Leopold's Maneuvers are difficult to perform on obese women and women who have hydramnios. The palpation can sometimes be uncomfortable for the woman if care is not taken to ensure she is relaxed and adequately positioned. To aid in this, the health care provider should first ensure that the woman has recently emptied her bladder. If she has not, she may need to have a straight urinary catheter inserted to empy it if she is unable to micturate herself. The woman should lie on her back with her shoulders raised slightly on a pillow and her knees drawn up a little. Her abdomen should be uncovered, and most women appreciate it if the individual performing the maneuver warms their hands prior to palpation. First maneuver: Fundal Grip While facing the woman, palpate the woman's upper abdomen with both hands. A professional can often determine the size, consistency, shape, and mobility of the form that is felt. The fetal head is hard, firm, round, and moves independently of the trunk while the buttocks feel softer, are symmetric, and the shoulders and limbs have small bony processes; unlike the head, they move with the trunk. Second maneuver After the upper abdomen has been palpated and the form that is found is identified, the individual performing the maneuver attempts to determine the location of the fetal back. Still facing the woman, the health care provider palpates the abdomen with gentle but also deep pressure using the palm of the hands. First the right hand remains steady on one side of the abdomen while the left hand explores the right side of the woman's uterus. This is then repeated using the opposite side and hands. The fetal back will feel firm and smooth while fetal extremities (arms, legs, etc.) should feel like small irregularities and protrusions. The fetal back, once determined, should connect with the form found in the upper abdomen and also a mass in the maternal inlet, lower abdomen. Third maneuver: Pawlick's Grip In the third maneuver the health care provider attempts to determine what fetal part is lying above the inlet, or lower abdomen.[2] The individual performing the maneuver first grasps the lower portion of the abdomen just above the symphysis pubis with the thumb and fingers of the right hand. This maneuver should yield the opposite information and validate the findings of the first maneuver. If the woman enters labor, this is the part which will most likely come first in a vaginal birth. If it is the head and is not actively engaged in the birthing process, it may be gently pushed back and forth. The Pawlick's Grip, although still used by some obstetricians, is not recommended as it is more uncomfortable for the woman. Instead, a two-handed approach is favored by placing the fingers of both hands laterally on either side of the presenting part. Fourth maneuver The last maneuver requires that the health care provider face the woman's feet, as he or she will attempt to locate the fetus' brow. The fingers of both hands are moved gently down the sides of the uterus toward the pubis. The side where there is resistance to the descent of the fingers toward the pubis is greatest is where the brow is located. If the head of the fetus is well-flexed, it should be on the opposite side from the fetal back. If the fetal head is extended though, the occiput is instead felt and is located on the same side as the back. Cautions Leopold's maneuvers are intended to be performed by health care professionals, as they have received the training and instruction in how to perform them. That said, as long as care taken not to roughly or excessively disturb the fetus, there is no real reason it cannot be performed at home as an informational exercise. It is important to note that all findings are not truly diagnostic, and as such ultrasound is required to conclusively determine the fetal position.

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Identify the anatomy and explain the physiology of the scrotum on diagrams and sonograms.

Describe and demonstrate the protocol for sonographic scanning of the scrotum.

Identify and describe sonographic images of congenital abnormalities of the scrotum.

Identify and describe sonographic images of pathologies of the scrotum.

Identify and describe sonographic images of extratesticular disease processes.

Identify the anatomy and explain the physiology of the prostate on diagrams and sonograms.

Describe and demonstrate the protocol for transabdominal and endorectal sonographic scanning of the prostate.

Identify and describe sonographic images of benign and malignant pathologies of the prostate, including benign hyperplasia, prostatitis, carcinoma, and calculi.

Explain the technique for prostate biopsy.

Define the criteria for an ultrasound appearance of prostate tumor staging.

Explain the technique for radiation seed implantation.

Explain the Patient Privacy Rule (HIPAA) and Patient Safety Act (see reference).

Prostate cancer is the most common cancer among men (after skin cancer), but it can often be treated successfully. If you have prostate cancer or are close to someone who does, knowing what to expect can help you cope. Here you can find out all about prostate cancer, including risk factors, symptoms, how it is found, and how it is treated.

This video is really sad. You can literally watch this man dying. He was shot in the chest and rushed to the emergency room. His heart has stopped beating or has arrested. As a last resort, surgeons did an extreme procedure called an open thoracotomy which is that crazy tool you see there that basically splits the ribs open and allows easy open access to the heart. They did this so they could give him a cardiac massage. A cardiac massage is when surgeons are manually trying to pump the heart after it has stopped working on its own (cardiac arrest). Unfortunately he lost so much blood from his gun shot wound and he was pronounced dead. There are cases of patients surviving after having this kind of invasive resuscitation but it is rare.

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For the first few days after giving birth, a new mother’s breasts remain soft. They will produce colostrum. Colostrum, the first milk, is available in just the right amount, and is rich in immune factors that protect newborns. Sometime during the next few days, the breasts will become full, firm, warm, and perhaps tender. When this occurs, people say: “the milk is coming in!” The scientific term for this event is: engorgement. Engorgement is normal, and lasts for various periods of time depending on the individual woman. Some women experience only a day or so of mild, easy-to-manage engorgement. For other women, engorgement may be more intense, and can last from several days to two weeks.

Each month inside your ovaries, a group of eggs starts to grow in small, fluid-filled sacs called follicles. Eventually, one of the eggs erupts from the follicle (ovulation). It usually happens about 2 weeks before your next period. Hormones Rise After the egg leaves the follicle, the follicle develops into something called the corpus luteum. The corpus luteum releases a hormone that helps thicken the lining of your uterus, getting it ready for the egg. The Egg Travels to the Fallopian Tube After the egg is released, it moves into the Fallopian tube. It stays there for about 24 hours, waiting for a single sperm to fertilize it. All this happens, on average, about 2 weeks after your last period.

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Hymenoplasty Hymen Repair Surgery in Delhi India by Dr. Prabhash, Specialist in Female genital surgery. Intact Natural Hymen is considered a sign of virginity and a broken hymen often creates difficult situation in newly married girls life. With increasing age of marriage premarital relations are turning common and affecting post marital life. Hymenoplasty or Hymen Repair or Hymen restoration surgery has been developed to overcome this difficult situations. In past it was assumed that hymen never heals after repair and we need to rely upon stitches which holds remnants and with penetrative force they cut through and cause bleeding. This old Hymenoplasty technique is unreliable and often your partner may find one or two stitches making circumstances even more ridiculous. With our hymenoplasty technique Hymen heals well and becomes soft and natural in 4-6 weeks, so you get a normal natural hymen with our hymenoplasty. Details of Revirgination or Hymenoplasty surgery you may find here http://www.cosmeticprabhash.com/hymenoplasty%20hymen%20repair%20delhi%20india.htm

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http://penilepapules.plus101.com/ ----- White Spots On Shaft, Pearly Penile Papules Treatment Cream, Single Red Bump On Shaft, Ppp Surgery. Common Home Made Remedies for Pearly Penile Papules. When it comes to treating pearly penile papules many people find it very difficult to reach one of the medical treatments. This is mainly because they are highly expensive and not many people can afford spending large amounts of money on surgery and recovery. In addition to that, these procedures have been reported as being quite risky, which make the men suffering from pearly penile papules think twice before going for one of the available surgeries. This is why, along the time, many homemade, natural treatments have been experienced, so that a cheaper and less risky way of curing pearly penile papules would be found. Some of the methods which have been tried proved to be very less effective, while some did not have any effect at all. Yet, there have also been methods which not only proved to be effective, but they were also considered to be much better than the medical treatment. Most of those who have tried the tea tree oil treatment reported significant diminish of the number of the papules from their penises. In addition to the clearing of the skin, they have also noticed that there were no side effects and the skin remained soft after the papules were removed. As the method was quite simple to put in practice (it requires the application of tea tree oil on the affected area with a cotton swab for three or four times per day), many men decided this was indeed a great solution to their problem.

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