St. John's wort (Hypericum perforatum) is an over-the-counter herbal supplement used for its antidepressant, anti-inflammatory, and wound-healing properties. Although it has been prescribed in Europe for mild to moderate depression, negative clinical trials and multiple reports of adverse drug interactions have raised concern about its use. St. John's wort induces various P450 isozymes (CYP 1A2, 2C19, 2C9, and 3A4) and P-glycoprotein systems. Drug interactions with the herbal product can lead to treatment failures with many medications, including hormonal contraceptives, antiretrovirals, immunosuppressive agents, narcotics, anticoagulants, and antifungals. There is also a risk for serotonin syndrome when St. John's wort is used in combination with other serotonergic antidepressants. The lack of strict regulation of herbal products that results in variable quality and content (unknown toxic ingredients or inactive ingredients) is also a concern.

-Hypopigmented spots, in combination with a family history of bilateral deafness, strongly suggest neurofibromatosis type 2 (NF-2), an autosomal-dominant disorder. The spots described actually represent cafe-au-lait spots that are usually hypopigmented (unlike the hyperpigmented cafe-au-lait spots found in NF-1 ). Deafness is caused by bilateral acoustic neuromas, a characteristic neurologic manifestation of the syndrome.

heart dissection / cardiac anatomy

Interlocking Continuous Suture

Volar Slab Splint for Forearm and Wrist Fractures and Sprains

It may be reassuring to know spotting or bleeding after sex is common and can come from the vagina, cervix, or urinary tract. It occurs most commonly in women 20 to 40 years old. Cervical Cancer: A very rare cause of spotting. ... Vaginal Dryness: Often caused by inadequate foreplay or vaginal lubrication.

The video will describe anatomical structures as seen on a CT scan. Please see discalimer on my website.

The video will describe aerobic and anaerobic metabolim in mitochondria. Please visit my website for disclaimer.

Simple technique to harvest Connective tissue graft from the Palate.

Bacterial vaginosis is a type of vaginal inflammation caused by the overgrowth of bacteria naturally found in the vagina, which upsets the natural balance. Women in their reproductive years are most likely to get bacterial vaginosis, but it can affect women of any age. The cause isn't completely understood, but certain activities, such as unprotected sex or frequent douching, increase your risk.

the video will shed some light on congential lobar emphysema. Please visit my website for discliamer. www.academyofprofessionals.com

This tutorial explains the difference in mechanisms between the 2 palsies. Bulbar palsy is a lower motor neuron condition and pseudobulbar palsy is an upper motor neuron condidtion.

Drs. Moore and Miklos are very excited to be one of the first centers in the US to offer the next step in minimally invasive treatment for Stress Urinary Incontinence, the single incision Mini-sling. The procedure utilizes the same concepts of the tension-free tape mid-urethral slings, however only one incision is needed and the procedure can be completed in as little as 5-10 minutes under local anesthesia.

The procedure was initially released in September of 2006 by Gynecare with a procedure called the TVT-Secure and Dr Miklos and Moore were some of the first surgeons to evaluate and study the procedure. They liked the concept of a single incision sling, however were not enthused by the engineering and design of the Secure sling. In early 2007, with development input from Dr Moore and Miklos, American Medical Systems made several improvements to the procedure and in April, Dr Moore was the first surgeon in the United States to place the Mini-Arc mini-sling. Dr Moore’s and Miklos’s center in Atlanta, because of their reputation of being world leader’s in treatment for Stress Urinary Incontinence, was chosen as the lead center in the USA to evaluate and study the Mini-Arc procedure. Dr Moore was chosen as principal investigator, leading 5 centers in the USA and the world, to study and present the initial results in the USA, which have been excellent and very exciting!

Dilation and curettage (D&C) is a procedure to remove tissue from inside your uterus. Doctors perform dilation and curettage to diagnose and treat certain uterine conditions — such as heavy bleeding — or to clear the uterine lining after a miscarriage or abortion.

Tenosynovitis is inflammation of the lining of the sheath that surrounds a tendon (the cord that joins muscle to bone).

giant systolic pulsations, known as C-V waves, were noticeable during jugular venous examination of a 33-year-old woman who had tricuspid-valve endocarditis. In video 2, transthoracic echocardiography revealed severe tricuspid regurgitation.

دكتور مصطفى ياقوت محاضرة القدم السكرى A lecture presented by Dr. Mostafa Yakoot to the Annual Congress of the Vascular Surgery, Alexandria 10/2009. Based on the original article published in JWC by: Yakoot M, Abdelatif M, Etman M.

Haemorrhoids is one of the most common problems seen in surgical OPD. Open haemorrhoidectomy has remained the gold standard for a long time with a high post-operative morbidity. The quest for a better understanding of the pathology of haemorrhoids resulted in the evolvement of stapler haemorrhoidopexy. Our aim is to study the efficacy of stapler haemorrhoidopexy with regards to role of immediate post-operative morbidity. A prospective study of 50 patients (n = 50) with the second- and third-degree symptomatic haemorrhoids was done. The mean age of the patients was 44.1 years. Fourteen patients had co-morbid conditions. The average duration of the operation was 29 min. Patients with the second-degree haemorrhoids had higher rate of complication. The complication rate was 32%. Three patients had urinary retention. Two patients had minor bleeding, and one patient experienced transient discharge. The mean analgesic requirement was 2.4 tramadol, 50 mg injections. Ten patients had significant post-operative pain. Average length of hospital stay was 2.7 days. There were no symptomatic recurrences till date.

MRI Shows Twins Fighting in the Womb

Midline Episiotomy