This animation shows you how a tummy tuck is performed at Boerhaave Medical Centre. Curious? Watch the video!

Boerhaave Medical Centre sets itself the goal of providing the highest quality care. Quality not just in terms of treatment, but also in terms of our staff and the before and after care given. By providing thorough information and clear advice in advance, carefully supporting our patients through the procedure and caring for them afterwards, we believe this quality is assured.

Although we are one of the largest clinics in the Netherlands and have built up many years of experience, we continuously strive to improve. After all, the Boerhaave Medical Centre intends to remain a pioneer in the healthcare sector, by working in accordance with the latest medical findings and techniques both now and in the future.

We offer the highest standard of plastic surgery in our cosmetic care department. For 365 days a year, you can also come to us for non-surgical treatments, such as injectables, permanent hair removal and gastric balloons.

We have been awarded the ZKN quality mark and are certified to ISO 9001-2008 for giving advice and carrying out plastic surgery, including after care.

Visit our website for more information: https://www.boerhaave.com/all-....treatments/upperbody

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The examination room should be quiet, warm and well lit. After you have finished interviewing the patient, provide them with a gown (a.k.a. "Johnny") and leave the room (or draw a separating curtain) while they change. Instruct them to remove all of their clothing (except for briefs) and put on the gown so that the opening is in the rear. Occasionally, patient's will end up using them as ponchos, capes or in other creative ways. While this may make for a more attractive ensemble it will also, unfortunately, interfere with your ability to perform an examination! Prior to measuring vital signs, the patient should have had the opportunity to sit for approximately five minutes so that the values are not affected by the exertion required to walk to the exam room. All measurements are made while the patient is seated. Observation: Before diving in, take a minute or so to look at the patient in their entirety, making your observations, if possible, from an out-of-the way perch. Does the patient seem anxious, in pain, upset? What about their dress and hygiene? Remember, the exam begins as soon as you lay eyes on the patient. Temperature: This is generally obtained using an oral thermometer that provides a digital reading when the sensor is placed under the patient's tongue. As most exam rooms do not have thermometers, it is not necessary to repeat this measurement unless, of course, the recorded value seems discordant with the patient's clinical condition (e.g. they feel hot but reportedly have no fever or vice versa). Depending on the bias of a particular institution, temperature is measured in either Celcius or Farenheit, with a fever defined as greater than 38-38.5 C or 101-101.5 F. Rectal temperatures, which most closely reflect internal or core values, are approximately 1 degree F higher than those obtained orally. Respiratory Rate: Respirations are recorded as breaths per minute. They should be counted for at least 30 seconds as the total number of breaths in a 15 second period is rather small and any miscounting can result in rather large errors when multiplied by 4. Try to do this as surreptitiously as possible so that the patient does not consciously alter their rate of breathing. This can be done by observing the rise and fall of the patient's hospital gown while you appear to be taking their pulse. Normal is between 12 and 20. In general, this measurement offers no relevant information for the routine examination. However, particularly in the setting of cardio-pulmonary illness, it can be a very reliable marker of disease activity. Pulse: This can be measured at any place where there is a large artery (e.g. carotid, femoral, or simply by listening over the heart), though for the sake of convenience it is generally done by palpating the radial impulse. You may find it helpful to feel both radial arteries simultaneously, doubling the sensory input and helping to insure the accuracy of your measurements. Place the tips of your index and middle fingers just proximal to the patients wrist on the thumb side, orienting them so that they are both over the length of the vessel.

Symptoms of blood clots in specific body locations are as follows: Symptoms of blood clots in legs (deep vein thrombosis (DVT) are pain, redness, and swelling. Symptoms of an arterial blood clot in a limb (leg or arm) include pain, pale color, and coolness to the touch. and the leg is cool and pale.

Majority of patients these days prefer PCNL ( Minimal Invasive Telescopic removal of kidney stones broken with lithoclast, removed through a button hole incision ). This patient with a big stone in the pelvis of the kidney wanted it open only so I did an open pyelolithotomy for this patient after a long time as I use to do it in routine in the past. Except for the long incision and scar as compared to PCNL the recovery time was the same and patient went home third day happily walking and eating.

Anatomy of The Peritoneal Cavity

Infected Tattoo Abscess

A clinical examination of the hands using the standard Look, Feel, Move approach. Specific​ examination structure derived from MacLeod's Clinical Examination 14th edition. Performed by Dr James Gill

Childbirth (also called labour, birth, partus or parturition) is the culmination of a human pregnancy or gestation period with birth of one or more newborn infants from a woman’s uterus. The process of normal human childbirth is categorized in three stages of labour: the shortening and dilation of the cervix, descent and birth of the infant, and birth of the placenta. In some cases, childbirth is achieved through caesarean section, the removal of the neonate through a surgical incision in the abdomen, rather than through vaginal birth

Physical Assessment of a Child

Watch that video of Tying The Sperm Canal to Avoid Ejaculation

External cephalic version, or version, is a procedure used to turn a fetus from a breech position or side-lying (transverse) position into a head-down (vertex) position before labor begins. When successful, version makes it possible for you to try a vaginal birth.

This video is a teaching aid for use in conjunction with broader surgical training

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.

A brief screening examination should be conducted checking the face, eyes, mouth, chest, abdomen, spine and limbs to exclude major abnormalities. A strong cry and a widespread pink blush over the face and body are good signs that all is well. Some children may be born with ambiguous genitalia. Ambiguous genitalia is a medical emergency and requires urgent assessment by a paediatrician. If you have sufficient clinical experience, an orogastric tube should be passed when the neonate's mother has suffered polyhydramnios. This excludes oesophageal atresia.

Routine Pap Smear and Pelvis Exam For Canadian Women

Shoulder Clinical Examination - Medical School Clinical Skills - Dr Gill

Personally, I find the shoulder examination the most complex examination possibly as there are so many variations and special tests. Some of which overlap and some will relate specifically to a patients presentation.

Often in a medical school syllabus, only select special tests will be used. In this shoulder exam demonstration, we include the Hawkins-Kennedy Test looking for impingement. This is dovetailed with examination for bicipital tendonitis as this is another possible cause of impingement type symptoms.

This shoulder upper limb exam follows the standard "Look, Feel, Move" orthopaedic exam approach, and overall order as set out in MacLeods Clinical Examination

Watch further orthopaedic examinations for your OSCE revision:

The Spine Examination:
https://youtu.be/pJxMHa6SCgU

Knee Examination
https://youtu.be/oyKH4EYfJDM

Hip Joint Clinical Examination
https://youtu.be/JC9GKq5nSdQ
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Please note that there is no ABSOLUTE way to perform a clinical examination. Different institutions and even clinicians will have differing degrees of variations - the aim is the effectively identify medically relevant signs.

However during OSCE assessments. Different medical schools, nursing colleges, and other health professional courses will have their own preferred approach to a clinical assessment - you should concentrate on THEIR marks schemes for your assessments.

The examination demonstrated here is derived from Macleods Clinical Examination - a recognized standard textbook for clinical skills.


#ShoulderExamination #ClinicalSkills #DrGill

Transurethral resection of the prostate (also known as TURP, plural TURPs and as a transurethral prostatic resection TUPR) is a urological operation. It is used to treat benign prostatic hyperplasia (BPH). As the name indicates, it is performed by visualising the prostate through the urethra and removing tissue by electrocautery or sharp dissection. This is considered the most effective treatment for BPH. This procedure is done with spinal or general anesthetic. A large triple lumen catheter is inserted through the urethra to irrigate and drain the bladder after the surgical procedure is complete. Outcome is considered excellent for 80-90% of BPH patients. Because of bleeding risks associated with the surgery, TURP is not considered safe for many patients with cardiac problems. As with all invasive procedures, the patient should first discuss medications they are taking with their doctor, most especially blood thinners or anticoagulants, such as warfarin (Coumadin), or aspirin. These may need to be discontinued prior to surgery. Postop complications include bleeding (most common), clotting and hyponatremia (due to bladder irrigation).

Additionally, transurethral resection of the prostate is associated with low but important morbidity and mortality.

Morning erections have colloquially been termed as “morning wood” while scientifically it is called nocturnal penile tumescence. It is a normal and healthy physiological reaction and response that most men experience in their lives. Morning erections are really the ending of a series of erections that happen to men during the night. Healthy men can, on average, have anywhere between three to five erections in a full night of sleep, each of which lasts from 25-35 minutes.