Emphysema gradually damages the air sacs (alveoli) in your lungs, making you progressively more short of breath. Emphysema is one of several diseases known collectively as chronic obstructive pulmonary disease (COPD). Smoking is the leading cause of emphysema. Your lungs' alveoli are clustered like bunches of grapes. In emphysema, the inner walls of the air sacs weaken and eventually rupture — creating one larger air space instead of many small ones. This reduces the surface area of the lungs and, in turn, the amount of oxygen that reaches your bloodstream. When you exhale, the damaged alveoli don't work properly and old air becomes trapped, leaving no room for fresh, oxygen-rich air to enter. Treatment may slow the progression of emphysema, but it can't reverse the damage.

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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This video details the layered closure of a through-and-through facial laceration

What is a brain aneurysm? A brain (cerebral) aneurysm is a bulging, weak area in the wall of an artery that supplies blood to the brain. In most cases, a brain aneurysm causes no symptoms and goes unnoticed. In rare cases, the brain aneurysm ruptures, releasing blood into the skull and causing a stroke. When a brain aneurysm ruptures, the result is called a subarachnoid hemorrhage. Depending on the severity of the hemorrhage, brain damage or death may result.

Basic well-male examination of the genitals and digital rectal exam.

Heart surgery in Thailand is world class and affordable.

Whereas it is true that no operation has been profoundly affected by the advent of laparoscopy than cholecystectomy has, it is equally true that no procedure has been more instrumental in ushering in the laparoscopic age than laparoscopic cholecystectomy has. Laparoscopic cholecystectomy has rapidly become the procedure of choice for routine gallbladder removal and is currently the most commonly performed major abdominal procedure in Western countries.[1] A National Institutes of Health consensus statement in 1992 stated that laparoscopic cholecystectomy provides a safe and effective treatment for most patients with symptomatic gallstones and has become the treatment of choice for many patients.[2] This procedure has more or less ended attempts at noninvasive management of gallstones. The initial driving force behind the rapid development of laparoscopic cholecystectomy was patient demand. Prospective randomized trials were late and largely irrelevant because advantages were clear. Hence, laparoscopic cholecystectomy was introduced and gained acceptance not through organized and carefully conceived clinical trials but through acclamation. Laparoscopic cholecystectomy decreases postoperative pain, decreases the need for postoperative analgesia, shortens the hospital stay from 1 week to less than 24 hours, and returns the patient to full activity within 1 week (compared with 1 month after open cholecystectomy).[3, 4] Laparoscopic cholecystectomy also provides improved cosmesis and improved patient satisfaction as compared with open cholecystectomy. Although direct operating room and recovery room costs are higher for laparoscopic cholecystectomy, the shortened length of hospital stay leads to a net savings. More rapid return to normal activity may lead to indirect cost savings.[5] Not all such studies have demonstrated a cost savings, however. In fact, with the higher rate of cholecystectomy in the laparoscopic era, the costs in the United States of treating gallstone disease may actually have increased. Trials have shown that laparoscopic cholecystectomy patients in outpatient settings and those in inpatient settings recover equally well, indicating that a greater proportion of patients should be offered the outpatient modality

The anatomy of the direct and indirect inguinal hernia.


Music:
Berries and Lime by Gregory David
https://www.epidemicsound.com/track/z6iCiiyCPm/

The Irish Thoracic Society speak about the importance of Exercise with Chronic or Acute Respiratory illnesses/ Diseases and respiratory distress

Pterygium excision and conjunctival autograft

When the hematocrit rises to 60 or 70%, which it often does in polycythemia, the blood viscosity can become as great as 10 times that of water, and its flow through blood vessels is greatly retarded because of increased resistance to flow. This will lead to decreased oxygen delivery.

A drill. A mallet. A robot. Go inside the operating room to see how Northwestern Medicine Orthopaedic Surgeon Linda Idris Suleiman, MD, uses these tools for a total knee replacement.

#insidetheor

The surgical procedure uses your own fat, so it is the most natural way to augment your buttocks. Over the last few years, the buttocks have received more press coverage than ever before. People of all ages and body types are having the Brazilian Butt Lift procedure.

If you are tired of dealing with glasses or squinting to read signs in the distance, then you should consider LASIK Eye Surgery. In this outpatient refractive procedure, lasers are used to correct vision issues by changing the structure of the cornea. This may entirely eliminate reliance upon glasses or contacts. In this interactive LASIK Eye Surgery, you will assist in numbing the patient’s eye and cleaning the area for the procedure. With a speculum, you will hold the eye open, mark the cornea using a water-soluble ink, then attach a suction ring to it. After that, a specialized blade device is used to cut into the corneal flap and peel it back so that the laser can clear away corneal tissue underneath. This process corrects the shape of the cornea in less than a minute before putting the corneal flap back in place. After the procedure, we will go over LASIK Eye Surgery recovery instructions. Scrub in and let’s get started!

Toxin is a protein produced by the bacterium Clostridium botulinum, and is extremely neurotoxic.

Johns Hopkins orthopaedic hip and knee surgeon, Savyasachi "Savya" Thakkar, explains how to prepare for knee replacement surgery, and what to expect before and after surgery. To learn more about our hip and knee replacement division, visit https://www.hopkinsmedicine.org/ortho. #KneeReplacement #JohnsHopkins

Q&A's
0:15 What causes someone to need a knee replacement?
0:29 What should patients do in advance of surgery?
1:10 Do you recommend physical therapy BEFORE surgery?
1:43 Will joint implants set off metal detectors at airports?

An enlarged spleen may cause: No symptoms in some cases. Pain or fullness in the left upper abdomen that may spread to the left shoulder. Feeling full without eating or after eating only a small amount from the enlarged spleen pressing on your stomach. Anemia. Fatigue. Frequent infections. Easy bleeding.

A tonsillolith lodged in the tonsillar crypt. Specialty. Otorhinolaryngology. Tonsilloliths, also known as tonsil stones, are clusters of calcified material that form in the tonsillar crypts, the crevices of the tonsils. While they occur most commonly in the palatine tonsils, they may also occur in the lingual tonsils.

External ring Invagination
Internal ring occlusion test
History Inspection Palpation
taxis
Zieman

Kidney Stone Breaking Device video, very interesting