Minimally Invasive Anterior Hip Replacement

The anterior approach is an approach to the front of the hip joint as opposed to a lateral (side) approach to the hip or posterior (back) approach. It is a true anterior approach to the hip and should not be confused with the Harding approach which is often referred to as an anterior approach.

Between Tinea capitis and Psoriasis of the scalp

 A 6-year-old child presents complaining of patchy hair loss on the back of the scalp. Examination reveals well-demarcated areas of erythema and scaling, and although there are still some hairs in the area, they are extremely short and broken in appearance. Which of the following is the most likely diagnosis?

• a.Androgenic hair loss
• b.Psoriasis of the scalp
• c.Seborrheic dermatitis
• d.Tinea capitis
• e.Carbuncle

 The answer is d. 

The history is most consistent with tinea capitis due to either Trichophyton tonsurans or Microsporum canis. It is usually seen in school-age children and may be transmitted from person to person.

 A mild but widespread infection by Tinea capitis (Scalp ringworm). Inflamed areas are seen on the front, behind the ear and on the back of the neck.Black dots are from broken hair

Psoriasisis a hereditary disorder characterized by scaling patches and plaques appearing in specific areas of the body, such as the scalp, elbows, lumbosacral region, and knees. The lesions are “salmon pink” with a silver-colored scale that on removal produces blood (Auspitz sign). The Koebner phenomenon (with trauma, the lesion jumps to a new location) is also elicited in patients with psoriasis.
Seborrheic dermatitisis a common chronic dermatosis occurring in areas with active sebaceous glands (face, scalp, and body folds) and may occur either in infancy or in people over the age of 20. The eczematous plaques of seborrheic dermatitis are yellowish red and are often greasy with a sticky crust. Androgenic hair loss is a progressive hereditary bitemporal, frontal, or vertex balding that may begin any time after puberty. A carbuncle is a deep infectious collection of interconnecting abscesses (furuncles) arising from several hair follicles.

Uvular Necrosis after Endoscopy

This 28-year-old man presented with a sore throat 72 hours after undergoing upper endoscopy. The patient had a 6-month history of intermittent solid-food dysphagia; upper endoscopy revealed a Schatzki ring. A wire was placed endoscopically, and a 20-mm Savary dilator was passed over the wire uneventfully.
The patient felt well after the procedure and was discharged home. He noted a mild sore throat, starting 24 hours after the procedure. When it persisted, he presented for evaluation.
Physical examination revealed necrosis of the distal uvula. No specific therapy was given, and acetaminophen was recommended for discomfort. The patient reported that the tip of the uvula spontaneously sloughed off the next day, and the discomfort resolved completely. He has had no further solid-food dysphagia.

Uvular necrosis is a rare event that can occur after upper endoscopy or direct laryngoscopy. The symptoms are generally mild, and the recovery is usually complete. The mechanism of injury is thought to be impingement of the uvula by the instrument against the hard palate or posterior pharynx, leading to ischemia. Uvular injury has also been reported as a result of aggressive oropharyngeal suctioning.

Penile Prosthesis Surgery for Erectile Dysfunction