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The task of a psychiatrist is to select the most appropriate medication or combination of drugs to treat the symptoms of schizophrenia while minimizing the risk of side effects and ensuring the patient achieves the highest level of functioning possible. This is a challenging task as the action of each drug or group of drugs is different. The efficacy of cariprazine, which affects D3 receptors as a D3/D2 receptor partial agonist, has been extensively studied and is one of the first medication choices by practicing psychiatrists when treating patients with negative symptomatology. In this clinical case, we demonstrate the effective and safe treatment of a patient's positive and affective symptoms using a combination of cariprazine, clozapine, and venlafaxine. [ABSTRACT FROM AUTHOR]

Background. Hemophagocytic Lymphohistiocytosis (HLH), characterized by uncontrolled activation of immune cells leading to a hyperinflammatory state, is seldom considered in the initial differential diagnosis of FUO. The rarity of idiopathic HLH, especially in young individuals without an identifiable trigger, emerges as an uncommon and particularly challenging diagnosis. This case report presents a compelling narrative of a young female grappling with the complexities of FUO, ultimately revealing the rare and life-threatening entity of idiopathic HLH. Case report. A 25 year old female was referred to our hospital in view of persistent high grade fever since 3 months. Patient has no other complaints. Vitals stable. General and systemic examination normal. Lab investigations showed a total leukocyte count 18000 cell/μL, hemoglobin 9.2 g/dL, and platelets 68000 cells/μL. Other blood investigations showed erythrocyte sedimentation rate (ESR) 88 mm/h, C-reactive protein 21 mg/L, ferritin 670 ng/mL, triglyceride 281 mg/dL, and fibrinogen 1.2g/L. She also had transaminitis with AST 80, ALT 92 and ALP 1442. The entire infectious diseases panel was done which came negative for all, including viral serologies and hepatitis markers. Procalcotonin level was normal and no other relevant investigations came positive. Autoimmune panel analysis also came negative. Blood cultures came negative in two different samples. Also, there is no evidence of vegetation in echocardiography. Coming to the invasive investigations, bone marrow biopsy and aspiration were done to arrive at a diagnosis and it showed Hemophagocytosis. Endoscopy and colonoscopy were done, which came normal. CT thorax and abdomen also showed no significant abnormality, ruling out the probability of missing any gross malignancies. After all this extensive work up and according to Hscore, which is used to estimate an individual’s risk of having reactive hemophagocytic syndrome, this patient was diagnosed with HLH. According to the current HLH guidelines, initial treatment for the disease consists of etoposide, corticosteroids (dexamethasone), or cyclosporine is given for 8 weeks. The patient was started on the same above treatment regimen, but only with corticosteroids for a period of 8weeks, after consultation with Hematologist. No recurrence is seen in her 6-months of follow-up. The regimen was well tolerated by the patient. Studies also have shown that therapeutic plasma exchange also has a role in HLH treatment, which can be tried in familial and relapsing cases. Conclusion. In our case, this young female was diagnosed to have Idiopathic HLH, after ruling out all the familial and secondary causes of HLH including Infections, Malignancy and Autoimmune diseases. The patient was also started on treatment early after the bone marrow and other relevant investigations according to HScore suggested the diagnosis of HLH and the patient improved accordingly. Hence, apart from clearly knowing the etiology or clinical manifestations, HLH is associated with a high mortality rate if appropriate treatment not given. Generally, the underlying etiology determines the prognosis of the disease. But, it is not a good idea to delay the treatment in order to find the cause and type of HLH, because the exhaustive work up might lead to unacceptable delays in improvement and prognosis of the patient. The diagnostic work up and treatment should be done simultaneously in the patient, which has been done in our case and it lead to a good outcome. Though HLH is a fatal and dangerous disease and also highly challenging to make a diagnosis due its uncommon and largely variable clinical presentation, smart work up and early initiation of treatment will lead to better prognostic outcome. [ABSTRACT FROM AUTHOR]

The task of a psychiatrist is to select the most appropriate medication or combination of drugs to treat the symptoms of schizophrenia while minimizing the risk of side effects and ensuring the patient achieves the highest level of functioning possible. This is a challenging task as the action of each drug or group of drugs is different. The efficacy of cariprazine, which affects D3 receptors as a D3/D2 receptor partial agonist, has been extensively studied and is one of the first medication choices by practicing psychiatrists when treating patients with negative symptomatology. In this clinical case, we demonstrate the effective and safe treatment of a patient’s positive and affective symptoms using a combination of cariprazine, clozapine, and venlafaxine.

Purpose: To explore the process of coping with financial toxicity among young women with breast cancer and formulate a grounded theory that serves as a foundation for creating intervention strategies aimed at supporting cancer survivors. Methods: A qualitative study using the Corbin and Strauss variant of grounded theory. A series of in-depth interviews were carried out with young women with breast cancer (n = 29) using the theoretical sampling method. We analyzed data by coding core categories in the patients’ coping processes and developing theory around these categories. Data collection and analysis were performed simultaneously. Results: A substantial theory of the process of coping with financial toxicity among young female breast cancer survivors was constructed. Two core concepts, suffering and adjustment, were identified. Young women with breast cancer suffered from financial toxicity, which was related to risk factors, coping resources, and unmet needs. To overcome financial toxicity, young women with breast cancer adjusted by reshaping consumption concept, re-dividing of family functions, re-planning of occupation career, and rebuilding life confidence. Conclusion: This qualitative study constructed a theory delineating the coping strategies employed by young women with breast cancer in response to financial toxicity, offering profound insights into the intricacies of cancer-related financial toxicity. Identifying risk factors, enhancing coping resources, and meeting unmet needs would be helpful to patients’ adjustment to financial stress. [ABSTRACT FROM AUTHOR]

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Abstract Purpose We investigated endometrial hyperplasia (EH) and endometrial endometrioid cancer (EEC) and developed a nomogram model to predict the EH/EEC risk and improve patients’ clinical prognosis. Methods Data were collected from young females (age: ≤ 40 years) who complained of abnormal uterine bleeding (AUB) or abnormal ultrasound endometrial echoes. The patients were randomly divided into training and validation cohorts at a 7:3 ratio. The risk factors for EH/EEC were determined through the optimal subset regression analysis and a prediction model was developed. We used the concordance-index (C-index), and calibration plots in the training and validation sets to assess the prediction model. We drew the ROC curve in the validation set and calculated the area under the curve (AUC), as well as its accuracy, sensitivity, specificity, negative predictive value, and positive predictive value, and finally, converted the nomogram into a web page dynamic nomogram. Results Predictors included in the nomogram model were body mass index (BMI), polycystic ovary syndrome (PCOS), anemia, infertility, menostaxis, AUB type, and endometrial thickness. The C-index of the model in the training and validation sets were 0.863 and 0.858. The nomogram model had good discriminatory power and was well-calibrated. According to the prediction model, the AUC of EH/EC, EH without atypia, and AH/EC were 0.889, 0.867, and 0.956, respectively. Conclusions The nomogram of EH/EC is significantly associated with risk factors, namely BMI, PCOS, anemia, infertility, menostaxis, AUB type, and endometrial thickness. The nomogram model can be used to predict the EH/EC risk and rapidly screen risk factors in a women population with high risk.

This article discusses a case report and literature review of bilateral vertebral artery dissection, a condition that can contribute to strokes in young adults. The article explains that spontaneous vertebral artery dissection is less common but increasingly recognized as a cause of strokes in individuals under 45 years of age. The case report describes a 28-year-old female who initially presented with severe unilateral headache and neck pain, which was later diagnosed as bilateral vertebral artery dissection. The article emphasizes the importance of timely diagnosis and appropriate management in preventing severe complications and improving patient outcomes. It also discusses the causes, diagnostic evaluation, and treatment options for vertebral artery dissection. [Extracted from the article]

Aims and Objectives: The aim of this study was to describe the prevalence of reproductive concerns among young female patients with colorectal cancer and explore the associated factors. Background: With the trend of longer survival and younger age at diagnosis of colorectal cancer patients, reproductive concerns have become increasingly prevalent among young female colorectal cancer patients. Design: Cross‐sectional design. Methods: The study included 150 young female patients with colorectal cancer who completed cancer treatment at 2 hospitals in Guangzhou, China, between November 2020 and December 2021 completed an investigation comprising A general questionnaire, The Reproductive Concerns After Cancer scale, The Family Adaptation and Cohesion Evaluation Scale II and unmet fertility information needs questionnaire. Multivariable linear regression analysis was performed in order to identify factors that influence reproductive concerns. This study was prepared and is reported according to the STROBE checklist. Results: The mean (SD) score on the Reproductive Concerns After Cancer scale was 54.78 ± 8.97. The highest score was for the children's health subscale (3.84 ±.92) and the lowest was for acceptance (2.24 ±.70). Multiple regression analysis showed that patients with fewer children, female children, lower education level (less than undergraduate degree), earlier disease stage, lower family function and higher unmet need for fertility information had more reproductive concerns, which explained 26.9% of the total variation of the model. Conclusions: The patients with fewer children, female children, low cultural degree (less than bachelor), early clinical patients, poorer family function and higher unmet fertility information needs had higher reproductive concerns. Relevance to clinical practice: These findings can guide the development of interventions to mitigate reproductive concerns, including understand and meet their fertility information needs, improve the level of family function. Patient or public contribution: Survey questionnaires were completed by participants among young female with colorectal cancer in this study. [ABSTRACT FROM AUTHOR]

Key Clinical Messages: The diagnosis of polyserositis due to tuberculosis (TB) is complex and challenging, which may cause delays in treatment. TB should be ruled out first before attributing polyserositis to any other cause like hypothyroidism, particularly in high TB burden countries. Polyserositis has numerous causes and frequently occurs in neoplasia, autoimmune disorders, endocrine conditions like hypothyroidism, and infectious diseases like tuberculosis (TB). The diagnosis of TB polyserositis is complex and challenging, which may cause the start of definitive therapy to be delayed. Here, we report the case of a 32‐year‐old female patient who presented with abdominal distension for 3 weeks associated with shortness of breath, cough, excessive fatigue, and loss of appetite. Thyroid function tests were suggestive of primary hypothyroidism, and later on, sputum GeneXpert MTB/RIF test turned out to be positive. She was initially started on oral levothyroxine and then anti‐TB medications. The polyserositis resolved a month after the initiation of anti‐TB drugs. TB should be ruled out first before attributing polyserositis to any other cause like hypothyroidism, particularly in high TB burden countries. Microbiologic tests, such as GeneXpert, remain the most important tools to make a diagnosis of TB and start anti‐TB medications early. [ABSTRACT FROM AUTHOR]

Purpose: Mammary Paget's disease (PD) in young women has seldom been reported. The aim of this study was to improve the knowledge of the clinicopathological characteristics in young patients with PD to provide a basis for the precise treatment of young patients. Methods: The medical records and pathological slides of 8 young patients (younger than 40 years old) with PD were reviewed. The data of 20 patients over 40 years old within the same period were used as controls. Results: The average age was 32.00 ± 3.96 years for the young patient group, with the youngest aged 27 years. The first symptom, physical examination, Paget cell morphology, and immunohistochemical marks were the same in different age groups. But young patients have varied tumor distribution patterns, fewer interstitial inflammatory cells, and advanced pathological local lymphatic metastasis than older patients in the same period. Conclusions: PD in young women has unique histopathological features. These manifestations seem to provide personalized treatment for PD treatment in young patients. More research is needed to clarify the significance of this research. [ABSTRACT FROM AUTHOR]

Key Clinical Messages The diagnosis of polyserositis due to tuberculosis (TB) is complex and challenging, which may cause delays in treatment. TB should be ruled out first before attributing polyserositis to any other cause like hypothyroidism, particularly in high TB burden countries. Abstract Polyserositis has numerous causes and frequently occurs in neoplasia, autoimmune disorders, endocrine conditions like hypothyroidism, and infectious diseases like tuberculosis (TB). The diagnosis of TB polyserositis is complex and challenging, which may cause the start of definitive therapy to be delayed. Here, we report the case of a 32‐year‐old female patient who presented with abdominal distension for 3 weeks associated with shortness of breath, cough, excessive fatigue, and loss of appetite. Thyroid function tests were suggestive of primary hypothyroidism, and later on, sputum GeneXpert MTB/RIF test turned out to be positive. She was initially started on oral levothyroxine and then anti‐TB medications. The polyserositis resolved a month after the initiation of anti‐TB drugs. TB should be ruled out first before attributing polyserositis to any other cause like hypothyroidism, particularly in high TB burden countries. Microbiologic tests, such as GeneXpert, remain the most important tools to make a diagnosis of TB and start anti‐TB medications early.

The terms “free air or gas located within the mediastinum and subcutaneous tissue that are not associated with any obvious causes, such as chest trauma,” are used to characterise spontaneous pneumomediastinum (SPM) and subcutaneous emphysema (SE). SPM has been linked to a variety of illnesses and causes, including bronchial asthma, diabetic ketoacidosis, strenuous exercise, strenuous coughing, medication intake, and other actions involving the Valsalva maneuver. We describe a case of spontaneous cervical, retropharyngeal, and mediastinal emphysema in a young female who was previously healthy. She was brought into the ward for observation, vital sign monitoring, analgesics, and prophylactic antibiotics. She started taking analgesics, preventative antibiotics, and 100% oxygen throughout that period to help with absorption. The neck pain gradually subsided, and there were no bouts of oxygen desaturation or abnormal vital signs. After subsequently getting better, the patient went home. The patient was examined in an outpatient clinic two weeks after being discharged and shown no signs of illness. To sum up, subcutaneous emphysema and pneumomediastinum are uncommon presentations seen in the emergency room, but they are typically self-limiting.

Purpose: Mammary Paget's disease (PD) in young women has seldom been reported. The aim of this study was to improve the knowledge of the clinicopathological characteristics in young patients with PD to provide a basis for the precise treatment of young patients. METHODS: The medical records and pathological slides of 8 young patients (younger than 40 years old) with PD were reviewed. The data of 20 patients over 40 years old within the same period were used as controls. RESULTS: The average age was 32.00 ± 3.96 years for the young patient group, with the youngest aged 27 years. The first symptom, physical examination, Paget cell morphology, and immunohistochemical marks were the same in different age groups. But young patients have varied tumor distribution patterns, fewer interstitial inflammatory cells, and advanced pathological local lymphatic metastasis than older patients in the same period. CONCLUSIONS: PD in young women has unique histopathological features. These manifestations seem to provide personalized treatment for PD treatment in young patients. More research is needed to clarify the significance of this research. [ABSTRACT FROM AUTHOR]

Abstract Venous thromboembolism has many risk factors including protein S deficiency, which poses a significant diagnostic challenge as it presents with atypical complaints. A treatable yet potentially fatal condition, acute pulmonary embolism, is currently third most common cause of cardiovascular death. Clinicians should include pulmonary embolism as differential diagnosis in young adults with atypical symptoms with 2 D ECHO findings of the dilated right atrium, right ventricle, and elevated pulmonary artery pressure, and diagnosis is confirmed by computed tomography pulmonary angiography (CTPA). Anticoagulants including NOACs should be initiated promptly to improve the outcome for patients.

Abstract Background Cystitis glandularis a rare benign proliferative disease of the urinary bladder mucosa is usually a microscopic finding and manifests rarely as a large visible macroscopic lesion of urinary bladder. Only few cases of cystitis glandularis presenting as urinary bladder mass in female patients have been reported in the literature. We are reporting a case of cystitis glandularis presenting as a urinary bladder mass in a very young female patient. Case presentation. Our patient, a young female 25 years of age presented in the Urology OPD with complaints of irritative lower urinary tract symptoms for two years and intermittent hematuria for one year. On evaluation, she was found to have a urinary bladder mass. Transurethral resection of her urinary bladder mass was done and on histopathological examination, it came out to be cystitis glandularis. Conclusion Clinical presentation of cystitis glandularis is variable. It may remain asymptomatic or could present as irritative lower urinary tract symptoms, hematuria, or mucus in the urine. It is normally a microscopic finding but could also present as an overt urinary bladder mass however this has been reported rarely in the literature.

In this case report, a 23-year-old female presented to the Emergency Department with complaints of abdominal pain, weight loss, progressive headaches, and an episode of seizure-like activity. Computerized tomography abdomen/pelvis revealed multilobulated ovarian masses and scattered peritoneal thickening. A brain Magnetic resonance imaging was ordered and demonstrated a peripherally enhancing intracranial mass. The brain lesion was resected and pathology revealed necrotizing granulomatous inflammation. Cultures were positive for acid fast bacilli. The patient was diagnosed with tuberculosis and treated with multidrug therapy. Upon further questioning, the patient had recently traveled to a tuberculosis endemic region. This case highlights the importance of an in-depth history and physical exam as a means to a more complete differential diagnosis considering the age of the patient and the findings on imaging.

Study aim: The aim of the current study is to explore the effect of obesity on spatiotemporal parameters of gait in obese young female students.

Stroke is one of the most severe complications of nephrotic syndrome (NS) which causes severe mortality and morbidity and patient initially presenting with stroke is rare. Here, we describe a case in which an 18-year-old female presented with ischemic stroke as an initial complication of membranous nephropathy (MN). Renal biopsy showed features of MN. This case illustrates that it is important to diagnose MN and anticoagulated this high-risk group of patients before they develop severe complications. There are only a few cases in the literature where the initial presentation of MN is ischemic stroke and it occurs in a young female patient with no risk factors apart from NS.

This paper mainly evaluates the road space adaptability of the streets around Wangjing East Metro Station (hereinafter referred to as "Wangjing East Station"), and studies the impact of the road space adaptability of Wangjing East Street on the walking activities of young female residents. Through literature survey, POI data analysis and street view photo scoring, the street characteristics that young female residents are suitable for walking and like walking are analyzed. The paper includes 3 parts: determination of functional types of streets around Wangjing East Station; the characteristics of young women's group walkability activities and the establishment of evaluation system; spatial adaptability assessment of the existing roads around Wangjing East Station. [ABSTRACT FROM AUTHOR]

Background: Given the mortality benefit of low-dose computed tomography (LDCT) screening on high-risk populations, the retrospective investigation intended to identify the benefits of LDCT on lung cancer screening among the general demographic cohorts. Methods: We used an opportunistic screening with LDCT implemented during the pandemic in Wuhan to study the impact on subsequent thoracic surgeries, especially surgeries for lung cancer. Patients who received LDCT from October 1, 2019, to July 31, 2020, in three Triple-A accredited hospitals in Wuhan were included in the study. Relative week volumes of both surgeries before and after the chest LDCT screening were compared pairwise. The counts of surgeries for pulmonary nodules or masses, and corresponding pathological results among different gender and age groups were also compared. Result: The relative weekly volumes of thoracic surgery were significantly greater than those of stomach surgery after the opportunistic screening with LDCT. They were 33% (95% CI, 0.20-0.46; p<0. 001) higher than those of stomach surgery. For every 1,000 chest LDCT scans conducted in a given week, on average, 3.52(95% CI,0.56-6.49, p =0.03) thoracic surgeries were performed in the following week. After the implementation of opportunistic screening with LDCT, there was a higher percentage of young females with pulmonary nodule or mass (64.4% vs. 45.8%, p = 0.032). The fraction of lung cancer surgery in the treatment period was significantly greater than that in the control period (74.09% vs. 68.79%, p=0.007). There was a higher percentage of stage I lung cancer surgery in young and mid-age females than in the senior age group (64% vs. 53%, p= 0.05). Interpretation: Opportunistic screening with LDCT can advance the early diagnosis window of lung cancer in non-high-risk populations, especially young women who are easy to be ignored. [ABSTRACT FROM AUTHOR]

To improve the classification method of body type, 103 young female college students in Jiaodong area(Shandong, China) were measured by a 3D body scanning system, and variables of upper body parts were selected and analyzed by SPSS software. According to the indices such as the chest ratio, the chest sagittal diameter ratio, and the shoulder angle, the tested population was quickly clustered into six categories by the classification method of “size feature+shape index+front and back indices”, which were divided into flat chest body, graceful body, breast augmentation body, normal body, convex back body, and flat body. The proportion of various body types and classification rules were obtained. According to the classification rules, 103 samples and 15 new females’ body data were analyzed and verified. Finally, according to the descriptive statistical analysis of upper body-related indicators of young female in this area, the height and the chest circumference were selected as independent variables, regression analysis was carried out on 11 related indicators, and the mapping relationship between height and chest circumference was studied, which provided a mathematical model for the design of fit clothing structure of young females in Jiaodong area. [ABSTRACT FROM AUTHOR]

BackgroundGiven the mortality benefit of low-dose computed tomography (LDCT) screening on high-risk populations, the retrospective investigation intended to identify the benefits of LDCT on lung cancer screening among the general demographic cohorts.MethodsWe used an opportunistic screening with LDCT implemented during the pandemic in Wuhan to study the impact on subsequent thoracic surgeries, especially surgeries for lung cancer. Patients who received LDCT from October 1, 2019, to July 31, 2020, in three Triple-A accredited hospitals in Wuhan were included in the study. Relative week volumes of both surgeries before and after the chest LDCT screening were compared pairwise. The counts of surgeries for pulmonary nodules or masses, and corresponding pathological results among different gender and age groups were also compared.ResultThe relative weekly volumes of thoracic surgery were significantly greater than those of stomach surgery after the opportunistic screening with LDCT. They were 33% (95% CI, 0.20-0.46; p

Adenocarcinoma of lung remains the commonest subtype of lung cancer. Despite of recent advances, the presentation of carcinoma of lung is delayed many of the times until later stages. Here is a case of a young pregnant female with adenocarcinoma of lung with brain metastasis with unusual presentation.

Objective: Investigate imaging follow‐up patterns and assessment of malignancy rate of BI‐RADS 3 lesions in women younger than 30 years. Methods: We retrospectively reviewed consecutive studies between January 1, 2013 and January 1, 2015 with BI‐RADS 3 assessment in women <30 years. Lesion size, follow‐up rate, and biopsy rate were recorded. Completion of 24‐month imaging follow‐up or biopsy determined the endpoint. Statistical analysis of follow‐up rates and biopsy timing was performed. Results: Of 2525 BI‐RADS 3 lesions, 278 were identified in 215 women <30 years. Fifty‐two (24%) women underwent a biopsy which was more frequently done at patient request than for lesion growth [33 (63.4%) versus 19 (36.5%), P <.01]. The odds of having biopsy upfront was significantly higher in lesions >2 cm in diameter (OR: 4.4 [95% CI 2.1–9.4], P <.01). The malignancy rate in our cohort was 0% (95% CI 0–1.7%). Of the 188 women expected for follow‐up imaging, 58 (30%) were lost to follow‐up, while 103 (55%) had 6‐month follow‐up, 74 (39%) 12‐month follow‐up, and 56 (30%) 24‐month follow‐up. Conclusions: BI‐RADS 3 lesions identified in our cohort had high biopsy rates and low compliance with no cancers. Our findings suggest that probable fibroadenomas in young women may only warrant abbreviated short‐term follow‐up at 6‐months. Access the CME test here and search by article title. [ABSTRACT FROM AUTHOR]

Background: Insufficient sleep duration and unhealthy diet are associated with weight gain. However, little is known about the association of sleep quality with dietary intake and obesity. The aim of the present study was to compare dietary intake and anthropometric indices between good and poor sleepers. Methods: In this cross-sectional study, a total of 260 femles youth aged 18-30 years were recruited among the students of Qazvin University of Medical Sciences. The evaluated variables consisted of sleep quality, dietary intake, and anthropometric indices. Statistical analysis was performed using SPSS version 21.0. Results: Participants in the poor quality sleep group had higher intakes of calorie (P < 0.001) and carbohydrate (P < 0.001), and lower protein intake (P < 0.01) in comparison with good sleepers. Regarding food groups, poor sleepers had higher intake of bread-grains (P = 0.02) group, but lower intake of meat-alternatives (P < 0.001), vegetables (P < 0.001), and fruits (P < 0.001) in comparison with the good sleepers. Participants in the poor quality sleep group had higher weight (P < 0.001), body mass index (P < 0.001), waist circumference (P < 0.001), and fat mass (P < 0.001) in comparison with good sleepers. Conclusion: Our findings emphasize the relationship of poor quality sleep with unhealthy dietary intake and obesity in young female women

Abstract Background The majority of breast lesions in women under 25 years are being benign. Imaging is important for diagnosis and selecting patients for further procedures. Although malignancy is rare in this group of patients, suspected lesions must be biopsied. Imaging is very important in the selection of patients for radiological intervention. Understanding of the clinical, pathologic, and imaging features allows the radiologist to guide proper management of these patients. The aim of this study was to determine the frequency of different breast lesions in symptomatic women under 25 years and the value of radiological imaging in the diagnosis. Results This was a retrospective study; a total number of 250 cases with breast lumps under 25 years of age were registered in the PACKS of our institution in the period from January 01, 2017 to December 31, 2018. Two hundred three cases coped with our inclusion criteria that include available histopathological results either by biopsy or after surgery based on their referring physicians decision. Our exclusion criteria were those cases (47) with definite BIRADS 2 lesions with no available pathology reports. Ultrasonography was done to all patients (203 cases) and MRI was performed to 26 cases. All cases were histologically verified; their findings were reviewed and compared to radiological findings. A total of 203 symptomatic breast lesions were received at the radiological department in women under 25 years; there were 115 (56.7%) benign, 85 (41.9%) cystic, and 3 (1.5%) malignant lumps. The commonest benign lesion was fibroadenoma (104 cases, 51.2%) and all the malignant lesions were invasive ductal carcinoma (IDC) (3 cases, 1.47%). The p value is > 0.05, so there were no differences between examination using the ultrasonography and the MRI imaging compared to histopathological results. Conclusions Most breast lesions in young women are benign. Ultrasonography is an essential first imaging modality in the diagnosis of women under 25 years with breast lesions.

Aortitis is a general term that describes inflammation of the aorta. In most cases, this inflammation is caused by an autoimmune etiology or an infectious etiology. In some instances, the underlying etiology may not be clear, and the diagnosis given is idiopathic aortitis. Cases of idiopathic aortitis are usually diagnosed based on histopathologic findings. Here, we present a case involving a 31-year-old female presenting with acutely worsening exertional shortness of breath and left-sided chest pain. An echocardiogram revealed a severely reduced ejection fraction with severe aortic regurgitation and diffusely increased aortic intima-media thickness. Bioprosthetic aortic valve replacement was performed with histology, showing findings consistent with aortitis, and the patient received the diagnosis of idiopathic aortitis. This case highlights the need to consider aortitis as a differential in young patients presenting with exertional chest pain and severe aortic insufficiency., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Raizada et al.)

Hepatocellular adenomas are rare and benign primary neoplasms of phenotypically mature hepatocytes. Our understanding of this pathology has greatly improved due to advances in molecular and anatomic knowledge. This article provides an in-depth review of hepatic adenomas (HCA) while presenting the case of a 20-year-old patient with a giant inflammatory hepatocellular adenoma with an atypical presentation, in whom surgical intervention was performed via right hepatectomy. In the post-surgical course, the patient had an in-hospital stay of three days with no complications. During outpatient monitoring via laboratory tests and imaging at eight months, the patient did not present any trace of recurrence., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Arias Rivera et al.)

This paper explores learning trajectories in becoming 'rural women' in Sweden, by using a biographical and socially-situated learning perspective. The data is based on in-depth biographical interviews with three young women who moved between rural and urban areas, and finally decided to return to a rural area. The findings show three learning phases: the mythical, the questioning and the self-positioning phase. Furthermore, the paper identifies four types of learning spaces of urban and rural areas: an imagined, a career-related, a cultural-emotional and a biographical learning space. The paper offers valuable insights about everyday life learning and identity development in young adulthood, and how stereotypes of rural areas negatively impact on young adults' views of themselves and their life choices.Keywords: young female, rural/urban dived, countryside returnees, learning space and trajectories, biographical learning. [ABSTRACT FROM AUTHOR]

Apolipoprotein B100 (ApoB100) is a glycoprotein and a member of the adipokine family. It plays a central role in lipoprotein metabolism. Many research studies have revealed a strong relation between ApoB100 and metabolic syndrome (MetS) and insulin resistance. In our research, we examined the relationship between ApoB100 rs693 gene polymorphism, body mass index (BMI) and the probability of MetS in young female students studying at King Abdulaziz University (KAU) in Saudi Arabia. The study group comprised 141 females whose ages ranged from 18 to 25 years. Anthropometric measurements and biochemical parameters were measured alongside a genetic analysis of ApoB100 rs693. The BMI, glucose concentration and total cholesterol level were found to be significantly associated with the ApoB100 rs693 gene. The differences noted between control and MetS groups regarding glucose concentrations were statistically significant (P = 0.001). A growing number of young females are being diagnosed with MetS in KAU because of unhealthy eating habits, in combination with the absence of physical exercise, causing increased body weight and the potential progression of chronic diseases. Our study showed that the allele associated with hypertensive individuals at ApoB100 rs693 and MetS may have a direct genetic influence. Further research on expanded sample sizes, however, is required in order to draw rigid conclusions. [ABSTRACT FROM AUTHOR]

Abstract Reversible cerebral vasoconstriction syndrome is a cerebrovascular disorder leading to multifocal arterial constriction and dilation. Reversible cerebral vasoconstriction syndrome is possibly caused by transient deregulation of cerebral vascular tone. We report a rare case of a patient with chief complain of postpartum headache, was later diagnosed as a case of reversible cerebral vasoconstriction syndrome. A young full term primigravida with good uterine contraction admitted to labour room. Later she complained of leaking per vagina and on examination meconium stained liquor was noted. Caesarean delivery under spinal anesthesia was done and intra-operative period was uneventful. Both mother and baby were normal and shifted to postoperative ward and nursery respectively. In postoperative ward, mother complained of severe headache after 1 h and later developed seizure. Midazolam was given intravenously and was intubated and transferred to critical care unit for further investigation and management. Non contrast computerised tomography scan of brain showed right occipital intracerebral as well as subarachnoid bleed. CT angiography showed right vertebral artery narrowing without any other vascular malformation. Patient was managed in critical care unit for 2 days and then extubated and shifted to high dependency ward after a day observation and discharged 3 days later after a full uneventful recovery.

Abstract Background Non-parasitic splenic cysts are associated with elevated serum carbohydrate antigen (CA) 19–9 levels. We report a case in which a 23-year-old female exhibited a large ruptured splenic cyst and an elevated serum CA19–9 level. Case presentation The patient, who experienced postprandial abdominal pain and vomiting, was transferred to our hospital and was found to have a large splenic cyst during an abdominal computed tomography (CT) scan. On physical examination, her vital signs were stable, and she demonstrated rebound tenderness in the epigastric region. An abdominal CT scan revealed abdominal fluid and a low-density region (12 × 12 × 8 cm) with enhanced margins in the spleen. The patient’s serum levels of CA19–9 and CA125 were elevated to 17,580 U/mL and 909 U/mL, respectively. A cytological examination of the ascitic fluid resulted in it being categorized as class II. Finally, we made a diagnosis of a ruptured splenic epidermoid cyst and performed laparoscopic splenic fenestration. The patient’s postoperative course was uneventful, and she was discharged on postoperative day 5. The cystic lesion was histopathologically diagnosed as a true cyst, and the epithelial cells were positive for CA19–9. Follow-up laboratory tests performed at 4 postoperative months showed normal CA19–9 (24.6 U/L) and CA125 (26.8 U/L) levels. No recurrence of the splenic cyst was detected during the 6 months after surgery. Conclusion Laparoscopic fenestration of a ruptured splenic cyst was performed to preserve the spleen, after the results of abdominal fluid cytology and MRI were negative for malignancy.

Breast cancer is common among females worldwide and is most commonly reported in women aged 30–40 years and less commonly in those aged

Hemoptysis is a common respiratory symptom. One of the most common cause for hemoptysis in India is pulmonary tuberculosis. Pulmonary tuberculosis is more common in young and usually present with fever, cough and hemoptysis. Chest x ray usually shows upper lobe lesions. When sputum examination for AFB smear is negative and chest radiology is not typical of tuberculosis further investigations are indicated for definitive diagnosis. We report a rare case of pleomorphic carcinoma of lung in a young female mimicking pulmonary tuberculosis. Definitive diagnosis was established by biopsy from the lung lesion.

Background: Hemolacria is a rare condition that is characterized by the presence of blood in tears. It is a rare condition due to which insufficient literature and resources are present. Therefore, its prevalence and predilection for a specific gender, race or age remain uncertain. Hemolacria is one of the most alarming symptoms in ophthalmology, associated with multiple underlying etiologies and diseases. Case report: We report an unusual case of a 12-year-old female patient who experienced episodic bilateral bloody tears for 3 days, which was associated with epistaxis. The patient's condition was thoroughly evaluated, and all investigations were unremarkable. The patient was then referred to an ophthalmologist for evaluation, and a slit-lamp examination was also unremarkable. After performing all necessary investigations and taking various causes of hemolacria into account, the child was diagnosed as having idiopathic hemolacria. The patient and parent were appropriately counseled regarding the disease, and thereafter, the patient is being followed-up by an ophthalmologist. The reports of the follow-up performed after a month from presentation stated that the patient was progressing favorably, and the bloody tears were resolved spontaneously.

Introduction: Angiofibroma is a rare histologically benign tumor that is an unencapsulated, highly vascular tumor.1 It shows very aggressive behavior due to local invasiveness and is associated with various symptoms.2 Angiofibroma is almost always seen in young adolescent males.2 Along main pathogenesis is unknown, but it is considered to be associated with sex hormones mainly testosterone and estradiol.3 In a study conducted from 1995 to 2012 all patients were male.4 Major symptoms include nasal obstruction and epistaxis and surgical removal of the tumor as a whole is considered the treatment of choice.5 There have been very few individual case reports of angiofibroma in female6-9 which were confirmed with radiological testing and histopathology report of the samples taken. Case presentation: We present a rare case of nasopharyngeal angiofibroma in a young female as confirmed by computed tomography scan findings and histopathology reports of the sample by well-qualified pathologists. Conclusion: The case is being reported to increase awareness among medical professionals and encouraging further workup on the pathogenesis of angiofibroma. [ABSTRACT FROM AUTHOR]

Lijun Shen,1,2* Miao Mo,2,3* Leon Jia,4 Huixun Jia,2,3 Qingguo Li,2,5 Lei Liang,2,5 Debing Shi,2,5 Zhen Zhang,1,2 Sanjun Cai,2,5 Xinxiang Li,2,5 Ji Zhu1,2 1Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China; 2Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; 3Department of Cancer Prevention, Fudan University Shanghai Cancer Center, Shanghai, China; 4Virginia Commonwealth University, Richmond, VA, USA; 5Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, China *These authors contributed equally to this work Purpose: To investigate the association of age and sex on survival in non-metastatic colorectal cancer (CRC) patients and to identify groups at high risk for poor outcomes.Materials and methods: We performed a retrospective analysis of 5,047 non-metastatic CRC patients from 2008 to 2013. Data regarding age at diagnosis; gender; tumor site; tumor stage; differentiation; lymphatic, neural or vascular invasion; and survival outcomes were collected. Patients were stratified into 10-year age groups (≤35, 36–45, 46–55, 56–65, 66–75, >75) and then further analyzed in three age groups (≤35, 36–75, >75). Disease-free survival (DFS) and overall survival (OS) were evaluated using univariate and multivariate Cox regression models.Results: Of the 5,047 eligible patients, 41.3% were female. The tumor stages were balanced between the genders. In the female patients, the tumor stages were similarly distributed among the different age groups, while younger male patients were diagnosed with more advanced disease (P75 had shorter DFS than patients between 36 and 75 years old (HR=1.57 [1.03–2.38] and HR=1.51 [1.11–2.05, respectively]), while there was no difference in DFS between females ≤35 and those >75. For male patients, older age was associated with poorer OS after the same adjustment.Conclusion: Young female CRC patients (≤35 years old) had the poorest DFS and quite poor OS compared to the other age groups. This emphasizes the need for health care providers to have a heightened awareness and to conduct further research when caring for young female CRC patients. Keywords: colorectal cancer, young female, prognosis, China

Abstract Background Eosinophilic myocarditis is one of the fatal complications of idiopathic hypereosinophilic syndromes. Given the rarity of this form of myocarditis, it is often under-recognized. We describe a young girl who presented with features of heart failure. To our knowledge, this is the first reported case of eosinophilic myocarditis in a young Sri Lankan female. Case presentation A previously healthy 21 year old Sri Lankan female admitted with shortness of breath for 1 week duration with associated low grade fever and profuse sweating. She was mildly febrile and dyspnoeic with absent ankle oedema. She was tachycardic and had elevated Jugular venous pressure with negative Kussmaul sign. Blood pressure was 100/70 mmHg. Clinically there was no cardiomegaly and heart sounds were slightly muffled with gallop rhythm. Bilateral basal fine end inspiratory crackles and mild hepatosplenomegaly were noted. The laboratory examinations showed leucocytosis with severe eosinophilia with no abnormal cells. Her ESR, Troponin I and Brain natriuretic peptide were elevated with normal CRP and electrocardiogram showed sinus tachycardia with wide spread ST depression. Heart failure was evident on chest X-ray and 2D-echocardiogram showed global left ventricular hypokinesia with 40% ejection fraction and a thin layer of pericardial effusion. Mild hepatosplenomegaly without lymphadenopathy was detected in the ultrasound scan. Bone marrow biopsy showed hypereosinophilia with no evidence of bone marrow infiltration. FIP1L1–PDGFRA fusion transcript and BCR–ABL transcript were not detected. Secondary causes for hypereosinophilia were excluded and the diagnosis of idiopathic hypereosinophilic syndrome and eosinophilic myocarditis was made. She had good response to steroids clinically and biochemically with complete recovery of left ventricular function. She is now on steroid to be continued at least 6 months to 1 year. Conclusion Eosinophilic myocarditis is a rare but fatal disease if left untreated. Hence clinicians should have high index of suspicion to diagnose eosinophilic myocarditis in clinical context of heart failure due to myocarditis. The diagnoses of eosinophilic myocarditis may often be challenged especially in a poor recourse setting. However available investigation should be used to diagnose this condition without delay. Early treatment with systemic steroids may prevent fatal outcome and therapies for this disease have yet to be validated in large prospective studies.

Fibrocalculous pancreatic diabetes (FCPD) is a rare form of diabetes secondary to chronic calcific pancreatitis. The patients generally have clinical triad of pain abdomen, steatorrhoea and diabetes. The peculiar features are presence in a tropical country, younger age of onset, presence of pancreatic calculi, ketosis resistance and chances of progression to malignancy. We present a case of a young female presenting with recurrent abdominal pain, diabetes and chronic calcific pancreatitis. She was diagnosed to have FCPD based on the clinical, biochemical and radiological findings. She was managed with insulin, pancreatic enzyme supplementation and analgesics for pain relief. This is the first case reported from south Gujarat as per our knowledge. FCPD is quite rare. This report signifies the importance of keeping high index of suspicion in patients presenting with high sugars and abdominal pain. Early management with sugar control, pain relief and supplementing enzymes may prevent progression to complications.

We report a rare case of eosinophilic mastitis in a young asthmatic female who presented with a breast lump and was managed conservatively with a successful outcome. Eosinophilic mastitis, characterized by eosinophilic infiltration of mammary glands, is one such entity which is frequently given a miss, and is diagnosed based on histopathological analysis. The identification of this disease is a primary step in the management of such benign disorders which can be successfully treated conservatively avoiding any surgical intervention and morbidities thereafter. Because presentation can be similar and confusing enough, we took a cue from the history of asthma, urticaria, and peripheral eosinophilia to clinch the diagnosis of eosinophilic mastitis, which was further confirmed on biopsy. To the best of our knowledge, this happens to be the youngest female patient aged 27 years who also had urticaria along with other eosinophilic manifestations, which is unreported in other cases and makes our case exceptional. She was treated with glucocorticoids and antihistaminics and is presently symptom free.

Background: Insufficient sleep duration and unhealthy diet are associated with weight gain. However, little is known about the association of sleep quality with dietary intake and obesity. The aim of the present study was to compare dietary intake and anthropometric indices between good and poor sleepers. Methods: In this cross-sectional study, a total of 260 females youth aged 18-30 years were recruited among the students of Qazvin University of Medical Sciences. The evaluated variables consisted of sleep quality, dietary intake, and anthropometric indices. Statistical analysis was performed using SPSS version 21.0. Results: Participants in the poor quality sleep group had higher intakes of calorie (P < 0.001) and carbohydrate (P < 0.001), and lower protein intake (P < 0.01) in comparison with good sleepers. Regarding food groups, poor sleepers had higher intake of bread-grains (P = 0.02) group, but lower intake of meat-alternatives (P < 0.001), vegetables (P < 0.001), and fruits (P < 0.001) in comparison with the good sleepers. Participants in the poor quality sleep group had higher weight (P < 0.001), body mass index (P < 0.001), waist circumference (P < 0.001), and fat mass (P < 0.001) in comparison with good sleepers. Conclusion: Our findings emphasize the relationship of poor quality sleep with unhealthy dietary intake and obesity in young female women. [ABSTRACT FROM AUTHOR]

Background: The majority of breast lesions in women under 25 years are being benign. Imaging is important for diagnosis and selecting patients for further procedures. Although malignancy is rare in this group of patients, suspected lesions must be biopsied. Imaging is very important in the selection of patients for radiological intervention. Understanding of the clinical, pathologic, and imaging features allows the radiologist to guide proper management of these patients. The aim of this study was to determine the frequency of different breast lesions in symptomatic women under 25 years and the value of radiological imaging in the diagnosis. Results: This was a retrospective study; a total number of 250 cases with breast lumps under 25 years of age were registered in the PACKS of our institution in the period from January 01, 2017 to December 31, 2018. Two hundred three cases coped with our inclusion criteria that include available histopathological results either by biopsy or after surgery based on their referring physicians decision. Our exclusion criteria were those cases (47) with definite BIRADS 2 lesions with no available pathology reports. Ultrasonography was done to all patients (203 cases) and MRI was performed to 26 cases. All cases were histologically verified; their findings were reviewed and compared to radiological findings. A total of 203 symptomatic breast lesions were received at the radiological department in women under 25 years; there were 115 (56.7%) benign, 85 (41.9%) cystic, and 3 (1.5%) malignant lumps. The commonest benign lesion was fibroadenoma (104 cases, 51.2%) and all the malignant lesions were invasive ductal carcinoma (IDC) (3 cases, 1.47%). The p value is > 0.05, so there were no differences between examination using the ultrasonography and the MRI imaging compared to histopathological results. Conclusions: Most breast lesions in young women are benign. Ultrasonography is an essential first imaging modality in the diagnosis of women under 25 years with breast lesions. [ABSTRACT FROM AUTHOR]

Background: Iron deficiency is prevalent in overweight and obese individuals and may be induced by adiposity-related inflammation that affect iron metabolism. Objective: The objective of this study was to investigate the relationship between hematological parameters and obesity-induced inflammation among young females. Methods: A total of 170 young women (aged between 18-35 years) participated in this cross-sectional study. Obesity was assessed by BMI (body mass index), WHR (waist to hip ratio), and body fat percentage. Inflammatory and hematological parameters including hs-CRP (high-sensitivity C-reactive protein), serum Fe, hemoglobin, ferritin, transferrin, TIBC (total iron binding capacity) were measured. Dietary intakes of some nutrients (total iron, proteins, calcium, and vitamin C) were assessed according to BMI, WHR and fat mass categories. Results: Serum iron were negatively correlated with BMI (P = 0.045, r = -0.154) and hs-CRP (P = 0.032, r = -0.165). Hemoglobin were also negatively correlated with BMI (P = 0.043, r = -0.155). A significant correlation was also shown between WHR with transferrin (P = 0.034, r = 0.163) and TIBC levels (P = 0.035, r = 0.162), hs-CRP was positively correlated with BMI (P = 0.014, r = 0.183), WHR (P = 0.009, r = 0.202) and body fat percentage (P = 0.037, r = 0.353). Dietary intakes did not differ significantly among BMI, WHR and fat mass categories (P > 0.05). Conclusions: Obesity-induced inflammation, regardless of dietary intake of iron, can lead to iron deficiency. Therefore, weight control, especially in obese subjects is necessary to prevent iron deficiency and anemia. [ABSTRACT FROM AUTHOR]