A decade ago we thought that Chikungunya was a tropical disease restricted to the rain forests. However, after the 2007 epidemic in Italy and later in the Reunion islands, this dreaded condition has now spread to the Carribean and the Americas. Its an arthropod borne alpha virus which causes fever, polyarthralgia and arthritis. There could be serious complications in the adult such as meningoencephalitis or GBS as well as in neonates. This presentation discusses in detail the clinical features, diagnosis and management of Chikungunya fever. A detailed discussion of its complications is also included. Check out our other videos

A leg ulcer is simply a break in the skin of the leg, which allows air and bacteria to get into the underlying tissue. This is usually caused by an injury, often a minor one that breaks the skin. In most people such an injury will heal up without difficulty within a week or two. However, when there is an underlying problem the skin does not heal and the area of breakdown can increase in size. This is a chronic leg ulcer.

Binding and Fusion: HIV begins its life cycle
when it binds to a CD4 receptor and one of two
co-receptors on the surface of a CD4+
Tlymphocyte. The virus then fuses with the host
cell. After fusion, the virus releases RNA, its
genetic material, into the host cell.

Reverse Transcription: An HIV enzyme
called reverse transcriptase converts the singlestranded HIV RNA to double-stranded HIV DNA.

Integration: The newly formed HIV DNA
enters the host cell's nucleus, where an HIV
enzyme called integrase "hides" the HIV DNA
within the host cell's own DNA. The integrated
HIV DNA is called provirus. The provirus may
remain inactive for several years, producing few or
no new copies of HIV

Transcription: When the host cell receives a
signal to become active, the provirus uses a host
enzyme called RNA polymerase to create copies of
the HIV genomic material, as well as shorter
strands of RNA called messenger RNA (mRNA).
The mRNA is used as a blueprint to make long
chains of HIV proteins.

Assembly: An HIV enzyme called protease cuts
the long chains of HIV proteins into smaller
individual proteins. As the smaller HIV proteins
come together with copies of HIV's RNA genetic
material, a new virus particle is assembled.

Budding: The newly assembled virus pushes out
("buds") from the host cell. During budding, the new
virus steals part of the cell's outer envelope. This
envelope, which acts as a covering, is studded with
protein/sugar combinations called HIV
glycoproteins. These HIV glycoproteins are
necessary for the virus to bind CD4 and coreceptors. The new copies of HIV can now move
on to infect other cells.

Gowers' sign is a medical sign that indicates weakness of the proximal muscles, namely those of the lower limb. The sign describes a patient that has to use his hands and arms to "walk" up his own body from a squatting position due to lack of hip and thigh muscle strength. It is named for William Richard Gowers. Gowers' sign is classically seen in Duchenne muscular dystrophy, but also presents itself in centronuclear myopathy, myotonic dystrophy and various other conditions associated with proximal muscle weakness. For this maneuver, the patient is placed on the floor away from any objects that could otherwise be used to pull oneself to a standing position. It is also used in testing paraplegia.

About 15 minutes of vibration produces similar results to an hour of conventional resistance therapy, and produces less stress on joints, ligaments and tendons. ~ Detroit Medical Center

Women's College Hospital is revolutionizing the way knee-replacement surgery is done. It is starting to provide the procedure as an ambulatory service. Patients can go home from hospital four hours after having the surgery. In some other hospitals knee replacement surgery patients have to stay as long as 4 days.

Read an excerpt from Theresa Boyle's story:
It’s been less than four hours since Greg Nemez underwent knee-replacement surgery and the 56-year-old Mississauga man is already on his way home from hospital.

This past Monday, he became the fifth patient at Toronto’s Women’s College Hospital to undergo the outpatient procedure, which normally requires a hospital stay of two or three days.

“I’m happy ... You have that freedom of movement from before. It’s like wow,” he said on the elevator as he was leaving the hospital.

After years of being unable to hold his leg straight, the real-estate agent can finally do so. A 20-year-old football injury had left him with severe arthritis and pain.

Read the full story:
https://www.thestar.com/news/g....ta/2018/04/11/he-got

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Histology of Dense Bone

In most cases, your body's immune system defeats an HPV infection before it creates warts. When warts do appear, they vary in appearance depending on which variety of HPV is involved: Genital warts. These appear as flat lesions, small cauliflower-like bumps or tiny stem-like protrusions. In women, genital warts appear mostly on the vulva but can also occur near the anus, on the cervix or in the vagina. In men, genital warts appear on the penis and scrotum or around the anus. Genital warts rarely cause discomfort or pain, though they may itch. Common warts. Common warts appear as rough, raised bumps and usually occur on the hands, fingers or elbows. In most cases, common warts are simply unsightly, but they can also be painful or susceptible to injury or bleeding.

Shoulder dystocia is a specific case of obstructed labour whereby after the delivery of the head, the anterior shoulder of the infant cannot pass below, or requires significant manipulation to pass below, the pubic symphysis. It is diagnosed when the shoulders fail to deliver shortly after the fetal head. Shoulder dystocia is an obstetric emergency, and fetal demise can occur if the infant is not delivered, due to compression of the umbilical cord within the birth canal. It occurs in approximately 0.3-1% of vaginal births. Contemporary management of shoulder dystocia requires a calm operator and a well-thought-out plan of action. It is imperative that if not already present, help is summoned immediately after shoulder dystocia is recognized. This help may include additional nursing staff, an anesthesiologist, a pediatrician or neonatologist and an additional obstetrician or midwife. Future coordination may demonstrate that rapid response teams are best suited to attend to this emergency.

Signs Of Heart Attack In Women, Healthy Habits, What To Do When Someone Is Having A Stroke.--- http://grow-younger-blood.good-info.co --- High Blood Pressure Cured In 9 Minutes Is it possible to drop your high blood pressure below 120/80 in just 9 minutes? Unbelievable…but the answer is YES! Not only is it possible…thousands of people have done it already. In fact, this little technique has become the #1 “underground” high blood pressure trend of the year. And we’re expecting it to become mainstream very soon. What’s more…this method requires NO pills, supplements, diets, or strenuous workouts. I explain this all here in today’s video… http://grow-younger-blood.good-info.co

Femoral Venous Line Placement

stop gunshot wound bleeding in 15 seconds

Genes are the building blocks of heredity. They are passed from parent to child. They hold DNA, the instructions for making proteins. Proteins do most of the work in cells. They move molecules from one place to another, build structures, break down toxins, and do many other maintenance jobs. Sometimes there is a mutation, a change in a gene or genes. The mutation changes the gene's instructions for making a protein, so the protein does not work properly or is missing entirely. This can cause a medical condition called a genetic disorder. You can inherit a gene mutation from one or both parents. A mutation can also happen during your lifetime.

Dr Allen’s device provides a new kidney stones treatment that tackles the cause of kidney stone formation which is hidden at the capillary level, read at http://www.finetreatment.co.uk. The unique natural Thermobalancing Therapy does not use harmful medication or shock waves and, of course, surgery. Learn by watching this video about kidney stones cause and how to dissolve kidney stone or kidney stones at home by using Dr Allen’s natural therapeutic device.

People whose back or neck pain has not been relieved by back surgery or other treatments may have another option to consider: spinal cord stimulation. Around the world, some 14,000 patients undergo spinal cord stimulator implants each year. Spinal cord stimulation (SCS) delivers mild electrical stimulation to nerves along the spinal column, modifying or blocking nerve activity in a non-medicinal way to minimize the sensation of pain reaching the brain.

Defecography showing Internal Rectal Prolapse

-Failure to thrive (FTT) is not a diagnosis in itself; rather, it is a term used to describe failure to gain weight in children younger than two years old. Children categorized as FTT weigh less than the 5th percentile for their age; more severe cases involve a slowing of linear growth and head circumference as well. The three causes of FTT are inadequate calorie intake, inadequate calorie absorption, and increased calorie requirements. Newborn infants need 110 kcal/kg/day, while children up to twelve months need 100

Prostate cancer is the most common cancer among men (after skin cancer), but it can often be treated successfully. If you have prostate cancer or are close to someone who does, knowing what to expect can help you cope. Here you can find out all about prostate cancer, including risk factors, symptoms, how it is found, and how it is treated.

Anterior Release Test

Digital Local Anaesthesia