This patient presented to the ER for umbilical pain and had a history of umbilical hernia. He was concerned about the possibility of incarceration of the hernia.

In this video we explain how the clinical exam helps to differentiate a simple painful hernia from an incarcerated one.

***Thanks to the patient for sharing his history and exam with YouTube world***

A vaginoplasty is a surgical procedure that tightens the vagina. This is done by removing excess vaginal lining and tightening the surrounding soft tissues and muscles. During delivery of a baby the vagina and surrounding tissues and muscles become stretched. After delivery the vagina may return to a more “normal” size, but it often fails to return to its’ pre pregnancy diameter. Generally, the more vaginal deliveries, the worse the condition gets. Many women will complain of decreased sensation and sexual satisfaction during intercourse. Commonly this is due to a lack of friction. Often their partner may notice a change although he may say nothing. Kegel exercises are often recommended but rarely succeed in restoring vaginal tightness.

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.

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This is a 60 year man having large swelling of size 7cm x 5 cm behind neck for one year. Patient complained pain and tenderness over local area for 7 days and came to us.On examination punctum found in the centre of swelling and fluctuation positive.Infected sebaceous cyst diagnosis made. /nIncision and drainage surgery done under local anesthesia.all infected pultaceous material evacuated.Pus culture sent and antibiotics given as per sensitivity report./nPatient improved with daily dressing.

Laser Circumcision

49-years old patient complaining of cough, fever and pleuritic pain for 2 weeks. At admission he was febrile and tachypnic. Chest X-Ray showed left pleural effusion. Thoracocentesis revealed purulent fluid. Chest CT-scan showed large and loculated left pleural effusion and pleural thickening. VATS decortication was performed through three incisions.

closing up teeth spaces

Pelvic Exam Video

Animated video on otitis media, infection of the middle ear, which is common in children.

Stress-related mucosal disease (SRMD) is an acute, erosive gastritis representing conditions ranging from stress-related injury to stress ulcers (1, 2). Stress-related injury is superficial mucosal damage that presents primarily as erosions, whereas stress ulcers are deep, focal mucosal damage penetrating the submucosa with high risk for gastrointestinal bleeding (2, 3). Mucosal damage has been reported to occur during the first 24 hours of hospital admission in 75% to 100% of intensive care unit (ICU) patients (4, 5). Clinically important gastrointestinal bleeding can cause hemodynamic instability and increase the need for red blood cell transfusions (1). Significant bleeding may also increase the length of stay in the ICU and mortality (1).

Permanent pacemaker insertion is considered a minimally invasive procedure. Transvenous access to the heart chambers under local anesthesia is the favored technique, most commonly via the subclavian vein, the cephalic vein, or (rarely) the internal jugular vein or the femoral vein.

Foley Catheter Insertion

A brief screening examination should be conducted checking the face, eyes, mouth, chest, abdomen, spine and limbs to exclude major abnormalities. A strong cry and a widespread pink blush over the face and body are good signs that all is well. Some children may be born with ambiguous genitalia. Ambiguous genitalia is a medical emergency and requires urgent assessment by a paediatrician. If you have sufficient clinical experience, an orogastric tube should be passed when the neonate's mother has suffered polyhydramnios. This excludes oesophageal atresia.

Insert the needle into the rubber stopper of the insulin bottle. Push the plunger down to inject air into the bottle (this allows the insulin to be drawn more easily). Leave the needle in the bottle. Turn the bottle and syringe upside-down.

Renal artery stenosis is a narrowing of arteries that carry blood to one or both of the kidneys. Most often seen in older people with atherosclerosis (hardening of the arteries), renal artery stenosis can worsen over time and often leads to hypertension (high blood pressure) and kidney damage.

Most people have general anesthesia right before surgery. This means you will be asleep and pain-free. Other kinds of anesthesia, like regional anesthesia or a block, may also be used for this surgery. The tissue to replace your damaged ACL will come from your own body or from a donor. A donor is a person who has died and chose to give all or part of his or her body to help others. Tissue taken from your own body is called an autograft. The two most common places to take tissue from are the knee cap tendon or the hamstring tendon. Your hamstring is the muscle behind your knee. Tissue taken from a donor is called an allograft. The procedure is usually performed with the help of knee arthroscopy. With arthroscopy, a tiny camera is inserted into the knee through a small surgical cut. The camera is connected to a video monitor in the operating room. Your surgeon will use the camera to check the ligaments and other tissues of your knee. Your surgeon will make other small cuts around your knee and insert other medical instruments. Your surgeon will fix any other damage found, and then will replace your ACL by following these steps: The torn ligament will be removed with a shaver or other instruments. If your own tissue is being used to make your new ACL, your surgeon will make a larger cut. Then, the autograft will be removed through this cut. Your surgeon will make tunnels in your bone to bring the new tissue through. This new tissue will be in the same place as your old ACL. Your surgeon will attach the new ligament to the bone with screws or other devices to hold it in place. As it heals, the bone tunnels fill in. This holds the new ligament in place. At the end of the surgery, your surgeon will close your cuts with sutures (stitches) and cover the area with a dressing. You may be able to view pictures after the procedure of what the doctor saw and what was done during the surgery.

A stress ulcer is a single or multiple mucosal defect which can become complicated by upper gastrointestinal bleeding during the physiologic stress of serious illness.

Intended to detect congenital anomalies of the musculoskeletal system and reassure parents their baby is healthy. This is a demonstration of a real-time physical examination in the nursery setting.

This could be caused by an infection, food poisoning, parasites, Crohn's disease, or reduced blood flow in the colon. Hemorrhoids are another common cause of GI or rectal bleeding. A hemorrhoid is an enlarged vein in your rectum or anus. These enlarged veins can rupture and bleed, causing rectal bleeding.