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Nosebleeds common. Most often they are a nuisance and not a true medical problem. But they can be both. Nosebleed care Sit upright and lean forward. By remaining upright, you reduce blood pressure in the veins of your nose. This discourages further bleeding. Sitting forward will help you avoid swallowing blood, which can irritate your stomach. Pinch your nose. Use your thumb and index finger to pinch your nostrils shut. Breathe through your mouth. Continue to pinch for five to 10 minutes. Pinching sends pressure to the bleeding point on the nasal septum and often stops the flow of blood. To prevent re-bleeding, don't pick or blow your nose and don't bend down for several hours after the bleeding episode. During this time remember to keep your head higher than the level of your heart. If re-bleeding occurs, blow out forcefully to clear your nose of blood clots and spray both sides of your nose with a decongestant nasal spray containing oxymetazoline (Afrin, Mucinex Moisture Smart, others). Pinch your nose again as described above and call your doctor. When to seek emergency care The bleeding lasts for more than 20 minutes The nosebleed follows an accident, a fall or an injury to your head, including a punch in the face that may have broken your nose
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.
The hepatitis E virus, responsible for major epidemics of viral hepatitis in subtropical and tropical countries, was cloned only 7 years ago.1 Hepatitis E was found to belong to the family of Caliciviridae, which includes the Norwalk virus—a common cause of gastroenteritis in humans—and consists of a single, plus-strand RNA genome of approximately 7.2 kb without an envelope (Fig. 1). The virus contains at least three open reading frames encoding viral proteins against which antibodies are made on exposure. These antibodies, especially those against the capsid protein derived from the second open reading frame2 and a protein of unknown function derived from the third open reading frame, are detected by currently available serologic assays. Retrospective studies on stored sera of past epidemics of viral hepatitis in Mexico, Africa, Afghanistan, Pakistan, India, Bangladesh, Burma, Nepal, and Borneo have revealed that all were caused by strains of hepatitis E. In addition, hepatitis E was found to be responsible for the hepatitis epidemic in the southern part of Xinjiang, China, in which 120,000 persons became infected between September 1986 and April 1988.3 Hepatitis E predominantly affects young adults (15 to 40 years old). The symptoms of hepatitis E are similar to those of hepatitis A. Frequently, a prodrome consisting of anorexia, nausea, low-grade fever, and right upper abdominal pain is present 3 to 7 days before jaundice develops. Aminotransferase levels peak (usually between 1,000 and 2,000 U/L) near the onset of symptoms; bilirubin levels (10 to 20 mg/dL) peak later. Jaundice usually resolves after 1 to 2 weeks. In about 10% of cases, the disease is fulminant—especially in pregnant women, among whom mortality rates as high as 20% due to hemorrhagic and thrombotic complications have been reported. No evidence has suggested that hepatitis E can cause chronic infection. Transmission is by the fecal-oral route, predominantly through fecally contaminated drinking water supplies. In addition, however, preliminary reports have suggested transmission of the hepatitis E virus through blood transfusions. Volunteer studies confirmed the presence of the virus in serum and feces before and during clinical disease.4 The virus is shed into feces approximately 1 week before symptoms develop. The incubation period varies from 2 to 9 weeks (mean duration, approximately 45 days). Until now, a few reports had described symptomatic hepatitis E acquired in Europe;5, 6 all patients with symptomatic hepatitis E in the United States were travelers returning from Mexico, Africa, or the Far East, in whom hepatitis E developed after their return home.7 In this issue of the Mayo Clinic Proceedings (pages 1133 to 1136), Kwo and associates describe a case of hepatitis E in a man who had not left the United States during the previous 10 years. Specific serologic tests for hepatitis E virus IgG (enzyme immunoassays and a fluorescent antibody blocking assay) and IgM8 (US strain-specific enzyme-linked immunosorbent assay with use of synthetic polypeptides deduced from the viral genome, as shown in Figure 1), developed at Abbott Laboratories (IgG and IgM) as well as at the Centers for Disease Control and Prevention (IgG), were used to prove that the patient indeed had acute hepatitis E. Researchers at Abbott Laboratories have prepared a report that describes most of the viral genome in this patient (Fig. I).8 Their results are interesting because this strain from the United States differs considerably from hepatitis E strains isolated in Mexico, Burma, Pakistan, or China. Furthermore, the sequence of the US strain is highly homologous (98% and 94% homology at the amino acid level to the second and third open reading frames, respectively) to a recently isolated hepatitis E strain from American swine.9 This finding suggests that, in the United States, hepatitis E is a zoonosis with the swine population as one of its hosts. This relationship would confirm earlier studies in Asia, where swine were also found to carry variants of the hepatitis E virus.10 Why are these two recent discoveries important for medicine in the United States? First, other sporadic, locally acquired cases of acute hepatitis may be caused by hepatitis E. Second, these back-to-back discoveries strongly suggest that a common natural host for hepatitis E is present in countries with more moderate climates. Because swine do not seem to experience any symptoms associated with infection and because symptoms in humans can be minor or absent, we now may also have an explanation for the 1 to 2% of positive hepatitis E serologic results in blood donors in the United States,11 Netherlands,12 and Italy,6 countries with large swine staples. Clearly, more research needs to be done to confirm this hypothesis. Third, in countries with more moderate climates, hepatitis E may often result in a subclinical infection. Is this variation in manifestation due to less virulent strains, and do sequence variations determine virulence? Fourth, swine may be used as an animal model for study of the disease as well as vaccine development.
For more information about living liver donor program, please visit https://cle.clinic/31rgy9F
Unlike open surgery that requires a large incision to access the liver, the laparoscopic procedure is performed with surgical tools and a camera inserted through a few half-inch holes in the abdomen of the living donor. Once the piece of the liver is dissected, the surgeon retrieves the graft through a small incision below the navel.
Liver transplant surgeon C.H David Kwon, MD, discusses the laparoscopic liver donor procedure more.
To learn more about Dr. Kwon, please visit https://cle.clinic/3Lvk9cv
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#clevelandclinic #livingdonor #livertransplantation #livertransplant #organdonation #laparoscopicsurgeon #laparoscopysurgery
Heavy period blood can be especially alarming if it contains clots. In most cases, though, red, brown, or even black menstrual blood clots are normal—just bits of the endometrium (the lining of the uterus) that are shed during menstruation.
#HerniaRepair #HerniaSurgery #LaparoscopicHerniaRepair #OpenHerniaRepair #InguinalHernia #UmbilicalHernia #VentralHernia #MeshRepair #HerniaRecovery #HerniaComplications
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If you’ve lost a significant amount of weight, either after pregnancy or through exercise and dietary changes, excess skin and weakened abdominal muscles can leave you self-conscious about your appearance. In this video, Dr. Catherine Hannan and Dr. Lauren Patrick, two of our Board-Certified Plastic Surgeons, are performing a Tummy Tuck (Abdominoplasty) surgery. Tummy Tuck surgery gets rid of the excess skin, as well as tightens your abdominal muscles, resulting in a flatter and smoother abdomen. The results of the surgery are permanent except in cases of large weight gain or pregnancy after surgery.
We are so excited to have taken a part in our patient's body transformation journey!
Before & After Gallery:
https://www.westendplasticsurg....ery.com/surgical/bod
To learn more, visit our website or call (202) 785-4187
http://www.westendplasticsurgery.com
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#TummyTuck #Abdominoplasty
To avoid pregnancy and STDs, always remember to use a condom every time you have sex — including oral, vaginal, or anal sex. Whenever oral sex is being performed on a girl, a dental dam should be used. A guy receiving oral sex should wear a latex condom — or, if he or his partner is allergic to latex, a polyurethane condom.
There are several things to consider when trying to decide between gastric bypass surgery and gastric sleeve surgery. Unlike the laparoscopic adjustable gastric band (Lap Band), these two operations are both permanent, reduce hunger, and lead to the highest percentage of weight loss. To properly compare gastric sleeve surgery to gastric bypass surgery we will examine the following data : Expected weight loss. Speed of weight loss. Time of surgery. Gastric bypass benefits over sleeve. Gastric sleeve benefits over bypass. Risk of complications. Surgeon skill and preference.
Cardiac anesthesiology is a subspecialty of anesthesiology that entails caring for patients undergoing major heart surgeries, including those that require cardiopulmonary bypass. I made this video to show a cardiac anesthesiologist's typical setup for surgery.
0:00 Start
0:28 IV pole #1
1:18 Perfusionist equipment
1:47 Anesthesia machine
3:01 Medications
3:36 Pacemaker
4:10 Echocardiography
4:34 IV pole #2
4:55 Arterial line
5:25 Defibrillators
5:40 OR table
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Find Max Feinstein, MD online:
Instagram: @MaxMFeinstein
Twitter: @MaxMFeinstein
Website: http://www.MaxFeinsteinMD.com
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The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional.
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Music
Subtle Swagger by Ron Gelinas Chillout Lounge | https://soundcloud.com/atmospheric-music-portal
Music promoted by https://www.free-stock-music.com
Creative Commons Attribution 3.0 Unported License
https://creativecommons.org/li....censes/by/3.0/deed.e
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#Anesthesiology #Residency #MedicalSchool
The MINI tummy-tuck is a lesser variant of the classic tummy tuck. The MINI tummy-tuck always involved skin excision (often a scar revision and skin excision of the flabby skin over a C-section scar or hysterectomy or laparotomy scar) but may also involve liposuction, umbilical floating, etc. Commonly it will not include any muscle repair otherwise it it now a classic tummy tuck (aka abdominoplasty). Cost varies depending on the components involved. Here, Toronto Aesthetic Plastic Surgeon Dr Marc DuPéré describes a MINI tummy-tuck done on a patient who had a Brazilian Butt Lift before (and skin harvesting from abdomen) and a recent 20 lbs weight loss, a patient who wants more liposuction to abdomen and flanks and whose skin has now lost elasticity, hence the requirement for this small skin excision. Dr DuPéré also explains what UMBILICAL floating means. Dr DuPéré performs more than 5 different techniques of tummy-tucks in Toronto and the technique chosen reflects the patient’s expectations and anatomy. Call us if interested in learning about YOUR options for a flatter tummy! 📱 416-929-9800
Patient consent obtained. Thank you to my patient.
Visage Clinic Toronto
https://www.visageclinic.com/
(416) 929-9800
101-133 Hazelton Avenue, Toronto, ON M5R 0A6
https://www.facebook.com/VisageClinic/
https://www.instagram.com/VisageClinicDrDuPere/
This is a surgery showing the removal of a large exostosis. Exostoses are bony growths in the ear canal from chronic exposure to cold water/air, most commonly from surfing. This patient had growths in both ears, which were completely obstructing the ear canals. This patient had a single exostosis that was blocking this side (the right side).