Monday, November 22, 2010

Electrotherapy in Physiotherapy

ANKYLOGLOSSIA and it`s solving

Ankyloglossia or tongue-tie is a congenital malformation caused by a short lingual frenulum that prevents the tongue from protruding. Occasionally, it could interfere with breast feeding.The patient in the photo is a young woman that was unable to extend her tongue. However, the short frenulum did not interfere with eating, swallowing, or speech. 
A grooved probe is used to retract the tongue and tense the frenulum.  The picture shows the site and horizontal direction of the frenulum incision.

The horizontally incised frenulum is now pulled vertically, allowing the release of the tongue. The incision is sutured vertically with absorbable stitches.







Post-operative appearance of the tongue that can now protrude down to the chin.

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Vascular CT Angiography Manual

Vascular medicine is an ever changing and rapidly advancing field, and with the onset of state of the art diagnostic and imaging modalities, we are recognizing that vascular illness is more prevalent than once thought. The proper diagnosis and treatment of this vascular illness may prevent stroke, salvage a limb and even save a life. Advancements in CT angiography have made vascular CT angiography the modality of choice for accurately diagnosing vascular disease and the management of its treatment. Modern, multi-slice CT provides noninvasive, direct imaging of virtually the entire vascular system in a safe, effective and accurate manner without the inherent risk attributed to invasive angiography. Furthermore, it is widely available, even in institutions that do not perform invasive angiography.




Vascular CT Angiography Manual distills vascular CT angiography and the diseases for which it is meant to diagnose into an easy to follow and inclusive resource. Designed for residents and fellows in cardiovascular medicine and radiology as well as for those already in practice, this work makes ‘difficult to understand’ concepts easy to comprehend with the aid of simple, intuitive diagrams, charts and clinical CT image examples. For those already proficient in vascular CT, this book will serve as a valuable resource as it compiles a complete radiation review, imaging protocols, screening recommendations, disease states and imaging tips in one location. It is organized and easy to follow, as each clinical chapter is organized to include sections on anatomy, disease states, accuracy of CT, and an approach to reading CT angiography.

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Handbook of Drugs in Intensive Care: An A - Z Guide - 2010 Edition

The fourth edition of this compact, practical pocketbook provides easy access for the reader with an A-Z listing of every drug and accompanying advice on its correct administration and potential adverse effects. It is an invaluable resource for all healthcare professionals working in the intensive care setting.

Numerous treatment options are available to intensive care staff; this requires detailed knowledge of routes of administration and contra-indications to use in certain clinical conditions. Now in its fourth edition, this concise, practical handbook to drugs and prescribing for intensive care gives up-to-date advice on established drugs as well as providing advice on those recently approved. The book is divided into two sections: an A-Z guide to many of the drugs available, with concise information on each drug, including uses, limitations, administration directions and adverse effects. The second section contains topics relevant to the critically ill patients, including factors that may affect drug prescribing and management of medical emergencies. There is also a key data section showing weight conversions, BMI and corresponding dosage calculations, and an invaluable chart indicating drug compatibility for IV administration. This is an invaluable resource for doctors, nurses, and pharmacists caring for critically ill patients.

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Koplik’s spots as described

This was a patient who presented with Koplik’s spots on palate due to pre-eruptive measles on day 3 of the illness. Measles is an acute, highly communicable viral disease with fever, conjunctivitis, coryza, cough, and Koplik spots. Koplik spots are ...........

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Chest X-rays of the Kyphotic Patient

The radiographer has, by force of habit, angled the X-ray tube caudally for the AP sitting projection. This is a positioning trap in bedside radiography of kyphotic patients. The result is extreme foreshortening of the chest. Even the use of a horizontal ray would have resulted in significant foreshortening of the lung fields (see the lateral image).

This is a lateral chest image taken on a patient with a moderately severe thoracic kyphosis. A triangular positioning sponge has been placed behind the patient. Note that the patient's chest is angled forward considerably and this position is associated with the patient's thoracic kyphosis.

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Foley Catheter


A Foley catheter is a thin, sterile tube inserted into the bladder to drain urine. Because it can be left in place in the bladder for a period of time, it is also called an indwelling catheter. It is held in place with a balloon at the end, which is filled with sterile water to hold it in place. The urine drains into a bag and can then be taken from an outlet device to be drained. Laboratory tests can be conducted on your urine to look for infection, blood, muscle breakdown, crystals, electrolytes, and kidney function. The procedure to insert a catheter is called catheterization.

A Foley catheter is used with many disorders, procedures, or problems such as these:

1.Retention of urine leading to urinary hesitancy, straining to urinate, decrease in size and force of the urinary stream, interruption of urinary stream, and sensation of incomplete emptying
2.Obstruction of the urethra by an anatomical condition that makes it difficult for you to urinate: prostate hypertrophy, prostate cancer, or narrowing of the urethra
3.Urine output monitoring in a critically ill or injured person
4.Collection of a sterile urine specimen for diagnostic purposes
5.Nerve-related bladder dysfunction, such as after spinal trauma (A catheter can be inserted regularly to assist with urination.)
6.Imaging study of the lower urinary tract
7.After surgery


Risks:
-The balloon can break while the catheter is being inserted. In this case, the doctor will remove all the balloon fragments.
-The balloon does not inflate after it is in place. Usually the doctor will check the balloon inflation before inserting the catheter into the urethra. If the balloon still does not inflate after its placement into the bladder, the doctor will then insert another Foley catheter.
-Urine stops flowing into the bag. The doctor will check for correct positioning of the catheter and bag or for obstruction of urine flow within the catheter tube.
-Urine flow is blocked. The doctor will have to change the bag or the Foley catheter or both.
-Patient urethra begins to bleed. The doctor will have to monitor the bleeding.
The Foley catheter may introduce an infection into the bladder. The risk of infection in the urine increases with the number of days the catheter is in place.
-If the balloon is opened before the Foley catheter is completely inserted into the bladder, bleeding, damage and even rupture of the urethra can occur. In some individuals, long-term permanent scarring and strictures of the urethra could occur.

Too see Procedure......

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