Bell's palsy - NHS video

Bell’s palsy is the abrupt paralysis of the facial nerve (cranial nerve 7, CN7), resulting in an inability to control facial muscles on the affected side. A common condition, Bell’s palsy has an annual incidence of 11-40 cases per 100 ,000 population. Many patients recover without intervention; however, up to 30% have poor recovery of facial muscle control and experience facial disfigurement, psychological trauma, and facial pain.

From the NHS Choices YouTube channel: Bell's palsy is the temporary weakness or paralysis of the muscles in one side of the face. In this video, a speech therapist explains who is most at risk and describes common causes and treatment options available. Helen explains how she dealt with the condition and recovered from it:



Remember:

U MN damage
U pper face is OK (the patient is able to wrinkle his forehead)

LMN damage = patient is unable to wrinkle his forehead (our patient)

The examination of CN 7 palsy can be remembered by the mnemonic COWS:

C lose your eyes
O pen (the examining physician tries to open the patient's eyes)
W rinkle your forehead
S mile

Two main types of pharmacological treatment have been used to improve outcomes from Bell’s palsy:

- steroids
- antivirals.

The rationale for these treatments is based on the presumed pathophysiology of Bell’s palsy, namely inflammation and viral infection.

In a 2009 study published in the BMJ antivirals did not provide an added benefit in achieving at least partial facial muscle recovery compared with steroids alone in patients with Bell’s palsy.

References:

The benefits of steroids versus steroids plus antivirals for treatment of Bell’s palsy: a meta-analysis | BMJ http://bit.ly/YD3iLG

Sickle cell anemia - NHS Choices video

From NHS Choices YouTube channel:

Sickle cell anaemia is a genetic (inherited) blood disorder where red blood cells develop abnormally. In this video a specialist nurse explains what it is, and Junior describes living with the condition:



The estimated survival at 18 years is now 94 percent for those with HbSS sickle cell disease or HbS/beta(0) thalassemia and 98 percent for those with HbSC or HbS/beta(+) thalassemia.

Related reading:

What's new in hematology from UpToDate http://bit.ly/Tm97Ee

Rosacea - NHS Choices video

From NHS Choices YouTube channel: Rosacea is a common but poorly understood long-term skin condition that mainly affects the face. It most commonly affects fair-skinned people from northern Europe and is estimated to affect up to 1 in 10 people. In this video, an expert explains what rosacea is, the symptoms to look out for and the various treatments.



Cathelicidin dysfunction may be a central factor in the pathogenesis of several cutaneous diseases, including rosacea.

Cathelicidins are antimicrobial peptides (AMPs) that protect the skin through 2 pathways:

- antimicrobial activity
- cytokine release, inflammation, angiogenesis, and reepithelialization

Bunions animation

From NHS Choices YouTube channel: A bunion is a bony deformity of the joint at the base of the big toe. This animation shows how a bunion forms and explains what could cause it. Find out how bunions are treated: http://nhs.uk/Conditions/Bunion/Pages/Treatment.aspx

Munchausen's syndrome - NHS video

From the NHS Choices YouTube channel: A psychiatrist explains the motivation behind Munchausen's syndrome, also known as factitious illness, where someone pretends to be ill or causes symptoms in themselves. This can include inflicting wounds or tampering with blood and urine samples. He also explains the importance of getting treatment and describes another form of the condition where a person fabricates an illness in someone in their care (Munchausen's syndrome by proxy):



Comments from Twitter:

Julie Meadows-Keefe @esq140: Fascinatingly & disturbingly real.

Sleepwalking: Lee's story

From NHS Choices YouTube channel: Lee started sleepwalking at the age of four. In this video he describes his sleepwalking episodes, including doing artwork despite having no interest in art, plus the physical side effects when he wakes up.

Also watch Sleepwalking in children.

Scabies - NHS patient education video

From the NHS Choices YouTube channel: Scabies is a contagious skin infection which itches intensely. A GP talks about the causes, symptoms and treatment.

From the memorable medical textbooks of the past: Medical textbooks were not always as dreary and as bland as they are now, according to BMJ.

Some examples of lively, first person didactic tone come from J L Burton’s Essentials of Dermatology: "The simultaneous occurrence of scabies in a doctor and a nurse may mean that they have shared nothing more exciting than a patient with Norwegian scabies."

References:

Memorable medical textbooks of the past

Paget's disease - NHS Choices video

From the NHS Choices YouTube channel: An expert describes the various areas of the body that can be affected by Paget's disease - a condition in which the normal cycle of bone growth is disrupted.

The earliest references to journal clubs are in the memoirs and letters of Sir James Paget, a British surgeon, who described a group at St. Bartholomew’s Hospital in London in the mid-1800s as “a kind of club … a small room over a baker’s shop near the Hospital-gate where we could sit and read the journals.”

Sir Paget (11 January 1814 – 30 December 1899) is best remembered for Paget's disease and is considered, together with Rudolf Virchow, as one of the founders of scientific medical pathology.

References:

When was the earliest journal club?
James Paget, Wikipedia.

Glaucoma: Aruna's story (video)

From NHS Choices YouTube channel: Glaucoma is a group of eye conditions that affect vision. Aruna talks about her diagnosis and subsequent treatment.

A consultant ophthalmologist explains what glaucoma is, how it can affect your vision and how it can be treated:

Coping with stress - NHS video

From NHS Choices YouTube channel:

There are many ways of coping with stress. Professor Cary Cooper provides some techniques for managing stress, such as exercising and using relaxation techniques, and explains who you can talk to if you're feeling under pressure.

Get more tips and advice about dealing with stress here: http://nhs.uk/livewell/stressmanagement

Tips for managing stress:

- Take a few deep breaths
- Get plenty of exercise
- Socialize - don't stress alone, talk to someone and have a laugh
- Get out - go to the park

Participation in sport is associated with a with a 20—40% reduction in all-cause mortality compared with non-participation. Exercise might also be considered as a fifth vital sign, according to the Lancet: http://goo.gl/gyxYf

If nothing else helps, consider this: Chewing gum may reduce stress and improve memory

Related reading:

Children chewing xylitol gum were 25% less likely to develop acute ear infections. NYTimes, 2011.

Pacemaker implantation animation

From NHS Choices YouTube channel: Pacemaker implantation involves surgically placing an electrical device into the chest to help your heart beat normally. This animation explains what causes an irregular heartbeat and how a pacemaker can correct it.

Sciatica: Robert's story

From NHS Choices YouTube channel: Robert's sciatica caused him intense pain in his right leg. He describes how the condition affected his life and mobility and what treatment options were available to him.

Hepatitis C: Teenager Jazzy's Story

NHS Choices: Teenager Jazzy was born with hepatitis C. This is her video diary about living with the condition.

Comments from Twitter:

@napernurse: Fortunate to live in UK where extensive med/psych prescriptions for HepatitisC covered by NHS. If liver transplant needed, that is covered too!

Varicose veins: an animation

From NHSChoices YouTube channel: This animation explains in detail what varicose veins are, their causes, symptoms and the various treatment options.