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Bronchiectasis is an abnormal dilation of the proximal and medium-sized bronchi (>2 mm in diameter) caused by weakening or destruction of the muscular and elastic components of the bronchial walls. Affected areas may show a variety of changes, including transmural inflammation, edema, scarring, and ulceration, among other findings. Distal lung parenchyma may also be damaged secondary to persistent microbial infection and frequent postobstructive pneumonia. Bronchiectasis can be congenital but is most often acquired.[9] Congenital bronchiectasis usually affects infants and children. These cases result from developmental arrest of the bronchial tree. Acquired forms occur in adults and older children and require an infectious insult, impairment of drainage, airway obstruction, and/or a defect in host defense. The tissue is also damaged in part by the host response of neutrophilic proteases, inflammatory cytokines, nitric oxide, and oxygen radicals. This results in damage to the muscular and elastic components of the bronchial wall. Additionally, peribronchial alveolar tissue may be damaged, resulting in diffuse peribronchial fibrosis.[12] The result is abnormal bronchial dilatation with bronchial wall destruction and transmural inflammation. The most important functional finding of altered airway anatomy is severely impaired clearance of secretions from the bronchial tree. Impaired clearance of secretions causes colonization and infection with pathogenic organisms, contributing to the purulent expectoration commonly observed in patients with bronchiectasis. The result is further bronchial damage and a vicious cycle of bronchial damage, bronchial dilation, impaired clearance of secretions, recurrent infection, and more bronchial damage
A digital rectal examination (DRE) is a simple procedure doctors use to examine the lower rectum and other internal organs. A DRE is done for a number of reasons. It's a quick, easy way to check the health of a man's prostate gland. It can detect conditions like an enlarged prostate
This poor old lady came with swelling in her left buttock for 10 days.She had history of injection in her buttocks two weeks back. She developed painful swelling and redness in her left gluteal region with difficulty in walking.It was diagnosed as injection abscess left gluteal region which needs incision and drainage under local anesthesia.Patient part painted and drapped.2% Lignocaine with adrenaline was infiltrated around the swelling for proper filed block.I use no-11 blade for stab incision over the swelling at the most fluctuating point of the abscess.You can watch how pus was flowing out from the cavity.The aim is to drain all pus from the abscess cavity.Finger exploration is essential to break all loculi inside the cavity, to know the depth and extend of the cavity and to fascilitate proper drainage of residual pus.after pus evacuation,, the cavity should be irrigated with normal saline and betadine solution.lastly the cavity to be packed with betadine soaked guage pieces.Proper dressing is essential.the dressing to be changed after 24 hours.daily dressing is essential with a good antibiotic coverage.the cavity usually obliterates within a period of seven to ten days.
During the examination, the doctor gently puts a lubricated, gloved finger of one hand into the rectum. He or she may use the other hand to press on the lower belly or pelvic area. A digital rectal exam is done for men as part of a complete physical examination to check the prostate gland .
Morning erections have colloquially been termed as “morning wood” while scientifically it is called nocturnal penile tumescence. It is a normal and healthy physiological reaction and response that most men experience in their lives. Morning erections are really the ending of a series of erections that happen to men during the night. Healthy men can, on average, have anywhere between three to five erections in a full night of sleep, each of which lasts from 25-35 minutes.
Kendall Lee, M.D., describes deep brain stimulation surgery, and how it is is typically done with patients who remain awake, so neurological functions can be measured and maintained. For more information on deep brain stimulation, visit http://mayocl.in/2A09T80.
An abscess is an infectious process characterized by a collection of pus surrounded by inflamed tissue. [1, 2] Abscesses can form anywhere in the body, from a superficial skin (subcutaneous) abscess to deep abscesses in muscle, organs, or body cavities. Patients with subcutaneous skin abscesses present clinically as a firm, localized, painful, erythematous swelling that becomes fluctuant (see the image below).