The term chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) has been used to identify patients with a chronically progressive or relapsing symmetric sensorimotor disorder with cytoalbuminologic dissociation and interstitial and perivascular endoneurial infiltration by lymphocytes and macrophages. It can be considered the chronic equivalent of acute inflammatory demyelinating polyradiculoneuropathy, the most common form of Guillain-Barré syndrome. Signs and symptoms CIDP typically starts insidiously and evolves slowly, in either a slowly progressive or a relapsing manner, with partial or complete recovery between recurrences; periods of worsening and improvement usually last weeks or months. Most experts consider the necessary duration of symptoms to be greater than 8 weeks for the diagnosis of CIDP to be made. Symptoms reported include the following: Preceding infection (infrequent) Initial limb weakness, both proximal and distal Sensory symptoms (eg, tingling and numbness of hands and feet) Motor symptoms (usually predominant) In about 16% of patients, a relatively acute or subacute onset of symptoms In children, usually a more precipitous onset of symptoms Symptoms of autonomic system dysfunction (eg, orthostatic dizziness) Pertinent physical findings are limited to the nervous system, except when the condition is associated with other diseases. Such findings may include the following. Signs of cranial nerve (CN) involvement (eg, facial muscle paralysis or diplopia) Gait abnormalities Motor deficits (eg, symmetric weakness of both proximal and distal muscles in upper and lower extremities) Diminished or absent deep tendon reflexes Sensory deficits (typically in stocking-glove distribution) Impaired coordination See Clinical Presentation for more detail. Diagnosis Laboratory studies that may be helpful include the following: Cerebrospinal fluid analysis: Elevated protein levels are common (80% of patients); 10% of patients also have mild lymphocytic pleocytosis and increased gamma globulin Complete blood count (CBC), erythrocyte sedimentation rate (ESR), antinuclear antibody (ANA) level, biochemistry profile, and serum and urine immunoelectrophoresis (to exclude associated systemic disorders) In certain instances, genetic testing Other tests and procedures that may be warranted are as follows: MRI of the spine with gadolinium enhancement Electromyography (EMG) is a critical test to determine whether the disorder is truly a peripheral neuropathy and whether the neuropathy is demyelinating Peripheral (sural) nerve biopsy (see the image below): This is considered when the diagnosis is not completely clear, when other causes cannot be excluded, or when profound axonal involvement is observed on EMG; biopsy was once commonly recommended for most patients before immunosuppressive therapy, but current guidelines no longer recommend it

a video of abdominal physical examination including all the required items:
-Inspection
-Palpation
-Percussion
-Auscultation

Pediatric surgeons at Texas Children’s Hospital West Campus perform general surgical procedures such as circumcisions, removal of foreign objects, hernia repair, and suturing of minor lacerations. While more complex surgeries take place at the Texas Children’s Main Campus, pre-operative and follow-up outpatient care for those procedures is available at the West Campus.

Everything about Texas Children’s Hospital West Campus is dedicated to the health and wellness of children. As greater Houston's first suburban hospital designed exclusively for children, we offer the expert care you've come to trust from Texas Children's Hospital coupled with a location that's convenient and accessible for area families. Our facility is located just off the westbound feeder road of the Katy Freeway (at I-10 and Barker Cypress).

For more information about Texas Children's Hospital West Campus, visit http://www.texaschildrens.org/....Locate/In-the-Commun

Meet Dr. Allen Milewicz, chief of community surgery at Texas Children's West Campus
https://www.youtube.com/watch?v=uMoCdipuKfA&index=16&list=PLiN68C9rloPBD-E9ChWhVy73h7V3SEMlm

, Liver hydatid cysts of the liver was treated with laparoscopic intervantion . The cysts was located in the eight segment of the liver.

This is a technique of correcting knock knee (genu valgum) deformity by surgery. Highligh of the technique is that the bone is not cut, but merely weakened. The advantage is that it provides accuracy to the surgeon, and rapid healing. Once corrected, the bone is held in place with a special plate (Tomofix), which permits walking with crutches the very next day.

The objective of carotid endarterectomy (CEA) is to prevent strokes. In the United States, stroke is the third leading cause of death overall and the second leading cause of death for women.[1] Among patients suffering a stroke, 50-75% had carotid artery disease that would have been amenable to surgical treatment. Several prospective randomized trials have compared the safety and efficacy of CEA with those of medical therapy in symptomatic and asymptomatic patients. Data from these prospective trials have confirmed that CEA offers better protection from ipsilateral strokes than medical therapy alone in patients presenting with either symptomatic or asymptomatic carotid artery disease.

28 years old gentleman presented with huge liver abscess in the right lobe, with repeated attempts of percutaneous aspirations in the past. He was evaluated and subjected to Laparoscopic drainage. This video depicts feasibility of laparoscopy in deep seated liver abscesses. Video created by: Dr. Juneed M. Lanker Fellow Minimal Access Surgery Apollo Hospitals Chennai.

Lumpectomy means that a focal area of cancer is going to be removed. A lot of patients with a lumpectomy don’t need any specific breast reconstruction, explains Dr. Miguel Angel Medina, Director of Microsurgery with Miami Cancer Institute.
Al the end of surgical treatment, all those patients go on to need radiation therapy. For patients who have large breasts, physicians have to take a larger lumpectomy than normal.

A subdural hematoma is a collection of blood outside the brain. Subdural hematomas are usually caused by severe head injuries. The bleeding and increased pressure on the brain from a subdural hematoma can be life-threatening.

A decade ago we thought that Chikungunya was a tropical disease restricted to the rain forests. However, after the 2007 epidemic in Italy and later in the Reunion islands, this dreaded condition has now spread to the Carribean and the Americas. Its an arthropod borne alpha virus which causes fever, polyarthralgia and arthritis. There could be serious complications in the adult such as meningoencephalitis or GBS as well as in neonates. This presentation discusses in detail the clinical features, diagnosis and management of Chikungunya fever. A detailed discussion of its complications is also included. Check out our other videos

An MRCP scan is a scan that uses magnetic resonance imaging (MRI) to produce pictures of the liver, bile ducts, gallbladder and pancreas. Note: the information below is a general guide only. The arrangements,and the way tests are performed, may vary between different hospitals.

Intramedullary nailing of the tibia with suprapatellar entry and semi-extended positioning makes it technically easier to nail the proximal and distal fractures. The purpose of this article was to describe a simple method for suprapatellar nailing (SPN). A step-by-step run through of the surgical technique is described, including positioning of the patient. There are as yet only a few clinical studies that illustrate the complications with this method, and there has been no increased frequency of intraarticular damage. Within the body of the manuscript, information is included about intraarticular damage and comments with references about anterior knee pain.

If you are a medical student, a resident, a primary care physician or you practice in an emergency department, you can improve your suture skills with this detailed instruction. As you practice towards a cosmetically perfect technique, your confidence will increase, especially when dealing with complex wounds. Areas of study include: methods of closure, closure materials, anesthetics, suture removal, infection, prophylaxis, when to call in a plastic surgeon, recapping techniques and more

A prenatal ultrasound (also called a sonogram) is a noninvasive diagnostic test that uses sound waves to create a visual image of your baby, placenta, and uterus, as well as other pelvic organs. It allows your healthcare practitioner to gather valuable information about the progress of your pregnancy and your baby's health. During the test, an ultrasound technician (sonographer) transmits high-frequency sound waves through your uterus that bounce off your baby. A computer then translates the echoing sounds into video images that reveal your baby's shape, position, and movements. (Ultrasound waves are also used in the handheld instrument called a Doppler that your practitioner uses during your prenatal visits to listen to your baby's heartbeat.) You may have an early ultrasound at your practitioner's office at 6 to 10 weeks to confirm and date the pregnancy. Or you may not have one until the standard midpregnancy ultrasound between 16 and 20 weeks. That's when you may learn your baby's sex, if you like. (The technician will probably present you with a grainy printout of the sonogram as a keepsake.) You may also have a sonogram as part of a genetic test, such as the nuchal translucency test, chorionic villus sampling, or amniocentesis, or at any other time if there are signs of a problem with your baby. You'll have more frequent ultrasounds if you have diabetes, hypertension, or other medical complications.

Patent ductus arteriosus (PDA) is a persistent opening between two major blood vessels leading from the heart. The opening, called the ductus arteriosus, is a normal part of a baby's circulatory system before birth that usually closes shortly after birth. If it remains open, however, it's called a patent ductus arteriosus. A small patent ductus arteriosus often doesn't cause problems and might never need treatment. However, a large patent ductus arteriosus left untreated can allow poorly oxygenated blood to flow in the wrong direction, weakening the heart muscle and causing heart failure and other complications. Treatment options for a patent ductus arteriosus include monitoring, medications and closure by cardiac catheterization or surgery.

The word enuresis is derived from a Greek word (enourein) that means “to void urine.” It can occur either during the day or at night (though some restrict the term to bedwetting that occurs at night). Enuresis can be divided into primary and secondary forms.

Watch that video of Bodybuilder's Colon Contains 10 lbs of Meat Worms

Knee replacement involves replacing a knee joint that has been damaged or worn away, usually by arthritis or injury. Find out more here: http://bit.ly/MAdfmE

The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Video shows a Hip resurfacing operation done using the Durom hip from Zimmer.
The patient is a young active male. Hip resurfacing is emerging as the surgical procedure of choice in young and active patients for pain relief from Hip arthritis.