Watch the discussion on "Pediatric Surgery – Know From The Specialist"
Dr. Hemant Lahoti, Consultant, Pediatric Surgery, Apollo Hospitals, Navi Mumbai.

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Examination of Peripheral Vascular System - Clinical Skills OSCE Revision - Dr Gill

In this video, we demonstrate the peripheral vascular examination - a less common examination, but still vitally important, particularly amongst the older population

Starting with the examination of the hands looking for clinical signs of vascular compromise, we then check the pulses of the major arteries of the upper body - the radial, brachial and carotid arteries, before moving down to assess for an abdominal aortic aneurysm.

At this point, I feel it's a practical step to check the femoral pulses before doing the overview of the legs.

After visually assessing we must examine the major vascular areas of leg.- namely the popliteal pulses, before wrapping up around the ankle with the posterior tibial and dorsalis pedis pulses

For completeness, the cardiovascular examination is demonstrated here
https://www.youtube.com/watch?v=ECs9O5zl6XQ&t=2s

#PeripheralVascular #ClinicalSkills #DrGill

Distal Humerus Fractures of the Elbow. A distal humerus fracture is a break in the lower end of the upper arm bone (humerus), one of the three bones that come together to form the elbow joint. A fracture in this area can be very painful and make elbow motion difficult or impossible.

Subtotal Thyroidectomy

Closure of a loop ileostomy is a relatively simple procedure although many studies have demonstrated high morbidity rates following it. Methods to reduce the number of complications, such as timing of closure or different surgical closure techniques, are investigated. The aim of this study was to evaluate the experience of the Abdominal Surgery Center at Vilnius University Hospital (VUH) ‘Santariskiu klinikos’ to review the complications after closure of loop ileostomy and to identify potential risk factors for postoperative complications.

The infection is generally transmitted by direct contact with the mucus or sores of someone else with strep. Common symptoms include sore throat, fever, and swollen lymph nodes in the neck. Rarely, complications can involve the heart or kidneys. Treatment is important to reduce complications. Oral antibiotics like penicillin, amoxicillin, cephalexin, or azithromycin are commonly used. Other medicines such as acetaminophen or ibuprofen can help with pain and fever.

Nursing skills lab procedure for IV insertion.

A video showing how to elicit the ankle clonus sign

This patient has infectious mononucleosis (IM), a disease caused by the Epstein-Barr virus. IM is a systemic viral infection that is usually seen in children and adolescents. The common presentation is fever with pharyngitis or tonsillitis, cervical adenopathy, splenomegaly, and mild hepatitis.

Chinese Sex Change Surgery

Laparoscopic resection of the right hepatic lobe for a 5 cm hepatoma

Patent ductus arteriosus (PDA), in which there is a persistent communication between the descending thoracic aorta and the pulmonary artery that results from failure of normal physiologic closure of the fetal ductus (see image below), is one of the more common congenital heart defects.

If a patient comes to you with a painful, throbbing, swollen, red face (a ''fat face'), perhaps with fever, trismus and lymphadenitis, he is probably suffering from an acute dental or oral infection, most probably an alveolar abscess. He may have: (1) An alveolar abscess begins as an infection in the bone around a non-vital infected tooth. He has severe pain, which becomes less as pus is released into more superficial tissues and his face starts to swell. After 36 hours of cellulitis he usually has a fluctuant abscess which needs draining. If drainage is delayed, the pus in his abscess discharges spontaneously through a sinus (26-8) in his gum or face, which may become chronic. First, control infection with antibiotics, and then drain the abscess, either by incising it where it is pointing, or by removing the infected tooth, which acts as a cork to prevent the pus escaping, or by doing both these things. If you remove a tooth before you have controlled the infection with antibiotics, and while his face is still severely swollen, you may spread the infection; your task will also be more difficult. (2) A periodontal abscess at the side of a tooth, caused by spread from an infected gum. (3) A pericoronal abscess caused by infection of the gum over the crown of an unerupted and impacted tooth, usually a lower third molar (''an infected wisdom tooth'). Often, an abscess does not form, and the gum round the tooth is merely inflamed.

3D animation video of Varicose Veins Sclerotherapy Treatment

Ear Infection Drainage Time Lapse Video

Neurological Examination

Most babies will move into delivery position a few weeks prior to birth, with the head moving closer to the birth canal. When this fails to happen, the baby’s buttocks and/or feet will be positioned to be delivered first. This is referred to as “breech presentation.” Breech births occur in approximately 1 out of 25 full-term births.

Nasal polyps are soft, painless, noncancerous growths on the lining of your nasal passages or sinuses. They hang down like teardrops or grapes. They result from chronic inflammation due to asthma, recurring infection, allergies, drug sensitivity or certain immune disorders. Small nasal polyps may not cause symptoms. Larger growths or groups of nasal polyps can block your nasal passages or lead to breathing problems, a lost sense of smell and frequent infections. Nasal polyps can affect anyone, but they're more common in adults. Medications can often shrink or eliminate nasal polyps, but surgery is sometimes needed to remove them. Even after successful treatment, nasal polyps often return.

TPE removes large-molecular-weight substances such as harmful antibodies from the plasma. It is usually carried out using an automated blood cell separator to ensure fluid balance and maintain a normal plasma volume. This may require the insertion of a femoral or jugular line to allow adequate blood flow. Typically, 30–40 mL/kg of plasma (1–1.5 plasma volumes) are removed at each procedure and replaced with isotonic 4.5 or 5.0% human albumin solution (some services substitute 25–50% of replacement volume with 0.9% saline). Exchange with fresh frozen plasma (FFP) is reserved for the replacement of ADAMTS13 in thrombotic thrombocytopenic purpura (see below) or to replace clotting factors. A one plasma volume exchange removes about 66% of an intravascular constituent and a two plasma volume exchange approximately 85%. TPE is normally combined with disease modifying treatment, such as immunosuppressive drugs, for the underlying condition.