Iranian Woman Research Articles

Allergic shiners in a patient with cough-variant asthma: a case report

BackgroundChronic cough, with a duration of coughing of more than 8 weeks in adults, affects 5–10% of the general population. One of the most common causes of chronic cough is cough-variant asthma, which accounts for approximately one-third of cases. This phenotype of asthma is characterized by extreme sensitivity of the neuronal pathways mediating cough to environmental irritants, which results in an urge to cough. This case is an example of cough-variant asthma presenting with allergic shiners due to her severe cough.Case presentationA 38-year-old Iranian woman, who was well before the start of the coronavirus disease 2019 pandemic, presented with a nonproductive hacking cough that had begun after excessive use of antiseptic solutions. The only positive finding on physical examination was a reddish-purple rash on and around the eyelids mimicking a heliotrope rash, which had probably evolved due to the severity of the cough. The results of the pulmonary function test were within normal limits. Methacholine challenge test and chest x-ray were both normal. Chest high-resolution computed tomography revealed hyperinflation and tree-in-bud opacities. All other laboratory tests were normal. Because of the reversibility in her pulmonary function test, despite normal baseline parameters, asthma treatment was initiated, resulting in disappearance of the cough and the eye discoloration, being indicative of the correct diagnosis and proper treatment.ConclusionPatients with cough-variant asthma may often have no other classic symptoms of asthma other than cough.

The Power of Unwanted Presence

Presenting human bodies in public space against the will of the state is a well-known strategy to protest. Indeed the presence of the body as a materiality bears meaning. Furthermore if the body is doing an act for the eyes of the spectator it has an explanation therefore a performance happens. As Judith Butler claims the body is a manner of doing, dramatizing and reproducing a historical situation. Meanwhile it is subjectivated by culture, power structures and its social environment. In a public protest performing bodies(body) get connected to each other and form a resistant performativity. This enables the subject to vitalize possibilities for social transformation and objection with dominating power structures. However there are groups of humans who are not eligible to appear as subjects. When the subject is defined by elimination then performance is a kind of resistance that reclaims agency and power. Since the Islāmization of Iran revolution(1979), Iranian women have managed to protest in four particular mass gatherings to resist socio-political oppression related to their gender and compulsory hijab. The very first was A five-day protest march starting on March 8, 1979 to prevent legalization of compulsory hijab. The second one was a peaceful gathering of women's rights defenders in June 2006 in Tehran’s central business district that ended with violent objection from the state and the third is a solo performance of an Iranian woman known as the Girl of Enghelab Street on 27 December 2017. Aesthetics of these Performances vary according to different strategic and artistic choices. This Article tries to define and explain the surrounding environment and socio-political basis which lead to formation of these different constructions. It studies the performative strategies of these public gatherings of powerful subjects with a common object: social equality through a nonviolence subversive performance. It is essential to mention that by the time of this article's publication, the very last nationwide uprising against compulsory Hijab with the Manifest “Woman, Life, Freedom” is ongoing in Iran. It is ignited by the brutal murder of Jina 'Mahsa' Amini while in the custody of the moral police on 16th September 2022. This article has been submitted by May 2021, hence these developments have not been considered.

Treatment of critical aluminum phosphide (rice tablet) poisoning with high-dose insulin: a case report

BackgroundAluminum phosphide (rice tablet) is a highly efficient agent for preserving grains against rodents and insects. It accounts for a large number of poisoning cases. Aluminum phosphide poisoning has a high mortality rate of about 90%, and to date, no antidote is available. It releases phosphine gas after exposure to moisture, and this reaction is catalyzed by the acidity of the stomach. Phosphine is then absorbed throughout the respiratory or gastrointestinal tracts and causes toxicity through inhibition of cytochrome c oxidase and formation of highly reactive free radicals. Treatment of patients with aluminum phosphide poisoning is supportive, including mechanical ventilation and vasopressors. The usage of infusion of glucose-insulin-potassium in rice tablet poisoning has been suggested, after its positive beneficial cardiac inotropic effects in patients with beta-blocker and calcium channel blocker poisoning.Case presentationWe report the case of a 30-year-old Iranian woman with critical aluminum phosphide poisoning, presented with hypotension and other signs of shock and severe metabolic acidosis, successfully treated with high-dose regular insulin and hypertonic dextrose and discharged from hospital in good condition. In contrast to our previous experiences, in which nearly all patients with critical aluminum phosphide poisoning died, this patient was saved with glucose-insulin-potassium.ConclusionAluminum phosphide poisoning has a high mortality rate, and to date, no antidote is available. Administration of high-dose intravenous regular insulin and dextrose is suggested as a potential life-saving treatment for patients with critical aluminum phosphide poisoning.

Uterine torsion as an elusive obstetrical emergency in pregnancy: is there an association between gravid uterus torsion and Ehlers–Danlos syndrome?: a case report

BackgroundTimely diagnosis of uterine torsion can lead to acceptable maternal and fetal outcomes. This article presents the case of a 42-year-old pregnant woman, diagnosed with a rare 270° uterine torsion, in whom proper management led to good maternal outcomes but, unfortunately, severe prematurity and metabolic acidosis led to neonatal death. Moreover, the mother was clinically suspected for Ehlers–Danlos syndrome.Case presentationIn December 2020, a 42-year-old pregnant Iranian woman, Gravid 3 para2 live2, at 30 weeks of gestation presented to the obstetric emergency department of Vali-Asr Hospital (Birjand, Iran) suffering from acute severe generalized abdominal pain, nausea, vomiting, and dizziness while she was hemodynamically unstable. After resuscitation, owing to persistent fetal bradycardia on fetal heart rate monitoring, she underwent an emergency cesarean section. Infra-umbilical midline skin incision was made, and when the abdominal cavity was opened, owing to abnormal appearance of the uterus, we further investigated the abdominopelvic cavity. Surprisingly, the uterus was dextrorotated by 270°. After uterine detorsion through a Kerr incision, a nonvigorous male baby was born with severe metabolic acidosis that led to his death soon after birth. Interestingly, we could find no predisposing factors such as pelvic abnormalities during surgery. Nevertheless, as her postoperative detailed physical examination revealed skin hyperextensibility, joint laxity, pelvic organ prolapse, and trivial exophthalmos, connective tissue disorders, mainly Ehlers–Danlos syndrome, were suspected. Unfortunately, for significant financial, cultural, and religious reasons, the patient refused to undergo further investigations. Additionally, despite severe congested uterus and subsequent uterine atony, timely diagnosis and anatomical correction of the gravid uterus before uterine incision prevented iatrogenic complications. The mother was discharged 2 days later without any postpartum complications.ConclusionAlthough uterine torsion is an extremely rare condition during pregnancy, based on severe associated maternal and perinatal complications, it is important to take this diagnosis into consideration as an differential diagnosis. Moreover, connective tissue disorders seem to be a potential risk factor for uterine torsion, although further studies on this subject are required.

Idiopathic combined retinal vessels occlusion in a pregnant woman: a case report

BackgroundOcular vascular occlusion is an extremely rare event, especially in the young population. This diagnosis is always associated with active systemic diseases in young adults and needs thrombophilia workup. Nevertheless, we present the case of a pregnant woman suffering from idiopathic combined central retinal vein and cilioretinal artery occlusion.Case presentationA 36-year-old pregnant Iranian woman at the 36th week of her second pregnancy complained of subacute unilateral painless decreased vision of her left eye. She had experienced a transient vision loss that lasted several minutes, but attacks gradually became more frequent and finally persistent over a several-day period. Finally combined central retinal vein and cilioretinal artery occlusion was established. Her visual acuity improved to 4/10 in a month without any ocular intervention except for a short duration of prophylactic dose enoxaparin, and the acuity reached 8/10 without any complications in the third month follow-up visit. At 1 year follow-up, the visual acuity had not changed and no macular edema was seen.ConclusionsOcular vascular occlusion is extremely rare among young adults, and even rarer among pregnant women. According to this, any suspected retinal vascular event in this population should raise suspicion for underlying diseases such as hypertension, diabetes, autoimmune diseases, migraine, preeclampsia syndrome, and thrombophilia. However, as seen in this presented case, idiopathic ocular vascular occlusion events can occur also.

Successful management of a patient with ovarian ectopic pregnancy by the end of the first trimester: a case report

BackgroundAmong all ectopic pregnancies, between 0.5% and 3.5% are ovarian ectopic pregnancies, a potentially life-threatening condition when ruptured due to its serious potential for hemorrhaging. A majority of ovarian ectopic pregnancies are diagnosed by the 7th week of pregnancy when the patient becomes symptomatic, and ultrasound can be used to diagnose this condition.Case presentationWe present the case of a 39-year-old Persian woman in the 12th week of gestation who presented with vaginal bleeding and abdominal pain and was diagnosed with ovarian ectopic pregnancy. Her notable laboratory finding was β-human chorionic gonadotropin > 15,000, which indicates definite pregnancy. Transvaginal ultrasound (TVS) revealed no evidence of intrauterine pregnancy, but a well-circumscribed gestational sac in the left ovary. The patient was successfully treated with resection of the gestational sac and partial left salpingo-oophorectomy. Histopathological studies confirmed the diagnosis of ovarian ectopic pregnancy.ConclusionThe case emphasizes the ability of ovarian ectopic pregnancy to develop asymptomatically through the course of pregnancy and points to the necessity for high-quality prenatal care and the importance of determining the fetal site during pregnancy.

Primary retroperitoneal mucinous cystadenoma in a female patient: A case report.

IntroductionPrimary retroperitoneal mucinous cystadenoma is an extremely uncommon tumor occurring mostly in females. The histogenesis of PRMC remains unclear and Open surgery is the most impressive treatment.Case presentationWe present a 20-year-old Iranian woman with history of intermittent abdominal pain. In physical examination, her abdomen had a mildly asymmetrical distention and a round shape mass was palpated in right abdomen also she had a mild tenderness in right abdomen. Radiologic assessment revealed a right retroperitoneal smooth cystic mass (20 × 15 cm) without invasive features. The patient underwent complete surgical excision of the tumor by a laparotomic approach because of its size. The lesion was gently dissected from the contiguous organs and removed completely without spillage of its content. In microscopic investigations, sections showed a unilocular cyst with fibrous wall lined via monolayered bland looking columnar mucinous epithelium and no atypia or stromal invasion was presented. Diagnosis of a PRMC was made. The patient has discharged without any complications in 2 days' postoperative course.DiscussionGenerally, cysts are asymptomatic and are found fortuitously after a routine checkup assessment. Symptoms and signs related to this cyst are mainly because of their huge size and compression effect. Radiological assessments are effective in specifying the lesion preoperatively; although, the final diagnosis always needs histopathological verification.ConclusionWhen the tumor is diagnosed, full resection should be considered because of the infectious or malignant potential of the tumor.

An unusual clinical manifestation of coronavirus disease 2019 in a woman with twin pregnancy: a case report

BackgroundAlthough coronavirus disease 2019 affects mainly the respiratory system, as time passes and our understanding of the disease improves, many nonrespiratory clinical manifestations such as thromboembolic events have been shown to occur with or without respiratory tract involvement.Case presentationWe present the case of a 21-year-old gravid 3, live 1, abortion 1 Iranian woman pregnant with twins in her early first trimester. Her initial chief complaint was headache that gradually increased in intensity. Eventually, cerebral vein thrombosis was confirmed. Although the patient first manifested with neurological involvement, she developed upper respiratory symptoms soon after, and then nasopharyngeal polymerase chain reaction test returned positive.ConclusionAny neurological complaints in pregnant women during the current coronavirus disease 2019 pandemic should raise suspicion for the presence of significant cerebral thrombotic or ischemic events, even if the patient has no complaint of respiratory tract involvement and/or when an initial nasopharyngeal polymerase chain reaction test is negative.

Association of acute hepatitis B and acute myopathy: a case report

BackgroundHepatitis B virus infection is a global public health problem. Although hepatitis B virus primarily affects hepatocytes, it sometimes develops disease manifestations outside the liver, such as myopathy, which is commonly caused by chronic hepatitis B.Case presentationThis case report describes a 57-year-old Iranian woman admitted to the hospital with jaundice, fever, body itching, abdominal pain, progressive muscle weakness, icteric sclera, right upper quadrant pain, and decreased muscle force. Examination on the first day of admission revealed that the patient was negative for hepatitis D antibody, positive for hepatitis B core (IgM) antibody, positive for hepatitis B surface antigen, and negative for hepatitis B e antibody but positive for hepatitis B e antigen. Moreover, she showed high levels of hepatitis B virus DNA viral load, creatine kinase, lactate dehydrogenase, serum glutamic-oxaloacetic transaminase, serum glutamic-pyruvic transaminase, total bilirubin, direct bilirubin, and alkaline phosphatase, and electromyography/nerve conduction velocity showed acute myopathic process.ConclusionsInterestingly, myopathy symptoms improved after improving hepatitis symptoms and decreasing hepatitis B viral load, suggesting a close association between hepatitis B infection and myopathy.

Guillain\u2013Barr\xe9/Miller Fisher overlap syndrome in a patient after coronavirus disease-2019 infection: a case report

BackgroundBeyond the typical respiratory symptoms associated with novel coronavirus, increasing evidence has been reported of the neurological manifestations affecting both the central and peripheral nervous systems.Case presentationWe observed a 30-year-old Persian woman developing acute motor sensory axonal neuropathy, a variant of Guillain–Barré syndrome that overlaps Miller Fisher syndrome, 30 days after confirmed coronavirus disease-2019 infection. Our case highlight the rare occurrence of Guillain–Barré syndrome overlapping with Miller Fisher during the coronavirus disease-2019 pandemic. These neurologic manifestations may occur because of an aberrant immune response to coronavirus disease-2019.ConclusionsThe early recognition of Guillain–Barré syndrome symptoms is critical, given the associated severe motor disabilities that may seriously limit the quality of life of these patients. We may still have much to learn about the co-occurrence of Guillain–Barré syndrome and Miller Fisher to improve the quality of life of these patients requiring an accurate evaluation by neurologists.

Nonsurgical management of a patient with multiple dens invaginatus affecting all maxillary incisors

This paper discussed a patient with dens invaginatus (DI) in all maxillary incisors that was accompanied by supernumerary tooth and also bifid cingulum, lingual pit, and talon cusp on the other teeth. DI is a rare developmental malformation usually seen in the maxillary lateral incisors of permanent dentition. A healthy 22-year-old Iranian woman was referred for the treatment of carious teeth. Following comprehensive clinical and radiographic examination, that was diagnosed DI affecting all maxillary central and lateral incisors. Left maxillary central incisor was Type I and the other incisors were Type II, according to Oehlers classification. Furthermore, she had supernumerary tooth and Class III malocclusion. All teeth responded to sensibility tests, except right maxillary central incisor that was diagnosed pulp necrosis and asymptomatic apical periodontitis. Conventional root canal therapy was done for the right maxillary central incisor using mineral trioxide aggregate and gutta percha and AH26 sealer by thermoplastic method. After 18 months of follow-up, clinical and radiographical examination revealed periapical healing of the right maxillary central incisor and absence of pulp and periapical pathosis in other incisors. The early recognition of DI, correct diagnosis, and appropriate management of this tooth is essential to ensure favorable treatment outcome.

Systemic lupus erythematosus after coronavirus disease-2019 (COVID-19) infection: Case-based review

BackgroundCoronavirus disease-2019 (COVID-19) is a novel infectious disease, which presents with various clinical manifestations. There is growing evidence of an association between COVID-19 infection and autoimmune diseases. The aim of this case report was to demonstrate the association of COVID-19 infection and the development of systemic lupus erythematosus (SLE). Case presentationA 38 year old Iranian woman presented with progressive icterus, pleuritic chest pain, palpitation, dyspnea, photosensitivity and arthralgia 18-days after COVID-19 symptoms proved by a positive polymerized chain reaction (PCR). The chest and abdomen computerized tomography (CT) scan showed pericardial and pleural effusion and enlarged liver and abdominal lymph nodes. Antinuclear antibody (ANA), anti-double stranded deoxyribonucleic acid (anti-ds DNA) antibody and perinuclear anti-neutrophil cytoplasmic antibody (P-ANCA) were positive. She was diagnosed as SLE and was successfully treated with prednisolone 30 mg daily, hydroxychloroquine 200 mg daily and azathioprine 150 mg daily and she remarkably improved. Repeated anti-ds DNA antibody was positive. Due to nausea and abdominal discomfort, azathioprine was discontinued and replaced with mycophenolate mofetil 1500 mg daily. In the article, similar cases were presented; the mean interval between COVID symptoms and SLE presentations was 24.86 days. Pulmonary and renal involvements were the most common presentations of SLE triggered by COVID-19. The most frequently reported autoantibody was ANA ConclusionIt is necessary to be aware of the development of lupus disease in COVID-19 infected patients, because prompt diagnosis and treatment is very important to improve their outcome.

Median 10 years follow-up of patients with covert Cushing\u2019s syndrome: a case series

BackgroundEctopic adrenocorticotropic hormone secretion syndrome occurs in 10% of all patients with adrenocorticotropic-hormone-dependent hypercortisolism. It is usually associated with overt malignancies or with occult and indolent tumors. This study aims to confirm the source of ectopic adrenocorticotropic hormone in four patients with ectopic Cushing’s syndrome over time.Case presentationA 38-year-old Iranian man with Cushing’s syndrome underwent bilateral adrenalectomy since the source of ectopic adrenocorticotropic hormone secretion was not localized and pituitary imaging was normal. A whole-body scan revealed a right-lung tumoral mass with mediastinal lymph node metastasis. The mass was assumed a lung carcinoid tumor with mediastinal adenopathy. Right-lung mid-zone lobectomy and mediastinal lymphadenectomy were done. In a 47-year-old Iranian man with Cushing’s syndrome, whole-body computed tomography scan revealed a pulmonary nodule in the posterior segment of the left lower lobe of the lung. The third case was a 25-year-old Iranian man who presented with symptoms and signs of Cushing’s syndrome. Pituitary magnetic resonance imaging revealed a microadenoma 5 × 9 mm. Whole-body scan showed abnormal focal somatostatin receptors analog avid lesion in the posterior aspect of inferior third of right lung, highly suggestive of ectopic adrenocorticotropic-hormone-producing tumor. The last case was a 43-year-old Iranian woman with Marfan syndrome with a history of mitral and aortic valve replacement and chronic dissection of the aorta, who presented with symptoms and signs of Cushing’s syndrome. She underwent bilateral adrenalectomy 1 year later owing to failure to locate ectopic adrenocorticotropic hormone syndrome. Whole-body scan showed abnormally increased radiotracer uptake in the midline of the skull base and posterior aspect of the middle zone of left hemithorax and bed of left lobe of thyroid.ConclusionThe clinical spectrum of ectopic adrenocorticotropic hormone secretion syndrome is wide, and distinguishing Cushing’s disease from ectopic adrenocorticotropic hormone secretion syndrome is difficult. Initial failure to identify a tumor is common. Pulmonary carcinoid or occult source of ectopic adrenocorticotropic hormone secretion syndrome is usually the cause. In occult cases of ectopic adrenocorticotropic hormone in which the tumor cannot be localized, serial follow-up with serial computed tomography, magnetic resonance imaging, or scintigraphy is recommended for several years until the tumor can be localized and treated.

VP31.24: Preterm Caesarean section in a pregnant woman infected with COVID‐19

Since the outbreak of COVID-19 disease in 2019, many reports have been describing the pregnancy situation among COVID-19 positive patients. We report a pregnant woman in whom early medical management for pneumonia due to COVID-19 and Caesarean section leads to saving the life of both mother and infant. The patient was a 37-year-old Iranian woman, gravida 1, with a singleton pregnancy, at 32 weeks and 6 days of gestation. She was previously healthy without any prior comorbid diagnosis. Her body mass index (BMI) was 30. Because of dyspnea, fever, and a positive COVID-19 RT PCR test, the patient was transferred to our tertiary centre on April 13, 2021. At admission time, O2 saturation was 98% with oxygen mask. She was admitted to intensive care unit due to the extensive involvement of lungs that was seen in chest CT. Remdesivir 100 mg, Dexamethasone 6 mg, Enoxaparin 60 mg were prescribed for her. During the second day of hospitalisation O2 saturation decreased progressively (60-70%) so the mother being intubated and put under mechanical ventilation. Because of repetitive late deceleration in CTG, emergency Caesarean section was done. The Apgar score of the neonate was 2/10 and 6/10, so resuscitation protocol was done immediately. She was admitted to the neonatal intensive treatment unit. The result of the newborn's COVID-19 test was negative. The mother was successfully extubated after 3 days and discharged 7 days after Caesarean section. Presently, the condition evaluation of the mother and her newborn is normal. This case shows that immunological and physiologic changes during pregnancy making them more susceptible to viral infections and timely treatment can be successful. In addition, combination therapy of Remdesivir and Dexamethasone can be a suitable treatment choice for pregnant women infected with COVID-19. In this respect, it is worth mentioning that more studies are required to evaluate the side effects of Remdesivir during pregnancy.

Beyond the Voice of Egypt: Reclaiming Women’s Histories and Female Authorship in Shirin Neshat’s Looking for Oum Kulthum (2017)

By drawing on postcolonial feminist discourse and Hamid Naficy’s (2001) notion of ‘accented’ cinema, in particular his approach of combining the interstitial position of exilic and diasporic filmmakers with concepts of authorship and genre, this paper explores the intersection between biographical film, gendered rewriting of history, and self-narrative as a site of resistance to nationalist and patriarchal ideologies in Shirin Neshat’s Looking for Oum Kulthum (2017). I argue that Neshat’s authorial style and her position as an exilic artist inflect the biographical film in its traditional form, showcasing an innovative perspective on the genre, restructuring it to reveal the constructedness of not only a cinematic process, but also of history and historical figures. Blending the stories of a present-day Iranian woman filmmaker and the professional life of the legendary Egyptian singer Oum Kulthum, Neshat displaces the biopic from its Western-centric roots by explicitly opening it up to a discourse of contemporary gender politics in the Middle East. In doing so, she exposes the social forces that shape the production of the biopic in relation to the notion of female authorship in the context of the transcultural circuits and feminist reclaiming of Oum Kulthum’s international stardom.

Health Policy Challenge for Breast Cancer Prevention: A Case Report

Breast cancer early diagnosis increases treatment chances, and self-examination is one of the commonest screening methods employed by women. The case of a 24-year-old Iranian woman with a history of mild mental retardation and chest pain was reported. A large lump was detected in the breast during visitation to the surgical clinic. The parents stated the lump was noticed due to a shape change in the clothes covering the patient's chest area. Therefore, the patient had mastectomy surgery after a biopsy and a malignant breast lump was confirmed. The registration and identification of people with mental disorder histories or various mental retardation degrees in each region's health centers to periodically assess their breast health tend to reduce the risk of late breast cancer detection in women.

Adrenocortical adenoma with myelolipomatous metaplasia: a potential diagnostic pitfall: a case report and review of the literature

BackgroundAdrenal incidentalomas are often found during investigation for another tumor or unrelated problems. Except for adrenal myelolipoma (second most common primary adrenal incidentaloma following adrenocortical adenomas), adrenal lipomatous tumors are uncommon generally and are often described as case reports in the literature. Since the amount of fat is variable, without the help of advanced imaging techniques, some adrenal lipomatous tumors may be misdiagnosed before pathologic examination. Herein, we report a case of adrenal adenoma with myelolipomatous metaplasia that was excised as a periceliac mass in the setting of recurrent pancreatic cyst.Case reportA 45-year-old Iranian woman with hypertension and end-stage renal disease presented with recurrence of a pancreatic cyst (previous pathologic report was mucinous cyst adenoma). During exploratory laparotomy, the mentioned pancreatic cyst was tightly attached to the stomach and jejunum. There was also a periceliac round rubbery lesion (firstly diagnosed by endoscopic ultrasound) that was excised for ruling out malignancy. Histologic examination of the periceliac mass was found to be adrenocortical adenoma with foci of myelolipomatous metaplasia. The pancreatic cyst histology was just a pseudocyst.ConclusionOur case highlights the significance of complete evaluation of incidental findings before surgical intervention, even in the setting of another primary tumor. Myelolipoma and myelolipomatous change (metaplasia) are two different entities. Although very similar as to pathogenesis, there are still some differences.

What women want: Fashion, morality and gendered subjectivities in the Highlands of Papua New Guinea

This article brings Papua New Guinean women’s perspectives on fashion, gender and morality into conversation with questions of colonial histories and global consumerism. The article shows that adherence to social norms is policed by women in the public sphere and that one person’s choices are enmeshed in ideas of responsibility and obligation to others. Increasingly, younger generations of women believe it is an individual woman’s right to wear what she wants in Papua New Guinea (PNG). Yet young women confront their peers in much the same way older women do. What women wear in PNG is embroiled in ideas of collective morality; plays out at intersections of class, age, race and gender; and demonstrates tensions between ideas of autonomy and collectivity. On whose terms do contemporary Papua New Guinean women get to decide how to dress: their own, or in accordance with community norms and standards? What are the contemporary and historical contexts of whiteness and colonial power that have influenced these norms and standards? This article brings together the experiences and perspective of a young professional Papua New Guinean woman, and her relatives, in dialogue with a young English–Iranian woman anthropologist.

Efficacy of low-dose methimazole in control of multiple relapses of Graves\u2019 hyperthyroidism: a case report

IntroductionMethimazole (MMI) is the treatment of choice for patients with Graves’ disease. The major drawback of this treatment is the relapse of hyperthyroidism in half of the patients after discontinuation of the recommended conventional 12–18 months of MMI treatment. TSH receptor antibody (TRAb) concentration is recognized as the strongest predictor of hyperthyroidism relapse. In this case report, efficacy of low-dose MMI to control hyperthyroidism even after multiple recurrences in the setting of normal TRAb concentrations is shown.Case presentationAn 80-year-old Iranian woman with Graves’ disease was treated with MMI for 31 years. While receiving treatment, she always had a normal serum TRAb concentration; however, three times during the 31 years she decided to stop MMI therapy, and each time the disease recurred 16–21 months after MMI withdrawal. It is noteworthy that she maintained euthyroidism with the low-dose 1.25–2.5 mg MMI daily without any adverse events during three decades of treatment.ConclusionsNormal serum TRAb is not a sufficiently strong marker to predict relapse of Graves’ hyperthyroidism. Long-term therapy with low-dose MMI is an effective and safe treatment to sustain euthyroidism.

Severe acute respiratory syndrome coronavirus-2- or pregnancy-related cardiomyopathy, a differential to be considered in the current\xa0pandemic: a case report

BackgroundThere are limited data on cardiovascular complications of coronavirus disease 2019 in pregnancy, and there are only a few case reports on coronavirus disease 2019 related cardiomyopathy in pregnancy. Differentiation between postpartum cardiomyopathy and coronavirus disease 2019 related cardiomyopathy in pregnant women who develop severe acute respiratory syndrome coronavirus-2 infection during peripartum could be challenging. Here, we present a case of possible coronavirus disease 2019 related cardiomyopathy in a pregnant patient, followed by a discussion of potential differential diagnosis.Case presentationIn this case report, we present the case of a young pregnant Iranian woman who developed heart failure with pulmonary edema after cesarean section. She was treated because of low left ventricular ejection fraction and impression of postpartum cardiomyopathy, and her severe dyspnea improved by intravenous furosemide. On day 3, she exhibited no orthopnea or leg edema, but she was complaining of severe and dry cough. Further evaluation showed severe acute respiratory syndrome coronavirus-2 infection.ConclusionsThe possibility of severe acute respiratory syndrome coronavirus-2 infection should be considered in any pregnant woman who develops cardiomyopathy and pulmonary edema.