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Hypothyroidism during pregnancy is treated with synthetic thyroid hormone, thyroxine (T4). Postpartum thyroiditis—inflammation of the thyroid gland—causes a brief period of hyperthyroidism, often followed by hypothyroidism that usually goes away within a year. Sometimes the hypothyroidism is permanent.

A step wise approach to the pathogenesis, types, disease entities and diagnosis of vasculitis. This discussion also includes the management options of vasculitis and their adverse drug reactions. In essence, vasculitis is a clfinicopathologic process characterised by inflammation and damage of blood vessels. This may be mainly due to three pathological processes which include immune complex deposition, anti-neutrophillic antibody formation and pathological T lymphocyte response and granuloma formation. The disease entities include Wegner's granulomatosis, Churg Strauss and many others. These present with palpable purpura, unexplained renal dysfunction etc which can be diagnosed based on biopsy and angiogram.

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.

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Homan’s sign test also called dorsiflexon sign test is a physical examination procedure that is used to test for Deep Vein Thrombosis (DVT). A positive Homan’s sign in the presence of other clinical signs may be a quick indicator of DVT. Clinical evaluation alone cannot be relied on for patient management, but when carefully performed, it remains useful in determining the need for additional testing (like D-dimer test, ultrasonography, multidetector helical computed axial tomography (CT), and pulmonary angiography) [1][2].

nkylosing spondylitis (pronounced ank-kih-low-sing spon-dill-eye-tiss), or AS, is a form of arthritis that primarily affects the spine, although other joints can become involved. It causes inflammation of the spinal joints (vertebrae) that can lead to severe, chronic pain and discomfort

Although most women have had enough experience to know how to pleasure a man in the bedroom, but you can be sure that are several girls who would be virgins when you first take them to bed. Though most Indian men actually prefer to make love with a virgin. There are also numerous men who dislike the idea due to the pressure of making love to someone with no experience. So if you happen to be dating a virgin then there are a few important things that you should always keep in mind when you take her to bed. Though you have made love to different women before, you need to understand that this one being a virgin will know little or nothing about what is expected of her in bed. Because she will be anxious and nervous, you have to be all the more careful to ensure that she gets to enjoy her first time with you. Kiss her Whether you are doing it with a virgin or someone with a record that would put Pam Anderson to shame, you should take your time to make love to her just with your lips. Use your lips with passion, and kiss her parts that other guys tend to ignore. Kiss her lips, her hips, her shoulders, her hands, nuzzle her ears - parts which aren’t necessary sexual. Give your girl a hand Okay this one may look straight out of a B-grade south Indian movie, but starting off with a sensual full body massage is an excellent way of warming her up. So use some nice aromatic oils like lavender or Yang-Yang to massage her body. If you are more experienced, you would be aware the various erogenous zones of a woman’s body. Start with the nape of her neck and slowly work your way down to her back, gently knead her breasts and play with her nipples, gently flick at them and manipulate them to erection. Get her to lie on her stomach and massage her inner thighs. Lovingly caress her buttocks and move your hands close to her valley of pleasure. She might be too shy to tell you, but her ultimate pleasure point would be dying for your attention. Gently, stroke her outer lips or the labia. Whatever, apprehensions or fears she may have had about sex will all disappear once your finger start creating magic in her nether regions. Never criticise her Remember, she has never felt a man’s body before, which essentially means that when she tries to explore your body you may not necessarily enjoy it. So let her hold your penis and fondle it, let her lick and nibble you and tickle you body. You may not find her amateurish attentions very arousing but don’t make her feel like an amateur in bed. If she does something right let her know how much you are enjoying it. Guide her fingers to your pleasure points and tell her what you would like a girl to do in bed. Being the more experienced partner you should be like her loving mentor, and teach her the intricacies of pleasuring a man. Make her touch herself While she may or may not have masturbated before, by getting her to touch herself you would be able to make her feel the unknown. Tell her how badly you want to see her masturbate. The idea is open her to own sexuality. Its time to penetrate When you think that she is finally ready to be penetrated, enter her as gently as possible. Also make sure that she is producing enough lubrication to facilitate the act. Keep your strokes slow and shallow and avoid pushing too deep during your first few strokes. If you are able to make her feel comfortable and safe, any pain that she may experience in the beginning will soon disappear, and be replaced by moans of ecstasy. The first time can be nerve racking for most men. Just remember how nervous you were when you had sex for the first time. So when your take your virginal girlfriend to bed for first time makes the experience as pleasurable for her as possible.

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MRI of Fetal Brain Development

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Insertion of a Palindrome TDC in the right internal jugular vein under ultrasound and fluoroscopic guidance at a restructured hospital in Singapore

fixation of a tibial fracture utilizing the Titanium Cannulated Tibial Nail

Wernicke's aphasia is a neurological disorder typically caused by stroke. It affects the Wernicke's region in the brain's left hemisphere which is reasoned to be responsible for processing of meaning, especially as it relates to verbal communication, hence the problems with speech witnessed in these patients

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