EKG Interpretation Part 1

As more couples explore anal sex, understanding the risks, rewards, and proper strategy is important. Here's what you need to know about safety and more.

The cervix is fully dilated to about 10 cm,with the baby's head moving beyond the cervical opening , into the birth canal. The mother is encouraged to push during contractions,and rest in between them. In a normal delivery, the head rotates to face the mother's back

M.Torabi Nami MD, PhDc Department of Neuroscience Institute for Cognitive Science Studies (ICSS), Tehran 15948 Iran Torabi_m@iricss.org Abstract Sleepiness, tiredness and fatigue are complaints which must be thoroughly analyzed to eliminate blur and ambiguity. Physiological sleepiness (“sleep pressure”) increases while being awake and additionally underlies the circadian rhythm with a lower threshold to fall asleep during night time. Excessive daytime sleepiness (EDS) is considered normal only after sleep deprivation. Clinically, EDS manifests by frequents daytime napping and/or reduced alertness with automatic behavior or - in its extreme form - in recurrent attacks of sudden, uncontrollable compulsion to sleep also in inappropriate situations (= “sleep attacks”). EDS is “objectively” addressed by measuring the mean sleep latency to four to five nap opportunities throughout the day using the multiple sleep latency test (MSLT) or the maintenance of wakefulness test (MWT). EDS denotes both, a ready entrance into sleep as well as difficulty in staying awake during daytime or accordingly in inappropriate situations. These two partially independent aspects of EDS are separately assessed by the “passive” MSLT and the “active” MWT respectively. For that reason the MSLT and MWT only weakly correlate with each other when tested over a broad range of patients with EDS. It is important to keep in mind, that these tests are importantly influenced by a great variety of factors such as mood, anxiety, and motivation. “Vigilance” comprises wakefulness, alertness and attention and therefore is more than just the reciprocal to sleepiness. Cognitive performance tasks such as Steer Clear Reaction Time Test (SCRTT) or driving simulators require the complete integrity of vigilance to achieve normal results. Hypersomnia is usually broadly defined as the combination of abnormally prolonged night-time sleep (regularly >10 h) with EDS during ≥1 months. On the other hand, the term hypersomnia has also been used in a narrower scene for the isolated abnormality of a prolonged night-time sleep need (>10 h). “Tiredness”, also in colloquial language often used for sleepiness, in a broader sense also describes the feeling of lack of energy, motivation and initiative. These patients seek rest rather than sleep. They often cannot fall asleep when given the opportunity in spite of feeling tired, and hence, in an MSLT, do not show an abnormally short sleep latency. Furthermore, tiredness (and fatigue) as opposed to sleepiness has a mental (“central”) and physiological (bodily or “peripheral”) component, which the patients can readily distinguish. Patients with insomnia, mild sleep apnea syndrome, or depression rather suffer from mental tiredness than sleepiness during the day. The simple subjective self-assessment using the Epworth Sleepiness Scale (ESS) quite reliably differentiates between sleepiness and mental tiredness (without sleepiness), which makes it a widely used test. The term “fatigue” is also heterogeneously used. In physiology the “fatigue” implied a “time on task performance decrement” to describe decreasing muscle force during a sustained physical effort. In clinical medicine one distinguishes physical (“peripheral”) from mental (“central”) fatigue and the term usually denotes a chronic and more abnormal situation than tiredness. In a broad sense “fatigue” implies a deficiency in coping satisfactorily with mental and physical work load. The chronic fatigue syndrome entails both mental as well as a physical fatigue (so called “leaden paralysis” of limbs). Depressive states are often associated with insomnia and fatigue, but there are also cases with hypersomnia rather than insomnia ( non organic hypersomnia , “atypical depression” or “hypersom

Part 2. Full Obstetric examination and normal delivery by Egyptian doctor Hussein Sulayman and the video is in English showing: Obstetric Examination Episiotomy Obstetric Forceps Obstetric Instruments

Curettage, electrosurgery, and laser surgery are more likely than cryotherapy to leave scars, so they are usually reserved for hard-to-remove or recurring warts. If you have a large area of warts, curettage may not be an effective treatment. Some surgical treatments may be too painful for some children.

A normal vaginal epithelial cell is clear, with recognizable contents, and sharp, distinct cell borders.

What could cause a blockage in the stomach? Mechanical causes of intestinal obstruction may include: Adhesions or scar tissue that forms after surgery. Foreign bodies (objects that are swallowed and block the intestines) Gallstones (rare) Hernias. Impacted stool. Intussusception (telescoping of one segment of bowel into another) Tumors blocking the intestines. Less common radiologic signs are seen in specific circumstances. Most closed-loop obstructions (75%) are caused by adhesions. A closed-loop obstruction occurs when a loop of bowel is not decompressed by the caudal passage of gas and fluid.

A video showing drainage of a bartholin cyst

Ever wonder How Male to Female Trans'Gender Surgery works?

Capsulorrhexis after trypan blue staining of anterior capsule. Controlled Rhexis with forceps. Phacoemulsification by devide and conquer technique

Patient Greg Grindley communicates with host Bryant Gumbel and his wife for the first time while undergoing deep brain stimulation surgery at University Hospital's Case Medical Center in Cleveland, Ohio.
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The Closure Procedure for Varicose Veins is a clinically proven, minimally invasive procedure that treats varicose veins and their underlying cause, venous reflux, with little or no pain. Closure patients can walk away from the vein procedure and be back to everyday activities – either at home or at work – typically within a day.

General Physical Examination

Watch that IUD Female Birth Control Insertion Surgery

Coronary artery bypass grafting (CABG) is a type of surgery that improves blood flow to the heart. Surgeons use CABG to treat people who have severe coronary heart disease (CHD). CHD is a disease in which a waxy substance called plaque (plak) builds up inside the coronary arteries.

Pulmonary hypertension is a type of high blood pressure that affects the arteries in your lungs and the right side of your heart. In one form of pulmonary hypertension, tiny arteries in your lungs, called pulmonary arterioles, and capillaries become narrowed, blocked or destroyed. This makes it harder for blood to flow through your lungs, and raises pressure within your lungs' arteries. As the pressure builds, your heart's lower right chamber (right ventricle) must work harder to pump blood through your lungs, eventually causing your heart muscle to weaken and fail. Some forms of pulmonary hypertension are serious conditions that become progressively worse and are sometimes fatal. Although some forms of pulmonary hypertension aren't curable, treatment can help lessen symptoms and improve your quality of life. Pulmonary hypertension care at Mayo Clinic

A 30 YEAR WOMEN WITH INTRACTABLE BILIARY COLIC

CASE REPORT: This 30 year women developed severe pain right upper quadrant for last 10 days. She sought many consultations and was given intravenous analgesics both (nonnarcortic and narcotic). Pain did not subside and she sought my consultation. Examination revealed her to be in agony with severe upper abdominal pain. General physical examination was otherwise unremarkable. Abdominal examination revealed mild tenderness in right hypochondrium with doubtful Murphy's sign. Urgent abdominal ultrasound showed a linear structure in bile ducts making slow writhing movements. The structure had an anechoic tube (alimentary canal) inside suggestive of a large Ascarid. Urgent ERCP was performed and bile duct and pancreatic duct cannulated selectively. Pancreatic duct was normal. Bile ducts contained a long linear filling defect extending from lower end of common bile duct to right intrahepatic duct (see image gallery for ERCP plate). A basket was introduced in the duct (see video clip) and the linear structure was engaged with soft closure and extracted out of the bile duct. Accompanying the basket was a 25 cm thick highly motile Ascarid. To recover the worm, endoscope was withdrawn along with the basket and the friendly catch. While the endoscope was being withdrawn and the basket was in the duodenum with the worm out of bile duct, patient indicated of relief of abdominal pain. A relook cholangiogram showed no more structures in the duct. She was given antihelmintic therapy and passed hundreds of worms with the feces. The worms recovered form stools were both male and female population and varied in length and size. However the lone worm recovered form bile ducts was the longest and the thickest male worm. The phenomenal behavior of this ubiquitous infection remains unexplained.

Watch that Human Body Medical Autopsy for Poison

Magnetic resonance imaging (MRI) can be an important tool in the diagnosis of multiple sclerosis (MS). MRI can also be used to monitor the progression of the disease in people living with MS. How does it work? MRI uses very strong magnets, radio signals, and computer software to take 3-dimensional pictures of the inside of the body. Will I need contrast material? Maybe. Contrast material is a substance that temporarily changes the way imaging tools interact with the body. They are often used to visualize certain types of MS disease activity on the MRI. If your doctor thinks your scan requires this contrast material, you may get an injection before you get in the MRI machine. How long will it take? The time may vary based on the type of MRI. Be sure to discuss with your doctor in advance so he or she can provide you with exact timing. But don’t worry, you won’t have to stay still the whole time. The technician will let you know when they’re starting a new image.