Hernia Exam Video

hernia123

What Is a Hernia?
A hernia occurs when an organ or fatty tissue squeezes through a weak spot in a surrounding muscle or connective tissue called fascia. The most common types of hernia are inguinal (inner groin), incisional (resulting from an incision), femoral (outer groin), umbilical (belly button), and hiatal (upper stomach).

The basics on hernias from the experts at WebMD.

In an inguinal hernia, the intestine or the bladder protrudes through the abdominal wall or into the inguinal canal in the groin. About 96% of all groin hernias are inguinal, and most occur in men because of a natural weakness in this area.

In an incisional hernia, the intestine pushes through the abdominal wall at the site of previous abdominal surgery. This type is most common in elderly or overweight people who are inactive after abdominal surgery.
A femoral hernia occurs when the intestine enters the canal carrying the femoral artery into the upper thigh. Femoral hernias are most common in women, especially those who are pregnant or obese.

In an umbilical hernia, part of the small intestine passes through the abdominal wall near the navel. Common in newborns, it also commonly afflicts obese women or those who have had many children.

A hiatal herniahappens when the upper stomach squeezes through the hiatus, an opening in the diaphragm through which the esophagus passes.

What Causes Hernias?
Ultimately, all hernias are caused by a combination of pressure and an opening or weakness of muscle or fascia; the pressure pushes an organ or tissue through the opening or weak spot. Sometimes the muscle weakness is present at birth; more often, it occurs later in life.

Anything that causes an increase in pressure in the abdomen can cause a hernia, including:

Lifting heavy objects without stabilizing the abdominal muscles
Diarrhea or constipation
Persistent coughing or sneezing
In addition, obesity, poor nutrition, and smoking, can all weaken muscles and make hernias more likely.

City of Medicine

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Some may be familiar with Durham’s start as a tobacco town or the popular nickname “Bull City,” but today Durham is also referred to as the City of Medicine.

Durham’s identity as a healthcare leader traces back to 1906, when Durham pharmacists Germain Bernard and C.T. Council developed BC Headache Powder. In the century that followed, healthcare has become Durham’s largest employment cluster – nearly one in three people in Durham works in a health-related field, and more than 300 medical and health-related companies, medical practices, weight management centers, and pharmaceutical research organizations are located here, with a combined payroll exceeding $1.2 billion.

Today, Durham continues to earn its name as the City of Medicine because it has:

  • A physician-to-population ratio almost 4.5 times the national average.
  • Over 3,700 licensed physicians and interns and more than 6,000 nurses.
  • 46% of the biotech firms based in North Carolina.
  • One of three US hospitals to be recognized by the American Hospital Association for leadership and innovation in quality, safety, and commitment to patient care.
  • One of the top 10 US hospitals according to U.S. News & World Report.
  • Facilities serving more than 200,000 veterans living in a 26-county area of central and eastern North Carolina.
  • Six modern hospitals that lie at the heart of Duham’s reputation: Duke University Hospital & Medical Center, Duke Children’s Hospital & McGovern-Davison Health Center, Duke Regional Hospital, Durham Veterans Administration (VA) Medical Center, Lenox Baker Children’s Hospital, and North Carolina Specialty Hospital.

Baby Born With Brain Malformation, Turns 1 year old

Despite what doctors predicted, Jaxon Buell, Baby Born With Brain Malformation, Turns 1 year old — (PHOTOS)
 

They asked for a miracle, and they got one. Brandon and Brittany Buell are celebrating the first birthday of their son, Jaxon Emmett Buell, a baby born with “an extreme brain malformation that the doctors are not even labeling with a name, and for which there is no cure,” they explain. They’re calling their son’s incredible story “Jaxon Strong.”


Yesterday (August 28), Brandon wrote on Facebook that Jaxon’s first birthday on that day is “a miracle, in and of itself, that through everything Jaxon has already been through, through his diagnosis, by the doubts of several medical teams, and with his perceived prognosis, he is still here, strong as ever, only dependent on a feeding tube, and can hear, see, talk, smile, laugh, and is learning more every day, even how to say ‘Mama’ and ‘Dadda’ directly to us.”

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Brandon adds that he and Brittany have moved to Cambridge, Massachusetts, to be closer to Boston’s Children’s Hospital, “where our family’s continued pursuit of answers for Jaxon’s life, from the #1 medical team in the country, has brought us.”
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New small animal model to study the pathogenesis of hypertrophic and burn scars

new small animal model to study the pathogenesis of hypertrophic and burn scars

new small animal model to study the pathogenesis of hypertrophic and burn scars

Duke University Medical Center invents a new small animal model to study the pathogenesis of hypertrophic and burn scars. This is the first immune-competent rodent model ever introduced in the field. Led by Mohamed Ibrahim, MD, the senior research fellow in the division of plastic and reconstructive surgery of Duke University, the new model will help introducing new medications and agents to mitigate hypertrophic scars.
For more information, follow the researcher here:
https://www.researchgate.net/profile/Mohamed_Ibrahim102

 

Government Upgrading Medical Colleges Across India: Health Minister

Union Health Minister J P Nadda today said that government is upgrading all the existing medical colleges and setting up many more across the country.

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The government is building super speciality blocks in 70 medical colleges and upgrading 58 district hospitals to medical colleges, Nadda said while speaking at the 34th convocation function of PGIMER here, where Prime Minister Narendra Modi was the chief guest.

“We are expanding the network of our medical colleges in a big way by upgrading 58 district hospitals to medical colleges. Also, twenty state cancer institutes and 50 tertiary cancer care centers are being set up. Our government’s vision is delivery of quality tertiary care services to our citizens,” he said.

Punjab and Haryana Governor, Kaptan Singh Solanki, BJP MP from Chandigarh and actor, Kirron Kher and Union Health Secretary, Bhanu Pratap Sharma, were among the others present on the occasion.

Nadda said the BJP-led government attaches a lot of importance to tertiary care and medical education.

“We have announced ten new AIIMS like institutions in various parts of the country,” he said.

He also said that PGIMER Chandigarh has been constantly upgrading its capacities in patient care, medical education and health research.

“The institution is conducting one of the most successful postgraduate programmes in the country with a capacity to train over 900 doctors every year in postgraduate and super specialities.

People of the entire northern region comprising Punjab, Haryana, Himachal Pradesh and Jammu and Kashmir and parts of Uttarakhand bank upon this institute for high quality tertiary care services…PGI Chandigarh is working towards full implementation of e-hospital,” Nadda said.

The chicken that lived for 18 months without a head

Seventy years ago, a farmer beheaded a chicken in Colorado, and it refused to die. Mike, as the bird became known, survived for 18 months and became famous. But how did he live without a head for so long, asks Chris Stokel-Walker._85456544_mike_headless_getty976

On 10 September 1945 Lloyd Olsen and his wife Clara were killing chickens, on their farm in Fruita, Colorado. Olsen would decapitate the birds, his wife would clean them up. But one of the 40 or 50 animals that went under Olsen’s hatchet that day didn’t behave like the rest.

“They got down to the end and had one who was still alive, up and walking around,” says the couple’s great-grandson, Troy Waters, himself a farmer in Fruita. The chicken kicked and ran, and didn’t stop.

It was placed in an old apple box on the farm’s screened porch for the night, and when Lloyd Olsen woke the following morning, he stepped outside to see what had happened. “The damn thing was still alive,” says Waters.

“It’s part of our weird family history,” says Christa Waters, Troy’s wife.

Waters heard the story as a boy, when his bedridden great-grandfather came to live with Troy’s family. The two had adjacent bedrooms, and the old man, often sleepless, would talk for hours.

“He took the chicken carcasses to town to sell them at the meat market,” Waters says.

“He took this rooster with him – and back then he was still using the horse and wagon quite a bit. He threw it in the wagon, took the chicken in with him and started betting people beer or something that he had a live headless chicken.”

Word spread around Fruita about the miraculous headless bird. The local paper dispatched a reporter to interview Olsen, and two weeks later a sideshow promoter called Hope Wade travelled nearly 300 miles from Salt Lake City, Utah. He had a simple proposition: take the chicken on to the sideshow circuit – they could make some money.

“Back then in the 1940s, they had a small farm and were struggling,” Waters says. “Lloyd said, ‘What the hell – we might as well.'”

First they visited Salt Lake City and the University of Utah, where the chicken was put through a battery of tests. Rumour has it that university scientists surgically removed the heads of many other chickens to see whether any would live.

It was here that Life Magazine came to marvel over the story of Miracle Mike the Headless Chicken – as he had by now been branded by Hope Wade. Then Lloyd, Clara and Mike set off on a tour of the US.

Clara and Lloyd OlsenImage copyrightWaters family
Image captionClara and Lloyd Olsen

They went to California and Arizona, and Hope Wade took Mike on a tour of the south-eastern United States when the Olsens had to return to their farm to collect the harvest.

The bird’s travels were carefully documented by Clara in a scrapbook that is preserved in the Waters’s gun safe today.

People around the country wrote letters – 40 or 50 in all – and not all positive. One compared the Olsens to Nazis, another from Alaska asked them to swap Mike’s drumstick in exchange for a wooden leg. Some were addressed only to “The owners of the headless chicken in Colorado”, yet still found their way to the family farm.

After the initial tour, the Olsens took Mike the Headless Chicken to Phoenix, Arizona, where disaster struck in the spring of 1947.

“That’s where it died – in Phoenix,” Waters says.


What happens when a chicken’s head is chopped off?

  • Beheading disconnects the brain from the rest of the body, but for a short period the spinal cord circuits still have residual oxygen.
  • Without input from the brain these circuits start spontaneously. “The neurons become active, the legs start moving,” says Dr Tom Smulders of Newcastle University.
  • Usually the chicken is lying down when this happens, but in rare cases, neurons will fire a motor programme of running.
  • “The chicken will indeed run for a little while,” says Smulders. “But not for 18 months, more like 15 minutes or so.”

Mike was fed with liquid food and water that the Olsens dropped directly into his oesophagus. Another vital bodily function they helped with was clearing mucus from his throat. They fed him with a dropper, and cleared his throat with a syringe.

The night Mike died, they were woken in their motel room by the sound of the bird choking. When they looked for the syringe they realised they had left it at the sideshow, and before they could find an alternative, Mike suffocated.

“For years he would claim he had sold [the chicken] to a guy in the sideshow circuit,” Waters says, before pausing. “It wasn’t until, well, a few years before he died that he finally admitted to me one night that it died on him. I think he didn’t ever want to admit he screwed up and let the proverbial goose that lays golden eggs die on him.”

Olsen would never tell what he did with the dead bird. “I’m willing to bet he got flipped out in the desert somewhere between here and Phoenix, on the side of the road, probably eaten by coyotes,” Waters says.

But by any measure Mike, bred as a fryer chicken, had a good innings. How had he been able to survive for so long?

The thing that surprises Dr Tom Smulders, a chicken expert at the Centre for Behaviour and Evolution at Newcastle University, is that he did not bleed to death. The fact that he was able to continue functioning without a head he finds easier to explain.

Postcard with poem about MikeFor a human to lose his or her head would involve an almost total loss of the brain. For a chicken, it’s rather different.

“You’d be amazed how little brain there is in the front of the head of a chicken,” says Smulders.

It is mostly concentrated at the back of the skull, behind the eyes, he explains.

Reports indicate that Mike’s beak, face, eyes and an ear were removed with the hatchet blow. But Smulders estimates that up to 80% of his brain by mass – and almost everything that controls the chicken’s body, including heart rate, breathing, hunger and digestion – remained untouched.

It was suggested at the time that Mike survived the blow because part or all of the brain stem remained attached to his body. Since then science has evolved, and what was then called the brain stem has been found to be part of the brain proper.

“Most of the bird brain as we know it now would actually be considered the brain stem back then,” Smulders says.

“The names that had been given to parts of the bird brain in the late 1800s were all indicating equivalences with the mammalian brain that were in fact wrong.”

Troy Waters stands next to a statue of Mike in Fruita
Image caption: Troy Waters stands next to a statue of Mike in Fruita, which holds the Headless Chicken festival every year in May

Why those who tried to create a Mike of their own did not succeed is hard to explain. It seems the cut, in Mike’s case, came in just the right place, and a timely blood clot luckily prevented him bleeding to death.

Troy Waters suspects that his great-grandfather tried to replicate his success with the hatchet a few times.

Certainly, others did. A neighbour who lived up the road would buy up any chickens for sale at an auction in nearby Grand Junction, Colorado, and stop by the family farm with a six-pack of beer for Olsen, to persuade him to explain exactly how he did it.

“I remember [him] telling me, laughing, that he got free beer every other weekend because the neighbour was sure he got filthy rich off this chicken,” Waters says.

“Filthy rich” was an opinion many held in Fruita of the Olsen family. But according to Waters, that was an exaggeration.

“He did make a little money off it,” Waters says. He bought a hay baler and two tractors, replacing his horse and mule. And also – a bit of a luxury – a 1946 Chevrolet pickup truck.

Waters once asked Lloyd Olsen if he had fun. “He said, ‘Oh yeah, I had a chance to travel around and see parts of the country I probably otherwise wouldn’t have seen. I was able to modernise and have farm equipment.’ But it was something he put in his past.

“He still farmed the rest of his life, scratched a living out of the dirt.”

This Face Will Change the Human Story

A trove of bones hidden deep within a South African cave represents a new species of human ancestor, scientists announced Thursday in the journal eLife. Homo naledi, as they call it, appears very primitive in some respects—it had a tiny brain, for instance, and apelike shoulders for climbing. But in other ways it looks remarkably like modern humans. When did it live? Where does it fit in the human family tree? And how did its bones get into the deepest hidden chamber of the cave—could such a primitive creature have been disposing of its dead intentionally?

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This is the story of one of the greatest fossil discoveries of the past half century, and of what it might mean for our understanding of human evolution.

Chance Favors the Slender Caver
Two years ago, a pair of recreational cavers entered a cave called Rising Star, some 30 miles northwest of Johannesburg. Rising Star has been a popular draw for cavers since the 1960s, and its filigree of channels and caverns is well mapped. Steven Tucker and Rick Hunter were hoping to find some less trodden passage.

In the back of their minds was another mission. In the first half of the 20th century, this region of South Africa produced so many fossils of our early ancestors that it later became known as the Cradle of Humankind. Though the heyday of fossil hunting there was long past, the cavers knew that a scientist in Johannesburg was looking for bones. The odds of happening upon something were remote. But you never know.
Sunlight falls through the entrance of Rising Star cave, near Johannesburg. A remote chamber has yielded hundreds of fossil bones—so far. Says anthropologist Marina Elliott, seated, “We have literally just scratched the surface.”

One Videographer’s Journey to Find a Lost Human Ancestor
Extracting Fossils From the Cradle of Humankind

Deep in the cave, Tucker and Hunter worked their way through a constriction called Superman’s Crawl—because most people can fit through only by holding one arm tightly against the body and extending the other above the head, like the Man of Steel in flight. Crossing a large chamber, they climbed a jagged wall of rock called the Dragon’s Back. At the top they found themselves in a pretty little cavity decorated with stalactites. Hunter got out his video camera, and to remove himself from the frame, Tucker eased himself into a fissure in the cave floor. His foot found a finger of rock, then another below it, then—empty space. Dropping down, he found himself in a narrow, vertical chute, in some places less than eight inches wide. He called to Hunter to follow him. Both men have hyper-slender frames, all bone and wiry muscle. Had their torsos been just a little bigger, they would not have fit in the chute, and what is arguably the most astonishing human fossil discovery in half a century—and undoubtedly the most perplexing—would not have occurred.

After Lucy, a Mystery
Lee Berger, the paleoanthropologist who had asked cavers to keep an eye out for fossils, is a big-boned American with a high forehead, a flushed face, and cheeks that flare out broadly when he smiles, which is a lot of the time. His unquenchable optimism has proved essential to his professional life. By the early 1990s, when Berger got a job at the University of the Witwatersrand (“Wits”) and had begun to hunt for fossils, the spotlight in human evolution had long since shifted to the Great Rift Valley of East Africa.

Most researchers regarded South Africa as an interesting sidebar to the story of human evolution but not the main plot. Berger was determined to prove them wrong. But for almost 20 years, the relatively insignificant finds he made seemed only to underscore how little South Africa had left to offer.

What he most wanted to find were fossils that could shed light on the primary outstanding mystery in human evolution: the origin of our genus, Homo, between two million and three million years ago. On the far side of that divide are the apelike australopithecines, epitomized by Australopithecus afarensis and its most famous representative, Lucy, a skeleton discovered in Ethiopia in 1974. On the near side is Homo erectus, a tool-wielding, fire-making, globe-trotting species with a big brain and body proportions much like ours. Within that murky million-year gap, a bipedal animal was transformed into a nascent human being, a creature not just adapted to its environment but able to apply its mind to master it. How did that revolution happen?

The fossil record is frustratingly ambiguous. Slightly older than H. erectus is a species called Homo habilis, or “handy man”—so named by Louis Leakey and his colleagues in 1964 because they believed it responsible for the stone tools they were finding at Olduvai Gorge in Tanzania. In the 1970s teams led by Louis’s son Richard found more H. habilis specimens in Kenya, and ever since, the species has provided a shaky base for the human family tree, keeping it rooted in East Africa. Before H. habilis the human story goes dark, with just a few fossil fragments of Homo too sketchy to warrant a species name. As one scientist put it, they would easily fit in a shoe box, and you’d still have room for the shoes.

Berger has long argued that H. habilis was too primitive to deserve its privileged position at the root of our genus. Some other scientists agree that it really should be called Australopithecus. But Berger has been nearly alone in arguing that South Africa was the place to look for the true earliest Homo. And for years the unchecked exuberance with which he promoted his relatively minor finds tended only to alienate some of his professional colleagues. Berger had the ambition and personality to become a famous player in his field, like Richard Leakey or Donald Johanson, who found the Lucy skeleton. Berger is a tireless fund-raiser and a master at enthralling a public audience. But he didn’t have the bones.

Then, in 2008, he made a truly important discovery. While searching in a place later called Malapa, some ten miles from Rising Star, he and his nine-year-old son, Matthew, found some hominin fossils poking out of hunks of dolomite.
The NOVA/National Geographic Special, “Dawn of Humanity,” premieres Sept. 16, 2015, at 9 p.m. ET/8 p.m. CT on PBS in the United States and is streaming online now.
Over the next year Berger’s team painstakingly chipped two nearly complete skeletons out of the rock. Dated to about two million years ago, they were the first major finds from South Africa published in decades. (An even more complete skeleton found earlier has yet to be described.) In most respects they were very primitive, but there were some oddly modern traits too.

Berger decided the skeletons were a new species of australopithecine, which he named Australopithecus sediba. But he also claimed they were “the Rosetta stone” to the origins of Homo. Though the doyens of paleoanthropology credited him with a “jaw-dropping” find, most dismissed his interpretation of it. A. sediba was too young, too weird, and not in the right place to be ancestral to Homo: It wasn’t one of us. In another sense, neither was Berger. Since then, prominent researchers have published papers on early Homo that didn’t even mention him or his find.

Berger shook off the rejection and got back to work—there were additional skeletons from Malapa to occupy him, still encased in limestone blocks in his lab. Then one night, Pedro Boshoff, a caver and geologist Berger had hired to look for fossils, knocked on his door. With him was Steven Tucker. Berger took one look at the pictures they showed him from Rising Star and realized that Malapa was going to have to take a backseat.
Skinny Individuals Wanted
After contorting themselves 40 feet down the narrow chute in the Rising Star cave, Tucker and Rick Hunter had dropped into another pretty chamber, with a cascade of white flowstones in one corner. A passageway led into a larger cavity, about 30 feet long and only a few feet wide, its walls and ceiling a bewilderment of calcite gnarls and jutting flowstone fingers. But it was what was on the floor that drew the two men’s attention. There were bones everywhere. The cavers first thought they must be modern. They weren’t stone heavy, like most fossils, nor were they encased in stone—they were just lying about on the surface, as if someone had tossed them in. They noticed a piece of a lower jaw, with teeth intact; it looked human.

 

Governor humiliates a physician in Egypt: “Take your hands out of your pockets”

“Take your hands out of your pockets”, these were the words that the Giza governor has used to humiliate a physician in duty during a sudden inspection surrounded by cameras and journalists.

The incident has caused widespread controversy among the medical community in Egypt and several

Facebook pages and protests were carried on to make the governor apologize to physicians for his behavior. The governor has refused to apologize.Screen Shot 2015-09-10 at 1.39.09 AM

Egyptian doctors often work in these difficult conditions for little to no pay. Young doctors are often given as little as LE185 ($30) basic salary for an entire month’s pay. When the incentives are added, usually the total salary is a meager LE900 ($148). And they get LE19 ($3) as a compensation for the risk of infection.

When doctors graduate from medical school, they usually have to complete a residency for two to three years, often far away from home, where they are expected to use the money to cover their living expenses and transportation. The low income often forces doctors to seek work in private institutions alongside their work in public hospitals. However, balancing two jobs is not easy and doctors begin to make mistakes.

 

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