This is video 2 of 2 on diabetic ketoacidosis (DKA).

Heart failure, sometimes known as congestive heart failure, occurs when your heart muscle doesn't pump blood as well as it should. Certain conditions, such as narrowed arteries in your heart (coronary artery disease) or high blood pressure, gradually leave your heart too weak or stiff to fill and pump efficiently.

Heart failure can be ongoing (chronic), or your condition may start suddenly (acute). Heart failure signs and symptoms may include: Shortness of breath (dyspnea) when you exert yourself or when you lie down Fatigue and weakness Swelling (edema) in your legs, ankles and feet Rapid or irregular heartbeat Reduced ability to exercise Persistent cough or wheezing with white or pink blood-tinged phlegm Increased need to urinate at night Swelling of your abdomen (ascites) Sudden weight gain from fluid retention Lack of appetite and nausea Difficulty concentrating or decreased alertness Sudden, severe shortness of breath and coughing up pink, foamy mucus Chest pain if your heart failure is caused by a heart attack

A spermatocele (SPUR-muh-toe-seel) is an abnormal sac (cyst) that develops in the epididymis — the small, coiled tube located on the upper testicle that collects and transports sperm. Noncancerous and generally painless, a spermatocele usually is filled with milky or clear fluid that might contain sperm. The exact cause of spermatoceles is unknown but might be due to a blockage in one of the tubes that transports sperm. Spermatoceles, sometimes called spermatic cysts, are common. They typically don't reduce fertility or require treatment. If a spermatocele grows large enough to cause discomfort, your doctor might suggest surgery.

Both lower extremities must be evaluated to determine the presence or extent of any disease and to ascertain the pulse status of the patient. The feet are examined for signs of peripheral vascular disease and the anterior and posterior tibial pulses are palpated. Because an intact arch can supply retrograde flow to the major vessels of the foot, it can be helpful to put pressure on the anterior tibial artery when detecting the presence of a posterior tibial pulse and visa-versa. This "modified Allen's test" may detect proximal vessel obstruction masked by an intact foot arch. The need for preoperative angiography in young, healthy patients with a normal physical examination has been hotly debated. Our tendency has been to obtain preoperative angiograms as a guide. Although rare, we have seen lower extremities with a dominant peroneal artery nourishing the foot and distal anterior and posterior vessels, contraindicating sacrifice of the peroneal artery. MRI or CT angiography can also be used in many circumstances.

Boxer’s Knuckle is an injury to the structures around the first knuckle of a finger, also known as the metacarpophalangeal joint (MPJ). The skin, extensor tendon, ligaments, joint cartilage, and the bone of the metacarpal head may all be involved. Repeated impacts to the extensor tendon over the knuckle causes Hypertrophic Interstitial Tendonosis, or HIT Syndrome. This is a thickening, weakening, inflammation, and scarring of the extensor tendon.

in this patient the aneurysm wasarising from middle cerebral artery M1 segment dividng into three branches,it is mandatory topreserve all three divisions,as was done in this case,this pt 25 yrs young man presented with sub arachnoid haemorrhage

COPD (chronic obstructive pulmonary disease) makes it hard for you to breathe. The two main types are chronic bronchitis and emphysema. The main cause of COPD is long-term exposure to substances that irritate and damage the lungs. This is usually cigarette smoke. Air pollution, chemical fumes, or dust can also cause it. At first, COPD may cause no symptoms or only mild symptoms. As the disease gets worse, symptoms usually become more severe. They include A cough that produces a lot of mucus Shortness of breath, especially with physical activity Wheezing Chest tightness Doctors use lung function tests, imaging tests, and blood tests to diagnose COPD. There is no cure. Treatments may relieve symptoms. They include medicines, oxygen therapy, surgery, or a lung transplant. Quitting smoking is the most important step you can take to treat COPD.

James Burke Fine DMD by James Burke Fine DMD Periodontal disease is a gum condition caused by the buildup of bacteria along and below the teeth's gumline. Acute forms are usually associated with pain from oral tissue gone bad – also known as necrotizing gingivitis or trench mouth – whereas chronic forms are painless but have a more long-term impact on your overall, systemic health. The most common chronic form is gingivitis, whose bleeding, puffiness and redness comes from an organized mass of bacteria called plaque. You may know it can advance into a form called periodontitis. If these conditions are left untreated, however, it can also lead to infections within other parts of the body, such as the lungs.

A rotator cuff tear is a common injury, especially in sports like baseball or tennis, or in jobs like painting or cleaning windows. It usually happens over time from normal wear and tear, or if you repeat the same arm motion over and over. But it also can happen suddenly if you fall on your arm or lift something heavy. Your rotator cuff is a group of four muscles and tendons that stabilize your shoulder joint and let you lift and rotate your arms. There are two kinds of rotator cuff tears. A partial tear is when the tendon that protects the top of your shoulder is frayed or damaged. The other is a complete tear. That’s one that goes all the way through the tendon or pulls the tendon off the bone.

This video is a teaching aid for use in conjunction with broader surgical training

Triplet C-section

ARDS was recognized as the most severe form of acute lung injury (ALI), a form of diffuse alveolar injury. The AECC defined ARDS as an acute condition characterized by bilateral pulmonary infiltrates and severe hypoxemia in the absence of evidence for cardiogenic pulmonary edema. The severity of hypoxemia necessary to make the diagnosis of ARDS was defined by the ratio of the partial pressure of oxygen in the patient’s arterial blood (PaO2) to the fraction of oxygen in the inspired air (FiO2). ARDS was defined by a PaO2/FiO2 ratio of less than 200, and in ALI, less than 300. This definition was further refined in 2011 by a panel of experts and is termed the Berlin definition of ARDS. [3] ARDS is defined by timing (within 1 wk of clinical insult or onset of respiratory symptoms); radiographic changes (bilateral opacities not fully explained by effusions, consolidation, or atelectasis); origin of edema (not fully explained by cardiac failure or fluid overload); and severity based on the PaO2/FiO2 ratio on 5 cm of continuous positive airway pressure (CPAP). The 3 categories are mild (PaO2/FiO2 200-300), moderate (PaO2/FiO2 100-200), and severe (PaO2/FiO2 ≤100).

Removal of spinal cord tumor (meningioma): Spine Tumor Surgery

finger pulp abscess drainage EXPLOSION of pus

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!”

An enlarged spleen may cause: No symptoms in some cases. Pain or fullness in the left upper abdomen that may spread to the left shoulder. Feeling full without eating or after eating only a small amount from the enlarged spleen pressing on your stomach. Anemia. Fatigue. Frequent infections. Easy bleeding.

Types of multiple myeloma. Multiple myeloma is the most common type of plasma cell cancer. The bones and bone marrow are the main sites where myeloma cells (abnormal plasma cells) are produced. The myeloma cells can form tumours, called plasmacytomas, in many bones in the body.

Your lungs are have 600 million air pockets -- enough to cover a tennis court.

Baby born in amniotic sac