Transfer of Swahili ‘until’ in contact with East African languages

Swahili has transformed the noun mpaka ‘boundary, border’ into a function word ‘until’, which has successfully spread to many other East African languages with locative and temporal readings. The grammaticalisation originated in a N-N construction without an associative ‘of’ interpreted as limiting the action adverbially. The main function is in the time interpretation of ‘until’. I provide an overview of this transfer in East Africa by looking at a large number of languages and argue that parallel independent grammaticalisation is not what is at stake but rather transfer of the function word and the preposition-like function.Descriptive and Comparative Linguistic

Injection sclerotherapy for the treatment of haemorrhoids in anticoagulated patients

BackgroundSymptomatic haemorrhoids (SH) are a common condition; however, conventional outpatient treatment, including rubber band ligation, is contraindicated in patients receiving concurrent anticoagulation. Injection sclerotherapy (IST) has been proposed as a treatment option for these patients.MethodsA retrospective review of case notes was performed in a colorectal surgery department that sits alongside a tertiary cardiothoracic surgical unit. Patients treated with an IST for SH between 1 April 2014 and 30 November 2021 were identified. Anticoagulation was not stopped in these patients as they were at high risk of developing thromboembolism, except in two patients who required alternative procedures. The primary outcome was symptom resolution, defined as no patient reporting bleeding for at least six months. The secondary outcomes were patient-reported complications, number of IST procedures and number of other procedures performed to achieve symptom resolution.ResultsA total of 20 patients with a median age of 64 years (range 35–86, 14 male) who underwent 32 IST treatments were identified. Symptom resolution was achieved in 18 (90%) patients using IST while continuing anticoagulation treatment, with two (10%) patients requiring alternative interventions. Ten patients (50%) required only one IST procedure, and three patients (15%) required two procedures. The remaining five (25%) patients required three or four interventions. The median time between IST treatments was 32 weeks (range 8–133). No complications were reported.ConclusionOur study demonstrates that IST can be considered as a potential treatment option for patients with SH who are at a high risk of thromboembolic disease requiring anticoagulation

Patient Satisfaction with Long-Term Sacral Neuromodulation for Faecal Incontinence: Experience from a Single Tertiary Centre

Background: Sacral Neuromodulation is an effective treatment for faecal incontinence in the long-term. Efficacy is typically assessed using bowel diary, symptom severity, or quality of life questionnaires and ‘success’ defined as &gt;50% improvement in these measures. Patient satisfaction may however be a more meaningful and individualised measure of treatment efficacy.Objective: To assess patient reported satisfaction with long-term sacral neuromodulation and compare it to the frequently applied efficacy measures.Design: An observational study of a prospectively maintained database. Setting: A single tertiary pelvic floor referral unit.Patients: Data from 70 (68 female, median age 69 [60 – 74]) patients were available. The median time since implantation was 11 (9 – 14) years. Nineteen patients reported inactive neuromodulation devices.Interventions: (None)Main Outcome Measures: Bowel diaries, the Manchester Health Questionnaire, and the St Marks Incontinence Score recorded at baseline, after percutaneous nerve evaluation, and at last follow-up. Patient reported satisfaction, using a 0%-100% visual analogue scale, with treatment since implantation (overall) and in the two-weeks preceding completion of the last outcome measures (current). Results: Satisfaction was significantly higher in those with active sacral neuromodulation devices (75% vs 20%, p&lt;0.001) at follow-up. No significant relationships exist between symptom improvement using conventional measures, and patient reported satisfaction. Current satisfaction was not associated with changes in bowel diary data following percutaneous nerve evaluation. Despite improvements in the St Marks incontinence score and Manchester Health Questionnaire below the 50% improvement threshold used to define ‘success’, patients reported high (80%) satisfaction.Limitations: Retrospective with gaps in the available data.Conclusions: High patient satisfaction with sacral neuromodulation can be achieved, however the response to percutaneous nerve evaluation may not predict treatment satisfaction in long-term. The change in questionnaire results, which measure the use of compensatory behaviours and quality of life impact, may better correspond to treatment satisfaction.<br/