Vulnerability to Sexually Transmitted Infections (STI) / Human Immunodeficiency Virus (HIV) among adolescent girls and young women in India: A rapid review.

Limited evidence is available on the vulnerability of Adolescent Girls and Young Women (AGYW) to sexual risk behaviour and STI/HIV. Though there are almost no statistics available on vulnerability, related literature suggests that AGYW have low awareness about sexual risk behaviour/ transmission and the prevalence of STI/HIV, making them vulnerable. We conducted a rapid review of peer-reviewed studies addressing transmission network, prevalence, incidence awareness, common determinants of sexual risk behaviour/STI/HIV, health-seeking behaviour and existing interventions addressing the situation among AGYW (age 15-24) to inform the evidence gap in this crucial area of research. We registered the study in PROSPERO (CRD42023403713). We developed detailed inclusion/exclusion criteria, searched JSTOR, PubMed, Google Scholar, Science Direct and Population Council Knowledge Commons databases and followed the guidance from Cochrane Rapid Review to develop the rapid review. We also searched the bibliography of the included studies. We included the English language peer-reviewed quantitative, qualitative, mixed method studies published from Jan 1 2000 to Mar 31 2023. Six reviewers extracted data, and the seventh reviewer independently assessed the quality. Ninety-six studies met the inclusion criteria. We used descriptive statistics and narrative synthesis methods for data analysis. We also conducted a Risk of Bias Assessment (RoB) to check the quality of the included studies. Inadequate literature was found on the transmission network. Prevalence and awareness of STI/HIV are low among AGYW. However, Female Sex Workers, sex-trafficked women or drug users in this age group suffer more. Age, education, income, relationship dynamics with spouses/partners, multiple partners, and substance use are crucial in determining STI/HIV. Traditional sources of health seeking are more popular than formal sources because of social stigma. Mass media campaigns, community mobilization programs, and life skills training programs increase awareness about HIV, condom use and self-efficacy. The inclusion of only English language studies and not conducting meta-analysis because of high heterogeneity are some of the limitations of the study.

99mTc-methionine scintimammography in the evaluation of breast cancer.

OBJECTIVE: The diagnostic utility of a C-methionine scan has been established in breast cancer. We were able to radiolabel methionine with Tc at our institute. Thus, we undertook clinical trials to determine the role of Tc-methionine scans in the detection of breast cancer. METHODS: Scintimammography was performed in 47 female (median age 44 years, range 28-68 years) patients having palpable breast masses. All of them underwent ultrasound, mammography, fine-needle aspiration cytology, and Tc-methionine scintimammography before surgery. The final diagnosis was made after histopathological examination. Tc-methionine scintimammography was done after injecting 555 MBq of radiotracer intravenously. The results of scintimammography were compared with histopathology. RESULTS: The histopathological findings were malignant in 33 (70%) and benign in 14 (30%) cases. Scintimammography showed true-positive findings in 29 patients out of 33 cases of breast cancer. True-negative findings were found in 13 out of 14 patients having benign breast lesions. The sensitivity, specificity, and positive predictive value were found to be 87.8, 92.8, and 96.6% respectively. CONCLUSION: Tc-methionine imaging can provide useful information with reasonably high sensitivity and specificity in evaluating patients having breast masses.

IgG4-Related disease simulating paraneoplastic syndrome: Role of 18FDG PET/CT imaging.

Immunoglobulin G4 (IgG4)-related systemic disease (IgG4-RSD) is a new systemic entity associated with autoimmune pancreatitis (AIP). Other organ involvements take the form of sclerosing cholangitis, sclerosing cholecystitis, sclerosing sialadenitis, retroperitoneal fibrosis, and interstitial nephritis. Recently, lung diseases related to IgG4 have been described to occur with or without other organ involvement. These diseases include interstitial lung disease (ILD), pulmonary inflammatory pseudotumor, and lymphomatoid granulomatosis. Most of these cases occur in combination with AIP, which also appears to have a general preponderance for males. The true incidence of IgG4-related ILD and the incidence of AIP are unknown. Here, we describe a case of a 53-year-old gentleman who presented with weight loss, fever, loose motions, altered sensorium, and persistent low hemoglobin, for which he was referred for 18-fluorodeoxyglucose positron emission tomography/computed tomography scan to diagnose probable underlying occult malignancy/paraneoplastic syndrome. It revealed features suggestive of IgG4 disease involving the pancreas and lungs, which was confirmed subsequently.

Can patient self-management explain the health gradient? Goldman and Smith's "Can patient self-management help explain the SES health gradient?" (2002) revisited.

In their much-cited paper, "Can patient self-management help explain the SES health gradient?"Goldman and Smith (2002) use samples of diabetic and HIV+ patients in the United States to conclude that disease self-management is an important explanation for the much-documented positive gradient in education and health outcomes. In this paper, I revisit their analysis and point to some fundamental difficulties in interpreting their results as conclusive evidence in favor of self-management. I also argue that for individuals for whom self-management might be expected to matter -i.e. populations of patients managing complex conditions - economic factors such as resource availability and insurance access might be a more important mechanism behind the gradient than medical compliance. The impact of self-management, though it might matter, is likely to be small.