'Surgical cure' for non-parathyroid hypercalcemia

Background: Sarcoidosis is a granulomatous disease of unknown aetiology. Over 90% patients of sarcoidosis present with pulmonary findings. Other organs such as lymph nodes, skin, and joints may be involved. Isolated granulomatous disease confined to the spleen is rare. Case presentation: This report documents a rare case of isolated granulomatous disease of spleen presenting as hypercalcemia. After all possible causes for hypercalcemia were ruled out, splenectomy was done which proved diagnostic and therapeutic, as calcium levels returned to normal. Conclusion: We propose that sarcoidosis should be kept in mind as a cause of unexplained hypercalcemia. Increased awareness of radiological features of splenic involvement in sarcoidosis, would help in diagnosis. We believe that we are reporting 9th case in the literature while writing this report

Evaluating the impact of conditional cash transfer programs on fertility: the case of the Red de Protección Social in Nicaragua

Fertility, Conditional cash transfer programs, Hazard model, J13, C41, H53,

Persisting stigma reduces the utilisation of HIV-related care and support services in Viet Nam

<p>Abstract</p> <p>Background</p> <p>Seeking and utilisation of HIV prevention, treatment, care, and support services for people living with HIV is often hampered by HIV-related stigma. The study aimed to explore the perceptions and experiences regarding treatment, care, and support amongst people living with HIV in Viet Nam, where the HIV epidemic is concentrated among injecting drug users, sex workers, and men who have sex with men.</p> <p>Methods</p> <p>In-depth interviews and focus group discussions were conducted during September 2007 in 6 districts in Hai Phong with a very high HIV prevalence among injecting drug users. The information obtained was analysed and merged within topic areas. Illustrative quotes were selected.</p> <p>Results</p> <p>Stigma and discrimination against people living with HIV in the community and healthcare settings was commonly reported, and substantially hampered the seeking and the utilisation of HIV-related services. The informants related the high level of stigma to the way the national HIV preventive campaigns played on fear, by employing a “scare tactic” mainly focusing on drug users and sex workers, who were defined as “social evils” in the anti-drug and anti-prostitution policy. There was a strong exclusion effect caused by the stigma, with serious implications, such as loss of job opportunities and isolation. The support and care provided by family members was experienced as vital for the spirit and hope for the future among people living with HIV.</p> <p>Conclusions</p> <p>A comprehensive care and support programme is needed. The very high levels of stigma experienced seem largely to have been created by an HIV preventive scare tactic closely linked to the “social evil“ approach in the national policy on drug and prostitution. In order to reduce the stigma and create more effective interventions, this tactic will have to be replaced with approaches that create better legal and policy environments for drug users and sex workers.</p

The Determinants of Low Fertility in India

Using a conceptual framework focusing on factors that enhance or reduce fertility relative to desired family size (see Bongaarts 2001), we study fertility variation across time (1992–2006) and space (states) in India. Our empirical analyses use data from three waves of the Indian National Family Health Surveys. We find that this framework can account for a substantial portion of the variation in the TFR across the states and over time. Our estimates focus attention on the critical components of contemporary Indian fertility, especially desired family size, unwanted fertility, son preference, and fertility postponement