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Purpose: To evaluate the results of LASIK and IntraLASIK treatment in myopic patients with nystagmus. Methods: Eight patients with congenital nystagmus (16 eyes), from 23 to 49 years of age, underwent LASIK surgery. Corneal flaps were created using either the Hansatome microkeratome or the Intral...ase femtosecond laser. The ablations were performed with the Bausch & Lomb excimer laser with an active tracking system. In some patients, the eyes were fixated with forceps or a fixation ring during the laser ablation. Results: The refractive errors were corrected in all cases. There was no decentration or loss of best corrected visual acuity greater than 1 line. In 56% of the eyes, the post-operative uncorrected visual acuity was better than the best spectacle corrected-visual acuity (BSCVA). 62.5% of the eyes improved their BSCVA. The overall visual performance was improved in all the patients. One patient that did not not drive before become eligible to get a driver license after the surgery. Conclusions: Selected patients with myopia and congenital nystagmus may benefit from laser refractive surgery. Laser refractive surgery may be safely and accurately performed by using either the Hansatome microkeratome or the Intralase femtosecond laser and an active tracking system with or without mechanical fixation. Certain patients improve their BSCVA post-operatively.
http://barretts-esophagus-cure.info-pro.co Barrett's Esophagus, Barrett's Esophagus Metaplasia, Barrett's Esophagus Bulimia. Are you lost, scared, frustrated, or confused? Have you been recently diagnosed with Barrett’s? Maybe your loved one or a close family member is now a victim of this painful disease. If so, I’d like to share with you some possibly life changing information on how I personally cured my own Barrett’s Esophagus. But before I do I’d like you to take a deep breath, relax for a moment, and let your worry subside because. Even though the Society of Thoracic Surgeons has determined that people with Barrett’s Esophagus are 40x’s more likely to get esophageal cancer, this diagnosis isn’t always a death sentence. Having been a victim of Barrett’s myself, I can relate to the excruciating pain this disease can cause. Maybe you’re like I was, trying to hide the symptoms when the burning, the heartburn, and the PAIN would become so unbearable I’d try doing anything to block it out. I can clearly recall the feeling of those scorching corroding acids inside my throat that would burn like fire, tearing up my esophagus from the inside out. It’s a pain I will NEVER forget. For me, maybe like you, many of my days were spent in anguish and painful agony. Barrett’s Reversed Without Surgery, Pills, PPI Pumps, Antacids, or Drugs. Clicking Here http://barretts-esophagus-cure.info-pro.co
Megacolon, as well as megarectum, is a descriptive term. It denotes dilatation of the colon that is not caused by mechanical obstruction.[1, 2] Although the definition of megacolon has varied in the literature, most researchers use the measurement of greater than 12 cm for the cecum as the standard. Because the diameter of the large intestine varies, the following definitions would also be considered: greater than 6.5 cm in the rectosigmoid region and greater than 8 cm for the ascending colon. Megacolon can be divided into the following 3 categories: Acute megacolon ( pseudo-obstruction) Chronic megacolon, which includes congenital, acquired, and idiopathic causes Toxic megacolon
The examination room should be quiet, warm and well lit. After you have finished interviewing the patient, provide them with a gown (a.k.a. "Johnny") and leave the room (or draw a separating curtain) while they change. Instruct them to remove all of their clothing (except for briefs) and put on the gown so that the opening is in the rear. Occasionally, patient's will end up using them as ponchos, capes or in other creative ways. While this may make for a more attractive ensemble it will also, unfortunately, interfere with your ability to perform an examination! Prior to measuring vital signs, the patient should have had the opportunity to sit for approximately five minutes so that the values are not affected by the exertion required to walk to the exam room. All measurements are made while the patient is seated. Observation: Before diving in, take a minute or so to look at the patient in their entirety, making your observations, if possible, from an out-of-the way perch. Does the patient seem anxious, in pain, upset? What about their dress and hygiene? Remember, the exam begins as soon as you lay eyes on the patient. Temperature: This is generally obtained using an oral thermometer that provides a digital reading when the sensor is placed under the patient's tongue. As most exam rooms do not have thermometers, it is not necessary to repeat this measurement unless, of course, the recorded value seems discordant with the patient's clinical condition (e.g. they feel hot but reportedly have no fever or vice versa). Depending on the bias of a particular institution, temperature is measured in either Celcius or Farenheit, with a fever defined as greater than 38-38.5 C or 101-101.5 F. Rectal temperatures, which most closely reflect internal or core values, are approximately 1 degree F higher than those obtained orally. Respiratory Rate: Respirations are recorded as breaths per minute. They should be counted for at least 30 seconds as the total number of breaths in a 15 second period is rather small and any miscounting can result in rather large errors when multiplied by 4. Try to do this as surreptitiously as possible so that the patient does not consciously alter their rate of breathing. This can be done by observing the rise and fall of the patient's hospital gown while you appear to be taking their pulse. Normal is between 12 and 20. In general, this measurement offers no relevant information for the routine examination. However, particularly in the setting of cardio-pulmonary illness, it can be a very reliable marker of disease activity. Pulse: This can be measured at any place where there is a large artery (e.g. carotid, femoral, or simply by listening over the heart), though for the sake of convenience it is generally done by palpating the radial impulse. You may find it helpful to feel both radial arteries simultaneously, doubling the sensory input and helping to insure the accuracy of your measurements. Place the tips of your index and middle fingers just proximal to the patients wrist on the thumb side, orienting them so that they are both over the length of the vessel.
Atrial Fibrillation is the most common heart rythmn abnormatlity and is very common as you age. Atrial fibrillation is a condition in which the top chambers of the heart, the Atrium are fibrillating, rather than having a regular synchronized contraction. One of the worst complications of Atrial Fibrillation can be Stroke. There are very good treatments of Atrial Fibrillation. This animated video is an overview of Atrial Fibrillation.
Hypoglycemia is a common and serious medical emergency which may occur in both daibetic and non-diabetic patients. The signs and symptoms of hypoglycaemia may be present in many individuals, but may also be masked in several individuals due to a condition called hypoglycaemia induced autonomic failure. This presentation aims to deal with the causes, clinical features, diagnosis and management of various causes of hypoglycaemia. The causes of hypoglycaemia may be divided into hypoglycaemia in ill or medicated individuals and hypoglycaemia in previously asymptomatic individuals. A variety of causes are discussed under both headings. Management of hypoglycaemia is also discussed in detail. There is also a brief discussion about management of insulinoma.