A video showing breast examination after breast implants

Do you think you have a hernia?
What are hernias?
The hernias we address in this http://DoctorsExpressHartsdale.com Medical Minute are inguinal, or groin, hernias. More common in men than women, an inguinal hernia can occur when part of the small intestine protrudes through a weakness or tear in the area between your abdomen and your thigh- or your groin. It's possible for anyone to get an inguinal hernia, but it is more commonly found in males.

Hernias form a bulge and can be accompanied by pain. Men have an approximate 26% lifetime risk of having hernia at some point in their life, where as women have a much lower chance of one- only about 3% of women will experience a hernia at some point in their life. There are other types of hernias, such as abdominal, or "hiatal" hernias but groin hernias outnumber abdominal hernias by about 3 to 1.

What causes a hernia?
The cause of a hernia is not always known, but hernias are often the result of weak spots in the abdominal wall. Weaknesses can be due to congenital defects (present at birth) or formed later in life. Some risk factors for inguinal hernia include:
• fluid or pressure in the abdomen
• heavy lifting
• straining during urination or bowel movements
• obesity
• chronic cough
• pregnancy

Hernias often form in people with weakened abdominal muscles or in those who do a lot of heavy lifting or straining, which is why we see it quite often in young men. Physiology plays a part: men have testicles and scrotum which descend through the inguinal canal-much larger in men than in women. That is part of the reason men tend to be more susceptible to hernias than women.

Symptoms of hernia

Symptoms of inguinal hernia usually include a bulge in the groin area and pain, pressure, or aching at the bulge—especially when lifting, bending, or coughing. These symptoms usually subside during rest periods. Men may also experience swelling around the testicles.


Screening and Diagnosis of Hernias
If you are having abdominal pain or pelvic bulge and pain, you want to see physician, and he or she will do an exam. They will use their finger, to see if you have a bulge in your scrotum or on your groin and they'll see if its reducible or not. If the exam doesn't give them the answer, they can then perform an ultrasound, an inexpensive test that can tell you the same day whether a hernia is present.


What to do if you think you have a hernia
Most of the time hernias do not cause problems. People often live with hernias their entire life without them becoming aggravated or painful. When they do cause pain though, there is concern that complications may have arisen. Most common hernias are what we call reducible; you can take your finger or you can lie down in bed and due to the effects of gravity, the bulge in the groin will actually disappear, which means the intestinal contents actually go back into the abdominal cavity or to the correct location. If it's not reducible by lying down or using a finger or having a physician trying to reduce it, then there are concerns about complications such as strangulation, or incarceration occurring. If those concerns are there, then you need to see a surgeon, and there may be a need for surgery.

How to Treat a Hernia
As stated earlier, hernias can often be watched for years without being treated. If however, they are causing pain, we generally refer you to a surgeon who can do a very simple laparoscopic surgery.

If you suspect a hernia, but have not been diagnosed, you should see your doctor, and of course, we are happy to see you here at Doctors Express

Today, the most common approach for open-heart surgery is a sternotomy, which requires a 12-14-inch incision through the breastbone. But in the hands of experienced minimally invasive surgeons, many cardiac procedures can be performed through smaller 2- to 3-inch incisions between the ribs without the need to cut through the breastbone. Learn more in this medical animation from Sarasota Memorial's Minimally Invasive Cardiac Surgery Team and medical director Jonathan Hoffberger, DO. For information or referrals, visit smhheart.com.

Circumcision Video 3D

The umbilical cord is wrapped around the baby's neck in about 25% of deliveries. If loose, it usually has no impact on the delivery. If tight, it may need to be relieved before delivery of the baby can proceed safely

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

The dilatation and Curettage procedure that is commonly performed (D and C)

Watch that video of Human Skull Opening and Brain Removal During Autopsy

A breech birth is the birth of a baby from a breech presentation. In the breech presentation the baby enters the birth canal with the buttocks or feet first as opposed to the normal head first presentation.

There are either three or four main categories of breech births, depending upon the source:

* Frank breech - the baby's bottom comes first, and his or her legs are flexed at the hip and extended at the knees (with feet near the ears). 65-70% of breech babies are in the frank breech position.

* Complete breech - the baby's hips and knees are flexed so that the baby is sitting crosslegged, with feet beside the bottom.

* Footling breech - one or both feet come first, with the bottom at a higher position. This is rare at term but relatively common with premature fetuses.

* Kneeling breech - the baby is in a kneeling position, with one or both legs extended at the hips and flexed at the knees. This is extremely rare, and is excluded from many classifications.

As in labour with a baby in a normal head-down position, uterine contractions typically occur at regular intervals and gradually cause the cervix to become thinner and to open. In the more common breech presentations, the baby’s bottom (rather than feet or knees) is what is first to descend through the maternal pelvis and emerge from the vagina.

At the beginning of labour, the baby is generally in an oblique position, facing either the right or left side of the mother's back. As the baby's bottom is the same size in the term baby as the baby's head. Descent is thus as for the presenting fetal head and delay in descent is a cardinal sign of possible problems with the delivery of the head.

In order to begin the birth, internal rotation needs to occur. This happens when the mother's pelvic floor muscles cause the baby to turn so that it can be born with one hip directly in front of the other. At this point the baby is facing one of the mother's inner thighs. Then, the shoulders follow the same path as the hips did. At this time the baby usually turns to face the mother's back. Next occurs external rotation, which is when the shoulders emerge as the baby’s head enters the maternal pelvis. The combination of maternal muscle tone and uterine contractions cause the baby’s head to flex, chin to chest. Then the back of the baby's head emerges and finally the face.

Due to the increased pressure during labour and birth, it is normal for the baby's leading hip to be bruised and genitalia to be swollen. Babies who assumed the frank breech position in utero may continue to hold their legs in this position for some days after birth.

Dr. James Wall performs a bilateral inguinial hernia repair surgical procedure.

Featured:
James Wall, MD
Assistant Professor of Surgery, Pediatric Surgery
Assistant Professor of Bioengineering (By Courtesy)
Lucile Salter Packard Children's Hospital

Micaela Esquivel, MD
Chief Resident of General Surgery

Anatomy of Love

Diastasis recti often occurs during pregnancy and can persist after pregnancy. It affects core strength and the appearance of the abdominal muscles.

Dr. Erick Sanchez repairs the abdominal muscles with every tummy tuck. This short video shows the muscle repair portion of the surgery with a bonus after photo at the end!

To request a consultation with Dr. Sanchez, visit sanchezplasticsurgery.com and click Request a Consultation. Fill out the form and someone will get in touch with you to answer all your questions.

Expected cost can be found at the bottom of each procedure page on our website.

Watch that Real Human Body Decaying Process

A new video illustrating the horizontal breast exam technique whihc is performed by doctors for any breast masses or abnormalities.

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.

Children are special patients, and their medical needs are unique, including their surgical needs. At UNC Hospitals, an expert and experienced team of physicians treat children in a kid-friendly and family-centered environment. UNC Pediatric Surgeon Dr. Timothy Weiner explains

Remove a Plantar Wart from a foot Procedure

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Intramuscular Injection Techniques (Nursing Skills)

In this video, we’re going to look at proper administration techniques for intramuscular medication administration. Of course, always follow your 5 rights and calculate the correct volume for administration. We love you guys! Go out and be your best selves today! And, as always, happy nursing!

Bookmarks:
0.05 Introduction to Intramuscular injections
0.16 site and needle selection
0.35 site sterilization
0.43 Z track method
0.58 needle insertion
1.10 medication injection
1.14 needle removal
1.25 bandaging and needle disposal
1.30 documentation and patient monitoring
1.35 Outro

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