Medical Terminology Lectures PDF - Dr. Zaid Al-Attar
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Baghdad College of Medicine
Dr. Zaid Al-Attar
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This is a series of medical terminology lectures by Dr. Zaid Al-Attar, covering medical terms, prefixes, suffixes, and other related concepts. This educational resource explores essential aspects of medical vocabulary, anatomical planes, and surgical procedures. The lectures are designed to provide a comprehensive understanding of medical language.
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Lecture 1 Medical Terminology Dr Zaid Al-Attar Medical conditions, diagnosis ﺗﺸﺨﯿﺺ treatments ﻋﻼجand terms should always be explained in lay person’s اﻟﺸﺨﺺ اﻟﻌﺎديlanguage when talking to patients, family and community members Be aware of the client's literacy level ﻣﺴﺘﻮى اﻟﺘﻌﻠﻢan...
Lecture 1 Medical Terminology Dr Zaid Al-Attar Medical conditions, diagnosis ﺗﺸﺨﯿﺺ treatments ﻋﻼجand terms should always be explained in lay person’s اﻟﺸﺨﺺ اﻟﻌﺎديlanguage when talking to patients, family and community members Be aware of the client's literacy level ﻣﺴﺘﻮى اﻟﺘﻌﻠﻢand language Lipo/ , adipo/ Vesico , musclo , Acoust/o lingua tongue Onych/o nail Dental tooth Pectoral chest Mammo breast Adeno gland Hystero Uterus Suggested dictionaries for medical reading 1. اﻟﻤﻮرد اﻟﻜﺒﯿﺮ 2. ﻗﺎﻣﻮس ﺣﺘﻲ اﻟﻄﺒﻲ Online dictionaries and installable on pc or mobile: 1. Reverso 2. babylon 3. Class code :bvnnodo Lecture 2 Dr Zaid Ihsan Al-Attar Apnea Anemia Antenatal Antibody Neonate Parathyroid gland Super ego Supra renal gland Lecture 3 Medical Terminology Dr Zaid Al-Attar , di Amounts Semi = Half (Semicolon - Half of a colon) Hemi = Half or One Side (Hemiplegia - Paralysis of one side of the body) Equi = Equal (Equilateral Triangle - 3 sides equal in length) Iso = Equal (Isocellular - Composed of cells of equal size) Eu = Normal (Euglycemia - Normal blood glucose level) Normo = Normal (Normotensive - Normal blood pressure) Hyper = Above Normal, Excess, High, Elevated (Hyperthermia - Elevated body temperature; Hyperactive - Overactive) Dys: difficult , hard (dyspnea: difficult breathing ) Ex: out, away from. excision= استئصال Hypo = Below Normal, Deficient, Low, Decreased (Hypoglycemia - Low blood glucose level) A/An = Absent or Lacking (Anoxia - Absence of oxygen reaching tissues), Atypical Pan = All (Pancytopenia - Deficiency of all 3 cell components of blood) Omni = All (Omnivore - Consumes food of both plant and animal origin) Polygon - Many sides Oligo = Few or Very Little (Oliguria - Production of small amounts of urine) Neonate Lecture 4 Dr Zaid Al-Attar Class code i3smujh e.g. Anemia e.g. Dwarfism Thank you Lecture 5 Prefixes - Five senses Ear : Oto- Eye: ophthalmo- , opto Smell : olfacto- Taste : gustus- Touch : tactus- Purpose of Directional Terms & Anatomic planes Directional terms: used to describe the relative position of one part of the body to another Anatomic planes: used to describe the location of internal organs and structures Standard Anatomic Position Body is viewed as erect, arms at the side with palms of the hands facing forward, and feet placed side by side. Whether the patient is standing or lying down face up, the directional terms are the same. Anatomic Planes Frontal or coronal ﺗﺎﺟﻲ: vertical field passing through the body from side to side, dividing the body into anterior and posterior portions Midsagittal ﻣﻧﺗﺻف اﻟﺳﮭﻣﻲ: vertical field running through the body from front to back; divides body into equal right and left halves Sagittal اﻟﺳﮭﻣﻲ: vertical field running through the body from front to back—divides body into uneven right and left parts Transverse ﻣﺳﺗﻌرض: horizontal field dividing the body into upper and lower portions Medical Terminology lecture 6 By Dr. Zaid Al-Attar Opposite Forms for Directional Terms anter/o اﻣﺎﻣﻲ poster/o ﺧﻠﻔﻲ cephal/o َرأْﺳِ ﱞﻲ caud/o َذﻧَﺒِ ّﻲ ; َذﯾْﻠ ّﻲ proxim/o ﻗﺮﯾﺐ dist/o ﺑﻌﯿﺪ ventr/o ﺑﻄﻨﻲ dors/o ظﮭﺮي super/o ﻋﻠﻮي infer/o ﺳﻔﻠﻲ Opposite Forms for Directional Terms deep superficial central peripheral Efferent ﺻﺎدر afferent وارد Planter أﺧﻤﺼﻲ Dorsal ظﮭﺮي Bilateral Unilateral يّ أُﺣَﺎ ِد ذو ﺟﺎﻧﺒﯿﻦ,ﺛﻨﺎﺋﻲ اَ ْﻟﺠَﺎﻧِﺐ Cavities Abdominopelvic Regions To assist medical personnel to locate medical problems with greater accuracy and for identification purposes, the abdomen is divided into regions: Epigastric & hypochondriac (right & left) Umbilical & lumbar (right & left) Hypogastric & iliac (right & left) Abdominopelvic Regions Abdominopelvic Quadrants Right upper quadrant: RUQ Left upper quadrant: LUQ Right lower quadrant: RLQ Left lower quadrant: LLQ Lecture 7 Zaid Al-Attar Surgical procedures -centesis : to puncture/tap to draw fluid from -desis : surgical fixation, fusion (arthrodesis) -ectomy : excision, removal, cut out -pexy : fixation -plasty : surgical repair, correction -rrhaphy : suture -sect : to cut (dissection) -stomy : forming a new opening -tome : instrument for cutting (microtome) -tomy : incision into, cut into (laparotomy) -tripsy : to crush, break down (lithotripsy) -puncture : to pierce a surface -assay : examine, analyze -gram : written record, recording -graph : instrument for recording -graphy : process of recording -manometer : instrument for measuring pressure (sphygmomanometer) -manometry : process of measuring pressure -meter : instrument for measuring -metry : process of measuring -opsy : to view (biopsy) -scope : instrument for examining -scopy : process of examining Common abbreviations & symbols ad lib: freely; at will b.i.d. twice a day BP blood pressure PR :pulse rate CDC :Center for disease and control CCU : critical care unit c/o :complains of CVA : cerebrovascular accident ﺟﻠطﺔ دﻣﺎﻏﯾﺔ I&O intake (input) and output lab. Laboratory M.I: myocardial infarction n.p.o. Nothing by mouth n&v nausea and vomiting P.O. By mouth R.C.U respiratory care unit p.r.n. As needed q.d. Daily, once a day q.h. Every hour q.i.d. Four times a day Rx :treatment RR :respiratory rate stat. immediately # fracture t.i.d. Three times a day Tx Treatment; traction VS vital signs Wt. Weight Miscellaneous Roots Cry (o) = cold (cryosurgery) Dips (o) = thirst (polydipsia) Geri =old age (geriatric) Gyne =women (gynecology) Kin(o) = movement Narco =sleep (narcotic drug) Necro =death , dying (necrosis) Noct =night (nocturnal polyuria) Onco =tumor (oncology) Pyo =pus Pyro =fever (pyrexia) Scler(o) =hardening (sclerosis) Scolio =bending (scoliosis) Xer(o)=dry (xerophthalmia) Prefixes Mal- = inadequate (malnutrition ) Mamm(o) - =breast (mammography) Mast - =breast (mastectomy ) Chole = bile (cholecystitis) Suffixes - asthenia = weakness - esthesia =sensation (anesthesia ) - clast =breaking (osteoclast) - crine =secreting (endocrine) - emesis =vomiting - malacia = softening (osteomalacia) - kinesia = movement - penia =deficiency ( leukopenia) - cytosis = many cells ( leukocytosis) - phobia=fear - phonia=sound (dysphonia) - stenosis =narrowing BY ALI Communication skills Duties & Responsibilities of Doctors اﻟدﻛﺗور زﯾد اﺣﺳﺎن اﻟﻌطﺎر ﻛﻠﯾﺔ طب اﻟﻛﻧدي -ﺟﺎﻣﻌﺔ ﺑﻐداد 1. Good Clinical Care : must include * adequate assessment of the patient's condition, based on the history and physical examination; * Provide appropriate investigations * Provide appropriate treatment * Referring اﺣﺎﻟﺔthe patient to another practitioner ﻣﻤﺎرس, when indicated. * Being neutral ﻣﺤﺎﯾﺪ 2. you must: * Work within limits of your professional competence اﻋﻤﻞ ﻓﻲ ﺣﺪود ﻛﻔﺎءﺗﻚ اﻟﻤﮭﻨﯿﺔ * Keep clear, accurate, medical records which report the relevant clinical findings, the decisions made, treatment given * Make sure that your prescriptions اﻟﻮﺻﻔﺎتare written correctly and clearly 3. Maintaining Good Medical Practice keep your knowledge and skills up to date. By educational activities, which develop your competence and performance اﻟﻜﻔﺎءة واﻷداءand read the important medical journals in your field. 4. laws and codes of conduct You must observe and keep up to date with the laws and codes of conduct. اﻟﻘﻮاﻧﯿﻦ وﺿﻮاﺑﻂ ﻗﻮاﻋﺪ اﻟﺴﻠﻮك Dress code ﻗﻮاﻋﺪ اﻟﺰي 5. contribute to the education and training of medical students and other doctors 6. Explanation If a patient under your care has suffered serious harm, you should act immediately to put matters right. ﻓﻌﻠﯿﻚ،إذا ﻋﺎﻧﻰ ﻣﺮﯾﺾ ﺗﺤﺖ رﻋﺎﯾﺘﻚ ﻣﻦ ﺿﺮر ﺟﺴﯿﻢ اﻟﺘﺼﺮف ﻋﻠﻰ اﻟﻔﻮر ﻟﺘﺼﺤﯿﺢ اﻷﻣﻮر. You should explain to the patient and his family what has happened and the likely effects. 7. Disclosure of Medical Information All Medical information about your patient shall be treated as confidential and shall not be disclosed other than to the patient, except with the patients consent ﻣﻮاﻓﻘﺔ. However, disclosure is legitimate ( ﻣﺸﺮوعwith out consent) in the following circumstances 1. Disclosure to colleagues and other health professionals for the purpose of treatment 2. Disclosure for research and teaching purpose 3. Disclosure pursuant to a Court Order اﻣﺮ ﻣﺤﻜﻤﺔ 4. Disclosure to the family of child or an incompetent person ﻣﻌﺎق ذھﻨﯿﺎ 5. Disclosure in the public interest اﻟﻤﺼﻠﺤﺔ اﻟﻌﺎﻣﺔ, this includes * Disclosure اﻻﻓﺼﺎحto the family of a patient that he has a communicable disease ﻣﺮض ﻣﻌﺪ * Disclosure for public safety purposes in relation to vulnerable persons in dangerous occupations as airline pilots or public transport drivers, if found to suffer from epilepsy or other incapacitating disease ﻣﺮض ﻣﻌﯿﻖ ذھﻨﯿﺎ او ﺟﺴﺪﯾﺎ. * Disclosure of a patient who is a threat ﺧﻄﺮto the safety of the public or a particular individual by reason of his mental disturbance اﺿﻄﺮاب ﻋﻘﻠﻲ. 8. You must NOT: * Recommend an investigation or treatment that is not in the best interest of the patient ﺗﺤﻠﯿﻞ او ﻓﺤﺺ ﻻ ﯾﺼﺐ ﻓﻲ ﻣﺼﻠﺤﺔ اﻟﻤﺮﯾﺾ * Put pressure on patient to accept private treatment, or otherwise promote your own private practice. اﻟﻀﻐﻂ ﻋﻠﻰ اﻟﻤﺮﯾﺾ ﻟﺘﻄﻮﯾﺮ ﻋﻤﻠﻚ اﻟﺨﺎص * You must not make any patient doubt a colleague's knowledge or skills by making degrading comments about them. ﺗﺠﻨﺐ اﻟﺘﻘﻠﯿﻞ ﻣﻦ ﺷﺄن زﻣﻼءك اﻣﺎم اﻟﻤﺮﺿﻰ ﺑﻤﻔﺮدات ﺗﺤﻂ ﻣﻦ ﻗﺪرھﻢ * If you publish or broadcast information about the services you provide, the information must be factual and verifiable ﻣﻮﺛﻘﺔ و ﺣﻘﯿﻘﯿﺔ. What Makes a Good Doctor? By Dr Zaid Al-Attar Medical Knowledge: Continually Knowledge and Skills updated understanding of medical science. Clinical Skills: Proficiency in diagnosing and treating various conditions. Technical Skills: Dexterity ﻣﮭﺎرةin performing medical procedures. Listening: Attentively ﺑﺎﻧﺘﺒﺎهunderstanding patient concerns. Communication A doctor should give their patients the time they need and deserve. He should answer questions using language that is clear, without using medical terminology. Explaining: Clearly conveying ﻧﻘﻞmedical information. Empathy ﺗﻌﺎطﻒ: Connecting with patients on a human level. He should be honest, but also offer hope. Ethics: Adhering to moral principles اﻟﻤﺒﺎديء اﻻﺧﻼﻗﯿﺔ Professionalis Responsibility: Being accountable ﻣﺴﺆولfor treatment outcomes ﻧﺘﺎﺋﺞ اﻟﻌﻼج. m اﻟﻤﮭﻨﯿﺔ Respect: Valuing the dignity ﻛﺮاﻣﺔand rights of patients. should not be condescending ﻣﺘﻌﺎﻟﻲor arrogant ﻣﻐﺮور. They should treat others as they want to be treated. This is critical to establishing a trusting relationship between a doctor and their patients. Good doctors are organized practice organization to be successful. You can’t succeed in medicine without being logic ﻣﻨﻄﻘﻲand being vigilantﯾﻘﻆ about details. A doctor needs to make sure that : patients get recommended screening tests their questions are answered patients have a clear plan of action upon leaving clinic Patient Care Compassion اﻟﺤﻨﺎن: Demonstrating kindness and care. Patience اﻟﺼﺒﺮ: Taking the time to address patient needs. أﺧﺬ اﻟﻮﻗﺖ اﻟﻜﺎﻓﻲ ﻟﺘﻠﺒﯿﺔ اﺣﺘﯿﺎﺟﺎت اﻟﻤﺮﯾﺾ Advocacy اﻟﺪﻋﻢ: examples; helping them navigate the health care system by finding specialists help patients get a prescription medicine approved, secure an urgent appointment for a test or with a specialist access physical therapy. Good doctors are curious ﺣﺐ, اﻟﻔﻀﻮل اﻻﺳﺘﻄﻼع When presented with confusing symptoms, a good doctor should allow their inherent curiosity to lead them to an accurate diagnosis ﺗﺸﺨﯿﺺ ﺻﺤﯿﺢ That may require extra research, reaching out to colleagues, or taking more time to gather a detailed history from the patient. Good doctors work together to support patients Just as a doctor needs team work practice for relaying ﺗﺒﺎدلinformation across the health care system. The primary care doctor اﻟﻄﺒﯿﺐ اﻟﻤﻤﺎرسshould make an effort to gather hospital records and offer follow-up. A good medical specialist اﻟﻄﺒﯿﺐ اﻻﺧﺘﺼﺎصwill involve a patient’s primary care doctor in any diagnoses or treatments. Being able to work well with others is imperativeاﻟﺰاﻣﻲ Continuous Improvement Learning: Seeking ongoing education and knowledge. Adaptability اﻟﻤﺮوﻧﺔ: Being flexible in the face of change. Innovation: Embracing new technologies and methods. ﺗﺒﻨﻲ اﻟﺘﻘﻨﯿﺎت واﻷﺳﺎﻟﯿﺐ اﻟﺠﺪﯾﺪة. Thank You Lecture 11 Foundation of Medicine By Dr. Zaid Al-Attar Types of teaching for a medical trainer Theory 1. Self study 2. Lecture ﻣﺤﺎﺿﺮة 3. Seminar ﺣﻠﻘﺔ دراﺳﯿﺔ 4. Symposium ﻧﺪوة 5. Workshop ورﺷﺔ ﻋﻤﻞ 6. Conference ﻣﺆﺗﻤﺮ Practical 1. Lab METHODS OF CLASSIFICATION 1. Mass Instruction -Conventional lectureﻣﺤﺎﺿﺮة ﺗﻘﻠﯿﺪﯾﺔ -Mass ﺟﻤﮭﻮرpractical demonstration class -Video broadcast Role of Teacher: Traditional expository role. اﻟﺪور اﻟﺘﻔﺴﯿﺮي اﻟﺘﻘﻠﯿﺪي Role of Student: Largely Passive. 2. In-Group learning Group discussions Seminar Role of Teacher: Organizer of group activity. Role of Student: Active 3. Individualized learning Direct study of texts Study of open-learning materials Individual assignments. Role of Teacher: Producer, manager of learning resource. Role of Student: Active. Lecture Lecture method is the most commonly used method of teaching. Teacher – controlled and information centered approach ADVANTAGES OF LECTURE 1. Properly presented 2. Facts presented in short time 3. Stimulate very good interest in the subject. 4. Spoken word has greater weight Disadvantages of Lecture 1. Student cannot easily take notes 2. Passive learners 3. Problem solving attitudes of students disappear 4. Less cooperation & interaction between teacher& students Conference ﻣﺆﺗﻤﺮ 1. It is the largest event ( versus smaller workshops and seminars). They can number anywhere between fifty attendees to thousands of attendees 2. the opportunity to present your work as a talk or as a poster. 3. When you attend a poster session, you can walk around and look at each of the different posters and stop to chat or to ask questions of the presenter as well. 4. conferences usually last for between a few days and a week, 5. Conference discusses one topic from several aspects Workshop ورﺷﺔ ﻋﻤﻞ workshops are generally smaller than conferences, and are usually only a day or two long and are dedicated to discussing a specific topic from one aspect. Workshops are a good opportunity to learn new skills and to familiarize اﻟﺘﻌﺮفyourself with a topic you don't know well. May involve a problem solving in the form of task or quiz to test knowledge ﻧﺪوة رﺋﯿﺲ اﻟﺠﻠﺴﺔ typically completed in a single day. experts presenting their work in summary symposiums will generally be smaller than a conference. Objectives of Symposium Identification & understanding of a problem Development of standards regarding a problem management وﺿﻊ ﻣﻌﺎﯾﯿﺮ ﺗﺘﻌﻠﻖ ﺑﺈدارة اﻟﻤﺸﺎﻛﻞ Advantages of Symposium 1. Suited for large groups 2. Used to present broad topics for discussion 3. Give deeper knowledge about the topics. Disadvantages of Symposium 1. Listeners remains passive 2. Speeches are limited to 15-20 minutes 3. Possibility of overlapping the subjects. Chairman roles : 1. Time Management:. Ensuring speakers stick to their allotted time slots to keep the symposium on trackﺿﻤﺎن اﻟﺘﺰام اﻟﻤﺘﺤﺪﺛﯿﻦ ﺑﺎﻟﻔﺘﺮات اﻟﺰﻣﻨﯿﺔ اﻟﻤﺨﺼﺼﺔ ﻟﮭﻢ ﻹﺑﻘﺎء اﻟﻨﺪوة ﻋﻠﻰ اﻟﻤﺴﺎر اﻟﺼﺤﯿﺢ 2. Session Transitions: Smoothly transitioning between speakers and sessions. اﻻﻧﺘﻘﺎل اﻟﺴﻠﺲ ﺑﯿﻦ اﻟﻤﺘﺤﺪﺛﯿﻦ واﻟﺠﻠﺴﺎت:اﻧﺘﻘﺎل اﻟﺠﻠﺴﺎت. SEMINAR ﺣﻠﻘﺔ دراﺳﯿﺔ Presented by student Subject is delivered as an article or report Concepts are analyzed & discussed through group discussion. Short for an hour or two Advantages 1. Skill Development: Participants can enhance their skills 2. Latest Trends: Offers exposure to the latest trends in a specific field. 3. Collaboration: Facilitates collaboration and team work. 4. Confidence Building: Presenting can boost confidence. 5. Public Speaking: Improves public speaking and presentation skills. 6. Critical Thinking: Encourages critical thinking اﻟﺘﻔﻜﯿﺮ اﻟﻨﻘﺪيand problem-solving abilities. DISADVANTAGES OF SEMINAR 1.Not applicable for every topic 2. The presenter must be resourceful. ﯾﺠﺐ أن ﯾﻜﻮن اﻟﻤﻘﺪم واﺳﻊ اﻻطﻼع ﻋﻠﻰ اﻟﻤﻮﺿﻮع 3. Subject area needs to be relevant to students field of study ﯾﺠﺐ أن ﯾﻜﻮن ﻣﺠﺎل اﻟﻤﻮﺿﻮع ﻣﻨﺎﺳﺒًﺎ ﻟﻠﻄﻼب ﻓﻲ ﻣﺠﺎل اﻟﺪراﺳﺔ Thank You Duties & Responsibilities of students , patients اﻟدﻛﺗور زﯾد اﺣﺳﺎن اﻟﻌطﺎر ﻛﻠﯾﺔ طب اﻟﻛﻧدي -ﺟﺎﻣﻌﺔ ﺑﻐداد Meetings When you need to see your lecturer, you should 1. Contact him to book an appointment 2. Attend the meeting on time 3. Be ready for the meeting like reading about the topic , having all the required resources e.g documents or laptop 4. Make use of the meeting time. 5. If you cant attend you should apologize with an excuse. Contacting the lecturer / professor Try to avoid phone calls as much as you can by using viber , email ….. If you need to call , You should take the permission to call e.g. by sending an email , message on viber Contact the secretary , stage rep to get an appointment Avoid contacting the lecturer on weekends or holidays or at unsuitable time like 2 a.m. This includes messages too. Dealing with lecturer You should keep in mind the following things: 1. The lecturer represents a formal entity/ authority. 2. You cant treat him as a friend or family member. 3. You should keep communication as formal as possible. This means great respect, choosing proper formal words , avoiding improper or illegal requests, privacy violation اﻧﺘﮭﺎك اﻟﺨﺼﻮﺻﯿﺔ, challenging, lies. 4. The lecturer can help you within the scope of law ﻧﻄﺎق اﻟﻘﺎﻧﻮن 5. Being a privately funded student doesn't mean that you should pass all the exams successfully. Avoid irritating the lecturer with silly questions The most irritant question is :Is this lecture required? ھﻞ ھﺬه اﻟﻤﺤﺎﺿﺮة ﻣﻄﻠﻮﺑﺔ According to Iraqi Law (education is compulsory in primary stage only) Never ask this question. The lecturer will tell you near the exam date if there are some unnecessary lectures. Or student's representative may ask before near the exam date. Attending a class 1. You should attend before the specified time. 8:00 am 2. If you are late , wait on door for a permission. Don’t talk or say hello, good morning , sallam alyukom ……any thing you say will make noise , disruption , interference. 3. Absence from a lecture or exam requires a legal excuse to be acceptable e.g. sick leave اﺟﺎزة ﻣﺮﺿﯿﺔor serious event like death of a close relative وﻓﺎة ﻗﺮﯾﺐ ﻣﻦ اﻟﺪرﺟﺔ اﻻوﻟﻰand this should be supported with a death certificate. proper student appearance in medical school In medical school, maintaining a professional appearance is essential as it reflects the seriousness ﺟﺪﯾﺔof the profession and respect for patients. Avoid strange , indecent ﻏﯿﺮﻣﺤﺘﺸﻤﺔclothes Avoid improper haircuts or colors Avoid tattoos Cleanness Don’t throw tissues and other waste on ground. Patients’ rights Right to get information on diagnosis, treatment and medicine Right to get simplified information Right to obtain all the relevant information about professionals involved in the patient care Right to Privacy and Confidentiality Right to expect prompt treatment in an emergency Right to get copies of medical records Right to know what hospital rules and regulations applies to him/her as patient to the obtainable facilities Right to get details of the bill اﻟﺤﺴﺎب Right to seek second opinion about the disease and treatment (from another doctor) Right to get Informed Consent in a Clinical Trial اﺧﺬ ﻣﻮاﻓﻘﺘﮫ ﻋﻠﻰ اﺟﺮاء ﺗﺠﺎرب ﺑﺤﺜﯿﺔ Responsibilities of Patient To undergo the treatment as prescribed by the doctor faithfully and follow instruction diligently If the doctor has prescribed certain preventive measures in case of infections, patient should follow the same To be punctual for the treatment and follow up To maintain all medical records and prescription in chronological order. If he wants to take second opinion, consult with your doctor about the same. In case of any doubts, clarify with the doctor first. Pay for the treatment to the doctor and hospital promptly To respect autonomy اﺳﺘﻘﻼﻟﯿﺔof doctor and nurses and treat with respect Keep doctor informed about your concerns and decisions