A Video showing a fine needle biopsy guided with ultrasound of a thyroid nodule

Hepatitis B is a serious liver infection caused by the hepatitis B virus (HBV). For some people, hepatitis B infection becomes chronic, meaning it lasts more than six months. Having chronic hepatitis B increases your risk of developing liver failure, liver cancer or cirrhosis — a condition that causes permanent scarring of the liver. Most people infected with hepatitis B as adults recover fully, even if their signs and symptoms are severe. Infants and children are more likely to develop a chronic hepatitis B infection. A vaccine can prevent hepatitis B, but there's no cure if you have it. If you're infected, taking certain precautions can help prevent spreading HBV to others.

A Brazilian butt lift (BBL) uses a person's own fat to enhance the size and shape of the buttocks. A plastic surgeon first performs liposuction to remove fat from other areas of the body (often the stomach, hips, and thighs), then injects that fat into the backside. Additional liposuction can be done around the butt to improve the appearance of lift and contour.

To facilitate the delivery of fluids during labour, obstetric anaesthetists from Coventry designed a triple IV peripheral connector with a central high-flow anti-reflux valve. This connector, now rightly known as the Coventry valve, can be used for all theatre settings and is especially useful in obstetrics, ICU, HDU and orthopaedics. More details on www.mediplus.co.uk

Urinary tract infections (UTIs) are infections of the urethra, bladder, ureters, or the kidneys, which comprise the urinary tract. E. coli bacteria cause the majority of UTIs, but many other bacteria, fungi, and parasites may also cause UTIs. Females have a higher risk for UTIs than most males, probably because of their anatomy; other risk factors for UTIs include any condition that may impede urine flow (e.g., enlarged prostate, kidney stones, congenital urinary tract abnormalities, and inflammation). Patients with catheters or those who undergo urinary surgery and men with enlarged prostates are at higher risk for UTIs.

Removal of drain tube after spleen surgery

Once the diagnosis of a splenic abscess has been made, the patient must be admitted to the hospital and treated. Treatment depends on the patient's overall condition, comorbidities, and primary disorder (if any), as well as the size and topography of the abscess

Sex reassignment surgery for male-to-female involves reshaping the male genitals into a form with the appearance of, and, as far as possible, the function of female genitalia. Prior to any surgeries, patients usually undergo hormone replacement therapy (HRT), and, depending on the age at which HRT begins, facial hair removal. There are associated surgeries patients may elect to, including facial feminization surgery, breast augmentation, and various other procedures.

What damage does atherosclerosis cause? Plaque may partially or totally block the blood's flow through an artery in the heart, brain, pelvis, legs, arms or kidneys. Some of the diseases that may develop as a result of atherosclerosis include coronary heart disease, angina (chest pain), carotid artery disease, peripheral artery disease (PAD) and chronic kidney disease.

There are several reasons that your doctor may recommend that you have your spleen removed. These include having: a spleen that’s damaged from injury an enlarged spleen or ruptured spleen, which can occur from trauma certain rare blood disorders cancer or large cysts of the spleen infection

When diving into a Breast Reduction procedure, there are many things to consider. Even as a patient, being aware of any concerns and how the procedure works is important. Therefore, when a plastic surgeon operates on a patient, the results are clear. Dr. Linder, a Breast surgeon specialist in Beverly Hills, helps explain what goes into a Breast Reduction Procedure.

Upper gastrointestinal bleeding (sometimes upper GI, UGI bleed, Upper gastrointestinal hemorrhage, gastrorrhagia) refers to bleeding in the upper gastrointestinal tract, commonly defined as bleeding arising from the esophagus, stomach, or duodenum. In fact, the proportion of UGIB cases caused by peptic ulcer disease has declined, a phenomenon that is believed to be due to the use of proton pump inhibitors (PPIs) and H pylori therapy. Duodenal ulcers are more common than gastric ulcers, but the incidence of bleeding is identical for both.

To understand high blood cholesterol (ko-LES-ter-ol), it helps to learn about cholesterol. Cholesterol is a waxy, fat-like substance that’s found in all cells of the body. Your body needs some cholesterol to make hormones, vitamin D, and substances that help you digest foods. Your body makes all the cholesterol it needs. However, cholesterol also is found in some of the foods you eat. Cholesterol travels through your bloodstream in small packages called lipoproteins (lip-o-PRO-teens). These packages are made of fat (lipid) on the inside and proteins on the outside. Two kinds of lipoproteins carry cholesterol throughout your body: low-density lipoproteins (LDL) and high-density lipoproteins (HDL). Having healthy levels of both types of lipoproteins is important. LDL cholesterol sometimes is called “bad” cholesterol. A high LDL level leads to a buildup of cholesterol in your arteries. (Arteries are blood vessels that carry blood from your heart to your body.) HDL cholesterol sometimes is called “good” cholesterol. This is because it carries cholesterol from other parts of your body back to your liver. Your liver removes the cholesterol from your body.

The cardiac cycle is the sequence of events that occurs when the heart beats. As the heart beats, it circulates blood through pulmonary and systemic circuits of the body. There are two phases of the cardiac cycle. In the diastole phase, the heart ventricles are relaxed and the heart fills with blood

Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus. The virus is one of several types of hepatitis viruses that cause inflammation and affect your liver's ability to function. You're most likely to contract hepatitis A from contaminated food or water or from close contact with someone who's infected. Mild cases of hepatitis A don't require treatment, and most people who are infected recover completely with no permanent liver damage. Practicing good hygiene, including washing hands frequently, is one of the best ways to protect against hepatitis A. Vaccines are available for people most at risk.

Thoracic Epidural Placement Paramedian Approach

A prenatal ultrasound (also called a sonogram) is a noninvasive diagnostic test that uses sound waves to create a visual image of your baby, placenta, and uterus, as well as other pelvic organs. It allows your healthcare practitioner to gather valuable information about the progress of your pregnancy and your baby's health. During the test, an ultrasound technician (sonographer) transmits high-frequency sound waves through your uterus that bounce off your baby. A computer then translates the echoing sounds into video images that reveal your baby's shape, position, and movements. (Ultrasound waves are also used in the handheld instrument called a Doppler that your practitioner uses during your prenatal visits to listen to your baby's heartbeat.) You may have an early ultrasound at your practitioner's office at 6 to 10 weeks to confirm and date the pregnancy. Or you may not have one until the standard midpregnancy ultrasound between 16 and 20 weeks. That's when you may learn your baby's sex, if you like. (The technician will probably present you with a grainy printout of the sonogram as a keepsake.) You may also have a sonogram as part of a genetic test, such as the nuchal translucency test, chorionic villus sampling, or amniocentesis, or at any other time if there are signs of a problem with your baby. You'll have more frequent ultrasounds if you have diabetes, hypertension, or other medical complications.

Middle cerebral artery syndrome is a condition whereby the blood supply from the middle cerebral artery (MCA) is restricted, leading to a reduction of the function of the portions of the brain supplied by that vessel: the lateral aspects of frontal, temporal and parietal lobes, the corona radiata, globus pallidus, caudate and putamen. The MCA is the most common site for the occurrence of ischemic stroke.[1] Depending upon the location and severity of the occlusion, signs and symptoms may vary within the population affected with MCA syndrome. More distal blockages tend to produce milder deficits due to more extensive branching of the artery and less ischemic response. In contrast, the most proximal occlusions result in widespread effects that can lead to significant cerebral edema, increased intracranial pressure, loss of consciousness and could even be fatal.[1] In such occasions, mannitol (osmotic diuretic) or hypertonic saline are given to draw fluid out of the oedematus cerebrum to minimise secondary injury. Hypertonic saline is better than mannitol, as mannitol being a diuretic will decrease the mean arterial pressure and since cerebral perfusion is mean arterial pressure minus intracranial pressure, mannitol will also cause a decrease in cerebral perfusion. Contralateral hemiparesis and hemisensory loss of the face, upper and lower extremities is the most common presentation of MCA syndrome.[1] Lower extremity function is more spared than that of the faciobrachial region.[2] The majority of the primary motor and somatosensory cortices are supplied by the MCA and the cortical homunculus can, therefore, be used to localize the defects more precisely.it is important to note that middle cerebral artery lesions mostly affect the dominant hemisphere i.e. the left cerebral hemisphere.

What is Venipuncture? While venipuncture can refer to a variety of procedures, including the insertion of IV tubes into a vein for the direct application of medicine to the blood stream, in phlebotomy venipuncture refers primarily to using a needle to create a blood evacuation point. As a phlebotomist, you must be prepared to perform venipuncture procedures on adults, children, and even infants while maintaining a supportive demeanor and procedural accuracy. Using a variety of blood extraction tools, you must be prepared to respond to numerous complications in order to minimize the risk to the patient while still drawing a clean sample. In its entirety, venipuncture includes every step in a blood draw procedure—from patient identification to puncturing the vein to labeling the sample. Patient information, needle placement, and emotional environment all play a part in the collection of a blood sample, and it's the fine details that can mean the difference between a definite result and a false positive. After placing the tourniquet and finding the vein, it's time for the phlebotomist to make the complex choice on what procedure will best suit the specific situation. Keeping this in mind, it should be noted that the following information is not an instructional guide on how to perform these phlebotomy procedures. Rather, the information below is intended to serve as an educational resource to inform you of the equipment and procedures you will use. Venipuncture Technqiues Venipuncture with an Evacuated or Vacuum Tube: This is the standard procedure for venipuncture testing. Using a needle and sheath system, this procedure allows multiple sample tubes to be filled through a single puncture. This procedure is ideal for reducing trauma to patients. After drawing the blood, the phlebotomist must make sure the test stopper is correctly coded and doesn't contact exposed blood between samples. Venipuncture with a Butterfly Needle : This is a specialized procedure that utilizes a flexible, butterfly needle adaptor. A butterfly needle has two plastic wings (one on either side of the needle) and is connected to a flexible tube, which is then attached to a reservoir for the blood. Due to the small gauge of the needle and the flexibility of the tube, this procedure is used most often in pediatric care, where the patients tend to have smaller veins and are more likely to move around during the procedure. After being inserted into a vein at a shallow angle, the butterfly needle is held in place by the wings, which allow the phlebotomist to grasp the needle very close to the skin. Phlebotomists should be careful to watch for blood clots in the flexible tubing. Venipuncture with a Syringe: This technique is typically only used when there is a supply shortage, or when a technician thinks it is the appropriate method. It uses the classic needle, tube, and plunger system, operating in a similar manner to the vacuum tube but requiring multiple punctures for multiple samples. Additionally, after the blood is drawn it must be transferred to the appropriate vacuum tube for testing purposes. If you choose to use this method, remember to check for a sterile seal, and use a safety device when transferring the sample. Fingerstick (or Fingerprick): This procedure uses a medical lance to make a small incision in the upper capillaries of a patient's finger in order to collect a tiny blood sample. It is typically used to test glucose and insulin levels. When performing a Fingerstick, the phlebotomist should remember to lance the third or fourth finger on the non-dominant arm. Never lance the tip or the center of the finger pad; instead, lance perpendicular to the fingerprint lines. Heelstick (or Heelprick): Similar to the Fingerstick procedure, this process is used on infants under six months of age. A medical lance is used to create a small incision on the side of an infant's heel in order to collect small amounts of blood for screening. As with a Fingerstick, the incision should be made perpendicular to the heel lines, and it should be made far enough to the left or right side of the heel to avoid patient agitation. Before performing a Heelstick, the infant's heel should be warmed to about 42 degrees Celsius in order to stimulate capillary blood and gas flow. Therapeutic Phlebotomy: This involves the actual letting of blood in order to relieve chemical and pressure imbalances within the blood stream. Making use of a butterfly needle, this therapy provides a slow removal of up to one pint of blood. Though the blood removed is not used for blood transfusions, the procedure and concerns are the same as with routine blood donation. As with any phlebotomy procedure, one should pay close attention to the patient in order to prevent a blood overdraw. Bleeding Time: A simple diagnostic test that is used to determine abnormalities in blood clotting and platelet production. A shallow laceration is made, followed by sterile swabbing of the wound every 30 seconds until the bleeding stops. Average bleed times range between one and nine minutes. As a phlebotomist, you should familiarize yourself with the application and cross-application of these procedures in order to recognize when a procedure is necessary, and what the risks are for each.

The most common symptoms of infection from animal bites are redness, pain, swelling, and inflammation at the site of the bite. You should seek immediate medical treatment if any of these symptoms continue for more than 24 hours. Other symptoms of infection include: pus or fluid oozing from the wound