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We are looking for 5 patients with knee pain who want to get significantly better in the next 30 days. Click this link to let me know you're interested and learn more.

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If you suffer a knee injury, what do you do about it? Should you be concerned? On one hand, you could give it a few days to see if it gets better on its own. How can you know if you risk making the problem worse? In this Ask Dr. Geier video, I offer four signs you have a serious knee injury that could require surgery.

Please note: I don't respond to questions and requests for specific medical advice left in the comments to my videos. I receive too many to keep up (several hundred per week), and legally I can't offer specific medical advice to people who aren't my patients (see below). If you want to ask a question about a specific injury you have, leave it in the comments below, and I might answer it in an upcoming Ask Dr. Geier video. If you need more detailed information on your injury, go to my Resources page: https://www.drdavidgeier.com/resources/

The content of this YouTube Channel, https://www.youtube.com/user/drdavidgeier (“Channel”) is for INFORMATIONAL PURPOSES ONLY. The Channel may offer health, fitness, nutritional and other such information, but such information is intended for educational and informational purposes only. This content should not be used to self-diagnose or self-treat any health, medical, or physical condition. The content does not and is not intended to convey medical advice and does not constitute the practice of medicine. YOU SHOULD NOT RELY ON THIS INFORMATION AS A SUBSTITUTE FOR, NOR DOES IT REPLACE, PROFESSIONAL MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT. You should consult with your healthcare professional before doing anything contained on this Channel. You agree that Dr. Geier is not responsible for any actions or inaction on your part based on the information that is presented on the Channel. Dr. David Geier Enterprises, LLC makes no representations about the accuracy or suitability of the content. USE OF THE CONTENT IS AT YOUR OWN RISK.

SWELLING
If you have a knee that is much more swollen than the opposite knee, especially if the swelling developed soon after you got hurt, then it could be a sign of structural damage. While a small amount of swelling could be normal or a sign of inflammation in the knee, a knee that is really swollen and much larger than the other knee could represent a fracture, torn ACL or other ligament or some other damaged structure.

INABILITY TO FULLY STRAIGHTEN YOUR KNEE
Pain can make it difficult for you to straighten your knee. But being unable to get your knee completely flat can be a sign of an injury like an ACL tear or meniscus tear.

LOCKING OF THE KNEE
Locking is a term orthopedic surgeons use to describe a knee that gets stuck in a certain position. Maybe you can straighten it to a certain point, but it gets stuck around 30 degrees short of fully straight. Or you can’t bend it past a certain point because something inside the knee is blocking it. Catching is a milder form of the same problem, where you can get to the point that the motion stops, but you can twist or rotate your knee past that point.

BUCKLING OR GIVING WAY
Having the tibia (shin bone) shift out from under the femur (thigh bone) usually represents an ACL injury. If your knee buckled during the traumatic injury and keeps happening in the days after the injury, you risk doing more damage to the other structures inside the knee.

This list is not comprehensive, so if you are concerned about your knee injury or knee pain, it never hurts to see your doctor or an orthopedic surgeon.

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NG (Nasogastric) Tube Insertion Techniques (Nursing Skills)

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NG (Nasogastric) Tube Insertion Techniques (Nursing Skills)

In this video we’re going to show you the correct technique for insertion of an NG tube or Nasogastric tube). We’ll also give you a few tips and tricks we use. Of course, before you get started, make sure you’ve determined which nare is more patent and that the patient doesn’t have a deviated septum. Before you start, lay a towel across the patient’s chest – I’m telling you I’ve had patients throw up on me – this step is WORTH IT!! We love you guys! Go out and be your best selves today! And, as always, happy nursing!

Bookmarks:
0.05 Introduction to NG Tube Insertion techniques
0.25 Towel placement
0.32 Measuring NG tube length
1.04 Tape preparation
1.27 Give patient water
1.34 NG Tube lubrication
1.42 NG Tube insertion technique
2.25 Securing the NG tube
2.36 Checking placement/ aspiration
2.55 Assessing pH
3.08 Confirming placement
3.22 Waiting for abdominal X-ray
3.35 Supply clean-up
3.48 NG Tube insertion outro

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Choosing to travel abroad for cosmetic surgery can feel overwhelming, but the right guidance can make it safe, simple, and stress-free. Online Consultation: https://drrajatgupta.com/contact-us/

In this video, we explain the complete journey for international patients who wish to come to India for aesthetic or cosmetic procedures.

With over 700 patients treated each year from over 70 countries, we share exactly what happens from the moment you contact the clinic to the day you return home after your surgery.

The process begins with connecting to the clinic’s dedicated patient coordinators who speak fluent English and guide you through every detail. You’ll learn how to send photos safely, attend a secure online consultation, and discuss your goals directly with Dr Gupta. During this virtual meeting, he explains your personalised treatment plan, estimated costs, and all details related to your surgery.
He also talks about how to plan your trip to India, including how to get a medical visa, how long to stay for recovery, and what to expect during your post-surgery care. His team even helps with safe travel advice and makes sure you feel supported every step of the way.

Transparency, safety, and personal attention matter. Every patient gets direct contact numbers for the surgeon, the nurse, and the patient coordinator, ensuring round-the-clock guidance. Whether it’s your first time travelling to India or your first surgery, this video helps you understand how the process works with complete confidence.

If you are planning a cosmetic or plastic surgery procedure in India, this video will help you prepare, plan, and make an informed decision with the right team.

You can also book an online consultation with our board-certified plastic surgeon in New Delhi for clear and transparent information.

1:55 Online Consultation everything about surgery is discussed in detail
2:35 Ask everything about surgery in consultation
4:05 Planning a surgery date
4:49 Planning your travel
5:48 Carrying your medical records
6:22 Planning travel duration

Related Video:
1- Patient Experience: https://www.youtube.com/watch?v=0CH6lXIQ6Bk&list=PLpc_Rm6_KnRi9DRLM5EF-7uUpsEMBPGKv

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after birth care for babies,a small glimpse just to let you know what happens

Scott Geller MD of Fort Myers Florida uses A LASAG Yag laser is in thermal mode, 1.5 Joules/pulse to treat the trabecular meshwork between the cornea and iris for glaucoma. The view is of the inside anterior eyeball.

Assessment of Head and Neck

Inspection of the mouth

Surgery during a Pancreatectomy. One can see the pancreas half extracted. This is Experimental Surgery, taken during a Pancreas transplantation

We herein describe endoscopic treatment of symptomatic pancreatic pseudocyst with significant necrosis and a fistula. Fifty eight year old man had presented to us with a large pseudocyst following an episode of acute pancreatitis. He was complaining of significant abdominal pain for two months. A... CT scan abdominal had revealed a large retro-gastric pseudocyst with necrosis and portal venous thrombosis. An upper GI endoscopy had revealed small linear fundal varcies. Endoscopic as well as surgical treatment for the cyst was discussed with the patient. Patient wished not to undergo surgical treatment and therefore endoscopic treatment was selected after a proper consent. EUS was performed to see for the interposed vessel prior to the pseudocyst puncture. Needle knife puncture was made and a guide wire was passed in the pseudocyst cavity. After confirming the wire placement in the cyst, the tract was dilated up to 20 mms using a CRE balloon. Fluid from the cyst was emptied out in the stomach. An ERCP scope was passed in to the cyst cavity, which revealed a significant necrotic material (much more than what the CT scan had revealed). All the free lying necrotic material was taken out with the help of a snare and a dormia basket. A lot of necrotic was stuck to the cyst wall, which was removed with the help of water jet, mechanical scooping and cutting through using a needle knife papillotome. Three 10 fr. Pigtail stents were placed at the end of the procedure. Further necrosectomy was carried out on alternate days for three more sessions. Dilation was required prior to each session three pigtail trans-gastric stents were placed at the end of each session. Single stent was kept in situ during each procedure to guide the path (the position of the stoma changed dramatically once the cyst was empty). During the last lesion (session four), a pancreatogram was taken. It revealed a mildly dilated CBD in the head, normally duct in the proximal body with a leak from the distal body, and contrast was seen going in to the pseudocyst cavity. The duct could not be opacified distally. A 7 fr. 15 cms stent was placed trans-papillary. When the cyst cavity was reentered through trans-gastric route, the trans-papillary pancreatic stent was clearly visible with soft necrotic material around it. In fact, the stent guided further necrosis removal. It also helped in diverting the pancreatic juice to the duodenum rather than in the pseudocyst cavity. Patient was discharged after this session and was followed up regularly. A CT scan was obtained after three months, which revealed a complete resolution of the necrosis and pseudocyst. There was a possibility of a persistent fistula after the removal of trans-papillary stent and a recurrence of the pseudocyst. Fistula closure with cyanoacrylate glue is well described in the literature. The procedure can have obvious complications secondary to accidental blockage of the main pancreatic duct. So, we thought it prudent to use a safer alternative to treat the condition. We removed the longer pancreatic stent and replaced it with a shorter pancreatic stent occupying only the head region. The patient was followed up after a month; sonography of the abdomen did not reveal any recurrence of the pseudocyst. All the stents were removed at this examination.

Pancreatic pseudocyst drainage was the first therapeutic application of EUS. The cyst is punctured under ultrasound guidance, contrast injected, and a guidewire inserted. Initial dilation to 8mm is performed over the wire The EUS scope is then exchanged over the wire for a forward viewing endoscope.... A second dilation to 18mm is performed. This enables entry of the endoscope into the cyst perform cystoscopy, debridement if necessary, and insertion of multiple large bore double pigtail stents. The curved linear array-or CLA—echoendoscope has oblique viewing optics located proximal to an oblique scanning transducer. The accessory exits from the shaft of the echoendoscope at an ablique angle, adjustable between 15 and 30 degrees. There are several technical limitations using this echoendoscope. The oblique angle of exit results in a weekend transfer of force when advancing the accessory, difficult deployment of larger bore accessories, and in instrument tunneling effect relative to the bowel wall. There is the potential loss of access during endoscope exchange. A novel CLA echoendoscope was developed by the Olympus Corporation that shifts the orientation of endoscopic and ultrasound views from oblique to forward viewing. The channel is therapeutic at 3.7mm Note that the working channel is located adjacent to the ultrasound transducer at the endoscope tip. The accessory exits the working channel in the axis of the shaft. Shown here are balloon inflation and deployment of a Dormia basket. We report on the use of the prototype forward viewing echoendoscope in six consecutive patients who were referred for pancreatic cyst drainage. Here you see endoscopic view-indistinguisable from that of a gastroscope-showing a bulge where the cyst impinges against the posterior gastric wall. Power Doppler is switched on and highlights multiple vessels interposed in the wall This allows selection of a safe vessel-free window for a cyst puncture A 19 G needle is advanced into the cyst lumen. A sample of contents is aspirated for fluid analysis. A guidewire under ultrasound guidance into the cyst. An 18mm balloon is coaxially thread over the wire and advanced across the cyst wall, Note that resistance is encountered, but the forward transfer of force overcome this. The dilation is performed under forward viewing endoscopuc and ultrasound guidance. As the balloon is maximally inflated we see the cystgastrostomy open up. The balloon is then deflated while simultaneously advancing the scope into the cyst cavity. Cystoscopy isnow performed showing the cyst contents to be filled with pasty wall-adherent necroses. Pulsed power Doppler is switched on we can see and hear arterial flow vessels within the wall of the cyst. This identifies sensitive areas at bleeding risk when performing debridement In this case vigorous water jet irrigation is performed through an accessory water irrigation channel built into the echoendoscope. This issued to clear nonadherent debris. Our experience has shown that it is not necessary to actively remove wall-adherent debris using extraction tools as such Dormia or Roth net basket to achieve cyst resolution. Three large bore 10 Fr double pigtail stents are now inserted into the cyst under direct endoscopic guidance. The first stent is delivered over a guide catheter. The second stent. And the third stent All three stents are deployed. Finally, a nasocystic catheter is inserted for maintenance irrigation. In another patient we used the Cook Cystome to perform cystgastrostomy. We have found the Cystotome easy to delivery through the forward viewing echoendoscope. As shown, we advance the Cystotome into the cyst while applying diathermy. This is performed under and endoscopic guidance, entering the cyst at a near perpendicular orientation. After entry, the Cystotome is removed and cyst fluid gushes from the cystagastrotomy site.

On screening colonoscopy, this abnormality was encountered in the cecum. This round worm is Ascaris Lumbricoides, one of the most common human parasites in the world. When ingested, the durable Ascaris eggs hatch in the small intestine releasing larva that migrate through the intestinal wall, and t...ravel both hematogenously and lymphatically to the heart and lungs. Over the next several days, the larva mature in the alveoli, then migrate up the trachea to be swallowed back into the gastrointestinal tract. These larva will then mature in the small bowel; adults couples will succeed in producing an extraordinary number of eggs, over 200,000 ova per day. The adults live one to two years. The majority of Ascaris infections are as in this example asymptomatic. Symptoms are a consequence of either the immunologic hypersensitivity of the host to the worm as in the pulmonary stage referred as Loffler's syndrome or to mechanical obstruction of lumen by the worm. Heavy worm burden can result in intestinal obstruction and migrating worms can cause pancreatitis and/or cholangitis when involving the pancreatobiliary tree. Multiple medical therapies are approved for its treatment including mebendazole. Epidemiologically, infections are most common in areas of lower socio-economic conditions. This man manages a pig farm in China that is used to test pharmaceutical agents. From an endoscopic standpoint it is noteworthy that the worms do not like light and will move away fro the attention it is receiving. In this example, the endoscopist was too slow to snare his prey which succeeded in escaping temporarily into the cooler and darker confines of the small bowel out of reach of the endoscope but not from the soon to be consumed anti-helminthic therapy.

Access to processes within the skull base with lateral extension to the pterygopalatine fossa are reached by combined subfrontal osteotomy and Le Fort I osteotomy

We will present technique of lifting a corneal flap, 10 months post IntraLASIK surgery, after epithelial nest. The nest changed in size and started to grow. The technique is minimal invasive and included partial flap lifting.

Animated video on sinusitis

Spinal Fusion operation