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Pyogenic granuloma (lobular capillary hemangioma[1] ) is a relatively common benign vascular lesion of the skin and mucosa whose exact cause is unknown. Also see the Medscape Reference article Oral Pyogenic Granuloma. Pyogenic granulomas are misnamed; they are neither infectious nor granulomatous. The lesion usually occurs in children and young adults as a solitary, glistening red papule or nodule that is prone to bleeding and ulceration. Pyogenic granulomas typically evolve rapidly over a period of a few weeks, most often on the head, neck, extremities, and upper trunk. Pyogenic granuloma often arises in pregnancy (or rarely with oral contraceptive usage), particularly on the gingiva or elsewhere in the oral mucosa, and then is termed the "pregnancy tumor." Other pyogenic granuloma variants that have been well documented include the disseminated, subcutaneous, intravenous, and medication-induced (for example, retinoid, antiretroviral, and oncologic agent) subtypes. Removal of pyogenic granuloma is indicated to alleviate any bleeding, discomfort, cosmetic distress, and diagnostic uncertainty. A number of malignant tumors may clinically mimic pyogenic granuloma, making histopathologic confirmation important if the presentation is atypical. Aside from cutaneous and oral lesions, pyogenic granuloma has been reported throughout the gastrointestinal tract and upper airway, at various ocular locations, the central nervous system, the bladder, and the internal vasculature. This article discusses only cutaneous and oral involvement.
Bacterial meningitis is very serious and can be deadly. Death can occur in as little as a few hours. While most people with meningitis recover, permanent disabilities such as brain damage, hearing loss, and learning disabilities can result from the infection. There are several types of bacteria that can cause meningitis. Some of the leading causes of bacterial meningitis in the United States include Streptococcus pneumoniae, group B Streptococcus, Neisseria meningitidis, Haemophilus influenzae, and Listeria monocytogenes.
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Renal artery stenosis is a narrowing of arteries that carry blood to one or both of the kidneys. Most often seen in older people with atherosclerosis (hardening of the arteries), renal artery stenosis can worsen over time and often leads to hypertension (high blood pressure) and kidney damage.
A torn meniscus is one of the most common knee injuries. Any activity that causes you to forcefully twist or rotate your knee, especially when putting your full weight on it, can lead to a torn meniscus. Each of your knees has two menisci — C-shaped pieces of cartilage that act like a cushion between your shinbone and your thighbone. A torn meniscus causes pain, swelling and stiffness. You also might feel a block to knee motion and have trouble extending your knee fully. Conservative treatment — such as rest, ice and medication — is sometimes enough to relieve the pain of a torn meniscus and give the injury time to heal on its own. In other cases, however, a torn meniscus requires surgical repair.
Take your left leg and place your ankle against the knee. Hold the position for a moment before changing legs. This helps stretch the tiny piriformis muscle, which sometimes becomes inflamed and presses against the sciatic nerve causing pain. Repeat by switching sides and doing the same exercise with the other leg.
Claudication, which is defined as reproducible ischemic muscle pain, is one of the most common manifestations of peripheral arterial occlusive disease (PAOD) caused by atherosclerosis. Claudication occurs during physical activity and is relieved after a short rest. Pain develops because of inadequate blood flow. Examination of a patient with claudication should include a complete lower-extremity evaluation and pulse examination, including measuring segmental pressures. Attempt to palpate pulses from the abdominal aorta to the foot, with auscultation for bruits in the abdominal and pelvic regions. When palpable pulses are not present, a handheld Doppler device may be used to assess circulation.
Methotrexate works by reducing the function of the cells that are causing inflammation in the joint tissues. "Its use can reduce inflammation and therefore should help relieve pain and protect from joint damage," notes Sean A. Whelton, MD, a rheumatologist and associate professor of medicine at MedStar Georgetown University Hospital in Washington, D.C. Less inflammation in the joints should mean less joint pain and less joint swelling. You should also feel less fatigue and less morning stiffness.
A simple test of fingernail clippings could replace a blood draw as a way to diagnose and monitor type 2 diabetes mellitus (T2DM), with huge implications for tracking the disease in the developing world. Research on this method by a team of Belgian researchers was reported July 28, 2015, at the 2015 American Association for Clinical Chemistry (AACC) Annual Meeting and Clinical Lab Expo in Atlanta. The team, led by Joris R. Delanghe, MD, PhD, of the Department of Global Chemistry, Microbiology and Immunology at Ghent University, collected nail clippings from 25 people with T2DM and 25 without the disease. The clippings were ground into a powder and tested with an inexpensive FT-IR photometer to measure how much the protein in the nails had bonded with sugar molecules, a process known as glycation. “We found a striking difference in the measurements between the control group and the patients with diabetes,” Delanghe said. In an interview with Evidence-Based Diabetes Management, he said replacing the standard blood test to measure glycated hemoglobin is a huge advantage. In many cultures, he said, “Taking blood is something that cannot be tolerated.” - See more at: http://www.ajmc.com/journals/evidence-based-diabetes-management/2015/september-2015/fingernail-tests-may-offer-cheap-simple-way-to-diagnose-diabetes#sthash.XQxnBcNO.dpuf
This operation can be performed as an open or laparoscopic (keyhole procedure). During the operation the sigmoid colon is removed. This involves taking away the blood vessels and lymph nodes to that part of the bowel. The surgeon then re-makes the join (anastomosis) between the remaining left side of the colon and the top of the rectum. The surgeon may use either sutures or special staples to make this join.
This short course reviews the main features of EKG tracings. A method for analyzing EKGs is also presented. This method includes assessment of rhythm, calculating heart rate, observing P-wave forms, measurement of EKG intervals and segments and the evaluation of other relevant waves.
Vertigo is a sense of rotation, rocking, or the world spinning, experienced even when someone is perfectly still. Many children attempt to create a sense of vertigo by spinning around for a time; this type of induced vertigo lasts for a few moments and then disappears. In comparison, when vertigo occurs spontaneously or as a result of an injury it tends to last for many hours or even days before resolving.
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For the surgeon to develop the same level of proficiency and dexterity in the endoscopic environment as he may possess in open surgery is not a simple matter. The use of proper Mishra's Knot, are essential. Participating in an in-depth, systematic training program in a laboratory setting is essential before applying endoscopic Mishra's Knot techniques to humans. Successful acquisition of these Mishra's Knot skill requires that the surgeon be motivated to succeed and willing to invest the time and effort necessary to do so. Succumbing to the temptation of mechanical devices in lieu of acquiring the manual skills results in a questionable dependence on disposable technology and reduces the cost effectiveness of the minimally invasive approach. It is the adoption of Mishra's Knotting skills by the surgeon that will expand the surgeon's capability of performing increasingly advanced endoscopic surgical procedures.
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NCR Delhi, 122002, India
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