The obstetric examination is distinct from other examinations in that you, the clinician, are trying to assess the health of two individuals – the mother and the fetus – simultaneously. From the initial history, you should be able to judge the health of the pregnancy, any risk factors that need to be addressed, and any concerns from the parents. The history is an opportunity for you to find out how much the parents know about pregnancy, labour and delivery and if they have any preferences to which these events are carried out. A carefully taken history will also direct your attention to specific signs during the examination. As such, it is important that you develop a concise and systematic method of taking the history and carrying out the examination so that you do not miss any important information. This article focuses primarily on the examination. Pregnancy is a sensitive issue, especially for the primigravida’s. Therefore, extra care is needed when you approach a pregnant woman. Always obtain expressed informed consent before examining her and have a chaperone accompany you throughout the examination. A walk-through of what you will be doing is a good way of reassuring the patient and allows the examination to go on smoothly. It is also important to let your patient know that if the examination is too painful, she can stop at any time she wants. Finally, before you begin, you should always wash your hands, especially at an OSCE station.

Postmenopausal bleeding (PMB) is defined for practical purposes as vaginal bleeding occurring after twelve months of amenorrhoea, in a woman of the age where the menopause can be expected.[1] Hence it does not apply to a young woman, who has had amenorrhoea from anorexia nervosa, or a pregnancy followed by lactation. However, it can apply to younger women following premature ovarian failure or premature menopause. Unscheduled bleeding in women of menopausal age taking hormone replacement therapy (HRT) should be managed in the same way from a practical perspective.[2] 'Unscheduled bleeding' is defined as non-cyclical bleeding still continuing six months after commencing HRT or after six months of amenorrhoea.

USMLE Step 2 CS - Palpitations This is just preview video. To get full access please visit our website : www.usmletutoring.com

The testicles are located inside a loose bag of skin (scrotum) underneath the penis. Symptoms include a lump in either testicle and a feeling of heaviness in the scrotum. Treatments include surgery, radiation, and chemotherapy.

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.

Choking Infant

Pediatric Cardiovascular Examination

Keratosis Pilaris Treatment, What Causes Keratosis Pilaris, Cream For Keratosis Pilaris, Kp Cause---- http://banishmybumps.plus101.com/ --- Keratosis Pilaris Treatment, What Causes Keratosis Pilaris, Cream For Keratosis Pilaris, Kp Cause. Natural Treatments for Keratosis Pilaris. Keratosis Pilaris or KP is a very common skin condition, but has a quite unknown cause, and this affects more than fifty percent of adults all over the world. Most people who have this illness do not even know about it. KP causes a small red bump that normally appears on the legs, upper arms and buttocks. This skin condition can form also on your face, where it closely resembles acne. Though these red bumps are harmless, these can affect the person’s self-esteem and could lessen a person’s lifestyle quality. In order to avoid these circumstances, here are some of the natural treatments for Keratosis pilaris. If you are searching for KP treatment, bear in mind that this skin condition doesn’t need to be cured using conventional medication that may worsen the problem. Begin with the basics like proper skin care and proper diet, and this will essentially enhance your condition. In your diet, include foods rich in vitamin E and essential fatty acids like omega-3, 6 and 9 as well as GLA as these aids in regulating the abnormal production of your skin outer layers. In short, they aid stimulate a healthy process of skin exfoliation that in turn helps your skin get rid of the body toxins. Regular cleansing washes away the dead skin cells from your body. In some circumstances, you may need to help the process of exfoliation by using exfoliating cleansers or soaps or even body loofah. This skin condition usually indicates imbalance immune system and lack of moisture. You want to bring back the moisture of your skin and this can be done by increasing your water intake and using skin moisturizer. Additionally, you need to re-establish balance by means of detoxifications and proper nutrition in order to remove the toxins which affect your immune health. Urea cream is also used to treat Keratosis pilaris. But before considering this treatment, you have to know that nitrogen, a waste product of human protein metabolism, is the main ingredient of urea. Urea is transmitted into the urine and is impassive from your body. It is utilized in creams medically, supposedly to bring back moisture. There are natural substitutes for moisturizing your skin such as borage oil, Vitamin E oil, and many more, so there is really no need to use a waste product to perform the job. Some of the prescribed creams which contain urea might include other harmful components that can worsen your situation. So, instead of using urea, try to use natural skin care home remedies such as rose hip oil, Vitamin E bath oil, exfoliating soap made of Burt’s. You can try detoxification and cleansing program in order to get rid of all the toxins inside your system. Try to avoid allergens that may aggravate your skin condition such as dust mites, harsh detergents, toothpaste with fluoride and etc. It is good to know that keratosis pilaris is harmless enough and can be treated easily. With proper diet and modifying your lifestyle, you can fight this condition easily. Choose the natural cure for keratosis pilaris to prevent more toxins to get into the body that can worsen the skin condition. Proper diet and healthy lifestyle is your way of having a healthy and flawless skin. Research has shown that all-natural keratosis pilaris treatment systems, such as Banish My Bumps, are a successful way to seek relief. You can learn more at http://banishmybumps.plus101.com/

A pneumothorax occurs when some of the tiny air sacs (alveoli) in a baby's lung become overinflated and burst. This causes air to leak into the space between the lung and chest wall (pleural space). The most common cause of pneumothorax is respiratory distress syndrome. This is a condition that occurs in babies who are born too early (premature). The baby's lungs lack the slippery substance (surfactant) that helps them stay open. Therefore, the tiny air sacs are not able to expand as easily. If the baby is put on a breathing machine (mechanical ventilator), there is extra pressure on the baby's lungs, which can sometimes burst the air sacs.

http://www.landging.com/nervous-system-animation.html Human body nervous system, 3D MOA (Mechanism of Action) animation, designed for Beijing Natural History Museum.

METHODS:
Previously existing methods are characterized by unpleasant scars that, despite surgeons promises, remain for life.
Incisions are:

- around the areola (Round block) leading to a flat areola, often unpleasant hypertophic skars, skin rippling.
- inverted T (around the areola, vertically down and in the fold under the breast).

- Vertical (around the areola and vertically down). Due to the extess skin, incisions often turn into inverted L or T. Rearrangement of glandular tissue and skin changes the shape of the breasts and may be different from expectations. Scars worry patients and sometimes cause disturbances in the relationship with their partner.

- No scars. The "Serdev Suture" lifting technique for breast lifting without scars (only points - needle perforations in the skin) is created by the Bulgarian cosmetic surgeon Prof. Dr. Nikolay Serdev. It is a novelty that had changed the cosmetic surgery world in the last 10-14 years for young patients. The technique is especially important in Asia and Latin America, for Asians, African-Americans, Indians, and others who form keloids and lumpy scars after operations.

The Serdev suture method can achieve lift upto and over 14 centimeters and is most suitable for the following types of breasts:
- not very heavy full breasts.
- in the presence of subpectoral implants with subsequent drooping of the breasts after childbirth and lactation.
- empty and loose breasts after childbirth and breastfeeding. In such cases this technique is combined with subpectoral implants. In sagging breasts implants should not be placed in the skin over the pectoral muscles, because thus will lead to even more drooping. Therefore, breast lift requires breast fixation to the level of the pectoral muscle (the normal position in young women), and then placement of appropriate implants under the muscle, to hold them in the appropriated position.
- in drooping breasts after subglandular augmentation (over the muscle). In such cases, patients should not wait until the skin elongation becomes visible. The implants should be removed, the capsule removed - a difficult but a necessary operation, preventing postop seromas and infection. Implants should be placed under the pectoralis muscle to wear them. Patients should orient the cosmetic surgeon at what level they want the nipples - in the middle of the implant, higher or lower.
Implants should be generally replaced - below the muscle implants should be smooth, move naturally without hurting the muscle.

Because of modern anesthetics and new methods without trauma, pain and swelling after surgery are not significant. In 3-4 days, patients can return to social life, even the next day, but it is preferable to rest for 2-3 days.

Exercises with the arms and weight lifting is prohibited for a month and a half.

Due to lack of scars, the breast lift using the Serdev sutures can be repeated to maintain the aesthetic appearence of the breasts even in advanced age.

Gigantomastia i.e. very large, very heavy and drooping breasts can not be operated in this manner, because of gravity and overskin.

Early mastopexy using Serdev sutures is recommended before too much changes in the tissues. If late, more and more complex interventions are required.

"A lot of people are opting for various breast procedures and one of the most common among them is “mastopexy”. This is the surgery that involved uplifting of sagging breasts and, in certain cases, repositioning of the nipple and areola in order to restore normality and beauty. The excess skin is removed and firmness is provided to the breasts. Though mastopexy can be done as a stand alone surgery, many people combine it with breast augmentation which involves inserting implants inside the b

prostate surgery

http://www.landging.com/breast-augmentation-animation.html4
This breast augmentation animation demonstrates the procedure of saline breast implants.

Watch that video of Nasty Female Genital Infection

Watch that video to know if it is safe to have sex during pregnancy

Watch that video to know How to Give Intramuscular Injection

Infection leg gets cleaning inside

Cardiac anesthesiology is a subspecialty of anesthesiology that entails caring for patients undergoing major heart surgeries, including those that require cardiopulmonary bypass. I made this video to show a cardiac anesthesiologist's typical setup for surgery.

0:00 Start
0:28 IV pole #1
1:18 Perfusionist equipment
1:47 Anesthesia machine
3:01 Medications
3:36 Pacemaker
4:10 Echocardiography
4:34 IV pole #2
4:55 Arterial line
5:25 Defibrillators
5:40 OR table

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Website: http://www.MaxFeinsteinMD.com
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The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional.
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Music
Subtle Swagger by Ron Gelinas Chillout Lounge | https://soundcloud.com/atmospheric-music-portal
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Creative Commons Attribution 3.0 Unported License
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#Anesthesiology #Residency #MedicalSchool

Watch that 200 lb Tumor in Man's Body Removal Surgery

Anatomy Tutorial During Trans Nasal Endoscopy