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An animation of blood flow inside the Hemodialysis circuit.

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Dr. Ahmad Oussama Rifai is certified by the American Board of Internal Medicine (ABIM) in the specialty of Internal Medicine and the sub-specialty of Nephrology.

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Labor And Delivery During Vaginal Child Birth

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The pelvic floor or pelvic diaphragm is composed of muscle fibers of the levator ani, the coccygeus, and associated connective tissue which span the area underneath the pelvis. The pelvic diaphragm is a muscular partition formed by the levatores ani and coccygei, with which may be included the parietal pelvic fascia on their upper and lower aspects. The pelvic floor separates the pelvic cavity above from the perineal region (including perineum) below.

The right and left levator ani lie almost horizontally in the floor of the pelvis, separated by a narrow gap that transmits the urethra, vagina, and anal canal. The levator ani is usually considered in three parts: pubococcygeus, puborectalis, and iliococcygeus. The pubococcygeus, the main part of the levator, runs backward from the body of the pubis toward the coccyx and may be damaged during parturition. Some fibers are inserted into the prostate, urethra, and vagina. The right and left puborectalis unite behind the anorectal junction to form a muscular sling . Some regard them as a part of the sphincter ani externus. The iliococcygeus, the most posterior part of the levator ani, is often poorly developed.

The coccygeus, situated behind the levator ani and frequently tendinous as much as muscular, extends from the ischial spine to the lateral margin of the sacrum and coccyx.

The pelvic cavity of the true pelvis has the pelvic floor as its inferior border (and the pelvic brim as its superior border.) The perineum has the pelvic floor as its superior border.

Some sources do not consider “pelvic floor” and “pelvic diaphragm” to be identical, with the “diaphragm” consisting of only the levator ani and coccygeus, while the “floor” also includes the perineal membrane and deep perineal pouch. However, other sources include the fascia as part of the diaphragm. In practice, the two terms are often used interchangeably.

Inferiorly, the pelvic floor extends into the anal triangle.

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Robot helps disabled patients regain control of their hands 1

Temporal arteritis is a condition in which the temporal arteries, which supply blood to the head and brain, become inflamed or damaged. It is also known as cranial arteritis or giant cell arteritis. Although this condition usually occurs in the temporal arteries, it can occur in almost any medium to large artery in the body. The journal Arthritis & Rheumatology states that approximately 228,000 people in the United States are affected by temporal arteritis. According to the American College of Rheumatology, people over the age of 50 are more likely than younger people to develop the condition. Women are also more likely than men to have temporal arteritis. It is most prevalent in people of northern European or Scandinavian descent. Although the exact cause of the condition is unknown, it may be linked to the body’s autoimmune response. Also, excessive doses of antibiotics and certain severe infections have been linked to temporal arteritis. There’s no known prevention. However, once diagnosed, temporal arteritis can be treated to minimize complications.

Medical Examination of the Lower Limbs

In patients age ;::25, HPV DNA testing is the preferred next step in management if the initial cytology shows ASC-US. In this method, samples are collected for both cytology and reflex HPV DNA. If cytology results are positive, HPV DNA testing is performed. If cytology results are negative, the sample for HPV DNA is discarded. HPV DNA testing along with Pap smear at 3 years is recommended if initial cytology shows ASC-US but HPV DNA testing is negative

A hematoma is a collection of blood outside of a blood vessel Some causes of hematomas are as pelvic bone fractures, fingernail injuries (subungual), bumps, passing blood clots, blood clot in the leg (DVT), blood cancers, and excessive alcohol use.

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NURSING VIDEO ACTUAL CATHETERIZATION PROCEDURE OF MALE. FULL LENGTH VERSION Clear quality photography. This video provides an excellant clinical view of the entire procedure.

foot cast used in Toe Fractures

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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IMPLANT POCKETS - an educational animation explaining the different implant pockets

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plastic surgeon demonstrates the results of a muscle separation(rectus diastasis) repair using 3 dimesional CAT scan and photographic images

Vaginal delivery is the most common and safest type of childbirth. When necessary in certain circumstances, forceps (instruments resembling large spoons) may be used to cup your baby's head and help guide the baby through the birth canal. Vacuum delivery is another way to assist delivery and is similar to forceps delivery. In vacuum delivery, a plastic cup is applied to the baby's head by suction and the health care provider gently pulls the baby from the birth canal.