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This is one of the most interesting medical topics to discuss. What are the responsibilities of a doctor? What are the basic skills a doctor needs to have? and what are the responsibilities of a doctor?

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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
________

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

An animation showing the general principle of Radiofrequency Ablation of Hepatocellular carcinoma HCC.

, Liver hydatid cysts of the liver was treated with laparoscopic intervantion . The cysts was located in the eight segment of the liver.

Watch this clinical examination video to learn how to diagnose inguinal related groin pain.

This video clip is part of the FIFA Diploma in Football Medicine and the FIFA Medical Network. To enrol or to find our more click on the following link http://www.fifamedicalnetwork.com

The Diploma is a free online course designed to help clinicians learn how to diagnose and manage common football-related injuries and illnesses. There are a total of 42 modules created by football medicine experts. Visit a single page, complete individual modules or finish the entire course.

The network provides the opportunity for clinicians around the world to meet and share ideas relating to football medicine. Ask about an interesting case, debate current practice and discuss treatment strategies. Create a profile and log on to interact with other health professionals from around the globe.

This is not medical advice. The content is intended as educational content for health care professionals and students. If you are a patient, seek care of a health care professional.

Plastic Surgeon in NY Doctor Michael Wolfeld of Wolfeld Plastic Surgery (http://www.drwolfeld.com) discusses case studies of of two patients who underwent a liposuction procedure.

At one time, women who had delivered by cesarean section in the past would usually have another cesarean section for any future pregnancies. The rationale was that if allowed to labor, many of these women with a scar in their uterus would rupture the uterus along the weakness of the old scar. Over time, a number of observations have become apparent: Most women with a previous cesarean section can labor and deliver vaginally without rupturing their uterus. Some women who try this will, in fact, rupture their uterus. When the uterus ruptures, the rupture may have consequences ranging from near trivial to disastrous. It can be very difficult to diagnose a uterine rupture prior to observing fetal effects (eg, bradycardia). Once fetal effects are demonstrated, even a very fast reaction and nearly immediate delivery may not lead to a good outcome. The more cesarean sections the patient has, the greater the risk of subsequent rupture during labor. The greatest risk occurs following a “classical” cesarean section (in which the uterine incision extends up into the fundus.) The least risk of rupture is among women who had a low cervical transverse incision. Low vertical incisions probably increase the risk of rupture some, but usually not as much as a classical incision. Many studies have found the use of oxytocin to be associated with an increased risk of rupture, either because of the oxytocin itself, or perhaps because of the clinical circumstances under which it would be contemplated. Pain medication, including epidural anesthetic, has not resulted greater adverse outcome because of the theoretical risk of decreasing the attendant’s ability to detect rupture early. The greatest risk of rupture occurs during labor, but some of the ruptures occur prior to the onset of labor. This is particularly true of the classical incisions. Overall successful vaginal delivery rates following previous cesarean section are in the neighborhood of 70 This means that about 30of women undergoing a vaginal trial of labor will end up requiring a cesarean section. Those who undergo cesarean section (failed VBAC) after a lengthy labor will frequently have a longer recovery and greater risk of infection than had they undergone a scheduled cesarean section without labor. Women whose first cesarean was for failure to progress in labor are only somewhat less likely to be succesful in their quest for a VBAC than those with presumably non-recurring reasons for cesarean section. For these reasons, women with a prior cesarean section are counseled about their options for delivery with a subsequent pregnancy: Repeat Cesarean Section, or Vaginal Trial of Labor. They are usually advised of the approximate 70successful VBAC rate (modified for individual risk factors). They are counseled about the risk of uterine rupture (approximately 1in most series), and that while the majority of those ruptures do not lead to bad outcome, some of them do, including fetal brain damage and death, and maternal loss of future childbearing. They are advised of the usual surgical risks of infection, bleeding, anesthesia complications and surgical injury to adjacent structures. After counseling, many obstetricians leave the decision for a repeat cesarean or VBAC to the patient. Both approaches have risks and benefits, but they are different risks and different benefits. Fortunately, most repeat cesarean sections and most vaginal trials of labor go well, without any serious complications. For those choosing a trial of labor, close monitoring of mother and baby, with early detection of labor abnormalities and preparation for

First time mom experiences a quick, natural, water-birth.

The pelvic diaphragm is composed of muscle fibers of the levator ani, the coccygeus, and associated connective tissue which span the area underneath the pelvis. The pelvic diaphragm is a muscular partition formed by the levatores ani and coccygei, with which may be included the parietal pelvic fascia on their upper and lower aspects. The pelvic floor separates the pelvic cavity above from the perineal region (including perineum) below.

The right and left levator ani lie almost horizontally in the floor of the pelvis, separated by a narrow gap that transmits the urethra, vagina, and anal canal. The levator ani is usually considered in three parts: pubococcygeus, puborectalis, and iliococcygeus. The pubococcygeus, the main part of the levator, runs backward from the body of the pubis toward the coccyx and may be damaged during parturition. Some fibers are inserted into the prostate, urethra, and vagina. The right and left puborectalis unite behind the anorectal junction to form a muscular sling . Some regard them as a part of the sphincter ani externus. The iliococcygeus, the most posterior part of the levator ani, is often poorly developed.

The coccygeus, situated behind the levator ani and frequently tendinous as much as muscular, extends from the ischial spine to the lateral margin of the sacrum and coccyx.

The pelvic cavity of the true pelvis has the pelvic floor as its inferior border (and the pelvic brim as its superior border.) The perineum has the pelvic floor as its superior border.

Some sources do not consider “pelvic floor” and “pelvic diaphragm” to be identical, with the “diaphragm” consisting of only the levator ani and coccygeus, while the “floor” also includes the perineal membrane and deep perineal pouch.

Natural birth encouragement pain and joy

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Finger Abscess Incision and Drainage. Digital block with drainage.

The best sleep position during pregnancy is “SOS” (sleep on side). Even better is to sleep on your left side. Sleeping on your left side will increase the amount of blood and nutrients that reach the placenta and your baby. Keep your legs and knees bent, and put a pillow between your legs.

This is an educational medical video for Medical Students showing how to examine a hernia swelling

To license this video for patient education or content marketing, visit: http://www.nucleushealth.com/?utm_source=youtube&utm_medium=video-description&utm_campaign=tephernia-030615

An inguinal hernia is a bulging of the intestine through a defect or weak spot in the wall of the lower abdomen. This video shows how inguinal hernias form and how they are treated.
#TotalExtraperitonealLaparoscopicInguinalHerniaRepair #TEP #laparoscopy
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If a fetal lung lesion is causing heart failure, fetal surgery may be performed to remove the CCAM before birth. http://fetalsurgery.chop.edu

N. Scott Adzick, MD, Mark Johnson, MD, and Holly Hedrick, MD, experts from the Center for Fetal Diagnosis and Treatment at Children’s Hospital of Philadelphia, explain when fetal intervention for CCAM is recommended, the various approaches that may be used to treat the most complex fetal lung lesions before birth, and how these procedures are performed.

One concern with fetal lung lesions is that they take up space in the chest. If the lung mass grows and pushes the heart and other organs out of place, it can lead to complications such as fetal hydrops (heart failure in the fetus). If this happens, a fetal surgery procedure may be performed to remove the CCAM before birth.
In other cases, an EXIT procedure may be performed to partially deliver the baby, so the team can remove the mass before the baby is fully delivered.

In this video series, parents, nurses and doctors from Children’s Hospital of Philadelphia’s Center for Fetal Diagnosis and Treatment talk about the different types of fetal lung lesions like congenital cystic adenomatoid malformation (CCAM) and bronchopulmonary sequestration (BPS), the importance of accurate diagnosis and monitoring, and the most advanced treatment options currently available. They also discuss follow-up care and long-term outcomes for babies diagnosed with fetal lung lesions.

This video demonstrates Laparoscopic Cholecystectomy Fully Explained Skin-to-Skin Video with Near Infrared Cholangiography performed by Dr R K Mishra at World Laparoscopy Hospital. A laparoscopic cholecystectomy is a minimally invasive surgical procedure that involves removing the gallbladder. It is typically performed using small incisions in the abdomen, through which a laparoscope (a thin tube with a camera and light) and surgical instruments are inserted. The surgeon uses the laparoscope to visualize the inside of the abdomen and to guide the instruments in removing the gallbladder.

Near-infrared cholangiography is a technique that uses a special camera and fluorescent dye to visualize the bile ducts during surgery. The dye is injected into the cystic duct (the tube that connects the gallbladder to the bile ducts) and the camera detects the fluorescence emitted by the dye, allowing the surgeon to see the bile ducts more clearly.

The combination of laparoscopic cholecystectomy and near-infrared cholangiography has become a standard of care in many hospitals and surgical centers. It allows for a more precise and efficient surgery, reducing the risk of complications such as bile duct injury.

The use of indocyanine green (ICG) with near-infrared imaging during laparoscopic cholecystectomy has several advantages. Here are some of them:

Better visualization of the biliary anatomy: ICG with near-infrared imaging allows for better visualization of the biliary anatomy during surgery. This helps the surgeon identify important structures, such as the cystic duct and the common bile duct, and avoid injuring them.

Reduced risk of bile duct injury: With better visualization of the biliary anatomy, the risk of bile duct injury during surgery is reduced. Bile duct injury is a serious complication that can occur during laparoscopic cholecystectomy and can lead to long-term health problems.

Improved surgical precision: ICG with near-infrared imaging also improves surgical precision. The surgeon can better see the tissues and structures being operated on, which can help reduce the risk of bleeding and other complications.

Shorter operating time: The use of ICG with near-infrared imaging can shorten the operating time for laparoscopic cholecystectomy. This is because the surgeon can more quickly and accurately identify the biliary anatomy, which can help streamline the surgery.

Overall, the use of ICG with near-infrared imaging is a valuable tool in laparoscopic cholecystectomy that can improve surgical outcomes and reduce the risk of complications.

Like any surgical procedure, laparoscopic cholecystectomy (gallbladder removal) has potential complications. Here are some of the most common ones:

Bleeding: Bleeding during or after the surgery is a possible complication of laparoscopic cholecystectomy. Most cases are minor and can be easily controlled, but in rare cases, significant bleeding may require a blood transfusion or even additional surgery.

Infection: Any surgical procedure carries a risk of infection. After laparoscopic cholecystectomy, there is a risk of infection at the site of the incisions or within the abdomen. Symptoms may include fever, pain, redness, or drainage from the incision sites.

Bile leakage: In some cases, a small amount of bile may leak from the bile ducts into the abdominal cavity after gallbladder removal. This can cause abdominal pain, fever, and sometimes requires further surgery or treatment.

Injury to nearby organs: During the surgery, there is a small risk of unintentional injury to nearby organs such as the liver, intestines, or bile ducts. This can cause additional complications and may require further treatment.

Adverse reactions to anesthesia: As with any surgery requiring general anesthesia, there is a small risk of adverse reactions to the anesthesia, such as an allergic reaction, respiratory problems, or heart complications.

Most patients recover without complications following a laparoscopic cholecystectomy, but it is important to discuss any concerns or questions with your surgeon beforehand.

Contact us
World Laparoscopy Hospital
Cyber City, Gurugram, NCR Delhi
INDIA : +919811416838

World Laparoscopy Training Institute
Bld.No: 27, DHCC, Dubai
UAE : +971525857874

World Laparoscopy Training Institute
8320 Inv Dr, Tallahassee, Florida
USA : +1 321 250 7653





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