Motivation for Medical Students!

Harvesting and prepare fat for grafting

IV cannulation is a skill that has scared a lot of student nurses and even professionals. Perhaps it’s because IV insertion is an invasive procedure, and nurses are too worried that they might hurt their patients. Or maybe it’s because they are just clueless about IV therapy do’s and don’ts–things that one can only fully understand through constant practice.

Median Sternotomy performed before open heart surgery !

Pivot Shift test to confirm ACL Injury

A stye (also called a hordeolum) is a small, red, painful lump that grows from the base of your eyelash or under the eyelid. Most styes are caused by a bacterial infection. There are two kinds of styes: External hordeolum: A stye that begins at the base of your eyelash. Most are caused by an infection in the hair follicle. It might look like a pimple. Internal hordeolum: A stye inside your eyelid. Most are caused by an infection in an oil-producing gland in your eyelid.

we use a single, tapered PDT dilator and kit . All the equipment and supplies listed must be present at the bed-side, because there is no time to go looking for supplies if an airway emergency occurs during the procedure. Two teams are used simultaneously. One team manages the endo-tracheal tube, and the other manages the placement of the tracheostomy tube

Medicine is advancing faster than ever and breakthroughs are happening right now at the Detroit Medical Center. ~ Detroit Medical Center

Contact us to find out more http://www.londonvisionclinic.com/contact-us/ A video of an actual lasik eye surgery procedure taking place, using VisuMax and MEL 80 at the London Vision Clinic.

Visit http://www.londonvisionclinic.....com/are-you-suitable to find out more about the laser eye surgery process.

A video discussing Causes of Itching in the Vulva

A Lecture Presented to The International Congress of Pediatric Hepatology & Gastroenterology, September 2010

Popping a Big Zit on the Face

Watch this clinical examination video to learn how to diagnose cervical spine pathology.

This video clip is part of the FIFA Diploma in Football Medicine and the FIFA Medical Network. To enrol or to find our more click on the following link http://www.fifamedicalnetwork.com

The Diploma is a free online course designed to help clinicians learn how to diagnose and manage common football-related injuries and illnesses. There are a total of 42 modules created by football medicine experts. Visit a single page, complete individual modules or finish the entire course.

The network provides the opportunity for clinicians around the world to meet and share ideas relating to football medicine. Ask about an interesting case, debate current practice and discuss treatment strategies. Create a profile and log on to interact with other health professionals from around the globe.

This is not medical advice. The content is intended as educational content for health care professionals and students. If you are a patient, seek care of a health care professional.

Diagnosis To determine the most appropriate treatment for your stroke, your emergency team needs to evaluate the type of stroke you're having and the areas of your brain affected by the stroke. They also need to rule out other possible causes of your symptoms, such as a brain tumor or a drug reaction. Your doctor may use several tests to determine your risk of stroke, including: Stroke consultation Stroke consultation Stroke consultation at Mayo Clinic Brain tissue damaged by stroke CT scan of brain tissue damaged by stroke Cerebral angiogram Cerebral angiogram Physical examination. Your doctor will ask you or a family member what symptoms you've been having, when they started and what you were doing when they began. Your doctor then will evaluate whether these symptoms are still present. Your doctor will want to know what medications you take and whether you have experienced any head injuries. You'll be asked about your personal and family history of heart disease, transient ischemic attack and stroke. Your doctor will check your blood pressure and use a stethoscope to listen to your heart and to listen for a whooshing sound (bruit) over your neck (carotid) arteries, which may indicate atherosclerosis. Your doctor may also use an ophthalmoscope to check for signs of tiny cholesterol crystals or clots in the blood vessels at the back of your eyes. Blood tests. You may have several blood tests, which tell your care team how fast your blood clots, whether your blood sugar is abnormally high or low, whether critical blood chemicals are out of balance, or whether you may have an infection. Managing your blood's clotting time and levels of sugar and other key chemicals will be part of your stroke care. Computerized tomography (CT) scan. A CT scan uses a series of X-rays to create a detailed image of your brain. A CT scan can show a hemorrhage, tumor, stroke and other conditions. Doctors may inject a dye into your bloodstream to view your blood vessels in your neck and brain in greater detail (computerized tomography angiography). There are different types of CT scans that your doctor may use depending on your situation. Magnetic resonance imaging (MRI). An MRI uses powerful radio waves and magnets to create a detailed view of your brain. An MRI can detect brain tissue damaged by an ischemic stroke and brain hemorrhages. Your doctor may inject a dye into a blood vessel to view the arteries and veins and highlight blood flow (magnetic resonance angiography, or magnetic resonance venography). Carotid ultrasound. In this test, sound waves create detailed images of the inside of the carotid arteries in your neck. This test shows buildup of fatty deposits (plaques) and blood flow in your carotid arteries. Cerebral angiogram. In this test, your doctor inserts a thin, flexible tube (catheter) through a small incision, usually in your groin, and guides it through your major arteries and into your carotid or vertebral artery. Then your doctor injects a dye into your blood vessels to make them visible under X-ray imaging. This procedure gives a detailed view of arteries in your brain and neck. Echocardiogram. An echocardiogram uses sound waves to create detailed images of your heart. An echocardiogram can find a source of clots in your heart that may have traveled from your heart to your brain and caused your stroke. You may have a transesophageal echocardiogram. In this test, your doctor inserts a flexible tube with a small device (transducer) attached into your throat and down into the tube that connects the back of your mouth to your stomach (esophagus). Because your esophagus is directly behind your heart, a transesophageal echocardiogram can create clear, detailed ultrasound images of your heart and any blood clots. Treatment Emergency treatment for stroke depends on whether you're having an ischemic stroke blocking an artery — the most common kind — or a hemorrhagic stroke that involves bleeding into the brain. Ischemic stroke To treat an ischemic stroke, doctors must quickly restore blood flow to your brain. Emergency treatment with medications. Therapy with clot-busting drugs must start within 4.5 hours if they are given into the vein — and the sooner, the better. Quick treatment not only improves your chances of survival but also may reduce complications. You may be given: Intravenous injection of tissue plasminogen activator (tPA). This injection of recombinant tissue plasminogen activator (tPA), also called alteplase, is considered the gold standard treatment for ischemic stroke. An injection of tPA is usually given through a vein in the arm. This potent clot-busting drug ideally is given within three hours. In some instances, tPA can be given up to 4.5 hours after stroke symptoms begin. This drug restores blood flow by dissolving the blood clot causing your stroke, and it may help people who have had strokes recover more fully. Your doctor will consider certain risks, such as potential bleeding in the brain, to determine if tPA is appropriate for you. Emergency endovascular procedures. Doctors sometimes treat ischemic strokes with procedures performed directly inside the blocked blood vessel. These procedures must be performed as soon as possible, depending on features of the blood clot: Medications delivered directly to the brain. Doctors may insert a long, thin tube (catheter) through an artery in your groin and thread it to your brain to deliver tPA directly into the area where the stroke is occurring. This is called intra-arterial thrombolysis. The time window for this treatment is somewhat longer than for intravenous tPA, but is still limited. Removing the clot with a stent retriever. Doctors may use a catheter to maneuver a device into the blocked blood vessel in your brain and trap and remove the clot. This procedure is particularly beneficial for people with large clots that can't be completely dissolved with tPA, though this procedure is often performed in combination with intravenous tPA. Several large and recent studies suggest that, depending on the location of the clot and other factors, endovascular therapy might be the most effective treatment. Endovascular therapy has been shown to significantly improve outcomes and reduce long-term disability after ischemic stroke. Other procedures. To decrease your risk of having another stroke or transient ischemic attack, your doctor may recommend a procedure to open up an artery that's narrowed by plaque. Doctors sometimes recommend the following procedures to prevent a stroke. Options will vary depending on your situation: Carotid endarterectomy. In a carotid endarterectomy, a surgeon removes plaques from arteries that run along each side of your neck to your brain (carotid arteries). In this procedure, your surgeon makes an incision along the front of your neck, opens your carotid artery and removes plaque that blocks the carotid artery. Your surgeon then repairs the artery with stitches or a patch made from a vein or artificial material (graft). The procedure may reduce your risk of ischemic stroke. However, a carotid endarterectomy also involves risks, especially for people with heart disease or other medical conditions. Angioplasty and stents. In an angioplasty, a surgeon usually accesses your carotid arteries through an artery in your groin. Here, your surgeon can gently and safely navigate to the carotid arteries in your neck. A balloon is then inflated to expand the narrowed artery. Then a stent can be inserted to support the opened artery. Hemorrhagic stroke Emergency treatment of hemorrhagic stroke focuses on controlling your bleeding and reducing pressure in your brain. You might also need surgery to help reduce future risk. Emergency measures. If you take warfarin (Coumadin, Jantoven) or anti-platelet drugs such as clopidogrel (Plavix) to prevent blood clots, you may be given drugs or transfusions of blood products to counteract the blood thinners' effects. You may also be given drugs to lower pressure in your brain (intracranial pressure), lower your blood pressure, prevent vasospasm or prevent seizures. Once the bleeding in your brain stops, treatment usually involves supportive medical care while your body absorbs the blood. Healing is similar to what happens while a bad bruise goes away. If the area of bleeding is large, your doctor may perform surgery to remove the blood and relieve pressure on your brain. Surgical blood vessel repair. Surgery may be used to repair blood vessel abnormalities associated with hemorrhagic strokes. Your doctor may recommend one of these procedures after a stroke or if an aneurysm or arteriovenous malformation (AVM) or other type of vascular malformation caused your hemorrhagic stroke: Surgical clipping. A surgeon places a tiny clamp at the base of the aneurysm, to stop blood flow to it. This clamp can keep the aneurysm from bursting, or it can prevent re-bleeding of an aneurysm that has recently hemorrhaged. Coiling (endovascular embolization). A surgeon inserts a catheter into an artery in your groin and guides it to your brain using X-ray imaging. Tiny detachable coils are guided into the aneurysm (aneurysm coiling). The coils fill the aneurysm, which blocks blood flow into the aneurysm and causes the blood to clot. Surgical AVM removal. Surgeons may remove a smaller AVM if it's located in an accessible area of your brain, to eliminate the risk of rupture and lower the risk of hemorrhagic stroke. However, it's not always possible to remove an AVM if its removal would cause too large a reduction in brain function, or if it's large or located deep within your brain. Stereotactic radiosurgery. Using multiple beams of highly focused radiation, stereotactic radiosurgery is an advanced minimally invasive treatment used to repair vascular malformations. Stroke recovery and rehabilitation Brain hemisphere connections Brain hemisphere connections After emergency treatment, stroke care focuses on helping you recover as much function as possible and return to independent living. The impact of your stroke depends on the area of the brain involved and the amount of tissue damaged. If your stroke affected the right side of your brain, your movement and sensation on the left side of your body may be affected. If your stroke damaged the brain tissue on the left side of your brain, your movement and sensation on the right side of your body may be affected. Brain damage to the left side of your brain may cause speech and language disorders. In addition, if you've had a stroke, you may have problems with breathing, swallowing, balancing and vision. Most stroke survivors receive treatment in a rehabilitation program. Your doctor will recommend the most rigorous therapy program you can handle based on your age, overall health and degree of disability from your stroke. Your doctor will take into consideration your lifestyle, interests and priorities, and the availability of family members or other caregivers. Your rehabilitation program may begin before you leave the hospital. After discharge, you might continue your program in a rehabilitation unit of the same hospital, another rehabilitation unit or skilled nursing facility, an outpatient unit, or your home. Every person's stroke recovery is different. Depending on your condition, your treatment team may include: Doctor trained in brain conditions (neurologist) Rehabilitation doctor (physiatrist) Nurse Dietitian Physical therapist Occupational therapist Recreational therapist Speech pathologist Social worker Case manager Psychologist or psychiatrist Chaplain Speech therapy session Speech therapy is often a part of stroke rehabilitation. Treatment outcomes One way to evaluate the care of patients diagnosed with stroke is to look at the percentage of patients receiving the timely and effective care measures that are appropriate. The goal is 100 percent. The graphs below display the percentage of eligible Mayo Clinic patients diagnosed with stroke receiving all of the appropriate care measures.

Ganglion Cyst Surgical Removal

Haemorrhoids is one of the most common problems seen in surgical OPD. Open haemorrhoidectomy has remained the gold standard for a long time with a high post-operative morbidity. The quest for a better understanding of the pathology of haemorrhoids resulted in the evolvement of stapler haemorrhoidopexy. Our aim is to study the efficacy of stapler haemorrhoidopexy with regards to role of immediate post-operative morbidity. A prospective study of 50 patients (n = 50) with the second- and third-degree symptomatic haemorrhoids was done. The mean age of the patients was 44.1 years. Fourteen patients had co-morbid conditions. The average duration of the operation was 29 min. Patients with the second-degree haemorrhoids had higher rate of complication. The complication rate was 32%. Three patients had urinary retention. Two patients had minor bleeding, and one patient experienced transient discharge. The mean analgesic requirement was 2.4 tramadol, 50 mg injections. Ten patients had significant post-operative pain. Average length of hospital stay was 2.7 days. There were no symptomatic recurrences till date.

For the first few days after giving birth, a new mother’s breasts remain soft. They will produce colostrum. Colostrum, the first milk, is available in just the right amount, and is rich in immune factors that protect newborns. Sometime during the next few days, the breasts will become full, firm, warm, and perhaps tender. When this occurs, people say: “the milk is coming in!” The scientific term for this event is: engorgement. Engorgement is normal, and lasts for various periods of time depending on the individual woman. Some women experience only a day or so of mild, easy-to-manage engorgement. For other women, engorgement may be more intense, and can last from several days to two weeks.

Massive PE causing hemodynamic instability (shock and/or low blood pressure, defined as a systolic blood pressure <90 mmHg or a pressure drop of 40 mmHg for >15 min if not caused by new-onset arrhythmia, hypovolemia or sepsis) is an indication for thrombolysis, the enzymatic destruction of the clot with medication.

Visualization of the larynx by direct or indirect means is referred to as laryngoscopy and is the principal aim during airway management for passage of a tracheal tube. This paper presents a brief background regarding the development and practice of laryngoscopy and examines the equipment and techniques for both direct and indirect methods. Patient evaluation during the airway examination is discussed, as are predictors for difficult intubation. Laryngoscope blade design, newer intubating techniques, and a variety of indirect laryngoscopic technologies are reviewed, as is the learning curve for these techniques and devices.

VID 20180317 WA0001