Serum Lipid Changes after Short Term SIPC Therapy for Lower Limb Lymphedema

Lymphedema is a ubiquitous chronic disease with various suggested treatment options, but no definite treatment. Using (Sequential) Intermittent Pneumatic Compression (SIPC) is one of the most appropriate non-surgical treatments without any noticeable complications. In this study, we evaluated the serum lipids changes following SIPC. Participants included 40 lower limb lymphedema patients who underwent High Pressure SIPC for a period of 48 hrs. Pre and Post SIPC serum lipids changes were evaluated. Though, there was some increase in the serum level of cholesterol and triglyceride, none of the patients had the values above the normal range. We concluded that, the fluid entering the serum during SIPC, contain large molecules such as lipids, which increases serum lipid levels. However this phenomenon does not have any significant complication for the patients

Variability in mortality following caesarean delivery, appendectomy, and groin hernia repair in low-income and middle-income countries: a systematic review and analysis of published data

Background Surgical interventions occur at lower rates in resource-poor settings, and complication and death rates following surgery are probably substantial but have not been well quantifi ed. A deeper understanding of outcomes is a crucial step to ensure that high quality accompanies increased global access to surgical care. We aimed to assess surgical mortality following three common surgical procedures—caesarean delivery, appendectomy, and groin (inguinal and femoral) hernia repair—to quantify the potential risks of expanding access without simultaneously addressing issues of quality and safety. Methods We collected demographic, health, and economic data for 113 countries classifi ed as low income or lower-middle income by the World Bank in 2005. We did a systematic review of Ovid, MEDLINE, PubMed, and Scopus from Jan 1, 2000, to Jan 15, 2015, to identify studies in these countries reporting all-cause mortality following the three commonly undertaken operations. Reports from governmental and other agencies were also identifi ed and included. We modelled surgical mortality rates for countries without reported data using a two-step multiple imputation method. We fi rst used a fully conditional specifi cation (FCS) multiple imputation method to establish complete datasets for all missing variables that we considered potentially predictive of surgical mortality. We then used regression-based predictive mean matching imputation methods, specifi ed within the multiple imputation FCS method, for selected predictors for each operation using the completed dataset to predict mortality rates along with confi dence intervals for countries without reported mortality data. To account for variability in data availability, we aggregated results by subregion and estimated surgical mortality rates. Findings From an initial 1302 articles and reports identifi ed, 247 full-text articles met our inclusion criteria, and 124 provided data for surgical mortality for at least one of the three selected operations. We identifi ed 42 countries with mortality data for at least one of the three procedures. Median reported mortality was 7·9 per 1000 operations for caesarean delivery (IQR 2·8–19·9), 2·2 per 1000 operations for appendectomy (0·0–17·2), and 4·9 per 1000 operations for groin hernia (0·0–11·7). Perioperative mortality estimates by subregion ranged from 2·8 (South Asia) to 50·2 (East Asia) per 1000 caesarean deliveries, 2·4 (South Asia) to 54·0 (Central sub-Saharan Africa) per 1000 appendectomies, and 0·3 (Andean Latin America) to 25·5 (Southern sub-Saharan Africa) per 1000 hernia repairs. Interpretation All-cause postoperative mortality rates are exceedingly variable within resource-constrained environments. Eff orts to expand surgical access and provision of services must include a strong commitment to improve the safety and quality of care

Global, regional, and national burden of colorectal cancer and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Funding: F Carvalho and E Fernandes acknowledge support from Fundação para a Ciência e a Tecnologia, I.P. (FCT), in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of the Research Unit on Applied Molecular Biosciences UCIBIO and the project LA/P/0140/2020 of the Associate Laboratory Institute for Health and Bioeconomy i4HB; FCT/MCTES through the project UIDB/50006/2020. J Conde acknowledges the European Research Council Starting Grant (ERC-StG-2019-848325). V M Costa acknowledges the grant SFRH/BHD/110001/2015, received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006.proofepub_ahead_of_prin

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Wintering in the Beginning of Cold Season: Ecofeminist Deconstruction of Nature in West and East in Farrokhzad’s “Let us Believe in the Oncoming of Cold Season”

Ecofeminists seek the reversal of the oppressing binary oppositions of nature/culture, woman/man as to reach a balanced ecosystem in which women are not considered inferior since they are associated with nature .Therefore, ecofeminism could be regarded as a suitable framework for the discussion of the literary works and their treatment of woman/nature theme. The present article would be an attempt to demonstrate the way  Farrokhzad’s “Let us Believe in the Oncoming of Cold Season” and Plath’s “Wintering”, concern such association and deconstruct the binary oppositions in a way that similarly both women personas are ultimately able to take the role of female artist. Both women transgress the winter and hope for the spring to come, while the winter they pass through differs since it originates from different social backgrounds. As such, new historicism would be applied to discover this difference, since the study is a comparative one and yields to the investigation of different societies in which the poems were composed. Farrokhzad lives in an era on the verge of modernism, that’s why she is still preoccupied with the traditions of the past, though she would finally depict the woman persona as having stepped beyond these limitations. Plath’s concerns, on the other hand, rise from a mind entangled with the impacts of modernity and the hollow men. Both are able to pass the winter, though, as female creators who await the reproductive spring blossoms to flourish.

Torn Between Two Worlds: Hybridity and In-between Identity Recognition in Goli Taraqqi’s Two Worlds

As one of the contemporary Iranian women writers living in the U.S, Goli Taraqqi’s fiction is mostly concerned with pains and difficulties of migrant Iranian women in other countries. Bearing a biographical resemblance, her sequence collection to Scattered Memories, entitled Two Worlds retells interrelated short stories of a woman writer narrator, entangled in an asylum in Paris, who digs into her past, writes stories about it, and is able to regain her sanity in the end, as she gets ready to enter the brave new world. The process of identity recognition is to be approached with an eye on Homi K, Bhabha’s assertions about ‘hybridity’ and ‘in-between’ as explained in his 1994 Location and Culture, to see to what degree the newly gained identity, which is resembled to a resurrection, is in fact a hybrid one. 

Postmodernism and Language in Sam Shepard's True West and Tooth of Crime

Sam Shepard has gained a reputation as one of America's foremost living playwrights. In over forty plays, Shepard has broken down traditional notions of dramaturgy in combining both modernist notions of the absurd and familiar icons from the American cultural landscape with an energy tinged by anarchy and violence. Moreover, Shepard has been considered by many critics as a postmodern dramatist. Hassan (1987) piles up a lengthy list of artists from various disciplines whose names epitomize postmodernism for him. The playwrights are: Samuel Beckett, Eugene Ionesco, Harold Pinter and only Sam Shepard and August Wilson from America. One characteristic of postmodern literature in general, is a focus on the instability of meaning and the inadequacy of language to completely and accurately represent truth, along with an irony and playfulness in the treatment of linguistic constructs. In other words, there is a questioning of language as a medium of perception and communication. Language can name the pain but it can’t be the pain; language cannot reach the actual individual feeling. Language is not strong enough to convey the intense emotion.  In postmodern poetics, there is a paradigmatic shift from the idea that language is transparent to the disclosure of its physicality, its intimacy, its obdurate persistence, and its paradoxical fragility. Thus, language is an insufficient means for transforming the ideas that exist in one's mind. The aim of the present article would be to present the ways in which the dramatic language of Sam Shepard, as a postmodern drama, demonstrates inadequacy of language in communication. In order to reach this goal, however, a number of his early dramas will be brought under scrutiny with regard to their language and style from the postmodern point of view.

Ruptured Giant Hepatic Hemangioma: Report of A Case

"nHemangiomas are the most common benign liver masses with a frequency of 0.4-7.3% at autopsy. They are usually discovered incidentally and a few require surgery. Spontaneous or traumatic ruptures are among indications of surgery for hemangiomas. We report a case of giant hepatic hemangioma presenting as hemoperitoneum following use of the slimming belt that underwent an emergent laparotomy. Abdominal exploration revealed that both right and left lobes of the liver were involved with giant hemangiomas. The liver was compressed by tightly packing laparotomy pads. After the operation, the patient was admitted to the surgical intensive care unit. Two days later, a second surgery was performed to remove the laparotomy pads. On the 6th day, the patient was discharged. One month later, to shrink the tumor, percutaneous transarterial embolization of the hepatic artery was performed

Consequences of inadvertent intravitreal Mitomycin C injection

Abstract Background Mitomycin C (MMC) as an alkylating agent is miscellaneous an antineoplastic, antibiotic and ophthalmic agent. Here we aim to report a case of inadvertent intravitreal MMC injection instead of Avastin in case of diabetic macular edema. Case presentation A 53 years old woman was planned to receive intravitreal Avastin injection, but accidentally, 0.05 ml of MMC 0.2% was injected. Best corrected visual acuity (BCVA) was 20/160 before injection. After 2 days, patient was referred to a tertiary referral eye center. BCVA was hand motion at presentation. Intraocular pressure was 4 mmHg. In slit lamp exams, conjunctival injection, corneal edema, Descemet fold, anterior chamber and anterior vitreous cells were presented. Pars plana vitrectomy with peripheral vitreous shaving and silicone oil tamponade was performed. Electroretinography showed undetectable responses. Ultrasound biomicroscopy showed ciliary body shortening and detachment. Optical coherent tomography showed diffuse retinal edema the day after surgery, subretinal fluid pockets in 2 weeks, and atrophy with undetectable and intertwined layers 2 months later. Gradually, like the retina, iris became atrophic and pigments were dispersed diffusely over the lens and endothelium. Conclusion MMC is showed to be severely toxic to intraocular tissues. In our case, iris and ciliary body became atrophic. Ciliary body detachment induced hypotony. Moreover, MMC induces retinal necrosis and atrophy. Visual outcome is profoundly poor