1.
Medicine
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Medicine is the science and practice of the diagnosis, treatment, and prevention of disease. The word medicine is derived from Latin medicus, meaning a physician, Medicine encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness. Medicine has existed for thousands of years, during most of which it was an art frequently having connections to the religious and philosophical beliefs of local culture. For example, a man would apply herbs and say prayers for healing, or an ancient philosopher. In recent centuries, since the advent of modern science, most medicine has become a combination of art, while stitching technique for sutures is an art learned through practice, the knowledge of what happens at the cellular and molecular level in the tissues being stitched arises through science. Prescientific forms of medicine are now known as medicine and folk medicine. They remain commonly used with or instead of medicine and are thus called alternative medicine. For example, evidence on the effectiveness of acupuncture is variable and inconsistent for any condition, in contrast, treatments outside the bounds of safety and efficacy are termed quackery. Medical availability and clinical practice varies across the world due to differences in culture. In modern clinical practice, physicians personally assess patients in order to diagnose, treat, the doctor-patient relationship typically begins an interaction with an examination of the patients medical history and medical record, followed by a medical interview and a physical examination. Basic diagnostic medical devices are typically used, after examination for signs and interviewing for symptoms, the doctor may order medical tests, take a biopsy, or prescribe pharmaceutical drugs or other therapies. Differential diagnosis methods help to rule out conditions based on the information provided, during the encounter, properly informing the patient of all relevant facts is an important part of the relationship and the development of trust. The medical encounter is then documented in the record, which is a legal document in many jurisdictions. Follow-ups may be shorter but follow the general procedure. The diagnosis and treatment may take only a few minutes or a few weeks depending upon the complexity of the issue, the components of the medical interview and encounter are, Chief complaint, the reason for the current medical visit. They are in the patients own words and are recorded along with the duration of each one, also called chief concern or presenting complaint. History of present illness, the order of events of symptoms. Distinguishable from history of illness, often called past medical history
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Surgery
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An act of performing surgery may be called a surgical procedure, operation, or simply surgery. In this context, the verb means to perform surgery. The adjective surgical means pertaining to surgery, e. g. surgical instruments or surgical nurse, the patient or subject on which the surgery is performed can be a person or an animal. A surgeon is a person who practices surgery and an assistant is a person who practices surgical assistance. A surgical team is made up of surgeon, surgeons assistant, anesthesia provider, circulating nurse, Surgery usually spans minutes to hours, but it is typically not an ongoing or periodic type of treatment. The term surgery can also refer to the place where surgery is performed, or simply the office of a physician, dentist, Surgery is a technology consisting of a physical intervention on tissues. As a general rule, a procedure is considered surgical when it involves cutting of a patients tissues or closure of a previously sustained wound, surgical procedures are commonly categorized by urgency, type of procedure, body system involved, degree of invasiveness, and special instrumentation. Based on timing, Elective surgery is done to correct a condition, and is carried out at the patients request, subject to the surgeons. A semi-elective surgery is one that must be done to avoid permanent disability or death, emergency surgery is surgery which must be done promptly to save life, limb, or functional capacity. Based on purpose, Exploratory surgery is performed to aid or confirm a diagnosis, therapeutic surgery treats a previously diagnosed condition. Cosmetic surgery is done to improve the appearance of an otherwise normal structure. By type of procedure, Amputation involves cutting off a part, usually a limb or digit. Resection is the removal of all or part of an organ or part of the body. Replantation involves reattaching a severed body part, reconstructive surgery involves reconstruction of an injured, mutilated, or deformed part of the body. Excision is the cutting out or removal of an organ, tissue, transplant surgery is the replacement of an organ or body part by insertion of another from different human into the patient. Removing an organ or body part from a human or animal for use in transplant is also a type of surgery. By body part, When surgery is performed on one system or structure. Examples include cardiac surgery, gastrointestinal surgery, and orthopedic surgery, by contrast, an open surgical procedure such as a laparotomy requires a large incision to access the area of interest
3.
Doctor of Medicine
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The Doctor of Medicine is a terminal medical degree for practitioners of medicine. The meaning of the varies between different countries. In countries that follow the United States system, the M. D. denotes a first professional degree awarded upon initial graduation from medical school. In those countries, the title of the equivalent first professional degree is Bachelor of Medicine, in 1703, the University of Glasgows first medical graduate, Samuel Benion, was issued with the academic degree of Doctor of Medicine. North American medical schools switched to the tradition of the ancient universities of Scotland, the Columbia University College of Physicians and Surgeons in New York was the first American university to grant the MD degree instead of the MB. Early medical schools in North America that granted the Doctor of Medicine degrees were Columbia, Penn, Harvard, Maryland and these first few North American medical schools that were established were founded by physicians and surgeons who had been trained in England and Scotland. A feminine form, Doctress of Medicine or Medicinae Doctrix, has also used by the New England Female Medical College in Boston in the 1860s. The MD degree is earned in four years. Following the awarding of the MD, physicians who wish to practice in the United States are required to complete at least one internship year and those who wish to further specialize in areas such as cardiology or interventional radiology then complete a fellowship. Depending upon the chosen field, residencies and fellowships involve an additional three to eight years of training after obtaining the MD. This can be lengthened with additional research years, which can last one, the Doctor of Osteopathic Medicine or DO degree allows similar practice in the United States and Canada to the M. D. degree and Doctor of Osteopathic Medicine are fully licensed physicians. The M. D. degree is awarded only by the 137 Medical Schools in the United States, similarly, M. D. s must attend M. D. rated residency and fellowship programs while D. O. s can attend either type of program. The American M. D. degree is recognized by most countries in the world. While the D. O. degree is getting more widely accepted in countries as fully licensed physicians. In Canada, the MD is the medical degree required to practice medicine. McGill University Faculty of Medicine is the medical school in Canada that continues to award the MD. MDCM is from the Latin Medicinae Doctorem et Chirurgiae Magistrum meaning doctor of medicine, upon graduation, students enter into a residency phase of training. Combined medical and research training is offered through programs granting MD-PhD, the National Institutes of Health through its Medical Scientist Training Program funds MD-PhD training programs at many universities
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Hospital
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A hospital is a health care institution providing patient treatment with specialized medical and nursing staff and medical equipment. The best-known type of hospital is the hospital, which typically has an emergency department to treat urgent health problems ranging from fire. A district hospital typically is the health care facility in its region, with large numbers of beds for intensive care. Specialised hospitals can help reduce health care costs compared to general hospitals, a teaching hospital combines assistance to people with teaching to medical students and nurses. The medical facility smaller than a hospital is called a clinic. Hospitals have a range of departments and specialist units such as cardiology, some hospitals have outpatient departments and some have chronic treatment units. Common support units include a pharmacy, pathology, and radiology, Hospitals are usually funded by the public sector, by health organisations, by health insurance companies, or by charities, including direct charitable donations. Historically, hospitals were founded and funded by religious orders, or by charitable individuals. During the Middle Ages, hospitals served different functions from modern institutions, Middle Ages hospitals were almshouses for the poor, hostels for pilgrims, or hospital schools. The word hospital comes from the Latin hospes, signifying a stranger or foreigner, another noun derived from this, hospitium came to signify hospitality, that is the relation between guest and shelterer, hospitality, friendliness, and hospitable reception. By metonymy the Latin word then came to mean a guest-chamber, guests lodging, hospes is thus the root for the English words host hospitality, hospice, hostel and hotel. The German word Spital shares similar roots, the grammar of the word differs slightly depending on the dialect. Some patients go to a hospital just for diagnosis, treatment, or therapy and then leave without staying overnight, while others are admitted and stay overnight or for several days or weeks or months. Hospitals usually are distinguished from other types of facilities by their ability to admit and care for inpatients whilst the others. Larger cities may have several hospitals of varying sizes and facilities, some hospitals, especially in the United States and Canada, have their own ambulance service. A district hospital typically is the health care facility in its region, with large numbers of beds for intensive care. In California, district hospital refers specifically to a class of healthcare facility created shortly after World War II to address a shortage of beds in many local communities. Twenty-eight of Californias rural hospitals and 20 of its critical-access hospitals are District hospitals, Californias District hospitals are formed by local municipalities, have Boards that are individually elected by their local communities, and exist to serve local needs
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Clinic
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A clinic is a healthcare facility that is primarily focused on the care of outpatients. Clinics can be operated or publicly managed and funded. They typically cover the primary needs of populations in local communities, in contrast to larger hospitals which offer specialised treatments. Most commonly, the clinic in English refers to a general medical practice, run by one or more general practitioners. Some clinics retain the name “clinic even while growing into institutions as large as hospitals or becoming associated with a hospital or medical school. Clinics are often associated with a medical practice run by one or several general practitioners. In China, for example, owners of such clinics do not have formal medical education, there were 659,596 village clinics in China in 2011. Health care in India, China, Russia and Africa is provided to those countries vast rural areas by mobile health clinics or roadside dispensaries, in India these traditional clinics provide ayurvedic medicine and unani herbal medical practice. In each of countries, traditional medicine tends to be a hereditary practice. The word clinic derives from Ancient Greek κλίνειν klinein meaning to slope, hence κλίνη klinē is a couch or bed and κλινικός klinikos is a physician who visits his patients in their beds. An early use of the clinic was one who receives baptism on a sick bed. The function of clinics differs from country to country, some clinics function as a place for people with injuries or illnesses to come and be seen by a triage nurse or other health worker. In these clinics, the injury or illness may not be enough to require a visit to an emergency room. Treatment at these clinics is often less expensive than it would be at a casualty department, also, unlike an ER these clinics are often not open on a 24 x 7 x 365 basis. They sometimes have access to equipment such as X-ray machines. Doctors at such clinics can often refer patients to specialists if the need arises, large outpatient clinics vary in size, but can be as large as hospitals. In some university cities, polyclinics contain outpatient departments for the teaching hospital in one building. Recent Russian governments have attempted to replace the polyclinic model introduced during Soviet times with a more western model, India has also set up huge numbers of polyclinics for former defence personnel
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Ancient Greek
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Ancient Greek includes the forms of Greek used in ancient Greece and the ancient world from around the 9th century BC to the 6th century AD. It is often divided into the Archaic period, Classical period. It is antedated in the second millennium BC by Mycenaean Greek, the language of the Hellenistic phase is known as Koine. Koine is regarded as a historical stage of its own, although in its earliest form it closely resembled Attic Greek. Prior to the Koine period, Greek of the classic and earlier periods included several regional dialects, Ancient Greek was the language of Homer and of fifth-century Athenian historians, playwrights, and philosophers. It has contributed many words to English vocabulary and has been a subject of study in educational institutions of the Western world since the Renaissance. This article primarily contains information about the Epic and Classical phases of the language, Ancient Greek was a pluricentric language, divided into many dialects. The main dialect groups are Attic and Ionic, Aeolic, Arcadocypriot, some dialects are found in standardized literary forms used in literature, while others are attested only in inscriptions. There are also several historical forms, homeric Greek is a literary form of Archaic Greek used in the epic poems, the Iliad and Odyssey, and in later poems by other authors. Homeric Greek had significant differences in grammar and pronunciation from Classical Attic, the origins, early form and development of the Hellenic language family are not well understood because of a lack of contemporaneous evidence. Several theories exist about what Hellenic dialect groups may have existed between the divergence of early Greek-like speech from the common Proto-Indo-European language and the Classical period and they have the same general outline, but differ in some of the detail. The invasion would not be Dorian unless the invaders had some relationship to the historical Dorians. The invasion is known to have displaced population to the later Attic-Ionic regions, the Greeks of this period believed there were three major divisions of all Greek people—Dorians, Aeolians, and Ionians, each with their own defining and distinctive dialects. Often non-west is called East Greek, Arcadocypriot apparently descended more closely from the Mycenaean Greek of the Bronze Age. Boeotian had come under a strong Northwest Greek influence, and can in some respects be considered a transitional dialect, thessalian likewise had come under Northwest Greek influence, though to a lesser degree. Most of the dialect sub-groups listed above had further subdivisions, generally equivalent to a city-state and its surrounding territory, Doric notably had several intermediate divisions as well, into Island Doric, Southern Peloponnesus Doric, and Northern Peloponnesus Doric. The Lesbian dialect was Aeolic Greek and this dialect slowly replaced most of the older dialects, although Doric dialect has survived in the Tsakonian language, which is spoken in the region of modern Sparta. Doric has also passed down its aorist terminations into most verbs of Demotic Greek, by about the 6th century AD, the Koine had slowly metamorphosized into Medieval Greek
7.
Male reproductive system
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The male reproductive system consists of a number of sex organs that play a role in the process of human reproduction. These organs are located on the outside of the body and within the pelvis, the corresponding system in females is the female reproductive system. The penis is the intromittent organ. It has a shaft and an enlarged bulbous-shaped tip called the glans penis. When the male becomes sexually aroused, the penis becomes erect, erection occurs because sinuses within the erectile tissue of the penis become filled with blood. The arteries of the penis are dilated while the veins are compressed so that blood flows into the erectile cartilage under pressure, the penis is supplied by the pudendal artery. The scrotum is a structure that hangs behind the penis. It holds and protects the testicles and it also contains numerous nerves and blood vessels. The scrotum remains connected with the abdomen or pelvic cavity by the inguinal canal, the vas deferens, also known as the sperm duct, is a thin tube approximately 30 centimetres long that starts from the epididymis to the pelvic cavity. It carries the spermatozoa from the epididymis to ejaculatory duct, three accessory glands provide fluids that lubricate the duct system and nourish the sperm cells. They are the seminal vesicles, the gland, and the bulbourethral glands. The embryonic and prenatal development of the reproductive system is the process whereby the reproductive organs grow. It begins with a fertilized egg and culminates 38 weeks later with birth of a male child. It is a part of the stages of sexual differentiation, the development of the male reproductive system coincides with the urinary system. The development of them can also be described together as the development of the urinary, sexual identity is determined at fertilization when the genetic sex of the zygote has been initialized by a sperm cell containing either an X or Y chromosome. If this sperm cell contains an X chromosome it will coincide with the X chromosome of the ovum, a sperm cell carrying a Y chromosome results in an XY combination, and a male child will develop. Genetic sex determines whether the gonads will be testes or ovaries, in the developing embryo if the testes are developed, it will produce and secrete male sex hormones during late embryonic development and cause the secondary sex organs of the male to develop. Chromosomal abnormalities can occur during fertilization impacting the development of the reproductive system
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Testes
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The testicle or testis is the male gonad in animals. Like the ovaries to which they are homologous, the testicles are components of both the system and the endocrine system. The primary functions of the testes are to produce sperm and to produce androgens, both functions of the testicle are influenced by gonadotropic hormones produced by the anterior pituitary. Luteinizing hormone results in testosterone release, the presence of both testosterone and follicle-stimulating hormone is needed to support spermatogenesis. Almost all healthy male vertebrates have two testicles and they are typically of similar size, although in sharks, that on the right side is usually larger, and in many bird and mammal species, the left may be the larger. The primitive jawless fish have only a single testis, located in the midline of the body, the testicles of a dromedary camel are 7–10 cm long,4.5 cm deep and 5 cm in width. The right testicle is often smaller than the left, the testicles of a male red fox attain their greatest weight in December–February. Spermatogenesis in male golden jackals occurs 10–12 days before the females enter estrus and, during this time, in mammals, the testes are often contained within an extension of the abdomen called the scrotum. In mammals with external testes it is most common for one testicle to hang lower than the other. While the size of the varies, it is estimated that 21. 9% of men have their higher testicle being their left. This is due to differences in the anatomical structure on the right. In healthy European adult humans, average volume is 18 cm³ per testis. The average testicle size after puberty measures up to around 2 inches long,0.8 inches in breadth, measurement in the living adult is done in two basic ways, comparing the testicle with ellipsoids of known sizes. Measuring the length, depth and width with a ruler, a pair of calipers or ultrasound imaging, the volume is then calculated using the formula for the volume of an ellipsoid, 4/3 π × × ×. Human testicles are smaller than chimpanzee testicles but larger than gorilla testicles, under a tough membranous shell, the tunica albuginea, the testis of amniotes and some teleost fish, contains very fine coiled tubes called seminiferous tubules. The tubules are lined with a layer of cells that from puberty into old age, the sperm move into the vas deferens, and are eventually expelled through the urethra and out of the urethral orifice through muscular contractions. Amphibians and most fish do not possess seminiferous tubules, instead, the sperm are produced in spherical structures called sperm ampullae. These are seasonal structures, releasing their contents during the breeding season, before the next breeding season, new sperm ampullae begin to form and ripen
9.
Robot-assisted surgery
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Robotic surgery, computer-assisted surgery, and robotically-assisted surgery are terms for technological developments that use robotic systems to aid in surgical procedures. Robotically-assisted surgery was developed to overcome the limitations of pre-existing minimally-invasive surgical procedures, in computer-controlled systems the surgeon uses a computer to control the robotic arms and its end-effectors, though these systems can also still use telemanipulators for their input. One advantage of using the method is that the surgeon does not have to be present. This approach seeks to improve open surgeries, particularly cardio-thoracic, that have so far not benefited from minimally-invasive techniques, Robotic surgery has been criticized for its expense, by one estimate costing $1,500 to $2000 more per patient. Major advances aided by surgical robots have been remote surgery, minimally invasive surgery, due to robotic use, the surgery is done with precision, miniaturization, smaller incisions, decreased blood loss, less pain, and quicker healing time. Articulation beyond normal manipulation and three-dimensional magnification helps resulting in improved ergonomics, due to these techniques there is a reduced duration of hospital stays, blood loss, transfusions, and use of pain medication. The existing open surgery technique has many flaws like limited access to area, long recovery time, long hours of operation, blood loss, surgical scars. The robot normally costs $1,390,000 and while its disposable supply cost is normally $1,500 per procedure, additional surgical training is needed to operate the system. Numerous feasibility studies have been done to determine whether the purchase of systems are worthwhile. As it stands, opinions differ dramatically, patient surveys indicate they chose the procedure based on expectations of decreased morbidity, improved outcomes, reduced blood loss and less pain. Higher expectations may explain higher rates of dissatisfaction and regret, compared with other minimally invasive surgery approaches, robot-assisted surgery gives the surgeon better control over the surgical instruments and a better view of the surgical site. In addition, surgeons no longer have to stand throughout the surgery, naturally occurring hand tremors are filtered out by the robots computer software. Finally, the robot can continuously be used by rotating surgery teams. Articles in the newly created Journal of Robotic Surgery tend to report on one surgeons experience, for surgical removal of the uterus and cervix for early cervical cancer robotic and laparoscopic surgery resulted in similar outcomes with respect to the cancer. In early 2000 the field of surgical interventions with the daVinci device was explored by surgeons at Ohio State University. In 2007, the University of Illinois at Chicago medical team, pier Cristoforo Giulianotti, reported a pancreatectomy and also the Midwests first fully robotic Whipple surgery. Furthermore, the patient can also leave with less pain than a usual surgery due to the four puncture holes, robot-assisted MIDCAB and Endoscopic coronary artery bypass operations are being performed with the Da Vinci system. Mitral valve repairs and replacements have been performed, in 2002, surgeons at the Cleveland Clinic in Florida reported and published their preliminary experience with minimally invasive hybrid procedures
10.
Laparoscopic surgery
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There are a number of advantages to the patient with laparoscopic surgery versus the more common, open procedure. Pain and hemorrhaging are reduced due to smaller incisions and recovery times are shorter, also attached is a fiber optic cable system connected to a cold light source, to illuminate the operative field, which is inserted through a 5 mm or 10 mm cannula or trocar. The abdomen is usually insufflated with carbon dioxide gas and this elevates the abdominal wall above the internal organs to create a working and viewing space. CO2 is used because it is common to the body and can be absorbed by tissue. It is also non-flammable, which is important because electrosurgical devices are used in laparoscopic procedures. Laparoscopic surgery includes operations within the abdominal or pelvic cavities, whereas keyhole surgery performed on the thoracic or chest cavity is called thoracoscopic surgery, specific surgical instruments used in a laparoscopic surgery include, forceps, scissors, probes, dissectors, hooks, retractors and more. Laparoscopic and thoracoscopic surgery belong to the field of endoscopy. Laparoscopic cholecystectomy is the most common procedure performed. In this procedure, 5–10 mm diameter instruments can be introduced by the surgeon into the abdomen through trocars, over one million cholecystectomies are performed in the U. S. annually, with over 96% of those being performed laparoscopically. There are two different formats for laparoscopic surgery, each located within its own incision site, but oriented toward the surgical objective. A camera and light provide feedback to the surgeon, who sees the enlarged surgical elements on a TV monitor, the Bonati system was designed for spinal surgery and has been promoted only for that purpose. The length of stay in the hospital is minimal. In certain advanced laparoscopic procedures, where the size of the specimen being removed would be too large to pull out through a trocar site, the most common of these procedures are removal of all or part of the colon, or removal of the kidney. This technique is called hand-assist laparoscopy, since they will still be working with scopes and other laparoscopic instruments, CO2 will have to be maintained in the patients abdomen, so a device known as a hand access port must be used. Surgeons who choose this hand-assist technique feel it reduces operative time significantly versus the straight laparoscopic approach and it also gives them more options in dealing with unexpected adverse events that may otherwise require creating a much larger incision and converting to a fully open surgical procedure. Conceptually, the approach is intended to minimise post-operative pain and speed up recovery times. For these reasons, minimally invasive surgery has emerged as a competitive new sub-specialty within various fields of surgery. Surgical residents who wish to focus on area of surgery gain additional laparoscopic surgery training during one or two years of fellowship after completing their basic surgical residency
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Nephrology
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Nephrology is a specialty of medicine and pediatrics that concerns itself with the study of normal kidney function, kidney problems, the treatment of kidney problems and renal replacement therapy. Systemic conditions that affect the kidneys and systemic problems that occur as a result of problems are also studied in nephrology. A physician who has undertaken additional training to become an expert in nephrology may call themselves a nephrologist or renal physician, the term nephrology was first used in about 1960. Before then, the specialty was usually referred to as kidney medicine, many diseases affecting the kidney are systemic disorders not limited to the organ itself, and may require special treatment. Examples include acquired conditions such as systemic vasculitides and autoimmune diseases, a nephrologist is a physician who specializes in the care and treatment of kidney disease. Nephrology requires additional training to become an expert with advanced skills, procedures a nephrologist may perform include native kidney and transplant kidney biopsy, dialysis access insertion, fistula management, and bone biopsy. The training pathway is overseen and accredited by the Royal Australasian College of Physicians, increasingly, nephrologists may additionally complete of a post-graduate degree in a nephrology research interest. In the United Kingdom, nephrology is a subspecialty of general medicine, the typical subspecialty training is five years and leads to a Certificate of Completion of Training in both renal medicine and general medicine. Subspecialty trainees often interrupt their clinical training to obtain research degrees, Nephrology training can be accomplished through one of two routes. The first being through an internal medicine pathway leading to an Internal Medicine/Nephrology specialty, the second pathway being through Pediatrics leading to a speciality in Pediatric Nephrology. In the United States, after medical school adult nephrologists complete a residency in internal medicine followed by a two-year fellowship in nephrology. This is followed by a fellowship in Pediatic Nephrology. Once training is completed, the physician is eligible to take the American Board of Internal Medicine or American Osteopathic Board of Internal Medicine nephrology examination. Nephrologists must be approved by one of these boards, to be approved, the physician must fulfill the requirements for education and training in nephrology in order to qualify to take the boards examination. If a physician passes the examination, then he or she can become a nephrology specialist, typically, nephrologists also need two to three years of training in an ACGME or AOA accredited fellowship in nephrology. Nearly all programs train nephrologists in continuous renal replacement therapy, fewer than half in the United States train in the provision of plasmapheresis, only pediatric trained physicians are able to train in pediatric nephrology, and internal medicine trained physicians may enter general nephrology fellowships. History and physical examination are central to the diagnostic workup in nephrology and this may include inquires regarding family history, general medical history, diet, medication use, drug use and occupation. Examination typically includes an assessment of state, blood pressure, skin, joints, abdomen
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Gynaecology
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Gynaecology or gynecology is the medical practice dealing with the health of the female reproductive systems and the breasts. Literally, outside medicine, the means the science of women. Its counterpart is andrology, which deals with issues specific to the male reproductive system. Almost all modern gynaecologists are also obstetricians, in many areas, the specialities of gynaecology and obstetrics overlap. The word gynaecology comes from the Greek γυνή, woman, and -logia, the Kahun Gynaecological Papyrus is the oldest known medical text of any kind. Dated to about 1800 BC, it deals with womens complaints—gynaecological diseases, fertility, pregnancy, contraception, the text is divided into thirty-four sections, each section dealing with a specific problem and containing diagnosis and treatment, no prognosis is suggested. Treatments are non surgical, comprising applying medicines to the body part or swallowing them. The womb is at times seen as the source of complaints manifesting themselves in other body parts, the Hippocratic Corpus contains several gynaecological treatises dating to the 5th/4th centuries BC. Aristotle is another source for medical texts from 4th century BC with his descriptions of biology primarily found in History of Animals, Parts of Animals. The gynaecological treatise Gynaikeia by Soranus of Ephesus is extant and he was the chief representative of the school of physicians known as the Methodists. J. Marion Sims is widely considered the father of modern gynaecology, Now criticized for the short comings. Now criticized for the short comings. He developed some of his techniques by operating on slaves, many of whom were not given anaesthesia, in some countries, women must first see a general practitioner prior to seeing a gynaecologist. If their condition requires training, knowledge, surgical procedure, or equipment unavailable to the GP, in the United States, however, law and many health insurance plans allow gynaecologists to provide primary care in addition to aspects of their own specialty. With this option available, some women opt to see a surgeon for non-gynaecological problems without another physicians referral. As in all of medicine, the tools of diagnosis are clinical history. Gynaecological examination is quite intimate, more so than a physical exam. It also requires unique instrumentation such as the speculum, Gynaecologists typically do a bimanual examination to palpate the cervix, uterus, ovaries and bony pelvis. It is not uncommon to do a rectovaginal examination for complete evaluation of the pelvis, male gynaecologists may have a female chaperone for their examination
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Gastroenterology
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Gastroenterology is the branch of medicine focused on the digestive system and its disorders. Diseases affecting the gastrointestinal tract, which include the organs from mouth to anus, physicians practicing in this field are called gastroenterologists. Gastroenterologists perform a number of diagnostic and therapeutic procedures including colonoscopy, endoscopy, endoscopic retrograde cholangiancreatography, endoscopic ultrasound, some gastroenterology trainees will complete a fourth-year in transplant hepatology, advanced endoscopy, inflammatory bowel disease, motility or other topics. Hepatology, or hepatobiliary medicine, encompasses the study of the liver, pancreas and they are traditionally considered sub-specialties of gastroenterology. Citing from Egyptian papyri, John F. Nunn identified significant knowledge of diseases among practicing physicians during the periods of the pharaohs. Irynakhty, of the dynasty, c.2125 B. C. was a court physician specializing in gastroenterology, sleeping. Among ancient Greeks, Hippocrates attributed digestion to concoction, Galens concept of the stomach having four faculties was widely accepted up to modernity in the seventeenth century. Eighteenth century, Italian Lazzaro Spallanzani was among early physicians to disregard Galens theories, in 1767, German Johann von Zimmermann wrote an important work on dysentery. In 1777, Maximilian Stoll of Vienna described cancer of the gallbladder and this is the earliest description of endoscopy. Charles Emile Troisier described enlargement of nodes in abdominal cancer. In 1823, William Prout discovered that stomach juices contain hydrochloric acid, in 1833, William Beaumont published Experiments and Observations on the Gastric Juice and the Physiology of Digestion following years of experimenting on test subject Alexis St. Martin. In 1868, Adolf Kussmaul, a well-known German physician, developed the gastroscope and he perfected the technique on a sword swallower. In 1871, at the society of physicians in Vienna, Carl Stoerk demonstrated an esophagoscope made of two metal tubes, initially devised by Waldenburg in 1870. In 1876, Karl Wilhelm von Kupffer described the properties of some liver cells now called Kupffer cell, in 1883, Hugo Kronecker and Samuel James Meltzer studied oesophageal manometry in humans. Twentieth century, In 1915, Jesse McClendon tested acidity of human stomach in situ, in 1921-22, Walter Alvarez did the first electrogastrography research. Rudolph Schindler described many important diseases involving the human digestive system during World War I in his textbook and is portrayed by some as the father of gastroscopy. He and Georg Wolf developed a semiflexible gastroscope in 1932, in 1932, Burrill Bernard Crohn described Crohns disease. In 1957, Basil Hirschowitz introduced the first prototype of a fibreoptic gastroscope, James Leavitt assisted in their research, but the Nobel Prize is not awarded posthumously so he was not included in the award
14.
Endocrinology
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Endocrinology is a branch of biology and medicine dealing with the endocrine system, its diseases, and its specific secretions known as hormones. Specializations include behavioral endocrinology and comparative endocrinology, the endocrine system consists of several glands, all in different parts of the body, that secrete hormones directly into the blood rather than into a duct system. Endocrinology is the study of the system in the human body. This is a system of glands which secrete hormones, hormones are chemicals which affect the actions of different organ systems in the body. Examples include thyroid hormone, growth hormone, and insulin, the endocrine system involves a number of feedback mechanisms, so that often one hormone will control the action or release of another secondary hormone. If there is too much of the hormone, it may provide negative feedback to the primary hormone. This definition holds for most classical hormones, but there are also paracrine mechanisms, autocrine signals, a neuroendocrine signal is a classical hormone that is released into the blood by a neurosecretory neuron. Peptide hormones and protein hormones consist of three to more than 200 amino acid residues and can have a mass as large as 30,000 grams per mole. All hormones secreted by the pituitary gland are peptide hormones, as are leptin from adipocytes, ghrelin from the stomach, steroid hormones are converted from their parent compound, cholesterol. Mammalian steroid hormones can be grouped into five groups by the receptors to which they bind, glucocorticoids, mineralocorticoids, androgens, estrogens, and progestogens. Some forms of vitamin D, such as calcitriol, are steroid-like and bind to homologous receptors and these organs include the pituitary, thyroid, adrenals, ovaries, testes, and pancreas. An endocrinologist is a physician who specializes in treating disorders of the system, such as diabetes, hyperthyroidism. The diagnosis and treatment of diseases are guided by laboratory tests to a greater extent than for most specialties. Many diseases are investigated through excitation/stimulation or inhibition/suppression testing and this might involve injection with a stimulating agent to test the function of an endocrine organ. Blood is then sampled to assess the changes of the relevant hormones or metabolites, an endocrinologist needs extensive knowledge of clinical chemistry and biochemistry to understand the uses and limitations of the investigations. A second important aspect of the practice of endocrinology is distinguishing human variation from disease, atypical patterns of physical development and abnormal test results must be assessed as indicative of disease or not. Diagnostic imaging of endocrine organs may reveal incidental findings called incidentalomas, Endocrinology involves caring for the person as well as the disease. Most endocrine disorders are diseases that need lifelong care
15.
Physician
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Both the role of the physician and the meaning of the word itself vary around the world. Degrees and other qualifications vary widely, but there are common elements, such as medical ethics requiring that physicians show consideration, compassion. Around the world the term refers to a specialist in internal medicine or one of its many sub-specialties. This meaning of physician conveys a sense of expertise in treatment by drugs or medications and this term is at least nine hundred years old in English, physicians and surgeons were once members of separate professions, and traditionally were rivals. Henry VIII granted a charter to the London Royal College of Physicians in 1518 and it was not until 1540 that he granted the Company of Barber/Surgeons its separate charter. In the same year, the English monarch established the Regius Professorship of Physic at the University of Cambridge, newer universities would probably describe such an academic as a professor of internal medicine. Hence, in the 16th century, physic meant roughly what internal medicine does now, currently, a specialist physician in the United States may be described as an internist. Another term, hospitalist, was introduced in 1996, to describe US specialists in internal medicine who work largely or exclusively in hospitals, such hospitalists now make up about 19% of all US general internists, who are often called general physicians in Commonwealth countries. In such places, the more general English terms doctor or medical practitioner are prevalent, in Commonwealth countries, specialist pediatricians and geriatricians are also described as specialist physicians who have sub-specialized by age of patient rather than by organ system. Around the world, the term physician and surgeon is used to describe either a general practitioner or any medical practitioner irrespective of specialty. This usage still shows the meaning of physician and preserves the old difference between a physician, as a practitioner of physic, and a surgeon. The term may be used by state medical boards in the United States of America, in modern English, the term physician is used in two main ways, with relatively broad and narrow meanings respectively. This is the result of history and is often confusing and these meanings and variations are explained below. In the United States and Canada, the term physician describes all medical practitioners holding a professional medical degree, the American Medical Association, established in 1847, as well as the American Osteopathic Association, founded in 1897, both currently use the term physician to describe members. However, the American College of Physicians, established in 1915, does not, its title uses physician in its original sense. A physician trained in the United States has either a Doctor of Medicine degree, all boards of certification now require that physicians demonstrate, by examination, continuing mastery of the core knowledge and skills for a chosen specialty. Recertification varies by particular specialty between every seven and every ten years, graduates of osteopathic medical schools in the United States should not be confused with osteopaths, who are trained in the European and Commonwealth nations. Their training is similar to physical therapy and they are not licensed to prescribe medications or perform surgeries, also in the United States, the American Podiatric Medical Association defines podiatrists as physicians and surgeons that fall under the department of surgery in hospitals
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Paruresis
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Paruresis is a type of phobia in which the sufferer is unable to urinate in the real or imaginary presence of others, such as in a public restroom. The analogous condition that affects bowel movement is called parcopresis and it appears that paruresis involves a tightening of the sphincter and/or bladder neck due to a sympathetic nervous system response. The adrenaline rush that produces the involuntary nervous system response probably has peripheral and central nervous system involvement, the internal urethral sphincter or the external urethral sphincter, levator ani muscle area, or some combination of the above, may be involved. It is possible there is an inhibition of the detrusor command through a reflex pathway as well. The pontine micturition center also may be involved, as its results in relaxation of the detrusor. Some people have brief, isolated episodes of urinary difficulty in situations where people are in close proximity. Paruresis, however, goes beyond simple shyness, embarrassment, fear of exposure, other people may find that they are unable to urinate while in moving vehicles, or are fixated on the sounds of their urination in quiet restrooms or residential settings. In severe cases, a person with paruresis can urinate only when alone at home or through the process of catheterization, although most sufferers report that they developed the condition in their teenage years, it can strike at any age. Many women are unaware that they, too, are subject to paruresis, articles about women and urination emphasize other female urinary dysfunctions, some people cope by deliberately holding in their urine, by refraining from drinking liquids, or locating unoccupied or single-occupancy public bathrooms. Severe cases of this disorder can have highly restricting effects on a persons life, in moderate to severe cases, overcoming paruresis can be extremely difficult without the help of a psychologist, therapist or support groups. Severe sufferers may not be willing to travel far from their home or be able to form intimate relationships, others cannot urinate even in their own home if someone else can be heard to be there. The term paruresis was coined by Williams and Degenhart in their paper Paruresis and they surveyed 1,419 college students and found 14. 4% had experienced paruresis, either incidentally or continuously. Paruresis is also known by many terms, including bashful bladder, bashful kidneys, stage fright, pee-shyness. There is growing recognition of the condition by the UKs National Health Service, the condition is catered for in the rules for mandatory urine testing for drugs in UK prisons, and UK Incapacity Benefit tribunals also recognise it. It is listed in the NHS on-line encyclopaedia of conditions and disorders and it is now reported to have been accepted as a valid reason for jury service excusal. The condition is recognised by the American Urological Association, who include it in their directory of conditions. It has, from time to time been the topic of advice such as Ann Landers, to which sufferers have written in. Paruresis was described in section 300.23 of the DSM-IV-TR as performance fears, using a public restroom but it was not mentioned by name
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Royal Australasian College of Surgeons
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The Royal Australasian College of Surgeons is the leading advocate for surgical standards, professionalism and surgical education in Australia and New Zealand. The head office of the College is in Melbourne, Australia, the College is a not-for-profit organisation that represents more than 7000 surgeons and 1300 surgical trainees and International Medical Graduates. RACS also supports healthcare and surgical education in the Asia-Pacific region and is a substantial funder of surgical research and its major roles are in training surgeons, continuing education, and setting standards for surgical practice. The members of the College fall into the categories, Fellows, Trainees. The College is independent from government and universities and is funded through fees paid by Trainees, the major activities of the College are surgical training and examination, setting standards for surgical practice, continuing professional development and government and media relations. The Surgical Education and Training program has improved the efficiency of surgical education, category, Fellows of the Royal Australasian College of Surgeons - fellows with Wikipedia articles about them Official website of RACS
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Australian nationality law
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Australian nationality law determines who is and who is not an Australian citizen. The status of Australian nationality or Australian citizenship was created by the Nationality, the 1948 Act was amended many times, notably in 1973,1984,1986 and 2002. The Australian Citizenship Act 2007 replaced the 1948 Act, commencing on 1 July 2007, on 13 December 1973, Australia acceded to the 1961 Convention on the Reduction of Statelessness and to the Convention relating to the Status of Refugees. Australian passports are issued to Australian citizens by the Department of Foreign Affairs, a person may acquire citizenship automatically, by operation of law, or by application after a period of residence in Australia. The process of acquiring citizenship by application is referred to as naturalisation, until the passing in Australia of the Nationality Act 1920, Australias nationality law, like that of other Commonwealth countries, was governed by the English common law concept of a British subject. The British Nationality and Status of Aliens Act 1914 codified the common law rules, Australia followed with the passing of the Nationality Act 1920, which codified the concept of a British subject in Australia, effective from 1 January 1921. Until then all Commonwealth countries, with the exception of the Irish Free State, had a single nationality status of British subject. It was decided at that conference that the United Kingdom and the self-governing dominions would each adopt a national citizenship. However, the status of other British subjects in Australia differed from the status of those who were not British subjects, aborigines became Australian citizens under the 1948 Act in the same way as other Australians. The same applied to Torres Strait Islanders and the population of the Territory of Papua. The relationship between Australian citizenship and a citizen of the British Empire or Commonwealth continued to evolve, in 1986, the Australia Act 1986 severed almost all of the last remaining constitutional links between the United Kingdom and Australia. Subsequently, in 1988, for the first time, the High Court ruled that anyone who was not an Australian citizen, the 1948 Act was amended many times, notably in 1958,1973,1984,1986 and 2002. In 1973 the 1948 Act was renamed the Australian Citizenship Act 1948, on 15 March 2007, the Australian Citizenship Act 2007 received Royal Assent and replaced the 1948 Act, commencing on 1 July 2007. 1948, Nationality and Citizenship Act 1948 created the concept of Australian citizenship, Australian citizens continued to also be British subjects. 1958, On 8 October 1958, provisions which caused some naturalised Australians resident outside Australia,1973, Significant changes to the law implemented by the Whitlam Labor government, mostly effective on 1 December 1973. Distinction between migrants from Commonwealth and other countries abolished, the previous residence requirements of 1 year and 5 years to become Australian citizens replaced by a common residence period of 3 years, but with a six-month transition period. Age of majority for citizenship purposes reduced from 21 to 18, the 1948 Act was renamed the Australian Citizenship Act 1948. 1975, The Papua New Guinea Regulations 1975 provided that any Australian citizen becoming a citizen of Papua New Guinea at Independence on 16 September 1975 should lose Australian citizenship
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