Hip Examination

Repair of the umbilical hernia, and placing the omentum back in

How bunions appear

Demonstration of a one-hand tie for suturing in the operating room.

Demonstration of a two-hand tie for wound closure

This high technology apparatus for the forearm is helping to restore hand movement in stroke patients. ~ Detroit Medical Center

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

A "Hallux Valgus" or "Hallux Abducto-Valgus" deformity, is commonly referred to as a "Bunion." This describes a pathological condition involving the position of the "hallux" in relation to the first metatarsal.

A bunion deformity can clinically present with a variety of characteristics. The foot itself may present with a wide splaying of the forefoot and a painful bump on the medial aspect of the first metatarsal phalangeal joint. In addition, the hallux may be abducted from the midline of the body, with a valgus rotation in the frontal plane.

A radiographic analysis of a bunion deformity in the Anterior/Posterior or Dorsal/Plantar view will reveal a variety of pathological components. Most notably so, is the exaggerated inter-metatarsal angle between the first and second metatarsal. This may be accompanied by a displacement of the first metatarsal from its position over the sesamoids, such that the metatarsal demonstrates a medial alignment away from the sesamoids which lie to the lateral side.

In some cases, the proximal articular set angle at the head of the first metatarsal may be off-set. This "PASA" is one of the factors which determines the position of the proximal phalanx on the metatarsal during movement as well as at rest.

Although conservative care may involve shoe modifications, padding, strapping, and custom orthosis; surgical reconstruction may be required to alleviate painful and immobilizing bunion conditions.

Soft tissue components of the bunion deformity are primarily addressed by means of a capsular modification, as well as a tenotomy of the adductor tendon at its insertion on the base of the proximal phalanx. The fibular sesamoid may be repositioned by a release of the surrounding ligaments.

Surgical management of the bone or osseous components of a bunion deformity will commonly include an osteotomy and correction to re-establish a more functional position of the first metatarsal within the forefoot. This capital fragment of bone is held in place with hardware fixation in order to secure a proper alignment during the healing phase, thus allowing the hallux to return to a more functionally useful position in the sagittal plane.

a great video showing the various techniques of stitches and suturing

Understanding Evidence-based Healthcare

laparoscopic cornuotomy using a temporary tourniquet suture and diluted vasopressin injection in interstitial pregnancy video

Anterior vaginal wall relaxation (cystocele) is one of the most commonly diagnosed forms of pelvic organ prolapse in women. More than 200,000 cystocele repairs are completed yearly, however to date the procedures that are completed do not provide very high cure rates and/or poor anatomic outcomes. Successful treatment of anterior vaginal wall prolapse remains one of the most challenging aspects of pelvic reconstructive surgery we face. We have developed very good procedures that provide excellent support for the posterior wall (ie rectoceles) and the apex of the vagina (ie vaginal vault prolapse) and reproduce normal anatomy. We were one of the first centers in the country to utilize grafts in rectocele repairs and have seen improved cure rates to over 90% with minimal complications. It has been known for many years that abdominal sacralcolpopexy with placement of a mesh graft at the top of the vagina for vaginal vault prolapse is the most successful procedure in the literature. We have made advancements with this procedure as well in being able to offer our patients a laparoscopic minimally invasive approach for sacralcolpopexy, with the same excellent cure rates (>92%) and with hospital stays typically less than 24 hours and reduced complications. However the anterior wall has been one of the most difficult compartments in the vagina to get good anatomic results and high cure rates with traditional repairs and at the same time not cause sexual dysfunction, pain with intercourse, voiding dysfunction (ie incontinence or urgency/frequency syndrome), or a shortened or scarred down vagina. The transobturator approach was developed as a less invasive way to place an anterior wall graft (see below) however this still involved blind needle passes and the graft did not support the apex of the vagina, therefore the search for improvements in these procedures is ongoing.

After 11 years of my work on my new migraine surgery, I start to do migraine surgery in all 4 principal places - places # 1 (STA) both sides, and places # 3 - Occipital artery also from both sides. You can see my first patients; he had bifrontal migraine headaches and daily chronic headaches in occipital area and the top of the head. On 30 September I sutured the occipital artery from both sides, and on 2 October I sutured STA in places # 1 from both sides. www.alisultaneh.8m.com

An animation showing the Electrode insertion in Radiofrequency Ablation of HCC

أ.د/ سمير عبد الغفار في برنامج الصحة و الجمال يتحدث عن الطرق العلاجية المختلفة لعلاج الأورام الليفية في الرحم و خاصة بالطرق التي تتفادى استئصال الرحم.
أ.د/ سمير عبد الغفار هو استشاري العمليات التداخلية بدون جراحة في كلية الطب بجامعة عين شمس

للمزيد من المعلومات عن الأورام الليفية في الرحم:
http://www.Fibroidstoday.com

Associate Professor Dr. Samir Abd Elghaffar spekaing in the famous TV show "Health and Beauty" discussing various non invasive techniques of curing fibroids and leiomyomas stressing on the interventional radiology techniques.

Dr. Samir Abd Elghaffar is the consultant of interventional radiology and non invasive procedures in Ain Shams Faculty of medicine.

Looking for Smart Lipo treatment in Shrewsbury, Monmouth, New Jersey, then visit Medispa. For successful liposuction procedures consider our smart lipo treatment offers, at a cost that suits your pocket.

د.أحمد عزوعبد الله- د.حسين الحمود- د.حازم العجيلي- د.حسان الضويحي- د.أحمد العيسى
hassandouayhi@yahoo.com

Cisplatin is in a class of drugs known as platinum-containing compounds used to treat various types of cancers including metastatic testicular and ovarian tumors. The molecule was first discovered in 1845, but did not receive FDA approval until 1978. Today it is known as the "penicillin of cancer drugs," because it is so effective for many different cancers. There are three key players involved in Cisplatin's mechanism: (1) Cisplatin, (2) DNA (3) and an HMG Protein. Most Cisplatin enters the body through active transport, but some molecules are passively defused through the cell membrane. Once in the nucleus, Cisplatin can form an adduct with two consecutive guanine bases within a strand of DNA. The molecule loses its chlorine atoms in exchange for the nitrogen atoms of the target guanines. Cisplatin can bond more tightly with nitrogen because nitrogen balances the platinum charge more effectively than chlorine. It is this adduct-induced DNA bend that allows binding of proteins which contain the high mobility group, HMG domain. Once the protein is bound to the DNA, it inserts a wedge-like phenyl group of phenylalanine 37 into the widened minor groove created by the bend. The tightly bound HMG protein causes destacking of the nucleotide bases, resulting in the DNA helix becoming kinked. In this way, Cisplatin can be thought of as a monkey wrench in the DNA repair system. With the HMG protein bound to the DNA, the modified strand is not repaired properly and so the cell dies. The success of Cisplatin depends on its ratio of efficacy between cancerous and healthy cells.

High definition video showing laparoscopic appendectomy operation

Tampa body sculpting is the specialty of Dr. Thomas Su of the Artistic Lipo Sculpting Center. Dr. Su’s dedication to body contouring has allowed him to finely hone his craft over the years, making him the most trusted Tampa lipo surgeon. To learn more about Tampa fat removal procedures, visit http://www.artlipo.com/liposuction/liposuction-body-areas/lipo-abdomen.html.