Torsion of a parasitic leiomyoma: a rare but important differential in women presenting with lower abdominal pain

A 39-year-old multiparous Afro-Caribbean woman attended the emergency department with sudden-onset severe right iliac fossa pain. Her inflammatory markers were mildly elevated. Computerised tomography of the abdomen demonstrated features of fat stranding in the right iliac fossa suspicious of acute appendicitis. The scan also noted uterine leiomyomas. The patient was taken to theatre for an emergency diagnostic laparoscopy where her appendix was found to be macroscopically normal. A necrotic heavily calcified parasitic leiomyoma was seen in the right adnexa, free of the uterus and adherent to the greater omentum on a long torted pedicle. The parasitic leiomyoma was successfully removed piecemeal laparoscopically. Complications of leiomyomas, namely, torsion and necrosis, are important differentials in women presenting with sudden-onset lower abdominal pain. A history of sudden-onset severe lower abdominal pain with a background of known leiomyoma should prompt the clerking surgeon to consider a complication of leiomyoma as part of the differential diagnoses.

From Devi to Diva: Indo-Caribbean Women Rising in Trinidad’s Chutney Soca

This chapter explores the conflicts and complexities of Indo-Caribbean femininity at a moment when the Indo-Caribbean woman is breaking away from embodiments of devi, traditional models of female representation strongly tied to religious patriarchy, to diva, a contemporary persona publicly expressed in the realm of chutney soca, a popular form of Indo-Caribbean music that has absorbed the Carnival aesthetic in Trinidad.

Afro-Caribbean Immigrants in STEM Careers

Afro-Caribbean immigrants have made a significant contribution to the STEM careers in the United States over the last 70 years. Their contributions have been mostly unrecognized, and they have had extraordinary challenges to overcome, as perceptions of people of color in these professions and their ability to competently excel has been constantly under scrutiny. This chapter examines the experiences of an Afro-Caribbean woman who came to the United States as a Mathematics teacher in 2002. Her story describes the racial prejudice she encountered while teaching Mathematics in two North Carolina high schools. It highlights some of the deep-rooted racial biases that exist toward people of color in the STEM professions, not only by non-Africans but also by African Americans themselves. It also reflects on the challenges that changing those perceptions will entail and the link those biases have to slavery and segregation in the United States.

Late Onset Systemic Lupus Erythematosus in an Afro-Caribbean Patient: A Diagnostic Challenge

Systemic Lupus Erythematosus may be missed in the elderly population as the clinical features may resemble more common conditions. Treatment remains a challenge in this group given the co-existing chronic illnesses and drug-related toxicities. Herein, we report a case of a 72-year-old Afro-Caribbean woman diagnosed with systemic lupus erythematosus after having pulmonary and renal manifestations.

Racism and Immigration

Arguably the most important discovery in the recent social epidemiology of schizophrenia is that the illness does not occur at a fixed rate across the globe as researchers used to believe, but at variable rates. One of the best documented cases is among the African Caribbean community in Britain, where the risk for schizophrenia is as high as fifteen times the rate for the local white community. Rates among the African-Caribbean British are much more elevated than rates among African-Caribbeans living in Jamaica. The author argues that there are five features of social experience within the community that may contribute to these increased rates: social inequality, racism, social fragmentation, increasingly fragile cultural identity, and community “expressed emotion.” This chapter describes a British African Caribbean woman living with schizophrenia.

Can Rihanna Have Her Cake and Eat It Too?

Sifting through the layered ways in which the winin’ Afro-Caribbean woman, exemplified here by the pop-diva Rihanna, weaves in and out of vulgarity, this chapter discusses the colonizing gaze, which propagates a culture of continual colonization by entrapping the black dancing body within the negative spaces of primitivism and deviant sexuality. In turn, the very public performance of Rihanna slapping her cake on the Saturday Night Live (SNL) show underscores the various ways in which the Caribbean gyrating “cake” has been captured, consumed, and reinterpreted throughout history by Western science, medicine, law, religion, heteropatriarchy, and slavery. The tension between the need to promote a decolonized discourse on the black dancing female body and the historical shame naturalized onto it triggers a state of schizophrenia, especially for the Afro-Caribbean female spectator who resides in the global North and must partake in multiple cultural codes of blackness.