An anal fissure is a small tear in the thin, moist tissue (mucosa) that lines the anus. An anal fissure may occur when you pass hard or large stools during a bowel movement. Anal fissures typically cause pain and bleeding with bowel movements. You also may experience spasms in the ring of muscle at the end of your anus (anal sphincter). Anal fissures are very common in young infants but can affect people of any age. Most anal fissures get better with simple treatments, such as increased fiber intake or sitz baths. Some people with anal fissures may need medication or, occasionally, surgery.

Watch that video of Removing Hundreds of Worms Living Inside Teeth

A video showing the delivery of the placenta

Tubal ligation using Fallope Ring

INDICATIONS Administration of agents into the central vasculature Central circulation and intracardiac access Maintenance of venous access Hemodialysis and plasmapheresis

There are 3 genetic types of FHH based on chromosome location. FHH type 1 accounts for 65% of cases and is due to inactivating mutations in the CASR gene, localized to 3q21.1. This gene encodes the calcium-sensing receptor (CaSR). Loss of CaSR function results in a reduction in the sensitivity of parathyroid and renal cells to calcium levels so hypercalcemia is perceived as normal. The other 35% have either a mutation GNA11 (19p13.3) seen in FHH type 2 or AP2S1 (19q13.2-q13.3) seen in FHH type 3 (see these terms) or in genes not yet discovered. FHH is rarely caused by auto-antibodies against CaSR in those without a mutation.

Parasitic twins: boy carrying dead twin inside him, giant tumor removed - tumors compilation

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Posterior dislocations with associated fractures, also known as complex posterior dislocations, often require open reduction and fixation (ORIF). These dislocations are often associated with significant ligamentous injury. In some cases, complex posterior elbow dislocations may be managed with closed reduction. Posterior elbow dislocations that are neglected, as is not uncommon in developing countries, can often be effectively treated with open reduction. [9] Delayed vascular compromise is an important complication after reduction. All patients should be observed for a period of approximately 2-3 hours after reduction. If no evidence of vascular compromise arises, patients can be sent home with appropriate follow-up and instructions to watch for further problems.

quick-stitch endoscopic sutering system in laproscopic Gastric Bypass surgery

Stapled hemorrhoidectomy for acute hemorrhoidal crisis could be undertaken under local anathesia with early recovery, short hospital stay and minimal postoperative pain

Suspect that a patient has a subphrenic abscess if he deteriorates, or recovers and then deteriorates, between the 14th and the 21st day after a laparotomy, with a low, slowly increasing, swinging fever, sweating, and a tachycardia. This, and a leucocytosis, show that he has ''pus somewhere', which is making him anorexic, wasted, and ultimately cachectic. If he has no sign of a wound infection, a rectal examination is negative, and his abdomen is soft and relaxed, the pus is probably under his diaphragm. The pus might be between his diaphragm and his liver, in (1) his right or (2) his left subphrenic space, or under his liver in (3) his right or (4) his left subhepatic space in his lesser sac. He may have pus in more than one of these spaces. Explore him on the suspicion that he might have a subphrenic abscess. Exploration is not a major operation; the difficulty is knowing where to explore, so refer him if you can. If you cannot refer him, explore him yourself. If you fail to find pus, you have done him no harm; missing a subphrenic abscess is far worse. If it is anterior, you can drain it by going under his costal margin anteriorly. If it is posterior, you can go through the bed of his 12th rib posteriorly.

Thoracoscopic Discectomy

SCOOP transtracheal oxygen is indicated for patients with chronic hypoxemia which persists in spite of optimal medical therapy. Arterial blood gases obtained while breathing room air should show a PaO2< 55 mm Hg. SCOOP transtracheal oxygen is also indicated for patients with a PaO2 of 56-59 mm Hg ...

if they also have: 1) dependent edema suggesting congestive heart failure, 2) "P" pulmonale on EKG (P wave greater than 3mm in standard leads II, III or AVF), or 3) erythrocythemia with a hematocrit of >55%.

Remove of ascaris lumbricoides worms due to intestinal obstruction

Thyroid Exam Physical Exam

Anatomy of The Shoulder and Arm Muscles

Blind loop syndrome (BLS), commonly referred to in the literature as small intestinal bacterial overgrowth (SIBO) or bacterial overgrowth syndrome (BOS), is a state that occurs when the normal bacterial flora of the small intestine proliferates to numbers that cause significant derangement to the normal physiological ...

Spina bifida is a type of birth defect called a neural tube defect. It occurs when the bones of the spine (vertebrae) don't form properly around part of the baby's spinal cord. Spina bifida can be mild or severe. The mild form is the most common.