Shoulder Injection

Dr. Ebraheim’s educational animated video describing the anatomy and associated injuries of the knee joint.
Disrupted quadriceps
•Patient is unable to actively extend the knee.
The most common cause of ACL ruptures:
•Traumatic force being applied during twisting motion.
•Side stepping or landing from a jump.
Patient complains of:
•Immediate pain
•Knee giving way
•Swelling
Aspiration of the knee
•If aspiration of the knee joint shows evidence of blood within the joint there is 75-80% chance of ACL and meniscal injury.
Lachamn’s test- ACL knee exam
•Knee is flexed at 30 degrees.
•ACL tear of the knee is identified by pulling on the tibia and examining the frontward motion of the lower leg in comparison to the upper leg.
Radiological exam – ACL
•MRI of the knee joint shows bone lesions or bruising associated with tears of the ACL. Injury is found in the typical location; middle of the femoral condyle and posterior part of the tibia laterally.
Posterior cruciate ligament tear (PCL)
•Common cause of injury is a bent knee hitting a dashboard in a car accident.
Tibial Sag Test –PCL knee exam
Quadriceps active test-PCL knee exam
•The examiner stabilizes the leg of the patient and then the patient is asked to actively contract the quadriceps muscle.
•The tibia is seen actively reduced from the posterior subluxed position.
Lachman’s test-PCL knee exam
•Knee is bent 20-30 degrees.
•The posterior drawer test is carried out while the patient is in a supine position and the knee is flexed to 90 degrees.
•The amount of translation of the tibia relative to the femur is observed.
The dial test is performed while the patient is in the supine or prone position and both knees are in 90 and 30 degrees of flexion. More than 10 degrees of external rotation indicates significant injury.
Common meniscal tears
Symptoms include
•Knee pain
•Pain with straightening the knee
•Swelling
•Locking
•Weakness

TPE removes large-molecular-weight substances such as harmful antibodies from the plasma. It is usually carried out using an automated blood cell separator to ensure fluid balance and maintain a normal plasma volume. This may require the insertion of a femoral or jugular line to allow adequate blood flow. Typically, 30–40 mL/kg of plasma (1–1.5 plasma volumes) are removed at each procedure and replaced with isotonic 4.5 or 5.0% human albumin solution (some services substitute 25–50% of replacement volume with 0.9% saline). Exchange with fresh frozen plasma (FFP) is reserved for the replacement of ADAMTS13 in thrombotic thrombocytopenic purpura (see below) or to replace clotting factors. A one plasma volume exchange removes about 66% of an intravascular constituent and a two plasma volume exchange approximately 85%. TPE is normally combined with disease modifying treatment, such as immunosuppressive drugs, for the underlying condition.

The essential steps of a translaminaterminalis approach for removal of craniopharyngiomas

When foreign organisms such as bacteria enter the body, the immune system sends white blood cells to fight the infection. This causes swelling (inflammation) at the site of infection and the death of nearby tissue, creating a hole called a cavity, which fills with pus to form an abscess.

What are the symptoms of spinal meningitis in adults? Causes. The most common cause of viral meningitis is. ... Symptoms. Viral meningitis usually begins with symptoms of a viral infection, such as fever, a general feeling of illness (malaise), cough, muscle aches, vomiting, loss of appetite, and headache. ... Diagnosis. ... Treatment. ... Prognosis.

Eric knew he needed help when an old knee injury began worsening over the course of time and was significantly affecting his quality of life. That’s when he turned to his hometown orthopedic experts at Mayo Clinic Health System in Mankato, who recommended a total knee replacement. After overcoming some initial fears, Eric decided it was time to have the operation — a fuller and more active life with his family depended on it.

METHODS:
Previously existing methods are characterized by unpleasant scars that, despite surgeons promises, remain for life.
Incisions are:

- around the areola (Round block) leading to a flat areola, often unpleasant hypertophic skars, skin rippling.
- inverted T (around the areola, vertically down and in the fold under the breast).

- Vertical (around the areola and vertically down). Due to the extess skin, incisions often turn into inverted L or T. Rearrangement of glandular tissue and skin changes the shape of the breasts and may be different from expectations. Scars worry patients and sometimes cause disturbances in the relationship with their partner.

- No scars. The "Serdev Suture" lifting technique for breast lifting without scars (only points - needle perforations in the skin) is created by the Bulgarian cosmetic surgeon Prof. Dr. Nikolay Serdev. It is a novelty that had changed the cosmetic surgery world in the last 10-14 years for young patients. The technique is especially important in Asia and Latin America, for Asians, African-Americans, Indians, and others who form keloids and lumpy scars after operations.

The Serdev suture method can achieve lift upto and over 14 centimeters and is most suitable for the following types of breasts:
- not very heavy full breasts.
- in the presence of subpectoral implants with subsequent drooping of the breasts after childbirth and lactation.
- empty and loose breasts after childbirth and breastfeeding. In such cases this technique is combined with subpectoral implants. In sagging breasts implants should not be placed in the skin over the pectoral muscles, because thus will lead to even more drooping. Therefore, breast lift requires breast fixation to the level of the pectoral muscle (the normal position in young women), and then placement of appropriate implants under the muscle, to hold them in the appropriated position.
- in drooping breasts after subglandular augmentation (over the muscle). In such cases, patients should not wait until the skin elongation becomes visible. The implants should be removed, the capsule removed - a difficult but a necessary operation, preventing postop seromas and infection. Implants should be placed under the pectoralis muscle to wear them. Patients should orient the cosmetic surgeon at what level they want the nipples - in the middle of the implant, higher or lower.
Implants should be generally replaced - below the muscle implants should be smooth, move naturally without hurting the muscle.

Because of modern anesthetics and new methods without trauma, pain and swelling after surgery are not significant. In 3-4 days, patients can return to social life, even the next day, but it is preferable to rest for 2-3 days.

Exercises with the arms and weight lifting is prohibited for a month and a half.

Due to lack of scars, the breast lift using the Serdev sutures can be repeated to maintain the aesthetic appearence of the breasts even in advanced age.

Gigantomastia i.e. very large, very heavy and drooping breasts can not be operated in this manner, because of gravity and overskin.

Early mastopexy using Serdev sutures is recommended before too much changes in the tissues. If late, more and more complex interventions are required.

"A lot of people are opting for various breast procedures and one of the most common among them is “mastopexy”. This is the surgery that involved uplifting of sagging breasts and, in certain cases, repositioning of the nipple and areola in order to restore normality and beauty. The excess skin is removed and firmness is provided to the breasts. Though mastopexy can be done as a stand alone surgery, many people combine it with breast augmentation which involves inserting implants inside the b

The procedure was performed under wrist block regional anesthesia with tourniquet control. A single Chinese finger trap was used on the thumb with 5 to 8 lb of ongitudinal traction. The arm was held down with wide tape around the tourniquet securing it to the hand table to serve as countertraction. A shoulder holder, rather than a traction tower, was used to facilitate fluoroscopic intervention more easily. The Trapeziometacarpal joint was detected by palpation. Joint distension was achieved by injecting 1 to 3 mL of normal saline (Fig. 1). It is important to distally direct the needle approximately 20 degrees to clear the dorsal flare of the metacarpal base and enter the joint capsule. This course should be reproduced upon entering with arthroscopic sleeve/ trocar assembly to minimize iatrogenic cartilage injury. Fluid distention is important to facilitate this. The incision for the 1-R (radial) portal, used for proper assessment of the dorsoradial ligament, posterior oblique ligament, and ulnar collateral ligament, was placed just volar to the abductor pollicis longus tendon. The incision for the 1-U (ulnar) portal, for better evaluation of the anterior oblique ligament and ulnar collateral ligament, was made just ulnar to the extensor pollicis brevis tendon. A short-barrel, 1.9-mm, 30- degree inclination arthroscope was used for complete visualization of the CMC joint surfaces, capsule, and ligaments, and then appropriate management was done, as dictated by the stage of the arthritis detected (Fig. 2A). A full-radius mechanical shaver with suction was used in all the cases, particularly for initial debridement and visualization. Most of the cases were augmented with radiofrequency ablation to perform a thorough synovectomy and radiofrequency was also used to perform chondroplasty in the cases with focal articular cartilage wear or fibrillation. Chondroplasty refers to thedebridement of the fibrillated cartilage to improve vascularity of the cartilage and enhance the growth of fibrocartilage. Ligamentous laxity and capsular attenu- ation were treated with thermal capsulorraphy using a radiofrequency shrinkage probe. We were careful to avoid thermal necrosis; hence, a striping technique was used to tighten the capsule of the lax joints. The striping technique refers to thermal shrinkage performed in longitudinal stripes on the lax capsule, so as to leave vascular zones between the stripes; hence, thermal necrosis is prevented. Arthroscopic stage I disease was characterized by synovitis without any cartilage wear, wherein a synovectomy coupled with thermal capsulor- raphy as described was performed.

Neck pain is a common complaint. Neck muscles can be strained from poor posture — whether it's leaning over your computer or hunching over your workbench. Osteoarthritis also is a common cause of neck pain. Rarely, neck pain can be a symptom of a more serious problem. Seek medical care if your neck pain is accompanied by numbness or loss of strength in your arms or hands or if you have shooting pain into your shoulder or down your arm

Gastric bypass, also called Roux-en-Y gastric bypass surgery, is considered a “metabolic” procedure because it changes how your body absorbs fat, calories and nutrients. This metabolic change occurs because your gastrointestinal tract is altered when your gastric bypass surgeon attaches the smaller section of your stomach directly to your small intestine. As a result, your appetite changes and you feel full faster.

Herniated or Ruptured Disc: Between each of the vertebre of the spine is a disc which is filled with a gel type material to cushion the connection between the vertebre. With age or injury these intervertebral discs can rupture or herniate. This herniation causes them to push against the adjacent nerves which come from the spinal cord. This can frequently cause pain, numbenss and tingling. This animated video reviews herniated disc.

Are you seeking sinus, allergy, or nasal congestion relief? Nasal irrigation, also known as nasal rinsining, is your solution! Nasal Care's nasal irrigation system is an all-natural, simple, and easy sinus and allergy treatment that brings gentle and soothing sinus relief. Visit www.nasalcleanse.com to learn more about the safe, simple and all-natural relief you can experience with NasalCare's nasal irrigation system.

The veins around your anus tend to stretch under pressure and may bulge or swell. Swollen veins (hemorrhoids) can develop from an increase in pressure in the lower rectum. Factors that might cause increased pressure include: Straining during bowel movements.

Histology of Inner Ear 1

Watch that video of an Ingrown hair turns into 140-pound tumor in man’s stomach

Gallbladder "Lumigram" - shows the common bile duct(being probed) and the cystic duct (the duct YOU WANT TO CUT)

Pyogenic liver abscess Email this page to a friend Email this page to a friend Facebook Twitter Google+ Pyogenic liver abscess is a pus-filled area in the liver. Causes There are many potential causes of liver abscesses, including: Abdominal infection, such as appendicitis, diverticulitis, or a perforated bowel Infection in the blood Infection of the bile draining tubes Recent endoscopy of the bile draining tubes Trauma that damages the liver The most common bacteria that cause liver abscesses are: Escherichia coli Bacteroides Enterococcus Klebsiella pneumoniae Staphylococcus aureus Streptococcus In most cases, more than one type of bacteria is found.

Flexible bronchoscopy is a procedure that allows a clinician to examine the breathing passages (airways) of the lungs (figure 1). Flexible bronchoscopy can be either a diagnostic procedure (to find out more about a possible problem) or a therapeutic procedure (to try to treat an existing problem or condition).