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Postpartum thyroiditis (PPT) is a destructive autoimmune disease occurring in the first year after delivery in women without a history of thyroid disease prior to pregnancy. Postpartum thyroiditis could cause transient or permanent thyroid disease. Three clinical presentations have been suggested for postpartum thyroiditis are as follows (1) transient hyperthyroidism (32% of patients), (2) transient hypothyroidism (43% of patients), and (3) transient hyperthyroidism followed by hypothyroidism and then recovery, which is the classic form of PPT (25% of patients). Postpartum thyroiditis is an autoimmune disease and associated with the presence of antibodies to thyroid peroxidase (TPO). Chances of developing postpartum thyroiditis in pregnant women who have positive TPO antibodies early in pregnancy are 30% to 52%. Postpartum thyroiditis could occur after the loss of a pregnancy at 5 to 20 weeks gestation. During pregnancy level of TPO antibodies naturally decreases due to the immunosuppressed state of pregnancy. Women who remain positive for TPO antibodies in the third trimesters of pregnancy will have an 80% chance of developing postpartum thyroiditis. Screening of high-risk women for developing postpartum thyroiditis, such as a positive test for antithyroid peroxidase antibody, history of postpartum thyroiditis, type 1 diabetes mellitus, is recommended by Endocrine Society clinical guidelines. High-risk women should be evaluated for serum TSH levels at three and six months postpartum.Epilepsy is a condition defined by the occurrence of two or more unprovoked seizures that happen at least 24 hours apart. These are typically associated with abnormal hypersynchronous discharges in the brain, resulting in clinical manifestations. An electroencephalogram (EEG) is a useful tool for recording the electrical activity from the cortex and the deeper brain structures. It is a useful tool for diagnosing and classifying various seizure types. Localization-related epilepsies, also known as focal epilepsies, refer to an abnormal neuronal activity arising from a localized focus and involve a limited portion of the cortex. When there is no associated impairment in consciousness, it is called a 'focal onset aware seizure' previously known as a simple partial seizure. When it is associated with impairment in consciousness, it is called a 'focal impaired awareness seizure,' earlier known as a complex partial seizure.Renal cell carcinoma (RCC) arises from the renal cortex or the renal tubular epithelial cells. It is classified into clear cell RCC (ccRCC), papillary RCC, and chromophobe RCC, accounting for about 85% of all the primary renal cancers. The other 15% constitutes for transitional cell carcinoma, Wilms tumor or nephroblastoma, tumors of the collecting ducts and renal sarcomas. They are heterogeneous diseases with different biology, genetics, and behavior. Overall, the incidence has been steadily increasing, and currently, it is the 7th most common cancer among men. Among the genitourinary cancers, RCC has the highest mortality rate. The increase in incidence could be attributed to incidental diagnosis. About 60% of the cases are detected incidentally.Herpetic infections have been well documented even in ancient Greek literature. Herpes viruses are large double-stranded DNA viruses. There are eight different types of herpes viruses affecting humans (human herpes virus (HHV)). Herpes simplex encephalitis is an acute or subacute illness associated with focal or global cerebral dysfunction caused by herpes simplex viruses belonging to either type 1(HSV-1) or type 2(HSV-2). The vast majority of herpes simplex encephalitis is caused by HSV-1, with HSV-2 constituting only less than 10%. Almost all of the herpes encephalitis beyond the neonatal period is caused by herpes simplex type 1(HSV-1), which is identified as the most common cause for fatal encephalitis, occurring in a sporadic and non-seasonal pattern across the globe. Herpes encephalitis in neonates could be either due to HSV-1 or HSV-2 though the latter is more common. HSV-2 can also cause encephalitis in immunocompromised patients. Herpes simplex 1 encephalitis (HSV-1) in adults is associated with significant morbidity and death despite treatment with antiviral therapy. Herpes simplex encephalitis is again a devastating disease in infants and children irrespective of treatment. Neonatal encephalitis caused by HSV-2 involves the brain more globally, and it results in more neurologic sequelae.Pulsus alternans, not to be confused with pulsus paradoxus or electrical alternans, is an arterial pulse with alternating strong and weak beats. Systolic pressures will vary from beat-to-beat as identified on physical exam and echocardiogram. Pulsus alternans is found in the setting of severe ventricular dysfunction and other forms of cardiac pathology. Variations of pulsus alternans include left ventricular alternans, right ventricular alternans, and biventricular alternans. The treatment and clinical outcomes for pulsus alternans vary depending upon the underlying causative etiology, though its presence generally suggests a poor prognostic outlook.Infectious endocarditis is the inflammation of the endocardium, the inner lining of the heart, as well as the valves that separate each of the four chambers within the heart. It is primarily a disease caused by bacteria and has a wide array of manifestations and sequelae. Without early identification and treatment, a myriad of intracardiac and far-reaching extracardiac complications can develop. Therefore, careful evaluation, including a thorough history and physical exam, can help diagnoses cases and guide management, limiting mortality and morbidity.Initially described by Hildebrand in 1895, Warthin tumor (also known as cystadenolymphoma), is a benign and frequent salivary gland neoplasm. It represents about 2% to 15% of all primary epithelial tumors of the parotid gland. Extra-parotid Warthin tumor is very rare and may occur in the periparotid lymph node, nasopharynx, eyelid, and oral cavity. Warthin tumor is histologically characterized by a dense lymphoid stroma and a double layer of oncocytic epithelium with a papillary and cystic architectural pattern. Its etiology remains controversial.The inguinal lymph node can be subdivided into the superficial and deep lymph nodes and collectively drains the anal canal(below the pectinate line), the skin below the umbilicus, lower extremity, scrotum, vulva, glans penis, and clitoris. The lymph node's primary function is to filter for harmful substances as lymphatic fluids travel through its cortex, paracortex, and medulla. LY-188011 Clinical signs of inguinal lymphadenopathy can help to clue physicians in possible diagnoses of sexually transmitted diseases such as syphilis, chancroid, and lymphogranuloma venereum. The lymph node can also serve to assist in the diagnosis of cancer.Allergic contact dermatitis (ACD) occurs after repeated exposure to an irritant or allergen. ACD is the most frequent occupational skin disease. It is based on a delayed-hypersensitivity reaction and can result from contact with metals, most commonly nickel. The metals that most frequently cause these reactions can be found in a variety of everyday items (e.g., kitchen tools, watches, earrings, bracelets), medical devices, and industrial applications.The sympathetic autonomic nervous system (SANS) is spatially and pathophysiologically related to both acute and chronic pain. Acute generalized sympathetic activation, as occurs with the stress response, can temporarily increase the nociceptive threshold via a combination of neural and endocrine effects. Given its trophic and immunomodulatory function, the SANS can exert pro-inflammatory and pro-nociceptive effects, particularly at the tissue level. Blocking regional sympathetic efferent activity can indirectly relieve ischemic pain. Similarly, a regional blockade of sympathetic activity can directly interrupt nociceptive transmission of pain from internal organs, as most general afferent visceral fibers travel with sympathetic nerves. link2 The SANS may pathologically evolve into a major contributor of pain (“sympathetically mediated pain”), as occurs in the case of complex regional pain syndrome (CRPS). Selective interventional blockade of sympathetic pathways is commonly used to treat ischemic pain or sympathetically mediated pain. Most large sympathetic ganglia and plexi are anatomically separate from somatic nerves in prevertebral and paravertebral regions, and thus are readily accessible to percutaneous interruption. When indicated, sympathetic blocks can provide significant analgesia without causing somatic sensory deficits; but blockade of visceral sympathetics will shift the homeostatic balance in the target region toward parasympathetic prevalence, with corresponding physiologic effects.The rooting reflex is one of the involuntary primitive motor reflexes, which are also known as the frontal release reflexes, that are mediated by the brainstem. It initiates when the corner of an infant’s mouth is stimulated. When the mouth is touched or stroked, the newborn will turn his or her head towards the stimulus and open the mouth with tongue thrusting. The rooting reflex is present at birth (approximately 28 weeks) and lasts about 4 to 6 months until the frontal lobe of the cerebral cortex develops and suppresses the primitive motor reflexes. As the frontal lobe matures, the primitive reflexes are replaced with voluntary motor functions. The age when each primitive reflex disappears varies. For example, the plantar grasp reflex disappears after about 9 to 12 months.The nasopharynx represents the most superior portion of the pharynx, bounded superiorly by the skull base and inferiorly by the soft palate. The nasopharynx connects the nasal cavity to the oropharynx and contains the Eustachian tube openings and adenoids. link3 Notable clinical situations include nasopharyngeal carcinoma and adenoidal hypertrophy. This review will discuss the anatomy of the nasopharynx, including the structure, function, embryology, blood supply, innervation, anatomical variants, and clinical relevance.The application of the knowledge on dihydrotestosterone-related processes spans from the prenatal development of organs to the aging-related complications in males. A clinician can single-handedly tackle the issues that occur out throughout the age spectrum. This hormone finds its utility as an essential hormone in males until puberty, after which it is considered an etiology for certain diseases. The dual function of this hormone places it in the basic science and applied field of medicine. This article aims to outline the basic biochemistry of the hormone, its physiological functions at different stages of development, and its role in certain pathological conditions.Auditory hallucinations are the sensory perceptions of hearing voices without an external stimulus. This symptom is particularly associated with schizophrenia and related psychotic disorders but is not specific to it. Auditory hallucinations are one of the major symptoms of psychosis. Nonpsychotic disorders known to be associated with auditory hallucinations are mood disorders, trauma-related, substance-related, neurological, personality, as well as their occurrence in "healthy" individuals. It is essential to recognize the disorders associated with the symptom of auditory hallucinations to treat the underlying cause. These voices can be distressful when they are threatening, derogatory, commanding, or haunting, affecting the social and occupational functioning of an individual. They can be distressing to families and friends. Even though many individuals attain full remission, a good number live with these harmful voices, thereby sirening for a close follow up with an elaborate interprofessional team with the objective of providing holistic treatment.