A 30 YEAR WOMEN WITH INTRACTABLE BILIARY COLIC

CASE REPORT: This 30 year women developed severe pain right upper quadrant for last 10 days. She sought many consultations and was given intravenous analgesics both (nonnarcortic and narcotic). Pain did not subside and she sought my consultation. Examination revealed her to be in agony with severe upper abdominal pain. General physical examination was otherwise unremarkable. Abdominal examination revealed mild tenderness in right hypochondrium with doubtful Murphy's sign. Urgent abdominal ultrasound showed a linear structure in bile ducts making slow writhing movements. The structure had an anechoic tube (alimentary canal) inside suggestive of a large Ascarid. Urgent ERCP was performed and bile duct and pancreatic duct cannulated selectively. Pancreatic duct was normal. Bile ducts contained a long linear filling defect extending from lower end of common bile duct to right intrahepatic duct (see image gallery for ERCP plate). A basket was introduced in the duct (see video clip) and the linear structure was engaged with soft closure and extracted out of the bile duct. Accompanying the basket was a 25 cm thick highly motile Ascarid. To recover the worm, endoscope was withdrawn along with the basket and the friendly catch. While the endoscope was being withdrawn and the basket was in the duodenum with the worm out of bile duct, patient indicated of relief of abdominal pain. A relook cholangiogram showed no more structures in the duct. She was given antihelmintic therapy and passed hundreds of worms with the feces. The worms recovered form stools were both male and female population and varied in length and size. However the lone worm recovered form bile ducts was the longest and the thickest male worm. The phenomenal behavior of this ubiquitous infection remains unexplained.

General appearance inspection and assessment of vital signs as blood pressure pulse...etc

A successful cardiovascular exam includes visual examination, palpation of the apical impulse, auscultation of Erb's point, auscultation of the carotids, and auscultation over the four different heart valve locations (aortic, pulmonic, tricuspid, and mitral). Additionally, the radial pulse is palpated while auscultating to distinguish whether a murmur is diastolic or systolic.

Video Index:
0:13 - Inspection of the thorax
0:29 - Palpation of the apex heart beat
0:59 - Auscultation of the heart
1:16 - Auscultation of the Erb’s point
1:33 - Using Erb’s point to check the heart rate
1:45 - Systolic and diastolic heart sound identification
2:01 - Ascultating individual valves: aortic, pulmonary, tricuspid, mitral
2:41 - Ascultation of the carotids
2:54 - Ascultating the pulmonary and aortic valves
3:04 - Ascultation of the mitral valve
3:16 - Mitral valve murmurs

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A laparoscope is a small, thin tube that is put into your body through a tiny cut made just below your navel. Your surgeon can then see your gallbladder on a television screen and do the surgery with tools inserted in three other small cuts made in the right upper part of your abdomen. Your gallbladder is then taken out through one of the incisions.

After their parents were strongly urged by their local hospital to go to Children's Hospital of Michigan, Dr. Jeffrey Taub controls an aggressive cancer in 2 month old twins. ~ Detroit Medical Center

Eosinophilic granulomatosis with polyangiitis (EGPA)—or, as it was traditionally termed, Churg-Strauss syndrome—is a rare systemic necrotizing vasculitis that affects small-to-medium-sized vessels and is associated with severe asthma and blood and tissue eosinophilia. [1] Like granulomatosis with polyangiitis (Wegener granulomatosis), and the microscopic form of periarteritis (ie, microscopic polyangiitis), EGPA is an antineutrophil cytoplasmic antibody (ANCA)–associated vasculitide. [2, 3, 4, 5] In 1951, Churg and Strauss first described the syndrome in 13 patients who had asthma, eosinophilia, granulomatous inflammation, necrotizing systemic vasculitis, and necrotizing glomerulonephritis. [3] In 1990, the American College of Rheumatology (ACR) proposed the following six criteria for the diagnosis of Churg-Strauss syndrome [6] : Asthma (wheezing, expiratory rhonchi) Eosinophilia of more than 10% in peripheral blood Paranasal sinusitis Pulmonary infiltrates (may be transient) Histological proof of vasculitis with extravascular eosinophils Mononeuritis multiplex or polyneuropathy

Dr. Salvador pioneered the development of new liposuction techniques. In 2005, he developed Smartlipo Ultra to provide a safer and more effective treatment for removal of unwanted fat. Smartlipo Ultra was the first liposuction treatment to combine ultrasound for fat removal with laser technology to tighten skin.Dr. Salvador now focuses his cosmetic practice exclusively on SafeSculpt Laser Liposuction. He is recognized internationally as an expert on minimally invasive liposuction and tumescent anesthesia.

Keep tabs on your blood pressure. If it's too high, your risk of a heart attack and heart disease goes up. Stress management, a healthy diet, and regular exercise can help you manage your blood pressure. Your doctor may also prescribe medications to lower your levels.

"Targeted" radiation therapy goes right to the problem, not throughout your system. Moreover, discomfort is minimal. ~ Detroit Medical Center

OPAXIO Mechanism of Action

Preventing heart attacks and stroke can involve extensive surgery to remove plaque from your arteries, but as FOX17's Nick Paranjape shows us, there's a new procedure in Middle Tennessee that is less invasive and substantially cuts down on your recovery time. At 76, Jimmy Wilkie of Hendersonville exercises on his treadmill 3-4 times a week. Recently, he started having pain in his left leg. It was so bad, he couldn't even walk. Turned out, Mr. Wilkie had a blocked artery in his leg. In years past, this would've required major bypass surgery. Not anymore!"The Turbohawk Catheter has really opened a new door for us," says Dr. Dan Wunder.Dr. Wunder, an Interventional Radiologist at Premier Radiology in Madison, is talking about the Turbohawk. It's a device which is inserted into the blocked artery, and inside the Turbohawk are 4 tiny blades."It can cut the plaque and with that shape of the disc it cuts with it pushes it forward into the catheter," says Dr. Wunder.The one-hour procedure doesn't just push the plaque to the sides where it can re-grow, but instead grabs it and removes it!"We pull it back out and it fills up," says Dr. Wunder. "Empty it out, go back down and we can cut some more out."Before and after images really say it all."They used a roto rooter as he called it," says Wilkie.A roto rooter, Turbohawk, call it what you want, but Wilkie says all he knows is the procedure worked right away!"There wasn't any pain at all in my leg," says Wilkie.It's rare, but the outpatient procedure can have complications like plaque getting pushed down in the leg. Dr. Wunder says the main symptoms of a blockage in your legs is having severe pain or cramping when you're walking or exercising.

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A video from Loyola medical school, Chicago showing full neonatal medical examination

A displaced fibular head can create tightness, pain, and even numbness or tingling along the outside of your knee and down your leg. This most often occurs after a modest hyperextension knee injury, such as landing on one leg after jumping. If you have lingering knee pain and are searching for an answer, try this move

In most cases, your body's immune system defeats an HPV infection before it creates warts. When warts do appear, they vary in appearance depending on which variety of HPV is involved: Genital warts. These appear as flat lesions, small cauliflower-like bumps or tiny stem-like protrusions. In women, genital warts appear mostly on the vulva but can also occur near the anus, on the cervix or in the vagina. In men, genital warts appear on the penis and scrotum or around the anus. Genital warts rarely cause discomfort or pain, though they may itch. Common warts. Common warts appear as rough, raised bumps and usually occur on the hands, fingers or elbows. In most cases, common warts are simply unsightly, but they can also be painful or susceptible to injury or bleeding.

Can a Vaccine Give Me the Disease It’s Supposed to Protect Me Against?

Anatomy of The Gastrointestinal Tract GIT

DMC Neurosurgeon Sandeep Mittal uses EEG and brain surgery to decode the secrets of adult epilepsy - Part I of a two-part series. ~ Detroit Medical Center

Bilateral Laparoscopic Pyeloplasty in Children

Skin cancer is the most common of all cancer types, accounting for an estimated one third of all new cases. It’s important to take the right steps to ensure proper protection and adopt good sun care habits no matter what your age or stage in life.