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Living Donor Liver Transplantation

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An educational childbirth video showing the delivery process as it happens. For learning purposes only — not medical advice.

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

a video showing the technique of Shave and Punch Skin Biopsies nique of

"The act of cutting off the prepuce or foreskin of males, or the internal labia of females." Webster's Revised Unabridged Dictionary (1913)

Breast Reduction Surgery video Operation مركز افارا لجراحات التجميل الخدود تكبير الشفايف

A report of Female Genital Mutilationn FGM (female circucision) in Menya In Egypt تقرير من مدينة المنيا في صعيد مصر عن ختان لاناث

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

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Identify the anatomy and explain the physiology of the breast on diagrams and sonograms.

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Identify and describe sonographic images of benign and malignant features and common breast pathologies.

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Define and use related medical terminology.

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High definition video of a woman giving birth through water vaginal childbirth maneauver.

This urology video demonstrates Foley catheter insertion in both male and female patients. The recording shows the sterile technique used to place an indwelling urinary catheter, a routine procedure in hospital, surgical, and nursing care. Urinary catheters drain the bladder when a patient cannot pass urine normally.

A medical examination of the urinary bladder is demonstrated in this physical examination video. The recording shows the assessment techniques used to evaluate the bladder during a routine examination. It is an educational resource for students learning abdominal and urinary system examination skills.

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Pain Management During Birth

Delivery Video