Laparoscopic Supracervical Hysterectomy

minimally invasive procedure is the new gold standard for hemorrhoidectomy, according to American and European experts in the field. The procedure, known as PPH (procedure for prolapse and hemorrhoids) stapled hemorrhoidectomy, combines hemorrhoidal devascularization and repositioning to return the veins to the anal canal. “This year, this is the revolutionary new procedure in the United States,” Gary Hoffman, MD, clinical faculty member in general and colorectal surgery, Cedars-Sinai Medical Center, Los Angeles, told General Surgery News after moderating a live PPH telesurgery at the 2003 annual meeting of the Society of American Gastrointestinal Endoscopic Surgeons.

The most reliable clinical sign to detect ascites is checking for bilateral flank dullness. If a patient with ascites is lying supine, fluid accumulates in the flank regions, leading to dullness on percussion. At the same time, the air-filled bowel loops are forced upwards by the free fluid due to buoyancy, resulting in tympanitic percussion. To locate specifically where dullness shifts to tympany, or the air-fluid level, percussion should be performed from the sides towards the middle. To confirm that the dullness is caused by ascites, ask the patient to switch to a lateral decubitus position. If ascites is present, the air-filled bowel loops will shift accordingly and remain at the surface of the fluid. As a result, the air-fluid level will shift as well. This is known as shifting dullness.

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Anterior vaginal wall relaxation (cystocele) is one of the most commonly diagnosed forms of pelvic organ prolapse in women. More than 200,000 cystocele repairs are completed yearly, however to date the procedures that are completed do not provide very high cure rates and/or poor anatomic outcomes. Successful treatment of anterior vaginal wall prolapse remains one of the most challenging aspects of pelvic reconstructive surgery we face. We have developed very good procedures that provide excellent support for the posterior wall (ie rectoceles) and the apex of the vagina (ie vaginal vault prolapse) and reproduce normal anatomy. We were one of the first centers in the country to utilize grafts in rectocele repairs and have seen improved cure rates to over 90% with minimal complications. It has been known for many years that abdominal sacralcolpopexy with placement of a mesh graft at the top of the vagina for vaginal vault prolapse is the most successful procedure in the literature. We have made advancements with this procedure as well in being able to offer our patients a laparoscopic minimally invasive approach for sacralcolpopexy, with the same excellent cure rates (>92%) and with hospital stays typically less than 24 hours and reduced complications. However the anterior wall has been one of the most difficult compartments in the vagina to get good anatomic results and high cure rates with traditional repairs and at the same time not cause sexual dysfunction, pain with intercourse, voiding dysfunction (ie incontinence or urgency/frequency syndrome), or a shortened or scarred down vagina. The transobturator approach was developed as a less invasive way to place an anterior wall graft (see below) however this still involved blind needle passes and the graft did not support the apex of the vagina, therefore the search for improvements in these procedures is ongoing.

Watch that video to know How to Give Intramuscular Injection

Subcutaneous Injection

Rotationplasty is a type of autograft wherein a portion of a limb is removed, while the remaining limb below the involved portion is rotated and reattached. This procedure is used when a portion of an extremity is injured or involved with a disease, such as cancer. Typically, the ankle joint becomes the knee joint.

The venipuncture procedure is complex, requiring both knowledge and skill to perform. Each phlebotomist generally establishes a routine that is comfortable for her or him. Several essential steps are required for every successful collection procedure: Identify the patient. Assess the patient's physical disposition (i.e. diet, exercise, stress, basal state). Check the requisition form for requested tests, patient information, and any special requirements. Select a suitable site for venipuncture. Prepare the equipment, the patient and the puncture site. Perform the venipuncture. Collect the sample in the appropriate container. Recognize complications associated with the phlebotomy procedure. Assess the need for sample recollection and/or rejection. Label the collection tubes at the bedside or drawing area. Promptly send the specimens with the requisition to the laboratory.

Cellulitis (sel-u-LIE-tis) is a common, potentially serious bacterial skin infection. Cellulitis appears as a swollen, red area of skin that feels hot and tender. It can spread rapidly to other parts of the body. Cellulitis isn't usually spread from person to person. Skin on lower legs is most commonly affected, though cellulitis can occur anywhere on your body or face. Cellulitis might affect only your skin's surface. Or it might also affect tissues underlying your skin and can spread to your lymph nodes and bloodstream. Left untreated, the spreading infection can rapidly turn life-threatening. It's important to seek immediate medical attention if cellulitis symptoms occur.

ACE Inhibitor Mechanisms. Angiotensin converting enzyme (ACE) inhibitors are agents used to relax blood vessels and lower blood pressure. They prevent an enzyme from producing angiotensin II, which narrows blood vessels and raises blood pressure, meaning the heart has to work harder to pump blood around the body.

Elbow Exam - Orthopaedic OSCE - Clinical Skills - Dr Gill

The elbow examination is a core skill - in this video, we demonstrate how to perform an elbow EXAM for an Orthopaedic Clinical Skills OSCE, which should be one of the more accessible examination stations for medical students.

For a passing grade in your Clinical Skills OSCE, an elbow assessment should follow the LOOK, FEEL, MOVE approach

Initially looking for erythema, scars, swelling and position

Palpating the elbow - specifically the olecranon, medial and lateral epicondyles, and radial head for heat, oedema and crepitus

Finally assess range of movement with flexion and extension at the elbow, before determining for tennis and golfers' elbows

Watch further orthopaedic examinations for your OSCE revision:

The Elbow - Deep Dive
https://youtu.be/SX5buhtCVDw

The Spine Examination:
https://youtu.be/pJxMHa6SCgU

The Knee examination
https://youtu.be/oyKH4EYfJDM

The Hip examination
https://youtu.be/JC9GKq5nSdQ

The GALS examination
https://youtu.be/5qJaf7gW-B0 - Gait, Arms, Legs, Spine - GALS screen

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Please note that there is no ABSOLUTE way to perform a clinical examination. Different institutions and even clinicians will have differing degrees of variations - the aim is the effectively identify medically relevant signs.

However during OSCE assessments. 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.

The examination demonstrated here is derived from Macleods Clinical Examination - a recognised standard textbook for clinical skills.

Some people viewing this medical examination video may experience an ASMR effect

#clinicalskills #Elbow #DrGill

This is an example of a surgery to fix a femur (thigh bone) fracture utilizing an intramedullary nail. This is a minimally invasive way of fixing this surgical problem and allows for immediate range of motion and full weight-bearing.

A hematoma is a common complication of surgical procedures. A large, expanding hematoma can result in necrosis of the overlying skin (1,2) or adjacent subcutaneous fat, increased incidence of infection, scarring, skin hyperpigmentation, tissue edema and a prolonged convalescence.

Video is an excellent introduction to Hysterosalpingography and summarizes different pathologies. While the information on this presentation is about health care issues, it is not medical advice. People seeking specific medical advice or assistance should contact their personal physician. Although we believe the information in this presentation to be accurate and timely, because of the rapid advances in health care and our reliance on information provided by outside sources, we make no warranty or guarantee concerning the accuracy or reliability of the content or other material which we may reference. When clinical matters are discussed, the opinions presented are those of the discussants only. The material discussed on the presentation is not intended to present the only or necessarily the best method or procedure, but rather presents the approach or opinion of the discussant. This presentation is provided in an “as is” format without warranties of any kind, expressed or implied, including but not limited to warranties of title, non-infringement or implied warranties of merchantability or fitness for a particular purpose.

Large Leg Abscess

Mysterious massage from East Asia(CHINA).it can cure cure Erectile dysfunction,can let their life better.This video from mainland of China,so the language is Chinese mandarin.but you can see English show on the video too.Tiedang gong means kongfu of Iron penis&balls.

Detroit TV meteorologist Jessica Starr posted a heart-wrenching video on social media a month before dying by suicide this week. She had told viewers she was struggling in the aftermath of undergoing Lasik surgery. After learning of her death, her heartbroken colleagues on WJBK fought back tears live on TV. Twelve people have died by suicide after suffering pain and even blindness after the operation. Inside Edition also spoke to a doctor who wants the surgery banned. #InsideEdition

White stretch marks are unsightly marks that are found along the thighs, abdomen and upper arms. These are marks that could be due to a recent weight loss, trauma or pregnancy. Stretch marks can affect your confidence if you wear revealing outfits and so you should do all you can to remove them.

Dr. James Wall performs a bilateral inguinial hernia repair surgical procedure.

Featured:
James Wall, MD
Assistant Professor of Surgery, Pediatric Surgery
Assistant Professor of Bioengineering (By Courtesy)
Lucile Salter Packard Children's Hospital

Micaela Esquivel, MD
Chief Resident of General Surgery

The Spirotome belongs to the Direct & Frontal type of biopsy systems for taking large core biopsy from virtually every soft tissue in the body. The FDA has approved 13 applications. This video shows how easy it is to take a large core from a thoracic wall tumor mass. The size and quality of the sample allows quantitative molecular biology.