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The most reliable clinical sign to detect ascites is checking for bilateral flank dullness. If a patient with ascites is lying supine, fluid accumulates in the flank regions, leading to dullness on percussion. At the same time, the air-filled bowel loops are forced upwards by the free fluid due to buoyancy, resulting in tympanitic percussion. To locate specifically where dullness shifts to tympany, or the air-fluid level, percussion should be performed from the sides towards the middle. To confirm that the dullness is caused by ascites, ask the patient to switch to a lateral decubitus position. If ascites is present, the air-filled bowel loops will shift accordingly and remain at the surface of the fluid. As a result, the air-fluid level will shift as well. This is known as shifting dullness.
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Lewy body dementia, also known as dementia with Lewy bodies, is the second most common type of progressive dementia after Alzheimer's disease dementia. Protein deposits, called Lewy bodies, develop in nerve cells in the brain regions involved in thinking, memory and movement (motor control). Lewy body dementia causes a progressive decline in mental abilities. People with Lewy body dementia may experience visual hallucinations, and changes in alertness and attention. Other effects include Parkinson's disease-like symptoms such as rigid muscles, slow movement and tremors.
Learn with Dr. Wahdan 2
You can download the lecture from this link
https://docdro.id/5ni1FFZ
Tetralogy of Fallot (teh-TRAL-uh-jee of fuh-LOW) is a rare condition caused by a combination of four heart defects that are present at birth. These defects, which affect the structure of the heart, cause oxygen-poor blood to flow out of the heart and to the rest of the body. Infants and children with tetralogy of Fallot usually have blue-tinged skin because their blood doesn't carry enough oxygen. Tetralogy of Fallot is often diagnosed during infancy or soon after. However, tetralogy of Fallot might not be detected until later in life, depending on the severity of the defects and symptoms. With early diagnosis followed by appropriate surgical treatment, most children who have tetralogy of Fallot live relatively normal lives, though they'll need regular medical care and might have restrictions on exercise.
Cardiovascular Examination Clinical skills - Medical School Revision - Dr Gill
The cardiac exam is one of the clinical skills that medical students learn completely, as more often than not, patients will consult regularly about chest pain, and it is important to be able to identify key cardiovascular signs
As a junior doctor, the examination of the cardiovascular system can be almost a dreaded examination, as cardiac murmurs can literally take years of exposure in order to gain confidence with their identification through cardiac auscultation.
This video demonstrates not merely the examination of the heart, but the complete cardiovascular system including its peripheries.
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Butt implants are a popular plastic surgery procedure among those who wish to enhance the appearance, shape, and size of their rear ends. Buttock augmentation involves the surgical insertion of artificial body implants into a patient’s buttocks to create a larger, shapelier, and more sensuous rear end. Patients who have underdeveloped buttocks can achieve a more proportionate figure with butt implants. Women who wish to achieve an “hour glass” figure or are unhappy with the size of their buttocks can benefit from female butt implants. Men with flat or poorly developed buttocks can enhance the shape of the area to their liking with male butt implants. Many buttock augmentation patients say that their clothes fit better, they feel more attractive, and their confidence levels have improved.
In patients age ;::25, HPV DNA testing is the preferred next step in management if the initial cytology shows ASC-US. In this method, samples are collected for both cytology and reflex HPV DNA. If cytology results are positive, HPV DNA testing is performed. If cytology results are negative, the sample for HPV DNA is discarded. HPV DNA testing along with Pap smear at 3 years is recommended if initial cytology shows ASC-US but HPV DNA testing is negative