A detailed description of the approach to a use of bleeding disorders. This presentation includes the causes, history, clinical features and diagnosis of specific bleeding disorders. These include Haemophilia, DIC, Von Willebrand Disease and others. The final differentiation is often made on the basis of the Prothrombin Time, activated Partial thromboplastin time and platelet count.

Lumbar Laminotomy and Microdiscectomy

Lipid-Lowering Agents HMG-CoA reductase inhibitors (statins) These agents inhibit the rate-limiting step in cholesterol biosynthesis by competitively inhibiting HMG-CoA reductase. Note the following: Low-density lipoprotein (LDL) reduction of 25%-60% Examples include Atorvastatin, fluvastatin, lovastatin, pitavastatin, pravastatin, rosuvastatin, simvastatin Contraindications include hypersensitivity, active liver disease, pregnancy, lactation, coadministration with strong CYP3A4 inhibitors (selected statins) Vitamin B3 Vitamin B3 inhibits very-low-density lipoprotein (VLDL) synthesis. Note the following: LDL reduction of 10% High-density lipoprotein (HDL) increase of 20% Example includes Niacin (nicotinic acid) Contraindications include hypersensitivity, liver disease, active peptic ulcer, severe hypotension, arterial bleeding Fibrates Fibrates enhance lipoprotein lipase, resulting in increased VLDL catabolism, fatty acid oxidation, and triglycerides elimination. They decrease hepatic extraction of free fatty acids. Note the following: LDL reduction of 15% Triglyceride reduction of 35% Examples include Gemfibrozil, fenofibrate, fenofibrate (micronized), fenofibric acid Contraindications include active liver disease, renal disease, primary biliary cirrhosis, gallbladder disease 2-Azetidiones These agents inhibit sterol transporter at brush border and, consequently, intestinal absorption of cholesterol. LDL reduction of 15% Example includes Ezetimibe Contraindications include hypersensitivity, coadministration with statins (if active liver disease) Bile acid sequestrants These agents lower cholesterol and LDL via bile duct sequestration. Note the following: LDL reduction of 15% Examples include Cholestyramine, colesevelam, colestipol Contraindications include biliary/bowel obstruction, serum triglycerides >300-500 mg/dL, history of hypertriglyceridemia-induced pancreatitis

Sex reassignment surgery for male-to-female involves reshaping the male genitals into a form with the appearance of, and, as far as possible, the function of female genitalia. Prior to any surgeries, patients usually undergo hormone replacement therapy (HRT), and, depending on the age at which HRT begins, facial hair removal. There are associated surgeries patients may elect to, including facial feminization surgery, breast augmentation, and various other procedures.

Triplet C-section

Intussuseption and Appendectomy

Parasitic Worm removed from Man's EYE

Your body has nerves that connect your brain to the rest of your organs and muscles, just like telephone wires connect homes all around the world. When you want your hand to move, your brain sends signals through your nerves to your hand telling the muscles to contract. But your nerves don’t just say “hand, move.” Instead your nerves send lots of electrical impulses (called action potentials) to different muscles in your hand, allowing you to move your hand with extreme precision.

Uterine fibroids are the most common benign tumors and can affect one in three in Canada. While most fibroids are asymptomatic, they can cause heavy and painful periods, urinary frequency and urgency and pelvic discomfort and pain. A new treatment is available that doesn’t involve invasive surgery. With Fibristal, you can treat fibroids, relieve symptoms and finally live your life the way you want to!

This video shows the heart transplant surgery

A very funny song made by the staff of the Ob/Gyn Gangnam style

Rafael Nadal missed seven months last year with a knee injury. That knee will face its toughest test when he plays in the French Open, his first Grand Slam event since his return.

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Analysis of Rafael Nadal's Knee Injury (Computer Animation)
http://www.youtube.com/user/TheNewYorkTimes

An untreated hepatic abscess is nearly uniformly fatal as a result of complications that include sepsis, empyema, or peritonitis from rupture into the pleural or peritoneal spaces, and retroperitoneal extension. Treatment should include drainage, either percutaneous or surgical. Antibiotic therapy as a sole treatment modality is not routinely advocated, though it has been successful in a few reported cases. It may be the only alternative in patients too ill to undergo invasive procedures or in those with multiple abscesses not amenable to percutaneous or surgical drainage. In these instances, patients are likely to require many months of antimicrobial therapy with serial imaging and close monitoring for associated complications.

Shoulder Clinical Examination - Medical School Clinical Skills - Dr Gill

Personally, I find the shoulder examination the most complex examination possibly as there are so many variations and special tests. Some of which overlap and some will relate specifically to a patients presentation.

Often in a medical school syllabus, only select special tests will be used. In this shoulder exam demonstration, we include the Hawkins-Kennedy Test looking for impingement. This is dovetailed with examination for bicipital tendonitis as this is another possible cause of impingement type symptoms.

This shoulder upper limb exam follows the standard "Look, Feel, Move" orthopaedic exam approach, and overall order as set out in MacLeods Clinical Examination

Watch further orthopaedic examinations for your OSCE revision:

The Spine Examination:
https://youtu.be/pJxMHa6SCgU

Knee Examination
https://youtu.be/oyKH4EYfJDM

Hip Joint Clinical Examination
https://youtu.be/JC9GKq5nSdQ
________

Please note that there is no ABSOLUTE way to perform a clinical examination. Different institutions and even clinicians will have differing degrees of variations - the aim is the effectively identify medically relevant signs.

However during OSCE assessments. Different medical schools, nursing colleges, and other health professional courses will have their own preferred approach to a clinical assessment - you should concentrate on THEIR marks schemes for your assessments.

The examination demonstrated here is derived from Macleods Clinical Examination - a recognized standard textbook for clinical skills.


#ShoulderExamination #ClinicalSkills #DrGill

Laparoscopic varicocellectomy

A pneumothorax occurs when some of the tiny air sacs (alveoli) in a baby's lung become overinflated and burst. This causes air to leak into the space between the lung and chest wall (pleural space). The most common cause of pneumothorax is respiratory distress syndrome. This is a condition that occurs in babies who are born too early (premature). The baby's lungs lack the slippery substance (surfactant) that helps them stay open. Therefore, the tiny air sacs are not able to expand as easily. If the baby is put on a breathing machine (mechanical ventilator), there is extra pressure on the baby's lungs, which can sometimes burst the air sacs.

An inguinal hernia occurs when tissue, such as part of the intestine, protrudes through a weak spot in the abdominal muscles. The resulting bulge can be painful, especially when you cough, bend over or lift a heavy object. However, many hernias do not cause pain.

An inguinal hernia isn't necessarily dangerous. It doesn't improve on its own, however, and can lead to life-threatening complications. Your doctor is likely to recommend surgery to fix an inguinal hernia that's painful or enlarging. Inguinal hernia repair is a common surgical procedure.

An abscess is a collection of pus. Pus is a thick fluid that usually contains white blood cells, dead tissue and germs (bacteria). The usual cause of an abscess is an infection with bacteria. Certain bacteria are more likely to be 'pus-forming' as they make chemicals (toxins) that can damage the body's tissues.

For more information on peritoneal dialysis: https://www.massgeneralbrigham.....org/en/about/newsro

Why does someone need dialysis? What is peritoneal dialysis? How does it work? John Kevin Tucker, M.D., Nephrologist at Brigham and Women's Hospital and Vice President for Education at Mass General Brigham, discusses peritoneal dialysis and its benefits for people who have lost their kidney function.

Subscribe Link: https://www.youtube.com/channe....l/UCYrLjATd88gPwIKnt

0:00 - Intro
0:24 - Why Do I Need Dialysis?
1:42 - Treatment
2:02 - Why Is It Called Peritoneal Dialysis
2:35 - 2 Forms of Peritoneal Dialysis
3:50 - Continuous Cycling Peritoneal Dialysis
4:38 - Myths
5:55 - Preparing For Peritoneal Dialysis

About Mass General Brigham:
Mass General Brigham combines the strength of two world-class academic medical centers, five nationally ranked specialty hospitals, 11 community hospitals, and dozens of health centers. Our doctors and researchers accelerate medical breakthroughs and drive innovations in patient care. They are leaders in medical education, serving as Harvard Medical School faculty and training the next generation of physicians. Mass General Brigham’s mission is to deliver the best, affordable health care to patients everywhere. Together, we transform the health of our communities and beyond.

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Peritoneal Dialysis: At Home Treatment for Kidney Failure | Mass General Brigham
https://youtu.be/of1T6hMEN_Q