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Invasive intracranial pressure monitoring. The most common surgically placed monitors for ICP measurement are intraventricular catheters (external ventricular drain [EVD] or a ventriculostomy drain) and fiberoptic ICP monitors implanted into the parenchyma of the brain.

The 12-lead ECG is a vital tool for EMT’s and paramedics in both the prehospital and hospital setting. It is extremely important to know the exact placement of each electrode on the patient. Incorrect placement can lead to a false diagnosis of infarction or negative changes on the ECG.

At first, grasping the needle is difficult because it will have a tendency to want to jump around. What can oftentimes help is to get hold of the thread with the left-hand forceps at a point 2 to 3 cm away from the needle. Dangle the needle until it just comes to rest on the surface. This will then allow you to use the angulated needle holder to grab the needle easily. Your needle is in a stable position if it is set up to 90 degrees to the axis of the tips of the forceps. You can make minor corrections by touching the needle with your left-hand forceps, or by partially relaxing your grip and nudging the needle tip against another firm object. You should hold the needle just behind its midpoint (If you hold it too near the tip, it will point downward. If you hold it too near the thread end, it will point upward.).

She is a twenty years young female presented with large cystic swelling in anterior aspect of neck. The swelling was of size 6cmx 6cm x5 cm ,tense tender, cystic just above sternal nutch.This was diagnosed as large neck abscess ./nRepeated aspiration done but the swelling reappeared. So Incision & Drainage planned under local anaesthesia./nPatient in supine position. Surgery part painted and draped. Local anaesthesia 2% xylocaine with adrenaline used for field block.After giving local anaesthesia, I used a no 11 blade for stab incision at the most prominent part of the swelling, where skin was thin and fluctuation present./nPus drained form that opening. Little dilatation of opening to be done with artery forceps or sinus forceps. Complete pus drainage to be ensured.Little finger can be introduced inside the pus cavity to ensure proper drainage of pus. The cavity I use to clean with a gauge piece. If necessary curette biopsy can be taken from the wall of the cavity.These wounds usually need daily proper dressing for faster healing.

Surgical technique: A 3cm skin incision under spinal or general anesthesia, depending on the patients’ preference, starts half way the line between the superior anterior iliac spine towards the midline in a 30° angle to the pubic tubercle. Scarpa’s fascia is opened as well as the external obliq...ue aponeurosis. By using this skin line incision the internal ring will be immediately visualized. Although it is important to look for both direct and indirect hernias evaluating the groin, we do not taper the cord and directly evaluate the ring for indirect hernias. In case of an indirect hernia the sac is reduced or resected according to the preference of the surgeon and the preperitoneal space is entered bluntly through the dilated internal ring. In case of a direct hernia the approach slightly differs. One could prefer to open the transversalis fascia through the internal ring over a few centimeters or you can open the fascia more medially, at the site of the direct hernia. As primary point of concern the epigastric vessels should be identified and retracted softly upwards. Then a gauze can be introduced into the preperitoneal space and by doing so most of the space needed medially will be created. Then one can already palpate Cooper’s ligament and the pubic bone. Laterally to the internal ring more digital dissection is needed to create just the appropriate space for the mesh. By placing the mesh it is important not to introduce the mesh too medially. Laterally of the internal ring an adequate overlap of the mesh is necessary, especially in indirect hernias. No splitting of the mesh seems necessary. The patient will be asked to strain and push on the ring to control its place and to check adequate spreading of the mesh to cover the whole myopectineum of Fruchaud. One single stitch of vicryl 3/0 is placed taking both the fascia transversalis and the mesh.

Appendectomy with corpus Luteal rupture

Excision of breast cancer that is visible only on mammogram. diagnosis is typically established on stereotactic biospy and excision is done with wire localization. This techniques involves localization by sonography of the hematoma that is left behind at the time of biopsy. It provides not only accu...rate location of the tumor but ensures adequate margins of excision.

Recommendations for clipping in endoscopic stomach surgery

Video shows a fine needle biopsy with guided ultrasound of a thyroid nodule.

There’s a strange, mysterious world inside us, an alien-looking environment that turns the food we eat into nutrients that keep us alive. Michael Mosley swallows a camera to take a closer look.

Understand Chest CT (Computed Tomography) scans with this clear explanation

A short lecture on albuterol for self-study or review.

Clonidine lowers blood pressure by decreasing the levels of certain chemicals in your blood. This allows your blood vessels to relax and your heart to beat more slowly and easily. The Catapres brand of clonidine is used to treat hypertension (high blood pressure). The Kapvay brand is used to treat attention deficit hyperactivity disorder (ADHD). Clonidine is sometimes given with other medications

Visual Acuity Exam of the eye from the USMLE collection

Henry Anhalt DO FAAP
Ped Eddo

Inserting the Enlite Sensor with insulin pump

A good case comprising of laparoscopic cholecystectomy with lap. assisted vaginal hysterectomy done simultaneously

Watch that Big Size Fibrodenoma Removal Under Local Anesthesia