Doing gender and development: understanding empowerment and local gender relations

A major dilemma in Gender and Development (GAD) work is why it is that sometimes women may feel better off colluding with gendered structures that ensure their continued subordination rather than seeking approaches that will allow them to break free of this. Kandiyoti (1988 Gender and Society 2 274-90) has identified this apparent collusion as 'patriarchal bargains', which offer women greater advantages than they perceive can be achieved by challenging the prevailing order. Such women are therefore reluctant to engage in empowering activities that may challenge their gendered bargain. This paper explains this dilemma in the context of GAD work undertaken with Bedouin women in Southern Egypt

Phlébolithes révélant des malformations veineuses multiples de la jambe: à propos d'un cas et revue de la littérature

Les auteurs rapportent le cas d'une jeune patiente de 27 ans, opérée dans l'enfance pour pied bot varus équin gauche, qui consulte dans notre formation pour syndrome douloureux aigu de la jambe gauche, sans notion de traumatisme. Le bilan radiographique standard a révélé de multiples phlébolithes disséminées dans les parties molles de la jambe, révélant des malformations veineuses profondes, confirmées par angioscanner et IRM. Une biopsie exérèse d'une masse à la face interne du 13 supérieur a confirmé le diagnostic histologique de malformation veineuse avec ablation de la calcification et d'un thrombus.Key words: Phlébolithes, malformation veineus

Changes in left atrial deformation in hypertrophic cardiomyopathy: Evaluation by vector velocity imaging.

OBJECTIVES: Hypertrophic cardiomyopathy (HCM) represents a generalized myopathic process affecting both ventricular and atrial myocardium. We assessed the global and regional left atrial (LA) function and its relation to left ventricular (LV) mechanics and clinical status in patients with HCM using Vector Velocity Imaging (VVI). METHODS: VVI of the LA and LV was acquired from apical four- and two-chamber views of 108 HCM patients (age 40 ± 19years, 56.5% men) and 33 healthy subjects, all had normal LV systolic function. The LA subendocardium was traced to obtain atrial volumes, ejection fraction, velocities, and strain (ϵ)/strain rate (SR) measurements. RESULTS: Left atrial reservoir (ϵsys,SRsys) and conduit (early diastolic SRe) function were significantly reduced in HCM compared to controls (P  - 1.8s(- 1) was 81% sensitive and 30% specific, SRa> - 1.5s(- 1) was 73% sensitive and 40% specific. By multivariate analysis global LVϵsys and LV septal thickness are independent predictors for LAϵsys, while end systolic diameter is the only independent predictor for SRsys, P < .001. CONCLUSION: Left atrial reservoir and conduit function as measured by VVI were significantly impaired while contractile function was preserved among HCM patients. Left atrial deformation was greatly influenced by LV mechanics and correlated to severity of phenotype

Effect of preoperative Mg sulfate infusion on serum cardiac troponin (cTn) in moderate preeclamptic undergoing elective cesarean section under spinal anesthesia

AbstractThis study was designed to investigate and compare the effect of preoperative Mg sulfate infusion on serum cardiac troponin (cTn) in moderate preeclampsia undergoing elective cesarean section. A total of fifty parturients having moderate preeclampsia scheduled for elective cesarean section were included. They were randomly allocated into two equal groups 25 each, magnesium group (GMg) received preoperative magnesium sulfate infusion and control group (GC) then both received spinal anesthesia, serum troponin measured preoperative then at 6, 12 and 24h postoperative. Mean arterial pressure and heart rate were also recorded. Baseline serum cardiac troponin was higher above normal and was comparable at the rest of times in both groups. Mean arterial pressure readings were significantly lower in GMg compared to GC at induction of spinal, skin incision and skin closure (P<0.05) and were comparable at the rest of times. Serum cardiac troponin (cTn) levels were comparable in parturients received magnesium sulfate infusion preoperatively with those did not receive magnesium sulfate

Empyema Thoracis

Epmyema thoracis is associated with high mortality ranging between 6% to 24%. The incidence of empyema is increasing in both children and adults; the cause of this surge is unknown. Most cases of empyema complicate community- or hospital-acquired pneumonia but a proportion results from iatrogenic causes or develops without pneumonia. Parapneumonic effusions (PPE) develop in about one half of the patients hospitalized with pneumonia and their presence cause a four-fold increase in mortality. Three stages in the natural course of empyema have long been described: the exudative, fibrinopurulent, and organizing phases. Clinically, PPE are classified as simple PPE, complicated PPE, and frank empyema. Simple PPE are transudates with a pH > 7.20 whereas complicated PPE are exudates with glucose level <2.2 mmol/l and pH < 7.20. Two guidelines statements on the management of PPE in adults have been published by the American College of Chest Physicians (ACCP) and the British Thoracic Society (BTS). Although they differ in their approach on how to manage PPE, they agree on drainage of the pleural space in complicated PPE and frank empyema. They also recommend the use of intrapleural fibrinolysis and surgical intervention in those who do not show improvement, but the level of evidence for the use of intrapleural fibrinolysis is not high highlighting the need for more research in this area. A recently published large randomized trial has shown no survival advantage with the use of intrapleural streptokinase in patients with pleural infection. However, streptokinase enhances drainage of infected pleural fluid and may still be used in patients with large collection of infected pleural fluid causing breathlessness or ventilatory failure. There is emerging evidence that the combination of intrapleural tPA/DNase is significantly superior to tPA or DNase alone, or placebo in improving pleural fluid drainage in patients with pleural space infection. A guideline statement on the management of PPE in children has been published by the BTS. It recommends the use of antibiotics in all patients with PPE in addition to either video-assisted thoracoscopic surgery (VATS) or tube thoracostomy and intrapleural fibrinolysis. Prospective randomized trials have shown that intrapleural fibrinolysis is as effective as VATS for the treatment of childhood empyema and is a more economic treatment and therefore, should be the primary treatment of choice

Intrapleural therapy in management of complicated parapneumonic effusions and empyema

Empyema thoracis causes high mortality, and its incidence is increasing in both children and adults. Parapneumonic effusions (PPEs) develop in about one-half of patients hospitalized with pneumonia, and their presence increases mortality by about four-fold. PPEs can be divided into simple PPEs, complicated PPEs, and frank empyema. Two guideline statements on the management of PPEs in adults have been published by the British Thoracic Society (BTS) and the American College of Chest Physicians; a third guideline statement published by the BTS focused on management of PPEs in children. The two adult guideline statements recommend drainage of the pleural space in complicated PPEs and frank empyema. They also recommend the use of intrapleural fibrinolysis in those who do not show improvement. The pediatric guideline statement recommends adding intrapleural fibrinolysis to those treated by tube thoracostomy if they have loculated pleural space or thick pus. Published guideline statements on the management of complicated PPEs and empyema in adults and children recommend the use of intrapleural fibrinolysis in those who do not show improvement after pleural space drainage. However, published clinical trial reports on the use of intrapleural fibrinolysis for the treatment of pleural space sepsis suffer from major design and methodologic limitations. Nevertheless, published reports have shown that the use of intrapleural fibrinolysis does not reduce mortality in adults with parapneumonic effusions and empyema. However, intrapleural fibrinolysis enhances drainage of infected pleural fluid and may be used in patients with large collections of infected pleural fluid causing breathlessness or respiratory failure, but a proportion of these patients will ultimately need surgery for definite cure. Intrapleural streptokinase and urokinase seem to be equally efficacious in enhancing infected pleural fluid drainage in adults. In most of the published studies in adults, the use of intrapleural fibrinolysis was not associated with serious side effects. There is emerging evidence that the combination of intrapleural tissue plasminogen activator (tPA) and deoxyribonuclease (DNase) is significantly superior to tPA or DNase alone or placebo in improving pleural fluid drainage in patients with pleural space infection. In children, intrapleural fibrinolysis has not been shown to reduce mortality, but has been shown to enhance drainage of the pleural space and was safe. In addition, two prospective, randomized trials have shown that intrapleural fibrinolysis is as effective as video-assisted thoracoscopic surgery for the treatment of childhood empyema and is a more cost-effective treatment and therefore should be the primary treatment of choice

Presence of Circulating Anti-Myosin Antibodies in Endomyocardial Fibrosis

Endomyocardial Fibrosis is a tropical disease in which the heart cannot open properly to receive blood due to a scar that covers its inner layer. It affects mainly children and adolescents, and has a poor prognosis because the cause and mechanisms of scarring are unknown. The conventional treatment is frustrating and does not alter the natural history of the disease. Despite affecting several million people worldwide there has been little investigation on the mechanisms of the disease or drug development to improve its prognosis. In this study we investigate the presence of antibodies against the myocardial cells of African patients with severe and advanced EMF aiming at uncovering new pathways for the disease. Our results reveal that EMF patients have anti-myocardial antibodies in their blood. The reaction of these antibodies with the heart may be one of the mechanisms involved in the genesis of the fibrotic lesions. This knowledge may help in diagnosing the condition and provide alternatives for its management, using drugs that reduce the impact of the circulating antibodies in the cardiac tissue. The significance of these results needs confirmation on studies involving larger number of subjects due to frequent finding of antiheart antibodies in African populations with heart failure of any cause

Pengaruh Tingkat Pendidikan, Masa Kerja dan Motivasi Kerja terhadap Kinerja Karyawan

Tujuan penelitian ini adalah untuk mengetahui pengaruh tingkat pendidikan terhadap kinerja karyawan pada Bank Ekonomi Raharja, mengetahui pengaruh masa kerja terhadap kinerja karyawan pada Bank Ekonomi Raharja, mengetahui pengaruh motivasi kerja terhadap kinerja karyawan pada Bank Ekonomi Raharja, dan mengetahui pengaruh tingkat pendidikan, masa kerja dan motivasi kerja terhadap kinerja karyawan pada PT. Bank Ekonomi Raharja.Teknik pengumpulan data yang digunakan adalah teknik komunikasi tidak langsung dan teknik studi dokumenter. Alat pengumpul data adalah kuesioner. Teknik analisis yang digunakan adalah teknik deskriptif kuantitatif dan teknik analisis regresi berganda. Hasil penelitian menunjukkan bahwa (1) terdapat pengaruh positif dan signifika tingkat pendidikan terhadap kinerja sebesar Pontianak sebesar 34.6% dengan signifikansi 0.00 ≤ 0,05. (2) Masa kerja berpengaruh positif terhadap kinerja sebesar 44.4% dengan signifikansi 0.00 ≤ 0,05. (3) Motivasi kerja berpengaruh positif terhadap kinerja sebesar 44.7% dengan signifikansi 0.00 ≤ 0,05. (4) Tingkat pendidikan, masa kerja dan motivasi kerja berpengaruh positif terhadap kinerja sebesar 72.9% dengan signifikansi 0.00 ≤ 0,05. Kata kunci : pendidikan, masa kerja, motivasi, kinerja Abstrack: The purpose of this study was to determine the effect of education on the performance of employees at Bank Ekonomi Raharja, knowing the effect of tenure on the performance of employees at Bank Ekonomi Raharja, knowing the effect of work motivation on employee performance in Bank Ekonomi Raharja, and determine the effect of education, tenure and work motivation on employee performance in PT. Bank Ekonomi Raharja. The data collection technique used is the technique of indirect communication and techniques of documentary studies. Data collection tool is a questionnaire. The analysis technique used is quantitative descriptive technique and multiple regression analysis techniques. The results showed that (1) there is positive and signifika level of education on the performance of Pontianak amounted to 34.6% at the 0.05 significance ≤ 0:00. (2) The tenure of the positive effect on the performance of 44.4% with a significance of 0.05 ≤ 0:00. (3) Motivation positive effect on the performance of 44.7% with a significance of 0.05 ≤ 0:00. (4) The level of education, years of service and work motivation positive effect on the performance of 72.9% with a significance of 0.05 ≤ 0:00