How Did Insects Evolve To Feast On Your Blood?

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Robotic Surgery Demonstration Using Da Vinci Surgical System

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Effect of Smoking 30 PACKS of Cigarettes on Your Lungs

ESCLEROTERAPIA

مرکز ایمپلنت و زیبایی دندان شیراز دکتر محمد امین دین پرور

Demystify knee pain and discover nine of the most common causes of pain in this complex joint. Join Burke Selbst PT as we work through our simple screening for the most common types of problems.

Burke is the founder and clinical director of Focus Physical Therapy in Bend Oregon.
Find him:
https://focusptbend.com
https://facebook.com/focusphysio

Intro Song Credit
Adventures by A Himitsu https://www.youtube.com/channel/UCgFw...
Creative Commons — Attribution 3.0 Unported— CC BY 3.0
http://creativecommons.org/licenses/b...
Music released by Argofox https://youtu.be/8BXNwnxaVQE
Music provided by Audio Library https://youtu.be/MkNeIUgNPQ8

Johns Hopkins orthopaedic hip and knee surgeon, Savyasachi "Savya" Thakkar, explains how to prepare for knee replacement surgery, and what to expect before and after surgery. To learn more about our hip and knee replacement division, visit https://www.hopkinsmedicine.org/ortho. #KneeReplacement #JohnsHopkins

Q&A's
0:15 What causes someone to need a knee replacement?
0:29 What should patients do in advance of surgery?
1:10 Do you recommend physical therapy BEFORE surgery?
1:43 Will joint implants set off metal detectors at airports?

A new procedure helps patients with unattractive bunions and hammertoes.

Laparoscopic cholecystectomy is a very safe operation. The overall complication rate is less than 2%. The complication rate for laparoscopic gallbladder surgery is similar to the complication rate for traditional open gallbladder surgery when performed by a properly trained surgeon.

Examination of the eye,vision,retina and field of vision

Examination of different gaits

A video showing how to perform knot tying

How to perform a lumbar puncture.

The Knee Exam
Observation:
1. Make sure that both knees are fully exposed. The patient should be in either a gown or shorts. Rolled up pant legs do not provide good exposure!
2. Watch the patient walk. Do they limp or appear to be in pain? When standing, is there evidence of bowing (varus) or knock-kneed (valgus) deformity? There is a predilection for degenerative joint disease to affect the medical aspect of the knee, a common cause of bowing. Varus Knee Deformity, more marked on the left leg. 3. Make note of any scars or asymmetry. Chronic/progressive damage, as in degenerative joint disease, may lead to abnormal contours and appearance. Is there obvious swelling as would occur in an effusion? Redness suggesting inflammation? 4. Is there evidence of atrophy of the quadriceps, hamstring, or calf muscle groups? Knee problems/pain can limit the use of the affected leg, leading to wasting of the muscles.

While both legs have well developed musculature,
the left calf and hamstring are bulkier than the right. 5. Look at the external anatomy, noting structures above and below the knee itself: 1. Patella 2. Patellar tendon 3. Quadriceps/Hamstring/Calf muscles 4. Medial and lateral joint lines. 5. Femur and Tibia 6. Tibial tuberosity


Ballotment (helpful if the effusion is large) 1. Slightly flex the knee which is to be examined.
2. Place one hand on the supra-pateallar pouch, which is above the patella and communicates with the joint space. Gently push down and towards the patella, forcing any fluid to accumulate in the central part of the joint.
3. Gently push down on the patella with your thumb.
4. If there is a sizable effusion, the patella will feel as if it's floating and "bounce" back up when pushed down.

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. (Source Records from Dr. Khuroo's Medical Clinic. Review prepared by Mehnaaz Sultan Khuroo Host website www.drkhuroo.org , E-mail: mkhuroo@yahoo.com ).