أيضا + +324 +00:27:17,000 --> 00:27:19,760 +كان في عنده defect تمام؟ + +325 +00:27:23,030 --> 00:27:28,090 +The lens should rotate to the same position as the + +326 +00:27:28,090 --> 00:27:32,890 +original trial lens دوران العدسة اللي هي تعتبر ال + +327 +00:27:32,890 --> 00:27:38,070 +final prescription أو ال final order لازم ان يكون + +328 +00:27:38,070 --> 00:27:45,360 +دورانها مشابه لدوران من العدسة ال trial lensIf it + +329 +00:27:45,360 --> 00:27:49,540 +doesn't طيب نفترض هي ماعملتش rotation مماثل لمين + +330 +00:27:49,540 --> 00:27:54,920 +لعدسات ال trial set او العدسة اللى تم اختيارها في + +331 +00:27:54,920 --> 00:28:00,640 +ال trial set First considering trying another lens + +332 +00:28:00,640 --> 00:28:05,460 +بدي احاول استخدام عدسة تانية موجودة وين في ال + +333 +00:28:05,460 --> 00:28:12,030 +trial او ال diagnostic اللى هو lensone from the + +334 +00:28:12,030 --> 00:28:16,950 +other eye is performing well or another trial lens + +335 +00:28:16,950 --> 00:28:21,310 +طب نفترض أن العجسة اللي مطلوبة إليه أو ال close + +336 +00:28:21,310 --> 00:28:25,730 +للقيمة بتاعة المريض مش موجودة في ال trial set اللي + +337 +00:28:25,730 --> 00:28:30,190 +عنده، بدي أضطر أنه ممكن أجيب إيه؟ trial set أخرى، + +338 +00:28:30,190 --> 00:28:33,890 +تمام؟ هذه لو أنا بشتغل إيه؟ diagnostic أو trial + +339 +00:28:33,890 --> 00:28:40,000 +methodto see if the rotation is consistent عشان + +340 +00:28:40,000 --> 00:28:43,340 +انا اشوف اذا كان اللي هو هذا ال rotation ثابت ولا + +341 +00:28:43,340 --> 00:28:49,580 +لأ consistent بمعنى ثابت if rotation is consistent + +342 +00:28:49,580 --> 00:28:55,180 +اذا كان قيمة الدوران ثابت then check to see if + +343 +00:28:55,180 --> 00:28:59,240 +left add right subtract طبعا هذه من خلال ايش بدي + +344 +00:28:59,240 --> 00:29:05,880 +اعرفها الاستثناء examinationتمام was calculated + +345 +00:29:05,880 --> 00:29:11,220 +correctly يعني بتم تحديد اللي هو قيمة ال rotation + +346 +00:29:11,220 --> 00:29:14,880 +من خلال استخدام ال rule هذه left add right + +347 +00:29:14,880 --> 00:29:18,180 +subtract with a sitlam examination + +348 +00:29:22,090 --> 00:29:24,770 +طبعا اللي هو ال over-refraction، spherical + +349 +00:29:24,770 --> 00:29:29,310 +cylindrical over-refraction، يعني هو لابس العجسة، + +350 +00:29:29,310 --> 00:29:32,930 +بدي أعمل معه spherical cylindrical over-refraction + +351 +00:29:36,810 --> 00:29:41,710 +النتيجة النهائية was calculated هيتم اللي هو + +352 +00:29:41,710 --> 00:29:47,390 +تحديدها correctly بشكل صحيح and is consistent with + +353 +00:29:47,390 --> 00:29:51,050 +left and right subtract وبعد ذلك من خلال ال rule + +354 +00:29:51,050 --> 00:29:56,070 +هذا هحدد اللي هو قداش قيمة ال rotation لمين للعدسة + +355 +00:29:56,070 --> 00:30:02,250 +بشكل صحيح تمام ان شاء الله؟ يعني الآنعندما يكون + +356 +00:30:02,250 --> 00:30:08,070 +المريض عنده عدم وضوح او عدم ثبات في الرؤية و هو + +357 +00:30:08,070 --> 00:30:11,330 +لابس العدسة ال software ال contact lenses اعرفنا + +358 +00:30:11,330 --> 00:30:16,650 +ايش المشاكل طب كيف نحلها؟ اول حاجة بده اشوف قيمة + +359 +00:30:16,650 --> 00:30:22,070 +ال rotation للعدسة ال trial lensو احدده من خلال + +360 +00:30:22,070 --> 00:30:26,690 +الاستلام examination هذه النقطة الاولى اتنين بدي + +361 +00:30:26,690 --> 00:30:30,890 +استخدم ال rule left add right subtract بقدر انه + +362 +00:30:30,890 --> 00:30:35,310 +اشوف وين اتجاه ال rotation للعدسة النقطة التانية + +363 +00:30:35,310 --> 00:30:39,170 +انه بدي اعمل spherical cylindrical oval refraction + +364 +00:30:39,170 --> 00:30:43,170 +واشوف القوة الملائمة للعدسة + +365 +00:30:46,630 --> 00:30:51,510 +Power changes due to masking or reflection can + +366 +00:30:51,510 --> 00:30:54,790 +best be determined with a spherical, cylindrical + +367 +00:30:54,790 --> 00:30:57,570 +over-refraction and a cross-cylinder calculation + +368 +00:30:57,570 --> 00:31:02,270 +اتفقنا انه في عملية ال evaluation لل software + +369 +00:31:02,270 --> 00:31:07,910 +contact lenses بتم تقريبا من عشرة لخمس عشر دقيقة + +370 +00:31:07,910 --> 00:31:13,590 +ليش؟ لأنه اي bubble بتجمع ما بين العدسة و الكورنية + +371 +00:31:13,590 --> 00:31:18,490 +بتم التخلص منهبعض الأحيان زي ما احنا كنا نعمل في + +372 +00:31:18,490 --> 00:31:23,410 +المعمل انه نعمل عملية ال evaluation للسرعة بعد خمس + +373 +00:31:23,410 --> 00:31:28,150 +دقائق هذه ممكن ايش تعمل masking أي بمعنى covering + +374 +00:31:28,150 --> 00:31:32,930 +اللي هو تغطية للقيمة الحقيقية لل power اللي موجودة + +375 +00:31:32,930 --> 00:31:36,910 +عند مين عند المريض تمام نتيجة اللي هو ال posterior + +376 +00:31:36,910 --> 00:31:42,520 +lens هذه نقطةالنقطة التانية ان اختلاف مين في + +377 +00:31:42,520 --> 00:31:47,720 +المنشأ للعدسة انا مثلا بدي مديرة dk على t راح هو + +378 +00:31:47,720 --> 00:31:51,880 +اعمل high dk على t فغير من كل ال parameters لمن؟ + +379 +00:31:51,880 --> 00:31:56,660 +للعدسة وبالتالي اثر على ايش؟ على ال power او + +380 +00:31:56,660 --> 00:32:02,150 +العدسة الملائمة للمريضفلذلك من ناحية ال power ممكن + +381 +00:32:02,150 --> 00:32:06,230 +استخدم اللي هو ال spherical cylindrical oval + +382 +00:32:06,230 --> 00:32:10,150 +refraction اما من ناحية اللي هو ال axis ممكن + +383 +00:32:10,150 --> 00:32:15,870 +استخدم مين ال Jackson cross cylinder بنوقف ان شاء + +384 +00:32:15,870 --> 00:32:21,010 +الله لهان و المحاضرة القادمة ان شاء الله بنكمل في + +385 +00:32:21,010 --> 00:32:25,330 +اي سؤال اي استفسار؟ اعطيكم العافية + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/tH3WkzkNA2U_raw.json b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/tH3WkzkNA2U_raw.json new file mode 100644 index 0000000000000000000000000000000000000000..a4f45e5f7b68c9912f8a104a1f397a2da790cd1c --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/tH3WkzkNA2U_raw.json @@ -0,0 +1 @@ +{"segments": [{"id": 1, "seek": 4363, "start": 21.51, "end": 43.63, "text": "بسم الله الرحمن الرحيم السلام عليكم ورحمة الله وبركاته ومرحبا لكم جميعا في محاضرة اليوم ان شاء الله هنكمل في موضوع ال software contact lenses طبعا في البداية لو نفترض عندنا وصفة minus three over minus point fifty", "tokens": [3555, 38251, 21984, 34892, 5016, 27842, 34892, 5016, 32640, 21136, 37440, 25894, 24793, 4032, 2288, 35571, 3660, 21984, 4032, 26890, 4117, 9307, 3224, 4032, 29973, 5016, 3555, 995, 5296, 24793, 10874, 2304, 40228, 995, 8978, 3714, 5016, 46958, 25720, 45595, 20498, 16472, 13412, 16606, 21984, 8032, 1863, 24793, 1211, 8978, 3714, 2407, 11242, 45367, 2423, 4722, 3385, 18059, 23032, 3555, 3615, 995, 8978, 29739, 28259, 10632, 45164, 8717, 5172, 2655, 43042, 43242, 8315, 4032, 9381, 5172, 3660, 3175, 1045, 670, 3175, 935, 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"probability": 0.84033203125}, {"start": 228.01, "end": 228.75, "word": " هيكون", "probability": 0.855712890625}, {"start": 228.75, "end": 229.19, "word": " نسبة", "probability": 0.9964192708333334}, {"start": 229.19, "end": 229.69, "word": " الخطأ", "probability": 0.9910481770833334}, {"start": 229.69, "end": 230.45, "word": " للعدسة", "probability": 0.96533203125}, {"start": 230.45, "end": 231.73, "word": " بسيطة", "probability": 0.98671875}, {"start": 231.73, "end": 232.41, "word": " تمام", "probability": 0.7279052734375}, {"start": 232.41, "end": 232.79, "word": " هدف", "probability": 0.8761393229166666}, {"start": 232.79, "end": 233.49, "word": " القاونة", "probability": 0.8380126953125}, {"start": 233.49, "end": 234.13, "word": " الأخيرة", "probability": 0.9401041666666666}], "temperature": 1.0}, {"id": 10, "seek": 26429, "start": 235.93, "end": 264.29, "text": "So there is little concern for errors when using the trial lens method of fitting من هذه الجملة انا باخد نقطة مهمة ان ال diagnostic او ال trial method هي تعتبر ايه ادق من ال empirical method تمام؟ اذا الان لو سالتك مين ادق ال empirical method ولا ال diagnostic ال trial method لأ ال diagnostic ال trial method هي الأدق تمام؟", "tokens": [6455, 456, 307, 707, 3136, 337, 13603, 562, 1228, 264, 7308, 6765, 3170, 295, 15669, 9154, 29538, 25724, 2304, 37977, 1975, 8315, 4724, 47283, 3215, 8717, 47432, 3660, 3714, 16095, 3660, 16472, 2423, 27897, 1975, 2407, 2423, 7308, 3170, 39896, 6055, 34268, 26890, 1975, 1829, 3224, 1975, 3215, 4587, 9154, 2423, 31886, 3170, 46811, 10943, 22807, 1975, 15730, 2423, 7649, 45164, 8608, 6027, 2655, 4117, 3714, 9957, 1975, 3215, 4587, 2423, 31886, 3170, 49429, 2423, 27897, 2423, 7308, 3170, 5296, 10721, 2423, 27897, 2423, 7308, 3170, 39896, 16247, 3215, 4587, 46811, 10943, 22807], "avg_logprob": -0.1691323073303446, "compression_ratio": 1.8484848484848484, "no_speech_prob": 0.0, "words": [{"start": 235.93, "end": 236.29, "word": "So", "probability": 0.0706787109375}, {"start": 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317.3, "word": " أو", "probability": 0.7509765625}, {"start": 317.3, "end": 317.9, "word": " تكنيك", "probability": 0.8067626953125}, {"start": 317.9, "end": 318.4, "word": " بديل", "probability": 0.888916015625}, {"start": 318.4, "end": 319.52, "word": " لاستخدام", "probability": 0.9082845052083334}, {"start": 319.52, "end": 320.2, "word": " التكنيك", "probability": 0.9637451171875}, {"start": 320.2, "end": 320.78, "word": " السابق", "probability": 0.98583984375}, {"start": 320.78, "end": 320.94, "word": " اللي", "probability": 0.906005859375}, {"start": 320.94, "end": 321.6, "word": " أخدناه", "probability": 0.832958984375}, {"start": 321.6, "end": 321.86, "word": " left", "probability": 0.78125}, {"start": 321.86, "end": 322.22, "word": " and", "probability": 0.90283203125}, {"start": 322.22, "end": 322.62, "word": " right", "probability": 0.92578125}, {"start": 322.62, "end": 323.34, "word": " subtract", "probability": 0.6884765625}, {"start": 323.34, "end": 325.12, "word": " which", "probability": 0.7626953125}, {"start": 325.12, "end": 325.66, "word": " some", "probability": 0.89697265625}, {"start": 325.66, "end": 326.12, "word": " believe", "probability": 0.80615234375}, {"start": 326.12, "end": 326.52, "word": " to", "probability": 0.9638671875}, {"start": 326.52, "end": 326.74, "word": " be", "probability": 0.9609375}, {"start": 326.74, "end": 327.06, "word": " more", "probability": 0.92529296875}, {"start": 327.06, "end": 327.78, "word": " precise", "probability": 0.95947265625}, {"start": 327.78, "end": 328.48, "word": " البعض", "probability": 0.9794921875}, {"start": 328.48, "end": 329.18, "word": " بيعتبرها", "probability": 0.873046875}, {"start": 329.18, "end": 329.66, "word": " أنها", "probability": 0.4344482421875}, {"start": 329.66, "end": 330.34, "word": " دقيقة", "probability": 0.99169921875}], "temperature": 1.0}, {"id": 14, "seek": 35202, "start": 336.84, "end": 352.02, "text": "once the fit of the lens has been confirmed يعني واحد من ال researcher أو واحد من الفتر بيعمل عملية confirmed إيش معناه confirmed؟ أي بمعنى تأكيد أو تثبيت تمام؟", "tokens": [26015, 264, 3318, 295, 264, 6765, 575, 668, 11341, 37495, 22653, 36764, 24401, 9154, 2423, 21751, 34051, 36764, 24401, 9154, 27188, 2655, 2288, 4724, 1829, 25957, 1211, 6225, 42213, 10632, 11341, 11933, 1829, 8592, 20449, 8315, 3224, 11341, 22807, 36632, 4724, 2304, 3615, 1863, 7578, 6055, 10721, 4117, 25708, 34051, 6055, 12984, 21292, 2655, 46811, 10943, 22807], "avg_logprob": -0.16433189937780643, "compression_ratio": 1.4709677419354839, "no_speech_prob": 6.556510925292969e-07, "words": [{"start": 336.84, "end": 337.78, "word": "once", "probability": 0.68310546875}, {"start": 337.78, "end": 338.24, "word": " the", "probability": 0.90087890625}, {"start": 338.24, "end": 338.54, "word": " fit", "probability": 0.9345703125}, {"start": 338.54, "end": 338.82, "word": " of", "probability": 0.9814453125}, {"start": 338.82, "end": 338.98, "word": " the", "probability": 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345.68, "word": " الفتر", "probability": 0.6990559895833334}, {"start": 345.68, "end": 346.54, "word": " بيعمل", "probability": 0.9605712890625}, {"start": 346.54, "end": 346.98, "word": " عملية", "probability": 0.9866536458333334}, {"start": 346.98, "end": 347.56, "word": " confirmed", "probability": 0.892578125}, {"start": 347.56, "end": 347.84, "word": " إيش", "probability": 0.7339680989583334}, {"start": 347.84, "end": 348.04, "word": " معناه", "probability": 0.6808268229166666}, {"start": 348.04, "end": 349.02, "word": " confirmed؟", "probability": 0.6383056640625}, {"start": 349.02, "end": 349.12, "word": " أي", "probability": 0.73876953125}, {"start": 349.12, "end": 349.6, "word": " بمعنى", "probability": 0.98408203125}, {"start": 349.6, "end": 350.14, "word": " تأكيد", "probability": 0.995849609375}, {"start": 350.14, "end": 350.44, "word": " أو", "probability": 0.92431640625}, {"start": 350.44, "end": 351.12, "word": " تثبيت", "probability": 0.9676513671875}, {"start": 351.12, 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"probability": 0.959228515625}, {"start": 361.64, "end": 363.82, "word": " لجاكسون", "probability": 0.8746744791666666}, {"start": 363.82, "end": 364.4, "word": " اكروس", "probability": 0.5364990234375}, {"start": 364.4, "end": 364.92, "word": " سيلندر", "probability": 0.78765869140625}, {"start": 364.92, "end": 365.86, "word": " لاحظت", "probability": 0.915283203125}, {"start": 365.86, "end": 366.14, "word": " انه", "probability": 0.6336669921875}, {"start": 366.14, "end": 366.2, "word": " ال", "probability": 0.78125}, {"start": 366.2, "end": 366.44, "word": " visual", "probability": 0.88720703125}, {"start": 366.44, "end": 367.1, "word": " acuity", "probability": 0.948486328125}, {"start": 367.1, "end": 367.6, "word": " بصيله", "probability": 0.78887939453125}, {"start": 367.6, "end": 368.36, "word": " compromise", "probability": 0.78076171875}, {"start": 368.36, "end": 368.64, "word": " ايش", "probability": 0.7921549479166666}, {"start": 368.64, "end": 368.9, "word": " منات", 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fitting relationship as well as to determine if there any power effects or cross cylinder effects يعني بدي اشوف انه هل القوة اللي مش مسلحة عند المريض هل هي تعتبر significant ولا insignificant طبعا احنا عارفين اذا كانت insignificant بدنا نتغابى عنها انه غير مهمة يعني مش مأثرة على النظر", "tokens": [3555, 16254, 1975, 8592, 38688, 281, 13059, 264, 1181, 22160, 6765, 15669, 2480, 382, 731, 382, 281, 6997, 498, 456, 604, 1347, 5065, 420, 3278, 17884, 5065, 37495, 22653, 4724, 16254, 1975, 8592, 38688, 16472, 3224, 8032, 1211, 25062, 2407, 3660, 13672, 1829, 37893, 47524, 1211, 5016, 3660, 43242, 9673, 16572, 11242, 8032, 1211, 39896, 6055, 34268, 26890, 4776, 49429, 43685, 23032, 3555, 3615, 995, 1975, 5016, 8315, 6225, 9640, 5172, 9957, 1975, 15730, 25961, 2655, 43685, 47525, 8315, 8717, 2655, 17082, 16758, 7578, 18871, 11296, 16472, 3224, 32771, 13546, 3714, 16095, 3660, 37495, 22653, 37893, 3714, 10721, 12984, 25720, 15844, 28239, 19913, 2288], "avg_logprob": -0.1357142868496123, 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"word": " نتغابى", "probability": 0.758740234375}, {"start": 623.63, "end": 623.97, "word": " عنها", "probability": 0.995361328125}, {"start": 623.97, "end": 624.53, "word": " انه", "probability": 0.857177734375}, {"start": 624.53, "end": 624.71, "word": " غير", "probability": 0.995849609375}, {"start": 624.71, "end": 625.25, "word": " مهمة", "probability": 0.986328125}, {"start": 625.25, "end": 625.73, "word": " يعني", "probability": 0.94189453125}, {"start": 625.73, "end": 625.91, "word": " مش", "probability": 0.9892578125}, {"start": 625.91, "end": 626.31, "word": " مأثرة", "probability": 0.652099609375}, {"start": 626.31, "end": 626.47, "word": " على", "probability": 0.6572265625}, {"start": 626.47, "end": 626.79, "word": " النظر", "probability": 0.9892578125}], "temperature": 1.0}, {"id": 26, "seek": 63394, "start": 627.06, "end": 633.94, "text": "تمام؟ لكن إذا كانت significant لابد من إعادة إيه؟ نعمل refitting للعدسات مرة تانية", "tokens": [39237, 10943, 22807, 44381, 11933, 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678.93, "text": "Distortion لو الرد رفليكس هذا ظهر فيه اللي هو تشوش أو عدم وضوح زي الميارز زي ما شوفناها في الجوال كراتوميتر Distortion may indicate a steep lens طيب لو سألنا الآن سيها ممكنش يكون اللي هو steep lens؟", "tokens": [35, 468, 8136, 45164, 34892, 3215, 12602, 5172, 20292, 4117, 3794, 23758, 1357, 116, 3224, 2288, 8978, 3224, 13672, 1829, 31439, 6055, 8592, 2407, 8592, 34051, 6225, 40448, 4032, 11242, 2407, 5016, 30767, 1829, 9673, 1829, 9640, 11622, 30767, 1829, 19446, 13412, 38688, 8315, 11296, 8978, 25724, 2407, 6027, 9122, 2288, 9307, 20498, 36081, 2288, 9840, 8136, 815, 13330, 257, 16841, 6765, 23032, 1829, 3555, 45164, 8608, 10721, 1211, 8315, 6024, 48506, 8608, 1829, 11296, 3714, 43020, 8592, 7251, 30544, 13672, 1829, 31439, 16841, 6765, 22807], "avg_logprob": -0.3160919574485428, "compression_ratio": 1.545, "no_speech_prob": 0.0, "words": [{"start": 662.13, "end": 662.85, "word": "Distortion", "probability": 0.6949462890625}, {"start": 662.85, "end": 663.19, "word": " 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71741, "start": 690.93, "end": 717.41, "text": "و احنا طلبنا من وعد نرجع للمثال انه تعمل اللي هو blinking او complete blinking من خلال ال reflex بتاع ال retinascope او الكيراتوميتر مايرز بعد الترميش هيكون ايه شماله؟ اللي هو clear واضح او crisp اللي هو مضيق تمام؟ طيب قبل الترميش هيكون unclear لو كانت flat العدسة before blinking هيكون clear", "tokens": [2407, 1975, 5016, 8315, 23032, 46152, 8315, 9154, 4032, 22488, 8717, 47341, 3615, 5296, 19528, 12984, 6027, 16472, 3224, 6055, 25957, 1211, 13672, 1829, 31439, 45879, 1975, 2407, 3566, 45879, 9154, 16490, 1211, 6027, 2423, 23802, 39894, 45761, 2423, 1533, 17094, 13960, 1975, 2407, 33251, 13546, 9307, 20498, 36081, 2288, 19446, 13546, 11622, 39182, 16712, 2288, 2304, 1829, 8592, 39896, 30544, 1975, 1829, 3224, 13412, 2304, 6027, 3224, 22807, 13672, 1829, 31439, 1850, 4032, 46958, 5016, 1975, 2407, 22952, 13672, 1829, 31439, 3714, 11242, 1829, 4587, 46811, 10943, 22807, 23032, 1829, 3555, 12174, 36150, 16712, 2288, 2304, 1829, 8592, 39896, 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"probability": 0.8427734375}, {"start": 764.12, "end": 764.38, "word": " اللي", "probability": 0.80029296875}, {"start": 764.38, "end": 764.64, "word": " هو", "probability": 0.9658203125}, {"start": 764.64, "end": 764.86, "word": " من", "probability": 0.5068359375}, {"start": 764.86, "end": 767.58, "word": " العدسة", "probability": 0.9453125}, {"start": 767.58, "end": 768.42, "word": " الملائمة", "probability": 0.83319091796875}, {"start": 768.42, "end": 768.78, "word": " او", "probability": 0.702880859375}, {"start": 768.78, "end": 769.68, "word": " المناسبة", "probability": 0.989990234375}, {"start": 769.68, "end": 770.82, "word": " للمريض", "probability": 0.9805908203125}, {"start": 770.82, "end": 771.6, "word": " لذلك", "probability": 0.8863932291666666}, {"start": 771.6, "end": 771.88, "word": " بدنا", "probability": 0.877197265625}, {"start": 771.88, "end": 773.42, "word": " نستبدل", "probability": 0.9906005859375}, {"start": 773.42, "end": 774.1, "word": " باللي", "probability": 0.4806315104166667}, {"start": 774.1, "end": 774.4, "word": " هو", "probability": 0.98046875}, {"start": 774.4, "end": 774.92, "word": " ايه", "probability": 0.8201497395833334}, {"start": 774.92, "end": 775.14, "word": " ال", "probability": 0.83203125}, {"start": 775.14, "end": 775.62, "word": " RGB", "probability": 0.9306640625}, {"start": 775.62, "end": 776.2, "word": " سواء", "probability": 0.9469401041666666}, {"start": 776.2, "end": 776.36, "word": " اللي", "probability": 0.925537109375}, {"start": 776.36, "end": 776.56, "word": " هو", "probability": 0.99169921875}, {"start": 776.56, "end": 776.96, "word": " spherical", "probability": 0.64599609375}, {"start": 776.96, "end": 777.66, "word": " RGB", "probability": 0.99169921875}, {"start": 777.66, "end": 778.4, "word": " او", "probability": 0.869140625}, {"start": 778.4, "end": 778.78, "word": " Toric", "probability": 0.33740234375}, {"start": 778.78, "end": 779.42, "word": " RGB", "probability": 0.9892578125}], "temperature": 1.0}, {"id": 33, "seek": 81163, "start": 784.43, "end": 811.63, "text": "Autorefraction over the lens can be of benefit as a starting point in determining an overrefraction بعض من الأخصائيين أو الأخصائيات أول ما بيضع ال trial lens اللي هي بتكون close لوصفة النضارة أو ال subjective refraction بروح بعمل ايه overrefraction", "tokens": [49769, 418, 69, 26766, 670, 264, 6765, 393, 312, 295, 5121, 382, 257, 2891, 935, 294, 23751, 364, 670, 33115, 26766, 45030, 11242, 9154, 16247, 9778, 9381, 16373, 1829, 9957, 34051, 16247, 9778, 9381, 16373, 1829, 9307, 5551, 12610, 19446, 4724, 1829, 11242, 3615, 2423, 7308, 6765, 13672, 1829, 39896, 39894, 30544, 1998, 5296, 2407, 9381, 5172, 3660, 28239, 11242, 9640, 3660, 34051, 2423, 25972, 1895, 26766, 4724, 32887, 5016, 4724, 25957, 1211, 1975, 1829, 3224, 670, 33115, 26766], "avg_logprob": -0.16826172396540642, "compression_ratio": 1.5728155339805825, "no_speech_prob": 0.0, "words": [{"start": 784.43, "end": 785.45, "word": "Autorefraction", 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"end": 792.43, "word": " determining", "probability": 0.91357421875}, {"start": 792.43, "end": 793.13, "word": " an", "probability": 0.8623046875}, {"start": 793.13, "end": 794.19, "word": " overrefraction", "probability": 0.7129720052083334}, {"start": 794.19, "end": 795.63, "word": " بعض", "probability": 0.80078125}, {"start": 795.63, "end": 796.39, "word": " من", "probability": 0.93603515625}, {"start": 796.39, "end": 797.77, "word": " الأخصائيين", "probability": 0.8809000651041666}, {"start": 797.77, "end": 797.97, "word": " أو", "probability": 0.84619140625}, {"start": 797.97, "end": 799.03, "word": " الأخصائيات", "probability": 0.9742838541666666}, {"start": 799.03, "end": 799.99, "word": " أول", "probability": 0.9140625}, {"start": 799.99, "end": 800.15, "word": " ما", "probability": 0.88037109375}, {"start": 800.15, "end": 800.61, "word": " بيضع", "probability": 0.7906494140625}, {"start": 800.61, "end": 800.93, "word": " ال", "probability": 0.9462890625}, {"start": 800.93, "end": 801.27, "word": " trial", "probability": 0.85888671875}, {"start": 801.27, "end": 801.85, "word": " lens", "probability": 0.92822265625}, {"start": 801.85, "end": 802.21, "word": " اللي", "probability": 0.8046875}, {"start": 802.21, "end": 802.41, "word": " هي", "probability": 0.6259765625}, {"start": 802.41, "end": 802.85, "word": " بتكون", "probability": 0.952880859375}, {"start": 802.85, "end": 803.47, "word": " close", "probability": 0.6376953125}, {"start": 803.47, "end": 805.15, "word": " لوصفة", "probability": 0.92919921875}, {"start": 805.15, "end": 805.93, "word": " النضارة", "probability": 0.9644775390625}, {"start": 805.93, "end": 806.23, "word": " أو", "probability": 0.82763671875}, {"start": 806.23, "end": 806.35, "word": " ال", "probability": 0.794921875}, {"start": 806.35, "end": 806.75, "word": " subjective", "probability": 0.94921875}, {"start": 806.75, "end": 807.55, "word": " refraction", "probability": 0.77587890625}, {"start": 807.55, "end": 808.59, "word": " بروح", "probability": 0.8479817708333334}, {"start": 808.59, "end": 809.17, "word": " بعمل", "probability": 0.9348958333333334}, {"start": 809.17, "end": 810.19, "word": " ايه", "probability": 0.85009765625}, {"start": 810.19, "end": 811.63, "word": " overrefraction", "probability": 0.656982421875}], "temperature": 1.0}, {"id": 34, "seek": 83219, "start": 812.45, "end": 832.19, "text": "الـ Over Refraction يقدّش قيمة السفير والسلمدر والأكسز فهذا بيسهّل عليه ايش في ال starting point زي بالضبط عندما اتفقنا ان في ال RGB الفكرة الأساسية وين اعرف ال initial point او ال starting point بتاعة ال base curve وهذا نفس الحاجة", "tokens": [6027, 39184, 4886, 16957, 26766, 7251, 28543, 11703, 8592, 12174, 32640, 3660, 21136, 5172, 13546, 16070, 3794, 19528, 3215, 2288, 16070, 10721, 4117, 3794, 11622, 6156, 3224, 15730, 4724, 1829, 3794, 3224, 11703, 1211, 47356, 1975, 1829, 8592, 8978, 2423, 2891, 935, 30767, 1829, 20666, 11242, 3555, 9566, 43242, 15042, 1975, 2655, 5172, 4587, 8315, 16472, 8978, 2423, 31231, 27188, 4117, 25720, 16247, 3794, 32277, 10632, 4032, 9957, 1975, 3615, 28480, 2423, 5883, 935, 1975, 2407, 2423, 2891, 935, 39894, 995, 27884, 2423, 3096, 7605, 37037, 15730, 8717, 36178, 21542, 26108, 3660], "avg_logprob": -0.3119959587691933, "compression_ratio": 1.5454545454545454, "no_speech_prob": 0.0, "words": [{"start": 812.45, "end": 812.75, "word": "الـ", "probability": 0.75146484375}, {"start": 812.75, "end": 812.95, "word": " Over", "probability": 0.472900390625}, {"start": 812.95, "end": 813.65, "word": " Refraction", "probability": 0.6297607421875}, {"start": 813.65, "end": 814.69, "word": " يقدّش", "probability": 0.5001220703125}, {"start": 814.69, "end": 815.13, "word": " قيمة", "probability": 0.9749348958333334}, {"start": 815.13, "end": 815.67, "word": " السفير", "probability": 0.699951171875}, {"start": 815.67, "end": 816.73, "word": " والسلمدر", "probability": 0.768505859375}, {"start": 816.73, "end": 817.71, "word": " والأكسز", "probability": 0.713916015625}, {"start": 817.71, "end": 818.55, "word": " فهذا", "probability": 0.69384765625}, {"start": 818.55, "end": 819.17, "word": " بيسهّل", "probability": 0.79144287109375}, {"start": 819.17, "end": 819.47, "word": " عليه", "probability": 0.93017578125}, {"start": 819.47, "end": 819.87, "word": " ايش", "probability": 0.6980794270833334}, {"start": 819.87, "end": 820.13, "word": " في", "probability": 0.52978515625}, {"start": 820.13, "end": 820.23, "word": " ال", "probability": 0.89501953125}, {"start": 820.23, "end": 820.67, "word": " starting", "probability": 0.7939453125}, {"start": 820.67, "end": 821.23, "word": " point", "probability": 0.98388671875}, {"start": 821.23, "end": 821.87, "word": " زي", "probability": 0.78076171875}, {"start": 821.87, "end": 822.45, "word": " بالضبط", "probability": 0.9735107421875}, {"start": 822.45, "end": 822.77, "word": " عندما", "probability": 0.685546875}, {"start": 822.77, "end": 823.39, "word": " اتفقنا", "probability": 0.955859375}, {"start": 823.39, "end": 823.89, "word": " ان", "probability": 0.6025390625}, {"start": 823.89, "end": 824.07, "word": " في", "probability": 0.6142578125}, {"start": 824.07, "end": 824.19, "word": " ال", "probability": 0.73974609375}, {"start": 824.19, "end": 824.67, "word": " RGB", "probability": 0.93408203125}, {"start": 824.67, "end": 825.77, "word": " الفكرة", "probability": 0.9742838541666666}, {"start": 825.77, "end": 826.39, "word": " الأساسية", "probability": 0.9696044921875}, {"start": 826.39, "end": 826.73, "word": " وين", "probability": 0.5328369140625}, {"start": 826.73, "end": 827.21, "word": " اعرف", "probability": 0.8115234375}, {"start": 827.21, "end": 827.41, "word": " ال", "probability": 0.9638671875}, {"start": 827.41, "end": 827.83, "word": " initial", "probability": 0.383056640625}, {"start": 827.83, "end": 828.35, "word": " point", "probability": 0.98876953125}, {"start": 828.35, "end": 828.71, "word": " او", "probability": 0.798095703125}, {"start": 828.71, "end": 828.85, "word": " ال", "probability": 0.787109375}, {"start": 828.85, "end": 829.31, "word": " starting", "probability": 0.95751953125}, {"start": 829.31, "end": 829.81, "word": " point", "probability": 0.984375}, {"start": 829.81, "end": 830.17, "word": " بتاعة", "probability": 0.7132975260416666}, {"start": 830.17, "end": 830.31, "word": " ال", "probability": 0.974609375}, {"start": 830.31, "end": 830.55, "word": " base", "probability": 0.6796875}, {"start": 830.55, "end": 830.83, "word": " curve", "probability": 0.65625}, {"start": 830.83, "end": 831.41, "word": " وهذا", "probability": 0.65087890625}, {"start": 831.41, "end": 831.63, "word": " نفس", "probability": 0.987548828125}, {"start": 831.63, "end": 832.19, "word": " الحاجة", "probability": 0.97705078125}], "temperature": 1.0}, {"id": 35, "seek": 85854, "start": 833.78, "end": 858.54, "text": "و ال over refraction هو يعتبر guide ليه عشان اعرف اللي هو جديش البداية اللي ابدأ فيها كعدسة ملائمة او مناسبة للمريض طيب في عندنا manual rotation يعني بمعنى انه دوران بشكل يدوي للعدسة وهنا راجزوا معي كويس لان في اختلاف شوية بسيط", "tokens": [2407, 2423, 670, 1895, 26766, 31439, 7251, 34268, 26890, 5934, 32239, 3224, 6225, 8592, 7649, 1975, 3615, 28480, 13672, 1829, 31439, 10874, 16254, 8592, 29739, 28259, 10632, 13672, 1829, 48127, 3215, 10721, 8978, 11296, 9122, 22488, 3794, 3660, 3714, 1211, 16373, 46007, 1975, 2407, 3714, 8315, 35457, 3660, 5296, 19528, 16572, 11242, 23032, 1829, 3555, 8978, 43242, 8315, 9688, 12447, 37495, 22653, 4724, 2304, 3615, 1863, 7578, 16472, 3224, 11778, 13063, 7649, 4724, 8592, 28820, 7251, 3215, 45865, 24976, 22488, 3794, 3660, 37037, 8315, 12602, 26108, 11622, 14407, 20449, 1829, 9122, 45865, 3794, 5296, 7649, 8978, 1975, 46456, 15040, 5172, 13412, 2407, 10632, 4724, 3794, 1829, 9566], "avg_logprob": -0.16970486262882198, "compression_ratio": 1.6336206896551724, "no_speech_prob": 5.960464477539063e-08, "words": [{"start": 833.78, "end": 833.84, "word": "و", "probability": 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final prescription أو ال final order لازم ان يكون دورانها مشابه لدوران من العدسة ال trial lens", "tokens": [2278, 6765, 820, 13121, 281, 264, 912, 2535, 382, 264, 3380, 7308, 6765, 11778, 13063, 7649, 18863, 3215, 3794, 3660, 13672, 1829, 39896, 6055, 34268, 26890, 2423, 2572, 22456, 34051, 2423, 2572, 1668, 5296, 31377, 2304, 16472, 7251, 30544, 11778, 13063, 7649, 11296, 37893, 16758, 3224, 5296, 3215, 13063, 7649, 9154, 18863, 3215, 3794, 3660, 2423, 7308, 6765], "avg_logprob": -0.17094809726133184, "compression_ratio": 1.562874251497006, "no_speech_prob": 0.0, "words": [{"start": 1643.03, "end": 1643.27, "word": "The", "probability": 0.07025146484375}, {"start": 1643.27, "end": 1643.71, "word": " lens", "probability": 0.89306640625}, {"start": 1643.71, "end": 1644.45, "word": " should", "probability": 0.9609375}, {"start": 1644.45, "end": 1645.15, "word": " rotate", "probability": 0.9423828125}, {"start": 1645.15, "end": 1645.75, "word": " to", "probability": 0.9638671875}, 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1652.21, "end": 1652.71, "word": " تعتبر", "probability": 0.9680989583333334}, {"start": 1652.71, "end": 1652.89, "word": " ال", "probability": 0.9501953125}, {"start": 1652.89, "end": 1653.43, "word": " final", "probability": 0.60107421875}, {"start": 1653.43, "end": 1654.67, "word": " prescription", "probability": 0.94677734375}, {"start": 1654.67, "end": 1655.21, "word": " أو", "probability": 0.6787109375}, {"start": 1655.21, "end": 1655.37, "word": " ال", "probability": 0.966796875}, {"start": 1655.37, "end": 1655.69, "word": " final", "probability": 0.90966796875}, {"start": 1655.69, "end": 1656.25, "word": " order", "probability": 0.974609375}, {"start": 1656.25, "end": 1657.27, "word": " لازم", "probability": 0.9715169270833334}, {"start": 1657.27, "end": 1657.49, "word": " ان", "probability": 0.4580078125}, {"start": 1657.49, "end": 1658.07, "word": " يكون", "probability": 0.849609375}, {"start": 1658.07, "end": 1658.81, "word": " دورانها", "probability": 0.988525390625}, {"start": 1658.81, "end": 1659.81, "word": " مشابه", "probability": 0.9783528645833334}, {"start": 1659.81, "end": 1660.45, "word": " لدوران", "probability": 0.9554443359375}, {"start": 1660.45, "end": 1660.71, "word": " من", "probability": 0.5400390625}, {"start": 1660.71, "end": 1661.69, "word": " العدسة", "probability": 0.99267578125}, {"start": 1661.69, "end": 1661.89, "word": " ال", "probability": 0.8662109375}, {"start": 1661.89, "end": 1662.31, "word": " trial", "probability": 0.97900390625}, {"start": 1662.31, "end": 1663.51, "word": " lens", "probability": 0.90478515625}], "temperature": 1.0}, {"id": 70, "seek": 168926, "start": 1664.82, "end": 1689.26, "text": "If it doesn't طيب نفترض هي ماعملتش rotation مماثل لمين لعدسات ال trial set او العدسة اللى تم اختيارها في ال trial set First considering trying another lens بدي احاول استخدام عدسة تانية موجودة وين في ال trial او ال diagnostic اللى هو lens", "tokens": [8031, 309, 1177, 380, 23032, 1829, 3555, 8717, 5172, 2655, 43042, 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check to see if left add right subtract طبعا هذه من خلال ايش بدي اعرفها الاستثناء examination", "tokens": [1353, 536, 498, 264, 12447, 307, 8398, 6225, 8592, 7649, 1975, 8315, 1975, 8592, 38688, 1975, 15730, 25961, 13672, 1829, 31439, 23758, 2423, 12447, 38637, 16758, 2655, 49429, 5296, 10721, 8398, 4724, 2304, 3615, 1863, 7578, 38637, 16758, 2655, 498, 12447, 307, 8398, 1975, 15730, 25961, 12174, 32640, 3660, 32748, 13063, 7649, 38637, 16758, 2655, 550, 1520, 281, 536, 498, 1411, 909, 558, 16390, 23032, 3555, 3615, 995, 29538, 9154, 16490, 1211, 6027, 1975, 1829, 8592, 47525, 1829, 1975, 3615, 28480, 11296, 2423, 32277, 2655, 12984, 1863, 16606, 1139, 259, 399], "avg_logprob": -0.21161684442473494, "compression_ratio": 1.6502242152466369, "no_speech_prob": 1.1920928955078125e-07, "words": [{"start": 1716.68, "end": 1716.88, "word": "to", "probability": 0.15087890625}, {"start": 1716.88, "end": 1717.18, "word": " see", "probability": 0.90380859375}, {"start": 1717.18, "end": 1717.48, 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consistent", "probability": 0.88037109375}, {"start": 1729.58, "end": 1730.02, "word": " اذا", "probability": 0.8798828125}, {"start": 1730.02, "end": 1730.3, "word": " كان", "probability": 0.98388671875}, {"start": 1730.3, "end": 1730.7, "word": " قيمة", "probability": 0.9964192708333334}, {"start": 1730.7, "end": 1731.22, "word": " الدوران", "probability": 0.9807942708333334}, {"start": 1731.22, "end": 1731.84, "word": " ثابت", "probability": 0.9964192708333334}, {"start": 1731.84, "end": 1732.78, "word": " then", "probability": 0.8291015625}, {"start": 1732.78, "end": 1733.42, "word": " check", "probability": 0.95458984375}, {"start": 1733.42, "end": 1734.5, "word": " to", "probability": 0.94970703125}, {"start": 1734.5, "end": 1734.86, "word": " see", "probability": 0.919921875}, {"start": 1734.86, "end": 1735.18, "word": " if", "probability": 0.97705078125}, {"start": 1735.18, "end": 1735.88, "word": " left", "probability": 0.865234375}, {"start": 1735.88, "end": 1736.42, "word": " add", "probability": 0.70751953125}, {"start": 1736.42, "end": 1736.86, "word": " right", "probability": 0.79248046875}, {"start": 1736.86, "end": 1737.52, "word": " subtract", "probability": 0.796875}, {"start": 1737.52, "end": 1738.0, "word": " طبعا", "probability": 0.9659423828125}, {"start": 1738.0, "end": 1738.22, "word": " هذه", "probability": 0.8125}, {"start": 1738.22, "end": 1738.38, "word": " من", "probability": 0.986328125}, {"start": 1738.38, "end": 1738.76, "word": " خلال", "probability": 0.9930013020833334}, {"start": 1738.76, "end": 1738.96, "word": " ايش", "probability": 0.7047526041666666}, {"start": 1738.96, "end": 1739.24, "word": " بدي", "probability": 0.468505859375}, {"start": 1739.24, "end": 1739.78, "word": " اعرفها", "probability": 0.9683837890625}, {"start": 1739.78, "end": 1741.12, "word": " الاستثناء", "probability": 0.4756673177083333}, {"start": 1741.12, "end": 1742.14, "word": " examination", "probability": 0.6883951822916666}], "temperature": 1.0}, {"id": 73, "seek": 175818, "start": 1742.88, "end": 1758.18, "text": "تمام was calculated correctly يعني بتم تحديد اللي هو قيمة ال rotation من خلال استخدام ال rule هذه left add right subtract with a sitlam examination", "tokens": [39237, 10943, 390, 15598, 8944, 37495, 22653, 39894, 2304, 6055, 5016, 16254, 3215, 13672, 1829, 31439, 12174, 32640, 3660, 2423, 12447, 9154, 16490, 1211, 6027, 44713, 9778, 3215, 10943, 2423, 4978, 29538, 1411, 909, 558, 16390, 365, 257, 1394, 4326, 23874], "avg_logprob": -0.3703496910276867, "compression_ratio": 1.261437908496732, "no_speech_prob": 1.1920928955078125e-07, "words": [{"start": 1742.88, "end": 1743.66, "word": "تمام", "probability": 0.5146408081054688}, {"start": 1743.66, "end": 1744.78, "word": " was", "probability": 0.37744140625}, {"start": 1744.78, "end": 1745.88, "word": " calculated", "probability": 0.97119140625}, {"start": 1745.88, "end": 1747.04, "word": " correctly", "probability": 0.912109375}, {"start": 1747.04, "end": 1748.36, "word": " يعني", "probability": 0.838623046875}, {"start": 1748.36, "end": 1748.76, "word": " بتم", "probability": 0.6650390625}, {"start": 1748.76, "end": 1749.4, "word": " تحديد", "probability": 0.972900390625}, {"start": 1749.4, "end": 1749.64, "word": " اللي", "probability": 0.702880859375}, {"start": 1749.64, "end": 1750.0, "word": " هو", "probability": 0.98974609375}, {"start": 1750.0, "end": 1750.64, "word": " قيمة", "probability": 0.99560546875}, {"start": 1750.64, "end": 1750.78, "word": " ال", "probability": 0.9755859375}, {"start": 1750.78, "end": 1751.22, "word": " rotation", "probability": 0.8466796875}, {"start": 1751.22, "end": 1751.8, "word": " من", "probability": 0.990234375}, {"start": 1751.8, "end": 1752.16, "word": " خلال", "probability": 0.99072265625}, {"start": 1752.16, "end": 1752.74, "word": " استخدام", "probability": 0.962890625}, {"start": 1752.74, "end": 1752.88, "word": " ال", "probability": 0.93017578125}, {"start": 1752.88, "end": 1753.08, "word": " rule", "probability": 0.6513671875}, {"start": 1753.08, "end": 1753.52, "word": " هذه", "probability": 0.5751953125}, {"start": 1753.52, "end": 1754.14, "word": " left", "probability": 0.6220703125}, {"start": 1754.14, "end": 1754.52, "word": " add", "probability": 0.2227783203125}, {"start": 1754.52, "end": 1754.88, "word": " right", "probability": 0.837890625}, {"start": 1754.88, "end": 1755.36, "word": " subtract", "probability": 0.5107421875}, {"start": 1755.36, "end": 1756.3, "word": " with", "probability": 0.91064453125}, {"start": 1756.3, "end": 1756.74, "word": " a", "probability": 0.59326171875}, {"start": 1756.74, "end": 1757.24, "word": " sitlam", "probability": 0.2230224609375}, {"start": 1757.24, "end": 1758.18, "word": " examination", "probability": 0.9267578125}], "temperature": 1.0}, {"id": 74, "seek": 177293, "start": 1762.09, "end": 1772.93, "text": "طبعا اللي هو ال over-refraction، spherical cylindrical over-refraction، يعني هو لابس العجسة، بدي أعمل معه spherical cylindrical over-refraction", "tokens": [9566, 3555, 3615, 995, 13672, 1829, 31439, 2423, 670, 12, 33115, 26766, 12399, 37300, 28044, 15888, 670, 12, 33115, 26766, 12399, 37495, 22653, 31439, 5296, 16758, 3794, 18863, 7435, 3794, 3660, 12399, 4724, 16254, 5551, 25957, 1211, 20449, 3224, 37300, 28044, 15888, 670, 12, 33115, 26766], "avg_logprob": -0.27094415908164166, "compression_ratio": 1.5593220338983051, "no_speech_prob": 0.0, "words": [{"start": 1762.09, "end": 1762.49, "word": "طبعا", "probability": 0.9228515625}, {"start": 1762.49, "end": 1762.73, "word": " اللي", "probability": 0.562744140625}, {"start": 1762.73, "end": 1762.93, "word": " هو", "probability": 0.99609375}, {"start": 1762.93, "end": 1763.07, "word": " ال", "probability": 0.83984375}, {"start": 1763.07, "end": 1763.29, "word": " over", "probability": 0.485107421875}, {"start": 1763.29, "end": 1764.33, "word": "-refraction،", "probability": 0.5086669921875}, {"start": 1764.33, "end": 1764.77, "word": " spherical", "probability": 0.85107421875}, {"start": 1764.77, "end": 1765.93, "word": " cylindrical", "probability": 0.681396484375}, {"start": 1765.93, "end": 1766.27, "word": " over", "probability": 0.9580078125}, {"start": 1766.27, "end": 1767.59, "word": "-refraction،", "probability": 0.8507080078125}, {"start": 1767.59, "end": 1767.75, "word": " يعني", "probability": 0.949462890625}, {"start": 1767.75, "end": 1767.93, "word": " هو", "probability": 0.6943359375}, {"start": 1767.93, "end": 1768.35, "word": " لابس", "probability": 0.93896484375}, {"start": 1768.35, "end": 1769.31, "word": " العجسة،", "probability": 0.825244140625}, {"start": 1769.31, "end": 1769.49, "word": " بدي", "probability": 0.6292724609375}, {"start": 1769.49, "end": 1769.75, "word": " أعمل", "probability": 0.8684895833333334}, {"start": 1769.75, "end": 1770.09, "word": " معه", "probability": 0.837158203125}, {"start": 1770.09, "end": 1770.77, "word": " spherical", "probability": 0.8798828125}, {"start": 1770.77, "end": 1771.91, "word": " cylindrical", "probability": 0.943603515625}, {"start": 1771.91, "end": 1772.33, "word": " over", "probability": 0.966796875}, {"start": 1772.33, "end": 1772.93, "word": "-refraction", "probability": 0.9627278645833334}], "temperature": 1.0}, {"id": 75, "seek": 180067, "start": 1776.81, "end": 1800.67, "text": "النتيجة النهائية was calculated هيتم اللي هو تحديدها correctly بشكل صحيح and is consistent with left and right subtract وبعد ذلك من خلال ال rule هذا هحدد اللي هو قداش قيمة ال rotation لمين للعدسة بشكل صحيح تمام ان شاء الله؟ يعني الآن", "tokens": [6027, 1863, 31371, 7435, 3660, 28239, 3224, 16373, 10632, 390, 15598, 39896, 39237, 13672, 1829, 31439, 6055, 5016, 16254, 3215, 11296, 8944, 4724, 8592, 28820, 20328, 5016, 1829, 5016, 293, 307, 8398, 365, 1411, 293, 558, 1422, 6903, 578, 46599, 22488, 29910, 23275, 9154, 16490, 1211, 6027, 2423, 4978, 23758, 8032, 24401, 3215, 13672, 1829, 31439, 12174, 3215, 33599, 12174, 32640, 3660, 2423, 12447, 32767, 9957, 24976, 22488, 3794, 3660, 4724, 8592, 28820, 20328, 5016, 1829, 5016, 46811, 10943, 16472, 13412, 16606, 21984, 22807, 37495, 22653, 6024, 48506], "avg_logprob": -0.23261937934361146, "compression_ratio": 1.5064377682403434, "no_speech_prob": 0.0, "words": [{"start": 1776.81, "end": 1777.77, "word": "النتيجة", "probability": 0.72373046875}, {"start": 1777.77, "end": 1778.53, "word": " النهائية", "probability": 0.984130859375}, {"start": 1778.53, "end": 1779.23, "word": " was", "probability": 0.11248779296875}, {"start": 1779.23, "end": 1780.43, "word": " calculated", "probability": 0.958984375}, {"start": 1780.43, "end": 1781.27, "word": " هيتم", "probability": 0.6383056640625}, {"start": 1781.27, "end": 1781.51, "word": " اللي", "probability": 0.5909423828125}, {"start": 1781.51, "end": 1781.71, "word": " هو", "probability": 0.97314453125}, {"start": 1781.71, "end": 1782.51, "word": " تحديدها", "probability": 0.98291015625}, {"start": 1782.51, "end": 1783.27, "word": " correctly", "probability": 0.487548828125}, {"start": 1783.27, "end": 1784.29, "word": " بشكل", "probability": 0.95166015625}, {"start": 1784.29, "end": 1785.23, "word": " صحيح", "probability": 0.9969482421875}, {"start": 1785.23, "end": 1785.83, "word": " and", "probability": 0.56591796875}, {"start": 1785.83, "end": 1786.21, "word": " is", "probability": 0.91259765625}, {"start": 1786.21, "end": 1786.89, "word": " consistent", "probability": 0.8583984375}, {"start": 1786.89, "end": 1787.39, "word": " with", "probability": 0.93994140625}, {"start": 1787.39, "end": 1787.69, "word": " left", "probability": 0.71240234375}, {"start": 1787.69, "end": 1787.93, "word": " and", "probability": 0.93359375}, {"start": 1787.93, "end": 1788.25, "word": " right", "probability": 0.92431640625}, {"start": 1788.25, "end": 1788.89, "word": " subtract", "probability": 0.50634765625}, {"start": 1788.89, "end": 1789.51, "word": " وبعد", "probability": 0.7374267578125}, {"start": 1789.51, "end": 1789.83, "word": " ذلك", "probability": 0.994873046875}, {"start": 1789.83, "end": 1789.99, "word": " من", "probability": 0.98095703125}, {"start": 1789.99, "end": 1790.47, "word": " خلال", "probability": 0.9951171875}, {"start": 1790.47, "end": 1790.79, "word": " ال", "probability": 0.8720703125}, {"start": 1790.79, "end": 1791.05, "word": " rule", "probability": 0.7626953125}, {"start": 1791.05, "end": 1791.47, "word": " هذا", "probability": 0.6796875}, {"start": 1791.47, "end": 1792.41, "word": " هحدد", "probability": 0.88623046875}, {"start": 1792.41, "end": 1792.61, "word": " اللي", "probability": 0.940673828125}, {"start": 1792.61, "end": 1792.77, "word": " هو", "probability": 0.99365234375}, {"start": 1792.77, "end": 1793.21, "word": " قداش", "probability": 0.5607096354166666}, {"start": 1793.21, "end": 1793.65, "word": " قيمة", "probability": 0.9954427083333334}, {"start": 1793.65, "end": 1793.75, "word": " ال", "probability": 0.9619140625}, {"start": 1793.75, "end": 1794.13, "word": " rotation", "probability": 0.97607421875}, {"start": 1794.13, "end": 1794.65, "word": " لمين", "probability": 0.6661376953125}, {"start": 1794.65, "end": 1796.07, "word": " للعدسة", "probability": 0.78228759765625}, {"start": 1796.07, "end": 1796.67, "word": " بشكل", "probability": 0.984375}, {"start": 1796.67, "end": 1797.51, "word": " صحيح", "probability": 0.997314453125}, {"start": 1797.51, "end": 1799.23, "word": " تمام", "probability": 0.868896484375}, {"start": 1799.23, "end": 1799.35, "word": " ان", "probability": 0.85595703125}, {"start": 1799.35, "end": 1799.51, "word": " شاء", "probability": 0.917236328125}, {"start": 1799.51, "end": 1800.09, "word": " الله؟", "probability": 0.771728515625}, {"start": 1800.09, "end": 1800.27, "word": " يعني", "probability": 0.930419921875}, {"start": 1800.27, "end": 1800.67, "word": " الآن", "probability": 0.734130859375}], "temperature": 1.0}, {"id": 76, "seek": 181969, "start": 1801.51, "end": 1819.69, "text": "عندما يكون المريض عنده عدم وضوح او عدم ثبات في الرؤية و هو لابس العدسة ال software ال contact lenses اعرفنا ايش المشاكل طب كيف نحلها؟ اول حاجة بده اشوف قيمة ال rotation للعدسة ال trial lens", "tokens": [3615, 41260, 15042, 7251, 30544, 9673, 16572, 11242, 43242, 3224, 6225, 40448, 4032, 11242, 2407, 5016, 1975, 2407, 6225, 40448, 38637, 3555, 9307, 8978, 34892, 33604, 10632, 4032, 31439, 5296, 16758, 3794, 18863, 3215, 3794, 3660, 2423, 4722, 2423, 3385, 18059, 1975, 3615, 28480, 8315, 1975, 1829, 8592, 9673, 8592, 995, 28820, 23032, 3555, 9122, 33911, 8717, 5016, 1211, 11296, 22807, 1975, 12610, 11331, 26108, 3660, 47525, 3224, 1975, 8592, 38688, 12174, 32640, 3660, 2423, 12447, 24976, 22488, 3794, 3660, 2423, 7308, 6765], "avg_logprob": -0.12853422565829187, "compression_ratio": 1.5751295336787565, "no_speech_prob": 0.0, "words": [{"start": 1801.51, "end": 1801.97, "word": "عندما", "probability": 0.919921875}, {"start": 1801.97, "end": 1802.25, "word": " يكون", "probability": 0.9873046875}, {"start": 1802.25, "end": 1802.69, "word": " المريض", "probability": 0.974609375}, {"start": 1802.69, "end": 1803.47, "word": " عنده", "probability": 0.9658203125}, {"start": 1803.47, "end": 1803.99, "word": " عدم", "probability": 0.966796875}, {"start": 1803.99, "end": 1804.55, "word": " وضوح", "probability": 0.9891357421875}, {"start": 1804.55, "end": 1805.31, "word": " او", "probability": 0.719970703125}, {"start": 1805.31, "end": 1805.61, "word": " عدم", "probability": 0.921875}, {"start": 1805.61, "end": 1806.07, "word": " ثبات", "probability": 0.94384765625}, {"start": 1806.07, "end": 1806.23, "word": " في", "probability": 0.92822265625}, {"start": 1806.23, "end": 1807.25, "word": " الرؤية", "probability": 0.9679361979166666}, {"start": 1807.25, "end": 1807.89, "word": " و", "probability": 0.450439453125}, {"start": 1807.89, "end": 1808.07, "word": " هو", "probability": 0.919921875}, {"start": 1808.07, "end": 1808.47, "word": " لابس", "probability": 0.9444986979166666}, {"start": 1808.47, "end": 1809.09, "word": " العدسة", "probability": 0.9173583984375}, {"start": 1809.09, "end": 1809.35, "word": " ال", "probability": 0.8662109375}, {"start": 1809.35, "end": 1809.69, "word": " software", "probability": 0.4384765625}, {"start": 1809.69, "end": 1809.91, "word": " ال", "probability": 0.74072265625}, {"start": 1809.91, "end": 1810.21, "word": " contact", "probability": 0.8544921875}, {"start": 1810.21, "end": 1810.73, "word": " lenses", "probability": 0.861328125}, {"start": 1810.73, "end": 1811.33, "word": " اعرفنا", "probability": 0.8505859375}, {"start": 1811.33, "end": 1811.51, "word": " ايش", "probability": 0.8846028645833334}, {"start": 1811.51, "end": 1812.19, "word": " المشاكل", "probability": 0.9913330078125}, {"start": 1812.19, "end": 1812.97, "word": " طب", "probability": 0.844482421875}, {"start": 1812.97, "end": 1813.21, "word": " كيف", "probability": 0.986328125}, {"start": 1813.21, "end": 1814.25, "word": " نحلها؟", "probability": 0.84775390625}, {"start": 1814.25, "end": 1814.57, "word": " اول", "probability": 0.890869140625}, {"start": 1814.57, "end": 1814.87, "word": " حاجة", "probability": 0.9806315104166666}, {"start": 1814.87, "end": 1815.19, "word": " بده", "probability": 0.5260009765625}, {"start": 1815.19, "end": 1815.55, "word": " اشوف", "probability": 0.93408203125}, {"start": 1815.55, "end": 1816.65, "word": " قيمة", "probability": 0.8359375}, {"start": 1816.65, "end": 1816.87, "word": " ال", "probability": 0.919921875}, {"start": 1816.87, "end": 1817.35, "word": " rotation", "probability": 0.96435546875}, {"start": 1817.35, "end": 1818.75, "word": " للعدسة", "probability": 0.8992919921875}, {"start": 1818.75, "end": 1818.91, "word": " ال", "probability": 0.8955078125}, {"start": 1818.91, "end": 1819.21, "word": " trial", "probability": 0.96044921875}, {"start": 1819.21, "end": 1819.69, "word": " lens", "probability": 0.86669921875}], "temperature": 1.0}, {"id": 77, "seek": 184317, "start": 1820.73, "end": 1843.17, "text": "و احدده من خلال الاستلام examination هذه النقطة الاولى اتنين بدي استخدم ال rule left add right subtract بقدر انه اشوف وين اتجاه ال rotation للعدسة النقطة التانية انه بدي اعمل spherical cylindrical oval refraction واشوف القوة الملائمة للعدسة", "tokens": [2407, 1975, 24401, 3215, 3224, 9154, 16490, 1211, 6027, 2423, 32277, 2655, 37440, 23874, 29538, 28239, 47432, 3660, 42963, 12610, 7578, 1975, 2655, 1863, 9957, 4724, 16254, 44713, 9778, 40448, 2423, 4978, 1411, 909, 558, 16390, 4724, 28543, 2288, 16472, 3224, 1975, 8592, 38688, 4032, 9957, 1975, 2655, 7435, 40294, 2423, 12447, 24976, 22488, 3794, 3660, 28239, 47432, 3660, 16712, 7649, 10632, 16472, 3224, 4724, 16254, 1975, 25957, 1211, 37300, 28044, 15888, 37175, 1895, 26766, 4032, 33599, 38688, 25062, 2407, 3660, 9673, 1211, 16373, 46007, 24976, 22488, 3794, 3660], "avg_logprob": -0.20538195073604584, "compression_ratio": 1.6367713004484306, "no_speech_prob": 0.0, "words": [{"start": 1820.73, "end": 1820.93, "word": "و", "probability": 0.9013671875}, 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{"id": 80, "seek": 191936, "start": 1900.04, "end": 1919.36, "text": "النقطة التانية ان اختلاف مين في المنشأ للعدسة انا مثلا بدي مديرة dk على t راح هو اعمل high dk على t فغير من كل ال parameters لمن؟ للعدسة وبالتالي اثر على ايش؟ على ال power او العدسة الملائمة للمريض", "tokens": [6027, 1863, 47432, 3660, 16712, 7649, 10632, 16472, 1975, 46456, 15040, 5172, 3714, 9957, 8978, 9673, 1863, 8592, 10721, 24976, 22488, 3794, 3660, 1975, 8315, 50113, 15040, 4724, 16254, 3714, 3215, 48923, 274, 74, 15844, 256, 12602, 39319, 31439, 1975, 25957, 1211, 1090, 274, 74, 15844, 256, 6156, 17082, 13546, 9154, 28242, 2423, 9834, 5296, 27842, 22807, 24976, 22488, 3794, 3660, 46599, 6027, 2655, 6027, 1829, 1975, 49115, 15844, 1975, 1829, 8592, 22807, 15844, 2423, 1347, 1975, 2407, 18863, 3215, 3794, 3660, 9673, 1211, 16373, 46007, 5296, 19528, 16572, 11242], "avg_logprob": -0.1900755523980319, "compression_ratio": 1.683673469387755, "no_speech_prob": 0.0, "words": [{"start": 1900.04, "end": 1900.54, 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اي", "probability": 0.9462890625}, {"start": 1941.91, "end": 1943.83, "word": " استفسار؟", "probability": 0.8544921875}, {"start": 1943.83, "end": 1944.95, "word": " اعطيكم", "probability": 0.8052734375}, {"start": 1944.95, "end": 1945.33, "word": " العافية", "probability": 0.9205729166666666}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 1945.9250625, "duration_after_vad": 1805.2112499999953} \ No newline at end of file diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/tH3WkzkNA2U_raw.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/tH3WkzkNA2U_raw.srt new file mode 100644 index 0000000000000000000000000000000000000000..e76a39f3ca314e805ca92533498b186fa5796586 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/tH3WkzkNA2U_raw.srt @@ -0,0 +1,1552 @@ +1 +00:00:21,510 --> 00:00:23,990 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:23,990 --> 00:00:29,390 +وبركاته ومرحبا لكم جميعا في محاضرة اليوم ان شاء + +3 +00:00:29,390 --> 00:00:33,050 +الله هنكمل في موضوع ال software contact lenses + +4 +00:00:33,050 --> 00:00:39,350 +طبعا في البداية لو نفترض عندنا وصفة minus three + +5 +00:00:39,350 --> 00:00:48,180 +over minus point fiftyaxis 90 تمام هذه كانت هي + +6 +00:00:48,180 --> 00:00:53,900 +عبارة عن ال subjective refraction اللي خاصة بالمرض + +7 +00:00:53,900 --> 00:00:59,400 +الخطوة الأولى انا ك examiner لو انا بشتغل في موضوع + +8 +00:00:59,400 --> 00:01:07,040 +ال diagnostic او + +9 +00:01:07,040 --> 00:01:09,740 +ال trial method تمام + +10 +00:01:13,470 --> 00:01:18,710 +يكون قريب من ال access اللي عند المريض تمام؟ يعني + +11 +00:01:18,710 --> 00:01:23,870 +مثلا لو كان عندنا access تمانين هذا بيكون accepted + +12 +00:01:23,870 --> 00:01:28,690 +بالنسبة لي أنا بحكي وين؟ في اللي هو ال trial set + +13 +00:01:28,690 --> 00:01:34,750 +تمام؟الخطوة التانية بختار اللى هو power قريب من + +14 +00:01:34,750 --> 00:01:39,010 +power السليندر اللى خاصة فى مين فى المريض والخطوة + +15 +00:01:39,010 --> 00:01:44,710 +التالتة انه بختار power يكون اللى هو يعني minus or + +16 +00:01:44,710 --> 00:01:49,670 +plus 2 ديوبتر قريب من إيش من قيمة السليندر اللى + +17 +00:01:49,670 --> 00:01:53,670 +خاصة بالمريض لأنه فى الآخر انا إيش هعمل over + +18 +00:01:53,670 --> 00:01:58,950 +refraction تمام خلينا نشوفIf the trial lens axis + +19 +00:01:58,950 --> 00:02:04,050 +is close to the refractive axis يعني إذا كان هان + +20 +00:02:04,050 --> 00:02:07,530 +المقصود في ال trial lens axis العدسة اللي موجودة + +21 +00:02:07,530 --> 00:02:11,890 +في ال trial set طبعا قريبة من ال refractive axis + +22 +00:02:11,890 --> 00:02:14,650 +اللي هي تحت ال subjective refraction أو تحت ال + +23 +00:02:14,650 --> 00:02:17,090 +spectacle العدسة أو النضارة + +24 +00:02:19,820 --> 00:02:23,300 +Compensating اللي هو بعد التعويض for the lens + +25 +00:02:23,300 --> 00:02:26,620 +rotation يعني بعد ما انا بدي اعود قيمة دوران A + +26 +00:02:26,620 --> 00:02:31,880 +العدسة The final lens power can be determined by + +27 +00:02:31,880 --> 00:02:35,820 +over refracting the sphere power اذا انا بدي اعمل + +28 +00:02:35,820 --> 00:02:40,420 +بعد ما احط ال trial lens بدي اعمل للمريض ايه over + +29 +00:02:40,420 --> 00:02:44,920 +refraction واشوف قداش قيمة السفير وقيمة السلندر + +30 +00:02:44,920 --> 00:02:51,320 +واشوف قداش قيمة ال axis الجديدة تمام؟إذن to obtain + +31 +00:02:51,320 --> 00:02:54,420 +the final lens to be ordered طب ليش أنا بدي أعمل + +32 +00:02:54,420 --> 00:02:58,740 +over refraction عشان أطلب العجزة النهائية للمريض؟ + +33 +00:03:00,110 --> 00:03:04,690 +reproducibility of software lenses have improved + +34 +00:03:04,690 --> 00:03:10,350 +greatly in recent years يعني الآن اللي هو صناعة أو + +35 +00:03:10,350 --> 00:03:14,690 +اللي هو إنتاج العدسات ال software في الآونة + +36 +00:03:14,690 --> 00:03:18,310 +الأخيرة صار فيها نوع من التطور يعني صارت اللي هو + +37 +00:03:18,310 --> 00:03:23,150 +متطورة تمام؟ من ناحية مين؟ ال manufacturer اللي هو + +38 +00:03:23,150 --> 00:03:28,290 +المصنع لهاSo there is little concern for errors + +39 +00:03:28,290 --> 00:03:31,790 +حيكون لو انا اشتغلت بطريقة ال diagnostic method + +40 +00:03:31,790 --> 00:03:37,190 +هيكون نسبة الخطأ عند المريض قليلة كتير يعني بمعنى + +41 +00:03:37,190 --> 00:03:41,650 +اخر لو انا اشتغلت للمريض diagnostic method ووصلت + +42 +00:03:41,650 --> 00:03:46,730 +لعدسة ال final power اللي مطلوب لما انا ببعتها + +43 +00:03:46,730 --> 00:03:52,790 +للشركة تمام هيكون نسبة الخطأ للعدسة بسيطة تمام هدف + +44 +00:03:52,790 --> 00:03:58,450 +القاونة الأخيرةSo there is little concern for + +45 +00:03:58,450 --> 00:04:02,110 +errors when using the trial lens method of fitting + +46 +00:04:02,110 --> 00:04:06,350 +من هذه الجملة انا باخد نقطة مهمة ان ال diagnostic + +47 +00:04:06,350 --> 00:04:10,390 +او ال trial method هي تعتبر ايه ادق من ال + +48 +00:04:10,390 --> 00:04:15,030 +empirical method تمام؟ اذا الان لو سالتك مين ادق + +49 +00:04:15,030 --> 00:04:18,130 +ال empirical method ولا ال diagnostic ال trial + +50 +00:04:18,130 --> 00:04:22,410 +method لأ ال diagnostic ال trial method هي الأدق + +51 +00:04:22,410 --> 00:04:24,290 +تمام؟ + +52 +00:04:25,560 --> 00:04:31,080 +إذا لم تتجاوز حركة الورق مع حركة الحرارة، يمكن أن + +53 +00:04:31,080 --> 00:04:32,980 +يكون مجرد عملية عملية عملية عملية عملية عملية + +54 +00:04:32,980 --> 00:04:33,440 +عملية عملية عملية عملية عملية عملية عملية عملية + +55 +00:04:33,440 --> 00:04:35,840 +عملية عملية عملية عملية عملية عملية عملية عملية + +56 +00:04:35,840 --> 00:04:38,720 +عملية عملية عملية عملية عملية عملية عملية عملية + +57 +00:04:38,720 --> 00:04:39,180 +عملية عملية عملية عملية عملية عملية عملية عملية + +58 +00:04:39,180 --> 00:04:39,500 +عملية عملية عملية عملية عملية عملية عملية عملية + +59 +00:04:39,500 --> 00:04:39,500 +عملية عملية عملية عملية عملية عملية عملية عملية + +60 +00:04:39,500 --> 00:04:41,740 +عملية عملية عملية عملية عملية عملية عملية عملية + +61 +00:04:41,740 --> 00:04:45,930 +عملية عملواخترت عدسة ملائمة ولاحظت ايضا في blood + +62 +00:04:45,930 --> 00:04:49,890 +vision في هذه الحالة ايش بدي اعمل بدي استخدم + +63 +00:04:49,890 --> 00:04:54,150 +الجاكسون cross cylinder زي ما اتفقنا في المعمل انه + +64 +00:04:54,150 --> 00:04:59,330 +استخدمناه عشان نصلمين لأفضل access ملائم للمريض + +65 +00:05:02,200 --> 00:05:07,580 +Cross-cylinder calculations is an alternate method + +66 +00:05:07,580 --> 00:05:12,680 +to left and right subtract يعني هذه العدسة + +67 +00:05:12,680 --> 00:05:17,300 +الـJackson cross-cylinder هي تعتبر طريقة بديلة أو + +68 +00:05:17,300 --> 00:05:21,600 +تكنيك بديل لاستخدام التكنيك السابق اللي أخدناه + +69 +00:05:21,600 --> 00:05:26,740 +left and right subtract which some believe to be + +70 +00:05:26,740 --> 00:05:30,340 +more precise البعض بيعتبرها أنها دقيقة + +71 +00:05:36,840 --> 00:05:42,020 +once the fit of the lens has been confirmed يعني + +72 +00:05:42,020 --> 00:05:46,980 +واحد من ال researcher أو واحد من الفتر بيعمل عملية + +73 +00:05:46,980 --> 00:05:50,440 +confirmed إيش معناه confirmed؟ أي بمعنى تأكيد أو + +74 +00:05:50,440 --> 00:05:57,500 +تثبيت تمام؟And if visual acuity is compromised + +75 +00:05:57,500 --> 00:06:04,400 +نفترض انه لان انا استخدمت التلاث صور لجاكسون اكروس + +76 +00:06:04,400 --> 00:06:08,360 +سيلندر لاحظت انه ال visual acuity بصيله compromise + +77 +00:06:08,360 --> 00:06:12,800 +ايش منات compromise يعني بمعنى بقل او بنزل تمام؟ + +78 +00:06:13,700 --> 00:06:17,580 +إذا أنا في عندي هن إيش؟ defect صح ولا لأ؟ بمعنى + +79 +00:06:17,580 --> 00:06:22,180 +آخر لو أنا عرضت الصورة الأولى، التانية قال مغبشة، + +80 +00:06:22,180 --> 00:06:25,800 +التالتة مغبشة، إذا الصورة الأولى هي الصح، ليش؟ + +81 +00:06:25,800 --> 00:06:29,260 +لأنه في الصورة التانية والتالتة صار تغبيش عند مين؟ + +82 +00:06:29,260 --> 00:06:32,940 +عند المريض، صحيحة ولا لأ؟ بدي أستخدم مين؟ ال + +83 +00:06:32,940 --> 00:06:36,640 +Jackson cross cylinderAnd if visual acuity is + +84 +00:06:36,640 --> 00:06:42,160 +compromised، لو كان الحدة الإبصار قل، then perform + +85 +00:06:42,160 --> 00:06:45,260 +a sphere-cylinder over-refraction over + +86 +00:06:45,260 --> 00:06:46,700 +equilibrated lenses + +87 +00:07:05,250 --> 00:07:11,770 +في هناك special test تمام maybe needed to attain + +88 +00:07:11,770 --> 00:07:16,790 +the best possible result يعني في هناك اللي هو + +89 +00:07:16,790 --> 00:07:22,450 +testات خاصة بنحتاجها في عملية ال evaluation لل + +90 +00:07:22,450 --> 00:07:25,830 +software اللي كنتك لينزل to attain أي بمعنى to + +91 +00:07:25,830 --> 00:07:32,430 +achieve لتحقيق أفضل اللي هو نتيجة محتملة common + +92 +00:07:32,430 --> 00:07:38,890 +errors causingPoor performance includes incorrect + +93 +00:07:38,890 --> 00:07:44,250 +base curve إذا الآن لو كان في هناك خطأ في العدسة + +94 +00:07:44,250 --> 00:07:48,990 +اللي لبسها المريض أنا ك examiner إيش بتوقع؟ إنه + +95 +00:07:48,990 --> 00:07:52,470 +يكون فيه أول حاجة خطأ في ال base curve بتاع العدسة + +96 +00:07:52,470 --> 00:07:56,470 +الأمر التاني ممكن إنه أتوقع إنه يكون فيه خطأ بال + +97 +00:07:56,470 --> 00:08:01,080 +power بتاع العدسة صح ولا لأ؟انا عمله subjective او + +98 +00:08:01,080 --> 00:08:04,180 +objective refraction بشكل غير صحيح او بشكل غير + +99 +00:08:04,180 --> 00:08:07,140 +دقيق عشان هي قلتلكم دايما اما تعمل subjective + +100 +00:08:07,140 --> 00:08:12,700 +refraction لابد ان يكون ايه؟ accurate دقيق تمام؟ + +101 +00:08:12,700 --> 00:08:17,640 +and unpredictable lens power effects يعني ماقدرنا + +102 +00:08:17,640 --> 00:08:22,180 +انه نستكشف ايه اللي هو او نتنبأ جديش اللي هو تأثير + +103 +00:08:22,180 --> 00:08:27,370 +قوة العدسةبمعنى اخر الان انا مثلا المريض زي المثال + +104 +00:08:27,370 --> 00:08:31,590 +السابق عنده minus 3 لما عملنا over refraction طلع + +105 +00:08:31,590 --> 00:08:37,710 +3.5 اذا في عنده اللي هو lens power اللي هو زائد صح + +106 +00:08:37,710 --> 00:08:41,950 +ولا لا بمعنى اخر ممكن انا ادي عدسة تمام اللي هي ال + +107 +00:08:41,950 --> 00:08:45,610 +final power واروح اعمله over refraction الاقي انه + +108 +00:08:45,610 --> 00:08:50,650 +لسه في عنده ايش اللي هو قيمةفهذا كله اشمله ان هذا + +109 +00:08:50,650 --> 00:08:55,270 +بيدي اللي هو انزعاج للمريض و بيقلل اللي هو الرؤية + +110 +00:08:55,270 --> 00:09:00,490 +اللي خاصة بالمريض اذا الان لو انا سألتك ايش هي + +111 +00:09:00,490 --> 00:09:04,470 +المشاكل ممكن واحد يكون عنده blurred vision في ال + +112 +00:09:04,470 --> 00:09:08,210 +software واحد ان يكون عنده incorrect لل base care + +113 +00:09:08,210 --> 00:09:11,610 +اتنين incorrect لل lens power incorrect لل + +114 +00:09:11,610 --> 00:09:16,230 +refraction ال lens effect unpredictable غير مكتشفة + +115 +00:09:16,230 --> 00:09:21,890 +او غير معروفةThis special test can aid in + +116 +00:09:21,890 --> 00:09:27,450 +achieving the best result quickly. إذن هذه التستات + +117 +00:09:27,450 --> 00:09:31,150 +اللي هيتم مناقشتها الآن كلها هادي بالساعد aid + +118 +00:09:31,150 --> 00:09:35,990 +بمعنى مساعدة في تحقيق اللي هو أفضل نتيجة اللي هو + +119 +00:09:35,990 --> 00:09:38,510 +بشكل سريع لمين للمريض + +120 +00:09:41,780 --> 00:09:46,560 +نمبر وان عندنا ال written scope طبعا احنا بنعرف ان + +121 +00:09:46,560 --> 00:09:49,860 +ال written scope هو عبارة عن objective method + +122 +00:09:49,860 --> 00:09:54,600 +بيستخدم لتحديد ايه ال refractive error للمريض لكن + +123 +00:09:54,600 --> 00:09:58,850 +احنا الآن ايش بدنا نستخدمها؟بدي اشوف to evaluate + +124 +00:09:58,850 --> 00:10:04,770 +the cornea lens fitting relationship as well as to + +125 +00:10:04,770 --> 00:10:08,810 +determine if there any power effects or cross + +126 +00:10:08,810 --> 00:10:13,570 +cylinder effects يعني بدي اشوف انه هل القوة اللي + +127 +00:10:13,570 --> 00:10:18,330 +مش مسلحة عند المريض هل هي تعتبر significant ولا + +128 +00:10:18,330 --> 00:10:21,230 +insignificant طبعا احنا عارفين اذا كانت + +129 +00:10:21,230 --> 00:10:25,730 +insignificant بدنا نتغابى عنها انه غير مهمة يعني + +130 +00:10:25,730 --> 00:10:29,580 +مش مأثرة على النظرتمام؟ لكن إذا كانت significant + +131 +00:10:29,580 --> 00:10:33,540 +لابد من إعادة إيه؟ نعمل refitting للعدسات مرة + +132 +00:10:33,540 --> 00:10:33,940 +تانية + +133 +00:10:38,700 --> 00:10:44,060 +الان نفترض واعد لابسة عدسة optimal fit تمام؟ لازم + +134 +00:10:44,060 --> 00:10:48,100 +انا يما اجي اشوف ال red reflex before و after + +135 +00:10:48,100 --> 00:10:52,280 +blinking و هي لابسة العدسة اللاصقة الحالتين يكونوا + +136 +00:10:52,280 --> 00:10:56,420 +crisp اي بمعنى clear او التنتين يكونوا bright مضيق + +137 +00:10:56,420 --> 00:10:59,700 +ال red reflex يكون واضح تمام؟ + +138 +00:11:02,130 --> 00:11:06,050 +Distortion لو الرد رفليكس هذا ظهر فيه اللي هو تشوش + +139 +00:11:06,050 --> 00:11:09,650 +أو عدم وضوح زي الميارز زي ما شوفناها في الجوال + +140 +00:11:09,650 --> 00:11:15,270 +كراتوميتر Distortion may indicate a steep lens طيب + +141 +00:11:15,270 --> 00:11:18,930 +لو سألنا الآن سيها ممكنش يكون اللي هو steep lens؟ + +142 +00:11:30,930 --> 00:11:35,730 +و احنا طلبنا من وعد نرجع للمثال انه تعمل اللي هو + +143 +00:11:35,730 --> 00:11:39,590 +blinking او complete blinking من خلال ال reflex + +144 +00:11:39,590 --> 00:11:43,190 +بتاع ال retinascope او الكيراتوميتر مايرز بعد + +145 +00:11:43,190 --> 00:11:47,210 +الترميش هيكون ايه شماله؟ اللي هو clear واضح او + +146 +00:11:47,210 --> 00:11:51,450 +crisp اللي هو مضيق تمام؟ طيب قبل الترميش هيكون + +147 +00:11:51,450 --> 00:11:57,030 +unclear لو كانت flat العدسة before blinking هيكون + +148 +00:11:57,030 --> 00:11:57,410 +clear + +149 +00:12:00,410 --> 00:12:05,950 +وفيه distortion okay poor lens optics يعني في هناك + +150 +00:12:05,950 --> 00:12:11,770 +مشكلة من المصنع في العدسة تمام سواء ممكن يكون في + +151 +00:12:11,770 --> 00:12:15,590 +ال base curve أو في ال diameter أو اللي هو يعني في + +152 +00:12:15,590 --> 00:12:19,030 +ال parameters الخاصة بالعدسة أو نفترض مثلا بال + +153 +00:12:19,030 --> 00:12:25,960 +water contentأو ربط الكورنيا غير عادل زي ما اتفقنا + +154 +00:12:25,960 --> 00:12:30,960 +ان الصفتوريك كونتاك لينزلز لبرنسبل تاحه انه موافق + +155 +00:12:30,960 --> 00:12:36,700 +لشكل الكورنيا فلو كان عنده اي تتشقق او اي مثلا + +156 +00:12:36,700 --> 00:12:42,220 +اعوجاج او عدم انتظام في الكورنيابناخد نفس الشكل صح + +157 +00:12:42,220 --> 00:12:48,420 +ولا لا فهذا هيأثر على اللي هو من العدسة الملائمة + +158 +00:12:48,420 --> 00:12:54,920 +او المناسبة للمريض لذلك بدنا نستبدل باللي هو ايه + +159 +00:12:54,920 --> 00:12:59,420 +ال RGB سواء اللي هو spherical RGB او Toric RGB + +160 +00:13:04,430 --> 00:13:09,830 +Autorefraction over the lens can be of benefit as + +161 +00:13:09,830 --> 00:13:14,190 +a starting point in determining an overrefraction + +162 +00:13:14,190 --> 00:13:20,930 +بعض من الأخصائيين أو الأخصائيات أول ما بيضع ال + +163 +00:13:20,930 --> 00:13:26,350 +trial lens اللي هي بتكون close لوصفة النضارة أو ال + +164 +00:13:26,350 --> 00:13:31,630 +subjective refraction بروح بعمل ايه overrefraction + +165 +00:13:32,450 --> 00:13:36,730 +الـ Over Refraction يقدّش قيمة السفير والسلمدر + +166 +00:13:36,730 --> 00:13:41,230 +والأكسز فهذا بيسهّل عليه ايش في ال starting point + +167 +00:13:41,230 --> 00:13:45,770 +زي بالضبط عندما اتفقنا ان في ال RGB الفكرة + +168 +00:13:45,770 --> 00:13:49,310 +الأساسية وين اعرف ال initial point او ال starting + +169 +00:13:49,310 --> 00:13:54,140 +point بتاعة ال base curve وهذا نفس الحاجةو ال over + +170 +00:13:54,140 --> 00:13:58,000 +refraction هو يعتبر guide ليه عشان اعرف اللي هو + +171 +00:13:58,000 --> 00:14:03,780 +جديش البداية اللي ابدأ فيها كعدسة ملائمة او مناسبة + +172 +00:14:03,780 --> 00:14:11,400 +للمريض طيب في عندنا manual rotation يعني بمعنى انه + +173 +00:14:11,400 --> 00:14:17,180 +دوران بشكل يدوي للعدسة وهنا راجزوا معي كويس لان في + +174 +00:14:17,180 --> 00:14:24,210 +اختلاف شوية بسيطManual rotation can only verify if + +175 +00:14:24,210 --> 00:14:30,110 +an axis change will improve vision الان انا قعدت + +176 +00:14:30,110 --> 00:14:34,770 +المريض تمام نفترض عندى في العيادة مش موجود اللى هو + +177 +00:14:34,770 --> 00:14:38,190 +ال Jackson cross cylinder قعدنا المريض امام ال + +178 +00:14:38,190 --> 00:14:43,830 +cylinder chart و العدسة inside the eye اعملنا اللى + +179 +00:14:43,830 --> 00:14:50,170 +هو تحريك للجفن السفليلا المريض فلاحظنا انه العدسة + +180 +00:14:50,170 --> 00:14:54,430 +يما بتروح باتجاه اليمين او باتجاه الشمال في + +181 +00:14:54,430 --> 00:15:01,590 +improvement في تحسن تمام هذا بيديني انطباع ان ال + +182 +00:15:01,590 --> 00:15:06,570 +axis الأصل عند المريض ايه مش صحيح incorrect بدنا + +183 +00:15:06,570 --> 00:15:10,830 +نعمل اللي هو ايه تعديل لل axis اما بالزيادة او + +184 +00:15:10,830 --> 00:15:13,910 +بالنقصان ال axis هذه المقصود فيها ال manual + +185 +00:15:13,910 --> 00:15:21,250 +rotationManual rotation can only verify إذا مالهاش + +186 +00:15:21,250 --> 00:15:24,230 +علاقة في ال rotation يا جماعة أو مالهاش علاقة بال + +187 +00:15:24,230 --> 00:15:31,110 +stability فقط إيش بتأكد اللي هو ال axis إذا can + +188 +00:15:31,110 --> 00:15:35,910 +only verify if an axis change will improve vision + +189 +00:15:35,910 --> 00:15:40,130 +يعني الآن أنا لما بغير اللي هو ال axis هل بتحسن + +190 +00:15:40,130 --> 00:15:46,740 +النظر ولا لا؟Using two lines worse on the Snillen + +191 +00:15:46,740 --> 00:15:51,800 +chart يعني نفترض المريض وصل بالعدسة ال trial او ال + +192 +00:15:51,800 --> 00:15:58,340 +diagnostic lens ستة على تمانتاش تمام حركت العدسة + +193 +00:15:58,340 --> 00:16:04,120 +المريض شاف الستة على اتناش و الستة على تسعة اذا في + +194 +00:16:04,120 --> 00:16:09,800 +عندنا ايش صار improve تمام اذا باخد ال two lines + +195 +00:16:09,800 --> 00:16:15,200 +اللي بعد منالـ line اللي شافهم طيب نفترض انه صار + +196 +00:16:15,200 --> 00:16:19,900 +في عنده worse يعني جل ال visual acuity يعني بدل ما + +197 +00:16:19,900 --> 00:16:24,360 +شاف ال 6 ع 18 يما حركنا العجزة اللي هو شاف ايه + +198 +00:16:24,360 --> 00:16:29,360 +اللي هو 6 على 60 او 6 ع 36 هذا بتديني انطباع ان ال + +199 +00:16:29,360 --> 00:16:32,500 +axis الاول ايش ماله صحيح تمام؟ + +200 +00:16:35,400 --> 00:16:40,640 +إذا using two lines worse on the Snellen chart ask + +201 +00:16:40,640 --> 00:16:45,320 +patient to report better or worse vision as the + +202 +00:16:45,320 --> 00:16:50,200 +lens repositions after you manually rotate the + +203 +00:16:50,200 --> 00:16:53,880 +lens face to the right and the left يعني الآن أنا + +204 +00:16:53,880 --> 00:16:58,800 +بدي أعرض السطرين اللي قبل اللي شافهم يعني نفترض هو + +205 +00:16:58,800 --> 00:17:04,950 +شاف ستة على تسعةبدي اعرض قبله بسطرين وبعده بسطرين + +206 +00:17:04,950 --> 00:17:08,930 +واشوف انه هل بيصير improve ولا worse لل visual + +207 +00:17:08,930 --> 00:17:14,730 +acuity طبعا من خلال ايه؟ تحريك ال lower eyelid + +208 +00:17:14,730 --> 00:17:19,330 +للمريض وبيشوف هل فيه تحسن لل visual acuity ولا لا + +209 +00:17:31,540 --> 00:17:38,380 +لو كان هناك تحسن لحظة زي ما اتفقنا للحظات في تحسن + +210 +00:17:38,380 --> 00:17:43,560 +لكن ايه؟ momentarily أي بمعنى لحظة when you rotate + +211 +00:17:43,560 --> 00:17:45,000 +the lens to the right + +212 +00:17:52,470 --> 00:17:55,830 +يعني بدنا نعمل إضافة لل axis هان احنا قلنا ماناش + +213 +00:17:55,830 --> 00:17:59,550 +علاقة في مين؟ في اللي هو ال rotation أو ال + +214 +00:17:59,550 --> 00:18:02,750 +stability عشان ما تقولليش واحدة انه left add و + +215 +00:18:02,750 --> 00:18:07,270 +right subtract تمام؟ اذا هان انا حركت العدسة + +216 +00:18:07,270 --> 00:18:13,570 +باتجاه اليمين لاحظت انه المريض بتحسن اذا بدي ازود + +217 +00:18:13,570 --> 00:18:18,430 +على ال axis الأصلي بالقيمة اللي اتحسن فيهاتمام؟ + +218 +00:18:18,430 --> 00:18:22,710 +لكن هي بتكون إيش اللي هو قيمة اللي هو about، يعني + +219 +00:18:22,710 --> 00:18:26,070 +مش دقيقة، لذلك الأفضل إنه إيش بستخدم؟ + +220 +00:18:32,470 --> 00:18:38,390 +طيب لو هو اتحسن ال vision باتجاه اللي هو الشمال في + +221 +00:18:38,390 --> 00:18:41,770 +ال left اذا معناه الكلام انه بدي اعمل عملية اللي + +222 +00:18:41,770 --> 00:18:46,250 +هو subtract طريح للي هو قيمة ال axis مرة تانية + +223 +00:18:46,250 --> 00:18:51,490 +بيذكرنا this doesn't verify the amount but only + +224 +00:18:51,490 --> 00:18:55,350 +direction for a new axis هو مابدي نجد اشهر قيمة ال + +225 +00:18:55,350 --> 00:18:59,290 +rotation او ال stability فقطبقول لي أن ال axis + +226 +00:18:59,290 --> 00:19:03,350 +بتاع العدسة غير ملائم أو غير مناسب و بدنا نعمل + +227 +00:19:03,350 --> 00:19:07,710 +اللي هو عملية ايه تغيير لهذا ال axis بالقيمة + +228 +00:19:07,710 --> 00:19:13,470 +الصحيحة Cornial + +229 +00:19:13,470 --> 00:19:20,950 +topography can predict more challenging fitsالجهاز + +230 +00:19:20,950 --> 00:19:26,670 +.. الجهاز ال corneal topography هو يستطيع تنبؤ أو + +231 +00:19:26,670 --> 00:19:31,390 +اللي هو تخمين اللي .. الفت اللي بيكون فيه له + +232 +00:19:31,390 --> 00:19:36,410 +تحديات، كيف يعني؟ نفترض مثلا بيشون عنده في ال + +233 +00:19:36,410 --> 00:19:41,210 +center normal value، لكن في ال peripheral في عنده + +234 +00:19:41,210 --> 00:19:46,200 +steep corneaاذا هان هيكون صعب في عملية ال + +235 +00:19:46,200 --> 00:19:49,760 +evaluation او في عملية ال fitting مين اللي بساعدني + +236 +00:19:49,760 --> 00:19:54,670 +في هذا العمل اللي هو ال corneal topography؟A + +237 +00:19:54,670 --> 00:19:59,130 +higher degree of empirical fitting failures of + +238 +00:19:59,130 --> 00:20:05,370 +care دايما الطريقة التجريبية بتفشل وين؟ لما واحد + +239 +00:20:05,370 --> 00:20:08,950 +يكون عنده high refractive error لأنه عنده high + +240 +00:20:08,950 --> 00:20:13,270 +sensitivity تمام؟ او بيكون في عنده irregular + +241 +00:20:13,270 --> 00:20:17,070 +peripheral corneal toricity يعني منطقة اللي هو + +242 +00:20:17,070 --> 00:20:23,850 +الأطراف فيها ال care reading هي تعتبريعني فيها ال + +243 +00:20:23,850 --> 00:20:28,750 +key reading أعلى ك corneal اللي هو power فها المين + +244 +00:20:28,750 --> 00:20:31,870 +اللي بساعدنا في عملية ال fitting هو عبارة عن ال + +245 +00:20:31,870 --> 00:20:37,690 +corneal topography instrument أيضا + +246 +00:20:37,690 --> 00:20:41,870 +في عندنا dialing and rotation يعني بمعنى اللي هو + +247 +00:20:41,870 --> 00:20:49,060 +التدوير عملية التدوير لل trial frameWhile the lens + +248 +00:20:49,060 --> 00:20:53,560 +is on the eye is helpful in checking rotational + +249 +00:20:53,560 --> 00:20:58,900 +velocity يعني الآن احنا لابد أسمع العدسة للمريض + +250 +00:20:58,900 --> 00:21:04,080 +تمام و بدأ أشوف سرعة الدوران للعدسة ممكن أني + +251 +00:21:04,080 --> 00:21:08,380 +أستخدم ال dial اللي هو الخاص في ال trial frame و + +252 +00:21:08,380 --> 00:21:13,120 +من خلاله بقدر اللي هو أحدد قيمة ال axis يعني قداش + +253 +00:21:13,120 --> 00:21:15,600 +في سرعة الدوران لمن للعدسة + +254 +00:21:19,170 --> 00:21:25,010 +سرعة الدوران is the speed at which a lens returns + +255 +00:21:25,010 --> 00:21:31,370 +to the proper position when mislocatedيعني سرعة + +256 +00:21:31,370 --> 00:21:36,230 +الدوران اللي هي عبارة عن سرعة بتمثل جداش دوران + +257 +00:21:36,230 --> 00:21:40,670 +العدسة عن ال proper fit يعني وضعها الملائم أو + +258 +00:21:40,670 --> 00:21:45,810 +المناسب جداش هي قادرة انه تعمل mislocated يعني انه + +259 +00:21:45,810 --> 00:21:49,610 +تبعد عن ايش مكانها الطبيعي او تعمل اللي هو + +260 +00:21:49,610 --> 00:21:56,750 +displacement ازاحة تمام يا جماعة؟ manually rotate + +261 +00:22:00,420 --> 00:22:05,560 +to return to position إذا هان أنا بشكل يدوي بدي + +262 +00:22:05,560 --> 00:22:10,580 +أعمل تحريك للعدسة و بدي أعمل observe بمعنى ملاحظة + +263 +00:22:10,580 --> 00:22:16,100 +لا اللي هو دوران العدسة عن موضوعها طيب في عندنا ال + +264 +00:22:16,100 --> 00:22:20,080 +dialing or rotation while the lens on the eye is + +265 +00:22:20,080 --> 00:22:24,760 +helpful in checking rotational velocityسرعة تحرك + +266 +00:22:24,760 --> 00:22:29,720 +هي السرعة التي تعود للمصطلح المناسب للمصطلح + +267 +00:22:29,720 --> 00:22:31,560 +المناسب للمصطلح المناسب للمصطلح المناسب للمصطلح + +268 +00:22:31,560 --> 00:22:32,140 +المناسب للمصطلح المناسب للمصطلح المناسب للمصطلح + +269 +00:22:32,140 --> 00:22:35,100 +المناسب للمصطلح المناسب للمصطلح المناسب للمصطلح + +270 +00:22:35,100 --> 00:22:37,460 +المناسب للمصطلح المناسب للمصطلح المناسب للمصطلح + +271 +00:22:37,460 --> 00:22:37,480 +المناسب للمصطلح المناسب للمصطلح المناسب للمصطلح + +272 +00:22:37,480 --> 00:22:37,480 +المناسب للمصطلح المناسب للمصطلح المناسب للمصطلح + +273 +00:22:37,480 --> 00:22:37,480 +المناسب للمصطلح المناسب للمصطلح المصطلح المناسب + +274 +00:22:37,480 --> 00:22:42,360 +للمصطلح المunacceptable rotational velocity is 15 + +275 +00:22:42,360 --> 00:22:47,360 +seconds يعني قيمة اللي هو الدوران للعدسة عن موضعها + +276 +00:22:47,360 --> 00:22:52,860 +الطبيعي إذا كان أقل من 15 فهو مقبول طبعا اللي هو + +277 +00:22:52,860 --> 00:22:57,900 +seconds طيب أكتر من 15 بتديني انطباع أنه قد تكون + +278 +00:22:57,900 --> 00:23:03,800 +العدسة unacceptable تمام وفي مشكلة في ال fitting + +279 +00:23:03,800 --> 00:23:04,660 +للعدسة + +280 +00:23:08,170 --> 00:23:14,090 +troubleshooting أي بمعنى مشاكل ممكن انه تكون في + +281 +00:23:14,090 --> 00:23:20,610 +العدسة وكيف بدنا نعمل عملية حل لهذه المشاكل اذا + +282 +00:23:20,610 --> 00:23:27,420 +مشاكل وحلول لل software contact lensesSoft Torque + +283 +00:23:27,420 --> 00:23:36,360 +Lenses أصبح أسهل بسبب تحسين تجارب التورك لينزز كما + +284 +00:23:36,360 --> 00:23:41,420 +اتفقنا أنه في القاونة الأخيرة تم تطوير في العدسات + +285 +00:23:41,420 --> 00:23:44,720 +الـ Soft Torque Contact Lenses خاصة في موضوع ال + +286 +00:23:44,720 --> 00:23:49,770 +designالـ software design بمعنى اخر انه بطلنا + +287 +00:23:49,770 --> 00:23:53,430 +نستخدم اللى هو موضوع ال graffiti او ال prism + +288 +00:23:53,430 --> 00:23:57,550 +palace على الساعة ستة صرنا مثلا نستخدم على الساعة + +289 +00:23:57,550 --> 00:24:02,110 +تلاتة و اللى هو الساعة تسعة بمعنى انه اصبح اللى هو + +290 +00:24:02,110 --> 00:24:07,110 +هناك عملية اللى هو amended اللى هو تغيير او عملية + +291 +00:24:07,110 --> 00:24:11,970 +improvement تحسن في اللى هو موضوع ال design اللى + +292 +00:24:11,970 --> 00:24:17,590 +خاص بالعدسات ال softwaredepending on when the + +293 +00:24:17,590 --> 00:24:21,710 +situation occurs that are several options to + +294 +00:24:21,710 --> 00:24:26,750 +consider هناك عديد من الخيارات وأنا بناء على كل + +295 +00:24:26,750 --> 00:24:31,290 +اللي هو مريض على حده بقدر أحددله إيش ال study + +296 +00:24:31,290 --> 00:24:33,730 +design الملائم له + +297 +00:24:37,030 --> 00:24:42,810 +A stable blurred vision at dispensing may indicate + +298 +00:24:42,810 --> 00:24:47,270 +that the axis is misaligned. There is a power + +299 +00:24:47,270 --> 00:24:51,970 +change or there is power effect changes due to + +300 +00:24:51,970 --> 00:25:00,250 +flexure.الان انا في عندى مريض نفترض بلانه ع minus + +301 +00:25:00,250 --> 00:25:08,660 +اتنينaccess 13 تمام؟ لبسته العدسة عنده غبش دائم + +302 +00:25:08,660 --> 00:25:14,660 +إذا عندنا stable blurred vision يعني هذا المريض + +303 +00:25:14,660 --> 00:25:21,600 +عنده غبش بشكل مستمر أو بشكل دائم أنا الآن بدي أفكر + +304 +00:25:21,600 --> 00:25:27,580 +تفكير إنه إيش أسباب الغبش الدائم هذا عند المريض؟ + +305 +00:25:27,580 --> 00:25:33,030 +ممكن يكونواحد ان ال access غير صحيح يعني الآن انا + +306 +00:25:33,030 --> 00:25:36,930 +بعطت access تلاتين، راحت الشركة عملت access نفترض + +307 +00:25:36,930 --> 00:25:42,370 +مثلا اربعين، تمام؟ اذا صار عند المريض فيه اختلاف + +308 +00:25:42,370 --> 00:25:46,630 +من حيث ال access اتنين، انا طلبت إبلانه على minus + +309 +00:25:46,630 --> 00:25:50,350 +اتنين، راح عمل إبلانه على minus واحد، اختلاف في + +310 +00:25:50,350 --> 00:25:52,590 +قوة العدسة، تمام؟ + +311 +00:25:55,520 --> 00:26:03,300 +due to flexure مين تعرف إيش مانعت flexure؟ أي + +312 +00:26:03,300 --> 00:26:09,120 +بمعنى تغيير بإنشاء العدسة يعني الآن أنا بعتت base + +313 +00:26:09,120 --> 00:26:15,540 +curve سبعة و تلاتة و diameter عشرة و نص و اللي هو + +314 +00:26:15,540 --> 00:26:21,260 +العدسة ال software دايما بتكون steep and thinner + +315 +00:26:21,260 --> 00:26:24,160 +مقارنة في مين؟ + +316 +00:26:28,710 --> 00:26:34,210 +المنشأ او المصنع عمل ما هو مخالف لهذا ال criteria + +317 +00:26:34,210 --> 00:26:39,070 +او مخالف لهذا ال role فهنا بيكون فيه مشكلة في منشأ + +318 +00:26:39,070 --> 00:26:43,650 +ايه؟ العدسة تمام يا جماعة؟ يعني الآن يما بيكون عند + +319 +00:26:43,650 --> 00:26:50,990 +المريضعدم وضوح وهو لابس العدسة بشكل مستمر لو سألتك + +320 +00:26:50,990 --> 00:26:54,530 +إيش أسبابها السبب الأول ممكن يكون مشكلة في ال + +321 +00:26:54,530 --> 00:26:58,430 +access التاني مشكلة في ال power تحت العدسة سواء ال + +322 +00:26:58,430 --> 00:27:01,550 +sphere أو ال cylinder تلاتة أنه في عنده over + +323 +00:27:01,550 --> 00:27:05,480 +refractionاللي هي ال power effect و أربع عنده + +324 +00:27:05,480 --> 00:27:09,180 +مشكلة وين؟ في منشأ العدسة يعني بمعنى أخر عنده + +325 +00:27:09,180 --> 00:27:12,920 +مشكلة بال base care أو مثلا في ال water content أو + +326 +00:27:12,920 --> 00:27:17,000 +في تصميم العدسة ال study design بتاع العدسة أيضا + +327 +00:27:17,000 --> 00:27:19,760 +كان في عنده defect تمام؟ + +328 +00:27:23,030 --> 00:27:28,090 +The lens should rotate to the same position as the + +329 +00:27:28,090 --> 00:27:32,890 +original trial lens دوران العدسة اللي هي تعتبر ال + +330 +00:27:32,890 --> 00:27:38,070 +final prescription أو ال final order لازم ان يكون + +331 +00:27:38,070 --> 00:27:45,360 +دورانها مشابه لدوران من العدسة ال trial lensIf it + +332 +00:27:45,360 --> 00:27:49,540 +doesn't طيب نفترض هي ماعملتش rotation مماثل لمين + +333 +00:27:49,540 --> 00:27:54,920 +لعدسات ال trial set او العدسة اللى تم اختيارها في + +334 +00:27:54,920 --> 00:28:00,640 +ال trial set First considering trying another lens + +335 +00:28:00,640 --> 00:28:05,460 +بدي احاول استخدام عدسة تانية موجودة وين في ال + +336 +00:28:05,460 --> 00:28:12,030 +trial او ال diagnostic اللى هو lensone from the + +337 +00:28:12,030 --> 00:28:16,950 +other eye is performing well or another trial lens + +338 +00:28:16,950 --> 00:28:21,310 +طب نفترض أن العجسة اللي مطلوبة إليه أو ال close + +339 +00:28:21,310 --> 00:28:25,730 +للقيمة بتاعة المريض مش موجودة في ال trial set اللي + +340 +00:28:25,730 --> 00:28:30,190 +عنده، بدي أضطر أنه ممكن أجيب إيه؟ trial set أخرى، + +341 +00:28:30,190 --> 00:28:33,890 +تمام؟ هذه لو أنا بشتغل إيه؟ diagnostic أو trial + +342 +00:28:33,890 --> 00:28:40,000 +methodto see if the rotation is consistent عشان + +343 +00:28:40,000 --> 00:28:43,340 +انا اشوف اذا كان اللي هو هذا ال rotation ثابت ولا + +344 +00:28:43,340 --> 00:28:49,580 +لأ consistent بمعنى ثابت if rotation is consistent + +345 +00:28:49,580 --> 00:28:55,180 +اذا كان قيمة الدوران ثابت then check to see if + +346 +00:28:55,180 --> 00:28:59,240 +left add right subtract طبعا هذه من خلال ايش بدي + +347 +00:28:59,240 --> 00:29:05,880 +اعرفها الاستثناء examinationتمام was calculated + +348 +00:29:05,880 --> 00:29:11,220 +correctly يعني بتم تحديد اللي هو قيمة ال rotation + +349 +00:29:11,220 --> 00:29:14,880 +من خلال استخدام ال rule هذه left add right + +350 +00:29:14,880 --> 00:29:18,180 +subtract with a sitlam examination + +351 +00:29:22,090 --> 00:29:24,770 +طبعا اللي هو ال over-refraction، spherical + +352 +00:29:24,770 --> 00:29:29,310 +cylindrical over-refraction، يعني هو لابس العجسة، + +353 +00:29:29,310 --> 00:29:32,930 +بدي أعمل معه spherical cylindrical over-refraction + +354 +00:29:36,810 --> 00:29:41,710 +النتيجة النهائية was calculated هيتم اللي هو + +355 +00:29:41,710 --> 00:29:47,390 +تحديدها correctly بشكل صحيح and is consistent with + +356 +00:29:47,390 --> 00:29:51,050 +left and right subtract وبعد ذلك من خلال ال rule + +357 +00:29:51,050 --> 00:29:56,070 +هذا هحدد اللي هو قداش قيمة ال rotation لمين للعدسة + +358 +00:29:56,070 --> 00:30:02,250 +بشكل صحيح تمام ان شاء الله؟ يعني الآنعندما يكون + +359 +00:30:02,250 --> 00:30:08,070 +المريض عنده عدم وضوح او عدم ثبات في الرؤية و هو + +360 +00:30:08,070 --> 00:30:11,330 +لابس العدسة ال software ال contact lenses اعرفنا + +361 +00:30:11,330 --> 00:30:16,650 +ايش المشاكل طب كيف نحلها؟ اول حاجة بده اشوف قيمة + +362 +00:30:16,650 --> 00:30:22,070 +ال rotation للعدسة ال trial lensو احدده من خلال + +363 +00:30:22,070 --> 00:30:26,690 +الاستلام examination هذه النقطة الاولى اتنين بدي + +364 +00:30:26,690 --> 00:30:30,890 +استخدم ال rule left add right subtract بقدر انه + +365 +00:30:30,890 --> 00:30:35,310 +اشوف وين اتجاه ال rotation للعدسة النقطة التانية + +366 +00:30:35,310 --> 00:30:39,170 +انه بدي اعمل spherical cylindrical oval refraction + +367 +00:30:39,170 --> 00:30:43,170 +واشوف القوة الملائمة للعدسة + +368 +00:30:46,630 --> 00:30:51,510 +Power changes due to masking or reflection can + +369 +00:30:51,510 --> 00:30:54,790 +best be determined with a spherical, cylindrical + +370 +00:30:54,790 --> 00:30:57,570 +over-refraction and a cross-cylinder calculation + +371 +00:30:57,570 --> 00:31:02,270 +اتفقنا انه في عملية ال evaluation لل software + +372 +00:31:02,270 --> 00:31:07,910 +contact lenses بتم تقريبا من عشرة لخمس عشر دقيقة + +373 +00:31:07,910 --> 00:31:13,590 +ليش؟ لأنه اي bubble بتجمع ما بين العدسة و الكورنية + +374 +00:31:13,590 --> 00:31:18,490 +بتم التخلص منهبعض الأحيان زي ما احنا كنا نعمل في + +375 +00:31:18,490 --> 00:31:23,410 +المعمل انه نعمل عملية ال evaluation للسرعة بعد خمس + +376 +00:31:23,410 --> 00:31:28,150 +دقائق هذه ممكن ايش تعمل masking أي بمعنى covering + +377 +00:31:28,150 --> 00:31:32,930 +اللي هو تغطية للقيمة الحقيقية لل power اللي موجودة + +378 +00:31:32,930 --> 00:31:36,910 +عند مين عند المريض تمام نتيجة اللي هو ال posterior + +379 +00:31:36,910 --> 00:31:42,520 +lens هذه نقطةالنقطة التانية ان اختلاف مين في + +380 +00:31:42,520 --> 00:31:47,720 +المنشأ للعدسة انا مثلا بدي مديرة dk على t راح هو + +381 +00:31:47,720 --> 00:31:51,880 +اعمل high dk على t فغير من كل ال parameters لمن؟ + +382 +00:31:51,880 --> 00:31:56,660 +للعدسة وبالتالي اثر على ايش؟ على ال power او + +383 +00:31:56,660 --> 00:32:02,150 +العدسة الملائمة للمريضفلذلك من ناحية ال power ممكن + +384 +00:32:02,150 --> 00:32:06,230 +استخدم اللي هو ال spherical cylindrical oval + +385 +00:32:06,230 --> 00:32:10,150 +refraction اما من ناحية اللي هو ال axis ممكن + +386 +00:32:10,150 --> 00:32:15,870 +استخدم مين ال Jackson cross cylinder بنوقف ان شاء + +387 +00:32:15,870 --> 00:32:21,010 +الله لهان و المحاضرة القادمة ان شاء الله بنكمل في + +388 +00:32:21,010 --> 00:32:25,330 +اي سؤال اي استفسار؟ اعطيكم العافية + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/vVvcBTMb4Lk.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/vVvcBTMb4Lk.srt new file mode 100644 index 0000000000000000000000000000000000000000..763f7e5c03e1ec7dae4fa8150efc9a4b34b87155 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/vVvcBTMb4Lk.srt @@ -0,0 +1,1671 @@ +1 +00:00:20,940 --> 00:00:23,760 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:23,760 --> 00:00:30,040 +وبركاته ومرحبا بكم جميعا اليوم هنبدأ في موضوع + +3 +00:00:30,040 --> 00:00:34,880 +bacterial corneal infection may produce any of + +4 +00:00:34,880 --> 00:00:41,640 +several signs طبعا في هناك علامات للعدوى البكتيرية + +5 +00:00:41,640 --> 00:00:46,860 +يعني الآن مثلا نتيجة ارتداء العدسات اللاصقة اللينة + +6 +00:00:46,860 --> 00:00:52,100 +صار عند الشخص نفترض أنه فيه infection في هناك + +7 +00:00:52,100 --> 00:00:57,840 +signs علامات للـ corneal infection إذا هنا ممكن + +8 +00:00:57,840 --> 00:01:09,040 +أقول أن العنوان signs of corneal infection ما هي + +9 +00:01:09,040 --> 00:01:16,580 +هذه العلامات اللي خاصة بالعدسات اللاصقة اللينة؟ + +10 +00:01:16,580 --> 00:01:21,940 +The presence of corneal pain of more than a + +11 +00:01:21,940 --> 00:01:27,580 +transitory nature in a contact lens wearer is a + +12 +00:01:27,580 --> 00:01:31,900 +warning sign of the possibility of a corneal + +13 +00:01:31,900 --> 00:01:38,460 +infection الآن أول ما يتم صرف العدسات اللاصقة من + +14 +00:01:38,460 --> 00:01:46,120 +قبل أخصائي البصريات للمريض أكثر symptom أنا بنبهه + +15 +00:01:46,120 --> 00:01:53,140 +المريض هو موضوع الـ pain الألم و أكثر علامة اللي + +16 +00:01:53,140 --> 00:01:57,420 +أخصائي البصريات بيظلوا ايش خايفين منها اللي هي موضوع + +17 +00:01:57,420 --> 00:02:02,240 +ايه الـ pain طبعا أنتم عارفين بعد ما بتم التقييم + +18 +00:02:03,120 --> 00:02:08,380 +يعني بعد خمس دقائق تقريبا لازم أنا أنه أسأل المريض + +19 +00:02:08,380 --> 00:02:11,800 +أنه هل أنا comfort.. هل هو comfort ولا discomfort + +20 +00:02:11,800 --> 00:02:16,220 +ايه في العدسة اللاصقة طبعا إذا كان هذا الـ pain + +21 +00:02:16,220 --> 00:02:20,580 +الألم غير طبيعي أو غير اعتيادي إذا كلمة a + +22 +00:02:20,580 --> 00:02:24,200 +transitory أي بمعنى غير عادي أو غير طبيعي أو غير + +23 +00:02:24,200 --> 00:02:30,280 +معتاد okay؟ أنا بدي أحذر مين؟ المريض لازم أديه + +24 +00:02:30,280 --> 00:02:35,780 +warning sign يعني علامة تحذير أنه من إمكانية ايه + +25 +00:02:35,780 --> 00:02:39,680 +أنه يسبب هذا الـ corneal infection عند المريض + +26 +00:02:39,680 --> 00:02:46,760 +طيب الآن ببساطة كيف هذا الـ pain بتم إزالته؟ من خلال + +27 +00:02:46,760 --> 00:02:52,020 +إزالة العدسة يعني بنطلب من المريض أنه يعمل removal + +28 +00:02:54,060 --> 00:02:59,480 +of soft contact lenses إذا الآن أنا بتكلم مع + +29 +00:02:59,480 --> 00:03:05,180 +المريض أنه إذا كان عندك ألم اعتيادي يعني بمعنى ألم + +30 +00:03:05,180 --> 00:03:10,540 +بسيط أنه يظل لابس العدسة اللاصقة إذا شعرت بهذا + +31 +00:03:10,540 --> 00:03:15,400 +الألم غير اعتيادي أو غير طبيعي وامتد لفترة زمنية + +32 +00:03:15,400 --> 00:03:19,340 +طويلة بدي أقوله أنه لازم توقف عن ارتداء العدسة + +33 +00:03:19,340 --> 00:03:25,660 +اللاصقة ليش؟ لأن هذا ممكن أنه يسبب ايش؟ Corneal + +34 +00:03:25,660 --> 00:03:36,000 +lens defect يعني بتتأثر القرنية نتيجة ايه ارتداء + +35 +00:03:36,000 --> 00:03:41,340 +العدسة اللاصقة طيب كيف أنا بدي أتخلص من الـ corneal + +36 +00:03:41,340 --> 00:03:47,820 +defect من خلال الـ removal للعدسة اللاصقة؟ بربط + +37 +00:03:47,820 --> 00:03:53,780 +تانية إذا في عندنا الـ corneal lens defect إذا بتتم + +38 +00:03:53,780 --> 00:04:00,220 +التخلص منها من خلال الـ removal للعدسة اللاصقة في + +39 +00:04:00,220 --> 00:04:05,500 +حاجة اسمها corneal keratitis + +40 +00:04:09,550 --> 00:04:13,930 +الـ corneal keratitis هذه أنا ما بقدر أتخلص منها + +41 +00:04:13,930 --> 00:04:18,230 +إلا ما أرفع العدسة، يعني بيظل الألم موجود حتى لو + +42 +00:04:18,230 --> 00:04:22,190 +الشخص عمل removal لمين؟ للـ spherical soft contact + +43 +00:04:22,190 --> 00:04:27,010 +lenses، إذا الألم بيبقى ايش؟ موجود وممكن إنه يعمل + +44 +00:04:27,010 --> 00:04:32,720 +بعد ذلك ايه؟ infection للشخص إذا في هناك مصطلحين + +45 +00:04:32,720 --> 00:04:37,420 +مهمين المصطلح الأول corneal lens defect بتتم + +46 +00:04:37,420 --> 00:04:42,840 +إزالته للألم بعد ما يتم إزالة العدسة بينما الـ + +47 +00:04:42,840 --> 00:04:47,100 +corneal keratitis بيظل الألم موجود حتى لو الشخص + +48 +00:04:47,100 --> 00:04:53,230 +عمل removal للعدسة إذا في عندنا a warning sign أي + +49 +00:04:53,230 --> 00:04:57,690 +بمعنى علامة علامة تحذير من احتمالية حدوث الـ + +50 +00:04:57,690 --> 00:05:01,810 +corneal infection هذه وقت ايش؟ لما يكون عنده الـ + +51 +00:05:01,810 --> 00:05:11,150 +corneal lens defect وعملت أكيد اللي هو pain ألم الـ + +52 +00:05:11,150 --> 00:05:17,250 +pain الألم may be exacerbated أي بمعنى يتفاقم By + +53 +00:05:17,250 --> 00:05:22,550 +lens removal مع إزالة من العدسة، إذا في الحالة + +54 +00:05:22,550 --> 00:05:26,070 +الأولى ولا الثانية، الألم بتفاقم لما بعمل removal + +55 +00:05:26,070 --> 00:05:30,650 +للعدسة مع الـ corneal keratitis، إذا قد يتفاقم هذا + +56 +00:05:30,650 --> 00:05:36,420 +الألم and accompanied by بيظهر على المريض redness + +57 +00:05:36,420 --> 00:05:41,880 +احمرار discharge أو decreased vision أو ما يسمى بـ + +58 +00:05:41,880 --> 00:05:46,680 +blurred vision إذا يما بيصير عند المريض الـ + +59 +00:05:46,680 --> 00:05:52,440 +keratitis infection بيحدث له اللي هو symptoms واضح + +60 +00:05:52,440 --> 00:05:55,600 +هذه الـ symptoms زي عندنا الـ redness أو الـ + +61 +00:05:55,600 --> 00:05:58,960 +discharge بالإضافة لـ الـ decreased vision + +62 +00:06:03,920 --> 00:06:10,920 +Infective ulceration الآن بعد ذلك حدث هناك عدوى للـ + +63 +00:06:10,920 --> 00:06:17,440 +قرنية وعملت أيضا ulceration أو corneal ulcer is + +64 +00:06:17,440 --> 00:06:21,460 +characterized by an epithelial defect يعني صار + +65 +00:06:21,460 --> 00:06:24,900 +هناك خلل وين في الـ corneal epithelium في الطبقة + +66 +00:06:24,900 --> 00:06:30,580 +الأولى للقرنية with an underlying stromal + +67 +00:06:30,580 --> 00:06:35,210 +exovation and infiltrate وهذا الـ infection أيضا + +68 +00:06:35,210 --> 00:06:40,670 +ممكن أنه يعمل excavation بمعنى ثقب وممكن أيضا يعمل + +69 +00:06:40,670 --> 00:06:45,230 +stromal infiltrate ربطنا في المحاضرة السابقة أن في + +70 +00:06:45,230 --> 00:06:49,230 +هناك علاقة ما بين الـ infection و الـ stromal + +71 +00:06:49,230 --> 00:06:53,710 +infiltrate دائما الـ infection بيحدث نتيجة اللي هو + +72 +00:06:53,710 --> 00:06:59,070 +الـ stromal infiltrate لأن هي بتمثل تقريبا 90% من + +73 +00:06:59,070 --> 00:07:00,570 +سماكة القرنية + +74 +00:07:04,440 --> 00:07:09,340 +These findings may be considered for corneal + +75 +00:07:09,340 --> 00:07:14,560 +infection until approved otherwise يعني كل هذه + +76 +00:07:14,560 --> 00:07:18,100 +اللي بنجدها من ناحية الـ readiness أو من ناحية الـ + +77 +00:07:18,100 --> 00:07:22,540 +discharge بعد ذلك اتفاقبت لها corneal ulceration و + +78 +00:07:22,540 --> 00:07:27,460 +corneal infection كل هذه بتظل موجودة حتى أنه يتم + +79 +00:07:27,460 --> 00:07:31,700 +إثبات العكس أن هذا الـ issue مش نتيجة الـ contact + +80 +00:07:31,700 --> 00:07:35,900 +lenses صار عنده مشاكل أخرى هي اللي سببت الأمر هذا + +81 +00:07:40,420 --> 00:07:45,040 +An infective ulcer is typically unilateral دائما + +82 +00:07:45,040 --> 00:07:49,340 +في الغالب يعني typically بمعنى usually غالبا بيكون + +83 +00:07:49,340 --> 00:07:54,180 +في عين واحدة اللي هو موضوع الـ infective ulcer and + +84 +00:07:54,180 --> 00:07:58,260 +the ulcer is likely to be central or mid + +85 +00:07:58,260 --> 00:08:02,260 +peripheral إذا الموقع بتاعه أما بيكون في الأطراف + +86 +00:08:02,260 --> 00:08:06,200 +أو بيكون ايه في الـ mid peripheral أو آسف اللي هو + +87 +00:08:06,200 --> 00:08:11,690 +الـ central إذا موقعه إما بالـ central أو بالـ mid + +88 +00:08:11,690 --> 00:08:12,270 +peripheral + +89 +00:08:16,950 --> 00:08:21,190 +Other possible associated signs are surrounding + +90 +00:08:21,190 --> 00:08:25,270 +epithelial و + +91 +00:08:25,270 --> 00:08:30,450 +أيضا في الـ stroma and endothelial edema يعني هذا + +92 +00:08:30,450 --> 00:08:35,750 +بنتشر في كل أجزاء تقريبا القرنية و بسبب الـ stroma الـ + +93 +00:08:35,750 --> 00:08:39,250 +thinning بالإضافة لـ الـ necrosis ايش معنات + +94 +00:08:39,250 --> 00:08:40,070 +necrosis؟ + +95 +00:08:42,430 --> 00:08:46,610 +الـ necrosis دائما بسبب موت للخلايا يعني بمعنى أنه + +96 +00:08:46,610 --> 00:08:52,470 +بيعمل زي اللي هو هاي لو مثلا نفترض الخلايا بيعملها + +97 +00:08:52,470 --> 00:09:02,670 +اللي هو died of cells موت للخلايا of + +98 +00:09:02,670 --> 00:09:07,330 +the infiltrate myocopurulent طبعا myocopurulent أي + +99 +00:09:07,330 --> 00:09:13,860 +بمعنى discharge أو بصراحة طبعا أيضا بيحدث اللي هو الـ + +100 +00:09:13,860 --> 00:09:19,120 +KPI، الـ KPI هذه مهمة، أي علامة للـ KPI اللي هي + +101 +00:09:19,120 --> 00:09:26,590 +عبارة عن ترسبات في القرنية لازم مباشرة أنا أتخلص + +102 +00:09:26,590 --> 00:09:30,550 +من ارتداء العدسة اللاصقة لأن الاستمرارية فيها + +103 +00:09:30,550 --> 00:09:34,830 +بتعمل للقرنية الـ opacity وبالتالي بتعمل اللي هو + +104 +00:09:34,830 --> 00:09:39,650 +الـ stroma الـ infiltrate وبتقلل من اللي هو سماكة + +105 +00:09:39,650 --> 00:09:45,150 +الـ stroma and anterior chamber reaction إذا بيصير + +106 +00:09:45,150 --> 00:09:50,430 +هناك اللي هو زي سد لطريق من الـ anterior chamber + +107 +00:09:55,080 --> 00:10:00,340 +In terms of management أي بمعنى كيفية العلاج أو + +108 +00:10:00,340 --> 00:10:05,880 +اللي هو معالجة أو التقنية symptoms or signs are + +109 +00:10:05,880 --> 00:10:11,500 +indications for immediate ophthalmic evaluation and + +110 +00:10:11,500 --> 00:10:17,060 +lens wear should immediately be ceased يعني الشخص + +111 +00:10:17,060 --> 00:10:21,740 +إذا وصل لمرحلة الـ bacterial infection لازم أنه + +112 +00:10:21,740 --> 00:10:27,500 +يتوقف عن ارتداء من العدسة اللاصقة طيب أنا بدأ أسأل + +113 +00:10:27,500 --> 00:10:31,620 +سؤال لو هذا الشخص عنده high refractive error plus + +114 +00:10:31,620 --> 00:10:36,780 +عشرة أو minus عشرة و متعود دائما أنه يرتدي عدسة + +115 +00:10:36,780 --> 00:10:41,970 +لاصقة ومش حابب يلبس نظارة طيب أوقفه عن ارتداء + +116 +00:10:41,970 --> 00:10:47,550 +العدسة بشكل كامل ولا كيف؟ ايش رأيكم؟ بنقلل ساعات + +117 +00:10:47,550 --> 00:10:52,870 +ارتداء العدسة اها بنقلل ساعات ارتداء العدسة okay + +118 +00:10:52,870 --> 00:10:58,690 +مع المحافظة على اللي هو الـ material الـ DK على T + +119 +00:10:58,690 --> 00:10:59,790 +للعدسة ولا كيف؟ + +120 +00:11:04,200 --> 00:11:07,800 +طبعا هنا إذا كان المريض عنده high refractive error + +121 +00:11:07,800 --> 00:11:12,660 +وما بيقدر يستخدم عن العدسة اللاصقة لازم أنا أبدأ + +122 +00:11:12,660 --> 00:11:18,200 +بالتفكير أن كيف أقلل المخاطر لهذا المريض ممكن مثلا + +123 +00:11:18,200 --> 00:11:24,020 +يكون الحل أن أدي moderate decay على T أو low decay + +124 +00:11:24,020 --> 00:11:29,860 +على T أو ممكن هذا الشخص مثلا أستبدل اللي هو العدسة + +125 +00:11:29,860 --> 00:11:34,180 +أنه أعمل replacement عملية استبدال في ارتداء + +126 +00:11:34,180 --> 00:11:38,400 +العدسة زي مثلا أقلل اللي هو ساعات ارتداء العدسة + +127 +00:11:38,400 --> 00:11:42,860 +اللاصقة في هناك عدة حلول ممكن حتى الـ solution + +128 +00:11:42,860 --> 00:11:47,180 +المحلول اللي بيستخدمه أغيره نتيجة اللي هو الـ + +129 +00:11:47,180 --> 00:11:48,520 +infective هذا + +130 +00:11:53,460 --> 00:11:57,560 +هو المشكلة طيب أنا مثلا قلت له أوقف عن ارتداء + +131 +00:11:57,560 --> 00:12:01,720 +العدسة اللاصقة هو يجيب مثلا يوم أو يومين أو ثلاثة + +132 +00:12:01,720 --> 00:12:05,560 +طب ما هو بده عنده فيه اللي هو quality of life ايش + +133 +00:12:05,560 --> 00:12:08,340 +هيصير أو الـ quality of vision أو الـ daily life + +134 +00:12:08,340 --> 00:12:11,580 +بتاعته يعني minus عشرة هتتكلم في رؤية جدّيش الـ + +135 +00:12:11,580 --> 00:12:15,020 +visual acuity فيها تقريبا هتكون من واحد على ستين + +136 +00:12:15,020 --> 00:12:19,560 +لااثنين على ستين طب كيف بده يمارس حياته اليومية؟ okay + +137 +00:12:20,370 --> 00:12:24,330 +هذا طبيعي في حالة أنه مصّر على ارتداء العدسة + +138 +00:12:24,330 --> 00:12:30,430 +اللاصقة يعني لذلك أنه دائما بينصح أخصائيي البصريات + +139 +00:12:30,430 --> 00:12:33,650 +يعني هذا according to American Academy لما أنت + +140 +00:12:33,650 --> 00:12:39,050 +بتصرفي العدسة اللاصقة لازم أن يكون معها ايش؟ نظارة + +141 +00:12:39,050 --> 00:12:44,070 +لهذا الموضوع أنه أي infection عند المريض أو أي + +142 +00:12:44,070 --> 00:12:47,790 +complication نتيجة العدسات اللاصقة يعمل عملية + +143 +00:12:47,790 --> 00:12:49,950 +استبدال لها بالنضارة + +144 +00:12:54,830 --> 00:13:00,410 +عندنا Acanthamoeba corneal infection is a rare but + +145 +00:13:00,410 --> 00:13:05,850 +particularly devastating cause of infection لو + +146 +00:13:05,850 --> 00:13:09,850 +عملنا عملية مقارنة ما بين ال bacterial corneal + +147 +00:13:09,850 --> 00:13:14,710 +infection و ال Acanthamoeba corneal infection أي + +148 +00:13:14,710 --> 00:13:20,670 +ما أخطر؟ طبعا ال Acanthamoeba corneal infection هي + +149 +00:13:20,670 --> 00:13:26,000 +تعتبر أكثر خطورة السبب بسيط لأن سببها أو ال + +150 +00:13:26,000 --> 00:13:31,480 +organism لها هو عبارة عن فنجي بينما ال corneal + +151 +00:13:31,480 --> 00:13:37,220 +bacterial infection سببها البكتيريا طبعا هي تعتبر + +152 +00:13:37,220 --> 00:13:42,840 +نادرة الحدوث ولكن إن حدثت بتعمل devastating أي + +153 +00:13:42,840 --> 00:13:49,640 +بمعنى دمار لمين؟ للـ cornea وبالتالي أنه بسبب + +154 +00:13:49,640 --> 00:13:56,260 +infection هتعمل للمريض severe ocular pain، ألم شديد + +155 +00:13:56,260 --> 00:14:01,500 +عند المريض out of proportion to the manifest + +156 +00:14:01,500 --> 00:14:07,850 +clinical signs is a hallmark sign of infection إذا + +157 +00:14:07,850 --> 00:14:12,450 +دايما علاماتها هتكون ظاهرة من خلال أنا بعمل + +158 +00:14:12,450 --> 00:14:17,610 +removal للعدسة و بحقن اللي هو fluorescein عند حقن + +159 +00:14:17,610 --> 00:14:22,290 +الـ fluorescein هتلاقي أن في هناك dendritic أي بمعنى + +160 +00:14:22,290 --> 00:14:27,210 +زي اللي هو الشجر في داخل اللي هو قرنية الشخص هذا + +161 +00:14:27,210 --> 00:14:31,010 +بتديني sign اشارة أن المريض قد يكون عنده + +162 +00:14:31,010 --> 00:14:37,160 +Acanthamoeba infection طبعا هييجي المريض أنه عنده + +163 +00:14:37,160 --> 00:14:41,940 +قلم غير محتمل يعني قلم شديد بشكل اللي هو إيه؟ أكبر + +164 +00:14:41,940 --> 00:14:47,240 +والعلامة بتاعته هتكون hallmark يعني فوق الطبيعي + +165 +00:14:47,240 --> 00:14:56,400 +أو فوق المعتاد أن الـ dendritic على القرنية Early + +166 +00:14:56,400 --> 00:15:02,320 +in the disease process, signs are frequently non- + +167 +00:15:02,320 --> 00:15:07,440 +specific دايما في المرحلة الأولى من حدوث المرض + +168 +00:15:07,440 --> 00:15:12,800 +هتكون العلامات غالبا إيه؟ غير محددة، non-specific + +169 +00:15:12,800 --> 00:15:18,930 +يعني بمعنى إيه؟ غير محددة and limited to an + +170 +00:15:18,930 --> 00:15:24,690 +epitheliopathy or neurokeratitis لكن بتم تحديدها + +171 +00:15:24,690 --> 00:15:29,750 +بشغلتين أو في two diseases اللي هي عبارة عن ال + +172 +00:15:29,750 --> 00:15:34,250 +epitheliopathy اللي هو هيكون disease وين في داخل ال + +173 +00:15:34,250 --> 00:15:38,870 +corneal epithelium وهو نادر الحدوث أو في الـ + +174 +00:15:38,870 --> 00:15:44,270 +Neurokeratitis أنه بيحدث هذا طبعا هيكون عصبي للـ + +175 +00:15:44,270 --> 00:15:48,570 +Trigeminal nerve العصب الخامس اللي بتكون من الـ + +176 +00:15:48,570 --> 00:15:53,770 +three branches ولذلك مدام هو عصبي إذا هيسبب مباشرة + +177 +00:15:53,770 --> 00:15:57,490 +severe ocular pain قلم اللي هو شديد + +178 +00:16:02,480 --> 00:16:07,660 +Later evidence of infection may include stromal + +179 +00:16:07,660 --> 00:16:12,380 +infiltration in a ring pattern and scleritis إذا + +180 +00:16:12,380 --> 00:16:16,120 +بعد ذلك يما بيحصل عند المريض الأكانثاميبيا + +181 +00:16:16,120 --> 00:16:21,000 +infection هذا بيحدث اللي هو إيه؟ التهاب ومن ثم + +182 +00:16:21,000 --> 00:16:25,020 +stromal infiltration طبعا دايما كلمة stromal + +183 +00:16:25,020 --> 00:16:30,250 +infiltration بتعمل شغلتين edema and opacity وباشرة + +184 +00:16:30,250 --> 00:16:36,210 +أية stromal infiltration edema زائد opacity وبيكون + +185 +00:16:36,210 --> 00:16:41,230 +شكلها عبارة عن ring pattern يعني بشكل اللي هو حلقي + +186 +00:16:41,230 --> 00:16:51,330 +وبعد ذلك بيسبب أيضا inflammation of the sclera ما + +187 +00:16:51,330 --> 00:16:56,350 +بنتهي لهذه المرحلة؟ إذا احنا ملاحظين صار edema و + +188 +00:16:56,350 --> 00:17:02,250 +opacity وين في الـ cornea أيضا بسبب إيش؟ أن الـ cornea بصير + +189 +00:17:02,250 --> 00:17:08,690 +عبارة عن waxing يعني مشمعة و بصير and waning + +190 +00:17:08,690 --> 00:17:15,370 +course يعني بالضبط زي العجينة إذا شكل القرنية بصير + +191 +00:17:15,370 --> 00:17:20,190 +اللي هو مشمع و شكلها لين كتير زي العجينة بالضبط + +192 +00:17:24,660 --> 00:17:28,800 +In terms of management where possible corneal + +193 +00:17:28,800 --> 00:17:33,820 +scrapings are vital for confirmation of diagnosis + +194 +00:17:33,820 --> 00:17:38,920 +طبعا هان قالية العلاج أنا باخد اللي هو إيه؟ + +195 +00:17:38,920 --> 00:17:43,500 +corneal scraping يعني كشط من القرنية و بروح على + +196 +00:17:43,500 --> 00:17:49,410 +الـ microscope و بعمل عملية إيه؟ تحليل للخلايا + +197 +00:17:49,410 --> 00:17:52,710 +اللي خاصة في القرنية وبشوف أنه هل عنده + +198 +00:17:52,710 --> 00:17:56,870 +Acanthamoeba Corneal Infection أو لا؟ طبعا من خلال + +199 +00:17:56,870 --> 00:18:01,550 +الـ Corneal Scraping أنا بحدد حاجة بنسميها الـ + +200 +00:18:01,550 --> 00:18:06,170 +organism وبعدها + +201 +00:18:06,170 --> 00:18:10,150 +بتم اللي هو صرف إيه؟ الـ treatment اللي خاص في + +202 +00:18:10,150 --> 00:18:17,720 +المريض طيب الآن لو إجأنا مثلا مريض على المركز طبعا + +203 +00:18:17,720 --> 00:18:22,060 +احنا بنعرف أن أغلب المراكز مابيكونش عنده إيه؟ + +204 +00:18:22,060 --> 00:18:28,160 +استثناء لكن بيكون عنده متوفر إيه؟ بنتورش okay وأنا + +205 +00:18:28,160 --> 00:18:32,220 +مثلا اكتشفت أنه عنده corneal opacity وهو مش قادر + +206 +00:18:32,220 --> 00:18:36,100 +مثلا يروح على مستشفى العيون أو مش قادر يروح على + +207 +00:18:36,100 --> 00:18:41,140 +طبيب عيون الحل الوحيد أنه في هذه المدة أنا بدي أدي + +208 +00:18:41,140 --> 00:18:45,420 +المريض لحد ديته الصباح gentamicin طبعا الـ gentamicin + +209 +00:18:45,420 --> 00:18:51,080 +إيش هيعمل؟ اللي هو ترطيب لسطح القرنية وأمنع المريض + +210 +00:18:51,080 --> 00:18:55,540 +أنه يلبس العدسة اللاصقة بالـ .. يعني بالمطلق أنه + +211 +00:18:55,540 --> 00:18:59,460 +لازم يلبسش نهائي العدسة اللاصقة لحد ما يروح لطبيب + +212 +00:18:59,460 --> 00:19:03,960 +العيون وبعد ذلك أنه يتم عملية الـ management بطريقة + +213 +00:19:03,960 --> 00:19:09,570 +صحيحة طبعا دايما بعد ما تم تحديد الـ organism من + +214 +00:19:09,570 --> 00:19:13,710 +خلال أخذ العينة أو الـ corneal scraping هذا بتديني + +215 +00:19:13,710 --> 00:19:18,990 +إيه؟ تأكيد confirmation أي بمعنى تأكيد لمين؟ للتشخيص + +216 +00:19:18,990 --> 00:19:25,050 +اللي خاص في المريض طيب + +217 +00:19:25,050 --> 00:19:30,050 +في هنا إشارة أن early diagnosis التشخيص المبكر له + +218 +00:19:30,050 --> 00:19:36,540 +دايما له علاقة بنجاح مين؟ بالعلاج إذا is correlated + +219 +00:19:36,540 --> 00:19:41,540 +مرتبط with success in a treatment إذا إله علاقة + +220 +00:19:41,540 --> 00:19:48,660 +مباشرة بنجاح العلاج possibly محتمل because viva + +221 +00:19:48,660 --> 00:19:53,000 +Acanthamoeba cysts أي بيصير عند المريض زي اللي هو + +222 +00:19:53,000 --> 00:19:58,810 +فقاعات أو أكياس بيسببها الـ Acanthamoeba وبتكون هذه + +223 +00:19:58,810 --> 00:20:03,230 +الظاهرة في القرنية early in the course of the + +224 +00:20:03,230 --> 00:20:07,610 +disease دايما بتكون موجودة على سطح القرنية يما + +225 +00:20:07,610 --> 00:20:14,150 +بيكون شكل القرنية لين أو اللي هو مشمع يعني بمعنى + +226 +00:20:14,150 --> 00:20:20,850 +أنه بتكون اللي هو زي العجينة القرنية طبعا + +227 +00:20:20,850 --> 00:20:25,570 +بتكثر Acanthamoeba infection دايما أنه بتكون + +228 +00:20:25,570 --> 00:20:30,600 +most common when في الأشخاص اللي بيروحوا مثلا على ال + +229 +00:20:30,600 --> 00:20:36,200 +swimming pool أو مثلا بتكون أكثر اللي هو شيوعا + +230 +00:20:36,200 --> 00:20:40,920 +مثلا شخص خلص عنده المحلول راح استخدم مثلا ميّة + +231 +00:20:40,920 --> 00:20:46,220 +الحنفية هذه كلها بتأدي لمين؟ للـ Acanthamoeba + +232 +00:20:46,220 --> 00:20:53,460 +infection طيب bacterial immunologic reactions طبعا + +233 +00:20:53,460 --> 00:20:59,920 +تفاعلات إيش؟ هتكون لمناعة القرنية أو رد فعل لها + +234 +00:20:59,920 --> 00:21:06,580 +مناعة من القرنية طبعا هذه هتكون بكتيريا سببها الـ + +235 +00:21:06,580 --> 00:21:10,840 +Acanthamoeba سببها فنجي okay إذا عندنا ال + +236 +00:21:10,840 --> 00:21:14,300 +bacterial corneal infection سببها بكتيريا + +237 +00:21:14,300 --> 00:21:18,680 +bacterial immunologic reaction أيضا الـ main reason + +238 +00:21:18,680 --> 00:21:24,730 +هو يعتبر بكتيريا There are several sources of + +239 +00:21:24,730 --> 00:21:29,770 +bacterial contamination هناك عدة مصادر لمين؟ للتلوث + +240 +00:21:29,770 --> 00:21:36,030 +البكتيري طبعا هذا الاختلاف الرئيسي بينها وما بين + +241 +00:21:36,030 --> 00:21:40,470 +الـ bacterial corneal infection أنه بيكون البساطة + +242 +00:21:40,470 --> 00:21:46,790 +هذه ما بقدر أتعرف عليها بشكل مباشر okay يعني التعرف + +243 +00:21:46,790 --> 00:21:49,750 +عليها مابقدرش أنه أقول أنا مريض عنده مثلا + +244 +00:21:49,750 --> 00:21:53,490 +bacterial immunologic reaction بشكل اللي هو + +245 +00:21:53,490 --> 00:21:58,350 +directly بشكل اللي هو مباشر إلا ما يتم اللي هو أخذ + +246 +00:21:58,350 --> 00:22:03,810 +عينة من القرنية وتحليلها وبعد ذلك الكشف عن المرض + +247 +00:22:03,810 --> 00:22:09,510 +ومن ثم الكشف عن الـ treatment اللي خاص بالمريض طبعا + +248 +00:22:09,510 --> 00:22:13,810 +هي تعتبر أيضا نادرة الحدوث بتحدث بشكل اللي هو + +249 +00:22:13,810 --> 00:22:14,130 +rarely + +250 +00:22:16,970 --> 00:22:21,810 +Bacteria may be harbored in the lid margins بيكون + +251 +00:22:21,810 --> 00:22:26,410 +البكتيريا بتسكن وين؟ في الـ eyelid margin أو in + +252 +00:22:26,410 --> 00:22:31,050 +biofilm on the lens surfaces and produce + +253 +00:22:31,050 --> 00:22:36,590 +substances toxic to the cornea إذا دايما بيكون + +254 +00:22:36,590 --> 00:22:40,930 +مكان البكتيريا في الـ eyelid margin أو في الـ + +255 +00:22:40,930 --> 00:22:47,230 +biofilm طيب الـ biofilm إيش المقصود فيه؟ هو عبارة عن + +256 +00:22:47,230 --> 00:22:51,730 +الـ antimicrobial factor المحاضرة السابقة احنا + +257 +00:22:51,730 --> 00:22:56,290 +قلنا أن في هناك دايما اللي هو نزاع مستمر ما بين + +258 +00:22:56,290 --> 00:23:01,110 +البكتيريا و الـ antibacterial factor الـ biofilm هي + +259 +00:23:01,110 --> 00:23:05,490 +عبارة عن الـ antibacterial factor اللي بتعمل عملية + +260 +00:23:05,490 --> 00:23:12,090 +إيه؟ مقاومة ضد البكتيريا On the lens surfaces هذي + +261 +00:23:12,090 --> 00:23:16,410 +بتكون كلها على سطح العدسة وبتنتج مواد، إيش هذه + +262 +00:23:16,410 --> 00:23:20,150 +المواد؟ بتكون سامة بالنسبة للقرنية + +263 +00:23:24,080 --> 00:23:28,260 +فيه هناك مدام هي في الـ eyelid margin، إذا قريبة من + +264 +00:23:28,260 --> 00:23:32,760 +مين؟ من الـ eyelash، إذا ممكن تعمل علامات لمين؟ للـ + +265 +00:23:32,760 --> 00:23:36,400 +blepharitis، اللي هو الـ inflammation of the eyelid + +266 +00:23:36,400 --> 00:23:40,400 +وهيظهر إن الـ eyelid هو عبارة عن redness and + +267 +00:23:40,400 --> 00:23:45,540 +thickness أيضا ممكن يعمل meibomianitis، اللي هو + +268 +00:23:45,540 --> 00:23:50,180 +inflammation للميبومياني gland، واضحة؟ اللي بتعمل + +269 +00:23:50,180 --> 00:23:55,960 +إفراز للـ oil layer may indicate that the lid + +270 +00:23:55,960 --> 00:24:01,080 +margin is the source of organisms، إذا الـ eyelid + +271 +00:24:01,080 --> 00:24:05,840 +margin هيكون مصدر من مصادر إيش؟ الـ organism زي مثلا + +272 +00:24:05,840 --> 00:24:12,040 +بكتيريا الاستفلاكوكس that can secrete exotoxins + +273 +00:24:12,040 --> 00:24:17,330 +اللي هي هتعمل على إفراز إيش؟ هذه السموم يعني ببساطة + +274 +00:24:17,330 --> 00:24:23,030 +في عناه هيكون في الـ eyelid margin بكتيريا وفي هناك + +275 +00:24:23,030 --> 00:24:27,210 +biofilm اللي هي عبارة عن الـ antibacterial factor + +276 +00:24:27,210 --> 00:24:31,670 +الاثنين هيصير بينهم نزاع، إذا انتصرت البكتيريا، + +277 +00:24:31,670 --> 00:24:36,610 +هتكون قادرة على اختراق من الكورنيا، إذا ما اللي هو + +278 +00:24:36,610 --> 00:24:41,570 +قدرة اللي هو عملية الاختراق، إذا هذا إيش بيقده؟ + +279 +00:24:42,770 --> 00:24:46,370 +بيكون عند الشخص فيه مناعة وبالتالي مش هيحدث ال + +280 +00:24:46,370 --> 00:24:50,370 +bacterial immunologic reaction طبعا في الغالب + +281 +00:24:50,370 --> 00:24:54,210 +بيكون سببها اللي هو بكتيريا من نوع الستافيلوكوكس + +282 +00:24:59,360 --> 00:25:07,300 +هذه الحالات ترتبط بمعنى الـ General ophthalmologic + +283 +00:25:07,300 --> 00:25:11,300 +conditions زي مثلا الـ Marginal Keratitis + +284 +00:25:11,300 --> 00:25:16,260 +وDipliferitis، إذا هذه الحالات كلها تكون مرتبطة + +285 +00:25:16,260 --> 00:25:21,860 +بالـ Inflammation of the eyelid وأيضا بالإنفلاميشن + +286 +00:25:21,860 --> 00:25:23,200 +للكورنيا + +287 +00:25:28,100 --> 00:25:32,700 +A source of particular note is the contact lens + +288 +00:25:32,700 --> 00:25:38,100 +case وهنا فيه تنويه مهم الآن بما أني بدي أدي .. + +289 +00:25:38,100 --> 00:25:42,000 +بما أني بدي أعطي عدسة لاصقة زي مثلا ال conventional + +290 +00:25:42,000 --> 00:25:47,860 +daily wear contact lens اللي هي مدة حياتها تقريبا + +291 +00:25:47,860 --> 00:25:55,860 +سنة okay بدي أدي للمريض two cases دائما إذا عندنا + +292 +00:25:55,860 --> 00:25:57,380 +في حالة ال conventional + +293 +00:26:02,400 --> 00:26:12,980 +Daily wear contact lenses هنبدل للمريض two cases + +294 +00:26:12,980 --> 00:26:20,230 +أو two vials اللي هو يعني two cases حاويتين ليش؟ + +295 +00:26:20,230 --> 00:26:25,010 +عشان يعمل عملية replacement استبدال للحاوية بمعنى + +296 +00:26:25,010 --> 00:26:29,910 +أنه المريض الآن مثلا أول خمس شهور بيستخدم حاوية + +297 +00:26:29,910 --> 00:26:35,070 +وبعد ذلك الخمس شهور الثانية بيستبدلها عشان ما يعمل + +298 +00:26:35,070 --> 00:26:39,970 +إيه؟ bacterial contamination تلوث بكتيري في داخل + +299 +00:26:39,970 --> 00:26:45,290 +الحاوية وطبعا التكنيك أو الـ instructions أنا أديتكم + +300 +00:26:45,290 --> 00:26:49,610 +إليها في العملية أنه دائما المريض لازم يعمل عملية + +301 +00:26:49,610 --> 00:26:54,590 +replacement استبدال للمحلول اللي في داخل الـ case + +302 +00:26:54,590 --> 00:27:00,870 +الحاوية تقريبا كل يوم فهذه كلها بتقلل من حدوث + +303 +00:27:00,870 --> 00:27:04,390 +من الـ bacterial immunologic reactions + +304 +00:27:08,690 --> 00:27:13,510 +أيضا patients need to clean and dry their case + +305 +00:27:13,510 --> 00:27:18,390 +daily، إذا بتحتاج دائما أنه يعمل عملية تنظيف + +306 +00:27:18,390 --> 00:27:24,670 +وعملية تشفيف لمن؟ للحاوية and replace their case + +307 +00:27:24,670 --> 00:27:30,010 +regularly to avoid the accumulation of biofilm and + +308 +00:27:30,010 --> 00:27:34,730 +the harbor bacteria لأن هذه بيكون مكان لاستعمار + +309 +00:27:34,730 --> 00:27:39,350 +البكتيريا أو لتكوين البكتيريا في داخل الحاوية + +310 +00:27:46,660 --> 00:27:51,380 +may present in two forms إذا الظهورها بيكون اللي + +311 +00:27:51,380 --> 00:27:55,820 +هو على شكلين إما either acute inflammation + +312 +00:27:55,820 --> 00:28:00,960 +reactions or low grade sterile or peripheral + +313 +00:28:00,960 --> 00:28:05,820 +ulcers يعني الظهورها بيكون بالشكل هذا فيه عدة + +314 +00:28:05,820 --> 00:28:10,720 +أشكال إما acute inflammation في داخل الكورنيا أو + +315 +00:28:10,720 --> 00:28:16,360 +بيكون عبارة عن reaction ردة فعل أو عبارة عن low + +316 +00:28:16,360 --> 00:28:19,980 +grade يعني دائما بيقلل اللي هو من إيه؟ من الـ + +317 +00:28:19,980 --> 00:28:26,110 +sensitivity للقرنية أيضا بسبب الـ sterile هذه + +318 +00:28:26,110 --> 00:28:30,250 +نتيجة الـ stromal infiltrate اللي بتعمل أديمة و + +319 +00:28:30,250 --> 00:28:34,830 +بتعمل أبسطة في داخل وين؟ في القرنية وأيضا عندنا الـ + +320 +00:28:34,830 --> 00:28:40,890 +peripheral ulcers طب ليش هم مش central ulcers؟ لأن + +321 +00:28:40,890 --> 00:28:44,290 +ببساطة دائما أنتو بتعرفوا العدسة اللاصقة ال + +322 +00:28:44,290 --> 00:28:48,050 +diameter بتاعها بيكون إيش؟ اللي هو كبير فبالتالي + +323 +00:28:48,050 --> 00:28:52,030 +أنه بتأثر على الـ peripheral أكثر من مين؟ من الـ + +324 +00:28:52,030 --> 00:28:52,310 +center + +325 +00:28:58,870 --> 00:29:05,890 +طيب، الآن في عندنا مجموعة من العوامل هذه بتؤدي إلى + +326 +00:29:05,890 --> 00:29:11,490 +تقليل من الـ bacterial infection أو بتقلل من + +327 +00:29:11,490 --> 00:29:15,730 +الـ acanthamoeba أو بتقلل من الـ bacterial + +328 +00:29:15,730 --> 00:29:20,970 +immunologic reaction إيش هي العوامل؟ أول حاجة الـ + +329 +00:29:20,970 --> 00:29:25,310 +lens fitting technique can be used to minimize the + +330 +00:29:25,310 --> 00:29:29,910 +risk of infection بعض الزملاء بيقولك أنا مثلا بلبس + +331 +00:29:29,910 --> 00:29:34,170 +المريض عدسة لاصقة لكن ما بعمله evaluation هل هي + +332 +00:29:34,170 --> 00:29:39,530 +مثلا steep أو flat أو optimal fit طبعا هذا كله + +333 +00:29:39,530 --> 00:29:45,130 +بيؤدي إلى زيادة اللي هو حدوث إيه؟ الآنفكشن أو زيادة + +334 +00:29:45,130 --> 00:29:49,790 +حدوث مثلا الـ acanthamoeba إذا أول حاجة لازم أنه + +335 +00:29:49,790 --> 00:29:53,650 +أدي optimal fit lens للمريض هذا مهم جدا + +336 +00:29:58,080 --> 00:30:04,100 +2- Ensure Educate Movement and Post Lens Teary + +337 +00:30:04,100 --> 00:30:09,900 +Flow لازم أن تكون حركة العدسة ملائمة أو مناسبة + +338 +00:30:09,900 --> 00:30:15,460 +تقريبا من نص إلى واحد مليمتر إذا قلت أو زادت حركة + +339 +00:30:15,460 --> 00:30:20,000 +العدسة أيضا أنه بيكون هذا إيه؟ يعني قد يؤدي إلى + +340 +00:30:20,000 --> 00:30:26,440 +infection أو قد يؤدي إلى حدوث أضرار لقرنية الـ + +341 +00:30:26,440 --> 00:30:33,460 +post lens tear flow هذا مرتبط في حركة العدسة، إذا + +342 +00:30:33,460 --> 00:30:40,380 +عندنا الـ post lens tear flow مرتبط أساسا في حركة + +343 +00:30:40,380 --> 00:30:44,060 +العدسة، لأنه زي ما نعرف أنه يكون هناك limitation + +344 +00:30:44,060 --> 00:30:49,000 +من حيث الـ tear exchange في العدسات اللاصقة الليلة + +345 +00:30:53,970 --> 00:30:59,630 +هذا يساعد الناس بتأدية كلير بكتيريا تبقى عدد + +346 +00:30:59,630 --> 00:31:05,450 +طبيعي للـ epithelial disformation طيب الآن لو سألنا + +347 +00:31:05,450 --> 00:31:08,550 +السؤال الـ epithelial disformation هل هي ظاهرة + +348 +00:31:08,550 --> 00:31:13,960 +طبيعية؟ بالضبط اللي هي عملية تقشر لمين؟ للقرنية + +349 +00:31:13,960 --> 00:31:19,060 +Epithelial هذه بتحدث اللي هو كل يوم تقريبا خلال 24 + +350 +00:31:19,060 --> 00:31:24,820 +اللي هو ساعة فأي شخص ما بيرتدي عدسات لاصقة بيكون + +351 +00:31:24,820 --> 00:31:29,100 +عنده هذا الـ rate إيش يعتبر؟ Normal rate أنا الآن + +352 +00:31:29,100 --> 00:31:33,780 +لما بدي أصرف العدسة اللاصقة بدي أحافظ أيضا على الـ + +353 +00:31:33,780 --> 00:31:39,600 +normal rate لمين؟ للـ Epithelial Discommation أيضا + +354 +00:31:39,600 --> 00:31:45,100 +replenish أي بمعنى استبدال الـ layer دائما في + +355 +00:31:45,100 --> 00:31:50,620 +العدسات اللاصقة الهدف من الـ layer عملية الترطيب + +356 +00:31:50,620 --> 00:31:55,400 +وبالإضافة إنه بعمل عملية التقاط لكل الـ bacterial + +357 +00:31:55,400 --> 00:31:59,860 +infection أو البكتيريا اللي بتؤدي لها الـ bacterial + +358 +00:31:59,860 --> 00:32:05,520 +infection and circulate tear film antibacterial + +359 +00:32:05,520 --> 00:32:11,760 +factors and nutritions for the epithelia أيضا + +360 +00:32:11,760 --> 00:32:18,960 +بتعمل عملية إيش؟ اللي هو دفاع للـ tear film وبتعمل + +361 +00:32:18,960 --> 00:32:21,880 +عملية تغذية لمين؟ للبطانية + +362 +00:32:26,380 --> 00:32:33,280 +Ensure عشان نضمن educate corneal oxygenation via a + +363 +00:32:33,280 --> 00:32:37,640 +lens with moderate DK on T wear or high DK + +364 +00:32:37,640 --> 00:32:43,280 +on T extended wear دائما أنا بدي أضمن أن يكون عند + +365 +00:32:43,280 --> 00:32:47,100 +المريض فيه هناك اللي هو سهولة في إيش؟ في توزيع الـ + +366 +00:32:47,100 --> 00:32:52,940 +oxygen أو سهولة في دخول الـ oxygen للقرنية طبعا هذا + +367 +00:32:52,940 --> 00:32:58,550 +بيتم من خلال إيه؟ أن يكون في عندنا إما moderate أو high + +368 +00:32:58,550 --> 00:33:06,910 +DK on T وهذا بيقلل من مين؟ من تأثر الظهارية و + +369 +00:33:06,910 --> 00:33:10,970 +another metabolic alterations that increase + +370 +00:33:11,620 --> 00:33:16,000 +Susceptibility to bacterial adherence أيضا اللي + +371 +00:33:16,000 --> 00:33:20,100 +هو التغيير اللي بيحدث في داخل اللي هو القرنية + +372 +00:33:20,100 --> 00:33:25,000 +ممكن هذا بيسبب إيش؟ أنه يصير هناك adherence التثاقب + +373 +00:33:25,000 --> 00:33:30,960 +ما بين القرنية وما بين العدسة إذا أنا بدي أمنع أي + +374 +00:33:30,960 --> 00:33:36,640 +تاء اللي هو مسبب لالتصاق العدسة مع مين؟ مع القرنية + +375 +00:33:36,640 --> 00:33:40,940 +من خلال توفير عدسة أن يكون فيها moderate أو high + +376 +00:33:40,940 --> 00:33:48,600 +DK on T Minimize + +377 +00:33:48,600 --> 00:33:53,080 +تقليل exposure of the eye to microbial + +378 +00:33:53,080 --> 00:33:59,640 +contamination by patient education on hygiene عندنا + +379 +00:33:59,640 --> 00:34:06,220 +السبب الأساسي لحدوث الـ bacterial infection أو الـ + +380 +00:34:06,220 --> 00:34:11,660 +acanthamoeba هو موضوع الـ poor hygiene فلازم أنه أنا + +381 +00:34:11,660 --> 00:34:16,240 +من ضمن الارشادات أعلم المريض أنه يكون فيه هناك إيش + +382 +00:34:16,240 --> 00:34:21,960 +تعليم اللي هو مهم في موضوع الـ hygiene أنه يلتزم + +383 +00:34:21,960 --> 00:34:26,020 +مثلا إذا كانت اللي هو male أو female أنه دائما + +384 +00:34:26,020 --> 00:34:31,160 +الأظافر مثلا قصيرة، اليدين نظيفة، يتجنبوا الـ occupation + +385 +00:34:31,160 --> 00:34:36,780 +المهمة كثير في عملية اللي هو صرف العدسة بعض الناس + +386 +00:34:36,780 --> 00:34:40,600 +مثلًا بيروحوا بيشتروا اللي هو محلول إيش مصنوعه + +387 +00:34:40,600 --> 00:34:44,940 +محليا، هذه قد تؤدي إلى bacterial infection أو + +388 +00:34:44,940 --> 00:34:49,480 +Acanthamibia، إذا avoiding the use of homemade + +389 +00:34:49,480 --> 00:34:55,380 +saline، أي محلول مصنوع محلي أو أي محلول ما بيكون + +390 +00:34:55,380 --> 00:34:59,720 +مكتوب عليه الـ materials، الاستخدامات بتاعته، + +391 +00:34:59,720 --> 00:35:03,660 +الإرشادات اللي خاصة فيه، دائما بدنا نتجنب اللي هو + +392 +00:35:03,660 --> 00:35:10,410 +شراءه أو بيعه للمريض أو Tap or Tab water بعض المرضى + +393 +00:35:10,410 --> 00:35:14,950 +بيخلص مثلا معه المحلول و بده ينظف العدسة بيروح + +394 +00:35:14,950 --> 00:35:19,170 +يحطها تحت الحنفية طبعا خاصة وين؟ في اللي هو الـ + +395 +00:35:19,170 --> 00:35:22,290 +hard contact lenses الـ soft contact lenses لو حطها + +396 +00:35:22,290 --> 00:35:27,090 +تحت الحنفية إيه اللي بيصير لها؟ اللي هو بتتمزق العدسة أو + +397 +00:35:27,090 --> 00:35:32,580 +تتمزق بشكل اللي هو سريع and attention to compliance + +398 +00:35:32,580 --> 00:35:37,540 +with lens care systems أيضا لازم أن المريض يلتزم + +399 +00:35:37,540 --> 00:35:44,840 +بنظام رعاية وعناية للعدسة اللاصقة طيب الآن لو + +400 +00:35:44,840 --> 00:35:48,460 +سألنا السؤال العدسات الـ extended wear أو الـ daily + +401 +00:35:48,460 --> 00:35:52,440 +disposable lenses ما في لها no care system أو + +402 +00:35:52,440 --> 00:35:55,940 +ما في لها اللي هو clean system طب كيف المريض بده + +403 +00:35:55,940 --> 00:36:00,370 +يلتزم بهذه الأمور؟ يعني ما بيغسل إيديه، ما بيغيرها + +404 +00:36:00,370 --> 00:36:05,270 +بيحطها أو بيتعرض لأتربة وأشياء كثيرة؟ بالضبط، يعني + +405 +00:36:05,270 --> 00:36:08,970 +مثلا موضوع الـ air condition أو موضوع مثلا الـ + +406 +00:36:08,970 --> 00:36:12,410 +exposure to the sun أو موضوع إنه يكون عنده poor + +407 +00:36:12,410 --> 00:36:16,130 +hygiene أو موضوع الـ occupation اللي خاصة فيه، كل + +408 +00:36:16,130 --> 00:36:16,470 +هذه + +409 +00:36:20,960 --> 00:36:26,180 +بالضبط دائما أيضا استخدام العدسة بيكون only for 24 + +410 +00:36:26,180 --> 00:36:31,000 +hours بعد ذلك لازم أنه نوقف اللي هو استخدام العدسة + +411 +00:36:31,540 --> 00:36:36,560 +Okay أيضا في حالة الـ extended wear واحد مثلا بيلبس + +412 +00:36:36,560 --> 00:36:41,420 +عدسة extended wear لكن استخدمها مثلا لمدة اللي هو + +413 +00:36:41,420 --> 00:36:46,360 +أسبوعين أو استخدمها لثلاثة أسابيع أو شهر مثلا بمعنى + +414 +00:36:46,360 --> 00:36:50,420 +أنه زود المدة فيها بيقولك أنا مرتاح مش شايف أي تا + +415 +00:36:50,420 --> 00:36:55,400 +اللي هو مشاكل قد يكون هذا الشخص عرضة لحدوث إيه؟ الـ + +416 +00:36:55,400 --> 00:37:01,870 +corneal infection بنوقف إن شاء الله لهذا الكلام وإن + +417 +00:37:01,870 --> 00:37:05,450 +شاء الله في المحاضرة القادمة بنكمل طبعا الامتحان + +418 +00:37:05,450 --> 00:37:08,530 +النصفي هيكون لحد الشريحة هذه إن شاء الله diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/vVvcBTMb4Lk_postprocess.srt b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/vVvcBTMb4Lk_postprocess.srt new file mode 100644 index 0000000000000000000000000000000000000000..36a25e14ec87ca901260750bd5f3e49ae26821ff --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/vVvcBTMb4Lk_postprocess.srt @@ -0,0 +1,1672 @@ +1 +00:00:20,940 --> 00:00:23,760 +بسم الله الرحمن الرحيم السلام عليكم ورحمة الله + +2 +00:00:23,760 --> 00:00:30,040 +وبركاته ومرحبا لكم جميعا اليوم هنبدأ في موضوع + +3 +00:00:30,040 --> 00:00:34,880 +bacterial corneal infection may produce any of + +4 +00:00:34,880 --> 00:00:41,640 +several signsطبعا في هناك علامات للعدوى البكتيرية + +5 +00:00:41,640 --> 00:00:46,860 +يعني الآن مثلا نتيجة ارتداء العدسات اللاصقة اللينة + +6 +00:00:46,860 --> 00:00:52,100 +صار عند الشخص نفترض انه فيه infection في هناك + +7 +00:00:52,100 --> 00:00:57,840 +signs علامات ل ال corneal infection اذا هنا ممكن + +8 +00:00:57,840 --> 00:01:09,040 +اقول ان العنوان signs of corneal infectionما هي + +9 +00:01:09,040 --> 00:01:16,580 +هذه العلامات اللي خاصة بالعدسات اللاصقة اللينة؟ + +10 +00:01:16,580 --> 00:01:21,940 +The presence of corneal pain of more than a + +11 +00:01:21,940 --> 00:01:27,580 +transitory nature in a contact lens wearer is a + +12 +00:01:27,580 --> 00:01:31,900 +warning sign of the possibility of a corneal + +13 +00:01:31,900 --> 00:01:38,460 +infectionالان اول ما يتم صرف العدسات اللاصقة من + +14 +00:01:38,460 --> 00:01:46,120 +قبل أخصاء البصريات للمريض اكتر symptom انا بنبهه + +15 +00:01:46,120 --> 00:01:53,140 +المريض هو موضوع ال pain الألم و اكتر علامة اللي + +16 +00:01:53,140 --> 00:01:57,420 +أخصاء البصريات بيظلوا ايش خايف منها اللي هي موضوع + +17 +00:01:57,420 --> 00:02:02,240 +ايه ال pain طبعا انتوا عارفين بعد ما بتم التقييم + +18 +00:02:03,120 --> 00:02:08,380 +يعني بعد خمس دقائق تقريبا لازم انا انه اسأل المريض + +19 +00:02:08,380 --> 00:02:11,800 +انه هل انا comfort .. هل هو comfort ولا discomfort + +20 +00:02:11,800 --> 00:02:16,220 +ايه في العدسة اللاصقة طبعا اذا كان هذا ال pain + +21 +00:02:16,220 --> 00:02:20,580 +الألم غير طبيعي او غير اعتيادي اذا كلمة a + +22 +00:02:20,580 --> 00:02:24,200 +transitory اي بمعنى غير عادي او غير طبيعي او غير + +23 +00:02:24,200 --> 00:02:30,280 +معتاد okay؟أنا بدي أحذر مين؟ المريض لازم أديه + +24 +00:02:30,280 --> 00:02:35,780 +warning sign يعني علامة تحذير انه من إمكانية ايه + +25 +00:02:35,780 --> 00:02:39,680 +انه يسبب هذا القلم corneal infection عند المريض + +26 +00:02:39,680 --> 00:02:46,760 +طيب الآن ببساطة كيف هذا القلم بتم إزالته؟ من خلال + +27 +00:02:46,760 --> 00:02:52,020 +إزالة العدسة يعني بنطلب من المريض انه يعمل removal + +28 +00:02:54,060 --> 00:02:59,480 +of soft contact lenses اذا الان انا بتكلم مع + +29 +00:02:59,480 --> 00:03:05,180 +المريض انه اذا كان عندك ألم اعتيادي يعني بمعنى ألم + +30 +00:03:05,180 --> 00:03:10,540 +بسيط انه يظل لابس العدسة اللاصقة اذا شعرت هذا + +31 +00:03:10,540 --> 00:03:15,400 +الألم غير اعتيادي او غير طبيعي وامتد لفترة زمانية + +32 +00:03:15,400 --> 00:03:19,340 +طويلة بدي اقوله انه لازم تقف عن ارتداء العدسة + +33 +00:03:19,340 --> 00:03:25,660 +اللاصقة ليش؟ لان هذا ممكن انه يسبب ايش؟Corneal + +34 +00:03:25,660 --> 00:03:36,000 +lens defect يعني بتتأثر الكورنيا نتيجة ايه ارتداء + +35 +00:03:36,000 --> 00:03:41,340 +العدسة اللاصقة طيب كيف انا بدى اتخلص من ال corneal + +36 +00:03:41,340 --> 00:03:47,820 +defect من خلال ال removal للعدسة اللاصقة؟بربط + +37 +00:03:47,820 --> 00:03:53,780 +تانية اذا في عندنا ال corneal lens defect اذا بتتم + +38 +00:03:53,780 --> 00:04:00,220 +التخلص منها من خلال ال removal للعدسة اللاصقة في + +39 +00:04:00,220 --> 00:04:05,500 +حاجة اسمها corneal keratitis + +40 +00:04:09,550 --> 00:04:13,930 +الـ corneal keratitis هذه أنا ما بقدر أتخلص منها + +41 +00:04:13,930 --> 00:04:18,230 +يما أرفع العدسة، يعني بيظل الألم موجود حتى لو + +42 +00:04:18,230 --> 00:04:22,190 +الشخص عمل removal لمين؟ للـ spherical soft contact + +43 +00:04:22,190 --> 00:04:27,010 +lenses، إذا الألم بيبقى إيش؟ موجود وممكن إنه يعمل + +44 +00:04:27,010 --> 00:04:32,720 +بعد ذلك إيه؟ infection للشخصإذا في هناك مصطلحين + +45 +00:04:32,720 --> 00:04:37,420 +مهمين المصطلح الأول corneal lens defect بتتم + +46 +00:04:37,420 --> 00:04:42,840 +إزالته للألم بعد ما يتم إزالة العدسة بينما ال + +47 +00:04:42,840 --> 00:04:47,100 +corneal keratitis بيظل الألم موجود حتى لو الشخص + +48 +00:04:47,100 --> 00:04:53,230 +عمل removal للعدسةإذا في عندنا a warning sign أي + +49 +00:04:53,230 --> 00:04:57,690 +بمعنى علامة علامة تحذير من احتمالية حدوث ال + +50 +00:04:57,690 --> 00:05:01,810 +corneal infection هذه وقت إيش؟ لما يكون عنده ال + +51 +00:05:01,810 --> 00:05:11,150 +corneal lens defect وعملت أكيد اللي هو pain ألم ال + +52 +00:05:11,150 --> 00:05:17,250 +pain الألم may be exacerbated أي بمعنى يتثاقمBy + +53 +00:05:17,250 --> 00:05:22,550 +lens removal مع إزالة من العدسة، إذا في الحالة + +54 +00:05:22,550 --> 00:05:26,070 +الأولى و لا الثانية، الألم بتفاقم لما بعمل removal + +55 +00:05:26,070 --> 00:05:30,650 +للعدسة مع الـ corneal keratitis، إذا قد يتفاقم هذا + +56 +00:05:30,650 --> 00:05:36,420 +الألمand accompanied by بيظهر على المريض redness + +57 +00:05:36,420 --> 00:05:41,880 +احمرار discharge او decreased vision او ما يسمى ب + +58 +00:05:41,880 --> 00:05:46,680 +blurred vision اذا يما بيصير عند المريض ال + +59 +00:05:46,680 --> 00:05:52,440 +keratitis infection بيحدث له اللي هو symptoms واضح + +60 +00:05:52,440 --> 00:05:55,600 +هذه ال symptoms زي عندنا ال redness او ال + +61 +00:05:55,600 --> 00:05:58,960 +discharge بالاضافة ل ال decreased vision + +62 +00:06:03,920 --> 00:06:10,920 +Infective ulceration الآن بعد ذلك حدث هناك عدوى ل + +63 +00:06:10,920 --> 00:06:17,440 +القرانية وعملت أيضا ulceration او corneal ulcer is + +64 +00:06:17,440 --> 00:06:21,460 +characterized by an epithelial defect يعني صار + +65 +00:06:21,460 --> 00:06:24,900 +هناك خلل وين في ال corneal epithelium في الطبقة + +66 +00:06:24,900 --> 00:06:30,580 +الأولى ل القرانية with an underlying stromal + +67 +00:06:30,580 --> 00:06:35,210 +exovation and infiltrateوهذا ال infection أيضا + +68 +00:06:35,210 --> 00:06:40,670 +ممكن انه يعمل excavation بمعنى ثقب وممكن ايضا يعمل + +69 +00:06:40,670 --> 00:06:45,230 +stromal infiltrate ربطنا في المحاضرة السابقة ان في + +70 +00:06:45,230 --> 00:06:49,230 +هناك علاقة ما بين ال infection و ال stromal + +71 +00:06:49,230 --> 00:06:53,710 +infiltrate دايما ال infection بيحدث نتيجة اللي هو + +72 +00:06:53,710 --> 00:06:59,070 +ال stromal infiltrate لان هي بتمثل تقريبا 90% من + +73 +00:06:59,070 --> 00:07:00,570 +سماكة القرنية + +74 +00:07:04,440 --> 00:07:09,340 +These findings may be considered for corneal + +75 +00:07:09,340 --> 00:07:14,560 +infection until approved otherwise يعني كل هذه + +76 +00:07:14,560 --> 00:07:18,100 +اللي بنجدها من ناحية ال readiness أو من ناحية ال + +77 +00:07:18,100 --> 00:07:22,540 +discharge بعد ذلك اتفاقبت لها corneal ulceration و + +78 +00:07:22,540 --> 00:07:27,460 +corneal infection كل هذه بتظل موجودة حتى انه يتم + +79 +00:07:27,460 --> 00:07:31,700 +اثبات العكسإن هذا ال issue مش نتيجة ال contact + +80 +00:07:31,700 --> 00:07:35,900 +lenses صار عنده مشاكل أخرى هي اللي سببت الأمر هذا + +81 +00:07:40,420 --> 00:07:45,040 +An infective ulcer is typically unilateral دايما + +82 +00:07:45,040 --> 00:07:49,340 +في الغالب يعني typically بمعنى usually غالبا بيكون + +83 +00:07:49,340 --> 00:07:54,180 +في عين واحدة اللي هو موضوع ال infective ulcer and + +84 +00:07:54,180 --> 00:07:58,260 +the ulcer is likely to be central or mid + +85 +00:07:58,260 --> 00:08:02,260 +peripheral اذا الموقع بتاعه اما بيكون في الأطراف + +86 +00:08:02,260 --> 00:08:06,200 +او بيكون ايه في ال mid peripheral او اسف اللي هو + +87 +00:08:06,200 --> 00:08:11,690 +ال centralإذا موقعه إما بالـ central أو بالـ mid + +88 +00:08:11,690 --> 00:08:12,270 +peripheral + +89 +00:08:16,950 --> 00:08:21,190 +Other possible associated signs are surrounding + +90 +00:08:21,190 --> 00:08:25,270 +epithelial و + +91 +00:08:25,270 --> 00:08:30,450 +أيضا في الاسترومة and endothelial edema يعني هذا + +92 +00:08:30,450 --> 00:08:35,750 +بنتشر في كل أجزاء تقريبا القرنية و بسبب استرومة ال + +93 +00:08:35,750 --> 00:08:39,250 +thinning بالاضافة ل ال necrosis ايش معنات + +94 +00:08:39,250 --> 00:08:40,070 +necrosis؟ + +95 +00:08:42,430 --> 00:08:46,610 +الـ necrosis دايما بسبب موت للخلايا يعني بمعنى انه + +96 +00:08:46,610 --> 00:08:52,470 +بيعمل زي اللي هو هاي لو مثلا نفترض الخلايا بيعملها + +97 +00:08:52,470 --> 00:09:02,670 +اللي هو died of cells موت للخلايا of + +98 +00:09:02,670 --> 00:09:07,330 +the infiltrate myocopurulent طبعا myocopurulent أي + +99 +00:09:07,330 --> 00:09:13,860 +بمعنى discharge او بصطبعا أيضا بيحدث اللي هو ال + +100 +00:09:13,860 --> 00:09:19,120 +KPI، ال KPI هذه مهمة، أي علامة لل KPI اللي هي + +101 +00:09:19,120 --> 00:09:26,590 +عبارة عن ترسباتفي الكورنيا لازم مباشرة انا اتخلص + +102 +00:09:26,590 --> 00:09:30,550 +من ارتداء العدسة اللاصقة لان الاستمرارية فيها + +103 +00:09:30,550 --> 00:09:34,830 +بتعمل كورنيا ال opacity وبالتالي بتعمل اللي هو + +104 +00:09:34,830 --> 00:09:39,650 +الاسترومة ال infiltrate وبتقلل من اللي هو سماكة + +105 +00:09:39,650 --> 00:09:45,150 +الاسترومة and anterior chamber reaction اذا بيصير + +106 +00:09:45,150 --> 00:09:50,430 +هناك اللي هو زي سد لطريق من ال anterior chamber + +107 +00:09:55,080 --> 00:10:00,340 +In terms of management أي بمعنى كيفية العلاج أو + +108 +00:10:00,340 --> 00:10:05,880 +اللي هو معالجة أو التقنية symptoms or signs are + +109 +00:10:05,880 --> 00:10:11,500 +indications for immediate ophthalmic evaluationand + +110 +00:10:11,500 --> 00:10:17,060 +lens wear should immediately be ceased يعني الشخص + +111 +00:10:17,060 --> 00:10:21,740 +إذا وصل لمرحلة ال bacterial infection لازم أنه + +112 +00:10:21,740 --> 00:10:27,500 +يتوقف عن ارتداء من العدسة اللاصقة طيب أنا بدأ أسأل + +113 +00:10:27,500 --> 00:10:31,620 +سؤال لو هذا الشخص عنده high refractive error plus + +114 +00:10:31,620 --> 00:10:36,780 +عشرة أو minus عشرة و متعود دايما أنه يرتدي عدسة + +115 +00:10:36,780 --> 00:10:41,970 +لاصقةو مش حابب يلبس نضارة طيب اوقفه عن ارتداء + +116 +00:10:41,970 --> 00:10:47,550 +العدسة بشكل كامل ولا كيف؟ ايش رأيكم؟ بنقلل ساعات + +117 +00:10:47,550 --> 00:10:52,870 +ارتداء العدسة اها بنقلل ساعات ارتداء العدسة okay + +118 +00:10:52,870 --> 00:10:58,690 +مع المحافظة على اللي هو ال material ال DK على T + +119 +00:10:58,690 --> 00:10:59,790 +للعدسة ولا كيف؟ + +120 +00:11:04,200 --> 00:11:07,800 +طبعا هنا إذا كان المريض عنده high refractive error + +121 +00:11:07,800 --> 00:11:12,660 +وما بيقدر يستخدم عن العدسة اللاسقة لازم انا ابدأ + +122 +00:11:12,660 --> 00:11:18,200 +بتفكير ان كيف اقلل المخاطر لهذا المريض ممكن مثلا + +123 +00:11:18,200 --> 00:11:24,020 +يكون الحل ان ادي moderate decay على T او low decay + +124 +00:11:24,020 --> 00:11:29,860 +على Tأو ممكن هذا الشخص مثلا أستبدل اللي هو العدسة + +125 +00:11:29,860 --> 00:11:34,180 +أنه أعمل replacement عملية استبدال في ارتداء + +126 +00:11:34,180 --> 00:11:38,400 +العدسة زي مثلا أقلل اللي هو ساعات ارتداء العدسة + +127 +00:11:38,400 --> 00:11:42,860 +اللاصقة في هناك عدة حلول ممكن حتى ال solution + +128 +00:11:42,860 --> 00:11:47,180 +المحلول اللي بيستخدمه أغيره نتيجة اللي هو ال + +129 +00:11:47,180 --> 00:11:48,520 +infective هذا + +130 +00:11:53,460 --> 00:11:57,560 +هو المشكلة طيب انا مثلا قلتله واقف عن ارتداء + +131 +00:11:57,560 --> 00:12:01,720 +العدسة اللاصقة هو يجيب مثلا يوم او يومين او تلاتة + +132 +00:12:01,720 --> 00:12:05,560 +طب ما هو بده عنده فيه اللي هو quality of life ايش + +133 +00:12:05,560 --> 00:12:08,340 +هيصير او ال quality of vision او ال daily life + +134 +00:12:08,340 --> 00:12:11,580 +بتاعته يعني minus عشر هتتكلم في رؤية جديش ال + +135 +00:12:11,580 --> 00:12:15,020 +visual acuity فيها تقريبا هتكون من واحد ع ستين + +136 +00:12:15,020 --> 00:12:19,560 +لاتنين ع ستين طب كيف بده يمارس حياته اليومية؟ okay + +137 +00:12:20,370 --> 00:12:24,330 +هذا طبيعي في حالة ان هو مصرق على ارتداء العدسة + +138 +00:12:24,330 --> 00:12:30,430 +اللاصقة يعني لذلك انه دايما بينصح أخصائين البصريات + +139 +00:12:30,430 --> 00:12:33,650 +يعني هذا according to American Academy لما انت + +140 +00:12:33,650 --> 00:12:39,050 +بتصرفي العدسة اللاصقة لازم ان يكون معها ايش نضارة + +141 +00:12:39,050 --> 00:12:44,070 +لهذا الموضوع انه اي ت infection عند المريض او اي ت + +142 +00:12:44,070 --> 00:12:47,790 +complication نتيجة العدسات اللاصقة يعمل عملية + +143 +00:12:47,790 --> 00:12:49,950 +استبدال لها بالنضارة + +144 +00:12:54,830 --> 00:13:00,410 +عندنا Acanthamibia corneal infection is a rare but + +145 +00:13:00,410 --> 00:13:05,850 +particularly devastating cause of infection لو + +146 +00:13:05,850 --> 00:13:09,850 +عملنا عملية مقارنة ما بين ال bacterial corneal + +147 +00:13:09,850 --> 00:13:14,710 +infection و ال Acanthamibia corneal infection أيه + +148 +00:13:14,710 --> 00:13:20,670 +ما أخطر؟ طبعا ال Acanthamibia corneal infection هي + +149 +00:13:20,670 --> 00:13:26,000 +تعتبر أكتر خطورةالسبب بسيط لأن سببها او ال + +150 +00:13:26,000 --> 00:13:31,480 +organism لها هو عبارة عن فنجاى بينما ال corneal + +151 +00:13:31,480 --> 00:13:37,220 +bacterial infection سببها البكتيريا طبعا هي تعتبر + +152 +00:13:37,220 --> 00:13:42,840 +نادرة الحدوث ولكن ان حدثت بتعمل devastating أي + +153 +00:13:42,840 --> 00:13:49,640 +بمعنى دمار لمين ل ال cornea وبالتالي انه بسبب + +154 +00:13:49,640 --> 00:13:56,260 +infectionهتعمل للمريض severe ocular pain، ألم شديد + +155 +00:13:56,260 --> 00:14:01,500 +عند المريض out of appropriation to the manifest + +156 +00:14:01,500 --> 00:14:07,850 +clinical signs is a hallmark sign of infectionإذا + +157 +00:14:07,850 --> 00:14:12,450 +دايما علاماتها هتكون ظاهرة من خلال انا بعمل + +158 +00:14:12,450 --> 00:14:17,610 +removal للعدسة و بحقن اللي هو efflorosin عند حقن + +159 +00:14:17,610 --> 00:14:22,290 +ال efflorosin هتلاقي ان في هناك dendritic اي بمعنى + +160 +00:14:22,290 --> 00:14:27,210 +زي اللي هو الشجر في داخل اللي هو قرنية الشخص هذا + +161 +00:14:27,210 --> 00:14:31,010 +بتديني sign اشارة ان المريض قد يكون عنده + +162 +00:14:31,010 --> 00:14:37,160 +acanthamibia infectionطبعا هييجي المريض انه عنده + +163 +00:14:37,160 --> 00:14:41,940 +قلم غير محتمل يعني قلم شديد بشكل اللي هو ايه اكبر + +164 +00:14:41,940 --> 00:14:47,240 +و العلامة بتاعته هتكون whole mark يعني فوق الطبيعي + +165 +00:14:47,240 --> 00:14:56,400 +او فوق المعتاد انه ال dendritic على القرنية Early + +166 +00:14:56,400 --> 00:15:02,320 +in the disease process, signs are frequently non + +167 +00:15:02,320 --> 00:15:07,440 +-specificدايما في المرحلة الأولى من حدوث المرض + +168 +00:15:07,440 --> 00:15:12,800 +هتكون العلامات غالبا ايه؟ غير محددة، non specific + +169 +00:15:12,800 --> 00:15:18,930 +يعني بمعنى ايه؟ غير محددةand limited to an + +170 +00:15:18,930 --> 00:15:24,690 +epithelopathy or neurokeratitis لكن بتم تحديدها + +171 +00:15:24,690 --> 00:15:29,750 +بشغلتين او في two diseases اللي هي عبارة عن ال + +172 +00:15:29,750 --> 00:15:34,250 +epithelopathy اللي هو هيكون disease وين في داخل ال + +173 +00:15:34,250 --> 00:15:38,870 +corneal epithelium وهو نادر الحدوث اوفي الـ + +174 +00:15:38,870 --> 00:15:44,270 +Neurokeratitis انه بيحدث هذا طبعا هيكون عصبي لـ + +175 +00:15:44,270 --> 00:15:48,570 +Trigeminal nerve العصب الخامس اللي بتكون من الـ + +176 +00:15:48,570 --> 00:15:53,770 +three branches ولذلك مدام هو عصبي اذا هيسبب مباشرة + +177 +00:15:53,770 --> 00:15:57,490 +severe ocular pain قلم اللي هو شديد + +178 +00:16:02,480 --> 00:16:07,660 +Later evidence of infection may include stromal + +179 +00:16:07,660 --> 00:16:12,380 +infiltration in a ring pattern and scleritis إذا + +180 +00:16:12,380 --> 00:16:16,120 +بعد ذلك يما بيحصل عند المريض الأكانثاميبيا + +181 +00:16:16,120 --> 00:16:21,000 +infection هذا بيحدث اللي هو إيه التهاب ومن ثم + +182 +00:16:21,000 --> 00:16:25,020 +stromal infiltration طبعا دايما كلمة stromal + +183 +00:16:25,020 --> 00:16:30,250 +infiltration بتعمل شغلتين edema and obesityوباشرة + +184 +00:16:30,250 --> 00:16:36,210 +أية stromal infiltration edema زائد opacity وبيكون + +185 +00:16:36,210 --> 00:16:41,230 +شكلها عبارة عن ring pattern يعني بشكل اللي هو حلقي + +186 +00:16:41,230 --> 00:16:51,330 +وبعد ذلك بيسبب ايضا inflammation of the sclera ما + +187 +00:16:51,330 --> 00:16:56,350 +بنتهي لهذه المرحلة؟إذا احنا ملاحظين صار اديمة و + +188 +00:16:56,350 --> 00:17:02,250 +بست وين في الكورنيا ايضا بسبب ايش ان الكورنيا بصير + +189 +00:17:02,250 --> 00:17:08,690 +عبارة عن waxing يعني مشمعة و بصير and waning + +190 +00:17:08,690 --> 00:17:15,370 +course يعني بالضبط زي العجينة إذا شكل القرنية بصير + +191 +00:17:15,370 --> 00:17:20,190 +اللي هو مشمع و شكلها لين كتير زي العجينة بالضبط + +192 +00:17:24,660 --> 00:17:28,800 +In terms of management where possible corneal + +193 +00:17:28,800 --> 00:17:33,820 +scrabings are vital for confirmation of diagnosis + +194 +00:17:33,820 --> 00:17:38,920 +طبعا هان قالية العلاج انا باخد اللي هو ايه؟ + +195 +00:17:38,920 --> 00:17:43,500 +corneal scrabbing يعني كشت من القرنية و بروح على + +196 +00:17:43,500 --> 00:17:49,410 +ال microscope و بعمل عملية ايه؟ تحليل لالخلايا + +197 +00:17:49,410 --> 00:17:52,710 +اللي خاصة في القرانية وبشوف انه هل عنده + +198 +00:17:52,710 --> 00:17:56,870 +Acanthamoebia Corneal Infection او لا طبعا من خلال + +199 +00:17:56,870 --> 00:18:01,550 +ال Corneal Scrubbing انا بحدد حاجة بنسميها ال + +200 +00:18:01,550 --> 00:18:06,170 +organism وبعدها + +201 +00:18:06,170 --> 00:18:10,150 +بتم اللي هو صرف ايه ال treatment اللي خاص في + +202 +00:18:10,150 --> 00:18:17,720 +المريض طيب الان لو اجهنا مثلا مريضعلى المركز طبعا + +203 +00:18:17,720 --> 00:18:22,060 +احنا بنعرف ان اغلب المراكز مابيكونش عنده ايه + +204 +00:18:22,060 --> 00:18:28,160 +استثناب لكن بيكون عنده متوفر ايه بنتورش okay وانا + +205 +00:18:28,160 --> 00:18:32,220 +مثلا اكتشفت انه عنده corneal obesity و هو مش قادر + +206 +00:18:32,220 --> 00:18:36,100 +مثلا يروح على مستشفى العيون او مش قادر يروح على + +207 +00:18:36,100 --> 00:18:41,140 +طبيب عيونالحل الوحيد انه في هذه المدة انا بدي ادى + +208 +00:18:41,140 --> 00:18:45,420 +المريض لحد ديته الصباح جنتاميسين طبعا الجنتاميسين + +209 +00:18:45,420 --> 00:18:51,080 +ايش هيعمل اللي هو ترطيب لسطح القرنية وامنع المريض + +210 +00:18:51,080 --> 00:18:55,540 +انه يلبس العدسة اللاصقة بال .. يعني بالمطلق انه + +211 +00:18:55,540 --> 00:18:59,460 +لازم يلبسش نهائي العدسة اللاصقة لحد ما يروح لطبيب + +212 +00:18:59,460 --> 00:19:03,960 +العيون وبعد ذلك انه يتم عملية ال management بطريقة + +213 +00:19:03,960 --> 00:19:09,570 +صحيحةطبعا دايما بعد ما تم تحديد ال organism من + +214 +00:19:09,570 --> 00:19:13,710 +خلال أخذ العينة او ال corneal scrubbing هذا بتديني + +215 +00:19:13,710 --> 00:19:18,990 +ايه؟ تأكيد confirmation اي بمعنى تأكيد لمين لتشخيص + +216 +00:19:18,990 --> 00:19:25,050 +اللي خاص في المريض طيب + +217 +00:19:25,050 --> 00:19:30,050 +في هن إشارة ان early diagnosis التشخيص المبكر له + +218 +00:19:30,050 --> 00:19:36,540 +دايما له علاقة بنجاح مين؟العلاج إذا is correlated + +219 +00:19:36,540 --> 00:19:41,540 +مرتبط with success in a treatment إذا إله علاقة + +220 +00:19:41,540 --> 00:19:48,660 +مباشرة بنجاح العلاج possibly محتمل because viva + +221 +00:19:48,660 --> 00:19:53,000 +acanthamoebia zest أي بيصير عند المريض زي اللي هو + +222 +00:19:53,000 --> 00:19:58,810 +فقاعات أو أكياس بيسببها ال acanthamoebiaوبتكون هذه + +223 +00:19:58,810 --> 00:20:03,230 +الظاهرة في القرنية early in the course of the + +224 +00:20:03,230 --> 00:20:07,610 +disease دايما بتكون موجودة على سطح القرنية يما + +225 +00:20:07,610 --> 00:20:14,150 +بيكون شكل القرنية ليّن أو اللي هو مشمّع يعني بمعنى + +226 +00:20:14,150 --> 00:20:20,850 +انه بتكون اللي هو زي العجينة القرنية طبعا + +227 +00:20:20,850 --> 00:20:25,570 +بتكثر ال acanthamoebia infection دايما انه بتكون + +228 +00:20:25,570 --> 00:20:30,600 +most common whenفي الأشخاص اللي بروحوا مثلا على ال + +229 +00:20:30,600 --> 00:20:36,200 +swimming pool أو مثلا بتكون أكتر اللي هو شيوعا + +230 +00:20:36,200 --> 00:20:40,920 +مثلا شخص خلص عنده المحلول راح استخدم مثلا ميّة + +231 +00:20:40,920 --> 00:20:46,220 +الحنفية هذه كلها بتأدي لمين؟ ل ال acanthamibia + +232 +00:20:46,220 --> 00:20:53,460 +infection طيب bacterial immunologic reactionsطبعا + +233 +00:20:53,460 --> 00:20:59,920 +تفاعلات ايش هتكون لمناعة القرانية او رد فعل لاله + +234 +00:20:59,920 --> 00:21:06,580 +مناعة من القرانية طبعا هذه هتكون بكتيريا سببها ال + +235 +00:21:06,580 --> 00:21:10,840 +acanthamibia سببها فنجاي okay اذا عندنا ال + +236 +00:21:10,840 --> 00:21:14,300 +bacterial corneal infection سببها بكتيريا + +237 +00:21:14,300 --> 00:21:18,680 +bacterial immunologic reaction ايضا ال main reason + +238 +00:21:18,680 --> 00:21:24,730 +هو يعتبر بكتيرياThere are several sources of + +239 +00:21:24,730 --> 00:21:29,770 +bacterial contamination هناك عدة مصادر لمين للتلوث + +240 +00:21:29,770 --> 00:21:36,030 +البكتيري طبعا هذه الاختلاف الرئيسي بينها و ما بين + +241 +00:21:36,030 --> 00:21:40,470 +ال bacterial corneal infection انه بيكون البساطة + +242 +00:21:40,470 --> 00:21:46,790 +هذه ما بقدر اتعرف عليها بشكل مباشرOkay يعني التعرف + +243 +00:21:46,790 --> 00:21:49,750 +عليها مابقدرش انه اقول انا مريض عنده مثلا + +244 +00:21:49,750 --> 00:21:53,490 +bacterial immunologic reaction بشكل اللي هو + +245 +00:21:53,490 --> 00:21:58,350 +directly بشكل اللي هو مباشر الا ما يتم اللي هو اخد + +246 +00:21:58,350 --> 00:22:03,810 +عينة من القرانية وتحليلها وبعد ذلك الكشف عن المرض + +247 +00:22:03,810 --> 00:22:09,510 +ومن ثم الكشف عن ال treatment اللي خاص بالمريض طبعا + +248 +00:22:09,510 --> 00:22:13,810 +هي تعتبر ايضا نادرة الحدوث بتحدث بشكل اللي هو + +249 +00:22:13,810 --> 00:22:14,130 +rarely + +250 +00:22:16,970 --> 00:22:21,810 +Bacteria may be hard-bore in the lid margins بيكون + +251 +00:22:21,810 --> 00:22:26,410 +البكتيريا بتسكن وين؟ في ال eyelid margin او in + +252 +00:22:26,410 --> 00:22:31,050 +biofilm on the lens surfaces and produce + +253 +00:22:31,050 --> 00:22:36,590 +substances toxic to the cornea اذا دايما بيكون + +254 +00:22:36,590 --> 00:22:40,930 +مكان البكتيريا في ال eyelid margin او في ال + +255 +00:22:40,930 --> 00:22:47,230 +biofilm طيب ال biofilm ايش المقصود فيه؟هو عبارة عن + +256 +00:22:47,230 --> 00:22:51,730 +الـ antimicrobial factor المحاضرة السابقة احنا + +257 +00:22:51,730 --> 00:22:56,290 +قلنا ان في هناك دايما اللي هو نزاع مستمر ما بين + +258 +00:22:56,290 --> 00:23:01,110 +البكتيريا و ال antibacterial factor ال biofilm هي + +259 +00:23:01,110 --> 00:23:05,490 +عبارة عن ال antibacterial factor اللي بتعمل عملية + +260 +00:23:05,490 --> 00:23:12,090 +ايه مقاومة ضد البكتيرياOn the lens surfaces هذي + +261 +00:23:12,090 --> 00:23:16,410 +بتكون كلها على سطح العدسة وبتنتج مواد، إيش هذه + +262 +00:23:16,410 --> 00:23:20,150 +المواد؟ بتكون سامة بالنسبة للقرانية + +263 +00:23:24,080 --> 00:23:28,260 +فيه هناك مدام هي في ال eyelid margin، إذا قريبة من + +264 +00:23:28,260 --> 00:23:32,760 +مين؟ من ال eyelash، إذا ممكن تعمل علامات لمين؟ ل + +265 +00:23:32,760 --> 00:23:36,400 +البليفريتس، اللي هو ال inflammation of the eyelid + +266 +00:23:36,400 --> 00:23:40,400 +و هيظهر إن ال eyelid هو عبارة عن redness and + +267 +00:23:40,400 --> 00:23:45,540 +thickness أيضا ممكن يعمل mepomianitis، اللي هو + +268 +00:23:45,540 --> 00:23:50,180 +inflammation للميبومياني gland، واضحة؟ اللي بتعمل + +269 +00:23:50,180 --> 00:23:55,960 +إفراز لل oil layermay indicate that the lead + +270 +00:23:55,960 --> 00:24:01,080 +margin is the source of organisms، إذا الـ I lead + +271 +00:24:01,080 --> 00:24:05,840 +margin هيكون مصدر من مصادر إيش ال organism زي مثلا + +272 +00:24:05,840 --> 00:24:12,040 +بكتيريا الاستفلاكوكس that can secrete X-toxins + +273 +00:24:12,040 --> 00:24:17,330 +اللي هي هتعمل على إفراز إيش هذه السموميعني ببساطة + +274 +00:24:17,330 --> 00:24:23,030 +في عناه هيكون في ال eyelid margin بكتيريا وفي هناك + +275 +00:24:23,030 --> 00:24:27,210 +biofilm اللي هي عبارة عن ال antibacterial factor + +276 +00:24:27,210 --> 00:24:31,670 +التنين هيصير بينهم نزاع، إذا انتصرت البكتيريا، + +277 +00:24:31,670 --> 00:24:36,610 +هتكون قادرة على اختراق من الكورنيا، إذا ما اللي هو + +278 +00:24:36,610 --> 00:24:41,570 +جدرة اللي هو عملية الاختراق، إذا هذا إيش بيقده؟ + +279 +00:24:42,770 --> 00:24:46,370 +بيكون عند الشخص فيه مناعة وبالتالي مش هيحدث ال + +280 +00:24:46,370 --> 00:24:50,370 +bacterial immunologic reaction طبعا في الغالب + +281 +00:24:50,370 --> 00:24:54,210 +بيكون سببها اللي هو بكتيريا من نوع الصفلكوكس + +282 +00:24:59,360 --> 00:25:07,300 +هذه الحالات ترتبط بمعنى الـ General ophthalmologic + +283 +00:25:07,300 --> 00:25:11,300 +conditions زي مثلا الـ Marginal Keratitis + +284 +00:25:11,300 --> 00:25:16,260 +وDipliferitis، إذا هذه الحالات كلها تكون مرتبطة + +285 +00:25:16,260 --> 00:25:21,860 +بالـ Inflammation of the eyelid وأيضا بالإنفلامش + +286 +00:25:21,860 --> 00:25:23,200 +للكورنيا + +287 +00:25:28,100 --> 00:25:32,700 +A source of particular note is the contact lens + +288 +00:25:32,700 --> 00:25:38,100 +case وهنا فيه تنويه مهم الان يما انا بدي ادي .. + +289 +00:25:38,100 --> 00:25:42,000 +يما بدي اعطي عدسة لاصقة زي مثلا ال conventional + +290 +00:25:42,000 --> 00:25:47,860 +daily wear contact lens اللي هي مدة حياتها تقريبا + +291 +00:25:47,860 --> 00:25:55,860 +سنة okay بدي ادي للمريض two cases دايما اذا عندنا + +292 +00:25:55,860 --> 00:25:57,380 +في حالة ال conventional + +293 +00:26:02,400 --> 00:26:12,980 +Daily wear contact lenses هانبدل المريض two cases + +294 +00:26:12,980 --> 00:26:20,230 +او two vitalاللي هو يعني two cases حاويتين ليش؟ + +295 +00:26:20,230 --> 00:26:25,010 +عشان يعمل عملية replacement استبدال للحاوية بمعنى + +296 +00:26:25,010 --> 00:26:29,910 +انه المريض الآن مثلا اول خمس شهور بيستخدم حاوية + +297 +00:26:29,910 --> 00:26:35,070 +وبعد ذلك الخمس شهور التانية بيستبدلها عشان ما يعمل + +298 +00:26:35,070 --> 00:26:39,970 +ايه؟ bacterial contamination تلوث بكتيري في داخل + +299 +00:26:39,970 --> 00:26:45,290 +الحاويةوطبعا التكنيك او ال instructions انا اديتكم + +300 +00:26:45,290 --> 00:26:49,610 +اليها في العملية انه دايما المريض لازم يعمل عملية + +301 +00:26:49,610 --> 00:26:54,590 +replacement استبدال للمحلول اللى فى داخل ال case + +302 +00:26:54,590 --> 00:27:00,870 +الحاوية تقريبا كل يوم فهذه كلهيتها بتقلل من حدوث + +303 +00:27:00,870 --> 00:27:04,390 +من ال bacterial immunologic reactions + +304 +00:27:08,690 --> 00:27:13,510 +ايضا patients need to clean and dry their case + +305 +00:27:13,510 --> 00:27:18,390 +daily، اذا بتحتاج دايما انه يعمل عملية تنظيف + +306 +00:27:18,390 --> 00:27:24,670 +وعملية تشفيف لمن؟ لالحاوية and replace their case + +307 +00:27:24,670 --> 00:27:30,010 +regularly to avoid the accumulation of biofilm and + +308 +00:27:30,010 --> 00:27:34,730 +the harbor bacteriaلأن هذه بيكون مكان لاستعمار + +309 +00:27:34,730 --> 00:27:39,350 +البكتيريا أو لتكوين البكتيريا في داخل الحاوية + +310 +00:27:46,660 --> 00:27:51,380 +may present in two forms إذا الظهورها بيكون اللي + +311 +00:27:51,380 --> 00:27:55,820 +هو على شكلين إما either acute inflammation + +312 +00:27:55,820 --> 00:28:00,960 +reactions or low grade sterile or peripheral + +313 +00:28:00,960 --> 00:28:05,820 +ulcers يعني الظهورها بيكون بالشكل هذا فيه عدة + +314 +00:28:05,820 --> 00:28:10,720 +أشكال إما acute inflammationفي داخل الكورنية او + +315 +00:28:10,720 --> 00:28:16,360 +بيكون عبارة عن reaction ردة فعل او عبارة عن low + +316 +00:28:16,360 --> 00:28:19,980 +grade يعني دايما بيقلل اللي هو من ايه من ال + +317 +00:28:19,980 --> 00:28:26,110 +sensitivity ل الكورنيةأيضا بسبب الـ sterile هذه + +318 +00:28:26,110 --> 00:28:30,250 +نتيجة الـ stromal infiltrate اللى بتعمل أديمة و + +319 +00:28:30,250 --> 00:28:34,830 +بتعمل أبسطة في داخل وين الكورنية و أيضا عندنا ال + +320 +00:28:34,830 --> 00:28:40,890 +peripheral ulcers طب ليش هم مش central ulcers لأن + +321 +00:28:40,890 --> 00:28:44,290 +ببساطة دايما انتوا بتعرفوا العدسة اللاصقة ال + +322 +00:28:44,290 --> 00:28:48,050 +diameter بتاعها بيكون ايش اللى هو كبير فبالتالي + +323 +00:28:48,050 --> 00:28:52,030 +انه بتأثر على ال peripheral أكتر من مين من ال + +324 +00:28:52,030 --> 00:28:52,310 +center + +325 +00:28:58,870 --> 00:29:05,890 +طيب، الآن في عندنا مجموعة من العوامل هذه بتأدي إلى + +326 +00:29:05,890 --> 00:29:11,490 +تقليل من ال bacterial infection أو بتقلل من + +327 +00:29:11,490 --> 00:29:15,730 +الacanthamibia أو بتقلل من ال bacterial + +328 +00:29:15,730 --> 00:29:20,970 +immunologic reactionإيش هي العوامل؟ أول حاجة ال + +329 +00:29:20,970 --> 00:29:25,310 +lens fitting technique can be used to minimize the + +330 +00:29:25,310 --> 00:29:29,910 +risk of infection بعض الزملاء بيقولك أنا مثلا بلبس + +331 +00:29:29,910 --> 00:29:34,170 +المريض عدسة لاصقة لكن ما بعمله evaluation هل هي + +332 +00:29:34,170 --> 00:29:39,530 +مثلا steep أو flat أو optimal fit طبعا هذا كله + +333 +00:29:39,530 --> 00:29:45,130 +بيؤدي إلى زيادة اللي هو حدوث إيهالانفكشن او زيادة + +334 +00:29:45,130 --> 00:29:49,790 +حدوث مثلا ال acanthamibia اذا اول حاجة لازم انه + +335 +00:29:49,790 --> 00:29:53,650 +ادي optimal fit lens للمريض هذا مهم جدا + +336 +00:29:58,080 --> 00:30:04,100 +2- Ensure Educate Movement and Post Lens Teary + +337 +00:30:04,100 --> 00:30:09,900 +Flow لازم ان يكون حركة العدسة ملائمة او مناسبة + +338 +00:30:09,900 --> 00:30:15,460 +تقريبا من نص الى واحد مليمتر اذا قلت او زادت حركة + +339 +00:30:15,460 --> 00:30:20,000 +العدسة ايضا انه بيكون هذا ايه يعني قد يؤدي الى + +340 +00:30:20,000 --> 00:30:26,440 +infection او قد يؤدي الى حدوث اضرار لا القرنيةالـ + +341 +00:30:26,440 --> 00:30:33,460 +post lens tear flow هذا مرتبط في حركة العدسة، إذا + +342 +00:30:33,460 --> 00:30:40,380 +عندنا ال post lens tear flow مرتبط أساسا في حركة + +343 +00:30:40,380 --> 00:30:44,060 +العدسة، لأنه زي ما نعرف أنه يكون هناك limitation + +344 +00:30:44,060 --> 00:30:49,000 +من حيث ال tear exchange في العدسات اللاصقة الليلة + +345 +00:30:53,970 --> 00:30:59,630 +هذا يساعد الناس بتأدية اكلير بكتيريا تبقى عدد + +346 +00:30:59,630 --> 00:31:05,450 +طبيعي لـ epithelial disformation طيب الان لو سألنا + +347 +00:31:05,450 --> 00:31:08,550 +السؤال الـ epithelial disformation هل هي ظاهرة + +348 +00:31:08,550 --> 00:31:13,960 +طبيعية؟بالضبط اللى هى عملية تقشر لمين؟ للكورنية + +349 +00:31:13,960 --> 00:31:19,060 +Epithelial هذه بتحدث اللى هو كل يوم تقريبا خلال 24 + +350 +00:31:19,060 --> 00:31:24,820 +اللى هو ساعة فأى شخص ما بيرتدي عدسات لاصقة بيكون + +351 +00:31:24,820 --> 00:31:29,100 +عنده هذا ال rate إيش يعتبر؟ Normal rate أنا الآن + +352 +00:31:29,100 --> 00:31:33,780 +لما بدي أصرف العدسة اللاصقة بدي أحافظ أيضا على ال + +353 +00:31:33,780 --> 00:31:39,600 +normal rate لمين؟ لل Epithelial Discommationأيضًا + +354 +00:31:39,600 --> 00:31:45,100 +replenish أي بمعنى استبدال ال layer دايماً في + +355 +00:31:45,100 --> 00:31:50,620 +العدسات اللاصقة الهدف من ال layer عملية الترطيب + +356 +00:31:50,620 --> 00:31:55,400 +وبالإضافة إنه بعمل عملية التقاط لكل ال bacterial + +357 +00:31:55,400 --> 00:31:59,860 +infection أو البكتيريا اللي بتقدي لها ال bacterial + +358 +00:31:59,860 --> 00:32:05,520 +infectionand circulate tear film antibacterial + +359 +00:32:05,520 --> 00:32:11,760 +factors and nutritions for the epithelia أيضا + +360 +00:32:11,760 --> 00:32:18,960 +بتعمل عملية ايش؟ اللي هو دفاع لل tear film و بتعمل + +361 +00:32:18,960 --> 00:32:21,880 +عملية تغذية لمين؟ للإبثالية + +362 +00:32:26,380 --> 00:32:33,280 +Ensure عشان نضمن educate corneal oxygenation via a + +363 +00:32:33,280 --> 00:32:37,640 +lens with moderate decay على T wear or high decay + +364 +00:32:37,640 --> 00:32:43,280 +على T extended wear دايما انا بدي اضمن ان يكون عند + +365 +00:32:43,280 --> 00:32:47,100 +المريض فيه هناك اللي هو سهولة في ايش؟ في توزيع ال + +366 +00:32:47,100 --> 00:32:52,940 +oxygen او سهولة في دخول ال oxygen للقرنية طبعا هذا + +367 +00:32:52,940 --> 00:32:58,550 +بتمن خلال ايه؟ان يكون في عنا اما moderate او high + +368 +00:32:58,550 --> 00:33:06,910 +DK على T وهذا بيقلل من مين؟ من تأثر الابيثيليام و + +369 +00:33:06,910 --> 00:33:10,970 +another metabolic alterations that increase + +370 +00:33:11,620 --> 00:33:16,000 +Susceptibility to bacterial adherence أيضًا اللي + +371 +00:33:16,000 --> 00:33:20,100 +هو التغيير اللي بيحدث في داخل اللي هو الكورنيا + +372 +00:33:20,100 --> 00:33:25,000 +ممكن هذا بيسبب إيش؟ إنه يصير هناك adherence التثاغ + +373 +00:33:25,000 --> 00:33:30,960 +ما بين الكورنيا و ما بين العدسةإذا أنا بدي أمنع أي + +374 +00:33:30,960 --> 00:33:36,640 +تاء اللي هو مسبب لالتساق العدسة مع مين مع الكورنيا + +375 +00:33:36,640 --> 00:33:40,940 +من خلال توفير عدسة أن يكون فيها moderate أو high + +376 +00:33:40,940 --> 00:33:48,600 +DK على T Minimize + +377 +00:33:48,600 --> 00:33:53,080 +تقليل exposure of the eye to microbial + +378 +00:33:53,080 --> 00:33:59,640 +contamination by patient education on hygieneعنا + +379 +00:33:59,640 --> 00:34:06,220 +السبب الأساسي لحدوث ال bacterial infection أو ال + +380 +00:34:06,220 --> 00:34:11,660 +acanthamibia هو موضوع ال poor hygieneفلازم انه انا + +381 +00:34:11,660 --> 00:34:16,240 +من ضمن الارشادات اعلم المريض انه يكون فيه هناك ايش + +382 +00:34:16,240 --> 00:34:21,960 +تعليم اللي هو مهم في موضوع ال hygiene انه يلتزم + +383 +00:34:21,960 --> 00:34:26,020 +مثلا اذا كانت اللي هو male او female انه دايما + +384 +00:34:26,020 --> 00:34:31,160 +الأضافر مثلا قصيرة الباد هبس يتجنبوا ال occupation + +385 +00:34:31,160 --> 00:34:36,780 +مهمة كتير في عملية اللي هو صرف العدسةبعض الناس + +386 +00:34:36,780 --> 00:34:40,600 +مثلًا بيروحوا بيشتريوا اللي هو محلي الإيش مصنوعه + +387 +00:34:40,600 --> 00:34:44,940 +محليًا، هذه قد تؤدي إلى bacterial infection أو + +388 +00:34:44,940 --> 00:34:49,480 +Acanthamibia، إذا avoiding the use of homemade + +389 +00:34:49,480 --> 00:34:55,380 +saline، أي محلول مصنوع محلي أو أي محلول ما بيكون + +390 +00:34:55,380 --> 00:34:59,720 +مكتوب عليه ال materials، الاستخدامات بتاعته، + +391 +00:34:59,720 --> 00:35:03,660 +الإرشادات اللي خاصة فيه، دائمًا بدنا نتجنب اللي هو + +392 +00:35:03,660 --> 00:35:10,410 +شراءه أو بيعه للمريضأو Tab or Tab water بعض المرضى + +393 +00:35:10,410 --> 00:35:14,950 +بيخلص مثلا معه المحلول و بده ينظف العدسة بيروح + +394 +00:35:14,950 --> 00:35:19,170 +يحطها تحت الحنفية طبعا خاصة وين؟ في اللي هو ال + +395 +00:35:19,170 --> 00:35:22,290 +hard contact lenses ال soft contact lenses لو حطها + +396 +00:35:22,290 --> 00:35:27,090 +تحت الحنفية إيه شمالها؟ اللي هو بتتمزق العدسة أو + +397 +00:35:27,090 --> 00:35:32,580 +تتمزق بشكل اللي هو سريعand attention to compliance + +398 +00:35:32,580 --> 00:35:37,540 +with lens care systems ايضا لازم ان المريض يلتزم + +399 +00:35:37,540 --> 00:35:44,840 +بنظام رعاية وعناية للعدسة اللاصقة طيب الان لو + +400 +00:35:44,840 --> 00:35:48,460 +ساننا السؤال العدسات ال extended wear او ال daily + +401 +00:35:48,460 --> 00:35:52,440 +disposable lenses مافيه لها no care system او + +402 +00:35:52,440 --> 00:35:55,940 +مافيه لها اللي هو clean system طب كيف المريض بده + +403 +00:35:55,940 --> 00:36:00,370 +يلتزم بهذه الأمور؟يعني ماببسرش إيدانة ماليزيا + +404 +00:36:00,370 --> 00:36:05,270 +بيحطها أو بيتعرض لأذرة و أشياء كثيرة؟ بالضبط، يعني + +405 +00:36:05,270 --> 00:36:08,970 +مثلا موضوع ال air condition أو موضوع مثلا ال + +406 +00:36:08,970 --> 00:36:12,410 +exposure to the sun أو موضوع إنه يكون عنده poor + +407 +00:36:12,410 --> 00:36:16,130 +hygiene أو موضوع ال occupation اللي خاصة فيه، كل + +408 +00:36:16,130 --> 00:36:16,470 +هذه + +409 +00:36:20,960 --> 00:36:26,180 +بالضبط دايما ايضا استخدام العدسة بيكون only for 24 + +410 +00:36:26,180 --> 00:36:31,000 +hours بعد ذلك لازم انه نوقف اللي هو استخدام العدسة + +411 +00:36:31,540 --> 00:36:36,560 +Okay ايضا في حالة ال extended wear واحد مثلا بلبس + +412 +00:36:36,560 --> 00:36:41,420 +عدسة extended wear لكن استخدمها مثلا لمدة اللي هو + +413 +00:36:41,420 --> 00:36:46,360 +أسبوعين او استخدمها لتلت أسابيع او شهر مثلا بمعنى + +414 +00:36:46,360 --> 00:36:50,420 +انه زود المدة فيها بيقولك انا مرتاح مش شاعر اي تا + +415 +00:36:50,420 --> 00:36:55,400 +اللي هو مشاكل قد يكون هذا الشخص معلبة لحدوث ايه ال + +416 +00:36:55,400 --> 00:37:01,870 +corneal infectionبنوقف ان شاء الله لهذا الكام و ان + +417 +00:37:01,870 --> 00:37:05,450 +شاء الله في المحاضرة القادمة بنكمل طبعا الامتحان + +418 +00:37:05,450 --> 00:37:08,530 +النصفي هيكون لحد الشريحة هذه ان شاء الله + diff --git a/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/vVvcBTMb4Lk_raw.json b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/vVvcBTMb4Lk_raw.json new file mode 100644 index 0000000000000000000000000000000000000000..4e4a8e9ebedf48ae076184c84f4af0aebf608900 --- /dev/null +++ b/PL9fwy3NUQKwYbgAjwV2UYtLptpBqDAqYs/vVvcBTMb4Lk_raw.json @@ -0,0 +1 @@ +{"segments": [{"id": 1, "seek": 3615, "start": 20.94, "end": 36.16, "text": "بسم الله الرحمن الرحيم السلام عليكم ورحمة الله وبركاته ومرحبا لكم جميعا اليوم هنبدأ في موضوع bacterial corneal infection may produce any of several signs", "tokens": [3555, 38251, 21984, 34892, 5016, 27842, 34892, 5016, 32640, 21136, 37440, 25894, 24793, 4032, 2288, 35571, 3660, 21984, 4032, 26890, 4117, 9307, 3224, 4032, 29973, 5016, 3555, 995, 5296, 24793, 10874, 2304, 40228, 995, 45595, 20498, 8032, 1863, 44510, 10721, 8978, 3714, 2407, 11242, 45367, 35632, 1181, 716, 304, 11764, 815, 5258, 604, 295, 2940, 7880], "avg_logprob": -0.18462171261770682, "compression_ratio": 1.4110429447852761, "no_speech_prob": 1.1920928955078125e-07, "words": [{"start": 20.94, "end": 21.26, "word": "بسم", "probability": 0.85546875}, {"start": 21.26, "end": 21.4, "word": " الله", "probability": 0.97216796875}, {"start": 21.4, "end": 21.72, "word": " الرحمن", "probability": 0.9757486979166666}, {"start": 21.72, "end": 22.16, "word": " الرحيم", "probability": 0.9938151041666666}, {"start": 22.16, "end": 22.54, "word": " السلام", "probability": 0.7412109375}, {"start": 22.54, "end": 23.0, "word": " عليكم", "probability": 0.95458984375}, 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32.74, "word": " infection", "probability": 0.87548828125}, {"start": 32.74, "end": 33.36, "word": " may", "probability": 0.78271484375}, {"start": 33.36, "end": 34.18, "word": " produce", "probability": 0.8896484375}, {"start": 34.18, "end": 34.6, "word": " any", "probability": 0.88330078125}, {"start": 34.6, "end": 34.88, "word": " of", "probability": 0.97607421875}, {"start": 34.88, "end": 35.44, "word": " several", "probability": 0.89453125}, {"start": 35.44, "end": 36.16, "word": " signs", "probability": 0.8759765625}], "temperature": 1.0}, {"id": 2, "seek": 6528, "start": 37.12, "end": 65.28, "text": "طبعا في هناك علامات للعدوى البكتيرية يعني الآن مثلا نتيجة ارتداء العدسات اللاصقة اللينة صار عند الشخص نفترض انه فيه infection في هناك signs علامات ل ال corneal infection اذا هنا ممكن اقول ان العنوان signs of corneal infection", "tokens": [9566, 3555, 3615, 995, 8978, 34105, 4117, 11203, 10943, 9307, 24976, 22488, 2407, 7578, 29739, 4117, 2655, 13546, 10632, 37495, 22653, 6024, 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"end": 290.1, "text": "إذا في هناك مصطلحين مهمين المصطلح الأول corneal lens defect بتتم إزالته للألم بعد ما يتم إزالة العدسة بينما ال corneal keratitis بيظل الألم موجود حتى لو الشخص عمل removal للعدسة", "tokens": [28814, 15730, 8978, 34105, 4117, 3714, 9381, 9566, 1211, 5016, 9957, 3714, 16095, 9957, 9673, 9381, 9566, 1211, 5016, 16247, 12610, 1181, 716, 304, 6765, 16445, 39894, 39237, 11933, 11622, 6027, 47395, 24976, 10721, 19528, 39182, 19446, 7251, 39237, 11933, 11622, 6027, 3660, 18863, 3215, 3794, 3660, 49374, 15042, 2423, 1181, 716, 304, 19377, 267, 16074, 4724, 1829, 19913, 1211, 16247, 19528, 3714, 29245, 23328, 11331, 49975, 45164, 25124, 9778, 9381, 6225, 42213, 17933, 24976, 22488, 3794, 3660], "avg_logprob": -0.13696598365337034, "compression_ratio": 1.5604395604395604, "no_speech_prob": 0.0, "words": [{"start": 270.94, "end": 271.26, "word": "إذا", "probability": 0.708251953125}, {"start": 271.26, "end": 271.44, "word": " في", "probability": 0.81787109375}, {"start": 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ulceration الآن بعد ذلك حدث هناك عدوى ل القرانية وعملت أيضا ulceration او corneal ulcer is characterized by an epithelial defect يعني صار هناك خلل وين في ال corneal epithelium في الطبقة الأولى ل القرانية with an underlying stromal exovation and infiltrate", "tokens": [4575, 1836, 488, 20352, 1776, 399, 6024, 48506, 39182, 29910, 23275, 11331, 3215, 12984, 34105, 4117, 6225, 3215, 2407, 7578, 5296, 25062, 2288, 7649, 10632, 4032, 25957, 1211, 2655, 36632, 11242, 995, 20352, 1776, 399, 1975, 2407, 1181, 716, 304, 20352, 1776, 307, 29361, 538, 364, 2388, 355, 338, 831, 16445, 37495, 22653, 20328, 9640, 34105, 4117, 16490, 1211, 1211, 4032, 9957, 8978, 2423, 1181, 716, 304, 2388, 355, 338, 2197, 8978, 41950, 3555, 28671, 16247, 12610, 7578, 5296, 25062, 2288, 7649, 10632, 365, 364, 14217, 1056, 298, 304, 454, 5179, 399, 293, 29085, 4404], "avg_logprob": -0.21663411986082792, "compression_ratio": 1.5217391304347827, "no_speech_prob": 0.0, "words": [{"start": 363.92, "end": 364.8, "word": "Infective", "probability": 0.7770182291666666}, {"start": 364.8, "end": 365.8, "word": " ulceration", "probability": 0.7749837239583334}, {"start": 365.8, "end": 367.48, "word": " الآن", "probability": 0.54730224609375}, {"start": 367.48, "end": 367.74, "word": " بعد", "probability": 0.94482421875}, {"start": 367.74, "end": 368.3, "word": " ذلك", "probability": 0.99462890625}, {"start": 368.3, "end": 368.88, "word": " حدث", "probability": 0.9873046875}, {"start": 368.88, "end": 369.3, "word": " هناك", "probability": 0.938720703125}, {"start": 369.3, "end": 370.64, "word": " عدوى", "probability": 0.81744384765625}, {"start": 370.64, "end": 370.92, "word": " ل", "probability": 0.8193359375}, {"start": 370.92, "end": 371.86, "word": " القرانية", "probability": 0.73388671875}, {"start": 371.86, "end": 372.96, "word": " وعملت", "probability": 0.9090576171875}, {"start": 372.96, "end": 373.34, "word": " أيضا", "probability": 0.8743489583333334}, {"start": 373.34, "end": 374.18, "word": " 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"probability": 0.81494140625}, {"start": 381.84, "end": 382.12, "word": " خلل", "probability": 0.9812825520833334}, {"start": 382.12, "end": 382.46, "word": " وين", "probability": 0.87158203125}, {"start": 382.46, "end": 382.8, "word": " في", "probability": 0.82421875}, {"start": 382.8, "end": 382.92, "word": " ال", "probability": 0.8037109375}, {"start": 382.92, "end": 383.42, "word": " corneal", "probability": 0.8263346354166666}, {"start": 383.42, "end": 384.12, "word": " epithelium", "probability": 0.754150390625}, {"start": 384.12, "end": 384.46, "word": " في", "probability": 0.73193359375}, {"start": 384.46, "end": 384.9, "word": " الطبقة", "probability": 0.9446614583333334}, {"start": 384.9, "end": 385.74, "word": " الأولى", "probability": 0.90478515625}, {"start": 385.74, "end": 386.1, "word": " ل", "probability": 0.8984375}, {"start": 386.1, "end": 387.1, "word": " القرانية", "probability": 0.81756591796875}, {"start": 387.1, "end": 387.98, "word": " with", "probability": 0.869140625}, {"start": 387.98, "end": 388.38, "word": " an", "probability": 0.884765625}, {"start": 388.38, "end": 389.36, "word": " underlying", "probability": 0.947265625}, {"start": 389.36, "end": 390.58, "word": " stromal", "probability": 0.8092447916666666}, {"start": 390.58, "end": 391.6, "word": " exovation", "probability": 0.5745849609375}, {"start": 391.6, "end": 392.04, "word": " and", "probability": 0.962890625}, {"start": 392.04, "end": 392.92, "word": " infiltrate", "probability": 0.9736328125}], "temperature": 1.0}, {"id": 16, "seek": 42057, "start": 393.45, "end": 420.57, "text": "وهذا ال infection أيضا ممكن انه يعمل excavation بمعنى ثقب وممكن ايضا يعمل stromal infiltrate ربطنا في المحاضرة السابقة ان في هناك علاقة ما بين ال infection و ال stromal infiltrate دايما ال infection بيحدث نتيجة اللي هو ال stromal infiltrate لان هي بتمثل تقريبا 90% من سماكة القرنية", "tokens": [2407, 3224, 15730, 2423, 11764, 36632, 11242, 995, 3714, 43020, 16472, 3224, 7251, 25957, 1211, 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{"start": 394.55, "end": 395.21, "word": " أيضا", "probability": 0.8927408854166666}, {"start": 395.21, "end": 395.87, "word": " ممكن", "probability": 0.97412109375}, {"start": 395.87, "end": 396.17, "word": " انه", "probability": 0.7509765625}, {"start": 396.17, "end": 396.55, "word": " يعمل", "probability": 0.9827473958333334}, {"start": 396.55, "end": 397.25, "word": " excavation", "probability": 0.57220458984375}, {"start": 397.25, "end": 397.77, "word": " بمعنى", "probability": 0.98857421875}, {"start": 397.77, "end": 398.27, "word": " ثقب", "probability": 0.912109375}, {"start": 398.27, "end": 399.69, "word": " وممكن", "probability": 0.8653971354166666}, {"start": 399.69, "end": 400.15, "word": " ايضا", "probability": 0.880859375}, {"start": 400.15, "end": 400.67, "word": " يعمل", "probability": 0.9558919270833334}, {"start": 400.67, "end": 401.39, "word": " stromal", "probability": 0.8880208333333334}, {"start": 401.39, "end": 402.19, "word": " infiltrate", "probability": 0.963134765625}, {"start": 402.19, "end": 403.15, "word": " ربطنا", "probability": 0.936279296875}, {"start": 403.15, "end": 403.37, "word": " في", "probability": 0.9453125}, {"start": 403.37, "end": 403.95, "word": " المحاضرة", "probability": 0.947998046875}, {"start": 403.95, "end": 404.63, "word": " السابقة", "probability": 0.98828125}, {"start": 404.63, "end": 404.97, "word": " ان", "probability": 0.90673828125}, {"start": 404.97, "end": 405.23, "word": " في", "probability": 0.64453125}, {"start": 405.23, "end": 405.75, "word": " هناك", "probability": 0.934814453125}, {"start": 405.75, "end": 406.33, "word": " علاقة", "probability": 0.9822591145833334}, {"start": 406.33, "end": 406.83, "word": " ما", "probability": 0.96044921875}, {"start": 406.83, "end": 407.07, "word": " بين", "probability": 0.9931640625}, {"start": 407.07, "end": 407.23, "word": " ال", "probability": 0.97119140625}, {"start": 407.23, "end": 407.73, "word": " infection", "probability": 0.919921875}, {"start": 407.73, "end": 408.35, "word": " و", "probability": 0.84375}, {"start": 408.35, "end": 408.61, "word": " ال", "probability": 0.716796875}, {"start": 408.61, "end": 409.23, "word": " stromal", "probability": 0.8702799479166666}, {"start": 409.23, "end": 409.95, "word": " infiltrate", "probability": 0.984375}, {"start": 409.95, "end": 410.81, "word": " دايما", "probability": 0.8177083333333334}, {"start": 410.81, "end": 411.05, "word": " ال", "probability": 0.9814453125}, {"start": 411.05, "end": 411.57, "word": " infection", "probability": 0.95751953125}, {"start": 411.57, "end": 412.53, "word": " بيحدث", "probability": 0.9468994140625}, {"start": 412.53, "end": 413.31, "word": " نتيجة", "probability": 0.9927978515625}, {"start": 413.31, "end": 413.51, "word": " اللي", "probability": 0.8544921875}, {"start": 413.51, "end": 413.71, "word": " هو", "probability": 0.9482421875}, {"start": 413.71, "end": 413.83, "word": " ال", "probability": 0.779296875}, {"start": 413.83, "end": 414.49, "word": " stromal", "probability": 0.9287109375}, {"start": 414.49, "end": 415.55, "word": " infiltrate", "probability": 0.9873046875}, {"start": 415.55, "end": 416.19, "word": " لان", "probability": 0.81787109375}, {"start": 416.19, "end": 416.41, "word": " هي", "probability": 0.529296875}, {"start": 416.41, "end": 417.05, "word": " بتمثل", "probability": 0.89794921875}, {"start": 417.05, "end": 417.73, "word": " تقريبا", "probability": 0.991796875}, {"start": 417.73, "end": 418.41, "word": " 90", "probability": 0.72509765625}, {"start": 418.41, "end": 418.73, "word": "%", "probability": 0.97216796875}, {"start": 418.73, "end": 419.07, "word": " من", "probability": 0.97705078125}, {"start": 419.07, "end": 419.77, "word": " سماكة", "probability": 0.87744140625}, {"start": 419.77, "end": 420.57, "word": " القرنية", "probability": 0.9368896484375}], "temperature": 1.0}, {"id": 17, "seek": 44862, "start": 424.44, "end": 448.62, "text": "These findings may be considered for corneal infection until approved otherwise يعني كل هذه اللي بنجدها من ناحية ال readiness أو من ناحية ال discharge بعد ذلك اتفاقبت لها corneal ulceration و corneal infection كل هذه بتظل موجودة حتى انه يتم اثبات العكس", "tokens": [28858, 16483, 815, 312, 4888, 337, 1181, 716, 304, 11764, 1826, 10826, 5911, 37495, 22653, 28242, 29538, 13672, 1829, 44945, 7435, 3215, 11296, 9154, 8717, 39319, 10632, 2423, 34954, 34051, 9154, 8717, 39319, 10632, 2423, 21718, 39182, 29910, 23275, 1975, 2655, 5172, 995, 4587, 3555, 2655, 5296, 11296, 1181, 716, 304, 20352, 1776, 399, 4032, 1181, 716, 304, 11764, 28242, 29538, 39894, 19913, 1211, 3714, 29245, 23328, 3660, 11331, 49975, 16472, 3224, 7251, 39237, 1975, 12984, 3555, 9307, 18863, 4117, 3794], "avg_logprob": -0.15987042537549648, "compression_ratio": 1.5066079295154184, "no_speech_prob": 0.0, "words": [{"start": 424.44, "end": 424.92, "word": "These", "probability": 0.1297607421875}, {"start": 424.92, "end": 425.82, "word": " findings", "probability": 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{"start": 434.56, "end": 434.9, "word": " اللي", "probability": 0.91943359375}, {"start": 434.9, "end": 435.62, "word": " بنجدها", "probability": 0.9732666015625}, {"start": 435.62, "end": 436.0, "word": " من", "probability": 0.98291015625}, {"start": 436.0, "end": 436.44, "word": " ناحية", "probability": 0.9856770833333334}, {"start": 436.44, "end": 436.6, "word": " ال", "probability": 0.92822265625}, {"start": 436.6, "end": 436.9, "word": " readiness", "probability": 0.2626953125}, {"start": 436.9, "end": 437.38, "word": " أو", "probability": 0.6669921875}, {"start": 437.38, "end": 437.54, "word": " من", "probability": 0.92822265625}, {"start": 437.54, "end": 437.94, "word": " ناحية", "probability": 0.9889322916666666}, {"start": 437.94, "end": 438.1, "word": " ال", "probability": 0.9697265625}, {"start": 438.1, "end": 438.72, "word": " discharge", "probability": 0.90478515625}, {"start": 438.72, "end": 439.38, "word": " بعد", "probability": 0.75048828125}, {"start": 439.38, "end": 439.82, "word": " ذلك", "probability": 0.994873046875}, {"start": 439.82, "end": 440.64, "word": " اتفاقبت", "probability": 0.878173828125}, {"start": 440.64, "end": 440.94, "word": " لها", "probability": 0.83642578125}, {"start": 440.94, "end": 441.56, "word": " corneal", "probability": 0.9064127604166666}, {"start": 441.56, "end": 442.36, "word": " ulceration", "probability": 0.9752604166666666}, {"start": 442.36, "end": 442.54, "word": " و", "probability": 0.73974609375}, {"start": 442.54, "end": 443.02, "word": " corneal", "probability": 0.81298828125}, {"start": 443.02, "end": 443.52, "word": " infection", "probability": 0.89794921875}, {"start": 443.52, "end": 444.18, "word": " كل", "probability": 0.86474609375}, {"start": 444.18, "end": 444.54, "word": " هذه", "probability": 0.8408203125}, {"start": 444.54, "end": 445.12, "word": " بتظل", "probability": 0.71044921875}, {"start": 445.12, "end": 445.96, "word": " موجودة", "probability": 0.989501953125}, {"start": 445.96, "end": 446.78, "word": " حتى", "probability": 0.889404296875}, {"start": 446.78, "end": 447.12, "word": " انه", "probability": 0.594482421875}, {"start": 447.12, "end": 447.46, "word": " يتم", "probability": 0.965087890625}, {"start": 447.46, "end": 448.06, "word": " اثبات", "probability": 0.8956298828125}, {"start": 448.06, "end": 448.62, "word": " العكس", "probability": 0.9930013020833334}], "temperature": 1.0}, {"id": 18, "seek": 45590, "start": 449.36, "end": 455.9, "text": "إن هذا ال issue مش نتيجة ال contact lenses صار عنده مشاكل أخرى هي اللي سببت الأمر هذا", "tokens": [28814, 1863, 23758, 2423, 2734, 37893, 8717, 31371, 7435, 3660, 2423, 3385, 18059, 20328, 9640, 43242, 3224, 37893, 995, 28820, 5551, 34740, 7578, 39896, 13672, 1829, 8608, 3555, 3555, 2655, 16247, 29973, 23758], "avg_logprob": -0.20117188201231115, "compression_ratio": 1.173913043478261, "no_speech_prob": 0.0, "words": [{"start": 449.36, "end": 449.62, "word": "إن", "probability": 0.6212158203125}, {"start": 449.62, "end": 449.96, "word": " هذا", "probability": 0.68798828125}, {"start": 449.96, "end": 450.08, "word": " ال", "probability": 0.611328125}, {"start": 450.08, "end": 450.32, "word": " issue", "probability": 0.439697265625}, {"start": 450.32, "end": 450.74, "word": " مش", "probability": 0.294921875}, {"start": 450.74, "end": 451.28, "word": " نتيجة", "probability": 0.99462890625}, {"start": 451.28, "end": 451.38, "word": " ال", "probability": 0.80908203125}, {"start": 451.38, "end": 451.7, "word": " contact", "probability": 0.88427734375}, {"start": 451.7, "end": 452.2, "word": " lenses", "probability": 0.87841796875}, {"start": 452.2, "end": 452.78, "word": " صار", "probability": 0.7802734375}, {"start": 452.78, "end": 453.08, "word": " عنده", "probability": 0.98974609375}, {"start": 453.08, "end": 453.58, "word": " مشاكل", "probability": 0.98291015625}, {"start": 453.58, "end": 454.14, "word": " أخرى", "probability": 0.93798828125}, {"start": 454.14, "end": 454.48, "word": " هي", 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"temperature": 1.0}, {"id": 20, "seek": 49227, "start": 487.79, "end": 492.27, "text": "إذا موقعه إما بالـ central أو بالـ mid peripheral", "tokens": [28814, 15730, 3714, 30543, 3615, 3224, 11933, 15042, 20666, 39184, 5777, 34051, 20666, 39184, 2062, 40235], "avg_logprob": -0.3010110294117647, "compression_ratio": 1.0, "no_speech_prob": 0.0, "words": [{"start": 487.79, "end": 488.11, "word": "إذا", "probability": 0.6285400390625}, {"start": 488.11, "end": 488.79, "word": " موقعه", "probability": 0.9493408203125}, {"start": 488.79, "end": 489.17, "word": " إما", "probability": 0.819091796875}, {"start": 489.17, "end": 489.87, "word": " بالـ", "probability": 0.6748046875}, {"start": 489.87, "end": 490.29, "word": " central", "probability": 0.360107421875}, {"start": 490.29, "end": 490.85, "word": " أو", "probability": 0.96044921875}, {"start": 490.85, "end": 491.47, "word": " بالـ", "probability": 0.685791015625}, {"start": 491.47, "end": 491.69, "word": " mid", "probability": 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هاي لو مثلا نفترض الخلايا بيعملها اللي هو died of cells موت للخلايا of the infiltrate myocopurulent طبعا myocopurulent أي بمعنى discharge او بص", "tokens": [6027, 39184, 408, 42471, 271, 11778, 47302, 15042, 4724, 35457, 3555, 3714, 35473, 24976, 9778, 15040, 25528, 37495, 22653, 4724, 2304, 3615, 1863, 7578, 16472, 3224, 4724, 1829, 25957, 1211, 30767, 1829, 13672, 1829, 31439, 8032, 47302, 45164, 50113, 15040, 8717, 5172, 2655, 43042, 33962, 15040, 25528, 4724, 1829, 25957, 1211, 11296, 13672, 1829, 31439, 4539, 295, 5438, 3714, 35473, 24976, 9778, 15040, 25528, 295, 264, 29085, 4404, 452, 905, 404, 374, 23405, 23032, 3555, 3615, 995, 452, 905, 404, 374, 23405, 36632, 4724, 2304, 3615, 1863, 7578, 21718, 1975, 2407, 4724, 9381], "avg_logprob": -0.22240690918678932, "compression_ratio": 1.6510416666666667, "no_speech_prob": 0.0, "words": [{"start": 522.43, "end": 522.75, "word": "الـ", "probability": 0.720703125}, {"start": 522.75, "end": 523.19, "word": " necrosis", "probability": 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أيضا بيحدث اللي هو ال KPI، ال KPI هذه مهمة، أي علامة لل KPI اللي هي عبارة عن ترسبات", "tokens": [9566, 3555, 3615, 995, 36632, 11242, 995, 4724, 1829, 24401, 12984, 13672, 1829, 31439, 2423, 591, 31701, 12399, 2423, 591, 31701, 29538, 3714, 16095, 3660, 12399, 36632, 11203, 10943, 3660, 24976, 591, 31701, 13672, 1829, 39896, 6225, 3555, 9640, 3660, 18871, 6055, 2288, 3794, 3555, 9307], "avg_logprob": -0.17170877849802058, "compression_ratio": 1.4230769230769231, "no_speech_prob": 2.384185791015625e-07, "words": [{"start": 550.72, "end": 551.6, "word": "طبعا", "probability": 0.9713134765625}, {"start": 551.6, "end": 552.24, "word": " أيضا", "probability": 0.90771484375}, {"start": 552.24, "end": 552.94, "word": " بيحدث", "probability": 0.936767578125}, {"start": 552.94, "end": 553.16, "word": " اللي", "probability": 0.84130859375}, {"start": 553.16, "end": 553.56, "word": " هو", "probability": 0.99365234375}, {"start": 553.56, "end": 553.86, "word": " ال", "probability": 0.9765625}, 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"probability": 0.6640625}], "temperature": 1.0}, {"id": 31, "seek": 76995, "start": 740.37, "end": 769.95, "text": "هذا طبيعي في حالة ان هو مصرق على ارتداء العدسة اللاصقة يعني لذلك انه دايما بينصح أخصائين البصريات يعني هذا according to American Academy لما انت بتصرفي العدسة اللاصقة لازم ان يكون معها ايش نضارة لهذا الموضوع انه اي ت infection عند المريض او اي ت complication نتيجة العدسات اللاصقة يعمل عملية استبدال لها بالنضارة", "tokens": [3224, 15730, 23032, 21292, 3615, 1829, 8978, 11331, 6027, 3660, 16472, 31439, 3714, 9381, 2288, 4587, 15844, 1975, 43500, 3215, 16606, 18863, 3215, 3794, 3660, 13672, 33546, 28671, 37495, 22653, 5296, 8848, 23275, 16472, 3224, 11778, 47302, 15042, 4724, 9957, 9381, 5016, 5551, 9778, 9381, 16373, 9957, 29739, 9381, 16572, 9307, 37495, 22653, 23758, 4650, 281, 2665, 11735, 5296, 15042, 16472, 2655, 39894, 9381, 28480, 1829, 18863, 3215, 3794, 3660, 13672, 33546, 28671, 5296, 31377, 2304, 16472, 7251, 30544, 20449, 11296, 1975, 1829, 8592, 8717, 11242, 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bacterial corneal infection سببها بكتيريا bacterial immunologic reaction ايضا ال main reason هو يعتبر بكتيريا", "tokens": [9566, 3555, 3615, 995, 6055, 5172, 995, 30241, 9307, 1975, 1829, 8592, 8032, 2655, 30544, 5296, 27842, 995, 27884, 25062, 2288, 7649, 10632, 1975, 2407, 12602, 3215, 6156, 30241, 5296, 6027, 3224, 9154, 995, 27884, 9154, 25062, 2288, 7649, 10632, 23032, 3555, 3615, 995, 29538, 8032, 2655, 30544, 4724, 4117, 2655, 13546, 25528, 8608, 3555, 3555, 11296, 2423, 696, 282, 392, 335, 897, 654, 8608, 3555, 3555, 11296, 6156, 1863, 7435, 47302, 1392, 1975, 15730, 43242, 8315, 2423, 35632, 1181, 716, 304, 11764, 8608, 3555, 3555, 11296, 4724, 4117, 2655, 13546, 25528, 35632, 13154, 36661, 5480, 1975, 1829, 11242, 995, 2423, 2135, 1778, 31439, 7251, 34268, 26890, 4724, 4117, 2655, 13546, 25528], "avg_logprob": -0.1671736662366749, "compression_ratio": 1.8027522935779816, "no_speech_prob": 0.0, "words": [{"start": 1253.02, "end": 1253.46, "word": "طبعا", "probability": 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2227.63, "word": " الشريحة", "probability": 0.98583984375}, {"start": 2227.63, "end": 2227.97, "word": " هذه", "probability": 0.7841796875}, {"start": 2227.97, "end": 2228.21, "word": " ان", "probability": 0.86328125}, {"start": 2228.21, "end": 2228.41, "word": " شاء", "probability": 0.99365234375}, {"start": 2228.41, "end": 2228.53, "word": " الله", "probability": 0.9658203125}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 2229.02275, "duration_after_vad": 2073.388749999991} \ No newline at end of file diff --git a/PL9fwy3NUQKwaRXaqd-S5-vsOEDL-Q45jU/NO131UJElEM.srt b/PL9fwy3NUQKwaRXaqd-S5-vsOEDL-Q45jU/NO131UJElEM.srt new file mode 100644 index 0000000000000000000000000000000000000000..e77874a183f4b19f9929a1069f860b5c20f1cfe2 --- /dev/null +++ b/PL9fwy3NUQKwaRXaqd-S5-vsOEDL-Q45jU/NO131UJElEM.srt @@ -0,0 +1,1919 @@ +1 +00:00:09,880 --> 00:00:14,520 +بسم الله الرحمن الرحيم اليوم هنكمل في اللي هو ال + +2 +00:00:14,520 --> 00:00:17,360 +residue theorem و كيف استخدام ال residue في حساب + +3 +00:00:17,360 --> 00:00:21,750 +التكامل فعنا كوشي الـ residue theorem بتقول لو في + +4 +00:00:21,750 --> 00:00:25,810 +أنا عندي دالة بدأ اعمل تكامل على closed curve C + +5 +00:00:25,810 --> 00:00:32,470 +الدالة أدلتك على ال C باستثناء عدد محدود من ال + +6 +00:00:32,470 --> 00:00:37,010 +singular points isolated singular points Z1, Z2, + +7 +00:00:38,030 --> 00:00:43,550 +Zn هدول ليهاش فيهم singular point isolated فبقول + +8 +00:00:43,550 --> 00:00:50,670 +أن التكامل على ال C F of Z دي z بيساوى 2πi + +9 +00:00:50,670 --> 00:00:59,650 +مجموعة residue k من واحد الى n residue عند zk كيف + +10 +00:00:59,650 --> 00:01:07,290 +of z عندما z تساوي zk فهذا هو كوشي ريزديو تيرام + +11 +00:01:07,290 --> 00:01:12,210 +كانت بهذه الصورة طبعا احنا عرفنا ال residue هي + +12 +00:01:12,210 --> 00:01:18,730 +عبارة عن مين؟ معامل z-zk أس سالب واحد هذه هي ال + +13 +00:01:18,730 --> 00:01:22,630 +residue وشوفت كيف بنستخدمها طبعا من ناحية نظرية + +14 +00:01:22,630 --> 00:01:27,730 +هذه نظرية قوية جدا وممكن نستخدمها لكن من ناحية + +15 +00:01:27,730 --> 00:01:31,030 +العملية إذا زاد عدد ال singular points بصير العملية + +16 +00:01:31,030 --> 00:01:34,180 +صعبة في الحساب أو طويلة في الحساب فبنشوف الآن في + +17 +00:01:34,180 --> 00:01:38,160 +صورة بديلة لو كان عدد ال singular point كبير في + +18 +00:01:38,160 --> 00:01:43,320 +طريقة بديلة ممكن نحسب التكامل بشكل مختصر أو بطريقة + +19 +00:01:43,320 --> 00:01:46,900 +أقصر من الطريقة هذه لو كان عدد ال singular point + +20 +00:01:46,900 --> 00:01:50,040 +كبير جوا ممكن نستبدل بالقانون اللي ورد under + +21 +00:01:50,040 --> 00:01:54,780 +infinity طبعا احنا لو شفنا احنا بالنسبة لل residue + +22 +00:01:56,320 --> 00:01:58,660 +بشكل عام احنا مش هندخل في التفاصيل كتير في ال + +23 +00:01:58,660 --> 00:02:02,800 +residue على ال infinity ولكن بس كفكرة طبعا احنا ال + +24 +00:02:02,800 --> 00:02:10,680 +residue z تساوي z أي كان z زيرو لل F of Z تعريفه + +25 +00:02:10,680 --> 00:02:13,800 +هو 1/2πi هذا المعامل هو هذا ال residue + +26 +00:02:13,800 --> 00:02:19,380 +وهذا المقدار هو عبارة عن مين 2πi تكامل على + +27 +00:02:19,380 --> 00:02:24,340 +منحنى C هذا أي closed curve في الدالة الكلاناتيك + +28 +00:02:24,340 --> 00:02:29,560 +في منطقة معينة دي z طبعا أنا فيها عندي z زيرو + +29 +00:02:29,560 --> 00:02:34,900 +هنا فيها مشكلة وبعمل اللي هو الدالة Expansion + +30 +00:02:34,900 --> 00:02:38,300 +حوالين z0 و بختار المنحنى c بهذا الشكل و باعيث أن + +31 +00:02:38,300 --> 00:02:39,940 +يكون فيها ان دي اللي هو الexpansion هذه الصورة + +32 +00:02:39,940 --> 00:02:45,000 +العامة ممكن تعميم هذا الكلام وتعريف ال residue عند + +33 +00:02:45,000 --> 00:02:48,860 +ال infinity تعريف ال residue عند ال infinity بشكل + +34 +00:02:48,860 --> 00:02:52,700 +مشابه ال residue عند ال infinity ممكن تتعرف بشكل + +35 +00:02:52,700 --> 00:02:58,580 +مشابه هذه ال residue عند ال infinity اللي هي علاقة + +36 +00:02:58,580 --> 00:03:01,400 +مع بقية ال residue اللي هي جميل من النقاط الأخرى + +37 +00:03:02,150 --> 00:03:05,770 +ممكن أنا أدرس ال Z النقطة عند ال infinity و هي ك + +38 +00:03:05,770 --> 00:03:10,090 +singular point و أعرف ال residue عندها و هيكون + +39 +00:03:10,090 --> 00:03:13,870 +التعريف طبعا هنا في هذه الحالة ال residue and Z + +40 +00:03:13,870 --> 00:03:18,290 +تساوي ال infinity لل F of Z هيكون عبارة عن 2πi + +41 +00:03:18,290 --> 00:03:22,610 +تكامل على منحنى من نقطة آخر هيسميها C + +42 +00:03:22,610 --> 00:03:27,390 +infinity منحنى F of Z دي z هذا المنحنى بدي يكون + +43 +00:03:27,390 --> 00:03:34,070 +منحنى تكون تدالة بشكل معين حوالي .. في نظر تبع ال + +44 +00:03:34,070 --> 00:03:38,770 +infinity بدي يكون منحنى كبير دائرة أوي خارجي في + +45 +00:03:38,770 --> 00:03:41,820 +جوار ال infinity .. في جوار ال infinity فأنا الآن + +46 +00:03:41,820 --> 00:03:46,060 +عشان أنا أحسب هذا التكامل لو أنا صارت عند النقطة + +47 +00:03:46,060 --> 00:03:48,640 +النقطة أنا ايه؟ خلّيني أفترض أن هذا صار C infinity + +48 +00:03:48,640 --> 00:03:52,620 +و هذا في جوار الملة نهائية closed إذا كانت ال + +49 +00:03:52,620 --> 00:03:55,240 +singular point كلهم جوا و مافيش ولا نقطة خارج ال C + +50 +00:03:55,240 --> 00:03:58,620 +infinity هذا الكلام فأنا الآن بقدر أطبق عليه فبقدر + +51 +00:03:58,620 --> 00:04:02,020 +أحسب التكامل هذا من وين؟ من هذه العلاقة من هذه + +52 +00:04:02,020 --> 00:04:05,140 +العلاقة فمرة أخرى لو أنا C infinity في هذه الصورة + +53 +00:04:05,140 --> 00:04:08,480 +فإيش صار هذا الكلام؟ هذا الكلام بيبقى إيش بيساوي؟ + +54 +00:04:08,480 --> 00:04:14,420 +بديساوي التكامل عبارة عن التكامل في 2πi من + +55 +00:04:14,420 --> 00:04:17,280 +غير 2πi من غير واحد على 2πi واحدة + +56 +00:04:17,280 --> 00:04:21,880 +على 2πi واحدة على 2πi صحيح 2πi + +57 +00:04:21,880 --> 00:04:25,260 +فبتصير هذا الكلمة نظرا عن واحد على 2πi + +58 +00:04:25,260 --> 00:04:29,300 +في مين انطبق هذا القانون بيصير في 2πi + +59 +00:04:29,300 --> 00:04:38,640 +مجموعة ال residue residue Z تساوي Zk F of Z وk من + +60 +00:04:38,640 --> 00:04:45,090 +واحد لأن طبعا هتروح مع بعض هذا الكلام ممكن أن + +61 +00:04:45,090 --> 00:04:47,150 +أبدل في هذا المقدار هو يساوي ال residue عند ال + +62 +00:04:47,150 --> 00:04:50,190 +infinity فصار أنا ممكن أبدل كل ال residue دول فيه + +63 +00:04:50,190 --> 00:04:55,730 +في ال residue عند ال infinity وتساوي 2πi ال + +64 +00:04:55,730 --> 00:05:00,690 +residue لمن لل F of Z عندها من Z تساوي ال infinity + +65 +00:05:00,690 --> 00:05:03,570 +فممكن أن أستبدل كل ال residue دول بال residue عند + +66 +00:05:03,570 --> 00:05:06,300 +ال infinity بال residue عند ال infinity فأنا بأحسب + +67 +00:05:06,300 --> 00:05:09,320 +ال residue واحدة بين المحسبين اللي هو عدد محدود + +68 +00:05:09,320 --> 00:05:12,480 +خمسة عشرة جد ما كان طب كيف نحسب ال residue عند ال + +69 +00:05:12,480 --> 00:05:15,400 +infinity طبعا بتعريف هذا لو عملنا change of + +70 +00:05:15,400 --> 00:05:19,260 +variables ال residual طبعا هذه طريقة دائما معروفة + +71 +00:05:19,260 --> 00:05:23,200 +أنا عشان أدرس ال infinity z تساوي ال infinity إيش + +72 +00:05:23,200 --> 00:05:27,500 +متقابل لو عملنا اللي هو إيش اللي هو واحد على w + +73 +00:05:27,500 --> 00:05:34,660 +نعمل له z تساوي واحد على w ماذا يعني؟ الوضع الوضع + +74 +00:05:34,660 --> 00:05:40,200 +الوضع + +75 +00:05:40,200 --> 00:05:52,260 +الوضع الوضع الوضع + +76 +00:05:52,260 --> 00:05:55,380 +الوضع + +77 +00:05:55,380 --> 00:05:58,040 +الوضع الوضع الوضع الوضع الوضع الوضع الوضع الوضع + +78 +00:05:58,040 --> 00:05:59,140 +الوضع الوضع الوضع الوضع الوضع الوضع الوضع الوسالة + +79 +00:05:59,140 --> 00:06:02,460 +واحد على w تربيع dw فبتيجي منها طبعا الإشارة بده شوية + +80 +00:06:02,460 --> 00:06:07,060 +ترتيب في اتجاهات المنحرية فمن هنا القانون فإذا أنا + +81 +00:06:07,060 --> 00:06:11,720 +بقدر أستبدل كل ال residue دولة العدد ب residue + +82 +00:06:11,720 --> 00:06:14,920 +واحدة هي اللي عندنا الفاتر اللي هي حساب عيش + +83 +00:06:14,920 --> 00:06:18,460 +residue Z تساوي Zero باش نبدأ لأ وإنما واحد على + +84 +00:06:18,460 --> 00:06:23,430 +z تربيع f طبعا ده مش شرط بس فيها شروط مهمة + +85 +00:06:23,430 --> 00:06:26,070 +عشان تطبق هذه النظرية إيش بيقول ليه ال C positively + +86 +00:06:26,070 --> 00:06:28,670 +oriented ده ليش تقع وبعدين close طبعا كل النظرية + +87 +00:06:28,670 --> 00:06:31,730 +كلها على close طيب ال F is analytical everywhere + +88 +00:06:31,730 --> 00:06:35,750 +in the finite plane except for a finite number of + +89 +00:06:35,750 --> 00:06:38,410 +singular point analytical everywhere مع ده عدد + +90 +00:06:38,410 --> 00:06:42,110 +محدود من نقاط كلهم U و C مايقعدش يكون برا اي حاجة + +91 +00:06:52,230 --> 00:06:56,890 +هذه النظرية بديلة لإن أنا عندي عدد كبير من ال + +92 +00:06:56,890 --> 00:06:59,730 +Residue و بدل أن أحسبهم ثلاثة أو أربعة بأحسب + +93 +00:06:59,730 --> 00:07:03,730 +Residue واحدة فهذه النظرية + +94 +00:07:09,690 --> 00:07:13,650 +صحيحة بقصد تغير اتجاه فالنظرية هذا تقل وعندما ياش + +95 +00:07:13,650 --> 00:07:17,750 +counter clockwise لما بتتغير اتجاه تضرب سالب واحد + +96 +00:07:17,750 --> 00:07:20,610 +فأنت مازال عارف واحدة فيهم اتجاه اتجاه التاني + +97 +00:07:20,610 --> 00:07:26,430 +تضربي سالب واحد نشوف مثال أسباب المثال لو أخذنا + +98 +00:07:26,430 --> 00:07:29,870 +الدال اللي اللي أمامكوا فيها three singular points + +99 +00:07:29,870 --> 00:07:34,950 +فيها three singular points و كلهم يقعوا جوا + +100 +00:07:34,950 --> 00:07:35,490 +المنحنى + +101 +00:07:38,640 --> 00:07:45,800 +فعندنا هذا المثال ال F of Z تساوي واحد على Z ناقص + +102 +00:07:45,800 --> 00:07:49,760 +واحد في Z تربيع زائد واحد وعندنا اللي هو طيب ماشي + +103 +00:07:49,760 --> 00:07:58,440 +فهذه ايه انالتك for all Z ما هذا mean الواحد وال i + +104 +00:07:58,440 --> 00:08:03,780 +والسالب i وزاد أو ناقص i ثلاث نقاط والنقاط كلهم + +105 +00:08:03,780 --> 00:08:07,740 +يقعوا جوا الدائرة الدائرة المطلقة تساوي 2 نسخة + +106 +00:08:07,740 --> 00:08:15,620 +درة تساوي 2 فهنا the singular point اللي + +107 +00:08:15,620 --> 00:08:22,060 +هم الواحد وزاد أو ناقص i ايه كلهم R inside ال C + +108 +00:08:22,280 --> 00:08:28,260 +اللي هي مين؟ مطلق Z تساوي 2 إذا حبينا نرسم، نوضح، + +109 +00:08:28,260 --> 00:08:31,920 +فالناس في القطب بديوا يساوي 2 تقريبا هذه هي الـC + +110 +00:08:31,920 --> 00:08:39,860 +وعندنا مين هم؟ الواحد الواحد هنا و ال i هنا و السالب + +111 +00:08:39,860 --> 00:08:44,020 +i هنا فطبعا هذه نقطة سالب 2، هذه نقطة 2، وهذه 2i و + +112 +00:08:44,020 --> 00:08:45,760 +تحت سالب 2i + +113 +00:08:57,110 --> 00:09:00,170 +النظرية الجديدة ممكن استخدام المدونة لجلب نظرية + +114 +00:09:00,170 --> 00:09:03,270 +واحدة عند ال infinity اللي هي من القانون الجديد + +115 +00:09:03,270 --> 00:09:08,850 +فالآن طبقا للنظرية التكامل ممكن نحسبه بطريقتين + +116 +00:09:09,430 --> 00:09:15,510 +فالآن تكامل على ال C لل F of Z دي Z يبدو يسوى 2πi + +117 +00:09:15,510 --> 00:09:21,830 +مجموعة ال 3 Residue Residue Z تسوى واحد F of Z + +118 +00:09:21,830 --> 00:09:29,710 +زائد Residue Z تسوى i لل F of Z زائد Residue Z تسوى + +119 +00:09:29,710 --> 00:09:36,880 +سالب i F of Z هذه طريقة احسب 3 Residue أو 2πi + +120 +00:09:36,880 --> 00:09:42,580 +أي ريزيديو z تساوي z ولا مين واحد على z تربيع + +121 +00:09:42,580 --> 00:09:48,540 +F واحد على z فأنت عندك طرق ثاني طبعا الطريق القديم + +122 +00:09:48,540 --> 00:09:51,780 +مش هنعملها احنا هنشتغل على هذا الطريق هنشتغل على + +123 +00:09:51,780 --> 00:09:54,700 +هذا الطريق فاحنا عايزين نحسب ريزيديو لواحد على z + +124 +00:09:54,700 --> 00:10:00,180 +تربيع F of واحد على z فنبدأ نشتر عليها ده الكلام + +125 +00:10:00,180 --> 00:10:05,620 +هي ال F of Z فإن واحد على z تربيع F of واحد على + +126 +00:10:05,620 --> 00:10:10,380 +z بتساوي واحد على z تربيع بنبدل ال z بواحد على z + +127 +00:10:10,380 --> 00:10:16,260 +بتصير واحد على واحد على z ناقص واحد في واحد على + +128 +00:10:16,260 --> 00:10:21,760 +z تربيع زائد واحد فبنبدل z بواحدة ل z إن ربط + +129 +00:10:21,760 --> 00:10:26,440 +بالأمر واتو ساوي لو دخلنا z تربيع جوا هنا بيصير + +130 +00:10:26,440 --> 00:10:30,700 +واحد على هذا أول شي واحد ناقص z على z الكسر الأول + +131 +00:10:30,700 --> 00:10:34,120 +و z تربيع تصير هنا بيصير مين واحد زائد z تربيع + +132 +00:10:34,120 --> 00:10:38,880 +اضرب z تربيع هنا ببسط هذا المقدار وهي أنا عايش + +133 +00:10:38,880 --> 00:10:42,920 +أو واحد طبعا مقام المقام بيطلع في البسط فالمقدار + +134 +00:10:42,920 --> 00:10:50,440 +سالب z على z ناقص واحد في z تربيع زائد واحد فهذه + +135 +00:10:50,440 --> 00:10:56,140 +هي الواحد على z تربيع F واحد على z فببنا ال + +136 +00:10:56,140 --> 00:11:02,900 +residual هذي عند الصفة بدنا نعمل expansion لهذه + +137 +00:11:02,900 --> 00:11:09,580 +الدالة اللي هو ال domain 0 أقل من مطلخ z أقل من r + +138 +00:11:09,580 --> 00:11:16,440 +معين أقل من r معين فاحنا عشان نحسب ال residue عشان + +139 +00:11:16,440 --> 00:11:21,840 +نحسب residue z تساوي 0 1 على z تربيع f of z أو 1 + +140 +00:11:21,840 --> 00:11:27,760 +على z as if هي عبارة عن z أس سالب واحد مظبوط وهذه كيف + +141 +00:11:27,760 --> 00:11:32,500 +بتحسبها بدي أحسب أكتب f of z على صورة summation مش + +142 +00:11:32,500 --> 00:11:36,180 +إيه أهمية هذه الدالة؟ خلينا نسميها ممكن اللي هو واحد + +143 +00:11:36,180 --> 00:11:39,280 +على z تربيع ممكن نسميها u of z بدنا نكتبها + +144 +00:11:39,280 --> 00:11:42,360 +summation من سالب infinity ل infinity اللي هو يعني + +145 +00:11:42,360 --> 00:11:47,260 +cn z أس n ايش ال domain؟ Zero أقل من مطلق z أقل من + +146 +00:11:47,260 --> 00:11:52,240 +R معين من ال R هنا 2 ليش هنعمل experiment؟ + +147 +00:11:52,240 --> 00:11:55,020 +أولا الـ zero و أول مشكلة بتقبلنا عند الواحد و ده + +148 +00:11:55,020 --> 00:11:58,580 +إيه؟ واحد، أقل من واحد، أقل من واحد، هذا ال domain + +149 +00:11:58,580 --> 00:12:03,840 +اللي بدناها، طبقا للتعريف طبعا احنا ممكن نحسب هذا + +150 +00:12:03,840 --> 00:12:07,340 +الكلام و نروح نعمل expansion لهدول ال series مع + +151 +00:12:07,340 --> 00:12:13,480 +بعض قدامك قدّ خيارات طبعا ال bus جاهز يعمل partial + +152 +00:12:13,480 --> 00:12:16,480 +fraction للمقارنة مدى طريقة أو تعمل كل واحد لحالة + +153 +00:12:16,480 --> 00:12:19,160 +تضربهم في بعض أنت مش معني تجيب الصيغة العامة أنت + +154 +00:12:19,160 --> 00:12:23,840 +معني معامل مين z أس -1 هاي طريقتين في طريقة + +155 +00:12:23,840 --> 00:12:29,520 +ثالثة مختصرة جدا لاحظ أن الدالة analytic عند ال + +156 +00:12:29,520 --> 00:12:33,340 +zero الدالة لو طلعت على ال domain هنا الدالة + +157 +00:12:33,340 --> 00:12:35,120 +analytic عند ال zero فانا لو عملت ال expression + +158 +00:12:35,120 --> 00:12:38,560 +حول ال zero ايش لازم تكون؟ Taylor series أتكون Taylor + +159 +00:12:38,560 --> 00:12:41,960 +series اسمه ناتو إن معامل z أس -1 بيساوي صفر اه + +160 +00:12:41,960 --> 00:12:47,860 +فهنا 1 على z تربيع، f of 1 على z is analytic + +161 +00:12:47,860 --> 00:12:56,450 +at z تساوي zero هذا implies ان ال residue عندما z + +162 +00:12:56,450 --> 00:13:00,430 +تساوي صفر لـ 1 على z تربيع f of 1 على z تساوي + +163 +00:13:00,430 --> 00:13:04,770 +صفر وبالتالي التكامل بيساوي صفر بكل سهولة thus + +164 +00:13:04,770 --> 00:13:10,790 +تكامل على c لل f of z دي z بدي يساوي صفر بعد ان + +165 +00:13:10,790 --> 00:13:13,350 +احسب تلت residue اجمعه هنطلع المجموع صفر بكل سهولة + +166 +00:13:13,350 --> 00:13:19,160 +بقدر اجيبه بكل سهولة أي سؤال طبعا مش ده .. مش ده + +167 +00:13:19,160 --> 00:13:24,060 +مهم يطلع صفر لكن في هذه المرة طلع معانا صفر اي + +168 +00:13:24,060 --> 00:13:28,720 +سؤال أنا أدرس عند زينا بس كانت قناة دي كانت مبريحة + +169 +00:13:28,720 --> 00:13:30,740 +خلاص خلاص ما بيني الحساب أنا أديك هنا فيها حساب + +170 +00:13:30,740 --> 00:13:38,500 +ثاني طبعا احنا بنحول بعد الشكل تمام + +171 +00:13:38,500 --> 00:13:45,300 +لسه ما فيش أسئلة سكاشة مترابطة الـ Section 55 The + +172 +00:13:45,300 --> 00:13:51,640 +Three Types of Isolated Singular Points في هذا الـ + +173 +00:13:51,640 --> 00:13:58,120 +Section هندرس تصنيف للـ Singular Points هندرس + +174 +00:13:58,120 --> 00:14:05,980 +تصنيف للـ Singular Points معظم + +175 +00:14:05,980 --> 00:14:08,300 +شرحنا معظم المواضيع يا شباب احنا بندور حوالين + +176 +00:14:08,300 --> 00:14:16,430 +النقطة التالية في أن احنا نقطة Z0 وبناخد domain + +177 +00:14:16,430 --> 00:14:22,810 +حوالها أو قرص حولها هذا نصف القطر يكون R وبناخد + +178 +00:14:22,810 --> 00:14:32,440 +المنطقة هذه Z-Z0 أقل من R إذا كانت ال Z0 هذه نقطة + +179 +00:14:32,440 --> 00:14:36,160 +عادية زي ما توي شفنا فالـ Dialogical في كل القرص + +180 +00:14:36,160 --> 00:14:39,680 +وبدأ اعمل أنا أو ال expansion اللي قدريش بيصير + +181 +00:14:39,680 --> 00:14:43,580 +Taylor Series فلو ال Dialogical عند ال Z0 في القرص + +182 +00:14:43,580 --> 00:14:47,440 +اللي حواليها فهي عندي إيش؟ Taylor Series فال F of Z + +183 +00:14:47,440 --> 00:14:52,340 +بتبدأ تساوي summation من 0 إلى مالانهاية من اللي هو + +184 +00:14:52,340 --> 00:14:57,110 +إيش Cn خليني أقول Z أس n لو كانت هذه التي كانت طيب + +185 +00:14:57,110 --> 00:15:00,870 +احنا بنحاول ندرس ال singular point لو كانت Z + +186 +00:15:00,870 --> 00:15:03,810 +singular point ببطل أدرسها عن كل نقطة بدها + +187 +00:15:03,810 --> 00:15:08,030 +stiffness Z بتساوي 0 مظبوط singular point فبيصير + +188 +00:15:08,030 --> 00:15:11,590 +عندي annular domain و بتحدث عن من عن Laurent + +189 +00:15:11,590 --> 00:15:14,430 +series هذه لو كانت أنا اللي تكلفها ال Taylor + +190 +00:15:14,430 --> 00:15:20,350 +series فLaurent series هتصير إيش summation F of Z + +191 +00:15:20,350 --> 00:15:25,070 +من سالب infinity ل infinity CN أي طبعا Z معقز Z + +192 +00:15:25,070 --> 00:15:28,910 +Zero هو النقطة طبعا احنا عند الصفر و لكن بشكل عام + +193 +00:15:28,910 --> 00:15:36,250 +لكل أس n و بنعمل expansion طبعا الاختلاف الأساسي + +194 +00:15:36,250 --> 00:15:40,350 +بين هذه وبين هذه الشوة .. ظهور الأسس السالبة .. + +195 +00:15:40,350 --> 00:15:45,290 +صحيح؟ صحيح طيب احنا هنا لو رجعنا لأمثلة شباب .. + +196 +00:15:45,290 --> 00:15:49,050 +بنلاحظ أنه في أحيان كثيرة الأسس السالبة دي مش كلها + +197 +00:15:49,050 --> 00:15:52,390 +بتوصل للسالب من النهاية .. مرة بيكون عندي حد بقى + +198 +00:15:52,390 --> 00:15:55,150 +واحد و كثير من الأمثلة .. حد اين عشر أبوك يكون + +199 +00:15:55,150 --> 00:15:59,990 +توصل للسالب من النهاية .. اه هلجيت دديش هادي بعيد + +200 +00:15:59,990 --> 00:16:04,240 +عن هادي إيش بيكون البعد فيها؟ ممكن نقصه بياش بعدد + +201 +00:16:04,240 --> 00:16:07,680 +الأسس السالبة تلاقيت الفرق من هده و من هده جديش + +202 +00:16:07,680 --> 00:16:10,980 +فيه عدد أسس سالب فإذا عدد الأسس السالب ده بلعب + +203 +00:16:10,980 --> 00:16:14,620 +دور أساسي في التمييز بين ال singular point و هذا + +204 +00:16:14,620 --> 00:16:18,360 +اللي احنا على تبدو لو كانت ما فيش ولا .. ولا .. ولا + +205 +00:16:18,360 --> 00:16:22,120 +term سالب بتكون التقرة ده لا إشمالها تقريبا ألالتك + +206 +00:16:22,120 --> 00:16:26,440 +أو ألالتك ممكن تكون إلا إذا كان في نقطة تانية طب + +207 +00:16:26,440 --> 00:16:30,110 +لو في عدد محدود هذه النوع بيكون ممكن تتعامل مع + +208 +00:16:30,110 --> 00:16:33,430 +مشكلة معينة مختلفة طب لو كان في عدد إلى ما لانهاية + +209 +00:16:33,430 --> 00:16:36,590 +بيكون فيه نوع مختلف بيكون إيش كأنه ال singular + +210 +00:16:36,590 --> 00:16:39,310 +point إشفاله أصعب أو في عمق في ال singular point + +211 +00:16:39,310 --> 00:16:42,710 +فهذه النقطة احنا اللي هندرسه فاعتماد على الأسس + +212 +00:16:42,710 --> 00:16:46,250 +السالب ده هنصنف ال singular point هنصنفهم إلى تلت + +213 +00:16:46,250 --> 00:16:50,650 +أنواع أول نوع ما فيش بيختفي اللي هو الأسس السالب + +214 +00:16:50,650 --> 00:16:53,780 +إشفاله أسس سالبة في النوع الثاني فيه عدد محدود من + +215 +00:16:53,780 --> 00:16:59,140 +الأسس السالبة فينات خمسة، عشرة، مية محدود أو فيه + +216 +00:16:59,140 --> 00:17:02,740 +مادة نهائية من الأسس السالب فده هي تلت أصناف + +217 +00:17:02,740 --> 00:17:05,440 +هنسميها .. هنعمل تلت أنواع من ال singular point + +218 +00:17:05,440 --> 00:17:09,400 +تبعا لجزء عدد السالب اللي هو بيميز ال singular + +219 +00:17:09,400 --> 00:17:12,280 +point عن من؟ عن ال ordinary point، عن النقطة + +220 +00:17:12,280 --> 00:17:17,440 +العادية فطبعا زي ما قلنا من الملعب الدور الأساسي + +221 +00:17:17,440 --> 00:17:20,100 +الأسس السالبة الأسس السالبة ممكن أنا أجسمها + +222 +00:17:20,100 --> 00:17:25,100 +طبعا بأجسمها لنوعين في عندنا من سالب ما له نهاية + +223 +00:17:25,100 --> 00:17:29,680 +لسالب واحد CN Z ناقص Z Zero لكل أس n ده هو المعنى + +224 +00:17:29,680 --> 00:17:34,000 +في هنا زائد ال Taylor series من Zero إلى مالانهاية يزرق + +225 +00:17:34,000 --> 00:17:38,220 +العادي Z ناقص Z Zero لكل أس n فهذا ال term عشان هو + +226 +00:17:38,220 --> 00:17:43,730 +الملعب الدور الأساسي زي ما شرحنا في قبل قليل هنسميه + +227 +00:17:43,730 --> 00:17:47,250 +ال principle part بنسميه الجزء الأساسي ال + +228 +00:17:47,250 --> 00:17:50,890 +principle part لأن زي ما قلنا هو ادلش الفرق بين ال + +229 +00:17:50,890 --> 00:17:54,150 +psi Taylor series و بين ال Laurent series فأنت بسميه ال + +230 +00:17:54,150 --> 00:17:59,230 +principle part طبعا زي في حالة اللي هو ال residue + +231 +00:17:59,230 --> 00:18:02,630 +أنا مزال بدي أدرس النقطة لازم أعمل Laurent series + +232 +00:18:02,630 --> 00:18:11,420 +وين؟ في domain 0 أقل من مطلق z ناقص z0 أقل من R + +233 +00:18:11,420 --> 00:18:17,800 +طبعا أنا أناقي z0 أقل من R هذا ال domain اللي هو + +234 +00:18:17,800 --> 00:18:21,160 +تبقى وجود تحت مظبوط هو عدد domain المطلوب لأن لو + +235 +00:18:21,160 --> 00:18:24,340 +أعمل في domain آخر بيبطل ال DNA ال Z بيبطل ال DNA + +236 +00:18:24,340 --> 00:18:27,100 +الصفات بتاعت ال Z0 فسنحن بقى عاملوا حقيقة + +237 +00:18:27,100 --> 00:18:29,200 +expansion حوالي الملايين و ليش حوالي ال Z بتساوي + +238 +00:18:29,200 --> 00:18:32,220 +Zero فانا عشان أشتغل و أدرس Z بتساوي Zero و ال Z و + +239 +00:18:32,220 --> 00:18:34,740 +عن Z بتساوي Zero هتبقى ال domain بهذه الصورة ال + +240 +00:18:34,740 --> 00:18:37,820 +domain بهذه الصورة فزي ما حكينا هذا اللي بقى + +241 +00:18:37,820 --> 00:18:42,920 +هنسميه ال principle part فهي التعريف let z0 be an + +242 +00:18:42,920 --> 00:18:45,400 +isolated singular point إذا ما أقدر أتحدث عن + +243 +00:18:45,400 --> 00:18:49,360 +domain بهذه الصورة وعملت Taylor series ف ال term + +244 +00:18:49,360 --> 00:18:54,880 +the portion هذا ال term يسميه principle part of f + +245 +00:18:54,880 --> 00:18:59,440 +at z0 is called the principle part of f at z0 طبعا + +246 +00:18:59,440 --> 00:19:02,360 +بدي أعمل expansion في domain زي هذا الكلام واحد من + +247 +00:19:02,360 --> 00:19:05,360 +كل الحدود اللي فيها السلسلة طبعا السقبة دايما مش + +248 +00:19:05,360 --> 00:19:07,580 +هي الأساس عشان هي .. ب .. ب .. ب .. ب .. ب .. ب .. + +249 +00:19:08,820 --> 00:19:11,160 +بيّعرفها، بيفسّرها إيش بتاعي، لأن ال sigma ممكن + +250 +00:19:11,160 --> 00:19:13,460 +تخدعنا زي ما كون جميع الأمثلة، يعني إيش بقول وإيش + +251 +00:19:13,460 --> 00:19:17,560 +بقول involving negative powers of Z-Z0، هذا هو + +252 +00:19:17,560 --> 00:19:20,260 +الأساس، طبعا أتوقع في الطباعة فيها أخطاء شباب، + +253 +00:19:20,260 --> 00:19:23,760 +انتبهوا، أظن الآن ساقطة من الطباعة، زي اللي عندهم + +254 +00:19:23,760 --> 00:19:26,200 +المحاضرات، الآن ساقطة من الطباعة، انتبهوا، لازم + +255 +00:19:26,200 --> 00:19:29,640 +ساقطة، انتبهوا اه إذا ساقطة من الطباعة تنتبهوله + +256 +00:19:29,640 --> 00:19:32,700 +فهذا مسمى ال principle بقى فهذا هو تفسيره بهذا + +257 +00:19:32,700 --> 00:19:35,660 +الشكل حتى لو ال sigma خدعتنا ما كانش صعبة بهذا + +258 +00:19:35,660 --> 00:19:38,160 +الشكل ننتبه ماشي بيعني هذا الكلام لأن ال sigma + +259 +00:19:38,160 --> 00:19:41,740 +مجرد رمز وحقيقه تمين جميع الحدود اللي فيها الأسس + +260 +00:19:41,740 --> 00:19:48,140 +السالبة خلينا نشوف بعض الأمثلة العملية عشان نثبت + +261 +00:19:48,140 --> 00:19:56,450 +هذا المفهوم نثبت هذا المفهوم اه فعنا الدالة F of Z + +262 +00:19:56,450 --> 00:20:02,330 +تساوي واحد على Z ناقص واحد لكل تربيع في Z زائد + +263 +00:20:02,330 --> 00:20:07,150 +واحد ايش بده؟ بده ال principle part عندما Z تساوي + +264 +00:20:07,150 --> 00:20:15,800 +واحد بدنا ال principle part of Fز تساوي واحد كيف + +265 +00:20:15,800 --> 00:20:21,280 +بدنا نحسب يا شباب طبقا للتعريف لازم اروح اكتب f of + +266 +00:20:21,280 --> 00:20:25,640 +z على صورة Laurent series من سالب infinity لانفينيتي + +267 +00:20:25,640 --> 00:20:32,100 +ال cn بدلالة 8زد ناقص واحد لكل أس n هيك لازم يكون + +268 +00:20:32,100 --> 00:20:39,500 +وإن هذا الكلام إن Zero أقل من مطلق Z أقل من R معين + +269 +00:20:39,500 --> 00:20:43,740 +أقل من R معين هذا المقبض مقدر اجيبه بس هذا المهم + +270 +00:20:43,740 --> 00:20:47,820 +يكون Zero أقل من زد ناقص حوالين ال Z بتساوي واحد + +271 +00:20:47,820 --> 00:20:52,400 +في دائرة حوالين Z بتساوي واحد طيب ممكن تلاقي ال R + +272 +00:20:52,400 --> 00:20:56,800 +هذه بسهولة نعم اطلع على الدالة وإن analytic + +273 +00:20:56,800 --> 00:21:01,000 +everywhere معناه واحد أساسي واحدانا عندي انات + +274 +00:21:01,000 --> 00:21:03,820 +كالمقادة عند الواحد في مشكلة اللي بدياها وفي عندي + +275 +00:21:03,820 --> 00:21:07,540 +السالب واحد فانا بدي اعمل دائرة تستصراعش بدي اعمل + +276 +00:21:07,540 --> 00:21:09,640 +دائرة عليها الواحد وين نفس القطر اللي بدي + +277 +00:21:09,640 --> 00:21:12,000 +قابلناه؟ هنا فالنفس القطر اللي بدي يكون بهذا الشكل + +278 +00:21:12,000 --> 00:21:16,320 +جديش نفس القطر هنا؟ 2 أقل من 2 المسافة + +279 +00:21:16,320 --> 00:21:18,980 +بين ال singular point اللي بشغل عليها و أول + +280 +00:21:18,980 --> 00:21:21,980 +singular point تانية بتقبلنا لأن الواحد هو المركز + +281 +00:21:21,980 --> 00:21:25,060 +الواحد هو المركز طب وين بده يمتد؟ لعندي السالب + +282 +00:21:25,060 --> 00:21:27,540 +واحد اللي بدهاش يتقطع جديش المسافة من هالهان؟ + +283 +00:21:27,540 --> 00:21:30,290 +اثنين طبعا هتطلع معاها بالتأكيد بس أنا ماقدرتش + +284 +00:21:30,290 --> 00:21:33,250 +أشتغل عليها فلازم أعمل expansion بعد الشكل وبعد + +285 +00:21:33,250 --> 00:21:36,270 +ما أعمل expansion إيش بدي أخد الجزر اللي فيه مين + +286 +00:21:36,270 --> 00:21:39,990 +الأسس السالبة بقى زي بنقص واحد بأسس السالبة فهذا هو + +287 +00:21:39,990 --> 00:21:43,870 +السواقط فطبعا كل ما تشتغل فينا عدة موضوع بتتحول + +288 +00:21:43,870 --> 00:21:47,450 +تتنحضر حول ال مين ال law and series منها بقدر أجيب + +289 +00:21:47,450 --> 00:21:50,090 +ال residue ومن هنا مين هيش ال principle part اللي + +290 +00:21:50,090 --> 00:21:52,810 +هيدخل في تصنيف ال singular points + +291 +00:21:56,110 --> 00:22:00,510 +فإذا هذه معارض ال learn series أصبحت تدخل في عدة + +292 +00:22:00,510 --> 00:22:05,830 +مواضيع فيعني اللي هاهم بيه ماشي نهجر ال F نكتبها + +293 +00:22:05,830 --> 00:22:11,630 +حوالين مين؟ Z-1 نحللها Z-1 لكل تربيع في المقام + +294 +00:22:11,630 --> 00:22:14,730 +يعني جاهزة يعني هي عبارة عن Z-1 أسلب اثنين ما فيش + +295 +00:22:14,730 --> 00:22:17,570 +فيها مشاكل الشغل كله على مين؟ على واحد على Z زائد + +296 +00:22:17,570 --> 00:22:21,690 +واحد فنبدأ نشتغل على Z في Z زائد واحد طبعا نترك + +297 +00:22:21,690 --> 00:22:24,550 +المشهور Z-1 زائد اثنين بالصفر + +298 +00:22:30,540 --> 00:22:36,220 +ممكن آخذ اثنين عام المشترك نجرب اه ناخذ اثنين عام + +299 +00:22:36,220 --> 00:22:42,700 +المشترك نشوف فواحد على اثنين بيصير واحد زائد زد + +300 +00:22:42,700 --> 00:22:47,510 +ناقص واحد على اثنين بهذا الشكل ولو عملنا expansion + +301 +00:22:47,510 --> 00:22:50,490 +هتصير أقل من واحد أقل من اثنين هي المطلوبة لأن هي + +302 +00:22:50,490 --> 00:22:52,990 +لابد أن تكون إيش أقل من اثنين اه لو ما زبطتش + +303 +00:22:52,990 --> 00:22:56,130 +هتاخد من وين العكس زد ناقص واحد على المشترك فالآن هذه + +304 +00:22:56,130 --> 00:23:00,590 +جاهزة وتساوي نصف هذه بيصير سالب السالب إذا + +305 +00:23:00,590 --> 00:23:06,210 +summation من صفر لما لا نهاية سالب واحد قس N زد + +306 +00:23:06,210 --> 00:23:11,050 +ناقص واحد على اثنين الكل قس N طبعا أنا بأختصر الآن + +307 +00:23:11,050 --> 00:23:14,210 +هي المفروض تكتبها سالب سالب أو سالب واحد إذا أنا + +308 +00:23:14,210 --> 00:23:18,710 +بتطلع برا أو كتبوها سالب أو سالب واحد ناقص زد إذا + +309 +00:23:18,710 --> 00:23:22,270 +حبيت بأي طريقة من الطريقة واضح؟ واضح هذه الخطوة + +310 +00:23:22,270 --> 00:23:25,750 +ولا أوضح؟ واضحة تمام خلاص الرفتر طبعا هذا تحت + +311 +00:23:25,750 --> 00:23:29,230 +الشروط أنه مين؟ زد ناقص واحد اثنين أقل من واحد + +312 +00:23:29,230 --> 00:23:31,730 +بالسالب أو بالموديلوس هذا الموديلوس ففعلا هذا ال + +313 +00:23:31,730 --> 00:23:34,470 +domain اللي بدنا نعمل لما أخذنا اثنين برا يصير + +314 +00:23:34,470 --> 00:23:38,090 +إيش؟ زد ناقص واحد أقل من اثنين هذا فعلا في نتيجة + +315 +00:23:38,090 --> 00:23:44,030 +الصحيحة إذاً واحد وتساؤل جديش summation من صفر لما + +316 +00:23:44,030 --> 00:23:48,350 +يسالب واحد قس N زد ناقص واحد لكل قس N على جديش + +317 +00:23:48,350 --> 00:23:52,750 +اثنين قس N ناقص واحد قس N صحيحة في زد ناقص واحد أقل + +318 +00:23:52,750 --> 00:23:56,670 +من اثنين هذه واحد على زد زائد واحد فاحنا ماشيين + +319 +00:23:56,670 --> 00:23:59,310 +من اتجاه الصحيح ما تبقاش نقل ال domain بالضبط لكن + +320 +00:23:59,310 --> 00:24:02,230 +نكمل اللي أنا بدنا نضرب في زد ناقص واحد لكل تربيع + +321 +00:24:02,230 --> 00:24:09,460 +بدنا نضرب في زد ناقص واحد لكل تربيع إذا f of z + +322 +00:24:09,460 --> 00:24:13,720 +هتسوى واحد على z ناقص واحد لكل تربيع في هذا + +323 +00:24:13,720 --> 00:24:18,900 +المقدار في z زائد واحد وتساوي واحد على z ناقص واحد + +324 +00:24:18,900 --> 00:24:22,700 +لكل تربيع في ال summation من صفر إلى مالانهاية + +325 +00:24:22,700 --> 00:24:29,760 +سالب واحد أسئن z ناقص واحد أسئن على اثنين أسئن + +326 +00:24:29,760 --> 00:24:35,650 +زائد واحد هل جئت وإن صحيح هذا صار؟ أولش السيريز + +327 +00:24:35,650 --> 00:24:40,570 +الصحيحة زد ناقص واحد أقل من اثنين طب عشان أجسم على + +328 +00:24:40,570 --> 00:24:43,810 +هذا المخدوع بدي إياه لا يساوي صفر لا يساوي صفر + +329 +00:24:43,810 --> 00:24:47,900 +فهذا ال domain اللي بدنا إياه تماما طلع بدا شكله مهم + +330 +00:24:47,900 --> 00:24:51,320 +جدا يا شباب ال domain نحدده أو يكون مواطن طبعا في + +331 +00:24:51,320 --> 00:24:54,380 +الأول كنا نديكوا إياه الآن احنا بنعرفه من السؤال + +332 +00:24:54,380 --> 00:24:56,920 +عشانّه بلعب دور أساسي في مين؟ في ال law and series + +333 +00:24:56,920 --> 00:24:59,820 +فزي ما قلت لك إن فيه كان خيارين الخيار الصحيح احنا + +334 +00:24:59,820 --> 00:25:03,300 +إيش .. الطبق مع ال domain اللي بدنا إياه فهي ال + +335 +00:25:03,300 --> 00:25:05,500 +series الصحيحة وين؟ في ال domain تبعنا .. في ال + +336 +00:25:05,500 --> 00:25:09,180 +domain اللي بدنا إياه اه طبعا فلازم ندخلها جوا وتساوي + +337 +00:25:09,180 --> 00:25:12,000 +summation من صفر إلى ما لا نهاية + +338 +00:25:29,710 --> 00:25:39,790 +part of f of z at الـ z تساوي الواحد فلا يعني يؤدي + +339 +00:25:39,790 --> 00:25:43,330 +is بدنا نقسّص السالب بقى بدنا نروح من فوق طبعا + +340 +00:25:43,330 --> 00:25:47,010 +المفروض إن أنا كان فكيتها قبل مش مشكلة هناخد طبعا + +341 +00:25:47,010 --> 00:25:49,970 +زي ما .. زي ما بقول ال sigma و إيه المثال ما يقال + +342 +00:25:49,970 --> 00:25:51,990 +واحد مش مش ضارع حد يقول بيساوي صفر اللي بنسبة + +343 +00:25:51,990 --> 00:25:55,390 +البارد لأ فدائما ال sigma ما تخدعناش طبعا هنروح من + +344 +00:25:55,390 --> 00:25:58,550 +فوق هدقش أول حد بيساوي n بتساوي صفر واحد n + +345 +00:25:58,550 --> 00:26:02,530 +بتساوي صفر z ناقص واحد أو السالب اثنين على اثنين + +346 +00:26:02,530 --> 00:26:07,750 +n بتساوي صفر بعدين أنا بتساوي واحد بالسالب زد ناقص + +347 +00:26:07,750 --> 00:26:11,690 +واحد ناقص سالب واحد أنا بتساوي واحد على اثنين تربيع + +348 +00:26:11,690 --> 00:26:16,330 +اللي هي أربعة زائد زد ناقص واحد ناقص صفر اللي هي + +349 +00:26:16,330 --> 00:26:20,630 +عايش وخلصت مظبوط فهي عايش على جديش على الوايش أنت + +350 +00:26:20,630 --> 00:26:23,290 +كايب وهكذا فهذا اللي هو ال principle bar فال + +351 +00:26:23,290 --> 00:26:27,590 +principle bar اللي هو نصف زد ناقص واحد ناقص سالب + +352 +00:26:27,590 --> 00:26:31,970 +اثنين ناقص ربع زد ناقص واحد ناقص سالب واحد فهذا هو + +353 +00:26:31,970 --> 00:26:37,150 +ال principle bar فهذا هو ال principle part الأصص + +354 +00:26:37,150 --> 00:26:41,810 +السالبة بس الأصص + +355 +00:26:41,810 --> 00:26:47,150 +السالبة فهذا هو ال principle part أي سؤال لعم + +356 +00:26:58,530 --> 00:27:02,950 +أقول إن هذا الكلام صحيح لمن؟ لل series، هذا الكلام + +357 +00:27:02,950 --> 00:27:05,910 +صحيح لل series، مظبوط؟ اللي نقلناها، طيب وهذا + +358 +00:27:05,910 --> 00:27:09,870 +المقدار إيش معناه؟ بتجسم على زد نقص أحد كل تربيع، + +359 +00:27:09,870 --> 00:27:13,410 +وهذا القسم أنا أسمّوها بشرط إن الـ z لا تساوي واحد، + +360 +00:27:13,410 --> 00:27:15,770 +لأن مش القسم على صفر، طب الـ z لا تساوي واحد إيش + +361 +00:27:15,770 --> 00:27:19,090 +معناه؟ أكبر من صفر، زي ما شرحناها أكثر من مرة، + +362 +00:27:19,090 --> 00:27:23,090 +تمام؟ فشوفوا أنتم كيف إن الرياضيات لما تكونوا مش + +363 +00:27:23,090 --> 00:27:25,150 +مستجمين تماما وكل الخطوات اللي احنا بناخدها + +364 +00:27:25,150 --> 00:27:29,570 +الشروط بتوضح لك كيف الأمور تمشي بشكل سليم + +365 +00:27:31,840 --> 00:27:34,500 +فبعد ما عرفنا ال principle part نجي للموضوع اللي + +366 +00:27:34,500 --> 00:27:38,320 +احنا مهدّينا له اللي أنا هنعمل عملية تصنيف طبقا لهذا + +367 +00:27:38,320 --> 00:27:42,080 +ال principle part هنقدر نعيش .. هنصنف لثلاث أنواع + +368 +00:27:42,080 --> 00:27:45,200 +اه فطبعا أنا عندي singular point وعملت Laurent + +369 +00:27:45,200 --> 00:27:49,040 +Series وطبعا في المنطقة زي ما حكينا لازم يكون صفر + +370 +00:27:49,040 --> 00:27:52,000 +أقل من زد ناقصه وأقل من اه اللي اه طبعا تتحدث + +371 +00:27:52,000 --> 00:27:57,420 +حوال السؤال أول حاجة إذا ما فيش principle part ال + +372 +00:27:57,420 --> 00:28:02,480 +principle part كل معاملاته أصفر cn تساوي صفر for + +373 +00:28:02,480 --> 00:28:07,400 +all n أقل أو تساوي سالب واحد معاملات كل الأسس + +374 +00:28:07,400 --> 00:28:11,800 +السالبة أصفر فإيش بقول؟ بقول إن z0 is a removable + +375 +00:28:11,800 --> 00:28:15,040 +singular point removal from singular point لأن إيش + +376 +00:28:15,040 --> 00:28:17,820 +صارت؟ كل السالب راح تم صار from the higher series + +377 +00:28:17,820 --> 00:28:21,420 +صارت higher series طبعا في الأصل النقطة singular + +378 +00:28:21,420 --> 00:28:23,920 +point يعني الدالة مش analytic اللي عندها فما أقدرش + +379 +00:28:23,920 --> 00:28:27,020 +أقول الدالة analytic لكن إيش معناها؟ removable إيش + +380 +00:28:27,020 --> 00:28:29,540 +معناها زي ما تتذكر remove from singularity أو + +381 +00:28:29,540 --> 00:28:34,040 +discontinuity نفس الخضية ممكن أعيد تعريف الدالة و + +382 +00:28:34,040 --> 00:28:37,130 +أخليها analytic هي في العصر مش analytic لكن مازال + +383 +00:28:37,130 --> 00:28:40,790 +إلها series إلها Tyler Series رغم إنها مش Analytic + +384 +00:28:40,790 --> 00:28:43,470 +فبقدر أعيد تعريفها وأخليها Analytic فيعني ما عنى + +385 +00:28:43,470 --> 00:28:44,270 +ما عنى ما عنى ما عنى ما عنى ما عنى ما عنى ما عنى ما عنى + +386 +00:28:44,270 --> 00:28:44,850 +ما عنى ما عنى ما عنى ما عنى ما عنى ما عنى ما عنى ما عنى + +387 +00:28:44,850 --> 00:28:45,310 +ما عنى ما عنى ما عنى ما عنى ما عنى ما عنى ما عنى ما عنى + +388 +00:28:45,310 --> 00:28:47,650 +ما عنى ما عنى ما عنى ما عنى ما عنى ما عنى ما عنى ما عنى + +389 +00:28:47,650 --> 00:28:49,110 +ما عنى ما عنى ما عنى ما عنى ما عنى ما عنى ما عنى ما عنى + +390 +00:28:49,110 --> 00:28:58,530 +ما عنى ما عنى ما عنى + +391 +00:28:58,530 --> 00:29:01,570 +ما عنى ما + +392 +00:29:05,240 --> 00:29:08,000 +لكن هذا الكلام اللي قنعش في ال domain اللي قنعش + +393 +00:29:08,000 --> 00:29:10,580 +زد ناقص زد أقل من R لكن احنا ال domain اللي بنشتغل + +394 +00:29:10,580 --> 00:29:15,480 +عليه وين هو؟ في هنا أكبر من صفر ففي مشكلة عن زد + +395 +00:29:15,480 --> 00:29:18,540 +بتساوي صفر في مشكلة اه فإذا هذه المشكلة موجودة + +396 +00:29:18,540 --> 00:29:21,780 +لكن إيش قابلة للإزالة removable ممكن أزيلها لكن هي + +397 +00:29:21,780 --> 00:29:24,180 +في الأصل موجودة في الأصل موجودة هنشوف الأدث لو + +398 +00:29:24,180 --> 00:29:30,560 +نوضح الحالة الثانية لو ال principle part بيحتوي على + +399 +00:29:30,560 --> 00:29:34,180 +عدد محدود من الحدود زي المثال تبعنا زي المثال اللي + +400 +00:29:34,180 --> 00:29:40,620 +هنا في عندي إيش عدد محدود C there is a negative + +401 +00:29:40,620 --> 00:29:45,060 +integer m such that cm لا تساوي صفر في عندي أنا + +402 +00:29:45,060 --> 00:29:50,530 +negative integer على الأقل واحد بيساوي الصفر لكن كل + +403 +00:29:50,530 --> 00:29:53,170 +اللي تحته اللي أقل منه الأسس اللي أقل منه أصفر + +404 +00:29:53,170 --> 00:29:58,230 +فبقول z0 ماهي إيش؟ عبارة عن قطب pole of order سالب + +405 +00:29:58,230 --> 00:30:02,430 +M على سبيل المثال هنا إيش عندي أنا أوطة يعني هي + +406 +00:30:02,430 --> 00:30:05,810 +الأمة دي أوطة أو السالب بيظهر أوطة أو السالب بيظهر + +407 +00:30:05,810 --> 00:30:09,050 +بهمنيّش إن كل اللي بعده يظهروا المهم إن هو قاعد بيظهر + +408 +00:30:09,330 --> 00:30:14,010 +أوطأ السالب بيظهر بالدين مين؟ مرتبة ال pole بتكون + +409 +00:30:14,010 --> 00:30:17,630 +قطب مازال في حد وجف عنده السالب بدأ منه وبعدين + +410 +00:30:17,630 --> 00:30:20,190 +هيتمه ماشي لدنيّا دي هو القطب فهذه عبارة عن مين + +411 +00:30:20,190 --> 00:30:25,550 +فالواع دي عبارة عن pole أو قطب من الرتبة الثانية + +412 +00:30:25,550 --> 00:30:28,730 +هنا من الرتبة الثانية فإنه أو تقصّه هو سالب اثنين + +413 +00:30:28,730 --> 00:30:32,310 +هذا ظهر ما ظهرش ما يهمّنيش هذا هو اللي بيحدد مين أو + +414 +00:30:32,310 --> 00:30:36,070 +تقصّه سالب ممكن بتديني مين الرتبة طبعا بيقول + +415 +00:30:36,070 --> 00:30:39,190 +الرتبة إيش؟ اثنين مش اه هو العدم تساوي اثنين سالب + +416 +00:30:39,190 --> 00:30:44,030 +اثنين الـ m لكن الرتبة اثنين سالب الـ m أصغر أصغر + +417 +00:30:44,030 --> 00:30:48,970 +ناقص سالب ظهر أصغر ناقص سالب ظهر طيب الحالة الثالثة + +418 +00:30:48,970 --> 00:30:52,910 +والأخيرة إذا احنا في عندنا حالة أول إيش فيه؟ ما فيش ولا + +419 +00:30:52,910 --> 00:30:56,890 +عدد سالب removable singular point في عدد محدود أو + +420 +00:30:56,890 --> 00:31:00,150 +من الحدود طبعا من المهم إنّه أصغر حد ممكن بوقف عنده + +421 +00:31:00,150 --> 00:31:02,910 +هيبدأ من من سالب خمسة من سالب عشر من سالب عشرين + +422 +00:31:02,910 --> 00:31:06,290 +فدي أيه نوع الـ order اللي هو أيه نوع سالب هذا + +423 +00:31:06,290 --> 00:31:09,190 +المقبرة اللي بدأت منه طب إذا في لأ إذا وصلنا لسالب + +424 +00:31:09,190 --> 00:31:12,450 +بقى لنهاية بسميها essential singularity essential + +425 +00:31:12,450 --> 00:31:16,030 +singularity طبعا وهذه الثلاث أنواع زي ما شوفنا شبهة + +426 +00:31:16,030 --> 00:31:19,950 +جداش زيادة الحدود جداش هذا بكون أصعب في التعامل + +427 +00:31:19,950 --> 00:31:24,110 +removable تقريبا بالممكن عمل معاها لو ضربت في Z + +428 +00:31:24,110 --> 00:31:27,470 +نقص الـ 0 بيخليها لتكل لكن الـ essential هذه أساسية + +429 +00:31:27,470 --> 00:31:30,830 +بصعب أن أتخلص منها بتخلصش منها بسهولة فدولة ثلاث + +430 +00:31:30,830 --> 00:31:34,490 +أنواع ففي عندي infinite number of coefficients في + +431 +00:31:34,490 --> 00:31:37,250 +مالة نهاية من الحدود اللي هي الأسس السالبة + +432 +00:31:37,250 --> 00:31:45,690 +لاتساوزيه فبسميها essential singular point خليني + +433 +00:31:45,690 --> 00:31:48,410 +بس إذا يعني هي أن أنا مثال ممكن تشوف مثال كمان على + +434 +00:31:48,410 --> 00:31:53,550 +السريع مثال على أسر يعني مثال أتوقع أنه ممكن نحله + +435 +00:31:53,550 --> 00:31:57,010 +بسهولة + +436 +00:31:57,010 --> 00:32:02,050 +بنتأكد + +437 +00:32:02,050 --> 00:32:06,870 +بس هي غالبا صح بس بنتأكد فهنا عندنا في هذا المثال + +438 +00:32:06,870 --> 00:32:13,810 +الأول الـ F of Z تساوي Cos Z على Z أس خمسة طبعا هنا + +439 +00:32:13,810 --> 00:32:17,210 +صيغة الأسئلة بيقول find the isolated singular + +440 +00:32:17,210 --> 00:32:21,170 +points of the function and determine ..بنصنفهم + +441 +00:32:21,170 --> 00:32:25,130 +whether they are poles removable or essential + +442 +00:32:25,130 --> 00:32:28,950 +singular point فهذا هي إيش سؤال الرئيسي أو المفهوم + +443 +00:32:28,950 --> 00:32:31,310 +الرئيسي اللي بنحاول نعمله نوجد الـ singular points + +444 +00:32:31,310 --> 00:32:35,600 +الـ isolated ونصنفهم لثلاث أصناف ثلاث أنواع فطبعا لو + +445 +00:32:35,600 --> 00:32:39,740 +طلعنا على هذه الدالة البسط entire function المقام + +446 +00:32:39,740 --> 00:32:42,700 +entire function إذا الدالة analytical everywhere + +447 +00:32:42,700 --> 00:32:45,820 +معدى أصفر المقام اللي هو مين الصفر فهذه is + +448 +00:32:45,820 --> 00:32:52,780 +analytic for all z تنتمي للـ c معدى الصفر فانا عند + +449 +00:32:52,780 --> 00:32:55,300 +النقطة الوحيدة هنا هي الصفر وبدي أصنفها فالـ + +450 +00:32:55,300 --> 00:33:00,140 +singular point هي الـ zero the only isolated + +451 +00:33:00,140 --> 00:33:03,920 +singular + +452 +00:33:03,920 --> 00:33:04,420 +point + +453 +00:33:08,300 --> 00:33:13,280 +الـ Z تساوي Zero كيف بنصنفها؟ بدنا نعمل Expansion + +454 +00:33:13,280 --> 00:33:17,140 +لولا Series Expansion حوالين الـ Zero فلازم أكتب F + +455 +00:33:17,140 --> 00:33:21,520 +of Z تساوي summation من سالب مال نهاية إلى مال + +456 +00:33:21,520 --> 00:33:27,620 +نهاية CN Z أس n في domain كيف يكون مطلخ الـ Z أكبر + +457 +00:33:27,620 --> 00:33:32,520 +من صفر في أي أول Singleton بتقبل نويان بعد الصفر؟ + +458 +00:33:32,520 --> 00:33:36,910 +مافيش، إذاً مالا نهاية فلازم نكون بدا الشكل زي ما + +459 +00:33:36,910 --> 00:33:39,910 +بنحسب الـ residue، domain مشابه تمامًا، فهنعمل بدا + +460 +00:33:39,910 --> 00:33:43,690 +الشكل طبعًا نبدأ الـ Z أُس سالب خمسة جهزة، الشغل + +461 +00:33:43,690 --> 00:33:47,630 +كله على الـ cosine طبعًا الـ cosine الـ Z أحفظناها هي + +462 +00:33:47,630 --> 00:33:53,430 +سالب واحد أُس N، Z أُس اتنين N، على يمين اتنين N + +463 +00:33:53,430 --> 00:33:59,670 +factorial فإذا f of z طبعا هذا كلام مطلق الـ z أقل + +464 +00:33:59,670 --> 00:34:02,910 +من ملة نهاية في الأصل لكن لما أجي أقول cosine z + +465 +00:34:02,910 --> 00:34:07,690 +على z أقصى خمسة هتسوى summation من zero لملة نهاية + +466 +00:34:07,690 --> 00:34:12,410 +سالب واحد أقصى n z أقصى اتنين n ناقص خمسة على + +467 +00:34:12,410 --> 00:34:16,510 +اتنين n factorial الآن جسمت على الـ z إذا z لأ غير + +468 +00:34:16,510 --> 00:34:20,930 +مسموح تساوي صفر فإذا الـ z غير مسموح تساوي صفر + +469 +00:34:26,260 --> 00:34:30,960 +فالآن عشان أُحدد بتشوف الـ principle part فبتشوف الـ + +470 +00:34:30,960 --> 00:34:36,620 +principle part فـ f of z تساوي نبدأ نعوض and الآن + +471 +00:34:36,620 --> 00:34:44,840 +بتساوي صفر واحد z أسالب خمسة ماقص and تساوي واحد + +472 +00:34:44,840 --> 00:34:50,100 +إيش بتديني واحد على اتنين factorial z أس قداش + +473 +00:34:50,100 --> 00:34:57,160 +minus ثلاثة بعد هيك زائد واحد على أربعة factorial z + +474 +00:34:57,160 --> 00:35:01,820 +ناقص جداش minus واحد اللي بعده ناقص واحد على ستة + +475 +00:35:01,820 --> 00:35:06,820 +factorial z ناقص واحد وهكذا فهذا هو الـ principle + +476 +00:35:06,820 --> 00:35:13,420 +part هذا هو الـ principle part والآن بتساوي خمسة + +477 +00:35:13,420 --> 00:35:17,260 +principle part فإذا هذه عبارة عن pole of order + +478 +00:35:17,260 --> 00:35:25,150 +خمسة فدي بيقول لي أن z تساوي زيرو is a pole of + +479 +00:35:25,150 --> 00:35:34,310 +order five مباشرة فبقدر أصنفها فهنوجب فن عشان + +480 +00:35:34,310 --> 00:35:37,510 +ناخد الـ quiz وإن شاء الله يوم التنين بنكمل diff --git a/PL9fwy3NUQKwaRXaqd-S5-vsOEDL-Q45jU/RJYHKpTIwQI_raw.srt b/PL9fwy3NUQKwaRXaqd-S5-vsOEDL-Q45jU/RJYHKpTIwQI_raw.srt new file mode 100644 index 0000000000000000000000000000000000000000..c29da2c28aae4f17c3d93d9cecdf60ff8c2a3c12 --- /dev/null +++ b/PL9fwy3NUQKwaRXaqd-S5-vsOEDL-Q45jU/RJYHKpTIwQI_raw.srt @@ -0,0 +1,1596 @@ +1 +00:00:09,640 --> 00:00:13,600 +بسم الله الرحمن الرحيم في المحاضرة الأخيرة بدأنا + +2 +00:00:13,600 --> 00:00:17,380 +الحديث عن cauchy corset theorem و النظرية بتقول + +3 +00:00:22,320 --> 00:00:27,620 +لو احنا في اندي دال انالتك على منحنى مغلق C وجوه + +4 +00:00:27,620 --> 00:00:33,060 +هذا المنحنى فالتكامل على ال C لل F of Z دي Z + +5 +00:00:33,060 --> 00:00:37,200 +بيساوزيه هادي كوشي كورسات تيرام + +6 +00:00:39,820 --> 00:00:45,640 +بس هحصل و هاد ايه نظرية نظرية أساسية مهمة بعد شفنا + +7 +00:00:45,640 --> 00:00:50,240 +تعميم لو كانت الدالة لا تحقق الشروط لو كان في عندي + +8 +00:00:50,240 --> 00:00:54,560 +بعض النقاط اللي دالة not identical عندهم فبتحدث عن + +9 +00:00:54,560 --> 00:00:57,880 +اعتبارها simply connected domain ففيها ده تعميم لو + +10 +00:00:57,880 --> 00:01:00,280 +انا عندي دي simply connected domain + +11 +00:01:10,710 --> 00:01:15,550 +Multiple connected domain يعني في بعض الفجوات و + +12 +00:01:15,550 --> 00:01:19,230 +هدولة اللي اعتبرناهم و هدولة كلهم C1 C2 و هكذا + +13 +00:01:19,230 --> 00:01:24,310 +فصار عندي تكامل على الملحانة الخارجية زي تكامل على + +14 +00:01:24,310 --> 00:01:29,610 +جميع الملحانات الداخلية بسوء Zero تكامل على CK + +15 +00:01:29,610 --> 00:01:37,160 +بسوء صفرعلى هذه الحالة العامة لو عندنا ملحانين بس + +16 +00:01:37,160 --> 00:01:44,060 +فيه ملحانة خارجي C1 وفيه ملحانة في داخله C2 في نفس + +17 +00:01:44,060 --> 00:01:47,360 +الاتجاه فطبعا مجموعة التكامل على دول الملحانين + +18 +00:01:47,360 --> 00:01:50,180 +بيساوي Zero بس كل واحد فيهم عكس التاني إذا كانوا + +19 +00:01:50,180 --> 00:01:54,000 +بنفس الاتجاه بيكون اللي هو إيش الأول ناقص التاني + +20 +00:01:54,000 --> 00:01:56,960 +بيساوي Zero فبمعنى أخر التكامل على ال C1 بيساوي + +21 +00:01:56,960 --> 00:01:59,960 +التكامل على ال C2 فهذه النتيجة اللي احنا في الآخر + +22 +00:01:59,960 --> 00:02:03,640 +وجفنا عنها في المحاضرة الماضيةأه طبعا هنا ايش + +23 +00:02:03,640 --> 00:02:07,440 +الفرق كان احنا في حالة ما كانت ده اللي انا لتك على + +24 +00:02:07,440 --> 00:02:10,620 +المحالة و جوا التكامل بيساوي zero فمافيش حاجة ايه + +25 +00:02:10,620 --> 00:02:14,620 +بده حساب انه نتيجة قوية جدا انه التكامل بيساوي صفر + +26 +00:02:14,620 --> 00:02:17,340 +الان هنا اختل الشرط ممكن تكون ده اللي مش انا لتك + +27 +00:02:17,340 --> 00:02:21,930 +اله على بعض النقات جوا هنا فاللي صار ان اناالدالي + +28 +00:02:21,930 --> 00:02:25,510 +انت كان بين المنحنين وبينهم فقط فاللي اقدرت اعمله + +29 +00:02:25,510 --> 00:02:28,090 +مش ممكن اقول ان التكامل بيساوي Zero ولكن ممكن + +30 +00:02:28,090 --> 00:02:31,210 +استبدل التكامل من منحنه الى منحنه طبعا ايش الفايدة + +31 +00:02:31,210 --> 00:02:34,610 +من هنا ممكن ان استبدل المنحنه يكون طويل معقد صعب + +32 +00:02:34,610 --> 00:02:38,650 +بمنحنه بسيط بمنحنه بسيط وقفنا عند اللي هو يمكن + +33 +00:02:38,650 --> 00:02:42,130 +بدأنا لبذة سريع على المثال التالد كتطبيق على هذا + +34 +00:02:42,130 --> 00:02:48,610 +الكلام نشوف المثالبنحسب تكامل على المستطيل Z كايب + +35 +00:02:48,610 --> 00:02:52,910 +على Z ناقص وعد لكل تربية دي Z والـC عبارة عن اللي + +36 +00:02:52,910 --> 00:02:56,930 +هو المستطيل في الاتجاه الموجة فنحاول نرسم هذا + +37 +00:02:56,930 --> 00:03:00,710 +الملحانة ونحاول نحل هذا السؤال ونشوف كيف بنطبق + +38 +00:03:00,710 --> 00:03:11,270 +النتيجة الأخيرة solution of example one فعنا ال F + +39 +00:03:11,270 --> 00:03:17,440 +of Zتساوي z تكييب على z ناقص واحد لكل تربيع + +40 +00:03:17,440 --> 00:03:22,920 +والمنحنى عبارة عن مستطيل yx + +41 +00:03:22,920 --> 00:03:26,320 +ال x من سالب تلاتة لتلاتة + +42 +00:03:29,210 --> 00:03:35,070 +تقريباً بهذا الشكل ممكن نرسمه فهذا هو المستطيل و + +43 +00:03:35,070 --> 00:03:40,510 +ال y من اتنين لثالث اتنين من اتنين لثالث اتنين فهي + +44 +00:03:40,510 --> 00:03:47,150 +اربعة فمتحدث عن هذا المستطيل تقريبا بهذا الصورة + +45 +00:03:51,840 --> 00:04:03,640 +1 2 3-1-2-3 I2I-I-2Iالنقطة يادي سالب اتنين ايه + +46 +00:04:03,640 --> 00:04:07,960 +طبعا في هذا الكلام طبعا جالي positive direction او + +47 +00:04:07,960 --> 00:04:13,800 +positive oriented عكس عقارب الساعة فلما يكون عندنا + +48 +00:04:13,800 --> 00:04:18,260 +المنحنة مفتوح بيقول من الى بعرف اتجاه اذا carry + +49 +00:04:18,260 --> 00:04:20,640 +closed طبعا البداية و النهاية نفس النقطة فلازم + +50 +00:04:20,640 --> 00:04:23,480 +يقول اتجاه عكس عقارب الساعة اللي هو اتجاه الموجد + +51 +00:04:23,480 --> 00:04:26,700 +او مع عقارب الساعة اللي هو اتجاه السالب فهذه + +52 +00:04:26,700 --> 00:04:30,440 +طريقتين لو أصف الاتجاه فمتحدث عن هذا المنحنة C + +53 +00:04:31,740 --> 00:04:36,380 +فبتكون من أربع خطوط مستقيمة لو حاولت أحسب التكامل + +54 +00:04:36,380 --> 00:04:41,300 +مباشرة عن طريق البراميترزيشن بحتاج أن أعمل أربع + +55 +00:04:41,300 --> 00:04:44,840 +مرات براميترزيشن لكل خط مستقيمة على حده و أحسب + +56 +00:04:44,840 --> 00:04:47,580 +التكامل على كل جزء من هذا الإلم الحده و أجمع + +57 +00:04:47,580 --> 00:04:50,510 +الأربع عزاه في النهاية و أوصل للجواطبعا هدى + +58 +00:04:50,510 --> 00:04:53,390 +التكامل طيب ممكن يستخدم قوش الكلسات فيها هدى + +59 +00:04:53,390 --> 00:04:56,610 +الدالة الانتقال على المنحنى وجواها لأ لإن الدالة + +60 +00:04:56,610 --> 00:04:59,530 +مش الانتقال عند الواحد الواحد وين هدا هي ففي مشكلة + +61 +00:04:59,530 --> 00:05:02,070 +عندها الدموق اللي داخل المنحنى داخل المنحنى + +62 +00:05:02,070 --> 00:05:05,010 +فبالتالي مقدرش اقول ان التكامل بيساوي zero قد يكون + +63 +00:05:05,010 --> 00:05:07,670 +بيساوي صفر لكن مقدرش انا اتسنتج من قوش الكلسات + +64 +00:05:07,670 --> 00:05:11,990 +فيها بتقول لازم يكون الانتقال على المنحنى وجواه هي + +65 +00:05:11,990 --> 00:05:14,870 +الانتقال على المنحنى وجواه مقعد الواحد في استثناء + +66 +00:05:14,870 --> 00:05:20,830 +إذا ان النظرية تفشل أو غير قابلةطبعا زى ما اقوله + +67 +00:05:20,830 --> 00:05:23,810 +لإن لو بدنا نحسبه مش هنقدر نستخدم كوشة كورساة ثيرة + +68 +00:05:23,810 --> 00:05:27,010 +طبعا هل بدنا نجيب عنها antiderivative مش سهل اللي + +69 +00:05:27,010 --> 00:05:29,070 +هو antiderivative اللى زى ما تشايفينه يا شباب مش + +70 +00:05:29,070 --> 00:05:32,550 +.. مش بسهولة فتمش أمامنا التعريف أه بدناش مش + +71 +00:05:32,550 --> 00:05:35,870 +هنستخدم اللي هو الملحانة نفسه هنستبدل بملحانة أبسط + +72 +00:05:35,870 --> 00:05:41,280 +بملحانة أبسطمين أبسط المنحانات المغلقة؟ الدوال لإن + +73 +00:05:41,280 --> 00:05:43,040 +ال programatization هي نفس ال programatization لكل + +74 +00:05:43,040 --> 00:05:46,060 +منحانة تتكون من جزء واحد تتكون من جزء واحد فهنا + +75 +00:05:46,060 --> 00:05:50,060 +أخد دائرة طبعا تبقى للنتيجة و النظرية لازم عشان + +76 +00:05:50,060 --> 00:05:53,480 +أنا أستبدل منحانة بمنحانة أخر تكون الدائرة اللي + +77 +00:05:53,480 --> 00:05:55,800 +أنا اتكلم علي المنحانين وبينهم علي المنحانين + +78 +00:05:55,800 --> 00:05:59,320 +وبينهم فلازم المنحان الجديد يحيط بالنقطة اللي هي + +79 +00:05:59,320 --> 00:06:01,120 +ال singular point النقطة اللي فيها المشكلة اللي هي + +80 +00:06:01,120 --> 00:06:04,220 +الواحد عشان الصيرية خارج المنطقة اللي بين + +81 +00:06:04,220 --> 00:06:07,990 +المنحانين فبدنا منحانة حوالين الواحدطيب بدنا نقول + +82 +00:06:07,990 --> 00:06:11,210 +احنا قول لأ افضل من الحياة هو الدائرة فبدنا + +83 +00:06:11,210 --> 00:06:13,390 +الدائرة حوالي الواحد افضل ايش ناخده؟ المركز اللي + +84 +00:06:13,390 --> 00:06:16,890 +بيساو واحد او على جينه أسهل طيب و بعدين لازم نطلعش + +85 +00:06:16,890 --> 00:06:20,430 +برا ف .. ف .. ف .. فدقس واحد بيساو واحد فالنفس + +86 +00:06:20,430 --> 00:06:22,910 +الخطر لازم يزلش عن اتنين ناخده بيساو واحد عشان + +87 +00:06:22,910 --> 00:06:25,270 +نطلعش برا فالناهي المركز لو أخدته اكتر من اتنين + +88 +00:06:25,270 --> 00:06:29,170 +هيطلع برا فياخده بيساو واحد فمتحدث عن الدائرة اللي + +89 +00:06:29,170 --> 00:06:32,090 +ايش مركزها الواحد و نفس الخطرة بيساو واحد تقري + +90 +00:06:36,190 --> 00:06:40,530 +في نفس الاتجاه يا شباب فهذه ال C1 مثلا طبعا C1 و + +91 +00:06:40,530 --> 00:06:43,770 +C2 اذا هذه C فهذه C1 او المهم المنحنى الجديد + +92 +00:06:43,770 --> 00:06:47,870 +المنحنى الجديد طبعا C1 خلينا نكتب هنا + +93 +00:06:50,920 --> 00:06:55,380 +C واحد عبارة عن الدائرة Z ماقص واحد تساوي واحد + +94 +00:06:55,380 --> 00:06:59,880 +فطبعا هذه الرسمية والكلام فالان أصبحت ال F + +95 +00:06:59,880 --> 00:07:04,140 +Analytical على الملحانيين و جواهم و بينهم ناقصات + +96 +00:07:04,140 --> 00:07:09,580 +مش مناطق المحصورة فالمنطق المحصورة بين الملحانيين + +97 +00:07:09,580 --> 00:07:12,520 +وعلى الملحانيين نفسهم مافيش مشاكل المشكلة واحد عند + +98 +00:07:12,520 --> 00:07:15,080 +الواحد والواحد صار طويل في المحصورة أو في الخارج + +99 +00:07:15,080 --> 00:07:23,560 +من المنطقة اذا هنا الان F of Z is analyticعلى C و + +100 +00:07:23,560 --> 00:07:27,980 +C1 و المنطقة بينهم + +101 +00:07:36,340 --> 00:07:39,560 +طبعا هو ممكن أي محانة أخر يقدّي، بس أنا إيش بدّيه؟ + +102 +00:07:39,560 --> 00:07:43,140 +إيش هدفي من المحانة؟ أبسط الحسابات، فأفضل إشي إنه + +103 +00:07:43,140 --> 00:07:46,140 +أبسط ناخد المركز هو النقطة اللي فيها المشكلة، اللي + +104 +00:07:46,140 --> 00:07:48,540 +هي ال singular point، لأن واحدنا هنشوف كأننا في + +105 +00:07:48,540 --> 00:07:51,920 +الحسابات، فهي أفضل حاجة إنه نختار بهذه الصورة، + +106 +00:07:51,920 --> 00:07:58,880 +واحدنا هنوضح بشكل كام وين برا؟لأ لأ مش برا الدماغ، + +107 +00:07:58,880 --> 00:08:02,300 +الآن انا بدي عشان اطبق النتيجة في المنطقة المحصورة + +108 +00:08:02,300 --> 00:08:05,260 +بين الدائرة وبين المستطيل في مشاكل في singular + +109 +00:08:05,260 --> 00:08:09,000 +points لأ فالتنظيم بتقول او النتيجة اذا ده اللي + +110 +00:08:09,000 --> 00:08:12,460 +انا اتكلم على المنحنين وبينهم فبكون التكامل على ال + +111 +00:08:12,460 --> 00:08:14,700 +C بيساوي التكامل على ال C واحد فده بيقول ليه؟ + +112 +00:08:15,720 --> 00:08:20,480 +التكامل على ال C لل F of Z دي Z بيساوي التكامل على + +113 +00:08:20,480 --> 00:08:24,780 +ال C واحد لل F of Z دي Z طبعا الميزة اللي قولنا ان + +114 +00:08:24,780 --> 00:08:27,680 +ال C واحد عمل برمتوزيشن مرة واحدة دي تبسيط وعلاج + +115 +00:08:27,680 --> 00:08:32,280 +الحسابات فعلا بيكون أبسط بشكل كبير فدى Z واحد ايش + +116 +00:08:32,280 --> 00:08:38,100 +برمتوزيشن لل C واحد؟ Z ايش تساوي؟ واحد زاد E to + +117 +00:08:38,100 --> 00:08:43,540 +power I T وT من وين لوين؟طبعا دورة كاملة هو أصلش + +118 +00:08:43,540 --> 00:08:47,780 +ايه من zero ل 2π دورة كاملة اه فالان لما بدأت يعود + +119 +00:08:47,780 --> 00:08:52,360 +النادر دي ساوي تكامل من صفر ل 2π ال F of Z هي Z + +120 +00:08:52,360 --> 00:08:58,400 +تكييب Z كل واحد زاد E to power IT لكل تكييب على Z + +121 +00:08:58,400 --> 00:09:01,500 +ناقص واحد تربية Z ناقص واحد يمين E to power IT + +122 +00:09:01,500 --> 00:09:06,710 +فالعبارة عن E to power اتنين ITتنين IT فالان لما + +123 +00:09:06,710 --> 00:09:09,770 +المركز كان واحد اللي سأل السؤال لما كان المركز + +124 +00:09:09,770 --> 00:09:12,490 +واحد صارت Z ناقص واحد سهلة ودائما المشكلة في + +125 +00:09:12,490 --> 00:09:15,490 +الغالب هتكون جزء جاية من المقام ودائما في صعوبة في + +126 +00:09:15,490 --> 00:09:18,250 +التعامل مع المقام في التكاملات فلما أبسط المقام + +127 +00:09:18,250 --> 00:09:21,450 +حسبت ايش؟ او التعامل مع التكاملات أثر فZ ناقص واحد + +128 +00:09:21,450 --> 00:09:24,230 +بتخلص منها بشكل كل صورة في ال programatization + +129 +00:09:24,230 --> 00:09:27,830 +فبما تكون صعب لو كان هذا واحد او واحد ناقص أوش + +130 +00:09:27,830 --> 00:09:31,170 +اتحاد هتكون صعوبة في التخلص من المقام لكن الآن ال + +131 +00:09:31,170 --> 00:09:33,890 +exponential بطلع في ال bus مباشرة بس بغير مين؟ + +132 +00:09:33,890 --> 00:09:38,410 +الشعارة الاصأه طبعا اللي هو Z' مش بتساوي I E to + +133 +00:09:38,410 --> 00:09:43,910 +power IT في DT أي سؤال اتفضل + +134 +00:09:48,400 --> 00:09:51,840 +لكن عكس الاتجاه بيكون مجموعة بيساوي صفر لكن عكس + +135 +00:09:51,840 --> 00:09:54,400 +الاتجاه بيبقى واحد بيساوي واحد و واحد بيساوي + +136 +00:09:54,400 --> 00:09:57,500 +التاني فالأصل هو النظرية بتقول مجموعة كل التكامل + +137 +00:09:57,500 --> 00:10:00,660 +يساوي zero بس يكون التكامل الخارجي بالاتجاه + +138 +00:10:00,660 --> 00:10:03,800 +والجوانين كلهم يمشي بالاتجاه المعاكس اللي بيبقى + +139 +00:10:03,800 --> 00:10:06,480 +موجود على الطرف التاني بيصير بالسالب واش معنى + +140 +00:10:06,480 --> 00:10:11,020 +بالسالب انه غير الاتجاه فهي نفس الاتجاه تمام لو + +141 +00:10:11,020 --> 00:10:14,420 +رجعت النتيجة مكتوبة بالنفس الاتجاهأه فالان نبدأ + +142 +00:10:14,420 --> 00:10:19,600 +نحسب هذا الكلام طبعا في اختصارات بتامة انه يساوي I + +143 +00:10:19,600 --> 00:10:25,920 +ات .. اه تتكامل من Zero اتنين by E minus IT تطلع + +144 +00:10:25,920 --> 00:10:28,900 +هذه فوق مع الفيسبوكي minus ان .. ان .. انكعب هذا + +145 +00:10:28,900 --> 00:10:32,900 +المقدار فوق الجزء مكعب الأول تلاتة في مربع الأول + +146 +00:10:32,900 --> 00:10:38,600 +في التاني IT زي التلاتة الأول في مربع التاني اتنين + +147 +00:10:38,600 --> 00:10:42,640 +IT زي مكعب التاني تلاتة IT DT + +148 +00:10:48,300 --> 00:10:51,940 +لا مافيش ناقص في المرة مافيش ال I4 ال I مالهيش + +149 +00:10:51,940 --> 00:10:55,980 +دعوة انا بربّى لإيه طبعا ال ITI مربّعة حق مافيش + +150 +00:10:55,980 --> 00:11:00,560 +فيه سالب اه بحط ال I بكعبها مباشرة طبعا هذه ممكن + +151 +00:11:00,560 --> 00:11:03,720 +تضربها انت تتربع و تضرب بعدين في التلخص التالت او + +152 +00:11:03,720 --> 00:11:07,780 +ترد أخوص في بعض لا + +153 +00:11:07,780 --> 00:11:13,260 +هو هاديفي واحد اختصار بس واحد فطبعا ادخليه وا وا + +154 +00:11:13,260 --> 00:11:19,340 +كامل I فبتدين يعني تكمل E to minus IT نفسها تقسيم + +155 +00:11:19,340 --> 00:11:23,660 +سالب I زائد تلاتة بيصير هذي واحد بيصير T لما + +156 +00:11:23,660 --> 00:11:26,960 +اضربهم في بعض انتبه هنا بيصير ايش تلاتة E to power + +157 +00:11:26,960 --> 00:11:38,190 +IT على I زائد E to power 2 IT على 2Iعلى 2I طبعا من + +158 +00:11:38,190 --> 00:11:45,730 +وين ل وين من 0 ل 2π من 0 + +159 +00:11:45,730 --> 00:11:52,370 +ل 2π عشان طبعا نبدأ نعوض و نختصر سالب هنا بتصير و + +160 +00:11:52,370 --> 00:11:58,690 +بتصير E to minus 2pi I ناقص E to power 0 زي ال 3I + +161 +00:11:58,690 --> 00:12:02,430 +ال T 2pi ناقص 0 الجثة التانية + +162 +00:12:05,960 --> 00:12:11,460 +انكمل ال I بتروح زي التلاتة E to power 2 by I ناقص + +163 +00:12:11,460 --> 00:12:17,620 +E to power 0 زي نص E to power 4 by I ناقص E to + +164 +00:12:17,620 --> 00:12:22,400 +power 0 كل الأقواص أصفر لإن 2 by I وE to power 0 + +165 +00:12:22,400 --> 00:12:25,800 +كلهم واحد والتسالد برضه واحد معادة عادة المقدار + +166 +00:12:25,800 --> 00:12:27,980 +فالجواب 6 by I + +167 +00:12:31,040 --> 00:12:35,360 +ان هي التلاتة هذه اه عندنا مضرب هذه في هذه بواحد + +168 +00:12:35,360 --> 00:12:39,500 +اه فالتلاتة تتي تلاتة تلاتة تكمل تلاتة تي فانا + +169 +00:12:39,500 --> 00:12:41,520 +طبعا درامت وكملت بنفس الوقت اختصار + +170 +00:12:44,400 --> 00:12:48,440 +أه طبعا فلازم مش هو انا بقولك ايه بيساوي ان انا + +171 +00:12:48,440 --> 00:12:52,040 +ايش كاتب تكامل f of z على ال c بيساوي تكامله على + +172 +00:12:52,040 --> 00:12:54,200 +ال c وعمله بيساوي و هذا الكلام اه فطبعا كده ايش + +173 +00:12:54,200 --> 00:12:57,920 +بدك تعمله و ده يعني exercise جيد تمرينه اعمله و + +174 +00:12:57,920 --> 00:13:01,020 +اصل لازم تجواب و شوف ويش الفرح في الحل اه جديش + +175 +00:13:01,020 --> 00:13:05,360 +المجهود اللي هتبذله في اللي هتعمله اه فطبعا هذه هي + +176 +00:13:05,360 --> 00:13:09,640 +احد التطبيقات على النظرية نعم + +177 +00:13:13,730 --> 00:13:18,210 +هو مركز اداء او منحنى جديد هو انت دايما ممكن تعمل + +178 +00:13:18,210 --> 00:13:21,110 +national chart تكون الدالة اللي كانت على المنحنيين + +179 +00:13:21,110 --> 00:13:24,330 +و بينهم هاي ال chart مركز دي هو من جوه المنحنى + +180 +00:13:24,330 --> 00:13:29,230 +التانى انت اللي بهمك سواء بس هي عندك منحنى C و هي + +181 +00:13:29,230 --> 00:13:34,190 +عندك كمان منحنى C1 او C1 او C2 تفرجش انت اللي بهمك + +182 +00:13:34,190 --> 00:13:39,070 +mainالمنطقة المغلقة بين المنحنايين وبينهم يعني + +183 +00:13:39,070 --> 00:13:42,010 +المنحنايين وبينهم فانت دي جوا يعني في singular + +184 +00:13:42,010 --> 00:13:44,990 +point مافيش singular point مالكاش ده مافيش مشكلة + +185 +00:13:44,990 --> 00:13:48,270 +اه لو لو ده ده انت جوا مصفاتيه فهو عمل كامل صفة اه + +186 +00:13:48,270 --> 00:13:51,130 +بس لكن ايش بقى ده من ناحية نظرية صح لكن من ناحية + +187 +00:13:51,130 --> 00:13:53,670 +عملية ماليش فايدة لإن لو ده ده انت كعامل منحنايه + +188 +00:13:53,670 --> 00:13:56,630 +جوا فانت كامل صفة كوش كوش صفة تفقيرة اه فهي من + +189 +00:13:56,630 --> 00:13:59,070 +ناحية نظرية صح لكن من ناحية عملية ماني مش محتاجها + +190 +00:13:59,070 --> 00:14:03,690 +انا انا محتاجه في حد مايكون فيه singular point كيس + +191 +00:14:03,690 --> 00:14:04,030 +شمال ا + +192 +00:14:07,670 --> 00:14:13,570 +هذه برامترزيشن .. انت مابتحتدرش .. انت مش .. بتبقى + +193 +00:14:13,570 --> 00:14:16,710 +ولا بتهيأك .. هذا كيف تعمل برامترزيشن للدائرة .. + +194 +00:14:16,710 --> 00:14:19,630 +كيف تعمل برامترزيشن للدائرة .. معروف ان احنا كل من + +195 +00:14:19,630 --> 00:14:24,170 +اكتوبر بحاول نكتوب exponential fourأيه سواء .. + +196 +00:14:24,170 --> 00:14:27,170 +عشان انا .. it's a function of four حيث انا عندي z + +197 +00:14:27,170 --> 00:14:29,550 +ماعقص واحد it's a function of four بيكون ال + +198 +00:14:29,550 --> 00:14:31,990 +modulus اللي هو واحد و E تبقى ورايه في ال argument + +199 +00:14:31,990 --> 00:14:34,670 +و ال argument دي اللي بتتغير نحو تملة T فأنا + +200 +00:14:34,670 --> 00:14:39,650 +شرحناك كيف نعمل برامجزيش لده بشكل عام خلينا نشوف + +201 +00:14:39,650 --> 00:14:40,430 +مثال آخر + +202 +00:14:51,640 --> 00:14:54,200 +فعن عملية الـ Parameterization شرحناها بتوسع + +203 +00:14:54,200 --> 00:14:57,240 +واخدنا عدة أمثلة عشان هيك احنا الان ممكن نمشي + +204 +00:14:57,240 --> 00:15:02,320 +بسرعة في انا مثال اخر ال F of Z في هذا المثال + +205 +00:15:02,320 --> 00:15:05,900 +بتساوي + +206 +00:15:05,900 --> 00:15:11,580 +2Z على Z تربيه زائد 1 والمنحنى + +207 +00:15:11,580 --> 00:15:18,700 +عبارة عن مربع طول ضلعه 2 مربع طول ضلعه 2 ال X من + +208 +00:15:18,700 --> 00:15:26,060 +سالف 1 ل 1 خلينا نحاول نرسمال X من سالب واحد لواحد + +209 +00:15:26,060 --> 00:15:31,980 +وال Y من Zero لاتنين سالب واحد واحد واحد هيتنين + +210 +00:15:31,980 --> 00:15:39,420 +فبنتحدث عن هذا المربع شباب طبعا جالي positive + +211 +00:15:39,420 --> 00:15:43,040 +sense او positive direction نفس المعنى اذا العكس + +212 +00:15:43,040 --> 00:15:50,280 +على خارج الساعة هذه I هذه اتنين I فهذه ال C فهذه + +213 +00:15:50,280 --> 00:15:55,240 +ال Cنفس الكلام لو الدالة انتقلت على الـC المغلقة + +214 +00:15:55,240 --> 00:16:00,060 +دي و جواها التكاول بيساوي Zeroفنطلع على الدالة، + +215 +00:16:00,060 --> 00:16:03,540 +وين قاعد الدالة analytic؟ Everywhere معناه أصفر + +216 +00:16:03,540 --> 00:16:07,760 +المقام، مين هي أصفر المقام؟ زائد أو ناقص I، ال I + +217 +00:16:07,760 --> 00:16:11,520 +جوا والسالب I برا، بتهمنيش، لكن السالب I جوا، إذا + +218 +00:16:11,520 --> 00:16:14,180 +ماقدرش أقول إن التكامل بالساوي زيه، أه لأن الدالة + +219 +00:16:14,180 --> 00:16:16,840 +مش analytic على كل المنطقة اللي جوا، فيه singular + +220 +00:16:16,840 --> 00:16:20,940 +point، فهنعمل نفس ال trick، فهنا هنقول إيه إيش؟ F + +221 +00:16:20,940 --> 00:16:23,240 +is analytic + +222 +00:16:32,430 --> 00:16:41,820 +الـ plus I هي اللي جوا المنطقة اللي بتعنينيبنفس + +223 +00:16:41,820 --> 00:16:43,860 +الأسلوب الشيء اللي هناخد دائرة حوالين ال singular + +224 +00:16:43,860 --> 00:16:47,040 +point ال I و طبعا بدنا نسف قطرة لما يزدش على + +225 +00:16:47,040 --> 00:16:49,240 +الواحد عشان ما يطلعش برا فناخده على سبيل المثال + +226 +00:16:49,240 --> 00:16:52,580 +يساوي نص لا واحد بيصير حدوق بيصير متلاسق لأ بدنا + +227 +00:16:52,580 --> 00:16:55,460 +ياخده أقل من واحد فناخده بيساوي نص على سبيل المثال + +228 +00:16:55,460 --> 00:17:00,580 +فناخده بيساوي نص على سبيل المثال أي عادي أقل من + +229 +00:17:00,580 --> 00:17:06,940 +واحد بتنفع فهذه ال C1 فال C1 انها عبارة عن زبد + +230 +00:17:06,940 --> 00:17:13,730 +اشمالها ناقص I تساوي نصالدائرة مركزها ال I وزي ما + +231 +00:17:13,730 --> 00:17:16,190 +شوفنا من المثال انه أفضل إيش ناخد المركز هو النقطة + +232 +00:17:16,190 --> 00:17:19,610 +اللي فيها مشكلة ال singular point وناخد نفس الخطر + +233 +00:17:19,610 --> 00:17:23,590 +أقل ما يوصلش الحدود فأقل من واحد نص ربوع تلت لكن + +234 +00:17:23,590 --> 00:17:29,090 +أي رقم بيبدو غلط بيصيروا + +235 +00:17:29,090 --> 00:17:34,270 +متمثلين هنا بالظبط فبقدرش أن أقول أن هو المنطقة + +236 +00:17:34,270 --> 00:17:38,920 +اللي بينهم فبصير في إشكاليةفأحنا طبعا مافيش مش + +237 +00:17:38,920 --> 00:17:42,320 +مضطرين ناخدها واحد فناخدها نص تلت و أي عدد يقدر + +238 +00:17:42,320 --> 00:17:44,560 +الغرض اه طبعا نعمل ال parameterization ع طوليش ال + +239 +00:17:44,560 --> 00:17:49,360 +parameterization z ده تساوي I زائد نص E to power + +240 +00:17:49,360 --> 00:17:54,840 +IT و T من وين لوين من 0 ل 2 بقى دورة كاملة بهذه + +241 +00:17:54,840 --> 00:18:02,660 +الصورة فطبعا اتأكد على ده الكلام F is analytic on + +242 +00:18:02,660 --> 00:18:08,880 +Cand c1 وفي المنطقة اللي بينهم and in the region + +243 +00:18:08,880 --> 00:18:12,860 +between them + +244 +00:18:12,860 --> 00:18:22,420 +between them اه فإذا التكامل على c f of z dz بدي + +245 +00:18:22,420 --> 00:18:28,580 +يساوي التكامل على c1 لل f of z dz ونبدأ يحسب هذا + +246 +00:18:28,580 --> 00:18:29,060 +التكامل + +247 +00:18:31,790 --> 00:18:34,830 +لو حاولنا نحسب التكامل بشكل مباشر، الشباب حاليا + +248 +00:18:34,830 --> 00:18:37,790 +جاي فيه صعوبة في الحساب شوية، بقى نفس المبدأ، في + +249 +00:18:37,790 --> 00:18:42,290 +trick هنا بسيط، لو طلعنا على الدالة اتنين زد على + +250 +00:18:42,290 --> 00:18:46,970 +زد تربية زيد واحد، المقام قدّان ال .. لأ لأ مش .. + +251 +00:18:46,970 --> 00:18:49,130 +مش .. مديش اعمل ال antiderivative، ممكن ادور على + +252 +00:18:49,130 --> 00:18:52,790 +ال antiderivative في هذه الحالة، و .. اه و .. و .. + +253 +00:18:52,790 --> 00:18:59,100 +اه بس ال ..لأن المقام طب مين ال branch بدك تحاول + +254 +00:18:59,100 --> 00:19:01,180 +تشوف ال branch و لا لو مول حد يدخل فيه المثال لإنه + +255 +00:19:01,180 --> 00:19:03,600 +لو كان في antiderivative سهل كان الجواب لازم يطلع + +256 +00:19:03,600 --> 00:19:06,540 +صفر و مش هتطلع صفر الجواب لأن لو .. لو في + +257 +00:19:06,540 --> 00:19:09,480 +antiderivative و ال close هيقدّيني صفر .. اه الان + +258 +00:19:09,480 --> 00:19:12,320 +يا شباب لو طلعتوا هنا z تربية زاد واحد لو عوضنا z + +259 +00:19:12,320 --> 00:19:16,400 +بتساوي I زاد نص E to power IT بيصير المقام كبير مش + +260 +00:19:16,400 --> 00:19:19,350 +بسهولة .. مش بسهولة ستخلص منه بسهولةلكن لو احنا + +261 +00:19:19,350 --> 00:19:24,430 +نظرنا نظرة دقيقة للمقام المقام الحقيقة في جزء + +262 +00:19:24,430 --> 00:19:28,030 +سببنا المشكلة في جزء ماسببناش مشكلة فممكن اننا + +263 +00:19:28,030 --> 00:19:31,190 +نروح نحلل هذا المقدار لو طلعنا على Z تربية زائد + +264 +00:19:31,190 --> 00:19:37,170 +واحد هو عبارة عن Z ماقص I في Z زائد Iفالجزء اللي + +265 +00:19:37,170 --> 00:19:40,830 +سبب للمشكلة هو Z-I و Z زايد واحدة لما مافيش في أي + +266 +00:19:40,830 --> 00:19:45,390 +مشكلة فعال فأقدر أعزله و أحسبه بسهولة وبالتالي + +267 +00:19:45,390 --> 00:19:48,510 +أسهل الحسابات الحقيقة لها ممكن نعمل partial + +268 +00:19:48,510 --> 00:19:53,690 +fraction ممكن نجزقه فنعمل partial fraction ف2 على + +269 +00:19:53,690 --> 00:19:57,750 +Zفي z تربية زائد واحد ممكن نعمل ع partial fraction + +270 +00:19:57,750 --> 00:20:03,670 +a على z ماقص i زائد b على z زائد i partial + +271 +00:20:03,670 --> 00:20:07,690 +fraction عشان الجزء اللي فيه المشكلة نعزله على جهة + +272 +00:20:07,690 --> 00:20:10,990 +و الجزء اللي مافيه مشكلة هنعزله على جهة وتكامل + +273 +00:20:10,990 --> 00:20:14,570 +هيكون صفر لإن الدليل اللتيك عليه فطبعا نعمل هو + +274 +00:20:14,570 --> 00:20:21,590 +نجيب ثوابت اتنين z هتسوى a في z زائد i زائد b في z + +275 +00:20:21,590 --> 00:20:25,490 +ماقص iالـ Partial Fraction العادية كل الأمور هذه + +276 +00:20:25,490 --> 00:20:31,490 +ممكن نعملها لو عوضنا Z تساوي I إيش بتصير؟ 2I تساوي + +277 +00:20:31,490 --> 00:20:37,890 +2I في A يعني A بتساوي 1 لو عوضنا Z سالب I بتصير + +278 +00:20:37,890 --> 00:20:42,790 +سالب 2I تساوي سالب 2I في B و برضه B بتساوي 1 فهذا + +279 +00:20:42,790 --> 00:20:48,540 +معناته أن F of Zاللي هي 2z على z تربية زائد واحد + +280 +00:20:48,540 --> 00:20:53,200 +واحد على z ناقص I زائد واحد على z زائد I + +281 +00:20:59,570 --> 00:21:06,470 +هذا معناته ان التكامل على ال C لل F of Z DZ تساوي + +282 +00:21:06,470 --> 00:21:11,170 +تكامل على C1 وتساوي تكامل على C1 لوحد على Z ناقص I + +283 +00:21:11,170 --> 00:21:17,330 +DZ زي التكامل على C1 لوحد على Z زيد واحد زيد I اسف + +284 +00:21:17,330 --> 00:21:21,160 +DZطبعا التكامل ممكن تجزّق الملحانة وممكن تجزّق + +285 +00:21:21,160 --> 00:21:23,560 +الدالة اللي احنا هنا يا عزيزي جزّقنا الدالة ومن + +286 +00:21:23,560 --> 00:21:27,240 +خواصه بتوزع على الجامعة واتطرح فيه الأدالة اه الآن + +287 +00:21:27,240 --> 00:21:30,820 +هذا التكامل بيساوي صفر شباب لأنه هالجهة على C1 + +288 +00:21:30,820 --> 00:21:34,640 +الدالة اللي كانت دائرة حوالين ال I اضطررت امحي + +289 +00:21:34,640 --> 00:21:39,740 +لأنه يا عزيزي لو تقول C1 من هي C1 من عيد رسمها هي + +290 +00:21:39,740 --> 00:21:46,300 +ال I و هي C1هي دالة عوالين ال I فالدالة لأ طبعا هو + +291 +00:21:46,300 --> 00:21:48,360 +هنا ايه؟ اه ده مشكلة انت عندك سلب I سلب I بعيدة + +292 +00:21:48,360 --> 00:21:52,320 +جدا هنا نسبيا فهي الدالة دي Analytical على ال C + +293 +00:21:52,320 --> 00:21:55,360 +وجوه ال C فالتكامل على طول Zero كوش كورسات كثيرة + +294 +00:21:55,360 --> 00:22:03,960 +فالان اللي هو واحد على Z زايد I is analytic on C + +295 +00:22:03,960 --> 00:22:10,680 +واحد and in the region in + +296 +00:22:10,680 --> 00:22:18,550 +a closedby c1 هذا يؤدي تكامل على c1 و 1 على z زاد + +297 +00:22:18,550 --> 00:22:23,410 +i دي z بيساوي 0 اه فهذا ال term بيساوي صفر خلصنا + +298 +00:22:23,410 --> 00:22:26,670 +منه تم علينا نحسب هذا المقدار الآن زي ما شوفنا من + +299 +00:22:26,670 --> 00:22:29,230 +المثال السابق z ناقص i بسيطة جدا في ال + +300 +00:22:29,230 --> 00:22:32,850 +parameterization هذا z ناقص i تتنصف جدا فإذا أصبح + +301 +00:22:32,850 --> 00:22:37,070 +التكامل الآن في ال parameterization خليكوا حظينه + +302 +00:22:37,070 --> 00:22:40,650 +فإذا أصبح التكامل + +303 +00:22:43,260 --> 00:22:49,020 +على الـ C للـ F of ZDZ بيساوي تكامل على C واعد لها + +304 +00:22:49,020 --> 00:22:53,900 +ده المقدار اللي هو من 0 ل 2 باي واعد على Z ناقص I + +305 +00:22:53,900 --> 00:22:58,940 +ايش بتساوي يا شباب نص E to power I T زي ما عملنا + +306 +00:22:58,940 --> 00:23:02,780 +تريكو و احنا ليش اخدنا المركز اه ف Z ناقص I ال Z + +307 +00:23:02,780 --> 00:23:06,360 +بيساوي I زاد نص E to power IT فافسيروا بهذا الشكل + +308 +00:23:06,360 --> 00:23:11,320 +طبعا Z برايم ايش بتساوي؟ بتساوي نص I E to power IT + +309 +00:23:11,320 --> 00:23:14,380 +مكتوب عنكوا طبعا ال Z ايش بتساوي برام ترزاشن؟ DT + +310 +00:23:14,820 --> 00:23:18,120 +فالقادة التكامل سهل جدا النص مع ال I كل بيروح + +311 +00:23:18,120 --> 00:23:23,340 +بيساوي تكامل من 0 ل 2π ل I DT و يساوي 2I في T من 0 + +312 +00:23:23,340 --> 00:23:32,180 +ل 2 بي و يساوي كداش 2 بي I و يساوي 2 بي I فبنحسبها + +313 +00:23:32,180 --> 00:23:32,780 +بكل سهولة + +314 +00:23:35,820 --> 00:23:40,060 +فهنا النقطة الشاهدة من المثال ان انا بحاول اعزل + +315 +00:23:40,060 --> 00:23:42,600 +الجزء اللى فى المشكلة اللى فى عاملى ال singular + +316 +00:23:42,600 --> 00:23:45,680 +points على جهة و الباقى اللى اعلى اللى كان ال term + +317 +00:23:45,680 --> 00:23:48,200 +مافيش مشكلة فانت كامله بساوة زيرو بقدر تخلص منه + +318 +00:23:48,200 --> 00:23:53,640 +بسوء وبقى هيك بسهل الحساباتفكل هذه يا شباب طرق كيف + +319 +00:23:53,640 --> 00:23:57,540 +نسهل حساب التكامل ال contour integral طبعا عندنا + +320 +00:23:57,540 --> 00:23:59,840 +التعريف الأصلي عن طريق ال programatization واحنا + +321 +00:23:59,840 --> 00:24:02,360 +بنشوف عدة طرق لتفسير الحسابات منها ال + +322 +00:24:02,360 --> 00:24:05,440 +antiderivative تحت الشروط تبعتها منها ال closed + +323 +00:24:05,440 --> 00:24:07,780 +contour والدالة اللي أنا التكالي عليه و جواب يساوي + +324 +00:24:07,780 --> 00:24:12,400 +صفر كل هذه طرق ومحاولات أو بدائل كيف نحسب التكامل + +325 +00:24:12,400 --> 00:24:14,700 +بأخصر الطرق أو بأسهل الطرق + +326 +00:24:18,610 --> 00:24:22,490 +لأنه هو اللي على المحالة الـC وجوا هذه الدالة + +327 +00:24:22,490 --> 00:24:25,810 +Analytic لإن المشكلة الوحيدة أني أسلب IPA ده برا، + +328 +00:24:25,810 --> 00:24:28,570 +فدائما اللي الكوشيكوساتفيرم نظرية الأساسية هذه + +329 +00:24:28,570 --> 00:24:32,110 +بتقول إذا الدالة Analytic على close control وجوا + +330 +00:24:32,110 --> 00:24:35,730 +بتكون التكامل بيساوي صفر، التكامل على طول بيساوي + +331 +00:24:35,730 --> 00:24:41,030 +صفر الأسئلة المطلوبة من واحد ده تسعة صفحة مية تسعة + 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+00:25:34,630 --> 00:25:38,270 +في بعض الأحيان فدي كلها طرق قوية كيف نحسب التكامل + +345 +00:25:38,730 --> 00:25:43,870 +الـ Cauchy Integral Formula بتقول لي التالي نظرية + +346 +00:25:43,870 --> 00:25:50,230 +فيها انا عندي دالة خلينا نحاول نرسم الرسمة + +347 +00:25:50,230 --> 00:25:53,930 +analytical everywhere within and on a simple + +348 +00:25:53,930 --> 00:25:58,210 +contour نفس القضية شباب انا عندي simple closed + +349 +00:25:58,210 --> 00:26:06,150 +contour طبعا مش شرط يكون دائرة في عندي منحنىسيمبل + +350 +00:26:06,150 --> 00:26:13,190 +وclosed in the positive sense فاتجه + +351 +00:26:13,190 --> 00:26:17,610 +عكس عقارب الساعة الدالة اف انالتك جوا المنحنة و + +352 +00:26:17,610 --> 00:26:21,560 +عليها المنحنةThen طبعا تكاملها بسوء صفر لكن أنا + +353 +00:26:21,560 --> 00:26:24,080 +مانديش الدول بتحدث عن تكاملها، بدأت قدم شوية شباب + +354 +00:26:24,080 --> 00:26:29,060 +لأن هذه خلاص معروفة Then التكامل او واحد على اتنين + +355 +00:26:29,060 --> 00:26:33,600 +by I لتكامل F على Z ماقص Z زيرو بيسوي F of Z زيرو، + +356 +00:26:33,600 --> 00:26:37,160 +ماذا يعني هذا الكلام؟ ال F شباب اتعملتك، تكاملها + +357 +00:26:37,160 --> 00:26:40,600 +بيسوي زيرو، أنا مانيش معنية كامل F، معنية كاملة + +358 +00:26:40,600 --> 00:26:48,300 +دالة G of Zتساوي F of Z على Z ماقص Z0 الـ Z0 مالها + +359 +00:26:48,300 --> 00:26:54,120 +interior to C الـ Z0 هي نقطة جوا الـ C Z0 ماذا + +360 +00:26:54,120 --> 00:26:59,090 +يعني هذا الكلام؟هذا يعني الكلام ان انا عندى الدالة + +361 +00:26:59,090 --> 00:27:03,790 +هسميها G اللى بدى اكملها هقسمها نصين نص يكون + +362 +00:27:03,790 --> 00:27:06,790 +Analytical و F of Z هذا الجزء اللى دلوقتى وعملناه + +363 +00:27:06,790 --> 00:27:09,850 +الجزء ال Analytical عفصله لحال بس ع صورته مش بص + +364 +00:27:09,850 --> 00:27:13,410 +وخل الجزء اللى فيه ال singular point هو المقام هو + +365 +00:27:13,410 --> 00:27:15,910 +عيديه من مقام ال singular point بهذا الشكل لإن انا + +366 +00:27:15,910 --> 00:27:18,150 +عندى الدالة اللى عمامى ال F Analytical everywhere + +367 +00:27:18,490 --> 00:27:22,430 +وعلى المرحلة في المنطقة تبعتي طب والمقام z نقص z + +368 +00:27:22,430 --> 00:27:25,570 +zero analytical everywhere لكن بيصير إيش؟ بدي أصلح + +369 +00:27:25,570 --> 00:27:29,190 +المقام اللي هي z zero فالدل جي analytical على ال c + +370 +00:27:29,190 --> 00:27:34,310 +كلها و جوا ما عدا z zero طبعا ممكن أستخدم الطريقة + +371 +00:27:34,310 --> 00:27:37,210 +تبعتي الأمثلة السابقة في الحساب نعم اللي إحنا + +372 +00:27:37,210 --> 00:27:40,490 +هجيبه الآن أفضل طريقة أفضل مش بدي أسهل بدي أحسب + +373 +00:27:40,490 --> 00:27:43,750 +الجواب مباشرة ايش الجواب بيقولي؟ بيقولي جواب + +374 +00:27:43,750 --> 00:27:47,680 +التكامل أفارع عن التكامل تبعها إيش بيساوي؟أقرأ + +375 +00:27:47,680 --> 00:27:55,740 +القوانين بطريقة أخرى فتكامل g of z dz ع ال c ايش + +376 +00:27:55,740 --> 00:28:02,290 +بيساوي اتنين by I F of z zeroلا أكمل ولا أعمل + +377 +00:28:02,290 --> 00:28:05,330 +memorization ولا أغلب حالي بس أشوف الجزء الأول ال + +378 +00:28:05,330 --> 00:28:09,650 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هل جيت احسب اف + +390 +00:28:53,640 --> 00:28:56,640 +واحد of I ايش بتساوي اتنين I على اتنين I تساوي + +391 +00:28:56,640 --> 00:28:59,720 +واحد تطلع نفسك جوا بكل سهولة مغير بيعمل ال + +392 +00:28:59,720 --> 00:29:04,340 +matrization كيف لأ لأ يعني ال I هي النقطة هي + +393 +00:29:04,340 --> 00:29:05,140 +النقطة اللي بيها المشكلة + +394 +00:29:07,830 --> 00:29:13,250 +النظرية هذه بتعطينا طريقة قوية جدا لحساب التكاملات + +395 +00:29:13,250 --> 00:29:17,310 +إذا قدرت أصل ال article bar f of z و ال singular + +396 +00:29:17,310 --> 00:29:20,290 +byte عبارة عن واحد على z ماقع ال z zero فقط + +397 +00:29:20,290 --> 00:29:24,090 +فالتكامل عبارة عن مين قيمة ال article bar عند ال z + +398 +00:29:24,090 --> 00:29:29,990 +zero مضروب في اتنين by I فطبعا في هذا المثال بدأت + +399 +00:29:29,990 --> 00:29:33,770 +شكرا، هنشوف أدلة و أمثلة متعددة المحاضرة اللي جاية + diff --git a/PL9fwy3NUQKwaRXaqd-S5-vsOEDL-Q45jU/SWvyCWmKIKs_raw.json b/PL9fwy3NUQKwaRXaqd-S5-vsOEDL-Q45jU/SWvyCWmKIKs_raw.json new file 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{"start": 1442.37, "end": 1442.59, "word": " هيك", "probability": 0.6864013671875}, {"start": 1442.59, "end": 1443.01, "word": " بتصير", "probability": 0.9108072916666666}, {"start": 1443.01, "end": 1443.39, "word": " بهذه", "probability": 0.782470703125}, {"start": 1443.39, "end": 1444.01, "word": " الصورة", "probability": 0.9876302083333334}, {"start": 1444.01, "end": 1444.29, "word": " طب", "probability": 0.61083984375}, {"start": 1444.29, "end": 1444.47, "word": " إيش", "probability": 0.800048828125}, {"start": 1444.47, "end": 1444.87, "word": " مستفيد", "probability": 0.8594970703125}, {"start": 1444.87, "end": 1444.97, "word": " من", "probability": 0.98193359375}, {"start": 1444.97, "end": 1445.07, "word": " هذا", "probability": 0.447265625}, {"start": 1445.07, "end": 1446.15, "word": " الكلام؟", "probability": 0.936279296875}, {"start": 1446.15, "end": 1446.47, "word": " الجيت", "probability": 0.299072265625}, {"start": 1446.47, "end": 1446.61, "word": " أنا", "probability": 0.55908203125}, {"start": 1446.61, "end": 1447.11, "word": " عنده", "probability": 0.698486328125}, {"start": 1447.11, "end": 1447.65, "word": " طبعا", "probability": 0.9083251953125}, {"start": 1447.65, "end": 1447.83, "word": " هذه", "probability": 0.5}, {"start": 1447.83, "end": 1448.03, "word": " الزد", "probability": 0.5433756510416666}, {"start": 1448.03, "end": 1448.25, "word": " ليه", "probability": 0.5921630859375}, {"start": 1448.25, "end": 1448.47, "word": " عبارة", "probability": 0.9471435546875}, {"start": 1448.47, "end": 1448.61, "word": " عن", "probability": 0.95703125}, {"start": 1448.61, "end": 1449.27, "word": " مين؟", "probability": 0.8976236979166666}, {"start": 1449.27, "end": 1449.41, "word": " E", "probability": 0.8701171875}, {"start": 1449.41, "end": 1449.51, "word": " to", "probability": 0.93115234375}, {"start": 1449.51, "end": 1449.75, "word": " power", "probability": 0.7919921875}, {"start": 1449.75, "end": 1450.01, "word": " I", "probability": 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0.045623779296875}, {"start": 1453.55, "end": 1453.67, "word": " power", "probability": 0.708984375}, {"start": 1453.67, "end": 1453.85, "word": " I", "probability": 0.66943359375}, {"start": 1453.85, "end": 1454.31, "word": " ثيتا", "probability": 0.56298828125}, {"start": 1454.31, "end": 1454.97, "word": " أُس", "probability": 0.62939453125}, {"start": 1454.97, "end": 1455.11, "word": " N", "probability": 0.77490234375}, {"start": 1455.11, "end": 1455.27, "word": " ده", "probability": 0.5546875}, {"start": 1455.27, "end": 1455.39, "word": " الكل", "probability": 0.6510009765625}, {"start": 1455.39, "end": 1455.51, "word": " ده", "probability": 0.7113037109375}, {"start": 1455.51, "end": 1455.89, "word": " الشكل", "probability": 0.9794921875}, {"start": 1455.89, "end": 1456.35, "word": " طب", "probability": 0.677001953125}, {"start": 1456.35, "end": 1457.13, "word": " انفكها", "probability": 0.880126953125}, {"start": 1457.13, "end": 1457.81, "word": " ودلنا", "probability": 0.59375}, {"start": 1457.81, "end": 1458.07, "word": " ال", "probability": 0.8203125}, {"start": 1458.07, "end": 1458.23, "word": " E", "probability": 0.9638671875}, {"start": 1458.23, "end": 1458.35, "word": " to", "probability": 0.96875}, {"start": 1458.35, "end": 1458.51, "word": " power", "probability": 0.865234375}, {"start": 1458.51, "end": 1458.69, "word": " I", "probability": 0.96337890625}, {"start": 1458.69, "end": 1458.91, "word": " ثيتا", "probability": 0.904296875}, {"start": 1458.91, "end": 1459.03, "word": " دي", "probability": 0.65966796875}, {"start": 1459.03, "end": 1459.37, "word": " اشمالها", "probability": 0.744189453125}, {"start": 1459.37, "end": 1459.77, "word": " رمز", "probability": 0.9119466145833334}, {"start": 1459.77, "end": 1460.39, "word": " ايش", "probability": 0.8312174479166666}, {"start": 1460.39, "end": 1461.11, "word": " حقيقتها", "probability": 0.9844970703125}, {"start": 1461.11, "end": 1462.01, "word": " cosine", "probability": 0.199951171875}, {"start": 1462.01, "end": 1463.65, "word": " ثيتا", "probability": 0.8614908854166666}, {"start": 1463.65, "end": 1464.17, "word": " زائد", "probability": 0.7568359375}, {"start": 1464.17, "end": 1464.59, "word": " I", "probability": 0.98095703125}, {"start": 1464.59, "end": 1464.79, "word": " في", "probability": 0.9267578125}, {"start": 1464.79, "end": 1465.13, "word": " sin", "probability": 0.56005859375}, {"start": 1465.13, "end": 1465.53, "word": " ثيتا", "probability": 0.9002278645833334}, {"start": 1465.53, "end": 1465.91, "word": " لكل", "probability": 0.96337890625}, {"start": 1465.91, "end": 1466.21, "word": " أُس", "probability": 0.90966796875}, {"start": 1466.21, "end": 1466.49, "word": " N", "probability": 0.9814453125}, {"start": 1466.49, "end": 1466.93, "word": " ايش", "probability": 0.8170572916666666}, {"start": 1466.93, "end": 1467.15, "word": " بده", "probability": 0.854736328125}, {"start": 1467.15, "end": 1467.53, "word": " يساوي", "probability": 0.8680419921875}, {"start": 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طبعا تطبيق على طول مباشرة من اللي برهنا", "tokens": [5172, 5016, 2407, 11703, 1211, 16247, 3794, 3794, 5296, 28814, 1863, 4724, 11242, 25513, 9154, 6024, 110, 14407, 25528, 8978, 25062, 9381, 7649, 31767, 5016, 1829, 5016, 13412, 38688, 23758, 9673, 9778, 3215, 2288, 13672, 1829, 31439, 20449, 28543, 39182, 25124, 1829, 38207, 45164, 16472, 2655, 39894, 9381, 13063, 16472, 1975, 8315, 50113, 15040, 8978, 21136, 995, 27884, 16490, 2304, 3794, 3660, 12399, 4724, 28259, 8592, 16472, 4117, 2655, 2288, 9122, 2655, 13546, 12399, 4724, 28259, 4117, 6055, 5172, 4117, 2288, 25062, 9381, 3660, 12399, 6055, 11242, 25513, 8978, 8717, 36178, 11296, 16490, 2304, 3794, 3714, 2288, 9307, 12399, 4724, 28820, 8608, 3224, 12610, 3660, 11933, 1829, 8592, 19446, 25894, 4117, 12399, 5296, 9307, 5016, 9566, 11933, 1829, 8592, 12399, 6055, 11242, 25513, 6024, 110, 995, 10632, 8978, 33962, 2304, 3794, 3660, 12399, 6156, 3224, 15730, 12174, 7649, 11536, 3714, 16095, 10874, 28259, 12399, 23032, 3555, 3615, 995, 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"probability": 0.98095703125}, {"start": 1486.3, "end": 1486.44, "word": " في", "probability": 0.73828125}, {"start": 1486.44, "end": 1486.64, "word": " نفسها", "probability": 0.8894856770833334}, {"start": 1486.64, "end": 1486.82, "word": " خمس", "probability": 0.9733072916666666}, {"start": 1486.82, "end": 1487.68, "word": " مرات،", "probability": 0.8521728515625}, {"start": 1487.68, "end": 1487.96, "word": " بكل", "probability": 0.9794921875}, {"start": 1487.96, "end": 1488.26, "word": " سهولة", "probability": 0.79327392578125}, {"start": 1488.26, "end": 1488.36, "word": " إيش", "probability": 0.6681722005208334}, {"start": 1488.36, "end": 1488.46, "word": " ما", "probability": 0.8388671875}, {"start": 1488.46, "end": 1488.76, "word": " عليك،", "probability": 0.7864583333333334}, {"start": 1488.76, "end": 1489.18, "word": " لاتحط", "probability": 0.82379150390625}, {"start": 1489.18, "end": 1489.7, "word": " إيش،", "probability": 0.9517822265625}, {"start": 1489.7, "end": 1490.0, 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مثال اه بدنا نحور جزر التلاتة زي I أس خمسة بدنا نكتبها بدلات الصيغة القياسية ليها X زي I Y بالصدفة الكلام بتاعة حكيته ايش أهميتها هذه؟", "tokens": [5172, 5172, 3615, 15040, 34105, 50113, 6027, 16247, 12610, 6156, 3615, 15040, 34105, 50113, 6027, 1975, 3224, 47525, 8315, 8717, 5016, 13063, 10874, 11622, 2288, 16712, 1211, 9307, 3660, 30767, 1829, 286, 5551, 3794, 16490, 2304, 3794, 3660, 47525, 8315, 8717, 4117, 2655, 3555, 11296, 47525, 1211, 9307, 31767, 1829, 17082, 3660, 25062, 25528, 3794, 10632, 32239, 11296, 1783, 30767, 1829, 286, 398, 20666, 9381, 3215, 5172, 3660, 2423, 28820, 10943, 39894, 995, 27884, 11331, 4117, 36081, 3224, 1975, 1829, 8592, 5551, 16095, 36081, 11296, 29538, 22807], "avg_logprob": -0.27095170319080353, "compression_ratio": 1.7696969696969698, "no_speech_prob": 2.384185791015625e-07, "words": [{"start": 1566.4, "end": 1566.92, "word": "ففعلا", "probability": 0.53155517578125}, {"start": 1566.92, "end": 1567.18, "word": " هنا", "probability": 0.91015625}, 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1604.29, "word": " القسمة", "probability": 0.9425455729166666}, {"start": 1604.29, "end": 1604.67, "word": " طبعا", "probability": 0.9571533203125}, {"start": 1604.67, "end": 1605.11, "word": " الأسس", "probability": 0.7440592447916666}, {"start": 1605.11, "end": 1605.77, "word": " ليس", "probability": 0.974365234375}, {"start": 1605.77, "end": 1606.23, "word": " الدرب", "probability": 0.919921875}, {"start": 1606.23, "end": 1606.79, "word": " متكرر", "probability": 0.7447916666666666}, {"start": 1606.79, "end": 1607.53, "word": " التربيه", "probability": 0.7852783203125}, {"start": 1607.53, "end": 1607.83, "word": " عبارة", "probability": 0.97119140625}, {"start": 1607.83, "end": 1607.97, "word": " عن", "probability": 0.98095703125}, {"start": 1607.97, "end": 1608.13, "word": " مين", "probability": 0.941162109375}, {"start": 1608.13, "end": 1608.35, "word": " عدد", "probability": 0.9332682291666666}, {"start": 1608.35, "end": 1608.47, "word": " في", "probability": 0.888671875}, {"start": 1608.47, "end": 1608.79, "word": " نفسه", "probability": 0.9959309895833334}, {"start": 1608.79, "end": 1609.27, "word": " التكييب", "probability": 0.787890625}, {"start": 1609.27, "end": 1609.53, "word": " عدد", "probability": 0.9786783854166666}, {"start": 1609.53, "end": 1609.61, "word": " من", "probability": 0.92724609375}, {"start": 1609.61, "end": 1609.85, "word": " نفسه", "probability": 0.9934895833333334}, {"start": 1609.85, "end": 1609.99, "word": " تلت", "probability": 0.6334635416666666}, {"start": 1609.99, "end": 1610.43, "word": " مرات", "probability": 0.83447265625}, {"start": 1610.43, "end": 1610.77, "word": " و", "probability": 0.6474609375}, {"start": 1610.77, "end": 1611.15, "word": " هكذا", "probability": 0.9484049479166666}], "temperature": 1.0}, {"id": 72, "seek": 163656, "start": 1611.34, "end": 1636.56, "text": "فطبعا لو تخيلتوا انك تتفكر الجزء تضرب هذا المقدار في نفسه خمس مرات او على الأقل بتعمل تربيع تربيع تضرب كمان مرة في كواحلة سلسلة كاي بعدين تجمعهم فعملية طويلة جدا لو تخيلتوا عملية الحساب هنحسبه بشكل بسيط جدا من استخدام ال exponential fork فهذا يدل على أهمية exponential fork solution فطبعا العملية هتبدأ ان نحول ال Z اللي هي جزء بتاعته Z واحد على مين exponential fork فإذا أول خطوة في الحال", "tokens": [5172, 9566, 3555, 3615, 995, 45164, 6055, 9778, 26895, 2655, 14407, 16472, 4117, 6055, 2655, 5172, 37983, 25724, 11622, 38207, 6055, 11242, 25513, 23758, 9673, 28543, 9640, 8978, 8717, 36178, 3224, 16490, 2304, 3794, 3714, 2288, 9307, 1975, 2407, 15844, 16247, 4587, 1211, 39894, 25957, 1211, 6055, 2288, 21292, 3615, 6055, 2288, 21292, 3615, 6055, 11242, 25513, 9122, 2304, 7649, 3714, 25720, 8978, 9122, 14407, 5016, 37977, 8608, 1211, 3794, 37977, 9122, 47302, 39182, 9957, 6055, 7435, 2304, 3615, 16095, 6156, 25957, 1211, 10632, 23032, 2407, 26895, 3660, 10874, 28259, 45164, 6055, 9778, 26895, 2655, 14407, 6225, 42213, 10632, 21542, 3794, 16758, 8032, 1863, 5016, 35457, 3224, 4724, 8592, 28820, 4724, 3794, 1829, 9566, 10874, 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"probability": 0.964599609375}, {"start": 1621.6, "end": 1621.96, "word": " طويلة", "probability": 0.9554443359375}, {"start": 1621.96, "end": 1622.18, "word": " جدا", "probability": 0.994140625}, {"start": 1622.18, "end": 1622.34, "word": " لو", "probability": 0.79736328125}, {"start": 1622.34, "end": 1622.82, "word": " تخيلتوا", "probability": 0.971875}, {"start": 1622.82, "end": 1623.18, "word": " عملية", "probability": 0.97314453125}, {"start": 1623.18, "end": 1623.6, "word": " الحساب", "probability": 0.9573567708333334}, {"start": 1623.6, "end": 1624.28, "word": " هنحسبه", "probability": 0.90263671875}, {"start": 1624.28, "end": 1624.66, "word": " بشكل", "probability": 0.994140625}, {"start": 1624.66, "end": 1625.02, "word": " بسيط", "probability": 0.9945068359375}, {"start": 1625.02, "end": 1625.28, "word": " جدا", "probability": 0.9873046875}, {"start": 1625.28, "end": 1625.48, "word": " من", "probability": 0.98388671875}, {"start": 1625.48, "end": 1625.94, "word": " استخدام", "probability": 0.973876953125}, {"start": 1625.94, "end": 1626.04, "word": " ال", "probability": 0.85986328125}, {"start": 1626.04, "end": 1626.34, "word": " exponential", "probability": 0.63720703125}, {"start": 1626.34, "end": 1626.68, "word": " fork", "probability": 0.314453125}, {"start": 1626.68, "end": 1627.26, "word": " فهذا", "probability": 0.9361979166666666}, {"start": 1627.26, "end": 1627.64, "word": " يدل", "probability": 0.7039388020833334}, {"start": 1627.64, "end": 1627.88, "word": " على", "probability": 0.9228515625}, {"start": 1627.88, "end": 1628.36, "word": " أهمية", "probability": 0.8902994791666666}, {"start": 1628.36, "end": 1628.74, "word": " exponential", "probability": 0.93896484375}, {"start": 1628.74, "end": 1629.08, "word": " fork", "probability": 0.97509765625}, {"start": 1629.08, "end": 1629.86, "word": " solution", "probability": 0.82080078125}, {"start": 1629.86, "end": 1630.9, "word": " فطبعا", "probability": 0.97060546875}, {"start": 1630.9, "end": 1631.3, "word": " العملية", "probability": 0.9786783854166666}, {"start": 1631.3, "end": 1631.7, "word": " هتبدأ", "probability": 0.967041015625}, {"start": 1631.7, "end": 1631.82, "word": " ان", "probability": 0.6435546875}, {"start": 1631.82, "end": 1632.24, "word": " نحول", "probability": 0.8024088541666666}, {"start": 1632.24, "end": 1632.44, "word": " ال", "probability": 0.880859375}, {"start": 1632.44, "end": 1632.66, "word": " Z", "probability": 0.57275390625}, {"start": 1632.66, "end": 1632.84, "word": " اللي", "probability": 0.669677734375}, {"start": 1632.84, "end": 1632.96, "word": " هي", "probability": 0.8984375}, {"start": 1632.96, "end": 1633.16, "word": " جزء", "probability": 0.7726236979166666}, {"start": 1633.16, "end": 1633.5, "word": " بتاعته", "probability": 0.7822265625}, {"start": 1633.5, "end": 1633.6, "word": " Z", "probability": 0.61572265625}, {"start": 1633.6, "end": 1633.82, "word": " واحد", "probability": 0.620849609375}, {"start": 1633.82, "end": 1634.0, "word": " على", "probability": 0.685546875}, {"start": 1634.0, "end": 1634.26, "word": " مين", "probability": 0.888671875}, {"start": 1634.26, "end": 1634.92, "word": " exponential", "probability": 0.5869140625}, {"start": 1634.92, "end": 1635.36, "word": " fork", "probability": 0.66748046875}, {"start": 1635.36, "end": 1635.68, "word": " فإذا", "probability": 0.7711588541666666}, {"start": 1635.68, "end": 1635.92, "word": " أول", "probability": 0.8623046875}, {"start": 1635.92, "end": 1636.16, "word": " خطوة", "probability": 0.9710693359375}, {"start": 1636.16, "end": 1636.28, "word": " في", "probability": 0.95361328125}, {"start": 1636.28, "end": 1636.56, "word": " الحال", "probability": 0.914306640625}], "temperature": 1.0}, {"id": 73, "seek": 166394, "start": 1637.38, "end": 1663.94, "text": "بدى تساوي اللى هى R E to power I فى ثيتا هى اللى هى الخطوة الاولى بقى نحوّل هذا العدد بدا الشكل بعدين هسي الأس على طول هقول R أس خمسة E to power خمسة ست ثيتا بس ليس L باستخدام ماشي دوموفريز theorem بها ده ديموفريز form طيب بالنسبة هنا للR إيش بتساوي اللى هو modulus جزر التلاتة زي بقى إذا حبينا نسموه زي ما ممكن تسموه اختصارا Y يساوي كدهاش؟", "tokens": [3555, 3215, 7578, 6055, 3794, 995, 45865, 13672, 7578, 8032, 7578, 497, 462, 281, 1347, 286, 6156, 7578, 38637, 36081, 995, 8032, 7578, 13672, 7578, 8032, 7578, 33962, 9566, 2407, 3660, 42963, 12610, 7578, 4724, 4587, 7578, 8717, 5016, 2407, 11703, 1211, 23758, 18863, 3215, 3215, 4724, 28259, 25124, 28820, 39182, 9957, 8032, 3794, 1829, 16247, 3794, 15844, 23032, 12610, 8032, 39648, 497, 5551, 3794, 16490, 2304, 3794, 3660, 462, 281, 1347, 16490, 2304, 3794, 3660, 8608, 2655, 38637, 36081, 995, 4724, 3794, 32239, 3794, 441, 4724, 995, 14851, 9778, 3215, 10943, 3714, 33599, 1829, 11778, 20498, 38688, 16572, 11622, 20904, 4724, 11296, 11778, 3224, 11778, 32640, 38688, 16572, 11622, 1254, 23032, 1829, 3555, 20666, 1863, 35457, 3660, 34105, 24976, 49, 11933, 1829, 8592, 39894, 3794, 995, 45865, 13672, 7578, 31439, 42287, 10874, 11622, 2288, 16712, 1211, 9307, 3660, 30767, 1829, 4724, 4587, 7578, 11933, 15730, 11331, 21292, 8315, 8717, 38251, 2407, 3224, 30767, 1829, 19446, 3714, 43020, 6055, 38251, 2407, 3224, 1975, 46456, 9381, 9640, 995, 398, 7251, 3794, 995, 45865, 9122, 3215, 3224, 33599, 22807], "avg_logprob": -0.3732443726464604, "compression_ratio": 1.817891373801917, "no_speech_prob": 5.960464477539063e-08, "words": [{"start": 1637.38, "end": 1637.7, "word": "بدى", "probability": 0.3830159505208333}, {"start": 1637.7, "end": 1638.16, "word": " تساوي", "probability": 0.9285888671875}, {"start": 1638.16, "end": 1638.32, "word": " اللى", "probability": 0.6346435546875}, {"start": 1638.32, "end": 1638.5, "word": " هى", "probability": 0.81396484375}, {"start": 1638.5, "end": 1638.88, "word": " R", "probability": 0.525390625}, {"start": 1638.88, "end": 1639.1, "word": " E", "probability": 0.6298828125}, {"start": 1639.1, "end": 1639.24, "word": " to", "probability": 0.068115234375}, {"start": 1639.24, "end": 1639.48, "word": " power", "probability": 0.66357421875}, {"start": 1639.48, "end": 1639.72, "word": " I", "probability": 0.751953125}, {"start": 1639.72, "end": 1639.88, "word": " فى", "probability": 0.752685546875}, {"start": 1639.88, "end": 1640.18, "word": " ثيتا", "probability": 0.460693359375}, {"start": 1640.18, "end": 1640.44, "word": " هى", "probability": 0.4619140625}, {"start": 1640.44, "end": 1640.48, "word": " اللى", "probability": 0.957275390625}, {"start": 1640.48, "end": 1640.6, "word": " هى", "probability": 0.801513671875}, {"start": 1640.6, "end": 1640.86, "word": " الخطوة", "probability": 0.8941650390625}, {"start": 1640.86, "end": 1642.16, "word": " الاولى", "probability": 0.8203125}, {"start": 1642.16, "end": 1642.48, "word": " بقى", "probability": 0.5828450520833334}, {"start": 1642.48, "end": 1642.84, "word": " نحوّل", "probability": 0.67490234375}, {"start": 1642.84, "end": 1642.98, "word": " هذا", "probability": 0.385498046875}, {"start": 1642.98, "end": 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اذا كان لا يساوي zero بنقدر نكتب على صورة مين الموديل الصدعو في مين في حصل في f exponential لأي argument لأي argument طبعا ال argument هي الأسهل وهي الأساسية اللي بتعمل معها", "tokens": [45636, 995, 1975, 5016, 8315, 1975, 1829, 8592, 10874, 1829, 3555, 8315, 11331, 9381, 1211, 32748, 25513, 3714, 3555, 33599, 25720, 4032, 4587, 9640, 1863, 11296, 20449, 20328, 1829, 17082, 3660, 11331, 9381, 1211, 32748, 25513, 1975, 1829, 8592, 9673, 2655, 30543, 3615, 1975, 1829, 8592, 5296, 31377, 2304, 6055, 30544, 1975, 1829, 8592, 25062, 7649, 11536, 1975, 3224, 6156, 39319, 8315, 34105, 9154, 11331, 3794, 16758, 9673, 3555, 33599, 2288, 37037, 8315, 1975, 1829, 8592, 9673, 5172, 32887, 11242, 6055, 30544, 5296, 7649, 1975, 1829, 6225, 3215, 3215, 3714, 31747, 3555, 1975, 15730, 25961, 20193, 7251, 3794, 995, 45865, 4018, 44945, 28543, 2288, 8717, 4117, 2655, 3555, 15844, 20328, 13063, 3660, 3714, 9957, 9673, 2407, 16254, 1211, 31767, 3215, 3615, 2407, 8978, 3714, 9957, 8978, 11331, 9381, 1211, 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2439.8, "text": "الثالثة اذكرناها طبعا اي ادية ما تؤدي للغلط ولكن هذه هي الاصل هذه هي الاصل", "tokens": [6027, 12984, 6027, 12984, 3660, 1975, 8848, 37983, 8315, 11296, 23032, 3555, 3615, 995, 1975, 1829, 1975, 3215, 10632, 19446, 6055, 33604, 16254, 24976, 17082, 1211, 9566, 35525, 19452, 29538, 39896, 2423, 33546, 1211, 29538, 39896, 2423, 33546, 1211], "avg_logprob": -0.40859374925494196, "compression_ratio": 1.488888888888889, "no_speech_prob": 3.6954879760742188e-06, "words": [{"start": 2428.46, "end": 2428.94, "word": "الثالثة", "probability": 0.665478515625}, {"start": 2428.94, "end": 2429.56, "word": " اذكرناها", "probability": 0.678125}, {"start": 2429.56, "end": 2429.88, "word": " طبعا", "probability": 0.9085693359375}, {"start": 2429.88, "end": 2430.12, "word": " اي", "probability": 0.876708984375}, {"start": 2430.12, "end": 2430.32, "word": " ادية", "probability": 0.453369140625}, {"start": 2430.32, "end": 2430.42, "word": " ما", "probability": 0.497802734375}, {"start": 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a/PL9fwy3NUQKwaRXaqd-S5-vsOEDL-Q45jU/cUGb2XhM-Lk_raw.srt b/PL9fwy3NUQKwaRXaqd-S5-vsOEDL-Q45jU/cUGb2XhM-Lk_raw.srt new file mode 100644 index 0000000000000000000000000000000000000000..03b9da892cd73864dbc86bb8be30b01162b639ab --- /dev/null +++ b/PL9fwy3NUQKwaRXaqd-S5-vsOEDL-Q45jU/cUGb2XhM-Lk_raw.srt @@ -0,0 +1,2232 @@ +1 +00:00:09,220 --> 00:00:14,480 +بسم الله الرحمن الرحيم اليوم في اليوم المحاضرة + +2 +00:00:14,480 --> 00:00:18,320 +الأخيرة في chapter 3 هتحدث عن معاقوس الدوال + +3 +00:00:18,320 --> 00:00:23,660 +المثلثية والدوال الزائديةهنا في دراسة ال inverse + +4 +00:00:23,660 --> 00:00:28,080 +function لن نتبع النموذج اللى يمكن مار علينا + +5 +00:00:28,080 --> 00:00:31,560 +التفاضل بها ان ندور الدالة هي one to one and one + +6 +00:00:31,560 --> 00:00:35,540 +to ومن ثم نبحث نعرف ال inverse وانما هنستمر في + +7 +00:00:35,540 --> 00:00:40,500 +السياسة السابقة اللى اتعمدناها في الجذور انونية + +8 +00:00:40,500 --> 00:00:44,240 +لما عرفنا الجذور انونية لعدد مركب z0 هي حلل معادلة + +9 +00:00:44,240 --> 00:00:48,510 +z أس أنتسا و z0ايضا استخدمناها في تعريف اللغة رتم + +10 +00:00:48,510 --> 00:00:50,930 +لم نعرف علي ان هو ال inverse function لل + +11 +00:00:50,930 --> 00:00:54,330 +exponential وانما عرفناها هو حل المعادلة E of W + +12 +00:00:54,330 --> 00:00:58,530 +تساوي Z فبنفس الاسلوب لما بدي انا ادرس ال inverse + +13 +00:00:58,530 --> 00:01:05,770 +sine function W تساوي sine inverse Z فهذا هدرسه ان + +14 +00:01:05,770 --> 00:01:15,060 +F and W تساوي Zفبنعرف الـSin inverse لعدد مُركّب Z + +15 +00:01:15,060 --> 00:01:20,880 +هو العدد المُركّب W اللي الـSin تبعه بيساوي Z بشكل + +16 +00:01:20,880 --> 00:01:24,360 +عام، بشكل عام. الآن عشان نحل هذه المعادلة ونشوف + +17 +00:01:24,360 --> 00:01:27,140 +الـW إيش بتساوي Z ونعملها في اللغتين، هنبدأ نحاول + +18 +00:01:27,140 --> 00:01:31,840 +نحل هذه المعادلة فهذه المعادلة if and only if Sin + +19 +00:01:31,840 --> 00:01:37,120 +W إيش بتساوي؟ بتساوي 1 على 2I E to power I في W + +20 +00:01:37,120 --> 00:01:43,540 +ماقص E to power سالب I في Wأي سؤال؟ بدأ تساوي الـ + +21 +00:01:43,540 --> 00:01:49,220 +z بدأ تساوي الـ z فحنحل هذه المعادلة و نجيب + +22 +00:01:49,220 --> 00:01:54,900 +المجهول اللي هو مين المجهول؟ و هحنحاول نحلي + +23 +00:01:54,900 --> 00:01:57,560 +المعادلة هذه و نجيب و فالسؤال كيف ممكن نحلي + +24 +00:01:57,560 --> 00:02:01,300 +المعادلة هذه؟ + +25 +00:02:01,300 --> 00:02:05,220 +كيف يمكن حل هذه المعادلة و إيجاد و؟ + +26 +00:02:09,570 --> 00:02:15,730 +عشان نحن اللغات المخاطرة الشياء لأن اللغات + +27 +00:02:15,730 --> 00:02:23,290 +المخاطرة الشياء لأن اللغات المخاطرة الشياء لأن + +28 +00:02:23,290 --> 00:02:24,950 +اللغات المخاطرة الشياء لأن اللغات المخاطرة الشياء + +29 +00:02:24,950 --> 00:02:25,510 +لأن اللغات المخاطرة الشياء لأن اللغات المخاطرة + +30 +00:02:25,510 --> 00:02:26,430 +الشياء لأن اللغات المخاطرة الشياء لأن اللغات + +31 +00:02:26,430 --> 00:02:26,430 +المخاطرة الشياء لأن اللغات المخاطرة الشياء لأن + +32 +00:02:26,430 --> 00:02:27,530 +اللغات المخاطرة الشياء لأن اللغات المخاطرة الشياء + +33 +00:02:27,530 --> 00:02:29,510 +لأن اللغات المخاطرة الشياء لأن اللغات المخاطرة + +34 +00:02:29,510 --> 00:02:31,390 +الشياء لأن اللغات المخاطرة الشياء لأن اللغات + +35 +00:02:31,390 --> 00:02:36,550 +المخاطرة الشياء لأن اللغات المخاطرة الشياء لأن + +36 +00:02:36,550 --> 00:02:39,330 +اللغات المخاطرة الشياء لأن اللغ + +37 +00:02:44,350 --> 00:02:46,690 +عالصورة اللي هو ممكن اكس ورانشة فور من و ساعة و + +38 +00:02:46,690 --> 00:02:50,170 +ممكن طريقة طوية لكننا هنستخدم طريقة أقصى هنحاول أن + +39 +00:02:50,170 --> 00:02:54,650 +نحل اللي عملنا لبعادة التاريخ بيائية و المجهول E + +40 +00:02:54,650 --> 00:03:00,030 +أُس IW إذا وجدنا E أُس IW نقل لغاية النمي IW و W و + +41 +00:03:00,030 --> 00:03:02,960 +ننسيب على I مش مشكلةفهنحول هذه لمعادلة تربية + +42 +00:03:02,960 --> 00:03:08,380 +فهنضغوا بالطرفين اتنين I E أس I في W تعرف علينا + +43 +00:03:08,380 --> 00:03:12,240 +الفكرة اللي جاب ليها مرة لما كنا نحل I bar بوليكوز + +44 +00:03:12,240 --> 00:03:15,480 +أوكسين I bar بوليكوز بنفس ال slope اتوقع هي أصلا + +45 +00:03:15,480 --> 00:03:17,760 +في حل I bar بوليكوز أوكسين فلما نضغو مش بتصير هذه + +46 +00:03:17,760 --> 00:03:23,780 +المعادلة بيصير E أس IW لكل تربية بتروح إلى اتنين + +47 +00:03:23,780 --> 00:03:29,900 +ناقص واحد بيبقى تسوى اتنين I في Z في E to power IW + +48 +00:03:31,630 --> 00:03:39,010 +أو بشكل مكافئ Iw لكل تربيع ناقص اتنين Iz e to + +49 +00:03:39,010 --> 00:03:46,050 +power Iw ناقص واحد تسلاوسفهذه معادلة تربيعية في + +50 +00:03:46,050 --> 00:03:51,430 +المجهول مين E اص IW فعصفة عندي معادلة تربيعية + +51 +00:03:51,430 --> 00:03:56,630 +المجهول فيها هو X او ايش ما تسميه سميه E to power + +52 +00:03:56,630 --> 00:04:00,810 +IW بقدر احلها عن طريق القانون او عن طريق اكمال + +53 +00:04:00,810 --> 00:04:04,210 +المربع طبعا مار عليكوا في التمرين انه ايش القانون + +54 +00:04:04,210 --> 00:04:08,230 +اللي هو العام بتامه صحيح في حالة مين الاعداد + +55 +00:04:08,230 --> 00:04:16,350 +المركب فطبقا لهذا القانونE اص I W هتساوي سالب هذا + +56 +00:04:16,350 --> 00:04:21,130 +المقدار اللي هو اتنين I في Z زائد من غير زائد او + +57 +00:04:21,130 --> 00:04:25,030 +ناقص هنحطه في الجزر التربية اقص نص هنحطه مش زائد + +58 +00:04:25,030 --> 00:04:28,830 +او ناقص هنحطه في اختلاف لو رجعته الكتاب طبعا بدنا + +59 +00:04:28,830 --> 00:04:32,090 +مربع هذا المقدار جديش المربع هنا + +60 +00:04:35,310 --> 00:04:39,970 +سالب أربعة زي التربية بعدين أربعة في هذا المقدار + +61 +00:04:39,970 --> 00:04:45,470 +اللي هو جديش زائد أربعة على جديش على اتنين على + +62 +00:04:45,470 --> 00:04:52,270 +اتنين لأنه في العداد اللي هو وزموجه أو ناقص بس في + +63 +00:04:52,270 --> 00:04:54,850 +معنى أخر بجدش أحط الجزر زاد أو ناقص الجزر هو جزر + +64 +00:04:54,850 --> 00:04:59,090 +فبديش تكرار لزاد أو ناقص لأن هنا بدي أحط مثلا انا + +65 +00:04:59,090 --> 00:05:02,290 +عندي على عضل مركب فايجي أحط زاد أو ناقص الجزر + +66 +00:05:02,290 --> 00:05:02,830 +لمين؟ + +67 +00:05:23,260 --> 00:05:31,900 +ممكن نحلها بهذه أسوأ أي سؤالالنقص من النقص من اين + +68 +00:05:31,900 --> 00:05:35,080 +النقص؟ زاد او ناقص فنقول انك تجي من النقص نص نص + +69 +00:05:35,080 --> 00:05:37,580 +حدين اقل تان كجزء التربية إلى هذا المعنى في حالة + +70 +00:05:37,580 --> 00:05:40,780 +المركب بتكون في هذه الصورة لإنه عفر ما زاد او ناقص + +71 +00:05:40,780 --> 00:05:43,940 +واحد ناقص في التربية نقص نص حدين تجي من هنا زاد و + +72 +00:05:43,940 --> 00:05:49,180 +ناقص بيصير فيه اللي هو تكرار او بيصير فيه العملية + +73 +00:05:49,180 --> 00:05:53,240 +مش مناسبة اه الآن جيبنا E of IW ناخد لغة الترفيه + +74 +00:05:53,240 --> 00:05:59,520 +لترفيه ف log E to power IW بدأ تساوي logلهذا + +75 +00:05:59,520 --> 00:06:05,200 +المقدار اللي هو مين I في Z زي واحد ما في Z تقريبا + +76 +00:06:05,200 --> 00:06:13,220 +أسمه Z اللي هو قيمتين زي ما احنا أرف جيد ايش رايك + +77 +00:06:13,220 --> 00:06:17,720 +كله غلطي مضايين ال differential ولا مضايحاش؟ مضايع + +78 +00:06:17,720 --> 00:06:23,800 +او مضايع ايه الجواب IW؟ لأ لأ اه فهذه عبارة عن IW + +79 +00:06:23,800 --> 00:06:24,560 +زي جديش + +80 +00:06:32,070 --> 00:06:36,870 +اللغتم هذا عبارة + +81 +00:06:36,870 --> 00:06:39,530 +عن لن مضطق هذا النقطة + +82 +00:07:01,870 --> 00:07:03,790 +اعداد صحيح + +83 +00:07:08,620 --> 00:07:14,220 +هنا لو عدنا الترتيب طب انا بدور على W I W هتساوي N + +84 +00:07:14,220 --> 00:07:18,220 +ملابس الطرف التاني بيصير Lين المقتار اللي هيزل زي + +85 +00:07:18,220 --> 00:07:25,680 +ما هو اشبه افتصار زائد I argument نفس النقدر برضه + +86 +00:07:25,680 --> 00:07:29,800 +هيزل زي ما هو زائد لو نخصنا هذا المقتار و هذا + +87 +00:07:29,800 --> 00:07:34,260 +المقتار اللي معاه المشترك هو اتنين by R اتنين by R + +88 +00:07:34,260 --> 00:07:41,670 +في مين؟ في N ناقص Nبنعرف هنا النقطة أو الشاهد من + +89 +00:07:41,670 --> 00:07:45,850 +هذا الاشتراك الأم والأغلى دول النتجات فالفقه من + +90 +00:07:45,850 --> 00:07:51,250 +النتجات فهذا الممكن أن استبدل منين ب name by ik + +91 +00:07:55,420 --> 00:07:59,440 +أيه صار يا شباب؟ ننتبه هنا لنقطة مهمة جدا، ايش في + +92 +00:07:59,440 --> 00:08:03,000 +عندي؟ على الطرف اليمين، في handling مطلع مقتار + +93 +00:08:03,000 --> 00:08:07,220 +زائد I في ال principle argument الو زائد عدد صحيح + +94 +00:08:07,220 --> 00:08:11,300 +2 by R، هو مين؟ هو تعريف النقل أصلي، فهذا هو نفسه، + +95 +00:08:11,300 --> 00:08:15,640 +برجع لنفس المقدار، لغتي نفس المقدار اللي هو مين؟ I + +96 +00:08:15,640 --> 00:08:22,570 +Z زائد واحد ماقص Z تربية أصلاكيف نستفيد من هذا + +97 +00:08:22,570 --> 00:08:26,270 +الكلام؟ إن إبعاط الاتنين عن طريق عيلة لم تؤثر على + +98 +00:08:26,270 --> 00:08:31,170 +العملية ككلها، لم تؤثر على عملية كل الناس، لأن + +99 +00:08:31,170 --> 00:08:33,670 +العدد اللي يعمل ضمنها ما تصير أيش في الآخر، انتجة + +100 +00:08:33,670 --> 00:08:36,610 +لواحد، انتجة لواحد، يعني ممكن تشمل العملية كيف، لو + +101 +00:08:36,610 --> 00:08:38,390 +أنا في حالة أني بكامل طرح فيها، أنا أضيف ثابت أو + +102 +00:08:38,390 --> 00:08:40,230 +أضف ثابت أو أضف ثابت ممكن أضف ثابت أو أضف ثابت + +103 +00:08:40,230 --> 00:08:42,870 +جديد، فإن لم تؤثر، لكن بالأصل إنه فيه + +104 +00:08:48,980 --> 00:08:51,900 +خلاص انتهت العملية، الآن هنتجسم على R يعني اضغط في + +105 +00:08:51,900 --> 00:08:58,200 +مين؟ في سالب R، اذا الـW اللي + +106 +00:08:58,200 --> 00:09:06,100 +يمين Psi Inverses Z بتساوي سالب I في لغة IZ زائد 1 + +107 +00:09:06,100 --> 00:09:10,960 +-Z تقريبا أصلا، فهذا هو تعريف Psi Inverses، فهذا + +108 +00:09:10,960 --> 00:09:18,840 +هو تعريف Psi Inverses، أي سؤالفطبعا زي ما حكينا + +109 +00:09:18,840 --> 00:09:25,440 +هالي عبارة عن اللغة multi-valued هذا هي السلم + +110 +00:09:25,440 --> 00:09:27,660 +اللي متكسم على R + +111 +00:09:34,660 --> 00:09:38,420 +مثال او اول مثال طبعا هذه multivalue ال multivalue + +112 +00:09:38,420 --> 00:09:42,560 +بيه من مصدرين يا شباب مش مصدر واحد هنا في عندك two + +113 +00:09:42,560 --> 00:09:45,640 +-valued function و هنا في one-loved one-loved فهذه + +114 +00:09:45,640 --> 00:09:48,720 +multivalue فإذا sine inverse of z ليس ال function + +115 +00:09:48,720 --> 00:09:51,880 +و هنا مبارك تظهر ال function بالمصطلح اللي مواطلين + +116 +00:09:51,880 --> 00:09:55,320 +عليه فطبعا هنحاول ندرس بتصري و كيف نعمل منها + +117 +00:09:55,320 --> 00:09:57,460 +function و كيف نعمل منها another function لكن + +118 +00:09:57,460 --> 00:10:02,760 +واحدة واحدة خليني الآن نحاول نتعول على التعريف + +119 +00:10:05,360 --> 00:10:09,220 +و نحاول نوضح تعريف كيف بنستخدم أو كيف بنفقد + +120 +00:10:09,220 --> 00:10:13,800 +القانون و نشوف مثال خلّينا + +121 +00:10:13,800 --> 00:10:20,460 +نحسب sine and this اتنين solution + +122 +00:10:20,460 --> 00:10:23,540 +of example one + +123 +00:10:32,640 --> 00:10:37,400 +هنا الـ z بالساومين اتنين اذا I في اتنين زائد واحد + +124 +00:10:37,400 --> 00:10:44,600 +مربع اتنين اربع الكل اص نص تبقى القانون z تساومين + +125 +00:10:44,600 --> 00:10:50,500 +اتنين انبسط على المقدار او انبسط الحسابات لو 2I + +126 +00:10:50,500 --> 00:10:53,260 +زائد ثالث تلاته اص نص + +127 +00:10:56,460 --> 00:11:00,260 +هذا هو المعنى طبعا زي المتفاق ماديش قمتين مين اللي + +128 +00:11:00,260 --> 00:11:03,820 +هو الديزير فيه لسهل التلاتة زائد او ماقص جزر + +129 +00:11:03,820 --> 00:11:06,420 +التلاتة I طبعا ممكن تحسبوها لكن انا مبادرة على ال + +130 +00:11:06,420 --> 00:11:12,880 +top هنا و تساوي سالب I log اتنين I زائد او ماقص + +131 +00:11:12,880 --> 00:11:18,900 +جزر التلاتة في I أي سؤال طبعا عامة التعريف هنا يا + +132 +00:11:18,900 --> 00:11:22,480 +شباب احنا حسبناها اكتر من مرة و دراسنا لواش ال + +133 +00:11:22,480 --> 00:11:24,600 +square root function حطينا على الطريقة مقتصرة جدا + +134 +00:11:30,810 --> 00:11:39,250 +أي سؤال .. اي سؤال .. اي + +135 +00:11:39,250 --> 00:11:43,890 +سؤالفانا في عندي رقمتين ممكن انا احسبهم كل واحدة + +136 +00:11:43,890 --> 00:11:47,530 +على حدة و انا يمكن الواحد ننصح فيه و اصحه في + +137 +00:11:47,530 --> 00:11:50,590 +البداية طبعا انا ممكن اعرجهم مع بعض نعم بس بدي + +138 +00:11:50,590 --> 00:11:54,130 +شوية التبارك انا هعرجهم مع بعض هشف عليهم مع بعض + +139 +00:11:54,130 --> 00:11:58,870 +طيب Y ساوي سالب I ايش عارف اللغة لتم نفتح جرس كبير + +140 +00:12:01,040 --> 00:12:05,800 +لن المضي لف لها للعدد اللي هو اتنين زائد او معقز + +141 +00:12:05,800 --> 00:12:09,340 +جزر التلاتة مضروفه في I كله اخد ال I عن المشترك + +142 +00:12:09,340 --> 00:12:14,920 +فبدنا نقول ايش لغتهم للمضي لف لها للكلام زائد I + +143 +00:12:14,920 --> 00:12:18,520 +principle argument لها للعدد argument اللي هو + +144 +00:12:18,520 --> 00:12:26,440 +اتنين زائد او معقز جزر التلاتة في I الكل في I بس + +145 +00:12:26,440 --> 00:12:34,240 +خلينا نعمل ايه اش قسيميزاد و 2N Pi في R و ال N + +146 +00:12:34,240 --> 00:12:40,960 +تنتمي لل Z أي انتجار التعيين يا شباب لم ال modulus + +147 +00:12:40,960 --> 00:12:44,980 +ال argument اللي هي principle argument زاد 2N + +148 +00:12:44,980 --> 00:12:50,690 +مطلوب كله في R من N Pi فهذا هو الملبسفطبعا انا + +149 +00:12:50,690 --> 00:12:53,510 +باختصار طبعا ممكن انتوا زي ما حكيتوا احد و كل واحد + +150 +00:12:53,510 --> 00:12:56,570 +لحاله لكن انا بدي احاول احلت الاتنين مع بعض و + +151 +00:12:56,570 --> 00:13:01,190 +هنقشهم و انتوا مخيرين نبدأ بالخطوة الأسهل وهي ال + +152 +00:13:01,190 --> 00:13:03,470 +modulus كيف نحسب ال modulus + +153 +00:13:14,980 --> 00:13:18,080 +يعني عدد ثابت في أي عدد حقيقي فعلا ايش اللي بيقول + +154 +00:13:18,080 --> 00:13:21,000 +ياسئله absolute value ازاى عدد لإن اللي بيقول ياسئ + +155 +00:13:21,000 --> 00:13:25,200 +وزعه بطلب ممكن يسأل أي واحد فهذه الحقيقة بيساوي + +156 +00:13:25,200 --> 00:13:33,260 +سالب I نفتح الجثث الكبير نفتح + +157 +00:13:33,260 --> 00:13:39,440 +الجثث الكبير عبارة عن Len absolute value اتنين + +158 +00:13:39,440 --> 00:13:44,790 +زائدهذا عدد حقيقي شباب، بتتابعوا أنه هنا مش هذا + +159 +00:13:44,790 --> 00:13:47,950 +يوري الواقع و المجلن و البعض، كله المجلن و البعض، + +160 +00:13:47,950 --> 00:13:50,450 +كل هذا يوري المجلن و البعض، فالمدرس هات المطلق + +161 +00:13:50,450 --> 00:13:53,410 +نصفه، طبعا من القانون، لو اللي بتقول X نصفه نصفه، + +162 +00:13:53,410 --> 00:13:56,490 +فهتقول هو Y تربيه، خلاص ال I راحة، طب الجنس تربيه + +163 +00:13:56,490 --> 00:13:58,970 +أو Y تربيه؟ مطلق الواقع، مطلق الواقع، اللي هو هذا + +164 +00:13:58,970 --> 00:14:02,290 +الكلام تمام، طبعا هذا المجرد اسم الجنس اللي انتقل + +165 +00:14:02,290 --> 00:14:07,730 +منه، ممكن انشي لفسي الفاريو عفوية إشارتهمافيش رأي + +166 +00:14:07,730 --> 00:14:10,510 +كل المختار الجيواني؟ طب اذا اتلص اتلص موجة فبتنين + +167 +00:14:10,510 --> 00:14:14,950 +ماقص .. صحيح لإن ده تبقى كل واحد مُن سفر فهذا + +168 +00:14:14,950 --> 00:14:18,050 +بالتامة مُن فلو سفر ممكن نشيله طب عاملوش داعي لكن + +169 +00:14:18,050 --> 00:14:20,730 +لو تحبت تشيله بتشيله مش مشكلة لإن المختار الجيواني + +170 +00:14:20,730 --> 00:14:24,070 +دايما مُن بالحالتين طب اتلص اتلص موجة لكن ايه؟ + +171 +00:14:24,070 --> 00:14:27,070 +اتنين ماقص جزء ثلاثة؟ مختار موجة .. مختار موجة .. + +172 +00:14:27,070 --> 00:14:29,790 +بس هذه كان ملاحظة .. بس هذه حفيظنا الآن طيب نيجي + +173 +00:14:29,790 --> 00:14:33,310 +نشوف ال argument بيأتنين .. بي + +174 +00:14:35,610 --> 00:14:40,990 +هو عبارة عن عدد في R يعني بيكون يانه بيعة اتنين + +175 +00:14:40,990 --> 00:14:45,150 +كذا في بيعة اتنين اذا نزالش بيقول بيعة اتنين اذا + +176 +00:14:45,150 --> 00:14:51,230 +زائد I في بيعة اتنين زائد اتنين I فتقرر ان انا + +177 +00:14:51,230 --> 00:14:55,110 +عرشت المعبار لكن زائد ده مش جادر كل واحد اللي عارف + +178 +00:14:55,110 --> 00:14:55,390 +يحسب + +179 +00:15:02,710 --> 00:15:06,290 +المفضل المفضل المفضل المفضل المفضل المفضل المفضل + +180 +00:15:06,290 --> 00:15:06,810 +المفضل المفضل المفضل المفضل المفضل المفضل المفضل + +181 +00:15:06,810 --> 00:15:09,910 +المفضل المفضل المفضل المفضل المفضل المفضل المفضل + +182 +00:15:09,910 --> 00:15:16,950 +المفضل المفضل المفضل المفضل المفضل المفضل المفضل + +183 +00:15:16,950 --> 00:15:20,830 +المفضل المفضل المفضل المفضل المفضل المفضل المفضل + +184 +00:15:20,830 --> 00:15:23,990 +المفضل المفضل المفضل المفضل المفضل المفضل المفضل + +185 +00:15:23,990 --> 00:15:23,990 +المفضل المفضل المفضل المفضل المفضل المفضل المفضل + +186 +00:15:23,990 --> 00:15:24,910 +المفضل المفضل المفضل المفضل المفضل المفضل المفضل + +187 +00:15:43,240 --> 00:15:47,400 +الحقيقة الإشارة اللي زالة ومحصلها ممكن أن تقولها + +188 +00:15:47,400 --> 00:15:53,160 +ضرر طبعا إيش؟ الكلام مش سهل لأول واحدة لأن اللغة + +189 +00:15:53,160 --> 00:15:55,600 +اللي بتوزعش على الديان أو الطرق فهذه فيها trick + +190 +00:15:55,600 --> 00:15:59,720 +بسيط طبعا اللي بص عشان إيه بص؟ هتطلع على اتنين + +191 +00:15:59,720 --> 00:16:05,410 +معقز جزر التلاتة هذا محطمه في المرافقإتنين زي جزر + +192 +00:16:05,410 --> 00:16:07,690 +التلاتة على إتنين زي جزر التلاتة طبعا المنافسة + +193 +00:16:07,690 --> 00:16:10,670 +كانت على number وليس ك complex number بهذا الشكل + +194 +00:16:10,670 --> 00:16:13,630 +زي ما تعودنا في النهايات في تفاضلاني لو حصلتوا + +195 +00:16:13,630 --> 00:16:16,750 +بهذا الشكل إيش بيساوي هذا بيساوي ايه تربيه ناقص من + +196 +00:16:16,750 --> 00:16:20,850 +تربيه أربع ناقص تلاتة واحد على مين جزر التلاتة + +197 +00:16:20,850 --> 00:16:24,530 +ماذا يعني هذا الكلام هتحارف بيساوي إتنين ناقص جزر + +198 +00:16:24,530 --> 00:16:28,090 +التلاتة لو أخدت لغريد من الطرفين فاللي بيقول إن لن + +199 +00:16:28,090 --> 00:16:31,950 +إتنين ناقص جزر التلاتة إيش بتساوي لن هذا اللي هو + +200 +00:16:31,950 --> 00:16:38,000 +عبارة عن سالب لنزي الجزر كده يعني هذا المقدار إذا + +201 +00:16:38,000 --> 00:16:41,580 +كان plus فهيأك هو vote plus وإذا كان من minus يكون + +202 +00:16:41,580 --> 00:16:44,680 +minus من المقدار فانا ممكن أدلها باش بتصير ما هو + +203 +00:16:44,680 --> 00:16:51,240 +minus plus I لل 2 زي الجزر كدهممكن زي ما السيدنا + +204 +00:16:51,240 --> 00:16:53,740 +محمد محمد محمد محمد محمد محمد محمد محمد محمد محمد + +205 +00:16:53,740 --> 00:17:08,020 +محمد محمد محمد + +206 +00:17:11,050 --> 00:17:14,570 +مش شرط .. لكن احنا .. ده .. ده مالك absolute value + +207 +00:17:14,570 --> 00:17:17,210 +ايش .. اه .. ايه .. انت مابتش تعرف بتشيله، اذا + +208 +00:17:17,210 --> 00:17:19,710 +عرفت إشارة اللي جوا، اذا كان موجة بتخلي زمويا، اذا + +209 +00:17:19,710 --> 00:17:22,170 +كان سلطة، مابسلم واحد، اه لأ، إذا مش عارف إشارته، + +210 +00:17:22,170 --> 00:17:26,030 +بتخليه، مظبوط؟ اه فأي تان تحافظ، تشيله أو تجيله، + +211 +00:17:26,030 --> 00:17:29,010 +مش مشكلة، ولكن احنا ما زال عالنا معلومة بنأكد + +212 +00:17:29,010 --> 00:17:33,330 +عليه، إنه عارفين الإشارة، شيلنا ال absolute value، + +213 +00:17:33,330 --> 00:17:33,930 +أي سؤال + +214 +00:17:37,120 --> 00:17:43,860 +فهذه هي sin inverse وشفنا كيف اشتقناها بشكل مشابه + +215 +00:17:43,860 --> 00:17:47,460 +او موازن ممكن اعرف cosine inverse الـ z هي عبارة + +216 +00:17:47,460 --> 00:17:52,120 +عن w بhigh او if and only if cosine of w تساوي z + +217 +00:17:52,120 --> 00:17:56,740 +لو قررت العملية قاعدة كexcel site هتلاقي ان cosine + +218 +00:17:56,740 --> 00:17:58,520 +inverse z بتساوي سالب r + +219 +00:18:02,680 --> 00:18:06,480 +نفس المفروض تماما اختلافات بسيطة بس ال I كانت + +220 +00:18:06,480 --> 00:18:09,660 +مضروبة في Z في ال sign صارت مضروبة ايش في الجزر + +221 +00:18:09,660 --> 00:18:12,320 +التالف يعني طبعا هذا بيقول انه في اختلاف التعريف + +222 +00:18:12,320 --> 00:18:16,300 +في ال sign في عندي مقصوم على اتنين I و هناك معبث + +223 +00:18:16,300 --> 00:18:19,240 +بينهم ال I موجود في ال cosine بس مقصوم على اتنين و + +224 +00:18:19,240 --> 00:18:21,380 +مافيش ايقوفيه بين ال plus بيصير هذا الاختلاف + +225 +00:18:21,380 --> 00:18:26,120 +البسيط طبعا المشكلة برضه مش هادرة tan inverse نفس + +226 +00:18:26,120 --> 00:18:32,010 +التعريف tan inverseطبعاً اللي هو المقدار W بحيث + +227 +00:18:32,010 --> 00:18:36,870 +تعمل W تساوزن لو حللها تطلع I ع اتنين look I زائد + +228 +00:18:36,870 --> 00:18:45,290 +Z على I نقص بنفس الأسلوب تماما ممكن انحنى أي سؤال؟ + +229 +00:18:45,290 --> 00:18:48,110 +طبعا بجميع الأحوال وإن ما ظهرت واحد نقص Z تنبيه + +230 +00:18:48,110 --> 00:18:51,230 +الصفة تفهم ان هي ليش two valid function + +231 +00:18:53,290 --> 00:18:55,630 +و أين بيجيد الدوايب الفرنسية اللي بعكس تبعهم + +232 +00:18:55,630 --> 00:18:59,670 +التلات التالية؟ مافيش داعي لهم، لمش داعي، ليش؟ لأن + +233 +00:18:59,670 --> 00:19:04,310 +for example cos inverse of z هي sin inverse واحدة + +234 +00:19:04,310 --> 00:19:08,370 +لزرد مباشرة تتحول لإن مثلا اللي هو ال cos واحدة + +235 +00:19:08,370 --> 00:19:12,210 +على sin تنقلب بال cos inverse لزرد هي sin inverse + +236 +00:19:12,210 --> 00:19:15,970 +واحدة لزرد مباشرة طبعا من التعريف دليني أبتدع هنا + +237 +00:19:15,970 --> 00:19:16,850 +على السريحة + +238 +00:19:20,860 --> 00:19:27,420 +فلو بدنا نعرف cos n versus z بتساوي W, if and only + +239 +00:19:27,420 --> 00:19:35,360 +if cos w تساوي z, if and only if 1 على sin w تساوي + +240 +00:19:35,360 --> 00:19:37,140 +z، طبعا if and only if + +241 +00:19:46,900 --> 00:19:50,320 +فاحنا هنا على ثلاث دور أساسيين كوتان انفرست + +242 +00:19:50,320 --> 00:19:54,900 +كوسيكان انفرست سيكان انفرست ممكن نجيبها بهذا الفيش + +243 +00:19:54,900 --> 00:19:59,060 +داعي إطلاقا نحط قوانين جديدة و نتعامل حالنا في + +244 +00:19:59,060 --> 00:20:06,960 +الحفظ أي سؤال؟ + +245 +00:20:06,960 --> 00:20:12,960 +زي + +246 +00:20:12,960 --> 00:20:13,500 +ما قلنا + +247 +00:20:16,500 --> 00:20:20,380 +هؤلاء اللي عرفناهم بعكس الدوايا المثلثية، طبعاً + +248 +00:20:20,380 --> 00:20:21,860 +لما جيتي الدوايا للتلاتة، اذا كنا بيها هذا + +249 +00:20:21,860 --> 00:20:25,000 +الاسلوب، فهدول عايش فيهم كل المعلومات على لغة مات + +250 +00:20:25,730 --> 00:20:29,930 +فهما multivalued function طبعا في منهم تنتين بحتوى + +251 +00:20:29,930 --> 00:20:33,230 +على إيش؟ على الجزر التربيهي للواحد مع خص التربيه + +252 +00:20:33,230 --> 00:20:36,570 +فهو برضه في two-valued طبعا هدول مش function عشان + +253 +00:20:36,570 --> 00:20:39,970 +أخليهم function لازم أختار قيمة من القيم المتعددة + +254 +00:20:39,970 --> 00:20:43,630 +هدول وعشان أخليهم انا لتكبد ب branches بوق، بدي + +255 +00:20:43,630 --> 00:20:46,710 +branches إيش؟ branches من هدول الدول branches من + +256 +00:20:46,710 --> 00:20:50,970 +هدول الدول فطبعا لو احنا على سبيل المثال رجعنا ل + +257 +00:20:50,970 --> 00:20:53,430 +Psi M versus L إيش بتساوي؟ + +258 +00:21:04,320 --> 00:21:09,620 +بهذا الشكل فعشان انا اخد لعبة التالة انا لاتك لازم + +259 +00:21:09,620 --> 00:21:12,520 +اختار اي branch لعبة التالة اصلا لعبة التالة لازم + +260 +00:21:12,520 --> 00:21:16,140 +اختار اي branch لعبة التالة لازم اختار اي branch + +261 +00:21:16,140 --> 00:21:16,140 +لعبة التالة لازم اختار اي branch لعبة التالة لازم + +262 +00:21:16,140 --> 00:21:16,140 +اختار اي branch لعبة التالة لازم اختار اي branch + +263 +00:21:16,140 --> 00:21:16,560 +لعبة التالة لازم اختار اي branch لعبة التالة لازم + +264 +00:21:16,560 --> 00:21:17,720 +اختار اي branch لعبة التالة لازم اختار اي branch + +265 +00:21:17,720 --> 00:21:18,620 +لعبة التالة لازم اختار اي branch لعبة التالة لازم + +266 +00:21:18,620 --> 00:21:23,880 +اختار اي branch لعبة التالة لازم اختار اي branch + +267 +00:21:23,880 --> 00:21:26,210 +لعبة التالة لعبة التالة لازم او اختارنا له brush + +268 +00:21:26,210 --> 00:21:29,570 +أصبح analytic و اللي جوا اختارناه brush لجزر + +269 +00:21:29,570 --> 00:21:32,570 +التبييزات analytic فتصير ده ل composition of two + +270 +00:21:32,570 --> 00:21:35,210 +analytic functions طبعا من ال domain المحدد بشكل + +271 +00:21:35,210 --> 00:21:38,030 +مواقعي بحيث ان هذا اللي ما اتبعش انت بلمين ده ال + +272 +00:21:38,030 --> 00:21:40,750 +domain تبع له اللي هو فيه analytic فتصير ده لمين + +273 +00:21:40,750 --> 00:21:43,580 +composition of two analytic functions اذا نعملطبعا + +274 +00:21:43,580 --> 00:21:46,380 +يعني مش حد .. مش حد خبر تفاصيل وين المنطقة بالظبط، + +275 +00:21:46,380 --> 00:21:49,300 +لكن ده دستور، بدي أخلي هذه أداتك، و أخلي كل + +276 +00:21:49,300 --> 00:21:52,780 +المختار عليه كل إيش و أعفع في هذه المنطقة في سيوة + +277 +00:21:52,780 --> 00:21:55,160 +أداتك، نفس القضية بالنسبة للقصانين في أولئك + +278 +00:21:55,160 --> 00:21:57,700 +التانية، و اعمل زي الأدب اللي كان defensible، إيش + +279 +00:21:57,700 --> 00:22:02,170 +المشتقى، كما هو متعتق عليه وين في ال calculusمش + +280 +00:22:02,170 --> 00:22:06,110 +فاقد sign in this وعد على الجزر التربية للواحد مع + +281 +00:22:06,110 --> 00:22:08,730 +قصد التربية طبعا اللي هو الجزر التربية فيه هو قص + +282 +00:22:08,730 --> 00:22:11,130 +نص بنفس المعنى ال branch اللي اخترته هنا بدي + +283 +00:22:11,130 --> 00:22:14,870 +اختاره هنا المقدار اللي اخترته القيمة من ال two + +284 +00:22:14,870 --> 00:22:15,310 +values + +285 +00:22:23,740 --> 00:22:26,660 +نفس القضية cosine inverse تفضل لسان cosine inverse + +286 +00:22:26,660 --> 00:22:30,900 +تفضل تان inverse واحد حتى لو عزيزي تبقى بنفس + +287 +00:22:30,900 --> 00:22:34,800 +الأسلوب بيكون بهذا الشكل طبعا هنا مُعرف في ال + +288 +00:22:34,800 --> 00:22:37,820 +domain اللي تكون دالة فيه أدنى دالة فيها أدنى هي + +289 +00:22:37,820 --> 00:22:41,760 +composition of two functions القيمة واحدة طبعا + +290 +00:22:41,760 --> 00:22:44,920 +بفضل الدالة لأ هي قيمة ماتتأورش جامعة اللي ممكن + +291 +00:22:44,920 --> 00:22:48,000 +تشتاق تقول الدالة هي تسأل نفسك هادي الاشتقاق ولا + +292 +00:22:48,000 --> 00:22:49,620 +لا هيتطبق القانون عشان تكون + +293 +00:22:53,810 --> 00:22:56,510 +مش بس قيمة بل ال graph بتاكد تشير كمان قطع اللي + +294 +00:22:56,510 --> 00:22:58,630 +يخلّيها يد النقطة القطع اللي يوصل عليها فهذه + +295 +00:22:58,630 --> 00:23:04,290 +المقطة مهمة جدا فبعد ما تشير عقبات اللي بتخلّيها + +296 +00:23:04,290 --> 00:23:08,110 +differentiable أي اناتك بتصير ايش؟ بتصير مشتققة + +297 +00:23:08,110 --> 00:23:13,070 +بادشة مشتققة بادشة فإذا ال derivative exist فهو + +298 +00:23:13,070 --> 00:23:17,350 +أخر للصورة بس يكون exist خلّينا + +299 +00:23:18,330 --> 00:23:24,070 +نكمل الصورة مع معقوس الدوال الزائدية زي ما حكينا + +300 +00:23:24,070 --> 00:23:27,050 +بالنسبة للدوال المثلثية يكفي لرأس التلاتة و + +301 +00:23:27,050 --> 00:23:30,370 +التلاتة التانية بدللتها نفس القضية ممكن اعرفتان هي + +302 +00:23:30,370 --> 00:23:30,930 +ماربوريك اندا + +303 +00:23:33,900 --> 00:23:37,380 +الثانية هي hyperbolic inverse هي تعريفها مشابه وهي + +304 +00:23:37,380 --> 00:23:39,860 +الصينية هي hyperbolic inverse انت بقول الاختلاف في + +305 +00:23:39,860 --> 00:23:43,000 +التعريف وكصينية هي hyperbolic inverse تعريف + +306 +00:23:43,000 --> 00:23:45,920 +وبالشكل كله طبعا مختلفين في هذه الصورة طبعا نفس + +307 +00:23:45,920 --> 00:23:49,180 +المعنى الجزر التربيعي الموجود two valid function + +308 +00:23:49,180 --> 00:23:54,900 +واللغاردم multi valid function نفس القضية نعم + +309 +00:23:56,910 --> 00:23:59,910 +مطلوب تحفظهم إلا أو تستغنع عنهم و تتحلوا المعادلة، + +310 +00:23:59,910 --> 00:24:04,470 +مطلوبين، هذول كانت تلاتة و تلاتة، إشتقاقهم إكسف + +311 +00:24:04,470 --> 00:24:10,310 +صينتز، إشتقاقهم إكسف صينتز، مش هو إشتقان واحدة زي + +312 +00:24:10,310 --> 00:24:12,730 +ما عملنا في الصينتز، زي ما عملنا في الصينتز، + +313 +00:24:12,730 --> 00:24:15,130 +inverse تماما، فده الإشتقاء + +314 +00:24:18,450 --> 00:24:22,350 +طيب هنا هذا مطلوب نحفظهم طيب لو حفظناهم إيش + +315 +00:24:22,350 --> 00:24:26,930 +هيستفيد؟ هيسأل علينا حل بعض المعادلات على سبيل + +316 +00:24:26,930 --> 00:24:31,190 +المثال احنا حلنا صين زت سو واحد حلناها إنه كتبناهم + +317 +00:24:31,190 --> 00:24:34,230 +real و imaginary ببعض وصولناهم في طعام و الحل إلى + +318 +00:24:34,230 --> 00:24:37,450 +حد ما كان طويل الهن هنشوف كيف هنحل المعادلة هذه + +319 +00:24:37,450 --> 00:24:40,190 +اللي حلناها في السابق في سطر و نصف هنحل المعادلة + +320 +00:24:40,190 --> 00:24:42,070 +بإن حفظنا صين inverse + +321 +00:24:47,040 --> 00:24:53,280 +of example one فعشان انا أحل صي z تساوي واحد if + +322 +00:24:53,280 --> 00:24:58,980 +and only if z تساوي صي inverse الواحد طبعا مش + +323 +00:24:58,980 --> 00:25:02,760 +هتركه بهذا الشكل لازم أحسبه مش بيساوي فطبعا z + +324 +00:25:02,760 --> 00:25:09,740 +تساوي الحلول صي inverse سالب R log من + +325 +00:25:13,100 --> 00:25:18,240 +زاد من واحد ماقص واحد تربية اللي هي واحد قص نص + +326 +00:25:18,240 --> 00:25:25,040 +تلقى للقانون sign in versatile هي انعود عن من زاد + +327 +00:25:25,040 --> 00:25:25,500 +تسوق + +328 +00:25:35,930 --> 00:25:41,670 +زالب I لغ ال I هو يساوي زالب I لغ ال I يساوي لأن + +329 +00:25:41,670 --> 00:25:49,070 +ال واحد صغر زاد ايه؟ I في ال argument باعة 2 زاد 2 + +330 +00:25:49,070 --> 00:25:55,030 +and 1و أنت تنتمي لزيك طبعا ايش بيساوي بيساوي بايع + +331 +00:25:55,030 --> 00:26:00,430 +اتنين زي اتنين أنبع انت تنتمي لزيك طبعا ده هو انكم + +332 +00:26:00,430 --> 00:26:04,130 +انكم قرروا هذا الحل بالحل الصحيح حلينا المثال هذا + +333 +00:26:04,130 --> 00:26:08,250 +بشكل مختلف وصلنا لنفس الحل فبسهولة حلينا و جيبنا + +334 +00:26:08,250 --> 00:26:17,690 +كل الحلول بايع اتنين زي اتنين أنبع نعم اشمالك زي + +335 +00:26:17,690 --> 00:26:18,430 +ما احنا مش بنقول + +336 +00:26:31,230 --> 00:26:35,770 +فيعني السؤال بنحط في مشاكل معينة، بدأ انا اختبرك + +337 +00:26:35,770 --> 00:26:38,890 +في جزء معين بقولك اتفقد من السلوب المعين، بدأ + +338 +00:26:38,890 --> 00:26:41,690 +اختبر على السلوب، بدي اشيار، بدي كده مثلا بهم نتحل + +339 +00:26:41,690 --> 00:26:51,090 +اي طريقة مضطر، فبقولك حل، و بلحق أي سؤال؟ هي + +340 +00:26:51,090 --> 00:26:54,590 +شوفيها مثال، برضه حلناه بالصادق بطريقة مختلفة، هي + +341 +00:26:54,590 --> 00:26:55,810 +نحله بطريقة لجديدة + +342 +00:27:02,260 --> 00:27:07,060 +بإن كوسين هيضربك ال Z تساوي I الحلول للمعادلة هذه + +343 +00:27:07,060 --> 00:27:13,380 +فالحلول + +344 +00:27:13,380 --> 00:27:22,240 +هي إيش كوسين هيضربك inverse ل I طبعا + +345 +00:27:22,240 --> 00:27:27,460 +إيش تعريف كوسين هيضربك inverse ل I نرجع للقانون + +346 +00:27:27,460 --> 00:27:36,500 +عبارة عن logالـ Z لي عارف هذا المثال زائد I تربية + +347 +00:27:36,500 --> 00:27:41,700 +ماغص واحد أُص أُص خلّيني أنا أكتبها بشكل تفصي طبعا + +348 +00:27:41,700 --> 00:27:45,620 +انتبه انه اختلاف في حالة الـ sine A inverse والـ + +349 +00:27:45,620 --> 00:27:48,780 +cosine A inverse واحد ناقص للتربية الآن مختلفة في + +350 +00:27:48,780 --> 00:27:51,460 +الـ sine hyperbolic inverse Z التربية زائد وفي ال + +351 +00:27:51,460 --> 00:27:54,780 +cosine hyperbolic inverse Z التربية ناقص في اختلاف + +352 +00:27:54,780 --> 00:27:56,480 +بدنا ننتبه + +353 +00:28:04,900 --> 00:28:13,180 +و تساوي له I زاد أو ناقص جزء الاتنين في I فهذه هي + +354 +00:28:13,180 --> 00:28:20,520 +الحب خلينا نحسبها بشكل صريح بشكل تفصيلي و يساوي + +355 +00:28:20,520 --> 00:28:29,060 +للمطلق فائد زاد أو ناقص جزء الاتنين كله مضروف في I + +356 +00:28:29,060 --> 00:28:33,780 +زاد اللي هو I في ال argument + +357 +00:28:46,060 --> 00:28:49,380 +تعريز طبعا زي ما أكيد في sine الاتنين طبعا هنا + +358 +00:28:49,380 --> 00:28:53,100 +sine inverse الواحد من حسب الحصل عن أيش قيمة واحدة + +359 +00:28:53,100 --> 00:28:56,320 +اللي جيز التنبيه فالثالث حلوة واحدة طبعا ليش حلق + +360 +00:28:56,320 --> 00:28:59,140 +قليل الحدوث انه طلع صفر لكن بشكل عام هيكون two + +361 +00:28:59,140 --> 00:29:02,900 +value two values اه فزي ما أكيد في حالة sine + +362 +00:29:02,900 --> 00:29:05,580 +inverse الاتنين فيانا قيمتين الآن + +363 +00:29:13,060 --> 00:29:16,920 +بالنسبة للكلام اللي قد علمته مطمئنق واحد زي اللي + +364 +00:29:16,920 --> 00:29:20,020 +هو ماخد جزر التليف دون أي مشكلة لك تشيل نفس ال + +365 +00:29:20,020 --> 00:29:23,300 +value الشركة عمال؟ ممكن تشيل نفس ال value؟ لا + +366 +00:29:23,300 --> 00:29:28,000 +ممكن، بس تنتبه أنه بالثالث تحديث التحديث، فانت + +367 +00:29:28,000 --> 00:29:31,480 +بتعكس الكلمة، نفس ال value مزال المقضعة على رأس + +368 +00:29:31,480 --> 00:29:34,200 +الإشارة تبتشي نفسها، فبتشيل نفس ال value + +369 +00:29:46,270 --> 00:29:49,910 +مش ممتاز هذا طبعا التحليل مفيد لنا طبعا مش قاعد + +370 +00:29:49,910 --> 00:29:53,370 +منك تشير لغة ليه مش مشكلة لكن المهم في هذه الحالة + +371 +00:29:53,370 --> 00:29:59,250 +الآن العدد فقه فإيش الprice of argument دايما زائد + +372 +00:29:59,250 --> 00:30:02,610 +او نقص اه زائد او نقص لو كان plus plus هو plus لو + +373 +00:30:02,610 --> 00:30:05,470 +انت cancel minus تكون plus minus فده ايش زائد او + +374 +00:30:05,470 --> 00:30:11,000 +نقص خلينا نضع هنا زائد او نقص و اكترهو انا زاد + +375 +00:30:11,000 --> 00:30:16,760 +اتنين and بعض and and and بس فخلاص ممكن نتركها بدا + +376 +00:30:16,760 --> 00:30:19,820 +الشكل و ممكن نقلتلها مافيش مشكلة فهذا هو .. اه ليش + +377 +00:30:19,820 --> 00:30:24,080 +مش سؤال بس بقى .. لا هو انت ده تشوف انت ايش فيه + +378 +00:30:24,080 --> 00:30:26,780 +عندك .. احنا مابنعش نخليه .. نختصر الأمور بها ده + +379 +00:30:26,780 --> 00:30:30,160 +الصورة اللي ممكن تخل .. احنا فيها عندنا عدد مطموعة + +380 +00:30:30,930 --> 00:30:33,370 +بس ده العدد الحقيقي مضروف فيه عيال نقول يا إيه مع + +381 +00:30:33,370 --> 00:30:36,230 +ال positive y-axis فبايع اتنين أو عن ال negative y + +382 +00:30:36,230 --> 00:30:38,190 +-axis فبايع اتنين فالسالب بايع اتنين بالنسبالي هيك + +383 +00:30:38,190 --> 00:30:40,990 +اتعلمنا .. اتعلمنا أنه على ال x-axis الاية zero + +384 +00:30:40,990 --> 00:30:43,610 +over وعلى ال y-axis بايع اتنين أو السالب بايع + +385 +00:30:43,610 --> 00:30:46,170 +اتنين فده ده الاشتراك .. طبعا هنا تقول لو أن واحد + +386 +00:30:46,170 --> 00:30:49,210 +زاد ياسر اتنين فهيك positive y-axis بايع اتنين لو + +387 +00:30:49,210 --> 00:30:52,070 +كان واحد مع الاسم تقول أن السالب y ايه ع ال + +388 +00:30:52,070 --> 00:30:54,350 +negative y-axis فهي السالب بايع اتنين فده هو + +389 +00:30:54,350 --> 00:30:57,220 +الحاجةطبعا هذا الverse الصحيحة ممكن تبصه لكن مش + +390 +00:30:57,220 --> 00:31:00,080 +مشكلتها زي ما حدقولتها إذا حدين شركات reviewers + +391 +00:31:00,080 --> 00:31:05,180 +تقولوا هذا الشكل زائد او ناقص واحد زائد او ناقص by + +392 +00:31:05,180 --> 00:31:10,840 +اتنين في R زائد اتنين and I and .. فهذا يرفلوا + +393 +00:31:10,840 --> 00:31:13,940 +فهذا + +394 +00:31:13,940 --> 00:31:17,660 +أحد التطبيقات على هذه الدالة طبعا التطبيقات الأهم + +395 +00:31:17,660 --> 00:31:20,260 +تبقى فيه في التكاملات تحلول لبعض التكاملات + +396 +00:31:28,070 --> 00:31:30,390 +هذه نهاية ال section و نهاية ال chapter الأسلحة + +397 +00:31:30,390 --> 00:31:36,730 +المطلوبة لوحدنا نشوفها على الصفحه الخامسه و اتنين + +398 +00:31:36,730 --> 00:31:51,210 +Chapter + +399 +00:31:51,210 --> 00:31:54,610 +أربع integrals التكاملات + +400 +00:31:57,590 --> 00:32:03,390 +نازل من امبيره شبطر 4 نازل على الموقع نعم كامل + +401 +00:32:03,390 --> 00:32:09,510 +كامل التكاملات في هذا اللي هو الشبطر هندرس كيف + +402 +00:32:09,510 --> 00:32:21,110 +نكامل F of Z بدنا تكامل ال F of Z دي Z فطبعا + +403 +00:32:21,110 --> 00:32:29,200 +هنا كيف ممكن ندرس هذا التكاملنتذكر إنه هذه ال F of + +404 +00:32:29,200 --> 00:32:35,820 +Z إذا بنحاول نقربها للريال إيش ممكن نكتبها؟ U of X + +405 +00:32:35,820 --> 00:32:43,460 +and Y زي I V of X and Y و ال DZ هذي إيش؟ DX زي I + +406 +00:32:43,460 --> 00:32:50,080 +DY ممكن تنكتب تكامل فسؤال كيف ممكن نعرف التكامل؟ + +407 +00:32:50,080 --> 00:32:54,770 +هل هو تكامل على فترة؟والا تكامل على منطقة double + +408 +00:32:54,770 --> 00:32:59,290 +integral و لا triple integral و لا ما هو المناسب + +409 +00:32:59,290 --> 00:33:02,650 +لهذا التكامل كيف ممكن كامل أفوفزن؟ هنكمل عن + +410 +00:33:02,650 --> 00:33:05,690 +complex plane هنكمل عن complex plane و اللي هو إيش + +411 +00:33:05,690 --> 00:33:08,750 +x و y يعني إيش ال complex plane ما هو x و y plane + +412 +00:33:10,790 --> 00:33:13,970 +رياضي .. طب كيف بتتكامل هذه الدالة؟ هي مُتغيرية .. + +413 +00:33:13,970 --> 00:33:18,470 +هي مُتغيرية .. هي مُتغيرية .. هي مُتغيرية .. هي + +414 +00:33:18,470 --> 00:33:24,410 +مُتغيرية .. هي مُتغيرية .. هي مُتغيرية .. هي + +415 +00:33:24,410 --> 00:33:25,150 +مُتغيرية .. هي مُتغيرية .. هي مُتغيرية .. هي + +416 +00:33:25,150 --> 00:33:25,870 +مُتغيرية .. هي مُتغيرية .. هي مُتغيرية .. هي + +417 +00:33:25,870 --> 00:33:28,270 +مُتغيرية .. هي مُتغيرية .. هي مُتغيرية .. هي + +418 +00:33:28,270 --> 00:33:31,830 +مُتغيرية .. هي مُتغيرية .. هي مُتغيرية .. هي + +419 +00:33:31,830 --> 00:33:34,770 +مُتغيرية .. هي مُتغيرية .. هي مُتغيرية .. هي + +420 +00:33:34,770 --> 00:33:37,970 +مُتغيرية .. هي مُتغيرية .. هي مُتغيرية .. هي + +421 +00:33:37,970 --> 00:33:42,170 +مُتغيرعن الملحانة نفسه كيف هي تكون متغيرة، طبعا لو + +422 +00:33:42,170 --> 00:33:44,510 +كانت هي متغيرية وكانت تتحدث عن double integrant + +423 +00:33:44,510 --> 00:33:47,250 +يعني على فنطقة في المستوى، مش حاجة ان انها جال + +424 +00:33:47,250 --> 00:33:50,690 +المنهج طبعا، التطبيقات وهميته تجي ليش من عرف حاجة + +425 +00:33:50,690 --> 00:33:50,970 +اسمها + +426 +00:33:58,460 --> 00:34:01,240 +على أهم حالة، لأن الدالة هنا معرفة في الـ complex + +427 +00:34:01,240 --> 00:34:03,780 +plane زي ما حكى زميل كون، فهي معرفة على ال + +428 +00:34:03,780 --> 00:34:06,460 +complex، فطبعا احنا معرفة في المنطقة لكلها، فطبعا + +429 +00:34:06,460 --> 00:34:09,300 +مدلاشة عاملة بس فارقة على مش realist axis، فانا في + +430 +00:34:09,300 --> 00:34:12,520 +المنطقة عادي ممكن اخد منحنة معينة، وعارف الدالة + +431 +00:34:12,520 --> 00:34:16,780 +عليه، وكامل على هذا المنحنة، على هذا المنحنة، طبعا + +432 +00:34:16,780 --> 00:34:19,340 +هنشوف التفاصيل، هذا ال line integral مش بس خاف + +433 +00:34:19,340 --> 00:34:22,920 +بالدالة بتاع المركب، فعادة لو دالة في متغير ممكن + +434 +00:34:22,920 --> 00:34:25,160 +اعرف حاجة اسمها line integral، ممكن اعرف حاجة + +435 +00:34:25,160 --> 00:34:26,920 +اسمها line integral، فهذا ما احنا .. اللي ا + +436 +00:34:29,900 --> 00:34:34,860 +هنا بس عشان تمهيد للمقدمة انا عندي منحنى ان يقابل + +437 +00:34:34,860 --> 00:34:38,720 +عليه x و y طبعا ممكن المنحنى يكون معادلته اللي هو + +438 +00:34:38,720 --> 00:34:41,960 +شهو صورة عاملة معادلة الاخر من x و y بيساوي زي و + +439 +00:34:41,960 --> 00:34:45,760 +او y بيساوي x حالة خاصة و أعرفه في x أسف و أتسارع + +440 +00:34:45,760 --> 00:34:50,640 +في x في فريقة تالتة تكرنها قبل ذلك ان أكد عليها هي + +441 +00:34:50,640 --> 00:34:53,380 +عملية environmentization عملية environmentization + +442 +00:34:53,380 --> 00:34:55,640 +فانا ممكن اكتبها دي عبارة عن x + +443 +00:34:59,000 --> 00:35:02,640 +طبعا بما ان ال F هي F of Z و ال Z عبارة عن ايش فان + +444 +00:35:02,640 --> 00:35:09,460 +هي Z تصير Z من مين؟ Of T Z of T فبالتالي هتتفصف + +445 +00:35:09,460 --> 00:35:15,470 +الأمور هصير التكامل هصير عندي Fزد of T هحاوله ل DT + +446 +00:35:15,470 --> 00:35:20,330 +بشكل معين طبعا في الحقيقة إذا عملتوا بدا الشكل + +447 +00:35:20,330 --> 00:35:24,150 +خليني أكمل ماذا زد هصير لديزل افرع عن مين؟ زد + +448 +00:35:24,150 --> 00:35:27,950 +براون of T و DT بشكل حامل تشير له إذا زد of T + +449 +00:35:27,950 --> 00:35:32,090 +بتسوي حالة معينة فبدا فاعل دي زد على دي T بيعمل + +450 +00:35:32,090 --> 00:35:35,870 +الشكل اصلافالصحيحة هي تصير تكامل طبعا لازم انا + +451 +00:35:35,870 --> 00:35:38,450 +اخبز على الملحانة في عندي بداية الملحانة اول قيمة + +452 +00:35:38,450 --> 00:35:41,030 +دي لان كل قيمة دي من اي نقطة على الملحانة لاخر + +453 +00:35:41,030 --> 00:35:46,350 +نقطة هشوف من هنا Z of A ل Z of B نقطة معينة خليها + +454 +00:35:46,350 --> 00:35:49,590 +نقطة نايف معاك اعمل تكامل من A لB و ال A هي + +455 +00:35:49,590 --> 00:35:53,320 +الرياضةطبعا أنا بيعمل التفصيلة شوفها بس relation + +456 +00:35:53,320 --> 00:35:56,240 +اللي لها ده فأصبح التقابل هيكون عندي عبارة عن + +457 +00:35:56,240 --> 00:36:00,960 +تقابل دلة في مين؟ في T هتتدلة كلها الريام؟ لأ لإن + +458 +00:36:00,960 --> 00:36:04,460 +ال I فيها موجودة لإن ال F إيش فيها؟ فيها U of T + +459 +00:36:04,460 --> 00:36:08,400 +حصير و I V of T إذا أنا عشان أدرس هذا التقابل ده + +460 +00:36:08,400 --> 00:36:15,770 +لازم أدرس كيف أكامل دلة U of T زي I V of Tمن A لـ + +461 +00:36:15,770 --> 00:36:20,010 +B فهيكون أول أقوى في دراسة التكونات بدرس الدواء + +462 +00:36:20,010 --> 00:36:25,450 +دالة متغير حقيقي لكن القيمة مركبة فيدالة تاخد الـ + +463 +00:36:25,450 --> 00:36:29,730 +D حقيقي لكن user ID قيمة مركبة فهيكون أول section + +464 +00:36:29,730 --> 00:36:35,730 +عندنا اللي هوcomplex values function W of T يعني + +465 +00:36:35,730 --> 00:36:40,190 +عبارة عن دالة مُركّبة بمتغير حقيقي الدالة متغير + +466 +00:36:40,190 --> 00:36:44,850 +حقيقتي لكن القيمة مُركّبة بمعنى هي دالة من ال + +467 +00:36:44,850 --> 00:36:48,710 +domain ميموعة جزئية من ال R و ال range أو المجال + +468 +00:36:48,710 --> 00:36:52,070 +المقابل C اللي عبارة عن المُركّبة فعادة هيكون + +469 +00:36:52,070 --> 00:36:54,370 +هدفنا الأول أو نقطة البداية في الدالة + +470 +00:37:01,240 --> 00:37:05,860 +كيف بنعرفها؟ التعريف بسيط جدا يا شباب انا عندي U + +471 +00:37:05,860 --> 00:37:12,480 +دالة حقيقية في متغير واحد وعندي command V دالة + +472 +00:37:12,480 --> 00:37:17,800 +حقيقية في متغير واحد T هزمحه بالشكل التالت S + +473 +00:37:17,800 --> 00:37:21,240 +وحطولها بالR سعر S القيمة مركبة ده حقيقة وحقيقة + +474 +00:37:21,240 --> 00:37:27,200 +ريال باق مليون باق هسميها W دالة دالة وفي متغير + +475 +00:37:27,200 --> 00:37:28,620 +حقيقية وقيمتها + +476 +00:37:31,930 --> 00:37:37,450 +هذا هو التعريف بيسميها complex valued function of + +477 +00:37:37,450 --> 00:37:43,030 +a real value ده لأ قيمتها متغيرة و لو قيمتها + +478 +00:37:43,030 --> 00:37:48,570 +مرتبطة بأسف و المتغير تبقى حقيقي فبيسميها complex + +479 +00:37:48,570 --> 00:37:51,850 +valued function of a real value ده دي الصورة + +480 +00:37:54,900 --> 00:37:57,760 +طب كيف بتتعامل مع حالة دالة بالنسبة لل .. لل .. + +481 +00:37:57,760 --> 00:38:01,480 +للاشتقاء و للاتصال مباشرة زي اللي هو هذا كلها؟ + +482 +00:38:01,480 --> 00:38:04,760 +هتكون قادمة مثلا متصلة إذا اليوم اللي فيه متصلين، + +483 +00:38:04,760 --> 00:38:07,560 +قادة للاشتقاء إذا اليوم اللي فيه متصلين، طب كيف + +484 +00:38:07,560 --> 00:38:08,520 +تدرس فقهة هنا؟ + +485 +00:38:12,060 --> 00:38:15,100 +الحالة العامة الـ R بساوي U of X and Y و U of X + +486 +00:38:15,100 --> 00:38:19,160 +and Y ده اللي لازم متغيرين فالاشتقاط اتقشت تجنب + +487 +00:38:19,160 --> 00:38:21,400 +تجنب ال .. ال .. ال .. Possible Equations الـ + +488 +00:38:21,400 --> 00:38:23,820 +Possible Derivatives لكن الأهم زي المتغير واحد على + +489 +00:38:23,820 --> 00:38:28,920 +طول بقى ال U برا ده بساوي U برا زي ال R في برا سهل + +490 +00:38:28,920 --> 00:38:32,160 +العملية لإنه متغير واحد فبهذه السهولة كل الأمور + +491 +00:38:32,160 --> 00:38:37,600 +هتمشي بهذه السهولة هنشوف بعضها، فضّال تبدأ نحو ال + +492 +00:38:37,600 --> 00:38:39,080 +U في X Y + +493 +00:38:42,880 --> 00:38:45,560 +هو يبقى علم الحالة بس، علم دي علم تفصيل، لكن علم + +494 +00:38:45,560 --> 00:38:49,020 +الحالة كله، يعني ان عندنا حالة خاصة ده اللي + +495 +00:38:49,020 --> 00:38:52,480 +مُركّبة في متغير حقيقي، الأمور أسهل كتير من الحالة + +496 +00:38:52,480 --> 00:38:56,360 +العامة، حالة خاصة فالأمور بتكون بها دي الصورة + +497 +00:38:56,360 --> 00:39:08,120 +أسابيع المثال، لو عندنا W تسوى 2T زي I Cos Tفإذا و + +498 +00:39:08,120 --> 00:39:13,780 +برامي تساوي اتنين ناقص I صالح فانت بتفاضل بشكل عام + +499 +00:39:13,780 --> 00:39:16,900 +أنك تقدر تتعامل مع دالتين و الفاصل بينهم بدل ما + +500 +00:39:16,900 --> 00:39:20,080 +تكتب and و لا كلمة كلمة الفاصل I ليس إلا فتتعامل + +501 +00:39:20,080 --> 00:39:24,000 +مع ال U لR و ال V لR و كل خلاصها كرية ..فهي ال + +502 +00:39:24,000 --> 00:39:26,660 +function مستمرة لكن هدولة هتقولوا functions + +503 +00:39:26,660 --> 00:39:30,220 +هتجمعهم عشان تكون ال complex value of ال function + +504 +00:39:30,220 --> 00:39:32,820 +في هذه الصورة و بقيت الشغل كله على ال U و ال V بس + +505 +00:39:32,820 --> 00:39:35,460 +هذي كان real bar و هذي كان imaginary bar و ده + +506 +00:39:35,460 --> 00:39:42,860 +هتتغير واحد فالعملية سهلة جدا بهذه الصورة ال + +507 +00:39:42,860 --> 00:39:46,820 +I هو constant أصلا لأن ال complex number لكن احنا + +508 +00:39:46,820 --> 00:39:51,210 +البهم ان هي اشتقالبعد الخلاص، بعد خلاص هذه التفاضل + +509 +00:39:51,210 --> 00:39:54,370 +اللي عرفناها قبل قليل، بقول لي لو ال set zero + +510 +00:39:54,370 --> 00:39:57,270 +complex number، يعني ثابت، فببقى فاضل، ماديش أفضل + +511 +00:39:57,270 --> 00:40:00,230 +لبن يو ده، كيو فيه ثابت، ثابت بطلع بطلع، الثابت + +512 +00:40:00,230 --> 00:40:02,990 +بطلع بطلع طيب، في دلنا مهمة جدا، حد مرها عيني كتير + +513 +00:40:02,990 --> 00:40:06,810 +و تقيقة، لو عندي ال exponential ثابت في T، اش من + +514 +00:40:06,810 --> 00:40:10,130 +اش، مستقل ال exponential زي ما هو، مستقل الأسف، + +515 +00:40:10,130 --> 00:40:14,920 +بننزل الثابتحتى لو كانت ال complex حتى الكلام اللي + +516 +00:40:14,920 --> 00:40:17,640 +بتعليه عليه إذا لو كانت ال z0 هي ال number الآن + +517 +00:40:17,640 --> 00:40:20,300 +حتى لو كانت ال complex الكلام صحيح الكلام صحيح + +518 +00:40:20,300 --> 00:40:23,680 +خلّيني أشوف قرهان لواحدة من هدول و أترك التانية + +519 +00:40:23,680 --> 00:40:30,460 +تفسر الصفر طبعا + +520 +00:40:30,460 --> 00:40:32,980 +هنا بحتاج المرهد عشان المرهد لإن الموضوع فيه كتير + +521 +00:40:32,980 --> 00:40:36,500 +لإن عندنا ال z0 هي complex number و ال w complex + +522 +00:40:36,500 --> 00:40:42,040 +value function فحلينا نقش المرهد التانية التانية + +523 +00:40:45,590 --> 00:40:54,110 +بالنسبة لنا نعتبر أن Z0 عبارة عن Z X0زي ال IY0 + +524 +00:40:54,110 --> 00:40:57,210 +عشان انا بتتعرف عشان انا اتفق في القانون ايش + +525 +00:40:57,210 --> 00:41:00,670 +القانون اللي عندنا يا شباب؟ بالفعل ال W كيف بالفعل + +526 +00:41:00,670 --> 00:41:03,750 +ال real part تبحر و ال imaginary part فعشان افقها + +527 +00:41:03,750 --> 00:41:05,950 +و اتفقها القانون لازم اعرف مين ال real part ومين + +528 +00:41:05,950 --> 00:41:08,110 +ال imaginary part فاني افقها و نشوف بيطلع نفس + +529 +00:41:08,110 --> 00:41:10,890 +القانون الكلام ولا لا طبعا ده هذا الشكل و انت + +530 +00:41:10,890 --> 00:41:17,450 +يقولني ايش ثابت اذا لان هو ال real مضبط اذا E T في + +531 +00:41:17,450 --> 00:41:22,510 +Z0 هتسوى E T في X0 زي ال IY0 في T + +532 +00:41:25,600 --> 00:41:29,240 +بنقش نعمل نفس ال real and imaginary بقى كيف نفصل + +533 +00:41:29,240 --> 00:41:36,620 +هذه؟ أوش نفعلها ممتاز امشي معاكم E ب X0 وE تبقى + +534 +00:41:36,620 --> 00:41:42,480 +ورقة I بY0 في T الفصلات ليست بعد فلنحوّلها sign + +535 +00:41:42,480 --> 00:41:46,560 +وصفر ما تساوي E أس X0 في T + +536 +00:41:54,150 --> 00:42:01,110 +الان الفصلة هروح افضلها اذا D over DT E أُس T Z + +537 +00:42:01,110 --> 00:42:06,070 +Zero تساوي تبقى للقانون تفاضل هذا كما قيلته بشكل + +538 +00:42:06,070 --> 00:42:12,510 +تفصيلي تفاضل real part X Zero في T في ال cosine Y + +539 +00:42:12,510 --> 00:42:14,930 +Zero في T زائد R + +540 +00:42:25,040 --> 00:42:29,240 +واضح يا شباب؟ انت باين؟ انفضل الان اصل ده بدلتين + +541 +00:42:29,240 --> 00:42:38,180 +اول واحدة X0 E of X0 of T في Cos Y0 of T زائد او + +542 +00:42:38,180 --> 00:42:44,640 +حقيقية ناقص Y0 في X0T صالح فانا مش تاخد ال Cos + +543 +00:42:44,640 --> 00:42:47,640 +سالب S سالب Si و بنطلع لمعامل U + +544 +00:42:53,800 --> 00:43:03,380 +بنفس الاسلوب زاد R نفتح جوس X0 E تبارك X0T زاد Y0 + +545 +00:43:03,380 --> 00:43:08,020 +E أُس X0T في Cos Y0 + +546 +00:43:10,830 --> 00:43:14,590 +فهذا هو الاشتقاء طبعا طويل كيف تثبت انه بيساوي + +547 +00:43:14,590 --> 00:43:18,470 +المقدار التاني اللي على اليمين نحسب الطرف اليمين + +548 +00:43:18,470 --> 00:43:23,950 +نحسب الطرف اليمين الطرف اليمين فده يمكن نقول هنا I + +549 +00:43:23,950 --> 00:43:29,950 +واحد Z Zero E تفوض Z Zero في T إيش ده تساوي X Zero + +550 +00:43:29,950 --> 00:43:34,750 +زي تقعي Y Zero هو ده هنا بنعمل عامل عن مين E بقص X + +551 +00:43:34,750 --> 00:43:38,670 +Zero في T كمين تساعي Y Zero T + +552 +00:43:48,820 --> 00:43:54,460 +و انا باخد + +553 +00:43:54,460 --> 00:44:00,660 +درب ريال مع كل الدرب عادي فبنطلع متساوم فهي نهيه + +554 +00:44:00,660 --> 00:44:04,720 +المفتاح ان انا عندي تعريف عشان اخده بالدالة بداش + +555 +00:44:04,720 --> 00:44:07,740 +اعملها ال real part من هو ال imaginary part من هو + +556 +00:44:07,740 --> 00:44:10,600 +فانت كل واحد لحق فبقى هذه الصورة طبعا بعدها + +557 +00:44:10,600 --> 00:44:13,740 +بيقولوا خلاص ال exponential بنفضه بسهولة و بعد + +558 +00:44:13,740 --> 00:44:14,500 +خلاص هذه ممكن + diff --git a/PL9fwy3NUQKwaRXaqd-S5-vsOEDL-Q45jU/jbR2NY6tb1o_postprocess.srt b/PL9fwy3NUQKwaRXaqd-S5-vsOEDL-Q45jU/jbR2NY6tb1o_postprocess.srt new file mode 100644 index 0000000000000000000000000000000000000000..c39e185d01a54810e1863c686c823af98e2666e6 --- /dev/null +++ b/PL9fwy3NUQKwaRXaqd-S5-vsOEDL-Q45jU/jbR2NY6tb1o_postprocess.srt @@ -0,0 +1,1904 @@ +1 +00:00:09,280 --> 00:00:14,220 +بسم الله الرحمن الرحيم اليوم هنكمل ما بدأنا فيه في + +2 +00:00:14,220 --> 00:00:19,720 +المحاضرة السابقة اللي هو طبعا تمهيد للتكامل للدالة + +3 +00:00:19,720 --> 00:00:24,440 +F of Z على منحنة زي ما ذكرنا وبدأنا كتمهيد كيف + +4 +00:00:24,440 --> 00:00:29,490 +نتعامل مع الدالة المركبة في متغير حقيقياللي هي ان + +5 +00:00:29,490 --> 00:00:34,450 +المتغير T متغير حقيقي و ال W قيمها اللي هي قيم + +6 +00:00:34,450 --> 00:00:38,910 +مركبة بمعنى انها دالة من مجموعة جزئية من ال R الى + +7 +00:00:38,910 --> 00:00:42,650 +مجموعة جزئية من ال C اه مجموعة جزئية من العداد + +8 +00:00:42,650 --> 00:00:46,310 +الحقيقية الى مجموعة جزئية من العداد المركبة فطبعا + +9 +00:00:46,310 --> 00:00:50,030 +احنا كنا عرفنا بسهولة لو فيها ان احنا دالتين من R + +10 +00:00:50,030 --> 00:00:57,350 +لR U of Tو V of T فكتبنا اللي هو U Z I V تساوي W + +11 +00:00:57,350 --> 00:01:03,490 +of T و بعدين ندرس هذه الدالة و شوفنا تفاضلها هو + +12 +00:01:03,490 --> 00:01:06,990 +تفاضل ال real part و ال imaginary part و شوفنا بعض + +13 +00:01:06,990 --> 00:01:07,610 +الخواص + +14 +00:01:10,220 --> 00:01:14,460 +لو فى عنا ثابت مضروف ال W فبخرج خارج التفاضل و لو + +15 +00:01:14,460 --> 00:01:18,980 +طبعا بشكل خاص تفاضل exponential اى عدد ثابت فى T + +16 +00:01:18,980 --> 00:01:23,640 +بيساوي ال Z0 اللى هى ثابت فى ال exponential هذه + +17 +00:01:23,640 --> 00:01:28,580 +اخر نقطة اتحدثنا عنها الان نجى لنقطة رئيسية ومهمة + +18 +00:01:28,580 --> 00:01:33,320 +وهو كيف نكامل هذه الدالة اللى هي الدالة المركبة فى + +19 +00:01:33,320 --> 00:01:37,340 +متغير حقيقيفطبعا انا زي يعني نفس مفهوم التفاضل + +20 +00:01:37,340 --> 00:01:40,420 +عشان اكمل الدلب ده كامل ال real part تبعها و ال + +21 +00:01:40,420 --> 00:01:44,360 +imaginary part فلو كانت ال Uعادل التكامل + +22 +00:01:44,360 --> 00:01:47,480 +Integrable على فترة محدودة AB والـ V م Integrable + +23 +00:01:47,480 --> 00:01:50,540 +بقول إن الـ W Integrable يعني بمعنى إن التكامل من + +24 +00:01:50,540 --> 00:01:56,040 +A إلى B إلى الـ U exist تكامل من A إلى B DT تكامل + +25 +00:01:56,040 --> 00:02:00,360 +من A إلى B DT exist فهذا number هذا number النتج + +26 +00:02:00,360 --> 00:02:03,100 +يكون complex number بقول إن التكامل هذا الشماله + +27 +00:02:03,100 --> 00:02:06,860 +exist يعني Integrable فده هو التعريز فبهذا الشكل + +28 +00:02:06,860 --> 00:02:12,850 +بنقول إن الـ W Integrableفبنعرف التكامل على فترة + +29 +00:02:12,850 --> 00:02:16,310 +محدودة من A ل B طبعا ال T real فمن الطبيعي ان انا + +30 +00:02:16,310 --> 00:02:19,710 +اتحدث ان ال T تتغير من A ل B فبتحدث عن تكامل على + +31 +00:02:19,710 --> 00:02:24,110 +الفترة من A ل B ل W of T بيساوي تكامل ال real part + +32 +00:02:24,110 --> 00:02:28,570 +زاد I بتكامل ال imaginary part خلينا نشوف مثال + +33 +00:02:28,570 --> 00:02:32,410 +فانا + +34 +00:02:32,410 --> 00:02:40,090 +بدها كامل من 0 ل Pi على 6 E تبار I او 2T في I DT + +35 +00:02:42,460 --> 00:02:46,540 +طبقا لما ذكرناه قبل قليل عشان اكمل هذه الدالة + +36 +00:02:46,540 --> 00:02:53,320 +باستخدام التعريف لازم افصلها ل real part و كامل كل + +37 +00:02:53,320 --> 00:02:56,780 +part على حد او كل جزء على حد فهذه بساوية تكامل من + +38 +00:02:56,780 --> 00:02:59,920 +zero خليني اكتب تحت افضل + +39 +00:03:03,470 --> 00:03:08,550 +تساوي تكامل من zero ل πاية على ستة طبعا اللي هو ال + +40 +00:03:08,550 --> 00:03:13,670 +experiment اللي عبارة عن cosine اتنين T زائد I sin + +41 +00:03:13,670 --> 00:03:21,530 +اتنين DT و بقى كامل الطرف اللي هو الجزء الحقيقي هو + +42 +00:03:21,530 --> 00:03:25,070 +الجزء اللي هو التخيل و تساوي تكامل ال cosine جداش + +43 +00:03:25,070 --> 00:03:27,930 +لأ sin من غير الكتالب + +44 +00:03:31,060 --> 00:03:37,900 +2t طبعا بجسم على 2 من 0 لπ على 6 زائد I تكامل اللي + +45 +00:03:37,900 --> 00:03:43,440 +هي دي فيها سالب الآن اخليها مش مشكلة زائد I سالب + +46 +00:03:43,440 --> 00:03:52,640 +نص cosine 2t من وين لوين من 0 لπ على 6بنكمل الريال + +47 +00:03:52,640 --> 00:03:55,720 +بارد لحال و الميجان بارد لحال و بنحسب طبعا لو + +48 +00:03:55,720 --> 00:04:01,700 +حسبنا ايش بيساوي ان اللي هو نص في sin باي على + +49 +00:04:01,700 --> 00:04:06,180 +تلاتة ناقص من sin الزيرو زي الاي او دعنا نقول هنا + +50 +00:04:06,180 --> 00:04:11,360 +سالب اللي هو اي على اتنين ايش فيه هنا كوساين ال + +51 +00:04:11,360 --> 00:04:15,500 +باي على تلاتة ناقص كوساين الزيرو طبعا sin الزيرو + +52 +00:04:15,500 --> 00:04:17,880 +بزيرو sin الستين كدهش يا شباب + +53 +00:04:20,890 --> 00:04:27,530 +جزر التلاتة على اتنين هذا يخلص ناقص I على اتنين + +54 +00:04:27,530 --> 00:04:31,910 +كوصين الستين نص وكوصين الواحد صفر فالجواب جزر + +55 +00:04:31,910 --> 00:04:39,670 +التلاتة زائد I على اتنين + +56 +00:04:40,880 --> 00:04:45,820 +فبقدر اكمل اي دالة مركبة في متغير حقيقتي على فترة + +57 +00:04:45,820 --> 00:04:50,140 +مفتوحة من a على فترة مغلقة من a لb فهيك بقدر اكمل + +58 +00:04:50,140 --> 00:04:55,200 +بهذه الصورة فهذا هو التعريف وهذه طريقة التطبيق + +59 +00:04:55,200 --> 00:05:03,280 +طبعا بما انهعشان أكامل الدالة المرتكبة بمتغير + +60 +00:05:03,280 --> 00:05:06,400 +حقيقي التعريف بيقول لازم اتكامل ال real part و ال + +61 +00:05:06,400 --> 00:05:09,880 +imaginary part اللي هم ال U و ال V هدول أشمالهم + +62 +00:05:09,880 --> 00:05:13,300 +دوالة حقيقية في متغير حقيقي دوالة عادية يعني اللي + +63 +00:05:13,300 --> 00:05:15,620 +متعودين عليها من التفاضل اللي بتفاضل بها U of T + +64 +00:05:15,620 --> 00:05:19,100 +بتاكملها من إله بيه و ال V من إله بيه بينطبق عليهم + +65 +00:05:19,100 --> 00:05:22,480 +جميع خواص التكامل القديمة كل هدول يقدروا استخدامها + +66 +00:05:22,480 --> 00:05:25,480 +كل الخواص بتوزع الجامعة بتوزع الطلع حيث هو اللي + +67 +00:05:25,480 --> 00:05:28,560 +بتطلع برافكل هذه الخواصة انطبق عليها كي بدها كامل + +68 +00:05:28,560 --> 00:05:31,140 +بجيب لها antiderivative لل U بجيب لها مستقلة U + +69 +00:05:31,140 --> 00:05:34,100 +بكامل زي ما عملنا هنا كل هذه الخواصة .. كل خاصية + +70 +00:05:34,100 --> 00:05:37,920 +من خواص التكامل مرت علينا في السابق تنطبق على هذا + +71 +00:05:37,920 --> 00:05:41,580 +التكامل بس بعمله measures in real part و imaginary + +72 +00:05:41,580 --> 00:05:43,440 +part فدي الملاحظة + +73 +00:05:48,750 --> 00:05:55,050 +نظرية أو حقيقة أخرى بتأكد على السابق ببعض الأمور + +74 +00:05:55,050 --> 00:05:58,710 +المهمة، زي ما حكينا، لو في عندي ثابت، طبعا، هل + +75 +00:05:58,710 --> 00:06:01,830 +بضروري أن أنا أفصلها real part و imaginary part؟ + +76 +00:06:01,830 --> 00:06:04,190 +لأ، خلاني أثبتها مرة واحدة، بلاش كل مرة نعمل، + +77 +00:06:04,190 --> 00:06:06,920 +فالثالث بيطلع برا التكامل، بيأثّجها التكامللو انا + +78 +00:06:06,920 --> 00:06:11,840 +عندي z0 number يعني ثابت بدي اكامل z0 في w فz0 و + +79 +00:06:11,840 --> 00:06:14,720 +انا اتدعو بالt بتخيل بره التكامل بكامل عادي طب اذا + +80 +00:06:14,720 --> 00:06:17,040 +انا اعملها في التفاضل لو فكناها في لاجئ لا تؤثر + +81 +00:06:17,040 --> 00:06:20,360 +نفس القضية زي ما قلنا احنا عشان نكامل في ال real + +82 +00:06:20,360 --> 00:06:23,200 +value function اعامش انا اجيب ال antiderivative طب + +83 +00:06:23,200 --> 00:06:26,200 +لو انا جيبت ال antiderivative لكل الدالة مع بعض + +84 +00:06:26,200 --> 00:06:28,880 +بدل ما اجيب ال antiderivative لل real part لحالة + +85 +00:06:29,330 --> 00:06:31,370 +والاميجار ال بارد العالي جيبت antiderivative لكل + +86 +00:06:31,370 --> 00:06:35,970 +مرة واحدة بنفع نعم بنفع لو جيب ال w كمة ال w اللي + +87 +00:06:35,970 --> 00:06:38,230 +هي ال antiderivative ايش ال antiderivative يعني مش + +88 +00:06:38,230 --> 00:06:41,290 +تقاطها بيستوي ال small w اه فعلا طول بقدر اكمل اه + +89 +00:06:41,290 --> 00:06:43,310 +بيقول ايه يا فضل متفير بيبقى في ال calculus فانا + +90 +00:06:43,310 --> 00:06:46,590 +بجيب الأول antiderivative لل small w و بكتب بها و + +91 +00:06:46,590 --> 00:06:50,130 +بقول من وين من a ل b من a ل b قيمتها عند ال b ماخص + +92 +00:06:50,130 --> 00:06:53,870 +قيمتها عند main عند ال aنقص قيمة and إيه؟ يعني + +93 +00:06:53,870 --> 00:06:57,190 +بمعنى أخر، يعني كيف المثال ممكن أحله؟ من غير + +94 +00:06:57,190 --> 00:07:01,610 +معفوك، هذا المثال ممكن أحله بسهولة تكامل من zero ل + +95 +00:07:01,610 --> 00:07:05,910 +pi على 6 e to power اتنين ti dt، ممكن تقولوا إن هي + +96 +00:07:05,910 --> 00:07:07,810 +حل آخر، another solution + +97 +00:07:11,540 --> 00:07:13,860 +بتنقل antiderivative ايش بتنقل antiderivative انا + +98 +00:07:13,860 --> 00:07:17,900 +بتنقل دالة مشطقتها تكون هذا الكلام مشطقتها طبعا + +99 +00:07:17,900 --> 00:07:21,100 +لما اشطق انا بنزل الثابت لما كامل بنزل معاه الثابت + +100 +00:07:21,100 --> 00:07:24,440 +فهذه الدالة ال antiderivative هي E to power 2T في + +101 +00:07:24,440 --> 00:07:29,200 +I تقسيم 2I ال I ثابت هنا طبعا عادل طبعا من وين + +102 +00:07:29,200 --> 00:07:34,040 +لوين من 0 ل5 على 6وبنكمل لازم نطلع إيهش نفس الجواب + +103 +00:07:34,040 --> 00:07:36,720 +فإن أنا بدى المانع مش بالضرورية أفك ال أي إيهش + +104 +00:07:36,720 --> 00:07:39,920 +real part و illusion part أجيب ده اللي مشتقتها ده + +105 +00:07:39,920 --> 00:07:42,940 +الكلام تكامل عادي ومتعودين بس إيش ده خلطنا عالمين؟ + +106 +00:07:42,940 --> 00:07:45,580 +ال I ده الشديد لإن معدات مركبة ونتعامل بشكل عام + +107 +00:07:45,580 --> 00:07:47,760 +فأنا بدي إيهش لما أبدأ كامل بدي أسمع اللي عادي + +108 +00:07:47,760 --> 00:07:50,140 +الصحيح لإن لو أفضلت هي دي عدد derivative ليش هي دي + +109 +00:07:50,140 --> 00:07:52,760 +عدد derivative؟ لإن مشتقتها مش بالساوية small w + +110 +00:07:52,760 --> 00:07:59,240 +هذه وعادي حشبات هذه نظرية بتقول بهذه الصورةالـ T + +111 +00:07:59,240 --> 00:08:04,840 +مش ثابت، الـ T متغير، فالنسبة للـ T صحيح؟ نشوف + +112 +00:08:04,840 --> 00:08:08,620 +مثال، فقلنا جميع خواص التكامل تتطابق علي هذا + +113 +00:08:08,620 --> 00:08:12,380 +الكلام، بما فيها ما عرفناه عن الـ improper + +114 +00:08:12,380 --> 00:08:15,560 +integral حتى الـ improper integral نفس الخواص، فلو + +115 +00:08:15,560 --> 00:08:18,680 +ده اللي يحسب التكامل من zero لما لنهاية, E to + +116 +00:08:18,680 --> 00:08:22,200 +minus T في واحد زائد I تتطابق علي هذا الكلام + +117 +00:08:34,470 --> 00:08:37,650 +ملاحظ هنا يا شباب طبعا هو في الأصل هذا عبارة عن + +118 +00:08:37,650 --> 00:08:41,590 +مين؟ في تكامل improper integral للreal part لل U + +119 +00:08:41,590 --> 00:08:45,610 +of T وفي تكامل للimager part للU of T طب لو واحد + +120 +00:08:45,610 --> 00:08:51,020 +فيهم diverseالتاني لأ لو انا عندي تكامل ال U + +121 +00:08:51,020 --> 00:08:54,040 +converged و تكامل ال V diverged ايش بيكون تكامل ال + +122 +00:08:54,040 --> 00:08:57,440 +W؟ Diverged بيكون Diverged لإن انا بتاعة complex + +123 +00:08:57,440 --> 00:09:00,200 +number ال real part معرف لإن ال real part مش معرف + +124 +00:09:00,200 --> 00:09:03,040 +فهيكون H مش معرف فلازم عشان يكون هذا converged يجب + +125 +00:09:03,040 --> 00:09:05,060 +ان ال real part يكون converged و ال H و ال real + +126 +00:09:05,060 --> 00:09:08,090 +part converged مع بعضولو بالعكس عجبنا كل + +127 +00:09:08,090 --> 00:09:09,410 +conversion يجب ان نبريها اتباع ال converge و ال + +128 +00:09:09,410 --> 00:09:11,910 +imaginary converge فهنا دي كمثال فهنا طبعا نتحدث + +129 +00:09:11,910 --> 00:09:15,590 +ان كل converge كجزءين يكونوا converge خيا نحسب + +130 +00:09:15,590 --> 00:09:18,930 +طبعا ماحنش محتاجين نفصل بالملاحظة السابقة لو جيبنا + +131 +00:09:18,930 --> 00:09:21,390 +العدد derivative نشغل مباشرة نشغل عليه مرة واحدة + +132 +00:09:21,390 --> 00:09:25,370 +مافيش مشكلة اطلاقابنان كامل فبالنسبة للأول شي + +133 +00:09:25,370 --> 00:09:29,590 +بالحل solution تكامل من zero لمله نهاية E to minus + +134 +00:09:29,590 --> 00:09:35,630 +T في واحد زائد I DT أول خطوة هي limit C تقوله لمله + +135 +00:09:35,630 --> 00:09:42,690 +نهاية تكامل من zero ل C E to minus T في واحد زائد + +136 +00:09:42,690 --> 00:09:48,240 +I DTزي اي improper integral هو ايش بان انا ايش + +137 +00:09:48,240 --> 00:09:50,840 +متعامل و اتكلمت هيك متعامل مع الـimproper integral + +138 +00:09:50,840 --> 00:09:53,260 +المشكلة عند المالة نهائية او الاقل عند المالة + +139 +00:09:53,260 --> 00:09:56,360 +نهائية فالـC تقول للمالة نهائية و مالك مابيش غير + +140 +00:09:56,360 --> 00:10:00,660 +ده التكامل تماما تماما بدون اي مشاكل طبعا لان هذا + +141 +00:10:00,660 --> 00:10:02,960 +عبارة عن اي ال part و ال major part لكن ممكن اعمله + +142 +00:10:02,960 --> 00:10:08,020 +مرة واحدة ممكن اعمله بنفس الوقت و يساويLimit C + +143 +00:10:08,020 --> 00:10:11,220 +تقول المالة نهاية انجيب ال antiderivative ايش + +144 +00:10:11,220 --> 00:10:15,840 +التكامل تبع هذا الادلة سالب T في واحد زائد I تقسيم + +145 +00:10:15,840 --> 00:10:21,600 +مين؟سالب واحد زائد I كل واحد ثابت سالب واحد زائد I + +146 +00:10:21,600 --> 00:10:27,940 +هذا عدد مركب ثابت طبعا من وين لوين من Zero لسي من + +147 +00:10:27,940 --> 00:10:32,140 +Zero لسي خلينا نطلع الثابت هذا برا بيساوي سالب + +148 +00:10:32,140 --> 00:10:37,980 +واحد على واحد زائد I limit C تقل الملا نهاية انعوض + +149 +00:10:37,980 --> 00:10:44,420 +عند C E سالب C في واحد زائد I ناقص E to power Zero + +150 +00:10:44,420 --> 00:10:48,270 +ليه واحد خلينا نمشي فيها واحدة واحدةأذا زي أي + +151 +00:10:48,270 --> 00:10:51,130 +improper integer زي ما اتعلمنا في تفاضل ألف أبا + +152 +00:10:51,130 --> 00:10:55,310 +بنجيب أولا بنشوف أين العلة بنخل الصي تقول هذه + +153 +00:10:55,310 --> 00:10:59,490 +العلة بس لإن أنا تكامل عادي بنحسبه بشكل كامل بعد + +154 +00:10:59,490 --> 00:11:03,650 +ما نخلص نحسب بنحسب ال limit بنحسب ال limit خلينا + +155 +00:11:03,650 --> 00:11:06,970 +بس نبسط طبعا هذا النقطة مش من ال standard form لأ + +156 +00:11:06,970 --> 00:11:10,010 +نجري عملية القسمة كيف أجري عملية القسمة أضرب في + +157 +00:11:10,010 --> 00:11:14,270 +المرافق سالب واحد ماقص I على جداش على ال modulus + +158 +00:11:14,270 --> 00:11:19,840 +تربية اللي هو جداش اتنينعملية القسمة بكل سهولة + +159 +00:11:19,840 --> 00:11:22,780 +خلّينا نحسب هذه ال limit السؤال طبعا هذا ثابت + +160 +00:11:22,780 --> 00:11:27,700 +بيسوء واحد السؤال كيف نحسب هذا ال limit E تقول + +161 +00:11:27,700 --> 00:11:31,220 +سالب C في واحد زائد I ومن اللي بتروح المدى نهاية + +162 +00:11:31,220 --> 00:11:35,300 +ال C فما رأيكم بهذه ال limit أو كيف يمكن أن نحسب + +163 +00:11:35,300 --> 00:11:42,370 +ال limit هذه على طريق الرسم لأ مش شرطعشان احلل هذا + +164 +00:11:42,370 --> 00:11:51,950 +ال limit خلّينا نكتبه بشكل صريح الفكهة عبارة عن + +165 +00:11:51,950 --> 00:11:57,250 +limit C تقول المنهية ال exponent هي عبارة عن مين E + +166 +00:11:57,250 --> 00:12:04,410 +أُس سالب C في E أُس سالب CI ليه ايش؟ cosine C ماقص + +167 +00:12:04,410 --> 00:12:08,960 +I في sine C طبعا E أُس 0 سالب 1ايش اللي عملناها + +168 +00:12:08,960 --> 00:12:13,340 +هنا يا شباب؟ هاد عبارة عن E أسالب C في E أسالب CI + +169 +00:12:13,340 --> 00:12:17,880 +مصبوخ E أسالب C ريال بارد مافيها مشكلة و E أسالب C + +170 +00:12:17,880 --> 00:12:21,120 +في I ايه ده السهل و cosine أسالب C اللي هي cosine + +171 +00:12:21,120 --> 00:12:25,320 +C لإنه even و cosine أسالب C أسالب sin C فبتنقل + +172 +00:12:25,320 --> 00:12:28,420 +كتابة ده الشكل I أنا ممكن حلو ال limit بشكل أفضل + +173 +00:12:28,420 --> 00:12:31,320 +ال I ال limit ممكن حلوها بشكل أفضلالـ C تقولنا + +174 +00:12:31,320 --> 00:12:33,460 +المالة نهائية E أُس سالب مالة نهائية E أس سالب + +175 +00:12:33,460 --> 00:12:36,320 +مالة نهائية E أس سالب مالة نهائية E أس سالب مالة + +176 +00:12:36,320 --> 00:12:43,720 +نهائية E أس سالب مالة نهائية E أس + +177 +00:12:43,720 --> 00:12:50,050 +سالب مالة نهائيةإيه يقول سالب C في cosine؟ بروح + +178 +00:12:50,050 --> 00:12:53,770 +إلى الـ0 فلو لتركت ال cosine اللي عالها مالياش + +179 +00:12:53,770 --> 00:12:56,630 +limit بتروح بين الواحد و بين السالب واحد لكن مع + +180 +00:12:56,630 --> 00:12:59,670 +بعض هذا عدد بين الواحد و بين السالب واحد و هذا + +181 +00:12:59,670 --> 00:13:02,230 +أشمل و بين الصغر رايح على الصفر فهذا كان نص، كان + +182 +00:13:02,230 --> 00:13:04,890 +سالب نص، كان واحد، كان سالب واحد، لما هذا يصغر مع + +183 +00:13:04,890 --> 00:13:07,150 +الملايكي في الغرف الآخر، ياخدوا معاها على الصفر + +184 +00:13:07,150 --> 00:13:10,630 +طبعا إذا أنا ماديش أن أدخل في التفاصيل، لكن كم + +185 +00:13:10,630 --> 00:13:13,990 +ممكن أثبت هذا ال limit؟بس أنا مش فيرة، فعندك + +186 +00:13:13,990 --> 00:13:16,950 +الكسايع بين الواحد و بين السالب واحد مع نفسه + +187 +00:13:16,950 --> 00:13:20,230 +بنانشال حصي المقرحة بين السالب E و السالب C و بين + +188 +00:13:20,230 --> 00:13:22,870 +ال E و السالب C الطرفين بيروح للصفر، إذا الفن نص + +189 +00:13:22,870 --> 00:13:26,250 +بده بيروح لمين؟ للصفر، والسايع نفس الشيء، لإن هذه + +190 +00:13:26,250 --> 00:13:29,290 +السايع و الكسايع دوال محدودة بين الواحد و بين + +191 +00:13:29,290 --> 00:13:39,170 +السالب واحد لصفر نعم معين أنا بكراشهير بالعربي ايش + +192 +00:13:39,170 --> 00:13:42,230 +يعني سم السيرة و مش عارف .. مش فاهمين و انا مش .. + +193 +00:13:42,230 --> 00:13:44,810 +مش ذاكرين .. اذاك .. اذاك .. اذاك .. اذاك .. اذاك + +194 +00:13:44,810 --> 00:13:46,490 +.. اذاك .. اذاك .. اذاك .. اذاك .. اذاك .. اذاك .. + +195 +00:13:46,490 --> 00:13:46,570 +اذاك .. اذاك .. اذاك .. اذاك .. اذاك .. اذاك .. + +196 +00:13:46,570 --> 00:13:47,150 +اذاك .. اذاك .. اذاك .. اذاك .. اذاك .. اذاك .. + +197 +00:13:47,150 --> 00:13:47,310 +اذاك .. اذاك .. اذاك .. اذاك .. اذاك .. اذاك .. + +198 +00:13:47,310 --> 00:13:48,130 +اذاك .. اذاك .. اذاك .. اذاك .. اذاك .. اذاك .. + +199 +00:13:48,130 --> 00:13:51,170 +اذاك .. اذاك .. اذاك .. اذاك .. اذاك .. اذا + +200 +00:13:54,280 --> 00:13:57,100 +انت لجأت انت كل كوارد جاسس انت متخصصين رياضيار + +201 +00:13:57,100 --> 00:14:00,080 +فاللي بتاخده في تفاضل ألف مش حد يتسوح هييجي معك + +202 +00:14:00,080 --> 00:14:03,340 +فلما انت طبعا في شي عادي احنا كلنا بننسى لما تنسى + +203 +00:14:03,340 --> 00:14:06,280 +اي شي بس تتذكر في انه موضوع في كتاب اذا الموضوع في + +204 +00:14:06,280 --> 00:14:09,240 +الcalculus تفتح كتاب الcalculus تتعرف تستخدم مين + +205 +00:14:09,240 --> 00:14:13,220 +المرجع ترجعله تتذكر فمش ضروري ان انت لما انت ذاكر + +206 +00:14:13,220 --> 00:14:16,380 +كلشي ومش ضروري برضه الدكتور يديك كلشي جاهز مش + +207 +00:14:16,380 --> 00:14:16,620 +هنأكل + +208 +00:14:20,280 --> 00:14:23,520 +و و و و و و و و و و و و و و و و و و و و و و و و و + +209 +00:14:23,520 --> 00:14:23,640 +و و و و و و و و و و و و و و و و و و و و و و و و و + +210 +00:14:23,640 --> 00:14:30,000 +و و و و و و و و و و و و و و و و و و و و و و + +211 +00:14:30,000 --> 00:14:30,800 +و و و و و و و و و و و و و و و و و و و و و و و و و + +212 +00:14:30,800 --> 00:14:31,920 +و و و و و و و و و و و و و و و و و و و و و و و و و + +213 +00:14:31,920 --> 00:14:34,420 +و و و و و و و و و و و و و و و و و و و و و و و و و + +214 +00:14:34,420 --> 00:14:34,500 +و و و و و و و و و و و و و و و و و و و و و و و و و + +215 +00:14:34,500 --> 00:14:38,240 +و + +216 +00:14:43,620 --> 00:14:47,040 +فهي converge فهذا الimproval integral converge + +217 +00:14:47,040 --> 00:14:54,700 +وقيمته واحد ناقص I على اتنين طب السلم واحد ناقص + +218 +00:14:54,700 --> 00:15:00,520 +ايه هو اللي تم وما قالها سعر plus واحد صفر وال + +219 +00:15:00,520 --> 00:15:01,200 +limit صفر + +220 +00:15:03,860 --> 00:15:07,580 +فشي طبيعي يا شباب ان انا مش كل اي امر لازم ناخده + +221 +00:15:07,580 --> 00:15:10,640 +جاهز .. المهم احنا نعرف .. نتعلم الأساسيات و نعرف + +222 +00:15:10,640 --> 00:15:13,980 +وين المصدر اللي نقدر نرجعله و نقدر نحسس فيها هذه + +223 +00:15:13,980 --> 00:15:23,640 +الأمور كيف + +224 +00:15:23,640 --> 00:15:27,000 +.. هذي السلب واحد .. انا عملت قص .. خلاص سلب مع + +225 +00:15:27,000 --> 00:15:29,700 +سلب وصرت واحد .. واحد ماقص اخر .. انا مع السلب + +226 +00:15:29,700 --> 00:15:36,780 +اللي ها .. صارت plus .. صارت plusانواصل مع التكامل + +227 +00:15:36,780 --> 00:15:42,420 +للدالة المركبة W في متغير حقيقي T من خلاص هذه + +228 +00:15:42,420 --> 00:15:48,460 +التكاملات تكامل محدود من A ل B فال modulus للتكامل + +229 +00:15:48,460 --> 00:15:53,480 +أصغر أو يساوي تكامل ال modulus ال modulus للتكامل + +230 +00:15:53,480 --> 00:15:59,470 +أصغر أو يساوي تكامل ال modulus هذه الخصيةموجودة + +231 +00:15:59,470 --> 00:16:02,190 +للدوال الحقيقية في متغير حقيقي او اذا موجود + +232 +00:16:02,190 --> 00:16:06,230 +التفاضل الالف ان القيمة المطلقة للتكامل اصغر ايه + +233 +00:16:06,230 --> 00:16:09,230 +ساوي تكامل القيمة المطلقة ممكن تتجاولها احنا + +234 +00:16:09,230 --> 00:16:13,910 +دلوقتي هبقى تلميذ للدوال المركبة في متغير حقيقي + +235 +00:16:13,910 --> 00:16:20,850 +خلينا نشوف البرهار ال proof حل + +236 +00:16:20,850 --> 00:16:25,250 +سم ال proof او البرهار لحالتين الحالة الاولى لو + +237 +00:16:25,250 --> 00:16:27,150 +كان التكامل بيساوي صفر + +238 +00:16:29,800 --> 00:16:36,100 +لو كان التكامل من A ل B W of T DT بيساوي صفر ففي + +239 +00:16:36,100 --> 00:16:38,980 +هذه الحالة الطرف اليسار للمتبادل اللي بدها أثبتها + +240 +00:16:38,980 --> 00:16:44,040 +القيمة المطلقة للتكامل جدش بتساوي إذا التكامل + +241 +00:16:44,040 --> 00:16:47,420 +بيساوي صفر بقيته المطلقة صفر طب إيش رأيكوا في + +242 +00:16:47,420 --> 00:16:52,240 +التكامل اللي على اليمين من A ل B مطلق W of T DT + +243 +00:16:53,260 --> 00:16:58,800 +بساوة صفر؟ لا مش شرط، لكن المطلق للدالة المركبة، + +244 +00:16:58,800 --> 00:17:02,560 +إيش بيكون؟ أعداد حقيقية، ولا لأ؟ فهذه الدالة ده + +245 +00:17:02,560 --> 00:17:05,520 +اللي حقيقية .. إيش حقيقية؟ ده اللي حقيقية موجة + +246 +00:17:05,520 --> 00:17:09,180 +بتكابلها، بدي يكون دايما positive أو أو أو أو + +247 +00:17:09,180 --> 00:17:11,780 +zero، لأنه لايوجد عليه في المساحة، فانا عندي هذا + +248 +00:17:11,780 --> 00:17:15,140 +المقدار أكبر أو يساوة zero، لأن modulus، بخد نظر + +249 +00:17:15,140 --> 00:17:17,820 +عالم كده، قيمة ال .. هذا الكلام ماهي دعوة في نوع + +250 +00:17:17,820 --> 00:17:21,720 +يساوة صفر، إذن هذا أشماله دايما أكبر أو يساوة zero + +251 +00:17:22,270 --> 00:17:26,090 +لأن بضاربة كامل دالة غير سالبة أكبر أو يساوي 0 + +252 +00:17:26,090 --> 00:17:29,450 +فالتكامل دائما أكبر أو يساوي 0 عشان رأيك في + +253 +00:17:29,450 --> 00:17:32,810 +المساحة احنا ايش بنقول انه زي المنحنى فوق ال X + +254 +00:17:32,810 --> 00:17:35,950 +axis positive فهي بتديني مساحة و اذا كانت مضاربة + +255 +00:17:35,950 --> 00:17:38,830 +سالب واحد فلما تكون هذا المقدار موجب أو يساوي 0 + +256 +00:17:38,830 --> 00:17:43,290 +فالتكامله برضه أكبر أو يساوي 0 فهذا دي احتمال + +257 +00:17:43,290 --> 00:17:47,640 +الحالة الأولى الحالة التانيةوالان هتبين ليش احنا + +258 +00:17:47,640 --> 00:17:56,520 +جسمنا للحالتين w of t dt لا تساوي zero احنا + +259 +00:17:56,520 --> 00:18:01,940 +متعامل معاش تكامل محدود يعني الجواب تبعه ايش بيكون + +260 +00:18:01,940 --> 00:18:11,420 +قيمة عدد اه عدد ايهاش ريال ليشعدد مُركّب قيمة عدد + +261 +00:18:11,420 --> 00:18:17,160 +مُركّب عدد مُركّب إذا كان لا يساوي صفر اللي بيكون + +262 +00:18:17,160 --> 00:18:19,900 +exponential فار هذا اللي بدنا يعني او polar فار + +263 +00:18:19,900 --> 00:18:23,540 +عشان هيك أنا ميزت لو صفر مالهوش polar فار لكن + +264 +00:18:23,540 --> 00:18:28,240 +علشان ده طلعت حالة سهلة و بديعة الآن مازال عدد + +265 +00:18:28,240 --> 00:18:31,020 +مُركّب لا يساوي صفر بدي اكتب عليهاش in polar فار + +266 +00:18:31,020 --> 00:18:33,360 +it can be written + +267 +00:18:38,310 --> 00:18:44,280 +التكامل بالدولار أو الـ exponential formبتساوي R0 + +268 +00:18:44,280 --> 00:18:50,160 +E to power I θ0 عدد مُركّب يا شباب طبعا الـ I عشان + +269 +00:18:50,160 --> 00:18:53,060 +انه بشكل عام مش معروف جداش هو العدد المُركّب بيكون + +270 +00:18:53,060 --> 00:18:56,260 +صعب لكن انا بنتخيل ان عدد مُركّب و هي الأمثلة اي + +271 +00:18:56,260 --> 00:18:59,500 +مثال جدانكوا اي واحد ناقص I على اتنين طوله طلع + +272 +00:18:59,500 --> 00:19:02,600 +المثال جداش جزر التلاتة زايد I على أربع المثال + +273 +00:19:02,600 --> 00:19:05,920 +الصعب فهو عدد مُركّب و بيسوي الصفر طبعا اذا ميله + +274 +00:19:05,920 --> 00:19:11,480 +برفع ال R0 ماذا تمثل؟الـ modulus ال modulus و ال + +275 +00:19:11,480 --> 00:19:14,400 +theta ايش بتمثل ال argument اعاد قيام ال argument + +276 +00:19:14,400 --> 00:19:22,560 +ان اكد على هذا الكلام where R0 + +277 +00:19:22,560 --> 00:19:29,140 +تساوي ال modulus للتكامل لهذا العدد W of T DT و ال + +278 +00:19:29,140 --> 00:19:34,600 +theta 0 هي اعاد ال argument اي قيمة لل argument + +279 +00:19:34,600 --> 00:19:42,790 +للتكامل من A ل B W of T DT تمامأي سؤال نكمل الان + +280 +00:19:42,790 --> 00:19:49,490 +نرجع للمتباينة ايش المتباينة بدنا المطلق طرف + +281 +00:19:49,490 --> 00:19:53,390 +اليسار هو المطلق و المطلق من المناقشة السابقة ايش + +282 +00:19:53,390 --> 00:19:54,770 +كتبنا R0 + +283 +00:19:57,900 --> 00:20:03,480 +تكامل من a ل b w of t dt in absolute value ايش + +284 +00:20:03,480 --> 00:20:09,320 +بيساوي؟ اصبح بيساوي r0 رمضان بالرمز r0 طيب من هذه + +285 +00:20:09,320 --> 00:20:13,760 +المعادلة r0 ايش كيب ممكن اكتبها؟ ممكن اكتبها احد + +286 +00:20:13,760 --> 00:20:17,720 +دسم على هذه العداد فهذه تساوي اللي هو اسف اكتب + +287 +00:20:17,720 --> 00:20:27,930 +اولا ال exponentialE-Iθ0 تكامل من A ل B W of T DT + +288 +00:20:27,930 --> 00:20:35,750 +نستخدم المعادلة هذه واضح يا شباب فاحنا ان عددأخر + +289 +00:20:35,750 --> 00:20:38,870 +خطوة قول لا احنا من هنا مالعلاقة لدى الكلام + +290 +00:20:38,870 --> 00:20:42,550 +التكامل العلاقات مُركَّب غير صفر اذا نبطل الهو + +291 +00:20:42,550 --> 00:20:44,890 +exponential four الان انا بتاعة بتاعة بتاعة + +292 +00:20:44,890 --> 00:20:47,810 +متباينة اللى جدامنا بدأت من الطرف اليسار هو ال + +293 +00:20:47,810 --> 00:20:51,030 +modulus و هو يماثر بال .. و يماثر بال exponential + +294 +00:20:51,030 --> 00:20:55,610 +four من R0 طب قل المعادلة ده R0 ايش بتساوي اجسم + +295 +00:20:55,610 --> 00:20:59,830 +على ال exponential بتساوي هذا المركز تمام؟ اه الان + +296 +00:21:01,120 --> 00:21:05,380 +ممكن ادخل هذا المقدار دي هو التكامل ليه؟ لأنه ثابت + +297 +00:21:05,380 --> 00:21:07,900 +او من خاصة التكامل اللي قلنا الثالث ممكن يطلع برضه + +298 +00:21:07,900 --> 00:21:13,320 +او يدخل جوا عوايش ما يناسبني وهذا يؤدي ان R0 تساوي + +299 +00:21:13,320 --> 00:21:21,670 +تكامل من A لB E to minus I θ0 W of T dtالفكرة + +300 +00:21:21,670 --> 00:21:23,970 +البرهانة الآن يا شباب اللي هتعمل عليها وهو امكان + +301 +00:21:23,970 --> 00:21:27,950 +الاسباب اللي خلتناها برهن هنستخدم خاصية مهمة من + +302 +00:21:27,950 --> 00:21:31,390 +خلاصة التكامل لما احنا عرضنا التكامل في الاصل + +303 +00:21:31,390 --> 00:21:37,350 +قلناش ما هنعمل؟ بنكامل ال real part لحال + +304 +00:21:37,350 --> 00:21:41,190 +و ال imaginary part لحال بمعنى ان ال real part + +305 +00:21:41,190 --> 00:21:45,170 +للتكامل بيساوي مين؟ تكامل ال real part يعني لو جيت + +306 +00:21:45,170 --> 00:21:50,810 +لو انا عندي بدي اكتمل W خليني اكتب بس ب ..هو W of + +307 +00:21:50,810 --> 00:21:56,990 +T بدنا نكملها من A ل B DT بيساوي تكامل من A ل B ل + +308 +00:21:56,990 --> 00:22:02,890 +U زائد I في تكامل من A ل B ل Vبنطلع لعنى المعادلة + +309 +00:22:02,890 --> 00:22:07,150 +فإذا لما أنا بدي أحسب التكامل هذا من وين عيجي + +310 +00:22:07,150 --> 00:22:09,670 +الريال بارد هذا اللي هو العدل اللي هو اللي عيجيه + +311 +00:22:09,670 --> 00:22:12,650 +بعضيها من ان انت من تكامل الريال بارد لها و الناتج + +312 +00:22:12,650 --> 00:22:15,830 +هي من وين من تكامل ال image in ال بارد هذا معناته + +313 +00:22:15,830 --> 00:22:19,730 +ان الريال بارد للتكامل بيساوي تكامل الريال بارد و + +314 +00:22:19,730 --> 00:22:22,650 +ال image in ال بارد للتكامل بيساوي ايش تكامل ال + +315 +00:22:22,650 --> 00:22:25,750 +image in ال بارد فنيجي للمعادلة هذه نيجي ناخد + +316 +00:22:25,750 --> 00:22:28,050 +الريال بارد للطرفين فهذا يؤدي + +317 +00:22:33,190 --> 00:22:41,250 +الريال بارت لل R0 بيتساوى الريال بارت للتكامل E2-I + +318 +00:22:41,250 --> 00:22:48,170 +θ0 W of T DT جيد فهمتوا أه دي واضح الخطوة شباب + +319 +00:22:48,170 --> 00:22:50,610 +طبعا ماعملاش اشي طبعا دي two complex numbers + +320 +00:22:50,610 --> 00:22:52,570 +فالريال بارت بيساوى الريال بارت المجنون بيساوى + +321 +00:22:52,570 --> 00:22:56,770 +المجنون دي قاعدة عامة الآن إيش رأيكوا ال R0 مين + +322 +00:22:56,770 --> 00:23:00,480 +الريال بارت طبعتها؟R0 نصف لأن دا يشعر بقى عدد + +323 +00:23:00,480 --> 00:23:03,340 +حقيقي على الحقيقي لإن الريال بارت بيساوي صفر فإذا + +324 +00:23:03,340 --> 00:23:08,220 +R0 تساوي مين الريال بارت هذا الكلام بيساوي تكامل + +325 +00:23:08,220 --> 00:23:11,440 +الريال بارت الريال بارت التكامل بيساوي تكامل + +326 +00:23:11,440 --> 00:23:14,560 +الريال بارت هذه الخاصية اللي بدي إياها أهم نقطة + +327 +00:23:14,560 --> 00:23:20,580 +بدي إياها في البرهان أن هذه تكامل الريال بارت تمام + +328 +00:23:20,580 --> 00:23:24,540 +نرجع الآن نحاول نوصل للطرف اليمين اللي عندنا هناك + +329 +00:23:24,540 --> 00:23:32,950 +فبنحاوللو ارجعنا نظرنا الى صلاله R0 يمين هي الطرف + +330 +00:23:32,950 --> 00:23:36,510 +اليسار للمتباينة بتام هاي الطرف اليمين بدنا نشوف + +331 +00:23:36,510 --> 00:23:39,950 +ايش علاقته بالطرف اليمين للمتباين هنستخدم الآن + +332 +00:23:39,950 --> 00:23:43,530 +خاصية أساسية من خلاص المتباينات بل أول متباين + +333 +00:23:43,530 --> 00:23:46,150 +أخدناها انه + +334 +00:23:48,280 --> 00:23:54,140 +الريال بارد لأي مقدار اللي هو a طبعاها θ0 في w of + +335 +00:23:54,140 --> 00:24:00,040 +t هو أصغر أو يساوي المد يناسب + +336 +00:24:00,040 --> 00:24:02,440 +كل الذنب + +337 +00:24:05,510 --> 00:24:09,250 +أول متباينة مرت علينا أن الـ real part لأي عدد + +338 +00:24:09,250 --> 00:24:12,570 +مُركّب أصغر أو يساوي مين الموديولاس على المُركّب + +339 +00:24:12,570 --> 00:24:16,230 +طيب لو شوفنا هذا الموديولاس بتوزع على مين؟ على + +340 +00:24:16,230 --> 00:24:19,810 +الضرب طيب إيش الموديولاس في الـ exponential هادي؟ + +341 +00:24:19,810 --> 00:24:23,230 +هادي .. هادي لحالة لو أنا أقول هادي أصغر أو يساوي + +342 +00:24:23,230 --> 00:24:27,410 +موديولاس E to minus I θ0 في مُطنَق الـWT وعند + +343 +00:24:27,410 --> 00:24:31,830 +الفورة وزنياش أصغر أو يساوي W فانتهت العملية الآن + +344 +00:24:31,830 --> 00:24:39,050 +إذننرجع لعادل علاحة R0 اللي هي ايش؟ اللي هي مطلق + +345 +00:24:39,050 --> 00:24:42,910 +التكامل اصغر + +346 +00:24:42,910 --> 00:24:46,190 +او يساوي مين؟ بما ان هذا اصغر او يساوي فالتكامل + +347 +00:24:46,190 --> 00:24:49,710 +اصغر لان اصغار كله real اصغر او يساوي مين؟ تكامل + +348 +00:24:49,710 --> 00:24:56,880 +من A لB W of T DT وهو المطلوب اثباتهفهنا اللي هو + +349 +00:24:56,880 --> 00:25:00,860 +الخاصيتين المهمين أهم خطوطين في البرهان ان + +350 +00:25:00,860 --> 00:25:06,540 +استخدمنا انه تكامل ال real part او ال real part + +351 +00:25:06,540 --> 00:25:09,380 +التكامل بصورة تكامل ال real part و استخدمنا + +352 +00:25:09,380 --> 00:25:13,280 +الحقيقة الخديمة ان ال real part لأي عدد مركب أكبر + +353 +00:25:13,280 --> 00:25:16,620 +يزاوى ال modulus لهذا العدد المركب فدون الخاصيتين + +354 +00:25:16,620 --> 00:25:22,300 +الأساسيتين اللي استخدمناهم في البرهان أي سؤال في + +355 +00:25:22,300 --> 00:25:24,100 +نتيجة على هذا الكلام + +356 +00:25:27,620 --> 00:25:30,780 +أحنا توقع النتيجة بتتحدث عن دي التكامل عادي من A ل + +357 +00:25:30,780 --> 00:25:34,160 +B طب لو كان تكامل المقتل من A ل M للنهاية بتعمل + +358 +00:25:34,160 --> 00:25:38,060 +صحيحة ليش؟ لأن التكامل المقتل هو عبارة عن تكامل من + +359 +00:25:38,060 --> 00:25:40,940 +A ل C تنطبق على المتباين اما اخد ال limit للطرفين + +360 +00:25:40,940 --> 00:25:43,580 +و ال limit بتحافظ على مين؟ على المتباين، على + +361 +00:25:43,580 --> 00:25:47,740 +المتباين، فهذه نتنية + +362 +00:25:47,740 --> 00:25:54,120 +تمام ننتقل + +363 +00:25:54,120 --> 00:26:01,030 +الآن لنقطة تمهيدية أخرى في موضوعنا وهو ال contours + +364 +00:26:01,780 --> 00:26:06,020 +وما هو ال contours تعريبة ومنحنايات نوع خاص من + +365 +00:26:06,020 --> 00:26:09,300 +المنحنايات مش قادر أن اناقش التعريب الدقيق لكن + +366 +00:26:09,300 --> 00:26:12,440 +احنا بنقصد في ال contours نوع معين من المنحنايات + +367 +00:26:12,440 --> 00:26:15,360 +اللي احنا بقوله هيتحدث عن تكامل لل F of Z على + +368 +00:26:15,360 --> 00:26:19,460 +منحنى .. على منحنى هنشوف المنحنايات الصالحة لمين + +369 +00:26:19,460 --> 00:26:22,940 +الإجراءها للتكامل هل كل منحنى بقدر عملية تكامل؟ لأ + +370 +00:26:22,940 --> 00:26:26,080 +هنشوف أنه فيه نوع معين من المنحنايات حد المنحنايات + +371 +00:26:26,080 --> 00:26:31,680 +الخاصة هنسميها ياش contours هنسميها contoursفنبدأ + +372 +00:26:31,680 --> 00:26:35,940 +نشوف هذه ال contours ماذا تمثل او ما هي خواصها + +373 +00:26:35,940 --> 00:26:43,680 +كمنحنيات الخواص الأساسي طبعا احنا بنتحدث هنا عن ال + +374 +00:26:43,680 --> 00:26:50,900 +complex plane شباب YX وبنتحدث عن منحنى في المستوى + +375 +00:26:50,900 --> 00:26:57,330 +منحنى في ال plane هذا المنحنىعشان أعبّر عنه في عدة + +376 +00:26:57,330 --> 00:27:02,390 +طرق من هذه الطرق ممكن تقولوا كمعادلة لمين F of X + +377 +00:27:02,390 --> 00:27:05,710 +and Y تساوي Zero طريقة معينة عبارة عن معادلة في X + +378 +00:27:05,710 --> 00:27:09,570 +و Y و لا لأ زي مثلا ما نقول Y تساوي X تربيع X + +379 +00:27:09,570 --> 00:27:12,510 +تربيع زائد Y تربيع تساوي واحد دائرة او مثلا X + +380 +00:27:12,510 --> 00:27:15,630 +تربيع على A زائد Y تربيع على B تساوي واحد اي + +381 +00:27:15,630 --> 00:27:19,210 +ellipse او كذا فهذه هي المعاملات المشهورة معادلة + +382 +00:27:19,210 --> 00:27:22,150 +في X and Y هذه طريقة في طريقة أخرة طبعا ممكن + +383 +00:27:22,150 --> 00:27:25,190 +تقولوا الـ y coordinate مار عليكمهو في طريقة اللي + +384 +00:27:25,190 --> 00:27:27,970 +احنا هيعتمدها باستخدام البراميتر او عملية + +385 +00:27:27,970 --> 00:27:32,150 +البرامترزيش عملية البرامترزيش ما هي قصة + +386 +00:27:32,150 --> 00:27:34,790 +البرامترزيش او يعني كل مرة تعالينا مثلا نؤكد عليه + +387 +00:27:34,790 --> 00:27:40,090 +لو انا اندي المنحوذ يتكبر من مين؟ من النقاء نقطة + +388 +00:27:40,090 --> 00:27:44,430 +نقوطيا إلى ما نقاء وكل نقطة هي عبارة عن مين؟ X1 + +389 +00:27:45,120 --> 00:27:49,760 +النقطة دي XY ببن ما أنا أجيبك علاقة بتحكم كل + +390 +00:27:49,760 --> 00:27:53,500 +النقاط بأي نقطة تتحقق هذه المعادلة بعبّر عن هذه + +391 +00:27:53,500 --> 00:27:58,360 +النقاط إنهم عبارة عن دوال بمتغير مساعد أو اللي هو + +392 +00:27:58,360 --> 00:28:02,480 +اللي بيسمونه parameter أو الوسيل عبارة عن إيش ال X + +393 +00:28:02,480 --> 00:28:07,530 +ده اللي في T وY ده اللي في Tيمكن ارفع الطريقة + +394 +00:28:07,530 --> 00:28:09,850 +ويمكن هو الاصل عشان افهم العملية الـ + +395 +00:28:09,850 --> 00:28:14,710 +Parameterization ان لو تخيلنا ان هناك جسم بتحرك + +396 +00:28:14,710 --> 00:28:19,610 +على مسار و غير من حد هذا جسم بتحرك و المسار تبعه + +397 +00:28:19,610 --> 00:28:21,890 +مين بتحرك من مستوى طبعا مساره اللي هنا فيه عنده + +398 +00:28:21,890 --> 00:28:25,190 +متعدد ممكن يروح أفق ممكن يروح عمودي او ممكن يروح + +399 +00:28:25,190 --> 00:28:30,010 +من محلة معين فهنا الجسم لو انا بدي اعرف مكان الجسم + +400 +00:28:30,010 --> 00:28:31,910 +بعد زمن معين فكان هنا + +401 +00:28:36,320 --> 00:28:41,160 +الـ LVT لجلطة. اه مظبوط فكل عند زمن معين كل بعض + +402 +00:28:41,160 --> 00:28:44,880 +زمن معين بيكون مكان اليسم الموضوع تبعه ده اللي في + +403 +00:28:44,880 --> 00:28:48,440 +مين ده اللي فيكتر. فهذا بالمثل. فأي منحنى إذا كتبت + +404 +00:28:48,440 --> 00:28:52,920 +على صورة XY تساوي X of T Y of T او بلغتة بال + +405 +00:28:52,920 --> 00:28:58,400 +complex عبارة عن مينz of t فهذا يكون ملحنة في ال + +406 +00:28:58,400 --> 00:29:01,320 +complex plane ملحنة في ال complex plane مُعطَى + +407 +00:29:01,320 --> 00:29:06,540 +بطريقة مين ال parameter او الوصيب ال parameter او + +408 +00:29:06,540 --> 00:29:10,140 +الوصيب نقطة مهمة هنا زي ما احنا قلنا فيه الاصل في + +409 +00:29:10,140 --> 00:29:15,060 +معنى في ذياء ايه طبعا احنا اذا بدأنا من زمن معينو + +410 +00:29:15,060 --> 00:29:18,900 +بزيد الزمن فبيخوذ إليك اتجاه للحركة فهذا اتجاه + +411 +00:29:18,900 --> 00:29:22,120 +الحركة طبعا باتجاه زيادة ايش؟ الزمن اللي هو + +412 +00:29:22,120 --> 00:29:25,600 +بالنسبة لنا كرياضيات زيادة مين؟ قيم ال T زيادة قيم + +413 +00:29:25,600 --> 00:29:29,380 +ال T فحنعتبر اتجاه الحركة او اتجاه المنحنى هو + +414 +00:29:29,380 --> 00:29:35,090 +اتجاه زيادة Tفاحنا بنصحب .. بنضيف للمنحنة اللي + +415 +00:29:35,090 --> 00:29:38,370 +مُعطَب وسط البراميتر نعمله ليش؟ بنصحب له .. بنصحب + +416 +00:29:38,370 --> 00:29:41,790 +معه مين الاتجاه؟ أو بنقول فيه إنه لديك اتجاه؟ هذا + +417 +00:29:41,790 --> 00:29:45,910 +الاتجاه هو اتجاه النقاط مع زيادة ال T عندي أنا + +418 +00:29:45,910 --> 00:29:49,010 +مثلا في شكل عام هناخد أن ال T بتنتمي من فترة على + +419 +00:29:49,010 --> 00:29:53,520 +فترة T بتنتمي على فترة معينة من A لBدائما بنعمل + +420 +00:29:53,520 --> 00:29:57,780 +parameterization في معادلة X of T إيش هي الدالة ال + +421 +00:29:57,780 --> 00:30:01,860 +Y of T إيش هي الدالة و الفترة اللي بتتحرك عليها ال + +422 +00:30:01,860 --> 00:30:06,000 +T أو تاخد من القيام فبكون عندي أول نقطة يمين Z of + +423 +00:30:06,000 --> 00:30:10,980 +A نقطة البداية و أخر نقطة يمين Z of B بكون اتجاه + +424 +00:30:10,980 --> 00:30:14,840 +الحركة مع زيادة من ال T طبعا ال A دائما أصغر من ال + +425 +00:30:14,840 --> 00:30:17,440 +B اللي هو الطريقة العادية أو الطريقة القياسية + +426 +00:30:17,440 --> 00:30:22,160 +لكتابة الفترة من صغير لكبير فهذا هو المنحنىهذا + +427 +00:30:22,160 --> 00:30:26,840 +المرحلة بشكل عام في ال complex بلاي دكتور طبعا لو + +428 +00:30:26,840 --> 00:30:30,360 +كان عندنا circle لو كان عندنا circle كيف بيكوني + +429 +00:30:30,360 --> 00:30:32,840 +يعني كيف نعرف ب .. ب .. ب .. ب .. ب .. ب .. ب .. ب + +430 +00:30:32,840 --> 00:30:33,140 +.. ب .. ب .. ب .. ب .. ب .. ب .. ب .. ب .. ب .. ب + +431 +00:30:33,140 --> 00:30:33,920 +.. ب .. ب .. ب .. ب .. ب .. ب .. ب .. ب .. ب .. ب + +432 +00:30:33,920 --> 00:30:35,600 +.. ب .. ب .. ب .. ب .. ب .. ب .. ب .. ب .. ب .. ب + +433 +00:30:35,600 --> 00:30:35,660 +.. ب .. ب .. ب .. ب .. ب .. ب .. ب .. ب .. ب .. ب + +434 +00:30:35,660 --> 00:30:35,700 +.. ب .. ب .. ب .. ب .. ب .. ب .. ب .. ب .. ب .. ب + +435 +00:30:35,700 --> 00:30:36,860 +.. ب .. ب .. ب .. ب .. ب .. ب .. ب .. ب .. ب .. ب + +436 +00:30:36,860 --> 00:30:39,160 +.. ب .. ب .. ب .. ب .. ب .. ب .. ب .. ب .. ب .. ب + +437 +00:30:42,750 --> 00:30:46,250 +هذه المعادلات هذي X of T ايش بتساوي ويقطعي وزيه + +438 +00:30:46,250 --> 00:30:49,830 +وديك main الفقرة فانت هتشوف لما تبدأ تزيد ال T في + +439 +00:30:49,830 --> 00:30:53,150 +الحركة هل بتروح نقاط تديك نقاط من هال لهال و لا + +440 +00:30:53,150 --> 00:30:53,790 +بعد اتجاه + +441 +00:30:57,550 --> 00:31:00,270 +مش بقدر على ده بس ماتعطيش الدائرة كامة لكي ترجع + +442 +00:31:00,270 --> 00:31:02,130 +لمحانة هو ال parameterization هو اللي ادّاك + +443 +00:31:02,130 --> 00:31:04,490 +المنوحانة كله اتنين ماهو مقصود بال .. بال .. + +444 +00:31:04,490 --> 00:31:08,290 +بالمحانة هتكون الدائرة نصها ربعها جزء منها كل + +445 +00:31:08,290 --> 00:31:10,490 +معادلة كل وقت مش فاترة و تلاتة و تلاتة مثلا اللي + +446 +00:31:10,490 --> 00:31:12,810 +اقول بدي لف اللف و يرجع لتلاتة تانية اه هو اللي + +447 +00:31:12,810 --> 00:31:15,370 +اداني ياه يعني انت أكيد ال parameterization ليش + +448 +00:31:15,370 --> 00:31:20,180 +بتكون من المعادلةX تساوي X of T و Y تساوي Y of T و + +449 +00:31:20,180 --> 00:31:24,020 +الفترة و ادول اذا قطعوا بشكل واضح بتدوك المنحنى + +450 +00:31:24,020 --> 00:31:27,620 +كيف شكله و وين فترته بالظبط و وين هم ايه القطعة دي + +451 +00:31:27,620 --> 00:31:30,940 +مديش اللي القطعة دي بتكافر بالظبط هذه الأمور كاملة + +452 +00:31:30,940 --> 00:31:37,280 +تعريف كامل و وصف كامل للمنحنى وصف كامل للمنحنىفزي + +453 +00:31:37,280 --> 00:31:40,360 +ما ذكرنا في بداية هذا ال section احنا بدنا .. بدنا + +454 +00:31:40,360 --> 00:31:44,780 +ندرس المنحلات بشكل عام او مش هندرس تكامل على اي + +455 +00:31:44,780 --> 00:31:48,060 +منحلة فاحنا عرفنا المنحلة بصورة عامة و كذبناها + +456 +00:31:48,060 --> 00:31:50,340 +بصورة اللي هو ال parameterization او وسط ال + +457 +00:31:50,340 --> 00:31:53,880 +parameter الآن هنبدأ دراستنا ما هو ال contour عشان + +458 +00:31:53,880 --> 00:31:58,760 +نوصل لهذا الهدف بدنا نشوف المنحليات ذات صفات معينة + +459 +00:31:58,760 --> 00:32:03,580 +صفات مناسبة لدراستنا اول خاصيةطبعا قولنا ان اي + +460 +00:32:03,580 --> 00:32:07,560 +منحنى منك تبع صورة مين Z of T تساوي X of T وY of T + +461 +00:32:07,560 --> 00:32:12,320 +وفي فترة ال T تتغير من A ل B اذا كان ال X و ال Y + +462 +00:32:12,320 --> 00:32:16,220 +دول دوال متصلة بسمي هذا منحنى منحنى متصل او Arc + +463 +00:32:16,220 --> 00:32:20,220 +قوص بسميه منحنى متصل او انه ايش Arc طبعا هادر + +464 +00:32:20,220 --> 00:32:23,060 +اتمنى ان المنحنى بتكون من قطعة واحدة مش قطعة متصلة + +465 +00:32:23,060 --> 00:32:26,200 +على البعض فهو ايش اول حاجة بنعرف مصطلح مين ان ال + +466 +00:32:26,200 --> 00:32:30,080 +continuous curve او ال Arc القوص ان X و Y دكونوا + +467 +00:32:30,080 --> 00:32:34,420 +متصلينطيب لو زدنا عليهم خاصية إضافية لو كانوا + +468 +00:32:34,420 --> 00:32:40,900 +differentiable بل X' Y' موجودين ومتصلين بسمي ايش + +469 +00:32:40,900 --> 00:32:43,480 +differentiable curve بسمي differentiable arc أو + +470 +00:32:43,480 --> 00:32:47,300 +differentiable curve فاحنا عندنا ال Z X of T زي I + +471 +00:32:47,300 --> 00:32:50,080 +of Y of T إذا ال X و ال Y continuous بسمي + +472 +00:32:50,080 --> 00:32:53,580 +continuous curve أو arc إذا ال X' و ال Y' exist + +473 +00:32:53,580 --> 00:32:57,220 +differentiable و لو ال derivative continuous بسمي + +474 +00:32:57,220 --> 00:33:00,930 +differentiable arc بسمي differentiable arcخلّينا + +475 +00:33:00,930 --> 00:33:08,130 +نشوف بعض الأمثلة، أتوقع أن هنا مكان مناسب إن نوقف + +476 +00:33:08,130 --> 00:33:09,770 +و هنرجع للتعريف مرة تانية + diff --git a/PL9fwy3NUQKwaRXaqd-S5-vsOEDL-Q45jU/nWDUcRq3_Pk.srt b/PL9fwy3NUQKwaRXaqd-S5-vsOEDL-Q45jU/nWDUcRq3_Pk.srt new file mode 100644 index 0000000000000000000000000000000000000000..6bf229b7528288978823cc7553c4984fb1f66b34 --- /dev/null +++ b/PL9fwy3NUQKwaRXaqd-S5-vsOEDL-Q45jU/nWDUcRq3_Pk.srt @@ -0,0 +1,1771 @@ +1 +00:00:00,000 --> 00:00:02,680 +موسيقى + +2 +00:00:12,050 --> 00:00:16,510 +بسم الله الرحمن الرحيم، اليوم في محاضرتنا هأتحدث عن + +3 +00:00:16,510 --> 00:00:24,610 +التفاضل أو الـ derivative، فطبعًا التعريف بشكل مشابه + +4 +00:00:24,610 --> 00:00:30,410 +أو متطابق تمامًا مع حالة التفاضل لـ دالة في متغير + +5 +00:00:30,410 --> 00:00:35,470 +الـ variables لو كان المتغير real زي ما عرفنا تفاضل + +6 +00:00:35,470 --> 00:00:40,390 +الدالة في متغير حقيقي، بنعرف التفاضل دالة في متغير + +7 +00:00:40,390 --> 00:00:46,570 +مركب لأنه متغير واحد، فالتعريف المشهور المشتقة + +8 +00:00:46,570 --> 00:00:51,450 +الدالة عن نقطة معينة z0، طبعًا هي عدة رموز، الرموز + +9 +00:00:51,450 --> 00:00:58,370 +بنرمز f prime of z0 أو D over DZ للـ F of Z عند Z0 و + +10 +00:00:58,370 --> 00:01:02,450 +Z بساوي Z0، إيش تعريفه؟ الـ limit التعريف على الـ limit + +11 +00:01:02,450 --> 00:01:07,670 +المشهور، Z تقترب من Z0، F of Z ناقص F of Z0 على Z ناقص + +12 +00:01:07,670 --> 00:01:13,230 +Z0، الصورة المشهورة هذه، أو في صورة مكافئة لها + +13 +00:01:13,230 --> 00:01:22,120 +لو اعتبرنا أنه Delta Z بتساوي z-z0، الـ limit يعني + +14 +00:01:22,120 --> 00:01:27,260 +ممكن تتغير، z تقترب من z0، يعني Delta z تقترب من الصفر، + +15 +00:01:27,260 --> 00:01:32,780 +وبتصبح العلاقة هي نهاية f of z0 زائد Delta z ناقص + +16 +00:01:32,780 --> 00:01:36,770 +f of z0 على Delta z عندما Delta z تقترب من الصفر، طيب أنا + +17 +00:01:36,770 --> 00:01:38,570 +أديت النهاية المشهورة اللي ممكن احنا نتفاضل ونقول + +18 +00:01:38,570 --> 00:01:41,990 +كنا مستخدمين بدل Delta Z مستخدمين رمز الـ H لسه + +19 +00:01:41,990 --> 00:01:45,790 +العملية، بس هنا الرمز الـ Delta يمكن أنسب عشان لو + +20 +00:01:45,790 --> 00:01:48,410 +أتحدثنا عن الـ real part ولما جينا الـ imaginary part نكتبوا + +21 +00:01:48,410 --> 00:01:52,370 +دلتا اكس و Delta واي، فيا ده هو إيش أته.. + +22 +00:01:52,370 --> 00:01:56,350 +فالمشتقة هي النهاية، طبعًا بشرط أن النهاية إيش + +23 +00:01:56,350 --> 00:02:00,090 +موجودة، exist، فإذا النهاية موجودة بقول أن اف برايم + +24 +00:02:00,090 --> 00:02:03,470 +exist وعكس ذلك، إذا النهاية غير موجودة بتكون اف + +25 +00:02:03,470 --> 00:02:09,040 +برايم غير موجودة أو غير معرفة، طبعًا المصطلح المتعارف + +26 +00:02:09,040 --> 00:02:12,760 +عليه، إذا f prime exist بنقول إن ده ليه قابل + +27 +00:02:12,760 --> 00:02:17,340 +لاشتقاق، فـ f prime of z0 exist يعني f قابل للاشتقاق عن + +28 +00:02:17,340 --> 00:02:23,860 +z0، differentiable at z0، فهذه التعريفات المتعارف + +29 +00:02:23,860 --> 00:02:28,820 +عليها والمشهورة، خلينا نشوف مثل كيف ممكن نستخدم + +30 +00:02:28,820 --> 00:02:31,500 +التعريف في حساب المشتقات + +31 +00:02:34,320 --> 00:02:39,200 +فبدنا نحسب f برايم عندما إن الـ f of z تساوي z تكعيب + +32 +00:02:39,200 --> 00:02:44,520 +فده الحل، فبدنا f برايم في الـ z بشكل عام مش + +33 +00:02:44,520 --> 00:02:49,120 +نقطة معينة، بصورة عامة، خلينا طبعًا نشوف مشتقتها + +34 +00:02:49,120 --> 00:02:53,060 +للدالة في حالة الـ complex ونشوف اتفاقها أو + +35 +00:02:53,060 --> 00:02:56,480 +اختلافها مع القوانين اللي متعرفين عليها، فطبعًا + +36 +00:02:56,480 --> 00:03:04,770 +التعريف هذا هو limit Delta z تقترب من صفر، f of z0 زائد + +37 +00:03:04,770 --> 00:03:10,490 +الـ Delta z ناقص f of z0 على Delta z، فده هو التعريف + +38 +00:03:10,490 --> 00:03:18,210 +التفاضل عن طريق النهاية، فنحسب بعد كده الـ limit + +39 +00:03:18,940 --> 00:03:23,840 +Delta z تقترب من الصفر، الـ F ان زد تكعيب، فـ F of Z zero + +40 +00:03:23,840 --> 00:03:29,480 +زائد Delta z ناقص Z zero زائد Delta z الكل تكعيب، F of Z + +41 +00:03:29,480 --> 00:03:34,000 +zero إيش هي؟ Z zero تكعيب على Delta z + +42 +00:03:37,050 --> 00:03:40,350 +طبعًا أنا بدأت أحسب الـ limit هذه، لو حسبتها مباشرة + +43 +00:03:40,350 --> 00:03:43,150 +تطلع 0 على 0، لكن احنا ممكن نحاول نعمل عمليات + +44 +00:03:43,150 --> 00:03:47,150 +اختصار مسموحة كالعادة زي ما متعودين في النهاية + +45 +00:03:47,150 --> 00:03:53,730 +فليجي نفك الـ guess هذا، فتساوي limit Delta Z تقترب + +46 +00:03:53,730 --> 00:03:57,810 +من الصفر، بين فوق التكعيب في binomial theorem + +47 +00:03:57,810 --> 00:04:03,430 +وممكن شفتوها في التمرين، مكعب الأول Z0 تكعيب تلاتة + +48 +00:04:03,430 --> 00:04:08,470 +في مربع الأول في الثاني زائد تلاتة في الأول في + +49 +00:04:08,470 --> 00:04:12,290 +مربع الثاني Delta Z الكل تربيع زائد مكعب الثاني + +50 +00:04:12,290 --> 00:04:16,670 +Delta Z الكل تكعيب، طبعًا مع Z0 الكل تكعيب زي ما هي + +51 +00:04:16,670 --> 00:04:23,060 +بتنزل، واقعة Delta Z، فالنقطة الأساسية اللي بتخلي + +52 +00:04:23,060 --> 00:04:27,640 +العملية تنجح إن Z zero تكعيب بتروح مع Z zero تكعيب، فهذا + +53 +00:04:27,640 --> 00:04:32,680 +المقدار بيروح مع هذا المقدار، وإيش الفايدة من هنا + +54 +00:04:32,680 --> 00:04:36,760 +إن باقي المقادير كلها تحتوي على Delta z، فبقدر + +55 +00:04:36,760 --> 00:04:39,960 +أختصر على Delta z اللي هو صفر المقادير، فهذه بتروح + +56 +00:04:39,960 --> 00:04:44,990 +هذه بتروح على التربيع، بيروح على التربيع، الأقل لما + +57 +00:04:44,990 --> 00:04:48,310 +نحسب ساعة الـ polynomial في Delta z، الباقي بس + +58 +00:04:48,310 --> 00:04:51,990 +polynomial، إن عوضنا Delta z تقترب من الصفر، إيش بتساوي؟ + +59 +00:04:51,990 --> 00:04:55,910 +فكل المقادير اللي فيها Delta z هتروح للصفر، بتمشي + +60 +00:04:55,910 --> 00:05:00,450 +لعين المقدار الأول، فبيساوي تلاتة Z zero تربيع + +61 +00:05:00,450 --> 00:05:03,650 +بيجي المقادير اللي فيها Delta z بتقول الصفر، وهذا + +62 +00:05:03,650 --> 00:05:07,650 +الشيء متعارف عليه، مشتقة Z تكعيب تلاتة Z تربيع، لو + +63 +00:05:07,650 --> 00:05:11,490 +أتحسبها عن Z zero هي تلاتة Z zero تربيع، فالقانون + +64 +00:05:11,490 --> 00:05:16,050 +ما اتغيرش، نفس الأمور، إنه في الاشتقاق بداشتق Z أس + +65 +00:05:16,050 --> 00:05:19,790 +N، هنكتبها بعد قليل، بينزل الأس وبطرح منه واحد + +66 +00:05:19,790 --> 00:05:24,290 +فمشتقة Z أس N بشكل عام هي N Z أس N ناقص واحد + +67 +00:05:24,290 --> 00:05:28,970 +فالكلام صحيح لأي عدد، إيش؟ لأي أس صحيح N، فبقدر + +68 +00:05:28,970 --> 00:05:35,180 +أجيبه باستخدام التعريف، خلينا نشوف مثال آخر + +69 +00:05:39,850 --> 00:05:42,450 +فطبعًا زي ما حكينا احنا التعريف هو عبارة عن هذه + +70 +00:05:42,450 --> 00:05:46,470 +النهاية، المشتقة هي النهاية، إذا النهاية exist بقول + +71 +00:05:46,470 --> 00:05:49,570 +إن f prime exist، إذا النهاية does not exist بقول + +72 +00:05:49,570 --> 00:05:52,890 +إنه ليهاش f prime أو مشتقة غير موجودة، فعشان + +73 +00:05:52,890 --> 00:05:57,490 +المثال بيقولي خد f of z تساوي real part of z، ده لأ + +74 +00:05:57,490 --> 00:06:01,610 +بأخد بس real part يعني f of z تساوي x، فبيقولي اثبت + +75 +00:06:01,610 --> 00:06:04,930 +إن f prime does not exist بشكل عام ولا عند أي نقطة + +76 +00:06:04,930 --> 00:06:09,900 +من النقاط، فهذه الدالة قابلة للاشتقاق، خلينا نكتب + +77 +00:06:09,900 --> 00:06:15,740 +هنا الحل، solution، فعنا هنا f of z تساوي real part + +78 +00:06:15,740 --> 00:06:22,280 +of z، فبدنا f prime، نحاول نحسبها عبارة عن limit Delta + +79 +00:06:22,280 --> 00:06:28,140 +z تقترب من الصفر، طبعًا f بشكل عام، نحسبها، f of z احنا + +80 +00:06:28,140 --> 00:06:28,620 +نشتغلها + +81 +00:06:35,860 --> 00:06:40,380 +فالقانون هو موجود عند نقطة معينة z0 واليوم أحسبه + +82 +00:06:40,380 --> 00:06:43,160 +بشكل عام، استخدم القانون بشكل عام بدلًا من z0 احط الـ + +83 +00:06:43,160 --> 00:06:46,960 +z برضه صحيح، فهذا هيخلي القانون بصورة عامة وهذا بيميز + +84 +00:06:46,960 --> 00:06:50,640 +الكتابة الجديدة، تبدأ z أسهل ما أقول z ناقص z0، فلما + +85 +00:06:50,640 --> 00:06:53,160 +الـ z0 يساوي z يصير في عنده صعوبة في تطبيق القانون + +86 +00:06:53,160 --> 00:06:57,120 +هذا القانون، بعد الصورة الأساسية، فهذا هو القانون و + +87 +00:06:57,120 --> 00:07:00,360 +بنكتبه عدة مرات عشان نتعود عليه ونحفظه بشكل آلي + +88 +00:07:00,360 --> 00:07:05,390 +طيب وتساوي نطبق على ذلل لأنها limit Delta z تقترب + +89 +00:07:05,390 --> 00:07:09,590 +من الصفر، main F of Z زائد Delta z ناقص، للتعريف هي real + +90 +00:07:09,590 --> 00:07:15,630 +part لمن؟ للـ Z زائد Delta z، وبالنسبة F of اليمين + +91 +00:07:15,630 --> 00:07:20,730 +real part الـ Z على main Delta z، على Delta z + +92 +00:07:24,960 --> 00:07:27,740 +فطبعًا كالعادة أنا بحاول أثبت أن هذا الـ limit does + +93 +00:07:27,740 --> 00:07:31,660 +not exist لأن أنا بقول ليش غير قبل الاشتقاق، فبحاول + +94 +00:07:31,660 --> 00:07:36,640 +نثبت أن هذا الـ limit does not exist عشان اللي حاول + +95 +00:07:36,640 --> 00:07:42,710 +يكتب العملية بشكلها الصريح، طيب احنا عارفين أن الـ + +96 +00:07:42,710 --> 00:07:47,930 +real part بتوزع الجامعة، فهذا ممكن يصير في اختصار فهو + +97 +00:07:47,930 --> 00:07:52,770 +عبارة عن limit Delta z تقترب من الصفر اللي هو real + +98 +00:07:52,770 --> 00:07:55,770 +part of Delta z على Delta z + +99 +00:07:58,880 --> 00:08:01,580 +هي صفر على صفر، بس ليش does not exist؟ ما نتوقعش + +100 +00:08:01,580 --> 00:08:04,720 +صفر على صفر، لكنها exist، بصموط هي صفر على صفر، + +101 +00:08:04,720 --> 00:08:08,360 +لكن حاول نثبت إنها إيش إنها does not exist، طبعًا + +102 +00:08:08,360 --> 00:08:12,520 +الآن هنختبر أو هنستخدم طريقة مهمة جدًا في إثبات إن + +103 +00:08:12,520 --> 00:08:15,540 +الـ limit does not exist، اتفاقنا إن النهاية exist + +104 +00:08:15,540 --> 00:08:18,500 +يعني إذا أنا وصلت من أي اتجاه لازم تكون نفس + +105 +00:08:18,500 --> 00:08:22,600 +القيمة، وتطبيق على هذه الملاحظة وهذه القاعدة لو + +106 +00:08:22,600 --> 00:08:26,680 +أجي أحسبها من اتجاهين وبدت النتيجتين مختلفتين + +107 +00:08:26,680 --> 00:08:29,140 +معناه أن الـ limit does not exist، فعن هذا اللي + +108 +00:08:29,140 --> 00:08:32,420 +هنستخدمه الآن في الإثبات، فطبعًا احنا عارفينه بشكل عام + +109 +00:08:32,420 --> 00:08:38,220 +خلينا نعتبر إن Delta z بقدر أكتبها على صورة مين؟ + +110 +00:08:38,220 --> 00:08:42,400 +Delta x زائد i في Delta y، طبعًا اي complex Delta z + +111 +00:08:42,400 --> 00:08:45,020 +دي هي complex number اللي هو عبارة عن z ناقص z zero + +112 +00:08:45,020 --> 00:08:48,020 +زي ما قولنا في البداية، فإلى إذا الـ real part والـ + +113 +00:08:48,020 --> 00:08:51,880 +imaginary part، اه، فالآن اللي أنا هحاول هاخد اتجاهين + +114 +00:08:51,880 --> 00:08:55,320 +الاتجاهين المشهورة، إن ممكن أمشي على الـ x axis يعني + +115 +00:08:55,320 --> 00:08:59,260 +أنا أخد الـ imaginary part بيساوي زيرو، in this way + +116 +00:08:59,260 --> 00:09:04,300 +فناخد، لو احنا الآن هذا بشكل عام لو أخدنا + +117 +00:09:08,060 --> 00:09:14,980 +إذا Delta Z تساوي Delta X، إذا + +118 +00:09:14,980 --> 00:09:18,820 +تساوي Delta Z تساوي Delta X، إذا تساوي Delta Z + +119 +00:09:18,820 --> 00:09:24,940 +تساوي Delta X، إذا + +120 +00:09:24,940 --> 00:09:29,520 +تساوي Delta Z تساوي Delta X + +121 +00:09:31,760 --> 00:09:35,780 +الآن إذا أخذت أي مسار آخر والجواب لم يكن واحد + +122 +00:09:35,780 --> 00:09:38,060 +بمعنى أن أنا مات بمعنى أن أنا مات بمعنى أن أنا مات + +123 +00:09:38,060 --> 00:09:38,360 +بمعنى أن أنا مات بمعنى أن أنا مات بمعنى أن أنا مات + +124 +00:09:38,360 --> 00:09:38,660 +بمعنى أن أنا مات بمعنى أن أنا مات بمعنى أن أنا مات + +125 +00:09:38,660 --> 00:09:39,260 +بمعنى أن أنا مات بمعنى أن أنا مات بمعنى أن أنا مات + +126 +00:09:39,260 --> 00:09:41,320 +بمعنى أن أنا مات بمعنى أن أنا مات بمعنى أن أنا مات + +127 +00:09:41,320 --> 00:09:44,960 +بمعنى أن أنا مات بمعنى أن أنا مات بمعنى أن أنا مات + +128 +00:09:44,960 --> 00:09:50,450 +بمعنى أن أنا مات بمعنى أن أنا مات Delta Z تساوي i في + +129 +00:09:50,450 --> 00:09:54,930 +Delta Y، ثم أصبحت F prime of Z في هذه الحالة تساوي + +130 +00:09:54,930 --> 00:09:59,990 +limit Delta Y تقترب من الصفر، طبعًا هذا مرة علينا المثال و + +131 +00:09:59,990 --> 00:10:04,110 +مشابه بشكل كبير للشباب، بس الآن احنا مش X و Y، Delta X + +132 +00:10:04,110 --> 00:10:07,050 +و Delta Y لأننا مانتعاملش عن Z، نتعاملش عن Delta Z، اه + +133 +00:10:07,050 --> 00:10:13,630 +الآن من الـ real part من Delta Z؟ Zero، و Delta Z اليمين + +134 +00:10:13,630 --> 00:10:18,080 +i في Delta Y، كيف ديش اللي هو؟ Zero، إذا في اتجاهين + +135 +00:10:18,080 --> 00:10:21,020 +اتجاهين الدنيا واحد واتجاهين الدنيا صفر، بيأكد أن الـ + +136 +00:10:21,020 --> 00:10:23,820 +limit does not exist، إفادة بيقول إن الـ limit does + +137 +00:10:23,820 --> 00:10:28,640 +not exist، فلو أنا رقمّت هذه واحدة واثنين، فواحد + +138 +00:10:28,640 --> 00:10:36,760 +واتنين implies f prime of z does not exist، does + +139 +00:10:36,760 --> 00:10:42,840 +not exist أي yes or no، فكالعادة هذا الفريق ممكن + +140 +00:10:42,840 --> 00:10:43,680 +نستخدمه + +141 +00:10:47,690 --> 00:10:56,290 +أي سؤال؟ تمام + +142 +00:10:56,290 --> 00:11:01,710 +في نظرية هنا، فده هو التعريف وده طريقة التطبيق يا + +143 +00:11:01,710 --> 00:11:08,680 +شباب، هنشوف تعريف المشتقة الأولى f prime of z بطريقة + +144 +00:11:08,680 --> 00:11:12,880 +ال limit واتفقنا أن ال f prime exist إذا ال limit + +145 +00:11:12,880 --> 00:11:15,400 +exist، وإذا ال limit does not exist معناه أن ال f + +146 +00:11:15,400 --> 00:11:19,200 +prime does not exist، في أنها نظرية مشهورة جداً + +147 +00:11:20,310 --> 00:11:22,770 +موجودة في الـ Calculus إن دائماً الـ + +148 +00:11:22,770 --> 00:11:25,370 +Differentiability هذا شرط أقوى من الـ Continuity + +149 +00:11:25,370 --> 00:11:28,390 +فدالة إذا كانت Differentiable عند نقطة فهي + +150 +00:11:28,390 --> 00:11:32,090 +Automatically بتكون متصلة، لكن العكس غير صحيح، في + +151 +00:11:32,090 --> 00:11:37,830 +دوال بتكون مش متصلة، لكن غير قابلة للاشتقاق، فخلينا + +152 +00:11:37,830 --> 00:11:41,930 +نشوف البرهان تبع هذه النظرية، إبروف، فلعنوان + +153 +00:11:41,930 --> 00:11:44,850 +Differentiability implies Continuity، if a function + +154 +00:11:44,850 --> 00:11:47,710 +f is differentiable at point z0، then it is + +155 +00:11:47,710 --> 00:11:52,040 +continuous at z0، فطبعاً عندي إيش أن ال F is + +156 +00:11:52,040 --> 00:11:56,080 +differentiable، فعندي المعطيات، assume F is + +157 +00:11:56,080 --> 00:11:59,020 +differentiable at z0، إيش معناه أن F' of z0، إيش ما + +158 +00:11:59,020 --> 00:12:03,940 +لا exist، هذا معناه إيش؟ بدنا نثبت، بدنا نثبت أنها + +159 +00:12:03,940 --> 00:12:11,140 +متصلة، بدنا نثبت we want to show that، إيش نوع + +160 +00:12:11,140 --> 00:12:15,480 +التواصل؟ عرفناه المحاضرة الماضية، أن نهاية F of Z + +161 +00:12:15,480 --> 00:12:18,060 +تساوي قيمة الدالة عند Z0 + +162 +00:12:21,320 --> 00:12:27,020 +هذه النهاية بتساوي تماماً أن f-f0 بتساوي صفر، هي + +163 +00:12:27,020 --> 00:12:27,760 +اللي عليها 10 + +164 +00:12:32,990 --> 00:12:53,270 +or limit z تقول ال z0 f of z ناقص f of z0 أقل + +165 +00:12:53,270 --> 00:13:00,690 +من أبسلون + +166 +00:13:00,850 --> 00:13:07,030 +لأن إذا أخذت ال F و L فالفرق بينهم يكون صفر، وأخذت + +167 +00:13:07,030 --> 00:13:10,170 +هذه ال F كلها مع بعض، وهذه ال L بصوت Zero، نفس + +168 +00:13:10,170 --> 00:13:14,050 +التعريف، نفس التعريف، فبينسبت على الكلام، فخلينا نبدأ + +169 +00:13:14,050 --> 00:13:20,290 +من الطرف اليسار، لأن limit Z تقول ال Z Zero F of Z + +170 +00:13:20,290 --> 00:13:25,040 +ناقص F of Z Zero، طبعاً ليش أنا هاورت بعد الشكل + +171 +00:13:25,040 --> 00:13:28,240 +الشباب، لإنه بدي استخدم ال trick التالي، بدي استفيد + +172 +00:13:28,240 --> 00:13:32,320 +من مين؟ من الموطنة، بدي استفيد من الموطنة اف برايم + +173 +00:13:32,320 --> 00:13:35,380 +exist، فبدي أحاول أكتب هذه النهاية دلوقتي اللي هو اف + +174 +00:13:35,380 --> 00:13:40,040 +برايم اللي هي limit z تقول ز ز ولا صفر، نفس المعنى + +175 +00:13:40,040 --> 00:13:43,900 +بس أنا جاهز أن أستخدم التعريف الثاني المكافئ، فما + +176 +00:13:43,900 --> 00:13:48,500 +عليك، أنا بديش عشان أجيب اف برايم، بدي أجيب المقام z + +177 +00:13:48,500 --> 00:13:52,490 +-z0، بنفعش أحطها لحالها، لكن لو ضربت أنا وبصمت على + +178 +00:13:52,490 --> 00:13:58,970 +z-z0، بكون ماغيرتش إيش، ماغيرتش إيش، فنضرب ونقسم، + +179 +00:13:58,970 --> 00:14:05,620 +ضربنا في واحد، الآن إيش صار؟ هذا المقدار هو ليس + +180 +00:14:05,620 --> 00:14:07,880 +اللي أف براه، طبعاً ممكن يتحولوا لدرجة زي بس، وهي + +181 +00:14:07,880 --> 00:14:11,340 +أف براه، وهذا المقدار صفر، فال limit between + +182 +00:14:11,340 --> 00:14:14,760 +exist، إذا ال limit تعرض على مين؟ على الدرجة، فهو + +183 +00:14:14,760 --> 00:14:18,460 +يساوي هذا ال limit، بتساوي أف براه مف زد زيرو، + +184 +00:14:18,460 --> 00:14:23,030 +درجة صفر، وتساوي صفر، وهو المطلوب يثبت، فالبرهان ده + +185 +00:14:23,030 --> 00:14:25,870 +الشكل، طبعاً احتمال أن اعتماد أساسي لو اف البرهان + +186 +00:14:25,870 --> 00:14:29,090 +دلظات exist، بقاش هوزق ال limit، فبالتالي ماكنتش + +187 +00:14:29,090 --> 00:14:31,810 +استفيد من هذا الكلام، فلو اف البرهان دلظات exist + +188 +00:14:31,810 --> 00:14:34,490 +حاجة مش مجهولة في الصفر، بتساوي الصفرين مش معروف + +189 +00:14:34,490 --> 00:14:37,650 +بقى ده هي بصفر غير معرفة مثلاً على سبيل المثال، و + +190 +00:14:37,650 --> 00:14:39,490 +إذا ال limit دلظات exist ما أعرفش قيمة معينة، أو ده + +191 +00:14:39,490 --> 00:14:41,970 +طبعاً بصفر، إيش أن هاتش ما أعرفش، لكن اعتماد اعتماد + +192 +00:14:41,970 --> 00:14:48,580 +أساسي أنه إيش اف البرهان exist، أي سؤال؟ الحقيقة + +193 +00:14:48,580 --> 00:14:51,020 +القوية جداً إنه دائماً Differentiability implies + +194 +00:14:51,020 --> 00:14:55,440 +Continuity، هذا الكلام موجود في دالة في متغير حقيقي + +195 +00:14:55,440 --> 00:14:59,820 +واحد، دالة في أكثر من متغير حقيقي، وأيضاً دالة في + +196 +00:14:59,820 --> 00:15:03,760 +متغير مركب، فال Differentiability شرط أقوى من + +197 +00:15:03,760 --> 00:15:10,880 +الـ إيش؟ من الاتصال، طبعاً + +198 +00:15:10,880 --> 00:15:18,640 +العكس غير صحيح، يمكن نجربه عن طر، العكس غير صحيح على + +199 +00:15:18,640 --> 00:15:21,520 +سبيل المثال، لو بدنا مثال عكسي ال absolute value + +200 +00:15:21,520 --> 00:15:27,260 +طبعاً هي مختلفة هنا شوية، لو أخذنا مثال عكسي f of z + +201 +00:15:27,260 --> 00:15:33,500 +تساوي مطلق الزئبق لكل تربيع، مطلق الذئب لكل تربيع، هذه + +202 +00:15:33,500 --> 00:15:38,100 +الدالة متصلة everywhere، لإيش؟ لأن ال real part + +203 +00:15:38,100 --> 00:15:42,200 +تبعها مين هو؟ X تربيع زي Y تربيع، متصلة everywhere + +204 +00:15:42,200 --> 00:15:46,000 +وال imaginary part هو الصفر، متصلة everywhere، لكن + +205 +00:15:46,000 --> 00:15:49,620 +هذه الدالة مش differentiable إلا عند ال zero، غير + +206 +00:15:49,620 --> 00:15:53,540 +قابلة للاشتقاق إلا عند من؟ عند الصفر، فهذه continuous + +207 +00:15:53,540 --> 00:15:59,960 +is continuous at each + +208 +00:16:02,100 --> 00:16:07,920 +لكن لو جاي بيحسب f prime of z ده تساوي limit delta + +209 +00:16:07,920 --> 00:16:16,600 +z تقول الصفر، طبعاً f of z زائد delta z ناقص قيمة + +210 +00:16:16,600 --> 00:16:21,400 +المطلقة لـ z زائد الـ delta z ناقص القيمة المطلقة + +211 +00:16:21,400 --> 00:16:25,420 +للـ z الكل تربيع طبعاً على مين؟ على اللي هو delta + +212 +00:16:25,420 --> 00:16:32,040 +z، فهذه المشتقة غير موجودة، اللي عند من؟ اللي عند + +213 +00:16:32,040 --> 00:16:38,800 +اللي هو الصفر، فبنحسبها بشكل مباشر، طبعاً ممكن أنا ال + +214 +00:16:38,800 --> 00:16:42,580 +delta z بتديها z لا تساوي صفر، عند الصفر ال limit + +215 +00:16:42,580 --> 00:16:45,280 +that exists بتساوي صفر + +216 +00:17:00,600 --> 00:17:03,420 +عشان نثبت أن هنا غير موجودة، خلّيني نلاقي مسارات + +217 +00:17:03,420 --> 00:17:07,120 +ندور على أحد المسارات، على سبيل المثال لو أخذنا + +218 +00:17:07,120 --> 00:17:12,100 +delta z تساوي delta x، إيش بيصير؟ بيصير f prime of z + +219 +00:17:12,100 --> 00:17:17,960 +تساوي limit delta z تقول الصفر، بدأت تصير إيش، وهنا + +220 +00:17:17,960 --> 00:17:26,200 +بيصير z زائد ال delta x ناقص مطلق ال z، بقى يمكن أجيت + +221 +00:17:26,200 --> 00:17:30,820 +أن أنا بحتاج يمكن أفكها بشكل مش مشكلة، تربيع تربيع + +222 +00:17:30,820 --> 00:17:37,640 +على delta x، طبعاً لو بنفك هذا المقدار تربيع، إيش + +223 +00:17:37,640 --> 00:17:44,700 +بيساوي؟ delta X تقول الصفر، ال Z أبعد عن X زائد دلتا X X + +224 +00:17:44,700 --> 00:17:51,080 +زائد دلتا X الكل تربيع، زائد من Y تربيع، مع قسمين X + +225 +00:17:51,080 --> 00:17:56,760 +تربيع زائد Y تربيع على من؟ على دلتا X، نكتبها بشكل + +226 +00:17:56,760 --> 00:18:03,330 +صريح، Z زائد دلتا X إيه بتساوي؟ لو كتبنا لل Z تساوي X + +227 +00:18:03,330 --> 00:18:07,490 +زائد I وY بشكل عام طبعاً مايساويش أصفر، فبيصير Z زائد + +228 +00:18:07,490 --> 00:18:11,030 +Delta X عبارة عن X زائد Delta X زائد I في Y، من الموضوع + +229 +00:18:11,030 --> 00:18:15,430 +الموضح، مربع الريال بارد زائد مربع الميجان بارد، فلو + +230 +00:18:15,430 --> 00:18:20,650 +طرحناهم الآن، هذا إيش بيساوي؟ هو يساوي limit Delta X + +231 +00:18:20,650 --> 00:18:24,370 +تقول الصفر، نفك هذا التربيع، هدي next تربيع وY تربيع + +232 +00:18:24,370 --> 00:18:29,290 +هيروح مع بعض، مش هيتم عندي اثنين X Delta X زائد Delta X + +233 +00:18:29,290 --> 00:18:34,030 +من تربيع على مين؟ على delta x، قداش هي ده limit + +234 +00:18:34,030 --> 00:18:39,110 +بتساوي يا شباب؟ بتساوي اثنين x، لو اختصرنا مظبوط + +235 +00:18:39,110 --> 00:18:41,790 +بتساوي اثنين x + +236 +00:18:44,730 --> 00:18:48,290 +هل جيت احنا إيه اللي عندنا هنا متابعين؟ اه، هل جيت + +237 +00:18:48,290 --> 00:18:52,970 +أخدنا delta z بتساوي delta y، delta x اسف، عوضنا عن + +238 +00:18:52,970 --> 00:18:58,430 +ال z، اه، ف ال z هذي عبارة عن مين؟ x زائد i y، و delta z + +239 +00:18:58,430 --> 00:19:02,010 +بتساوي delta x، ف z زائد delta x عبارة عن x زائد delta x + +240 +00:19:02,010 --> 00:19:06,590 +زائد i في y، من المدير، اسم مربع أشماله مربع ال real + +241 +00:19:06,590 --> 00:19:10,510 +part زائد مربع ال imaginary part، يعني هنا عندي z زائد + +242 +00:19:10,510 --> 00:19:15,730 +delta z إيش بتساوي؟ x زائد delta x زائد I في Y، خلّيها + +243 +00:19:15,730 --> 00:19:20,430 +يكون يا هامش هنا مظبوط، فعير مديوز تبعه تمين + +244 +00:19:20,430 --> 00:19:24,290 +المديوز لازم X تربيع زائد Y تربيع، بقى الآن فكّينا + +245 +00:19:24,290 --> 00:19:28,580 +مربع الأول، ضعف الأول في الثاني، مربع الثاني، الـ x + +246 +00:19:28,580 --> 00:19:30,620 +تربيع هو y تربيع، بيروح مع الـ x تربيع هو y تربيع + +247 +00:19:30,620 --> 00:19:33,240 +بتاع مربع ده، في الأول في الثاني ومربع الثاني + +248 +00:19:33,240 --> 00:19:36,900 +اختصر الآن، هذه تروح معادي تروح مع التربيع وأخلي + +249 +00:19:36,900 --> 00:19:40,300 +delta x تساوي صفراش في المدينة، اثنين x، لو جينا الآن + +250 +00:19:40,300 --> 00:19:45,220 +ناخد delta z تساوي I في delta Y، اسم السيرة في + +251 +00:19:45,220 --> 00:19:51,110 +prime of z هتصير limit delta x to a delta y تقول + +252 +00:19:51,110 --> 00:19:57,270 +للصفر، مين صار موديلس مين؟ z زائد i في delta y الكل + +253 +00:19:57,270 --> 00:20:03,350 +تربيع، ناقص موديلس ال z تربيع على i delta y على i + +254 +00:20:03,350 --> 00:20:10,640 +delta y، وتساوي بنفس الأسلوب، delta Y تقول للصفر، بدنا + +255 +00:20:10,640 --> 00:20:15,520 +نفكر الآن إيش مربع هذي؟ هذي عبارة عن X تربيع زائد Y + +256 +00:20:15,520 --> 00:20:21,420 +زائد Delta Y كل تربيع، الموديولس هنا ناقص من X + +257 +00:20:21,420 --> 00:20:27,320 +تربيع ناقص Y تربيع على ده إيش؟ I في Delta Y، بنفس + +258 +00:20:27,320 --> 00:20:34,640 +الطريقة، محتاجين نكتب هنا الآن، نكمل نعم + +259 +00:20:36,720 --> 00:20:41,420 +بنفس الأسلوب، هذا هي ساوي limit delta y تقول للصفر + +260 +00:20:41,420 --> 00:20:44,840 +لو فكت التربيع، y تربيع y تربيع بيروحوش، بتاع ما + +261 +00:20:44,840 --> 00:20:50,820 +عنده اثنين y delta y زائد delta y تربيع على مين؟ على + +262 +00:20:50,820 --> 00:20:56,460 +i في delta y، وهذا المقدار كم بيساوي؟ اثنين y على i + +263 +00:20:56,460 --> 00:21:01,280 +أو سالب اثنين i في 1، فهذا المقدار مش صحيح، يساوي + +264 +00:21:01,280 --> 00:21:05,040 +البعض إلا إذا كانت Y تساوي X تساوي صفر عند الصفر + +265 +00:21:05,040 --> 00:21:08,080 +فقط، غير هيك إيش بتكون؟ ال limit does not exist، فهنا + +266 +00:21:08,080 --> 00:21:15,740 +if Z لا تساوي 0 then the same، يعني X وY لا تساوي + +267 +00:21:15,740 --> 00:21:20,980 +صفر لا تساوي 00، فإذا إيش معناه؟ نفس ال prime of Z + +268 +00:21:20,980 --> 00:21:21,660 +does not exist + +269 +00:21:24,810 --> 00:21:28,610 +بقى من الدالة المتصلة، فإذا العكس غير صحيح، الاشتقاق + +270 +00:21:28,610 --> 00:21:31,870 +دائماً يؤدي للاتصال، لكن الدالة المتصلة ممكن تكون + +271 +00:21:31,870 --> 00:21:35,210 +قابلة للاشتقاق،ها ممكن تكون لأ، وهذا المثال عكسي أنا + +272 +00:21:35,210 --> 00:21:38,230 +معقولك تصدقنا؟ احنا أول مرة كنا delta z تساوي delta + +273 +00:21:38,230 --> 00:21:41,870 +x، ال delta z صحيح معناه z تساوي x، معقول مباشرة ال + +274 +00:21:41,870 --> 00:21:45,950 +x ده مختلف لأ، لأ، مختلف، أنا بلاقي ال z بشكل عام، أي + +275 +00:21:45,950 --> 00:21:49,930 +نقطة من اللي بتغير من ال limit، ال limit delta z + +276 +00:21:49,930 --> 00:21:53,270 +فهذه اللي بأخد فيها مسارات مش ال z، ال z هنا فادة + +277 +00:22:01,340 --> 00:22:08,380 +أنا بشتغل الآية على المستوى delta z، الاسم دلتا + +278 +00:22:08,380 --> 00:22:12,860 +اكس، دلتا واعوالنقطة هنا ثابتة ال z، ال limit + +279 +00:22:12,860 --> 00:22:16,840 +minimum تغير في ال limit، بنت z واضح كإن أنا بتقصر + +280 +00:22:16,840 --> 00:22:20,240 +ال limit عند ال one، عند ال I، عند واحد ناقص I فال + +281 +00:22:20,240 --> 00:22:26,780 +z ثابت لكن أنا مش بشتغل عليها بشكل عام ومش + +282 +00:22:26,780 --> 00:22:29,420 +اللي مش .. هو ليش مش عارف القيمة المطلقة مربع ال + +283 +00:22:29,420 --> 00:22:33,980 +modulus؟ مجموع مربعي الريال الباطل الميجان الباطل + +284 +00:22:33,980 --> 00:22:37,140 +فأنا قولت لك إيه مثلا إذا فهمت الأول تفهم الثاني هي + +285 +00:22:37,140 --> 00:22:40,860 +z وهي delta z أجمعها مع بعض تجمع الريال مع الريال x + +286 +00:22:40,860 --> 00:22:42,240 +زي ال delta x والريال والريال والريال والريال وال + +287 +00:22:42,240 --> 00:22:42,480 +الريال والريال والريال والريال والريال والريال وال + +288 +00:22:42,480 --> 00:22:43,020 +الريال والريال والريال والريال والريال والريال وال + +289 +00:22:43,020 --> 00:22:43,160 +الريال والريال والريال والريال والريال والريال وال + +290 +00:22:43,160 --> 00:22:45,140 +الريال والريال وال + +291 +00:22:48,850 --> 00:22:52,170 +أه فهذا بيؤكد طبعًا هنا شباب انتبهوا صحيح أنه في + +292 +00:22:52,170 --> 00:22:55,630 +تشابه بالمثال بالنسبة لـ absolute value of X هذه + +293 +00:22:55,630 --> 00:22:58,710 +الدالة قابلة للاشتقاق عند جميع النقاط ما عدا الصفر + +294 +00:22:58,710 --> 00:23:02,370 +ما عدا الصفر غير قابلة للاشتقاق عند الصفر للعكس هنا + +295 +00:23:02,370 --> 00:23:05,290 +قابلة للاشتقاق عند الصفر طبعًا بطولة العاصمة + +296 +00:23:05,290 --> 00:23:08,750 +السابعة هذه أو ليش لمختلفة مو ديروس الزد لكل تربية + +297 +00:23:08,750 --> 00:23:12,090 +أو مدرس الزد مختلفة هنا بالكملة لكن أدتنا نفسنا + +298 +00:23:12,090 --> 00:23:15,730 +المثال أنه اللي هو continuity does not imply + +299 +00:23:15,730 --> 00:23:18,270 +differentiable أي سؤال + +300 +00:23:25,230 --> 00:23:28,810 +فهذا هو تعريف الاشتقاق وهذا تطبيق على الاشتقاق من + +301 +00:23:28,810 --> 00:23:32,750 +قواعد الاشتقاق أن الدالة القابلة للاشتقاق بتكون + +302 +00:23:32,750 --> 00:23:36,550 +متصلة + +303 +00:23:36,550 --> 00:23:43,630 +طبعًا + +304 +00:23:43,630 --> 00:23:48,890 +أمرنا أننا كنا دائمًا محكمين للتعريف، ومانحسبش + +305 +00:23:48,890 --> 00:23:52,550 +الاشتقاق كله عن طريق التعريف، هناك قوانين ممكن + +306 +00:23:52,550 --> 00:23:57,510 +تطويرها بسهولة عشان تسهل حساب التفاضل، لأن حساب + +307 +00:23:57,510 --> 00:24:02,350 +التفاضل عملية سهلة تطبيقًا، من ناحية الممارسة سهلة + +308 +00:24:02,350 --> 00:24:06,660 +كثير، وفي قوانين كثير بتسهل عملية مين التفاضل طبعًا + +309 +00:24:06,660 --> 00:24:09,440 +التعريف هو الأصل لكن باستخدام التعريف نقدر نطور + +310 +00:24:09,440 --> 00:24:14,540 +قوانين نطور نظريات للحساب هذه القوانين أهم واعدت + +311 +00:24:14,540 --> 00:24:19,400 +فيها لو كانت الـ C ثابت أي عدد ثابت فتفاضل ثابت صفر + +312 +00:24:19,400 --> 00:24:22,980 +على طول طيب Z أس N زي مثلًا، وذكرنا نحن شفنا مثال + +313 +00:24:22,980 --> 00:24:25,840 +الـ N تساوي تلاتة، الحقيقة أن هذا الكلام دائمًا صحيح + +314 +00:24:25,840 --> 00:24:29,560 +برأي الـ N في Z أس N ناقص واحد هذا الكلام صحيح لكل + +315 +00:24:29,560 --> 00:24:34,420 +integer N الأس N هنا الآن طبعًا هي صحيحة حتى لما الآن + +316 +00:24:34,420 --> 00:24:38,160 +تكون ليست integer لكن احنا نأجر شوية لأن احنا حتى + +317 +00:24:38,160 --> 00:24:42,060 +الآن ما عرفناش الأسس لغير العداد الصحيحة بس عرفنا Z + +318 +00:24:42,060 --> 00:24:45,620 +أس N لما الآن تكون عدد صحيح نقطة أخرى مهمة هنا جدًا + +319 +00:24:45,620 --> 00:24:48,960 +أن هذه الدالة لو كانت الآن negative يعني يواعد على + +320 +00:24:48,960 --> 00:24:52,120 +Z مثلًا غير قبل اشتقاق اللي عند الصفر قبل اشتقاق + +321 +00:24:52,120 --> 00:24:54,500 +جميع النقاط اللي عند الصفر لكن الآن positive + +322 +00:24:54,500 --> 00:24:58,190 +integer فهي دائمًا قبل الاشتقاق عند جميع النقاط، من ما + +323 +00:24:58,190 --> 00:25:01,570 +فيهم الصفة، لكن الـ Unnegative بتكون قاعدة صحيح، + +324 +00:25:01,570 --> 00:25:06,930 +عبادة صحيح، ده ما قياسش، ذات لا تساوي الصفة فالقوانين + +325 +00:25:06,930 --> 00:25:10,150 +اللي متعودين عليها من التفاضل اللي تم شغالها شرط + +326 +00:25:10,150 --> 00:25:14,990 +أو اللي هو القاعدة أخرى الثابت ممكن يطلع بره + +327 +00:25:14,990 --> 00:25:18,410 +التفاضل بسهولة لأن طبعًا يمكن أن يتبقى عليها حتى + +328 +00:25:18,410 --> 00:25:22,870 +حاصل الضرب كحالة خاصة لإن مشتقة الـ C صفر التفاضل + +329 +00:25:22,870 --> 00:25:27,030 +بتوزع على الجمع والطرح بسهولة نفس القضية قاعدة + +330 +00:25:27,030 --> 00:25:30,450 +التفاضل لحاصل الضرب مشتقة الأول في الثاني زائد + +331 +00:25:30,450 --> 00:25:35,020 +الأول ومشتقة الثاني صحيحة القسمة مربع المقام مشتقة + +332 +00:25:35,020 --> 00:25:38,720 +البسط في المقام ناقص مشتقة المقام في البسط فكل + +333 +00:25:38,720 --> 00:25:42,040 +قواعد التفاضل صحيحة لأن التعريف نفس التعريف زي + +334 +00:25:42,040 --> 00:25:45,660 +تفاضل ألف فان اثباته برضه إيه إيه أوتوماتيك مش + +335 +00:25:45,660 --> 00:25:48,860 +هتطلبك الإثبات زي تفاضل ألف نفس العملية ما اختلفتش + +336 +00:25:48,860 --> 00:25:53,160 +تمامًا اطلاقًا ما فيش أي اختلاف طبعًا بالنسبة للثابت + +337 +00:25:53,160 --> 00:25:57,480 +ممكن ياخد حالة خاصة لو جيه بساوي C فإيش جيه برايم + +338 +00:25:57,480 --> 00:26:03,770 +صفر فبتكون حالة خاصة من هذه ولكن نتأكد عليها النقطة + +339 +00:26:03,770 --> 00:26:07,230 +اللي هو القانون السابق المهم الـ chain rule فشفنا + +340 +00:26:07,230 --> 00:26:09,990 +كيف تتعامل مع الضرب، مع القسمة، مع الجمع، مع + +341 +00:26:09,990 --> 00:26:12,470 +الطرح بالنسبة للـ composition نفس القضية الـ chain + +342 +00:26:12,470 --> 00:26:16,590 +rule مشتقة الدالة الخارجية ضرب مشتقة الدالة + +343 +00:26:16,590 --> 00:26:19,930 +الداخلية فكل هذه القوانين اللي متعودين عليها من + +344 +00:26:19,930 --> 00:26:23,950 +التفاضل الألف بتامها صحيحة في حالة الـ complex value + +345 +00:26:23,950 --> 00:26:29,630 +خلينا + +346 +00:26:29,630 --> 00:26:32,230 +نشوف مثال بس سريع + +347 +00:26:37,280 --> 00:26:40,740 +نحسب المشتقة بس هيك بس للتأكيد ونتعود نتذكر + +348 +00:26:40,740 --> 00:26:55,260 +القوانين ليس إلا فطبعًا + +349 +00:26:55,260 --> 00:27:00,070 +الاشتقاق كالعادة بكل سهولة اشتقاق الدالة فعندي + +350 +00:27:00,070 --> 00:27:05,890 +solution f prime of z مربع المقام z ناقص i لكل + +351 +00:27:05,890 --> 00:27:10,070 +تربيع مشتقة البسط بدا الاشتقاق من الخارج جوس + +352 +00:27:10,070 --> 00:27:16,910 +تلاتة في واحد زي التلاتة z زي اتنين i في z تربيع + +353 +00:27:16,910 --> 00:27:22,690 +أس تربيع مشتقة ما في الداخل تلاتة z زائد 4 i + +354 +00:27:22,690 --> 00:27:28,100 +في z هذا كله ضرب مين ضرب المقام مشتقة البسط في + +355 +00:27:28,100 --> 00:27:33,980 +المقام ناقص البسط في مشتقة المقام تلاتة z زائد + +356 +00:27:33,980 --> 00:27:36,420 +2 i z التربيع اللي كنت كنت عايز مشتقة المقام + +357 +00:27:36,420 --> 00:27:43,760 +كده؟ واحد بس بكل سهولة فكل القواعد السابقة منطبقة + +358 +00:27:43,760 --> 00:27:47,520 +لجديد هنا بدل ما نكتب X بنكتب Z وممكن تدخل معناه + +359 +00:27:47,520 --> 00:27:53,130 +مين الـ I ليه سهل فعمر سهل وبسيط أي سؤال فجميع + +360 +00:27:53,130 --> 00:27:57,350 +قوانين التفاضل وطرق التفاضل بتامها صحيحة في حالات + +361 +00:27:57,350 --> 00:28:02,890 +الـ complex variables طبعًا الأسئلة المطلوبة صفحة 47 + +362 +00:28:02,890 --> 00:28:19,430 +من 1 لـ 9 على الاشتقاق كوشي + +363 +00:28:19,430 --> 00:28:26,620 +Riemann equations خلينا نطور الأمور شوية ونشوف + +364 +00:28:26,620 --> 00:28:31,690 +حاجات جديدة في من بداية المحاضرة حتى الآن كل اللي + +365 +00:28:31,690 --> 00:28:38,390 +شفناها هي عملية إعادة كتابة لقوانين بخصوص الاشتقاق + +366 +00:28:38,390 --> 00:28:41,390 +في حالة الـ real variables لحالة main الـ complex + +367 +00:28:41,390 --> 00:28:45,590 +variables مع اللي هو اختلافات طفيفة جدًا نشوف الآن + +368 +00:28:45,590 --> 00:28:49,710 +في موضوع الاختلاف والتطوير، ويتبدأ دي النقطة من ما + +369 +00:28:49,710 --> 00:28:53,130 +يُعرف بـ Cauchy-Riemann equations الـ Cauchy + +370 +00:28:53,130 --> 00:28:57,510 +-Riemann equations هذه القضية طبعًا احنا الآن الأول + +371 +00:28:57,510 --> 00:29:07,400 +مرة بنفكر أن F of Z نقدر نكتبها في صورة U XY ZI V + +372 +00:29:07,400 --> 00:29:08,200 +XY + +373 +00:29:10,530 --> 00:29:13,430 +فاحنا حتى الآن شباب في من أول المحاضرة حتى الآن + +374 +00:29:13,430 --> 00:29:17,530 +ما جبناش سيرة الـ U والـ V لكن في دراستنا السابقة + +375 +00:29:17,530 --> 00:29:20,990 +شفنا أن الـ U والـ V بيلعبوا دور أساسي في دراسة + +376 +00:29:20,990 --> 00:29:24,930 +النهايات قولنا أن limit الـ F بتساوي L if and only + +377 +00:29:24,930 --> 00:29:27,990 +if الـ U بتروح للـ real part للـ L والـ V بتروح للـ + +378 +00:29:27,990 --> 00:29:33,050 +imaginary part للـ L وعادةً بتترتب عليه أن الـ F متصلة + +379 +00:29:33,050 --> 00:29:37,230 +عند نقطة F و L في الـ U والـ V متصلين عند مين عند + +380 +00:29:37,230 --> 00:29:42,310 +نفس النقطة X0Y0 زي ما تساوي X0 زي IY0 فالآن السؤال + +381 +00:29:42,310 --> 00:29:46,070 +الطبيعي السؤال اللي هو قاعد يسأل نفسه زي ما احنا + +382 +00:29:46,070 --> 00:29:49,870 +مشينا طبعًا الأمور دراسة طبيعية تبدأ من دراسة + +383 +00:29:49,870 --> 00:29:53,700 +النهايات بتدوس الاتصال اللي متعلق بيه وبتدوس التفاض + +384 +00:29:53,700 --> 00:29:56,280 +اللي هو التفاضل التعريف هو limit التفاضل اللي زي ما + +385 +00:29:56,280 --> 00:29:59,020 +شفناه تعريفه هو limit فالأمور متعلقة مع بعض + +386 +00:29:59,020 --> 00:30:02,040 +ومتواجدة بالترتيب فالسؤال اللي بيسأل نفسه ما زال + +387 +00:30:02,040 --> 00:30:05,400 +احنا ربطنا الـ limit بالـ real part والـ imaginary + +388 +00:30:05,400 --> 00:30:08,600 +part للـ F وربطنا اتصال الـ F بالاتصال الـ imaginary + +389 +00:30:08,600 --> 00:30:11,360 +part والـ real part فالسؤال اللي بيسأل نفسه إيه + +390 +00:30:11,360 --> 00:30:14,240 +علاقة الـ differentiability للـ F في الـ real part والـ + +391 +00:30:14,240 --> 00:30:19,820 +imaginary part فطبعًا هنا لما يتحدث عن الاشتقاق + +392 +00:30:19,820 --> 00:30:23,440 +الـ U والـ V دول دالة في المتغيرين فبيتحدث هنا عن + +393 +00:30:23,440 --> 00:30:27,920 +إيش تفاضل جزئي U sub X U sub Y V sub X V sub Y + +394 +00:30:27,920 --> 00:30:31,620 +فالأمور شوية هتتشعب وهنشوف إيش القواعد اللي + +395 +00:30:31,620 --> 00:30:35,720 +بتربطها فهذا الكلام الرابط بينهم هو ما يتحدث عنه + +396 +00:30:35,720 --> 00:30:39,000 +مين؟ Riemann أو Cauchy-Riemann equation هو علاقة + +397 +00:30:39,000 --> 00:30:42,740 +الـ F prime في مين؟ في المشتقات الجزئية للـ U والـ + +398 +00:30:42,740 --> 00:30:47,240 +V للـ real part والـ imagine part فيها أن الحقيقة + +399 +00:30:47,240 --> 00:30:50,520 +فيها بالموضوع نظريتين، النظرية الأولى، هنشوفها + +400 +00:30:50,520 --> 00:30:53,520 +بالـ Section، وهي بتدينا شرط ضروري، necessary + +401 +00:30:53,520 --> 00:30:57,900 +condition for differentiability، أه، وكثيرًا، إذا + +402 +00:30:57,900 --> 00:31:01,020 +الدالة كانت قابلة للاشتقاق، ما هي الشروط؟ يعني هذه + +403 +00:31:01,020 --> 00:31:04,490 +النظرية بتديني، لو كانت F' exists، ما هي الشروط + +404 +00:31:04,490 --> 00:31:08,170 +اللي بتضمن أن الـ U والـ V بيحققوها أن الـ U والـ V + +405 +00:31:08,170 --> 00:31:11,790 +بيحققوها ف أنا بالاتجاه الأول إذا F' exists إيش + +406 +00:31:11,790 --> 00:31:15,270 +بيرتب على ذلك؟ ما هي نتيجة ذلك؟ هنشوف نظرية لو + +407 +00:31:15,270 --> 00:31:18,430 +وقتيش ما هي الشروط اللي بالـ U بتخلي أن F' exists + +408 +00:31:18,430 --> 00:31:23,130 +ف أنا بقيم في الاتجاهين الآن إذا F' معروف لدي موقع + +409 +00:31:23,130 --> 00:31:27,370 +أنها exists ما هي إيش النتائج؟ ما هي اللي هو + +410 +00:31:27,370 --> 00:31:31,150 +المترتب على ذلك على هذه المعلومة بالنسبة لمن؟ للـ U + +411 +00:31:31,150 --> 00:31:35,000 +والـ V ف أنا ذريع بتقول له كان الـ f of z + +412 +00:31:35,000 --> 00:31:37,500 +differentiable يعني f prime of z0 exist + +413 +00:31:37,500 --> 00:31:43,400 +differentiable على z0 then u sub x و u sub y و v + +414 +00:31:43,400 --> 00:31:48,200 +sub x و v sub y لازم يكونوا موجودين عند الـ x0 والـ y0 + +415 +00:31:48,200 --> 00:31:52,020 +يعني جميع الـ first order partial derivatives للـ u + +416 +00:31:52,020 --> 00:31:55,250 +والـ v exist على نفس النقطة طبعًا احنا دائمًا عندنا + +417 +00:31:55,250 --> 00:32:02,210 +المقابلة مين؟ z0 ليه يش x0 y0 z0 تساوي x0 zi y0 + +418 +00:32:02,210 --> 00:32:08,530 +وتساوي x0 y0 اصل طبعًا همليكي أعرفها مظبوط فهمتحدث + +419 +00:32:08,530 --> 00:32:13,730 +أن الـ F prime of z0 exist إذا الـ U مشتقات الـ U والـ + +420 +00:32:13,730 --> 00:32:18,670 +V الجزئية بيتحدث عن مشتقة أولى فمتحدث عن مشتقات + +421 +00:32:18,670 --> 00:32:20,830 +من المرتبة الأولى بس طبعا هنا ليه عندي مشتقة + +422 +00:32:20,830 --> 00:32:25,980 +ثانية U sub X U sub Y V sub X V sub Y كلهم موجودين + +423 +00:32:25,980 --> 00:32:30,120 +المين نفس النقطة X0 Y0 وكمان في شرط بعض هذا + +424 +00:32:30,120 --> 00:32:33,740 +النقطة الجديدة المهمة ويحقق ما يُعرض بال Cauchy + +425 +00:32:33,740 --> 00:32:35,660 +Riemann equations ما هي ال Cauchy Riemann + +426 +00:32:35,660 --> 00:32:40,600 +equations بيقول U sub X تساوي V sub Y وU sub Y + +427 +00:32:40,600 --> 00:32:44,460 +تساوي minus V sub X هم مش ماليش بس exist في بينهم + +428 +00:32:44,460 --> 00:32:49,660 +علاقة في بينهم علاقة وكمان النقطة الجديدة الجديدة + +429 +00:32:51,150 --> 00:32:57,730 +وبمجرد تبقى f prime بدلالة من u sub x زائد i v sub + +430 +00:32:57,730 --> 00:33:01,810 +x فزي اللي احنا فيها نعدد نقاط اول شي f prime + +431 +00:33:01,810 --> 00:33:05,310 +exist ايش هناك تاع في المشتقات تضمن ان مايش + +432 +00:33:05,310 --> 00:33:09,920 +المشتقات exist ومش بس هيك بدي اكتب F' بدلالة من + +433 +00:33:09,920 --> 00:33:14,220 +المشتقات هذه المشتقات هذه فالعملية الحقيقة ممكن + +434 +00:33:14,220 --> 00:33:18,340 +تكون عملية ممتقية انا لو بدي اشتق لل F' في عندي + +435 +00:33:18,340 --> 00:33:21,120 +صار اربع مشتقات مين اللي يدخل ومين اللي يطلع في ال + +436 +00:33:21,120 --> 00:33:24,380 +F' فلازم يكون فيه تساوي لازم يكون فيه تساوي لحد + +437 +00:33:24,380 --> 00:33:28,740 +تأسسني ان لو استبدلت انا استخدمت U sub X او V sub + +438 +00:33:28,740 --> 00:33:34,720 +Y استخدمت V U V sub X او سالب U sub Y بدينياش نفس + +439 +00:33:34,720 --> 00:33:35,320 +النتيجة + +440 +00:33:40,190 --> 00:33:42,770 +عادي .. هنشوف هنا طريقة .. محتاج بعض الشوط الإضافي + +441 +00:33:42,770 --> 00:33:46,190 +.. هذا موضوع آخر .. هذا موضوع آخر .. طبعا الآن عشان + +442 +00:33:46,190 --> 00:33:48,630 +.. بس بدنا ناخد الكزك .. هننهي المحاضرة هنا .. + +443 +00:33:48,630 --> 00:33:50,250 +البرهان .. وهذا إن شاء الله في المحاضرة القادمة diff --git a/PL9fwy3NUQKwaRXaqd-S5-vsOEDL-Q45jU/oW5zd8hchyw_postprocess.srt b/PL9fwy3NUQKwaRXaqd-S5-vsOEDL-Q45jU/oW5zd8hchyw_postprocess.srt new file mode 100644 index 0000000000000000000000000000000000000000..e01ea07e8ae2718677a7cf2c486cb816d15c7a28 --- /dev/null +++ b/PL9fwy3NUQKwaRXaqd-S5-vsOEDL-Q45jU/oW5zd8hchyw_postprocess.srt @@ -0,0 +1,2464 @@ +1 +00:00:00,000 --> 00:00:02,680 +موسيقى + +2 +00:00:10,020 --> 00:00:13,480 +اليوم هنشرح اللي هو ال analytic functions او + +3 +00:00:13,480 --> 00:00:16,980 +الدوال التحليلية طبعا هذا هو عنوان ال chapter + +4 +00:00:16,980 --> 00:00:20,460 +الرئيسي فهذا هو المفهوم يمكن يعتبر الرئيسي في هذا + +5 +00:00:20,460 --> 00:00:24,420 +ال chapter والان احنا وصلنا او جاهزين عشان ندرس + +6 +00:00:24,420 --> 00:00:27,760 +هذا المفهوم الاساسي اللي باعتمد على الدراسات + +7 +00:00:27,760 --> 00:00:30,900 +السابقة بشكل اساسي هيعتمد على اللي هو ال + +8 +00:00:30,900 --> 00:00:34,790 +differentiability قابلية الاشتقاءفهنا طبعا في + +9 +00:00:34,790 --> 00:00:38,810 +اختلاف بس قليل ودقيق بين ال differentiability و + +10 +00:00:38,810 --> 00:00:42,710 +بين تعريف ال analytic function اول اشي خلاني اعرف + +11 +00:00:42,710 --> 00:00:47,550 +ايش معناه ان الدالة تكون analytic عند نقطة z0 فانا + +12 +00:00:47,550 --> 00:00:53,270 +في عندي هاي المستوى ال complex z plane وعندي نقطة + +13 +00:00:53,270 --> 00:00:58,870 +معينة z0عشان اقول ان الدالة f ايالتك عند ال z0 + +14 +00:00:58,870 --> 00:01:04,750 +بدياها تكون قابل اشتقاق في جوار معين حول ال z0 + +15 +00:01:04,750 --> 00:01:10,250 +قابل اشتقاق في epsilon لا يبرد لل z0 هذا هو تعريف + +16 +00:01:10,250 --> 00:01:13,330 +الانالتك فبقول ان ال f if common x variable is + +17 +00:01:13,330 --> 00:01:16,770 +analytic at a point z0 if f is differentiable in + +18 +00:01:16,770 --> 00:01:20,490 +some neighborhood قداشي تكون عند الجوار الصغير + +19 +00:01:20,490 --> 00:01:24,140 +كبير بميتيموم فيه جوار الأبسلين المعينالأبسلون + +20 +00:01:24,140 --> 00:01:27,760 +صغيرة كبيرة المهم في جوار معين و تكون الآية دالة + +21 +00:01:27,760 --> 00:01:31,240 +قبل اشتقاء في كل الجوار دي يعني عند النقطة و في + +22 +00:01:31,240 --> 00:01:34,640 +جوارها فببقى على هذه الدالة نلقاها في analytic and + +23 +00:01:34,640 --> 00:01:40,030 +then zeroالتعريف التاني، لو بنعرف أن الدالة قبل + +24 +00:01:40,030 --> 00:01:45,270 +Analytic على مجموعة معينة، هنبدأ بالـ Open Set، لو + +25 +00:01:45,270 --> 00:01:49,710 +كانت المجموعة Open Set، فالأن بالطبق تعريف الـ + +26 +00:01:49,710 --> 00:01:52,770 +Analyticity مع تعريف الـDifferentiability، فلو كان + +27 +00:01:52,770 --> 00:01:54,430 +عندي أنا مجموعة معينة، + +28 +00:02:00,960 --> 00:02:06,420 +مازال المجموع مفتوح ان كل نقطة يوجه انترال ربوت + +29 +00:02:06,420 --> 00:02:14,340 +يعني ان في جوار كامل جوا من المجموعالان ال F .. + +30 +00:02:14,340 --> 00:02:17,480 +انا نالتك عند النقطة دي يعني differentiable على كل + +31 +00:02:17,480 --> 00:02:20,880 +من ال O ب L لها د الجوار، كل نقطة بقدر اللي اجعلها + +32 +00:02:20,880 --> 00:02:23,560 +جوار، اذا ليش differentiable في كل الجوار، اذا دي + +33 +00:02:23,560 --> 00:02:26,880 +differentiable في وين، في كل المجموع، بكل المجموع، + +34 +00:02:26,880 --> 00:02:30,910 +فالاناحنا عندنا بالنسبة للتعريف ال analytic .. ال + +35 +00:02:30,910 --> 00:02:34,210 +analyticity عند نقطة في اختلاف بين تعريف + +36 +00:02:34,210 --> 00:02:36,930 +differentiable at the point وإيش analytic at the + +37 +00:02:36,930 --> 00:02:39,610 +point لأن هنا بكتفيش differentiable عشان أقول + +38 +00:02:39,610 --> 00:02:42,450 +analytic عند النقطة وإنما بدي differentiable عند + +39 +00:02:42,450 --> 00:02:45,670 +النقطة وإيه جوار معين في حوالها لكن إذا كان عندنا + +40 +00:02:45,670 --> 00:02:48,370 +المجموعة open بصير differentiability وanalyticity + +41 +00:02:48,370 --> 00:02:52,390 +نفس المعنى نفس .. نفس المفهوم .. نفس المفهوم فده + +42 +00:02:52,390 --> 00:02:57,330 +هو التعريفخلّينا نشوف و نوضّح هذه المفاهيم عن طريق + +43 +00:02:57,330 --> 00:03:05,670 +بعض الأمثل نشوف المثال الأول ناخد الدالة 1 على z + +44 +00:03:05,670 --> 00:03:11,290 +بدنا نثبت أن أنلتك عن z تسوّح فنبدأ بهذا المثال و + +45 +00:03:11,290 --> 00:03:18,110 +ندرس أن الanalyticity عند من؟ عند الـ z بتسوّح 1 + +46 +00:03:18,110 --> 00:03:26,680 +على z solutionطبعا هنا z0 تسوّع عشان اثبت ان انا + +47 +00:03:26,680 --> 00:03:30,620 +ارتك عن z1 ايش بده اعمل بده اثبت ان قبل الاشتقاق + +48 +00:03:30,620 --> 00:03:35,320 +في جوار معين في جوار معين حوالين الواحد فانا خلينا + +49 +00:03:35,320 --> 00:03:40,720 +نرسم نستعين بالرسم هاي ال x وهي ال y وهي z تسوّع + +50 +00:03:40,720 --> 00:03:47,090 +يعني هنا النقطةهي z0 اتساوة واحد بدي جواهر تكون في + +51 +00:03:47,090 --> 00:03:50,490 +f prime exists عن جميع النقاط في هذا الجواهر في + +52 +00:03:50,490 --> 00:03:54,510 +هذا الجواهر طيب لو جينا نشوف احنا f prime هل هذه + +53 +00:03:54,510 --> 00:03:58,630 +ال f prime قابلة الاشتقاء او وين او دائما ملط + +54 +00:03:58,630 --> 00:04:02,250 +علينا هذه في المعادلة f prime exist عن ما عدا + +55 +00:04:02,250 --> 00:04:04,570 +الصفر اللي هو خارج ال domain واحدة في زي التربيع + +56 +00:04:04,570 --> 00:04:10,190 +وهذه اسمها لا exist for all z تنتمي لل c ما عدا من + +57 +00:04:10,190 --> 00:04:17,100 +الصفرأذا الأن عشان أثبت أن الدالة دي analytic عند + +58 +00:04:17,100 --> 00:04:21,400 +الواحد بدي ألاقي جوار حوالين الواحد لا يحتوي الصفر + +59 +00:04:21,400 --> 00:04:25,080 +لا يحتوي الصفر فهي الواحد بدي أختار الأبسلون بشكل + +60 +00:04:25,080 --> 00:04:28,540 +مناسب بس إيش بيكون بايد عن الصفر بيكون بايد عن + +61 +00:04:28,540 --> 00:04:32,640 +الصفر طبعا إيش ممكن نختاره نختار الأبسلون سواء نص + +62 +00:04:32,640 --> 00:04:38,940 +فالآن f prime exists for all z بشكل خاص in + +63 +00:04:38,940 --> 00:04:39,580 +particular + +64 +00:04:44,190 --> 00:04:52,190 +F prime of Z exist for all Z تنتمي لـ Z such that + +65 +00:04:52,190 --> 00:04:57,310 +الـ Z ناقص + +66 +00:04:57,310 --> 00:05:05,630 +واحد أقل من نصفهذا هو ال جوار ممكن تسميه N نص of + +67 +00:05:05,630 --> 00:05:11,710 +واحد for all z اللي هي عبارة عن N نص للواحد جوار + +68 +00:05:11,710 --> 00:05:17,610 +ال one half neighborhood of one جوار ال واحد و نص + +69 +00:05:17,610 --> 00:05:20,770 +لمن؟ للواحد اللي هو نص قطره بيساوي هات نص فده + +70 +00:05:20,770 --> 00:05:27,590 +معناته ان مين خلاص انتهى اذا f is analytic at z + +71 +00:05:27,590 --> 00:05:31,320 +تساويألاقي جوار طبعا هذا ال جوار مش الوحيد ممكن + +72 +00:05:31,320 --> 00:05:34,700 +اخد ربع ممكن اخد تلات تربع تسعة من عشر المهم بس + +73 +00:05:34,700 --> 00:05:37,440 +ايش أطول عن الصفر حتى لو أخدت بيسواحد ما هو ياش + +74 +00:05:37,440 --> 00:05:41,100 +اللي بيكون زيه على حدود و مش داخله برضه صح فالمهم + +75 +00:05:41,100 --> 00:05:43,640 +انه ياش هذا بفهم عشان أثبت ان الانت كانت نقطة + +76 +00:05:43,640 --> 00:05:47,040 +معينة ايش بديه؟ بدي ألاقي جوار حوالين النقطة تكون + +77 +00:05:47,040 --> 00:05:50,900 +الدل دل ايش F'Z في كل جوار عدى الجوار ده ما بدي + +78 +00:05:50,900 --> 00:05:53,620 +أظهر مش مشكلة المهم يكون اللي هو نصف القطر تبعه + +79 +00:05:53,620 --> 00:05:57,020 +أبسلون positive واحد من عشرة واحد من مليون واحد + +80 +00:05:59,370 --> 00:06:04,670 +I guess what؟اللي بقوله علشان نثبت أنه أدنى اللي + +81 +00:06:04,670 --> 00:06:07,190 +كان نقطة و هذا التعريف يبقى على الوضح بدنا نلاقي + +82 +00:06:07,190 --> 00:06:09,890 +جوار انظغر و انكبر و مش مهم، الواحد اللي بيكون فيه + +83 +00:06:09,890 --> 00:06:12,870 +جوار أبسلون جد ما .. ما .. ما بدي أختارها، طبعا + +84 +00:06:12,870 --> 00:06:16,530 +الخضية كيف أختارها .. ال .. الكبيرة دايما أسهل، + +85 +00:06:16,530 --> 00:06:18,810 +بدي أختارها .. ممكن أنظغر عشان نحصل على الخاصية + +86 +00:06:18,810 --> 00:06:21,130 +اللي بدنا إياها، فممكن ناخد الأبسلون واحد من عشرة، + +87 +00:06:21,130 --> 00:06:24,470 +واحد من مية، المهم فيه أبسلون positive، اه و كل + +88 +00:06:24,470 --> 00:06:29,350 +إيهش أفبرايه exist في كل هذا الجوار، في هذا الجوار + +89 +00:06:29,560 --> 00:06:31,820 +فطبعا دي هو المثال اللي قدرنا نختاره ايش على سبيل + +90 +00:06:31,820 --> 00:06:35,240 +المثال اخدنا absolute ساوي نص اه طبعا اي عدد اصغر + +91 +00:06:35,240 --> 00:06:39,200 +من نص و positive بيقدي الغرض بيقدي الغرض فده هو + +92 +00:06:39,200 --> 00:06:42,820 +المفهوم يعني F prime of واحد exist في هذه الحالة + +93 +00:06:42,820 --> 00:06:46,200 +ماتكفيش بنأكد على هذه النقطة مانفعش اقول ان F + +94 +00:06:46,200 --> 00:06:48,600 +prime of واحد بتساوي سالب واحد exist اذا هي + +95 +00:06:48,600 --> 00:06:51,440 +negative مضبوطش هذا الاتعار يقول الناس مش بس بدي F + +96 +00:06:51,440 --> 00:06:54,000 +prime of zero exist بديها تكون في الجواهر and + +97 +00:06:54,000 --> 00:07:00,620 +النقطة وفي الجواهر اي سؤالخلّيني أشوف مثال آخر + +98 +00:07:00,620 --> 00:07:07,800 +برضه عشان نفهم التعريف بشكل جيد ال F of Z تسوى + +99 +00:07:07,800 --> 00:07:11,180 +واحد على Z ماقص اتنين لكل تربية بقول اثبت انها + +100 +00:07:11,180 --> 00:07:15,760 +analytic في المجموعة Z بحيث مطلق ال Z أقل من واحد + +101 +00:07:15,760 --> 00:07:19,200 +فالان بده نثبت او ندرس ان ال analyticity وين في + +102 +00:07:19,200 --> 00:07:23,530 +مجموعة واحد المجموعة open ولا closed؟open set + +103 +00:07:23,530 --> 00:07:26,830 +المطلق الزرد أقل من واحد هي عبارة عن دائرة مركزها + +104 +00:07:26,830 --> 00:07:32,940 +من الـ zero و لسه قطرابين بثالث الواحدفالان ال + +105 +00:07:32,940 --> 00:07:36,580 +analyticity ان ال F analytic تكافئ تمام ان F is + +106 +00:07:36,580 --> 00:07:40,200 +differentiable عن المجموعة F analytic on open set + +107 +00:07:40,200 --> 00:07:43,660 +if and only if it is differentiable on the open + +108 +00:07:43,660 --> 00:07:48,360 +set التعريف هنا بينطبق فهنا المثال التاني تبعنا ال + +109 +00:07:48,360 --> 00:07:54,000 +F of Z تساوي واحد على Z ناقص اتنين لكل تربية طبعا + +110 +00:07:54,000 --> 00:07:59,960 +هنا مجموعة وليس نقطة Z مطلق ال Z أقل من واحد خلينا + +111 +00:07:59,960 --> 00:08:05,750 +نوصل المجموعةبتكون عبارة عن دائرة مركزها نقطة + +112 +00:08:05,750 --> 00:08:09,190 +الأصل و نص خطرة بيساوي مين بيساوي واحد طبعا open + +113 +00:08:09,190 --> 00:08:14,850 +لأن الحدود مش موجودة فهذه سالب واحد واحد I سالب I + +114 +00:08:14,850 --> 00:08:21,410 +فهذه المجموعة S open set فالان كل اللي بدي اعمله + +115 +00:08:21,410 --> 00:08:25,590 +بتاعة بتنياش F prime exist على كل main ال S فخلينا + +116 +00:08:25,590 --> 00:08:33,780 +نقول هنا S تساوي ال solution S is openفهذا بيقول f + +117 +00:08:33,780 --> 00:08:51,140 +is analytic على المجموعة in S if and only if f + +118 +00:08:51,140 --> 00:08:58,640 +prime of z exists for all z وين موجودة في الأسس + +119 +00:08:58,640 --> 00:09:05,450 +لأنها open setواضحة بالفرق بين الاناليز الستي عند + +120 +00:09:05,450 --> 00:09:08,550 +نقطة واناليز الستي في open set فهذا من الفرق بينهم + +121 +00:09:08,550 --> 00:09:13,350 +طيب بنشوف هى ال F كيه ممكن افضلها زى قوانين + +122 +00:09:13,350 --> 00:09:15,970 +التفاضل العادية شفها اه فاحنا مانساش هاد الأمور + +123 +00:09:15,970 --> 00:09:17,790 +احنا ماروحنا عليها بسرعة لإن نقول هى ده سبب قضية + +124 +00:09:17,790 --> 00:09:23,810 +فإنا عند هى ال F of Z F prime of Z اش تساوي سالب + +125 +00:09:23,810 --> 00:09:30,770 +اتنين على Z ناقص اتنين لكل تكييب تكييبفانت ايش + +126 +00:09:30,770 --> 00:09:34,610 +بتكتبها Z نقص 2 أس ثالث ب2 بتنزل الثالث ب2 و بتطرح + +127 +00:09:34,610 --> 00:09:37,810 +من الأس واحد و تفاضل الجوز في ال جيوز واحد مافيش + +128 +00:09:37,810 --> 00:09:41,450 +اي تغيير اشملها دليل المشتقة exist everywhere ما + +129 +00:09:41,450 --> 00:09:49,490 +عدا أند التنين اه فديش exist for all Z تنتمي لل C + +130 +00:09:49,490 --> 00:09:53,330 +ما عدا التنين طبعا فبالتالي نشوف هاي الاس هل الاس + +131 +00:09:53,330 --> 00:09:57,430 +تحتوي التنين لأ إذا نشملها it exists for all A Z + +132 +00:09:57,430 --> 00:10:07,730 +تنتمي للاسthus f prime of z exists for + +133 +00:10:07,730 --> 00:10:16,470 +all z تنتمي لل S وبالتالي therefore f is analytic + +134 +00:10:16,470 --> 00:10:26,870 +in S أي سؤالهذا هو المفهوم المفهوم التحليل ان + +135 +00:10:26,870 --> 00:10:31,310 +الدالة تكون تحليلية analytic function متعلق او + +136 +00:10:31,310 --> 00:10:34,870 +مرتبط ارتباط وثيق بمين في قابلية الاشتقاء بال + +137 +00:10:34,870 --> 00:10:38,170 +differentiability بالنسبة للنقطة بد الدالة تكون + +138 +00:10:38,170 --> 00:10:40,950 +differentiable عند النقطة وفي الجوار بقول انها + +139 +00:10:40,950 --> 00:10:44,190 +analytic عند النقطة بالنسبة لل open set + +140 +00:10:44,190 --> 00:10:46,210 +differentiable او analytic عند ال differentiable + +141 +00:10:46,210 --> 00:10:49,810 +تماما نفس المفهوم لكن عند النقطة في اختلاف لأن هو + +142 +00:10:49,810 --> 00:10:52,390 +مش differentiable عند النقطة وانما في جوار النقطة + +143 +00:10:52,390 --> 00:10:59,810 +في النقطة و جوارأي سؤال؟ طبعا + +144 +00:10:59,810 --> 00:11:05,050 +ولا شي طبيعي بالنسبالي .. طبعا دايما احنا شباب لو + +145 +00:11:05,050 --> 00:11:09,430 +تطلعنا على المفاهيم بنعرف continuity at the point + +146 +00:11:09,430 --> 00:11:11,790 +و بعدين بنعرف ال continuity على المجموع كيف + +147 +00:11:11,790 --> 00:11:16,360 +continuous على كل نقطة في المجموعبنعرف + +148 +00:11:16,360 --> 00:11:18,300 +differentiable at the point أنه إيش؟ اللي هو الـA' + +149 +00:11:18,440 --> 00:11:19,840 +في الـprimary، اللي الـlimit exist طب + +150 +00:11:19,840 --> 00:11:21,940 +differentiable في المجموعة تكون إيش؟ + +151 +00:11:21,940 --> 00:11:24,420 +differentiable at every point in the set، أه الآن + +152 +00:11:24,420 --> 00:11:26,840 +نفس القضية differentiable .. the analytic .. + +153 +00:11:26,840 --> 00:11:30,260 +analyticity at the point وعرفناها طيب analyticity + +154 +00:11:30,260 --> 00:11:33,840 +في المجموعة بيكون انتج عن كل نقطة في المجموعة إذا + +155 +00:11:33,840 --> 00:11:36,040 +كانت open فالanalytic بيصير إيش بابس ال + +156 +00:11:36,040 --> 00:11:37,540 +differentiability؟ نعم + +157 +00:11:41,730 --> 00:11:43,610 +طبعاً لإن هو اي تعريف يقول يجب ان تكون + +158 +00:11:43,610 --> 00:11:45,910 +differentiable at every point in the set + +159 +00:11:53,180 --> 00:11:54,680 +طبعا هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي + +160 +00:11:54,680 --> 00:11:54,800 +هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي + +161 +00:11:54,800 --> 00:11:56,340 +هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي + +162 +00:11:56,340 --> 00:11:56,400 +هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي + +163 +00:11:56,400 --> 00:11:56,420 +هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي + +164 +00:11:56,420 --> 00:11:57,160 +هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي + +165 +00:11:57,160 --> 00:12:00,760 +هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي + +166 +00:12:00,760 --> 00:12:00,800 +هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي + +167 +00:12:00,800 --> 00:12:01,500 +هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي + +168 +00:12:01,500 --> 00:12:01,560 +هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي + +169 +00:12:01,560 --> 00:12:02,200 +هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي + +170 +00:12:02,200 --> 00:12:19,540 +هي هي هي هي هي هي هي هي هي هي هي هي هي هي هي + +171 +00:12:19,540 --> 00:12:24,790 +هي هي هيهو مش هنالي .. وين؟ .. مثلا لو .. وين ممكن + +172 +00:12:24,790 --> 00:12:28,630 +.. نقطة مثلا ما تكونش .. نقطة نفسك ولا .. لأ لأ + +173 +00:12:28,630 --> 00:12:30,770 +هذه أداتك في كل ال domain دلوقت طبعا بس احنا مش + +174 +00:12:30,770 --> 00:12:33,810 +عارفين الواقع ان هو صحيح لو خدنا أي نقطة .. خد أي + +175 +00:12:33,810 --> 00:12:36,490 +نقطة .. بيه مثلا على سبيل المثال؟ بتبتاخد مثلا + +176 +00:12:36,490 --> 00:12:39,030 +واحدة قريبة من الصغر، بتكون فيها شوية صعوبة لو + +177 +00:12:39,030 --> 00:12:42,470 +خدنا نقطة قريبة من الصفر، مثلا نص، ناخد ال .. ال + +178 +00:12:42,470 --> 00:12:45,530 +.. ال أبسول وليهاش ربع او لو بتبتاخد مثلا نص I، + +179 +00:12:45,530 --> 00:12:48,160 +نفس القضية، الممتلكة بيبقى على الصفرتقدر تختار + +180 +00:12:48,160 --> 00:12:52,660 +أبسلون تخلّي الصفر خارج من الـcircle هذي اللي هي + +181 +00:12:52,660 --> 00:12:55,520 +الـ neighborhood فأي نقطة جد ما تكون خريبة حتى لو + +182 +00:12:55,520 --> 00:13:01,200 +واحد من مية بختار أبسلون واحد من ألف أو نص من مية + +183 +00:13:01,200 --> 00:13:04,380 +فنفس القضية فكوية فيا تتوعن Analytic في كل ال + +184 +00:13:04,380 --> 00:13:07,960 +domain تبعها سنعامل مع هذه الأمور بس أحنا في الأول + +185 +00:13:07,960 --> 00:13:11,360 +هذه الأمثلة البسيطة وهذا الحل عشان نفهم التعريفين + +186 +00:13:11,360 --> 00:13:15,660 +الفرق بين Analytic at the point و Analytic in an + +187 +00:13:15,660 --> 00:13:16,140 +open cell + +188 +00:13:21,830 --> 00:13:27,190 +خلّيني أشوف مثال آخر نفجر + +189 +00:13:27,190 --> 00:13:29,770 +على الدالة f of z تساوي مطلق z تربية مرّت عليها + +190 +00:13:29,770 --> 00:13:34,650 +هذه الدالة و ذكرنا إنها .. هذه الدالة طبعا جيبناها + +191 +00:13:34,650 --> 00:13:38,390 +كمثال عكسي إنها متصلة عند جميع النقاط لكن غير قابل + +192 +00:13:38,390 --> 00:13:41,470 +اشتراك اللي عند ال zero و أثبتنا إنها غير قابل + +193 +00:13:41,470 --> 00:13:44,790 +اشتراك في جميع النقاط و قلنا ك exercise إنها + +194 +00:13:44,790 --> 00:13:47,510 +أثبتوا إنها قابل اشتراك عن من؟ عند الصفر اليوم + +195 +00:13:47,510 --> 00:13:50,990 +هنحرركم ال exerciseفاول سؤال بيقول للي f of z + +196 +00:13:50,990 --> 00:13:53,850 +تساوي مطلق 0 لكل تربيع show that f prime of 0 + +197 +00:13:53,850 --> 00:13:57,650 +تساوي 0 هنثبت ان f prime of 0 exist و تساوي 0 لكن + +198 +00:13:57,650 --> 00:14:01,430 +هذه الدالة ليست analytic عند من عند z بتساوي صفر + +199 +00:14:01,430 --> 00:14:05,690 +مش بنحاول بنؤسس او بنأكد على المعنى differentiable + +200 +00:14:05,690 --> 00:14:08,370 +عند النقطة ما يعني ان انا analytic فعندنا مثال + +201 +00:14:08,370 --> 00:14:12,850 +differentiable at 0 لكن not analytic at 0 فهذا كله + +202 +00:14:12,850 --> 00:14:16,430 +بيأكد على ايش على التعريف خلنا نبدأ الحل + +203 +00:14:20,070 --> 00:14:27,690 +فهذا المثال التالت عندنا ال f of z تساوي مطلق ال z + +204 +00:14:27,690 --> 00:14:33,150 +لكل تربية نبدأ بما هو المطلوب الأول ايه؟ بدنا نثبت + +205 +00:14:33,150 --> 00:14:37,910 +ان f prime of 0 تساوي 0 اه + +206 +00:14:37,910 --> 00:14:42,950 +اه نعم هنجيها بس خينا واحدة واحدة فبدنا نثبت ان f + +207 +00:14:42,950 --> 00:14:46,370 +prime of 0 تساوي 0 كيف ممكن نحسب هذا الكلام يا + +208 +00:14:46,370 --> 00:14:46,810 +شباب؟ + +209 +00:14:52,700 --> 00:14:57,940 +ممكن انتقل من بعض او من اخر؟ + +210 +00:14:57,940 --> 00:15:02,120 +تعريف هدا واحد في غيرها؟ + +211 +00:15:13,890 --> 00:15:16,290 +أو بمعنى النظرية التنهية النيفية من الأولة أو + +212 +00:15:16,290 --> 00:15:18,590 +التانية التانية اللي فيها sufficient conditions + +213 +00:15:18,590 --> 00:15:20,730 +اللي فيها sufficient conditions اه فالان طبعا + +214 +00:15:20,730 --> 00:15:23,070 +الشباب لازم احنا نركز احنا صار عندنا نجد طريقتين + +215 +00:15:23,070 --> 00:15:26,250 +لإن نثبت ان ألف إبراهيم exist او لايزال exist + +216 +00:15:26,250 --> 00:15:30,130 +أولشي التعريفبعملتين تانى طبعا تعريف عن طريق ال + +217 +00:15:30,130 --> 00:15:32,210 +limit ال limit exist اف ال prime exist ال limit + +218 +00:15:32,210 --> 00:15:34,290 +does not exist اف ال prime does not exist بعدين فى + +219 +00:15:34,290 --> 00:15:37,190 +عامة نظرية تانى ان ال sunny condition ممكن + +220 +00:15:37,190 --> 00:15:39,890 +نستخدمها ليثبت ان اف ال prime does not exist و ال + +221 +00:15:39,890 --> 00:15:42,310 +suction condition النظرية نستخدمها ليثبت ان اف ال + +222 +00:15:42,310 --> 00:15:47,570 +prime exist اه تمام الاول اسي اد ال f of zأيش + +223 +00:15:47,570 --> 00:15:53,430 +بتساوي X تربيع زي Y تربيع؟ يعني عندنا U of X and Y + +224 +00:15:53,430 --> 00:15:59,090 +X تربيع زي Y تربيع و V تساوي صفر V of X and Y + +225 +00:15:59,090 --> 00:16:05,210 +تساوي صفر الآن عشان أثبت أن F prime exist و تساوي + +226 +00:16:05,210 --> 00:16:08,110 +zero بدى اطبق نظرية اللي هي such a condition ايش + +227 +00:16:08,110 --> 00:16:13,610 +بتقول النظرية؟ بالنص الكابل لازم يكون ال F معرفة + +228 +00:16:13,610 --> 00:16:17,930 +عند عوالم ال zeroمعرفة ولا مش معرفة؟ طب عايش ال + +229 +00:16:17,930 --> 00:16:19,010 +domain تبع الدلها دي؟ + +230 +00:16:26,480 --> 00:16:30,300 +النقطة ده تانية ايش قال ليه لازم ال f اللي اللي + +231 +00:16:30,300 --> 00:16:33,440 +اللي اللي اللي ال u sub x و ال u sub y و vx و vy + +232 +00:16:33,440 --> 00:16:36,880 +يكون ايش exist في جواها عند النقطة وجواها اه + +233 +00:16:36,880 --> 00:16:43,720 +تفريجي نحسب ux اسمه تساوي اتنين x uy اتنين y vx + +234 +00:16:43,720 --> 00:16:50,070 +صفر vy تساوي صفر طبعا كلهم exist allexist طبعا for + +235 +00:16:50,070 --> 00:16:55,430 +all x and y تنتمي ل الارتو مش مثلا الجوار جد مكب + +236 +00:16:55,430 --> 00:16:59,450 +الجوار بتاعتهم صحيحين exist ولا لأ معرفين وين مكان + +237 +00:16:59,450 --> 00:17:09,790 +ويش كمان و continuous عند النقطة and continuous at + +238 +00:17:09,790 --> 00:17:15,290 +zero zeroوالا لأ مش continuous لان عند الصفر صفر + +239 +00:17:15,290 --> 00:17:18,250 +ايش هتقول الصفر و لما ناخد ال limit بتكون ايش صفر + +240 +00:17:18,250 --> 00:17:20,570 +لإن واحد تقول نعم يعني فهما continuous everywhere + +241 +00:17:20,570 --> 00:17:25,430 +بما فيهم ايش and 00 اذا ممكن نستخدم ال main النقطة + +242 +00:17:25,430 --> 00:17:29,510 +الأخيرة تحقق الكوشريم ال equation عند الصفر صفر + +243 +00:17:29,510 --> 00:17:39,230 +moreover moreover ux00 تساوي صفر تساوي vy عند ال + +244 +00:17:39,230 --> 00:17:46,260 +00UY عند الـ 00 تساوي صفر تساوي سالف VX عند الـ 00 + +245 +00:17:46,260 --> 00:17:53,460 +فبالتالي ايش F prime exists therefore F + +246 +00:17:53,460 --> 00:18:03,690 +prime of 0 ايش بتساوي UX 00 ZI VX 00 وتساوي قداشفى + +247 +00:18:03,690 --> 00:18:07,950 +Vx Zero بساوية صفر و Vx صفر صفر بساوية صفر و + +248 +00:18:07,950 --> 00:18:11,850 +تساوية صفر اشمالها exists خلاص يعني من غير ما يكتب + +249 +00:18:11,850 --> 00:18:14,950 +كلمة exists ممكن ولكن لو كتبت فهذه طريقة تانية يا + +250 +00:18:14,950 --> 00:18:17,670 +شباب هذه الطريقة التانية طبعا عن طريقة تعريف ايضا + +251 +00:18:17,670 --> 00:18:26,730 +ممكن نحسبه من التعريف اي سؤال عشان + +252 +00:18:26,730 --> 00:18:29,110 +نثبت ان ال limit ان ال a في ال brand does not + +253 +00:18:29,110 --> 00:18:29,450 +exist + +254 +00:18:32,760 --> 00:18:38,900 +صحيح طيب إيش الفرق بين التنتين؟ فيه فرق كبير؟ + +255 +00:18:38,900 --> 00:18:43,900 +إيش هو الشروط؟ التصالي اللي اليوم موجود مش فقط عند + +256 +00:18:43,900 --> 00:18:47,200 +النقطة وفي الديوار يعني الشرط الحقيقي هتخنيه لكن + +257 +00:18:47,200 --> 00:18:49,520 +اللي هو لب الموضوع الكوشي و اليماني كوشي نفس الشي + +258 +00:18:49,520 --> 00:18:52,840 +متحقق عند نفس النقطة لكن هم نتأكد ان ال partial + +259 +00:18:52,840 --> 00:18:55,820 +derivatives exist عند النقطة و في الديوار و متصنين + +260 +00:18:55,820 --> 00:18:58,280 +عند النقطة بس هذا الشرط اللي لاش لب صفشان كنتش + +261 +00:18:58,280 --> 00:19:02,830 +صحيحفننتبه لها بالحقيقة من ناحية الأساسية مافيش + +262 +00:19:02,830 --> 00:19:05,430 +فرق حساسي عاملي مافيش فرق كبير عامل، لكن من ناحية + +263 +00:19:05,430 --> 00:19:08,090 +وضعية فيه فرق، اللي هو ننتبه، لا نلاقيهاش الفرق + +264 +00:19:08,090 --> 00:19:10,570 +الـderivate منهم موجزت في الجواب ومتصلين عند + +265 +00:19:10,570 --> 00:19:14,490 +النقطة، لكن من ناحية عملية مافيش فرق بهذا الحل، + +266 +00:19:14,490 --> 00:19:20,580 +تمام، الأخر ينكمل الحلفرغم أن F' موجود عند الـ + +267 +00:19:20,580 --> 00:19:24,880 +Zero، لكن F هو مصدر أنالتك عند الـ Zero، لماذا؟ + +268 +00:19:24,880 --> 00:19:28,360 +كيف تكون أنالتك؟ بدأت تكون قابل استقاط في جوار + +269 +00:19:28,360 --> 00:19:32,380 +معين، في جوار معين، إحنا إيش جولنا عند هذه الدالة؟ + +270 +00:19:32,380 --> 00:19:36,660 +ليست قابل استقاط اللي عند من؟ اللي عند الصفرجدما + +271 +00:19:36,660 --> 00:19:40,900 +زغر الجوارات، بدوا يحتوي نقاط غير الصفر، والدالة + +272 +00:19:40,900 --> 00:19:44,460 +غير قابلة الاشتقاء عن من عندها دي النقاط، فعشان + +273 +00:19:44,460 --> 00:19:47,200 +هيك بهذا الكلام، طب نادر بيش اثبت ان انا not + +274 +00:19:47,200 --> 00:19:49,920 +differential، بقول اثبتناها، حين ده هنقول هنا + +275 +00:19:49,920 --> 00:19:55,320 +since f prime of z does not exist + +276 +00:19:58,780 --> 00:20:05,180 +for all z لا تساوي 0 فإن في أي جوار ال F' لا يوجد + +277 +00:20:05,180 --> 00:20:09,780 +في + +278 +00:20:09,780 --> 00:20:15,260 +أي + +279 +00:20:15,260 --> 00:20:18,300 +جوار أبسلون + +280 +00:20:25,090 --> 00:20:36,350 +of 0 وبالتالي and hence f is not analytic at + +281 +00:20:36,350 --> 00:20:44,010 +z تساوي 0 فارجو + +282 +00:20:44,010 --> 00:20:49,430 +أنه يكون الرجية المفهوم مضح بشكل كاملالفرق بين ال + +283 +00:20:49,430 --> 00:20:53,410 +differentiability و ال analyticity بشكل عام طبعا + +284 +00:20:53,410 --> 00:20:56,090 +عند نقطة طبعا عند ال open set بيكون مافيش فرق لكن + +285 +00:20:56,090 --> 00:20:58,510 +عند النقطة ده هو الفرق ففي الدالة ممكن تكون + +286 +00:20:58,510 --> 00:21:00,790 +differentiable عند point لكن مات analytical عند + +287 +00:21:00,790 --> 00:21:02,750 +point لكن طبعا اللي ماني analytical عند ال point + +288 +00:21:02,750 --> 00:21:04,890 +بالتأكيد يت differentiable عند the point لإن هو + +289 +00:21:04,890 --> 00:21:08,150 +عايش من الشروط أي سؤال؟ + +290 +00:21:17,250 --> 00:21:21,990 +فإن شاء الله بعد ما نروح نقول فيم التعريف وشوفنا + +291 +00:21:21,990 --> 00:21:25,850 +دلوقتي أمثلة وفرقنا بين دراسة ال analytics عند + +292 +00:21:25,850 --> 00:21:30,370 +نقطة معينة ودراسة ال analytics في فترة مفتوحة او + +293 +00:21:30,370 --> 00:21:35,670 +في مجموعة مفتوحة هو بنسيت، الآن ننتقل لبعض + +294 +00:21:35,670 --> 00:21:39,810 +الملاحظات، ننتقل لنقطة جديدةأول حاجة بالنسبة + +295 +00:21:39,810 --> 00:21:43,790 +لمصطلح analytic function في بعض اللي هو الكتب او + +296 +00:21:43,790 --> 00:21:47,470 +بعض اللي هو الناس بيستخدمه كلمة regular function + +297 +00:21:47,470 --> 00:21:52,010 +او holomorphic او holomorphic طبعا regular يمكن + +298 +00:21:52,010 --> 00:21:55,730 +استخدامها قبل جدا holomorphic بيوتوا استخدم يعني + +299 +00:21:55,730 --> 00:21:59,930 +holomorphic يعني analytic if is analytic at z0 او + +300 +00:21:59,930 --> 00:22:03,710 +holomorphic at z0 نفس المعنى فبعد الناس بيستخدموها + +301 +00:22:03,710 --> 00:22:10,840 +النقطة التانيةأحنا عرفنا analytic at a point + +302 +00:22:10,840 --> 00:22:15,680 +وanalytic in open set طب لو كان فينا مجموعة مش + +303 +00:22:15,680 --> 00:22:20,080 +مفتوحة كيف ندرس ال analytic في هذه المجموعة اللي + +304 +00:22:20,080 --> 00:22:23,820 +هو المحظر رقم 2 إذا قلنا إن ال F analytic في + +305 +00:22:23,820 --> 00:22:26,480 +مجموعة و هذه المجموعة مش بالضرورة تكون مفتوحة + +306 +00:22:26,480 --> 00:22:30,760 +بنقصد إنها analytic في مجموعة open تحتوي هذه + +307 +00:22:30,760 --> 00:22:34,480 +المجموعة بمعنىلو احنا عندنا اللي هو الملاحظة الرقم + +308 +00:22:34,480 --> 00:22:38,600 +اتنين اللي امامك يا شباب ا function f that is + +309 +00:22:38,600 --> 00:22:41,480 +analytic in a set which is not open اذا مش open + +310 +00:22:41,480 --> 00:22:45,080 +ايش نفهم من هذا الكلام ان ال analytic في open set + +311 +00:22:45,080 --> 00:22:49,520 +تحتوى من ال S خلينا نحاول نوضح هذا الكلام اللي هو + +312 +00:22:49,520 --> 00:22:55,720 +بشكل رسمى ونشوف ليش هذا الكلام لازم نفهم بهذا + +313 +00:22:55,720 --> 00:23:01,590 +الصورةتقريبا نحاول نبرر هذا التعريف أو هذا التفاهم + +314 +00:23:01,590 --> 00:23:09,050 +أو هذا الاتفاق هاي Y هاي X انا عندش مجموعة Sهذه + +315 +00:23:09,050 --> 00:23:13,970 +المجموعة مش open، اذا في جزء من الحدود جوا، اه + +316 +00:23:13,970 --> 00:23:17,010 +طبعا لو ده ادرس ال analyticity at any point في + +317 +00:23:17,010 --> 00:23:20,270 +الداخل، معروف ما زال interior point، اذا في جوار + +318 +00:23:20,270 --> 00:23:23,590 +كله جوا المجموعة و العملية سهلة، لكن لما بدي ادرس + +319 +00:23:23,590 --> 00:23:27,290 +في الحدود و بدي اقلش تكون اقلتك عند هذه النقطة، + +320 +00:23:27,290 --> 00:23:29,830 +ايش معنى اقلتك عند هذه النقطة؟ يعني differentiable + +321 +00:23:29,830 --> 00:23:33,260 +في جوايعني define door في الجواهر طب لو بدأنا اكرر + +322 +00:23:33,260 --> 00:23:36,020 +كل الحدود بدأ ادخل جواهر و بدأ ادخل جواهر اذا انا + +323 +00:23:36,020 --> 00:23:37,900 +ايش لازم كان فال define shape اللي تمشي بس في + +324 +00:23:37,900 --> 00:23:41,280 +المجموعة و في الخارج شوية بدي اطلع مرة فكأني انا + +325 +00:23:41,280 --> 00:23:45,200 +بدي ادور علي مجموعة ما تكون open مافيش فيها حدود + +326 +00:23:45,200 --> 00:23:48,480 +اللي هي بيعد الشكل و تحتها و مين؟ تحتها و الأسس + +327 +00:23:48,600 --> 00:23:52,080 +بتكون open تحتوي الاسم فهي لدى وحدنا لاناش هتصرف + +328 +00:23:52,080 --> 00:23:56,140 +differentiable في كل هذه المجموعة ليش؟ هتحتوي + +329 +00:23:56,140 --> 00:23:59,880 +الحدود، مظبوط؟ لأن ما بدناش بدنا جواها، كل نقطة + +330 +00:23:59,880 --> 00:24:02,620 +الحدود بدنا جواها بتبقى هايش يكون differentiable، + +331 +00:24:02,620 --> 00:24:05,020 +إذا هي ال differentiable بساطة هي في مجموعة تحتوي + +332 +00:24:05,020 --> 00:24:08,980 +الحدود يعنياش تحتوي اللي هو الاسم، تحتوي الاسم، + +333 +00:24:08,980 --> 00:24:13,340 +فده هو المفهومفهي تماما بها دي الصورة اذا عشان اول + +334 +00:24:13,340 --> 00:24:16,540 +شي ندرس ال point بدنا جوار تكون different و مافيه + +335 +00:24:16,540 --> 00:24:19,800 +جوار عشان ندرس ال open set analyticity يعني ال + +336 +00:24:19,800 --> 00:24:24,040 +differentiability عشان ندرس closed أو open يعني + +337 +00:24:24,040 --> 00:24:27,360 +فيها جزء من الحدود بدنا مجموعة تكون تحتوي الاسم و + +338 +00:24:27,360 --> 00:24:29,400 +تكون open فبصير ال differentiability هي ال + +339 +00:24:29,400 --> 00:24:35,960 +analyticity نفس المعنى ناخد مثال سريع بسبس عشان + +340 +00:24:35,960 --> 00:24:40,080 +انا اوضح هذه الفكرة لو بدى ادرس الanalyticity لل F + +341 +00:24:40,080 --> 00:24:43,340 +of Z تساوي واحد على Z مثال بسيط على المجموعة + +342 +00:24:43,340 --> 00:24:47,500 +المغلقة Z ناقص واحد اقل او يساوي نص خلينا نحاول + +343 +00:24:47,500 --> 00:24:54,700 +نوضح هذا المثال طبعا المجموعة نرسمها ايش هذه + +344 +00:24:54,700 --> 00:25:00,160 +المجموعة دائرة و المركزها واحد واسخطرة بيساوي نص + +345 +00:25:00,160 --> 00:25:06,190 +فهي دائرة باد الشكل طبعا مغلقةهذه الأس تبعتنا وهذا + +346 +00:25:06,190 --> 00:25:11,730 +الواحد وهذا طبعا هيكون تلاتة على اتنين وهذا نص اه + +347 +00:25:11,730 --> 00:25:14,770 +فطبعا هنا عشان اقول ان ايش هذه analytic لازم الاجي + +348 +00:25:14,770 --> 00:25:18,650 +open set تحتويها و تكون ده ليش قاعدة الاشتراك في + +349 +00:25:18,650 --> 00:25:21,490 +المحل طبعا قولنا ان واحدة عايزة تقابل اشتراك عندنا + +350 +00:25:21,490 --> 00:25:24,370 +اننا قابلنا واحدة عندنا صفر فبدي open set تحتوي + +351 +00:25:24,370 --> 00:25:27,250 +هذه المجموعة انا على سبيل المثال اخدت ايهش زي + +352 +00:25:27,250 --> 00:25:30,290 +بناقص واحد تساومين واحد فانا هناخد مجموعة اكبر + +353 +00:25:30,290 --> 00:25:36,420 +شوية تكون open فانكبر open بهذا الشكلطبعاً صح + +354 +00:25:36,420 --> 00:25:41,000 +كمثال المهم أنه ليش فيه open set تحتوي صحيح تلت + +355 +00:25:41,000 --> 00:25:44,480 +ارباع او واحد المهم open set تحتوي فهي طبعا قال + +356 +00:25:44,480 --> 00:25:46,840 +طبعا ليش هاد ال analytic لأنه قابل اشتقاق + +357 +00:25:46,840 --> 00:25:49,380 +everywhere في هذه ال open set حتى لو كبرت شوية + +358 +00:25:49,380 --> 00:25:53,340 +طبعا بشكل خاص الحدود صاروا هنا جوا النقاط اللي + +359 +00:25:53,340 --> 00:25:56,580 +differentiable عندهم و حواليهم عندهم و حواليهم + +360 +00:25:56,580 --> 00:26:01,790 +فبهذا المعنىفانا لما بده اقول ان هيش analytic and + +361 +00:26:01,790 --> 00:26:04,310 +open set يعني differentiable من open set ان انا + +362 +00:26:04,310 --> 00:26:07,610 +بتحدث عن مجموعة غير مفتوحة بحصل انها + +363 +00:26:07,610 --> 00:26:10,530 +differentiable في open set تحتوي الاسم + +364 +00:26:10,530 --> 00:26:14,050 +differentiable في open set تحتوي main الاسم طبعا + +365 +00:26:14,050 --> 00:26:16,590 +لما بتحدث عن differentiable بتقول ان open set يعني + +366 +00:26:16,590 --> 00:26:22,540 +نفس المعنى هيش analytic في open setفهذه هي التلات + +367 +00:26:22,540 --> 00:26:26,140 +حالات اللى بتقابل الناس بقى ان ادرس analyticity + +368 +00:26:26,140 --> 00:26:30,480 +عند نقطة ادرس analyticity في open set ادرس + +369 +00:26:30,480 --> 00:26:33,700 +analyticity في مجموعة غير مفتوحة بتحتوي جزء من ال + +370 +00:26:33,700 --> 00:26:36,880 +domain او جزء من الحدود او كل الحدود جزء من الحدود + +371 +00:26:36,880 --> 00:26:40,680 +على اقل او كل الحدود فهذه اول دهش التلات تعريفات + +372 +00:26:40,680 --> 00:26:46,550 +او التلات حالات وكوان فرق بينهم في التعريفمصطلح + +373 +00:26:46,550 --> 00:26:50,530 +مهم جدا انمر عليه Entire Function الـ Entire + +374 +00:26:50,530 --> 00:26:55,150 +Function ده المصطلح بيطلقوه على الدالة اللي هي + +375 +00:26:55,150 --> 00:26:59,550 +Analytic في كل ال Complex بلاي إذا هي Analytic لكل + +376 +00:26:59,550 --> 00:27:03,090 +ال Z بنسميها Entire Functionبنسميها Entire طبعا + +377 +00:27:03,090 --> 00:27:05,350 +احنا مر علينا مصطلح Entire يعني الكل Entire + +378 +00:27:05,350 --> 00:27:08,230 +complex plane يعني الكل اللي هو إيش ال complex + +379 +00:27:08,230 --> 00:27:11,270 +plane finite entire يعني أنتك برضه في كل ال + +380 +00:27:11,270 --> 00:27:14,490 +complex plane ف function is analytic at each point + +381 +00:27:14,490 --> 00:27:17,630 +in the entire finite complex plane طبعا هو في + +382 +00:27:17,630 --> 00:27:19,430 +الكلمة finite عشان أكيد لإن ال infinity مش داخلة + +383 +00:27:19,430 --> 00:27:22,190 +هو ال complex plane العادى لما يقولنا هنا دا + +384 +00:27:22,190 --> 00:27:25,910 +extended complex plane لما نضغط الملأ نهاية up is + +385 +00:27:25,910 --> 00:27:30,960 +called an entire functionطبعا أسهل مثال و أبسط + +386 +00:27:30,960 --> 00:27:37,200 +مثال الدالة كثيرة الحدود قابل شقاق everywhereقابل + +387 +00:27:37,200 --> 00:27:40,860 +اشتقاق everywhere طبعا ال complex plane هذا ايش + +388 +00:27:40,860 --> 00:27:44,220 +كمجموعة هو open set و هو closed set بنفس الواقفة + +389 +00:27:44,220 --> 00:27:46,280 +يعني هو open فلما ده .. ده .. ده .. ده .. ده .. ده + +390 +00:27:46,280 --> 00:27:47,080 +.. ده .. ده .. ده .. ده .. ده .. ده .. ده .. ده .. + +391 +00:27:47,080 --> 00:27:49,140 +ده .. ده .. ده .. ده .. ده .. ده .. ده .. ده .. ده + +392 +00:27:49,140 --> 00:27:49,820 +.. ده .. ده .. ده .. ده .. ده .. ده .. ده .. ده .. + +393 +00:27:49,820 --> 00:27:51,000 +ده .. ده .. ده .. ده .. ده .. ده .. ده .. ده .. ده + +394 +00:27:51,000 --> 00:27:52,040 +.. ده .. ده .. ده .. ده .. ده .. ده .. ده .. ده .. + +395 +00:27:52,040 --> 00:27:52,420 +ده .. ده .. ده .. ده .. ده .. ده .. ده .. ده .. ده + +396 +00:27:52,420 --> 00:27:54,080 +.. ده .. ده + +397 +00:28:09,540 --> 00:28:14,100 +Show that f of z تساوي cosine of x cosine + +398 +00:28:14,100 --> 00:28:17,940 +hyperbolic of y ناقص i sine of x sine hyperbolic + +399 +00:28:17,940 --> 00:28:22,140 +of y is an entire function ايش معنى هذا السؤال؟ + +400 +00:28:22,140 --> 00:28:26,420 +ايش مطلوب؟ بدي اثبت ان f prime of z exist for all + +401 +00:28:26,420 --> 00:28:32,320 +z فهذا هو معنى السؤال في ضوء التعريف الأخير لما + +402 +00:28:32,320 --> 00:28:35,320 +يقول يثبت ان ال f entire يعني يثبت ان f prime + +403 +00:28:35,320 --> 00:28:39,370 +exist for all z نفس المعنى نفس المعنىعشان ايك انا + +404 +00:28:39,370 --> 00:28:41,570 +بقول ان واحدة section داخل فاني بتعلم داخل مش فارق + +405 +00:28:41,570 --> 00:28:43,950 +بدل ما اقولك اثبت انها انطيار بقولك اثبت انها إيش + +406 +00:28:43,950 --> 00:28:49,790 +نفس المطلوب بس اللغة هتختلف فالأمور احنا قاعدين + +407 +00:28:49,790 --> 00:28:52,190 +بالركز على ال differentiability بس المعنى الدقيق + +408 +00:28:52,190 --> 00:28:57,470 +اللي حاطناها في التعريف لكن من ناحية عملية فشيري + +409 +00:28:57,470 --> 00:29:01,490 +جديدة شباب بس هو شوية اللي هو التعريفات بدلات كله + +410 +00:29:01,490 --> 00:29:04,290 +بدلات مين ال differentiable دلات ال differentiable + +411 +00:29:04,290 --> 00:29:11,120 +فخليني نشوف هذا المثالمثال رقم اتنين f of z تساوي + +412 +00:29:11,120 --> 00:29:18,020 +cosine ال X cosine hyperbolic ال Y ناقص I sine ال + +413 +00:29:18,020 --> 00:29:22,080 +X sine hyperbolic ال Y طبعا من أيث بتمنى ايش + +414 +00:29:22,080 --> 00:29:30,380 +solution نعم we want to show entire يعني ايش f + +415 +00:29:30,380 --> 00:29:40,900 +prime of z exist for all z تنتمي لسهتمام فهذا هو + +416 +00:29:40,900 --> 00:29:44,540 +ايش اول حاجة فسرنا ما نا تنطيع اول خطوة في الحل + +417 +00:29:44,540 --> 00:29:47,840 +فسرنا ما نا تنطيع وهذا الكلام مهم جدا يا شباب عشان + +418 +00:29:47,840 --> 00:29:50,520 +ايه دائما في الرياضيات انك تعرف التعريفات تحفظها + +419 +00:29:50,520 --> 00:29:56,100 +هذا شيء ضروري لكن قد يكون كافر تحفظ القانون تحفظ + +420 +00:29:56,100 --> 00:30:00,560 +التعريف ضروري تستغنيش عنه من غير مش هتعرف تمشي لكن + +421 +00:30:00,560 --> 00:30:03,860 +اللي حفظ لحاله ممشيش بتاعتقف التطبق بتاعتقف التطبق + +422 +00:30:03,860 --> 00:30:04,360 +تمام + +423 +00:30:14,760 --> 00:30:20,480 +طبعا اول حاجة هنا U of X and Y U of X and Y تساوي + +424 +00:30:20,480 --> 00:30:31,320 +Cos X Cos Y V of X and Y تساويSin X وSin Y طبعا + +425 +00:30:31,320 --> 00:30:35,240 +ننتبه كيف نجيب ال U و ال V و ننتبه للإشارات لإن + +426 +00:30:35,240 --> 00:30:39,280 +الأمور دقيقة و أي خطأ هيغير السؤال طيب دول معرفية + +427 +00:30:39,280 --> 00:30:42,120 +طبعا everywhere لإن الدوال هذه دوال domain تبح على + +428 +00:30:42,120 --> 00:30:45,020 +كل ال R فبالتالي لما تصوم مضربيه في بعض يصير + +429 +00:30:45,020 --> 00:30:49,270 +domain تبح ع ر تر بي او ار تر بي او ارتونحسب + +430 +00:30:49,270 --> 00:30:59,090 +الواقع المشتقات UX تساوي سالب sin X cos Y UY تساوي + +431 +00:30:59,090 --> 00:31:08,270 +cos X sin YVx تساوي سالب cosine ال X sin + +432 +00:31:08,270 --> 00:31:15,070 +hyperbolic Y و Vy تساوي سالب sin X cosine + +433 +00:31:15,070 --> 00:31:21,350 +hyperbolic Y طبعا كلهم exist all exist و متصلين + +434 +00:31:21,350 --> 00:31:25,390 +and continuous لأن الدوال اللي بتكونهم مش دوال + +435 +00:31:25,390 --> 00:31:30,010 +متصلة خواصها جيدة جدا طبعا continuous for all x y + +436 +00:31:30,010 --> 00:31:36,200 +تنتمي للأرضفهذه الأمور مباشرة فانا بناخدها شباب + +437 +00:31:36,200 --> 00:31:39,780 +جاهزة من دراساتها السابقة في تفاضة الألف في تفاضة + +438 +00:31:39,780 --> 00:31:42,340 +البقى في تفاضة الجيم اي معلومة عارفينها عن الدولة + +439 +00:31:42,340 --> 00:31:44,340 +هناخدها مباشرة مش هناخدها .. مش مطلوب من الناس + +440 +00:31:44,340 --> 00:31:46,840 +بتنوع دي متصلة او انها معرفة خلاص هذه المعلومات + +441 +00:31:46,840 --> 00:31:51,080 +السابقة هناخدها جاهزة اه ممتاز اذا نقل بقى ايش .. + +442 +00:31:51,080 --> 00:31:53,520 +هتطبق اللي هو النظرية بتبقى نتأكد ان هو ايش ال + +443 +00:31:53,520 --> 00:31:56,160 +questions really questions متحققين اه moreover + +444 +00:31:59,240 --> 00:32:09,160 +Ux انقارن مع Vy متساويين صح تساوي Vy and Uy بتساوي + +445 +00:32:09,160 --> 00:32:14,200 +سالف Vx نعم اتاكد منهم شفوا بيدا الشكل مش مشكلة اه + +446 +00:32:14,200 --> 00:32:22,640 +Thus if F prime of Z exist for all Z تنتمي لسه + +447 +00:32:22,640 --> 00:32:31,230 +واحد دي معناته ان هي F in time and henceF is نعم + +448 +00:32:33,870 --> 00:32:38,970 +بدأ .. يعني .. لأ .. بدك تثبت .. تكتب كده يا .. لو + +449 +00:32:38,970 --> 00:32:41,710 +أنا مش معروف هو بدك تثبت .. لكن احنا بشكل أساسي مش + +450 +00:32:41,710 --> 00:32:44,610 +.. احنا بنتعامل مع دواء زيك مشهورة كلها حد قدابية + +451 +00:32:44,610 --> 00:32:47,390 +.. مش .. مش .. مش غيرادة لو نتقل في تفاصيل دواء + +452 +00:32:47,390 --> 00:32:49,610 +المقتصر ولا لأ .. احنا بنستنى نستعمل زي ما حكيتلك + +453 +00:32:49,610 --> 00:32:52,650 +.. نستعمل كل معلوماتنا السابقة من الف با جيب كله + +454 +00:32:52,650 --> 00:32:56,010 +ونقولنا .. بس نتأكد من الكلام .. نحف .. ن .. نقدر + +455 +00:32:56,010 --> 00:32:59,010 +.. نتأكد منه ونفحصه عشان نعرف ان اش .. احنا في + +456 +00:32:59,010 --> 00:33:04,330 +طريق الصحيح .. أف is analyticentire اسف is an + +457 +00:33:04,330 --> 00:33:08,610 +entire function طب اي اناتك everywhere in .. in + +458 +00:33:08,610 --> 00:33:15,730 +entire function .. in entire function اه + +459 +00:33:15,730 --> 00:33:18,090 +فبنلاحظ يا شباب انه زي ما احنا شايفينه حتى الآن + +460 +00:33:18,090 --> 00:33:23,010 +المصطلح جديد لكن عشان نوصله اعتمدناش ع ال + +461 +00:33:23,010 --> 00:33:25,650 +differential الماضي ال differentiability فالادوات + +462 +00:33:25,650 --> 00:33:29,390 +قديمة لكن يمكناش اللغة الجديدة و المصطلحات الجديدة + +463 +00:33:29,390 --> 00:33:32,570 +لكن نفس الأدوات الصحيح اي سؤال + +464 +00:33:49,340 --> 00:33:54,700 +ننتقل لنقطة أخرى نقطة جديدة singular point طبعا + +465 +00:33:54,700 --> 00:33:59,080 +احنا يمكن معلومه قولنا analytic يعني holomorphic + +466 +00:33:59,080 --> 00:34:05,340 +او regular فالان singular point يعني نقطة غير + +467 +00:34:05,340 --> 00:34:09,020 +عادية singular point نقطة غير عادية + +468 +00:34:14,900 --> 00:34:18,420 +فهذا طبعا بيجي معلومة اقرب لما نقول regular يعني + +469 +00:34:18,420 --> 00:34:22,040 +ايش عادية هنا singular يعني غير عادي هو النقطة + +470 +00:34:22,040 --> 00:34:27,640 +اللي هيش الغير عادي ايش تعريفها طبعا هو الدالب + +471 +00:34:27,640 --> 00:34:30,140 +يكون مش ادلتك اللي عندها لكن برضه يكون التعريف + +472 +00:34:30,140 --> 00:34:34,680 +شوية دقيق زي ما شفنا انه ادلتك عند point مش بس ال + +473 +00:34:34,680 --> 00:34:36,740 +differential اللي عنده هو point وانما متعلق في + +474 +00:34:36,740 --> 00:34:40,360 +الجوار و هنا الكلام نفس القضية هيتعلق في الجوار + +475 +00:34:41,530 --> 00:34:44,950 +بقول الـ singular point هي نقطة الدالة ليست + +476 +00:34:44,950 --> 00:34:50,070 +identical عندها Z0 مش بس هيك وإن أي جوار بتكون + +477 +00:34:50,070 --> 00:34:53,450 +الدالة مش identical على الأقل النقطة معاها يعني + +478 +00:34:53,450 --> 00:34:57,150 +كأنه هذه النقطة معزولة في أي جوار بدأت في نقاط + +479 +00:34:57,150 --> 00:35:01,030 +الدالة انتقال عندها نزغر الجوار في .. خليني بس + +480 +00:35:01,030 --> 00:35:05,260 +أغير الألوان فهذه Z0أنا لما ياخد أي يوارح عليها + +481 +00:35:05,260 --> 00:35:10,920 +جميل نقاط الدالة analytical عندها في نقاط هنا في + +482 +00:35:10,920 --> 00:35:13,940 +نقاط الدالة analytical عندها فإنه كأنه هذه النقطة + +483 +00:35:13,940 --> 00:35:16,500 +هي النقطة المعزولة الوحيدة اللي الدالة مش + +484 +00:35:16,500 --> 00:35:18,800 +analytical عندها فبقول a function is not + +485 +00:35:18,800 --> 00:35:21,360 +analytical at a point that is zero but is analytic + +486 +00:35:21,910 --> 00:35:25,410 +at some point ما هو طبعا ان الانالتكال عند النقطة + +487 +00:35:25,410 --> 00:35:28,290 +التانية لذا هي differentiable في الجوار فكأن + +488 +00:35:28,290 --> 00:35:30,570 +الدالة differentiable في جميع النقاط مع بعض النقطة + +489 +00:35:30,570 --> 00:35:33,690 +المعزولة هذه بسميها singular point بسميها singular + +490 +00:35:33,690 --> 00:35:37,670 +point فهي بتكون اللي هي not analytic عند النقطة + +491 +00:35:37,670 --> 00:35:42,070 +لكن أي جوار هتكون على الأقل انالتكال النقطة في هذا + +492 +00:35:42,070 --> 00:35:45,950 +الجوار لدى ما يصغر الجوار أو يكبر فبسميها ايش + +493 +00:35:45,950 --> 00:35:48,150 +singular point او singularity + +494 +00:35:50,360 --> 00:35:55,000 +خلّيني أشوف مثال نفهم فيه التعريف بشكل أفضل طبعا + +495 +00:35:55,000 --> 00:36:00,640 +مثالنا اللي هو احنا شغالين عليه لأ هذا مختلف شوية + +496 +00:36:00,640 --> 00:36:02,840 +واحد على زي التربية احنا انا شغالنا على واحد على + +497 +00:36:02,840 --> 00:36:07,100 +زي فهذا المش دالة قريبة جدا واحد على زي التربية + +498 +00:36:07,100 --> 00:36:10,800 +طبعا ال domain تبعها كل ال C معدل Zero وقابل + +499 +00:36:10,800 --> 00:36:13,420 +اشتقاق في كل ال C معدل Zero في كل ال domain مستقفة + +500 +00:36:13,420 --> 00:36:16,840 +سالة اتنين على زي التكييف بدون اي مشاكل اطلاق + +501 +00:36:16,840 --> 00:36:18,340 +فاحنا عندنا هذا المثال + +502 +00:36:21,400 --> 00:36:26,600 +الأول فعنا اللي هو f of z تسوى واحد على z تربيه + +503 +00:36:26,600 --> 00:36:31,620 +طبعا f prime of z تسوى سالب اتنين على z تكلفة + +504 +00:36:31,620 --> 00:36:35,760 +معرفة لكل z مع عداء الصفر اه فالان هذا مثال ان + +505 +00:36:35,760 --> 00:36:39,380 +الصفر هنا بسميها singular point بسميها singular + +506 +00:36:39,380 --> 00:36:43,300 +point لانه لما نيجي ندرس هنا كيف التعريف بده ينطبق + +507 +00:36:43,300 --> 00:36:47,820 +هي الصفر طبعا الدالة مش معرفة عند الصفر و برضه مش + +508 +00:36:47,820 --> 00:36:49,220 +ناجحة عند الصفر طبعا شيء automatic + +509 +00:36:53,090 --> 00:36:55,750 +بتكون هي اش الاقل ادلتك عن النقطة الحقيقة ادلتك عن + +510 +00:36:55,750 --> 00:36:59,990 +جميع النقات اه ادلتك عن جميع النقات فده اقوى من ال + +511 +00:36:59,990 --> 00:37:02,170 +.. من التعريف و بيقول بس الاقل اجي النقطة انا اجي + +512 +00:37:02,170 --> 00:37:05,770 +النقات كتير ده المزاقر الجوار فيبتمي اش ادلتك في + +513 +00:37:05,770 --> 00:37:11,050 +هذا الجوار بس ايش بنحذف من الصفر بس يصفر فهذا تكون + +514 +00:37:11,050 --> 00:37:14,290 +هي ال singular point فكان هي النقطة الوحيدة اشذة + +515 +00:37:14,290 --> 00:37:18,490 +عن الصياق ده اللي ادلتك مقعد عندين؟ هذه النقطة + +516 +00:37:18,490 --> 00:37:21,770 +مقعد عند هذه النقطة فسميها singular point سميها + +517 +00:37:21,770 --> 00:37:28,160 +singular pointطبعا ليش التعريف شويه مش مباشر أو + +518 +00:37:28,160 --> 00:37:32,640 +بهذا الشكل؟ بدا نفهم هل جاءت ال function f of z + +519 +00:37:32,640 --> 00:37:37,560 +بصوى z تربية طبعا differentiable عند ال zero ومش + +520 +00:37:37,560 --> 00:37:41,680 +differentiable ولا عن نقطة أخرى غير الصفر فهنا بدا + +521 +00:37:41,680 --> 00:37:44,660 +نفهم الدقة هنا طبعا هل جاءت مزار يعمل على سبيل + +522 +00:37:44,660 --> 00:37:48,560 +المثال f of z بصوى z تربية غير قابل اشتراك عند + +523 +00:37:48,560 --> 00:37:51,040 +الواحد، مظبوط؟ هل معناه أن الواحد هنا singular + +524 +00:37:51,040 --> 00:37:56,090 +point؟المثال بيقول لأ و احنا مش كفاية تكون نط + +525 +00:37:56,090 --> 00:37:58,130 +قدرتك طب النط differentiable يعني انا عارف اقول نط + +526 +00:37:58,130 --> 00:38:00,830 +قدرتك اوتوماتيك لكن differentiable مش كافية بتكون + +527 +00:38:00,830 --> 00:38:04,190 +في الجوار اه فهنا النقاط اللي هو عشان نفهم التعريف + +528 +00:38:04,190 --> 00:38:08,430 +بشكل بشكل دقيق فمثلا انا اخد هذا المثال هذا المثال + +529 +00:38:08,430 --> 00:38:11,670 +بس differentiable عند ال zeroفهو ليس analytic ولا + +530 +00:38:11,670 --> 00:38:14,430 +عند نقطة على الإطلاق في نفس الوقت هو مالهوش ولا + +531 +00:38:14,430 --> 00:38:17,810 +singular point لإن مافيش نقطة تكون هي شاذة كل + +532 +00:38:17,810 --> 00:38:21,290 +النقاط نفس الاشي مافيش نقطة تكون هي ما هي النقطة + +533 +00:38:21,290 --> 00:38:23,690 +الوحيدة اللي مافيهش اللي عندها التحليلية ال + +534 +00:38:23,690 --> 00:38:26,650 +analyticity وباجية النقاط اللي فيها ال analyticity + +535 +00:38:26,650 --> 00:38:28,890 +ده اللي .. ده اللي فمافيش فينا ولا singular point + +536 +00:38:28,890 --> 00:38:32,430 +لإن هو جد معظم .. لو يعقد أي ايوار بيجد نقاط .. + +537 +00:38:32,430 --> 00:38:35,590 +بيجدش بيجد نقاط ان ده ليش analytic انت تكون ليش + +538 +00:38:35,590 --> 00:38:37,350 +analytic اللي عندك لإن هو مافيش analytic ولا عند + +539 +00:38:37,350 --> 00:38:40,270 +نقطةفجد ما انا هاخد اي جواهر و مافيش نقاط بتكون ده + +540 +00:38:40,270 --> 00:38:44,070 +لأ انا انا انا انا انا انا انا انا انا انا انا انا + +541 +00:38:44,070 --> 00:38:44,770 +انا انا انا انا انا انا انا انا انا انا انا انا + +542 +00:38:44,770 --> 00:38:48,150 +انا انا انا انا انا انا انا انا انا انا انا + +543 +00:38:48,150 --> 00:38:48,870 +انا انا انا انا انا انا انا انا انا انا انا انا + +544 +00:38:48,870 --> 00:38:51,450 +انا انا انا انا انا انا انا انا انا انا انا انا + +545 +00:38:51,450 --> 00:38:53,330 +انا انا انا انا انا انا انا انا انا انا انا انا + +546 +00:38:53,330 --> 00:38:53,350 +انا انا انا انا انا انا انا انا انا انا انا انا + +547 +00:38:53,350 --> 00:38:58,330 +انا انا انا + +548 +00:39:26,370 --> 00:39:34,310 +خلّيني أمر على بعض الملاحظة .. بعض الأمور الهامة + +549 +00:39:35,510 --> 00:39:38,930 +هنشوف اللي هو بعض البلاحظات، بعض التعليقات، بعض + +550 +00:39:38,930 --> 00:39:42,590 +اللي هو .. ممكن اللي هو عملت تلخيص لبعض الأمور و + +551 +00:39:42,590 --> 00:39:46,400 +رابطها مع بعضاحنا هنا نتحدث عن domain، إيش معناه + +552 +00:39:46,400 --> 00:39:49,680 +ال domain؟ open connected set، فاحنا عندنا مجموعة + +553 +00:39:49,680 --> 00:39:52,700 +مفتوحة واش و connected، فإذا لما نتحدث عن + +554 +00:39:52,700 --> 00:39:55,300 +differentiability هنا، يكوناش ال analyticity يعني + +555 +00:39:55,300 --> 00:39:57,340 +differentiability في ال domain، differentiability + +556 +00:39:57,340 --> 00:40:00,460 +يعني analyticity في ال domain، لأنه إيش؟ open set، + +557 +00:40:00,460 --> 00:40:02,480 +فهو بنطبق على أي open set؟ connected ولا لأ؟ + +558 +00:40:02,480 --> 00:40:05,600 +التعريف، لكن احنا هناخداش في شرط أضعف نعيش إنها + +559 +00:40:05,600 --> 00:40:09,010 +connectedطيب أول حاجة أقعد بقوللي إذا ده ال + +560 +00:40:09,010 --> 00:40:12,290 +analytic فهي continuous طبعا شي طبيعي لإن analytic + +561 +00:40:12,290 --> 00:40:13,650 +يعني إيش differentiable و ال differentiability + +562 +00:40:13,650 --> 00:40:17,730 +implies continuity لإن احنا في open set فهذا + +563 +00:40:17,730 --> 00:40:20,970 +الكلام صحيح فإذا ندى بنأكد عليها المعلومة طبعا هي + +564 +00:40:20,970 --> 00:40:23,210 +غير مباشرة المفروض تكون معروفة ولكن بنأكد عليها + +565 +00:40:23,750 --> 00:40:27,990 +النقطة التانية يمكن احنا طبقنا عليها إذا ال F + +566 +00:40:27,990 --> 00:40:31,130 +Analytic يعني differentiable النظرية الأولى لأنسان + +567 +00:40:31,130 --> 00:40:33,970 +اللي كنتش لازم ال U و ال V يحققوه ال Cauchy + +568 +00:40:33,970 --> 00:40:37,250 +Riemann Equations يعني اللي هو ال Ux و ال Uy و ال + +569 +00:40:37,250 --> 00:40:39,590 +Vx exist و يحقق ال Cauchy Riemann Equation هذا + +570 +00:40:39,590 --> 00:40:42,190 +اتجاه الأول Analyticity يعني ايش؟ + +571 +00:40:42,190 --> 00:40:44,530 +Differentiability يعني Cauchy Riemann Equation طيب + +572 +00:40:44,530 --> 00:40:47,390 +العكس و هذا ال book برضه احنا شغلناها بس برضه + +573 +00:40:47,390 --> 00:40:50,590 +بنأكد عليه إذا ال partial derivative exist و + +574 +00:40:50,590 --> 00:40:54,160 +بيبقوا continuous on Dهو يحققوا الـ Query من الـ + +575 +00:40:54,160 --> 00:40:56,720 +Questions اللي عارفها Analytic لأنه خلاص زي ما + +576 +00:40:56,720 --> 00:41:00,300 +يحلينا المثال .. بس بنأكد على هذه المعلوم أن + +577 +00:41:00,300 --> 00:41:03,580 +الأمور واضحة مافيش فيها أي لبس لأنه مازال + +578 +00:41:03,580 --> 00:41:06,620 +differentiable على كل المجموعة أي asset تحقق + +579 +00:41:06,620 --> 00:41:08,920 +الشروط على كل ال open set يعني differentiable على + +580 +00:41:08,920 --> 00:41:11,700 +كل ال open set دي إذا ماهيش Analytic على من؟ على + +581 +00:41:11,700 --> 00:41:15,140 +ال دي، على ال دي، انأكد على هذا الكلام تمام + +582 +00:41:15,140 --> 00:41:20,290 +ملاحظات إضافيةالان انا عندي two analytic functions + +583 +00:41:20,290 --> 00:41:25,290 +هذي هيدينا شوية كيف نطور الأمور فبقولي مجموعهم + +584 +00:41:25,290 --> 00:41:29,330 +بيكون analytic و الفرق بينهم analytic حاصل ضربهم + +585 +00:41:29,330 --> 00:41:34,590 +analytic و قسمتهم analytic بشرط ان المقام ليه سوزي + +586 +00:41:34,590 --> 00:41:37,670 +فهذه النقطة مباشرة طبعا من differentiable برضه انت + +587 +00:41:37,670 --> 00:41:42,150 +تتحدث عن دي لإن احنا عارفين ان هو دلتين + +588 +00:41:42,150 --> 00:41:44,330 +differentiable فتدفضوا شباله وتوزعوا على الجامعة + +589 +00:41:44,330 --> 00:41:47,370 +على الطرحوحصل ضرب القانون ما زال differentiable + +590 +00:41:47,370 --> 00:41:49,370 +برضه حصل ضرب الـdifferentiable والقسمة + +591 +00:41:49,370 --> 00:41:52,110 +differentiable طالما المقام لا يساوي فيه فهذا + +592 +00:41:52,110 --> 00:41:54,870 +الكلام automatic نقطة إضافية كمان هو ال + +593 +00:41:54,870 --> 00:41:57,390 +composition أيضا لل two analytic function برضه + +594 +00:41:57,390 --> 00:42:02,030 +بتتم analytic طبعا مع القيود أنه تكون الداخلية + +595 +00:42:02,030 --> 00:42:04,150 +differentiable في domain و الخارجية differentiable + +596 +00:42:04,150 --> 00:42:09,170 +عن قيم الداخلية بهذا الشكل فال composition of two + +597 +00:42:09,170 --> 00:42:11,650 +analytic function is analytic + +598 +00:42:13,370 --> 00:42:17,630 +الملاحظة السادسة هي تعليق على عملية القسمة احنا + +599 +00:42:17,630 --> 00:42:20,770 +قلنا انواش اذا الدالة .. اذا الدالتين analytic + +600 +00:42:20,770 --> 00:42:24,950 +فالقسمة معاهماش analytic ماقعده أصفار المقام طب + +601 +00:42:24,950 --> 00:42:29,570 +لما نيجي حالة خاصة دالة نسمية كثيرة حدود على كثيرة + +602 +00:42:29,570 --> 00:42:33,810 +حدود المقام ال bus analytic everywhere المقام + +603 +00:42:33,810 --> 00:42:36,710 +analytic everywhere اذا خارج القسمة analytic + +604 +00:42:36,710 --> 00:42:39,750 +ماقعده من أصفار المقام فإذا نجيش بيكون دو أصفر + +605 +00:42:39,750 --> 00:42:42,840 +المقامهما singular point لإن هم مجرد ماياش نقاط + +606 +00:42:42,840 --> 00:42:45,640 +معزولين عن بعض بيكونوا أصفر معزولين عن بعض فبتالي + +607 +00:42:45,640 --> 00:42:48,940 +هم ماياش وين ما كانتك معادة من أصفر مقارفة ميكونوا + +608 +00:42:48,940 --> 00:42:54,300 +أياش singular point بيكونوا singular pointنعم اللي + +609 +00:42:54,300 --> 00:42:57,120 +هي أصفار المقام في الدالة النسبية العملية سهلة جدا + +610 +00:42:57,120 --> 00:43:00,180 +اللي هو إيش اللي هو النقاط ال singular point هم + +611 +00:43:00,180 --> 00:43:03,640 +مين أصفار المقام فدائما زي ما تشوفينا شبه بإن ال + +612 +00:43:03,640 --> 00:43:07,380 +polynomial و التابع له الدالة النسبية من أسهل + +613 +00:43:07,380 --> 00:43:11,040 +الدول من أسهل الدول ففي حال الدالة النسبية ال + +614 +00:43:11,040 --> 00:43:14,500 +singular point هم بس أصفار المقام هم خارج ال + +615 +00:43:14,500 --> 00:43:17,160 +domain نوقفها إن شاء الله المراجعة بنعلق عليها و + +616 +00:43:17,160 --> 00:43:18,040 +بنشوف بعض الأمثل + diff --git a/PL9fwy3NUQKwaRXaqd-S5-vsOEDL-Q45jU/vL7RShsV4rQ.srt b/PL9fwy3NUQKwaRXaqd-S5-vsOEDL-Q45jU/vL7RShsV4rQ.srt new file mode 100644 index 0000000000000000000000000000000000000000..6c0463d914cb4c088321a8b93d95558149762f3d --- /dev/null +++ b/PL9fwy3NUQKwaRXaqd-S5-vsOEDL-Q45jU/vL7RShsV4rQ.srt @@ -0,0 +1,615 @@ +1 +00:00:09,640 --> 00:00:13,300 +بسم الله الرحمن الرحيم فاليوم هنبدأ chapter 6 + +2 +00:00:13,300 --> 00:00:20,880 +وعنوانه residues and poles البواقي والأقطاب فاحنا + +3 +00:00:20,880 --> 00:00:27,260 +شوفنا بنرجع هنا للتكامل وهنرَبِط بين اللغة ال + +4 +00:00:27,260 --> 00:00:30,300 +series وبين التكاملات وبشكل أساسي بين اللغة ال + +5 +00:00:30,300 --> 00:00:34,200 +series وبين التكاملات فطبعًا إحنا عندنا بالنسبة + +6 +00:00:34,200 --> 00:00:39,980 +للتكامل على الـ C f of z dz لو عملنا + +7 +00:00:39,980 --> 00:00:43,440 +parameterization كتبنا الـ C على صورة z تساوي z of t + +8 +00:00:43,440 --> 00:00:48,680 +واللي هو الـ t تنتمي لفترة من a لـ b فالتعريف هو + +9 +00:00:48,680 --> 00:00:55,380 +تكامل من a لـ b f of z of t z prime of t d t هذا + +10 +00:00:55,380 --> 00:00:59,860 +التعريف لكن في عدد من الطرق الأخرى للحساب غير التعريف + +11 +00:00:59,860 --> 00:01:04,900 +وهذه طرق مهمة جدًّا وقوية اللي هي بتعتمد إن أنا بقدر + +12 +00:01:04,900 --> 00:01:07,900 +أحسب التكامل من غير ما أجيب الـ antiderivative ومن + +13 +00:01:07,900 --> 00:01:11,200 +غير ما... فبالتالي إذا في عندي طرق قوية بقدر أحسب + +14 +00:01:11,200 --> 00:01:16,180 +تكاملات متعددة من أهم النظريات إن لو كانت الـ C + +15 +00:01:16,180 --> 00:01:17,520 +closed + +16 +00:01:29,560 --> 00:01:35,050 +النظرية قوية جدًّا بعدها شفنا... طب لو الدالة مش أنا + +17 +00:01:35,050 --> 00:01:38,210 +بتكلم عن الـ C U والـ C فيه بعض المشاكل شفنا فيه + +18 +00:01:38,210 --> 00:01:41,670 +quotient integral formula قلنا إن تكامل على الـ C + +19 +00:01:41,670 --> 00:01:47,410 +برضه كله هنا closed F of Z على Z ناقص Z0 لكل أسّ + +20 +00:01:47,410 --> 00:01:54,030 +زائد واحد DZ بتساوي 2πI على N factorial المشتقة رقم + +21 +00:01:54,030 --> 00:01:57,970 +N عند الـ Z0 برضه هذا قانون جدًّا خلانا فبالتالي أنا + +22 +00:01:57,970 --> 00:02:02,110 +بقدر أكمله داشت صار في عنده مشكلة عند Z0 وقدرت أحسب + +23 +00:02:02,110 --> 00:02:04,610 +التكامل هنا طب لو أنا التكامل صفر هنا ما فيش أنا + +24 +00:02:04,610 --> 00:02:07,110 +التكامل لأن في صفر المقام عند Z0 وقدرت أحسبها بهذه + +25 +00:02:07,110 --> 00:02:11,930 +الصورة وطبعًا في عدة طرق أخرى للحساب إن ممكن أحول + +26 +00:02:11,930 --> 00:02:15,310 +لو في عدة مشكلة واحدة لو في عدة مشاكل برضه بقدر + +27 +00:02:15,310 --> 00:02:19,950 +أتعامل معاهم لو في بقعد Z0 هنا لو في كمان مشاكل Z1 + +28 +00:02:19,950 --> 00:02:23,670 +وZ2 بقدر أعمل منحيات بدل شكل وأقول التكامل على + +29 +00:02:23,670 --> 00:02:25,790 +الـ C++ والتكاملات على كل واحدة من هدول بقدر + +30 +00:02:25,790 --> 00:02:29,530 +أستخدم عدة طرق فالآن هنُجْمِل ونشوف طرق أخرى للحساب + +31 +00:02:29,530 --> 00:02:34,990 +طرق أخرى للحساب فبنبدأ أول section على الـ Residue + +32 +00:02:34,990 --> 00:02:38,870 +فإحنا هدفنا الأساسي زي ما أنا شايف يا شباب هو دراسة التكامل + +33 +00:02:38,870 --> 00:02:42,570 +على Simple Close Contour Simple Close Contour لما + +34 +00:02:42,570 --> 00:02:45,970 +الـ contour ده لأقل تكامل على الـ C وجوّا الـ C باستثناء + +35 +00:02:45,970 --> 00:02:49,330 +بعض النقاط عدد محدود من النقاط finite number of + +36 +00:02:49,330 --> 00:02:51,990 +singular points finite number of singular points + +37 +00:02:51,990 --> 00:02:58,230 +فهذا هو الهدف الأساسي طبعًا الآن Singular Point + +38 +00:02:58,230 --> 00:03:01,770 +تعريفه نتذكره ليس أن الدالة ليست Analytical فقط + +39 +00:03:01,770 --> 00:03:06,730 +وإنما الدالة اللي فيها أنا عندي نقطة هنا Z0 الدالة + +40 +00:03:06,730 --> 00:03:10,130 +مش Analytical عندها طبعًا أمانات Analytic يعني ال + +41 +00:03:10,130 --> 00:03:13,440 +differential والفيجوار عند النقطة دي لما نقول إن + +42 +00:03:13,440 --> 00:03:16,860 +الـ Differentiable عند نقطة معينة إذا كانت F' exists في + +43 +00:03:16,860 --> 00:03:20,800 +some neighborhood حول الـ Z0 طيب، ليست Analytical + +44 +00:03:20,800 --> 00:03:24,140 +عند النقطة الـ Z0 إذا هي ليست Analytical عند الـ Z0 + +45 +00:03:24,140 --> 00:03:28,460 +لكن لما آخد أنا أي جوار صغير أو كبير بقدر ألاقي على + +46 +00:03:28,460 --> 00:03:30,760 +الأقل نقطة واحدة تكون Differentiable عندها فهو أقدر + +47 +00:03:30,760 --> 00:03:35,440 +ألاقي نقطة Differentiable عندها آه، لو أنا أخدت جوار + +48 +00:03:35,440 --> 00:03:41,000 +آخر أصغر أو أكبر برضه بقدر ألاقي فيها نقطة، على الأقل + +49 +00:03:41,000 --> 00:03:44,140 +نقطة، على الأقل نقطة Differentiable اللي عندها، فهذا + +50 +00:03:44,140 --> 00:03:46,860 +معناه الـ singular point singular point of a + +51 +00:03:46,860 --> 00:03:48,680 +function if it's not differentiable and it's a zero + +52 +00:03:48,680 --> 00:03:51,980 +part is differentiable at some points على الأقل نقطة + +53 +00:03:51,980 --> 00:03:54,700 +واحدة in every neighborhood، in every + +54 +00:03:54,700 --> 00:03:57,200 +neighborhood، فهذا تعريف الـ singular point بالشكل + +55 +00:03:57,200 --> 00:04:02,030 +العام إحنا هنَهتَم في موضوعها زي ما أقول إن إحنا هدفنا + +56 +00:04:02,030 --> 00:04:06,050 +دراسة التكامل على منحنة الدالة اللي كله عندها + +57 +00:04:06,050 --> 00:04:08,630 +الدالة اللي كله على المنحنى ويجوّه المنحنى + +58 +00:04:08,630 --> 00:04:11,330 +باستثناء بعض النقاط اللي هم الـ singular point مش + +59 +00:04:11,330 --> 00:04:13,390 +أي نوع من الـ singular point عشان اللي هو بتعلق بال + +60 +00:04:13,390 --> 00:04:16,610 +Laurent series الموضوع ده إحنا هنَهتَم بنوع معين من ال + +61 +00:04:16,610 --> 00:04:19,510 +singular point هو يكون معزول isolated singular + +62 +00:04:19,510 --> 00:04:22,250 +point فهدفنا نعرف إحنا الـ isolated singular point + +63 +00:04:22,250 --> 00:04:27,310 +إيش هي؟ هي نقطة الدالة مش أي نقطة اللي عندها لكن + +64 +00:04:27,310 --> 00:04:30,900 +باقي النقاط كلهم analytical points، analytical + +65 +00:04:30,900 --> 00:04:33,800 +everywhere، هنشوف هنا إحنا إيش بنقول، singular، هي + +66 +00:04:33,800 --> 00:04:36,260 +مش analytical عند z0، لكن في الجوار، في نقطة تكون + +67 +00:04:36,260 --> 00:04:38,680 +analytical، لكن النقاط الأخرى مضمونش، differentiable أيه + +68 +00:04:38,680 --> 00:04:42,520 +analytical ولا لا، لكن الآن أنا بدأت آخد z0، فيها + +69 +00:04:42,520 --> 00:04:49,110 +مشكلة، لكن بقيت أي جوار معين بقدر ألاقي جوار في هذا + +70 +00:04:49,110 --> 00:04:52,890 +الجوار الدالة differentiable تكامل يعني هنا شوف رمز + +71 +00:04:52,890 --> 00:04:56,430 +باللون الأزرق وين اللي هو الدالة مش differentiable تكامل هنا + +72 +00:04:56,430 --> 00:04:59,850 +في بس نقطة بأضمن نقطة هنا بأضمن قلقان نقطة ممكن + +73 +00:04:59,850 --> 00:05:03,070 +يكون أكتر لكن الناس بيقولي كل النقاط في الجوار + +74 +00:05:03,070 --> 00:05:06,050 +الدالة differentiable عندهم ماعرفش زلزل آه طبعًا هنا + +75 +00:05:06,050 --> 00:05:09,150 +الكلام أي جوار بقدر ألاقي فيه نقطة هناش بدي ألاقي + +76 +00:05:09,150 --> 00:05:13,740 +جوار بس واحد يتحقق في هذا الكلام في هذا الكلام بسمي + +77 +00:05:13,740 --> 00:05:16,300 +النقطة اللي هي singular point طبعًا لكن أسميها + +78 +00:05:16,300 --> 00:05:19,720 +isolated معزولة آه فـ الـ singular point إذا بقدر + +79 +00:05:19,720 --> 00:05:21,980 +أأدي جوار طبعًا هذا الجوار اللي فيه الدالة + +80 +00:05:21,980 --> 00:05:24,680 +differentiable كل النقاط معاها ده مين المشكلة عند الـ z0 + +81 +00:05:24,680 --> 00:05:28,960 +فده بقدر أكتبه على صورة مين z ناقص z0 أقل من أبسلون + +82 +00:05:28,960 --> 00:05:33,000 +بدي إسبيلون الـ z0 إذا أكبر من صفر فهو إيه؟ إيش deleted + +83 +00:05:33,000 --> 00:05:35,040 +neighborhoods زي ما سمينا deleted neighborhoods + +84 +00:05:35,040 --> 00:05:38,200 +فالدالة بتكون differentiable بعد الجوار فيجي طبعًا فرصة من + +85 +00:05:38,200 --> 00:05:41,100 +أبسلون أقدر ألاقي أبسلون بيساوي واحد من عشرة + +86 +00:05:41,100 --> 00:05:43,480 +بيساوي نص بيساوي عشرة مش مشكلة المهم أقدر ألاقي + +87 +00:05:43,480 --> 00:05:47,960 +جوار differentiable في كل جوار معادل مركز الـ z0 فبيكون + +88 +00:05:47,960 --> 00:05:50,760 +الدالة الـ singular point أجملها isolated singular point + +89 +00:05:50,760 --> 00:05:53,380 +فعزوز نقطة عين المعنفها هي النقطة الوحيدة في + +90 +00:05:53,380 --> 00:05:56,900 +المشكلة لكن حولها هي المستثناء هي الـ... هي الشاذة + +91 +00:05:56,900 --> 00:06:01,690 +في هذا الجوار هي النقطة الشاذة في هذا الجوار فده + +92 +00:06:01,690 --> 00:06:04,430 +تعريف isolated singular point هي singular point + +93 +00:06:04,430 --> 00:06:09,690 +لكن ممكن أعزلها باقي النقاط في جوارها الدالة differentiable + +94 +00:06:09,690 --> 00:06:13,050 +الـ differentiable حوالها خلينا نفهم هذا التعريف بشكل أفضل + +95 +00:06:13,050 --> 00:06:17,330 +عن طريق مثالين المثالين الحقيقة هيوضحوا الفرق بين + +96 +00:06:17,330 --> 00:06:20,530 +isolated singular point و singular point غير + +97 +00:06:20,530 --> 00:06:26,630 +المعزولة أو not isolated فمثالنا الأول لو طلعنا على + +98 +00:06:26,630 --> 00:06:29,490 +المثال الأول طبعًا ما فيش مطلوب هنا بس مجرد مثال + +99 +00:06:29,490 --> 00:06:35,670 +توضيحي إن الـ F of Z تساوي Z ناقص واحد على Z في Z + +100 +00:06:35,670 --> 00:06:39,210 +تربيع ناقص واحد طبعًا ده نسبة كثيرة حدود على + +101 +00:06:39,210 --> 00:06:42,610 +كثيرة حدود Analytical Everywhere ماعدا أصفار + +102 +00:06:42,610 --> 00:06:45,450 +المقام اللي هي الـ zero والواحد والسالب واحد + +103 +00:06:45,450 --> 00:06:51,850 +فهي دي إيش is analytic for all z تنتمي للـ C ما عدا + +104 +00:06:51,850 --> 00:06:58,450 +الصفر والواحد والسالب واحد فهدول هم هم الـ singular + +105 +00:06:58,450 --> 00:07:03,170 +points طبعًا هنأكد منهم وهنثبت إن هم isolated كيف؟ + +106 +00:07:03,170 --> 00:07:08,870 +لو جينا نرسمها على مستوى x y من الـ singular + +107 +00:07:08,870 --> 00:07:15,530 +points ها هي الصفر صفر singular point والواحد + +108 +00:07:15,530 --> 00:07:22,430 +والسالب واحد والسالب واحد طب ليه هدول معزولين؟ إيش + +109 +00:07:22,430 --> 00:07:25,710 +اللي جاب له؟ تقدر تلاقي deleted neighbourhood الدائرة + +110 +00:07:25,710 --> 00:07:29,930 +اللي كانت عندها فالأقل لو أنا أخدت حوالين الصفر أي + +111 +00:07:29,930 --> 00:07:33,550 +دائرة ليست كبيرة بس أقل من واحد آخد دائرة بلا شكل + +112 +00:07:33,550 --> 00:07:38,250 +deleted neighbourhood أسبيل المثال zero أقل من + +113 +00:07:38,250 --> 00:07:41,960 +مطلق الـ Z أقل من نص ماذا يظهر هنا الـ vertical في + +114 +00:07:41,960 --> 00:07:45,220 +كل هذه الدائرة في هذا الجوار لأن بعيد المشكلة بعد + +115 +00:07:45,220 --> 00:07:48,340 +ذلك هي الواحد السالب واحد ففي جوا هذا الجوار ما فيش + +116 +00:07:48,340 --> 00:07:50,600 +مشاكل غير الصفر آه فإذا أنا هنا بقول إن هيّش + +117 +00:07:50,600 --> 00:07:52,800 +معزولة بقدر أعزلها عن جميع النقاط الأخرى عن الـ + +118 +00:07:52,800 --> 00:07:55,660 +isolated point نفس القضية هنا برضه بقدر إيش آخد + +119 +00:07:55,660 --> 00:07:58,220 +جوار طبعًا إذا اتقطع ما يهمّنيش اتقطع إن إن أنا + +120 +00:07:58,220 --> 00:08:00,880 +ألاقي جوار المهم الصفر ما تدخلش الـ singular point + +121 +00:08:00,880 --> 00:08:03,980 +هنا نفس القضية بقدر آخد مين؟ جوا فدول كلهم إيش + +122 +00:08:03,980 --> 00:08:06,640 +isolated singular point فـ these singular points + +123 +00:08:06,640 --> 00:08:11,300 +are isolated فالتلاتة بقدر أعزلهم عن بعض طيب عشان + +124 +00:08:11,300 --> 00:08:14,580 +الصورة تتضح أفضل طيب إيش الفرق؟ هل ممكن تكون singular point + +125 +00:08:14,580 --> 00:08:19,060 +isolated؟ نعم، لو أخذنا مثالنا الثاني اللي هو f of + +126 +00:08:19,060 --> 00:08:25,140 +z تساوي log z، where هاتي أنماطيك؟ كل مارن سريع، + +127 +00:08:25,140 --> 00:08:27,860 +سلاح سيبعد وكل ميجا تكرير + +128 +00:08:38,030 --> 00:08:41,970 +بما يجينا الـ Z اللي هي 9 و0 الـ Real الـ Z أقل + +129 +00:08:41,970 --> 00:08:46,190 +أويسا أويسا مباشرة + +130 +00:08:46,190 --> 00:08:48,390 +أنا دي composition فيلم بتاعنا بس لما مباشرة + +131 +00:08:48,390 --> 00:08:53,670 +افتحنا الفكرة وين ما قعدت كل النقاط اللي هي فكل + +132 +00:08:53,670 --> 00:08:56,770 +النقاط اللي هي على هذا الخط اللي هو دي في X-axis + +133 +00:08:56,770 --> 00:09:00,410 +كلهم singular points كلهم singular points ليش؟ من + +134 +00:09:00,410 --> 00:09:03,930 +دهنين singular point بس يمكننا نفهم في مرحلة قبلها + +135 +00:09:03,930 --> 00:09:08,990 +لو أخدت أنا أي نقطة منها يا شباب آخد أي جوار عليها، + +136 +00:09:08,990 --> 00:09:14,490 +القبض اللي ذي كان عليها هو فوق وتحت، فسمع عن خطة، + +137 +00:09:14,490 --> 00:09:19,490 +فهذه الـ singular points بشكل تركيز أكثر، لو ارتفع + +138 +00:09:19,490 --> 00:09:21,290 +الصفر، تحت الـ singular point الصفر + +139 +00:09:24,210 --> 00:09:27,510 +لو أخدت الصفر هل ذهبت العزيزي عن مقيم الـ singular + +140 +00:09:27,510 --> 00:09:31,290 +point لأ كان مقصد غير الـ circle اللي تبقى ياخد + +141 +00:09:31,290 --> 00:09:34,370 +تسعة من الـ nature x axis فهي الأولى تبقى شوف هنا + +142 +00:09:34,370 --> 00:09:37,710 +كده إبعاد عن بعض لكن الـ singular point هالي و اللي + +143 +00:09:37,710 --> 00:09:41,770 +جالته مباشرة بدأت تفصل مع بعض بدأت عزيزي فهي الفرق + +144 +00:09:41,770 --> 00:09:45,790 +بينه في تلت نقاط إبعاد عن بعض في فصل بينهم لكن هنا + +145 +00:09:45,790 --> 00:09:50,070 +الـ singular point ماتتش فصل بينهم فهذا هو الفرق + +146 +00:09:52,550 --> 00:09:56,970 +هنا أنا عندي سالب واحد تفصلوا لحاله ولا سالب نص + +147 +00:09:56,970 --> 00:09:59,430 +سالب تسعة من عشرة سالب واحد واحد من عشرة كله من + +148 +00:09:59,430 --> 00:10:01,490 +جنبه تفصلت تفصلت تفصلت تفصلت تفصلت تفصلت تفصلت + +149 +00:10:01,490 --> 00:10:01,870 +تفصلت تفصلت تفصلت تفصلت تفصلت تفصلت تفصلت تفصلت + +150 +00:10:01,870 --> 00:10:03,030 +تفصلت تفصلت تفصلت تفصلت تفصلت تفصلت تفصلت تفصلت + +151 +00:10:03,030 --> 00:10:03,610 +تفصلت تفصلت تفصلت تفصلت تفصلت تفصلت تفصلت تفصلت + +152 +00:10:03,610 --> 00:10:07,290 +تفصلت تفصلت تفصلت تفصلت تفصلت تفصلت تفصلت تفصلت + +153 +00:10:07,290 --> 00:10:11,030 +تفصلت + +154 +00:10:11,030 --> 00:10:12,930 +تفصلت تفصلت تف diff --git a/PL9fwy3NUQKwaRXaqd-S5-vsOEDL-Q45jU/zesVfkOsMq8.srt b/PL9fwy3NUQKwaRXaqd-S5-vsOEDL-Q45jU/zesVfkOsMq8.srt new file mode 100644 index 0000000000000000000000000000000000000000..9621096bef5c3b9a4b6d2f9da2658ca98251a548 --- /dev/null +++ b/PL9fwy3NUQKwaRXaqd-S5-vsOEDL-Q45jU/zesVfkOsMq8.srt @@ -0,0 +1,2333 @@ +1 +00:00:10,280 --> 00:00:15,880 +الرحمن الرحيم هذه المحاضرة الأولى نبدأ فيها + +2 +00:00:15,880 --> 00:00:19,260 +chapter الأول نتحدث فيه عن اللي هو الأعداد المركبة + +3 +00:00:23,880 --> 00:00:30,420 +فنبدأ بتعريف الأعداد المركبة وبعض خواصها في ال + +4 +00:00:30,420 --> 00:00:34,540 +section الأول هنعرف عمليتين اللي هو تعريف الأعداد + +5 +00:00:34,540 --> 00:00:38,620 +المركبة وعمليتي الجمع والضرب، وأنواع الـ section + +6 +00:00:38,620 --> 00:00:42,320 +الأول sums + +7 +00:00:42,320 --> 00:00:43,240 +and products + +8 +00:00:51,430 --> 00:01:00,870 +فنبدأ بتعريف الأعداد المركبة، definition فنعرف + +9 +00:01:00,870 --> 00:01:05,170 +العدد المركب هو عبارة عن زوج مرتب من الأعداد + +10 +00:01:05,170 --> 00:01:09,250 +الحقيقية فالعدد المركب هنبدأ بالتعريف أنه هو عبارة + +11 +00:01:09,250 --> 00:01:17,970 +عن زوج مرتب من الأعداد الحقيقية، we define complex + +12 +00:01:25,050 --> 00:01:41,010 +number كزوج مرتب (x, y) من الأعداد الحقيقية x + +13 +00:01:41,010 --> 00:01:41,430 +و y + +14 +00:01:44,630 --> 00:01:48,190 +فنبدأ هذه نقطة البداية في تعريفنا للعدد المركبة + +15 +00:01:48,190 --> 00:01:53,110 +هنبدأها كأزواج مرتبة، لذلك من الأسماء القديمة قبل + +16 +00:01:53,110 --> 00:01:57,110 +ما يستقر التسمية على العدد المركبة كان أسماء two + +17 +00:01:57,110 --> 00:02:00,550 +dimensional numbers كأنه أعداد في اللي هو اتجاهين + +18 +00:02:00,550 --> 00:02:03,710 +أو أحياناً أعداد اللي هو planar numbers كأنها في + +19 +00:02:03,710 --> 00:02:07,710 +المستوى، إذا بنقارن مع اللي هو العدد الحقيقية لخط + +20 +00:02:07,710 --> 00:02:11,230 +العدد، فهذه الأسماء القديمة، طبعا احنا هنبدأ بهذه + +21 +00:02:11,230 --> 00:02:15,690 +الصورة وهنتقل لصيغة أشهر وأريح في الاستخدام لكن + +22 +00:02:15,690 --> 00:02:20,570 +احنا هنبدأ به كزوج مرتب بالنسبة لنا، خلينا نتفق على + +23 +00:02:20,570 --> 00:02:24,230 +بعض اللي هو الرموز اللي هنستخدمها notations + +24 +00:02:26,780 --> 00:02:31,660 +أه كما اتفقنا أو حكينا في السابق أنه بنحاول نستخدم + +25 +00:02:31,660 --> 00:02:34,660 +رموز متعرف عليها مشهورة، وهذه الرموز لما تكون + +26 +00:02:34,660 --> 00:02:38,380 +مشهورة بتساعدنا في التعامل من غير ما نرجع لماذا + +27 +00:02:38,380 --> 00:02:43,660 +ترمز، فالرموز اللي هو اللي هنتعامل معها (z, w) هي + +28 +00:02:43,660 --> 00:02:55,720 +الأشهر، فـ we denote complex numbers by + +29 +00:02:59,610 --> 00:03:05,430 +مجموعة جميع الأعداد المركبة هنرمزها بالرمز C، فده + +30 +00:03:05,430 --> 00:03:08,810 +نقول الـ notation الأول اللي هنتعرف عليه أو الرمز + +31 +00:03:08,810 --> 00:03:17,330 +الأول، الرمز الثاني we denote the set of all + +32 +00:03:17,330 --> 00:03:25,810 +complex numbers by + +33 +00:03:27,340 --> 00:03:31,360 +C، الرمز هذا وكالعادة اللي هو زي ما فينا الـ real + +34 +00:03:31,360 --> 00:03:36,680 +numbers بنحط اللي هو الخط العمودي عشان نميزه عن + +35 +00:03:36,680 --> 00:03:44,060 +باقي الرموز، أي سؤال مصطلحات + +36 +00:03:44,060 --> 00:03:45,200 +أخرى مهمة + +37 +00:03:50,710 --> 00:03:56,210 +طبعا احنا هنا أصبح أن الرمز (x, y) بين قوسين والفاصلة + +38 +00:03:56,210 --> 00:04:00,430 +يستخدم في صرف الرياضيات لثلاث أشياء، ممكن يرمز لـ + +39 +00:04:00,430 --> 00:04:04,290 +open interval فترة مفتوحة، ممكن يرمز لنقطة في + +40 +00:04:04,290 --> 00:04:07,170 +المستوى (x, y)، وعندنا الجهة المصلحية الجيدة هي ترمز + +41 +00:04:07,170 --> 00:04:09,850 +لمين؟ لـ complex number، لـ complex number، فطبعا + +42 +00:04:09,850 --> 00:04:13,430 +السياق بيكون بيميز بين هذول الثلاث حاجات، نفهم من + +43 +00:04:13,430 --> 00:04:17,910 +السياق ايش الرمز ده والمعنى فيه، طبعا في حالة لو كان + +44 +00:04:17,910 --> 00:04:21,630 +هذا الـ (x, y) عبارة عن نقطة فبنسمي الـ x الإحداثي + +45 +00:04:21,630 --> 00:04:24,690 +الأفقي مثلا أو الـ x coordinate والـ y الإحداثي + +46 +00:04:24,690 --> 00:04:27,870 +الرأسي أو الـ y coordinate، ففي الـ complex هنميزهم + +47 +00:04:27,870 --> 00:04:32,470 +بشكل مختلف، هنسمي الـ x هي الجزء الحقيقي للـ complex + +48 +00:04:32,470 --> 00:04:35,530 +number والـ y هي الجزء التخيلي، فلو ما ليه ليش + +49 +00:04:35,530 --> 00:04:38,170 +مصطلح جديد، طبعا احنا لو كان open interval بنعرف + +50 +00:04:38,170 --> 00:04:40,510 +أن واحد يسموها left endpoint وواحد right endpoint + +51 +00:04:40,510 --> 00:04:43,950 +فالآن في كل مرة باستخدام المصطلح دول يلهم مصطلحات + +52 +00:04:43,950 --> 00:04:47,180 +مختلفة، فاحنا هنتفق أنه إذا كانت الـ x والـ y زوج + +53 +00:04:47,180 --> 00:04:51,800 +المرتب عبارة عن عدد مرتب، فهنسمي الـ x هي الجزء + +54 +00:04:51,800 --> 00:04:55,540 +الحقيقي والـ y هي الجزء التخيلي، بعد قليل هيتضح ليش + +55 +00:04:55,540 --> 00:05:02,380 +هذه التسمية بشكل أوضح، فإذا أول حاجة لو كان في + +56 +00:05:02,380 --> 00:05:06,800 +عندنا let z تساوي (x, y) بيكون number complex + +57 +00:05:13,280 --> 00:05:23,300 +فاعلم أن أول حاجة x is called the real part the + +58 +00:05:23,300 --> 00:05:30,940 +real part of z and هنرمزها بالرمز and denoted by + +59 +00:05:30,940 --> 00:05:39,560 +من كلمة real هناخد Re(z) real part of z بشكل + +60 +00:05:39,560 --> 00:05:46,120 +مختصر، الـ y بيسميها imaginary part is called the + +61 +00:05:46,120 --> 00:05:50,180 +imaginary part + +62 +00:05:50,180 --> 00:05:56,740 +part + +63 +00:05:56,740 --> 00:06:02,860 +of z وهنمزها بالرمز Im(z) أو تقرأ imaginary + +64 +00:06:02,860 --> 00:06:06,940 +of z and denoted by + +65 +00:06:10,070 --> 00:06:15,750 +Im أو imaginary of z، في مصطلح مهم في التعامل مع + +66 +00:06:15,750 --> 00:06:20,070 +العدد المركبة، العدد المركب اللي الجزء الحقيقي + +67 +00:06:20,070 --> 00:06:24,150 +بيسوي صفر فيه بيسموه pure imaginary يعني تخيلي + +68 +00:06:24,150 --> 00:06:27,290 +خالص، ليس في جزء حقيقي يعني كل جزء تخيلي، الجزء + +69 +00:06:27,290 --> 00:06:30,370 +الحقيقي يبقى صفر بيسموه pure imaginary فده برضه + +70 +00:06:30,370 --> 00:06:39,850 +مصطلح أو تعريف تالت، if x تساوي zero then z اللي هي + +71 +00:06:39,850 --> 00:06:48,370 +على صورة (0, y) is called a pure imaginary a + +72 +00:06:48,370 --> 00:06:55,810 +pure imaginary number + +73 +00:06:55,810 --> 00:07:01,570 +يسمى + +74 +00:07:01,570 --> 00:07:02,110 +مثال + +75 +00:07:09,640 --> 00:07:14,340 +لتكن z تساوي (-3, 1) هذا complex number، إذا + +76 +00:07:14,340 --> 00:07:16,800 +بيه المثال لأنه يقول لا أي زوج مرتب من الأعداد + +77 +00:07:16,800 --> 00:07:24,020 +الحقيقية هو complex number، ففي هذه الحالة real z + +78 +00:07:24,020 --> 00:07:31,700 +مش بيساوي -3 والـ imaginary partof z بيساوي + +79 +00:07:31,700 --> 00:07:36,240 +1، ففي هذه البساطة وهذه الأمور الوضوح تتعالوا نأخذ + +80 +00:07:36,240 --> 00:07:40,200 +عليها كبداية، فهذا هو المفصل بالـ image and part والـ + +81 +00:07:40,200 --> 00:07:45,040 +real part في + +82 +00:07:45,040 --> 00:07:51,820 +هنا ملاحظة مهمة جدا، remark كما + +83 +00:07:52,630 --> 00:07:57,270 +هو معروف أن عملية المجموعات الأعداد هذه، كل مجموعة + +84 +00:07:57,270 --> 00:08:00,770 +جديدة تحتوي المجموعة السابقة فإن مجموعة الأعداد + +85 +00:08:00,770 --> 00:08:03,710 +الطبيعية هي مجموعة جزئية من مجموعة الأعداد الصحيحة + +86 +00:08:03,710 --> 00:08:07,030 +وإن مجموعة الأعداد الصحيحة هي مجموعة جزئية من + +87 +00:08:07,030 --> 00:08:10,490 +الأعداد النسبية، والنسبية مجموعة جزئية من الحقيقية + +88 +00:08:10,490 --> 00:08:16,530 +أيضا هنا هنتعرف أن الأعداد الحقيقية هي مجموعة جزئية + +89 +00:08:16,530 --> 00:08:20,960 +من مجموعة الأعداد المركبة، طيب هنا عشان أنا العدد + +90 +00:08:20,960 --> 00:08:24,900 +الحقيقي مثلا 1 عدد حقيقي، كيف سيكون عدد مركب؟ + +91 +00:08:24,900 --> 00:08:31,360 +لازم أكتب على صورة زوج مرتب، فضلاً في سؤال، بس كيف نكتب + +92 +00:08:31,360 --> 00:08:35,940 +على صورة زوج مرتب؟ فأنت عارف هنا أن أي عدد حقيقي x + +93 +00:08:35,940 --> 00:08:39,660 +عشان أخليه جزء من عدد مرتب حتكتبه على صورة زوج مرتب + +94 +00:08:39,660 --> 00:08:44,380 +(x, 0) فالعدد الحقيقي هو في نفس الوقت عدد مرتب ولكن + +95 +00:08:44,380 --> 00:08:47,840 +اتفاقاً مع هذا التعريف هنكتبه على صورة زوج مرتب، الجزء + +96 +00:08:47,840 --> 00:08:51,680 +اللي تخيلي فيه صفر، فأي x تنتمي للأعداد الحقيقية هنكتبه على صورة + +97 +00:08:51,680 --> 00:08:58,090 +(x, 0) وبالتالي هي تنتمي لمن؟ للـ C، فهنا For all x تنتمي + +98 +00:08:58,090 --> 00:09:04,110 +للـ R، الـ x هنكتبه على صورة (x, 0) تنتمي لمين؟ للـ C + +99 +00:09:04,110 --> 00:09:09,770 +فبالتالي احنا هنا قدنا ملاحظة أن الـ R فكنتيجة لذلك + +100 +00:09:09,770 --> 00:09:15,030 +Thus، الـ R هي subset من الـ C، بهذه الطريقة نجعل + +101 +00:09:15,030 --> 00:09:18,810 +مجموعة الأعداد الحقيقية هي مجموعة جزئية من الأعداد + +102 +00:09:18,810 --> 00:09:20,290 +المركبة بهذا المفهوم + +103 +00:09:23,300 --> 00:09:29,760 +لأ لأ الـ x تكتب هي (x, 0) بالتالي تنتمي إلى + +104 +00:09:29,760 --> 00:09:37,200 +C، أي سؤال الآن + +105 +00:09:37,200 --> 00:09:43,100 +احنا جاهزين نعرف العمليتين الحسابيتين الأساسيتين + +106 +00:09:43,100 --> 00:09:48,260 +على الأعداد المركبة، الجمع والضرب + +107 +00:09:58,070 --> 00:10:10,650 +لتكن z1 تساوي (x1, y1) and z2 وتساوي (x2, y2) بي two + +108 +00:10:10,650 --> 00:10:17,610 +complex numbers then + +109 +00:10:17,610 --> 00:10:27,670 +فأول حاجة هنعرف التساوى، z1 تساوي z2 if + +110 +00:10:27,670 --> 00:10:33,070 +and only if، أول وش بنقول على عددين مركبين + +111 +00:10:33,070 --> 00:10:37,670 +متساويين إذا كان الجزء الحقيقي يساوي جزء الحقيقي، وإذا + +112 +00:10:37,670 --> 00:10:40,070 +التخيلي يساوي جزء التخيل، إذا أن هذا الكلام صحيح if + +113 +00:10:40,070 --> 00:10:45,250 +and only if x1 تساوي x2 and y1 تساوي + +114 +00:10:45,250 --> 00:10:49,770 +y2، فهذه أول عملية ممكن تتعامل معها، لو قارن عددين + +115 +00:10:49,770 --> 00:10:55,280 +مركبين هل هم متساويين أو لا، العملية الثانية الجمع + +116 +00:10:55,280 --> 00:11:00,340 +z1 زائد z2 كيف بنجمع؟ بنجمع الحقيقي مع + +117 +00:11:00,340 --> 00:11:04,460 +الحقيقي والتخيلي مع التخيل، فهي بتساوي x1 + +118 +00:11:04,460 --> 00:11:10,260 +زائد x2 و y1 زائد y2، فعملية سهلة وبسيطة بهذا الشكل، العملية اللي بدها شوية انتباه مش + +119 +00:11:10,260 --> 00:11:14,300 +صعبة، إذا عملت ضرب بإنفعش أضرب الحقيقي مع الحقيقي و + +120 +00:11:14,300 --> 00:11:18,000 +التخيلي مع التخيل، وإنما عملت ضرب تخضع للقانون + +121 +00:11:18,000 --> 00:11:20,700 +التالي، العملية هي x1 x2 + +122 +00:11:20,700 --> 00:11:28,490 +- y1 y2 + +123 +00:11:28,490 --> 00:11:31,990 +يعني بضرب الحقيقي مع الحقيقي وبطرح منه التخيلي مع + +124 +00:11:31,990 --> 00:11:35,810 +التخيلي عشان أجيب الجزء الحقيقي من حاصل الضرب و + +125 +00:11:35,810 --> 00:11:39,610 +بعدين بضرب عملية ضرب عكسي x1 y2 زائد x2 y1 عشان أجيب + +126 +00:11:39,610 --> 00:11:47,370 +الجزء التخيلي من حاصل الضرب، فهذه هي القاعدة بهذا + +127 +00:11:47,370 --> 00:11:54,340 +الشكل، طبعا بنلاحظ أنه طبعا عامل اسابقيه بمقارنة + +128 +00:11:54,340 --> 00:11:59,260 +وشوفنا ايش اللي فيها، عملية الجمع مجموعة لديها + +129 +00:11:59,260 --> 00:12:02,900 +مركبين وعدد مركب من نفس الجنس الناتج، وحاصل ضرب + +130 +00:12:02,900 --> 00:12:07,800 +لديها مركبين وعدد مركب آخر، فبنتحدث عن الجزء + +131 +00:12:07,800 --> 00:12:10,880 +الحقيقي من هذا العدد الناتج والجزء التخيلي من هذا + +132 +00:12:10,880 --> 00:12:13,700 +العدد الناتج، طبعا هنا خصوصا قانون الضرب شوية يمكن القانون + +133 +00:12:18,770 --> 00:12:23,890 +شوية صعب لكن ماتخافوش منه، مش هنستخدمه، هنسيطر عليه في + +134 +00:12:23,890 --> 00:12:27,450 +صيغة أسهل في العملية، ولكن مؤقتا لأن الصيغة اللي + +135 +00:12:27,450 --> 00:12:31,210 +كتبنا فيها عدد المركب مؤقتا هي زوج مرتب، فبالتالي + +136 +00:12:31,210 --> 00:12:34,490 +القانون بهذه الصعوبة، بعد قليل هنجي فيه طريقة أسهل + +137 +00:12:34,490 --> 00:12:38,590 +لإجراء العمليات الحسابية، فهذه العمليات اللي ممكن + +138 +00:12:38,590 --> 00:12:41,930 +نجريها على العدد المركب، نشوف مثل على ذلك + +140 +00:12:44,810 --> 00:12:48,810 +خلينا نتعامل مع الضرب اللي هو شوية بده تعود لأن + + + +141 +00:12:48,810 --> 00:12:54,850 +القيون فيه حسابات خلينا نثبت أنه 2 سالب 3 ضرب + +142 +00:12:54,850 --> 00:12:58,430 +سالب 2 و 1 تساوي عدد المركب سالب 1 + +143 +00:13:01,280 --> 00:13:05,680 +فكما ذكرت قبل قليل حاصل ضرب عددين مركبين هو عدد + +144 +00:13:05,680 --> 00:13:09,020 +مركب جديد فطبعًا لإن عددين مركبين طبعًا هنا نحصل + +145 +00:13:09,020 --> 00:13:12,180 +فيه معداد مركبة طبعًا عشان أجري عمليات حسابية حاصل + +146 +00:13:12,180 --> 00:13:15,580 +ضربهم عدد مركب جديد هو سالب واحد و تمام فالآن عشان + +147 +00:13:15,580 --> 00:13:19,100 +بس نتعامل على القانون ويصير بالنسبة لنا مألوف + +148 +00:13:19,100 --> 00:13:22,660 +مؤقع يؤدي الغرض خلينا نشوف هذا الكلام solution + +149 +00:13:25,370 --> 00:13:30,770 +فعندنا اتنين سالب تلاتة وسالب اتنين واحد تساوي + +150 +00:13:30,770 --> 00:13:36,870 +تبقى للقانون نضرب هنا الحقيقي مع الحقيقي اتنين و + +151 +00:13:36,870 --> 00:13:43,370 +سالب اتنين سالب أربعة ناقص التخيل مع التخيلين اللي + +152 +00:13:43,370 --> 00:13:51,610 +هو إيش سالب تلاتة فاصل X1 مع X2 مناقص Y1 مع Y2 ففي + +153 +00:13:51,610 --> 00:13:58,430 +هذا السؤال X1 2 و X2 2 Y1 3 و Y2 1 وبينهم minus + +154 +00:13:58,430 --> 00:14:04,030 +بالنسبة لكم تتخيلوا لماذا تطلب عملية عكسية مقص X1 + +155 +00:14:04,030 --> 00:14:14,970 +مع Y2 2 فوق في وعد 2 زائد X2 مع Y1 يعني 6 سالب 3 + +156 +00:14:14,970 --> 00:14:18,970 +سالب 2 سالب 6 فده هو العملية طب على المجموع جداش + +157 +00:14:18,970 --> 00:14:24,730 +سالب 4 زائد 3 سالب 1 و 8 زي ما هو متوقع فده هو + +158 +00:14:24,730 --> 00:14:28,490 +المقصود بس اللي هو هدف من المثال إن نشوف كيف + +159 +00:14:28,490 --> 00:14:34,490 +القانون بيشتغل وكيف بنحن نحصل على النتيجة أي سؤال + +160 +00:14:34,490 --> 00:14:44,430 +فهذه العمليات الحسابية جمع وضرب وهي عملية كيف يحكم + +161 +00:14:44,430 --> 00:14:48,990 +على عدد المركبين إن هم متساويين أو غير متساويين + +162 +00:14:52,590 --> 00:14:58,470 +أهم شيء في العدد المركب هو الـ I اللي هو مربع + +163 +00:14:58,470 --> 00:15:02,270 +بيساوي سالب واحد فحتى الآن ما ذكرناهوش، الآن هنعرفه + +164 +00:15:02,270 --> 00:15:06,450 +وتعريف الـ I هذا هيسهل علينا كل عمليات الحسابية + +165 +00:15:06,450 --> 00:15:10,050 +وأمور كتيرة هتعرفها، فاحنا فيها إننا نعرف العدد + +166 +00:15:10,050 --> 00:15:17,550 +المركب I Definition We + +167 +00:15:17,550 --> 00:15:29,580 +define the complex number I + +168 +00:15:29,580 --> 00:15:33,060 +بيساوي Zero One + +169 +00:15:35,630 --> 00:15:39,170 +احنا شفنا أن أي عدد مركب أو عضار عن زوج مركب + +170 +00:15:39,170 --> 00:15:42,310 +فأي زوج مركب للعداد العقلية هو عدد مركب Zero, + +171 +00:15:42,450 --> 00:15:45,410 +one, minus one, zero, minus one, minus one, minus + +172 +00:15:45,410 --> 00:15:48,250 +one كل هذه أنثي على عداد المركب طيب هذا العدد + +173 +00:15:48,250 --> 00:15:51,810 +عشان مميز ومهم الرمز له برمز I من كلمة imaginary + +174 +00:15:51,810 --> 00:15:55,370 +لأنه مهم وهذا شيء فاضي طبعًا احنا فيه عداد متعددة + +175 +00:15:55,370 --> 00:15:58,850 +لكن العدد المهم بنديله اسم عشان نستخدمه على سبيل + +176 +00:15:58,850 --> 00:16:01,730 +المثال احنا عندنا من العداد العقلية اللي هو ال E ده + +177 +00:16:01,940 --> 00:16:04,980 +لو إيش عرفناها في التفاضل بها هو ln inverse + +178 +00:16:04,980 --> 00:16:08,120 +الواحد، مصبوب؟ لكن عشان هو مهم يغلق المنظر برمز مي + +179 +00:16:08,120 --> 00:16:11,980 +ن إيه؟ اه لأنه مهم، مثلًا، وعدد غير نسبي؟ أيه من ال + +180 +00:16:11,980 --> 00:16:14,640 +باية، عدد غير نسبي، لكنه مهم في نديره رمز، ففي عدد + +181 +00:16:14,640 --> 00:16:17,020 +نوعي غير نسبية كتيرة، ولا لأ؟ زي ما اتعلمنا في + +182 +00:16:17,020 --> 00:16:20,470 +المبادرة، عدد غير نسبية أكثر من نسبية لكن المشهور + +183 +00:16:20,470 --> 00:16:23,770 +منها قليل فالعدد اللي بيكون مهم نديله رمز عشان إيش + +184 +00:16:23,770 --> 00:16:28,050 +هيستخدمه كتير فبنتمنى نرجعله مش هنتمنى نعمل قصة من + +185 +00:16:28,050 --> 00:16:31,070 +هو لأ فبنتديله رمز فهذا العدد المركب اللي هو + +186 +00:16:31,070 --> 00:16:34,690 +صفر واحد وعدد مهم كتير هيلعب دور أساسي في التعامل + +187 +00:16:34,690 --> 00:16:38,150 +مع اللي مركبها فهيلمزله بالرمز I هلمزله بالرمز + +188 +00:16:38,150 --> 00:16:42,250 +I أي سؤال تمام خلينا نشوف بعض خواص الـ I اللي خلتة + +189 +00:16:42,250 --> 00:16:46,670 +مميز واللي سهل عملية التعب ففي عندنا هنا بعض + +190 +00:16:46,670 --> 00:16:50,740 +الخواص proposition على قصة ال proposition التالية + +191 +00:16:50,740 --> 00:16:55,020 +لت + +192 +00:16:55,020 --> 00:17:03,840 +اي بتساوي 01 ثم فيانا الغواس التالية أول حاجة اي + +193 +00:17:03,840 --> 00:17:08,480 +تربية تساوي سالب واحد من النقاط المهمة إن اي تربيه + +194 +00:17:08,480 --> 00:17:11,600 +بيساوي سالب واحد طبعًا هذا ليس جديد وهذا نقطة مهمة + +195 +00:17:11,600 --> 00:17:15,420 +جدا مافيش عدد حقيقي مربع بيساوي سالب واحد أو سالب + +196 +00:17:15,420 --> 00:17:18,100 +لكن هنا عندنا عدد مركب ومربع بيساوي سالب واحد فهذه + +197 +00:17:18,100 --> 00:17:21,960 +نقطة مهمة جدًا وهذه يمكن هي المفتاح أو السؤال + +198 +00:17:21,960 --> 00:17:25,640 +الأساسي اللي يخلي يؤدي الاختراع لعداد المركبة + +199 +00:17:25,640 --> 00:17:30,800 +الخاصية التانية المهمة اي عدد مركب every + +200 +00:17:37,260 --> 00:17:46,500 +complex number z يساوي x y ممكن يكتب بدلات ال I + +201 +00:17:46,500 --> 00:17:50,860 +can be written as + +202 +00:17:50,860 --> 00:17:58,800 +z تساوي x زائد I y فهذا الـ I اللي هو العدد المركب + +203 +00:17:58,800 --> 00:18:03,040 +I مهم جدًا من أهم خلاصه إنه مربع بيساوي سالب واحد + +204 +00:18:03,040 --> 00:18:07,180 +النقطة التانية أهميته أنه بقدر أكتب جميع العدد + +205 +00:18:07,180 --> 00:18:10,740 +المركب بدلالته جميع العدد المركب بدلالته بدل + +206 +00:18:10,740 --> 00:18:14,380 +ما هو العدد المركب XY زو المركب هنحطه على صورة + +207 +00:18:14,380 --> 00:18:17,820 +اللي هو إيش مقدار جبري طريقة جبرية في الكتابة + +208 +00:18:17,820 --> 00:18:21,240 +عساهل العملية عساهل العملية طبعًا جدا ما نشوف + +209 +00:18:21,240 --> 00:18:25,580 +البرهان طريقة الكتابة تبدل التسمة، نحن قلنا X هو + +210 +00:18:25,580 --> 00:18:28,500 +الجزء الحقيقي و Y هو الجزء التخيلي، طبعًا هي التسمة + +211 +00:18:28,500 --> 00:18:32,380 +أصبح إليها سبب أو سقفهم أكثر، لماذا؟ لأن Y هي + +212 +00:18:32,380 --> 00:18:35,620 +معامل الـ I، فعشان هي الجزء التخيلي، و X من غير I + +213 +00:18:35,620 --> 00:18:40,680 +فهو الجزء الحقيقي أيضًا في ضوء هذه الكتابة قلنا لو + +214 +00:18:40,680 --> 00:18:44,180 +كانت لو كانت عدد حقيقي X إيش بدي يكون؟ محامر من Y + +215 +00:18:44,180 --> 00:18:48,180 +أقل بيصير X فبصير جزء من العدد الحقيقي إنه بشكل + +216 +00:18:48,180 --> 00:18:52,100 +طبيعي هو إيش عدد مركب عدد مركب فهذه الطريقة مهمة + +217 +00:18:52,100 --> 00:18:55,740 +جدا فهذه النقطة نقطة مهمة جدًا لكن طبعًا كان لابد من + +218 +00:18:55,740 --> 00:18:58,400 +المقدمة السابقة عشان نوصل لهذه الصيغة لأن هو + +219 +00:18:58,400 --> 00:19:01,800 +المدخل الرياضي الصحيح نبدأ من زوج مرتب لحد ما يوصل + +220 +00:19:01,800 --> 00:19:06,040 +لهذه الصيغة وهي الصيغة المعتمدة والمألوفة في + +221 +00:19:06,040 --> 00:19:08,660 +التعامل هو المألوفة في التعامل فهنا بعد هذا ال + +222 +00:19:08,660 --> 00:19:12,340 +proposition هنحول الركز تعاملنا من ازاوز مركز لمين + +223 +00:19:12,340 --> 00:19:16,380 +إلى الصيغة الجابرية XYY ونطور كل تعاملنا مع + +224 +00:19:16,380 --> 00:19:21,540 +الأعداد المركز أي سؤال خليني اشوف برهان لهذه + +225 +00:19:21,540 --> 00:19:28,820 +الحقائق المهمة اللي قلنا إن هي إيش أساسية فأول + +226 +00:19:28,820 --> 00:19:33,820 +حاجة في ال proof نبرهن الجزء الأول نبرهن I تربيه + +227 +00:19:33,820 --> 00:19:38,790 +تساوي سالب واحد هذا هو المطلوب العملية سهلة جدًا + +228 +00:19:38,790 --> 00:19:46,470 +طبعًا إن اي تربيه أقارة عن 01 ضرب 01 واحنا عايش + +229 +00:19:46,470 --> 00:19:51,030 +قبل قليل عرفنا كيف نضرب عددين مركبين بها بالصيغة + +230 +00:19:51,030 --> 00:19:56,630 +إيه كيف بنضرب؟ بنضرب اللي هو الحقيقي مع الحقيقي فـ 0 + +231 +00:19:56,630 --> 00:20:02,190 +في 0 ناقص التقوم مع التخيل وناقص واحد فاصلة هذا + +232 +00:20:02,190 --> 00:20:05,790 +الجزء الأول طب الجزء التخيل معاه في الدرع عملية + +233 +00:20:05,790 --> 00:20:10,810 +مقاس صفر في واحد زائد واحد في صفر فهي صفر فجدتش + +234 +00:20:10,810 --> 00:20:15,270 +الجواب سالب واحد وصفر واتفقنا إن هذا إيش نكتبه سالب + +235 +00:20:15,270 --> 00:20:18,710 +واحد لإن ال real number بيه طرق تانية في الكتابة + +236 +00:20:18,710 --> 00:20:24,350 +يا زوج مرتب X0 أو X أو X فإذا هذه أول جزء من + +237 +00:20:24,350 --> 00:20:28,990 +البرهان أو برهان الجزء الأول هنشوف برهان الجزء + +238 +00:20:28,990 --> 00:20:29,490 +الثاني + +239 +00:20:36,820 --> 00:20:45,140 +هذا هو المطلوب فهنبدأ نقول let z تساوي xy then + +240 +00:20:45,140 --> 00:20:51,360 +طبعًا هذه تساوي مخدرين زي ما اتعلمنا نبدأ من الطرف + +241 +00:20:51,360 --> 00:20:55,060 +الأول إلى الطرف الآخر حد برهان من الطرف اليمين + +242 +00:20:55,060 --> 00:21:00,360 +طبعًا احنا في هذه الصيغة ال x وال y أشمالهم real + +243 +00:21:00,860 --> 00:21:06,060 +real إذا X هذه تنتمي لل R فإذا أنا مقدر أكتب X على + +244 +00:21:06,060 --> 00:21:11,440 +صورة 2 X و 0 بنفس الأسلوب ال Y برضه real إذا مقدر + +245 +00:21:11,440 --> 00:21:18,210 +أكتب Y على صورة 2 Y و 0Y وصفر ريال فهي إيش؟ Y و + +246 +00:21:18,210 --> 00:21:21,650 +صفر مباريها ال real number ممتاز فزي ما أقول إن + +247 +00:21:21,650 --> 00:21:26,230 +أنا بدي أحسب من اليمين ال X جاهزة بدي I في Y نحسب + +248 +00:21:26,230 --> 00:21:31,590 +I في Y نحسب I في Y عملية ضرب معروفة نقدر نجريها + +249 +00:21:31,590 --> 00:21:35,430 +نجري العملية وبعدين نجمع لأن هذا ال X عدد مركب و + +250 +00:21:35,430 --> 00:21:42,160 +I في Y عدد مركب وبعدين نجمعه فده هي البرهان لأ ال + +251 +00:21:42,160 --> 00:21:45,980 +Y لأ اسمه جزء التخيلة مش عدد التخيلة ال Y هو الجزء + +252 +00:21:45,980 --> 00:21:50,860 +التخيلة العدد المركب انتهى يا عزيزي لكن هو في أصل + +253 +00:21:50,860 --> 00:21:53,300 +ال X وال Y دول أشمال كل زوج احنا كيف عرفنا عدد + +254 +00:21:53,300 --> 00:21:57,480 +المركب زوج مرتب من الأعداد الحقيقية فال X هو + +255 +00:21:57,480 --> 00:22:00,720 +حقيقي وال Y حقيقي لكن ال Y عشان ما عامل Y بيسموها + +256 +00:22:00,720 --> 00:22:07,100 +الجزء التخيلة فبنفرق بينهم الصلاحة ممتاز إذا IY + +257 +00:22:07,100 --> 00:22:14,810 +إيش هتساوي 0 1 برب y و 0 وتساوي نضرب إيش قلنا اللي + +258 +00:22:14,810 --> 00:22:18,650 +هو الحقيقي مع الحقيقي صفر والتخيين مع التخيين صفر + +259 +00:22:18,650 --> 00:22:23,910 +فجزء الأول صفر الآن برب بالعكس صفر مع اللي هو + +260 +00:22:23,910 --> 00:22:30,970 +الصفر والواعد مع ال y فور إذا I في Y نجل ال Y على + +261 +00:22:30,970 --> 00:22:35,710 +الطرف اللي هو المتوقع اللي هو التخيين الآن إذا إيش + +262 +00:22:35,710 --> 00:22:43,660 +أصبح هنا X زائد IY إيش دي يساوي؟ X0 زائد 0Y ويساوي + +263 +00:22:43,660 --> 00:22:51,500 +X و Y اللي هي main إذا فعلاً أي عدد مركب Z أكدرنه + +264 +00:22:51,500 --> 00:22:55,880 +يكتب على صورة main X Z I فيها في هذه الطريقة بعد + +265 +00:22:55,880 --> 00:22:58,940 +إن البنانات تبع الصورة بيصير عملية الجامعة والضرب + +266 +00:22:58,940 --> 00:23:02,820 +عملية سهلة جدًا كأننا نتعامل مع مقادير جابرية لا + +267 +00:23:02,820 --> 00:23:04,800 +بدنا نحفظ القانون تبع الجامعة ولا القانون تبع + +268 +00:23:04,800 --> 00:23:08,540 +الضرب اللي هو لشوية ساعة هلاجي الأمور أسهل بكثير + +269 +00:23:08,540 --> 00:23:14,500 +خلينا نوضح نشوف فايدة هذا المخدر مثال في عندنا + +270 +00:23:14,500 --> 00:23:20,320 +أكثر من مثال لا مثال واحد مش مشكلة فخلينا نحسب find + +271 +00:23:20,320 --> 00:23:29,260 +z1 زائد z2 and z1 في z2 if z1 + +272 +00:23:29,260 --> 00:23:36,780 +تساوي 2-3i and z2 تساوي سالب 2 زائد i + +273 +00:23:40,670 --> 00:23:43,430 +فإذا احنا يا شباب ال answer فيانا طريقتين لكتابة + +274 +00:23:43,430 --> 00:23:47,870 +ال complex number الطريقة الأولى القديمة طبعًا قبل + +275 +00:23:47,870 --> 00:23:51,770 +ربع ساعة قديمة هي زوج مرتب والطريقة التانية + +276 +00:23:51,770 --> 00:23:55,850 +باستخدام ال I باستخدام ال I اه الآن احنا طبعًا هنا + +277 +00:23:55,850 --> 00:23:58,570 +في إننا هنجي لعملية حسابية باستخدام الصورة الجديدة + +278 +00:23:58,570 --> 00:24:01,770 +لإن هي المعتمدة هي الأسهل في التعامل لكن عشان إننا + +279 +00:24:01,770 --> 00:24:03,870 +احنا بال mark I المتقلة دي خلينا نقارن بين + +280 +00:24:03,870 --> 00:24:07,490 +العمليتين فطبعًا أنا زد واحد خدعيني اكتبه بالطريقتين + +281 +00:24:07,490 --> 00:24:11,410 +هي اثنان ناقص ثلاثة i وهي اثنان سالب ثلاثة كزوج + +282 +00:24:11,410 --> 00:24:17,530 +مرتب طبعا لازم يتعود على الصفين زد اثنان وهي + +283 +00:24:17,530 --> 00:24:23,650 +سالب اثنان زائد i وهي زوج مرتب سالب اثنين أو واحد + +284 +00:24:23,650 --> 00:24:27,810 +بس عشان نقارن ونتعود آه في الأقل طبعا زد واحد زائد + +285 +00:24:27,810 --> 00:24:34,230 +زد اثنان عملية الجمع طبعا عملية سهلة بتجمع الحقيقة + +286 +00:24:34,230 --> 00:24:37,410 +مع الحقيقة والتخيل مع التخيل أو أتعامل معهم + +287 +00:24:37,410 --> 00:24:41,130 +بكصيغة كمقادير جبرية إيش نجمع اثنان وسالب اثنان + +288 +00:24:41,130 --> 00:24:46,610 +صفر سالب ثلاثة i و r سالب اثنان i فالجمع ده + +289 +00:24:46,610 --> 00:24:49,840 +الشكل الجمع عادي، العدد الحقيقي بيجمع أجزاء + +290 +00:24:49,840 --> 00:24:52,660 +كالعادة اثنان وسالب اثنان صفر، والـ i مع الـ i + +291 +00:24:52,660 --> 00:24:55,900 +بيجمعها مع بعض، فهي الحقيقة مع الحقيقة والتخيل مع + +292 +00:24:55,900 --> 00:25:00,760 +التخيل، فسالب ثلاثة i واثنان i وسالب اثنان i، + +293 +00:25:00,760 --> 00:25:03,360 +بهاذي البساطة، لا بنخالف قوانين ولا نغلب حالة، + +294 +00:25:03,360 --> 00:25:06,330 +الجمع عادي بس طبعا تعرف إن العيّة دي عشان عدد جديد + +295 +00:25:06,330 --> 00:25:09,870 +ما ينفعش أقول اثنان i وثلاثة i إيش الناتج أنا بس + +296 +00:25:09,870 --> 00:25:12,850 +بأأتم العيّة ما أقدرش أخلص منها ما أقدرش أخلص منها + +297 +00:25:12,850 --> 00:25:16,330 +فبأتمّها كأنّها إيش العيّة دي مقدّرة زي ما أنا متعامل + +298 +00:25:16,330 --> 00:25:20,970 +مثلا مقدّرة جبرياً في س أو في x فبشكل مشابه طبعا + +299 +00:25:20,970 --> 00:25:23,710 +مش نفس الشيء ولكن بشكل مشابه فأنا بجمع العيّة مع + +300 +00:25:23,710 --> 00:25:28,390 +بعض والحقيقة جزء ثاني مع بعض باللغة العامية بعد + +301 +00:25:28,390 --> 00:25:31,370 +الشكل فعملية الجمع بعد السهولة هي أصلاً سهلة طبعاً + +302 +00:25:31,370 --> 00:25:37,420 +عملية الضرب أيضاً ممكن أن سهيلة بدأت شكل كثير خير + +303 +00:25:37,420 --> 00:25:40,220 +نشوف طبعا هنا هذا المثال هو نفس المثال بتاعة + +304 +00:25:40,220 --> 00:25:43,980 +حسبناه فهو نصل للنتج المفروض يكون إيش سالب واحد + +305 +00:25:43,980 --> 00:25:46,840 +كمان هو نفسه اللي عملنا خير نشوف كده نوصل + +306 +00:25:46,840 --> 00:25:50,540 +بسهولة من غير ما نغلب حالة زي واحد وزي اثنين + +307 +00:25:50,540 --> 00:25:57,580 +فنكتبها بالصيغة الجديدة اثنان ناقص ثلاثة i واللي + +308 +00:25:57,580 --> 00:26:01,960 +هو سالب اثنين زائد i ونجري عملية الضرب كيف نضرب؟ + +309 +00:26:01,960 --> 00:26:06,400 +كأننا نضرب مقادير جبرية أقواس نفك الأقواس عالية + +310 +00:26:06,400 --> 00:26:10,860 +جداً لأن القانون التوكتات نقص طويل اللي هو حقيقة ما + +311 +00:26:10,860 --> 00:26:13,960 +حقيقة وبينهم سالب وتخيلوا ما تخيلوا بينهم سالب و + +312 +00:26:13,960 --> 00:26:18,200 +عملية مقص بينهم مدبلة لأننا نغلب حالنا نضرب ضرب + +313 +00:26:18,200 --> 00:26:22,440 +عادي نضرب اثنان في سالب اثنين سالب أربعة اثنان في + +314 +00:26:22,440 --> 00:26:28,830 +اثنان i سالب ثلاثة i في اثنان i ستة i² سالب + +315 +00:26:28,830 --> 00:26:33,080 +ثلاثة i في اثنان i سالب ثلاثة i تربيع بهذه البساطة + +316 +00:26:33,080 --> 00:26:38,260 +يا شباب واضح؟ فمضرب ضرب عادي كأنك عندك أقواس و + +317 +00:26:38,260 --> 00:26:41,700 +بتفكها وبتفكها عادي تماماً إيش الشيء الجديد؟ إيش + +318 +00:26:41,700 --> 00:26:45,380 +المميّز؟ الـ i تربيع يساوي سالب واحد بس غير هيك ما فيش + +319 +00:26:45,380 --> 00:26:49,520 +شيء فهي عملية ضرب عادية كأنك تضرب مقادير جبرية فقوم + +320 +00:26:49,520 --> 00:26:53,220 +على هذا i ساوي سالب أربعة اثنان i ستة i ممكن أجمعهم + +321 +00:26:53,220 --> 00:26:56,760 +ثمانية أقل الـ i تربيع سالب واحد في ثلاثة إيش؟ زاد + +322 +00:26:56,760 --> 00:27:01,690 +ثلاثة إيش جواب النهاية؟ اللي هو طبعاً طلعناه قبلين + +323 +00:27:01,690 --> 00:27:09,430 +نفس الـ i فبهذه السهولة i يساوي فإذا هذا الـ i على + +324 +00:27:09,430 --> 00:27:12,870 +ده مهم جدا مكّننا من كتابة ال complex number على + +325 +00:27:12,870 --> 00:27:18,370 +صورة x زائد i y وسهل علينا العمليات الحسابية لذلك + +326 +00:27:18,370 --> 00:27:22,510 +هذه الصيغة x زائد i y هي المعتمدة هي الأكثر + +327 +00:27:22,510 --> 00:27:26,750 +استخداماً من الزوج المرتب أكثر استخداماً وأكثر شيوعاً + +328 +00:27:26,750 --> 00:27:33,050 +في الاستخدام من اللي هو الزوج المرتب أي سؤال أي + +329 +00:27:33,050 --> 00:27:38,310 +استفسار تمام الواصل طبعاً ده هو ال section الأول + +330 +00:27:38,310 --> 00:27:41,570 +نهايته ال section الثاني هنواصل مع الأداء الملكب + +331 +00:27:41,570 --> 00:27:48,610 +ولكن الخواص الجبرية الجبرية ال properties طبعاً احنا + +332 +00:27:48,610 --> 00:27:52,170 +بس عشان نتابع الكتاب بنواصل + +333 +00:27:53,150 --> 00:27:55,970 +الخواص الجبرية لأعداد المركبة ما زلنا تحت عنوان + +334 +00:27:55,970 --> 00:28:03,010 +الأعداد المركبة وبعض الخواص الجبرية طبعا + +335 +00:28:03,010 --> 00:28:07,580 +احنا متعامل مع أعداد وشية طبيعية نسأل نفسنا إننا + +336 +00:28:07,580 --> 00:28:10,260 +متعودين مثلاً على التعامل مع أعداد الطبيعية أو + +337 +00:28:10,260 --> 00:28:14,080 +الأعداد الصحيحة أو الحقيقية وعرفنا العمليات + +338 +00:28:14,080 --> 00:28:17,860 +الحسابية لذا وعرفناها جمع وضرب على هذه الأعداد + +339 +00:28:17,860 --> 00:28:21,000 +ومعروف إن هذه العمليات لها بعض الخواص في الأعداد + +340 +00:28:21,000 --> 00:28:24,100 +الحقيقية زي خاصية التجميع، خاصية الإبدال، خاصية + +341 +00:28:24,100 --> 00:28:29,080 +اللي هو الإبدال والتجميع والتوزيع مع بعض في محاياة + +342 +00:28:29,080 --> 00:28:34,650 +جمع في محاياة ضرب هل هذه الخواص تمتد وتنتقل في حاجة + +343 +00:28:34,650 --> 00:28:38,210 +عادة مركبة ولا في منها بينتقل ومنها ما بينتقلش مين + +344 +00:28:38,210 --> 00:28:41,870 +اللي بتنطبق صح ومين اللي بتختلف هذا اللي هنشوفه مع + +345 +00:28:41,870 --> 00:28:45,930 +بعض في الخواص الجبرية آه فعندنا أول حاجة إن كل + +346 +00:28:45,930 --> 00:28:54,230 +الخواص بتنتقل بشكل مباشر proposition حاجة خواص + +347 +00:28:54,230 --> 00:29:06,370 +الخواص let z z واحد z اثنان and z ثلاثة ب complex + +348 +00:29:06,370 --> 00:29:10,370 +numbers أنا بتحدث عن خواص complex number فبدي + +349 +00:29:10,370 --> 00:29:13,990 +أخذ أي complex number وما ينطبق عليها ينطبق علي + +350 +00:29:13,990 --> 00:29:17,270 +الجميع طبعا بس من الرموز اللي لها بالرموز اللي + +351 +00:29:17,270 --> 00:29:21,990 +موجودة أمامكم z أول + +352 +00:29:21,990 --> 00:29:30,290 +حاجة عملية الجمع وعملية الضرب عمليتان إبداليتان في + +353 +00:29:30,290 --> 00:29:34,890 +جمع الأعداد المركبة وضرب الأعداد المركبة + +354 +00:29:34,890 --> 00:29:38,970 +عمليات إبدالية فالترتيب فيها مش مهم لو قلت z واحد + +355 +00:29:38,970 --> 00:29:42,110 +زائد z اثنان أو z اثنان زائد z واحد الناتج نفس + +356 +00:29:42,110 --> 00:29:46,570 +العملية والضرب بنفس القضية فالخاصية الأولى z واحد + +357 +00:29:46,570 --> 00:29:53,790 +زائد z اثنان تساوي z واحد زائد z اثنان and فده + +358 +00:29:53,790 --> 00:29:57,590 +خاصية الإبدال z واحد في z اثنان تساوي z اثنان + +359 +00:29:59,770 --> 00:30:03,690 +خلّيني أعكس الترتيب z2 z1 فهذه خاصية الإبدال + +360 +00:30:03,690 --> 00:30:12,070 +الخاصية الثانية خاصية مهمة جداً خاصية التجميع z1 z2 + +361 +00:30:12,070 --> 00:30:21,360 +z3 تساوي z1 z2 z3 طبعاً خاصية التجميع يا شباب مهمة + +362 +00:30:21,360 --> 00:30:25,620 +جداً، ليش؟ لأنه احنا عرفنا الجمع والضرب كعملية + +363 +00:30:25,620 --> 00:30:29,100 +ثلاثية، يعني أنا بقدر أجمع عددين حقيقيين أو عددين + +364 +00:30:29,100 --> 00:30:32,540 +مركّبين أو أضربهم، فالآن خاصية التجميع بتفتح للباب + +365 +00:30:32,540 --> 00:30:37,890 +إن أجمع ثلاثة أعداد ومن ثم أربعة على كذا فهذه مهمة جداً + +366 +00:30:37,890 --> 00:30:41,010 +لأنّه بتحول العملية من عملية ثلاثية لعملية متعددة + +367 +00:30:41,010 --> 00:30:44,610 +بقدر إيش أطبّق على أي عدد من الأعداد المركبة طبعا + +368 +00:30:44,610 --> 00:30:47,810 +إيش أهميتها؟ بتقول إن عندك مثلاً أربعة خمس أعداد عشرة + +369 +00:30:47,810 --> 00:30:50,370 +أعداد كيف ده تجمعهم؟ بيجمعوا اثنين اثنين والنتيجة + +370 +00:30:50,370 --> 00:30:52,930 +تجمعهم اللي بعده طب من وين أبدأ؟ من وين أبدأ كيف + +371 +00:30:52,930 --> 00:30:55,650 +ده أبدأ؟ من اليمين من اليسار من اليسار؟ النتيجة + +372 +00:30:55,650 --> 00:31:02,070 +ما تتغيرش ما تتغير تضرب بنفس القضية and z واحد z اثنان + +373 +00:31:02,070 --> 00:31:07,250 +z ثلاثة تساوي z واحد في z اثنان أولاً وبعدين أعمل + +374 +00:31:07,250 --> 00:31:15,690 +z ثلاثة الخاصية الثالثة خاصية التوزيع طبعا عندي + +375 +00:31:15,690 --> 00:31:18,810 +عملتين جمع أو ضرب لو كان في عندي عمليتين مع بعض + +376 +00:31:18,810 --> 00:31:23,310 +بقدر أوزّع الضرب على الجمع z ثلاثة وتساوي z واحد + +377 +00:31:23,310 --> 00:31:28,150 +z اثنان زائد اللي هو z واحد في z ثلاثة يعني عملية + +378 +00:31:28,150 --> 00:31:33,460 +التوزيع طبعا جمع مع جمع تجميع ضرب مع ضرب تجميع + +379 +00:31:33,460 --> 00:31:37,360 +جمع وضرب توزية توزية اختلافات العملية طبعاً + +380 +00:31:37,360 --> 00:31:40,280 +التوزية بقراها من اليسار اليمين هي التوزية هو + +381 +00:31:40,280 --> 00:31:43,360 +قانون توزية بسمّوه لكن لما بقراها من اليمين اليسار + +382 +00:31:43,360 --> 00:31:46,980 +هي عامل مشترك اللي بأخذ عامل مشترك وهي بس اسم + +383 +00:31:46,980 --> 00:31:51,340 +الرسمي توزية توزية بس بتنصّ إن تساوي بدلاً من + +384 +00:31:51,340 --> 00:31:54,340 +اليسار اليمين أو اليمين اليسار فالاتجاهين صحيحين + +385 +00:31:54,340 --> 00:31:57,840 +أحياناً بحتاج أوزّع أحياناً العكس بأخذ العامل المشترك + +386 +00:31:57,840 --> 00:32:05,850 +عوا الغرض اللي بديهالخاصية الرابعة المحايد الجمعي + +387 +00:32:05,850 --> 00:32:09,010 +والمحايد الضربي طبعا الصفر هو عدد مركب يا شباب + +388 +00:32:09,010 --> 00:32:11,350 +لإن قلنا أي عدد حقيقي هو عدد مركب فالصفر بشكل + +389 +00:32:11,350 --> 00:32:16,770 +خاص طبعا كيف هو كزوج مرتب 0,0 أو كعدد زائد + +390 +00:32:16,770 --> 00:32:20,110 +0,i فهو على أيش عدد مركب وهو المحايد الجمعي + +391 +00:32:20,110 --> 00:32:25,190 +بمعنى 0 زائد z يساوي z لأي عدد مركب z فإذن + +392 +00:32:25,190 --> 00:32:32,970 +ذا اللي هو إن باختصار 0 زائد z تساوي z ما هيش + +393 +00:32:32,970 --> 00:32:37,970 +اسمه إبدالي ما فيش ده أكرر بتساوي it and والواحد + +394 +00:32:37,970 --> 00:32:42,950 +هو لعب المحايد الضرب هو المحايد الضربي طبعاً الواحد زي + +395 +00:32:42,950 --> 00:32:46,330 +هو زي أي عدد حقيقي وعدد مركب فإذا الـ 0 هو + +396 +00:32:46,330 --> 00:32:52,550 +المحايد الجمعي والواحد هو المحايد الضربي طبعاً إذا + +397 +00:32:52,550 --> 00:32:56,740 +ذكرنا المحايد بنحتاج اللي هو ال inverse يبطل إيش + +398 +00:32:56,740 --> 00:33:00,020 +يُبطل بال inverse أو يترتب عليه ال inverse فما هو + +399 +00:33:00,020 --> 00:33:03,420 +المعكوس الجمعي هو السالب z بالنسبة للمعكوس + +400 +00:33:03,420 --> 00:33:08,260 +الجمعي للـ z والمعكوس الضربي إيه؟ واحد إذا هو صح + +401 +00:33:08,260 --> 00:33:13,130 +مش غلط لكن لما أنا عندي مثلاً لو أنا عندي الـ z تساوي + +402 +00:33:13,130 --> 00:33:17,230 +واحد زائد i فواحد على z تساوي هتكون واحد على + +403 +00:33:17,230 --> 00:33:21,470 +زائد i هذه الصيغة مش غلط يا شباب لكن مش هي الصيغة + +404 +00:33:21,470 --> 00:33:25,150 +الـ standard ليش؟ قبل قليل ذكرنا إن أي عن المركّبين + +405 +00:33:25,150 --> 00:33:28,810 +تبقى صورة مين؟ x زائد i y فدايماً الـ i والـ y موجودة + +406 +00:33:28,810 --> 00:33:31,710 +في البسط مش موجودة في المقام فهذه الصيغة صحيحة مش + +407 +00:33:31,710 --> 00:33:34,810 +خاطئة لكن مش هي الصيغة المطلوبة مش هي الصيغة الـ + +408 +00:33:34,810 --> 00:33:38,070 +standard القياسية فهنحوّلها فهنشوف كيف نكتب الـ .. + +409 +00:33:38,070 --> 00:33:41,330 +اللي هو واحد على z المعكوس الضربي بشكل standard + +410 +00:33:41,330 --> 00:33:50,650 +بشكل قياسي فهي طبعاً the additive inverse المعكوس + +411 +00:33:50,650 --> 00:33:55,610 +الجمعي of + +412 +00:33:55,610 --> 00:34:02,930 +z تساوي x زائد i y is سالب z وتساوي سالب x مع i سالب y + +413 +00:34:03,680 --> 00:34:07,840 +مباشرة نضرب في سالب واحد نحصل على المعكوس الجمعي + +414 +00:34:07,840 --> 00:34:11,360 +طبعا شيء ما ننتقلش لـ y z وy سالب z نجمعهم مع بعض + +415 +00:34:11,360 --> 00:34:15,720 +حقيقية على حقيقية x مع سالب x صفر التخيل مع التخيل + +416 +00:34:15,720 --> 00:34:19,260 +y مع سالب y صفر صحيح بالنسبة لمعكوس الضرب شوية + +417 +00:34:19,260 --> 00:34:27,140 +طبعا أصعب لأن عملية الضرب أيضاً كانت أصعب the + +418 +00:34:27,140 --> 00:34:28,340 +multiplicative inverse + +419 +00:34:37,290 --> 00:34:43,990 +of z تساوي x زائد i y is z السالب واحد أو واحد على + +420 +00:34:43,990 --> 00:34:50,390 +z وتساوي x على x تربيع زائد y طبعاً of z لا تساوي 0 + +421 +00:34:50,390 --> 00:34:54,490 +طبعا هنا في شرط أن z لا تساوي 0 of z لا تساوي 0 + +422 +00:34:54,490 --> 00:34:57,150 +طبعا ال 0 مايعنيش لنا نص ضرب لا في ال real ولا في + +423 +00:34:57,150 --> 00:35:02,890 +ال complex هي طبيعي نفس القضية ماقص اللي هو i في y + +424 +00:35:02,890 --> 00:35:08,790 +على x تربيع زائد y فهذا هو المعكوس الضرب عشان أحطه + +425 +00:35:08,790 --> 00:35:12,870 +بالصيغة العادية هي الجزء الحقيقي و سالب y على x تربيع زائد y تربيع + +426 +00:35:12,870 --> 00:35:16,670 +سالب 7 هو الجزء ايه أتخيل فخلت ال I في البسط فهذا + +427 +00:35:16,670 --> 00:35:19,450 +هو المعكوس الضرب طبعا لو ضربت هذا في z هتلاقوا + +428 +00:35:19,450 --> 00:35:24,270 +نتيجة فعلا واحد هتلاقوا نتيجة فعلا واحد خلينا + +429 +00:35:24,270 --> 00:35:27,750 +نبرهن بعضهم بس عشان نشوف فكرة البرهان + +430 +00:35:39,290 --> 00:35:43,850 +البرهان سهل جدا ولكن الهدف بس هو مراجعة و طرح + +431 +00:35:43,850 --> 00:35:48,300 +البرهان أو نعطي فكرة طبعا زي ما أنتو عارفين يا + +432 +00:35:48,300 --> 00:35:52,660 +شباب أن البرهان باعتمد على التعريفات أو نظريات + +433 +00:35:52,660 --> 00:35:56,560 +سابقة برهان سابقة برهان فاحنا هنا في كل البراهين + +434 +00:35:56,560 --> 00:35:59,520 +اللي هنا نعتمد بشكل أساسي على خلاصة العدد الحقيقي + +435 +00:35:59,520 --> 00:36:03,480 +فاحنا هننقل المسألة إلى الجزء الحقيقي اللي هو X وY + +436 +00:36:03,480 --> 00:36:06,720 +دولة عدد حقيقية وأي خاصية من خلاصة عدد الحقيقية + +437 +00:36:06,720 --> 00:36:10,000 +ممكن تستخدمها في هذا المجال في هذه المجال على سبيل + +438 +00:36:10,000 --> 00:36:15,960 +المثال طبعا خلينا نفترض أن Z1 تساوي X1 زائد I في Y1 + +439 +00:36:16,470 --> 00:36:20,830 +وزد 2 نكتبها بالشكل الطبيعي تبعها أو الشكل + +440 +00:36:20,830 --> 00:36:28,610 +القياسي بعد الصورة ثم z1 زائد z2 نحطه يساوي + +441 +00:36:28,610 --> 00:36:35,070 +إيش بتساوي x1 زائد x2 زائد i في y1 زائد y2 + +442 +00:36:35,070 --> 00:36:40,130 +زائد y2 تمام هاي اللي عملناها عايز أعكس + +443 +00:36:40,130 --> 00:36:44,370 +التبديل، أعكس الترتيب، بدي اللي هو X2 تبدأ أولا و + +444 +00:36:44,370 --> 00:36:47,770 +Y2 تبدأ أولا، بعد ما حضرتها على الصيغة، هالجيت X + +445 +00:36:47,770 --> 00:36:50,210 +1 و 6 من ال real number، والجامعة اللي بين + +446 +00:36:50,210 --> 00:36:52,770 +الضوص هنا، ده جامعة عملية جمع، زي ما أنتو شفتوا + +447 +00:36:52,770 --> 00:36:55,410 +بالمثال، لكن الجامعة اللي في المصدر هو ال complex، + +448 +00:36:55,410 --> 00:36:58,240 +جمع ال complex، وجمع اللي هنا real طب ودى ما + +449 +00:36:58,240 --> 00:37:06,060 +احنا real أبدا فانا ممكن إيش أبدل X2 زي X1 زي R في + +450 +00:37:06,060 --> 00:37:09,760 +Y2 زي Y1 طبعا بلغة المفادة اللي حط السبب ليش لإن + +451 +00:37:09,760 --> 00:37:16,640 +ال plus is commutative on R على + +452 +00:37:16,640 --> 00:37:21,860 +الريال نقطة عاصر تاعة العملية دي ليست لمن؟ Z2 زي + +453 +00:37:21,860 --> 00:37:26,700 +Z1 وهكذا تجيه إلى ال 80 بنفس الأسلوب فأنت بتحول + +454 +00:37:26,700 --> 00:37:30,480 +المسألة إلى الأجزاء الجزء الحقيقي من الناتج جزء + +455 +00:37:30,480 --> 00:37:33,860 +التخيلي من الناتج جوا من الأجزاء العمليات عمليات + +456 +00:37:33,860 --> 00:37:36,640 +عالمية على ال real لإن ال X1 و Y2 و Y + +457 +00:37:36,640 --> 00:37:39,280 +1 و Y2 ال real تستخدم خلاصة ال real توصل + +458 +00:37:39,280 --> 00:37:46,240 +للخاصية بشكل عام والباقي بنفس الأسلوب خليني أقفر + +459 +00:37:46,240 --> 00:37:49,600 +انتماء جزء الخامس وهو عملية اللي هو ضرب هذه + +460 +00:37:49,600 --> 00:37:55,390 +اللي هو المعكوس الضرب طبعا الأداء كلها سهلة القوانين + +461 +00:37:55,390 --> 00:38:00,030 +الأخرى بتعمل exercise Z inverse تساوي X على X + +462 +00:38:00,030 --> 00:38:05,150 +تربيع زائد Y تربيع ناقص I في Y على X تربيع زائد Y + +463 +00:38:05,150 --> 00:38:09,810 +تربيع طبعا هذا مش جدا من البرامج كيف بدي أبرهن أن + +464 +00:38:09,810 --> 00:38:14,240 +هذا هو المعكوس الضرب؟ ما هو المعكوس الضرب هو عدد + +465 +00:38:14,240 --> 00:38:16,820 +أضربه في العدد الأصلي يديني المعايير للضرب هو + +466 +00:38:16,820 --> 00:38:21,320 +الواحد فاحنا هنا بنثبت أن Z في Z inverse تساوي + +467 +00:38:21,320 --> 00:38:26,180 +واحد هذا هو السؤال الثاني نضرب Z في Z inverse بتساوي + +468 +00:38:26,180 --> 00:38:33,120 +X زائد IY ضرب X على X تربيع زائد Y تربيع ناقص I في + +469 +00:38:33,120 --> 00:38:38,740 +Y على X تربيع زائد Y فاجد طلع الناتج بيساوي واحد + +470 +00:38:38,740 --> 00:38:43,780 +بتكون القوانين أنت طبعا لازم يطلع واحد نضرب X في X + +471 +00:38:43,780 --> 00:38:49,860 +تربيع على X تربيع زائد Y تربيع نضرب الأول ماقص I في + +472 +00:38:49,860 --> 00:38:54,060 +XY على X تربيع زائد Y تربيع زي ما دا واتعلمنا شباب + +473 +00:38:54,060 --> 00:38:58,380 +الطرق معقدير جبرية ضربنا ال X في الجزء فاجد نضرب I + +474 +00:38:58,380 --> 00:39:04,910 +في Y في الجزء تمام؟ هيكون عندي زائد IY في X على X + +475 +00:39:04,910 --> 00:39:12,070 +تربيع زائد Y تربيع بعدين ناقص I تربيع في Y تربيع + +476 +00:39:12,070 --> 00:39:18,310 +على X تربيع زائد Y تربيع أي سؤال فضل + +477 +00:39:34,830 --> 00:39:40,550 +هذا المقارب الجبري مع بعض طبعا I تربيع بسالب واحد + +478 +00:39:40,550 --> 00:39:46,830 +أصبح plus فهذا يعني ال plus واحد خلاص اجمع المقام + +479 +00:39:46,830 --> 00:39:50,170 +واحد وخالص اجمع بصير X تربيع زائد Y تربيع على X + +480 +00:39:50,170 --> 00:39:55,190 +تربيع زائد Y تربيع وتساوي واحد فطبعا الهدف من + +481 +00:39:55,190 --> 00:39:58,250 +هذا البرهان أنه أنزل الرعب بالإن أنا ما أعرف أنا إيش + +482 +00:39:58,250 --> 00:40:02,490 +المطلوب في البرهان ونعمل والعملية بها للبساطة أي + +483 +00:40:02,490 --> 00:40:09,350 +سؤال فبجيت البرهان نفس الأسلوب أي سؤال فبهذه + +484 +00:40:09,350 --> 00:40:14,030 +الطريقة، باعتماد على خواص الأعداد الحقيقية وعلى + +485 +00:40:14,030 --> 00:40:17,670 +التعريفات، بنقدر نجيب، ننشطق خواص من الأعداد + +486 +00:40:17,670 --> 00:40:22,920 +المركبة أي سؤال. فإذا هذا بيدينا راحة كبيرة في + +487 +00:40:22,920 --> 00:40:27,500 +التعامل لإن زي ما شايفين كل الخواص بتنتقل عملية + +488 +00:40:27,500 --> 00:40:31,600 +الإبدال في الترتيب ما بدوش شهد انتباه عملية الجمع + +489 +00:40:31,600 --> 00:40:37,000 +أجمع زي ما بدي توزيع كل الخواص الجيدة اللي بتسهل + +490 +00:40:37,000 --> 00:40:39,640 +التعامل موجودة في ال complex number موجودة في ال + +491 +00:40:39,640 --> 00:40:42,240 +complex number يعني النقطة الأساسية لإن نتعرف إن + +492 +00:40:42,240 --> 00:40:45,410 +في عندنا الآية ده بالعربية الأساسيوأهم حاجة أن I + +493 +00:40:45,410 --> 00:40:47,590 +تربيع بتساوي سالب واحد هي بتخلّي العمليات الحسابية + +494 +00:40:47,590 --> 00:40:52,870 +بالباقي كلها بنفس ال slope بنفس ال slope أي سؤال + +495 +00:40:52,870 --> 00:41:00,210 +طبعا الباقي كله exercise نشوف بعض الأمثلة أوجد + +496 +00:41:00,210 --> 00:41:08,450 +Z inverse if Z تساوي I نعم وين؟ + +497 +00:41:08,450 --> 00:41:14,690 +هان كانت سالب مع سالب I تربيع سالب واحد غيرتها فهو + +498 +00:41:14,690 --> 00:41:17,710 +انتهت العملية هي في الأصل ثالث بس أنا بدي اختصرها + +499 +00:41:17,710 --> 00:41:21,530 +شوية في الكتاب بس اختصار في الكتاب نوصل هناك درجة + +500 +00:41:21,530 --> 00:41:24,990 +فحطيتكو مفتاح الحل وأنتم ممكن تكملوا التفاصيل + +501 +00:41:24,990 --> 00:41:29,430 +اختصارا للوقت فالفكرة أولها هي كيف نثبت والباقي و + +502 +00:41:29,430 --> 00:41:32,150 +عملناها تقريبا لو فيه شوية تفاصيل بتكملوها لحالك + +503 +00:41:32,830 --> 00:41:36,450 +خلينا على سبيل المثال نحسب الـH معكوس الـI قال + +504 +00:41:36,450 --> 00:41:39,530 +عزيزي أنا حكيت ده ولو حطينا 1 على I هي مش غلط + +505 +00:41:39,530 --> 00:41:43,490 +لكن مش عملية مش هي الصيغة القياسية لأن لازم كل عدد + +506 +00:41:43,490 --> 00:41:47,350 +مركب نكتبه على صورة X زائد I في Y لازم الـI يكون في + +507 +00:41:47,350 --> 00:41:51,690 +الـBus فخلينا نحل هذا الكلام ف Z inverse اللي هي + +508 +00:41:51,690 --> 00:41:57,460 +I أس -1 تساوي 1 على I وتساوي خليني أتعلم + +509 +00:41:57,460 --> 00:42:00,580 +طريقة عملية كيف نحسب ناس نحفظ القوانين طبعا احنا + +510 +00:42:00,580 --> 00:42:04,080 +بنحاول نتجنب الحفظ قدر الإمكان بهمنا الفهم وليس + +511 +00:42:04,080 --> 00:42:08,920 +الحفظ عشان نجيب المعكوس الضرب بنعمل .. بنضرب فيها + +512 +00:42:08,920 --> 00:42:13,920 +حاجة اسمها المرافقة فلو ضربنا في .. خليني أحسب في + +513 +00:42:13,920 --> 00:42:19,170 +سالب I على سالب I طب احنا ما عرفناش المرافق ولكن + +514 +00:42:19,170 --> 00:42:23,110 +مؤقتا إذا في عندنا عدد مركب X زائد I و I المرافق + +515 +00:42:23,110 --> 00:42:27,570 +تبعه بنغير إشارة معامل I بنغير إشارة معامل I فال + +516 +00:42:27,570 --> 00:42:31,410 +I معاملة إيش؟ واحد، بنغيرها سالب واحد طب ليش؟ لأن + +517 +00:42:31,410 --> 00:42:34,410 +في هذه الحالة هنتخلص من I في المقام هنتخلص من I + +518 +00:42:34,410 --> 00:42:37,770 +المقام في المحادثة السابقة عارف ليش، إنه دائما أنا + +519 +00:42:37,770 --> 00:42:41,290 +بعمل أو في عندي ضمان إن أنا هتخلص من المقام اللي + +520 +00:42:41,290 --> 00:42:45,190 +هو إيش يكون عدد مركب فطب عندما نيجي نضرب سالب I + +521 +00:42:45,190 --> 00:42:49,310 +البسط في البسط والمقام في المقام سالب I تربيع وهي + +522 +00:42:49,310 --> 00:42:54,430 +واحد اقعد يساوي فهي سالب I فانا هأجي واحد فإذا + +523 +00:42:54,430 --> 00:42:59,490 +المعكوس الضربي لل I سالب I شيء منطق ليش I في سالب + +524 +00:42:59,490 --> 00:43:03,250 +I واحد لكن I في I لأ سالب واحد لكن عشان يطلع الناتج + +525 +00:43:03,250 --> 00:43:07,210 +واحد المعكوس الضربي بدي سالب I فمعكوس الضربي لل I + +526 +00:43:07,210 --> 00:43:12,530 +سالب I سالب I فال I لانحطت في ليش في الشكل المعروف + +527 +00:43:12,530 --> 00:43:17,880 +في الشكل القياسي عشان نتعود على طريقة الحساب هذه + +528 +00:43:17,880 --> 00:43:27,900 +find z inverse if z تساوي 2 ناقص 3 + +529 +00:43:27,900 --> 00:43:33,060 +solution زي + +530 +00:43:33,060 --> 00:43:37,380 +ما حكينا قبل قليل عشان أجيب المعكوس اللي هو 1 على + +531 +00:43:37,380 --> 00:43:41,400 +2 ناقص 3 I اللي هي طبعا خلينا نكتبها + +532 +00:43:41,400 --> 00:43:46,320 +بالترتيب عشان لسه احنا في البداية inverse بتساوي + +533 +00:43:46,320 --> 00:43:50,680 +1 على 2 ناقص 3 I كيف بتحسبها؟ هضربها في + +534 +00:43:50,680 --> 00:43:56,280 +المرافق فهضرب ب 2 زائد 3 I على 2 زائد + +535 +00:43:56,280 --> 00:44:03,520 +3 I الجد هادي ناخدها كطريقة السبب أو التفسير + +536 +00:44:03,520 --> 00:44:07,480 +ليش دائما بتنجح هنشوفه إن شاء الله في أتوقع ال وات + +537 +00:44:07,480 --> 00:44:11,000 +السيكشن الثالث أو الرابع في المحاضرات القادمة فبنجي + +538 +00:44:11,000 --> 00:44:14,280 +نعمل عملية الضرب 1 في البسط بده يساوي زي ما هو + +539 +00:44:14,280 --> 00:44:20,100 +تقسيم وهذه النقطة الأساسية نضرب 2 في 2 + +540 +00:44:20,100 --> 00:44:26,740 +4 زائد 6 I مظبوط بعدين ناقص 6 I وهذه ال + +541 +00:44:26,740 --> 00:44:32,320 +critical point لازم تختفي ال I من المقام بعدين + +542 +00:44:32,320 --> 00:44:36,760 +مافي عندنا 3 3 I في 3 I 9 I + +543 +00:44:36,760 --> 00:44:41,440 +تربيع نقوم هنا محاضرة أولى نعمل بالتفاصيل بدون + +544 +00:44:41,440 --> 00:44:45,260 +اختصار بدون استجابة ما في مشكلة فالآن أهم حاجة أن + +545 +00:44:45,260 --> 00:44:49,820 +ال I تختفي فجدش الجواب 2 زائد 3 I على جدش + +546 +00:44:51,930 --> 00:44:54,790 +طبعا هذا يعيش الصيغة مسموحة طبعا هذا الكلام صح قبل + +547 +00:44:54,790 --> 00:44:59,870 +أن تكتبه بالشكل الأنسب ال 2 على 13 زائد ال 3 على 13 في I + +548 +00:44:59,870 --> 00:45:05,510 +فزي ما أنتو شايفين ال X 2 على 13 وال Y 3 على 13 هذا + +549 +00:45:05,510 --> 00:45:08,730 +حقيقي وهذا حقيقي لكن مع بعض مع ال I بيصير عدد + +550 +00:45:08,730 --> 00:45:13,510 +مركب احنا قلنا أن نتعامل مع المعلومات الحسابية و + +551 +00:45:13,510 --> 00:45:19,250 +على وقت الجمع والضرب قد يسأل سائل وين الطرح و + +552 +00:45:19,250 --> 00:45:27,320 +القسمة بناش ندرسهم؟ لأ هم معرفين وخلاصين فالطرح هو + +553 +00:45:27,320 --> 00:45:32,060 +ليس إلا المعكوس ليهاش التجمع لأ والضرب هو عبارة عن + +554 +00:45:32,060 --> 00:45:34,940 +الجمع هي ضرب في المعكوس الضرب فهم معرفين جاهزين + +555 +00:45:34,940 --> 00:45:38,980 +طبعا الطرح سهل فماشي ده عنه نذكره فخلينا نشوف مثال + +556 +00:45:38,980 --> 00:45:41,880 +على القسم اللي عبارة عن ليهاش الضرب في المعكوس + +557 +00:45:41,880 --> 00:45:46,150 +الضرب خلينا نشوف مثال على القسم فإذن احنا القسم + +558 +00:45:46,150 --> 00:45:50,150 +اتعرفه بطريقة غير مباشرة لإن القسم يعني ضرب + +559 +00:45:50,150 --> 00:45:54,110 +بالمعكوس الضرب لما يقولك 5 على 2 إيش معناه؟ + +560 +00:45:54,110 --> 00:45:56,490 +يعني اضرب 5 في المعكوس الضرب لل 2 اللي هي + +561 +00:45:56,490 --> 00:45:59,750 +النص يعني خمسة في النص وكذا في المركز بنفس الأسلوب + +562 +00:45:59,750 --> 00:46:06,030 +خليني أشوف مثال find + +563 +00:46:06,030 --> 00:46:12,010 +سالب واحد زائد اثنين i تقسيم اللي هو سالب ثلاثة زائد + +564 +00:46:12,010 --> 00:46:17,600 +أربعة، عملية القسمة الآن معرفة بالمعنى الذي ذكرناه + +565 +00:46:17,600 --> 00:46:21,680 +قبل قليل، فبِنقدر نجري عملية القسمة عشان أنا أجري + +566 +00:46:21,680 --> 00:46:24,260 +عملية القسمة جاهزة في باب القسمة اللي هو البَعْقُوس + +567 +00:46:24,260 --> 00:46:27,480 +الضربي لازم نتخلص من الـ i في المقام بهذا المعنى + +568 +00:46:27,480 --> 00:46:32,000 +فهو نجري عملية القسمة سالب واحد زائد اثنين i على + +569 +00:46:32,000 --> 00:46:37,260 +سالب ثلاثة زائد أربعة i تساوي، هنضرب في المرافق تبع + +570 +00:46:37,260 --> 00:46:44,550 +المقام وهو سالب ثلاثة ناقص أربعة i، ناقص أربعة يعني + +571 +00:46:44,550 --> 00:46:48,070 +نحطّه في قوس عشان ما تدخلش الإشارة + +572 +00:46:57,040 --> 00:47:00,740 +فنَجري عملية الضرب، نضرب الـ bus مع الـ bus سالب واحد + +573 +00:47:00,740 --> 00:47:05,760 +في سالب ثلاثة، ثلاثة زائد أربعة i، بعدين عندنا سالب + +574 +00:47:05,760 --> 00:47:10,660 +ستة i، مظبوط؟ بعدين اثنين i في سالب أربعة، سالب + +575 +00:47:10,660 --> 00:47:15,040 +ثمانية i تربيع، مؤقتًا خلينا نمشي حد ما نِتَعَوّد، مش ضروري + +576 +00:47:15,040 --> 00:47:20,560 +نتصرّف الآن، سالب ثلاثة في سالب ثلاثة، تسعة زائد 12i، مظبوط؟ + +577 +00:47:20,560 --> 00:47:27,480 +بعدين ناقص 12i، نضرب الـ 4i وبعدين ناقص 16i تربيع + +578 +00:47:28,480 --> 00:47:33,860 +متابعين معايا؟ هيك صح إن شاء الله، فطبعًا إن نُرتّب هنا + +579 +00:47:33,860 --> 00:47:38,060 +عشرة زائد ثمانية أو ثلاثة عشر، ناقص اثنين i + +580 +00:47:38,060 --> 00:47:41,440 +تقسيم، طبعًا أهم حاجة يا شباب إن الـ i تروح مع الـ i + +581 +00:47:41,440 --> 00:47:45,420 +في المقام، البصمة، نجعة في المشكلة في المقام، وخمسة + +582 +00:47:45,420 --> 00:47:51,180 +وزائد ستة، فـ تسعة، وستة عشر، خمسة وعشرين، فهذه ناتج القسمة + +583 +00:47:51,180 --> 00:48:00,250 +فهذه هي نتيجة القسمة أو ناتج القسمة، أي سؤال؟ هذا نهاية + +584 +00:48:00,250 --> 00:48:04,210 +محاضرة اليوم، إن شاء الله يوم السبت نُكمّل