Ear Examination ENT is often a challenging examination, crossing over with the cranial nerve examination of the vestibular cochlear exam as well at other neurological assessments of balance

Here we will review the ear examination, looking both at the use of the otoscope, but also the Dix-Hallpike Manoeuvre, along with HINTS assessment. the Webers and Rinne's test is also included to determine types of hearing loss.

Often these ear examination techniques are performed separately, depending on the patients presenting complaint

#EARExamination #DrGill #ClinicalSkills

Given the success of drugs to treat erectile dysfunction, such as sildenafil (Viagra), tadalafil (Cialis) and vardenafil (Levitra), drug companies have sought a comparable drug for women. Viagra has even been tried as a treatment for sexual dysfunction in women. However, the Food and Drug Administration (FDA) hasn't approved this use of Viagra. Indeed, until recently there were no FDA-approved drugs for treating sexual arousal or sexual desire problems in women. Yet 4 in 10 women report having sexual concerns. A prescription medication known as flibanserin (Addyi) — originally developed as an antidepressant — has been approved by the FDA as a treatment for low sexual desire in premenopausal women. A daily pill, Addyi may boost sex drive in women with low sexual desire and who find the experience distressing. Potentially serious side effects include low blood pressure, dizziness and fainting, particularly if the drug is mixed with alcohol. Experts recommend that you stop taking the drug if you don't notice an improvement in your sex drive after eight weeks.

This video: Pancreatic cancer begins in the tissues of your pancreas — an organ in your abdomen that lies horizontally behind the lower part of your stomach. Your pancreas secretes enzymes that aid digestion and hormones that help regulate the metabolism of sugars. Pancreatic cancer often has a poor prognosis, even when diagnosed early. Pancreatic cancer typically spreads rapidly and is seldom detected in its early stages, which is a major reason why it's a leading cause of cancer death. Signs and symptoms may not appear until pancreatic cancer is quite advanced and complete surgical removal isn't possible.

Rhomboid muscle strain and spasm causes upper back pain between the shoulder blades. Some patients describe the muscle spasms and discomfort as knots in the back. Early treatment is important to speed healing and recovery. Ice therapy for the first few days followed by moist heat can help relieve symptoms.Oct 12, 2015

What is vascular access? What are the different types of accesses for hemodialysis? Does vascular access require surgery? Adina Voiculescu, M.D., FASDIN, General and Interventional Nephrologist at Brigham and Women's Hospital and Assistant Professor at Harvard Medical School, discusses the different types of vascular access, such as AV fistulas and AV grafts, and how to stay healthy while on hemodialysis.

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

0:00 - Intro
0:29 - Peritoneal dialysis & Hemodialysis
0:44 - Types of access to perform dialysis
1:48 - Recommendations

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Hemodialysis: Types of Accesses for Kidney Dialysis and How to Stay Healthy | Mass General Brigham
https://youtu.be/_bxLpudpqnc

Vascular dementia is a general term describing problems with reasoning, planning, judgment, memory and other thought processes caused by brain damage from impaired blood flow to your brain. You can develop vascular dementia after a stroke blocks an artery in your brain, but strokes don't always cause vascular dementia. Whether a stroke affects your thinking and reasoning depends on your stroke's severity and location. Vascular dementia also can result from other conditions that damage blood vessels and reduce circulation, depriving your brain of vital oxygen and nutrients

Urogenital neoplasms spreading to the inguinal lymph nodes are penile carcinoma (the most frequent), urethral and scrotum cancers, tumors of the testis with scrotal violation. Penile carcinoma is an uncommon malignant disease and accounts for as many 0.4-0.6% of male cancers. Most patients are elder...ly. It rarely occurs in men under age 60 and its incidence increases progressively until it reaches a peak in the eighth decade 1. The risk of a lymph node invasion is greater with high grade and high stage tumors 2. Some investigators have reported the inaccuracy of the sentinel node biopsy 3, 4, described by Cabanas 5. Patients with metastatic lymph node penis cancer have a very poor prognosis if penectomy only is performed. Ilioinguinal lymphadenectomy is basically carried out as a treatment modality and not only as a staging act. Patients with lymph node invasion have a 30-40% cure rate. Ilioinguinal lymphadenectomy should be also performed in patients with disseminated neoplasms for the local control of the disease. The 5 years survival rate of patients with clinically negative lymph nodes treated with a modified inguinal lymphadenectomy is 88% versus 38% in patients not initially treated with lymphadenectomy 6. This video-tape clearly shows a therapeutic algorithm, the anatomy of the inguinal lymph nodes, according to Rouviere 7 and Daseler 8, the radical ilioinguinal node dissection with transposition of the sartorius muscle and the modified inguinal lymphadenectomy proposed by Catalona 9. References: 1. Lynch D.F. and Schellhammer P: Tumors of the penis. In Campbell’s Urology Seventh Edition, edited by Walsh P.C., Retik A.B., Darracott Vaughan E. and Wein A.J. W.B. Saunders Company, Vol. 3, chapt. 79, p. 2458, 1998. 2. Pizzocaro G., Piva L., Bandieramonte G., Tana S. Up-to-date management of carcinoma of the penis. Eur. Urol. 32: 5-15, 1997 3. Perinetti E., Crane D.B. and Catalona W.J. Unreliability of sentinel lymph node biopsy for staging penile carcinoma. J. Urol. 124: 734, 1980 4. Fowler J.E. Jr. Sentinel lymph node biopsy for staging penile cancer. Urology 23: 352, 1984 5. Cabanas R.M. An approach for the treatment of penile carcinoma. Cancer 39: 456, 1977 6. Russo P. and Gaudin P. Management strategies for carcinoma of the penis. Contemporary Urology;5:48-66, 2000 7. Rouviere H. Anatomy of the human lymphatic system. Edwards Brothers, p. 218, 1938 8. Daseler E.H., Anson B.J., Reimann A.F. Radical excision of the inguinal and iliac lymph glands: a study based on 450 anatomical dissections and upon supportive clinical observations. Surg. Gynecol. Obstet. 87: 679, 1948 9. Catalona W.J. Modified inguinal lymphadenectomy for carcinoma of the penis with preservation of saphenous veins: technique and preliminary results. J. Urol. 140: 306-310, 1988

An educational video of water birth vaginal delivery

How do you know if you have pneumonia? They may include: Cough. You will likely cough up mucus (sputum) from your lungs. ... Fever. Fast breathing and feeling short of breath. Shaking and "teeth-chattering" chills. Chest pain that often feels worse when you cough or breathe in. Fast heartbeat. Feeling very tired or very weak. Nausea and vomiting.

Although your body may harbor the bacteria that cause tuberculosis, your immune system usually can prevent you from becoming sick. For this reason, doctors make a distinction between: Latent TB. In this condition, you have a TB infection, but the bacteria remain in your body in an inactive state and cause no symptoms. Latent TB, also called inactive TB or TB infection, isn't contagious. It can turn into active TB, so treatment is important for the person with latent TB and to help control the spread of TB. An estimated 2 billion people have latent TB. Active TB. This condition makes you sick and can spread to others. It can occur in the first few weeks after infection with the TB bacteria, or it might occur years later. Signs and symptoms of active TB include: Coughing that lasts three or more weeks Coughing up blood Chest pain, or pain with breathing or coughing Unintentional weight loss Fatigue Fever Night sweats

Medications are the most proven, effective way to treat gout symptoms. However, making certain lifestyle changes also may help, such as: Limiting alcoholic beverages and drinks sweetened with fruit sugar (fructose). Instead, drink plenty of nonalcoholic beverages, especially water. Limit intake of foods high in purines, such as red meat, organ meats and seafood. Exercising regularly and losing weight. Keeping your body at a healthy weight reduces your risk of gout.

Achalasia is a neurogenic esophageal motility disorder characterized by impaired esophageal peristalsis and a lack of lower esophageal sphincter relaxation during swallowing. Symptoms are slowly progressive dysphagia, usually to both liquids and solids, and regurgitation of undigested food. Evaluation typically includes manometry, barium swallow, and endoscopy. Treatments include dilation, chemical denervation, surgical myotomy, and peroral endoscopic myotomy.

External ring Invagination
Internal ring occlusion test
History Inspection Palpation
taxis
Zieman

Shingles is a viral infection that causes a painful rash. Although shingles can occur anywhere on your body, it most often appears as a single stripe of blisters that wraps around either the left or the right side of your torso. Shingles is caused by the varicella-zoster virus — the same virus that causes chickenpox. After you've had chickenpox, the virus lies inactive in nerve tissue near your spinal cord and brain. Years later, the virus may reactivate as shingles. While it isn't a life-threatening condition, shingles can be very painful. Vaccines can help reduce the risk of shingles, while early treatment can help shorten a shingles infection and lessen the chance of complications.

STOP SMOKING

Masturbating is totally healthy, and totally normal. There are tons of myths out there meant to scare you into thinking masturbation is wrong or bad. But the truth is masturbation is perfectly safe. Masturbating won't make you blind, crazy, or stupid. It won’t damage your genitals, cause pimples, or stunt your growth. It doesn’t use up all your orgasms or ruin other kinds of sex. In fact, masturbation can actually be good for you. Here are some benefits of masturbation: Masturbation is safer than any other type of sex. You can’t get pregnant or get any sexually transmitted infections from masturbating. Masturbation can help you learn what you like and don’t like sexually. And if you decide to have sex with someone, you can know what you do/don’t want to do. BONUS: getting comfortable talking about sex and your body with your partner makes it easier to talk about protecting yourself against STDs and pregnancy, too. Exploring your body and learning how to give yourself sexual pleasure can be empowering and help improve your body image. Masturbation can lower stress and help you relax. It even helps some people fall asleep. Having an orgasm releases endorphins — feel good chemicals in your brain. Orgasms can be a natural painkiller and can even help with period cramps. Mutual masturbation (masturbating with a partner) is a really safe way to have sex and let the other person know what feels good to you. If you share a sex toy, use condoms on the toy and clean it before swapping. And if you touch each other’s genitals, wash your hands before touching your own. Can I get an STD from masturbating? Nope. Masturbating is the safest sexual activity out there. There is virtually NO chance of getting an STD or any other infection from touching your own genitals (and there’s also no chance of pregnancy). STDs have to be passed from one person to another, so you can’t give yourself an STD. The one exception to this is herpes - so if you have any cold sores on your mouth and touch them, make sure to wash your hands before masturbating. But it IS possible to get an STD if you’re masturbating with another person and touching each other’s genitals. Anytime semen (cum) or vaginal fluids are spread to someone else’s body, or your genitals rub against each other, there’s a risk of STDs. So if you touch each other’s genitals, wash your hands before touching your own. STDs can also be spread by sharing sex toys with another person. You can help protect yourself by using condoms on any toys that you share (even if they’re not shaped like a penis). Put a new condom on anytime a different person uses it. If you’re the only one using your sex toys, you don’t have to worry about STDs. But if you use them with other people, protect those sex toys just like you’d protect your own genitals — put a condom on ‘em! It’s possible for masturbation to cause irritation or infections if your body is sensitive to the way you masturbate or the things you masturbate with — but this isn’t the same thing as an STD. Lotions, Vaseline, oils, and scented or flavored stuff may irritate your vulva and vagina. Masturbating roughly and not using lubrication can also lead to irritation because of friction. And germs from the anus can cause vaginal infections — so never put something in your vagina that’s been in your butt without washing it or covering it with a condom. If you’re worried that you have an STD because of pain, itching, or discomfort in your genitals, go to your doctor or your local Planned Parenthood health center.

This procedure describes proximal humeral fracture fixation with an angular stable plate (A). Sometimes, these implants are not available. Standard plates provide an alternative option, for example the modified cloverleaf plate (B). Presently, the specific indications, advantages, and disadvantages of angular stable and standard plates are being clarified. There is some evidence that angular stable plate provide better outcomes. In addition to type and technique of fixation, the quality of reduction, the soft-tissue handling, and the characteristics of the injury and patient significantly influence the results. There is no evidence that the use of angular stable plates will overcome these other factors.

The 12-lead ECG is a vital tool for EMT’s and paramedics in both the prehospital and hospital setting. It is extremely important to know the exact placement of each electrode on the patient. Incorrect placement can lead to a false diagnosis of infarction or negative changes on the ECG.