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Benign paroxysmal positional vertigo
Benign paroxysmal positional vertigo samer kareem 8,666 Views • 3 years ago

Benign paroxysmal positional vertigo is an abnormal feeling of motion triggered by certain provocative positions. The condition is most often attributed to the presence of calcium debris within the posterior semicircular canal. Nystagmus is commonly seen

Kidney Dialysis pump test
Kidney Dialysis pump test samer kareem 1,912 Views • 3 years ago

Bulbar Palsy
Bulbar Palsy samer kareem 16,236 Views • 3 years ago

Tongue fassiculations

Complex cataract and glaucoma surgery
Complex cataract and glaucoma surgery Scott 7,052 Views • 3 years ago

Phacolytic glaucoma usually is associated with a mature or hypermature cataract and typically occurs in elderly patients. Today, phacolytic glaucoma is rare in the United States, found primarily in areas where access to care is poor. Will the increase in the number of under- and uninsured patients lead to an increase in this condition? Evaluation and Diagnosis Signs and symptoms. Patients typically report acute-onset pain, decreased vision, tearing and photophobia. Examination will reveal injection, corneal edema, elevated IOP, anterior chamber reaction with or without pseudohypopyon, particles on the lens capsule and anterior capsule wrinkling. Patient history. The duration of symptoms should be elicited; a delayed presentation of more than five days since onset can result in glaucomatous disc damage and poorer prognosis.¹ The ocular history may reveal that the patient decided against removal of an advanced cataract. Prior intraocular surgery or trauma may have left residual lens material that could cause phacoanaphylactic glaucoma or exacerbate infectious endophthalmitis. Visual acuity and visual potential should be assessed. Exam essentials. A complete ophthalmologic examination should be done. The eye should be inflamed, and the cornea may be edematous due to the high IOP. The anterior chamber will demonstrate massive inflammation and/ or pseudohypopyon. Gonioscopy is essential; it will help rule out angle closure due to phacomorphic glaucoma or neovascularization of the angle. Assess ment of the posterior pole should be performed to rule out vitreous hemorrhage (which can result in ghost-cell glaucoma) or vitritis (which may be associated with infectious endophthalmitis or panuveitis). If the view to the fundus is obstructed, B-scan ultrasonography also should be performed. Differential diagnosis. The differential diagnosis includes infectious endophthalmitis, phacoanaphylactic glaucoma, inflammatory glaucoma, glaucoma secondary to intraocular tumor, phacomorphic glaucoma, acute-angle closure glaucoma and neovascular glaucoma. Management Medication. Medical management is used to temporarily control the glaucoma and inflammation. Initial treatment consists of hyperosmotic agents, aqueous suppressants, anti-inflammatory drugs and cycloplegics. Surgery. Definitive treatment is removal of the lens via extracapsular cataract extraction with or without an IOL. Some ophthalmologists defer placement of an IOL until after the inflammation subsides; however, there is no significant difference in final visual acuity between those patients who did receive an IOL and those who did not.¹ If the phacolytic glaucoma is of long duration (more than seven days), a combined trabeculectomy may be needed to prevent postoperative IOP spikes.² In eyes with hypermature Morgagnian cataracts, one must be especially careful, as the capsule is fragile, the zonules are weak and the view is difficult due to the white, milky cortex. Vision limited to light perception on presentation is not a contraindication to performing cataract extraction. Surgical Tips For a planned extracapsular cataract extraction with a posterior chamber IOL, fashion a superior fornix-based conjunctival flap.³ Make a partial-thickness incision along the sclerolimbal junction superiorly for 120 degrees with a No. 69 blade. Forty-five degrees away, a paracentesis should be done to decompress the eye. The anterior chamber fluid can be withdrawn for analysis, to look for macrophages and high molecular-weight proteins. Inject balanced salt solution in a cannula to wash out any residual particulate matter, then inject Healon or viscoelastic into the anterior chamber. Make an incision entering the anterior chamber at the 12 o’clock position with a keratome. A 26-gauge cystotome mounted on a syringe is then introduced through the 12 o’clock incision and used to puncture the capsular bag. The milky cortex should be aspirated as much as possible, until the nucleus is visible. Withdraw the needle through the keratome incision, then inject Healon through the 12 o’clock incision into the capsular bag. Next, enlarge the corneoscleral keratome incision with curved Westcott scissors to 120 degrees. Perform a partial V-shaped capsulotomy; this can be done either with the cystotome or with an angled Vannas scissors. Place viscoelastic under the nucleus to float the nucleus and sever any adhesions between the nucleus and the capsule. The nuclear portion of the lens can then be removed with an irrigating vectis (lens loop) with or without gentle pressure at the inferior limbus (6 o’clock). Irrigate and aspirate the residual cortex with the Simcoe cannula. Inspect the capsular bag; if it is intact, place a posterior chamber IOL into the bag. Close the incision with several interrupted 10-0 monofilament nylon sutures and reattach the conjunctival flap. Potential Sequelae and Prognosis Postoperatively, the patient should be managed with topical steroids and/or aqueous suppressants and hyperosmotics if necessary. Vitreous opacification behind the posterior capsule occurs in a small percentage of eyes. These vitreous opacities are typically absorbed by one to two weeks postoperatively. IOP usually is controlled without antiglaucoma medications after the cataract removal. A detailed glaucoma evaluation (including repeat gonioscopy to assess for peripheral anterior synechiae, visual field and optic nerve status) should be done to assess the extent of glaucomatous damage. The prognosis is dependent on the duration of elevated IOP, PAS and optic nerve damage. In one study, patients who were older than 60 and whose glaucoma was present for more than five days did significantly worse than a comparison group of younger individuals with shorter disease duration.

Markle Test for Peritonitis
Markle Test for Peritonitis samer kareem 12,087 Views • 3 years ago

Markle Test (heel jar test) for Peritonitis

What Is Dumping Syndrome?
What Is Dumping Syndrome? samer kareem 4,690 Views • 3 years ago

Dumping syndrome is a condition that can develop after surgery to remove all or part of your stomach or after surgery to bypass your stomach to help you lose weight. Also called rapid gastric emptying, dumping syndrome occurs when food, especially sugar, moves from your stomach into your small bowel too quickly. Most people with dumping syndrome develop signs and symptoms, such as abdominal cramps and diarrhea, 10 to 30 minutes after eating. Other people have symptoms one to three hours after eating, and still others have both early and late symptoms. Generally, you can help prevent dumping syndrome by changing your diet after surgery. Changes might include eating smaller meals and limiting high-sugar foods. In more-serious cases o

Lupus hair loss
Lupus hair loss samer kareem 1,450 Views • 3 years ago

Lupus hair loss and alopecia explained

How To Study Human Anatomy Quickly and Efficiently?
How To Study Human Anatomy Quickly and Efficiently? hooda 3,285 Views • 3 years ago

Watch that video to know How to Learn Human Anatomy Quickly and Efficiently?

Asthma Management
Asthma Management samer kareem 1,272 Views • 3 years ago

Includes discussion on asthma pathophysiology, signs and symptoms of asthma, diagnosis, triggers (GERD, post nasal drip, down feathers, etc.), flow volume loops, samter's triad, and more. This is video 1 of 2 on asthma and treatment.

Keratoprosthesis Corneal Transplant
Keratoprosthesis Corneal Transplant samer kareem 1,560 Views • 3 years ago

This patient had a history of herpes and had a previous corneal transplant that subsequently became opacified. There was also a previous Baerveldt implant placed into the anterior chamber. This surgery consists of Baerveldt tube being moved from the anterior chamber to posterior chamber, removal of failed graft, placement of temporary keratoprosthesis, pars plana vitectomy and corneal transplant. Jeffrey Liebmann, MD. Mark Speaker, MD. Uri Shabto, MD. Christopher Teng, MD.

Active Cycle of Breathing Technique
Active Cycle of Breathing Technique samer kareem 1,736 Views • 3 years ago

The Irish Thoracic Society explain the Active Cycle of Breathing Technique for patients with acute and chronic respiratory illnesses and diseases and respiratory distress

How to Shape Your Saggy Breasts Naturally
How to Shape Your Saggy Breasts Naturally hooda 10,278 Views • 3 years ago

Watch that video to know How to Shape Your Saggy Breasts Naturally

Intraocular tumor Surgery( Melanoma)
Intraocular tumor Surgery( Melanoma) samer kareem 11,128 Views • 3 years ago

Eye cancers can be primary (starts within the eye) and metastatic cancer (spread to the eye from another organ). The two most common cancers that spread to the eye from another organ are breast cancer and lung cancer. Other less common sites of origin include the prostate, kidney, thyroid, skin, colon and blood or bone marrow. Melanomas (choroidal, ciliary body and uveal) -Early stages has no symptoms (the person does not know there is a tumor until an ophthalmology examination). As the tumor grows, symptoms can be blurred vision, decreased vision, double vision, eventual vision loss and if they continue to grow the tumor can break past the retina causing retinal detachment.

Mitosis & Duplication
Mitosis & Duplication samer kareem 1,806 Views • 3 years ago

Mitosis, a process of cell duplication, or reproduction, during which one cell gives rise to two genetically identical daughter cells. Strictly applied, the term mitosis is used to describe the duplication and distribution of chromosomes, the structures that carry the genetic information.

Prenatal Repair of Spina Bifida
Prenatal Repair of Spina Bifida samer kareem 2,561 Views • 3 years ago

Repairing a myelomeningocele in utero, rather than after birth, reduces the risk for fetal or neonatal death and the need for shunting by age 1 and substantially improves neurologic and motor outcomes. However, it is not without maternal and fetal risks. These are the findings, in a nutshell, of the long-awaited Management of Myelomeningocele Study (MOMS), which were published online February 9 in The New England Journal of Medicine.

This wearable robot helps disabled patients regain control of their hands.
This wearable robot helps disabled patients regain control of their hands. samer kareem 1,451 Views • 3 years ago

Exo-Glove Poly (Seoul National University). This wearable robot helps disabled patients regain control of their hands.

Reactive Arthritis Causes
Reactive Arthritis Causes samer kareem 1,615 Views • 3 years ago

Reactive arthritis is a painful form of inflammatory arthritis (joint disease due to inflammation). It occurs in reaction to an infection by certain bacteria. Most often, these bacteria are in the genitals (Chlamydia trachomatis) or the bowel (Campylobacter, Salmonella, Shigella and Yersinia). Chlamydia most often transmits by sex. It often has no symptoms, but can cause a pus-like or watery discharge from the genitals. The bowel bacteria can cause diarrhea. If you develop arthritis within one month of diarrhea or a genital infection – especially with a discharge – see a health care provider. You may have reactive arthritis. - See more at: https://www.rheumatology.org/i-am-a/patient-caregiver/diseases-conditions/reactive-arthritis#sthash.PukaaQhj.dpuf

Cross match & Blood groups
Cross match & Blood groups samer kareem 1,979 Views • 3 years ago

Everybody needs to know this!

Immunotherapy cancer trial cures 90% of participants.
Immunotherapy cancer trial cures 90% of participants. samer kareem 1,453 Views • 3 years ago

Immunotherapy cancer trial cures 90% of participants.

Understanding the Brain
Understanding the Brain samer kareem 4,030 Views • 3 years ago

t’s the brain, after all, that devises experiments and interprets their results. How the brain perceives, how it makes decisions and judgments, and how those judgments can go awry are at least as important to science as knowing the intricacies of nonbiotic experimental machinery. And as any brain scientist will tell you, there’s still a long way to go before understanding the brain will get crossed off science’s to-do list. But there has been progress. A recent special issue of the journal Neuron offers a convenient set of “perspective” papers exploring the current state of understanding of the brain’s inner workings. Those papers show that a lot is known. But at the same time they emphasize that there’s a lot we don’t know.

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