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Asthma was originally described as an inflammatory disease that predominantly involves the central airways. Pathological and physiological evidence reported during the past few years suggests that the inflammatory process extends beyond the central airways to the peripheral airways and the lung parenchyma. The small airways are capable of producing T-helper-2 cytokines, as well as chemokines, and they have recently been recognized as a predominant site of airflow obstruction in asthmatic persons. The inflammation at this distal site has been described as more severe than large airway inflammation. These findings are of great clinical significance, and highlight the need to consider the peripheral airways as a target in any therapeutic strategy for treatment of asthma.
PARASITE REMOVED FROM THE EYEBALL OF A YOUNG N, NOT FOR THE SCREAMISH!Loa Loa worms (also known as the "eye worm") are classified as filarial worms, meaning they thrive in human tissue. The Loa Loa worm is also called the "eye worm" because they often migrate through the eye and surrounding subsurface areas. At one time, prior to the 1920s, loa loa worm infections occurred in the United States. Today, however, they mainly infect people who are native to Sudan, and those who live in or near Central and West Africa's swamps and rain forests.
Loiasis is the infestation of loa loa worms in humans. The larvae are first collected from an infected individual when a mango fly (horsefly) or a deer fly bites the individual, and acquires the larvae. The larvae then progress through the fly's body, finally reaching the feeding tube. They are then transferred to a human host when the fly bites the human. The larvae may remain unnoticed for months or years before becoming an adult, mating, and producing offspring.
Adult female Loa Loa worms can reach a length of 2 1/2 inches while males are approximately half that size. Loa Loa worms can live approximately fifteen years inside their human hosts. They travel continuously through connective and deep tissue, often without the victim experiencing any sensation other than occasional itching.
It is when the worm slows or reaches a sensitive spot that a person will often feel the greatest discomfort. At this point, immune reactions may also include localized redness and a condition called "Calabar" swelling. Skin eruptions and muscle pain may be evident.
When the Loa Loa worm reaches the eye tissue, it can be easily seen and felt within the eyeball for up to an hour. It is usually removed under local anesthesia if the patient is within proximity of a qualified physician. When an adult worm dies, the surrounding tissue may abscess and require excision. Encephalitis can occur if the worm reaches the brain.
After mating, the female will deposit eggs - called microfilariae. These tiny organisms then travel in a worm-like fashion in the bloodstream during daytime hours, when potential host flies are most abundant. They congregate in the lungs at night.
A Loa Loa worm infection is rarely fatal and treatments often cause more life-threatening side effects than the actual infestation, especially if the worms are widespread. The most common treatments are DEC (diethylcarbamazine) and Ivermectin
A blood transfusion is a routine medical procedure that can be lifesaving. During a blood transfusion, donated blood is added to your own blood. A blood transfusion may also be done to supplement various components of your blood with donated blood products. In some cases, a blood transfusion is done with blood that you've donated ahead of time before you undergo elective surgery. During a typical blood transfusion, certain parts of blood are delivered through an intravenous (IV) line that's placed in one of the veins in your arm. A blood transfusion usually takes one to four hours, though in an emergency it can be done much faster.
Initial symptoms may include: Pain or discomfort in the upper tummy (abdomen), especially after eating. Indigestion. (Note: most people who have indigestion do not have stomach cancer.) Feeling sick, and being off food. ... Weight loss and/or loss of appetite. You may pass blood out with your stools (faeces).
A 30 YEAR WOMEN WITH INTRACTABLE BILIARY COLIC CASE REPORT: This 30 year women developed severe pain right upper quadrant for last 10 days. She sought many consultations and was given intravenous analgesics both (nonnarcortic and narcotic). Pain did not subside and she sought my consultation. Examination revealed her to be in agony with severe upper abdominal pain. General physical examination was otherwise unremarkable. Abdominal examination revealed mild tenderness in right hypochondrium with doubtful Murphy's sign. Urgent abdominal ultrasound showed a linear structure in bile ducts making slow writhing movements. The structure had an anechoic tube (alimentary canal) inside suggestive of a large Ascarid. Urgent ERCP was performed and bile duct and pancreatic duct cannulated selectively. Pancreatic duct was normal. Bile ducts contained a long linear filling defect extending from lower end of common bile duct to right intrahepatic duct (see image gallery for ERCP plate). A basket was introduced in the duct (see video clip) and the linear structure was engaged with soft closure and extracted out of the bile duct. Accompanying the basket was a 25 cm thick highly motile Ascarid. To recover the worm, endoscope was withdrawn along with the basket and the friendly catch. While the endoscope was being withdrawn and the basket was in the duodenum with the worm out of bile duct, patient indicated of relief of abdominal pain. A relook cholangiogram showed no more structures in the duct. She was given antihelmintic therapy and passed hundreds of worms with the feces. The worms recovered form stools were both male and female population and varied in length and size. However the lone worm recovered form bile ducts was the longest and the thickest male worm. The phenomenal behavior of this ubiquitous infection remains unexplained. (Source Records from Dr. Khuroo's Medical Clinic. Review prepared by Mehnaaz Sultan Khuroo Host website www.drkhuroo.org , E-mail: mkhuroo@yahoo.com ).
Scoliosis is a sideways curvature of the spine that occurs most often during the growth spurt just before puberty. While scoliosis can be caused by conditions such as cerebral palsy and muscular dystrophy, the cause of most scoliosis is unknown. Most cases of scoliosis are mild, but some children develop spine deformities that continue to get more severe as they grow. Severe scoliosis can be disabling. An especially severe spinal curve can reduce the amount of space within the chest, making it difficult for the lungs to function properly. Children who have mild scoliosis are monitored closely, usually with X-rays, to see if the curve is getting worse. In many cases, no treatment is necessary. Some children will need to wear a brace to stop the curve from worsening. Others may need surgery to keep the scoliosis from worsening and to straighten severe cases of scoliosis.
Nystagmus is a condition of involuntary (or voluntary, in rare cases) eye movement, acquired in infancy or later in life, that may result in reduced or limited vision. Due to the involuntary movement of the eye, it has been called "dancing eyes"
Mohs surgery is a procedure used to remove skin cancers (most commonly basal and squamous cell carcinoma and melanoma) in a way that preserves a maximum amount of healthy tissue. It is useful for skin cancers when:
(1) the location of the cancer is near sensitive areas, like the fingers or face;
(2) earlier treatments have not worked;
(3) a skin cancer is large; and
(4) regular surgery is less likely to remove the cancer.
This procedure video illustrates the procedure on 2 patients with basal cell carcinoma. Click https://ja.ma/3b4scuY to learn more.
0:00 Disclaimer
0:07 Introduction
0:28 What this video will cover
0:43 Mohs "stage" steps
1:09 Marking surgical sites
1:27 Stage 1: skin layer resection (patient 1)
1:59 Maintaining skin layer orientation
2:55 Stage 1: processing layer onto slides (patient 1)
3:53 Stage 1: histology review for cancer (patient 1)
4:31 Discussion on wound closure
5:10 Wound closure (patient 1)
5:47 Stage 1: histology review for cancer (patient 2)
6:24 Stage 2: skin layer resection (patient 2)
6:38 Stage 2: histology review for cancer (patient 2)
6:56 Stage 3: skin layer resection (patient 2)
7:07 Stage 3: histology review for cancer (patient 2)
7:20 Wound closure (patient 2)
7:57 1-week follow-up before-and-after wound healing
Most people develop several moles (nevi) throughout adulthood. Moles can be found anywhere on the body, usually in sun-exposed areas, and are usually brown, smooth, and slightly raised. In most cases, a nevus is benign and doesn't require treatment. Rarely, they turn into melanoma or other skin cancers. A nevus that changes shape, grows bigger, or darkens should be evaluated for removal.
Surgery is an elective procedure done in people who have had extensive testing to decide if they are potential candidates. The following criteria are considered when determining if a person may be a good candidate for surgery. Person has failed adequate trials of two first-line seizure medicines (ones that are commonly effective in controlling the type of seizures the person is experiencing) and one combination of at least two drugs. A trial of a medication is considered adequate when it has been increased gradually to the maximum dosage that does not cause serious side effects. If the person has frequent seizures, any improvement will be obvious after a short time. If the seizures generally occur far apart, however, it may take months to determine whether a medication is helping. At some epilepsy centers, patients are offered additional conventional or experimental medications before surgery is considered. But research suggests that each time a trial of medication fails to control a person's seizures, it becomes less likely that a different medicine or combination will be successful. Since uncontrolled seizures present serious physical risks and social and psychological consequences, the trend these days is to proceed with surgery much sooner than in the past if it seems appropriate for that person.
She is a twenty years young female presented with large cystic swelling in anterior aspect of neck. The swelling was of size 6cmx 6cm x5 cm ,tense tender, cystic just above sternal nutch.This was diagnosed as large neck abscess ./nRepeated aspiration done but the swelling reappeared. So Incision & Drainage planned under local anaesthesia./nPatient in supine position. Surgery part painted and draped. Local anaesthesia 2% xylocaine with adrenaline used for field block.After giving local anaesthesia, I used a no 11 blade for stab incision at the most prominent part of the swelling, where skin was thin and fluctuation present./nPus drained form that opening. Little dilatation of opening to be done with artery forceps or sinus forceps. Complete pus drainage to be ensured.Little finger can be introduced inside the pus cavity to ensure proper drainage of pus. The cavity I use to clean with a gauge piece. If necessary curette biopsy can be taken from the wall of the cavity.These wounds usually need daily proper dressing for faster healing.
his patient had spilled boiling water on his lower leg a couple days before. This isn't complicated but the teaching points should focus on draining the large blistered areas and attempting to maintain moisture as long as we can so the skin doesn't contract down on itself.
The hepatic portal system is the system of veins comprising the hepatic portal vein and its tributaries. It is responsible for directing blood from the region of the gastrointestinal tract between the esophagus and rectum and also includes venous drainage from the supplementary organs such as the spleen and pancreas.
A tracheotomy or a tracheostomy: is simply an opening surgically created through the neck into the trachea (windpipe) to allow direct access to the breathing tube and is commonly done in an operating room under general anesthesia. A tube is usually placed through this opening to provide an airway and to remove secretions from the lungs. Breathing is done through the tracheostomy tube rather than through the nose and mouth. The term “tracheotomy” refers to the incision into the trachea (windpipe) that forms a temporary or permanent opening, which is called a “tracheostomy,” however; the terms are sometimes used interchangeably.
A central venous catheter (CVC), also known as a central line, central venous line, or central venous access catheter, is a catheter placed into a large vein. Catheters can be placed in veins in the neck (internal jugular vein), chest (subclavian vein or axillary vein), groin (femoral vein), or through veins in the arms (also known as a PICC line, or peripherally inserted central catheters). It is used to administer medication or fluids that are unable to be taken by mouth or would harm a smaller peripheral vein, obtain blood tests (specifically the "central venous oxygen saturation"), and measure central venous pressure.
Three to five years after gastric bypass surgery, some patients start to regain weight because the size of their stoma (the opening at the bottom of the stomach pouch) or their stomach pouch itself has increased. This can keep you from feeling full after small meals.
To resolve this problem, our surgeons use new surgical tools to create and suture folds into the pouch, reducing its volume and at the stoma to decrease its diameter. The surgeon performs the procedure entirely through the mouth -- inserting an endoscope under heavy sedation -- so there are no external incisions into the body.
Hysteroscopy is a procedure that allows your doctor to look inside your uterus in order to diagnose and treat causes of abnormal bleeding. Hysteroscopy is done using a hysteroscope, a thin, lighted tube that is inserted into the vagina to examine the cervix and inside of the uterus.