This video demonstrates the use of an episiotomy to facilitate vaginal delivery of a baby

Urinary incontinence isn't a disease, it's a symptom. It can be caused by everyday habits, underlying medical conditions or physical problems. A thorough evaluation by your doctor can help determine what's behind your incontinence. Temporary urinary incontinence Certain drinks, foods and medications can act as diuretics — stimulating your bladder and increasing your volume of urine. They include: Alcohol Caffeine Decaffeinated tea and coffee Carbonated drinks Artificial sweeteners Corn syrup Foods that are high in spice, sugar or acid, especially citrus fruits Heart and blood pressure medications, sedatives, and muscle relaxants Large doses of vitamins B or C Urinary incontinence also may be caused by an easily treatable medical condition, such as: Urinary tract infection. Infections can irritate your bladder, causing you to have strong urges to urinate, and sometimes incontinence. Other signs and symptoms of urinary tract infection include a burning sensation when you urinate and foul-smelling urine. Constipation. The rectum is located near the bladder and shares many of the same nerves. Hard, compacted stool in your rectum causes these nerves to be overactive and increase urinary frequency. Persistent urinary incontinence Urinary incontinence can also be a persistent condition caused by underlying physical problems or changes, including: Pregnancy. Hormonal changes and the increased weight of the uterus can lead to stress incontinence. Childbirth. Vaginal delivery can weaken muscles needed for bladder control and also damage bladder nerves and supportive tissue, leading to a dropped (prolapsed) pelvic floor. With prolapse, the bladder, uterus, rectum or small intestine can get pushed down from the usual position and protrude into the vagina. Such protrusions can be associated with incontinence. Changes with age. Aging of the bladder muscle can decrease the bladder's capacity to store urine. Menopause. After menopause women produce less estrogen, a hormone that helps keep the lining of the bladder and urethra healthy. Deterioration of these tissues can aggravate incontinence. Hysterectomy. In women, the bladder and uterus are supported by many of the same muscles and ligaments. Any surgery that involves a woman's reproductive system, including removal of the uterus, may damage the supporting pelvic floor muscles, which can lead to incontinence. Enlarged prostate. Especially in older men, incontinence often stems from enlargement of the prostate gland, a condition known as benign prostatic hyperplasia. Prostate cancer. In men, stress incontinence or urge incontinence can be associated with untreated prostate cancer. But more often, incontinence is a side effect of treatments for prostate cancer. Obstruction. A tumor anywhere along your urinary tract can block the normal flow of urine, leading to overflow incontinence. Urinary stones — hard, stone-like masses that form in the bladder — sometimes cause urine leakage. Neurological disorders. Multiple sclerosis, Parkinson's disease, stroke, a brain tumor or a spinal injury can interfere with nerve signals involved in bladder control, causing urinary incontinence.

Carpal tunnel syndrome is a hand and arm condition that causes numbness, and other symptoms. Carpal tunnel syndrome is caused by a pinched nerve in your wrist. A number of factors can contribute to carpal tunnel syndrome, including the anatomy of your wrist, certain underlying health problems and possibly patterns of hand use. Bound by bones and ligaments, the carpal tunnel is a narrow passageway located on the palm side of your wrist. This tunnel protects a main nerve to your hand and the nine tendons that bend your fingers. Compression of the nerve produces the numbness, tingling and, eventually, hand weakness that characterize carpal tunnel syndrome.

Before ovulation occurs, the average diameter of the dominant follicle is 22 to 24 mm (range 18-36 mm). It is the only marker that can predict ovulation with ease. * In stimulated cycle (hormonal treatment), generally, all or most of the antral follicles grow. The growth rate will be different for each of them.

An atrial septal defect (ASD) is a hole in the wall between the two upper chambers of your heart (atria). The condition is present from birth (congenital). Small atrial septal defects may close on their own during infancy or early childhood. Large and long-standing atrial septal defects can damage your heart and lungs. Small defects may never cause a problem and may be found incidentally. An adult who has had an undetected atrial septal defect for decades may have a shortened life span from heart failure or high blood pressure that affects the arteries in the lungs (pulmonary hypertension). Surgery may be necessary to repair atrial septal defects to prevent complications.

Masturbating is totally healthy, and totally normal. There are tons of myths out there meant to scare you into thinking masturbation is wrong or bad. But the truth is masturbation is perfectly safe. Masturbating won't make you blind, crazy, or stupid. It won’t damage your genitals, cause pimples, or stunt your growth. It doesn’t use up all your orgasms or ruin other kinds of sex. In fact, masturbation can actually be good for you. Here are some benefits of masturbation: Masturbation is safer than any other type of sex. You can’t get pregnant or get any sexually transmitted infections from masturbating. Masturbation can help you learn what you like and don’t like sexually. And if you decide to have sex with someone, you can know what you do/don’t want to do. BONUS: getting comfortable talking about sex and your body with your partner makes it easier to talk about protecting yourself against STDs and pregnancy, too. Exploring your body and learning how to give yourself sexual pleasure can be empowering and help improve your body image. Masturbation can lower stress and help you relax. It even helps some people fall asleep. Having an orgasm releases endorphins — feel good chemicals in your brain. Orgasms can be a natural painkiller and can even help with period cramps. Mutual masturbation (masturbating with a partner) is a really safe way to have sex and let the other person know what feels good to you. If you share a sex toy, use condoms on the toy and clean it before swapping. And if you touch each other’s genitals, wash your hands before touching your own. Can I get an STD from masturbating? Nope. Masturbating is the safest sexual activity out there. There is virtually NO chance of getting an STD or any other infection from touching your own genitals (and there’s also no chance of pregnancy). STDs have to be passed from one person to another, so you can’t give yourself an STD. The one exception to this is herpes - so if you have any cold sores on your mouth and touch them, make sure to wash your hands before masturbating. But it IS possible to get an STD if you’re masturbating with another person and touching each other’s genitals. Anytime semen (cum) or vaginal fluids are spread to someone else’s body, or your genitals rub against each other, there’s a risk of STDs. So if you touch each other’s genitals, wash your hands before touching your own. STDs can also be spread by sharing sex toys with another person. You can help protect yourself by using condoms on any toys that you share (even if they’re not shaped like a penis). Put a new condom on anytime a different person uses it. If you’re the only one using your sex toys, you don’t have to worry about STDs. But if you use them with other people, protect those sex toys just like you’d protect your own genitals — put a condom on ‘em! It’s possible for masturbation to cause irritation or infections if your body is sensitive to the way you masturbate or the things you masturbate with — but this isn’t the same thing as an STD. Lotions, Vaseline, oils, and scented or flavored stuff may irritate your vulva and vagina. Masturbating roughly and not using lubrication can also lead to irritation because of friction. And germs from the anus can cause vaginal infections — so never put something in your vagina that’s been in your butt without washing it or covering it with a condom. If you’re worried that you have an STD because of pain, itching, or discomfort in your genitals, go to your doctor or your local Planned Parenthood health center.

Amniotomy is the official term for artificially breaking the bag of waters during labor. It is believed that breaking the bag of waters will help to speed up an otherwise slow labor. Amniotomy is part of the Active Management of Labor practiced in some hospitals. Amniotomy is performed by a midwife or doctor. A long, thin instrument with a hook on the end is inserted into the vagina and through the cervix so it can catch and rip the bag of waters. To perform an amniotomy, the cervix must be dilated enough to allow the instrument through the cervix, generally at least a two. Why choose Amniotomy? Unlike other medical methods of starting labor, amniotomy does not add synthetic hormones to your labor. Instead it seems to stimulate your body’s own labor process. Amniotomy allows the use of an internal electronic fetal monitor. How effective is Amniotomy? Amniotomy alone is unpredictable, it may take hours for labor to start with amniotomy. Because amniotomy increases the risk for infection, most caregivers use amniotomy in combination with synthetic oxytocin. Birth does happen faster when amniotomy is combined with synthetic oxytocin than when amniotomy is used alone. Risks of Amniotomy Risks for Mother Increases the risk for infection. This risk is increased with length of time the waters are broken and with vaginal exams. Because of the infection risk, a time limit is given by which the mother must give birth. As the time limit approaches attempts to progress labor will become more aggressive. The fore waters equalize pressure on the cervix so it will open uniformly. When they are broken, the mother increases her chances of having uneven dilation. Risks for Baby Increases the risk of umbilical cord compression. The fore waters equalize pressure on the baby’s head as it presses against the cervix. When they are broken, the pressure on the baby’s head may be uneven causing swelling in some parts.

The pelvic floor or pelvic diaphragm is composed of muscle fibers of the levator ani, the coccygeus, and associated connective tissue which span the area underneath the pelvis. The pelvic diaphragm is a muscular partition formed by the levatores ani and coccygei, with which may be included the parietal pelvic fascia on their upper and lower aspects. The pelvic floor separates the pelvic cavity above from the perineal region (including perineum) below.

The right and left levator ani lie almost horizontally in the floor of the pelvis, separated by a narrow gap that transmits the urethra, vagina, and anal canal. The levator ani is usually considered in three parts: pubococcygeus, puborectalis, and iliococcygeus. The pubococcygeus, the main part of the levator, runs backward from the body of the pubis toward the coccyx and may be damaged during parturition. Some fibers are inserted into the prostate, urethra, and vagina. The right and left puborectalis unite behind the anorectal junction to form a muscular sling . Some regard them as a part of the sphincter ani externus. The iliococcygeus, the most posterior part of the levator ani, is often poorly developed.

The coccygeus, situated behind the levator ani and frequently tendinous as much as muscular, extends from the ischial spine to the lateral margin of the sacrum and coccyx.

The pelvic cavity of the true pelvis has the pelvic floor as its inferior border (and the pelvic brim as its superior border.) The perineum has the pelvic floor as its superior border.

Some sources do not consider “pelvic floor” and “pelvic diaphragm” to be identical, with the “diaphragm” consisting of only the levator ani and coccygeus, while the “floor” also includes the perineal membrane and deep perineal pouch. However, other sources include the fascia as part of the diaphragm. In practice, the two terms are often used interchangeably.

Inferiorly, the pelvic floor extends into the anal triangle.

Although the exact cause of abdominal aortic aneurysms is unknown, a number of factors may play a role, including: Tobacco use. ... Hardening of the arteries (atherosclerosis). ... High blood pressure. ... Blood vessel diseases in the aorta. ... Infection in the aorta. ... Trauma. ... Heredity.

Cervical cerclage can be placed via transvaginal, open transabdominal, or laparoscopic transabdominal approach, preferably before pregnancy. Recurrent late miscarriages may be due to a weak (sometimes called an incompetent) cervix that shortens or opens too early in pregnancy. Cervical cerclage involves placing a stitch around the upper part of the cervix to keep it closed; the operation may be carried out through the vagina, or through the abdomen, as an open or laparoscopic ('keyhole') procedure.

ADC was first identified early in the AIDS epidemic as a common and novel CNS syndrome.(4,5) The three components of the term, AIDS dementia complex embody central features of the condition. AIDS emphasizes its morbidity and poor prognosis, particularly when its severity is at stage 2 or greater (see Table 1), a severity comparable to other clinical AIDS-defining complications of HIV-1 infection. Dementia designates the acquired and persistent cognitive decline with preserved alertness that usually dominates the clinical presentation and determines its principal disability. Complex emphasizes that this disease not only impairs the intellect, but also concomitantly alters motor performance and, at times, behavior. This involvement of the nervous system beyond cognition is evidence of a wider involvement of the CNS than occurs in some other types of dementia such as Alzheimer's disease. Additionally, myelopathy may be an important, indeed predominating, aspect of ADC, and organic psychosis may also be a feature in a subset of patients (see Rheumatologic and Musculoskeletal Manifestations of HIV). These manifestations are therefore also encompassed within this term. By contrast, neither neuropathy nor functional psychiatric disturbance are included in ADC.

Glycogen storage disease (GSD, also glycogenosis and dextrinosis) is the result of defects in the processing of glycogen synthesis or breakdown within muscles, liver, and other cell types. GSD has two classes of cause: genetic and acquired.

Esophageal varices are abnormal, enlarged veins in the tube that connects the throat and stomach (esophagus). This condition occurs most often in people with serious liver diseases. Esophageal varices develop when normal blood flow to the liver is blocked by a clot or scar tissue in the liver. To go around the blockages, blood flows into smaller blood vessels that aren't designed to carry large volumes of blood. The vessels can leak blood or even rupture, causing life-threatening bleeding. A number of drugs and medical procedures can help prevent and stop bleeding from esophageal varices.

Thalassemia is an inherited blood disorder characterized by less hemoglobin and fewer red blood cells in your body than normal. Several types of thalassemia exist, including alpha-thalassemia, beta-thalassemia intermedia, Cooley's anemia and Mediterranean anemia. Hemoglobin is the substance in your red blood cells that allows them to carry oxygen. The low hemoglobin and fewer red blood cells of thalassemia may cause anemia, leaving you fatigued. If you have mild thalassemia, you may not need treatment. But, if you have a more severe form of thalassemia, you may need regular blood transfusions. You can also take steps on your own to cope with fatigue, such as choosing a healthy diet and exercising regularly.

Joint Replacement Surgery is part of Orthopedics hence surgical as well as non-surgical techniques are carried out by orthopedic surgeons. The burden of pain can be reduced with the help of minimally invasive orthopedic therapies prescribed by doctors. https://goo.gl/VhzaUr

M.Torabi Nami MD, PhDc Department of Neuroscience Institute for Cognitive Science Studies (ICSS), Tehran 15948 Iran Torabi_m@iricss.org Abstract Sleepiness, tiredness and fatigue are complaints which must be thoroughly analyzed to eliminate blur and ambiguity. Physiological sleepiness (“sleep pressure”) increases while being awake and additionally underlies the circadian rhythm with a lower threshold to fall asleep during night time. Excessive daytime sleepiness (EDS) is considered normal only after sleep deprivation. Clinically, EDS manifests by frequents daytime napping and/or reduced alertness with automatic behavior or - in its extreme form - in recurrent attacks of sudden, uncontrollable compulsion to sleep also in inappropriate situations (= “sleep attacks”). EDS is “objectively” addressed by measuring the mean sleep latency to four to five nap opportunities throughout the day using the multiple sleep latency test (MSLT) or the maintenance of wakefulness test (MWT). EDS denotes both, a ready entrance into sleep as well as difficulty in staying awake during daytime or accordingly in inappropriate situations. These two partially independent aspects of EDS are separately assessed by the “passive” MSLT and the “active” MWT respectively. For that reason the MSLT and MWT only weakly correlate with each other when tested over a broad range of patients with EDS. It is important to keep in mind, that these tests are importantly influenced by a great variety of factors such as mood, anxiety, and motivation. “Vigilance” comprises wakefulness, alertness and attention and therefore is more than just the reciprocal to sleepiness. Cognitive performance tasks such as Steer Clear Reaction Time Test (SCRTT) or driving simulators require the complete integrity of vigilance to achieve normal results. Hypersomnia is usually broadly defined as the combination of abnormally prolonged night-time sleep (regularly >10 h) with EDS during ≥1 months. On the other hand, the term hypersomnia has also been used in a narrower scene for the isolated abnormality of a prolonged night-time sleep need (>10 h). “Tiredness”, also in colloquial language often used for sleepiness, in a broader sense also describes the feeling of lack of energy, motivation and initiative. These patients seek rest rather than sleep. They often cannot fall asleep when given the opportunity in spite of feeling tired, and hence, in an MSLT, do not show an abnormally short sleep latency. Furthermore, tiredness (and fatigue) as opposed to sleepiness has a mental (“central”) and physiological (bodily or “peripheral”) component, which the patients can readily distinguish. Patients with insomnia, mild sleep apnea syndrome, or depression rather suffer from mental tiredness than sleepiness during the day. The simple subjective self-assessment using the Epworth Sleepiness Scale (ESS) quite reliably differentiates between sleepiness and mental tiredness (without sleepiness), which makes it a widely used test. The term “fatigue” is also heterogeneously used. In physiology the “fatigue” implied a “time on task performance decrement” to describe decreasing muscle force during a sustained physical effort. In clinical medicine one distinguishes physical (“peripheral”) from mental (“central”) fatigue and the term usually denotes a chronic and more abnormal situation than tiredness. In a broad sense “fatigue” implies a deficiency in coping satisfactorily with mental and physical work load. The chronic fatigue syndrome entails both mental as well as a physical fatigue (so called “leaden paralysis” of limbs). Depressive states are often associated with insomnia and fatigue, but there are also cases with hypersomnia rather than insomnia ( non organic hypersomnia , “atypical depression” or “hypersom

-The cremasteric reflex test is considered positive if there is elevation of the testis in response to stroking the upper inner thigh. This reaction is typically absent in testicular torsion and boys under the age of 6 months. Although not completely reliable in older boys and adults, an absent cremasteric reflex is highly suggestive of torsion. Patients with epididymitis usually have a normal cremasteric reflex, with pain and swelling isolated to

Watch that video of a Woman Giving Triplets Natural Vaginal Birth

Watch that Full Human Body Medical Anatomy Autopsy

To use the diaphragm, first cover the inside of it with spermicide. Then insert it into your vagina so that it covers your cervix. You can insert the diaphragm up to 6 hours before sex. You should leave it in for at least 6 hours after the last time you have sex.