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Function and Anatomy:
Hinge type joint formed by the articulation of the Ulna and Radius (bones of the forearm), and Humerus (upper arm). Full extension is equal to 0 degrees, full flexion to ~ 150 degrees. Maximum supination (turning hand palm up so that it can hold a bowl of "soup") and pronation (palm down) are both 90 degrees
Transurethral resection of the prostate (also known as TURP, plural TURPs and as a transurethral prostatic resection TUPR) is a urological operation. It is used to treat benign prostatic hyperplasia (BPH). As the name indicates, it is performed by visualising the prostate through the urethra and removing tissue by electrocautery or sharp dissection. This is considered the most effective treatment for BPH. This procedure is done with spinal or general anesthetic. A large triple lumen catheter is inserted through the urethra to irrigate and drain the bladder after the surgical procedure is complete. Outcome is considered excellent for 80-90% of BPH patients. Because of bleeding risks associated with the surgery, TURP is not considered safe for many patients with cardiac problems. As with all invasive procedures, the patient should first discuss medications they are taking with their doctor, most especially blood thinners or anticoagulants, such as warfarin (Coumadin), or aspirin. These may need to be discontinued prior to surgery. Postop complications include bleeding (most common), clotting and hyponatremia (due to bladder irrigation).
Additionally, transurethral resection of the prostate is associated with low but important morbidity and mortality.
This video depicts how a stent is placed in the coronary artieries. We first place a guiding wire in the heart artery through a catheter, usually from the groin. Then the stent is inflated by a balloon in the artery, which is then removed. The stent remains permanently. Blood thinners, aspirin and plavix, are both required after a stent is placed in your heart artery.
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.
When both mucosa and stroma are parts of the suspect lesion, a deep biopsy is needed. The Cervicore is designed to harvest samples from the cervix and vagina with minimal collateral injury to the surrounding tissues. The procedure is easy with minimal discomfort to the patient.
A spontaneous vaginal delivery (SVD) occurs when a pregnant woman goes into labor with or without use of drugs or techniques to induce labor, and delivers her baby in the normal manner, without forceps, vacuum extraction, or a cesarean section. Assisted vaginal delivery (AVD) occurs when a pregnant woman goes into labor with or without the use of drugs or techniques to induce labor, and requires the use of special instruments such as forceps or a vacuum extractor to deliver her baby vaginally.