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parotidectomy has always been considered to be a daunting aesthetic surgical exercise reuiring extreme care to safeguard the facial nerve. most surgeons master the skill with experience and effort and develop thier own tips and tricks for safe conduct of the procedure. details of the procedure along... with practical tips are illustrated in the video for the benefit of head neck surgeons
Spinal anesthesia is done in a similar way. But the anesthetic medicine is injected using a much smaller needle, directly into the cerebrospinal fluid that surrounds the spinal cord. The area where the needle will be inserted is first numbed with a local anesthetic. Then the needle is guided into the spinal canal, and the anesthetic is injected. This is usually done without the use of a catheter. Spinal anesthesia numbs the body below and sometimes above the site of the injection. The person may not be able to move his or her legs until the anesthetic wears off.
The eyelid is injected with a local anesthetic, a clamp is put on the eyelid, then the eyelid is turned over, an incision is made on the inside of the eyelid, and the chalazion is drained and scraped out with a curette. A scar on the upper lid can cause discomfort as some patients feel the scar as they blink.
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
Varicose veins are generally benign. The cause of this condition is not known. For many people, there are no symptoms and varicose veins are simply a cosmetic concern. In some cases, they cause aching pain and discomfort or signal an underlying circulatory problem. Treatment involves compression stockings, exercise, or procedures to close or remove the veins.
Beating heart or "off pump" coronary artery surgery is the latest revolution in the management coronary disease. It is being embraced world-wide by increasing numbers of surgeons. Many of the advantages are subtle but reduced mortality, stroke, and bleeding as well as earlier discharge are well-established benefits. A cardiac stabiliser is mandatory for this surgery, most are single use only and very expensive, this one is multiple use and is saving many healthcare dollars
This video contains five segments with best practices on how to prevent infection in patients with catheters, fistulas or grafts. It also includes segments on hand hygiene and glove use and dialysis station disinfection. The video is intended to be used by outpatient hemodialysis facilities as an educational tool to help remind their frontline staff, including technicians and nurses, about infection prevention measures. It can be used as an orientation video for new staff and as an annual in-service training tool to remind staff of proper protocols.
See the Spanish captioned version at: http://youtu.be/L5ypnOvOFMQ
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Occupational respiratory disease is any lung condition you get at work. Certain workplaces lend themselves to disease. The most common are coalmines and factories or areas with high amounts of toxins. These include asbestos and silica dust, as well as smoke, fumes, gases, and other particles. Types of occupational respiratory disease include: coal workers’ pneumoconiosis, also known as Black Lung Disease asbestosis silicosis farmers’ lung, also known as allergic alveolitis. It also includes forms of asthma, bronchitis, or emphysema.
Loa loa filariasis (also known as loiasis, loaiasis, Calabar swellings, Fugitive swelling, Tropical swelling and African eyeworm) is a skin and eye disease caused by the nematode worm, loa loa. Humans contract this disease through the bite of a Deer fly or Mango fly (Chrysops spp), the vectors for Loa loa. The adult Loa loa filarial worm migrates throughout the subcutaneous tissues of humans, occasionally crossing into subconjunctival tissues of the eye where it can be easily observed. Loa loa does not normally affect one's vision but can be painful when moving about the eyeball or across the bridge of the nose.The disease can cause red itchy swellings below the skin called "Calabar swellings". The disease is treated with the drug diethylcarbamazine (DEC), and when appropriate, surgical methods may be employed to remove adult worms from the conjunctiva.