Idiopathic thrombocytopenic purpura (ITP) is a disorder that can lead to easy or excessive bruising and bleeding. The bleeding results from unusually low levels of platelets — the cells that help blood clot. Idiopathic thrombocytopenic purpura, which is also called immune thrombocytopenia, affects children and adults. Children often develop ITP after a viral infection and usually recover fully without treatment. In adults, the disorder is often long term. If you don't have signs of bleeding and your platelet count isn't too low, you may not need any treatment. In rare cases, the number of platelets may be so low that dangerous internal bleeding occurs. Treatment options are available.

Fetal heart sound by sonique

How to open a glass ampoule

During 34 week of pregnancy, the baby is getting ready for delivery, you may feel less wriggling and kicking. Watch out this video to learn more about being 34 weeks pregnant.

How a Tattoo is Removed

Microsurgical varicocelectomy is performed for patients with a varicocele and impaired semen parameters, testicular atrophy or pain due to the varicocele.

The exam should be performed in an orderly fashion as follows: 1. Have the patient stick out their tongue so that you can examine the posterior pharynx (i.e. the back of the throat). Ask the patient to say "Ah", which elevates the soft palate, giving you a better view. If you are still unable to see, place the tongue blade � way back on the tongue and press down while the patient again says "Ah," hopefully improving your view. This causes some people to gag, particularly when the blade is pushed onto the more proximal aspects of the tongue. It may occasionally be important to determine whether the gag reflex is functional (e.g. after a stroke that impairs CNs 9 or 10; or to determine if a patient with depressed level of consciousness is able to protect their airway from aspiration). This is done by touching a q-tip against the posterior pharynx, uvula or tongue. It is not necessary to do this during your routine exam as it can be quite noxious!
2. Note that the uvula hangs down from the roof of the mouth, directly in the mid-line. With an "Ah," the uvula rises up. Deviation to one side may be caused by CN 9 palsy (the uvula deviates away from the affected side), a tumor or an infection. CN9 Pasly Cranial Nerve 9 Dysfunction: Patient has suffered stroke, causing loss of function of left CN 9. As a result, uvula is pulled towards the normally functioning (ie right) side. 3. The normal pharynx has a dull red color. In the setting of infection, it can become quite red, frequently covered with a yellow or white exudate (e.g. with Strep. Throat or other types of pharyngitis).
4. The tonsils lie in an alcove created by arches on either side of the mouth. The apex of these arches are located lateral to and on a line with the uvula. Normal tonsils range from barely apparent to quite prominent. When infected, they become red, are frequently covered by whitish/yellow discharge. In the setting of a peritonsilar abscess, the tonsils appear asymmetric and the uvula may be pushed away from the affected side. When this occurs, the tonsil may actually compromise the size of the oral cavity, making breathing quite difficult.
5. Look carefully along the upper and lower gum lines and at the mucosa in general, which can appear quite dry if the patient is dehydrated.
6. Examine the teeth to get a sense of general dentition, particularly if the patient has a dental complaint. Pain produced by tapping on a tooth is commonly caused by a root abscess. Tooth Abscess: Tooth abscess involving left molar region. Associated inflammation of left face can clearly be seen. 7. Have the patient stick their tongue outside their mouth, which allows evaluation of CN 12. If there is nerve impairment, the tongue will deviate towards the affected side. Any obvious growths or abnormalities? Ask them to flip their tongue up so that you can look at the underside. If you see something abnormal, grasp the tongue with gauze so that you can get a better look. Left CN 12 Dysfunction: Stroke has resulted in L CN 12 Palsy. Tongue therefore deviates to the left.
8. Make note of any growths along the cheeks, hard palate (the roof of the mouth between the teeth), soft palate, or anywhere else. In particular, patients who smoke or chew tobacco are at risk for oral squamous cell cancer. Any areas which are painful or appear abnormal should also be palpated. Put on a pair of gloves to better explore these regions. What do they feel like? Are they hard? To what extent does a growth involve deeper structures? If the patient feels something that you cannot see, try to get someone else to hold the light source, freeing both your hands to explore the oral cavity with two tongue depressors.

People whose back or neck pain has not been relieved by back surgery or other treatments may have another option to consider: spinal cord stimulation. Around the world, some 14,000 patients undergo spinal cord stimulator implants each year. Spinal cord stimulation (SCS) delivers mild electrical stimulation to nerves along the spinal column, modifying or blocking nerve activity in a non-medicinal way to minimize the sensation of pain reaching the brain.

Pediatric IV insertion

On Tuesday May 29th at 3:00pm EDT, University Hospitals Case Medical Center Cleveland, Ohio, will host a live webcast to demonstrate the removal of brain tumor and epileptic focus from an awake patient using intra-operative MRI and brain mapping. See this on OR-Live.com

The patient was a middle-aged gentleman with new onset seizures. An MRI showed what appeared to be a low grade glioma near the motor strip on the right. Studies have shown that complete removal can cure the seizures, improve quality of life and survival, but this is difficult to do with conventional technology without harming the surrounding normal brain because its difficult to determine where tumor ends and normal brain begins.

-Intrapartum antibiotic prophylaxis for mothers colonized with group B Streptococcus can prevent early-onset neonatal disease. Adequate prophylaxis consists of ampicillin, penicillin, or cefazolin for ;::4 hours before delivery. Regardless of intrapartum treatment, all high-risk infants must be observed for ;::49 hours. A complete blood count with differential and blood culture are indicated if the infant is preterm <37 weeks or was exposed to prolonged rupture of membranes.>18 hrs.

Large Leg Abscess

Examination of the Hands

What Happens During an Erection?
In order to attain an erection, messages from the brain and other sense organs trigger the arteries of the penis to dilate. This allows an increased amount of blood to flow into three columns of spongy tissue in the penis.

As the arteries supplying blood to the corpus spongiosum and to the two larger columns, the corpus cavernosa, become filled with blood; the penis grows and becomes rigid. Pressure of the engorged tissue against the veins in the penis effectively traps blood within the penis until climax is reached or the sensation wanes.

What Are Penile Implants?
Impotence, or the inability to attain or maintain an erection, can be caused by a disruption at any stage in this process. Several types of penile implants are available that create an artificial erection. Two common types of implants are the semi-rigid malleable rod and the inflatable implant.

•The semirigid malleable rod is usually made of plastic with a core of flexible wire. These rods can be bent down to conceal the penis under clothing or raised to form an artificial erection.


•The inflatable implant is more complex and involves several working parts: a reservoir of fluid that is implanted into the abdomen, a pump system located in the scrotal sac near the testes, and two inflatable cylinders.
How Penile Implants Help Erectile Fuctioning
In order to attain an erection, the scrotal pump must be squeezed repeatedly to propel fluid into the penile cylinders. When an erection is no longer desired, a release valve is pressed on the side of the pump and the cylinders deflate.
Before Having Penile Implant Surgery
Persons considering these types of implants should speak with their physician or healthcare professional about possible risks and complications.

DOING LESS BUT BRAINY DESCRIBES A NEW GENERATION OF IMMEDIATE ZIRCONIA IMPLANTS ANATOMICAL AND CUSTOM-MADE. YOUR DENTAL ROOT IS MILLED IN ZIRCONIA AND IN 20 SECONDS SEATED, NO DRILLING, NO AUGMENTATION, NO MEMBRANES, FLAPLESS, NO 3D PLANNING, NO CAD/CAM SPLINTS OR GUIDED SURGERY REQUIRED! EASY AND CONSEQUENTIAL SYSTEM. NO MORE INCONGRUOUS AND UGLY SILVER-COLORED TITANIUM IMPLANTS IN TIME CONSUMING, PAINFUL AND COSTLY PROCEDURES. IT`S HIGH TIME TO RESPECT THE ANATOMY NOT ALTER IT BY DRILLING AND AUGMENTATION. BIOIMPLANT

Neglected elbow dislocations are seen in patients hailing from Africa and Asia. A Nigerian patient with this condition was successfully treated by open reduction and external fixator application

Rhabdomyolysis is a condition in which damaged skeletal muscle (Ancient Greek: rhabdomyo-) tissue breaks down rapidly (Greek –lysis). This damage may be caused by physical (e.g. crush injury), chemical, or biological factors. Breakdown products of damaged muscle cells are released into the bloodstream; some of these, such as the protein myoglobin, are harmful to the kidney and may lead to kidney dysfunction. The severity of the symptoms (which may include muscle pains, vomiting and confusion) depends on the extent of the muscle damage, and whether kidney failure develops. The mainstay of treatment is generous intravenous fluids, but could include dialysis or hemofiltration.

Rhabdomyolysis and its complications are significant problems for those injured in disasters such as earthquakes and bombing. Relief efforts in areas struck by earthquakes often include medical teams with skills and equipment for treatment of survivors with rhabdomyolysis. The disease and its mechanisms were first fully elucidated during the Blitz of London in 1941.

Systemic Lupus Erythematosus (SLE)information

Posterior Urethral Strictures Associated with Urinary Incontinence after Prostatectomy Management

Foley Catheter Insertion Men and Women