Primary biliary cholangitis (PBC), formerly known as primary biliary cirrhosis, is a chronic liver disease resulting from progressive destruction of the bile ducts in the liver – called the intrahepatic bile ducts. Bile produced in your liver travels via these ducts to your small intestine where it aids in the digestion of fat and fat-soluble vitamins (A, D, E and K). When the ducts are destroyed, bile builds up in the liver contributing to inflammation and scarring (fibrosis). Eventually this can lead to cirrhosis and its associated complications, as scar tissue replaces healthy liver tissue and liver function becomes increasingly impaired.

As the liver becomes more severely damaged, more obvious and serious symptoms can develop, such as: yellowing of the skin and whites of the eyes (jaundice) swelling in the legs, ankles and feet, due to a build-up of fluid (oedema) swelling in your abdomen, due to a build-up of fluid known as ascites.

Baby Delivery

Histology of Bone Marrow Smear

A club foot, or congenital talipes equinovarus (CTEV), is a congenital deformity involving one foot or both. The affected foot appears rotated internally at the ankle. TEV is classified into 2 groups: Postural TEV or Structural TEV.

Without treatment, persons afflicted often appear to walk on their ankles, or on the sides of their feet. It is a common birth defect, occurring in about one in every 1,000 live births. Approximately 50% of cases of clubfoot are bilateral. In most cases it is an isolated dysmelia. This occurs in males more often than in females by a ratio of 2:1. A condition of the same name appears in animals, particularly horses.

Assuming you haven't been diagnosed with Cushing's disease by your doctor, here are steps you can take to help lower high cortisol levels naturally: Switch to a Whole Foods, Anti-inflammatory Diet. Reduce and Manage Stress. Exercise Regularly. Use Adaptogen Herbs and Superfoods. Try Essential Oils to Promote Relaxation.

Overweight does not necessarily equal unhealthy. There are actually plenty of overweight people who are in excellent health (1). Conversely, many normal weight people have the metabolic problems associated with obesity (2). That’s because the fat under the skin is actually not that big of a problem (at least not from a health standpoint, it’s more of a cosmetic problem). It’s the fat in the abdominal cavity, the belly fat, that causes the biggest issues (3). If you have a lot of excess fat around your waistline, even if you’re not very heavy, then you should take some steps to get rid of it. Belly fat is usually estimated by measuring the circumference around your waist. This can easily be done at home with a simple tape measure. Anything above 40 inches (102 cm) in men and 35 inches (88 cm) in women, is known as abdominal obesity. There are actually a few proven strategies that have been shown to target the fat in the belly area more than other areas of the body.

Normal Heart Sounds With the aid of a stethoscope you can hear the characteristic sounds of the normal heartbeat, typically described as a "lub-dub." These sounds are produced by the closure of the heart valves. The first heart sound or "lub" results from closure of the tricuspid and mitral valves. It is a rather low-pitched and a relatively long sound which, as indicated in, represents the beginning of ventricular systole. The second heart sound, or "dub," marks the beginning of ventricular diastole. It is produced by closure of the aortic and pulmonary (pulmonic) semilunar vanes when the intraventricular pressure begins to fall. This "dub" sound is typically heard as a sharp snap because the semilunar valves tend to close much more rapidly than the AV valves. Because diastole occupies more time than systole, a brief pause occurs after the second heart sound when the heart is beating at a normal rate. Therefore, the pattern that one hears is one of: "lub-dub" pause, "lub-dub" pause, and so on. Sometimes, especially in young normal individuals, a third heart sound can be heard. This sound is produced by the very rapid influx of blood into the partially filled ventricle. It is typically very faint and as such difficult to hear.

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.

Pioneer Plus IVUS Re-Entry Catheter plaque removal

Cricothyroidotomy NEJM

Basic ECG Interpretation Our ECG Interpretation Training and Reference Guides provide basic lessons for ECG analysis as well as a quick reference guide for over 40 types of ECG tracings. The arrhythmia drills and quizzes allow you to practice ECG interpretation. What is ECG Interpretation? An electrocardiogram or ECG, records electrical activity in the heart. An ECG machine records these electrical signals across multiple heart beats and produces an ECG strip that is interpreted by a healthcare professional. How Electrocardiograms Work - ECG Strips To briefly summarize the components of a normal ECG tracings, it consist of waveform components which indicate electrical events during one heart beat. These waveforms are labeled P, Q, R, S, T and U. P wave is the first short upward movement of the ECG tracing. It indicates that the atria are contracting, pumping blood into the ventricles. The QRS complex, normally beginning with a downward deflection, Q; a larger upwards deflection, a peak (R); and then a downwards S wave. The QRS complex represents ventricular depolarization and contraction. The PR interval indicates the transit time for the electrical signal to travel from the sinus node to the ventricles. T wave is normally a modest upwards waveform representing ventricular repolarization. ECG Interpretation illustration spacer image ECG Training - Introduction The focus of this introductory ECG course is to provide a tutorial about the main features of ECGs along with a method for analyzing ECGs. This method includes assessment of rhythm, calculating heart rate, observing P-wave forms, measurement of intervals and segments and the evaluation of other relevant waves. ECG practice exercises serve to reinforce the lesson content.

A very funny video

Adult Still's disease is a rare type of inflammatory arthritis that features fevers, rash and joint pain. Some people have just one episode of adult Still's disease. In other people, the condition persists or recurs. This inflammation can destroy affected joints, particularly the wrists. Treatment involves medications, such as prednisone, that help control inflammation

In 2003, ETS was banned in its birthplace, Sweden, due to overwhelming complaints by disabled patients. In 2004, Taiwanese health authorities banned the procedure on patients under 20 years of age.

This video is a collection of selected cases of Plastic Surgery performed on children with congenital deformities.

Errata: Cleft Lip Case 2 has a center photo which belongs to case 1 at day of surgery.

Better Vein Care and Safer Injection

Rheumatoid Arthritis Onset and Symptoms and general information

Alpha blockers relax certain muscles and help small blood vessels remain open. They work by keeping the hormone norepinephrine (noradrenaline) from tightening the muscles in the walls of smaller arteries and veins, which causes the vessels to remain open and relaxed. This improves blood flow and lowers blood pressure.

Subcuticular Pattern Continuous Suture