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Lumbar puncture is a common emergency department procedure used to obtain information about the cerebrospinal fluid (CSF) for diagnostic and, less commonly, therapeutic reasons. Please refer to the full article on Lumbar Puncture for more details on the lumbar puncture procedure. Lumbar puncture is typically performed via “blind” surface landmark guidance. The surface landmark technique is reported to be successful in a high percentage of attempted lumbar punctures; however, surface landmark identification of underlying structures has been shown to be accurate only 30% of the time. [1] Unsuccessful identification of proper landmarks often leads to increased difficulty in obtaining CSF, if the procedure is performed, and a higher rate of complications. Few alternatives are available in these cases. If available, fluoroscopic-guided lumbar puncture may be performed. If not, treatment is sometimes initiated empirically without obtaining CSF. Disadvantages of using fluoroscopy include limited availability or necessary transport of the patient outside of the emergency department, inability to directly visualize the spinal canal, and inherent radiation exposure

A renal biopsy is a procedure used to extract kidney tissue for laboratory analysis. The word “renal” describes the kidneys. A renal biopsy is also called a kidney biopsy. The test helps your doctor identify the type of kidney disease you have, how severe it is, and the best treatment for it.

Sickle cell anemia causes pain, fatigue and delayed growth, all because of a lack of enough healthy red blood cells. And yet genetic mutations that cause it — recessive genes for the oxygen-carrying hemoglobin protein — have survived natural selection because they also seem to provide a natural defense against malaria.

Indications for endovascular repair of the iliac artery are: Stenosis or (short-segment) occlusion of iliac artery (TASC type A and B, TASC C lesions are controversial) with ipsilateral lower extremity ischemia (lifestyle-limiting, progressive claudication, rest pain, gangrene). Patients with asymptomatic aneurysm greater than 4 cm in diameter. An iliac aneurysm which has also increased in size by 0.5 cm in last six months. Symptomatic iliac artery aneurysms mandate endovascular (or open) repair regardless of size. Patients with long occluded lesions/poor run-off/acute limb ischemia are poor endovascular candidates.

White stretch marks are unsightly marks that are found along the thighs, abdomen and upper arms. These are marks that could be due to a recent weight loss, trauma or pregnancy. Stretch marks can affect your confidence if you wear revealing outfits and so you should do all you can to remove them.

Like any syndrome, fetal alcohol syndrome (FAS) is a group of signs and symptoms that appear together and indicate a certain condition. In the case of FAS, the signs and symptoms are birth defects that result from a woman's use of alcohol during her pregnancy.

Diabetes Complications and Kidney Disease

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The examination of the groin, hernial orifices and male external genitalia are clinical examinations which undergraduate medical students are commonly less confident about performing competently, due to the lack of clinical exposure.

The veins around your anus tend to stretch under pressure and may bulge or swell. Swollen veins (hemorrhoids) can develop from an increase in pressure in the lower rectum. Factors that might cause increased pressure include: Straining during bowel movements.

Colonoscopy is a test that allows your doctor to look at the inner lining of your large intestine (rectum and colon). He or she uses a thin, flexible tube called a colonoscope to look at the colon. A colonoscopy helps find ulcers, colon polyps, tumors, and areas of inflammation or bleeding.

Gastric bypass is surgery that helps you lose weight by changing how your stomach and small intestine handle the food you eat. After the surgery, your stomach will be smaller. You will feel full with less food. The food you eat will no longer go into some parts of your stomach and small intestine that absorb food. Because of this, your body will not get all of the calories from the food you eat.

This hormone, insulin, causes the liver to convert more glucose into glycogen (this process is called glycogenesis), and to force about 2/3 of body cells (primarily muscle and fat tissue cells) to take up glucose from the blood through the GLUT4 transporter, thus decreasing blood sugar.

Scleroderma (skleer-oh-DUR-muh) is a group of rare diseases that involve the hardening and tightening of the skin and connective tissues — the fibers that provide the framework and support for your body. In some people, scleroderma affects only the skin. But in many people, scleroderma also harms structures beyond the skin — such as blood vessels, internal organs and the digestive tract. Signs and symptoms vary, depending on which structures are affected. Scleroderma affects women more often than men and most commonly occurs between the ages of 30 and 50. While there is no cure for scleroderma, a variety of treatments can ease symptoms and improve quality of life.

There are two main purposes of an arterial line. Firstly when patients are very sick an arterial line is inserted to provide constant monitoring and recording of the patient's blood pressure. Secondly some patients require frequent blood tests and the arterial line provides easy access to a patient's blood.

Pruritis is itchy skin that makes you want to scratch. It can be caused by many things. Normally, itchy skin isn't serious, but it can make you uncomfortable. Sometimes, itchy skin is caused by a serious medical condition. It can occur in association with a primary rash (e.g. dermatitis) or may occur because of hypersensitive nerves in the skin (neuropathic pruritus). ... Scratching a localised itch may lead to lichen simplex, prurigo or prurigo nodularis. Systemic causes of pruritus. Sytemic diseases may cause generalised pruritus.

The bladder is a hollow organ in the lower abdomen (pelvis). It collects and stores urine produced by the kidneys. The bladder is connected to the kidneys by a tube from each kidney called a ureter. When the bladder reaches its capacity of urine, the bladder wall contracts, although adults have voluntary control over the timing of this contraction. At the same time, a urinary control muscle (sphincter) in the urethra relaxes. The urine is then expelled from the bladder. The urine flows through a narrow tube called the urethra and leaves the body. This process is called urination, or micturition.

Laryngectomy is the removal of the larynx and separation of the airway from the mouth, nose and esophagus. In a total laryngectomy the entire larynx is removed and in a partial laryngectomy only a portion is taken out. The laryngectomee breathes through an opening in the neck known as a stoma.

Cosmetic Eye and Eyelid Surgery