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For the surgeon to develop the same level of proficiency and dexterity in the endoscopic environment as he may possess in open surgery is not a simple matter. The use of proper Mishra's Knot, are essential. Participating in an in-depth, systematic training program in a laboratory setting is essential before applying endoscopic Mishra's Knot techniques to humans. Successful acquisition of these Mishra's Knot skill requires that the surgeon be motivated to succeed and willing to invest the time and effort necessary to do so. Succumbing to the temptation of mechanical devices in lieu of acquiring the manual skills results in a questionable dependence on disposable technology and reduces the cost effectiveness of the minimally invasive approach. It is the adoption of Mishra's Knotting skills by the surgeon that will expand the surgeon's capability of performing increasingly advanced endoscopic surgical procedures.
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NCR Delhi, 122002, India
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Bartter syndrome is a rare inherited defect in the thick ascending limb of the loop of Henle. It is characterized by low potassium levels (hypokalemia), increased blood pH (alkalosis), and normal to low blood pressure. There are two types of Bartter syndrome: neonatal and classic
Absence seizures involve brief, sudden lapses of consciousness. They're more common in children than adults. Someone having an absence seizure may look like he or she is staring into space for a few seconds. This type of seizure usually doesn't lead to physical injury. Absence seizures usually can be controlled with anti-seizure medications. Some children who have them also develop other seizures. Many children outgrow absence seizures in their teens.
Patients are generally placed in a supine position with the head in an extended position. As noted above, Gardner-Wells tongs can be used for additional cervical traction. The hands can also be tied downward to increase the operative exposure. Once the surgical site is properly prepared with cleansing material, the appropriate surgical level is identified with intraoperative radiographs. A scalpel is used to make a linear longitudinal incision just medial to the body of the sternocleidomastoid muscle. The incision is made long enough to include at least 2 vertebral levels if a 1-level discectomy is being performed. Alternatively, transverse skin incisions over the targeted vertebral level can also be performed. The platysmal muscle is identified and incised. The platysmal incision can be extended if a multilevel decompression is the surgical aim. Extensive subplatysmal dissection is performed to reduce retraction injury.
The cardiac conduction system is a group of specialized cardiac muscle cells in the walls of the heart that send signals to the heart muscle causing it to contract. The main components of the cardiac conduction system are the SA node, AV node, bundle of His, bundle branches, and Purkinje fibers.
Aspirin is a salicylate (sa-LIS-il-ate). It works by reducing substances in the body that cause pain, fever, and inflammation. Aspirin is used to treat pain, and reduce fever or inflammation. It is sometimes used to treat or prevent heart attacks, strokes, and chest pain (angina).
Shoulder Clinical Examination - Medical School Clinical Skills - Dr Gill
Personally, I find the shoulder examination the most complex examination possibly as there are so many variations and special tests. Some of which overlap and some will relate specifically to a patients presentation.
Often in a medical school syllabus, only select special tests will be used. In this shoulder exam demonstration, we include the Hawkins-Kennedy Test looking for impingement. This is dovetailed with examination for bicipital tendonitis as this is another possible cause of impingement type symptoms.
This shoulder upper limb exam follows the standard "Look, Feel, Move" orthopaedic exam approach, and overall order as set out in MacLeods Clinical Examination
Watch further orthopaedic examinations for your OSCE revision:
The Spine Examination:
https://youtu.be/pJxMHa6SCgU
Knee Examination
https://youtu.be/oyKH4EYfJDM
Hip Joint Clinical Examination
https://youtu.be/JC9GKq5nSdQ
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Please note that there is no ABSOLUTE way to perform a clinical examination. Different institutions and even clinicians will have differing degrees of variations - the aim is the effectively identify medically relevant signs.
However during OSCE assessments. Different medical schools, nursing colleges, and other health professional courses will have their own preferred approach to a clinical assessment - you should concentrate on THEIR marks schemes for your assessments.
The examination demonstrated here is derived from Macleods Clinical Examination - a recognized standard textbook for clinical skills.
#ShoulderExamination #ClinicalSkills #DrGill
Central venous catheter. Diagram showing a tunneled central line inserted into the right subclavian vein. A central venous catheter (CVC), also known as a central line, central venous line, or central venous access catheter, is a catheter placed into a large vein.
Intramedullary nailing of the tibia with suprapatellar entry and semi-extended positioning makes it technically easier to nail the proximal and distal fractures. The purpose of this article was to describe a simple method for suprapatellar nailing (SPN). A step-by-step run through of the surgical technique is described, including positioning of the patient. There are as yet only a few clinical studies that illustrate the complications with this method, and there has been no increased frequency of intraarticular damage. Within the body of the manuscript, information is included about intraarticular damage and comments with references about anterior knee pain.
kin grafting is a type of graft surgery involving the transplantation of skin. The transplanted tissue is called a skin graft. Skin grafting is often used to treat: Extensive wounding or trauma Burns Areas of extensive skin loss due to infection such as necrotizing fasciitis or purpura fulminans[2] Specific surgeries that may require skin grafts for healing to occur - most commonly removal of skin cancers Skin grafts are often employed after serious injuries when some of the body's skin is damaged. Surgical removal (excision or debridement) of the damaged skin is followed by skin grafting. The grafting serves two purposes: reduce the course of treatment needed (and time in the hospital), and improve the function and appearance of the area of the body which receives the skin graft.
Testicular sperm aspiration (TESA) is a procedure performed for men who are having sperm retrieved for in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). It is done with local anesthesia in the operating room or office and is coordinated with their female partner's egg retrieval.
Transvenous cardiac pacing, also called endocardial pacing, is a potentially life saving intervention used primarily to correct profound bradycardia. It can be used to treat symptomatic bradycardias that do not respond to transcutaneous pacing or to drug therapy.
Atrial flutter is a type of abnormal heart rate, or arrhythmia. It occurs when the upper chambers of your heart beat too fast. When the chambers in the top of your heart (atria) beat faster than the bottom ones (ventricles), it complicates your heart rhythm