This tutorial explains the difference in mechanisms between the 2 palsies. Bulbar palsy is a lower motor neuron condition and pseudobulbar palsy is an upper motor neuron condidtion.

a disease in which the body’s ability to produce or respond to the hormone insulin is impaired, resulting in abnormal metabolism of carbohydrates and elevated levels of glucose in the blood and urine.

Urogenital neoplasms spreading to the inguinal lymph nodes are penile carcinoma (the most frequent), urethral and scrotum cancers, tumors of the testis with scrotal violation. Penile carcinoma is an uncommon malignant disease and accounts for as many 0.4-0.6% of male cancers. Most patients are elder...ly. It rarely occurs in men under age 60 and its incidence increases progressively until it reaches a peak in the eighth decade 1. The risk of a lymph node invasion is greater with high grade and high stage tumors 2. Some investigators have reported the inaccuracy of the sentinel node biopsy 3, 4, described by Cabanas 5. Patients with metastatic lymph node penis cancer have a very poor prognosis if penectomy only is performed. Ilioinguinal lymphadenectomy is basically carried out as a treatment modality and not only as a staging act. Patients with lymph node invasion have a 30-40% cure rate. Ilioinguinal lymphadenectomy should be also performed in patients with disseminated neoplasms for the local control of the disease. The 5 years survival rate of patients with clinically negative lymph nodes treated with a modified inguinal lymphadenectomy is 88% versus 38% in patients not initially treated with lymphadenectomy 6. This video-tape clearly shows a therapeutic algorithm, the anatomy of the inguinal lymph nodes, according to Rouviere 7 and Daseler 8, the radical ilioinguinal node dissection with transposition of the sartorius muscle and the modified inguinal lymphadenectomy proposed by Catalona 9. References: 1. Lynch D.F. and Schellhammer P: Tumors of the penis. In Campbell’s Urology Seventh Edition, edited by Walsh P.C., Retik A.B., Darracott Vaughan E. and Wein A.J. W.B. Saunders Company, Vol. 3, chapt. 79, p. 2458, 1998. 2. Pizzocaro G., Piva L., Bandieramonte G., Tana S. Up-to-date management of carcinoma of the penis. Eur. Urol. 32: 5-15, 1997 3. Perinetti E., Crane D.B. and Catalona W.J. Unreliability of sentinel lymph node biopsy for staging penile carcinoma. J. Urol. 124: 734, 1980 4. Fowler J.E. Jr. Sentinel lymph node biopsy for staging penile cancer. Urology 23: 352, 1984 5. Cabanas R.M. An approach for the treatment of penile carcinoma. Cancer 39: 456, 1977 6. Russo P. and Gaudin P. Management strategies for carcinoma of the penis. Contemporary Urology;5:48-66, 2000 7. Rouviere H. Anatomy of the human lymphatic system. Edwards Brothers, p. 218, 1938 8. Daseler E.H., Anson B.J., Reimann A.F. Radical excision of the inguinal and iliac lymph glands: a study based on 450 anatomical dissections and upon supportive clinical observations. Surg. Gynecol. Obstet. 87: 679, 1948 9. Catalona W.J. Modified inguinal lymphadenectomy for carcinoma of the penis with preservation of saphenous veins: technique and preliminary results. J. Urol. 140: 306-310, 1988

Phlebitis may occur with or without a blood clot. It can affect surface or deep veins. When caused by a blood clot, it's called thrombophlebitis. Trauma to the vein, for instance from an IV catheter, is a possible cause. Symptoms include redness, warmth, and pain in the affected area. Treatments may include a warm compress, anti-inflammatory medication, compression stockings, and blood thinners.

A disease of the immune system due to infection with HIV. HIV destroys the CD4 T lymphocytes (CD4 cells) of the immune system, leaving the body vulnerable to life-threatening infections and cancers. Acquired immunodeficiency syndrome (AIDS) is the most advanced stage of HIV infection. To be diagnosed with AIDS, a person with HIV must have an AIDS-defining condition or have a CD4 count less than 200 cells/mm³ (regardless of whether the person has an AIDS-defining condition).

watch that video of Popping a Huge Hand Burn Blister

Laparoscopy in acute bowel obstruction following previous surgery is a difficult procedure and avoided by most of the surgeons due to the difficulty in obtaining pneumoperitoneum, port placement, lack of working space, adhesions and risk of bowel injury.
Here is a patient who had a previous laparotomy for trauma with a midline incision from xyphysternum to pubis; after unsuccessful conservative management he underwent a laparoscopy; a prior CT scan showed adhesions in the left side and a distal-mid small bowel obstruction. The pneumoperitoneum was obtained with the Visiport placed in the right lower quadrant; although the abdomen was grossly distended, under significant tension and distended loops of small bowel were occupying most the peritoneal cavity, with muscle relaxation there is usually enough space to perform a thorough inspection of the abdominal cavity. Port placement has to be done with special care as there is no room to push and usually a blunt trocar directed away from the bowel is employed in my practice. The collapsed loops of small bowel point quickly to the site of obstruction -- it is better to avoid manipulating the distended bowel as it is heavy, oedematous and prone to be lacerated with the instruments; once the pathology is identified, in this case the obstructive band, light packing is performed in order to expose the working space and protect the bowel from instruments like scissors or diathermy. In this case the band adhesion was slightly more difficult to separate from the bowel and required a combination of sharp and gentle blunt dissection.
Once the obstruction is release and the transit of contents is confirmed in the collapsed bowel the procedure is terminated. No abdominal drainage is usually necessary.

Duct tape is one home remedy. Put a small strip over the wart and leave it on for six days. Then, remove the tape, soak the wart in water, and then gently debride it with a pumice stone or emory board. Repeat the process many times until the wart is gone.

Erectile dysfunction (ED) is the inability to get or keep an erection firm enough for sexual function. It’s a common sexual problem, affecting as many as 30 million men in the United States. Most cases of ED have a physical cause, such as heart disease, diabetes, and obesity. Lifestyle choices like smoking and drinking excessive amounts of alcohol can also lead to ED. But for some men, psychological issues are the root of the problem.

Acne is a skin disease that involves the oil glands at the base of hair follicles. Acne is not dangerous, but can leave skin scars. Types of pimples include whiteheads, blackheads, papules, pustules, nobules, cysts. ... Treatment for acne may depend on how severe and persistent .

The big bang is the moment when the uterus, vagina, and anus contract simultaneously at 0.8-second intervals. A small orgasm may consist of three to five contractions; a biggie, 10 to 15. Many women report feeling different kinds of orgasms

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Mesenteric cyst is one of the rarest abdominal tumours, with approximately 820 cases reported since 1507. The incidence varies from 1 per 100,000 to 250,000 admissions. The lack of characteristic clinical features and radiological signs may present great diagnostic difficulties.

This video is really sad. You can literally watch this man dying. He was shot in the chest and rushed to the emergency room. His heart has stopped beating or has arrested. As a last resort, surgeons did an extreme procedure called an open thoracotomy which is that crazy tool you see there that basically splits the ribs open and allows easy open access to the heart. They did this so they could give him a cardiac massage. A cardiac massage is when surgeons are manually trying to pump the heart after it has stopped working on its own (cardiac arrest). Unfortunately he lost so much blood from his gun shot wound and he was pronounced dead. There are cases of patients surviving after having this kind of invasive resuscitation but it is rare.

Nosebleeds common. Most often they are a nuisance and not a true medical problem. But they can be both. Nosebleed care Sit upright and lean forward. By remaining upright, you reduce blood pressure in the veins of your nose. This discourages further bleeding. Sitting forward will help you avoid swallowing blood, which can irritate your stomach. Pinch your nose. Use your thumb and index finger to pinch your nostrils shut. Breathe through your mouth. Continue to pinch for five to 10 minutes. Pinching sends pressure to the bleeding point on the nasal septum and often stops the flow of blood. To prevent re-bleeding, don't pick or blow your nose and don't bend down for several hours after the bleeding episode. During this time remember to keep your head higher than the level of your heart. If re-bleeding occurs, blow out forcefully to clear your nose of blood clots and spray both sides of your nose with a decongestant nasal spray containing oxymetazoline (Afrin, Mucinex Moisture Smart, others). Pinch your nose again as described above and call your doctor. When to seek emergency care The bleeding lasts for more than 20 minutes The nosebleed follows an accident, a fall or an injury to your head, including a punch in the face that may have broken your nose

Vaginal Hysterectomy Procedure of a 42 years old female patient with a 3 months history of symptomatic vaginal bulge

Kegel exercises strengthen the pelvic floor muscles, which support the uterus, bladder, small intestine and rectum. You can do Kegel exercises, also known as pelvic floor muscle training, just about anytime. Start by understanding what Kegel exercises can do for you — then follow step-by-step instructions for contracting and relaxing your pelvic floor muscles.