حاج عمره ٥٨ سنة عنده إسهال مائي كثير وقيء من يوم، والجو حار جداً. يشعر بدوخة وتشنج في الساقين، وبوله قليل. الضغط ٩٨/٦٠ جالساً و٨٠/٥٠ واقفاً، والنبض ١١٦. ما الإجراء الأهم؟

A 58-year-old pilgrim has profuse watery diarrhoea and vomiting for a day in very hot weather. He feels dizzy with leg cramps and low urine output. BP 98/60 sitting and 80/50 standing, HR 116. What is the most important action?

1. Rapid fluid and electrolyte replacement, oral or IV by severity
2. A strong antidiarrhoeal so he can continue the rituals
3. Withhold drinks until diarrhoea and vomiting stop
4. Give an antibiotic alone without any fluids

Answer: A) Rapid fluid and electrolyte replacement, oral or IV by severity. Watery diarrhoea in heat causes rapid dehydration, and postural hypotension signals significant volume loss. Fluid and electrolyte replacement is the priority; antibiotics and antidiarrhoeals are not the mainstay.