GLENROY MEDICAL CENTRE

1 POST OFFICE PLACE, GLENROY, 3046 Phone: 03 9306 8880 Fax: 03 9304 3170
email: info@glenroymedicalcentre.com.au
Dr Samuel Youssef Provider No. 415214XB Dr Dr Azadeh Kamali Provider No. 5664252B
Arezoo Mirzaei Provider No. 5008456F Dr Magda Moroki Provider No. 5886362W
Dr sabeq Hamoosh Provider No. 5008746W Dr Surena Niknejad Provider No. 5721302 Y
Dr Reda Aboelsaad Provider No. 5539773H Dr Dr Abdolali Zolghadrasli Provider No. 6002823H
Farshid Shokrkon Provider No. 5949853W Dr MD Golam Mostafa Provider No 233356RT
Dr Maikel Sakia Provider No. 6135542K Dr Indra Rajaretnam Provider No 583458314
15 th August 2023

To whom it may concern

Re: MR MAHMOUD EL RAJAB
Address: 5 Carlisle Crt
CAMPBELLFIELD VIC 3061
Date of birth: 12/01/1984
Phone No.:0431 095 919

I certify that today 13 th August 2023 I have examined Mr El

Rajab and based on examination I have decided Mr El Rajab is unfit
for work/study from dates 13 August 2023 Until the 15 August 2023

Kind Regard

Dr Surena
5721302YDr Surena Niknejad MBBS

MEDCD022?G304 Provider
3721302M G!e. Wlel
%cal CefAtre o
Cffice Place,
Gienroy 3046
93058880 Fax 03 93043170
PHS 28/01/2022 PM PAGE 2/003 Fax Server

Obstetrics
Service
 Flemington
Parkville: Victrjria 30.32
8
03 834 3032

28/01/22

Stefan Kane, Consultant

20 Flemington Road
Parkville,Victoria
3052 Via In Basket

Dear Stefan,
RE: Lana Gee
**Secure Address**
Please See Rw Ipm For Details
DOB 1 2/1 0/1993
MRN 5007596

Issues:1. Fetal tetralogy of Fallot

2. Amniocentesis result pending
I had the pleasure of reviewing Lana in the Fetal Cardiology Outpatient
clinic today (28/1/2022). Lana is currently 23w4d wks GA. Lana comes today
for first fetal cardiology review in the setting of abnormal fetal heart
seen at morphology assessment. There were additional concerns on morphology
review including right sided dysplastic kidney and single umbilical artery.
There has been aneuploidy screening with NIPT which is reported to be low
risk (not views by myself).

Investigations:
Fetal Echocardiogram today was technically very challenging due to the
fetal position throughout assessment. On views obtained today findings
were consistent with tetralogy of Fallot.
1. Large sub aortic ventricular septal defect
2. Moderate degree of aortic valve override
3. Moderately small pulmonary valve with antegrade flow (PV size 3.2, Z
score -2.9)
4. Good size confluent central branch pulmonary arteries with antegrade flow in
the ductus arteriosus (difficlt views)
5. Otherwise normal cardiac connections and cardiac systolic function.
Pulmonary veins require reassessment due to fetal position.

Summary and Plan:

The findings and the limitations of todays assessment were discussed with the
family. Fetal position today was difficult throughout as at previous
morphology review. Using cardiac diagrams the finding of tetralogy of
Fallot was discussed in detail. This is generally well tolerated in
utero. Delivery would be planned here at The Royal Womens Hospital to
allow postnatal assessment and echocardiogram. Postnatally this is a
cardiac lesion that will-require, cardiac
nsufficientpulmonar:y.v
blood flow in the first few months of life some children do require interim
insertion of a BT shunt to improve pulmonary blood flow. We discussed that for
the majority of children surgical repair is single stage. Up to 1520% of
 children will require repeat intervention, usually on the pulmonary valve,
before adulthood. We
RE: Gee, Lana - DOB 12/10/1993 - MRN: 5007596 Page 2 of 3