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LASIK in patient with congenital nystagmus
LASIK in patient with congenital nystagmus DrHouse 21,804 Views • 3 years ago

Purpose: To evaluate the results of LASIK and IntraLASIK treatment in myopic patients with nystagmus. Methods: Eight patients with congenital nystagmus (16 eyes), from 23 to 49 years of age, underwent LASIK surgery. Corneal flaps were created using either the Hansatome microkeratome or the Intral...ase femtosecond laser. The ablations were performed with the Bausch & Lomb excimer laser with an active tracking system. In some patients, the eyes were fixated with forceps or a fixation ring during the laser ablation. Results: The refractive errors were corrected in all cases. There was no decentration or loss of best corrected visual acuity greater than 1 line. In 56% of the eyes, the post-operative uncorrected visual acuity was better than the best spectacle corrected-visual acuity (BSCVA). 62.5% of the eyes improved their BSCVA. The overall visual performance was improved in all the patients. One patient that did not not drive before become eligible to get a driver license after the surgery. Conclusions: Selected patients with myopia and congenital nystagmus may benefit from laser refractive surgery. Laser refractive surgery may be safely and accurately performed by using either the Hansatome microkeratome or the Intralase femtosecond laser and an active tracking system with or without mechanical fixation. Certain patients improve their BSCVA post-operatively.

CT Scan of the Chest
CT Scan of the Chest samer kareem 2,789 Views • 3 years ago

Understand Chest CT (Computed Tomography) scans with this clear explanation

Female IM Injection
Female IM Injection DrPhil 72,140 Views • 3 years ago

Female IM injection

Propofol Use in the ED
Propofol Use in the ED samer kareem 2,347 Views • 3 years ago

Multiple studies demonstrate the safety of propofol in pediatric EDPS. Each has identified a drop in blood pressure and transient hypoxemia as the most frequent complications. In all of the studies in which hypotension was identified there was no evidence of poor perfusion. The hypoxemia in all of these studies quickly responded to minimal intervention with no apparent lasting complications. Although these were pediatric studies, the results were very similar to ours in complication rates and sedation times. Our study did not demonstrate the frequency of decreased blood pressure seen in these pediatric studies but had similar hypoxemia rates.

Life Journey
Life Journey samer kareem 1,794 Views • 3 years ago

9 Months In The Womb: A Remarkable Look At Fetal Development Through Ultrasound

Baby who was born premature at 24 weeks.
Baby who was born premature at 24 weeks. Scott 33,614 Views • 3 years ago

Meet Toby, the baby who was born premature at 24 weeks. He may be small, but he's definitely a fighter! Share his story.

Forehead wound repaired
Forehead wound repaired samer kareem 2,456 Views • 3 years ago

Forehead wound repaired with "Liquiband" glue

Decortication For Pleural Empyema
Decortication For Pleural Empyema Mohamed Ibrahim 24,197 Views • 3 years ago

49-years old patient complaining of cough, fever and pleuritic pain for 2 weeks. At admission he was febrile and tachypnic. Chest X-Ray showed left pleural effusion. Thoracocentesis revealed purulent fluid. Chest CT-scan showed large and loculated left pleural effusion and pleural thickening. VATS decortication was performed through three incisions.

Pyelolithotomy
Pyelolithotomy M_Nabil 29,584 Views • 3 years ago

51 yr old female with right flank pain and recurrent UTI. IVP showed a UPJ calculus on the right.

Dissection of the Transverse Process
Dissection of the Transverse Process samer kareem 1,818 Views • 3 years ago

Surgeon performs a dissection of the transverse process during spine surgery, explaining the benefits of including the AQUAMANTYS System from Salient Surgical Technologies during the procedure. The AQUAMANTYS System uses Salient's patented TRANSCOLLATION technology, which has been clinically shown to reduce blood loss and lower blood transfusion rates when used during surgery.

Examination of the Spleen
Examination of the Spleen samer kareem 15,557 Views • 3 years ago

Start in RLQ (so you don’t miss a giant spleen). Get your fingers set then ask patient to take a deep breath. Don’t dip your fingers or do anything but wait. When patient expires, take up new position. Note lowest point of spleen below costal margin, texture of splenic contour, and tenderness If spleen is not felt, repeat with pt lying on right side. Gravity may bring spleen within reach. “LET THE SPLEEN PALPATE YOUR FINGERS AND NOT THE OTHER WAY AROUND. THERE IS NO GOLD, SO DON’T DIG!”

Sacrococcygeal Teratoma
Sacrococcygeal Teratoma samer kareem 2,240 Views • 3 years ago

Sacrococcygeal teratoma (SCT) is an unusual tumor that, in the newborn, is located at the base of the tailbone (coccyx). This birth defect is more common in female than in male babies. Although the tumors can grow very large, they are usually not malignant (that is, cancerous).

Ruptured Liver Abscess
Ruptured Liver Abscess samer kareem 9,230 Views • 3 years ago

A liver abscess is a pus-filled mass inside the liver. Common causes are abdominal infections such as appendicitis or diverticulitis due to haematogenous spread through the portal vein. A pyogenic liver abscess (PLA) is a pocket of pus that forms in the liver in response to an infection or trauma. Pus is a fluid composed of white blood cells, dead cells, and bacteria that forms when your body fights off infection.Dec 11, 2015

Microvascular Decompression of facial nerve
Microvascular Decompression of facial nerve samer kareem 1,221 Views • 3 years ago

Brain Surgery: Microvascular Decompression of facial nerve for hemifacial spasm

Ovarian Teratoma
Ovarian Teratoma samer kareem 23,976 Views • 3 years ago

Ovarian teratoma is a type of germ cell tumour. Germ cell tumours are cancers that begin in egg cells in women or sperm cells in men. There are 2 main types of ovarian teratoma. Mature teratoma, which is benign. Immature teratoma, which is cancerous.

Gerstmann Syndrome
Gerstmann Syndrome samer kareem 2,392 Views • 3 years ago

Testing for the four features of Gerstmann Syndrome in this patient with two separate left sided strokes (left frontoparietal ischaemic stroke followed by left posterior parietal haemorrhagic stroke). He exhibits (i) acalculia, (ii) agraphia, (iii) left-right disorientation, and (iv) finger agnosia. Complicating the issue is his obvious nonfluent aphasia (expressive dysphasia) with paraphasic errors (replacing words with associated words (e.g. says 'fork' instead of 'spoon')) and some comprehension issues.

Twins Conversation in the Womb
Twins Conversation in the Womb samer kareem 14,233 Views • 3 years ago

Twins Conversation

Colposcopy
Colposcopy samer kareem 3,293 Views • 3 years ago

Colposcopy (kol-POS-kuh-pee) is a procedure to closely examine your cervix, vagina and vulva for signs of disease. During colposcopy, your doctor uses a special instrument called a colposcope. Your doctor may recommend colposcopy if your Pap test has shown abnormal results.

Aspirin fights against cancer
Aspirin fights against cancer Doctor 7,411 Views • 3 years ago

A new well designed randomized study has suggested that long term baby aspirin usage may aid in fight against cancer. The suggested mechanism is that cancers induce inflammatory responses so the anti-inflammatory mechanism of prostaglandins inhibitors may cease the progress of many cancers. There are some concerns about the study because despite the well-designed randomized study; the study didn't include a satisfying number of female participants. The study was also conducted on esophageal, colorectal and lung cancers.

Acalculous Cholecystopathy - Umbilical Hernia
Acalculous Cholecystopathy - Umbilical Hernia Doctor 9,296 Views • 3 years ago

Patient 65-year-old of age who comes to the medical consultation with pain moderated pain in the right hypochondrium of “several years of evolution” but that it increased one week ago. Also, she shows pain in the umbilical region of “many years of evolution”, that is supported according to the patient - in a constant way.rnTo the examination, we observe an umbilical hernia, apparently divided into two parts. The hernia of the external region measures 25.1 centimeters x 18.0 centimeters and the one that occupies the average region measures 12.0 centimeters x 10.0 centimeters.rnPatient who comes to the medical consultation with moderated pain in the right hypochondrium of one year of evolution but it increased one week ago after eat duck.rnIn the ultrasound scan of the region of the right hypochondrium (patient came having breakfast, that is to say, without previous preparation ) we can observe the liver of 123.8 millimeters high, as well as the porta vein with a diameter of 7.3 millimeters.rnOn having observed the Gallbladder, we think that a side wall is increased in 2.7 mm (hyperechogenic) with several “echogenics points” in the interior (”Biliary Mud”).

The measurements of the gallbladder were: 39.0 x 17.4 millimeters.rnWe can appreciates an echogenic image in the interior that it would make think about stone. The stones are identified as echogenic foci casting acoustic shadowing but but this image did not appear and a re-evaluation is decided in 15 days.

Acalculous cholecystopathy which means disease or condition of the gallbladder without the presence of gallstones. You might also call it functional gallbladder disorder or impaired gallbladder emptying. Some causes may be chronic inflammation, a problem with the smooth muscles of the gallbladder or the muscle of the Sphincter of Oddi being too tight.

REMEMBER:
Umbilical hernia is a congenital malformation, especially common in infants of African descent, and more frequent in boys. An Acquired umbilical hernia directly results from increased intra-abdominal pressure and are most commonly seen in obese individuals.
Presentation:A hernia is present at the site of the umbilicus (commonly called a navel, or belly button) in the newborn; although sometimes quite large, these hernias tend to resolve without any treatment by around the age of 5 years. Obstruction and strangulation of the hernia is rare because the underlying defect in the abdominal wall is larger than in an inguinal hernia of the newborn. The size of the base of the herniated tissued is inversely correlated with risk of strangulation (i.e. narrow base is more likely to strangulate).
Babies are prone to this malformation because of the process during fetal development by which the abdominal organs form outside the abdominal cavity, later returning into it through an opening which will become the umbilicus.
Differential diagnosisrnImportantly this type of hernia must be distinguished from a paraumbilical hernia which occurs in adults and involves a defect in the midline near to the umbilicus, and from omphalocele.

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