General Considerations Because a discussion of reproductive issues may be difficult for some women, it is important to obtain the history in a relaxed and private setting. The patient should be clothed, particularly if she is meeting the provider for the first time. Ordinarily, the patient should be interviewed alone. Exceptions may be made for children, adolescents, and mentally impaired women, or if the patient specifically requests the presence of a caretaker, friend, or family member. However, even in these circumstances, it is desirable for the patient to have some time to speak with the clinician privately. The manner of address should be formal using the title Mrs., Ms., Miss, or Dr. with the patient’s surname, unless the patient requests otherwise. In some settings, it may be appropriate for nursing staff to be involved with history taking. A nurse may be perceived as less threatening, and may be able to take the history in a less hurried manner.1 The provider can verify the history and focus on areas of concern. Alternatively, it may be helpful to ask the patient to complete a self-history form on paper or by computer prior to speaking with the provider. This allows the provider to devote time to addressing positive responses, and ensures that important questions are not missed. Hasley2 showed that responses to a computer-based questionnaire designed to update a patient’s gynecologic history were equivalent to those obtained during a personal interview. Several studies involving patients in non-gynecologic settings have shown that patients are more likely to provide sensitive information when responding to a computer-based questionnaire as opposed to a personal interview or even a paper questionnaire.3 In order to increase a patient’s level of comfort during the interview, questions should be asked in an open-ended and nonjudgmental way. Assumptions should not be made about aspects of the patient’s background such as sexual orientation. At the conclusion of the interview, patients should be asked whether there are concerns that they would like to discuss that were not addressed previously in the interview.

Examination of the eye,vision,retina and field of vision

Stephen has sharing his experience with the others.

This procedure describes one of the most versatile approaches to the anterior skull base for large tumors of the sinonasal cavity. It may be used with or without a craniofacial resection. The benefits of this approach are: wide access around the tumor; good postoperative cosmesis; & decreased operative & postoperative morbidity. We have used this approach for many bilateral tumors of the nasal & sinus cavities that approach &/or invade the skull base & brain. This video show the resection of a large esthesioneuroblastoma.

Demonstration of staple insertion and removal technique for laceration repair or wound closure in the operating room.

Laparoscopic Appendectomy for Acute Appendicitis Post-illeal Appendix

Hemophilia B is a hereditary bleeding disorder caused by a lack of blood clotting factor IX. Without enough factor IX, the blood cannot clot properly to control bleeding.

HD Cataract Surgery Video

Nuclear Transfer is a form of cloning. The steps involve removing the DNA from an oocyte and while(unfertilized egg), and injecting the nucleus which contains the DNA to be cloned. In rare instances, the newly constructed cell will divide normally, replicating the new DNA while remaining

Anatomy of The Brain

This animated video covers statins, fibrates, niacin, bile resins, and ezetimibe. We will discuss mechanisms of action, which part of the lipid profile is affected by each drug, and common side effects.

Histology of Heart Endocardium Pericardium Epicardium

Histology of Tooth Development

Lipomas are single or multiple, benign subcutaneous tumors that are easily recognized because they are soft, rounded, or lobulated and movable against the overlying skin. Many lipomas are small but may also enlarge to 6 cm. They occur especially on the neck, trunk, and on the extremities but can occur anywhere on the body. Lipomas are composed of fat cells that have the same morphology as normal fat cells, and there is a connective tissue framework. Angiolipomas have a vascular component and may be tender in cold ambient temperature. These often require excision, whereas other lipomas should be excised only when considered disfiguring. Liposuction can also be performed when liposomas are soft and thus have only a minor connective tissue component.

The cat's stomach is a sac-like structure designed to store large volumes of food and continue the digestive process. The esophagus carries food to the stomach, where it enters via a valve-like structure called the cardiac sphincter. On the interior surface of the stomach is a series of folds called gastric folds. These folds function to help grind and digest food. The inner stomach lining secretes acids and enzymes to break down food. Once the initial stomach digestive process is complete, the partially digested food exits the stomach through the pyloric sphincter area and then enters the duodenum (first segment of the small intestine). Once eaten, most food leaves the stomach within twelve hours after entering.

Treating Lymphedema -

Ten percent of all pregnancies are complicated by hypertension. Eclampsia and preeclampsia account for about half of these cases worldwide, and these conditions have been recognized and described for years despite the general lack of understanding of the disease. [1] In the fifth century, Hippocrates noted that headaches, convulsions, and drowsiness were ominous signs associated with pregnancy. In 1619, Varandaeus coined the term eclampsia in a treatise on gynecology. [2, 3]

Wound-closure technologies are becoming less painful and more efficient at closing wounds.

the elbow is the second most frequently dislocated major joint, after the shoulder. It is the most commonly dislocated joint in children. [1] More than 90% of all elbow dislocations are posterior dislocations. This injury entails disengagement of the coronoid process of the ulna from the trochlea of the humerus with movement posteriorly. [2] The mechanism of injury is typically a fall onto an outstretched hand (FOOSH) with the elbow in extension upon impact.