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ransjugular intrahepatic portosystemic shunt (TIPS) is a procedure to create new connections between two blood vessels in your liver. You may need this procedure if you have severe liver problems.

Hepatitis and chronic alcohol abuse are frequent causes. Liver damage caused by cirrhosis can't be undone, but further damage can be limited. Initially patients may experience fatigue, weakness, and weight loss. During later stages, patients may develop jaundice (yellowing of the skin), gastrointestinal bleeding, abdominal swelling, and confusion. Treatments focus on the underlying cause. In advanced cases, a liver transplant may be needed.

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Acute respiratory distress syndrome is characterised by rapid onset dyspnea, bilateral infiltrates on chest x-ray and respiratory failure. This may be due to conditions which directly affect the lung such as pneumonia, aspiration and near drowning. It may also be due to indirect lung injury, as in conditions like sepsis, pancreatitis, trauma and poisoning. The diagnostic criteria of ARDS, often described as the Berlin criteria is discussed in this presentation along with various management aspects of ARDS including ventilation strategies and use of antibiotics and diuretics. Finally prognostic features and alternative strategies are also discussed.

Small cell lung cancer, which occurs almost exclusively in smokers, is a malignancy characterised by rapid doubling time, high growth fraction and widespread metastasis at presentation. In this presentation, we will briefly discuss the classification of pulmonary Neuro-endocrine tumours by the World Health Organisation followed by a detailed discussion of the clinical features, lab evaluation and management of SCLC, both limited and extended stage. The frontline therapy in small cell lung cancer is etoposide and cisplatin along with thoracic radiotherapy and prophylactic cranial irradiation in patients who have a good response to therapy. Hyperfractionation of radiotherapy may provide some benefit but is also associated with increase incidence of complications. Newer agents for SCLC include Vandetanib and immunotherapy molecules, such as Iplimumab and nivolumab.

Ascites, the collection of fluid within the peritoneal space is caused due to a variety of causes including cirrhosis, cardiac causes, sinusoidal obstruction syndrome, tubercular peritonitis and pancreatitis, amongst others. Most commonly, the cause of ascots may be cirrhosis , which in turn, is most frequently causes by alcohol use, hepatitis C and non-alcoholic steatohepatitis. At the heart of the ascitic fluid analysis is the serum albumin ascitic gradient, the differential diagnosis of which has been discussed in detail in this presentation. Both low SAAG and high SAAG ascites have been dealt with in some depth, with a brief overview of the management of these conditions

Chronic myeloid leukaemia is a common malignancy worldwide. We have come a long way from the limited treatment options and survival in this condition. Today, CML is a treatable malignancy with more than 80% patients surviving beyond 10 years after diagnosis, in absence of complications. This presentation deals with the definition, diagnostic criteria of chronic phase, accelerated and blastic phase (MD Anderson cancer centre, International bone marrow transplant registry and the WHO for the latter two) and management (first and second generation tyrosine kinase inhibitors) of this condition. Finally, a stepwise approach to chronic myeloid leukaemia is also presented including the definitive modality of treatment, allogeneic stem cell transplantation.

Systemic lupus erythematous is an autoimmune condition characterised by damage to organ systems due to autoantibodies and immune complex deposition. Genes, epigenetic changes and environment play a role in its pathogenesis. SLE is a truly multi system disease causing widespread clinical manifestations in almost all organ systems. Autoantibodies in SLE are numerous and mainly include ANA, dsDNA, Sm and others.

Hemophagocytic lymphohistiocytosis is a rare but life threatening condition characterised by activation of macrophages which result in phagocytosis of RBCs and cytokine mediated tissue damage. This presentation aims to discuss the genetic basis, clinical features, diagnostic criteria and management options in this serious condition. The management options in HLH include Etoposide, Dexamethasone, Cyclosorine, Tacrolimus, Alemtuzumab and stem cell transplant.

A stepwise approach to the causes and diagnosis of Anaemia in clinical practice. This presentation includes the all important concept of the Reticulocyte production index. Discussion of Hereditary and acquired causes of Anaemia has been included in detail.

A brief description of hypertensive emergencies including its definition, risk factors, clinical manifestations and management