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Digoxin Toxicity
Digoxin Toxicity samer kareem 1,878 Views • 2 years ago

The incidence of digitalis toxicity has declined in recent years, due to decreased use of this drug along with improved technology for monitoring of drug levels and increased awareness of drug interactions. Nevertheless, cardiac glycoside toxicity continues to be a problem in the United States because of the wide use of digoxin (a preparation of digitalis) and its narrow therapeutic window. Digitalis is a plant-derived cardiac glycoside commonly used in the treatment of chronic heart failure (CHF), atrial fibrillation, and reentrant supraventricular tachycardia.[1, 2] Digoxin is the only available preparation of digitalis in the United States. (See Etiology and Epidemiology.) Cardiac glycosides are found in certain flowering plants, such as oleander and lily-of-the-valley. Indigenous people in various parts of the world have used many plant extracts containing cardiac glycosides as arrow and ordeal poisons. The ancient Egyptians used squill (Urginea maritime) as a medicine. The Romans employed it as a diuretic, heart tonic, emetic, and rat poison. Digitalis, or foxglove, was mentioned in the year 1250 in the writings of Welsh physicians. Fuchsius described it botanically 300 years later and named it Digitalis purpurea. William Withering published his classic account of foxglove and some of its medical uses in 1785, remarking upon his experience with digitalis. He recognized many of the signs of digitalis toxicity, noting, "The foxglove, when given in very large and quickly repeated doses, occasions sickness, vomiting, purging, giddiness, confused vision, objects appearing green or yellow; increased secretion of urine, slow pulses, even as low as 35 in a minute, cold sweats, convulsions, syncope, death." (See Presentation and Workup.) During the early 20th century, as a result of the work of Cushny, Mackenzie, Lewis, and others, the drug was gradually recognized as specific for treatment of atrial fibrillation. Only subsequently was the value of digitalis for treatment of CHF established. Cardiac glycosides enhance cardiac contractility and slow conduction through the atrioventricular (AV) junction by increasing vagal tone.[3] (See Etiology.) Cardiac glycoside toxicity has been known to result from ingestion of some plants, including yellow oleander (Thevetia peruviana) and foxglove, and a similar toxidrome has been associated with the use of herbal dietary supplements that contain cardiac glycosides. Digoxin is among the top 50 prescribed drugs in the United States.[4] In 2011, the American Association of Poison Control Centers reported 1601 single exposures to cardiac glycoside drugs.[5] Cardiac glycosides account for 2.6% of toxic plant exposures in the United States.[6, 7] Most of these exposures are in children.[7] (See Epidemiology.) Digoxin-specific fragment antigen-binding (Fab) antibody fragments have contributed significantly to the improved morbidity and mortality of toxic patients since their approval in 1986 by the US Food and Drug Administration (FDA). (See Prognosis, Treatment, and Medication.)

Testicular Biopsy for ICSI
Testicular Biopsy for ICSI Mohamed Ibrahim 45,644 Views • 2 years ago

open multi puncture testicular biopsy to retrieve sperm for ICSI (IntaCytoplasmic Sperm Injection) Procedure video

leaving your feet feeling soft and revitalised
leaving your feet feeling soft and revitalised samer kareem 2,302 Views • 2 years ago

Callus Peel is a luxury, spa foot treatment that removes hard, callused skin leaving your feet feeling soft and revitalised. The treatment is a 15 minute...

Ear Examination
Ear Examination DrPhil 39,887 Views • 2 years ago

Complete clinical examination of the ears with all the associated tests

Amniotomy - Breaking the bag of water prior to childbirth
Amniotomy - Breaking the bag of water prior to childbirth Doctor 285,832 Views • 2 years ago

Amniotomy is the official term for artificially breaking the bag of waters during labor. It is believed that breaking the bag of waters will help to speed up an otherwise slow labor. Amniotomy is part of the Active Management of Labor practiced in some hospitals. Amniotomy is performed by a midwife or doctor. A long, thin instrument with a hook on the end is inserted into the vagina and through the cervix so it can catch and rip the bag of waters. To perform an amniotomy, the cervix must be dilated enough to allow the instrument through the cervix, generally at least a two. Why choose Amniotomy? Unlike other medical methods of starting labor, amniotomy does not add synthetic hormones to your labor. Instead it seems to stimulate your body’s own labor process. Amniotomy allows the use of an internal electronic fetal monitor. How effective is Amniotomy? Amniotomy alone is unpredictable, it may take hours for labor to start with amniotomy. Because amniotomy increases the risk for infection, most caregivers use amniotomy in combination with synthetic oxytocin. Birth does happen faster when amniotomy is combined with synthetic oxytocin than when amniotomy is used alone. Risks of Amniotomy Risks for Mother Increases the risk for infection. This risk is increased with length of time the waters are broken and with vaginal exams. Because of the infection risk, a time limit is given by which the mother must give birth. As the time limit approaches attempts to progress labor will become more aggressive. The fore waters equalize pressure on the cervix so it will open uniformly. When they are broken, the mother increases her chances of having uneven dilation. Risks for Baby Increases the risk of umbilical cord compression. The fore waters equalize pressure on the baby’s head as it presses against the cervix. When they are broken, the pressure on the baby’s head may be uneven causing swelling in some parts.

Tampons for The First Time
Tampons for The First Time Scott 9,786 Views • 2 years ago

How to Use Tampons for The First Time Demo Video

Spinal Injury - Jaw Thrust
Spinal Injury - Jaw Thrust samer kareem 5,640 Views • 2 years ago

The jaw thrust is a method of opening the airway of a patient. The airway is very important in first aid! It consists of the structures in the back of the throat and upper neck. A patient who is unconscious is not able to maintain their own airway as it can become blocked by the tongue (see picture). Normally, first aid courses teach the head tilt – chin lift technique to open an airway. However, this airway manoeuvre involves significant movement of the patient’s neck. Therefore if there is any suspicion of a spinal (neck) injury it may cause further damage.

Female Body Medical Autopsy for Anatomy Class
Female Body Medical Autopsy for Anatomy Class hooda 20,952 Views • 2 years ago

Watch that Female Body Medical Autopsy for Anatomy Class

Breast Augmentation with Cohesive Gel Implants Procedure by Dr. Ajaya Kashyap
Breast Augmentation with Cohesive Gel Implants Procedure by Dr. Ajaya Kashyap Dr Ajaya Kashyap 2,312 Views • 2 years ago

This is a complete video of breast augmentation procedure with implants also includes some before after photographs of breast augmentation surgery by Dr. Ajaya Kashyap at MedSpa Clinic, Delhi, India. source: https://www.youtube.com/watch?v=tRg3RkvCvOE Get more information: www.bestbreastsurgeryindia.com Get more information: www.themedspa.us Email at: info@themedspa.us Call/WhatsApp on:+91-9818369662, 9958221983/82/81

Cirrhosis
Cirrhosis samer kareem 6,657 Views • 2 years ago

Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism. The liver carries out several necessary functions, including detoxifying harmful substances in your body, cleaning your blood and making vital nutrients. Cirrhosis occurs in response to damage to your liver. Each time your liver is injured, it tries to repair itself. In the process, scar tissue forms. As cirrhosis progresses, more and more scar tissue forms, making it difficult for the liver to function. Decompensated cirrhosis is the term used to describe the development of specific complications resulting from the changes brought on by cirrhosis. Decompensated cirrhosis is life-threatening. The liver damage done by cirrhosis generally can't be undone. But if liver cirrhosis is diagnosed early and the cause is treated, further damage can be limited and, rarely, reversed.

Cremasteric reflex test
Cremasteric reflex test samer kareem 66,427 Views • 2 years ago

-The cremasteric reflex test is considered positive if there is elevation of the testis in response to stroking the upper inner thigh. This reaction is typically absent in testicular torsion and boys under the age of 6 months. Although not completely reliable in older boys and adults, an absent cremasteric reflex is highly suggestive of torsion. Patients with epididymitis usually have a normal cremasteric reflex, with pain and swelling isolated to

How Does Diabetes Cause Silent Heart Attacks?
How Does Diabetes Cause Silent Heart Attacks? samer kareem 6,173 Views • 2 years ago

A silent heart attack is a heart attack that has few, if any, symptoms. You may have never had any symptoms to warn you that you've developed a heart problem, such as chest pain or shortness of breath. Having diabetes or prediabetes puts you at increased risk for heart disease and stroke. You can lower your risk by keeping your blood glucose (also called blood sugar), blood pressure, and blood cholesterol close to the recommended target numbersthe levels suggested by diabetes experts for good health. (

Cytomegalovirus (CMV)
Cytomegalovirus (CMV) samer kareem 1,895 Views • 2 years ago

CMV is a common virus in the same family as herpesvirus, and it can infect anyone. CMV is spread by direct contact of body fluids, such as saliva, blood, urine, semen, vaginal fluids, and breast milk. Thus breastfeeding, blood transfusions, organ transplants, and sexual contact are possible modes of transmission. Most healthy people do not experience any symptoms when infected with CMV, and it does not pose a serious health concern. A majority of adults have antibodies consistent with past infection. Most healthy children and adults who do have symptoms will recover from CMV infection without complications and do not require antiviral treatment. However, in those with a weakened immune system, CMV can cause serious disease (retinitis, hepatitis, colitis, pneumonia, or encephalitis).

Cleft Lip Repair animation
Cleft Lip Repair animation samer kareem 2,184 Views • 2 years ago

This animation demonstrates how a unilateral complete cleft lip repair is performed. This video is meant for educational purposes for patients and families. There are many ways to fix a complete cleft lip, but the technique shown here is the most common known as the Millard Rotation Advancement Repair.

Varicose Vein Laser Treatment
Varicose Vein Laser Treatment samer kareem 1,892 Views • 2 years ago

It can treat spider veins and tiny varicose veins just under the skin's surface. ... (If you have poor blood circulation feeding these tiny veins, the larger "feeder" vein must first be treated with surgery, endovenous laser or radiofrequency treatment, or sclerotherapy.) Endovenous laser treatment.

急性坏疽性阑尾炎并穿孔de 腹腔镜手术治疗
急性坏疽性阑尾炎并穿孔de 腹腔镜手术治疗 wang bzh 1,834 Views • 2 years ago

急性坏疽性阑尾炎并穿孔de 腹腔镜手术治疗

Hemorrhoidectomy Surgery
Hemorrhoidectomy Surgery Mohamed 35,962 Views • 2 years ago

Hemorrhoidectomy Operation Video

急性坏疽阑尾炎的手术治疗
急性坏疽阑尾炎的手术治疗 wang bzh 2,441 Views • 2 years ago

急性坏疽阑尾炎的手术治疗

Acute Myeloid and Lymphoid Leukemia
Acute Myeloid and Lymphoid Leukemia samer kareem 4,596 Views • 2 years ago

Cancer starts when cells in a part of the body begins to grow out of control and can spread to other areas of the body. There are many kinds of cancer. Cells in nearly any part of the body can become cancer. To learn more about how cancers start and spread, see What Is Cancer? Leukemias are cancers that start in cells that would normally develop into different types of blood cells. Here we will talk about acute myeloid leukemia (AML). Acute myeloid leukemia (AML) has many other names, including acute myelocytic leukemia, acute myelogenous leukemia, acute granulocytic leukemia, and acute non-lymphocytic leukemia. “Acute” means that this leukemia can progress quickly if not treated, and would probably be fatal in a few months. “Myeloid” refers to the type of cell this leukemia starts from. Most cases of AML develop from cells that would turn into white blood cells (other than lymphocytes), but some cases of AML develop in other types of blood-forming cells. The different types of AML are listed in “ How is acute myeloid leukemia classified?” AML starts in the bone marrow (the soft inner part of certain bones, where new blood cells are made), but in most cases it quickly moves into the blood. It can sometimes spread to other parts of the body including the lymph nodes, liver, spleen, central nervous system (brain and spinal cord), and testicles. Other types of cancer can start in these organs and then spread to the bone marrow. But these cancers that start elsewhere and then spread to the bone marrow are not leukemias. Normal bone marrow, blood, and lymphoid tissue To understand the different types of leukemia, it helps to know about the blood and lymph systems.

Worst Plantar Warts & Plantar Wart Removal
Worst Plantar Warts & Plantar Wart Removal samer kareem 60,068 Views • 2 years ago

Plantar warts are hard, grainy growths that usually appear on the heels or balls of your feet, areas that feel the most pressure. This pressure also may cause plantar warts to grow inward beneath a hard, thick layer of skin (callus). Plantar warts are caused by the human papillomavirus (HPV). The virus enters your body through tiny cuts, breaks or other weak spots on the bottom of your feet. Most plantar warts aren't a serious health concern and may not require treatment. But plantar warts can cause discomfort or pain. If self-care treatments for plantar warts don't work, you may want to see your doctor to have them removed.

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