Top videos
For the first few days after giving birth, a new mother’s breasts remain soft. They will produce colostrum. Colostrum, the first milk, is available in just the right amount, and is rich in immune factors that protect newborns. Sometime during the next few days, the breasts will become full, firm, warm, and perhaps tender. When this occurs, people say: “the milk is coming in!” The scientific term for this event is: engorgement. Engorgement is normal, and lasts for various periods of time depending on the individual woman. Some women experience only a day or so of mild, easy-to-manage engorgement. For other women, engorgement may be more intense, and can last from several days to two weeks.
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.
The menstrual cycle is the regular natural change that occurs in the female reproductive system like the uterus and ovaries that make pregnancy possible. The cycle is required for the production of ovocytes, and for the preparation of the uterus for pregnancy.
Pain in the affected bone is the most common complaint of patients with bone cancer. At first, the pain is not constant. It may be worse at night or when the bone is used (for example, leg pain when walking). As the cancer grows, the pain will be there all the time. The pain increases with activity and the person might limp if a leg is involved.
Microscopic polyangiitis (MPA) is vasculitis of small vessels. It was initially considered as a microscopic form of polyarteritis nodosa (PAN). In 1990, the American College of Rheumatology developed classification criteria for several types of systemic vasculitis but did not distinguish between polyarteritis nodosa and microscopic polyarteritis nodosa. [1] In 1994, a group of experts held an international consensus conference in Chapel Hill, North Carolina, to attempt to redefine the classification of small vessel vasculitides. [2, 3]
The voice box, or larynx, has three important functions. It is necessary for breathing, voice and swallowing. The vocal folds have two positions, open (apart) for breathing (picture I) and closed (together) for making sound, coughing and sealing off the lungs when swallowing (picture II). When one of the vocal folds are paralyzed, it usually rests in an in-between position (picture III), and neither opens for breathing, nor closes for voicing, coughing, or swallowing. Usually, the effects on the voice are the most dramatic. The voice becomes weak and breathy. People can only say a few words per breath, and are frequently out-of-breath, or physically tired when trying to speak for more than a few minutes straight. The voice may also get somewhat high and squeaky, with a diminished range. Swallowing may be affected as well, where you may notice some choking or coughing with certain liquids. Your cough is frequently different and very weak. This is a serious problem for patients with with vocal fold paralysis because one of the most important functions of the larynx is to keep liquids out of the lungs, and to be able to cough up mucus. When this does not happen, you are at risk for getting an "aspiration" pneumonia. The surgical procedure to restore these important functions is called "medialization laryngoplasty"
A brief description of the mechanisms, types and assessment of chromosomal analyses. Techniques such as standard cytogenetic testing, FISH and array methods are discussed. Indications for testing in prenatal, neonatal and adult periods are also discussed. Deletions, translocations, inversions etc are described, as are mosaicism and aneuploidy.