Phacolytic glaucoma usually is associated with a mature or hypermature cataract and typically occurs in elderly patients. Today, phacolytic glaucoma is rare in the United States, found primarily in areas where access to care is poor. Will the increase in the number of under- and uninsured patients lead to an increase in this condition? Evaluation and Diagnosis Signs and symptoms. Patients typically report acute-onset pain, decreased vision, tearing and photophobia. Examination will reveal injection, corneal edema, elevated IOP, anterior chamber reaction with or without pseudohypopyon, particles on the lens capsule and anterior capsule wrinkling. Patient history. The duration of symptoms should be elicited; a delayed presentation of more than five days since onset can result in glaucomatous disc damage and poorer prognosis.¹ The ocular history may reveal that the patient decided against removal of an advanced cataract. Prior intraocular surgery or trauma may have left residual lens material that could cause phacoanaphylactic glaucoma or exacerbate infectious endophthalmitis. Visual acuity and visual potential should be assessed. Exam essentials. A complete ophthalmologic examination should be done. The eye should be inflamed, and the cornea may be edematous due to the high IOP. The anterior chamber will demonstrate massive inflammation and/ or pseudohypopyon. Gonioscopy is essential; it will help rule out angle closure due to phacomorphic glaucoma or neovascularization of the angle. Assess ment of the posterior pole should be performed to rule out vitreous hemorrhage (which can result in ghost-cell glaucoma) or vitritis (which may be associated with infectious endophthalmitis or panuveitis). If the view to the fundus is obstructed, B-scan ultrasonography also should be performed. Differential diagnosis. The differential diagnosis includes infectious endophthalmitis, phacoanaphylactic glaucoma, inflammatory glaucoma, glaucoma secondary to intraocular tumor, phacomorphic glaucoma, acute-angle closure glaucoma and neovascular glaucoma. Management Medication. Medical management is used to temporarily control the glaucoma and inflammation. Initial treatment consists of hyperosmotic agents, aqueous suppressants, anti-inflammatory drugs and cycloplegics. Surgery. Definitive treatment is removal of the lens via extracapsular cataract extraction with or without an IOL. Some ophthalmologists defer placement of an IOL until after the inflammation subsides; however, there is no significant difference in final visual acuity between those patients who did receive an IOL and those who did not.¹ If the phacolytic glaucoma is of long duration (more than seven days), a combined trabeculectomy may be needed to prevent postoperative IOP spikes.² In eyes with hypermature Morgagnian cataracts, one must be especially careful, as the capsule is fragile, the zonules are weak and the view is difficult due to the white, milky cortex. Vision limited to light perception on presentation is not a contraindication to performing cataract extraction. Surgical Tips For a planned extracapsular cataract extraction with a posterior chamber IOL, fashion a superior fornix-based conjunctival flap.³ Make a partial-thickness incision along the sclerolimbal junction superiorly for 120 degrees with a No. 69 blade. Forty-five degrees away, a paracentesis should be done to decompress the eye. The anterior chamber fluid can be withdrawn for analysis, to look for macrophages and high molecular-weight proteins. Inject balanced salt solution in a cannula to wash out any residual particulate matter, then inject Healon or viscoelastic into the anterior chamber. Make an incision entering the anterior chamber at the 12 o’clock position with a keratome. A 26-gauge cystotome mounted on a syringe is then introduced through the 12 o’clock incision and used to puncture the capsular bag. The milky cortex should be aspirated as much as possible, until the nucleus is visible. Withdraw the needle through the keratome incision, then inject Healon through the 12 o’clock incision into the capsular bag. Next, enlarge the corneoscleral keratome incision with curved Westcott scissors to 120 degrees. Perform a partial V-shaped capsulotomy; this can be done either with the cystotome or with an angled Vannas scissors. Place viscoelastic under the nucleus to float the nucleus and sever any adhesions between the nucleus and the capsule. The nuclear portion of the lens can then be removed with an irrigating vectis (lens loop) with or without gentle pressure at the inferior limbus (6 o’clock). Irrigate and aspirate the residual cortex with the Simcoe cannula. Inspect the capsular bag; if it is intact, place a posterior chamber IOL into the bag. Close the incision with several interrupted 10-0 monofilament nylon sutures and reattach the conjunctival flap. Potential Sequelae and Prognosis Postoperatively, the patient should be managed with topical steroids and/or aqueous suppressants and hyperosmotics if necessary. Vitreous opacification behind the posterior capsule occurs in a small percentage of eyes. These vitreous opacities are typically absorbed by one to two weeks postoperatively. IOP usually is controlled without antiglaucoma medications after the cataract removal. A detailed glaucoma evaluation (including repeat gonioscopy to assess for peripheral anterior synechiae, visual field and optic nerve status) should be done to assess the extent of glaucomatous damage. The prognosis is dependent on the duration of elevated IOP, PAS and optic nerve damage. In one study, patients who were older than 60 and whose glaucoma was present for more than five days did significantly worse than a comparison group of younger individuals with shorter disease duration.

USMLE Step 2 CS - DIARRHEA - This is just preview video. To get full access please visit our website : www.usmletutoring.com

Registered Nurse Ken describes what a real "sore throat"

USMLE Step 2 CS - Numbness Weakness Full Video

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B-Lynch suture for uterine atony technique described

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The Hypertensive urgency must be distinguished from hypertensive emergency. Urgency is defined as severely elevated blood pressure (ie, systolic >220 mm Hg or diastolic >120 mm Hg) with no evidence of target organ damage.

In this video, the viewer will learn the key aspects of the newborn physical exam, and how to distinguish between normal and abnormal findings.
Direct Links to chapters:
0:00-Intro
1:30-Head
3:49-Face
8:05-Neck
8:30-Chest
10:13-Abdomen
11:01-Groin
13:17-Extremities
14:05-Back
14:47-Neurologic

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OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open access-and thus at no expense to the user.

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SINUS LIFT SURGERY surgical procedure which aims to increase the amount of bone in the posterior maxilla (upper jaw bone), in the area of the premolar and molar teeth, by lifting the lower Schneiderian membrane (sinus membrane) and placing a bone graft.

Piles Treatment
contact : drjamil79@yahoo.com
Rubber band application around the pile is a pain free procedure.Patient is put to sleep for a few minutes and can go home after a few hours.In this procedure anal fissure was also treated with the transparent anoscope that comes with the PPH gun set.
Piles Treatment piles: HAL Hemorrhoidal Artery Ligation new fast and painless treatment of haemorrhoids dr jamil ahmad hashmi -PainlessRubber band application around the pile is pain free procedure.Patient put to sleep for few minutes can go home after hours.In this procedure anal fissure was also treated with transparent anoscope that comes PPH gun set. Category: health

Airline travel. When you're pregnant, the safest time to travel is during your second trimester (18 to 24 weeks), when your risks for miscarriage and preterm labor are lowest. During your third trimester, it's best to stay within 300 miles of home, in case of sudden changes that need medical attention.

Watch that video of Removing Front Teeth

In this video, we have explained the procedure of total #knee #replacement #surgery in patient in 3D animation.
Learn more: https://ecgkid.com
_____________________________________________________________________
Knee replacement, commonly known as complete knee replacement or knee arthroplasty, is a surgical treatment that resurfaces a knee that has been destroyed by arthritis. The extremities of the bones that make up the knee joint, as well as the kneecap, are capped with metal and plastic pieces. Someone with severe arthritis or a major knee injury may benefit from this procedure.

The knee joint can be affected by a variety of arthritis forms. The degradation of joint cartilage and neighboring bone in the knees can be caused by osteoarthritis, a degenerative joint disease that primarily affects middle-aged and older persons. Rheumatoid arthritis produces pain and stiffness by inflaming the synovial membrane and resulting in an excess of synovial fluid. Traumatic arthritis, or arthritis caused by an injury, can harm the joints.
The purpose of knee replacement surgery is to resurface damaged areas of the knee joint and cure knee discomfort that has not responded to prior therapies.

On this week's episode of Macro Beauty, we follow a young woman on her journey to getting Lasik eye surgery. She opts for this corrective vision procedure and we captured it up close. Watch this video to see what the process is really like!

https://maloneyvision.com/

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Watch that video of a Black Salve Left an Inch Hole In Man's Hole

Most scoliosis surgeons agree that children who have very severe curves (45-50° and higher) will need surgery to lessen the curve and prevent it from getting worse. The operation for scoliosis is a spinal fusion. The basic idea is to realign and fuse together the curved vertebrae so that they heal into a single, solid bone. With the tools and technology available today, scoliosis surgeons are able to improve curves significantly.

A Cryptic Pregnancy is a pregnancy, where the feotus is hidden or camouflaged in its natural environment; due to no HcG hormone being produced by the placenta and/or by difficulty in finding with ultrasound devices.

This operation can be performed as an open or laparoscopic (keyhole procedure). During the operation the sigmoid colon is removed. This involves taking away the blood vessels and lymph nodes to that part of the bowel. The surgeon then re-makes the join (anastomosis) between the remaining left side of the colon and the top of the rectum. The surgeon may use either sutures or special staples to make this join.

The brain is that part of the CNS contained within the cranial cavity (figure 13.1). It is the control center for many of the body's functions. The brain is much like a complex central computer but with additional functions that no computer can as yet match. Indeed, one goal in computer technology is to make computers that can function more like the human brain. The brain consists of the brainstem, the cerebellum, the diencephalon, and the cerebrum (table 13.1). The brainstem includes the medulla oblongata, pons, midbrain, and reticular formation. The structure of the brain is described in this chapter. Its functions are primarily discussed in chapter 14. Twelve pairs of cranial nerves, which are part of the PNS, arise directly from the brain. Two pairs arise from the cerebrum, nine pairs arise from the brainstem, and one pair arises from the spinal cord.