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MRCPCH Clinical Revision - more videos at http://mrcpch.paediatrics.co.uk
Revise for your MRCPCH Clinical exam, with videos and high quality content created by the London Paediatrics Trainees Committee.
Examiner: Jonathan Round
Candidate: Amitav Parida
Filming: Mary Chesshyre, Huey Miin Lee, Chris Kelly
Thank you to the Evelina Children's Hospital for allowing us to film during their MRCPCH Revision Course (https://www.guysandstthomaseve....nts.co.uk/mrcpch-cli
Do you think you have a hernia?
What are hernias?
The hernias we address in this http://DoctorsExpressHartsdale.com Medical Minute are inguinal, or groin, hernias. More common in men than women, an inguinal hernia can occur when part of the small intestine protrudes through a weakness or tear in the area between your abdomen and your thigh- or your groin. It's possible for anyone to get an inguinal hernia, but it is more commonly found in males.
Hernias form a bulge and can be accompanied by pain. Men have an approximate 26% lifetime risk of having hernia at some point in their life, where as women have a much lower chance of one- only about 3% of women will experience a hernia at some point in their life. There are other types of hernias, such as abdominal, or "hiatal" hernias but groin hernias outnumber abdominal hernias by about 3 to 1.
What causes a hernia?
The cause of a hernia is not always known, but hernias are often the result of weak spots in the abdominal wall. Weaknesses can be due to congenital defects (present at birth) or formed later in life. Some risk factors for inguinal hernia include:
• fluid or pressure in the abdomen
• heavy lifting
• straining during urination or bowel movements
• obesity
• chronic cough
• pregnancy
Hernias often form in people with weakened abdominal muscles or in those who do a lot of heavy lifting or straining, which is why we see it quite often in young men. Physiology plays a part: men have testicles and scrotum which descend through the inguinal canal-much larger in men than in women. That is part of the reason men tend to be more susceptible to hernias than women.
Symptoms of hernia
Symptoms of inguinal hernia usually include a bulge in the groin area and pain, pressure, or aching at the bulge—especially when lifting, bending, or coughing. These symptoms usually subside during rest periods. Men may also experience swelling around the testicles.
Screening and Diagnosis of Hernias
If you are having abdominal pain or pelvic bulge and pain, you want to see physician, and he or she will do an exam. They will use their finger, to see if you have a bulge in your scrotum or on your groin and they'll see if its reducible or not. If the exam doesn't give them the answer, they can then perform an ultrasound, an inexpensive test that can tell you the same day whether a hernia is present.
What to do if you think you have a hernia
Most of the time hernias do not cause problems. People often live with hernias their entire life without them becoming aggravated or painful. When they do cause pain though, there is concern that complications may have arisen. Most common hernias are what we call reducible; you can take your finger or you can lie down in bed and due to the effects of gravity, the bulge in the groin will actually disappear, which means the intestinal contents actually go back into the abdominal cavity or to the correct location. If it's not reducible by lying down or using a finger or having a physician trying to reduce it, then there are concerns about complications such as strangulation, or incarceration occurring. If those concerns are there, then you need to see a surgeon, and there may be a need for surgery.
How to Treat a Hernia
As stated earlier, hernias can often be watched for years without being treated. If however, they are causing pain, we generally refer you to a surgeon who can do a very simple laparoscopic surgery.
If you suspect a hernia, but have not been diagnosed, you should see your doctor, and of course, we are happy to see you here at Doctors Express
Check out @barrettplasticsurgery on TikTok!
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LASIK eye surgery has been popular for more than 20 years, with an estimated 20 million Americans undergoing the procedure to correct nearsightedness and improve distance vision. But some patients says the surgery has ruined their eyesight. Now an expert who once backed LASIK is campaigning to get it off the market. Dr. Tara Narula reports.
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Contact us to find out more http://www.londonvisionclinic.com/contact-us/ A video of an actual lasik eye surgery procedure taking place, using VisuMax and MEL 80 at the London Vision Clinic.
Visit http://www.londonvisionclinic.....com/are-you-suitable to find out more about the laser eye surgery process.
#lasik #eyesurgery #BusinessInsiderIndia #lasereyesurgery
Business Insider's Michelle Yan has been nearsighted since she was 9 years old. After laser eye surgery, she has 20/20. She walks us through the pre-surgery steps, the actual surgery which the doctor referred to as a spa for eyes, as well as the recovery process.
Don't miss the suggestions and recommendations she has for all those who are planning to undergo laser eye surgery for themselves, towards the end.
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What It's Like To Get Laser Eye Surgery
LASIK eye surgery is commonly performed laser refractive surgery to correct vision problems. This 3d animation shows how laser-assisted in situ keratomileusis (lasik) can be an alternative to glasses or contact lenses.
It’s one of many vision correction surgeries that work by reshaping your cornea, the clear front part of your eye, so that light focuses on the retina in the back of your eye.
In eyes with normal vision, the cornea bends (refracts) light precisely onto the retina at the back of the eye. But with nearsightedness (myopia), farsightedness (hyperopia) or astigmatism, the light is bent incorrectly, resulting in blurred vision.
During LASIK surgery, a special type of cutting laser is used to precisely change the shape of the dome-shaped clear tissue at the front of your eyes (cornea) to improve vision.
Glasses or contact lenses can correct vision, but reshaping the cornea itself also will provide the necessary refraction.
For more information about medical animation, please visit https://www.amerra.com
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LASIK is one of the most popular elective surgeries in the United States with 95% of patients walking away satisfied with their vision, according to one FDA study. But like with any surgery, there are risks.
Mitra Nejad, MD
Associate Physician Diplomate
UCLA Stein Eye Institute, Cataract and Refractive Surgery Division
In this video, Professor Dan Reinstein performs a bilateral LASIK procedure filmed in real-time to demonstrate the full 8 and-a-half minute procedure from multiple angles. The superior design and experience of the Carl Zeiss Meditec Visumax femtosecond Laser for flap creation is seen, where the patient is only in contact with the device for about 30 seconds with extremely low contract force such that the patient feels effectively nothing, there are no red splodges (subconjunctival haemorages) left behind. From the surgeons' standpoint there is no device that is easier to use or faster for LASIK flap creation. The Carl Zeiss Meditec MEL80 excimer laser portion of the procedure is seamlessly integrated and incorporates all the features that make clinical outcomes so reproducible including the unique cone-for-controlled-atmosphere (CCA) and high efficiency, high sensitivity calibration test which can be performed for each individual patient to compensate for minor changes in energy that occur with excimer laser devices during the course of a day.
For reference to the clinical outcomes for LASIK with the MEL80 in presbyopia using PRESBYOND Laser Blended Vision see:
Reading glasses presbyopia (ageing eyes) only:
LASIK for presbyopia correction in emmetropic patients using aspheric ablation profiles and a micro-monovision protocol with the Carl Zeiss Meditec MEL 80 and VisuMax.
J Refract Surg. 2012 Aug;28(8):531-41. Reinstein DZ, Carp GI, Archer TJ, Gobbe M.
http://www.ncbi.nlm.nih.gov/pubmed/22869232
Short sighted, astigmatism and presbyopia (ageing eyes)
LASIK for Myopic Astigmatism and Presbyopia Using Non-Linear Aspheric Micro-Monovision with the Carl Zeiss Meditec MEL 80 Platform.
J Refract Surg. 2011 Jan;27(1):23-37. Epub 2010 Mar 1.
Reinstein DZ, Archer TJ, Gobbe M.
http://www.ncbi.nlm.nih.gov/pubmed/20205360
Long-sighted, astigmatism and presbyopia (ageing eyes)
LASIK for hyperopic astigmatism and presbyopia using micro-monovision with the Carl Zeiss Meditec MEL80 platform.
J Refract Surg. 2009 Jan;25(1):37-58. Reinstein DZ, Couch DG, Archer TJ.
http://www.ncbi.nlm.nih.gov/pubmed/19244952
For more information about laser eye surgery and PRESBYOND Laser Blended Vision, please contact the London Vision Clinic on 020 7224 1005.
Detroit TV meteorologist Jessica Starr posted a heart-wrenching video on social media a month before dying by suicide this week. She had told viewers she was struggling in the aftermath of undergoing Lasik surgery. After learning of her death, her heartbroken colleagues on WJBK fought back tears live on TV. Twelve people have died by suicide after suffering pain and even blindness after the operation. Inside Edition also spoke to a doctor who wants the surgery banned. #InsideEdition
Contact us to find out more http://www.londonvisionclinic.com/contact-us/ Mr Carp explains the risks involved in losing sight as being extremely rare. Only 1 in 5 million may lose sight in one eye.
#clean #leg #surgery #knee
✍️Dr. Matthew Harb talk about knee replacement surgery
https://www.MatthewHarbMD.com/links
👨⚕️Orthopedic Hip and Knee Surgeon
📍Located in Washington DC, and Maryland
📚Education and Insight
🛠Minimally invasive, outpatient, hip and knee replacement surgery
👉Visit me Online: https://www.MatthewHarbMD.com
☎️Schedule a virtual or in office appointment: https://www.MatthewHarbMD.com/links
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✍️QUESTION — Have a question or comment about medicine, orthopedic surgery, or musculoskeletal conditions. Post in the comment sections and let me know!
Dr. Matthew Harb specializes in minimally invasive, muscle sparing, hip and knee replacement surgery. Minimally invasive surgery allows patients to recover faster and have less pain post operatively. Implants are tailored and custom fit to each patient to allow for improved performance. Dr. Harb’s expertise in rapid recovery protocols allow for quick recovery after surgery and excellent outcomes in patients with hip and knee arthritis. With minimally invasive, muscle sparing surgery patients can return to their lifestyles and get back to doing the things they love sooner. Dr. Harb performs outpatient joint replacement surgery with many of his patients walking independently and going home the day of surgery.
“My focus is excellence in patient care, expedited recovery after surgery, and getting people back to the normal activities they love. Our team focused approach is committed to superb outcomes, improving lives, and returning patients to living pain free.”
#surgical #arthritis #surgery #medical #ortho #health #orthopaedic #medicine #ortopedia #medstudent #physicaltherapy #medschool #medicalstudent #medlife #sports
✍️Dr. Matthew Harb talks about knee replacement surgery
https://www.MatthewHarbMD.com/links
👨⚕️Orthopedic Hip and Knee Surgeon
📍Located in Washington DC, and Maryland
📚Education and Insight
🛠Minimally invasive, outpatient, hip and knee replacement surgery
👉Visit me Online: https://www.MatthewHarbMD.com
☎️Schedule a virtual or in office appointment: https://www.MatthewHarbMD.com/links
📲Follow me on Social Media:
💥TIKTOK: https://www.tiktok.com/@matthewharbmd
💥INSTAGRAM: https://www.instagram.com/thebonesurgeon
📲Please SUBSCRIBE for new #shorts #doctor videos!
https://www.youtube.com/channel/UCbte-7tl7kaAm1xfWgz6xvQ?app=desktop&sub_confirmation=1
✍️QUESTION — Have a question or comment about medicine, orthopedic surgery, or musculoskeletal conditions. Post in the comment sections and let me know!
Dr. Matthew Harb specializes in minimally invasive, muscle sparing, hip and knee replacement surgery. Minimally invasive surgery allows patients to recover faster and have less pain post operatively. Implants are tailored and custom fit to each patient to allow for improved performance. Dr. Harb’s expertise in rapid recovery protocols allow for quick recovery after surgery and excellent outcomes in patients with hip and knee arthritis. With minimally invasive, muscle sparing surgery patients can return to their lifestyles and get back to doing the things they love sooner. Dr. Harb performs outpatient joint replacement surgery with many of his patients walking independently and going home the day of surgery.
“My focus is excellence in patient care, expedited recovery after surgery, and getting people back to the normal activities they love. Our team focused approach is committed to superb outcomes, improving lives, and returning patients to living pain free.”
Patient information from Sunnybrook's Holland Musculoskeletal Program. For more, visit: http://sunnybrook.ca/holland
Three to five years after gastric bypass surgery, some patients start to regain weight because the size of their stoma (the opening at the bottom of the stomach pouch) or their stomach pouch itself has increased. This can keep you from feeling full after small meals.
To resolve this problem, our surgeons use new surgical tools to create and suture folds into the pouch, reducing its volume and at the stoma to decrease its diameter. The surgeon performs the procedure entirely through the mouth -- inserting an endoscope under heavy sedation -- so there are no external incisions into the body.
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All images/videos by Alila Medical Media are for information purposes ONLY and are NOT intended to replace professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition.
Trabeculectomy, also called Filtration Surgery, is a surgical procedure performed for treatment of glaucoma. The treatment involves removing part of the trabecular meshwork and creating a new escape route for the aqueous humor. When successful, it allows the aqueous fluid to drain from the eye into an area underneath the conjunctiva where it is subsequently absorbed by the body's circulatory system or filtered into tears.
In this procedure:
- A conjunctival pocket is created and maybe treated with Mitomycin or other antimetabolites for a few minutes. These drugs are used to prevent scarring of the operation site. Scarring, if occurs, may clog the new drainage canal, and is therefore the major reason the procedure may fail.
- A half thickness flap is then made in the sclera and is dissected all the way to the clear cornea.
- A block of scleral tissue including part of the trabecular meshwork and Schlemm's canal is then removed to make a hole into the anterior chamber of the eye.
- As the iris may plug up this hole from the inside, a piece of the iris maybe removed at this time. This is called iridectomy.
- The scleral flap is then sutured loosely back in place. These sutures can be released gradually during a couple of weeks after surgery. This allows adjustment of the aqueous flow in order to achieve target pressure and to avoid the complication of having a too low intraocular pressure.
- The conjunctiva is sewn back in place to cover the area.
After surgery, aqueous humor drains into a filtering area called a "bleb" under the conjunctiva. Since the surgery is usually performed near the top of the eye, the bleb can easily be concealed behind the upper eyelid.
