Anorectal malformations are defects that occur during the fifth to seventh weeks of fetal development. With these defects, the anus (opening at the end of the large intestine through which stool passes) and the rectum (area of the large intestine just above the anus) do not develop properly

Doctors at the Mayo Clinic used 3D-printed models to prepare for their first-ever face transplant.

Constipation is a common problem. It means either going to the toilet less often than usual to empty the bowels, or passing hard or painful stools (faeces). Constipation may be caused by not eating enough fibre, or not drinking enough fluids. It can also be a side-effect of certain medicines, or related to an underlying medical condition. In many cases, the cause is not clear. Laxatives are a group of medicines that can treat constipation. Ideally, laxatives should only be used for short periods of time until symptoms ease. Note: there is a separate leaflet on constipation in children. What is constipation? Constipation is common. If you are constipated it causes one or more of the following: Stools (faeces) become hard and difficult or painful to pass. The time between toilet trips increases compared with your usual pattern. (Note: there is a large range of normal bowel habit. Some people normally go to the toilet to pass stools 2-3 times per day. For others, 2-3 times per week is normal. It is a change from your usual pattern that may mean that you are constipated.) Sometimes, crampy pains occur in the lower part of your tummy (abdomen) You may also feel bloated and feel sick if you have severe constipation. What are the causes of constipation? Known causes include the following: Not eating enough fibre (roughage) is a common cause. The average person in the UK eats about 12 g of fibre each day. But, 18 g per day is recommended by the British Nutrition Foundation. Fibre is the part of plant food that is not digested. It remains in your gut. It adds bulk to the stools (faeces) and helps your bowels to work well. Foods high in fibre include fruit, vegetables, cereals and wholemeal bread. Not drinking much may make constipation worse. Stools are usually soft and easily passed if you eat enough fibre and drink enough fluid. However, some people need more fibre and/or fluid than others in order to avoid constipation. Some special slimming diets are low in fibre and may cause constipation. Some medicines can cause constipation as a side-effect. Examples are painkillers (particularly those with codeine, such as co-codamol, or very strong painkillers, such as morphine), some antacids, some antidepressants (including amitriptyline) and iron tablets; however, there are many others. See the list of possible side-effects on the leaflet that comes with any medicine that you may be taking. Tell a doctor if you suspect a medicine is making you constipated. A change of medication may be possible. Various medical conditions can cause constipation. For example, an underactive thyroid gland, irritable bowel syndrome, some gut disorders and conditions that cause poor mobility, particularly in the elderly. Pregnancy. About 1 in 5 pregnant women will become constipated. It is due to the hormonal changes of pregnancy that slow down the gut movements. In later pregnancy, it can simply be due to the baby taking up a lot of room in the tummy and the bowels being pushed to one side.

arteriovenous hemodialysis access has been the "gold standard" for patients needing hemodialysis for the past 30 years. Despite the reported advantages of autologous access, the availability of prosthetic graft material, coupled with the challenging dialysis candidate, has led to a trend of primary prosthetic graft dialysis access in the 1980s and 1990s. In recognition of this unfortunate trend, the National Kidney Foundation Dialysis Outcomes Quality Initiative (DOQI) used evidence from published studies and summary articles to generate clinical practice guidelines, emphasizing a shift back to autologous arteriovenous fistula (AVF) as the key to long-term successful hemodialysis.[1,2] These initial guidelines proposed a goal of 50% autologous AVF as the initial access, with a 40% prevalence of autologous access for a given practice or unit.

A surgical video showing Femoro-Popliteal Bypass with a Saphenous Vein Graft

Possible complications could include: Difficulty healing. Infection. Stump pain (severe pain in the remaining tissue) Phantom limb pain (a painful sensation that the foot or toe is still there) Continued spread of gangrene, requiring amputation of more areas of your foot, toes or leg. Bleeding. Nerve damage.

Care must be taken to prevent stenosis at the anastomotic site. If the diameter of the anastomosis is less than 2 cm, the anastomosis should be taken down and resected. A classic end-to-end anastomosis should be performed to ensure adequate diameter to the intestine. If the posterior wall of the colon has been preserved, care should be taken to close the colostomy prior to opening the peritoneal cavity. This will reduce intraperitoneal contamination from the stoma site. Copious irrigation of the wound should be made prior to primary closure. If gross contamination has occurred, delayed closure of the wound should be considered.

Bone tumors include abnormal healing of an injury, inherited conditions, radiation therapy. It can also be caused by bone cancer or another cancer that has spread to the bone from other parts of the body. A bone tumor may cause a painless mass. Some people have dull, aching pain. And in some cases, minor injury causes a fracture near the tumor. Treatments include surgery and radiation. Some noncancerous tumors go away without treatment

Not every woman undergoes a traditional vaginal delivery with the birth of her child. Under conditions of fetal or maternal distress, or in the case of breech presentation (when a baby is turned feet first at the time of delivery), or if the woman’s first baby was born by cesarean delivery, a procedure called a cesarean section may be required. During a cesarean, a doctor will make either a lateral incision in the skin just above the pubic hair line, or a vertical incision below the navel. As the incision is made, blood vessels are cauterized to slow bleeding. After cutting through the skin, fat, and muscle of the abdomen, the membrane that covers the internal organs is opened, exposing the bladder and uterus. At this time the physician will generally insert his or her hands into the pelvis in order to determine the position of the baby and the placenta. Next, an incision is made into the uterus and any remaining fluids are suctioned from the uterus. The doctor then enlarges the incision with his or her fingers. The baby’s head is then grasped and gently pulled with the rest of its body from the mother’s uterus. Finally, the abdominal layers are sewn together in the reverse order that they were cut. The mother is allowed to recover for approximately three to five days in the hospital. She will also be quite sore and restricted from activity for the following several weeks. There are several potential complications associated with this procedure that should be discussed with a doctor prior to surgery.

This video show the steps in a total parotidectomy with VII nerve preservation. The patient had a malignant parotid tumor without VII nerve compromise.

Intrauterine insemination (IUI) is a fertility treatment that involves placing sperm inside a woman's uterus to facilitate fertilization. The goal of IUI is to increase the number of sperm that reach the fallopian tubes and subsequently increase the chance of fertilization.

Gastroesophageal reflux disease (GERD) is a chronic digestive disease. GERD occurs when stomach acid or, occasionally, stomach content, flows back into your food pipe (esophagus). The backwash (reflux) irritates the lining of your esophagus and causes GERD. Both acid reflux and heartburn are common digestive conditions that many people experience from time to time. When these signs and symptoms occur at least twice each week or interfere with your daily life, or when your doctor can see damage to your esophagus, you may be diagnosed with GERD. Most people can manage the discomfort of GERD with lifestyle changes and over-the-counter medications. But some people with GERD may need stronger medications, or even surgery, to reduce symptoms.

Hand hygiene for healthcare workers: Learn how to perform hand washing with soap and water (nursing procedures).

There are two ways to perform hand hygiene as a nurse. You can use soap and water or an alcohol-based hand rub (also called hand sanitizer or hand gel).

Hand hygiene is essential for providing safe patient care. If hand hygiene is not performed regularly, germs can be easily be spread to patients, other healthcare workers, and even yourself.

Hand hygiene is ALWAYS performed before and after patient care, after coming into contact with any type of body fluid or open wounds, when touching any object that is near a patient (hand railing, bedside table etc.), removing gloves, prior to eating, or after using the bathroom.

This video discusses when you should use soap and water versus an alcohol-based hand gel, when to perform hand hygiene, and demonstrates how to perform hand hygiene using soap and water.

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What happens when you crack your joints?

A video discussing Causes of Itching in the Vulva

This is second video to describe mediastinal structures on a Chest x-ray. Please see my website for disclaimer.

Functional endoscopic sinus surgery is a minimally invasive surgical treatment which uses nasal endoscopes to enlarge the nasal drainage pathways of the paranasal sinuses to improve sinus ventilation.

Doctors have many options to choose from, including interferon (Avonex, Betaseron, Extavia, and Rebif ), glatiramer acetate (Copaxone), mitoxantrone (Novantrone), teriflunomide (Aubagio), fingolimod (Gilenya), dimethyl fumarate (Tecfidera), and natalizumab (Tysabri).

In multiple sclerosis, the immune system attacks the protective sheath called myelin, that covers nerve fibers and causes communication problems between your brain and the rest of your body. Eventually, the disease can cause the nerves to deteriorate or become damaged.

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