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Effect of dexamethasone on reducing pain and gastrointestinal symptoms associated with cesarean section: a systematic review and meta-analysis
Full text linkBackground: Dexamethasone has analgesic and antiemetic actions that have been documented in the literature. Therefore, we performed a systematic review and meta-analysis to investigate its overall effectiveness in reducing a variety of negative outcomes after cesarean section.
Objectives: To investigate the efficacy and safety of dexamethasone for reducing pain associated with cesarean section, nausea, vomiting, pruritus, postoperative need for analgesia, postoperative antiemetic requests and headache.
Methods: We searched PubMed, Cochrane CENTRAL, SCOPUS, and Web of Science for relevant clinical trials. We then performed a systematic review and meta-analysis, including only randomized, placebo-controlled clinical trials. Our main population target was women undergoing elective cesarean delivery. The intervention under consideration was dexamethasone administered both by intravenous (IV) or subcutaneous (SC) over a variety of doses. The comparator was a placebo. Our main outcomes included: (1) perceptions as indicated by pain scores, (2) occurrence of nausea and (3) occurrence of vomiting. Secondary outcomes included: (4) occurrence of pruritus, (5) need for postoperative analgesia, (6) need for postoperative antiemetic drugs and (7) occurrence of headache. We assessed the quality of included studies using the risk of bias tool described in Cochrane\u27s handbook for systematic reviews of interventions.
Results: We found that dexamethasone seemed to significantly reduce scores for pain at rest (p\u3c0.001), as well as occurrence of nausea (p\u3c0.001) and vomiting (p\u3c0.001). The drug also showed significant reduction of negative symptoms in other secondary outcomes, including need for postoperative analgesia (p\u3c0.001) and postoperative antiemetic drugs (p\u3c0.001). However, the drug showed no significant effect in reducing headache and pruritus or in improving pain at movement scores.
Conclusion: Dexamethasone appears to decrease perception of pain at rest and protects against nausea and vomiting. However, it does not seem effective against headaches or pruritus
Quantitative blood loss: a validation study
Full text linkObjective: To determine if quantitative blood loss would correlate to predicted blood loss based on change in blood concentration of hemoglobin.
Conclusion: The correlation between calculated blood using modified Brecher’s formula showed poor overall correlation to quantitative blood loss. There was a higher correlation at blood loss greater than 1500 cc which is where estimated blood loss has been shown to be most poor. Possible reasons for this poor correlation include maternal factors influencing hemoglobin levels, gestational age, error in blood loss calculation, inaccuracy of Brecher’s formula in pregnancy
Islamic Rule and Iranian Women in the Films of Hatef Alimardani
Full text linkThis article reconsiders some Western textual and visual (mis)representations of Muslim women as mentally imprisoned by Islamic rules and patriarchy through analyzing three prominent films by the Iranian screenwriter and director, Hatef Alimardani (b. 1976). It begins by a brief discussion of the portrayals of women in Islamic societies promulgated by Anglo-American media. Then, by examining For Pooneh’s Sake (Beh Khāter-e Pooneh, 2013), The Nameless Alley (Kucheh-ye Binām, 2015), and Ābā Jān (2017), box-office hits offering sociocultural critiques through realistic cinematic depictions of contemporary Iranian society, it demonstrates how Alimardani’s films dismantle stereotypical and essentialist portrayals of Muslim women by Western media and scholarly works, and thus, help us better understand the lived experience of women in Islamic countries
“Writing History, Writing Trauma” : The Rape of Igerna in the Medieval Brut Narratives
No full textIn the Brut narratives of medieval historiography, male heroic success and specifically the birth of Arthur are predicated upon the rape of Igerna. A comparative approach to the Tintagel episode across several of these narratives reveals how the emphasis on romance, magic, and nation-building function to validate sexual assault and elide Igerna’s experience. Ultimately, the repetition entailed in translatio studii, specifically the transfer that takes place within history-writing, reinforces the silencing of the survivor’s voice. This repetition lends trauma to the reading experience or creates the risk that readers become inured to the rape
Political and Social Conflict in Local Deer Management
Full text linkOverpopulation of any species, including white-tailed deer, has the potential to cause damage to ecosystems and social conflict. To solve the problem of overabundant deer and prevent it from recurring, communities must work together to come to a solution. However, deer management is highly contentious and provokes deeply held emotions among many different groups of people. The different underlying conceptual frameworks that motivate the various participants and how these frameworks lead groups of participants to conflict with each other were analyzed in order to understand why deer management in Iowa City is such a controversial issue
Investigating PCB Sources to Indoor Air at Homes in East Chicago, Indiana
Full text linkThis project determined airborne concentrations of persistent, toxic polychlorinated biphenyls (PCBs) inside and outside homes in urban East Chicago, Indiana. Possible sources of PCBs to home air include modern pigments present in house paint and cabinet varnish, adhesives and sealants, and historical Aroclor mixtures of PCBs such as what is found in some old window caulking, insulation, and light ballasts. PCB concentrations in outdoor air of these homes may be impacted by the dredging of the Indiana Harbor and Ship Canal (IHSC). The IHSC is a PCB-contaminated waterway that is currently being dredged by the Army Corps of Engineers. Indoor and outdoor air samples were collected by field staff using polyurethane foam passive air samplers (PUF-PAS) before and after dredging started. We establish the following hypotheses for this study: That Aroclor and non-Aroclor PCBs and their possible sources can be identified inside East Chicago homes, and that the IHSC is a source of PCBs to home air.
Samples collected before dredging started (n=73) and after dredging started (n=62) were analyzed for all 209 PCBs. The 62 samples collected after dredging started are the focus of this thesis. Extraction efficiency, reproducibility, and accuracy were assessed using surrogate standards and replicates of method blanks. Using the cosine theta measure of similarity, prominent potential sources to indoor air were found to be the IHSC (21 samples with cos theta greater than 0.8) and Aroclor 1254 (9 samples with cos theta above 0.8). Two of the 32 samples did not have any close matches to Aroclors or IHSC air, and they were compared against top congeners in other known sources to home air. Some contributing sources from this analysis were cabinet varnish, yellow and green colorants, and adhesive. We expect the results of this study to inform our stakeholders, including our study participants, the East Chicago community, the Army Corps of Engineers, and the EPA, of the effect of this dredging and of common housing construction materials on airborne PCBs
Comparability of IFRS and GAAP
Full text linkIFRS had been adopted by 166 countries, with the U.S. being a notable exception. The U.S. still uses GAAP as its reporting framework. Comparability of financial statements should be an important factor in evaluating the best frameworks. I collected data about operating leases of domestic and international airlines to compare the disclosures between IFRS and GAAP for the two reporting frameworks. The international airlines had more inconsistencies with the reported items, whereas the domestic airlines all reported the same items under GAAP standards, making it easier to compare the companies. My preliminary research of the new leasing standards under both GAAP and IFRS show that GAAP is a better reporting framework for comparability, and the U.S. should not adopt IFRS as it would compromise that comparability
Efficacy and safety of Elagolix in the treatment of endometriosis associated pain: a systematic review and network meta-analysis
Full text linkBackground: Endometriosis commonly presents with dysmenorrhea, non-menstrual pelvic pain, and infertility. Elagolix is an oral, short-acting, gonadotropin-releasing hormone antagonist acting through complete estrogen suppression.
Objective: To evaluate the evidence from published randomized controlled trials (RCTs) about the efficacy and safety of Elagolix in the treatment of endometriosis associated pain.
Search strategy: Electronic databases containing articles published between January 2000 and February 2020 were searched using the MeSH terms (Elagolix OR gonadotropin-releasing hormone antagonist OR GnRH antagonist OR antigonadotropin) AND (endometriosis) AND (pelvic pain).
Selection criteria: All RCTs assessing the efficacy of Elagolix in the treatment of pain associated with endometriosis were considered for this network meta-analysis, where five studies were deemed eligible for this review.
Data collection and analysis: The mean difference (MD) and confidence intervals (95% CI) for continuous outcomes including analgesic use, dysmenorrhea, non-menstrual pelvic pain, and quality of life were calculated.
Main results: Elagolix 250 mg reduced dysmenorrhea significantly, as compared to placebo, (MD = -0.41, 95% CI [-0.7, -0.13]) at 12 weeks, while Elagolix 200 mg reduced dysmenorrhea significantly (MD= -1.2, 95% CI [-1.9, -0.57]) compared to placebo after 24 weeks of treatment.
Conclusions: Elagolix 200 mg seems to be an effective drug with fewer side effects when used to reduce dysmenorrhea and non-menstrual pelvic pain after 24 weeks of treatment in patients with endometriosis
Water Inaccessibility in South Africa: Current Spatial Patterns and Future Impacts of Climate Change
Full text linkGlobally, billions of people face water insecurity, negatively impacting not only health but other facets of their lives. Prior research indicates that water security is not evenly distributed between nor within populations, and inequities are predicated upon many factors, including gender and wealth. One aspect in the complex landscape of water insecurity is accessibility, the focus of this research. We aim to explore water accessibility in South Africa, a nation with a complicated relationship with water, by examining the association of current water access with various sociodemographic characteristics. Further, we look at the potential effects of future climate change on existing water inaccessibility.
Using a nationwide, representative survey, we mapped water inaccessibility hotspots across the country. We used a logistic regression model to study the association between water inaccessibility and household characteristics. Using predictions for precipitation levels under various climate models, we mapped and plotted the relationship between locations of current water inaccessibility and decreases in precipitation in the coming decades.
We found rural location and larger household size to be associated with increased water inaccessibility. Increasing wealth index was associated with decreased water inaccessibility. While hotspots of water inaccessibility were detected, we did not find relationship between these locations of current water inaccessibility and projected precipitation declines.
This research is significant in its potential to influence policy decisions about where to target water accessibility interventions in the present. Although the data did not show future declines in precipitation to be associated with current water inaccessibility, there are likely other factors that are associated with these changes, highlighting the need for more research to influence targeted interventions in the coming decades as the climate crisis continues