Observation of both jugular veins can provide a reliable indication of the volume and pressure in the right side of the heart since internal jugular veins pulsate in response to phasic changes in right atrial pressure. Proper positioning of the patient to increase the effects of gravity enhances distention of the jugular veins and, therefore, increases the ability to observe venous pulsations.

A video showing how to perform knot tying

Cannula are often introduced into blood vessels in 80% of patients in the hospital for treatment. This can be a daunting experience to patients and stressful to doctors as multiple attempts are used. This may result in introducing spreading MRSA, E Coli & Chlostredium living on your skin into blood and results in Invasive MRSA infection.

Skin is often not adequatly cleaned during subsequent atempts as doctors/nurses do not wait for 1 min after applying cleaning solution on the skin before they puncture your skin.

Multiple punctured sites allow CA-MRSA to enter blood stream resulting in bacteremia and death.

Our mission is to reduce spreading invasive CA-MRSA in the hospitals by developing alternative technique to introduce cannulae.

Medifix was created by doctors with a mission to reduce the threat of spreading antibiotic resustant bacteria to mankind.

A video of appendectomy surgery performed by the laparoscope

A vidoe showing the pronator drift from the USMLE collection

Open Inguinal Hernia Operation (German)

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 ).

Examination of the upper limb by Loyola medical school, Chicago Part 2

Loyola Respiratory System Exam Part 1 A video from Loyola Medical School, Chicago showing the medical and clinical examination of the respiratory system.

Part 6: from Loyola Medical School, Chicago showing clinical examination of the neurological system.

Removal of pregnancy within the fallopain tube using laparoscopic keyhole surgery. A segment of the tube together with the pregnancy within is removed video.

The colonoscope is slowly withdrawn during this screening colonoscopy down from the transverse colon, back around the splenic flexure, and down the descending colon, and reveals this finding a colonic diverticula. Diverticulosis is a common, acquired, age-related occurrence affecting over 50% of the... western adult population over the age of 50. It is seen rarely in Africa and Asia where the dietary fiber content is traditionally higher. Thus most investigators feel that low fiber diets are related to the development of this condition. Ironically, colonic diverticula are not true diverticula but rather pseudodiverticula in that the sac includes layers of the mucosa and submucosa that push through rather than include the outer muscular layer. As with the small bowel the colon has an inner circular muscular layer, but the outer longitudinal layer is composed of three bands of muscle that run the length of the colon known as teniae. Diverticula occur in rows between the mesenteric and two antimesenteric teniae where the colonic wall is further weakened by the defect caused by the perforating vasa recti artery which supplies the colonic mucosa. Occasionally, the anatomic propensity of diverticula to form in rows is quite apparent as seen when this clip is replayed in slow motion. Most often, however, the arrangement of the diverticula appears random due to the angulation of the bowel and thickening of the semi lunar folds. The conditions that cause these pulsion diverticula are not know with certainty but may include high intrahaustral pressures, muscular hypertrophy, and age related alterations in collagen cross linking. Diverticula can bleed or can abscess and perforate. The incidence of diverticulitis or diverticular bleeding is in the range of 1:1,000 patients with diverticulosis.

Lichtenstein mesh repair of hernia

This video shows how to draw a blood sample which is medically known as venepuncture

A 49-year old female patient complainig of cough. X-ray and chest CTscan showed a 2.5cm nodule in the left upper lobe. Transthoracic biopsy was consistent with adenocarcinoma. PET-Scan and CT Scan showed no mediastinal disease. The procedure was performed through three incisions.

small bowel anastomosis (the luminescent material check for leaks, and good flow)

This video demonstrates how to test for trace amounts of blood in the patients stool. Trace amounts of blood in the stool can be sign of a number of problems, colon cancer being the most worrisome.

At Children's Hospital, Dr. Mary Bedard and the NICU nursing staff save the life of a tiny infant struggling from a serious intestinal infection. ~ Detroit Medical Center

Instructional video explaining intravitreal injection technique used in endophthalmitis (a serious eye infection), macular degeneration, and other eye diseases.

An Echocardiography showing an Acute Pulmonary Embolism