OB-GYN concepts and pain points in studying and deciding in the context of Gaza healthcare

I am here to help you. Study and help you, inshallah. تتلقوا and and you finish your medical studies. لتعينوا أخواتنا إن شاء الله. And you can make your parents proud. I want to make sure that I explain I am an intensive care specialist, العناية المركزة, and I may not know as much as everybody else. But I do know how to help you study. So let's get started. It's very important for me to know if you have what's going on next week, for example. Is it what I'm teaching you or not? أنا بحاول to connect with colleagues of yours in order to understand. لشان مفهم كيف عندكم ظروفكم بس لو تساعدوني راح تساعدوا أنفسكم. So let me start it. I understand that you are starting with OB-GYN, so I made some PowerPoints and I wanted to start teaching you how to help yourself to study. Okay. Every week we will have these sessions, and when we have these sessions, you will also see them recorded on YouTube. And I also have a link on LinkedIn that is dedicated for this opportunity. Let me explain what this opportunity is. I Wanted to help my brothers and sisters. I just didn't know how. So last year, I started teaching at a Najah University. I taught them clinical research, and unfortunately, there is no other ways to reach everybody. So I created this opportunity. وسميتها رست أمل. لأنه this is what I feel. I feel like I would like to put a badra sapling of hope from myself to yours, and it is under a caliph of the organization called Academic Solidarity with Palestine. Today we will be doing OB-GYN, and I understood that you have a website where all of the slides and all of the lectures are. I also follow the Instagram. So if there is anything to tell me, please do not hesitate to use the WhatsApp today. Please do not hesitate to do the reaction or type in the chat or type in the WhatsApp. Or come off mute and talk to me if you can. I will do my best to— full material. So the topic here is not to redo the lectures. You have professors, you have excellent material. The purpose here is to help you see a different way of studying for this. And that different way for this is hopefully, perhaps I had some of you ask me how to find question banks to study, or how to explain certain concepts into perhaps Much easier to understand. Let us start, for example, with the topic of CTG or fetal heart tracing. When we're looking at fetal heart tracing, some of what is confusing is the deceleration types. When I have a woman who is delivering, or even if it's not her time to deliver, and we do a fetal heart tracing, this is what we find. Usually, if we find the fetal heart tracing and it starts to drop like you see in here, but these drops are uniform, And they're mirroring the contractions. These are normal. When the contraction happens, the baby's heart starts to not like it. And so you just monitor the progression. If there are late decelerations, meaning that the heart rate starts to dip delayed after the contractions, that is worrisome. It means that there is an oxygen drop in Within the baby, and so these are very, very important to act upon. Sometimes you have to increase the patient's oxygen. Sometimes you have to. It just means that there's a uteroplacental insufficiency, and if you have these V-shaped sudden dips that are unrelated to contraction, understand that there might be a control. A compression of the cord. And that's important to keep in mind because you have to make sure that the baby is not in distress. So you have to define a risk. Is the risk due to contractions or is the risk due to umbilical? You have to see the frequency and the duration of contractions. Sometimes you can have decelerations, late decelerations, but they just started and the woman is already effaced and you can actually ask her to push and to get started with the labor. So it really depends on that circumstance. And I want to share with you, if I am studying this, how can I try to understand what can help me understand these decelerations, especially if I'm not somebody who is familiar with all of this. So let me teach you about something you may not be aware of. This is free on the internet, and you can start to use it right away. If you cannot, please let me know. This is called notebooklm.google.com. Some of you may be familiar with it. In NotebookLM, what you can do is you can actually upload anything that you have on the left panel right here. Add sources. You can add websites. You can add something on your Google Drive. You can add copied text, and you can upload files. What I did was I uploaded the PDF of your OB-GYN from the website that you have. Once you upload all of this in the middle here, you have the chats, which means that you can chat with So I'm going to ask, for example, what are late decelerations? Explain it to me as if I am a first-year college student in simple terms. I get confused. With the different decelerations, and you can click it here, and it's going to start answering you. It's like having a professor. It's like having a professor, Alan Muhammad. محمد لساتك، you joined. So I wanted to teach you that what we are discussing right now is how to independently, if you had no professor and nothing and you were studying, are there resources that you could use? And I'm teaching about notebooklm.google.com. This is a free resource from Google. If you have a Gmail address or Google, you can use it. And what you can do is add your sources right here. A source can be PowerPoint. A source can be copied text, your lectures, your notes. You can have something on Drive. You can have websites that you find. So I added the website of your lectures. And I also— you can upload files, and I uploaded the file of the PDF from OB-GYN from the website that they gave me, that you guys have all the lectures and all of the slides there. And then in the middle, you can chat with the material. So what I did, for example, I actually went and looked at what are the confusing points for medical students. In OB-GYN, and I made a list of them, and this is what we're going to go through today. One of them is the late deceleration. So I asked, what are the late decelerations? Explain them to me like I'm a first-year college student. In simple terms, I get confused with the different decelerations, and it answers them for you, and it also gives you where did they find it. Okay, now what's interesting about this is that You can actually ask it, translate this to me in Palestinian Arabic. Okay? And it's going to find keywords, and it's going to look for answers, and then eventually it's going to translate it to you in Arabic, and you can compare the Arabic and English, and that way it can help you. I have a question. You can answer on chat. You can answer by reactions. You can answer on WhatsApp. Did you know about the Notebook LM? Mina, Muhammad. Excellent. So this is going to help this. I'm not done. What is going to help as well is that you can create flashcards. ففي منكم اللي سألني إذا في website عنده أسئلة وأجوبة ليتمرنوا الامتحان. ف I did this already. It takes about twenty minutes or so. So I created one already, and here it is. Okay, and I did it in Arabic and English as well. According to the 2000 ACOG update, which clinical finding is no longer strictly required for the diagnosis of preeclampsia? Visual disturbances, new onset hypertension, platelet count. Let's do visual disturbances. Not quite. Proteinuria. Proteinuria allows the diagnosis. Okay, and then you can go And you can create a quiz for yourself. Okay. لو تشوفوا هون في ممكن يكون عندكم ملخص أوديو، ممكن يكون عندك ملخص فيديو، ممكن يكون عندك فلاش كارد. So I created flashcards for you. Here they are. And And we're going to say no. And if you click on it, no, it is not required. بس أنا اللي طلبت منه إنه يكون في الظهر بال بالانجليزي وبالعربي. And you can say explain the answer, and it's going to explain the answer. And moving to the next, what liver function test level constitutes a severe feature in preeclampsia, etc.? Okay. وآخرها I also created a video for you. So here's a video, 23 minutes. Modern obstetrics is built on precise sequential algorithms. A patient presents with specific symptoms. You run the indicated lab panels, and you follow the decision tree to a predictable standardized intervention. But that system assumes an unbroken supply chain. When the infrastructure shatters, those decision trees hit dead ends. This creates an immediate, life-threatening tension. You understand the exact standard of care required to stabilize a seizing or hemorrhaging patient, but the blood bank is empty, the lab is offline, and the pharmacy shelves are bare. Surviving this environment requires executing algorithmic— So I just wanted to let you know that you have multiple sources in that notebook LM alone as a student. So let's help with some of what we're going to do today. We're gonna go back to the PowerPoint. Okay? And So what are CTG decelerations? What must we know? What must we know is there's early decelerations. They mirror the contractions. That's because the head of the baby is compressed. That is reassuring. There's no intervention needed here. Late decelerations, those are bad. We need to worry about those. The cause is uteroplacental insufficiency. What you do, you give oxygen, you start fluids, and you have to consider delivery. Not always, because sometimes they are very temporary. And then variable deceleration. This is likely because of cord compression. So you have to understand this. It depends on the shape. You have to remember that late deceleration is bad, and you have to remember how it looks like on the CTG. Okay, any questions so far? Okay, so لو نشوف الخط بينزل and it is independent للانقباضات ف this is بيخوف لأنه بتاعني نقص أكسجين. ومشاكل بالبلاسنتة. That is bad. بس لو النزلة بالخط كانت مراية للانقباضات ومع الانقباضات فهي استجابة طبيعية لضغط على رأس الجنين. طيب. Next, we're going to go into preeclampsia, eclampsia, and HELLP syndrome. I want to tell you a story, short story. It was I was in your shoes. لساتني بتعلم بتمرن and اختي توأم She was pregnant. My niece, الحمد لله اسمها سوريا. And بس هذيك الوقت كانت pregnant with سوريا, and she was telling me that she was having pain, and the pain was in her belly on the right side. I was still training, بس I was feeling responsible. For one day she called me in the middle of the night, and I want to tell you that any pain that wakes somebody in the middle of the night you have to take seriously. فإنت لازم تروح على المستشفى راحت على المستشفى and she was found in pre-eclampsia and the beginning of help, and we had to take her to C-section immediately. Okay, so even though I was not a doctor at that time, it was not even though I was not an OB-GYN. زي ما بقول بال to my students in Morocco, I tell them في مرات just one sentence جملة واحدة تعلمتها في one chapter in medicine can save somebody's life and somebody who could be somebody very Close to you. So what are the diagnostic criteria for preeclampsia? New onset hypertension and proteinuria, or end organ dysfunction. End organ dysfunction, معناته تشوف الكبد. You start to have liver function tests going up. You start to see creatinine going up. The kidney. فارتفاع ضغط الدم حديث العهد اختي ما كان عنده ضغط الدم في هذيك الوقت حمراء 31 سنة ولا 30 سنة في هذيك الوقت فلما ارتفعت ضغط ولقينا بروتين في البول We started to see that she actually started to have late decelerations. We took her to C-section. How do you? At least that's what I know medical students struggle with. What to do when you have preeclampsia? You have to confirm gestational age. You have to confirm. That the baby is viable. There's still a heartbeat. You have to look at the platelets. You have to look at the blood pressure, and do not jump to conclusion. You cannot call it. ما فينا نسميها pre-eklampsia ولا eclampsia ولا help بدون يكون عنا مؤشرات ونتحقق من كل المؤشرات. Okay. So that's important. Sometimes questions will give you one indicator, and you jump to this is preeclampsia. No, you have to check all of the indicators. When you see liver function tests, they can't just be elevated; they have to be elevated twice or more. في مرات بنشوف pulmonary edema. Okay, platelets very low, creatinine very low, and the blood pressure very high. Okay, what do we do? We can actually— Muhammad, yes, this is— please confirm for me. This is 4th year going to 5th year, and I checked the program and it is for OB-GYN. Is that okay? Beautiful. Okay, you can text me what is next week so I can prepare next week. Insha'Allah. وهذا أخذت من conversations with Students like you, and خذت من ال website اللي أعطوه لي فهذول fourth level. Absolutely, it's taken directly from your curriculum. Okay, ففي مرات how do we treat this preeclampsia? IV magnesium sulfate very important. You give a loading dose, and after that you give infusion. Now, 4th year to 5th year, sometimes it's very difficult to think that this is going to be treatment, but I like to be complete by giving you treatment. You don't have to remember it if it's not in your curriculum. You do monitor the toxicity, meaning you have to look at their breathing, you have to look at the reflexes, and you have to sometimes have the antidote ready, which is calcium. Okay, sometimes you can use diazepam or benzodiazepines for seizure prophylaxis. This is the decision tree for preeclampsia. You confirm gestational age and viability. نتأكد من عمر الحمل وإنو البابى still alive. We also check the blood pressure. We take 2s. Readings before four hours, and then we look for proteinuria or other symptoms of end organ. End organ معناته liver معناته platelets إلى آخره. Okay, if it's less than thirty-four weeks, أقل من أربعة وثلاثين أسبوع نستنى لو ممكن نديل steroids لكان ال baby to increase the maturity. If it's 34 to 37, we talk, we communicate about delivery. في مرات بيكون الفيتوس still not very growth. You there's conversation. If it's more than 37 weeks, we deliver. For my niece, it was 37 weeks and we delivered. Okay. We then tackle the postpartum hemorrhage. If someone has blood loss more than 500 milliliters vaginally, فقدان الدم من المهبل أكثر من خمسمائة خمسمائة ملاليتر ولا أكثر من لتر بعد C-section. It depends on which one. Okay. This is how we diagnose postpartum hemorrhage. How do we do that? هذي كساعة شو بنعمل؟ ندي أوكسيتوسين to contract. ندي كاربोपروست، مسوبروستول، هدول to try to help with any hypertension. And carboprost we can give it, but you cannot give it if the person has asthma attack. And misoprostol. In order for you to remember postpartum hemorrhage, there are 4 Ts. The tone of the uterine— the uterine muscle is very weak. We have to increase the tone. The retained placenta, we have to take it out. If there is any trauma or rupture, if there's any lacerations, and coagulopathy. How is the bleeding? Is— so we send blood tests to make sure that the person can clot, can coagulate. Okay, so 3 things, 4 things actually: tone, tissue, trauma, and thrombin. We support with them Transfusion, blood transfusion, and we try to help with the tone, such as with oxytocin, with, with the coagulation. And if there is any laceration, we try to suture it so it doesn't continue bleeding, etc. Okay. We make sure that we speak Two, we call for help. We speak to the mother and the family so they know the danger that is ongoing. Sometimes what we do is we do massage of the uterus. We give uterotonics medications. لست نتكلم عنهم في مرات بن we put a balloon وبننفخه So it compresses and it keeps it from bleeding. If there is anything that needs to be ligated, or femoral rods, if available— there are some hospitals in which it was available— you can go in the radiology department and inject and embolize to close the artery that is bleeding. No, nothing worked. Sometimes we have to take the uterine out. It's the last resort. Okay, type. I want to take a moment and I want us to go into doing some Questions. So I showed you how NotebookLM has created questions for us, and those questions are going to be here. Let's do some in the few minutes that are left for us. Mina, is everything okay? Do you have any questions? Do you have any تعليقات? Okay, having seen nothing, we're going to continue. Let's go to our flashcards. No, we're not creating flashcards. We already created flashcards. Okay, so we're gonna go to these. Which blood pressure reading is classified as severe feature of preeclampsia? That is more than 160 over 110. And if you click on Explain, it's going to give you the explanation. Gathering the facts. Ahlan Mahmoud. Mahmoud, this is 4th year going to 5th year. And this is for OB-GYN. We are close to finishing, but I will give you at least this. This is a website that a lot of my students use. notebooklm.google.com. And if you have a Gmail address, it will give you access. You can upload on the left here under Add Sources anything. And I did upload the PDF for boards and so on from your curriculum. And in here you can chat and ask questions if you are not sure, or if you have questions you do not understand in the course. You can even ask it to explain it to you in Arabic. And on here there are sources that you can create flashcards, you can create quizzes, you can create an audio summary. So we created flashcards, and that's what we are doing. Okay, so which blood pressure reading is severe feature of preeclampsia? And if you click, I'm the one who created this, and I asked it to give it to me in Arabic as well. It gave me this answer, and then I said explain, and it opened the explanations here. And here I will say, explain it to me in Palestinian Arabic. And it's going to give it to me in Arabic. We'll go to the next question while it's doing that. What is the recommended intravenous loading dose for magnesium sulfate in preeclampsia management? We just did it in our slide. And it is 4 to 6 grams intravenously. Okay. What is the standard IV maintenance infusion rate? And we just went over it. That's 1 to 2 grams per hour. Okay. Which 3 clinical parameters must be monitored for magnesium toxicity? Deep tendon reflexes. Respirations and urine outputs. And here I asked it to explain to me the blood pressure parameter for preeclampsia. قراءة ضغط الدم الانقباضي فوق مية وستين أو الانبساطي فوق مية وعشرة. This is the severe features. يعتبر الميزات الشديدة أو الملامح الحادة عشان نتأكد هذا التشغيل. شخص طبياً لازم تتقاس هذه القراءات مرتين بينهم أربع ساعات على الأقل والأم مرتاحة في السرير. So this hopefully will help you if you need to understand concepts that you studied and you couldn't or you skipped a lab or something. What is the specific antidote for magnesium sulfate? That's calcium. We just talked about it. Okay, let me see. Is this helpful? Answer me in the chat or in— perfect, perfect, excellent. Thank you both. Thank you. Let's go back to Okay, topic number four. Topic number four, and Mahmoud to explain to you what I did. لأنه من يعيش معكم. So I try as best as I can to learn about you. So I went online and I started to ask what are the difficult concepts for medical students like you. In OB-GYN, and this is what we are discussing today. These sessions are helpful; they're complementary. They are not replacing the lectures that you have in your school. So topic number four was about gestational age dependent decision making. تخاد القرار بناء على gestational age العمر الحملي. Okay. فأقل من أربعة وعشرين أسبوع. We focus on the mother. It's very difficult for a fetus to survive if there was less than 24 weeks. Okay, 24 to 28 weeks. Maybe we have to discuss. It's risky. بس نستشير ونشوف ونتأكد من العمر الحملي ونشوف لأن العمر الحملي we know it. Based on ultrasound, and ultrasound, there are parameters and the measurements, and all these measurements tell us what is the gestational age. But measurements, if they're not done well, you can be off by 1 or 2 weeks. Okay, 24 to 34 weeks, we give steroids with the hope. ترقب إنه ممكن الستيرويدات يساعدوا الفيتس على إنه to to mature so we can accelerate بعد ال ال الستيرويدز then بعد ثلاث أربعة وثلاثين أسبوع بنحكي إنه ممكن ولا مش ممكن نعمل C-section. ال common mistake الخطأ شائع إنه ال الستيرويدات ما بين أربعة وعشرين وأربعة وثلاثين أسبوع مش ستة وثلاثين أسبوع. So keep those in mind. What are some of the clinical scenarios؟ My style تدريس تبعي نمط التدريس إنه أنا بفهم أحسن لو كان عندي examples، أمثلة. فالمثال الأول ستة وعشرين أسبوع، ستة وعشرين أسبوع هذي ولادة مبكرة. So لو في contractions ولا dilation ولا premature rupture of the membranes هدول شو بنعمل؟ We try to Bring down the stress. We give tocolysis. معناته إنه ممكن ندي medication to lessen the contraction or stop the contraction. لنضبط المخاد. Okay. ندي steroidات لو كانت between أربعة وعشرين وأربعة وثلاثين. And وبندي كمان ال magnesium sulfate. And then we transfer to the NICU facility. Okay, neonatal ICU. Scenario اثنين لو في severe preeclampsia. Severe preeclampsia بس اثنين وثلاثين أسبوع. شو بنعمل؟ اثنين وثلاثين أسبوع. if it's pre eclampsia severe, it's an emergency. you must take the baby. the baby is making mom sick. you must. بس هيدولي اللي بقولكن لازم يكون في استشارة الاختصاصي واستشارة مع الأم ومع العائلة. بس it's very important we give magnesium for seizure prophylaxis and we control the blood pressure. لا ينبغي الانتظار أو manage expectantly لأنه خطر على الأم. سيناريو أربعة هو بعد ما تكمل الحمل ولساته ما في مخاض ولساته ما في nothing. So full term clean painful bleeding. Fetal— what is fetal or meconium fluid? Low phi distress for the fetus, and they start to have— they release their sphincter and their poop comes out in the fluid, and that fluid goes into the lungs of the baby. This is something to keep in mind. We do not want it to happen because it's very, very hard on the lungs of the baby when they just start. Okay, so full-term meconium or stillbirth. It's— we have to make sure that we make the right diagnosis. We talked about the gestational age, and we talked about we need to have the induction immediately to lessen the danger of the— on The baby. لا تكون مضاعفات على البابى. والسناريو ثلاثة. This is different, and no, this is actually diabetes, gestational diabetes. Gestational diabetes is not like diabetes. It doesn't mean you might have diabetes, although it increases your risk for it, but it can actually get better after you give birth. Insulin. But insulin, you have to make sure insulin works. So you have to continue doing glycemic control, testing it. Do you give long-term insulin? Do you give short-term insulin? It really depends on how you eat. So short-term insulin before you eat, long-term insulin so that you can do maintenance. If I wanted to have concepts of— obviously I can't go into Several details, but I wanted to at least go over these. I know they are the most painful chapters here. Unfortunately, sometimes the baby, as they are coming out, instead of the head comes out, it gets stuck in the shoulder. We call that shoulder dystocia. السكاك الكتف. Failures of the shoulder to deliver after the head, and that requires additional maneuvering. You have a baby, and if it takes more than five minutes, the baby's oxygen starts to drop. So shoulder dystocia is an emergency. So this is what we need to do when you have shoulder dystocia, and you have to remember the mnemonic helper. Help evacuate. معناها إطلاق إبزيوتومي. You open it so that the baby can come out if needed for maneuvers. The episiotomy helps. ليش الإبزيوتومي؟ أنا لما كنت في السنة الخامسة ما كنتش فاهم. I it was very difficult for me, very difficult for me. بأخذ المقص and I create a laceration. It was very difficult for me to know when. To do it. Why would I do it? Because you knew that that's going to stay with the mother for the rest of her life, and then you have to repair it. So when you know— because if you don't do an episiotomy, there will be a laceration that is going to be by itself, which means episiotomy is clean. You know how you created it, so you know. How you're going to suture it plane by plane. If it tears up by itself, laceration, that's random. The repair and the suturing is not going to be the same as the one you did clean and surgical. But you have to understand when the episiotomy to create more space for you to have maneuvers for shoulder dystocia. And that needs to have a decision, decision to make it in order to have to, to be quick about the shoulder dystocia. Leg hyperflex the hip. Pressure, you have to push suprapubic pressure to apply downward pressure, never fundal pressure. And then you try sometimes to roll the mother on all fours in order to create a 3-dimensional way. To do any maneuvers. في مرات لازم you can push your hand in there to create an internal maneuver, and then you try to remove the posterior arm so that you can allow for the the shoulder to come out. So it's very important that we remember. All of these are ways to help evacuate the baby. Okay. Let's go and do a couple more questions and then we can finish. Is this helpful so far? Is this what you guys see? Yes. It's very important for me to know that I give you What you see and what is needed in your studying and not something else. Okay. What is the immediate action for a patient at 32 weeks gestation with severe preeclampsia? I have a lot more, insha'Allah, Mina. I have a lot more to share with you, insha'Allah. So just stay with me. This is meant for complementary. What is the immediate action for a patient at 32 weeks gestation? What do you think the answer is? Give me the answer if you can on chat. I am trying to not quiz you, but to replicate. بعطيكم أمثلة كيف تستعملوا هال link إن شاء الله. So what is the immediate action for a patient at 32 weeks gestation? It's إلنا أربعة وعشرين لستة وعشرين لأربعة وعشرين لأربعة وثلاثين. فا نينو تلاتين. We are talking about a delivery, so we have to give steroids, right? At what gestational here it is immediate delivery seizure prophylaxis. What is the management recommendation for preeclampsia at 30 C seven weeks gestation? Delivery. At what gestational age are steroids appropriate? Less than 34 weeks, we give steroids. So 32 weeks, we needed to give steroids unless it's severe. If it's severe preeclampsia, we have to deliver. We don't have time. And the steroids, they're not magic. They need time to work. فهمتوا قصدي؟ فلما بنعطي steroids that is preeclampsia but not severe preeclampsia. Severe preeclampsia هلأ هسا we have to do something. If you give steroids you have to wait for them a few days for them to work. So only if it's not severe. منشان هيك إلنا we have to give steroids and wait. But if we cannot wait just deliver and we have to give My sister, she received magnesium sulfate. She received seizure prophylaxis, etc. Okay. So let's say I don't understand this. I don't explain. Here it is, and it's going to go into here. And now this is a chat. This is as if you are texting with your professor. It's going to give you answer. And you can literally as many times as you want. I still don't understand. I still don't understand. Tell it to me in a different way. Repeat it to me in Arabic. Repeat it to me in English. I want you to give it to me in a question. I still don't understand. Show it to me in an image. Find something on the internet that can explain it to me better. You can say it 10 times. You can ask. This is a very patient professor. When management managing preeclampsia, We must constantly balance the health of the mother against the maturity of the fetus, because the only definitive cure is delivering the baby and the placenta. Let's say I don't speak very good English. I want, I want you to say it to me in simple English with each sentence in Arabic so I can understand. Okay, this is الدكات الاستناعي من جوجل من شان تتعلموا and it is excellent. Now after I'm done with this, I want to show you before we finish how I started this whole thing. When a mother had preeclampsia without severe features, doctors want to delay the baby's delivery if it's إنما تصاب الأم بتسمم الحمل دون ملامح حادة يفضل الأطباء تأخير ولادة الطفل إذا كان ذلك آمناً. I under I hope you understand what I mean. Okay. طيب what can we do if it's I showed you when it's already done now I'm going to show you before it's done. I create a notebook here it is and when I create it سميه هون بس قبل ما سميه how do we you can drop all your files upload files this is for okay something that you have on your computer if you have a website and هون I give it the website اللي اسمه medicine is life اللي عندكم فيه I will share again. Is this the website you guys use? Is this accurate? طيب إحنا حن. Excellent. Okay, so we will go into website, notebook LM, and I put website here, and I put the website insert. Okay, here it is, the portal. Okay, and I put in here. Now, now I have it. And now you can actually go here. And this is artificial intelligence. It already knows that website. You can ask any question you want. You can say, can you go into whatever? Okay? Or you can come here and you can say create slide deck. Okay? And in create slide deck, you can ask anything, including choose the language. Okay? You can short, long, your instructions. I can put in here the instructions: create 10 slides about respiratory, make examples of exam questions, moderate difficulty for 5th-year medical students, combine it with some Examples of respiratory in OB patients, whatever you want, and it will create it for you. Okay, we are at time, so I want to أشكركم إنكم حضرت اليوم I will إن شاء الله create a summary أهل الحسين we are at the end of our session بس I will put the recording on YouTube and in academic solidarity with Pakistan Palestine dot org or on LinkedIn. And I will put them on WhatsApp so you can see them. Please, I'm here not to teach you but to interact with you. So if you have any questions, Allah يبارك فيك مين؟ If لو عندكم أسئلة، لو عندكم أي شغلة، please do not hesitate. وإن شاء الله as we go along, I will be teaching various artificial intelligence. Please share them with others. I want as many of you, insha'Allah, تتألقوا وتكونوا إن شاء الله في الطب، إن شاء الله. لا شكر على واجب مين ومحمود وحسين very very quick. لو ما فيها غلبة تبعتنا روابط مجموعات الواتس تبعت. تنشرها. Of course كل أسبوع هدول الروابط كلها حتكون بالواتساب. كمان نص ساعة ولا ساعة تكون إن شاء الله قبليها بس. قال بقلكن نص ساعة ولا ساعة لأنه رايح الشغل دلوقتي. So I want to make sure that I give you everything quickly وإن شاء الله Just ask me what you what you need. Ask me what you want. The recording of this session will be there as well. It's going to be on my YouTube, insha'Allah ta'ala. Yalla. سلام عليكم.