For patients in extremis from respiratory failure or shock, securing vascular access is crucial, along with establishing an airway and ensuring adequacy of breathing and ventilation. Peripheral intravenous catheter insertion is often difficult, if not impossible, in infants and young children with circulatory collapse. Intraosseous (IO) needle placement, shown in the images below, provides a route for administering fluid, blood, and medication. An IO line is as efficient as an intravenous route and can be inserted quickly, even in the most poorly perfused patients.

Watch that video of a Man’s Hand Inside Meat Grinder Emergency Removal

Watch that video of full Testicles Autopsy

For nurses: a video showing how to hang an IV bag with line insertion

Laparoscopy in acute bowel obstruction following previous surgery is a difficult procedure and avoided by most of the surgeons due to the difficulty in obtaining pneumoperitoneum, port placement, lack of working space, adhesions and risk of bowel injury.
Here is a patient who had a previous laparotomy for trauma with a midline incision from xyphysternum to pubis; after unsuccessful conservative management he underwent a laparoscopy; a prior CT scan showed adhesions in the left side and a distal-mid small bowel obstruction. The pneumoperitoneum was obtained with the Visiport placed in the right lower quadrant; although the abdomen was grossly distended, under significant tension and distended loops of small bowel were occupying most the peritoneal cavity, with muscle relaxation there is usually enough space to perform a thorough inspection of the abdominal cavity. Port placement has to be done with special care as there is no room to push and usually a blunt trocar directed away from the bowel is employed in my practice. The collapsed loops of small bowel point quickly to the site of obstruction -- it is better to avoid manipulating the distended bowel as it is heavy, oedematous and prone to be lacerated with the instruments; once the pathology is identified, in this case the obstructive band, light packing is performed in order to expose the working space and protect the bowel from instruments like scissors or diathermy. In this case the band adhesion was slightly more difficult to separate from the bowel and required a combination of sharp and gentle blunt dissection.
Once the obstruction is release and the transit of contents is confirmed in the collapsed bowel the procedure is terminated. No abdominal drainage is usually necessary.

H&E stain is a popular staining method in histology. Its a combination of two dyes: the basic dye (hematoxylin) and the alcohol-based dye (eosin). In an H&E stain you will usually see both eosinophilia and basophilia: the nuclei of cells basophilic (blue), while eosinophilia is typical of cytoplasmic constituents (pink). Xylene, alcohols, distilled water are also required.

Work out the length of your average menstrual cycle. Day one is the first day of the menstrual period and the last day is the day before the next period begins. Ovulation happens about two weeks before the next expected period. So if your average menstrual cycle is 28 days, you ovulate around day 14.

First aid - Shock and bleeding

A 30 YEAR WOMEN WITH INTRACTABLE BILIARY COLIC CASE REPORT: This 30 year women developed severe pain right upper quadrant for last 10 days. She sought many consultations and was given intravenous analgesics both (nonnarcortic and narcotic). Pain did not subside and she sought my consultation. Examination revealed her to be in agony with severe upper abdominal pain. General physical examination was otherwise unremarkable. Abdominal examination revealed mild tenderness in right hypochondrium with doubtful Murphy's sign. Urgent abdominal ultrasound showed a linear structure in bile ducts making slow writhing movements. The structure had an anechoic tube (alimentary canal) inside suggestive of a large Ascarid. Urgent ERCP was performed and bile duct and pancreatic duct cannulated selectively. Pancreatic duct was normal. Bile ducts contained a long linear filling defect extending from lower end of common bile duct to right intrahepatic duct (see image gallery for ERCP plate). A basket was introduced in the duct (see video clip) and the linear structure was engaged with soft closure and extracted out of the bile duct. Accompanying the basket was a 25 cm thick highly motile Ascarid. To recover the worm, endoscope was withdrawn along with the basket and the friendly catch. While the endoscope was being withdrawn and the basket was in the duodenum with the worm out of bile duct, patient indicated of relief of abdominal pain. A relook cholangiogram showed no more structures in the duct. She was given antihelmintic therapy and passed hundreds of worms with the feces. The worms recovered form stools were both male and female population and varied in length and size. However the lone worm recovered form bile ducts was the longest and the thickest male worm. The phenomenal behavior of this ubiquitous infection remains unexplained. (Source Records from Dr. Khuroo's Medical Clinic. Review prepared by Mehnaaz Sultan Khuroo Host website www.drkhuroo.org , E-mail: mkhuroo@yahoo.com ).

The hepatic portal system is the system of veins comprising the hepatic portal vein and its tributaries. It is responsible for directing blood from the region of the gastrointestinal tract between the esophagus and rectum and also includes venous drainage from the supplementary organs such as the spleen and pancreas.

Alzheimer’s disease is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills, and eventually the ability to carry out the simplest tasks. In most people with Alzheimer’s, symptoms first appear in their mid-60s. Estimates vary, but experts suggest that more than 5 million Americans may have Alzheimer’s. Alzheimer's disease is currently ranked as the sixth leading cause of death in the United States, but recent estimates indicate that the disorder may rank third, just behind heart disease and cancer, as a cause of death for older people. Alzheimer’s is the most common cause of dementia among older adults. Dementia is the loss of cognitive functioning—thinking, remembering, and reasoning—and behavioral abilities to such an extent that it interferes with a person’s daily life and activities. Dementia ranges in severity from the mildest stage, when it is just beginning to affect a person’s functioning, to the most severe stage, when the person must depend completely on others for basic activities of daily living. The causes of dementia can vary, depending on the types of brain changes that may be taking place. Other dementias include Lewy body dementia, frontotemporal disorders, and vascular dementia. It is common for people to have mixed dementia—a combination of two or more disorders, at least one of which is dementia. For example, some people have both Alzheimer's disease and vascular dementia. Alzheimer’s disease is named after Dr. Alois Alzheimer. In 1906, Dr. Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. Her symptoms included memory loss, language problems, and unpredictable behavior. After she died, he examined her brain and found many abnormal clumps (now called amyloid plaques) and tangled bundles of fibers (now called neurofibrillary, or tau, tangles). These plaques and tangles in the brain are still considered some of the main features of Alzheimer’s disease. Another feature is the loss of connections between nerve cells (neurons) in the brain. Neurons transmit messages between different parts of the brain, and from the brain to muscles and organs in the body.

This is a diabetic foot ulcer. The patient reportedly went on vacation and noticed this ulcer upon their return. Debridement (removal of damaged tissue) to the level of healthy bleeding tissue is medically necessary as damaged tissue acts an impediment to wound healing. Due to their diabetic neuropathy, they did not feel any pain or indication that a wound was forming. This ulcer appeared to have penetrated to the level of subcutaneous tissue or even fascia, but turned out to be much deeper than that. These are serious wounds and are the beginnings of what lead to foot and leg amputations if they are not treated promptly by your healthcare provider, AKA Podiatrist.

What causes rheumatic fever? Rheumatic fever is not an infection itself, but rather the result of an untreated strep infection. When your body senses the strep infection, it sends antibodies to fight it. Sometimes, these antibodies attack the tissues of your joints or heart instead. If the antibodies attack your heart, they can cause your heart valves to swell, which can lead to scarring of the valve "doors" (called leaflets or cusps). Who is at risk for rheumatic fever? Fewer than 0.3% of people who have strep throat also get rheumatic fever. Rheumatic fever is most common among children aged 5 to 15, but adults may have the condition as well. Doctors think that a weakened immune system may make some people more likely to get rheumatic fever. And, although antibiotic medicines have reduced the number of cases of rheumatic fever in developed countries, there are still thousands of reported cases. What are the symptoms of rheumatic fever and how is it diagnosed? Symptoms of rheumatic fever usually begin 1 to 6 weeks after you have had a strep infection. They are Fever Joint pain or swelling in your wrists, elbows, knees, or ankles Small bumps under the skin over your elbows or knees (called nodules) A raised, red rash on your chest, back, or stomach Stomach pain or feeling less hungry Weakness, shortness of breath, or feeling very tired Your doctor will begin by doing a throat culture to find out if you have a strep infection. Then, your doctor will use a stethoscope to listen to your heart. He or she will also look for nodules on your joints. Sometimes, blood tests, chest x-rays, or an electrocardiogram (ECG or EKG) may be needed for a more definite diagnosis. How is rheumatic fever treated? Rheumatic fever must be treated right away. If you have a sore throat that lasts longer than 3 days, or if you have a fever and headache along with your sore throat, you should see your doctor for a throat culture. Even if you do not have a sore throat but have a fever and a skin rash, this could also mean a strep infection, and you should get tested. Remember rheumatic fever can result from an untreated strep infection, so it is very important to treat the infection before it leads to a worse condition.

The venipuncture procedure is complex, requiring both knowledge and skill to perform. Each phlebotomist generally establishes a routine that is comfortable for her or him. Several essential steps are required for every successful collection procedure: Identify the patient. Assess the patient's physical disposition (i.e. diet, exercise, stress, basal state). Check the requisition form for requested tests, patient information, and any special requirements. Select a suitable site for venipuncture. Prepare the equipment, the patient and the puncture site. Perform the venipuncture. Collect the sample in the appropriate container. Recognize complications associated with the phlebotomy procedure. Assess the need for sample recollection and/or rejection. Label the collection tubes at the bedside or drawing area. Promptly send the specimens with the requisition to the laboratory.

Piriformis syndrome refers to when the piriformis muscle irritates the sciatic nerve and caues pain along the back of the leg and foot.

What is a Cataract

Abortion real ghraphics

Tears Of Abortion - Story of an aborted baby,

Back pain during pregnancy is a common complaint — and it's no wonder. You're gaining weight, your center of gravity changes, and your hormones are relaxing the ligaments in the joints of your pelvis. Often, however, you can prevent or ease back pain during pregnancy. Consider seven ways to give pregnancy back pain the boot. 1. Practice good posture As your baby grows, your center of gravity shifts forward. To avoid falling forward, you might compensate by leaning back — which can strain the muscles in your lower back and contribute to back pain during pregnancy. Keep these principles of good posture in mind: Stand up straight and tall. Hold your chest high. Keep your shoulders back and relaxed. Don't lock your knees. When you stand, use a comfortably wide stance for the best support. If you must stand for long periods of time, rest one foot on a low step stool — and take time for frequent breaks. Good posture also means sitting with care. Choose a chair that supports your back, or place a small pillow behind your lower back. 2. Get the right gear Wear low-heeled — not flat — shoes with good arch support. Avoid high heels, which can further shift your balance forward and cause you to fall. You might also consider wearing a maternity support belt. Although research on the effectiveness of maternity support belts is limited, some women find the additional support helpful. 3. Lift properly When lifting a small object, squat down and lift with your legs. Don't bend at the waist or lift with your back. It's also important to know your limits. Ask for help if you need it. 4. Sleep on your side Sleep on your side, not your back. Keep one or both knees bent. Consider using pregnancy or support pillows between your bent knees, under your abdomen and behind your back.

Several options are available to remove spider veins — thin red lines or weblike networks of blood vessels that appear on your legs and feet. Spider veins are usually harmless, though they can sometimes cause aching, burning or pain, especially when you've been standing for long periods. If you have symptoms or are concerned about the appearance of spider veins, treatment options include: Sclerotherapy. In this procedure, your doctor injects the veins with a solution that scars and closes those veins, causing the blood to reroute through healthier veins. In a few weeks, treated spider veins fade. Although the same vein may need to be injected more than once, sclerotherapy is usually effective if done correctly. Sclerotherapy doesn't require anesthesia and can be done in your doctor's office. Side effects include swelling, itching and skin color changes in the treated area. Laser surgery. Laser surgery works by sending strong bursts of light into the vein that make the vein slowly fade and disappear. No incisions or needles are used. The treatment is often less effective than sclerotherapy, particularly for larger veins. Side effects may include redness, bruising, itching, swelling and permanent skin tone changes. After treatment, blood vessels fade over several months, but they may not disappear completely. Also, new spider veins can develop in the same area.