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Transvenous cardiac pacing, also called endocardial pacing, is a potentially life saving intervention used primarily to correct profound bradycardia. It can be used to treat symptomatic bradycardias that do not respond to transcutaneous pacing or to drug therapy.
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At URBN Dental, we offer the best dental services and highest quality care for your gum tissue health. Proper flossing techniques prevent your gum tissue from swelling, which often occurs from food and debris catching between your teeth. A routine dental cleaning every 6 months is recommended to maintain gum tissue health. Skipping bi annual checkups and improper flossing techniques often lead to periodontal disease which usually require a dental deep cleaning to undo tissue damage.
Examination of Peripheral Vascular System - Clinical Skills OSCE Revision - Dr Gill
In this video, we demonstrate the peripheral vascular examination - a less common examination, but still vitally important, particularly amongst the older population
Starting with the examination of the hands looking for clinical signs of vascular compromise, we then check the pulses of the major arteries of the upper body - the radial, brachial and carotid arteries, before moving down to assess for an abdominal aortic aneurysm.
At this point, I feel it's a practical step to check the femoral pulses before doing the overview of the legs.
After visually assessing we must examine the major vascular areas of leg.- namely the popliteal pulses, before wrapping up around the ankle with the posterior tibial and dorsalis pedis pulses
For completeness, the cardiovascular examination is demonstrated here
https://www.youtube.com/watch?v=ECs9O5zl6XQ&t=2s
#PeripheralVascular #ClinicalSkills #DrGill
Overview
Heart bypass surgery creates a new route, called a bypass, for blood and oxygen to reach the heart.
Heart bypass surgery begins with an incision in the chest, and the breastbone is cut exposing the heart. Next, a portion of the saphenous vein, which is very large, is harvested from the inside of the leg. Pieces of this large vein are used to bypass the blocked coronary arteries, which are arteries that supply blood to the heart. The venous graft is sewn to the aorta, the main artery of the body, and to the affected coronary artery, to bypass the blocked site.
The internal mammary artery from the chest may also be used to bypass a clogged artery.
Several arteries may be bypassed depending on the condition of the heart. After the graft is created, the breastbone and chest are closed.
Hyponatremia is defined as a serum sodium of less than 135 Meq per litre and occurs in upto 22 % of hospitalised patients. The causes of hyponatremia may be understood based on the pre-existing volume status of the patient which may either be hypovolemic, euvolemic or hypervolemic hyponatremia. This presentation discusses in detail, the causes of these underlying conditions. Also mentioned are the clinical features and management options and therapeutic sodium targets in patients with hyponatremia. Drugs such as demeclocycline and vaptans (Tolvaptan, Conivaptan) are also mentioned as management options which may be used on a case to case basis. Finally, the all important targets of sodium correction over 24 hours are also mentioned, along with a practical formula for calculation of sodium deficit which is explained with an example.
A subdural hematoma is most often the result of a severe head injury. This type of subdural hematoma is among the deadliest of all head injuries. The bleeding fills the brain area very rapidly, compressing brain tissue. This often results in brain injury and may lead to death. Subdural hematomas can also occur after a minor head injury. The amount of bleeding is smaller and occurs more slowly. This type of subdural hematoma is often seen in older adults. These may go unnoticed for many days to weeks, and are called chronic subdural hematomas. With any subdural hematoma, tiny veins between the surface of the brain and its outer covering (the dura) stretch and tear, allowing blood to collect. In older adults, the veins are often already stretched because of brain shrinkage (atrophy) and are more easily injured.
If you use condoms perfectly every single time you have sex, they’re 98% effective at preventing pregnancy. But people aren’t perfect, so in real life condoms are about 85% effective — that means about 15 out of 100 people who use condoms as their only birth control method will get pregnant each year.