Hip joint willard mo

In a bad spot, don't know when to go to ER.

2023.06.09 14:57 PuffHoney In a bad spot, don't know when to go to ER.

37F 206lbs don't drink, occasionally smoke tobacco. I was an opioid user for about 10 years with short, intermittent periods of sobriety. I've been mostly sober for over a year (I still smoke Marijuana and occasionally take some kratom because I have awful back pain. Please don't come at me, I'm not stealing money for weed like I was real drugs.)
I started feeling very sick last Wednesday with nausea and worse, stomach pain. Between Wednesday and Sunday I managed to eat 2 cups of applesauce and about 10 crackers. The nausea went away by Monday and I ate, lightly Monday and Tuesday. On Wednesday I woke up with sensitivity to the touch around my waist, the very bottom of my rib cage to the top of my hips just hurts. I also have bad joint pain as though I have a high fever, but with no temperature.
Just not sure if I should go to the ER or wait it out. Any help appreciated.
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2023.06.09 14:36 alafiyameditour1 Hip replacement surgery cost in India Hip replacement surgery in India

Hip replacement surgery cost in India Hip replacement surgery in India - Hip replacement surgery is a major medical procedure. It involves replacing a damaged or diseased hip joint with an artificial joint. In India, the cost of hip replacement surgery varies depending on the type of implant used and the hospital where it is performed. We help you in hip replacement in India 24x7.
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2023.06.09 14:07 Amazing_Pool1084 Hair treatment in Pashim vihar, Delhi

BR HEALTH CARE provides comprehensive orthopedic and Hair Loss our Dental Treatment in Delhi services for patients. We offer surgical and non-surgical treatments for sports injuries and a broad range of bone, muscle, and joint problems. Our goal is to restore your health, so you can return to your normal activities. Through comprehensive services for sports medicine, arthroscopy, and total joint reconstruction, our physicians treat problems with the shoulder, knee, Hip, foot, ankle, neck, fracture care, and pediatric orthopedics.
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2023.06.09 09:32 digiri-dont-do-that Body is degenerating and after 2.5 years I still don't know what the cause is.

25M 70kgs 5'8
Straight off the bat I have to say I posted in this sub a few months back but since then there's been some developments.
In a nutshell I was recently discharged by a rheumatologist because they have no idea what is happening to me.
For the past 2.5 years or so I have developed crepitus throughout my entire body, it is incredibly loud, repeatable (so I believe it is not typical cavitation like when you crack your knuckles and have to wait before doing so again) and is often accompanied by pain. My neck, lower back and knees are the worst. However, it is also present in my ankles, wrists, hips, elbows, shoulders, thighs/coccyx (I haven't been able to fully identify where this one is coming from), sternum/ribcage, jaw etc. I'm basically a walking sound system at this point, the most minute of movements results in noise, it's maddening. What's worse is having absolutely no answer as to its cause. I have also started to experience a strange phenomena of whooshing and ringing in my ears, which I assume is tinnitus.
I have been seen by a variety of rheumatologists and specialist physiotherapists who have debated whether I'm hypermobile, or at least somewhere on the high end of that spectrum. Most of them have concluded that I am definitely not hypermobile. All of these rheumatologists have been very senior and accredited in the research hospital I've been seen in. However I'm always given contradictory information from each of them, with no diagnosis ever made.
I've so far had 4 X-rays and an MRI, with nothing of note found besides osteophytes and scleroderma in some portions of my lower spine. I was also investigated for concerns of ankylosing spondyloarthritis but that came back negative. I'm also HLA B27 positive. Since these scans my symptoms have increased in severity.
In conjunction with this I had previously, and technically continue still to this day continue to "suffer" from Henoch Schonlein Purpura. Although these days it is nowhere near as much of a problem as it was for me a few years ago.
My last interaction with the most senior rheumatologist was a plan to medicate me with steroid injection and then a DMARD if the steroids proved effective. They didn't. And so for my follow up appointment I saw a different rheumatologist who I informed that the treatment plan hadn't worked and I had not responded to the steroids. To which he essentially said, your body will stiffen up as you get older and this should resolve on its own. Not the answer I was looking for.
Due to my ongoing medical issue I have started to distance myself from activities I enjoyed such as BJJ due to fear of making my condition worse. I was also suspicious of this activity itself being either the direct cause of my condition due to its physical nature, and my joint issues only began after I started doing the activity. However, I have since stopped doing the sport and my symptoms haven't only persisted but have spread to previously unaffected areas. Still it may be a contributing factor.
Nobody I have come across has an answer, I really do want to know what is going wrong with my body, especially since each day I am experiencing its degeneration. I feel weaker, the structures in my body feel much more lax and are prone to injury. A few people on reddit have claimed very similar symptoms to mine also without a diagnosis. I don't know where to turn. I'm also currently searching for alternative treatments such as prolotherapy/prp injections etc. but have frame of reference for whether they would work or not.
Any information would be greatly appreciated.
Thank you.
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2023.06.09 08:25 Vast_Suggestion_5145 Bone Specialist in Hyderabad Dr. Srinivas Kasha

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Fractures can be distressing and debilitating, but with Dr. Srinivas Kasha's comprehensive fracture treatment, you can rest assured that you are in capable hands. Dr. Kasha employs the latest advancements in orthopedic medicine to ensure optimal healing and recovery. From initial assessment and diagnosis to the final stages of rehabilitation, he guides his patients throughout the entire treatment process. His approach involves a combination of non-surgical techniques, minimally invasive procedures, and, when necessary, surgical interventions to achieve the best outcomes.
Orthopedic Hip Specialist
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As an accomplished orthopedic surgeon, Dr. Srinivas Kasha has gained recognition for his surgical skills and precision. He is committed to staying abreast of the latest surgical techniques and advancements in the field of orthopedics. Dr. Kasha combines his surgical expertise with a patient-centric approach, ensuring that each surgical procedure is tailored to the individual needs of his patients. Whether you require joint replacement surgery, arthroscopic procedures, or complex fracture repairs, Dr. Kasha's surgical proficiency and attention to detail make him the preferred choice for orthopedic surgeries in Hyderabad.
In conclusion, if you are seeking a bone specialist in Hyderabad, Dr. Srinivas Kasha should be your first choice. With his vast experience, comprehensive fracture treatment, orthopedic hip specialization, and exceptional surgical skills, Dr. Kasha provides unparalleled orthopedic care. Don't let bone and joint problems limit your lifestyle – consult Dr. Srinivas Kasha and regain your mobility and well-being.
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2023.06.09 07:40 PICT0GRAMJONES Wife Rammed Into Loaded Pallets By Forklift, MVA a Year Later. Can Someone Explain These CT Results?

She is 28F 5'5 about 140 pounds.
As the title states, my wife was rammed into some loaded pallets by a forklift at work. A year later we were in a car accident and her previous injuries got worse. Can someone please explain these findings for me like I'm 5? They were never explained to her.
"The right femoral head is well seated within the acetabulum. There is a 9 mm corticated ossicle along the anterosuperior acetabulum (images 30 series 3, 40 series 8, 38 series 7). No acute fracture or focal osseous destruction. The right hip joint space is maintained. Visualized portions of the pelvis are unremarkable. Soft tissues are unremarkable"
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2023.06.09 07:32 Adam-best Silicone Hammer Toe Corrector

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2023.06.09 06:41 e-spinehospital Hip Pain Treatment Non-Surgical

At e-spine hospital, They offer non-surgical treatment options for hip pain. The team of experts specializes in providing comprehensive care to alleviate hip pain and improve your quality of life. Here's a short note on our non-surgical hip pain treatment:
the Hip Pain Treatment Non-Surgical at e-spine hospital focuses on conservative approaches to relieve pain, enhance mobility, and restore functionality without the need for surgery. Our dedicated team of orthopedic specialists, physical therapists, and pain management experts work together to create personalized treatment plans tailored to your specific needs.
  1. Accurate Diagnosis: They begin with a thorough evaluation and diagnostic process to identify the underlying cause of your hip pain. The experts utilize advanced imaging techniques and clinical assessments to determine the precise source of discomfort and develop an individualized treatment approach.
  2. Medication Management: The experienced physicians will prescribe appropriate medications to manage pain and reduce inflammation associated with hip conditions. These may include nonsteroidal anti-inflammatory drugs (NSAIDs), analgesics, or corticosteroid injections, depending on your specific condition and needs.
  3. Physical Therapy: The skilled physical therapists design tailored exercise programs to improve hip joint flexibility, strengthen supporting muscles, and enhance overall mobility. Through targeted exercises, manual therapy techniques, and specialized equipment, they aim to reduce pain, improve range of motion, and restore normal function.
  4. Assistive Devices: They may recommend assistive devices such as crutches, canes, or walkers to relieve weight-bearing pressure on the affected hip and promote stability. The team will guide you on the proper use of these devices to ensure optimal pain relief and mobility.
  5. Pain Management Interventions: The pain management specialists offer various minimally invasive procedures to provide targeted relief for hip pain. These interventions may include corticosteroid injections, viscosupplementation (hyaluronic acid injections), or nerve blocks, which can reduce inflammation and alleviate pain for an extended period.
  6. Lifestyle Modifications: The experts will provide guidance on lifestyle modifications, such as weight management, activity modification, and ergonomics, to minimize stress on the hip joint and promote long-term joint health.
At e-spine hospital, they are dedicated to providing non-surgical hip pain treatment options that are personalized, effective, and focused on improving your overall well-being. The team is committed to helping you regain mobility, reduce pain, and restore your quality of life.
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2023.06.09 05:56 Objective_Campaign82 Sins of the Father Ch35 (Hellworlder pirates 2)

The Battle You Can Never Win
Years ago, aboard a poorly maintained ship, in a dimly lit cargo hold with stained mats haphazardly thrown on the ground, a young girl glared at the old man before her. Her breath came in ragged heaves, her clothes were stained with sweat, and her exposed skin was covered in welts from the older mans bamboo blade. She was on the ground while the man was standing up straight, his breathing only slightly faster than normal but otherwise gave no hint that only moments before he had been swinging his practice sword like a demented blender.
The girl tried to stand but instead fell back down. “Why, the fuck are you making me do all this.” She growled at the man. Earning her a quick smack to the side for her foul mouth and impertinence. “Fuck!” she cursed, earning another strike in the process.
She continued to glare at the old bastard, most people usually flinched under her hateful glare. Especially the weak prey-like Xenos, they always coward at her wrath. But the old bastard didn’t. He just watched her with a calm and patient gaze.
The man was silent for a while before he sighed and looked to the pipes and looses wires along the ceiling. “You ask why I make you train? Why I push you unlike all the others? The better question is why you resist my teaching?” he looked down at her again. “You are taller than most men, you are naturally stronger than a girl has any right to be, and your fire is enough to melt iron. And yet you resist my attempts to polish those advantages. By all rights you should seek every chance to better yourself. And yet you don’t.”
“What’s the fuckin point? Like you said, I’m strong, and being already human makes me faster and tougher than everything out there. So what’s the point in training with stupid swords?”
He frowned, but didn’t strike her again for her foul mouth. “You are stronger than most creatures in this galaxy. But not all. The Kaydic are as strong as a grizzly, and if they get a good charge going they can pass through brick walls like they were wet paper. The Balikstro are faster on four legs than we can ever be on two. Any Uplifted Mammaloid could easily disembowel you with a careless swipe. And that isn’t mentioning the true monsters out there like the Aunviry.”
“Okay, yeah they’re all better. So what’s the point in training if they’re always going to be better than me? I’m only human.” She whined as she felt the growing bruise on her side.
“Because you don’t train for the battle that you can win, but for the battle that you’ll always lose. Because on those days the only thing that will keep you alive is training, good reflexes, and hardened combat experience. They are how you will win the battle you can never win.”
“That doesn’t make sense old man.” The girl snarked.
The air cracked, a brown sword blurred, and the girl let out a yelp as her ass was struck by a Shinai.
The old man who decided to be her mentor continued. “And the only way you get there is by training every day until your hands bleed and your legs give out.”
The girl glared at the old man, but she saw the sense in the words. Even if she hated the old man and his stupid sword. “Fine, but can we call it here. I have a cargo shift tomorrow.”
He looked down at her hands a tilted his head. “Your hands aren’t bleeding yet.” He said blandly as if remarking on the weather.
Daisey groaned, but got up anyways.
The old bastard Mizuno really did make her work until her hands began to bleed before letting her crawl off to her hammock in the sweltering space above the engine bay. She only got a few hours of sleep before the ship docked with the pirate capital and she had to spend the next ten hours moving cargo off the Black Saint.
And after that, when she had finally gotten to sit for a few minutes Mizuno found her and dragged her back to his ‘dojo’ for another round.
She had hated it at the time. Hated him. Hated the shitty rusty ship. Hated almost everyone one onboard. And hated those stupid bamboo swords.
But in time the pain paid off, and those skills that had been beaten into her the hard way saved her life when Greyson’s crazy bitch of a lieutenant tried to kill Daisey in some back alley on Parox. And later those same skills allowed her to best the men she had eventually called Sensei instead of Bastard.
It was strange to feel nostalgic for a time where everything sucked, and you hated everyone around you. But fighting Zera again brought back those bittersweet memories. She had hated Mizuno so much back then, but the man who had decided to mentor her eventually became one of the most influential figures in her life. Aster may hate her father and everything about him, but she couldn’t ever hate the heritage he had unwittingly tied her too. Because it was the same culture Mizuno had loved with all his heart. Warts and all.
Zera fought like a deranged beast. Slashing and stabbing with wild abandon. But while she had received some training to polish out her blind aggression, she never took Mizuno’s philosophy to heart. Greyson had ordered Mizuno to share his teaching with Zera just like he did with Daisey. But where Daisey, now Astarte, had accepted his ideas of training for the battle you’ll always lose top heart.
Zera hadn’t.
Zera learned how to cut better and how to save her strength. But once she had learned that she used her strength and youth to overpower Mizuno-sensei in sparring matches. While Daisey had restrained her own strength where she could so as to better learn Mizuno’s skill and techniques.
Even when after she had fought off Zera and took her spot as Greyson’s right hand she still trained until her hands bled. Even when she left the Terran Pirates and drifted around with her mother she trained. And when she met Karega and got a ship of her own she continued to train for the battle she would never win.
It was that mindset that let her finally surpass her old mentor during their final battle on the central Temple of Temple city. The very same mindset that let her match blows with a vile abomination like Kazlum and his brood. A literal battle she had no right ever winning. And it was the same teachings that she would use to beat this cyborg blast from the past.
Zera’s metal exterior was too tough for Astarte to cut. And it was highly unlikely that Astarte would ever exhaust her. But while she failed to land any actual wounds on her opponent, Zera the Butcher couldn’t land any on Astarte.
Zera aimed her mantis like blades at the kinks in Aster’s armor, but Aster’s reflexes and agility was enough to dodge and deflect Zera’s attacks.
But time was not on her side in this fight. Human endurance was legendary and superior to anything any other biological species could replicate. But no amount of sweat or anaerobic exertion would ever match the ceaseless movements of a machine.
Zera also had plenty of tricks hidden within her robotic limbs. The extra power in her legs had nearly bowled Astarte over when she triggered it as their blades were crossed. A third use had allowed her to dart to Astarte’s and strike at her thigh. Zera had found a kink in her armor, but a single step back had spared Astarte from any real damage.
Her leg felt warm and sticky as blood trailed down. But it was only a flesh wound and nothing that would hinder her mobility.
That attack had finally allowed Astarte to see exactly how Zera kept leaping forward. Somehow she was building up energy in her leg which could be released. A joint opened around where a bulging calf should have been and allowed her to double the length of her leg and gave her explosive forward momentum when used right. In the heat of battle Astarte couldn’t make heads or tails of the mechanism, she saw wires, tubes, and what looked like a hydraulic valve thing. She didn’t need to understand it at the moment though, right now knowing there was a way past the tough metal shell and into some more vulnerable internals was all that mattered.
The assassins’ arms also had a similar ability. But instead of explosively doubling the length of her arm Zera could have curved blade on her forearm launch forward in a powerful stabbing motion. Astarte dodged one of those attacks and saw the blade punch through the concrete of a nearby building. Zera had been stuck in the wall for only a second as she used the leg extension to pull her out and launch her back into melee with Astarte.
Zera also had a wider range of motion than Astarte was used to seeing in a human shoulder joint. When Astarte had rolled under a swing and came up for a slash at her exposed back the other arm was capable of swinging a full 180° backwards and deflecting her blow.
The way the arm had rotated in the joint had unnerved Astarte. She would have shivered in horror if had been given a moment to do so.
Those tricks had surprised Astarte the first time she saw them. And only quick thinking kept her alive. But once she saw them, she was capable of accounting for them and making her plans around them. She had fought enough alien opponents to know how to compensate for strange physiologies. The Aunviry for example had been far stranger to deal with than this borged-out human woman.
Sparks rang from their clashes and Astarte began to look for any more surprises. But as the fight stretched on Astarte began to suspect that Zera had already played her hand. And if she was reserving something then it was probably something she could only do once. With the factors accounted for, Astarte began to plan her actual counterattack, no more probing.
She couldn’t do much about the powerful arm attacks besides dodge, and couldn’t hope her armor could take the hit. The legs presented a weak point, but not one easy to get at. She would have to bait Zera into a launching attack and then sidestep fast enough to stab into her leg. A risky maneuver.
She thought about the full rotational ability in the arm joint. She didn’t know much about engineering, but she remembered some of Alwen’s lectures on the shoulder joint area after the Battle for the Confederacy. Alwen had to reset several bones in that region and she had taken the time to explain everything instead of just doing it. It was a complicated joint, and already prone to coming out of its socket. Did enhancing that range of motion come with any added structural weakness?
It was an idea.
As the fight drew on Astarte began to feel Zera speed up as her strikes became more and more sure. Astarte realized there was another blatant weakness that Zera had carried with her from the days she was fully human. Her mind.
Zera had a mercurial temper, plenty of triggers, and was highly unstable. And Astarte knew how to use all that to her advantage.
“You wanna know the funny part.” Astarte said in between blows. “Greyson didn’t even care that you were gone.” She taunted in between breaths. There was a reason most real combat didn’t have witty banter or heart felt speeches between foes. Every breath counted and wasting it on speaking was stupid. But she judged it to be worth the effort.
“Didn’t even question me about. Just said ‘Zera’s gone, now you will guard my back’” Astarte teased. “Then not even a week later I was second in command and got to sleep in his comfy bed.” She gave Zera a sloppy self-satisfied grin.
In reality Daisey hadn’t wanted to be Greyson’s guard, nor sleep in the same bed as a forty something man with the reputation for fucking anything with a hole and a heart beat. But she had little choice in the matter if she wanted to stay alive and keep working with the Terran Pirates.
The assassin’s eyes flared “And then you killed him like the deceptive whore you are!” she roared with another predicable jab.
“Of course I did, I refused to be the latest women he ruined and dumped into the gutter.” Astarte countered as she side stepped the blow. She was really glad Mizuno-sensei drilled her foot work so often, it was paying dividends at the moment. “Face it, your days were numbered. If it wasn’t me it would have been him.”
“LIAR!” Zera roared as she overextended again.
It didn’t offer Astarte the opening she looking for, so instead she went for a different sort of weak point. No matter how much her body changed there was one place that had to stay mostly organic.
No one fucked with the brain, not the Toy man, not the Union, and not the people who rebuilt Zera. It was too delicate to touch and far too complex. Just wiring in an advanced cybernetic eyeball to the optic nerve had caused a knock-on effect in Astarte’s head. And that was just a peripheral change.
The hilt of Tenken rammed into Zera’s face, smacking the same place she had dented earlier. There was a thud, like the sound of a dropped metal can, and then the sound of shattering glass. Zera stumbled back and put a hand up to her face where Astarte’s strike had warped the metal enough to loosen up her left eye out of its artificial eye socket. The eye had fallen and shattered at Astarte’s feet, and it now leaked a white fluid.
Zera looked up and Astarte saw the strange deformed metal plate of her face all scrunched up on one side. Half her lip was pulled up in a permanent smile while the more mobile part of her face scowled. She charged right back at Astarte and her right arm splint down the middle, Astarte saw the prongs of a stun weapon race towards her just as the other arm came up for a slash at her face. Astarte stood her ground, took the prongs, and lifted arm to intercept the blade.
The electricity didn’t feel like waves of fire like she had expected, but instead like all her muscles just got pulled at once. She felt her knees go weak as they wanted to buckle. But she gritted her teeth, remained on her feet, and took the pain. This was nothing compared to when she caught in that Egh’ahd sneak attack, nor when she fought Kazlum and had been bitch slapped across a whole room. This was a pain she could handle.
And compared to the electricity coursing through he the Mantis blade in her arm was nothing.
With one arm occupied in tasing her, and the other wedged into the bone of her forearm Astarte knew she wouldn’t get another chance like this. She grabbed the bladed arm with her other hand and with a twist of her hips, threw the Cyborg over her shoulder.
The assassin hit the ground with a thud and Astarte moved foot on her back.
The blade in her arm cut back upwards, got caught in the plates of her arm guard, and snapped off by the hinge. The pain in the arm grew too much to bear so she let that arm fall limp as her other arm held onto the assassin now beneath her feet and pulled. Zera let out a scream that hit the far range of human vocal cords and dipped into a sound only possible in dogs, dolphins, and machines. It even began to stutter like a corrupted audio file.
Even her voice was fake.
Then there was a pop and rip, and the arm came clean off.
Astarte stood there holding the still clothed arm in her hands as white fluids leaked out of the cyborgs open joint. Astarte glanced to the fake arm in her hands then down to the struggling cyborg, and with little hesitation lifted the arm and proceeded to beat the womans head in with her own arm.
Or she would have if a heavily distorted voice hadn’t interrupted her bludgeoning.
Astarte turned to stare at the cloaked black figure of the Arbiter aiming a pulse rifle right at her.
Astarte then raised her hands above her head, still holding the prosthetic arm. “It was self defense” Astarte said to the unwavering gaze of the Arbiter. A flicker of her eye into the Ultraviolet showed the scowling face of a much-recovered Rachel glaring at both of them.
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2023.06.09 05:13 wildkatz56 Hidradenitis Supprativa and Arthritis

Pre information to my rant and ask for help - I was diagnosed with HS about 15 years ago, also have a pilonidal cyst and lots of knee, back, and shoulder pains. I have had corticosteroid shots in my knees, shoulders, SI joint, and one wrist. I have to buy specific shoes due to plantar faciatis.
I was on remicade every 6 weeks for HS when I started having unexplained pain in the joints of my hands, ankles, fingers, toes, wrists, and jaw as well as escalated pain in my shoulders, knees, and hips. I also developed a trigger finger. This pain was mostly during week 5 and 6 before my next infusion. I was also having HS flares happening during this time. Several trips to the ER and urgent care for steroids and anti inflammatories as well as missing work because I couldn't even unbutton my own pants. They run blood that shows elevated inflammatory markers, but not an elevated rheumatoid marker. PCP sends me to rheumatologist who says it's not rheumatoid arthritis based on blood work and there's nothing he can do for me. My infusion gets moved to every 4 weeks which helped a lot with my HS flares, but now I'm having sporadic joint pain, sometimes several days a week.
I ask for second opinion from a rheumatologist in a nearby large city who does x-rays and then an MRI based on those, thinking it is ankylosing spondylitis (which my grandfather had). They call with the MRI results and say that there is damage to the SI joint and can I come in to discuss medication options. I take this to mean that the tests confirmed ankylosing spondylitis. Follow up appointment today and the 2nd rheumatologist says it's just inflammation from my HS, because I have a cyst in my anal region, and a sprain of my gluteal muscle. She said my SI joints do show degradation, but no active inflammation, and I need to have the dermatologist get my HS under control and the pain will stop.
Has anyone had a similar experience? I'm feeling frustrated, unheard, and that nobody believes my pain. I don't know if I should go off my remicade to see what happens. Any information would be appreciated.
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2023.06.09 05:05 HaykakanTxa Daily News Report: 6/8/2023

Date: 06/08/2023
Reading time: 9 minutes, 1872 words

The units of the Azerbaijani armed forces open fire in the direction of the Armenian positions in Gegharkunik

Azerbaijani forces opened fire on Armenian positions in the Tretuk sector, Gegharkunik Province. The Armenian side has no casualties.
Armenpress, Azerbaijani forces open fire at Armenian positions, Azerbaijani forces open fire at Armenian positions near Khoznavar – MoD, Azerbaijan opens fire on Armenian positions

Red Cross visits kidnapped Armenian servicemen in Azerbaijani detention

Representatives of the International Committee of the Red Cross (ICRC) have visited the two Armenian servicemen who were kidnapped by the Azerbaijani military and jailed. Private conversations took place, and they also helped them to make contact with their families.
Armenpress, Baku shares info about 2 Armenian troops abducted by Azerbaijan

Azerbaijan violates Nagorno Karabakh ceasefire

Azerbaijani forces violated the ceasefire in Nagorno Karabakh in the early hours of June 8, the Ministry of Defense said. The situation on the line of contact is relatively stable, the ministry said. Azerbaijan continues to spread disinformation, trying to substantiate the regular ceasefire violations committed by its units.
Armenpress, Artsakh reports fresh ceasefire violation by Azerbaijan, Armenia reports ceasefire violation by Azerbaijan, The Ministry of Defense of Armenia and Artsakh report about the firing by Azerbaijan, there are no losses, Azerbaijan violated the ceasefire in Artsakh, the Armenian side has no losses. PB:, Karabakh reports new ceasefire violations by Azerbaijan

Military universities will merge

Military University named after Vazgen Sargsyan and Aviation University will merge. The draft of the relevant decision is included in the agenda of the June 8 session of the government. The rationale of the decision is due to the decrease in the number of university applicants and the demand for certain professions in recent years.

Armenia makes every effort to encourage the development of "North-South" and "East-West" directions. Prime Minister

Prime Minister of Armenia Nikol Pashinyan participated in the regular session of the Eurasian Intergovernmental Council in Sochi. The EAEU plays a key role in strengthening ties, establishing a single market, promoting trade and creating a single market. The Prime Minister delivered a speech, in which he said: "During these nine years, we have achieved considerable success"
Armenpress, Armenia advocates the systematic development of mutually beneficial and equal cooperation within CIS – PM

Azerbaijan attempts to derail agreements, Armenia warns at meeting of CSTO Security Council chiefs

Secretary of the Security Council of Armenia Armen Grigoryan delivered a speech on June 8 at the CSTO meeting of Security Council Secretaries. He said Azerbaijan continues to escalate the situation on the Armenian-Azerbaijani border and Nagorno Karabakh.
Armenpress, Armenia participates in CIS Border Guard council meeting in Baku, Azerbaijan, The delegation of border guard troops of the National Security Service of Armenia left for Baku

Prime Minister Pashinyan participates in CIS Council of Heads of Government session

Prime Minister Nikol Pashinyan participated in the regular session of the Council of Heads of Government of the CIS in Sochi. The meeting is taking place in the year of the 30th anniversary of the adoption of the Charter of the Commonwealth of Independent States.

Russia ready to discuss financial issues on building new nuclear power plant in Armenia, says PM Mishustin

Russia is ready to discuss financial issues and parameters of building nuclear power plants in the territories of Eurasian Economic Union members, including Armenia, Russian Prime Minister Mikhail Mishustin said at the Eurasia Is My Home exhibition. The heads of government were briefed on Rosatom’s most effective plant, a joint Russian-Belarusian project with two reactors with 1200 megawatt capacity.

Belarusian leader Lukashenko calls on Armenia and Azerbaijan to find mutually acceptable solution

Belarusian leader Alexander Lukashenko has called on Armenia and Azerbaijan to find a mutually acceptable solution to end the conflict. President Lukas

Russia aims to block EU from hosting COP29 summit, potentially leaving Armenia and Azerbaijan as contenders - report

Russia intends to block EU countries from hosting next year's UN international climate negotiations, according to internal emails seen by Reuters. Armenia and Bulgaria had put themselves forward to host the summit. If Russia vetoed all EU countries, then Armenia or Azerbaijan could still be in the running.

Armenia eager to develop ties with UK, Speaker Simonyan tells Leader of House of Commons Penny Mordaunt

Speaker of Parliament of Armenia Alen Simonyan and his delegation met with Penny Mordaunt, the Leader of the House of Commons of the UK Parliament. The delegation also discussed regional security with their British colleagues and presented the situation resulting from Azerbaijan aggression.

At CSTO, Armenia’s Security Council chief calls for targeted assessment of the situation in Artsakh

Azerbaijan continues to escalate the situation on the Armenian-Azerbaijani border and Nagorno-Karabakh and the Lachin Corridor. Secretary of the Armenian Security Council Armen Grigoryan addressed the Security Council Secretaries of CSTO member states.

Russia has no long-term strategic plans in Artsakh. Lilit Gevorgyan

Analyst Lilit Gevorgyan says Russia has no long-term strategic plans in Artsakh. He says the issue of making Armenia a part of the Union State is not removed from Russia's agenda. The analyst says the guarantor of a possible Armenian-Azerbaijani treaty is Azerbaijan itself.

Armenian Foreign Minister speaks with new Turkish counterpart

Ararat Mirzoyan congratulates Hakan Fidan on his appointment as the head of the Ministry of Foreign Affairs of Turkey. The sides expressed their willingness to continue working towards full normalization of relations between Armenia and Türkiye.

Germany expects immediate release of Armenian POWs kept in Azerbaijan

Germany expects that the Armenian prisoners of war held in Baku will be immediately released as part of the peace negotiations. Chairman of the Committee on Foreign Affairs of the German Bundestag Michael Roth said at the press conference in Yerevan on Wednesday, June 8.

Semi-precious stones, precious metals, machinery named top Armenian exports in January-April

Armenia exported goods worth 2 billion 158 million 463,4 thousand dollars in January-April of 2023. Most of the exports went to Russia, a growth of 3,8 times compared to 2022. Precious and semi-precious stones, precious metals and related items comprised most of the exported goods.

The CSTO countries intend to increase the number of joint exercises

Secretaries of the Security Councils of the member states of the Collective Security Treaty Organization (CSTO) discussed security challenges and threats in the region. The Security Council of the Russian Federation noted that tasks were set to block the ways of recruiting citizens and traveling to different places to participate in terrorist activities.

Armenian President receives Maren Jasper-Winter, member of Executive Board of Friedrich Naumann Foundation for Freedom

President of the Republic of Armenia Vahagn Khachaturyan received delegation headed by Maren Jasper-Winter. Meeting was attended by Martin Kothé, Regional Director for East and Southeast Europe, Katrin Bannach and Armen Grigoryan.

Speaker meets SNP’s Drew Hendry, calls for cooperation between Armenia’s self-governing municipalities and Scotland

Speaker of Parliament Alen Simonyan and members of his delegation have met with Drew Hendry, Member of Parliament of the United Kingdom representing the Scottish National Party. Regional challenges, post-war issues and consequences were discussed at the meeting, the Armenian parliament’s press service said.

Armenian metal smelting plant will continue its activities in the border area irrespective of Azerbaijan's complaint

GTB Steel, which is building a smelting plant in the village of Yeraskh, Ararat Province, Armenia, issued a statement responding to the statement of the Ministry of Environmental Protection of Azerbaijan that the construction of the smelter will harm the environment of their country.
Armenpress, Company behind smelter in Armenia’s border village of Yeraskh to continue activity despite statements from Azerbaijan, Azerbaijan opposes Armenia’s plans to build new metallurgical plant

Armenian Minister, German Ambassador discuss the possibility of concluding a migration partnership agreement

Minister of Internal Affairs Vahe Ghazaryan received Viktor Richter, Ambassador Extraordinary and Plenipotentiary of the Federal Republic of Germany to Armenia. The issue of the possibility of concluding a migration partnership agreement with Germany was discussed at the meeting.

ICJ ruling on Azeri checkpoint in Lachin Corridor expected soon

Armenia is waiting for the International Court of Justice (ICJ) ruling on its request regarding Azerbaijan’s checkpoint in Lachin Corridor. The United Nations’ highest court ordered Azerbaijan on February 22 to “take all steps at its disposal” to ensure unimpeded movement of persons, vehicles and cargo in both directions.

2 Ukrainian-Armenians affected in Kakhovka Dam collapse

Two Ukrainian-Armenians are among those affected as a result of the collapse of the Kherson Dam. Several Armenian communities have already offered to accommodate those affected.

In Syunik, United States Ambassador to Armenia observes tense situation at border with Azerbaijan

United States Ambassador to Armenia Kristina Kvien has visited the Syunik Province, the U.S. Embassy said on social media. The Ambassador also traveled to Tegh where she observed first-hand the tense situation at the border.

Turkey's lira plunges 7.6% to record low

Turkey's lira plunged 7.6% to a record low on Wednesday in its biggest selloff since the historic 2021 crash. Traders called it a "strong signal" that Ankara is moving away from state controls toward a freely traded currency. The lira was trading at 23.2300 against the dollar at 1739 GMT after touching a record-low of 23.2620.

Christian Lawmakers urged to de-platform Azerbaijan ambassador

Azerbaijan has attacked and ethnically cleansed vast areas of Artsakh – a Christian land and democratic state on the frontiers of global faith and freedom. Azerbaijan has executed armed and bound Armenian prisoners of war, using prohibited munitions and recruiting jihadist, ISIS-aligned mercenaries from Syria.

Donations to Armenia:

Armenian Wounded Heroes
If you'd like to support me: Patreon
submitted by HaykakanTxa to armenia [link] [comments]

2023.06.09 05:03 yippee123321 24F seeking diagnosis help

hi! seeking feedback/advice/similar comfort. i’m 24F with a long history of medical issues, that have all accumulated and rapidly worsened throughout the last year:
i’m seeing a renown gi specialist for those issues, and he’s the one who immediately said UCTD within our first visit. he sent through the test where i tested ANA negative. i then saw a rheum who majorly wrote me off and basically said she wouldn’t consider me without a positive ANA. i went back to my GI who stands by his diagnosis based on his experience, recommended i continue seeking alternative opinions, and explained that it may take many years to test positive but we will find the right doctor to understand my clinical symptoms.
so — have any of you faced a similar journey? do you have any advice for finding a dr that will evaluate holistically?
im beyond thankful for my GI doctors support but i feel so alone in this that any insight would be so appreciated. i feel so sick everyday and i can’t believe there’s only more to come.
submitted by yippee123321 to UCTD [link] [comments]

2023.06.09 04:43 FineExample2115 One week post-op

My fellow hippies,
Here I am at one-week post op and lemme tell you, the last week has flown by. As the anesthesia wore off, my pain worsened (but only slightly thus far) to where I am now taking the pain meds out of necessity rather than to just put myself out of my misery. But, it is pretty manageable, especially when I spend a whole night in the CPM with some ice. I haven’t experienced as much tightness as I would have expected, which is good. Ive had a lot of help. My mom has been an absolute hero and I owe her enormously although shed never expect anything in return. As much as it sucks to take showers and feels like I’m destroying my other hip by constantly putting twice the usual weight on it, I am pretty confident that I am gonna come out on top of this. I have a couple minor concerns. One is that my PT provider doesn’t have upright bikes for some reason. Should I seek out another PT joint? Its a part of my protocol (Dr. Stubbs) and I am concerned that I’m not being pushed hard enough even though I’m just over a week out. Second, I’m having some pain in what I think is my hip flexor. While I am pretty sure thats normal, I am just wondering if anyone else has had pain predominately only remaining in the hip flexor even more than the portal site itself? I admittedly an having a hard time using it literally 0% when i have to maneuver myself into the car or shower. Anatomy wise, does the surgeon have to access the joint through the hip flexor? A bit confused as I do feel plenty of strength there and could probably walk if I were to be negligent if the protocol.
Anyways, thanks for reading and would appreciate any feedback at all or feel free to DM me with questions. Kinda bored 🥱 if anyone wants to play smash bros hmu LOL. ✌️
submitted by FineExample2115 to HipImpingement [link] [comments]

2023.06.09 03:49 Massive_Level_7127 What Are The Advantages of Wireless Bluetooth Bone Conduction Headphones and How Do They Work?

What Are The Advantages of Wireless Bluetooth Bone Conduction Headphones and How Do They Work?
I believe you also have the common experience that when we eat cookies, even if we cover our ears, we can hear the cracking sound of cookies. Or when we scratch our head, we hear the sound of fingers rubbing against our head. This is actually the most common example of bone conduction.The vibration of a cookie or the friction of the head is transmitted through the skull to our inner ear, which helps us to hear sound. This sound transmission method has also been cleverly applied by scientists to wireless Bluetooth bone conduction headphones, and in the past 2 years, they have become the most popular digital product.

What are the advantages of wireless Bluetooth bone conduction headphones?

First of all, because they use the principle of bone conduction to transmit sound instead of air conduction, most wireless Bluetooth bone conduction headphones do not affect the acquisition of ambient sound by both ears when used. Therefore, it is very safe when you use it outdoors, and you will not ignore the possible dangers because you are immersed in the music when wearing it.

Secondly, because most of the them are close to the hard bone position (beside the ear), instead of directly blocking the ear canal like in-ear headphones, or clamping the soft tissue of the ear like clip-on headphones.After wearing wireless Bluetooth bone conduction headphones for a long time,ear damage cause of Headphones is much less than in-ear headphones or clip-on headphones. For example, if you wear them for four hours, clip-on headphones may cause your ears to hurt unbearably, but even if you wear wireless Bluetooth bone conduction headphones for a long time, you will basically feel nothing. Therefore, they are very comfortable to wear.
On top of that, common headphones can clog the ear canal, leading to the growth of a lot of bacteria that can lead to ear infections. Wireless Bluetooth bone conduction headphones do not have these effects because they do not need to be worn in the ear, and they will not rub against the external auditory canal when worn. So they are more suitable for people with oily ears, otitis media, small ears, and some people with sensitive ears because they do not need to be inserted into the ears. They are also more suitable for people who need to wear headphones for a long time. Therefore, wireless Bluetooth bone conduction headphones are very healthy.
Wireless Bluetooth bone conduction headphones have relatively little hearing damage, because hearing damage generally occurs in the eardrum and inner ear, while wireless Bluetooth bone conduction headphones directly bypass the eardrum to avoid eardrum damage. Moreover, the vibration waves of them are relatively moderate, and the impact on auditory hair cells will be less, so the damage to hearing caused by them is minimal. For these reasons, wireless Bluetooth bone conduction headphones have become very popular these years.
Of course, wireless Bluetooth bone conduction headphones are not perfect, and they have their drawbacks.
The first is that the sound quality is not as good as traditional headphones because of its wearing method. Due to its design characteristics, the anti-interference effect is not ideal in noisy environments such as shopping, taking the subway, and taking a car. Because it is transmitted to the ear ossicles through the skin and skull, so their degree of music reproduction is not as good as traditional in-ear headphones.

The second is that the phenomenon of sound leakage still needs to be overcome. If there is a common problem with wireless Bluetooth bone conduction headphones, it is the problem of sound leakage. Although major manufacturers are trying to improve the sound leakage, judging from the actual status, sound leakage still exists in the headphones. Of course, mainstream wireless Bluetooth bone conduction headphone brands, such as wissonly and Aftershokz, have made a lot of efforts to improve the sound leakage of wireless Bluetooth bone conduction headphones, and have almost solved the sound leakage problem.
In general, wireless bone conduction headphones have more advantages than disadvantages, which is why they are becoming more and more popular.Their advantages and disadvantages are determined by the way they work.

How do wireless Bluetooth bone conduction headphones work?

When it comes to the working principle of wireless Bluetooth bone conduction headphones, you must first understand the "essence of sound". Simply put, the sounds we hear every day are vibrations in the air. For example, have you ever seen a scene of “loud high-pitched sound shatters a glass window”on TV? This phenomenon is caused by the treble that transmits strong air vibrations to the glass window, causing the glass window to resonate.
We hear sound as vibrations in the air. Sound travels through the ear canal to the eardrum, then through a spiral organ called the cochlea to the brain, where it is finally perceived by us. While standard headphones that fit into the ear canal use this "standard" path to transmit air vibrations to the brain, wireless Bluetooth bone conduction headphones work quite differently.

The sound transmission path of standard headphones: sound source vibration → external auditory canal → eardrum → cochlea → brain
The sound transmission path of wireless Bluetooth bone conduction headphones: sound source vibration → skull → cochlea → brain
So, with wireless Bluetooth bone conduction headphones, you can enjoy music without ear canals or eardrums. wireless Bluetooth bone conduction headphones do not need to be plugged into the ear canal when worn, which will cause less damage to the eardrum and better hygiene for the ear canal, so they are the healthiest headphones.
Bone conduction headphones are safer than common headphones,and they have a lot of advantages, They are your best sports headphones.So how can you find your most suitable one of them? Let me recommend a few headphones.

1, Wissonly Hi Runner wireless Bluetooth bone conduction headphones

Reason for recommendation:
As a veteran electronic product fans, I can responsibly tell you that the Wissonly wireless Bluetooth bone conduction headphones are true bone conduction, which can protect hearing, so they are recommended by many otologists.
At the same time, Wissonly Hi Runner is also very good in terms of sound quality. It uses a 360 surround vibration unit, which can increase the vibration area by 35% compared with traditional wireless Bluetooth bone conduction headphones.They reduces the loss during bone conduction sound transmission, and which makes the sound more powerful.
Wissonly Hi Runner wireless Bluetooth bone conduction headphones are made of memory titanium that can be self-adjusted, which can ensure that the headphones have a good wearing experience and take into account more users.
In terms of functionality, as the flagship model of Wissonly Brand, Wissonly Hi Runner supports IPX8 waterproof level which is higher than the industry standard, and it can be worn in diving. It is equipped with 32G body memory, as well as the latest Bluetooth 5.0. Its product performance and experience have been comprehensively improved, truly making wireless Bluetooth bone conduction headphones suitable for more life scenarios.

2. Philips A6606 wireless Bluetooth bone conduction headphones

Reason for recommendation:
Philips A6606 is very pleasant to touch, especially the side is softer and touches the skin. It looks like an advanced product on hand. And the charging joint soft plug of the headphone and the gap between different parts are smooth, and the overall workmanship is quite good.
It supports for dual-microphone stereo calls, and is made very well in terms of call quality. A6606 supports mobile phone APP control, if a call comes in during running or cycling, it can be connected by simply touching the left unit, which will not affect the safety of riding. And bone conduction sound pickup technology + dual noise-canceling microphones can also filter out the wind noise during moving forward, and the call effect is guaranteed.

3.AfterShokz OPENRUN PRO wireless Bluetooth bone conduction headphones

Reason for recommendation:
AfterShokz Openrun Pro's headphones are very light, weighs only 26g. It's very light and comfortable to run on your ears. The whole machine is made of titanium alloy, and the headphones on both sides are wrapped with skin-friendly silica gel, which make it has a IP67 waterproof grade. It can be drenched in the rain, splashed with water and washed, and there is no problem even in bad weather during outdoor sports. The structure adopts the back-hanging design and can't be worn in the ear, which is very friendly to users who often wears it. The whole machine is also equipped with Bluetooth 5.0 three-core chip, which can realize fast connection, stable sound quality connection within 10 meters, and intelligent identification by algorithm, which can effectively filter the ambient sound and make the voice clearer.

4.Earsopen peace tw-1 wireless Bluetooth bone conduction headphones

Reason for recommendation:
It is IP67 waterproof grade, easily resistant to sweat, and even capable of a short immersion underwater, but not suitable for swimming. The lightweight body just weighs 9g,its clip-on wearing method is novel.At the same time,It has a certain stability. But it is not suitable for long-term wear, and there will be a lot of discomfort.

5.Moing wireless Bluetooth bone conduction headphones

Reason for recommendation:
The overall experience is average, but the price is low, so it is worth trying.
It weighs only 30g, so it can be worn for a long time without burden. Streamlined sinking design is adopted, which fits the ear shape when wearing. Its body is made of memory alloy material, so you don't have to worry about deformation after bending for many times. The overall configuration of Moing is good, Bluetooth 5.0. Titanium alloy frame, built-in power capacity of 200mAh, and it supports 6 hours of battery life.
If you are still confused about how to choose wireless bone conduction headphones, I suggest you choose Wissonly or Aftershokz. Their R&D teams have more than 10 years of technical experience in this field, which makes their products perform well in terms of sound quality and sound leakage reduction. If you consider the cost performance ratio, it is recommended to choose Wissonly.
submitted by Massive_Level_7127 to HeyNewGadget [link] [comments]

2023.06.09 02:47 Dreambeanz 7 weeks after hit by a car and leg surgery, dog is still not squatting to use the bathroom.

My parents Belgian Malinois was hit by a car a little over 7 weeks ago now. We rushed her to the vet and they told us her right leg was very badly fractured and would need surgery to put a plate in. She also had fractures and trauma in the SI Joints in her hips but the doctor said it was in the gray area where he didn’t want to do surgery.
7 weeks since her leg surgery now and we’ve kept her movement limited but still walking her several times a day according to the drs instructions. We also used a sling around her hips to help her up and walk. She’s able to stand and walk in her own now without the sling and at her 6 week check up the vet said she looked like she was healing well and happy with her progress.
The only problem is she’s not using the bathroom like normal. She doesn’t squat and her poo just slowly comes out of her. Her bladder gets so full it just dribbles out and she’ll start licking.
We express her bladder especially in the early days but the vet said for us not to do it so much or she’d become dependent on it and for the last few weeks she became very adverse to it and even with someone holding her and petting her and another expressing she’d wiggle and move till she was free.
The vet didn’t seem too worried just that he wasn’t surprised she had trouble postering because of her back end trauma. (She also had a lot of poo fall out as she was walking around the vet and got scared at one point and some pee came out.)
We’re so scared that she may not ever use the bathroom properly again even though she’s walking around so much better.
Anyone have any thoughts/things we can do/experience with something similar? I’ve tried doing research but haven’t found anything similar to this problem.
submitted by Dreambeanz to AskVet [link] [comments]

2023.06.09 01:42 Popular_Professor130 Gotti Green - LNEP [Hiphop/Rap]

Buckle up for this chest-pounding rhythmic ride with rising artist Gotti Green‘s brand-new release “LNEP”. Right from the start, the rhythm is gonna get you. Gotti Green ‘s lyrical flow makes you bounce. Hailing from Corpus Christi, Texas he is pound for pound no lightweight in the rap game. Gotti Green has been grinding hard to bring fans this joint.
“LNEP” is a infectious introspective track, proving that Gotti Green won't be confined to one style of hip-hop. He's an artist who naturally stands out - the confidence and attitude he brings on the mic is intimidating and unrivaled by his peers. Gotti Green lyrical flow combined with impressive production from @DuvinOnTheBeat the song will leave fans hitting the repeat button on this hypnotizing track!
“LNEP” is available on all your favorite streaming platforms, along with his entire discography and music videos released exclusively on Gotti Green official YouTube channel. Stay tuned for more to come from this talented artist on the rise! https://youtu.be/PBdx7WpZ4FI
submitted by Popular_Professor130 to Music [link] [comments]

2023.06.09 00:18 HeiferHustler Recommendations for St. Louis?

Hi all, have a weekend trip in St. Louis MO this weekend. What are you’re recommendations for good q joints?
submitted by HeiferHustler to smoking [link] [comments]

2023.06.08 23:24 traitor25 CaRMS 2022-2023 Pathway Experience + Advice/Tips from a UK Graduate CSA Perspective

Hey guys! I just wanted to put up my own experience moving through this year’s Canadian Resident Matching Service or CaRMS cycle so that others have a bit more clarity into what to prepare/focus on for future cycles. Here’s a bit of my background in a nutshell below to give some context:
I am currently a 27M Vietnamese-Canadian studying abroad (CSA originally born in Winnipeg, MB but spent the majority of my life in Ottawa, ON) awaiting to start family medicine residency on July 1 in Brandon, Manitoba but started this journey back in 2015.
I originally did 1.5 years of my undergraduate degree in Biochemistry at the University of Ottawa before seriously deciding on medicine as my career path. During my 1st university year, I applied to different medical schools in the UK (I think only Cardiff + Bristol considered me briefly but still turned down in the end) but got rejected from them. I was only invited + accepted to the MBChB programme at the University of Buckingham Medical School which lasted for about 4.5 years starting from January 2015. I had also done 2 electives in Ottawa (one under neurosurgery and the other in orthopaedics) during my final year of medical school prior to graduation in June 2019.
From there, I entered into the Foundation Programme in August 2019 (equivalent of medical internship in the US/Canada), which I did under the West Midlands South Foundation School, with pretty much all my time being in Worcestershire county. I did my FY1 rotations at the Alexandra Hospital, Redditch and my FY2 rotations at the Worcestershire Royal Hospital, Worcester. During this time, I had attempted the MCCQE1 exam twice (failed at 202 in January 2020, passed at 236 in October 2020) and attempted the NAC exam once (failed at 390 in March 2020). Ultimately, I withdrew early before my last FY2 rotation in April 2021 to focus on my 2nd NAC exam attempt, gain some clinical experience/connections on Canadian ground, and sort out other personal issues. I attempted the NAC exam again in October 2021 but failed at 1364. After taking a mixture of time off to mentally recover with family support and studying for the USMLE step I via UWorld as a distraction from November 2021 to April 2022, I took up a few different private NAC courses in the following chronological order from then onward to figure out where I was lacking at up until my third NAC attempt (passed with superior performance at 1452 on September 17, 2022):
  1. BeMo’s OSCE Preparation Platinum (all done virtually over Zoom; first session on April 11, 2022 and last session on August 28, 2022 for a total of 13 sessions).
  2. TutorIMG NAC OSCE Live Online Course (all done virtually over Zoom; first session on July 21, 2022 and last session on August 30, 2022 for a total of 11 sessions over).
  3. Medical Training Express Live Online OSCE Course (all done virtually over Zoom on July 28, 2022 and last session on September 10, 2022 for a total of 12 sessions).
  4. Mark’s MedSckool Reviews (technically took last year in person from August 30 - September 3, 2021 and again virtually over Zoom from August 22 – 26, 2022).
After I received notification of my NAC exam result on November 3, 2022, things were pretty hectic as I was busy entering into this year’s CaRMS cycle preparing different things:
  1. CaRMS documents (e.g. personal CV, personal letters, letters of reference/LOR’s, MSPE/MSPR, post-graduate internship regarding Foundation training, university & high school transcripts).
In total, I applied to about 105 different programs and 76 unique, personal letters to go along with them.
  1. Additional exams (FMProC and CASPer) – wrote my FMProC exam on December 12, 2022 and CASPer exam on December 15, 2022 after registering for them separately.
I primarily used a combination of the PasTest SJT question bank (went with 6 month subscription for £4) and free, online practice SJT’s provided for Foundation Programme Applicants as per the UKFPO website while I signed up for BeMo’s CASPerSIM Gold (3x mock CASPer sessions with feedback from different assessors).
  1. USMLE Step I (wrote on November 29, 2022 but had been revising for it again since my 3rd NAC wrapped up; was originally a backup plan in case I had failed the NAC for a 3rd time as you’re only allowed a maximum of 3 attempts).
  2. F2 Standalone application – the application window was opening on January 16 this year and was preparing evidence of my previous Foundation training + securing my Reapplication to Foundation Training form from my previous Foundation School director.
  3. Volunteer shadowing at local family medicine practice (managed to shadow a GP in Ottawa for both Canadian experience and fortunately an LOR in the end).
  4. Mock interview scenarios – did not have any previous formal/professional interview experience so I practiced with a combination of family members, my previous NAC study partner, and BeMo’s Residency Interview Gold Program (3x mock interview sessions with feedback from different assessors).
I recall having my joint FM ON interview first on February 3 followed by my FM MB interview second on February 13 (both were around midday/noon).
  1. USMLE Step II CK (after passing the USMLE step I around early December, I was intermittently studying for the USMLE Step II CK until Match Day on March 22, 2023).
I have already been in contact with a mix of people from both inside and outside Reddit regarding NAC practice and general info/advice around the CaRMS process. A good starting point about common, high-yield complaints to prepare for can be found on the MCC website under the “Medical Expert” tab. Outside of private NAC courses, I primarily used a mix of Dr. Basil’s notes (for focusing my history-taking approach), Geeky Medics/Macleod’s Clinical Examination (for structuring my physical examinations; focusing it down for NAC’s time limits came through practice), and the USMLE First Aid Step II CS mini-cases (for inspiration of mock NAC scenarios to do). I personally never used much of other mentioned NAC resources so can’t really say too much as to how useful they are:
  1. Edmonton Manual, “Master the NAC” by Dr. Bryce Lowry
  2. “NAC OSCE – A Comprehensive Review” by Canadaprep
  3. “OSCE and Clinical Skills Handbook” by Dr. Katrina F. Hurley
  4. “Canadian IMG’s Guide to OSCE and Practice” by Dr. Hanan Ahmed
The most important thing other than the following tips below would be to find ~1-2 regular, dedicated NAC partners you can study with and exchange honest feedback to each other with (nicely organized NAC partner spreadsheet (https://docs.google.com/spreadsheets/d/10Kk6YJtFKKn9IY3g96cC-rIWBQGyxtMUB9YQkAfND1g/edit#gid=0) with NAC partners made originally by u/MarinatedinPeace). Other specifics (ex. what can I bring?) around the NAC exam can be found on the MCC website but I generally recommend that ~3-4 months of time practicing 1-2x/week then ramping up to every other day (ideally everyday but I understand everyone has different backgrounds and recency of studying/practice) in the last 1-2 months seems to be a good time frame.
During my time giving advice about both, these were the most important points in terms of approaching preparation for the NAC exam that I've encountered:

  1. Make sure you exhaust the presenting complaint(s) as that will ensure your following questions into the systems review (mostly for ruling in/out the 3-5 differentials on your list) + associated risk factors (i.e. PMedHx, PSurgHx, medications, allergies, smoking, alcohol, drugs, social living/financial conditions, occupational history, travel/immigration history) will be focused on what's relevant as not every section of a mnemonic needs to be asked (ex. SOCRATES, OCD PQRST AAA, COCA OCDCS, PM BINDE, MGOS, DIGFAST/MSIGECAPS).
  2. If a patient is acting in pain, acknowledge it and try to address it on the spot if you can by offering pain relief with a follow-up question about allergies to ensure it's safe to give.
  3. Counselling can be difficult as it's not a format many people are used to but you still need to take a focused history regardless so that your management options are personalized/tailored to the person in front of you (ex. do not discuss smoking cessation/NRT as a long term management option for someone you're counselling about asthma for if they told you clearly they are a non-smoker; do discuss changing to hypoallergenic soaps/shampoos if they have an asthma exacerbation triggered by a new shampoo they tried out 3 days ago).
  4. Be wary that you're expected to rule in/out differentials (you should have ~3-5 by the time you enter after knocking) that you have considered outside the door within the time given (ex. don't stop asking other questions about PE, pneumothorax, GERD, or costochondritis even if the case sounds dead on for acute congestive cardiac failure).
  5. Do not try to track the time on the timer in the room because it can be anywhere (the side, top of a wall, behind the SP/examiner) and your focus should be on the SP/examiner anyways.
  6. Make good use of transitioning statements when moving between different sections of your consultation whether it's the history or physical exam (ex. after exhausting the presenting complaint, you could say "There is a list of other symptoms we look for in patients experiencing [insert their presenting complaint/issue if applicable] and I just want you to give me a yes or no answer, OK?" to transition to the systems review).
  7. PLEASE show empathy and kindness when the SP is acting/says something unusual ex. SP appears visibly down in mood, poor eye contact, and slow in speech so acknowledge it, "Mr. Anderson, I see that you appear quite down in yourself. I want to assure you that everything we discuss between us will remain confidential unless required by law." This also applies to situations where the patient's most pressing issue is different from what's on the door (ex. door vignette suggestive of abdominal pain hinting appendicitis but the patient abruptly drops that they're pregnant).
  8. Make good use of the time (about 1.5 minutes) outside the door to write your ~3-5 differentials along with any relevant investigations, management/counselling, and follow-up.
  9. Don't forget to ask about vital signs and any pending lab work/investigations if a station has a physical exam component (ex. highly relevant to ask if vital signs are available and if a FAST USS + routine bloods have been done in a patient you suspect with a dissecting AAA just before you're about to start your physical exam).
  10. The SP cannot lie to you however they can be vague or provide a different answer other than a clear, "No." ex. You ask the SP, "Have you ever smoked any tobacco or cigarettes in the past? and the SP responds, "Well, not recently that I know of, doctor." This is your cue to probe further about what they mean by "not recently".
  11. Some NAC stations can be mean by giving you normal investigations in what seems like a highly suggestive history/physical in an attempt to mislead you ex. You complete your history/physical exam and your working diagnosis in a 3 year old child with 4-day history of fever, SOB, and purulent sputum production is bacterial pneumonia but you're handed a normal CXR (treat based on the clinical evidence gathered/known not on your gut feeling).
Same is true vice-versa where a patient presentation seems benign but then the examiner hands you an alarming investigation ex. 35F in ED has symptoms consistent with likely viral URTI but the examiner hands you an EKG that shows saddle shaped ST elevation in line with acute pericarditis.
  1. Avoid repeating or leading questions as it wastes time, unless it’s to clarify something a patient says that you may not understand, and looks unprofessional (remember the CANMEDS framework expected for CMG's in your clinical approach; these are some ways I practiced phrasing my intro, "How would you like to be addressed today?" or "How would you like me to address you?" or "What name do you usually go by?").
  2. You can place the exam sticky labels you get on the back of your hand prior to entering a station so you don't fumble/experience difficulty handing it to the examiner (?unless the MCC decides you can just verbalize your candidate code for the NAC this year).
  3. Introduce yourself as a doctor not a medical student (you're assuming the role of a family/ED physician or PGY-1 resident on exam day depending on the scenario).
  4. Don't assume a patient's mode of address/pronouns used. Ask them first how they would like to be addressed today.
  5. Make sure to clearly wash your hands AT THE START of BOTH your history-taking AND physical examination.
  6. Even if you feel like you messed up the previous station, try as hard as you can to push it out of your mind until the NAC is over. You can cry, vent, or get frustrated AFTERWARD but not in the stations themselves.

These next points are more towards preparing for upcoming CaRMS cycles from what I've gathered reading/listening around:

  1. High MCCQE1 & NAC scores (most people who were invited for interviews, if not matched, to ON FM from the CaRMS 2024 Discord server and the CaRMS stats spreadsheet set up by Carms#5615 (https://docs.google.com/spreadsheets/d/1HAtnmyfCIAxKIux2akj8-hgWGvPgOVejVlfEHXuUa-8) had QE1 scores > 250-260 and NAC scores well above 1420-1430.
  2. Research into how CaRMS works to really have a careful look at the general overview, current year timelines, program descriptions, past trending data (may need to scroll down page further) in previous cycles. This will give you a good idea into what to have ready in time for the CaRMS file submission opening.
For reference, the rates of matching in R-1 as a current-year IMG was about 72.3% and 30.1% as a previous-year IMG according to the table on slide 11 of the CaRMS 2023 forum presentation. This goes down further in R-2 as a current-year IMG to about 39.0% and 12.5% as a previous-year IMG (about 751 went unmatched after R-1 and 822 went unmatched after R-2 for previous-year IMG’s).
  1. Recent practice or graduation (my last time practicing clinically was in April 2021 as an FY2 doc at the time which was only 2 years back at the time of my application (my year of graduation/YOG was 2019 but I know that time since YOG or gaps in studying/training are scrutinized especially if they're big like >5 years so it'd be worthwhile having an explanation ready if this applies to you).
  2. At least one Canadian LOreferee (seems a lot of university programs prefer applicants who have had clinical exposure in the form of shadowing/electives/observership with a Canadian doctor related to their field that you're applying to; mine happened to be a GP in Ottawa I connected to via family friends).
  3. Personal research around First Nation/Indigenous Peoples of Canada (this one is very specific particularly to Manitoba as they had several questions around ethnic minorities + Indigenous peoples; ex. smudging as a common Indigenous practice that even I only became aware of via the IMG/IEHP resources provided by Ontario Health Force or [[email protected]](mailto:[email protected])).
  4. Canadian research and electives - at the time of application, I was involved in a systematic review around women's health issues (had not been published at time of application) and I had done two electives under neurosurgery + orthopedics (heard that observerships don't count as formal clinical experience relative to electives so this was important too).
  5. High CASPer + FMProC scores (had 4th quartile score for CASPer and 516/4th quartile for FMProC which I know a lot of FM and some psych/pediatric programs look at).
  6. Try to secure as many Canadian LOR's/referees as they're favoured over international ones (ideally 3 but even 1 seems to be good), shadowing Canadian doctors depending on where you're applying to (ex. FM has the biggest seat pool so reach out to Canadian GP's around you to see who's willing to take you on).
  7. If you have the time and money for it, try to apply to as many programs and attend their relevant socials/events (can be found on CANPREPP closer to the opening of CaRMS) that you think you may have a chance at as you'll never know who might invite you later on for interviews!
  8. Really rank by your TRUE preference as CaRMS will prioritize your rank order first BEFORE considering how other programs ranked you (Rural Brandon was my 13th choice out of 22 programs I ranked across FM ON + FM MB). Even if you ranked a program at the bottom of your ROL, as long as that particular program has ranked you and they still have an available spot, you will match to them in the end!
There's a YouTube video regarding the CaRMS Match algorithm which clears things up nicely.
  1. Make sure to check your main email’s spam/junk inbox during the period where interview invitations/rejections are sent out as they can end up here sometimes (my joint FM ON interview invitation ended up in my spam and it is time sensitive to take it up).
In terms of the QE1, I think a lot of other people on Reddit have covered that much better than I have in terms of approaching it as I agree that a combination of UWorld Step II CK question bank (personally found Canada QBank questions and explanations to be lacking relative to UWorld in retrospect even if the price was much friendlier) and the Toronto Notes are the way to go. I also used Sketchy videos as a nice support for pharmacology/microbiology related topics.
Overall, I was glad to have had the opportunity to try for FM ON in the first iteration even if it didn't work out as I understand they only invite the top 300 applicants for interviews and even fewer of those 300 match (only ~80-90 from I heard but could be wrong so feel free to correct me). I understood the possibility my poor QE1 score and 2-year gap from formal clinical training may filter me despite my other scores being good.
I’m sure there are other things in this that I didn’t quite cover or explore (ex. the F2 Standalone process, IELTS/OETS, BC CAP/AIMG requirements, gaining permanent residency/PR, clinical/physician/medical assistant positions, CV/PL structure, thoughts around the different private programs/courses I took etc.) but I’m more than happy to discussing finemiscellaneous points via Reddit, Discord (herrdok#6944), email ([[email protected]](mailto:[email protected])), text, or virtual/phone call. For the time being though, I’m not taking on any new, regular NAC practice partners but would consider it once I figure out things more.
Otherwise, thanks to anyone reading this wall of text (if anything is incorrect/inconsistent, do let me know and I can have a look), looking forward to giving advice where I can, and best of luck to everyone moving through what is an extremely vague, challenging, and unforgiving process for matching into Canadian residency!😊
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2023.06.08 22:21 Salt-Yellow BIEL initiating study/clinical trial to treat Osteoarthritis

CEO of $BIEL just announced the start of an investigator initiated study / clinical trial evaluating their FDA cleared device for its ability to also reduce pain in patients with thumb carpometacarpal (CMC) joint osteoarthritis (OA). Stanford University initiated a study entitled "Pulsed Electromagnetic Field (PEMF) Therapy in Thumb CMC Arthritis" (www.ClinicalTrials.gov Identifier: NCT05315297) Osteoarthritis is the second-most common musculoskeletal disorder, leading to pain and functional limitations with a high social and economic burden. OA can affect every joint in the body, but it is most common in the knee, hip, spine, and hand. Within the hand, the thumb base is the most affected single joint.
submitted by Salt-Yellow to pennystocks [link] [comments]

2023.06.08 22:04 zogmuffin 6+ months of pain in left leg, clean MRI. Has anyone ever experienced sciatic nerve issues like this?

Hey guys. I had a whole bunch of weird symptoms hit me last winter and am desperately trying to disentangle them. I have experienced tingling and pain in all four limbs at one point or another but my left leg is by far the worst and most consistent, though it changes day by day and week by week. I have pain radiating from my hip joint, around my knee (worse with weight bearing when it flares up), and occasionally all the way to my foot. I have days where my upper leg aches like I have a fever, and days where the bigger muscle groups up there spontaneously feel strained and tired, like they’ve been overworked. The pain has never extended into my back, although sometimes I think I can feel the deep “butt cheek” origin people talk about. Sometimes I experience similar symptoms in the other leg. Meanwhile, some days I barely notice anything at all. I have never experienced any numbness or weakness.
I’ve had MRIs of my whole spine at this point (minus sacral) and it’s all been normal.* Docs are starting to settle on fibromyalgia, but another MRI recently uncovered a hidden shoulder injury and now I’m wondering if some of the pain in my other limbs could also be attributed to other, more concrete issues.
I never gave much thought to sciatica because I’ve never had any back pain and because I didn’t know people could feel it in their legs so much. I also have tingling in my labia, which I recently learned can be a sciatica symptom.
Has anyone had it manifest like this?
*I’ve also had a normal NCS, but no EMG. Normal x-rays of left hip, thigh, and knee. Gallons of normal blood work.
submitted by zogmuffin to Sciatica [link] [comments]

2023.06.08 21:20 Professional-Town724 Niggas been wearing ski mask in the city for bricks

The world just getting hip to em. Not them hot ass cotton joints neither with the mouth cut out pause I say since around 04 and took off fr around 06 when niggas was wearing the big ass square ear rings and vneck tees
submitted by Professional-Town724 to TheCapitalLink [link] [comments]

2023.06.08 21:14 digiri-dont-do-that Over 2 years without a proper answer is maddening.

25M 70kgs 5'8
Straight off the bat I have to say I posted in this sub a few months back but since then there's been some developments.
In a nutshell I was recently discharged by a rheumatologist because they have no idea what is happening to me.
For the past 2.5 years or so I have developed crepitus throughout my entire body, it is incredibly loud, repeatable (so I believe it is not typical cavitation like when you crack your knuckles and have to wait before doing so again) and is often accompanied by pain. My neck, lower back and knees are the worst. However, it is also present in my ankles, wrists, hips, elbows, shoulders, thighs/coccyx (I haven't been able to fully identify where this one is coming from), sternum/ribcage, jaw etc. I'm basically a walking sound system at this point, the most minute of movements results in noise, it's maddening. What's worse is having absolutely no answer as to its cause. I have also started to experience a strange phenomena of whooshing and ringing in my ears, which I assume is tinnitus.
I have been seen by a variety of rheumatologists and specialist physiotherapists who have debated whether I'm hypermobile, or at least somewhere on the high end of that spectrum. Most of them have concluded that I am definitely not hypermobile. All of these rheumatologists have been very senior and accredited in the research hospital I've been seen in. However I'm always given contradictory information from each of them, with no diagnosis ever made.
I've so far had 4 X-rays and an MRI, with nothing of note found besides osteophytes and scleroderma in some portions of my lower spine. I was also investigated for concerns of ankylosing spondyloarthritis but that came back negative. I'm also HLA B27 positive. Since these scans my symptoms have increased in severity.
In conjunction with this I had previously, and technically continue still to this day continue to "suffer" from Henoch Schonlein Purpura. Although these days it is nowhere near as much of a problem as it was for me a few years ago.
My last interaction with the most senior rheumatologist was a plan to medicate me with steroid injection and then a DMARD if the steroids proved effective. They didn't. And so for my follow up appointment I saw a different rheumatologist who I informed that the treatment plan hadn't worked and I had not responded to the steroids. To which he essentially said, your body will stiffen up as you get older and this should resolve on its own. Not the answer I was looking for.
Due to my ongoing medical issue I have started to distance myself from activities I enjoyed such as BJJ due to fear of making my condition worse. I was also suspicious of this activity itself being either the direct cause of my condition due to its physical nature, and my joint issues only began after I started doing the activity. However, I have since stopped doing the sport and my symptoms haven't only persisted but have spread to previously unaffected areas. Still it may be a contributing factor.
Nobody I have come across has an answer, I really do want to know what is going wrong with my body, especially since each day I am experiencing its degeneration. I feel weaker, the structures in my body feel much more lax and are prone to injury. A few people on reddit have claimed very similar symptoms to mine also without a diagnosis. I don't know where to turn. I'm also currently searching for alternative treatments such as prolotherapy/prp injections etc. but have frame of reference for whether they would work or not.
Any information would be greatly appreciated.
Thank you.
submitted by digiri-dont-do-that to AskDocs [link] [comments]