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Testing for the four features of Gerstmann Syndrome in this patient with two separate left sided strokes (left frontoparietal ischaemic stroke followed by left posterior parietal haemorrhagic stroke). He exhibits (i) acalculia, (ii) agraphia, (iii) left-right disorientation, and (iv) finger agnosia. Complicating the issue is his obvious nonfluent aphasia (expressive dysphasia) with paraphasic errors (replacing words with associated words (e.g. says 'fork' instead of 'spoon')) and some comprehension issues.
Septoplasty (SEP-toe-plas-tee) is a surgical procedure to correct a deviated septum — a displacement of the bone and cartilage that divides your two nostrils. During septoplasty, your nasal septum is straightened and repositioned in the middle of your nose.
Rubber band ligation is a procedure in which the hemorrhoid is tied off at its base with rubber bands, cutting off the blood flow to the hemorrhoid. This treatment is only for internal hemorrhoids. To do this procedure, a doctor inserts a viewing instrument (anoscope) into the anus. The hemorrhoid is grasped with an instrument, and a device places a rubber band around the base of the hemorrhoid. The hemorrhoid then shrinks and dies and, in about a week, falls off. A scar will form in place of the hemorrhoid, holding nearby veins so they don't bulge into the anal canal. The procedure is done in a doctor's office. You will be asked whether the rubber bands feel too tight. If the bands are extremely painful, a medicine may be injected into the banded hemorrhoids to numb them. After the procedure, you may feel pain and have a sensation of fullness in the lower abdomen. Or you may feel as if you need to have a bowel movement. Treatment is limited to 1 to 2 hemorrhoids at a time if done in the doctor's office. Several hemorrhoids may be treated at one time if the person has general anesthesia. Additional areas may be treated at 4- to 6-week intervals.
Labia minoraplasty is an elective procedure that can reduce the size and reshape the inner vaginal lips. Large or asymmetrical labia minora can leave you feeling self-conscience in tight clothing or during intimacy. Long labia may result in rubbing, irritation or discomfort during intercourse and exercise. Certain skin conditions can cause increased sensitivity or tearing of the labia minora. In some cases, the labia minora may be fused with tissue in the labia majora and require medical correction.
Personality disorders are a group of mental illnesses. They involve long-term patterns of thoughts and behaviors that are unhealthy and inflexible. The behaviors cause serious problems with relationships and work. People with personality disorders have trouble dealing with everyday stresses and problems. They often have stormy relationships with other people. The cause of personality disorders is unknown. However, genes and childhood experiences may play a role. The symptoms of each personality disorder are different. They can mild or severe. People with personality disorders may have trouble realizing that they have a problem. To them, their thoughts are normal, and they often blame others for their problems. They may try to get help because of their problems with relationships and work. Treatment usually includes talk therapy and sometimes medicine.
Tummy-tuck surgery or abdominoplasty, can flatten your abdomen by removing loose, excess fat and skin and tightening muscles in the abdominal wall. It can also remove some if not all of the stretch marks in your lower abdomen. It is popular following pregnancy, massive weight loss or whenever a flabby abdomen with weak muscles impairs body contour. Most patients report improved self-esteem as a result of this procedure.
The obstetric examination is distinct from other examinations in that you, the clinician, are trying to assess the health of two individuals – the mother and the fetus – simultaneously. From the initial history, you should be able to judge the health of the pregnancy, any risk factors that need to be addressed, and any concerns from the parents. The history is an opportunity for you to find out how much the parents know about pregnancy, labour and delivery and if they have any preferences to which these events are carried out. A carefully taken history will also direct your attention to specific signs during the examination. As such, it is important that you develop a concise and systematic method of taking the history and carrying out the examination so that you do not miss any important information. This article focuses primarily on the examination. Pregnancy is a sensitive issue, especially for the primigravida’s. Therefore, extra care is needed when you approach a pregnant woman. Always obtain expressed informed consent before examining her and have a chaperone accompany you throughout the examination. A walk-through of what you will be doing is a good way of reassuring the patient and allows the examination to go on smoothly. It is also important to let your patient know that if the examination is too painful, she can stop at any time she wants. Finally, before you begin, you should always wash your hands, especially at an OSCE station.