Methotrexate-induced toxidermia and pancytopenia in a patient with ectopic pregnancy: a case report

Background Methotrexate is an anticancer drug from the antimetabolite class. It is also used in gynecology and obstetrics and is the molecule of choice for the medical treatment of ectopic pregnancies. We report a case of toxidermia associated with severe pancytopenia induced by methotrexate for ectopic pregnancy. Case presentation A 30-year-old Malagasy (African) woman was admitted to the Emergency and Intensive Care Department for probable toxidermia following injection of 75 mg of methotrexate for an ectopic pregnancy. She had developed generalized erythema, which started 48 hours after the injection. The secondary onset of phlyctenular maculopapular skin lesions, generalized purpura, and erosions of the oral mucosa in a context of febrile jaundice prompted her hospitalization. On admission, the patient presented with febrile neutropenia, pancytopenia, renal failure, and hepatic cytolysis. She received transfusions of fresh whole blood, erythromycin, and amphotericin B. The course was fatal within 2 days of hospitalization. The patient died of multiple organ failure. Conclusions Our case is mainly distinguished by the lack of use of granulocyte growth factors and folinic acid. In the event of severe reactions to methotrexate, the management should be multidisciplinary and as much as possible within an intensive care unit.

The Case of 'Suspected Adulteress': Reading Numbers 5:11-31 from the Perspective of a Married African Woman

As studies have shown, marital sexual infidelity is attested in every society of the world.1 In African societies, adultery is not only strictly prohibited on social, moral and religious grounds but is also regarded, in some African cultures, as an abomination. This is rooted, among others, in the sacredness of marriage in Africa and the inseparable link between the use of human sexuality in marriage and the generation of new life for the perpetuation of the family-lineage and the community. In theory, the ban on adultery applies equally to all married men and women but in praxis, there are some hints of gender injustice against women in observing the ban on adultery. The patriarchal context in some African cultures provides the background for such gender inequality and sexual injustice against women. By using bosadi biblical hermeneutics to interpret the Sotah ritual (Num 5:11-31) - a ritual that is gender-specific, meant only for women accused of adultery - this article condemns the sexual injustice endured by married women in some (African) patriarchal societies and advocates the reading of Num 5:11-31 and other biblical texts containing 'oppressive elements' in a way that is liberating and empowering to the oppressed and marginalised.

Women of power- spirit mask series: 12 faces of a north american african woman

I am writing about my first series of painted photographs, The Women of Power-Spirit Mask series. There are twelve works in this series, and all works are oil pastel and acrylic paint on my photographs, which are printed on archival inkjet paper.

Mitral valve-in-valve implantation during pregnancy

A 32-year-old, 11-week pregnant African woman with known rheumatic heart disease presented to the emergency department with worsening shortness of breath on exertion. She had undergone a double bioprosthetic valve replacement and left atrial appendage resection 8 years prior for severe mitral stenosis, moderate mitral regurgitation and moderate aortic regurgitation. A transo-oesophageal echocardiography at this presentation confirmed a morphologically calcified and stenosed mitral bioprosthesis, with moderate stenosis of her aortic bioprosthesis. Her multidisciplinary team, including cardiologists, cardiothoracic surgeons and obstetricians, came to a consensus decision to proceed with a transseptal transcatheter valve implantation within the mitral valve prosthesis (valve-in-valve implantation). Transthoracic echocardiography performed 2 months post procedure showed satisfactory mitral valve gradients and at 30 weeks’ gestation, she successfully delivered her fifth child. 2 years later, the valve in valve complex is still functioning well.

Marginal umbilical cord insertions in a bipartite placenta responsible for placenta abruption: a case report

Hemorrhage is one of the major causes of maternal death. Main causes of APH are placenta previa, placenta abruption and uterine rupture. Rare causes of placenta abruption include marginal and velamentous umbilical cord insertions. We hereby present a case of placenta abruption due to marginal umbilical cord insertions occurring on a bipartite placenta. A 40-year-old nulliparous African woman, 35 weeks pregnant consulted for dark red pervaginal bleeding, which occurred recently. Past history was unremarkable. Her pregnancy was well followed up. A recent ultrasound scan revealed a fundal inserted placenta. Physical examination revealed a fundal height of 37 cm, no uterine activity, normal fetal heart tones and a blood-stained vulva. Our diagnosis was a mild placenta abruption. An obstetrical ultrasound carried out revealed a normal pregnancy and a retroplacental blood clot of 11mm. A safe baby was born through an emergency cesarean section which revealed a normally inserted bipartite placenta with a 10% placenta detachment located on one placenta half and two cords inserted marginally. The postoperative period was uneventful and she was discharged five days after cesarean section. This case report shows that marginal cord insertion, which can lead to placenta abruption, can be also observed on a bipartite placenta.

The “African male literary tradition” and revisionist polemics in Isidore Okpewho’s writing

African literature has been very polemically, but usefully engaged, by feminists and other concerned gender stakeholders in the past three decades on the note that its foundational discursive platform of representation is patriarchal, largely representing the female body as ‘absent’ and ‘other’ in the imaginative landscape of canonical African(ist) expression. While these critical efforts have significantly succeeded in interrogating phallocentrism in African male writing, they have, however, failed to recognize several masculinist indicators in the latter that have purposively undermined the hegemonic/patriarchal frame of maleness. In this article I argue, through a reading of Isidore Okpewho’s first three novels, that certain representations of African male writing preceding those of the contemporary turn portray revisionist attitudes to patriarchy, or any form of hegemonic masculinity. In these, the African woman is made to gain visibility and she becomes active on her own social terms. I thus debunk popular feminist-oriented claims that the canonical African literary male tradition necessarily inscribes the African woman in the stereotypical narrative of being a ‘mother-nation/mother-Africa image’, ‘prostitute’, ‘witch’, or socio-cultural other. I suggest a more careful, distilled, and responsible approach toward the politics of agency and power involving gender and identity (re)formation in the African world, culture, and literature.

Hybridity and the Shape of the New African Woman

Hybridity is argued as an intricate combination of attraction and repulsion that describes the relationship between the colonizers and the colonized. This combination creates a challenge to and disruption of the monolithic power exercised by the colonizers of Africa who (mis)represented the land as a Dark Continent. Such monolithic power underpins the portrayal of the colonizers’ patriarchal tradition within which women characters in creative works by Africans are commonly situated. The inclusion of women as part of the many subjects of power strengthens the discourse on hybridity in African literature. To question power is to see men and women both apart and together as ambivalence that defines the idea of hybridity in the African literary tradition. In this paper, the employment of deconstruction in the analysis of women characters in five selected stories by African writers reveals a new consciousness in African literature using the Dark Continent metaphor as a mirror of the female aesthetics. In this sense, the use of women’s bodies in the short stories does not only point to the issue of gender oppression but also to a power that is disrupting and slowly dismantling the long-entrenched patriarchal stance forcing the male characters to question their current worldview and position. Overall, this paper has established that contemporary African literature on women recognizes the hybridized identity and shape of the new woman, consequently proving that the so-called Dark Continent is nothing but a myth.

Giving Voice to a Portrait: The Intersection of Gender, Race, and Law in Belle

The 2013 feature film Belle presents an account of the life of Dido Elizabeth Belle (1761-1804). Belle was the daughter of Sir John Lindsay, a British naval officer, and Maria Belle, an enslaved African woman, and she was raised in the home of her great uncle Lord Mansfield during his tenure as Chief Justice of England. The record of Belle’s life is thin, and her story might have been altogether forgotten had it not been for a 1779 portrait of her in which she was painted alongside her white cousin Lady Elizabeth Murray. The film was inspired by the portrait. The paucity of available facts left the filmmakers much latitude for fictionalizing, but even so the film makes significant departures from the historical record, for example, in its representations of Belle’s eventual husband, and in its insertion of Belle into the unfolding of the Zong case, a case involving slavery that was decided by Lord Mansfield in 1783. In this paper, I consider the effectiveness and the ethical implications of the filmmakers’ use of law to give voice to this historical figure.