Testicular sperm aspiration (TESA) is a procedure performed for men who are having sperm retrieved for in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). It is done with local anesthesia in the operating room or office and is coordinated with their female partner's egg retrieval.

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Demonstration of staple insertion and removal technique for laceration repair or wound closure in the operating room.

A rare video showing the flail chest which is traumatic condition during which the chest wall shows paradoxical movement i.e. in with expiration and out with inspiration

Tracheostomy

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Amniocentesis,before the actual procedure, a local anesthetic is sometimes given to relieve the pain when inserting the needle used to withdraw the fluid. A needle is usually inserted through the mother's abdominal wall or at the end of the vagina, and through the wall of the uterus into the amniotic sac. With assistance from ultrasound, a physician aims towards an area of the sac that is away from the fetus and extracts a small amount of amniotic fluid for testing. The puncture heals, and the amniotic sac replenishes the liquid over a day or so. After the amniotic fluid is extracted, the fetal cells are separated from it using a centrifuge, and the fetal chromosomes are examined for abnormalities. Various genetic testing may be performed, but the three most common abnormalities tested for are Down's syndrome, Trisomy 18 and spina bifida. Amniocentesis can be performed as soon as sufficient amniotic fluid surrounds the fetus to allow a sample to be recovered relatively safely, usually no earlier than the 14th week of pregnancy. Often, genetic counseling is offered in conjunction with amniocentesis.

Neurosurgeon Sujit Prabhu, M.D., discusses what happens after surgery and how a patient recovers.

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Tracheotomy and tracheostomy are surgical procedures that create an opening in the trachea (windpipe) to help patients breathe when they have difficulty doing so through the nose or mouth. Though they are similar in purpose, there are some key differences between them.

Tracheotomy is a temporary procedure that involves creating a small incision in the trachea to insert a breathing tube. The tube is typically removed once the patient no longer requires it, and the incision heals on its own. Tracheostomy, on the other hand, is a more permanent solution that involves creating a hole in the trachea and inserting a tracheostomy tube, which remains in place for an extended period.

Indications for these procedures include:

Airway obstruction due to trauma, tumors, or infection
Severe respiratory distress or failure
Prolonged mechanical ventilation
Inability to protect the airway due to neurological disorders or impaired consciousness
Steps for performing a tracheotomy and tracheostomy:

Preparation: The patient is positioned, and the neck area is cleaned and draped. Local anesthesia is often administered, although general anesthesia may be used in some cases.
Incision: A small incision is made in the neck, and the muscles and tissues are carefully separated to expose the trachea.
Tracheal opening: A small opening is made in the trachea, typically between the second and third tracheal rings.
Tube insertion: A tracheotomy tube is inserted through the incision and into the trachea for a tracheotomy, while a tracheostomy tube is inserted for a tracheostomy. Both tubes are secured in place.
Confirmation: Proper placement of the tube is confirmed by listening for breath sounds and checking for adequate ventilation.
Pre-operative care typically involves a thorough assessment of the patient's medical history, as well as any necessary imaging studies or lab tests to ensure the procedure is appropriate and safe. Informed consent should be obtained from the patient or their legal representative.

Post-operative care includes monitoring the patient's vital signs, ensuring the tube remains secure and patent, and managing any pain or discomfort. For tracheostomy patients, regular cleaning and maintenance of the stoma (the opening in the trachea) and the tracheostomy tube are essential to prevent infection and other complications. Long-term care may involve speech therapy, respiratory therapy, and support from a multidisciplinary team to address any ongoing needs.

It's crucial to remember that these procedures should only be performed by trained medical professionals in a clinical setting.



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In patients age ;::25, HPV DNA testing is the preferred next step in management if the initial cytology shows ASC-US. In this method, samples are collected for both cytology and reflex HPV DNA. If cytology results are positive, HPV DNA testing is performed. If cytology results are negative, the sample for HPV DNA is discarded. HPV DNA testing along with Pap smear at 3 years is recommended if initial cytology shows ASC-US but HPV DNA testing is negative

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