Dr. Chynn graduated from Harvard's ophthalmology program, which is probably the most famous in the world.
As the only member of his graduating class to specialize in Refractive Surgery, and now an recognized authority, Dr. Chynn is frequently invited back to Harvard to give updates on the State of the Art in Refractive Surgery.
This slide show presentation was given to 100 eye surgeons who flew in from across the country to learn the latest advances in glaucoma, retina, cataract surgery--and laser vision correction (from Dr. Chynn).
The title of his talk reflects the movement in the US and worldwide from leading surgeons that is called "Back to the Surface." This means that surgeons are moving away from LASIK and IntraLase, to avoid flap complications and the # 1 problem causing lawsuits (iatrogenic keratoconus, or KC), and back to the surface.
For some doctors, this means going back to the original procedure, PRK, which has a lot of pain, delayed healing, and scarring.
For Dr. Chynn, this means performing an Advanced Surface Ablation, which is either a LASEK or epiLASEK. These are more advanced than PRK because they do not hurt, healing and recovery is quick, and there is no haze or scarring.
For example, Dr. Chynn performs over 1,000 LASEKs and epiLASEKs per year--he performed his last PRK in 1999.
Obviously, he moved away from PRK to LASIK, then to IntraLase, and now back to the safer LASEK and epiLASEK procedures.
View the following slide show to find out more, and call us with your questions--better yet, come in and meet with our MDs!
Refractive eye surgeries have become enormously popular worldwide.
Although numerous types of surgical and laser refractive procedures are available today, a procedure known as laser in situ keratomileusis (LASIK) to correct nearsightedness is currently the most common type.
La chirurgie correctrice au laser peut se faire directement sur la surface oculaire a l'aide du laser excimer. Cette technique n'implique pas la découpe d'un volet et est une excellente alternative pour les patients avec de faibles myopies ou des cornées fines.
PRK ..... Is it a good alternative to lasik ????Amr Mounir
This presentation try to answer the recent debatable question about which is better LASIK or PRK , when to choose each of them and how to exclude complications of both procedures.
Refractive eye surgeries have become enormously popular worldwide.
Although numerous types of surgical and laser refractive procedures are available today, a procedure known as laser in situ keratomileusis (LASIK) to correct nearsightedness is currently the most common type.
La chirurgie correctrice au laser peut se faire directement sur la surface oculaire a l'aide du laser excimer. Cette technique n'implique pas la découpe d'un volet et est une excellente alternative pour les patients avec de faibles myopies ou des cornées fines.
PRK ..... Is it a good alternative to lasik ????Amr Mounir
This presentation try to answer the recent debatable question about which is better LASIK or PRK , when to choose each of them and how to exclude complications of both procedures.
Доклад на Пятой научно-практической конференции с международным участием «Основные тенденции в современной офтальмологии», организованной клиникой профессора Эскиной Э.Н. «Сфера», совместно с кафедрой офтальмологии ФГБОУ ДПО ИПК ФМБА России —→ http://www.sfe.ru/information/ophthalmology-news/conference2015.html
SMILE', short for 'Small Incision Lenticular Extraction' is no flap, no pain, quick recovery, and fully computer operated by the femtosecond laser. This new technique, is only possible with the Visumax femotsecond laser by Carl Zeiss, and is the least invasive therapy possible these days.
Relex Smile Laser surgery : is this the end of lasik ?
Presentation at the Annual Meeting in Clinical Ophthalmology (AMICO) in Brussels, March 14 2015.
The recent updates about corneal collagen crosslinkingAmr Mounir
This concentrated presentation describes the recent advances in the topic of corneal collagen cross linking with interaction with the most recent publications about this topic.
Describes the procedure of ReLEx smile, and illustrates why it is likely to replace excimer laser LASIK over time. For more details, visit www.newvisionindia.com
A lecture on the current techniques (mainly surgical) for the correction of Presbyopia. This includes information on static and dynamic surgical and non surgical approaches.
presbyopia
So essentially, Presbyopia is the state in which, as a result of age and age processes, the least distance of distinct vision recedes beyond 25cm.
This is majorly due to loss of plasticity of the lens.
During accommodation, the lens fails to develop the desired convexity for adequate near vision around the age of 40 and above, a person complains of blurring of vision while reading or doing close work especially at night or in a condition of poor lighting.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Current Trends in Refractive Surgery - Lecture given at Harvard by Emil Chynn, MD
1. Emil
William
Chynn,
MD,
FACS,
MBA
Park
Avenue
LASEK
333
Park
Avenue
South,
New
York,
NY
dr@ParkAvenueLASEK.com
2. Evolu&on
of
Refrac&ve
Surgery
RK,
AK
(Fyodorov
–
Russia/Ukraine)
PRK
(Trokel
&
L Esperance,
Columbia
U)
LASIK
(Pallikaris,
Greece)
LASEK
(Talamo,
Abad
&
Azar,
Mass
Eye
&
Ear
Intra-‐LASE,
i-‐LASIK
(Kurtz,
USA)
Epi-‐LASIK,
epi-‐LASEK
(Pallikaris,
Greece)
3. Original
Procedures:
Incisional
Chance
favors
the
prepared
mind
–
Louis
Pasteur
Boy
falls
off
bike/glasses
shatter/corneal
lacs-‐>no
specs!
Discovery/invention
of
RK
–
Svyatoslav
Fyodorov
Hex
K
–
Antonio
Medez
(Mexico)
Metal
blade-‐>Diamond
blade-‐>Guarded
diamond
blade
Risks:
perforation,
infection
Side-‐effects:
starbursts,
irregular
astigmatism
Unpredictability,
overcorrection
(PERK,
Waring)
4. First
move
to
the
surface:
PRK
Excimer
( excited
dimer )
laser,
193
nm
IBM
Labs,
Armonk,
NY
(chip
etching)
Trokel
(VISX)
&
L Esperance
(Summit),
Columbia
US
Patent
#5,108,388
(1983/87/92),
Claim
4:
The
method
of
changing
optical
properties
of
an
eye
by
operating
solely
upon
the
anterior
surface
of
the
cornea
of
the
eye
(using)
selective
UV
irradiation
and
attendant
ablative
photodecomposition
of
the
anterior
surface
of
the
cornea
in
a
volumetric
removal
of
corneal
tissue
and
with
depth
penetration
into
the
stroma
and
to
a
predetermined
curvature
profile
7. Safer
Flaps:
IntraLase/i-‐LASIK
Fewer
incomplete
or
button-‐hole
flaps
Thinner
flaps
Safer
for
thin
corneas,
high
Rx,
irregular
astig/FF
KC
Persistent
inflammation
+
photophobia
DES
Late
flap
trauma
Iatrogenic
KC
8. Move
Back
to
the
Surface
LASEK
–
remove
epithelium
en
bloc
using
EtOH
Epi-‐LASEK(IK)
–
en
bloc
dissection
using
epi-‐keratome
Advanced
Surface
Ablation
(ASA)
Flap-‐on
vs.
flap-‐off
13. Complicated
LASIK
enhancements
Safer
to
re-‐treat
surface/flap
No
increased
depth/decreased
stromal
bed
No
added
risk
of
ectasia
No
chance
of
epithelial
ingrowth/corneal
melt
No
risk
of
DLK
No
incomplete
flaps
No
risk
of
recutting
flaps
14. Enhancement
procedure
LASEK
OU
+
MMC
+
CustomVue
WaveFront
(HD)
LASEK
–
safer
than
epi-‐LASEK
on
retreatments
To
prevent
scarring:
MMC—mitomycin
C
(1
sec
/
sec.
of
ablation
time)
Vitamin
C
oral
steroids
(methylprednisolone)
x
1
week
PredForte
(prednisolone
acetate)
QID,
taper
over
mos
UV
protection
CustomVue
WaveFront—Prevue
Lens
15. PreVue
Lens:
useful
in
complex
cases1
LASIK
retreatments
UCVA
close
to
20/20
BCVA
not
20/20
No
objective
improvement
on
manifest
refraction
Subjective
complaints
disproportionate
Glare,
halos,
diplopia,
ghosting
Lawyers,
legal
considerations
1Bansal,
Chynn,
Rubinfield,
Refractive
Surgery
Complex
Case
Management,
Cataract
&
Refractive
Surgery
Today,
July
2008
16. Epithelial
PreVue
New
Universal
Way
to
PreVue
Can
be
used
with
any
laser
platform
(not
just
VISX)
More
accurate
than
PreVue
Larger
optical
zone
More
realistic
real-‐life
trial
Zero
downside
risk?
turning
lemons
into
lemonade
Useful
to:
encourage/discourage
enhancement
pre-‐sell /justify
WaveFront
upgrade
17. A.F.
–
62
yo
M
s/p
RK
+
AK
CC:
I
can t
see
well
far
or
near
without
glasses!
Had
multiple
RK
+
AK
incisions
OU
28
years
ago
VA
(distance):
20/80
OD,
20/100
OS,
20/60
OU
VA
(near):
20/100
OD,
20/80
OS,
20/80
OU
Rx:
+3.25
–
2.25
x
80
OD
+
4.50
–
4.75
x
95
OS
Saw
numerous
LASIK
surgeons
who
said:
I
wouldn t
touch
you
with
a
10-‐foot
pole!
If
you
get
LASIK
you
will
wind
up
with
pizza
slices!
18. Surgical
plan
Enhance
non-‐dominant
eye
first
Wait
3
months
before
enhancing
second
eye
Maximum
scarring
prophylaxis
Stress
patient
compliance
Frequent
post-‐op
visits/SLE
to
check
for
scarring
Slow
taper
of
topical
steroids
20. 1
year
postop
UCVA:
20/20
at
distance
(OU)
20/25
at
near
(OU)
Rx:
OD:
+0.50
–
0.75
x
13
OS:
-‐0.75
–
1.25
x
123
SLE:
clear
CC:
I
can
see
near
and
far
like
when
I
was
30,
which
is
good
as
I
just
married
a
30-‐year-‐old
and
am
having
my
tubes
reconnected
to
try
to
have
kids!
21. LASEK
of
Granular
Dystrophy
22
yo
F
–
Hx
Granular
Dystrophy
OU
UCVA
OD:
20/100
OS:
20/80
OU:
20/70
BSCVA:
OD:
-‐1.75
–
1.50
x
170
(20/80)
OS:
-‐1.00
–
0.50
x
5
(20/70)
OU:
20/60
25. Sze
H.
Wong,
BS
Lynnette
P.
Williams,
MD
Emil
W.
Chynn,
MD,
FACS,
MBA
The
authors
have
no
financial
interest
in
the
Presented
at
ASCRS,
2011
subject
ma4er
of
this
poster.
27. Gain
in
VA
at
3
months
Postop
UCVA
vs.
Preop
Best
Corrected
Visual
Acuity
(BCVA)
100
%
of
eyes
had
postop
UCVA
>
preop
UCVA!
Extreme
Myopic
Eyes
Extreme
Extreme
Hyperopic
Eyes
Astigmatic
Eyes
Number
of
Lines
Gained
8.42
3.58
6.68
LogMAR
Gained
1.51
0.77
1.08
29. Complica&ons
" 11/153
(7
%)
of
eyes
had
postop
haze
(tr
to
2+)
" 3/153
(2%)
of
eyes
lost
≥
1
line
of
BCVA
due
to
postop
haze
" 1/153
(0.7%)
of
eyes
lost
≥
2
lines
of
BCVA
due
to
postop
haze
30. CONCLUSION
Extreme
prescriptions
may
be
safely
and
effectively
treated
with
Advanced
Surface
Ablation,
combined
with
adjunctive
treatments
to
prevent
scarring
72%
eyes:
3-‐mo.
postop
UCVA
≥
preop
BCVA
Further
studies
are
needed
to
determine
whether
extremely
hyperopic
eyes
are
more
likely
to
lose
BCVA
and
how
to
avoid
this
loss
31. Summary:
ASA
=
LASEK
+
EpiLASEK
10x
safer
than
primary
LASIK
or
i-‐LASIK/
IntraLase?
Definitely
safer
in
complicated
enh
(RK,
AK,
PK)
Need
steroids
+
MMC
to
prevent
scarring
Slower
healing
/
patient
compliance
Combine
safety
of
PRK
with
comfort
of
LASIK
Can
Return
to
the
Surface
revitalize
Refractive
Surgery?
(still
0%
penetration
of
candidate
population)