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Tracheotomy is a surgical procedure which consists of making an incision on the anterior aspect of the neck and opening a direct airway through an incision in the trachea (windpipe). The resulting stoma (hole), or tracheostomy, can serve independently as an airway or as a site for a tracheostomy tube to be inserted; this tube allows a person to breathe without the use of his or her nose or mouth. Both surgical and percutaneous techniques are widely used in current surgical practice. It is among the oldest described procedures.
No two people alike. Here are the 10 most rare and strange medical conditions all expecting parents dread.
Top weirdest medical conditions in the world. Beware of these shocking & rare medical syndromes that make up some of the worst and most bizarre in the world.
Tip #1: See your healthcare provider You can lay the groundwork for a healthy pregnancy even before you get pregnant. You're more likely to have a successful pregnancy when your body is up to the task. Schedule a preconception checkup with a doctor or midwife to find out whether you're in your best baby-making shape – and to learn what changes may help. You may not be able to get an appointment right away or resolve any health issues immediately, but taking these steps as soon as possible can help you conceive more easily in the long run. Tip #2: Plan for a healthy pregnancy When you're trying to conceive, eat nutritious foods, maintain a healthy weight, get regular exercise, and try to kick any bad habits (like drinking, smoking, or using drugs). Limit your caffeine intake to less than 200 milligrams a day (about 12 ounces of coffee). Any more than that may contribute to fertility problems. At your preconception appointment, discuss any medications you're taking and find out if they'll be safe to use during pregnancy. You can dramatically reduce the risk of certain birth defects if you begin taking folic acid at least one month before you start trying to conceive. Find out what else you can do ahead of time to give your baby a healthy start. Tip #3: Figure out when you ovulate The biggest secret to getting pregnant quickly is knowing when you ovulate (release an egg from your ovary). You ovulate only once each menstrual cycle, and there are just a few days during that time when it's possible to conceive. Knowing when you ovulate means that you and your partner can time intercourse to have the best chance of getting pregnant that cycle. You can use a few different methods to figure out when you ovulate. Our article on predicting ovulation walks you through them. This ovulation calculator also does the math for you by determining when you're most likely to be fertile. (If you have irregular periods, pinpointing ovulation could be difficult. Ask your provider for advice.) Tip #4: Have sex at the right time Once you know the timeframe your egg is likely to be released from your ovary, you can plan to have sex during your most fertile days, which is usually about three days before ovulation through the day you ovulate. You have a range of days for baby-making sex because sperm can survive for three to six days in your body. (Your egg survives for only about a day.) That means if you have sex on Monday, sperm can survive in your fallopian tubes until Thursday – or even as late as Sunday. If you're not sure when your fertile period will be, just have sex every other day. This means you'll have healthy sperm in your fallopian tubes whenever your egg gets released. (If you want to have sex more often than every other day, that's fine. It won't improve your chances any more, but it won't hurt, either.) Another tip: If you and your partner are waiting to have sex until your most fertile time, make sure you haven't gone through too long of a dry spell beforehand. Your partner should ejaculate at least once in the days just before your most fertile period. Otherwise there could be a buildup of dead sperm in his semen. (Ed. note: Vaginal lubricants including saliva, olive oil, and most water-based lubricants can slow down sperm. Ask your provider to recommend one that's safe to use when trying to conceive. Canola oil can be a good alternative.) Tip #5: Give sperm a boost Sperm have the best shot of fertilizing an egg when they're healthy, strong, and plentiful. Your partner can do several things to help: •Cut back on alcohol. Studies show that drinking daily can lower testosterone levels and sperm counts, increasing the number of abnormal sperm. •Skip tobacco and recreational drugs. These can cause poor sperm function. •Try to maintain a healthy weight. Obesity can lower sperm count and slow down sperm. •Get enough of certain key nutrients – like zinc, folic acid, calcium, and vitamins C and D – that help create strong and plentiful sperm. •Don't use hot tubs and saunas or take hot baths because heat kills sperm. (Testicles function best at 94 to 96 degrees Fahrenheit, a couple of degrees cooler than normal body temperature.) The sooner your partner can make these changes, the better: Sperm take a while to mature, so any improvements now will yield better sperm specimens about three months from now. How long to try before getting help If you're going to get pregnant naturally, it's very likely to happen within the first six months. About 8 out of 10 couples have conceived by then. After that, how long you should keep trying before you seek help from a fertility specialist depends in large part on your age. Fertility declines as you get older, so if you're age 40 or older, get help from an expert right away. If you're 35 to 40, talk to a specialist after you've tried for six months with no luck. And if you're younger than 35, it's probably fine to keep trying for a year before seeking assistance. Of course, if you know of a reason you or your partner are more likely to have a fertility problem, make an appointment right away. There's no reason to wait in that case.
A subdural hematoma (SDH) is a collection of blood below the inner layer of the dura but external to the brain and arachnoid membrane (see the images below). Subdural hematoma is the most common type of traumatic intracranial mass lesion. Subdural hematoma occurs not only in patients with severe head injury but also in patients with less severe head injuries, particularly those who are elderly or who are receiving anticoagulants. Subdural hematoma may also be spontaneous or caused by a procedure, such as a lumbar puncture (see Etiology). Rates of mortality and morbidity can be high, even with the best medical and neurosurgical care (see Prognosis). Subdural hematomas are usually characterized on the basis of their size and location and the amount of time elapsed since the inciting event age (ie, whether they are acute, subacute, or chronic). When the inciting event is unknown, the appearance of the hematoma on neuroimaging studies can help determine when the hematoma occurred. These factors, as well as the neurologic and medical condition of the patient, determine the course of treatment and may also influence the outcome. Generally, acute subdural hematomas are less than 72 hours old and are hyperdense compared with the brain on computed tomography scans. The subacute phase begins 3-7 days after acute injury. Chronic subdural hematomas develop over the course of weeks and are hypodense compared with the brain. However, subdural hematomas may be mixed in nature, such as when acute bleeding has occurred into a chronic subdural hematoma. Presentation varies widely in acute subdural hematoma (see Clinical). Many of these patients are comatose on admission. However, approximately 50% of patients with head injuries who require emergency neurosurgery present with head injuries that are classified as moderate or mild (Glasgow Coma Scale scores 9-13 and 14-15, respectively). Many of these patients harbor intracranial mass lesions. In a large series of patients who developed intracranial hematomas requiring emergent decompression, more than half had lucid intervals and were able to make conversation between the time of their injury and subsequent deterioration. In a more comprehensive review of the literature on the surgical treatment of acute subdural hematomas, lucid intervals were noted in up to 38% of cases. These patients may be more likely to benefit from medical and surgical intervention when instituted in a timely fashion (ie, before further neurological deterioration).
LASIK, which stands for laser in-situ keratomileusis, is a popular surgery used to correct vision in people who are nearsighted, farsighted, or have astigmatism. All laser vision correction surgeries work by reshaping the cornea, the clear front part of the eye, so that light traveling through it is properly focused onto the retina located in the back of the eye. LASIK is one of a number of different surgical techniques used to reshape the cornea.
Have you watched a surgery on a horse before?
Ganglion Cyst Volar Wrist Removal Ganglion cysts are noncancerous lumps that most commonly develop along the tendons or joints of your wrists or hands. They also may occur in the ankles and feet. Ganglion cysts are typically round or oval and are filled with a jellylike fluid. Small ganglion cysts can be pea-sized, while larger ones can be around an inch (2.5 centimeters) in diameter. Ganglion cysts can be painful if they press on a nearby nerve. Their location can sometimes interfere with joint movement. If your ganglion cyst is causing you problems, your doctor may suggest trying to drain the cyst with a needle. Removing the cyst surgically also is an option. But if you have no symptoms, no treatment is necessary. In many cases, the cysts go away on their own.
Not every woman undergoes a traditional vaginal delivery with the birth of her child. Under conditions of fetal or maternal distress, or in the case of breech presentation (when a baby is turned feet first at the time of delivery), or if the woman’s first baby was born by cesarean delivery, a procedure called a cesarean section may be required. During a cesarean, a doctor will make either a lateral incision in the skin just above the pubic hair line, or a vertical incision below the navel. As the incision is made, blood vessels are cauterized to slow bleeding. After cutting through the skin, fat, and muscle of the abdomen, the membrane that covers the internal organs is opened, exposing the bladder and uterus. At this time the physician will generally insert his or her hands into the pelvis in order to determine the position of the baby and the placenta. Next, an incision is made into the uterus and any remaining fluids are suctioned from the uterus. The doctor then enlarges the incision with his or her fingers. The baby’s head is then grasped and gently pulled with the rest of its body from the mother’s uterus. Finally, the abdominal layers are sewn together in the reverse order that they were cut. The mother is allowed to recover for approximately three to five days in the hospital. She will also be quite sore and restricted from activity for the following several weeks. There are several potential complications associated with this procedure that should be discussed with a doctor prior to surgery.
The majority of fetuses are in a breech presentation early in pregnancy. By week 38th week of gestation, however, the fetus normally turns to a cephalic presentation. Although the fetal head is the widest single diameter, the fetus’s buttocks [ breech], plus the lower extremities, actually takes up more space. The fundus, being the largest part of the uterus, probably accounts for the fact that in approximately 97% of all pregnancies, the fetus turns so that the buttocks and lower extremities are in the fundus. Vaginal delivery of a breech presentation requires great skill if the fetus is not to be damaged. With the low rate of vaginal breech deliveries in the developed world, experience is being lost. 6% of women with breech presentation still have a vaginal breech delivery as they present too late - so units need to retain a high level of preparedness. Types of breech presentation: I. Complete breech [ flexed breech]: The fetal attitude is one of complete flexion, with hips and knees both flexed and the feet tucked in beside the buttocks. The presenting part consists of two buttocks, external genitalia and two feet. It is commonly present in multiparae. II. Incomplete breech: This is due to varying degrees of extension of thighs or legs at podalic pole. Three varieties are possible; - Breech with extended legs [ frank breech ]: The breech presents with the hips flexed and legs extended on the abdomen. 70% of breech presentations are of this type and it is particularly common in primigravidae whose good uterine muscle tone inhibits flexion of the legs and free turning of the fetus. - Footling breech: This is rare. One or both feet present because neither hips nor knees are fully flexed. The feet are lower than the buttocks, which distinguishes it from the complete breech. - Knee presentation: This is very rare. Thighs are extended but the knees are flexed, bringing the knees down to present at the brim.
This is the incredible moment a new-born baby arrived still inside its amniotic sac, completely intact. The tiny infant can be seen moving and stretching still inside the sac, as medics prepare to snip the new born free. The amniotic sac is a thin but durable membrane filled with fluid which helps keep a baby warm and safe from bumps during pregnancy. When it breaks, this is typically referred to as a woman's 'waters breaking' shortly before she gives birth. But in rare cases, less than 1-in-80,000 births, the baby is delivered with the membranes still intact and this is known as a 'caul birth'. Some babies are born with part of the membrane still attached to them, but to be born completely encased in the intact membrane is incredibly rare. Many people still believe the phenomenon to be a good omen for the child's infancy and it is has even been suggested, but not proven, that caul babies will always have a natural affinity for water. The video was taken in Spain on Saturday and captures the rare moment the baby was born with the membrane covering its entire body, just minutes after its twin was delivered normally.
Shoulder dystocia is a specific case of obstructed labour whereby after the delivery of the head, the anterior shoulder of the infant cannot pass below, or requires significant manipulation to pass below, the pubic symphysis. It is diagnosed when the shoulders fail to deliver shortly after the fetal head. Shoulder dystocia is an obstetric emergency, and fetal demise can occur if the infant is not delivered, due to compression of the umbilical cord within the birth canal. It occurs in approximately 0.3-1% of vaginal births. Contemporary management of shoulder dystocia requires a calm operator and a well-thought-out plan of action. It is imperative that if not already present, help is summoned immediately after shoulder dystocia is recognized. This help may include additional nursing staff, an anesthesiologist, a pediatrician or neonatologist and an additional obstetrician or midwife. Future coordination may demonstrate that rapid response teams are best suited to attend to this emergency.
Your baby's sex is set at conception. At around 7 weeks, your baby's internal sex organs – such as ovaries and testes – begin to form in the abdomen. Male and female sex organs and genitalia look the same at this stage because they're derived from the same structures. At around 9 weeks, boys and girls begin to develop differently. In girls, a tiny bud emerges between the tissue of the legs. This bud will become the clitoris. The membrane that forms a groove below the bud separates to become the labia minora and the vaginal opening. By 22 weeks, the ovaries are completely formed and move from the abdomen to the pelvis. They already contain a lifetime supply of 6 million eggs. In boys, the bud develops into the penis and starts to elongate at around 12 weeks. The outer membrane grows into the scrotal sac that will later house the testicles. By 22 weeks, the testes have formed in the abdomen. They already contain immature sperm. Soon they'll begin their descent to the scrotum, but it's a long journey. They'll reach their destination late in pregnancy, or for some boys, after birth. If you're eager to find out whether you're having a girl or a boy, you'll have to wait until you're at least 17 weeks pregnant. That's when the genitals have developed enough to be seen on an ultrasound.
External cephalic version, or version, is a procedure used to turn a fetus from a breech position or side-lying (transverse) position into a head-down (vertex) position before labor begins. When successful, version makes it possible for you to try a vaginal birth.
What is Myelomeningocele and how does it affect my baby? Myelomeningocele (MMC), one of the most severe forms of spina bifida, is a condition where the fetus’ spinal cord fails to close during development. This happens between 20 and 28 days of gestation, often before a woman knows she is pregnant. Because the spinal cord does not close, many of the nerves are exposed, resulting in damage to the cord as the pregnancy continues. Spina bifida can impact the nervous system, bones and muscles, kidneys and bladder. The location on the spine where the undeveloped area occurs is called the level of the spina bifida. Because nerve damage at this site prevents function below that level, the higher the level, the greater the impact on normal development and function. The opening in the spinal cord also results in loss of the fluid surrounding the nervous system. This causes the brain to be positioned further down into the upper spinal column than normal, which is called an Arnold Chiari II malformation. When this happens, the normal flow of fluid out of the brain is obstructed, causing Hydrocephalus, an excess of cerebrospinal fluid within the brain. After birth, most children with Hydrocephalus need to have the extra fluid shunted out of the brain into the abdomen via a ventriculoperitoneal shunt. MMC affects about 1 in every 1,000 babies, and it ranges in severity. Some children, with mild cases very low on the spinal cord, can function nearly normally. More severe cases can cause leg weakness and paralysis, as well as Hydrocephalus, and the Arnold Chiari malformation. People with MMC often live long lives, especially if the condition is diagnosed and treated early. How is Myelomeningocele diagnosed? At about 15 weeks gestation, a blood test measuring the levels of alpha-fetoprotein can show the physician that there might be a problem. After that, an ultrasound is performed to detect the MMC, but also to detect the conditions that can result from it, such as Hydrocephalus, the Chiari malformation, and any problems with the lower extremities. In all cases, we perform a fetal MRI to gain more detailed information and we perform a fetal echocardiogram (echo) to rule out any problem with the heart. What is the prenatal surgery for Myelomeningocele, and how does it differ from postnatal surgery? Until recently, the only way to treat MMC was surgery after birth. But, now that the nine-year long Management of Myelomeningocele (MOMS) trial has been completed, we know that repairing the MMC before birth, in the womb, can be beneficial to the baby’s outcome. The SSM Health St. Louis Fetal Care Institute has one of the fastest growing fetal MMC repair programs in the country. The results of the trial found that prenatal treatment helps reduce, or even eliminate, the major complications of MMC—the Hydrocephalus, the Chiari malformation, and the lack of movement in the lower extremities. Diagnosis and repair of the MMC before birth can make a big difference in the way the baby develops. The MOMS trial showed that babies treated in the womb need half the VP shunts, often have reversal of the Arnold-Chiari malformation, and are more likely to walk, at least until 30 months. Long-term follow up data of children treated with prenatal surgery is still being collected, so the benefit beyond 30 months is not fully known. The operation for open fetal surgery for MMC repair involves making a small opening in the uterus, then closing the spinal cord opening just like after birth. The womb is repaired and the mother is in the hospital for four to five days. The surgery is performed between 19 and 26 weeks of the pregnancy. Mothers usually stay locally for about two weeks so that we can monitor the pregnancy. After this, they can return home for delivery. Because of the scar caused by the surgery on the uterus, the baby and all future babies have to be delivered by Cesarean birth. The benefit to the fetal repair is several fold. First, the spine is protected after the fetal repair. The spine can no longer be damaged during the pregnancy and after. Second, the leakage of CSF is stopped. We think that this causes the brain to rise back into the skull, allowing the fluid within the brain to drain normally and preventing the development of Hydrocephalus. As with any prenatal surgery, there are risks to both the mother and the baby. Our team at the Fetal Care Institute will discuss all of the risks and benefits of the surgery with you and your family, so you can make the best decision for your baby. The standard care for babies with spina bifida is to repair the defect after birth. The neurosurgeon closes the opening of the spinal cord, and restores the muscle, skin, and tissue to cover it. Unfortunately, postnatal surgery cannot restore any of the function that has been lost during the pregnancy, and the damage from Hydrocephalus, the Chiari malformation, and/or loss of movement are then permanent. How will Myelomeningocele impact my baby after birth? MMC is a disease affecting many parts of the body. There can be a major impact on a baby’s leg and hip movement, depending on the level of the defect. Problems with Hydrocephalus and the Arnold-Chiari malformation need to be followed carefully. Because the spinal cord also affects urine and bowel function, these bodily functions often need to be managed to prevent complications. Optimally, babies need to be followed in a spina bifida clinic, where a team of specialists work together to help determine the best course of treatment. At SSM Health Cardinal Glennon Children’s Hospital, a long established spina bifida clinic is available for follow up care after birth. This is a very specialized clinic in which many doctors of different specialties and nurses are dedicated to the care of these babies.
Spina Bifida
Doctors save the life of an unborn baby who was injured along with her mother in a missile attack in the Syrian city of Aleppo. The video shows a team of emergency medical workers delivering the baby by Cesarean section and then treating the newborn for the shrapnel wounds covering her body and one very large gash in her head. “Medics can be seen frantically reviving the baby, after delivering her by emergency cesarean, as she lies motionless,” the article states. “Eventually the tiny newborn begins to cry and seemingly comes to life as she is given an oxygen mask and rubbed vigorously.” “According to Reuters, the woman also has three other children, all of whom were injured in the attack, but are reported by doctors in the hospital to be in a good condition,” the Daily Mirror article states. The article does not provide the gestational age of the baby before it was delivered. The article said the pregnant woman was hit by a barrel bomb – “crude explosives and shrapnel and dropped from helicopters used by [Syrian] President Bashir al-Assad’s regime." The article notes an estimated 7.6 million Syrians have been displaced by the ongoing civil war and that 320,000, including 11,000 children, have been killed in the conflict. The Daily Mirror also reports that the doctors suggested that the tiny girl be named Amal, which means hope in Arabic. UK Daily Mirror: Incredible footage shows Syrian doctors perform lifesaving caesarean after missile strike leaves shrapnel embedded in unborn baby's face
Sex reassignment surgery for male-to-female involves reshaping the male genitals into a form with the appearance of, and, as far as possible, the function of female genitalia. Prior to any surgeries, patients usually undergo hormone replacement therapy (HRT), and, depending on the age at which HRT begins, facial hair removal. There are associated surgeries patients may elect to, including facial feminization surgery, breast augmentation, and various other procedures
Autonomous Tumor Localization and Extraction: Palpation, Incision, Debridement and Adhesive Closure with the da Vinci Research Kit. This video demonstrates a successful trial of the entire five-step procedure where human input is required only at four points to change tools. We also show failure modes of the current autonomous system and we are working on experiments to characterize the reliability of each step and on incorporating computer vision and new probing algorithms to improve robustness.
Soon enough, a robot will be doing surgeries on you!