This minimally invasive technique allows surgeons to remove skull base tumors as large as softballs through the nose, with less trauma to the brain and critical nerves than with a traditional craniotomy.

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With ECT, electrodes are placed on the patient's scalp and a finely controlled electric current is applied while the patient is under general anesthesia. The current causes a brief seizure in the brain. ECT is one of the fastest ways to relieve symptoms in severely depressed or suicidal patients.

This condition is seen in imperforate hymen or transverse vaginal septum. Pt presents with primary amenorrhea. Dr Hemant Damle Prof Dept of OBGYN SKNMC Pune India

Retinitis pigmentosa is a rare, inherited degenerative eye disease that causes severe vision impairment. Symptoms often begin in childhood. They include decreased vision at night or in low light and loss of side vision (tunnel vision).

Benefits of Breast Feeding

Microcalcifications in the breast can be the first sign of cancer. They are, as the name says, very small and clustered. A precise biopsy without pain under stereotactic guidance is the standard procedure. What makes this Spirotome different from the vacuum assisted biopsies is that only a few biopsies are needed and that the approach of the needle towards the microcalcifications is direct and frontal. There is no damage to the surrounding tissues making this procedure rather painfree and with minimal bleeding.

The night before the exam...

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Kite flap, Guy Fouchier flap, 2nd finger to thumb. Cadaver dissection. Prof Steven Hovius demonstrates dissection technique and planning for a kite flap.

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A c-section, or cesarean section, is the delivery of a baby through a surgical incision in the mother's abdomen and uterus. In some circumstances, a c-section is scheduled in advance. In others, the surgery is needed due to an unforeseen complication. If you or your baby is in imminent danger, you'll have an emergency c-section. Otherwise, it's called an unplanned section. According to the U.S. Centers for Disease Control, about 32 percent of American women who gave birth in 2015 had a cesarean delivery.

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.

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