Dr Tayyab Riaz Ch

21/04/2026

What is Your Spot Diagnosis after watching this Clinical Case. And what is this sign called upon tongue protrusion ?
Tell me in Comments 👇🏽

08/04/2026

𝗟𝘆𝘁𝗹𝗲'𝘀 𝗥𝗲𝗽𝗮𝗶𝗿 𝗧𝗲𝗰𝗵𝗻𝗶𝗾𝘂𝗲 𝗼𝗳 𝗜𝗻𝗴𝘂𝗶𝗻𝗮𝗹 𝗛𝗲𝗿𝗻𝗶𝗮
​Lytle's technique is a classic tissue-based (non-mesh) surgical procedure specifically designed to address an indirect inguinal hernia by focusing on the repair and reinforcement of the patulous" or wide internal (deep) inguinal ring.
It is commonly used for pediatric inguinal hernias and inguinal hernias in adults where posterior wall is already strong.
Lytle's repair can also be performed along with posterior wall herniorrhaphy or prosthetic mesh
𝗖𝗼𝗿𝗲 𝗣𝗿𝗶𝗻𝗰𝗶𝗽𝗹𝗲
​Unlike repairs that focus on the inguinal floor, Lytle's repair specifically targets the "shutter mechanism" of the internal ring.
𝗧𝗵𝗲 𝗥𝗲𝗽𝗮𝗶𝗿
• ​after hernia sac has been transfixed and reduced, The spermatic cord is retracted laterally.
• ​The redundant or weakened transversalis fascia on the medial side of the internal ring is identified.
• ​Interrupted non-absorbable sutures with polypropylene 2-0 is used to suture the conjoint tendon to inguinal ligament effectively narrowing the deep ring from its medial aspect.
• A finger breadth narrowing is left to prevent cord strangulation.
• 2-3 such sutures at 5mm interval are used to reinforce the deep ring.
• Adding posterior wall herniorrhaphy or mesh placement is Surgeon's choice after checking posterior wall strength.

👉🏻 Watch latest video on my youtube channel for step by step technique
'srepair

07/04/2026

DIY project by my House Officers ✔️💯

04/04/2026

𝗦𝗵𝗼𝘂𝗹𝗱𝗶𝗰𝗲 𝗶𝗻𝗴𝘂𝗶𝗻𝗮𝗹 𝗛𝗲𝗿𝗻𝗶𝗮 𝗥𝗲𝗽𝗮𝗶𝗿
Shouldice Repair is a Mesh free tissue based repair that uses a four-layer, continuous suturing method to imbricate (overlap) the fascia, reinforcing the abdominal wall with the patient's own tissue. It has 99.5% success rate
Watch complete step by step video 👇🏽

Shouldice inguinal hernia repair ...

04/04/2026

𝗦𝗵𝗼𝘂𝗹𝗱𝗶𝗰𝗲 𝗶𝗻𝗴𝘂𝗶𝗻𝗮𝗹 𝗛𝗲𝗿𝗻𝗶𝗮 𝗥𝗲𝗽𝗮𝗶𝗿
Shouldice Repair is a Mesh free tissue based repair that uses a four-layer, continuous suturing method to imbricate (overlap) the fascia, reinforcing the abdominal wall with the patient's own tissue. It has 99.5% success rate
Visit my youtube channel "drtayyabriazch" for detailed learning based video

𝗟𝗮𝘆𝗲𝗿 𝟭: 𝗠𝗲𝗱𝗶𝗮𝗹 𝘁𝗼 𝗹𝗮𝘁𝗲𝗿𝗮𝗹 𝗶𝗺𝗯𝗿𝗶𝗰𝗮𝘁𝗶𝗼𝗻
The first suture line is started at the p***c tubercle using continuous polypropylene 2-0 suture, and The inferior flap of the transversalis fascia is sutured to the deep surface of the superior flap
𝗟𝗮𝘆𝗲𝗿 𝟮: 𝗟𝗮𝘁𝗲𝗿𝗮𝗹 𝘁𝗼 𝗠𝗲𝗱𝗶𝗮𝗹 𝗶𝗺𝗯𝗿𝗶𝗰𝗮𝘁𝗶𝗼𝗻
At the internal ring the suture is reversed and continued medially by approximating the free edge of the superior flap to the shelving edge of the inguinal ligament.
𝗟𝗮𝘆𝗲𝗿 𝟯: 𝗟𝗮𝘁𝗲𝗿𝗮𝗹 𝘁𝗼 𝗺𝗲𝗱𝗶𝗮𝗹 𝗖𝗹𝗼𝘀𝘂𝗿𝗲 (Reinforcement of conjoint tendon to inguinal ligament)
The third suture line is started at the level of the internal ring where the conjoined tendon is approximated to the inguinal ligament and tied when the p***c tubercle is reached.
𝗟𝗮𝘆𝗲𝗿 𝟰: 𝗠𝗲𝗱𝗶𝗮𝗹 𝘁𝗼 𝗹𝗮𝘁𝗲𝗿𝗮𝗹 𝗖𝗹𝗼𝘀𝘂𝗿𝗲 (Reinforcement of conjoint tendon to inguinal ligament)
Using the same suture of 3rd layer, the fourth suture line attaches these same structures to one another and is tied at the level of the internal ring

01/04/2026

While taking clinical exam today i asked student where are Valvulae conniventes present ?
"Sir in Large gut"
And where are the Haustrations present ?
"Sir in colon"
Okay what is jejunum ?
"Sir it is Large part of small intestine"
🤯🤯🤯🤯

28/03/2026

How to Remove a Chest Tube Safely ✔️💯

26/03/2026

How to Excise a Pipilloma under 1 minute ✔️💯

22/03/2026

What is Phantom Limb, Phantom Pain and Phantom Sensations. Different Theories of its underlying pathophysiology and Management

18/03/2026

𝗘𝗻𝗱𝗼𝘀𝗰𝗼𝗽𝗶𝗰 𝗧𝗵𝗼𝗿𝗮𝗰𝗶𝗰 𝗦𝘆𝗺𝗽𝗮𝘁𝗵𝗶𝗰𝗼𝘁𝗼𝗺𝘆 (𝗘𝗧𝗦) for Primary Palmar Hyperhydrosis
What is palmar hyperhydrosis ?
Primary Palmar hyperhidrosis is a condition characterized by chronic, excessive, and often unpredictable sweating of the palms, typically starting in childhood or adolescence and often linked to sympathetic nerve hyperactivity.
Cause is mostly idiopathic, though it often runs in families and is not necessarily linked to any underlying disease.
Treatment Options:
• Topical Agents: Antiperspirants containing aluminum chloride.
• Iontophoresis: A device using water and mild electrical currents to shut down sweat glands.
• Botox Injections: over multiple points on palms effective only for 6–12 months.
• Oral Medications: Anticholinergics can help reduce overall perspiration.
Endoscopic Thoracic Sympathicotomy (ETS): Endoscopic Thoracic Sympathectomy/sympathicotomy is only permanent solution for patients where other options fail or if its severe hyperhydrosis.
In Sypathectomy segment of the thoracic sympathatic shain is excised leading to severe side effects while in sympathicotomy only transection of the thoracic chain is done either at T3 or T4 level with T4 producing more promising results and lower side effects.
Watch complete 𝗘𝗻𝗱𝗼𝘀𝗰𝗼𝗽𝗶𝗰 𝗧𝗵𝗼𝗿𝗮𝗰𝗶𝗰 𝗦𝘆𝗺𝗽𝗮𝘁𝗵𝗶𝗰𝗼𝘁𝗼𝗺𝘆 (𝗘𝗧𝗦) video on my youtube channel.

07/03/2026

𝗕𝘂𝗰𝗰𝗶𝗻𝗮𝘁𝗼𝗿 𝗖𝗮𝘃𝗲𝗿𝗻𝗼𝘂𝘀 𝗛𝗲𝗺𝗮𝗻𝗴𝗶𝗼𝗺𝗮
5y old Dua fatima having gradually increaseing right sided cheek swelling from last 2 years. Parents got concerend and reached me for diagnosis and treatment. On clinical examination it was freely mobile, soft to firm, non tender and compressible swelling in right buccinator muscle region. USG confirmed the clinical diagnosis of hemangioma. Small jawline incision planned taking care of the cosmesis and exploration done. Hemangioma was found taking its blood supply from facial artery branches. Feeding vessels were meticulously ligated and hemangioma excised taking care not to damage facial nerve branches. Wound closed in subcut fashion. On followup visit both Dua and parents are happy and satisfied.
A buccinator cavernous hemangioma is a rare, benign, slow-growing vascular tumor arising within the buccinator muscle, often presenting in children and young adults as a progressive, soft tissue mass. Diagnosis is confirmed through imaging and histopathology, with complete surgical excision being the primary treatment, often requiring careful dissection to avoid facial nerve branches.