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A colonoscope is the special tool used to perform a colonoscopy. It is a thin, flexible, tubular ‘telescope’ with a light and video camera that your doctor carefully guides through your colon in order to see and determine the health of your colon. Watch this animation to learn about the features of the colonoscope, how the colonoscopy procedure is performed and how polyps are removed, and the follow-up care you and your doctor should talk about after your procedure.
Leopold's Maneuvers are difficult to perform on obese women and women who have hydramnios. The palpation can sometimes be uncomfortable for the woman if care is not taken to ensure she is relaxed and adequately positioned. To aid in this, the health care provider should first ensure that the woman has recently emptied her bladder. If she has not, she may need to have a straight urinary catheter inserted to empy it if she is unable to micturate herself. The woman should lie on her back with her shoulders raised slightly on a pillow and her knees drawn up a little. Her abdomen should be uncovered, and most women appreciate it if the individual performing the maneuver warms their hands prior to palpation. First maneuver: Fundal Grip While facing the woman, palpate the woman's upper abdomen with both hands. A professional can often determine the size, consistency, shape, and mobility of the form that is felt. The fetal head is hard, firm, round, and moves independently of the trunk while the buttocks feel softer, are symmetric, and the shoulders and limbs have small bony processes; unlike the head, they move with the trunk. Second maneuver After the upper abdomen has been palpated and the form that is found is identified, the individual performing the maneuver attempts to determine the location of the fetal back. Still facing the woman, the health care provider palpates the abdomen with gentle but also deep pressure using the palm of the hands. First the right hand remains steady on one side of the abdomen while the left hand explores the right side of the woman's uterus. This is then repeated using the opposite side and hands. The fetal back will feel firm and smooth while fetal extremities (arms, legs, etc.) should feel like small irregularities and protrusions. The fetal back, once determined, should connect with the form found in the upper abdomen and also a mass in the maternal inlet, lower abdomen. Third maneuver: Pawlick's Grip In the third maneuver the health care provider attempts to determine what fetal part is lying above the inlet, or lower abdomen.[2] The individual performing the maneuver first grasps the lower portion of the abdomen just above the symphysis pubis with the thumb and fingers of the right hand. This maneuver should yield the opposite information and validate the findings of the first maneuver. If the woman enters labor, this is the part which will most likely come first in a vaginal birth. If it is the head and is not actively engaged in the birthing process, it may be gently pushed back and forth. The Pawlick's Grip, although still used by some obstetricians, is not recommended as it is more uncomfortable for the woman. Instead, a two-handed approach is favored by placing the fingers of both hands laterally on either side of the presenting part. Fourth maneuver The last maneuver requires that the health care provider face the woman's feet, as he or she will attempt to locate the fetus' brow. The fingers of both hands are moved gently down the sides of the uterus toward the pubis. The side where there is resistance to the descent of the fingers toward the pubis is greatest is where the brow is located. If the head of the fetus is well-flexed, it should be on the opposite side from the fetal back. If the fetal head is extended though, the occiput is instead felt and is located on the same side as the back. Cautions Leopold's maneuvers are intended to be performed by health care professionals, as they have received the training and instruction in how to perform them. That said, as long as care taken not to roughly or excessively disturb the fetus, there is no real reason it cannot be performed at home as an informational exercise. It is important to note that all findings are not truly diagnostic, and as such ultrasound is required to conclusively determine the fetal position.
Visit http://www.nasalcleanse.com/index.html after watching our video on nasal irrigation as a natural sinus infection remedy. Learn how & why this natural sinus remedy really works! Unlike the messy, old-fashioned neti pot or competitors with badly-designed, backflow-prone squeeze bottles that can cause sinus infection, NasalCare’s patented NasalCare® Nasal Rinse System ensures comfortable and effective delivery throughout the nasal passages, preventing sinus infection, allergy and post nasal drip. A soothing mix of sea salt and Aloe Vera extract washes away nasal irritants and the common causes of colds and flu while providing nasal congestion relief via our nasal wash. NasalCare also acts as a sinus rinse for allergy treatment. Though used for centuries in the Orient as a natural remedy and preventative measure for all sinus conditions, nasal irrigation is just catching on here. Catch us now and stop catching colds and the flu! Learn more at: http://www.nasalcleanse.com/index.html.
Acute aortic dissection can be treated surgically or medically. In surgical treatment, the area of the aorta with the intimal tear is usually resected and replaced with a Dacron graft. Emergency surgical correction is the preferred treatment for Stanford type A (DeBakey type I and II) ascending aortic dissection. It is also preferred for complicated Stanford type B (DeBakey type III) aortic dissections with clinical or radiologic evidence of the following conditions: Propagation (increasing aortic diameter) Increasing size of hematoma Compromise of major branches of the aorta Impending rupture Persistent pain despite adequate pain management Bleeding into the pleural cavity Development of saccular aneurysm
MRCPCH Clinical Revision - more videos at http://mrcpch.paediatrics.co.uk
Revise for your MRCPCH Clinical exam, with videos and high quality content created by the London Paediatrics Trainees Committee.
Video Credits: Dr Caroline Fertleman, Dr Hermione Race, Dr Camilla Sen, Dr Chloe Macaulay, Dr Emma McLaren, Chris Knapp
Are you getting enough vitamin B12? Many people don’t, and that deficiency can cause some serious problems. Vitamin B12 does a lot of things for your body. It helps make your DNA and your red blood cells, for examples. Since your body doesn't make vitamin B12, you'll need to get it from animal-based foods or from supplements, and it needs to be consumed on a regular basis. Exactly how much you need and where you should get it from depends on things like your age, the diet you follow, your medical conditions, and in some cases what medications you take.
Small cell lung cancer, which occurs almost exclusively in smokers, is a malignancy characterised by rapid doubling time, high growth fraction and widespread metastasis at presentation. In this presentation, we will briefly discuss the classification of pulmonary Neuro-endocrine tumours by the World Health Organisation followed by a detailed discussion of the clinical features, lab evaluation and management of SCLC, both limited and extended stage. The frontline therapy in small cell lung cancer is etoposide and cisplatin along with thoracic radiotherapy and prophylactic cranial irradiation in patients who have a good response to therapy. Hyperfractionation of radiotherapy may provide some benefit but is also associated with increase incidence of complications. Newer agents for SCLC include Vandetanib and immunotherapy molecules, such as Iplimumab and nivolumab.
On screening colonoscopy, this abnormality was encountered in the cecum. This round worm is Ascaris Lumbricoides, one of the most common human parasites in the world. When ingested, the durable Ascaris eggs hatch in the small intestine releasing larva that migrate through the intestinal wall, and t...ravel both hematogenously and lymphatically to the heart and lungs. Over the next several days, the larva mature in the alveoli, then migrate up the trachea to be swallowed back into the gastrointestinal tract. These larva will then mature in the small bowel; adults couples will succeed in producing an extraordinary number of eggs, over 200,000 ova per day. The adults live one to two years. The majority of Ascaris infections are as in this example asymptomatic. Symptoms are a consequence of either the immunologic hypersensitivity of the host to the worm as in the pulmonary stage referred as Loffler's syndrome or to mechanical obstruction of lumen by the worm. Heavy worm burden can result in intestinal obstruction and migrating worms can cause pancreatitis and/or cholangitis when involving the pancreatobiliary tree. Multiple medical therapies are approved for its treatment including mebendazole. Epidemiologically, infections are most common in areas of lower socio-economic conditions. This man manages a pig farm in China that is used to test pharmaceutical agents. From an endoscopic standpoint it is noteworthy that the worms do not like light and will move away fro the attention it is receiving. In this example, the endoscopist was too slow to snare his prey which succeeded in escaping temporarily into the cooler and darker confines of the small bowel out of reach of the endoscope but not from the soon to be consumed anti-helminthic therapy.
This minimally invasive surgical procedure repairs the valve without removing the old, damaged valve. Instead, it wedges a replacement valve into the aortic valve’s place. The surgery may be called a transcatheter aortic valve replacement (TAVR) or transcatheter aortic valve implantation (TAVI).
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Diabetic ketoacidosis is an acute complication of uncontrolled hyperglycaemia characterised by high anion gap metabolic acidosis, dehydration and other metabolic abnormalities. Upto half of patients with Type 1 diabetes mellitus may have DKA. The incidence in T2DM is also rising. Precipitants include acute illness such as myocardial infarction, trauma and infection. Paitents of diabetic ketoacidosis may present with vomiting, pain abdomen and lethargy. Mental obtundation may also be present. Management of diabetic ketoacidosis revolves around administration of IV normal saline, insulin, replacement of potassium with frequent monitoring of sugars and electrolytes.
An unnamed Russian scientist has introduced the concept of a device that attaches to the wall of the artery. It would first stop blood flow to the area to prevent breakaway plaque. A drill would then scrape the plaque from the artery wall. The procedure of treating plaque buildup could include bypass surgery, stent replacement and balloon angioplasty. Since the plaques are of different types and locations in the body, the inventor proposed using different types of cutting mills.
Paracentesis is a procedure to take out fluid that has collected in the belly (peritoneal fluid). This fluid buildup is called ascites . Ascites may be caused by infection, inflammation, an injury, or other conditions, such as cirrhosis or cancer. The fluid is taken out using a long, thin needle put through the belly.