Reclaiming Impact in the Age of Awareness-raising for Human Rights

In the last decade, the practice of awareness-raising for human rights has appeared as notably common across the board. Nevertheless, widespread awareness-raising has not necessarily always resulted in meaningful and sustainable impact. Accepting that awareness raising is not a panacea, we challenge the global collective fascination with big impact, while considering the power of small strategic impact that invests in education, and building alliances, and has the potential to last and to expand by way of gradual encroachment through contextually-defined grassroots means natural to its course. Empowered through social media, advocates are increasingly enthusiastic about reaching massive audiences by way of campaigns which if effectively designed and executed, travel far and wide. Acknowledging the potential power of awareness-raising, this practice should not be mistaken as an end in and of itself. In fact, if viewed as an end, such campaigns can arguably bear detrimental unintended consequences: While giving an impression of activism they may fail to channel the collective energy of the public into strategic and sustainable action focused on appropriately-scoped and scalable change. In this context, we explore the original aim(s) of awareness-raising as a concept, as well as its limitations and capacities. Moreover, we will revisit the parameters of structural, foundational and sustainable impact. In doing so, we will examine successful strategies for translating awareness-raising into behavioral change and measurable impact in other contexts (e.g., environmental movement, or public health). Finally, we will challenge the notion of global as it stands today, rejecting the notion that the west always seem to have lessons learned on human rights to offer to the Global South. As western societies struggle with backlash and hostility towards progress, there are valuable opportunities to learn from experiences of the Global South on grassroots activism, and the importance of patience in seeking impact

Hormone Receptor Status in Breast Cancer and its Relation to Age and Other Prognostic Factors

Background Increasing evidence shows the importance of young age, estrogen receptor (ER), progesterone receptor (PR) status, and HER-2 expression in patients with breast cancers. Patients and methods We organized an analytic cross-sectional study of 105 women diagnosed with breast cancer who have been operated on between 2008 to 2010. We evaluated age, size, hormone receptor status, HER-2 and P53 expression as possible indicator of lymph node involvement. Results There is a direct correlation between positive progesterone receptor status and being younger than 40 ( P < 0.05). Also, compared with older women, young women had tumors that were more likely to be large in size and have higher stages ( P < 0.05). Furthermore patients with negative progesterone receptor status were more likely to have HER-2 overexpression ( P < 0.05). The differences in propensity to lymph node metastasis between hormone receptor statuses were not statically significant. Conclusions Although negative progesterone receptor tumors were more likely to have HER-2 overexpression, it is possible that higher stage and larger size breast cancer in younger women is related to positive progesterone receptor status

Giant prosthetic reinforcement of the visceral sac : The Stoppa groin hernia repair in 234 patients.

<b>Background: </b>Recurrent and complex bilateral inguinal hernias are associated with a high recurrence rate. Giant prosthetic reinforcement of the visceral sac (GPRVS) is popular in America and Europe, but there are no prospective data from Iran. <b>Patients and Methods: </b>From 20 March 1995 to 20 March 2003, 234 patients (227 men and 7 women) with 420 inguinal hernias (186 bilateral and 48 unilateral) underwent repair using a large polyester mesh based on Stoppa`s preperitoneal technique. Mean age was 60 years (range 25 to 88) and 44.8&#x0025; had one or more comorbid conditions. In 154 instances, the relapsed hernia had already been operated once or twice for recurrence. <b>Results: </b>Mean hospital stay after surgery was 2.2 days (range 1-13 days). The mean operative time was 45 minutes (range 30-75 minutes). General complications were one case of upper gastrointestinal bleeding, one case of ileus and one case of atelectasis. Local complications consisted of three local seroma formations. In no instance was postoperative neuralgia, chronic pain or testicular atrophy, mesh infection or death reported. Follow-up was obtained in all patients. The recurrence rate was 0.71&#x0025; (3 of 420) per inguinal repaired or 0.85&#x0025; (2 of 234) per patient. Factors predicating a high risk for recurrence included large hernia size (>5 cm), failure of one or more previous repairs (65.8&#x0025;, 154 of 234), chronic cough and associated lower abdominal hernias. <b>Conclusion: </b>GPRVS is anatomic, sutureless, tension-free and the absolute weapon to eliminate all type of groin hernias. No other technique produces better results for the repair of recurrent and re-recurrent groin hernias

Granulomatous lobular mastitis ,A case series.

BACKGROUND: Granulomatous lobular mastitis (GLM) is an inflammatory disease of the breast, which can mimic breast cancer in clinical and radiological findings. We conducted the present study in order to determine the diagnostic and other important aspects of this disease. METHODS: In this study, we reviewed the records of 38 patients with granulomatous lobular mastitis in order to describe the clinical, imaging, laboratory, pathologic, and treatment aspects of this disease. RESULTS: All of the patients’ ages were in the range of 22-62 years (mean age: 42 years). All of them had children, history of oral contraceptive pill (OCP) usage, antibiotic therapy and mammoplasty. In physical examination, dimpling, edema, inflammation, ulcer, abscess, and firm mass were detected. Size of masses was in the range of 2 × 2 to 8 × 6 cm and their location, in most cases, was in the superior lateral quadrant or central region. In Ultrasonography, a hypoechoic fibroglandular mass and collection, and in pathologic findings, granulomatous reaction was reported. These patients were treated by antibiotics, corticosteroids, and surgery. CONCLUSIONS: GLM is a chronic inflammatory lesion of the breast which can mimic breast cancer. A history of child bearing, lactation, and OCP drug usage have suspicious roles in the formation of GLM. The most common clinical sign in these patients is a painful mass in the breast. We uncovered that clinical and radiological findings are not specific and sufficient for diagnosis of GLM. Therefore, for better diagnosis of this disease, usage of core, incisional, or excisional biopsy are recommended

Management of high-risk popliteal vascular blunt trauma: clinical experience with 62 cases

Ali Pourzand, Bassir A Fakhri, Ramin Azhough, Mohammad Ali Hassanzadeh, Shahryar Hashemzadeh, Amrollah M BayatDepartment of General Surgery, Tabriz University of Medical Sciences, Tabriz, East Azarbaijan Province, IranPurpose: The purpose of this study is to report the clinical and functional outcomes of patients, treated between 2004 and 2009, with high-risk popliteal vascular injuries due to compound fractures about the knee.Patients and methods: A retrospective analysis was conducted of prospectively collected data from Tabriz Medical Trauma Center. Our aim was to perform surgical revascularization as soon as the arterial injury was recognized. The mechanism of injury was blunt in the entire cohort of patients, and all of them had bone fractures about the knee. The treatment of arterial injury included vein graft interposition in 39 (63%), primary anastomosis in 20 (32.3%), and lateral repair in 3 (4.8%) patients. The patients were divided into 2 study groups: limb salvage group (group 1) and amputation group (group 2). Subgroup analysis consisted of univariate analysis comparing the 2 groups and multivariate analysis examining the factors associated negatively and positively with the primary endpoint, limb salvage.Results: In the entire cohort of patients, 60 patients (97%) were male and 2 were female (3%); the mean age was 34.1 years (16&amp;ndash;49 years). The overall amputation rate in this study was 37.1% (23 amputations). Significant (P &amp;lt; 0.05) independent factors associated negatively with limb salvage were combined tibia and fibula fracture, concomitant artery and vein injury, ligation of venous injury, and lack of backflow after Fogarty catheter thrombectomy, while repair of popliteal artery and vein injury, when present, was associated with improved early limb salvage. For 40 patients, we adopt a liberal attitude toward open 4-compartment fasciotomy through both medially and laterally placed incisions.Conclusion: Expeditious recognition of vascular injury, transport to repair, and repair of associated venous injury when possible are necessary to optimize limb salvage. The importance of a high level of suspicion and low threshold for timely amputation has been emphasized when limb salvage was deemed impossible to prevent life-threatening complication. Delays in surgery, extensive soft tissue defect, compound tibia&amp;ndash;fibula fracture, and other factors are associated with high amputation rate following popliteal artery injury.Keywords: popliteal vascular blunt trauma, knee, fractur

Correlation between Serum level of Troponin I and High Sensetive CRP in Renal transplant Patients

Background and Aim: Accompaniment of high serum levels of CRP to troponin increases the mortality rate in dialysis patients, and both of them are considered to be independent risk factors for uremic cardiomyopathy. In the present study, the relationship between serum troponin I and hs-CRP in renal transplant patients was investigated. Materials and Methods: This .study was conducted on 52 patients undergone kidney transplantation. The patients’ serum troponin I and hs-CRP were measured. Clinical characteristics of them including sex, age, duration of disease, and donor type were obtained by their respective medical record review. Spearman’s correlation coefficient method was applied to specify correlation between serum troponin and hsCRP levels. Results: In the current study, 52 patients (27 males and 25 females) with the mean age of 42.98±13.4 yrs were studied. It was found that Hs-CRP levels statistically differed between recipients who had received kidney from deceased and those from live donors. The formers who had received kidney from deceased donors showed significantly higher hsCRP levels compared to recipients from. live donors, but the difference between serum troponin I in the two groups was not significant. There was no significant correlation between serum troponin I and hs-CRP in the total population (p=0.6, r=-0.04), and also in recipients who had received kidney from live or deceased donors. Conclusion: Regarding the insignificant relationship between serum troponin I and hs-CRP in kidney transplant patients, it seems that inflammation has no role on myocardial injury