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The majority of fetuses are in a breech presentation early in pregnancy. By week 38th week of gestation, however, the fetus normally turns to a cephalic presentation. Although the fetal head is the widest single diameter, the fetus’s buttocks [ breech], plus the lower extremities, actually takes up more space. The fundus, being the largest part of the uterus, probably accounts for the fact that in approximately 97% of all pregnancies, the fetus turns so that the buttocks and lower extremities are in the fundus. Vaginal delivery of a breech presentation requires great skill if the fetus is not to be damaged. With the low rate of vaginal breech deliveries in the developed world, experience is being lost. 6% of women with breech presentation still have a vaginal breech delivery as they present too late - so units need to retain a high level of preparedness. Types of breech presentation: I. Complete breech [ flexed breech]: The fetal attitude is one of complete flexion, with hips and knees both flexed and the feet tucked in beside the buttocks. The presenting part consists of two buttocks, external genitalia and two feet. It is commonly present in multiparae. II. Incomplete breech: This is due to varying degrees of extension of thighs or legs at podalic pole. Three varieties are possible; - Breech with extended legs [ frank breech ]: The breech presents with the hips flexed and legs extended on the abdomen. 70% of breech presentations are of this type and it is particularly common in primigravidae whose good uterine muscle tone inhibits flexion of the legs and free turning of the fetus. - Footling breech: This is rare. One or both feet present because neither hips nor knees are fully flexed. The feet are lower than the buttocks, which distinguishes it from the complete breech. - Knee presentation: This is very rare. Thighs are extended but the knees are flexed, bringing the knees down to present at the brim.

Bartholin gland Marsupialization in Primary Bartholin Cyst

Fibroadenomas (fy-broe-ad-uh-NO-muhz) are solid, noncancerous breast tumors that occur most often in adolescent girls and women under the age of 30. You might describe a fibroadenoma as firm, smooth, rubbery or hard with a well-defined shape. Usually painless, a fibroadenoma might feel like a marble in your breast, moving easily under your skin when touched. Fibroadenomas vary in size, and they can get bigger or even shrink on their own. Fibroadenomas are among the most common breast lumps in young women. Treatment may include monitoring to detect changes in the size or feel of the fibroadenoma, a biopsy to evaluate the lump, or surgery to remove it.

Assisted Birth Delivery HD

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This video demonstrates the Retrograde Wire Intubation

Burns are classified as first-, second-, or third-degree, depending on how deep and severe they penetrate the skin's surface. First-degree burns affect only the epidermis, or outer layer of skin. The burn site is red, painful, dry, and with no blisters. Mild sunburn is an example.

Video giving an overview of histology, slide preparation, histological stains, and types of microscopy. This video is a part of our Histology Video Course (https://youtube.com/playlist?l....ist=PLnr1l7WuQdDynxT

Specific topics: what is histology, general composition of tissues, histotechnology: how histology slides are prepared, histology stains, immunohistochemistry, light microscopy vs electron microscopy, and pro tips for learning histology

Additional YouTube Content
Anatomy Videos: https://youtube.com/playlist?l....ist=PLnr1l7WuQdDz2dK
Biochemistry videos: https://youtube.com/playlist?l....ist=PLnr1l7WuQdDzCUC
DaVinci Cases Videos: https://youtube.com/playlist?l....ist=PLnr1l7WuQdDyJUl
The DaVinci Hour Podcast: https://youtube.com/playlist?l....ist=PLnr1l7WuQdDwSm9

DaVinci Academy Website: https://www.dviacademy.com/

In vitro fertilization, or IVF, is the most common and effective type of assisted reproductive technology to help women become pregnant. It involves fertilizing an egg outside the body, in a laboratory dish, and then implanting it in a woman's uterus. By 2016, some 6.5 million babies had been born using in-vitro fertilization (IVF). According to the Centers for Disease Control and Prevention (CDC), around 1.6 percent of babies born in the United States each year are conceived through assisted reproductive technology (ART).

Dr. Leo Maguire, a Mayo Clinic ophthalmologist, explains how laser-assisted in situ keratomileusis (LASIK) eye surgery can correct common vision problems.

This interview originally aired Jan. 26, 2019.

To learn more about LASIK surgery, visit: https://www.mayoclinic.org/tests-procedures/lasik-eye-surgery/about/pac-20384774?mc_id=us&utm_source=newsnetwork&utm_medium=l&utm_content=content&utm_campaign=mayoclinic&geo=national&placementsite=enterprise&cauid=100721&_ga=2.112234244.1227307149.1547427243-1780934405.1469629163

Timothy Lovell, MD, an orthopedic surgeon, talks to Spokane, WA knee replacement surgery patients about the procedure, possible risks and complications of surgery, and about your recovery time.

Dr. Lovell addresses anesthesia, the size and location of the incision, and shows you what the knee replacement ball and socket joint looks like. He'll talk about the recovery process; using a crutches, a walker or a cane to get around; movements to avoid; and how long it takes to feel better and return to your normal, active life.

To learn more about Dr. Lovell, visit http://washington.providence.o....rg/find-a-provider/l

And, to learn more about having orthopedic surgery in Spokane, WA, visit http://washington.providence.o....rg/clinics/providenc

How to Insert a Tampon

Dr. Celia Divino, Chief, Division of General Surgery at The Mount Sinai Hospital, performs a laparoscopic appendectomy. Visit the Division of General Surgery at http://bit.ly/18z944M. Click here to learn more about Dr. Celia Divino http://bit.ly/12RF0ee

You don't have to play tennis to get tennis elbow. These easy exercises can help:

One thing we do know: We can live without it, without apparent consequences. Appendicitis is a medical emergency that requires prompt surgery to remove the appendix. Left untreated, an inflamed appendix will eventually burst, or perforate, spilling infectious materials into the abdominal cavity.

Lipid-Lowering Agents HMG-CoA reductase inhibitors (statins) These agents inhibit the rate-limiting step in cholesterol biosynthesis by competitively inhibiting HMG-CoA reductase. Note the following: Low-density lipoprotein (LDL) reduction of 25%-60% Examples include Atorvastatin, fluvastatin, lovastatin, pitavastatin, pravastatin, rosuvastatin, simvastatin Contraindications include hypersensitivity, active liver disease, pregnancy, lactation, coadministration with strong CYP3A4 inhibitors (selected statins) Vitamin B3 Vitamin B3 inhibits very-low-density lipoprotein (VLDL) synthesis. Note the following: LDL reduction of 10% High-density lipoprotein (HDL) increase of 20% Example includes Niacin (nicotinic acid) Contraindications include hypersensitivity, liver disease, active peptic ulcer, severe hypotension, arterial bleeding Fibrates Fibrates enhance lipoprotein lipase, resulting in increased VLDL catabolism, fatty acid oxidation, and triglycerides elimination. They decrease hepatic extraction of free fatty acids. Note the following: LDL reduction of 15% Triglyceride reduction of 35% Examples include Gemfibrozil, fenofibrate, fenofibrate (micronized), fenofibric acid Contraindications include active liver disease, renal disease, primary biliary cirrhosis, gallbladder disease 2-Azetidiones These agents inhibit sterol transporter at brush border and, consequently, intestinal absorption of cholesterol. LDL reduction of 15% Example includes Ezetimibe Contraindications include hypersensitivity, coadministration with statins (if active liver disease) Bile acid sequestrants These agents lower cholesterol and LDL via bile duct sequestration. Note the following: LDL reduction of 15% Examples include Cholestyramine, colesevelam, colestipol Contraindications include biliary/bowel obstruction, serum triglycerides >300-500 mg/dL, history of hypertriglyceridemia-induced pancreatitis

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