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Epidural hematoma (EDH) is a traumatic accumulation of blood between the inner table of the skull and the stripped-off dural membrane. EDH results from traumatic head injury, usually with an associated skull fracture and arterial laceration.The inciting event often is a focused blow to the head, such as that produced by a hammer or baseball bat. In 85-95% of patients, this type of trauma results in an overlying fracture of the skull. Blood vessels in close proximity to the fracture are the sources of the hemorrhage in the formation of an epidural hematoma. Because the underlying brain has usually been minimally injured, prognosis is excellent if treated aggressively. Outcome from surgical decompression and repair is related directly to patient's preoperative neurologic condition. [1]
At one time, women who had delivered by cesarean section in the past would usually have another cesarean section for any future pregnancies. The rationale was that if allowed to labor, many of these women with a scar in their uterus would rupture the uterus along the weakness of the old scar. Over time, a number of observations have become apparent: Most women with a previous cesarean section can labor and deliver vaginally without rupturing their uterus. Some women who try this will, in fact, rupture their uterus. When the uterus ruptures, the rupture may have consequences ranging from near trivial to disastrous. It can be very difficult to diagnose a uterine rupture prior to observing fetal effects (eg, bradycardia). Once fetal effects are demonstrated, even a very fast reaction and nearly immediate delivery may not lead to a good outcome. The more cesarean sections the patient has, the greater the risk of subsequent rupture during labor. The greatest risk occurs following a “classical” cesarean section (in which the uterine incision extends up into the fundus.) The least risk of rupture is among women who had a low cervical transverse incision. Low vertical incisions probably increase the risk of rupture some, but usually not as much as a classical incision. Many studies have found the use of oxytocin to be associated with an increased risk of rupture, either because of the oxytocin itself, or perhaps because of the clinical circumstances under which it would be contemplated. Pain medication, including epidural anesthetic, has not resulted greater adverse outcome because of the theoretical risk of decreasing the attendant’s ability to detect rupture early. The greatest risk of rupture occurs during labor, but some of the ruptures occur prior to the onset of labor. This is particularly true of the classical incisions. Overall successful vaginal delivery rates following previous cesarean section are in the neighborhood of 70 This means that about 30of women undergoing a vaginal trial of labor will end up requiring a cesarean section. Those who undergo cesarean section (failed VBAC) after a lengthy labor will frequently have a longer recovery and greater risk of infection than had they undergone a scheduled cesarean section without labor. Women whose first cesarean was for failure to progress in labor are only somewhat less likely to be succesful in their quest for a VBAC than those with presumably non-recurring reasons for cesarean section. For these reasons, women with a prior cesarean section are counseled about their options for delivery with a subsequent pregnancy: Repeat Cesarean Section, or Vaginal Trial of Labor. They are usually advised of the approximate 70successful VBAC rate (modified for individual risk factors). They are counseled about the risk of uterine rupture (approximately 1in most series), and that while the majority of those ruptures do not lead to bad outcome, some of them do, including fetal brain damage and death, and maternal loss of future childbearing. They are advised of the usual surgical risks of infection, bleeding, anesthesia complications and surgical injury to adjacent structures. After counseling, many obstetricians leave the decision for a repeat cesarean or VBAC to the patient. Both approaches have risks and benefits, but they are different risks and different benefits. Fortunately, most repeat cesarean sections and most vaginal trials of labor go well, without any serious complications. For those choosing a trial of labor, close monitoring of mother and baby, with early detection of labor abnormalities and preparation for
Multiple sclerosis causes many different symptoms, including vision loss, pain, fatigue, and impaired coordination. The symptoms, severity, and duration can vary from person to person. Some people may be symptom free most of their lives, while others can have severe chronic symptoms that never go away. Physical therapy and medications that suppress the immune system can help with symptoms and slow disease progression.
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.
Femoral Embolectomy. Back. All emboli of the lower extremity, including a proximal saddle embolus at the aortic bifurcation, can be removed through the common femoral artery using Fogarty catheters. By passing these through the embolus, and by inflating the small balloon, the clot can be withdrawn and the flow restored
Labia minoraplasty is an elective procedure that can reduce the size and reshape the inner vaginal lips. Large or asymmetrical labia minora can leave you feeling self-conscience in tight clothing or during intimacy. Long labia may result in rubbing, irritation or discomfort during intercourse and exercise. Certain skin conditions can cause increased sensitivity or tearing of the labia minora. In some cases, the labia minora may be fused with tissue in the labia majora and require medical correction.
A surgeon begins the PPH stapled hemorrhoidectomy by inserting a circular anal dilator and obturator into the anal canal and then securing the dilator in place with four sutures. The surgeon then inserts a PPH anoscope into the obturator. Next, he places a circumferential purse-string suture of 2-0 Monocryl on a UR-6 needle 4 cm proximal to the dentate line. The surgeon opens a PPH stapler and places its anvil across the purse string. The stapler is then closed and fired; it is held closed for two minutes to improve hemostasis. Prior to firing the stapler in a female patient, the surgeon places a gloved finger in the vagina to ensure the vaginal mucosa and rectal-vaginal septum are not trapped within the jaws of the closed stapler. The surgeon then opens and removes the stapler.
WARNING: Explicit and Educational Surgical Content.
Visage Clinic's Dr. Marc DuPéré - located in Toronto, Ontario, Canada discusses Liposuction (upper bra, back rolls, lower back rolls, love handles & abdomen) and "Tummy Tuck" (Abdominoplasty): Skin excision, muscle repair and umbilicoplasty.
For more info and to book a consultation visit www.VisageClinic.com/cosmetic-....surgery/mommy-makeov or call (416) 929-9800.
General Examination - Clinical Skills OSCE - Dr Gill
The general examination is one of those early exams, which is essentially used to start medical students off with their clinical skills studies.
In the real world, it's mainly used with regard to gaining an overview of a patient, such as for a medical check up, or a baseline examination, for example, a health report.
They have been a couple of comments about the pulse monitor used in the video. For those who are interested. I’ve reached out to the manufacturer, and they’ve requested that the following code is provided to viewers, in order to get 20% off, if they decide on themselves.
Product model number: Vibeat SP20
Official Website: https://vibeatstore.com/produc....ts/sp20-handheld-pul
Special 20% OFF code: JAMES
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Different medical schools, nursing colleges and other health professional courses will have their own preferred approach to a clinical assessment - you should concentrate on THEIR marks schemes for your assessments.
Some people watching this video may experience an ASMR effect
#DrGill #Asmr #Clinicalskills
#drgill #clinicalskills #asmr
“People need to realize this is imminently preventable,” he said. Lyme disease develops following an infection with the bacteria Borrelia burgdorferi. It's transmitted to humans through the bite of infected blacklegged ticks. The tick must be attached to its host for 36 to 48 hours to transmit the bacteria.