Rhode Island Hospital's outpatient dialysis program cares for patients with chronic kidney disease. Learn more about the program, which includes a new, state of the art dialysis center in East Providence. http://www.rhodeislandhospital.....org/outpatient-dial

Removal of large epidermoid cyst from floor of the mouth

The goal of a decompression surgery is usually to relieve pain caused by nerve root pinching. There are two common causes of lumbar nerve root pressure: from a lumbar herniated disc or lumbar spinal stenosis. This type of pain is usually referred to as a radiculopathy, or sciatica. A decompression surgery involves removing a small portion of the bone over the nerve root and/or disc material from under the nerve root to relieve pinching of the nerve and provide more room for the nerve to heal. The most common types of decompression surgery are microdiscectomy and laminectomy.

Common causes of the knee pain
Knee pain is very common and in this video we will present the most common problems that can cause pain in the knee. (Patella) itself, which is in front of the knee, or from the tendons that are attached to the kneecap (patellar tendon and quadricep tendon). One of the most common problems is patellar chondromalacia which is chronic pain due to the softening of the cartilage beneath the kneecap. The cartilage of the kneecap will have some erosions, defects, or holes from mild to complete inside the joint (exactly in the back of the kneecap).
• Pain in the front of the knee
• Occurs more in young people
• Becomes worse from climbing up stairs and going downstairs
Treatment is usually nonsteroidal anti-inflammatory medication, physical therapy, and surgery is very rare. Also in front of the kneecap, the patient may get pain due to prepatellar bursitis.
When there is prepatellar bursitis, the patient will see that the swelling, the inflammation, and the pain is located over the front of the kneecap. The bursa becomes inflamed and fills with fluid at the top of the knee, causing pain, swelling, tenderness and a lump in that area on top of the kneecap. If the pain is in front of the knee but below or above the patella, this may indicate that the patient has tendonitis. Patellar tendonitis is an overuse condition that often occurs in athletes who perform repetitive jumping activities. Patellar tendonitis is a knee pain that is associated with focal patellar tendon tenderness and it is usually activity related. It is located below the kneecap and is called "jumper's knee". Patellar tendonitis affects approximately 20% of jumping athletes. There will be tenderness to palpation at the distal pole of the patella in extension and not in flexion. Quadriceps inflexibility, atrophy and hamstring tightness are predisposing factors for this condition. Treatment is rest, anti-inflammatory medication, stretching and strengthening of the hamstrings and quadriceps. Use an eccentric exercise program. The early stages of patellar tendonitis will respond well to nonoperative treatment. Another important cause of knee pain is a meniscal tear. The meniscus is the cushion that protects the cartilage in the knee. Injury will cause pain on the medial or the lateral side of the knee exactly at the level of the joint. The patient will complain of a history of locking, instability and swelling of the knee. McMurray test will be positive. A painful pop or click is obtained as the knee is brought from flexion to extension with either internal or external rotation of the knee. Arthritis of the knee Knee arthritis is very common. The cartilage cells die with age and its repair response decreases in the joint collapses with increased breakdown of the framework of the cartilage. The patient will have progressive blurring away of the cartilage of the joint with decreased joint space as seen on x-rays. Another source of pain is the Baker's cyst. The cyst is in the back of the knee between the semimembranosus yes and the medial gastrocnemius muscles. Another important source of knee pain is a ligament injury. Here is a normal knee without a ligament injury. Here you can see from the front, you can see the lateral and medial collateral ligament. You can see the ACL and PCL from the side view. These ligaments are usually injured as a result of a sports activity. Here is an example of a sports knee injury. Here is an example of the medial collateral ligament injury. This is the most commonly injury knee ligament injury to this ligament is on the inner part of the knee. Here is an example of an injury of the anterior cruciate ligament. It involves a valgus stress to the knee. Lachman test is usually positive, and MRI is diagnostic. Another important cause of knee pain is iliotibial band syndrome of the knee. Inflammation of the thickening of the iliotibial band results from excessive friction as the iliotibial band slides over the lateral femoral condyle. The iliotibial band is a thick band of fascia that extends along the lateral thigh from the iliac crest to the knee. And as the knee moves, the IT band was repeatedly shifted forwards and backwards across the lateral femoral condyle. The patient will complain of swelling, tenderness, and crepitus over the lateral femoral condyle. The condition occurs in the ITB S occurs in runners, cyclist and athletes that require repeated knee flexion and extension. The pain may be reproduced by doing a single-leg squat. The Ober's test is used to at assess tightness of the iliotibial band. MRI may show edema in the area of the ITB. Treatment is usually nonoperative with rest and ice, physical therapy, with stretching, proprioception, and improvement in neuromuscular coordination. Training modification and injections may be helpful. Surgery is a last resort. Surgical excision of the scarred inflamed part of the iliotibial band.

A very funny video showing the other non-bright side of being a doctor

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Dont worry sister!

Colon polyp facts Colon polyps are growths on the inner lining of the colon and are very common. Colon polyps are important because they may be, or may become malignant (cancerous). They also are important because based on their size, number, and microscopic anatomy (histology); they can predict which patients are more likely to develop more polyps and colon cancer. Changes in the genetic material of cells lining the colon are the cause of polyps. There are different types of colon polyps with differing tendencies to become malignant and abilities to predict the development of more polyps and cancer. It is important to recognize families with members who have familial genetic conditions causing polyps because some of these conditions are associated with a very high incidence of colon cancer, and the cancer can be prevented or discovered early.

A video showing the examination of femoral hernia.

From our beginnings in 1990 in primary healthcare, Healthway Medical has grown to become a respected medical group in Singapore. With over 100 clinics and medical centres, Healthway Medical has a wide network of medical centres and clinics in Singapore.

We offer comprehensive services including GP & family medicine clinics, health screening, adult specialists, baby & child specialists, dental services and allied healthcare services.

Renal agenesis is a condition in which a newborn is missing one or both kidneys. Unilateral renal agenesis (URA) is the absence of one kidney. Bilateral renal agenesis (BRA) is the absence of both kidneys. Both types of renal agenesis occur in fewer than 1 percent of births annually, according to the March of Dimes. Fewer than 1 in every 1,000 newborns has URA. BRA is much rarer, occurring in about 1 in every 3,000 births.

A successful cardiovascular exam includes visual examination, palpation of the apical impulse, auscultation of Erb's point, auscultation of the carotids, and auscultation over the four different heart valve locations (aortic, pulmonic, tricuspid, and mitral). Additionally, the radial pulse is palpated while auscultating to distinguish whether a murmur is diastolic or systolic.

Video Index:
0:13 - Inspection of the thorax
0:29 - Palpation of the apex heart beat
0:59 - Auscultation of the heart
1:16 - Auscultation of the Erb’s point
1:33 - Using Erb’s point to check the heart rate
1:45 - Systolic and diastolic heart sound identification
2:01 - Ascultating individual valves: aortic, pulmonary, tricuspid, mitral
2:41 - Ascultation of the carotids
2:54 - Ascultating the pulmonary and aortic valves
3:04 - Ascultation of the mitral valve
3:16 - Mitral valve murmurs

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#CardiovascularExamination #AuscultationOfTheHeart #USMLE #AMBOSSMed

Are you worried about getting a sports hernia exam? In this video, we'll show you exactly what to expect when you get your hernia exam.

We'll take you through the various steps that are taken during the hernia exam, so you can have a more comfortable and informative experience. After watching this video, you'll have a better idea of what to expect and be prepared for your hernia exam!
#sportshernia #groinpain #california

In this video, we show a sports hernia self treatment we give many of our clients. It is not the only part of treatment. Grabbing the skin around the region of the groin strain can reduce pain and stiffness with turning and twisting. Sports hernias are often misdiagnosed with hip labrum tears, hip impingement, adductor tendonitis and abdominal strains.

Want more information? We have a more detailed free webinar on our page here. https://bit.ly/37thtNF

Want some treatment or suggestions of exercises or stretches? Contact us! We have in-person and virtual sessions.
Costa Mesa CA 715-502-4243 www.p2sportscare.com

Sports Hernia Diagnosis

What Is A Sports Hernia?

A sports hernia is tearing of the transversalis fascia of the lower abdominal or groin region. A common misconception is that a sports hernia is the same as a traditional hernia. The mechanism of injury is rapid twisting and change of direction within sports, such as football, basketball, soccer and hockey.

The term “sports hernia” is becoming mainstream with more professional athletes being diagnosed. The following are just to name a few:

Torii Hunter
Tom Brady
Ryan Getzlaf
Julio Jones
Jeremy Shockey
If you follow any of these professional athletes, they all seem to have the same thing in common: Lingering groin pain. If you play fantasy sports, this is a major headache since it seems so minor, but it can land a player on Injury Reserve on a moments notice. In real life, it is a very frustrating condition to say the least. It is hard to pin point, goes away with rest and comes back after activity, but is hardly painful enough to make you want to stop. It lingers and is always on your mind. And if you’re looking for my step-by-step sports hernia rehab video course here it is.

One the best definitions of Sport hernias is the following by Harmon:
The phenomena of chronic activity–related groin pain that it is unresponsive to conservative therapy and significantly improves with surgical repair.”

This is truly how sports hernias behave in a clinical setting. It is not uncommon for a sports hernia to be unrecognized for months and even years. Unlike your typical sports injury, most sports medicine offices have only seen a handful of cases. It’s just not on most doctors’ radar. The purpose of this article is not only to bring awareness about sports hernias, but also to educate.

Will you find quick fixes in this article for sports hernia rehab?
Nope. There is no quick fix for this condition, and if someone is trying to sell you one, they are blowing smoke up your you-know-what.

Is there a way to decrease the pain related to sports hernias?
Yes. Proper rehab and avoidance of activity for a certain period of time will assist greatly, but this will not always stop it from coming back. Pain is the first thing to go and last thing to come. Do not be fooled when you become pain-free by resting it. Pain is only one measure of improvement in your rehab. Strength, change of direction, balance and power (just to name a few) are important, since you obviously desire to play your sport again. If you wanted to be a couch potato, you would be feeling better in no time. Watching Sports Center doesn’t require any movement.

Why is this article so long?
There is a lot of information on sports hernias available to you on the web. However, much of the information is spread out all over the internet and hard for athletes to digest due to complicated terminology. This article lays out the foundational terminology you will need to understand what options you have with your injury. We will go over anatomy, biomechanics, rehab, surgery, and even the fun facts. The information I am using is from the last ten years of medical research, up until 2016. We will be making updates overtime when something new is found as well. So link to this page and share with friends. This is the best source for information on sports hernias you will find.

Common Names (or Aliases?) for Sports Hernias
Sportsman’s Hernia
Athletic Pubalgia
Gilmore’s Groin
How Do You Know If You Have A Sports Hernia?
Typical athlete characteristics:
Male, age mid-20s
Common sports: soccer, hockey, tennis, football, field hockey
Motions involved: cutting, pivoting, kicking and sharp turns
Gradual onset

How A Sports Hernia Develops
Chronic groin pain typically happens over time, which is why with sports hernias, we do not hear many stories of feeling a “pop” or a specific moment of injury. It is the result of “overuse” mechanics stemming from a combination of inadequate strength and endurance, lack of dynamic control, movement pattern abnormalities, and discoordination of motion in the groin area.

#sportsherniadiagnosisselftreatment #sportshernia #california

Breast reconstruction 3D Animation
on Friday, December 17, 2010




The primary part of the procedure can often be carried out immediately following the mastectomy. As with many other surgeries, patients with significant medical comorbidities (high blood pressure, obesity, diabetes) and smokers are higher-risk candidates. Surgeons may choose to perform delayed reconstruction to decrease this risk. Patients expected to receive external beam radiation as part of their adjuvant treatment are also commonly considered for delayed autologous reconstruction due to significantly higher complication rates with tissue expander-implant techniques in those patients. Breast reconstruction is a large undertaking that usually takes multiple operations. Sometimes these follow-up surgeries are spread out over weeks or months. If an implant is used, the individual runs the same risks and complications as those who use them for breast augmentation but has higher rates of capsular contracture (tightening or hardening of the scar tissue around the implant) and revisional surgeries. Outcomes based research on quality of life improvements and psychosocial benefits associated with breast reconstruction served as the stimulus in the United States for the 1998 Women's Health and Cancer Rights Act which mandated health care payer coverage for breast and nipple reconstruction, contralateral procedures to achieve symmetry, and treatment for the sequelae of mastectomy. This was followed in 2001 by additional legislation imposing penalties on noncompliant insurers. Similar provisions for coverage exist in most countries worldwide through national health care programs. There are many methods for breast reconstruction. The two most common are: * Tissue Expander - Breast implants This is the most common technique used in worldwide. The surgeon inserts a tissue expander, a temporary silastic implant, beneath a pocket under the pectoralis major muscle of the chest wall. The pectoral muscles may be released along its inferior edge to allow a larger, more supple pocket for the expander at the expense of thinner lower pole soft tissue coverage. The use of acellular human or animal dermal grafts have been described as an onlay patch to increase coverage of the implant when the pectoral muscle is released, which purports to improve both functional and aesthtic outcomes of implant-expander breast reconstruction. o In a process that can take weeks or months, saline solution is percutaneously injected to progressively expand the overlaying tissue. Once the expander has reached an acceptable size, it may be removed and replaced with a more permanent implant. Reconstruction of the areola and nipple are usually performed in a separate operation after the skin has stretched to its final size. * Flap reconstruction The second most common procedure uses tissue from other parts of the patient's body, such as the back, buttocks, thigh or abdomen. This procedure may be performed by leaving the donor tissue connected to the original site to retain its blood supply (the vessels are tunnelled beneath the skin surface to the new site) or it may be cut off and new blood supply may be connected. o The latissimus dorsi muscle flap is the donor tissue available on the back. It is a large flat muscle which can be employed without significant loss of function. It can be moved into the breast defect still attached to its blood supply under the arm pit (axilla). A latissimus flap is usually used to recruit soft-tissue coverage over an underlying implant. Enough volume can be recruited occasionally to reconstruct small breasts without an implant. o Abdominal flaps The abdominal flap for breast reconstruction is the TRAM flap or its technically distinct variants of microvascular "perforator flaps" like the DIEP/SIEP flaps. Both use the abdominal tissue between the umbilicus and the

Describe pre-procedure considerations for administering a subcutaneous injection.

Describe and demonstrate the preparation for administering a subcutaneous injection.

Describe and demonstrate needle and blood safety.

Describe and demonstrate suitable injection sites for subcutaneous injections.

Discuss the appropriate needle and syringe sizes for subcutaneous injection.

Describe and demonstrate the preparation of the substance to be injected.

Describe and demonstrate safe and correct administration of a subcutaneous injection.

Understand and apply Occupational Safety and Health Administration (OSHA) guidelines.

Understand and apply drug administration safety guidelines (seven rights).

Understand correct post-procedure considerations.

Describe and demonstrate correct documentation.

Define and demonstrate correct recording and reporting procedures.

Define and use related medical terminology.

Explain the Patient Privacy Rule (HIPAA), Patient Safety Act, and Patients' Bill of Rights.

www.simtics.com

Sports Hernia: Causes, Symptoms, and Treatments. Explained by Dr. Tayyaba Ahmed is a doctor of physical medicine and rehabilitation at Pelvic Rehabilitation Medicine.

Topics discussed include:

Description of a sports hernia

Where a sports hernia is located

How this causes pelvic pain

Symptoms that may be experienced

Where pain can radiate

Causes of a sports hernia

Treatment options and recommendations


Dr. Tayyaba Ahmed completed the BS/DO program at New York Institute of Technology and was trained at the New York College of Osteopathic Medicine, Northwell Health Plainview Hospital and the NYU Langone Medical Center/RUSK Institute for Rehabilitation. A board-certified Physical Medicine and Rehabilitation physician, Dr. Ahmed is also a fellow of the Academy of Physical Medicine and Rehabilitation and a member of the International Pelvic Pain Society. Dr. Ahmed is a contributing author to a textbook which is considered a staple during every Physiatrist’s training. The fourth edition has been published in November of 2018. This full chapter title reference is: Ahmed T, Chan I: “Pelvic Pain”, which is included in, Essentials of Physical Medicine and Rehabilitation, 4th edition by Frontera W, Silver J, Rizzo T; Elsevier, Philadelphia, In Press. After spending the last five years honing her skills in outpatient care, Dr. Ahmed is ready to focus on her passion for treating pelvic pain. Dr. Ahmed has chosen a focused practice, because she believes concentrating on a specific field creates the greatest expertise. Chasing that greatness has been her consistent driving force.

At Pelvic Rehabilitation Medicine, our pelvic pain specialists provide a functional, rehab approach to pelvic pain. When you visit one of our offices, you spend an hour with your doctor reviewing in detail your medical history and symptoms. Then, we perform an internal exam (no speculum) to evaluate your nerves and muscles. Together, we'll discuss an individual treatment plan that gets to the root cause of your pain and helps you to feel better. The best part: you can begin treatment the same day!

At PRM, our mission is to decrease the time patients are suffering from pelvic pain symptoms.

LEARN MORE: https://www.pelvicrehabilitation.com/

JOIN OUR COMMUNITY and get in on the discussions happening:

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#PelvicRehabilitationMedicine #sportshernia #pelvicpain

****

Very often, we have patients who present with abdominal tenderness which likely is a sports hernia. A sports hernia is a weakness in the soft tissue and muscle area around their pubic symphysis and their lower abdomen. This is important because these muscles are their core muscles, and the core muscles are part of your pelvic floor as well. So if you have a weakness there, you will have a weakness in your pelvic floor and thus causing the pelvic pain. Having a sports hernia can now result into pelvic pain because of their weakness in their abdominal muscles and their core. Then patients may present with pain in their groin, they may present with pain going down their leg, pain in their hip. Pelvic pain does radiate, and it does not just stay in one location, so it can mimic other things like lower back pain.

Patients with sports hernias can attribute this from being very active. Oftentimes, they are athletes or have active lifestyles. We're evaluating their lumbar spine, we're evaluating their hips, we're evaluating their abdomen and checking to see if they could have a potential hernia. When patients have sports hernias, we also have to treat the underlying pelvic floor dysfunction that they may have.

Typically, we do that with pelvic floor physical therapists, possibly some Valium suppositories, maybe a nerve medication for any neurogenic inflammation, if they need, we may do hydrodissection nerve blocks and trigger point injections to their pelvic floor. And at the same time, we're hopefully working with a hernia surgeon to evaluate if there is a need for repair of the sports hernia. When patients present with pelvic pain, we're trying to understand where their pelvic pain is coming from and why they have it. Until we figure out what's causing the issue, the pain won't resolve.

The products of a surgical abortion.

The following guidelines are an interpretation of the evidence presented in the 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations1). They apply primarily to newly born infants undergoing transition from intrauterine to extrauterine life, but the recommendations are also applicable to neonates who have completed perinatal transition and require resuscitation during the first few weeks to months following birth. Practitioners who resuscitate infants at birth or at any time during the initial hospital admission should consider following these guidelines. For the purposes of these guidelines, the terms newborn and neonate are intended to apply to any infant during the initial hospitalization. The term newly born is intended to apply specifically to an infant at the time of birth.

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