Unusual presentation of membranous nephropathy

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.

Breast cancer in the young: A 10-year review of the diagnosis, treatment and outcomes at the Philippine General Hospital

RATIONALE@#Breast cancer is the most prevalent cancer in the world. It is usually diagnosed in women 50 years old and older, but is also found in younger women. Its occurrence in young women led to questions with regards issues on its tumor biology, survival and fertility. There is insufficient local data to formulate treatment options relevant to this age group. This study reviews the data on breast cancer in young female patients seen in a tertiary institution.@*METHODS@#This is a descriptive study involving a review of medical records of young female breast cancer patients (<35 years of age), seen at the Philippine General Hospital - Breast Care Center from January 2008 to December 2017. @*RESULTS@#A total of 119 patients were included in the study. Of these young female patients, 29.4% presented with locally advanced disease (Stage IIIB) correlating with a high number of patients who underwent neoadjuvant chemotherapy (38.7%) and modified radical mastectomies with primary closure (62.18%). @*CONCLUSION@#Breast cancer in young females should be aggressively investigated as it commonly presents in an advanced stage.

Study the role of hepcidin in diagnosis of iron deficiency anemia in young females of northern India

Background: Iron deficiency is one of the most common nutritional disorder. Maintenance of body iron status is an integral part of healthcare in young female of reproductive age group. Thereby early detection could lead to early intervention and reduce its comorbidity.  Indeed, an ideal screening test should be capable of identifying iron deficiency long before developing anemia. Henceforth, the present study was aimed to determine utility of serum hepcidin in iron deficiency and to access the baseline value of hepcidin in young female.Methods: This sectional study was conducted in the Department of biochemistry SGT Medical College Hospital and Research Institute, Budhera, Gurugram. It included non-pregnant female students of age 18-25 years with normal RBC indices and hemoglobin >12 gm%. Estimation of serum hepcidin-25 was by ELISA.Results: The reference range of hepcidin established in this study was 12.14-139.89 ng/ml for females with the mean being 42.4±29.13 ng/ml. It showed higher discriminating power in evaluating iron status in young healthy women (AUC 0.984) with best combination of diagnostic sensitivity (95.7%) and specificity (93.2%) at a cut off of >15.7 ng/ml. Serum hepcidin identified 17% of young healthy females with normal hemoglobin to have functional or storage iron deficiency.Conclusions: The prevention of iron deficiency anemia remains insufficient worldwide especially among underprivileged women and children Therefore, estimation of serum hepcidin may be considered as a valuable tool in assessing iron status in young healthy female population who are the prime target group for iron supplements to reduce comorbidity associated with iron deficiency and anemia.

A rare case presentation of large mucinous ovarian cystadenocarcinoma in a young female

Here authors report a case of large ovarian mucinous cystadenocarcinoma in a young female complicating young pregnancy. Ovarian mucinous adenocarcinoma is a rare ovarian tumour that arises from the surface epithelium of the ovary. A 25-year young female, 9 days post-partum presented to the hospital with complain of abdominal distension. USG finding suggesting large solid cystic mass 36 × 14 cm arising from pelvis extending up to epigastrium. MRI pelvis evident of heterogenous hyperintense solid cystic mass lesion giving bunch of grapes appearance with size 24.5 × 25 × 11.5 cms seen in intra peritoneal space extending cranially up to epigastrium and caudally into pelvis giving anterior displacement of uterus.  And posterior displacement of bowel loops. A large part of lesion is cystic with solid component with multiple internal echoes.

Reversible cerebral vasoconstriction syndrome a rare cause of post-partum headache: an anesthetic overview / Síndrome de vasoconstrição cerebral reversível, uma causa rara de cefaleia pós-parto: visão da anestesia

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.

Resumo A síndrome de vasoconstrição cerebral reversível é uma doença cerebrovascular que leva à constrição e dilatação arterial multifocal. A síndrome de vasoconstrição cerebral reversível é possivelmente causada pela desregulação transitória do tônus vascular cerebral. Relatamos um caso raro de uma paciente com queixa principal de cefaleia pós-parto, posteriormente diagnosticada como um caso de síndrome de vasoconstrição cerebral reversível. A jovem primigesta a termo apresentando boa contração uterina foi internada em sala de parto. Mais tarde, a parturiente queixou-se de perda de líquido pela vagina e, ao exame, líquido amniótico manchado foi observado. O parto cesariano sob raquianestesia foi realizado, e não houve intercorrência no período intraoperatório. Tanto a mãe quanto o bebê estavam normais e foram transferidos para a sala de recuperação pós-operatória e berçário, respectivamente. Na sala de recuperação, a mãe queixou-se de forte dor de cabeça após uma hora e depois desenvolveu convulsão. Midazolam foi administrado por via intravenosa, e a paciente foi intubada e transferida para uma unidade de terapia intensiva para posterior investigação e tratamento. A tomografia computadorizada sem contraste do cérebro mostrou hemorragia intracerebral occipital direita e subaracnoide. A angiotomografia mostrou estreitamento da artéria vertebral direita, sem qualquer outra malformação vascular. A paciente foi tratada em unidade de terapia intensiva por dois dias e, em seguida, foi extubada e transferida para a ala de alta dependência onde permaneceu um dia em observação, recebendo alta hospitalar três dias depois, após uma recuperação completa e sem intercorrências.

Eating behaviour of young female workers with low socioeconomic status in Malang City, East Java: a qualitative study

@# Introduction: Eating behaviour is one of the important factors affecting nutritional status that has been widely investigated. However, there are few studies on the eating behaviour of young female workers in Indonesia. This study aimed at investigating the factors affecting eating behaviour of young female workers of low socioeconomic status in Malang, East Java province, Indonesia. Methods: Participants were recruited using purposive sampling from low-income families living in Malang City. The eligibility criteria were based on demographic information, including monthly household income and expenses. The participants recruited comprised 21 women aged 18-22 years who were employed outside their homes, unmarried and living with their parents. A qualitative methodology was used to understand the meaning and context of the eating behaviour of these women. In-depth interviews and focus group discussions were used as the primary data collection methods. Results: Two primary themes emerged as the main influences of the participants’ eating behaviour: individual attributes (food preferences, healthy eating knowledge and self-efficacy), and socio-environmental factors (peer influence, mother’s role and food availability). In general, the participants had some knowledge about healthy eating behaviour; however, they lacked self-efficacy to practise such behaviour. Conclusion: Individual motivations and socio-environmental factors were found to mediate the eating behaviour of young working women from poor households. These factors should be considered when designing nutrition programmes for achieving healthier eating behaviour among young working women.

Minimally Invasive Surgery for Hallux Valgus Deformity Using Intramedullary Low Profile Plate Fixation: A Case Report / 대한족부족관절학회지

According to a recent systemic review, hallux valgus deformity has a prevalence rate of about 23% among adults aged 18 to 65 years. To date, more than 100 operative methods have been reported for the correction of hallux valgus deformity. For young female with mild to moderate hallux valgus deformity, minimally invasive surgery can be considered for aesthetic demands. Here, we report a case of a young female patient with mild hallux valgus deformity treated by minimally invasive surgery using intramedullary low profile plate fixation. This can be the favorable method for secure fixation of the osteotomy site and prevention of medial skin irritation symptoms derived from a sharp osteotomy margin.

A case of bilateral breast gangrene in lactating non diabetic young lady.

This report describes an unusual case of gangrene affecting the breast in a lactating non-diabetic patient.She was admitted to Minia University hospital complaining of swelling, pain and blackish discoloration of both breasts that was more extensive on the left side. Wound cultures revealed heavy growth of styphalcoccusaureus showing sensitivity to linzeolid, Methicillin and Vancomycin.Blood culture was sterile. Examination revealed that both breasts were large, tender and the gangrene involved all quadrants of the left breast and the medial side of the right breast (15x7 cm). Debridement was carried out and then skin graft was carried out for the left breast and primary closure for the right breast. The objective of this case report is to study clinical presentation and management of youngfemale with breast gangrene.

Cosmetic selection of skin incision for resection of choledochal cyst in young female patients

BACKGROUNDS/AIMS: Open surgery for choledochal cyst has a disadvantage of skin incision scar from operative wound, which can be a definite disadvantage especially in young female patients. This study focused on the cosmetic aspect of skin incision for resection of choledochal cyst in young female patients. METHODS: During a 2-year study period, 11 adult female patients aged less than 40 years underwent primary resection of choledochal cyst by a single surgeon. The cosmetic effect of two types of skin incision was evaluated. RESULTS: The patients underwent mini-laparotomy through either a right subcostal incision (n=8) or an upper midline incision (n=3). The mean length of skin incision was 10 cm for right subcostal incisions and 9 cm for upper midline incisions. It took approximately 1 hour to repair the operative wound meticulously in both groups. At the 6 month to 1 year follow-up, a slight bulge on the skin scar was observed in 3 (37.5%) patients of the right subcostal incision group and 1 (33.3%) patient of the upper midline incision group. CONCLUSIONS: The results of this preliminary study support the claim that cosmetic effect of the upper midline incision for CCD surgery appears to be non-inferior to that of the right subcostal incision if the incision is placed accurately and repaired very meticulously.

Giant Chondrosarcoma of Proximal Humerus in an Adult Female Patient: A Case Report

Chondrosarcoma is the third most common primary tumour of the bone, after myeloma and osteosarcoma. Most of the chondrosarcoma grow slowly and rarely metastasize, and they have an excellent prognosis after adequate surgery. However most of them are chemo or radio-resistant. We report a case of primary chondrosarcoma of proximal humerus in a 36-year-old female who presented with a six years history of left shoulder swelling and restricted range of motion. Trucut biopsy showed a well-differentiated chondrosarcoma. The patient underwent forequarter amputation of left upper limb and was started on chemotherapy following operation.

Analysis of characteristics of risk factors and coronary angiography in young female patients with a-cute myocardial infarction / 中国医师杂志

Objective To investigate the characteristics of risk factors and coronary angiography (CAG)in young patients with acute myocardial infarction(AMI).Methods A total of 36 consecutive AMI female patients (age≤44 years)who underwent coronary angiography were retrospectively retrieved from the database,and 90 AMI patients whose age >44 years who also underwent coronary angiography were enrolled as a control (elderly)group.Characteristics of risk factors and coronary angiography were com-pared between the two groups.Results The risk factors:BMI,family history of coronary heart disease and high triglycerides(TG)were major in the youth group.The percentage of single-branch lesion was lower in the young patients.The prevalence of left anterior descending (LAD)was higher in the young patients(P <0.05).Conclusions The main risk factors in young and elderly patients are significantly different.The out-comes of CAG in the young patients show the coronary lesion are mostly single vessel lesion,and early inter-vention may improve prognosis.

Neoadjuvant chemotherapy via different approaches for the treatment of cervical carcinoma in young female patients：comparison of the therapeutic effect / 介入放射学杂志

Objective To compare the efficacy and side-effects of preoperative neoadjuvant uterine arterial chemoembolization and venous chemotherapy in treating cervical cancer in young female patients. Methods A total of 241 young females(≤35 years old) with cervical cancer were enrolled in this study. The clinical data were retrospectively analyzed. The patients were divided into group A (n=63) and group B (n=57). Patients in group A received preoperative neoadjuvant uterine arterial chemoembolization with subsequent surgery, while patients in group B were treated with preoperative neoadjuvant intravenous chemotherapy followed by surgery. The chemotherapy scheme included carboplatin (50 mg/m2) and gemcitabine (1 000 mg/m2). The short-term effect, the amount of blood loss during the surgery, pathological findings and the side-effects of the two groups were compared. The Kaplan-Meier method was used to calculate survival rate, and the log-rank test was used for survival difference analysis. Results The short-term response rate of group A was 90.5%, which was significantly higher than that of group B (71.9%), the difference between the two groups was statistically significant (χ2=7.5, P0.05). In both groups, the clinical stage, the pathological grade and the size (≥ 4 cm) of the tumor were the main factors that could influence the prognosis in young females with cervical cancer (P<0.05). Conclusion The short-term efficacy of preoperative uterine artery chemoembolization is better than that of preoperative intravenous chemotherapy for the treatment of cervical cancer in young female patients. Besides, this therapy carries mild side effect, and it can improve the 5-year progression-free survival rate, although the long-term survival rate has not been obviously improved.

Implemention of cognitive behavioral therapy in the young female with facial burn / 中国实用护理杂志

Objective To explore the effects of cognitive behavioral intervention in psychological nursing of young female patients with facial burn.Methods 64 cases of young women patients with facial bum were selected as the research object,and randomly divided into the observation group and the control group,with 32 cases in each group.The observation group was given the cognitive behavioral intervention and the control group was done by conventional nursing methods.The anxiety and depression scores between the two groups before and after the intervention were compared.Results After injury,the anxiety and depression scores of both the observation group and the control group were higher than those of the domestic norm; the anxiety and depression scores between two groups showed no statistic significance before intervention,and after intervention,the anxiety and depression scores between two groups had significant difference,scores of the observation group were lower than those of the control group.Conclusions Cognitive behavioral intervention can reduce anxiety and depression of young female patients with facial burn.It is a kind of effective psychological nursing method,and worthy of clinical promotion.

Nutritional and antioxidant status by skin types among female adults

This study was performed to analyze the relationship among sebum . hydration content of the skin and nutritional intake, serum antioxidant minerals and antioxidant enzymes, and lipid peroxide concentration in 50 female subjects in their 20s. The skin type was divided into Dry Skin, Mixed Skin, and Oily Skin, and the dry skin group was 14%, the mixed skin group was 56%, and the oily skin group was 30% of all subjects. The average age of the subjects was 20.54 +/- 1.43 years and BMI was 20.66. The average sebum content in each group was in the order of T-zone>forehead>chin>cheek. In case of the T-zone, a significant difference between the dry skin group and the oily skin group was observed, suggesting that the area is most sensitive to sebum content by skin type. Significant differences were not observed in energy and nutrient intakes by skin type. Serum concentrations of antioxidant minerals such as copper, manganese, zinc and selenium were not significantly different among the groups, but the dry skin group tended to be higher than the oily skin group. Serum catalase was significantly higher in the oily skin group (P < 0.05), and MDA was significantly higher in the mixed skin group (P < 0.05). The hydration of the cheek and serum zinc showed a negative correlation, and the sebum content of the cheek and GPx showed a significant negative correlation. The hydration of the forehead and serum copper showed a significant negative correlation, and the hydration of the forehead and GPx showed a significant positive correlation. The hydration of the chin and serum SOD showed a significant positive correlation. With these results, it is considered that the basic condition of nutritional status can affect the skin health.

Association of Cardiorespiratory Fitness with Insulin Resistance, Blood Lipids and Bone Mineral Density in Young Female Adults / 대한스포츠의학회지

Whether cardiorespiratory fitness is associated with insulin resistance, blood lipids, and bone mineral density remain less clear. The purpose of this study was to investigate the relationship between cardiorespiratory fitness and insulin resistance, blood lipids, and bone mineral density in young female adults. Twenty-two female adults (body mass index: 21.62+/-2.23, age: 20.05+/-1.81) participated in this study. Harvard step test was assessed, and fasting glucose, insulin, total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglyceride (TG) and bone mineral density (BMD) were measured. Pearson product-moment correlation, partial correlation, simple linear regression and Dubin Watson test were used to investigate the association of cardiorespiratory fitness with insulin resistance, blood lipids and BMD to examine the statistical significant. Cardiorespiratory fitness was significantly associated with LDL-C, insulin, T-score and insulin resistance, respectively. In conclusion, young female adults who have lower level of cardiorespiratory fitness were more likely to have higher LDL-C and insulin and lower BMD and insulin resistance. This study suggests that not only prevention of obesity but also promoting cardiorespiratory fitness and bone density are important for the health of young female adults.

Idiopathic Calcium Pyrophosphate Dihydrate (CPPD) Crystal Deposition Disease in a Young Female Patient : A Case Report

PURPOSE: Calcium pyrophosphate dihydrate crystal deposition disease(CPPD) is a disease of the elderly and extremely rare in young individuals. If young people develop CPPD crystal deposition disease, it may be associated with metabolic diseases, such as hemochromatosis, hyperparathyroidism, hypophosphatasia, hypomagnesemia, Wilson's disease, hypothyroidism, and gout. MATERIALS AND METHODS: Therefore, in young-onset CPPD crystal deposition disease, an investigation of any predisposing metabolic conditions is warranted. CONCLUSION: We report a case of a young female patient who presented with idiopathic CPPD crystal deposition disease at 25 years of age.

EFFECTS OF EXERCISE INTERVENTION ON BLOOD LIPID LEVELS, GLYCOMETABOLISM, ADIPOCYTOKINE LEVELS, AND CARDIAC AUTONOMIC FUNCTION IN YOUNG FEMALES WITH HIDDEN OBESITY / 体力科学

We performed exercise intervention for 12 weeks in young females (22.3±2.5 yrs ; mean±SD) with a %fat value of 30% or more (dual energy X-ray absorptiometry : DXA) despite a body mass index (BMI) of less than 25 kg/m², which indicates hidden obesity, and the following results were obtained.The intensity of exercise was established as the double product break point calculated from heart rate and systolic blood pressure, and the subjects were instructed to exercise for 30 minutes or more for 3 or more times a week. Six weeks after exercise intervention, the BMI, body fat level, and plasma glucose level were lower than those before exercise intervention, and the %fat value was lower 12 weeks after intervention. Furthermore, cardiac autonomic function (CAF) was negatively correlated with changes in Total power and changes in fat (kg), suggesting that exercise-related improvement in CAF is involved in a decrease in %fat.

Preoperative concurrent chemoradiation effective for stage Ⅰb-Ⅱb high-risk cervical carcinoma in young females / 医学研究生学报

Objectives: The incidence of cervical carcinoma is increasing in young females.More and more clinical researches focus on the choice of therapeutic methods and improvement of the patients' survival.This study aimed to evaluate the efficacy of preoperative concurrent chemoradiation for stage Ⅰb-Ⅱb high-risk cervical carcinoma in young females.Methods: We retrospectively analyzed the clinical data of 118 female patients(≤35 years) with stage Ⅰb-Ⅱb high-risk cervical carcinoma,bulky,low-differentiation or non-squamous.According to preoperative treatments,the patients were divided into three groups,Group 1 preoperatively treated by concurrent chemoradiation,Group 2 by neoadjuvant chemotherapy and Group 3 by radiotherapy(intracavitary irradiation),all followed by radical hysterectomy.And those with pathologically reported pelvic lymph node metastasis,deep cervical stromal invasion,vascular tumor thrombosis,or surgical margin positivity received postoperative chemotherapy and/or radiotherapy.Results: The disappearance rate of cancer cells and the rate of superficial myometrial invasion were significantly higher in Group 1 than in the other two groups(P

Two Cases of Urethral Injury in Girls Without Pelvic Bone Fracture / 대한비뇨기과학회지

Urethral injury secondary to blunt trauma in the boys is fairly common occurrence, its diagnosis and management are well documented. Due to the low incidence of urethral injury in girls, there is no settled method of diagnosis and management. In this report, the clinical course of 2 young female patients with complete traumatic rupture of the uretha was evaluated in an effort to propose guide lines for the investigation and initial management of this unusual injury.

A clinical analysis of thyroid carcinoma in young females / 中国普通外科杂志

Objective To study the clinical characteristics of thyroid carcinoma in young females,in order to improve the diagnosis and treatment of this disease.Methods The clinical data of 74 consecutive young female patients with thyroid carcinoma treated in our hospital in the recent ten years were analysed.In most of the cases,there was no firm texture or fixation of the thyroid nodules to surrounding structures on physical examination before operation.Ultrasonography was performed in all patients and multiple thyroid nodules were found in 61 cases(82.43%).Thyroid scintiscans were performed in 43 cases,and thyroid nodules were found in 41 cases.The cold,cool and warm nodules were found in 14,18 and 9 cases,respectively,by scintiscans.Fine needle aspiration biopsy(FNAB) was performed in 11 cases,and in 2 cases were negative,1 case showed abnormal cell,3 cases were suspicious of carcinoma,and 5 cases were confirmed papillary carcinoma.Results Papillary carcinoma was found in 70 cases,follicular carcinoma in 3 cases and medullary carcinoma in 1 case by histological examination,and benign disease was also accompanied in most cases.Lymph node metastases was found in 28 cases(37.84%),and the rate of metastases was significantly different than that of older female patients(16.46%) at the same time.There were 2 cases who died 3 years after operation because of metastases.Conclusions The lymph node metastases were prevalent in young female patients with thyroid carcinoma.The texture and mobility of the nodules cannot be used to differentiate benign from malignant nodules.We should carefully analyze every nodule found on ultrasonography.For the solid nodules with diameter larger than 1.0cm,we suggest operation;for the non-solid nodules with diameter larger than 2.0cm,we prefer scintiscans and FNAB for diagnosis.